PMID- 3504184 TI - Effect of colchicine on iron transport during stages of maturation and enamel pigmentation in rat incisor enamel: an autoradiographic study using 55Fe. PMID- 3504185 TI - A comparative study of disturbed mineralization of rat incisor enamel induced by strontium and fluoride administration. PMID- 3504186 TI - Temperature-related ultrastructural changes in early stage amelogenesis in vascularly perfused rat incisors. PMID- 3504187 TI - [69th Congress of the Association of Anatomists. 24-27 May 1987, Thessalonique (Greece). Abstracts]. PMID- 3504188 TI - [The concept of teaching biocybernetics in a physiology course]. PMID- 3504190 TI - [Abstracts of the 13th working conference of the Commission on Experimental Cardiology. October 1984, Uherske Hradiste]. PMID- 3504189 TI - [A simple method for microinjections into the brain of conscious laboratory rats]. PMID- 3504191 TI - [Clinical overview of the present state of treatment of cardiac insufficiency using vasodilating agents]. PMID- 3504192 TI - [Positive inotropic agents]. PMID- 3504193 TI - [Pharmacologic aspects of therapeutic advances in the treatment of cardiac insufficiency using vasodilating agents]. PMID- 3504194 TI - [Selective, rational, monitored chronic therapy of heart decompensation using vasodilators]. PMID- 3504195 TI - [Prazosin in the treatment of chronic heart failure]. PMID- 3504196 TI - [Pharmacologic aspects of advances in the field of anti-arrhythmics]. PMID- 3504197 TI - [The effect of verapamil on action potentials in the ventricular myocardium in the human embryo]. PMID- 3504199 TI - European Society for Surgical Research, 22nd congress. Aarhus, May 10-13, 1987. Abstracts. PMID- 3504198 TI - [Comparison of the effects of mesocaine (trimecaine) and isoptin (verapamil) on the electrical and mechanical activity of cardiac cells]. PMID- 3504200 TI - A wide-band efficient inductive transdermal power and data link with coupling insensitive gain. PMID- 3504201 TI - Radio-frequency coils in implantable devices: misalignment analysis and design procedure. PMID- 3504202 TI - Scalp current density mapping: value and estimation from potential data. PMID- 3504203 TI - The influence of model parameters on EEG/MEG single dipole source estimation. PMID- 3504204 TI - A low-cost multichannel preamplifier for physiological signals. PMID- 3504205 TI - An incremental phase shifter and frequency modulator for magnetic resonance imaging and spectroscopy. PMID- 3504206 TI - Psoriatic arthritis--a clinico-radiological study. PMID- 3504207 TI - New multidrug regimen with indigenous drugs and dapsone in the treatment of lepromatous leprosy (preliminary report). PMID- 3504208 TI - "Anti-inflammatory property of steroidal and non steroidal creams."--a comparative study. PMID- 3504210 TI - Sexually transmitted diseases. PMID- 3504209 TI - Moustachology. PMID- 3504211 TI - Antiviral chemotherapy. PMID- 3504212 TI - Computer-aided molecular modeling of a D2-agonist dopamine pharmacophore. AB - Using computer-aided molecular modeling techniques to analyze models recently proposed for the receptor binding sites of dopaminergic agonists, we superimposed the chemical structures of various compounds that mimic the pharmacological behavior of dopamine, as well as inactive enantiomers, on a postulated three dimensional frame of reference. We analyzed the vector directionalities of the lone pairs of the nitrogen common to these molecules, and the acidic hydrogen of phenols (in aminoindanes, aminotetralins, apomorphines, p-phenol-piperazines, octahydrobenzo(g)quinolines, octahydrobenzo(f)quinolines, and benzazepines) or of nitrogen (in ergoline-type compounds and related structures). This model, when expressed as distances from that of the reference compound pergolide, correlates with the dopaminergic binding affinity observed in compounds previously reported to act on the dopaniergic system in the central nervous system (CNS). The regression analysis of log KD with respect to the distances of the vectors of the acidic hydrogen support the hypothesis that these compounds bind to the receptor as donors in hydrogen bond formation. PMID- 3504213 TI - Structure-activity relationships for apomorphine congeners. Conformational energies vs. biological activities. AB - A series of apomorphine congeners has been studied with respect to their ability to mimic the structural requirements of the dopamine pharmacophore in the potent and stereoselective dopamine receptor agonist (R)-apomorphine. Conformational energies of the mimicking structures calculated by molecular mechanics (MMP2) correlate well with the observed biological activities. PMID- 3504214 TI - Thermodynamic cycle integration by computer simulation as a tool for obtaining free energy differences in molecular chemistry. AB - A new and promising development in the field of computer simulation of molecular systems is the so-called thermodynamic cycle integration technique, which combines well-known results from statistical thermodynamics with powerful computer simulation methods. The basic formulas, the development and the applications in the areas of drug design, protein engineering and conformational analysis of this elegant technique are discussed. PMID- 3504215 TI - Effect of washing on surface properties of synthetic hydroxyapatite. PMID- 3504216 TI - [Proceedings of the 14th annual meeting of the Japanese Society of Toxicological Sciences. July 23-24, 1987, Kita-Kyushi. Abstracts]. PMID- 3504217 TI - Virulence associated ingestion of Legionella pneumophila by HeLa cells. AB - Invasion of HeLa cell monolayers by Legionella pneumophila was studied. Virulent L. pneumophila strains efficiently entered cultured HeLa cells whereas isogenic avirulent isolates were nearly 1000-fold less efficient at cellular entry. Animal passage of avirulent strains, which restored bacterial virulence, coincided with a return to the virulent parental level of HeLa cell invasion. Diminished HeLa cell invasion by avirulent strains was not a function of reduced bacterial association with the cell monolayer. These data suggest that ingestion of L. pneumophila by non-professional phagocytes is a virulence directed property. PMID- 3504218 TI - Differential production of endogenous pyrogen by human peripheral blood leucocytes following interaction with H3N2 or H1N1 influenza viruses of differing virulence. AB - Fever and other constitutional effects of influenza (headache, myalgia, listlessness, nausea, shivering, anorexia and depression) result from liberation of endogenous pyrogen (EP) from phagocytes. These effects are milder for recent H1N1 influenza virus isolates than for H3N2 strains. Interaction with human peripheral blood leucocytes in vitro showed that H1N1 strains, A/USSR/90/77 and A/Fiji/15899/83, elicited significantly less EP (as assessed by the rabbit pyrogen assay) than two virulent clones, 7a and 64c, of the A/Puerto Rico/8/34 A/England/939/69 (H3N2) reassortant virus system. Similar observations were made with UV-inactivated A/Fiji/15899/69 and clone 64c. These results are in accord with the differential severity of fever produced by these strains in ferrets when intranasally infected or intracardially inoculated with live and inactivated viruses. They show that influenza virus strains differ in capacity to induce EP from phagocytes. Furthermore, the observations with inactivated virus show that certain virion components are pyrogenic and differ in quantity or nature between strains. These results are important in relation to the differential severity of influenza epidemics and the reactogenicity of vaccine strains. PMID- 3504219 TI - Campylobacter diarrhea in an adult mouse model. AB - An adult mouse (18-20 g) model was developed for studying the pathogenesis of Campylobacter isolates. Iron-loaded BALB/c mice given 10(8)-10(9) Campylobacter colony forming units by intraperitoneal injection developed a severe mucoid diarrhea within 4 h. Severe diarrhea, consisting of unformed stools containing blood, mucus, and fecal leukocytes, persisted for 24 h. Diarrheal symptoms in surviving mice resolved gradually; no diarrhea was observed 5 days after inoculation. Mice not pretreated with iron developed no diarrheal symptoms, and no severe diarrhea was produced in mice inoculated orally. A transient (less than 24 h) bacteremia occurred in mice inoculated either orally or intraperitoneally. Liver, spleen, and kidney were positive for Campylobacter for 48 h; intestinal contents were positive for 5-7 days. Mice given greater than or equal to 10(10) colony forming units showed symptoms of endotoxemia (ruffled fur, inactivity, shaking, tearing, and hypothermia) and died without diarrheal symptoms. Mice given nonpathogenic Escherichia coli strain HB101, heat-killed C. jejuni cells (greater than 10(10)), C. jejuni lipopolysaccharide extract, or purified lipopolysaccharide from either Vibrio cholerae 569B or Salmonella typhimurium showed no diarrheal symptoms. PMID- 3504221 TI - Risk management--good patient care. PMID- 3504220 TI - Reovirus serotype 1 binds to the basolateral membrane of intestinal epithelial cells. PMID- 3504222 TI - Corporate transformation of medicine in Minnesota. The view from Eagan: an interview with Minnesota Blue Cross-Blue Shield officials. Seventeenth in a series. Interview by Richard L. Reece. PMID- 3504223 TI - A simple reversible cause of infant upper airway obstruction. PMID- 3504224 TI - Aggressive behavior in acinic cell carcinoma. PMID- 3504225 TI - Chemical disaster drill in the State of Minnesota. PMID- 3504226 TI - Acquired immunodeficiency syndrome. Serological testing for HTLV-III antibody. PMID- 3504227 TI - Doctors journey, ruminations on town and gown. PMID- 3504228 TI - Polarization of the town and gown. PMID- 3504229 TI - Causes of anemia in endurance athletes. PMID- 3504230 TI - MMIE malpractice claim review. Internal medicine. MMIE Risk Management Committee. PMID- 3504231 TI - Pain in Parkinson's disease. AB - We studied the prevalence and character of pain in Parkinson's disease (PD) and its association with motor fluctuations. Of 95 outpatients, 46% experienced pain they attributed to PD. Patients with pain were younger but no more disabled on objective motor scores than patients without pain. Musculoskeletal, dystonic, and joint pains were most frequent. Painful episodes, especially musculoskeletal cramps, usually occurred when parkinsonian disability was maximal. PMID- 3504232 TI - Parkinsonism and acquired hydrocephalus. AB - Left hemiparkinsonism was the first symptom of increased intracranial pressure in a 14-year-old girl. The parkinsonism resolved when the increased intracranial pressure was relieved by a ventriculo-peritoneal shunt. This is the first case of parkinsonism associated with hydrocephalus caused by non-neoplastic aqueductal stenosis. PMID- 3504233 TI - Preservation of the substantia nigra and locus coeruleus in a patient receiving levodopa (2 kg) plus decarboxylase inhibitor over a four-year period. AB - A 72-year-old hypertensive man developed parkinsonism and was treated with Sinemet for 4 years but then died of a bronchial carcinoma. Necropsy revealed cerebrovascular disease and amyloid angiopathy. The substantia nigra and locus coeruleus were normal on light microscopy. PMID- 3504234 TI - Tics in a patient with Parkinson's disease. AB - A patient with Gilles de la Tourette syndrome later developed Parkinson's disease in middle age. This was accompanied by a marked reduction in the frequency of tics but levodopa toxicity exacerbated the tics. The dopamine hypothesis of tic disorders is supported by this observation. PMID- 3504235 TI - Menstrual-related fluctuations in Parkinson's disease. AB - Eleven of 12 premenopausal women with idiopathic Parkinson's disease recognised an increased severity of their symptoms for a few days before and during menstruation. PMID- 3504236 TI - The effect of single and repeated administration of bromocriptine on monoamine metabolism in rat brain and [3H]spiroperidol binding to striatal membranes. AB - Administration of a single high dose of bromocriptine decreased synthesis and release of dopamine and serotonin in several brain regions, most notably in the striatum. Bromocriptine modified the kinetics of [3H]spiroperidol binding to striatal membranes, but these changes were not prominent 2 h after injection when modifications of monoamine metabolism were evaluated. After injection of the same dose of bromocriptine daily for 10 days, the decrease in dopamine synthesis persisted, while other aspects of monoamine metabolism, presumably controlled by dopamine autoreceptors, returned to normal values. This adaptation was not caused by decreased blood levels of bromocriptine, since bromocriptine accumulated in plasma after repeated drug administration. This study provides evidence that different aspects of dopamine cell function, presumably controlled by autoreceptors, show different patterns of adaptation after chronic administration of dopamine agonists. PMID- 3504237 TI - Electrophysiology of the corticomotoneurone pathways in patients with movement disorders. AB - The corticomotoneurone pathways were examined in 21 patients with movement disorders, using the technique of percutaneous electrical stimulation of the motor cortex. Conduction in these pathways was assessed by measuring the latency to onset of electromyographic activity in the muscles of the upper limb after cortical stimulation. In all patients [five with primary (idiopathic) torsion dystonia and two with secondary (symptomatic) hemidystonia, seven with Huntington's disease, four with essential tremor, and three with Parkinson's disease] central motor conduction was normal. This and other evidence suggests that the origin of the disorder of movement in these conditions lies in the delivery of abnormal motor commands to a normal corticomotoneuronal system. PMID- 3504238 TI - Long-term followup computed tomography and magnetic resonance imaging findings in hepatolenticular degeneration: case report and summary of the literature. AB - Pretreatment and long-term followup computed tomography (CT) findings were reported in a patient with successfully treated Wilson's disease. Results of magnetic resonance imaging (MRI) are correlated with followup CT findings, with MRI being more specifically sensitive than CT. The literature of CT and MRI findings in Wilson's disease is reviewed and summarized. PMID- 3504239 TI - Parkinsonism following dystonia in three patients. AB - Three patients who presented initially with dystonia and subsequently developed typical idiopathic parkinsonism were evaluated. One patient presented with a writer's cramp, one with axial dystonia, and one with Meige syndrome. All three displayed amelioration of their dystonia with progression of their parkinsonism over a period of 2 to 15 years. Treatment with levodopa gave some relief of the parkinsonism symptoms in two patients but exacerbated or reactivated the dystonia. It is suggested that both the dystonia and the parkinsonism represent the changing clinical expression of the same disorder at different times in its evolution. PMID- 3504240 TI - The video medium creates new responsibilities and opportunities. PMID- 3504241 TI - Levodopa dose-related fluctuations in presumed olivopontocerebellar atrophy. AB - The parkinsonism that occurs in some patients with olivopontocerebellar atrophy (OPCA) can cause diagnostic confusion with idiopathic Parkinson's disease (IPD). The response to levodopa is usually a distinguishing feature, the OPCAs either failing to benefit or losing efficacy relatively quickly. A fluctuating response to levodopa in those OPCA patients who do benefit has not been emphasized in the literature previously. Reported here are three patients with presumed OPCA, dominated by parkinsonian features, who eventually developed typical fluctuations with morning akinesia, wearing off, and periodic lack of response related to meals. These fluctuations were a major source of disability and an important reason for diagnostic confusion with IPD. The possible mechanisms of these fluctuations are discussed. PMID- 3504242 TI - Analysis of the clinical course of non-Jewish, autosomal dominant torsion dystonia. AB - We have analyzed the clinical course of non-Jewish, autosomal dominant torsion dystonia in 41 patients among 15 families. The median age of onset was 8 years, with a range of 0.8-57 years. The body regions most frequently affected at the onset were the legs and arms. There was a relationship between age of onset and site of onset; at earlier ages the legs were more frequently affected, whereas at later ages, the arms and cranial structures were more frequently affected. Fifty three percent of patients developed generalized dystonia within a median time of 1 year. Two factors strongly associated with the occurrence of generalized dystonia are: early age of onset, and onset in the legs. Our results are similar to those of prior studies of non-Jewish and Jewish patients with torsion dystonia. Whether there are clinical distinctions between the Jewish and non Jewish forms of dystonia, as proposed in the past, must be reinvestigated in patients within the same referral base. PMID- 3504243 TI - Electrophoresis and immunoblot of cerebrospinal fluid proteins in spasmodic torticollis. AB - Protein patterns of cerebrospinal fluid (CSF) from patients with spasmodic torticollis (ST) were investigated to determine whether abnormalities previously reported could be detected and further identified. CSF was collected from 12 patients with ST and 6 normal controls. The CSF proteins were analyzed using sodium dodecyl sulfate (SDS) polyacrylamide gel electrophoresis and silver staining. In 11 of the 12 patients with ST, a CSF protein pattern was observed which differed from that in the controls. The identity of the abnormal proteins was ascertained by blotting and immunostaining with specific antisera to IgG and ceruloplasmin (Cp). CSF from 2 of 12 patients had distinct bands staining for IgG and 7 had abnormal immunostaining for Cp. PMID- 3504244 TI - Individual manifestations of Parkinson's disease after ten or more years of levodopa. AB - Twenty-five consecutive patients with Parkinson's disease, who had been on levodopa for 10 or more years, were studied. Over the 12.9 years of treatment, the average Northwestern Disability Score had increased from 9.6 to 18.9. By this measure, 24 of 25 patients were worse, and one was unchanged. The progression of disability did not involve all pretreatment parkinsonian features equally in any of the patients studied. Instead a distinctive pattern of deterioration was seen: postural reflexes worsened in 24/25, speech in 24/25, and gait in 22/25. In contrast, rigidity was improved or unchanged in 17/25, tremor was improved or unchanged in 17/17, while handwriting was improved or unchanged in 21/22. Finger dexterity which was improved in 5/25, unchanged in 15/25, and worse in 5/25 which seemed to be between these two extremes. These observations demonstrate that some signs of parkinsonism can remain quite responsive to levodopa for more than 10 years while at the same time other manifestations of the disease are no longer as responsive to this form of treatment. PMID- 3504245 TI - Ramsay Hunt syndrome and coeliac disease: a new association? AB - Two patients with the syndrome of Ramsay Hunt (dyssynergia cerebellaris myoclonica, DCM), associated with malabsorption due to adult coeliac disease, are reported. Both presented with progressive cerebellar ataxia, action myoclonus, and epilepsy. One had gastrointestinal symptoms (recurrent diarrhea and weight loss which responded satisfactorily to a gluten-free diet), but the other did not. In both patients, jejunal biopsy revealed subtotal villous atrophy; serum folate and vitamin E level were also reduced. Neither a gluten-free diet nor vitamin supplements improved the neurological picture. However, some symptomatic relief was afforded by treatment with clonazepam, sodium valproate, carbamazepine, and piracetam. It could be argued that the association between these two disorders is coincidental. However, since we have found this combination in 2 of 14 consecutive cases with DCM, a causal relationship seems likely, although the underlying mechanism remains unknown. Patients with the Ramsay Hunt syndrome should be investigated for malabsorption, and also undergo small intestinal biopsy. PMID- 3504246 TI - Do enkephalins in basal ganglia mediate a physiological motor rest mechanism? AB - Thermal injury (30-s immersion in water at 62 degrees C) of one hind limb of rats caused a gradual withdrawal of the limb from use, such that after 1 week 50% of the animals walked on three legs. At 24 h following thermal lesion and at a time when the lesioned paw was still used for walking there was a reduction in met- and leu-enkephalin content in the periaqueductal grey (PAG) and bilateral reduction in leu-enkephalin content of the globus pallidus, but no change in enkephalin levels in caudate-putamen. One week following the lesion, animals exhibiting complete withdrawal of the injured limb, showed bilateral reduction of met- and leu-enkephalin content of PAG. Both met- and leu-enkephalin content in caudate-putamen. In each case the change was more marked in basal ganglia areas contralateral to the lesion. In animals lesioned 1 week previously and which did not use the injured limb, there was no change in the monoamine (or metabolite) content of caudate-putamen or in the spontaneous or potassium-evoked release of 3H-dopamine from strial slices. Thermal injury did not cause any general change in pain sensitivity and the time of change in pain threshold in the injured limb did not parallel the withdrawal of the affected limb from walking. The results suggest that after a thermal limb lesion, delayed changes in basal ganglia enkephalin content may be important in withdrawing the injured limb from the normal pattern of locomotion. Basal ganglia enkephalins may be involved in a physiological rest mechanism, which allows healing of the affected part. PMID- 3504247 TI - Autosomal dominant episodic ataxia: a heterogeneous syndrome. AB - We describe six kindreds with autosomal dominant episodic ataxia, apparently representing three distinct syndromes. Four kindreds were characterized by episodic ataxia and response to acetazolamide, and in three, interictal nystagmus. One kindred was characterized by paroxysmal ataxia and in one member, paroxysmal choreoathetosis. The last kindred had brief attacks of ataxia and interictal neuromyotonia. The age of onset and severity of the disorder varied within each kindred. These kindreds illustrate the heterogeneity of episodic ataxia as well as the variable expressivity within each kindred. PMID- 3504248 TI - Simple and complex movements in a patient with infarction of the right supplementary motor area. AB - The role played by the supplementary motor area (SMA) in the higher-level organization of motor behaviour (motor programming) has been highlighted by the study of cerebral blood flow during voluntary movements in normal humans. We present a detailed physiological investigation from a patient with a right SMA lesion and show that the right SMA plays a role in programming simultaneous and sequential movements in both arms, though the contralateral arm was the more severely impaired. In addition, we obtained evidence to suggest that the precentral motor cortex may be more responsive to peripheral perturbations when the modulating influence of the SMA is absent. In view of the similarity of the physiological findings in this subject to those in patients with Parkinson's disease, we suggest that the defect of motor programming in Parkinson's disease is likely to reflect functional deafferentation of the SMA. PMID- 3504249 TI - Sudden onset of confusion with severe exacerbation of parkinsonism during levodopa therapy. AB - Two patients with Parkinson's disease presented with unprovoked, abrupt onset of hallucinations, confusion and the simultaneous worsening of parkinsonian symptoms. This clinical syndrome appears to be a rare complication of dopaminergic therapy since improvement occurred gradually with reduction of Sinemet dosage. PMID- 3504250 TI - Focal asterixis caused by a small putaminal hemorrhage. AB - Unilateral asterixis and mild pure motor hemiparesis contralateral to a small putaminal hemorrhage were observed in a 74-year-old hypertensive man. The motor deficit proved to be rapidly reversible, but the focal asterixis remained for some time as the only sign of the intracranial hemorrhage. This case suggests that altered striopallidal inhibitory input to the thalamus probably disturbed the circuit subserving the maintenance of postural tone. PMID- 3504251 TI - What is it? Case 1, 1986. PMID- 3504252 TI - What is it? Case 2, 1986. PMID- 3504253 TI - What is it? Case 3, 1986. PMID- 3504254 TI - What is it? Case 4, 1986. PMID- 3504255 TI - What is it? Case 5, 1986. PMID- 3504256 TI - Gait disorder of subcortical arteriosclerotic encephalopathy: Binswanger's disease. AB - The abnormality of gait that may occur in patients with subcortical arteriosclerotic encephalopathy (Binswanger's disease) is described in 12 patients in whom difficulty walking was the presenting symptom. Their gaits had elements of both Parkinsonism and ataxia, which were most marked in 4 patients unable to stand unaided. The difficulty in using their legs to walk was out of proportion to that of other movements of the lower limbs when lying or seated. In contrast, upper limb mobility and facial expression were relatively preserved. Attention is drawn to the similarity of this gait pattern to that of some patients with hydrocephalus, frontal lobe lesions, and "senile" disorders of gait. A possible mechanism for this Parkinsonian-ataxia in these various conditions may be their propensity to damage the afferent and efferent interconnections of the leg areas of the motor and supplementary motor areas of the cerebral cortex with, the cerebellum and basal ganglia. PMID- 3504257 TI - Essential tongue tremor. AB - Twenty patients with tongue tremor associated with essential tremor are reported. Patients were unaware of the tongue tremor, and voice disturbance was a complaint in only one patient. Three patients had an isolated tongue tremor. Hand tremor was present in 16 patients. Dystonia, myoclonus, and tremor of other body parts were present in some patients. Three patients had a mild-to-moderate dysarthria. The frequency of tongue tremor (4-8 Hz) was identical to hand tremor. The intravenous infusion of ethanol suppressed tongue tremor. Therapy with propranolol, primidone, or clonazepam also reduced tongue tremor amplitude. Tongue tremor is a common finding in some essential tremor patients but often there are no symptoms. PMID- 3504258 TI - Increased shortening reaction in Parkinson's disease reflects a difficulty in modulating long loop reflexes. AB - Short and medium latency electromyographic (EMG) responses to stretch of the triceps surae muscle and long latency EMG responses (LL) in the anterior tibial muscle (TA) were evoked by toe-up tilt of a movable platform while standing or sitting, in normal subjects and patients with Parkinson's disease. With the stimulus parameters used (amplitude 4 degrees, velocity 50 degrees/s), LL in TA were absent in normals while sitting, but were present in 11 of the 12 patients with Parkinson's disease. In patients, LL latencies were identical in both positions. The results indicate that patients with Parkinson's disease have difficulty modulating long latency responses according to functional demands. Long latency responses in TA in the sitting position may correspond to the shortening reaction observed by others when much stronger stimuli were used. PMID- 3504259 TI - Anticholinergic-induced chorea in the treatment of focal dystonia. AB - The occurrence of chorea, induced by trihexyphenidyl (benzhexol hydrochloride) during the treatment of five adult patients who had focal or segmental dystonia, is described. The dose at which chorea appeared ranged from 15 to 60 mg/day (mean 31.7 mg/day). All but one patient had developed common adverse effects of this drug (dry mouth, blurred vision, and confusion) at lower doses (mean 21.8 mg per day). There was an inverse relationship between the age of the patient and the dose of trihexyphenidyl at which chorea developed. PMID- 3504260 TI - Neuroleptic malignant-like syndrome induced by metoclopramide. AB - A prompt recognition of neuroleptic malignant-like syndrome is essential because of its high morbidity and mortality. A similar condition i described associated with metoclopramide, an agent with dopamine receptor-blocking properties. An increased index of suspicion for early diagnosis of this condition and adjustment of metoclopramide dosing in patients with renal failure are emphasized. PMID- 3504261 TI - Generalized chorea due to basal ganglia lacunar infarcts. AB - Although hemichorea is often ascribed to a vascular lesion, generalized chorea of adult onset is often thought to be due to degenerative diseases. We describe a 74 year-old woman with generalized chorea that was diagnosed at autopsy as due to multiple lacunar infarcts in the basal ganglia. Generalized chorea in adults may be caused by vascular disease of the basal ganglia. PMID- 3504262 TI - Involuntary grasping and groping responses to space-related visual stimuli. AB - Involuntary groping-grasping responses to visual stimuli were studied in relation to the location of the stimuli in the space surrounding the patient. The following space-related patterns of stimulus-response were observed in four patients: (a) responses were evoked only by visual stimuli in the hemispace ipsilateral to the arm involved; (b) responses were evoked only by visual stimuli within the reach of maximal arm extension; (c) responses were evoked only by visual stimuli in the space around the hand; (d) all such patterns were variously combined. These findings are discussed in relation to the general problem of specific correlations between sensorimotor subsystems and peripersonal behavioral space. PMID- 3504263 TI - A single family with writer's cramp, essential tremor, and primary writing tremor. AB - We studied seven members of a family who had different types of movement disorders: Two had typical essential tremor, two (twins) had typical writer's cramp, one had both essential tremor and writer's cramp, one had primary writing tremor, and one (deceased) had uncharacterized tremor. This appears to be the first report of writer's cramp in twins and in so many family members. This family links together primary writing tremor, essential tremor, and writer's cramp and may help resolve the apparent controversy about the relationship of primary writing tremor to essential tremor and writer's cramp. PMID- 3504264 TI - Life-threatening tardive dyskinesia caused by metoclopramide. AB - A case of severe life-threatening tardive dyskinesia resulting in esophageal and respiratory difficulties due to metoclopramide therapy is presented. A 66-year old man with a primary diagnosis of clear cell carcinoma of the biliary duct was treated with metoclopramide for gastrointestinal symptoms related to his chemotherapy regimen. The patient initially presented with tremor and rigidity in the upper extremities. On antiparkinsonian therapy, symptoms progressed to hemiballism and involuntary movements of the face, mouth, and tongue, with respiratory and esophageal dyskinesia. Despite discontinuance of metoclopramide, severe tardive dyskinetic symptoms resulted in placement of a gastrostomy tube to maintain nutritional support. This case along with others in the literature should emphasize the need for continuous reevaluation of metoclopramide during long-term therapy, since serious side effects have been reported to occur. PMID- 3504265 TI - Blepharospasm accompanying hypoxic encephalopathy. AB - Severe bilateral blepharospasm with left hemiplegia occurred in a 50-year-old woman, who developed cardiac arrest following ventricular aneurysmectomy. The blepharospasm was present constantly, even during sleep, and increased during attempts at voluntary eye opening. CT scan revealed multiple hypodense areas involving basal ganglia bilaterally and the right perisylvian area. The blepharospasm improved gradually over a 6-month period, although the left hemiplegia remained unchanged. PMID- 3504266 TI - Young onset Parkinson's disease. AB - We describe a personal series of 60 cases of parkinsonism with onset under the age of 40 years. Known causes for early onset of secondary parkinsonism, such as Wilson's disease or encephalitis, were excluded in every case. Two groups were identified: those with onset after the age of 21 in whom no hereditary factors could be ascertained (56 cases), and those with onset before 21 years all of whom had familial parkinsonism. In neither group have we found any association with prematurely grey hair, hypertension, diabetes, pernicious anaemia, or thyroid disorder. Among their families, we have not found any association with diabetes, pernicious anaemia, or thyroid disorder. We propose that cases of apparent idiopathic Parkinson's disease beginning between age 21-40 years should be called "young onset Parkinson's disease." Twenty percent of such patients in our series had at least one first- or second-degree relative in the same or antecedent generations with parkinsonism, but only 1.5% of their relatives at risk had parkinsonism, which is similar to the prevalence in the general population. Ten percent of these patients had at least one relative with essential tremor, but only 1.6% of their relatives at risk had tremor, which again was similar to the prevalence in the population in general. These patients with young onset Parkinson's disease responded well to levodopa therapy. However, dyskinesias and response fluctuations occurred early and frequently. The prevalence of dyskinesias and response fluctuations was strongly correlated with the duration of levodopa treatment, but not with the duration (or probably the severity) of the disease before levodopa therapy was commenced. The involuntary movements often were severe and frequently were diphasic. Despite long disease duration, the incidence of dementia in young onset patients aged less than 65 years was negligible. We believe that most, if not all, patients in this group have degenerative Lewy body idiopathic Parkinson's disease, representing the lower end of a skewed deviation for age of onset of this disease. We have so far failed to identify any additional environmental factor which may have accelerated disease onset in these patients. In contrast, cases of parkinsonism beginning before age 21 years were invariably familial. We proposed that they should be called "juvenile parkinsonism." All affected relatives with parkinsonism also had young disease onset, and all but one were siblings. None of four such patients seen by us has demented, and computed tomography (CT) scan has been normal in all four. We believe that most such patients have some form of genetically determined secondary parkinsonism. PMID- 3504267 TI - Effectiveness of trihexyphenidyl against pendular nystagmus and palatal myoclonus: evidence of cholinergic dysfunction. AB - Palatal myoclonus and acquired pendular nystagmus result from lesions in dentatorubroolivary pathways. We have investigated the effect of high doses of the anticholinergic drug trihexyphenidyl in four patients with palatal myoclonus and in four patients with acquired pendular nystagmus. The movements of each patient were videotaped three times: before administration of trihexyphenidyl, at the time of maximum or effective dosage, and after withdrawal from trihexyphenidyl. In five patients the movements were also electrographically recorded. A neurologist not familiar with the patients reviewed the tapes and rated the changes. In seven of eight patients, administration of trihexyphenidyl resulted in marked improvement of both movements and complaints by patients. This observation indicates that disturbance of cholinergic mechanisms plays an important role in the pathophysiology of these two movement disorders. PMID- 3504268 TI - [AIDS--present status and prospects]. PMID- 3504269 TI - [Bacterial and mycotic infections in immunosuppressed patients: studies during antineoplastic therapy]. PMID- 3504270 TI - [Clinico-epidemiological study on the diffusion of neuropsychological disorders in a school-age population in Rome]. PMID- 3504271 TI - [Antibiotic prophylaxis in surgery: experience of a large hospital in Milan]. PMID- 3504272 TI - [1st results on the diffusion of HIV infection in Apulia]. PMID- 3504273 TI - [Human hydatidosis caused by Echinococcus granulosus: studies on patients hospitalized at the Umberto I Polyclinic (Rome 1980-1984)]. PMID- 3504274 TI - [Informatics applied to health: development and prospects]. PMID- 3504275 TI - Programme of vaccinations in Somalia. PMID- 3504276 TI - [Disinfection and sterilization in the field of dentistry: practical implications and possibility of control in the confrontation with HIV]. PMID- 3504277 TI - [Isolation of halophilic vibrios from seawater of the Palermo coastline used for bathing]. PMID- 3504278 TI - [Episodes of food poisoning caused by Salmonella C2 transmitted via prosciutto]. PMID- 3504279 TI - [Anti-tetanus immunity in an elderly population in some regions of southern Italy]. PMID- 3504280 TI - [Genital infections caused by Chlamydia trachomatis: diagnostic aspects and clinico-etiological correlations]. PMID- 3504281 TI - [Parasitologic survey in 2 primary schools in North Uganda]. PMID- 3504282 TI - [Incidence and distribution of sexually transmitted diseases and infective and parasitic dermatoses in the decade 1976-1985 in the Messina territory]. PMID- 3504283 TI - [Nosocomial environment in lung diseases: mycological aspects]. PMID- 3504284 TI - [Effect of sodium pyruvate on the resumption of cell division of Staphylococcus aureus subjected to freezing]. PMID- 3504285 TI - Intracranial arteriovenous anomalies of infancy: modern concepts. AB - A variety of cerebrovascular abnormalities may become manifest in the first years of life. We present our recent experience with 7 children, ages 1 week to 7 months of age, who presented with congestive heart failure and progressive head enlargement (3), heart failure alone (1) and head enlargement alone (2). The anomalies include vein of Galen aneurysm (3), complex arteriovenous fistula (2) and posterior fossa dural arteriovenous malformations (2). Computed tomographic scanning was invaluable in delineating the site of the lesion while arterial digital subtraction angiography was utilized to obtain the high-quality images, reduced dye volume and rapid filming. Direct surgical intervention was accomplished in 5 cases, while embolization was utilized in 2. One child underwent direct partial occlusion and embolization. Congestive heart failure resolved in 2 of 3 operated cases and improved in those undergoing embolization. Hydrocephalus improved in 2 cases with the elimination of the fistula. Morbidity included seizures and a hemorrhagic infarction in 1 case. Neurologic outcome was satisfactory and there was no surgical mortality. PMID- 3504286 TI - External ventricular drainage for initial treatment of neonatal posthemorrhagic hydrocephalus: surgical and neurodevelopmental outcome. AB - Thirty-seven infants were treated for posthemorrhagic hydrocephalus (PHH) with external ventricular drainage (EVD) in 1977-1985. The mean age at EVD placement was 13 days; the mean duration of drainage was 21 days, and an average of 1.8 drains was used per patient. Complications were apnea (10%), hemorrhage (8%) and ventriculitis (6%). Ten infants died from pulmonary disease unrelated to the surgery. Thirty-two percent of the survivors did not require a permanent shunt. Neurodevelopmental outcome was evaluated at a mean age of 38 months. Eighteen of the twenty-seven survivors (67%) had normal cognitive function, 3 had borderline and 6 (22%) had moderate to profound mental retardation. Nine of the children (33%) had a normal neuromuscular exam. One child had mild, 11 had moderate and 6 had severe cerebral palsy. Four children had serious visual impairment. The worst outcomes were in the children with parenchymal or large intraventricular hemorrhages. PMID- 3504287 TI - The Neuro Image Quiz. Anterior fontanelle dermoid. PMID- 3504288 TI - Arthrogryposis multiplex congenita and hypotonia in a male neonate. PMID- 3504290 TI - [Peptic ulcer. Disadvantages of the surgical treatment. Alkaline gastritis?]. PMID- 3504289 TI - [Alkaline reflux gastritis]. PMID- 3504291 TI - [Consumption of drugs, alcoholic beverages and cigarettes by workers of Cubatao]. PMID- 3504292 TI - [Enterogastric reflux after partial gastrectomy: comparative study of Billroth I and Billroth II anastomoses]. PMID- 3504293 TI - [Alkaline reflux gastritis: clinical picture and diagnosis]. PMID- 3504294 TI - [Evaluation of the endocrine function and study of the anti-insulin antibodies in hemochromatosis]. PMID- 3504295 TI - [Extracorporeal shockwave lithotripsy]. PMID- 3504296 TI - [Grading awarded to medical students by the group self-evaluation method]. PMID- 3504297 TI - [Factors in the progression of renal diseases]. PMID- 3504298 TI - [The influence of oral hygiene on pregnancy gingivitis]. PMID- 3504299 TI - [Factors to consider before final cementation of a fixed prosthesis in the mouth]. PMID- 3504300 TI - [Mucogingival surgery: laterally displaced flap]. PMID- 3504302 TI - [Delaire--facial apparatus used as an aid in orthodontic practice]. PMID- 3504301 TI - [Deciduous teeth--basis for normal development of the masticatory system]. PMID- 3504303 TI - [Disease symptoms--evaluation, occurrence and seriousness]. PMID- 3504304 TI - Moral pioneers: women, men and fetuses on a frontier of reproductive technology. AB - As one of the new reproductive technologies, amniocentesis is rapidly becoming routinized, especially for pregnant women in their mid-thirties and older. Prenatal diagnosis has been evaluated medically, economically, and bioethically. But we know very little about how pregnant women and their families who use, or might use, this new technology respond to its benefits and burdens. This article reports on a two-year field study in New York City. Responses of genetic counselors, a multicultural patient population using and refusing amniocentesis, women who had received "positive" diagnoses, and families with children who have the conditions that can now be diagnosed prenatally were all elicited through participant-observation. My goal in this study is to assess the social impact and cultural meaning of one new reproductive technology. PMID- 3504305 TI - In vitro fertilization and gender politics. AB - From the point of view of the couple rather than the individual, infertility is in many ways a social rather than a physiological problem. Originally developed to bypass the blocked or missing Fallopian tubes of infertile women, IVF treatment has expanded to cases of male infertility due to poor sperm motility or low sperm count. In these cases, the woman may be physiologically normal reproductively, but nonetheless must undergo hormonal stimulation, sonargrams, and laparoscopy. Health care professionals so take it for granted that the most sophisticated techniques will be sought for correction of patients' problems that they rarely question patients on their motivations to undergo discomforting, expensive, and possibly dangerous treatments. Despite our culture's emphasis on motherhood, men are often the dominant partner in reproductive decisions. The increasing popularity of the use of IVF treatment in cases of male infertility is understandable in the light of men's investment in biological parenting and women's willingness to take on the physiological responsibility for treatment. PMID- 3504306 TI - Brave new baby in the brave new world. AB - Society would be wise to ponder the psychology of the adopted in order to gain some insights into what the psychological makeup of the brave new baby might be. Whatever combinations of reproduction and parenting we make, we should relinquish the secrecy that has been the scourge of the adoption system. PMID- 3504307 TI - Problems in commercialized surrogate mothering. AB - Commercialized surrogate mothering is an unworkable arrangement for helping infertile couples to have children. The arrangement requires a woman to undergo artificial insemination, to sustain a pregnancy and to relinquish the child upon birth to the genetic father. During the course of the pregnancy, the arrangement calls for restrictions on the surrogate mother's behavior and authority to make medical decisions concerning herself and the fetus. Such restrictions are unenforceable under contract law, and the usual social mechanisms to induce compliance are absent. Due to the large sums of money involved and the growing industry of surrogate mother brokering, efforts have begun in many state legislatures to regulate the arrangements, and in particular the behavior of the surrogate mothers, in order to increase the predictability and workability of the arrangements. If passed, these state laws could set a dangerous precedent for regulating all women during pregnancy and standardizing the behavior and medical care of pregnant women. Noncommercialized surrogate mothering does not pose these same threats, and is likely to continue for many years to come. PMID- 3504308 TI - Prenatal screening and discriminatory attitudes about disability. AB - There is a widespread assumption, with the increased use of reproductive technologies, that prenatal screening reduces the incidence of disability and increases our quality of life. However, because of a growing awareness of the social and political implications of prenatal screening, people have begun to challenge these notions about the quality of life and social value of people with disabilities. This paper presents an overview of the issues surrounding prenatal screening of fetuses with intent to abort on the basis of disability. It raises some of the difficult social, political, and personal questions that women, especially prospective mothers, face regarding these issues, and suggests new perspectives for the decision-making process regarding abortion. PMID- 3504309 TI - A short answer to "who decides"? AB - Technology increases the control which experts and the medical professions exercise over conception, pregnancy, and childbirth. However, it is women and women alone who should make the ultimate decisions regarding their own childbearing. PMID- 3504310 TI - What the king can not see. AB - This paper contrasts the ways in which the physician-scientist developing in vitro fertilization ("the king") sees the world and the way women experience it. It challenges the truth of what the king sees: i.e., that women have a desperate will to be mothers that must be fulfilled at all costs; that the way to make infertile women mothers is through the use of new reproductive technologies; that IVF programs are quite successful and that women who enter these programs actually come away with babies. PMID- 3504311 TI - Personal philosophy of nursing. PMID- 3504312 TI - Confronting rheumatoid arthritis at home. PMID- 3504313 TI - The investigation of anaemia in the asymptomatic elderly. PMID- 3504314 TI - Combined administration of controlled release theophylline and ranitidine: a 53 day controlled survey in patients with chronic obstructive lung disease (COLD) and peptic disease. PMID- 3504315 TI - Therapeutic focus. Aztreonam. PMID- 3504316 TI - Streptococcus bovis endocarditis and carcinoma of the colon. PMID- 3504317 TI - Recurrence of childhood diverticulitis. PMID- 3504318 TI - Unilateral facial pain as a rare presentation of bronchial carcinoma. PMID- 3504319 TI - If I suffered from rheumatoid arthritis. PMID- 3504320 TI - An assessment of the clinical efficacy in general practice of cefuroxime axetil when used in the management of unidentified infections of the lower respiratory tract. PMID- 3504321 TI - Therapeutic efficacy and gastric tolerance of ibuprofen (Brufen) at 1600-2400 mg dosage in rheumatoid arthritis. PMID- 3504322 TI - Immunological hypersensitivity to environmental antigens in the irritable bowel syndrome. PMID- 3504323 TI - A comparison of diagnostic techniques in the diagnosis and management of allergic conditions. PMID- 3504324 TI - Initial presentation of malignant disease to accident and emergency departments. PMID- 3504325 TI - Nifedipine: a calcium channel blocking drug. PMID- 3504326 TI - Primary transitional cell carcinoma of the renal pelvis in a duplicated collecting system. PMID- 3504327 TI - Vascular trauma in drug abuse: patterns of injury. AB - We have reviewed 172 occurrences of vascular injuries caused by intravascular or perivascular drug injections. Various patterns of injury are discussed including presentation. Recommendations have been made for diagnostic evaluation, surgical and medical treatment based on proposed pathophysiologic etiologies and bacteriology. Expected outcomes are presented. It is important that all physicians become familiar with the management of these injuries as the number of patients who seek treatment for complications of substance abuse continues to increase in our present day society. PMID- 3504328 TI - Exclusion-bypass for aneurysms of the descending thoracic and thoracoabdominal aorta. AB - From October 1973 to April 1985, 81 patients with aneurysms of the descending thoracic or thoracoabdominal aorta underwent surgery. Eight (10%) of these patients were treated by exclusion-bypass. The aneurysm was located in the descending aorta alone in five cases, and in the descending thoracic and thoracoabdominal aorta in three cases. In all cases, the proximal anastomosis of the bypass was performed on the ascending aorta. The site of the distal anastomosis was the supraceliac aorta in two cases, the infrarenal aorta in three cases and the iliac arteries in three other cases. Exclusion was bipolar, at each end of the aneurysm, in six cases, and unipolar, ie. proximal interruption only, in two cases. Two patients died during the first postoperative month, one of rupture of the distal portion of the aortic arch, the second, after onset of secondary paraplegia. There were no other spinal, cardiac or cerebral complications. One patient died three months postoperatively of intercurrent pulmonary infection. The five other surviving patients whose mean follow-up period is 48.1 +/- 25 months, are alive and enjoying good health. Resection and grafting as advocated by Crawford, is the usual treatment proposed for aneurysms of the descending thoracic and thoracoabdominal aorta. Exclusion-bypass may however be preferred in the following cases: elderly patients with compromised respiratory status, aneurysms of the descending thoracic aorta, either voluminous, of infectious origin or associated with aneurysm of the infrarenal abdominal aorta. PMID- 3504329 TI - Traumatic aneurysms of the descending thoracic aorta. AB - From July 1979 to December 1985 we observed 51 patients with traumatic lesions of the descending thoracic aorta. Twenty-nine had acute ruptures, mostly accompanied by multiple injuries, and 27 had to be operated upon immediately. Twenty-two patients (19 males, 3 females) had chronic traumatic aneurysms of the descending thoracic aorta (more than six weeks after trauma). Mean age at the time of trauma was 24 years. Mean age at time of surgery was 36.5 years. Twelve patients were symptomatic. All were treated surgically. At surgery, complete aortic disruption was found in 15 patients and partial rupture in seven. We did not use aortic shunting of any kind, only aortic cross-clamping. Hypertension was controlled by intravenous drug infusion. The ruptured aortic segment was replaced in all cases by prosthetic Dacron graft. There were no operative deaths. One patient (age 77) died 11 weeks after surgery from multiple organ failure. One case of postoperative paraplegia was observed. This patient recovered almost completely from his neurological deficit. PMID- 3504330 TI - Early results of femoropopliteal bypass using a five millimeter "thin wall" polytetrafluoroethylene (Gore-Tex) prosthesis. AB - We report the early results of a series of 86 femoropopliteal bypass operations in which a 5 mm diameter thin wall polytetrafluoroethylene (Gore-Tex) prosthesis was used. Sixty-five bypasses were implanted in men and 21 in women. Thirty bypasses were done in conjunction with an aortic bifurcation graft and 18 patients had a bilateral procedure. The indication for operation was severe claudication in 74 cases and critical ischaemia in 12 cases. The angiographic run off was good (three patent vessels) in 22 limbs and poor (one or two patent vessels) in 64 limbs. The cumulative patency rate for the whole group was 62% after 18 months. Angiographic run-off and the indication for operation were both found to influence cumulative patency rate significantly (p = 0.035 and p = 0.055, respectively). We also compared the results obtained when run-off was poor with equivalent data from our own previously published series in which a standard 6 mm diameter Gore-Tex prosthesis was used. This shows a difference in patency rate, for example 57% against 37% after 18 months, in favour of the smaller bore thin wall graft. PMID- 3504331 TI - Vascular surgery: what was and what will be. PMID- 3504332 TI - Changes in the education of a vascular surgeon. PMID- 3504333 TI - Hair transplantation producing arteriovenous fistulization. AB - Arteriovenous fistula formation is a rare complication of the punch graft technique of hair transplantation. This report describes a large donor site arteriovenous fistula that was clearly demonstrated on arteriography. Operative correction was guided by precise directional Doppler ultrasound localization of the fistulous communication, thus avoiding a large disfiguring incision. PMID- 3504334 TI - Arterial manifestations in Behcet's disease: four new cases. AB - Four new arterial lesions observed with Behcet's disease are reported: two popliteal aneurysms, one carotid aneurysm and one carotid stenosis. The clinical features, therapeutic modalities and postoperative complications of these uncommon lesions are reviewed briefly. PMID- 3504335 TI - Aneurysm of the inferior mesenteric artery associated with occlusion of the celiac axis and superior mesenteric artery. AB - The authors report a case of aneurysm of the inferior mesenteric artery encountered in a 38-year-old man, associated with occlusion of the celiac axis, the superior mesenteric artery and the inferior mesenteric artery distal to the aneurysm. All three arteries were revascularized. In spite of failure in the bypass of the superior mesenteric artery, the patient remained symptom free until his demise four years later, from a probable myocardial infarction. Only 11 cases of aneurysms of the inferior mesenteric artery have been reported in the literature. The causes, diagnosis and treatment of these uncommon lesions are discussed. When occlusion of the celiac axis is associated with that of the superior mesenteric artery, a complete mesenteric revascularization should be attempted whenever possible. PMID- 3504336 TI - Persistant carotido-hypoglossal artery associated with atherosclerotic stenosis treated by venous bypass. AB - A 66 year-old woman presented with a tight but asymptomatic atheromatous stenosis in a persistant carotido-hypoglossal artery. Stenosis was documented by ultrasound Doppler tomography whereas the embryologic anomaly was disclosed by digital angiography. A successful venous bypass was done. Based on this case report, the diagnostic and therapeutic problems raised by such anomalies are discussed. PMID- 3504337 TI - Basic data related to carotid endarterectomy. PMID- 3504338 TI - Simultaneous revascularization of the internal carotid and vertebral arteries in their distal cervical segments. AB - Fibrodysplasic lesions or tortuosity, involving both ipsilateral carotid and distal vertebral arteries may be treated by a one stage combined procedure of external and internal carotid artery transposition and possibly dilatation of the internal carotid artery. Indications for this technique are uncommon. Only 4 of 969 cerebrovascular reconstructions performed between January 1980 and June 1986 utilized this method. Good results were obtained in all cases. This technique is a satisfactory and simple solution for certain situations requiring vascular reconstruction. PMID- 3504339 TI - Extrinsic arterial supply of the great saphenous vein: an anatomic study. AB - The extrinsic arterial supply to the great saphenous vein was studied by dissection following latex injection, diaphanisation and contrast roentgenograms. Arterial supply arises from the external pudendal, superficial femoral, superior genicular and posterior tibial arteries. These branches ensure the irrigation of the vasa vasorum. The role they play in the outcome of bypass with the great saphenous vein is a further argument pleading in favor of the in situ technique. PMID- 3504340 TI - Endofibrosis of the external iliac artery in bicycle racers: an unrecognized pathological state. AB - Since December 1985, we have operated upon seven bicycle racers for endofibrosis of the external iliac artery. In all instances, the athletes had started cycling early in life and were engaged in top level competition by the age of 17. The principal complaint was intermittent claudication of one lower limb at "near maximal" exercise. Pain could be reproduced by exertional tests on an ergometric bicycle, and in all cases except one, measurement of ankle systolic pressure of that limb compared with the opposite side and brachial pressures showed a marked decrease on the involved side. Arteriography, performed with multiple views and positions, documented a 5 to 6 cm moderately stenotic (less than 40% diameter) segment, associated with arterial lengthening. Surgical treatment consisted of endarterectomy and shortening of the artery. Four patients were able to return to competition. The origin of this pathology is discussed, based on gross and histologic findings. Under certain predisposing anatomic conditions, abnormal hemodynamics, probably due to a high flow arterial state and an aerodynamic position on the bicycle, provoke repeated trauma which eventually produces the lesion. Practically unrecognized until now with only two previous publications on the subject in the literature, this entity is probably not uncommon. PMID- 3504341 TI - Blood pressure aberrations associated with carotid endarterectomy. AB - This report examines and reviews the frequency, potential causes and management of blood pressure aberrations in 100 consecutive carotid thromboendarterectomies. Reasons for operation and postoperative sequelae included: asymptomatic stenosis, transient ischemic attacks, non-hemispheric symptoms, amaurosis fugax, previous stroke, and evolving stroke. Hypertension (greater than or equal to 100 mmHg diastolic) occurred within 24 hours of operation in 37 instances (37%). Recognized causes included: manifestation of preoperative hypertension (19); carotid sinus denervation or transient mild cerebral edema (16); and massive cerebral edema in the two postoperative strokes of the series. Control of hypertension was most commonly managed by intravenous administration of nitroprusside. Profound immediate hypotension and bradycardia occurred in association with six procedures (6%). Accelerated carotid sinus nerve activity after removal of the noncompliant plaque was the probable cause of this reflex. Management included intravenous administration of parasympatholytic (atropine) and sympathomimetic (epinephrine) drugs. Aberrations of blood pressure after carotid TEA are common but with proper management do not represent a risk factor for perioperative stroke. PMID- 3504342 TI - Embolization of the mesenteric arteries: surgical treatment in twenty-three consecutive cases. AB - Twenty-three patients with acute embolization of the superior mesenteric artery are presented. Twenty-one of them presented with sudden abdominal pain but no other remarkable physical findings. One had diffuse abdominal pain while one did not have any abdominal pain. Twenty-two patients underwent direct surgical revascularization and one patient refused operation. The total mortality in this series was 27%. Eighteen patients underwent revascularization without resection and 15 of them (83%) survived. Early diagnosis is the key to improved results in acute mesenteric ischemia. It relies on the aggressive utilization of arteriography to identify patients with superior mesenteric artery embolization before intestinal infarction takes place. PMID- 3504343 TI - The role of echocardiography in patients with acute peripheral arterial embolization. AB - Forty-seven patients with acute arterial embolism requiring urgent embolectomy had postoperative echocardiography (36 2-D, 11 M-mode) in an attempt to identify a cardiac source of emboli. On the basis of history, physical examination, electrocardiogram, and chest roentgenogram, 37 patients were believed to have an apparent cardiac source. All histories and physical examinations in this group reaffirmed significant underlying cardiac disease. Nine of the 47 patients had no discernible source based on clinical data, and one had an arterioarterial embolus. In the presence of a clinically obvious source, although echocardiography (26 2-D, 11 M-mode) helped to clearly define evident cardiac disease in these patients, it failed to demonstrate a cardiac embolic source in those without clinical evidence of cardiac disease or to influence subsequent management. The continued use of echocardiography for the sole purpose of identifying a potential cardiac embolic source should be reconsidered. PMID- 3504344 TI - Aneurysms of the renal artery and its branches. AB - During the last ten years, 29 aneurysms of the renal artery, observed in 20 patients were operated on. These cases represent 10% of the total number of renal vascularization procedures performed during the same period. Diagnosis was made most often during the workup for arterial hypertension (16 patients). There were 20 cases of sacciform aneurysms, eight cases of fusiform aneurysms, usually associated with stenotic lesions, and one case of dissecting aneurysm. Fibromuscular dysplasia was the principal etiological factor. A total of 22 kidneys were involved. Restoration was performed "in situ" in 15 cases (21 aneurysms), using aortorenal bypass in fusiform aneurysms and usually aneurysmorrhaphy for sacciform aneurysms. Six cases (seven aneurysms) were treated with "ex situ" surgery. Primary nephrectomy was performed in one patient. There was no operative mortality. Early occlusion occurred in two cases, resulting in secondary nephrectomy. During a mean follow-up period of 51 months, there were no secondary occlusions. Blood pressure control was obtained in 14 patients (87%). Surgical management is recommended for most renal artery aneurysms. Repair using "in situ" techniques is usually feasible and provides satisfactory long-lasting results in most cases. PMID- 3504345 TI - The human umbilical vein graft in below-knee femoropopliteal and femorotibial surgery: an eight year experience. AB - The authors present a series of 175 femoropopliteal (below-knee) and 65 femorotibial reconstructions with the human umbilical vein (HUV) graft performed over an eight year period. With a mean follow-up of 36.7 months (range one month to 84 months) the early patency rate of 89% decreased to 54% after five years. Long-term patency was found to be primarily related to the location of the distal anastomosis and the quality of the outflow, showing a statistically significant decrease after repeat revascularization. Early thrombosis, even in the absence of a technical failure and late aneurysmal degeneration remain the major problems associated with the use of the HUV graft. It is therefore recommended that these reconstructions be preserved for patients with advanced ischemia or a limited life-expectancy. PMID- 3504346 TI - Hemodynamics of in situ vein bypass: the role of side branch fistulae. AB - Ten patients undergoing femoral-popliteal and femoral-tibial in situ saphenous vein bypass for limb salvage were studied to determine the effects of side branch arteriovenous fistulae on flow through the distal end of the graft into the outflow artery. Studies were performed intraoperatively with electromagnetic flow probes. Following completion of proximal and distal anastomoses, flow was established through the graft and measured through its proximal and distal ends. Side branches were then ligated, and flow through the distal end of the graft measured again. Papaverine was administered and flow measured once more. Measured flows were consistent with those observed in previous studies, as were changes in flow induced by papaverine. Results indicate statistically significant diversion of blood through the fistulae, and a statistically significant increase in distal graft flow accompanying ligation of side branch fistulae. These data support the practice of routine side branch ligation during in situ bypass grafting. PMID- 3504347 TI - Infrageniculate thin-walled PTFE bypass: preliminary study of 53 cases. AB - Between May 1, 1983 and May 1, 1985, 53 patients whose mean age was 75 years, and who presented with rest pain or ischemic changes had infrageniculate insertion of femoropopliteal or femorotibial thin-walled polytetrafluoroethylene (PTFE-TW) bypasses. Occlusive atherosclerotic disease was present in all patients. Postoperative follow-up ranged from 6 to 30 months. One patient died in the immediate post-operative period whereas 15 others died later during follow-up. There was one case of prosthetic sepsis. No anastomotic aneurysms occurred. Actuarial analysis of overall patency rates in significant population samples showed that 88% and 68% of bypasses were functional at one month and two years, respectively. The overall rate of early amputation was 17%. Overall limb salvage was 67% at 30 months. In patients over 75, 85% of bypasses were patent at one year whereas life expectancy for one year in this same group of patients was 49%. Although this is a preliminary study, results obtained with this new material suggest that an average gain of 20% in patency rates can be expected compared to those recorded with standard PTFE prostheses. The PTFE-TW vascular prosthesis may be the material of first choice for the geriatric patient in order to promote early hospital discharge and return to the home environment. Even though long term patency rates of venous grafts are better, we believe that the use of PTFE TW prostheses in elderly patients with limited life expectancy may be preferred. PMID- 3504348 TI - Arterial systolic pressures in critical ischemia. AB - Segmental systolic pressures were measured in a group of patients with clinically irreversible ischemia. There was a good relationship between the level of pressure in a limb and the eventual outcome, but a particular level of pressure was found to be a poor indicator of a specific level of viability. These results support previous concern about the limitations of systolic pressure measurements in determining the level of limb viability. We suggest that local intrinsic regulation of the microcirculation plays a major role in the ultimate survival of tissues in an ischemic limb. PMID- 3504349 TI - Unusual approaches for insertion of the Greenfield vena cava filter: the value of its approach through the jugulosubclavian junction. AB - During the last four years, we have attempted 249 insertions of the Greenfield inferior vena cava filter using the right internal jugular vein. This approach was impossible in 31 patients (12.5%). Our first alternative was the insertion of the filter through the venous junction between the right internal jugular and right subclavian veins. If this latter technique was not possible we attempted the insertion of the Greenfield filter through the left internal jugular vein before using the retrograde femoral route which is associated with high morbidity. By these techniques we have been able to reduce the number of patients in whom it is impossible to achieve mechanical endocaval partial interruption to 2.4%. PMID- 3504350 TI - Perigraft seroma following axillofemoral bypass: report of three cases. AB - One hundred and twenty-three axillofemoral or bifemoral bypasses were performed in the Department of Cardiovascular and Thoracic Surgery of the Catholic University of Louvain, Belgium between 1975 and 1986. Three cases of perigraft seroma were noted. A polytetrafluoroethylene (PTFE) graft had been inserted in all three cases. In one case, the seroma recurred rapidly after surgical drainage. The two others were not drained. In all three cases appearance remained unchanged throughout the observation period. The three bypasses are patent at 5, 14 and 24 months. Observation is advocated for this complication especially in high risk patients. PMID- 3504351 TI - Surgical treatment of a tuberculous thoracoabdominal aneurysm. AB - We report a case of tuberculous thoracoabdominal aneurysm successfully treated by surgery. Computerized tomography was diagnostic for location and etiology. The therapeutic plan included antituberculosis drug therapy started before surgery, direct PTFE prosthetic replacement and omentoplasty. A survey of other reports dealing with tuberculous abdominal or thoracic aorta involvement shows that their frequency, as that of tuberculosis in general, is diminishing. PMID- 3504352 TI - Intervertebral disk space infection following translumbar aortography. AB - After 1,748 translumbar aortograms three cases of intervertebral disk space infection were observed over a five-year period, for an incidence of 0.15%. Cultures suggested that the intervertebral disk had been inoculated with digestive tract organisms by the needle used to puncture the aorta. Diagnosis of this complication can be made early by retrieval of the responsible organisms from the intervertebral disk under CT control. Treatment consists of prolonged immobilization associated with appropriate antibiotic therapy for at least three months. PMID- 3504353 TI - Subclavian steal syndrome in a congenitaly anomalous subclavian artery: a case report. AB - The case of a 50 year-old man with a subclavian steal syndrome caused by an occlusive lesion of an aberrant right subclavian artery is presented. There was no dysphagia lusoria. The right subclavian artery was anastomosed to the right common carotid artery. At follow-up, 18 months later, the patient is symptom free and the right subclavian artery is patent. PMID- 3504354 TI - Primary iliac artery aneurysm in a two-year-old girl. AB - Isolated idiopathic iliac artery aneurysm in the pediatric population is extremely rare. Aneurysms in children may be secondary to connective tissue disease, arteritis, or mycotic causes. Presented here is the case of a 2 1/2-year old female child who, despite the absence of these predisposing factors, presented with a single large iliac artery aneurysm which was successfully resected. The literature on this subject is reviewed. Only two other cases have been reported. PMID- 3504355 TI - Predicting pulmonary embolism in postoperative patients with deep venous thrombosis of lower limbs. AB - Ventilation-perfusion lung scans were done in 70 patients admitted because of an iliofemoral deep vein thrombosis (DVT), and diagnosed by venography. Eighteen items of clinical and laboratory information were measured to predict the presence of lung scan abnormalities consistent with asymptomatic pulmonary embolism. Eighteen patients had perfusion defects in the lung scan that were classified as "high probability of pulmonary embolism", while the lung scan was normal in 32 patients. Patients with an idiopathic DVT were at high risk of pulmonary embolism, but those with a postoperative DVT had a low embolic risk. In patients with a postoperative DVT two factors predicted pulmonary embolism: those patients who developed symptomatic DVT after an operation but had a normal lung scan showed higher platelet counts than their preoperative levels. Conversely, it they developed a pulmonary embolism their platelet count dropped from their preoperative levels. PMID- 3504356 TI - Femoropopliteal in situ saphenous vein bypass: technical aspects and factors determining patency. AB - The results and the factors influencing long-term patency rates in two technical variations of femoropopliteal "in situ" saphenous vein bypass procedures were evaluated retrospectively. Technique I (n = 33) consisted of a limited approach to the saphenous vein, destruction of the valves with a Cartier stripper and no tributary ligation. Technique II (n = 55) included complete exposure of the saphenous vein valvular destruction using Hall's stripper and ligation of all tributaries. Early thrombosis was observed in 21% and 3.6% of cases in techniques I and II, respectively. The frequency of local complications was identical in both techniques (18%). Overall actuarial primary patency at 4 years was 70%. Secondary patency (including patency following reoperations for graft failure) was 88% overall, 78.5% in technique I and 95% in technique II (p less than 0.05). The site of the distal anastomosis significantly influenced the four year cumulative patency rate (upper popliteal - 100%, lower popliteal - 93.6%, tibioperoneal vessels - 70.5%, p less than 0.05), whereas the number of patent leg vessels, the clinical stage of disease and the site of the proximal anastomosis (common femoral or superficial femoral artery) did not. Results obtained with the in situ saphenous vein bypass using technique II were better than with technique I. Close follow-up and preventive reoperations clearly enhanced patency rates. The site of distal anastomosis significantly affected long-term results. PMID- 3504357 TI - In situ versus reversed saphenous vein for femoropopliteal bypass: a prospective randomized study of 100 cases. AB - With the purpose of comparing results using the greater saphenous vein in situ or as a reversed conduit, 100 femoropopliteal bypasses, performed in 91 patients between October 1980 and January 1985, were randomized into two statistically comparable groups of 50 procedures of each type. Seventy-five percent of patients had cutaneous signs of ischemia and 20% had isolated rest pain. Average follow-up was 32 months for the in situ group and 33.4 months in the reversed bypass group. The quality of the vein was statistically better in the in situ group (p less than 0.01). There were six cases of early thrombosis in the in situ group compared to four in the reversed bypass group. In the in situ group, half of the thromboses could be attributed to inadequate valvular destruction. Seven delayed thromboses were noted in the in situ group whereas there were two in the reversed saphenous vein bypass group. The actuarial rates of bypass patency at three years in the reversed and in situ groups were 88.2 and 70.8%, respectively (chi 2 = 2.62; NS). Analysis of results suggests that: 1) the reversed saphenous vein bypass provides excellent results if vein harvest and preparation are as atraumatic as possible; 2) expertise in rendering the valves incompetent markedly increases patency in the in situ technique; 3) during the first 12 months, Doppler follow-up of measured distal pressures is necessary in order to detect pathologic changes of the bypass and adjacent arterial tree. PMID- 3504358 TI - Laser vascular welding--how does it work? AB - This study evaluated the histology and electron microscopy of four samples of 2 cm long venotomies and artery-vein anastomoses formed in canine femoral arteries and veins using the argon laser (0.5 W power, 1 800 J/cm2, 4 min exposure/1 cm length of anastomosis). Welds were continuously irrigated with saline during the procedure to limit maximal temperatures to 44.2 +/- 1.6 degrees C (mean +/- SD), and the specimens were removed immediately following fusion and preserved for examination. Histologic and electron microscopic examination of different areas of the welds revealed various mechanisms of fusion including a) apposition of denatured collagen and elastin in the media and adventitia; b) bonding of vein medial collagen and elastin to the internal elastic membrane of the artery; and c) fusion consisting of a coagulum of platelets and fibrin depending on the alignment and apposition of the vessel edges. This study demonstrates that vascular tissue fusion by the argon laser occurs by various mechanisms. Future experiments should delineate which types of seal produce the optimal strength at the time of fusion, and enhance long-term healing. PMID- 3504359 TI - A new cold test for the diagnosis of Raynaud's phenomenon. AB - An objective test for the diagnosis of Raynaud's phenomenon is useful for three reasons: 1. the phenomenon may not be evident at the time of the clinical examination, 2. proof of diagnosis is required by insurance companies when an occupational origin is suspected, and 3. to assess drug induced improvement. Most cold tests in the medical literature are either complex and expensive or unreliable for routine clinical use. We studied cold induced post-ischemic reactive hyperemia in 14 patients with Raynaud's disease and in 15 healthy controls. The hand was immersed in a stirred water bath at 13 degrees C, and ischemia was induced by placing an inflatable tourniquet around a finger for five minutes. Afterwards the tourniquet was deflated while the hand remained in the cold water bath. The temperature of the finger with the deflated tourniquet was compared with that of an adjacent finger serving as control. Hyperemia was the increase in differential temperature between these two fingers after tourniquet release minus the difference in temperature existing before deflating the tourniquet. With a normal lower limit of 0.7 degrees C for hyperemia, 13 of the 14 patients with Raynaud's phenomenon were abnormal (93% sensitivity), and 14 of the 15 controls were normal (93% specificity). All these 14 controls were also normal at a second examination done to assess test reproducibility. A false positive healthy control was still positive at the second examination. This new, simple and inexpensive cold test can reliably diagnose Raynaud's phenomenon. Further studies are necessary to establish its reliability in monitoring the effectiveness of treatment in prospective trials. PMID- 3504360 TI - Brachial artery entrapment: compression by the supracondylar process. AB - Ischemia occurring during hyperextension of the upper limb in a 25-year-old woman led to the discovery of a supracondylar spur responsible for compression of the brachial artery with anomalous insertion of the pronator teres muscle. Resection of all abnormal structures provided immediate relief of symptoms. When atypical arterial symptoms of thoracic outlet syndrome occur in the upper limb, the brachial artery entrapment syndrome should be considered. PMID- 3504361 TI - Rupture of retroperitoneal hydatid cyst into the abdominal aorta. AB - We report the case of a retroperitoneal hydatid cyst ruptured into the infrarenal abdominal aorta. Initial treatment consisted of marsupialization of the cyst with patch angioplasty of the aorta. Formation of a false aneurysm led to reoperation for placement of an aortobifemoral bypass, but the patient died postoperatively. In spite of the exceptional character of this location, diagnosis should be suggested routinely in endemic areas when a retroperitoneal mass is discovered. Treatment should be either in situ prosthetic replacement or extra-anatomic exclusion bypass. PMID- 3504362 TI - Abdominal and thoracic coarctation of the aorta with bilateral renal artery stenosis. AB - A case of a young patient with mild coarctation of the thoracic and abdominal aorta associated with bilateral renal arterial stenosis is reported. The only clinical finding was hypertension. Surgical treatment with bilateral aortorenal venous bypass was successful. PMID- 3504364 TI - Chronic myeloid leukemia. PMID- 3504363 TI - Surgical approach to the superior mesenteric artery by the Kocher Maneuver: anatomy study and clinical applications. AB - The Kocher maneuver allows approaching the origin of the superior mesenteric artery. This affords adequate exposure for procedures such as embolectomy or mesenteric arterial reimplantation into the aorta. Because of its simplicity, this technique may be better than the classical interpancreaticoduodenal or splenopancreatic methods. The results of 11 cadaveric dissections and two surgical operations for mesenteric ischemia using this technique are reported. PMID- 3504365 TI - The Ontario Provincial Dental Health Index. PMID- 3504366 TI - Periodontal index of treatment needs--Simcoe Survey. PMID- 3504367 TI - A periodontal index for dental health screening. PMID- 3504368 TI - The National School of Dental Therapy: satellite teaching field clinics report. PMID- 3504369 TI - A mandatory preventive dentistry program. PMID- 3504370 TI - The Nain T.H.E.T.A. Programme. A peer group dental education programme. PMID- 3504371 TI - Oral health status of the elderly in Northern Economies. PMID- 3504372 TI - A calorimetric study on the interaction of phenol derivatives with phospholipid liposomes as a model for biological membranes. PMID- 3504373 TI - Wear test of composite restorative materials by a polishing machine. PMID- 3504374 TI - Cemented pins: the in vitro relationship between retention and retentive area. PMID- 3504375 TI - Thermal expansion of dental casting alloys and phosphate-bonded investments. PMID- 3504376 TI - Amalgam corrosion determined by dissolution of component elements and microstructural changes. PMID- 3504377 TI - Abrasion-resistance of dental base resin treated with surface smoothing agent. PMID- 3504378 TI - Composite type adhesive opaque resin. PMID- 3504379 TI - Evaluation of the EVA-MMA-TBB-O adhesive composite material for root canal sealer. PMID- 3504380 TI - Structurally stable burst and synchronized firing in human amygdala neurons: auto and cross-correlation analyses in temporal lobe epilepsy. AB - Burst structure and synchronized firing of bursts were studied, in the interictal period, using auto- and cross-correlation analyses in human amygdala neurons in temporal lobe epilepsy patients diagnosed as having a unilateral limbic seizure focus in anterior hippocampus and/or amygdala. Satisfactory single unit recordings were obtained from chronically implanted microelectrodes in 51 amygdala neurons, and auto-correlation analysis identified 27 of 51 neurons where burst firings recurred with regular interspike interval structures (structurally stable burst: S-burst). This structural stability was characteristic only for a short burst, or at the beginning of a series of repetitive firings, involving 2-5 action potentials. In 'non-epileptic' amygdala neurons located contralateral to the seizure focus, the average duration of S-burst was 15 msec and the number of action potentials (spikes) in the S-burst was inversely related to the interspike intervals in the S-burst, suggesting that endogenous membrane characteristics of non-epileptic amygdala neurons determine the patterns of S-burst. In contrast, in the seizure focus amygdala ('epileptic'), the duration of the S-burst was prolonged among epileptic neurons, not because of the occurrence of more action potentials within the S-burst, but because of a prolonged interspike interval within the S-burst. Furthermore, there was no relationship between the interspike interval and the number of action potentials in the S-burst, suggesting that synaptic inputs and/or extracellular environmental factors may affect an intrinsic mechanism for generating stable S-burst in epileptic neurons. Cross correlation analysis identified synchronized firings in epileptic neurons: when two epileptic neurons both exhibited S-bursts, when either epileptic neuron exhibited S-burst, but never when neither exhibited S-bursts. Conversely, non epileptic neurons rarely fired synchronously; even though they showed S-bursts. The difference in the pattern of S-bursts between epileptic and non-epileptic amygdala neurons seems to be the degree of firing synchrony. Our results provide, for the first time, direct evidence that human epileptogenic amygdala neurons recorded in vivo have unique burst firing patterns and significant synchronous excitatory interactions, different from a burst pattern found in non epileptogenic amygdala neurons during the interictal period. PMID- 3504381 TI - Differential effect of ethosuximide and of electrical stimulation on inhibitory and excitatory mechanisms. AB - Much longer trains of conditioning stimuli are required to elicit inhibition descending from the reticular formation than to elicit segmental inhibition in the trigeminal nucleus. In contrast, a single conditioning stimulus is the most effective in eliciting descending facilitation, while the test stimulus alone is most effective in eliciting segmental excitation. Ethosuximide (ESM) selectively depresses descending inhibition and to a lesser extent segmental inhibition. Thus, ESM only depresses pathways requiring repetitive stimulation, such as inhibitory pathways in the reticular formation. This action would account for ESM's specificity for absence seizures, which are probably due to paroxysmal activity in inhibitory pathways. PMID- 3504382 TI - Reduced uptake and release of 5-hydroxytryptamine and taurine in the cerebral cortex of epileptic El mice. AB - Inbred mutant El mice are highly susceptible to convulsive seizures upon 'throwing' stimulation, and the inhibition of 5-hydroxytryptamine (5-HT) and taurine activities appears to be involved in the El mouse seizures. Uptake and release of [3H]5-HT and [3H]taurine into and from cerebral neurocortical slices using a superfusion system were investigated in both non-stimulated and stimulated El mice [El(-), El(+)] and in ddY mice, which do not have a convulsive disposition. Release was defined as 40 mM K+-stimulated release. 5-HT and taurine uptake in El(+) was lower than El(-) but no difference in either uptake was found between ddY and El(-). Release of 5-HT and taurine in El(-) was higher than in ddY whereas their release in El(+) was lower than in El(-). The taurine level in the cerebral neocortex of El(-) and El(+) was higher than in ddY. These results suggest that the synaptic function of the 5-HT and taurine containing neurons is suppressed and that dysfunction of these inhibitory neurons is involved in the seizure susceptibility in the El mice. PMID- 3504383 TI - Distribution of Calbindin-D28K 1 (CaBP) in the cerebral cortex and hippocampus of the epileptic (El) mouse. AB - The distribution of Calbindin-D28K (CaBP), a calcium-binding protein that binds Ca2+ with high affinity, was measured by radioimmunoassay in various cortical regions of the epileptic strain of mice El. The El strain, in which seizures are induced by repeated vestibular stimulation, had significantly lower levels of CaBP in the hippocampus and dorsal occipital cortical areas than the control CF-1 strain. Following induction of seizures in the El strain, a further decrease in CaBP levels was observed in the hippocampal formation and ventral temporal cortical regions, areas where paroxysmal activity is generated in this strain. Considering the role of CaBP as an intraneuronal calcium buffer, the present findings indicate that neuronal calcium regulation is genetically altered in the El strain and is further disturbed during the events that lead to induction of seizures. PMID- 3504384 TI - Use of unbound drug concentrations to determine neonatal anticonvulsant exposure. AB - Unbound and total concentrations of several anticonvulsant drugs were measured by liquid chromatography in maternal and neonatal cord serum collected at birth from 16 women being treated for epilepsy and their newborns. Maternal and neonatal unbound drug concentrations agreed closely for phenobarbital (n = 6), phenytoin (n = 7), carbamazepine (n = 8), and its epoxide metabolite. Mean maternal total drug concentrations were higher than neonatal concentrations in the cases of phenobarbital, carbamazepine, its epoxide and diol metabolites. The differences were due to greater protein binding in maternal serum. Measurement of total anticonvulsant concentrations in newborns may be misleading, because of altered protein binding in the neonate. For the medications tested, neonatal and maternal exposures to unbound drug appear to be equivalent. PMID- 3504385 TI - Vigabatrin: no microvacuoles in a human brain. AB - Vigabatrin (gamma-vinyl-GABA) has been shown to be an effective antiepileptic drug. However, clinical investigations have been hampered by the finding of intramyelin edema (microvacuoles) in rats and dogs. In an autopsy study of a 38 year-old woman with astrocytoma, treated with vigabatrin 80 mg/kg body weight per day for over 6 months and 125 mg/kg body weight per day for the last 2 months as add-on therapy because of drug-resistant epilepsy, we did not find any microvacuoles in the brain. So far microvacuoles have never been observed in primates, warranting continued investigations of this promising antiepileptic drug. PMID- 3504386 TI - Anticonvulsant effects of GABA elevation in the deep prepiriform cortex. AB - Microinjection of gamma-vinyl GABA (GVG), a GABA elevating agent, into a discrete region of the deep prepiriform cortex elevated local GABA levels nearly 4-fold and exerted an anticonvulsant action against seizures induced by intravenous injection of the GABA antagonist, bicuculline, but was ineffective against seizures induced by maximal electroshock. This, together with a previous finding that blockade of GABA transmission in the deep prepiriform cortex induces convulsions, suggests that this area may be crucial, if not primarily responsible, for the genesis of clonic seizures resulting from a deficit in GABA function. PMID- 3504387 TI - Endogenous opioids and post-ictal increase in seizure threshold in Mongolian gerbils. AB - In gerbils, the convulsive thresholds both for electroconvulsions and for pentetrazole-induced convulsions were increased when determined 15 min after a convulsion elicited by an air blast to the back of the animals. Contrary to a recently offered hypothesis, this sign of post-ictal depression could not be reversed by pretreatment with the morphine antagonists naloxone and naltrexone. This result speaks against a mediation of post-ictal depression by endogenous opioids. PMID- 3504388 TI - The anticonvulsant action of AHR-11748 on kindled amygdaloid seizures in rats. AB - The anticonvulsant effectiveness of AHR-11748 (3-[3-(trifluoromethyl)phenoxy]-1 azetidinecarboxamide) was evaluated in the kindled amygdaloid seizure model in rats. Doses of AHR-11748 that did not cause prestimulation toxicity significantly attenuated elicited afterdischarge durations and the severity of the accompanying behavioral convulsive response in previously kindled rats. AHR-11748 (25-100 mg/kg i.p.) was evaluated at 30 min in previously kindled rats using both threshold (20 microA increments) and suprathreshold (400 microA) paradigms. AHR 11748 (50-100.mg/kg) reduced suprathreshold elicited after discharges and seizure severity. Utilizing a suprathreshold kindling paradigm, the maximum anticonvulsant effectiveness for the 100 mg/kg i.p. dose of AHR-11748 was seen at 180 min. AHR-11748 significantly elevated seizure thresholds only at the 100 mg/kg dose. AHR-11748 (25-100 mg/kg) significantly reduced the severity of threshold elicited seizures. When AHR-11748 (50 and 100 mg/kg i.p.) was administered daily during kindling acquisition, the number of daily trials necessary to complete kindling significantly increased. A reduction in both the duration and the severity of the responses induced by the daily stimulations during the acquisition period was seen with AHR-11748 treatment. This study has demonstrated that AHR-11748 significantly modifies both the acquisition of kindling and the fully kindled amygdaloid seizures at doses that do not cause behavioral toxicity. PMID- 3504389 TI - Synaptosomal high-affinity noradrenaline uptake does not differ between mice susceptible (DBA/2J) and resistant (C57 BL/6) to audiogenic seizures. AB - Abnormalities in noradrenaline-mediated neurotransmission have been advocated as a basis of the age-related susceptibility of DBA/2J mice to generalised convulsions induced by auditory stimulation. We have measured the kinetics of synaptosomal high-affinity noradrenaline uptake in 5 brain regions of DBA/2J mice at ages before, during and after their maximal susceptibility to audiogenic seizures, and age-matched C57 BL/6 mice, a strain resistant to audiogenic seizures at all ages. No differences were found between the two strains of mice in any of the brain regions studied. Abnormalities of high-affinity noradrenaline uptake do not contribute to audiogenic seizure susceptibility of DBA/2J mice. PMID- 3504390 TI - Pregnancy decreases the frequency of spontaneous recurrent seizures in rats with kainic acid lesions of the hippocampus. AB - Spontaneous recurrent seizures (SRSs) were observed in female rats following the injection of kainic acid into the dorsal hippocampus. Pregnancy and nursing decreased the frequency of SRSs in such animals. The finding of a protective effect of pregnancy and lactation in this animal model of temporal lobe epilepsy stresses the usefulness of this model. PMID- 3504391 TI - An epidemiologic study of febrile seizures and epilepsy in children. AB - Prevalence and annual incidence rates of febrile seizures and types of epilepsy were investigated in all children of the Altenburg district (German Democratic Republic) being 0-14 years old. The mean total population for the period 1982 through 1985 was 108,905. The proportion of children aged 0-14 years was 20,132. The average annual incidence of febrile seizures in children being 0-5 years old was 240.8/100,000. For children between 0 and 14 years the rate of epilepsy 51.1/100,000. Based on 87 epileptic patients, the exact point prevalence rate per 1000 on December 31, 1985, was 4.4. PMID- 3504392 TI - Disappearance of neonatal seizures and low CSF GABA levels after treatment with vitamin B6. AB - In an infant with neonatal seizures, CSF GABA levels were determined before and after treatment with vitamin B6. Before onset of treatment, the level of GABA in CSF was very low (13 pmol/ml). Injection of vitamin B6 blocked the seizures immediately. When GABA level in CSF was again analysed after continued treatment with vitamin B6, a value of 127 pmol/ml was determined, which is within the normal concentration range in children. The data substantiate previous findings in brain tissue from a patient with vitamin B6-dependent seizures, and strongly indicate that impairment of central GABAergic activity was the cause of the seizures. PMID- 3504393 TI - Deep prepiriform cortex kindling and amygdala interactions. AB - The deep prepiriform cortex (DPC) has been recently suggested to be a crucial epileptogenic site in the rat brain. We investigated the susceptibility of the DPC to the development of electrical kindling as compared to that of the superficial prepiriform cortex (SPC) and amygdala as well as the transfer interactions between the two prepiriform sites and amygdala. Adult rats with electrodes implanted in the right prepiriform cortex (DPC or SPC) and left amygdala were divided into a DPC-amygdala and SPC-amygdala group while a third group consisted of rats with electrodes implanted in the ipsilateral DPC and amygdala. Within each group the rats were initially kindled from one site selected randomly and then rekindled from the other site. Both DPC and SPC were as sensitive to the development of kindling as the amygdala. The behavioral seizures elicited with DPC or SPC primary kindling were identical to those induced by amygdala kindling. Initial DPC kindling facilitated the development of kindling from either ipsilateral or contralateral amygdala with the ipsilateral transfer being significantly more potent than the contralateral. SPC kindling also facilitated the development of contralateral amygdala kindling but was less effective than DPC kindling. On the other hand, amygdala kindling did not facilitate contralateral SPC or DPC kindling although it transferred to the ipsilateral DPC. These results indicate that the prepiriform cortex can be readily kindled but not faster than the amygdala and that there are unequal kindling transfer interactions between prepiriform cortex and amygdala. PMID- 3504394 TI - Mutual interactions between repeated flurothyl convulsions and electrical kindling. AB - The interactions between repeated flurothyl seizures and electrical kindling induced from the neocortex or the amygdala were investigated. Three consecutive flurothyl-induced convulsions enhanced the rate of development of subsequent electrical kindling from the neocortex. Similarly multiple (more than 15) generalized kindled seizures, induced from either the neocortex or the amygdala, reduced the latency of onset of flurothyl seizures with repeated exposures producing a 'kindling-like' effect for flurothyl. These results indicate that eventually seizures will beget seizures independently of the site of origination of the seizures. PMID- 3504395 TI - Distribution of diphenylhydantoin in the brain during experimental status epilepticus of the cat. AB - The distribution of diphenylhydantoin (PHT) (40 mg/kg i.p.) in the brain was investigated in cats with convulsive generalized (group 1) and focal penicillin induced status epilepticus (group 2), and in controls. A significant increase in the amount of PHT entering the brain during the convulsive status was found, with peak brain levels at 45 min (12 +/- 3.2 micrograms/g vs. 6.0 +/- 0.8 in normal cats, P less than 0.05). In the focal status brain concentrations of PHT reached levels intermediate between controls and group 1 cats. At 15 min, elevated blood levels of the drug were paralleled by increased concentrations in the brain, whereas at 30 and 45 min other factors, such as changes in cerebral blood flow, cerebral pH, vascular resistance, metabolic derangement and blood-brain barrier disruption were presumably responsible for the altered brain PHT uptake. The relevance of these data to clinical practice is discussed, in relation to the treatment of human status epilepticus and the potentially neurotoxic effects of the drug. PMID- 3504396 TI - Hemisphere memory of concrete and abstract information determined with the intracarotid Sodium Amytal test. AB - An extended version of the bilateral intracarotid Sodium Amytal test was administered pre-operatively to 13 patients with intractable complex partial epileptic seizures, to determine cerebral hemisphere speech and memory. There were 6 patients with left temporal lobe lesions and 7 patients with right temporal lobe lesions. Amobarbital (175 mg, 10%), injected on 2 occasions, determined the left hemisphere to be speech dominant in all cases. Memory assessed with recall, cued recall, and recognition of concrete/abstract words and pictures, was studied on 3 occasions: in a baseline test considered to indicate the degree of patient cooperation and the bilateral hemisphere memory; in a right hemisphere Amytal test; and in a left hemisphere Amytal test. The specific data pattern obtained, that abstract pictorial information is most efficiently processed by an intact right hemisphere and that verbal information is processed best by an intact left hemisphere, demonstrates the reliability of the approach taken here to present abstract and concrete to be remembered information. PMID- 3504397 TI - Lamotrigine: single-dose pharmacokinetics and initial 1 week experience in refractory epilepsy. AB - Twenty-three residential patients on chronic antiepileptic drugs (AEDs) were entered into an open study of 4 weeks duration. Baseline variables and seizure frequency were determined in the first week. All patients received a single dose of lamotrigine in the second week to determine single-dose pharmacokinetic parameters. Twenty patients then received daily or twice daily lamotrigine for a week. Post-treatment seizure frequency was observed for a further week. Patients taking liver enzyme inducing antiepileptic drugs showed a mean lamotrigine plasma elimination half-life (T1/2) of 14 h (+/- 7) (T1/2 of normal volunteers = 24 h) and those taking sodium valproate and an inducing AED showed a mean lamotrigine T1/2 of 30 h (+/- 10). The plasma concentrations of co-administered sodium valproate, phenytoin, carbamazepine, phenobarbitone and primidone were not altered by 1 week lamotrigine dosing. There was a significant reduction in complex partial seizures in the treatment week compared with baseline. Some patients showed a marked increase in seizure frequency on stopping lamotrigine. There was an increase in reports of drowsiness during lamotrigine administration, but there were no clinically significant changes in any safety measure. PMID- 3504398 TI - Amygdalar kindling is associated with elevated zinc concentration in the cortex and hippocampus of rats. AB - The reported convulsant properties of zinc and its association with hippocampal function prompted investigation of zinc levels during the induction and maintenance of kindling. Rats were fed zinc adequate diets during kindling, incited by daily amygdalar stimulation. The concentration of zinc in hippocampus was unperturbed during 3 stages of kindling induction when compared to either naive, sham surgery, or electroshock controls. In contrast, cortical zinc increased during kindling induction but returned to control levels in fully kindled animals. Two weeks after full kindling was established, the concentration of zinc in the hippocampus and overlying cortex increased significantly, in the absence of further electrical stimulation. The effect was restricted to the central nervous system inasmuch as zinc levels were unaffected in liver and other extracerebral tissues. Moreover, the zinc concentration was relatively unchanged during the 24 h period following a single electroconvulsive seizure, implying that the observed changes were not simply a postictal phenomenon. The results of this study suggest that long-lasting elevations in zinc are present after kindling is established. Whether this finding is related to the perpetuation of abnormal neuronal excitability or represents a compensatory response remains to be elucidated. PMID- 3504399 TI - Effects of aminophylline and enprofylline on the protective activity of phenobarbital against amygdala-kindled seizures in rats. AB - Two xanthine derivatives, aminophylline and enprofylline, were tested on the protective activity of phenobarbital, 20 mg/kg i.p. (60 min before the test) against amygdala-kindled seizures in female rats. Enprofylline, 27.8 mg/kg i.p. (0.143 mmol/kg) 30 min, and aminophylline, 10 mg/kg i.p. (0.043 mmol/kg) 30 min, did not modify any kindling parameter. Aminophylline, 30 mg/kg (0.143 mmol of theophylline/kg), considerably increased seizure and afterdischarge durations. Aminophylline, 30 mg/kg, abolished the effect of phenobarbital (20 mg/kg) upon these seizure parameters. Both values reached the level observed in animals treated with aminophylline alone. Aminophylline, 10 mg/kg, only moderately increased afterdischarge duration in phenobarbital (20 mg/kg)-treated group. Enprofylline, 27.8 mg/kg, was devoid of any action upon the protection offered by phenobarbital in this model of epilepsy. PMID- 3504400 TI - Interactions of epileptiform EEG discharges and cognition. AB - Interactions of subclinical epileptiform EEG discharges and cognitive functioning were studied in 91 patients with epilepsy, under video monitoring, to exclude overt clinical ictal phenomena during the investigations. A short-term memory test was presented as an engaging television game, in two versions, using spatial, or verbal material. Transitory cognitive impairment (TCI) was demonstrated during EEG discharges, either generalised or focal, in half the patients. Right-sided discharges were associated with impairment of the spatial task and left-sided with errors on the verbal version. TCI was demonstrable only when the discharge occurred during presentation of the material to be recalled. Increasing task difficulty, up to the patients' limit of performance, was associated with increasing susceptibility to TCI. Sixteen patients showed a significant effect of task on discharge rate, but in some this increased during the stimulus and in others while responding. There are thus complex interactions of epileptiform EEG activity on cognitive function and vice versa. PMID- 3504401 TI - Lennox-gastaut syndrome with and without Dandy-Walker malformation. AB - The authors present two siblings suffering from Lennox-Gastaut syndrome. One of them also had the Dandy-Walker malformation. His seizures were difficult to control with anticonvulsant drugs, and somnolence and cerebellar ataxia easily occurred during administration of low dose anticonvulsants. On the other hand, his brother did not have this malformation, and his seizures were easily controlled. The relationship of seizure control to the Dandy-Walker malformation is discussed. PMID- 3504402 TI - Induction of seizures by air blast in gerbils: stimulus duration/effect relationship. AB - In air blast-induced seizures in gerbils, there is a relationship between the duration of the air blast and the incidence of 'major' convulsions. An ET50 of 9.6 sec was determined in untreated controls; pretreatment with anticonvulsant drugs shifted the stimulus/effect curve to the right. This 'stimulus summation' phenomenon makes a clearly defined challenge necessary when drug effects are to be evaluated. PMID- 3504403 TI - Clinical and EEG prediction of seizure recurrence following antiepileptic drug withdrawal. AB - A prospective study is reported of antiepileptic drug withdrawal in 62 neurologically intact adult patients who had become seizure-free at least 3 years previously. No single clinical or laboratory finding was reliably predictive of outcome and in particular the presence of epileptiform EEG activity prior to AED withdrawal or appearance of such activity during withdrawal was not associated with relapse. A multivariate model was however developed which suggested that patients capable of remaining seizure-free without medication could be reliably identified at a much reduced cost of relapses in the remainder. PMID- 3504404 TI - Comparison of oxcarbazepine and carbamazepine: a double-blind study. AB - The antiepileptic efficacy and side-effects of oxcarbazepine (OXC), a new carbamazepine derivate, were evaluated in a double-blind study. Forty ambulatory epileptics with unsatisfactory seizure control or unwanted effects due to phenytoin monotherapy were changed to OXC or carbamazepine (CBZ) and were then followed for 48-50 weeks. Thirty-four of the patients completed the study. The seizure frequencies on the trial drugs were not significantly different and the antiepileptic efficacy of OXC was comparable to CBZ. The incidence of side effects during the initiation phase was lower with OXC suggesting better tolerability of OXC compared to CBZ. PMID- 3504405 TI - Symptomatology and prognosis in adolescent epilepsies (a study of 1033 cases). AB - A follow-up study was carried out on a group of 1033 epilepsy patients seen consecutively between 1955 and 1979. They were all aged between 11 and 19 years at the time of first seizure. Nine hundred and twelve patients were followed up for periods of 5-30 years. The aims of the study were (1) to test the practical applicability of the International Classification of Epilepsy and Epileptic Syndromes, and (2) to examine its prognostic value. The International Classification fitted this group of epileptic patients rather well. The prognosis of adolescent epilepsy varies with the particular syndrome, the probability of being in remission after 10 years ranging from 30 to 67%. PMID- 3504406 TI - Effects of flunarizine on Metrazol-induced seizures in developing rats. AB - Antimetrazol action of flunarizine (5, 10, 20 and 40 mg/kg i.p.) was tested during ontogenesis on male Wistar rats aged 7, 12, 18, 25 and 90 days. The latencies and incidences of jerks, minimal Metrazol seizures and major Metrazol seizures remained unchanged by flunarizine in all age groups. A specific action (an abolition of the tonic phase of major seizures) was seen throughout the development and was reflected in lower scores of seizures. PMID- 3504407 TI - Alterations in neurotransmitter amino acids in hippocampal kindled seizures. AB - Rats were rapidly kindled with electrical stimuli to the hippocampus, and the concentrations of GABA and related amino acids were measured in several brain regions, both in the baseline kindled state and during active seizures. In the baseline kindled state, a consistent pattern was found throughout the hippocampus where GABA levels were depressed and glutamate and glutamine levels were elevated. During seizures GABA rose slightly while glutamate and glutamine increased to twice control values. These changes were seen to various degrees in other brain areas. Turnover in the GABA-glutamate-glutamine cycle was measured in kindled rats experiencing seizures and compared to control animals. During seizures there was an increased turnover of the excitatory compounds glutamate and aspartate relative to GABA. The data indicate that kindling produces a change of presynaptic GABA metabolism which results in diminished inhibition. PMID- 3504408 TI - GABA and amino acid concentrations in lumbar CSF in patients with treated and untreated epilepsy. AB - Lumbar free CSF GABA and amino acid concentrations were measured in 43 patients with newly diagnosed untreated epilepsy and 26 patients with chronic drug resistant epilepsy. The results were compared with those from 51 control patients. No differences in free CSF GABA concentration could be detected between patients with epilepsy, either treated or untreated, and controls. Untreated patients with primary generalised epilepsy and partial seizures had similar free CSF GABA concentrations. These results would not support the hypothesis that patients with epilepsy have a global disturbance of GABA function. CSF taurine, asparagine, aspartate, glycine and alanine were significantly reduced in patients with epilepsy compared to the control population. PMID- 3504409 TI - Adverse behavioral response to clonazepam as a function of Verbal IQ-Performance IQ discrepancy. AB - Eight of 38 consecutive patients who received clonazepam had significant behavioral side effects. In these 8 patients, the mean absolute IQ discordance between Verbal IQ (VIQ) and Performance IQ (PIQ) was 17.5 points. Thirty of 38 patients had no adverse behavioral side effects while receiving clonazepam. In these 30 patients, the mean absolute VIQ-PIQ discrepancy was 6.5 points. Full neuropsychological testing had been performed on all patients. The only test variable showing a statistically significant difference was the absolute discrepancy between VIQ and PIQ (P less than 0.0001). PMID- 3504410 TI - Rates of antiepileptic drug reduction in active epilepsy--current practice. AB - We have surveyed the rates at which clinicians in the U.K. and Eire withdraw antiepileptic drugs (AEDs) in patients with active epilepsy. Practice differed widely and there was a lack of consensus regarding the rates employed. Inpatient reductions were 2-4 times faster than outpatient reductions. AED reductions tended to be slower if reduction was from 2 to 1, than 4 to 3, agents; and in patients with adverse risk factors. In general, non-sedating AEDs were not reduced more quickly than was phenobarbitone. PMID- 3504411 TI - [Fungal infections in patients with ARC with or without AIDS. Evaluation of the chemosensitivity of the isolated strains]. PMID- 3504412 TI - Rationale and experimental data in support of the use of a fixed-triple combination of isoniazid, rifampicin and pyrazinamide in the chemotherapy of tuberculosis. PMID- 3504413 TI - [Changes in monocyte chemotaxis in patients with primary lung neoplasia]. PMID- 3504414 TI - [Use of sulbactam/ampicillin in the treatment of infections at various sites]. PMID- 3504415 TI - [Clinical and pharmacokinetic study of ciprofloxacin at the level of the respiratory system]. PMID- 3504416 TI - [Chronic bronchitis and immunomodulating therapy]. PMID- 3504417 TI - [Effect of clofoctol on various parameters of phagocyte function]. PMID- 3504418 TI - Sexual dimorphism in the cranium of infant and juvenile organutans. AB - The present study examines sexual dimorphism in the cranium of the immature orangutan. A series of 37 craniometric dimensions were measured on 56 immature crania. The total sample was divided into two subsamples: infants and juveniles. Univariate statistics and an analysis of variance were prepared for each subsample. Results indicate that the males and females in both subsamples are significantly different (p less than or equal to 0.05) for two measures of skull length. Eight additional dimensions from the infant category also appear to differ significantly (p less than or equal to 0.05) between the sexes. PMID- 3504419 TI - Hand abnormalities in pygmy chimpanzees (Pan paniscus). AB - Hand deformities in 2 wild-born pygmy chimpanzees were investigated through dissection, linear measurements, bone mineral analysis and X-rays. Weight of tissue (skin, muscle, bone) was determined for each body segment (hand, forearm, upper arm), permitting comparison between the abnormal and normal upper limbs. In one individual, the right and left forearms and hands differed in tissue weights and bone mineral content. In the other, the hands differed in tissue composition, but not the forearms. PMID- 3504420 TI - Habitat use by squirrel monkeys (Saimiri oerstedi) in Costa Rica. AB - This paper analyses movement patterns, habitat preferences, activity schedules, and dispersion of troop members in squirrel monkeys (Saimiri oerstedi) in relation to seasonal changes in food abundance in a Costa Rican tropical wet forest. Secondary forest was the preferred habitat and use of primary forest and late successional forest was limited primarily to seasons when food availability was low. Range area differed between seasons, varying from 79 to 110 ha, and totaling 176 ha over 11 months. The number of hectares used, hourly rate of group movement, and proportion of time spent foraging each season were all negatively related to relative food abundance. There was a tendency to spend less time in foraging activities in the middle of the day and to spend more time exclusively in travel at dawn and dusk. In all seasons dispersion was least when the troop was travelling and it was generally greatest during seasons of low food abundance. Measures of the allocation of time by the troop to food-related activities and the extent of troop dispersion each season were consistent with estimates based on behavior sampling of individuals. PMID- 3504421 TI - Evolution of immunoglobulin allotypes and phylogeny of apes. AB - Serum samples from 72 Pan troglodytes, 5 Pan paniscus, 22 Gorilla gorilla, 23 Pongo pygmaeus abelii, 5 Pongo pygmaeus pygmaeus, 2 hybrids P.p. abelii X P.p. pygmaeus and 13 Hylobates lar were tested for Gm(1, 2, 3, 5, 6, 10, 11, 13, 14, 15, 16, 17, 21, 24, 28), Km(1) and Bm(1, 2, 3, 4, 5, 6, 7, 8) immunoglobulin allotypes by the classical hemagglutination inhibition method. The distribution of the various alleles and phenotypes makes it possible to distinguish each species or subspecies. Common chimpanzees have the richest polymorphism. Pygmy chimpanzees share common phenotypes with gorillas. Bornean and Sumatran orangutans have their own patterns of polymorphism, as do gibbons. Our principal component plot and dendrogram are compatible with the traditional classification of Hominoidea [e.g. Simpson, Bull. Am. Mus. nat. Hist. 85: 1-350, 1945] in 3 families: Hominidae, Pongidae and Hylobatidae. PMID- 3504422 TI - Generational bias in mating in captive groups of rhesus monkeys (Macaca mulatta). PMID- 3504423 TI - [Diagnosis of periodontal disease in 1987]. PMID- 3504424 TI - [Microscopy in daily practice]. PMID- 3504425 TI - [Use of antimicrobials in the treatment of periodontal disease in 1987]. PMID- 3504426 TI - [The place of antibiotics in periodontics]. PMID- 3504427 TI - [The role of subgingival irrigation in daily periodontics]. PMID- 3504428 TI - Childhood T-cell malignancy resembling adult T-cell leukemia/lymphoma. AB - We describe two childhood cases of a T-cell malignancy indistinguishable from nonendemic, idiopathic adult T-cell leukemia/lymphoma. The cases illustrate the heterogeneity of nonendemic, idiopathic ATLL, including the presence of mediastinal masses and more heterogeneous immunologic markers than endemic cases, and represent the two youngest cases of ATLL yet described. The differential diagnosis of nonendemic, idiopathic ATLL is discussed. PMID- 3504429 TI - Comparison of the usefulness of bone marrow sections and smears in diagnosis of multiple myeloma. AB - Pretreatment bone marrow specimens from 273 patients with multiple myeloma (MM) and 148 patients with nonmyelomatous plasmacytosis were studied retrospectively to evaluate the usefulness of bone marrow sections and smears in establishing the diagnosis of MM. The combined findings in the sections and smears confirmed the clinical impression of MM in 83% of myeloma patients: in 59%, both sections and smears were diagnostic; in 17% the smears were diagnostic, the sections nondiagnostic; in 7% the sections, but not the smears, were diagnostic. In the remaining 17% of myeloma patients, both the sections and the smears failed to confirm the clinical impression of MM. Of the 148 patients with nonmyelomatous plasmacytosis, a pathologic over-diagnosis of MM was made in 2 patients. Reasons for these discrepancies, and problems relating to the validity of the current diagnostic criteria for MM are discussed. It is concluded that both bone marrow sections and smears should be examined when attempting the diagnose MM since either, by themselves, may not be diagnostic. Recommendations are made that immunoperoxidase staining methods be used in difficult cases, and that the marrow findings be correlated with clinical, laboratory, and radiologic findings prior to establishing the diagnosis of MM. PMID- 3504430 TI - Phenotypic expression of cells of stationary elements in human lymphoid tissues. A histochemical and immunohistochemical study. AB - The stationary elements of lymphoid tissues are composed of four types of cells: histiocytes, interdigitating reticulum cells, follicular dendritic cells, and fibroblastic reticulum cells. The phenotypes of these cells were determined with a large panel of monocyte/histiocyte, C3 receptor monoclonal antibodies, and others. Based on the monocyte-marker expression, histiocytes can be separated into two groups: (1) free histiocytes (monocyte-marker positive) and (2) fixed histiocytes (monocyte-marker negative). The former are characterized by the expression of monocyte markers, such as OK M1, Co Mo2, BRL Mol/Mo2, and Leu M3, whereas the latter are not. Interdigitating reticulum cells are localized in the T-cell zone. These cells are characterized by the expression of 1E9, 2H9, and Leu M1. Interdigitating reticulum cells and fixed histiocytes are similar in terms of marker expression and enzyme histochemistry. However, in interdigitating reticulum cells, the Leu M1 antigen is localized on the membrane, in contrast to histiocytes, in which it has a Golgi distribution. Follicular dendritic cells are present in germinal centers and mantle zones. These cells express complement (C3) receptors and several monocyte markers (including OK M1 and Co Mo2). Follicular dendritic cells are capable of trapping antigens onto their membranes. This unique property makes us reluctant to conclude that follicular dendritic cells are related to monocytes. Fibroblastic reticulum cells express BA-1 and alkaline phosphatase, and they form a dendritic network, especially in the T-cell zone. The results of this study demonstrate that immunoperoxidase staining with monoclonal antibodies can reveal the distribution of histiocytes and dendritic/reticulum cells in lymphoid tissues. PMID- 3504431 TI - The eosinophilic variant of acute myelomonocytic leukemia developing as a secondary leukemia in a patient with mycosis fungoides. AB - The eosinophilic variant of acute myelomonocytic leukemia (AMML) is highly associated with characteristic abnormalities of chromosome 16. Leukemias developing secondary to chemotherapy frequently show abnormalities of chromosomes 5 and 7. This report describes a secondary AMML, eosinophilic variant (M4Eo), developing in a patient with coexistent mycosis fungoides who had received chemotherapy, including an alkylating agent, and showing characteristic abnormalities of both chromosomes 7 and 16. This is the first reported case of the M4Eo arising secondarily in a patient treated for another hematopoietic malignancy, and the second case of treatment-induced M4Eo to show coexistent abnormalities of chromosomes 7 and 16. Additional cytochemical, ultrastructural, and cell surface marker findings are described supporting malignant transformation of the eosinophilic cell line. PMID- 3504433 TI - Correlative patterns of neutrophil and platelet counts during very early remission of acute myeloblastic leukemia. AB - Patterns of recovery for peripheral blood neutrophils and platelets were analyzed in 65 patients with acute myeloblastic leukemia (AML) undergoing their first course of induction chemotherapy. Specifically, for every patient linear correlation coefficients (r values) were computed for neutrophils versus platelet counts every three days from Day 12 to 27 of therapy. Correlations were designated as "significant" if r greater than or equal to 0.82 (p less than or equal to 0.05). Patients who would enter complete remission with the first course of therapy were significantly more likely to have significant neutrophil-platelet correlations in the recovery phase than patients who did not achieve remission with the first course or who would have resistant disease (76% versus 20% and 76% versus 15%, respectively, both p less than 0.001). Although these data are preliminary and retrospective they nonetheless demonstrate a trend that may prove useful for patient monitoring if proven correct by formal studies. A prospective investigation examining neutrophil and platelet correlations within a defined period of early hematologic recovery is indicated to assess if such parameters have early prognostic value for the prediction of remission in individual patients receiving induction therapy for AML. PMID- 3504432 TI - Acute myelomonocytic leukemia associated with abnormalities of chromosome 16: a light and electron microscopic study. AB - We investigated the light and ultrastructural morphology of 37 patients with acute nonlymphocytic leukemia (ANLL) and inv(16)(p13q22) or del (16)(q22) with specific emphasis on the changes in the eosinophils (EOS). All but one of the 37 patients were classified as French-American-British M4 with eosinophilia (FAB M4 E) on the basis of the monocytoid nature of the leukemic cells and the presence of large EOS with interspersed basophilic-staining granules. A median of 92% of the blasts were peroxidase positive, and Auer rods were found in 71% of cases. Only 27% of the cases had sufficient alpha-naphthyl butyrate positivity to confirm the diagnosis of FAB M4, but electron microscopy demonstrated a sufficient monocytic component to support this classification in all cases examined. Electron microscopy also demonstrated nuclear blebs both in the blasts and notably, in the EOS of all cases examined (16 of 16). Nuclear blebs in EOS were found in only 1 of 13 cases of ANLL that showed eosinophilia but lacked abnormalities of chromosome 16. This case was also classified as FAB M4-E. The finding of nuclear blebs in EOS in FAB M4-E suggests that the EOS may be derived from the malignant clone in this leukemia. These blebs are also of diagnostic in value classifying a leukemia as FAB M4-E. PMID- 3504434 TI - Evaluation of red cell volume distribution width (RDW). AB - The purpose of this study was to evaluate red cell distribution width (RDW) in the differential diagnosis of patients with well defined iron deficiency (ID), anemia of chronic disease (ACD), and thalassemia trait. Mean RDW in 100 "normals" was 13.1%. Elevated RDW (greater than 15.0%) was observed in 90% of ID (N = 39), 32% of ACD(N = 79), 66% of beta-thalassemia trait (N = 100), 53% of alpha thalassemia trait men (N = 127), 34% of alpha-thalassemia trait women (N = 116), 3% of sickle cell trait (N = 101), and 88% of sickling disorders (N = 32). The Bessman classification by mean corpuscular volume and RDW was of limited value in separating ID from thalassemia trait but was improved by adopting 16.0% as the upper limit of normal for RDW. Although many attempts have been made to discriminate between ID and thalassemia trait on the basis of red cell values from a cell counter, none (including RDW) is sufficiently specific or sensitive to obviate the need for confirmation of the diagnosis by standard laboratory methods. PMID- 3504435 TI - Acute myeloid leukemia and other myelopathic disorders following treatment with alkylating agents. AB - Several large cohorts of patients treated with alkylating agents served as a means to review the clinical and pathologic features of 55 cases of myelopathic disorders that resulted. The incidence was 1.8% overall and consisted of five patients (9.9%) who developed bone marrow hypoplasia or aplasia, 15 (27.2%) who developed a myelodysplastic syndrome, and 35 cases of acute myeloid leukemia (62.9%). The median time to recognition of MPD was 14 months, following cessation of chemotherapy. The distribution of the treatment-related MDS cases was different than "de novo" MDS with a high percentage of RAEB-T, and with the treatment related AMLs, there were a higher percentage of patients with FAB M6 (erythroleukemia), and no cases of FAB M3 (hypergranular promyelocytic). The median survival of all patients was very brief. PMID- 3504436 TI - Karyotype is prognostically more important than the FAB system's distinction between myelodysplastic syndrome and acute myelogenous leukemia. AB - Patients with myelodysplastic syndrome (MDS) and patients with acute myelogenous leukemia (AML) share certain specific karyotypes. Therefore, we compared the relative importance of karyotype and morphology (MDS vs. AML) in determining survival in these patients. We analyzed 768 patients with a banded karyotype who presented as either MDS or AML. Patients with "unfavorable" karyotypes had similarly short survivals regardless of whether they were classified as refractory anemia with excess blasts (RAEB), refractory anemia with excess blasts in transformation (RAEBT), or AML. Patients with diploid karyotypes survived significantly longer, again with relatively minor differences between patients with RAEB, RAEBT, and AML. We conclude that classification of patients with excess myeloblasts in the marrow might more appropriately be based on cytogenetics than on the distinction between MDS and AML. PMID- 3504438 TI - New challenges from infectious diseases. PMID- 3504437 TI - Chronic myeloproliferative diseases with an elevated platelet count (in excess of 1,000,000/microliter): a clinicopathological study on 46 patients with special emphasis on primary (essential) thrombocythemia. AB - A clinicopathological study was performed on 46 patients with chronic myeloproliferative diseases (CMPD) showing a thrombocythemia in excess of 1,000 x 10(9)/liter. When applying rigid diagnostic criteria only 23 patients were compatible with the initially suspected diagnosis of primary thrombocythemia (PTH). Comparison of PTH with the other entities of CMPD (CGL, 10, AMM, 6, and polycythemia, 7 cases) revealed a sustained elevation of the platelet count observable over a period of 2 to 8 years, no marked leukocytosis or abnormalities of the differential blood count, and a normal score of the leukocyte alkaline phosphatase. Episodes of hemorrhage and thrombosis as well as neurological symptoms (paresthesias, dizziness, headache), were encountered frequently as clinical manifestations in PTH. Survival time in PTH was significantly longer than in CGL with accompanying thrombocythemia. In a consecutively biopsied population of patients with CMPD, incidence of PTH was about 8%. In PTH the characteristic histopathology of the bone marrow consisted of an isolated (monolinear) proliferation of the megakaryocytes (density 127 +/- 47/mm2) without gross abnormalities of this cell lineage or a conspicuous increase in neutrophilic granulo- or erythrocytopoiesis. These lesions are significantly different from the morphological findings in the other CMPD with extreme thrombocytosis. PMID- 3504439 TI - Pseudomonas infections associated with hot tubs and other environments. AB - Infections due to Pseudomonas aeruginosa are not confined to the hospital intensive care unit. This paper examines the association of P. aeruginosa and several community-acquired infections. Hot tub folliculitis is a recently described disorder occurring in outbreaks among persons who unknowingly immerse themselves in contaminated whirlpools, spas, or swimming pools. The green nail syndrome and other dermatoses are also reviewed. Infective endocarditis, invasive external otitis, and puncture would osteomyelitis are serious infections that carry high risks for the patient and challenge the physician's most potent therapies. PMID- 3504440 TI - Use of sputter coating to prepare whole mounts of cytoskeletons for transmission and high-resolution scanning and scanning transmission electron microscopy. AB - This paper describes the use of sputter coating to prepare detergent-extracted cytoskeletons for observation by scanning (SEM), scanning transmission (STEM), inverted contrast STEM, and transmission (TEM) electron microscopy. Sputtered coats of 1-2 nm of platinum or tungsten provide both an adequate secondary electron signal for SEM and good contrast for STEM and TEM. At the same time, the grain size of the coating is sufficiently fine to be just at (platinum) or below (tungsten) the limit of resolution for SEM and STEM. In TEM, the granular structure of platinum coats is resolved, and platinum decoration artifacts are observed on the surface of structures. The platinum is deposited as small islands with a periodic distribution that may reveal information about the underlying molecular structure. This method produces samples that are similar in appearance to replicas prepared by low-angle rotary shadowing with platinum and carbon. However, the sputter-coating method is easier to use; more widely available to investigators; and compatible with SEM, STEM, and TEM. It may also be combined with immunogold and other labeling methods. While TEM provides the highest resolution images of sputter-coated cytoskeletons, it also damages the specimens owing to heating in the beam. In SEM and STEM cytoskeletons are stable and the resolution is adequate to resolve individual microfilaments. The best single method for visualizing cytoskeletons is inverted contrast STEM, which images both the metal-coated cytoskeletal structures and electron-dense material within the nucleus and cytoplasm as white against a dark background. STEM and TEM were both suitable for visualizing colloidal gold particles in immunolabeled samples. PMID- 3504441 TI - Transmission electron microscopy studies of plasma-etched silicon nitride/silicon carbide composites. AB - Transmission electron microscopy has been used to isolate and examine the intergranular glass phase in hot-pressed silicon nitride/silicon carbide composites. Previously there have been difficulties in locating a suitable region for studies of this nature because the interfering nitride and carbide grains inhibit isolation of the glass for examination. Radiofrequency plasma etching of thinned sections of 6 wt% Y2O3, 2 wt% A12O3 in Si3N4 containing 30 vol% of SiC proved to be fruitful in isolating the glass phase. A mixture of CF4 and O2 quantitatively remove the acicular nitride phase without any evidence of attack on either the glass or carbide. Composites containing ceria and magnesia as substitutes for yttria behave similarly. This indicates that glasses containing minor to major concentrations of elements forming stable fluorides inhibit the attack of fluoride ions on silica glasses containing these elements. PMID- 3504442 TI - Quantitative ultrastructural approach to the study of the spatial relationships among cell organelles. I. Cytological organization of human exocrine epithelia. AB - Currently available morphometric methods provide useful information on the three dimensional properties (such as volume, surface, etc.) of biological structures. These methods, however, do not reveal how the same structures are spatially organized within the cell. A sum of problems, which concern mainly the definition of shape and location of the sectioned structures, does not allow the three dimensional representation of the organelle arrangement from a quantitative analysis of sections. Following a different approach, this study considers the topographic relationship between ten distinct subcellular structures: nucleus, Golgi, ribosomes, mitochondria, lysosomes, lipid droplets, secretory granules, and apical, lateral, and basal plasmalemma. The analysis of associations from 2 X 2 tables calculated for each pair of structures and the pattern of multiple associations obtained by clustering methods provide a useful description of the spatial relationship among different cell compartments. The results of the investigation carried out in parallel on seven human exocrine glands (pancreas, parotid gland, submandibular gland, lacrimal gland, ceruminous gland, ampulla of the vas deferens, and seminal vesicle) allow an immediate evaluation of the method and a comparative analysis of the cytologic organization of secreting cells of human exocrine glands. PMID- 3504443 TI - Effects of the coherence of illumination on electron microdiffraction pattern intensities. AB - Microdiffraction is capable of revealing the local structure within an area of the specimen consisting of only a few, or a few tens of, unit cells. However, the extent to which the diffraction pattern intensities can show the local structure depends strongly on the coherence of the illumination. If the coherence width of the illumination is smaller than the diameter of the electron probe at the specimen level, the details within the diffraction spots, which indicate deviations of the local structure from the periodicity of the crystal, will be lost. The differences in the amount of spot splitting observed in microdiffraction patterns from out-of-phase domain boundaries, observed with two instruments, are attributed to differences in the effective source sizes. PMID- 3504444 TI - New cryoultramicrotome with a feedback-advance system. AB - Cryoultramicrotomy is gaining in significance and use as technical improvements are made. In comparison with epoxy resin procedures, cryopreparations are more rapid; there is only a negligible loss of material and thus antigenicity is well preserved. The present work contains some newly developed details for the exact determination of the advancement of the sample in the direction of the knife in a microtome. It is a software-controlled ultramicrotome advance drive system with feedback regulation as well as repeatedly patented devices for advancement sensors. PMID- 3504445 TI - A computer program for morphometry of circular and elliptical profiles on the microscope. AB - We describe a short computer program, which is written in Pascal language, to measure the diameter of circular and elliptical profiles in sections. Coordinate pairs on the microscope stage, corresponding to two or three points of a profile, are input to obtain its diameter. The program enables one to take measurements directly on the microscope, thereby reducing photographic work and caliper measurement. While the program is largely designed for electron microscopy, it also may be useful for light microscopy morphometry. PMID- 3504446 TI - A microcomputer program for the generation of random grid squares in quantitative analysis. AB - Subjectivity in selecting random grid squares for routine quantitative analysis can be circumvented through a combination of finder grids and a computer program. The simple BASIC program described in this paper generates a list of random grid square numbers, which are sequentially analyzed. The concept was applied in the quantitation of asbestos and other microparticles in environmental samples. The use of finder grids and this program can also be useful in quality-control programs and in cross-referencing analyses, as well as in the study of biological specimens. PMID- 3504447 TI - Data acquisition system for maximum-likelihood analysis of electron microscopic autoradiographs. AB - EMAMAP is a program for the data acquisition phase of maximum-likelihood analysis of electron microscope autoradiographs. This program is written in C and has been implemented on a Masscomp MC-500 which supports a graphics processor and a digitizing tablet. The image analysis is automated at a low level: the program operator outlines the edges of the structures of interest using the digitizing tablet, while contiguous regions formed by closed contours are automatically filled by the software. The resulting image is compressed for efficient storage by a quadtree encoding technique for which data compression ratios of greater than 25:1 have been achieved. In practical terms, this implies that the data from a typical experiment of 50 autoradiographs could be stored on a single floppy disk. The system is currently in use for acquiring actual biological experimental data. PMID- 3504449 TI - Chromatin organization in detergent-lysed chicken erythrocyte nuclei. AB - A method for electron microscopic demonstration of supranucleosomal (20-30 nm chromatin) fiber loops was developed. Chicken erythrocytes were treated with varying concentrations of detergents, such as Joy, sodium N-lauroyl sarcosinate, and sodium laurylsulfate, and then fixed with a formalin solution. The fixed cells were centrifuged onto an electron microscope grid, followed by staining and metal shadowing. Thin-sectioned specimens of the fixed cells were prepared routinely. Although supranucleosomal fiber loops could be observed when any one of these detergents was used, Joy gave the best result. Electron micrographs of rotary-shadowed specimens of erythrocyte ghosts formed by treatment with a low concentration (0.07-0.11 w/w%) of Joy showed a halolike, radial arrangement of supranucleosomal fiber loops around the ghost cells. The width of the halo was about 3 micron. By increasing the detergent concentration (approximately 8% Joy), nucleosome fibers and naked DNA appeared and increased in number, indicating that the supranucleosomal fibers were disassembled by the action of the detergent. Thin-sectioned specimens of cells treated with 0.09% Joy showed granulofibrillar chromatin radially dispersed from the nuclear cage. The fibers were thought to be identical with the supranucleosomal fibers observed in the rotary-shadowed specimens. PMID- 3504448 TI - Electron microscopic visualization of fatty acids in tissues. AB - Long-chain fatty acids are amphipathic molecules with important structural and metabolic functions in tissues. Fatty acids are derived from triacylglycerol-rich particles in capillaries (chylomicrons and very-low-density lipoproteins) and from triacylglycerol stored in cells (lipid droplets) by the hydrolytic activity of tissue lipases. The identification and localization of fatty acids in tissues has been considered difficult to obtain by using conventional ultrastructural techniques. However, structural findings from our studies on fatty acid transport in tissue became interpretable due to the use of many overlapping techniques. We present here these ultrastructural techniques developed to study fatty acids in tissues and review data which demonstrate lipase activity and fatty acid production from triacylglycerol in aldehyde-fixed tissue. Accumulations of fatty acid in tissue are present as lamellar structures with periodicity of 40-50 A in sections of resin-embedded tissue and as hydrated myelin figures in freeze fracture replicas of unfixed and fixed tissue. Finally, a new method, using the ionization properties of fatty acids combined with freeze fracture, locates these amphipathic molecules to leaflets of membrane bilayers. PMID- 3504450 TI - Two improvements of Polaron quick freezing slammer. PMID- 3504451 TI - Birthday honors. PMID- 3504452 TI - Addiction in pregnancy: high risk intrapartum management and outcome. AB - Drug-dependent women (DDW) have an increased incidence of medical and obstetrical complications; however, little information exists on the intrapartum course and management of these patients. Within the context of Family Center, a study was undertaken to determine if the DDW had normal patterns of labor and if standard intrapartum management is appropriate. The study population included 336 women of which 112 were DDW (72 per cent receiving methadone maintenance). The comparison group of 224 non drug dependent women was matched for gravidity, parity, and socioeconomic background. The incidence of premature delivery, abruptio placentae, breech presentation, and intrauterine growth retardation were significantly greater in the DDW. The average duration of the first, second, and third stages of labor compared well with the normal course of labor and matched the results of the comparison group. Labor abnormalities and cesarean sections were of no greater incidence, but there were more than twice as many forceps deliveries which coincides with the 40 per cent increased use of epidural anesthesia. Analgesia and anesthesia were in excess of that which is given to the average patient. There were three stillborns, one neonatal death, and one maternal death. Apgar scores and the incidence of fetal distress and meconium staining were identical in both groups. Postpartum complications were more common in the DDW, but most were secondary to the use of subclavian intravenous lines inserted due to the presence of sclerotic veins. These data suggest that high risk prenatal management and careful monitoring in the intra- and postpartum periods utilizing epidural anesthesia identifies and usually prevents untoward complications in DDW. PMID- 3504453 TI - Total anomalous pulmonary venous return: report of a case diagnosed on ECMO. AB - After repeated echocardiographic assessment and cardiology consultation, a 2,750 g, 36 weeks' gestation neonate with esophageal atresia, tracheo-esophageal fistula, and pneumonia thought to be complicated by persistent pulmonary hypertension was placed on extracorporeal membrane oxygenation (ECMO). While on ECMO, pre-oxygenator and umbilical artery blood gas patterns suggested the diagnosis of total anomalous pulmonary venous return which was subsequently confirmed by cardiac catheterization. PMID- 3504454 TI - Cervical ripening and labor outcome with preinduction intracervical prostaglandin E2 (Prepidil) gel. AB - Delivery with an unfavorable cervix using oxytocin is frequently unsuccessful. Used widely in Europe and increasingly in this country, locally applied prostaglandin E2 appears to improve labor induction. The present study prospectively evaluated the efficacy and safety of a prostaglandin gel (0.5 mg) placed intracervically. The use of the gel, when compared to a control group who received no pretreatment prior to labor induction, resulted in improved Bishop scores (7.5 +/- 1.0 vs. 1.8 +/- 0.3, P less than 0.0001), reduced induction to delivery intervals (10.1 +/- 2.1 vs. 20.6 +/- 2.0 hours), reduced oxytocin infusion duration (10.0 +/- 2.1 vs. 20.0 +/- 2.3 hours. P less than 0.0001) resulting in a lower cesarean delivery rate, 26 vs. 47 per cent (P greater than 0.05). Thirty-two per cent of patients receiving the prostaglandin gel labored and delivered within 12 hours and required no oxytocin. In addition, the use of prostaglandin E2 gel appeared safe in that no patient experienced an untoward reaction. Two cases of uterine hyperstimulation occurred that required uterine tocolysis but were not associated with fetal distress. The use of prostaglandin gel appears to be a safe and effective method to improve cervical inducibility in patients undergoing induction for a variety of maternal and fetal indications. PMID- 3504455 TI - Factors involved in the decline of the developmental quotient in the very low birth weight infant during the first two years. AB - The developmental status of 62 infants with birth weights less than 1,501 g was evaluated at nine or 12 months and at two years of age corrected for prematurity. The mean developmental scores were 99.8 at the first examination and 84.4 at the second, a significant drop (P less than 0.0001). Half of the infants (Group 1) dropped less than 16 points (mean score from 97.1 to 91.3) and half of the infants (Group 2) dropped less than 15 points (mean score from 102.8 to 76.9). The incidence of small for gestational age infants was overrepresented in Group 2. A multivariate analysis revealed that a group of factors including maternal hypertension and diabetes, gestational age, birth weight, and resuscitation at birth correctly classified 87 per cent of the infants into the two groups. The influence of this cluster of medical factors on developmental decline of the very low birth weight infant deserves further consideration. PMID- 3504456 TI - Resolution of oliguria in a pre-eclamptic after treatment with magnesium sulfate. AB - Oliguria is shown to resolve repeatedly in a woman with severe pre-eclampsia after two successive infusions of magnesium sulfate. The hypothesized mechanisms is relaxation of renal arteriolar vasospasm. PMID- 3504457 TI - Effects of hyperoxia on entry of bilirubin and albumin into rat brain. AB - The effects of hyperoxia on the entry of bilirubin and albumin into the brain were studied in five to six-week-old male Sprague-Dawley rats. Bilirubin was infused at 20 mg/kg/hour for three hours through a carotid catheter, resulting in serum bilirubin levels of 200-220 microM at 180 minutes. Group 1 (n = 8) was normoxic at all times. Group 2 (n = 8) was given oxygen (FiO2 = 0.75 -0.80) for the last hour of the three-hour bilirubin infusion. Group 3 (n = 10) was given oxygen (FiO2 = 0.75 -0.80) for 24-27 hours prior to, as well as during the bilirubin infusion. No significant differences were found in brain bilirubin (as measured by chloroform extraction) or brain albumin (as measured by 125I-albumin uptake) between the groups. Under these experimental conditions, hyperoxia does not increase bilirubin deposition in rat brain nor does it cause opening of the blood-brain barrier as measured by albumin entry into the brain. PMID- 3504458 TI - Immediate management of the asphyxiated infant: facilitating the cardiorespiratory transition from fetus to newborn. AB - The authors discuss the possible ways of managing the asphyxiated infant by considering the respiratory circumstances of the fetus and newborn. However, they conclude that further multicenter clinical trials are required to evaluate the efficacy of the various methods of management of delayed transition in cardiorespiratory function after birth. PMID- 3504459 TI - Polemics in perinatology: highriskology. PMID- 3504460 TI - A second view on polemics in electronic fetal monitoring. PMID- 3504461 TI - A timely scenario. Ode to surrogation. PMID- 3504462 TI - Diagnostic methods for Chlamydia trachomatis disease in neonates. AB - Chlamydia trachomatis is an obligate intracellular parasite responsible for many clinical syndromes, including neonatal conjunctivitis and pneumonia. The gold standard of diagnosis has been isolation in cell culture. However, this requires days of processing. Several rapid diagnostic tests are available. Giemsa staining of conjunctival smears, enzyme immunoassay, and the fluorescein-conjugated monoclonal antibody test. Both the EIA and the FA tests show promise as ideal rapid diagnostic tests. Treatment of chlamydial conjunctivitis must focus upon the eradication of nasopharyngeal carriage as well as cure of ophthalmic symptoms. The need for nasopharyngeal eradication is underscored by the fact that it is the source for chlamydial pneumonia as well as for conjunctival re infection. Clinical studies have shown that oral erythromycin estolate or ethylsuccinate suspension 50 mg/kg/day twice-daily or four times a day for 14 to 21 days are the therapeutic regimens of choice. Neonatal ocular prophylaxis is currently under study. One per cent silver nitrate does not prevent chlamydial conjunctivitis but preliminary studies do show favorable results with topical erythromycin. Nevertheless, neither 1 per cent silver nitrate nor topical erythromycin eradicate nasopharyngeal carriage, elimination of which is necessary for the prevention of neonatal chlamydial pneumonia. PMID- 3504463 TI - Indomethacin therapy in premature infants of advanced postnatal age. AB - Indomethacin (0.3 mg/kg every eight hours IV for three doses) was administered to eight infants whose postnatal ages were eight weeks or greater and who developed patent ductus arteriosus either in the late postnatal life or in the early neonatal period but persisted. In spite of maintenance of appropriate plasma indomethacin levels, none of the infants responded with ductus closure. The present study suggests that a distinct group of infants may exist whose ductus arteriosus is prostaglandin independent and the patency of the ductus may persist. PMID- 3504464 TI - Medico-legal consultation: an expanded role of the tertiary neonatologist. AB - Between January 1982 and December 1984, the neonatologists at the University of Michigan Medical Center were asked to render 115 consultations regarding potential medical litigation. Requests for consultation were made by attorneys representing plaintiffs in 36 per cent of cases and defendants in 64 per cent (hospitals, 32 per cent, physicians, 30 per cent, private industry, 2 per cent). A review of these cases indicates frequently recurring themes, especially fetal distress, postdate pregnancies, and birth trauma among obstetrical cases, and neurologic injury, birth asphyxia, meconium aspiration, and hypoglycemia among neonatal cases. In many instances, incomplete documentation in the medical record and poor physician-patient communications were the issues leading to litigation. In 49 per cent of plaintiff cases reviewed, outcomes were felt not be related to the medical care rendered. Sixty-one per cent of defendant cases were felt to be strongly defensible; in 30 per cent of cases significant doubt as to defensibility existed. The physician practicing perinatal or neonatal medicine must be aware of the areas of vulnerability to malpractice litigation and the need for adequate documentation and patient communication. The daily activities of the tertiary neonatologist support his credentials as an expert medical witness in his specialty. PMID- 3504465 TI - Clot lysis for thrombosed central venous catheters in pediatric patients. AB - Central venous catheters (CVC) in pediatric patients provide a reliable method for administration of total parenteral nutrition and chemotherapy. Catheter thrombotic occlusion is a major complication and, until recently, the only therapeutic option was removal and surgical replacement of the catheter. Two fibrinolytic agents, streptokinase and urokinase, have been used successfully in adults to dissolve the clots. Few side effects have been reported when these agents were administered for this purpose. The Physician's Desk Reference advises against the use of such agents in the pediatric population. However, several reports of successful use of these agents in pediatric patients have been reported. They have also been infused systemically to relieve both arterial and venous thrombi. We prospectively evaluated the safety and efficacy of thrombolytic drugs in infants and children with CVCs who were receiving parenteral nutrition and/or hemodialysis. Abbokinase was used on 14 occasions to unclot silastic catheters in 10 pediatric patients. All catheters restored to patency were cleared within 50 minutes with an average clearance time of 19.3 minutes. Only one catheter could not be salvaged. Protime levels were obtained whenever possible before and after administration of the abbokinase. No significant elevations were noted after abbokinase administration. No allergic reactions or other complications occurred. Abbokinase was found to clear clotted central lines in a shorter time frame than has previously been reported in this patient population. PMID- 3504466 TI - An unusual neonatal case presentation: neonatal candidemia and meningitis. PMID- 3504467 TI - Topics in perinatal genetics. Prader Willi syndrome in a newborn infant. PMID- 3504468 TI - Pneumocardiogram casebook. Paroxysmal atrial tachycardia. PMID- 3504469 TI - Abuses of oxygen. PMID- 3504470 TI - X-ray photoelectron spectroscopic (ESCA) study on the surface of hydroxyapatite. PMID- 3504471 TI - A fine structure study on the mandibular condylar cartilage in the mouse. PMID- 3504472 TI - Enzyme-histochemical findings in Behcet's syndrome. PMID- 3504474 TI - [A study on diagnosis of stomatognathic function by analysis of chewing movements]. PMID- 3504473 TI - A serial study on the mandibular secondary cartilage and its ossification in the fetal mouse--especially on the condylar cartilaginous tissue. PMID- 3504475 TI - [Phospholipase A2 activator in carrageenin-induced granuloma of rats]. PMID- 3504476 TI - [Experimental studies on radiation injury of the salivary gland]. PMID- 3504477 TI - [Production of an anti-angiogenesis factor by cultured chondrocytes and establishment of a cell line which produces the factor]. PMID- 3504478 TI - [Relationship between differentiation and tumorigenicity in temperature-sensitive mutants of teratocarcinoma F 9 cells]. PMID- 3504479 TI - [Influences of normal human fibroblasts on growth and differentiation of human neoplastic salivary epithelial cell]. PMID- 3504480 TI - [Three-dimensional analysis of facial morphology based on Moire topography]. PMID- 3504481 TI - [Immunohistochemical studies on phosphophoryn in fetal tooth germs with a monoclonal antibody]. PMID- 3504482 TI - [Modulation of jaw movements and jaw muscle activities in human mastication]. PMID- 3504483 TI - [Experimental study on effects of (NH4)2MoO2F4 on pulp and dentin: comparing with diamine silver fluoride, acidulated fluoride-phosphate and saline solution]. PMID- 3504484 TI - [A role of trigeminal sensation in the control of jaw movements]. PMID- 3504485 TI - [Influences of 1-hydroxyethylidene-1, 1-bisphosphonate (HEBP) on dentinogenesis in rat incisor]. PMID- 3504486 TI - [Clinico-pathological study on malignant tumors of the maxillofacial region. I. Squamous cell carcinoma]. PMID- 3504487 TI - [Utilization of screening medical questionnaires in Osaka University Dental Hospital]. PMID- 3504488 TI - [Dynamic statistics of new patients in the Department of Orthodontics before and after moving of Osaka University Dental Hospital]. PMID- 3504489 TI - [Bending deformation of alveolar bone incident to orthodontic tooth movement]. PMID- 3504490 TI - [Clinical features of oral malignant tumors--clinical false positive and false negative cases]. PMID- 3504491 TI - [Impacted third molar in the coronoid process: report of two cases]. PMID- 3504492 TI - p-Nitrophenetole deethylase activity of rat liver microsomes entrapped in polyelectrolyte capsules. AB - Liver microsomes from phenobarbital induced rats are entrapped in capsules prepared from polyelectrolytes. A comparative analysis of the deethylase activity against p-nitrophenetole by encapsulated and freely suspended microsomes is carried out. The pH optimum occurs at about 7.2 for encapsulated as well as free microsomes. The pH activity profile of encapsulated microsomes, however, is strongly flattened. The maximal velocity of entrapped microsomes is about a quarter of that of free microsomes. The Michaelis-Menten constants are virtually equal. Despite of the lowered activity of encapsulated microsomes this kind of immobilization of enzymes may be useful in biotechnology and medicine because mild immobilization conditions like room temperatures and aqueous solutions are realized. PMID- 3504493 TI - Preparation of microcapsules from complex coacervation of Gantrez-gelatin. I. Development of the technique. AB - Trials to induce complex coacervation between two grades Gantrez-AN polymer (G AN), and Type A gelatin were made. Physical parameters influencing the coacervation process were studied. Maximum coacervation was attained when the pH of the gelatin solution was at 6.8. Increasing the molecular weight of Gantrez decreased the ratio of combination of both polymers. The ratio for optimum coacervation was 1:4 for Gantrez-AN 119-gelatin system and 2:3 for Gantrez-AN 149 gelatin system with total colloid concentration of 2.5 g per cent w/v in both cases. High stirring speed gave almost spherical uniform coacervates. Recovery of the product as water-insoluble discrete units required the use of formaldehyde and isopropanol for coacervate denaturation and flocculation, respectively. PMID- 3504494 TI - Preparation of microcapsules from complex coacervation of Gantrez-gelatin. II. In vitro dissolution of nitrofurantoin microcapsules. AB - Nitrofurantoin crystals were encapsulated in a Gantrez-gelatin complex coacervation system. The encapsulation process was reproducible and inexpensive and the microcapsules were free flowing and directly compressible into tablets. In vitro release of nitrofurantoin from Gantrez-gelatin microcapsules was studied as a function of the core:coat ratio, the molecular weight of Gantrez and the particle size of the microcapsules. The release of the drug was significantly reduced using G149-gelatin microcapsules of core:coat ratio of 1:2. Release data were examined kinetically and were found to follow a diffusion-controlled model. In vitro release of the drug from the microcapsules filled in capsules and compressed into tablets confirmed the efficiency of the encapsulation process for preparing prolonged release formulations. PMID- 3504495 TI - Streptomycin sulphate microspheres: dissolution rate studies and release kinetics. I. AB - Targeting of drugs by microspheres, nanoparticles and liposomes is intended to increase the selective targeting to specific organs and to reduce their side effects. Streptomycin sulphate, a tuberculostatic antibiotic, is used as the active principle in this study. The aim is to accumulate the loaded microspheres in the lungs. The release of drugs associated with microsphere carriers has been found to be dependent on a number of factors. The aim of the investigation was to study the influence of the extent and nature of cross-linking, the type and the amount of the matrix material on the release characteristics of streptomycin sulphate microspheres. Human serum albumin and gelatin (Type B) were used as two different matrix materials. The crosslinking agents used were 2,3-butanedione and formaldehyde at different concentrations, and variable duration times. The in vitro release of streptomycin sulphate from microspheres is characteristically biphasic, with an initial fast release (the 'burst effect'), followed by a much slower release. Alteration in the characteristics of drug-loaded microspheres result in significant changes in the second (slow) phase of release. The release profiles of the different formulations has been studied and evaluated kinetically. PMID- 3504496 TI - Electrophoretic study of the degradation properties of poly(L-lactide) microcapsules. AB - The degree of degradation of poly(L-lactide) microcapsules was measured as a function of the time elapsed in solutions of different pH values. To determine how the distribution of poly(L-lactide) molecules in the microcapsule membrane changes during degradation, poly(L-lactide) microcapsules, at various stages of the degradation process in various solutions, were sampled and redispersed in pH 7.6 buffer solutions of different ionic strengths and their zeta potentials determined. In the early stages of the process, the zeta potential became more negative as time elapsed. Analysis of the ionic strength dependence of the surface potential on the basis of a simple model shows that hydrolytic scission of ester bonds in the polymer chains takes place preferentially at the microcapsule membrane surface creating negative charges localized at the membrane/solution interface. In the later stages of the degradation process, the zeta potential again became less negative. This suggests that liberation of degraded segments takes place in the later stages. PMID- 3504497 TI - In vivo performance of pentaestergum-coated aspirin microcapsules. PMID- 3504498 TI - Specific surface area measurement of ethyl cellulose-walled microcapsules containing theophylline. AB - The choice of microencapsulation system was limited by drug solubility and the possibility of its thermal decomposition at elevated temperatures. On the basis of the solubility study the toluene-petroleum ether system was found to be suitable. An accurate determination of specific surface area was obtained by gas adsorption. By use of the BET equation, the monolayer capacity of the microcapsules could be calculated. The results showed variations due to microcapsule size, petroleum ether fraction used in the preparation and the core to wall ratio. Dissolution from the microcapsules appeared to depend on a number of factors including the wall thickness, the amount of core material enclosed and the surface area available for diffusion. PMID- 3504499 TI - The influence of a block copolymer on the efficiency of interfacial microencapsulation. AB - Both the presence of poloxamer in concentrations from 1 to 100 per cent w/v and variation in non-aqueous phase ratio in the range 0.2 to 2.0 influence the extent to which acetanilide is incorporated into piperazine arabate microcapsules compared to acetanilide encapsulation without polymer. Low poloxamer concentrations and phase ratios nearly double the amount of acetanilide encapsulated, but high concentrations or phase ratios or both decrease the efficiency of incorporation. PMID- 3504500 TI - Effect of encapsulation of mefenamic acid with cationic Eudragit E on its bioavailability and gastric ulcerogenic activity in rabbits. AB - Encapsulation of mefenamic acid (MFA), a potent non-steroidal anti-inflammatory drug with cationic acrylic resin, Eudragit E, was carried out using a fluidized bed granulator (Glatt AG). Three drug:polymer ratios were prepared using 50 ml of 1, 2.5 and 5 per cent w/v aqueous suspension of Eudragit to coat 100 mg powdered drug. The bioavailability of the coated and uncoated drug was studied using four groups of animals, each consisting of six male rabbits (2-2.5 kg). Investigations were performed using the rabbits to examine the effects of prolonged administration of the coated and the uncoated MFA with Eudragit E(1 and 5 per cent) in a dose of 100 mg filled in hard gelatin capsules. One capsule was given daily for 30 days. Plasma levels of MFA with Eudragit E were significantly higher than those of drug only. Meanwhile, 5 per cent w/v polymer coating afforded higher drug availability than 2.5 per cent w/v which induced a higher level than 1 per cent w/v. Chronic gastric ulcers with different severities were found in the internal mucosa of all animals. In addition, there were multiple erosions in the glandular mucosa of stomachs of rabbits receiving MFA within the treatment period. IN the control group the gastric photograph was normal in every instance. Despite the extensive morphological damage at the end of treatment, the observed changes in the stomach of rabbits given coated drug is less deleterious than that treated with uncoated drug. The results of this study indicate that the coating of MFA with cationic Eudragit E increases its bioavailability and decreases the probability of ulceration.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3504501 TI - A new approach to encapsulating nonsteroidal anti-inflammatory drugs. I. Bioavailability and gastric ulcerogenic activity. AB - Different classes of nonsteroidal anti-inflammatory drugs, NSAIDs, were separately coated with cationic (E) and anionic (L) Eudragit using the fluidized bed technique. The bioavailability and ulcerogenic activity of coated and uncoated drugs were assessed in rats. The cationic coat decreased the ulcerogenic activity in all classes of NSAIDs and increased the bioavailability only in acidic and enolic ones. The anionic coat, however, increased the bioavailability in basic NSAIDs. PMID- 3504502 TI - A new approach to encapsulating nonsteroidal anti-inflammatory drugs. II. Physiochemical properties. AB - Nonsteroidal anti-inflammatory drugs, NSAIDs, were encapsulated with cationic and anionic Eudragit polymers. The properties of the microcapsules were studied. The interactions, if any, between the polymers and NSAIDs were also investigated. PMID- 3504503 TI - Microencapsulated organophosphorous insecticides. III. Some aspects on the volatilization of malathion and disulfoton from aqueous suspensions of microcapsules. AB - Comparative studies of the vaporization rate of the volatile components present in aqueous suspensions of microcapsules containing the organophosphorous insecticides S-1,2-bis (ethoxycarbonyl) ethyl-O,O-dimethyl phosphorodithioate (malathion) and O,O-diethyl S-2-ethylthioethyl phosphorodithioate (disulfoton) from inert, porous surfaces, under controlled laboratory conditions simulating natural environmental factors, were carried out. Volatilization into the atmosphere, under the given experimental conditions, was evaluated by the rate of weight loss of the microcapsule deposit and by gas chromatographic analysis of the residual insecticide on the support. PMID- 3504504 TI - Fate of different kinds of liposomes containing dexamethasone palmitate after intra-articular injection into rabbit joints. AB - The fate of oligolamellar and multilamellar vesicles containing dexamethasone palmitate after intra-articular injection into healthy rabbit joints was investigated to improve the liposome formulation in respect to better bioavailability of the effective substance within the arthritic joint. The defined negatively charged oligolamellar vesicles (dexamethasone) palmitate, egg phosphatidylcholine, phosphatidic acid, molar ratio 0.24:10.1) of a mean diameter of 0.75 micron gave better results than multilamellar vesicles (dexamethasone palmitate, dipalmitoylphosphatidylcholine, phosphatidic acid, molar ratio 0.24:10:1) used for the same purpose by several other authors. The positive charge carrier stearylamine does not induce any improvement. PMID- 3504505 TI - Preparation, characterization, therapeutic efficacy and toxicity of liposomes, containing the antitumour drug cis-dichlorodiamineplatinum(II). AB - Cis-dichlorodiamineplatinum(II) (cis-DDP) was encapsulated in reverse phase evaporation vesicles (REV, 0.6 mg cis-DDP/ml lipid solution) and multilayered liposomes (MLV, 0.3 mg cis-DDP/ml lipid solution) with different cholesterol content. The identity of cis-DDP in free and encapsulated form was checked by various techniques. Particle size, homogeneity of liposomes and distribution of cis-DDP in REVs were shown by electron microscopy. The examination of entrapped cis-DDP in REVs relating to buffer and serum stability, in vitro and in vivo antitumour activity and nephrotoxicity proved that all points are strongly influenced by the cholesterol (CH) content. Enclosed cis-DDP in phosphatidyl (PC) REV has the same, and in PC: CH-REV, a lower effect in vitro and in vivo compared to treatment with the free drug. Irrespective of the application of tumour cells and substance (i.v., i.p.) in optimal therapeutic doses, an equal increase in life-span (ILS) was registered with the free drug and with PC-cis-DDP-REV, while cis-DDP in PC: CH-REV had a significantly reduced effectiveness. Liposomal encapsulation of cis-DDP also influenced body weight change and leucocyte counts. The blood urea nitrogen (BUN) level, as an indicator of renal toxicity, was only moderately increased after very high doses of cis-DDP (24 mg/kg) in PC: CH-REV. PMID- 3504506 TI - In vitro release behaviour of theophylline from PIB-induced ethylcellulose microcapsules interpreted by simple mathematical functions. AB - Theophylline microcapsules were prepared by phase separation using polyisobutylene as a coacervation-inducing agent. The release rate was dependent on the molecular weight of the polyisobutylene used. A simple mathematical function has been used for the quantitative description of the release process of the drug from PIB-induced microcapsules. It was found that 1/y = A(1/x) + B is the best for interpreting the release process of microcapsules, since the values of the constants A and B are proportional to the amount of the drug released. PMID- 3504507 TI - Optimization of a fluid bed spray coating process using reduced factorial design. AB - A sequential approach to the optimization of a fluid bed coating process of pellets for controlled release using organic solvents and ethylcellulose has been applied using reduced factorial experiments. The optimization was started by applying a 2(4-1) experiment then, based on the results from that study, further experiments were carried out where only the variables which had the most significant effect on the film yield were used. Finally, a 2(3-1) experiment was performed. A relationship was found between the film yield and degree of agglomeration, indicating a limiting value of the film yield (75 per cent) below which only little agglomeration takes place. Above this value, the degree of agglomeration increases dramatically. The limit value was found to change only to a minor extent as a function of experimental conditions. PMID- 3504508 TI - An evaluation of albumin microcapsules prepared using a multiple emulsion technique. AB - Albumin microcapsules containing sulphadiazine were prepared using a multiple emulsion technique. Heat was utilized to denature the albumin and form the capsule shell. Albumin microcapsules prepared using this technique were free flowing, spherical in shape, and had varying degrees of vacuolation. The effects of drug: polymer ratio and concentration of cross-linking agent on the percentage of drug retained in the microcapsules and release of drug from the microcapsules were studied. Also, the effect of viscosity of the innermost oil layer, of the multiple emulsion, upon the mean diameter of the microcapsules and release of drug from the microcapsules was investigated. PMID- 3504509 TI - Polylactic acid microspheres containing quinidine base and quinidine sulphate prepared by the solvent evaporation technique. I. Methods and morphology. AB - D,1-polylactic acid (PLA) microspheres containing the antiarrhythmic drug, quinidine, were prepared by the solvent evaporation method. The drug was present as either the base or as the sulphate salt. A slight modification in the process resulted in high yields of free-flowing, non-aggregated microspheres. The successful entrapment of drug within the microspheres was highly dependent on drug solubility in the aqueous phase. Diffusion and drug loss to the aqueous phase was minimized by adjusting the pH of the aqueous phase to minimal drug solubility. Saturation of the aqueous phase with drug further improved the payload of the microspheres. The appearance of the microsphere surface depended on the pH of the aqueous phase, the electrolyte concentration, and the type and amount of drug present. Structural changes and erosion of the polymer were observed at high pH-values. PMID- 3504510 TI - Polylactic acid microspheres containing quinidine base and quinidine sulphate prepared by the solvent evaporation technique. II. Some process parameters influencing the preparation and properties of microspheres. AB - D,L-polylactic acid (PLA) microspheres containing quinidine base and quinidine sulphate were prepared by the solvent evaporation method. The present study was carried out to examine how various process parameters in the aqueous phase influenced the preparation and properties of PLA-microspheres. The amount of drug that could be incorporated into the microspheres depended primarily on the solubility of the drug in the aqueous phase and the precipitation of PLA at the droplet surface. The drug content was found to be influenced by the organic solvent: aqueous phase ratio, the temperature of the aqueous phase, and the amount of emulsifying agent. Time-dependent pH-change studies in the aqueous phase showed that polymer precipitation at the outer surface of the microspheres, and drug loss due to partitioning, occurred rapidly. A partition method for increasing the payload of drug in the microspheres was developed by incorporating drug in both the aqueous and the organic phases. Using this method, drug could be loaded into the microspheres independent of the pH of the aqueous media. The partition method circumvented the surface degradation observed with PLA microspheres prepared at high pH values of the aqueous phase. This method may prove useful for the entrapment of water-soluble drugs. PMID- 3504511 TI - Membrane formation and characterization of semi-permeable magnetic polyhexamethyleneterephthalamide microcapsules containing polyethyleneimine (PEI) for trapping carcinogens. AB - The membrane characteristics were studied of semi-permeable magnetic polyhexamethyleneterephthalamide microcapsules containing polyethyleneimine (PEI) in order to optimize their use for trapping carcinogens in vivo. The microcapsules were prepared by interfacial polymerization techniques from an aqueous mixture of hexamethylenediamine, PEI and ferrofluid EMG 705 dispersed in an organic phase containing terephthaloyl chloride and trimesoyl chloride. The resulting microcapsule membranes had a complex structure consisting of a polyamide component (70-84 per cent by weight) with chain-terminating carboxy functions and the remainder were PEI incorporated throughout the membrane having residual amine functions. Substantial variation in preparative conditions had little effect upon membrane incorporation of PEI which cross-linked the polyamide chains. However, both TEM and SEM data indicated structural differences when lower concentrations of hexamethylenediamine were used, there being a more uniform formation to give a distinct outer membrane layer (18-45 nm) visible on cross-section and appearing as a smooth outer surface. Magnetite particles appeared to be present throughout the membrane. During membrane formation, no PEI was present in the organic phase, indicating that the microcapsule membrane had formed inwards contrary to the membranes formation reported previously in other systems. The inward transfer of reactive acid chlorides into the aqueous phase resulted in a core of modified PEI. Microcapsule binding of probe substances [14C]N-methyl-N-nitrosourea and eosin varied with the microcapsule preparative conditions used, and appeared to be critically dependent upon the membrane characteristics, especially the incorporation of PEI into the membrane. Characterization of membrane formation and properties allows the optimization of microcapsule binding properties. PMID- 3504512 TI - Determination of the encapsulation efficiency in liposomes obtained by the 'extruder method'. AB - The encapsulation efficiency of carboxyfluorescein in liposomes obtained by the 'extruder method' has been determined. The encapsulating efficiency has also been related to the captured volume. The results show that the efficiency is proportional to the liposome diameter. PMID- 3504513 TI - Adriamycin-loaded niosomes: drug entrapment, stability and release. AB - The effect of encapsulation of adriamycin into niosomes, and its resultant chemical purity, was studied by means of HPLC and high-speed scanning spectrophotometry (the simultaneous use of which allowed investigation of potential non-fluorescent drug degradation products), and the process shown not to adversely affect the drug. Efficiency of entrapment of aqueous solutions of the drug was apparently dependent on neither vesicle composition nor method of production, and evidence of a degree of surfactant-adriamycin association was provided by the high entrapment values. Light-induced drug degradation was reduced by niosome encapsulation, and efflux of entrapped adriamycin was decreased by inclusion of cholesterol into the vesicles, in a manner similar to that reported for liposome preparations. Thus only chemically pure adriamycin was entrapped in, and released from, niosomes. PMID- 3504515 TI - [Mechanism of the effect of acidosis on masseter muscle calcium transport]. PMID- 3504514 TI - Application of a drug delivery system to a steroidal ophthalmic preparation with lipid microspheres. AB - The applicability of a drug delivery system to an ophthalmic preparation was examined using lipid microspheres containing hydrocortisone 17-butyrate 21 propionate (HBP). A 3H-labelled HBP ophthalmic suspension and 3H-labelled HBP lipid microspheres were applied to rabbit eyes, which were then enucleated at fixed intervals to determine the level of 3H-labelled HBP in ocular tissues. The lipid microspheres were shown to deliver the drug to the anterior ocular tissues more effectively than the ophthalmic suspension. It is suggested that a lipid microsphere ophthalmic preparation of various lipophilic drugs including steroids may be useful as a drug delivery system for ophthalmic therapy. PMID- 3504516 TI - [Androgen receptor in rat submandibular salivary gland--the role of cytosol for the salt resistant dihydrotestosterone binging site in nuclei]. PMID- 3504517 TI - [Response characteristics of tooth and head to impact of tapping]. PMID- 3504518 TI - [A stereomorphological study on vascularization in experimental extraction wounds of dog using corrosive resin cast]. PMID- 3504519 TI - [The influence of pulse current on electroforming (2nd. report)]. PMID- 3504520 TI - [SEM study of periodontal vasculature and alveolar bone following application of intrusive forces]. PMID- 3504521 TI - [A-V anastomoses in dog's tongue using corrosive resin cast with scanning electron microscope]. PMID- 3504522 TI - [Radiographic studies on third molars]. PMID- 3504523 TI - [Morphological changes of the intercalated duct cells associated with the postnatal development of the mouse submandibular gland]. PMID- 3504524 TI - [Retentive effect of potassium gluconate (K-GL) on potassium Level--mechanism of the effect of K-GL on potassium transport of rat erythrocytes]. PMID- 3504525 TI - [A study on reducing radiation dose in dental radiography for children. Part 1. The sheltering effects of lead content rubber sheet and ready-made apron]. PMID- 3504526 TI - [An approach to the planning of community health programs for dental caries in deciduous teeth at early childhood--screening through the oral conditions of children aged one and a half]. PMID- 3504527 TI - [Hemoglobin and iron content of serum: their correlation and clinical significance]. PMID- 3504528 TI - [Research on the head position during mastication]. PMID- 3504529 TI - [Electromyographic observation of before and after treatment of unilateral cross bit in child]. PMID- 3504530 TI - [Age estimation from teeth using the racemization of aspartic acid in human dentin and its practical application]. PMID- 3504531 TI - [Mechanism of the effect of potassium gluconate (K-GL) on rat erythrocyte glycolysis and potassium transport across the membrane]. PMID- 3504532 TI - [Biochemical study of diphenylhydantoin gingival hyperplasia--effect of DPH on rat gingival glycosaminoglycan synthesis from succinate-1,4-14C]. PMID- 3504533 TI - [An experimental study of the palatal mucosa reaction to a reinforced bar used as a permanent splint for cleft lip and palate patients]. PMID- 3504534 TI - [Biochemical study of diphenylhydantoin gingival hyperplasia--effect of DPH on intermolecular cross-links of rat gingival collagen]. PMID- 3504535 TI - [An attempt to measure tooth mobility in terms of time domain wave forms]. PMID- 3504536 TI - [Alteration of osteonectin synthesis incident to experimental tooth movement in rabbit alveolar bone]. PMID- 3504537 TI - [Isolation and characterization of osteonectin from rabbit alveolar bone]. PMID- 3504538 TI - [Studies for dental fluorographic imaging system (Dentalux)--fundamental characteristics in endodontic practice]. PMID- 3504539 TI - [Research on the distribution of impact on the tooth among tooth roots--a method of retention for an experimental model]. PMID- 3504540 TI - [Hepatitis B virus and epidemiological study on efficacy of HBIG for the prevention of type B hepatitis after accidental exposures among medical staff]. PMID- 3504541 TI - [A study on reducing radiation dose in dental radiography for children. Part 2. Problems of the ready-made cervical shield's thyroid gland radiation protection for the pedodontic intraoral radiography]. PMID- 3504542 TI - [Fine structures of primary cilia in the odontoblasts of the lower molar teeth of rats]. PMID- 3504544 TI - Fundamental mechanisms in development. Marco Island, Florida, December 7-11, 1986. PMID- 3504543 TI - [A specific case of over root canal filling]. PMID- 3504545 TI - Genetics of cold-adapted B/Ann Arbor/1/66 influenza virus reassortants: the acidic polymerase (PA) protein gene confers temperature sensitivity and attenuated virulence. AB - The cold-adapted B/Ann Arbor/1/66 influenza virus (ca B/AA/1/66) expresses temperature-sensitive (ts), cold-adapted (ca) and attenuation phenotypes. Reassortants which inherit one or more genes from ca B/AA/1/66 and all other genes from a virulent, wild-type influenza virus, B/Houston/1732/76, were produced and evaluated in order to identify the gene(s) responsible for the ts, ca and attenuation phenotypes. Only reassortants which inherited the PA gene from ca B/AA/1/66 expressed the ts phenotype in MDCK cells at 39 degrees C. None of the reassortants tested expressed the ca phenotype in embryonated eggs at 25 degrees C. The virulence of several reassortants was evaluated in ferrets. Inheritance of the PA gene from ca B/AA/1/66 was correlated with significant febrile attenuation and the apparent restriction of viral replication in the lower respiratory tract. Isolation of a virulent, non-ts revertant virus inheriting only the PA gene from ca B/AA/1/66 established a direct relationship between expression of the ts phenotype and attenuated virulence. Evidence for the contribution of at least one other gene from ca B/AA/1/66 to attenuation was observed. Thus, based on the methods used to determine reassortant gene compositions, these results indicate that the PA gene is primarily responsible for attenuation of ca B/AA/1/66 and its reassortants. PMID- 3504546 TI - Profiles of antibody-dependent enhancement of dengue virus type 2 infection. AB - Antibody-dependent infection enhancement (ADE) was studied with P-388D1 mouse macrophage-like cells, 21 dengue virus type 2 (DEN-2) strains, and 8 monoclonal antibodies reactive with flavivirus group-specific or dengue serotype-specific determinants. Testing a constant number of virions against serial dilutions of antibody for their ability to infect P-388D1 cells, a reproducible 'enhancement profile' was observed. The profile was characterized by (1) appearance, peak, decline, and disappearance of infection enhancement when antibody-containing ascitic fluids were diluted beyond the neutralizing endpoint, and (2) evolution over an approximate 10,000-fold dilutional range. The profiles were similar regardless of whether viruses were complexed with antibody at flavivirus group or serotype determinants, but the antibody dilution at which infection enhancement was maximal varied with the neutralization titer of the antibody. Neutralization and antibody-dependent enhancement of dengue infection appear to be biological outcomes of interactions between antibodies and single viral epitopes at different antibody: virus ratios. PMID- 3504547 TI - Post-translational regulation of Lcr plasmid-mediated peptides in pesticinogenic Yersinia pestis. AB - The low calcium response of wild type Yersinia pestis, the causative agent of bubonic plague, and of enteropathogenic Yersinia pseudotuberculosis and Yersinia enterocolitica is known to be mediated by a shared Lcr plasmid of about 70 kb. At 37 degrees C in Ca2+-deficient medium, this element promotes restriction of growth with concomitant production of virulence functions including the common V antigen and a set of yersiniae outer membrane peptides termed YOPs (Lcr+). The latter are expressed by the enteropathogenic species but not by wild type Y. pestis which possesses a unique 10 kb Pst plasmid associated with pesticinogeny (Pst+). We show in this report that, after pulse with 35S-methionine, peptides with molecular weights corresponding to YOPs of 78, 47, 45, 44, 36, and 26 kDa are synthesized during the low calcium response by both Lcr+, Pst+ and Lcr+, Pst- cells of Y. pestis. Although stable in the latter, radioactivity in YOPs of wild type was rapidly chased into lower molecular weight degradation products. At least four soluble peptides, including V, were also labeled during starvation for Ca2+; these structures were stable in both Lcr+, Pst+ and Lcr+, Pst- yersiniae. These findings suggest that a product encoded by the Pst plasmid of Y. pestis is required for post-translational regulation of outer membrane but not soluble peptides mediated by a second unrelated Lcr plasmid. PMID- 3504548 TI - Stability of the head: studies in normal subjects and in patients with labyrinthine disease, head tremor, and dystonia. AB - The dynamics of postural control of the head were investigated in normal human subjects and patients with neurological disease. The technique adopted was to measure the head movements provoked by passive, unpredictable oscillations of the trunk in the frequency range 0-6-7 Hz when subjects were required (a) to try to stabilise their head "in space" and (b) to try to make their heads move "en bloc" with the trunk. Head movement responses were characterised by the gain and phase with respect to trunk movement (transfer function) and degree of linear relationship between head and trunk (coherence). The normal transfer function approximated a cascade of two second-order, underdamped, systems representing the passive inertial, viscous, and elastic properties of the muscle and joints of the head and neck. Stabilisation of the head "in space" produced about 40% reduction in transmission of body movement, was only evident at frequencies less than 1 Hz and was affected partly by voluntary movements. An alabyrinthine patient could also achieve some spatial stabilisation. The findings indicate a weak role for vestibular-collic reflexes and emphasise that the primary control of head posture during unpredictable movement is through the tonic visco-elastic properties of neck muscles that work to stabilise the head on the shoulders. In patients with dystonia of the neck and essential and cerebellar head tremor, the head showed a tendency to unstable oscillation (resonance). The instability and dystonia could be measured in terms of visco-elastic constants and damping ratios. The head movements of some tremor patients did not linearly follow the trunk movement, showing that the motion stimulus provoked abnormal phasic muscle activity at frequencies other than those of the tremor. The technique quantifies head control in movement disorders and is sensitive to abnormal function. PMID- 3504549 TI - Familial paroxysmal dystonic choreoathetosis: a family study. AB - We interviewed and examined 12 members of a single family affected by paroxysmal dystonic choreoathetosis. Three subjects experienced characteristic painful dystonic spasms, often precipitated by cold and prolonged physical activity. Three other family members suffered painful cramping of their limbs, without involuntary movement, following physical exertion. Based on the clinical features of affected subjects, we suggest that exertional cramping may represent a "forme fruste" of paroxysmal dystonia. PMID- 3504550 TI - Parkinsonism induced by high-dose cytosine arabinoside. AB - We report a severe parkinsonian condition following high dose, parenteral cytosine arabinoside (Cytosar) that persisted for 8 weeks. The drug was used in a patient with acute myelogenous leukemia that was refractory to all other treatment. The syndrome was partially responsive to antiparkinsonian drugs and fortunately remitted completely within 12 weeks. PMID- 3504551 TI - Sudden confusion with levodopa withdrawal. PMID- 3504552 TI - Corneal and blink reflexes in Parkinson's disease with "on-off" fluctuations. AB - In 13 patients with Parkinson's disease and "on-off" fluctuations and in a control group, the electrically evoked blink (R1 and R2 component) and corneal reflexes (CR), the habituation of the glabellar reflex, and the blink rate were studied. Latency, amplitude, and recovery cycle of R1 was normal. CR latency, but not R2 latency, was significantly shorter in patients than in normal subjects. R2 recovery cycle, but not CR recovery cycle, was facilitated in "off" patients in comparison to normal subjects. CR and R2 duration was longer in "off" than in "on" patients. R2 recovery cycle became similar to that of normal subjects after fluctuation from "off" to "on" period, but CR recovery cycle varied only slightly. The habituation of the glabellar reflex and the blink rate were decreased in "off" patients. These findings indicate that the enhanced excitability of R2 is related to the central dopamine activity levels. The differences between the recovery cycles of CR and R2 may be explained with the smaller number of interneurons subserving CR than R2 circuit. The shorter latency of CR, but not of R2, both in "on" and "off" patients, may suggest that in Parkinson's disease basal ganglia exert a different control of incoming sensory input transmitted via beta and delta fibers. PMID- 3504553 TI - Localized injections of botulinum toxin for the treatment of focal dystonia and hemifacial spasm. AB - Medical treatment of dystonia usually results in an incomplete response and is frequently unsuccessful. Peripheral surgical therapy is available for some focal dystonias, but may only offer temporary relief and may have unacceptable complications. We have used local injections of botulinum toxin into the appropriate muscles for treatment of disabling focal or segmental dystonia in 93 patients with torticollis, blepharospasm, oromandibular dystonia (OMD), limb dystonia, lingual dystonia, and dystonia adductor dysphonia, in addition to four patients with hemifacial spasm. Significant relief of motor symptoms was seen in 69% of the patients with blepharospasm and 64% of patients with torticollis; 74% of the latter group with pain experience relief. Relief of symptoms was noted in most patients with OMD and limb dystonia, and all with lingual dystonia, dystonic adductor spastic dysphonia, and those with hemifacial spasm. Benefit averaged 2 1/2-3 months initially; however some patients experienced longer relief with subsequent injections. Adverse effects were transient, although 2 patients developed antibodies against the toxin, and we documented evidence for distant effects in others. This approach of chemically weakening contracting muscles in focal dystonia offers many advantages over pharmacotherapy and surgical therapy. Additional experience is needed to explore the proper doses, and potential for long term adverse effects. PMID- 3504554 TI - Computed tomographic findings in progressive supranuclear palsy: correlation with clinical grade. AB - We report clinical and computed tomography (CT) findings in 17 patients with progressive supranuclear palsy (PSP). Patients were divided into four clinical groups according to the severity of the disease and functional disability. In Grade 1, patients demonstrated minor disability and decreased anteroposterior (AP) diameter of the midbrain tegmentum was present. As the disease progressed clinically to Grade 2, more severe atrophy of the pons and midbrain and dilatation of the quadrigeminal plate cistern were noted. The most severe stages of clinical disability (Grades 3 and 4) were characterized radiologically by dilatation of the aqueduct, progressive dilatation of the third and fourth ventricles and atrophy of the temporal lobes. Cortical atrophy was variable and not a prominent radiological feature. Midbrain and pontine AP diameters were significantly smaller in PSP patients than normal patients. Serial studies showed progressive involution of the pons and midbrain and enlargement of the third ventricle. While the most obvious CT changes in PSP occur late in the disease, CT may in fact suggest the correct diagnosis long before the classic clinical picture is evident. PMID- 3504555 TI - Hereditary myoclonus and chorea: the spectrum of hereditary nonprogressive hyperkinetic movement disorders. AB - We report three members of a single family who developed a newly described combination of myoclonus and chorea in association with mild ataxia. The occurrence of this and related syndromes suggests that inherited, slowly progressive myoclonus, chorea, and dystonia, alone or in combination, should be viewed as a spectrum of hyperkinetic involuntary movements, and that each motor component may represent variable expression of the same genetic defect. PMID- 3504556 TI - Tardive myoclonus. AB - We describe a 46-year-old, schizophrenic woman with late-onset myoclonus after treatment with antipsychotic drugs. The myoclonic jerking of the neck with synchronous contractions of the face persisted after all the antipsychotic drugs had been discontinued. Tardive myoclonus has not been documented previously. PMID- 3504557 TI - Central stridor from an ependymoma. AB - Described herein is the case of one patient who presented with manifestations of an acquired obstructive hydrocephalus and hiccups. After shunting, this patient developed paroxysmal laryngeal stridor and other noises refractory to medications. At autopsy he was found to have a calcified ependymoma. PMID- 3504558 TI - Torticollis following radiation therapy. AB - A patient with adenocarcinoma in the apical portion of the lung producing a Pancoast's syndrome developed torticollis a few months after receiving a course of radiation therapy (5,040 rad) to his upper chest and neck. We describe this case, in which local radiation fibrosis of the neck muscles and perhaps segmental demyelination of the 11th cranial nerve resulted in peripheral nervous system lesion causing torticollis. PMID- 3504559 TI - What is it? Case 1, 1987: unusual tremors, bradykinesia, and cerebral lucencies. PMID- 3504560 TI - Hereditary paroxysmal ataxia. PMID- 3504561 TI - [Swim training of patients after myocardial infarct]. PMID- 3504562 TI - [The functional vertebrogram--benefits and risks]. PMID- 3504563 TI - [[Late functional-anatomic changes after surgical treatment of congenital pes equinovarus]. PMID- 3504565 TI - [The role of spas in the treatment of rheumatoid arthritis]. PMID- 3504564 TI - [Mechanical analysis of inguinal pain in kinesiotherapy of the diseased or injured hip]. PMID- 3504566 TI - [Rehabilitation of children with elbow injuries]. PMID- 3504567 TI - [Morphologic and functional sequelae of talus injury]. PMID- 3504568 TI - [Echocardiographic, phonomechanocardiographic and electrocardiographic abnormalities in patients with ankylosing spondylitis]. PMID- 3504569 TI - [Intrauterine growth retardation in rats. I. Energy metabolism during the development of the fetal liver]. PMID- 3504570 TI - [Deficit of essential elements in children of Antofagasta. Analysis by neutron activation]. PMID- 3504571 TI - [Asymptomatic carotid bruit in Chile]. PMID- 3504572 TI - [Ulcerative colitis: indications and results of surgical treatment]. PMID- 3504573 TI - [Validity of rapid biopsy as an intraoperative diagnosis of cancer at the Pathological Anatomy Service of the Hospital Salvador during 1983]. PMID- 3504574 TI - [Asymptomatic carotid artery disease]. PMID- 3504576 TI - [Conflict at the University of Chile]. PMID- 3504575 TI - [Eosinophilic granuloma of the lung]. PMID- 3504577 TI - [Characteristics of physician graduates from Chilean universities. Promotions 1978-1982. Part II. Employment and perceptions about improving, income and other relevant aspects of the professional activity]. PMID- 3504578 TI - [Reality of the emergency medical consultation (1965-1984)]. PMID- 3504579 TI - [Prevalence of fetal alcohol syndrome in foster homes of the Servicio Nacional de Menores, VIII region, Chile]. PMID- 3504580 TI - [Why the interest in osteoporosis?]. PMID- 3504581 TI - [Lumbar spine, coxofemoral and calcaneus osteoporosis: clinico-radiologic study]. PMID- 3504582 TI - [Exposure to hexachlorophene during pregnancy: effects on the development of pups from eutrophic and malnourished rats]. PMID- 3504583 TI - [Serum levels of triiodothyronine, thyroxine, thyrotropic hormone, free thyroxine and reverse triiodothyronine in patients with chronic renal insufficiency subjected to hemodialysis]. PMID- 3504584 TI - [Ovarian cysts in early pregnancy associated with the use of gonadotropins with abortive intention (2 cases)]. PMID- 3504585 TI - [Heterogenous carcinoma of the lung]. PMID- 3504586 TI - [Involvement of the central nervous system in systemic connective tissue diseases]. PMID- 3504587 TI - [The picture of the normal brain in two-dimensional echoencephalography in neonates and infants]. PMID- 3504588 TI - [Results of skin phototests in photosensitive patients and controls tested at the skin clinic in Hradci Kraalove]. PMID- 3504589 TI - [Suicide in a psychiatric facility]. PMID- 3504590 TI - [Renal osteopathy in relation to the accumulation of fluorides]. PMID- 3504591 TI - [Changes in glucose metabolism in persons dependent on alcohol]. PMID- 3504592 TI - [Volumetry of the left heart ventricle in children with congenital heart defects]. PMID- 3504593 TI - [Personal experimental experience with the administration of liquid obliterative agents using percutaneous intra-arterial balloon catheters with a controlled leak]. PMID- 3504594 TI - [Ultrastructural changes in the cells of the striated ducts of the parotid gland in rats during the secretory cycle]. PMID- 3504595 TI - [Occurrence of uremia and dialysis therapy in children in the East Bohemia Region]. PMID- 3504596 TI - [Preoperative care and treatment of acute subarachnoid hemorrhage]. PMID- 3504597 TI - [Operational diagnostic systems in psychiatry--comparison of classical and operational diagnoses in schizophrenia]. PMID- 3504598 TI - [Methods of processing clinical and laboratory results in paired sampling studies]. PMID- 3504599 TI - [Surgical treatment of obstructive icterus of malignant etiology (clinical analysis of material from the last 5 years)]. PMID- 3504600 TI - [Personal experience with high-resolution computer tomography in the diagnosis of diseases of the auditory organs]. PMID- 3504601 TI - [The present state of cytodiagnosis. Experience with cytological evaluation in a group of 50 patients]. PMID- 3504602 TI - [Photobiologic aspects of malignant melanoma (clinical studies)]. PMID- 3504603 TI - [The effect of ionizing radiation and cystamine on DNA synthesis in liver tissue in rats after partial hepatectomy]. PMID- 3504604 TI - [The effect of tetrahydroaminoacridine on the toxic effects of atropine in cells cultured in vitro. II]. PMID- 3504605 TI - [The usefulness of the results of noninvasive test data in the diagnosis of aortic valve stenosis and in monitoring its development in young people]. PMID- 3504606 TI - [Changes in specific and nonspecific immunity in children with acute lymphoblastic leukemia and in children with malignant lymphogranuloma]. PMID- 3504607 TI - [Comparison of the effects of 1st and 3d generation platinum cytostatics on the chromosomes of lymphocytes in human peripheral blood in vitro]. PMID- 3504608 TI - [Trends in mortality and the average life span of the population of Czechoslovakia 1963-1983]. PMID- 3504609 TI - [The effect of premedication with neurotropic and myotropic vasodilators on the effect of adrenaline in the isolated liver in rabbits. I. Premedication with phenoxybenzamine and papaverine]. PMID- 3504610 TI - [The effect of premedication with neurotropic and myotropic vasodilators on the effect of adrenaline in the isolated liver in rabbits. II. Premedication with phenoxybenzamine, papaverine and Palerol]. PMID- 3504611 TI - Aromatase: future perspectives. Miami, Florida, March 4-7, 1987. Proceedings: II. PMID- 3504612 TI - Concerning the pathway from 19-oxoandrost-4-ene-3,17-dione to estrone. AB - The conversion of a molecule of 19-oxoandrost-4-ene-3,17-dione [1a] to estrone [2a] by human placental aromatase requires a molecule of oxygen and of NADPH. An atom of this molecule of oxygen is incorporated into the extruded formic acid derived from C-19 of [1a]. It was proposed that the O2 is utilized for the enzymatic 2 beta-hydroxylation of [1a] and the released intermediate 2 beta hydroxy-19-oxoandrost-4-ene-3,17-dione [5a] aromatized nonenzymatically. Should [5a] be an obligatory intermediate of estrogen biosynthesis, then all the oxygen of its 2 beta-hydroxyl must be incorporated into the extruded formic acid. We have previously synthesized [2 beta-18O; 19-3H] [5c] and proved that none of its 2 beta-18O was incorporated in the formic acid extruded in the aromatization. On this basis we concluded that [5a] can not be an obligatory precursor of estrogen biosynthesis. The trapping of radioactive androst-4-ene-2 beta,3 beta,17 beta,19 tetrol in a reductively terminated incubation of a mixture of radioactive androst 4-ene-3,17-dione and [5a] with crude placental aromatase was interpreted as evidence in support of the intermediacy of [5a]. We confirmed that the tetrol can indeed be trapped in the reductively terminated incubations. However, considering that the crude placental enzyme preparation very likely contains numerous activated oxygen species capable of a variety of oxidation reactions, most of which may not be related to estrogen elaboration, and in view of our results quoted above, the origin and the eventual biosynthetic role of the parent compound of the tetrol remains to be determined. PMID- 3504613 TI - Aromatase activity in human ovarian cancer. AB - Eighty-four tumor samples from 70 women with primary ovarian cancer were assayed for cytosol estrogen (ERc) and progestin (PRc) receptor concentrations and aromatase activity. In addition, 22 of the tumors were studied for their response to the aromatase inhibitor, 4-OH-androstenedione, in a soft agar clonogenic cell assay system. Although aromatase activity was detected in almost all of the primary tumors, this enzyme was barely detectable in the majority of metastatic tumor samples. There was no significant correlation between aromatase activity and either the ERc or PRc content of the tumors, or tumor grade. Of 12 tumors grown successfully in the soft agar culture system, only 1 showed a substantial (greater than 50%) reduction in colony-forming efficiency after exposure to the aromatase inhibitor. These results suggest that local estrogen biosynthesis probably does not play an important role in the majority of epithelial ovarian tumors. However, there may be a small subset of estrogen receptor-positive tumors in which aromatase could provide a local growth stimulus. PMID- 3504614 TI - Studies on the role of catecholamines in the regulation of the developmental pattern of hypothalamic aromatase. AB - Experiments were conducted to study the regulation of the developmental pattern of aromatase in the forebrain of the perinatal rat. Two experimental designs were used: aromatase measured in primary cultures of fetal hypothalamic cells and in cell-free preparations of forebrain tissue excised at varying ages. In cultured cells, aromatase decreased logarithmically at a slow rate (t1/2 = 7.8 days). Norepinephrine caused a pronounced dose (4 x 10(-6) M) and time-dependent (2-6 days) drop in aromatase without affecting the levels of 5 alpha-reductase or substance P. In isolated tissue, aromatase activity was compared with the concentrations of norepinephrine and dopamine in the forebrain of males vs females at different perinatal ages and in discrete forebrain areas at postnatal day 4. In no case was a sex difference in catecholamines seen. An overall developmental decline in aromatase was associated with developmental increases in catecholamine levels. Acute treatment with the beta-agonist, isoproterenol, had no effect on brain aromatase activity. PMID- 3504615 TI - The importance of local synthesis of estrogen within the breast. AB - Tumor aromatase has been correlated with clinical response to treatment with aminoglutethimide in patients with estrogen receptor-positive advanced breast cancer. There was a significant positive relationship between aromatase status and likelihood of response to therapy, none of five patients with aromatase negative tumors responding compared with 11 of 18 having aromatase-positive cancers. Measurement of in vitro aromatase in sequential biopsies of large primary tumors before and during treatment with aminoglutethimide-hydrocortisone showed a marked but paradoxical rise in activity following therapy. Assays of aromatase in adipose tissue from the different quadrants of mastectomy specimens from patients with breast cancer indicate that activity was always higher in quadrants associated with tumor as compared with non-involved quadrants. These results emphasize the importance of local estrogen synthesis within the breast in terms of both the natural history and behavior of breast cancers. PMID- 3504616 TI - Conversion of androgens to estrogens in the male squirrel monkey (Saimiri sciureas). AB - Many New World primates such as the squirrel monkey have extraordinarily high plasma levels of steroid hormones including cortisol, testosterone, progesterone and vitamin D3. While plasma estrogen levels in female squirrel monkeys apparently are approximately the same as those found in other species no information is available for males. The present results indicate that the plasma levels of estrone (E1), estradiol (E2), and E1 sulfate are approximately 10-fold higher than those found in men. Comparative in vitro studies of androgen metabolism in genital skin fibroblasts indicate that squirrel monkey cells have higher aromatase and lower 5-alpha-reductase activity than human cells. Estimation of aromatase activity in vivo by a radiometric assay indicates that the high plasma estrogens are derived by peripheral conversion from testicular and/or adrenal androgens. PMID- 3504617 TI - [The importance of the recall system in the maintenance of the therapeutic results of periodontal disease]. PMID- 3504618 TI - [Histochemical study of pleomorphic adenomas of minor salivary glands]. PMID- 3504619 TI - [A case of body identification after a bomb explosion in an airplane]. PMID- 3504620 TI - [Complete denture esthetics]. PMID- 3504621 TI - [The antimicrobial chemotherapy of orofacial infections; current concepts]. PMID- 3504622 TI - [Histochemical study of the glycoproteins of the intercalary and striated ducts of human parotid gland]. PMID- 3504623 TI - [A statistical study of the faulty vertical dimension of occlusion in complete dentures]. PMID- 3504624 TI - [Radiochemical study in vitro of the change of volume of the root canal filling material Pulpispad]. PMID- 3504626 TI - [Consequences of lower first permanent molar loss and its treatment in adults]. PMID- 3504625 TI - [The effects of functional disturbances of the thyroid gland on periodontal tissues]. PMID- 3504627 TI - [Findings of an epidemiological survey for oral diseases of the population of Kiato-Vrachati Corinthias]. PMID- 3504628 TI - [Modifications on the ultrastructure of the microbes of saliva under in vitro influence of sparse solutions chlorhexidine di-gluconate (Electron microscopical study)]. PMID- 3504629 TI - [The coincidence of the roentgenographic image and macroscopical appearance of the mandibular canal of the inferior dental nerve]. PMID- 3504630 TI - [Temporomandibular joint dysfunction. Second part: Bite planes to be used at night]. PMID- 3504631 TI - [Thrombolytic treatment in the acute phase of myocardial infarct]. PMID- 3504632 TI - [Hodgkin's disease]. PMID- 3504633 TI - [Hemophilic arthropathies. Apropos of 50 cases]. PMID- 3504634 TI - [The pelvic kidney. Apropos of 18 cases]. PMID- 3504636 TI - [Quality control of the radioimmunoassay of T3, T4 and TSH]. PMID- 3504635 TI - [A discordance between urea and creatinine figures. Apropos of several patients]. PMID- 3504637 TI - [Intestinal polyparasitism in a military milieu]. PMID- 3504638 TI - [A case of malignant gastrinoma of the pancreas]. PMID- 3504639 TI - [Anomalies of the aortic arch in infants (apropos of 12 cases)]. PMID- 3504640 TI - [Ophthalmologic causes of unfitness for military service in Tunisia (apropos of 1165 cases)]. PMID- 3504642 TI - [Reconstructive surgery of bladder exstrophy (apropos of 37 cases)]. PMID- 3504641 TI - [Fetal morbidity and perinatal mortality in a trial of labor]. PMID- 3504643 TI - [Primary bone angiosarcoma (apropos of a case)]. PMID- 3504644 TI - [Coagulase-negative staphylococcal endocarditis]. PMID- 3504645 TI - [Therapeutic results of acute lymphoblastic leukemia in children in Tunisia (181 cases)]. PMID- 3504646 TI - [Viral hepatitis B (retrospective study of 158 cases)]. PMID- 3504647 TI - [Hallucinations of drinkers. An unusual complication of chronic alcoholism]. PMID- 3504648 TI - [Late complications of mesenteric malposition]. PMID- 3504649 TI - [Treatment of lymphedema of the extremities using pneumatic lymph drainage. Principles and indications]. PMID- 3504650 TI - [Endoscopic resection of urethral stricture (apropos of 49 controlled cases)]. PMID- 3504651 TI - [Percutaneous nephrostomy: an easy and reliable technic for temporary drainage of the kidney (apropos of 17 cases)]. PMID- 3504652 TI - Genetic analysis of the gene ICL1 of the yeast Yarrowia lipolytica. AB - The gene ICL1 codes for the tetrameric enzyme isocitrate lyase of Y. lipolytica. Twenty icl1- alleles have been analysed for their reversion frequency, their interallelic complementation pattern, and the position of the corresponding mutation site on the fine structure map of the gene ICL1. One intragenic temperature-sensitive revertant of the allele icl1D-39 was isolated, which expressed a thermolabile enzyme. In spite of the fact that nonsense mutations have been detected, the direction of transcription of the gene ICL1 was inferred from the localization of a linked cis-dominant regulatory mutation site. The size of the mitotic map of this gene suggests that recombination frequency in Y. lipolytica is lower than in Saccharomyces cerevisiae. PMID- 3504653 TI - [Biological bone implants of sea algae]. PMID- 3504654 TI - [Apical root canal filling with standard titanium points]. PMID- 3504655 TI - [Comparison of two dental care materials by extra- and intraoral pH measurement]. PMID- 3504656 TI - [Monitoring and emergency equipment in the dental office]. PMID- 3504657 TI - [Allergies in dental practice]. PMID- 3504658 TI - [Toothpastes--effects of zinc salts on cleansing action]. PMID- 3504659 TI - [Autogenous tooth germ grafting--clinical and experimental studies]. PMID- 3504660 TI - [Comparative hygienic and bacteriologic studies in 35 dental practices. 1. Hand disinfection and instrument care]. PMID- 3504661 TI - [Follow-up after surgical correction of mandibular prognathism]. PMID- 3504662 TI - [Reflections on implantology]. PMID- 3504663 TI - [The sapphire implant. Aluminum monocrystal]. PMID- 3504664 TI - [The role of implants in maxillofacial prosthesis]. PMID- 3504665 TI - [Surgical management of supporting areas in complete dentures]. PMID- 3504666 TI - [Implants: risks--traps--failures]. PMID- 3504667 TI - [Pre-implant radiologic survey: current technics and trends]. PMID- 3504668 TI - [Scanner survey for dental implant indications]. PMID- 3504669 TI - [Psychological examination of the implant candidate]. PMID- 3504670 TI - Ameliorating effects of early sensory stimulation on the behavior of adult rats underfed during the lactating period. PMID- 3504671 TI - Effects of metoclopramide on spontaneous and pharmacologically-induced yawning in the rat. PMID- 3504672 TI - [Sister chromatid exchange and accidental exposure to phenyl-mercury acetate]. PMID- 3504673 TI - [Hypoxia and the diffusion of rubidium 86 in the brain of the rat]. PMID- 3504674 TI - Nickel chloride and diabetes. II. Calcium, zinc, phosphorus and iron determinations in alloxan diabetic and in rats treated by nickel chloride injections. PMID- 3504675 TI - [Effect of the type of balanced diet on the growth and reproductive parameters of Wistar strain rats]. PMID- 3504676 TI - [Morphometric study of renal changes in rats subjected to hypervitaminosis A]. PMID- 3504677 TI - [Morphometric study of the reversibility of renal changes in rats subjected to hypervitaminosis A]. PMID- 3504678 TI - Spectral analysis of EEG during carotid endarterectomy. AB - Spectral analysis of the electroencephalogram (EEG) was monitored during 105 carotid endarterectomies. Seventy-eight percent of the patients showed no significant change in EEG spectral power as a result of clamping of the internal carotid artery. Two patterns of change were observed in the remaining 22% of patients: partial reduction (significant decrease of power in one or two of three frequency bands) and global reduction (significant decrease of power in all three frequency bands). High frequencies (over 10.5 Hz) changed more frequently with clamping than did low frequencies (less than 6 Hz), but reduction of high frequencies alone was tolerated with no postoperative deficits. The only non shunted patient demonstrating global EEG reduction for the duration of carotid clamping suffered a transient hemiparesis. PMID- 3504680 TI - Arterial reconstructions: fundamental questions. PMID- 3504679 TI - The short retropharyngeal route for arterial bypass across the neck. AB - Occasionally, in order to revascularize the carotid bifurcation one may need to cross the neck with a bypass that originates in the opposite subclavian or common carotid artery. This report describes a short, natural route behind the pharynx that permits using a shorter bypass as well as a direct reimplantation of one common carotid into its opposite without an intervening graft. PMID- 3504681 TI - Intraoperative autotransfusion with a new disposable system. AB - In the past 2 years we have used a simple, disposable set for intraoperative autotransfusion. The system consists of a rigid plastic case with a flexible bag inside constituting a 600 ml reservoir which can be connected to any suitable vacuum source. We used it so far in 56 patients undergoing various vascular operations who were autotransfused a total of about 160 units of blood without any complications with regard to blood coagulation or hemolysis. PMID- 3504682 TI - Giant venous aneurysm associated with hypogastric arteriovenous malformation. AB - Venous aneurysms are extremely rare. They may be congenital or acquired in origin and occasionally related to arteriovenous communications. A 58-year-old man complained of dull left lower quadrant pain and constipation. On physical examination a soft deep mass was palpated. Ultrasonogram and CT scan revealed a cystic formation in the pelvic cavity. Angiograms disclosed an arteriovenous malformation (AVM) at the pelvic floor draining into a large cavity. The patient was successfully managed by intraoperative selective embolization of the AVM and partial resection of a 10.6 x 8 x 6.7 cm venous aneurysm. The histopathologic studies of the wall confirmed a venous structure. Venous dilatation has been reported in high flow vein grafts, blood access V fistulas and rarely, proximal to traumatic AV fistulas of the lower extremities. The etiology of the present case is probably congenital, being to the best of our knowledge, the first case affecting the hypogastric territory, reported in the English literature. PMID- 3504683 TI - Penetrating atherosclerotic ulcers of the thoracic aorta: natural history and clinicopathologic correlations. AB - Clinically, penetrating atheromatous ulceration of the aortic wall may be confused with either symptomatic thoracic aneurysm or classic spontaneous aortic dissection. Aortography and computed tomographic (CT) scanning of the thoracic aorta provide specific diagnostic information which permits one to distinguish this lesion from atherosclerotic aneurysm and classic dissection. Hallmarks of findings on aortography and CT scan include the presence of the ulcer and an intramural hematoma. Since the findings may be disarmingly subtle, the potentially progressive and serious nature of this condition may remain unappreciated. Recognition of the penetrating atheromatous ulcer and distinguishing it from aortic dissection arising just distal to the origin of the left subclavian artery is mandatory. Resection of only a conservative segment of the proximal descending aorta suffices for classic dissection in the upper descending thoracic aorta, but the penetrating aortic ulcer requires graft replacement in the area of the ulcer and intramural hematoma. PMID- 3504684 TI - Transaxillary first rib resection. PMID- 3504685 TI - Transaxillary sympathectomy. PMID- 3504686 TI - Aortoiliac endarterectomy in young patients. AB - From 1976 to 1981 a total of 304 aortoiliac thromboendarterectomies (TEA) were carried out. Of these, 47 (16%) were performed in young patients: 25 cases were done through a transperitoneal and 22 through a retroperitoneal approach. All retroperitoneal operations were unilateral. All patients were smokers. Twenty seven patients had incapacitant claudication, 14 had rest pain and 6 had necrotic lesions. Patency rates at four years were 78% for transperitoneal TEA and 79% for retroperitoneal unilateral TEA. These patency rates compared favorably with those obtained using similar techniques in patients over 50 years of age. In this older group, similar 4 year patency rates were 85% and 82%, respectively. The morbidity and mortality of these approaches was analyzed in patients above and below the age of 50. Our results support the use of TEA in young patients with symptomatic advanced atherosclerosis and question the wisdom of limiting the use of TEA to localized segmental lesions of the aortoiliac segment. PMID- 3504687 TI - Supraceliac aorta-to-lower extremity arterial bypass. AB - From 1979 to 1986, ten patients had a revascularization procedure using the supraceliac portion of the aorta. Six patients had aortofemoral or aortoiliac bypasses and four others had additional procedures for revascularization of the lower extremities or of the visceral arteries. The latter included four renal, three superior mesenteric and three hepatic artery revascularizations. There were no postoperative deaths. One patient with chronic renal failure underwent temporary hemodialysis after the operation. The postoperative course was uneventful in the nine remaining patients. Postoperative arteriograms showed all visceral artery revascularizations to be patent. All patients were symptom-free at follow-up (mean 3.8 years, range 1 month to 7 years). One patient had a successful percutaneous balloon angioplasty for a late anastomotic stenosis in a renal artery. The operative technique is described and the specific indications for the technique are discussed in patients with renal and suprarenal aortic disease. PMID- 3504688 TI - Aorto-femoral bypass with polytetrafluoroethylene prostheses: preliminary results in 363 cases. AB - From October 1977 to October 1982, 363 unilateral aorto-femoral bypasses using polytetrafluoroethylene (PTFE) prostheses were performed for predominantly unilateral aorto-iliac disease. The distal anastomosis was extended into the deep femoral artery in 57% of the patients. The postoperative mortality was 0.5%. The actuarial patency rate after 6 years was 87% in patients with claudication and 77% in those with critical ischemia. No false aneurysm developed. Thrombosis of the prosthesis was due to progression of distal disease, intimal hyperplasia and postural extrinsic compression. The latter seems to be characteristic of PTFE prostheses and can be treated by thrombectomy. In 21 cases a cross-over femoro femoral bypass was done during the follow-up period because of contralateral progression of disease. PMID- 3504689 TI - Effects of isovolemic hemodilution on abdominal aortic aneurysmectomy in high risk patients. AB - Intraoperative isovolemic hemodilution might increase blood flow and tissue oxygenation in the periphery but there is concern that acute anemia may have deleterious effects on myocardium in patients with coronary artery disease. This study investigates the effects of intraoperative isovolemic hemodilution on morbidity, mortality and hemodynamics in 32 patients with significant cardiovascular disease undergoing elective abdominal aortic aneurysmectomy. The average hematocrit was lowered intraoperatively from 43% to 31% by withdrawing blood and replacing volumes with 1:3 Ringer's lactate. In ten patients myocardial function was evaluated during aortic cross-clamping and declamping in the face of hemodilution. There were two deaths: one myocardial infarction and one multiple organ failure. Aortic cross clamping did not change heart rate, vascular pressures (VP), vascular resistance (SVR), cardiac output (CO), and left ventricular stroke work (LVSW). Following declamping, VP, CO and LVSW decreased and SVR increased momentarily (p less than 0.05), but the myocardial function did not change. Isovolemic hemodilution had no apparent adverse effects on morbidity, mortality and cardiovascular performance in these patients. PMID- 3504690 TI - Arterial healing in rabbits following carbon dioxide laser endarterectomy. AB - CO2 laser open endarterectomy of small atherosclerotic vessels appears feasible. Under the conditions described, the endarterectomized arterial wall is not smooth but the thrombogenicity of the laser-treated surface is low, and the endothelial healing rapid. These advantages are to be weighed against the consequence of thermal injury, in particular, the late development of aneurysms. Before human clinical trials are made, further experimental studies are required to determine the best type of laser and optimal wave length to limit thermal injury. PMID- 3504691 TI - Short-term in vivo stability of endothelial-lined polyester elastomer and polytetrafluoroethylene grafts. AB - A fibronectin substrate will significantly enhance the strength of endothelial cell attachment on grafts constructed of polyester elastomer (PE) and polytetrafluoroethylene (e-PTFE). This experiment was undertaken to determine the short-term in vivo stability of endothelium on these fibronectin coated surfaces. Eight mongrel dogs underwent bilateral carotid artery replacement with both graft materials. All grafts were inoculated with 2,000 cells/mm2 using cultured autogenous venous endothelium labelled with Indium-111-oxine. The Indium-111 label in the grafts was measured immediately prior to implantation, after 1 hour of in vivo perfusion, and at explantation after 24 hours. The percentage of inoculated cells attached to the grafts before perfusion was similar for both materials, 93.3 +/- 3.0% versus 92.2 +/- 7.2%, for PE and e-PTFE respectively. All grafts were patent at one hour after implantation. PE grafts were found to have 93.8 +/- 3.9% of the attached cells present at one hour while e-PTFE grafts had only 54.5 +/- 10.8% remaining, p less than .001. After 24 hours, 5/8 (62.5%) e-PTFE grafts and 2/8 (25.0%) PE grafts remained patent, p = .13. Of the patent grafts however, endothelial cell retention was still superior on the PE grafts with 78.0 +/- 0.6% of the attached cells remaining compared to only 24.5 +/- 6.1% on e-PTFE, p less than .001. Occluded PE grafts had fewer cells remaining at 24 hours than patent ones, 78.0 +/- 0.6% versus 31.1 +/- 32.8%, respectively, p = .13. Histologically, patent PE grafts demonstrated nearly confluent endothelial monolayers while e-PTFE had patches of endothelial cells surrounded by a platelet fibrin carpet.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3504692 TI - Femoro-distal bypass for critical ischemia: is the use of prosthetic grafts justified? AB - The results of 240 femoro-distal bypass operations for critical ischemia have been reviewed. Autologous saphenous vein was the graft material in 112 cases (46.7%) and prosthetic grafts were used in the other 128 cases (53.3%). A distal arteriovenous shunt (AVS) was employed as an adjunct to 72 grafts (30%). The cumulative patency rate at 4 years was 53% for all of the grafts together and the cumulative limb salvage rate was 70%. When autologous saphenous vein was available the actual patency rate at one year after operation was 70% for popliteal grafts and 53% for tibial grafts. In the case of prosthetic grafts the equivalent patency rates were 51% and 35%. In view of the poor success rate of prosthetic grafts anastomosed to distal tibial vessels these procedures are of doubtful value in routine clinical practice. PMID- 3504693 TI - Neurologic complications following carotid artery surgery: pathophysiology and predictive factors. AB - This study analyzes the results of 457 carotid artery operations done in 416 patients by the same surgeon during a five-year period. A total of 27 central neurologic complications were observed, 14 were transient and 13 were permanent neurologic deficits, nine of which resulted in death. The causes of these accidents were: embolism (12), intolerance to clamping (7), carotid thrombosis (3), and reperfusion injury (2). In three cases no cause could be found. Preoperative predictive factors for these complications were analyzed statistically by multivariate analysis techniques. A high-risk group was identified, characterized by diffuse atherosclerotic disease and by the presence of a previous neurologic deficit. The prevention of neurologic complications in carotid surgery goes far beyond the controversy of whether or not a temporary inlying shunt should be used. In our opinion indications for shunting are limited. Neurologic complications can be prevented by maintaining awareness of certain temporary contraindications in patients with permanent neurologic deficits and by exacting operative techniques. PMID- 3504694 TI - Thrombolytic therapy for venous thrombosis. PMID- 3504695 TI - Patency after iliofemoral and iliocaval venous thrombectomy. AB - Between 1981 and 1984, 42 iliac venous thrombectomies were performed in 41 patients with recent iliofemoral venous thromboses. Of the 42 thromboses, 18 extended into the inferior vena cava. In 31 cases a temporary arteriovenous fistula was constructed and in 21 cases the inferior vena cava was partially interrupted. Early postoperative venography was performed in 40 of 42 thrombectomy cases. One or more late venograms were done one to four years postoperatively. None of the patients died during the hospital stay, and there were no cases of intraoperative or early postoperative pulmonary embolism. Six postoperative hematomas were evacuated. Patency of the iliac veins was maintained in 93% of cases. When performed with care venous iliac thrombectomy associated with a temporary arteriovenous fistula appears to be the appropriate treatment for iliofemoral or iliocaval thromboses less than ten days old. PMID- 3504696 TI - Magnetic resonance imaging of aneurysms and chronic dissections of the thoracic aorta. AB - Magnetic resonance imaging (MRI) was performed in 30 patients having an aneurysm or chronic dissection of the thoracic aorta. Using a magnetic field of 0.5 Tesla, multislice image acquisition was obtained by the ECG gated spin-echo imaging technique with dual-echoes. These results were retrospectively compared with those obtained in the same patients by angiography and computerized tomography (CT). In 10 cases of aneurysm, MRI measured their diameters and residual lumina and assessed the extension of the aneurysm with the same precision as CT scan and angiography. In 17 other cases, the diagnosis of chronic dissection was made by documenting an intimal flap and double channel filling of the aorta, and MRI compared favorably with CT scan. In three dissections in which the false lumen was thrombosed, MRI was unable to distinguish between dissection and partially thrombosed aneurysm. We believe MRI constitutes a useful noninvasive method for the study of aneurysms and chronic dissections of the thoracic aorta. PMID- 3504697 TI - Disseminated intravascular coagulation as a result of supraceliac clamping: implications for thoracoabdominal aneurysm repair. AB - Massive coagulopathy and bleeding continues to play a major role in the operative mortality and perioperative multi-system failure of patients requiring elective thoracoabdominal aneurysm repair. It was the purpose of this study to determine the coagulation defect that occurs with supraceliac aortic clamping and the effects of increasing aortic cross-clamp time (AXCT) on the coagulation system and its recovery. Through a standard thoracoabdominal incision, 16 mongrel dogs had their aortas cross-clamped simultaneously just above the diaphragm and at the aortic bifurcation. Animals were divided into four groups of four animals each; sham operation, 30 minute AXCT, 60 minute AXCT, and 90 minute AXCT. Central venous blood was sampled prior to aortic cross clamping (AXC), during AXC and 1 hour, 2 hours, 5 hours, 7 hours, 12 hours, and 24 hours after the clamp was removed. All samples were assayed for platelets, fibrinogen, fibrin split products, prothrombin time (PT) and partial thromboplastin time (PTT). Platelets and fibrinogen decreased as PT and PTT increased with increasing AXCT consistent with disseminated intravascular coagulation (DIC) (P less than .001). Fibrin split products were positive in the 90 minute AXCT group only. The drop in platelets was greater for increasing AXCT and continued to fall in the 30, 60 and 90 minute AXCT groups at 24 hours (p less than .001). Fibrinogen dropped to the lowest levels between two and twelve hours after AXC and returned to normal at twenty-four hours in the 60 and 90 minute AXCT groups (p less than .05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3504698 TI - Polytetrafluoroethylene bypass for revascularization of the atherosclerotic internal carotid artery: late results. AB - Between 1979 and 1986, 60 patients underwent a total of 62 revascularizations of the internal carotid artery with an expanded polytetrafluoroethylene (ePTFE) bypass. In 54 cases, the indication for surgery was the presence of extensive lesions in both the internal and common carotid arteries and, in 8 cases, a late complication of a previous surgical procedure. There were no early postoperative deaths (within 30 days). Three patients (5%) experienced postoperative neurologic complications. Two complications resolved completely whereas one left minimal residua. The bypasses remained patent in all three cases. All patients had early postoperative Doppler B-mode ultrasonography. Two early occlusions (3.2%) were disclosed but the patients remained symptom-free. Four neurologic complications were observed over long-term (average 23 months) follow-up. None were related to the operated carotid artery. There were no cases of infection or late occlusion. No hemodynamic or morphologic anomalies were observed on late follow-up ultrasound studies. These favorable results support the use of ePTFE as a reliable substitute when adequate autologous saphenous vein is not available for carotid bypass. Routine utilization might be indicated in cases of long bypasses, especially when it is necessary to implant the bypass on the ascending aorta, or when the proximal site of implantation is made on a thickened arterial wall. PMID- 3504699 TI - Rupture of abdominal aortic aneurysm into the inferior vena cava: a study of seven cases. AB - The authors report seven cases of abdominal aortic aneurysm rupturing into the inferior vena cava system. Symptoms were protean, but included local clinical manifestations and general findings due to the high-flow arteriovenous fistula. In spite of different types of clinical presentation, the correct preoperative diagnosis was made when a continuous bruit with systolic accentuation was heard over the abdomen. Venous repair consisted of simple closure of the fistula from within the aneurysm in six cases. In one case, treatment required ligation of the right common iliac vein. There were two cases of paraplegia, one before and one after the operation. Two of the seven patients died. PMID- 3504700 TI - Aortitis presenting as Buerger's disease. AB - Buerger's disease is frequently diagnosed in young smokers, based on clinical presentation rather than histologic criteria. This report describes a young male with idiopathic aortitis who had been managed for 10 years as Buerger's disease solely on the basis of clinical manifestations. This case emphasizes the need for establishing histopathologic, and perhaps biochemical, criteria to identify the underlying arteriopathy. PMID- 3504701 TI - Management of pediatric visceral arterial and aortic coarctation. AB - Two unusual pediatric vascular problems have been managed surgically. The first patient is a five-and-a half-year old girl who presented with renal artery stenosis and aneurysm and renovascular hypertension. This was treated by excision of the aneurysm and reimplantation of the right renal artery. The second patient is a two-year old girl with atresia of the abdominal aorta, superior mesenteric artery (SMA) and both renal arteries. She was treated by PTFE patch graft angioplasty of the aorta, SMA reimplantation and bilateral aorto-renal autogenous saphenous vein bypass. PMID- 3504702 TI - Computer-generated phonemic cues: an effective aid for naming in aphasia. PMID- 3504703 TI - Articulatory description and treatment of "lateral /s/" using electropalatography: a case study. PMID- 3504704 TI - Language deficits and specific reading retardation: cause or effect? PMID- 3504705 TI - Language and speech disorders in children attending a day psychiatric programme. PMID- 3504706 TI - Counselling and care of laryngectomees: a preliminary study. PMID- 3504707 TI - Psychological change and fluency therapy: a pilot project. PMID- 3504708 TI - Communication disorders in Legionnaires' disease. PMID- 3504709 TI - Stimulation of bone resorption in cultured mouse calvaria by Lys-bradykinin (kallidin), a potential mediator of bone resorption linking anaphylaxis processes to rarefying osteitis. AB - Lys-Bradykinin (kallidin) stimulated bone resorption in vitro as assessed by the release of 45Ca and 3H from mouse calvaria radiolabelled in vivo with [45Ca]CaCl2 and [3H]proline, respectively. The stimulatory effect of Lys-bradykinin was reduced by calcitonin, indicating that the bone resorptive effect of Lys bradykinin was dependent on osteoclastic activity. Different inhibitors of arachidonic acid metabolism, including glucocorticoids, inhibited Lys-bradykinin stimulated mobilization of mineral, implicating the synthesis of prostaglandins as an intermediary step. Lys-Bradykinin enhanced the biosynthesis of PGE2 in osteoblast-like cells isolated from mouse calvaria. In view of these findings and the capacity of mast cells to generate kininogenase activity, resulting in formation of Lys-bradykinin and bradykinin, the role of these cells in the pathogenesis of bone loss in rheumatoid arthritis, mastocytosis and osteoporosis is discussed. PMID- 3504710 TI - Iliac crest biopsy: an investigation on certain aspects of precision and accuracy. AB - We investigated the intraobserver and section to section variation in static and dynamic histomorphometric variables in ten iliac crest biopsies. We also did a comparative study of iliac crest and lumbar spine specimens from 14 cadavers. The ten patients had osteoporosis (spinal crush fractures) and the 14 specimens taken at the necropsies were either normal or osteopenic, without malignant bone disease, bone metastases or metabolic bone disease. The majority of the coefficients of variation (CV%) were between 5 and 15% in the intraobserver analysis and 10 and 30% in the section to section analysis. These results suggest that more sections from each biopsy should be investigated to increase the precision. The correlation of variables from the iliac crest and spine showed poor agreement between resorption and osteoid variables. This fact, combined with a rather low precision of bone dynamic variables in the section to section investigation, raises the question of whether iliac crest biopsy is representative for trabecular bone turnover in the skeleton. PMID- 3504711 TI - Intestinal calcium and phosphate transport and intestinal alkaline phosphatase. AB - The aim of the study was to investigate the link, if any, between alkaline phosphatase activity and intestinal calcium and phosphate transport using the hypophysectomized (HX) rat model. Ionic transport was evaluated by the in situ ligated loop technique. Hypophysectomy (HX) resulted in a decrease in both duodenal and jejunal alkaline phosphatase activity but did not alter the active transport of calcium and phosphate. Vitamin D depletion (-D), suppressed intestinal transport in the HX rat without altering alkaline phosphatase activity. Repletion of 1,25(OH)2D3 in the -DHX rat resulted in an increase in active transport of calcium and phosphate without altering the alkaline phosphatase activity. Thus, using the HX animal model, we were able to differentiate intestinal alkaline phosphatase activity from the overall intestinal transport of calcium and phosphate. PMID- 3504712 TI - The relationship between fluoride effects on bone histology and on bone mass in patients with postmenopausal osteoporosis. AB - Twenty-one patients with postmenopausal osteoporosis were studied for 4 years after initiation with sodium fluoride (NaF), 20-25 mg b.i.d., elemental calcium, 1.0 g/day, and vitamin D2, 50,000-100,000 I.U. weekly. Histomorphometry was carried out on bone biopsies taken prior to and while on NaF treatment. The total bone mineral mass of the central third of the skeleton was measured by neutron activation analysis at 0.5-1.0 year intervals, and the result expressed as the Calcium Bone Index (CaBI), which normalizes the mineral mass to values for normal subjects of the same size. Twelve patients (57%) who developed, within the first 2 years of treatment, histological effects of fluoride (F) (increased bone formation surfaces together with thickened osteoid seams or hyperosteoidosis) increased their CaBI significantly (P less than 0.01) over the 4 year period, from 0.64 +/- 0.02 to 0.78 +/- 0.03 (or 21.0 +/- 2.9%). No other agent is known to stimulate bone growth to this degree. The remaining nine patients showed no histological evidence of F stimulation and no increase in CaBI (from 0.67 +/- 0.03 to 0.66 +/- 0.03 over 4 years). The results suggest that the histological findings of hyperosteoidosis are prerequisite for the increases in bone mass of osteoporotic patients. Although serum and bone F levels were higher in patients with F response compared to those without response, there was considerable overlap in values between the two groups so that these parameters of F retention were not reliable for predicting F response. Histological evidence of hyperosteoidosis appears to be a more reliable predictor of subsequent increase in bone mass. The effect on fracture prevention of the hyperosteoidosis associated with the increases in bone mass remains to be shown. PMID- 3504713 TI - Effects of systemic glucocorticoids on the degradation of glycosaminoglycans in the mandibular condylar cartilage of newborn mice. AB - This investigation studied the early in vivo effects of triamcinolone hexacetonide, a potent fluorinated analogue of cortisol, on the degradation of sulfated proteoglycans in condylar cartilage of newborn mice. While determining the rate of [35S]sulfate release in test and control specimens, it became evident that in hormone-treated animals there was a dose-dependent retardation of the isotope clearance. Further, triamcinolone was found to have increased the half life of condylar glycosaminoglycans (GAGs) from 16 h in control animals to 31.4 h in hormone-treated ones. Dexamethasone, another fluorinated analogue of cortisol, and progesterone evoked a similar effect. On the other hand, hydrocortisone and cortisone induced a much milder effect, whereas the non-glucocorticoid steroid deoxycorticosterone did not affect the turnover of radiosulfate in this tissue. Clearance of the isotope from the serum was faster in the hormone-treated animals. Further, the hormone led to a decrease in the overall content of GAGs, a feature that lasted for 24 h. These data tend to imply that, concomitant with the inhibitory effects of glucocorticoids on proteoglycan synthesis in cartilage, they also induce a transient depressive effect upon the degradation of proteoglycans and thereby interfere with the normal growth and development of this cartilage. PMID- 3504714 TI - Prolonged effect of estradiol on calcitonin secretion. AB - Incubation of thyroparathyroid gland from 8-day-old rats with estradiol (10(-7) and 10(-9) M) and progesterone (10(-9) and 3 X 10(-10) M) resulted in stimulation of CT secretion. The effect of the gonadal steroids on CT secretion occurred at near physiological concentrations and persisted for at least 73 h. The studies demonstrate that exposure to gonadal steroids results in direct and prolonged stimulation of CT secretion. Therefore the decrease in bone resorption observed after the administration of gonadal steroids in vivo may at least in part be mediated via stimulation of CT secretion. PMID- 3504715 TI - Recommendations on nomenclature and standards for bone proteins and growth factors. PMID- 3504716 TI - Parathyroid hormone-degrading enzyme of high molecular weight in the cytosol of rat renal cortical cells. AB - Using unlabeled bovine parathyroid hormone (b-PTH) as the substrate, the PTH degrading activity in the 100,000 x g supernatant of rat renal cortex was examined. The PTH-degrading activity showed the highest peak at pH 7.25, along with 3 minor peaks at pH 4.5, 6.0 and 8.5. The neutral PTH-degrading activity of the 100,000 x g supernatant (pH 7.25) was eluted at V0 in Sephadex G-200 gel filtration corresponding to a high molecular weight. The neutral PTH-degrading activity was inhibited by ATP and calcium, but the acid PTH-degrading activity (pH 4.5) was slightly activated by ATP and was uninfluenced by calcium. The cytosolic neutral PTH-degrading activity was not inhibited by PMSF, trypsin inhibitor, E-64, chymostatin, leupeptin or pepstatin, whereas the acid PTH degrading activity was inhibited by pepstatin, leupeptin, trypsin inhibitor and chymostatin. The neutral and acid PTH-degrading activities most probably depend on different enzymes. The neutral PTH-degrading enzyme is unlike any of the PTH degrading enzymes so far reported. PMID- 3504717 TI - Maternal effects on the phenotypic expression of the skeletal store of calcium (bone mass) and related variables in the rat. AB - The phenotypic expression of bone mass and several related variables were investigated in the rat, assessing the differences and resemblances between two strains of inbred rats and their reciprocal hybrids. The data obtained indicated a strong influence of the maternal environment in the expression of total calcium mass and the rates of true calcium (Ca) absorption, endogenous fecal Ca excretion and bone Ca accretion. The simultaneous occurrence of maternal effects on characters obviously related, suggested that formation and maintenance of bone mass is accomplished by a series of specialized cellular functions, possibly regulated by a single genetic block. Maternal effects on bone mass and related variables appear to be determined in utero and are fully expressed at adulthood. PMID- 3504718 TI - Progression of mineral metabolism derangements in childhood chronic renal failure. AB - 2 groups of children affected by different degrees of chronic renal failure (group 1, 55-36 ml/min/1.73 m2; group 2, 35-20 ml/min/1.73 m2 of creatinine clearance) due to tubulo-interstitial disease were studied for one year. The spontaneous evolution of altered mineral metabolism at different levels of glomerular filtration rate (GFR) was aimed at. Parathyroid hormone, vitamin D metabolites and bone mineral content were evaluated. At the end of the year, only a decrease of plasma levels of 1,25(OH)2D in group 1 and a worsening of all mineral metabolism parameters in group 2 were found. The results are consistent with the hypothesis that mineral metabolism derangements progress rapidly after a certain 'threshold' of endocrinologically active renal mass is reached. The falling of plasma 1,25(OH)2D levels below a still undetermined critical value might be assumed as an index of this threshold. PMID- 3504719 TI - Bone maturation and quality of bone material in rats flown on the space shuttle 'Spacelab-3 Mission'. AB - The maturation profiles of calcium, phosphorus, magnesium and hydroxyproline in the femoral trabecular and cortical bone and in the thoracic vertebrae from male rats flown on the 7-day 'Spacelab-3 Mission' were measured by density gradient analysis. In rats exposed to a spaceflight environment, profiles of the matrix and mineral moieties were shifted toward both the lower (vertebrae) and higher density fractions (femurs and vertebrae), patterns indicating a decrease in bone growth/turnover. X-Ray diffraction of vertebrae indicated that spaceflight is associated with a decrease in apatite crystal size/perfection. PMID- 3504720 TI - Does calcium potentiate the effect of estrogen therapy on postmenopausal bone loss? AB - Calcium metabolism were examined in 66 healthy postmenopausal women every 3 months during 2 years of treatment with oral or percutaneous 17 beta-estradiol combined with different doses of calcium supplementation. Bone mineral content measured in the forearm (single photon absorptiometry) in the spine and in the total skeleton (dual photon absorptiometry) was unchanged in all estrogen-treated groups during the two years of treatment, and the responses in the groups with and without calcium supplementation were not significantly different. Furthermore, the responses were independent of route of administration of the estrogen. Biochemical indices of bone turnover (serum alkaline phosphatase and fasting urinary hydroxyproline/creatinine) decreased highly significantly during estrogen treatment (P less than 0.001) independent of route of administration of the estrogen and of the calcium supplementation. We conclude that calcium supplementation has no additive effect to estrogen therapy in the prevention of the early postmenopausal bone loss. PMID- 3504721 TI - Effect of glucocorticoids on the passive transport of phosphate in different segments of the intestine in the rat. AB - We investigated the influence of glucocorticoids on phosphate absorption in the duodenum, mid-jejunum, ileum and colon. Phosphate transport, fluid absorption and sodium absorption were determined by the in vivo ligated loop technique. The administration of cortisone stimulated intestinal fluid absorption in each segment of the small intestine, but not in the colon. Cortisone enhanced net sodium absorption in proportion to the increase in fluid absorption. Phosphate was most effectively absorbed in the duodenum and jejunum. Net phosphate absorption in the ileum and colon was negligible. Administration of cortisone stimulated the passive transport of phosphate in each segment of the small intestine studied. The 32Pi absorption was increased 56, 54 and 97% in the duodenum, jejunum and ileum, respectively. There was no apparent stimulation of passive transport of phosphate by cortisone in the colon. Although the exact mechanism is unknown, increased luminal phosphate concentration gradient or enhanced sodium and water absorption after cortisone administration could account for the increase in phosphate transport in the small intestine. However, the effects of these factors vary from segment to segment. PMID- 3504722 TI - Enhancement of the inhibitory action of APD on the transformation of osteoclast precursors into resorbing cells after dimethylation of the amino group. AB - The amino-bisphosphonate APD is distinct from the bisphosphonates EHDP and Cl2MDP by a greater molar potency in vivo as inhibitor of osteoclastic bone resorption and in vitro by a pronounced inhibitory effect on the accession of osteoclast precursors to mineralized matrix. Dimethylation of the aminogroup, which increases the basic properties of this residue but precludes others, like the liability to glucuronidation or acetylation, increased the in vivo potency of this amino bisphosphonate, as well as its in vitro specificity for osteoclast precursor accession, but decreased its cellular toxicity. The in vitro actions of dimethyl-APD were reversible with administration of PTH. It is concluded that the introduction of a basic residue in bisphosphonates may increase affinity for the specific sites on the mineralized matrix that are involved in directing the accession of precursors and their transformation into actively resorbing osteoclasts. PMID- 3504723 TI - Reduced life span of the osteoclast in osteopetrotic (mi and midi) mice. AB - Osteoclasts were enumerated on the parietal bones of mice carrying combinations of alleles (mi, midi and +) at the microphthalmic locus. Homozygous mutants at this locus show varying degrees of osteopetrosis due to defective bone resorption. As the severity of the bone resorption defect increased across the genotypes, there was an increase in the total number of osteoclasts and also an increase in the proportion of uninucleate osteoclasts. In parietal bones incubated for 24 h with parathyroid hormone (PTH) there was no significant difference between osteopetrotic and normal bones in terms of the number of osteoclast nuclei that had taken part in fusion. When bones were incubated for 24 h in the absence of PTH the percentage of osteoclasts remaining was correlated inversely with the severity of the bone resorption defect. Thus, we suggest that the increased proportion of uninucleate osteoclasts in these mutants results from a shortened life span, reducing the time-dependent accumulation of nuclei. This implies a reduced efficiency of uninucleate osteoclasts over multinucleate ones and we speculate on the reason for this. PMID- 3504724 TI - Bone turnover determined by urinary excretion of [99mTc]diphosphonate in the prediction of postmenopausal bone loss. AB - Bone mineral content (BMC) of the forearms was measured in 62 healthy early postmenopausal women every 3 months for 2 years to calculate the rate of bone loss. Furthermore, bone turnover was determined at one year using the urinary excretion (UE) of [99mTc]diphosphonate. UE was assessed as a diagnostic test using BMC changes as the gold standard for bone loss. The predictive value for 'accelerated bone loss' (positive test) was 0.58 and for 'non-accelerated bone loss' (negative test) 0.76. The data do not warrant the use of UE as a screening method for bone loss. PMID- 3504725 TI - Assessment of the biological effectiveness of nasal synthetic salmon calcitonin (SSCT) by comparison with intramuscular (i.m.) or placebo injection in normal subjects. AB - For patients who require treatment over a period of some years, intranasal administration of synthetic salmon calcitonin (SSCT) obviates the discomfort associated with administration by injection. Moreover, this mode of administration is not associated with the side effects normally encountered when calcitonin is injected intramuscularly or subcutaneously. The aim of this study was to assess, in normal subjects, the biological activity of nasal SSCT by comparing the fluctuations of parameters reflecting calcium-phosphorus metabolism after nasal instillation, injection of SSCT and injection of placebo, respectively. In nine healthy subjects, this instillation of 200 IU of SSCT into the nasal cavity caused a fall in serum calcium, a fall in serum phosphorus and a transient rise in parathyroid hormone levels similar to that observed after the intramuscular (i.m.) injection of 80 IU of SSCT. SSCT whether administered by the nasal route or by injection, does not inhibit endogenous calcitonin secretion. There were no changes in serum beta-endorphin, magnesium or erythrocyte magnesium levels after administration of calcitonin by the intranasal route or by injection. PMID- 3504726 TI - Effects of age and menopause on vertebral bone density. AB - Vertebral bone density was assessed with dual photon absorptiometry in 280 white females, aged 19-87, without symptoms of osteoporosis. Those who had not experienced a menstrual period for at least one year were classified as postmenopausal, and those menstruating normally were deemed premenopausal. The remainder were considered perimenopausal. Regression links were fit: (1) to the entire data set, (2) to two groups by age (less than 50, 50+), (3) to three groups by age (less than 40, 40-54, 55+) and (4) to three groups by menopausal status. Only that regression which considered menopausal status had a significantly better fit than the simple linear model with slopes of +0.04% per year for the premenopausal (ns, different from zero), -1.8% per year for the perimenopausal (P less than 0.05) and -0.6% per year for the postmenopausal (P less than 0.05). These data suggest that the loss of trabecular bone is accelerated around the time of the onset of menopause, and slows somewhat thereafter, although continuing to be significant. However, the findings of this study are based on cross-sectional data, and there remains a need for prospective studies of vertebral bone around the time of menopause. PMID- 3504727 TI - Co-localization and secretion of parathyrin of Stannius corpuscles (immunoreactive parathyroid hormone) and of secretory glycoproteins including secretory protein-I in the European eel (Anguilla anguilla L.). AB - Until recently, teleosts were considered to be devoid of parathyroids. We showed recently that the corpuscles of Stannius, that structurally have features in common with the parathyroid gland, produce a molecule resembling mammalian parathyroid hormone (PTH). We refer to this molecule as parathyrin of corpuscles of Stannius (PCS). Parathyroid secretory protein-I (SP-I) is an acidic glycoprotein, probably identical to adrenal chromogranin A, that is co-stored and co-secreted with PTH. In the present study, PCS was localized in secretory granules of fresh water eels by immunocytochemistry. In addition, several glycoproteins were identified in these granules by periodic acid-Schiff staining and/or concanavalin A lectin binding. One of the glycoproteins that was positive with periodic acid-Schiff, but not with concanavalin A, cross-reacted with antisera to bovine parathyroid secretory protein-I. When the eels were made hypercalcemic by injecting calcium or pituitary extract, there was a coincidental translocation of the PCS, immunoreactive SP-I and the glycoproteins, suggestive that these granules were undergoing exocytosis. Immunoblot analysis of saline extract of the corpuscles of Stannius confirmed that immunoreactive SP-I was present in the tissue. It exhibited a molecular mass of about 55 kDa compared to about 70-80 kDa exhibited by mammalian SP-I when analyzed by sodium dodecylsulfate-polyacrylamide gel electrophoresis. PMID- 3504728 TI - Co-localization of parathyroid hormone and secretory protein-I in bovine parathyroid glands: a double immunocytochemical study at the electron microscopical level. AB - Secretory protein-I (SP-I), also known as chromogranin A, is an acidic glycoprotein of unknown function that is found in large amount in the secretory granules of all endocrine and neuroendocrine cells, but not in exocrine or epithelial cells. It is cosecreted with parathyroid hormone (PTH) and by immunocytochemical staining has been reported to exist in the same subcellular structures of the gland. In the present study we have used the colloidal gold double immunocytochemical technique at the ultrastructural level to precisely define the locales of SP-I and PTH in the bovine parathyroid cell. SP-I and PTH were co-localized to the same secretory granules. The patterns for both gold labels were diffuse ones throughout the granule and suggested that there was a general association of SP-I and PTH. There was little or no localization of the SP-I at the secretory granule membrane. The results support the concept that SP-I is responsible for stabilization of PTH within the secretory granules. PMID- 3504729 TI - Tumor cells stimulate in vivo periosteal bone formation. AB - It was demonstrated that in mice a variety of tumor cells of both viral (XC, MSVC) and non-viral origin (rat ameloblasts, Ehrlich ascites carcinoma, KB, WAMIB, WISH cell lines) produce, on transplantation in the adjacent bones, periosteal osteogenesis, and in addition can stimulate osteoclastic and tumor mediated bone resorption. The production by the tumor cells of an osteoblast activating factor, besides the osteoclast-activating factor described earlier by others, is postulated. PMID- 3504730 TI - Elevated serum 1,25-dihydroxyvitamin D in osteopetrotic mutations in three species. AB - Osteopetrosis is an inherited bone disease in which bone mass accumulates due to a reduction in bone resorption. We have examined serum levels of vitamin D metabolites in seven mutations from three species and found that serum 1,25 dihydroxyvitamin D is markedly elevated in each. In some mutations, these findings cannot be solely explained by the known stimulators of this hormone; namely hypophosphatemia and hyperparathyroidism, and suggest a compensatory adjustment to an end-organ resistance to this hormone. These data, taken together with known alterations in osteoclast structure and function in congenital osteopetrosis and the effects of this hormone on monocyte differentiation and bone resorption, indicate that resistance to 1,25-dihydroxyvitamin D could be a unifying concept to explain the osteoclast heterogeneities in osteopetrosis. Furthermore, this may be an ideal system in which to examine the effects of this hormone on the proliferation, differentiation and function of bone cells. PMID- 3504731 TI - Phosphoethanolamine- and fructose 1,6-diphosphate-induced calcium uptake in bone formed in vitro. AB - The purpose of this investigation was to determine whether biologically available organic phosphates other than beta-glycerophosphate were capable of inducing mineralization of bone in vitro. The chick periosteal osteogenesis model was used to demonstrate that endogenously available organic phosphates, fructose 1,6 diphosphate (F1,6-D) and phosphoethanolamine (PEA) induce calcium accumulation in bone formed in vitro. Alkaline phosphatase activity was inhibited in a dose dependent manner by PEA, and the sodium salt of F1,6-D. There was an inverse correlation between alkaline phosphatase activity and organic phosphate-mediated mineralization. The data demonstrate that certain biologically available organic phosphates can induce mineralization and modulate bone metabolism in vitro. PMID- 3504732 TI - Spine and femur density using dual-photon absorptiometry in US white women. AB - Bone mineral density (BMD) of the spine (n = 892) and femur (n = 634) was measured using dual-photon absorptiometry in normal white women from seven diverse locations. The same model commercial scanner with a 153Gd source was used in all locations (SD = 1.3% among locations). There was not an age-associated decrease of spinal BMD during young adulthood (20-40 years); the correlation of age and femoral BMD in this period was low but significant (r = -0.21). There was a narrow range of intra-population variation at all ages (10-12%). The cross sectional data showed an average diminution of about 20% in the spine and 25% in the femur between 40 and 70 years of age, followed by a continued but slower, decrease of density in older women. Adjustment of values for height and weight was called for mainly at extremes of body size. PMID- 3504733 TI - Is there a need for whole body physiology? PMID- 3504734 TI - Capsular structures of black-pigmented Bacteroides isolated from humans. PMID- 3504735 TI - Inhibitory effect of xylitol on the acid production activity from sorbitol by Streptococcus mutans and human dental plaque. PMID- 3504736 TI - In vivo comparison of antimicrobial effectiveness of conventional and ultrasound activated irrigation techniques in root canal therapy. PMID- 3504737 TI - Morphometric analysis of the capillary loop endothelium underlying sulcular epithelium. PMID- 3504738 TI - An experimental study on wound healing of surgically exposed dental pulps in germ free rats. PMID- 3504739 TI - A voltage-clamp study of bethanechol-hyperpolarization in hamster submandibular ganglion cells. PMID- 3504740 TI - Removal of the characteristic X-ray from intraoral source radiography. PMID- 3504741 TI - A study on Pd-Sb alloy system for metal-ceramics. PMID- 3504742 TI - Detection of plasmid DNA in periodontopathic bacteria. PMID- 3504743 TI - Pulpal response to partial pulpotomy. Report 1. PMID- 3504744 TI - Effects of age on the sensory innervation of the alveolar mucosa of mouse. PMID- 3504745 TI - Relationship between tooth enamel fluoride and dental caries. PMID- 3504746 TI - The UV erythema action spectra of three coal tar preparations. PMID- 3504747 TI - Persistent skin pain after PUVA. PMID- 3504748 TI - Coexistence of obstructive arterial disease and chronic venous stasis in leg ulcer patients. PMID- 3504749 TI - Frequency and isotype distribution of serum antibodies reactive with dietary proteins in adults with chronic urticaria. PMID- 3504750 TI - Decreased tissue fibrinolytic activity in granuloma annulare. PMID- 3504751 TI - Non-Hodgkin's lymphoma associated with long-term azathioprine therapy. PMID- 3504752 TI - Cutaneous cryptococcosis mimicking molluscum contagiosum in a haemophiliac with AIDS. PMID- 3504753 TI - Hairy-cell leukaemia presenting with pyoderma gangrenosum. PMID- 3504755 TI - Broadening of action spectrum in a patient with solar urticaria. PMID- 3504754 TI - Hypopigmented mycosis fungoides. PMID- 3504756 TI - Nodular localized primary cutaneous amyloidosis. PMID- 3504757 TI - Juvenile plantar dermatosis. PMID- 3504758 TI - Is the horse lung well designed? PMID- 3504759 TI - Vascular malformations and angiomatous lesions in horses: a review of 10 cases. AB - Vascular malformations and angiomas are rather uncommon in horses and the literature concerning these lesions is reviewed. The pathology is described in 10 additional cases. These lesions were classified as arteriovenous malformation (one case), haemangiomas (six cases), 'proliferative angiomas' (two cases) and lymphangioma (one case). The haemangiomas and lymphangioma were probably hamartomatous in origin. Both cases of 'proliferative angioma' developed in aged animals and their pathogenesis was uncertain. More information is needed on the natural history and behaviour of lesions of this type. PMID- 3504760 TI - Observations on equine strongyle control in southern temperate USA. AB - A program of rotational anthelmintic treatments at eight-week intervals had failed to provide satisfactory equine strongyle control at a stable in southern USA. Anthelmintic resistance had rendered benzimidazoles ineffective, and intervals between treatments with other drugs were too great to prevent environmental contamination with ova. Ivermectin treatments at eight week intervals or pyrantel pamoate treatments at four week intervals successfully reduced egg counts for the majority of the summer grazing period. In southern temperate USA, translation of strongyle ova to larvae was most efficient during autumn and winter. Minimal larval translation occurred during summer when meteorological conditions limited pasture infectivity as effectively as anthelmintic treatments. PMID- 3504762 TI - Oral administration of ascorbic acid to horses. AB - The effects of oral administration of high doses of ascorbic acid on plasma concentrations were investigated in both experimental Thoroughbred horses and those within racing stables. A single oral dose (20 g) did not result in any increase in plasma concentrations. However, daily administration of either 4.5 g or 20 g doses resulted in significant increases in plasma concentrations. Monthly variations in plasma ascorbate concentrations were found in both supplemented (20 g daily) and unsupplemented stables. It is concluded that oral supplementation with ascorbic acid is a satisfactory route to increase plasma and tissue concentrations. PMID- 3504761 TI - Ventilation-perfusion relationships in the standing horse: an inert gas elimination study. AB - The multiple inert gas elimination technique was adapted for use in the conscious standing horse. The modifications included increased infusion rate of the inert gases (30 ml/min), extended infusion time (60 mins) in order to reach steady state, and construction of a nose mask mixing box system for collection of expired gas. Eight adult horses with a mean weight of 454 kg and a mean age of 6.1 years were studied while standing under resting conditions. Ventilation was 65.2 liters/min and cardiac output measured by thermodilution 40.2 liters/min. Systemic and pulmonary artery mean pressures were 114 and 26 mmHg, respectively. Three horses showed a unimodal VA/Q distribution centred upon a mean VA/Q of one. Five horses had a bimodal distribution with an additional high VA/Q mode comprising 2 to 18 per cent of ventilation. The mean logarithmic standard deviation of perfusion was 0.41. There was no perfusion of 'low' VA/Q regions, but minor shunting on an average of 1 per cent was noted. Inert gas dead space (minus apparatus dead space) averaged 38 per cent of total ventilation. Arterial oxygen tension varied from 11 to 14 kPa and the mean arterial CO2 tension was 5.7 kPa. It is concluded that the standing horse in general has a good match between ventilation and perfusion but that some individuals display high VA/Q regions, possibly explained by poor perfusion of upper lung regions. PMID- 3504763 TI - The relationship of air hygiene in stables to lower airway disease and pharyngeal lymphoid hyperplasia in two groups of Thoroughbred horses. AB - The relationship between air hygiene within two types of identically managed horse housing and the incidence of covert respiratory disease (as revealed by endoscopic examination) of their inhabitants was assessed. The horses were all under the supervision of the same trainer. In one yard the design ensured the boxes were well ventilated in still air conditions. In the other yard the boxes were insulated and there was little provision for natural ventilation in still air conditions. There was heavy fungal and actinomycete contamination of wood shavings in the heavily insulated, poorly ventilated housing but not in the shavings of better ventilated boxes. There was increased incidence and severity of mucopus in the tracheas of horses stabled in the contaminated environment over that seen in the other group. There was no such association between the incidence or degree of pharyngeal lymphoid hyperplasia and the two environments or between the degree of tracheal mucopus and PLH found in the 72 horses examined in this study. PMID- 3504764 TI - Observations on the examination of Thoroughbred yearlings for idiopathic laryngeal hemiplegia. PMID- 3504765 TI - Equine paranasal sinus cysts: a report of 15 cases. AB - The clinical and radiographic features of 15 cases of paranasal sinus cysts are described. Breed, sex and side frequency were unremarkable but two distinct categories of age incidence emerged. Onset of signs had occurred before one year of age in three cases, while all but two of the remaining 12 animals were older than nine years. The most common clinical signs were nasal airway obstruction, facial swelling and nasal discharge, often occurring in combination. Radiographic changes were recorded in all horses. Sinus opacification was a consistent finding and in several cases the bone surrounding the sinus had increased in thickness. Increase in intra-maxillary sinus pressure was demonstrated by septal displacement on ventro-dorsal radiographs in almost half the cases. Less common signs included expansion, free fluid accumulation within the affected sinus, dental distortion and displacement and mineralisation. Two horses were destroyed without treatment but in 13 animals surgical exploration was performed. Two of these were destroyed, one at the time of surgery and one five days postoperatively. In the remaining 11 cases, all accessible parts of the cyst were removed through a facial flap and drainage to the nasal meati was established. All these horses recovered satisfactorily and were followed up for periods between three months and six years without evidence of recurrence. Thirteen cysts arose in the caudal maxillary sinus and one each in the frontal and rostral maxillary compartments. Histopathological examination of portions of the cyst walls suggests that, like ethmoidal haematomas, they may originate from episodes of haemorrhage beneath the upper respiratory tract mucosa. PMID- 3504766 TI - Renal carcinomatosis in a horse. PMID- 3504767 TI - Brain abscess in a horse: diagnosis by computed tomography and successful surgical treatment. PMID- 3504768 TI - Detection by computed tomography of occult osteochondral defects in the fetlock of a horse. PMID- 3504769 TI - Bilateral sinus empyema in a six-year-old mare. PMID- 3504770 TI - A congenital laryngeal web defect in a quarterhorse filly. PMID- 3504772 TI - [Application of acupuncture for dental practice. (1st report). Pain control after endodontic treatment]. PMID- 3504771 TI - A study of natural history of chronic glomerulonephritis. XIII. Five cases of long-term (more than 23 years) observed chance proteinuria. PMID- 3504774 TI - [Two cases of the anomalous common hepatic artery]. PMID- 3504773 TI - [Application of acupuncture for dental practice. (2nd report). Suppression of choke reflex during dental treatment]. PMID- 3504775 TI - [A case of dentigerous cyst. A radiographic observation on healing course following fenestration of the cyst]. PMID- 3504776 TI - [A case of pathologic migration with initial preparation and orthodontic treatment]. PMID- 3504777 TI - [A case of guest passenger injury]. PMID- 3504779 TI - Plasma concentrations of lidocaine following infiltration anesthesia in oral surgery under inhalation anesthesia. PMID- 3504778 TI - [Severe mandibular prognathism: report of two cases and soft tissue profile analysis]. PMID- 3504780 TI - A study of natural history of chronic glomerulonephritis. XIV. Analysis of eleven dead cases of chronic glomerulonephritis. PMID- 3504781 TI - A case of blunt renal trauma. PMID- 3504782 TI - [Clinical investigation of disease in relation to maxillary sinus in our Department. Especially postoperative buccal cyst and maxillary sinusitis]. PMID- 3504783 TI - [The primary irritant testing to the human skin of gallium alloy]. PMID- 3504784 TI - [Plaque control in periodontal therapy]. PMID- 3504785 TI - A study of the natural history of chronic glomerulonephritis. XV. Long-living (more than 25 years) 25 cases of chronic glomerulonephritis. PMID- 3504786 TI - [Physical properties of the microwave cured denture base resins. (1) Effects of irradiation time on physical properties of resins]. PMID- 3504787 TI - [Effect of acupuncture to Gokoku (Hoku) on pain threshold. The first report: study by heat stimulation]. PMID- 3504788 TI - [A study of proteinuria. (XI) The incidence of patients with proteinuria, microscopic hematuria and glycosuria in Fukuoka Dental College students in 1986]. PMID- 3504789 TI - [Clinical investigation of phlegmon of maxillofacial area]. PMID- 3504790 TI - [A study on root canal medicament with Nishika Thesirol--bacterial growth inhibition test and clinical effect]. PMID- 3504791 TI - [Conditions to cause off-responses to tactile flow stimulus in the frog lingual surface]. PMID- 3504792 TI - [Study on the relation between dental caries prevalence of permanent teeth in schoolchildren and their living environment by quantification. Comparison among Fukuoka (Japan), Jeonju (Korea) and Taipei (Republic of China)]. PMID- 3504793 TI - [Studies on biological evaluation of gallium alloy. 1. Pulp irritation in primary teeth]. PMID- 3504794 TI - [Application of ultraviolet photograph in dentistry. Part 1. Comparison with visible light photograph]. PMID- 3504795 TI - [Capability of polysaccharide production by three types of colonial form mutants isolated from S. mutans FIL]. PMID- 3504796 TI - [Two cases of anterior crossbite using Frankel functional regulator (FR3)]. PMID- 3504798 TI - The World Food Programme at work. PMID- 3504797 TI - [A case of primary aldosteronism treated as essential hypertension]. PMID- 3504799 TI - Built-in monitoring and evaluation systems for food-assisted projects. PMID- 3504800 TI - The nutritionist in food aid. PMID- 3504801 TI - Soybean utilization in Africa: making a place for a new food. PMID- 3504802 TI - Standardized karyotypes for the greater Galagos, Galago crassicaudatus E. Geoffroy, 1812 and G. garnettii (Ogilby, 1838) (Primates: Prosimii). AB - Karyotypes were analyzed of 21 greater galagos, using classical, G-banding, C banding and silver nitrate staining techniques. A composite G-banded karyotype and high resolution idiogram are presented for each species. Areas of possible rearrangement are identified. The results support the interpretations derived from earlier, unbanded studies, rather than a more recent proposal from G-banded data. Failure of repeated attempts to obtain C-bands, despite success in human controls, indicates that the heterochromatic bands generally revealed by these staining methods are either absent or extremely small in greater galagos. Silver staining revealed a single pair of NOR-bearing autosomes in both species, as shown by previous authors. PMID- 3504803 TI - The chromosomes of Nycticebus coucang (Boddaert, 1785) (Primates: Prosimii). AB - The high-quality karyotype of a specimen of Nycticebus coucang is described and illustrated. The X chromosome is found to be indistinguishable from that of the greater galagos, and may represent a synapomorphic trait. The y chromosome is a medium to small submetacentric (3.2% TCL) and constitutes one of the larger Y chromosomes known in primates. N. coucang is found to have multiple NOR-bearing chromosomes in contrast to the single pair found in galagine and catarrhine monkeys. Since a single NOR-bearing pair is often considered ancestral for primates, this new finding may have important implications for the evolution of these cistrons. One of the chromosomal polymorphisms in this specimen is a pericentric inversion, involving a NOR-bearing autosomal pair (no. 6), that alters the position of the active site. Further, homologues 2p differ by a paracentric inversion. These results confirm that lorisiforms are characterized by considerable chromosomal polymorphism. PMID- 3504804 TI - Genetic differentiation among cottontails from isolated playa basins. AB - Protein variation in 182 Sylvilagus floridanus from 19 playa basins in Castro Co., Texas was examined using starch-gel electrophoresis. Heterozygote deficiencies were noted for all populations. This heterozygote deficiency may be due to differential selection against heterozygous individuals over the winter months. Results of F-statistics indicated a significant degree of population differentiation at six loci. Nei's genetic distance between populations ranged from 0.20 to 0.388 and a significant association between genetic distance and linear geographic distance among playas was found. These results suggest that genetic exchange and long-distance dispersal may be hindered by expanses of unsuitable habitat. PMID- 3504805 TI - Cytogenetic mapping of marker genes on the chromosome elements C and E of Drosophila pseudoobscura and D. subobscura. AB - Enzyme loci, visible marker genes and lambda-cloned DNA-sequences from a D. miranda library were mapped cytologically on the chromosome elements C and E of D. pseudoobscura and D. subobscura. New data are incorporated into the linkage maps of the two species. Homologous segments can now be localized in the polytene chromosomes with these markers. A comparison of the chromosome elements E of D. melanogaster and D. subobscura shows 12 conserved subsections which have been rearranged by paracentric inversions in the evolution of the two lineages. PMID- 3504806 TI - Free radical reactions with alpha-tocopherol and N-stearoyl tryptophan methyl ester in micellar solutions. AB - The rate constants have been measured for one-electron oxidation by N3. and Br2-. of N-stearoyl tryptophan methyl ester (STME) and alpha-tocopherol (alpha-T) in micelles of sodium dodecyl sulphate (SDS) or tetradecyl trimethyl ammonium bromide (TTAB). Compared with analogous reactions of tryptophan and Trolox C in aqueous solution, the rate constants for oxidation in micellar solution by N3. are reduced by 30-70%. The micellar charge increased the rate of oxidation of STME by Br2-. in TTAB micelles by almost an order of magnitude, compared with the reaction of Br2-. with tryptophan in aqueous solution. In SDS micelles the rate of oxidation of STME by Br2-. was reduced more than 30-fold. Quenching of fluorescence from STME in micelles by acrylamide confirmed the accessibility of the indole ring to the aqueous solvent. The rate of repair of the neutral STME radical by alpha-T in TTAB micelles was found to be accelerated by a factor of at least 27, compared with the similar reaction between Trolox C and tryptophan radicals in aqueous solution. PMID- 3504807 TI - Basic principles of reactivity in free radical chemistry. AB - This review is concerned with an overall survey of reactivity in free radical chemistry. A concise classification is given of elementary reaction steps which can be combined in different ways to account for overall chemical transformations: radical forming reactions, radical transformations, and radical destroying reactions. From this is derived the concept of the chain reaction which leads on to an up-to-date theory for understanding reactivity in free radical processes. Finally, a few aspects of autoxidation are discussed. PMID- 3504808 TI - Control of the generation and reactions of free radicals in biological systems by kinetic and thermodynamic factors. AB - Quantifiable redox properties are useful predictors of substrate reactivity in enzyme-catalysed redox reactions of e.g. nitroreductases or peroxidases. Redox properties may also control the rates of electron-transfer reactions between radical products of reduction and oxidation, and endogenous oxidants and reductants respectively. However, in numerous instances prototropic properties of substrate or radical may have profound kinetic consequences, protonation of radicals frequently slowing down electron-transfer reactions. Further, reactions which are thermodynamically extremely unfavourable may still proceed if radical products are removed from the pre-equilibrium efficiently. Thus kinetic considerations often outweigh the purely thermodynamic viewpoint. PMID- 3504809 TI - DNA radiation damage and its modification by metallothionein. AB - Thiol compounds have long been known to protect living cells against the harmful effects of ionizing radiation. Maetallothionein is a naturally occurring low molecular weight polypeptide rich in cysteine residues and may be useful in protection against low-level radiation effects. Radiation damage to DNA and its nucleotide components and the radioprotective effect of metallothionein have been studied in model chemical systems and compared to its effect on cells. Metallothionein acts both as a free radical scavenger and a reductant, and its radioprotective effectiveness has been studied as a function of dose, drug concentration, and in the presence and absence of oxygen. It is more effective in protecting against sugar-phosphate damage under hypoxic conditions. The chemical modification is greater than that of cell killing as measured by the loss of colony-forming ability. Dose reduction factors greater than two are observed for DNA radioprotection, but the values in cells are much lower. These findings will be discussed in terms of the molecular mechanisms and their implications. PMID- 3504810 TI - Radical scavenging by flavonoid antioxidants. AB - Aroxyl radicals of fifteen structurally distinct flavonoids were generated by attack of azide radicals (N3.) on the parent compounds dissolved in aqueous solution at pH 11.5. Generation rate constants were all found to be very high (2.4-8.8 x 10(9) dm3mol-1 s-1), whereas the decay rates differed considerably, ranging from 10(5) to 10(8) dm3mol-1 s-1. In most cases the spectral characteristics of the transient aroxyl radicals relate to structural features of the parent compounds and according to spectral similarities they can be classed in three distinct groups (with only two exceptions). Although the data do not conclusively prove that the biological function of flavonoids might be the scavenging of radicals, the very high rate constants of formation and the relative stability of some of the aroxyl radicals, are in support of such a hypothesis. PMID- 3504811 TI - Quantitative measurement of the diastereoisomers of cis thymidine glycol in gamma irradiated DNA. AB - A technique for determining the relative content of each of the diastereoisomers of cis thymidine glycol (dTG) in DNA exposed to ionizing radiation has been developed. [3H]thymidine DNA was gamma-irradiated, digested to 2' deoxyribonucleosides, authentic [14C] (+, -) cis dTG added to the digestate and the mixture resolved by HPLC. 3H fractions coeluting with [14C] (+, -) dTG were collected and acetylated. The acetoxy derivatives of (+) and (-) cis dTG were easily resolved by a second HPLC analysis and their absolute configuration determined by NMR and mass spectroscopies. We have constructed a dose-response curve for formation of each isomer in gamma-irradiated DNA and shown that they are formed in equal amounts. This technique may be used to determine the relative formation of cis dTG isomers in DNA resulting from other oxidative stresses and whether repair of these is influenced by their configuration. PMID- 3504812 TI - The ene reaction of singlet oxygen with olefins. AB - The reactions of singlet oxygen (1O2) with cis and trans butenes-1,1,1-d3, at -80 degrees C in Freon-11, show a product isotope effect (kH/kD) of 1.38 and 1.25 respectively. Isomerization of the starting materials or formation of dioxetanes were not observed during the course of the photooxygenation. Together with the isotope effects on the reactions of tetramethylethylene-d6 isomers with singlet oxygen, these results require the reversible formation of a perepoxide or charge transfer intermediate. PMID- 3504813 TI - New singlet oxygen source and trapping reagent for peroxide intermediates. AB - Application of newly-developed water-soluble singlet oxygen sources in the oxidation of biologically important compounds and the electron-transfer process involving singlet oxygen has been reviewed. Particularly, oxidation products of tryptophan by chemically generated singlet oxygen were compared to those obtained in dye-sensitized photooxygenation. The usefulness of trimethylsilyl cyanide as a trapping reagent for dipolar peroxide intermediates has been demonstrated in the photooxygenation of N-methylindoles, 2-(methoxymethylene)adamantane and adamantylideneadamantane in aprotic solvents. Based on these trapping reactions mechanism of singlet oxygen reaction of electron-rich enol ethers and enamines is discussed in light of theoretical calculation. PMID- 3504814 TI - Cell-dependent chemiluminescence. Modulation of the N-formyl chemotactic peptide (FNLPNTL) mediated oxidative burst in human polymorphonuclear leukocytes (PMNL) by murine monoclonal antibody NMS-1. AB - Binding of purified monoclonal antibody (moAB) IgM NMS-1 to suspended initially spherical living human PMNLs is not associated with the generation of chemiluminescence but was found to enhance the chemiluminescence response to the N-formyl chemotactic peptide FNLPNTL. We investigated quantitatively the kinetics of oxygen metabolite generation by PMNLs stimulated with FNLPNTL +/- moAB NMS-1 using luminol-dependent chemiluminescence as a very sensitive detection system. Chemiluminescence detection allowed the analysis of the time sequence of onset and development of reactive oxygen metabolites following stimulation of PMNLs by FNLPNTL in the presence of moAB NMS-1. The increase of response of PMNLs stimulated with FNLPNTL in the presence of moAB NMS-1 depended on the concentration of the antibody and the sequence of stimulus addition. Stimulation of human PMNLs by 10 nM FNLPNTL induced a rapid burst of chemiluminescence which peaked approximately 5 min after stimulus addition. The subsequent addition of moAB NMS-1 (greater than or equal to 2 micrograms/ml DPBS(+) - 0.1% HSA, 37 degrees C) to FNLPNTL-stimulated PMNLs - after the FNLPNTL-mediated response had already decayed (16-18 min) - without delay induced a second burst of oxygen metabolite generation. The magnitude of this second peak of activation was dose dependent. Treatment of PMNLs with moAB NMS-1 (greater than or equal to 1 microgram/ml DPBS(+) - 0.1% HSA, 3 min, 37 degrees C) - prior to FNLPNTL (10 nM) stimulation - increased rate and magnitude of the FNLPNTL-mediated response. This response is biphasic with the first peak at the FNLPNTL position and a second, higher peak approximately 16 min after FNLPNTL addition. The magnitude of response was dose-dependent. The latency (lag time) of the response was not changed compared to controls which received no moAB NMS-1 treatment. The observed moAB NMS-1 dependent increase in FNLPNTL-mediated chemiluminescence is transient (50-60 min), persistent activation was not detected. PMID- 3504815 TI - [In vitro study on biocompatibility evaluation of polysulfone resin]. PMID- 3504816 TI - [A cephalometric investigation on changes before and after chin cap therapy of anterior cross-bite in the case of reverse occlusion. A comparison with the bite plane appliance]. PMID- 3504817 TI - [Systematization of endodontic therapy--investigation of efficiency operation in endodontic therapy--(the modified rubber dam frame)]. PMID- 3504818 TI - [A case of neurinoma of the tongue]. PMID- 3504819 TI - [Effects of ascorbic acid deficiency on differentiation of osteogenic MC3T3-E1 cells]. PMID- 3504820 TI - [Roentgenography of child patients (1st report)]. PMID- 3504821 TI - [Traumatic prolapse of the buccal fat pad into the mouth]. PMID- 3504822 TI - [A case report of an odontogenic keratocyst in the cuspid region of the mandible]. PMID- 3504823 TI - [The characteristics for vaporization of Fluotec Mark 3 and Enfluratec]. PMID- 3504824 TI - [The significance of Musculus pterygoideus spinosus, an anomaly of the Musculus pterygoideus lateralis]. PMID- 3504825 TI - [Relationship of the glycolytic activity of human saliva with its composition and the oral health condition]. PMID- 3504826 TI - [Dynamic studies on occlusion and temporomandibular joint. VI. Observation of the inclination of the vertical condylar axis on the non-working side of lateral movement on the sagittal plane]. PMID- 3504827 TI - [Reexamination of glycolytic enhancing factors]. PMID- 3504828 TI - [Radiographic studies of so-called odontogenic keratocyst and ameloblastoma]. PMID- 3504829 TI - [Roentgenographic investigation of the mandibular third molar tooth (1st report)]. PMID- 3504830 TI - [Incidence of caries in deciduous teeth of nursery school children in Shinshinotsu]. PMID- 3504831 TI - [Salivary gland scintigraphy in mice]. PMID- 3504832 TI - [Roentgenographic diagnosis of fibro-osseous lesions]. PMID- 3504833 TI - [Changes in the flow rate and pH of human parotid saliva in response to tongue sour stimulation]. PMID- 3504835 TI - [Characteristics of the dental X-ray films II--RMS graininess of various films]. PMID- 3504834 TI - [Gelation mechanism of polyaddition type silicone impression materials]. PMID- 3504836 TI - [Experimental studies on the healing of bone injuries]. PMID- 3504838 TI - [Roentgenographic diagnosis of calcifying lesions in jaws]. PMID- 3504837 TI - [A report of three cases of epulis osteoplastica]. PMID- 3504839 TI - [A morphological study of reversed occlusion cases with early loss of deciduous molars]. PMID- 3504840 TI - [Caries prevalence of permanent teeth in primary schoolchildren in Urausu]. PMID- 3504841 TI - [A case of geminated primary canine associated with fused teeth and consideration of developmental mechanism]. PMID- 3504843 TI - Genetic and related effects: An updating of selected IARC monographs from Volumes 1 to 42. PMID- 3504842 TI - [Clinical and statistical observations on aged in-patients hospitalized in the Department of Oral Surgery, Higashi-Nippon-Gakuen University School of Dentistry over the past 7 years]. PMID- 3504844 TI - [Sound checking of percussion sound. II. Statistical inference of the intra-crown sealers]. PMID- 3504845 TI - [The relationship between probing depth and width of interdental space in maxillary central incisors]. PMID- 3504846 TI - [Relationship between mastication and intelligence in children]. PMID- 3504847 TI - [Effect of anterior and posterior condylar positioning on electromyographic silent period of masticatory muscles]. PMID- 3504848 TI - [Solubility of dissolving agents for dental plasters and stones]. PMID- 3504849 TI - [Changes in anterior tooth color with aging]. PMID- 3504850 TI - [A measuring device for the color determination of gingiva]. PMID- 3504851 TI - [Decreased mandibular arch width in jaw movement]. PMID- 3504853 TI - [Discussion of dentistry affairs in China]. PMID- 3504852 TI - [Clinical applications of occlusal sound. Part 3. Wave analyzing performance of experimental crown sounds in time and frequency domain]. PMID- 3504854 TI - [The role of periodontal membrane in interdental dimension discrimination]. PMID- 3504855 TI - [Experimental study on an apical barrier constructed of synthetic hydroxyapatite]. PMID- 3504856 TI - High-performance liquid chromatographic analysis of residual monomer eluted from dental acrylic resins. PMID- 3504857 TI - [Clinico-statistical observation of various prosthetic restorations at the Prosthetic Department, Asahi University Hospital. Part 1. Frequency of various prosthetic restorations inserted for the duration from April 1983 to March 1984]. PMID- 3504858 TI - [Clinico-statistical observation of various prosthetic restorations at the Prosthetic Department, Asahi University Hospital. Part 2. Circumstances concerning prosthetic method for missing teeth from April 1983 to March 1984]. PMID- 3504859 TI - [The effect of fluoride containing coating agent on white spot lesions. Clinical appraisal]. PMID- 3504860 TI - Dental deformities caused by radium therapy for hemangioma of upper lip. PMID- 3504861 TI - ["Team-care" for multiple maxillofacial injuries in Shimada Municipal Hospital]. PMID- 3504862 TI - [Ultrastructural study on the effects of the single dose of X-ray irradiation on rat incisors]. PMID- 3504863 TI - [Scanning electron microscopic study of fracture surfaces of periodontally diseases cementum]. PMID- 3504864 TI - [On the survey of dental disease of children at a public health center]. PMID- 3504865 TI - [Dental behavioral science. Part IV. A motivational study of periodontal health for senior high school students]. PMID- 3504866 TI - [Effect of fluoride in drinking water on rat alveolar bone]. PMID- 3504867 TI - [Studies on physical properties of light cured veneer resin]. PMID- 3504868 TI - [Clinicostatistic observations of eosinophilic granulomas of the soft tissue in Japan]. PMID- 3504869 TI - [Clinico-pathological investigations of mucoceles of oral region]. PMID- 3504870 TI - [Consideration to orthodontic treatment of cleft lip and palate]. PMID- 3504871 TI - [Late development of complications following silicone injections for soft tissue augmentation of the cheek; a case report and its problems]. PMID- 3504872 TI - [Antibacterial mechanisms of synthetic monobactams against gram-negative bacilli]. PMID- 3504873 TI - [Isolation and purification of biologically active substances from Staphylococcus aureus isolated from a skin disease. I. Isolation and purification of an epidermal cell differentiation inhibitor]. PMID- 3504874 TI - [Isolation and purification of biologically active substances from Staphylococcus aureus isolated from a skin disease. II. Isolation and purification of exfoliative toxin]. PMID- 3504875 TI - [Studies on the abrasion of composite resins]. PMID- 3504876 TI - [Studies on Streptococcal adherence on various restoratives]. PMID- 3504877 TI - [Dose distribution of scattered X-rays in dental roentgenography]. PMID- 3504878 TI - [Most adequate lead equivalent value for protective aprons in intraoral roentgenography]. PMID- 3504879 TI - [Adhesive strength between tissue conditioners and denture base resin--effect of vaseline as separating agents]. PMID- 3504880 TI - [Changes in the bovine dentin collagen by acids]. PMID- 3504881 TI - [Measurements of radiation dose distribution around the rotational panoramic X ray machines]. PMID- 3504882 TI - [Orthodontic findings of seven cases with cleidocranial dysostosis]. PMID- 3504883 TI - [Studies on residual monomer in dental acrylic resins. Part 3. Curing methods and residual monomers]. PMID- 3504884 TI - [Clinical effectiveness of occlusal splint therapy to mandibular dysfunction patients--features in some psychological examinations]. PMID- 3504885 TI - Complicated and multiple orofacial bone fracture associated with epileptic seizure: report of a case and short review of facial bone fractures. PMID- 3504886 TI - [Consideration to the orthodontic treatment of the maxillary impacted central incisors]. PMID- 3504887 TI - Control of an outbreak of mosquito-borne encephalitis along the Colorado River in 1983. PMID- 3504888 TI - Mortality in mite-infested, male Anopheles crucians. PMID- 3504890 TI - Assessment of six benzyl-1,3-benzodioxole compounds for anti-juvenile hormone activity in Culex pipiens. AB - Fourth instar larvae of Culex pipiens were exposed to six benzyl-1,3-benzodioxole derivatives to assess the effectiveness of these compounds as anti-juvenile hormone agents. Mortality ranging from between 18 and 99% was observed in larvae and early pupae but the surviving adults showed no clearly defined anti-juvenile hormone effects. Adult effects included a reduction in number of eggs developed and the presence of degenerating eggs 4 days after the blood meal. PMID- 3504889 TI - A cage for use with small aquatic animals in field studies. PMID- 3504891 TI - Laboratory and field efficacy of Bacillus thuringiensis var. Israelensis and Bacillus sphaericus against Anopheles gambiae s.l. and Culex quinquefasciatus in Ouagadougou, Burkina Faso. AB - Two wettable powders (Bactimos and Vectobac) and one flowable concentrate (Teknar) of Bacillus thuringiensis var. israelensis (B.t.i.) and primary powders of Bacillus sphaericus isolates 1593 and 2362 were evaluated (laboratory) against field-collected larvae of Anopheles gambiae s.l. and Culex quinquefasciatus in Ouagadougou, Burkina Faso. Bactimos, Vectobac and a Corn-cob B.t.i. formulation (ABG-6138G) were field tested against Cx. quinquefasciatus and An. gambiae s.l. The isolates of B. sphaericus were also tested against An. gambiae s.l. in artificial ponds. Both wettable powders of B.t.i. showed superior activity than the flowable concentrate formulation against An. gambiae s.l. in the laboratory. Culex quinquefasciatus was more susceptible (3-4X) to B.t.i. (Bactimos) than An. gambiae s.l. The isolates of B. sphaericus were more effective (2-3X) against both mosquito species than Bactimos. In a ditch and two channels, Bactimos, Vectobac and ABG-6138G at 0.65, 1.5 and 5.6 kg/ha, respectively, gave 91-100% control of Cx. quinquefasciatus within 3 days of treatment. The same formulations at rates ranging from 0.25 to 5.6 kg/ha, produced 82-97% control of An. gambiae s.l. in rainwater pools 24 h after treatment. Isolates 1593 and 2362 at 0.12 and 0.24 kg/ha gave excellent control of An. gambiae s.l. in artificial ponds. PMID- 3504892 TI - Importance of construction sites as foci for urban Culex in northern Illinois. AB - Expanding urbanization in America has created many new artificial sources which serve as focal points for urban, opportunistic and disease-vectoring mosquitoes. One such urban source, building construction sites, has received little attention despite a growing construction industry. During the summer of 1985, 522 unfinished buildings, 90% as single-family homes, were surveyed for water accumulation, larval mosquito occurrence and density, and species involved. Sump pits and basements proved to be the most abundant sites of water accumulation of unfinished homes in the later stages of completion with Culex restuans and Cx. pipiens dominating the collections from these sites. Buildings at early stages of construction were much less productive, probably due to sun-exposure. Factors which favor mosquito colonization such as reduced illumination and temperatures, and increased organic content are discussed. Various cultural and insecticidal controls of mosquitoes breeding at construction sites are suggested. PMID- 3504893 TI - Comparative larvivorous performances of mosquitofish, Gambusia affinis, and juvenile Sacramento blackfish, Orthodon microlepidotus, in experimental paddies. AB - Mosquitofish, Sacramento blackfish, or combinations of both species were stocked in experimental paddies. Cultured Culex tarsalis larvae, stocked weekly into each paddy, and wild Anopheles freeborni larvae were counted by dipping. At the end of the 12 week experiment, paddies were drained and the remaining fish and visible invertebrates counted. Data show the highest number of mosquito larvae in the blackfish-stocked paddies. This low larvivorous ability of blackfish may result from their rapid growth to ca. 70 mm standard length and a consequent shift to a filtering mode of feeding. Although blackfish populations decreased from one third to one-half of their stocked levels and mosquitofish populations increased to very high levels, mosquito control seemed to be a function of species rather than just the number of predatory fish. The lower number of larvae in the control paddies compared with the blackfish paddies might be attributable to predatory invertebrate communities. PMID- 3504894 TI - Occurrence and ovitrap site preference of tree hole mosquitoes: Aedes triseriatus and Aedes hendersoni in eastern Kentucky. AB - This ovitrap study examined the effects of altitude above sea level, tree species, and tree trunk diameter on the distribution of eggs of the 2 tree hole mosquitoes, Aedes hendersoni and Ae. triseriatus. Only tree species and trunk diameter affected the distribution significantly. Aedes hendersoni eggs were found more frequently associated with trees of border and sunny habitat, while Ae. triseriatus eggs were more frequently found in association with trees of mesic habitat. Oviposition of Ae. hendersoni occurred more often at trees with smaller diameter at breast height than did Ae. triseriatus. These differences in ovipositing frequency appear to be related to the microhabitat associated with different sample sites. PMID- 3504895 TI - Nuisance midges (Diptera: Chironomidae) and their control in Japan. AB - In recent years, adult Chironomidae (particularly Chironomus yoshimatsui and Tokunagayusurika akamushi) emerging from polluted natural and man-made aquatic habitats in urban areas of Japan have become intolerable because they pose severe nuisance and economic problems. Several organophosphorus (OP) insecticides and insect growth regulators (IGRs) including methoprene and diflubenzuron were tested in the laboratory against C. yoshimatsui and several other midge species. The OP insecticides were effective against the midge larvae except for Procladius sp. Both IGRs were highly effective against C. yoshimatsui at concentrations less than 0.001 ppm; diflubenzuron showed superior activity over methoprene. In field studies, temophos has been successfully used at rates ranging from 0.1 to 2 ppm against C. yoshimatsui and several other species in a variety of habitats. Diflubenzuron at 1 ppm rate of treatment provided excellent control of C. yoshimatsui in polluted rivers while methoprene at the same rate was less effective. Frequent field use of temephos and fenthion has led to increased tolerance of these insecticides (particularly the latter) by C. yoshimatsui. PMID- 3504897 TI - A behavioral mechanism for resting site selection by pupae in three mosquito species. AB - Pupae of Aedes aegypti, Ae. triseriatus and Culex restuans dive less frequently when resting in a concave meniscus than when resting in open water. They also tend to terminate diving after contacting submerged vertical surfaces, increasing their chances of surfacing in a concave meniscus. As a result pupae tend to rest in concave menisci associated with emergent vertical surfaces, a behavioral adaptation by which they probably conserve energy and avoid predation. PMID- 3504896 TI - A genetic sexing strain of Anopheles quadrimaculatus, species A. AB - A genetic sexing strain of a mosquito, Anopheles quadrimaculatus, Species A, was synthesized for the preferential elimination of females during the egg stage. Malathion susceptibility was used as a conditional lethal, and the dominant malathion-resistance allele was linked to the Y chromosome via a radiation induced reciprocal translocation involving the terminal end of the right arm of chromosome 3 and the Y chromosome. Examination of mitotic chromosomes and salivary polytene chromosomes revealed the precise nature of the translocation. Genetic leakage, through recombination, in the strain was very low (0.02%). PMID- 3504898 TI - Genetic sexing system for the preferential elimination of females in Culex quinquefasciatus. AB - A genetic sexing strain T(1M;2)1 of Culex quinquefasciatus was synthesized for the preferential elimination of females during the larval stage. Translocations were induced which linked the gene for resistance to malathion to the male determining factor. Mitotic chromosomes were analyzed to determine the precise nature of the translocation. PMID- 3504899 TI - Increased toxicity of malathion diluted with heavy aromatic naphtha on adult Aedes taeniorhynchus. AB - Field tests of ground ULV application of Cythion diluted with heavy aromatic naphtha (HAN), 1:4 ratio, at 0.45 oz AI/acre resulted in a 96% and 49% mortality of caged adult Aedes taeniorhynchus located 150 and 300 ft downwind. Cythion, 0.45 oz AI/acre produced a 33% mortality at 150 ft and a 21% mortality at 300 ft. This compares with an 8% mortality at 150 ft on a plot treated with HAN only (0.45 oz/acre), and a 6% mortality in an untreated area. The study was repeated on four successive nights, reversing test plots, and the data pooled. Statistical analysis shows that the toxicity of the active ingredient, malathion, is significantly increased with the addition of the diluent, HAN. PMID- 3504900 TI - Do different instars of Aedes triseriatus feed on particles of the same size? PMID- 3504901 TI - Strategies for the emergency control of arboviral epidemics in New Orleans. AB - A study was initiated to evaluate the effectiveness of aerial ULV spraying for the control of Aedes aegypti and Culex quinquefasciatus as an emergency antiepidemic measure against dengue fever and St. Louis encephalitis, respectively. Malathion was aerially applied at 219 ml/ha over 344 ha area of the Ninth Ward in New Orleans. Laboratory susceptibility tests and field-cage exposures indicated that the target populations were susceptible to malathion and that acceptable coverage of the study area occurred. Two consecutive aerial applications decreased the relative abundance and ovipositional activity of adult mosquitoes. However, suppression was transient and, in the event of an epidemic, multiple treatments may be required to decrease vector abundance below the threshold levels required for the spread of virus to the human populations. PMID- 3504902 TI - A bionomic study of adult Aedes (Neomelaniconion) circumluteolus in northern Kwazulu, South Africa. AB - Sixteen monthly visits were made to the Ndumu game reserve when resting Aedes circumluteolus mosquitoes were collected on the ground. The population density reached exceedingly high levels 7 or more days after the Usutu and/or Pongola rivers inundated their flood plains, and was related mainly to river flooding and far less to local rainfall. During dry months male Ae. circumluteolus disappeared while females persisted at very low levels. Blood-feeding and ovarian development occurred throughout the year and precipitin tests showed the preferred host was almost exclusively antelope (Bovidae), the dominant large mammal present. It was concluded that Ae. circumluteolus is a floodwater mosquito. Owing to the low density of females during dry months and low infection rates with arboviruses it is considered unlikely that Ae. circumluteolus would support viral transmission throughout the year. It is more likely that viruses survive in overwintering eggs and are transovarially transmitted. PMID- 3504903 TI - Genetic studies on two carboxylesterase loci in Aedes albopictus. AB - Two esterase loci, Est-4 and Est-5, in Aedes albopictus encode carboxylesterases in 4th-instar larvae, pupae and adults. The electrophoretic bands migrate on agar gels toward the most anodal side, those of Est-5 followed by those of Est-4. Linkage studies on the two loci revealed that they were arranged on linkage group 2 in the following order: Est-4-(0.9 +/- 0.7 to 4.3 +/- 1.4 map units) p(pigmented pupa)-(2 map units, as previously determined)-Wb(White-body)-(18.2 +/ 2.6 to 21.0 +/- 1.8 map units)-Idh-2(isocitrate dehydrogenase-2)-(13 map units, as previously determined)-alpha-Gpdh(alpha-glycerophosphate dehydrogenase)-(9.0 +/- 1.8 to 19.9 +/- 3.1 map units)-Est-5. The esterase loci were compared with those reported in other Aedes species with respect to their linkage homology. PMID- 3504904 TI - Morphological differentiation in Anopheles maculatus of Thailand accompanied with genetical divergence assessed by hybridization. AB - Anopheles maculatus of Thailand were distinguished morphologically into densely and sparsely scaled types and cross-mating experiments between these types revealed a substantial amount of genetic divergence. Progeny of wild females of An. maculatus collected throughout Thailand from north to south were examined morphologically with respect to adult tergal pale scales. Northern progeny broods could be separated into densely scaled (willmori) and sparsely scaled (maculatus) types, or W and M types, respectively. Using these two types of An. maculatus from Chiang Rai and Nakhon Phanom, cross-mating experiments were conducted, which resulted in sterile F1 male hybrids in one direction of cross and very low survival rate of F1 male hybrids in the reciprocal cross. However, southern broods could not be separated clearly because of intergradation of scaling. These results indicate that Thai An. maculatus involves at least 2 forms differentiated morphologically, as well as by incomplete reproductive isolation. PMID- 3504905 TI - Experimental transmission of Plasmodium mexicanum by bites of infected Lutzomyia vexator (Diptera: Psychodidae). AB - Lutzomyia vexator is an efficient experimental vector of Plasmodium mexicanum, infecting 69.2% (9/13) of the Sceloporus undulatus lizards with as few as one bite. Sporozoites were present in the salivary glands by day 6.5 postfeed and infective by day 8 postfeed at 27 degrees C. The prepatent period was relatively long, ranging from 23 to 40 days for bite-induced infections and appears to be related to the number of sporozoites injected. The acute phase of the infection is initially exponential and rapid. All lizards (6) that were not sacrificed, died of fulminating infections from 13 to 56 days after parasites were seen in the blood films. Gametocytes from 2 experimentally infected lizards were infective to L. vexator during the course of the acute infection. The majority of P. mexicanum parasites were in erythrocytes of Sc. undulatus. Exoerythrocytic forms were observed in circulating lymphocytes and thrombocytes, lymphocytes of spleen and bone marrow, and endothelial cells of brain capillaries. PMID- 3504906 TI - Vector incrimination and experimental transmission of Plasmodium floridense by bites of infected Culex (Melanoconion) erraticus. AB - A survey of mosquitoes which are attracted to and readily feed upon lizards in a northcentral Florida area where there is a relatively high prevalence of Plasmodium floridense in Anolis carolinensis was conducted. Culex erraticus and Cx. territans, collected in lizard-baited traps, readily fed on lizards in the traps and in the laboratory, and the former mosquito species is an experimental vector of Plasmodium floridense. Sporozoites were observed in the salivary glands from 11 to 14 days at 21-25 degrees C following an infective blood meal. The prepatent period of P. floridense in A. carolinensis at 18-24 degrees C was relatively long, 24-25 days (n = 2). At 32 degrees C, the prepatent period was decreased to 13-17 days (n = 4). The transmission rate of P. floridense by bite of Cx. erraticus and intraperitoneal inoculation of sporozoites from the salivary glands of Cx. erraticus, was relatively low (16.2%). Peak parasitemias ranged from 912 to 4,280 parasites per 10,000 red blood cells. Sporogonic development of P. floridense in Cx. territans which fed on infected lizards was not observed. PMID- 3504907 TI - Increased female mortality as a barrier to hybridization between members of the Aedes scutellaris complex of mosquitoes. AB - Interspecific crosses between the mosquitoes Aedes polynesiensis and Aedes malayensis have shown a unidirectional pattern of compatibility. Aedes polynesiensis females inseminated by Ae. malayensis males fail to produce viable offspring while the reciprocal cross is viable. In both crosses, rates of insemination are comparable to control rates. The Ae. polynesiensis females fail to lay eggs. One apparent reason for this is that the Ae. polynesiensis females have a high rate of mortality after insemination by Ae. malayensis males. Such mortality is an effective barrier to hybridization in that cross, and is a new class of isolating mechanism. PMID- 3504908 TI - An alternative bioassay employing neonate larvae for determining the toxicity of suspended particles to mosquitoes. AB - An alternative bioassay using neonate larvae of Aedes aegypti is described for determining the toxicity of suspended particles, particularly insecticidal bacteria, to mosquitoes. This new assay is comparable in precision to the 4th instar bioassay recommended by the World Health Organization, but is quicker and requires much less space. Values obtained using neonate larvae as the test insect showed less variation within and between replicates in regard to LC50 and slope of the regression line, and in general required fewer replicates to fulfill the requirements for a statistically valid bioassay than the W.H.O. assay. The precision of the neonate larval bioassay in combination with its requirements for less time and space may make it especially useful for screening large numbers of samples. PMID- 3504909 TI - Susceptibility of Aedes aegypti and Anopheles quadrimaculatus larvae to infection with the cercariae of Plagiorchis noblei (Trematoda: Plagiorchiidae). AB - The impact of interspecific behavioral differences on the relative susceptibility of third instar Aedes aegypti and Anopheles quadrimaculatus larvae to infection with cercariae of Plagiorchis noblei was determined. When permitted to move freely in a column of water, larvae of Ae. aegypti were significantly more susceptible to infection with the parasite than were An. quadrimaculatus larvae. This difference is ascribed to the significantly greater activity of Ae. aegypti larvae in the water column. Since cercariae are suspended in the column, particularly near the bottom, contact with larvae of Ae. aegypti may be enhanced, whereas contact with An. quadrimaculatus larvae, which tend to remain near the surface, may be reduced. Interspecific differences other than behavior are not thought to play a major role, since immobilized larvae of the two species did not differ significantly in their susceptibility to this parasite. PMID- 3504910 TI - Evaluation of larvicides for the control of Simulium damnosum s.l. (Diptera: Simuliidae) in West Africa. AB - The Onchocerciasis Control Program of the World Health Organization is carrying out an extensive screening program in a search for new larvicides to be used for control of Simulium damnosum s.l. Emphasis has been given to finding a pyrethroid and a carbamate to supplement the organophosphates currently in use. These chemicals with differing modes of action, together with Bacillus thuringiensis H 14, are being used in an attempt to cope with the development and spread of resistance to the organophosphates temephos and chlorphoxim. PMID- 3504911 TI - Temperature and water quality effects in simulated woodland pools on the infection of Culex mosquito larvae by Lagenidium giganteum (Oomycetes: Lagenidiales) in North Carolina. AB - Asexual stages of the California (CA) isolate of Lagenidium giganteum cultured on sunflower seed extract (SFE)-agar, were applied to outdoor pools containing Culex larvae near Raleigh, NC in August and September 1984. Infection rates among the larvae ranged from 19 to 74% at 2-4 days posttreatment and subsequent epizootics eliminated most of the newly hatched larvae for at least 10 days posttreatment. Substantial reductions in numbers of larvae and adult emergence were achieved from a single application of the fungus. Water quality and temperature data are presented. From laboratory assays of organically polluted water, the percent infection of Culex quinquefasciatus by the fungus was correlated with water quality and temperature. A logistic model of water quality (COD and NH3-N) effects on infectivity rates by the CA isolate is described. PMID- 3504912 TI - The ovarian nurse cell polytene chromosomes of Anopheles quadrimaculatus, species A. AB - Nurse cells in the ovaries of adults of Anopheles quadrimaculatus, Species A, were used to prepare a polytene chromosome map. The chromosome quality is superior to that of salivary glands, and it is easier to use adults rather than larvae for cytological analysis of field populations. The most reliable homologies between the salivary and ovarian maps are located in the distal ends of the respective arms, and one homologous region is a prominent landmark in all of the members of the nearctic Maculipennis complex and related species. The left arm of chromosome 3 is uniquely dimorphic. The homokaryotype for 3L1 is synonymous with 3L of the published map of salivary gland polytenes. The 3L heterokaryotype is mostly asynaptic, except for two small homologous, synaptic areas, one of which is inverted. Each homokaryotype contains a unique, diffuse puff that is adjacent to the centromere. PMID- 3504913 TI - Laboratory rearing techniques and adult life table parameters for Anopheles sergentii from Egypt. AB - Techniques are presented for maintaining colonies of Anopheles sergentii, an important malaria vector in Egypt. Larval development time and survival rates were determined for 3 rearing solutions and 4 temperatures. Under optimal conditions larval survival rates averaged 85%. Mean life expectancy at emergence for mated An. sergentii was 23.3 days under insectary conditions of 27 +/- 2 degrees C, 70-80% R.H. The net reproductive rate, mean generation time and instantaneous rate of increase were respectively, 45.8 females per female per generation, 29.7 days and 0.127. In the context of vector potential for malaria transmission, An. sergentii has a daily survivorship rate of 0.95. PMID- 3504914 TI - Highly polluted larval habitats of the Culex pipiens complex in central Sweden. AB - Larvae of the Culex pipiens complex (Cx. pipiens and Cx. torrentium) were abundant in two highly polluted pools receiving sewage sludge in Uppsala, Sweden (early August through late September 1985). The water was characterized by high BOD, and high ion concentration of Cu, Fe, Al and much suspended matter. Maximum larval number at the pool surface area was 26.1/ml. The ratio between species was studied and Cx. torrentium comprised ca. 20% at the peak of abundance. Some egg rafts showed no embryogeny. PMID- 3504915 TI - Testing for assortative mating between two Culex tarsalis strains reared in different environments. PMID- 3504916 TI - On the occurrence of Aedes purpureipes along the lower Colorado River. PMID- 3504917 TI - Estimation of the northern limits of distribution of Aedes albopictus in North America. PMID- 3504918 TI - A revised version of the CDC Gravid Mosquito Trap. PMID- 3504919 TI - Report of radionuclides in Aedes communis pupae from central Sweden, 1986. PMID- 3504920 TI - Heleidomermis sp. (Nematoda: Mermithidae) infecting Culicoides variipennis (Diptera: Ceratopogonidae) in Alabama. PMID- 3504921 TI - Mosquitoes and the quality of life. PMID- 3504922 TI - Variation in the vector competence of geographic strains of Aedes albopictus for dengue 1 virus. AB - Eight geographic strains of Aedes albopictus from Asia and North America and one North American strain of Aedes aegypti were tested for their vector competence with dengue 1 virus. Three groups of Ae. albopictus were established based on their vector competence: a) the OAHU laboratory strain, b) the three Malaysian strains, and c) the TOKYO and three North American strains. The three North American strains were similar to the strain of Ae. aegypti from Houston, Texas in their ability to transmit dengue 1 virus. A comparison of barriers to infection and transmission suggests that Ae. albopictus HOUSTON represents an introduced strain distinct from the more similar MEMPHIS and NEW ORLEANS strains. Based on these studies the North American strains were seen as more similar to a northern Asian strain (TOKYO) than to the three Malaysian (southern Asia) strains, supporting the current hypothesis that the indigenous strains of Ae. albopictus recently introduced into the United States had a northern Asian origin. PMID- 3504923 TI - Evaluation of naled applied as a thermal fog against Culicoides furens (Diptera: Ceratopogonidae). AB - Naled/diesel oil (1:99), applied as a thermal fog, was tested against the biting midge Culicoides furens. The insects were confined in small cages suspended at 4 heights on poles at progressively greater distances from the fog release point. In terms of population survival 24 hr after treatment, a parabolic equation accurately described the regression of percent survival on distance from the release point. If 10% survival is considered as the maximum acceptable, then the equation predicts adequate control up to 19.6 m (64.3 ft) from the fog release point. PMID- 3504924 TI - Malaria control in Iran--present and future. AB - The malaria eradication campaign in Iran, which started in 1958, has not been able to achieve its final goals. The technical, administrative, socio-economic and financial obstacles involved in this unfinished task are mentioned and the present status of malaria in the country is discussed. It is urged that eradication policy, presently used, be substituted by malaria control program, as defined by The World Health Organization. This would serve as a prerequisite for eventual eradication of malaria, from the country, in the future. Within such agreement, the improvement of basic health services and search for better technical means of controlling the transmission of the infection are emphasized as vital to achieve this goal. Intensive training of experienced staff, in Iran, for stimulation and promotion of relevant research and training activities in malaria control is highly recommended. PMID- 3504925 TI - Oviposition and biting patterns of Aedes triseriatus in the flood plains of Fort Bend County, Texas. AB - Aedes triseriatus deposited eggs at all tree heights between ground level and 3.7 meters, from June through early August, 1985, in a flood plain area of Fort Bend County, TX. Percentage of eggs decreased with increasing oviposition heights and greater preferences were found for ground level and 1.2 meters. More eggs were deposited at all heights in June than in July and August. Weekly biting activity of the mosquito was recorded for a 24-hour period throughout the study. Biting occurred during the day with early morning and late afternoon peaks and continued into the crepuscular period. PMID- 3504926 TI - Seasonal appearance and size of egg rafts of Culex halifaxii and Culex fuscanus in Okinawajima, the Ryukyu Archipelago, Japan. AB - The seasonal chronology of eggs of Culex halifaxii, Cx. fuscanus and their cohabitant Cx. quinquefasciatus were observed from March 1984 to early May 1985 in Okinawa prefecture, Japan. In Okinawajima, egg rafts of Cx. halifaxii and Cx. quinquefasciatus were found throughout the year. The greatest peak in eggs of Cx. halifaxii were observed in early June. The egg rafts of Cx. fuscanus were first collected on June 15, with the greatest peak of oviposition in early November. The egg raft of Cx. fuscanus was larger and both the maximum and mean numbers of eggs per raft were approximately two times greater than those of Cx. halifaxii. PMID- 3504927 TI - The origin and movement of gas during adult emergence in Aedes aegypti: an hypothesis. AB - Several events which precede adult emergence in Aedes aegypti were studied, including changes in buoyancy, changes visible through the pupal cuticle and changes at the foregut-midgut junction. Our data suggest tht the gas which is present in the posterior midgut at the time of emergence originates in the tracheal system. During the process of emergence this gas moves into the exuvial space through the adult spiracles and then follows the exuvial fluid into the alimentary canal. PMID- 3504928 TI - The house-frequenting, host-seeking and resting behavior of Anopheles darlingi in southeastern Amazonas, Brazil. AB - Studies on the behavior of Anopheles darlingi were conducted at a site along the Ituxi River, Amazonas, Brazil. Patterns of host-seeking activity inside and outside a single-walled house both presented activity peaks at sunset and sunrise, but biting activity inside a four-walled house peaked after sunset then gradually decreased during the night. Major movements of females into and out of the four-walled house occurred at sunset and sunrise, respectively. Marked engorged and unengorged females released indoors were observed to preferentially rest on the ceiling. These behavior patterns were confirmed by replication and/or with more than one sampling technique or study method. Additional observations on exit sites, spatial distribution of resting females and physiological condition of exiting specimens were recorded. PMID- 3504929 TI - Population dynamics of Culex quinquefasciatus and the fungal pathogen Lagenidium giganteum (Oomycetes: Lagenidiales) in stagnant water pools. AB - The fungal pathogen Lagenidium giganteum (California isolate), cultured on sunflower seed extract (SFE) and agar, was introduced once (May 15) into outdoor caged replicated stagnant water pools containing all instars of larval Culex quinquefasciatus. Subsequently, first-instar larvae were added daily (May 15 September 30) to simulate natural oviposition. The fungus persisted for the entire 138-day study period, which corresponded with the season of Cx. quinquefasciatus breeding in this region of North Carolina, and recycled in the mosquito larvae producing an 82% reduction of adult mosquitoes produced in comparison to untreated pools. The cycles of fungal activity varied among the pools with 2-4 major epizootics occurring during the study period. Data are presented on the cycling of populations of fungal zoospores, mosquito larvae, pupae and adults during the entire mosquito breeding season. PMID- 3504930 TI - Effects of aerial thermal fog applications of fenthion on caged pink shrimp, mysids and sheepshead minnows. AB - Mosquito control applications of fenthion by aerial thermal fog equipment were studied at 2 sites in Collier County, FL, for sprays that occurred on June 20 and 23, 1984. Acute, lethal effects of fenthion deposited in these estuarine habitats were assessed for caged pink shrimp (Penaeus duorarum), mysids (Mysidopsis bahia) and sheepshead minnows (Cyprinodon variegatus). At Site 1, along a bay with substantial dilution and tidal mixing, fenthion concentrations of 1.5 and 0.29 micrograms/liter were measured in samples taken immediately after both sprays. Concentrations decreased to less than or equal to 0.020 microgram/liter 12 h postspray and no mortality was observed for caged pink shrimp and mysids. Site 2 was along a residential canal system that offered limited dilution and mixing. Maximum concentrations were 2.6 and 0.51 micrograms/liter and measurable concentrations (greater than 0.038 microgram/liter) of fenthion persisted at this site for 4 days. Fenthion concentrations in surface waters were toxic to caged pink shrimp and mysids after both sprays. No mortality occurred among caged sheepshead minnows at either site. PMID- 3504932 TI - Impact of fenoxycarb, a carbamate insect growth regulator, on some aquatic invertebrates abundant in mosquito breeding habitats. AB - The insect growth regulator, Fenoxycarb, induced various morphogenetic aberrations in Notonecta unifasciata, Anax junius and Pantala hymenaea after treatment of late nymphal stages. Most affected nymphs died while molting from nymphs to adults. Fenoxycarb is also ovicidal to young eggs of N. unifasciata. The treatment rate of 0.034 kg AI/ha fenoxycarb induced some reduction in N. unifasciata population densities and produced a few morphogenetic abnormalities in some Odonata. However, planktonic organisms and aquatic beetles regularly found in the mosquito breeding habitats showed no deleterious effect. PMID- 3504931 TI - Genetic association between highly active esterases and organophosphate resistance in Culex tarsalis. AB - The genetics of two highly active esterases, A3H and B3H, in a methyl parathion resistant strain (MP-R) of Culex tarsalis was investigated in relation to organophosphate (OP) resistance. The increased activity of esterase A3 and of esterase B3 is under the control of two distinct and closely linked (approximately 4.4 centimorgans) genes. Each gene possesses two forms, one controlling high activity (A3H or B3H, respectively) and one controlling low activity (A3L or B3L, respectively) of the enzymes. Organophosphate resistance in the MP-R strain is strongly associated with the presence of these highly active esterases. The results are discussed in relation to the present knowledge on the mechanisms responsible for high activity of esterases observed in other OP resistant mosquitoes of the genus Culex. PMID- 3504933 TI - Monandry (monogamy) in natural populations of anopheline mosquitoes. AB - Polymorphic Y chromosomes within two species of anopheline mosquitoes provide markers for testing if females are inseminated by one or more males in nature. Wild-caught females of Anopheles dirus (sp. A) and An. maculatus s.s. produced 291 and 55 families, respectively, which showed a single type of Y chromosome. One family of the former species showed two types of Y chromosomes. These field data support the idea, established from laboratory studies, that female mosquitoes are largely monandrous (monogamous). Such information is important in interpretation of population biological data and, practically, in attempts to control insect pests by use of genetically designed males. PMID- 3504935 TI - Future role of the Agency for International Development in world-wide malaria control programs. AB - The world-wide importance of malaria in restricting economic growth, labor productivity and social progress in many less developed portions of the world and A.I.D.'s past, present and future role in the control of this disease is briefly reviewed. In developing its future role in a changing and dynamic setting, the A.I.D. has developed and established new policies for malaria control which interlink more closely with the Primary Health Care systems and directly relate, in many cases, to other A.I.D. health projects in child survival. These new policies and criteria are summarized. A review of the three emphasis areas of research, training and program design is provided. Intersectorial coordination is stressed as is cooperation in its assistance efforts with multilateral and other bilateral agencies in combatting this disease. The paper concludes that malaria remains an important health interest of the A.I.D. and support for technology development, transfer and adaptation is expected due to the economic and social importance of the disease. PMID- 3504934 TI - Efficacy of Arosurf MSF and formulations of Bacillus thuringiensis var. israelensis against Anopheles albimanus: laboratory bioassay. AB - The efficacy of Arosurf MSF alone and in combination with three preparations of Bacillus thuringiensis var. israelensis (B.t.i.) against Anopheles albimanus larvae, pupae and eggs was determined by bioassay. Arosurf MSF alone was effective against the egg, 4th larval instar and pupal stages. All Arosurf MSF and B.t.i. combined formulations produced over 90% mortality of all larvae and pupae, 48 hr posttreatment. Egg eclosion was reduced to approximately 25% with all formulations containing Arosurf MSF. PMID- 3504936 TI - Establishment of a free-mating colony of Anopheles barberi with notes on developmental rates. PMID- 3504937 TI - Laboratory evaluation of the bladderwort plant, Utricularia vulgaris (Lentibulariaceae), as a predator of late instar Culex pipiens and assessment of its biocontrol potential. PMID- 3504938 TI - Digital spray mileage recorder. PMID- 3504940 TI - Protecting truck beds against rust and chemicals. PMID- 3504939 TI - Seasonal size variability in Culicoides variipennis (Diptera: Ceratopogonidae) in southern California. PMID- 3504941 TI - The control of malaria vectors in the context of the Health for All by the Year 2000 Global Strategy. AB - The changing picture of malaria worldwide needs to be viewed in the context of other developments before we can determine the directions to take to be able to provide the thrusts required in malaria vector control. As a result of population growth, increasing urbanization and continuing pressure on scarce natural resources, the epidemiology of malaria and its manifestation as a public health problem are undergoing profound modifications, indeed in several parts of the world. This picture is further complicated by the spread of resistance to pesticides in the vector and to drugs in Plasmodium falciparum. In the immediate future, these trends will continue. In addition, the appearance of suitable vaccines is a highly probable event to be taken into consideration. The WHO Global Strategy of Health For All by the Year 2000 aims at the improvement of levels of health through primary health care. Among other things, this implies a greater reliance on community involvement and on intersectoral collaboration for health. In this light, the major malaria problems in the year 2000 will be: (1) "hard core" endemic areas with inadequate infrastructure and poor socio-economic development; (2) resource development areas, in particular those under illegal or poor controlled exploitation; (3) expanding urban areas and (4) increased mobility of non-immunes, particularly if uncontrolled. In order to cope with these problems, thrusts are required towards the development of vector control strategies, covering the following fields: (1) tools for vector control integrated in primary health care, (2) new chemicals, (3) improved and new biologicals, (4) environmental management and the adoption of health safeguards in resource development projects and (5) manpower development. PMID- 3504942 TI - Distribution of Anopheles quadrimaculatus and An. crucians larvae within rice field habitats in southwestern Louisiana. AB - This study, conducted in 3 parishes of Louisiana, documented the distribution pattern of Anopheles quadrimaculatus and An. crucians during the first crop season. Ratios of numbers of 3rd and 4th instar larvae of An. quadrimaculatus to the number of An. crucians 3rd and 4th instar larvae (Q/C), varied both spatially and temporally. The mean Q/C ratio during 1984 was 1.37; during 1985 it was 1.40. The ratios changed from week to week during each year, and increases or decreases in a particular week of 1984 were paralleled by increases or decreases during that same week of 1985. The changes in relative abundance of the 2 species were strongly related to the timing of irrigation practices and to a succession of habitat conditions. Anopheles quadrimaculatus larvae were dominant or exclusively present for several days after fresh water was added to the field. Anopheles crucians larvae then became dominant or exclusively present as the habitat progressed towards a eutrophic condition. Irrigation influenced the conditions of the habitat by freshening and deepening the water, causing a reversion towards a more oligotrophic condition. PMID- 3504943 TI - Efficacy of Bacillus sphaericus and Bacillus thuringiensis var. israelensis for control of Culex pipiens and floodwater Aedes larvae in Iowa. AB - Granular and flowable concentrate formulations of Bacillus thuringiensis var. israelensis provided a 90-100% reduction in Aedes vexans and Culex spp. larvae in natural larval habitats. A briquet formulation of B. thuringiensis was less effective, providing a 12-76% reduction. No residual activity occurred in sites treated with B. thuringiensis. Granular formulations of Bacillus sphaericus (2.78 8.42 kg/ha) caused a 100% reduction in Culex pipiens larvae in natural sites and artificial pools. Bacillus sphaericus also controlled (84-98% reduction) a mixed population of Aedes trivittatus and Cx. pipiens in subplots of a retention pond. In field sites, B. sphaericus continued to control Cx. pipiens larvae for 96 hr. PMID- 3504944 TI - Floating bait formulations increase effectiveness of Bacillus thuringiensis var. israelensis against Anopheles larvae. AB - The development and screening of floating-type bait formulations designed to improve the activity of bacterial toxins against larval Anopheles is described. Floating and spreading abilities of carrier particles (wheat flour) were compared using corn oil, lecithin, and two products yielding surface films on water (Arosurf and Liparol). Mixtures containing 1 or 5% Arosurf showed the best spreading abilities on a water surface, but strongly inhibited the ingestion of wheat flour by Anopheles albimanus larvae. Corn oil and lecithin improved spreading satisfactorily at a concentration of 5% and inhibited larval feeding by only 6-25%. To select a suitable concentration of active ingredient in formulations, Bacillus thuringiensis var. israelensis (B.t.i.) primary powder in concentrations ranging from 0.01 to 0.5% was mixed with wheat flour/corn oil mixtures and tested in quantities exceeding the gut volumes of treated larvae. Complete mortality was obtained with concentrations of 0.1% (Anopheles stephensi), 0.2% (An. albimanus), or 0.3% (An. quadrimaculatus) B.t.i. When in 175-liter containers the activity of formulations (5% corn oil, 0.2% B.t.i.) and of toxin suspensions was compared by conventional dosage-mortality regression, formulations were more active by a factor of 68 against An. stephensi, 39 against An. albimanus and 67 against An. quadrimaculatus. PMID- 3504945 TI - Larval salinity tolerances of the sibling species of Anopheles farauti. AB - Experiments conducted with laboratory colonies of the sibling species of Anopheles farauti showed larvae of An. farauti No. 1 had a higher salinity tolerance than larvae of An. farauti No. 2 and An. farauti No. 3. The salinity response of field-collected larvae of An. farauti No. 1 from Cowley Beach, Queensland, Australia was similar to that of larvae from two colonies of this species which originated from Papua New Guinea. These results indicate that An. farauti No. 1 is the species which is likely to be found breeding in brackish water whereas the other species may be restricted to freshwater habitats. Laboratory experiments conducted with the colonies and with specimens collected from three localities in northern Queensland indicated that a simple test, based on exposure of first-instar larvae to sea water for 1 hr, should enable identification of An. farauti No. 1 in the field. PMID- 3504946 TI - Effectiveness of five methods for sampling adult Culex mosquitoes in rural and urban habitats in San Bernardino County, California. AB - The comparative effectiveness of NJ light traps, CO2-baited traps, walk-in red boxes, high-intensity light traps and gravid traps for sampling adult Culex mosquitoes for arbovirus surveillance was compared at rural dairy and residential urban habitats near Chino, California. Culex quinquefasciatus was the most abundant of the 3 species present comprising 94.9% of the 23,159 mosquitoes collected, followed by Cx. peus (4.2%) and Cx. tarsalis (0.9%). Female mosquitoes of all species were most abundant in CO2-baited traps at both urban and rural environments. Males were collected most effectively by walk-in red boxes in rural, but not urban, environments. More parous females were collected by CO2 baited traps at urban than rural habitats; however, 70-79% of all females were nulliparous and had never blood fed. These data point out the potential insensitivity of the current sampling methodology in monitoring mosquito arbovirus infection rates. PMID- 3504947 TI - Factors affecting the acquisition of Plagiorchis noblei (Trematoda: Plagiorchiidae) metacercariae by larvae and pupae of Aedes aegypti in the laboratory. AB - When exposed to concentrations of less than one Plagiorchis noblei cercariae per cc of water, the acquisition of metacercariae by Aedes aegypti larvae increased significantly with each successive instar but declined precipitously upon pupation. Thus, 1st instar larvae acquired no metacercariae, whereas 4th instars had a mean abundance of 6.15: pupae only acquired a mean of 0.62 parasites. Parasite acquisition was largely a function of host size and activity. Other factors, such as grooming and feeding behavior, may affect the success of cercarial penetration and the distribution of metacercariae in the body of the insect host. PMID- 3504948 TI - Sampling and distribution of Anopheles quadrimaculatus immatures in rice fields. AB - Dipper samples of Anopheles quadrimaculatus immatures from stocked enclosures in Arkansas rice fields were used to develop regression equations relating dipper sample counts to absolute density. Confidence limits were developed for mean number of immatures collected at each density and stadia, including combined stadia. These data can be used to estimate absolute density from mean dipper count. Distribution of rice field immatures approximated but did not fit the Poisson distribution. Sample size was calculated for 10, 25 and 50% of the true mean, at various levels of Type I and II error. A sample size of N = 6,424 was necessary to detect differences within 10% of the true mean, with 5 and 10% probability of Type I and II error, respectively. PMID- 3504949 TI - Studies on autogeny in Culex tarsalis: 3. Life table attributes of autogenous and anautogenous strains under laboratory conditions. AB - The reproductive biology and life table attributes of autogenous and anautogenous strains of Cx. tarsalis which were selected from the same parent colony were compared under laboratory conditions. Autogenous mosquitoes required 1 day longer to complete immature development, but oviposited 1 to 2 days earlier than anautogenous mosquitoes. Autogenous females readily imbibed blood meals from restrained chickens if ovarian maturation had not progressed to Christophers' Stage III. Wing length and life expectancy were not significantly different between strains; however, autogenous females laid a significantly smaller number of eggs per raft during initial oviposition than anautogenous females. Egg raft size did not differ significantly between strains during subsequent ovipositions resulting in similar net reproductive rates (Ro). Earlier oviposition and a comparable Ro resulted in a greater intrinsic rate of increase (rm) and birth rate (b) for autogenous than anautogenous cohorts. Thus, highly autogenous populations would be able to exploit newly created surface water breeding sources more rapidly than highly anautogenous populations. However, highly autogenous populations probably would not be able to transmit a horizontally maintained arbovirus as efficiently as anautogenous populations, since autogenous females imbibe their initial blood meal later in life than anautogenous females. PMID- 3504950 TI - Adult body size and parity in field populations of the mosquitoes Anopheles crucians, Aedes taeniorhynchus and Aedes sollicitans. PMID- 3504951 TI - Effect of water quality on the efficacy of water-base suspensions of Arosurf MSF against larvae of Aedes taeniorhynchus: bioassay evaluations. PMID- 3504952 TI - A sulfide detection test for field use. PMID- 3504953 TI - Aedes albopictus in Chicago, Illinois. PMID- 3504954 TI - Interviews with Ms. Mary F. Malone and Dr. Elnora D. Daniel: 1986 Mary Mahoney award recipients. PMID- 3504955 TI - What every nurse should know about the policy making process. PMID- 3504956 TI - Public health issues for the black professional women's agenda. PMID- 3504957 TI - Exercise: the outcomes of a program for elderly clients. PMID- 3504958 TI - Compliance and health beliefs in the black female hypertensive client. PMID- 3504959 TI - Collaborative efforts of law enforcement and health professionals to decrease violence and crime in the black community. PMID- 3504960 TI - Enhancing cultural sensitivity in clinical practice. PMID- 3504961 TI - Guest editorial: research in nursing. PMID- 3504962 TI - Towards an identification of the pyrethroid pharmacophore. A molecular modelling study of some pyrethroid esters. AB - A molecular modelling and computer graphics study of a series of pyrethroid insecticides has been carried out. The three-dimensional arrangement of the groups essential for the biological activity (pharmacophore) has been identified for the acid and the alcohol moieties, respectively. These pharmacophores are based on the relationship between molecular structure and biological activity for a number of pyrethroid esters. The pharmacophores, which describe the relative location in space of the unsaturated systems, the dimethyl groups and the ester moiety, may be useful in the design of novel compounds with pyrethroid activity. PMID- 3504963 TI - A method for fast energy estimation and visualization of protein-ligand interaction. AB - A new computational and graphical method for facilitating ligand-protein docking studies is developed on a three-dimensional computer graphics display. Various physical and chemical properties inside the ligand binding pocket of a receptor protein, whose structure is elucidated by X-ray crystal analysis, are calculated on three-dimensional grid points and are stored in advance. By utilizing those tabulated data, it is possible to estimate the non-bonded and electrostatic interaction energy and the number of possible hydrogen bonds between protein and ligand molecules in real time during an interactive docking operation. The method also provides a comprehensive visualization of the local environment inside the binding pocket. With this method, it becomes easier to find a roughly stable geometry of ligand molecules, and one can therefore make a rapid survey of the binding capability of many drug candidates. The method will be useful for drug design as well as for the examination of protein-ligand interactions. PMID- 3504964 TI - Energy minimization and molecular dynamics studies of Asn-102 elastase. AB - Four isomeric forms of the Asn-102 PPE (D102N mutant according to the emerging protocol, [Knowles, Science, 236 (1987) 1252-1258]) have been investigated using energy minimization (EM) and molecular dynamics (MD) techniques. MD simulation data for 175 ps are reported for each form (in total 700 ps for about 2500 atoms). The His-57 N epsilon-protonated forms are calculated to be more stable than the N delta-protonated ones. The active site region of the most stable form is very similar to that found in the D102N rat trypsin enzyme [Craik et al., Science, 237 (1987) 909-913]. Conformations of the active sites and their hydrogen bond patterns are presented for each of these forms and are compared with the structure of the native enzyme active site. The pH dependent activity of the D102N derivative is discussed. PMID- 3504965 TI - Molecular dynamics simulations of cyclosporin A: the crystal structure and dynamic modelling of a structure in apolar solution based on NMR data. AB - The conformation of the immunosuppressive drug cyclosporin A (CPA), both in apolar solution and in crystalline state, has been studied by computer simulation techniques. Three molecular dynamics (MD) simulations have been performed: one modelling the crystal structure and two modelling the structure in apolar solution, using a restrained MD approach in which data from nuclear magnetic resonance (NMR) and infrared (IR) spectroscopy are taken into account. The simulation of the crystalline state (MDC) concerns a system of 4 unit cells containing 16 cyclosporin A molecules and 22 water molecules, which is simulated using crystalline periodic boundary conditions. The simulations modelling the apolar solvent conformation (MDS) concern one isolated cyclosporin A molecule. In these simulations an extra term in the interatomic potential function is used, which forces the molecule to satisfy a set of 57 atom-atom distance constraints originating from nuclear Overhauser effects (NOEs) obtained from NMR spectroscopy and one distance constraint deduced from IR spectroscopy. From a comparison of the results of the crystal simulation to those of the X-ray experiment in terms of structure, atomic fluctuations, hydrogen bond pattern, etc., it is concluded that the force field that is used yields an adequate representation of crystalline cyclosporin A. Secondly, it is shown that the dynamic modelling technique that is used to obtain a structure in a polar solution from NMR distance information works well. Starting from initial conformations which have a root mean square difference of 0.14 nm both distance restrained MD simulations converge to the same final solution structure. A comparison of the crystal structure of cyclosporin A and the one in apolar solution shows that there are significant differences. The overall difference in atomic positions is 0.09 nm for the C alpha atoms and 0.17 nm for all atoms. In apolar solution, the molecule is slightly more bent and the side chains of 1 MeBmt and 10 MeLeu adopt a different conformation. PMID- 3504966 TI - Designing novel nicotinic agonists by searching a database of molecular shapes. AB - We introduce an approach by which novel ligands can be designed for a receptor if a pharmacophore geometry has been established and the receptor-bound conformations of other ligands are known. We use the shape-matching method of Kuntz et al. [J. Mol. Biol., 161 (1982) 269-288] to search a database of molecular shapes for those molecules which can fit inside the combined volume of the known ligands and which have interatomic distances compatible with the pharmacophore geometry. Some of these molecules are then modified by interactive modeling techniques to better match the chemical properties of the known ligands. Our shape database (about 5000 candidate molecules) is derived from a subset of the Cambridge Crystallographic Database [Allen et al., Acta Crystallogr., Sect. B,35 (1979) 2331-2339]. We show, as an example, how several novel designs for nicotinic agonists can be derived by this approach, given a pharmacophore model derived from known agonists [Sheridan et al., J. Med. Chem., 29 (1986) 889-906]. This report complements our previous report [DesJarlais et al., J. Med. Chem., in press], which introduced a similar method for designing ligands when the structure of the receptor is known. PMID- 3504968 TI - Strategies II. PMID- 3504967 TI - Distance geometry analysis of ligand binding to drug receptor sites. AB - The method known as 'distance geometry approach' for receptor mapping procedures is discussed. In this method a ligand binding to a certain receptor is considered as a collection of ligand points. Binding sites of the receptor are either 'empty' or 'filled' site points; a ligand point might bind to an empty site point; filled site points indicate that at that point no binding is possible. A binding mode of a ligand is a list of which ligand points coincide with which empty binding sites. The applicability of the method for QSAR studies is discussed; as examples are mentioned the dihydrofolate reductase, beta 1- and beta 2-receptors. Finally, some ideas on future developments in receptor mapping are discussed. PMID- 3504969 TI - Dynamic properties of the rabbit mandible during application of occlusal force. PMID- 3504970 TI - In vitro effect of molybdenum on fluoride uptake and remineralization in artificial subsurface lesions of bovine enamel. PMID- 3504971 TI - Characterization of Hexsyn, a polyolefin rubber. AB - Hexsyn is the Goodyear Tire and Rubber Company tradename for a polyolefin rubber synthesized from 1-hexene with 3-5% methylhexadiene as the source of residual double bonds for vulcanization. Under license from Goodyear, this same polymer has been manufactured by Lord Corporation for the hinge portion of finger joint prostheses using the tradename Bion. This rubber is currently licensed to the University of Akron and to the Cleveland Clinic Foundation for use in biomedical applications, and is being used primarily for biocompatible and highly fatigue resistant rubber components in ventricular assist and artificial heart systems. Results are presented from the physical, mechanical, and biological characterization of Hexsyn. Procedures are described for the synthesis, compounding, and post-molding extraction for Hexsyn. The physical testing of Hexsyn reported includes determinations of its density at 23 and 37 degrees C, initial hardness and hardness after aging in oxygen, blood, pseudoextracellular fluid and polyethylene glycol 600, typical molecular weights determined by gel permeation chromatography/low angle laser light scattering and intrinsic viscosity, thermal analyses by differential scanning calorimetry of Hexsyn gum, and vulcanized Hexsyn after exposure to blood and blood/fatigue conditions. Also reported are results of differential thermal analyses, thermomechanical analyses of virgin and annealed samples, and thermogravimetric analyses conducted in helium and in air. Dynamic mechanical analyses of Hexsyn include Clash-Berg and Rheovibron tests. Swelling was conducted to determine lot-to-lot and sheet-to sheet variation for quality control and also a number of solvents were used so that the polymer-solvent interaction parameters could be determined. The permeability of Hexsyn to water, water vapor, and a variety of gases is reported. The permeability by contact angle measurements, refractive index, residual solvent analyses, migration of blood components into Hexsyn, melt rheology by Monsanto Rheometer, resistance to acids, and typical mold shrinkage for Hexsyn are reported. Mechanical testing of Hexsyn includes tensile strength, elongation, and tensile stress (modulus) at 23 and 37 degrees C and after conditions including exposure to blood, pseudoextracellular fluid, polyethylene glycol, oxygen, 100% relative humidity, and fatigue testing. Stress/strain calibration curves, flexural rigidity after aging in blood, tension set, compression set, stress relaxation, and the effect of repeated cycling on the elastic modulus are presented along with the results of Pico abrasion, skid resistance tests on wet concrete.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3504972 TI - Introduction of surface functional groups onto biomaterials by glow discharges. AB - An attempt was made to graft the monomer HEMA to the polymer surface by "Glow discharge" technique. Experiments were carried out for different surfaces varying the exposure times of samples to HEMA and also as a function of glow discharge time. It was found that as the percentage of grafting increases the hydrophilicity also increases. Contact angle measurements were performed on these substrates, which confirmed the hydrophilic nature of the grafted samples compared to the controls. The role of protein adsorption and their effects to modulate the blood polymer interaction is briefly discussed. When a foreign material comes in contact with blood, the initial event is the adsorption of plasma proteins in parallel with the adhesion of platelets to the material. Albuminated surfaces discourage platelet adhesion while fibrinogen enhances the platelet attachment and thrombosis. Hence a decreased ratio of fibrinogen to albumin on a substrate can be correlated as an indication to its improved blood compatibility. Fibrinogen to albumin ratios of the grafted samples showed a reduction, indicating that albumin adsorption is high; which may make the modified surfaces non-thrombogenic. PMID- 3504973 TI - Hemocompatibility of hydrogel with polyethyleneoxide chains. AB - We have synthesized a hydrogel with long polyethyleneoxide (PEO) chains and evaluated its hemocompatibility. The hydrogel significantly suppressed the adsorption of plasma proteins and adhesion of platelets. In addition, the marked retardation of thrombus formation on its surface was recognized. These findings seems to be caused by the volume restriction effects derived from the highly flexible and hydrophilic PEO chains. PMID- 3504974 TI - Blood compatible polyurethane elastomers. AB - Medical applications of blood compatible polyurethane elastomers contribute significantly to the quality and effectiveness of the nation's health system. These projects range from artificial hearts to diagnostic/therapeutic cardiac catheters which are saving the lives of many critically ill patients. PMID- 3504975 TI - Disaster and refugee psychiatry: guidelines for the armed forces medical officer. PMID- 3504976 TI - Ileostomy: a personal viewpoint. PMID- 3504977 TI - A review of the treatment and recurrence of varicose veins in the Royal Naval Hospital, Plymouth 1981-1985. PMID- 3504978 TI - Computers: application of micro computer in a Royal Naval Air Station. PMID- 3504979 TI - Private consulting forensic pathology. PMID- 3504981 TI - Euthanasia: where are we? Where are we going? PMID- 3504982 TI - Homicide investigation--importance of scene visit by forensic pathologist. PMID- 3504980 TI - The use of videotechnology by the medical trial defense bar--a case study. PMID- 3504983 TI - The validity of urine alcohol analysis in drunk drivers. AB - Blood and breath are the specimens of choice for determining alcohol levels. A random urine specimen may not reflect a blood level because of the influences due to the stage of absorption, the quantity of urine in the bladder, and the frequency of urination. A urine sample may accurately reflect a blood level only 30 minutes after the bladder is completely emptied. Individual states that permit urinalysis for alcohol must provide procedures for sample collection and statutory limit levels. PMID- 3504984 TI - [Hypogammaglobulinemia in childhood. Report of 19 cases]. PMID- 3504985 TI - [Estimation of heterozygote frequency of Sandhoff disease in a high-risk Argentinian population. Predictive assignment of the genotype through statistical analysis]. PMID- 3504986 TI - [The epidemiology of cancer in the Province of Neuquen, Argentina]. PMID- 3504987 TI - [Proximal and distal peripheral nerve conduction in chronic renal insufficiency]. PMID- 3504988 TI - [Digital neural conduction]. PMID- 3504989 TI - [Aspiration cytology of nodular goiter: cytohistological correlation and selectivity of the method]. PMID- 3504990 TI - In vitro capacitation of spermatozoa in different strains of mice: the acrosome reaction. PMID- 3504991 TI - [Meningeal cryptococcosis]. PMID- 3504992 TI - [The past and future]. PMID- 3504993 TI - [Psychosocial aspects of the offprint, or the reprint game]. PMID- 3504994 TI - [Prevalence of dengue in a risk area in Argentina]. PMID- 3504995 TI - [Hemofiltration in adult respiratory distress syndrome]. PMID- 3504997 TI - [Reflections on acquired immunodeficiency syndrome (AIDS)]. PMID- 3504996 TI - [Serological diagnosis of HIV infection in subjects of high risk for AIDS in the city of Rosario. Comparative study of 3 different technics]. PMID- 3504998 TI - [The referees of papers]. PMID- 3504999 TI - [Treatment of hematosis disorders in chronic obstructive bronchitis with almitrine bismesilate]. PMID- 3505000 TI - [Combination of different inotropic agents in the treatment of chronic refractory cardiac insufficiency]. PMID- 3505001 TI - [Microbial contamination of the air in dental departments. Preliminary note]. PMID- 3505002 TI - [Microbiological factors in the epidemiology of periodontal disease]. PMID- 3505003 TI - [Seroepidemiology of rubella, hepatitis B and tetanus in students of graduate courses in dentistry and dental prosthesis]. PMID- 3505004 TI - [Evaluation of allele gene frequency in beta-thalassemia in a population sample from Conca Ternana]. PMID- 3505005 TI - [Survey of the time span (1975-1980) on mortality due to original liver tumor in Lazio]. PMID- 3505006 TI - [Evaluation of the actual level of contamination by organochlorine pesticides in meat produced in Campania]. PMID- 3505007 TI - [Microbiological studies on vaginal smears: casuistry of women consulting a Rome walk-in clinic]. PMID- 3505008 TI - [Incidence and distribution of vaginal yeast in non selected obstetric and gynecologic patients]. PMID- 3505009 TI - [Resistance to disinfectants: experience with opportunistic species in the hospital]. PMID- 3505010 TI - [Activity of benzalkonium chloride, polyvinyl povidone and chlorhexidine on families of microorganisms isolated in a hospital environment]. PMID- 3505011 TI - [Contamination of river water around Rome: microbiological index and presence of Salmonella]. PMID- 3505012 TI - [Enumeration of fecal coliforms in sea water: importance of reestablishment of microbes]. PMID- 3505013 TI - [Chlorinated volatile hydrocarbons in ground water from Campania]. PMID- 3505014 TI - [Liquid waste and its treatment in the city of Bologna]. PMID- 3505015 TI - [Environmental investigation of non tubercular mycobacteria in the province of Sassari]. PMID- 3505016 TI - [Importance of summer holiday trips on the epidemiology of salmonellosis, shigellosis and Yersinia enterocolitica infections]. PMID- 3505017 TI - Doctors and nuclear war. PMID- 3505018 TI - Accidental poisoning in childhood. PMID- 3505020 TI - Coming to terms with computers. PMID- 3505019 TI - How readily do children with asthma have access to their treatment? PMID- 3505021 TI - Extending the roles of practice nurses and facilitators in preventing heart disease. PMID- 3505022 TI - Families, family doctors and family therapy. PMID- 3505023 TI - Undergraduate education in general practice. Present emphases and future directions. PMID- 3505024 TI - The process of postgraduate education in general practice. PMID- 3505025 TI - The vastness of general practice. PMID- 3505026 TI - Lower limb amputees: advantages of the team approach. PMID- 3505027 TI - Thyroid function tests. PMID- 3505028 TI - Trivia in general practice. PMID- 3505030 TI - Organising our clinical work. PMID- 3505029 TI - Trial of ultrasonic therapy for acute herpes zoster. PMID- 3505031 TI - GPs alert to serious psychological distress. PMID- 3505033 TI - Changing role of the community pharmacist. PMID- 3505032 TI - Recent advances in obstetric care. PMID- 3505034 TI - Recent advances in psychology which affect general practice. PMID- 3505035 TI - Holistic medicine: new lessons to be learned. PMID- 3505036 TI - The politics of health care. Interview by Roger Neighbour. PMID- 3505037 TI - General practice and the ethics of resource allocation. PMID- 3505038 TI - How to make medical research more successful. Part 2. PMID- 3505039 TI - Decontamination of equipment in general practice. PMID- 3505040 TI - Proceedings of the International Workshop on Driver Reaction Times. Jerusalem, Israel, 5-6 January 1987. PMID- 3505041 TI - Driver brake reaction times: unobtrusive measurement on public roads. PMID- 3505042 TI - The latency of simple reaction on highways: a field study. PMID- 3505043 TI - Notes on the relationship between headways and traffic flow. PMID- 3505045 TI - Too short headways: a treatable risk for road crash death and injury? PMID- 3505044 TI - Epidemiology and headways. PMID- 3505046 TI - Time scale involved in reaction time studies. PMID- 3505047 TI - Introduction to legal aspects of headways. PMID- 3505048 TI - Traffic police viewpoint on headways. PMID- 3505049 TI - Regulation of headways. PMID- 3505050 TI - Legal evidence for tailgating--technological options. PMID- 3505051 TI - History of legal aspects of enforcing minimum headways. PMID- 3505052 TI - Consumer behavior and health promotion: a reply to Becker's "The tyranny of health promotion". PMID- 3505053 TI - Israel Society of Epidemiology. Sixth annual meeting. 29 March 1988, Beer Sheva, Israel. Abstracts. PMID- 3505054 TI - [Treatment of infrabony pocket]. PMID- 3505056 TI - [A case report of juvenile periodontitis]. PMID- 3505055 TI - [Histologic evaluation of bone graft material]. PMID- 3505057 TI - [Flap operation--application of osseous resection for aberrant bony architecture]. PMID- 3505058 TI - [Flap operation--through a change in my clinical attitude]. PMID- 3505059 TI - [The furcation problem--root resection]. PMID- 3505060 TI - [The furcation problem--diagnosis and therapy]. PMID- 3505061 TI - [Initial or accelerative factors of periodontal disease and crown-bridge prostheses]. PMID- 3505062 TI - [The furcation problem--therapy and prognosis]. PMID- 3505063 TI - [Brushing instruction in a dental office]. PMID- 3505064 TI - [Treatment planning in a case of advanced periodontitis]. PMID- 3505065 TI - [Physical properties on posterior restorative composite resins of various consistencies]. PMID- 3505066 TI - [The clinical observation of exposure and traction cases of impacted teeth]. PMID- 3505067 TI - [A histopathological study on the resorption after pulpotomy in primary teeth]. PMID- 3505068 TI - [Mechanical properties of the dental composite resins]. PMID- 3505069 TI - [The quantification of nursery environment to caries prevalence in children]. PMID- 3505070 TI - [Study on electrometric pulp testing in permanent teeth with incompletely formed apices]. PMID- 3505071 TI - [A morphological study on the dentition using Fourier analysis. The relationship between deciduous dentition and permanent dentition]. PMID- 3505073 TI - [Hyperplasia of pericoronal fibrous connective tissue resulting in impaction of the bilateral secondary molars of both mandible and maxilla, a case report]. PMID- 3505072 TI - [Serotypes and extracellular bacteriocin (mutacin) production among strains of Streptococcus mutans isolated from the human oral cavity]. PMID- 3505074 TI - [A case of the transposition and the dentigerous cyst formation of the permanent tooth germ due to the extrusion with calcium hydroxide root canal filling material containing silicone to the deciduous tooth]. PMID- 3505075 TI - [A case of fibrous hyperplasia in a 9-month-old infant]. PMID- 3505076 TI - [Current prevalence of dental caries in children visited to the Pedodontic Clinic of Tsurumi University Dental Hospital]. PMID- 3505077 TI - [Clinical observations of submerged deciduous molars (5 cases)]. PMID- 3505078 TI - [Restoration of the "supporting zone" of the mandible in partially dentate mouth (Part 4). "Supporting zone" of periodontally and occlusally insufficient individuals]. PMID- 3505079 TI - [Studies on visible light cured composites. Increase in temperature of light tips and tooth surface during irradiation and heat generation by polymerization on various composite resins]. PMID- 3505080 TI - [Clinical estimation on the efficacy and usefulness of SI-3906]. PMID- 3505081 TI - [Effect of levamisole (LMS) on lysosomal enzyme release and receptors of polymorphonuclear leukocytes]. PMID- 3505082 TI - [Suppression of the tail flick reflex by selective stimulation of a delta afferent nerve fibers]. PMID- 3505083 TI - [Correlation between skeletal pattern and the shape of the nose in the Japanese adult]. PMID- 3505084 TI - [The effect of beryllium chloride on alkaline phosphatase activity in rat bone cells in culture]. PMID- 3505085 TI - [Enclosing method for visual tooth color matching]. PMID- 3505086 TI - [Three dimensional ultrastructures of the osteocytes and the walls of osteocyte lacunae in immature bone]. PMID- 3505087 TI - Nostril asymmetry--a microform of cleft lip and palate? PMID- 3505088 TI - [Determination of total fluorine and ionizable fluorine levels in milk]. PMID- 3505089 TI - [Study on the curve symbol of the deciduous dentition]. PMID- 3505090 TI - [Clinical evaluation of gallium restorations. 6-month results of gallium alloy]. PMID- 3505091 TI - [A case of herpes zoster treated with acyclovir]. PMID- 3505092 TI - [A case of lipoma of the lower lip]. PMID- 3505093 TI - [Structure of the parotid gland in the rat and its changes during aging]. PMID- 3505094 TI - [Immunologic response in children treated with long-term bacterial autovaccination]. PMID- 3505095 TI - [Treatment of infected pseudarthroses in the long bones using external fixation]. PMID- 3505096 TI - [The importance of studying circulating platelet aggregation in cerebrovascular stroke]. PMID- 3505097 TI - [The effect of total photochemotherapy on liver tests in patients with psoriasis treated with the PUVA method]. PMID- 3505098 TI - [Evaluation of risk factors for stroke in hospitalized patients at the Medical School Neurologic Clinic in Hradci Kralove over the past 10 years]. PMID- 3505099 TI - [A new method of calculating the biting force of patients using electromyography]. PMID- 3505100 TI - [Removing the bridge because of the eruption of an impacted tooth]. PMID- 3505101 TI - [An electromyographic study on functional development of mastication in children with mixed dentition]. PMID- 3505103 TI - [Elution of residues from composite resins]. PMID- 3505102 TI - [Studies on the clinical application of several visible light-cured composite resins. 1. Relationship between irradiation time and hardness]. PMID- 3505104 TI - [Biochemical and histological study of oral mesenchymal neoplasia--reducible cross-link and type of collagen of analysis]. PMID- 3505105 TI - [Clinical study of the Gow-Gates mandibular nerve block--comparison with the inferior alveolar nerve block]. PMID- 3505106 TI - [One case with speech defect as chief compliment]. PMID- 3505107 TI - [An apparatus for experimental cavity preparation using the pantograph]. PMID- 3505108 TI - [A case of long-standing dislocation of the temporomandibular joint]. PMID- 3505109 TI - [Immunohistochemical study on leukoplakia and squamous cell carcinoma of the oral cavity with special reference to detection of basement membrane by staining of Laminin and type IV collagen]. PMID- 3505110 TI - [Electromyographic changes in masticatory muscles after injecting pain producing substance with special reference to the dysfunction of masticatory muscles]. PMID- 3505111 TI - [Medical treatment of urinary infections in children]. PMID- 3505112 TI - [Evolution of non-operated interventricular communications]. PMID- 3505113 TI - [Diagnosis of pelvic distress by radiopelvimetry using 2 plates. Apropos of 102 cases]. PMID- 3505114 TI - [Acute benign lymphocytic meningitis. Apropos of a childhood epidemic in northwest Tunisia]. PMID- 3505115 TI - [Informatics in medicine]. PMID- 3505116 TI - [Ergotism revealing Horton's disease]. PMID- 3505117 TI - [Clinical and etiological aspects of mental confusion. Apropos of 5 cases]. PMID- 3505119 TI - [Kidney needle biopsy: indications, value and results]. PMID- 3505118 TI - [Multiple myeloma exhibiting 2 monoclonal immunoglobulins. Apropos of a case]. PMID- 3505120 TI - [Hypospermia and the post-coital test]. PMID- 3505121 TI - [Index of severity of hydatid cyst of the liver rupturing into the biliary ducts. Apropos of 23 cases--1977-1984]. PMID- 3505122 TI - [Rupture of the urethra (apropos of 17 cases)]. PMID- 3505123 TI - [Heredity in pigmented retinopathy]. PMID- 3505124 TI - [It was 1 year ago...Chernobyl]. PMID- 3505125 TI - [Can the phospho-calcium analysis be simplified?]. PMID- 3505126 TI - [Atrial fibrillation--the role of echocardiography]. PMID- 3505127 TI - [Acute granulocytic leukemia in children. Apropos of 51 cases]. PMID- 3505128 TI - [Idiopathic thrombopenic purpura. Retrospective, clinical, biological, developmental, therapeutic study of 148 cases]. PMID- 3505129 TI - [Uterine rupture in the Maternity Department in Sfax. Apropos of 72 cases 1980 1984]. PMID- 3505130 TI - [Unusual indications of peridural anesthesia in obstetrics]. PMID- 3505131 TI - [Spontaneous cutaneous-cystic-hepatic-bronchial fistula due to an hydatid cyst]. PMID- 3505133 TI - [Percutaneous drainage in the treatment of kidney abscess]. PMID- 3505132 TI - [Congenital liver fibrosis in adults. Apropos of a case]. PMID- 3505134 TI - [Pasteurellosis after a cat bite. Apropos of a case]. PMID- 3505135 TI - [Abscess of the ovary. Apropos of 3 cases]. PMID- 3505137 TI - [WHO wrote to us: the International Decennial of drinkable water and sanitary conditions]. PMID- 3505136 TI - [Bone echinococcosis. Apropos of 4 cases]. PMID- 3505138 TI - [Tranquilizing agents: their indications and risks]. PMID- 3505139 TI - [Electromyography in children: indications and use. Apropos of 383 cases]. PMID- 3505140 TI - [Congenital cataracts and heredity]. PMID- 3505141 TI - [Analytic study of typhoid fever in southern Tunisia 1982-1985. Apropos of 119 cases]. PMID- 3505142 TI - [Usefulness of clinical indices in the prognosis of bronchial cancer]. PMID- 3505143 TI - [Adult acute respiratory distress syndrome after hemorrhagic shock. Apropos of a case]. PMID- 3505144 TI - [Reliability and value of cytology in breast lesions]. PMID- 3505145 TI - [Chylothorax due to thrombosis of the superior vena cava during Behcet's disease]. PMID- 3505146 TI - [Secondary sclerosis of the bile ducts. An unusual complication of the surgical treatment of an hydatid cyst of the liver]. PMID- 3505147 TI - [Segmental bronchial atresia. Apropos of a case]. PMID- 3505148 TI - [Hemodynamic pulmonary edema after axillary plexus block]. PMID- 3505149 TI - [Homozygous O Arab hemoglobinopathy in a Tunisian family. Apropos of a case]. PMID- 3505150 TI - [Effects of environmental hypoxia on various hemodynamic, acid-base and electrolytic constants of Iguana iguana (L., 1758)]. PMID- 3505151 TI - Muscarinic activation of phosphatidylinositol breakdown in neuroblastoma cells. PMID- 3505152 TI - Acute effects of carbon disulphide on hepatic lipid metabolism in Fischer rats. PMID- 3505154 TI - [Rapid method for isolation and purification of myosin from muscle of tarantulas]. PMID- 3505153 TI - Relationship between sagittal sinus pressure and cerebrospinal fluid pressure during sympathetic stimulation, hypoxia and hypercapnia in the rat. PMID- 3505155 TI - [Alcoholic hepatitis: epidemiologic nature and severity of the clinical course in Argentina]. AB - Focusing on frequency and severity of alcoholic hepatitis (AH) in our country, data provided by 10 university and health care centers were analyzed, based on a form specially designed; 3428 autopsy protocols, 4315 laparoscopy and/or liver biopsy records, and 414 clinical histories from histopathologically proved AH patients, were selected as information source. Autopsy prevalence was 2.4%, corresponding to AH 7.7% of whole diagnostic liver biopsies, 24.6% of those taken from chronic alcoholics, and 32.2% of biopsied alcoholic liver diseases. Clinical severity was related to the kind of centre where data came from (hepatological, neuropsychiatric, etc.) but general sample showed 76.5% mild AH, 17.6% moderate, and 5.7% severe. Acute mortality attributable to AH was 5.5%, raising up 40.0% in severe type group; clinical severity seemed to be more related to mortality than co-existent cirrhosis. Spontaneous encephalopathy, prothrombin concentration under 50% without response to K vitamin supply, and hepato-renal syndrome, were the more significant bad prognosis factors (31.2%, 50.6% and 66.6% mortality respectively). PMID- 3505156 TI - [Mortality trends in cancer of the digestive tract in the province of Buenos Aires, Argentina, 1950-1979]. AB - Digestive tract cancer mortality rates are described in the Province of Buenos Aires, Argentina, from 1950 to 1979. Total digestive tract cancer rates obtained from the world population and adjusted by age and by fifteen years periods show similar annual average decrease for both sexes (1.08%). The above mentioned rates have been shown to decrease in people under 79 years and they were slightly increased in those over 80 years. Total cancer mortality rate has shown an increase of 0.14% annual average (0.18% and 0.10% for male and female, respectively). Mortality cancer rates found in four different levels of the digestive tract have shown different results. Mortality rate at the esophagus level showed an average decrease of 1.17% (1.42% and 0.92% for female and male respectively), this results from a decrease in population of females over 45 and males over 65 years. The highest decrease was observed in stomach cancer mortality rates similar for both sexes (annual average 1.44%). This decrease was found in people within 15 and 79 years; while, the mortality rates found in people over 80 were steady showing a slight increase. Cancer column mortality rate depicts an increase for both sexes, showing an annual average of 0.71% (0.84% and 0.64% for male and female, respectively). Partially adjusted rates show different behaviours: decreasing in both sexes within 15 and 44 years, and increasing in those over 80 years; but increasing in males and slightly decreasing in females within 45 and 79 years. Rectum cancer mortality rates show an increase in females (annual average 1.21%) and a decrease in females (annual average 0.47%), showing a general increase in males, except for those within 65 and 79 years, while for females under 79 years the rates were decreased and increased in those over 80 years. PMID- 3505157 TI - [An awareness campaign on the diagnosis and prevention of colon and rectal cancer. Planning and evaluation of its results]. AB - Colorectal cancer is very frequent in Argentina. It is the third most frequent cancer, after skin and breast tumor in the city of Rosario. Our population usually ignores the symptoms of colonic cancer and early diagnosis are infrequent. The Societies of Gastroenterology, Oncology and Colonoproctology organizes a public awareness campaign during july, august and september 1985 in Rosario and its surrounding (population 1,300,000) by means of newspaper, radio and specially by television, describing the symptoms were present, as well as insisting of the possibility of prevention by endoscopy diagnosis and removal of polyps. Literature and pamphlets were distributed, and information letters were send to all the physicians in Rosario. An International update meeting on colon and rectal took place. The results of this campaign were evaluated through the Tumor Registry of Rosario. Since september 1984 still february 1986, the monthly incidence of polyps and cancer of the colon and rectum was recorded. The monthly average incidence of polyps was 18.9. Previous to the campaign, the monthly average of diagnosed polyps was 17.5; during the campaign, 27.5; and after it, 13.8. The monthly average of colorectal cancer was 39, before the campaign, 41; during the campaign, 49, and 26 afterwards. These results were statistically studies by the parametric test of Mann and Whitney. During the campaign a significant (p = 0.05) increase of diagnosed polyps and cancers, was found. Our conclusion is that the awareness was successful, but we think that it is necessary to insist with periodic and longer campaigns. PMID- 3505158 TI - [Value of the D-xylose test in elderly subjects]. AB - To ten patients who have more than sixty years old (medium: 75.5), the test of D Xylose with 25 g was carried out. They have not intestinal or extraintestinal disease, that difficult the results. A control group was, ten adults young (medium: 23.7). The xylose in blood was in the first hours, between the normals limits in both groups. It does not occurred with the xylose in urine of five hours. This work support that the absorption of D-Xylose is carried out normally in old people, when the detection is in blood not in urine. Although we purpose the detection of xylose in blood during the first two hours in both groups, as an easy way for this test. PMID- 3505159 TI - [Postoperative anus stricture and leukoplakia lesions]. AB - We present 35 cases postoperative anal stenosis of patients operated at the Sanatorio y Maternidad del Sur, Bahia Blanca, Argentina, in the last 9 years (1978-1986). In 9 cases (25.7% the pathologist reported leukoplasic lesions from the anus and anal channel. We remark the value of the pathology in these cases and we suggest to send to the pathologist all the tissues from anal surgery, because we believe this is the way to make the best prophylaxis of anal cancer. PMID- 3505161 TI - [Hepatic granulomatosis]. PMID- 3505160 TI - [A duodenal trichophytobezoar]. AB - A case of intestinal obstruction with surgical diagnosis of duodenal trichophytobezoar occurs in a 20 years old man, undergoing Military Service, with alterations in his behavior labelled as "border-line" schizophrenia, and hysteroschizoid characteristics (oral anxiety). It couldn't be determined neither trichophagy nor ingestion of any of nutrients involved by literature in bezoars formation. Etiological and physiopathological data offered by literature are compared. Without the existence of organic causes of remora in our case the presence of alterations in his behavior determined by the anxiety caused by his military duties might be the catalyst of the atypical ingestion. PMID- 3505162 TI - The West syndrome: developmental aspects. PMID- 3505163 TI - Radiation dose to patients from radiopharmaceuticals. A report of a Task Group of Committee 2 of the International Commission on Radiological Protection. PMID- 3505164 TI - [Exercises in clinical reasoning]. PMID- 3505165 TI - [Clinical conference at the Brazilian Institute for Study and Research in Gastroenterology]. PMID- 3505166 TI - [Vagotomy--the other side]. PMID- 3505167 TI - Effect of vagal stimulation on gastric mucosal barrier in albino rats. AB - To study the influence of vagus nerves on gastric mucosal barrier in albino rats, gastric adherent mucus and mucosal epithelial neutral glycoproteins were quantitatively assessed after vagal stimulation at the cardio-esophageal region by a specially designed circular electrode. Gastric adherent mucus and epithelial mucus were studied from oxyntic and pyloric gland areas by Alcian blue binding and periodic acid Schiff's (PAS) staining method respectively. The results when compared with sham operated control animals showed increase in the visible mucus concurrent with decrease in PAS positive materials. The stimulation at the cardio esophageal region of vagotomized animals did not produce these effects. This study indicates that in an acute condition, increased vagal influence is important in increasing mucus secretion and strengthening the first line of defence of the mucosal barrier. PMID- 3505168 TI - [Endoscopic evaluation of esophageal varices. Comparison of a classic method and the metric system]. AB - The authors compare 2 endoscopic systems of classification of esophageal varices size, one metric system and the classification by degrees, evaluated simultaneously in 70 endoscopic examinations of 53 patients with portal hypertension. They show that the classification by degrees is inadequate, especially in serial evaluation, for its inherent subjectivity, even when executed by one sole examiner. The metric system, under these circumstances, is less liable to change under the subjective influences and gives more exact reproductions, thus being recommended by the authors. PMID- 3505169 TI - [Hemobilia due to chronic cholecystitis. A case report]. AB - The authors report a case of hemobilia in which a fistula was created by corrosion of the cystic artery into the gallbladder. The value of arteriography in diagnosis is emphasized. Cholecystectomy was the definitive treatment. PMID- 3505170 TI - [Diagnosis of esophageal dysfunction: sensibility vs. specificity]. PMID- 3505171 TI - [Dynamic scintigraphy of the esophagus--a method for esophageal dysfunction]. AB - The authors present their experience with radionuclide transit in the study of esophageal motility using a very simple and easy technique. They have established a normal pattern and analyse their findings in achalasia and probable diffuse esophageal spasm. They review the literature and submit the method as a very important tool for the diagnosis of esophageal motor disorders. PMID- 3505172 TI - Gastrointestinal motility in constipation. AB - This study included ten subjects with normal intestinal habits and 25 with constipation. Data were collected from X-rays of gastrointestinal transit times and from intraluminal pressures in the sigmoid and rectum using electromanometry. A comparison of the results led to the following conclusions: a) transit times to the cecum were essentially similar in both the control group and patients with constipation; b) the barium contrast arrived faster in the proximal sigmoid of patients with constipation compared to the control group; c) the mean of the total time of gastrointestinal emptying was slower in constipation; d) under unstimulated conditions, the electromanometry study of the sigmoid and rectum showed a higher motility index in constipation than in the control group; e) the high values of the percent activity was the most important element in the elevation of the motility index in constipation; f) the propulsion and retention activities of the colon were higher in constipation than in normals, as was demonstrated by radiologic and electromanometric studies. PMID- 3505173 TI - [Endoscopic and histopathologic changes in the gastric mucosa in Billroth II gastrectomy and in Roux-en-Y]. AB - The gastric mucosa changes induced by enterogastric reflux remain to interest, thus, 20 patients with surgical duodenal ulcer disease were studied, and after raffle, they consisted in 2 groups of 10 patients each, in which were performed antrectomy and truncal vagotomy, with reestablishment of the gastrointestinal continuity, in the group I, through a Billroth II gastrojejunostomy, and, in the group II, by a Roux-en-Y gastrojejunostomy. In the preoperative course, all the patients were undergone to endoscopic and histopathologic studies, when body gastric mucosa biopsies were analysed; after an average time of follow-up about 7.3 months for the group I, and 8.9 months for the group II, these studies were repeated in an attempt to check, in these 2 groups, the presence of gastric mucosa changes on the gastric remnant induced by reflux of alkaline juices. According to Fisher's exact test the outcome of these searches were significants when had compared the bile reflux into the stomach (p = 0.0549), gastritis (p = 0.00) and anastomosis changes (p = 0.0899) at endoscopic study, and were not significants when it comes to the condition of chronic gastritis (p = 0.6672) present at histopathologic study. PMID- 3505174 TI - [Hepatolenticular degeneration (Wilson's disease). 4 cases in brothers]. PMID- 3505176 TI - Proceedings of the Symposium on Cardiovascular Diseases of Infancy and Childhood- Selected topics. 8 March 1986, New Orleans. PMID- 3505175 TI - [Clinical conference at the Brazilian Institute for Study and Research in Gastroenterology]. PMID- 3505177 TI - Selected topics in cardiovascular disease in children. PMID- 3505178 TI - If I suffered from pelvic inflammatory disease. PMID- 3505179 TI - Is oral cefuroxime axetil suitable for the treatment of unidentified bacterial infection of skin and soft tissue? PMID- 3505180 TI - Effects of labetalol on lipid metabolism. PMID- 3505181 TI - Giant lipoma of the mesentery. PMID- 3505182 TI - Premature menopause: three teenage cases. PMID- 3505183 TI - [The cranio-spinal joint: apropos of some anomalies]. AB - The occipitocervical region settles down around the rostral extremity of the chorda, from components coming from the parachordal cartilage, the occipital somites and the first cervical somites. The evolution of the ossification points may be defective. This explains the malformations of this region, and their eventual mechanical repercussions. These malformations may be associated with malformations of the nervous system. PMID- 3505184 TI - [Comparative anatomy of the velopharyngeal complex in mammals--excluding primates (1)]. AB - From the anatomic element known with the man by the name of soft palatal pharyngeal sphincter and which takes a major part in the phonation, the swallowing, the breathing, we have studied the evolutive morphology of the soft palatal-pharyngeal unity in several mammals. This unity which includes the levator palati and palatopharyngeus muscles is confirmed by the phylogenic and embryologic investigations. The comparative anatomy of the rat, rabbit, sheep and lion, allows to make obvious a evolutive line characterized by the gradual divergence of the axis of the two muscles common to the soft palatal and pharyngeal musculature, which could correspond with a phylogenic evolution. PMID- 3505185 TI - [Comparative anatomy of the velopharyngeal complex in human and non-human primates (2)]. AB - The authors describe the soft palatal-pharyngeal unity, composed of the levator palati and palatopharyngeus muscles in the adult man, the new-born and the Saimiri. They recall the importance of the soft palatal-pharyngeal sphincter in the man's phonation. After having described the general evolution of the aerodigestive tract in the no human mammals and the man, notions of evolutive morphology of the soft palatal-pharyngeal unity are established. They are characterized by the gradual divergence of the axis of the 2 muscles forming the soft palatal-pharyngeal unity ending in the appearance met in the adult man, indispensable in view of a soft palatal-pharyngeal ability allowing a articulated language. PMID- 3505186 TI - [Effects of intracranial pressure on frontal sinus development]. AB - Through a study of some syndromes of intra-cranial high and low pressure, the authors try to find out the relations between the intra-cranial stresses and the development of frontal sinuses. They account for the choice of frontal sinuses and the various factors determining this pneumatization. They study the morphology of the frontal sinuses in 20 cases of old and chronic hydrocephaly, in 13 cases of oxycephaly with a late diagnosis, and in 20 cases of adults suffering with infantile cerebral hemiatrophy. They show that in these syndromes, the development of frontal sinuses is an inverse ratio to the intracranial pressure. However, they point out that in standard people, the extreme differences in the morphology of their frontal pneumatization can be explained not only by various causes--a number of which is as yet not known--but also by an aleatory distribution. PMID- 3505188 TI - [Measurement of the renal veins: dissection of 200 fresh corpses]. AB - The total length of the vena renalis sinistra is 100.5 mm in mean, the v. renalis dextra one is 47.4 mm. The end diameter in the v. cava inferior is 16.1 mm in mean for the v. renalis sinistra, and 12.8 mm for the v. renalis dextra. The end of the v. testicularis (ovarica) sinistra in the v. renalis sinistra is more distant from the v. cava inferior in 71% of the cases than the end of the v. surrenalis principalis sinistra. PMID- 3505187 TI - [Development and regression of the fetal adrenal cortex]. AB - The adrenal glands from a series of 300 fetuses and infants which had died in the Hospital Saint-Vincent-de-Paul, Paris, were dissected, weighed and processed for routine histology. The development of the fetal cortex and its regression have been compared to the general development of the gland. Our results show that there is an important development of the fetal cortex up to birth, when the adrenal glands represent almost one third of the size of the kidneys and possess only very reduced permanent cortex and practically no medulla. The regression of the fetal cortex in the postnatal period is marked by a decrease in weight of the adrenal glands up to the 2nd or 3rd month, by the persistence of a few dispersed cells up to the fifth month and by the persistence of a few fibrous elements up to 2 years of age. PMID- 3505189 TI - [The cervical vertebral venous plexus and anastomoses with the cranial venous sinuses]. AB - Despite Breschet's detailed description of the vertebral venous system in 1819, it was only in 1940, that Batson demonstrated the preponderant role it plays in the propagation of metastatic carcinomatosis, infection or gas emboli. Although many authors were interested by Batson's theories, but nobody argued on Breschet anatomical description. In their effort to study the role of the venous system in encephalic blood drainage, the authors were confronted with anatomical constatations which differed considerably from the initial descriptions. They also evidenced the existing anatomoses between the cerebral venous sinuses and the vertebral venous system. These anastomoses being the hypoglossal plexus and condylary vein. The emissary veins, if they existing during embryogenesis, most rapidly atrophy to completely disappear in adult. PMID- 3505190 TI - Effect of PGE2 on regional cortico-endosteal remodeling in beagles with fractured ribs: a histomorphometric study. AB - A histomorphometric study was done on healing defects in the ribs of Beagles. A transverse fracture was made in the left 9th and 10th ribs. Beagles were given either ethanol vehicle (n = 6) or prostaglandin E2 (PGE2) orally (n = 5) for the 30-day period after surgical manipulation to time of necropsy. Double fluorescent labels were given to measure bone matrix mineralization. Two fluorochrome markers were used: calcein before dogs were surgically manipulated and oxytetracycline HCl before they were killed. The two objectives of the present study were: (1) to determine the effects of fracture on regional cortico-endosteal remodeling 2 cm from a fracture site in the ribs of Beagles; and (2) to determine the effects of orally administered PGE2 on the above condition. The results suggested that the fractured and the non-fractured ribs in either group show a similar static and dynamic remodeling during the first 30 days of healing. The activation frequency in the PGE2 group was increased in both fractured and non-fractured ribs more than in the non-treated group. Therefore, the systemic administration of PGE2 can activate and synchronize remodeling cycles among BMUs. PMID- 3505191 TI - Osteopetrosis in the toothless rat: failure of osteoclast differentiation and function. AB - Toothless is an osteopetrotic mutation in the rat characterized by reduced bone resorption, few osteoclasts and failure to be cured by bone marrow transplants from normal littermates. The latter could be due to the production of bone that cannot recruit or activate normal osteoclasts or their precursors. We tested this hypothesis using a metatarsal organ culture system in which metatarsals are cultured with various tissues which act as sources of osteoclast precursors. Mutant metatarsals cultured alone or with mutant tissue had numerous large mononuclear cells, few osteoclasts, no marrow spaces and no evidence of bone resorption. Culture of mutant metatarsals with normal liver or spleen caused no changes in osteoclast number or bone resorption. Cultures of normal metatarsals had large osteoclasts, bone resorption and marrow spaces. Histochemical analyses demonstrated that strong tartrate-resistant acid phosphatase (TRAP) staining was present in all osteoclasts and in some mononuclear cells in normal metatarsals. Mutant metatarsals before or after culture contained no TRAP-positive osteoclasts and an occasional, weakly staining mononuclear cell only when co-cultured with normal spleen which contained TRAP-positive mononuclear cells. We interpret these data to mean that the mutant skeletal environment is unable to support the development and differentiation of normal osteoclasts. These observations are consistent with the failure of toothless rats to be cured by bone marrow transplants from normal littermates. PMID- 3505192 TI - Reduced occurrence of vertebral crush fractures in senile osteoporosis treated with 1 alpha (OH)-vitamin D3. AB - To examine whether the administration of 1 alpha (OH)-vitamin D3 (1 alpha (OH)D3) could prevent the occurrence of vertebral crush fractures in senile osteoporosis, crush fractures of the thoracic or lumbar spine in senile osteoporosis treated with 1 alpha (OH)D3, 1.0 microgram/day (22 cases), 1 alpha (OH)D3 1.0 microgram/day + Ca 1.0 g/day (16 cases) or Ca 1.0 g/day (23 cases) were compared with those in non-treated controls (25 cases). The average treatment periods were 1.7 +/- 0.7 years in the 1 alpha (OH)D3 group, 2.1 +/- 1.0 years in the 1 alpha (OH)D3 + Ca group and 1.7 +/- 0.9 years in the Ca group. Occurrence of spinal crush fractures per 1000 patient years was significantly less in the 1 alpha (OH)D3 + Ca group (P less than 0.01) than in the non-treated control group. These findings suggest that administration of 1 alpha (OH)D3 is effective in preventing the occurrence of pathological fractures in senile osteoporosis. PMID- 3505194 TI - An analysis of bone structure in patients with hip fracture. AB - The prevalence of osteoporosis in patients with hip fracture is not well defined. We performed a histomorphometric analysis of bone structural parameters in transilial biopsies of 39 patients with hip fracture (21 cervical, 18 trochanteric), 23 patients with one or more vertebral crush fractures and 20 control subjects. Trabecular bone volume (TBV) and trabecular surface density (Sv) were significantly lower in trochanteric than in cervical fractures. Mean trabecular plate thickness (MTPT), mean wall thickness (MWT) and TBV were significantly lower in trochanteric fractures than in the control group. Vertebral crush fractures are mainly characterized by a decreased TBV and Sv. There was a strong positive correlation between MWT and MTPT in trochanteric fractures suggesting that the decreased trabecular thickness in this group is due to decreased osteoblastic apposition. Trochanteric fractures are associated with serious osteoporosis, whereas cervical fractures constitute a more heterogeneous group. The osteoporosis of trochanteric fractures is characterized by significant trabecular thinning, whereas that of vertebral fractures is mainly associated with loss of trabecular plates. PMID- 3505193 TI - A study on the phalanx bone mineral content in 273 normal pre- and post menopausal females (transverse study of age-dependent bone loss). AB - Quantitative Rontgen microdensitometry (QMD) can be used to provide a precise quantification of mean specific bone mass (rho) from standardized radiographs. The method is simple, non-invasive, low in cost and suitable for frequent repetition. Bone mineral mass at the mid-length (largely cortical bone) of the middle phalanx of digital II of the left and right hands was investigated. Normalized quantification of bone structure can be achieved with a precision (coefficient of variation) of the order of 1%. Rho values were determined for the right and left phalanx in 273 apparently healthy women 43-73 years of age (mean menopausal age, 49.8 years) in an attempt to differentiate between normal changes with age and excessive bone mineral loss. The mean rate of age-dependent bone mineral loss was -1.4% per year in pre-menopausal women; in post-menopausal women between 50 and 57 years it was -3.5% per year and between 58 and 73 years it was 0.8% per year. The mean rate of change of bone mineral mass in the same group, as a function of the number of years after menopause, was -1.9% per year for the group 2-8 years after menopause and +0.1% per year for the group 9-20 years after menopause. PMID- 3505196 TI - In vitro albumin binding on apatite crystals from developing enamel. AB - Serum proteins have never been described in enamel as they have been in dentin or bone where they are bound to apatite, may be because of the specific organic/crystal relationship which makes enamel crystals different from the other biological apatites. In the present study, crystals from bovine developing enamel have been isolated to test their ability to bind serum albumin in vitro. Those crystals, although naturally coated with enamelins proved to be able to bind gold labelled serum albumin. Consequently, free binding sites exist at the surface of these biological crystals. It is suggested that the 'sheath' surrounding crystals in TEM observations is the fixed aspect of a dynamic process in vivo. Finally, the lack of blood proteins in enamel cannot be attributed to a particular property of enamel crystallites. PMID- 3505195 TI - PTH bioactivity in osteoporosis. AB - The cytochemical bioassay for parathyroid hormone was used to measure the levels of PTH bioactivity in normal elderly subjects and patients suffering from idiopathic or postmenopausal osteoporosis. In normal subjects, PTH bioactivity did not increase with age. In the osteoporotic patients levels of bioPTH discriminated between two populations, one with normal levels and the other with elevated levels. In both these groups the PTH bioactivity was neutralised by the addition of a PTH antiserum. The recovery of the bioactivity of PTH added to the plasma samples was significantly higher in the plasmas from patients with elevated levels of bioPTH. Levels of immunoreactive PTH also discriminated between the two groups of osteoporotic patient although no serum parameters indicative of increased PTH were detectable. However, patients with the high levels of bio- and immunoPTH had a lower incidence of fracture within the previous 12 months. PMID- 3505197 TI - Purification of bone alkaline phosphatase from human osteosarcoma. AB - Purification of human bone alkaline phosphatase, derived from human osteosarcoma tissue, has been carried to electrophoretic homogeneity. The purification procedure involved three major steps: (1) chromatography on hydroxylapatite; (2) ion exchange chromatography; and (3) gel filtration. The resultant purified enzyme is a glycoprotein, has a molecular weight of approximately 80,000 (consistent with previous reports for the bone isoenzyme), and is characteristically inhibited by modest heat (56 degrees C, 30 min) and L homoarginine but not by L-phenylalanine. The isolation and purification procedure described can lead to the production of significant amounts of highly purified bone alkaline phosphatase. Purified ALP can be used for an analysis of minor structural differences that appear to exist between the bone, liver and kidney isoenzymes. Such information could lead to the development of a clinical diagnostic procedure specifically for bone alkaline phosphatase. PMID- 3505199 TI - ADA courts young dentists. PMID- 3505198 TI - Exogenous calcitonin protects against renal bone disease in rats with early renal failure. AB - Chronic renal failure was induced in four groups of male Sprague-Dawley rats by unilateral nephrectomy followed by removal of the outer poles and cautery of the remnant kidney. The four groups of animals received isocaloric diets with normal (groups 1 and 4) or low (groups 2 and 3) phosphate contents and variable amounts of calcium. In addition, rats in group 4 were given salmon calcitonin. After 90 160 days the 4 groups of rats had developed comparable levels of chronic renal failure. The serum phosphate values were significantly lower in rats on low phosphate intake than in those on normal phosphate diet. Bone histology was evaluated on tibiae, lumbar vertebrae and ribs. The rats kept on low phosphate diet (groups 2 and 3) had significantly lower frequency of osteomalacia and bone resorption than those fed a normal phosphate diet. Rats treated with calcitonin (group 4) had the lowest frequency of osteomalacia and virtually no association with bone resorption, despite normal phosphate intake. The serum levels of parathyroid hormone were not significantly different in rats in groups 1 and 4 as compared to controls. Serum 1,25-dihydroxycholecalciferol levels were significantly lower in group 1 than in controls and were significantly higher in group 4 than in group 1. These data show that calcitonin effectively prevents bone lesions in rats with early chronic renal failure. PMID- 3505200 TI - South of the border. PMID- 3505201 TI - Drug dispensing spills into dental marketplace. PMID- 3505202 TI - Thin ridge implants require versatility for placement. PMID- 3505203 TI - Orthodontic 'data base' forms treatment strategy. PMID- 3505204 TI - OSHA enforces infection guidelines. PMID- 3505205 TI - Prevention of rheumatic fever and rheumatic heart diseases: problems, strategies and new developments. PMID- 3505206 TI - Successful management of flail chest without the use of volume ventilator. PMID- 3505207 TI - Prognostic significance of serum cholesterol in childhood nephrotic syndrome. PMID- 3505208 TI - Acute jaundice in Zimbabwean children. PMID- 3505209 TI - Managing dental caries at the dental unit of Kenyatta National Hospital Nairobi, Kenya. PMID- 3505210 TI - Disseminated strongyloidiasis presenting as septicaemia and meningitis: a case report. PMID- 3505211 TI - Correlation between renal functions and renal pathohistology. PMID- 3505212 TI - Two cases of malignant progression of oral leukoplakia. PMID- 3505213 TI - [Statistical analysis of new out-patients in the Department of Medicine, Fukuoka Dental College Hospital VIII: from January 1 to December 31, 1985]. PMID- 3505214 TI - [The results of oral examination and caries activity test]. PMID- 3505215 TI - [Odontometrical study of shovel-shaped upper incisors in the people of Northern Kyushu]. PMID- 3505216 TI - [Anthropometrical study of the head and face of the Atayal and the Saisiyat]. PMID- 3505218 TI - Children and family breakdown. Report on a WHO meeting. PMID- 3505217 TI - [Application of acupuncture to dental practice. 3rd Report. Acupuncture anesthesia for dental phobia]. PMID- 3505219 TI - Methemoglobin and carboxyhemoglobin levels in smokers and non smokers. AB - The authors examined the blood of 856 subjects (377 smokers and 479 non smokers) in order to evaluate the levels of Methemoglobin (MetHb) in relationship to tobacco smoke. The Methemoglobin, Carboxyhemoglobin, Percent Oxyhemoglobin and Total Hemoglobin were measured using an automated spectrometer (IL 282 CO - Oximeter). The authors found that the levels of MetHb in the smokers exceed that in the non smokers: in fact the level of MetHb in the smokers (% MetHb = 0.63) was significantly greater than in the non smokers (% MetHb = 0.56), unlike what was reported in literature. The levels of Carboxyhemoglobin in the blood has been shown to be a useful marker of tobacco smoke absorption: a close relationship exists between COHb and cigarette smoking. PMID- 3505220 TI - [Use of gas chromatography with flame ionization (GC-FID) in the measurement of solvents in the urine]. AB - The urinary concentration of some solvents (acetone, cyclohexane, 1,2 dichloropropane, n-hexane, methyl ethyl ketone, perchloroethylene, styrene, toluene, 1,1,1, trichloroethane) was measured by means of a gas chromatography Hewlett-Packard 5890 supplied with a flame ionization detector (GC-FID, DANI HS 3950). The coefficient of variation of the method was lower than 5%. The sensitivity of the GC-FID was very similar to what of mass spectrometer detector (GC-MSD, HP 5970 A). PMID- 3505221 TI - [Criteria of the evaluation of the cause-effect relationship of toxic substances in the industrial environment]. AB - The author at first analyses the concepts of exposure, biological monitoring and dose. Therefore, he takes into consideration the varieties of the occupational hazard underlining the more and more prominent role of the different co-factors causing occupational diseases. Then he examines the judgement of the legal criteria in theme of occupational diseases, coming to the conclusion that, for the diagnosis of chronic intoxications, it is difficult to recognise cause-effect relationship in industrial toxicology due to: poor knowledge of toxic action mechanism, incomplete information on metabolic-dysfunctions and last, the frequent interference of non occupational factors which are not always easy to identify. PMID- 3505222 TI - [Anesthetics vapors and gases and health hazards: results of an environmental survey]. AB - The occupational exposure to nitrous oxide and other anaesthetic agents in two hospitals was measured with personal samplers. The highest concentration of nitrous oxide was found in the orthopaedic theatre (2932 ppm), but in other operating theatres the values were not less than 200 ppm. Both the average volume of anaesthetic gases and vapours used per patient and per room and lack of appreciable active ventilation may affect the exposure of staff, potentially at risk from excessive occupational exposure to anaesthetic agents. These observations suggest that adequate health and safety programmes should be established in occupational health care. PMID- 3505223 TI - [The histopathological substrate of the empty fingers phenomenon in vibration disease]. AB - Vibration syndrome is comprised of a series of skeletal, vascular and nervous alterations in the upper limbs and in particular the hands. These alterations have been describe extensively, but the result of the present study that is the "empty digit" sign, has never been documented. This observation is related to trophic disturbance of the dermis and epidermis, sustained by organic alterations of the vascular, muscular, connective and nervous structure of the skin itself, as has been shown in the present study from histological preparations obtained by biopsy of the skin of the IV digit of the hand. It seemed useful to describe other than our personal sample study of patients affected by vibration syndrome (1014 cases), this new clinical sign. The importance of describing this clinical sign seemed to be connected with the demonstration of vascular damage, which is also responsible for the other clinical symptoms. PMID- 3505224 TI - Chromosomal polymorphism in Drosophila subobscura at different elevations in central Chile. AB - Samples of D. subobscura were collected at four localities, one at sea level and the three others at 620 m, 1,016 m and 1900 m elevation in the pre-andean zone of Central Chile, where the species is very abundant since its first detection in 1978. Cytogenetic analysis were performed on F1 larvae resulting from laboratory crosses of wild males and homozygous virgin females for all the chromosomal arrangements. The observed frequencies of homozygotes and heterozygotes for 19 different gene arrangements present in the populations, fit very well with the expected frequencies estimated according to the Hardy-Weinberg equilibrium. In comparing the gene arrangement frequencies, interpopulational differences were observed, suggesting an incipient process of microdifferentiation, that does not follow a clinal variation according to the altitudinal gradient. PMID- 3505225 TI - Relationship between frequencies of univalents and meiotic segregation in different mouse strains and their hybrids. AB - Although univalents in diakinesis are often used as an estimator for chromosome mis-segregation during meiosis, no clear-cut relationship was demonstrated between both phenomena. In this study, the frequencies of autosomal and gonosomal univalents in diakinesis were related to the frequencies of aneuploid metaphase II gonocytes during spermatogenesis and oogenesis of different mouse strains and their hybrids (inbred strains: DBA/2J, C57Bl; outbred strain; Swiss, inbred x outbred hybrids: Swiss X C57Bl, C57Bl X Swiss, inbred X inbred hybrids: DBA/2J X C57Bl, C57Bl X DBA/2J). As far as the frequencies of univalents are concerned, they were shown to be strain-dependent and similar in both sexes. Moreover, there is a high non-disjunction rate of DBA males and PMSG-HCG-primed DBA females. Aneuploidy in metaphase II is also strain-dependent but different in both sexes; in the male, a clear decrease of aneuploidy frequencies is observed as compared to the frequency of univalents. This decrease does not occur in females. PMID- 3505226 TI - Nucleolus-organizer regions and heterochromatin in three species of bovidae. AB - Ag-NOR staining and a counterstain-enhanced fluorescence technique (chromomycin A3/distamycin A/DAPI staining = CDD-method) have been applied to ibex (Capra ibex L.), chamois (Rupicapra rupicapra L.) and bison (Bison bison L.) chromosomes. Chromomycin A3 visualization led to a well defined R-banding pattern along the chromosome arms and to a clear demonstration of centric heterochromatic bands of variable size. The nucleolus organizer regions (NORs) were found in the telomeric regions of the chromosomes 2, 3, 4, 5 and 28 of the ibex, of the chromosomes 1/3 (short arm), 2, 4, 5 and 28 of the chamois and of the chromosomes 2, 3, 4, 11 and 28 of the bison. PMID- 3505227 TI - Differential response to environmental alcohol among second-chromosome arrangements in experimental populations of Drosophila buzzatii. AB - Drosophila buzzatii feeds and breeds on the decaying cladodes and fruits of several species of Opuntia (prickly pear) which contain significant levels of ethanol and isopropanol. The potential influence of these two alcohols on the inversion polymorphism of the second and fourth chromosomes was investigated in ten experimental populations with different amounts of alcohol (either ethanol or isopropanol) added to the culture medium. All populations were started with the offspring of 29 wild females collected at Adeje (Tenerife, Canary Islands) and their genetic composition was monitored for about two years (more than 30 generations). Consistent changes in the frequency of most second- and fourth chromosome arrangements occurred in all populations including those without alcohol (control). The comparison of inversion frequency through the various treatments revealed a significant influence of the alcohol on the frequency changes of the four second-chromosome arrangements. Moreover, this influence was of a different type for every one of them, sometimes with opposite effects between alcohols and/or concentrations. These results indicate genetic differentiation among second-chromosome arrangements with regard to alcohol and suggest that the alcohol heterogeneity found in the species' trophic niche may play an important role in the maintenance of this polymorphism and also in the recent historical changes in the frequency of some arrangements associated with colonization. PMID- 3505228 TI - Effect of the redox state of the red blood cell components on the inactivation of glutathione peroxidase by divicine. AB - The redox state of red blood cell components was found to have profound effects on the specific inactivation of erythrocyte glutathione (GSH) peroxidase by divicine, a hydroquinone imine molecule of fava beans likely to be responsible, through redox cycling, of the oxidative damage of red blood cells ultimately resulting in the hemolysis of favism. Oxidation of hemoglobin is a necessary step for the inactivation to take place, apparently as a H2O2-MetHb adduct. On the other hand, the presence of either reduced NADP or glutathione enhances the inactivating effect although NADPH inhibits the oxidation of hemoglobin, and this suggests a catalytic role for MetHb in the inactivation process. PMID- 3505229 TI - Age-dependent resistance to the toxic effects of paraquat in relation to superoxide dismutase activity in rat lung. AB - Young rats are much more resistant to the toxic effects of orally-administered paraquat than are older rats. The possible relation of this phenomenon to the activity of superoxide dismutase in lung is discussed. PMID- 3505230 TI - Time kinetics of hemoglobin and myoglobin activation by tetrachlorodecaoxide (TCDO). AB - In the presence of peroxidase, myoglobin or hemoglobin, Tetrachlorodecaoxide (TCDO) forms an active oxygen species which is similar to the product of the polymorphonuclear leucocyte (PMNL) myeloperoxidase reaction and the 'Klebanoff Model' of phagocytosis, but it is also produced under anaerobic conditions. Randomly destructive species such as the free OH radical or singlet oxygen are not formed. The kinetics of the heme-dependent activation vary according to the heme type present. In comparison to myoglobin, blood shows a 2 h delay in the appearance of maximal activity. On the basis of known biochemical and clinical physiological data, a hypothesis can be proposed to explain the reoxygenation observed in hypoxic tissue, induced by TCDO via this activated heme species. Under normal physiological conditions, vasodilation occurs via catalysis by xanthine oxidase or PMNL-dependent activation of fatty acids. PMID- 3505231 TI - Phenyl-T-butyl-nitrone is active against traumatic shock in rats. AB - Oxygen free-radicals appear to be involved in the pathogenesis of shock; therefore trapping of these radicals would modify the evolution of experimental shock. Experiments were performed on rats submitted to 100% lethal whole body trauma (rotating drum) and their survival, pathology, acid-base status and hematocrit level observed. The spin trapping agent phenyl-t-butyl-nitrone (PBN) was administered before trauma (50, 100, 150 mg/kg i.p.) or at various intervals (30, 60 minutes) after establishment of a severe traumatic shock. It appeared that PBN administration was highly effective both in prevention and in reversion of traumatic shock in rats. PMID- 3505232 TI - Effects of liposomal superoxide dismutase on human neutrophil activity. AB - Study of the effects of liposomal bovine copper superoxide dismutase on human polymorphonuclear neutrophils with respect to production of active oxygen species, chemotaxis and random migration, or bacterial killing show that no significant interference with neutrophil function is observed at levels far exceeding the clinical doses used in the treatment of various pathologies. PMID- 3505233 TI - Copper-zinc containing and manganese containing superoxide dismutase in the ground squirrel/Citellus citellus/--the effect of hibernation. AB - The distribution of Copper-Zinc containing and Manganese-containing superoxide dismutase in the liver, kidney, interscapular brown adipose tissue (IBAT) and brain of the ground squirrel, as well as the effect of hibernation, was studied. Activity of both forms of SOD was highest in the liver and lowest in the brain. Activity of the Mn SOD in relation to total SOD was higher in the liver and kidney of the ground squirrel as compared with results reported for other rodents. The highest activity of Mn SOD in relation to total SOD was found in the IBAT and brain (36% and 49%, respectively). Total SOD activity per mg proteins and per g wet mass in IBAT and brain of hibernating animals was increased: for IBAT, p less than 0.05 and p less than 0.025, respectively; for brain, p less than 0.01 and p less than 0.025, respectively. Protein content in hibernating ground squirrel was not significantly changed. In the hibernating ground squirrel CuZn SOD activity in IBAT and brain was higher as compared with the active animal (p less than 0.025 and p less than 0.005, respectively). In the liver and kidney CuZn SOD was not significantly changed during the hibernation. In the liver and brain of the hibernating animals a lower Mn SOD activity was found (p less than 0.005 and p less than 0.05, respectively). PMID- 3505234 TI - Free radical participation in bacterial bioluminescence. AB - The metastable intermediate II produced on reaction of bacterial luciferase with reduced flavin mononucleotide and O2, reacts with any of several stable free radicals to produce bioluminescence. The bioluminescence spectrum is very similar to that from the well-studied intermediate II and aldehyde reaction, and the number of photons per luciferase molecule reacted is at least 40% of the aldehyde reaction. PMID- 3505235 TI - Effect of isoproterenol administration of rat heart glutathione status. AB - The intraperitoneal administration of 3, 10 and 80 mg/Kg isoproterenol produced in the cardiac muscle a dose dependent increase of GSH content and a slight elevation of GSSG content. In addition, the treatment with the catecholamine at the doses of 3 and 10 mg/Kg produced a slight decrease of the mixed glutathione disulfides level, whilst at the dose of 80 mg/Kg, this effect was more pronounced. These changes were not accompanied by modifications of the activities of the enzymes glutathione peroxidase, glutathione reductase and glutathione S transferase. PMID- 3505236 TI - In vitro screening of iron chelators using models of free radical damage. AB - The effect of chelators on free radical damage to deoxyribose induced by iron, on IgG by UV irradiation, and on mouse muscle by homogenisation has been studied using the Thiobarbituric acid method and the increase in fluorescence in IgG mixtures. Although there were some variations on the effects of the chelators in the three models, it was shown that most of the chelators could inhibit the noxious effects of the free radicals and some which are orally effective in increasing iron excretion in animals could be potentially useful in preventing iron toxicity in related pathogenic diseases. PMID- 3505237 TI - Influence of the iron chelating agent desferrioxamine on two rat inflammatory models. AB - The carrageenin rat paw edema was dose-dependently inhibited by i.v. and i.m. administration of desferrioxamine, a specific iron chelating agent. Therefore, iron-catalyzed formation of free radicals might be involved in this acute inflammatory reaction. In contrast, no antiinflammatory activity of desferrioxamine could be seen in rat adjuvant arthritis, a model of subacute and chronic inflammation. PMID- 3505238 TI - Anti-inflammatory activity of superoxide dismutases: inhibition of adriamycin induced edema in rats. AB - Various superoxide dismutases from different sources, containing Cu, Mn or Fe at the active centre, have been examined with respect to anti-inflammatory activity in a model using adriamycin-induced edema in rats. Very large differences in efficiency are observed, the most active being E. coli Mn-SOD and bovine Cu-SOD. The Fe-SOD from E. coli is active whereas P. leiognathi Fe-SOD is not. Human Mn SOD shows no significant activity and homologous rat Cu-SOD is totally inactive. Yeast Cu-SOD shows pro-inflammatory properties. Anti-inflammatory activity is not a function of molecular weight or circulation life-time. PMID- 3505239 TI - Effects of oxidative stress caused by hyperoxia and diquat. A study in isolated hepatocytes. AB - The effects of oxidative stress caused by hyperoxia or administration of the redox active compound diquat were studied in isolated hepatocytes, and the relative contribution of lipid peroxidation, glutathione (GSH) depletion, and NADPH oxidation to the cytotoxicity of active oxygen species was investigated. The redox cycling of diquat occurred primarily in the microsomal fraction since diquat was found not to penetrate into the mitochondria. Depletion of intracellular GSH by pretreatment of the animals with diethyl maleate promoted lipid peroxidation and sensitized the cells to oxidative stress. Diquat toxicity was also greatly enhanced when glutathione reductase was inhibited by pretreatment of the cells with 1,3-bis(2-chloroethyl)-1-nitrosourea. Despite extensive lipid peroxidation, loss of cell viability was not observed, with either hyperoxia or diquat, until the GSH level had fallen below approximately 6 nmol/10(6) cells. The iron chelator desferrioxamine provided complete protection against both diquat-induced lipid peroxidation and loss of cell viability. In contrast, the antioxidant alpha-tocopherol inhibited lipid peroxidation but provided only partial protection from toxicity. The hydroxyl radical scavenger alpha-keto-gamma-methiol butyric acid, finally, also provided partial protection against diquat toxicity but had no effect on lipid peroxidation. The results indicate that there is a critical GSH level above which cell death due to oxidative stress is not observed. As long as the glutathione peroxidase - glutathione reductase system is unaffected, even relatively low amounts of GSH can protect the cells by supporting glutathione peroxidase-mediated metabolism of H2O2 and lipid hydroperoxides. PMID- 3505240 TI - Unpaired electron migration between aromatic and sulfur peptide units. AB - Cysteine thiyl radicals (Cys/S.) were found capable of one-electron oxidation of tyrosine. Equilibration occurred, using Cys and Gly-Tyr, with an equilibrium constant of K5 = 20 +/- 4 at pH 9.15: Cys/S. + Tyr in equilibrium Cys + Tyr/O. (5) Hence the reduction potentials of these couples differ at pH 9.15 by E(Cys/S., Cys) - E(Tyr/O., Tyr) = 80 mV. Oxidation of Trp-Gly by Cys/S. was not detectable from pH 7 to 12. The methionyl radical cation (Met/S.N), formed via .OH-attack on Met-Gly, reacts with Trp-Gly to generate the indolyl radical (Trp/N.). New results on intramolecular Trp/N.----Tyr/O. transitions indicate that the reaction requires direct contact between the two redox centers. Various possible pathways for migration of unpaired electrons between peptide units are compiled in a scheme. PMID- 3505241 TI - Nitro-tyrosine as promoter of free radical damage in a DNA model system. AB - Nitro-tyrosine considerably promotes the degradation of DNA, when incubated with Cu2+ and ascorbate in oxygenated aqueous solution. This deleterious process requires oxygen and can be inhibited with catalase, indicating that H2O2 is involved, via the reduction of oxygen. Menadione and 2,4,6 trinitrobenzenesulfonate, known to catalyze particularly fast such reduction of oxygen, were only slightly more active than nitro-tyrosine. Degradation of DNA can be explained by a site-specific Fenton type reaction of H2O2 with the DNA-Cu+ complex, DNA-Cu+ + H2O2----DNA...OH + Cu2+ + OH- Copper-chelating agents (EDTA and penicillamine) prevent DNA degradation, whereas .OH-scavengers (t-butanol) are ineffective. The deleterious activity of nitro-tyrosine (and of other nitroaromatics) in the DNA model system may indicate important toxicological implications, since aromatic nitration is a significant mode of action of nitrogen dioxide. PMID- 3505242 TI - Antioxidant behaviour of ubiquinone and beta-carotene incorporated in model membranes. AB - Experiments with model membranes, in which ubiquinone was incorporated, were performed in order to clarify the mechanism by which ubiquinone can prevent or control chain lipid peroxidation in biomembranes. Comparing the behavior of ubiquinone-containing vesicles with beta-carotene containing vesicles we suggest that a possible explanation of the ubiquinone antioxidant effect could be to scavenge singlet oxygen and to affect structurally the lipid bilayer inhibiting hydroperoxide decomposition. PMID- 3505243 TI - NADPH-induced microsomal lipid peroxidation as measured by malondialdehyde production in rat liver. Inhibitory effect of naftidrofuryl. AB - The effects of naftidrofuryl have been studied on NADPH-induced microsomal lipid peroxidation by measuring malondialdehyde (MDA) production. Conditions adequate to measure MDA production and effects of naftidrofuryl on MDA production have been tested. It has been shown that the addition of ferric ions is essential with Tris or Pipes buffers while it can be omitted with phosphate known to contain traces of ferric ions. However the initial rate of MDA production is much lower with phosphate in the absence of added ferric ions, showing that the initiation of lipid peroxidation is limited by ferric ions. The effects of naftidrofuryl have been studied on MDA production in phosphate buffer in the presence or absence of ferric ions. Naftidrofuryl inhibits lipid peroxidation in both conditions indicating that the inhibition is not related to an interaction with added ferric ions. Naftidrofuryl is efficient at concentrations slightly higher than butylhydroxytoluene but lower than aminopyrine. PMID- 3505245 TI - Desktop publishing. PMID- 3505244 TI - Inhibitory effects of ebselen on lipid peroxidation in rat liver microsomes. AB - The effects of ebselen(2-phenyl-1,2-benzoisoselenazol-3(2H)-one), a synthetic seleno-organic compound with glutathione peroxidase-like activity were investigated on lipid peroxidation in rat liver microsomes. Ebselen inhibited malondialdehyde production coupled to the lipid peroxidation stimulated by either ADP-iron-ascorbate or CCl4. The inhibitory activity of ebselen on each system was strongly increased by a 5-min preincubation with liver microsomes; the IC50 values against ADP-Fe-ascorbate-stimulated and CCl4-stimulated lipid peroxidation were 1.6 microM and 70 microM respectively. Ebselen also inhibited the endogenous lipid peroxidation with a NADPH-generating system, but it slightly stimulated the endogenous activity of ADP-Fe-ascorbate-stimulated lipid peroxidation (without a NADPH-generating system). Furthermore, ebselen inhibited oxygen uptake coupled to the lipid peroxidation by ADP-Fe-ascorbate and NADPH-ADP-iron; the IC50 values were 2.5 microM and 20.3 microM respectively. Ebselen also prolonged the lag-time of onset of ADP-Fe-ascorbate-stimulated lipid peroxidation significantly, but not that observed with NADPH-ADP-Fe-stimulated lipid peroxidation. These findings suggest that ebselen penetrates into the membrane lipid and acts as an effective antioxidant, and that there may be some differences between the modes of inhibitory action on the several types of lipid peroxidation. PMID- 3505246 TI - The use of videotapes in improving clinical performance in the final MB examination. PMID- 3505247 TI - Holography--the clear plate syndrome. PMID- 3505248 TI - Reproduction of radiographs for 2 X 2 transparencies. PMID- 3505249 TI - [Dental formulae and identification numbers of pharyngeal teeth in cypriniformes on the basis of their ontogeny]. PMID- 3505250 TI - [Effect of continuous exposure to cadmium on the development of early somite mouse embryos in vitro]. PMID- 3505251 TI - [Effects of tolperisone hydrochloride on the silent period of the masseter muscle]. PMID- 3505252 TI - [The effects of soft laser on surrounding tissues during retention in rats]. PMID- 3505253 TI - [Clinical observation of acrylic resin dentures treated with surface smoothing and hardening agents]. PMID- 3505254 TI - [Removable partial dentures: Part 3. Denture use after setting]. PMID- 3505255 TI - Vascular surgery and the National Health Service. PMID- 3505256 TI - Mechanism of the potentiation of thrombolysis by pentoxifylline (Trental). AB - Streptokinase induced thrombolysis of radioactive labeled human fibrin clots was potentiated by simultaneous treatment with pentoxifylline (Trental). This appears to be due in part to the prevention of platelet aggregation on the clot. In addition, release of t-PA and PgI2 from the endothelium and increases in red cell deformability may also play a role. PMID- 3505257 TI - Incidence and clinical significance of peripheral and bone marrow basophilia. AB - We reviewed 2110 bone marrow aspirations from the same number of patients to establish the incidence and associations of peripheral and bone marrow basophilia. Of these, 125 cases of marrow basophilia (5.9% incidence) and 63 cases of peripheral basophilia (3.0% incidence) were identified. There were 33 patients with simultaneous marrow and peripheral basophilia, which was only significantly associated with chronic myelogenous leukemia (24 cases). Isolated peripheral basophilia was rarely seen (30 patients, 1.4% incidence) and it did not reflect any significant pathologic association. Marrow basophilia was significantly present in chronic myeloproliferative disorders, idiopathic myelodysplasia, certain erythrocyte disorders, such as iron deficiency anemia, and aplastic anemia. The incidence of marrow basophilia in patients with lymphoma, acute leukemia, or solid carcinoma was not significantly different from what it would be as a chance occurrence. Our findings suggest that marrow basophilia is a specific, but not sensitive, marker of myeloproliferative and dysmyelopoietic syndromes. PMID- 3505258 TI - Prevalence and type of sexual dysfunctions in diabetic males: a standardized clinical approach. AB - The diagnosis of sexual dysfunctions (SD) in diabetic male patients is usually based on interviews about the sexual behavior of the patients themselves. The absence of a standardized procedure may explain the discrepancies in the prevalence reported in previous papers. In this work, we show a rational procedure to assess the presence and the type of SD in a group of 128 diabetic men. By means of an appropriate questionnaire, SD were pointed out in 40% of insulin-dependent diabetics (IDD) and 52% of non-insulin-dependent diabetic patients (NIDD). Among the patients with SD, 28% had organic impotence, 11% psychogenic impotence and 8% reduction of libido. IDD with SD were older (p less than 0.01) and with a longer duration of diabetes (p less than 0.02) than IDD without SD. NIDD with and without SD had similar ages and known duration of diabetes. Both in IDD and in NIDD, the prevalence of SD was not affected by the quality of short-term metabolic control. In the patients in whom it was studied by a different technique, the predominant cause of organic impotence (76%) was a damage of parasympathetic nervous system, as evaluated by non-invasive tests. In 12% of the cases with organic impotence, a reduced penile flow alone was observed, while hormonal parameters were similar in patients with and without organic impotence. PMID- 3505259 TI - Plasma sialic acid alterations in neoplastic diseases. AB - The several types of neoplastic transformations are accompanied by alterations in the composition of cell glycoproteins, which are major structural components of cell surfaces. One such observed alteration is in the level of sialic acid on the cell surface. In the present investigation, plasma sialic acid levels were measured in normal volunteers and neoplastic patients using thiobarbituric acid spectrophotometric methods. The mean plasma sialic acid level from 124 normal volunteers was 3.0 mumol/ml. The mean for 20 non-malignant patients was 3.2 mumol/ml. Such observed mean values of sialic acid were 3.7 mumol/ml in 64 breast cancer patients, 5.1 mumol/ml in 22 lung cancer patients, 4.1 mumol/ml in 20 colon patients, and 5.0 mumol/ml in 26 patients having ovarian, cervix, pancreas, prostate, thyroid, uterine, squamous cell, esophageal and endometrial cancers. Serial determinations of plasma sialic acid in 15 patients correlated well with the progression and regression of disease. These results indicate that plasma sialic acid levels are elevated over control levels in the different types of cancer patients studied. Assay of plasma sialic acid is not sensitive enough to be used for screening, but could be used as a prognostic determinant in a variety of neoplastic conditions. PMID- 3505260 TI - Treatment of hairy cell leukemia with alpha-interferon and splenectomy. AB - A typical case of hairy cell leukemia, very rare in Japan, is described. The biological characteristics of the disease and histological features of liver and spleen are also reported. Treatment with alpha-interferon and splenectomy was successfully performed, and the patient is now in good health. PMID- 3505261 TI - The "hands-on or hands-off?" dilemma revisited. PMID- 3505262 TI - Postnatal regression of the tunica vasculosa lentis. AB - Previous studies have shown a good correlation between appearance of the tunica vasculosa lentis (TVL) at birth and gestational age in 27-34 week premature infants. We studied the effect of postnatal age on the rate of regression of the TVL in premature infants to assess whether this occurred at a similar rate to that in utero. Fifty-eight premature infants were enrolled into the study. Gestational age was assessed using the method described by Ballard. Lens examination was by direct ophthalmoscopy within 36 hours of birth and then on a weekly basis. Regression of the TVL was graded according to the system described by Hittner; grade IV being the most immature (vascularity covering virtually the entire anterior surface of the lens) to grade I (vascular regression to a point at which only occasional vessels are visualized). Results were analyzed and compared according to postconceptional age. No significant differences were found in the rate of disappearance of the TVL when infants were studied at equivalent postconceptional ages irrespective of postnatal age. Thus, premature delivery was not associated with accelerated regression of the TVL. These findings may be useful in assessing gestational age of a preterm infant who has not had an assessment of gestational age within the first days after birth or who is transferred to a high-care centre beyond the stage when other gestational aging systems are considered reliable. PMID- 3505263 TI - Large for gestational age: dilemma of the infant of the diabetic mother. AB - A retrospective analysis was undertaken of 128 pregnancies (131 infants) complicated by diabetes; 66 (51 per cent) were Class A and 62 (49 per cent) Class B-D-F-R. 53.9 per cent of all infants were large for gestational age (LGA) and there were no differences between the classes of diabetics. LGA infants occurred with equal frequency in those diabetic patients with pregnancy-induced or chronic hypertension. Congenital anomalies occurred in 9.7 per cent with 11/12 in Class A, B, or C. Major neonatal morbidity included: 1) hypoglycemia: two (3 per cent) Class A and 21 (32.8 per cent) insulin-dependent mothers (P less than 0.01); and 2) respiratory distress syndrome: seven (5.3 per cent) and all were in classes B F (P less than 0.05). Modern management of diabetes in pregnancy has, for unknown reasons, increased the incidence of LGA infants. PMID- 3505264 TI - Neurodevelopmental outcome following persistent pulmonary hypertension of the neonate. AB - The neurodevelopmental status of 12 children with persistent pulmonary hypertension of the newborn (PPHN) was examined. All had neonatal documentation of PPHN by echocardiogram, and all were ventilated at least 72 hours. The mean age at follow-up was 20 months (range, 12-28). Five of the 12 subjects were normal at follow-up, three were felt to be suspect but not clearly abnormal, and four had neurodevelopmental abnormalities, including three with sensorineural hearing impairment (25 per cent incidence in this study). These findings represent a concerning frequency of neurodevelopmental dysfunction and support early routine hearing evaluation in this unique subgroup of neonatal intensive care unit survivors. PMID- 3505265 TI - Systemic to pulmonary shunting masquerading as patent ductus arteriosus: a pitfall in clinical diagnosis. AB - Patent ductus arteriosus (PDA) frequently complicates the course of respiratory distress syndrome in premature infants. A 920-g, 28 weeks' gestation infant with clinical and radiographic evidence of left to right shunting, was presumed to have a patent ductus arteriosus. Following ductal ligation the signs persisted. Aortic angiogram demonstrated multiple collateral vessels arising from the systemic circulation and communicating with pulmonary vessels. Accurate diagnosis of left to right shunting is imperative if such collateral shunting is not to go undiagnosed. PMID- 3505266 TI - Effects of infant ventilator design on spontaneous breathing. AB - Study of the mechanical work of spontaneous breaths taken by eight infants attached to infant ventilators. Work was estimated from the volume displacement and pressure fluctuations of breathing during steady state mechanical ventilator conditions (i.e., stable peak or PEEP pressures). A broad difference existed between manufacturers of infant ventilators; a dramatic reduction was seen in work when attached to a demand as compared to a continuous flow device. Additionally, some change in work occurred, depending on the phase of the IMV cycle in which spontaneous breath was taken. Dynamic testing of ventilators can reveal differences in function. PMID- 3505267 TI - Chest physiotherapy in preterm infants with RDS in the first 24 hours of life. AB - To evaluate if chest physiotherapy is beneficial to premature infants with respiratory distress syndrome (RDS) during the first 24 hours of life, 20 infants were randomly assigned to two groups; 10 infants in Group I received routine chest physiotherapy and suction, and 10 infants in Group II received suction only. The birth weight, gestational age, postnatal age, Apgar scores, blood gases, acid-base status, and ventilatory requirements prior to study were comparable between the two groups. There were no significant differences between the groups in the amount of endotracheal secretions removed, the PO2/FIO2 ratio, blood gases, and pH during the study. The incidence of patent ductus arteriosus (PDA), bronchopulmonary dysplasia (BPD), Grade I and II intraventricular hemorrhage (IVH), and mortality was comparable. However, five of 10 Group I and zero of 10 Group II infants developed Grade III or IV IVH (P less than 0.05). PMID- 3505268 TI - Proceedings of the Broadmoor Symposium: The uses, benefits, and limitations of pulse oximetry in neonatal medicine. November 12-14, 1986, Colorado Springs, Colorado. PMID- 3505269 TI - The theory and principles of pulse oximetry. PMID- 3505270 TI - Pulse oximetry versus transcutaneous oxygen monitoring in perinatology applications. PMID- 3505271 TI - Clinical experience with pulse oximetry in managing oxygen therapy in neonatal intensive care. PMID- 3505272 TI - The clinical use of pulse oximetry with bronchopulmonary dysplasia. PMID- 3505273 TI - Evaluation of arterial oxygen saturation of the newborn in the labor and delivery suite. PMID- 3505275 TI - The use of pulse oximetry during infant transport from outside facilities. PMID- 3505276 TI - Polemics in perinatology: malpractice--we have met the enemy. PMID- 3505274 TI - Display variability, false alarms, probe cautions, and recorder use in neonatal pulse oximetry. PMID- 3505277 TI - Perinatal acquired immunodeficiency syndrome. AB - To date in the United States, 41,366 cases of acquired immunodeficiency syndrome (AIDS) have been reported, constituting a major health disaster. As AIDS spreads to the heterosexual population, perinatal hospital areas are seeing increasing numbers of AIDS patients and their families. Many health care workers have had no formal training in caring for these patients, a dilemma now complicated by fear. It is the challenge and responsibility of health care workers today to educate themselves about this disease. Preparation, both philosophically and with a protocol for standard of care, is essential to avoid a crisis in the workplace and to be able to deliver high quality care and support to these patients and their families. This article contains a protocol of care for mothers and infants with AIDS. Recommendations are made for changes in the routine care of the general population, as many cases of AIDS pass through the perinatal areas undetected. PMID- 3505278 TI - Noninvasive blood pressure patterns. AB - The apparatus described in this report provides a noninvasive, nonocclusive technique for continuously measuring cutaneous blood pressure changes over extended periods of time. The data are acquired with miniature pressure transducers mechanically coupled to the cutaneous tissue overlying the thumb and wrist. The cutaneous blood pressure patterns obtained with this apparatus indicate that the stress of uterine contractions causes readily identifiable blood pressure pattern changes. Preliminary results suggest that data obtained with this instrumentation is more complete than that obtainable with intermittent occlusive blood pressure measuring systems currently in use. PMID- 3505279 TI - Fetal heart rate monitoring casebook. Antepartum testing: its role in the diagnosis of premature labor. PMID- 3505280 TI - Neonatal radiologic casebook. H-type tracheo-esophageal fistula. PMID- 3505281 TI - The health needs of homeless families. PMID- 3505282 TI - Future trends in general practice computing. PMID- 3505283 TI - Survey of population coverage in cervical cancer screening in the Oxford region. AB - A postal survey of a random sample of 3307 women aged 18-64 years living in the Oxford region (the Oxford healthy life survey) revealed age and social class differences in the proportion of women reporting an up-to-date cervical smear test. Although 86% of women in the 25-34 years age group reported a test in -the previous five years, the proportion dropped to 53% among the 55-64 year olds. Women in social classes 4 and 5 were significantly less likely to report a recent smear test (P<0.01) than women in higher social classes. An audit of the general practice notes of 176 of the respondents suggested that these self-reported results are likely to be reasonably accurate.A reduction in the number of deaths from cervical cancer will largely depend on the efforts of primary health care teams to screen women who are at relatively high risk of developing the disease, namely older women and those of lower social class. PMID- 3505284 TI - A 'house doctor' scheme for primary health care for the single homeless in Edinburgh. AB - The single homeless are a heterogeneous population with health care needs greater than those of the general population. The Edinburgh primary health care scheme for single homeless hostel dwellers is an attempt to provide an easily accessible service for this population. Having continued for eight years it is one of the longest established of such schemes. The original aim was for house doctors to take services to the residents in the hostels but the scheme has developed to include a primary health care team operating from a central clinic.The scheme was evaluated by a study of the use of the service and by interviews with recipients of the service, hostel managers and others. The study confirmed the high health care burden from chronic handicapping conditions for this population. It was also found that the nature and level of primary health care provided by the scheme was acceptable to the hostel residents and the majority of hostel managements and to accident and emergency department staff. The female hostel dwellers expressed a need for a female practitioner in the scheme. Alternatives for primary health care provision for the single homeless are discussed in the light of the findings, and recommendations are made for the future of the scheme. PMID- 3505285 TI - Providing census data for general practice. 1. Feasibility. AB - The availability of census data to general practice is limited by the form of publication, restricted access to computerized data and the technical difficulties of linking computerized information to a practice population. In a feasibility study it is shown how a population registered with a general practice may be linked through postcodes to computerized enumeration district data. Examples of the data available are discussed together with current problems of postcode/enumeration district mismatch. Suggestions are made for ensuring that general practitioners have access to the 1991 census data. PMID- 3505286 TI - Providing census data for general practice. 2. Usefulness. AB - Computerized census data are described in relation to a general practice population. The previously published methods for scoring deprivation - underprivileged areas score and material deprivation score - are applied to the data. Wards and enumeration districts within a single practice area are ranked by both methods and examples show the wide variation in deprivation scores for enumeration districts within single wards. The value of these data to a general practice is discussed with particular reference to developing a profile of the practice and to planning prevention and anticipatory care. PMID- 3505287 TI - Consultation-based screening of the elderly in general practice: a pilot study. AB - The lack of evidence to support formal annual screening of all older people does not weaken arguments for a preventive and anticipatory component to primary care. A number of short screening schedules for use by nurses or volunteers or for self completion by patients have been developed. Patients 'failing' the screening stage are then fully assessed. This paper describes the design and pilot study of a brief anticipatory care system which can be integrated into routine general practice as the first stage of the twostage process. It was found that only about 28 of the 102 patients screened required follow up and in general the doctors found the system easy to administer during normal surgery sessions. PMID- 3505288 TI - Students' awareness of and attitudes to AIDS. AB - Students' attitudes to and knowledge and awareness of the acquired immune deficiency syndrome (AIDS) was assessed by questionnaire. The recent information campaign reached a high proportion of the sample of 1063 students and television was the most memorable medium. Students were generally aware that AIDS was not associated with social contact but there was confusion about the risk of infection from donating or receiving blood, with 17.9% of blood donors now less willing to donate blood. Most of the students were aware that the condom reduces the risk of spread of AIDS sexually but there was no indication of widespread condom usage among the 399 students who admitted they were sexually active; 39.1% of this group used condoms alone or with other protection. Almost half the sample (47.6%) would like to have the opportunity to have their blood tested for the AIDS virus; 96 students would prefer this to be at a clinic and 59 of them would not wish their family doctor to know the result. A high proportion of the sample considered that AIDS victims should be cared for at home or in a special hospice. PMID- 3505289 TI - Aspirin and Reye's syndrome--do parents know? AB - Amid growing concern over the association between aspirin and Reye's syndrome, the Aspirin Foundation has recently mounted a publicity campaign advising against the use of aspirin in children. Of 50 parents questioned at a children's ward of a district general hospital, 46 (92%) had heard of the publicity, 38 via the television. The number of parents who would give aspirin to their child had dropped significantly from 45 before the campaign to five after it (P<0.001); only one parent chose to ignore the advice. The media, particularly television, is again shown to be a potent means of publicity. Despite the very high response to the advice about aspirin none of the parents mentioned Reye's syndrome as the reason. PMID- 3505291 TI - [Structure and function of cytoskeleton]. PMID- 3505290 TI - Serum theophylline concentrations in general practice patients. PMID- 3505292 TI - [Effects of trigeminal stimulation on the solitarius nucleus neurons in cat]. PMID- 3505293 TI - [Morphological changes of the vascular network of the periodontal membrane and alveolar bone incident to orthodontic tooth movement]. PMID- 3505294 TI - [The effect of fluoride application on the surface of apatite following after calcium and aluminium ions pretreatment]. PMID- 3505295 TI - [In vitro studies with the effect of artificially produced pellicle and plaque on the uptake of fluoride by bovine enamel]. PMID- 3505296 TI - [A study on development of high speed electroforming]. PMID- 3505297 TI - [Morphological change of terminal tubule cells in rat submandibular gland during weaning period]. PMID- 3505298 TI - Dual-channel self-balancing electrodermal impedance reactometer for autonomic response studies. PMID- 3505299 TI - Combined 2.25 MHz ultrasound velocity and bone mineral density measurements in the equine metacarpus and their in vivo applications. PMID- 3505300 TI - Real-time measurement of muscle fatigue related changes in surface EMG. PMID- 3505301 TI - Dependence of biomechanical impedance upon living body structure. PMID- 3505302 TI - Flow through a stenosed artery subject to periodic body acceleration. PMID- 3505303 TI - Turbulence downstream from the Ionescu-Shiley bioprosthesis in steady and pulsatile flow. PMID- 3505304 TI - Design and fabrication of laboratory-scale membrane separation units. PMID- 3505305 TI - One-dimensional computer simulation of a wave incident on randomly distributed inhomogeneities with reference to the scattering of ultrasound by blood. PMID- 3505306 TI - Microcomputer analysis and display of canine small intestinal electrical activity. PMID- 3505307 TI - Possible technique to measure ventricular volume using electrical impedance measurements with an oesophageal electrode. PMID- 3505308 TI - Thoracic impedance of adult males during defibrillation--a curious discrepancy. PMID- 3505309 TI - Surface EMG spectral changes with muscle length. PMID- 3505310 TI - Ultrasound attenuation in biological tissues using a bone transducer. PMID- 3505311 TI - Robotic force platform for the study of posture and stance in the quadruped. PMID- 3505312 TI - Small, triaxial force plate. PMID- 3505313 TI - Two-dimensional mathematical representation of joint surfaces. PMID- 3505314 TI - Voice identification of prepubertal boys and girls by normally sighted and visually handicapped subjects. PMID- 3505315 TI - Acquisition of reading and spelling in a syllabo-alphabetic writing system. PMID- 3505317 TI - Adolescents' narrative use of orientations and codas. PMID- 3505316 TI - Children's comprehension of time-altered sentences. PMID- 3505318 TI - Automatic processing of morphemic orthography by mature readers. PMID- 3505319 TI - Career what...? PMID- 3505320 TI - Questionnaires in medical education. PMID- 3505321 TI - Training health profession students to be effective patient teachers. PMID- 3505322 TI - Preparing medical students to teach: an educational program using three approaches. PMID- 3505323 TI - Critical person-in-environment transitions in medical education. PMID- 3505324 TI - Self-directed learning to educate medical educators, Part 2: Why do we use self directed learning? PMID- 3505325 TI - A self-directed learning package in rheumatology for family physicians. PMID- 3505326 TI - Continuing education for health professionals as part of a broader experiment in health education--Health Care Expo '85: a case report. PMID- 3505327 TI - Inter-rater variability in an advanced cardiac life support course: a case study. PMID- 3505328 TI - How to produce visual material for multiple choice examinations. PMID- 3505329 TI - Nutrition education in medical school. PMID- 3505330 TI - General practice through the medical students' eyes. PMID- 3505331 TI - The role of undergraduate project work in clinical audit in general practice. PMID- 3505332 TI - Graduate teaching practicum: preparation for careers in academic medicine. PMID- 3505333 TI - Regulation of the pentose phosphate pathway in human astrocytes and gliomas. AB - Several aspects of the regulation of the pentose phosphate pathway were examined in cultured normal human cortical astrocytes and gliomas of pathological grades I IV. The generation of radiolabeled CO2 from [1-14C]glucose by the oxidative arm of the pentose phosphate pathway is a saturable process and has a maximum flux rate of 8-9 nmol/hr/mg cell protein. The flux can be blocked by the glycolytic inhibitor iodoacetamide but is unaffected by agents which inhibit oxidative phosphorylation. The magnitude of the pentose phosphate flux is directly related to the glioma grade. Grade IV gliomas (glioblastoma) show a pentose phosphate flux rate of approximately 4% of the total glucose flux. The flux rate can be increased by pharmacological agents which decrease the NADPH/NADP+ ratio. Both the activity and the regulation of glioma glucose-6-phosphate dehydrogenase (G6PDH) are altered in high-grade gliomas. While the affinity constants for cofactors in whole homogenates were not significantly different in glioma or normal astrocyte homogenates, normal astrocytes have a lower Km for glucose-6 phosphate and a G6PDH activity which is 10-fold greater than that of gliomas. NADPH is a powerful regulator of G6PDH activity in the normal astrocytes and in gliomas. At a NADPH/NADP+ ratio of 7:1 the normal astrocyte G6PDH is entirely inhibited, while the glioma enzyme is only 70% inhibited even at a ratio of 20:1. Increased metabolic flux through the oxidative arm of the pentose phosphate pathway is apparently due to an altered form of G6PDH. PMID- 3505334 TI - Simultaneous double-isotope autoradiographic measurement of local cerebral glucose metabolic rate and acid-base status in rat brain. AB - We developed a double-isotope autoradiographic method for the simultaneous measurement of the local cerebral metabolic rate for glucose (1CMRG) and index of regional acid-base status (rABI) in single brain slices using [2-14C]deoxy-D glucose (DG) and 5,5-dimethyl-[2-14C]oxazolidine-2,4,dione (DMO). After iv isotope administration, paper chromatography separates plasma DMO from DG activity using a methanol-methylene chloride solvent system. Initial tissue autoradiograms depict regional DMO plus DG and DG metabolite distribution. After 14 days in a well-ventilated hood, 97.5 +/- 0.5% of all DMO is lost from tissue sections by sublimation, and a second autoradiogram depicts DG plus DG metabolite distribution. Retention of brain lipids does not alter beta-particle self absorption, avoiding problems associated with isotope extraction with solvents. Autoradiograms are digitized and converted to isotope-content images. The second autoradiogram is used for 1CMRG computation. After subtracting the second regional isotope-content value from the first, the DMO content is obtained and used to compute rABI. Application of this method to normal animals yields expected values for 1CMRG and rABI. This method is amenable to whole-slice digitization and creation of functional images of 1CMRG and ABI followed by pixel by-pixel correlations of the two variables, making this a potentially valuable tool for the investigation of the relationships between glucose metabolism and brain acid-base balance. PMID- 3505335 TI - Effects of lead treatment on intracellular iron and copper concentrations in cultured astroglia. AB - Astroglia are implicated in the pathogenesis of lead (Pb) neurotoxicity in two capacities: as a lead sink that sequesters lead and as a target for direct cellular damage. A proposed cellular mechanism of Pb neurotoxicity is the alteration of metal concentrations, particularly the intracellular accumulation of Cu2+. We measured Pb uptake and the effects of Pb acetate on intracellular trace metal concentrations in astroglial cultures prepared from 0- to 4-day-old rat cerebral hemispheres. Mature Sprague Dawley and immature Wistar rat astroglia in culture took up lead from the medium. This finding replicates in vitro the finding reported by others that astroglia in the brain take up Pb. Intracellular Cu and Fe concentrations (micrograms per 2 x 10(6) cells) were increased fourfold or more by treatment with 100 microM Pb for 3 days in the cultures of immature astroglia. Cu levels were also increased twofold or more in mature astroglia treated for 1-3 days with 100 microM Pb. The significance of this finding is that Cu is a potent inhibitor of Na+, K+-ATPase, an enzyme by which astroglia are thought to remove K+ from the extracellular fluid in the brain. Thus, this finding supports the hypothesis that elevated [Cu], and perhaps [Fe], is a subcellular mechanism of neurotoxicity. PMID- 3505337 TI - An overview of computer-assisted diagnostic software. PMID- 3505336 TI - Brain cellular and mitochondrial respiration in media of altered pH. AB - This study was designed to investigate the effects of altered pH on cellular aerobic energy metabolism in the immature and adult rat cerebral cortex. Cerebral cortical slice respiration was measured polarographically in acid and alkaline media. In separate experiments, the extracellular pH was changed by altering the HCO3- concentration or the intracellular pH and extracellular pH were changed by altering the CO2. Respiratory rates and oxidative phosphorylation in adult rat cerebral mitochondria also were measured in media with an altered pH. Increased intracellular pH inhibited respiratory rates in cortical slices from immature rats more than in tissue from adults. Decreasing the pH to 6.7 produced no changes in respiration in mature cortical slices and moderate inhibition of immature tissue respiration. In cerebral mitochondria, altered pH caused inhibition of State 3 respiration, respiratory control ratios, and ADP/O ratios. These changes were greater and occurred with smaller pH changes in the alkaline compared to the acid direction. From the results of these studies, we conclude that brain cellular respiration is not affected by moderate decreases in intracellular pH. With increased pH, there is inhibition of cellular and mitochondrial respiration, which may be the mechanism for the rise in lactic acid previously observed to result from hypocarbia in vivo. PMID- 3505338 TI - Disposition of homovanillic acid in the primate. AB - Prior studies have shown that homovanillic acid is the principal metabolite of dopamine in the primate central nervous system (CNS). In studies of primates given deuterated homovanillic acid systemically, however, only 50% of the administered amounts have been recovered in the urine over the next 4-48 hr. These findings have left it unclear whether there is a slowly turning-over compartment of homovanillic acid, conversion of homovanillic acid to another compound, or excretion of homovanillic acid from the body by a nonrenal route. We synthesized [3H]homovanillic acid and administered it intravenously to four rhesus monkeys. Over the subsequent 4 hr, 94.9 +/- 8.9% (SD) of the administered radioactivity was recovered in the urine, almost entirely as homovanillic acid. These results are consistent with the interpretation that, in primates, there is not a major body pool of homovanillic acid with slow turnover, nor is metabolism to other compounds significant, nor is there evidence for nonrenal excretion. PMID- 3505339 TI - Regional brain glucose use in unstressed rats after two days of starvation. AB - Regional brain glucose use was measured in conscious, unrestrained, fed rats and after 2 days of starvation, using quantitative autoradiography and [6 14C]glucose. Plasma glucose, lactate, and ketone body concentrations and brain glucose and lactate content were measured in separate groups of rats. Glucose concentrations were lower in starved rats in both plasma and brain; plasma ketone body concentrations were elevated. Glucose use was found to be lower throughout the brain by about 12%. While some areas seemed to be affected more than others, statistical analysis showed that none were exceptionally different. The results could not be explained by increased loss of 14C as lactate or pyruvate during the experimental period, because the arteriovenous differences of these species were insignificant. The calculated contribution by ketone bodies to the total energy consumption was between 3 and 9% for the brain as a whole in the starved rats and could, therefore, partially account for the depression seen in glucose use. It was concluded that glucose oxidation is slightly depressed throughout the brain after 2 days of starvation. PMID- 3505340 TI - Adaptive decreases in amino acids (taurine in particular), creatine, and electrolytes prevent cerebral edema in chronically hyponatremic mice: rapid correction (experimental model of central pontine myelinolysis) causes dehydration and shrinkage of brain. AB - The experimental model of central pontine myelinolysis--chronic (4-day) hyponatremia induced by daily injections of hypotonic dextrose solutions and vasopressin followed by rapid correction with saline--was used in young fasted and thirsted mice. In normal controls chronic fasting and thirsting lowered plasma and brain glucose levels and cerebral glycolytic and tricarboxylic acid cyclic metabolic fluxes. The fasting state had little effect on brain amino acids. Clinically, the animals became semistuporous; about one-third died. Chronic hyponatremia in fasted mice almost tripled the plasma glucose concentrations and increased the brain carbohydrate reserve. Levels of other brain glycolytic and Krebs citric acid cycle intermediates were similar to those of controls. Severe hyponatremia and hypoosmolality induced profound decreases in levels of brain electrolytes, amino acids (especially taurine), and creatine. These changes permitted a new osmotic balance between blood and brain and a normal brain water content. The behavior and mortality of the hyponatremic animals were not different from those of the fasted control mice. Correction of hyponatremia to normonatremic levels over a 9-hr period returned brain Na+ and K+ levels to normal but the contents of the measured amino acids and creatine were still reduced one-third or more. As a result, treatment produced a significant degree of dehydration and shrinkage of the brain. The findings stress the importance of amino acids (taurine in particular) and creatine levels, as well as electrolytes, in brain osmoregulation and suggest a role for an osmotic disequilibrium--blood osmolality higher than brain--in the production of brain lesions following rapid correction of chronic hyponatremia in animals and possibly in humans. Replenishment of depleted brain K+ and amino acid levels, as well as slow elevation of the chronically depressed level of plasma Na+, is recommended. PMID- 3505341 TI - Differential effects of axotomy on immature and mature hamster facial neurons: a tritiated-uridine autoradiographic study. AB - In this study, tritiated-uridine incorporation was autoradiographically examined following axotomy of hamster facial motor neurons (HFMN) at the critical development age of 15 days postnatal and in the adult. The postoperative times selected were 0.5, 1, 2, and 4 days. In the 15-day operative series, no changes in incorporation were observed at any of the postoperative times, except at 4 days postoperative, when there was a decrease in tritiated-uridine incorporation in the axotomized neurons relative to the controls. In the adult operative series there were no changes in incorporation at 0.5 or 1 day postoperative, relative to the controls. At 2 days postoperative in the adult, there was a transient increase in tritiated-uridine incorporation that returned to control levels by 4 days postoperative. When axotomized and control cytoplasmic/nuclear grain densities were compared, no changes were found in either operative series. These results of the time course of axotomy-induced changes in RNA synthesis in HFMN corroborate our previous findings of an age-dependent reactive sequence in HFMN and lend support to the hypothesis that the young neurons are synthesizing at peak capacity related to final growth and cannot be stimulated further by axotomy. As discussed, the transient increase in RNA levels in the adult, the lack of any changes in the rate of transfer of RNA from the nucleus to the cytoplasm, and the decrease in RNA levels in the 15-day neurons may be related to the presence of an unusual intranucleolar body within the nucleolus of HFMN that contains ribosomal precursors. PMID- 3505343 TI - Getting started on diabetic care. PMID- 3505344 TI - Regular diabetic review in surgery time. PMID- 3505345 TI - The diabetic day. A model for the management of chronic illness in general practice. PMID- 3505342 TI - Quantitative assessment of the synergistic and independent effects of estradiol and progesterone on ventromedial hypothalamic and preoptic-area proteins in female rat brain. AB - In this study, quantitative assessment of the synergistic and independent effects of estradiol and progesterone on protein synthesis in the ventromedial hypothalamus (VMN) and the preoptic area (POA) was accomplished using in vitro 35S-methionine and 35S-cystein labeling, two-dimensional gel electrophoresis, and computerized densitometry. Ovariectomized (OVX) rats were divided into four groups. Group 1 was implanted with estradiol (E) capsules for 6 hr and injected with progesterone (P; 0.1 ml, 5 mg/ml propylene glycol) at 20 hr. Group 3 was sham-implanted for 6 hr and injected with 0.01 ml P at 20 hr. Group 4 was sham planted for 6 hr and injected with vehicle alone at 20 hr. All animals were sacrificed at 24 hr. A number of proteins in both VMN and POA were found to be increased or decreased in labeling by E plus P, E alone, and P alone. Two important synergistic effects of the hormones were found. First, the effects of E on labeling of several proteins in both brain regions were countered by P, and conversely, the effects of P on labeling of several proteins in both brain regions were countered by E. Second, E priming increased the number of proteins affected in labeling by P in both brain regions. Comparison of the effects of E and P on proteins in the VMN and POA indicated that the populations of proteins affected in labeling were markedly different. These results begin to clarify the mechanism in which E and P affect neuronal functioning in two regions involved in the control of reproduction and lend support to the hypothesis that gonadal steroids accomplished their action on brain tissue via a mechanism that is partly unique to the brain region. PMID- 3505346 TI - Running a diabetic miniclinic in a general practice. PMID- 3505347 TI - Screening for sight-threatening diabetic retinopathy. PMID- 3505349 TI - Developing the role of the practice nurse in diabetic care. PMID- 3505348 TI - Think feet: the health care team approach. PMID- 3505350 TI - Diabetes education: what, who, when, where and how? PMID- 3505351 TI - The team approach to diabetes in general practice. PMID- 3505352 TI - General practice, chronic care and the treatment of 'difficult' patients. PMID- 3505353 TI - Quantification of IgG-containing plasma cells as an adjunct to histopathology in distinguishing acute self-limited colitis from active idiopathic inflammatory bowel disease. AB - ASLC is clinically and endoscopically similar to active idiopathic IBD, especially ulcerative colitis. While several histopathologic criteria have been described which are useful in distinguishing these conditions, the diagnosis can still be difficult. In this study, we review the use of immunofluorescence on formalin-fixed paraffin-embedded biopsies from patients with ASLC. While tissues from active IBD have a striking increase in the number of IgG- and a lesser increase in the IgA- and IgM-containing plasma cells in the lamina propria, tissues from ASLC have normal numbers of IgG-containing cells with only a slight increase in IgA- and IgM-containing cells. The use of immunofluorescence on these tissues can provide quantifiable information which may be a helpful diagnostic adjunct in distinguishing these alternatives if histopathologic evaluation is equivocal. PMID- 3505354 TI - Two magnetic methods for articulatory measurements. AB - We present two magnetic methods for measuring articulatory activities. Unlike previous methods, the magnetic fields are uniform. Three alternating magnetic fields induce voltages in two detectors, a magnetic potentiometer and a flat coil. Thus we are able to measure jaw and tongue movements during speech production. These methods are biologically safe. The miniaturized detectors do not disturb the speech movements. Some preliminary results are presented. These methods can also be applied for other kinds of vectorial distance measurement. PMID- 3505355 TI - Palatoglossus activity during nasal/nonnasal vowels of Hindi. AB - Prior electromyographic (EMG) research reveals a lack of agreement as to the role of the palatoglossus muscle in speech. Some reports have concluded that it bears primary responsibility for lowering the velum and that it actively controls velar lowering on nasal sounds in speech, whereas others have concluded that it acts to assist in the tongue-body movements associated with the production of back vowels and linguavelar articulations. To clarify these conflicting claims, EMG recordings were obtained from the palatoglossus (as well as the levator palatini) muscle of a native speaker of Hindi who produced CVC nonsense and meaningful syllables containing a nasal or nonnasal vowel in a symmetric consonantal environment. The results showed the following: Palatoglossus activity for the central and back nasal and nonnasal vowels was moderately to considerably higher than for the front nasal and nonnasal vowels. The levels of palatoglossus activity for the back rounded nasal vowels and for the front nasal vowel /e/ were comparable to those for the corresponding nonnasal vowels, while in all other vowels, the nasal vowels exhibited relatively higher levels of palatoglossus activity than their nonnasal counterparts. In all nonnasal vowels, the increase in palatoglossus activity occurred simultaneously with strong levator palatini activity. On the other hand, in nasal vowels, the increase in palatoglossus activity and the decrease in levator palatini activity were virtually synchronous for the front nasal vowels, while the increase in palatoglossus activity began much earlier than the decline in levator palatini activity for the central and back nasal vowels. This difference in temporal relationship between palatoglossus activation and levator suppression for different vowel types is important since it unambiguously supports the 'gate-pull' model (that is, active velar lowering) for the production of front nasal vowels whereas in the case of central and back vowels, nasal and nonnasal, the palatoglossus appears to be primarily involved in moving the tongue-body. PMID- 3505356 TI - Kinematic characteristics of postvocalic labial stop consonants produced by children and adults. AB - It has been commonly observed in the speech of English-speaking adults and children that vowels are longer when they precede voiced versus voiceless final obstruents. However, less is known about articulatory characteristics of such productions, particularly in the case of children. The present study investigated kinematic properties of children's and adults' productions of labial stop consonants in postvocalic position. Acoustic measures of the same segments were also obtained. It was observed that for all three groups of children and the adults, closing gestures into [p] occurred more rapidly than did closing gestures into [b]; however, there was a tendency for the difference between [p] and [b] closing velocities to increase with age. Possible relationships between acoustic and kinematic factors were also explored. PMID- 3505357 TI - 'Metrical' factors in the scaling of sentence-initial accent peaks. AB - Past studies of declination make contradictory claims about the relationship between the length of an utterance and the height of its first accent peak (P1): Some find a large increase in P1 with increased length, others find little or no increase. A possible explanation for this contradiction is that large increases in P1 occur when the first major constituent of the sentence increases from one accented item to more than one, but not as a function of overall length alone. In an experiment, 1 of 2 speakers behaved in the way just outlined; data from the 2nd speaker supported the more general hypothesis that 'metrical' constituent structure is relevant to P1. PMID- 3505358 TI - Classification of basic fundamental frequency patterns using discriminant functions. AB - An attempt was made to see whether realizations of eight different pitch patterns can be classified automatically by subjecting fundamental frequency curves to statistical treatment using two kinds of discriminant functions. The materials consisted of 150 imitations of each of the eight prototypes (eight intonations of a short Polish phrase). Approximately 80% of the time the statistical procedures assigned the individual tokens to the appropriate classes. Most of the misassignments were due to wrong imitations. The discriminant functions also indicated similarities and dissimilarities among the pitch patterns. It is suggested that perceptually and linguistically, some differences between pitch patterns may not be quite categorical. PMID- 3505360 TI - Cell calcium and the control of membrane transport. PMID- 3505359 TI - Biological activities of phythalocyanines--IV. Type II sensitized photooxidation of L-tryptophan and cholesterol by sulfonated metallo phthalocyanines. PMID- 3505361 TI - Intracellular calcium in cardiac myocytes: calcium transients measured using fluorescence imaging. AB - We have examined the distribution of Ca2+ in voltage-clamped cardiac myocytes under resting conditions and during the Ca2+ transient. We find that the resting Ca2+ level in a quiescent rat myocyte bathed in 1 mM extracellular Ca is relatively low (between 60 and 100 nM) and uniform. At the peak of the Ca2+ transient, Ca2+ can rise to a level as high as 600 nM to 1.0 microM. Furthermore, the magnitude of the Ca2+ transient is dependent on the size of the membrane depolarization. There is good agreement between measurements made using video imaging and those made using a photomultiplier tube for the value of intracellular Ca2+ at the peak of the Ca2+ transient and for the subsequent slow changes in intracellular Ca2+. On repolarization, intracellular Ca2+ falls with a half-time of approximately 100 ms. The uniform distribution of Ca2+ reported in the Ca2+ images of myocytes at rest and at the peak of the Ca2+ transient under normal conditions is in contrast to what is observed during "Ca2+ overload" when subcellular regions of elevated Ca2+ are observed to propagate along the cell. Thus, the measurement of [Ca2+]i in cardiac myocytes with fura-2 has already yielded important new information that was not available using other techniques to measure [Ca2+]i in cardiac ventricular muscle. PMID- 3505362 TI - The relationship between the cytosolic free calcium ion concentration and the control of pyruvate dehydrogenase. PMID- 3505363 TI - Development of presynaptic specializations induced by basic polypeptide-coated latex beads in spinal cord cultures. AB - The development of the neuromuscular synapse is initiated by an interaction between the motoneuron processes and the skeletal muscle. Previously we showed that basic polypeptide-coated latex beads can mimic the nerve in effecting a postsynaptic differentiation (Peng, H.B. and Cheng, P.-C.: J. Neurosci., 2:1760 1774, 1982). In this study, we examined whether these beads can also induce a presynaptic differentiation along the nerve processes. Explant cultures were prepared from the spinal cords of Xenopus larvae and polyornithine-coated latex beads (0.45-4.5 micron in diameter) were applied. After 1-2 days, the cultures were processed for light and electron microscopy. For light microscopy, the cells were permeabilized and labeled with a monoclonal antibody against a 65-KD antigen on synaptic vesicles. Indirect immunofluorescence revealed that this antigen was concentrated at 60% of the bead-neurite contacts, therefore suggesting the clustering of synaptic versicles at these sites. This phenomenon was not observed at the contacts between neurites and negatively charged (polycarboxylate) beads. However, a concentration of this antigen was also observed at the varicosities along the neurites cultured on polylysine substrate. Thin-section electron microscopy showed the following features: (1) The neurites formed terminal-like varicosities on the bead. (2) Within these varicosities, clusters of 50-60-nm clear vesicles were prominent at the bead-neurite contact. (3) Large (80-100 nm) dense-cored vesicles were also present in the varicosity, but they did not form clusters. (4) Basement membrane did not form at the bead-neurite interface, in contrast to its appearance at the bead-muscle contact from our previous study.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3505364 TI - Electrophysiological responses of serotoninergic dorsal raphe neurons to 5-HT1A and 5-HT1B agonists. AB - A direct comparison was made of the effects of serotonin 5-HT1A and 5-HT1B selective compounds on the spontaneous firing rate of dorsal raphe serotoninergic neurons in chloral-hydrate-anesthetized rats. Following intravenous administration, the 5-HT1A selective compounds ipsapirone (TVX Q 7821) and LY 165163 potently inhibited single-unit activity in a dose-dependent manner whereas the 5-HT1B selective compounds, m-chlorophenylpiperazine (mCPP) and trifluoromethylphenylpiperazine (TFMPP), displayed only weak or irregular actions. Low microiontophoretic currents of ipsapirone and LY 165163 were also effective in suppressing spontaneous firing; dose-response relationships for the 5-HT1A compounds were indistinguishable from that of 5-HT itself. In contrast, dorsal raphe neurons were only weakly responsive to microiontophoretic application of mCPP and TFMPP; dose-response relationships for the 5-HT1B compounds were significantly displaced from that of 5-HT. In intracellular studies, ipsapirone and LY 165163, when added to the media bathing brain slices, mimicked the actions of 5-HT in hyperpolarizing dorsal raphe cell membranes and decreasing input resistance; however, the maximal effects of the 5-HT1A compounds on these membrane properties exceeded those of 5-HT. In summary, dorsal raphe 5 HT neurons appear highly responsive to 5-HT1A, but not to 5-HT1B compounds; these findings are discussed with regard to the 5-HT receptor subtypes as candidates for the somatodendritic autoreceptor of dorsal raphe neurons. PMID- 3505365 TI - Effects of fimbria-fornix transection and ganglioside treatments on histochemical staining for glucose-6-phosphate dehydrogenase in the lateral septum. AB - The present study examined whether ganglioside treatments would affect an enzyme marker (glucose-6-phosphate dehydrogenase; G6PDH) of neural metabolism in an established model system (the hippocamposeptal projection) of deafferentation and sprouting. Rats were subjected to unilateral transections of the fimbria-fornix (FF) in order to (1) interrupt the hippocamposeptal projection, (2) deafferent the lateral septal nucleus (LSN) ipsilaterally, and (3) induce sprouting by the contralateral FF. In untreated rats which were killed at 2-4 days postlesion, histochemical staining for G6PDH was reduced by 35-40% in the deafferented LSN relative to the contralateral side. However, at 6-8 days (i.e., when sprouting begins), staining intensity returned toward contralateral values (i.e., recovered). This pattern of changes in G6PDH staining was not observed in the caudate nucleus adjacent to the LSN. In ganglioside-treated rats which were killed at 4 days, there was a significantly smaller reduction of G6PDH staining in the deafferented LSN (23%; P = .05). This effect was not observed in the LSN of treated rats killed at 2 days, nor in the caudate nucleus at either time point. The present data indicate that (1) FF transection results in a reduction and subsequent recovery of G6PDH staining in the deafferented LSN; and (2) ganglioside treatments may accelerate the onset of the recovery of G6PDH activity. We suggest that gangliosides' effect on G6PDH reflects an acute enhancement of biosynthetic events in deafferented neurons. PMID- 3505367 TI - On the distribution of cholecystokinin receptor binding sites in the human brain: an autoradiographic study. AB - Cholecystokinin (CCK) binding sites were localized by in vitro autoradiography in human postmortem brain materials from 12 patients without reported neurological diseases using [125I]Bolton-Hunter CCK octapeptide (BHCCK-8) as a ligand. The pharmacological characteristics of BHCCK-8 binding to mounted tissue sections were comparable to those previously reported in the rat. CCK-8 being the most potent displacer, followed by caerulein, CCK-4, and gastrin I. The distribution of BHCCK-8 binding sites was heterogeneous. These sites were highly concentrated in a limited number of gray matter areas and nuclei. The highest binding densities were seen in the glomerular and external plexiform layers of the olfactory bulb. BHCCK-8 binding sites were also enriched in the neocortex, where they presented a laminar distribution with low levels in lamina I, moderate concentration in laminae II to IV, high density in lamina V, and low levels in lamina VI. A different laminar distribution was seen in the visual cortex, where a low receptor density was observed in lamina IV but higher density in laminae II and VI. In the basal ganglia the nucleus accumbens, caudatus, and the putamen presented moderate to high densities of binding sites, while the globus pallidus lacked sites of BHCCK-8 binding. In the limbic system the only area presenting moderate to high density was the amygdaloid complex, particularly in the granular nucleus, while most of the thalamic nuclei were extremely poor or lacked BHCCK-8 binding. The hippocampal formation showed low (CA1-3) to moderate (subiculum) densities. Midbrain areas generally disclosed very low levels of BHCCK-8 binding sites. The pontine gray and the nucleus reticularis tegmenti pontis showed a relatively high density of CCK-8 receptor specific binding. Moderate to very high densities were found in few nuclei of the lower brainstem and spinal cord as the inferior olives and their accessory nuclei, the arcuate nuclei, the striae medullares, the efferent (motor) nucleus of the vagus, and the substantia gelatinosa of the cervical and thoracic spinal cord. These results are discussed in relation to the distribution of endogenous peptide and to the known physiological and pharmacological effects of substances acting on these receptors. PMID- 3505366 TI - A critical level of protein synthesis is required for long-term potentiation. AB - Long-term potentiation (LTP) of the hippocampal population spike in area CA1 was studied in the hippocampal slice before, during, and after inhibition of protein synthesis. LTP was tested 15 and 30 min following addition of the protein synthesis inhibitor cycloheximide (CXM) to the bathing medium. Stimulation induced LTP of the population spike was reduced in slices incubated in CXM for 15 min and completely blocked if incubated for 30 min. Measures of protein synthesis inhibition under the same conditions showed 79% at 15 min and 85% after 30 min. Tests of the effects of repeated LTP treatments at these same time points in the absence of CXM and evaluation of the time course of recovery of LTP from CXM blockade were also conducted. The results confirm previous observations and indicate that a critical amount of protein synthesis inhibition is required to completely block LTP in the hippocampal slice. PMID- 3505368 TI - In vitro studies of the role of gamma-aminobutyric acid in inhibition in the lateral septum of the rat. AB - Focal stimulation, stimulation of the fimbria, and stimulation of the medial septal area result in an inhibitory postsynaptic potential (IPSP) in lateral septal neurons. Increased stimulus intensity results in the appearance of a late hyperpolarizing potential (LHP). Treatment of the slice with bicuculline methiodide or picrotoxin results in blockade of the IPSP. When present, LHPs are enhanced in the presence of bicuculline or picrotoxin. Spontaneous and evoked IPSPs reverse near -70 mV, and LHPs reverse near -90 mV. Iontophoretic application of gamma-amino-butyric acid (GABA) results in hyperpolarizing, depolarizing, or biphasic potentials. Treatment with bicuculline or picrotoxin results in depression of biphasic GABA responses that appears selective for the depolarizing portion of the potential. At high concentrations of bicuculline, a portion of the hyperpolarizing GABA potential persists. The reversal potential of the depolarizing GABA potential is near -30 mV, and the reversal potential of monophasic hyperpolarizing GABA potential is near -70 mV. The bicuculline resistant hyperpolarizing GABA response has a reversal potential near -90 mV. GABA activates three separate conductances on septal neurons, which are similar to those reported on hippocampal neurons. The resistance of the hyperpolarizing GABA potential to bicuculline appears to be due to the presence of a GABA activated potassium conductance, which is similar to that activated by baclofen. PMID- 3505369 TI - Primordial synaptic structures and synaptogenesis in rat olfactory cortex. AB - Mature synaptic contacts and various primordial synaptic elements were studied, counted, and analyzed in rat olfactory cortex from birth to 30 days of age. Primordial structures possess one or a few, but not all, of the features of a true mature synapse and have been grouped into two major classes based upon type of apposition: 1) single or 2) partial and multiple, with vacant postsynaptic sites included in the latter. There is a classical fivefold increase in number of mature synapses between birth and 30 days, but different patterns in the primordial appositions are observed. It is suggested that single apposition contribute to early synapse formation, while partial and multiple appositions participate later on during a time of rapid growth of new afferents to the area. The results suggest a clear role for primordial synaptic structures in synaptogenesis; that the sequence may be more diverse than originally hypothesized, occurring at different stages; and that competition, synapse elimination, and replacement may be more prevalent in normal synaptogenesis than has been previously suspected. PMID- 3505370 TI - Sexual dimorphism in the synaptogenic effect of estradiol in prepuberal female rats. AB - A study has been made of the effects of estradiol benzoate (EB) on synaptogenic induction in the hypothalamic arcuate nucleus (ARC), medial preoptic area (MPOA), and medial septal area (MSA) of prepuberal male and female rats. Subcutaneous administration of EB to 25-day-old female rats induces accelerated synaptogenesis in the ARC concomitant with a precocious surge of plasma luteinizing hormone (LH) at 1600 h on day 27 of age. The synaptic area densities (No. synapses/unit area of tissue section) of the MPOA and MSA are not increased at 27 days of age in rats treated with EB on day 25 of age. The synaptic area densities of the ARC, MPOA, and MSA are significantly higher on day 31 compared to day 27. However, only the ARC exhibits a further increase of synaptic numbers in EB-treated female rats. Similar estrogen treatment to prepuberal male rats induces neither an LH surge in plasma nor increased synaptogenesis in the ARC, MPOA, or MSA. Male 27 day-old rats of both estrogen-treated and control groups exhibit a synaptic area density in the ARC similar to 27-day-old control female rats. These data indicate that the sexually dimorphic positive response to estrogen with LH secretion has an equally sexually dimorphic neuromorphological response in rats. In addition, the synaptogenic effect of EB in the prepuberal female rat ARC remains manifest for at least 6 days after estrogen treatment. PMID- 3505371 TI - Human brain dopamine receptors in children and aging adults. AB - Since spontaneous oral dyskinesias are more prevalent in the elderly, and since these movements may be controlled by the balance of brain dopamine D1 and D2 dopamine receptors, we measured the densities of these receptors in 247 postmortem brain striata. In childhood, the densities of D1 and D2 dopamine receptors in the brain striatum rise and fall together. After age 20 years, D1 receptors disappear at 3.2% per decade while D2 receptors disappear at about 2.2% per decade. Overall, therefore, the D1/D2 ratio falls with age. Since perioral motion in rats is dominated by a high D1/D2 ratio, the observed decline in the human D1/D2 ratio with age suggests that the perioral control mechanisms for humans and rats may be different. PMID- 3505372 TI - Functional properties of models for direction selectivity in the retina. AB - Poggio and Reichardt (Kybernetik, 13:223-227, 1973) showed that if the average response of a visual system to a moving stimulus is directionally selective, then this sensitivity must be mediated by a nonlinear operation. In particular, it has been proposed that at the behavioral level, motion-sensitive biological systems are implemented by quadratic nonlinearities (Hassenstein and Reichardt: Z. Naturforsch., 11b:513-524, 1956; van Santen and Sperling: J. Opt. Soc. Am. [A] 1:451-473, 1984; Adelson and Bergen: J. Opt. Soc. Am. [A], 2:284-299, 1985). This paper analyzes theoretically two nonlinear neural mechanisms that possibly underlie retinal direction selectivity and explores the conditions under which they behave as a quadratic nonlinearity. The first mechanism is shunting inhibition (Torre and Poggio: Proc. R. Soc. Lond. [Biol.], 202:409-416, 1978), and the second consists of the linear combination of the outputs of a depolarizing and a hyperpolarizing synapse, followed by a threshold operation. It was found that although sometimes possible, it is in practice hard to approximate the Shunting Inhibition and the Threshold models for direction selectivity by quadratic systems. For instance, the level of the threshold on the Threshold model must be close to the steady-state level of the cell's combined synaptic input. Furthermore, for both the Shunting and the Threshold models, the approximation by a quadratic system is only possible for a small range of low contrast stimuli and for situations where the rectifications due to the ON-OFF mechanisms, and to the ganglion cells' action potentials, can be linearized. The main question that this paper leaves open is, how do we account for the apparent quadratic properties of motion perception given that the same properties seem so fragile at the single cell level? Finally, as a result of this study, some system analysis experiments were proposed that can distinguish between different instances of the models. PMID- 3505373 TI - Co-localization of N-acetyl-aspartyl-glutamate in central cholinergic, noradrenergic, and serotonergic neurons. AB - An immunohistochemical technique for simultaneously visualizing two different antigens has been used to investigate the presence of the acidic dipeptide, N acetyl-aspartyl-glutamate (NAAG), in cholinergic, noradrenergic-adrenergic, and serotonergic neurons within CNS. The brain slices were processed sequentially with purified antisera against NAAG and then monoclonal antibody against choline acetyltransferase (ChAT), a marker for cholinergic neurons, or antiserum against dopamine-beta-hydroxylase (DBH), a marker of noradrenergic-adrenergic neurons, or antiserum against serotonin (5HT). Both antigens were revealed by the peroxidase reaction but with different chromogens, which are easily distinguishable. An intense double staining of NAAG-like immunoreactivity (NAAG-LI) and ChAT was observed in the motoneurons of the spinal cord as well as in the several motor components of cranial nerve nuclei including facial, ambiguus, and trigeminal nuclei. A partial colocalization of NAAG-LI and ChAT was evident in the perikarya of the basal forebrain cholinergic system, whereas cholinergic neurons of the medial septum exhibited only sporadic staining for NAAG-LI. A complete coexistence of NAAG-LI and DBH was observed in the locus coeruleus. Most of the other noradrenergic and adrenergic cell groups of the medulla region exhibited substantial co-localization with the exception of the A2 cell group, which was virtually devoid of NAAG-LI. In the dorsal raphe, only a low percentage of serotonergic neurons stained for NAAG-LI. The co-existence of NAAG-LI and serotonin was more evident in the neurons of the median raphe, although the majority of cells failed to show double staining.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3505375 TI - [Hemorrhagic complications during extracorporeal circulation]. PMID- 3505374 TI - [Prognosis of surgically treated bronchopulmonary cancer. Apropos of 42 cases]. PMID- 3505376 TI - [Results of the combination of radiation-surgery in the treatment of cancer proximal stage I and II of the cervix uteri]. PMID- 3505377 TI - [The latissimus dorsi flap: anatomic value and clinical application. Apropos of 15 cases]. PMID- 3505378 TI - [Retroperitoneal tumors in adults. Apropos of 25 cases]. PMID- 3505379 TI - [Abdominal neuroblastoma in childhood: diagnostic and therapeutic aspects. Apropos of 26 cases]. PMID- 3505380 TI - [Conservative treatment of injuries of the spleen]. PMID- 3505381 TI - [Calculi-induced anuria. Apropos of 31 cases]. PMID- 3505382 TI - [The pelvic kidney. Apropos of 50 cases]. PMID- 3505383 TI - [Anomalies of the aortic arch. Apropos of a case of a double arch]. PMID- 3505384 TI - [Carcinoid tumor of the small intestine. Apropos of 3 cases]. PMID- 3505385 TI - [Prevalence of HBs antigens and anti-HTLV antibodies in a population of 43 hemophiliacs]. PMID- 3505386 TI - [The status of intestinal anti-infective agents in diarrhea at an urban practice in Tunisia]. PMID- 3505388 TI - [Treatment of echinococcosis of the spleen]. PMID- 3505387 TI - [Benign tumors of the gallbladder]. PMID- 3505389 TI - [Reoperation due to ileus]. PMID- 3505390 TI - [Reintervention in biliary surgery]. PMID- 3505391 TI - [Report of 2 cases of pulmonary echinococcal cyst rupture in children without any evident initial symptomatology]. PMID- 3505392 TI - [Treatment of deformities of the anterior wall of the thorax associated with deformities of the spinal column]. PMID- 3505393 TI - [Spontaneous cholecystocutaneous fistula]. PMID- 3505394 TI - [Early reintervention in dehiscence of the anastomosis of the small intestine and colonic perforation at the site of the serous lesion]. PMID- 3505395 TI - [Gastric ulcer following suture of a perforated duodenal ulcer]. PMID- 3505397 TI - [Biliary pancreatitis--indications and timing of care of lithiasis]. PMID- 3505396 TI - [Team care of multiple injuries due to firearms]. PMID- 3505398 TI - [Ectopic ureter, case report]. PMID- 3505399 TI - [Antibodies against smooth muscle in the detection and follow-up of the celiac disease patient]. AB - The presence of smooth muscle antibodies (SMA) as determined by indirect immunofluorescence was investigated in the serum of 40 patients, 36 out of which were children. Group I included patients having celiac disease (diagnosed by three biopsies). 7/7 (Group Ia) showed no SMA on gluten-free diet while antibodies were present after challenge. 4/6 (Group Ib) were positive also after challenge (these had not had previous determination). Group II was composed by patients presumed to have celiac disease for they had only one biopsy showing grade IV villous atrophy. 5 patients were of recent diagnosis (group IIa) and showed SMA. 4/5 (Group IIb) who admitted not to had been able to follow the gluten-free diet were also positive for SMA. 6/6 (Group IIc) patients on strict gluten-free diet and showing good clinical response had no detectable SMA. Group III included relatives of patients having celiac disease. 5/6 with SMA showed pathologic small bowel biopsies; only 1/4 with no SMA had mucosal alterations. It is concluded that the presence of serum SMA can be considered a useful marker in the follow-up of cases of celiac disease already diagnosed and to investigate presumed cases of such disease. PMID- 3505400 TI - [Peroral suction biopsy of the small intestine directed under endoscopic monitoring]. AB - The technical difficulties of the procedures for jejunal biopsy are a waste of time. In the present paper we consider the suction biopsy of small bowel with the Olympus equipment, under endoscopic control. We studied 47 patients, mean age 46 years old (range 22-70) with clinical suggestion of malabsorption. In all patients, we tried to obtain 3 samples, in 31 (66%) we obtained the 3, in 8 (17%) we obtained 2 and in 2 (4.2%) no samples. With this procedure we had 121 samples; from these 114 (94.2%) were useful for diagnosis. We had no complications. The small bowel biopsy with Olympus system was fast, sure and effective. PMID- 3505401 TI - [Alkaline gastritis. Gastric reoperations]. AB - The authors present 23 cases (1.6%) of reoperated patients with alkaline gastritis syndrome at Dr. Bonorino Udaondo National Gastroenterology Hospital. Over 1400 surgical operations performed in order to treat the gastroduodenal ulcer disease; 19 patients showed an evident syndrome of alkaline gastritis and the rest of cases had a mixed syndrome, because of another syndromes. The initial operation was a gastric resection Billroth II type in 22 cases and the rest are had a vagotomy with a gastroenterostomy. In all the cases, clinical, radiological, laboratory, endoscopy and histopathology aspects as well as Kay and Hollander test were studied. The modified surgical operations were: Soupault Bucaille with isoperistaltic loop (7 cases), with anisoperistaltic loop Poth type (1 case), reoperations with the Y en Roux technique (14 cases), desgastroenterostomy, closing of the jejunal and gastric drainage and pyloroplasty (1 case). It was fulfilled with a vagotomy. The 50% of the cases have to 8 years after the operation; another were reexamined at 100 and 15 years being without symptoms. PMID- 3505402 TI - [Finding of pyloric Campylobacter in the operated stomach and therapeutic results]. AB - We present a trial on 21 patients with gastric surgery, by different pathologies, benign and malignant, with the aim of detecting presence or absence of Pyloric Campylobacter. The clinical, endoscopic findings and presence-absence of Pyloric Campylobacter were correlated. Regarding the clinical symptomatology, it was not possible to obtain a favourable conclusion to the presence of Pyloric Campylobacter in both groups. The endoscopic findings showed changes more evident in those cases of positive Pyloric Campylobacter. The therapeutical response of positive Pyloric Campylobacter to TDB during 30 days was beneficial regarding the disappearance of the symptoms. PMID- 3505404 TI - [Foreign bodies in the digestive tract]. PMID- 3505403 TI - [Gastric dysplasia: a theme to reconsider]. PMID- 3505405 TI - New and still emerging field of fetal medicine. PMID- 3505406 TI - Fascination with the mystery of new life in utero. PMID- 3505407 TI - Ethical issues in intrauterine diagnosis and therapy. AB - This essay considers ethical problems raised by recent developments in intrauterine diagnosis and therapy. Diagnostic and therapeutic innovations applicable to the previable fetus and to the possibly viable or viable fetus are briefly described. A central ethical issue prior to viability is whether intrauterine therapy for fetal health problems should be attempted or whether selective abortion should be chosen as an alternative. Beyond viability, an important question is the extent to which a pregnant woman is morally obligated to accept risks to her own life or health for the sake of the fetus. PMID- 3505408 TI - Simultaneous assessment of blood flow velocity waveforms in uteroplacental vessels, the umbilical artery, the fetal aorta and the fetal common carotid artery. AB - We investigated simultaneously blood flow velocity waveforms of uteroplacental vessels, the umbilical artery, the fetal aorta and the fetal common carotid artery. In pregnancies with intrauterine growth retardation or preeclampsia we found low diastolic velocities in uteroplacental vessels, the umbilical artery and the fetal aorta and high diastolic velocities in the common carotid artery. Abnormal waveforms of the common carotid artery were most effective in predicting fetal compromise and might be a valuable clinical tool for the supervision and therapy of high-risk pregnancies in the future. PMID- 3505409 TI - Effect of amnioinfusion on the umbilical Doppler flow velocity waveform: a case report. AB - A case of intrauterine growth retardation with marked oligohydramnios is presented in which, following amnioinfusion of 200 ml of a 5% glucose solution, the diagnosis of bilateral renal agenesis was established. Doppler flow study in the umbilical artery revealed a high resistance flow velocity waveform which became normal following amnioinfusion, suggesting cord compression rather than poor uteroplacental perfusion. Abnormal Doppler flow velocity waveforms in the umbilical artery in the presence of severe oligohydramnios should be interpreted with caution. PMID- 3505410 TI - Morphometry of the second trimester fetal brain. Comparison of ultrasonographic and post-mortem findings. AB - With the increasing use of ultrasound examination in the antenatal period the lack of morphological correlates has become a problem. This study was carried out in order to correct this deficiency. An antenatal real-time ultrasound scan of the fetal head was performed and measurements of the biparietal diameter, occipitofrontal diameter, head circumference and cerebral ventricle-to-hemisphere ratio were undertaken in 103 fetuses at 13-24 weeks gestation. After prostaglandin termination of pregnancy, the fetal brains were perfused in situ through the right carotid artery with 10% formal saline. Horizontal slices of the fetal head were cut, photographs were obtained and measurements of the same parameters as in the ultrasound examination were undertaken. There is a significant correlation (p less than 0.001) between the ultrasonographic and post mortem measurements of all parameters. Also several anatomical structures of the fetal brain are now confidently identified in the antenatal ultrasound scan, using the anatomical preparations for comparison. PMID- 3505411 TI - Vehicular trauma in pregnancy: an algorithm for diagnosis and fetal therapy. AB - The incidence of motor vehicle accidents resulting in trauma in pregnant women is increasing. The best chance for fetal survival is to ensure maternal survival, so awareness of the types of injuries and their presentation after vehicular trauma is of the utmost importance. An algorithm for the approach to diagnosis and fetal therapy based upon obstetrics and trauma care parameters is hereby presented to the trauma team. PMID- 3505412 TI - Cardiac tachyarrhythmia in the fetus: diagnosis, treatment and prognosis. AB - Real-time directed M-mode echocardiography permits analysis of atrial and ventricular mechanical systole and allows inference of the type of arrhythmia present. Accurate diagnosis in cases of fetal tachyarrhythmia is of vital importance when therapy is considered, and in planning further management and delivery of an affected infant. Fetal tachyarrhythmia may be life-threatening especially when fetal hydrops is present and aggressive therapy is mandatory in these cases with digoxin being the drug of choice. In our series the incidence (8.3%) of congenital heart disease was as expected, but the incidence (54%) of atrial flutter was surprisingly high. The prognosis was dependent on the presence or absence of fetal hydrops and was not influenced by the type of arrhythmia or gestational age. PMID- 3505413 TI - Application of intracellular ATP determination in lymphocytes for HLA-typing. AB - The amount of adenosine triphosphate (ATP) in human lymphocytes was determined using a technique based on light emission from a bioluminescent reaction with luciferin-luciferase. The amount of ATP changed when cells were incubated in the presence of specific HLA antisera and complement. For determination of intracellular ATP a modified method was applied, which was based on reduction of extracellular ATP by the addition of ATPase. The results of titration of an anti human lymphocyte serum using the bioluminescence assay were in agreement with the results of fluorescence vitality staining. Bioluminescent HLA-determination in 57 cell samples each tested with 5 different antisera also gave good agreement (95.8%) with the conventional method. From these experimental data the calculated ATP content per lymphocyte was 0.135 +/- 0.058 pg ATP. PMID- 3505415 TI - Fourth International Symposium on Bioluminescence and Chemiluminescence. Freiburg, 8-10 September 1986. Abstracts. PMID- 3505414 TI - A rapid enhanced chemiluminescent immunoassay for allergen-specific IgE antibodies. AB - An enhanced chemiluminescent immunoassay is described for the measurement of allergen-specific IgE antibodies. The assay is demonstrated for pollen from four grass species. A comparison was made between results obtained by this method and those obtained by the radioallergosorbent (RAST) procedure; a high degree of correlation (r = 0.95) was found for D. glomerata specific IgE. The assay is rapid and can be carried out in under 1 hour. The advantages of the luminescent assay as compared with the RAST procedure are discussed. PMID- 3505417 TI - The empirical jurisprudence of the United States Supreme Court. PMID- 3505416 TI - Consciousness: the most critical moral (constitutional) standard for human personhood. PMID- 3505418 TI - Medical ethics and personal doctors: conflicts between what we teach and what we want. PMID- 3505419 TI - [Follow-up critical evaluation of mechanical and biological heart valve prostheses]. PMID- 3505420 TI - [Current clinico-epidemiological aspects of tuberculosis]. PMID- 3505421 TI - [Reduced or lost work capacity in chronic pneumopathies. Medicolegal evaluation trends in relation to the effects of the Law 222 of 6-12-1984]. PMID- 3505423 TI - The relative effectiveness of chewing sticks and toothbrush on plaque removal. PMID- 3505422 TI - [The allergic component in the etiopathogenesis of asthmatic syndrome: evaluation performed in relation to clinical data, familial aspects and environmental factors]. PMID- 3505424 TI - [Preliminary bacteriologic study of chewing sticks used in Senegal]. PMID- 3505425 TI - A one-stage technique for the repair of large defects of the lips. PMID- 3505426 TI - Giant cell fibroma in Nigerians: a review of 13 cases. PMID- 3505427 TI - Tooth attrition among rural Nigerians. PMID- 3505428 TI - The effects of crown margin location on the aesthetics and periodontal status of fluorosed teeth treated with jacket crowns. PMID- 3505429 TI - The effects of tooth related factors on masticatory function. PMID- 3505430 TI - Goltz-Gorlin syndrome--report of a case. PMID- 3505431 TI - [The effect of 10% SnF2 on acute thermal hypersensitivity following pulp capping procedures]. PMID- 3505432 TI - [The importance of bone scanning in the clinical evaluation of ameloblastoma]. PMID- 3505433 TI - [A study of the characteristics of the micro-electrode which is prepared to measure corrosion potentials of prosthesis and restoration alloys]. PMID- 3505434 TI - [A follow-up study of 149 cases in the surgical treatment of mandibular and maxillary cysts]. PMID- 3505435 TI - [A histopathological investigation of the effects of hypercupremy on bone healing]. PMID- 3505436 TI - [Evaluation of the effectiveness of Listerine as an anti-plaque agent]. PMID- 3505438 TI - [An investigation of candidal glossitis]. PMID- 3505437 TI - [Soft tissue profile changes in Class II, 1 treatment with and without extractions]. PMID- 3505439 TI - [Heat transfer effect of various denture bases]. PMID- 3505440 TI - [The prevalence of Candida isolated from the throat cultures of patients between 5 and 15 years old during the last two years]. PMID- 3505441 TI - [The new Cerestore system (shrink-free) crowns]. PMID- 3505442 TI - [Comparison of sutures and butyl-2-cyanoacrylates on the healing of mucosal incisional wounds]. PMID- 3505443 TI - [Histopathologic evaluation of the reattachment following flap operations]. PMID- 3505444 TI - [Corynebacterium incidence in the throat cultures of 5-15 year olds]. PMID- 3505445 TI - [Dentinal dysplasia (report of a case)]. PMID- 3505446 TI - [Eosinophilic granuloma (report of a case)]. PMID- 3505447 TI - [Hereditary enamel dysplasia]. PMID- 3505448 TI - [Sialodochoplasty of Wharton's duct (case report)]. PMID- 3505449 TI - [Mandibular fibrosarcoma]. PMID- 3505450 TI - [Prosthetic treatment of hidrotic ectodermal dysplasia (a case report)]. PMID- 3505451 TI - [Problems of bacterial resistance to antibiotics]. PMID- 3505452 TI - [Laboratory procedures in the selection of chemotherapeutics]. PMID- 3505453 TI - [Histopathologic evaluation of the healing of full thickness laterally sliding flaps]. PMID- 3505454 TI - [The effects of naproxen and vitamin C on experimental gingivitis]. PMID- 3505455 TI - [Evaluation of human cement tissue in health and periodontal disease by means of polarizing microscopy]. PMID- 3505456 TI - [The skeletal and dental changes and lower incisor anchorage control in Angle Class II. Anomalies treated with Edgewise technique, including tooth extraction both in upper and lower jaws]. PMID- 3505457 TI - [Potentiometric determination of active fluoride in toothpaste]. PMID- 3505458 TI - [The pocket depth measurements and clinical crown height of teeth which had flap operations with and without osseous recontouring in a five-year period]. PMID- 3505459 TI - [Laminate veneer restorations]. PMID- 3505460 TI - A multi-disciplinary approach to the treatment of craniomandibular disorders. PMID- 3505461 TI - Sexual dimorphism in mastication and speech? Or do men and women eat and talk differently? PMID- 3505462 TI - Bacteriocinogenicity of oral Bacteroides species. PMID- 3505463 TI - Tight junctions in an undifferentiated carcinoma originating in the parotid gland: a study with freeze-fracture. PMID- 3505464 TI - A longitudinal study of clinical crowns on deciduous anterior teeth. PMID- 3505465 TI - Estimation on residual stress in porcelain/alloy system by thermal shock test. PMID- 3505466 TI - Sliding wear of various composite resins and bovine enamel. PMID- 3505467 TI - Element solubility from dental implants. PMID- 3505468 TI - Mercury content in tissues of rats given diet containing dental amalgam powder. PMID- 3505469 TI - A calorimetric study on the interaction of photoinitiators with phospholipid liposomes as a model for biological membranes. PMID- 3505470 TI - pH determinations on the surface of luting cements. II. Effects of test conditions. PMID- 3505471 TI - pH determinations on the surface of luting cements. III. pH change and setting reaction of zinc phosphate cements. PMID- 3505472 TI - Microleakage of composite resin restorations with dentin margins. PMID- 3505473 TI - Composite restorative resins. Part 1. Setting characteristics of UV and visible light-activated composite resins. PMID- 3505474 TI - Composite restorative resins. Part 2. Physical and mechanical properties of UV and visible light-activated composite resins. PMID- 3505475 TI - In vitro corrosion of dental amalgams and their phases in 0.9% NaCl solution. PMID- 3505476 TI - [Analysis of indicators of efficacy of prevention of hospital infections]. PMID- 3505477 TI - [Burn injuries and immunologic reactivity--function and regulatory mechanisms of activities of NK cells]. PMID- 3505478 TI - [The emotionally immature personality and possibilities of adaptation to the military environment]. PMID- 3505479 TI - [Use of peroperative pyeloscopy in the prevention of false recurrent kidney calculi]. PMID- 3505480 TI - [Early diagnosis of drug-induced coma]. PMID- 3505481 TI - [Experimental and clinical study of submandibular salivary gland secretion in the evaluation of peripheral paralysis of the facial nerve]. PMID- 3505482 TI - [The importance of spontaneous compensation of post-traumatic fluid loss from the circulation in relation to resistance to further injury]. PMID- 3505483 TI - [Diagnosis of occlusion of the main branch of the left coronary artery]. PMID- 3505484 TI - [Stabilization of the resected tooth root with a transdental 2-piece metal ceramic implant of our own construction]. PMID- 3505485 TI - [Diagnosis and prognosis of unstable angina pectoris]. PMID- 3505486 TI - [The effect of estramustine phosphate on carcinoma cell proliferation depends on the estrogen receptor status in the cytosol]. PMID- 3505488 TI - [The most frequent psychopathologic manifestations in recruits-- problems in diagnosis and evaluation of suitability for military service]. PMID- 3505487 TI - [Neuronitis vestibularis--analysis of clinical material, differential diagnosis]. PMID- 3505489 TI - Prevalence and significance of prescription medication usage among gerodontic patients. PMID- 3505491 TI - Demographic trends of aging--application to gerodontology. PMID- 3505490 TI - Comparison of two routines for long-term oral hygiene treatment with chlorhexidine gel in geriatric patients. PMID- 3505492 TI - Dementia: its diagnosis and medical management. PMID- 3505493 TI - Caring for the Alzheimer's patient. PMID- 3505494 TI - The coordination of dentists and physicians in managing adverse oral effects of drug therapy--report of a case. PMID- 3505495 TI - The occurrence of retained roots in association with oral health among the adult population of Finland. PMID- 3505496 TI - The efficacy of mucin-containing artificial saliva in alleviating symptoms of xerostomia. PMID- 3505497 TI - Aortic regurgitation in Tetralogy of Fallot. PMID- 3505498 TI - Coronary artery disease in the young. PMID- 3505499 TI - Normal coronary arteries in myocardial infarction, typical and atypical angina. PMID- 3505500 TI - A study of right ventricular infarction. PMID- 3505501 TI - Evaluation of noninvasive tests for identifying patients with pre-excitation syndrome with short refractory period of the accessory pathway. PMID- 3505502 TI - Role of 2-D echocardiography in atrial tumors. A PGI experience. PMID- 3505503 TI - Risk factors of myocardial infarction in Indian women. PMID- 3505504 TI - Closed versus open approach to mitral stenosis: an objective analysis. PMID- 3505505 TI - Asplenia polysplenia syndrome--a study of 28 cases. PMID- 3505506 TI - Primary pulmonary hypertension in India (autopsy study of 26 cases). PMID- 3505507 TI - Hemangioendothelioma following chronic granulocytic leukemia--a case report. PMID- 3505508 TI - Non-Hodgkin's lymphomas in children, clinical histological and treatment analysis. PMID- 3505509 TI - Papillary adenofibroma of the cervix. An unusual tumour of the cervix. PMID- 3505510 TI - Limitations of grading of adenocarcinoma on colorectal biopsies. PMID- 3505511 TI - CA 125 as a marker in epithelial ovarian cancer: Alone and in comparison with CEA. PMID- 3505513 TI - Serum pseudocholinesterase activity & protein bound fucose level in oral malignancy. PMID- 3505512 TI - Chronic esophagitis in a population (Kashmir) with high prevalence of esophageal carcinoma. PMID- 3505514 TI - "Hypernephroma--a review of 70 cases". PMID- 3505515 TI - Patterns of psychological disturbance among leukemia patients and their relatives. PMID- 3505516 TI - Imagining and remembering. PMID- 3505517 TI - How does psychiatric drug therapy work? PMID- 3505518 TI - Brainstem auditory evoked responses in hospitalized unmedicated schizophrenic patients. PMID- 3505519 TI - Lithium and carbamazepine therapy in a patient with manic depressive illness: clinical effects, interactions and side effects. PMID- 3505520 TI - The changing profile of the Israeli psychiatrist. PMID- 3505521 TI - Comparison of FEV1 and FEF25-75 with respiratory resistance within--and across- subjects: are these comparisons mutually exclusive? PMID- 3505522 TI - Evaluation of a sustained-release theophylline product in children with asthma. AB - The purpose of this study was to determine the dose requirements and dose interval of a sustained-release theophylline sprinkle preparation (Somophyllin 12) necessary to maintain therapeutic serum theophylline concentrations in children with asthma. Eighteen patients aged 3-7 years (subgroup 1) and 21 patients aged 8-12 years (subgroup 2), who had been on continuous theophylline therapy with Somophyllin-12, completed the study. Prior to entry into the study, each patient's dosage of Somophyllin-12 was titrated to achieve predose and peak (4-hour postdose) theophylline levels in the therapeutic range (8-20 mg/L). The patients subsequently had predose and peak serum theophylline levels determined at baseline (week 0) and at weeks 2 and 4 of the study. The majority of children maintained theophylline levels in the therapeutic range throughout the 4-week trial, and t-tests showed no significant change from baseline in mean values of peak, trough, or peak-trough theophylline differences in either patient subgroup at weeks 2 and 4. Nevertheless, some individual patients had considerable variation from baseline in peak and trough theophylline levels at follow-up visits. Dosage requirements standardized for weight were significantly higher in patients in subgroup 1 than in subgroup 2 (21.3 +/- 4.5 mg/kg per day versus 17.5 +/- 4.7 mg/kg per day; p less than 0.05). The majority of the patients required 12-hourly administration of Somophyllin-12, but seven of 39 patients required 8 hour dosing.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3505523 TI - Total respiratory resistance and spirometric measures: within-subject comparisons. PMID- 3505524 TI - Allergic predisposition among infants with bronchiolitis. AB - Allergic predisposition among infants with bronchiolitis was examined. The number of infants with serum IgE exceeding mean +1 SD was 31/70 (44.3%). The rate of positive radioallergosorbent test (RAST) scores of 1 or more to mites, egg white, or milk was 31/71 (43.7%) and that of scores over 2 was 11/71 (15.5%). Eosinophils and/or mast cells were found in their nasal smears on several occasions. These results indicated that allergic predisposition may be observed among infants with bronchiolitis. PMID- 3505525 TI - Bronchial hyperresponsiveness in children with atopic and nonatopic asthma. AB - We have studied the bronchial hyperresponsiveness of children with atopic and nonatopic asthma by methacholine inhalation challenge, using a new device, the "Astograph." Three parameters, initial respiratory resistance (Rrs cont), bronchial sensitivity (Dmin), and bronchial reactivity (St), were studied. The Rrs cont values of atopic asthma were higher than those of the disease controls (p less than 0.05), while there was no difference between nonatopic asthma and disease controls. The Dmin values of atopic and nonatopic asthma were lower than those of disease controls (p less than 0.001; p less than 0.01). The St values of atopic and nonatopic asthma were higher than those of disease controls (p less than 0.001; p less than 0.01). There was no difference of Rrs cont and Dmin between the children with atopic and nonatopic asthma. However, St of the children with nonatopic asthma was remarkably higher than that of the children with atopic asthma (p less than 0.001). These data suggested that there was a remarkable difference of bronchial response to methacholine between the children with atopic asthma and those with nonatopic asthma. PMID- 3505527 TI - Preoccupational asthma. PMID- 3505526 TI - Effects of different dosages of the calcium antagonist verapamil in exercise- and methacholine-induced bronchospasm in children with chronic asthma. AB - The protective effect of 5 mg/2 ml and 10 mg/4 ml of the calcium antagonist verapamil on methacholine challenge and exercise were evaluated in two groups of asthmatic children. Saline solution was used as placebo. No significant differences were seen in baseline pulmonary function in and within groups. There was a minimal but significant bronchodilation 30 minutes after inhalation of verapamil 5 mg/2 ml. The drug did not reduce methacholine sensitivity at any dosage. After exercise, verapamil 5 mg/2 ml showed a significant change in the maximum percentage drop in forced expiratory volume in 1 second (FEV1) compared with placebo. This was not the case for the group treated with a double dosage. At this time, there is no evidence for a major role of verapamil in the treatment of childhood asthma. PMID- 3505528 TI - Development and evaluation of an adult asthma self-management program: Wheezers Anonymous. AB - The efficacy of an adult asthma self-management program, Wheezers Anonymous (WA), was tested utilizing 79 adult asthmatic patients. Subjects were randomly assigned to a treatment or waiting-list control group. Baseline data gathered included measures of symptom severity, health-care utilization, knowledge of asthma, attitudes about asthma, and self-efficacy. All subjects completed the same measures 1, 2, and 3 months following the WA intervention. Knowledge about asthma increased in the treatment group relative to the waiting-list controls; the number of attacks decreased in the treatment group only, thus demonstrating the efficacy of the WA program. PMID- 3505529 TI - Total and specific IgE responses in the acute and recovery phases of respiratory infections in children. AB - Total IgE and specific IgE antibodies to common allergens were determined by the enzyme-linked immunosorbent assay in children with Mycoplasma pneumoniae or respiratory syncytial virus (RSV) infections. The decrease of total IgE from the acute to convalescent phase was observed in 105 of 134 (78.4%) children with M. pneumoniae infection and in 40 of 49 (81.6%) of those with RSV infection. Similarly, many patients showed a decrease of the responses of specific IgE in the convalescent phase of the infections. The results indicated that these infections might alter the production of total IgE and IgE specific to common allergens unrelated to the infectious agents. PMID- 3505530 TI - Airway effects of monosodium glutamate in subjects with chronic stable asthma. AB - We studied the effect of oral monosodium glutamate (MSG) on airways function in 12 subjects with a history of chronic stable asthma in a double-blind, randomized, crossover protocol. Subjects ingested either 25 mg/kg of MSG or sodium chloride (equimolar to MSG) following a 6-hour fast. Spirometry [forced expiratory volume in 1 second (FEV1) and forced vital capacity] was performed before administration of the test substances and for a minimum of 4 hours thereafter. At no time during the observation period was the mean change in FEV1 more negative following MGS than following placebo. MSG is unlikely to be a contributing factor in bouts of bronchospasm in subjects with asthma, and routine avoidance of MSG by individuals with asthma need not be advised. PMID- 3505531 TI - Saliva and serum theophylline concentration in management of asthma in children on sustained-release therapy. AB - Relationships between theophylline concentrations in saliva and serum and lung functions were investigated in 27 asthmatic children receiving a sustained release theophylline. Improvements in lung functions were related to increasing theophylline concentrations. The concentration required to maintain normal lung functions was 10 micrograms/ml in serum and 7 micrograms/ml in saliva. Theophylline concentrations in serum and saliva statistically correlated (r = 0.949). The mean serum - saliva ratio was 1.45 +/- 0.02, with a 13.7% intersubject and a 14.9% intrasubject variation. Predicted serum concentrations were +/- 2 micrograms/ml of measured concentrations in 92 samples (92%). From the results, theophylline concentrations in saliva may be useful in predicting serum values. PMID- 3505532 TI - Immediate effect of verapamil on pulmonary functions in bronchial asthma. AB - This article describes the immediate effect of verapamil, a calcium antagonist, on pulmonary functions in bronchial asthma. The effect of oral administration of 80 mg of verapamil or placebo was studied in a randomized double-blind manner in 30 extrinsic asthmatic subjects. No significant bronchodilator effect was observed with verapamil administration. There were no significant changes in heart rate and blood pressure after verapamil. PMID- 3505533 TI - Kunjal: a nonspecific protective factor in management of bronchial asthma. AB - Seven asthmatic patients having nocturnal symptoms performed a yogic maneuver called Kunjal. Definite improvement was noticed subjectively and objectively in six patients during the week Kunjal was performed, and improvement in symptoms persisted into the third week in five patients. PMID- 3505535 TI - Serum IgE levels in adults with asthma. AB - Serum total immunoglobulin E (IgE) was measured in 88 normal adults and 100 adults with asthma using Phadebas IgE PRIST kits. The geometric mean IgE in our normal subjects was found to be higher than that reported by some investigators but was similar to or lower than that reported by others without showing any geographic pattern. It increased progressively from 92 kU/L in normal controls through 205 kU/L in cases of asthma with low atopic scores to 464 kU/L in asthma cases with high atopic scores. There was wide variation in IgE levels among individuals, making it difficult to use it to classify any subject into one of these groups. However, as a group, female asthmatics had lower mean IgE levels (182 kU/L) than did men (577 kU/L), and a higher proportion of them had low atopic scores (60% of the women versus 47% of the men). This suggests that probably more women had intrinsic asthma, while extrinsic asthma was more common among men in the population studied. PMID- 3505534 TI - Improving compliance for asthmatic patients visiting the emergency department using a health belief model intervention. AB - The sample included 74 asthmatic patients presenting to an emergency department with an acute asthmatic attack. The purposes of the study were: to assess demographic and situational variables associated with compliance, and to test the impact of a Health Belief Model (HBM) intervention to increase compliance. Compliance was operationalized as making and/or keeping a follow-up referral appointment for the patient's asthmatic condition. Demographic and situational variables associated with compliance included age, sex, marital status, previous treatment experience, seriousness of the asthmatic condition, and need for child care. Most important, the HBM intervention was very effective in increasing compliance in both making and keeping a follow-up referral appointment. PMID- 3505536 TI - Differing bioavailability of salbutamol metered-dose inhalers. AB - The bronchodilator efficacy of two brands of salbutamol (USAN albuterol) metered dose inhalers (MDIs) was compared in a double-blind protocol involving 31 asthmatics. Specific airways conductance (SGaw) measured by body plethysmography was used as an indicator of airway caliber. The results show that chemically equivalent salbutamol MDIs can differ significantly in therapeutic efficacy. PMID- 3505537 TI - Specific immunological therapy with the sulfite chemicals. AB - Provocative oral tests with 1000 mg of the sulfite chemicals produced allergic reactions in 10% of the patients tested. Parenteral therapy with an Allpyral extract of the sulfite chemicals was instituted. After 3 months' therapy three patients were challenged with 1000 mg of the sulfite chemicals and modified attacks of asthma were produced. After 6 months' therapy the same three patients failed to react. Therefore, I rechecked all patients after 6 or more months of therapy. Thirty-five patients were retested; 29 failed to react and six reacted with allergic symptoms. The 29 patients no longer reacted to foods treated with the sulfite chemicals. PMID- 3505538 TI - The mystique of age. PMID- 3505539 TI - Age, rage, and the fear of AIDS. AB - In this paper, the author has presented an in-depth case report of the ongoing analysis of an aging male homosexual, who entered analysis in his late fifties because of his fear of AIDS. This initial spur to his motivation to achieve characterological change was joined subsequently by two other factors. These were the "last chance" syndrome described by Pearl King (1980) and the wish to achieve a richer life than that of his father. As a result of these forces acting in confluence in his life, the patient was able to move from a lower to a higher level of object relatedness. The relationship between the intense narcissistic traumata suffered by male homosexuals on growing older, in terms of their no longer being found desirable in the world of bars and bathhouses, and their accessibility to psychotherapeutic and psychoanalytic treatment is described and discussed. PMID- 3505540 TI - Love, lust, and money: values in old age. PMID- 3505541 TI - Inhibited sexual excitement in the aging male. PMID- 3505543 TI - [A study on the standard and evaluation of facial photographs in children]. PMID- 3505542 TI - [Experimental studies on heterotransplantation of human squamous cell carcinoma in nude mice and sensitivity test for anticancer agents]. PMID- 3505544 TI - [Physiologic characteristics of mechanoreceptive units innervating the gingiva, lip and mental skin in the cat]. PMID- 3505545 TI - [Distribution of trigeminospinal neurons--a retrograde HRP study in the Macaque monkey and the cat]. PMID- 3505546 TI - [Studies on stimulatory modulating action of prostaglandins on catecholamine secretion in adrenal chromaffin cells]. PMID- 3505547 TI - [Studies on gingivitis in puberty--relationship between salivary sex hormones and gingival conditions or subgingival plaque]. PMID- 3505548 TI - [Effect of halothane anesthesia on rat liver microsomal cytochrome P-450 enzyme system]. PMID- 3505549 TI - [Influences of nasopharyngeal obstruction on dentofacial growth and respiratory mode in the monkey]. PMID- 3505550 TI - [Clinical application of the pulsating jet type irrigator with a device of heating function for periodontal treatment (Pocket Irrigator).I. The clinical and microbiological effects on the irrigation on periodontal patients]. PMID- 3505551 TI - [Evaluation of reproducibility of standardized dental radiographs]. PMID- 3505552 TI - [Case report of the paramolar tubercle in the molar region]. PMID- 3505553 TI - [The cineradiographical study of positional changes of the tongue and the hyoid bone following mandibular osteotomy in skeletal 3 patients]. PMID- 3505554 TI - [Studies on calculus-like deposits on dentures]. PMID- 3505555 TI - [Long-term observation of pulpectomy and pulpotomy treated by undergraduate students]. PMID- 3505556 TI - [Prevalence of periodontal disease in junior high schoolchildren in Hiroshima region. Part I. Findings of first examination]. PMID- 3505557 TI - [Prevalence of periodontal disease in junior high schoolchildren in hiroshima region. Part II. Finding of second examination]. PMID- 3505558 TI - [Prevalence of periodontal disease in junior high schoolchildren in Hiroshima region. Part III. Findings of third examination]. PMID- 3505559 TI - [Tongue movements in experimental palatal plate wearers (natural dentate subjects)]. PMID- 3505560 TI - [Physical properties of poryethersulfone resin]. PMID- 3505561 TI - [Comparison of orthodontic treatment cases and surgical-orthopedic treatment cases for skeletal mandibular protrusion]. PMID- 3505562 TI - [Findings on several examinations of orthodontic patients with dual bite revealed after active treatment]. PMID- 3505563 TI - [A case of cleidocranial dysostosis with a large number of impacted supernumerary teeth]. PMID- 3505564 TI - [Adherence of Fusobacterium nucleatum to human cells]. PMID- 3505565 TI - [Straight arch wire technique]. PMID- 3505566 TI - [Parallel pathways of the trigeminothalamic tract]. PMID- 3505567 TI - [Studies on the adherence of oral Streptococci on solid surface]. PMID- 3505568 TI - Ascending and descending internuclear connections in the trigeminal sensory nuclear complex. PMID- 3505569 TI - [Application of copolymers of crystalline monomers having urethane linkages and hydroxypropyl dimethacrylate to thermosetting resin for crown and bridge]. PMID- 3505570 TI - [Biomechanical basis of tooth movement]. PMID- 3505572 TI - [Prevalence of temporomandibular dysfunction with anterior crossbite malocclusion in 6-10-year-old Japanese children]. PMID- 3505571 TI - Scanning electron microscopic study of vascular changes of periodontal ligaments following experimental tooth movement in rats. PMID- 3505573 TI - [The normal standards of quadrilateral analysis in Japanese adults]. PMID- 3505574 TI - [The relationship between the movement of molars and the transmitted mechanism of orthodontic forces in extraoral anchorage (I)]. PMID- 3505575 TI - [Observations on the periodontal tissue changes in undecalcified specimens during molar depression in rats (Part 2)]. PMID- 3505576 TI - [Scanning electron microscopic observations of root resorption in the rat molar following experimental tooth movement]. PMID- 3505577 TI - [Somatomedin-like effect on cultured chondrocytes from rabbit cranio-facial complex by their own conditioned medium]. PMID- 3505578 TI - [Morphological studies of skeletal mandibular prognathism. Morphological differences of dentofacial complex between orthodontic cases and orthognathic surgical cases and a discussion of criterion of orthognathic surgery]. PMID- 3505579 TI - [Studies on 3-dimensional prediction of orthognathic surgery cases. 3-dimensional computer graphic surgery for the skeletal Class III cases]. PMID- 3505580 TI - [Short-term changes of mandibular position following sagittal splitting osteotomy of mandibular prognathism]. PMID- 3505581 TI - [Morphological evaluation on craniofacial dysmorphology of Apert's syndrome and Crouzon disease]. PMID- 3505582 TI - [Effects of therapy using the function regulator (FR III) on cases with reversed occlusion]. PMID- 3505583 TI - [Orthodontic findings in a case of microgenia]. PMID- 3505584 TI - Modelling of alpha-lactalbumin from the known structure of hen egg white lysozyme using molecular dynamics. AB - The prediction of protein conformation by homology is being widely pursued using interactive computer graphics. However, there have been a limited number of energy minimization and/or molecular dynamics studies for such predictions. This paper reports one such study on alpha-lactalbumin, a system that can be tested as the X-ray crystal structure has recently been determined. The differences in structure of the Ca2+ binding loop reported for the holo-protein (Stuart et al., Nature, 324 [1986] 84-87) and that predicted for the apoprotein could be attributed to the presence or absence of the Ca2+ ion. PMID- 3505585 TI - A molecular graphics study on structure-action relationships of calcium antagonistic and agonistic 1,4-dihydropyridines. AB - Based on force field and quantum chemical calculations a hypothesis on the molecular mechanism of Ca channel-modulating 1,4-dihydropyridines (DHPs) has been developed. A careful investigation of the molecular electrostatic fields of the compounds led to the discovery of a unique area of the molecular potentials where Ca agonists and antagonists possess potentials with opposite sign. It is further demonstrated that the molecular potential of a simple receptor site model is reduced by interaction with Ca channel-activating DHPs and on the contrary increased by Ca channel-blocking DHPs. It is concluded that these effects could be the basis for opposite actions of 1,4-dihydropyridine enantiomers at the potential-dependent Ca channels. PMID- 3505586 TI - Strategic approaches to drug design. I. An integrated software framework for molecular modelling. AB - An integrated molecular graphics and computational chemistry framework is described which has been designed primarily to handle small molecules of up to 300 atoms. The system provides a means of integrating software from any source into a single framework. It is split into two functional subsystems. The first subsystem, called COSMIC, runs on low-cost, serial-linked colour graphics terminals and allows the user to prepare and examine structural data and to submit them for extensive computational chemistry. Links also allow access to databases, other modelling systems and user-written modules. Much of the output from COSMIC cannot be examined with low level graphics. A second subsystem, called ASTRAL, has been developed for the high-resolution Evans & Sutherland PS300 colour graphics terminal and is designed to manipulate complex display structures. The COSMIC minimisers, geometry investigators, molecular orbital displays, electrostatic isopotential generators and various interfaces and utilities are described. PMID- 3505587 TI - WIZARD: AI in conformational analysis. AB - A program which utilizes the techniques of Artificial Intelligence and Expert Systems to solve problems in the area of Conformational Analysis is described. The program searches conformational space in a systematic fashion, based on the technique known as heuristic state-space search. The program proceeds by recognizing conformational units, assigning one or more conformational templates to each unit, and joining them to form conformational suggestions. These suggestions are criticized to discover logical inconsistencies, and any resulting stresses are resolved. The resulting conformational suggestions are sometimes accurate enough for immediate use, or may be further refined by a numerical program. The latter combination is shown to be quite efficient compared to purely numerical conformational search techniques. PMID- 3505588 TI - Computer graphic study on models of the molybdenum cofactor of xanthine oxidase. AB - Within the scope of our molecular modeling studies on xanthine oxidase (XOD) inhibition by purine analogs we were interested to build up a three-dimensional model of the molybdenum active site. Spectroscopic data indicated that a Mo (VI)atom which is coordinated to sulfur, oxygen and/or nitrogen is clearly involved in substrate binding. In the present study, those data and X-ray crystallography data were used to reconstruct molybdenum-organic complexes from models proposed in the literature. The computer graphic-assisted modeling and evaluation of the model complexes show that the description of the molybdenum center needs further refinement. PMID- 3505589 TI - The electron microscopy of the People's Republic of China, Part II: Material science. PMID- 3505590 TI - High-resolution electron microscopy and its applications. AB - A review of research on high-resolution electron microscopy (HREM) carried out at the Institute of Physics, the Chinese Academy of Sciences, is presented. Apart from the direct observation of crystal and quasicrystal defects for some alloys, oxides, minerals, etc., and the structure determination for some minute crystals, an approximate image-contrast theory named pseudo-weak-phase object approximation (PWPOA), which shows the image contrast change with crystal thickness, is described. Within the framework of PWPOA, the image contrast of lithium ions in the crystal of R-Li2Ti3O7 has been observed. The usefulness of diffraction analysis techniques such as the direct method and Patterson method in HREM is discussed. Image deconvolution and resolution enhancement for weak-phase objects by use of the direct method are illustrated. In addition, preliminary results of image restoration for thick crystals are given. PMID- 3505592 TI - Computer software for specimen orientation adjustment using double-tilt or rotation holders. AB - Computer software for specimen orientation adjustment relative to the incident electron beam has been developed. The difficulties encountered when tilting severely strained, highly beam-sensitive, or small-grain-size specimens with known structures using either a double-tilt or a rotation holder in transmission electron microscopy (TEM) can be minimized. Combined with computer programs for obtaining the reduced bases from diffraction patterns, the software is also useful for unknown crystals. The algorithm is introduced and examples are given. PMID- 3505591 TI - Structural studies of lanthanide phthalocyanines by high-resolution electron microscopy. AB - Epitaxial films of lanthanide phthalocyanines (LnPc2H, Ln = Nd, Tb, Er, Tm, Yb, or Lu) formed on a KCl or NaCl crystal have been studied by means of high resolution electron microscopy. These complexes are isomorphous and have both tetragonal and base-centered orthorhombic structures. Though radiation damage makes it difficult to study these beam-sensitive materials by electron microscopy, the behaviors of thin film growth and details of structural defects can still be identified at the molecular level. PMID- 3505593 TI - Application of convergent beam electron diffraction in the structural study of high-temperature superconducting oxides. AB - Convergent beam electron diffraction (CBED) is a powerful technique for symmetry study of crystal. It has widespread application in physics and material sciences, as demonstrated in a recent superconducting oxide study. Using this technique, we have studied Ba-La-Cu-O superconductors with a transition temperature of about 40 degrees K and Ba-Y-Cu-O superconductors with a critical temperature (Tc) of about 90 degrees K. We have found that in Ba-La-Cu-O superconductors the superconducting phase La2-xBaxCuO4-y has a distorted K2NiF4-type structure and the space group Fmmm. The two other phases in Ba-La-Cu-O superconductors have also been studied. In our Ba-Y-Cu-O superconductors, the Ba2YCu3O7-x compound, which is responsible for 90 degrees K superconductivity, has two different space groups: An orthorhombic space group Pmmm and a tetragonal space group P4mm or P4/mmm. PMID- 3505594 TI - Quasicrystals and noncrystallographic symmetry. AB - New findings on quasicrystals with icosahedral, octagonal, decagonal, and dodecagonal symmetries obtained recently in the Beijing Laboratory of Electron Microscopy, Chinese Academy of Sciences, are presented. Special emphasis is put on the relation between quasicrystalline and crystalline structures. The important role played by electron diffraction and high-resolution electron microscopy in revealing these quasiperiodic structures is pointed out. PMID- 3505595 TI - High-resolution electron microscopy and domain structures of pentagonal Frank Kasper phases. AB - The Laboratory of Atomic Imaging of Solids is dedicated to the direct imaging of materials in various fields of solid-state sciences at the atomic or molecular level. The main programs of this laboratory are briefly described, including quasicrystals, new phases and microdomains in Frank-Kasper phases, suboxides of metals, catalysts, minerals found in China, and molecular structure of organic substances. A recent systematic investigation of domain structures consisting of juxtaposed icosahedral columns is also presented. PMID- 3505596 TI - Electron diffraction identification of structure types of martensite in Cu-Zn-Al alloys. AB - Electron diffraction technique for identifying structure types of martensite in beta-Hume-Rothery alloys is described. It includes determination of the stacking sequence of the martensite of the basal planes, differentiation of the long-range ordering in martensite inherited from its parent phase (A2 type disordered; B2 type ordered; and D03, or Heusler, type ordered), and distinguishing between normal-type and modified-type martensite. In addition to the 18R1-type martensite, 12R, 6R, and 2H martensites were found in quenched Cu-Zn-Al alloys using this technique. PMID- 3505598 TI - Microdiffraction and analysis. AB - The intensity distribution in the microdiffraction pattern depends strongly on the coherence of the illuminated source. The coherence width at the specimen level is considered as a parameter to check the coherence of an electron microscope. Two application examples are illustrated. A small interphase precipitate of MgNi2 in an Ni superalloy has been identified by a combination of microdiffraction and energy dispersive spectrum (EDS) techniques, though it can not be found by conventional transmission electron microscopy (TEM) and selected area diffraction (SAD). By means of microdiffraction as well as high-resolution electron microscopy (HREM) imaging a defect structure has been determined. Such a defect makes the lattice extinction spots appear with various intensities in the selected area diffraction and microdiffraction patterns. PMID- 3505597 TI - Some nanostructural features in ceramics. AB - Nanostructural features in some ceramics have been discussed and reviewed. Based on our research results and recent published investigations, many topics, such as grain, grain boundary, interface film, grain boundary engineering, microcrack, microdomain, nanodomain, domain boundary, and phase transformation, etc., have been dealt with; and many materials, such as Si3N4, beta''-Al2O3, MgO, SiC, (Hg, Cd) Te, BNN, ZrO2, PLZT, CdSe, Ca10(PO4)6, (OH)2, etc., have been involved. The results are important to understand the relation between the structure and property of materials and to improve the materials' technology. PMID- 3505599 TI - Cross-sectional transmission electron microscopy of silicon LSI circuits and Josephson junction devices. AB - Cross-sectional transmission electron microscopy (XTEM) has been used to diagnose silicon LSI circuits and Josephson junction devices. For LSI circuits, some typical failure problems have been presented. For Nb-Si-Nb Josephson junction, microholes in the thin silicon layer have observed, and they are responsible for the short circuiting of these devices. PMID- 3505600 TI - Standardless EDS analysis of bulk and thin specimens. AB - A direct relationship between the x-ray intensity ratio and the concentration ratio for bulk and thin specimens has been established by use of a revised full diffusion model of electron scattering. The suitable ionization cross section, the most important parameter influencing the accuracy of the calculated Cliff Lorimer factors, has been found after comparing the experimental intensity ratio I(L)/I(K) of eight elements (from Ge to Sn) and I(M)/I(L) of six elements (from Sm to Bi) with the calculated values. The quantitative standardless EDS analysis of bulk samples obtained by this direct method is more satisfactory than the commercial indirect method which gives the composition through ZAF correction after calculating the intensity factors of pure elements. The quantitative standardless analysis of thin samples has been improved by the suitable cross section significantly. This method has been applied to the analysis of film on substrate either without any common element or with one common element (P-Si glass film on Si). It has also been used to calculate the intensity factors of pure bulk samples and the backscattering correction factor in Auger electron spectroscopy. PMID- 3505601 TI - Theoretical research on electron optics. AB - This paper summarizes theoretical research on electron optics in the field of electron microscopy that has been carried out by the author and his colleagues over a long period of time. The main topics to be discussed include the rotationally symmetrical imaging system and its aberrations; the method of matrix algebraic calculation and its applications to electron optics; new developments in scanning electron beam systems, i.e., the combined electromagnetic focusing deflection system with superimposed fields; the electromagnetic multipole system and its aberrations; the ion optical system with a curvilinear axis and its aberrations; and the phase retrieval in Fourier electron microscopy. This review may help to promote a better understanding of the present state of, and trends in, Chinese electron optics research. PMID- 3505602 TI - California case file on cerebral palsy and mental retardation. PMID- 3505603 TI - The effect of chorioamnionitis on perinatal outcome in preterm gestation. AB - Six hundred ninety-eight patients with premature rupture of the membranes between 26 and 34 weeks were managed expectantly without the use of tocolytics or corticosteroids. Of these, 92 (13 per cent) developed chorioamnionitis. Although latency period (defined as the time from rupture of the membranes to the onset of labor) had no correlation with the incidence of chorioamnionitis, the mean latency period was significantly shorter for those gestations complicated by infection. The risk of chorioamnionitis was found to be inversely related to gestational age. The length of labor, once chorioamnionitis was diagnosed, had no correlation with neonatal outcome, but the development of chorioamnionitis led to a statistically significant increase in neonatal mortality, infection rate, incidence of respiratory distress syndrome (RDS), intraventricular hemorrhage (IVH), and five-minute Apgar score less than 7. Maternal endometritis and other complications of infection were increased in the presence of chorioamnionitis, especially in patients delivered by Cesarean section. Useful predictors of early chorioamnionitis were maternal leukocytosis, fetal tachycardia, and elevated maternal C-reactive protein titers. PMID- 3505604 TI - Intrapartum suctioning of meconium: comparative efficacy of bulb syringe and De Lee catheter. AB - Intrapartum suctioning of the newborn's pharynx with a De Lee catheter (DL) has reduced the incidence of meconium aspiration syndrome (MAS) in neonates born with meconium staining of the amniotic fluid. However, the bulb syringe (BLB) is used more often for this purpose because of greater technical convenience. In a prospective study, 60 offspring of such deliveries received intrapartum pharyngeal suctioning either by BLB (29 cases) or by DL (31 cases), according to random selection. The presence and amount of meconium in the trachea, incidence and severity of MAS, and mortality from the disease were similar between the two groups. This study suggests that the BLB is as effective as the DL for intrapartum removal of nasopharyngeal meconium in deliveries with meconium staining of the amniotic fluid. Since the BLB is easier to use, less expensive and probably safer, our results suggest that it may be the preferable method. PMID- 3505605 TI - Term human fetal umbilical vein oxygen content, placental weight, and maternal blood pressure. AB - The relationship of umbilical venous oxygen content to placental weight and mean maternal arterial blood pressure was investigated in 38 normal nonlaboring subjects undergoing elective cesarean section at 38.4 +/- 0.2 weeks (mean +/- SEM). In 14 subjects breathing room air, umbilical vein oxygen content was found to be a function of the lowest mean maternal arterial blood pressure (r = 0.48, P = 0.04), but not to placental weight. In 24 subjects breathing supplemental oxygen, umbilical vein oxygen content was not related to placental weight or lowest mean maternal arterial blood pressure. Fetuses attached to placentas less than 396 g had a higher hemoglobin concentration than fetuses attached to placentas greater than 396 g. This suggests the possibility of chronic in utero hypoxemia in human fetuses attached to small placentas. PMID- 3505606 TI - The effect of body position on the respiratory rate of infants with tachypnea. AB - In neonatal disease states where lung compliance is reduced (e.g., inadequate resorption of fetal lung fluid or, surfactant deficiency) an infant's normally low functional residual capacity (FRC) decreases even further. Tachypnea is an efficient compensatory maneuver for the newborn. We evaluated the effect of different bed and body positions on the increased respiratory rate observed in infants with transient tachypnea of the newborn (TTN), infant respiratory distress syndrome (RDS), and bronchopulmonary dysplasia (BPD). Seventeen infants were studied (TTN, n = 6; RDS, n = 6; BPD, n = 5) in four different positions: supine flat, supine elevated, prone flat, and prone elevated. Respiratory rate and heart rate were evaluated in each position. Analysis of variance for the three patient groups showed a lower respiratory rate when the bed was elevated 20 30 degrees compared to flat (P = 0.0001), in the prone posture compared to supine (P = 0.031), and no significant difference in heart rate. The lowest mean respiratory rate occurred when patients were in the prone elevated position. The significant improvement in tachypnea seen in the prone and elevated positions was likely related to improved FRC resulting from reduced cephalad stress on the diaphragm from the abdomen. Positioning neonatal patients with respiratory insufficiency was a simple and safe therapeutic maneuver with prompt and demonstrable benefit. PMID- 3505607 TI - Polemics in perinatology: the tango of the sharks. PMID- 3505608 TI - Sempere plangere. PMID- 3505609 TI - A timely scenario. PMID- 3505610 TI - Successes and struggles of parent support groups in neonatal intensive care units. AB - A national sample of 129 neonatal intensive care units were surveyed to elicit information about parent support groups in their nurseries. In addition to demographic data, the questionnaire requested information about the purpose, primary focus, format, attendance, and facilitators of the parent groups. Attendance problems were a central issue in the establishment and/or maintenance of the support groups. Our data suggest that dual purpose (education and support), combination format (topic and open discussion), evening meetings, and average attendance of five to 10 parents positively affected the groups perceived outcome. PMID- 3505611 TI - The course of hyperbilirubinemia in the very low birth weight infant treated with phenobarbital. AB - We examined the effect of early phenobarbital therapy on the course of jaundice in 57 infants with birth weight below 1,500 g. The study group of 28 infants was treated with a phenobarbital loading dose of 20 mg/kg at 4.2 (3.6) [mean (SD)] hours of age, followed by a maintenance dose of 5 mg/kg/day for one week; 29 infants served as controls. Seventeen study and 19 control infants suffered from periventricular-intraventricular hemorrhage (IVH). The two groups had comparable risk factors that can potentially affect the course of hyperbilirubinemia. Peak serum bilirubin concentration was 7.9 (1.8) mg/dl in the treated group and 8.6 (2.2) mg/dl in the control group. Three infants in the treated group and seven infants in the control group had peak serum bilirubin concentration above 10 mg/dl. These differences in the peak serum bilirubin concentration or in the number of infants with peak serum bilirubin concentrations above 10 mg/dl are not statistically significant. However, treated infants achieved peak serum bilirubin concentration earlier (mean age 90 hours as compared to 138 hours in control infants), and required phototherapy for a shorter duration of time (5.5 days in the treated group as compared to 7.5 days in the control group). While these differences in the two groups with regard to age of peak serum bilirubin concentration and duration of phototherapy are statistically significant, they do not seem to be clinically important. Thus, in our group of very low birth infants phenobarbital failed to show any clinically important effects on the course of jaundice when used in conjunction with phototherapy. PMID- 3505612 TI - Ventilatory management casebook. Plugged endotracheal tube. PMID- 3505613 TI - Topics in perinatal genetics. Cornelia de Lange syndrome. PMID- 3505614 TI - Developmental psychology casebook. Developmental language delay. PMID- 3505615 TI - Nursing interventions. The nurse's role in the care of a 730 g baby treated with prostaglandins for 62 days for a coarctation of the aorta. AB - As techniques for saving very low birth weight babies improve, there will be a need to maintain babies with cardiac lesions on continuous infusions of prostaglandins until they gain enough weight so that corrective surgery can be performed. An organized approach to overcome the problems of prematurity through primary nursing is essential when caring for the very low birth weight baby with congenital heart disease requiring long-term prostaglandin therapy. PMID- 3505616 TI - The rationale for supportive care after perinatal death. AB - Parents experiencing perinatal death have health care needs beyond the physical needs of the postpartum woman. Health care providers must direct their attention to the emotional needs of the couple. Parents can be offered the opportunity to participate in decisions regarding their care and thereby regain a sense of control over a situation that frequently produces frustration and anger. Appropriate care, offered within a variety of structures, will more likely be provided when the health care professional addresses the needs of the grieving couple in an open, sensitive manner. PMID- 3505617 TI - Sudden death following white cell transfusion in a premature infant. AB - A 1,700-g, 31 weeks' gestational age infant developed early onset Group B streptococcal septicemia associated with shock and respiratory distress. The infant was treated with antibiotics, exchange transfusion, and white cell transfusion. The infant improved, and then acutely deteriorated following the third white cell transfusion. Cause of death was presumed to be pulmonary sequestration of white cells or anaphylaxis. PMID- 3505618 TI - Effects of asphyxia on telencephalic microvessels of premature beagle pups. AB - The authors identified alterations in the brain microvasculature of the premature Beagle pup that could be attributed to asphyxia and potentially associated with the etiology of intraventricular hemorrhage (IVH). Beagle pups were delivered by cesarean section six days before their predicted whelping date and exposed to an alternating protocol of asphyxial episodes known to produce IVH. Data from the telencephalic microvasculature at both the germinal matrix (an area susceptible to IVH) and the borderzone cerebral cortex (an area rarely involved in hemorrhage) were analyzed. The germinal matrix microvessels responded differently to asphyxia than the cortical vessels. The germinal matrix microvessels maintained junctional complexes and intraluminal microvilli, and increased in cross-sectional luminal area following asphyxia; however, total vessel cross sectional area did not change. After the asphyxial insult, cortical microvessels no longer exhibited intraluminal microvilli and increased in both total cross sectional area and luminal area. The number of junctional complexes in cross sections of cortical vessels was significantly reduced due at least in part to the narrowing of the endothelial cell lateral borders. The data provide indirect evidence to substantiate vasodilation speculated to be due to an increased cerebral blood flow to telencephalic vessels (both the germinal matrix and cerebral cortex) following asphyxia. The data also suggest differential rates of maturation between germinal matrix and cortical microvessels. PMID- 3505619 TI - [The Second Conference on Mitral Valve Prolapse. Tokyo, August 30-31, 1986. Proceedings]. PMID- 3505620 TI - [Surgical problems of mitral regurgitation in patients with mitral valve prolapse]. PMID- 3505621 TI - [Timing of mitral regurgitation in patients with mitral valve prolapse: phonocardiographic and Doppler echocardiographic analysis]. PMID- 3505622 TI - [Mitral valve prolapse in patients with anorexia nervosa]. AB - Mitral valve prolapse was echocardiographically examined for 23 female patients with anorexia nervosa. The age was ranged from 13 to 26 and averaged 19.6 years. Their body weights ranged from -25 to -45% of the ideal body weights. Mitral valve prolapse was detected in 19 (83%) cases. The involved valve leaflets were anterior and posterior in 10 and anterior in nine cases, and significant bradycardia was present in the former. Left ventricular end-diastolic dimension was less than the control subjects. The follow-up study in five patients disclosed that each prolapse was unchanged despite of the significant improvement of the disease. The involved mechanism of prolapse in patients with anorexia nervosa was discussed in the light of vagotony based on the pharmacodynamic tests and the results of the previous experimental works of Imataka et al. PMID- 3505623 TI - [Exercise echocardiography and clinical features in patients with mitral valve prolapse]. AB - To assess left ventricular (LV) functional reserve and prognosis in patients (pts) with idiopathic mitral valve prolapse (MVP), we performed ergometer exercise echocardiography for 10 normal subjects and 30 MVP pts without or with mild mitral regurgitation (MR). These 30 pts were followed for 2-8 years (mean 4.5). Percent changes (delta%FS) of % fractional shortening (%FS) during exercise at initial study in MVP pts and normal subjects were 7 +/- 7 and 11 +/- 3%, respectively. Based on delta%FS, MVP pts were divided into two groups; Group I: 13 cases with delta%FS less than 5%, Group II: 17 cases with delta%FS greater than or equal to 5%. The incidence of cardiac symptoms was higher in Group I than in Group II (85 vs 41%, p less than 0.05). ST-T changes on standard 12 lead ECG and life-threatening arrhythmias on Holter ECG were more frequently observed in Group I (38 vs 18%, 58 vs 20%). During follow-up period, M-mode echo measurements did not change in Group II, but LV end-diastolic dimension, LV end-systolic dimension and left atrial dimension significantly increased (p less than 0.05, p less than 0.01, p less than 0.01, respectively), and %FS significantly decreased (p less than 0.01) in Group I without any changes of MR severity. Thus, some MVP pts with impaired cardiac reserve detected by exercise echo may develop progressive deterioration of cardiac function even without significant MR. PMID- 3505625 TI - [Mitral valve angle as a new diagnostic index of mitral valve prolapse]. PMID- 3505624 TI - [Clinical features of ruptured chordae tendineae with special reference to mitral valve prolapse]. PMID- 3505626 TI - [Optimum time for surgical intervention in pure mitral regurgitation: serial echocardiographic evaluations]. AB - To determine the optimum time for surgical intervention in pure mitral regurgitation, 39 patients were studied by echocardiography before and after surgery. Pure mitral regurgitation included mitral valve prolapse with or without ruptured chordae tendineae. Twenty-two patients had mitral valve replacement and 17 had mitral valve reconstruction. Serial echocardiograms were obtained from all 39 patients (average follow-up: 40 months). Two of the 39 patients died suddenly at home on 26 and 62 months after surgery. One of the 39 patients now suffers from congestive heart failure. These three patients had preoperative left ventricular end-diastolic dimensions greater than 70 mm and left ventricular end systolic dimension greater than 50 mm. Operation is recommended for patients with end-diastolic dimension less than 70 mm and end-systolic dimension less than 50 mm. PMID- 3505627 TI - [Involvements of the mitral apparatus in rabbits induced by vagal stimulation: histological and biochemical investigations]. AB - To assess the influence of the vagus on the pathogenesis of changes in the mitral apparatus, histochemical study using acetylcholinesterase was performed in the rabbit heart. Vagal stimulation was conducted by electrical stimulation (Group I), clipping (Group II), or clipping with crushing (Group III) of the left cervical vagus. Acetylcholinesterase activity was not observed in any groups. However, in a rabbit with one-hour electrical stimulation of the vagus the activity was observed around the artery. However, the present study could not prove the direct effect of the peripheral vagal nerve on the changes observed by cervical vagal stimulation. PMID- 3505628 TI - [A new echocardiographic diagnostic criterion of mitral valve prolapse]. PMID- 3505629 TI - [Left ventriculographic diagnostic criteria of mitral valve prolapse]. PMID- 3505630 TI - [Relationship of two-dimensional echocardiographic mitral valve prolapse to mitral regurgitation assessed by color Doppler flow imaging]. AB - Although two-dimensional echocardiography is a standard for diagnosing mitral valve prolapse, the diagnostic criteria are controversial. Regardless of valve ballooning we have used our criteria which are based on the dislocation of the mitral valve coaptation. The purpose of this study was to clarify the relationship between the location and the degree of mitral valve prolapse assessed by two-dimensional echocardiography and those of mitral regurgitation evaluated by color Doppler flow imaging, which enables us detailed analysis of regurgitation. Twenty-three patients with idiopathic mitral valve prolapse diagnosed by our criteria were studied. They were 14 men and nine women, ranging in age from 19 to 72 years (mean 44.7). In any patients, prolapse of either the anterior or posterior leaflet does not satisfy the Gilbert's criteria. Twenty of the 23 patients had mitral regurgitation by color Doppler flow imaging, and the grade was II, III or IV in 16 of these 20 patients. In 19 of 20 patients, the localization of the regurgitant jet flow from the mitral orifice coincided with the two-dimensional echocardiographic site of dislocation of mitral valve coaptation. Therefore, it was concluded that the dislocation of mitral leaflet coaptation detected by two-dimensional echocardiography is an abnormal finding regardless of the protrusion of the valve beyond the mitral ring. PMID- 3505631 TI - [Natural history of mitral valve prolapse with respect to the heart size and ventricular arrhythmias]. AB - To evaluate the evolution of mitral valve prolapse (MVP) with increasing age, 158 patients were studied by two-dimensional echocardiography and 24-hour ambulatory electrocardiography (Holter monitoring). The patients were divided into seven age groups (25 patients ranging in age from 12 to 14 years, 21 from 15 to 17, 24 from 18 to 20, 24 from 21 to 30, 37 from 31 to 50, 8 from 51 to 60 and 19 older than 61). Each patient was echocardiographically graded as mild, moderate and severe MVP. Ventricular arrhythmia by Holter monitoring was graded as I, II, III and IV according to Lown et al. The following results were obtained. 1. Incidence of moderate and severe MVP was less than 10% in patients younger than 20 years, but increased with age. Incidence of left ventricular dilatation (left ventricular end-diastolic dimension less than or equal to 55 mm) and left atrial dilatation (left atrial dimension greater than or equal to 40 mm) were minimal in patients younger than 20 years, but increased with age, especially in patients older than 51 years. 2. Ventricular couplets or triplets (Lown grade IV) were found in less than 10% in patients in age from 15 to 17 years, 33% in patients from 18 to 20 years and showed no increase with age. The rate of ventricular tachycardia was over 150 beat per min (bpm) in five of nine patients (56%), and the sinus rate preceding ventricular tachycardia was from 65 to 140 bpm. PMID- 3505632 TI - [Relationship between arrhythmias and autonomic dysfunction in patients with mitral valve prolapse]. PMID- 3505633 TI - [Prognostic significance of arrhythmias in mitral valve prolapse]. PMID- 3505634 TI - Is there a case for smaller lists? PMID- 3505635 TI - Use of hospital based investigations. PMID- 3505636 TI - Health and preparation for retirement. PMID- 3505637 TI - Comparison of outcome of low-risk labour in an isolated general practice maternity unit and a specialist maternity hospital. AB - The outcome of labour of 185 low-risk pregnancies at an isolated general practitioner maternity unit was compared with that for 185 comparable low-risk pregnancies at a specialist maternity hospital. No difference was found in mode of delivery or in the proportion of women requiring no analgesia, although significantly more women in the general practice group received analgesia beyond nitrous oxide. There was a significantly higher level of intervention in labour in the maternity hospital group in the form of fetal monitoring and augmentation of labour. The duration of first stage of labour was longer and meconium staining less frequent in the general practice group. Fourteen (7.6%) of the general practice group were transferred in labour to the specialist unit.The results suggest that where considerations for selection of low-risk pregnancy permit, the general practice maternity unit can provide a distinctive style of intrapartum care with minimum intervention. PMID- 3505638 TI - Outcome of women booked into an isolated general practice maternity unit over eight years. AB - The outcome of pregnancy of 1303 women admitted for delivery (including those transferred after admission) at an isolated general practitioner maternity unit over the period 1978-85 was studied. The outcome following change of booking before admission was also assessed for the years 1982-85. The crude perinatal mortality rate was 1.5 per 1000 for all admissions between 1978 and 1985. Of the women admitted in 1978-85 7.4% were transferred after admission while for those booked at the unit in 1982-85 11.3% had their place of booking changed. A higher proportion of nulliparous women than multiparous women were transferred or had their place of booking changed. The main reasons for transfer after admission were delay in the first stage of labour (21.9%), spontaneous rupture of membranes not in labour (16.7%) and hypertension (15.6%), and for change of booking postmaturity (26.9%) and hypertension (16.4%).Sufficient information concerning risk of transfer and change of booking may now be available from studies of isolated general practice maternity units for pregnant women at low risk to make an informed choice of place for delivery. PMID- 3505639 TI - The emergency bed service--a barometer of London's hospital service. AB - The emergency bed service in London exists to facilitate admissions to hospital in cases referred to them by general practitioners and deputizing doctors. The data collected by the emergency bed service provides a unique London-wide perspective of the hospital service and the recent changes observed are examined in this paper. When the emergency bed service fails to arrange for the admission of a patient after trying at least four hospitals the case is medically refereed. The number of cases reviewed by the medical referee has increased over the period 1976-86 as has the necessity for hospitals to stop or slow nonemergency admissions (red and yellow alerts). External factors, such as severe weather and influenza epidemics, were examined to see whether they could account for these changes. However, it was concluded that bed closures accounted for the changes and were making it more difficult to obtain hospital admission for emergency cases via the emergency bed service in Greater London. PMID- 3505640 TI - Study of discharge communications from hospital doctors to an inner London general practice. AB - In inner London patients are now being discharged from hospital earlier to be cared for by the community services. In this study the general practitioners in one inner London practice were asked to evaluate discharge communications from hospital doctors. The general practitioners were dissatisfied with the delay in receiving over one third of the letters and with the content of almost a fifth. They also felt that delay and lack of detail affected their management in 24% of cases. They would have liked more information in the letters, particularly about drug regimens. Some suggestions for improvement in written discharge communications are made. PMID- 3505641 TI - Notifying general practitioners about deaths in hospital: an audit. AB - Information from hospital doctors about the death of a patient in hospital is important to general practitioners. Six general practices in the Dundee district recorded the date and place of death for all 272 practice patients dying over a 14-month period. In the 193 cases (71%) for which the hospital was responsible for informing the practice of the death the method by which the practice first learned of the death and the time interval between death and the writing of the official hospital letter was also recorded. An immediate telephone call, the established method of informing practices of deaths occurring in hospital took place in only 58% of cases and the letter from hospital was sent within one week in only 49% of cases. These proportions were unaltered by the issue of a unit medical circular to hospital staff informing them of the problem and requesting more prompt notification.The ability of general practitioners to help bereaved relatives is compromised by the present inadequacies in communication between hospitals and general practice. The unit medical circular - the standard method of resolving interprofessional problems - would appear to be ineffective. PMID- 3505642 TI - Length of consultation: how well do patient's choose? AB - Patients attending a rural Berkshire surgery were invited to decide the length of appointment they required with the general practitioner. They were offered a choice of five minutes, 10 minutes, or longer, but the general practitioner was unaware of the time requested. Of 200 consecutive patients 115 requested five minutes, 80 requested 10 minutes and five requested longer. The mean consultation length of these groups was 6.5, 9.2 and 14.5 minutes, respectively. Patients given a diagnosis of psychiatric disorder were less accurate in their choice of time than any other diagnostic group. The results suggest that patients are generally good at estimating the time they require in consultation, and do not request over long appointments. It may thus be reasonable to allow patients to choose their consultation length. PMID- 3505643 TI - Study of the women overdue for a smear test in a general practice cervical screening programme. AB - Of the 1527 women aged 30-59 years in one general practice who were eligible for a cervical smear examination 196 (12.8%) were overdue for the test. These women were contacted randomly by post or in person to ascertain their reasons for not responding to the practice screening programme. Of 118 women contacted personally 47% had no major objection to the smear test but had a low view of its priority. A further 24% gave incorrect reasons for thinking a smear test was unnecessary while 29% had strong reasons for not wanting to attend and probably never would. Social and medical factors from the medical records were also examined and compared with those of a group of age and sex matched controls. It was found that women overdue for a smear test lived in more ;socially stressed' areas and used their general practitioner much less than the controls. The theoretical upper limit for smear uptake in the practice was calculated to be around 96%. To help achieve this we need to ensure: (1) that all women understand that the test is to detect a stage before cancer; (2) that some women receive more counselling; and (3) that promotional material is directed at the families of women at risk. PMID- 3505644 TI - Changes in prescribing for terminal care patients in general practice, hospital and hospice over a five-year period. AB - Differences in prescribing between 1981 and 1986 were examined for 100 terminal care patients admitted to a city hospice in each year. Prescribing before and after the patients were admitted to the hospice was also compared for the two years. Between 1981 and 1986 there was a large increase in the number of patients receiving morphine sulphate tablets and a reduction in the numbers receiving Brompton's mixture and other unsuitable analgesics both before and after admission. Contrary to critical opinion, general practitioners showed more acceptable prescribing patterns in both years than hospital doctors. In the hospice more patients received non-narcotic analgesics and parenteral diamorphine by syringe driver in 1986 than in 1981. The need for an organized system of postgraduate training in terminal care is considered. PMID- 3505645 TI - Health care units: an extended alternative to the Cumberlege proposals. AB - The proposals of the Cumberlege report are reviewed as they relate to general practitioners and the effectiveness of the primary health care team. An alternative proposal is described which uses combined general practitioner lists rather than a neighbourhood boundary to define the population served by a ;health care unit'. This would be the basis for both general practitioner and nursing care, and would allow effective multidisciplinary teamwork, as well as encouraging cooperation between general practices and the development of community general practice. PMID- 3505646 TI - AIDS: not deficient but immune. PMID- 3505647 TI - AID, HIV and general practice. PMID- 3505648 TI - General practitioners' responses to government proposals. PMID- 3505649 TI - Cervical screening in general practice. PMID- 3505650 TI - Health questionnaire. PMID- 3505651 TI - Strip aids. PMID- 3505652 TI - The worldwide need for basic infection control procedures. PMID- 3505653 TI - Blood component therapy in neonatal disease. Vail, Colorado, June 15-19, 1986. PMID- 3505654 TI - The effects of linguistic stress on ASL signs. PMID- 3505655 TI - Stress and intonation in the speech of hearing-impaired Hebrew-speaking children. PMID- 3505656 TI - [Possibilities of diagnosis and treatment of the cervico-brachial pain syndrome]. PMID- 3505657 TI - [Comparison of CT and MRI findings in the diagnosis of cerebral complications in AIDS]. PMID- 3505658 TI - [Central nervous system disorders: the dominant manifestation in the clinical spectrum of HIV infection]. PMID- 3505660 TI - Comparison of electrocardiographic changes in patients suffering from subarachnoid hemorrhage and ischemic cerebral infarction. PMID- 3505659 TI - [Morbidity in cerebrovascular insult and the age of patients. Report on hospitalized patients over a twenty-year period]. PMID- 3505661 TI - [The cervico-cephalic syndrome--our diagnostic program and method of grouping patients]. PMID- 3505662 TI - [The effect of Hydanphene on reflex activity of the spinal cord]. PMID- 3505663 TI - [Progressive rubella panencephalitis]. PMID- 3505664 TI - [Essential tremor: therapeutic possibilities]. PMID- 3505665 TI - Common sites of viral integration in lymphomas arising in AKXD recombinant inbred mouse strains. AB - Lymphomas from 21 AKXD recombinant inbred mouse strains were analyzed for retrovirally induced rearrangements in seven known or putative proto-oncogene loci. Among the rearrangements detected in the 258 lymphomas screened, most rearrangements appeared to be caused by viral integration. Rearrangements were detected in the Myc, Pvt-1, Pim-1, Mlvi-1, Mlvi-2, and Fis-1 loci, but not in the Myb locus. Seven lymphomas contained rearrangements in two loci. Nearly 90% of the rearrangements were observed in T cell lymphomas; few were detected in B cell or myeloid tumors. Rearrangements in Pvt-1, Fis-1, Mlvi-1, and Mlvi-2 were identified only in T cell lymphomas. Alterations in the Myc and Pim-1 loci, although occurring predominantly in T cell lymphomas, were occasionally detected in other types of lymphoma. These data suggest that the repertoire of cellular proto-oncogenes activated by integration of virus into lymphomas may be different for each hematopoietic cell lineage. The AKXD lymphomas represent a useful resource for identifying these sites. PMID- 3505666 TI - C-myc activation in an unusual retrovirus-induced avian T-lymphoma resembling Marek's disease: proviral insertion 5' of exon one enhances the expression of an intron promoter. AB - Characterization of nonacute retrovirus-induced neoplasms have greatly facilitated our understanding of the mechanisms by which host protooncogenes are activated. Here we report the molecular characterization of a newly identified chicken lymphoma, which does not involve the bursa of Fabricius. This lymphoma, specifically induced by reticuloendotheliosis virus (REV), is similar in tumor location and T-cell origin to Marek's disease, a herpesvirus-induced T-lymphoma. We show the c-myc is the specific target locus for REV insertion. Integrated proviruses are all located upstream of the c-myc coding exons, and 60% are 5' to the first noncoding exon. One-half of the proviruses are oriented in the opposite transcriptional direction as the c-myc gene. This insertion pattern is in contrast to the pattern in B-lymphomas induced by the same virus. While some of the proviruses in these T-lymphomas used the 3' LTR promoter to transcribe the downstream c-myc gene, others apparently activated a common, cryptic promoter located in the first intron. To our knowledge, this is the first molecular description of an avian T-lymphoma induced by a nonacute retrovirus. PMID- 3505667 TI - [Biological pollution of the Tiber in the last 100 years]. PMID- 3505668 TI - [Biological control of vectors and infectious diseases associated with water]. PMID- 3505670 TI - [Control of dental caries among the compulsory school population of Arcinazzo Romano: longitudinal study]. PMID- 3505669 TI - [Evaluation of the physical, chemical and bacteriological characteristics of sludge produced by various urban sewage treatment plants in Emilia up to its eventual use in agriculture]. PMID- 3505671 TI - [Campylobacter jejuni in food originating from poultry]. PMID- 3505672 TI - [Epidemiology and prevention of hospital infections in the local health unit of Sassari. Results of a monitoring and control program]. PMID- 3505673 TI - [Noise levels in working environments of the Umberto I Polyclinic in Rome]. PMID- 3505674 TI - [Primary prevention of HIV infections. Prophylactic standards in relation to behavioral risks: a public health information-education program]. PMID- 3505675 TI - [Outpatient surgical centers: functions and responsibilities of the medical director]. PMID- 3505677 TI - What is a specialist, anyway? PMID- 3505676 TI - [Community medicine in developing countries]. PMID- 3505678 TI - Amoebic colitis--an often misdiagnosed disease. PMID- 3505679 TI - Starting treatment for diabetes. PMID- 3505680 TI - The elderly diabetic with multiple problems. PMID- 3505681 TI - Diabetes and life problems. PMID- 3505682 TI - Contraception, pregnancy and breast feeding in the insulin-dependent diabetic. PMID- 3505683 TI - Effects of nuclear war: new findings. PMID- 3505684 TI - Looking back, looking forward. PMID- 3505685 TI - Why I visit my patients in hospital. PMID- 3505686 TI - Diuretic prescribing in our community. PMID- 3505687 TI - Reasons for advising exercise. PMID- 3505688 TI - The GP's role in child accident prevention. PMID- 3505689 TI - The prevention of common behaviour problems in the pre-school child. PMID- 3505690 TI - Health education in general practice. PMID- 3505692 TI - An initiative to improve men's health. PMID- 3505691 TI - Developing a computerised preventive programme. The Chrisp Street Practice. PMID- 3505693 TI - Comprehensive health assessments. PMID- 3505694 TI - Psychosomatic medicine: new facts and old controversies. Part I. Proceedings of the 9th world congress of the College of Psychosomatic Medicine. Sydney, Australia, August 30-September 4, 1987. PMID- 3505695 TI - An investigation of patients presenting with multiple physical complaints using the illness behaviour questionnaire. AB - The Illness Behaviour Questionnaire was used to determine whether three groups of patients who had presented with multiple symptoms in different treatment settings (Briquet's syndrome, post-viral fatigue syndrome, and a heterogeneous general practice group) could be differentiated from one another and from a mixed group of psychiatric patients on the basis of their abnormal illness behaviour. All groups completed a version of the Perley and Guze diagnostic criteria for Briquet's syndrome. The three groups presenting with multiple symptoms were more similar to each other than to the psychiatric patients. The results suggest that patients presenting with multiple symptoms include similar populations of patients who are poorly distinguished using current schemes of classification. PMID- 3505696 TI - Evoked response potentials and regional cerebral blood flow in somatization disorder. AB - Somatization disorder (SMD) is a chronic condition characterized by multiple complaints which are not due to any apparent organic illness but frequently involve pain. This study employs computer-aided imaging technologies to examine brain function in thousandths of a second (event-related brain potentials) and over a number of minutes (regional cerebral blood flow). Fourteen patients with SMD and 14 normal controls were investigated. Results from both studies suggest that patients with SMD have a dysfunction in the processes of attention, compared to normal controls. PMID- 3505697 TI - Age and health perceptions of psychogeriatric patients. AB - How the elderly perceive themselves has interested gerontologists for some time. Younger age perceptions have been associated with better psychological functioning or emotional adjustment. Most researchers and professionals agree that an important component of 'emotional adjustment' or 'mental health' is life satisfaction. Because of this consensus, numerous studies and papers have been written on life satisfaction in the elderly. In general, these studies have found significant correlations between life satisfaction and health, and despite the relative stability of life satisfaction, it can be affected by life events. While most studies have dealt with the 'healthy' elderly, there is little if any literature on elderly hospitalized psychiatric patients. This study explores age biases, health and age perceptions, as well as life satisfaction over the course of psychiatric hospitalization for geriatric patients. A questionnaire was developed to elicit age and health perceptions of psychogeriatric patients. The questionnaire was piloted with 17 geriatric patients admitted to the Geriatric Day Treatment Center. The questionnaire was administered to 24 patients admitted to the inpatient service of the Department of Geriatric Psychiatry during the first week of admission and on the week of discharge. The results of this study may help us with the educational needs of psychogeriatric patients regarding the normal aging process, as well as increase understanding of the effects of psychiatric illness on perceived age, health and life satisfaction in the geriatric population. PMID- 3505698 TI - Unemployment, drug use, and health in late adolescence. AB - In order to study the health correlates of unemployment, young urban South Australians, of average age 19.6 years and with 10.5% unemployed, were asked to rate their health and report number of doctor visits of the preceding month. Information about financial state, work satisfaction, and drug use was also collected. The satisfied employed rated their health somewhat more favourably than did either the dissatisfied employed or the unemployed, but changes in work situation over the next year were not related to changes in health. Alcohol use differed according to work situation for females but not males; cigarette smoking, which did not vary with work situation, was associated with poorer health. PMID- 3505699 TI - Panic disorder associated with mitral valve prolapse: psychosomatic implications. AB - Findings of the second part of the clinical study initiated in 1982 are presented. Both aimed to determine possible clinical differences among panic disorder, agoraphobia with panic attacks and mitral valve prolapse syndrome (MVPS). Such clinical psychiatric differences could be useful because MVPS poses potentially dangerous consequences in patients with a high rate of serious cardiac and neurological complications. The first part of the study included 35 patients, 20 of whom were confirmed MVPS. This group appeared distinguishable by the increased frequency of fear of doing something uncontrolled and, even more so, by the anger-rage symptoms manifested during the attacks. In the present study of 100 patients, 36 of whom were documented MVPS, fear of doing something uncontrolled was not greater, although attacks of anger and rage were again higher than in the other two groups and exceeded 5% standard deviation. In all other psychological dimensions, the three groups did not differ from one another. This paper considers possible causes and consequences of symptoms seen in the MVPS. PMID- 3505700 TI - Type A behaviour, attention, and the report of subjective arousal. AB - Previous research has indicated a tendency among type A individuals to report less subjective arousal than type B individuals. Differences in attentional style between type A and type B individuals have been suggested to account for this tendency. The present paper describes a study which employed adult male subjects to examine this notion. The results of this study replicated previous findings of symptom underreport by type A subjects, but findings pertaining to the role of attention in this phenomenon were ambiguous. These data are discussed in the light of previous studies. PMID- 3505701 TI - Psychosomatic medicine: new facts and old controversies. Part II. Proceedings of the 9th world congress of the International College of Psychosomatic Medicine. Sydney, Australia, August 30-September 4, 1987. PMID- 3505702 TI - The integrated psychosomatic inpatient unit. A new approach to hospital medical care. AB - In contrast to the liaison psychiatry model, various types of psychosomatic inpatient units have been established successfully especially in Europe. Since Simmel's first attempt, they all use the unique possibility to create a special milieu of psychosomatic understanding and treatment of patients with all kinds of illnesses and somatic diseases. To fulfill this goal, the psychosomatic unit has to rely on three conditions: it must (1) be institution-independent as well as integrated within a large hospital system; (2) provide psychotherapeutic and somatic care of equally high standard, and (3) have the possibility to keep the patient sometimes for a longer duration than in other (e.g. internal) medical inpatient units. Principles, experiences and results of a psychosomatic unit with 60 beds integrated in a large municipal hospital are presented as an example for this promising approach to modern medicine. PMID- 3505703 TI - Comprehensive management of persistent somatization: an innovative inpatient program. AB - Psychiatry has been largely unsuccessful in developing effective treatment strategies for patients with chronic somatization. They continue to utilize a disproportionate share of health care resources and experience personal distress and significant social and occupational dysfunction. The Psychosomatic Medicine Unit at the Clarke Institute of Psychiatry is attempting to treat these patients with a comprehensive treatment program that takes into account the multifactorial etiology of the disturbance. The unit is in a tertiary care facility and the patient population is heterogeneous with respect to the underlying psychiatric diagnosis and the duration of symptoms. All patients are significantly dysfunctional and have typically failed other treatment approaches. The treatment process begins with an assessment phase in which the patient is comprehensively evaluated from the physical and psychiatric perspectives. The rehabilitation phase consists of a variety of treatment modalities including group programs in goal-setting, life skills and interpersonal relations, group therapy, individual psychotherapy, family therapy, occupational therapy and vocational rehabilitation, biofeedback and physiotherapy. Psychotropic medications play an important role in some patients. This paper will describe the unit and its program in detail. PMID- 3505704 TI - Behavioral medicine programs in teaching hospitals. AB - Behavioral medicine is a relatively new interdisciplinary field which combines biomedical and behavioral science knowledge, and applies them to prevention, diagnosis, treatment and rehabilitation. Behavioral medicine programs provide a valuable service to patients with chronic illness, psychosomatic or functional disorders, treatment noncompliance, and behavioral risk factors. Behavioral medicine faculty are also active in teaching and research on patient behavior, interviewing skills, health promotion and counseling, and management of chronic illnesses. However, the survival of behavioral medicine programs in teaching hospitals depends on their economic viability and academic status. Positive action is needed to ensure their continued growth and development. PMID- 3505705 TI - Follow-up results from a psychosomatic outpatient clinic. AB - On the background of the German situation of psychosomatic medicine as an independent department beside the psychiatric clinic, we describe the theoretical issues, organizational structure and functioning of a psychosomatic outpatient clinic. 186 consecutive referrals were analyzed. The ratio of man to woman was 1:2, mean age was 32 years (range 17-58). About half of the patients suffered from psychogenic disorders (according DSM-III criteria subsumed to the category of 'psychological factors affecting physical condition'), 21% had anxiety disturbances, and of the remaining patients 15% had affective illnesses and 13% somatoform disorders. There were three treatment conditions: inpatient psychotherapy, outpatient individual or group psychotherapy and family therapy. Follow-up results (2 years after the first contact) give some hints on the effectiveness of the different treatment procedures. The results show that the psychosomatic outpatient clinic may offer treatment for a specific patient population whose characteristics differ significantly from those of patients treated in consultation liaison services as well as by practicing psychotherapists. PMID- 3505706 TI - A structured behaviorally oriented group treatment for bulimia nervosa. AB - Preliminary results are reported on the efficacy of a 4-month group (n = 8) therapy compared with waiting-list controls (n = 9) in women with DSM-III bulimia. Treatment consisted of a standard behaviorally oriented stress management program and of basic nutritional management. A significantly greater decrease in binge frequency and specific psychopathology was found in the treated compared with the waiting-list group. The treated subjects showed further improvement 3 months after treatment termination. The usefulness of the different treatment components is briefly discussed. PMID- 3505707 TI - Hypoglycemia and death in anorexia nervosa. AB - Several deaths in patients with anorexia nervosa have been ascribed to 'inanition'. The proximate cause of death from inanition has not been established. There are few previous reports of life-threatening hypoglycemia in anorexia nervosa. We participated in the care of two severely cachectic women with anorexia nervosa who were in coma with serum glucose levels of 8 and 14 mg/dl, respectively. Both patients became alert after administration of intravenous glucose. Both were found to have pneumonia at the time of the hypoglycemic event. While the mechanism of the hypoglycemia is unknown, it may be related to the suppression of gluconeogenesis by infection in the setting of reduced substrate, depleted fat stores and decreased catecholamine release. PMID- 3505708 TI - Behaviour therapy in the management of patients with anorexia nervosa. A lenient, flexible approach. AB - Many different treatment approaches have been advocated for anorexia nervosa, and most clinicians now incorporate some aspects of behaviour modification in refeeding an emaciated patient. Traditional operant programmes have required the patient to spend prolonged periods of time confined to a solitary existence in a bedroom devoid of her normal possessions. The present paper evaluated the rate of weight gain in 68 patients with anorexia nervosa (100 consecutive admissions to a specialised eating disorders unit) using a lenient, flexible approach to refeeding. Despite this more humane approach, similar results were achieved when compared to other more rigid behavioural programmes in that they gained 0.16 kg/day. This finding is discussed in the context of the rigid application of behavioural programmes which can be seen as punitive, undermine the patient's co operation and destroy any therapeutic relationship which may develop. PMID- 3505709 TI - An evaluation and follow-up investigation of a behavioural group treatment programme for obesity. AB - This paper describes an evaluation and 2-year follow-up of a comprehensive behavioural group obesity programme. The sample was made up of three groups totalling 31 patients who were referred to the Weight Reduction Advice Service at Prince of Wales Hospital, Randwick. Patients were thoroughly screened prior to treatment and completed psychological questionnaires before and after treatment. The programme consisted of weekly, 1.5- to 2-hour sessions of formal treatment. An additional 2 sessions were held fortnightly. Treatment was conducted by a clinical psychologist, two dietitians and a physiotherapist. Outcome results for the end of treatment and at 2 years follow-up are presented. The implications of the results for the treatment of obesity are discussed. PMID- 3505710 TI - Sleep and dreams in eating disorders. AB - The results of several studies on sleep EEG and dreams in patients with eating disorders are presented and compared with the data obtained in patients with a major depression. The sleep pattern, which is characteristic of depression, could not be found in the eating disorder group. Regarding the cholinergic REM induction test, the depressive displayed a pronounced shortening of REM sleep latency. However, this biological marker, indicating a cholinergic hyperactivity in depression, could not be observed in patients with eating disorders. The content analysis of laboratory-recorded dreams yielded several differences between depression and eating disorders and also, more subtle, between anorexia and bulimia. PMID- 3505711 TI - A prospective study of eating disturbances in the ballet. AB - A group of 35 ballet students was assessed and then retested between 2 and 4 years later to determine the persistence of eating symptoms and to identify factors which predict eating disorders. Of those interviewed at follow-up, 25.7% had anorexia nervosa and 14.2% had either bulimia nervosa or a 'partial syndrome'. 'Drive for thinness' and 'body dissatisfaction' scales of the Eating Disorder Inventory were the only measures which predicted development of eating disorders at follow-up. The finding that most cases of anorexia nervosa gained weight at follow-up was similar to an earlier report; however, the view that these disorders were benign adaptations to the ballet subculture was challenged by the observation that many continued to experience significant eating disorder symptoms at follow-up. Findings indicate that vulnerable adolescents may be identified early using economical self-report measures as the initial step in a two-stage screening process. PMID- 3505713 TI - Towards the prevention of eating disorders. Some preliminary findings from an empirical investigation. AB - The high incidence of disordered eating among female adolescents and young adult women has been noted in surveys carried out in Australia, the USA, New Zealand and the UK. While a critical feature that distinguishes those who go on to develop anorexia nervosa or bulimia nervosa is their sense of a loss of control over their eating, the psychological and nutritional concomitants of this loss of control have not been empirically investigated. Preliminary findings are described from an experimental study which is aimed at systematically investigating the relationship between dietary composition and consumatory patterns, hunger and satiety. The results are discussed in terms of the possible role of 'diet' in perpetuating the symptoms of bulimia nervosa and anorexia nervosa. PMID- 3505712 TI - Hormonal and metabolic mechanisms in the development of cerebral pseudoatrophy in eating disorders. AB - Cranial computed tomography (CT) examinations performed on patients with schizophrenia, affective disorders or on patients with anorexia and bulimia nervosa revealed morphological brain alterations. In patients with eating disorders these structural changes were characterized by enlarged ventricles and sulci. Malnourishment-induced hormonal and metabolic disturbances may be responsible for this morphological brain alteration which, due to its reversibility after clinical remission, is frequently called 'pseudoatrophy'. As patients with alcohol dependency also display a cerebral pseudoatrophy, the search for similarities between alcoholics and patients with eating disorders may help to elucidate some of the pathogenetic factors which cause the CT findings in patients with different psychiatric or psychosomatic disorders. PMID- 3505714 TI - Eating disorders and psychiatric morbidity in patients with diabetes mellitus. AB - The role of psychological factors in diabetes mellitus is discussed, with particular reference to the influence of eating disorders. The paper describes a prevalence study of eating disorders in outpatients with insulin-dependent diabetes (IDDM) and a controlled questionnaire study of eating attitudes in a similar population. These studies suggest there is a genuine association between eating disorders and IDDM. PMID- 3505715 TI - Psychological characteristics of breast cancer patients. AB - Two breast cancer groups (mastectomised or chemotherapeutic intervention) and a control group of healthy female nurses were given a demographic questionnaire and the Minnesota Multiphasic Personality Inventory. The personality profiles of all three groups emerged as significantly different from each other on all scales with the exception of social introversion and psychopathic deviance. Both cancer groups displayed inflated scores on the clinical scale Depression. A separate series of univariate F tests revealed that the mastectomised patients were characterised by elevated scores on the clinical scales Hypochondriasis, Depression, Hysteria, Masculinity-Femininity and Schizophrenia compared to normals. The discriminant analysis confirmed that between the clinical groups the mastectomised patients exhibited higher scores (compared to those receiving chemotherapy) along the scales Hypochondriasis, Paranoia, Psychaesthenia, Schizophrenia and Hypomania, the latter 4 scales constituting the psychotic tetrad. PMID- 3505716 TI - Coping with breast cancer--a longitudinal prospective study. AB - In a prospective longitudinal study over several years, 58 patients with breast cancer are compared to 52 patients with fibrocystic disease and 24 patients with mastodynia. Results of coping (as assessed with the Bernese Coping Modes) are presented for the illness course of the first 6 months: (1) There is considerable variation of coping depending on illness situation and illness state. A core group of coping modes is predominant in most situations: 'attention & care', 'problem analysis', and 'Tackling'. In average 10 different coping modes were used by patients per given illness situation. (2) The different aspects of illness (in the same organ) ask for different coping. In the initial evaluation phase, however, the possibly fatal diagnosis overrides these differences. (3) Change over time (first 6 months) is net. Besides the core group of coping modes mentioned above, there is more variability in coping; in cancer a trend from a more fighting to a more accepting attitude is obvious; in fibrocystic disease more restricted coping is observed. Interdependence of coping with emotional stability and social adaptation will be studied as well. PMID- 3505717 TI - Development of children's concepts about the interior of the body. AB - Recent research suggests that children's understanding of the interior of the body and its functioning develops in an orderly sequence that parallels cognitive development generally. Two hundred and ten healthy school children aged 5-11 years were studied individually and required to draw the interior of the body inside a body outline provided. In order to overcome the constraints of pictorial representation, they were also interviewed about their understanding of the contents of the body. Changes were measured in the number and nature of body parts drawn and described. Responses on drawings were coded to differentiate level of integration of organs and parts into body systems. The findings demonstrate a significant increase in conceptual sophistication with age. Developmental changes in conceptualization of the body are interpreted within the context of a Piagetian model of cognitive development, supporting the possibility of delineating stages in the development of the child's thinking about the body interior. The implications of the findings for communicating with children about health and illness are discussed. PMID- 3505718 TI - Relationships between Jenkins Activity Survey scores and responsivity of the dopaminergic system in psychosomatic disorders. AB - First, the Jenkins Activity Survey (JAS) was administered to 150 healthy subjects and 127 psychosomatic patients. Next, the responsivity of the dopaminergic system of the hypothalamo-pituitary gland was measured in 81 of these psychosomatic patients by examining the effect of bromocriptine on plasma growth hormone levels. Subjects were classified as either responders or nonresponders based on their secretion patterns. Multidimensional scaling techniques successfully discriminated between healthy subjects, psychosomatic responders and psychosomatic nonresponders using the items of the JAS. Implications for treating nonresponder psychosomatics in Japan are discussed. PMID- 3505719 TI - Integration of DSM-III and ICD-8 to be used in a consultation-liaison psychiatric service. Preliminary experiences. AB - In 1983 a total of 405 patients received psychiatric supervision in somatic departments in the general hospital. At this supervision, these patients were registered by means of a five-axial diagnostic coding according to the DMS III principle, and this was combined with a quantitative global assessment of the severity of the condition. Reliability testing was undertaken by five supervising physicians with a total of 15 patients. The total number of supervisions constituted one supervision per somatic bed per annum. Women were overrepresented, and medical departments made the greatest use of psychiatric supervision. Reactive conditions dominated parallel with a high relative incidence of alcohol-related conditions. In patients with diagnoses of psychoses, only slight to moderate psychiatric symptoms were encountered. This held true also for personality deviations. 50% of the patients had experienced significant psychosocial stress, but 10% of these were diagnosed as having non-reactive psychoses, 52% of the patients had moderate to pronounced disturbances of social function. Half of the patients supervised in this manner could be investigated or treated in the referring departments. Approximately half of the patients in whom referral to private psychiatric specialists was made did not keep these appointments. Reliability testing in the material shows the employability of the diagnostic armamentarium. All in all, the investigation suggests that extension of the liaison psychiatric service in somatic departments would result in a relative increase in the number of patients who could be treated in the referring department and an increase in the number of psychiatric conditions diagnosed. Establishment of a psychiatric outpatient clinic in the somatic environment appears to be indicated. PMID- 3505720 TI - Multidisciplinary teams in consultation-liaison psychiatry: the Yale model. AB - The consultation-liaison service at Yale features integrated teams of psychiatrists, social workers, and clinical nurse specialists working together in both consultation and outpatient settings. The model is based on the tenets that (1) comprehensive evaluation of patients is essential for effective treatment; (2) role definition is necessary for specific disciplines, including the definition of overlapping and separate areas of expertise and practice. The multidisciplinary teams are coordinated by a psychiatric resident, who is supervised by an attending psychiatrist. The role of the resident is that of a diagnostician and coordinating physician. The social worker functions as an expert in family evaluation and treatment, and the nurse specialist functions as supportive therapist and liaison with the nursing staff. The structure of the division of consultation-liaison and ambulatory services at Yale is described and the advantages and disadvantages of the multidisciplinary team concept are discussed in comparison with other models of consultation-liaison psychiatry. PMID- 3505721 TI - [Iatrogenic acute renal insufficiency: risk factors and prophylaxis]. PMID- 3505722 TI - [Drug nephrotoxicities]. PMID- 3505723 TI - [Radiological contrast and acute renal insufficiency]. PMID- 3505725 TI - [Some factors influencing the progression of renal insufficiency]. PMID- 3505724 TI - [Hepatorenal syndrome]. PMID- 3505726 TI - [Dietary management in the conservative treatment of chronic renal insufficiency]. PMID- 3505727 TI - [Antibiotic therapy in the patient with chronic renal insufficiency]. PMID- 3505728 TI - [Infection in hemodialysis]. PMID- 3505729 TI - [Hepatitis in dialysis units]. PMID- 3505730 TI - Chronic behavioral disorders of human REM sleep: a new category of parasomnia. AB - Four men, aged 67-72 years, had 4-month to 6-year histories of injuring themselves or their spouses with aggressive behaviors during sleep, often during attempted dream enactment. A 60-year-old woman had disruptive though nonviolent sleep and dream behaviors. Polysomnography did not detect seizures but did document REM sleep pathology with variable loss of chin atonia, extraordinarily increased limb-twitch activity, and increased REM ocular activity and density. A broad range of REM sleep behaviors was recorded on videotape, including stereotypical hand motions, reaching and searching gestures, punches, kicks, and verified dream movements. Stage 3-4 slow wave sleep was elevated for age in all patients. NREM sleep was devoid of harmful behaviors, although three men had periodic myoclonus. There was no associated psychiatric disorder, whereas serious neurologic disorder was closely associated in four cases: olivo-ponto-cerebellar degeneration, Guillain-Barre syndrome, subarachnoid hemorrhage, and an atypical dementia. Two patients had immediate and lasting sleep behavioral suppression induced by clonazepam, and another patient had the same response with desipramine. All instances of drug discontinuation prompted immediate relapse. In four cases there was associated dream hyperactivity, which resolved with behavioral control. These REM sleep neurobehavioral disorders constitute another category of parasomnia, replicate findings from 21 years ago in cats receiving pontine tegmental lesions, and offer additional perspectives on human behavior, neurophysiology, pharmacology, and dream phenomenology. PMID- 3505731 TI - Transient insomnia and rapidly eliminated hypnotics. AB - The effects of an ultra-rapidly eliminated hypnotic (midazolam 7.5-15.0 mg; mean elimination half-life approximately 2 h) and a rapidly eliminated hypnotic (brotizolam 0.125-0.25 mg; mean elimination half-life approximately 5 h) were studied on transient insomnia induced by sleeping in a reclining seat. Rest in the seat did not lead to delay in sleep onset, but there was increased wakefulness and drowsy sleep and less REM sleep. There were no differences in wakefulness or drowsiness between sleep with drugs in the seat and with placebo in bed, but with midazolam, though not with brotizolam, there was a reduction in REM sleep less than or equal to 300 min after sleep onset. Ultra-rapidly and rapidly eliminated compounds used in the management of transient insomnia should be given in doses that are as free as possible from central nervous system depression as indicated by suppression of REM sleep during the early part of the night. Low doses of ultra-rapidly eliminated drugs are indicated for sleep-onset insomnia and for short periods of sleep, while rapidly eliminated hypnotics with elimination half-lives of approximately 5 h have the potential to sustain sleep free of residual effects. PMID- 3505732 TI - Hypernychthemeral sleep-wake cycle: some hidden regularities. AB - A patient with a sleep-wake cycle greater than 24 h recorded his sleep-onset and wake times for 4 years. During this time the patient found himself unable to maintain a 24-h sleep-wake schedule. The lengths of his sleep-wake periods (subjective days) and his sleep periods were highly variable. Nonetheless, there were certain unexpected regularities in his sleep-wake data, corresponding to fixed clock hours. Across the 4-year period, there were certain clock hours during which sleep onset and waking were likely to occur and certain clock hours that may be considered forbidden zones for sleep, during which the patient rarely either began or ended a sleep period. It is possible that the unexpected regularities resulted from partial entrainment to external cues or from some residual influence of an endogenous ultradian-regulating mechanism. PMID- 3505733 TI - Effects of aging and housing in an enriched environment on sleep-wake patterns in rats. AB - The effects of aging and housing in an enriched environment were assessed in young adult (4-7 months) and old (27-31 months) male Brown Norway rats by conducting 24-h sleep-wake recordings. Comparison of recordings made in rats of different ages, housed in a standard laboratory environment, revealed a reduction of the time spent in slow wave and desynchronized sleep during the light period in the old rats. Furthermore in the old rats, sleep was more fragmented and the amplitude of the circadian sleep-wake rhythm was reduced. In both age groups, housing in an enriched environment resulted in an increase of the time spent in slow wave and desynchronized sleep during the light period. Old "enriched" rats showed an additional alleviation of the senescence-related shortening of sleep cycles and desynchronized sleep epochs. The reduction of the circadian sleep-wake amplitude observed in old age was, however, not affected by the differential housing period. It is concluded that the similarity of the changes in sleep pattern in young and old rats after increased environmental complexity may reflect a preserved capacity of the senescent nervous system to adapt to environmental changes. PMID- 3505734 TI - Modulation of delta activity by hypnotics in middle-aged subjects: studies with a benzodiazepine (flurazepam) and a cyclopyrrolone (zopiclone). AB - Period crossing analysis was used to study the effects of flurazepam (30 mg) and zopiclone (5, 7.5, and 10 mg) on delta wave activity (0.5-2.0 Hz) during the first 4 h of sleep in middle-aged subjects. The drugs do not affect the visual scoring of slow wave sleep in middle age, but modification of delta activity does occur. Mean amplitude of delta wave activity over the 4-h period was reduced by both drugs, while the total number of delta waves and their mean period increased. The number of high-amplitude delta waves (greater than 60 microV) was decreased by the drugs, and those of low amplitude (10-60 microV) increased. Power in the frequency band 1.2-2.0 Hz was reduced. PMID- 3505735 TI - Circadian regulation dominates homeostatic control of sleep length and prior wake length in humans. AB - During prolonged temporal isolation in caves or windowless rooms, human subjects often develop complicated sleep-wake patterns. Seeking lawful structure in these patterns, we have reanalyzed the spontaneous timing of 359 sleep-wake cycles recorded from 15 internally desynchronized human subjects. The observed sleep wake patterns obey a simple rule: The phase of the circadian temperature rhythm at bedtime determines the lengths of both prior wake (alpha) and subsequent sleep (rho). From this rule we derive an average alpha:rho relationship that depends on circadian phase. The relationship reconciles the established negative alpha:rho correlation observed in synchronized subjects with the positive alpha:rho correlation found in desynchronized subjects. Our most surprising result concerns the residual deviations of alpha and rho from their circadian phase-adjusted mean values. We report that there is no significant positive correlation between the residuals of alpha and rho, contrary to the prediction of restorative models of sleep duration. Our findings illuminate the mechanisms underlying sleep regulation and provide much-needed tests of mathematical models of the sleep-wake cycle. PMID- 3505736 TI - Evaluation of a filter/integrator system for quantifying delta activity in the sleep electroencephalogram. AB - The integrated output of a delta bandpass filter was evaluated as a means of quantifying delta activity in the sleep electroencephalogram (EEG). Total integrated slow wave amplitude (ISWA) and a density measure (ISWA/20-s epoch) were determined from four complete NREM sleep periods (NREMPs) on each of 2 baseline nights from 15 subjects. Total ISWA displays a linear decline across NREMPs, whereas ISWA/20-s epoch shows a curvilinear decline. Both measures show highly significant correlations with manually staged slow wave sleep and a high degree of intra-individual consistency between nights, for both whole-night values and those of individual NREMPs. The slow-wave density index (ISWA/20-s epoch) demonstrated consistently higher between-night correlations across NREMPs than did the total ISWA index, particularly in the first NREMP, suggesting it may better characterize the nightly distribution of delta activity in an individual's sleep EEG. PMID- 3505737 TI - The opioid system in the restless legs and nocturnal myoclonus syndromes. PMID- 3505738 TI - [Taxonomical study of spirochetes isolated from human periodontal lesions]. PMID- 3505739 TI - [Growth and development of the dental arch and alveolar ridge in the incisal segment, mainly in the late period of mixed dentition]. PMID- 3505740 TI - [Electron-microscopic study of dentin-bridge formation observed during the self healing process in exposed rat molar pulp]. PMID- 3505741 TI - [Statistics on autopsies performed in the Department of Pathology of the Tokyo Dental College between 1964 and 1984]. PMID- 3505742 TI - [Clinical statistical observation of impacted teeth by orthopantomograph]. PMID- 3505743 TI - A new type of methylamine oxidase: the sole oxidase produced during growth of Sporobolomyces albo-rubescens on primary alkylamines. AB - Under conditions known to separate methylamine oxidase from benzylamine oxidase in other yeast strains, only a single oxidase could be detected in Sporobolomyces albo-rubescens. This occurred irrespective of whether methylamine or n-butylamine was the nitrogen source for growth. The oxidase did not attack benzylamine. It was concluded that this organism can only produce a methylamine oxidase. The enzyme was purified to 90% homogeneity and found to have properties significantly different from the methylamine oxidases previously characterised. It lost only 40% of its activity in 30 min at 45 degrees C, whereas methylamine oxidases previously described had half-lives of from 2 to 9 min at 45 degrees C. It showed also a lower activity with short chain 1-aminoalkanes and a higher activity with longer chain 1-aminoalkanes than other methylamine oxidases, and had a significantly smaller subunit molecular weight (57,000 compared with 80,000). PMID- 3505744 TI - Synergistic effects of weak-acid preservatives and pH on the growth of Zygosaccharomyces bailii. AB - In completely randomised factorial experiments, individual and synergistic effects of pH, benzoic acid and sorbic acid on the growth rate of the yeast Zygosaccharomyces bailii were determined, and expressed in polynomial equations. Synergism between benzoic and sorbic acid was pH dependent. A distinct effect of the anionic form of benzoic acid on doubling time was demonstrated by experiments in which concentrations of benzoic acid and benzoate were varied. The resultant polynomial equation showed that both species act synergistically. PMID- 3505745 TI - [Institut Pasteur de Madagascar: Annual report 1986]. PMID- 3505746 TI - [Cation concentrations in myocardium and skeletal muscle of normal and hypertensive rats, young and adults]. PMID- 3505747 TI - [Endomyocardial biopsy of the right ventricle--9 years (1978-1987)]. PMID- 3505748 TI - [Aortoplasty with balloon catheterization in the treatment of aortic coarctation]. PMID- 3505749 TI - [Sydenham's chorea and cardiac orovalvar lesions]. PMID- 3505750 TI - [Acute myocardial infarction following dissection of the aorta during pregnancy. A case report]. PMID- 3505751 TI - [Paralysis of the left recurrent laryngeal nerve associated with patent ductus arteriosus. A case report]. PMID- 3505752 TI - [3rd Symposium on the Biology of Reproduction. Paris, 1987. Abstracts]. PMID- 3505753 TI - [A collaborative study of habitual abortion in couples with normal and abnormal karyotypes]. AB - A collaborative study in 732 couples presenting repeated spontaneous abortions (RSA) and normal karyotype and in 144 couples with RSA and chromosome abnormality has been carried out involving 18 French cytogenetic laboratories. Couples with RSA and normal karyotype were classified from prior reproductive history in order to find other etiological factors. Couples with RSA and abnormal karyotype were investigated with respect to the types of aberration and familial history. Results are compared to previous reports. PMID- 3505754 TI - [Estimation of the quality of embryos obtained during fertilization in vitro as a function of their morphology]. AB - Embryo quality after IVF should allow provisions for their pregnancy potential. We have classified all the transferred embryos into 4 types according to morphological criteria and we have studied the implantation rate of the different types. The results show: That pregnancies have been obtained with the 4 types of embryos. That it has been impossible to demonstrate statistically significant differences between the different types of transferred embryos even if embryos morphologically normal seem to be more favourable than others to induce a pregnancy. That the average implantation rate for each transferred embryo is of 14.4%. PMID- 3505755 TI - [45X/46XY formula and male sterility]. PMID- 3505756 TI - [A cytogenetic study of human gametes]. PMID- 3505757 TI - Peers, press, and public: a cautionary note. PMID- 3505758 TI - Taste aversion learning in autoimmune Mrl-lpr/lpr and Mrl +/+ mice. AB - Conditioned taste aversion to a neutral stimulus paired with an immunosuppressive drug (cyclophosphamide) was assessed in lupus-prone MRL-lpr/lpr and congenic control (MRL +/+) mice. The presence of lymphoproliferation in MRL-lpr/lpr mice was associated with poorer taste aversion learning and varied as a function of the dose of cyclophosphamide. There were no differences in learning performance between MRL-lpr/lpr and MRL +/+ mice when the animals were tested at an age prior to the development of lymphadenopathy, or when lithium chloride or electric shock were used as unconditioned stimuli. These results are consistent with the hypothesis that the immune status of an organism has an impact on behavior and the possibility that behavior can serve an in vivo immunoregulatory function. PMID- 3505759 TI - Conditioned tolerance to drug-induced (poly I:C) natural killer cell activation: effects of drug-dosage and context-specificity parameters. AB - Three experiments were conducted to evaluate the role of drug-dosage and stimulus specificity parameters on the tolerance of drug-induced (poly I:C) natural killer (NK) cell activity. In the first experiment a protocol which provided mice with four weekly 20 micrograms/mouse ip injections of the immunostimulatory synthetic polynucleotide (poly I:C) following exposure to either a simple odor cue or a complex cue resulted in tolerance of NK cell activity. The identical protocol with a higher drug dose (50 micrograms/mouse) did not produce tolerance. In a second experiment, the stimulus specificity of tolerance was assessed by giving two groups of mice repeated signaled drug injections. For one of these groups the final poly I:C injection of the series was signaled, while for the other group it was not. Although both groups were tolerant relative to controls not previously exposed to the drug, indirect evidence of conditioning was obtained. Specifically, it was found that tolerance among mice receiving the signal on the test was such that they were not different from undrugged controls, while uncued mice had significantly higher levels of NK cell activity. The third experiment evaluated the role of stimulus specificity within an extinction paradigm. It was found that tolerance was reversed in mice provided with repeated nonreinforced reexposure to drug-signaling cues, while mice exposed to novel cues remained tolerant. These results further support the hypothesis that associative factors contribute to the tolerance of a drug-induced immune response. PMID- 3505760 TI - Effect of differential housing and time on immune reactivity to sheep erythrocytes and Candida. AB - Male C3H/HeJ mice were housed 5 or 1 per cage for varying periods of time. Approximately 10-14 days after the animals were placed under the differential housing conditions, the reactivity of lymphocytes to concanavalin A and to intraperitoneal injection of sheep erythrocytes became greater in animals housed 1 per cage in comparison with those housed five per cage. By 3 weeks the immune reactivity was similar regardless of the number of animals housed per cage. Similarly, resistance to infection with Candida albicans was greater in animals housed one per cage at approximately 10-14 days after the animals had been isolated. By 3 weeks a difference in resistance to C. albicans was not apparent between animals housed 5 or 1 per cage. Thus, housing conditions can transiently alter immunologic reactivity, including susceptibility to an infectious agent in male C3H/HeJ mice. However, female C3H/HeJ mice and male C57BL/6J mice did not show an effect of housing conditions on immune reactions. PMID- 3505761 TI - Effects of high dietary contents of calcium and phosphorus on mineral metabolism and growth of vitamin D-deficient suckling and weaned rats. AB - We have tested the hypothesis that normalization of the plasma calcium (Ca) and phosphorus (P) concentrations by dietary means in vitamin D-deficient rat pups will prevent rickets. From day 6 of pregnancy rats were given a vitamin D-free diet containing 1.6% Ca and 1.4% P (-D 1.6) which normalized plasma Ca during lactation. Pups weaned from these mothers, and continuing on the -D 1.6 diet until 56 days of age, had a mean plasma Ca value of 8.6 +/- 0.2 mg/dl and were not significantly different from pups fed a vitamin D-replete diet with 0.4% Ca and 0.4% P in the following parameters: body weight (mean +/- SE for -D 1.6 rats: 197 +/- 4 g), percent bone ash (53 +/- 0.5), and tibia epiphyseal cartilage width (385 +/- 26 micron). In contrast, pups consuming the vitamin D-free diet with 0.4% Ca and 0.4% P had plasma Ca of 4.9 +/- 0.2 mg/dl, body weight of 156 +/- 4 g, reduced bone ash (45 +/- 0.5%) and abnormally wide epiphyseal cartilage (727 +/- 113 micron). Thus, elevating the plasma Ca level of vitamin D-deficient rat pups by dietary means can normalize body weight, epiphyseal cartilage width and bone mineral content. PMID- 3505762 TI - Effect of ipriflavone on accessory sexual organs and bone metabolism in male rats. AB - Ipriflavone administered for 10 days to orchiectomized rats did not show androgenic or androgen-augmenting activities. The wet weight of the accessory sexual organs, and dry weight, ash content and calcium content of the femur were decreased by orchiectomy and were restored by androgen administration, but were not influenced by ipriflavone administered alone or in combination with androgen for 21 days. In intact rats, ipriflavone increased these variables slightly or definitely. Basal and calcium-stimulated calcitonin levels in orchiectomized rats were not influenced by pretreatment with estrone (0.25, 0.5 and 1 microgram/kg body weight/day) or ipriflavone (100 mg/kg body weight/day) for 42 days but were increased significantly by simultaneous pretreatment with these compounds. Therefore, it might be concluded that the increase in bone variables in intact rats that received ipriflavone resulted, at least in part, from the augmentation by ipriflavone of estrogen, which exists in the peripheral blood of male rats, in addition to intrinsic androgen, which maintains bone mineral content. PMID- 3505763 TI - Corticosteroids inhibit the differentiation of U937 cells induced by the combination of lymphocyte-conditioned media and calcitriol. AB - Corticosteroids improve humoral hypercalcemia of malignancy in some patients presumably by decreasing osteoclast activity or number. Using the monoblastic U937 cell line as a model of osteoclast formation, it is shown that hydrocortisone (10(-6)M) and dexamethasone (10(-6)M) completely inhibited lymphokine-induced formation of mature, adherent cells. These changes were concentration dependent and specific for corticosteroids since neither progesterone nor 17 beta-estradiol produced similar effects. When used alone none of these hormones had toxic effects on U936 cells nor did they directly cause differentiation. These data are consistent with the possibility that in some types of humoral hypercalcemia of malignancy corticosteroids may work by inhibiting osteoclast formation from their precursors. PMID- 3505764 TI - Direct and indirect radiation effects on osteoclast formation in vitro. AB - An in vitro co-culture system was applied to study the direct and indirect effects of irradiation on osteoclast formation. Osteoclast precursor-free fetal mouse metatarsal bones were employed as osteoclast-forming inductor and periostea dissected from fetal calvaria as source of proliferating progenitor cells. Direct radiation effects on the formation of osteoclasts were assessed in co-cultures of irradiated periostea and non-irradiated bone rudiments. The results showed that the (blood-borne) periosteal progenitors were rather radiosensitive. A radiation 'survival' curve of osteoclast formation in relation to various doses could be constructed yielding a mean lethal dose (Do value) of 0.94 +/- 0.02 Gy and an extrapolation number of 1.67 +/- 0.01. Irradiation of the fetal long bones by low doses, effective for direct elimination of osteoclast progenitor cells, did not indirectly affect osteoclast development from the non-irradiated periosteal progenitor population. However, at relatively high radiation levels, though not lethal for the long bone rudiments, a significant inhibition of osteoclast formation became evident. The results indicate that radiation primarily affects osteoclast formation via a direct action on radiosensitive, proliferating progenitor cells. Injury to long bone models by relatively high radiation doses may also lead to severe disturbance of osteoclast formation kinetics. PMID- 3505765 TI - Trabecular and cortical bone in the radii of women with parathyroid adenomata: a greater trabecular deficit, with a preliminary assessment of recovery after parathyroidectomy. AB - Radial bone mineral content (BMC) has been reported to be lower than normal in patients with hyperparathyroidism, but those measurements have been made with techniques which do not discriminate between trabecular and cortical bone. We have used a low radiation dose computed tomography technique to make differential measurements of trabecular and cortical bone in the radii of 18 out of 27 eligible female patients with surgically proven adenomata. Prior to parathyroidectomy there was a mean deficit of 40% (P less than 0.001) in trabecular bone density in the distal radius, and a deficit of 16% in cortical bone in the radius mid-shaft compared to normal values. Seventeen months after parathyroidectomy there was a small but significant increase in trabecular bone density in the distal radius in 13 of these patients, and no significant change in cortical bone. If these results represented the situation throughout the skeleton, it is possible that parathyroidectomy may provide some reduction in future risk of fracture in women with primary hyperparathyroidism. PMID- 3505766 TI - The changes in plasma diffusible levels and renal tubular handling of magnesium during pregnancy: a longitudinal study. AB - Magnesium fasting plasma levels (total, PMg, and ultrafiltrable, PMgUF), daily urinary excretion and tubular reabsorption in the fasting state were measured in 14 healthy women along an uncomplicated gestation and compared with the values observed 3-6 months after delivery (C). PMg and PMgUF progressively fell during gestation (from 1.96 +/- 0.14 and 1.38 +/- 0.09 mg/dl in C, respectively, to 1.67 +/- 0.13 (P less than 0.0005) and 1.2 +/- 0.09 (P less than 0.0005) after 17-26 weeks of gestation and to 1.66 +/- 0.10 (P less than 0.0005) and 1.17 +/- 0.08 (P less than 0.0005) after 27 weeks to term). The decrease in PMg and PMgUF was further apparent in an additional group of 46 pregnant women in comparison with 20 sex-matched non-pregnant controls. Urinary Mg excretion remained unchanged throughout gestation, as did glomerular filtered load of PMgUF and tubular Mg reabsorption in the fasting state, due to the increase in GFR. Moreover, urinary Mg excretion per unit GFR (MgE, mg/dlGFR) and fractional excretion of MgUF filtered load (FEMgUF, %) fell (from 41 +/- 25 and 3.0 +/- 0.9 in C, respectively, to 26 +/- 12 (P less than 0.01) and 2.2 +/- 1.0 (P less than 0.05] in the last period, indicating that a greater fraction of filtered Mg was being reabsorbed by renal tubules. There was a significant inverse correlation between PMgUF and GFR in all the periods studied (r = 0.39, P less than 0.025).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3505768 TI - Increased bone formation and decreased bone resorption in fetal mouse calvaria as a result of intermittent compressive force in vitro. AB - We have shown earlier that hypertrophic chondrocytes of growth plate cartilage in vitro react to an intermittent compressive force (ICF) of physiological magnitude by an increased calcification of the matrix. In this communication, we report the influence of ICF on bone metabolism, i.e., osteoblastic and osteoclastic activity, using fetal mouse calvaria in vitro. Seventeen-day-old calvaria were cultured for 5 days under control conditions (atmospheric pressure), or under the influence of ICF. ICF was generated by intermittently compressing the gas phase above the culture medium (130 mbar, 0.3 Hz). Osteoblastic activity was monitored by measuring alkaline phosphatase (AP) activity and 45Ca incorporation into the bone mineral. Osteoclastic resorption of the mineral phase was monitored by measuring the release of 45Ca from prelabeled bone rudiments. In addition, the total mineral content (Ca and Pi) of the calvaria was determined. Exposure to ICF resulted in a significant increase in bone formation, indicated by an enhanced alkaline phosphatase activity and increased incorporation of 45Ca, as well as a decreased bone resorption. The combined effects led to a net increase in mineral content per calvarium of some 16%. We conclude that both osteoblasts and osteoclasts are affected by intermittent compressive force. Osteoblasts are stimulated, and osteoclasts are inhibited in their activity and/or growth. The effect of ICF on osteoblasts is comparable with the effect on fetal growth plate chondrocytes; both cell types respond to ICF by an increase in calcium-phosphate mineral deposition in the matrix. The lower bone resorption may be a direct effect of ICF on osteoclasts, but it is also possible that osteoblasts play an intermediate role. PMID- 3505767 TI - A correlation and path coefficient analysis of components of calciuria in normal subjects and idiopathic stone formers. AB - The composition of 24 h urine samples collected by 50 normal controls and 76 stone formers (30 hypercalciurics, 13 hyperuricosurics and 33 patients without metabolic abnormalities) were studied. Statistically significant multiple regression equations were obtained between calciuria and the urinary excretions of sulfate, citrate, sodium and creatinine. The three former ions were selected as variables because they were assumed to affect the tubular fluid concentration of ionized calcium and interfere with the reabsorption of calcium. Urinary creatinine was included because it increased the statistical significance of the multiple regression equations; it is assumed to be a function of body size. The regression equations differed between both groups of subjects because stone formers excreted significantly more sulfate and less citrate than controls. The four factors considered (sulfate, citrate, sodium and creatinine) account for 28.3, 6.8, 7.3 and 26.4% of the total variation of calciuria of normal controls and 45.0, 2.6, 8.6 and 14.7%, respectively, for stone formers. PMID- 3505769 TI - Comparative studies of membrane potentials of rat osteoblasts in situ and in primary culture. AB - The aim of the present study was to compare the membrane potential, Vm, of rat calvarium osteoblasts in situ and during primary culture using electrophysiological techniques. For osteoblasts studied in situ the Vm (mean +/- S.D.) was found to be -42.0 +/- 10 mV, n = 32. Comparable values (-46.8 +/- 9.n, n = 152) were found for cultured osteoblasts during the first week. Thereafter when cells began to form multilayers an increase in Vm negativity was observed ( 58.6 +/- 12.8, n = 82). The Vm of osteoblasts in situ and during the first week of culture were highly dependent on the Na+ diffusion potential and slightly influenced by the increase in extracellular [K+]. In contrast, the more negative Vm of the cells cultured 2 weeks were highly dependent on the K+ diffusion potential and were not influenced by changes in external [Na+]. Parathyroid hormone (bPTH(1-34], 240 nM, in the external solution, induced a rapid membrane depolarization in situ (+10.2 +/- 5.0, n = 18) as it does in cultured cells. Additional investigation on the possible effects of Ca2+ and PO4(2-) (since, in situ, mineralized matrix prevents such an approach) showed that low external [Ca2+] only slightly hyperpolarizes the membrane, whereas cell Vm was highly sensitive to changes in external [PO4(2-)]. PMID- 3505770 TI - Circulating 1 alpha,25-dihydroxyvitamin D levels after a single dose of 1 alpha,25-dihydroxyvitamin D3 or 1 alpha-hydroxyvitamin D3 in normal men. AB - In order to clarify the differences between 1 alpha,25-dihydroxyvitamin D3 (1,25(OH)2D3) and 1 alpha-hydroxyvitamin D3 (1(OH)D3) as a drug, we determined the serum levels of 1,25(OH)2D at different times after oral administration of each drug to normal men. In the paired test which was carried out on the same people, the integrated change of serum 1,25(OH)2D levels, defined as the mean area under the concentration curve over 24 h, was significantly higher in the 1,25(OH)2D3 group than in the 1(OH)D3 group. The mean of the peak serum level (Cmax) was also significantly higher in the former group. On the other hand, the mean time to reach the peak level (Tmax) was significantly shorter in the 1,25(OH)2D3 group than in the 1(OH)D3 group. The same results were obtained even when we performed the non-paired administration tests. In the present study, the peak serum level of 1,25(OH)2D after ingestion of a single dose of 1,25(OH)2D3 was reached rapidly, i.e., between 4 and 6 h, and the value had usually returned to the baseline by 24 h. On the contrary, 1(OH)D3 administration resulted in a slow rise in the serum level of 1,25(OH)2D with a relatively low peak level. Therefore, clinical use of these two drugs demands careful consideration of their differences. PMID- 3505771 TI - Immunoreactive parathyroid hormones in the circulation and cerebrospinal fluid from patients with renal failure: possible restriction of parathyroid hormone by the blood-brain barrier. AB - Parathyroid hormone is reported to be a possible causal factor of abnormalities of electroencephalograms of patients with renal failure. In this study, the parathyroid hormone levels were compared in the circulation and cerebrospinal fluid of seven normal subjects and 22 patients with renal failure including those who showed abnormal electroencephalograms. The circulating levels of both C terminal and N-terminal parathyroid hormone in the subjects studied showed a positive correlation (C-terminal, r = 0.58, P less than 0.01; N-terminal, r = 0.61, P less than 0.01) with the grade of abnormality of the electroencephalogram. However, the levels of C-terminal and N-terminal parathyroid hormone in the cerebrospinal fluid of both normal subjects and patients with renal failure were below the detectable limit (C-terminal, less than 0.1 ng/ml; N-terminal, less than 2.3 pg/ml). These data suggest that in patients with renal failure, the effect of parathyroid hormone on the central nervous system is mediated in some other way than via the cerebrospinal fluid. PMID- 3505772 TI - [Multivariate analysis of the relationships among concentrations of bicarbonate and inorganic phosphorus, flow rate, and buffer capacity of saliva]. PMID- 3505773 TI - [Electron microscopical study on the subcutaneously transplanted cartilage of the rat rib]. PMID- 3505775 TI - Study of the displacement during articulator adjustment. Part 1: Vertical displacement. PMID- 3505774 TI - [Influence of duration of water exposure after the mixing of Fuji ionomer cement on appearance of color]. PMID- 3505776 TI - [Effect of buccolingual position of cusp and gingival width on food flow- analysis by the finite element method]. PMID- 3505777 TI - Studies on drinking water at selected locations in the State of Mexico, Mexico. PMID- 3505778 TI - [Purification and properties of lactate dehydrogenase-1 isozyme from dental pulp]. PMID- 3505779 TI - [On the facial muscles of the rabbit]. PMID- 3505780 TI - [Developmental abnormality of medullated nerve fibers in the retina as complication of multiple jaw cysts]. PMID- 3505781 TI - [Treatment of mandibular fracture using ceramic screws]. PMID- 3505782 TI - [A study on psychological factors related to dental health--with an original dental questionnaire]. PMID- 3505783 TI - [Studies on the new clinical marker of diabetes mellitus (2)--Human erythrocyte insulin receptor]. PMID- 3505784 TI - [Nitrite reductase in soluble cytoplasmic fraction and particulate membrane-bound fraction from Veillonella]. PMID- 3505785 TI - [Peroxidase and glycoprotein in salivary glands of beige (Chediak-Higashi) mice]. PMID- 3505786 TI - [Statistical review of patients with malignant tumors of the jaw and oral cavity]. PMID- 3505787 TI - Studies on the photodegradation of platonin and the effect of irradiation on the hepatocyte suspension containing the drug. PMID- 3505788 TI - [Electron microscopic observations of the soft tissue in the gubernacular canal]. PMID- 3505789 TI - [Histological study on osteoid- and cementoid-like tissues of rats treated with dihydrotachysterol]. PMID- 3505790 TI - Sagittal splitting ramus osteotomy. PMID- 3505791 TI - [Effect of low-calcium diet on tooth movement in the rat]. PMID- 3505792 TI - [Modulators of catecholamine synthesis in rat salivary glands (2). The activity of GTP cyclohydrolase in salivary glands of young and adult rats]. PMID- 3505793 TI - Study of displacement during articulator adjustment. Part 2: Lateral displacement. PMID- 3505794 TI - [Psychological perception of X-ray film graininess. I: Evaluation by blending distance method]. PMID- 3505795 TI - [Psychological perception of X-ray film graininess. II: Measurement of physical granularity and matching with between granularity and graininess]. PMID- 3505796 TI - [Experimental study of the mechanism of orbital floor fracture]. PMID- 3505797 TI - [Ciliocytophthoria (CCP) in nasal secretions--relation of viral infection to otorhinological disease]. PMID- 3505798 TI - [Stereological study on the ductal system of the goat parotid gland]. PMID- 3505799 TI - [Studies of radiographic analysis and clinical examination in haemodialysed patients. (1st report)]. PMID- 3505800 TI - [Fractionation of lactate dehydrogenase isozyme from pig dental pulp, and comparison of the properties in each isozyme]. PMID- 3505801 TI - [Studies on coloration of various composite resins]. PMID- 3505803 TI - [A rapid, simplified procedure for simultaneous assay of 5-hydroxytryptamine and metanephrines on thin-layer chromatograms]. PMID- 3505802 TI - [Clinico-pathological study on giant cell fibroma of oral mucosa]. PMID- 3505804 TI - [A case report of secondary glaucoma following central retinal artery occlusion]. PMID- 3505805 TI - [Osteosynthesis with titanium miniplate]. PMID- 3505806 TI - High-performance liquid chromatography of fluorescent components in serum. PMID- 3505807 TI - [Study on castable glass ceramic inlays: adaption to the cavity]. PMID- 3505808 TI - [Age-related changes in lectin binding patterns of rat cartilaginous tissues]. PMID- 3505809 TI - [Clinical evaluation of automated perimetry with OCTOPUS 500 E]. PMID- 3505810 TI - [The infraorbital artery and its branches in the guinea pig]. PMID- 3505811 TI - [The arterial distribution to the floor region of the mouth and the submandibular region of the hamster]. PMID- 3505812 TI - [The arterial distribution to the palate of the crab-eating monkey]. PMID- 3505813 TI - [Incidence of sites of chromosomal fragility in the child]. PMID- 3505814 TI - [Compressive strength of human dentin]. PMID- 3505815 TI - [Study on "photo stimulative effect" of soft laser; the effect of its irradiation on carrageenan granuloma pouch]. PMID- 3505816 TI - Study of displacement during articulator adjustment. Part 3: Anteroposterior displacement. PMID- 3505817 TI - [Effects of various solvents on dentin permeability to dyes]. PMID- 3505819 TI - [Electron microscopic observations of the soft tissue in the gubernacular canal. 2. Epithelial remnants]. PMID- 3505820 TI - [Fine structure of pollen of cupressaceae]. PMID- 3505818 TI - [Studies on the palates of children 9 to 12 years old by Moire topography]. PMID- 3505821 TI - [Sex differences in the palate of the crab-eating monkey as noted by Moire topography--the first stage of deciduous dentition]. PMID- 3505822 TI - [Two cases of impacted second molar]. PMID- 3505823 TI - Critical care management of the trauma patient. PMID- 3505825 TI - [Mechanical properties of experimental dental composite resin]. PMID- 3505824 TI - [An electrochemical study for the relative sealing ability of several root canal sealers combined with gutta percha point]. PMID- 3505826 TI - [Chromosome aberration and sister chromatid exchanges induced by eugenol in Chinese hamster cells]. PMID- 3505827 TI - [Clinical data analysis in the Division of Operative Dentistry, Dental Department of the National Taiwan University Hospital]. PMID- 3505828 TI - [Myxoma of the maxilla--a case report]. PMID- 3505829 TI - Sperm auto-immunity associated with vasectomy, vasovasostomy and epididymovasostomy in Korean males. AB - The prevalence and pattern of circulating antisperm antibodies were assessed in the serum of Korean males undergoing vasectomy, vasovasostomy, epididymovasostomy and in a control group of men with normal semen by means of the gelatin agglutination test and the tray agglutination test. Sperm-agglutinating antibodies in serum were positive at a titre of 1:32 or greater in 3% of normospermic control males and in 27% of vasectomized men. No significant changes were observed in prevalence of the antibodies over the period following vasectomy. There were no significant differences in prevalence of antibodies in patients with and without postoperative sperm granulomas. Antibodies were positive in 35% of vasectomized men just prior to vasovasostomy and in 29% of patients 12 months after a successful (patent) reversal operation. There was no significant difference in prevalence of antibodies in patients with successful and unsuccessful vasovasostomies. Antibodies were positive in 20% of men who achieved pregnancies and in 43% of those with persisting infertility in the presence of a patent vasovasostomy. Sperm agglutinating antibodies were present in 5% of the patients with pathological epididymal obstruction. They were negative in patients with a patent epididymovasostomy and positive in 17% of those with an unsuccessful epididymovasostomy. The four patients who achieved a pregnancy after epididymovasostomy were antibody-negative. The prevalence of antibodies in the serum of patients with azoospermia due to surgical vasal obstruction was higher than that in patients with azoospermia due to pathological epididymal obstruction. The agglutination patterns produced by sperm antibodies in the total group of positive sera were tail-to-tail in 56%, head-to-head in 30% and mixed in 14%. PMID- 3505830 TI - Does treatment with bromocriptine influence the course of hyperprolactinaemia? AB - Twenty-two women with hyperprolactinaemia without evidence of microadenoma, either untreated (n = 3), treated with bromocriptine for a total of less than 1 year (n = 12), or treated with bromocriptine for a total of more than 1 year (n = 7) were followed up by retrospective case-note review for at least 53 months. More than 50% of the women showed a fall in serum prolactin concentrations by more than 40% over the period of follow-up. The occurrence of a fall did not appear to be related to either length of treatment with bromocriptine or to the occurrence of pregnancy. Some women elected to remain untreated, despite symptoms, in preference to taking tablets and having to use contraception. The wisdom of leaving patients untreated in the light of these findings is discussed. PMID- 3505831 TI - Relationship between the coagulation-liquefaction property of human ejaculates and their volume, sperm count and motility. AB - In ejaculates from selected infertile couples, the degree of coagulation revealed significant positive correlations with liquefaction time, sperm count and motility, but negative correlation with semen volume. Comparison of presumptively fertile and infertile ejaculates also showed significant variations in their amount of coagulum and liquefaction time. The study suggested a possible relationship between the coagulation-liquefaction property of human ejaculates and their semen quality. PMID- 3505832 TI - Tongue brushing versus tongue scraping. PMID- 3505833 TI - Quality of dental and preventive care in military setting. PMID- 3505834 TI - Practical procedures involved in reducing postoperative visits. PMID- 3505835 TI - The antiplaque effect of toothpaste containing salvadora persica compared with chlorhexidine gluconate. PMID- 3505837 TI - Controversy over effects of peptide T on AIDS virus intensifies. PMID- 3505836 TI - Comparison of the Silness-Loe (1964) Index with gravimetric measurement of dental plaque. PMID- 3505838 TI - Consideration of platelet effects in the selection of an anti-inflammatory agent. PMID- 3505839 TI - Comparing warfarin-dosage-prediction techniques. PMID- 3505840 TI - Evaluation of prenatal vitamin-mineral supplements. AB - Nutritional requirements of pregnancy are reviewed, and guidelines for evaluating prenatal vitamin-mineral supplements are provided. Daily antepartum supplementation of 0.4-0.8 mg of folic acid and 30-60 mg of elemental iron is currently recommended, although the lower ends of these ranges may be most appropriate. Dietary intake of these nutrients is likely to be inadequate without supplementation, and their importance is well established. Requirements for other minerals and vitamins are not well established, and there is no consensus on the need for supplementation. However, available data suggest that prenatal supplements should probably contain other nutrients; pyridoxine hydrochloride, cholecalciferol, vitamin E, pantothenic acid, calcium, magnesium, zinc, copper, and possibly selenium should be considered. Interactions among the minerals and vitamins commonly found in prenatal supplements may affect the absorption of various nutrient components. Thus, very high or low levels of certain nutrients should be avoided. The chemical form of minerals should also be considered. Products should have demonstrated bioavailability for iron, zinc, and other components that are subject to bioavailability problems. Use of low-potency product that contains a wide range of vitamins and minerals appears to be the most prudent approach to prenatal vitamin and mineral supplementation. PMID- 3505841 TI - Accuracy of Bayesian, Sawchuk-Zaske, and nomogram dosing methods for vancomycin. AB - The predictive performance of a Bayesian method for vancomycin dosing was compared with that of two nomogram-based methods and the Sawchuk-Zaske method. Prospectively collected serum concentration data were evaluated retrospectively in patients who had at least two steady-state peak and trough serum vancomycin concentrations obtained during two different dosage regimens. The methods evaluated were a Bayesian program that uses a one-compartment weighted-sum-of squares expression; the nomogram methods of Moellering and Matzke, which derive vancomycin clearance from urinary creatinine clearance; and the Sawchuk-Zaske method, which uses equations for one-compartment, first-order elimination. The ability of each method to predict the second set of serum concentrations when given the first set of concentrations was evaluated using mean prediction error (ME), mean absolute error (MAE), and root mean squared error (RMSE). To compare the predictions made by each of the four methods, the differences in mean error and the differences in the natural logarithm of mean absolute error and their 95% confidence intervals were compared. No significant difference in ME (bias) or MAE (precision) was found between the Moellering and Matzke methods. The Sawchuk Zaske method was significantly more precise than the Matzke method in predicting peak serum concentrations and more precise than the Moellering or Matzke method in predicting trough concentrations. The Bayesian program was significantly more precise and less biased than the Moellering and Matzke methods and less biased than the Sawchuk-Zaske method in predicting both peak and trough concentrations.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3505843 TI - Effect of dicloxacillin sodium on the hypoprothrombinemic response to warfarin sodium. PMID- 3505842 TI - Steady-state pharmacokinetics of two sustained-release theophylline products during once-daily and twice-daily dosing. PMID- 3505844 TI - Safety and antiemetic effects of metoclopramide in metrizamide myelography. PMID- 3505845 TI - Recognizing minor psychiatric disorders at primary health care level. PMID- 3505846 TI - Prevalence of psychiatric morbidity and utilisation of traditional healers in a general outpatient clinic in Nigeria. PMID- 3505847 TI - Childhood empyema in south east of Nigeria. PMID- 3505849 TI - Caesarean-section: indications and maternal mortality at Pumwani Maternity Hospital, Nairobi (1983). PMID- 3505848 TI - Pulmonary oedema between dialyses during intermittent haemodialysis at the Kenyatta National Hospital (KNH). PMID- 3505850 TI - Menarche in African girls in some post-secondary institutions in Kenya. PMID- 3505851 TI - Hormonal and biochemical evaluation of azoospermic men in Cameroon. PMID- 3505852 TI - Epidemiology and strategy of goitre control in Malawi. PMID- 3505853 TI - Ten years experience of a diabetes clinic in northern Tanzania. PMID- 3505854 TI - Acute balantidial dysentery associated with cholera: a case report. PMID- 3505855 TI - Malaria: its therapy and drug resistance. PMID- 3505856 TI - Menarche in African secondary school girls in Kenya. PMID- 3505857 TI - Female genital granuloma venereum at University Teaching Hospital, Lusaka. PMID- 3505858 TI - The chronic leukaemias in Benin City, Nigeria. PMID- 3505859 TI - Psychotic and non-psychotic temporal lobe epileptics. PMID- 3505860 TI - Africa immunization year 1986 (Botswana experience). PMID- 3505861 TI - Chloroquine administration in the treatment of malaria with reference to brands, specification and dosage: a survey in north-eastern Tanzania. PMID- 3505862 TI - Behcets syndrome presenting with multiple cerebral and brainstem infarcts: a case report. PMID- 3505863 TI - Advances in prenatal diagnosis. PMID- 3505864 TI - The outcome of psychiatric hospitalization at a Nigerian state hospital. PMID- 3505865 TI - A study on the prevalence of rotavirus diarrhoeas in Ohaozara local government area, Imo State, Nigeria and the Lagos University Teaching Hospital, Lagos, Nigeria. PMID- 3505866 TI - Open study in the treatment of Trichuris trichiura and Taenia saginata with 800 mg albendazole as a single dose. PMID- 3505867 TI - Anaesthesia for bronchoscopy in children with inhaled solid foreign body: a review of thirty-six cases. PMID- 3505868 TI - Minor and major phlebectasia: a report of three cases. PMID- 3505869 TI - District focus: trends in transfusion therapy: revisited. PMID- 3505870 TI - Comprehension of informed consent information by young-old through old-old volunteers. AB - Comprehension of typewritten informed consent information was evaluated for young old (60-69 years) through old-old (80-89 years) volunteers as a function of years of education (less than 12, 12, and greater than 12), readability of information (low [college level] vs high [7th grade]), and typeface used in the preparation of the materials (Prestige Elite 72, Letter Gothic, and Orator). All volunteers (N = 235) read a typewritten information sheet and retained it for review while answering eight multiple choice questions. Immediate feedback was provided, and a second test was administered if any answers were incorrect. The findings indicated that comprehension varied directly with education and inversely with age. Typeface and age interacted due to age-related differences with the two smaller (Prestige Elite and Letter Gothic), but not with the largest of the typefaces (Orator). These findings suggest that the observed age-related differences may have been due to visual and not cognitive deficits. Readability did not affect performance either by itself or in combination with any other variable. PMID- 3505871 TI - Levels upon levels: predicting age differences in text recall. AB - Younger and older adults read and recalled narrative and expository prose passages of varying propositional density. Age differences in recall were smaller when text units were from higher levels in a coherence graph and when the young and elderly groups compared were higher in verbal ability. The extent to which age differences were moderated by these factors varied, however, as a function of text characteristics. These results reinforce the position that the extent of age differences in text recall depends on both text and reader characteristics. PMID- 3505872 TI - The effect of mnemonic training on perceived recall confidence in the elderly. AB - This study examined the effects of memory training on the relationship between perceived recall confidence and recall performance. The sample consisted of 76 elderly, community dwelling volunteers. Fifty-nine individuals received eight hours of memory training; the remaining 17 were wait-list controls. Participants were tested at pre- and post-intervention, and rated their confidence for recall of name-face pairs prior to each testing. The results showed a significant improvement in name-face recall at post test, favoring the group receiving mnemonic training. There was a significant association found between confidence ratings and recall performance at post-test. A closer examination of standardized regression residuals (confidence ratings and number of name-face pairs recalled) revealed that with mnemonic training, there was an improvement in the relationship between perceived confidence and recall performance following mnemonic training. The results suggest that the ability to assess changes in recall capacity and to judge future memory performance is enhanced by exposure to mnemonic training. PMID- 3505873 TI - Origins of stereotypes of the elderly: an experimental study of the self-other discrepancy. AB - An experiment using young and old subjects was carried out to test two different explanations for the Harris survey data showing that elderly persons rate their own lives much more positively than they rate the lives of similarly aged others. The informational bias explanation suggests that the old (and young) are passive recipients and mediators of widely disseminated information concerning the life problems of the elderly. The negative evaluations of the elderly in general reflect in part the objective conditions of the lives of the elderly and the tendency of the media to focus on the problems of the elderly. In contrast, self evaluations are relatively positive because generalized views of growing old are attenuated by lowered expectancies regarding living conditions in late life. The motivational bias explanation assumes a self-enhancing cognitive bias among the elderly that causes them to devalue the lives of similarly aged others. The first explanation is supported by replicating the Harris poll data and demonstrating that the self-other discrepancy can be systematically manipulated by varying, in theoretically relevant ways, the instructions given to subjects. PMID- 3505874 TI - Self-perception of personality at midlife in elderly people: continuity and change. AB - This study examined the extent of self-perceived continuity and change in personality in older people. Two visits were made to 362 elderly female and male volunteers, randomly assigned to either an experimental or control condition. In the first visit, the subjects completed a life interview and psychological battery including the Eysenck Personality Inventory. In the second visit, the experimental subjects had their life circumstances at age 40 reviewed and were asked to complete the personality inventory again, this time answering as if they were aged 40. Control subjects completed the personality inventory twice under standard directions. The dominant pattern for individuals in both conditions was one of personality continuity, however, subjects in the experimental group had significant differences between scores in the two test administrations, while the scores of control group subjects did not change significantly. Current personality scores were the major predictors of perceived personality at midlife, although ratings of financial adequacy and subjective age were also significant but minor predictors in the experimental condition. PMID- 3505875 TI - The verbal selective reminding test: preliminary data for healthy elderly. AB - The verbal selective reminding test was administered to sixty independent living well-educated, healthy elderly, aged 65-75. All subjects met exclusion criteria which were designed to ensure that the results were not secondary to deficits in attention, verbal fluency and intellectual function. On selective reminding, the females did significantly better than the males on most dependent measures. Males and females showed a significant decrease from last trial recall to recall following a fifteen minute delay. PMID- 3505876 TI - Similarities in visual imagery ability in young and old women. AB - Young (age 25 to 39 years, n = 50) and old (age 65 to 79 years, n = 50) women were administered both subjective and objective measures of imagery ability and imagery control. Little evidence of an age-related deficit in image vividness was observed. It would appear that imaginal ability does not vary with age. Alternatively, self-reports of images may not be accurate representations of images experienced. PMID- 3505877 TI - An examination of the relationship between parental intelligence and children's age: preliminary findings. PMID- 3505878 TI - Inversion polymorphism in species of the Drosophila nasuta subgroup from Thailand. AB - Thailand populations of three species of the D. nasuta complex have been analysed for the presence of paracentric inversions. D. albomicans and D. sulfurigaster albostrigata were collected from Phuket, Chiang Mai and the River Kwai, whilst D. kohkoa was found only in Phuket and the River Kwai. Chromosomal polymorphism was studied in respect to geographical distribution. The Phuket populations of all three species proved to be highly polymorphic by comparison with the River Kwai and Chiang Mai populations. The heterozygosity frequencies of inversions were calculated and the variations interpreted as a result of adaptation to local ecogeographical conditions. Shared polymorphisms revealed that D. kohkoa and D. s. albostrigata are more closely related to D. albomicans than they are to each other. PMID- 3505879 TI - A polymorphic variant of the lactate dehydrogenase B subunit in the rat. AB - A new electrophoretic variant of the lactate dehydrogenase B subunit was found in the erythrocytes of the COP strain of the rat. The location of the band after the electrophoresis suggested a product of the structural gene for the B subunit. Two alleles that regulated the high amount (Ldh-2a) or the low amount (Ldh-2b) of the B subunit were found and segregated in Mendelian fashion. The activity was regulated by the closely linked (less than 1 cM) regulatory gene Ldr-1. PMID- 3505880 TI - The genetic basis of resistance and sensitivity to the meiotic drive gene D in the mosquito Aedes aegypti L. AB - A study has been made on the genetic basis of meiotic drive at the Distorter (D) locus which, in coupling with the male-determining gene (or region) M on the Y chromosome, causes production of excess male progeny. Its effect is regulated by the sensitivity/resistance of the X chromosome. This study demonstrates that there are two major loci controlling resistance/sensitivity to MD: (1) the m gene (or region) on the X chromosome (allelic with M) which may be either mR or mS (resistant or sensitive), (2) the t (tolerance) gene (or genes) which recombines with m and, if present, largely counteracts the effect of mS. There is also evidence that MD itself is capable of limited adaptation. The conclusions were derived from using MD males of the T30 or ACCRA strains (from Trinidad and Ghana respectively). The work involved the use of the CHIPEI and RED strains with sensitive X chromosomes, the latter also carrying the t (tolerance) gene which is linked to re (red eye) and m (the sex-determining locus or region) but recombines with both. The implications of these findings for using MD as a method of population control are discussed. PMID- 3505881 TI - Non-random associations between Lap and Pept-1 loci and gene arrangements of chromosome O in D. subobscura--experiments in laboratory populations. AB - In this paper the well-known non-random associations between Lap and Pept-1 loci and gene arrangements of chromosome O are studied in laboratory populations of D. subobscura. An increase of the frequency of the allele Lap1.00, towards an equilibrium point (0.70), was found to be associated with an increase of the gene arrangement O3+4. This is an accordance to the associations found in natural populations. On the contrary no such an increase was observed in populations polymorphic for Lap and Pept-1 loci but homokaryotypic for gene arrangement O3+4+8 differing in the initial allele frequencies at these loci. Although epistatic selection cannot be completely ruled out, our results are better explained under the assumption of neutrality. PMID- 3505882 TI - DNA composition in South American camelids. I. Characterization and in situ hybridization of satellite DNA fractions. AB - The DNA composition and the in situ hybridization of satellite fractions were analysed in the New World camelids llama, alpaca, guanaco and vicuna. In the four camelid forms, it was possible to identify a similar main band DNA and five satellite fractions (I-V) with G + C base contents ranging from 32% to 66%. Satellites II-V from llama were in situ reannealed on chromosomes from the four camelid forms. The results obtained were: (a) the four satellites hybridized with regions of C-banding (centromeric regions of all chromosomes and short arms of some autosomes); (b) in general, homologous hybridizations (llama DNA versus llama chromosomes) were more efficient than heterologous reassociations; there were however three exceptions to this rule (vicuna and alpaca satellite fraction II, chromosome group B; vicuna fraction V, chromosome groups A and B); (c) X chromosomes from the four camelids had satellites III-V but lacked satellite II, (d) no satellite fraction was detected on chromosome Y. The analysis of the in situ hybridization patterns allowed to conclude that most or all C-banded chromosome regions comprise several satellite DNA fractions. It is, moreover, proposed that there is an ample interspecies variation in the number of chromosomes that cross-react with a given satellite fraction. Our data give further support to the close genomic kinship of New World camelids. PMID- 3505883 TI - Nonhomologous synapsis of the XY during early pachynema in In(X)1H male mice. AB - It has been previously supposed that meiotic synapsis is restricted to homology during early, but not late pachynema. The synaptic behavior of an inverted X chromosome, In(X)1H as reflected in the synaptonemal complexes of the sex chromosomes has been examined in microspread spermatocytes by electron microscopy and evidence of extensive nonhomologous synapsis between the X and Y during early pachynema has been obtained. PMID- 3505884 TI - Structural rearrangements of chromosome Nr 8 involving 8q12--a primary event in pleomorphic ademona of the parotid gland. AB - Nine pleomorphic adenomas of the human parotid gland were investigated. Within this series the group of cases having clonal aberrations of chromosome Nr 8 predominates. The occurrence of cases with trisomy-8 and cases with structural rearrangements involving a breakpoint in 8q11-8q13 allows a further subdivision of this group of tumors. Our special interest in this paper is devoted to the latter group. The hypothesis is proposed that in these cases the chromosomal rearrangement is the primary event in tumorigenesis, leading to activation of a so far unknown oncogene located most likely at 8q12. The translocations to different recipient chromosomes may serve as sign posts to transcriptionally active chromosomal domains in the salivary gland. PMID- 3505886 TI - Decision making in genetic management of primate breeding colonies. AB - A method is described by which systematic decisions about future membership in a breeding colony of baboons are made on the basis of rarity of known genetic marker phenotypes, and reproductive performance. PMID- 3505885 TI - The genetic consequences of primate social organization: a review of macaques, baboons and vervet monkeys. AB - Primates, as long-lived, iteroparous, socially complex mammals, offer the opportunity to assess the effects of behavior and demography on genetic structure. Because it is difficult to obtain tissue samples from wild primate populations, research in this area has largely been confined to terrestrial and semi-terrestrial old world monkeys (e.g., rhesus and Japanese macaques, vervets and several subspecies of baboons). However, these species display a multi-male, multi-female social structure commonly found in many other primate and non primate mammals. Electrophoretic analyses of blood proteins from individually recognized and/or marked wild Himalayan rhesus monkeys, themselves the subject of long-term behavioral and demographic research, have begun to reveal the genetic consequences of such phenomena as social group fission, male-limited dispersion, non-consanguineous mating patterns, and agonistically defined male dominance. Specifically, rhesus social groups, consisting primarily of clusters of maternal relatives, appear to be non-random samples of a population's genotypes and genes. The genetic effects of social group fission are highly dependent on each group's size, demographic structure, and average degree of relatedness. In all cases fission contributes to the degree of intergroup genetic differentiation. Male limited dispersion appears both to retard genetic differentiation between social groups and to lead to mating patterns that result in an avoidance of consanguinity. Groups, therefore, appear to be genetically outbred. Comparing these results with studies of other free-ranging or wild cercopithecines allows several generalizations: (a) genetic variation seems to be evenly distributed throughout each local population of multi-male social groups; (b) social groups, however, because they contain clusters of relatives, are distinctive in their specific frequencies of genes; (c) the degree of genetic differentiation between a population's social groups, because of the effects of social group fission and non-deterministic forms of male dispersal, is somewhat greater than expected on the basis of migration rates alone; and (d) the asymmetrical pattern of dispersion with respect to sex effectively precludes inbreeding in any one social group or the population as a whole. These observations have important implications for understanding the unusually rapid rates of evolution among the primates. PMID- 3505887 TI - Genetics of primate lymphomas in a baboon (Papio hamadryas) colony of Sukhumi, USSR. AB - A lymphoma outbreak occurred at the Sukhumi Center in the Late 1960's, when 12 baboons were inoculated with blood from human leukemia patients. Out of a total of 3219 animals, 218 contracted lymphoma and died. This outbreak appears to be primarily horizontal in transmission. Genetic investigations reveal that: (1) inbreeding does not increase risk of lymphoma; (2) there is a weak association between the PGM2 locus and lymphoma; (3) based upon path analysis, there is evidence of a significant transmissible component (genetic predisposition) passed from the parental to the next generation. PMID- 3505888 TI - Detecting genetic effects on lipoprotein phenotypes in baboons: a review of methods and preliminary findings. AB - Statistical methods for detecting the contribution of major genes to quantitative phenotypes have been widely applied in human family studies. Some of these methods are reviewed, and their application to analysis of an animal model for a human disease is described. Analysis of lipoprotein concentrations in pedigreed baboons provides evidence for genetic effects on specific lipoprotein components that have been associated with reduced susceptibility to atherosclerosis in humans. PMID- 3505889 TI - Genetic research with nonhuman primates: serving the needs of mankind. Symposium summary and future prospects. AB - The wide array of papers delivered at this symposium, ranging from population genetics to molecular genetics, is convincing evidence that genetic research with nonhuman primates is in full bloom. In fact, progress has been quite remarkable considering that a significant number of pedigreed colonies of nonhuman primates have been available for less than 25 years, which is hardly enough time to raise 3 generations of chimpanzees, 5 generations of baboons or 6 generations of rhesus monkeys. Were it not for these pedigreed colonies, we would not have been privileged to have this assemblage of papers on behavior, social structure, predisposition to disease and management of breeding colonies. It is indeed exciting that preliminary evidence has been obtained for major genes that play a role in susceptibility to dyslipoproteinemias in baboons, and that monoclonal antibodies and DNA markers are helping us to understand cholesterol metabolism. And thanks to computers, we can now rank animals in a colony in terms of their useful genotypes as well as their productivity. One can not help but be impressed with the commonality of humans and nonhuman primates at the structural and functional levels. For example, the major histocompatibility systems and the maternal-fetal relationships are very similar. We heard that this similarity is even more striking at the chromosomal, biochemical and DNA levels. A provocative question yet to be answered is, "what accounts for the obvious differences between humans and nonhuman primates in view of these incredible similarities?" In light of these advances, this symposium was at the cutting edge of primate genetics and the papers published in this issue of Genetica are certain to be hallmarks in the literature. PMID- 3505890 TI - DNA markers in primate models of human disease. AB - Nonhuman primates are particularly useful as animal models for common human diseases in which both genetic and environmental factors play important roles. The recent development of DNA markers (restriction fragment length polymorphisms, RFLPs) greatly increases the power of linkage analysis to detect major genes that affect quantitative phenotypes, including those related to diseases. This paper summarizes a strategy for using RFLPs in linkage analysis of baboon pedigrees to identify genes that control lipoprotein phenotype, which in turn is predictive of susceptibility to atherosclerosis. This strategy also can be applied to other common human diseases for which nonhuman primate models exist. PMID- 3505891 TI - Evolution of nuclear gene families in primates. Copy-number variation in the argininosuccinate synthetase (ASS) pseudogene family and the anonymous DNA sequence, D1S1. AB - Changes in the copy number of nuclear genes provide the raw material for the creation of new gene functions. To better understand the mechanisms for such events, and their physiologic and evolutionary consequences, it is valuable to study a well characterized and closely related group of species such as primates. Fortuitously, most of the powerful molecular techniques and DNA probes developed for research in humans are equally applicable to non-human primates. We review what is known of copy number variation in primates and describe two informative DNA probes: pAS-1, a cDNA probe to the human urea cycle enzyme argininosuccinate synthetase (ASS), and an anonymous DNA probe, D1S1. In addition to the ASS structural locus on human chromosome 9, pAS-1 detects at least 14 dispersed, processed pseudogenes in humans. The number of pseudogene copies appears to be approximately the same in humans, chimpanzees, gorillas, orangutans and baboons; less in marmosets; and least in some rodents. Chimpanzees and gorillas appear to have all of the human pseudogenes though an Xp copy may be missing from gorillas. The Y pseudogene is apparently absent from orangutans and baboons, and, finally, a comparison of humans and chimpanzees revealed that the number of nucleotide substitutions in the Y chromosome pseudogenes is approximately 1 per 100. D1S1 maps to human chromosome 3 but also detects a high homology copy on chromosome 1. Chimpanzees, gorillas and orangutans all appear to have only the chromosome 3 homolog suggesting that this is the ancestral sequence and that the duplication occurred after separation of humans and the great apes. Both the ASS pseudogene family and the D1S1 system provide valuable information on the evolution of nuclear gene families in primates. PMID- 3505893 TI - Non-enzymic lipid peroxidation in microsomes and microsomal phospholipids induced by anthracyclines. AB - The stimulation of non-enzymic lipid peroxidation by doxorubicin, daunorubicin and 7 derivatives was investigated in extracted microsomal phospholipids and in intact microsomes. Evidence was obtained for the necessity of a free amino-sugar moiety for a stimulative effect on lipid peroxidation. Binding of anthracyclines to RNA (which is present in microsomes) was inhibitory towards stimulation. Drugs that stimulated lipid peroxidation in a non-enzymic system with extracted phospholipids also were stimulative in an enzymic, NADPH-dependent, microsomal system. They were not always effective in intact microsomes without the enzymic system. The role of the enzymic system in the stimulation of anthracycline induced lipid peroxidation is thought to be the reduction of iron ions rather than the stimulation of oxygen radical production via the anthracyclines. PMID- 3505892 TI - Antioxidant systems in tumour cells: the levels of antioxidant enzymes, ferritin, and total iron in a human hepatoma cell line. AB - The human hepatoma cell line Hep 3B, which has the hepatitis B virus genome, shows over 80% decrease of copper/zinc superoxide dismutase activity, over 90% decrease of manganese superoxide dismutase activity, over 70% decrease of catalase activity, absence of glutathione peroxidase and glutathione S transferase activities, over 270-fold increase of ferritin content and 25-fold increase of total iron compared to normal autopsy liver. These conditions of low antioxidant enzyme activities and iron overload are those which support the accumulation of oxygen free-radicals and DNA damage commonly considered to be carcinogenic mechanisms. PMID- 3505894 TI - Glutathione S-transferase from bovine tissues: relationship between multiple forms, distribution and catalytic activity. AB - Cytosolic functions obtained from various bovine tissues was individually subjected to column isoelectric focusing in order to resolve the glutathione S transferase isoenzymes. The results showed a large variability in the isoenzyme pattern. All the tissues were found to have neutral-acidic forms of the enzyme, whilst liver, adrenal gland, testicle, lung and kidney contained a conspicuous amount of activity associated with the cationic forms of the enzyme. In spite of these differences, by comparison of the conjugating activity of transferases, we did not find essential inter-organ variations. Conversely, when the same tissue samples were tested for selenium independent glutathione peroxidase activity, using cumene hydroperoxide as second substrate, we observed a higher activity in the organs having the cationic form of glutathione S-transferase. PMID- 3505896 TI - Oncogenes. PMID- 3505895 TI - Treatment of radiofibrosis with liposomal superoxide dismutase. Preliminary results of 50 cases. AB - Well and long established radio-fibroses have been treated successfully with a liposomal encapsulated bovine copper superoxide dismutase. After a short treatment (three weeks intramuscular injection of 5 mg twice a week) regression of the fibrosis is stable. The average size is reduced by one third and significant softening occurs in 82% of the cases. Efficiency is independent of the time between radiotherapy (origin of the fibrosis) and treatment with liposomal SOD. Complete regression even after this limited treatment is seen in cases of chronic prefibrotic inflammatory syndromes and prophylactic action in cases where the probability of fibrosis formation is certain appears to be successful. The roles of superoxide and superoxide dismutase are discussed. PMID- 3505897 TI - Serum-free selection of onc genes. AB - We have described the development of a selective system useful for the identification and characterization of onc genes capable of conferring growth factor independence. The use of defined, serum-free media allows us to select for transformed cells which have lost specific growth factor requirements. We have used this system to show that several cloned onc genes generate different transformed phenotypes with respect to growth factor requirements. BPV-1 is active in relieving contact inhibition, yet these transformed NIH/3T3 cells retain their stringent requirement for FGF. In contrast, sis and H-ras were equally proficient at relieving contact inhibition and the requirement for FGF. Sis induced equal numbers of colonies regardless of the presence or absence of insulin, however, H-ras-mediated colony formation decreased four-fold when insulin was removed. This suggests that H-ras is less efficient in relieving the insulin requirement than is sis. To determine if colony formation by H-ras is a function of dosage, we are conducting experiments to measure the level of expression of p21 in transformants selected with and without insulin in the media. We have also presented data to show that loss of contact inhibition and loss of growth factor requirements are dissociable phenotypes under separate control in some cells. Thus, it should be possible to use this selective system to identify transforming genes in tumor DNA. Since some of these genes may be undetectable by the standard focus forming assay, selection in MSF medium may prove to be a useful tool for identifying and elucidating the action of activated cellular onc genes. PMID- 3505898 TI - Properties of the met oncogene. PMID- 3505899 TI - Structure and function of the EcoR I restriction endonuclease. PMID- 3505900 TI - The enzymes of the BamH I restriction-modification system. PMID- 3505901 TI - [Biological and clinical significance of glycocorticoid receptors in acute lymphatic leukemia]. PMID- 3505902 TI - [Localization of bronchogenic carcinoma in smokers and non-smokers]. PMID- 3505903 TI - [Primitive gall bladder carcinoma in the aged. Clinical statistical contribution]. PMID- 3505904 TI - [Ten years' experience in colpocytology. Statistical considerations on the relation of dysplasia and carcinoma]. PMID- 3505905 TI - [Relation of cytology and histology in vulvar physiology and pathology]. PMID- 3505906 TI - [Colpocytologic screening at the Institute of Gynecology, Obstetrics and Physiopathology of Human Reproduction of the 2d Medical and Surgical Faculty of the University of Naples from January 1978 to December 1985]. PMID- 3505907 TI - [Carcinoma of the breast in young women]. PMID- 3505908 TI - [Endoscopic surveillance in the follow-up of patients operated on for colorectal cancer. The importance of endoscopic polypectomy]. PMID- 3505909 TI - [Epidemiologic aspects of ovarian carcinoma]. PMID- 3505910 TI - [Gastric non-Hodgkin's lymphoma: cytogenetic correlations]. PMID- 3505911 TI - [Hormonal receptors for estrogens and progesterone in neoplastic breast tissue. Correlation with some morphologic and clinical parameters]. PMID- 3505912 TI - [Nuclear magnetic resonance in a case of cystic teratoma of the sacrum]. PMID- 3505913 TI - [Histopathologic and ultrastructural studies on hyperplastic dysplasia of the stomach]. PMID- 3505914 TI - [Alizapride vs metoclopramide in the control of emesis induced by chemotherapy]. PMID- 3505915 TI - Mortality of captive whooping cranes caused by eastern equine encephalitis virus. AB - Of 39 captive whooping cranes (Grus americana), 7 died during a 7-week period (Sept 17 through Nov 4, 1984) at the Patuxent Wildlife Research Center, Laurel, Md. Before their deaths, 4 cranes did not develop clinical signs, whereas the other 3 cranes were lethargic and ataxic, with high aspartate transaminase, gamma glutamyl transferase, and lactic acid dehydrogenase activities, and high uric acid concentrations. Necropsies indicated that the birds had ascites, intestinal mucosal discoloration, fat depletion, hepatomegaly, splenomegaly, and visceral gout. Microscopically, extensive necrosis and inflammation were seen in many visceral organs; the CNS was not affected. Eastern equine encephalitis (EEE) virus was isolated from specimens of the livers, kidneys, lungs, brains, and intestines of 4 of the 7 birds that died, and EEE virus-neutralizing antibody was detected in 14 (44%) of the 32 surviving birds. Other infectious or toxic agents were not found. Morbidity or mortality was not detected in 240 sandhill cranes (Grus canadensis) interspersed among the whooping cranes; however, 13 of the 32 sandhill cranes evaluated had EEE virus-neutralizing antibody. Of the 41 wild birds evaluated in the area, 3 (4%) had EEE virus-neutralizing antibody. Immature Culiseta melanura (the most probable mosquito vector) were found in scattered foci 5 km from the research center. PMID- 3505916 TI - Effect of tolazoline on xylazine-ketamine-induced anesthesia in turkey vultures. AB - Fifteen turkey vultures were each given xylazine (1 mg/kg of body weight, IM) and ketamine (10 mg/kg, IM). In 5 of the birds (controls), the mean (+/- SD) induction time was 5.4 +/- 1.0 minutes and the mean duration of anesthesia was 109.8 +/- 25.4 minutes. The remaining 10 vultures (test birds) were given tolazoline (15 mg/kg, IV) 45 minutes after administration of xylazine and ketamine. In the test birds, the mean induction time was 4.5 +/- 1.6 minutes and the mean duration of anesthesia was 49 +/- 2.1 minutes. After administration of tolazoline, the birds regained consciousness in 3.7 +/- 1.9 minutes and were standing with normal posture in 14.2 +/- 5.4 minutes. All birds remained moderately sedated yet ambulatory and responsive to stimuli for 30 to 60 minutes after tolazoline administration. Results indicated that tolazoline was useful in controlling the duration of xylazine-ketamine-induced anesthesia in turkey vultures. PMID- 3505917 TI - Comparison of two methods for determination of white blood cell counts in macaws. PMID- 3505918 TI - Survival versus nonsurvival determinants for neonatal harbor seals. AB - Of 29 neonatal harbor seals that had been abandoned, separated from their mothers, or stranded in the wild, 22 succumbed during hospitalization at the California Marine Mammal Center in the spring of 1982. Compared with standard reported harbor seal pup measurements, 8 of the nonsurviving pups were premature (ie, creamy-white lanugo coat, early pupping season birthdate, and decreased body size [6 to 10 cm shorter and 2.3 to 4.5 kg less than normal]). The premature pups and the young pups (less than or equal to 10 days old) had at least two of the following findings: jaundice, emaciation, labored respiration, hyperbilirubinemia, hypoglobulinemia, or leukopenia. Most of the nonsurviving pups died within 96 hours after admission. Macroscopic and microscopic findings indicated that a high percentage of these pups had pulmonary congestion and edema (72.7%), alveolar squamous cells/debris (27.3%), and/or congenital cardiac anomalies (ie, patent ductus arteriosus [63.6%] and patent foramen ovale [45.4%]). Two older pups (greater than 10 days old) died from chronic bacterial infections, accompanied by adrenal cortical hyperplasia. The 7 surviving pups had adult spotted pelage, normal body weights (9 to 11 kg), normal globulin concentrations (3.0 to 5.1 g/dl), and normal WBC counts (7 to 9 X 10(3)/microliters) and did not have clinical signs of icterus or respiratory distress. PMID- 3505919 TI - Survey of selected diseases in wild swine in Texas. AB - Tissue, fecal, and serum specimens and swabs of nasal turbinates and tracheas were collected from 100 wild swine (Sus scrofa) from 10 populations in Texas and, along with 24 additional serum specimens, were evaluated for selected swine diseases. Swine positive for pseudorabies were detected in 7 populations. Brucella suis biovar 1 was isolated from 4 swine from 2 populations, but positive serologic results may indicate a more widespread distribution of the organism. All populations contained swine that were positive for leptospirosis. Trichinella spiralis was not found in the swine evaluated. PMID- 3505920 TI - Cryptosporidiosis in guinea pigs: a retrospective study. AB - Cryptosporidiosis was diagnosed in 81 guinea pigs (Cavia porcellus) from 1979 through 1985 at a research animal diagnostic laboratory. Most of the guinea pigs were juveniles of Hartley stock and originated from 6 commercial laboratory animal suppliers or from one pet store supplier. Common clinical signs reported were failure to gain weight, weight loss, diarrhea, and death. At necropsy, macroscopic findings included emaciation, hyperemia of the small intestine, serosal edema of the cecal wall, and increased fluidity of ingesta throughout the intestines. Oval to round cryptosporidia (1 to 4 microns) were seen microscopically within or on the brush border of mucosal epithelial cells from the duodenum through the cecum. Acute histologic lesions consisted of necrosis and sloughing of enterocytes at the villus tips, inflammation, hyperemia and edema of the lamina propria, and hyperplasia of crypt epithelium. More chronic lesions consisted of marked villus bridging or villus fusion and blunting, metaplasia of the mucosal epithelium, and lymphocytic infiltration of the lamina propria. PMID- 3505921 TI - Anesthesia in the Richardson's ground squirrel: comparison of ketamine, ketamine and xylazine, droperidol and fentanyl, and sodium pentobarbital. AB - A combination of ketamine and xylazine (88.9 mg of ketamine/ml and 11.1 mg of xylazine/ml) given IM (85.5 +/- 3.4 mg of ketamine/kg of body weight and 10.6 +/- 0.5 mg of xylazine/kg) or subcutaneously (85.6 +/- 4.0 mg of ketamine/kg and 10.7 +/- 0.7 mg of xylazine/kg) induced effective surgical anesthesia for 20 to 30 minutes in Richardson's ground squirrels. Use of ketamine alone (86 +/- 7 mg/kg, IM), a droperidol and fentanyl combination (2.6 +/- 0.4 mg of droperidol/kg and 52 +/- 8 micrograms of fentanyl/kg, IM), or sodium pentobarbital (50 +/- 2 mg/kg, intraperitoneally) did not induce surgical anesthesia, but did induce depressed respiratory rates in the squirrels. PMID- 3505922 TI - Euthanasia of rabbits by intravenous administration of ketamine. AB - Six New Zealand White rabbits (5 females and 1 male) were anesthetized with a combination of xylazine (4.3 mg/kg of body weight) and ketamine (29.1 mg/kg) administered IM. The rabbits were then attached to instruments that continuously monitored blood pressure and electrocardiographic and electroencephalographic values. Each rabbit was then administered a lethal dose of ketamine (600 mg, IV). Within 90 seconds after injection of the ketamine, brain death developed and the heart rate and blood pressure decreased greatly. Circulatory activity persisted for a maximum of 240 seconds. This method of euthanasia did not result in histopathologic changes in tissue specimens evaluated. Although death occurred rapidly, extensive muscle contractions made euthanasia of rabbits with ketamine aesthetically unacceptable. Therefore, this method would not be a suitable means of euthanasia for routine use in rabbits. PMID- 3505923 TI - Xylazine-ketamine-induced anesthesia in rats and its antagonism by yohimbine. AB - A combination of xylazine and ketamine was used to anesthetize 60 male rats, and then yohimbine was given to evaluate its reversing effect on xylazine-ketamine induced anesthesia. In experiment A, xylazine (21 mg/kg of body weight) and ketamine (45 mg/kg) were admixed and administered IM to 12 Sprague-Dawley rats. Anesthesia lasted approximately 70 minutes. The xylazine-ketamine combination also induced polyuria, bradycardia, and bradypnea. When yohimbine (2.1 mg/kg) was given intraperitoneally 20 minutes after the xylazine-ketamine injection, the rats regained consciousness and righting reflexes within approximately 10 minutes. Yohimbine also reversed the bradycardia and bradypnea and appeared to reduce the polyuria induced by the xylazine-ketamine combination. In experiment B, xylazine (15.4 mg/kg) and ketamine (33 mg/kg) were admixed and given IM to 48 Holtzman rats. The combination induced surgical anesthesia for at least 30 minutes, during which a surgical procedure involving grafting a section of the sciatic nerve into the hypothalamus was performed. In rats in which yohimbine (1 mg/kg) was given intraperitoneally 45 to 60 minutes after xylazine-ketamine administration (before natural recovery from the anesthesia), the righting reflex was apparent in less than 10 minutes. PMID- 3505924 TI - Single-injection method for evaluation of renal function with 3H-inulin and 14C tetraethylammonium bromide in conscious unrestrained Sprague-Dawley rats. AB - A single-injection, double-isotope method for simultaneously determining glomerular filtration rate (GFR) and effective renal plasma flow (ERPF) in conscious, unrestrained rats was evaluated. 3H-inulin and 14C-tetraethylammonium bromide were used to determine GFR and ERPF, respectively. Using a modified, single exponential, 1-compartment, mathematical model, solute clearance was estimated, using a plasma radioactivity disappearance curve constructed from samples collected during a 60-minute period. In 12 healthy, conscious, adult male Sprague-Dawley rats, the mean (+/- SEM) GFR, ERPF, and filtration fraction were 5.65 +/- 0.40 ml/min/kg, 13.92 +/- 0.82 ml/min/kg, and 0.41 +/- 0.03, respectively. In 7 adult male Sprague-Dawley rats that had undergone a three quarter nephrectomy 6 weeks prior to study, the mean GFR, ERPF, and filtration fraction were 2.69 +/- 0.36 ml/min/kg, 7.02 +/- 0.90 ml/min/kg, and 0.39 +/- 0.03, respectively. In 37 adult male rats in various stages of renal disease, the mean GFR and ERPF correlated significantly (r = 0.85, P less than 0.001 and r = 0.83, P less than 0.001, respectively) with the reciprocal of plasma creatinine. The single-injection, double-isotope technique yielded functional values similar to those reported for healthy rats in which other clearance methods were used. Using this technique, we were able to detect alterations associated with various degrees of renal functional loss. The technique enabled us to evaluate conscious, unrestrained rats, eliminated the need to collect urine, and required short blood collection times (60 min) and small volumes (0.1 ml) of plasma. PMID- 3505925 TI - Survival of sylvatic Trichinella spiralis isolates in frozen tissue and processed meat products. AB - The ability of Trichinella spiralis larvae to survive at subfreezing temperatures encysted in the musculature of wild carnivorous mammals was assessed by evaluating motility and infectivity (to rodents) of trichinae at various intervals after storage in frozen skeletal muscle. Fifty to 60% of the larvae in grizzly bear meat were alive after storage for 27 months at -6.5 to -20 C, and 30% to 50% were still alive at 34 months. However, none survived for 38 months, on the basis of infectivity in mice and larval motility. Trichinella larvae survived up to 4 months in frozen (-6.5 to -20 C) wolverine tissue. Viable larvae were not recovered from mountain lion or fisher muscle frozen for 1 month. The effect of postslaughter processing on Trichinella larvae encysted in bear meat was evaluated by use of a similar bioassay procedure. Viability of larvae recovered from black bear meat that had been processed into ham or jerky was not affected by dry curing with a commercial salt mixture. Trichinae from both preparations induced infections in mice (58 to 90 larvae/g of tissue). However, a combination of curing and smoking was consistently lethal to encysted larvae. Viable trichinae were not recovered from ground bear meat preparations (pepperoni, salami, or sausage) processed according to commercial standards. PMID- 3505926 TI - Sloth bear immobilization with a ketamine-xylazine combination: reversal with yohimbine. AB - Five captive sloth bears (Melursus ursinus) were immobilized with a combination of ketamine (5.80 to 9.75 mg/kg of body weight) and xylazine (1.40 to 2.44 mg/kg), given IM. The youngest bear was immobilized twice, 62 days apart; all other bears were immobilized only once. Induction times were 4 to 25 minutes. After completion of various intended procedures, yohimbine (0.125 mg/kg) was administered IV. Arousal times were 2 to 20 minutes and bears were standing in 17 to 51 minutes. Compared with reported recovery times of 2 to 3 hours for bears immobilized with ketamine-xylazine combinations but not given an antagonist, results of the present study indicated that yohimbine reduces anesthesia recovery times in sloth bears immobilized with ketamine-xylazine combination. PMID- 3505927 TI - Congestive cardiomyopathy in neonatal artiodactyls. AB - From January 1982 through December 1985, 11 newborn artiodactyls died with clinical and/or pathologic evidence of cardiomyopathy. Clinical signs were inability to rise, depression, failure to nurse, hypothermia, and shivering. Macroscopically, the animals had mild to marked dilatation and thinning of the interventricular septum and left ventricular free wall. Histologic findings included thinning and waviness of myofibers and acute myodegeneration and myocytolysis. PMID- 3505928 TI - Susceptibility of the Speke's gazelle to hepatic abscesses. PMID- 3505929 TI - Recovery of nematode eggs and larvae in deer: evaluation of fecal preservation methods. AB - Fresh fecal specimens from deer were examined for nematode eggs (primarily Haemonchus and Ostertagia), using a flotation technique (sugar, sp gr = 1.27), and then were reexamined for up to 200 days after storage in 2.5, 5, or 10% formalin, absolute methyl alcohol, or 70% ethyl alcohol at room temperature (20 C) or after storage without preservative at 4, 0, or -20 C. For long-term storage, 10% formalin was the best fixative for recovery of eggs (compared with the rate of recovery of eggs from fresh feces). Approximately 50% of the strongyle eggs were detected in feces stored in formalin for 200 days. However, between days 3 and 10 of storage, the recovery rate was low (less than 50%), presumably due to ion binding. Alcohols were unsuitable for preservation, and storage at 0 or -20 C resulted in an egg recovery rate of less than 50%. Storage at 4 C for 50 days resulted in approximately 90% recovery of nematode eggs. Number of Parelaphostrongylus tenuis larvae recovered from fecal specimens stored in 10% formalin for 24 days was greater than that recovered from fresh fecal specimens. PMID- 3505930 TI - Helminthiasis and toxoplasmosis among exotic mammals at the Santiago National Zoo. AB - Parasitologic evaluations of 112 fecal specimens from 292 mammals from the Santiago National Zoo (36 specimens were pooled specimens from greater than or equal to 2 animals) indicated that 51 mammals had protozoa or helminths in their feces. Most of the parasites in the herbivorous species were trichurids and strongylids, whereas most of the parasites in the carnivorous species were ascarids. Coccidia spp and Giardia spp were the most frequently detected protozoans in the mammals evaluated. Of 127 captive mammals serologically evaluated for antibodies against Toxoplasma gondii (indirect hemagglutination test), 35 (27.5%) were positive for T gondii: 7 (46.6%) of 15 carnivores, 24 (25.2%) of 95 artyodactyls, and 4 (22.5%) of 17 nonhuman primates. Antibodies against T gondii also were found in 8 of 10 domestic cats captured within the zoo and in 6 of 13 volunteer zookeepers. PMID- 3505931 TI - Serum concentrations of etorphine in juvenile African elephants. AB - Eleven juvenile African elephants were given etorphine hydrochloride (2.19 +/- 0.11 micrograms/kg of body weight; mean +/- SD) as a single IM injection; 3 elephants were given additional etorphine (0.42 +/- 0.09 micrograms/kg) IV. After immobilization, each elephant was maintained in lateral recumbency by administration of a 0.5% halothane/oxygen mixture or by administration of multiple IV injections of etorphine. At postinjection hours 0.25 and 0.5 and at 30-minute intervals thereafter, blood samples were collected via an auricular artery, and serum concentrations of etorphine were determined by use of radioimmunoassay. The highest mean serum concentration of etorphine in 6 elephants given a single IM injection and subsequently maintained on halothane and oxygen was 1.62 +/- 0.97 ng/ml at postinjection hours 0.5; thereafter, the mean serum concentration decreased steadily. In 4 elephants maintained in lateral recumbency with multiple IV administrations of etorphine, a correlation was not found between the time to develop initial signs of arousal and serum concentrations of etorphine before arousal. After administration of the initial immobilizing dose of etorphine, the interval between successive IV administrations of etorphine decreased. PMID- 3505932 TI - Periodontal status in snow leopards. AB - Periodontal examinations were performed on ten 1- to 22-year-old snow leopards (6 males and 4 females), using dentistry methods for determining the plaque and gingival indices. All tooth surfaces were probed, and alveolar bone attachment loss was determined. After subgingival plaque removal, plaque specimens were examined for differential bacterial morphotypes. The small number of leopards evaluated precluded definitive statistical analysis. However, the progression from gingival health to gingivitis to periodontitis was similar to that seen in man. Therefore, the use of plaque index, gingival index, alveolar bone attachment loss, and differential bacterial morphotypes can be used to determine the dental health of snow leopards. PMID- 3505933 TI - Comparative efficacies of ivermectin, febantel, fenbendazole, and mebendazole against helminth parasites of gray foxes. AB - Anthelmintic efficacies of ivermectin, febantel, fenbendazole, and mebendazole were compared in 45 adult gray foxes (Urocyon cinereoargenteus) naturally infected with helminth parasites. Fecal specimens were examined one week before treatment and one week and 3 weeks after treatment with each anthelmintic, using a sucrose flotation technique. Compared with pretreatment, fewer foxes in all groups were infected with helminths one week and 3 weeks after treatment. Ivermectin, febantel, and fenbendazole more effectively eliminated helminths than did mebendazole. Parasites found were Ancylostoma sp, Capillaria aerophila, and Aelurostrongylus abstrusus and/or Filaroides osleri. PMID- 3505935 TI - Pathologic findings in rabies-suspect, random-source, and accidentally killed skunks. AB - To evaluate sampling biases, pathologic findings in accidentally killed skunks (ie, killed by motor vehicles) were compared with those in random-source skunks (live-trapped and euthanatized, or trap-killed during research) and skunks submitted to a public health laboratory as rabies-suspect. Presence or absence of microscopic lesions in the brain, kidneys, liver, and lungs were used to test the null hypothesis that prevalence of disease did not differ by source of collection. Brain lesions differed with the source; rabid and nonrabid skunks submitted to a public health laboratory had higher prevalences of lesions than did other skunks. Kidney, liver, and lung lesions did not differ among skunks by source of collection. Liver and lung lesions were attributed mainly to parasitism, were not severe, and did not cause debilitated condition. Lesions were seen more often in the kidneys than in other tissues. Usually, lesions were mild to severe, focal, chronic, nonsuppurative, interstitial nephritis (possibly a consequence of leptospirosis). Six of 177 skunks necropsied appeared cachectic. Aleutian disease was diagnosed in one skunk and histoplasmosis was diagnosed in another, but rabies and canine distemper virus infection were the only diseases found with the potential to cause the high population mortality. Public health surveillance cases were biased toward diseased animals (rabies and canine distemper virus infection), but random-source or accidentally killed animals provided unbiased data. Although other factors must be considered, accidentally killed skunks provided cost-effective and useful data for the evaluation of enzootic rabies. PMID- 3505934 TI - Evidence of canine distemper virus infection in skunks negative for antibody against rabies virus. AB - Between January 1981 and October 1985, brain tissue specimens from 192 skunks that were negative for antibodies against rabies virus were obtained from 2 Illinois Public Health laboratories (A and B). Brain lesions were detected microscopically in specimens from 17 of the 91 (18.7%) skunks from laboratory B and in specimens from 30 of the 101 (29.7%) skunks from laboratory A. Lesions in 3 skunks (1 from laboratory A, 2 from B) were caused by cerebral parasitism. Lesions in the remaining 44 skunks were characterized by perivascular, nonsuppurative, mononuclear cell infiltrates and foci of glial cells of differing severity. The similarity of lesions and the finding of inclusions diagnostic of canine distemper virus (CDV) in some skunks indicated that CDV may be the main cause of neurologic disease in nonrabid skunks. Seventeen of 36 (47.2%) skunks evaluated for antibody against CDV, using an unlabeled antibody-enzyme method, were positive for CDV. Findings in skunks from the 2 laboratories indicated similar annual prevalences of brain lesions in 1982, 1983, and 1984. The highest percentage (40.5%) of nonrabid skunks with encephalitis was found in skunks submitted to laboratory B in 1981, which was concurrent with a rabies epizootic among skunks in Illinois in 1981. The number of skunks from both laboratories with CDV infection peaked during winter-spring. Importance of CDV in skunk population dynamics remains to be elucidated; however, infection with CDV appears to be enzootic and occasionally epizootic in skunks. Because enzootic/epizootic CDV may bias rabies surveillance data, caution in interpretation of surveillance data is necessary.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3505936 TI - Experimentally induced Histoplasma capsulatum infection in coyotes and a dog. AB - Captive coyotes (Canis latrans) were inoculated intragastrically (1 coyote), and intratracheally (6 coyotes) with Histoplasma capsulatum to simulate natural routes of exposure. In addition, the infectious organism was inoculated IV into another coyote and into a dog (C familiaris) to simulate hematogenous dissemination of H capsulatum. Isolation of the pathogen from various tissue specimens, using direct plating and mouse inoculation methods, provided mycologic evidence of infection. The presence of anti-Histoplasma serum antibodies also was monitored. Of the 6 coyotes challenged intratracheally, one developed a benign pulmonary form of histoplasmosis. This coyote developed a transient cough, and intracellular yeasts typical of H capsulatum were observed microscopically in pulmonary tissue specimens. The pathogen was isolated from specimens of pulmonary tissue and associated lymph nodes. The coyote that was fed Histoplasma-infected mice (intragastric challenge) did not develop clinical disease. The coyote and the dog inoculated IV developed a multifocal, nonsuppurative infection, without clinical evidence of histoplasmosis. Pathologic findings in the coyote and dog were similar; both animals had splenitis, lymphadenitis, and petechiation of the lungs. The liver and spleen were considered the primary extrapulmonary target organs on the basis of mycologic and histologic findings. PMID- 3505937 TI - Canine distemper virus in coyotes: a serologic survey. AB - Serum samples from 228 coyotes were selected randomly from a serum bank assembled from Texas from 1975 to 1984 and were evaluated serologically for neutralizing antibodies against canine distemper virus (CDV). One hundred and twenty-eight (56%) of the 228 coyotes had antibody titers of greater than or equal to 1:5 against CDV (seropositive). The serologic prevalence (seroprevalence) of antibodies against CDV infection was higher in the spring (62%) than in the fall (40%). The seroprevalence of CDV in various age groups was different; 25 of 101 coyotes (25%) were seropositive at less than 1 year of age, 35 of 52 (67%) were positive between 1 and 2 years of age, and 68 of 75 (91%) were positive at greater than or equal to 2 years of age. The results indicated that CDV was enzootic in coyote populations of southern Texas, with an increasing number of seropositive coyotes noted annually. The sex of the coyote did not appear to be related to the seroprevalence against CDV. PMID- 3505938 TI - Ineffectiveness of clorsulon against Nanophyetus salmincola in coyotes. AB - Efficacy of clorsulon against the trematode Nanophyetus salmincola was evaluated in coyotes. Ten 16-week-old coyote pups were fed fish that contained metacercariae of N. salmincola. Twenty-one days later, 5 of the coyotes were given a suspension of clorsulon (approx 16 mg/kg of body weight, orally). Within 30 days after treatment, the numbers of fluke eggs in fecal specimens from the 5 treated coyotes had not decreased, and numbers of fluke eggs and flukes recovered from treated coyotes at necropsy did not differ from numbers of fluke eggs and flukes recovered from 5 untreated coyotes. Therefore, clorsulon at a dosage of 16 mg/kg was not effective against N. salmincola. PMID- 3505939 TI - Hepatic trematodiasis in five cockatoos. PMID- 3505940 TI - Malignant intraocular medulloepithelioma in two cockatiels. PMID- 3505941 TI - Pancreatic atrophy in a blue and gold macaw. PMID- 3505942 TI - Subconjunctival hibernoma in a goose. PMID- 3505943 TI - Pansteatitis in great blue herons. PMID- 3505944 TI - Ivermectin treatment of ocular nematodiasis in birds. PMID- 3505945 TI - Physalopterine larvae in muscles of blue grouse and a chukar partridge. PMID- 3505946 TI - Ventriculostomy for removal of multiple foreign bodies in an ostrich. PMID- 3505947 TI - A recurrent epizootic of proliferative tracheobronchitis in black korhaans. PMID- 3505948 TI - Mortality of chicks and decreased fertility and hatchability of eggs from a captive breeding pair of ostriches. PMID- 3505949 TI - Gastric hypertrophy associated with cryptosporidiosis in a snake. PMID- 3505950 TI - Aortitis caused by Ophidascaris papuanus in a python. PMID- 3505951 TI - Ulcerative stomatitis and subcutaneous granulomas caused by Mycobacterium chelonei in a boa constrictor. PMID- 3505952 TI - Conjunctivoralostomy for treatment of an occluded lacrimal duct in a blood python. PMID- 3505953 TI - Hirstiella trombidiiformis infestation in a colony of chuckwallas. PMID- 3505954 TI - Gastric cryptosporidiosis in a chameleon. PMID- 3505955 TI - Hyalohyphomycosis caused by Paecilomyces lilacinus in an Aldabra tortoise. PMID- 3505956 TI - Diet-associated systemic granuloma in African cichlids. PMID- 3505957 TI - Blastomycosis in an Atlantic bottlenose dolphin. PMID- 3505958 TI - Diskospondylitis in a California sea lion. PMID- 3505959 TI - Fungal meningoencephalitis in a laboratory rat. PMID- 3505960 TI - Blepharoconjunctivitis associated with Staphylococcus aureus in a rabbit. PMID- 3505961 TI - Amyloid A protein deposits in a rabbit with pyometra. PMID- 3505963 TI - Gastroenteritis associated with a Cryptosporidium sp in a chinchilla. PMID- 3505962 TI - Osteogenic sarcoma with subcutaneous involvement in a rabbit. PMID- 3505964 TI - Multiple primary neoplasms in an opossum. PMID- 3505965 TI - Osteosclerosis in a skunk with renal fibrous osteodystrophy. PMID- 3505966 TI - Pseudorabies in free-ranging raccoons. PMID- 3505967 TI - Pseudorabies and volvulus in a black bear. PMID- 3505968 TI - Epizootic of toxoplasmosis in kangaroos, wallabies, and potaroos: possible transmission via domestic cats. PMID- 3505969 TI - Repair of complete choanal atresia in a llama. PMID- 3505970 TI - Pediculosis of mule deer and white-tailed deer fawns in captivity. PMID- 3505971 TI - Toxicosis in tule elk caused by ingestion of poison hemlock. PMID- 3505972 TI - Correction of angular forelimb deformity in a nilgai: periosteal transection and elevation of the radius and partial ulnectomy. PMID- 3505973 TI - Coccidiosis in a kudu antelope. PMID- 3505974 TI - Volvulus of the ileum in a reticulated giraffe. PMID- 3505975 TI - Polyarthritis and polyosteomyelitis in a juvenile giraffe. PMID- 3505976 TI - Chronic colic associated with volvulus of the large colon in a Grant's zebra. PMID- 3505977 TI - Interstitial pulmonary fibrosis in an African elephant. PMID- 3505978 TI - Polyp in the urogenital canal of an African elephant. PMID- 3505979 TI - Dermoid cyst in an African elephant. PMID- 3505980 TI - Medical treatment of tusk pulpitis in an African elephant. PMID- 3505981 TI - Suppurative spinal meningitis caused by an Actinomyces sp in an Arctic fox. PMID- 3505982 TI - Disseminated histoplasmosis in a Fennec fox. PMID- 3505983 TI - Vertebral body fracture in a captive cheetah. PMID- 3505984 TI - Bilateral testicular seminoma in a snow leopard. PMID- 3505985 TI - Management of a schwannoma in the larynx of a lion. PMID- 3505986 TI - Bilateral separation of the olecranon and proximal epiphysis from the ulnar diaphysis in a snow leopard cub. PMID- 3505987 TI - Urethral incarceration and colonic obstruction caused by vaginal leiomyoma in a margay. PMID- 3505988 TI - Coccidioidomycosis in a ring-tailed lemur. PMID- 3505989 TI - Gastric pneumatosis in a red ruffed lemur. PMID- 3505990 TI - Gastric trichuriasis in a black and white colobus monkey. PMID- 3505991 TI - Pseudomonas aeruginosa infection in squirrel monkeys. PMID- 3505992 TI - Maxillofacial abscesses in captive squirrel monkeys. PMID- 3505993 TI - Sacrococcygeal dysgenesis in a crab-eating macaque. PMID- 3505994 TI - Pemphigus vulgaris in a pigtail macaque. PMID- 3505995 TI - Endometritis and valvular endocarditis in a rhesus monkey. PMID- 3505996 TI - Colonic stenosis in a rhesus monkey. PMID- 3505997 TI - Congestive heart failure and pneumonia in a baboon. PMID- 3505998 TI - Lingual abscess in a lowland gorilla. PMID- 3505999 TI - What is your diagnosis? Case 1. Decreased bone density, multiple pathologic fractures, and excessive periosteal new bone formation. PMID- 3506000 TI - What is your diagnosis? Case 2. Intraluminal filling defects in the proventriculus and ventriculus. PMID- 3506001 TI - Reducing the risk of malpractice. PMID- 3506002 TI - A survey of free-living falconiform birds for Salmonella. AB - Of 105 migrating falconiform birds of 7 species examined for Salmonella shedding in New Jersey, 2 (1.9%) were positive for Salmonella spp. Both positive birds were immature red-tailed hawks (Buteo jamaicensis). Salmonella enteritidis and S newport were the serotypes isolated. Neither serotype expressed multiple resistance when tested against a panel of 12 antimicrobial drugs. PMID- 3506003 TI - Feather and beak dystrophy and necrosis in cockatoos: clinicopathologic evaluations. AB - Several species of imported and captive-bred southeast Asian cockatoos with feather and beak disease (FBD) were evaluated. In recently emerging stained feathers from affected birds, intracytoplasmic magenta to basophilic inclusions of various sizes were found in macrophages and basophil-like cells within the pulp and feather epidermis. Occasionally, amphophilic intranuclear inclusions were seen within degenerated feather epidermal cells. On the basis of electron microscopic findings, intracytoplasmic inclusions were not membrane bound and consisted of crystalline arrays of viral particles (17 to 22 nm in diameter). On the basis of size and conformation, viral particles most closely resembled those of parvovirus or picornavirus. Consistent hematologic or serum enzyme differences were not found among affected or healthy cockatoos. Compared with findings in healthy cockatoos, cockatoos with FBD had significantly lower serum protein concentrations, and results of serum protein electrophoresis indicated that birds with FBD had significantly lower concentrations of prealbumin and gamma-globulin fractions. Mean pre- and post-ACTH plasma corticosterone concentrations of cockatoos with FBD were not significantly different from those of healthy cockatoos. In 8 of 9 affected cockatoos evaluated, serum T4 concentrations before and after thyrotropin stimulation were considered normal. PMID- 3506004 TI - [Immunological study of experimental gingivitis in rats. I. Antigenicity of rat plaque and rabbit anti-rat plaque antibodies against several oral indigenous microorganisms]. PMID- 3506005 TI - [Correlations between clinical symptoms and serum IgG antibody titers to periodontally associated microorganisms in various types of periodontal disease]. PMID- 3506006 TI - [Serum antibodies of periodontally related microorganisms--changes of the IgG antibodies following periodontal treatment]. PMID- 3506007 TI - [Studies of leukocyte functions in patients with periodontal diseases. 1. Neutrophil phagocytosis in patients with rapidly progressive periodontitis]. PMID- 3506008 TI - [Studies of leukocyte functions in patients with periodontal diseases. 2. Chemotaxis of neutrophil and monocyte in patients with rapidly progressive periodontitis]. PMID- 3506009 TI - [The implantation of hydroxyapatite and tricalcium phosphate in periodontal osseous defects in dogs--histological study]. PMID- 3506010 TI - [Effect of initial treatment on interdental distance of proximal contact]. PMID- 3506012 TI - [Marginal periodontitis in outpatients and their etiologic factors]. PMID- 3506011 TI - [Quantitative evaluation of oral prophylaxis using tooth mobility checker]. PMID- 3506013 TI - [A laboratory study of HBsAg detection using punctured blood on gingiva]. PMID- 3506014 TI - [An improved method for comprehensive investigation of subgingival microflora with particular reference to obligate anaerobic spirochetes]. PMID- 3506015 TI - [Effects of sodium fluoride on bone-lining cells from fetal chick calvaria in vitro]. PMID- 3506017 TI - [Experimental study on microvascularization following free gingival autograft- process of the recirculation to grafts]. PMID- 3506016 TI - [Physicochemical analysis of exposed cementum from periodontally diseased human teeth]. PMID- 3506018 TI - [Effect of iodglycol paste containing 20% Guaiacol on periodontal pockets]. PMID- 3506019 TI - [Graft of synthetic hydroxyapatite granule and block on periodontal osseous defect in monkeys]. PMID- 3506020 TI - [Histopathological study on experimental gingivitis in rats--the reaction of gingival epithelium in initial gingivitis]. PMID- 3506021 TI - [Imaging technological study on radiographic structure of the bone trabeculae]. PMID- 3506022 TI - [Antibiotic therapy in periodontal disease. 1. Selection of antibiotics]. PMID- 3506023 TI - [Antibiotic therapy in periodontal disease. 2. Trial of local delivery with minocycline]. PMID- 3506024 TI - [Studies on microflora and host defensive function of a mother and daughter with early onset periodontitis]. PMID- 3506025 TI - [Purification and some properties of superoxide dismutase from Bacteroides gingivalis 381]. PMID- 3506026 TI - [Study of the mechanism of bone-mineral destruction by human monocytes]. PMID- 3506027 TI - [Gamma-carboxyglutamic acid in rat alveolar bone]. PMID- 3506028 TI - [Application of calcium phosphate ceramics to periodontal therapy. 7. A histopathological study on bone tissues among hydroxyapatite]. PMID- 3506029 TI - [Relationship between the roentgenological rate of bone filling one year after bone grafting and the prognosis of the graft]. PMID- 3506030 TI - [Studies on root surface areas of extracted teeth with periodontal problems]. PMID- 3506031 TI - [Experiment-morphological survey of CPITN]. PMID- 3506033 TI - [Studies on the effect of different kinds of toothbrushes on plaque removal and toothbrushing pressure in scrubbing method of toothbrushing. (Report II)--For toothbrushes of nylon bristles arranged in different lengths and rows of bristles]. PMID- 3506032 TI - [Epidemiological study of periodontal disease. 2. Oral findings in persons with various mental disorders]. PMID- 3506034 TI - [Study of premature contact--the characteristics of synchronous recording system with masticatory muscle activity, initial occlusal contact and jaw movements]. PMID- 3506035 TI - [Clinical estimation on efficacy and usefulness of the SI-3906 for oral injuries]. PMID- 3506036 TI - [The treatment of chronic desquamative gingivitis using DEXALTIN ointment]. PMID- 3506037 TI - Nationwide distribution of indoor radon measurements: a preliminary data base. PMID- 3506038 TI - 1987 market outlook for air pollution control and hazardous waste management. PMID- 3506039 TI - A critical flow device for accurate PM10 sampling and correct indication of PM10 dosage to the thoracic region of the respiratory tract. PMID- 3506041 TI - Reconciliation of air quality models for control strategy decisions. PMID- 3506040 TI - Evaluation of a pilot-scale circulating bed combustor as a potential hazardous waste incinerator. PMID- 3506043 TI - Increasing the computational feasibility of urban air quality models that employ complex chemical mechanisms. PMID- 3506042 TI - An air emission risk assessment for benzo(a)pyrene and arsenic from the Mt. Tom power plant. PMID- 3506044 TI - Adequacy of a single monitoring site for defining mean outdoor concentrations of fine particles in a demarcated residential community. PMID- 3506045 TI - Screening methodology for assessing potential health effects from municipal sludge incinerators. PMID- 3506047 TI - A glow discharge unit to render electron microscope grids and other surfaces hydrophilic. AB - We describe the design, construction, and operation of a simple glow discharge unit that can be used to make surfaces such as carbon-coated electron microscopy grids and glass coverslips hydrophilic. The use of a vacuum leak detector (Tesla coil) in place of a conventional high-voltage power supply and a small plastic desiccator for the vacuum chamber make the unit very inexpensive. Owing to the small volume of the chamber and the simplicity of the unit, the whole glow discharge process can be carried out in only 2 to 3 min, a time considerably shorter than that required for conventional vacuum evaporators. The hydrophilic surface improves adsorption of particles by several orders of magnitude in preparation for negative staining, freeze-drying, and other procedures. PMID- 3506048 TI - Electron diffraction structure analysis of phospholipids. AB - The use of lamellar electron diffraction data from epitaxially oriented phospholipid crystals for quantitative structure analysis is described in this review of the technique. It is seen that an appropriate correction for crystal texture, which is justified by the analysis of low-dose lattice images, enables these intensity data to be used much as they would be used in X-ray crystallography. Analyses of two classes of phospholipids are reviewed, revealing that the recently determined lamellar structures of ether-linked phosphatidylethanolamine and phosphatidylcholine and quite similar to the acyl chain structures. Preliminary analysis of 1,2-dihexadecyl-sn-glycerophospho-N methyl ethanolamine indicates that the headgroup conformation may be similar to that of the ether-linked lecithin. PMID- 3506049 TI - Application of two-bath development processing to transmission electron films and plates. AB - In particular areas of materials research transmission electron microscopy has traditionally been plagued by the seemingly inherent problems of excessive photographic contrast and high densities. This need not always be the case. This article will suggest that the use of a development process in which the developing agent and its accelerator are split into two baths can accomplish the desirable effects of compressing the contrast range of the negative and limiting excessive density without loss of recorded detail. The developer used in the study is a commercially available formula called Diafine. Two-bath developers can be formulated by individuals. At the time of writing, Diafine was the only off the-shelf split developer known to the author. PMID- 3506046 TI - Visualization of the inner and outer surfaces of the cell membrane and cytoskeleton by polyethylene glycol embedding, subsequent deembedding, and rotary replication with platinum. AB - Using rotary replication with platinum and carbon to embedment-free sections of polyethylene glycol (PEG)-embedded tissue from which PEG had been removed, the membrane specializations on the outer (exoplasmic) and inner (protoplasmic) cell surface as well as the organization of the cytoskeleton was demonstrated. The high quality and excellent preservation were comparable to that obtained by the rapid-freezing, deep-etched replica method. The present results indicate that the PEG method is essentially acceptable as a reliable morphological technique. Because either sectioned or replica images from the same tissue cells can be observed simultaneously, the PEG method with rotary replication should provide valuable information on cell ultrastructure. PMID- 3506050 TI - Montaging electron micrographs. AB - The preparation of overlapping electron micrographs (particularly from transmission electron microscopy) requires special forethought in planning, exceptional skills in microscopy and photographic techniques, as well as in display preparations which are unique in their handling and execution. In this report, step-by-step instructions are given on specimen preparation, micrography, darkroom printing, and mounting for montage display purposes. PMID- 3506051 TI - Percutaneous computed-tomography-stabilization of pelvic fractures: preliminary report. AB - The authors performed percutaneous computed-tomography (CT)-guided stabilization of reproduced pelvic fractures in eight cadaver studies and in three additional clinical cases. The details of the technique are illustrated in this article. The authors conclude that percutaneous CT-guided stabilization of pelvic fractures in selected cases can be performed safely, rapidly, and with less associated morbidity than conventional open methods presently used. Clinical studies are currently being expanded. PMID- 3506052 TI - Radiographic assessment of soft tissue signs in clinically suspected scaphoid fractures: the incidence of false negative and false positive results. AB - Radiographs of 127 patients who presented with suspected scaphoid fractures were reviewed to determine whether, as recent studies have suggested, an absence of dorsal soft tissue swelling of the wrist and a normal scaphoid fat stripe invariably excluded the possibility of such a fracture. Both false negative and false positive results were found to occur. False negative results (only approximately one in four patients with normal soft tissue signs had scaphoid fractures) might occur if the radiograph was obtained before the onset of edema. False positive results (only approximately a third of patients with abnormal soft tissue signs did not have any bony injury) might reflect soft tissue injury alone. Normal soft tissue signs do not exclude the possibility of a scaphoid fracture. Abnormal signs do not always indicate a scaphoid fracture. PMID- 3506053 TI - Treatment of unstable femoral shaft fractures with closed interlocking intramedullary nailing. AB - From 1979 to 1982, 64 femoral shaft fractures in 62 patients were treated by closed interlocking nailing at Harborview Medical Center, Seattle, WA, U.S.A., and Parkland Memorial Hospital, Dallas, TX, U.S.A. Twenty-nine patients sustained multiple system injuries and 29 of the involved extremities (45%) had at least one additional injury. There were 17 (26%) open fractures. Static mode nailing was used to treat 52 fractures; dynamic mode nailing was performed for 12 fractures. Patient follow-up averaged 17 months (range 7-41 months). The average time to union was 13.5 weeks. Normal femoral length within 1 cm was achieved in 97% of cases. Knee range of motion averaged 127 degrees. Complications (9%) included two delayed unions, one nonunion, two cases of shortening or lengthening of more than 1 cm, and one case of malunion with angulation or more than 10 degrees. The delayed unions and nonunions healed after one additional procedure. This study shows that closed interlocking nailing is a safe, effective technique that provides stable fixation in most unstable femoral shaft fractures. This technique represents a major advance in the treatment of difficult femoral shaft fractures that would be poorly suited for standard closed nailing. PMID- 3506054 TI - Biomechanical evaluation of various forms of fixation of transverse patellar fractures. AB - A study was undertaken to evaluate the strength and ease of application of four different forms of patellar fracture fixation. Modified tension band, screw fixation, Lotke longitudinal anterior band (LAB), and Magnusson wiring were examined using a Materials Testing System. Using cadaver lower extremities, the tibia was mounted in a fixed base and the tibiofemoral joint was fixed at 36 degrees. Tension was applied to the patella through the quadriceps tendon and fracture displacement was measured with linear motion transducers. Based on the results, we recommend screw fixation for transverse patellar fractures in patients with adequate bone stock. In patients with patellar fractures with comminution and/or osteopenia, modified tension band fixation is recommended. Simple wiring techniques alone may not provide sufficient fixation to allow immediate range of motion. PMID- 3506055 TI - All-terrain vehicle accidents: a survey of a community hospital's experience. AB - A rural community hospital's record of persons injured from all-terrain vehicle use in 1985 was reviewed. A total of 46 persons sustained 67 injuries, with 11 persons (24%) requiring hospital admission. Collisions (22%), flipping backwards (18%), rollovers (18%), and falling off (18%) accounted for the majority of accidents. Helmet use (40%) and alcohol use (30%) were also recorded. This study was compared to other recently published literature. Recommendations are made to lessen the risk of injury with usage of these vehicles. PMID- 3506056 TI - Three-dimensional imaging of acetabular trauma. AB - Computed tomography (CT) scanning is widely used in evaluation of acetabular fractures. Three-dimensional (3D) images of the pelvis can be created from CT scan data. This article reports two studies, each employing one type of 3D imaging in acetabular trauma cases. The first was a study of 21 patients utilizing surface-rendered 3D images, the second, a study of 19 patients using volume-rendered 3D images. Both types of 3D images were clinically helpful and can be used in lieu of conventional plain films as a supplement to CT examination. Advantages of volume-rendered images are described. PMID- 3506057 TI - Unusual combination of Monteggia, Colles', and navicular fractures. AB - A rare combination of an ulnar fracture with posterior dislocation of the head of the radius and intraarticular fracture of the distal radius concomitant with an ipsilateral navicular fracture is presented. To the best of our knowledge, no such case has been reported. The mechanism of this fracture combination is discussed with respect to its role in producing the Monteggia type II fracture. Treatment consisted of a combination of closed and open reduction with external fixation. PMID- 3506058 TI - Therapeutic concept and results of operative treatment in acute trauma of the thoracic and lumbar spine: the Hannover experience. AB - A therapeutic concept for the treatment of acute thoracolumbar spinal injury includes an early closed reduction as the first step. In cases with a surgical indication in the lower thoracic area as well as in the lumbar spine, the posterior approach is preferred. Following decompression of the spinal cord, a transpedicular lifting of the upper endplate is done and the fractured vertebra is filled with corticocancellous bone chips. Stabilization is achieved with an internal fixator usually over two motion segments only. Subsequently, autologous corticocancellous bone is added between lamina and between the transverse processes. In the thoracic spine proper, the anterior approach is more advantageous. Following spondylectomy (removal of the vertebral body whole or in part), an intercorporal spine arthrodesis is performed utilizing a solid bone graft and plates. Seventy-six patients with 78 fractures and subluxations of the thoracolumbar spine were reexamined for an average of 3 years and 4 months after their operation. Of the patients with an incomplete cord injury (Frankel B-D) 60% improved at least one Frankel grade and an additional nine patients improved within their group. Clinical deterioration did not occur. Irrespective of the localization, the radiologically determined loss of correction following an anterior approach was an average of 7 degrees whereas the settling after posterior approach averaged 9 degrees. The sagittal index of the affected vertebra improved from 0.59 preoperatively to 0.80 postoperatively. All spinal arthrodeses healed with osseous reorganization. Twelve postoperative computer tomographies were analyzed (11 after a posterior decompression), and showed a decrease of the spinal canal compromise from 65% preoperatively to 11% following surgery. PMID- 3506059 TI - Closed intramedullary nailing of the humerus: a modified technique. PMID- 3506060 TI - New tibial interlocking nail system. PMID- 3506061 TI - The use of tobramycin-impregnated polymethylmethacrylate beads in the therapy of deep bone and joint infections. PMID- 3506062 TI - Acute anterior compartment syndrome in the thigh: a case report and review of the literature. PMID- 3506063 TI - Lisfranc fracture-dislocations of the foot: a clinical-kinesiological study. AB - Twenty-three patients with Lisfranc fracture dislocation of the foot were reviewed at an average of 19.4 months following injury. Results were assessed by a subjective questionnaire, physical examination, and radiographic analysis. There were 10 good (43.5%), 10 fair (43.5%), and 3 poor (13.0%) results. A subgroup of 11 patients underwent gait analysis in the pathokinesiology laboratory. No patient had a normal gait following a displaced Lisfrance fracture. Limp was thought to be due to a prolonged hindfoot period, and a delayed and shortened period of weight transfer through the midfoot to the forefoot as a result of pain inhibition. The best results both clinically and by gait analysis were achieved in those patients who had anatomic reductions. PMID- 3506064 TI - Supramalleolar osteotomy for the treatment of symptomatic tibial malunion. AB - Supramalleolar osteotomy was performed on eight patients who were symptomatic from a malunion of the distal two-thirds of the tibia. The patient's subjective reports of pain, limp, appearance, instability, and limitation of activity were evaluated pre- and postoperatively. Objective measurements of range of motion, angular deformity, and radiographic signs of ankle arthritis were also evaluated. All of the patients had varus malunion with a mean angulation of 15 degrees. Three of these patients also had sagittal malalignment. Supramalleolar dome or wedge osteotomies were performed to correct the coronal and sagittal plane deformities. Either internal (three patients) or external (five patients) fixation devices were applied to maintain correction. All osteotomies healed. The final mean angulation was 0 degrees in the coronal plane and 8 degrees of recurvatum. Complications included pin tract infections, wound breakdown, failure to completely correct the deformities, and loss of reduction. Seven of the patients reported symptomatic improvement after the procedure. The one patient who had a loss of reduction became more symptomatic. PMID- 3506065 TI - Sliding of the compression hip screw in femoral neck fractures. AB - Backing out of the compression screw in the sliding screw-plate hip osteosynthesis was analyzed in a series of 71 hips with medial femoral neck fractures during an observation period of 12-42 months, with a median of 26 months. In addition to the compression screw device, a parallel cranial lag screw was used. A postoperative primary diastasis in the fracture space of 1-5 mm in 11 cases did not predispose to major sliding of the screws or to healing problems. Thirteen of 27 fractures with late screw telescoping of 4 mm or more showed healing disturbances, 11 late segmental collapses, and 2 nonunions, compared with 7 disturbances, 6 late segmental collapses, and 1 nonunion among 39 cases with screw gliding of 3 mm or less. The difference was significant (p less than 0.05, Mann-Whitney). Five early mechanical failures were excluded from this analysis. PMID- 3506066 TI - Factors affecting hip fracture mortality. AB - This retrospective analysis of 300 patients with proximal femoral fractures was undertaken to determine what factors were significant and nonsignificant in determining patient mortality. Mortality rates were based on survival of the patient 1 year after surgery. Of 283 patients followed until death or for at least 1 year postoperatively, the mortality rate was 14.8% (42/283). The expected mortality rate for the normal population over 50 years of age is 3%. Factors considered significant in influencing patient mortality were age, number of pre existing medical conditions, postoperative level of ambulation, and delay of surgery for more than 24 h in relatively healthy patients. The authors feel that on the basis of this study, healthy patients should undergo surgery within 24 h of admission and less healthy patients can be stabilized medically before undergoing surgery without adding increased risk from the delay. PMID- 3506067 TI - CT detection of intrapelvic origin of lower extremity infections in traumatized limbs. AB - Late appearing, lower extremity infections in previously traumatized limbs may originate from occult intrapelvic sources. Computerized tomography can accurately document the intrapelvic source and trace its pathway into the lower extremity. In this paper, we describe two cases of thigh infections originating from pelvic abscesses in limbs that were previously operated on following trauma. Computerized tomography was instrumental in making the diagnosis and directing the appropriate surgical treatment. PMID- 3506068 TI - Simultaneous fractures of the distal radius and scaphoid. AB - Simultaneous fractures of the distal radius and the scaphoid are uncommon. A study of seven male patients who had sustained this fracture combination revealed the most frequent cause of the injury was a fall from a height. The distal radial fracture, usually unstable and intra-articular, was the principle fracture in this complex injury. In contrast, most of the scaphoid fractures were stable. Four of the radial fractures were treated by closed reduction and cast immobilization. In the remaining three, an external fixator was used to maintain the reduction. Four scaphoid fractures were immobilized in a cast, two were internally fixed, and one was left untreated. At an average follow-up period of 20 months (range from 12 to 52 months), all seven patients had regained satisfactory use of their hands. (Three results were classified as excellent and four good.) All scaphoid fractures healed. Transient avascular necrosis was noted in one scaphoid, but cleared within 5 months. Advanced radiocarpal arthritis developed in one wrist, but its presence did not adversely affect the late functional result. PMID- 3506069 TI - Fractures about the interphalangeal joints in children. AB - Fracture patterns in 87 interphalangeal joint fractures in children's hands were studied and correlated with unique anatomic features of these joints. The collateral ligaments, which extend beyond the physis into the metaphysis, were found to protect the growth plate in the frontal plane. With laterally directed forces, fractures on the proximal side of the joint occurred, rather than epiphyseal fractures. There was good remodeling of angular deformities in the sagittal plane, but minimal correction in the frontal plane. In those patients treated surgically, angular deformities did not result. Of 24 condylar fractures followed for an average of 55 months, 11 (46%) demonstrated some restriction of joint motion. PMID- 3506070 TI - Efficacy of bone staples for fixation. AB - The pull-out strength of two types of bone staples (A, Techmedica; B, Richards) was evaluated in a canine model and compared with a control of 6.5 mm cancellous bone screw (Synthes). Fifteen adult mongrel dogs were divided into three groups of five animals each. The implants were placed in the lateral femoral condyle and proximal humerus on the right side at time zero, and on the left side 3 weeks later. The dogs were killed at 6 weeks. In addition a third site, the tibial tubercle, was used to examine the effectiveness of each device for patellar tendon reattachment. The strength of the reattached patellar tendon was measured and compared with a control intact patellar tendon insertion. The pull-out loads from bone of the two staple types are not statistically different. The displacement to failure, however, was found to be 71% greater (p less than 0.007), and the work to failure 128% greater (p less than 0.010) for staple A as compared with staple B. This may be of clinical relevance in avoiding staple back out. Both staples were inferior to the screw for pull-out load displacement and work to failure (p less than 0.0001). All reattached tendons were significantly weaker (mean 202 N) than the intact tendon (mean 1,448 N) regardless of implant type. The dissected specimens uniformly showed necrosis of the tendon under the implant. Healing was by massive scar formation surrounding the implant. PMID- 3506071 TI - The effect of implant axial and torsional stiffness on fracture healing. AB - A study was performed to compare the mechanical properties of healing transverse femoral osteotomies fixed with either (a) plates of high or low axial stiffness (compression or slotted plates) but equivalent bending and torsional stiffnesses, or (b) rods of high or low torsional stiffness (solid or slotted rods) but equivalent bending and axial stiffnesses. Compression and slotted plates were implanted contralaterally in one group of adult mongrel dogs and solid or slotted rods were implanted contralaterally in a second group as fixation for transverse osteotomies. We found that the compression-plated femora regained strength and stiffness earlier than the slotted-plated femora and healed with less callus formation. The femora fixed with rods healed with no significant differences in properties at any time interval. Also, the femora fixed with rods had mechanical properties close to those of the slotted-plated femora and lower than those of the compression-plated femora at the same time intervals. We concluded that contact compression caused the differences in the healing results and was more important than differences in torsional or axial rigidity of the implant. PMID- 3506072 TI - Stress distributions in the periodontal membrane associated with various moment to force ratios in orthodontic force systems. PMID- 3506073 TI - Melted properties of FHAp and FHAp-porcelain castings. PMID- 3506074 TI - Experimental study on the functional adaptation to aluminum oxide, hydroxyapatite and titanium implants. PMID- 3506075 TI - Amalgam restorations using an adhesive resin cement as a cavity liner--basic technique and three clinical cases. PMID- 3506076 TI - The influence of jaw opening degree in tapping movement on muscle activity. PMID- 3506077 TI - A study on diagnosis of stomatognathic function by the analysis of chewing movements. PMID- 3506078 TI - Mandibular autorotation associated with Le Fort I total maxillary osteotomy. PMID- 3506079 TI - Surface coating on TiNi shape memory implant alloys. PMID- 3506080 TI - Epidemiologic survey on periodontal disease and oral hygiene in junior high school children. PMID- 3506081 TI - Enzyme-linked immunosorbent determination of the binding component to salivary glycoprotein from Streptococcus mitis ATCC 9811. PMID- 3506082 TI - Late results of two-stage palatal closure in complete unilateral cleft lip and palate. PMID- 3506083 TI - Association between hard and soft tissue changes resulting from Le Fort I total maxillary osteotomy. PMID- 3506084 TI - Application of microwave for dental technique (Part 3)--Development of model materials for microwave polymerization. PMID- 3506085 TI - Vascular perfusion studies of the influence of levamisole on calcium influx into the maturing enamel of rat incisors. PMID- 3506086 TI - Cell size spectra of trigeminal primary neurons innervating the mandibular incisor and molar tooth pulps of the rat. PMID- 3506087 TI - Further analysis of cell body sizes of trigeminal primary afferent neurons of the rat: ophthalmic and maxillary divisions. PMID- 3506088 TI - Societal and ethical considerations of artificial hearts. AB - The present state of artificial heart research and development is analyzed in light of public perceptions affected by accounts of the experiences of those who received the Jarvik-7. On the assumption that research will continue, it is argued that the therapeutic goals of the artificial heart can be realized, and funding be obtained, only in an atmosphere of positive publicity. To this end, formation of an association of companies involved in artificial heart R & D is recommended. Such a group would articulate voluntary standards and produce reports of advances in the field. Artificial hearts, it is noted in conclusion, have been effective as temporary assist devices in patients destined to receive heart transplants. PMID- 3506089 TI - The human heart: vault of the soul or pump? AB - Medical causes that led to the development of artificial hearts are reviewed. Ventricular assist systems are compared with other designs. A discussion of the functioning and surgical implantation of Thermedics Corporation's ventricular assist pump provides a context for an analysis of technical challenges still to be solved. PMID- 3506090 TI - Primary ciliary dyskinesia in the dog. AB - Electron microscopy was used to diagnose primary ciliary dyskinesia in a litter of English pointer dogs and in a golden retriever dog. A technique of membrane solubilization, fixation, and negative staining with glutaraldehyde tannic acid identified abnormally constructed central and B microtubules in respiratory cilia from dogs with primary ciliary dyskinesia. Shortened outer dynein arms commonly associated with primary ciliary dyskinesia actually represents the absence of a specific subset of the three most peripheral components of the whole outer dynein arm structure. PMID- 3506091 TI - Systemic mastocytosis in 16 dogs. AB - The clinical and pathologic features of systemic mastocytosis in 16 dogs are reported. There was no apparent breed or sex predilection, and the median age at presentation was 9.5 years. In 14 of 16 cases there was a primary cutaneous mast cell tumor (MCT). When cutaneous tumor location was compared with previous reports, there was no association between location and systemic dissemination. The most common presenting signs associated with the cutaneous tumor were regional dissemination, edema, ulceration, and abscessation. They were present in 12 dogs (69%). Signs of systemic illness, including anorexia, vomiting, and diarrhea, were seen in eight dogs (50%). Other than the cutaneous tumors, the most consistent physical and radiographic abnormalities included lymphadenopathy, splenomegaly, and hepatomegaly. Eosinophilia and basophilia were seen in two and five dogs, respectively. Six dogs had increased numbers of mast cells in peripheral blood or buffy coat smears. Five of the nine dogs evaluated had increased numbers of mast cells in bone marrow aspirates. Bone marrow aspiration was superior to both peripheral blood and buffy coat smears in predicting mastocytosis. Coagulation abnormalities were seen in three of five dogs tested. Using a conventional histomorphologic grading system, 10 of 13 (77%) tumors were classified as Grade III or undifferentiated and were overrepresented when compared with previous reports of cutaneous MCTs. Eighty-eight percent of the dogs either died or were euthanatized because of their tumors. Organs commonly involved at necropsy included lymph nodes, spleen, liver, and bone marrow; four dogs had gastroduodenal ulcers. PMID- 3506092 TI - Cardiac preload. Physiology and clinical implications. PMID- 3506093 TI - Effect of thyrotropin storage on thyroid-stimulating hormone response testing in normal dogs. AB - The stability of reconstituted, refrigerated thyrotropin was evaluated. Thyrotropin (TSH) was reconstituted at the start of the study and stored at 4 degrees C. A TSH stimulation test was performed in eight healthy, euthyroid dogs at weekly intervals for 1 month. In seven of eight dogs, there was no significant difference (P less than 0.05) between the post-TSH T3 concentrations and the post TSH T4 concentrations for the duration of the study. For one dog, the post-TSH T4 concentration was below the normal post-TSH T4 range following the administration of reconstituted TSH that had been stored 4 weeks. The T3 response to the TSH, however, was normal. This dog responded normally to freshly reconstituted TSH. The results of this study suggest that reconstituted bovine TSH can be stored at 4 degrees C for at least 3 weeks without loss of biologic activity in the dog. PMID- 3506094 TI - Clinical transplantation in veterinary medicine. PMID- 3506095 TI - Fine-needle aspiration of the spleen as an aid in the diagnosis of splenomegaly. AB - Results from transabdominal fine-needle aspiration of the spleen in 28 dogs and 5 cats are reported. Splenomegaly was present in 79% of these patients, and splenic masses were present in 15%. Extramedullary hematopoiesis, the most common cytologic diagnosis, was found in 24% of the patients and was associated with a variety of diseases including immune hemolytic anemia, hemangiosarcoma, and bone marrow hypoplasia. Hematopoietic neoplasms including lymphosarcoma, plasmacytoma, myelogenous leukemia, and systemic mastocytosis were diagnosed in 24% of the patients. Other diagnoses included malignant neoplasia of undetermined cell type and lymphoreticular hyperplasia. Splenic aspirates were considered normal in 18% of the animals. Two (6%) of the aspirates contained liver tissue rather than spleen. Histologic evaluation of splenic tissue was performed in 42.5% of the patients. All cytologic diagnoses correlated well with their final histologic diagnoses. Complications from the aspiration procedure were not observed, even in thrombocytopenic patients. PMID- 3506096 TI - The acute hemodynamic effects of milrinone in dogs with severe idiopathic myocardial failure. AB - To examine the effects of acute oral milrinone administration (0.75 mg/kg) on dogs with severe idiopathic myocardial failure and the effect of prolonged milrinone administration on survival time, we measured hemodynamics before and 2 hours after drug administration and recorded survival time and cause of death in 13 dogs with dilated cardiomyopathy. Hemodynamics were measured using a Swan-Ganz catheter and femoral artery puncture along with recording an M-mode echocardiogram. Cardiac index increased from 1.92 +/- 0.54 to 3.06 +/- 0.81 L/min/m2, stroke volume index increased from 11.3 +/- 4.3 to 16.7 +/- 6.3 ml/beat/m2, and pulmonary capillary wedge pressure decreased from 23 +/- 8 to 12 +/- 8 mmHg. A clinically significant increase in heart rate was observed in seven dogs, resulting in a statistically significant increase in heart rate for the group from 174 +/- 34 to 194 +/- 44 beats/minute. Mean arterial blood pressure did not change significantly for the group but did decrease more than 20 mmHg in three dogs, suggesting a predominant primary vasodilating effect of milrinone in these dogs. An increase in contractility appeared to be the predominant reason for the improved hemodynamics in seven dogs. Eight dogs died of causes other than worsening heart failure, including four of eight Doberman pinschers that died suddenly, presumably from an acute tachyarrhythmia. Two dogs that had the greatest increase in an index of contractility are alive more than 2 years after the initiation of milrinone administration. PMID- 3506097 TI - Clinical, clinicopathologic, and epidemiologic features of anhidrosis in central Florida Thoroughbred horses. AB - A group of 834 Thoroughbred horses was surveyed on four central Florida farms for clinical and epidemiologic features of anhidrosis. In addition, comparative analysis was made of serum thyroxine, serum electrolytes, and fractional urinary electrolyte excretion ratios. An overall disease prevalence of 6.12% was observed. Training horses and nonpregnant broodmares had a predilection for the disease. Adolescent horses were infrequently affected. There was no correlation with sex or color. Comparative clinical signs, related to thermoregulatory compromise, included tachypnea and hyperthermia. Long-term effect included focal and generalized alopecia, decreased appetite, and impaired performance. Previously reported hypothyroidism and hypochloremia were not demonstrated; however, fractional urinary chloride excretion ratios indicated a significant relative conservation of chloride. PMID- 3506098 TI - Serum thyroid hormone concentrations fluctuate in cats with hyperthyroidism. AB - We measured serum thyroxine (T4) and 3,3',5-triiodothyronine (T3) concentrations in hyperthyroid cats (hourly for 10 hours in 14 cats, and daily for 15 days in seven cats) to assess fluctuation in thyroid hormone levels. Over the 10-hour study period the coefficient of variation (CV) for serum T4 and T3 concentrations ranged from 6.4-22.6% (mean = 12.0 +/- 4.8%) and from 9.6-33.1% (mean = 17.5 +/- 6.3%), respectively. During the 15-day study period, CV for serum T4 ranged from 6.6-34.8% (mean = 18.4 +/- 9.3%), while CV for serum T3 ranged from 7.8-31.0% (mean = 20.1 +/- 8.6%). These CV values were significantly higher than the expected intra-assay CVs (T4 assay, 5.1%; T3 assay, 7.7%). In addition, some of the cats with mild hyperthyroidism showed one or more normal serum T4 and T3 values during the course of the respective study periods. There was no specific time during the 10-hour study period at which the cats consistently showed peak serum T4 or T3 concentrations. These results suggest that serum thyroid hormone concentrations are subject to a degree of fluctuation that exceeds the usual assay variation, and that cats with mild hyperthyroidism can, at a given time, exhibit normal serum T4 and T3 values. Therefore, a diagnosis of feline hyperthyroidism should not be excluded on the basis of the finding of a single normal serum T4 or T3 value in a cat with clinical signs and physical examination findings consistent with the disease. PMID- 3506100 TI - Histoplasma capsulatum osteomyelitis in the cat. AB - Seven cats with osseous lesions as the primary manifestation of disseminated Histoplasma capsulatum infection were evaluated. The major clinical signs in these cats were related to the bony lesions and included lameness, bone pain, and soft tissue swelling of limbs and joints. Other clinical and pathologic findings were similar to previously reported forms of disseminated histoplasmosis in the cat. The radiographic appearance of the lesions was predominantly osteolytic; periosteal and endosteal new bone production was present in some cases. Infection occurred primarily in bones of the appendicular skeleton with a predilection for sites below the elbow and stifle joints. PMID- 3506099 TI - Probable vitamin K--deficient bleeding in two cats with malabsorption syndrome secondary to lymphocytic-plasmacytic enteritis. AB - Two cats with intestinal malabsorption developed a hemorrhagic diathesis. Although unsubstantiated, the probable cause of bleeding was a chronic malabsorption of fat and the fat-soluble vitamin K. When treated with vitamin K1 per os, one cat's clotting times were only partially corrected. Since vitamin K1 is actively absorbed in the proximal small intestine, the incomplete response of this case to orally administered vitamin K1 was predictable. The infrequent occurrence of bleeding in animals with malabsorption is, in part, attributable to the ileal and colonic absorption of bacterially derived vitamin K2. For this reason, nonspecific use of antibiotics in these animals is contraindicated. Since long-chain, polyunsaturated fats impair vitamin K absorption, dietary fat given to animals with malabsorption should be restricted to medium- and short-chain, saturated fats. Vitamin K should be administered subcutaneously to these animals if prolonged clotting times or active bleeding is present, and routinely prior to surgery. Oral supplementation with vitamin K3, which is absorbed in the colon and less lipid soluble than vitamin K1, should be given to animals with malabsorption that are maintained as outpatients. Adequate dosage levels of vitamin K3, however, are yet to be established for the cat, and dose-dependent hemolytic anemia is a probable toxic manifestation. PMID- 3506101 TI - Incessant atrial tachycardias in a dog with tricuspid dysplasia. Clinical management and electrophysiology. AB - In a dog, tricuspid regurgitation due to congenital tricuspid dysplasia resulted in extreme right heart enlargement and right heart failure. Incessant supraventricular tachycardias were present, requiring the intravenous administration of verapamil to reduce the ventricular rate. Oral therapy using a combination of verapamil and quinidine was partially effective in controlling the ventricular rate during the following week. At that time, electrophysiologic studies were performed. They revealed that a succession of several atrial tachycardias with different cycle lengths, including one episode of atrial flutter, was present. Atrial activity was spanning the majority of the cycle length in all these arrhythmias. Epicardial mapping was performed during the atrial flutter. This enabled the detection of a depolarization wave-front traveling counterclockwise from the dorsolateral right atrium toward the right appendage, following the tricuspid valve annulus. No areas of abnormal conduction were detected. Because programmed electric stimulation maneuvers could not be performed, definitive conclusions about the mechanism of the arrhythmia could not be drawn. The two most likely possibilities were circus movement using part of the dilated tricuspid valve annulus as an anatomic barrier or a leading circle type of re-entry. PMID- 3506102 TI - Evaluation of two reagent strips and three reflectance meters for rapid determination of blood glucose concentrations. AB - We evaluated three reflectance meters (Accu-Chek II, Glucometer II, and Glucoscan 2000) and two reagent strips (Chemstrip bG and Glucostix) for accuracy and precision in determining blood glucose concentrations in the dog. To evaluate accuracy, we compared results of blood glucose determinations performed on 95 samples using the various strips and meters vs. the glucose concentrations obtained using the glucose-oxidase method on a Beckman Glucose Analyzer. Accuracy was evaluated statistically using least squares regression analysis. To evaluate precision, samples in various ranges of blood glucose concentration were tested repeatedly (20 times within a 1-hour period) on the same reflectance meter. Coefficient of variation (CV) was determined to evaluate reproducibility of results. Overall, there were significant correlations (P less than 0.001) between the laboratory glucose values and the blood glucose concentrations obtained with Chemstrip bG (r = 0.976), Glucostix (r = 0.904), Accu-Chek II (r = 0.986), Glucometer II (r = 0.911) and Glucoscan 2000 (r = 0.944). In the precision study, all three meters had excellent CVs in the normal range (3.6% to 4.9%). However, Accu-Chek II was found to be more precise in the hypoglycemic and hyperglycemic ranges (3.6% and 2.6%, respectively) than either Glucometer II (8.8% and 5.4%) or Glucoscan 2000 (7.8% and 8.2%). The results of this study indicate that all of the meters and reagent strips tested are highly accurate in determining blood glucose concentrations in the dog. However, both in terms of accuracy and reproducibility of results, Accu-Chek II and Chemstrip bG, gave the highest correlation coefficients and, as such, are probably of the greatest clinical value. PMID- 3506103 TI - Therapy of suspected septicemia in neonatal foals using plasma-containing antibodies to core lipopolysaccharide (LPS). AB - Equine antiserum to core lipopolysaccharide (LPS) was evaluated in a double-blind prospective study for therapeutic benefit in suspected septicemia in neonatal foals. Forty foals younger than 7 days of age were included in the study by satisfaction of clinical and laboratory criteria, suggestive of gram-negative septicemia. Twenty-two foals were treated with core LPS antiserum (plasma produced from horses which were hyperimmunized with rough gram-negative mutant bacterin) and 18 foals received "nonimmune" plasma (from horses prior to immunization against core LPS). All foals received antimicrobials, fluids, and other supportive care measures, depending on clinical signs and according to accepted current practice. The clinical and laboratory data of each foal were monitored and recorded daily for 14 days after plasma treatment or until death. The overall survival rate of these 40 foals with septicemia was 52.5%. The most prevalent diagnoses in addition to septicemia were enteritis and pneumonia. Of 30 positive bacterial cultures, 93% were due to gram-negative organisms. There was no statistically significant increase in survival rate in the 22 foals given core LPS antiserum (P greater than 0.05). PMID- 3506105 TI - Fetal lung development. Vail, Colorado, June 14-18, 1987. PMID- 3506104 TI - The influence of castration on the development of prostatic carcinoma in the dog. 43 cases (1978-1985). AB - Prostatic carcinoma (PC) was diagnosed in 43 dogs at the Michigan State University Veterinary Clinical Center (MSU-VCC) between 1978 and 1985. Of the 43 dogs with histologically confirmed PC, 19 (44.19%) had been castrated at least three years prior to the development of any prostatic disease. Seven of the castrates had been neutered at less than 12 months of age. Fourteen dogs (32.55%) were presented as intact males at the time of diagnosis. The remaining ten dogs (23.62%) had been castrated as treatment for presumptive prostatic disease prior to referral to the MSU-VCC. Dates of castration were known in all cases. In this study, therefore, castration at any age showed no sparing effect on the risk of development of PC in the dog. The etiology of PC in the dog may not be exclusively related to testicular hormones. Work in humans suggests that the adrenal and pituitary glands play a significant role in the disease. Preliminary work in dogs supports that nontesticular androgens exert a significant influence on the canine prostate. PMID- 3506106 TI - Molecular biology of surfactant associated proteins. PMID- 3506107 TI - [Examination of easy hepatitis B surface antigen test method by R-PHA method with whole blood]. PMID- 3506108 TI - [Three-dimensional measurements of the lingual surface of upper central incisors in Japanese population]. PMID- 3506109 TI - [A metrical study of the horizontal overlap between upper and lower corresponding teeth at the centric occlusion-a case of Indians]. PMID- 3506110 TI - [Influence of antibiotics on anti-inflammatory activity of anti-inflammatory drugs in simultaneous administration]. PMID- 3506111 TI - [Evaluation of the treatment for Class III malocclusion in the permanent dentition]. PMID- 3506112 TI - [Changes of hard tissue on orthognathic surgery cases]. PMID- 3506113 TI - [The possibility of identification by occlusal sound on premature contact]. PMID- 3506114 TI - [Anti-stress effect of compound-drug constituted with galenicals]. PMID- 3506115 TI - [Basic study on high frequency occlusal sound]. PMID- 3506116 TI - [Diagnostic evaluation on spectrum of masticatory movement]. PMID- 3506117 TI - [Effects of phospholipase on PGE2 binding in osteoblast-like clonal UMR 106 cell membranes from rat osteogenic sarcoma]. PMID- 3506119 TI - [Role of host responses in inflamed gingiva on the experimental neutropenia dogs]. PMID- 3506118 TI - [The effect of local anesthetic on the pharmacodynamics of antibiotics in tissue]. PMID- 3506121 TI - [Statistics on the crown prosthetic appliances in the clinical practice of students]. PMID- 3506120 TI - [A case of severe cellulitis in the oral floor with tracheotomy]. PMID- 3506122 TI - [Effects of prostaglandins on [3H]-thymidine uptake to human gingival carcinoma cells]. PMID- 3506123 TI - [A maxillary distomolar found in Cercopithecus aethiops]. PMID- 3506124 TI - [Evaluating the areas of the skull by measuring the areas using cephalometric radiographs]. PMID- 3506125 TI - [Evaluation on the difference in Vordere Asthohe between the sexes and among normal occlusion, Class II division 1 malocclusion, and true-Class III malocclusion]. PMID- 3506126 TI - [A case of supernumerary teeth accompanied by congenital missing teeth]. PMID- 3506127 TI - [Calcification pattern of rat and rabbit incisor dentin]. PMID- 3506128 TI - [Study of illumination level in oral cavity--particularly on the palatal mucosa]. PMID- 3506129 TI - [An examination on dental application of imaging information--a basic study in X ray CT value of the teeth]. PMID- 3506130 TI - [Infrared spectrophotometric analysis of unheated and heated human enamel apatite]. PMID- 3506132 TI - [Experimental findings of pantomography by ZONARC]. PMID- 3506131 TI - [Lattice parameters of human enamel apatites]. PMID- 3506133 TI - [Corrosion of orthodontic bands]. PMID- 3506134 TI - [Changes in salivary s-IgA level in liver disease patients]. PMID- 3506135 TI - [Effect of general anesthesia on body temperature: with detailed examination of deep body temperature]. PMID- 3506136 TI - [Effects of smoking on skin temperature: with detailed examination of non smokers]. PMID- 3506137 TI - [Ultrasonic microscopy of bovine incisor tooth]. PMID- 3506138 TI - [Clinical decision analysis on diagnostic examination--Part 2. Periapical periodontitis]. PMID- 3506139 TI - Post-traumatic defects in computed tomography. AB - Long term CT-investigations of nearly 6000 brain-traumatized patients undergoing rehabilitative measures in the past ten years, showed pathologic findings in 85 90%: 40% showed abnormalities of the ventricular system; 60% traumatic tissue lesions; and 15% abnormalities of the brain surface. Kind and frequency of occurrence of the ventricular changes found by CT were in similar to those found by pneumencephalography. Traumatic inner-hydrocephalus permagnus, which occurred in about 0.25% of our patients, is considered with regard to its rehabilitative meaning. Most traumatic defects were found in the frontal lobe (36%) or in the temporal lobe (46%). Presence and etiology of traumatic infarctions were shown in CT images in 3.5% of all traumatic cases. 25% of these were situated in the posterior area: 25% in the basal ganglia; 15% in the midcerebral artery region, and 30% were typical borderline area infarctions. Because of the frequent differences between CT-findings and neurologic or neuropsychologic symptoms, CT findings are to be judged only in conjunction with the clinical picture. They should never serve as the only guide for the exaluation of traumatic brain defects, prescribing therapy or predicting outcome. PMID- 3506141 TI - Cranial magnetic resonance imaging in multiple sclerosis--indicated only in exceptional cases? AB - Clinical examination, spinal fluid laboratory data, evoked potentials (EP), cranial computed tomography (CT), and magnetic resonance imaging (MRI) were compared for their value in diagnosing multiple sclerosis (MS) in 51 patients aged 18-60 yrs. MRI was superior to CT imaging: supratentorial lesions were found in 90% of the patients with confirmed MS. These lesions are not specific, however, as vascular processes, vitamin B12 deficiency or chronic encephalitis, can show similar MRI-patterns. The detection of infratentorial lesions in symptomatic patients was poor (8% compared to 64% pathological EP-findings). Thirty-eight patients (= 75%) could be classified correctly as "confirmed MS" according to Bauer-criteria without any CT or MR imaging. In the remaining 13 patients presenting classificatory problems due to normal CSF, first manifestation or possible alternate processes, MRI helped for the final diagnosis in only 6 cases. The value of MRI in diagnosing MS seems to lie in its superiority to CT in excluding other pathological processes or for research rather than in its value for the confirmation of the diagnosis. In a minority of cases, it can detect supratentorial lesions in patients with pure spinal symptoms, normal CSF, or first manifestations. PMID- 3506140 TI - Functional imaging of the brain in psychiatry--mapping of EEG and evoked potentials. AB - Topographic brain mapping of EEG and evoked potentials permits the display of spontaneous and event-related activity of the brain. This new method is superior to conventional polygraphy because of the topographic approach which delineates structural and functional brain lesions. Data from 16 to 20 scalp electrodes were evaluated. Not only spontaneous EEG but also EEG during various testing conditions which activated particular brain regions was measured. For EEG fast Fourier transformation (FFT) was used for mapping. For late evoked potentials (VEP, AEP, SEP and P300) a single value representing the amplitude of EP at each 2-ms poststimulus latency point was used. Statistical techniques (Students'-test, correlation coefficient) were used to render the regions where a clinical population differs from normal subjects. The results show abnormalities of EGG and EP in patients with psychiatric and neurological diseases. PMID- 3506142 TI - Symptomatic subependymoma with nuclear polymorphism. AB - Two patients with symptomatic subependymomas are described. Histologically prominent cellular polymorphism was revealed. The existence of subependymoma with unusually marked polymorphism of the tumor cells should be taken into consideration in diagnosis and treatment. PMID- 3506143 TI - Ventricular meningiomas--report of 4 cases. AB - Four cases of rarely occurring meningiomas of the lateral ventricles are reported. These tumors are said to originate from meningeal cell clusters that have been mislocated during embryonal development. Patients of clinical history, diagnostic and surgical findings, and the postoperative course are described, with special emphasis on tumor growth aspects. PMID- 3506144 TI - Epidermoid tumor of unusual expansion at the skull base. AB - The case of an epidermoid tumor of unusual extension at the skull base is reported. Various and comprehensive radiologic examinations are described and the difficulty of diagnosis of rare brain-base processes is shown. Although neuroimaging with CT scan, CT cisternography, angiography and MRI was carried out on adequate diagnosis could not be made so that the question of operability could not be answered. In this case MRI did not prove to be more sensitive than other traditional radiologic examinations for the primary diagnosis, postoperative control, or clarification of suspected recurrence. PMID- 3506145 TI - Cerebral blood flow in autogenic training and hypnosis. AB - In 12 healthy volunteers with at least an experience of six months in autogenic training (AT), the cerebral blood flow (CBF) was measured at rest, in AT and in hypnosis (H). The results were correlated with individual test profiles. The cortical flow pattern at rest of our AT trained volunteers did not show the hyperfrontality which is described in the literature. This may be interpreted as an effect of better and habitualized relaxation in long trained AT practitioners. This flow pattern corresponds to the low grades of neuroticism and aggressivity found in the tests. Furthermore an activation in central cortical areas and a deactivation in regions which are associated with acoustic and autonomous functions occur. Possible explanations for these phenomena as well as for the relatively low perfusion of the left hemisphere at rest and activation in AT are discussed. The global rise of CBF in H may be an activation effect caused by resistance against the hypnotizer: the deeper the trance, the smaller the CBF increase in the motor cortical area needed for maintaining catalepsy of the right arm and in temporal cortical fields processing acoustic inputs. PMID- 3506146 TI - EEG changes during five minutes of inhalation of a 33% xenon-O2 mixture. AB - The effects on the EEG of inhalation of a 33% Xenon O2 mixture over a period of 5 minutes were studied in 18 human volunteers. This dosage is similar to that used in xenon CT studies. In 4 subjects no EEG changes were observed during the study. In the 14 other subjects, EEG variations were detected, the most prominent of which was an increase in beta power. No change was observed in theta and delta power. These findings seem to support an early induction (excitation) phase of anaesthetics. All changes disappeared rapidly following the termination of xenon inhalation. The effects reported are minimal and should not impair the clinical value of CBF measurements using the xenon CT method. PMID- 3506147 TI - Intraspinal mesenchymal chondrosarcoma in a three-year-old boy. AB - A case is presented of a 3-year-old boy with a mesenchymal chondrosarcoma extending from the 1st to the 5th lumbar vertebra. This is the youngest case of a mesenchymal chondrosarcoma located outside the skeleton or in the C.N.S. After assumed total excision with subsequent radiotherapy and chemotherapy, local tumor recurrence and (later) systemic metastases were detected. Standard therapy should include radical excision because of the high incidence of local recurrence and subsequent radiotherapy because of the expected high incidence of tumor cells in the CSF. The value of chemotherapy cannot be assessed, as it has been applied in only one other case found in the literature. PMID- 3506148 TI - Intracerebral Nocardia brasiliensis infection. AB - Case report about cerebral infection with the species Nocardia Brasiliensis in a not immunocompromised host. Diagnosis, treatment and neuroradiological findings are shown and compared with current studies. PMID- 3506150 TI - [Changes of alveolar bone architecture of sheep due to development, eruption and occlusion of teeth]. PMID- 3506149 TI - Difficulties in the diagnosis of brain abscesses. AB - The diagnosis of brain abscesses has been improved during the last 10 years because to introduction of computerized tomography (CCT) and improved methods for the analysis of cerebrospinal fluid (CSF). Typical ring-like enhancement in the CT and an elevated CSF cell count combined with disturbances of the blood-brain barrier and elevated CSF lactate are common and confirm preliminary diagnoses. However, in spite of these procedures, brain abscess is still sometimes misdiagnosed because of the lack of pathological CT findings or a misleading case history sometimes causing cerebral affections. We present the case histories of two young patients in whom diagnosis of brain abscess was delayed. We recommend the immediate performance of contrast-enhanced CT and CSF analysis. If these procedures do not exclude a brain abscess, antibiotic treatment should be begun immediately. PMID- 3506151 TI - [The effects of aging and dose on salivary glycoproteins secreted by submandibular functional segments in response to methoxamine in rats]. PMID- 3506152 TI - [Nitella polarization by direct current]. PMID- 3506153 TI - [Myofibrous organization of human temporal muscles]. PMID- 3506154 TI - [Nitella polarization applied by the high direct potential]. PMID- 3506155 TI - An abnormal human suprahyoid and infrahyoid musculature. PMID- 3506156 TI - [Effects of thiocyanate on metabolisms by salivary microorganisms (I)]. PMID- 3506157 TI - [Relations of some chelating agents to hydroxyapatite and to lactate production by salivary microorganisms]. PMID- 3506158 TI - [Scanning electron microscopic observations of the human oral epithelium]. PMID- 3506160 TI - [About the Nitella considered the condenser with parallel and series resistances as the equivalent circuit]. PMID- 3506159 TI - [Effects of mouth opening with experimental nasal obstruction on the growth and development of craniofacial complex in young golden hamsters]. PMID- 3506161 TI - [Effect of hydrogen peroxide on cultured V79 cells]. PMID- 3506163 TI - [Production of putrescine from arginine by oral microorganisms]. PMID- 3506162 TI - [Mineral distribution from enamel surface to enamel-dentin junction in developing human deciduous teeth]. PMID- 3506164 TI - [The relationship between the position of upper and lower cusps and the path of condyles and cusps in lateral movement studies with the three-dimensional measurement system]. PMID- 3506165 TI - [A study on silent period during chin tapping of edentulous patients]. PMID- 3506166 TI - [Practice patterns and lifestyles of female dentists]. PMID- 3506167 TI - [Effect of parachlorophenol on cultured V79 cells]. PMID- 3506168 TI - [Effect of m-cresol on cultured V79 cells]. PMID- 3506169 TI - [Effect of phenolsulfonic acid on cultured V79 cells]. PMID- 3506170 TI - [Effect of benzalkonium chloride on cultured V79 cells]. PMID- 3506171 TI - [Effect of paraformaldehyde on cultured V79 cells]. PMID- 3506172 TI - [A basic study of the abrasion of preformed primary crown and composite resin]. PMID- 3506173 TI - [Effect of components of curing mixtures on the antagonistic properties of enterococci and other bacteria isolated from cured meat]. AB - Effect of sodium chloride, glucose, sodium glutamate, potassium nitrate, sodium nitrate, sodium nitraite, ascorbic acid, sodium citrate, polyphosphates (Hamine) on antagonistic activity of enterococci and various bacteria isolated from cured meat against Bacillus cereus, Bacillus subtilis, Salmonella typhi-murium, Salmonella cholerae-suis, Staphylococcus aureus, Clostridium botulinum type A, Clostridium botulinum type B, Clostridium botulinum type E, Clostridium bifermentans, Clostridium perfringens type A, Clostridium sporogenes. It was found that some of the chemical compounds examined increased the antagonistic effect and other compounds partly or totally inhibited it. Sodium nitrate, sodium nitrite, potassium nitrate, glucose, and ascorbic acid in majority of cases increased antagonism and sodium citrate and polyphosphates restrained this phenomenon. PMID- 3506174 TI - [Alanine and aspartate transaminase and acid and alkaline phosphatase activities in the blood serum in relation to the protein and energy levels in the pigs' feeds]. AB - The activity of alanine and asparagine transaminase and of acid and basic phosphatase was studied in blood serum of 72 porkers of the Polish large-white breed, fed with PT-2 feeds of various protein and energy levels. It was found that the activity of both transaminases in blood serum depended on the protein energy level of the diet. The activity of transaminases was not found to increase at the protein content compatible with the standard and at increased energy value of the feeds, whereas the same protein level and decreased energy amount caused a decrease in the activity of alanine and asparagine transaminase. At a decreased protein content in the diet the activity of transaminases in plasma was lower than in the porkers on a diet containing protein according to the standard. An increased amount of energy with a decreased protein content in the diet did not affect the activity of asparagine transaminase but slightly stimulated alanine transaminase, whereas a decrease in the amount both of energy and protein in the diet caused an increase in the activity of both transaminases. Acid and basic phosphatase were not adequate indices of changes in the organism of the porkers in relation to the protein-energy level of their diet. PMID- 3506175 TI - [Variability in the levels of carotenoids and vitamin A in the blood serum and milk of cows]. AB - Observations of 20 milk cows of the lowland black and white breed were conducted for 14 successive days in four seasons of the year. The age, lactation stages and efficiency of the animals were different. They were divided into two groups: the first with healthy udders (clinically, bacteriologically, cytologically); the second with secretion disturbances and mastitis subclinical. Blood and milk samples were taken every day during the morning milking. The content of carotenoids and vitamin A was determined by the methods of Carr-Price. Although the same feeding and environment conditions of the animals were maintained, the determined levels of the studied components of both body fluids showed a great variation. Significant differences were found between the mean values calculated for individual cows (individual variability). In the milk of cows from group II, a higher concentration of carotenoids and vitamin A was found. It is proposed to assume a physiological minimum of 30 mcg/100 cm3 for vitamin A and of 100 mcg/100 cm3 respectively for carotenoids in blood serum and 100 mcg/100 cm3 and 5 mcg/100 cm3 respectively in milk. PMID- 3506176 TI - [Effect of hysterectomy in swine on health status and various indicators of peripheral blood. I. Clinical observations]. AB - Studies were carried out on 36 sows from 100-250 kg of body weight, divided into 5 groups. The sows of group I were given Stresnil and Vetbutal to examine the effect of the anesthetics used during operation on the health condition of the animals studied in the other groups. Laparotomy was performed in group II, amputation of unpregnant uterus in group III, amputation of pregnant uterus or several hours after delivery in group IV, and amputation of pathologically changed uterus by the intraabdominal method and of fallen out uterus after delivery by the extra-abdominal method in group V. It was found that laparotomy, amputation of unpregnant uterus and that several hours after delivery were not a serious danger to the life of pigs, but general disturbances occurring after the operation depended on the magnitude of the operational trauma and health condition before operation. The treatment of pathologically changed uterus by intraabdominal amputation gave positive results in 69.2% of cases. However, no positive results were obtained in the treatment of fallen out uterus after delivery by extraabdominal amputation. PMID- 3506177 TI - [Effect of hysterectomy in swine on health status and various indicators of peripheral blood. II. Hematological studies]. AB - The effect of uterus amputation in various physiological and pathological conditions on the morphological picture of the peripheral blood in pigs was studied. It was found that amputation of the uterus in sows caused a decrease in the level of haematocrit and haemoglobin, in the number of erythrocytes and an increase of leucocytes. In the leucocyte picture an increase of segmented and rod shaped granulocytes and a decrease of lymphocytes, eosinophils and basophils were found. The greatest changes observed were in the group of sows which were amputated pregnant uterus, the uterus short after delivery and that pathologically changed. The return of most of the indices studied to physiological values depended on the magnitude of the operation trauma and health condition of the pigs before operation. PMID- 3506178 TI - The effect of gastric banding on body weight in experimental animals. AB - Recently a new method of gastroplasty has been used in operative treatment of extreme obesity in humans. It depends on putting on the stomach an inabsorbable band in order to form two reservoirs: one small upper, the other large lower, and a narrow passage connecting them, without the necessity to open the stomach. Before using this method on humans it has been experimentally examined on 19 pigs. Gastric banding has little effect on the decrease of body weight, it has some effect only in the first 3-6 weeks. Bands put on the stomach move inside it because of the excessive built-up of pressure in the upper reservoir. The reservoirs vanish. Animals quickly put up weight. The pathological mechanism of moving the band inside the stomach can be explained by the presence of two processes: one reperative, on the serose layer, the other destructive, into the stomach. These findings prove that in operative treatment of extreme obesity in humans it seems essential not to allow the pressure to build up excessively in the upper stomach reservoir. PMID- 3506179 TI - [Effect of hysterectomy in swine on health status and various indicators of peripheral blood. III. Serum electrolyte levels]. AB - The studies carried out on sows which were amputated the uterus in various physiological and pathological conditions showed that this operation caused a decrease in the content of sodium and chloride and an increase of magnesium in blood serum. The changes in the level of electrolytes were the highest in the groups of sows which were amputated unpregnant and pregnant uterus and that short after delivery. PMID- 3506180 TI - The evaluation of effects of selected medicaments in healing of claw wounds in dairy cattle. AB - The influence of 30 chosen medicaments on healing of 148 surgical claw wounds obtained by removing the lateral part of horny capsule was examined. 37 cows of black and white breed were the subject of the investigation. The course of treatment was stated throughout clinical and histological examinations and the evaluation of its final results (the regenerated horn) was made. The interdependence of healing of the pododerm and application of the medicaments was stated. Their form and composition influences the healing. PMID- 3506181 TI - [Biological properties of Mycoplasma isolated from bulls' semen]. AB - The occurrence of Mycoplasma in bulls' semen obtained from different Artificial Insemination Centers in Poland was studied. Out of 380 semen samples 234 mycoplasma strains were isolated (61%). Nutritional requirements and biochemical properties of the isolated strains were studied. On the basis of the results of catabolism of glucose and arginine three different groups of isolates were found. The final identification was determined by growth inhibition test and indirect antibody fluorescent technique. 98% of the isolated strains were classified. In Acholeplasma genus two species were found: A. laidlawii and A. modicum. In the genus of Mycoplasma the majority of isolates were identified as M. bovigenitalium (76%). The remaining strains belonged to three other species: M. bovis, M. bovirhinis, M. arginini and to serological group number 7. The sensitivity of isolates to streptomycin and their viability at different temperature were examined. The occurrence of the pathogenic Mycoplasma strains in the examined bulls' semen, their long survival time at -196 degrees C (24 months) and the resistance of some strains to streptomycin indicate the necessity to examine the semen before it is used in artificial insemination. PMID- 3506182 TI - [Effect of vitamins B1, B2, B6, folic acid and vitamin C on the motor activity of chicken's intestines in chronic experiments and in vitro]. AB - The studies were carried out on 33 chickens of the broiler breed in chronic experiments and in vitro. In the chronic experiments the motility of the jejunum under the influence of vitamins of group B and vitamine C was recorded in 8 chickens. The vitamins were used at concentrations from 10 mg/l to 2.5 x 10(3) mg/l. In the experiments in vitro, the motility of the isolated segment of the jejunum was recorded by the method of Magnus. In this part of experiments the chickens were divided into 3 groups, of which group I (15 chickens) were fed with DKA finischer mixture, group II (5 hens) received, besides the mixture, per os 200 mg of vitamin C for 2 weeks, group III (5 hens) received the mixture and for 2 weeks intraperitoneally 200 mg of vitamin C. The effect of vitamins of group B in vitro was determined in chickens of group I, whereas that of vitamin C in chickens of group I, II and III. At the same time the level of vitamin C in the wall of the jejunum was determined by the method of Roe-Kuenther. It was shown that vitamin B2 and folic acid caused stimulation of intestine motility in the chickens, while vitamin B1, B6 and C decreased the motoric activity. Increased level of vitamin C in the intestinal wall resulted in increased intestine sensitivity. Chicken intestines sensitivity to vitamins was 10 times stronger to vitamins than that of the intestines of rabbits. PMID- 3506183 TI - [Effect of ascorbic acid on the intestinal motor activity in domestic animals]. AB - In this paper, the effect of ascorbic acid on motoric activity of the intestines of rabbits, pigs, cows, sheep and horses has been determined, and a possible participation of the adrenogenic system in this mechanism has been shown. In experiments in vitro the motility of the duodeum, jejunum, caecum and colon in the animals mentioned abowe was recorded by the method of Magnus after administration of ascorbic acid. Diastolic reactions were observed in all animals, which were much greater in small intestines than in large ones. To elucidate the diastolic mechanism under the influence of ascorbic acid, it was applied before and after blocking cholinergic and adrenergic receptors in the jejunum of the animals studied. The observed changes in the motility of the intestines seem not to be connected with cholinergic receptors. However, the action of ascorbic acid inhibiting the motility is probably mediated by adrenergic receptors, which was also confirmed by chronic experiments carried out on rabbits. In the farm animals studied the content of ascorbic acid in the wall of the particular intestine segments was determined by the colorimetric method after Roe and Kuenther. A direct proportional relationship was shown between the sensitivity of the intestines to ascorbic acid and its content in the intestine wall. The intestine segments richest in vitamin C showed the highest diastolic reaction under its influence. In control experiments, it was shown that diastolic reactions of the intestines obtained after the application of ascorbic acid were not caused by decreased pH. PMID- 3506184 TI - Paediatric and perinatal epidemiology. PMID- 3506185 TI - A light in a dark tunnel. PMID- 3506186 TI - So what? Coping with doctors. PMID- 3506187 TI - Mother's and father's birthweight as predictors of infant birthweight. AB - Mothers' and fathers' birthweights are each significantly related to their infants' birthweight, even after control for 31 potentially confounding variables. The relationship is stronger for mothers and daughters than for other parent-offspring pairs. Parents' birthweights together account for 2% of the variance in sons', and 5% of the variance in daughters' birthweights. There are interactions of maternal birthweight with maternal adult weight, pregnancy weight gain, and parity; the predicted effect of maternal birthweight on infant birthweight is enhanced when the mother weighs more, gains more weight during pregnancy, or is multiparous. Race and parents' drinking and smoking also modify the predicted effect of parents' birthweights. The correlation between mother and offspring birthweights has been attributed to the mother's own uterine experience and its effect on her later reproductive performance. However, the significant relationship of father and infant birthweights reported in this paper suggests that the fetal genes also play some role in determining size at birth. PMID- 3506188 TI - Access to intensive neonatal care and neonatal survival in low birthweight infants: a population study in Norway. AB - This study evaluates the impact of regional differences in access to intensive neonatal care on neonatal survival in geographically defined populations of 4,692 low birthweight births in Norway 1979-81. For infants weighting 1,250 to 2,499 g our results are consistent with the existence of a dose-response association between neonatal survival and the level of immediate access to intensive neonatal care. Although not statistically significant, there was a clear gradient in the risk of mortality within 24 hours. A similar pattern of survival could not be consistently demonstrated for infants weighing less than 1,250 g. PMID- 3506189 TI - Causes, continua and other concepts. I--The 'continuum of reproductive casualty'. PMID- 3506190 TI - The Greek national perinatal survey: I: Design, methodology, case ascertainment. AB - A nationwide cross-sectional survey covering the perinatal period was attempted throughout Greece for the 30 consecutive days of April 1983. It aimed to determine the perinatal mortality rate (PNMR) and the way it varied in the country in relation to underlying demographic, biological, socioeconomic and medical factors. For this purpose a coded questionnaire was completed by the obstetrician and/or the midwife responsible for (or, at least, present at) the delivery for every mother giving birth either to a livebirth or a stillborn infant weighing at least 500 g. All livebirths were followed until 7 days of age. The survey was administered centrally through a network of county-based co ordinators. It resulted in the coverage of all state and private maternity hospitals, rural health centres and newborn units. In all 11,048 completed questionnaires were returned and 264 perinatal deaths reported, 42% of which had had a post-mortem examination. The crude PNMR was 23.8 per 1,000 births, with a stillbirth rate of 11.5 per 1,000 births and early neonatal mortality rate of 12.5 per 1,000 livebirths. This rate was substantially higher than would have been calculated from registration rates. PMID- 3506191 TI - The St. Thomas's Hospital maternity case notes study: a randomised controlled trial to assess the effects of giving expectant mothers their own maternity case notes. AB - At an antenatal clinic in St. Thomas's Hospital, London, 246 expectant mothers were randomly allocated to hold either their own maternity case notes or the standard co-operation card. Information was collected on three occasions during their care on attitudes and health behaviour. Clinical outcomes were recorded and the effects of the two systems on clinic administration were observed. More of the notes group expressed satisfaction with most aspects of their care and delivery and significantly more of the notes group felt well informed and satisfied with their companion during labour. There were no differences in clinical outcomes between the two groups except that, for no identifiable systematic reason, there were more assisted deliveries among the notes group. A number of administrative advantages resulted from mothers holding their own notes and although initial reservations were found amongst professional staff interviewed at the start of the study, the results proved persuasive and the practice of giving mothers their own notes is now to be extended throughout the department. PMID- 3506192 TI - The epidemiology of childhood eczema: I. A population based study of associations. AB - Information on whether they thought their child had ever had eczema was obtained from the mothers of 12,555 children in a national cohort of five-year-olds born in 1970. This question was part of a multiple battery of questions concerning the medical, social, environmental and behavioural background of the child. These data were linked to the information that had been collected on the cohort at birth, and a profile of characteristics of the children with reported eczema was produced. A large proportion (46/135) of associations were statistically significant at the 1% level. The major associations were with socio-economic indicators and characteristics of parental health behaviour, with the most advantaged socio-economic groups and those with more positive health behaviour having increased rates of reported eczema. The patterns of associations form an interesting profile of the backgrounds of children reported to have had eczema. Identification of these factors was necessary before more advanced statistical techniques were employed to investigate which of these variables predominate when they are considered simultaneously, and to generate hypotheses as to which factors may be causally associated with the disorder. PMID- 3506193 TI - The epidemiology of childhood eczema: II. Statistical analyses to identify independent early predictors. AB - Amongst a nationally representative sample of singletons born in one week of April 1970 for whom information was available, 12.3% were reported by their mothers as having developed eczema at some time before their fifth birthday. Data from both the birth and the five-year follow-up surveys have been analysed to identify the independent early predictors of this (reported) condition in 11,920 children. Using an initial set of possible predictors suggested by previous analyses of these data, the dominant risk characteristics have been identified as: a positive maternal history of eczema; a positive maternal history of asthma or hay fever; higher parental educational qualifications and the mother originating from the West Indies or Africa. There were also increased risks for children of mothers born in England (relative to the rest of the United Kingdom) and for children of mothers who used contraceptives in the 18 months prior to the index pregnancy. There was no protective effect of breast-feeding even among children whose mothers had a history of allergy. PMID- 3506194 TI - Causes, continua and other concepts. II--Risks are not causes. PMID- 3506195 TI - Fumes from the spleen. PMID- 3506196 TI - Is epidemiology for us or them? PMID- 3506197 TI - So what? The patient's dilemma: medicine or milk? PMID- 3506198 TI - Village health workers are able to teach mothers how to safely prepare sugar/salt solutions. AB - In the predominantly rural Hewu district of Ciskei 54% of infant deaths are diarrhoea-related. The aim of this study was to determine whether village health workers (VHWs) could teach mothers to safely prepare homemade sugar-salt solutions (SSS). VHWs from 11 villages were selected for training while 11 randomly selected villages acted as controls. VHWs selected for training were taught to prepare SSSs and to teach mothers with children under 5 years about the use of such solutions. A card illustrating the main points was given to all mothers. Six weeks after training, randomly selected mothers in control villages (n = 320) and experimental villages (n = 327) were interviewed and asked to prepare SSS. Experimental and control villages had similar children's diarrhoeal disease rates (using a 2 week recall period). In experimental villages 81.5% of mothers compared to 29.7% in control villages had received SSS cards (i.e. been visited). Of recently occurring diarrhoeal-episodes 76.6% were initially treated with a SSS (correct formula used in 81% of cases) in experimental villages compared to 50.5% (correct formula used in 48% of cases) in control villages (P less than 0.05 for SSS use). Greater use of enemas and home remedies occurred in control villages (P less than 0.05). Of solutions made in experimental villages 7% had sodium concentrations over 100 mmol/litre compared to 36% in control villages. Results show that VHWs can effectively train mothers to safely prepare SSS and the VHW program has been expanded to other areas. PMID- 3506200 TI - Competing causes of death in young cases of myeloid leukaemia. PMID- 3506199 TI - Parity specific perinatal mortality. A longitudinal study based on sibships. AB - Perinatal mortality in sibships has been examined using the Medical Birth Registry of Norway. Using linear logistic regression, parity specific perinatal mortality in the period 1967-1981 has been analysed, controlling simultaneously for maternal age, year of birth and survival of earlier births. The risk of a perinatal loss was increased by a factor of up to 6.0 following one earlier perinatal loss, and with three earlier losses the increase was 17.0. The general reduction in mortality between the different five year periods varied according to parity and maternal age. No secular reduction in risk, however, was demonstrated in sibships where the first birth died perinatally; for some subgroups of women the risk actually increased between the first and the second five year period. The effect of maternal age changed with parity, being strong in the first birth order, but of no effect either for the third or the fourth birth orders once the perinatal survival of earlier births was controlled for. This study shows the need to take heterogeneity of risk between women into account in studies of perinatal loss; the overall improvement in perinatal mortality does not apply to every woman. As care improves, perinatal losses become less and less random, demonstrated by increased risks of recurrence. PMID- 3506201 TI - Classification and reproducibility of inflamed gingivae. PMID- 3506202 TI - The prevention and treatment of postoperative pain in dentistry. PMID- 3506203 TI - [Bimaxillary immobilization and feeding in Africa--dietetic suggestions]. PMID- 3506204 TI - [Epidemiological approach to periodontal disease in Black Africa]. PMID- 3506205 TI - [Role of the dental staff in the school medical system in Senegal]. PMID- 3506206 TI - [Epidemiology of maxillofacial trauma in Senegal]. PMID- 3506207 TI - A survey of community dentistry teachers' attitudes toward primary health care training for dental undergraduates. PMID- 3506208 TI - Professional dental education in the Kingdom of Saudi Arabia--an overview. PMID- 3506209 TI - A compound composite odontoma. A case report from Nigeria. PMID- 3506210 TI - [Prosthetic restorations in Zaire, luxury or necessity?]. PMID- 3506211 TI - Trigeminal neuralgia: an unusual case of dental origin. PMID- 3506212 TI - [Amino acid concentration in the serum and urine of Chilean children 0 to 6 years of age]. PMID- 3506213 TI - [Continuous treatment with trimethoprim-sulfamethoxypyrazine of immunocompromised patients]. PMID- 3506214 TI - [Clinical and psychopathologic aspects of early pathologic stuttering]. PMID- 3506215 TI - [Kawasaki disease]. PMID- 3506216 TI - [The course of acute glomerulonephritis in 29 cases confirmed by renal biopsy. 8 years' follow-up]. PMID- 3506217 TI - [Acute bacterial laryngotracheobronchitis]. PMID- 3506218 TI - [Complications of the central nervous system in trichinosis]. PMID- 3506219 TI - [Hyperlipoproteinemia type I]. PMID- 3506220 TI - [Comparison of the morbidity registered at outpatient clinics and in the field. Prospective study in infants]. PMID- 3506222 TI - [Strength evaluation of dental adhesives]. PMID- 3506221 TI - [A computer surveillance system of the critically ill newborn infant patient]. PMID- 3506223 TI - [The development of a new viscometer using hollow PVA fibers and its application for human plasma viscosity]. PMID- 3506224 TI - [The application of unidirectionally solidified Co-Cr-C eutectic composites for artificial hip joint]. PMID- 3506225 TI - [Tissue reaction of nickel-titanium alloy]. PMID- 3506226 TI - [Effect of preparative method of platelets on their morphology]. PMID- 3506227 TI - [Cytotoxicity of hydroxyapatite-polyacrylic acid cement]. PMID- 3506228 TI - [Synthetic studies on acetylacetylene derivatives]. PMID- 3506229 TI - [A man-machine interactive system for processing data obtained from epileptic patients by a long-term ambulatory monitor]. PMID- 3506230 TI - An electronic device for the hearing handicapped drivers. PMID- 3506231 TI - Effects of DSIP analogues on sleep in unrestrained rats. PMID- 3506232 TI - [Dental patient robot instrumented for training tooth cutting techniques]. PMID- 3506233 TI - [Effects of excess oxygen supply on sleep in unrestrained rats]. PMID- 3506234 TI - [Technical developments for long-term continuous measurements of physiological quantities]. PMID- 3506235 TI - [Unconstrained records and dynamic relationship analysis of physical activity rate, heart rate and posture]. PMID- 3506236 TI - [Improvement of the probe of the deep body thermometer]. PMID- 3506237 TI - [Monitoring of temperature distribution in a bed]. PMID- 3506238 TI - [Telemetry system for intraoral pressure measurement]. PMID- 3506239 TI - [Monitoring of glucose concentration in subcutaneous tissue with a glucose electrode mounted in a hydroxyapatite skin button]. PMID- 3506240 TI - [Corrosion resistance of dental cast Ni-Ti alloys]. PMID- 3506241 TI - [Synthetic studies of antiatherogenic agents (13). Synthesis of phthalazinol analogues]. PMID- 3506242 TI - Mechanism of vasodilating action of a novel quinazolinone derivative, 3-(2 chlorophenyl)-6-ethoyxcarbonyl-5, 7-dimethyl-2-(N-methylcarbamoyloxymethyl)-4(3H) quinazolinone (EG1088). PMID- 3506243 TI - Anti-atherosclerotic agents. XIV. Mode of inhibitory action of TH016 on platelet aggregation. PMID- 3506244 TI - [Development of continuous blood gases and pH measurement system]. PMID- 3506245 TI - [New system of a solid model formation with robot arms and dispenser]. PMID- 3506246 TI - [The thermal cycling equipment for dental adhesives]. PMID- 3506247 TI - [Effects of intracerebroventricularly administered nitrazepam and flurazepam on sleep in intrestrained rats]. PMID- 3506248 TI - [Observation of the surface condition of dental cements by scanning electron microscope using freeze directness observation technique]. PMID- 3506249 TI - [Program of care of the diabetic patient at the primary level]. PMID- 3506251 TI - [Why undertake biomedical research in Chile? Response from a medical student]. PMID- 3506250 TI - [Agreements of the Directive Board of the Latin American Association of Academies of Medicine in defense of health and life]. PMID- 3506252 TI - [Use of drugs on sale at private pharmacies]. PMID- 3506253 TI - [Nutrition and catabolism in critically ill medical patients]. PMID- 3506254 TI - [Clinical profile of depression in general practice]. PMID- 3506255 TI - [Evaluation of the surgical treatment of hyperthyroidism]. PMID- 3506256 TI - [Rapid determination of blood glucose with reagent strips in the hospital: a reliable alternative?]. PMID- 3506257 TI - [Depression in the practice of the internist]. PMID- 3506258 TI - [Electrophysiological characteristics of 2 modalities of incessant reciprocating tachycardia]. PMID- 3506259 TI - [Study of various aspects of endocrinology in Chile]. PMID- 3506260 TI - [The brain attic of Sherlock Holmes and undergraduate medical education]. PMID- 3506261 TI - [A system based on a microcomputer for clinical measurement of auditory evoked potentials. I. Description of the computer programs used]. PMID- 3506262 TI - [A system based on a microcomputer for clinical measurement of auditory evoked potentials. II. The system used and normative values]. PMID- 3506263 TI - [Dietary intake of adolescents graduating from high school in the metropolitan area of Santiago, Chile]. PMID- 3506264 TI - [Use of drugs in subjects over 65 consulting an outpatient clinic for the first time]. PMID- 3506265 TI - [Reduced absorption of aminophylline (theophylline) administered by naso-enteral catheter in 5 healthy volunteers]. PMID- 3506266 TI - [Multiple myeloma. Clinical experience of 15 years in the 10th region]. PMID- 3506267 TI - [Cardiac amyloidosis: a case diagnosed by endomyocardial biopsy]. PMID- 3506268 TI - [Analysis of the economic situation of the University of Chile and its means of solution. The University Council of the University of Chile]. PMID- 3506269 TI - [On the creative process]. PMID- 3506271 TI - [Pursuing coronary disease]. PMID- 3506270 TI - [Measles in adults. An unforeseen consequence of vaccination?]. PMID- 3506272 TI - [Determinants of arterial pressure in school children of Santiago]. PMID- 3506273 TI - [The lipid profile in a population of patients with untreated hypertension]. PMID- 3506274 TI - [Prevalence of alcohol abuse and other diagnoses related to the drinking problem in emergency services of Santiago, Chile]. PMID- 3506275 TI - [Scenes related to the use of tobacco in television programs in Santiago]. PMID- 3506276 TI - [Effects of antihypertensive therapy with acebutolol on plasma lipids]. PMID- 3506277 TI - [Effect of chemotherapy with C-MOPP in Hodgkin's disease in stages III B and IV B]. PMID- 3506278 TI - [Sensitivity of Streptococcus pneumonias and its clinical importance]. PMID- 3506279 TI - [Antimicrobial sensitivity of Clostridium difficile]. PMID- 3506280 TI - [Pharmacotherapy and clinical research]. PMID- 3506281 TI - [Diabetic neuroarthropathy]. PMID- 3506282 TI - [Unusual forms of presentation of primary hypothyroidism]. PMID- 3506283 TI - [Statement of the Academia Chilena de Medicina on the decrease of infant mortality and other health indicators]. PMID- 3506284 TI - [Ethics and randomized or double-blind research studies]. PMID- 3506285 TI - [Vasodilator agents in pulmonary hypertension]. PMID- 3506286 TI - [Primary pulmonary hypertension]. PMID- 3506287 TI - [Insolubilization of deciduous tooth enamel by two-step method with fluoride and lanthanum treatment]. PMID- 3506288 TI - [Studies on cooperation-enhancing approach in dealing with children in the dental setting. 1. A detailed record of children's emotional and behavioral reactions in dental settings]. PMID- 3506290 TI - [A study on morphological characteristics of the upper and lower dental arch and occlusional pattern of children with cleft lip and palate in deciduous dentition]. PMID- 3506289 TI - [Studies on cooperation-enhancing approach in dealing with children in the dental setting. 2. Mother's anxiety-trait and child's personality]. PMID- 3506291 TI - [Effect of candy containing palatinose on human dental plaque formation]. PMID- 3506292 TI - [Dental findings on the Rubinstein-Taybi syndrome; a case report]. PMID- 3506293 TI - [The state of the recall visit at the Pediatric Dentistry Clinic of Nagasaki University Dental Hospital]. PMID- 3506294 TI - [Current status of juvenile gingival pigmentation in Japanese children and young adults]. PMID- 3506295 TI - [Report of four cases of sialolithiasis in children and scanning electron microscopic study of the salivary calculi]. PMID- 3506296 TI - [Mobius syndrome: report of a case]. PMID- 3506297 TI - [Stress analysis of the deciduous tooth using the finite element method. Part 2: Depth of the proximal wall of Class II cavity preparation]. PMID- 3506298 TI - [Experimental study of tooth eruption and the effects of drugs using soft X-ray photographic and continuous electromechanical methods]. PMID- 3506299 TI - [Influence of cell growth inhibitors on the eruption rate using the soft X-ray photographic method]. PMID- 3506301 TI - [A questionnaire concerning the style of treatment at the pedodontic clinic of Niigata University Dental Hospital]. PMID- 3506300 TI - [An investigation into actual condition of recall in the pedodontic clinic of Niigata University Dental Hospital]. PMID- 3506302 TI - [In vitro study of pit and fissure sealant. Part 1: Effect of marginal sealing and penetration into pit and fissure of sealant materials]. PMID- 3506303 TI - [Mesio-distal crown diameter and arch size of deciduous dentition in Japanese born between 1970-1975]. PMID- 3506304 TI - [Dental caries prevalence among children of day-nursery and kindergarten in Kohriyama city]. PMID- 3506305 TI - [A radiological investigation of the effect of calcium on jawbones in the growing stage]. PMID- 3506306 TI - [The relationship between the external shape of the morphology and pulp cavity of the maxillary first deciduous molars--three computerized dimensional analyses]. PMID- 3506307 TI - [Effects of immunization with Streptococcus mutans on experimental dental caries in rats: comparisons among three different immunization methods]. PMID- 3506308 TI - [Electromyographic and occlusal sound studies during tooth tapping in children]. PMID- 3506309 TI - [Cariogenicity and anti-cariogenicity of glucosyloligosaccaride in experimental dental caries of rats]. PMID- 3506310 TI - [Accuracy of the tooth tapping rhythms in children]. PMID- 3506311 TI - [A case of Hallermann-Streiff syndrome--dental findings]. PMID- 3506312 TI - [Study on impacted and displaced permanent teeth for children. Report 1. Management of displaced teeth after marsupialization of dentigerous cysts: report of 3 cases]. PMID- 3506313 TI - [Cariostatic effects of topical application of (NH4)2MoO2F4 solution: clinical study]. PMID- 3506314 TI - [Child abuse: a case report]. PMID- 3506315 TI - [A case of impacted mandibular second primary molar impacted following surgical exposure and orthodontic guidance]. PMID- 3506316 TI - [Preclinical verification of possibilities of extracorporeal lithotripsy of gallstones in experimental animals]. PMID- 3506317 TI - [A computer model of hemoglobin glycosylation]. PMID- 3506318 TI - [The effect of 4-acetamidosalicylic acid on fetal development]. PMID- 3506319 TI - [Mammography in the diagnosis of diseases of the breast]. PMID- 3506320 TI - [Evaluation of the apical base of the upper jaw in anomalies with protrusion of the upper incisors and overbite]. PMID- 3506321 TI - [Specific functions of medical schools]. PMID- 3506322 TI - [Fine structure of tumor cells in acute leukemia]. PMID- 3506323 TI - [Non-Hodgkin's malignant lymphoma with a low level of malignancy]. PMID- 3506324 TI - [Laser surgery of dysplasia and malignant tumors in the region of the head and neck]. PMID- 3506325 TI - [Regeneration of sensory nerve endings in the labial mucosa as a consequence of primary and secondary neurorrhaphy of the mental nerve]. PMID- 3506326 TI - [Recent progress in thymic hormone research--special reference to platelet aggregability and acquired immune deficiency syndrome]. PMID- 3506327 TI - [Pulp response to composite resin full crown restoration on deciduous anterior teeth]. PMID- 3506328 TI - [Three-dimensional ultrastructure of the osteoblast and of the bone matrix in immature bone]. PMID- 3506329 TI - [Physiochemical characteristics of hydroxyapatite (HAP) particles and tricalcium phosphate (TCP) particles used for substitute bone]. PMID- 3506330 TI - [A clinical observation on changes in oral-habit incidence]. PMID- 3506331 TI - [Factor analysis for dental health status of junior high school students with experience or non-experience of fluoride mouthrinse. Part 1: Effects of fluoride mouthrinse experience on dental health status]. PMID- 3506332 TI - [Factor analysis for dental health status of junior high school students with experience or non-experience of fluoride mouthrinse. Part 2: Influences of individual dental health behavior, dental health education and care at primary school and preventive services during dental visits on caries prevalence]. PMID- 3506333 TI - [Experimental studies on healing process of vascularized bone replantations in the mandible]. PMID- 3506334 TI - [Skeletal and dental changes after surgical correction of mandibular protrusion by sagittal splitting technique of the ramus]. PMID- 3506336 TI - [Clinical evaluation of Ga-Al-As semiconductor laser diode (UNI-LASER) irradiation in treatment of solitary aphtha, erosion and hypersensitive dentin]. PMID- 3506335 TI - [The hemodynamic effects of intraoral surgery under intravenous sedation with diazepam in patients with a history of so-called cerebral anemia]. PMID- 3506337 TI - [Research work of the procedure for obtaining Al2O3--ceramic implants and instruments for clinical application (technical-technological aspects)]. PMID- 3506338 TI - [Strict anaeroba in the endodontic region]. PMID- 3506340 TI - [Analysis of oral harm in alcoholics]. PMID- 3506339 TI - [Systemic disorders and HLA in recurrent aphthous ulcerations]. PMID- 3506341 TI - [Transit zone in fixed prosthetic works]. PMID- 3506342 TI - [The effects of propolis on microflora of carious lesion]. PMID- 3506343 TI - [Registration and therapy of functional disorder in dental-prosthetic practice]. PMID- 3506344 TI - [Crown margin and periodontal health]. PMID- 3506345 TI - [Surgical aspect of upper canines transplantation]. PMID- 3506346 TI - [The effect of nutrition on the occurrence of caries in children]. PMID- 3506348 TI - [Significance and the role of a stomatologist in the domain of social orthodoncy]. PMID- 3506347 TI - [Contribution to the problems of correlative relations between the two sums of incisors and the sum of mesiodistal changes of canine and premolar crowns]. PMID- 3506349 TI - [Congenital deformity of oro-facial region as a cause of psycho-social stress]. PMID- 3506350 TI - [The use of computers in modern education]. PMID- 3506351 TI - [Orthodontic treatment of adult patients]. PMID- 3506352 TI - [Trauma of orofacial region and its consequences in children]. PMID- 3506353 TI - [Opening of sports stomatologic centers, planning, organization and principle of work]. PMID- 3506354 TI - [A clinical investigation of young periodontal patients. Conventional laboratory tests, second metacarpal bone degeneration studies, nutritional studies]. PMID- 3506355 TI - [Research into pharmaceutical students' consciousness concerning their expectations toward dental students and their views of medical ethics]. PMID- 3506356 TI - [A case of symptomatic trigeminal neuralgia with brain tumor]. PMID- 3506357 TI - [Development of a new device for measuring the corrosion rate and evaluation of corrosion resistance of dental silver alloys]. PMID- 3506358 TI - [Clinical technique with light-cured reliner for denture base]. PMID- 3506359 TI - [Marginal leakage of Class II composite resin restorations: Part I]. PMID- 3506360 TI - [Electromyographic study of masticatory muscle dysfunction in patients with temporomandibular joint arthrosis--with special reference to the frequency changes of the electromyogram]. PMID- 3506362 TI - Platelet antibodies in viral hepatitis. PMID- 3506361 TI - Serum-25-hydroxycholecalciferol levels in children and adolescents. PMID- 3506363 TI - The incidence of microcytosis in the newborn (possible alpha-thalassemia) in the Tabuk region of Saudi Arabia. PMID- 3506364 TI - Flexor tendon contractures in an insulin-dependent diabetic young girl (Rosenbloom syndrome). PMID- 3506365 TI - [Working Group for Clinical Respiratory Physiology. Work session 1986. Bad Aussee, 11-13 September 1986. Abstracts]. PMID- 3506366 TI - [Uptake and release mechanisms of 3H-dopamine in the retina of Eugerres plumieri]. PMID- 3506367 TI - [Cultivation of Cystoisospora felis Frenkel, 1977 (Isospora felis Wasielewski, 1904, Wenyon, 1923) in the chorioallantoic membrane of chick embryos]. PMID- 3506368 TI - [Orientation at an angle to the light in schools of Moenkhausia dichroura Kner: a model of a circannual clock]. PMID- 3506369 TI - Myoplasmic (Ca2+) in Duchenne muscular dystrophy patients. PMID- 3506370 TI - Effect of chlorpromazine administered to pregnant and lactating rat females on the behaviour of their offspring and its brain content of bioamines. PMID- 3506371 TI - Plasma noradrenaline and adrenaline concentrations and blood pressure at various stages of spontaneous hypertension in the rat (SHR). PMID- 3506372 TI - Gastric ulcer and gastritis. Results of short-term follow-up. PMID- 3506373 TI - Arterial hypertension among Warsaw diabetics. PMID- 3506374 TI - Relation of body mass to ischaemic heart disease in diabetics. PMID- 3506375 TI - Plasma and leukocytic bactericidal activity in the course of chemotherapy of Hodgkin's disease. PMID- 3506376 TI - Variation in the growth of the preweaning Syrian hamster (Cricetus auratus). AB - An assessment of the growth rate spectrum based on a longitudinal weight study of golden hamsters was undertaken over the preweaning period. The period covered 23 days with data probes at 24-hourly intervals and encompassed 16 litters providing a birth number of 120 young and a weaning survival number of 82. Subsequent analysis directed initially at the pooled or averaged data showed sex differences with males gaining weight faster than females. Further analysis showed the total period to have three definitive break-points and therefore four phases of growth activity. The segmented linear regression line calculations showed that the phasic duration of males in the second and third phases were two days later than the females. Following data-analysis adjustments and taken into account aberrations of the sample, final indications pointed to the preweaning hamster growth spectrum as quadrophasic, exhibiting a stable first phase, a second and third phase terminating earlier in females and a final weaning weight being heavier in males. The growth curves demonstrated a 'U' shaped outline and formed an integral part of hamster preweaning precocity. PMID- 3506377 TI - Lectin histochemical study on the infraorbital gland of the Japanese serow (Capricornis crispus). AB - Histology and lectin histochemistry were performed in the infraorbital gland of the Japanese serow. The gland is composed of glandular tissues and a pouch filled with the secretion. The tissues consist of an inner layer of sebaceous glands and an outer layer of apocrine glands. The male sebaceous layer is made up of the ordinary type, whereas the female's layer consists of the ordinary and modified types. In the apocrine gland stained with Arachis hypogaea (PNA), nine different patterns of glandular tubules were distinguished on the basis of staining of the cytoplasm, the Golgi area of secretory cells and secretion. Secretory modes of apocrine secretion and exocytosis were included in these stainings. Myoepithelial cells stained constantly with Glycine max (SBA) except when only the Golgi area of secretory cells was positive. The modified sebaceous gland was stained with PNA, SBA, Ricinus communis I (RCA), Triticum vulgaris (WGA), Canavalia ensiformis (Con A) and Ulex europaeus I (UEA), while the ordinary type was positive in PNA, RCA, SBA, WGA and Con A. The secretion in the pouch was stained with PNA, RCA, SBA, Dolichos biflorus (DBA), WGA and Con A. These findings suggest that the modified sebaceous gland contains large amounts of glycoconjugates and the apocrine gland shows a cyclic secretory process of apocrine secretion and exocytosis. PMID- 3506378 TI - Regeneration in surgically produced cleft palate in rabbits. A microscopical study. AB - In order to study the effects of surgical procedures on the regeneration process in cleft palate, an artificial cleft was made in 4-weeks old female New Zealand rabbits. The 47 animals were divided into 5 groups: group 1: controls, group 2: cleft made in the bony palate, using a dental burr (phi 3 mm), group 3: cleft as in group 2, oral mucosa stitched, group 4: cleft made without perforating the nasal mucosa; oral mucosa stitched ("Veau"), group 5: cleft made as in group 4; before stitching the oral mucosa pieces of autologous rib bone were introduced into the cleft ("Schuchardt"). At the ages of 4, 5, 6, 8, 12, 18 and 24 weeks, one or two animals per group were sacrificed. The palatal region was microscopically studied using 10 mu paraffin sections stained according to Herovici. It was found that it is difficult to make a reproducible cleft on the histological level. A large interindividual variation in local damage due to the surgical procedure was observed; this might contribute to the variation in growth results of the facial skeleton reported in literature. Signs of excessive bone resorption were found. The presence of bone in places where sutural tissue should be present, observed in some growing animals, will contribute to reduction of palatal width, medial collapse of the palate and asymmetry of the facial skeleton. There appeared to be no striking differences between the three methods of repair, used in group 3, 4 and 5 respectively. PMID- 3506379 TI - A new method for early in utero experiments in rat embryos: endoscopy. AB - The merits of in vitro and in vivo techniques for experiments in rat embryos are discussed in this paper. Time limitation of culture, which is only feasible during 48 hours, up to day 13 post coitum (p.c.) is a major draw-back in the in vitro whole embryo culture. With the in utero operation technique used to date, no controlled experiments can be performed in rat embryos of 15 days p.c. and younger due to the high mortality of the embryos. Therefore a new technique has been developed, in which successful in utero operations can be performed as early as day 12 of gestation. Controlled micro-injection with the help of an endoscope can be given in any desired embryonic organ or structure. This paper describes this technique. Endoscopy in rat embryos of 12 days p.c. onwards has proven to be a new facility for in utero operations. PMID- 3506380 TI - Avian cranio-cervical systems. Part III: Robot kinematics for cervical systems. AB - A 2D-model for the kinematics of the cranio-cervical system is developed from algorithms applied for robot kinematics. The model is proposed for avian cranio cervical systems. Three main problems were to be solved. The problem of underdetermination in an open multi-element kinematic chain, which develops because only kinematics were included, is solved by the application of two approximations for economic motion. The straight-line approximation for the course of the bill tips and the least-motion approximation for all articulations are both assumed to occur in selected phases of pecking and drinking behaviour. The problem that internal constraints and constraints resulting from demands for proper functioning may be operating is solved by incorporating the measured maximal dorsal and ventral flexion of each joint, and also both the target location of the bill tips and the target orientation of head and beak. The third problem, viz. how to handle variations in initial conditions, which developed from the relatively independent working locomotory part, is solved by standardizing the foot-food distance in the experiments, and further by running the simulations for the locomotory components over the trajectories they cover in reality, rather than to allow them to move over their full work-envelope. The model is highly adaptable to changes in the number of bars involved, in bar lengths, in work-envelopes, and in motion patterns. The predicted patterns were tested against combined film- and radiographic analyses. The comparisons lead to some general conclusions. The economy principles tested appear to be confirmed from the observations. Also, the fixed-target orientation approximation seems to be confirmed while the locomotory components clearly operate primarily under different constraints. PMID- 3506381 TI - Lumbar back muscle activity during walking with a leg inequality. AB - The influence of an artificial leg length discrepancy (= ALLD) on stride times, pelvic rotations and activity of the intrinsic lumbar back muscles (= ILBM) was investigated for 20 subjects. An ALLD was created by shoes with a raised sole. Walking with an ALLD produced an increase of the swing phase time and a decrease of the stance phase time for both feet. The influence of an ALLD on pelvic rotations in the sagittal and frontal plane and on ILBM-activity was small. Changes in pelvic rotations in the sagittal plane were too small to observe. The mean pelvic rotation angle in the frontal plane was changed 1.52 degrees when walking with an ALLD of 40 mm (6.9 degrees while standing with an ALLD of 40 mm with extended knees). Only small changes were found in activity time due to an ALLD (not in EMG-amplitude). The activity time of the ILBM around heel strike of the raised limb was increased and unilaterally shifted from toe off in the direction of heel strike with the raised limb. PMID- 3506382 TI - Proceedings of the 141st meeting of the Netherlands' Anatomical Society. Amsterdam, October 31, 1987. Abstracts. PMID- 3506383 TI - Proceedings of the 142nd meeting of the Netherlands' Anatomical Society. Amsterdam, January 30, 1988. Abstracts. PMID- 3506384 TI - [Occlusal patterns of deciduous dentition in children from a new suburban area and a village near Zagreb (Second part)]. PMID- 3506385 TI - [Surface characteristics of a cobalt chromium alloy resulting from a range of electrolytic polishing conditions]. PMID- 3506386 TI - [The frequency of lesions to molar furcations in patients with periodontal disease]. PMID- 3506387 TI - [Fear of dental clinics as a limiting factor in the delivery of mouth and teeth health care]. PMID- 3506388 TI - [A correlation of LDH isoenzymatic activity of radicular cyst content with cytologic and microbiologic analysis]. PMID- 3506389 TI - [Factors determining the choice of therapeutic methods in xerostomia]. PMID- 3506390 TI - [The role of a dentist in the prevention of microbial endocarditis]. PMID- 3506391 TI - Management of the periodontal tissues following trauma. PMID- 3506392 TI - Occlusal consideration following trauma--the surgeon's view. PMID- 3506393 TI - Effects of ionizing radiation on facial bones and developing dental tissues. PMID- 3506394 TI - The bruxer. PMID- 3506395 TI - Psychosomatic aspects of dentistry. PMID- 3506396 TI - Changing injury patterns in road crash casualties. PMID- 3506397 TI - Diagnosis of maxillofacial injuries. PMID- 3506398 TI - Oral and maxillofacial injuries. The role of the oral and maxillofacial surgeon in treatment. PMID- 3506399 TI - Preschool child feeding, health and nutritional status in Gualaceo, Ecuador. AB - Anthropologic, survey, dietary recall and anthropometric techniques were used to study the correlates of nutritional status of preschool children under five years of age in Gualaceo Ecuador. A widespread stunting was found among the children. Nutritional status was worst among infants comprised between 12 and 23 months old but it improved between April and August, thus suggesting seasonality changes of nutritional status. The correlates of nutritional status (expressed as Z score of weight-for-age) were dietary diversity, birth-spacing, fertility, migration, household income, material goods owned, and parental education. A regression model with these variables predicted 63% of the variability in weight-for-age. The prediction of height-for-age was similar, but only predicted 43% of the variability in height-for-age. Correlates of dietary diversity, birth-spacing, fertility, and migration were child age, maternal age and arm circumference, parental education, use of birth control, household food expenditure, material goods owned, and the raising of animals. Parental education was a correlate of dietary diversity, fertility and migration. Parental education was related to change in weight-for-age in the longitudinal subset. Pre-harvest time and a pathway of illness leading to decreased dietary diversity and to decreased nutritional status in April, were suggested as important to preschool child nutritional status. Hot-cold ideology--resulting in food withdrawal during illness and restriction of high-protein and high-calorie foods--appears to be an important mechanism determining preschool child nutritional status. Breast feeding, sanitary, higienic, birth control, and drinking (alcohol) practices were suggested as areas that could be improved, in order to improve preschool child nutritional status. Communication between parents and western health care providers was also suggested as an area for improvement. PMID- 3506400 TI - [Serum levels and urinary excretion of magnesium in pregnancy. Effect of milk intake]. AB - Magnesium levels in serum, as well as 24-hr urine and 2-hr post-fasting urine levels, were studied in 107 pregnant women, who were later separated into two groups. One group was advised to follow their usual intake, and the other, to supplement the diet with 750 cc of milk. The control group (30 healthy non pregnant women) underwent the same protocol. Magnesium intake in pregnant women was much lower than that recommended for gestation. In both groups of pregnant women, serum magnesium levels were lower than those of the controls, in the second and third trimester of pregnancy. Urinary magnesium in 24-hr urine was higher in each trimester of pregnancy than the controls. Hypomagnesemia and hypermagnesuria not influenced by milk intake was observed. PMID- 3506401 TI - [Use of chigo (Campsiandra comosa Benth) seeds in human nutrition. III. Energetic value of chiga flour]. AB - The proximate composition as well as vitamin and mineral contents of a sample of chiga (Campsiandra comosa Benth) flour was analyzed, having determined that it was essentially a carbohydrate source. The product was evaluated as source of energy, substituting 33, 67 and 100% of the corn starch of isoproteic and isocaloric feeds for growing Sprague-Dawley rats. In an experimental period of 15 days, results indicated that the substitution of one-third of the carbohydrate with chiga flour did not reduce the weight gain, food consumption, metabolizable energy or utilization of the food energy by the rats. Higher levels of the product in the diet originated a decrement in these variable values. The apparent nitrogen and energy digestibility of the diets was progressively reduced as the concentration range of chiga flour utilized was increased. The metabolizable energy value of chiga flour was 3.15 kcal/g, which indicated that approximately 78% of its gross energy (4.01 kcal/g) was metabolized. PMID- 3506402 TI - Development and evaluation of a low-cost amaranth (Amaranthus cruentus) containing food for preschool children. AB - A powdered blend for feeding preschool children was prepared from whole amaranth (Amaranthus cruentus) seeds, pearled oats, soybeans, sucrose and vegetable oil. The blend was similar in proximal chemical analysis and total caloric content, and identical in calorie distribution and vitamin and mineral patterns to a soy/oats infant formula previously developed. The amaranth blend equalled the FAO/WHO 1973 children's pattern in tryptophan and exceeded this pattern, as well as the soy/oats formula in all other essential amino acids; it reflected higher PER than casein and the soy/oats formula. In feeding trials with children 1-3 years of age, no significant differences in weight gain was observed when either product was fed. The anticipated cost of the amaranth blend is 6% lower than that of the soy/oats formula. PMID- 3506403 TI - [A model for the extrusion of a corn:soybean blend (70:30)]. AB - Most of the physicochemical and sensorial properties of the extrudates depend on the extent of the starch degradation. A cereal extrudate has physicochemical properties similar to those of a blend of raw, gelatinized and dextrinized starch. Based on this postulate, models of cereal: oilseed blends were prepared, and different analytical techniques for their characterization were applied. Results revealed that the corn:soy (70:30) extruded sample under study, was similar to moderately dextrinized corn:soy blend obtained in the laboratory. Therefore, it could be used to prepare "papillas" or precooked foods. PMID- 3506404 TI - [Nutritional and stability evaluation during storage of blends extruded with sorghum]. AB - Binary sorghum:soy (70:30) and ternary sorghum:corn:soy (30:40:30) blends using high and low tannin content dehulled sorghum were extruded. The effectiveness of heat treatment was determined by protein dispersion index (PDI) and ureasic activity (delta PH), indicating that proteins were denatured and antinutritional factors reduced. The nutritional evaluation supported the fact that samples were adequately treated, giving ternary blends true digestibility (TD) and biological values (BV) similar to milk casein. Blend stabilities, expressed as peroxide index (PI), revealed a low lipid oxidation rate during the first seven months, and were acceptable up to a year of storage. Extrudates with incorporated sorghum cover protein and energy demands of the growing infant, and provide a high nutritional value and long-life product. PMID- 3506405 TI - [Supplementation of wheat flour with chickpea (Cicer arietinum) flour. II. Chemical composition and biological quality of breads made with blends of the same]. AB - Experimental bread made of wheat flour complemented with 5, 10 and 15% chick-pea flour was studied, using wheat bread as control. Samples were analyzed for their proximal chemical composition and amino acids content. Crude fiber and protein increased from 0.36% to 0.55%, and from 14% to 17.6%, respectively, when 15% chick-pea flour was added. The lysine content increased as the level of supplementation was raised. Biological quality of proteins was measured in rats as protein efficiency ratio (PER) as well as apparent digestibility resulting in an increase of PER values from 0.90 to 1.34 and small variations in bread protein digestibility. Bread nutritive value was significantly improved by adding chick pea flour. PMID- 3506406 TI - Nutritional evaluation of roasted, flaked and popped A. caudatus. AB - A study was carried out with a selection of A. caudatus CAC-064, which was processed in three different forms: popped, flaked and roasted. The popped sample was prepared by subjecting the grains to a temperature between 175 and 195 degrees C for 15-25 seconds. The flaked sample was obtained by adjusting moisture content to 26% and using heated (200 degrees C) rotating drums for a contact time of 1-3 seconds, and roasting was achieved by heating the grain at 150 degrees C for a lapse of 60-90 seconds. All samples, including a raw sample, were analyzed for proximate chemical composition, minerals, available lysine and tryptophan content, as well as damaged starch, calories, soluble and insoluble fiber, and protein quality. Differences in chemical composition due to the processing applied were small and insignificant, except for lower available lysine values, and insoluble fiber with higher values in the roasted sample than in the flaked and popped samples. Likewise, the roasted sample had higher levels of damaged starch. Protein quality was highest in the popped sample (NPR 3.19), followed by the flaked (NPR 2.78), the roasted (NPR 2.24) and the raw (NPR 1.73) samples. These values were related to available lysine. Protein digestibility was lowest in the roasted material followed by the flaked and the popped products. It is concluded that establishment of optimum processing conditions is necessary in order to achieve maximum utilization of amaranth grain. PMID- 3506407 TI - [Formulation, preparation and evaluation of shortening, laminated and cut biscuits, for diabetic patients]. AB - Laminated and cut cookies formulated with natural and/or artificial sweeteners as substitutes of sucrose, are presented as a new alternative of choice for persons on a restricted diet. According to data in the literature, market availability and technological and economic limitations involved in the use of pure sweeteners, four mixtures were selected for the formulation of the cookies, instead of sucrose. Their composition and relative sweetness were as follows: (table; see text) After the statistical analysis of results, formulations presenting significantly superior quality characteristics were selected. As observed, all alternatives subjected to evaluation were grade 1. A study of acceptability by diabetic patients was carried out with these products through a ranking test, in order to determine which were the formulations preferred. This revealed a significant preference for the cookies containing saccharin-sorbitol = 0.35:99.65, at a 1% level of significance. Their nutritional and caloric values, as well as the chemical composition of the selected formulations were then determined. The results showed a 10.9% decrease in caloric contribution. PMID- 3506408 TI - [Effects of treatment with polyvinylpyrrolidone on nutritional quality of sorghum]. AB - The purpose of this paper was to show that a high polyphenolic compound content in the sorghum grain (Sorghum saccharatum, var sugar drip) has an unfavorable influence on the nitrogen absorption. In order to arrive at this conclusion, the tannin content in sorghum flour was reduced by means of a treatment with polyvinylpyrrolidone (PVP) as a complexing agent. Several biological experiments were performed with non-treated flour (S) and with PVP-treated flour (S + PVP). Treatment improved true digestibility (D), having obtained the following values: for S = 31 +/- 2.67, and for S + PVP = 55.8 +/- 3.48 (significance P less than 0.001). The tannin evaluation yielded the following results: S = 1.90 g/100 g, and S + PVP = 0.85 g/100 g reported as tannic acid. The digestibility increase induced a better nitrogenous utilization, the net protein utilization (NPU) values being from 19 +/- 1.58 to 37 +/- 3.36 for S, and S + PVP, respectively. PMID- 3506409 TI - [Use of chickpea (Cicer arietinum L.) in non-dairy formulas. I. Chemical composition and nutritive quality of chickpeas and a comparison with commercial infant formulas]. AB - A study was carried out to determine, in rats, the chemical composition and protein quality determinations: PER, NPR and NPU of chick-pea, milk powder and two different commercial infant formulas for babies with lactose intolerance. The formulas studied were "Casec" (calcium caseinate), "Sobee" (soy flour), "Plenilac" (milk powder) and cooked chick-pea flour, alone or supplemented with methionine and/or tryptophan. The protein and fat contents of "Casec" were 88 and 2%, respectively, while chick-pea, "Sobee" and "Plenilac" exhibited 18.9 and 8%, 22 and 18%, 26 and 28%, respectively. The four products were deficient in sulfur amino acids, with "Sobee" exhibiting the lowest chemical score (57), followed by chick-pea (62), "Casec" (68) and "Plenilac" (82). The chick-pea supplemented with methionine was deficient in valine (C.S. 76). The higher values of PER, NPR and NPU were obtained with the chick-pea supplemented with methionine, and with the "Plenilac" samples, while chick-pea without amino acid supplementation, however, had a protein quality similar to "Casec" and to "Sobee". According to these results, therefore, chick-pea alone or supplemented with methionine can be utilized as a milk substitute in malnourished children with lactose intolerance. PMID- 3506410 TI - [Preparation and evaluation of fish portions from shrimp by-catch]. AB - Fish portions were obtained from a mixture of fish flesh from shrimp by-catch. Physical, chemical, microbiological and sensory tests were done to evaluate quality of raw materials, formulations and processing conditions. Several technological procedures proved to be feasible for this product. Stability of frozen products for four months was determined by physical, chemical and microbiological tests, the results of which indicated its stability during the study period. Findings of our study, therefore, suggest the potential of shrimp by-catch for the preparation of fish portions in view of its high acceptability and simple processing technique, by using marine resources not fully utilized at present. PMID- 3506411 TI - [Effects of some extrusion variables on corn flour]. AB - Grits and flour extrusion is a relatively simple operation. Nevertheless, understanding the transport mechanism and property modifications which occur during the operation, is quite complex. Analysis of the effects produced on the material properties, through those methods that better describe the transformations produced, and the correlation of these "indicators" or responses with the process variables, would allow a better interpretation of the process as well as the selection of operation conditions to keep in mind so as to obtain the desirable characteristics in the product. In the present study, the effect of feed moisture, extrusion temperature and screw speed as well as compression ratio on corn flour properties, was evaluated through the following parameters or responses: feed rate, specific consumption of mechanical energy, specific volume, expansion, water solubility and amylogram. According to the results, feed moisture is the most relevant in modifying the properties, whereas the relative importance of temperature and compression ratio depend on the property being analyzed. Thus, for example, for specific consumption of mechanical energy, compression ratio is more important, while for expansion and specific volume, temperature is the most important. On the other hand, solubility appears to be the property that best describes changes involved during processing of the sample, while specific volume and specific consumption of mechanical energy- although being less efficient--also turn out to be very useful responses. PMID- 3506412 TI - [The importance of maxillofacial traumatology in the context of polytrauma]. PMID- 3506414 TI - [Congenital erythropoietic porphyria]. PMID- 3506413 TI - [Antibiotics. I. Overview]. PMID- 3506415 TI - [Overview of insurance. I. Professional responsibility of the dentist]. PMID- 3506416 TI - [Recurrent oral aphthae in children]. PMID- 3506417 TI - [Amalgam condensation technics and evaluation of residual free mercury]. PMID- 3506418 TI - [Orthognathodontic surgical treatment of skeletal Class III]. PMID- 3506419 TI - [Insurance. 2. Policy coverage for civil responsibility of the physician-surgeon dentist according to current requirements]. PMID- 3506420 TI - The periodontal health of post-orthodontic subjects. PMID- 3506421 TI - The Bauschinger effect in stainless steel orthodontic wires. PMID- 3506422 TI - Clinical orthodontic photography. Part II--Facial photography. PMID- 3506423 TI - A BASIC digitising program. PMID- 3506424 TI - Cephalometric landmark identification error. PMID- 3506426 TI - Molecular pathology. PMID- 3506425 TI - Environmental risk assessment. PMID- 3506427 TI - Selected somatic and psychological problems of asthmatic syndrome sufferers. AB - Clinical and psychological examinations were carried out on 30 inpatients suffering from asthmatic syndrome and 33 inpatients suffering from effort syndrome. Discrepancies between these two groups are shown with respect to the parameters examined. On the basis of the factor analysis the role and significance of psychological and social factors (the conditions of service at sea) among these sufferers were underlined. PMID- 3506429 TI - Cross cultural study of productive phenomenology of schizophrenia. AB - A study of 97 cases of schizophrenia in Libya and 100 in Malta. Clinical analyses have showed differences of the content of the delusions and hallucinations as a result of cultural pathoplastic influences. The pattern of delusions and hallucinations was studied. In comparison with the Maltese the Libyan schizophrenics had less described and less systematized productive symptoms. PMID- 3506428 TI - Application of gas chromatography combined with enrichment of samples on activated carbon to determine low concentrations of organic compounds in the air. Part II. Butanol and butyl acetate. AB - The gas chromatography with initial enrichment of the samples on activated carbon was employed to determine low concentrations of butanol and butyl acetate mixture in the air with different humidity content. In the range of concentrations examined (20-30 MAC for the atmospheric air) no apparent influence of moisture content in the air on the "breakthrough" of sorbent layer was stated. Moreover, butanol desorption efficiency decreased simultaneously with the increase of quantity of humidity adsorbed on the activated carbon. The analytic technique discussed should not be employed in determination of butanol low concentrations in the air with relative humidity exceeding 50%, and, in case this is of necessity, when the desorption coefficient is estimated, the amount of water adsorbed on the activated carbon during sampling should be regarded. PMID- 3506430 TI - Characteristic differences in the use of psychotropic drugs as a stigma of cultural influences. AB - The study aimed at investigation of the influence of the cultural and racial factors upon therapeutic response of the schizophrenic patients in Libya and Malta. The study revealed high frequency of polypharmacy, liberal use of minor tranquillizers and antiparkinsonian agents, and daily multiple administration of drugs. Long-acting preparations were not administered in Libya, while in Malta they were used in 37.5% of patients. Therapeutic response in both investigated groups were different. The Libyans responded to low doses of regular drugs. Maltese were treated in comparatively higher doses due to combinations of drugs. The number of chronic withdrawn and apathetic schizophrenics was a larger among Maltese and there the disintegration of personality was much more visible. PMID- 3506431 TI - A study of sleep patterns on two Finnish icebreakers, ambulatory recording and automatic analysis. AB - The effects of noise and vibration on sleep in Finnish ice-breaking ships were studied in healthy volunteer workers and a control group. EEG, EOG and EMG were recorded by means of portable tape recorders. The recordings were analysed by an automatic hybrid system. Both sleep stage parameters and the quantities of single EEG waveforms were used for the evaluation of the sleep quality. Measurements were made before, during and after the ice-breaking season in the winter. Higher amounts of wakefulness and sleep stage 1, and lower amounts of delta and theta activity were found on a night during the ice-breaking season, compared with a night after the season. This was interpreted as indicating a "lightening" of sleep, caused by noise and vibration. No differences between the nights before and during the ice-breaking season were observed. The crew members had an appr. 1 h shorter Time In Bed and Sleep Period Time than the controls also on the nights studied ashore. Because of the small number of subjects the results are not conclusive, even though statistically significant differences were obtained. The delta activity in seconds/minute seems to be a more informative measure than the percentages of the sleep stages S3 and S4. The possibility of using the theta activity as a measure of the length of sleep should be further investigated. PMID- 3506432 TI - Physical stress and strain in catering work on the Baltic car ferries. AB - Physical stress and strain was investigated in the work of cabin cleaner, waitress/waiter, domestic assistant, assistant cook and store assistant. During one work shift the heart rate and bad work postures were registered. The maximal oxygen consumption and the physical condition of the test subjects were assessed by a submaximal ergometer test. The cardiovascular system was subjected to the greatest load in the work of the cleaner and store assistant but the relative strain was higher in cabin than in the work of the store assistant. The highest peaks occurred during lifting or load carrying, stair climbing, floor cleaning and bed making. Unphysiological work postures occurred during about half of the cleaner's, dishwasher's and assistant cook's working time. The catering work on the car ferries is physically more strenuous on both the cardiovascular and the musculoskeletal system than the comparable work on land. PMID- 3506433 TI - Psychological and somatic factors and the conditions of service at sea in relation to the different stages of coronary heart disease among sailors. AB - The clinical and psychological examinations were performed on the group of 94 inpatients suffering from coronary heart disease. They were divided into 3 subgroups: a) before infarct--31 inpatients, b) during infarct--33 inpatients, c) after infarct--30 inpatients. The discrepancies between these three subgroups were distinguished. With regard to factor analysis the significance of changes in the personality make-up among inpatients before and during infarct was underlined. The important role of somatic features in determining the state of the patient's health in the post-infarct subgroup was also emphasized. It was shown that the conditions of service at sea in connection with the parameters of personality can be included among the less important factors. PMID- 3506434 TI - Limited, intragroup epidemics of acute infectious diseases of the upper respiratory tracts and throat among workers of a Polish construction site in a tropical country. AB - The occurrence of small, short-term epidemics of acute infectious diseases of the respiratory system and throat among the employees of a Polish construction site in an area of the Persian Gulf was described. It was stated that they occurred most often during the cold season and they comprise from 10 up to 45% of the employees, often as a consequence of arrival of new groups of employees. The most probably etiology of these diseases is infection with the following viruses: rhino-myxo-, adeno-viruses. Coxsackie A, as well as with bacteria, most probably with streptococcus. As they can cause the phenomenon of the temporary disability for work among considerable percentage of the employees they can disorganize rhythm and efficiency of the construction site. PMID- 3506435 TI - EEG changes measured by spectrum analysis under hyperbaric conditions. AB - The subject of experimental, saturated dividing to 20 m depth was alertness level measured by means of spectral analysis of EEG records. Air was served as breathing mixture compressed to a given depth in closed circulating system. Altogether 49 EEG records made during compression, plateau and decompression, were analysed. Two methods of analysis were applied. "Normality ratio" combined the information from 20 different EEG values and "EEG alertness indicator" showed in three cases pathological slowing and fluctuations of the alertness. According to index of alertness, the most prominent changes were seen during the compression and decompression phase. During the plateau phase sleepiness was recorded. The applied method could provide information when slowing is due to metabolic impairment of brain activity from that of sleepiness. PMID- 3506436 TI - Preliminary research on possibility of bronchial asthma treatment with hyperbaric oxygenation. AB - The total of the persons examined was divided into 3 groups. There were 11 men and 5 women with various diseases diagnosed in Group I, 5 healthy men in Group II and 9 man and 2 women with allergy in Group III, the control group. The subjects were treated with hyperbaric oxygenation exposures from 1.8 to 2.5 ata O2 within a 60-90 minute period. The number of exposures ranged from 1-4 for Group II till 10-15 for Group I and Group III. In all the cases the following examinations were carried out: hematological tests (Hb, Ht, erythrocytes, leucocytes, and blood platelets counts, blood picture), immunological tests (IgG, IgM, IgA, IgD, IgE, C3 fraction of complement and hematolytical activity of complement--CH50) and all required additional clinical tests. These examinations were made before the series of hyperbaric exposures, after 4 exposures, after their completion and a month later. Full documentation in Group I was obtained in 6 cases and in the 10 remaining only before the exposures and after their completion. In Group II full documentation was available only in 1 person, but before the exposures and after their completion in the rest, and finally, in Group III full documentation was obtained in 7 persons, but before the exposures and after their completion in 4 others. Generally, it was in allergic states that a positive therapeutic effect of hyperbaric oxygenation was found. It had already been corroborated by the respective shifts of immunological coefficients, noted by other authors too. The above observations need to be confirmed in a wider material, in different periods of the disease and with other additional examinations employed. PMID- 3506437 TI - Research on parasitic arthropods of the Lake Zarnowieckie environs, conducted in 1981-1985. I. Part: Biting midges (Diptera, Ceratopogonidae). AB - In the environs of the Lake Zarnowieckie in 1982-1985 systematic investigations on haematophagic biting midges of genus Culicoides were conducted. A total of 2,188 specimens of Culicoides were caught, among which the occurrence of 26 species was stated. Up to now in this area a total of 28 species was observed. In the cattle spaces 478 specimens (7 species) were caught, with use of the light trap--554 specimens (16 species), with the help of entomological net--79 specimens (5 species) as well as from the soil samples by the method of the laboratory rearing 1077 specimens (24 species) were obtained. The most suitable habitat for the biting midges turned out to be the shores of water bodies (mainly of streams). The seasonal abundance of the Culicoides preimaginal forms in the soil during the two first research seasons reflected characteristic features of the insects biology--the two peaks occurrence took place: spring peak and summer peak. In 1984 and 1985 the number of the biting midges decreased significantly. However, the final conclusions concerning the reasons, the character as well as the determination of the possible influence of environmental changes (as a result of construction and operating of two modern power plants) can be drawn after conduct of the further research in future. PMID- 3506438 TI - Leptospirosis from the clinical viewpoint. AB - Epidemiological, clinical and microbiological data of 27 patients suffering from leptospirosis are presented. Because of the sporadic occurrence of the disease, diagnosis on admission was correct in only 18% of the patients. As proved by the agglutination test, most of the infections were due to serotype icterohaemorrhagiae, but in only one case could the leptospires be detected directly in the blood culture. In most of the cases the course of the disease was moderately severe with one fatality. Symptomatology and treatment are discussed. PMID- 3506439 TI - Main health problems of seafarers. PMID- 3506440 TI - Trends in the prevalence of cardiovascular diseases among maritime industry workers. PMID- 3506441 TI - Heart rhythm disturbances in seafarers. PMID- 3506442 TI - Influence of physical factors on the ro-ro vessel over selected parameters of the circulatory system. PMID- 3506443 TI - Noise environment and exposure of the catering crew on car ferries. PMID- 3506444 TI - Functioning of field of vision in the seamen of a merchant navy ship. PMID- 3506445 TI - Psychosocial factors causing specificity of work at sea. PMID- 3506446 TI - Alcohol--a specific psychosocial factor in the Polish merchant navy. PMID- 3506447 TI - Socio-medical aspects of a physician's work in the tropics. PMID- 3506448 TI - Electrocardiographic findings based on Minnesota Code criteria in a group of individuals going to the tropics. PMID- 3506449 TI - Today's children--the world of tomorrow. PMID- 3506450 TI - Epilepsy control in a developing country--the challenge of tomorrow. PMID- 3506451 TI - A survey of general practitioners in Sri Lanka. PMID- 3506452 TI - Turtle flesh poisoning. PMID- 3506453 TI - Coal worker's pneumoconiosis in Sri Lanka. PMID- 3506454 TI - [The effect of chlorhexidine gluconate on non-spore-forming anaerobes]. PMID- 3506455 TI - [The state of health of the stomatologists]. PMID- 3506456 TI - [Preparation and disinfection of root canals by own method]. PMID- 3506457 TI - [Orbit exenteration in the treatment of malignant neoplasms in own experience]. PMID- 3506458 TI - [Introduction of retained anterior teeth into the dental arch]. PMID- 3506459 TI - [Observations and treatment of a patient with post-traumatic luxation of teeth]. PMID- 3506460 TI - [Radiological image of parotid glands in patients with anemia]. PMID- 3506461 TI - [Metindonium in the treatment of oral mucosa diseases]. PMID- 3506462 TI - [Metindonium in the treatment of inflammatory forms of periodontopathies]. PMID- 3506463 TI - [Diseases of the periodontium and oral mucosa in workers exposed to various harmful working environmental factors]. PMID- 3506464 TI - [Viral hepatitis in Polish stomatologists in light of an inquiry into epidemiological and professional problems]. PMID- 3506465 TI - [Prevalence of developmental enamel damage in the permanent teeth of Warsaw children]. PMID- 3506466 TI - [The effect of an environment contaminated with lead and cadmium compounds on the condition of teeth in schoolchildren in Zyglin and Pniowiec]. PMID- 3506467 TI - [Assessment of the condition of teeth and basic requirements for dental care services in village children in Lipsk in the province of Radom]. PMID- 3506468 TI - [Clinical assessment of the Isofill composite material used for filling of caries defects]. PMID- 3506470 TI - [The mechanism of dental fluorosis development]. PMID- 3506469 TI - [The condition of periodontium and oral mucosa in workers operating heavy self propelled machinery in the Legnica-Glogow copper mining district]. PMID- 3506471 TI - [Evaluation of the state of knowledge of oncology principles in stomatologists]. PMID- 3506472 TI - [Viral hepatitis in Polish stomatologists in the light of an inquiry. Prophylaxis]. PMID- 3506473 TI - [Characteristics of certain kinetic features of salivary acid phosphatase]. PMID- 3506474 TI - [A contribution to the study of the side effects of antibiotics]. PMID- 3506475 TI - [Certain problems of the radiography of the facial skeleton and assessment of the Periomat Dur Dental automatic dark-room]. PMID- 3506476 TI - [Pathological arteriovenous communications in the region of the head]. PMID- 3506477 TI - [Healing-in of free gingival grafts after application of adhesive paste Solcoseryl]. PMID- 3506478 TI - [Collagen fibers in periodontal diseases-clinical and biochemical investigations]. PMID- 3506479 TI - [Intraoral ultraviolet irradiation in comprehensive treatment of periodontal diseases]. PMID- 3506480 TI - [Effect of selected antibiotics on pocket depth and level of attachment in patients with periodontitis]. PMID- 3506481 TI - [Characteristics of certain kinetic features of salivary enolase]. PMID- 3506483 TI - [The resistance of the Stabil B amalgam in comparison to capsulated amalgams]. PMID- 3506482 TI - [Oral hygiene, condition of periodontium and malocclusion in children aged 7-15 years from a region of mining and power production]. PMID- 3506484 TI - [Osteosynthesis of mandibular fractures using miniature plates Nichrominox]. PMID- 3506485 TI - [Stevens-Johnson syndrome in the light of own observations and certain immunological tests]. PMID- 3506486 TI - [The role of the third molar in the development of third crowding of teeth]. PMID- 3506487 TI - [Effectiveness of orthodontics teaching in the light of the results of examinations for diploma in the years 1978-1984]. PMID- 3506488 TI - [Fluorine circulation in the mouth]. PMID- 3506489 TI - [Black sediment on teeth and dental caries in children]. PMID- 3506490 TI - [The condition of milk teeth in schoolchildren living in areas of exposure to supranormal concentrations of non-iron metals]. PMID- 3506491 TI - [Analysis of calcium content in healthy teeth in children at different ages]. PMID- 3506492 TI - [Dynamics of eruption of permanent teeth and somatic development of children aged 6 years]. PMID- 3506493 TI - [Malocclusion and range of mandibular movements in children with polyarthrous laxity of joints]. PMID- 3506495 TI - [Supernumerary teeth in the anterior maxillary segment]. PMID- 3506494 TI - [Depot-iontophoresis in endodontic treatment]. PMID- 3506496 TI - [Introduction of retained teeth into the dental arch by means of surgical orthodontic methods]. PMID- 3506497 TI - [The usefulness of endoscopic treatment in certain pathological states of the maxillary sinus]. PMID- 3506498 TI - [Spontaneous speech improvement after surgical closure of palatal defect]. PMID- 3506499 TI - [Assessment of the usefulness of the Carident ointment in the treatment of periodontal diseases]. PMID- 3506500 TI - [Carident in the treatment of oral mucosa diseases]. PMID- 3506501 TI - [Fluoride levels in saliva and bacterial plaque and the condition of periodontium in elementary schoolchildren living in the regions with fluoridated or non fluoridated water]. PMID- 3506502 TI - [Gingiva proper and the treatment of periodontitis]. PMID- 3506503 TI - [Modern views on the aetiology and pathogenesis of dental caries]. PMID- 3506504 TI - [Effect of Fluor-Protector varnish on the inhibition of the carious process in milk teeth]. PMID- 3506505 TI - [The use of applicators in contact prevention of dental caries]. PMID- 3506506 TI - [Fluoride level in the urine of preschool children]. PMID- 3506507 TI - [Demographic characteristics and professional workload of stomatologists in Poland]. PMID- 3506508 TI - [Clinical classification of the severity of injuries to the facial skeleton]. PMID- 3506509 TI - [Alveolar rhabdomyosarcoma of the cheek and maxilla in a patient aged 16 years]. PMID- 3506510 TI - [Surgical methods of exposure of non-erupted and retained teeth]. PMID- 3506512 TI - [The usefulness of a holder for pterygo-occlusal films]. PMID- 3506511 TI - [Changes in the direction of growth of the maxilla and mandible caused by the treatment of anterior occlusal anomalies]. PMID- 3506513 TI - [Fluorine level in hard dental tissues in milk teeth of schoolchildren exposed to excessive concentrations of Zn, Cd and Pb in air]. PMID- 3506514 TI - [Late evaluation of fillings made of Evicrol composite material]. PMID- 3506515 TI - [Certain elements of working conditions of stomatologists in Poland]. PMID- 3506516 TI - [Investigations on the variability of the bacterial flora in the years 1971 1984]. PMID- 3506517 TI - [Experimental ankylosis, infraocclusion and root resorption and clinical reinclusion of tooth]. PMID- 3506518 TI - [Functional treatment of progressive facial hemiatrophy (Romberg's syndrome) with ocular signs]. PMID- 3506519 TI - [A case of Ellis van Creveld syndrome]. PMID- 3506520 TI - The effect of a single dose of ethanol on melatonin secretion in women. PMID- 3506521 TI - [Extensiveness of resection of the thyroid gland in the treatment of euthyroid nodular goiter]. PMID- 3506522 TI - [The hypothalamo-hypophyseal-gonadal system in men with myocardial infarction]. PMID- 3506523 TI - [Early stimulation with testosterone of the sexual system of male rats after administration of a single dose of stilbestrol in the first day of life]. PMID- 3506524 TI - The characteristics of monoclonal antibodies against human albumin. AB - Three hybridoma lines secreting antibodies against human albumin have been characterized. Monoclonal antibody (mAb) A1-01 reacted only with human albumin, whereas antibodies A1-02 and A1-03 reacted with both albumin and transferrin but differed in their affinity for these proteins. The mAbs did not react with albumins or transferrins of other mammalian species. Their specificities were tested by isolating the proteins that bind specifically to the purified immobilized antibodies. Only albumin was isolated on immobilized antibodies A1-01 and A1-02, whereas albumin and transferrin were isolated on antibody A1-03. The minor bands specifically detected by antibody A1-01 were fragments or aggregates of albumin, as shown by two-dimensional electrophoresis and transfer to nitrocellulose sheets. It was found by ELISA that as much as 3 ng/ml human albumin is detectable by mAb A1-01. PMID- 3506525 TI - Nucleologram variations in circulating lymphocytes after chemotherapy. AB - The lymphocyte nucleologram of cancer patients was studied before and after chemotherapy. Drug treatment was constantly followed by morphological and numerical changes in lymphocyte nucleolar pattern, characterized by an increase in micropolynucleolated forms. This variation is a non-specific marker of drug cytotoxicity. PMID- 3506526 TI - Cyclophosphamide- or ifosfamide-treated L 1210 leukaemia cells: immunogenicity, viability and metabolism. AB - We have demonstrated that lymphoid leukaemia L 1210 cells treated with cyclophosphamide or ifosfamide were immunogenic for semisyngeneic CD2F1 mice and that they effectively prevented the development of the later inoculated leukaemia L 1210 cells. Non-dividing and immunogenic L 1210 cells were only obtained when an appropriate dose of cyclophosphamide was applied. These cells lost their immunogenicity after killing by repeated freezing and thawing or after fixing with glutaraldehyde. Non-dividing immunogenic L 1210 cells treated with cyclophosphamide possessed the histocompatibility and tumour-associated transplantation antigens and had the ability to synthesize proteins, the RNA and partially the DNA. PMID- 3506527 TI - The loss of Y-sperm in "sex ratio" (SR) males of Drosophila subobscura is compensated. AB - In Drosophila subobscura sex ratio (SR) males, a mechanism compensating for the loss of Y-sperm is present since these males produced a higher number of female offspring than did males of three control strains. Moreover, the number of female offspring from SR-males was even higher (average 1719) than the number of female and male offspring together (average 1460) from T2, one of the control strains. The fertile life span of SR-males was found to lie between those of the control strains. The rate of insemination was the same for SR- and control males. PMID- 3506529 TI - Influence of age on chiasma number in male Locusta migratoria. AB - The influence of age on chiasma formation in Locusta migratoria has been studied both in wild-type and irradiated males. Samples were obtained on the one hand from different individuals and on the other hand from the same individuals at different ages through repeated biopsies. It was observed that mean chiasmata per cell decreased in ageing animals. Chi-squared tests and correlation coefficients showed that the decrease of chiasmata with age is progressive but not continuous. Intermediate values coincide with the first mating. It seems that older individuals tend to transmit their genetic combinations unaltered, increasing the probability of transmitting gene combinations of adaptive value. PMID- 3506528 TI - Possible correlations of polypeptides and Balbiani rings in the salivary glands of Drosophila auraria Peng. AB - Salivary glands of various stocks of Drosophila auraria and some of its close relatives were examined with a variety of electrophoretic techniques both from larval and prepupal stages, and after ecdysterone treatments, in an effort to detect possible translation products of the two Balbiani rings (BR1 and BR2) found in the salivary gland chromosomes of these species. Two polypeptides (P2 and P1), with molecular weights of 12,000 and 53,000, respectively, have been detected, the appearance of which coincides with the presence of BR2. The results do not allow the correlation of BR1 action with any specific polypeptide(s). PMID- 3506530 TI - New data on the synaptic process of Mesocricetus auratus: connecting fibers, telomere association and heterosynapsis. AB - The progression of the prophase-I stage in Syrian hamster spermatocytes has been studied at different ages, from 12 to 41 days after birth. Two stages, leptotene and diplotene, were identified, which had not previously been described in the Syrian hamster using spreading techniques. The most interesting observations are the presence of heterosynapses and telomere associations in 2.5% of the cells studied, and of nucleolar filaments also in 2.5%. Connecting fibers are structures that establish different types of bridges between two or three synaptonemal complexes (SCs) or between the elements of a single SC. Heterosynapses and telomere associations consist in the partial pairing of the terminal regions of non-homologous lateral elements. These phenomena can be observed both in the autosomes and in the sex chromosomes. PMID- 3506531 TI - Cytogenetic studies on Cervus elaphus. II. Synaptonemal complexes and NOR activity during spermatogenesis. AB - The activity of the nucleolus organizer regions (NORs) in various stages of spermatogenesis of the red deer was studied with the silver staining technique. The Ag-stainability of the NORs, an indicator of the transcriptional activity of the r-RNA genes, is present during the meiotic prophase until pachytene and is absent during the remainder of the meiotic prophase, to reappear during the first stages of spermiogenesis and then disappear again during the elongation phase of the spermatids. The development and behaviour of synaptonemal complexes (SCs) of primary spermatocytes were also studied with the silver staining technique under the light microscope. The organization of SC is similar to that of other mammalian species. The pairing behaviour of the axes of the sex chromosomes is described. PMID- 3506532 TI - Multiple incompatibilities within populations of Culex pipiens L. in southern France. AB - Strains of Culex pipiens derived from natural populations collected in southern France were crossed to determine their ability to give fertile offspring. Uni- and bi-directional incompatibilities occurred between these strains and each of them had its own crossing properties. Compatibility or incompatibility of a cross seemed to be related to the geographic distance separating the parental colonies, but not to their ecological origin (hypogeous or epigeous). Our results showed evidence for the variation in time of crossing properties of a strain. PMID- 3506533 TI - Differences in life history traits between alcohol dehydrogenase genotypes of Drosophila mercatorum: background and maternal genotype effects. AB - The effects of genotype at the alcohol dehydrogenase (ADH) locus on developmental time and fecundity were studied using three strains of Drosophila mercatorum. All three strains had similar genetic backgrounds and two were homozygous for the same electrophoretic allele (F for fast). The third strain was homozygous for the slow allele (S). The life history traits of all possible progeny of these strains were studied. The results showed that for both mean developmental time and pattern of eclosion, strong maternal genotype and background effects were present. Fecundity among genotypes was not different, although there was an effect on the total number of offspring suggesting differences in egg-to-adult survivorship. PMID- 3506534 TI - Localization of NORs in spermatogonial metaphase chromosomes of six species of grasshoppers. AB - The silver staining technique was employed to locate Nucleolar Organiser Regions (NORs) in six species of grasshoppers viz. Aiolopus thalassinus F. (Tryxalinae); Oeodaleus abruptus Thunb., Gastrimargus transversus Thunb., Heteropternis respondens Walk. (Oedipodinae); Parahieroglyphus biliniatus Bol. and Spathosternum prasiniferum Walk. (Catantopinae). Usually the NORs were located on the larger elements of the chromosomal complement. However, in O. abruptus NORs were found on autosomes S8 and S9. The salient observations were: (1) NORs were seen in only a few of the several spermatogonial metaphases examined; (2) Active NORs were mostly located either on one chromatid of the homologues or on the homologue depicting heteromorphism; (3) NORs showed either proximal, subproximal or interstitial locations. However, in O. abruptus and P. bilineatus NORs were located at two positions. Distribution of NORs in different species and their probable role in tracing the evolutionary pathways in Acridoidea are discussed. PMID- 3506536 TI - Unusual occurrences as clues to cancer etiology. Proceedings of the 18th International Symposium of the Princess Takamatsu Cancer Research Fund. Tokyo, 1987. PMID- 3506535 TI - A thermal denaturation study of genomic DNAs from North American minnows (Cyprinidae: Teleostei). AB - Base compositions and differential melting rate profiles of genomic DNAs from twenty species of North American cyprinid fishes were generated via thermal denaturation. Base pair composition expressed as % GC values ranged among the twenty species from 36.1-41.3%. This range is considerably broader than that observed at comparable taxonomic levels in other vertebrate groups. Both the range and average difference in base pair composition between species in the diverse and rapidly evolving genus Notropis were considerably greater than those between species in other North American cyprinid genera. This may indicate that genomic changes at the level of base pair composition are frequent and possibly important events in cyprinid evolution. Compositional heterogeneity and asymmetry values among the twenty species were uniform and low, respectively, suggesting that most of the species lacked DNA components in their genomes which differed substantially from their main-band DNAs in base pair composition. The melting rate profiles revealed a prominent and distinct heavy or GC-rich DNA component in the genomes of three species belonging to the subgenus Cyprinella of Notropis. These and other data suggest that the heavy melting component may reflect a large, comparatively GC-rich family of highly repeated or satellite DNA sequences common to all three genomes. PMID- 3506537 TI - Etiology of lung cancer at the Gejiu tin mine, China. AB - There were 1,724 lung cancer cases registered at the Yunnan Tin Corporation in the period 1954-1986, of which 90% had a history of working underground. Previous exposure to radon, and radon daughters and arsenic is considered to be responsible for the high incidence of lung cancer in these miners. Arsenic may come from inhalation of arsenic-containing ore dust or other environmental arsenic pollution. It appears that radon exposure accounts to a greater extent than arsenic for the increase of lung cancer in these miners. Pathological study was made of 100 surgically resected lung cancer specimens. In this way the distribution and composition of dust retention was determined in relation to peripheral lung cancer. PMID- 3506538 TI - Radiation-induced cancer and its modifying factor among A-bomb survivors. AB - The Atomic Bomb Casualty Commission (ABCC) and its successor, the Radiation Effects Research Foundation, have conducted a long-term follow-up study of a cohort of 120,000 atomic bomb (A-bomb) survivors and non-exposed controls since 1950. The most recent findings regarding cancer mortality and incidence in this cohort can be briefly summarized as follows: 1) An increase in leukemia mortality among A-bomb survivors peaked 5-6 years after the bombing and has decreased with time thereafter. In addition to leukemia, the incidence of cancer of the lung, breast, esophagus, stomach, colon, thyroid, ovary, urinary tract, and multiple myeloma increases with dose. At present, there is no indication of an increase in cancer of the rectum or uterus among A-bomb survivors. In general, radiation induced solid cancers begin to appear after the age at which they are normally prone to develop, and have continued to increase with time in proportion to the natural increase in mortality of the control group. 2) There are factors which modify the effects of radiation, such as age at the time of bombing (ATB) and sex. Sensitivity to radiation, in terms of cancer induction, is higher for persons who were young ATB in general, than for those who were older ATB. 3) There was no increase in childhood cancer among those exposed while in utero, but there is a recent indication of an increase in cancer incidence among these persons as they age. 4) There seems to be no interaction in a multiplicative way between radiation and smoking and lung cancer induction. PMID- 3506539 TI - Opportunistic malignancies and the acquired immunodeficiency syndrome. AB - The clinical manifestations of chronic infection with the Human Immunodeficiency Virus (HIV) fall into two broad categories: opportunistic infections and opportunistic malignancies. The initial observation of both occurring in outbreak fashion among young homosexual men led to the early identification of the present pandemic. Conversely, the identification of additional malignancies which occur in excess frequency in the presence of the immunodeficiency of HIV infection can provide insight into the role of viruses in human malignancy. The first report related to the acquired immunodeficiency syndrome (AIDS) epidemic was of a series of 5 cases of Pneumocystic carinii in young homosexual men in Los Angeles and was published in June 1981. This was shortly followed by the report of additional cases of P. carinii as well as Kaposi's sarcoma (KS) occurring among young homosexual men in California and New York City. The increased risk of KS among people with HIV infection has been confirmed since these initial reports, with 1 in 5 AIDS patients in the United States developing KS sometime in their course of disease. However, the proportion of AIDS patients with KS has decreased from 35% before 1983 to 15% in the first half of 1987. Among the recognized risk groups of AIDS patients, the proportion with KS is highest among homosexual men and female intravenous drug abusers, and lowest among children and hemophiliacs. This variation suggests that risk of KS in AIDS parallels that of sexually-transmitted infections. A second family of opportunistic malignancy in AIDS is comprised of the non-Hodgkin's disease lymphomas (NHL). These lymphomas are typically of B cell origin, immunoblastic or Burkitt's-like in character, and frequently present with extra-nodal involvement such as the central nervous system. These were first recognized somewhat later than KS as being associated with AIDS; together, KS and NHL account for about 95% of all neoplasms seen in AIDS patients. Additional malignancies are currently suspected to occur excessively with HIV infection. These include Hodgkin's disease, anorectal carcinoma, and testicular cancer. Validation of these associations will require extensive epidemiologic surveillance. Since HIV infection leads to progressive loss of cellular immunity, it is probable that these malignancies result from the progressive reactivation or loss of immunologic control of latent oncogenic viruses. The cytomegalovirus has been implicated in the pathogenesis of KS, perhaps with reinfection, and the Epstein-Barr virus in the NHL. The role of papilloma viruses in anorectal carcinoma has also been proposed.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3506540 TI - Epidemiologic similarities leading to etiologic hypotheses. AB - Analogy is a useful means of generating etiologic hypotheses which can be tested by epidemiologic, clinical, or laboratory studies. We describe how the use of analogy has furthered the understanding of three disease entities--Hodgkin's disease (HD), testicular cancer (TC), and acquired immune deficiency syndrome (AIDS). HD is probably caused by a virus of low pathogenicity with clinical expression dependent on social factors. TC may have a viral etiology, although clinical disease may be triggered by other factors. AIDS is caused by a virus which may act as an initiator. AIDS-related Kaposi's sarcoma (KS) may be the result of exposure to a carcinogenic chemical acting as a promoter. In all three diseases, the clinical manifestation could be regarded as varying expressions of host response to a viral agent, modified by an array of socioeconomic and/or biologic cofactors. PMID- 3506542 TI - Where have dysplastic nevi led us? AB - In 1977, Dr. Mark Greene and Dr. Wallace Clark examined members of the B. and K. families, in which several individuals had developed cutaneous malignant melanoma. They recognized that both families had nevi that were unusual in morphology, pattern, distribution, size, and number. These dysplastic nevi identify the individuals in melanoma-prone families who are at increased risk of melanoma; the cumulative risk of melanoma approaches 100% in affected members. Formal genetic analyses have revealed that the dysplastic nevus and melanoma traits appear to be pleiotropic effects of a single, highly penetrant, autosomal dominant gene. Linkage studies have revealed weak linkage with Rh on the short arm of chromosome 1 (1p), and excluded linkage with the HLA region on chromosome 6p, transferrin on 3q, H-ras on 11p, and Gm on 14q. The most promising location for the melanoma/dysplastic nevus susceptibility locus remains chromosome 1p. Future studies will focus on the localization of the melanoma gene, and then the characterization of the gene product to elucidate the etiology of melanoma. PMID- 3506541 TI - Cutaneous Ki-1 lymphoma: pathology, immunology and clinical characteristics. AB - This paper describes a newly recognized clinicopathologic syndrome of regressing cutaneous nodules, peripheral lymphadenopathy and fever occurring mainly in children and adolescents. Skin lesions show pseudoepitheliomatous hyperplasia, absence of epidermotropism and pleomorphic large lymphoma cells infiltrating the dermis and subcutaneous fat. Lymph nodes have a distinctive appearance with lymphoma cells in sinuses and paracortex. Despite their usual histiocyte-like appearance, the lymphoma cells in most cases have an aberrant T-cell phenotype, expressing several activation antigens including Hodgkin's disease associated antigen Ki-1 (CD30). Clonal rearrangements of the beta chain genes for the T-cell antigen receptor (TCR) were found and revealed a T-cell origin in one case lacking T-cell surface antigens. Identical rearrangements of the TCR genes indicated a monoclonal origin for separate lesions on the arm and leg of another patient. Treatment results in the first group of patients indicate that radiation treatment of an affected area is associated with frequent relapse at other sites, but multiagent chemotherapy (COMP or D-COMP) produces durable remissions in nearly all patients. Bone marrow transplantation was effective salvage therapy for treatment failures. Further studies are underway to investigate the mechanism(s) of tumor regression, the epidemiology, and etiology of Ki-1+ lymphomas which appear to be relatively more frequent in Oriental and Black patients, and in which the first lesion may resemble an insect bite. PMID- 3506543 TI - Genetic models for linkage analysis of ataxia-telangiectasia. AB - Ataxia-telangiectasia (AT) is a multifaceted autosomal recessive disorder, inherited as a single gene in each family, presumably due to a defective DNA processing protein such as a recombinase, endonuclease or even a regulatory DNA binding protein. We are attempting to identify the chromosomal location of the AT gene(s) by performing linkage analyses on a variety of genetic models. At least five AT complementation groups have been defined. This genetic heterogeneity complicates linkage analysis. Model I assumes that the complementation genes are clustered into a single genomic region and, therefore, lod scores of linkage data from all families can be added. Model II assumes that the AT complementation genes are dispersed throughout the genome and the lod scores cannot be added. This model necessitates assigning the complementation group of every family that is included in the linkage analyses and reduces the number of families in each data base. Model III utilizes heterozygote identification to follow the AT gene (in a Group A pedigree of 61 members) as a dominant trait, thereby increasing the amount of linkage information that can be derived from that family. Model IV will focus only on consanguineous offspring of first-cousin marriages, seeking to identify the location of the AT gene(s) by the increased degree of homozygosity of genetic markers in close proximity. This model has several advantages, including that much smaller numbers of patients are required. Model V assumes that a subset of our patients will carry deletions and can be used to confirm the relationship of a candidate gene to the AT phenotype. Progress: Models I and II have been used to survey 7% and 2% of the genome, respectively. (An additional 5% of the genome can be added for exclusion of the X chromosome on clinical grounds). Model III is intended to survey the entire genome. Our initial studies have surveyed approximately 30% of the genome. Several areas of increased lod scores have been identified and are under further investigation. PMID- 3506544 TI - Frequency of multiple primary cancers and risk factors for lung and breast cancer patients. AB - Among nearly 50,000 cancer patients at the National Cancer Center, about 2,000 have multiple primary cancer (MPC), and its frequency has been increasing in recent years. MPC is considered to be a reflection of severe exposure to carcinogens or of a predisposition to cancer, or sometimes it is thought to be an individual expression within familial aggregation. To clarify the roles of these proposed mechanisms, case-control studies and chromosome analyses, including fragile sites on chromosomes, were performed focusing in particular on breast and lung cancer patients. A histology-matched case-control study of multicentric lung cancer revealed a risk of cigarette smoking, which was also recognized in MPC in different sites among breast cancer patients, in addition to the radiotherapy. The frequency of heritable (rare) fragile sites among 87 lung cancer patients was more than double that of the general population, and the rare fragile site, 17q12, was clustered in the adenocarcinoma. The frequencies of heritable fragile sites among breast cancer patients were the same as the general population. MPC occurred in 10 of 87 lung cancer cases, and in 9 of 90 breast cancer patients; these individuals did not have heritable fragile sites. Heavy smoking and hazardous occupations were recognized in MPC cases with lung cancer, and a family history of rather rare cancers was also more common in MPC cases with breast cancer. One of three triple cancer cases had breast cancer as a feature in chromosomal aberrations of the peripheral blood lymphocytes, which may signify predisposition to cancer in these patients. PMID- 3506545 TI - Vinyl chloride-induced hepatic angiosarcoma. AB - In early 1974, an alert plant physician reported the occurrence of several cases of the otherwise rare hepatic angiosarcoma (HAS) at a single polyvinyl chloride (PVC) production facility in Louisville, Kentucky (U.S.A.). Upon further investigation, the relative risk for HAS at this plant appeared to be approximately 5,000, strongly indicating a causal relationship with some factor at the plant. Epidemiologic studies at this and other PVC polymerization plants identified vinyl chloride monomer (VCM) as the causative agent. Experimental studies reported in early 1974 confirmed VCM as a hepatic carcinogen capable of producing HAS and other tumors. Follow-up epidemiologic studies revealed that: 1) HAS is the end stage of a progressive liver disease consisting of hepatocytic and sinusoidal cell hyperplasia, sinusoidal dilatation, and hepatic fibrosis; 2) over 100 cases of VCM-induced HAS have occurred worldwide; and 3) an increased risk of lung cancer has been reported in some cohort studies of PVC polymerization workers, although this outcome may be related to PVC dust or factors other than VCM. A national study of HAS in the United States identified 3 other causes of HAS: Thorotrast, inorganic arsenic, and androgenic-anabolic steroids. Of 168 cases found to occur during 1964 through 1974, 42 cases (25%) were associated with the 4 known etiologic agents, while 126 cases (75%) were of unknown etiology. PMID- 3506546 TI - The effects in the human of diethylstilbestrol (DES) use during pregnancy. AB - Intrauterine diethylstilbestrol (DES) exposure is associated with an increased risk for the development of clear cell adenocarcinoma (CCA) of the vagina and cervix. The age of the patients at diagnosis has varied from 7-35 years with the highest frequency from 14-22 years. The risk among the exposed, however, is small and is of the order of 1 per 1,000. Almost all of the cases occur in postmenarchal females. Other factors that may increase the risk are maternal history of prior miscarriage, exposure to DES in early gestation, a fall season of birth and prematurity. The occurrence of CCA has paralleled the sales of DES for pregnancy support in the U.S. Both vaginal adenosis (benign glands in the vagina) and CCA are more frequent among those whose mothers began DES in early pregnancy. An increased risk of squamous cell neoplasia has been hypothesized but not proven. The changes that occur in the female genital tract of the DES exposed appear to result from alterations in the development of the mullerian ducts. Currently there is not definitive evidence for an elevated risk of cancer among DES mothers or DES sons but studies have suggested a possible increase of breast cancer in the former group and testicular cancer in the latter group; a valid association has not been established in either. PMID- 3506547 TI - Epidemiological studies of lung cancer in Japanese mustard gas workers. AB - Until the end of the Second World War, a poison gas manufacturing plant was operating on Okunojima, an island in the Seto Inland Sea. Of the gases produced there, mustard gas and Lewisite were found to be associated with various malignant tumors including lung cancer. The mortality rate for lung cancer in workers directly or indirectly involved in the production of poison gas was significantly higher than that of workers not involved in the production there. Lung cancer caused by poison gas was characterized by the following features: it was found as a central pulmonary carcinoma and was distributed from the upper airway to the hilar region. Squamous cell carcinoma and undifferentiated carcinoma predominated, whereas adenocarcinoma and other types were rare. Retired workers who had been engaged in the manufacture of mustard gas were found to have depressed immunological competence. We therefore started to enhance immunological competence with the use of Nocardia rubra cell wall skeleton (N-CWS) in order to prevent carcinogenesis. To date, no conclusion has been reached on its effectiveness in preventing carcinogenesis, however, we do expect it to be effective. PMID- 3506548 TI - [A study on the influence of gelatin concentration in the formation of fluorapatite by gelatin gel method]. PMID- 3506549 TI - [Reliability in three dimensional measurement of dental casts]. PMID- 3506550 TI - [Development of automatic cephalometric analysis by image processing. Automatic extraction of landmarks]. PMID- 3506551 TI - [The variation and formation of vertical skeletal facial pattern in skeletal Class III cases. Investigation by means of multivariate analysis]. PMID- 3506552 TI - [An evaluation of crystallinity of fluorapatite formed in silica gel by infrared absorption spectroscopy]. PMID- 3506553 TI - [Roentgenographic observation about root deflection of developing tooth under orthodontic treatment]. PMID- 3506554 TI - [A study of soft tissue profile in female skeletal mandibular prognathism with midface depression--the factors of midface depression]. PMID- 3506555 TI - [A study of morphological changes of the dental arches after treatment of anterior crossbites--an examination with dental casts and cephalograms]. PMID- 3506556 TI - [The periodontal vascular changes and bone resorption incident to experimental tooth movement using corrosive resin cast with SEM]. PMID- 3506557 TI - Effects of headgear traction on the nasomaxillary complex--a biomechanical study using strain gauges. PMID- 3506558 TI - [A three-dimensional facial measurement by the combination of Moire photographs in two directions]. PMID- 3506559 TI - [The effect of high protein low calcium diet on vascular system of rats alveolus]. PMID- 3506560 TI - [Effects of destruction of the spheno-occipital synchondrosis to the growth of the mandibular condyle in growing rats]. PMID- 3506561 TI - [Computerized tomography for 3D analysis of mandibular apical base form and tooth arrangement]. PMID- 3506562 TI - [The application of the finite element method (FEM) to craniofacial growth analysis (Part 1)]. PMID- 3506563 TI - [The application of the finite element method to craniofacial growth analysis. Part 2. The comparison of finite element method and biorthogonal analysis]. PMID- 3506564 TI - [Reversible application of Wilson's bimetric distalizing arch for two adult Angle's Class III-type patients]. PMID- 3506565 TI - [The periodontal changes associated with orthodontic treatment. Four adult cases treated with combined orthodontic-periodontal treatment]. PMID- 3506566 TI - [Application of quadrilateral analysis to cases treated with orthognathic surgery]. PMID- 3506568 TI - [Histological investigations on the effect of prostaglandin E2 (PGE2) applied to experimental tooth movement]. PMID- 3506567 TI - [A case of Tricho-Rhino-Phalangeal syndrome]. PMID- 3506569 TI - [Growth timing of mandibular length, body height, hand bones and cervical vertebrae during puberty]. PMID- 3506570 TI - [The ossification of the distal phalanx of the first digit]. PMID- 3506571 TI - [Morphological compensatory mechanism in craniofacial complex of adult mandibular prognathism. II. Anterior lower facial height, overbite and occlusal plane]. PMID- 3506572 TI - [Point N and point S changes utilizing structural components of the cranial base for superimposition]. PMID- 3506573 TI - [An orthodontic case report of porphyria]. PMID- 3506574 TI - [A roentgeno-cephalometric study on the craniofacial morphology and growth change of Angle Class II division 1 malocclusion by using Ricketts analysis]. PMID- 3506575 TI - [A cytochemical study of periodontal tissues (osteoclasts and fibroblasts) under tooth movement by microperoxidase]. PMID- 3506576 TI - [A 20-year progress report at the Department of Orthodontics, School of Dentistry, Iwate Medical University]. PMID- 3506577 TI - [Occlusal features of orthodontic patients with symptoms of temporomandibular joint dysfunction]. PMID- 3506578 TI - [The application of the finite element method to craniofacial growth analysis. Part III. The application to predict craniofacial growth]. PMID- 3506579 TI - [Stress generated electric potentials from bone surface of rabbit in vivo. In relation to orthopedic treatment]. PMID- 3506580 TI - [Description of mandibular apical base form and tooth arrangement by means of spline functions]. PMID- 3506581 TI - [A case report of malocclusion and masticatory disturbance resulting from fracture of mandible. Improvement of mandibular deviation and intercuspal occlusion]. PMID- 3506582 TI - Biomechanical factors affecting fracture stability and femoral bursting in closed intramedullary nailing of femoral shaft fractures, with illustrative case presentations. AB - Closed intramedullary nailing is an accepted method of treatment for femoral shaft fractures. Technical complications of the procedure include fracture instability, which may result in proximal nail migration, malrotation, delayed union, and occasionally femoral bursting during insertion of the nail, sometimes leading to fracture instability as well as shortening. This study defines the effect of starting hole position, fracture component length, reamed diameter, and nail type on the potential for femoral bursting and fracture instability. The most significant factor in the proximal femoral component was found to be the position of the starting hole. Anterior displacement by greater than 6 mm from the neutral axis of the medullary canal consistently caused high hoop stresses at the level of the fracture, which resulted in bursting of the proximal femoral component by lifting off the anterior cortex. Hoop stresses at the level of the fracture were less sensitive to lateral or medial placement of the starting hole. Distally, fracture stability was governed by femoral component length and reamed diameter. In the proximal and distal components, fracture stability and the potential for bursting were influenced by the particular nail used. This was due to significant differences in mechanical geometric properties between nails of different manufacturers. Case reports are presented to illustrate these biomechanical principles as they apply to clinical situations. PMID- 3506583 TI - Operative management of intra-articular fractures of the distal humerus. AB - Over a 5-year period (1979-1984), 33 patients with intra-articular fractures of the distal humerus underwent open reduction and internal fixation of their fractures. Twenty-two (67%) of the patients had multiple injuries. Fourteen (42%) of the fractures were open (1 was Grade I, 8 were Grade II and 5 were Grade III). The mean age was 32 years (range: 15-61 years), which is significantly younger than in other series. A subgroup of 25 of the patients was evaluated clinically at a mean of 18.3 months postoperatively. "Excellent" and "good" functional results occurred in 23 patients (92%). "Poor" results were seen in the remaining two patients (8%). Complications occurred in 15 patients (45%). Nine of these complications related to fixation of the transolecranon osteotomy, which was used in 29 patients. The method by which reduction and stabilization was achieved was not as important as obtaining sufficient rigidity, which permitted early motion. PMID- 3506584 TI - Open reduction and internal fixation of radial head fractures associated with olecranon fracture or dislocation. AB - Six fracture dislocations or dislocations of the olecranon associated with radial head fractures were treated with open reduction and internal fixation of the radial head. The olecranon was reduced and if fractured (three cases) was internally fixed. Postoperatively, early active range of motion was achieved in all cases. Twelve to 48 months after surgery, there was an average loss of 18 degrees of elbow extension and 56 degrees of forearm rotation. An average of 132 degrees of flexion was maintained. There was no elbow instability or wrist pain. PMID- 3506585 TI - Pediatric polytrauma: orthopaedic care and hospital course. AB - Seventy-eight children with multiple trauma who had sustained one major musculoskeletal injury and at least one other major injury were studied. Injury severity was classified by the Modified Injury Severity Scale. There were 137 musculoskeletal injuries; 47 complications occurred in 27 patients. Early osteosynthesis tended to shorten the hospital stay, intensive care unit stay, and length of time ventilatory support was needed. Those patients undergoing immediate surgical stabilization of fractures had fewer complications than those undergoing surgical stabilization after 72 h. Those children with fractures treated by prolonged bed rest and who also had both neural and thoracoabdominal injuries had a higher rate of complications related to immobilization. PMID- 3506586 TI - Clavicle fractures in head-injured children. AB - Between the years 1960 and 1985, 499 children were treated at Rancho Los Amigos Hospital for residuals of head trauma. Of these, 35 had fractures of the clavicle (38 total fractures). Two of the patients had lateral physeal injuries and subsequently developed a "double" clavicle. All of the clavicle fractures healed without immobilization and exhibited excellent remodeling. All patients recovered complete range of motion of the shoulder. Only one of the patients required surgery (for removal of a tender bony prominence after the formation of a "double" clavicle). PMID- 3506587 TI - Management of severely displaced medial epicondyle fractures. AB - The role of surgical fixation of the displaced medial epicondyle fracture remains controversial. We reviewed 20 patients with displaced (mean 10 mm) fractures, all associated with elbow dislocation. All elbows were therefore unstable, and all were managed nonoperatively. Although all fractures healed by fibrous union, the functional results were good. Clinical and radiological tests were used to assess the static stability of the ulnar collateral ligament. All patients had demonstrable ulnar collateral ligament laxity, but only one patient had slight impairment of elbow function. None had late-onset ulnar neuritis. We have shown that even the severe forms of this injury can be managed without internal fixation. PMID- 3506588 TI - Distal tibial physeal injuries in children: a different treatment concept. AB - Fifty-six patients with Salter-Harris type II physeal fractures of the distal tibia were treated with a weight-bearing long leg cast for 4 weeks. Forty patients were followed clinically and radiographically for an average of 22 months. There were no nonunions or angular deformities. There was one case of clinically insignificant premature physeal closure. Premature physeal closure results from the trauma to the physis that occurs at the time of injury and is not affected by early weight-bearing. Four weeks of immobilization in a long leg weight-bearing cast allows adequate healing and faster rehabilitation without an adverse effect on the growth of the distal tibia. PMID- 3506589 TI - Compressive fixation of osteochondritis dissecans fragments with Herbert screws. AB - Current methods of fixation of femoral osteochondritic fragments do not provide rigid enough stabilization to allow early postoperative motion. We describe a technique using Herbert screws in a patient to secure a large unstable medial condylar fragment. A second procedure for removal of the screws was not required, and the patient had an excellent clinical result. The Herbert differential pitch bone screw is able to provide compressive fixation, allow early motion, and minimize the potential for complications. PMID- 3506590 TI - Radiographic analysis of the Brooker-Wills interlocking nail in the treatment of comminuted femoral fractures. AB - Forty-three patients with 43 comminuted femoral shaft fractures treated with the Brooker-Wills interlocking nail were followed through bony union to determine the device's ability to maintain length and rotational control of these difficult injuries. Only severely comminuted fractures, types III and IV, were included. Implant complications were also studied. Average shortening for type III and type IV fractures measured 0.43 and 0.51 cm, respectively. Overall average shortening measured 0.47 cm (range, 0.0-2.2 cm). Maximal shortening occurred in a 72-year old osteopenic female. Six of the 23 femurs stabilized with the smaller 13- and 14-mm-diameter nails shortened more than 1.0 cm, whereas lesser degrees of shortening tended to occur with larger-diameter implants. The proximal locking diagonal screw provided adequate proximal control and was never found to be the cause of fracture shortening. Rod deformation occurred in nine patients (21%) and was seen only in 13.0- and 14.0-mm-diameter rods. The distal lock was found to control rotation clinically but played only a minor role in preventing shortening. Distal shortening appeared to be controlled by bone-rod contact at the metaphysis, as nailings within 0.5 cm of the epiphyseal scar resulted in the least amount of shortening. Although this intramedullary device produced adequate clinical and radiographic results in comminuted femoral shaft fractures in the young, multiply injured patient, we caution against the use of the 13.0- and 14.0 mm implants. In addition, the efficacy of this implant is unproved in the osteopenic patient. PMID- 3506591 TI - Locked flexible intramedullary nails in treatment of unstable femoral fractures. AB - Twenty patients with unstable femoral fractures were treated with distally locked flexible intramedullary nails. We present our surgical technique and our results. The method has the following advantages: it prevents rotational malalignment and shortening, it is a closed procedure, no reaming is necessary, there is no increase in c-arm time, and there is minimal increase in operative time. Locked flexible intramedullary nails should be used in patients with unstable femoral fractures who have dense metaphyseal bone. Osteopoenia is a contraindication to this method as it increases the risk of nail penetration into the hip. PMID- 3506593 TI - Energy cost of three-point crutch ambulation in fracture patients. AB - The energy consumption associated with unilateral nonweight-bearing (three-point) crutch ambulation was evaluated in a group of 25 newly injured fracture patients immobilized in a long or short leg cast. After 5 min of crutch ambulation, the rate of oxygen uptake was 32% greater than the value for normal walking (averaging 15.7 ml/kg-min); the heart rate was 53% greater than normal (averaging 153 beats/min); and the respiratory quotient was markedly elevated (averaging 1.03). In those subjects able to ambulate for 10 min, these values averaged 17.6 ml/kg-min and 173 beats/min, approaching the peak values for maximal upper extremity exercise. The prescription of three-point crutch ambulation is a severe exercise challenge requiring strenuous arm and shoulder exertion under anaerobic conditions. These findings account for the common clinical experience that the newly injured fracture patient, unable to weight bear on an injured limb and requiring crutches, is a severely restricted ambulator. PMID- 3506592 TI - Tibial fractures with infrapopliteal arterial injuries. AB - Tibial fractures with associated infrapopliteal arterial injuries have been inadequately documented in the literature. Eighteen patients with these injuries were admitted to Boston City Hospital during a 10-year period. Three patients required below-knee amputation, and two of these had ischemic intervals of greater than 8 h before vascular treatment. Six patients had delayed diagnoses of arterial injuries, but none required amputation. There were 15 open and three closed tibial fractures. Nine fractures were badly comminuted. Eight of the 14 viable limbs had delayed unions, but only one was associated with local vascular insufficiency. Five patients had complaints attributed to vascular insufficiency without clinical findings. Our conclusion is that the limb with an infrapopliteal arterial insult combined with a tibial fracture can survive with patency of only the anterior tibial or posterior tibial artery. Poor clinical results correlate with the severity of bony injury and not with the particular arterial injury. The incidence of below-knee amputation can best be related to delay in vascular treatment. PMID- 3506594 TI - Transient simultaneous sciatic and femoral nerve palsy secondary to iliacus and gluteal hematomas following heparinization for pulmonary embolus in a patient with posterior hip dislocation. AB - Sciatic nerve palsy as a result of a posterior hip dislocation has been reported in the literature. Femoral nerve palsy as a result of a iliacus hematoma has also been documented. However, a simultaneous sciatic and femoral nerve palsy occurring after heparinization for a pulmonary embolus in a patient with a posterior hip dislocation has not been reported. This combined nerve palsy was found in a 64-year-old white woman who had been involved in a motor vehicle accident and sustained a posterior hip dislocation. This patient subsequently had a pulmonary embolism, was heparinized, and then developed a large iliacus and gluteal hematoma, resulting in a simultaneous sciatic and femoral nerve palsy. Without treatment, the patient regained motor and sensory of the sciatic nerve in a few days, and a gradual improvement of function of her femoral nerve was evident over several months. PMID- 3506595 TI - Closed interlocking nailing of the femur complicated by an intramedullary calcified lesion. AB - The interlocking intramedullary nail has greatly expanded the indications for closed intramedullary nailing of the femur. We describe a complication caused by the presence of a calcified lesion located at the proximal metaphyseal-diaphyseal junction of the femur. This lesion could not be penetrated by hand reamers. We used a long 3.5-mm drill bit to place a hole in the infarct, which then allowed passage of the hand reamer. The operation then proceeded in the standard fashion without complications. PMID- 3506596 TI - Acute anterior compartment syndrome in the thigh: a case report and review of the literature. AB - An unusual case of acute anterior thigh compartment syndrome promptly recognized and successfully treated in a young athletic patient is presented and the literature reviewed. With the increased interest in physical fitness in today's society, this condition may occur more frequently than it is recognized. Prompt diagnosis and treatment can reduce morbidity. PMID- 3506597 TI - [Blood flow patterns in the left ventricle in patients with myocardial infarction and ventricular aneurysm: evaluation using real-time two-dimensional Doppler echocardiography]. AB - To evaluate how the intraventricular blood flow is affected by the size of a left ventricular aneurysm and ventricular dysfunction, systolic left ventricular blood flow patterns were evaluated using two-dimensional Doppler flow images (real-time 2-D Doppler echo). The subjects consisted of 10 normal controls, 35 patients with anteroseptal infarction, two patients with inferior infarction and five patients with anteroseptal-inferior infarctions. The systolic period was divided into three subsets; early, mid- and end-systole. Forty-two patients with myocardial infarction were classified into three groups according to the left ventricular inflow patterns on real-time 2-D Doppler echo using the apical left ventricular long-axis approach; i.e., inflow signals confined to early systole (Group I), visualized up to mid-systole (Group II) and end-systole (Group III). Left ventricular end-diastolic dimension (LVDd), left ventricular end-systolic dimension (LVDs), and % non-contractile circumference (delta L) were calculated by the same echocardiographic approach. Ejection fraction (EF) was calculated by left ventricular cineangiography using the Simpson's method. The left ventricular inflow Doppler signals in the normal controls and Group I turned in the apex and then directed toward the left ventricular outflow tract during late diastole and early systole. Significant differences in EF were observed among the three groups. EF in Group I, II and III was 53 +/- 9%, 41 +/- 8% and 29 +/- 7%, respectively. However, LVDd, LVDs and delta L had the largest values in Group III and the smallest values in Group I. LVDd, LVDs and delta L were smallest in Group I and largest in Group III. In the normal controls, the left ventricular inflow signals proceeded to the apex and directed toward the left ventricular outflow tract in the early systolic period. Various changes in the inflow pattern were observed in patients with myocardial infarction and severe wall motion abnormalities, including delayed timing in proceeding from the apex to the left ventricular outflow tract, stagnant blood at the apex and further inflow of blood toward the apex even during end-systole. The patients with sustained inflow during late systole had hypofunction of the left ventricle as demonstrated by smaller EF and larger LVDd, LVDs, and delta L. In conclusion, the observation of intracardiac blood flows by real-time 2-D Doppler echo is of help in evaluating the severity of myocardial infarction. PMID- 3506598 TI - [Left ventricular asynergy in patients with impending myocardial infarction: two dimensional echocardiographic assessment]. AB - To determine the clinical significance of regional left ventricular asynergy in patients with impending myocardial infarction, we recorded two-dimensional echocardiograms (2DE) serially and performed coronary angiography immediately after the hospital admission in nine patients with initial impending infarction and their last anginal attacks were within 48 hours. Left ventricular asynergy on the first 2DE was observed in six of nine patients during symptom-free periods (Group A: LV asynergy group). Five of the six patients had significant coronary artery lesions (greater than or equal to 75% stenosis) in at least one major coronary artery. Intracoronary filling defects were detected in four of the five patients. Another three patients without asynergy (Group B) had significant fixed stenosis. Coronary artery spasm was observed in two patients during coronary angiography, but no patient had intracoronary filling defects. Intracoronary nitroglycerin (0.1-0.3 mg) reduced the severity of coronary artery narrowing in two patients. In addition, urokinase (240,000-480,000 IU) via the corresponding vessel (PTCR) in the remaining seven patients resulted in reduction in the severity of coronary artery stenosis in four patients, but not in the remaining three patients. Left ventricular wall movement in the asynergy group improved rapidly and no asynergy was observed by the seventh hospital day in five of the six patients. Successful PTCR treatment resulted in improvement of left ventricular wall movement. No asynergy was found in the non-asynergy group throughout their hospitalizations. These findings indicated that abnormal left ventricular wall movement is found in patients with impending myocardial infarction, even during symptom-free periods, but the wall movement gradually improves. The 2DE observations are useful for estimating the clinical status and for planning precise therapy for impending myocardial infarction. PMID- 3506599 TI - [Papillary muscle infarction: echocardiographic features and genetic factors]. AB - To study the pathogenesis of papillary muscle infarction, its echocardiographic features were examined in 60 patients with old inferior infarction. Sixty-three healthy elderly persons served as the controls. 1. The papillary muscles were echocardiographically classified as fingerlike and non-fingerlike in configuration whose frequencies were 43% and 57%, respectively. In healthy subjects, the papillary muscles were less echogenic than the left ventricular wall. 2. In five patients, the posteromedial papillary muscle exhibited enhanced echo intensity and no contraction. The papillary muscles in two of these five patients were histologically examined and the diagnosis of papillary muscle infarction was verified. In these five patients, the papillary muscles were echocardiographically classified as fingerlike, and left ventricular infarction was observed to involve the attachment of the posteromedial papillary muscle. All five patients had mitral valve prolapse; posterior in four and anterior in one. Inferior infarction extended to the region just beneath the mitral annulus in the former four patients, but not in the latter one. 3. The echocardiographic features of papillary muscle infarction consisted of enhanced echo intensity of the papillary muscle and mitral valve prolapse, especially that of the posterior leaflet at the posteromedial commissural side, and extension of the asynergy region to the attachment portion of the papillary muscle. The fingerlike morphology of the papillary muscle and involvement of the attachment within the infarcted region are predispositions to the development of papillary muscle infarction.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3506600 TI - [Evaluation of right ventricular function in severe left ventricular failure: comparison of old myocardial infarction with dilated cardiomyopathy]. AB - To evaluate right ventricular (RV) function in severe left ventricular (LV) failure, we measured RV and LV ejection fractions (EF) in 18 patients with old myocardial infarction (OMI) and in 18 with dilated cardiomyopathy (DCM) using cardiac blood pool scintigraphy. In patients with OMI, RVEF was significantly greater in stage II LV failure than in stage III (functional class of the New York Heart Association, 47 +/- 8% and 28 +/- 12%, respectively: p less than 0.01), and this correlated well with exercise tolerance by bicycle ergometer and mean pulmonary artery pressure (r = 0.83 and r = -0.71, respectively). In patients with DCM, however, there was no correlation between RVEF and these indexes. After the oral administration of denopamine (beta 1 effector), both RVEF and LVEF increased in patients with OMI (35 +/- 13% to 45 +/- 12%, and 27 +/- 9% to 30 +/- 10%: p less than 0.01), but they did not change significantly in patients with DCM. These results indicate that RVEF in patients with OMI correlates well with subjective symptoms, exercise tolerance and RV afterload, but these correlations were not apparent in patients with DCM. We concluded that RV function in cases of severe LV failure has a different meaning between OMI and DCM. PMID- 3506601 TI - The prognostic significance of left ventricular response to isoproterenol infusion in patients with dilated cardiomyopathy. AB - To evaluate the prognostic value of the left ventricular response to isoproterenol infusion in patients with dilated cardiomyopathy (DCM), 25 patients, 17 men and eight women, were studied. According to responses of left ventricular function to isoproterenol (0.02 microgram/kg/min), the patients were classified in two groups: the normal response group, in which fractional shortening increased by more than 10% (n = 10); and the low response group, in which fractional shortening increased by 10% or less (n = 15). A follow-up spanning four to 40 months with an average of 21 months disclosed that six patients died, two deteriorated, and six had no change in the low response group, while seven patients were improved, three stabilized, and no one deteriorated or died in the normal response group. There was a difference in the clinical courses of the two groups. Thus, the left ventricular response to isoproterenol proved useful in predicting the course of DCM. PMID- 3506602 TI - [Aortic regurgitation in hypertrophic cardiomyopathy as detected by color Doppler echocardiography]. AB - Aortic regurgitation (AR) in patients with hypertrophic cardiomyopathy (HCM) has rarely been reported. Using color Doppler echocardiography, we assessed the incidence and the cause of AR in patients with HCM. There were 86 patients with HCM (M:F = 66: 20, 57 +/- 12 years, mean +/- SD) and 43 control subjects (M: F = 33: 10, 57 +/- 8 years). HCM was diagnosed by echocardiography; the thickness of the interventricular septum (IVS) was more than 15 mm and the ratio to the thickness of the left ventricular free wall (LVPW) was more than 1.3. The rate and degree of aortic regurgitation were observed by color Doppler echocardiography, and aortic regurgitant murmurs were recorded by phonocardiography. Echocardiographic measurements were made using standard techniques. In the M-mode echocardiograms, the aortic diameter, the thicknesses of the IVS and LVPW were measured. In the 2DE, calcification of the aortic valve and systolic anterior movement of the mitral valve (SAM) were evaluated. In the early systolic 2DE image, the distance from the point of the greatest bulging of the upper IVS to the aortic root (D1) and the distance from the point of the greatest bulging to the line which is parallel to the long axis of the aorta (D2) were measured. Results were as follows: 1. Color Doppler echocardiography revealed aortic regurgitation in 17 (21%) patients with HCM; whereas it was observed in only three (7%) of the control subjects. 2. The aortic regurgitant signals were limited to the left ventricular outflow tract both in patients with HCM and in the control subjects. 3. Aortic regurgitant murmurs were recorded in only two patients with HCM and in none of the control subjects. 4. There was no difference between the patients with and without AR as to age (59 vs 56 years), blood pressure (141/84 vs 136/80 mmHg), aortic diameter (34 vs 33 mm), aortic valve calcification (12% vs 9%) and SAM (53% vs 52%). 5. In the patients with HCM, D1 was shorter (9.9 vs 14 mm, p less than 0.001) and D2 was longer (16 vs 10 mm, p less than 0.001) in the patients with AR than in those without AR. That is, the basal septum of the patients with AR protruded more deeply into the outflow tract, and the distance to the aortic valve was significantly shorter than in those without AR.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3506603 TI - [Pulsed Doppler echocardiographic findings in 117 professional cyclists]. AB - To investigate the effect of long-term athletic training on the heart, pulsed Doppler echocardiography was performed in 117 male professional cyclists (Group C: 20-59 years of age), and 40 age- and sex-matched untrained normal controls (Group N). According to age, the subjects in each group were categorized in two subgroups: 74 cyclists (Group CI), 20-39 years of age and 43 cyclists (Group CII), 40-59 years of age; 24 control subjects (Group NI), 20-39 years of age and 16 control subjects (Group NII), 40-59 years of age. The average durations as professional cyclists were eight years in Group CI and 29 years in Group CII. The ratios of pre-ejection period to ejection time (LV-PEP/ET, RV-PEP/ET) as obtained from Doppler flow velocity patterns of the left and right ventricles (LV, RV) were used as parameters of systolic function. The peak flow velocities during rapid filling (LV-R, RV-R) and atrial systole (LV-A, RV-A), and the ratio of A to R (LV-A/R, RV-A/R) were used as parameters of diastolic filling dynamics. The parameters of systolic function of both ventricles and those of diastolic filling dynamics of the RV did not differ between Group C and Group N, Group CI and Group NI, and Group CII and Group NII. Study of the diastolic filling dynamics of the LV disclosed that Group C had a significantly higher LV-A/R (p less than 0.05) than did Group N; therefore, no significant differences between Group CI and Group NI, and Group CII had a significantly lower LV-R (p less than 0.005) and a higher LV-A/R (p less than 0.005) than did Group NII. Twenty-four hour ambulatory ECG monitoring was performed for 49 cyclists. Thirty cyclists aged 20-39 years were categorized in two groups according to their LV-A/R values: eight cyclists (Group A) with the LV-A/R greater than the mean + SD value (0.69) in Group NI and 22 cyclists (Group B) with the LV-A/R lower than or equal to 0.69. Nineteen cyclists aged 40-59 years were separated into two groups according to the LV-A/R value: 11 cyclists (Group A) with the LV-A/R values greater than the mean + SD value (0.89) in Group NII, and eight cyclists (Group B) with the LV-A/R equal to or less than 0.89.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3506604 TI - [A trial diagnosis of latent dilated cardiomyopathy]. AB - To diagnose latent dilated cardiomyopathy (latent DCM), we performed loading echocardiography with Angiotensin II and ergometer exercise in 41 patients. Twenty-one patients were suspected of having latent DCM because of histories, of heart failure of myocarditis; 10 patients had DCM; and 10 normal persons served as controls. On angiotensin II loading, cardiac function deteriorated in the DCM group, but it was maintained in the normal controls. Nine patients in the latent DCM group showed the same pattern as normals (L1-group), and 12 did as the DCM group (L2-group). Although % fractional shortening, end-diastolic and end systolic dimensions of the left ventricle did not differ between the L1 and L2 groups, the A/R, the ratio of the pulsed Doppler echocardiogram at the left ventricular inflow tract, was larger and the exercise change of the % fractional shortening and exercise tolerance were less in the L2-group than in the L1-group. Furthermore, the biopsy findings of the L2-group were similar to those of the DCM group in terms of myocardial degeneration, myocardial hypertrophy and interstitial fibrosis. Thus, patients in the L2-group were thought to have a risk for DCM, and were cases of latent DCM. Angiotensin II loading is thought to be useful for diagnosing such cases. PMID- 3506605 TI - [Effect of brain death on hemodynamics and cardiac function: an experimental study]. AB - An experimental model was designed to study hemodynamic and left ventricular functional changes in the course of and after brain death in 13 mongrel dogs. Brain death was induced by creating intracranial hypertension by inflating a balloon inserted into the subdural space. Hemodynamic parameters and left ventricular systolic function as assessed by echocardiography were measured before and during intracranial hypertension and 30 min and 1, 2, 3, 5 and 8 hrs after brain death. During intracranial hypertension, heart rate, systemic and pulmonary blood pressures, cardiac output and systemic vascular resistance raised significantly. After brain death, all parameters decreased rapidly and significantly, and then stabilized. On comparison with values obtained before intracranial hypertension, systemic blood pressure decreased markedly following brain death, while no marked change was noted in cardiac output. This result is attributable to a marked reduction in peripheral vascular resistance following the induction of intracranial hypertension. The left ventricular end-diastolic and end-systolic diameters did not change; consequently, fractional shortening did not change, either. The Weissler's index improved after brain death, reflecting a marked reduction in systemic vascular resistance. This indicates limited usefulness of afterload-dependent cardiac indices. At the agonal period of brain death, three of 13 dogs died because of ventricular fibrillation or a marked decline in systemic blood pressure. Within five to eight hours after brain death, seven dogs died because of intractable acidosis. These results represent the specific hemodynamic features occurring after brain death. It is thought that recognition of these features is useful in managing cases of brain death and in selecting donors for heart transplants. PMID- 3506606 TI - [Tricuspid regurgitation evaluated by intraoperative epicardial pulsed Doppler echocardiography: investigation of patients with combined valvular diseases]. AB - To evaluate the grade of tricuspid regurgitation (TR) associated with mitral valve disease and to ascertain the operative procedure for the involved tricuspid valve, epicardial pulsed Doppler echocardiography (PDE) was performed during cardiac surgery. Thirty-two patients with mitral valve disease were studied, 17 of whom had only mitral valve lesion; the remaining 15 had combined mitral and aortic valve disease. The patients' ages ranged from 24 to 63 years and averaged 48.3 years. There were nine men and 23 women. Echocardiographic examinations were performed using a Toshiba SSH-60A for parasternal study and a SSH-11A combined with a SDS-10A with a specially-devised flat transducer for intraoperative use. Intraoperatively, the PDE performed was from the right side of the right atrium (RA), referenced by a four-chamber view and a long-axis view of the right ventricular inflow. The sampling volumes were positioned in the inflow of the right ventricle, immediately above the tricuspid valve, the middle and upper areas of the RA, and adjacent to the interatrial septum. PDE was performed before and immediately after the operative procedure and before chest closure. By severity, TR was classified as non -, mild +/-, moderate +, and severe ++, according to the distances attained by the TR signals from the tricuspid valve orifice, and the velocities and durations of the TR signals during systole. The TR signal was recorded in 23 of 32 patients before surgery, whereas it was determined more adequately in 28 patients by intraoperative epicardial PDE. The gradings of TR via the parasternal approach before surgery were as follows: no TR, in nine cases; mild TR, in three; moderate, in 13; and severe, in seven. Intraoperatively, four patients had none; eight had mild TR; 14, moderate TR; six, severe TR before surgical intervention, respectively. In cases with mild or no TR before surgery, TR was rarely detected by contrast echocardiography using saline solution injected into the right ventricle during surgery. The moderate or severe cases before surgery had moderate or severe TR according to the contrast method during surgery, except for one case not operated on for tricuspid valve disease. Tricuspid valve replacement was performed for two patients, and tricuspid annuloplasty or valvuloplasty for eight.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3506607 TI - [Diagnosis of atrial septal defect using magnetic resonance imaging]. AB - We studied the morphological features of defects of the interatrial septum using magnetic resonance imaging (MRI) to determine the sizes of defects and other abnormalities. MR images were obtained in 28 patients with atrial septal defect, including five cases with complicated anomalies (two with Ebstein's anomaly, one pentalogy of Fallot, and one anomalous pulmonary vein connection and azygos continuation). Images were also obtained in the control subjects including seven normal volunteers and 142 patients with various acquired heart diseases. The diagnosis of atrial septal defect was established by cardiac catheterization, angiography and two-dimensional echocardiography prior to the MRI studies, and in 14 patients, the diagnosis was confirmed by surgery. The MRI unit had a superconducting magnet and operated at 0.25 or 0.50 Tesla. A spin echo pulse sequence was used with an echo time of 40 or 60 msec. At the beginning of this study, non-gated MRI images were obtained in the 28 controls and in three patients with atrial septal defect. Nongated MRI could not image the anatomical structure of the interatrial septa of 12 of the 28 controls, or any of the three patients with atrial septal defect. Nongated MRI was, therefore, inadequate for visualizing cardiac anatomy. Gated MRI images were obtained in 141 controls and in 25 patients with atrial septal defect. Gated MRI revealed the interatrial septum, interventricular septum, atrioventricular septum, mitral valve, tricuspid valve and other intracardiac structures in most subjects. In 17 control subjects (12%), however, there was a very faint signal from the central portion of the interatrial septum. In these instances, there was a gradual fading of the signal of the interatrial septum, so that they could be distinguished from the atrial septal defect. The sudden disappearance of the signal from the interatrial septum was observed by gated MRI in all 25 patients with atrial septal defect. The sizes of the defects by MRI coincided with the findings at surgery in all 14 patients. MRI showed right atrial dilatation, right ventricular hypertrophy and dilatation, and pulmonary artery dilatation in most of the patients having atrial septal defect. Complex anomalies associated with atrial septal defect were also clearly shown by MRI, such as displacement of the tricuspid leaflets in two patients with Ebstein's anomaly, and anomalous pulmonary venous connection and persistent left superior vena cava in one patient. These results indicated that gated MRI is a valuable noninvasive method of diagnosing atrial septal defect and complicating anomalies. PMID- 3506608 TI - [Usefulness of measuring right ventricular anterior wall thickness in patients with right ventricular overload using M-mode echocardiography]. AB - Right ventricular anterior wall thickness measured by M-mode echocardiography and right ventricular systolic pressure obtained by right heart catheterization were correlated in 62 patients with chronic right ventricular overload including congenital heart disease and primary pulmonary hypertension. The patients were divided into two groups; one, with right ventricular systolic pressures of 39 mmHg or less; the other, 40 mmHg or more. The following results were obtained. 1. The correlation coefficient for right ventricular anterior wall thickness and right ventricular systolic pressure was r = 0.90 (p less than 0.001), and the regression equation was y = 13.2x-1.3. 2. Right ventricular end-diastolic dimension increased significantly in both groups, but no statistically significant differences were detected between the two. Right ventricular anterior wall thickness increased significantly in the group with higher right ventricular pressures (7.1 +/- 0.5 mm vs 3.1 +/- 0.5 mm). 3. When right ventricular anterior wall thickness was more than 4.0 mm, pulmonary hypertension was detected, with a sensitivity of 97.5% and a specificity of 90.9%. In conclusion, measurements of right ventricular anterior wall thickness by M-mode echocardiography via the anterior chest wall proved to be potentially useful in predicting right ventricular systolic pressures in patients with chronic right ventricular overloads. PMID- 3506609 TI - [Noninvasive estimation of left ventricular end-systolic pressure]. AB - A method for noninvasively determining left ventricular (LV) end-systolic pressure (ESP) using carotid pulse tracings and cuff-measured blood pressure was re-evaluated. It was validated during diagnostic cardiac catheterization in 60 patients with cardiovascular diseases. LVESP calculated by this method and systolic blood pressure measured by the cuff were compared with aortic dicrotic notch pressures obtained by a catheter-tip manometer system as true LVESP. The calculated ESP was measured by the following formula; [the ratio of the excursion of dicrotic notch (b) to the peak (a) in carotid pulse tracings: (b/a) x pulse pressure] + diastolic blood pressure. This calculated ESP had a high correlation coefficient with true ESP invasively measured (r = 0.96), but was estimated to be 5.3 +/- 5.0 mmHg less than true ESP. Systolic blood pressure, used as a noninvasive index of ESP, accurately estimated ESP, but it was higher by 14.8 +/- 11.2 mmHg (r = 0.84). Calculated ESP measured by the present method was not affected by age or systemic vascular resistance. This is a reliable noninvasive means of estimating LV end-systolic pressure. Compared with the peak arterial pressure, this is a better parameter for the analysis of LV contractility, such as stress-shortening, and end-systolic pressure-volume relations. PMID- 3506610 TI - [The influence of the right or left ventricular pressure overload on right and left ventricular diastolic behaviors as examined by pulsed Doppler echocardiography]. AB - The influence of morphological and dynamic changes in the interventricular septum (IVS) on right ventricular (RV) and left ventricular (LV) fillings in cases of LV or RV pressure overload was evaluated. Using pulsed Doppler echocardiography, LV and RV inflow signals were recorded in 20 healthy subjects, in 36 cases of chronic pulmonary disease (CPD) with pulmonary hypertension, and in 46 cases of essential hypertension (HT). Two-dimensional short-axis echocardiograms were recorded at end-diastole (ED) and end-systole (ES) in the healthy subjects and in the cases with CPD. M-mode echocardiograms of the LV were recorded in the healthy subjects and in the cases with HT. We measured (1) the ratio of the peak velocity of inflow due to atrial contraction to that of rapid inflow (A/R), (2) the deceleration half-time of rapid inflow (delta TD), (3) the corrected radius of curvature of the IVS at ED and ES, (4) the % change of lengthening (CL) of 16 radial grids using a fixed method on the ED and ES short-axis images, and (5) the IVS end-diastolic thickness (IVSEDTh). The results were as follows: 1. In the patients with CPD, (1) the diastolic behavior was impaired not only in the RV, but in the LV as well, as shown by the increased A/R and prolonged delta TD in both ventricles, (2) the IVS was flattened at ED, as shown by the decreased corrected radius of the curvature, (3) the regional wall motion of the IVS was impaired, as shown by the decreased CL of the IVS. 2. In the patients with HT, (4) the RV diastolic filling was not impaired, (5) the LV A/R correlated with IVSEDTh, but the RV A/R did not correlate with IVSEDTh. We concluded that RV pressure overload interferes with IVS motion during diastole, and that the regional impairment of diastolic behavior of the IVS causes impairment of LV diastolic filling. Furthermore, the increased IVS wall thickness due to LV pressure overload has a little or no influence on the RV inflow pattern because the RV free wall was so distensible as to overcome the effect of increased IVS stiffness. PMID- 3506611 TI - [Pre- and post-operative right ventricular functions in valvular heart diseases: the significance of noninvasive assessment]. AB - This investigation was undertaken to evaluate right ventricular function in valvular heart diseases by calculating right ventricular ejection fraction (RVEF) from first-pass radionuclide angiography (RNA). One hundred cases of valvular heart disease were examined by RNA, 93 of whom underwent cardiac catheterization and contrast left ventriculography, preoperatively. Fifty of the 100 cases were examined by RNA; 18 by cardiac catheterization post-operatively. The results were as follows: 1. In 49 cases of mitral valve disease, there was a correlation (r = 0.75) between pulmonary artery mean pressure (PAm) and RVEF. This suggested that afterload of left atrial pressure elevation induced a decrease in RVEF. 2. Although PAm did not increase so much in aortic valve disease, RVEF decreased in some cases, especially in those having massive aortic stenosis or regurgitation. In 22 cases of aortic regurgitation which had normal PAm and a left ventricular aortic systolic pressure gradient less than 50 mmHg, there was a correlation (r = -0.69) between the RVEF and the left ventricular end-diastolic volume index (LVEDVI). 3. Although post-operative RVEF did not improve significantly in mitral valve disease, it increased significantly in the early post-operative period in aortic valve disease. Also, the increase in RVEF and the decrease in LVEDVI seemed to correlate closely in aortic valve disease. It was speculated that pre operative decrease of RVEF is derived from a deformity of the RV caused by pressure from the enlarged or thickened LV, and that post-operative increase of RVEF is dependent upon a decrease of LV size and volume. PMID- 3506612 TI - Ambulatory ventricular function monitoring for serial assessments of cardiac function during exercise. AB - An ambulatory ventricular function monitor (VEST) facilitated measuring left ventricular (LV) function, and performing electrocardiography (ECG) in a natural environment. To assess cardiac response to a variety of exercises, LV function was serially recorded for each of 18 normal subjects using a VEST. The VEST detector was fixed over the LV region following the gated blood pool scan, and the beat-to-beat LV time-activity curve and ECG were continuously recorded. After a baseline recording was made with the subject sitting quietly, the subject performed on a bicycle exercise (n = 16), on a treadmill (n = 14), and by walking up 10-16 flights of stairs (n = 18) while wearing the VEST. The beat-to-beat radionuclide data were averaged for 15-30 seconds to calculate ejection fraction (EF), relative end-diastolic (EDV) and end-systolic (ESV) volumes, and the heart rate. Serial LV function monitoring during each exercise, particularly while walking upstairs and on a treadmill, documented rapid increases in EF during the early stages of exercise, with increases in EDV, decreases in ESV, and no change in EF in the later stages. Heart rate and systolic blood pressure increased progressively with successive stages. The pressure rate product at the peak exercise was highest during treadmill exercise (32,600) and lowest while climbing stairs (24,700). Immediately after exercise, EDV and ESV rapidly decreased and EF increased further, particularly after bicycle and treadmill exercise. These data demonstrate that the VEST can measure LV function continuously in an ambulatory environment, and that it is an effective means of evaluating normal cardiac physiology during various exercises. PMID- 3506613 TI - [Interventricular septal wall motion abnormality in left bundle branch block]. AB - An experimental study was performed to clarify the mechanism of perfusion defects in the interventricular septum on T1-201 scintigraphy, as seen in patients with left bundle branch block (LBBB) having normal coronary arteries. In anesthetized open-chest dogs, the following parameters were assessed during right atrial pacing as a control, left ventricular pacing to produce right bundle branch block (RBBB), and right ventricular pacing for LBBB; 1. intramuscular pressure in the interventricular septum, 2. blood flow of the left anterior descending coronary artery (LAD) measured by an electromagnetic flowmeter; 3. regional myocardial blood flow (MBF) determined at three sites, including the interventricular septum, LAD area, and left circumflex coronary artery (LCx) area using the H2 washout method. Aortic pressure, left ventricular pressure, and M-mode echocardiograms were recorded during the procedures. During right ventricular pacing, LAD flow remained unchanged; whereas MBF at the interventricular septum decreased from 99.6 +/- 23.4 to 79.2 +/- 17.6 ml/min/100 g, but MBF at the LCx area increased from 103.2 +/- 19.8 to 122 +/- 18.4 ml/min/100 g. In contrast, there were no significant changes in regional flow in any sites during left ventricular pacing. During right ventricular pacing, an early systolic dip was observed in the septal wall concomitantly with the onset of rise in intramuscular pressure in the interventricular septum. However, the beginning of the rise in left ventricular pressure was delayed 33 +/- 4 msec after that of the septal intramuscular pressure.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3506614 TI - [Right ventricular flow dynamics in the early neonatal period assessed by pulsed Doppler echocardiography]. AB - Right ventricular hemodynamic changes in the early neonatal period were observed by pulsed Doppler echocardiography in 45 neonates free of organic cardiac disease. Subjects consisted of 19 male and 26 female infants who were categorized by delivery as 22 normals, seven breech presentations, eight vacuum delivery and eight Cesarean section. Asphyxia was present at birth in 11 cases. Echocardiography was performed at 0, 1, 3, 5 and 30 days of age. The pulmonary flow pattern was recorded using the suprasternal long-axis view as a reference, and the maximum pulmonary flow velocity (PaV), acceleration time (AcT) and right ventricular ejection time (RVET) were measured. Mean pulmonary arterial pressure (MPAP) was estimated from the AcT and AcT/RVET ratio, according to Kitabatake et al. The tricuspid flow pattern was recorded with the four-chamber view as a reference, and the peak velocities of rapid filling (R) and atrial filling (A), and the A/R ratio were measured. The A/R ratio of tricuspid flow decreased with age in days and no significant differences were observed on each successive day, but there were significant differences between 0 and 3, 5 and 8 days of age. There were no significant differences by age in days in the maximum velocity of pulmonary blood flow, and the mean value was 74.9 +/- 3.0 cm/sec. The estimated MPAP was maximum at 0 day of age, declined gradually until 5 days of age, and was unchanged thereafter. No significant differences were found according to the type of delivery. Transient tricuspid regurgitation (TR) was detected in nine infants comprised of seven asphyxic infants and two of breech presentations. In these infants with TR, significantly higher estimates of MPAP were observed as compared with those without TR, and the A/R ratio of tricuspid flow was also higher among the infants with TR. These results indicate that the data obtained by this study reflect well acute hemodynamic changes in the early neonatal period in normal infants, and it can be applied for assessing cardiopulmonary disease, as well. PMID- 3506615 TI - [Familial cardiomyopathy with different clinical features in individual members]. AB - The mother and three children of a family whose parents were consanguineous, each had cardiomyopathy with various patterns of hypertrophy and dilatation. All members had asymmetrical septal hypertrophy (ASH), and three of them were characterized as hypertrophic cardiomyopathy (HCM). Another one had ventricular dilatation mimicking dilated cardiomyopathy (DCM). Case 1: The 57-year-old mother had a typical ASH pattern; her septal/posterior wall thickness ratio (IVST/LVPWT) was 2.5. Case 2: The 37-year-old daughter had basal septal hypertrophy. Case 3: The 32-year-old elder son had typical concentric hypertrophy. Case 4: The 30-year old younger son had an episode of congestive heart failure, and showed DCM-like features with considerable dilatation and impaired wall motion of the left ventricle. The hypertrophic pattern in cardiomyopathies is thought to depend partially on the ages of the onset, or its evolution with aging. PMID- 3506616 TI - [Regression of mitral valve prolapse to a state masquerading as dilated cardiomyopathy: a case report]. AB - A 40-year-old man was admitted to our hospital in May 1982 for evaluation of a heart murmur. A standard 12-lead electrocardiogram (ECG) showed an abnormal Q wave in lead III. Echocardiography revealed prolapse of the anterior mitral valve leaflet (MVP), but neither dilatation nor wall motion abnormalities of the left ventricle (LV) were observed. Thallium-201 scintigraphy revealed an abnormal thallium uptake at the apex and inferior wall. He had no episode of acute myocardial infarction or myocarditis, but complete right bundle branch block suddenly appeared, and he was hospitalized in October 1984. He had no coronary artery lesions, and only mild mitral regurgitation on left ventriculography. The motion of the interventricular septum and apex was reduced on echocardiography and a persistent perfusion defect was observed at the inferior wall and the interventricular septum on T1-201 scintigraphy. In December 1985, he experienced an Adams-Stokes attack due to complete atrioventricular block. Echocardiographically, the left ventricle became enlarged and the wall motion abnormality and a perfusion defect on T1-201 scintigrams were of relatively severe degree. Thus, left ventricular dilatation and wall motion abnormality may progress in some cases of MVP as it did in this one. We consider this case a very interesting one in speculating on the relationship between MVP and DCM. PMID- 3506617 TI - Monoclonal gammopathy associated with naturally occurring canine ehrlichiosis. AB - Clinical, hematologic, and immunologic findings for 14 dogs with Ehrlichia canis monoclonal gammopathy were studied retrospectively. Epistaxis, anemia, thrombocytopenia, hypoalbuminemia, hypergammaglobulinemia, and proteinuria were documented in the majority of these dogs. The serum protein electrophoresis pattern was characterized by a distinct narrow-base monoclonal spike, by a broad base monoclonal spike, or by a monoclonal spike superimposed on a polyclonal gammopathy. The monoclonal spike disappeared following tetracycline treatment for ehrlichiosis. The long-term prognosis following treatment was generally good. The diagnostic features of monoclonal gammopathy due to myeloma were compared with those of E. canis monoclonal gammopathy. Owing to numerous similarities in clinical, hematologic, and immunologic findings, we conclude that an E. canis antibody titer should be determined in all dogs in which a diagnosis of benign monoclonal gammopathy is contemplated or definitive evidence of myeloma, leukemia, or macroglobulinemia is lacking. PMID- 3506618 TI - Platelet aggregation in feline cardiomyopathy. AB - Platelet aggregation in response to adenosine diphosphate (ADP) was evaluated in 16 healthy cats and in 10 cats with cardiomyopathy. The minimum threshold concentration of ADP required to induce irreversible (2nd-phase) aggregation was determined in each cat. The minimum ADP concentration needed for 2nd-phase aggregation in platelets from healthy cats ranged from 1 microM to 100 microM ADP, with 56% (9/16) requiring 100 microM ADP. Of the remaining seven normal cats, three had platelets responding irreversibly to 10 microM ADP, and four had platelets responding to 1 microM ADP. In cats with cardiomyopathy, the threshold concentrations ranged from 0.01 microM ADP to 10 microM ADP. Two cats had platelets responding irreversibly to 0.01 microM ADP, whereas another cat had a threshold response at 0.1 microM ADP. Platelets from the remaining seven cats with cardiomyopathy exhibited 2nd-phase aggregation in response to 1 microM ADP (five cats) or 10 microM ADP (two cats). Platelet counts ranged from 210,000/mm3 to 630,000/mm3 in healthy cats and from 218,000/mm3 to 624,000/mm3 in cats with cardiomyopathy. There was no apparent correlation between the platelet count and the magnitude of the threshold aggregation response, as measured by lag phase and slope of the aggregation curves. The results indicate that some cats with cardiomyopathy have platelets that are hyperaggregable to ADP in vitro. PMID- 3506619 TI - Cisplatin toxicity in cats. AB - Cisplatin (cis-diamminedichloroplatinum; Platinol, Bristol, Syracuse, NY) was administered to 11 cats, divided into three groups of experimental and clinical patients. In group 1, cisplatin was administered at a dose of 60 mg/m2 to four cats. In an attempt to avoid renal toxicity, saline diuresis was induced by administering 0.9% saline solution intravenously at a rate of 20 ml/kg/hr for 4 hours before and 2 hours after cisplatin administration. All four cats became dyspneic and died 48-96 hours after cisplatin administration. Postmortem findings included severe hydrothorax, pulmonary edema, and mediastinal edema. In group 2, four experimental cats entered a trial comparing the effects of saline diuresis and cisplatin (60 mg/m2) with the effects of saline diuresis and placebo (0.9% saline solution). The cats in the saline control group remained completely normal, while the cats that received cisplatin developed clinical signs and gross postmortem pulmonary changes identical to those in the first group of cats. Histopathologic examination showed that the alveolar septa were thickened and congested, and contained macrophages, occasional neutrophils, thrombi, and small foci of necrosis and fibrin. Microangiopathic changes were seen in the alveolar capillaries. In the third group, three additional cats were treated with a lower dose of cisplatin. Two cats that received 40 mg/m2 of cisplatin developed pulmonary changes similar to, but less severe than, those seen in the cats that received the higher dose of cisplatin. One cat treated with 20 mg/m2 of cisplatin showed no pulmonary changes ante mortem or post mortem. This series of 11 clinical and experimental cases identifies an apparent species-specific, dose related, primary pulmonary toxicity of cisplatin in cats. PMID- 3506621 TI - Clotting changes in borderline hypertension. AB - Coagulation factors evaluated in a group of patients with borderline hypertension. The following tests were carried out: prothrombin time (PT) and partial thromboplastin time (PTT), Factor VIII coagulant activity, Factor VIII antigen and Factor VIII ristocetin cofactor, Factor XII and Factor XI activities. These tests were selected for their relationship to the contact coagulative activation near the vascular wall. Comparing the results with those of normal controls, Factor VIII coagulant activity, Factor XII and PTT levels were significantly higher. Other tests were all within normal limits in both groups. High Factor VIII and Factor XII levels associated with PTT shortening suggest that an increased synthesis and/or release of these coagulation factors was present in our patients. Activated coagulation seems to be present in borderline hypertension before the appearance of clinical signs of vascular lesions. PMID- 3506620 TI - Equine degenerative myeloencephalopathy: a vitamin E deficiency that may be familial. AB - Two horse farms, on which there was a high incidence of proven and suspected equine degenerative myeloencephalopathy (EDM), were studied. Symmetric ataxia and paresis, along with laryngeal adductor, cervicofacial, local cervical, and cutaneous trunci hyporeflexia, characterized the syndrome. Serum vitamin E concentration reflected a deficient state in affected and unaffected horses on both farms when compared with selected reference groups and with published values. A high incidence of the disease was evident in offspring of two particular sires on one farm. Vitamin E supplementation resulted in correction of the deficient state in most horses and was associated with a drastic reduction in the incidence of EDM on one farm from 40% to less than 10% the year following vitamin E supplementation. In addition, during the last year, the severity of signs in the few cases was dramatically reduced. This information substantiates the hypothesis that EDM is a vitamin E-responsive disorder of Equidae with a possible familial predisposition. PMID- 3506622 TI - Cardiovascular changes during mental stress: correlations with presence of coronary risk factors and cardiovascular disease in physicians and dentists. AB - Stress may play a role in the etiology of cardiovascular disease. Research showing that mental stress administered in laboratory settings causes great change in cardiovascular and hemodynamic functioning supports this hypothesis. In a small sample of physicians and dentists, those who showed greater cardiovascular reactivity (hot reactors) to stress were more likely to be hyperlipidemic or to have had a myocardial infarction or coronary bypass surgery. In addition, some of the nonreactive group were hypertensives taking medication, which may have blunted their response to stress. Persons with higher cholesterol, higher triglyceride levels, and lower HDL levels all showed greater increases in blood pressure (BP) in response to stress. Also, the reactive group reported less emotional support and experienced greater numbers of family-related stressful events in the previous year. The degree of aerobic fitness influenced resting hemodynamics and percentage of body fat but not reactivity to stress. Likewise, smoking did not affect reactivity, but former smokers did have a significantly elevated total systemic resistance at rest. While it is impossible to say whether reactivity causes disease, is the result of the presence of risk factors and disease, or is caused by some other factor which also contributes to disease, these results suggest that the presence of cardiovascular reactivity to mental stress is a sign of potential illness and indicates the need for further medical and risk factor study of the patient. PMID- 3506623 TI - The efficacy and tolerability of antihypertensive treatment based on atenolol in the prevention of stroke and the regression of left ventricular hypertrophy. AB - Nine hundred and thirty nine moderate to severe hypertensive patients were treated with a combination of atenolol, a beta 1 selective receptor blocker, diuretics and where required, additional vasodilator therapy to achieve adequate blood pressure (BP) control. Patients were followed up for a period of 10.2 years (mean 6.1 years). Amassed clinical exposure amounted to 5465 patient years. Mean BP fell from 183.0 +/- 1.0/109.2 +/- 0.5 mmHg to 145.1 +/- 0.6/89.3 +/- 0.3 mmHg and treatment resulted in a significant regression of the electrocardiographic signs of left ventricular hypertrophy (LVH). Side effects of treatment were consistent with those expected from a regime comprising a combination of a beta 1 selective hydrophilic beta-blocker, diuretics and vasodilators. Reported side effects appeared to diminish with time; were more common in the elderly than in the young and increased in frequency as the dose of atenolol increased. Biochemical disturbance was minimal. Total mortality (n = 91) and mortality from myocardial infarction (n = 40) were positively related to treated systolic blood pressure (SBP). A J-shaped curvilinear relationship between treated diastolic blood pressure (DBP) and death rate from myocardial infarction has been shown. Although the number of deaths from stroke was small (n = 21), there appeared to be a positive relationship with treated DBP: by contrast the data suggest that in the elderly, lowering SBP to below about 140 mmHg might be associated with an increased incidence of death from stroke. PMID- 3506624 TI - Calcium metabolism and blood pressure in children. AB - Raised urinary calcium excretion has been reported in patients with essential hypertension, but it is not known whether this finding is an early expression of altered calcium metabolism or a consequence of longstanding high blood pressure (BP). BP and 24 h urinary excretion of calcium, sodium and creatinine were measured in a representative sample of healthy normotensive sixth grade school boys (n = 146: mean age 11.2 +/- 0.1 yrs, SEM). A significantly higher calcium output was found in children in the upper quarter of the BP distribution, even when differences due to body size, urinary creatinine and sodium excretion were excluded. The same result was obtained when students from the upper BP quartile were compared with age, height and weight-matched students from the rest of the study population (urinary calcium: 2.63 +/- 0.42 vs 1.54 +/- 0.23 mmol/24 h, P less than 0.02). Enhanced urinary calcium excretion is thus found in children in the upper part of the BP distribution for their age and sex and who are therefore at higher risk of hypertension in adulthood. This finding is compatible with the hypothesis of a primary abnormality of calcium metabolism in essential hypertension. PMID- 3506626 TI - The effect of chronic prazosin therapy on the response of the renin-angiotensin system in patients with essential hypertension. AB - Changes in plasma active and inactive renin and angiotensin II in response to tilt and intravenous frusemide were assessed in ten patients with essential hypertension, before treatment and again during chronic therapy with the alpha 1 adrenoceptor antagonist prazosin. During prazosin treatment blood pressure in the patients fell from mean levels 172/108 mmHg to 149/88 mmHg (P less than 0.05). Both before and during prazosin, tilt and frusemide each led to significant elevation of plasma active renin (P less than 0.001) and angiotensin II (P less than 0.05). Inactive renin tended to fall with tilt, and fell significantly following frusemide (P less than 0.05). Active renin (P less than 0.05) and angiotensin II (P less than 0.01) were lower 15 hours after dosing during chronic prazosin therapy than before treatment, but changes after tilt and frusemide were not attenuated during treatment. Chronic prazosin administration does not appear substantially to affect changes in active renin or angiotensin II in response to two standard stimuli, and may be useful in controlling hypertensive patients pending investigation of their renin-angiotensin system. PMID- 3506627 TI - How to perform mental stress tests. AB - To study the phenomenon of cardiovascular hyperreactivity it is essential to know the impact of stimulus intensity and the effects induced by repeated exposure to a stressful situation like a mental arithmetic task. All subjects in this study were young healthy male students. Two different mental stressors were used: a mental arithmetic task with low stimulus intensity and one with high stimulus intensity characterised by more challenging instructions, a more competitive situation, and exposure to affective noise. The lower level mental test did not disclose any differences in the hemodynamic response in the subjects. Only the mental stress test with high stimulus intensity proved capable of detecting the cardiovascular hyperreactivity in normotensive subjects with familial hypertension. As hemodynamic response was attenuated during the second mental stress test if the second test was the lower stimulus test, and since repeated stress testing is necessary when prospective or intervention studies are performed, the stimulus intensity and sequence of mental stress tests had to be controlled carefully. To counteract any cardiovascular adaptation, it is suggested that the stimulus intensity of mental stress tests should slightly increase when repeatedly applied. PMID- 3506625 TI - Hypertension treatment without labelling effects: the North Karelia Project. AB - Increases in disability and work loss have been noted following hypertension identification and treatment. To determine if iatrogenic disability is a necessary side-effect of successful treatment, self-reports of days lost from work and days spent in bed because of illness in the year before interview were compared in 1972 and 1977 for three groups in eastern Finland: hypertensives who had been told of their hypertension before 1972, hypertensives newly identified by screening in 1972, and a group of normal controls. The groups were stratified by sex and residence (urban or rural), and analysis of covariance was used to adjust for the effects of age differences among the groups. In 1972, the hypertensives identified before 1972 were significantly older and had significantly higher systolic blood pressure levels than the hypertensives identified in 1972. Hypertensives identified before 1972 had higher work loss and days spent in bed than hypertensives identified in 1972. This association was independent of age, sex, residence, and systolic blood pressure. Upon resurvey in 1977, the group with hypertension newly identified in 1972 had no greater increase in work loss or days spent in bed due to illness than the normal controls. These data support the hypothesis that hypertension identification and treatment can be but does not have to be associated with significant increases in occupational disability and days spent in bed due to illness. PMID- 3506629 TI - The histopathology of Scomber japonicus infection by Nematobothrium scombri (Trematoda:Didymozoidae) and of larval anisakid nematode infections in the liver of Pagrus pagrus. AB - The histopathology induced by Nematobothrium scombri (Trematoda) in Scomber japonicus and of larval anisakid nematodes in Pagrus pagrus is described. Nematodes larvae occurred within the liver capsule and N. scombri occurred within nodules in the opercula. The fishes were collected off the coast of Rio de Janeiro State. PMID- 3506628 TI - Pressor response to stress and exercise in the young: intracellular ion content relationships and prognostic implications. AB - The relationships between intracellular Na+ (Nai) and K+ (Ki) content, blood pressure and peripheral hemodynamics were investigated in young subjects with a family history of hypertension or with borderline hypertension. A direct correlation was found between Nai and pressor response to stress and exercise; after a short-term low-salt diet a parallel decrease was found in Nai and in pressor response to provocative tests. On the contrary, Ki was inversely related to diastolic blood pressure (DBP) both a rest and during mental and physical stimulation. The mechanism by which alterations in intracellular ion content lead to hemodynamic changes may be mediated by a reduced vasodilatory capacity. In fact, during handgrip testing, the increase in forearm vascular resistance (FVR) was directly related to the Nai/Ki ratio while after the exercise, FVR decrease in subjects with normal Nai/Ki and increases in those subjects with high Nak/Ki. In borderline subjects FVR at rest was inversely related to Nai but acute salt loading causes an increase in FVR proportional to Nai. These observations suggest that in subjects with borderline hypertension FVR at rest is normal perhaps as a response to a high cardiac output; however, a further hemodynamic load (salt loading) causes an increase in FVR directly related to Nai and inversely related to Ki. The study of Nai can also give useful information about the risk of developing sustained hypertension. While no subject with borderline hypertension with normal Nai developed hypertension within five years, 31% of those subjects with high Nai developed hypertension after five years. PMID- 3506630 TI - Ecology of sandflies (Diptera:Psychodidae) in a restricted focus of cutaneous leishmaniasis in northern Venezuela. III. Seasonal fluctuation. AB - A one year-long study (March 1979-March 1980) was carried out at San Esteban, an endemic focus of cutaneous leishmaniasis in Northern Venezuela, with the aim of observing the seasonal fluctuation of the local phlebotomine sandflies species. The influence of climatic factors (temperature, relative humidity and rainfall) on population dynamics was analyzed in three collecting sites--a house, a peridomestic area and a sylvatic region. Among anthropophilic species, L. panamensis behaved as a wetseason species, the mean minimum relative humidity being the critical factor influencing the total number of individuals. When the population density of this fly decreased, it was successfully replaced by L. ovallesi, a dry-season species. On the other hand, seasonal variations of L. gomezi were more strongly affected by the temperature. PMID- 3506632 TI - Comparative ELISA reagents for detection of hepatitis B surface antigen (HBsAg). AB - Conjugates of goat anti-HBs IgG and horseradish peroxidase (HRP) prepared by two different methods, one using NaIO4 and the other SPDP, were compared. Anti-HBs antibodies obtained from goat, rabbit and guinea-pig were tested as capture serum. The ELISA showed a sensitivity similar to RIA and a level of antigen captation ranging from 4.37 to 8.75 nanograms/ml was obtained when rabbit or guinea-pig captures were used combined with both NaIO4 or SPDP conjugates. PMID- 3506631 TI - Ecology of sandflies (Diptera:Psychodidae) in a restricted focus of cutaneous leishmaniasis in northern Venezuela. IV. Sandfly monthly fluctuation and leishmaniasis incidence relationship. AB - An attempt has been made to correlate the monthly incidence of human leishmaniasis with the temporal distribution of sandfly species at San Esteban, Northern Venezuela. Upon statistical analysis, the seasonal fluctuation of L. ovallesi population correlated strongly with the human disease, while the dynamics of L. panamensis, generally believed to be the vector in the Central area of the country, showed only a very weak correlation. These findings support the hypothesis that L. panamensis might not be the main or unique species responsible for the transmission in this area and that L. ovallesi and additionally L. olmeca bicolor might be involved in the epidemiology of the disease. PMID- 3506633 TI - Behavior of Biomphalaria glabrata, the intermediate host snail of Schistosoma mansoni, at different depths in water in laboratory conditions. AB - Using three columns of different depths (1.10m, 8.40m and 10.40m), we investigated the possibility of Biomphalaria glabrata moving towards deep regions. In the 1.10m column, we noted that locomotion can occur in two manners: 1) when the foot is in contact with the substrate: a) sliding descent; b) sliding ascent; c) creeping descent; d) creeping ascent, 2) when the foot is not in contact with the substrate: a) sudden descent without emission of air bules; b) sudden descent with emission of air bules; c) sudden ascent. In the 8.40m column containing food on the bottom (experimental group), the snails remained longer at this depth when compared to those of the group which received no food (control). The sliding behavior was characteristic of locomotion occurring at 0 to 1m both in upward and downward directions. Creeping behavior was typical for the ascent of the snails that reached deeper levels. When the snails were creeping, the shell remained hanging as if it were heavier, a fact that may have been due to water entering the pulmonary chamber. In the 10.40m column, the snails slid downward to a depth of 4m or descended suddenly all the way to the bottom. Ascent occurred by creeping from the bottom to the surface. In the 8.40m and 10.40m columns, copulation, feeding and oviposition occurred at the deepest levels. PMID- 3506635 TI - Aging in Malaysia. PMID- 3506634 TI - Dermal leishmaniasis in the Amazon region of Brazil: Leishmania (Viannaia) lainsoni sp.n., a new parasite from the State of Para. PMID- 3506636 TI - The health of the aging Malaysian: policy implications. PMID- 3506637 TI - Smoking profile and coronary risk among patients admitted to the Coronary Care Unit, General Hospital, Kuala Lumpur. PMID- 3506638 TI - Lung cancer among young Malaysians. PMID- 3506639 TI - Traumatic dislocation of the knee. PMID- 3506640 TI - Chronic subdural hematoma: a review at General Hospital, Kuala Lumpur. PMID- 3506641 TI - The surgical repair of ruptured sinus of valsalva aneurysms. PMID- 3506643 TI - Endourology new vistas in the management of urinary tract disease. PMID- 3506642 TI - Intracranial arteriovenous malformations in Malaysian population. PMID- 3506644 TI - Polymyalgia rheumatica: are we missing them? PMID- 3506645 TI - Nine fatal cases of puffer fish poisoning in Sabah, Malaysia. PMID- 3506646 TI - Giant cerebral mycotic aneurysm: a case report. PMID- 3506647 TI - Late presentation of actinomycosis after third molar surgery. PMID- 3506648 TI - Malignant melanomas of the vulva: two case reports. PMID- 3506649 TI - Transient complete heart block during acute rheumatic fever: a case report. PMID- 3506650 TI - The media and medicine. PMID- 3506651 TI - Daily 2-minute meeting keeps doctor in charge. PMID- 3506652 TI - Conservative management of ectopic gestations. A surgical alternative. PMID- 3506653 TI - Regression of renal tumor with seven-year survival following renal artery embolization. PMID- 3506654 TI - Selecting a computer. PMID- 3506655 TI - Controversy. HMOs in Missouri. PMID- 3506656 TI - Eagle-Barrett syndrome. Results of six cases and review. PMID- 3506658 TI - Improving your practice development. PMID- 3506657 TI - Extracardiac malignancies producing tamponade. PMID- 3506659 TI - William D. Bradshaw, M.D. PRO medicine. Interview by Susan Flanigan Gold. PMID- 3506660 TI - The changing face of leukocytosis. PMID- 3506661 TI - Leprosy in Missouri. PMID- 3506662 TI - Thermography of the curved living skin surface. PMID- 3506663 TI - William D. Bradshaw, M.D.:PRO medicine. Interview by Susan Flanigan Gold. PMID- 3506664 TI - Do's and don'ts of writing a personnel manual. PMID- 3506665 TI - Where the fault lies. PMID- 3506666 TI - Human immunodeficiency virus (HIV) antibody seropositivity in the greater Kansas City area. PMID- 3506668 TI - Missouri's changing health care system. PMID- 3506667 TI - Medical progress and the U.S. Constitution: two centuries. PMID- 3506669 TI - "Physician, heal thyself!". PMID- 3506670 TI - Alzheimer's disease. PMID- 3506672 TI - Computers. PMID- 3506671 TI - First Aids. PMID- 3506673 TI - The radiology of the calcaneus. PMID- 3506674 TI - A case-control study of lung cancer in St. Francois County, 1976-1984. PMID- 3506675 TI - [Histopathological study of pulpal irritation of dental adhesive resin. Part 1. Panavia EX]. PMID- 3506676 TI - [Electromyographic feature of complete denture wearers. Part 1. Comparison between complete denture wearers and the subjects with complete dentitions]. PMID- 3506677 TI - [Studies on tooth carving methods]. PMID- 3506678 TI - [A dynamical study on mastication. VII. Checkup examination of masticatory efficiency by using a Japanese fish cake so-called "Kamaboko" (1st report)]. PMID- 3506679 TI - [In vitro study on biocompatibility of implant materials using MC3T3-E1 osteogenic cell line]. PMID- 3506680 TI - [Analysis of the jaw opening pathway]. PMID- 3506681 TI - [A report of hypersensitive teeth induced by abnormal occlusal contacts]. PMID- 3506682 TI - [Unexpected fractures of wrought wire clasp arising from application of adhesive denture resin]. PMID- 3506683 TI - [Studies on the marginal leakage of various setting materials of a metal crown, including newly developed adhesive resins]. PMID- 3506684 TI - [The evaluation of prognosis in complete denture wearers using masticatory electromyogram. Part 1. Comparison between the group immediately after the insertion and the group with good prognosis in complete denture wearers]. PMID- 3506686 TI - [Chromatic study on tooth using spectroradiometry. In the anterior areas of the upper and lower jaws]. PMID- 3506687 TI - [Chromatic study on gingiva using spectroradiometry. Concerning the anterior teeth of young people]. PMID- 3506685 TI - [The healing process following mucosalplasty of the edentulous ridges to improve pontic adaptation]. PMID- 3506688 TI - [Mechanism of speech. Part 2. Complete denture wearers]. PMID- 3506689 TI - [Pain in the sternocleidomastoid muscle and defects of anterior guidance]. PMID- 3506690 TI - [Histopathological study of pulpal irritation of dental adhesive resin. Part 2. Super Bond C & B]. PMID- 3506691 TI - [The evaluation of prognosis in complete denture wearers using masticatory electromyogram. Part 2. Investigation of the validity of the constancy in EMG parameters]. PMID- 3506692 TI - [Physical and bacteriological examinations of self-administered relining materials]. PMID- 3506693 TI - [Kinesiological and electromyographical studies on masticatory movement. I-2. Concerning the quantitative analysis of the ranges of frontal masticatory movements in a person with normal dentate jaws]. PMID- 3506694 TI - [Fundamental studies on superelastic Ni-Ti alloy for wire clasp]. PMID- 3506695 TI - [Influence of the elements of mandibular movement on tooth pain. Part 4. Curvature of sagittal condylar path of balancing side]. PMID- 3506696 TI - [An experimental study of sliding abrasion on the marginal parts of cast restored teeth]. PMID- 3506697 TI - [Clinical studies on chewing movement effects of foods]. PMID- 3506698 TI - [Influence of occlusal overload on tooth sensation and periodontal tissue]. PMID- 3506699 TI - [Functional property of the masseter muscle in man]. PMID- 3506700 TI - [A study on mandibular movement in six degree-of-freedom with a newly developed jaw movement analyzer]. PMID- 3506701 TI - [Articulatory movements of the tongue and the mandible on pronouncing /S/ sound]. PMID- 3506702 TI - [Conservative therapy of anterior disk displacement without reduction (closed lock) by "disk recapturing bite plane"]. PMID- 3506703 TI - [The EMG activities of the sternocleidomastoid muscle during occlusal function]. PMID- 3506704 TI - [The effect of thermal therapies on the masseter muscle for temporomandibular joint disorders]. PMID- 3506705 TI - [Zinc phosphate cement. Effect of the improved slab and mixing conditions on physical properties]. PMID- 3506706 TI - [Research of condylar movements on protrusive and lateral jaw positions (2nd report)]. PMID- 3506707 TI - [A three-dimensional study of the retrusive movement of the mandible]. PMID- 3506708 TI - [Stress analysis on tetrasilicic fluormyca crystal by finite element method]. PMID- 3506709 TI - [A case report of open-bite after surgical correction of mandibular prognathism]. PMID- 3506710 TI - [Estimating vibration transmission characteristics in tooth roots: a study]. PMID- 3506711 TI - [Reexamination of precision during articulator handling. Part 1: Vertical displacement]. PMID- 3506712 TI - [Reproducibility between days of the silent period of the masticatory muscles]. PMID- 3506713 TI - [A clinical study of the reproducibility of different occlusal registrations]. PMID- 3506714 TI - [The burn-in and devitrification of calcium phosphate crystalline ceramic crowns]. PMID- 3506715 TI - [Viscoelastic behavior of alginate impression materials. Part 1. Linear viscoelasticity]. PMID- 3506716 TI - [Osseointegrated implant]. PMID- 3506718 TI - [A study of test food list in evaluating masticatory function for complete denture wearers]. PMID- 3506717 TI - [Visible light-curing for a denture base. Part 7. The physical properties and fitness on the trial relining material]. PMID- 3506720 TI - [Experimental studies on the longitudinal deformation of upper and lower complete dentures. Influences of occlusions and lateral gliding excursions]. PMID- 3506719 TI - [Clinical application of the titanium blade-vent implant coated with HAP . alumina]. PMID- 3506721 TI - [Restoration of oral function accompanying prosthetic treatment of a patient with cleft lip and palate]. PMID- 3506722 TI - [A new measuring system for the determination of gingival color and its fundamental research]. PMID- 3506723 TI - [Multidimensional analysis of dental arch patterns in tooth arrangements from educational view of full denture practice]. PMID- 3506724 TI - [Evaluation of masticatory efficiency using TV-measuring analyzer]. PMID- 3506725 TI - [Method for evaluating the masticatory function. Masseter muscle cross-sectional image by X-ray CT scan]. PMID- 3506726 TI - [Apatite 2-piece implant. Part 1. Histological study of root part implantation]. PMID- 3506727 TI - [Determination of vertical dimension by phonetics in a case of maxillofacial deformity]. PMID- 3506728 TI - [Visualization of occlusal contacts on a TV monitor]. PMID- 3506729 TI - External fixation of open comminuted fractures of the proximal phalanx. AB - External fixation is an accepted method of treatment for many injuries, however, only a limited number of reports concern its use in open, comminuted fractures of the hand. Ten patients with eleven fractures of the proximal phalanx were treated using the AO/ASIF small external fixator. Five fractures involved the interphalangeal joint (IPJ), two the metacarpophalangeal joint (MPJ), and four the shaft. Nine fractures were caused by small caliber gunshot wounds, one was due to a power saw injury, and one occurred during a three wheeler accident. The patients with interphalangeal joint involvement all had extensive involvement of one or both of the joint surfaces. The fixator was placed across the joint and a stable ankylosis allowed to occur with the IPJ in 30 degrees to 40 degrees of flexion. MPJ motion averaged 75 degrees in these patients while distal interphalangeal joint (DIPJ) motion averaged 20 degrees. The four patients with shaft fractures all healed, but three required bone grafting. These patients averaged 85 degrees of MPJ motion, 25 degrees of proximal interphalangeal joint (PIPJ) motion, and 30 degrees of DIPJ motion. One patient with metacarpophalangeal joint involvement regained 85 degrees of MPJ motion but had limited motion at the PIPJ and DIPJ. The other patient with MPJ involvement suffered massive bone loss; a ray amputation was eventually performed. Complications included pin tract drainage in three of the eleven fractures and slight loss of reduction in two fractures. The best clinical results occurred when the fixator was used as a digit salvage procedure in interphalangeal joint fractures.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3506730 TI - Roentgen rounds #93. Third degree acromioclavicular dislocation with a fracture of the left coracoid process base. PMID- 3506731 TI - Pain clinic #8. Patient-controlled analgesia for postoperative pain in orthopaedic patients. AB - Patient-controlled analgesia for pain management following orthopaedic surgery was evaluated subjectively by 22 patients and 11 nurses. Half of the patients received morphine and half received meperidine. No difference was found in the amount of drug used between groups. Although pain was never completely relieved, 91% of patients experienced only mild pain or were mildly comfortable with the technique. All patients reported a high satisfaction with patient-controlled analgesia and all nurses ranked the technique as good to excellent. Eight-six percent of patients who had previously used another type of pain management ranked patient-controlled analgesia superior. PMID- 3506732 TI - Ninth congress of the Polish Pharmacological Society. Lublin (Poland), September 4-5, 1986. Proceedings. PMID- 3506733 TI - Anticonvulsant role of adenosine. AB - The effects of 2-chloroadenosine (2-CLA), a metabolically stable analog of adenosine, and aminophylline, an adenosine receptor antagonist, on seizures produced by pilocarpine (PILO) were examined in rats. The effects of 2-CLA on amygdaloid and hippocampal kindled seimres were also examined. In the animals pretreated with aminophylline (25-100 mg/kg), a non-convulsant dose of PILO (100 mg/kg) resulted in severe motor limbic seizures which rapidly evolved to status epilepticus. 2-CLA (5-10 mg/kg) blocked the appearance of behavioral and EEG seizures produced by a convulsant dose of PILO (380 mg/kg) and completely blocked the evolution of hippocampal and amygdaloid kindled seizures. The results indicate that purinergic mechanisms are involved in the modulation of seizure threshold within the limbic system. PMID- 3506735 TI - [Studies on the hardness discrimination mechanism of foods. Especially on the significance of periodontal pressoreceptive information and of the amount of biting into foods]. PMID- 3506734 TI - Defibrotide protects rabbit myocardium from ischemia: relationship with the eicosanoid system. AB - In the isolated rabbit heart preparation we studied the action of defibrotide--a natural polydesoxyribonucleotide from mammalian lungs--on the ischemic myocardial injury and on concentration of prostaglandin-like material in the perfusate. Defibrotide counteracted the ischemic myocardial contracture and significantly improved the recovery of cardiac contractibility and normalization of the rhythm in the postischemic period. This effect seems to be correlated with the concentration of the prostaglandin-like material in the cardiac perfusate. A simultaneous infusion of indomethacin inhibited both the protective effect of defibrotide and the prostaglandin-like material release from the cardiac muscle. PMID- 3506736 TI - [Observations, by means of Moire topography and 16mm cinematography, of facial activities during pronunciation of Japanese vowels]. PMID- 3506737 TI - [The most effective toothbrushing force for permanent dentition with Bass method]. PMID- 3506738 TI - [Experimental studies on the appearance of silent period in discharge of masticatory muscles during crushing foods]. PMID- 3506739 TI - [Clinical survey of the effect of traumatic injuries to deciduous teeth on their permanent successors]. PMID- 3506740 TI - [Morphological studies on the tissues around the nose part]. PMID- 3506741 TI - [The natural head position in orthodontics]. PMID- 3506742 TI - [Quantitative and morphological studies on the bones by mathematical morphology- theory and practice of mathematical morphology]. PMID- 3506743 TI - [Quantitative and morphological studies on the trabecular bones in the processus condylaris of the Japanese mandible --comparison between dentulous and edentulous specimens and differences in ages]. PMID- 3506744 TI - [Video-fluoroarthrographic study on abnormal disc movements in patients with internal derangements of the temporomandibular joint]. PMID- 3506745 TI - [Statistical analysis of written documents of expert opinion provided by the Department of Forensic Odontology of Tokyo Dental College from 1964 to 1987]. PMID- 3506746 TI - [Assessment of the cariogenicity of caramel sweetened with Palatinose and Palatinose syrup]. PMID- 3506747 TI - [Studies on the suture of the posterior body of the maxilla and surrounding bones]. PMID- 3506748 TI - [Clinico-pathological studies on the indirect and direct pulp protective effects with calcium hydroxide preparations]. PMID- 3506749 TI - [The method of root canal filling based on the root canal preparation theory using an improved Gutta percha point]. PMID- 3506750 TI - [The capillary structure underlying the attached epithelium of golden hamster (Cricetus auratus). I. Comparative study of the golden hamster, the rat and the mouse]. PMID- 3506751 TI - [The capillary structure underlying the attached epithelium of golden hamster (Cricetus auratus). II. Relation between the gingivitis and the capillary structure]. PMID- 3506752 TI - [Tooth abrasion caused by use of toothbrushing machine for a period of 60 years]. PMID- 3506753 TI - [Observation on the structure of the pulp-chamber floor]. PMID- 3506754 TI - [Relationships among the tooth crown, the root structure and the pulp cavity in human molars]. PMID- 3506755 TI - [A case of allergic stomatitis due to Carbamazepine (Tegretol)]. PMID- 3506756 TI - [Ultrastructural changes caused in dentin by fluoride iontophoresis]. PMID- 3506757 TI - [Changes occurring over the years in the interdental spaces of the lateral segments]. PMID- 3506758 TI - [The chronological changes of the position of permanent teeth in the process of eruption]. PMID- 3506759 TI - [A case of acute maxillary osteomyelitis in the newborn infant with hard palate swelling]. PMID- 3506760 TI - [Clinico-pathological studies of calcium phosphate ceramics as a basic material in endodontic therapy]. PMID- 3506761 TI - [Histo-pathological studies on the influence of root canal sealers on dogs' teeth with periapical lesions]. PMID- 3506762 TI - [Irritation caused by polyvinylpyrrolidone-iodine paste (PVP-I paste) for intraoral application]. PMID- 3506763 TI - [A histological study of beta-tricalcium phosphate implantation in experimental bone defects of rats]. PMID- 3506764 TI - [Healing process after reimplantation of frozen mandibular bone in dogs]. PMID- 3506765 TI - [Multivariate statistical analysis used in the evaluation of clinical image quality of intraoral radiographs]. PMID- 3506766 TI - [The internal structure of Japanese maxillary bone. Concerning adult dentulous ridge and edentulous ridge]. PMID- 3506767 TI - [Mandibular movement by electromyography in unilateral cleft lip and palate patients]. PMID- 3506768 TI - [Computed tomographic diagnosis in the oral and maxillofacial regions. Part 1: Diagnosis of mass lesions in the neck and the submandibular space]. PMID- 3506769 TI - [An aged case of oral inveterated infection restored with albumin transfusion]. PMID- 3506770 TI - [Healing process with hydroxyapatite (HAP) particles and tricalcium phosphate (TCP) particles implantation in rabbit mandible. Comparison of Ca/P ratios]. PMID- 3506771 TI - [A study on corrosion of dental titanium alloys]. PMID- 3506772 TI - [Clinical experiences and physiological response to induced hypotensive anesthesia during oral and maxillofacial surgery. Especially on ATP]. PMID- 3506773 TI - [The mechanism of fibrillary twitch of the skeletal muscle observed in acute fluoride intoxication]. PMID- 3506774 TI - [Facial-form cognition by mandibular-prognathism patients, before orthognathic surgery]. PMID- 3506775 TI - [Histo-pathological studies on the porous alumina ceramic implants used as artificial teeth]. PMID- 3506776 TI - [Experimental study of pulpotomy with calcium hydroxide-iodoform paste in permanent teeth with incompletely formed apices]. PMID- 3506777 TI - [Diagnostic aspects of bilateral chronic subdural hematoma]. PMID- 3506778 TI - [Electrophoresis in forensic medicine professional practice]. PMID- 3506779 TI - [Non-Hodgkin's lymphoma in children: results of treatment on the LSA2L2 protocol]. PMID- 3506780 TI - [Sensitivity, resistance and tolerance of Streptococci to beta-lactam antibiotics]. PMID- 3506782 TI - [Caroli's disease]. PMID- 3506781 TI - [Forensic medicine analysis of fatal cases of narcotic addiction in Belgrade 1980 1984]. PMID- 3506783 TI - [Tuberculosis of the nasopharynx]. PMID- 3506784 TI - [Uremic toxicity]. PMID- 3506785 TI - [Problems with expertise in traffic accidents involving two-wheeled vehicles]. PMID- 3506786 TI - [Modern problems in toxicology research]. PMID- 3506787 TI - [Thyroid status and metabolic activity in the lungs]. PMID- 3506788 TI - [Immunoelectrophoresis in the study of blood stains of menstrual origin]. PMID- 3506789 TI - [Antibodies against the LAV/HTLV-III retroviruses etiologically associated with AIDS in the Yugoslav population at increased risk]. PMID- 3506790 TI - [Aphasic variant of Gerstmann's syndrome]. PMID- 3506791 TI - [Characteristics of injuries in tractor drivers in agriculture]. PMID- 3506792 TI - [Clinico-forensic significance of injuries in drivers and co-drivers of automobiles]. PMID- 3506793 TI - [Possibilities of deviations in electrodiagnostic findings in lesions of the central motor neuron]. PMID- 3506795 TI - [Toxicology today]. PMID- 3506794 TI - [Unknown cause of death viewed as a quarantinable disease]. PMID- 3506796 TI - [Occupational hearing loss]. PMID- 3506797 TI - [Development of the hyoid apparatus of Wistar rats]. PMID- 3506798 TI - [Cariogenicity of S. intermedius ATCC 27335 and S. sobrinus 1089 in germ-free rats]. PMID- 3506799 TI - [Morphological study of occlusal fissures in upper primary molars. Enamel thickness, depth, and angle]. PMID- 3506800 TI - [Relationship of crown size and enamel thickness on the primary teeth. 1. Lower primary teeth]. PMID- 3506801 TI - [Ecological study on chondroitinase-producing bacteria in human oral cavities]. PMID- 3506802 TI - [A case of a forced tooth left in the peritonsillar region]. PMID- 3506803 TI - [Two cases of herpes zoster in trigeminal nerve region]. PMID- 3506804 TI - [Lymphoepithelial cyst within the parotid gland: report of a case]. PMID- 3506805 TI - [Six cases of foreign body in oral and maxillo facial region]. PMID- 3506806 TI - [The problem of technical practices in dental education]. PMID- 3506807 TI - Implantable glucose sensors: choosing the appropriate sensing strategy. AB - The special requirements for implantable glucose sensors which differ from laboratory analysers and in vitro probes include continuous operation without drift, compatibility with in vivo body conditions, electrical and toxicological safety and patient acceptability. We have studied the effect of oxygen tension, operating temperature and pH, and the stability of various potentially implantable amperometric glucose sensors so as to aid the choice of the technologies most suitable for in vivo application. PMID- 3506808 TI - Sensory control of a multifunction hand prosthesis. AB - The current generation of prostheses that are fitted to limb deficient individuals have only a single degree of freedom which limits their functional range. Furthermore, electrically powered prostheses have a limited user input. Electrical signals generated by the contraction of muscles in the user's stump open and close the hand in an 'on and off' fashion. Since the only feedback is visual, the prostheses tend to be used less dexterously than body powered devices. A different approach has been adopted by the Control Engineering Group at Southampton University. They have retained a single electromyographic input channel, but added sensory feedback to an electronic controller, which decides on the grip posture and tension. Satisfactory operation of the hand depends on the sensors employed. A review of transducers used on previous prostheses at Southampton is followed by a description of recent sensor developments. Finally the intentions for a new generation of prostheses are outlined. These include combining sensory input with an integrated circuit microcontroller to provide a more reliable system. PMID- 3506809 TI - An instrument for measurement of thermal thresholds in man. AB - Routine clinical electrophysiological techniques assess function in the large diameter, motor and sensory nerve fibres, but not in the smaller diameter fibres subserving pain, thermal sensation and autonomic function. The instrument we describe measures thermal sensation thresholds to both cooling and warming thus providing an index of function in the small diameter thinly myelinated A delta fibres and unmyelinated C fibers respectively. A commercial version, the Thermal Threshold Tester (TRIPLET) provides a portable instrument for routine clinical use. It has a particularly important role in the sequential and quantitative monitoring of small nerve fibre function as for example in diabetic neuropathy. It can also be applied to the study of small nerve fibre function in persons exposed to potentially neurotoxic substances either as medication or in industry. PMID- 3506810 TI - [Diagnosis of symptomatic plaque in the carotid arteries of patients with neurologic ischemia symptoms]. AB - We compared the neurological symptoms and the results of Duplex-scan (ATL Marc 600 and Ultramarc 4 Duplex Scanner, Advanced Technology Laboratories, Inc., Bothell, WA) examinations of the carotid arteries in 123 patients with transitory or persistent neurological deficit without hemodynamically relevant stenosis or other source of embolism. 87.8% of patients showed atherosclerotic changes of the carotids, 37.3% signs of ulceration. In patients with ulcers cerebral ischemic events were more frequent than ocular ischemic events. Homogenous plaque formation without signs of ulceration was more correlated with retinal symptoms. Hemodynamically nonsignificant plaque formation in the carotid arteries may be an important cause of cerebral ischemic events. Heterogenous plaques cause bigger embolies than homogenous plaques. PMID- 3506811 TI - [Abnormalities of the brain in childhood in nuclear magnetic tomography]. AB - 25 of about 300 infants and children, who had been examined by magnetic resonance imaging since 1984, had a congenital malformation of the brain. Cystic malformations (e.g. arachnoid cysts) were the most frequent lesion. Other findings were: Arnold-Chiari malformation, septo-optic dysplasia, Dandy-Walker syndrome, agenesis of the corpus callosum, migration disorders. The multiplanar slice orientation and the good tissue contrast in magnetic resonance imaging supplied a clear diagnosis in all cases. Compared with other imaging modalities (CT, ultrasonography) the depiction of the morphology was superior in MR imaging in most cases. PMID- 3506812 TI - Fluorescence high performance liquid chromatographic determination of 3 alpha hydroxysteroids in urine of 21-hydroxylase deficiency. AB - A fluorescence high performance liquid chromatographic method using an immobilized 3 alpha-hydroxysteroid dehydrogenase column as a post-column enzymatic reactor was developed for the determination of corticosteroid metabolites in the urine of subjects with congenital adrenal hyperplasia. 3 alpha Hydroxysteroids, such as pregnanetriol, pregnanediol and pregnanetriolone, in the eluate from mu-Bondapak phenyl column (300 x 3.9 mm I.D.) using 0.05% ammonium phosphate buffer (pH 7.1)-acetonitrile-methanol (100:55:15) as the mobile phase was mixed with NAD+ solution in the enzyme column at 30 degrees C to generate NADH, which was monitored by a fluorophotometric detector. Each steroid was measured at the 2.5 micrograms/dl at the highest sensitivity of the detector. The mean recoveries and reproducibilities were 91.5-108.2% with 0.9-6.5% (CV%). PMID- 3506813 TI - Amino acid composition analysis of minute amounts of cysteine-containing proteins using 4-(aminosulfonyl)-7-fluoro-2,1,3-benzoxadiazole and 4-fluoro-7-nitro-2,1,3 benzoxadiazole in combination with HPLC. AB - The simultaneous determination of amino acid composition including cysteine of egg albumin, a model protein containing a/s cysteine residue, is reported. All the thiol groups of the cysteine residue(s) of egg albumin were labelled with 4 (aminosulfonyl)-7-fluoro-2,1,3-benzoxadiazole, a fluorogenic reagent for thiol groups. The labeled egg albumin was hydrolyzed in 6N HCl at 110 degrees C for 24 h. The hydrolysate was lyophilized, derivatized with 4-fluoro-7-nitro-2,1,3 benzoxadiazole, a fluorogenic reagent for amines, and subjected to HPLC. 18 derivatized amino acids including double labelled cysteine were separated within 90 min on a Nucleosil ODS column (150 mm X 4.6 mm i.d.; 5 microns), and detected at 530 nm (ex. 470 nm) in a range from 90 fmol (aspartic acid) to 1.3 pmol (cysteine) (S/N = 3). Composition ratios of amino acids of egg albumin were similar to theoretical values except for methionine, which would be destroyed under the present acid hydrolysis condition. Analytical methods for cysteine residues are reviewed, and the availability of fluorogenic reagents having the benzofurazan structure is also discussed. PMID- 3506814 TI - Measurement of urinary cystine and cysteinyl-penicillamine in patients with cystinuria. AB - A high-performance liquid chromatographic method with electrochemical detection (LC/EC) was developed to measure cystine and cysteinyl-penicillamine disulfide in the urine of patients screened or treated for cystinuria. Urine was acidified, centrifuged to remove urinary protein, diluted and injected. The disulfides were separated on a reversed-phase column, reduced at the upstream electrode of a dual electrochemical detector with gold-mercury amalgam (Au/Hg) electrodes and the resultant thiols measured at the downstream electrode. The sample preparation is simple, the analysis rapid, specimens can be easily batched and the specificity of the method is better than those of two other separative procedures with which it was compared. The coefficient of variation for cystine in cystinuric urine is 6.7%, 5.5% and 3.2% for levels of 0.09, 0.52 and 1.02 mmol/l respectively, and for cysteinyl-penicillamine disulfide 2.6% and 7.5% for levels of 0.45 and 0.98 mmol/l respectively. Urine for analysis of these disulfides should not be collected within 24 hours of administration of the radiopaque agent diatrizoate but no other interference to the assay has been noted. This method is suitable as a screen for cystinuria in patients with renal tract calculi, for ongoing monitoring of cystinuric patients and to check patient compliance with d penicillamine therapy. PMID- 3506815 TI - Column separation using Bio-Gel P100 for the characterization of the products of human lung elastin degradation by leucocyte elastase and cathepsin G. AB - The solubilization of human lung elastin by leucocyte elastase and cathepsin G is described. Elastolysis kinetic studies clearly show that leucocyte elastase is more efficient in solubilizing elastin fibres than is cathepsin G. Cathepsin G can degrade elastin but at a much slower rate. Characterization of elastase and cathepsin G soluble elastin fragments, obtained after 24 h of digestion (enzyme substrate ratio, 1:100), was first performed by isoelectric focusing. Whole digests were focused as 6 bands in a pH range 4.2 to 4.7 and were found to have no significant differences in amino acid compositions. Biogel P-100 gel filtration of the elastase digested fragments separated a major excluded fraction (Mr's: 80,000 to 30,000) and a small retained one (Mr's: 6000 to 4000). Conversely, cathepsin G digests were eluted as a minor excluded fraction and a more important retarded one (Mr's: 6000 to 4000). Only the high molecular weight fractions of both enzymes digests contain crosslinked amino acids; this assigns a role for desmosines in the resistance of elastin to these proteases. These results are discussed in comparison with the data obtained by others. PMID- 3506816 TI - Thin layer chromatography overlay technique in the analysis of the binding of the solubilized protoxin of Bacillus thuringiensis var. kurstaki to an insect glycosphingolipid of known structure. AB - The hypothesis tested was that a particular glycoconjugate(s) in the exposed cell surface membrane of susceptible insect cells acts as a receptor and/or modulator for the specific interaction with the protoxin/activated toxin of the delta endotoxin of Bacillus thuringiensis var. kurstaki. As candidates, the total neutral and acidic fraction glycolipids, and the isolated neutral glycosphingolipid components, were screened for binding activity by the thin layer chromatogram overlay technique. The main protoxin/activated toxin-binding glycolipid in the neutral fraction (5B) had the structure: Gal(alpha 1 3)GalNAc(beta 1-4)GlcNAc(beta 1-3)Man(beta 1-4)Glc(beta 1-1)Cer. The main protoxin/activated toxin-binding glycolipid in the acidic fraction was designated band 1, the structure of which is at present unknown. The possibility that the component 5B carbohydrate sequence may also function as a toxin-binding site of relevant insect plasma membrane glycoproteins is discussed. PMID- 3506817 TI - Early identification of isovaleric aciduria using photodiode array detection for liquid chromatographic profiling of urinary carboxylic acids. AB - The 190 nm high performance liquid chromatographic photodiode array profiling of the urinary carboxylic acids of the first urine of a newborn affected with isovaleric aciduria afforded an abnormal peak at 27.8 min. This peak was greatly increased in the carboxylic acid profiling of the 14 h urine sample from the same infant. Isolation of this peak by fraction collecting; solvent extraction of the eluent; trimethylsilyl derivatization of the residue and gas chromatographic/mass spectrometric analysis identified the compound as isovalerylglycine. Correlation of the 190 nm absorbance of isovalerylglycine (y) with concentration (x) afforded a least squares curve: y = 476.4x-13.72 (r = 0.99); run-to-run variation 6.92%; day-to-day variation 8.88% with a minimum detectable concentration of 25 micrograms/ml. PMID- 3506818 TI - Determination of serum catecholamine metabolites in neuroblastoma by high performance liquid chromatography with electrochemical detection. AB - A method for determining serum catecholamine metabolites such as vanillylmandelic acid (VMA), 3-methoxy-4-hydroxyphenyl glycol (MHPG) and homovanillic acid (HVA) in neuroblastoma by using high performance liquid chromatography and electrochemical detector is described. The separation of catecholamine metabolites was performed on a reverse phase column with an eluting system containing citric acid-potassium hydrogen phosphate buffer and methanol as the organic modifier. The experimental results showed that VMA and HVA levels in the serum of neuroblastoma patients were 15-30 times higher than that of the normal control group. The same phenomenon also occurred in patients with stage II neuroblastoma. Serum VMA, MHPG and HVA levels reduced to normal in patients suffering from neuroblastoma after surgery. Serum catecholamine metabolites analysed by using HPLC/ECD is more simple, sensitive and reliable than that by usual urine assay and might be used for the diagnosis of neuroblastoma even in early stage. PMID- 3506819 TI - A simple quantitative HPLC assay for ifosfamide in biological fluids. AB - A high performance liquid chromatography method is described for measuring Ifosfamide (I) in human serum. This involves solvent extraction, reverse phase HPLC and UV detection at 190 nm. Standard curves of peak height x detector sensitivity versus I concentration in serum were linear with a lower limit of detection of 100 ng/ml. Authentic 14C-labelled I cochromatographed with standard I and with I found in serum from treated patients. The concentration-time curves of I determined by both HPLC and gas chromatography were indistinguishable. We conclude that this method is suitable for determining I pharmacokinetics in biological specimens. PMID- 3506820 TI - Use of biological fluids for the rapid diagnosis of potentially lethal inherited disorders of human purine and pyrimidine metabolism. AB - Inherited purine and pyrimidine disorders may be associated with serious, sometimes life-threatening consequences. Early and accurate diagnosis is essential. Difficulties encountered when using existing high pressure liquid chromatographic (HPLC) methods led to the development of an improved method based on prior fractionation of urine. The advantages are as follows. 1. Production of fingerprints demonstrating altered urinary excretion patterns characteristic of any one of ten different disorders, in 30 minutes. 2. Positive identification and quantification by comparison with established methods (using conventional chromatography, electrophoresis and UV spectrophotometry) in addition to specific retention times and characteristic UV absorbance ratios at two separate wavelengths (245 and 280 nm) by HPLC. 3. Direct analysis of all the purines and pyrimidines normally found in human body fluids as well as identification of abnormal compounds. 4. Short time between successive analyses while maintaining excellent resolution between compounds of interest and column longevity. 5. Improved separation of the different adenine-based compounds encountered in some disorders, plus demonstration of potential interference by dietary or drug metabolites. 6. Applicability to the monitoring of therapy involving a variety of different purine and pyrimidine analogues. Particular attention should be paid to sample preparation. Plasma profiles will confirm the diagnosis in some, but not all, of these disorders. PMID- 3506821 TI - Isolation and sequencing of a new biologically active peptide from human lung carcinoma. AB - A biologically active peptide designated hLCP has been isolated and purified to homogeneity from human lung carcinoma by means of acidic extraction and successive chromatography on Sephadex G-50, Toyopearl HW-40 F and reverse-phase high performance liquid chromatography columns. Analysis showed that peptide consists of thirteen amino acids. Primary structure of hLCP has been deduced by double-coupling Edman degradation combined with enzyme digestion as H-Ser-Pro-Pro Asp-Gly-Lys-Lys-Glx-Ser-Ala-Asp-Val-Lys-OH. hLCP possessed significant excitatory activity on an electrical stimulation induced contraction. No hLCP could be detected in normal lung tissue. The possibility of using hLCP as a biochemical marker in the clinic for the early detection of lung carcinoma is being investigated. PMID- 3506822 TI - Metabolic studies of explosives. 5. Detection and analysis of 2,4,6 trinitrotoluene and its metabolites in urine of munition workers by micro liquid chromatography/mass spectrometry. AB - Metabolites of 2,4,6-trinitrotoluene (TNT) were found in the urine of a group of TNT munition workers. The urine extracts were analysed by micro liquid chromatography/mass spectrometry. The metabolites found included 2-amino-4,6 dinitrotoluene, 4-amino-2,6-dinitrotoluene, 2,4-diamino-6-nitrotoluene, 2,6 diamino-4-nitrotoluene and untransformed TNT. The detection limit of the metabolites in urine was 0.1 ng/ml for 20 ml urine samples. PMID- 3506823 TI - Metabolic profiling of opioid peptides in canine pituitary and selected brain regions using HPLC with a radioreceptor assay detector. AB - A combination of gradient reversed-phase high performance liquid chromatography (RP/HPLC) with a radioreceptor assay detector that uses two ligands is used to obtain effectively the metabolic profile of endogenous receptoractive opioid peptides in the canine pituitary and in seven selected brain regions including the hypothalamus, caudate nucleus, mid-brain, amygdala, thalamus, pons-medulla, and the hippocampus. Gradient RP/HPLC separates a mixture of endogenous peptides over a wide range of hydrophobicities. A novel opioid preparation from canine limbic system synaptosomes is utilized in a radioreceptorassay screen; tritiated etorphine (ET) or D-2ala, D-5leuleucine enkephalin (DADL) is used as the competitively displaced ligand. This receptor-rich preparation contains several receptor types, and thus serves well as a screen with the required low level of specificity. Subsequent analysis with other detectors of high specificity (MS, RIA) will follow this screen in other studies. Etorphine interacts with several of the opioid peptide-preferring receptors, whereas DADL is more specific towards the delta receptor that preferentially binds the smaller pentapeptides of the enkephalin family. The highest amount of peptide receptor activity found in this study is in the pituitary tissue, a smaller amount in the hypothalamus and caudate nucleus, and still lower amounts in the other five brain tissue extracts. This variation in peptide concentration most probably reflects three separate factors that operate in this biologic system: differential tissue-specific processing patterns of the large peptide precursors; distribution of the three opioid peptide systems; and the receptor preparation and the radioligand used in the assay. The structures of the receptoractive compounds in each RP/HPLC peak await mass spectrometric confirmation. PMID- 3506824 TI - Measurement of penbutolol and 4-hydroxypenbutolol in plasma or serum by HPLC. AB - A simple HPLC method for penbutolol and 4-hydroxypenbutolol assay has been developed. Plasma or serum (200 microliters) is vortex-mixed (30 s) with Tris solution (2 M, pH 10.6) containing an internal standard (50 microliters) and methyl t-butyl ether (200 microliters). After centrifugation, the extract (100 microliters) is analysed using an unmodified silica column (250 x 5 mm ID) and iso-octane-methanol-methyl t-butyl ether (55:25:20) containing ammonium perchlorate (10 mM, pH 5.7) as eluent and with fluorescence detection. No interference has been encountered and the limit of accurate measurement for both compounds is 5 micrograms/l. PMID- 3506825 TI - Paper chromatography of urinary amino acids. A 30 year survey of dietary influences on the normal pattern, and patients' results. AB - In the clinical laboratory, paper chromatography is still the most useful, simple, inexpensive procedure for initial identification of abnormalities of amino acid excretion. The results of its use for more than 8000 paediatric and adult renal patients is surveyed. Nonspecific generalized aminoaciduria was the most frequent abnormality found, comprising some 70% of abnormal results, with cystine-lysinuria the next most common. The identification of the abnormal excretory pattern of amino acids as distinct from the normal was complicated by the effects of the New Zealand diet. In particular, valine, citrulline, hydroxyproline and glutamic acid are found in considerable amounts as part of the normal pattern. Their dietary origin is discussed. Varying mixtures of monosaccharides and disaccharides occurred in association with a range of amino acid patterns. PMID- 3506826 TI - Simple determination of forphenicinol in human plasma and erythrocytes by HPLC with native fluorescence detection. AB - A high performance liquid chromatographic method is described for monitoring forphenicinol, a possible therapeutic drug for cancer and muscular dystrophy, in human plasma and erythrocytes. Forphenicinol in the deproteinized samples was separated from interfering biogenic substances on an aminopropyl-bonded silica (Unicil NH2) column within 10 minutes with isocratic elution, and determined with fluorescence detection. The detection limits for forphenicinol in plasma and erythrocytes are 65 pmol (12.8 ng)/ml and 160 pmol (31.5 ng)/ml, respectively, corresponding to 2 pmol each in a 100 microliters injection volume. The method is very simple, and sensitive enough to permit the quantification of forphenicinol in the blood samples from man dosed with forphenicinol. PMID- 3506827 TI - The determination of nivacortol in plasma using HPLC. AB - A high performance liquid chromatographic method with ultraviolet detection was developed for the determination of nivacortol (WIN 27914) in biological samples. The drug was isolated from human plasma by using a solid-phase extraction and eluted with ethanol. The solvent was evaporated and the residue dissolved in the chromatographic eluent. The sample was subjected to chromatography on a C8 silica column and eluted with a gradient of acetonitrile in 0.1 M sodium acetate buffer, pH 6.5. A single concentration of a structural analogue (WIN 31338) was used as internal standard for the quantitative determination of the analyte. The plasma concentrations were below that needed to suppress ACTH secretion by pituitary cells in culture and did not suppress plasma ACTH in Nelson's syndrome. PMID- 3506828 TI - Opioid peptides in the cerebrospinal fluid of Alzheimer patients. AB - Endogenous opioid receptoractive peptides in the cerebrospinal fluid (CSF) of human controls and in those patients diagnosed as having senile dementia of the Alzheimer's type (SDAT) are measured with a radioreceptorassay following HPLC separation. [3H]Etorphine is the ligand used to detect in the HPLC fractions the presence of those endogenous peptides that preferentially interact with several opioid receptors. The RRA uses a receptor-rich P2 fraction extracted from a canine limbic system. The total opioid peptide content found in the HPLC fractions 6-20 (to avoid salts in fractions 1-5) of SDAT CSF (383 +/- 187 pmol ME equivalents per ml CSF) is significantly higher than the corresponding total from patients with no known neurological disorders (89.1 +/- 46.3 pmol ME-equivalents per ml). PMID- 3506829 TI - Solid phase extraction and isocratic separation of urinary porphyrins by HPLC. AB - A method for determining urine porphyrins by HPLC is described. In the preliminary step, porphyrins are purified in high yields and concentrated by low pressure reverse-phase chromatography on C18 (octadecylsilane bonded silica) cartridge. Porphyrins are stable for 10 days after adsorption on C18 cartridge. The separation of porphyrin esters is performed on an aminopropyl-bonded silica column with an eluting system containing n-heptane and ethyl acetate. The system enables rapid isocratic separation of porphyrin methyl esters with high selectivity. The simplicity and reproducibility of the whole procedure allows its application to the routine analysis of urinary porphyrins in the clinical laboratory. PMID- 3506830 TI - Red cell zinc protoporphyrin and protoporphyrin by HPLC with fluorescence detection. AB - A high performance liquid chromatographic (HPLC) method was developed for the determination of zinc protoporphyrin (ZnPP) and protoporphyrin (PP) in whole blood. After adding the blood to dilute acetic acid, ZnPP and PP were extracted with dimethyl sulfoxide-acetone containing mesoporphyrin as internal standard. Following evaporation of the acetone, the haemin-free extract was analysed by HPLC. ZnPP and PP were separated on a reversed-phase column and quantitated by measuring fluorescence peak areas. The extraction method is simple, and applicable to batch analysis, and the HPLC separation is rapid and repoducible. The coefficient of variation for ZnPP was 5.6% and 3.3% for total red cell porphyrin levels of 3.5 and 10.2 mumol per litre RBC respectively. Results are discussed in patients with erythrohepatic protoporphyria, lead exposure, iron deficiency and nonspecifically elevated total red cell porphyrins. PMID- 3506831 TI - HPLC determination of orthophosphate coexisting with large amounts of organophosphates in biological samples. AB - A simple and accurate HPLC method for the determination of orthophosphate in the presence of large amounts of organophosphates is described. The method is based on the formation and separation of the molybdenum orthophosphate complex. In order to prevent the hydrolysis of organophosphates, the sample was deproteinized with silicotungstate in acetate buffer (pH 4.0) under ice-cooling and then treated with ammonium molybdate in maleate buffer (pH 7.0). The sample was injected onto Styragel 60 A column (5 mm ID x 100 mm) with 38% (v/v) acetonitrile containing 0.3 M sulfuric acid as eluent. Detection was at 310 nm. The method was applied to the determination of orthophosphate in liver, kidney, spleen and mouse blood. PMID- 3506832 TI - HPLC of trazodone in serum after microscale protein precipitation. AB - Trazodone, an anti-depressant medication, is found in serum in the 500-1000 ng/mL range in patients taking therapeutic doses. Because of this relatively high concentration, it has been possible to devise an HPLC assay system using the rapid, convenient microscale procedure described previously by Lam et al. (Clin. Chem. 26, 963 1980) to prepare the sample for chromatography. To 0.1 mL serum were added 0.1 mL acetonitrile and 10 microL of 10% zinc sulfate in water. The mixture was centrifuged and 50 microL of the clear supernatant was injected into a reversed-phase column which was eluted with 65% 0.05 M potassium phosphate-35% acetonitrile, with detection by ultraviolet absorbance at 210 nm. The trazodone elutes in 6 min, clearly resolved from endogenous interferences. The recovery of trazodone added to serum was better than 90%. Peak height was proportional to concentrations in the serum sample from 125 ng/mL to 3000 ng/mL. PMID- 3506833 TI - HPLC measurement of meptazinol in plasma using electrochemical oxidation detection. PMID- 3506834 TI - Determination of artemether in plasma and whole blood using HPLC with flow through polarographic detection. AB - An HPLC method with polarographic detection for the trace determination of artemether in plasma and whole blood was developed and applied to pharmacokinetic and clinical pharmacological studies. The method showed high sensitivity and selectivity because of the easy reduction of the peroxide linkage of artemether at the mercury drop electrode. The detection limit was 10 ng and the detector response was linear over the range of 10 ng to 1 microgram artemether injected onto the column. The largest relative standard deviation of 10 replicate measurements of standard solutions (concentrations of 10 ng/mL-1 microgram/mL) was 8%. The recovery from whole blood and plasma of added drug (concentrations of 15-480 ng/mL) was 71-100%. PMID- 3506835 TI - Chromatographic studies of human lung elastin digestion products obtained by leucocyte elastase: comparison between newborn and adult soluble fragments. AB - Human insoluble elastin was prepared from newborn lungs and digested by leucocyte elastase. The soluble fragments were compared to those obtained from adult lung elastin in a previous work (Smyrlaki et al., 1986). Gel filtration on a Bio-Gel P 100 column of newborn elastin allowed the separation of fraction F1N (Mr's 30,000 10,000) which was eluted later than the excluded fraction F1A (Mr's 80,000 30,000) previously isolated from adult elastin. The difference in the sizes of the large peptide fragments originating from both elastins was also shown on SDS PAGE. Reversed phase HPLC was performed on a C18 column using a multi-step gradient elution procedure. Different patterns were observed for the high (F1N) and the low (F2N) molecular size fragments of newborn elastin. The same peak distribution was obtained with adult elastin. Comparison of the amino acid compositions of the most retained peaks (3, 4 and 5), derived from fractions F1N and F1A, showed analogies for the contents of the major nonpolar amino acids and crosslinks. Thus, this procedure allowed the separation of typical fragments of elastin which might be released in vivo by leucocyte elastase during pulmonary diseases. PMID- 3506836 TI - The use of Bond-Elut for the estimation of serum bile pigments bonded covalently to albumin. AB - A simple and precise method has been devised for the quantitation of biliprotein (delta-bilirubin or albumin bound bilirubin) in serum. In the presence of caffeine/benzoate, Bond-Elut (C8, 200 mg) extracts unconjugated and conjugated bilirubin but not pigments that are covalently bonded to albumin which pass through the column and can be quantitated by a standard diazo method. Following elution from the Bond-Elut column with methanol-acetonitrile (50:50, v/v) unconjugated and conjugated bilirubin can be quantitated either as total pigments or individually by HPLC. PMID- 3506837 TI - HPLC determination of ferrochelatase activity in human liver. AB - A method utilizing HPLC to estimate ferrochelatase activity in human liver cells is presented. A partially purified homogenate of liver cells is incubated with mesoporphyrin IX and cobalt(II)ion. The ferrochelatase in the homogenate incorporates the cobalt(II)ion into the mesoporphyrin. After a fixed time (90 min) the porphyrins are extracted into an ethyl acetate-acetic acid mixture. The porphyrins are then separated using reversed phase HPLC with a mobile phase of methanol-acetonitrile-phosphate buffer pH 3.0 (200:60:30 v/v). The enzyme activity is estimated by measuring the rate of utilization of mesoporphyrin. The optimum pH and substrate concentration for the reaction have been determined. PMID- 3506838 TI - Evaluation of vaginal malodor and efficacy of treatment by high performance ion exchange chromatography. AB - High performance ion exchange chromatography was employed to evaluate the presence of short chain organic acids in the vaginal fluid of a woman troubled by persistent foul vaginal odor, but who did not have typical bacterial vaginosis. The vaginal secretions from this patient were collected on a weighed cotton swab and eluted into water and extracted by acidified ether. Salts of the acids were back-extracted into aqueous solution and chromatographed on an H-form resin column and compared to commercially available standards. A strikingly large amount of caproic acid was found. The caproic acid disappeared after metronidazole therapy, and a subsequent follow-up chromatogram showed a predominance of lactic acid. The success of this technique in evaluating the present case suggests that such a method may prove useful in other types of vaginal infection. PMID- 3506839 TI - Routine clinical determination of carotene, vitamin E, vitamin A, 25-hydroxy vitamin D3 and trans-vitamin K1 in human serum by straight phase HPLC. AB - A universal extraction procedure is described for fat-soluble vitamins in human serum. Methods are presented for routine quantitative analysis by isocratic straight phase HPLC with UV-detection of (alpha + beta)-carotene, vitamin E (alpha-tocopherol) and vitamin A (all-trans-retinol) in one single run, and of vitamin K1 (trans-phylloquinone) and 25-hydroxy vitamin D3 after sample clean-up using disposable reversed-phase cartridges. The limits of detection, precisions and selectivities of the developed assays are shown to be satisfactory after more than three years' experience. The routine clinical determination of fat-soluble vitamins can be performed in less than 5 mL of serum. Analyses of external quality control and randomly taken outpatient samples are shown to be of great value in assessing laboratory performance. PMID- 3506840 TI - Determination of guanine plus cytosine bases in bacterial DNA hydrolysate by reversed phase HPLC. PMID- 3506841 TI - Surgical superior maxillary repositioning and mandibular arch expansion for anterior open bite and internal derangement. PMID- 3506842 TI - Treatment of anterior disk displacement in an adult with extreme Class II, division 2 malocclusion using proclination of the incisors, repositioning splints, orthodontics, and orthognathic surgery. PMID- 3506843 TI - Unilateral hyrax expansion of a maxillary posterior segment with surgical assistance. PMID- 3506844 TI - Potential international benefits from the evolution of ophthalmic practice in the United States. PMID- 3506845 TI - Surgery of congenital cataract. PMID- 3506846 TI - [Argon laser treatment for primary angle-closure glaucoma]. PMID- 3506847 TI - Congenital glaucoma (primary infantile glaucoma). PMID- 3506848 TI - [Comparison between polar coordinates computational method and computerized image analysis in measuring foveal avascular zone (FAZ)]. PMID- 3506849 TI - Non-penetrating traumatic retinopathy. PMID- 3506850 TI - [An ultrastructural histo-pathological study of the membrane formation in retinal detachment]. PMID- 3506851 TI - Amblyopia patches--a preliminary study. PMID- 3506852 TI - Update remarks on the control of eye movements. PMID- 3506853 TI - Psychophysical evaluation of the temporal response of the retina in ocular disease. PMID- 3506854 TI - [Studies on scraping cytology of patients with conjunctivitis and keratitis]. PMID- 3506855 TI - [Ultrastructural studies of the human cornea stored in M-K medium]. PMID- 3506856 TI - Cataract extraction in infants. PMID- 3506857 TI - Traumatic hyphaema--medical and surgical management. PMID- 3506858 TI - [Surgical treatment of orbital hypertelorism--a report of 5 cases]. PMID- 3506859 TI - Tragal cartilage used for repair of orbital blowout fractures. PMID- 3506860 TI - Early diagnosis of glaucoma. PMID- 3506861 TI - Argon laser trabeculoplasty in primary open angle glaucoma: long-term clinical results and its future. PMID- 3506862 TI - Proliferative diabetic retinopathy. PMID- 3506863 TI - [A survey of ocular diseases and blindness in Sichuan Province]. PMID- 3506864 TI - [Blindness prevention in rural areas of Province Heilongjiang: 35 years]. PMID- 3506865 TI - [Blindness investigation to the islanders]. PMID- 3506866 TI - [Color pattern visual evoked potential in glaucomatous optic nerve atrophy]. PMID- 3506867 TI - [Pattern visual evoked potentials in normal Chinese people and in patients with open angle glaucoma]. PMID- 3506868 TI - Surgery of glaucoma prevention and management of complications. PMID- 3506869 TI - Laser in anterior segment and glaucoma microsurgery. PMID- 3506870 TI - [Contents of glucose, sorbitol and fructose in the human lens]. PMID- 3506872 TI - [Scanning electron microscopy of the fetal lenses]. PMID- 3506871 TI - [Abnormal zinc metabolism in senile cataract]. PMID- 3506873 TI - [Relationship of corrected visual acuity and macular lesion in high myopia]. PMID- 3506874 TI - [Clinical study on posterior fundus changes in high myopia]. PMID- 3506875 TI - [Stargardt's disease and choroidal silence sign]. PMID- 3506876 TI - [Fluorescein angiography]. PMID- 3506877 TI - [A staging system of retinoblastoma and its clinical significance]. PMID- 3506878 TI - [A preliminary report on the tissue source of retinoblastoma]. PMID- 3506879 TI - [Aqueous humour lactic acid dehydrogenase and its isoenzymes in retinoblastoma]. PMID- 3506880 TI - Leukocoria: CT diagnosis. PMID- 3506882 TI - [Ocular lymphangioma]. PMID- 3506881 TI - [Non-Hodgkin's lymphoma of the primary ocular adnexa--clinical and histopathologic analysis of 44 cases]. PMID- 3506883 TI - [Ophthalmologic signs and symptoms of nasopharyngeal carcinoma (NPC)]. PMID- 3506884 TI - Compressive optic neuropathy in dysthyroid eye disease. PMID- 3506885 TI - Basic concept of immunology. PMID- 3506886 TI - [Lens-induced uveitis]. PMID- 3506887 TI - [Treatment of herpes simplex keratitis with human leucocyte interferon combined with antiviral drugs]. PMID- 3506888 TI - The use of photo-electric automatic exposure device for localisation of intraocular foreign bodies. PMID- 3506889 TI - Patterns of puffing activity and chromosomal polymorphism in Drosophila subobscura. IV. Position effect at the boundaries of the E12 inversion. AB - The puffing patterns in polytene E chromosomes of Drosophila subobscura were followed in third-instar larvae and throughout the prepupa period. Two gene arrangements, Est and E1+2+9+12 were studied. A majority of puffs exhibit a similar pattern, but the puffs 61AC and 67AB behave differently in the two chromosomal arrangements, both in homozygotes and in heterozygotes. These two puffs are located at the end of the E12 inversion. This position effect is an interesting phenomenon that probably is not due to a heterochromatinization effect. PMID- 3506891 TI - Factor analysis of the activities of superoxide dismutase, catalase and glutathione peroxidase in normal tissues and neoplastic cell lines. AB - Exploratory factor analysis of reported specific activities of the antioxidant enzymes superoxide dismutase, catalase and glutathione peroxidase in normal human tissues, normal mouse tissues, vertebrate red blood cells and neoplastic human cell lines shows that the activities of copper-zinc superoxide dismutase, catalase and glutathione peroxidase in normal tissues are influenced by a single factor. Catalase activity has the highest loading and correlation with this factor, suggesting a catalase- or hydrogen peroxide-related influence. The activity of manganese superoxide dismutase is influenced by a separate factor. The activities of copper-zinc and manganese superoxide dismutases in normal tissues therefore appear to be dichotomously regulated. The activities of superoxide dismutase and glutathione peroxidase in vertebrate red blood cells are influenced by a single factor. The activity of catalase is influenced by a separate factor. The roles of glutathione peroxidase and catalase in hydrogen peroxide catabolism in red blood cells in fact differ. In neoplastic human cell lines, two bipolar factor factors appear to influence the activities of catalase and manganese superoxide dismutase, and glutathione peroxidase and copper-zinc superoxide dismutase, respectively. The factors are, however, mainly catalase and glutathione peroxidase activity factors as the loadings and correlations of manganese superoxide dismutase on the one hand and copper-zinc superoxide dismutase on the other, with the respective factors, are relatively small. Potentially low superoxide production and intrinsically low peroxidizability of tumour cell membranes underlie the peculiar variation of antioxidant enzyme activities in tumour cells. Factor analysis is proposed as a heuristic data reduction and hypothesis-creating technique for the variation of antioxidant and other functionally-linked enzyme activities in normal and pathological cells and tissues. PMID- 3506890 TI - The banding pattern of polytene chromosomes of Drosophila guanche compared with that of D. subobscura. AB - A detailed map of the salivary gland chromosomes of Drosophila guanche is presented and compared to the standard gene arrangements of D. subobscura. Generally, the polytene chromosome banding patterns of the two species show a high degree of homology. Only Segment I of the sex chromosome (Chromosome A) shows marked differences. The banding pattern proposed for this segment in D. guanche could have originated from a cluster of overlapping inversions including A1 arrangement. PMID- 3506892 TI - Stimulation of peroxidation in rat liver microsomes by (copper, zinc) metallothioneins. AB - The abilities of pig liver (copper, zinc) metallothionein I and rat liver zinc metallothionein II to modify lipid peroxidation in incubations of liver microsomes have been compared with the activities of reduced glutathione, mannitol, quinacrine, EDTA, dimethyl-pyrroline-N-oxide and phenyl-butyl-nitrone. Lipid peroxidation was determined by assay of thiobarbituric acid reactive substance formation in incubations of microsomes with iron/ADP or a mixture of xanthine and xanthine oxidase. Zinc metallothionein II had no effect on the extent of peroxidation in either system but (copper, zinc) metallothionein I caused a stimulation of peroxidation initiated by xanthine and xanthine oxidase, all other compounds tested were inhibitory. Gel exclusion chromatography of incubations of (copper, zinc) metallothionein I with xanthine and xanthine oxidase revealed aggregation of the metalloprotein. This may have exposed copper in a form capable of initiating peroxidation. PMID- 3506893 TI - Tissue damage in vitamin E deficient rats is not detected by expired ethane and pentane. AB - Despite evidence for tissue damage in vitamin E deficient rats, no discernible difference in ethane and pentane production was apparent compared with controls. It is suggested that other sources of hydrocarbons may mask hydrocarbon production from peroxidation of polyunsaturated fatty acid components of cell membranes, or that tissue damage occurs before peroxidation of the polyunsaturated fatty acids. PMID- 3506894 TI - Myocardial glutathione alterations in acute coronary occlusion in the dog. AB - Glutathione (GSH) decreases in dog myocardium upon acute coronary occlusion when compared with sham-operated dogs. Total glutathione content (GSHeq = GSH + 2GSSG) remains unchanged throughout the experiment (6 h after surgery) in both sham- and acute coronary occlusion-operated dogs. GSSG and GSH/GSSG ratio increases and decreases respectively in all animals but tends to reach the normal value after 6 h in sham-operated dogs. Both parameters (GSSG and GSH/GSSG ratio) remain altered in acute coronary occlusion-operated ones. This alteration of glutathione status in ischemic myocardium is discussed. PMID- 3506895 TI - Damage of erythrocytes by activated oxygen generated in hypoxic rat liver. AB - The implication of activated oxygen in the interaction between hypoxic rat liver and circulating erythrocytes was investigated. Reduced species of oxygen generated in hypoxic liver owing to accelerated purine nucleotide degradation via xanthine oxidase initiate alterations of plasma membrane and glutathione system of erythrocytes. Osmotic fragility, hemolysis rate and erythrocytic GSSG:GSH ratio may be considered as appropriate indicators of oxidative load in liver and other tissues. Addition of erythrocytes to the perfusion medium attenuates the GSSG efflux of hypoxic liver from 2.7 +/- 0.5 nmol x g w.w.-1 x min-1 to 1.4 +/- 0.2 nmol x g w.w.-1 x min-1 Thus, circulating erythrocytes protect the liver against oxidative attack. PMID- 3506896 TI - Flow sorting of X and Y chromosome-bearing spermatozoa into two populations. AB - The only established difference on which to base the separation of X and Y chromosome-bearing spermatozoa is chromosomal constitution. This difference is quantifiable both from chromosome morphology (karyotype) and from DNA content. Flow cytometric techniques were used to measure relative DNA content of the X and Y populations and to flow-sort spermatozoa from Chinchilla laniger. Epididymal spermatozoa were recovered in PBS, fixed in 80% ethanol, treated with papain and dithioerythritol, and stained for DNA with Hoechst 33342. Sperm nuclei were analyzed and sorted on an EPICS V flow cytometer/cell sorter, modified specifically for spermatozoa. Two clearly resolved peaks (coefficient of variation less than 1.5%) with approximately 7.5% difference in DNA content between X and Y chromosome-bearing spermatozoa were evident. Sperm nuclei were sorted from a portion of the X and Y peaks at a rate of 55 nuclei/sec for each population. Purities of individual X and Y populations averaged 95% as determined by reanalysis of the sorted populations. Successful sorting of Chinchilla X and Y chromosome-bearing spermatozoa into separate populations may aid in the identification of a biochemical marker that could be used to discriminate between the two sperm populations and lead to a practical procedure for sexing spermatozoa. PMID- 3506897 TI - Action of gossypol on rat germinal cells. II. The acrosome. AB - The action of gossypol on the acrosomal complex in rats has been investigated by microscopical and submicroscopical methods. The drug displays its morphological action only on spermatozoa during the transit through the epididymis, causing malformations and vesiculations. It appears to exert a primary action on the S-S groups formation, disturbing morphological molding occurring in this period and inhibiting capacitation. PMID- 3506898 TI - Formation of the cylindrical structure during the acrosome reaction of abalone spermatozoa. AB - Spermatozoa of abalone Haliotis discus were examined before and during the acrosome reaction with special regard to one of the newly formed structures: a cylindrical structure surrounding a part of the elongated acrosomal process near the opening of the acrosomal vesicle. The structure, about 0.2 micron in diameter and about 1 micron in length, was revealed to be composed of a tightly coiled, fine tubular structure about 20 nm in diameter. In the course of the acrosome reaction, a triple-spiral structure appeared in the anterior part of the acrosomal vesicle. Since this spiral structure was also composed of a tightly coiled 20 nm tubule(s), it was concluded that this structure was transformed into the single-walled cylindrical structure by simple stretching in the direction of its longitudinal axis. In the clumps of spermatozoa that underwent acrosome reaction in suspension, the cylindrical structures were frequently found in contact with each other and/or other structures, indicating that they are very sticky. PMID- 3506899 TI - Interactions of aged gametes: in vitro fertilization using in vitro-aged sperm and in vivo-aged ova in the mouse. AB - A study of varying combinations of in vitro-aged sperm and in vivo-aged ova at 3 hr intervals from 0-24 hr resulted in failures at different steps of the fertilization process during in vitro fertilization of mouse ova. Significant decreases caused by sperm aging, ova aging, and sperm X ova aging interaction were found in sperm penetration. Pronuclear formation was not affected by sperm aging and was enhanced by ova aging, and there was a significant effect of sperm X ova aging interaction. Sperm aging significantly influenced the prometaphase stage of the fertilization process. Therefore, it is suggested that the detrimental fertilization effects resulting from aging gametes are due to different mechanisms in sperm and ova, that these mechanisms are affected at different times, and that they affect different steps in the fertilization process. PMID- 3506900 TI - In vitro fertilization of hamster and human oocytes by microinjection of human sperm. AB - In this study, swollen sperm heads were obtained after the injection of human sperm into the perivitelline space of hamster oocytes. The number of injected sperm and the sperm concentration in the preincubation medium were found to have an influence on the rate of penetrated hamster oocytes. The optimal injected sperm number was always between five to 12 to obtain 8, 37, and 36% penetration for donors A, B, and C, respectively. The optimal sperm concentration in preincubation medium was between 6 and 22 x 10(6) sperm/ml to obtain 16, 47, and 43% penetration for donors A, B, and C, respectively. The rate of polyspermic oocytes was related to the injected sperm number (0, 55, and 100% for one to four, five to 12, and more than 12 injected sperm respectively). Ten human mature oocytes were injected with the sperm from six normal donors. Five fertilized eggs were obtained, and of these four cleaved in in vitro culture. PMID- 3506901 TI - Distribution by sex of mouse fetuses in the intrauterine position. AB - We examined whether or not the sex of the fetuses of polytocous animals distributes randomly in the position along the uterine horn in 255 mouse litters. The fetal sex ratio did not differ significantly among the three intrauterine segments (ovarian, middle, and cervical). Based on the number of fetuses examined in this study, it can be stated that even if sex ratio differences exist among the segments, the ratio in individual segments would fall mostly inside the +/- 0.1 range, when the overall sex ratio (M/(M + F] is around 0.5. PMID- 3506902 TI - Spontaneous continuous release of spermatozoa and its predawn surge in male passerine birds. AB - Spontaneous, continuous release of morphologically normal spermatozoa occurs in males of species of passerine (order Passeriformes) birds that were examined. It was demonstrated and studied quantitatively in temporarily captive and isolated house sparrows and house finches by means of repetitive cloacal lavages and extraction of excreta. It is suggested that this phenomenon could be exploited to facilitate comparative and quantitative evaluations of release of spermatozoa in relation to diverse environmental, physiological, and social factors. PMID- 3506903 TI - Effects of superovulatory doses of pregnant mare serum gonadotropin on oocyte quality and ovulatory and steroid hormone responses in rats. AB - Immature rats (aged 28 days) were injected with 4, 20, or 40 IU pregnant mare serum gonadotropin (PMSG) and sacrificed every 6 or 12 hr. Control rats (4 IU) ovulated between 60 and 72 hr, whereas rats given superovulatory doses of PMSG (20 and 40 IU) ovulated between 24 and 72 hr. The oocyte count from the superovulated rats increased slightly between 24 and 36 hr and markedly between 48 and 72 hr. Degenerated oocytes were recovered 48 and 36 hr after administration of 20 and 40 IU PMSG, respectively. Thereafter, the proportion of degenerated oocytes was dose dependent and reached a maximum at 72 (30.9%, 20 IU) and 60 hr (61.0%, 40 IU). 17 beta-estradiol content of the superovulated ovaries increased significantly (P less than 0.01) from 36 hr and was maximal at 60 (20 IU) or 54 hr (40 IU), when compared to the control regimen. Administration of 40 IU PMSG resulted in a biphasic increase of progesterone content with the peaks at 36 and 60 hr. Androgen content of the superovulated ovaries was lower than control levels during the first 36 hr but was significantly (P less than 0.01) higher thereafter. The results suggest that these alterations in the steroid response (particularly androgens) from 36 hr onward following superovulation may be responsible for the coincidental occurrence of abnormal oocytes, possibly by disturbing the specific intrafollicular steroid environment essential for complete maturation. In addition, oocyte aging that is due to earlier activation by the exogenous luteinizing hormone activity may be a contributing factor. PMID- 3506904 TI - Dilauroylphosphatidylcholine liposome effects on the acrosome reaction and in vitro penetration of zona-free hamster eggs by bull sperm: I. A fertility assay for fresh semen. AB - Fresh sperm from five bulls having nonreturn rates ranging from 48% to 77% were treated with 15.7, 21.0, 26.2, 31.5, 36.7, and 42.0 microM dilauroylphosphatidylcholine (PC12) to induce the sperm acrosome reaction (AR). Treated sperm were incubated 3 hr with zona-free hamster eggs at 39 degrees C prior to fixation. The eggs were then stained and examined for sperm penetration. Differences in the percentages of motile sperm and of sperm exhibiting an AR among bulls were small when compared on a within-liposome-concentration basis. Increasing the PC12 concentration from 15.7 microM to 42.0 microM increased the percentage of sperm exhibiting an AR for all bulls. At the lowest lipid concentration (15.7 microM), the percentage of eggs penetrated by sperm from the five bulls was 6% to 36%, with 0% in controls. When sperm were incubated with increasing lipid concentrations, the egg penetration rate increased to over 80%, and the total number of sperm increased to over 100 per 36 eggs in each treatment for every bull. These penetration rates decreased at the highest lipid concentration. A correlation between the PC12 concentration maximizing egg penetration and the nonreturn rate of -.63 was found. The correlation between the PC12 concentration maximizing the total number of penetrated sperm per treatment and the bull nonreturn rate was -.96. It was concluded that PC12 liposomes induce the AR in bull spermatozoa, which enables them to penetrate zona-free hamster eggs. High fertility bulls required less lipid to induce the AR than did lower fertility bulls. Consequently, this assay of fresh semen could provide a laboratory method to estimate the fertility of a bull. PMID- 3506905 TI - Dilauroylphosphatidylcholine liposome effects on the acrosome reaction and in vitro penetration of zona-free hamster eggs by bull sperm: II. A fertility assay for frozen-thawed semen. AB - Frozen-thawed sperm from five bulls with fertility rates ranging from 48% to 77% were treated with seven concentrations of dilauroylphosphatidylcholine (PC12) liposomes to induce an acrosome reaction (AR) that enabled sperm to penetrate eggs. Treated sperm were incubated with liposomes for 7 min prior to insemination of zona-free hamster eggs in vitro. Sperm and eggs were incubated 3 hr at 39 degrees C prior to fixation, staining, and examination for sperm penetration and nuclear decondensation. The percentage of motile sperm immediately after thawing as well as after treatment with liposomes had a low correlation with sire fertility (r = .39 and less than or equal to .63, respectively). The percentage of sperm exhibiting an AR was more highly correlated with fertility (r less than or equal to -.85). Similar correlations were found between fertility and the penetration rates of zona-free hamster eggs or the total number of penetrating sperm. When data for two high and for two lower fertility bulls were each grouped to increase information per data point the correlation between the PC12 concentration giving the maximum proportion of eggs penetrated and fertility was r = .92 (P less than .05). The correlation between the PC12 concentration producing the most total sperm penetrating the eggs and fertility r = .97 (P less than .05). It was concluded that PC12 liposomes induced an AR in bull sperm frozen-thawed in egg yolk extender. Frozen-thawed sperm from low fertility bulls require less PC12 to induce the AR and to penetrate zona-free hamster eggs than do sperm from higher fertility bulls. These differences in lipid requirements may help to provide a quick, direct laboratory assay method to estimate the fertility of frozen bull semen. PMID- 3506906 TI - In vitro fertilization with normal development in the sheep. AB - Ovine tubal (n = 87) and ovarian in vitro matured oocytes (n = 99) were fertilized in vitro with ejaculated spermatozoa capacitated for 8 h in modified defined medium buffered with Hepes. High levels of fertilization were obtained as assessed by development to two- to six-cell stage within 40 h (75.8% for ovulated and 62.6% for in vitro matured oocytes). Electron microscope analysis of oocytes 20-22 h after insemination indicated that in vitro fertilization approximated the in vivo events. Embryos (two- to six-cell) were transferred surgically to the oviducts of pseudopregnant rabbits. Three days later, 42 (from ovulated oocytes) and 15 (from in vitro matured oocytes) embryos were recovered; 26 (61.9%) and 10 (66.6%), respectively, had cleaved at least once. Embryos incubated in vivo (n = 20 from ovulated oocytes; n = 9 from in vitro matured oocytes) were transferred surgically to the uteri of seven and four recipient ewes resulting in four and two pregnancies, respectively, from which three and one, respectively, have been maintained (greater than 3 months). The first lamb resulting from the in vitro fertilization of an ovulated oocyte was born. In addition, six embryos (two- to four-cell) from tubal oocytes and ten embryos (two- to six-cell) from in vitro matured oocytes were directly transferred to the oviducts of two and three ewes, respectively. Two pregnancies resulting from in vitro matured fertilized oocytes are in progress (greater than 3 months). PMID- 3506907 TI - Seasonal variation in estrous cycling in the mouse: implications for artificial insemination. AB - Artificial insemination in the C3HeB/FeJ inbred strain of mice has been shown to be more successful at the middle and end of the calendar year. The reasons are twofold: 1) an increase in the number of normal estrous cycles exhibited by females and 2) an increase in the tightness of the phasing of ovarian and vaginal events. The latter phenomenon was found to be the key to the success of artificial insemination, since it permitted the use of vaginal smears to predict accurately the time females could be expected to ovulate and, therefore, the appropriate time for artificial insemination. Seasonal variations in the frequency of estrous cycling also have been observed in SJL/J and B6D2F1/J females. PMID- 3506908 TI - Reproduction in mice: protein kinase mimics the sperm effect on preimplantation embryo development. AB - The creation of an environment in mouse fallopian tubes that is sufficient to sustain preimplantation embryo development is known to require the participation of spermatozoa in excess of those involved in the process of fertilization. We have now found that highly purified cAMP-dependent protein kinase can substitute for spermatozoa in the facilitation of the first cleavage of mouse embryos. Both spermatozoa and purified protein kinase induce increases in fallopian phosphoproteins. It is suggested that nonfertilizing spermatozoa could exert their effects on preimplantation embryo development through the provision of protein kinase. PMID- 3506909 TI - Ethanol inhibits human and hamster sperm penetration of eggs. AB - The effect of alcohol on the fertilizing ability of both human and hamster spermatozoa was examined by an in vitro fertilization assay using hamster ova. Spermatozoa were incubated in capacitating media for 3 hr (hamster sperm) and 4 hr (human sperm). Hamster ova were inseminated with preincubated sperm and were examined after 2 to 3 hr. Ethanol was added to the capacitating media at concentrations of 25, 50, 100, 200, and 400 mg%. Fertilization of zona-free hamster eggs by human spermatozoa was reduced from 49.6% in no alcohol to 16.7% in 400 mg% ethanol. Fertilization of hamster eggs by hamster sperm revealed a reduction from 63.6% to 33.7% in cumulus-intact eggs and from 65.8% to 10.8% in cumulus-free eggs in the presence of ethanol at 400 mg%. Hamster sperm acrosome reaction was reduced from 47% to 12%. When these hamster sperm with reduced acrosome reaction were placed with zona-free hamster eggs, the 100% fertilization rate was not reduced; however, the fertilization index, which reflects the number of swelling sperm heads per egg, was reduced from 8.5 to 1.8. This suggests that as little as 12% of the sperm with an acrosome reaction is sufficient to fertilize 100% of the zona-free eggs. If ethanol was added to the insemination media only, there was no inhibition of fertilization by human sperm or hamster sperm that had been previously capacitated in an ethanol-free media. Removal of the ethanol from the preincubated sperm produced fertilization at control levels; thus the inhibitory effect is reversible. These results indicate that ethanol may affect fertilization by an inhibition of the capacitation and/or acrosome reaction process. PMID- 3506910 TI - Effect of liquid storage and cryopreservation of boar spermatozoa on acrosomal integrity and the penetration of zona-free hamster ova in vitro. AB - The effect of liquid storage and cryopreservation of boar spermatozoa on sperm motility, acrosomal integrity, and the penetration of zona-free hamster (ZFH) ova was examined. The sperm penetration assay (SPA) provides valuable information on specific events of fertilization and is a potentially useful indicator of sperm fertility. Ejaculated semen from 4 boars was subjected to 3 treatments: fresh (FRE, no storage), liquid-stored (LIS, stored at 18 degrees C for 3 days), and frozen (FRO, frozen by pellet method and stored at -196 degrees C for 3 days). A highly motile sperm population was isolated by the swim-up procedure (1 hr). FRE and LIS were incubated an additional 3 hr at 39 degrees C in a Tris-buffered medium to elicit capacitation and the acrosome reaction. Sperm motility and acrosomal integrity were assessed before and after incubation. For the SPA, sperm and eggs were incubated at 39 degrees C for 3 hr in Hams F-10 medium. Each egg was assessed for sperm penetration, sperm binding, and stage of development. Percentages of sperm motility and sperm with a normal apical ridge (NAR) prior to incubation were 78 and 78 (FRE), 75 and 69 (LIS), and 28 and 50 (FRO). After incubation, percentages of motility, NAR, and acrosome-reacted sperm were 34, 10, and 73 (FRE); 43, 24, and 51 (LIS); and 18, 13, and 59 (FRO). A somewhat higher (P less than .05) percentage of ZFH ova was penetrated by FRE (45.8) than by LIS (42.0). Penetration of ZFH ova by FRO was markedly (P less than .05) reduced (30.2). Sperm penetration was not significantly correlated with motility or acrosomal integrity before or after incubation, regardless of treatment. These data suggest that the SPA can be used in conjunction with conventional measures of semen analysis in assessing the potential fertilizing capacity of boar sperm and that liquid storage is superior to frozen storage with respect to preserving sperm fertility. PMID- 3506911 TI - Incidence of chromosome anomalies in first-cleavage mouse embryos obtained from frozen-thawed oocytes fertilized in vitro. AB - To assess the effect of low temperature storage on mouse oocytes we (1) examined the capacity for normal development of embryos derived from frozen oocytes fertilized in vitro after transfer to pseudopregnant foster mothers and (2) analyzed the chromosome complement at the first cleavage division. Fewer frozen than control oocytes were fertilized (36% vs 66%), but after embryo transfer the proportion of fertilized eggs that implanted (67-68%) and formed normal foetuses (50-53%) was similar in the two groups. Freezing did not affect the observed incidence of aneuploidy (1.5-3.3%). The frequency of polyploid embryos derived from frozen oocytes was almost double that of controls (15.8% vs 8.5%), but it is unclear whether this is a real effect of freezing or is an artifact produced by the chromosome preparation technique. PMID- 3506912 TI - A protein family immunorelated to a sperm-binding protein and its regulation in human semen. AB - In human seminal plasma a family of proteins that is immunologically related to the RSV-IV protein secreted under androgen control from the epithelium of the rat seminal vesicles was detected by a radioimmunoassay. Evidence for the origin of these antigens from human seminal vesicle is presented. Quantitative measurements of this family of proteins were performed in men with low levels of serum testosterone (idiopathic hypogonadotropic hypogonadism) and in individuals having serum testosterone in the normal range of values but carrying sex chromosome aberrations (Klinefelter's syndrome). In the first case we have found a marked decrease in the total amount of the RSV-IV-related proteins. An increase of about 40% in the total amount of these antigens was obtained in these subjects by gonadotropin treatment. A decreased amount of these proteins was also detected in the subjects affected by Klinefelter's syndrome. The possibility that some factor(s) under genetic control is involved, in addition to testosterone, in the regulation of this family of proteins is discussed. PMID- 3506913 TI - Parthenogenetic activation of cattle follicular oocytes in vitro with ethanol. AB - Cattle follicular oocytes cultured in vitro for 24-33 h were treated with ethanol to induce artificial activation. When oocytes were cultured for 27-33 h before ethanol treatment, 60-68% of oocytes were activated and were found to have a female pronucleus(ei). In contrast, maturation culture of oocytes for 24-26 h resulted in low activation rates (25-38%). The female pronucleus was formed in the activated oocytes within 8-10 h of incubation after ethanol treatment. And it became visible under interference-contrast microscope by centrifugation for 3 min at 15,000g and 10 min at 20,000g. These results indicate that ethanol treatment is effective for activation of cattle follicular oocytes and that the pronucleus formed in the activated oocyte can be visualized by centrifugation. PMID- 3506914 TI - Ultrastructural study of the mature egg of Tethya citrina Sara and Melone (Porifera, Demospongiae). AB - Tethya citrina is an oviparous demosponge in which eggs are distributed in clumps within the choanosome. The cytoplasm of the mature egg presents a peripheral cortex consisting of a slightly granular layer sandwiched between two densely granular, vesiculated ones. The cortex probably has a specialized, trophic function. Mesohyl bacteria are phagocyted at the egg surface, included in vacuoles, and transferred across the cortical sheath toward the inner cytoplasm. The region of the egg extending between the cortex and the nucleus shows a lacunary system mostly developed beneath the cortical envelope. The noncortical cytoplasm also contains lipid droplets, dense rodlike bodies, and phagosomelike granules. Most of the latter are probably autophagosomes, forming lacunae and supporting autosynthetic vitellogenesis. Rodlike inclusions are probably proteinaceous; they likely originate within the phagosomes and represent the actual yolk material. PMID- 3506915 TI - Characterization of hatching-associated changes in the sea urchin fertilization envelope. AB - The embryo of the sea urchin Strongylocentrotus purpuratus hatches from the fertilization envelope (FE) via synthesis and secretion of a hatching enzyme and by ciliary activity. Although the basic characteristics of the hatching enzyme are known, little is understood about changes in the FE during hatching. We have studied the biochemical changes in FEs during hatching. Polyacrylamide gel analysis revealed an increasingly complex polypeptide spectrum of the extractable fraction of FEs isolated during development. Immunoblotting of these polypeptides (using antiserum against the soluble polypeptides extracted from FEs isolated at 30 minutes postinsemination) revealed a decrease in the soluble FE components during hatching. Immunochemical analysis of hatching medium showed a strong correlation between the soluble FE components released and the hatching interval. Immunoblotting of hatching media indicated the presence of soluble FE polypeptides of similar and lower molecular weights than those obtained for extracts of FEs. These results imply that the hatching-associated changes in the FE of S purpuratus occur via proteolysis of FE components, which are derived from the paracrystalline protein fraction, a subset of cortical granule proteins. PMID- 3506916 TI - Superovulation in immature and mature Chinese hamsters. AB - Mature female Chinese hamsters ovulate an average of 8.8 +/- 1.0 (mean +/- SD) eggs per female in each estrous cycle. Superovulation can be induced in both immature and mature females by subcutaneous or intraperitoneal injections of pregnant mare serum gonadotropin (PMSG) and either human chorionic gonadotropin (hCG) or pituitary luteinizing hormone (PLH). The best superovulation in immature females was induced by the administration of 15 IU of PMSG followed 72 hr later by injection of 15 IU of hCG (about 25 eggs per female) or 0.2 mg (200 IU) PLH (about 46 eggs per female). Ovulation started about 13-15 hr after administration of hCG (or PLH) and was completed during the next 5-6 hr. Superovulation in mature females could be induced by injecting PMSG any day of the estrous cycle, but the best superovulation (about 39 eggs per female) was induced by injecting 15 IU of PMSG on day 1 (day of ovulation) followed by the injection of 0.4 mg of PLH 72 hr later. When immature females treated with the best superovulatory protocol were mated on the evening of PLH injection, only 5% of the eggs were found fertilized 50 hr after PLH administration. On the other hand, about 60% of the eggs were found fertilized in mature females mated following treatment with the best superovulatory protocol. The majority (83-85%) of superovulated eggs obtained from both immature and mature females were normally fertilized in vitro. PMID- 3506917 TI - Isolation of 125I-concanavalin A-labeled plasma membrane from unfertilized mouse eggs. AB - A procedure was developed for isolation of plasma membrane (PM) preparations from unfertilized mouse eggs. Zona-free mouse eggs prepared by the method of Boldt and Wolf (Gamete Res 13:213-222, 1986) were labeled with 125I-concanavalin A (ConA) prior to sonication and fractionation on iso-osmotic self-generated Percoll density gradients. Experiments using the ConA-specific sugar alpha methylmannoside (alpha MM) indicated that 125I-ConA bound specifically to the egg PM. Greater than 95% of 125I-ConA binding to zona-free eggs was blocked in the presence of 0.1 M alpha MM, and incubation of eggs in alpha MM after 125I-ConA labeling caused release of 85-90% of bound label. Fractionation of 125I-ConA labeled eggs by Percoll density gradient centrifugation yielded a single radioactive peak at density = 1.025, corresponding to egg PM material. Prolonged incubation of 125I-ConA-labeled eggs or egg sonicates prior to fractionation did not alter the location of the radioactive peak, indicating that 125I-ConA did not label other organelles. As a control, human erythrocytes were labeled with 125I ConA and fractionated under identical experimental conditions and yielded a single radioactive peak at density (1.020) comparable to that observed for 125I ConA-labeled eggs. These results indicate that 125I-ConA can be used as a specific marker to support PM isolation from small numbers of zona-free mouse eggs. PMID- 3506918 TI - Inhibition of in vitro fertilization by mouse anti-mouse sperm sera and preliminary antigen identification. AB - Antisperm antibodies are implicated as one causative factor of infertility, but the target antigens have not been identified. Immune responses to sperm antigens are qualitatively variable even within a single mouse strain. We took advantage of this variability and immunized individual female mice to allogeneic sperm to reflect their natural exposure during mating. We determined the ability of the individual sera to inhibit in vitro fertilization and to bind to sperm antigens separated by electrophoresis. Compared to preimmune sera, four of five immune sera significantly inhibited in vitro fertilization. The serum from individual mice bound variable panels of sperm antigens. By comparing the panels, we identified two polypeptides with molecular weights of 40,000 and 44,000 that were bound by all sera. We propose that these molecules may be good candidates for further investigation of the immunoprophylaxis of pregnancy. PMID- 3506919 TI - Effects of induced ovulation by pregnant mare's serum and human chorionic gonadotropin on the sex ratio of mouse fetuses. AB - The sex ratio of the fetuses from mice treated with pregnant mare's serum (PMS)/human chorionic gonadotropin (HCG) to induce ovulation did not differ appreciably from that of spontaneously ovulated controls. Rather, an intriguing observation was that the sex ratio in the right uterine horns tended to be lower than that in the left horns in both spontaneously ovulated controls and PMS/HCG treated groups. We speculate on its possible relation to the observed right-left asymmetry of horn sizes (number of fetuses in the horn). PMID- 3506920 TI - Analysis of the biological properties of antibodies raised against intact and deglycosylated porcine zonae pellucidae. AB - Zonae pellucidae (ZP) were isolated from 1,500 porcine ovaries and heat solubilized to generate approximately 15 mg ZP glycoprotein. Analysis of this material by isoelectric focusing, one-dimensional electrophoresis, and gas chromatography indicated the presence of a major glycoprotein species that exhibited considerable microheterogeneity with respect to its charge (pI 7.5-3.5) and molecular mass (45-85 kDa) and that contained 39.6% carbohydrate, predominantly N-acetylglucosamine. Chemical deglycosylation of porcine ZP using trifluoromethanesulphonic acid (TFMS) resulted in the production of five discrete protein bands on one-dimensional sodium dodecyl sulphate/polyacrylamide gel electrophoresis (SDS/PAGE) with molecular masses of 66, 52, 36, 32, and 16 kDa. Antisera raised in rabbits and marmosets to ZP and/or deglycosylated ZP (DGZP) were used in immunoblotting experiments to demonstrate the retention of immunogenicity by DGZP and the cross-reactivity of the antisera with their heterologous antigen. These studies indicated that antisera that were capable of inhibiting the fertility of primates in vivo and the penetration of the human ZP in vitro reacted preferentially with 3 of the 5 products of deglycosylation, with molecular masses of 66, 52, and 36 kDa. Anti-DGZP antibodies were also shown to interact with intact porcine and human ZP and, with the latter, to block the ability of human spermatozoa to both bind to and penetrate this structure. PMID- 3506921 TI - Morphology and fertilizability of frozen human oocytes. AB - Human oocytes were frozen and thawed by four methods previously used for cryopreservation of human embryos. Most of these oocytes were inseminated after thawing to assess their capacity to fertilize and form pronuclear ova. Their morphology was assessed by phase-contrast microscopy used in routine IVF. Twenty three oocytes were examined by electron microscopy to critically evaluate the effects of cooling and cryopreservation and to confirm fertilization. Morphological survival was observed in more than 60% of the oocytes examined after freeze-thawing. The main features of cryoinjury were cracks in the zona pellucida, disruption of the plasma membrane and extensive disorganization of the ooplasm. Subtle changes in the cytosol of cumulus cells was also observed. Cooling to 0 degrees C or -6 degrees C had little effect on cytoplasmic structure. Spindles were damaged in two frozen oocytes. Cumulus cell activity, sperm binding to the zona, sperm penetration of the zona seem to be largely unaffected by freeze-thawing. Fertilization was observed in eight oocytes after postthaw insemination and three embryos (8-cell to morula stages) were developed from pronuclear ova on further culture. Both monospermic and polyspermic fertilization were confirmed by electron microscopy and micronuclei were detected in three pronuclear ova. The genetic implications of these nuclear aberrations are discussed. These preliminary studies indicate that oocyte freezing needs to be integrated cautiously with clinical IVF by further assessment of embryos developed from frozen oocytes. PMID- 3506922 TI - Embryonic development in culture of two dasyurid marsupials, Sminthopsis crassicaudata (Gould) and Sminthopsis macroura (Spencer), during cleavage and blastocyst formation. AB - Embryos of Sminthopsis crassicaudata and Sminthopsis macroura were cultured for up to 96 hours during cleavage and early expansion of the blastocyst in Dulbecco's modified Eagle's medium (DMEG), DMEG containing 2.76 gm/liter sodium lactate (DMEGL), DMEG containing 3.5 gm/liter galactose (DMEGAL), DMEG containing 15 ng/ml progesterone (DMEGP) or 150 ng/ml progesterone (DMEGP10), and DMEGL containing 15 ng/ml progesterone (DMEGLP). The disappearance of sperm was used to indicate the time of ovulation (day 0). Fertilized eggs were found in the uterus at the end of day 1, four-cell stages at the end of day 2, and embryos completing the fourth division by the end of day 3 in S. macroura and day 4 in S. crassicaudata. Estimated developmental times in culture were similar to those obtained in vivo. In both species, the first two divisions take about 24 hours, cleavage is arrested for 24 hours or longer at the rounded four-cell stage, and the third and fourth divisions take a further 24 hours. The blastocyst expands during the next 24 hours in which time the fifth and sixth divisions occur. It was possible to culture embryos from S. macroura but not S. crassicaudata over the four-cell stage to early expanding blastocysts. DMEGAL did not support cleavage in culture. DMEG, DMEGL, DMEGP, DMEGP10, and DMEGLP all supported culture during cleavage and early blastocyst expansion. Blastocyst expansion was slightly enhanced using media containing sodium lactate. More embryos completed the fifth division and formed expanding blastocysts in DMEG, DMEGL, and DMEGLP. PMID- 3506923 TI - Acute microvascular reactions to ionizing irradiation in bone-anchored titanium implants: a vital microscopic study. PMID- 3506924 TI - Analysis of plasma flame-sprayed coatings on endosseous oral titanium implants exfoliated in man: preliminary results. PMID- 3506925 TI - Eye donation and eye banking. PMID- 3506926 TI - Ocular infections. PMID- 3506927 TI - Intra lesional corticosteroid therapy of chalazia. PMID- 3506928 TI - Chlamydial conjunctivitis--an outbreak in neonatal ward. PMID- 3506929 TI - Oral ketoconazole in Keratomycosis. PMID- 3506930 TI - Exophoria and refractive errors-evaluation of 250 cases. PMID- 3506931 TI - Role of occlusion in treatment of intermittent exotropia. PMID- 3506932 TI - Intra orbital osteoma--a case report. PMID- 3506933 TI - Reversibility of diabetic maculopathy with sulindac--a case report. PMID- 3506934 TI - Further studies on the exposed germ-free dental pulp. PMID- 3506935 TI - Further studies on heat generation during obturation techniques involving thermally softened gutta-percha. PMID- 3506936 TI - The effect of Giromatic files on the preparation shape of severely curved canals. PMID- 3506937 TI - The response of the dental pulp to mechanical exposure in gnotobiotic rats mono infected with a strain of Streptococcus mutans. PMID- 3506938 TI - Pulp-capping studies with Analar calcium hydroxide and zinc oxide-eugenol. PMID- 3506939 TI - A comparison of the paralleling and bisecting-angle radiographic techniques in endodontics. PMID- 3506940 TI - Effect of calcium hydroxide treated dentine on pulpal responses. PMID- 3506941 TI - Vital pulpectomy and root filling with N2 or Endomethasone. PMID- 3506942 TI - [Research on a shape memory NiTi alloy. Orthodontic applications]. PMID- 3506943 TI - [Composite resins: relationship of surface state and bacterial adherence]. PMID- 3506944 TI - [Biological evaluation of dental products]. PMID- 3506945 TI - Urinary tract infections. PMID- 3506946 TI - [A study on the clinical use of Vitapex]. PMID- 3506947 TI - [Photoelastic study on stress distribution of the fixed partial dentures with various designed endosseous implants]. PMID- 3506948 TI - [A study on the F ion concentration of the drinking water in Chonnam mine area]. PMID- 3506950 TI - [Clinical evaluation of Famprofazone (Apagan, liquid type) in oral surgery]. PMID- 3506949 TI - [Comparative studies on the characteristics of new type polycarboxylate cements]. PMID- 3506951 TI - [A densitometric study of dental films]. PMID- 3506952 TI - [Case reports of Rieger's syndrome]. PMID- 3506953 TI - Autooxidative degradation of implanted polyether polyurethane devices. AB - While certain polyether polyurethanes have been shown to be biostable, undesirable interactions between polymer, the body environment and device can occur. For example, the corrosion products of metallic parts can cause relatively rapid autooxidation of polyether soft segments. This phenomenon was first demonstrated in our laboratories by immersing polyurethane test specimens in metal ion solutions of different oxidation potentials. Subsequently, the mechanism was reasonably duplicated by immersing Pellethane 2363-80A insulated cardiac pacing leads in 3%, 37 degrees C hydrogen peroxide. In vivo studies after 1 year show that corrosion products from pure Co and Fe produce the most rapid degradation of the polyurethane. PMID- 3506954 TI - Poly(ether) urethane reactivity with metal-ion in calcification and environmental stress cracking. AB - Since their introduction to the biomedical community in 1967, polyurethanes have been used in a number of biomedical applications. In chronic applications evidence is now available which suggests that polyurethanes may be subject to various cracking phenomena. Environmental stress cracking and calcification are two phenomena resulting in poly(ether)urethane cracking, which have been shown to be enhanced by ion complexation. Much evidence now exists which defines the ability of poly(ether)urethanes to selectively extract ions, especially calcium ion from solution. Metal ion binding appears to enhance environmental stress cracking and appears to be a first step in the process of calcification. PMID- 3506955 TI - The in vivo biodegradation of nylon 6 utilized in a particular IUD. AB - The particular IUD of this study was composed of a plastic shield and a nylon 6 coated filament tail string. This IUD was unique, in the fact that its tail string was the only one (and has been to date) that consisted of a coated multifilament arrangement. Studies on the tail string have revealed bacteria and debris existing between the outer filaments that are underneath the coating. Other studies have reported that removed devices were found to exhibit an unusually high incidence of breaks in the tail string coating. Studies at the University of Lowell also found that upon examination of devices that had been in vivo for periods of two years or longer, 67% of these devices examined had breaks in the coating of the tail string. Investigations have determined that the design of the tail string was serving as an avenue of transport for the bacteria to bypass the protective cervical mucus barrier and enter the sterile uterine cavity through the breaks in the tail string coating. This mechanism has been suggested to account for the higher frequency of uterine infections associated with this device. Research at the University of Lowell was undertaken to study the degradation of the nylon 6 coating and to determine the in vivo degradation mechanism. The biochemistry of the fluids present in the reproductive tract were carefully documented and the more aggressive ones selected for in vitro trials. The results of the study revealed that the in vivo physical breakdown of the coating may depend upon a series of mechanisms and variables. PMID- 3506956 TI - Inhibition of platelet adhesion to glow discharge modified surfaces. AB - Plasma glow technique has created much interest in the field of surface modification of polymers due to its versatility of generating active polar groups on the surface without affecting the bulk properties. Here an attempt is made to inter-relate the surface properties and platelet adhesion on various polymeric substrates due to plasma treatments. Initially, a critical review of the process and development of thrombosis upon contact of an artificial surface with blood, has been provided, which has been extended with the need for surface modifications to improve their blood compatibility and the versatility of plasma treatments for such modifications have been emphasized. Phospholipids like phosphoryl choline, phosphatidyl choline and phosphoryl ethanolamine were attached to Angioflex surface by plasma glow. The role of such modified substrates to interact with platelets were investigated using Tyrode washed calf platelets. It seems, glow discharge modified phosphoryl choline bilayers dramatically inhibited the platelet-surface binding, which may be due to their biochemical resemblance with thromboresistant surfaces of human blood cells. Further, the behaviour of all phospholipids towards bloodpolymer interaction is not similar and may change depending on the nature of their functional groups, net charge of the phospholipid adsorbed surface and their interaction with platelets and its activation. It is possible to chemically immobilize lipid bilayers on standard polymers, using plasma glow, to improve their biological performance; by suitably selecting the phospholipid combinations. PMID- 3506957 TI - Imaging techniques in perinatal medicine. PMID- 3506958 TI - Magnetic resonance imaging in pediatric diagnosis. PMID- 3506959 TI - Phosphorus nuclear magnetic resonance spectroscopy in neonatal disorders. PMID- 3506960 TI - Cardiac ultrasonography in the fetus and newborn. PMID- 3506961 TI - Digital radiography. PMID- 3506962 TI - [Research of condylar movements on protrusive and lateral jaw positions (3rd report)]. PMID- 3506963 TI - [The application of metal plating to acrylic denture base resin. The mechanical properties of metal plated to the ABS resin-coated acrylic denture base resin and the adhesive strength between metal plating and the ABS coated denture base resin]. PMID- 3506964 TI - [The buccal and lingual crown contours. Especially about the influence on food flow and the masticated food pressure on marginal gingiva]. PMID- 3506965 TI - [Reexamination of the precision during articulator handling. Part 2. Lateral displacement]. PMID- 3506966 TI - [Experimental studies on therapeutic mechanism of HV splint for temporomandibular disorders. I. Effects of wearing HV splint on TMJ]. PMID- 3506967 TI - [An experimental study of soft tissue reactions to methacrylate resin, hydroxyapatite and titanium alloy]. PMID- 3506968 TI - [The porcelain firing furnace, using infrared radiation heating elements. 2nd report. Reference to the shear bond strength of non-precious alloys]. PMID- 3506969 TI - [The effect of anterior crossbite on stomatognathic function]. PMID- 3506970 TI - [The porcelain firing furnace using infrared radiation heating elements. 3. Reference to the firing temperature and its distribution in the muffle]. PMID- 3506971 TI - [Clinical studies on the effect of molar cusps and inclinations on chewing movement]. PMID- 3506972 TI - [Dental symptoms in a child with Ehlers-Danlos syndrome]. PMID- 3506974 TI - [The patient decides]. PMID- 3506973 TI - [Psychotherapeutic treatment of extreme dental fear: a case study]. PMID- 3506975 TI - [Cariostatic effect of fluoride mouth rinsing in children with low socioeconomic status]. PMID- 3506976 TI - [A survey of variation and accuracy in radiographic caries diagnosis and treatment decision making]. PMID- 3506977 TI - [Some fundamentals of oral implantology]. PMID- 3506978 TI - [Pain in dental education: problem orientation]. PMID- 3506979 TI - [A clinical development in oral surgery during the past decade]. PMID- 3506980 TI - [Incidence of cleft lip and palate in the Netherlands]. PMID- 3506981 TI - [Tasks of the dental hygienist in general practice]. PMID- 3506983 TI - [Students' opinion on a curricular personalized system of instruction]. PMID- 3506982 TI - [Politics and health care]. PMID- 3506984 TI - [Dento-maxillofacial radiology: developments for the dental practice]. PMID- 3506985 TI - [Positive and negative properties of zinc oxide-eugenol]. PMID- 3506986 TI - [The effects of dental insurance on the utilization of dental services]. PMID- 3506987 TI - [Radiographical versus clinical diagnosis in a caries prevalence study in 14-year old children]. PMID- 3506988 TI - [Behavior of dentists and children during dental treatment]. PMID- 3506989 TI - [Reflections with regard to the 'willingness to change': report of the Dekker Committee reviewed]. PMID- 3506990 TI - [ASPOC, a management support system for dental clinical teaching]. PMID- 3506991 TI - [Cephalometric values using the Bjork analysis of white Brazilian adolescents with normal occlusion]. PMID- 3506992 TI - [Cephalometry--biotype--vertical and horizontal growth in the mental region]. PMID- 3506993 TI - [Comparative study of the P-NB measurement in white Brazilian adolescents of Mediterranean origin with normal occlusion, and with orthodontically treated malocclusion (Class I and Class II, Division 1)]. PMID- 3506994 TI - [A cephalometric evaluation of dento-skeletal structures of young Class II, division 1 Brazilian white patients of Mediterranean origin]. PMID- 3506996 TI - Microleakage of restorative materials. PMID- 3506995 TI - [Facial esthetics in white Brazilian adolescents with normal occlusion, using the Burstone analysis]. PMID- 3506997 TI - Biocompatibility of dental materials in the absence of bacterial infection. PMID- 3506998 TI - When is microleakage a real clinical problem? PMID- 3506999 TI - Infection beneath composite resin restorations: can it be avoided? PMID- 3507000 TI - Model systems for determining biologic effects of microleakage. PMID- 3507001 TI - Nutritional evaluation of pigeon pea meal. AB - Mineral, amino acid and fatty acid composition of pigeon pea meal were determined by analysis, while with chick essays, availability (true digestibility) of minerals and amino acids in the meal were estimated. Gross energy, metabolizable energy and true protein digestibility experiments were also conducted. Pigeon pea meal had a very high content of potassium, high content of potassium, high content of phosphorus, moderate content of calcium and magnesium and low content of iron, zinc, copper and manganese. Average availability of minerals was 58.09%. Amino acid content was low, especially cystine and methionine. Amino acid availability was 82.32%, lower than amino acid availability of soybean meal (greater than 90%). Pigeon pea lipids were predominantly saturated fatty acids (69.04%) with low content of unsaturated fatty acids (30.69%) and a total absence of linolenic acid. Metabolizable energy content (N-corrected) was 11.08 MJ/kg in raw pigeon pea and 12.03 MJ/kg in toasted pigeon pea meal. PMID- 3507002 TI - Effect of blanching and drying methods on the nutritional and sensory quality of leafy vegetables. AB - The nutrient retention and sensory quality factors of vegetables blanched by two methods and solar-dried or dried in the cabinet dryer were evaluated. The type and conditions of the blanching treatment prior to drying affect the retention of ascorbic acid, carotene, and ash in the dried vegetables. The sun-dried vegetables had inferior colour, texture and acceptibility compared to the vegetables dried in the cabinet dryer. There were significant differences in the rehydration and drying ratio of the dried vegetables. The implications of the blanching and drying processes for an effective preservation technique are discussed. PMID- 3507003 TI - Lipids of high-yielding varieties of cashew (Anacardium occidentale L.). AB - Cashew kernel lipids from high-yielding varieties have been characterised. Neutral lipid accounted for 96% while glycolipid and phospholipid accounted for the remaining 4%. Triglycerides were very rich in unsaturated fatty acids (oleic and linoleic) while glycolipids were rich in saturated fatty acids (lauric and myristic). Varietal difference was noticed with respect to the composition of neutral and glycolipids. Composition of phospholipid did not differ among high yielding varieties. PMID- 3507004 TI - Nutritional responses of rats fed mixtures of plant and animal proteins. AB - Twenty four male rats (45-65 g) were used to determine the nutritional responses to mixed plant and animal protein diets. Rats were fed various mixtures of sorghum (S), pigeon pea (PP), bread fruit (TAP) plus crayfish (CR) to provide 1.6 g N/100 g of daily diet for a 35-day study period. Three different diets were fed to 6 rats assigned to each diet on the basis of body weight. Combination of PP:CR caused increases in N intake and retention, weight gain, and PER higher than for those of the other test groups. Its values for N intake and retention, and BV were higher than for those of the control except for food intake, NPU, weight gain and PER. Substitution of CR (20%) with TAP and PP as supplements to S decreased food intake, weight gain and PER and increased N intake, digested and retained N, NPU and BV. The results appear to indicate that (a) PP:CR blend was better than other blends as judged by the parameters, and (b) TAP and PP were superior to CR alone as supplement to S. PMID- 3507005 TI - Varietal and environmental effect on the glycoalkaloid content of potato (Solanum tuberosum L.). AB - The tubers of 14 potato varieties were analysed for glycoalkaloids. The level of glycoalkaloids in tubers of all the varieties analysed are within the safe limits for human consumption. The peels of tuber contained about 60-70% of the total glycoalkaloids present in the whole tuber. The levels of glycoalkaloids in leaves and tubers were correlated (r = 0.865). There was a significant increase in the content of glycoalkaloids in peels of tubers exposed to sunlight. Glycoalkaloid contents increased at the rate of 1.9 mg/100 g fresh weight per day in peels of "Kufri Jyoti" tubers exposed to diffused sunlight. PMID- 3507006 TI - Long-term consumption of beef extended with soy protein by men, women and children: I. Study design, nutrient intakes, and serum zinc levels. AB - The effect of long-term consumption, under practical conditions, of beef extended with soy protein on serum zinc levels of men, women and children was studied. Fifty-two families were randomly assigned to consume for 180 days 1 of 7 beef products: all beef, beef extended with either soy isolate, soy concentrate or soy flour (20% reconstituted soy product, 80% beef), or beef extended with each of the 3 soy products fortified with 60 mg Fe and 25 mg Zn/100 g protein. The beef product was consumed by the subjects as their principal source of protein for 1 meal a day (children 1-8 yrs) or 1-2 meals a day (11 per week) for adult men and women. A control group consumed their usual self-selected diet. Diet records (4 day) of all foods and beverages consumed by the subjects were obtained pre-study and 63 +/- 7 and 126 +/- 7 days for calculation of nutrient intakes. No deleterious effects were found on the serum zinc levels when subjects consumed beef extended with soy protein for 180 days. PMID- 3507007 TI - Long-term consumption of beef extended with soy protein by men, women and children: II. Effects on iron status. AB - The iron status of men, women and children consuming beef extended with soy protein was evaluated by measuring serum ferritin and clinical parameters of iron status during a six-month study. Fifty-two families (245 participants) were randomly assigned to consume, for 180 days, 1 of 7 beef products: all beef, beef extended with either soy isolate, soy concentrate or soy flour (20% reconstituted soy product, 80% beef), or beef extended with each of the three soy products fortified with 60 mg Fe and 25 mg Zn/100 g protein. The beef product was consumed by the subjects as their principal source of protein for 1 meal a day (children 1 18 yr) or 1-2 meals a day (11 per week; adult men and women). A control group consumed their usual self-selected diets. No evidence was found that consumption of beef extended with soy protein deleteriously affected the iron status of men, women or children. Consumption of beef extended with soy protein, at the levels used in this study, by military men and women and by school lunch participants would not appear to impose a risk in these population groups. PMID- 3507009 TI - [Solitary keratoacanthoma of the oral mucosa]. PMID- 3507010 TI - [Three-dimensional focus in space maintenance]. PMID- 3507008 TI - Long-term consumption of beef extended with soy protein by children, women and men: III. Iron absorption by adult men. AB - Forty-nine ostensibly healthy men consumed either patties of all-beef or beef extended with soy-isolate, -concentrate or -flour as the principal protein source in 1 to 2 meals daily for 180 days. Iron status was monitored by absorption of radioiron from a reference dose of ferrous ascorbate and by serum ferritin concentration. In addition, nonheme iron absorption from a test meal of the respective beef pattie consumed for the 180 days was estimated by the extrinsic tag procedure. There was no detrimental effect on iron stores as indexed by reference ferrous ascorbate absorption or serum ferritin concentration. Absorption of nonheme iron from the test meals was low except for individuals having indices of low iron stores. When adjusted for the effect of level of iron stores the relative absorption of nonheme iron from soy-isolate and -flour containing meals was greater than from the all-beef meal, indicating marked differences in the effect on iron absorption by different soy products. Consumption of soy-extended beef should have no detrimental effect on iron status of adult men if consumed in mixed diets at the level used in this study. PMID- 3507011 TI - [Relative growth of condylar cartilage of mandible heads in rats with altered occlusion]. PMID- 3507012 TI - [Hypophosphatasia--premature loss of deciduous teeth]. PMID- 3507013 TI - [Cholinergic stimulation of the LHA: evaluation of temporary changes in renal excretion of water, sodium and potassium]. PMID- 3507014 TI - A study of ocular prostheses. I. Manufacture and indications for use. PMID- 3507015 TI - [Renal excretion of water, sodium and potassium in rats with an overload of aqueous barbatimao (stryphnodendron obovatum) bark. Preliminary results]. PMID- 3507016 TI - [Electrophoresis of coronary vasodilators]. PMID- 3507017 TI - [Morphological changes in the rat submandibular gland after sectioning of the chorda tympani nerve. Observations after a year]. PMID- 3507018 TI - [Scanning electron microscopy study of the surface of compact bone of the external face of the mandibular ramus in rats]. PMID- 3507019 TI - [Role of the hippocampus in feeding behavior elicited by electric stimulation of the lateral hypothalamus]. PMID- 3507020 TI - [Cervical adaptation of pre-fabricated stainless steel crowns--clinical study]. PMID- 3507021 TI - [Morphometric study of condylar cartilage of mandible heads in rats with altered occlusions]. PMID- 3507022 TI - Evaluation of the density of the mouse submandibular gland by the method of Scherle. PMID- 3507023 TI - [Effects of extract of dried leaves of Jambolao (Syzygium Jambolanum) on renal excretion of water, sodium and potassium in rats. Preliminary results]. PMID- 3507024 TI - [Protein content of the submandibular gland in aging rats]. PMID- 3507025 TI - [Evaluation of consumption of medications following a pharmacology class, Araraquara, S.P.--1985]. PMID- 3507026 TI - [Morphological changes in the submandibular gland in aging rats]. PMID- 3507027 TI - [Histometry of age-induced structural changes in the adrenal of rats]. PMID- 3507028 TI - [Morphological and morphometric study of changes in the rat submandibular gland caused by sectioning of the chorda lingual nerve]. PMID- 3507029 TI - [Tests to determine caries activity]. PMID- 3507030 TI - [First evidence for mineralization of third molars]. PMID- 3507031 TI - [Lateral condensation versus McSpaden technic. Evaluation of apical marginal infiltration "in vitro"]. PMID- 3507032 TI - [Ni-Cr alloys and stainless steel alloys containing niobium. Micrographic study and surface hardness]. PMID- 3507033 TI - [Cavity preparation for fractured anterior teeth. Comparison and clinical evaluation of 2 types of cavity preparation]. PMID- 3507034 TI - [New device for precise registration of centric relation]. PMID- 3507036 TI - [Ectopic premolar. Retained in the mandibular base]. PMID- 3507035 TI - [Peripheral ossifying fibroma]. PMID- 3507037 TI - [Survey of oral lesions]. PMID- 3507038 TI - [Frequency of Baume type I and II arches and the primate space in children with terminal relation of the second deciduous molars in the vertical plane and mesial degree]. PMID- 3507039 TI - [Correlation of the DMF-S index with the age of the child]. PMID- 3507040 TI - [Polishing of dental amalgam. Effect of polishing and type of alloy]. PMID- 3507041 TI - [The action of the extract of submandibular salivary glands of mice on the activity of some enzymes in the salivary glands, liver and blood serum of rats]. PMID- 3507042 TI - [Postoperative nutrition of patients with maxillofacial pathology]. PMID- 3507043 TI - [Application of intravenous anesthesia in surgical stomatological practice]. PMID- 3507044 TI - [Mathematical analysis of correlation between tightness of occlusal contacts and anatomic localization of the teeth]. PMID- 3507046 TI - [Our experience in organization of premises for hygiene of oral cavity]. PMID- 3507045 TI - [The information of the nurses on the problems of stomatological prophylaxis]. PMID- 3507047 TI - [Sutton aphthae with the contribution of one case]. PMID- 3507048 TI - [A case of self-injury in the maxillofacial region aimed at a change in serving a term of imprisonment]. PMID- 3507049 TI - [Standard plastic matrix for clinical working out of Schwartz cap]. PMID- 3507050 TI - [The role of fasigyn in the complex therapy of periodontosis in a patient with chronic hepatitis and cirrhosis of liver]. PMID- 3507051 TI - [Changes in hydrogen-ion concentration of saliva in aphthous stomatitis]. PMID- 3507052 TI - [Electroacupuncture analgesia in surgical stomatology (preliminary communication)]. PMID- 3507053 TI - [Actual problems in selection of indices for evaluation of the oral-hygienic and periodontal status]. PMID- 3507054 TI - [The role of connective tissue as a terrain for development of odontogenic foci]. PMID- 3507055 TI - [Allergic reactivity to local anesthetics determined by scratch-test and by prick test]. PMID- 3507057 TI - [Diagnostic methods in the disease of lymphatic system in the maxillofacial region of the neck]. PMID- 3507056 TI - [Comparative study on the antibacterial and antiphlogistic action of a new pharmaceutical in the treatment of dental pulp diseases]. PMID- 3507058 TI - [Treatment of rheumatoid arthritis of the temporomandibular joint by electrophoresis with Pomorie lye]. PMID- 3507059 TI - [Clinical-statistical analysis of the diseases of the salivary glands according to material of the chair of surgical stomatology and maxillofacial surgery at the stomatological faculty]. PMID- 3507060 TI - [Analysis of occlusal contacts of bridge prostheses]. PMID- 3507061 TI - [Precious stomatological alloy with reduced gold content. I. Laboratory and clinical studies]. PMID- 3507062 TI - [Stomatological information system--possibilities of construction the basic microcomputer techniques]. PMID- 3507063 TI - [Study on the distribution of stomatological posts in P. R. Bulgaria]. PMID- 3507064 TI - [Dental dysplasias in children with a past rickets history]. PMID- 3507066 TI - [A case of traumatic penetration of alien body in the maxillofacial region]. PMID- 3507065 TI - [Hematogenic osteomyelitis in a child involving the right shoulder bone and lower jaw]. PMID- 3507067 TI - [Possibilities of using Tonn method in the treatment of patients with supernumerary teeth]. PMID- 3507068 TI - [Some epidemiological and clinical-etiological studies on exfoliative marginal glossitis (geographic tongue) in childhood]. PMID- 3507069 TI - [Some problems of odontogenic cystic formations in the maxillofacial region]. PMID- 3507070 TI - [Peroral administration of metronidazole (trichomonacid) in the stomatological practice]. PMID- 3507071 TI - [Application and laboratory technology of base cobalt-chromium and nickel chromium stomatological alloys. I. Composition, structural characteristics and corrosion behavior]. PMID- 3507072 TI - [Experimental study on the pharmaceutical BAW F, used in the treatment of inflammatory diseases of periodontium]. PMID- 3507073 TI - [Comparative clinical results in the treatment of gingivitis catarrhalis in childhood with the pharmaceuticals BAW-F, Phytodont, Polyminerol]. PMID- 3507074 TI - [Linear velocities of dissolution of the superficial enamel layers and distribution of calcium and phosphorus in them]. PMID- 3507075 TI - [Focal sanation effect of two-seance Indextol filling in chronic diffuse periodontitis]. PMID- 3507076 TI - [Symmetry and asymmetry of the lower jaw joint in orthopantomography]. PMID- 3507077 TI - [Experimental restoration of the fenestrated anterior wall of the maxillary sinus]. PMID- 3507078 TI - [The inclination of teeth in premature loss of milk teeth and effect of some space-keepers]. PMID- 3507079 TI - [Functional characteristics of the management of stomatological attendance as information process]. PMID- 3507080 TI - [Complex treatment of dental abrasion via rational methods--model casting and Adapta]. PMID- 3507081 TI - [Application and laboratory technology of cobalt-chromium and nickel-chromium stomatological alloys. II. Biochemical properties and laboratory technology]. PMID- 3507082 TI - [Histological and histochemical investigations in an experimental model for complex mineral prophylaxis of caries]. PMID- 3507083 TI - [Possibilities of diagnosis of odontogenic foci--progress and new aspects]. PMID- 3507084 TI - [Extraoral apparatuses--principles of their construction, action and treatment of some dental-jaw deformities]. PMID- 3507085 TI - [Determination of pulse rate and the values of designing test "draw a man" as a criterion for the diagnosis of fear in children during stomatologic treatment]. PMID- 3507086 TI - [Our experience in combined traumas of the maxillofacial region]. PMID- 3507087 TI - [The problem of submucosal resection of the nasal septum at the present stage of corrective septoplastics development]. PMID- 3507088 TI - [Morphological and biochemical changes in pavement cellular cancer in the oral cavity (preliminary communication)]. PMID- 3507089 TI - [Noble stomatological alloy with reduced gold content--histo-biological studies (Part II)]. PMID- 3507090 TI - [Effect of premature loss of milk teeth and of some space-keepers on the number of occlusal contacts]. PMID- 3507091 TI - [Disturbances in the eruption of the upper permanent incisors. III. Surgical interventions]. PMID- 3507092 TI - [Scientific standardization of labor during production of removable dental prosthetic construction at the dental mechanic laboratories]. PMID- 3507094 TI - [Results from the planned treatment of dental caries in sailors from Shipping Company BMF-Varna of a brigade base for the period 1978-1985]. PMID- 3507093 TI - [Indices for assessment of the oral health state and contribution to the complete stomatological activity for its optimization]. PMID- 3507095 TI - [The problem of teeth alterations in osteogenesis imperfecta]. PMID- 3507096 TI - [Plaque-prosthetic index]. PMID- 3507097 TI - [Our experience in the treatment of acute aphthous stomatitis in workers exposed to occupational noxae]. PMID- 3507098 TI - [Scanning electron microscopy of dental enamel after irradiation with YAG neodymium laser]. PMID- 3507099 TI - [Lymphoscintigraphic study of maxillofacial region and neck]. PMID- 3507100 TI - [Correction of blepharochalasis in 170 patients]. PMID- 3507101 TI - [Treatment of bruxism and bruxomania by vestibular stops]. PMID- 3507102 TI - [Shapes and horizontal size of rima oris in smiles]. PMID- 3507104 TI - [Disturbances in the cutting of the upper permanent incisors. IV. Results from the therapeutic-prophylactic measures]. PMID- 3507103 TI - [Method for determination of interocclusal distance]. PMID- 3507105 TI - [Model for organization of stomatological prophylactic consulting room]. PMID- 3507106 TI - [Oral hygiene and the state of gingiva in stomatology students]. PMID- 3507107 TI - [Autosomal-dominant hypoplastic form of amelogenesis imperfecta]. PMID- 3507109 TI - [Permanent ligature of splinting in the treatment of lower jaw fractures]. PMID- 3507108 TI - [Our experience with the application of the biological tissue adhesive "Kanokonlit B" in the treatment of traumatic pulpitis of permanent frontal teeth]. PMID- 3507110 TI - [Significance of exogenous factors for origination of diseases of oral cavity mucosa and periodontium among pupils]. PMID- 3507111 TI - [Quantitative determination of aldehyde diffusion from some canal-filling agents]. PMID- 3507112 TI - [The etiological factors and localization of the lower jaw fractures for the period 1980-1985]. PMID- 3507113 TI - [Implants in prosthodontics]. PMID- 3507114 TI - [Knowledge of the population, at an active age in our country, about stomatological health (pilot study)]. PMID- 3507115 TI - [The reasons for stomatological personnel shift among the districts]. PMID- 3507116 TI - [Scanning electron microscopy of enamel surface before and after fluoric gel treatment]. PMID- 3507117 TI - [A case of allergic reaction during devitalization of dental pulp with Caustinerf Rapide]. PMID- 3507118 TI - [A case with big osteoma in the frontal sinus]. PMID- 3507119 TI - [Analgesia methods in out-patient department stomatological practice]. PMID- 3507120 TI - The radiographic and histologic appearance of controlled surgical manipulation of the equine periosteum. AB - This study documented the normal histologic features of the equine metacarpal and metatarsal periosteum and characterized its osteogenic response to surgical manipulation. Two periosteal flaps were elevated from the dorsomedial matacarpal and metatarsal diaphysis in each of three limbs of four yearling and four adult lightbreed horses. The superficial metacarpal cortex under the flap was resected with a bone chisel in one-half of the horses and was undisturbed in the remainder. One periosteal flap in each limb was excised and the other flap was replaced and secured by sutures. All limbs in the horses were radiographed at regular intervals postoperatively. Horses were killed either 30 or 120 days after surgery. Periosteal bone production occurred only at treatment sites of young horses treated by periosteal flap replacement and was limited to approximately 50% of these sites, as determined by radiography and microradiography. Cortical abrasion resulted in an increased incidence of bone production in the periosteum adjacent to the flap perimeter. The histologic features of the periosteum were similar to those reported in other species; young horses had active osteogenesis referable to appositional growth and adults had an inactive periosteum. Histologically, osteogenesis induced by surgery resembled accentuated appositional growth in both yearlings and adults. In the horse, the cambial (osteogenic) layer is included in sharply elevated periosteal flaps. It should be removed in surgical procedures where bone production is to be avoided, and preserved where osteogenesis is desired. PMID- 3507121 TI - Lameness associated with coxofemoral soft tissue masses in six dogs. AB - Six cases of mechanical lameness involving the coxofemoral joint are presented. All dogs had a history of chronic rear leg pain and lameness, and decreased range of motion of the hip. On physical examination, ventral subluxation of the coxofemoral joint during extension was present in three dogs. A radiographic diagnosis of subluxation was made in five dogs. In each dog, surgical exploration of the area caudal to the coxofemoral joint revealed a fibrous mass between the lesser or third trochanters and the ischium, diagnosed as a nonneoplastic fibrous reaction by microscopic examination. The clinical, radiographic, and histopathologic signs were similar to previously described cases of myositis ossificans. Five dogs returned to normal function after excision of the soft tissue mass, and one dog was normal when lost to follow-up 4 weeks postoperatively. PMID- 3507122 TI - Scalpel blade contamination with skin bacteria during orthopedic and neurosurgical procedures in dogs. AB - Skin incision and internal incision scalpel blades used during 40 clean canine orthopedic or neurologic operations were cultured. A biopsy of skin was taken from the incision edge and cultured aerobically and anaerobically. Culture of five skin blades, eight skin biopsies, and nine deep dissection blades resulted in bacterial growth. Results indicate that the skin blade does not add significantly to bacterial inoculum contaminating clean wounds. PMID- 3507123 TI - Clinical results of surgical correction of medial luxation of the patella in dogs. AB - Thirty-four dogs that had surgical correction of medial patellar luxation (MPL) in 52 stifle joints were examined after a minimum follow-up period of 1 year (median, 3.6 years). The dogs were divided into the following three groups depending on their age at the time of surgery: group 1, 3 to 6 months; group 2, 8 to 20 months; and group 3, 2.2 to 12 years. Two of the dogs in group 3 had ruptured their cranial cruciate ligament in addition to having MPL. The results were based on a clinical assessment of the animal's gait, and physical and radiographic examination of the stifle joints. Six of seven stifle joints evaluated in group 1 had radiographic evidence of moderate to severe degenerative joint disease of the patellofemoral joint, and in two of the joints recurrence of MPL was observed. Failure to maintain reduction of the patellofemoral joint was also observed in 11 of 22 (50%) and 12 of 23 (52%) of the stifle joints in groups 2 and 3, respectively. In the latter groups, mild degenerative joint disease was evident radiographically in stifle joint that had not maintained reduction. Four of the 34 dogs were consistently (n = 2) or intermittently (n = 2) lame; the two dogs that were consistently lame had cranial instability of the stifle consistent with rupture of the cranial cruciate ligament. In the latter two dogs, the cranial cruciate ligament had been intact at the time of surgery for correction of MPL. PMID- 3507124 TI - Diagnostic and surgical arthroscopy of the equine shoulder joint. AB - An arthroscopic technique for examination and surgical treatment of conditions of the shoulder joint was evaluated in eight normal horses and two horses with osteochondrosis lesions. A single arthroscope entry point caudal to the infraspinatus tendon allowed inspection of the cranial, lateral, and caudal surfaces of the shoulder joint. With the humeral head and glenoid cavity distracted by a curved forceps, the entire cartilage surface of the shoulder could be examined. The caudomedial portion of the humeral head was seen better with a 70 degree angled arthroscope. Instruments for intra-articular manipulation were introduced through a separate skin incision 2 to 4 cm caudal to the arthroscope entry point. Two horses with osteochondrosis lesions of the shoulder were examined arthroscopically and debrided with instrument triangulation. Five normal horses and both horses with osteochondrosis lesions were euthanized immediately after the procedure and a necropsy was performed. Minor iatrogenic damage to the cartilage surfaces and joint capsule resulted from the technique. Three horses recovered from anesthesia and were killed 3, 30, or 60 days after surgery. Subcutaneous fluid that accumulated during surgery had resorbed by 3 days and lameness was evident for 12 to 24 hours. Gross examination and histopathologic findings of specimens collected at 30 and 60 days showed several small nonhealing partial-thickness cartilage defects attributed to instrument insertion. Arthroscopy is a satisfactory method to examine the joint surfaces and to evaluate and treat osteochondrosis lesions of the shoulder joint in horses. PMID- 3507125 TI - Fractures of the calcaneus in racing greyhounds. AB - Fifty-one calcaneus fractures associated with (41) or without (10) central tarsal bone (Tc) fractures in racing greyhounds were evaluated and categorized. All calcaneal fractures with no Tc fractures had a plantar proximal intertarsal subluxation. No subluxations were found in dogs with both calcaneal and central tarsal fractures. The calcaneal fractures were treated either with coaptation splints or surgical repair. Surgical techniques included a Steinmann pin with a figure eight tension band device or screw or plate fixation as primary techniques supplemented by Kirschner wires and cerclage wires. In all calcaneal fractures associated with plantar proximal intertarsal subluxation, an arthrodesis of the calcaneoquartal joint was performed. All 22 surgically repaired fractures in dogs available for physical and radiographic reexamination had healed within 1 to 6 months. Eight dogs with fractures of the calcaneus associated with fractures of Tc returned to a racing career. None of the dogs with plantar proximal intertarsal subluxation raced again. Based on the orientation of the fracture lines and on dissection of two tarsi with calcaneal fractures, a hypothesis on the pathogenesis of calcaneal fractures in racing greyhounds was formulated. PMID- 3507126 TI - Accessory carpal bone fractures in the racing greyhound. Classification and pathology. AB - Fractures of the accessory carpal bone in 35 racing Greyhounds were classified into five types. Type I fractures (27 fractures) involved the distal articular surface of the accessory carpal bone, type II (6 fractures) were of the proximal articular margin, type III (1 fracture) were at the origin of the accessorometacarpal ligaments, type IV (6 fractures) were avulsion fractures at the tendon of insertion of the flexor carpi ulnaris muscle, and type V (3 fractures) were comminuted fractures. PMID- 3507128 TI - American College of Veterinary Surgeons, 22nd annual meeting. February 1987. Abstracts. PMID- 3507127 TI - Radiographic and histologic changes after thoracolumbar disc curettage. AB - Forty-eight thoracolumbar disc spaces were approached by a dorsolateral muscle separating technique in six mature dogs. Twenty-four of the discs were fenestrated and curetted, and the changes were followed radiographically and histologically for 16 weeks. Disc space collapse was visible radiographically immediately after the surgical procedure, and those disc spaces remained narrow throughout the observation period. Histologically, there was evidence of chondrocyte activation within 2 weeks in the excavated disc spaces. By 16 weeks, fibrocartilage had filled the void in the curetted disc spaces. PMID- 3507130 TI - In vitro strength of the suspensory apparatus in training and resting horses. AB - Forty-eight limbs of 12 freshly euthanized horses were used to generate data on the strength of the equine suspensory apparatus. The point of failure of the suspensory apparatus of each limb was determined. Immediately before euthanasia, 6 of the 12 horses (thoroughbreds and standardbreds) had been engaged in active training or racing, and six horses in stall and/or pasture activity. In the actively training or racing horses, the point of acute failure of the suspensory apparatus was within the proximal sesamoid bones in 20 (83%) limbs (resulting in 17 apical fractures, 2 basilar fractures, and 1 midbody fracture). In the pasture exercised or stalled horses, the point of failure of the suspensory apparatus was either acutely within the suspensory ligament (10 horses, 42%) or, if no acute failure occurred, insidiously within the suspensory ligament (12 horses, 50%). Active training appeared to have a strengthening effect on the suspensory ligament, causing the weakest point in the suspensory apparatus to become the sesamoid bones rather than the suspensory ligament. An average force of 1338 kg (between 1082 and 1673 kg) was needed to fail the suspensory apparatus in this group of horses. In nontraining horses, the site of failure was most often the suspensory ligament. An average force of 1100 kg (between 918 and 1241 kg) used to fail the suspensory apparatus in this group of horses was significantly (p less than 0.5) less than in the first group. PMID- 3507129 TI - Rectal resection in the dog. A new surgical approach and the evaluation of its effect on fecal continence. AB - Thirteen healthy mixed breed dogs (6 female and 7 male) underwent rectal transection and resection of 0 to 6 cm using a dorsal approach. Rectoanal sphincter pressure studies were performed preoperatively and 6 weeks after surgery using a double balloon manometer device. Sphincter pressure profiles were altered in the 6 cm resection dogs. Clinical observations of defecation and degree of continence were made over a 10 week period postoperatively. The transection only and 4 cm resection dogs defecated normally. All dogs in the 6 cm resection group involving the peritoneal reflection were incontinent but retained some normal posturing behavior. Surgical complications included minor infection in two dogs, rectocutaneous fecal leakage in four dogs, breakdown of the anastomotic site in four dogs, and incontinence in all of the dogs that underwent 6 cm resections. Barium enemas were performed on the rectums postmortem to ascertain the degree of stricturing induced by the surgery. The index of stenosis measured did not correlate well with the extent of straining in each group. Histopathologic findings on dogs in the transection only and 4 cm resection groups without dehiscence showed mild granulomatous proctitis with normal myenteric plexi seen. Dogs suffering dehiscence had suppurative proctitis, necrosis, and obliteration of the myenteric plexi. PMID- 3507131 TI - The treatment of chronic sinusitis in six cats by ethmoid conchal curettage and autogenous fat graft sinus ablation. AB - Six cats with chronic recurrent rhinitis and frontal sinusitis were treated by surgical ablation of their frontal sinuses by the implantation of autogenous fat grafts and curettage of the remaining ethmoid conchae. Deep nasal bacterial cultures and skull radiographs were performed before surgery. Excellent results were achieved in four of six cats and there was significant improvement in two of six cats. Median follow-up time was 15 months. Subcutaneous emphysema over the temporal area was managed by needle aspiration and bandaging. Frontal sinus ablation with autogenous fat graft in combination with ethmoid conchal curettage appears to be an effective treatment for chronic sinusitis in cats. PMID- 3507132 TI - Conservative versus surgical management of gastrointestinal linear foreign bodies in the cat. AB - Twenty-four cases of gastrointestinal linear foreign bodies (LFB) in cats were reviewed. Nine cats were successfully managed conservatively, with passage of the LFB occurring 1 to 3 days after presentation. Ten cats that were initially managed conservatively were subsequently treated surgically. The decision to operate was based on worsening of clinical signs and failure to pass the LFB. Five cats were initially treated surgically. The cats that were managed successfully via conservative treatment had a shorter duration of clinical signs before presentation, decreased incidence of abdominal pain and palpable intestinal plication, and less severe hematologic abnormalities. Radiographic signs were of little benefit in deciding whether to treat the cats conservatively or surgically. None of the cats died. PMID- 3507133 TI - Proximal urethral reconstruction using a distally based ventral bladder tube flap. An experimental study. AB - Reconstruction of the proximal urethra using a distally based tube flap mobilized from the ventral bladder wall was performed on 12 clinically normal dogs after total prostatectomy and resection of 2 cm of membranous urethra. One dog was euthanized at 6 hours and one at 36 hours after surgery because of surgical complications. Five dogs were euthanized at 10 days, two dogs at 6 weeks and three dogs at 12 weeks. Advancement of the tube flap allowed for tension-free anastomosis to the membranous urethra. Vascular integrity was maintained in all flaps. Intermittent to continuous postoperative urinary incontinence occurred in 7 of 10 dogs. The incontinence was transient in all 6 and 12 week dogs except one in which a persistent stress incontinence developed. Mild to severe dysuria was noted in 8 of 10 dogs, but was also transient in all of the 6 and 12 week dogs, with the exception of one dog. Postoperative urethral closure pressure profilometry revealed decreased tone in the membranous urethra in all 6 and 12 week dogs. It was concluded that proximal urethral reconstruction, using a ventral bladder tube flap, is a viable technique that may permit functional urodynamic recovery in dogs with significant proximal urethral loss. PMID- 3507134 TI - Evaluation of experimental transection and partial excision of the caudal cruciate ligament in dogs. AB - The caudal cruciate ligament (CaCL) of one stifle joint in seven dogs was transected and a 2 to 4 mm section was removed. Six months after surgery, none of the dogs were lame. Thigh muscle circumference, stifle range of motion, and internal tibial rotation in the operated limb were not significantly different from the preoperative measurements or the contralateral, unoperated limb. A caudal drawer motion was consistently present in the stifle joints with a transected CaCL. A radiographic evaluation of the operated stifle joints did not reveal osteoarthritic changes; four of seven stifle joints had an irregular fat pad 6 months after surgery. Results of a joint fluid analysis revealed a slight increase in synovial cells within treated stifle joints; inflammatory cells were not observed. The only gross morphologic change in stifle joints with a severed ligament was enlarged knobby remnants of the CaCL. Articular cartilage defects or osteophytes were not observed. Results of a histologic examination of the CaCL remnants revealed synovial cellular capping and intraligamentous fibroplasia. Based on a limited number of dogs, it was concluded that isolated transection of the CaCL produced minimal clinical and pathologic changes in the stifle joint during a 6 month period. PMID- 3507136 TI - Repair of a traumatically induced oronasal fistula in a cat with a rostral tongue flap. AB - Repair of an extensive oronasal fistula in a cat was accomplished by the use of a tongue flap. The dorsal surface of the tongue was debrided of mucosa and the edges were trimmed to produce a bleeding surface. Rotation of the tongue 180 degrees upon its long axis allowed the debrided surface to be sutured in apposition with the palatine mucosa. The mouth was wired closed and the cat was fed blenderized canned cat food for 4 weeks through a pharyngostomy tube. The tongue pedicle was amputated in successive stages to stimulate collateral circulation. Complications included a partial dehiscence along one edge of the suture line, which was corrected by resuturing. PMID- 3507135 TI - Use of a vascular skeletal muscle graft for canine esophageal reconstruction. AB - A technique for reconstruction of the thoracic esophagus was evaluated in 13 dogs. A 9 x 10 cm section of transversus abdominis muscle was harvested, fashioned into a tubular graft, and vascularized via the greater omentum. The vascularized tube was advanced into the caudal thorax through the diaphragm at a second surgery 20 to 44 days after harvesting the section of the transversus abdominis muscle. A 5 cm section of caudal thoracic esophagus was replaced with the vascular tubular graft. One dog died because of incarceration of the intestine within the tube and two dogs were euthanized because of infected tubes. One dog died due to an anesthetic complication, one dog had a diaphragmatic hernia and died, and one dog died from pyothorax. Leakage of luminal contents at the anastomoses did not occur in any dog. Seven dogs survived both surgeries but showed deglutitory difficulty 6 days postoperatively due to the grafted esophageal segments becoming severely strictured in each case. Angiography demonstrated vascularization of the full thickness of the graft in each of the seven dogs. An unacceptably high incidence of infection and stricture formation made this technique unsuitable for clinical use. PMID- 3507137 TI - Research training of surgical residents as studied from the Resident's Forum. AB - Participants in the Resident's Forum were surveyed to gain an appreciation of their impression of their research training. The vast majority believed that adequate resources and supervision had been available for their research. The resident generally was the principal investigator, the primary writer of the grant to fund the study, and developed the experimental design. Supervision was usually by a diplomate who took an active role in the project. Projects were funded by several different sources for widely varying amounts. The most common duration of the studies was more than 4 months, and most residents conducted at least one other study during their residency. Ninety per cent stated that the study and its presentation at the Resident's Forum increased their enthusiasm for research, in contrast to the less than one half who, at the start of their residency, were planning on doing research during their career. PMID- 3507138 TI - High frequency ventilation: a review. PMID- 3507139 TI - Isoflurane anesthesia for equine colic surgery. Comparison with halothane anesthesia. AB - Isoflurane was compared with halothane as an anesthetic agent for emergency colic surgery in a series of 38 juvenile and adult horses. After presurgical stabilization with fluids and supportive medications, anesthesia was induced by intravenous xylazine and/or diazepam followed by ketamine. Anesthesia was maintained with isoflurane or halothane in oxygen with controlled ventilation. Heart rates (HR), arterial blood gases, mean arterial pressures (MAP), rate pressure products (RPP), requirements for cardiovascular support medications, and recovery times to standing were compared using nonparametric methods. Cardiopulmonary responses to isoflurane and halothane anesthesia were generally comparable although some temporal differences were observed. Higher HR (p less than 0.02) and lower PaCO2 levels (p less than 0.01) were identified during the course of isoflurane anesthesia. Recovery times to standing were significantly shorter (0.02 less than p less than 0.05) after isoflurane than halothane anesthesia. PMID- 3507140 TI - A potential technique error in stapled side-to-side anastomosis of the small intestine of the horse. AB - Anastomotic leakage was noted to occur at the junction of the staple lines used to create the stoma during small intestine side-to-side anastomosis. The anastomosis was performed in a clinical equine patient by joining the lateral surfaces of the intestinal segments using a gastrointestinal anastomosis stapling instrument (GIA). The cause of this problem was investigated by performing six anastomoses in the jejunum of a single anesthetized adult horse using the GIA; three anastomoses were created by joining the antimesenteric edges of the bowel segments and three anastomoses were created by joining the lateral surfaces of the bowel segments. Bowel segments were then dissected to examine the stoma and the integrity of the staple lines. No defects were detected in anastomoses performed by joining the antimesenteric edges. Anastomoses performed by joining the lateral surfaces all had a defect at the junction of the double rows of staples used to create the stoma. Such defects would have allowed leakage of fluid and/or ingesta at the anastomotic site. PMID- 3507141 TI - Surgical treatment of priapism in a stallion. AB - Priapism occurred in a stallion after the administration of acetylpromazine. When conservative measures failed, the corpus cavernosum penis (CCP) was drained and irrigated, and a vascular shunt between the erectile bodies was created. Subsidence of erection resulted, but subsequently, the stallion was unable to retract or erect the penis. The stallion was castrated and the penis was surgically retracted into the sheath. PMID- 3507142 TI - Antimicrobial susceptibility of microorganisms isolated from equine orthopedic patients. AB - Positive cultures were obtained from 60 equine orthopedic cases during a 12 year period (1974-1985). These cases consisted of 34 long or cuboidal bone fractures, 13 arthrotomy/arthroscopy procedures for removal or internal fixation of a fracture, 7 proximal splint bone fractures, and 6 facial or mandibular fractures. Excluding the 13 arthrotomies, only 10 (21%) of the 47 were open fractures. Multiple organisms were isolated from 36 cases (20 long or cuboidal bone fractures, 7 splint bone fractures, 5 mandibular fractures, and 4 intra-articular fractures). Of the 142 isolates, 35 (24%) were members of the family Enterobacteriaceae, 33 (23%) Streptococcus spp., and 25 (18%) Staphylococcus spp. with the majority being coagulase positive (65%). Other organisms isolated were Pseudomonas spp. (16, 11%), obligate anaerobes (11, 7%), and Actinobacillus spp. (7, 5%). the remaining 10% consisted of Pasteurella spp., Bacillus spp., Corynebacterium spp., Micrococcus spp., and Actinomyces spp. When comparing results between two time periods (1974-1979 and 1980-1985) there was an increase in the percentage of coagulase positive staphylococci isolates resistant to all antimicrobics tested except oxacillin and amikacin, and Escherichia coli isolates were resistant to all but amikacin. For Pseudomonas spp., resistance to gentamicin increased in the second time period (1980-1986). During the initial time period (1974-1979) culture tests for obligate anerobes were not conducted until 1975. No anerobes were cultured during those initial 5 years; however, one third of those isolated after 1980 were resistant to penicillin and ampicillin.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3507143 TI - Caudal cruciate ligament rupture. A retrospective analysis of 14 dogs. AB - Fourteen dogs were presented with caudal cruciate ligament (CaCL) rupture without concurrent cranial cruciate ligament (CrCL) rupture. The history usually included moderate to severe trauma. Presenting signs included lameness, positive drawer sign, and additional orthopedic injuries. A final diagnosis of CaCL rupture was made during surgical exploration of the joint in 12 of the dogs. In nine of the dogs, this diagnosis was not included in the preoperative differential diagnoses, and seven of the dogs were misdiagnosed as sustaining CrCL rupture. Methods of treatment included intracapsular and extracapsular stabilization. Follow-up time ranged from 3 weeks to 7 years. Function of the limbs was good regardless of surgical procedure chosen and did not appear to depend upon stifle stability. PMID- 3507144 TI - Comparison of the strength and holding power of 4 pin designs for use with half pin (type I) external skeletal fixation. AB - The strength and holding power of four pin designs for use with half pin (type I) external skeletal fixation were evaluated. Pins that were tested were fully threaded, nonthreaded, two cortices partially threaded, and one cortex partially threaded. The study involved three parts: (1) resistance of the pins to axial extraction immediately after insertion; (2) resistance of the pins to axial extraction 8 weeks after being inserted into the tibiae of live dogs; and (3) resistance of the pins to bending load. Pins with threads engaging two cortices were more resistant to axial extraction than nonthreaded pins in both the acute (p less than 0.0001) and chronic (p less than 0.0001) studies. Nonthreaded pins were more resistant to bending than fully threaded and two cortices partially threaded pins (p less than 0.0005). One cortex partially threaded pins possessed similar bending strength to nonthreaded pins (p = 0.21) and had 5.3 times more resistance to axial extraction in the acute study (p less than 0.0001) and 6.9 times more in the chronic study (p less than 0.0001). Though one cortex partially threaded pins were not as resistant to axial extraction as pins with threads engaging two cortices (p less than 0.0001), they were more resistant to bending loads (p less than 0.0005). Loss of holding power and pin failure are two of the most serious problems associated with fracture stabilization using external skeletal fixation. The results of this study suggest that one cortex partially threaded pins are better at maintaining holding power and resisting bending and breaking than nonthreaded pins.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3507145 TI - Management of intractable pleural effusion in a dog with pleuroperitoneal shunt. AB - Persistent nonchylous pleural effusion followed thoracic duct ligation for chylothorax in a dog. Attempts at tetracycline pleurodesis twice failed to reduce the quantity of pleural effusion. Repeated thoracentesis caused malnutrition and hypoproteinemia. A modified Denver peritoneal-venous shunt was implanted to internally drain the pleural fluid into the peritoneal cavity. Normal body weight and plasma protein concentration were regained in 40 days. Digital compression of the pump chamber alleviated the signs of respiratory compromise, without complication. At 50 weeks post-installation, a proteinaceous clot obstructed the original efferent pump valve, necessitating shunt replacement. Eight weeks after replacement, the dog was asymptomatic. PMID- 3507146 TI - Axial pattern flap based on the genicular branch of the saphenous artery in the dog. AB - Axial pattern flaps based upon the genicular branch of the saphenous artery and medial saphenous vein were developed in eight dogs. On one hind limb of each dog, the experimental flap was raised and immediately transferred to a cutaneous defect created over the lateral aspect of the lower limb distal to the stifle. A control flap was elevated and transferred on the opposite hind limb with the genicular branches of the saphenous artery and vein ligated and divided at the base of the flap. Eighty-nine per cent of the length of the flap survived in those flaps in which the genicular vessels were left intact, whereas only 54% of the flap's length survived in the control flaps. Postoperatively, all dogs were bearing weight on the limbs normally. The genicular axial pattern flap may have special clinical application in cases of cutaneous defects involving the lateral aspect of the tibia. PMID- 3507147 TI - A comparison of standard femoral head and neck excision and femoral head and neck excision using a biceps femoris muscle flap in the dog. AB - Sixteen normal 20 to 30 kg dogs had standard femoral head and neck excision (8 dogs) or femoral head and neck excision with interposition of a biceps muscle flap (8 dogs). Lameness lessened at week 6, and did not differ between groups; neither group returned to a completely normal gait. Weightbearing decreased on the operated pelvic limb compared to controls (forceplate analysis). Weightbearing force of the muscle flap dogs was significantly less at weeks 6 and 16 than that of the standard femoral head and neck excision dogs. The operated limb of both groups was shortened; shortening was significantly greater for the muscle flap group. Hip extension was limited in both groups. Both groups had decreased (more acute) hip, stifle, and hock angles measured in standing position. Thigh muscle atrophy was more pronounced in the muscle flap group at week 6. More soft tissue was interposed in the muscle flap group at necropsy compared to the group with standard femoral head and neck excision, but the difference was not statistically significant. Skeletal muscle fibers were present in the interposed fibrous connective tissue of the muscle flap group, and the healed surfaces were smoother than those of the standard femoral head and neck excision group. PMID- 3507148 TI - Mitral valve replacement in dogs. Surgical technique and postoperative management. AB - Although techniques for the perioperative management of patients undergoing mitral valve replacement have been well established in humans, the use of these techniques has not been widely accepted in veterinary practice. The purpose of this study is to demonstrate that low morbidity and mortality could be achieved in the dog undergoing mitral valve replacement. Nine mongrel dogs (25-45 kg body weight) were subject to left thoracotomy and mitral valve replacement using cardiopulmonary bypass (CPB). The average time on CPB was 1 hour with an aortic cross-clamping time of 40 minutes using chemically induced cardiac arrest. CPB was performed under conditions of moderate systemic hypothermia (28-30 degrees C) and hemodilution (hematocrit, 25-35%). Operative mortality was 22% (2/9) with one death from excessive bleeding and the other from cerebral air embolism. All other animals recovered and were clinically normal 3 weeks after surgery. The authors conclude that successful mitral valve replacement is possible in the large dog. PMID- 3507149 TI - Lung resection using surgical staples in dogs and cats. AB - Thirty seven dogs and cats were subjected to lobectomy, partial lobectomy, or pneumonectomy using stapling equipment. The most common indication was neoplasia. No operative, perioperative, or long-term deaths could be attributed to the use of staples: complications were minimal. Staple resection was believed to be safe, fast, and efficient for removal of various segments of canine and feline lung. PMID- 3507150 TI - The use of a silicone T-tube to treat tracheal stenosis in a llama. AB - A female llama was presented at 4 days of age with severe dyspnea resulting from bilateral choanal atresia. A tracheostomy was performed before surgical treatment of the airway obstruction. Although the choanal atresia was successfully corrected, tracheal stenosis secondary to mucosal necrosis, malacia of the cartilage rings, and proliferation of intraluminal granulation tissue at and distal to the tracheal stoma developed. The affected segment of the trachea was resected and an end-to-end anastomosis was performed, but the lumen again became obstructed by granulation tissue. A silicone "T-tube" was placed in the trachea to provide a patent airway and intraluminal support. The llama has done well for 12 months with this prosthesis, and the complications that are often seen with long-term use of traditional tracheostomy tubes have not developed. PMID- 3507151 TI - Cardiovascular effects of intravenous sodium penicillin, sodium cefazolin, and sodium citrate in awake and anesthetized horses. AB - Sodium penicillin, sodium cefazolin, and sodium citrate were administered to six adult horses on separate occasions, when awake and during anesthesia. The order of administration was randomized and studies were separated by a minimum of 7 days. Arterial blood pressure decreased significantly (less than 0.05) from control 5 minutes after intravenous (IV) sodium penicillin in awake and anesthetized horses. Systolic arterial blood pressure remained significantly (less than 0.05) decreased 10 minutes after IV sodium penicillin in anesthetized horses. Sodium cefazolin and sodium citrate did not significantly affect any of the measured cardiovascular variables. Although the changes in arterial blood pressure were small (8-15 mm Hg), monitoring of arterial blood pressure is advised when sodium penicillin is administered IV to anesthetized horses. PMID- 3507152 TI - Surgical repair of an esophageal stricture in a horse. AB - An esophageal stricture was diagnosed in a 9-month-old quarterhorse by esophagoscopy and positive pressure contrast esophagography. Medical management and two attempts at surgical intervention were unsuccessful. The initial surgical technique used was a linear esophagotomy, mucosal resection and anastomosis, and closure of the muscular tunic, which resulted in a more severe stricture. The second surgical procedure was interruption of the stricture cicatrix by a single linear esophagotomy and primary closure of only the esophageal muscular tunic. This technique resulted in an increased lumen diameter, but failed to adequately resolve the stricture. Successful resolution of the stricture with return to a normal diet was achieved by a two stage repair using formation of an esophagostomy to stabilize the esophagus, followed by fenestration of the mucosal submucosal cicatrix. Six months postoperatively, the horse was asymptomatic on a normal diet. PMID- 3507153 TI - Evaluation of 2 types of external skeletal fixation for repair of experimental tibial fractures in foals. AB - Transverse or oblique midshaft tibial osteotomies were created in 11 foals. The osteotomies were repaired during the same procedure using external skeletal fixation in either full splint or 3-dimensional (3-D) tent configurations. Four of the six foals receiving the full splint fixator recovered to full soundness; two were euthanized because of complications. The foals receiving the 3-D tent configuration would not bear weight on the limbs and consequently suffered significant secondary fracture disease. These foals were euthanized for humane reasons before the scheduled termination of the project. The full splint configuration is considered a viable option for use in foals less than 150 kg with fractures that are not amenable to other proven method of repair. PMID- 3507154 TI - Jejunocolic anastomosis for the surgical management of recurrent cecal impaction in a horse. AB - A 5-year-old Thoroughbred gelding with recurrent cecal impaction refractory to medical management was treated with a side-to-side jejunocolic anastomosis. Cecal impaction did not recur after surgery. The horse gained weight and performed successfully for 14 months, but experienced three episodes of mild abdominal pain between 14 and 20 months after surgery. Mild cecal gas distention and firm ingesta in the colon were detected on rectal examination. The horse's feces remained soft after surgery, except during the colic episodes when dry, firm feces were passed. PMID- 3507155 TI - A surgical approach to the canine olfactory bulb for meningioma removal. AB - Olfactory bulb lesions were diagnosed in four dogs presented for generalized seizure disorders. Surgery was performed on each dog using a transfrontal craniotomy. A free fascial-fat graft was used to cover the dural defect resulting from surgery. No major complications were observed during the immediate postoperative period. The histopathologic diagnosis in each case was meningioma. Generalized seizures recurred in all dogs, and three dogs were euthanized for this reason from 9 to 29 weeks postoperatively. One dog was euthanized 12 weeks after surgery due to pancreatitis and pneumonia. Necropsy showed that two dogs had recurrent olfactory bulb meningiomas, one dog had a meningioma of the opposite olfactory bulb, and one dog was tumor free. PMID- 3507156 TI - Use of a double hook plate for treatment of a distal radial fracture in a dog. AB - Attempted stabilization of open, distal radius and ulnar fractures in a 3-year old German shepherd dog using intramedullary pins and a Schroeder-Thomas splint resulted in malalignment of the limb and osteomyelitis. A double hook plate was used to rigidly stabilize the distal radial fracture after anatomical realignment. An autogenous cancellous bone graft was used where a lateral architectural defect remained after reduction. Culture of the fracture site showed Staphylococcus sp., which responded to chloramphenicol therapy. Fracture union and resolution of osteomyelitis occurred by 9 weeks after surgery, and the dog had no lameness and a normal muscle mass 22 weeks after surgery. The double hook plate provided rigid internal fixation of the radial fracture, allowed a rapid return to function during osteosynthesis, and minimal interference of antebrachiocarpal joint function occurred. PMID- 3507157 TI - A comparison of the cutaneous trunci myocutaneous flap and latissimus dorsi myocutaneous flap in the dog. AB - Latissimus dorsi and cutaneous trunci myocutaneous flaps of equal dimension and location were randomly elevated on opposite sides of the thorax in 10 dogs (group 1) and resutured to their respective bed. The procedure was repeated in four additional dogs (group 2); however, the short perforating branches of the thoracodorsal artery and vein were divided at the base of each cutaneous trunci myocutaneous flap, whereas the cutaneous pedicle and underlying cutaneous trunci muscle were divided in the latissimus dorsi myocutaneous flaps to determine subsequent skin survivability and the major source of circulation of each myocutaneous flap. There was little difference in the percentage of skin survival between the latissimus dorsi and cutaneous trunci myocutaneous flaps in group 1 dogs. Circulation to the "skin island" of group 2 latissimus dorsi myocutaneous flaps originated from intramuscular anastomotic connections between the major branch of the thoracodorsal artery entering the latissimus dorsi muscle and the proximal lateral intercostal arteries perforating the muscle. Ligation of the short perforating branches of the thoracodorsal artery resulted in partial skin necrosis in all group 2 cutaneous trunci myocutaneous flaps. Results from this study indicate that it is unnecessary to elevate the latissimus dorsi muscle for major skin flap elevation and survival. The thicker latissimus dorsi myocutaneous flap is more difficult to develop surgically and appears to have no clinical major advantage over the more mobile cutaneous trunci myocutaneous flap or the adjacent thoracodorsal axial pattern flap for closure of large skin defects within the radius of flap rotation. PMID- 3507158 TI - Effect of application of polyvinilidine plates on the dorsal spinous processes of dogs. AB - Anecdotal comments in the literature suggest that spinous fracture many weeks after application of polyvinilidine plates to the dorsal spinous processes of dogs may be due to associated adverse vascular changes. This study was undertaken to evaluate that hypothesis. Large size Lubra plates were cut to the appropriate length and applied to the dorsal spines of vertebrae L3 and L4. Vertebrae L2 and L5 served as operated controls. Vertebrae L1 and L6 served as unoperated normals. Two dogs were euthanized 1 week postoperatively, and three dogs each at 4, 8, and 12 weeks. The effect of the plate on the dorsal spinous processes was evaluated using microangiography and correlated histology. There was no apparent change in vascular architecture associated with plate application, nor with surgery alone, at any time interval. There did appear to be a time dependent loss of bone associated with plate application, indicating a change in the relative balance of osteoblastic and osteoclastic activity, and altered bone turnover. PMID- 3507159 TI - Effect of cerclage wires on periosteal bone in growing dogs. AB - Three diameters of wire were placed circumferentially around the femora of six 22 week old puppies. The wires were placed over the periosteum on one limb and under the periosteum on the other limb. The effect of the wires on actively growing bone was evaluated 3 and 8 weeks after placement. Diffuse growth of periosteal new bone occurred in immature dog femora in which cerclage were placed under the periosteum. This reaction corresponded with dramatically increased medullary and periosteal microvascularity coupled with histologic active trabecular bone formation. In femora in which wires were placed over the periosteum, even though the placement of the wires should supposedly have been the most detrimental, there were active vessels within the cortex directly under all wires. In both preparations, cerclage wires were becoming encased in the growing cortical bone 8 weeks after placement. Cerclage wires did not devitalize immature bone nor did it restrict adjacent appositional bone growth. PMID- 3507160 TI - Arthroscopic surgery for the treatment of osteochondrosis in the equine shoulder joint. AB - Osteochondritis dissecans (OCD) and subchondral cyst-like lesions in 13 shoulders of 11 horses were treated arthroscopically by curettage and lavage. Lameness decreased in all 11 horses. Nine horses were sound, five of them athletically sound, after 5 to 20 months. Complications included the development of subchondral cyst-like lesions and signs of degenerative joint disease. Arthroscopic surgery of the equine shoulder can be done through two portals, one for the arthroscope and one for an instrument. A few hand instruments such as a probe, Ferris-Smith rongeurs, and small, large, and right-angled curettes are needed to debride most lesions. Motorized equipment can expedite the process. PMID- 3507161 TI - Arthroscopic surgical approaches and intraarticular anatomy of the equine shoulder joint. AB - Arthroscopic approaches to the scapulohumeral joint were developed in four clinically normal, live horses (5 limbs) to determine their usefulness for evaluation and potential surgical treatment of intraarticular lesions. The articular surface of the entire glenoid, cranial humeral head (medial and lateral) and caudolateral humeral head, as well as the synovial membrane, could be closely examined from an arthroscopic portal cranial to the infraspinatus tendon. The caudomedial humeral head could be examined partially. Cranial and caudal instrument portals allowed good surgical access to the entire glenoid and the majority of the humeral head (except caudomedial in adult, heavily muscled horses). The described arthroscopic and instrument portals allowed access to the areas frequently affected with osteochondritis dissecans (OCD). Potential difficulties with this technique include problems establishing triangulation, extravasation of fluids, and inability to reach potential lesions on the caudomedial humeral head with conventional equipment in heavily muscled horses. PMID- 3507162 TI - Abstracts from the Veterinary Midwest Anesthesia Conference. May 2, 1987, Illinois. PMID- 3507163 TI - Gastric drainage procedures: effects in normal dogs. II. Clinical observations and gastric emptying. AB - Complete gastric emptying time using barium sulfate mixed with commercial canned dog food was measured radiographically in 29 mature mixed breed dogs before and 3 to 4 weeks after Fredet-Ramstedt pyloromyotomy (FRP) (6 dogs), Heineke-Mikulicz pyloroplasty (HMP) (6 dogs), Finney pyloroplasty (FP) (6 dogs), Jaboulay's gastroduodenostomy (JG) (6 dogs), and antral gastrojejunostomy (AG) (5 dogs). The dogs were observed for clinical evidence of side effects. Postoperative endoscopic examination and double contrast gastrography were performed to subjectively evaluate the diameter of the gastrointestinal communication and the amount of enterogastric reflux. Although none of the procedures significantly (p less than 0.05) altered gastric emptying time, the overall tendency was toward slowing down gastric emptying time. The severity of gastrointestinal side effects and enterogastric reflux appeared to be related to the size and/or location of the gastrointestinal opening. PMID- 3507164 TI - Gastric drainage procedures: effects in normal dogs. III. Postmortem evaluation. AB - Postmortem macroscopic examination of the gastrointestinal tract and plastic moldings of the gastrointestinal communication were done in 29 dogs which had been subjected 3 to 4 weeks previously to one of the following gastric drainage procedure: (1) Fredet-Ramstedt pyloromyotomy (FRP) (6 dogs); (2) Heineke-Mikulicz pyloroplasty (HMP) (6 dogs); (3) Finney pyloroplasty (FP) (6 dogs); (4) Jaboulay's gastroduodenostomy (JG) (6 dogs); and (5) antral gastrojejunostomy (AG) (5 dogs). Plastic moldings were also done in nine normal dogs of similar size for comparative measurements. Postmortem examinations and plastic casts of the antropyloroduodenal segment and antrojejunal communication showed significantly widened pyloric canal or large gastrointestinal communication compared to control dogs in all groups except for the FRP group. Almost complete healing had occurred at the myotomy site in FRP dogs, and the pyloric lumen was not significantly larger (less than 0.05) than the pyloric lumen of the control dogs. The lumen of the gastrointestinal junction was increased approximately 4.5 times in the HMP group, 12.0 times in the FP group, 7.2 times in the JG group, and 10.0 times in the AG group. PMID- 3507165 TI - A retrospective study of prosthetic capsule technique for the treatment of problem cases of dislocated hips. AB - This article describes a technique for stabilizing coxofemoral luxations in dogs that uses placement of nonabsorbable sutures from two screws in the dorsal acetabular rim to a screw in the trochanteric fossa of the femur to create a prosthetic capsule. Twenty-one hips with luxations that were either recurrent or greater than 7 days duration were treated. Owners of 17 dogs were contacted from 4 to 40 months after surgery. Eight dogs were reported as having excellent function, three had good function, three had fair function, and three had poor function. No complications directly related to the technique were reported. PMID- 3507166 TI - Arthroscopic examination of the femorotibial joints of horses. AB - A technique for satisfactory arthroscopic examination of the lateral and medial femorotibial joints of the horse is described. The entry portal is made between the middle and medial patellar ligaments with the horse on its back and the stifle flexed. This position allows easy access to view the intercondylar eminence of the tibia. From this reference point, examination of all but the most caudal and medial structures of the joints are possible by manipulating the sleeve and telescope and maintaining joint distention. In a series of 20 examinations, iatrogenic trauma was recognized only once. PMID- 3507167 TI - Feline thyroidectomy. A comparison of postoperative hypocalcemia associated with three different surgical techniques. AB - Three bilateral thyroidectomy techniques used in 41 hyperthyroid cats over a 7 year period were compared for rates of postoperative hypocalcemia. Extracapsular dissection of the thyroid glands resulted in an 82% rate of postoperative hypocalcemia. An intracapsular dissection technique produced a 36% rate of postoperative hypocalcemia. The incidence of postoperative hypocalcemia was reduced to 11% when bilateral thyroidectomies were done asynchronously (staged), 3 to 4 weeks apart. Immediate postoperative treatment with dihydrotachysterol did not reduce the incidence of postoperative hypocalcemia. Because the incidence of hypocalcemia did not differ significantly between intracapsular and staged intracapsular dissection, the authors concluded that staged bilateral thyroidectomy in hyperthyroid cats had limited benefit over simultaneous bilateral thyroidectomy. PMID- 3507168 TI - Surgical management of proximal splint bone fractures in the horse. AB - Fractures of Metacarpal and Metatarsal II and IV (the splint bones) were treated in 283 horses over an 11 year period. In 21 cases the proximal portion of the fractured bone was stabilized with metallic implants. One or more cortical bone screws were used in 11 horses, and bone plates were applied in 11 horses. One horse received both treatments. Complications of screw fixation included bone failure, implant failure, radiographic lucency around the screws, and proliferative new bone at the ostectomy site. Only two of the horses treated with screw fixation returned to their intended use. Complications of plate fixation included partial fixation failure (backing out of screws), wound drainage, and proliferative bony response around the plate. Six of the 11 horses treated by plate fixation returned to their intended use. The authors recommend consideration of plate fixation techniques for repair of fractures in the proximal third of the splint bone. PMID- 3507169 TI - Paranasal sinusitis complicated by inspissated exudate in the ventral conchal sinus. AB - Primary paranasal sinusitis complicated by inspissated exudate within the ventral conchal sinus was diagnosed in five horses. Clinical signs included a unilateral, foul-smelling, mucopurulent nasal exudate of 2 to 7 months' duration. Two of the horses had partial nasal obstruction from distortion of the ventral concha. Radiographs of the skull showed a mass of soft tissue density dorsal to the roots of the superior third and fourth or fourth and fifth cheek teeth. Treatment included bone flap maxillary sinusotomy with exposure of the ventral nasal concha and removal of inspissated exudate. Resolution of the sinusitis occurred in all five horses. PMID- 3507170 TI - The effects of beveling the margins of articular cartilage defects in immature dogs. AB - Eight 4 month old crossbred puppies underwent surgery simulating treatment of osteochondritis dissecans. Both humeral heads were exposed by a caudal approach to the shoulder joint. In one, an 8 mm circular, full-thickness cartilage defect was created so that the remnant cartilage margin was perpendicular to the joint surface. In the other, a similar 8 mm defect was created with the chondral margins beveled at approximately 45 degrees. There was no clinical lameness in any of the dogs. At necropsy after 16 weeks, the cartilage defects with beveled edges were significantly larger (11.0 +/- 0.6 mm SD) than those with perpendicular edges (8.0 +/- 0.1 mm SD), because of the beveling (p = 0.0039). Fibrocartilage was present but did not always completely fill the defects. Articular surfaces of the glenoid cavities suffered erosion and fibrillation more frequently opposite beveled defects than opposite defects with vertical walls (p = 0.0312). This was presumably due to the larger apposing defect. It was concluded that the cartilage margins surrounding a chondral defect should not be beveled. PMID- 3507171 TI - A technique for elective splenectomy of equidae using a transthoracic approach. AB - Splenectomy was performed electively on 80 ponies, horses, and donkeys for preparation in collecting Babesia antigens. Access to the abdomen was by resection of the sixteenth left rib and incision of the diaphragm. The technique afforded good exposure of the splenic vessels and attachments. Closure was facilitated by preservation of the periosteum of the resected rib. Difficulty was encountered both in surgical technique and postoperative complications in obese animals. The transthoracic approach was found to be a useful technique for equine splenectomy. PMID- 3507172 TI - Effects of the Y-U pyloroplasty on gastric emptying and duodenogastric reflux in the dog. AB - A Y-U pyloroplasty was performed on five healthy adult dogs. Gastric emptying half times (t1/2 GE) of a canned food meal were measured by scintigraphy three times before surgery and three times from 6 to 8 weeks after surgery. Fluoroscopic studies of gastric and duodenal motility were made before surgery and 3, 7, and 35 days after surgery. Clinical observations were made daily throughout the study. Gross and histologic evaluations of the gastroesophageal and pyloric regions were performed at the termination of the study. The t1/2 GE was significantly decreased after surgery. By positive contrast fluoroscopy, the vigor of antral contractions was seen to be decreased in three of the five dogs. On days 7 and 35, fluoroscopic findings were comparable to preoperative studies. Duodenogastric reflux was recognized fluoroscopically in three dogs on four different occasions. This may reflect normal reflux patterns in the dog. No gastrointestinal problems were evident after surgery in four dogs. Reflux esophagitis developed in one dog after surgery, which resolved with therapy. Studies of the Y-U pyloroplasty after 2 months indicated that it decreased gastric emptying time of solid food. Results of postmortem examination showed no abnormal gross or histopathologic changes of esophageal, gastric, or proximal duodenal tissues. PMID- 3507173 TI - Effects of xylazine and ketamine on epinephrine-induced arrhythmia in the dog. AB - Ten dogs were studied to determine the effects of xylazine, ketamine, and xylazine combined with ketamine on the dosage of epinephrine required to produce ventricular arrhythmia. Untreated dogs required an arrhythmogenic dose (AD) of 5.88 +/- 2.85 micrograms/kg/min. The AD was 4.28 +/- 3.25 micrograms/kg/min in xylazine-treated dogs, 3.05 +/- 2.3 micrograms/kg/min in ketamine-treated dogs, and 2.96 +/- 1.95 micrograms/kg/min in xylazine/ketamine-treated dogs. The latter two dosages were significantly less than that of the controls (p less than 0.025). The duration of increased arrhythmogenicity was also examined. Four hours after drug administration, the AD for xylazine-treated dogs was decreased further to 3.87 +/- 2.52 micrograms/kg/min (p less than 0.05). Ketamine-treated dogs had returned partially to normal with an AD of 4.09 +/- 3.09 micrograms/kg/min, as had xylazine/ketamine-treated dogs, at 4.22 +/- 2.71 micrograms/kg/min. PMID- 3507174 TI - Urodynamic alterations after prostatectomy in dogs without clinical prostatic disease. AB - Prostatectomy in dogs with clinical prostatic disease has been associated with a high incidence of urinary incontinence. In this study, urodynamic alterations after prostatectomy in 10 dogs without clinical prostatic disease were evaluated. Measurements of residual urine volume, simultaneous urethral pressure profilometry and electromyography, and carbon dioxide cystometry were made before and 14 and 20 weeks after prostatectomy. Voiding was observed daily for 20 weeks after prostatectomy. All dogs remained continent for 20 weeks after prostatectomy, and only minor urodynamic abnormalities were noted. Castration had no effect on urodynamic changes associated with prostatectomy. Prostatectomy produced minimal functional changes in dogs without clinical prostatic disease. PMID- 3507175 TI - Percutaneous nephrolithotomy in the dog. An experimental study. AB - Percutaneous nephrostomies (PN) were created with teflon fascial dilators under fluoroscopic guidance, to implant stones bilaterally into the renal pelves of five dogs weighing 7 to 35 kg. Between one and seven stones of 0.25 to 1.00 cm diameter were implanted into each renal pelvis. Two to 4 weeks later, PN tracts were recreated, and the implanted renal stones were successfully removed under fluoroscopic and endoscopic visualization. Results of gross and histopathologic evaluation of the kidneys 2, 7, 14, 30, and 90 days after stone removal showed minimal, localized renal parenchymal trauma. Complications, although infrequent, included proximal ureteral tears and hemorrhage. Difficulty was encountered in maneuvering equipment around large or numerous stones. Canine percutaneous nephrolithotomy was successful despite great variation in kidney size, as well as variations in the number, size, and shape of stones in the upper urinary tract. PMID- 3507176 TI - A retrospective comparison of three techniques for femoral head and neck excision in dogs. AB - Femoral head and neck excision was performed in 169 dogs over a 7 year period. A written questionnaire completed by 56 owners, evaluating a total of 72 joints, was the basis for retrospective evaluation of the efficacy of the procedures used. There were four surgical groups: femoral head and neck excision (FHNE) in dogs with body weights over 14 kg, the same procedure in dogs with body weights less than 14 kg (SMALL), femoral head and neck excision with muscle interposition (MI), and the wedge resection technique (WRT). Although differences in results were noted, there were no statistically significant differences between any of the groups for the percentage of leg use during normal activity (p greater than 0.05), mean postoperative time until leg use, use of the leg or hopping while running, or lameness with exercise (p greater than 0.10). The results of this study suggest that there is little advantage in performing the more time consuming and traumatic muscle interposition and wedge resection procedures. PMID- 3507177 TI - Osteofascial compartment syndrome in the dog. AB - Experimentally induced osteofascial compartment syndrome (OFCS) has been reported in the craniolateral compartment of the canine crus. In this study, anatomic dissections and contrast radiographs were used to describe three additional osteofascial compartments in canine limbs. Experimental OFCS was produced in four different compartments, and caused muscle and nerve pathology in each. When compartment pressures were evaluated in traumatized animals, moderate elevations in compartment pressures were found. A compartment syndrome that developed in one dog was surgically decompressed, returning elevated pressures to a safe level. PMID- 3507178 TI - Effect of distal femoral growth plate fusion on femoral-tibial length. AB - Unilateral distal femoral epiphysiodesis in seven 10 week old crossbred Doberman Pinscher littermates resulted in a significant (p less than or equal to 0.0001) femoral length deficit of 23.5% without clinically detectable alterations in gait up to 42 weeks after surgery. In addition to compensatory hyperextension of the stifle joint, the ipsilateral tibia showed significant (p less than or equal to 0.0001) acceleration in longitudinal growth. The combined femoral-tibial length at necropsy was still significantly shorter (p less than or equal to 0.0001) in the treated leg than in the control leg despite the increased tibial growth. Unlike other species, neither of the other two femoral growth plates produced any significant compensatory increase in length after fusion of the distal growth plate. The femoral condyles of the treated legs rotated caudally and degenerative joint disease developed in all stifle joints of the treated legs. No contralateral limb abnormalities were evident radiographically. PMID- 3507179 TI - Transfer of free vascular cutaneous flaps by microvascular anastomosis. Results in six dogs. AB - Skin defects on the distal extremities of six dogs were reconstructed with free vascular cutaneous transfers by microvascular anastomosis. The donor flaps were based on the superficial cervical artery and vein. In five of the dogs, bone was exposed and skin was lost from half of the circumference of the limb. Two had infected fractures with sequestra and three had acute shearing injuries. The sixth dog had sensory denervation of the left antebrachium and a carpal acral lick granuloma. Before surgery, the patency of potential recipient vessels was confirmed with arteriography in five dogs and an ultrasonic doppler in one dog. Microvascular technique was used to reestablish circulation to the flaps after they were transferred to the recipient site. Total ischemic time of the flaps averaged 100 minutes. All flaps survived. Successful reconstruction of the cutaneous defects was achieved in these six cases. PMID- 3507180 TI - Ileocolostomy. A technique for surgical management of equine cecal impaction. AB - Several surgical alternatives have been described for the management of cecal impaction in the horse, but none has met with consistently successful results. This study was done to evaluate a surgical bypass of the cecum by anastomosis of the ileum to the right ventral colon (ileocolostomy). A ventral midline celiotomy was performed on nine adult ponies (155-350 kg) and a mechanically stapled 10 cm side-to-side ileocolostomy was created. In five ponies a complete cecal bypass (CCB) was created by transecting the ileum distal to the anastomosis. In the other four, an incomplete cecal bypass (ICB) was created with no interruption of the ileum. Six horses with clinical cecal impaction also underwent cecal bypass procedures. Five had a CCB and one had an ICB. All the ponies maintained body weight, had no change in consistency of the feces and had no abdominal pain during the 6 month observation period. At necropsy, the lengths of the lateral cecal band, lateral free band of the colon, and the diameter of the anastomotic stoma were compared to measurements made at surgery. The lateral cecal band length decreased significantly more in the CCB ponies than in the ICB ponies (p = 0.008). The anastomotic stoma diameter was significantly larger in the ICB group than in the CCB group (p = 0.032). Five of the six clinical cases recovered and returned to their previous activity. CCB by an ileocolostomy resulted in removal of the cecum from the functional flow of ingesta without complication in the ponies, and was successful in five clinical cases of cecal impaction. PMID- 3507181 TI - Diagonal paramedian approach for removal of ovarian tumors in the mare. AB - A diagonal paramedian approach to the abdomen was used for unilateral ovariectomy in 15 mares. In each case, surgery was performed for removal of a granulosa cell tumor. All horses recovered from surgery with minimal complications. Surgical exposure of the affected ovary was adequate to allow exteriorization and ligation. Other advantages of this approach were ease of closure and lack of postsurgical complications. PMID- 3507182 TI - Prevention of intraabdominal adhesions in ponies by low-dose heparin therapy. AB - An ischemic bowel model was used to stimulate adhesion formation in eight ponies. Heparin (40 USP u/kg) or saline was administered intravenously at surgery and was continued subcutaneously every 12 hours for 48 hours to evaluate the efficacy of heparin in preventing intraabdominal adhesions. Ponies were euthanatized after 6 weeks, and postmortem examinations were performed. A statistically significant difference was found between the heparin-treated and the control groups. Adhesions developed in three of four control ponies, and adhesions did not develop in three of four heparin-treated ponies. None of the adhesions resulted in clinical disease. In this study, heparin decreased the formation of adhesions in ponies after experimentally induced intestinal ischemia. PMID- 3507184 TI - [INFOODS and food composition data]. PMID- 3507183 TI - Postural influence on systemic blood pressure in large full-term pregnant bitches during general anesthesia. AB - Effects of positioning on systemic blood pressure were evaluated in six full-term pregnant golden retriever bitches during general anesthesia. Two positions (dorsal and left lateral recumbency) were examined. Anesthesia was induced with thiamylal sodium and maintained with halothane in oxygen. Direct arterial blood pressures were recorded from the bitches in each position. Effects of positioning for each bitch during general anesthesia were reexamined after the bitch weaned its pups; thus, each bitch served as its own control. Maternal posture had no significant effect (p greater than 0.05) on systemic blood pressure. Pregnancy had no significant effect (p greater than 0.05) on systemic blood pressure. Supine hypotension did not occur in anesthetized large, full-term pregnant bitches. Dorsal recumbency was an acceptable position for cesarean sections performed with the patient under general anesthesia. PMID- 3507185 TI - [Use of food chemical composition tables]. PMID- 3507186 TI - [Information required for the establishment of a data system on the chemical composition of foods]. PMID- 3507187 TI - [Practical experiences with food composition tables in Latin America]. PMID- 3507188 TI - [Effect of processing on the nutritive value of foods. Status in Latin America and the Caribbean, and importance for the preparation of composition tables]. PMID- 3507189 TI - [General aspects of the organization of data base systems on food composition for Latin America and the Caribbean]. PMID- 3507190 TI - [Report from Chile--current status of the food composition tables in Chile]. PMID- 3507191 TI - [Analysis of the use of chemical composition tables of Chilean food, in community food services]. PMID- 3507192 TI - [Report from Argentina--report on the current status, interest and existent limitations with reference to "Food composition tables in the Republic of Argentina"]. PMID- 3507193 TI - [Report from Brazil--tables of nutrient composition of foods: status in Brazil and requirements]. PMID- 3507194 TI - [Report from Bolivia--the composition table of Bolivian foods]. PMID- 3507195 TI - [Report from Peru--chemical composition and nutritive value of native Andean foods]. PMID- 3507196 TI - [Report from Ecuador--food composition data in Ecuador]. PMID- 3507197 TI - [Report from Venezuela--use of the official table of food composition at present]. PMID- 3507198 TI - [Report of the Instituto Nacional de Nutricion of Venezuela]. PMID- 3507199 TI - [Report from Colombia]. PMID- 3507200 TI - [Report from Colombia--proposal for the preparation of statistical standards for nutrients presented in the food composition tables]. PMID- 3507201 TI - [Report from the Dominican Republic--use of food composition tables in the Dominican Republic]. PMID- 3507202 TI - English-speaking Caribbean region report. PMID- 3507203 TI - [Report from the Central American Isthmus--food composition tables for Central America and Panama: current status and future needs]. PMID- 3507204 TI - [Report from Mexico--analysis of food composition in Mexico. Antecedents, current status and perspectives]. PMID- 3507205 TI - [Isthmus fractures in Class II amalgams]. PMID- 3507206 TI - [Langerhans cells in normal, inflamed and hydantoin hyperplastic gingiva]. PMID- 3507207 TI - [Helium-neon (He-Ne) laser radiation versus placebo in the treatment of acute maxillary sinusitis]. PMID- 3507208 TI - [The physiology of tooth eruption]. PMID- 3507209 TI - [Extraoral force applied to the upper jaw]. PMID- 3507210 TI - [Cysticercosis of the oral cavity, report of 2 cases]. PMID- 3507211 TI - A rapid and reliable method for extraction and assay of tricyclic antidepressant drugs in serum or plasma. AB - Because of their narrow therapeutic ranges and differing patient tolerances, the monitoring of tricyclic antidepressants (TADs) commonly prescribed for control of endogenous depression is highly desirable for the satisfactory treatment of patients. The majority of methods for analysis of TADs require multiple extractions from plasma with organic solvents, accompanied by obligatory centrifugation steps. We describe a simple procedure for the rapid extraction of serum TADs, with high recovery of the analyte drugs. It involves sample preparation using Analytichem 'BOND-ELUT' C-2 reverse phase columns, and analysis by gas chromatography using a nitrogen-phosphorus detector. The method offers a quick, inexpensive and low-maintenance assay which is applicable to all the common tricyclic class drugs. PMID- 3507212 TI - Determination of clozapine and its metabolites in serum and urine by reversed phase HPLC. AB - A rapid, specific and sensitive method using reversed phase HPLC for the simultaneous determination of clozapine and its two metabolites in serum and urine has been developed. The mobile phase was a mixture of 67% (v/v) methanol in water containing 0.4% tetramethylethylenediamine and 0.32% acetic acid (pH 5.5). The influence of methanol content, the pH of the mobile phase and the effect of adding alkylammonium ions as peak tailing reducer in the mobile phase have been investigated. The solvent for extracting clozapine from serum and urine was ether. 50 microliters of 0.25 M H2SO4 solution was used to redissolve the dry residue to eliminate the endogenous compounds which could otherwise be eluted together with clozapine from the HPLC column. The analysis of a single sample was accomplished within half an hour. The identities of the chromatographic peaks of clozapine and its N-demethyl metabolite collected from the patient urine sample were confirmed by mass spectrometry. The method is sufficiently sensitive (5 ng/ml) and reproducible (CV 2.9%-6.7%) for clinical and pharmacokinetic studies, and preliminary results in these respects are presented. PMID- 3507213 TI - Efficient HPLC separation of N-p-nitrophenylglycosylamines derived from complex oligosaccharide mixtures. Human orosomucoid as a model. AB - With human orosomucoid as model compound, a new method was developed to separate neutral oligosaccharides as N-p-nitro-phenylglycosylamines. Asialo orosomucoid was prepared by treatment with neuraminidase and purified by size exclusion HPLC on TSK 2000 SW. Oligosaccharides were isolated by reversed phase HPLC on Hamilton PRP-1 after hydrazinolysis and re-N-acetylation. Glycosylamination was performed with p-nitroaniline in DMSO-formic acid-water, where the whole mixture of oligosaccharide derivatives was isolated by reversed phase HPLC on Hamilton PRP-1 and separated into single glycosylamines on Shandon Hypersil ODS. The purified glycosylamines could be methylated by a new rapid method with sodium hydroxide and methyl iodide in DMSO, isolation and purification were carried out on Hamilton PRP-1 and Spherisorb ODS 2, respectively, as described for the glycosylamines. Preparative scale HPLC separations were performed on analytical columns using repetitive collection mode and automatic sample loading by means of a peristaltic pump operated by the HPLC controller. The purified glycosylamines can be used for sugar analyses or, after permethylation, for methylation analyses or related procedures. PMID- 3507214 TI - An automated direct-injection HPLC-method for the electrochemical/fluorimetric quantitation of monoamines and related compounds optimized for the screening of large numbers of animals. AB - An automated, highly stable HPLC system is described allowing the quantitation of monoamines and related compounds with virtually online data processing and statistical evaluation of the mean values of various differently treated groups of animals. The system is highly suited to the screening of drugs involving large numbers of samples. To ensure long-term, uninterrupted performance, two robust chromatographic systems were developed optimized to separate neighboring peaks as widely as possible. This was achieved by using mobile phases of relatively low pH to retard acidic compounds, and optimal concentrations of the ion-pairing reagent to manipulate the retention times of amines on the RP-18 column, resulting also in clearcut separations from the solvent/tissue peak. Direct injection of deproteinized tissue samples, requiring no clean up procedures is used. One faster system allows measurement of the main biogenic amines, metabolites and TRP, whereas another system allows the simultaneous quantitation of DOPA, 5HTP, NA, MOPEG, NMN, A, MN, VMA, DA, 3MT, DOPAC, HVA, 5HT, 5HIAA and TYR. By pretreatment of animals with a decarboxylase inhibitor the latter system offers the possibility of detecting drug effects in the same animal on either dopamine and serotonin turnover or noradrenaline and serotonin turnover, depending on the brain area chosen. The system described has been running for over a year without major disturbance and with minimal technician attendance. PMID- 3507215 TI - Analysis of urine and faecal porphyrins by HPLC coupled to an advanced automated sample processor. PMID- 3507216 TI - Computerized chromatographic peak detection using the trigg tracking signal. An application devised for use with an online analog to digital converter connected between an amino acid analyser and a personal computer. AB - Manual integration of the amino acid peaks from physiological samples produced by conventional anion exchange liquid chromatography is a time-consuming process. This paper describes a combined unit, consisting of an analog to digital converter and a personal computer, which was connected in parallel with the chart recorder and the analyser's 570 nm channel of the colorimeter. The computer was programmed to log the digitized data, detect the start, maximum and end of each chromatographic peak, calculate the area under the peak and its retention time and provide a printout of the results at the end of the elution program. The computer program successfully exploited the Trigg Tracking Signal as both a peak detection and as a moving baseline monitoring device. This approach proved to have an equivalent performance to the manual method for 17 out of the 19 amino acids normally quantitated in physiological samples. The automated detection and quantitation of arginine was unsatisfactory due to its characteristically low profile peak shape, and proline was not measured because the device was not connected to the 440 nm channel of the colorimeter. The automated system provided economic and analytically acceptable solutions to the problem of providing an online integrator versatile enough to be used with the 255 min long amino acid analysis of physiological fluids. PMID- 3507217 TI - Separation and quantitation of plasma free fatty acids as phenacyl esters by HPLC. AB - We have developed a rapid method for the separation of plasma free fatty acids as their phenacyl esters by high-performance liquid chromatography (HPLC) using a reversed-phase (C18) column. The derivatives of series of both saturated and unsaturated fatty acids (C12:0-C22:6) are simultaneously separated within 45 min and detected with ultraviolet at 241 nm. The limit of detection of fatty acids was approximately 0.5 nmol in 20 microL injected volume of extracts, and the coefficient of variation of the present method did not exceed 3.0%. Comparison of the results of the present HPLC method with those of gas chromatography, gave very good correlations for all fatty acids in human plasma. PMID- 3507218 TI - Studies on the chromatographic fractionation of metabolites of benzo[a]pyrene in faeces and urine from germfree and conventional rats. AB - Rats, germfree and conventional, were dosed with 14C-labelled benzo[a]pyrene. Faeces and urine were collected. Metabolites in faeces were effectively extracted with a new method using a combination of solvents and solid sorbents. Metabolites in urine were extracted with octadecylsilane-bonded silica. The metabolites were fractionated into groups by chromatography on a cation exchanger (SP-LH-20 or SP Sephadex C-25) and an anion exchanger (TEAP-LH-20). Some of the groups were further purified by column chromatography and analysed by HPLC and TLC. The analyses show a complex pattern of metabolism. A large part of the metabolites (9 24% depending on animal type and route of excretion) had amphoteric properties, e.g. like glutathione and cysteine conjugates. The abundance of conjugates sensitive to beta-glucuronidase and sulphatase was low. The relative amount of acidic conjugates in faeces was much higher in the germfree than in the conventional rats indicating the influence of the intestinal flora on the metabolism. The results support the view that the mercapturic acid pathway is a quantitatively important metabolic route for benzo[a]pyrene in rats. The methods of extraction and group fractionation were designed to be generally applicable to the analysis of lipophilic xenobiotics and their metabolites. PMID- 3507219 TI - Liquid chromatographic analysis of metoclopramide with fluorescence detection in cirrhotic patients. AB - Metoclopramide extracted from plasma and urine has been analysed using reversed phase HPLC with acetic acid/acetonitrile/triethylamine as eluent and fluorescence detection. This method exploits the natural fluorescence of metoclopramide for its detection in patients on multiple drug therapies. PMID- 3507220 TI - Rapid and simple HPLC determination of 5,5-dimethyl-2,4-oxazolidynedione in rabbit serum. AB - A new method for the determination of 5,5-dimethyl-2,4-oxazolidynedione (DMO) in rabbit serum by reversed phase-HPLC with UV detection is described. The determination of DMO is performed without derivatisation. The internal standard is 5,5-diethylbarbituric acid (barbital). The method is rapid and simple with sensitivity limit of 20 ng/mL, high recovery (above 92%) and is suitable for pharmacokinetic studies. PMID- 3507221 TI - Quantitative determination of adriamycin in rat hepatocytes using a volatile extraction buffer, HPLC and fluorescence detection. AB - A rapid and sensitive isocratic technique is described for the determination of concentrations of adriamycin and two of its metabolites, adriamycinol and adriamycinone, in freshly isolated rat hepatocytes. The drugs are easily and efficiently extracted from the cells with an organic mixture (chloroform-n butanol) after proteolytic digestion with trypsin. Mean recoveries from spiked culture medium cell suspension are greater than 96%. The within run and day-to day coefficients of variation are less than 7.5%. PMID- 3507222 TI - Determination of galactose in human plasma by HPLC with electrochemical detection. AB - Galactose in plasma from patients with hepatic diseases who had undergone low level galactose infusion was determined by using HPLC with electrochemical detection (LCEC). Agreement between galactose concentration determined by the LCEC and a fluorometric method was remarkably good at moderate levels of galactose in plasma. However, the fluorometric method is not suitable for samples containing very small amounts of galactose (blood from hepatic veins) and even for a few samples at moderate galactose content (blood from peripheral veins), suggesting the presence of an endogenous interference. There was no interference for the quantitation of galactose by the LCEC method, by virtue both of the specificity involved in the electrochemical detection and the separation by liquid chromatography. The detection limit of the LCEC method was 0.4 mg galactose/L blood. PMID- 3507223 TI - HPLC electrochemical fluorometric detection of amino acids including tryptophan using 4-fluoro-7-nitrobenzo-2-oxa-1,3-diazole. AB - It has been shown that by electrochemical oxidation 7-nitrobenzo-2-oxa-1,3 diazole-tryptophan (NBD-T) is converted to fluorophores having the same emission and excitation spectra as those for other NBD-amino acids. NBD-dioxindolylalanine was tentatively assumed to be a main electrochemical oxidation product of NBD tryptophan. A coulochemical cell placed between an analytical column and a fluorometer showed no detrimental effect on the separation of NBD-amino acids by reversed phase HPLC. Highly sensitive fluorescence detection was achieved for amino and imino acids at 10-100 fmol levels. The detection limit for tryptophan was 50 fmol. PMID- 3507224 TI - Micro-scale sequence analysis from the N-terminus of peptides using the fluorogenic Edman reagent 4-N,N-dimethylamino-1-naphthyl isothiocyanate. AB - The fluorogenic Edman reagent 4-N,N-dimethylamino-1-naphthyl isothiocyanate (DNTC) was reacted with amino acids and peptides, cyclized by acid and the liberated 4-N,N-dimethylamino-1-naphthyl thiohydantoin (DNTH) amino acids were then separated and detected by HPLC. The fluorescence intensities of DNTH-amino acids except DNTH-proline and -serine were dramatically increased in the alkaline solution and organic solvent. Thus, the postcolumn reaction with alkaline acetonitrile solution was adopted in HPLC. The polar and aromatic amino acids afforded two DNTH-amino acids on derivatization with DNTC and cyclization with acids. These were suggested to be stereoisomers of DNTH-amino acids. The sequence analysis of 0.5 nmol Leu-enkephalin was achieved by the double coupling method with DNTC and phenyl isothiocyanate followed by the proposed HPLC system. PMID- 3507225 TI - A rapid and sensitive method for measurement of leukotrienes based on HPLC. AB - A rapid and sensitive method for simultaneous detection of leukotriene (LT) B4, LTC4, LTD4, LTE4, 5S,12S-dihydroxy-eicosatetraenoic acid, 6-trans LTB4, 12-epi-6 trans LTB4 and the omega-metabolites of LTB4 has been developed. Leukocyte incubations were terminated by the addition of one volume of methanol, and the mixture was centrifuged. Analysis was then directly performed by reverse phase high performance liquid chromatography on a column packed with 3 microns Nucleosil C18 guarded by a precolumn. Quantitation of eluted compounds was carried out by UV-monitoring at 280 nm and integration of the elution profile. The sensitivity of the method was approximately 1 ng for both LTB4 and LTC4. Accuracy was 101.6% (SD +/- 9.8%) for LTB4 and 99.9% (SD +/- 8.7%) for LTC4 in the interval 5-160 ng. PMID- 3507226 TI - Determination of plasma cytidine deaminase activity by HPLC. AB - Cytidine deaminase is an enzyme of nucleic acid metabolism, the measurement of which has been proposed as a useful test for the early detection of pre-eclamptic toxaemia in pregnancy. The enzyme converts the nucleoside cytidine to uridine, with the release of ammonia, and it is the measurement of this latter compound that forms the basis of the conventional methods for the assay of cytidine deaminase. The low activity of the enzyme requires long incubation times, which in turn increase the possibility of contamination by exogenous ammonia. We have developed a new method for determining cytidine deaminase activity, utilising high performance liquid chromatography to measure the production of uridine. This method uses much shorter incubation times and is unaffected by ammonia contamination. This paper describes the development of the method and its comparison with the established assay. The relative merits of each are discussed. Finally, the adaptation of incubation and chromatographic conditions, in order to measure other enzymes of nucleic acid metabolism which are of clinical interest, is briefly mentioned. PMID- 3507227 TI - Hydrophobic interaction chromatography of autoproteolysis products of human seminal plasma. AB - Hydrophobic interaction chromatography was employed for the fractionation of the glycopeptide mixture obtained after autoproteolysis and delipidization treatment of normal human seminal plasma samples. This sequence of procedures led to the elimination of highly hydrophobic components and to the concentration of the carbohydrate-rich fractions. A partial separation between the O- and N-glycosidic linked oligopeptides was also achieved after the chromatographic step. PMID- 3507228 TI - Simultaneous determination of myocardial creatine phosphate and adenine nucleotides by reversed-phase HPLC. AB - An isocratic HPLC system has been developed which allows for the rapid (single run of 20 min) measurement of creatine phosphate (PCr) and adenine nucleotides (ATP, ADP and AMP) in extracts from freeze-clamped and freeze-dried myocardial tissues. The separation was achieved at room temperature by using a RP18 column and a dual variable wavelength spectrophotometer, set at 210 and 254 nm. The solvent was 30 mM potassium dihydrogen phosphate, 15 mM tetrabutylammonium hydrogen sulfate, pH 6.7, 19% (v/v) acetonitrile. A distinct separation (confirmed with the retention time of standard sample) of these high energy compounds was achieved. Standard curves were linear. In isolated rat hearts the following values were obtained (mumol/g dry wt, mean +/- SEM): ATP 21.5 +/- 1.3, ADP 4.6 +/- 0.2, AMP 1.5 +/- 1.1 and PCr 32.5 +/- 1.3; which are consistent with previously published values for high energy compounds in this tissue. PMID- 3507229 TI - Comparison of iodinated [Nle15]- and [Met15]-gastrin17 prepared by reversed-phase HPLC. AB - 125I-[Nle15]-gastrin17 prepared by the iodogen method can be separated by reversed-phase high performance liquid chromatography into two peaks, both of which elute after [Nle15]-gastrin17. Direct determination of the specific activities of the two derivatives by microbore reversed-phase HPLC indicated that they were the mono- and di-iodinated species. In contrast the two peaks obtained with [Met15]-gastrin17 iodinated under the same conditions eluted earlier, relative to the appropriate gastrin17 standard, than the [Nle15]-gastrin derivatives. Treatment of either peak with 0.75 M dithiothreitol at 56 degrees C or 95 degrees C resulted in progressive conversion to compounds migrating in relative positions similar to the 125I-[Nle15]-gastrin17 derivatives. Direct determination of the specific activity of the earlier eluting [Met15]-gastrin17 derivative before reduction indicated that it was the mono-iodinated species. It thus appears likely that iodination of [Met15]-gastrin17 by the iodogen method results predominantly in the formation of mono- and di-125I-[Met sulphoxide15] gastrin17. To avoid problems arising from oxidation of the methionine residue of gastrin during iodination, the use of 125I-[Nle15]-gastrin17 in binding studies is therefore recommended. PMID- 3507231 TI - HPLC determination of polyamines in the femtomole range. AB - A new method for the chromatographic determination of polyamines is presented. The procedure consists of the reaction of 9-fluorenylmethyl chloroformate (FMOC Cl) with polyamines at 50 +/- 1 degrees C for 10 min, followed by stepwise elution chromatography. The reaction is simple and the derivatives are stable. All the polyamine-FMOC derivatives can be separated within 13 min. The linearity of this method is satisfactory in the range of 0.5-100 pmol. The detection limits for putrescine, cadaverine, spermidine and spermine are 83.3 fmol, 109 fmol, 25.5 fmol and 22.7 fmol respectively. PMID- 3507230 TI - An HPLC assay for rat liver ferrochelatase activity. AB - A rapid, reliable, sensitive and reproducible HPLC method was developed for the assay of ferrochelatase activity in rat liver. The assay was carried out aerobically with Zn2+ and mesoporphyrin or protoporphyrin IX as substrates. Zn porphyrins formed were extracted with dimethyl sulphoxide/methanol (30:70, v/v) containing Zn-deuteroporphyrin as the internal standard for separation and quantification by reversed-phase chromatography. The Km for mesoporphyrin was 5.9 microM, for protoporphyrin IX 8.8 microM and for zinc 6.0 microM. The specific activities were 33.1 +/- 5.0 nmol Zn-mesoporphyrin or 13.4 +/- 2.0 nmol Zn protoporphyrin formed per hour per mg of protein for mitochondria and 12.3 +/- 2.2 nmol Zn-mesoporphyrin or 4.6 +/- 0.9 nmol Zn-protoporphyrin per hour per mg of protein for liver homogenate. PMID- 3507232 TI - A rapid method for the determination of benzylpenicillin in serum by reversed phase HPLC. AB - A simple procedure for the determination of benzylpenicillin in serum is described. The assay involves the extraction of the drug and the internal standard (phenoxymethylpenicillinic acid) from the sample into dichloromethane, using tetrabutylammonium hydrogen sulfate neutralized with NaOH and buffered with citrate as an ion-pairing reagent. RP-HPLC was performed on a Spherisorb 5 ODS column, eluting the drugs isocratically with 14% acetonitrile in 10 mM ammonium acetate buffer. Monitoring was by UV detection at 208 nm. Our results show that the method is accurate and reproducible, permitting quantification of serum levels of benzylpenicillin without interference from other drugs commonly used in therapy. Analytical recovery was greater than 79.2%. PMID- 3507233 TI - HPLC measurement of diltiazem and desacetyldiltiazem in serum or plasma. PMID- 3507234 TI - Thin-layer chromatography--the forgotten alternative for the quantitative determination of steroids. AB - We have developed a high performance thin layer chromatography (HPTLC) system for quantitative determination of androgens, corticosteroids, mineralocorticoids and gestagens on silicagel KG-60 HPTLC-plates with different solvent systems. A complete separation of androgens, gestagens and metabolites was achieved with dichlormethane/cyclohexane/acetone (70:25:5). Corticosteroids, mineralocorticoids and their derivatives were completely separated with diethylether/isooctane/isopropanol (70:25:5). The quantitative in situ fluorescence determination was carried out after post-chromatographic derivatization with cinnamic aldehyde, 4-dimethylaminobenzaldehyde and sulfuric acid. The sensitivity of detection was found between 500 pg and 1 ng per spot. The steroid metabolism as catalysed by rat liver microsomal oxidoreductases was measured by these procedures, and was compared with determination of steroids by gas chromatography (GC). According to HPTLC, steroids were reduced by NADPH-5 alpha-reductase (EC 1.3.1.4) in the order progesterone greater than testosterone greater than aldosterone greater than cortisol greater than corticosterone. The enzyme activities as measured by HPTLC agree well with those obtained by GC (r = 0.94). When turnover of enzyme assays, speed of determination, detection limit, application to labile steroids and costs of steroid determination are considered, all points speak in favour of HPTLC. PMID- 3507235 TI - Simple and rapid GLC method for the determination of orphenadrine in human plasma. AB - A rapid and specific method has been developed for the determination of orphenadrine concentration in plasma. It involves a one-step sample preparation using n-hexane/isopropyl alcohol (98:2) extraction, and analysis by gas chromatography on a wide bore capillary column using nitrogen/phosphorus detection. This procedure considerably simplifies previously reported assays and is specific and sensitive enough for the determination of orphenadrine in plasma of patients on chronic therapy. PMID- 3507236 TI - The effect of storage on rat tissues and human plasma amino acid levels determined by HPLC. AB - Tissue concentrations of the amino acids tryptophan, methionine, valine, phenylalanine, isoleucine and leucine were determined in rat liver, skeletal muscle and brain tissue and human plasma. The effect of storage at -20 degrees C for up to 21 days was examined. Significantly elevated levels after 7 and 21 days of storage were observed in liver and brain tissue but no changes were found in muscle and plasma. Minimal changes occurred in liver tissue stored up to 6 hours at -4 degrees C. This study emphasizes the need for rapid deproteinization of tissues to avoid changes in the free pool of amino acids. PMID- 3507237 TI - Measurement of ascorbic acid and dehydroascorbic acid in gastric juice by HPLC. AB - New methods are presented for measuring total vitamin C and the ascorbic acid/dehydroascorbic acid ratio in gastric juice. Extracts are prepared from a gastric juice which are suitable for direct injection onto a Waters Nova-pak C18 Radial-pak cartridge for high performance liquid chromatography (HPLC) using ultraviolet absorbance at 270 nm for detection. Both enable removal of interfering mucus and mucopolysaccharide breakdown products in a novel way. The first uses mini-columns of Sephadex G-50, run in acidic conditions to remove large molecular weight material while maintaining the ascorbic acid/dehydroascorbic acid ratio as it was in the fresh sample. Addition of dithiothreitol converts the dehydroascorbic acid quantitatively to ascorbic acid, thus enabling measurement of both components. The second method converts all the dehydroascorbic acid to ascorbic acid at the outset. A perchloric acid extract is neutralized and passed through a Sep-Pak C18. A new internal standard, reductic acid, is introduced for ascorbic acid analysis which behaves identically on Sep Pak C18. Samples are analysed by ion-pair chromatography using 0.02 M NH4H2PO4 buffer (pH 7.1): methanol (80:20 v/v) containing 0.62 g/L tetrapentylammonium bromide. The detection limit was 1 ng ascorbic acid, and chromatography was completed in 5 min. The values obtained by the two independent HPLC methods were in good agreement with each other and with those obtained by the 2,4 dinitrophenylhydrazine colorimetric method. PMID- 3507238 TI - The determination of cysteamine in physiological fluids by HPLC with electrochemical detection. AB - Cysteamine, an amino thiol, was separated by rapid isocratic cation exchange chromatography and detected by electrochemical oxidation at a platinum electrode maintained at +0.45 V relative to an Ag/AgCl reference electrode. Eluent pH and electrode working potentials were optimized and the effects of alternative buffers and organic modifiers have been examined. On column sensitivity for cysteamine was 1.5 pmol at a signal-to-noise ratio of 5. Although the specificity was good, plasma samples required maximal sensitivity whereas urine samples required greater selectivity, which was achieved by use of lower working potentials. Cysteamine concentrations were determined in serial samples of plasma and urine from volunteers who had received a single oral dose of 200 mg of the drug. Cysteamine was rapidly oxidized in vivo, and detection required prior reduction with dithiothreitol before analysis. PMID- 3507239 TI - Determination of 4-methylpyrazole in plasma using solid phase extraction and HPLC. AB - A rapid method for the determination of 4-methylpyrazole in plasma is described. Internal standard (3-methylpyrazole) is added to the plasma which is subsequently applied to a BondElut SCX column. After washing the column the 3- and 4 methylpyrazoles are eluted with a phosphate buffer and analyzed by isocratic reversed-phase high performance liquid chromatography with UV detection. The concentration of 4-methylpyrazole is calculated from the 4-methylpyrazole/3 methylpyrazole peak height ratio. The method is linear between 2.5 and 100 mumol/L with a within-day precision (CV) of 2.2% (n = 10) and a day-to-day precision of 2.8% (n = 30). The sensitivity is sufficient for analysis of plasma levels in the low micromolar range. PMID- 3507240 TI - Spreadsheet statistics. AB - Four spreadsheet templates are presented to carry out routine statistical analyses with relatively small amounts of data: two-sample Student's t test, one factor analysis of variance with replication, two-factor analysis of variance with replication, and Wilcoxon's non-parametric two-sample T-test (Mann and Whitney U-test). The use of sometimes complex IF and logic (AND, OR) functions in these templates is a means of maintaining a neat output presentation by avoiding error values, selection of appropriate forms of the t-test, and iteratively assigning mean ranks to data in the non-parametric test. The advantages of the spreadsheet approach accrue through using a multi-purpose package rather than dedicated statistics programs, having usually unobstructed access to the program for modification, relative ease of programming spreadsheets, and ease of correction and alteration of input data. Disadvantages are the limited size of templates and the small number of templates available. Spreadsheets represent a declarative form of programming rather than procedural, with consequent advantages in specifying the problem to be solved, which may have particular application in teaching statistics and programming at undergraduate level. PMID- 3507241 TI - Solving algebraic equations on a microcomputer. AB - Equation-solving programs for microcomputers make the numerical solution of algebraic equations an easy task. It is no longer necessary to learn or to program algorithms for the solution of many different types of equations. A single equation or a set of simultaneous equations may simply be entered into the computer and numerically solved for unknowns without concern as to whether the equations are linear or non-linear. Several examples of possible applications of equation-solving programs are discussed. Solution times for these examples are given for SEQS on the Apple II and Macintosh computers. The example sets of equations, which include chemical equilibrium and enzyme kinetics problems, have been chosen to demonstrate important aspects of the uses and limitations of equation solving. The four examples discussed are: a two-compartment pharmacokinetic model, citric acid ionization in aqueous solution, an enzyme inhibition model, and an example of the application of an equation-solving program in doing a simple non-linear regression problem. PMID- 3507242 TI - Lap computers in the laboratory. AB - The acquisition of data from laboratory instruments and the automatic control of experimental apparatus is facilitated by the use of small, inexpensive battery powered microcomputers ('lap computers'). Useful capabilities and features of currently available lap computers are summarized. A general strategy for data acquisition from laboratory instruments is outlined, and three illustrative examples of particular applications of lap computers in data acquisition and experimental control are described. PMID- 3507243 TI - Computer-aided analysis of infrared, circular dichroism and absorption spectra. AB - Marquardt and Powell optimization methods without constraints on the optimized spectral parameters were employed for decomposition of complex i.r., c.d. and absorption spectra into component bands. The procedure resolved experimental spectra into eight component bands and it can be easily adjusted for a larger set of component bands. The CPU time required for achievement of satisfactory convergence of parameters for eight component bands is rather large even when using mainframe computers and therefore division of spectra into a few non overlapped parts is advisable. The program also can be used for calculation of absorption, c.d. and difference spectra from formatted raw spectral data. PMID- 3507244 TI - A Pascal microcomputer program for prediction of protein secondary structure and hydropathic segments. AB - This paper describes a simple Pascal microcomputer program for prediction of protein secondary structure according to the Chou and Fasman algorithm. In addition, it performs an analysis of the hydropathic character of the residues for prediction of external/internal regions of the polypeptide chain. Also it searches for probable glycosylation and phosphorylation sites. PMID- 3507245 TI - Effect of biological toxins on gap-junctional intercellular communication in Chinese hamster V79 cells. AB - Since chemical modulation of gap-junctional intercellular communication has been implicated in several toxicological endpoints, a study to examine the ability of several biological toxins to inhibit this process was undertaken. Eight biological toxins were tested for their ability to inhibit metabolic cooperation, a measure of gap-junctional intercellular communication, in the Chinese V79 cell system. Aplysiatoxin, anhydrodebromoaplysiatoxin and debromoaplysiatoxin showed the strongest ability to inhibit metabolic cooperation while T2-toxin and vomitoxin inhibited metabolic cooperation to a lesser degree. Aflatoxin B1, aflatoxin B2 and palytoxin were inactive in the Chinese V79 system. Palytoxin, which was extremely cytotoxic, might act as a tumor promoter if it induces compensatory hyperplasia in vivo. PMID- 3507246 TI - Induction of malignant transformation in vitro and mammary tumors in rats by two new potent anthracycline antitumor antibiotics, morpholinodaunomycin and cyanomorpholinoadriamycin. AB - The two new potent anthracycline antitumor antibiotics, morpholinodaunomycin and cyanomorpholinoadriamycin, are non-mutagenic or weakly mutagenic in Salmonella typhimurium or V79 Chinese hamster cells, but highly active inducing DNA repair in in cultured rat hepatocytes. Both agents were found to induce malignant transformation in vitro of C3H M2 mouse fibroblasts and mammary tumors in female Sprague-Dawley rats. The data indicate a) that these new anthracyclines, too, are highly oncogenic and b) in conjunction with previously published results, that the predictive value of in vitro short-term tests for in vivo carcinogenicity is dependent on the employment of a battery of such tests. PMID- 3507247 TI - Organotin-induced hemolysis, shape transformation and intramembranous aggregates in human erythrocytes. AB - Organotin compounds examined in this study exhibited a relative order of potency for induction of in vitro hemolysis in human erythrocytes as follows: tri-n butyltin greater than tri-n-propyltin greater than tetra-n-butyltin greater than triphenyltin chloride greater than tri-n-ethyltin bromide greater than dibutyltin dichloride greater than stannous chloride greater than tri-n-methyltin chloride = butyltin chloride dihydroxide. All of the organotin compounds induced erythrocyte shape transformation from the normal discocyte to an echinocyte and, in addition, triphenyltin chloride, tetra-n-butyltin and tri-n-ethyltin bromide also elicited stomatocyte formation at higher concentrations. Select organotin compounds also formed tin-containing aggregates within the plasma membrane. The relative order of effectiveness for organotin induction of intramembranous aggregates was tri-n butyltin greater than tri-n-propyltin greater than tetra-n-butyltin greater than tri-n-ethyltin bromide, which was based upon the lowest concentration at which they were observed. These results support the previously suggested theory that organotins are membrane effectors because of their comparatively high hydrophobic, lipid partitioning properties. The relatively lipophilic compound, triphenyltin chloride, appeared to be anomalous because it did not readily promote hemolysis or induce the formation of intramembranous aggregates in human erythrocytes. A log-linear statistical model demonstrated an association of hemolysis with both tri-n-butyltin aggregate formation and shape transformation. Select organotin compounds should be useful probes in membrane studies because of their numerous effects. PMID- 3507248 TI - In vitro cytotoxicity of heavy metals, acrylamide, and organotin salts to neural cells and fibroblasts. AB - The cytotoxicity of neurotoxic agents was determined for a series of brain derived cell types and compared with their toxic effects on BALB/c 3T3 fibroblasts, using the neutral red assay. Ranking of toxicants according to their potencies was the same for all cells tested and was in the order of methylmercury greater than cadmium greater than mercury greater than zinc greater than acrylamide. For a series of di- and triorganotins the ranking order was dibutyl greater than diphenyl greater than dibenzyl greater than dipropyl greater than diethyl greater than dimethyltin and triphenyl greater than tribenzyl greater than trimethyltin, respectively. The test was sensitive enough to detect structure activity relationships between the degree of toxicity and the hydrophobic characteristics of the agents tested. PMID- 3507249 TI - Unscheduled DNA synthesis: workshop overview. PMID- 3507250 TI - Influence of age, sex and strain on the in vitro induction of unscheduled DNA synthesis in rat hepatocyte primary cultures. AB - The activity of chemical-induced unscheduled DNA synthesis was evaluated in hepatocyte primary cultures from Fischer 344 and Sprague-Dawley rats over a period of two years. In this two-year study hepatocytes from both sexes and strains were prepared from animals 2, 8, 14, 20 and 25 months of age and UDS was measured by autoradiography following treatment with N-methyl-N'-nitro-N nitrosoguanidine and 2-acetylaminofluorine. A dose-related positive response occurred for both compounds throughout the study in hepatocytes from male and female Fischer rats and male Sprague-Dawley rats. The magnitude of the response was greatest in hepatocytes from male Fischer rats and a markedly lower response in unscheduled DNA synthesis occurred in all cultures prepared from animals of both strains and sexes at 20 and 25 months of age. Hepatocytes from female Sprague-Dawley rats showed a low level of unscheduled DNA synthesis with N-methyl N'-nitro-N-nitrosoguanidine throughout the study. The most striking finding was the absence of a UDS response to 2-acetylaminofluorene by hepatocytes from Sprague-Dawley females at the 8, 14, 20 or 25 month periods. The results indicate an age-related decrease in chemical-induced unscheduled DNA synthesis activity among rats. PMID- 3507251 TI - Use of scintillometric quantitation of unscheduled DNA synthesis in isolated rat hepatocytes for the screening of genotoxic agents. AB - The induction of unscheduled DNA synthesis has been considered as a suitable endpoint for the screening of genotoxic agents. Experimentally, unscheduled DNA synthesis is most frequently measured by autoradiography. The purpose of this report was to examine the usefulness of the liquid scintillation counting technique in measuring unscheduled DNA synthesis response in isolated rat hepatocytes. The various liquid scintillation counting-based unscheduled DNA synthesis assay procedures were examined according to the following groupings: (1) procedures based on the acid precipitation of cellular macromolecules, (2) procedures based on isopycnic gradient centrifugation of solubilized cells, (3) procedures based on nuclei isolation in conjunction with other DNA purification methods, and (4) procedures based on the selective retention of hepatocellular DNA. Limited cases in which test chemicals gave positive unscheduled DNA synthesis response in liquid scintillation counting-based assays and negative unscheduled DNA synthesis response in autoradiography-based assays are presented. It is concluded that liquid scintillation counting-based unscheduled DNA synthesis assays represent an appropriate system for inclusion in carcinogenicity and mutagenicity testing programs. PMID- 3507252 TI - Effects of pretreatment with inducers of hepatic mixed function oxidases on DNA repair elicited by various compounds in hepatocytes from adult and neonatal rats. AB - Studies were conducted to assess the effects of inducers of hepatic mixed function oxidases on DNA repair responses to 13 different genotoxic agents in hepatocytes from adult male mice. Phenobarbital pretreatment increased DNA repair elicited by diethylnitrosamine but had no effect on responses to the other compounds. Pretreatment with p,p'-dichlorodiphenyltrichlorethane, 3-methyl cholanthrene or beta-naphthoflavone induced the DNA repair responses to a variety of activation-dependent carcinogens. DNA repair responses to the direct-acting alkylating agents methyl methanesulfonate and N-methyl-N'-nitro-N nitrosoguanidine were not increased by any of the pretreatments, which indicated that the pretreatment-related enhancement of responses to the other compounds was due to induction of their metabolic activation. Taken together, the findings suggest that Aroclor, or other pretreatments, may increase the sensitivity of the hepatocyte DNA repair assay for detecting the genotoxicity of certain compounds; however, the potential benefit may be limited due to specific features of the assay. In contrast, Aroclor pretreatment did not produce any enhancement of in vivo DNA repair elicited by dimethylnitrosamine, diethylnitrosamine, o aminoazotoluene, 2-acetylaminofluorene, 3-methylcholanthrene or aflatoxin B1, and thus does not appear to be useful for improving the sensitivity of the in vivo/in vitro assay. Whereas the amount of DNA repair produced by dimethylnitrosamine was not increased by classical inducers of liver microsomal enzymes, pretreatment with pyrazole greatly augmented in vitro and in vivo DNA repair responses to dimethylnitrosamine; responses to diethylnitrosamine were increased to a lesser degree by pyrazole pretreatment. The effects of lactational exposure to enzyme inducing agents on DNA repair in neonatal hepatocytes was also investigated. PMID- 3507254 TI - Unscheduled DNA synthesis: some statistical thoughts. AB - Statistical interpretation of results of experiments involving unscheduled DNA synthesis is examined from a design standpoint. Most appropriate methods currently in use are evaluated and some modifications and extensions are suggested. Concerns about replication and/or interaction errors are evaluated and methods for their appropriate handling are discussed. It is suggested that methods incorporating both dose-response and heterogeneity statistics should be considered in treating results from unscheduled DNA synthesis experiments. Proper designs for such experiments are emphasized. PMID- 3507253 TI - In vivo measurement of unscheduled DNA synthesis and S-phase synthesis as an indicator of hepatocarcinogenesis in rodents. AB - Measurement of chemically induced DNA repair as unscheduled DNA synthesis in rodent liver following in vivo treatment is a useful screen for potential hepatocarcinogens. In addition to measurement of unscheduled DNA synthesis, examination of S-phase synthesis provides an indicator of chemically induced cell proliferation in the liver, which may be a basis for hepatic tumor promotion. Several chemicals and classes of chemicals have been examined using these end points. The pyrrolizidine alkaloid riddelline is a potent genotoxic agent in vitro, and in vivo studies confirm this response as riddelline induces significant elevations in unscheduled DNA synthesis and S-phase synthesis in rat liver. Conversely, H.C. Blue dyes #1 and #2 are both potent genotoxic agents in vitro but fail to express this genotoxicity in vivo. H.C. Blue #1 induces significant increases in S-phase synthesis in B6C3F1 mouse liver, which correlates with the observed carcinogenicity of this compound. Halogenated hydrocarbons likewise fail to induce unscheduled DNA synthesis in vivo, but many of these compounds do increase hepatic cell proliferation in mice, which may be the principal mechanism of hepatocarcinogenesis in this species. PMID- 3507255 TI - Variations on the standard protocol design of the hepatocyte DNA repair assay. AB - Several variations on the standard primary rat hepatocyte DNA/repair assay were evaluated for their ability to enhance the sensitivity of this genotoxicity test system. The use of hamster hepatocytes proved to be a much more sensitive system than rat hepatocytes for detecting the DNA repair inducing ability of the nitrosamines, dimethylnitrosamine and diethylnitrosamine, and the aromatic amines, 2-acetylaminofluorene, 9-aminoacridine, 1-naphthylamine and benzidine. In addition, hamster hepatocytes were a more sensitive indicator of the genotoxicity of the azo dyes, o-aminoazotoluene, Congo Red and Evans Blue. However, the azo reduction product of the azo dyes Congo Red, Trypan Blue and Evans Blue, benzidine and o-tolidine, respectively, were active in both rat and hamster hepatocytes at concentrations that were 10-100 fold lower than the parent dyes. This suggests that little or no azo reduction of the dyes occurred in the in vitro assay systems. The in vivo-in vitro variation of the rat hepatocytes DNA/repair assay exhibited a positive DNA repair response with the azo dye solvent Yellow 5, which was negative in the standard in vitro assay. The in vivo in vitro hepatocyte DNA repair assay was also more sensitive for detecting the genotoxic activity of Evans Blue, which was positive in the in vivo-in vitro assay and equivocal in the standard in vitro assay. Also, Solvent Yellow 14 was negative in the in vitro assay, but induced an equivocal DNA repair response in the in vivo-in vitro assay system. A treatment/3H-thymidine labeling period of approximately 18 hours, compared to 4 hours, was demonstrated to be superior for detecting the DNA repair elicited by the mutagens 4-nitroquinoline-1-oxide, mitomycin C, dimethylnitrosamine and methyl methanesulfonate in the in vitro rat hepatocyte assay. There was little or no difference observed between the 4 hour and 18 hour treatment/labeling incubation periods for the detection of DNA repair induced by 2-acetylaminofluorene, aflatoxin B1, and benzidine. The data suggest that these several variations on the standard rat hepatocyte DNA/repair assay should be considered when evaluating the genotoxicity of chemicals for safety purposes. PMID- 3507256 TI - The hepatocyte primary culture/DNA repair test using hepatocytes from several species. AB - The hepatocyte primary culture/DNA repair test, originally validated with rat hepatocytes, has been extended to use hepatocytes from other species including mouse, hamster, guinea pig, rabbit, monkey and human. Both qualitative and quantitative differences have been observed when chemicals are examined in the hepatocyte primary culture/DNA repair test using hepatocytes from more than one species. Examples are discussed that illustrate that the genotoxicity of a chemical can be a species-specific response and that multi-species testing permits a more complete assessment of genotoxicity. PMID- 3507257 TI - Relative cytotoxicity of psychotropic drugs in cultured rat hepatocytes. AB - The relative cytotoxic effects of ten psychotropic drugs were assessed in rat hepatocyte monolayer cultures. Clear concentration-related toxicity was seen in the narrow range of 10(-5) M to 5 X 10(-5) M. The four cytotoxicity endpoints chosen were: release of the cytosolic enzyme, lactate dehydrogenase, and impairment of biosynthesis and secretion of proteins, bile acids and glycerolipids. LDH leakage and inhibition of protein secretion into the culture medium proved to be the parameters which allowed the best differentiation between the test compounds. The inhibition of glycerolipid secretion was the most sensitive test in relation to concentration and time of exposure. Based on the effects of these endpoints, the following ranking of relative in vitro toxicity, using equimolar drug concentrations, could be established: clomipramine greater than imipramine = thioridazine greater than chlorpromazine greater than amitriptyline = fluperlapine greater than haloperidol greater than promazine greater than clozapine much greater than sulpiride. This ranking order of in vitro cytotoxicity correlated well with the potential of the drugs to impair liver function in man. Only clozapine had to be classified as a false negative. There was, however, no correlation between the cytotoxicity and the intracellular accumulation of the test drugs. Furthermore, the comparison of the data obtained with psychotropics with the data from five other amphiphilic cationic drugs was consistent with the widely accepted concept of a direct toxic interaction of the drugs with cytomembranes. This nonspecific toxicity of the membrane-active drugs was further corroborated by a positive correlation between their potential to induce LDH leakage in hepatocytes and their ability to induce hemolysis in red cells. In conclusion, the results obtained in our study strongly suggest that it is possible to assess the relative cytotoxicity of psychotropic drugs in rat hepatocyte cultures. It is proposed that this in vitro system provides a useful tool to evaluate new drugs at an early stage of their development, and to identify the most promising candidates within a class of structurally related compounds. In addition, it allows information to be obtained on possible mechanisms of cytotoxicity. PMID- 3507258 TI - The evaluation of biological interactions using response surface methodology. AB - Response surface methodology was employed in the statistical analysis of the combination exposures of genotoxic agents, bischloroethylnitrosourea with cis diamminedichloroplatinum (II) and cis-diamminedichloroplatinum (II) with X rays. The measured endpoint in each case was sister chromatid exchanges in V79 Chinese hamster cells. The combination experiments employed a factorial design in which cells were treated, in various concentration combinations, with two agents simultaneously. Bis-chloroethylnitrosourea and cis-diamminedichloroplatinum (II) each exhibited curvilinear concentration-related increases in sister chromatid exchanges. X rays exhibited a dose-dependent increase in sister chromatid exchanges. For the cis-diamminedichloroplatinum (II)/X ray combinations, response surface methodology indicates a less-than-additive interaction, suggested by the non-parallel concentration-response curves of one agent at varying concentrations of the other, and a slight dose-dependent increase in sister chromatid exchanges due to X rays alone. Both cis-diamminedichloroplatinum and bis chloroethylnitrosourea exhibited concentration-related increases in sister chromatid exchanges, cis-diamminedichloroplatinum (II) being 8-10 times (dependent on what level of effect was compared) more potent than bis chloroethylnitrosourea. For the cis-diamminedichloroplatinum (II)/bis chloroethylnitrosourea combinations, an increasingly less-than-additive interaction was detected. The analysis of these combinations demonstrates the strength of response surface methodology, a collection of mathematical and statistical techniques for detecting, analyzing and describing the biological effects resulting from exposures to multiple cytotoxic agents. The descriptive ability of these procedures is shown to be useful in that it leads to the suggestion of hypotheses regarding mechanisms of action. PMID- 3507259 TI - Effect of chronic exposure to 2,3,7,8-tetrachlorodibenzo-p-dioxin on sister chromatid exchange levels in peripheral lymphocytes of the rhesus monkey. AB - Frequencies of sister chromatid exchanges and chromosomal aberrations were examined in peripheral lymphocytes of Rhesus monkeys which had been fed a diet containing 25 parts per trillion 2,3,7,8-tetrachlorodibenzo-p-dioxin for a period of 4 years. When compared to non-exposed control animals, no significant differences were noted for either of these cytogenetic endpoints. In addition, there was not a significant difference in sister chromatid exchange response to a challenge dose of mitomycin C in cells from 2,3,7,8-tetrachlorodibenzo-p-dioxin exposed animals compared to controls. Our results confirm the lack of genotoxic effects associated with 2,3,7,8-tetrachlorodibenzo-p-dioxin exposure. PMID- 3507260 TI - Sister chromatid exchanges in lymphocytes of early cases of nasopharyngeal carcinoma and in 100 healthy subjects. AB - Sister chromatid exchange rate was studied in 12 early diagnosed cases of nasopharyngeal carcinoma and in their paired controls. Exchange frequencies were also analyzed in 100 healthy subjects distributed in four regions of Hunan Province and correlated to nationality, age and sex. The incidence of sister chromatid exchange was significantly higher in the cancer patients than in the normal controls. No correlation was found between the frequency of sister chromatid exchange and region, nationality, age or sex. PMID- 3507261 TI - Gas chromatography-mass spectrometry analysis of tert.-butyldimethylsilyl derivatives of 2-acetylaminofluorene and metabolites in isolated rat hepatocytes. AB - A new technique for the conversion of 2-acetylaminofluorene and several ring hydroxylated metabolites to mono- and di-tert.-butyldimethylsilyl derivatives was developed to permit their analysis by gas chromatography-mass spectrometry in order to quantify the metabolism of 2-acetylaminofluorene incubated in freshly isolated rat hepatocytes. This new gas chromatography-mass spectrometry method allowed the separation, identification and quantitation of seven known metabolites comprising five arylhydroxylated compounds, 2-aminofluorene and N hydroxy-2-acetylaminofluorene. PMID- 3507262 TI - Effect of cellular glutathione depletion on cadmium-induced cytotoxicity in human lung carcinoma cells. AB - The effect of glutathione depletion on cellular toxicity of cadmium was investigated in a subpopulation (T27) of human lung carcinoma A549 cells with coordinately high glutathione levels and Cd++-resistance. Cellular glutathione levels were depleted by exposing the cells to diethyl maleate or buthionine sulfoximine. Depletion was dose-dependent. Exposure of the cells to 0.5 mM diethyl maleate for 4 hours or to 10 mM buthionine sulfoximine for 8 hours eliminated the threshold for Cd++ cytotoxic effect and decreased the LD50S. Cells that were pretreated with 0.5 mM diethyl maleate or 10 mM buthionine sulfoximine and then exposed to these same concentrations of diethyl maleate or buthionine sulfoximine during the subsequent assay for colony forming efficiency produced no colonies, reflecting an enhanced sensitivity to these agents at low cell density. Diethyl maleate was found to be more cytotoxic than buthionine sulfoximine. Synergistic cytotoxic effects were observed in the response of diethyl maleate pretreated cells exposed to Cd++. Thus the results demonstrated that depletion of most cellular glutathione in A549-T27 cells prior to Cd++ exposure sensitizes them to the agent's cytotoxic effects. Glutathione thus may be involved in modulating the early cellular Cd++ cytotoxic response. Comparison of reduced glutathione levels and of Cd++ cytotoxic responses in buthionine sulfoximine treated A549-T27 cells with those levels in other, untreated normal and tumor derived cells suggests that the higher level of glutathione in A549-T27 is not the sole determinant of its higher level of Cd++ resistance. PMID- 3507263 TI - Cystathionase activity and glutathione metabolism in redifferentiating rat hepatocyte primary cultures. AB - Capacity to incorporate methionine sulfur into glutathione as well as cystathionase activity were lost in cultured hepatocytes in a biphasic manner with 75% of the total capacity disappearing with a half-life of about 10.6 hr, the remainder with a half-life of greater than 20 hr. Nicotinamide, 25 mM, produced a single phase loss with a t 1/2 of approximately 21 hr for both transsulfuration and cystathionase activity. Loss of both methionine sulfur incorporation and cystathionase activity occurred in transferrin/sodium selenite supplemented Williams Medium E (TS-HWME) with a t 1/2 of about 96 hr through 72 hr in culture. Addition of the cystathionase inhibitor, propargylglycine, blocked glutathione synthesis in TS-HWME cells through 48 hr in culture, while propargylglycine blocked glutathione synthesis only at 4 hr in HWME cultured cells. Further, the accumulation of gamma-glutamyl transpeptidase was delayed by 48 hr in TS-HWME versus unsupplemented medium. Variation in the transport of sulfur amino acids was also found to occur with culture age. The Km values for cysteine and methionine transport were found to be approximately 150 and 100 microM, respectively, and were unaffected by culture age or the presence of TS HWME. However, the Vmax for transport of methionine declined from 0.29 to 0.012 nmol/min/mg protein over 48 hr in culture. In TS medium, the Vmax at 48 hr for methionine transport had only decreased to 0.20 nmol/min/mg protein and increased for cysteine transport to 0.17 nmol/min/mg protein. These data suggest that during the redifferentiation of hepatocytes in culture, transsulfuration is regulated by control of the flow of substrate through cystathionase and that cystathionase is regulated by alteration of enzyme activity or content. Variations in the rate of transport of precursor sulfur amino acids are also an important component of the regulation of the net glutathione status of the redifferentiating hepatocyte. PMID- 3507265 TI - Effects of long-term in vitro exposure to aluminum, cadmium or lead on differentiation and cholinergic receptor expression in a human neuroblastoma cell line. AB - Neurotoxicity of long-term exposure to lead, aluminum and cadmium has been studied in vitro on the human neuroblastoma cell line IMR32 by measuring cytotoxicity, and the effects on neuronal-specific characteristics such as nitrite outgrowth and expression of cholinergic receptors as parameters of toxicity. Cytotoxicity was highest with cadmium, intermediate with lead and lowest with aluminum exposure. Lead, but not cadmium and aluminum, interfered with neurite growth. The expression of alpha-bungarotoxin binding sites and muscarinic receptors was markedly increased by cadmium and not affected by aluminum exposure. Lead induced only an increase of toxin binding sites. These in vitro modifications are discussed in relation to the possible use of neuronal cell lines for detecting neurotoxic effects of heavy metals. PMID- 3507264 TI - Lipid peroxidation and cellular damage caused by the pyrrolizidine alkaloid senecionine, the alkenal trans-4-hydroxy-2-hexenal, and related alkenals. AB - Lipid peroxidation was examined as a possible mechanism for cell injury by trans 4-OH-2-hexenal, the macrocyclic pyrrolizidine alkaloid senecionine and related alkenals in isolated rat hepatocytes. Each compound elicited a positive dose response for peroxidation of cellular lipids as measured by the formation of thiobarbituric acid-reactive products. The addition of the anti-oxidant N,N' diphenyl-p-phenylenediamine to the hepatocyte suspensions inhibited the production of thiobarbituric acid-reactants. However, the presence of the anti oxidant had no protective effects on the cell membrane integrity as evidenced by the leakage of lactate dehydrogenase from the cells into the surrounding media. These results suggest that lipid peroxidation which occurs in the presence of senecionine, trans-4-OH-2-hexenal or related alkenals is not entirely responsible for the cellular damage in isolated rat hepatocytes. PMID- 3507267 TI - [Use of axiography for observation and frontal measurement of internal derangements of the TMJ]. PMID- 3507266 TI - Cell injury and regeneration of human epithelium in organ culture. AB - Human esophageal, tracheal, and pancreatic ductal fragments were collected at autopsy after a postmortem interval of 12 hours or less and maintained in explant organ culture for 30 days. The viability and growth of the explants was assessed by morphology, LDH enzyme release, and cellular outgrowth. The viability and growth of the bronchial explant epithelium was directly related to the postmortem interval. Esophageal epithelial regeneration followed the desquamation of the superficial cell layers. Pancreatic epithelia appeared to grow more slowly and with less outgrowth than the other tissues. Epithelial cell growth along the explant surface and onto the culture dish appeared to proceed through the well characterized process that follows cell injury, i.e., flattening, migration, replication, and differentiation. Thus, sufficient numbers of viable epithelial cells capable of regeneration were present in routine autopsy epithelium, but there was considerable variation from tissue to tissue and case to case. The most effective and accurate approach to follow when evaluating and predicting the growth and viability of these explants is by using a combination of morphologic, enzymatic and biologic assays. Errors in the interpretation of viability are possible when only one assay method is utilized. These tissues grown in explant organ culture are suitable for studies on the mechanism and response of epithelia to cell injury, recovery and wound healing. PMID- 3507268 TI - Genes, gene map, gene mapping. PMID- 3507269 TI - Report of the committee on the genetic-constitution of chromosomes 1 and 2. PMID- 3507270 TI - Guidelines for human gene nomenclature. An international system for human gene nomenclature (ISGN, 1987). PMID- 3507271 TI - Report of the committee on the genetic constitution of chromosomes 3 and 4. PMID- 3507272 TI - Report of the committee on the genetic constitution of chromosomes 5 and 6. PMID- 3507273 TI - Report of the committee on the genetic constitution of chromosomes 7, 8 and 9. PMID- 3507274 TI - Report of the committee on the genetic constitution of chromosomes 10, 11, and 12. PMID- 3507275 TI - Report of the committee on the genetic constitution of chromosomes 13, 14, 15 amd 16. PMID- 3507276 TI - Report of the committee for chromosomes 17, 18, and 19. PMID- 3507277 TI - Report of the committee on the genetic constitution of chromosomes 20, 21, and 22. PMID- 3507278 TI - Report of the committee on the genetic constitution of the X and Y chromosomes. PMID- 3507279 TI - The 1987 Catalog of mapped genes and report of the nomenclature committee. PMID- 3507281 TI - Committe on clinical disorders. PMID- 3507280 TI - Report of the committee on cytogenetic markers. PMID- 3507282 TI - Report of the committee on linkage data and gene order. PMID- 3507283 TI - Report of the committee on structural chromosome changes in neoplasia. PMID- 3507284 TI - Report on the committee on comparative mapping. PMID- 3507285 TI - Report of the committee on human gene mapping by recombinant DNA techniques. PMID- 3507286 TI - Congenital laryngotracheal (LT) cleft: report of a successful repair in an adult. PMID- 3507287 TI - Patients' perceptions of self-help groups in achalasia. PMID- 3507288 TI - Preliminary findings on the nature of dysphagia in patients with chronic obstructive pulmonary disease. PMID- 3507289 TI - A fluid mechanical perspective on esophageal bolus transport. PMID- 3507290 TI - Magnetic resonance imaging for evaluating neurogenic dysphagia. PMID- 3507291 TI - Abnormal solid bolus swallowing in the erect position. PMID- 3507292 TI - Abnormal head and neck movements associated with esophageal perforation and abscess caused by an ingested foreign body. PMID- 3507293 TI - Radiology of the adult soft palate. PMID- 3507294 TI - Editorial: esophageal symptoms and the "irritable esophagus". PMID- 3507295 TI - Pedunculated pharyngeal lipoma presenting as an esophageal polyp. PMID- 3507296 TI - Progression of Barrett's mucosa to adenocarcinoma after antireflux surgery: radiologic-pathologic correlation. PMID- 3507297 TI - Evaluation of dysphagia: a careful history is crucial. PMID- 3507298 TI - A modification of the modified barium swallow. PMID- 3507299 TI - Pharyngeal findings in 21 patients with achalasia of the esophagus. PMID- 3507300 TI - Aerosol regurgitation as a laryngeal-sensitizing event explaining acute laryngospasm. PMID- 3507301 TI - [The action of the preparations Incodyna and Incozan W on oral microorganisms]. PMID- 3507302 TI - [Black stain and caries in children and adolescents in schools]. PMID- 3507303 TI - [The level of health awareness in schoolchildren exposed to excessive concentrations of heavy metals]. PMID- 3507304 TI - [Determination of total fluorine content in preparations used for contact fluoridation in caries prevention]. PMID- 3507305 TI - [Iatrogenic mandibular fracture]. PMID- 3507306 TI - [Differences in stomatological-orthopedic diagnoses and their effect on the mode of treatment]. PMID- 3507307 TI - [The effect of orthodontic appliances on the periodontium and oral hygiene]. PMID- 3507309 TI - Paediatric surgery in Kenya. PMID- 3507310 TI - Peptic ulcer disease at Kenyatta National Hospital: an endoscopic experience. PMID- 3507308 TI - [A contribution to the treatment of fractures of mandibular condylar processes in children]. PMID- 3507311 TI - Nutrition in pulmonary tuberculosis: a comparison of African patients from Malawi and Nigeria. PMID- 3507312 TI - Praziquantel for the treatment of tapeworms in Kenya. PMID- 3507313 TI - Torsion of the testis: a real emergency? PMID- 3507314 TI - The practice of paediatric surgery at a rural district hospital in Kenya. PMID- 3507316 TI - Medical curriculum in a developing country. PMID- 3507315 TI - Intrauterine-neonatal torsion of the spermatic cord in an Ethiopian newborn: a case report. PMID- 3507317 TI - [Carabelli's tubercle and its relation to the occlusal surface of the upper second molar]. PMID- 3507319 TI - Empty sella syndrome occurring with polyostotic fibrous dysplasia of the midface: report of a case. PMID- 3507318 TI - [Orthodontic treatment of Class III malocclusion. Report of a case]. PMID- 3507320 TI - Soft tissue proliferation in a non-healing extraction site. A sign of metastatic malignancy. PMID- 3507321 TI - Gigantiform cementoma. Report of 2 cases. PMID- 3507322 TI - Radiation doses to sensitive organs from intraoral dental radiography. PMID- 3507323 TI - An analysis of different planes within the image layer in rotational panoramic radiography. PMID- 3507324 TI - Student-directed education in oral radiology: an alternative teaching technique. PMID- 3507325 TI - Remodelling of the temporomandibular joint after conservative treatment of condylar fractures. PMID- 3507326 TI - Changes in glutathione peroxidase activities and the oxidative burst of leukocytes during inflammation in the mouse and rat. AB - The relationship between glutathione peroxidase (GSH-Px) activity and opsonized zymosan-induced chemiluminescence (CL) has been studied with exudate leukocytes obtained at different times after induction of inflammatory responses in the mouse peritoneal cavity with heat-killed Corynebacterium parvum and in the rat pleural cavity with lambda-carrageenin. GSH-Px activity in mouse peritoneal exudate cells fell markedly after 2-4 h, returning to normal within 1-2 days. The lowered enzyme activity was associated with an increased ability of the cells to generate CL. Rat pleural exudate cells exhibited a slight fall in GSH-Px activity after 6 h which increased to supranormal levels within 1-2 days. During this period the ability of the cells to generate CL continually increased. The data indicate that during the early phase of increased generation of reactive oxygen species (ROS) by inflammatory leukocytes, the intracellular protective mechanism, represented by GSH-Px, is compromised. Subsequently, GSH-Px activity increases to or above initial levels possibly due to the presence of mononuclear cells and/or as a response to the increased generation of ROS. PMID- 3507327 TI - Nutrient foramina of humerus, radius and ulna in human fetuses. PMID- 3507328 TI - Development of the stapedius muscle in human fetuses. PMID- 3507329 TI - Morphology of the gastrocnemius muscle of the calf in men representing the white and black races. PMID- 3507330 TI - Arteries of the aortic arch in pastel fox Vulpes vulpes fulva. PMID- 3507331 TI - Arterial pattern of the medial basal segment (S7) of the human left lung. PMID- 3507332 TI - Skin innervation of the foot in human fetuses. PMID- 3507333 TI - Lamina medullaris pretectothalamica and adjacent nuclei in the rat. PMID- 3507334 TI - Studies on cortical index of the second metacarpal bone from 6 to 9th life decade. PMID- 3507335 TI - The formation of motor cell groups in the human embryonic spinal cord. PMID- 3507336 TI - The method of demonstration of prometaphase chromosomes. PMID- 3507337 TI - Electrofusion for the pronuclear transplantation of mouse eggs. AB - The present study was undertaken to determine the efficiency of HVJ treatment and electrofusion for pronuclear transplantation in the mouse. The output voltage and duration of the pulses were fixed to 200 microsec at 10 V or to 150 microsec at 15 V for electrofusion, because the maximum rates of blastomere fusion of 2-cell embryos and development of fused embryos in vitro were obtained under these conditions. Although the proportion of eggs with fused karyoplast (78%) and the fused eggs developed to morulae or blastocysts the proportion of pregnant recipients and young obtained after treatment of fused eggs was not significantly different between these two procedures. It is advised that electrofusion can be used as a fusogenic procedure for pronuclear transplantation in the mouse in some cases where HVJ cannot be applied. PMID- 3507338 TI - Structural organization of the sperm chromatin in a fern (Scolopendrium vulgare) studied by spreading methods. AB - To investigate chromatin organization, we applied the spreading techniques to nuclei isolated from Scolopendrium spermatozoids. Well-dispersed chromatin shows three types of fibers: beaded fibers corresponding to a nucleosomal filament with adjacent nucleosomes in close contact, smooth fibers (14 nm in diameter) associated in a complex network, and knobby fibers constituted by local supercoiling of a very thin (4 nm) smooth filament. Along the knobby fibers, beads of variable size are irregularly spaced. The knobby fibers lie parallel and coalesce in thick bundles. The sperms basic proteins identified by electrophoretic analysis probably promote the supercoiling and the side-to-side attachment of the knobby fibers, which are all the more abundant in spread preparations. These results indicate that knobby fibers are probably located in the outer part of the sperm nucleus in which the chromatin is densely packed. As for the nucleosomal and smooth filaments, they may be situated in the inner part. PMID- 3507339 TI - Ultrastructural localization of labeled acrosomal glycoproteins during in vivo fertilization in the rabbit. AB - Rabbit spermatozoa were labeled predominantly in their acrosomal glycoproteins by 1-3H-glucosamine during spermiogenesis. Ova fertilized in vivo by spermatozoa labeled 22 days earlier were analyzed by fine-structure autoradiography for the localization of the label. The latter was found associated with 1) the fused membranes of the acrosomal cap remaining on the zona pellucida surface, 2) the material released on the zona surface after the acrosome reaction and possibly detectable after tannic acid fixation, 3) the equatorial segment of the sperm head and the preequatorial swellings, and 4) other sperm components, eg, the sperm tail. No labeling, on the other hand, was detected on the denuded leading edge of spermatozoa found either in the penetration slit or in the perivitelline space. Our observations suggest the involvement of acrosomal glycoproteins in different mechanisms of sperm/zona pellucida interaction but are not in favor of a major role of (enzymatic) glycoproteins bound to the inner acrosomal membrane during the penetration of the zona pellucida. PMID- 3507340 TI - Intermolecular cross-linking of vitelline envelope polypeptides predominates in the hardened sea urchin fertilization envelope. AB - At fertilization, the sea urchin egg vitelline envelope (VE) elevates, and a subset of released cortical granule proteins, paracrystalline protein fraction (PCF), associates with the VE to form the fertilization envelope (FE). Cortical granule peroxidase cross-links FE polypeptides by phenolic coupling of tyrosyl residues. We have used an immunological approach to determine which polypeptides are linked together in the hardened FE of Strongylocentrotus purpuratus. Soluble polypeptides were extracted from hardened FEs, and antibodies were prepared in rabbits against the insoluble envelope matrix (FE ghost). Whole immune serum and purified IgGs each reacted with FE ghosts when using an enzyme-linked immunosorbent assay. VEs isolated by means of three published procedures cross reacted with the immune serum and purified IgGs. Soluble FE polypeptides also cross-reacted with whole immune serum and IgGs owing to the presence of VE polypeptides. Hyalin, a protein not found in FEs, and PCF did not cross-react with antiserum against FE ghosts. To determine which VE polypeptides were cross linked in the hardened FE, VE polypeptides were immunoblotted by using antiserum against FE ghosts. Most of the VE polypeptides that ranged from 68,000 to 283,000 molecular weight cross-reacted with the antibody. PMID- 3507341 TI - Identification of a male-specific histocompatibility protein on preimplantation porcine embryos. AB - An indirect immunofluorescence assay was used to detect the presence of male specific protein(s) on various stages of preimplantation porcine embryos. Embryos were collected at slaughter from the reproductive tracts of day-2.5, -4, -5, -6, and -8 (day 0 = first day of estrus) sows and gilts. Embryos were placed in medium containing an anti-male primary antibody, washed, and transferred to culture drops containing a fluorescein isothiocyanate (FITC)-labeled secondary antibody. Embryos were classified as either fluorescent (H-Y positive) or nonfluorescent (H-Y negative), transferred to coded drops, and karyotyped to examine sex chromosomes. A total of 91 eight-cell to blastocyst stage embryos were evaluated; of these, 46% were classified as fluorescent and 54% as nonfluorescent. Of readable metaphase spreads (65%) from these embryos, 81% (48 of 59, P less than 0.005) were correctly sexed by immunological detection of the male-specific antigen. Although 13% (2/15) of four-cell embryos evaluated were classified as fluorescent, the accuracy with which embryos at this stage were sexed by detection of H-Y antigen was not different from 50%. Fifty percent of eight-cell embryos were classified as H-Y positive with 78% of embryos correctly sexed. It was concluded that the eight-cell embryo is the earliest stage of development for which there is evidence for expression of H-Y antigen. Detection of the male-specific protein was difficult at the expanded blastocyst stage. PMID- 3507342 TI - Formation of the ventral hooks on the sperm head of the plains mouse, Pseudomys australis. AB - The sperm head of the plains mouse, Pseudomys australis, has three curved hooks projecting from its anterior margin. The two ventral hooks have previously been shown to consist largely of an extension of the subacrosomal material. To characterize further the structure and composition of the ventral hooks, we have examined their formation during spermiogenesis using transmission electron microscopy, silver staining, and actin localization with NBD-phallacidin. The ventral hooks develop as an extension of the perinuclear space and postacrosomal dense lamina on the anteroventral margin of the sperm head. Bundles of 6-nm-thick filaments appear in the core of each hook; these are probably actin filaments based on staining of the hooks with NBD-phallacidin. Just prior to spermiation, electron-dense material condenses in the core of the ventral hooks and concurrently in the perinuclear space in the remainder of the sperm head. The two ventral hooks thus appear to consist of a core of perinuclear material and actin filaments, which is enclosed by a continuation of the postacrosomal dense lamina. PMID- 3507343 TI - Sea urchin testicular cells evaluated by fluorescence microscopy of unfixed tissue. AB - A procedure is presented for rapid, quantitative evaluation of cell and nuclear types present in the male gonad of the sea urchin. Vitally stained whole mounts of tissue fragments or dissociated cells are prepared, which reveal detailed 3 dimensional chromatin patterns and enough cytoplasmic features to provide reliable markers for most of the somatic and germ line cell types. Representative cellular morphologies are described. Nuclear volume changes during spermatogenesis are quantified. Spermatid nuclei contain an apparently interconnected network of heterochromatin. Regions relatively devoid of chromatin decrease in size as nuclear condensation proceeds and spherical nuclear shape is maintained. The major decrease in nuclear volume occurs prior to the late spermatid stage. The volume of the spermatozoan nucleus is achieved by the smallest late spermatid nucleus before the change from spherical to conoid morphology. The relationship of this morphological transition to sperm histone dephosphorylation is discussed. PMID- 3507344 TI - Impaired ability of human spermatozoa to penetrate zona-free hamster oocytes: is a postacrosomal sheath anomaly involved? AB - We selected 17 infertile men whose sperm ultrastructural study revealed at least 70% of spermatozoa with postacrosomal sheath (PAS) anomalies. Among the other sperm head defects, those affecting the nuclear shape were most frequently encountered and were highly correlated with PAS anomalies (r = +0.71; P less than .01). PAS anomalies were also correlated with chromatin condensation defects (r = +0.67; P less than .01) and acrosome anomalies (r = +0.53; P less than .05). Those spermatozoa were tested for their ability to penetrate zona-free hamster oocytes and were compared to a control sperm population. It was shown that sperm head morphological anomalies impaired the ability of spermatozoa to attach to and penetrate the oocyte. The highest significant and negative correlations were found between the penetration rate and 1) the percentage of spermatozoa with PAS anomalies (r = -0.81; P less than .01) and 2) the percentage of spermatozoa with nuclear shape anomalies (r = -0.66; P less than .01). The effect of PAS anomalies on human fertilization process are discussed. PMID- 3507345 TI - Impaired spermatogenesis in the finch hybrid L. castaneothorax by L. punctulata: transmission electron microscopy and genetic analysis. AB - As part of a project to determine whether there is any correlation between the form of hybrid sterility and the genetic relatedness of the parental species, we studied a male intrageneric hybrid between two finch species (Lonchura castaneothorax X L. punctulata), and compared the ultrastructural basis of hybrid sterility in this species with that reported by Swan [1985] for an intergeneric bird hybrid. In the latter study the sterility appeared to have an autoimmune basis, due to lack of Sertoli-Sertoli tight junctions. In the hybrid examined in the present study, lanthanum tracing showed that the junctions were tight. There was no testicular immune reaction; the parental species were almost identical in chromosomal constitution, having only a small inversion difference on chromosome 5, and only two structural protein differences could be detected through examination of the variation at 38 protein loci. Nevertheless, the hybrid appeared sterile and had the following ultrastructural testicular features. Intercellular bridges where present were usually abnormal in structure; centrioles in a centriole pair were arranged in parallel. Many spermatocytes and spermatids degenerated and were phagocytosed by Sertoli cells. Some spermatids progressed to mature testicular spermatozoa in sperm bundles, but commonly had multiple (2-4) axonemes or disrupted doublets and accessory fibers. The multiple axonemes present in most spermatids inserted separately into the base of the nucleus and the multiple centrioles were capable of organizing separate neck structures. We conclude that these cytological abnormalities were caused by genic effects and discuss why they appeared to be restricted to the germ line. PMID- 3507346 TI - Use of salt-stored zonae pellucidae for assessing rabbit sperm capacitation for in vitro fertilization. AB - Zonae pellucidae of tubal and follicular oocytes were collected and prepared for salt storage. Cumulus and corona radiata cells were removed from oocytes with hyaluronidase and a small bore pipette. The oocytes (referred to as zonae since vitelline were rendered nonfunctional) were stored in a salt solution at 4 degrees C. Using in utero capacitated sperm, the penetrability of zonae from tubal and follicular oocytes stored immediately after collection was compared to controls, i.e., in vitro development of tubal ova to the 4-cell stage within 24 hr. The penetration rates were 100% (8 penetrated/8 inseminated), 77.8% (7 penetrated/9 inseminated), and 100% (10 fertilized/10 inseminated), respectively, and these were not statistically different. The mean (x) numbers of sperm able to penetrate the zonae, into the perivitelline space (PVS) for tubal (34.0) and follicular (1.1) oocytes were significantly different (P less than 0.01). However, following maturational incubation before salt storage, zonae of tubal and follicular origin showed no significant differences in penetrability of in utero capacitated sperm when assessed by percent penetration, or mean numbers of sperm cells reaching the PVS: tubal zonae, 100% (15/15), and follicular zonae, 100% (18/18), and mean number of sperm in the PVS (x [tubal zonae] = 12.4, and x [follicular zonae] = 11.8). The penetrability of tubal zonae with and without maturational incubation was compared, and no significant differences in penetrability by in utero capacitated sperm were present when assessed by percent penetration nonmatured 92.6% (25/27) and matured 93.3% (28/30) and mean number of sperm in the PVS (x [nonmatured] = 3.33 and x [matured] = 2.41). In vitro capacitation of ejaculated rabbit sperm by serum treatment was assessed by the penetration of salt-stored zonae, zona-free hamster oocytes (ZFHO), and in vitro fertilization of freshly collected tubal oocytes. None of 60 salt-stored zonae and none of 31 tubal oocytes were penetrated, and these values were significantly (P less than 0.005) smaller than the 9 of 78 (12%) zona-free hamster ova that were penetrated by sperm cells from the same sample. In vitro capacitation of ejaculated rabbit sperm by washing and preincubation was assessed by the penetration of salt-stored zonae, zona-free hamster oocytes (ZFHO), and fertilization of freshly collected tubal oocytes. Seventy-six of 80 salt-stored zonae were penetrated, and this was significantly (P less than 0.005) greater than the 67 of 87 tubal oocytes fertilized and 30 of 35 ZFHO penetrated, which were not significantly different.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3507347 TI - Flow cytometry of X and Y chromosome-bearing sperm for DNA using an improved preparation method and staining with Hoechst 33342. AB - A new and improved method of preparing mammalian spermatozoa for high resolution flow cytometric DNA analysis and flow sorting is described. Ejaculated or cryopreserved sperm were briefly sonicated to remove tails and then stained with Hoechst 33342. This simple procedure was found superior to more severe treatments of dimethylsulfoxide washes, fixation in 80% ethanol, and protease digestion of the sperm membranes and tails by papain. Flow cytometric DNA analyses of sperm samples subjected to varying sonication times indicated that X and Y chromosome bearing sperm populations could be well resolved with as little as 15-sec sonication. In addition, a comparison of sonicated samples stained with four concentrations of bisbenzimide (Hoechst 33342) or 4',6-diamidino-2-phenylindole (DAPI) indicated that 2.5 or 5.0 micrograms/ml of Hoechst was sufficient to resolve the X and Y sperm populations. In order to quantitatively describe the flow cytometric data, several indices (sample quality, orientation and splitting) were developed. PMID- 3507348 TI - Effects of exposing bovine sperm to bovine serum albumin, or freeze-thawing, on sperm-bound amidase activity. AB - Isolation of a self-selected population of motile spermatozoa is possible by using a gradient of bovine serum albumin (BSA). We determined if exposure to BSA altered the sperm or if isolated sperm differed from nonisolated cells in terms of motility or activity of sperm-bound amidase, either before or after subsequent cryopreservation. Exposure of sperm to 6% BSA in egg yolk Tris extender induced changes in the plasma and acrosomal membranes of sperm that resulted in exposure and activation of sperm-bound amidase (P less than .01). In experiment 2, semen extended in egg yolk Tris was cooled to 5 degrees C or layered onto a solution of 6% BSA in extender at 37 degrees C, from which the sperm that had swum into the BSA solution were recovered 2 h later and cooled to 5 degrees C. Sperm in both treatments were cryopreserved. The percentage of progressively motile sperm was determined visually and by track motility. Activity of sperm-bound amidase exposed to substrate was evaluated. After recovery of sperm from the 6% BSA solution, 81% were progressively motile as compared to 59% in the starting samples (P less than .01). However, the amount of exposed sperm-bound amidase also was greater (P less than .05); this was a deleterious change. Immediately after thawing, more (P less than .01) sperm were motile in samples of isolated sperm than for nonisolated cells (43 vs 24%), but after incubating the thawed sperm for 1 h at 37 degrees C there was no difference.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3507349 TI - Sperm chromosome analysis as a new system to test human X- and Y-sperm separation. AB - The correlation between the percentage of F-body-positive spermatozoa (F-sperm) and that of Y-chromosome-bearing spermatozoa (Y-sperm) determined by human sperm chromosome analysis was examined after spermatozoa were separated by an albumin column method [Ericsson et al, Nature 246:421-424:1973]. The percentages of F sperm were 43.1 +/- 4.8 (36.1-48.8) and 45.8 +/- 8.3 (35.3-66.5) before and after separation, respectively. A slight but significant (p less than 0.05) increase in F-sperm after the separation was observed in two semen donors. A total of 570 sperm karyotypes was analyzed and the percentage of Y-sperm ranged from 36.0 to 59.1 with a mean of 47.3. In one semen donor, the percentage of Y-sperm (45.6) was significantly (p less than 0.05) higher than that of F-sperm (35.3) after separation. In the remaining nine semen donors, the results obtained by chromosome analysis corresponded well with those obtained by F-body scoring. The validity of the albumin column method in isolating a Y-sperm-rich sperm population is discussed. PMID- 3507351 TI - Effect of mating on sperm distribution in the reproductive tract of the male rat. AB - Extragonadal sperm reserves in male rats were measured in different regions of the genital tract before and subsequent to normal ejaculation. In sexually rested rats, the sperm count (million spermatozoa for the paired organs) in different regions was: distal vas, 18; proximal vas, 9.8; cauda epididymidis, 229; caput + corpus epididymidis, 154. Following mating, the sperm count was reduced in the proximal and distal vas deferens and in the cauda epididymidis. The reproductive tract of mated females was found to contain 29% (no copulatory plug) or 59% (with copulatory plug) of the estimated mean ejaculate, which was estimated from the difference between the sperm counts in the sexually rested rat and following ejaculation. It is concluded that in the rat the immediate source of spermatozoa for ejaculation is the cauda epididymidis, with a smaller contribution arising from the vas deferens. PMID- 3507350 TI - Receiver-operating characteristics curves for semen analysis variables: methods for evaluating diagnostic tests of male gamete function. AB - This study draws on decision analysis to estimate the utility of seminal variables in predicting pregnancy. The infertile couples selected (n = 709) excluded those who had donor insemination or known female factors (history of pelvic infection, ovulatory disorders, endometriosis, and tubal disease). Diagnostic test properties were calculated with respect to pregnancy for two variables derived from the semen analysis report: sperm density, and the total number of motile sperm in the ejaculate (TMS). Receiver-operating characteristic (ROC) curves based on sensitivity and specificity revealed that none of the proposed thresholds for sperm density or TMS is clearly a best choice. The highest positive predictive values for sperm density (75%) and TMS (75%) were associated with cutoff points at five million sperm per milliliter and five million motile sperm per ejaculate, respectively. The false positive rates when these cutoff points were used were 4.3% (sperm density) and 5.6% (TMS). ROC analysis provides visual and numeric evidence of the quality of a diagnostic test and constitutes a set of procedures for incorporating information from new tests of male gamete function into the diagnostic assessment of infertility. PMID- 3507353 TI - Development of mouse embryos in vitro is affected by strain and culture medium. AB - One-cell and two-cell embryos from three random-bred strains of mice--CF1, Dub:(ICR), and CFW (Swiss-Webster)--were cultured to the blastocyst stage in Spindle's, Earle's, Ham's F10, Whittingham's T6, or Hoppe and Pitts' medium. CFW embryos were more successful than CF1 and Dub:(ICR) embryos in developing to the blastocyst stage in all five media. Dub:(ICR) and CFW two-cell embryos showed the best development in Spindle's, Whittingham's T6, and Hoppe and Pitts', whereas CF1 two-cell embryos were most successful in developing in Hoppe and Pitts' medium. Similar results were obtained with one-cell embryos, although fewer developed to the blastocyst stage, and T6 rather than Hoppe and Pitts' medium sustained the best development of CF1 one-cell embryos. For all strains, the least successful development was in Ham's F10, but CFW embryos did show good development in this medium. In addition to the effects of various media on mouse embryo development, our results indicate that the strain of mouse used for the bioassay of media is of critical importance. Random-bred CFW (Swiss-Webster) mice are as suitable as a hybrid strain for this purpose. PMID- 3507352 TI - Inhibition of progesterone-mediated maturation of oocytes of Xenopus laevis by oocyte maturation inhibitor from pig follicular fluid: development of a routine assay for the inhibitor with Xenopus oocytes. AB - We describe an assay for oocyte maturation inhibitor (OMI) using the progesterone mediated maturation of Xenopus oocytes. The test fraction used was a partially purified fraction from pig follicular fluid, which gave consistent inhibition of maturation in the pig oocyte assay. In the toad assay, oocytes (30-50) from each toad were pretested to determine whether satisfactory maturation was achieved because widespread animal variation was observed. Toads whose oocytes showed greater than 60% maturation in the pretest could be used directly. Toads whose oocytes showed less than 60% maturation were injected with pregnant mares serum gonadotropin (PMSG) in order to increase progesterone-mediated maturation. The dose and time after injection of PMSG before harvesting oocytes, dose and duration of progesterone exposure, and order of exposure of oocytes to OMI and progesterone were important variables. Opposing effects of OMI and progesterone were seen in oocytes from toads receiving 60 IU PMSG. In the routine assay we use animals whose oocytes show greater than 60% maturation in the pretest or animals treated with 12 IU of PMSG 4 to 7 days before use. Oocytes are exposed to the OMI fraction for 1 hr, progesterone is added, and incubations continued until controls reach maximum maturation (5 to 8 hr). The inhibition of toad oocyte maturation by OMI is reversible. The toad and mammalian oocyte assays were compared using more highly purified fractions of OMI and gave identical results. PMID- 3507354 TI - Formation of the rupture site in preovulatory hamster and mouse follicles: loss of the surface epithelium. AB - Changes in the morphology of epithelial cells covering the sides and apex of ovarian follicles were examined in mice and hamsters during the final 13 hr before rupture using light and electron microscopy. At the time of the surge of luteinizing hormone, approximately 13 hr before follicle rupture, epithelial cells along the follicle sides are spherical, covered with microvilli, and remain so throughout the entire cycle. As ovulation approaches, cells at the apex become progressively flatter, increase in diameter, and undergo a reduction in the number and length of microvilli. By 2 hr before ovulation, the microvilli are present only along the boundary between adjacent cells and the cells are in different stages of degeneration. In some cells, the cytoplasm is electron dense and the nuclei are pyknotic. Other cells become electron lucent and cytoplasmic elements are leached from the cell. The apical plasma membrane is lost first over the center of the cell and later over the periphery. Epithelial cells detach from the apex individually until a large patch devoid of cells is formed. This includes the site of eventual rupture. The loss of epithelial cells from the apex of ovarian follicles of other species is compared with our results, and the processes involved in stretching, degeneration, and sloughing of the epithelial cells are discussed. PMID- 3507355 TI - Formation of the rupture site in preovulatory hamster follicles: morphological and morphometric analysis of thinning of the granulosa and thecal layers. AB - The wall of hamster ovarian follicles is composed of the following cell layers: granulosa, theca interna, theca externa, and the surface epithelium. To determine the morphological changes occurring in the follicle during formation of the rupture site, we measured: the thickness of each layer, the number of cells in each layer, and size of cells in each layer, at the apex and base of follicles at specific times during the final 13 hr before ovulation. Changes in the wall occur in 3 stages. During stage 1 (T0-T8), which includes the first 8 hr following the surge in luteinizing hormone, the apical and basal walls thin at the same rate and the antrum increases in size. During stage 2 (T9-T12), there is no change in the thickness of the apical and basal follicle wall nor in the size of the antrum. During the third stage (T12-T13), the size of the antrum decreases slightly and there is an increase in the thickness of the basal wall, which is correlated with its constriction caused by the contraction of smooth muscle cells. The apical wall rapidly thins to the point of rupture. The morphology of cells from each layer is described. Theca interna cells form the final tissue preventing escape of the oocyte-cumulus complex. The roles of cell migration, stretching, and death in thinning of the apical wall are described, and the mechanisms involved in follicle rupture are discussed. PMID- 3507356 TI - Isolation of a stable apical segment of the guinea pig sperm acrosome. AB - The large apical segments of guinea pig sperm acrosomes were mechanically separated from the spermatozoa and subsequently isolated by density gradient centrifugation. The isolated acrosomal caps were very stable and maintained their crescent morphology when suspended in sucrose-based medium buffered at pH 5.6, with or without the acrosin inhibitor p-aminobenzamidine (pAB). Examination under the electron microscope showed that the acrosomal caps were free of plasma membrane and were bound by an outer acrosomal membrane which was discontinuous. Enzymatic analysis after lysis of the caps indicated that acrosin and hyaluronidase were present with high specific activity, while only a trace amount of acid phosphatase activity and no arylsulphatase, phospholipase A2, or phospholipase C activities were present. Significant particulate acrosin activity, but only trace amounts of soluble acrosin activity, could be detected in the isolated acrosomal caps if assayed immediately after isolation in the absence of pAB. However, soluble acrosin activity of high specific activity was obtained after the acrosomal caps were extracted by 10% glycerol buffered at low pH (pH 3.0). The new procedures provide a means to isolate and purify guinea pig sperm apical acrosomal segments rapidly. PMID- 3507357 TI - Homospermic versus heterospermic insemination of zona-free hamster eggs to assess fertility of fluorochrome-labeled acrosome-reacted bull spermatozoa. AB - Fresh spermatozoa from six bulls, with fertility ranging from 64% to 78%, (based upon 59-day nonreturn rates for 159,448 cows inseminated) were mixed with zona free hamster eggs in 15 heterospermic pair inseminations. Five of the bulls were used in homospermic insemination studies. Prior to incubation, spermatozoa from each bull were labeled with contrasting fluorescent stains pretested for effects on spermatozoa. Equal numbers of spermatozoa were mixed and treated with liposomes of dilauroylphosphatidylcholine to induce the acrosome reaction. Spermatozoa from split ejaculates within a male competed against each other equally in the hamster egg test, indicating that the staining procedure did not affect egg penetration rates. Bulls differed in their egg penetration rates when their sperm were inseminated either homospermically or heterospermically, but the differences in the homospermic inseminations were not significantly correlated with sire fertility. The number and percentage of sperm which penetrated eggs, and the number of eggs penetrated in the heterospermic competitive tests were highly correlated with fertility (r greater than or equal to 0.86). Therefore, egg penetration rates from heterospermic inseminations appear to be valuable indicators of fertility and much more sensitive predictors than results from homospermic inseminations. PMID- 3507358 TI - Susceptibility of epididymal boar sperm to cold shock and protective action of phosphatidylcholine. AB - Rapidly cooling (cold shocking) washed cauda boar sperm irreversibly reduced motility and respiration and greatly increased the uptake of 45Ca2+; the plasma membranes were removed and the acrosomes detached from nuclei. The motility, respiration, and calcium uptake of the less mature caput sperm were largely unaffected; and there was little damage to the ultrastructure. This indicates that boar sperm becomes less resistant to cold shock as they mature in the epididymis. The oxygen uptake, glucose breakdown, and lactic acid production of control caput sperm was less than that of cauda sperm. This suggest that the maturation of sperm in the epididymis of the boar involves an increase in both the glycolytic and oxidative phases of glucose metabolism. The presence of 2.0 mg/ml phosphatidylcholine (lecithin) in the medium prevented ultrastructural damage to cauda sperm on cold shock, and motility and respiration were maintained at levels similar to those of control sperm. Although the presence of phospholipid reduced the large calcium influx following cold shock, it was still greater that that of control sperm. The "protective" effect against cold shock was not maintained after rewashing the sperm free of phosphatidylcholine prior to cold shock, indicating a fairly "loose" interaction of the phospholipid with boar sperm membranes that was easily disrupted. PMID- 3507359 TI - Separation of motile human spermatozoa by means of a glass bead column. AB - Fertility potential of semen depends upon the presence of viable and motile spermatozoa. A variety of techniques has been reported whereby motile spermatozoa are separated from semen for use in homologous insemination. Using a column of glass beads, we tested various sizes for spermatozoa-separating efficiency. This procedure is quick and simple and results in a significantly better recovery of motile and viable spermatozoa from poor-quality semen. Therefore it has the potential for use in intrauterine insemination for treating male factor infertility. PMID- 3507360 TI - Sperm-sperm associations in the loris epididymis. AB - In a few mammals, the passage of maturing spermatozoa through the epididymis is characterized by development of persistent associations between one or more neighboring cells over the acrosomal region. The converse situation is described here in the loris, Nycticebus coucang, a prosimian primate. Loris spermatozoa released at spermiation enter the caput epididymidis as single cells and then become stacked in rouleaux of 2-8 spermatozoa there, the peri-acrosomal plasmalemma of one being linked by a unique junctional complex to that of its neighbor. However, by the time the cauda is reached, all the spermatozoa have separated again to lie as single cells, which now display major aggregations of ordered material over the concave surface of the acrosome. The functional significance of these unusual sperm surface-related phenomena in the loris epididymis is not clear. PMID- 3507361 TI - Ovulation and fertilization of primary and secondary oocytes in LT/Sv strain mice. AB - In this study, the chromosome constitution of both unfertilized oocytes and fertilized eggs isolated from the oviducts of LT/Sv strain mice were analyzed. Air-dried chromosome preparations from unfertilized oocytes revealed that about one-third of those examined were ovulated as primary oocytes. These were arrested at metaphase of the first meiotic division and exhibited the characteristic "tetrad" chromosome configuration. The remaining two-thirds of the unfertilized oocytes were ovulated at metaphase of the second meiotic division. The fertilized eggs were isolated from the oviducts of LT/Sv females previously mated to (C57BL x CBA) F1 hybrid males. Analysis of the fertilized eggs at metaphase of their first cleavage mitosis revealed that about one-third of the eggs examined were digynic triploids, whereas the remaining two-thirds had the normal diploid chromosome constitution. In the triploids, the 40 female chromosomes present (mouse, n = 20) were derived from a single diploid pronucleus formed after the extrusion of a first polar body, and following the monospermic fertilization of primary oocytes. The female pronuclear-derived chromosomes invariably exhibited "homologous pairing," and these were associated at their centromeres. The ovulation, penetration, and subsequent fertilization of primary oocytes is an extremely unusual phenomenon in mammals and only appears to occur on a regular basis in LT/Sv mice. The premature "cytoplasmic maturation" of these oocytes is of interest, as they clearly have the same developmental capacity as secondary oocytes. The significance of these observations in relation to folliculogenesis and litter size in LT/Sv mice is discussed. PMID- 3507362 TI - Binding of morphologically abnormal sperm to mouse egg zonae pellucidae in vitro. AB - The ability of morphologically abnormal mouse sperm to bind to the zona pellucida of the egg was examined with techniques of fertilization in vitro. After incubation with sperm, cumulus-free ova were scored by either phase microscopy or scanning electron microscopy for the number and type of sperm bound. The percentages of abnormal sperm bound to zonae were compared to the percentages of abnormal sperm in the inseminating suspension. In general, all abnormal classes (except broadly spatulate sperm) bound to zonae at a frequency significantly lower than their representation in the inseminating suspension. However, when the percentage of abnormal sperm was quite high, no significant difference existed between frequencies of abnormal sperm bound and in the inseminating solution. The percentage of abnormal sperm bound did not increase significantly over time. Scanning electron microscopy studies demonstrated that the association of abnormal sperm with the zona pellucida varied according to sperm morphology. Normal and some abnormal sperm bound at an angle perpendicular to the zona, while more grossly abnormal sperm bound to ova tangentially. PMID- 3507363 TI - The distribution of organelles in mammalian oocytes following centrifugation prior to injection of foreign DNA. AB - The centrifugation of oocytes from the domestic species is a necessary prerequisite to allow visualization of nuclei for the introduction of foreign DNA. This improvement in visibility which has allowed the production of transgenic animals is accompanied by a clear stratification of the organelles. In immature oocytes from the sheep, pig, and cow, four distinct zones are formed. These comprise, lipid, membrane-bound vesicles, organelle-free cytoplasm, and mitochondria. In mature ovine oocytes, a fifth zone of smooth endoplasmic reticulum (SER) beneath that of the vesicles is formed. This SER is produced at discrete locations within the untreated cell. The potential for removal of these fractions has implications for relating patterns of protein synthesis with particular structural components. In intact oocytes, the cortical granules are located in a peripheral position beneath the plasma membrane. However, even after subjection to high centrifugal force (65,000g for 60 min), they maintain their original location. However, treatment with the cytoskeletal inhibitors, nocodozole and cytochalasin, results in rapid exocytosis after centrifugation. It is concluded that the maintenance of the spatial relationships of this organelle is mediated through the peripheral cytoskeleton. PMID- 3507364 TI - Cytogenetic technique for mouse metaphase II oocytes. AB - The acquisition of cytogenetic data from mammalian oocytes has required considerable time and expense, since only a relatively small number of oocytes could be processed from three to four animals daily. The availability of a procedure that would facilitate fixation and preparation of air-dried slides from 25-30 superovulated mice within a 3-h period would enhance development of germ cell cytogenetic data by reducing technician time and animal maintenance expense. We present such a procedure for mouse metaphase II oocytes. Mice were superovulated and the oocytes collected were fixed en masse prior to making air dried slides. Chromosomes were subsequently C-banded to enhance objective cytogenetic analysis. The reliability of the procedure was determined by harvesting 44,814 oocytes from 1,875 mice over a 9-month period and calculating the proportion of cells cytogenetically analyzed to those not analyzed. Cytogenetic analysis of oocytes is an assay for chemicals (and other agents) capable of inducing numerical and structural chromosomal aberrations. PMID- 3507365 TI - DNA synthesis following microinjection of heterologous sperm and somatic cell nuclei into hamster oocytes. AB - We have investigated the ability of the hamster oocyte to initiate DNA synthesis in nuclei differing in basic protein content. DNA synthesis was studied by autoradiography in oocytes that had been incubated in 3H-thymidine after being parthenogenetically activated by sham microinjection, or microinjected with hamster, mouse, rabbit, or fish sperm nuclei, or hamster hepatocyte nuclei. Within 6 hr of sham or nucleus microinjection, nuclei of each type underwent transformation into pronuclei and synthesized DNA. These results demonstrated that the hamster egg can access and utilize its own and each type of template provided, whether homologous or heterologous. However, pronuclei derived from hamster sperm nuclei were more likely to be synthesizing DNA at 6 hr than pronuclei derived from sperm nuclei of other species. We conclude that the mechanisms employed by the hamster oocyte to transform hamster sperm nuclei into pronuclei and to effect DNA synthesis in these nuclei are not specific for the hamster sperm nucleus. Nevertheless, these mechanisms apparently operate more efficiently when the hamster sperm nucleus, rather than a heterologous sperm nucleus, is present. PMID- 3507366 TI - A computer-assisted assay for mouse sperm hyperactivation demonstrates that bicarbonate but not bovine serum albumin is required. AB - Mammalian sperm hyperactivation (HA) is a change in motility that accompanies capacitation (CAP) and is dependent on calcium (Ca) (Yanagimachi and Usui, Exp Cell Res 89:161, 1974). HA may be important for transport through the female tract and/or for fertilization. To develop an objective and quantitative assay for HA in individual mouse sperm, a computer-assisted motion-analysis system was used to describe sperm translational movements. To determine which movements were characteristic of HA, Ca-dependent motility was identified. This was done by incubating sperm with or without calcium (Ca+ or Ca- sperm, respectively), and determining the range of values for each motility parameter that was present only among Ca+ sperm. To do this, we compared frequency distributions of motility parameter values at the time of maximal CAP (90 min). CAP was monitored by measuring the level of in vitro fertilization and by evaluating the pattern of chlortetracycline binding to individual sperm heads [Ward and Storey, Dev Biol 104:287, 1984]. Two Ca-dependent motility subgroups were apparent: 1) a "slow speed" subgroup with a curvilinear velocity (Vc) less than 169 microns/sec that had none of the characteristics expected of HA sperm; and 2) a subgroup with higher speeds (Vc greater than 169 microns/sec) and wider-amplitude head movements as measured by curvilinear progressiveness ratio (PRc less than 0.56). The latter subgroup was selected as HA, since the frequencies and time course were similar to those for CAP in the same population. Two media components known to be important for CAP, bicarbonate and bovine serum albumin (BSA) were then tested to determine whether they were necessary for HA. Incubation of sperm without bicarbonate prevented HA, but omitting BSA did not affect HA during the first 3 hrs. These data suggest that HA is not tightly coupled with CAP. PMID- 3507367 TI - Effects of in utero and in vitro incubation on the lipid-bound fatty acids and sterols of porcine spermatozoa. AB - Sperm-rich semen and washed porcine spermatozoa were incubated for up to 2 hr either in utero in the presence of oviduct fluid or in vitro at 37 degrees C. Sperm lipids were extracted and separated into phospholipid and neutral lipid fractions. Eleven phospholipid and five neutral lipid fatty acids were identified and quantified using GC and GC-MS. The percentage of 22:5n6, the major phospholipid fatty acid, decreased slightly but significantly during 1.5 hr of in utero incubation (41.2-38.0%), but after 2.0 hr of in utero incubation no significant difference was observed (40.0%). None of the phospholipid fatty acids changed in concentration during in vitro incubation. The mole ratio of phospholipid to phospholipid fatty acid (1.00:1.27) did not change during incubation. The levels of neutral lipid-bound 14:0 decreased (43.5% to 31.8%) and that of 18:0 increased (11.1% to 18.2%) during in utero incubation. Similar but less pronounced changes were observed during in vitro incubation. (43.5% to 36.0%; and 11.1% to 15.8%, respectively). Two major sterols, cholesterol (73%) and desmosterol (27%) were identified by gas chromatography-mass spectrometry. The mole ratio of phospholipid to sterol (2.47:1:00) did not change during incubation. PMID- 3507368 TI - Changes in binding of a 27-kilodalton chimpanzee cauda epididymal protein glycoprotein component to chimpanzee sperm. AB - Motility patterns of caput epididymal chimpanzee sperm, caput epididymal chimpanzee sperm incubated in vitro with chimpanzee cauda epididymal fluid, and cauda epididymal chimpanzee sperm were assessed quantitatively. Sperm recovered from the caput epididymis showed no motility, whereas sperm recovered from cauda epididymis showed progressive forward motility. After incubation in cauda fluid, approximately 25% of caput epididymal sperm showed some motile activity. Electrophoretic analysis of 125I-labeled sperm plasma membrane preparations revealed that the surface of caput epididymal sperm, incubated in cauda fluid, was modified by the appearance of a major protein-glycoprotein surface component with an apparent molecular weight of 27 kilodaltons (kD). THis 27-kD component was not detected on caput epididymal sperm incubated in buffer or in caput fluid. However, it was present in cauda fluid and on cauda epididymal sperm. Binding to caput epididymal sperm was cell specific in that chimpanzee erythrocytes incubated in cauda fluid did not bind this 27-kD cauda fluid component. Motility patterns of ejaculated chimpanzee sperm and of ejaculated chimpanzee sperm incubated in the uterus of adult female chimpanzees also were assessed quantitatively. Ejaculated sperm showed progressive forward motility, whereas in utero incubated ejaculated sperm showed hyperactivated motility typical of capacitated sperm. Electrophoretic analysis of 125I-labeled sperm plasma membrane preparations revealed the loss of a 27-kD component from the surface of ejaculated sperm after in utero incubation. No significant change in the 125I distribution pattern was detectable when ejaculated sperm were incubated in buffer. These results suggest that the lumenal fluid component, which becomes adsorbed to the surface of chimpanzee sperm during maturation in the epididymis and which is removed from the surface of mature chimpanzee sperm in the female reproductive tract, affects sperm motility. PMID- 3507369 TI - Phosphorylation state of protamines 1 and 2 in human spermatids and spermatozoa. AB - The basic nuclear proteins of a fraction of elongating spermatids from human testes and of a fraction of motile spermatozoa from the ejaculate, separated by ion-exchange chromatography, were compared. Analysis by acetic acid-urea polyacrylamide gel electrophoresis (PAGE) showed that, in both fractions, four proteins of lower mobility were coeluted with protamine 1 by 23% guanidinium chloride (GuCl) while protamine 2 alone was eluted by 50% GuCl. Treatment with alkaline phosphatase identified those four proteins as phosphorylated protamines, and cyanogen bromide (CNBr) treatment of the dephosphorylated protamines distinguished them as variants of protamine 2 and not of protamine 1. Thus far, phosphorylated forms of protamine 1 have not been detected in either spermatids or spermatozoa. Those observations indicate that protamine 2 functions in the cycle of phosphorylation-dephosphorylation, which is essential to the process of sperm chromatin condensation, while the role of protamine 1 in human spermiogenesis is not yet defined. The presence of phosphorylated protamine in motile, presumably mature spermatozoa appears to be characteristic of human sperm but not of the sperm of other mammals and is probably the basis for the heterogeneity of chromatin condensation frequently observed in human spermatozoa. PMID- 3507370 TI - Ultrastructure of in vivo fertilization in the goat. AB - In vivo fertilization of goat eggs has been studied by electron microscopy. Eggs were recovered from superovulated or natural cyclic goats, 32 to 52 hours after the onset of oestrus; only eggs recovered between 46 and 52 hours were fertilized. Spermatozoa penetrated the zona pellucida tangentially leaving vesiculated products of the acrosome reaction at the zona surface. As sperm penetrated into the ooplasm, the second meiotic division completed and cortical granule exocytosis occurred. However a few unreacted cortical granules usually remained in the cortex of the fertilized eggs, adjacent to the plasma membrane. After swelling the two pronuclei presented similar ultrastructural morphology: they contained small, compact, agranular nucleoli and unevenly distributed chromatin. The cytoplasm in close vicinity to the apposed pronuclei contained large stacks of annulate lamellae, smooth endoplasmic reticulum, prominent Golgi complexes, as well as dense areas of unidentified material. The abundance of cytoplasmic organelles near the pronuclei might be the expression of intensive metabolic activity. Conversely, in the cortex of fertilized ova several large organelles-free cytoplasmic areas were randomly distributed. PMID- 3507371 TI - Protein synthesis in mature human oocytes. AB - As a first step toward understanding control of gene expression in early human development, an analysis of protein synthesis and amino-acid transport in unfertilized mature oocytes was initiated. Qualitative patterns of protein synthesis were examined in individual oocytes cultured in medium containing radiolabeled methionine. No differences in synthetic pattern of proteins, resolved by one-dimensional electrophoresis and fluorography, were observed in oocytes analyzed from times varying from 12 to 52 hr following collection by laparoscopy. Contamination by follicular or corona radiata cells was readily distinguished on the basis of increased relative synthesis of a polypeptide with Mr = 44,000, a dominant product of synthesis in follicular cells. Based on the specific activity of the methionine precursor, the absolute rate of synthesis was measured to be about 50 pg/oocyte/hr, a value higher than in mouse unfertilized eggs. No difference in protein synthetic rate was observed in oocytes analyzed at 12 hr postcollection versus later times up to 50 hr postcollection. Competition of methionine uptake by leucine, efflux of radiolabeled methionine from preloaded oocytes into medium containing methionine and uptake of methionine in medium with low sodium ion concentration was observed. These findings are consistent with the presence of an L (leucine-preferring) system for neutral amino acid transport, similar to that in mouse and rabbit eggs. Total protein was measured to be about 150 ng/oocyte, a value five times that of the mouse. These studies provide basic data for further analysis of oocytes and perhaps preimplantation stage embryos in the future. PMID- 3507372 TI - Development of the nucleolus in early goat embryos. AB - In vivo nucleologenesis was studied in goat embryos from the pronuclear stage to the blastocyst stage by light and electron microscopy. Ultrastructural changes of the nucleoli were characterized by the following progression: homogeneous electron-dense fibrillar primary nucleoli in the pronucleus; small, dense fibrillar masses dispersed in clusters of chromatin at the two-cell stage; ring shaped nucleoli made up of a fibrillar center surrounded by a layer of dense fibrillar components at the four-cell stage; reticulated nucleoli composed of a three-dimensional network of fibrillar components surrounded by small amounts of granular components at the eight-cell stage; fully developed compact-type nucleoli consisting of several fibrillar centers each surrounded by a layer of fibrillar components and abundant granular components in morulae and blastocysts. Moreover, it was concluded that activation of rRNA transcription, as evidenced by specific silver nitrate staining of the nucleolus organizer regions of metaphase chromosomes, occurs at the two- to four-cell stage and that the morphological changes accompanied a substantial increase in nucleolar transcriptional activity up to the blastocyst stage. This study provides evidence that a structure function relationship exists during nucleologenesis in goat embryos. PMID- 3507373 TI - Detection of acrosome-reacted toad sperm based on specific lectin binding to the inner acrosomal membrane. AB - When the sperm of the toad Bufo japonicus were treated with fluorescein isothiocyanate (FITC)-conjugated peanut agglutinin (PNA), soybean agglutinin (SBA), or Dolichos biflorus agglutinin (DBA), a few sperm fluoresced at the acrosomal region. The number of sperm showing this lectin binding to the acrosome increased significantly upon mild sonication of the sperm suspension. Electron microscopy revealed that ferritin-conjugated PNA bind not to the outer acrosomal and overlying plasma membranes, but specifically to the surface of the inner acrosomal membrane exposed by sonication. Both the percentage of FITC-PNA-labeled sperm and the activity of vitelline coat lysin released by sperm increased in good correlation with increasing sonication time, although the PNA-labeled sperm decreased in number upon longer sonication. These results indicate that the binding of FITC-PNA to the sperm provides a reliable measure of the acrosome reaction of Bufo sperm. PMID- 3507374 TI - Zona pellucida penetration assay for capacitation of bovine sperm. AB - In vitro capacitation and in vitro zona penetration systems are described for bovine spermatozoa. The criterion for capacitation was penetration by sperm of either 1) the zona pellucida of dead bovine oocytes, or 2) live, intact oocytes in which subsequent development was observed. Sperm were washed free of seminal plasma by centrifugation and incubated in a modified Tyrode's medium (TALP) in a 5% CO2-air atmosphere at 38 degrees C. Dead bovine oocytes were obtained from greater than 1 mm follicles from ovaries stored at -20 degrees C. Spermatozoa at a final concentration of 10(7) ml were coincubated with the oocytes for 3 hr after capacitation treatments. Initial experiments established that: 1) dead bovine oocytes can be penetrated by bovine sperm capacitated in the rabbit reproductive tract; 2) oocytes should be used for the penetration test within 24 hr of thawing; 3) oocytes could be stored for 24 hr at 4 degrees C after penetration before evaluation; and 4) penetration of zonae pellucidae of dead bovine oocytes by sperm is species specific. The percentages of dead oocytes penetrated after incubating frozen-thawed sperm for 0, 6, 12, 24, and 30 hr prior to incubation with oocytes were 17, 24, 34 10, and 0% respectively; the corresponding percentages for fresh semen were 1, 2, 5, 42, and 25%. Addition of 1% bovine seminal plasma to suspensions of washed, capacitated sperm decreased oocyte penetration percentages from 48% for the control (no seminal plasma) to 23%. Spermatozoa capacitated in vitro for 24 hr fertilized 15 of 22 ovulated oocytes (68%) from superovulated cows. Three embryos developed to the morula stage, but no pregnancy resulted after transfer of these embryos to bovine recipients. The present results provide the basis for a reliable (interassay C.V. = 13.4%) in vitro assay system for capacitation based on sperm penetration of the zona pellucida of dead bovine oocytes. PMID- 3507375 TI - Polyclonal antibodies to a 32-kDa deglycosylated polypeptide from porcine zonae pellucidae will prevent human gamete interaction in vitro. AB - The major deglycosylated polypeptides of the porcine zona pellucida (ZP), with molecular masses of 66, 52, 36, and 32 kDa, were purified to homogeneity with one dimensional sodium dodecyl sulphate/polyacrylamide gel electrophoresis (SDS/PAGE). Immunofluorescence studies demonstrated that antibodies to the DGZP fraction, and the 66- and 32-kDa polypeptides, bound predominantly to the outer ZP; however, only the first two of these antisera formed an immunoprecipitate around the outer human ZP. In immunoblotting experiments using polyclonal antisera raised to these molecules all four polypeptides exhibited cross reactivity with each other and their parental glycoprotein families (ZP 1-4). In addition, the antisera were tested in an in vitro human gamete bioassay to determine their contraceptive potential; antibodies to the 32-kDa deglycosylated polypeptide inhibited human gamete interaction to the greatest extent, 5.3% (+/- 1.2%), relative to a control value of 100%. PMID- 3507376 TI - Influence of proteins in rat cauda epididymidal lumen fluid on cauda sperm motility. AB - Rat cauda epididymidal spermatozoa are kept quiescent in the cauda lumen by a protein fraction termed "immobilin", but it has not been shown whether or not this activity is unique to the immobilin fraction. Cauda fluid was subjected to gel filtration chromatography and the eluents contributing to three peaks of absorbance at A280 were pooled, and reconstituted at equivalent concentrations. Their relative viscoelasticity and their effects on sperm motility were determined. Peak 1 (P1), containing proteins greater than 400 kd, retained the greatest sperm-immobilizing activity but P2 and P3 also had sperm-immobilizing activity related to their viscoelasticity. P1 and an immobilin fraction obtained by ultracentrifugation of rat cauda fluid were generally similar in their sperm immobilizing activity, viscoelasticity index, electrophoretic patterns, and binding characteristics to Concanavalin A; perm-immobilizing factor obtained by gel filtration chromatography and the immobilin fraction obtained by centrifugation are believed to be the same products. Further, it was shown that intraluminal intraluminal testicular fluids did not inhibit cauda sperm motility even at epididymal-like protein concentrations; thus, it is believed that the sperm-immobilizing factor(s) is of epididymal, not testicular, origin. PMID- 3507377 TI - Mechanism of egg attachment stalk formation in the lobster, Homarus. AB - We have examined the formation of the egg attachment stalk in the lobsters Homarus americanus and H. gammarus. The formation of the stalk is similar in both species. Ovulated oocytes are surrounded by a single coat, envelope 1, composed of layers 1A and 1B. After passage through the gonopore and exposure to sea water, envelope 1 swells and becomes sticky. A second coat, envelope 2, forms between the oocyte and envelope 1 during a complex cortical reaction initiated after fertilization. Eggs pass over the ventral surface of spawning females to the region of the pleopods, where they stick by means of layer 1A to each other and to the ovigerous setae. Layers 1A and 1B are soft and pliable at this time. During egg attachment, the pleopods beat vigorously and cause envelope 1 to stretch and form attachment stalks. Beating probably also causes the attachment stalks to twist and wrap around the ovigerous setae. After the egg mass is secured to the ovigerous setae, envelope 1 of both the attachment stalk and egg coat condenses to form a tough material capable of securing the egg mass to the pleopods for intervals up to 16 months. After larvae hatch, portions of the egg coats and the attachment stalks are retained on the ovigerous setae until the female undergoes her next molt. PMID- 3507378 TI - Fertilizability of unovulated mature eggs following indomethacin administration in mice. AB - Using mice as subjects, we investigated the effects of indomethacin (ID) on follicle rupture and nuclear maturation, and studied the fertilizability of ova retained in the follicles as a result of ovulation inhibition by ID. Ten units each of PMSG and hCG were administered intraperitoneally to mice at 56-hr intervals to induce superovulation. ID was administered 90 min after hCG injection. The ova recovered from the oviduct 17 hr after hCG injection numbered 32.2 +/- 7.8, 16.9 +/- 5.8, 5.6 +/- 2.9, and 1.0 +/- 1.3 for mice receiving 0, 0.5, 1.0, and 2.0 mg ID, respectively, demonstrating dose-dependent inhibition of ovulation. Ten hours after hCG administration, the intrafollicular ova that had matured to metaphase second stage comprised 43% in both groups. The fertilization rate (73.7%, 56/76) for the follicle-retained eggs in the 2 mg ID mice was similar to that for controls (72.9%, 62/85). Essentially the same results were seen with respect to efficacy of ovulation inhibition, rate of egg maturation, and fertilizability of the intrafollicular ova when ID was administered 30 min before hCG injection. These findings indicate that in the mouse, prostaglandins (PG), while required for follicle rupture, are not involved in the ovum maturation process, including fertilizability, under the experimental conditions employed. PMID- 3507379 TI - Changes of elemental concentrations around/on the rat sperm plasma membrane during maturation in the male genital tract. AB - This study was undertaken to analyze the changes of elemental concentrations around/on the plasma membrane of the head, midpiece, and principal piece regions of individual rat spermatozoa during maturation in the male genital tract by X ray microprobe analysis. Around/on the plasma membrane of the three different subcellular regions, concentrations of sodium, potassium, chlorine, and calcium decreased gradually during sperm passage through the male genital tract. Phosphorous showed almost constant concentrations. In contrast, magnesium concentration increased significantly through the process of maturation, and the concentration in the vas deferens was about three times higher than that in the testis. The Na-to-K ratios on the midpiece also increased gradually during maturation. PMID- 3507380 TI - Cytochemical analysis of the anionic sites on the membrane of the stallion spermatozoa during the epididymal transit. AB - The structure, relative density, and distribution of anionic sites on the surface of epididymal and ejaculated spermatozoa were studied using polycationic ferritin (CF), colloidal iron hydroxide (CIH), various enzymatic treatments, methylation, and de-acetylation. Macro-molecules containing sugar residues, probably sialic acid, are part of the sperm membrane and show a characteristic distribution and density that is dependent of the sperm region and of its origin. Unlike the spermatozoa of other eutheria examined, the exposure of the stallion spermatozoa to neuraminidase treatment did not produce significant changes in the density of the negative charge of the sperm surface. The ability of purified neuraminidase to act only after saponification suggests that sialic acid may be present in the acetylated form. When CIH was used it is seen that the density of the negative charge is rather uniform within a particular segment of the spermatozoa and abruptly changes at the junction of morphologically distinct segments (Between the acrosomal and post acrosomal region of the sperm head and between the post acrosomal region and middle piece of the flagellum). The acrosome presented more negative groups dissociated at pH 1.8 than the postacrosomal region. A greater concentration of anionic sites over the flagellum was also observed when CIH and CF were used. This asymmetry probably represents different domains that may be related to specific functions. The cytochemical observations and the cellular electrophoretic mobility measurements did not show striking differences on the negative charge of sperm obtained from different regions of epididymis and ejaculates in contrast to previous results in other species. The spermatozoa collected from caput epididymidis bind CIH but not all population present equal response. In corpus and cauda region of epididymis the population displaying the capacity to bind CIH or CF significantly over the head and tail surface was the majority. This study corroborates that the distribution and density of terminal oligosaccharide residues on the sperm plasma membrane has species specific characteristics. The surface charge of the spermatozoa obtained either during the breeding or nonbreeding season, determined by measurements of cellular electrophoretic mobility and by the binding pattern of CIH and CF, does not show significant differences. PMID- 3507381 TI - Failure of hamster eggs fertilized in vitro to extrude the second polar body correlates with high levels of polyspermy. AB - The occurrence of second polar body (PB2) retention in in-vitro fertilized hamster eggs is reported. Of 2,872 eggs examined, 6.9% (199 eggs) failed to extrude PB2. Eggs that failed to extrude PB2 were more likely to be polyspermic than eggs with PB2 (63% and 14.6%, respectively), and the number of fusing sperm per egg was higher in the abnormal eggs. These data indicate that eggs which fail to extrude PB2 have an impaired block to polyspermy. The level of PB2 retention varied between females and ranged from all eggs extruding PB2 to 20% of the eggs failing to extrude PB2 (41% and 4% of the females, respectively). There was no correlation within a female between the percentage of eggs that failed to extrude PB2 and the level of polyspermy in the sister eggs with PB2. Therefore, regardless of the condition of their sister eggs, eggs that fail to extrude PB2 have an impaired block to polyspermy and eggs that extrude PB2 have a normal block. PMID- 3507382 TI - Strontium supports capacitation and the acrosome reaction in mouse sperm and rapidly activates mouse eggs. AB - Extracellular Ca2+ is required for capacitation and fertilization in the mouse, but very little is known about the ability of other divalent cations to substitute for Ca2+. In this study, Sr2+, Ba2+, and Mg2+ were evaluated for their ability to support capacitation, the acrosome reaction, hyperactivated motility, and fertilization. Ba2+ proved to be ineffective, but Mg2+-containing medium was able to support capacitation to a greater extent than unsupplemented Ca2+ deficient media; despite this, Ca2+ was required for fertilization. In contrast, Sr2+ proved capable of substituting for Ca2+ in all events. Furthermore, Sr2+ induced responses were indistinguishable from the corresponding Ca2+-induced ones: Sperm capacitated at the same rate and underwent the acrosome reaction to the same extent. However, demonstration of sperm:egg fusion in Sr2+ required the use of zona-free eggs. This was due not to the inability of the sperm to penetrate the zona but to the very rapid activation and cortical granule release by eggs in response to Sr2+. When zona-intact eggs were used, the block to polyspermy had been mounted by the time sperm had penetrated the zona. A 15 min exposure to Sr2+ was sufficient to block sperm fusion, but a longer exposure was required to ensure the resumption of meiosis in eggs; such a response was surprising in that the eggs were freshly ovulated and not susceptible to activation by many different treatments. Thus Sr2+ can profoundly affect both gametes in the mouse: It substitutes completely for Ca2+ in sperm responses and rapidly activates eggs, possibly by displacing Ca2+ from intracellular stores into the cytoplasm, where the Ca2+ can then trigger the various events of activation. PMID- 3507383 TI - Acrosomal enzymes and ultrastructure of unfrozen and cryotreated human spermatozoa. AB - Pooled semen judged to be normal in all parameters was divided into a number of aliquots which were either 1) kept untreated; 2) mixed with glycerol (10% v/v); 3) washed by centrifugation and resuspended to the original volume with buffer; or 4) washed and resuspended in buffer with glycerol (10% v/v). The progressive motility, viability, ultrastructure, and acrosomal enzyme activity (8 different hydrolases) were studied before and after cryotreatment. The described washing procedure effectively removed seminal plasma, and did not alter sperm motility, sperm viability, sperm ultrastructure, or the acrosomal enzymes studied. Glycerol (10%, v/v) had a deleterious effect on most parameters evaluated before cryotreatment. Cryotreatment severely altered the motility and viability of the spermatozoa and their acrosomal morphology but did not cause significant decreases in most of the acrosomal hydrolases measured. However, acrosin/proacrosin levels decreased by 50-80% and were correlated to the acrosomal damage. A simple assay for the measurement of acrosin/proacrosin enzyme levels in whole sperm is presented which could be used as a monitor for acrosomal integrity. No significant differences were seen between the samples cryotreated in the absence or presence of seminal plasma. PMID- 3507384 TI - Efficient purification of mouse monoclonal antibodies from ascites fluid by medium-performance anion exchange chromatography. AB - Medium-performance anion-exchange chromatography was applied to the purification of murine IgG class monoclonal antibodies from ascites fluid. The separations were performed under mild conditions at pH 8 using relatively low sodium-chloride concentrations. Recoveries for monoclonal antibodies of subclasses IgG1, IgG2a, and IgG2b were about 90%. The IgG preparations were free of other ascites fluid proteins. PMID- 3507385 TI - Improvements in production of cDNA libraries in lambda gtll. Detection of ligation inhibitor and separation of cDNA from free linkers. AB - A ligation assay was designed to determine if a ligation inhibitor is present in a Bio-Gel A-50-m column, the traditional tool used for separation of cDNA from free linkers during the lambda gtll cloning procedure. A new and simple electrophoresis method is also presented for performing this separation, which is rapid, efficient, and reduces the chance of carrying along a ligation inhibitor. PMID- 3507386 TI - An improved method for the isolation of supercoiled DNA molecules using ion exchange column chromatography. AB - An improved procedure is presented for the rapid isolation of supercoiled molecules using ion-exchange chromatography of alkali-denatured material. Under the conditions employed, contaminating cellular DNA, RNA, and nicked circular molecules are denaturable and are presented to the column as single strands while intact, covalently closed, supercoiled molecules resist denaturation and are batch eluted from the column as the only remaining duplex species. Small amounts of protein and short, duplex fragments (less than 1 kb) are removed in the void volume. There is no need for gradient fractionation. Supercoil fractions are virtually free of contamination with linear molecules as determined by electron microscopy, have an A260 nm/A280 nm ratio approaching 2.0, and are suitable for subsequent heteroduplex analysis, molecular cloning, subcloning, or restriction enzyme mapping. The method has been used successfully to purify plasmids up to 45 kb in length and to isolate rare circular replication intermediates from an overwhelming excess of contaminating linear molecules in retrovirus-infected cells. PMID- 3507387 TI - Analysis of closely related genes by the use of synthetic oligonucleotide probes labeled to a high specific activity. AB - A method for labeling synthetic oligonucleotide probes to high specific activity is described. The method utilizes two partly complementary oligonucleotides that are labeled by a fill-in reaction using the Klenow fragment of DNA polymerase I and four alpha 32P-nucleoside triphosphates. Such probes can, in combination with Southern blot analysis, be used for routine analysis of individual genes in multigene families. PMID- 3507388 TI - Sequence analysis of proteins. AB - There has been a rapid increase in the number of available protein sequences derived from gene-sequence information. Computer-based sequence analysis of proteins is gaining in importance as an analytical tool. With the help of these analyses such sequences may be characterized and some insights gained into their probable role in the system. The principles involved in computer-based sequence analysis and some of the methods are discussed. PMID- 3507390 TI - Cytogenetic methodologies for gene mapping and comparative analyses in mammalian cell culture systems. AB - Presented here are the detailed methods employed in our laboratory for gene mapping and cytogenetic analyses in human beings, in the domestic cat, and in other mammalian species. Induced in the procedures are: 1) establishment of primary fibroblast and lymphoid cell cultures; 2) heterologous cell fusion for production of rapidly proliferating cell hybrids; 3) cellular transformation of primary fibroblasts using an oncogenic retrovirus; 4) cell synchronization for high-resolution banding of promethaphase chromosomes; 5) chromosome-banding procedures, including G-banding, alkaline G-11, and Q-banding; and 6) in situ hybridization of radiolabeled molecular clones to metaphase chromosomes for regional gene localization. PMID- 3507389 TI - Electric field-mediated gene transfer (electroporation) into mouse Friend and human K562 erythroleukemic cells. AB - Electroporation, the technique of electric field mediated gene transfer, was evaluated as a means of introducing and expressing genes into mouse Friend and human K562 erythroleukemic cells. Long-term (stable) gene expression in both Friend and K562 cells was measured using the recombinant plasmid Homer 6, which carries the aminoglycoside phosphotransferase (aph) gene as a selectable marker under the transcriptional control of the Moloney murine sarcoma virus long terminal repeat promoter/enhancer sequences. Parameters such as the DNA concentration, the initial field strength, the concentration of recipient cells, and the preselection expression time were examined to obtain optimal transfection frequencies. Short-term (transient) expression was also examined using the plasmid pLW4, which carries the chloramphenicol acetyltransferase gene under the transcriptional control of herpes simplex virus immediate early 5 gene promoter/enhancer sequences. Conditions that gave maximal stable transformation frequency were similar to those giving highest transient gene expression in the mouse and human erythroleukemic cell lines. Under optimal conditions, electroporation gave about ten times higher transfection frequencies and levels of transient expression for both types of cells when compared with the calcium phosphate technique. Because both Friend and K562 cells can be induced to differentiate in vitro, measurement of transient or stable expression levels for genes introduced into these cells may prove to be useful in the study of developmental regulation of genes from the erythroid pathway. PMID- 3507392 TI - Condylomatous lesions of uterine cervix: a cytological and histopathological study. PMID- 3507391 TI - A method for cloning mixtures of long, synthetic oligodeoxynucleotides. AB - A method is described for cloning synthetic oligodeoxynucleotides, which can theoretically be of any length. The method requires only a single oligodeoxynucleotide strand and a vector with two unique restriction sites, one of which is for an enzyme that generates 3' protruding ends. A mixture of unpurified oligonucleotides containing a wild-type genetic regulatory sequence of the Escherichia coli gnd gene and two mutations of it was cloned into a plasmid carrying a gnd-lacZ protein fusion. Individual cloned oligonucleotides were readily identified by direct DNA sequencing of plasmid templates. The method is rapid, efficient, and has application to gene synthesis and site-directed mutagenesis. PMID- 3507393 TI - Unexplained infertility and sperm antibodies. PMID- 3507394 TI - Histological changes in kidney surrounding the renal cell carcinoma. PMID- 3507395 TI - A virus in the Indian palm tree squirrel that resembles the human hepatitis B virus. PMID- 3507396 TI - Gliomatosis peritonei: a rare complication of malignant ovarian teratoma. PMID- 3507397 TI - The radiation effects on humoral immune response in carcinoma of the uterine cervix. PMID- 3507398 TI - Neutrophil function tests in disseminated malignancies. PMID- 3507399 TI - Solitary trichoepithelioma of mons pubis. PMID- 3507400 TI - Mesenchymal hamartoma of the liver. A case report. PMID- 3507401 TI - Evaluation of carcinoembryonic antigen test in human mammary carcinoma. PMID- 3507402 TI - Ocular injuries: an analytical study in a teaching general hospital. PMID- 3507403 TI - Retinal haemorrhages in vacuum extraction deliveries. PMID- 3507404 TI - Intra-orbital foreign bodies and their management. PMID- 3507405 TI - Magnetic intra ocular foreign bodies in the posterior segment. PMID- 3507406 TI - Levator surgery in post traumatic ptosis. PMID- 3507407 TI - Long term follow up of ocular lesion of methyl-isocyanate gas disaster in Bhopal. PMID- 3507408 TI - A survey on heredity of open angle glaucoma. PMID- 3507409 TI - Study of topical corticosteroid response in glaucoma suspects and family members of established glaucoma patients. PMID- 3507410 TI - Comparative evaluation of pilocarpine 2% and combined guanethidine 1% & adrenaline 0.5% in the treatment of chronic simple glaucoma. PMID- 3507411 TI - Cyclo-cryo therapy in glaucoma of advanced stage. PMID- 3507412 TI - Surgical management in ocular leprosy. PMID- 3507414 TI - Herpes zoster maxillaries--a case report. PMID- 3507413 TI - Pigmented squamous cell papilloma--a case report. PMID- 3507415 TI - Abnormal foreign body in the orbit. PMID- 3507416 TI - Fifth NCI-EORTC symposium on new drugs in cancer therapy. October 22-24, 1986, Amsterdam, The Netherlands. Abstracts. PMID- 3507417 TI - Esthesioneuroblastoma metastatic to the trachea. AB - Esthesioneuroblastoma is an uncommon nasal neoplasm of neural crest origin, which is recognized for its propensity for local recurrence and distant dissemination by both lymphatic and hematogenous routes. Hematogenous spread occurs most frequently to the lungs and bones, but metastases to the liver, spleen, scalp, face, breast, adrenal, aorta, and ovary have been reported. We present a patient who developed metastatic esthesioneuroblastoma of the trachea 1 year after successful craniofacial resection of his primary tumor. The patient was treated by YAG laser resection of the metastatic tumor followed by radiotherapy. He was free of tracheal disease 1 year after treatment of the metastases. PMID- 3507419 TI - Chondrosarcoma of the temporomandibular joint: case report. AB - Chondrosarcoma of the head and neck region is a rarely encountered tumor. Aggressive surgical excision offers the best chance for cure. In our case, combined diagnostic techniques consisting of fine needle aspiration (FNA), computed tomography (CT), and magnetic resonance imaging (MRI) made an accurate preoperative assessment possible and greatly influenced the treatment provided. PMID- 3507418 TI - Value of postoperative radiotherapy for thyroid cancer. AB - A series of 405 patients with thyroid cancer treated by surgery with or without postoperative radiotherapy from February 1958 through 1979 is reported. The immediate evaluation of the operation was that it was either incomplete or complete. Incomplete surgery implied that there was (1) possible residual tumor in the operative field, the result of difficult dissection of the tumor off the neighboring organs or tissues, as assessed by the surgeon; (2) multiple (more than five) lymph nodes involved; (3) positive border of the removed lesions; or (4) microscopic evidence of tumor in the operative field. Complete surgery implied through extirpation of cancer grossly and microscopically. In 297 patients who had complete surgery, 238 patients treated by surgery alone had a 5 year survival rate of 92% (218/238), while 59 patients who received postoperative radiotherapy had a 5-year survival rate of 78% (46/59). The optimum dose of postoperative radiotherapy was 50-70 Gy in 5 to 8 weeks, with the spinal dose kept under 40 Gy. Our experience shows that postoperative radiotherapy did not improve the survival of patients who had had complete surgery. Yet, in 108 patients who had incomplete surgery, surgery alone yielded a 5-year survival rate of 33% (19/57), while surgery plus radiotherapy yielded a 5-year survival of 71% (36/51). Our observation shows a remarkable benefit with postoperative radiotherapy in patients who have had incomplete surgery (P less than 0.05). According to pathologic criteria, postoperative radiotherapy was more effective in well-differentiated cancers than in poorly differentiated ones. It was equally effective in untreated as well as recurrent lesions. The prognosis for younger patients was better, but the sex of the patients did not affect prognosis. PMID- 3507420 TI - Acinic cell carcinoma metastatic to the brain: case report and ultrastructural study. AB - We report a case of isolated cerebral metastasis from an acinic cell carcinoma, which arose in minor salivary glands 20 years previously. The clinical, pathologic and ultrastructural features are described, together with a review of the literature, which suggests that this is an unusual occurrence. PMID- 3507421 TI - Venous bypass for decompression of bleeding varices of the pharynx. AB - Bilateral radical neck dissection results in major morbidity when both jugular veins are ligated. Reported complications include massive facial edema, airway obstruction, and increased intracranial pressure. We describe a case in which a previously unreported complication of bleeding pharyngeal varices was encountered. The problem was successfully managed by decompressing the neck veins with a venous bypass using a transposition of the cephalic vein. PMID- 3507422 TI - Standardization of neck dissection nomenclature. PMID- 3507423 TI - Injury to the orbital plate of the frontal bone. AB - Twelve cases of fracture of the orbital plate of the frontal bone are reviewed to clarify this important clinical problem and to suggest satisfactory methods of management. Common signs and symptoms include forehead laceration and deformity, and fracture of the frontal sinus. Loss of vision can occur, and in the seeing eye, diplopia can develop in several fields of gaze. Downward or upward projection of the orbital plate of the frontal bone can cause exophthalmos or enophthalmos. Cerebrospinal fluid leak, with or without meningitis, and seizures can also be part of the syndrome. Effective treatment consists of repairing or obliterating the frontal sinus, reducing the orbital root fracture, and repositioning the globe. Rib or iliac crest grafts, acrylic implants, and temporalis muscle-galea flaps are useful in correcting the deformity and restoring appropriate function. Long-term follow-up examinations are an important part of patient care. PMID- 3507424 TI - Long-term effects of orbital irradiation. AB - This retrospective study is a review of 18 patients who received radiotherapy to the orbit between the ages of 1 month and 10 years. Patients were followed for 7 21 years in an attempt to define the effects of orbital irradiation on a growing child. None of the patients in the study was spared injurious effects on soft tissue or bone, but soft tissue appeared to be more vulnerable to radiation than bone. Orbital irradiation caused soft tissue deficits of the upper face in 100% of the patients. Sixty-seven percent of patients had soft tissue deformities of the midface, and 13% had soft tissue deformities of the lower face. Bony deficits were found in the upper face in 67% of the patients, the midface in 50%, and the lower face in 6%. This study found no correlation between age and time of radiotherapy on the effects of facial growth. PMID- 3507425 TI - Squamous cell carcinoma of the pyriform sinus treated with surgery and/or radiotherapy. AB - One hundred fifty-five patients with squamous cell carcinoma of the pyriform sinus were treated with curative intent at the University of Florida between 1962 and 1984. All patients were staged according to the AJCC staging system and had a minimum 2-year follow-up; 84% had at least 5 years of follow-up. The locoregional control rates, the incidence of treatment-related complications, and survival rates are presented for radiotherapy as well as for surgery, with or without adjuvant irradiation. PMID- 3507426 TI - Pharyngeal repair after laryngopharyngectomy: 4-year experience. AB - The most common forms of surgical intervention carried out at the National Cancer Institute of Cairo for patients initially seen with hypopharyngeal carcinoma are (1) laryngopharyngectomy and pharyngeal repair using the pectoralis major myocutaneous flap (PMMF) and (2) extrapleural total pharyngolaryngoesophagectomy with gastric transposition (GT) and pharyngogastrostomy. The advantages and disadvantages with both techniques will be discussed on the basis of results of 69 patients with different tumor distributions over a 4-year period. PMID- 3507428 TI - Plasmid patterns, serotyping and Kanagawa phenomenon of Vibrio parahaemolyticus isolates from man, water and fish in Calcutta, India. PMID- 3507427 TI - Oral rehydration therapy in reducing diarrhoea-related mortality in rural India. PMID- 3507429 TI - Cholera in a Pacific island. PMID- 3507430 TI - Persistent campylobacteriosis in an immune deficient child. PMID- 3507431 TI - Symposium proceedings. Cereal-based oral rehydration therapy: theory and practice. February 17, 1987, Washington, D.C. PMID- 3507432 TI - Oral rehydration therapy: the next generation. PMID- 3507433 TI - Global view of ORT. PMID- 3507434 TI - The global implementation of ORT. PMID- 3507435 TI - Nutritional aspects of ORT. PMID- 3507436 TI - Status of cereal-based oral rehydration therapy. PMID- 3507437 TI - Global training needs: U.S. perspective. PMID- 3507438 TI - Oral therapy for diarrheal diseases. PMID- 3507439 TI - Status summary: WHO key research activities in ORT. PMID- 3507440 TI - Persistency and recycling of Bacillus sphaericus in Culex quinquefasciatus Say in the laboratory. PMID- 3507441 TI - Gamma irradiation effect on oogenesis in Culex quinquefasciatus Say exposed as pupa. PMID- 3507442 TI - Evaluation of vaccination coverage through sample surveys. PMID- 3507443 TI - Pseudo HBsAg positivity among blood donors. PMID- 3507444 TI - Acute respiratory infections: a priority health problem in India. PMID- 3507445 TI - Production of low titre and non-precipitating antibodies against Plasmodium knowlesi isoenzyme bands. PMID- 3507446 TI - Lowered immunity status of rubella virus infection in pregnant women. PMID- 3507447 TI - Shigellosis induced acute watery diarrhoea at Delhi. PMID- 3507448 TI - Sandflies from a kala-azar outbreak area of district Darbhanga (Bihar), India. PMID- 3507449 TI - Host preference of phlebotomine sandflies in and around Delhi. PMID- 3507450 TI - Target antigens of malaria transmission blocking immunity. PMID- 3507451 TI - Isolation of subgenus VI Salmonella for the first time in India. PMID- 3507452 TI - Isolation of Salmonella wentworth (11 : Z10 : 1, 2) for the first time in India. PMID- 3507453 TI - Isotype regulation: IgG and IgA. PMID- 3507454 TI - [Electron microscopic study of the periodontal tissues in progressive periodontal disease. I. Alteration of junctional epithelium]. PMID- 3507455 TI - [A case report of the ameloblastic fibro-odontoma]. PMID- 3507457 TI - [Scanning electron microscopic study of pins in dentin]. PMID- 3507456 TI - [Two brothers with extraction of 4 second molars]. PMID- 3507458 TI - [Esthetic consideration on genioplasty]. PMID- 3507459 TI - [A case report of the squamous cell carcinoma arising in an odontogenic keratocyst]. PMID- 3507460 TI - [A comparative study of the accuracy of occlusal plane angle on mounting the Hanau 96-H2 articulator]. PMID- 3507461 TI - [A clinical study on the analgesic effectiveness of diphenpyramide in patients with orofacial pain following oral surgery]. PMID- 3507462 TI - The biology of Aedes thibaulti in northern Indiana. AB - The biology of Aedes thibaulti was studied in a northern Indiana woodlot. There was a single generation in 1984. Adult emergence began in late May and was complete by mid-June. Females were captured into early August. Female daily survivorship was estimated at 0.954, while female population density peaked at over 2100/ha. Precipitin tests on blood-fed females indicated that Ae. thibaulti fed on vertebrates found in the same woodlot, with deer providing 70% of the meals. Adults were also collected in southwestern Michigan, a new state record for this species. PMID- 3507463 TI - Colonization of the oasis malaria vector, Anopheles sergentii, in Egypt. PMID- 3507464 TI - Autogeny in Culex annulirostris from Australia. AB - In the laboratory, 8.5% and 5.1% of colonized Culex annulirostris from Brisbane and Mildura, Australia respectively were autogenous when reared and maintained on nutrient rich diets. Females reared and/or maintained on poor diets mainly had ovaries at Christophers' stage I and exhibited from 0 to 0.7% autogeny. All autogenous females had previously mated. Insemination rates in the Brisbane and Mildura colonies respectively, were 72.8% and 78.8%. No autogeny was detected in 997 females reared from 7 localities throughout Queensland but this may have been due to their poorer nutritional status (as indicated by wing size) or more likely to a low insemination rate of 0 to 16%. Our laboratory results, particularly with well-fed females, may have little relevance to the field situation, where adults are generally smaller and less well-nourished. PMID- 3507465 TI - Temporary small-scale colonization of the Beffa form of the Simulium damnosum theobald complex (Diptera: Simuliidae) in Africa. AB - Two populations of the Beffa form of Simulium damnosum s.l. were colonized on a small scale for the first time in Africa. The colonies survived for three and five generations, respectively. Information gained led to improvements in adult handling techniques which proved adequate for colony maintenance despite the small numbers reared. Nevertheless, large scale rearings are required to avoid inbreeding and to produce sufficient numbers for experimental purposes. PMID- 3507466 TI - Malathion-specific resistance in Anopheles stephensi from Pakistan. AB - A strain of Anopheles stephensi from Pakistan (MalR) was 8.7-fold resistant to malathion and 6.7-fold cross-resistant to phenthoate, but not to other carboxylesters; no cross-resistance to bendiocarb, fenitrothion, permethrin and carbaryl was detected. Resistance was not associated with elevated levels of general esterase activity, as determined by hydrolysis of naphth-l-yl acetate (alpha-NA), but was correlated with higher levels of malathion carboxylesterase (MCE) activity in vitro. The results suggest that a highly specific type of esterase mediated resistance, such as MCE, can best be detected by an enzyme specific assay rather than one for general esterase activity. A new, rapid and sensitive assay for mosquito MCE is given. PMID- 3507467 TI - Absence of La Crosse virus in the presence of Aedes triseriatus on the Delmarva Peninsula. AB - Between 1980 and 1984, field studies were conducted in 2 areas on the Delmarva Peninsula to identify the presence of La Crosse (LAC) virus. Ovitraps were used to collect eggs of Aedes triseriatus complex mosquitoes. No virus was obtained from 969 pools containing 22,370 adult mosquitoes reared from eggs. Only 1 of 143 raccoon serum samples had neutralizing antibody to LAC virus; 36 sentinel domestic goats, and 99 other wild mammal serum samples were negative. The apparent absence of LAC virus may be due to the uncommon occurrence of the eastern chipmunk, a species which has been shown to be an amplifying host for this virus, on the Peninsula. PMID- 3507468 TI - Studies on autogeny in Culex tarsalis: 1. Selection and genetic experiments. AB - Autogenous and anautogenous strains were selected from a laboratory colony of Culex tarsalis established from a foothill environment in Kern County, California. An autogenous strain also was selected from immatures collected at the Kern River. Autogenous and anautogenous strains remained heterogeneous and did not consistently exhibit 100 or 0% autogeny, respectively, despite continual selection pressure and inbreeding. Autogeny rates did not increase when sublines selected from the anautogenous strains were outcrossed within single female lines; however, autogeny rates increased when crosses were made between single female lines. Crosses and backcrosses between the autogenous and anautogenous strains indicated that autogeny was controlled by a dominant, autosomal gene(s). The persistence of heterogeneity during selection and the decrease in autogeny rates among the female progeny of crosses where autogeny was inherited through the male indicated that the genetics of autogeny may be polyfactorial and/or phenotypic expression compromised by sex. PMID- 3507469 TI - Studies on autogeny in Culex tarsalis: 2. Simulated diapause induction and termination in genetically autogenous females. AB - Exposure to simulated "mid-winter" conditions (16 degrees C, 10L:14D) inhibited the expression of autogeny among the female progeny of field-collected Culex tarsalis females. The same F1 progeny expressed 43% autogeny when reared in an insectary under simulated "summer" conditions (25 degrees C, 16L:8D). Diapausing F1 progeny did not express autogeny after a 42-day simulated winter or after diapause termination periods of 4 days in the insectary or 29 days outdoors during January. Females were then blood fed and the progeny reared in the insectary; autogeny rates among F2 females in 4 families ranged from 0 to 43%. Autogeny rates among females emerging from pupae collected during March at 2 localities in Kern County, California were 15 and 17%. Diapause was not induced uniformly among females from a laboratory-selected autogenous colony. Autogeny rates before and after a simulated winter period did not change significantly. PMID- 3507471 TI - The size of emerging and host-seeking Aedes aegypti and the relation of size to blood-feeding success in the field. AB - The average wing length of Aedes aegypti females collected as pupae was 2.47 mm, which was significantly smaller than the 2.64 mm average wing length of the host seeking females collected in the field. The average wing length of nulliparous host-seeking females was 2.62 mm, which was significantly smaller than the 2.76 mm wing length of parous host-seeking females. Thus, small Ae. aegypti females exhibited reduced blood-feeding success and, most likely, reduced survival when compared with large adults. PMID- 3507470 TI - Natural transmission of Dirofilaria immitis by Aedes aegypti. AB - The Liverpool strain of the mosquito Aedes aegypti was infected with microfilariae of the canine heartworm, Dirofilaria immitis, and was used to transmit heartworm larvae to three dogs. Methods of confirming heartworm infection in these dogs included the modified Knott's test, a commercial enzyme linked-immunosorbent assay (ELISA), an indirect fluorescent antibody (IFA) test, and post-mortem examination. PMID- 3507472 TI - The influence of constant versus fluctuating water temperatures on the preimaginal development of Culex tarsalis. AB - Culex tarsalis larvae derived from field-collected egg rafts were reared outdoors in a deep pond with constant water temperature or a shallow pond with fluctuating temperature. No significant differences were found between ponds in the proportion of larvae surviving to adults, female autogeny rates or wing lengths of adults. The average time from 1st instar to adult emergence ranged from 8 days at 31 degrees C to 16 days at 17 degrees C. Males developed faster than females, and both sexes always emerged faster from the shallow pond than from the deep one. However, the temperature-adjusted mean emergence times were equal, and normalized cumulative development curves, fitted to a Weibull function, were identical for the 2 ponds. PMID- 3507473 TI - Aedes canadensis, a vector of La Crosse virus (California serogroup) in Ohio. AB - Aedes canadensis was shown to be a vector of La Crosse (LAC) virus in Ohio through isolation of LAC virus from field-collected specimens, infection of 54 of 72 (75%) individuals when fed on viremic suckling mice and transmission of LAC virus by 29 (54%) of infected individuals. Frequent identification of Ae. canadensis as a human biting species implicates it as an auxiliary vector of LAC virus to man. A possible regional association in Ohio of Ae. canadensis and Type C LAC virus is discussed. PMID- 3507474 TI - The effect of salinity on oviposition and egg hatching in Culicoides variipennis sonorensis (Diptera: Ceratopogonidae). AB - The preferences of Culicoides variipennis sonorensis females for oviposition on different salinities were tested in experiments using small wells in a 4 x 4 latin square array. The mean numbers of eggs deposited on wet surfaces on salinites of 0.0, 9.9, 19.0 and 34.0O/OO, were 1212, 659, 287, and 0, respectively. Within a higher range, salinites of 19.0, 23.0, 28.0 and 34.0O/OO yielded mean numbers laid of 110, 3, 6 and 0, respectively. The overall relationship could be reasonably well described by linear regression, implying, under experimental conditions, a decline of 458 eggs laid for every 10O/OO increase in salinity. Eggs laid directly onto salinities up to 19.0O/OO survived and hatched equally well; at 34O/OO, however, no eggs became tanned and none hatched. In contrast, when eggs were laid onto fresh water, then transferred to different salinities 24 hr later, they survived and hatched even at 34O/OO. PMID- 3507475 TI - A remotely piloted vehicle (RPV) for ULV experimentation. PMID- 3507476 TI - Adult dispersal of Aedes communis using Giemsa self-marking. PMID- 3507478 TI - Mosquito captures using a mechanical aspirator and an encephalitis virus surveillance trap in Guangzhou (Canton) city, Guangdong Province, People's Republic of China. PMID- 3507477 TI - Sewage-associated breeding of Aedes sollicitans and Aedes dorsalis in southwestern Michigan. PMID- 3507479 TI - Genetic sexing in Anopheles stephensi using dieldrin resistance. PMID- 3507480 TI - Cache Valley virus from Aedes sollicitans in New Jersey. PMID- 3507481 TI - Aedes aegypti larvae in Portsmouth, Rhode Island. PMID- 3507482 TI - An educational campaign for mosquito control in Lexington, Massachusetts. PMID- 3507483 TI - Culex tarsalis in Rhode Island. PMID- 3507484 TI - The biting and resting behavior of Anopheles albimanus in northern Haiti. AB - A one-year study of the biting and resting habits of the malaria vector Anopheles albimanus was carried out in four rural villages of northern Haiti. Man-biting rates and nightly biting cycles were determined by the use of all-night man biting captures inside and outside houses. Seasonal changes in density and behavior were determined by repeating the captures on a bimonthly basis throughout one year. Exophily was demonstrated in these anopheline populations by a comparison of inside-biting with inside-resting densities. These behavior characteristics are discussed in relation to malaria transmission and to the choice of malaria control methods. PMID- 3507485 TI - Comparison of an experimental updraft ultraviolet light trap with the CDC miniature light trap and biting collections in sampling for Anopheles albimanus in Haiti. AB - Three methods of capturing Anopheles albimanus mosquitoes were compared during a field study in four villages in northern Haiti. Updraft ultraviolet (UV) light traps proved to be more effective than biting collections, regardless of season or whether the tests were done indoors or outdoors. Biting collections were in turn more effective than the Centers for Disease Control (CDC) miniature light traps. Updraft UV light traps and biting collections yielded more An. albimanus outdoors than indoors; the reverse was found for the CDC miniature light traps. The updraft UV light traps caught An. albimanus on 86% of the occasions used outside and 75% of the occasions inside. The biting collections were equally as successful as the traps in catching mosquitoes outside but caught An. albimanus only on 64% of the occasions when used inside houses. The CDC miniature light traps were successful in collecting An. albimanus on 33% of the occasions outside and 60% of the occasions inside. PMID- 3507487 TI - Ground and aerial application of the sexual and asexual stages of Lagenidium giganteum (Oomycetes: Lagenidiales) for mosquito control. AB - Fermentor-grown cultures of the sexual and asexual stages of Lagenidium giganteum were applied in rice fields in the Central Valley near Sacramento, CA. Both ground and aerial applications of the asexual stage resulted in high levels of immediate control of sentinel Culex tarsalis and indigenous Cx. tarsalis and Anopheles freeborni larvae and provided some degree of control throughout the four-month mosquito breeding season. Oospores which were desiccated in the field following application provided consistently high larval infection levels after reflooding of the fields. Advantages of using the sexual stage of L. giganteum for field larval control are presented. PMID- 3507486 TI - The salivary gland chromosomes of Culex tarsalis. AB - The salivary gland chromosomes of Culex tarsalis are described and briefly compared to similar descriptions of other Culex species previously published. Additional cytogenetic evidence will be needed to make meaningful comparisons and hypothesize speciation relationships. PMID- 3507488 TI - Effect of nutrient concentration in culturing three isolates of the mosquito fungal pathogen, Lagenidium giganteum (Oomycetes: Lagenidiales), on sunflower seed extract. AB - The requirements for soluble protein concentration in sunflower seed extract (SFE) cultures were similar for 3 isolates of Lagenidium giganteum from North Carolina, Louisiana and California. Sunflower seed extract agar containing soluble protein in the range of 1.0 to 4.0 mg/ml was satisfactory for high levels of zoospore production. It is recommended that the protein concentration be 2.0 mg/ml for both SFE agar and liquid SFE culturing media, and the protein assay be with the Bradford method using bovine serum albumin as the standard. PMID- 3507490 TI - Determination of chronological age in Culex pipiens s.l. AB - Daily survival rate is a major determinant of the vectorial capacity of mosquitoes, but current methods are difficult or lack the accuracy needed for epidemiologic models. We used daily growth bands on the thoracic apodemes to estimate age and survival of Culex pipiens s.l. from Memphis, Tennessee. Coded specimens of known age were used to evaluate the procedure's accuracy. Field collected specimens of unknown age were also examined. We were unable to consistently determine the age of the coded, cage-reared specimens. Growth bands in cage-reared specimens were less well-defined than those in field-collected material. In its present form, the method is impractical for ecological or epidemiologic studies. PMID- 3507489 TI - Western equine encephalitis surveillance in Utah. AB - The history of WEE surveillance in Utah is reviewed, beginning with the 1933 outbreak involving 3,958 horses. The step by step formation of the Utah Mosquito Abatement Associations surveillance program from 1957 to the present is discussed. Results of an enlarged sentinel chicken flock surveillance program in Utah during 1983 (3 sero-conversions in September), 1984 and 1985 (no sero conversion) show the lack of WEE activity in the surveillance area. PMID- 3507491 TI - Evaluation of the CDC gravid trap for the surveillance of St. Louis encephalitis vectors in Memphis, Tennessee. AB - Collections with CDC Gravid Mosquito Traps on 954 trap-nights from May through September 1983 are compared to 2,608 concurrent resting site collections made in the same area of Memphis, Tennessee. Gravid Traps yielded 88 times more Culex per collection and 96 times more Culex per man hour. The total Gravid Trap catch was 135,724 mosquitoes, 99% of which were either Culex pipiens or Cx. restuans, whereas these species comprised only 63% of the 6,613 mosquitoes collected from resting sites. Gravid Traps also collected significant numbers of Aedes aegypti and Ae. triseriatus. On most nights, more than 95% of mosquitoes in the Gravid Trap catch were gravid females. These results demonstrate that the trap is an effective and efficient device for collecting several important vector species. The preponderance of gravid mosquitoes should enhance the probability of encountering pathogens acquired by blood-feeding. PMID- 3507492 TI - Seasonal and meteorological effects on activity of Chrysops variegatus (Diptera: Tabanidae) in Paraguay. AB - Activity of adult, female Chrysops variegatus was studied for 17 months near Aregua, Paraguay. The population was sampled by walking along a forest path while swinging an insect net. Results of sampling indicated that this species followed no seasonal pattern of activity. Fluctuation in activity appeared to follow a 13 week cycle. Meteorological effects on activity were studied during 2 weeks of peak tabanid abundance. Temperature, humidity, and wind accounted for 89% of the variation observed during the 23 weeks. Activity of this species observed on a particular day appeared to be the result of the overall population level and meteorological conditions at the time. PMID- 3507493 TI - The discovery and distribution of Aedes albopictus in Harris County, Texas. PMID- 3507494 TI - A standardized procedure for the quantitative surveillance of certain Culex mosquitoes by egg raft collection. PMID- 3507495 TI - Variation in the length of the median pale band on the proboscis of Aedes taeniorhynchus. PMID- 3507496 TI - Potential effects of Altosid (methoprene) briquet treatments on Eubranchipus bundyi (Anostraca: Chirocephalidae). PMID- 3507497 TI - Predicting the spring emergence of Coquillettidia perturbans. PMID- 3507498 TI - A basic program for analysis of droplet size distribution in insecticide sprays. PMID- 3507499 TI - Laboratory evaluations of formulations of Arosurf MSF and Bacillus sphaericus against larvae and pupae of Culex quinquefasciatus. PMID- 3507500 TI - A simple method for sampling Coquillettidia perturbans larvae. PMID- 3507501 TI - Field trials of Tolypocladium cylindrosporum against larvae of Aedes polynesiensis breeding in crab holes in Fiji. AB - The New Zealand isolate of the entomopathogenic fungus Tolypocladium cylindrosporum was field-tested against larvae of the crab hole breeding mosquito Aedes polynesiensis. A reduction of approximately 87% was achieved in the larval populations of all crab holes treated with T. cylindrosporum by day 21 of spore application. However, the mosquito populations recovered to the pretreatment level within two months indicating that any residual activity of this pathogen was insignificant. PMID- 3507502 TI - A laboratory study of cyromazine on Aedes aegypti and Culex quinquefasciatus and its activity on selected predators of mosquito larvae. AB - In a laboratory study, the insect growth regulator, cyromazine, exerted a high level of biological activity on Aedes aegypti and Culex quinquefasciatus treated in the 4th larval instar. At 1.5 and 1.0 ppm this IGR produced 97 and 99% inhibition of emergence in adult Ae. aegypti, respectively. In Cx. quinquefasciatus, there was 99% inhibition at 1 ppm and complete inhibition at 1.5 ppm. The overall pupal mortality was higher than larval or adult stages of both species. This material induced different types of morphogenetic abnormalities in pupae and adults of the 2 species similar to those induced by other IGRs. However, most abnormalities were observed in the pupal stage. Adverse effects were not detected on the 4 mosquito predator species during the acute or posttreatment tests. PMID- 3507503 TI - Studies on insecticide susceptibility of Anopheles gambiae s.1. and Culex quinquefasciatus in the area of Ouagadougou, Burkina Faso (west Africa). AB - Tests to evaluate the susceptibility level in Anopheles gambiae s.1. and Culex quinquefasciatus from Ouagadougou and two nearby villages have been carried out. Anopheles gambiae s.1. larvae from Ouagadougou showed complete susceptibility to organophosphates and carbamates, and adults showed low level resistance to DDT. Nine percent survival of adult An. gambiae s.1. to one hour exposure of 4% DDT was observed in samples from Zaghtouli village while in those from Koubri village, where dieldrin also was tested, resistance to both organochlorine insecticides was detected. Culex quinquefasciatus showed susceptibility to fenthion, malathion, fenitrothion, and chlorpyrifos, whereas incipient resistance to temephos was detected. Electrophoretic analysis showed polymorphism of high and low active esterases (Est-2 + Est-3) confirming the association between OP resistance and enhanced esterase activity in this species. PMID- 3507504 TI - Effect of three pyrethroids on blood feeding and fecundity of Aedes aegypti. AB - Caged Aedes aegypti were exposed to a range of concentrations of d-phenothrin, d allethrin and tetramethrin in a wind tunnel. Mortality, blood engorgement and egg production among these mosquitoes and their progeny were recorded. Tetramethrin was the most effective (LC50 of 0.0017%), followed by d-phenothrin (LC50 0.0031%) and d-allethrin (LC50 0.01%). Blood engorgement was decreased by treatment with each pyrethroid at the high concentration (0.002%, 0.003% and 0.01% respectively). Treatment with d-phenothrin or d-allethrin decreased egg production, but tetramethrin increased oviposition. These effects had ceased in the F2. PMID- 3507505 TI - Swarming and mating of univoltine Aedes mosquitoes in the laboratory. AB - Swarming is a requisite for mating in populations of Aedes communis and Ae. stimulans in Maine. Swarming can be induced in a large, walk-in cage in the laboratory by proper control of humidity, temperature and light. The act of mating appears to be controlled by the behavior of the females and is usually completed during flight. Receptive females may vary in age from 5 to 12 days. The physiological conditions that give rise to receptive females are unknown. Field studies suggest that numerous univoltine Aedes species swarm and mate under similar conditions. PMID- 3507506 TI - Effects of sublethal exposure to Bacillus thuringiensis var. israelensis on larval development and adult size in Aedes aegypti. AB - The effects of exposure to sublethal concentrations of Bacillus thuringiensis var. israelensis (Serotype H-14) on second instar Aedes aegypti larvae were investigated. A test system was developed in which adverse effects would be detected as increased duration of larval development and decreased adult body size. No evidence of negative effects on survivors could be detected when sufficient B.t.i. dosages were applied to kill approximately half of the larvae in the treatment groups. However, when larval density was not controlled, and competition for food decreased as a result of larval mortality in the B.t.i. treated groups, adult wing length was greater in the B.t.i. survivors than in the untreated controls. In addition, a residual mortality was noted in larvae that had been exposed to B.t.i. for 24 hr and then removed to habitats without B.t.i. PMID- 3507507 TI - Studies on potential biological control agents of immature mosquitoes in sewage wastewater in southern California. AB - Three biological control agents, a copepod, Mesocyclops leuckarti pilosa, and two fish, Cyprinodon macularius and Poecilia reticulata, were evaluated for their survival in secondary sewage effluent (SSE) and predation potential on mosquito larvae. Results showed that the survival of M. l. pilosa was not significantly affected in SSE or SSE diluted (50%) with water. In predation tests, the copepod consumed from 50 to 90% of the 1st-instar larvae of Culex quinquefasciatus in 24 to 72 hr and P. reticulata fed on almost all stages (egg to pupa) of the test mosquitoes. Survivorship of P. reticulata and C. macularius in SSE was not significantly affected by SSE under both greenhouse and sewage aquaculture conditions. Poecilia reticulata was distributed towards the influent end and C. macularius towards the effluent end of the aquaculture ponds, indicating the former species can tolerate higher levels of pollution which exists at the influent end of the pond. However, low water temperature and dissolved oxygen may be detrimental to these fish species in sewage aquacultural systems. PMID- 3507508 TI - The identification of Aedes albopictus in the Nearctic region. AB - An introduced, breeding population of Aedes albopictus has been established in Harris County, Texas, and several parishes in Louisiana. The problem of its identification and separation from the indigenous Nearctic mosquito fauna is addressed. Using the keys of Darsie and Ward (1981), the author offers suggested inserts which will accomplish the identification of adult females and larvae in the Nearctic Region. Additional pointers are given for distinguishing albopictus from the 2 common container breeders, Ae. aegypti and Ae. triseriatus. PMID- 3507509 TI - Distribution and prevalence of Octomyomermis troglodytis (Nematoda: Mermithidae), a parasite of the western tree hole mosquito, Aedes sierrensis. AB - Octomyomermis troglodytis was found infecting Aedes sierrensis larvae in 14.5% of 165 tree holes sampled between 1982 and 1986. Mermithid infections were detected in tree hole waters that ranged in pH from 6.5 to 9.3 and electrical conductivities between 0.10 and 5.11 mmhos/cm. Third and fourth instar larvae were most frequently infected, and most immatures that succumbed to infections died while in the fourth instar. Most hosts contained only one nematode. Infected adults were obtained from emergence traps over tree holes, from field-collected immatures reared in the laboratory, and from mosquito collections from sentinel humans. Octomyomermis troglodytis escaped from adults into water vials in the laboratory, suggesting that infected adult mosquitoes serve as dispersal agents for this parasite. PMID- 3507510 TI - Toxicity of pyrethroids to Aedes aegypti larvae in relation to temperature. AB - The influence of temperature on the toxicity of the pyrethroids cypermethrin, permethrin, fenvalerate, d-phenothrin, flucythrinate and bioallethrin to 3rd instar Aedes aegypti larvae was determined. Based on LC50 levels, the toxicities of all pyrethroids were in the range of 1.33- to 3.63-fold greater at 20 degrees C than at 30 degrees C. Our laboratory results suggest that for larval control of Ae. aegypti, field performance of these pyrethroids may be reduced at warmer temperatures. PMID- 3507511 TI - Factors affecting storage of mycelial cultures of the mosquito fungal pathogen Lagenidium giganteum (Oomycetes: Lagenidiales). AB - Sunflower seed extract (SFE) agar cultures (in petri dishes) of Lagenidium giganteum (California isolate) were evaluated for zoospore production and ability to infect mosquito larvae, Culex quinquefasciatus, after periods of storage up to 93 days at 15 degrees C. Rates of decrease in zoospore production and infectivity were related to soluble protein concentration in the SFE-agar media but at all concentrations (0.7-6.0 mg/ml) about 50% of the initial levels were lost after 40 50 days of storage. Water loss from the SFE-agar did not affect zoospore production or infectivity except at extremely high levels (about 98% water loss). PMID- 3507512 TI - An adjustable restrainer for sentinel chickens used in encephalitis surveillance. PMID- 3507513 TI - A simple, yet efficient aircraft chemical loading system. PMID- 3507514 TI - Notes on deer flies and horse flies (Diptera: Tabanidae) from southern Vermont. PMID- 3507515 TI - Field experiments on persistence of Culicinomyces clavisporus. PMID- 3507517 TI - New state records for Aedes communis and Aedes punctor in Connecticut. PMID- 3507516 TI - Evaluation of a sustained release formulation of Bacillus thuringiensis (H-14) for control of woodland Culex mosquitoes. PMID- 3507518 TI - Activity of Culex quinquefasciatus in an underground storm drain in San Antonio, Texas. PMID- 3507519 TI - Avoidance of scouring by larvae of Simulium vittatum (Diptera: Simuliidae) during a spring flood. PMID- 3507520 TI - The bottom line. PMID- 3507521 TI - The perspective of Aedes albopictus from the administrative viewpoint. AB - Mosquito control administrators should consider a newly introduced species in view of local conditions. Aedes albopictus was discovered in Harris County while surveying for Aedes aegypti. Recognizing a potential threat to public health, local and state officials were notified of the discovery. Questions posed by the introduction of a foreign species requires a cooperative application of research resources. The Centers for Disease Control (CDC) should serve as the coordinator of this effort. PMID- 3507522 TI - The significance of the introduction of Aedes albopictus into the southeastern United States with implications for the Caribbean, and perspectives of the Pan American Health Organization. AB - The introduction and apparent infestation of Aedes albopictus into the Gulf States of Texas and Louisiana in the United States is viewed as the most singular medical entomological happening of this decade in the Americas. The implications for the Caribbean and other countries southward are serious, as the habitat described for this Stegomyia cousin of Ae. aegypti, is amply available in the Windward and Leeward islands of the Antilles. Studies from the Pacific and regions of Southeast Asia indicate that Ae. albopictus competes for the same peridomestic niches as Ae. aegypti and it has been found to be a competent vector of several dengue serotypes. In this presentation, a call is issued to the mosquito control and abatement programs in the Gulf States to take stringent measures to eliminate this new dengue vector before it becomes thoroughly established and spreads to other states as well as into countries of the Americas and into the West Indies. PMID- 3507523 TI - Swath width determination for Beecomist-applied Bacillus thuringiensis (H-14) against Anopheles quadrimaculatus larvae in rice fields. AB - Optimum flight path interval of Beecomist-applied Bacillus thuringiensis var. israelensis (serotype H-14) (Bti) against Anopheles quadrimaculatus larvae was determined by assessing the effective swath width in rice fields. Droplet sensitive cards, laboratory-reared and naturally occurring populations of larvae were used to monitor aerial treatments 1 day posttreatment. Overlapping swaths were necessary to provide high levels of larval reduction. Based on tests where flight path intervals were 18.3, 36.6 and 73.2 m, optimal flight path interval was estimated to be approximately 67 m downwind of the extreme downwind flight path when flow rate was 1.44 liter/min. PMID- 3507524 TI - Laboratory and field studies with 32P labeled Toxorhynchites rutilus rutilus. AB - Females and eggs of Toxorhynchites r. rutilus were labeled with 32P by feeding fourth-stage larvae 32P labeled Aedes aegypti larvae. Eggs from females up to 3 weeks in age had detectable levels of radioactivity and individual eggs contained ca. 0.3% of the mother's total radioactivity. Comparisons of labeled and unlabeled females in indoor and outdoor cage tests indicated that survival and fecundity of the 2 groups were approximately equal. No differences were noted for dispersal and fecundity of labeled and control females released in field tests. The 32P-labeled Tx. r. rutilus females behave similarly to unlabeled females, and this method of radiolabeling provides a sound tool for tracking laboratory-reared females released into an area with an indigenous population. PMID- 3507525 TI - Seasonal variation in populations of Anopheles maculipennis, Anopheles claviger and Culex pipiens in Turkey. AB - Seasonal variation in larval populations of three species of mosquitoes, Anopheles maculipennis, An. claviger and Culex pipiens, common in the vicinity of Ankara, were studied. Populations of An. maculipennis and Cx. pipiens disappeared in larval habitats by December but An. claviger, overwintering as larvae remained until the middle of March. Animal footprints are densely populated and are preferred by Cx. pipiens and An. claviger over larger water bodies. PMID- 3507526 TI - A model for polygenic inheritance of abdominal tergal scale pattern in Aedes aegypti. AB - There is much variation in the amount of white scaling on the abdominal tergites of Aedes aegypti. The genetic basis for this white scale pattern was investigated in two laboratory strains established by selection from the CARN Strain of Ae. aegypti. These experimental strains were crossed in all possible directions in single pair matings. Based on analysis of their progeny it is proposed that genes at three separate independently assorting loci control abdominal tergal scale pattern. Correlation of observed data and expected data was high. Since the abdominal tergal scale pattern in Ae. aegypti appears to be controlled by one major polygenic system with modifiers, it is proposed that it is better to consider differences in ethology, physiology, and reproductive behavior as the bases for separation of the species into intraspecific groups. PMID- 3507527 TI - Studies on wide mesh netting impregnated with insecticides against Culex mosquitoes. AB - Seven insecticides, fenitrothion, d-phenothrin, fenvalerate, permethrin, cyphenothrin and fenpropathrin, were each impregnated onto wide-mesh netting and bioassayed for insecticidal activity against Culex mosquitoes. After 9 months of aging, cyphenothrin was the most effective chemical. The movement of adult females through untreated nets was recorded. When the size of the opening of the mesh was less than the width of wing expanse, the mosquitoes were found to rest on the netting before they passed through, thus allowing them time to pick up a lethal dose of the insecticide. PMID- 3507528 TI - The use of CDC light traps and other procedures for sampling malaria vectors in southern Iran. AB - An investigation was carried out over a year in the village of Chelow, Hormozgan Province, southern Iran, to study the efficacy of CDC light traps for sampling malaria vectors. The CDC light traps were useful in determining the seasonal and habitat distribution of Anopheles stephensi and An. fluviatilis, the primary and secondary vectors of malaria, in Chelow, as well as other mosquitoes in that area. Light traps compared favorably with other adult mosquito collection techniques for detecting the presence of vectors during periods of low density. In Iran, time and labor-saving features and flexibility for use in different situations make CDC light traps a useful sampling tool in the entomological assessment of malaria control programs. PMID- 3507529 TI - Inheritance of glucosephosphate isomerase in Aedes togoi. AB - Two isozymes of glucosephosphate isomerase (GPI:E.C. 5.3.1.9.) were observed in the mosquito Aedes togoi by means of agar gel electrophoresis. The locus (Gpi-1) controlling the more anodally migrated isozyme (GPI-1) was located on linkage group 1 (sex chromosome) of this species; the gene arrangement being Gpi-1--(18.2 map units)--To-2 (tetrazolium oxidase-2)--(27.3 map units)--M/m(sex)--(about 40 map units, as estimated by previous studies)--s (straw-colored larva). Linkage homologies concerning Gpi and Odh (octanol dehydrogenase) are compared among three species: Ae. aegypti, the Ae. scutellaris group, and the Ae. triseriatus group in terms of chromosomal evolution. PMID- 3507530 TI - Beecomist-applied Bacillus sphaericus for the control of riceland mosquitoes. AB - An aerially applied flowable concentrate (FC) of Bacillus sphaericus Neide (isolate 2362) was evaluated against riceland mosquitoes using the Beecomist spray head. Application of the FC at 0.58 and 1.17 liter/ha in maturing rice fields resulted in a 48 hr mean posttreatment reduction of Anopheles quadrimaculatus of 71 and 82%, respectively. A significant reduction in larval populations one week posttreatment was also observed. Treatment rates of 0.29, 0.44, and 0.58 liter/ha in reflooded second crop rice fields resulted in 48 hr posttreatment reduction of Psorophora columbiae larvae of 50, 76 and 98% respectively. PMID- 3507531 TI - Susceptibility of DDT, dieldrin and malathion resistant Anopheles culicifacies populations to deltamethrin. PMID- 3507532 TI - Toxicity in carcasses of Bacillus thuringiensis var. israelensis-killed Aedes aegypti larvae against scavenging larvae: implications to bioassay. PMID- 3507533 TI - Comparative efficacy of technical and water-base formulations of Arosurf MSF against Aedes taeniorhynchus. PMID- 3507534 TI - The nursery network--an option to deregionalization. PMID- 3507535 TI - Early detection of cerebral palsy: sensitivity and specificity of two motor assessment tools. AB - The early detection of cerebral palsy is an important goal of NICU follow-up clinics, and a variety of different neuromotor assessment tools are used to assess its presence. This study aimed to examine retrospectively the sensitivity and specificity of the Bayley Motor Scale and the Movement Assessment of Infants (MAI) in correctly identifying infants at four months' corrected age as either "normal" or "suspect/abnormal." The MAI was more than twice as sensitive as the Bayley Motor Scale at detecting early signs of cerebral palsy. However, the Bayley Motor Scale had fewer "false positives" for cerebral palsy than the MAI. Sensitivity and specificity for these two instruments were compared to those of other neurological assessment tools in previously published studies. PMID- 3507536 TI - The amniostat immunologic slide test for phosphatidylglycerol: a comparison of efficacy among screening tests for fetal lung maturity. AB - The Amniostat Immunologic Slide test detects the presence of phosphatidylglycerol (PG) that occurs in pregnancies complicated by diabetes. This paper reports on the performance of this test against other methods that determine the presence of fetal lung maturity. PMID- 3507537 TI - Episodic abnormalities in transcutaneous oxygen (TcPO2) recorded during neonatal intensive care. AB - An automated TcPO2 data system was tested and used to: 1) quantitate the frequency and duration of hypoxemic and hyperoxemic events experienced during the first three days after birth by 25 very low birth weight infants, and 2) determine whether hypoxemic events were associated with the occurrence of periventricular-intraventricular hemorrhage. During the first three days after birth, infants experienced a median of 41 episodes with a TcPO2 less than 40 torr having a cumulative duration of 37 minutes, and a median of 28 episodes with a TcPO2 greater than 100 torr having a cumulative duration of 14 minutes. Most episodes were less than 30 seconds in duration, but in some infants the duration was longer. There was no association between the occurrence of periventricular intraventricular hemorrhage and either the frequency or cumulative duration of episodes with a TcPO2 less than 40 torr. A major problem with automated TcPO2 data systems is the inability of currently available systems to recognize inaccurate TcPO2 data. Twenty-four per cent of the summary TcPO2 monitoring data collected in this study was contaminated with unreliable TcPO2 values. Before automated TcPO2 data systems can be recommended for widespread research use or for medicolegal documentation, the problem of data contamination must be resolved. PMID- 3507538 TI - Computerized ventilation management system for neonates. AB - This paper introduces a ventilation management system for neonates. Its main feature is the manner in which it incorporates the clinician's decisions and the prediction of ventilator adjustments based upon actual patient data. PMID- 3507539 TI - Nonnutritive sucking in the sick infant. AB - The role of nonnutritive sucking (NNS) in the care of the sick infant is discussed. Several benefits may be derived from NNS: 1) in behavioral and physiologic terms; 2) the maturation of the sucking reflex, the resulting efficiency in feeding, and early hospital discharge; and 3) the change in the perceptions of the caretakers in their alertness and responsiveness to the infants' needs. PMID- 3507540 TI - Breast milk collection and storage practices among mothers of hospitalized neonates. AB - Data about breast milk expression, collection, and storage practices were obtained by questionnaires from 51 mothers of hospitalized neonates in the San Francisco Bay Area between September 1, 1984 and July 1, 1985. In addition, teaching sources, mothers' recall of breast-feeding information, and areas of concern as described by mothers were identified. The majority of mothers collected breast milk in plastic containers: however, over 50 per cent stored frozen milk in glass--this is considered a less than optimal choice for storage. Over 50 per cent of the mothers identified the need for additional information about breast-feeding upon returning home from the hospital, particularly in relation to pumping and storage techniques. Although 88 per cent of the mothers reported having received information on breast-feeding from ICN nurses, 47 per cent were not provided with written take-home instructions. Eighteen mothers considered discontinuing breast milk collection citing insufficient milk supplies and time requirements cited as common reasons. PMID- 3507541 TI - The anatomy of an obstetrical service. AB - Major technologic advancements have occurred in obstetrics allowing health care providers to offer improved perinatal outcome for the mother and child. However, because of rapid scientific progress, simple methods of improving health care are often overlooked. The study analyzed the anatomy of one year's deliveries at the authors' institution in an attempt to determine if changes in nursing or physician staffing would allow for a better perinatal outcome for their patients. PMID- 3507542 TI - Screening term LGA neonates for hypoglycemia: the Colorado vs. the Portland Intrauterine Growth Chart. AB - It was postulated that identification of term (LGA) large for gestational age newborns by the Portland Intrauterine Growth Curve rather than the Colorado Curve would classify a lesser number of neonates as LGA, but would identify the LGA neonates at risk for hypoglycemia. One hundred inborn neonates who plotted LGA on the Colorado Chart were reviewed. Sixty-one infants were LGA on the Portland Chart. Of the 100 infants, 17 were found to have dextrostix less than 45 mg% in the first two hours of life, 15 of these had quantitative blood glucose (BG) test performed. Eleven of the 15 neonates had a BG less than 40 mg%; all 11 hypoglycemic neonates were identified LGA on the Colorado Graph whereas only seven were identified LGA by the Portland Graph. The authors conclude that the Colorado Graph is a better tool in their population than the Portland in identifying term LGA neonates at risk for hypoglycemia. PMID- 3507543 TI - Polemics in perinatology: an econium to Alexander Graham Bell. PMID- 3507544 TI - A timely scenario. PMID- 3507545 TI - Consumer participation on a family-centered care committee. AB - Changes within the complex bureaucracy of a hospital can be difficult, and it usually occurs in increments. To be successful, a change in attitude must occur. Essential to effecting change is the creation of a shared philosophy. One of the changes in perinatal health care recommended by the Interprofessional Task Force on Health Care of Women and Children was the formation of a hospital committee on family-centered care that included representatives from the community. The mission of tis committee was to develop, implement, and regularly evaluate the hospital's family-centered care program; such a committee is described below. PMID- 3507546 TI - Care of very low birth weight infants by neonatal nurse clinicians. AB - In 1980, the medical facility at the authors' hospital developed a program to train neonatal critical care nurses for primary care provider roles in the intensive care nursery. The neonatal nurse clinician (NNC) program consists of a didactic portion that emphasizes physiology and pathophysiology of sick newborns, and an internship that focuses on the medical needs of very low birth weight (VLBW) neonates. At the completion of the internship, the NNC is assigned to be the primary care provider for infants with birth weights less than or equal to 1,250 g. This report discusses the NNC training program and the five-year experience with the NNC caring for VLBW infants. PMID- 3507547 TI - Neonatal surgical casebook: nasal glioma. PMID- 3507548 TI - Neonatal radiologic casebook: pleural calcification in a premature newborn infant. PMID- 3507549 TI - Visual diagnosis casebook: congenital anomalies associated with maternal varicella infection during early pregnancy. PMID- 3507550 TI - Protocol. Hypoglycemia. PMID- 3507551 TI - Neonatal transcutaneous arterial oxygen saturation monitoring. AB - Transcutaneous arterial oxygen saturation (TcSaO2) and directly measured oxygen saturation values from 25 neonates with a variety of respiratory problems were compared. At arterial oxygen saturations above 60 per cent, TcSaO2 measurements were accurate and reliable. However, SaO2 values less than 60 per cent were significantly overestimated by TcSaO2, so careful laboratory confirmation of low SaO2 values is necessary. The use, accuracy, and limitations of this noninvasive transcutaneous technique for measuring arterial hemoglobin-oxygen saturation are discussed. PMID- 3507552 TI - Experimental murine tularemia caused by Francisella tularensis, live vaccine strain: a model of acquired cellular resistance. AB - We have established a model of experimentally-induced tularemia in mice, using the live vaccine strain of Francisella tularensis. A sublethal, intravenous inoculation of this organism caused in C57BL/6 strain mice an acute infection which lasted approximately 12 days. The clearance of Francisella from the bloodstream was shown to be complete by 5.5 hours postinfection. At this time, approximately twice as many bacteria were isolated from the spleen as from the liver. Mice which had recovered from a primary infection demonstrated a significant resistance to re-infection with autologous Francisella, a memory which persisted for at least 15 weeks. Resistance to experimental tularemia could be passively transferred from infected mice to naive mice by means of non adherent spleen cells. Cells capable of adoptive transfer of resistance were present at a maximal concentration 7 days following infection, and persisted in significant numbers within the spleen cell population for at least 20 days after infection. Treatment of mice with serum from recovered animals caused a decrease in resistance when measured in the livers, and an increase in resistance when measured in the spleens. Suppression of T cell-mediated immunity during infection by treatment with cyclosporin A resulted in a dramatic increase in the tissue bacterial counts. Cyclosporin A-induced suppression of antitularemic resistance was first noted 2-3 days following infection and remained apparent for at least 8 days. The results of these experiments demonstrate that resistance to experimental murine tularemia is mediated predominantly by a cell-mediated mechanism. This mechanism involves T cells which become activated as early as 2-3 days following infection. Experimental, non-lethal infection with Francisella tularensis is thus an excellent model for investigating the mechanisms of acquired cellular immunity. PMID- 3507553 TI - Association of Chlamydia trachomatis with mammalian and cultured insect cells lacking putative chlamydial receptors. AB - The association of radiolabelled Chlamydia trachomatis (strains DK-20 and 434) with cultured cell monolayers has been examined. Previously, N-acetyl neuraminic acid and N-acetyl-glucosamine had been suggested to be involved in the association of certain strains of C. trachomatis with cultured cell monolayers. We have now studied the association of non-LGV (DK-20) and LGV (434) strains of C. trachomatis with cultured cells lacking these putative receptor components. Comparison of the association of strain DK-20 with McCoy or HeLa cells (containing sialic acids), with neuraminidase-treated McCoy or HeLa or with Aedes aegypti cells (all lacking sialic acids), surprisingly, showed enhanced binding to cells lacking the putative receptor component. Similarly, comparison of the association of chlamydial strain 434 with BHK-21 wild-type (containing N-linked N acetylglucosamine) and BHK-21 RicR14 mutant cells (lacking this component) showed enhanced binding to the mutant cells. PMID- 3507554 TI - Molecular cloning and expression of calcium-regulated, plasmid-coded proteins of Y. pseudotuberculosis. AB - A number of plasmid-associated proteins (YOPs) of Y. pseudotuberculosis are induced and expressed at high levels when the pathogen is grown at 37 degrees C in absence of Ca2+ ions. These proteins were recovered both from the outer membrane fraction and the culture supernatant. Two hours after a temperature shift the YOPs were only found in the culture supernatant, amounting to about 5% of the total cell protein. After 4 h of incubation they were also detected in the outer membrane fraction. Separation by 2-D gel electrophoresis revealed that the YOPs could be separated into 6 different polypeptides; YOP2a (45 kDa), YOP2b (45 kDa), YOP3 (41-42 kDa), YOP4a (34 kDa), YOP4b (34 kDa) and YOP5 (26 kDa). The structural genes of all of these YOPs, except the YOP2a gene, were cloned to pBR322 and their respective genetic localization was established. It was found that the genes were not part of a common operon but scattered around plasmid plB1. Only the YOP4b protein was found to map within the Ca2+ region. The hybrid plasmid plB572 coded for a number of plasmid plB1 specific proteins, one of which showed a molecular weight of 38 kDa. This polypeptide could be precipitated by monospecific V-antiserum, showing that this protein is the V-antigen. PMID- 3507555 TI - Role of the alveolar macrophage in host defense and immunity to Legionella micdadei pneumonia in the guinea pig. AB - Guinea pigs develop a lethal pneumonia after intratracheal infection with Legionella micdadei, and the lung displays pathological changes similar to those observed in humans. To investigate the role of the resident alveolar macrophage in the pathogenesis of L. micdadei pneumonia, guinea pig alveolar macrophages obtained by bronchoalveolar lavage were cultured in vitro and infected with L. micdadei. In the absence of opsonins L. micdadei was phagocytized by, and multiplied within, alveolar macrophages with greater than a 100-fold increase in cell-associated colony forming units over 20 h. L. micdadei opsonized with complement or antibody multiplied within alveolar macrophages at the same rate as unopsonized bacteria. Guinea pigs which were treated with antimicrobials after infection with L. micdadei and recovered from the pneumonia were immune to challenge with an otherwise lethal inoculum of L. micdadei. However, the growth curve of both unopsonized and opsonized L. micdadei in the alveolar macrophages from immune animals was essentially identical to that in macrophages from susceptible animals. Thus, the resident alveolar macrophage is not capable of limiting the growth of Legionella. Rather, the alveolar macrophages appear to be the primary site of Legionella multiplication within the lung. Although alveolar macrophages may participate in other aspects of pulmonary immunity to the legionellae, these data indicate that the alveolar macrophage alone does not act as an effector cell in cell-mediated immunity to Legionella. PMID- 3507556 TI - Transcription of the yop regulon from Y. enterocolitica requires trans acting pYV and chromosomal genes. AB - Virulent Y. enterocolitica strains restrict their growth at 37 degrees C, in rich medium deprived of calcium. This property, called calcium dependency, correlates with pathogenicity. It is conditioned by a 70 kb plasmid called pYV. The analysis of calcium independent (Cl) insertion mutants defined a 20 kb region called the calcium region. This region contains at least three transcription units called virA, B and C. In growth restriction conditions, Y. enterocolitica releases and inserts in its outer-membrane several pYV encoded proteins (POMPs). By transposition mutagenesis using a mini-Mu dlac element, we localized plasmid genes encoding POMPs of 84, 51, 30 and 25 kDa. These genes appear to be scattered on pYV, outside the calcium region and to constitute a regulon. Transcription of these yop genes increased by factors of 3.5 (yop84) to 200 (yop51) when temperature was shifted from 25 to 37 degrees C. On the contrary, calcium had only a moderate effect. Transcription was also dependent on the culture medium and on a trans-acting factor encoded by the calcium region. One Cl double mutant severely affected in transcription of yop51 defined a new locus called virF in the calcium region of pYV. Transcription of the yop genes was very poor in E. coli K12, even in the presence of a fully functional calcium region. PMID- 3507557 TI - The molecular pathogenesis of astrogliosis in scrapie and Alzheimer's disease. AB - In slow infections caused by scrapie and other unconventional agents, and in Alzheimer's disease (AD), the formation of neuritic plaques and the increase in astrocytes and astrocyte-specific protein, glial fibrillary acidic protein (GFAP), are pathological changes common to both conditions. With the rationale that these parallels imply convergent pathogenetic mechanisms, we identified a gene whose expression increases in both. We now report the results of a more extensive analysis of this gene and show that by sequence analysis it is highly homologous and likely identical to GFAP. GFAP mRNA accumulates late in the course of scrapie in subpial and periventricular astrocytes and in cells in foci in the hippocampus. The increased abundance of GFAP mRNA is accompanied by an increase in the corresponding protein. GFAP mRNA is localized by in situ hybridization to the cell body and processes of astrocytes. In AD, the latter pattern predominates, consistent with induction of GFAP mRNA in the sites of synthesis in glial processes in the neuritic plaque. PMID- 3507558 TI - Modulation of the low-calcium response in Yersinia pestis via plasmid-plasmid interaction. AB - Virulent cells of Yersinia pestis, Yersinia pseudotuberculosis, and Yersinia enterocolitica are known to exhibit a low-calcium response in vitro characterized by restriction of growth and induction of V antigen at 37 degrees C in Ca2+ deficient media (Lcr+). A shared Lcr plasmid mediates these properties and encodes yersiniae outer membrane peptides (Yops) that are expressed in Lcr+ Y. pseudotuberculosis and Y. enterocolitica but not Y. pestis. We present direct evidence here verifying that synthesis of major Yops in the former two species is, like V, repressed by Ca2+ and that these structures are located primarily in the outer membrane. We also verified that rabbits infected with live Lcr+ Y. pestis can raise antibodies against V and Yops. Similar antisera, however, were recovered after immunization with sterile extracts of Ca2+-starved Lcr+ cells of Y. pestis. Results of immunoblots obtained with these antisera showed that restricted Y. pestis produced Yops of about 46 kDa (YopB) and 44 kDa (YopC) after shiftup by addition of Ca2+ at 37 degrees C or reduction of temperature to 26 degrees C. It is established that virulent cells of Y. pestis also possess a unique plasmid known to mediate pesticinogeny (Pst+). Restricted Lcr+, Pst- Y. pestis expressed YopB and YopC plus additional 76 kDa (YopF), 48 kDa (YopH), 36 kDa (YopD), 32.5 kDa (YopJ), and 27 kDa (YopE) outer membrane structures at concentrations comparable to those in Ca2+-starved Y. pseudotuberculosis and Y. enterocolitica. These findings indicate that carriage of the Pst plasmid prevents expression of the Lcr plasmid-mediated Yops in wild type Y. pestis. PMID- 3507559 TI - Ecology of sandflies (Diptera: Psychodidae) in a restricted focus of cutaneous leishmaniasis in northern Venezuela. I. Description of the study area, catching methods and species composition. AB - A study on the ecology of phlebotomine sandfly fauna in a restricted focus of cutaneous leishmaniasis in northern Venezuela was undertaken in order to investigate the species responsible for the transmission. The study area and catching methods for phlebotomine sandflies are described. A total of 9,061 females and 1,662 males were collected during a year-term study. 12 species of Lutzomya and 1 species of Brumptomya sp. were identified. Absolute and relative abundance and occurrence for each species were determined. The relative occurrence allowed to distinguish the common species, viz. L. panamensis, L. ovallesi, L. gomezi, L. trinidadensis, L. atroclavata, L. cayennensis, L. shannoni and L. olmeca bicolor from the rare species vis., L. punctigeniculata, L. rangeliana, L. evansi and L. dubitans. General comments on the species composition of the sandfly fauna in this locality are made. PMID- 3507560 TI - Ecology of sandflies (Diptera:Psychodidae) in a restricted focus of cutaneous leishmaniasis in northern Venezuela. II. Species composition in relation to habitat, catching method and hour of catching. AB - The ecology of phlebotomine sandflies in an endemic focus of cutaneous leishmaniasis in Northern Venezuela (San Esteban, Carabobo State) was investigated through a year-term study. Three different habitats: viz. a house, a peridomestic area and a sylvatic area, were covered and the species composition, the abundance and occurrence of each species were analyzed in relation to the habitats, catching methods and hour of catching. L. panamensis, L. gomezi and L. ovallesi are the species which bite man, although almost exclusively at night. All of them hide by day and are common in the sylvatic area. Moreover, L. panamensis and L. gomezi successfully approach the house and seem to settle in the peridomestic area. L. shannoni and L. olmeca bicolor also approach and accidentally bite man. L. trinidadensis, L. atroclavata and L. cayennensis are the common non-anthropophilic species in the area. PMID- 3507561 TI - [Rodent ectoparasites in forest environments of the municipality of Juiz de Fora, Minas Gerais]. PMID- 3507562 TI - Human, canine and equine leishmaniasis caused by Leishmania braziliensis braziliensis in an endemic area in the State of Rio de Janeiro. PMID- 3507563 TI - [Natural infection of a pig (Sus scrofa) by Leishmania in a recent focus of cutaneous leishmaniasis on the Island of Sao Luis, Maranhao]. PMID- 3507564 TI - [Abdominal angiostrongyloidiasis. 6 cases observed in Parana and in Santa Catarina, Brazil]. AB - The author presents a clinical and anatomopathologic study of six cases of abdominal angiostrongyloidiasis seen in the southeast part of the state of Parana and western part of the state of Santa Catarina--Brazil. The importance of the disease, in our region is such that it should be considered in the differential diagnosis of acute abdominal conditions in children and adults. The number of cases in the last two years have increased probably related to the extensive use of pesticides on corps. PMID- 3507565 TI - [Salmonella serotypes isolated from human enteric processes in Recife, Pernambuco, during 1978-1980]. AB - From 13,196 faecal cultures made in Recife-Pernambuco during the period from 1978 to 1980, 1,720 strains of Salmonella were isolated. Serological typing on 1,387 of the isolates recognized 63 serotypes, 73.18% of which belonged to group B. The prevalent serotypes adding up to 1,231 strains (88.75% of the total of the isolates) were: S. typhimurium, S. saint-paul, S. poona, S. derby, S. agona, S. newport, S. oranienburg, S. infantis, S. tshiongwe and S. ndolo. PMID- 3507566 TI - The conduction system of the heart in mice chronically infected with Trypanosoma cruzi: histopathological lesions and electrocardiographic correlations. AB - Chronic focal and diffuse myocarditis with interstitial fibrosis developed in Swiss outbred mice and in the inbred AKR and A/J strains of mice which were chronically infected with several Trypanosoma cruzi strains belonging to three biological types (Type I, II and III). High incidence of electrocardiographic changes with predominance of intraventricular conduction disturbances, 1st. and 2nd. degree AV block, arrhythmias, comparable with those found in human Chagas' disease, were also present. Morphological study of the conduction tissue of the heart revealed inflammatory and fibrotic changes. The presence of inflammation in the inter-atrial septum almost always coincided with the inflammatory involvement of the ventricular conduction system. Focal inflammation was associated with vacuolization and focal necrosis of the specific fibers. Most of the lesions were seen affecting the His bundle (76.3% of the cases), the right bundle branch (73.3%), AV node (43.9%) and left bundle branch (37.5%). Correlation between morphological changes in the conduction tissue and electrocardiographic alteration occurred in 53.0 to 62.5% of the cases, according to the experimental groups. PMID- 3507568 TI - [Occurrence of pleistocenic planorbids in the municipality of Jacobina, Bahia]. AB - We registered Biomphalaria aff. glabrata (Say, 1818) from upper Pleistocene (or Holocene) based on paleontologic and stratigraphic data and in agreement with shell morphology. The shells came from Gruta das Oncas, district of Caatinga do Moura, Jacobina country, state of Bahia. We also registered one more evidence of the ancient presence of water in the cave, which agree Cartelle & Bohorquez's (1982) hypothesis about the site. PMID- 3507567 TI - [Potential of Biomphalaria tenagophila from Pampulha lake, Belo Horizonte, MG, as a host of Schistosoma mansoni]. AB - Biomphalaria tenagophila snails, from a population originally obtained from "Pampulha" lake, Belo Horizonte, Minas Gerais State, Brazil, were exposed to miracidia from four strains of Schistosoma mansoni: "LE" and "HK" from Belo Horizonte, "AL" from Alagoas and "SJ" from Sao Jose dos Campos, Sao Paulo. The "LE", "AL" and "SJ" strains are maintained in the laboratory and the "HK" strain was obtained from feces of a patient residing near to "Pampulha" lake. Infection rates were of 4% ("LE" strain), 6% ("HK" strain), 30% ("SJ" strain) and 40% ("AL" strain). These infection rates were similar to those obtained by others authors for B. tenagophila from Minas Gerais. Experimentally infected snails when compared to B. glabrata of the control group and B. tenagophila naturally infected in "Pampulha" lake shed similar number of cercariae (2000 cercariae/snail). The high density of B. tenagophila in the "Pampulha" lake, the number of cercariae shed by naturally infected snails, the great number of persons who use the water for fishing and swimming, and the water contamination with human feces, are favourable factors for growing the Schistosomiasis focus in the lake. PMID- 3507569 TI - [Factors that can affect the breeding and maintenance of infected snails and the production of Schistosoma mansoni cercariae]. AB - Mass production of Schistosoma mansoni cercariae was affected by biological and chemical agents. Rotifers and ostracods, snail predators, were identified in our colony. Rotifers were easily eradicated by washing the aquaria and lettuce with diluted solution of acetic acid. On the other hand, ostracods were difficult to eradicate and led to a high level mortality of infected snails (50-60%). Snails maintained in an incubator at constant temperature and total darkness produced maximum shedding when submitted to brightness and high temperature (about 30 degrees C). The number of cercariae shed was practically the same between pH 5-7. Contaminants such as Cu and Pb added to glass distilled water decreased the cercariae production. In conclusion, laboratory maintenance of large number of infected snails for mass production of cercariae is much simpler and more efficient than the conventional technique with running tap water although a high rate of mortality is observed in the snail colony. PMID- 3507570 TI - [Epidemiology of human leptospirosis, with special reference to greater Rio de Janeiro, Brazil, from 1970 to 1982]. AB - From 1970 to 1982, 884 cases of human leptospirosis were serologically diagnosed at the Leptospirosis Laboratory, Fundacao Oswaldo Cruz - FIOCRUZ, by means of the microscopic agglutination test. Of these patients, 775 were hospitalized in the city of Rio de Janeiro, and 109 were reported by other Brazilian cities. Icterohaemorrhagiae was the presumptive infecting serogroup most commonly encountered in greater Rio patients (76.4%) and in the others (41.3%). During this 13-year period, two Icterohaemorrhagiae strains were isolated. In greater Rio the illness predominated between January and April (53.7%), the male sex accounted for 89.9% of the cases, and patients ranging from 16 to 45 year-olds were the most affected (74.9%). PMID- 3507571 TI - [Molluscicide activity of a butanol extract from Phytolacca dodecandra (endod) on Biomphalaria glabrata]. AB - A buthanol extract of Phytolacca dodecandra (type 44) obtained from Ethiopia berries, was tested as molluscicide in our laboratory and in the field. The lethal dose (LD90) for adult snails, newly hatched and egg-masses of Biomphalaria glabrata, in 24 hours exposure, were of 4.5, 23.0 and 102.0 ppm respectively. The LD90 for the fish Lebistes reticulatus was of 2.0 ppm. These results are similar to those of Lemma (1984) in Ethiopia. In two water ponds treated with 10 ppm of the buthanol extract or 3 ppm of niclosamide the mortality rates of B. glabrata were of 84.6 and 100.0%, respectively. Both treatments were toxic for L. reticulatus in the field trials. The possibility of using molluscicides derived from plants is discussed as an alternative for treatment of schistosomiasis foci in Brazil. PMID- 3507572 TI - [Ecoepidemiology of Haemonchus contortus bahiensis, ecotype present in sheep of arid zones of Venezuela]. AB - The frequency distribution of female Haemonchus contortus bahiensis Grisi, 1974 in sheep from Venezuelan arid zones is 15.32% for the type with vulvar flap, 51.6% for the vulvar-knob and 33.07% for smooth type. A Shannon-Weaver diversity index corresponding to 1.44 bits was calculated for these forms with similarities in the general size, egg-size and in the number of the longitudinal cuticular ridges. An aggregated kind of distribution in the host population according to the K parameter of a negative binomial distribution was recorded for male and female worms. A complicated interaction was observed between the abundance, aggregation and prevalence of this ecotype and the importance of these findings is discussed with regard to host-parasite relationships. PMID- 3507573 TI - [A matched study of Chagas' cardiopathy in Rio Grande do Sul, Brazil. Behavior of electrocardiographic changes according to the skin color]. AB - The pattern of ECG changes of 150 black individuals from rural areas of southern Rio Grande do Sul, Brazil, was compared with that of a group of 150 whites of similar age, sex and geographical residence. The mean age of the study group was 39.2 years (9-78 years), and 62% were women. 84 out of the 150 showed positive serological reactions to infection by Trypanosoma cruzi. The prevalence of ECG changes was significantly higher among the blacks, irrespective of their serological state. Those changes which were considered as suggestive of Chagas cardiopathy were more common among blacks with positive serological reactions. Blacks with seronegative reactions had more frequent ECG changes which were of increased severity, than those of whites with negative reactions. The increased prevalence and severity of ECG changes among black might be attributed to several factors, including: higher levels of poverty, leading to strenuous working conditions; poorer housing quality facilitating infestations by triatominae; inadequate feeding habits. In addition, the increased levels of arterial tension found among the blacks, might be associated with possible racial factors, in collaborating to increase the likelihood of myocardial lesions. PMID- 3507574 TI - Infective stages of Leishmania in the sandfly vector and some observations on the mechanism of transmission. AB - Infective stages of Leishmania (Leishmania) amazonensis, capable of producing amastigote infections in hamster skin, were shown to be present in the experimentally infected sandfly vector Lutzomyia flaviscutellata 15, 25, 40, 49, 70, 96 and 120 hours after the flies had received their infective blood-meal. Similarly, infective stages of Leishmania (L.) chagasi were demonstrated in the experimentally infected vector Lu. longipalpis examined 38, 50, 63, 87, 110, 135, 171 and 221 hours following the infective blood-meal, by the intraperitoneal inoculation of the flagellates into hamsters. The question of whether or not transmission by the bite of the sandfly is dependent on the presence of "metacyclic" promastigotes in the mouthparts of the vector is discussed. PMID- 3507575 TI - The influence of Physa marmorata (Mollusca; Physidae) on the oviposition of several planorbid hosts of Schistosoma mansoni. PMID- 3507576 TI - A practical method for mass breeding of sandflies in the laboratory: Lutzomyia intermedia (Lutz & Neiva, 1912) and Lutzomyia longipalpis (Lutz & Neiva, 1912) (Diptera, Psychodidae). PMID- 3507577 TI - Cutaneous leishmaniasis in a horse (Equus caballus) from endemic area in the state of Espirito Santo, Brazil. PMID- 3507578 TI - The finding of one male specimen of Lutzomyia renei: (Martins, Falcao & Silva, 1957) experimentally infected by Leishmania. PMID- 3507579 TI - Endocytosis of the human immunodeficiency virus in vitro. PMID- 3507581 TI - What the Missouri State Medical Association is doing about medical malpractice. PMID- 3507580 TI - Is the best diagnosis an early retirement? PMID- 3507582 TI - Reexpansion pulmonary edema. PMID- 3507583 TI - AIDS update for Missouri. PMID- 3507584 TI - To be heard, we must speak in one voice. PMID- 3507585 TI - Viridans streptococcal endocarditis. Lessons we've learned from the animal model. PMID- 3507586 TI - Temporomandibular joint disorders. PMID- 3507588 TI - PRO is unjustly criticized by a few, vocal physicians. PMID- 3507587 TI - The numbers game adds up to trouble. PMID- 3507589 TI - Physician fee advertising. PMID- 3507590 TI - The "industrialization" vs. the professionalism of medicine, Part I. PMID- 3507591 TI - Treatment of carotid-cavernous fistula by intravascular balloon embolization. PMID- 3507592 TI - The role of endocervical curettage in the management of patients with abnormal cervical cytology. PMID- 3507593 TI - The "industrialization" vs. the professionalism of medicine, Part II. PMID- 3507594 TI - Cutaneous leishmaniasis in a native of Missouri. PMID- 3507595 TI - Galactosemia: progress in neonatal screening in Missouri. PMID- 3507596 TI - Pubertal development with gonadal dysgenesis. PMID- 3507597 TI - A few things for PRO reviewers to remember. PMID- 3507598 TI - Prepaid health care wave of the future? PMID- 3507599 TI - Rocky Mountain spotted fever in Missouri. PMID- 3507600 TI - Carotid endarterectomy. Results with selective shunt use. PMID- 3507601 TI - Gonorrhea in children. Kansas City, 1982 to 1984. PMID- 3507602 TI - Myofascial pain. What is it? PMID- 3507603 TI - [The restoration of vertical dimension and occlusion by means of light-curing composites]. PMID- 3507604 TI - [Health history questionnaire for edentulous patients]. PMID- 3507605 TI - [Interactions between dentists and (anxious) patients; a behavioral analysis]. PMID- 3507606 TI - [Hydroxyapatite in infrabony pockets: a clinical follow-up over two years]. PMID- 3507607 TI - [A dental ombudsman project: the period between 1984 and 1987]. PMID- 3507608 TI - [A scenario for the first meetings of students with their patients]. PMID- 3507609 TI - [Supernumerary teeth in the deciduous and permanent dentition of cleft patients]. PMID- 3507610 TI - [Evaluation of the results of the undergraduate dental curriculum through the 1978 to 1983 classes]. PMID- 3507611 TI - [Comparative, double blind study of the analgesic and anti-inflammatory activity of glucamethacin (Indicin), aspirin and placebo in oral surgery]. PMID- 3507612 TI - [Dental identification in massive disasters]. PMID- 3507613 TI - [Infection in sclerotic cemental nodules]. PMID- 3507614 TI - [Immediate fabrication of occlusal splints in clinical practice]. PMID- 3507615 TI - Environmental surface disinfection. PMID- 3507616 TI - Dental advertising and the law. A need for effective guidelines. PMID- 3507617 TI - Further data on an esthetic laboratory processed composite restoration. The SR Isosit inlay onlay. PMID- 3507618 TI - Responsibility for office premises. Knowledge of the risks. PMID- 3507619 TI - Growth studies of Wolinella recta, a gram-negative periodontopathogen. PMID- 3507620 TI - Effects of extracts from Bacteroides gingivalis, Bacteroides intermedius, and Bacteroides asaccharolyticus on the growth of fibroblast lines obtained from healthy and inflamed human gingiva. PMID- 3507621 TI - Aminopeptidase activity in strains of oral streptococci. PMID- 3507622 TI - High prevalence of mutans streptococci in a population with extremely low prevalence of dental caries. PMID- 3507623 TI - Penicillin-induced lysis in related species of oral streptococci. PMID- 3507624 TI - Isolation and characterization of low-pH fluoride-resistant mutants of Streptococcus mutans. PMID- 3507625 TI - Detection of colonies of Bacteroides gingivalis by a rapid fluorescence assay for trypsin-like activity. PMID- 3507627 TI - The microbiota associated with successful or failing osseointegrated titanium implants. PMID- 3507626 TI - Comparative studies on the biology of Actinobacillus actinomycetemcomitans leukotoxin in primates. PMID- 3507628 TI - Actinobacillus actinomycetemcomitans, Bacteroides gingivalis and Bacteroides intermedius: predictors of attachment loss? PMID- 3507629 TI - Chlorhexidine affects arginine metabolism as well as glycolysis in a strain of Streptococcus sanguis. PMID- 3507630 TI - Strains of mutans streptococci isolated in a population with extremely low caries prevalence are cariogenic in the hamster model. PMID- 3507631 TI - Comparison of different methods for detection of urease activity in oral Actinomyces species. PMID- 3507632 TI - Gnathological equilibration in orthodontic practice. PMID- 3507633 TI - Comparison of electrosurgery and formocresol as pulpotomy techniques in monkey primary teeth. PMID- 3507634 TI - Assessment of filling techniques for primary teeth. PMID- 3507635 TI - The use of a colorimeter in analyzing the fluoride content of public well water. PMID- 3507636 TI - The acidogenic potential of plaque from sound enamel, white spot lesions, and cavities in children. PMID- 3507637 TI - Antibodies to indigenous and laboratory strains of Streptococcus mutans in saliva from children with dental caries and from caries-free children. PMID- 3507638 TI - Increased prevalence of developmental dental defects in low birth-weight, prematurely born children: a controlled study. PMID- 3507639 TI - Peripheral calcifying odontogenic cyst in a child: case report of an unusual lesion. PMID- 3507640 TI - Oversedation in a pediatric patient: case report. PMID- 3507641 TI - Oral condyloma acuminatum in a child: case report. PMID- 3507643 TI - Guidelines for dental health of the adolescent--May, 1986. PMID- 3507642 TI - Staining and hypoplasia of enamel caused by tetracycline: case report. PMID- 3507644 TI - Nitrous oxide as a potential health hazard in pediatric dentistry: protocol, May, 1987. PMID- 3507645 TI - Histopathology of furcation lesions associated with pulp degeneration in primary molars. PMID- 3507646 TI - Periodontal health, dental caries, and metabolic control in insulin-dependent diabetic children and adolescents. PMID- 3507647 TI - Flow rate and organic constituents of whole saliva in insulin-dependent diabetic children and adolescents. PMID- 3507648 TI - An in vitro study of bacterial inhibition by VLC calcium hydroxide pulp cap compounds. PMID- 3507649 TI - Microbiological studies on denture-induced stomatitis in children. PMID- 3507651 TI - The teenager's reality. PMID- 3507650 TI - The use of sedation agents by Canadian pediatric dentists. PMID- 3507652 TI - Parenting the adolescent. PMID- 3507653 TI - Psychosocial pathology and developmental tasks in the adolescent. PMID- 3507654 TI - Adolescents and the health care professional. PMID- 3507655 TI - A periodontal view of radiology. PMID- 3507656 TI - Parallax between panoramic and intraoral radiographs. PMID- 3507657 TI - Computerized measurements of skull radiographs. PMID- 3507658 TI - Invasive characteristics of neural crest cells in vitro. AB - An investigation of the invasiveness of avian neural crest cells and neural crest derived melanocytes through a human amniotic basement membrane (BM) was undertaken. Avian neural tube explants or derived melanocyte populations were seeded directly onto BMs in membrane invasion culture system (MICS) chambers for periods of 24, 48, and 72 h. In 36 experimental trials for each group, neither neural crest nor neural crest-derived melanocytes were observed to have invaded the BMs. In concert with these studies, coculturing of B16F10 murine melanoma cells with avian neural crest-derived melanocytes was performed in MICS chambers. Under these experimental conditions, the neural crest-derived melanocytes were able to successfully invade the BMs and to a greater extent than the B16F10 tumor cells. These data suggest that neural crest cells and neural crest-derived melanocytes do not have the ability to invade the BM alone; however, they can be induced to be invasive when cocultured in the presence of B16F10 cells. Alternatively, the B16F10 cells may create weaknesses within the BM that facilitate migration of the pigmented crest cells. PMID- 3507659 TI - Identification and quantification of subsets of mononuclear inflammatory cells in melanocytic and other human tumors. AB - We used monoclonal antibodies and an indirect immunoperoxidase technique to identify mononuclear inflammatory cells associated with human tumors. The absolute number of the different types of inflammatory cells was assessed by using a point-counting technique. We studied tissues from six primary cutaneous melanomas, six metastatic melanomas, eight melanocytic nevi, 14 breast cancers, seven examples of fibrocystic disease of the breast, 11 lung cancers, and six colon cancers. Virtually all tumors were associated with substantial numbers of T lymphocytes (Leu3a-positive T helper-inducer cells predominating) and macrophages. Primary melanomas contained significantly more T lymphocytes (P less than .002), macrophages (P less than .005), and Langerhans/dendritic cells (P less than .002) than nevi or normal skin and had a higher proportion of T cells than metastatic melanomas (P less than .01). Breast cancers contained more T lymphocytes and macrophages than occur with fibrocystic disease (P less than .0001 and P less than .002, respectively) and more B lymphocytes. Cancers of the lung and colon contained moderate numbers of T lymphocytes and macrophages; however, colon cancers contained a higher proportion of B cells. Leu7-positive NK/K cells were noted in small numbers in all tumors examined. PMID- 3507660 TI - Differentiation of neural crest cells of Xenopus laevis in clonal culture. AB - Clonal cultures were performed with the use of neural crest cells and their derivatives, chromatophores, from Xenopus laevis in order to elucidate the state of commitment in early embryogenesis. Neural crest cells that outgrew from neural tube explants were isolated and plated at clonal density. Cloned neural crest cells differentiated and gave rise to colonies that consisted of 1) only melanophores, 2) only xanthophores, or 3) melanophores and xanthophores. Xanthophores and iridophores, which differentiated in vitro, were also isolated and cloned. Cloned xanthophores proliferated in a stable fashion and did not lose their properties. On the other hand, cloned iridophores converted into melanophores as they proliferated. These results suggest that there is heterogeneity in the state of commitment of neural crest cells immediately after migration with regard to chromatophore differentiation and that iridophore determination is relatively labile (at least in vitro), whereas melanophore and xanthophore phenotypes are stable. PMID- 3507661 TI - Effects of exogenous guanosine on chromatophore differentiation in the axolotl. AB - Guanosine is shown to dramatically alter the pigment phenotype of axolotls by suppressing melanization and enhancing the biosynthesis and deposition of purine derived pigments. Phenotypic changes caused by guanosine are manifested by altered chromatophore differentiation patterns such that few black pigment cells (melanophores) differentiate (and those that do are punctate and necrotic in appearance), whereas the development of yellow (xanthophore) and reflecting (iridophore) pigment cells is enhanced. Mechanisms for changes in chromatophore differentiation, and thus pattern formation, are discussed, including the possibility that pigment cells may undergo transdifferentiation in vivo. PMID- 3507663 TI - Distal retinal pigment of the fiddler crab, Uca pugilator: release of the dark adapting hormone by methionine enkephalin and FMRFamide. AB - The neuropeptides methionine enkephalin and FMRFamide, when injected into intact fiddler crabs, Uca pugilator, produce dark adaptation of the distal retinal pigment. Furthermore, both neuropeptides stimulate release of distal retinal pigment dark-adapting hormone activity from the isolated eyestalk neuroendocrine complex. It is hypothesized that both neuropeptides, when injected into intact fiddler crabs, act only indirectly on the distal retinal pigment, by stimulating release of this dark-adapting hormone. PMID- 3507662 TI - Electron microscopic evidence for stimulation of melanosomal maturation by lysosomotropic agents and monensin in cultured B16 mouse melanoma cells. AB - Mouse melanoma cells, B16-C2M in monolayer culture were treated with either lysosomotropic agent, 10 mM NH4Cl, or 20 microM chloroquine, an ionophore, or 10 microns monensin for 3 h at 37 degrees C, and examined with regard to the site of melanin deposition and numbers of melanized (type 1) and unmelanized (type 2) melanosomes under a transmission electron microscope. The numbers of these two types of melanosomes were counted on electron micrographs of thin sections of 20 to 40 cells for each experimental group and expressed in terms of number per unit area of sectioned cytoplasm. Although most melanosomes were largely swollen in monensin-treated cells, melanin deposition was apparently confined in melanosomes in all experimental groups. The compound melanosomes were scarcely found. The mean population density (number per unit cytoplasmic area) of type 1 melanosomes was highest in the NH4Cl-treated cell group followed by monensin-treated, chloroquine-treated, and control cell groups. When the relative abundance of type 1 melanosomes was expressed as a fraction of total number of type 1 and 2 melanosomes (melanosomal maturation index, MMI), the differences were much more evident. Type 1 melanosomes were found in every cell (MMI not equal to 0) of the groups treated with NH4Cl and chloroquine only, which suggested the existence of a subpopulation of cells responsive to lysosomotropic agents but not to monensin in regard to melanosome maturation. All these findings indicate that the stimulation of melanogenesis proceeds mainly through maturation of preexisting melanosomes under these conditions. PMID- 3507664 TI - Theophylline effects on normal uveal melanocytes in culture: an ultrastructural study. AB - Theophylline enhances maturation and differentiation of uveal melanocytes. By electron microscopy, we showed that theophylline changes small, dendritic melanocytes into large, platelike cells; it also enhances DOPA reaction as evidenced by increased deposition of DOPA reaction products in dilated cisternae and vesicles around the Golgi region. The effect is partially reversible in choroidal melanocytes but irreversible in iridial cells. It appears that theophylline, in addition to inducing tyrosine activity, accelerates the maturation and/or aging that normally occurs in cultured melanocytes when incubation is prolonged. PMID- 3507665 TI - Deficient melanosome formation in some coat-color mutant mice revealed by a monoclonal antibody against melanosome. AB - Some coat-color loci in mice are considered to control melanosome formation. In order to investigate genetic control of melanosome-associated proteins, we prepared monoclonal antibodies against mouse melanosomes. Melanosomes were isolated from B16 mouse melanoma through differential fractionation. BALB/c mice were immunized with an SDS-solubilized melanosome fraction. The spleen cells were subsequently fused with mouse myeloma cells, the resulting hybridomas cloned. Their secreted IgG was screened for reactivity to the SDS-solubilized melanosome fraction. One monoclonal antibody, M10, was shown to react to melanosomes by immunoelectronmicroscopy. It recognized a single protein band of 61,000 dalton on immunoblots of gel-fractionated melanosomes. The reactivities of M10 to skin homogenates from various coat-color mutants were examined by the ELISA method. Five congenic genotypes, non-agouti (a/a), brown (b/b), albino (c/c), dilute (d/d), and pink-eyed dilution (p/p) were examined. Among these, b/b and p/p showed significantly lower reactivities than a/a. Our results seem to suggest that the pigment abnormalities in these mutants result from abnormalities of the melanosomal proteins. In the case of albino mice, the reactivity of M10 to skin homogenate was almost the same as the wild-type mouse. It seems that the albino mice are capable of producing the melanosomal protein. PMID- 3507666 TI - Pteridines and purines as major pigments of the avian iris. AB - Stromal pigments from the irises of 28 species of birds having brightly colored eyes were extracted and analyzed. Carotenoids were present in six species and they were the sole bright pigment in only two of these. The iris pigments of the majority of the birds examined were soluble in 0.1 M NaOH and chromatographic analysis indicated they were primarily pteridines and purines. The pteridines often occurred in a crystalline state, either alone or, more commonly, in conjunction with purines. PMID- 3507667 TI - RNA and DNA in melanosomes of hamster melanoma. AB - The melanosomes were isolated from Syrian hamster melanoma Ma by three different methods. Levels of about 0.2% RNA and less than 0.05% of DNA were detected in the melanosome preparations. The higher the purification of the melanosome samples, the lower the DNA content observed. Consequently, traces of DNA in melanosomes could originate from contamination. The irreversible interaction of DNA with melanosomes in vitro was not demonstrated. PMID- 3507668 TI - Ability of melanins to protect against the radiolysis of thymine and thymidine. AB - Individuals with black skin rarely get skin cancer, and melanomas, tumors arising from pigmented cells, are generally resistant to radiation therapy. The role of melanin in these two phenomena has not been defined, but oxygen-radical species have been implicated in both effects. These studies were undertaken to determine the ability of various melanins to compete for ionizing radiation-produced radicals which destroy nucleic acid bases. The ability of Sigma eumelanin (S eumelanin) to protect against the radiolysis of thymidine in buffered solutions was compared to the protective ability of seven amino acids, including melanin precursors; bovine serum albumin, as a model protein; ficoll, as a model polysaccharide; and DNA. Both proteins and polysaccharides are known to scavenge hydroxyl radicals in cells. The concentration of thymidine after exposure to gamma radiation was determined by High Performance Liquid Chromatography (HPLC) analysis after removal of insoluble melanin by acid precipitation. S-eumelanin was more effective at competing with thymidine for free radicals than bovine serum albumin, Ficoll, or DNA, but less effective than certain of the small molecules. Several of the above compounds were also examined for ability to protect against thymine radiolysis. In addition, melanins from other sources were compared to S-eumelanin. Of these, enzymatically synthesized phaeomelanin was the most effective. The results indicate that melanins can compete for base- and nucleoside-damaging free radicals more effectively than other cellular macromolecules. Of the small molecules, the phenolic compounds had the greatest scavenging ability. In vivo, melanins are found in melanosomes bound to protein. Therefore, the relevance of these findings to the photo- and radiobiology of melanins in vivo has yet to be determined. PMID- 3507669 TI - Collisional spectroscopy in structural characterization of melanins: I. A first study on [C8H7ON](+.) ions originating from pyrolysis of biosynthetic and synthetic tryptophan melanins. AB - The structural investigation of four bio- and synthetic melanins, obtained by the action of polyphenol oxidase from potatoes and Psalliota campestris mushrooms and of tyrosinase from Sepia officinalis on tryptophan, or by means of performic oxidation, has been carried out by thermal decomposition performed in the ion source of a mass spectrometer. The structural characterization of the ionic species [C8H7ON](+.), common and abundant for all the examined compounds, has been obtained by accurate mass measurements and collisional spectroscopy. These mass spectrometric techniques have shown unequivocally for ionic species [C8H7ON](+.) the structure of 2-indolinone. PMID- 3507670 TI - Normal uveal melanocytes in culture. AB - Normal uveal melanocytes of rhesus and cynomolgus macaques can be grown in culture for 3-9 months and subcultured a few times. Postnatal and adult choroidal melanocytes are terminally differentiated cells. They are melanin-containing but not actively melanin-synthesizing cells. They do not undergo cell division, nor do they incorporate tritiated thymidine, but otherwise they are metabolically active. Postnatal and young adult iridial melanocytes are metabolically more active than choroidal cells. They require a feeder cell layer for attachment and to be maintained in a healthy condition. An endothelial cell line established from a rhesus fetal choroid-retina proves to be an effective feeder layer for adult iridial cells. Fetal uveal melanocytes divide slowly and usually require some stimulus and a special culture environment supplemented with 12-O tetradecanolphorbol-13-acetate and cholera toxin. They can grow and differentiate in vitro. Iridial melanocytes grow and change into cells resembling postnatal choroidal melanocytes. Similar changes occur during development in utero. These findings further suggest that, in vivo, iridial melanocytes migrate and mature to become choroidal melanocytes. PMID- 3507671 TI - [Composed radix inlay]. PMID- 3507672 TI - [Therapy of chronic osteomyelitis of mandible by permanent rinsing drainage]. PMID- 3507673 TI - [Indication and contraindication of preprosthetic surgical treatment]. PMID- 3507674 TI - [Universal facial arch for precise work with all types of partially adjustable articulators]. PMID- 3507675 TI - [Selection survey of the teeth condition in the population--documentation card of WHO]. PMID- 3507676 TI - [Surgical treatment of periodontal processes by a method of reduced palatinal lobus]. PMID- 3507677 TI - [Classification of composite materials and their development]. PMID- 3507679 TI - [Adjustment of the chart of a set of teeth for computer processing]. PMID- 3507678 TI - [The problem of remelting cobalt-chromium alloys]. PMID- 3507680 TI - Influence of phytate on in vitro digestibility of casein under physiological conditions. AB - The phytic acid content of four different varieties of beans under different processing conditions was estimated. It was highest in red kidney (1.86-2.13%) slightly lower in pigeon (1.86-2.03%), white (1.80-1.96%) and black eyed beans (1.15-1.64%). There was no significant change in phytic acid content of beans after soaking at 25 degrees C for 22 hours. However, both soaking and cooking revealed 26-37% loss of phytic acid in all four varieties of beans. The rate of in vitro casein digestibility with and without phytic acid at concentrations found in legumes was determined at pH 8 and 37 degrees C using multienzyme technique. Addition of 5 mg Na-phytate reduced the casein digestibility up to 20% compared to the control. However, only 25% reduction of casein digestibility was observed in the presence of 25 mg of Na-phytate. Higher concentration of Na phytate had no significant effect on the rate of casein digestibility. Data strongly suggest the formation of protein phytate complex at alkaline pH of small intestine. PMID- 3507681 TI - Protein and energy utilization of boiled rice-legume diets and boiled cereals in growing rats. AB - In growing rats, boiled milled rice-legume diets (2:1 N ratio) had lower energy digestibility than boiled milled rice and equal if not better true digestibility, biological value, and net protein utilization (NPU). Rice-soybean diets showed better NPU than the other rice-legume diets. Boiled whole-grain corn and sorghum had lower digestible energy and NPU than boiled milled rice. NPU of the diets did not follow strictly the trend of the amino acid score of the diets; phenol (tannin) content reduced energy and protein digestibility of all diets, but sugars reduced energy and protein digestibilities of rice-legume diets only. PMID- 3507682 TI - Mycoflora and vitamin content of sun-dried food condiments in Nigeria. AB - The fungi most frequently isolated (of 20-100% incidence) from fresh okra, pepper fruits and melon seeds are Botryodiplodia theobromae, Rhizopus stolonifer, Trichoderma harzianum, Mucor mucedo and Fusarium oxysporum. The major mycoflora of the fruits which had been sun-dried for twenty days are comprised of Aspergillus spp and Penicillium spp which initially had formed the minor components (of less than 20% incidence) of the colonising population. The effect of sun-drying on the fruits was a statistically significant (P = 0.05) decrease in the riboflavin content and a generally small and non-significant decrease in the concentrations of thiamine, niacin, biotin and ascorbic acid. The effect of mouldiness during sun-drying was to further decrease the concentration of the vitamins. PMID- 3507683 TI - Amino acid profile of winged bean (Psophocarpus tetragonolobus (L.) DC): a rich source of vegetable protein. AB - Twenty one cultivars of winged bean (17 of Indian origin and 4 exotic strains obtained from Sri Lanka) were cultivated on marginal (alkaline) soils in the sub tropics and evaluated for their food value. Whereas the seeds showed wide variations in total protein content (38.1 to 45 per cent), the amino acid compositions were in close proximity to those of soybean. Nevertheless, some strains of winged bean registered higher levels of certain amino acids as compared to soybean. PMID- 3507685 TI - Nutritive value of different grape musts (Vitis vinifera L.). AB - Musts of 11 different grape sorts were analyzed for titratable acids, total sugars, nitrogen, vitamin B group (B1, B2, B6, pantothenic acid) and macro- and micro elements (K, Ca, Mg, Fe, Zn, Cu, Mn, Mo). Analyses were done on samples collected in 1983 and 1984. The nutritive value of each sample was characterised by indices based on the nutrient concentrations and recommended dietary allowances (RDA). The nutritive values of the various grape must sorts were generally similar to those of the following vintage. Favourable climatic conditions had a positive effect on the nutritive values. PMID- 3507684 TI - Nutritive value of acetylated and hydrolysed rapeseed proteins in rats. AB - Acetylated, hydrolysed and unmodified rapeseed proteins were compared to casein for nutritive value as determined by net protein ratio (NPR) and nitrogen apparent digestibility coefficient (ADC). The NPR and nitrogen ADC values of rapeseed proteins did not change significantly (P less than 0.05) after hydrolysis but decreased significantly (P less than 0.05) after 30% and 70% acetylation. Acetylation (30%) followed by protein hydrolysis decreased significantly (P less than 0.05) the NPR value but increased significantly (P less than 0.05) the nitrogen digestibility compared to the control and unmodified rapeseed proteins. Casein gave the highest value (P less than 0.05) for NPR and nitrogen ADC. Modification of rapeseed proteins significantly (P less than 0.05) decreased the nutritive value, and the effect was more pronounced with increasing level of acetylation. PMID- 3507686 TI - The crystal structure of alpha-bungarotoxin at 2.5 A resolution: relation to solution structure and binding to acetylcholine receptor. AB - We report collection of 2.5 A resolution X-ray diffraction data from newly grown crystals of the rare 'small unit cell' form of the long snake neurotoxin, alpha bungarotoxin. The previous model of the molecule has been rebuilt, and refined using least-square methods to a crystallographic residual of 0.24 at 2.5 A resolution. alpha-Bungarotoxin's crystal structure is compared with the crystal structures of two other snake neurotoxins (cobratoxin and erabutoxin), and with its solution structure inferred from spectroscopic studies. Significant differences include less beta-sheet in bungarotoxin's crystal structure than in solution, or in the crystal structures of other neurotoxins, and an unusual orientation in the crystal of the invariant tryptophan. The functional, binding surface of bungarotoxin is described; it consists primarily of hydrophobic and hydrogen-bonding groups and only a few charged side-chains. The structure is compared with experimental binding parameters for neurotoxins. PMID- 3507687 TI - Specificity of tRNA charging in Tyr-tRNA synthetase. PMID- 3507688 TI - The cloning and expression of an anti-peptide antibody: a system for rapid analysis of the binding properties of engineered antibodies. AB - The cloning of the light and heavy chain genes of an antilysozyme monoclonal antibody is described and the application of site-directed mutagenesis for reconstruction of complete cDNAs from incomplete cDNA clones is discussed. The behaviour of the RNA transcripts produced from these cDNAs after their subcloning into an appropriate Salmonella typhimurium, SP6, vector and subsequent injection into Xenopus oocytes has been analysed. The antibody secreted by oocytes after RNA injection has been quantitated and its antigen-binding properties compared with wild-type hybridoma antibody. The results show that this route for expression of antibodies, though limited in its capacity to produce more than a few micrograms of protein, is potentially a means for rapid evaluation of the antigen-binding properties of engineered antibodies. PMID- 3507689 TI - Single-stranded DNA 'blue' T7 promoter plasmids: a versatile tandem promoter system for cloning and protein engineering. AB - Chimeric phage-plasmid expression vectors were constructed from pUC18/19 plasmids by cloning a single-stranded DNA (ssDNA) origin of replication from bacteriophage f1 and inserting a bacteriophage T7 promoter within the beta-galactosidase gene. A T7 promoter permits in vivo or in vitro expression of single proteins by the translation of T7 RNA polymerase transcripts. Insertional inactivation of the T7 promoter-containing beta-galactosidase gene permits a simple blue-to-white color cloning assay. Compared with several helper phages that were examined, superinfection with M13K07 resulted in the highest yields of the pTZ plasmids as ssDNA viral particles. These ssDNA promoter plasmids are uniquely suited for protein engineering because they simplify cloning, oligonucleotide directed mutagenesis, verification by enzymatic sequence analysis, and expression of mutant proteins from a single vector. These vectors were utilized to eliminate an efficient transcriptional terminator of T7 RNA polymerase in the cDNA of bovine preproparathyroid hormone by oligonucleotide directed mutagenesis. The mutation changed the codon for phenylalanine-19 in the signal peptide to alanine. In a cell-free system the mutant cDNA transcripts were translated into preproparathyroid hormone, which was converted to proparathyroid hormone in the presence of microsomal membranes. PMID- 3507690 TI - Oligonucleotide-directed misincorporation mutagenesis on single-stranded DNA templates. PMID- 3507691 TI - Alignment of the amino acid sequences of distantly related proteins using variable gap penalties. PMID- 3507692 TI - The role of cysteine oxidation in the thermal inactivation of T4 lysozyme. AB - Wild-type T4 lysozyme contains unpaired cysteine residues at positions 54 and 97. To investigate the role these residues play in the thermal inactivation of the wild-type, we constructed a double mutant with these cysteines replaced with valine and serine. This molecule, T4 lysozyme (C54V/C97S), is more stable than the wild-type to inactivation at 70 degrees C at pH 6.5 and 8.0. Guanidine hydrochloride reactivation experiments and SDS-PAGE on the inactivated products show that the wild-type is susceptible to varying degrees of oxidative damage, depending on buffer conditions, while the cysteine-minus mutant inactivates only by other pathways. The products of thermal, oxidative inactivation of the wild type are disulfide-linked oligomers. The dependence of inactivation rate on temperature suggests that the formation of these aggregates depends on prior thermal unfolding of the T4 lysozyme molecule. PMID- 3507693 TI - A synthetic IgG-binding domain based on staphylococcal protein A. AB - A synthetic IgG-binding domain based on staphylococcal protein A was designed with the aid of sequence comparisons and computer graphic analysis. A strategy, utilizing non-palindromic restriction sites, was used to overcome the difficulties of introducing site-specific changes into the repetitive gene. A single mutagenized gene fragment was polymerized to different multiplicities, and the different gene products were expressed in Escherichia coli. Using this scheme, protein A-like proteins composed of different numbers of IgG-binding domains were produced. These domains were changed to lack asparagine--glycine dipeptide sequences as well as methionine residues and are thus, in contrast to native protein A, resistant to treatment with hydroxylamine and cyanogen bromide. PMID- 3507694 TI - Use of site-directed mutagenesis to obtain isomorphous heavy-atom derivatives for protein crystallography: cysteine-containing mutants of phage T4 lysozyme. AB - Five different cysteine-containing mutants of the lysozyme from bacteriophage T4 were used to explore the feasibility of using site-directed mutagenesis to generate isomorphous heavy-atom derivatives for protein crystallography. Cysteines 54 and 97, present in wild-type lysozyme, can be readily reacted with mercuric ion to produce an excellent isomorphous heavy-atom derivative. Mutants with an additional cysteine at position 86, 146, 153 or 157, or with Cys 97 replaced by Val, were engineered by site-directed mutagenesis. The mutant lysozyme Thr 157----Cys reacts with mercuric chloride to give an excellent new derivative although Cys 157 is only approximately 60% substituted with the heavy atom. The cysteine at position 146 is largely buried but reacts readily with mercuric chloride. In this case the isomorphism is poor and the resultant derivative is of marginal quality. Cys 153 reacts rapidly with mercuric ion but the derivative crystals do not diffract. The mutant Pro 86----Cys does not yield a particularly good heavy-atom derivative. This is due in part to a loss of isomorphism associated with the mutation. In addition, Cys 86 shows very little reactivity towards mercurials even though it is fully exposed to solvent. The mutation Cys 97----Val was used to explore the possibility of creating an independent derivative by deleting a heavy-atom site already present in wild-type lysozyme. In all cases that were tested, the quality of the heavy-atom derivative was improved by using as an isomorphous pair mercury-substituted mutant versus non-substituted mutant rather than mercury-substituted mutant versus (non substituted) wild-type lysozyme.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3507695 TI - Comparison of scales of amino acid side chain properties by conservation during evolution of four proteins. AB - As the amino acid sequence of a given protein changes along the phylogenetic tree, enough of the overall folding pattern must be conserved to ensure that the protein still fulfils its biological function. Eighteen published scales which tabulate various side chain properties are compared here by computing the variance of each scale when applied to each of several protein families. The conservation of each scale of side chain properties is examined for the 20,627 residues in 60 mammalian myoglobins, 31 mammalian ribonucleases, insulin A and B chains (29 sequences each), 29 vertebrate and 28 plant cytochrome c's. Those scales which are the most highly conserved through the evolution of each protein family may well be the best predictors of protein folding patterns. The mean-area buried scale and the optimized matching hydrophobicities scale are more conserved than other scales. An additional result is the relatively poor conservation across evolution of the Chou-Fasman secondary structure predictors. PMID- 3507697 TI - Gordian knot loosened somewhat. PMID- 3507696 TI - The oxidative folding of proteins by disulfide plus thiol does not correlate with redox potential. AB - The rate and yield of oxidative renaturation of reduced RNase A has been studied as a function of [-S-S-]/[-SH]. The principal conclusion of these studies is that rates and yields of oxidative renaturation are strongly dependent on the low mol. wt disulfide/thiol ratio. The relationships are complex and do not parallel the redox potential of the system. The present results are consistent with earlier findings on other proteins, and lead us to believe that the above conclusion is general. Kinetic studies of oxidative renaturation should recognize and account for the dependence of reaction rate and extent on the disulfide/thiol ratio. This ratio can change substantially over the course of a reaction, either due to stoichiometric transfer of disulfide to protein, and/or adventitious air oxidation of thiols. Failure to account for changes in the disulfide/thiol ratio may compromise the interpretation of such experiments. PMID- 3507698 TI - Hydrophobic and hydrophilic signals in protein sorting. PMID- 3507699 TI - Evaluation and improvements in the automatic alignment of protein sequences. AB - The accuracy of protein sequence alignment obtained by applying a commonly used global sequence comparison algorithm is assessed. Alignments based on the superposition of the three-dimensional structures are used as a standard for testing the automatic, sequence-based methods. Alignments obtained from the global comparison of five pairs of homologous protein sequences studied gave 54% agreement overall for residues in secondary structures. The inclusion of information about the secondary structure of one of the proteins in order to limit the number of gaps inserted in regions of secondary structure, improved this figure to 68%. A similarity score of greater than six standard deviation units suggests that an alignment which is greater than 75% correct within secondary structural regions can be obtained automatically for the pair of sequences. PMID- 3507700 TI - Macromolecular structure in solution. PMID- 3507701 TI - Analysis of site-directed mutagenesis experiments by linear free energy relationships. PMID- 3507702 TI - Comparison of solvent-inaccessible cores of homologous proteins: definitions useful for protein modelling. AB - The three-dimensional structures of 41 homologous proteins (belonging to eight families) were compared by pairwise superposition. A subset of 'core' residues was defined as those whose side chains have less than 7% of their surface exposed to solvent. This subset has significantly higher sequence identity and lower root mean square (RMS) alpha carbon separation than for all topologically equivalent residues in the structure, when members of a protein family are superposed. For such superpositions the relationship between RMS distance and percentage sequence identity of this subset of residues is similar to that for all equivalent residues, although some variation is observed between families of proteins which are predominantly beta sheet and those which are mainly alpha helix. The definition of a structurally more conserved core may be useful in model building proteins from an homologous family. The RMS differences of coordinates of structures of proteins with identical sequences are found to be related to the resolutions of the structures. PMID- 3507703 TI - Structural and sequence patterns in the loops of beta alpha beta units. AB - The conformation and sequences of the 129 loops of 70 beta alpha beta units from 17 alpha/beta proteins were analysed for patterns. Many different conformations of the loop regions were observed, but 18 of the loops could be classified into one of four loop families with distinctive conformation and sequence patterns. (i) Adjacent alpha beta loops with one residue between the alpha-helix and beta strand. The residue is a glycine with conformationally restricted phi/psi angles; (ii) adjacent alpha beta loops of three residues with a conformationally restricted glycine as the first of the loop followed by an analine or histidine residue and a third residue with helical phi/psi angles; (iii) adjacent beta alpha loops of 3/4 residues previously reported to bind nucleotides and which have three glycine residues in the loop region; (iv) non-adjacent beta alpha loops of 0 residues with a serine or threonine as the last residue of the beta strand. The analysis provides information for the model building of loops and prediction of secondary structure from amino acid sequences. PMID- 3507704 TI - Highly controlled carbodiimide reaction for the modification of lysozyme. Modification of Leu129 or Asp119. AB - In the cross-linking reaction of lysozyme between Leu129 (alpha-COO-) and Lys13 (epsilon-NH3+) using imidazole and 1-ethyl-3-[3 (dimethylamino)propyl]carbodiimide hydrochloride (EDC), a side reaction of the peptide bond inversion from alpha to beta between Asp101 and Gly102 was greatly reduced by addition of beta-(1,4)-linked trimer of N-acetyl-D-glucosamine [(NAG)3]. When methylamine or 2-hydroxyethylamine was further added, the extent of the cross-link formation was decreased and the derivative where the alpha carboxyl group of Leu129 was modified with the amine was newly obtained. On the other hand, when ammonia was added, the beta-carboxyl group of Asp119 instead of the alpha-carboxyl group was mainly amidated. From these results, the presence of a salt bridge between Asp119 and Arg125 besides that between Lys13 and Leu129, is proposed. Enzymatic activities of the derivatives prepared here indicated that the modification of the alpha-carboxyl group reduced the activity to approximately 90% of that of native lysozyme. Des-Leu129 lysozyme, which lacks Leu129, also showed approximately 90% of the activity of native lysozyme. Therefore, the salt bridge between Lys13 and Leu129 may play some role in maintaining the active conformation of lysozyme. PMID- 3507705 TI - A peripheral giant cell granuloma associated with long-standing unusual gingival recession and labial radicular bone loss. PMID- 3507706 TI - Swallowing of a small metal fragment during periodontal surgery. PMID- 3507707 TI - Treatment of localized oral erosive lichen planus lesions with free soft tissue grafts. PMID- 3507708 TI - Clinical and microbiologic evaluation of the covered and exposed molar furcation area following periodontal flap surgery. PMID- 3507709 TI - Treatment of an intrabony defect associated with vertical root fracture with hydroxyapatite graft. PMID- 3507710 TI - The replacement of attachment-retained prostheses. PMID- 3507711 TI - Assessment of noise-reducing devices for the dental office personnel. PMID- 3507712 TI - SEM evaluation of sonic and ultrasonic devices for root canal preparation. PMID- 3507713 TI - Congenital lipoma in the oral cavity. A case report. PMID- 3507714 TI - Office design for the temporomandibular joint and facial pain practice. PMID- 3507715 TI - Porosity in denture acrylic resins cured by microwave energy. PMID- 3507716 TI - A survey assessing the existing employment status of dental hygienists in departments of periodontology in the United States. PMID- 3507717 TI - A case of enamel color modification: 60-year results. PMID- 3507718 TI - Posterior composites: criteria for assessment. Introduction. PMID- 3507719 TI - Limitations of posterior composite resins and extending their use with glass ionomer cements. PMID- 3507720 TI - Evaluation of criteria used for assessing the clinical performance of composite resins in posterior teeth. PMID- 3507721 TI - A materials scientist's view: assessment of wear and marginal integrity. PMID- 3507723 TI - Posterior composites: criteria for assessment. Discussion and conclusions. PMID- 3507722 TI - The implications of assessment criteria for the dental industry. PMID- 3507724 TI - Effect of surface injury on chemically strengthened dental porcelain. PMID- 3507725 TI - [Clinical and esthetic results of roentgenotherapy of cancer of the lower lip]. PMID- 3507726 TI - [2 cases of limited cutaneo-muscular atrophy of occupational origin]. PMID- 3507727 TI - [Studies of the fungal flora of the interdigital spaces of the feet]. PMID- 3507728 TI - [Pathologic changes of the hair and nails in generalized geotrichosis]. PMID- 3507729 TI - [Evaluation of the results of the treatment of psoriasis by the modified "minute therapy" in comparison with the Ingram method]. PMID- 3507730 TI - [Three dimensional alignment]. PMID- 3507732 TI - [A simple method to increase the efficiency of a magnifying lens]. PMID- 3507731 TI - [History of oral aphthae and smoking in university students]. PMID- 3507733 TI - [Coronary invaginated teeth. Their relation to caries and periapical pathology (radiographic study of 100 cases)]. PMID- 3507734 TI - Augmentation of localised alveolar bone loss using porous hydroxyapatite particles. PMID- 3507735 TI - Modifying upper lateral incisors to mimic missing central incisors: new ways to overcome old problems? PMID- 3507736 TI - The effect of three adhesive restorative systems on impact fracture of premolar teeth. PMID- 3507737 TI - Localised alveolar ridge augmentation with dense hydroxyapatite. PMID- 3507738 TI - [Mucocutaneous entomophthoromycosis. Presentation of a case with an atypical development]. PMID- 3507739 TI - Paracoccidioidomycosis: a recently proposed classification of its clinical forms. PMID- 3507741 TI - The eradication of poliomyelitis. PMID- 3507740 TI - [The Aedes aegypti problem in Brazil]. PMID- 3507742 TI - [Psychosocial and stigmatizing aspects of mucocutaneous leishmaniasis]. PMID- 3507744 TI - Isolation and functional characterization of mononuclear phagocytes from human lepromatous lesions. PMID- 3507743 TI - [Toxoplasmosis of the central nervous system. Clinicopathological correlation with 7 autopsy cases]. PMID- 3507745 TI - [Significance of the adhesion site of Pediculus capitis eggs in hair samples collected from barber shop floors]. PMID- 3507746 TI - Human immunodeficiency virus infection in selected hemodialysis patients in Belo Horizonte, Brazil. PMID- 3507747 TI - [Fluoride as a preventive agent of periodontal disease in adults]. PMID- 3507748 TI - [Dental malocclusion and its relation to speech disorders. 1]. PMID- 3507749 TI - [Dental malocclusion and its relation to speech disorders. 2]. PMID- 3507750 TI - [Periodontology and orthodontics: their interrelationship]. PMID- 3507752 TI - [Periodontal disease and oral hygiene in a group of pregnant women]. PMID- 3507751 TI - [Eruption of permanent teeth in a sample from the city of Havana]. PMID- 3507753 TI - [Evaluation of a preventive method in the Periodontal Prevention Service of the Santa Clara Dental Teaching Clinic, 1983]. PMID- 3507754 TI - [Child primary care (CPC) in dental internship]. PMID- 3507755 TI - [The development of dentistry in the providence of Camaguey in the last decade]. PMID- 3507756 TI - [Emotional aspects of maxillofacial rehabilitation]. PMID- 3507757 TI - [Reconstruction of the sequelae of surgery for oncologic lesions. Report of a case]. PMID- 3507758 TI - [Corrosion resistance of copper-aluminum alloys (I). Study on apparent reflectance and microscopic analysis. 1. Effect of type of alloy, conditions and times]. PMID- 3507759 TI - [Occupational risk from mercury in dentistry]. PMID- 3507760 TI - [Gingivectomy using a marking probe. Type of gingival tissue removed. Histological analysis]. PMID- 3507761 TI - [Ni-Cr and stainless steel alloys. Tarnishing and loss of brightness--in vitro study]. PMID- 3507762 TI - [Craniofacial growth. Longitudinal study. Archive of selected data from the Burlington Growth Centre]. PMID- 3507763 TI - [Metastatic neuroblastoma of the mouth]. PMID- 3507764 TI - [Ankylosis of a deciduous tooth with complete submersion and compromise of the mandibular osseous base]. PMID- 3507765 TI - [Perspectives on professional practice. An analysis of dental graduates. 2. Post graduate]. PMID- 3507766 TI - [A new processing system for periapical radiographic films]. PMID- 3507768 TI - [Arthrotomography of the TMJ]. PMID- 3507767 TI - [Glass-ionomer cement. Clinical evaluation as a temporary restoration in posterior teeth]. PMID- 3507770 TI - [Ocular prosthesis: study of anterior curvature in relation to minor optical distortion of the artificial iris]. PMID- 3507769 TI - [Anatomical radiographic study of the submandibular fossa]. PMID- 3507771 TI - [Vestibulo-lingual inclination of lower posterior teeth in the deciduous dentition]. PMID- 3507772 TI - [Sterometric study of angular values between the versants of the anterior wall of the mandibular fossa, in Brazilian adults]. PMID- 3507773 TI - [Inclination of occlusal surfaces of lower first deciduous molars in relation to lower second deciduous molars]. PMID- 3507774 TI - [Simplified index of induction of deciduous teeth in children of 4 to 6 years]. PMID- 3507775 TI - [Comparative study of the effects of lidocaine with noradrenaline and prilocaine with felypressin on the cardiovascular system of dogs, according to variations in dosage, time and route of administration]. PMID- 3507776 TI - [Pulpal and periapical diagnosis]. PMID- 3507777 TI - [Comparative study of 3 different commercial forms of chlorhexidine in equal concentration (0.2%)]. PMID- 3507778 TI - [Technic for placement of implants in the maxillary sinus]. PMID- 3507779 TI - [Cephalometric evaluation of patients with operated cleft lip and palate at different ages compared with normals]. PMID- 3507780 TI - Veterinary oncology: what does the future hold? PMID- 3507781 TI - Advances in the treatment of cancer. PMID- 3507782 TI - Surgical oncology: old and new ideas. PMID- 3507783 TI - Cancer therapy: radiation and hyperthermia. PMID- 3507784 TI - Prognostic factors in canine mammary tumors. PMID- 3507785 TI - Oral neoplasia in 15 dogs and four cats. PMID- 3507786 TI - Lymphoma in the cat: an approach to diagnosis and management. PMID- 3507787 TI - Doxorubicin-induced cardiotoxicity in five dogs. PMID- 3507788 TI - Psychosocial aspects of veterinary clinical oncology. PMID- 3507789 TI - [Distribution of proteins and enzymes in 3 submitochondrial fractions isolated from the internal mitochondrial membrane of the rat liver]. AB - Three fractions, A, B and C, were separated from rat liver inner mitochondrial membranes by sonication and centrifugation on a discontinuous sucrose gradient, and their distribution of enzyme activities, cytochromes and proteins was studied, in order to obtain data about the heterogeneous composition of the inner membrane. Fraction C was mitochondrial matrix. It contained about 90% of glutamate dehydrogenase activity, and its protein distribution in polyacrylamide gels was similar to that of mitochondrial matrix. Fraction B, with nearly 85% of enzyme activities and cytochrome contents of control inner membranes, would correspond to the crista membrane. Only 4% of cytochromes and enzyme activities of the inner membrane were found in fraction A, which would be the inner peripheral membrane, in contact with the outer membrane. PMID- 3507790 TI - [Xerosis caused by abuse of vasoconstrictor eye drops: apropos of a case]. AB - This is the case of a 63 year old patient with chronic conjunctivitis on chronic local phenylephrine instillation for the last 13 years. We have observed that the protracted use of vasoconstrictor eyedrops can induce conjunctival xerosis and that its simple withdrawal can result in marked symptomatic improvement leaving behind only degenerative cicatricial changes. PMID- 3507791 TI - [Thrombotic, thrombocytopenic purpura: treatment with plasmapheresis, fresh plasma, platelet antiaggregants and corticoids]. AB - A combination of antiplatelet agents, corticosteroids, plasmapheresis and fresh plasma achieved complete remission in a 35-yr old man diagnosed of thrombotic thrombocytopenic purpura who presented with hemolytic anemia, renal and neurologic damage. No symptoms 9 months after finishing treatment have been observed. Platelet and lactate dehydrogenase levels were the most useful analytical parameters in the follow-up. PMID- 3507792 TI - [Pharmacologic surveillance outside the hospital: necessity and methods]. PMID- 3507793 TI - [Drugs for maintaining life]. PMID- 3507794 TI - AIDS hard to catch, two studies found. PMID- 3507796 TI - TMJ arthroscopy. PMID- 3507795 TI - [Total dental treatment for the cleft palate patient]. PMID- 3507797 TI - Beyond TMJ: how does myofascial pain fit in? PMID- 3507798 TI - Two case reports. PMID- 3507799 TI - The TMJ scale: quantitative measurements of symptoms and treatment results. PMID- 3507800 TI - Temporomandibular disorders and the insurance dilemma: one consultant's view. PMID- 3507801 TI - New directions in therapy of osteoarthritis. PMID- 3507802 TI - Chondroprotection. PMID- 3507803 TI - [Pathogenesis and treatment of acute intestinal obstruction]. AB - The article analyzes the development of viewpoints to pathogenesis of acute intestinal obstruction and modern principles of treatment of the disease. PMID- 3507804 TI - [Hemodynamic effect of pericardiectomy]. AB - The method of integral rheography was used for the examination of 126 patients with different forms of pericarditis. The authors have established different nature of the blood circulation insufficiency (heart compression and myocardiodystrophy), which should be taken into consideration in choosing the methods of treatment. PMID- 3507805 TI - [Interrelations of changes in liver tissue and chemical composition of the bile and biliary calculi]. AB - The correlation between the degree of morphological alterations of the hepatic tissues, changes in the chemical composition of bile and bile stone structure was established after comparing clinico-laboratory findings, results of examinations of liver bioptates, chemical composition of the bile and bile stones in 216 patients with cholelithiasis. The formation of cholesterol and mixed stones in the gallbladder is in correspondence with mild alterations of the liver tissue and colloid stability of the hepatic bile. The formation of pigment stones in the gallbladder and common bile duct is considered to be a symptom of chronic hepatitis followed by deep alterations of the chemical structure of hepatic bile. PMID- 3507806 TI - [Remote results of the surgical treatment of chronic acalculous cholecystitis]. AB - An analysis of long-term results of the surgical treatment of acalculous cholecystitis in 180 patients has been made. Good results were obtained in 112 patients, satisfactory--in 58 patients, bad results in 20 patients. The authors recommend early surgical treatment to patients with the diagnosed chronic acalculous cholecystitis. PMID- 3507807 TI - [Surgical treatment of complicated cancer of the rectum]. AB - The authors make an analysis of results of the surgical treatment of 246 patients with rectum carcinoma complicated by partial or complete ileus, pararectal abscess and perforation of the tumor. The data obtained show that primary resection of the tumor especially with a one-step reestablishment of the colon continuity is one of the main prerequisites for the elimination of postoperative complications and lethality. PMID- 3507808 TI - [Results of the conservative treatment of patients with ischemia of the lower extremities by hyperbaric oxygenation]. AB - A comparison is made of results of conservative treatment of 123 patients with ischemia of lower extremities of atherosclerotic genesis. It was shown that the maximum efficiency of the treatment was achieved by an associated application of pharmacological drugs and HBO. An analysis of angiograms has shown that the absence of collaterals is one of the causes of the HBO being inefficient. PMID- 3507809 TI - [Expediency of combined lumbar sympathectomy with reconstructive-restorative operations in arteriosclerotic lesion of the aorto-femoral segment]. AB - An examination of patients after reconstructive operations on the aorto-femoral segment in combination with lumbar sympathectomy (173 patients) and without it (75 patients) has shown sympathetcomy to promote reduction of the amount of postoperative thromboses and amputations in the early postoperative period. In the remote period the frequency of reocclusions in patients subjected to sympathectomy was higher. The authors consider that sympathectomy is responsible for progress of atherosclerosis. PMID- 3507810 TI - [Effect of functional disorders of deep veins of the lower extremities on the clinical course of varicose veins]. AB - Results of the complex clinical and phlebographic examination of 106 patients with the varicose disease were studied. It was established that the degree of alterations of the venous outflow was dependent on the spread of ectasia of profound veins, while the clinical form of ectasia of the profound veins--on the state of the valve system. PMID- 3507811 TI - [Variants of hemodilution and intraoperative blood loss in children]. AB - The authors have made a comparative assessment of variants of the infusion transfusion aid in operations on kidneys in nephrolithiasis and echinococcosis of the lungs and liver in 286 children. Results of the investigation have shown considerable advantages of hemodilution methods. Of special value is thought to be artificial hemodilution with controlled hypotension which makes the donor blood not necessary in 90% of children during operation. PMID- 3507812 TI - [Post-traumatic sequestration of the right hepatic lobe complicated by profuse external hemorrhage in a child]. PMID- 3507813 TI - [Acute gangrenous cholecystitis with calculi of the common bile duct in a child]. PMID- 3507814 TI - [Experimental substantiation and clinical evaluation of posterior spinal fusion using acryloxide]. AB - The investigation was performed in 24 isolated preparations of the spine, experiments in 33 rabbits and 8 dogs and clinical observation of 43 patients who were subjected to posterior fixation of the spine with copolymer Acryloxide by the method proposed by the authors. It was established that the method is very effective and may be recommended for wide practical use. PMID- 3507815 TI - [Effect of controlled normovolemic hemodilution on the microcirculatory bed and the incidence of postoperative complications in abdominal surgery]. AB - Directed normovolemic hemodilution with the preoperative reservation of part of the patients' blood considerably reduced the pathologic effect of the operative aggression on the microcirculation system, allowed reduction of the frequency of postoperative complications and increased the efficiency of treatment of 93 patients with diseases of organs of the abdominal cavity. PMID- 3507816 TI - [Diagnosis and treatment of incompetence of sutures of the duodenal stump]. AB - The author presents an analysis of 37 cases of incompetence of sutures of the duodenal stump per 1896 resections of the stomach for ulcer disease, cancer, polyposis and postburn scarry constrictions. For diagnostics of this complication the author proposes to contrast the afferent loop of gastroenteroanastomosis. Relaparotomy for the detection and drainage of the place of incompetence is recommended in cases with incompetence of duodenal stump sutures and appearance of peritonitis. PMID- 3507817 TI - [Various practical considerations regarding appendicular infiltrates]. AB - Surgical methods of treatment of the appendicular infiltrate are dependent on the degree of the disease. Conservative treatment should be performed at the stage of a dense infiltrate. The infiltrate stage is treated by appendectomy. In the initial abscess the operation must be associated with adequate drainage of the abdominal cavity. In great abscesses the the surgical procedure is restricted by opening the abscess and drainage of its cavity. The vermiform process must be removed but when it is accessible. PMID- 3507818 TI - [Organizational and clinical principles of the surgical treatment of non neoplastic diseases of the gallbladder and bile ducts]. PMID- 3507819 TI - [Gas exchange in various stages of injury]. PMID- 3507820 TI - [Biomechanical study of osteosynthesis of the vertebral column using the compressive Harrington apparatus]. PMID- 3507821 TI - [General and high epidural anesthesia in relation to general anesthesia in patients at risk in abdominal surgery]. PMID- 3507822 TI - [Kinetic characteristics of human acid phosphatases A and B and their isoenzymes]. PMID- 3507823 TI - [Wide resection of the gastric body with preservation of the pylorus in the treatment of normal and hypoacidic gastric ulcers]. PMID- 3507824 TI - [Post-corrosive esophageal stenosis--treatment, our experience]. PMID- 3507825 TI - [Evaluation of the therapeutic results of various surgical methods in the treatment of post-phlebitic syndrome of the lower extremities 1976-1987]. PMID- 3507826 TI - [Abdominal tuberculosis in children]. PMID- 3507827 TI - [Changes in tooth color]. PMID- 3507828 TI - [Disinfection and sterilization]. PMID- 3507829 TI - [Statistical analysis of endodontically treated patients]. PMID- 3507830 TI - [Adverse reactions to local anesthetics in pedodontics]. PMID- 3507831 TI - [Dental research in Venezuela and its relation to positivism]. PMID- 3507832 TI - [The presence of the social sciences in Acta Odontologica Venezolana]. PMID- 3507833 TI - [Scientific publications in Latin America]. PMID- 3507834 TI - [Correlative histopathological and radiographic analysis of the dental follicle]. PMID- 3507835 TI - [Contamination and infection control]. PMID- 3507836 TI - [U.S.A. dentistry: crisis and code of ethics]. PMID- 3507837 TI - [Precautions in the use of X-rays in dentistry]. PMID- 3507838 TI - [Examination of the indices useful for evaluation of masticatory function]. PMID- 3507840 TI - [Some observations on a continuously polished cross-section of non-decalcified teeth]. PMID- 3507839 TI - [The effects of glucose added solution on non-respiratory acidosis observed during general anesthesia of infants and children. Carbohydrate-fat, electrolyte metabolisms and acid-base balance during lip plasty for infants]. PMID- 3507841 TI - [Effect of fluoride on the mandibular condyle in growing rats]. PMID- 3507842 TI - [Effects of 1-alpha,25(OH)2D3 on dentin mineralization and serum calcium in parathyroidectomized rats]. PMID- 3507843 TI - [Articulation and accompanying tongue and mandibular movements before and after surgical correction of mandibular prognathism. Part 1. The articulation test in pronunciation of Japanese vowels and consonants]. PMID- 3507844 TI - [A case report of adenomatoid odontogenic tumor resembling a globulomaxillary cyst]. PMID- 3507845 TI - [A large mucous cyst found on the inferior surface of the tongue in a neonate]. PMID- 3507846 TI - New organizational models and financial arrangements for nursing services. PMID- 3507847 TI - [Health and disease: a study of social representation]. PMID- 3507848 TI - [Pulpotomy: alternative to extraction]. PMID- 3507849 TI - [The role of humoral immunity in periodontal changes in rats]. PMID- 3507850 TI - [Verification of adaptation discrepencies in cast metal restorations (technic using a copper-aluminum alloy)]. PMID- 3507851 TI - [Effects of dental plaque on phagocytosis and chemotaxis of peritoneal cells]. PMID- 3507852 TI - [The effect of progestagen medroxyprogesterone acetate on the healing of dental extraction wounds. Histological study in rats]. PMID- 3507853 TI - [Experimental hypervitaminosis A in the rat. 7. Volumetric changes in the hard palate epithelium]. PMID- 3507854 TI - [The synovial membrane of the temporomandibular joint in mice in relation to age]. PMID- 3507855 TI - [Comparative study of the prevalence of dental caries in permanent teeth with differing levels of public water fluoridation in Belo Horizonte and Rio Acima MG]. PMID- 3507856 TI - [Alveolar socket repair in rats treated with sugar cane brandy. Histological study]. PMID- 3507857 TI - [Morphometric study of changes in the submandibular gland of aging rats. I. Acini]. PMID- 3507858 TI - Amperometric enzyme-immunosensor based on ferrocene-mediated amplification. AB - Coimmobilized glucose oxidase and anti-T4 antiserum are employed in the construction of a biosensor for thyroxine measurements. The resulting enzyme immunosensor yields an amplified response to T4 with a detection limit of 15 nM. PMID- 3507859 TI - [The opinion of low-income women living in a city of the interior on family planning]. PMID- 3507860 TI - [Nursing actions directed at the overall care of mental deficiency. A trial of the applicability of these actions]. PMID- 3507861 TI - Perinatology--how firm a foundation? PMID- 3507862 TI - [Treatment of anterior dislocation of the articular disc]. PMID- 3507863 TI - [Serum immunoglobulin levels in patients with head and neck cancer]. PMID- 3507864 TI - [The effect of systematic plaque control on the periodontal status of pregnant women: a longitudinal clinical study]. PMID- 3507865 TI - [Clinical evaluation of free gingival grafts]. PMID- 3507866 TI - [Bacterial contamination of dental unit water systems]. PMID- 3507867 TI - [Conformity of various properties of the toothpastes produced in Turkey with the Turkish Standards Institution values]. PMID- 3507868 TI - [The comparison of three inspection methods]. PMID- 3507869 TI - [The cephalometric investigation of Class II division 1 cases at post-retention period, treated by edgewise mechanics]. PMID- 3507870 TI - [The effect of systematically given indomethacin on bone resorption]. PMID- 3507871 TI - [Evaluation of different clinical methods in the measurement of periodontal attachment levels]. PMID- 3507872 TI - [The influence of Visco-Gel and Voco-Pak tissue conditioning materials on the bacterial lesion floras of the patients with vestibuloplasties]. PMID- 3507873 TI - [The investigation of the disordered and reorganized relations in patients having backward and downward rotated mandible]. PMID- 3507875 TI - [Hand-Schuller-Christian disease (report of a case)]. PMID- 3507874 TI - [Phenytoin and gingival hyperplasia]. PMID- 3507876 TI - [Cranio-maxillofacial fracture (case report)]. PMID- 3507877 TI - [The fourth molar teeth (report of two cases)]. PMID- 3507878 TI - Where does the public get its health information? PMID- 3507879 TI - Changes in public reaction to a new epidemic: the case of AIDS. PMID- 3507880 TI - The physician's role in health-promotion and disease prevention. PMID- 3507881 TI - Medical privacy and the right to know. PMID- 3507882 TI - Medical libraries and the public: friends, foes and frustrations. PMID- 3507883 TI - Radiologic diagnosis of pain in the athlete. PMID- 3507884 TI - Pitfalls to avoid in diagnosing pain in the athlete. AB - Symptoms in the competitive athlete frequently are assumed to be related to overuse. A limited number of these patients will have orthopedic problems not related to their activity. This article outlines specific examples of bone tumors, infections, and metabolic causes of pain in the athlete. PMID- 3507885 TI - Effects of age, season and active immunization against estrogen on serum prolactin concentrations in stallions. AB - Prolactin concentrations in stallion serum were measured by radioimmunoassay based on antiserum generated against equine prolactin and radioiodinated canine prolactin. Prolactin concentrations in serum collected from 152 stallions at a slaughterhouse were higher (P less than .01) in summer than in winter (5.7 +/- .15 vs 2.0 +/- .17 ng/ml). Moreover, there was an effect of age (P less than .02) in the analysis of variance; there was no interaction between age and season. In general, prolactin concentrations increased with age up to 3 to 5 years. Samples of serum collected from five control and five estrogen-immunized stallions from 6 to 26 months of age also were assessed for prolactin concentration. Active immunization against estrogen had no effect (P greater than .10) on prolactin concentrations. In contrast, whether analyzed by age or by month of the year, prolactin concentrations varied with time (P less than .01) in these stallions. Averaged over both groups, concentrations were high during summer and low during winter and were also gradually increasing with time as indicated by a linear trend (P less than .01) in the data. It is concluded that serum prolactin concentrations in stallions 1) are seasonal, as in many other seasonally breeding species, 2) in general are highest in older stallions and lowest in young stallions and 3) are not affected by active immunization against estrogens. PMID- 3507886 TI - Effects of induced fescue toxicosis on plasma and tissue catecholamine concentrations in sheep. AB - Sixteen crossbred wethers were distributed among four treatments and fed a control ration based on annual rye-orchardgrass (R-O) for 8 days. Indwelling jugular cannulae were installed and experimental regimes begun the following day (experimental day 1). One-half of the wethers were fed a ration based on endophyte-infected Kentucky-31 fescue while the remainder continued to receive the R-O control diet for 10 days. Spiperone, a dopamine antogonist, was administered to one-half of the wethers receiving each ration on days 8 and 9. Plasma prolactin (PRL), dopamine (DA), norepinephrine (NE) and epinephrine (E) were measured in jugular venous blood on days 1, 3, 5 and 7-10 of the trial. On day 10, the animals were decapitated; and DA, NE, E and 3,4-dihydroxyphenylacetic acid (DOPAC) and monoamine oxidase (MAO) were determined in hypothalamic and pituitary tissue. Plasma DA was elevated (P less than .05) following day 8 in wethers fed infected fescue over those fed (R-O), while plasma PRL was reduced (P = .08). Wethers receiving Spiperone had lowered (P less than .05) plasma DA and elevated (P less than .01) plasma PRL. Plasma DA was negatively correlated (P less than .01) with plasma PRL (r = -0.50) following day 8. Plasma NE and E levels and NE, E, DA and DOPAC tissue concentrations were not affected by Spiperone administration or diet. MAO levels in pituitaries were higher (P less than .01) for Spiperone-treated wethers. Wethers receiving the toxic fescue ration exhibited elevated plasma DA concentrations which was associated with depressed prolactin secretion in wethers.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3507887 TI - Measurement of urinary and plasma estrone sulphate concentrations from pregnant sows. AB - The accuracy of urinary estrone sulphate (E1S) concentrations as an indication of pregnancy was compared to that of plasma E1S concentration. Urine and plasma were collected from 145 sows 18 to 30 days after mating. Concentrations of E1S in urine were indexed to creatinine concentration (CR) and specific gravity (SG) to correct for urine dilution. There was no significant difference in E1S concentration between urine corrected for CR or SG and uncorrected urine (UN) from pregnant sows. Urinary E1S concentrations were 20 to 100 times higher than plasma E1S concentrations. The E1S test was accurate in the detection of pregnancy in sows using both plasma and urine (test sensitivity, 98.8% vs. 96.4%, respectively) during the optimal sampling period of 20 to 30 days post mating. The test was slightly more accurate (NS) using plasma than urine in detecting non pregnant sows (test specificity, 100.0% vs. 91.9%, respectively) 20-30 days after mating. Urinary E1S concentrations could be used to predict litter size, but the precision was poor ( +/- 3 piglets), and thus could only be used to predict small (less than 5 piglets), medium (6-10 piglets) and large (greater than 11 piglets) litters. PMID- 3507888 TI - LH release from dispersed bovine pituitary cells in culture: in vitro effects of estradiol and procedural variables. AB - Procedures for cell dissociation and in vitro culture were validated to investigate secretion of luteinizing hormone (LH) from bovine anterior lobe (AL) pituitary cells. The concentration of trypsin used for dissociation affected cell yield, cell loss during preincubation, LH secretion, and response to gonadotropin releasing hormone (GnRH). Optimum results were obtained with trypsin concentrations of 8-16 micrograms/mg fresh tissue. Duration of preincubation and of experimental culture markedly affected LH secretion and response to GnRH. Immediately after dissociation, cells contained relatively low quantities of LH, but they were able to release a substantial proportion of this LH. Basal release of LH and GnRH-induced release of LH were highly correlated with total quantities of LH, and all three parameters increased with time of preincubation until 24 hr. Experimental treatments of 2 hr duration were optimal for investigating GnRH stimulation of LH release, whereas longer treatments may be required to investigate effects of agents that inhibit the release of LH. Preincubation of dissociated AL cells with physiological concentrations of estradiol increased all three LH parameters. Progesterone had no effect either alone or in combination with estradiol. In conclusion, the procedures described for cell dissociation and culture of suspended cells provide a useful tool for studying release of LH from the bovine AL cell. PMID- 3507889 TI - Characterization of a monoclonal antibody which detects luteinizing hormone from diverse mammalian species. AB - The present study describes the development and characterization of a monoclonal antibody (518B7) generated against bovine LH (bLH). Although 518B7 was extremely specific for LH, very low species specificity was observed. A RIA using this antibody and radioiodinated equine LH (eLH) showed good sensitivity for all mammalian LH preparations tested, with the exception of human LH (15%, relative to the eLH reference standard). Activities of most mammalian LH's ranged between approximately 50-200%. Much less activity was detected with reptilian LH (less than 1.5%). Amphibian and avian LH fractions were essentially inactive. The reactivities of LH alpha and beta subunits from a variety of mammals clearly showed that the antibody reacts with the beta subunit. Sensitive RIAs were also developed utilizing 125I-bovine and 125I-rat LH. Interestingly, all hormone preparations which showed sufficient reactivity for statistical analysis within the dose ranges used in the present study (0.01-1000 ng/tube) produced a displacement curve parallel to the reference standard. We have also validated the use of 518B7 in detecting LH in serum. Parallel dilution curves relative to purified LH reference standards were observed with equine and bovine serum samples and equine pituitary extract. High (average 94%) recoveries were also seen with bovine serum with known amounts of exogenously added bLH. Similar patterns of LH secretion were detected with a RIA based upon 125I-bLH and 518B7 and a previously described polyclonal antibody-based RIA in bovine serum samples during estrus. Thus, a monoclonal antibody for LH has been produced which can be used to develop sensitive and specific RIAs in many different mammalian species.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3507890 TI - Gonadal regulation of LH secretion in prepubertal bull calves. AB - In the present study we examined the influence of castration and exogenous estradiol on pulsatile LH release during the transition from infancy to the prepubertal period of development. Bull calves were assigned to treatments (N = 5 treatment) at 6 weeks of age. Treatments consisted of intact controls, castrates and castrates receiving estradiol implants. Plasma LH response was monitored over 8 hr periods at 7, 8, 9, 10, 11 and 13 weeks of age. Castration alone did not alter LH concentrations, compared to controls until 10 weeks of age. At 10, 11 and 13 weeks, mean LH concentration and the number of LH pulses/8 hr period were greater (P less than .05) in castrates than in controls. In castrates with estradiol implants, mean LH concentration and the number of LH pulses/8 hr period were suppressed at all ages compared to controls and castrate treatments. These results indicate that LH release is not inhibited by gonadal factors from 6 to 9 weeks of age in the bull calf. However, estradiol negative feedback on LH secretion is evident during this same developmental period. PMID- 3507891 TI - Exogenous pituitary and recombinant growth hormones induce insulin and insulin like growth factor 1 resistance in pig adipose tissue. AB - In the present study, pigs were treated daily for 7 days with exogenous porcine growth hormone (pGH; 70 micrograms/kg BW) in order to determine whether pGH induced insulin and insulin-like growth factor 1 (1GF-1) resistance in pig adipose tissue. In the first experiment, pituitary-derived pGH (ppGH) decreased basal and insulin-stimulated lipogenesis by 50%. Insulin sensitivity decreased more than 90% as the result of pGH treatment. Sensitivity and responsiveness to IGF-1 were decreased 50% by ppGH. In a second experiment, pigs were treated daily (70 micrograms/kg BW) with exogenous pituitary pGH (ppGH) or recombinant pGH (rpGH) for 7 days in order to determine if the effects of pGH were intrinsic properties of the hormone. Both rpGH and ppGH caused similar decreases in basal rates of lipogenesis, insulin- and IGF-1-stimulated lipogenesis, and insulin and IGF-1 responsiveness in pig adipose tissue. In summary, the decrease in adipose tissue growth of pigs treated chronically with pGH is due in large part to the suppression of fatty acid synthesis and a decrease in the ability of insulin to stimulate lipid synthesis in pig adipocytes. These responses are intrinsic properties of pGH since the effects of rpGH mimicked those of ppGH. The role and importance of a decrease in IGF-1 responsiveness remains to be resolved. PMID- 3507892 TI - The concentration of bovine placental lactogen and the incidence of different forms in fetal cotyledons and in fetal serum. AB - The concentration of bovine placental lactogen (bPL) was determined in fetal placentomes, allantoic fluid, amniotic fluid, maternal and fetal plasma throughout pregnancy. In addition, chromatofocusing chromatography was used to separate the different forms of bPL found both in fetal serum and in placental homogenates in order to determine whether the different forms that have been reported to exist in the cotyledon are also found in the fetal circulation. Reproductive tracts were collected from cows between 109 and 247 days of pregnancy. The concentration of bPL in the fetal cotyledonary tissue was measured by both radioreceptor assay and radioimmunoassay, both assays showed that the concentration of bPL in the fetal portion of the placentomes remained constant throughout the period of pregnancy tested. The mass of the placenta increased approximately 10-fold during the period of study but the concentration of bPL in the maternal plasma was low (0.9 +/- 0.1 ng/ml) at all stages of pregnancy tested. The mean concentration of bPL (Mean +/- S.E.M.) in amniotic and allantoic fluid was 0.4 +/- 0.1 and 1.2 +/- 0.2 ng/ml respectively. Fetal blood contained the highest concentrations of bPL, from 11.6 to 18.4 ng/ml, and the concentration tended to decrease with advancing gestation (slope = 0.07, P = 0.001). Several forms of bPL were found in the fetal circulation; however, a higher percentage of forms with more acidic isoelectric points were found in the fetal serum than in placental homogenates. These results suggest that either some forms of bPL are more stable or that the hormone isolated from placental tissue is not representative of the final secreted product. PMID- 3507893 TI - Postnatal changes in circulating concentrations of growth hormone, somatomedin C and thyroid hormones in pigs. AB - Plasma concentrations of growth hormone (GH), somatomedin (SmC), thyroxine (T4) and triiodothyronine (T3) were determined from birth to post weaning in pigs (Yorkshires). Plasma samples were obtained from the smallest, median and largest piglet from 11 litters. No differences in the circulating concentrations of any of the hormones were observed between piglets of different sizes. However, there were changes in circulating concentrations of hormones during postnatal development. Plasma concentrations of GH decreased between 2 and 8 to 10 days of age. A progressive increase in the circulating concentrations of SmC was observed with concentrations rising (3.83-fold between 2 days and 40 days of age). Plasma concentrations of T4 and T3 were maximal at 23 and 16 days of age, respectively. PMID- 3507894 TI - Dopaminergic-like activity in toxic fescue alters prolactin but not growth hormone or thyroid stimulating hormone in ewes. AB - Studies were conducted to determine the specificity and cause of altered pituitary hormone secretion when ewes ingest endophyte-infected (Acremonium coenophialum) GI-307 tall fescue (toxic fescue). Plasma concentrations of prolactin (PRL) but not growth hormone (GH) or thyroid stimulating hormone (TSH) in ewes grazing toxic fescue were significantly lower (P less than .01) than concentrations measured in ewes grazing orchardgrass (OG). Comparing hormone secretory responses of ewes grazing each grasstype, ewes on toxic fescue released less PRL following thyrotropin releasing hormone (TRH) challenge than ewes on OG. TSH responses to TRH were not affected by grasstype. At this dose of TRH, GH secretion was not significantly affected in either group of ewes. In a separate study, dopamine hydrochloride (DA) was infused into control ewes to define the effect of a pure dopamine agonist on basal and TRH-stimulated secretion of PRL, GH and TSH. DA depressed both basal and TRH-stimulated secretion of PRL without affecting the basal concentrations or responses of GH or TSH. Based on the assumption that the active agent in toxic fescue responsible for the observed hypoprolactinemia was a dopaminergic agonist, haloperidol (HAL), a DA receptor blocking drug, was administered to ewes grazing toxic fescue or OG. HAL evoked significant PRL secretion unaccompanied by any GH or TSH effect in both toxic fescue and OG ewes. Administration of HAL resulted in a gradual increase over 4 hr in PRL in toxic fescue ewes and prolonged the duration of the PRL response to TRH. No differences in circulating plasma concentrations of DA, epinephrine or norepinephrine were measured in ewes on troxic fescue or OG. Alterations in pituitary hormone secretion due to toxic factors in fescue were confined to PRL. Hormone secretory responses to TRH and HAL suggest that the effects on PRL are mediated through dopamine-like activity in toxic fescue. PMID- 3507895 TI - The effect of estrogen, progesterone and prostaglandin F2 alpha on uterine contractions in seasonally anovulatory mares. AB - Uterine contractions were studied in two experiments utilizing ultrasonography and seasonally anovulatory mares. A one-minute ultrasound scan was done to produce longitudinal real-time images of the uterine body and an overall uterine contractile activity score (0 = no or minimal activity to 4 = maximal activity) was assigned to each scan. In experiment 1, a two-hour uterine activity trial (one score every 10 minutes) was done in mares given a single injection of prostaglandin F2 alpha (PGF2 alpha group; n = 4) and in control mares (n = 4). There was no difference between the two groups over the two-hour trial (mean activity score averaged over the two-hour trial: PGF2 alpha group, 0.2; control group, 0.1). In experiment 2, 16 mares were randomly assigned to one of four groups: 1) controls (corn oil vehicle), 2) 1 mg estradiol 17 beta on days 0 to 9 and 100 mg progesterone on days 10 to 20 (E2--greater than P4 group), 3) 100 mg progesterone on days 0 to 20 (P4 group), and 4) 100 mg progesterone on days 0 to 9 and 1 mg estradiol 17 beta + 100 mg progesterone on days 10 to 20 (P4--greater than E2 + P4 group). Uterine activity was assessed for each mare daily. The day by group interaction was significant. Scores for the E2--greater than P4 group were greater on days 4 to 11 (P less than .05) than for the other three groups. From day 14 to 21, scores did not differ among the three steroid-treated groups (except on day 15), but the scores averaged over each steroid-treated group were greater for each day (P less than .1 or .05) than for the controls (except on day 17).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3507896 TI - Effect of exogenous prolactin administration on lactational performance of dairy cows. AB - Eight Holstein cows were utilized to examine the effect of prolactin on lactational performance prior to peak milk production (day 21-34 postpartum) and after peak milk production (day 60-73 postpartum). During each 14 day period, cows received daily intramuscular injections of pituitary-derived bovine prolactin (120 mg; 13.0 IU/mg protein) or excipient. Cows were housed in a controlled environment at 18.1C, 47.8% relative humidity and a 15 hr light: 9 hr dark cycle. In cows administered exogenous prolactin, circulating prolactin concentrations increased within one-half hr post injection, peaked within 2 to 6 hours and declined through the remainder of the day. Average prolactin concentration in the plasma was increased 2 to 5 fold over the 24 hr period in response to prolactin treatment. Yields of milk and milk components (fat, lactose and protein) were not affected by prolactin treatment in either period but the concentration of alpha-lactalbumin in milk was significantly increased (P less than .10) in both periods. Circulating concentrations of somatotropin, triiodothyronine, thyroxine, glucagon, nonesterified fatty acids and glucose were not altered. In prolactin-treated cows, the milking-stimulated prolactin release was decreased at both the PM milking, when circulating concentrations of prolactin were high, and the AM milking, when prolactin concentrations had returned to baseline. Concentration of prolactin in milk tended to increase but was not significantly altered by administration of exogenous prolactin. However, prolactin concentrations in plasma were correlated (r = .56) with milk concentrations. It is clear that postpartum administration of exogenous prolactin during the period of lactation prior to peak milk yield or after peak milk yield does not alter lactational performance in high producing dairy cows. PMID- 3507897 TI - Failure of neuropeptide Y to modulate the release of LH and prolactin by cultured bovine pituitary cells. AB - Possible direct effects of neuropeptide Y (NPY) on dispersed and cultured cells of the anterior lobe (AL) of the bovine pituitary were investigated. AL tissue from steers was enzymatically dissociated into individual cells, preincubated for 18 hr and then incubated in suspension cultures for 2 hr or 24 hr with either NPY, gonadotropin-releasing hormone (GnRH) or both. Release of luteinizing hormone (LH) and prolactin (PRL) into medium was quantified by radioimmunoassay and expressed as hormone released per 100,000 cells. Basal release of LH averaged 38 and 86 ng for 2 hr and 24 hr respectively while that of PRL averaged 118 and 438 ng for the same incubation periods. Addition of NPY did not alter (P greater than .05) basal release of LH or PRL for either duration of incubation. Also, NPY did not affect (P less than .05) release of of LH in response to GnRH. In summary, this study indicated that NPY, at in vitro dosages of .01 to 100 nM, does not modulate the release of LH or PRL at the pituitary level in castrate cattle. PMID- 3507898 TI - Women's health. PMID- 3507899 TI - Whither epidemiology and management the two king-pins in public health. PMID- 3507900 TI - [Peripheral nerve lesions of experimental leprosy in monkeys. II. Edema]. PMID- 3507901 TI - [Peripheral nerve lesions of experimental leprosy in monkeys. III. Intracytoplasmic foamy structure and fibrosis]. PMID- 3507902 TI - Hyperbaric oxygenation (HBO) as a complementary treatment of patients with multibacillary lepromatous leprosy. PMID- 3507903 TI - [Epidemiological immunological studies on leprosy in Okinawa. I. A survey on personal and family histories of inpatients]. PMID- 3507905 TI - [Proceedings of the regional meetings of the Japanese College of Cardiology. Abstracts]. PMID- 3507904 TI - [Epidemiological immunological studies on leprosy in Okinawa. II. Statistical observations on clinical symptoms of inpatients]. PMID- 3507907 TI - The effect of steroids on the viability of endothelial cells of stored cornea. PMID- 3507906 TI - The effects of experimental ocular hypertension on the electroretinogram and ultrastructure of the retina in rabbits. PMID- 3507908 TI - Observations on iris melanocytes implanted in the cornea. PMID- 3507909 TI - Evaluation of clinically applied visual evoked potential (VEP) in ophthalmological and neurological diseases. PMID- 3507910 TI - A retrospective study of 1,073 cases of intraocular lens implantation. PMID- 3507911 TI - Clinical study of Korean glaucomatous patients. PMID- 3507912 TI - Radial keratotomy in high myopia. PMID- 3507913 TI - The influence of miotics on the visual field. PMID- 3507914 TI - Isolation and antigenic characterization of human immunodeficiency virus (HIV) in Brazil. AB - A retrovirus infecting a Brazilian AIDS patient was isolated and characterized in terms of its reactivity with sera from individuals infected with human immunodeficiency viruses 1 and 2 (HIV-1 and HIV-2). The Western blot analysis revealed that the Brazilian isolate is very similar to the well characterized HIV 1 strain. The serum of the patient from whom the virus was isolated did not react with the 140 kDa envelope glycoprotein specific for HIV-2. PMID- 3507915 TI - Identification of vector species (Diptera:Simuliidae) of human onchocerciasis in the amazonia focus of Brazil and Venezuela. AB - The taxonomic status of three Amazonian simuliid species, Simulium guianese Wise, S. oyapockense Floch & Abonnenc and S. yarzabali Ramirez Perez is reviewed. Simulium cuasisanguineum Ramirez Perez, Yarzabal & Peterson is synonymized with S. oyapockense, and S. yarzabali is revalidated from its synonymy with S. incrustatum Lutz. The role of these three species in the transmission of human onchocerciasis and mansonelliasis in Amazonia is reviewed. PMID- 3507916 TI - [Ecologic aspects of American tegumentary leishmaniasis. 5. Stratification of the spatial and seasonal activities of Phlebotominae (Diptera, Psychodidae) in areas of agricultural culture of the Vale do Ribeira region, State of Sao Paulo, Brazil]. AB - This paper deals with the investigation on the composition and stratification of the Phebotominae activity developed in patch and clear areas of high agricultural activity. The employment of a CDC light trap proved to be a useful tool in determining the local faune. Thirteen species of sandflies and a total of 5,423 individuals were caught. The catch places situated in the ecotone were the ones in which the results reached their best, being outstanding for Psychodopygus intermedius, Lutzomyia migonei and L. fischeri. Thereby, data lead us to believe they have acrodendrophilous habit. On the other hand, when the global results were gathered according to male and female categories, the first one proved to be predominant. In the analysis of seasonal distribution for the three species cited, it was clear that the high-activity peaks were bi- and tri-modal for different seasons. P. intermedius was almost the exclusive sandfly caught at ground level in the Autumn season. This exclusiveness has practically extended itself to the catch places situated in open field. PMID- 3507918 TI - [The influence of anhydrobiosis on the infestation of Biomphalaria glabrata by Schistosoma mansoni miracidium]. AB - 410 Biomphalaria glabrata (Caribbean strain of Guadeloupe) have been infected with one miracidium of Schistosoma mansoni, 110 snails, used as controls have been kept into water; the survival rate was 96.4% after 4 weeks and 25.4% produced cercariae. 300 snails were kept on wet soil, and submitted for 6 weeks to progressive desiccation. The survival rate was 23.4% but only 9 of them produced cercariae. Periodic variations of the production of male and female larvae have been shown by the weekly test of the cercariae productions. In previously desiccated snails, the production of male and female cercariae is similar while in controls the production of female larvae is more important. In experimental snails, the larval development seems to be stopped during anhydrobiosis. The production of cercariae is just delayed for the length of the dry keeping. PMID- 3507917 TI - [Comparative study of helminth parasites of fishes from the Mogi Guassu river, collected during expeditions between 1927 and 1985]. AB - This paper concerns the parasitism of Nematoda, Trematoda, Acanthocephala and Cestoda from 1027 fishes of 45 species from Mogi Guassu river, examined in the years 1927, 1946, 1947, 1962, 1983 and 1985 as a contribution to the knowledge of the parasitological fauna in 58 years. Thirty two species of nematodes, 21 of trematodes, 3 of acanthocephalans and 2 of cestodes are reported. New hosts are presented for the nematodes Cucullanus pinnai, Spirocamallanus inopinatus and Travnema travnema, for the trematode Pararhipidocotyle jeffersoni and for the acanthocephalan Gorytocephalus spectabilis. New measurements for the trematode Creptotrema lynchy, tables, graphics and a list of the examined hosts with their parasites are presented. PMID- 3507919 TI - The change of behaviour of two strains of Leishmania after cultivation in a defined medium. AB - Attempts have been made to characterize two strains of Leishmania that became infective to golden hamsters only after they had been maintained for several years in a chemically defined culture medium. Observations were made on the growth rates of promastigotes in vitro, course of infection in hamsters, morphology of amastigotes, and electrophoretic mobility patterns of eight isoenzymes. Information was obtained about the buoyant densities of n-DNA and k DNA, and one strain was tested against monoclonal antibodies. The identity of both strains remains obscure. PMID- 3507920 TI - The relevance of characterizing Leishmania from cutaneous lesions. A simple approach for isolation. PMID- 3507921 TI - Disseminated American cutaneous leishmaniasis in a patient with AIDS. PMID- 3507922 TI - Ecology of the sandflies of Itaguai, an area of cutaneous leishmaniasis in the State of Rio de Janeiro. Food preferences (Diptera, Psychodidae, Phlebotominae). PMID- 3507923 TI - [Dimensional accuracy of castable ceramic crowns made of calcium phosphate crystalline ceramics]. PMID- 3507924 TI - [Series, parallel resistances and capacitance of Nitella when the amplitude of applying finite alternating potential is varied]. PMID- 3507925 TI - [Dentofacial changes by means of occipital traction type headgears]. PMID- 3507926 TI - [Effect of pH on lactate production by oral microorganisms]. PMID- 3507927 TI - [Experimental study of the changes of dynamics in the alveolar bone after implantation of hydroxyapatite ceramic into the dental extraction sockets]. PMID- 3507928 TI - [Experimental study of the changes of dynamics on duct-ligated rat submandibular gland]. PMID- 3507929 TI - [Characterization of Staphylococci isolated from acute suppurative periapical periodontitis]. PMID- 3507930 TI - [Effect of thyroid gland function following 60Co-gamma ray irradiation on rabbit pituitary gland]. PMID- 3507931 TI - [Release of nickel and chromium from simulated orthodontic appliances made of stainless steel in various solutions]. PMID- 3507932 TI - [A case report treated with the Begg IV stage system]. PMID- 3507933 TI - [Sialographic images of a patient with cancer of the mouth floor presenting specific clinical features]. PMID- 3507934 TI - [Hearing loss caused by musical sounds of concert]. PMID- 3507935 TI - [Radiographical study of supernumerary teeth with special reference to the upper molar region]. PMID- 3507936 TI - [Equilibrium function in relation to the stomatognathic system in preschool children by means of stabilometer]. PMID- 3507938 TI - [Occurrences and histological structures of enamel projections and enamel drops]. PMID- 3507937 TI - [Comparison of each fluorapatite crystallized on tooth enamel using silica-hydro gel and gelatin gel methods]. PMID- 3507939 TI - [Effect of amino acids and dipeptides on the growth of oral Treponemes]. PMID- 3507940 TI - [Clinical studies on the application of Michigan type full coverage bite plane for dysfunction of the masticatory system]. PMID- 3507941 TI - [Craniomaxillofacial morphology by X-ray computed tomography]. PMID- 3507942 TI - [Bruxism during sleep. Effect of Michigan type full coverage bite plane]. PMID- 3507943 TI - [A scanning electron microscopic study of the root surface in periapically diseased teeth]. PMID- 3507944 TI - [Traction resistance limit of dental amalgam. Effect of inclusion of a silver plate or wire and time]. PMID- 3507945 TI - [Evaluation of marginal infiltration of the principal provisional sealing materials against 0.2% Rodamine B. "In vitro" study]. PMID- 3507946 TI - [Electrosurgery in periodontics. Presentation of 2 cases with osseous necrosis]. PMID- 3507947 TI - [Comparative histological evaluation of the efficiency of manual and ultrasonic instrumentation in narrow and wide canals]. PMID- 3507948 TI - [Standardization of gutta-percha cones from different manufacturers]. PMID- 3507949 TI - [Computerized dental records. Analysis of systems]. PMID- 3507950 TI - [Pregnancy granuloma: Clinical and therapeutic considerations]. PMID- 3507951 TI - [Dental amalgam. Study of the oxide layer formation using the apparent reflectance method and microscopic analysis. Effect of type of alloy, time of polishing, and time]. PMID- 3507952 TI - [Microscopic aspects of incipient caries]. PMID- 3507953 TI - [Are photocuring lamps a risk to the retina of the operator?]. PMID- 3507954 TI - Staining of posterior resin restorative materials. PMID- 3507955 TI - The microleakage of a glass ionomer cement using two methods of moisture protection. PMID- 3507956 TI - Effect of provisional luting agents on provisional resin additions. PMID- 3507957 TI - Anterior crossbite correction in the primary dentition using fixed inclined planes. I. Technique and examples. PMID- 3507958 TI - An introduction to clinical dental photography. PMID- 3507959 TI - Use of glass ionomer restorative and microfill composite resin veneers to improve esthetics in periodontally involved teeth. PMID- 3507960 TI - [The use of Isofil for regeneration of pathological attrition of teeth in patients with lowered occlusal height (some cases)]. PMID- 3507961 TI - [Spectral assessment of the degree of speech signal deformity in patients wearing complete denture]. PMID- 3507962 TI - [Prosthetic treatment of patients with soft palate defects]. PMID- 3507963 TI - [Assessment of the effectiveness of treatment of denture stomatitis infected with yeast-like fungi in patients after surgical treatment of maxillofacial neoplasms]. PMID- 3507964 TI - [Functional shaping of lost guiding of anterior teeth]. PMID- 3507965 TI - [Analysis of eccentric occlusion in the light of own investigations]. PMID- 3507966 TI - [The use of computerized tomography in the diagnosis of temporomandibular myoarthropathy]. PMID- 3507967 TI - [Radiological assessment of edentulous parts of the alveolar processes in cases of partial tooth loss in patients of the dental prosthetics outpatient clinic in Legnica]. PMID- 3507968 TI - [Superpont C + B material]. PMID- 3507969 TI - [Elimination of factors contributing to the formation of bacterial plaques on acrylic removable prostheses]. PMID- 3507970 TI - [Location of teeth in relation to certain facial elements]. PMID- 3507971 TI - [Assessment of the condition of the stomatognathic system in the inmates of the old age home in Szczecin]. PMID- 3507972 TI - [Method of and equipment for parallel fixation of the lower recording plate for intraoral recording of mandibular movements]. PMID- 3507973 TI - [Cell-mediated immune response in patients with fungal oral infections in prosthetic stomatopathies. Part I. Antibody-dependent cellular cytotoxicity (ADCC)]. PMID- 3507974 TI - [Structural examination of the dentistic alloy Co-Cr-Mo Mikromed 1-04]. PMID- 3507975 TI - [Biological assessment of the dentistic alloy Mikromed 1-04 in comparison with similar foreign-made alloys]. PMID- 3507976 TI - [Radiographic study of the upper vertebral segment]. PMID- 3507977 TI - A study of bacterial contamination of rattlesnake venom. PMID- 3507978 TI - [Attempt to develop erythrocyte forms of Plasmodium brasilianum in vitro]. PMID- 3507979 TI - [Standards for the serology of parasitic diseases]. PMID- 3507980 TI - Investigation of the response to the enterobacterial common antigen after typhoid vaccination. PMID- 3507981 TI - [Carious dentin under plastic restorations]. PMID- 3507982 TI - [Analysis of variations of exposure and development times of Kodak (Ektaspeed) and Agfa-Gevaert (Dentus M-2) periapical films]. PMID- 3507983 TI - [The shelf life of Dakin solution]. PMID- 3507984 TI - [The effect of ischemia on the dentinal glycolitic activity in rat molars]. PMID- 3507985 TI - [Electrolytic changes in potassium in surgically treated patients with facial injuries]. PMID- 3507987 TI - [Staining and characterization of composite resins]. PMID- 3507986 TI - [The terminal hinge axis of the mandible. (Determination in totally edentulous patients.)]. PMID- 3507988 TI - [The kinematic facial arch of the T.T. articulator]. PMID- 3507989 TI - [Proximal displacement of M.O.D. inlays subjected to occlusal loading. (Influence of the depth of the occlusal segment, the double inclination of the gingival wall, and the presence of cement bases on the cavity pulpal floor)]. PMID- 3507990 TI - [The influence of sialadenectomy and thymectomy on the bone and tooth growth of the rat]. PMID- 3507991 TI - [Radiographic evaluation of amalgam restorations with proximal overhangs]. PMID- 3507992 TI - [Chemical properties and biocompatibility of Ca(OH)2]. PMID- 3507993 TI - [Restorations with glass-ionomer cements]. PMID- 3507994 TI - [Labial position, at rest and smiling, and its relation to the central upper incisors]. PMID- 3507995 TI - Presentation of a histochemical method for the study of root dentin permeability. PMID- 3507996 TI - [Composite resins in posterior teeth]. PMID- 3507997 TI - [Clinical case: dens in dente]. PMID- 3507998 TI - [A multiple dermoid cyst of the mouth floor. Report of a case]. PMID- 3507999 TI - [Measurement of the mechanical stress developed on the active edge of Seldin angulated elevators of different dimensions and origin]. PMID- 3508000 TI - [Development and study of the properties of alternative alloys for cast restorations (preliminary note)]. PMID- 3508001 TI - [Characterization of tooth set-up in complete denture]. PMID- 3508003 TI - [Morphometric correlation between the hard palate, the upper dental arch, and facial width]. PMID- 3508002 TI - [Inter- and intra-examiner variation in determination of vertical and rest dimension in totally edentulous patients]. PMID- 3508004 TI - [Post-natal development of the submandibular glands of male and female mice: Histologic, histometric and histochemical study]. PMID- 3508006 TI - [Meniscus transplantation--animal experiment study]. AB - The possibility of repairing meniscus lesions by transplantation was studied in 30 sheep. Grafting of the meniscus was performed in 15 animals each either with lyophilised homologous menisci that had been sterilised by gamma rays, or with deep frozen homologous menisci. 27 menisci could be evaluated over a period of 48 weeks. Besides the clinical, microscopical and scanning electron microscopical evaluation, the grafts were also examined microangiographically and biomechanically. Both lyophilised and deep-freeze menisci are suitable for transplantation, but the processes of transformation of the grafts are significantly different: Whereas complete transformation takes place in the lyophilised transplant during the study period of 48 weeks, the deep-frozen transplant is accepted and heals without any remarkable transformation process to full function. Although the biomechanical stress tests yielded good stress tolerance for both types of transplants, the deep frozen homologous menisci appear to be more favourable with regard to possible clinical aspects since they do not undergo any transformation. PMID- 3508005 TI - [Clinical case: treatment of overextension of the subgingival preparation by alveolar restorative interface treatment (ARI)]. PMID- 3508007 TI - [Stress reactions of the bony skeleton of athletes]. AB - A stress fracture atypical lesion caused by overstraining the bony skeleton could result in a long-term rest in training. Depending on the type of stress, the localisation changes. The lower extremities are without doubt afflicted most frequently. Complaints, findings and x-ray findings may be unspecific. This complicates the diagnosis in the same way as stress fractures with rare localisation. The concept "stress fracture" is often misleading and should preferably be replaced by "stress reaction". This applies particularly to non typical radiological patterns. Diagnosis, differential diagnosis and therapeutical aspects are discussed. PMID- 3508008 TI - [Neurophysiological and biomechanical analysis of a gymnastics accident with high transverse paralysis. An example of a sports medicine research study in the area of prevention of sports accidents]. AB - The development of preventive provisions is an important topic of sport accident research. We demonstrate the stepwise procedure of judging a provision taking the analysis of a gymnastic exercise. This includes determination of the inner and outer reasons of accidents, the biomechanical conditions of the exercise and leads to mathematical and experimental simulation of the dangerous movement. The specific exercise we studied was the efficiency of a coach in protecting position for the handstand somersault with 1 1/2 breakneck leap. The reaction ability of the coach during the exercise and his force capacity to prevent an accident is explored by a newly developed reaction time analyzer and by a catapult apparatus throwing a dummy. Our results show the inadequacy of the prevention provision of a coach in protecting position for the special gymnastic exercise. PMID- 3508009 TI - [Multilocular myositis ossificans--damage caused by excessive stress in performance sports?]. AB - This is a report of a girl of 16 years of age who complained of pain in both legs after intensive competitive sports, the main event being the 800 m race. Radiologically visualised were periostal reactions and new periostal bone formations at the femur and lower leg. Diagnosis was extremely difficult due to generalised signs and symptoms, such as temperature, associated with inappetence and a "run-down" feeling, increase of alkaline phosphatase and liver enzyme levels and of the blood sedimentation rate. Differential diagnosis of heterotopic ossifications is dealt with in detail. PMID- 3508010 TI - [Importance of the ossicle and therapy of Osgood-Schlatter disease]. AB - If ossicles occur within the disease pattern of Osgood-Schlatter disease (apophysitis tibialis adolescentium) the duration of the complaints is usually extended to twice the normally expected period. Their shape and location influences the clinical course of the disease. Surgical removal of these ossifications is the therapy of choice if the complaints persist for a relatively long time. With regard to conservative treatment it has been shown on the basis of the duration of healing that functional therapy with an expansion of the ischiocrural musculature is preferable to immobilization of the joint. We consider functional treatment to be justified even if there is an increased formation of ossicles on non-immobilization of the joint, since such ossification occurs with only 20-25% of all cases of Osgood-Schlatter disease and the duration of the complaints is markedly less enhanced than with immobilization measures. As far as the sportsman is concerned, this entails only brief loss of training and the possibility to avoid muscular atrophy of the affected leg by means of physiotherapeutic exercise. PMID- 3508011 TI - [Long-term roentgenologic studies in peak performance javelin throwers]. AB - The example of the javelin thrower demonstrates that an unphysiological movement sequence at the elbow joint (valgus stress) leads to regular arthrotic alterations by summation of such strains: these are known as "javelin elbow". Since the new javelin introduced in 1986 requires a greater explosive force, a tendency to an increased incidence of these alterations must be reckoned with in the future. Further observations are necessary to clarify whether there will be an increase in degenerative alterations in the lumbar spine by abrupt hyperlordosis and trunk rotation in producing the bow tension of the javelin thrower; whether the above-average incidence of patients with spondylolysis amongst competitive javelin throwers is coincidental; whether the processes of remodelling in the interarticular portion of javelin throwers constitute zones of fatigue; and, finally, whether the unilateral trunk strain of the javelin thrower influences the scoliotic posture. PMID- 3508012 TI - [Animal experiment studies of the resistance to wear of a teflon ligament prosthesis]. AB - In a randomised study the anterior cruciate ligament (ACL) was resected in 16 sheep and replaced by a PTFE-Ligament prosthesis. The device was examined 1/2 year and 1 year after implantation. 1 year after implantation the signs of wear were considerably greater than 1/2 year after implantation and the tensile strength was significantly decreased. As a result of the implantation technique and by the large volume, the device underwent an unphysiologically high mechanical stress, leading to early breakage. The improved implantation technique should result in lower mechanical stress in the larger human knee joint and a longer lifetime should be expected. PMID- 3508014 TI - [Measuring pressure distribution on the human tibia in ski boots]. AB - Pressure distribution inside shoes is of great importance for orthopaedic and biomechanical inquiries. Especially in sports, safety and comfort depend essentially on this quantity, which also determines whether a shoe is well suited for a certain discipline. Therefore, the measurement of pressure distribution allows detailed and objective statements about these factors. Using a set of newly developed thin and highly flexible measuring mats and the corresponding electronic equipment, such statements have become possible. First results with this method were obtained in alpine skiing. 8 different types of ski boots (sizes 5 and 8) worn by 14 subjects were tested on different foreward leans and temperatures using 7-point measuring mats (2 cm2/point) fixed between the boot shaft and the front of the lower leg of each leg. Additional measurements on three different types of boots using a 3 x 24-point mat (1 cm2/point) for the lower leg, as well as measurements underneath the foot with a 14-point (2 cm2/point) and a 80-point (1 cm2/point) mat were performed. A complementary determination of the force at the heel element of a ski binding and a registration of muscular activity (EMG) helped in the interpretation of the results. Some field research using telemetry completed our study. Considerable variations between different boots were found in value and location of pressure maxima. Traditional boots show high pressure values over the instep at foreward leans of 35 degrees and a rise of pressure underneath the forefoot while fixing the buckles, whereas minimal pressure over the instep, no compression of the forefoot and a pressure maximum near the upper end of the shaft are observed in rear entry boots. The force at the heel-important for binding release-varies widely between different boots at the same foreward lean. There was no asymmetry between the pressure distributions of right and left. The pressure distributions for different subjects measured in the same boot were very similar. The temperature dependence of pressures is strongly influenced by the construction principle of the boot: If shaft stiffness is caused by deformation of plastics, boots become much stiffer at the freezing point than they are at room temperature. Well-suited ski boots should cause low pressure over the instep and show a relatively low maximum in the upper part of the shaft, in order to allow a good transmission of torque, which is necessary for a safe binding release and easy skiing without fatigue. The shaft stiffness must not depend strongly on temperature.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3508013 TI - [Apophyseal rupture of the pelvis and lower extremity caused by sports]. AB - Apophyses are secondary ossification centers and serve as the insertion or origin of tendons. They are under a dynamic but not static load. During sexual maturity, they represent a weak point in the locomotor system. Apophyseal injuries can apparently be attributed to an incongruity between load tolerance and increased strain on the seam of the apophysis. The majority of these injuries occur during sports and involve men more frequently than women. The injury is often primarily misinterpreted as a pulled-muscle. The treatment method is dependent on the localization of the injury and the extent of the fragment dislocation. PMID- 3508015 TI - [The importance of isokinetic measurement of force in sports and rehabilitation]. AB - The musculature serves as motor of the human body and hence promotes our movement within our environment. Its organ-specific performance is the translation of force into movement. This force can be described by means of different qualities maximal force, speed and endurance. These properties are essential for sports activities and also set limits for the achievement of athletic records. Muscular force can be evaluated by different means. Measurement of force via isokinetic systems enables quantitative measurement of effective muscular forces in various body positions which are frequently comparable under conditions specific to different types of sports. The relevance of these measurements in sports and rehabilitation is documented in this article. Two different groups of subjects (72 sportsmen and 73 patients after capsular ligament reconstruction in the knee joint) were examined. The measurement values: dynamic maximal force, energy of acceleration, average performance and the hamstring/quadriceps ratios (H/Q quotient) are measured at different speeds. The maximal force shows intraindividual differences depending on the speed. These differences are due to different conditions of training and different distribution of muscle fibre types. The acceleration energy enables assessment of differences in the ability to exercise force. Likewise, the different muscle performances can be described by means of the appropriate individual performance maximums. In rehabilitation, muscle atrophy caused by immobilization can be measured and described. Measurement of force by means of isokinetic systems enables the analysis of muscular forces with their different properties, and hence to give advice in training matters and to supervise and control popular recreational sports and competitive sports activities.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3508016 TI - [Epiphysiolysis of the proximal tibia in high jumping]. AB - Damage to the proximal epiphysis of the tibia is a most unusual injury. The case in point happened without a trauma. The mechanism of the injury is discussed. The different types and the frequency of the injury are presented on the basis of the literature. Treatment of this typical AITKEN-I fracture rarely offers problems. PMID- 3508017 TI - [Oral pathology in pregnancy]. PMID- 3508018 TI - [Immunological aspects of endodontics]. PMID- 3508020 TI - [Speaking of computers]. PMID- 3508019 TI - [Problems of antibiotic therapy in infections of the oral cavity]. PMID- 3508021 TI - [Statistical study of fissure sealants]. PMID- 3508022 TI - [Oral cancer. Symptomatology and diagnosis]. PMID- 3508023 TI - [Survey of caries in children in Mogadouro]. PMID- 3508024 TI - [Leukoplakia. Review of 37 cases]. PMID- 3508025 TI - [Manual of dental technic for fixed restorations]. PMID- 3508026 TI - [Surgical aspects of oral rehabilitation]. PMID- 3508027 TI - [Efficacy of combination quaternary ammonium based disinfectants against the HIV virus (human-immunodeficiency-virus) Micro 10]. PMID- 3508028 TI - [Epithelial dysplasia in oral leukoplakia. Study of 200 cases]. PMID- 3508029 TI - [Epithelial dysplasia in oral lichen planus]. PMID- 3508030 TI - [Focal osteoporotic defect of the bone marrow of the jaws. Report of 3 cases]. PMID- 3508031 TI - [The latero-labial modiolus. Structure and morphology in the adult]. PMID- 3508032 TI - [Meckel's cartilage and derivatives. Sympheseal and paramandibular region]. PMID- 3508033 TI - [Malignant tumors of the oral mucosa]. PMID- 3508034 TI - [Vascularization and elastic systematization of the mandibular condyle]. PMID- 3508035 TI - [Bronchoalveolar lavage in pulmonary interstitial diseases]. PMID- 3508036 TI - [Tricuspid valve endocarditis in drug addicts]. PMID- 3508037 TI - The ability of granulocytes from patients with atopy to engulf neutral latex particles and Staphylococcus aureus. AB - The granulocytes obtained from patients with atopic diseases were investigated for their ability to engulf neutral latex particles and bacteria (S. aureus) in the presence of antigenically compatible sera of healthy subjects. Similar tests were done using the granulocytes of healthy subjects and sera of the patients with atopic diseases, and the granulocytes of these patients in autologous sera. Granulocytes of healthy subjects suspended in autologous sera served as a control. In all patients IgE globulins were determined in the serum. It was observed that only granulocytes from the patients with atopy showed a defect in engulfing latex particles and S. aureus. This defect was independent of the serum in which these granulocytes were suspended, and of the IgE level in the patient's serum. PMID- 3508038 TI - HLA as an immunogenetic risk factor in juvenile chronic arthritis. AB - We investigated the frequencies of HLA-A, -B, -C and -DR antigens in diseased and control group with the aim to find immunogenetic factors that influence the pathogenesis and clinical course of juvenile chronic arthritis (JCA). The study was conducted on 73 JCA patients, 24 boys and 49 girls. On the basis of observed HLA antigen frequencies the relative risks (RR) and their statistical significance as well as the attributable risks (delta) were calculated. In the group of 73 JCA children the only statistically significant finding was a decreased RR for DR7. When the calculations were performed on boys taken from the JCA group, significantly higher RR were found for DR5, B27, B40 and A32. Further analysis was performed on clinically defined subgroups of JCA. In 15 children with pauciarticular persistent arthritis significantly increased RR and delta were found for A25, DR2 and DR3. No significant RR were observed in a subgroup of 44 sero-negative polyarticular arthritis. When only boys of this subgroup were selected for calculations, significantly increased frequencies were found for antigens A32, B40, DR1 and DR5. The reason for a stronger association of immunogenetic risk factors in diseased males than females is discussed. PMID- 3508040 TI - Partial purification of porcine platelet-derived growth factor (PDGF). AB - Fresh porcine blood platelets, subjected to ethanol acid extraction and purification on DEAE-Sephadex A-50 and CM-Sephadex C-50, were used to obtain partially purified, cationic PDGF (pI 8.5-10) of Mr 38,000 and biological activity 10(4) U/ml. Reduction of porcine PDGF with 2-mercaptoethanol revealed the presence of two polypeptides with Mr 18,000-22,000. PMID- 3508039 TI - HLA antigens and susceptibility to myasthenia gravis. AB - HLA-A, -B, -C and -DR antigen frequencies determined in a group of 73 myasthenia gravis (MG) patients were compared with those of a control group of 205 subjects. The strongest positive association with MG was found antigens B8 and DR3 (relative risks 9.56 and 8.84 respectively). Analysis of our data indicates that both antigens, independently from their linkage disequilibrium, are involved in susceptibility to MG. No relationship between HLA antigens on thymic pathology was observed in our material. In male MG patients the association with DR3 was weaker than in female patients. The difference in DR3 frequency between male and female patients was statistically significant; no significant difference was found for antigen B8. It appears that DR3 contributes to development of MG only in females. In male patients aged more than 30 years at the onset of disease, MG was not associated with B8 or DR3. In contrast, in female patients aged more than 30 years at the onset of disease there was a strong association of B8 and DR3 with the disease. PMID- 3508041 TI - Separation of transforming growth factors TGF alpha and TGF beta during chromatographic purification of extracts from mouse C-234 tumors. AB - Polypeptide transforming growth factors: TGF alpha and TGF beta were isolated and separated from acidic ethanol extracts of mouse C-243 tumors. The purification of the acid-soluble extract was achieved by Bio-Gel P-60 filtration chromatography, followed by CM-Sepharose CL-6B ion exchange, Bio-Gel P-10 filtration, and dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE). At the Bio-Gel P-10 purification step, TGF alpha was separated from TGF beta. TGF alpha stimulated mouse Balb/c-3T3, rat NRK-49F and human A549 cells to form colonies in soft agar, and competed with 125I-labeled epidermal growth factor (EGF) for binding to human placenta membrane receptors. Over 40,000-fold SDS-PAGE-purified TGF beta had an Mr of 25,000. Unlike TGF alpha, TGF beta stimulated the clonal growth of NRK fibroblasts only in the presence of the suboptimal amounts of EGF (0.5 ng/ml). TGF beta significantly inhibited the anchorage-independent growth of malignant human lung carcinoma A549 cells, and in the radioreceptor assay with 125I-EGF it had no affinity to EGF receptors. PMID- 3508042 TI - ADCC in aging rats with methylcholanthrene-induced sarcoma (MC-Sa). AB - Investigations on the relationship between the aging of the immune system and the tumor growth are the trigger of our studies. The purpose of the present paper was to determine a relation between cytotoxic activity of the spleen lymphocytes in ADCC assay and the MC-induced sarcoma growth in adult and aging rats. In ADCC assay the mouse leukemia L1210 labeled with Cr and sensitized with rabbit anti L1210 serum was used as target cells. In aging rats with MC-Sa tumors the lymphocyte activity in ADCC was increased or remained unchanged in the comparison with normal animals. On the contrary, in adult rats with MC-Sa tumors ADCC activity was decreased. In comparative studies between the groups of adult and aging rats a reverse relationship between the tumor growth and the lymphocyte activity in ADCC was found. In aging rats the level of ADCC was higher than in adults, but the tumor growth was slower. We suggest that ADCC phenomenon may be involved in an antitumor response, especially effective in aging rats. PMID- 3508043 TI - Hybrid resistance to the ascites form of the murine sarcoma. AB - An ascites form (AA) of the methylcholanthrene-induced murine sarcoma of C3H origin was used for present experiments. The AA cells were intraperitoneally injected to syngeneic (C3H, H-2k), allogeneic (DBA, H-2d) or semisyngeneic (C3H x DBA, H-2k/d) mice at a dose 10(7) cells per animal. The DBA mice developed small amount of ascites in the peritoneal cavity followed by rejection of allogeneic tumor cells and recovery. All syngeneic and semisyngeneic animals developed tumor and died. The C3H x DBA hybrids survived significantly longer than C3H mice (mean survival times: 21.9-24.8 and 10.1-11.8 days, respectively). The hybrid mice died with voluminous ascites tumor accompanied by a sponge-like form of tumor cell aggregates dispersed in the peritoneal cavity while the syngeneic mice died with small amount of dense ascites with an accompanying massive solid tumor in the vicinity of the spleen. Therefore in the experimental system used the semisyngeneic mice were found to develop a better response against parental strain tumor cells than the syngeneic mice. This is an example of the phenomenon referred to as "hybrid resistance" or "allogeneic inhibition". PMID- 3508044 TI - Evaluation of the effect of staphylococcal serine proteinase on phagocytosis. AB - Correlations between values of phagocytosis index and values of concentrations of staphylococcal serine proteinase were analysed. Preincubation of granulocytes with the proteinase stimulated phagocytosis of three bacterial strains: S. saprophyticus, S. aureus VS and S. aureus Smith diffuse. Significant correlations were also observed for S. saprophyticus strain in phagocytosis performed with or without bovine serum. Specific rabbit IgG anti-serine proteinase effected the increase of phagocytosis index only in the case of S. aureus Smith diffuse. Summary statistical analysis for all experimental conditions exhibits significant correlations also for S. aureus VS strain. No significant correlations were noted for the three remaining strains taken from patients. PMID- 3508045 TI - Efficacy of radiotherapy in optic gliomas. AB - Twenty-five children with optic gliomas were evaluated over a seven year period by sequential computed axial tomography in order to determine the efficacy of radiotherapy as a treatment modality. Indices of tumor progression or regression included both size and contrast enhancement characteristics. Twenty of 25 patients followed during this period received radiotherapy. Of these patients, ten had tumor regression, nine were stable, and one was worse. This result contrasts with five untreated patients, four of whom had tumor progression and one who was stable (x2 = 18.37, p less than .001). One of the children with tumor progression later received radiotherapy and demonstrated marked tumor regression. Of the 18 treated patients who could be tested reliably, visual function and/or regression occurred in seven children. None of the untreated patients improved. There were no definite complications of radiotherapy in this small group. PMID- 3508046 TI - Increased serum creatine kinase due to hypocalcemia in vitamin D deficiency. AB - An 8-year-old boy with vitamin D-deficiency rickets, increased serum creatine kinase (CK), and hypocalcemia is described. At 5 years of age, he was evaluated because of recurrent tonic seizures. He had growth retardation, microcephaly, quadriplegia, mental retardation, and epilepsy. Muscle strength was difficult to assess because of multiple joint contractures. Deep tendon reflexes were hyperactive. Laboratory data indicated rachitic changes on x-ray, hypocalcemia, low serum 25-hydroxyvitamin D3 (25-OH-D) and 1-alpha-25-dihydroxyvitamin D3 (1 alpha-25-[OH]2-D) levels, a normal response to the Ellsworth-Howard test, and markedly increased CK. Electromyography and nerve conduction velocities were normal. The patient responded to 1-alpha-OH-D treatment with increased serum calcium and normal CK activity; a significant correlation (p less than 0.01) was observed between calcium and log CK. The clinical course and laboratory findings supported the hypothesis that the increased CK was due to hypocalcemia, which in turn was due to the vitamin D deficiency in the severely handicapped child with malnutrition. PMID- 3508047 TI - Infantile free sialuria without lysosomal storage. AB - Except for two reported patients, increased free sialic acid excretion has been associated with lysosomal storage. This is a report of a child with progressive neurologic deterioration and increased excretion of free sialic acid. Although lysosomal storage was absent, nuclear invagination or inclusions were present. PMID- 3508048 TI - Carnitine palmityltransferase deficiency with permanent weakness. AB - A 16-year-old male had a history of muscle pain and exercise intolerance from the age of six years. At 14 years of age, he experienced the first episode of myoglobinuria and has had eight episodes subsequently. The longest interval between episodes was 14 months. Between attacks he manifested permanent, mild proximal limb weakness, elevated serum creatine kinase activity, and myopathic features indicated by electromyography and muscle biopsies. The muscle carnitine palmityltransferase activity was 30% of normal. This patient demonstrates that carnitine palmityltransferase deficiency can be a progressive disorder leading to permanent weakness. The need for early diagnosis and treatment is stressed. PMID- 3508049 TI - Creatine kinase brain isoenzyme in infantile osteopetrosis. AB - A 14-month-old girl with infantile osteopetrosis had hematologic and neurologic complications with severe brain atrophy. Although serum contained high creatine kinase brain isoenzyme activity (CK-BB), CK-BB activity was not detected on repeated cerebrospinal fluid examinations. After frequent blood transfusions and steroid therapy, hematologic involvement improved gradually and disappeared finally at age 11 months; serum CK-BB tended to show a concomitant proportional increase in activity. A 111Indium chloride scan was performed at age 4 weeks when the patient had relatively low serum CK-BB activity. It indicated active extramedullary hematopoiesis in the liver and spleen. The second scan was performed at age 12 months when she had high serum CK-BB activity and indicated active medullary hematopoiesis in the cranium. The tests disclosed that the elevated serum CK-BB activity was the result of bone marrow serum leakage, and not leakage from brain tissue. This finding may be a good marker of medullary hematopoietic activity in patients with osteopetrosis. Meanwhile, biopsied sural nerve revealed storage of cellular debris, including myelin figures in the Schwann cells, which suggested increased degradation process in the cells or lysosomal enzyme deficiency. PMID- 3508050 TI - Myopathy and peroxisomal disease. PMID- 3508051 TI - Intervertebral disc calcification in children. AB - Calcification of cervical intervertebral discs in children is due to an uncommon, but distinct, disease of unknown etiology. Signs and symptoms of nerve root or spinal cord compression are unusual and acute symptoms are followed by a benign course and spontaneous recovery. We describe a 5-year-old patient with symptomatic cervical disc calcification and discuss the relevant clinical and radiographic features. PMID- 3508052 TI - Aicardi syndrome with holoprosencephaly and cleft lip and palate. AB - This 14-day-old Japanese girl demonstrated the classic features of Aicardi syndrome, including infantile spasms, agenesis of the corpus callosum, chorioretinopathy, microphthalmia, vertebral anomalies, electroencephalographic abnormalities, and severe mental retardation. Furthermore, she had a cleft lip and palate and a severe brain malformation due to semilobar-type holoprosencephaly. This patient is the second reported with Aicardi syndrome and associated cleft lip and posterior palate; she is the first patient with an additional severe brain malformation due to semilobar-type holoprosencephaly. PMID- 3508053 TI - Life-threatening congestive heart failure as the presentation of centronuclear myopathy. AB - Myocardiopathy is associated infrequently with centronuclear myopathy. We present biopsy studies of a 15 1/2-year-old black male who presented with profound acute congestive heart failure and diffuse muscular atrophy. Cardiac symptoms had been present for 6 months; limb weakness had been unassociated with either infantile hypotonia or developmental delay. Cardiac catheterization demonstrated a dilated myocardiopathy and poor left ventricular contractility. Biopsies of both ventricles revealed striking hydropic degeneration and fibrosis. Right triceps biopsy disclosed centronuclear myopathy. Because the spectrum of disease expression in centronuclear myopathy is extensive, an association with cardiac disease always should be considered in these patients. In addition, we recommend that patients who present with idiopathic myocardiopathy should be evaluated for this and other skeletal muscle diseases. PMID- 3508054 TI - Primary thalamic hemorrhage in a preterm infant. PMID- 3508055 TI - Perinatal asphyxia. PMID- 3508056 TI - Prognostic utility of SEPs in comatose children. AB - Somatosensory evoked potentials (SEPs) were recorded in 73 comatose children upon admission to the intensive care unit and were studied in respect to initial neurologic status and final outcome. SEP results were graded normal, increased interpeak latencies, and unilaterally or bilaterally absent cortical responses. Of the 50 patients with Glasgow Coma Scale scores less than 7 upon admission, only 3 had SEPs within the normal range, while 37 had unilaterally or bilaterally absent SEPs. None of the 27 who died had normal SEPs; 1 had increased interpeak latencies, 26 had more abnormal SEPs. The 14 with normal outcomes had normal (9 patients) or delayed (4 patients) SEPs; the latter group returned to normal within a few days. Repeat SEP studies were performed in 33 patients. SEPs were relatively stable during the intensive care observation, with the exception of 6 patients with Reye syndrome. Subsequent studies are recommended in all patients, but are essential in those with Reye syndrome in order to be useful prognostically. The utility of SEPs did not vary as a function of coma etiology. These data support the usefulness of SEPs in early prediction of neurologic outcome in comatose children. PMID- 3508057 TI - Gaucher disease (type III): intellectual profile. AB - In 20 patients with Gaucher disease type III (Norrbottnian variant), long-term intellectual prognoses were analyzed on the basis of psychometric tests which were performed on an average of five tests per patient. Intellectual delay was not found to be characteristic of the early stages of the disease. Slow regression occurred through childhood and adolescence. Patients splenectomized at an early stage averaged lower IQ scores in the long-term than those in whom the spleen had been spared as long as possible. These data added to other evidence of increased neurologic and other organ impairment after splenectomy, support the view that the spleen should not be removed in other than emergent situations. PMID- 3508058 TI - Outcome of shunted posthemorrhagic hydrocephalus in premature infants. AB - Patient histories of 29 infants were reviewed whose birth weights were less than 2,000 gm and who had received ventricular shunts in the neonatal period for posthemorrhagic hydrocephalus. This procedure was performed at a time when routine screening of low birth weight infants for intracranial hemorrhage was not undertaken and serial lumbar puncture usually was not employed. The overall outcome was poor, with 62% of shunted infants either dying or surviving with moderate or severe handicap. Neurodevelopmental outcome was associated with the interval between the diagnosis of hydrocephalus and shunting; an adverse outcome was associated with an increased interval. Current practices for treating posthemorrhagic hydrocephalus are discussed. PMID- 3508059 TI - Focal cerebral infarction in the newborn: a distinct entity. AB - Recent reports, which described early computed tomography findings of unsuspected cerebral arterial infarctions in term newborns who presented with seizures, prompted a review of our neonatal intensive care unit records. Seven newborns demonstrated arterial infarctions by computed tomography. Five of the 7 had focal motor seizures and 2 had generalized seizures. Electroencephalograms of 6 infants correlated with the area of infarct, mainly disclosing focal spike- and/or sharp wave activity. All infarcts involved the territory of the middle cerebral arteries and all were evident on initial scans. Subsequent examinations at age 12 months to 9 years demonstrated 4 children with spastic hemiparesis, and 3 children with normal neurologic examinations. Neonatal cerebral arterial infarction is a distinct entity which should be recognized and should be included in the differential diagnosis of neonatal seizures, regardless of the presenting symptoms or predisposing factors. PMID- 3508060 TI - Outcome of brain abscess treatment in children: reduced morbidity with neuroimaging. AB - Records were reviewed of 17 patients, ages 4 months to 18 years, who had been diagnosed as having brain abscesses between 1975-1984. Serial computed tomography was used to guide treatment; consequently, 8 patients were managed medically and 9 received surgical intervention. All medically treated patients were free of neurologic residua upon subsequent examination. Positive identification of organisms from systemic cultures and close computed tomographic monitoring prevented the need for surgical intervention in these patients. The surgically treated patients were sicker at presentation, and of the 9 patients requiring surgical intervention, 4 had neurologic sequelae and 1 patient died. Brain abscess aspiration or excision revealed organisms in 7 of the 9 surgically treated patients. The reduction in morbidity and mortality was due in part to early recognition and monitoring of abscess size with contrast-enhanced computed tomography and avoidance of surgical excision of the abscess. PMID- 3508061 TI - Effects of therapeutic agents in a rabbit model of Reye syndrome. AB - Six potential therapeutic agents were evaluated in an experimental model simulating Reye syndrome produced by infusion of the short-chain fatty acid, sodium octanoate, into rabbits. Administration of carnitine, dexamethasone, or fatty acid-free albumin resulted in prolongation of survival, less rise in intracranial pressure, and amelioration of some of the metabolic abnormalities found typically during octanoate infusion. Treatment with pentobarbital or dimethyl sulfoxide prevented intracranial pressure elevations but had no protective effect on survival. Hypertonic glucose administration produced no improvement in any of the parameters studied. PMID- 3508062 TI - Kluver-Bucy syndrome in children. AB - Kluver-Bucy syndrome is an uncommon syndrome of behavioral abnormalities following bilateral temporal lobe injury. Only four children have been reported previously with this syndrome. We report three additional pediatric patients who developed Kluver-Bucy syndrome following hypoxic insults. In two patients, features of the syndrome were transient. Problems in intermediate memory were present in each patient. Behavioral abnormalities did not respond to the medications administered. Our experience suggests that Kluver-Bucy syndrome may occur more commonly in children than was suspected previously, especially following hypoxia. PMID- 3508063 TI - Poliomyelitis-like syndrome following asthmatic attack (Hopkins syndrome). AB - A 12-year-old boy is described with a combination of right arm paralysis resembling poliomyelitis and severe asthma. At 4 years of age, he developed flaccid paralysis one day after a severe asthma attack. No etiologic factors could be found for his flaccid paralysis. Nineteen patients with similar poliomyelitis-like illnesses following asthmatic attack are reviewed. PMID- 3508064 TI - Transient acute cortical blindness associated with hypoglycemia. AB - A 7-year-old boy with glycogen storage disease type III developed transient acute cortical blindness associated with hypoglycemia on two separate occasions; the patient also demonstrated transient high-voltage slowing on the electroencephalogram over both occipital areas. This patient is the second examined in our pediatric department during a 5 year period with acute cortical blindness associated with hypoglycemia. PMID- 3508065 TI - Recurrent vertebrobasilar embolism in an infant with Klippel-Feil anomaly. AB - The vertebral arteries have been hypothesized to be a source of recurrent emboli that obstruct the posterior circulation of the brain in children, but mechanisms for formation of such emboli have not been documented. An infant with Klippel Feil anomaly experienced multiple embolic events in the posterior circulation, documented by serial computed tomography and cerebral angiography. Angiography identified a source for the emboli in the left vertebral artery. The value of lateral cervical spine radiographs in screening for bony abnormalities which may predispose to arterial anomalies is demonstrated. PMID- 3508066 TI - Short-latency somatosensory evoked potentials in perinatal asphyxia. AB - Ten asphyxiated term newborns were studied in the first 6 months of life with median nerve short-latency somatosensory evoked potentials (SLSEP) and followed subsequently to a mean age of 20 months. Results of SLSEP correlated with subsequent outcome in every patient; normal and abnormal infants at subsequent examination were separable on the basis of prior SLSEP, although the severity of later disability could not be inferred from SLSEP. PMID- 3508068 TI - Benign extracerebral fluid collections: a cause of macrocrania in infancy. AB - In order to determine the frequency and natural history of benign extracerebral fluid collections, computed tomography reports from a period of 26 months at Oklahoma Children's Memorial Hospital were reviewed (total scans: 3,411). Bilateral frontal extracerebral fluid collections were found in 94 infants under 1 year of age. Eighty-two infants had computed tomography scans as part of the evaluation for macrocrania. Thirteen patients had the typical findings of benign extracerebral fluid collections but otherwise were completely asymptomatic. Longitudinal observation for up to 30 months failed to reveal any changes in neurologic status of these patients. Benign extracerebral fluid collections are a relatively common cause of macrocrania in infants. The presence of these fluid collections is not of immediate concern, providing that clinical evaluations fail to identify either neurologic or developmental abnormalities. PMID- 3508067 TI - Benign complex partial epilepsies in infancy. AB - Nine infants with benign complex partial seizures, diagnosed by simultaneous electroencephalogram and video recordings, are described. At mostly 3-10 months of age, these infants demonstrated clusters of seizures which consisted of motion arrest, decreased responsiveness, staring or blank eyes mostly with simple automatisms, and mild convulsive movements associated with focal paroxysmal discharges. The seizures were controlled easily with carbamazepine or phenobarbital and all patients remained seizure-free for more than 3 years. Four patients had family histories of benign types of infantile convulsions. Interictal electroencephalogram and psychomotor development were normal in all patients. PMID- 3508069 TI - Intracranial aneurysms in a child with recurrent atrial myxoma. AB - Subarachnoid hemorrhage and formation of intracranial aneurysms occurred in an adolescent with recurrent atrial myxomas without a history of cerebral embolic infarction. Myxomatous intracranial aneurysm is a potentially lethal complication in children. PMID- 3508070 TI - Cystinuria with congenital myotonic dystrophy. AB - Two brothers with congenital myotonic dystrophy also had cystinuria with large renal stones. This report is the first to document the concurrence of cystinuria and congenital myotonic dystrophy. It is uncertain whether these two conditions are coincidental or share a common pathogenesis. PMID- 3508071 TI - Cerebral venous thrombosis as a cause of neonatal seizures. AB - Intracranial venous thrombosis has been described in newborns, but there have been no reports of intractable neonatal seizures due to this condition. We report cortical venous sinus thrombosis in two term neonates who presented with seizures in the first 24 hours of life. The diagnosis was made by cranial computed tomography and was confirmed by cerebral angiography. Both patients improved clinically after the intracranial venous thrombosis resolved. These patients demonstrate that intracranial venous thrombosis should be considered in the differential diagnosis of neonatal seizures. PMID- 3508072 TI - Myasthenia gravis associated with human T-cell lymphotropic virus type III infection. AB - A 15-year-old boy is described with myasthenia gravis, hemophilia A, positive HTLV-III serology, antithyroglobulin and antimicrosomal antibodies, and laboratory evidence of altered cell-mediated immunity. Treatment with pyridostigmine produced dramatic clinical improvement. The results of this patient raise the possibility of myasthenia gravis as the sole or presenting clinical manifestation of infection with HTLV-III. PMID- 3508073 TI - Guidelines for the determination of brain death in children. Task Force for the Determination of Brain Death in Children. PMID- 3508074 TI - Estimation of gestational age by electrographic, clinical, and anatomic criteria. AB - Current methods for estimating gestational age utilizing clinical parameters can be inaccurate in the very premature neonate. Neuropathologic studies have been used to verify these clinical estimates of gestational age. Estimates of maturity using neonatal electroencephalography have documented the evolution of regional and hemispheric electrical patterns at different gestational ages; however, electroencephalographic studies have not been compared with both anatomic brain studies and clinical examination criteria. Therefore, we studied 25 neonates with at least one electroencephalographic study prior to death and subsequent neuropathologic examination. Twenty-three estimates (92%) of gestational age in weeks, which were based on specific electrical patterns, agreed with sulcal-gyral development (e.g., the delineation of inferior frontal, superior temporal, calcarine sulci, and cytoarchitecture in various brain regions). Clinical (Ballard score) criteria and anatomic estimations of gestational age agreed in 18 of 24 patients (74%). Electroencephalographic estimates were significantly better than clinical estimates (p less than .05) for sick neonates who were less than or equal to 30 weeks gestational age. PMID- 3508075 TI - Temporal lobe epilepsy in childhood: reappraisal of etiology and outcome. AB - This article reports the neurologic and psychologic findings, seizure characteristics, family histories, and etiology of clinically and electroencephalographically defined temporal lobe epilepsy in 63 children who were studied retrospectively. Subsequent data were available for 53 patients (84%), 15 of whom had undergone temporal lobectomies; 38 patients had been managed conservatively for at least 2 years. Previous, complicated febrile convulsions were the most common predisposing factor, occurring in 13 patients (21%), while 6 patients had tumors (10%). Of the 10 children whose onset of temporal lobe seizures occurred before 2 years of age, 5 had tumors. The presence of emotional or behavioral problems was related significantly to the presence of borderline or low intelligence, but not to the frequency of seizures. Although there was a tendency for a reduction in seizure frequency over time, only 10% of those managed by medical therapy alone were seizure-free at a mean subsequent examination interval of 6.6 years. PMID- 3508076 TI - Vocal cord paralysis in children studied by monopolar electromyography. AB - Twelve children with symptoms of vocal cord paralysis were studied by monopolar needle electromyography. Recordings were used to verify complete or partial paralysis as well as to evaluate the etiology of the problem, paralytic or mechanical. These results then were useful in patient management. The monopolar electromyographic technique is of value in evaluating and treating vocal cord problems. PMID- 3508077 TI - Cyclic vomiting and the slit ventricle syndrome. AB - Recurrent bouts of vomiting with headache and lethargy occurred in 6 children with ventriculoperitoneal shunts who had small ventricles rather than the expected dilated ones. Slit ventricle syndrome is not uncommon in children with shunts and its early recognition allows for appropriate surgical treatment. PMID- 3508078 TI - Connatal Pelizaeus-Merzbacher disease: an autosomal recessive form. AB - An infant female had connatal Pelizaeus-Merzbacher disease with neonatal onset of developmental failure, seizures, nystagmus, visual impairment, abnormal movements, and spasticity. There was nearly complete absence of central myelin with preservation of peripheral myelin. The 17 reported patients with connatal Pelizaeus-Merzbacher disease are summarized. Evidence of autosomal recessive inheritance is provided by our patient, 3 previously described girls, and 1 family with both boys and girls affected equally. This possible form of inheritance is important to consider in genetic counseling. PMID- 3508079 TI - Intrauterine chronic subdural hematoma with postoperative tension pneumocephalus. AB - A newborn infant demonstrated prenatal, bilateral chronic subdural hematomas with recent hemorrhage, internal hydrocephalus, and macrocephaly at birth. Serial cranial ultrasound and computed tomography evaluations revealed progressive hydrocephalus and subdural hematomas. Following surgical evacuation of subdural hematomas the child developed tension pneumocephalus with clinical deterioration. The pathogenesis of congenital subdural hematoma and rare postoperative complication of tension pneumocephalus are discussed. PMID- 3508080 TI - Focal MRI findings in early SSPE. AB - Many investigators have identified localized cortical involvement in subacute sclerosing panencephalitis (SSPE) by clinical and electrophysiologic criteria. Some investigators have reported such abnormalities in the posterior cerebrum early in the course of the disease, but without radiologic correlation. Recently, magnetic resonance imaging has been used to follow the progression of SSPE. The largest reported study of SSPE utilizing magnetic resonance imaging indicated that focal abnormalities were distinctly rare and actually mitigated against the diagnosis of SSPE. We report an SSPE patient with focal cerebral dysfunction and magnetic resonance imaging evidence of distinctly focal inflammatory disease early in the course of the illness. PMID- 3508081 TI - Neuromyelitis optica (Devic syndrome) in a 12-year-old male with complete recovery following steroids. AB - Neuromyelitis optica is one of the rarest forms of central nervous system demyelinating disease. It is particularly infrequent in Western countries and complete recovery is rare. We report a 12-year-old boy with neuromyelitis optica which occurred shortly after an upper respiratory infection. Magnetic resonance imaging revealed several small areas of increased signal intensity within the cerebral and cerebellar white matter on T2-weighted images. The patient recovered completely following treatment with high-dose prednisone. PMID- 3508082 TI - Evoked potentials and coma. PMID- 3508083 TI - Somatosensory evoked response abnormalities in high-risk newborns. AB - In a previous study from our laboratory, the prognostic significance of the auditory brainstem evoked response was assessed in high-risk neonates. An abnormal auditory brainstem evoked response predicted neurologic deficits at age 1 year; however, a normal result did not predict a normal outcome. In order to evaluate the prognostic utility of examining other sensory pathways, somatosensory evoked responses were elicited following median nerve stimulation. Testing was performed at 37-44 weeks conceptional age (defined as gestational age plus chronologic age) and at 2 and 6 months conceptional ages. Those patients studied included 34 high-risk neonates and 18 healthy, term infants as controls. Ten of the 34 patients had abnormal somatosensory evoked responses. Abnormalities included increased absolute (N19, P22) and interwave (N13-N19, N19-P22) latencies and flat potentials, alone or in combination. Three children with flat potentials demonstrated a persistence of this abnormality on subsequent examination and they later presented clinically with spastic quadriparesis. Four infants with increased latencies manifested normal responses on subsequent examination. Recently, these 4 patients exhibited tone abnormalities and mild developmental deficits; developmental outcome, however, will be assessed in a blind study at 1 year of age as part of this ongoing prospective study. Preliminary results suggest that somatosensory evoked responses may be valuable as an electrophysiologic predictor of outcome. PMID- 3508084 TI - Quantitative histologic study of sural nerves in xeroderma pigmentosum. AB - The sural nerves of 2 siblings, 7 and 6 years of age with Group A xeroderma pigmentosum, were biopsied. The densities of myelinated fibers, 5,808/mm2 and 5,163/mm2, respectively, were strikingly decreased in comparison to control data. Both large and small myelinated fibers were reduced. Electron microscopy demonstrated many collagen fibers in the endoneurium and some collagen pockets. The loss of myelinated fibers was less severe than in previously reported patients. This discrepancy may be due to age differences at biopsy; our patients were biopsied at the ages of 7 and 6 years, while those patients reported previously were 10 years of age or older. The incidence of neurologic manifestations in xeroderma pigmentosum may increase after 6 years of age. PMID- 3508085 TI - Cerebellar infarction in children. AB - We report 3 children with posterior circulation strokes. Cerebellar infarction is rare in children; therefore, it was not the clinical diagnosis suspected primarily in 2 of these patients. The diagnostic value and limitations of neuroimaging studies, including computed tomography and magnetic resonance imaging, in cerebellar infarction in children are discussed. Because 3 patients were examined in a 2 year period in one institution, this entity may be more prevalent than generally believed and should be considered in the differential diagnosis of posterior fossa lesions in children. PMID- 3508086 TI - Ondine curse and neurocristopathy. AB - Two newborns, 1 male and 1 female, had both Ondine curse, also known as congenital, central hypoventilation syndrome, and Hirschsprung disease. Both infants demonstrated insufficient respiration while asleep and normal respiration when awake. The lesser affected child had an otherwise normal neurologic examination, but suffered from seizures. He died at 18 months of age; neuropathologic examination of the brain was unremarkable. The girl had a severe and ultimately fatal form of this disorder and manifested a variety of neurologic abnormalities indicative of developmental failure of the neural crest-derived tissues. These abnormalities included unreactive pupils and deafness. She died at 40 days of age; autopsy permission was denied. The etiology of sleep apnea is not known. Mechanisms of central integration may be abnormal but the association with neural crest maldevelopment implicates the peripheral nervous system. PMID- 3508087 TI - Direct determination of vanillylmandelic acid in human urine by reversed-phase HPLC. AB - A reversed-phase HPLC method for the determination of epinephrine, norepinephrine, dopamine, and vanillylmandelic acid (VMA) has been developed. The concentration of VMA in the urine of hypertensive patients was measured by direct injection after centrifugation. The method is useful for the diagnosis of pheochromocytoma. PMID- 3508088 TI - Simultaneous determination of gastrodin and its metabolite by HPLC. AB - A rapid and specific HPLC method for the simultaneous determination of gastrodin and its metabolite gastrodigenin (p-hydroxybenzyl alcohol) in rat plasma, bile, liver, urine and faeces is described. The separation was achieved by using a reversed phase column (YWG-C18) eluted with methanol-water (2.5:97.5 v/v). Phloroglucinolum was used as internal standard and the peaks were detected at UV 221 nm. The protein precipitation with ethanol was a very simple and rapid method for sample preparation. The gastrodin and gastrodigenin were quantitated by measuring the peak-height ratios. There was a linear concentration range of 10 320 micrograms/mL in the assay for both compounds. The coefficients of variation (within-day) for samples spiked with gastrodin and gastrodigenin were 2.94% and 3.08%, respectively. The method demonstrated a high specificity and was suitable for use in pharmacokinetic studies. PMID- 3508089 TI - Rapid purification of arrowhead proteinase inhibitors by high performance hydrophobic interaction chromatography on a PEG bonded phase column. AB - A new hydrophobic interaction HPLC column is used for the rapid purification of proteinase inhibitors isolated from arrowhead. The inhibitors, partially purified by DEAE-cellulose column chromatography, are resolved into three components with a mobile phase gradient of decreasing salt concentration from 1.1 M ammonium sulfate in 0.01 M phosphate buffer to phosphate buffer alone. This new HPLC column is found to be very useful for rapid, semipreparative purification of hydrophobic protein and sample loading of up to 1.6 mg of inhibitors can be fully resolved on an analytical column. PMID- 3508090 TI - Detection and identification of three thioether conjugates of 2 hydroxyacetanilide by liquid chromatography/electrochemistry. AB - The three 2-mercaptoethanol (ME) thioether conjugates of 2-hydroxyacetanilide (2HAA) are detected and identified using liquid chromatography/electrochemistry (LC/EC). The conjugates are produced either by incubations of 2HAA with liver microsomes in the presence of NADPH and ME or by chemically oxidizing a solution of 2HAA and allowing it to react with ME. Identification of the three isomers is based on retention time and comparison of the electrochemical behavior of model compounds. Production of the three isomers by microsomal protein occurs only in the presence of NADPH and shows that 2HAA proceeds through a cytochrome P-450 mediated pathway to a reactive intermediate similar to acetaminophen, possibly N acetyl-o-quinoneimine. The relative percentages of each isomer produced were calculated as the percentage of the total peak areas of the isomers. Compound A (2HAA-5-ME) is produced in 53.7% and 24.6%, compound B (2HAA-4-ME) is produced in 16.2% and 70.3% and compound C (2HAA-3-ME) is produced in 30.1% and 5.1% by microsomal incubations and chemical oxidation respectively. PMID- 3508091 TI - Determination of 3,4-dihydroxyphenylglycol (DHPG) by HPLC with coulometric detection, and correlation with 3-methoxy-4-hydroxyphenylglycol (MHPG) in human plasma. AB - A method for determining plasma 3,4-dihydroxyphenylethyleneglycol (DHPG), a central noradrenaline (NA) metabolite, is described. The method used HPLC with dual coulometric detection set in screen mode of operation. The isolation of DHPG and related catecholamines (noradrenaline, dopamine and dihydroxybenzylamine) was performed on acid washed alumina extracted with 0.2 M HCIO4 containing EDTA (0.2%), and reduced glutathione as stabilizer. A reversed phase column with an eluting system containing 0.025 M citric acid-sodium hydrogen phosphate buffer in the ratio 3:2 (v:v) and 5% methanol was used. The experimental results of plasma DHPG levels compared favourably with the results from the literature, and a positively significant correlation with plasma MHPG was found. This method could be used as an alternative in central NA assessment. PMID- 3508092 TI - HPLC measurement of penticainide and desalkylpenticainide in biological fluids. AB - A simple HPLC method has been developed to measure the antiarrhythmic agent penticainide and its N-desalkyl metabolite in biological fluids. Solvent extraction of a small (200 microL) sample volume with direct analysis of the extract is used to measure the plasma and urinary concentrations of these compounds attained during chronic therapy, although a larger sample volume (1.0 mL) and prior concentration of the extract are required for single oral dose work. In each case chromatographic analysis is performed using a microparticulate (5 microns) silica column and methanolic ammonium perchlorate (10 mM, pH 6.7) as eluent with UV detection (260 nm). No endogenous sources of interference have been encountered and potential interference from other drugs is minimal. PMID- 3508093 TI - Determination of adriamycin and its fluorescent metabolites in human plasma by HPLC. AB - We describe a method for measuring adriamycin and its metabolites, adriamycinol and adriamycinone in plasma, using reversed phase HPLC and fluorescence detection. The lower limit of detection is approximately 1 ng/mL for each compound. An extraction technique for serum is described which is capable of an almost equal recovery (greater than 93%) of adriamycin and metabolites without interference from endogenous components of plasma and from other common drugs. Within-day and day to day coefficients of variation are estimated. PMID- 3508094 TI - Reduction of quinones with zinc metal in the presence of zinc ions: application of post-column reactor for the fluorometric detection of vitamin K compounds. AB - A simple and effective chemical method has been developed for quantitatively reducing quinones, which is based on their reaction with zinc metal and zinc ions. Comparison of this method with conventional electrochemical reduction revealed the chemical method to be considerably superior. The reduction of quinones to their corresponding hydroquinones was verified by ultraviolet spectrophotometry. The reduction methodology has been applied to derivatize phylloquinone and its metabolite, namely phylloquinone 2,3-epoxide, 'on-line', with subsequent fluorometric detection of the generated hydroquinones. PMID- 3508095 TI - Rapid sample preparation methods for analysis of residues of sulfamethazine and its N4-acetyl and desamino metabolites in swine tissue by HPLC. AB - Rapid sample preparation methods for the determination of sulfamethazine (SMZ) and its N4-acetyl and desamino metabolites in swine tissues at the 0.1 mg kg-1 level are presented. The methods use sonication-aided extraction with dichloromethane. For SMZ and N4-acetyl SMZ analysis extracts are cleaned up and concentrated on a silica disposable column followed by HPLC on a CP Spher C8 column using acetonitrile-sodium acetate buffer as the mobile phase. For desamino SMZ analysis the extract was cleaned up and concentrated on a Florisil disposable column, followed by HPLC on a Nucleosil 5-CN column after formation of an ion pair complex with 1-heptanesulfonic acid. For desamino SMZ peak identification by diode-array UV/VIS detection is also described. Mean recoveries from spiked tissue samples were about 87% (muscle) and 76% (kidney) for SMZ and N4-acetyl SMZ and about 70% for desamino SMZ. PMID- 3508096 TI - Determination of free and total catecholamines in human urine by HPLC with fluorescence detection. AB - A simple and highly sensitive method for the determination of free and total (free + conjugated) catecholamines (norepinephrine, epinephrine and dopamine) in human urine is described which employs HPLC with fluorescence detection. Conjugated catecholamines (sulfate form) are hydrolyzed by a sulfatase-mediated reaction to the corresponding free amines. After cation exchange chromatography on a Toyopak IC-SP S cartridge, catecholamines and isoproterenol (internal standard) in urine samples were converted into the corresponding fluorescent compounds by reaction with 1,2-diphenylethylenediamine. These compounds were separated within 8 min on a reversed phase column with isocratic elution using a mixture of water, methanol and acetonitrile containing a Tris-hydrochloric acid buffer (pH 7.0). The detection limit for each catecholamine is ca 2 fmol per 100 microL injection volume. PMID- 3508098 TI - Head and neck injuries. PMID- 3508097 TI - Field evaluation and management of head and neck injuries. AB - This article presents clear, concise guidelines for classification, evaluation, and emergency management of injuries that occur to the head and neck as a result of competitive and recreational sports. There are several principles that must be considered by individuals responsible for an athlete who sustains a serious head or neck injury: a person who "captains" the medical/first-aid team; knowledge of the appropriate emergency management techniques; availability of emergency medical equipment including a spine board, telephone, and ambulance; and a clear understanding of the philosophy that emergency management should "do no further harm." PMID- 3508099 TI - Neck injuries in ice hockey: a recent, unsolved problem with many contributing factors. AB - Previously unrecognized, major neck injuries in hockey have become a common problem in Canada and they have increased markedly in the 1980s. At the present time, the incidence remains high and has shown no sign of diminishing. The etiology of the problem appears to be multifactorial. Several epidemiologic factors have been identified and a reporting system established so that prevention programs can be monitored. It is hoped that greater awareness of the risk factors among players, coaches, leagues, referees, and parents will be an effective prophylactic measure in itself. Prevention must involve several approaches by hockey organizations and leagues, players, equipment manufacturers, and health care professionals and researchers. PMID- 3508100 TI - Rehabilitation of cervical spine, brachial plexus, and peripheral nerve injuries. AB - The cervical spine is placed at risk of injury in a number of athletic activities. It is important to understand the principles and methods of therapeutic and rehabilitative exercises both to prepare the athlete for the demands each sport will place on his or her body and to return the injured athlete to activity safely. General principles of rehabilitation are reviewed, followed by a discussion of the clinical entities of concern and descriptions of specific rehabilitation exercises for each injury. PMID- 3508101 TI - Spinal injury at the level of the third and fourth cervical vertebrae resulting from the axial loading mechanism: an analysis and classification. AB - The traumatic C3-C4 level injuries sustained by young athletes and documented by the National Football Head and Neck Injury Registry are discussed. Twenty-eight of 885 (2.8 per cent) injuries involved the C3-C4 vertebrae. Review of these cases reveals that the response to energy inputs at the C3-C4 level differ from that of those involving the upper (C1-C2) and lower (C5-C6) cervical segments. Specifically, these lesions appear unique with regard to infrequency of bony fracture, difficulty in effecting and maintaining reduction, and their more favorable response to early aggressive treatment. It is the authors' belief that these lesions resulting from athletic activity are due to axial loading. PMID- 3508102 TI - Management guidelines for head injuries in athletics. AB - The spectrum of athletic head injuries is presented with discussion of on-site recognition, definite diagnosis, and specific treatment. Emphasis is placed on the proper medical evaluation of athletes to ensure recovery and prevent serious consequences of repeated injury. PMID- 3508103 TI - Fatalities from head and cervical spine injuries occurring in tackle football: 40 years' experience. AB - Football head and cervical spine fatalities have been related to 84.6 per cent of all football fatalities from 1945 through 1984. The decade from 1965 through 1974 was responsible for the greatest number and percentage of head and cervical spine fatalities, and the decade from 1975 through 1984 was associated with the smallest number and percentage. The data reveal that the majority of head and cervical spine fatalities are related to high-school football players either tackling or being tackled in a game. The majority of head fatalities are subdural hematomas, and almost all of the cervical spine fatalities are fractures, dislocations, or fracture-dislocations. There has been a dramatic reduction in these types of fatalities during the last decade, 1975 through 1984, and the preventive measures that have received most of the credit have been the 1976 rule change that prohibits initial contact with the head and face when blocking and tackling, the NOCSAE helmet standard that went into effect in colleges in 1978 and high schools in 1980, better coaching in the techniques of blocking and tackling, and improved medical care. There has been a reduction of head and cervical spine fatalities, but the analysis of data for the next decade, 1985 through 1994, will reveal the effects of the preventive measures discussed and continued research efforts. PMID- 3508104 TI - Legal aspects of athletic injuries to the head and cervical spine. AB - The author discusses the history of athletic litigation, some reasons for its proliferation, and the effects of such litigation on schools, equipment manufacturers, and others involved with athletics. Some suggestions are offered for minimizing the risk of becoming a defendant in a lawsuit. PMID- 3508105 TI - University of Virginia prospective study of football-induced minor head injury: status report. AB - We have recently completed the field work phase of a 4-year prospective study of football-induced minor head injuries. Players from 10 University football teams were monitored up to 4 years, and a brief neuropsychological and psychosocial assessment battery was administered to them up to five times before and after injury. Objectives of this project focus on the frequency of head injuries in college football, the impairments that might result from such injury, the duration of impairments, the time course of their recovery, and the possibility of cumulative effects of multiple injuries during the player's college career. Approximately 2500 players were monitored during the study, and nearly 200 players were restudied following minor head injuries. A series of nearly 60 players with orthopedic injuries were tested using the same protocol, and a college student control series of 50 patients were similarly studied. Data analyses are currently underway, and the first report of the findings of this study will be available soon. This article has described the objectives and design of this study, outlined the neuropsychological and psychosocial assessment protocol, and discussed some of the issues related to project implementation. Current data analyses focus on the size of the effects of minor head injury on cognitive and psychosocial performance observed following minor head injury. Upon completion of the initial data analyses, our analysis plan includes having at least two neuropsychologists make independent assessments of the clinical significance of the findings. Similar assessments will be made of the neurophysical symptoms and complaints and psychosocial performance of players after injury. PMID- 3508106 TI - Management guidelines for athletic injuries to the cervical spine. AB - The potential or actual involvement of the nervous system in injuries to the cervical spine requires that management must proceed with particular care. Prevention of further injury is the main objective. Proper management must begin with the removal of the athlete from the field, and the correct procedures for doing this are reviewed. Treatment procedures for the following injuries are discussed: (1) nerve root and brachial plexus neurapraxia; (2) acute cervical sprain syndrome; (3) cervical vertebral subluxation without fracture; (4) cervical fractures and dislocations; (5) cervical spinal cord neurapraxia with transient quadriplegia; and (6) cervical spinal instability. Also, guidelines for activity restrictions are presented. PMID- 3508107 TI - Rugby injuries of the spine and spinal cord. AB - This article analyzes the type and circumstances of injury in 50 rugby players who sustained cervical spinal cord injury with paralysis. Specific mechanisms of injury occurring during certain phases of the game are identified as being responsible for the majority of injuries. Each phase of the game is discussed in detail, emphasizing the vulnerability of the cervical spine to certain maneuvers, the dangers of illegal play, and the importance of preventive measures to decrease the incidence of these catastrophic injuries. PMID- 3508108 TI - Vitreous changes in acquired retinoschisis. PMID- 3508109 TI - [Single binocular vision of central serous choroid-retinopathy]. PMID- 3508110 TI - [Visual evoked potential (VEP) abnormality in central serous choroid-retinopathy during the active stage]. PMID- 3508111 TI - Physiology of contact lens wear. PMID- 3508112 TI - [The studies of macula and macular diseases]. PMID- 3508113 TI - [Cone dystrophy--7 cases report]. PMID- 3508114 TI - [Rhegmatogenous retinal detachment and glaucoma (a report of 15 cases)]. PMID- 3508115 TI - [Scanning electron microscopic observations on experimental HSV-1 keratitis of the rabbits]. PMID- 3508116 TI - [Observation of microcirculation in bulbar conjunctiva, before and after the treatment with external counter pulsation in coronary heart disease and cerebrovascular accident]. PMID- 3508117 TI - [Anatomical and functional changes in lacrimal drainage system with ageing--IDCG and QLS findings]. PMID- 3508118 TI - [Local anesthetic effect of bupivacaine in ophthalmic operations]. PMID- 3508119 TI - [The specific immune responses in patients with complicated cataract in uveitis]. PMID- 3508120 TI - [The influence of uveitis on the corneal endothelium]. PMID- 3508121 TI - [Fuchs's syndrome (report of 9 cases)]. PMID- 3508122 TI - [Iris nevus syndrome (report of 9 cases)]. PMID- 3508123 TI - [Hallermann-Streiff syndrome--report of 4 cases]. PMID- 3508124 TI - [Binocular vision--binocular vision of normal people]. PMID- 3508125 TI - [Binocular vision--binocular vision of concomitant strabismus]. PMID- 3508126 TI - [Clinicopathologic study of Coats' disease]. PMID- 3508127 TI - Persistent symptoms after peripheral iridectomy for angle closure glaucoma. PMID- 3508128 TI - [Nd:YAG laser treatment complications of after-cataract]. PMID- 3508129 TI - [Complications of implantation with a Shearing's type posterior chamber lens]. PMID- 3508131 TI - [Contrast sensitivity in early senile cataract]. PMID- 3508130 TI - [Separation and identification of lens proteins]. PMID- 3508132 TI - Effects of oxygen free radical scavengers on the membrane myoinositol dehydrogenase of Bacillus pumilus strain 5. AB - Micromolar amounts of superoxide dismutase (SOD) or parabenzoquinone (PBQ) inhibit the membrane-bound myoinositol dehydrogenase of Bacillus pumilus strain 5 in the mode of this enzyme transferring electrons to 2,6-dichlorophenol indophenol (DCPIP). The inhibition trends are similar to those reported earlier by us for the inhibition by mannitol and benzoate. We postulate that the transfer of electrons from the enzyme to DCPIP involves in its rate-limiting step, a catalytic intermediate in the nature of superoxide (O2-) and/or hydroyl free radical (OH.). Scavenging of any one or both of these radicals, therefore, inhibits the electron transfer reaction. PBQ serves as an electron sink in the reaction preventing the reduction of DCPIP. PMID- 3508134 TI - In vitro damage to rat lens by lumazine and xanthine oxidase: prevention by superoxide dismutase. AB - Intact rat lenses incubated with lumazine and xanthine oxidase are physiologically damaged as evidenced by a decrease in the net accumulation of rubidium ions against a concentration gradient. Superoxide dismutase protected the tissue against this damage. These experiments, therefore, demonstrate the susceptibility of the lens tissue to O2- injury under ambient and nonphotochemical conditions, suggesting a possible implication of this radical in the tissue in vivo and eventual cataract formation. The lumazine/xanthine oxidase system which is known to cause oxygen reduction predominantly by the monovalent route, producing superoxide, appears quite suitable to evaluate the toxicity of O2- to the tissues in vitro. PMID- 3508133 TI - The neutralization of hydroxyl radical by silibin, sorbinil and bendazac. AB - The compounds silibin, sorbinil and bendazac act as hydroxyl radical scavengers, when the hydroxyl radical is generated by the Fenton reaction. Hydroxyl was detected by the degradation of deoxyribose. The Authors discuss the possibility that the scavenger activities of those compounds may explain, at least in part, their therapeutic activity. PMID- 3508135 TI - The metabolism of low molecular weight hydrocarbon gases in man. AB - The metabolism of ethane and pentane in man is demonstrated to occur from the uptake of an enriched atmosphere of these gases in a rebreathe spirometer circuit. Dithiocarb, an inhibitor of alkane metabolism, reduced uptake and increased the respiratory excretion of these gases. This effect was least marked for the slowly metabolised ethane. Therefore the endogenous production of ethane as measured by respiratory excretion is less affected. However pentane is rapidly metabolised and this limits the use of simple respiratory excretion of pentane as a measure of in vivo lipid peroxidation. PMID- 3508136 TI - Neuronal morphology of the hypoglossal nucleus in aurochs. PMID- 3508137 TI - Pineal gland ultrastructure in wild boar and miniature pig. PMID- 3508138 TI - The lumbosacral plexus in coypu. PMID- 3508140 TI - Morphology of the anterior papillary muscle in the right ventricle in human heart. PMID- 3508139 TI - Patterns of normality for the right ventricular volumetric capacity in human fetal hearts from 100-500 grams of body weight. PMID- 3508141 TI - The cerebral and meningeal venous valves during human ontogenesis. PMID- 3508142 TI - Variations in shape and position of human renal pelvis. PMID- 3508143 TI - Morphology of human bony palate. PMID- 3508144 TI - Morphology of the rhomboid muscle in human fetuses. PMID- 3508145 TI - Sectional anatomy of the human temporal bone. PMID- 3508146 TI - The alar bone in birds and its role in the integrated frontoalar biomechanic system. PMID- 3508147 TI - Neonatal mortality. PMID- 3508148 TI - Salmonella carriers in foodhandlers in Bombay. PMID- 3508149 TI - Susceptibility of some Anopheles mosquitoes to DDT and dieldrin in Tezpur (Assam). PMID- 3508150 TI - Anopheline, mosquitoes of Tenga Valley (Arunachal Pradesh). PMID- 3508151 TI - Post insertion fertility behaviour of I.U.C.D. acceptors. PMID- 3508152 TI - Study on mortality from cancer diseases in an urban community. PMID- 3508153 TI - A comparative study of neonatal morbidity between preterm and term neonates. PMID- 3508154 TI - Health manpower study stock of allopathic medical graduates in Andhra Pradesh. PMID- 3508156 TI - Isolated fractures of the olecranon in children. AB - Fifteen isolated fractures of the olecranon in children aged 3-13 years were studied over 1-2 years. The mechanism of injury was not clear in most of them. Ten with little displaced fractures were treated conservatively with excellent results. Four with grossly displaced fractures were treated operatively with good results. A unique case was left without treatment because of the parents' refusal. PMID- 3508155 TI - Feeding pattern practised by the mothers attending an under five clinic. PMID- 3508157 TI - Fractures of the femur in childhood. AB - Child abuse, usually diagnosed by its soft-tissue signs, is not often considered as a cause of fractures of the femur in young children. In this retrospective review of 150 such fractures we show that child abuse was suspected or proven in 22 per cent of the fractures in the under-5 year age group, and in 39 per cent of the under-1 year group. PMID- 3508159 TI - Fractures of the carpal bones in children. PMID- 3508158 TI - Cerclage wiring in the management of comminuted fractures of the femoral shaft. AB - A retrospective series of 20 patients is presented, comprising 21 fractures of the femoral shaft treated by open reduction and internal fixation (usually by medullary nailing) combined with cerclage wiring. Most of the patients were young with comminuted fractures of the femoral shaft, many with multiple injuries. The aims of stable reduction and early sound union of the fracture in anatomical position were achieved in all cases and that of early mobilization of the knee to a good ultimate range of flexion in almost all cases. PMID- 3508160 TI - Duration of fracture healing after early versus delayed internal fixation of fractures of the femoral shaft. AB - The effect of delayed internal fixation in closed uncomplicated fractures of the femoral shaft was studied by comparing 40 patients from a hospital where this fracture was principally treated within 24 hours of the injury, with 46 patients from another hospital where this type of fracture was principally treated after a mean period of 13 days in skeletal traction. The two groups of patients were similar with regard to age, level of fracture, type of fracture and incidence of comminution. All fractures were treated by stable internal fixation. In the group treated by early operation considerably longer AO plates were used. Although delayed fixation resulted in more callus and although secondary bone healing was more frequent than in the group with early internal fixation, no difference in the rate of union of the fractures could be demonstrated. PMID- 3508161 TI - Treatment of unstable trochanteric fractures with Dimon-Hughston osteotomy displacement fixation and acrylic cement. AB - For the management of unstable trochanteric fractures, a new method consisting of Dimon-Hughston medial displacement osteotomy, fixation with a sliding screw sleeve-plate device, with augmentation of the posterior and medial upper femoral cortical defect with acrylic cement, was performed in 84 patients. All patients were allowed full weight bearing on the affected extremity within 1 week of operation. Sixty-five patients were available for follow-up more than 12 months after operation. Complication rates were low and 77 per cent of the patients achieved excellent and good functional results. PMID- 3508163 TI - The design of a new spring-loaded tong-type caliper for cervical traction. PMID- 3508162 TI - The treatment of unstable fractures of the ankle in the elderly. AB - It is now widely accepted that the best results of treating unstable fracture subluxations of the ankle follow accurate and secure internal fixation and early use of the part. This study of 31 operations on ankles in persons over the age of 65 shows that although satisfactory results were achieved in 58 per cent of elderly patients, poor results are likely when osteoporosis prevents adequate fixation. PMID- 3508164 TI - Training aids for instruction in the initial management of injury casualties and in resuscitation procedures. AB - Practical experience in the initial treatment of injured patients is not easily available to the medical student. The small number of injured patients available for observation in a short time, the fact that the patients do not necessarily arrive in regular teaching hours, and the large number of students present in teaching groups compound this difficulty. Specialized instruction in these subjects is therefore important. The acquisition and use of teaching aids facilitate precise and efficient presentation of the material. We present teaching aids specifically prepared for instruction in the initial management of the injured and in resuscitation procedures. These aids include a library of video recordings documenting important emergency procedures, a TV camera used for filming these procedures, a collection of slides on the subject of emergency medicine and recent injuries, mannequins for instruction in cardiopulmonary resuscitation (CPR), utilization of the hospital's animal research laboratory for instruction in critical procedures such as venous cutdown, chest drainage, etc., and simulated computer programs. PMID- 3508165 TI - Abdominal stab wounds. PMID- 3508166 TI - Blunt injury of the neck of the pancreas: a report of nine patients. AB - Nine patients with injury of the neck of the pancreas following blunt abdominal injury are reported. Eight were sustained in road traffic accidents and only two victims had used seatbelts. Serious associated injuries were present in four patients and the pancreatic injury was missed in two patients. The diagnosis of this injury was made at laparotomy in six, while one patient had the diagnosis confirmed at endoscopic retrograde pancreatography (ERP). The neck of the pancreas was the site of injury in all nine cases. Pancreatic drainage (3), suture repair (1) and distal resection with splenectomy (2) were the operative procedures performed. Pseudocyst of the pancreas (2), pancreatic fistulas (2), pancreatitis (1) and ascites (1), which necessitated a further laparotomy, accounted for postoperative morbidity. There was one postoperative death from haemorrhage due to stress ulceration. This study emphasizes that the neck of the pancreas is at special risk following blunt abdominal injury. PMID- 3508167 TI - Medical statistics of battlefield casualties. AB - War surgery presents conditions and problems that are radically different from those of peacetime surgery. Categorization of the injured may be necessary (triage), while a short or erratic supply of drugs, materials and personnel may exist. In this study, the hospital mortality following military action was 6.4 per cent. In the group of patients with combined thoracoabdominal injuries mortality was high. However, the inflow of this type of patient was relatively low. In 50 per cent of the cases, ketamine/benzodiazepine anaesthesia without intubation and artificial ventilation was sufficient, with the result that the use of oxygen and nitrous oxide was minimized. PMID- 3508168 TI - Immune mechanisms studied with tumor models. PMID- 3508169 TI - Inhibition of serine proteinases by tetra-p-amidinophenoxy-neo-pentane: thermodynamic and molecular modeling study. AB - The inhibitory effect of the aromatic tetra-benzamidine derivative tetra-p amidinophenoxy-neo-pentane (TAPP) on the catalytic properties of beta-trypsin (EC 3.4.21.4), alpha-thrombin (EC 3.4.21.5), factor Xa (EC 3.4.21.6), Lys77-plasmin (EC 3.4.21.7) and beta-kallikrein-B (EC 3.4.21.35) was investigated (between pH 2 and 8, I = 0.1 M; T = 37 +/- 0.5 degrees C), and analyzed in parallel with that of benzamidine, commonly taken as a molecular inhibitor model of serine proteinases. Over the whole pH range explored, TAPP and benzamidine show the same values of the dissociation inhibition constant (Ki) for beta-trypsin; at variance with the affinity of TAPP for alpha-thrombin, factor Xa, Lys77-plasmin and beta kallikrein-B which is higher than that found for benzamidine association around neutrality, but tends to converge in the acidic pH limb. On lowering the pH from 5.5 to 3.0, values of Ki for TAPP binding to beta-trypsin as well as for benzamidine association to all the enzymes investigated decreased thus reflecting the pK-shift, upon inhibitor binding, of a single ionizing group. Over the same pH range, values of Ki for TAPP binding to alpha-thrombin, factor Xa, Lys77 plasmin and beta-kallikrein-B may be described as depending on the pK-shift, upon inhibitor association, of two equivalent proton-binding amino acid residues. Considering the X-ray three-dimensional structures and the computer-generated molecular models of serine proteinases: TAPP and :benzamidine adducts, the observed binding behaviour of TAPP and benzamidine to the enzymes considered has been related to the inferred stereochemistry of proteinase: inhibitor contact region(s). PMID- 3508170 TI - Binding of the trypsin inhibitor from white mustard (Sinapis alba L.) seeds to bovine beta-trypsin: thermodynamic study. AB - The effect of pH and temperature on the association equilibrium constant (Ka) for the binding of the trypsin inhibitor from white mustard (Sinapis alba L.) seeds (MTI) to bovine beta-trypsin (EC 3.4.21.4) has been investigated. On lowering the pH from 9 to 3, values of Ka for MTI binding to bovine beta-trypsin decrease thus reflecting the acid-pK and -midpoint shifts, upon inhibitor association, of two independent ionizable groups, and of a three-proton transition, respectively. At pH 8.0, values of thermodynamic parameters for MTI binding to bovine beta-trypsin are: Ka = 4.5 X 10(8)M-1, delta G0 = -11.6 kcal/mol, and delta S0 = +53 entropy units (all at 21 degrees C); and delta H0 = +4.1 kcal/mol (temperature independent between 5 degrees C and 45 degrees C). Binding properties of MTI to bovine beta-trypsin have been analyzed in parallel with those concerning macromolecular inhibitor association to serine (pro)enzymes. PMID- 3508171 TI - Effect of chlorpromazine associated with liposomes on the biosynthesis of acidic lipids in subcellular membranes. AB - The study examined the effect of an association of chlorpromazine, phosphatidic acid and cytidine-diphosphoryl-1,2-diglycerides (CDP-diglycerides) with small unilamellar lecithin liposomes on the formation, hydrolysis and transfer of lipids and cytidine liponucleotides in microsomal and mitochondrial membranes isolated from guinea-pig liver. Association with liposomes undermined the effect of chlorpromazine on these processes, but the type of effect, i.e. inhibitory or stimulatory, was retained. Association of CDP-diglycerides with small unilamellar lecithin liposomes tended to protect this substrate from subcellular uptake, thereby inhibiting phosphatidylinositol and polyglycerophosphatide formation. Phosphatidic acid in the form of liposomes stimulated CDP-diglyceride formation. The nature of fatty acids influenced the magnitude of these effects in polyglycerophosphatide biosynthesis. Transfer of CDP-diglycerides from microsomal to mitochondrial membranes was inhibited by both chlorpromazine associated with liposomes and liposomes alone. PMID- 3508173 TI - A solid colloidal drug delivery system for the eye: encapsulation of pilocarpin in nanoparticles. AB - The present study was undertaken in order to encapsulate pilocarpin into nanoparticles. Two principally different methods for manufacturing these particles were investigated. Firstly, pilocarpin was dissolved in an aqueous medium in which the polymerization was carried out, and secondly, the polymerizing monomer was kept saturated with the drug solution under acidic conditions resulting in an incorporation into the nanoparticles in an aqueous environment. The amount of pilocarpin that could be incorporated into the nanoparticles was found to be largely influenced by the temperature at which the nanoparticles were produced and by the stabilizers used. At low temperatures, up to 60 per cent of pilocarpin nitrate could be encapsulated into butylcyanoacrylate nanoparticles using emulsion polymerization techniques. Larger amounts of pilocarpin could not be incorporated because of the hydrophilicity of the salts of this drug. The physico-chemical characteristics of the nanoparticles are reported: the particle size and morphology were determined by scanning and transmission electron microscopy and photon correlation spectrometry. The average particle size was about 100 nm. The results obtained in this study show that photon correlation spectrometry is a suitable method for the sizing of nanoparticles. PMID- 3508172 TI - Production of monodispersed capsules. AB - A new prehardening process has been demonstrated by passing falling drops through a fine mist of hardening solution, in which drops were generated as monodispersed and concentric two-phase particles. A mixture of vegetable oil and vitamin E has been encapsulated using calcium alginate for rapid hardening and hydroxy propyl methyl cellulose acetate succinate for slow hardening. Both hardening agents produced satisfactory stable encapsulation. PMID- 3508174 TI - Microencapsulation of soluble pharmaceuticals. AB - A method to microencapsulate water-soluble and liquid-paraffin insoluble drugs into spherical, discrete and free-flowing particles of approximately 175 microns size with excellent yield has been described taking diethylcarbamazine citrate as a model drug. In this method a gelatin-drug dispersion at 50 degrees C is sprayed, using a simple apparatus designed in our laboratory, into chilled, dry liquid paraffin present in a china dish previously coated with a layer of hard paraffin and maintained at 5 degrees C. After allowing the droplets to gel at 5 degrees C for an hour, water was removed by freeze drying. Later liquid paraffin adhering to freeze-dried microcapsules was removed by washing with chilled, dry acetone. Various factors affecting the yield, size, shape and size distribution of microcapsules were optimized. PMID- 3508175 TI - Encapsulation of triphenyltin hydroxide. AB - Triphenyltin hydroxide was encapsulated to prolong its fungicidal activity and to decrease its phytotoxicity in peanut fields. The envelopes found to be adequate for this purpose were polyureas and ethyl cellulose, as was demonstrated by biological tests. PMID- 3508176 TI - Streptomycin sulphate microspheres: formulation and in vivo distribution. AB - Albumin and gelatin microspheres of streptomycin sulphate were formulated and their potential as a drug delivery system for a tuberculostatic agent in vivo was evaluated. Biodistribution was determined by i.v. administration of a 99mTc labelled microsphere suspension to mice. The radioactivity of the lungs was compared with the radioactivity of the liver, spleen, kidney and heart at 10 min, 60 min, 4 h and 24 h post-injection. The percentage accumulated was higher in the lungs than in the other organs for both albumin and gelatin microspheres. PMID- 3508177 TI - Preparation and characteristics of dichloromethylene diphosphonate-containing liposomes. AB - Dichloromethylene diphosphonate (DMDP), encapsulated in liposomes and administered intravenously in mice, will eliminate all macrophages in spleen and liver. DMDP can be incorporated in liposomes to a maximum of 15 mM, if less than 12 mM is encapsulated not all macrophages will be eliminated (since the animals could not be injected with more liposomes). To determine DMDP content of the liposomes before in vivo administration, an in vitro test system was developed. This method is based on the competition for calcium binding by either DMDP or murexide. Murexide is a metallochromatic indicator which gives a distinct wavelength shift after binding of calcium. The decrease in absorbance at 510 nm of the murexide-calcium complex, due to the addition of DMDP, was used as a reliable (s.d. 5 per cent) value for measurement of DMDP concentrations. The possible use of this system in the study of calcium binding and transport over artificial biomembranes is discussed. PMID- 3508178 TI - Encapsulation of proteins and peptides in milkfat: encapsulation efficiency and temperature and freezing stabilities. AB - Encapsulation of aqueous protein solution was most efficient when the butter and protein solution emulsion was at 58 degrees C before dispersion into water, although encapsulation efficiencies were high between 46 and 66 degrees C. Capsules could be produced with no emulsifiers and an emulsion temperature of 66 degrees C but no capsules were formed when emulsion temperature was lowered to 38 degrees C. Capsules with encapsulated beta-casein peptides and with proteose peptone had similar low-temperature stabilities with a loss of about 10 per cent of the peptides after 24 h at 4 degrees C. However, capsules with beta-casein peptides were slightly more stable above 26 degrees C. Little diffusion of the haemoglobin from capsules occurred at less than 20 degrees C but above 32 degrees C capsules destabilized and the haemoglobin diffused out of the capsules. Capsules were stable after freezing at -90 degrees C and -18 degrees C and could be thawed and redispersed; a 15-25 per cent loss of capsules was observed during freezing. Concentrating capsules by removing all or one-half of the dispersion fluid did not increase stability to freezing. PMID- 3508179 TI - Effect of pH on the release characteristics of pentaestergum microcapsules and a study of dissolution kinetics. AB - Rosin and rosin esters have excellent film-forming properties. Pentaerythritol rosin ester (penta-ester gum) is found to be useful as moisture-protecting material with delayed release of drug. This communication relates the effect of pH on the release characteristics of a drug from penta-ester gum coated microcapsules. Salicylic acid granules were encapsulated using a 10 per cent solution of penta-ester gum in acetone. The microcapsules were evaluated for their drug release characteristics. Various pH media (pH 1.2, 3.0, 5.0, 7.2 and 8.0) were used. The results showed that penta-ester gum exhibits excellent resistance to higher pH levels and can be used for the sustained release of the drug. Dissolution rate constants were calculated and they agree with the assumption of Hixson and Crowell's cube-root equation. PMID- 3508180 TI - Sorption of 5-fluorouracil from aqueous solutions onto methyl methacrylate nanoparticles. AB - The sorption of 5-fluorouracil from aqueous solutions onto poly(methyl methacrylate) was investigated. Linear sorption isotherms were obtained and no crystallinity of the nanoparticles after sorption was detectable by X-ray analysis indicating a partitioning of the drug into the polymer particles-forming a solid solution. Standard enthalpy, standard entropy and standard free energy of sorption were -36.9 kJ mol-1, -85.0 J mol-1 K-1 and -12.0 kJ mol-1, respectively. PMID- 3508181 TI - Antineoplastic activity and toxicity of some alkylating cytostatics (cyclophosphamide, CCNU, cytostasan) encapsulated in liposomes in different murine tumour models. AB - The encapsulation of Cyclophosphamide in MLV (PC:CH 1:1) revealed a total loss of antineoplastic activity in the P 388 tumour model compared to an equal dose of the free drug, though a moderate toxicity, registered as decrease of leukocyte and platelet counts, was still present. CCNU in liposomes of different size and composition showed in lower doses a diminished therapeutic effectiveness in the P388 or L 1210 leukaemia and the B 16 melanoma, while in higher doses toxic deaths occurring with the free drug could be prevented totally by using liposomes. Liposomal encapsulation also influenced body weight change and leukocyte counts, causing them to be less drastically reduced than with use of the free drug. The entrapment of Cytostasan, an N-lost derivative, had the same effect on the increase of lifespan of tumour-bearing animals (mammary carcinoma 1142 A) as equal doses of the free drug and caused only a slight improvement of toxicity. In general, liposomal encapsulation of alkylating cytostatics seems advantageous only for certain lipophilic drugs. PMID- 3508182 TI - The effect of surfactants on the microencapsulation and release of phenobarbitone from gelatin-acacia complex coacervate microcapsules. AB - The effects of sodium lauryl sulphate (SLS), cetrimide and polysorbate 20 surfactants at concentrations below, at and above their critical micelle concentration (CMC) on the microencapsulation and release of phenobarbitone have been described. Bimodal particle size distributions were produced both in the absence and presence of each of the three surfactants. The presence of surfactant had little or no effect on the particle size distribution at any given stirring speed. A large variation was noted in the amount of phenobarbitone microencapsulated dependent upon the type of surfactant and its concentration. The amount of phenobarbitone encapsulated decreased with increasing concentration of polysorbate 20 and with SLS. Cetrimide (0.025 per cent w/v) enhanced encapsulation with 2 per cent w/w colloids but higher concentrations at the CMC and above decreased encapsulation. The results are explained in terms of decreased interfacial tension by the surfactant and by steric and electrostatic effects caused by surfactant adsorption onto the coacervate droplets and phenobarbitone particles. PMID- 3508183 TI - The effect of niosomes and polysorbate 80 on the metabolism and excretion of methotrexate in the mouse. AB - The effect of non-ionic surfactant vesicle (niosome) encapsulation on the metabolism and urinary and faecal excretion of methotrexate (MTX) in mice has been studied following oral and intravenous administration, and compared with the effects of co-administration of free drug and polysorbate 80, which does not form vesicles. Niosome entrapment reduces the excretion of MTX into urine and bile whereas polysorbate 80 increases its excretion. Monitoring of the levels of MTX and its 7-hydroxy metabolite indicates that entrapped MTX is protected from rapid metabolism in vivo, particularly in niosomes but to a small degree in the micellar systems formed by polysorbate. PMID- 3508184 TI - Aggregation of unilamellar lecithin liposomes induced by cyclosporin. AB - Small unilamellar [14C]lecithin liposomes prepared in the presence of cyclosporin sedimented at 12,000 g. Sepharose 4B gel filtration of the resuspended pellet and supernatant yielded identical peaks consisting of small unilamellar liposomes containing cyclosporin. The column retained 40-50 per cent of 14C-labelled liposomes prepared in the presence of cyclosporin as liposome aggregates. PMID- 3508185 TI - Kinetics of drug release from polylactic acid-hydrocortisone microcapsules. AB - Polylactic acid microcapsules of similar particle size distribution containing various drug loadings of hydrocortisone were prepared. The microcapsules, which contained randomly dispensed drug particles, showed a dissolution pattern which consists of a fast first-stage and a slow second-stage drug release. Our studies showed that the kinetics of drug release from the microcapsules can be adequately described by a spherical matrix model based on a flux mechanism involving the diffusion of dissolved drug at the penetrating front of the dissolution medium. Drug loading played an important role in the control of drug release rate. An empirical relationship between drug loading and drug diffusibility through the polymeric matrix was developed and showed that the rate of drug release increased exponentially with the increase in drug loading. The microcapsules were further shown to exhibit increased rate of drug release in dissolution medium containing either cetylpyridium chloride or aerosol OT. The effect of the surfactants was attributed to surface tension lowering and improved wetting of the microcapsule particles. PMID- 3508186 TI - Mechanism of hydrolytic degradation of poly(L-lactide) microcapsules: effects of pH, ionic strength and buffer concentration. AB - The hydrolytic degradation rate of poly(L-lactide) molecules constituting the microcapsule membrane was estimated at different pH, ionic strength and buffer concentration. Poly(L-lactide) microcapsules were observed to be hydrolytically degraded rapidly in a strongly alkaline solution to lactic acid as the final product. The degradation was accelerated when the poly(L-lactide) microcapsules were immersed in solutions of high ionic strength. The effect of pH and ionic strength of the bulk solution is interpreted in terms of the electric potential distribution in the membrane. It is suggested that the concentration of OH- in the membrane has an important role in the hydrolysis of poly(L-lactide) microcapsules, when the microcapsules are dispersed in solutions where the zeta potential of the microcapsules is negative. On the other hand, when the zeta potential is positive, the concentration of H+ in the membrane has a predominant effect on the degradation. The degradation was also found to be affected by the salt concentration in buffered solutions, suggesting that the cleavage reaction of the polymer ester bonds is accelerated by conversion of the acidic degradation products into neutral salts. PMID- 3508187 TI - Ocular drug delivery of progesterone using nanoparticles. AB - The objective of this study was to evaluate ocular delivery of a lipid-soluble drug, [3H]progesterone, using nanoparticles. Polybutylcyanoacrylate nanoparticles loaded with [3H]progesterone were prepared by an emulsion polymerization technique using a hydrophilic continuous phase. The resulting nanoparticle suspension contained 2 x 10(-5) M progesterone. It was found that, at equilibrium, 99 per cent of the progesterone resided in the nanoparticles and the remainder in the aqueous phase indicating an excellent encapsulation efficiency. In addition, an appropriate control solution of progesterone was prepared, which did not contain polybutylcyanoacrylate. Concentrations of [3H]progesterone in various ocular tissues of the albino rabbit were monitored at various times following topical administration of either the nanoparticle suspension or the control solutions. Comparison of the concentration-time profiles indicates that tissue concentration of progesterone following topical administration of nanoparticles is generally four to five times less than that obtained with control solutions. This decreased concentration suggests that, due to the high affinity of progesterone for the nanoparticles, the drug is being made less available for absorption during its residence time in the precorneal area. The utility of nanoparticles as an ocular drug delivery system may depend on optimizing lipophilic-hydrophilic properties of the polymer-drug system, in addition to increasing retention efficiency in the precorneal pocket. PMID- 3508188 TI - A study on heat-resistance of microencapsulated glucose oxidase. AB - Polyurea microcapsules containing glucose oxidase were prepared and their thermodurability was examined. Microencapsulated glucose oxidase was found to be more stable to heat than the enzyme in free solution. This stability was enhanced with an increase in the amount of enzyme entrapped in the microcapsules. PMID- 3508189 TI - Phagocytosis of microcapsules by guinea-pig polymorphonuclear leucocytes. AB - Phagocytosis of microcapsules by guinea-pig polymorphonuclear leucocytes (PMNs) was examined particularly considering the method of measurement and the effects of surface negative charges of the microcapsules and plasma proteins. Estimation of phagocytosis by oxygen consumption was found to correlate fairly well with the measured amount of the microcapsules phagocytosed. In the absence of plasma proteins, microcapsules having the same surface negative charge as that of the PMNs underwent less phagocytosis than those having surface negative charges different from those of the PMNs. The presence of plasma proteins was found to suppress phagocytosis. PMID- 3508190 TI - Eudragit RS and RL (acrylic resins) microcapsules as pH insensitive and sustained release preparations of ketoprofen. AB - Microencapsulation of ketoprofen using Eudragit RS and RL (acrylic resins) was investigated based on the dispersion system of ketoprofen-containing acetone in liquid paraffin. Aluminium tristearate was used as an additive for the preparation of microcapsules. Good reproducibility was observed in the microencapsulation and the resulting microcapsules were uniform, free-flowing particles. The phase diagram of ketoprofen-Eudragit RS or RL-aluminium tristearate indicated that it is only in a very limited region that spherical microcapsules ranging from 250 to 1000 microns in diameter could be prepared. Instrumental analysis using an energy dispersive-type X-ray microanalyser and a scanning electron microscope showed that aluminium tristearate was localized near the surface of the microcapsules. From these results, it was presumed that aluminium tristearate reduces the phase tension between Eudragit microcapsules and liquid paraffin. The dissolution patterns of ketoprofen from Eudragit RS and RL microcapsules were independent of the pH of the dissolution medium, and the dissolution rates were considerably lower than those from ketoprofen powders. PMID- 3508191 TI - Eudragit E, L and S (acrylic resins) microcapsules as pH sensitive release preparations of ketoprofen. AB - Microencapsulation of ketoprofen using Eudragit E, L and S (acrylic resins) was investigated. The preparation is based on the dispersion of acetone containing ketoprofen in liquid paraffin. Aluminium tristearate was used as an additive for the preparation of microcapsules. In the preparation of microcapsules, the reproducibility of the Eudragit E microcapsule was better than that of Eudragit L and S microcapsules. The microcapsules obtained were uniform and free-flowing particles. From the phase diagram of ketoprofen-Eudragit E or S-aluminium tristearate, it became clear that the region in which the spherical microcapsules ranging from 250 to 1000 microns in size could be prepared was limited. The dissolution patterns of ketoprofen from Eudragit E, L and S microcapsules were dependent on the pH of the dissolution medium. PMID- 3508192 TI - Hypertension--moving toward the year 2000. PMID- 3508193 TI - Clinical evaluation of the Nippon Colin BP-103N blood pressure monitor. AB - The automatic oscillometric Nippon Colin BP-103N blood pressure-monitor was evaluated in comparison with the Hawksley random zero mercury sphygmomanometer using standard methods. The monitor under test was found significantly to over read mean systolic pressures by 4.2 mmHg and mean diastolic pressures by 4.6 mmHg. The coefficient of variation was 5.4% for systolic and 6.4% for diastolic pressures. Analysis of variance showed that the difference between the two manometers was within the random variability of readings obtained. PMID- 3508194 TI - Transient leucopenia and thrombocytopenia associated with sodium nitroprusside infusion. AB - The case history of a 42 year old male on CAPD who was receiving sodium nitroprusside (SNP) for hypertensive encephalopathy is described. Leucopenia and thrombocytopenia developed but were resolved by hydroxocobalamin infusion during administration. PMID- 3508195 TI - The relationship between obesity-related metabolic factors and vascular changes in early hypertension. AB - The relationships of obesity, glucose metabolism and hormonal variables to mean arterial pressure (MAP) regional vascular resistance and signs of structural vascular changes, were determined in 70 men aged 49 years with normal to mildly elevated MAP randomly selected from a population sample. Regional vascular resistances and signs of structural vascular changes were measured in the calf by plethysmography at rest and during maximal dilatation, and in the kidneys by renal blood flow determination during graded subpressor doses of angiotensin II. MAP was positively correlated to body fat, waist circumference, fat cell size, and to blood glucose 60 minutes after an oral load. This supports an association between central obesity, impairment of glucose tolerance and hypertension. MAP was, however, unrelated to sodium intake, blood volume and indices of sympathetic nervous activity and the renin-angiotensin system. Resting vascular resistance in the calf was unrelated to MAP, while renal vascular resistance rose significantly with increasing MAP. Signs of structural change were significantly correlated to MAP in both these vascular areas. These signs were also associated with central obesity of the hypertrophic type and with impairment of glucose tolerance, even when the association to MAP was accounted for. These factors may be involved in the pathogenesis of the structural adaptation of resistance vessels as hypertension develops. PMID- 3508196 TI - Blood pressure, smoking, obesity and alcohol consumption in black and white patients in general practice. AB - A comparison of blood pressure (BP), smoking, alcohol consumption and obesity between whites and blacks of Caribbean origin aged 17-70 was undertaken in a general practice in North West London. Mean systolic and diastolic blood pressures (DBP) showed no consistent overall differences between the two ethnic groups, though DBP rose significantly more with age in black males than white males. Somewhat higher proportions of the black patients were receiving anti hyper-tensive treatment compared with the whites, the difference was statistically significant in the case of males (P less than 0.02). This observation did not appear to be due to more effective detection of hypertension amongst black males. Overall, fewer than one-third of black females were current cigarette smokers compared with around one-half of white females (P less than 0.001). Amongst males, however, the proportions of never, ex and current smokers were similar in the two ethnic groups. Young black patients of both sexes were more likely to smoke than older blacks. Blacks who smoked tended to smoke fewer cigarettes than white smokers. Eleven of 190 (5.8%) black males had consumed 35 units or more of alcohol within the last week compared with 87 of 452 (19.2%) of white males, (P less than .001). Amongst females the differences were smaller, 5 of 227 (2.2%) of black females had consumed 21 units or more in the last week compared with 23 of 490 (4.7%) of white females (NS).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3508197 TI - The pressor response to exercise and stress in uncomplicated insulin-dependent diabetes. AB - We investigated whether or not an increased pressor response to exercise or stress is a feature of the diabetic state per se or a feature of its complications was investigated. Twelve insulin-dependent diabetic patients without clinical evidence of complications and with normal albumin excretion rates (less than 20 micrograms/min) were studied together with 12 matched control subjects. Each underwent a study protocol of isometric handgrip exercise at 30% of maximum capacity for four minutes, a cold pressor test with immersion of one hand in ice-cold water for two minutes, and bicycle ergometry at a resistance of 105 watts per minute for six minutes. The tests were undertaken in the same order in all subjects. There was, in both groups, a similar and significant rise in systolic blood pressure and pulse rate in response to each stimulus. Diastolic pressure also rose significantly in response to handgrip exercise and to cold pressor stimulation, but fell slightly during bicycle ergometry in both groups. Mean plasma noradrenaline concentration rose in response to each stimulus but the changes reached conventional significance in both groups only in response to handgrip exercise. Pressor responses to exercise and stress, as tested here, are concluded to be normal in insulin-dependent diabetic patients without complications due to their disease. PMID- 3508198 TI - Abnormalities of erythrocyte membrane fatty acid composition in human essential hypertension. AB - The fatty acid content of erythrocyte plasma membrane was estimated in cells of 17 untreated hypertensive patients, and compared to that of 16 control subjects matched for age, sex and weight. Mean linoleic acid (18:2) content was significantly lower in hypertensives than controls, whereas arachidonic acid (20:4) and oleic acid (18:1) were significantly higher. These results provide further evidence for an alteration in the physiochemical structure of the plasma membrane in cells of hypertensive patients and may be related to the multiple disturbances in erythrocyte ion fluxes which have been observed. PMID- 3508199 TI - Veterinary education. PMID- 3508200 TI - [Africaans in veterinary medicine]. PMID- 3508201 TI - [Disseminated intravascular coagulation in the horse: a report of six cases]. AB - Six cases of disseminated intravascular coagulation in the horse are reported. They were characterised clinically by severe subcutaneous oedema of the head and neck, and clinocopathologically by abnormal partial thromboplastin and prothrombin times, a thrombocytopaenia and an increase in fibrin degradation product concentrations. Various aetiologies played a role in the pathogenesis of the condition including African horsesickness, babesiosis, lymphosarcoma and verminosis. PMID- 3508202 TI - Foot abscess in goats in relation to the seasonal abundance of adult Amblyomma hebraeum and adult Rhipicephalus glabroscutatum (Acari: Ixodidae). AB - The seasonal prevalence of foot abscess affecting Angora and Boer goats in Valley Bushveld in the eastern Cape Province of South Africa was significantly related to the seasonal abundance of adult Amblyomma hebraeum and adult Rhipicephalus glabroscutatum. Angora goats harboured more ticks than Boer goats and also had a greater number of abscessed feet. Larger numbers of ticks and abscesses were recorded on hind feet than on fore feet. There was no significant correlation between rainfall and the occurrence of foot abscess. The seasonal abundance of adult A. hebraeum and adult R. glabroscutatum on several ruminant species at various localities in the Cape Province is described. PMID- 3508203 TI - The effect of post-milking teat dipping on teat canal infections. AB - Teat canal infection (TCI) or colonization, subclinical mastitis (SCM) cases and other forms of intramammary infections (IMI) may persist despite regular post milking teat disinfection. Spontaneous healing of TCI can occur and this points to the dynamic state of the reactions of TCI etc. Disinfecting teat dipping does not necessarily prevent new TCI and IMI. Teat dipping may, however, be applied with good effect in the prevention of new udder and teat canal infections. Several factors predispose to TCI e.g. poor management, hygiene and animal husbandry. PMID- 3508204 TI - Effects of certain anaesthetics on plasma metabolite concentrations in the baboon (Papio ursinus). AB - Four groups of 12 baboons each were sedated for a period of 3 hours by means of one of 4 anaesthetic treatments. The treatments involved repeated administration of either ketamine or phencyclidine, or initial sedation with one of these followed by pentobarbitone. A number of plasma metabolites were measured at 30 min intervals. With one exception, there were no significant differences between the 4 individual anaesthetic treatments; there was a small, but significant, decrease in plasma calcium (3.4%) in the group receiving phencyclidine followed by pentobarbitone. There were, however, significant changes with time. Plasma inorganic phosphorus and magnesium concentrations in all the groups rose similarly, reaching mean respective increases of 21.8% and 7.7% after 3 hours. In a number of cases divergent time trends were observed between the pair of groups given pentobarbitone and the pair receiving only ketamine or phencyclidine. Pooling the results from each of these pairs of treatment groups doubled the overall group sizes to 24 animals each and enabled significant differences between the divergent time trends to be detected. In the former pair plasma zinc increased (by a maximum of 16.1%) and protein decreased (by a maximum of 4.0%), while in the latter pair alkaline phosphatase and cholesterol levels both increased (up to maximums of 7.8% and 5.2%, respectively). No significant changes with time were found to be attributable to diurnal variation. Some of the changes in plasma metabolite concentrations following anaesthesia are such that due care should be exercised in their determination and interpretation in anaesthetised baboons. PMID- 3508205 TI - Chronic splenitis as a possible complicating factor in calves inoculated with an attenuated redwater vaccine. AB - In two consecutive years a total of 3810 calves were inoculated with the Onderstepoort redwater live-blood vaccine, containing attenuated strains of Babesia bigemina and Babesia bovis. Twenty calves died 8-13 days later due to B. bigemina-infection. Necropsies were performed on 19 of these animals. In 11 calves the spleen was distinctly smaller than normal and its morphology was distorted, and showed changes of chronic splenitis. Histological lesions in the spleens of 6 of the 11 calves are described. The potentiating effect of the splenic lesions to reduce the ability to contain the vaccine reaction, is discussed. PMID- 3508206 TI - Blood chemical and electrolyte concentrations in the mountain reedbuck Redunca fulvorufula. AB - Concentrations of sodium, potassium, chloride, inorganic phosphorus, total magnesium, total calcium, iron, urea, creatinine, total protein, albumin, total bilirubin, alkaline phosphatase (ALP), alanine transaminase (ALT), lactate dehydrogenase (LD), creatine kinase (CK), gamma-glutamyltransferase (GGT) and aspartate transaminase (AST) were determined in serum specimens collected from 53 free-ranging mountain reedbuck (Redunca fulvorufula) during live capture using nets. Considerable variations in the concentrations of the enzymes ALP, LDH, CK, GGT and AST were found as well as in the concentrations of creatinine, bilirubin and iron. This wide variation in results seriously questions the usefulness of similar blood investigations on heterogenous groups of mechanically restrained animals. PMID- 3508207 TI - Blood chemical parameters in the warthog Phacochoerus aethiopicus. AB - Concentrations of sodium, potassium, chloride, inorganic phosphorus, total calcium, total magnesium, albumin, total protein, cholesterol, urea, creatinine, cortisol as well as the activities of alkaline phosphatase, alanine transaminase, aspartate transaminase, gamma-glutamyltransferase, creatine kinase and lactate dehydrogenase were determined in serum specimens collected from 100 free-ranging warthogs Phacochoerus aethiopicus within five minutes after they were killed with a shotgun. Average concentrations for the following chemical constituents were found: sodium (145 mmol l-1), potassium (8.6 mmol l-1), chloride (102.5 mmol l 1), phosphorus (2.31 mmol l-1), calcium (2.93 mmol l-1), magnesium (1.23 mmol l 1), albumin (26.4 g l-1), serum proteins (62.2 g l-1), cholesterol (1.82 mmol l 1) and urea (8.74 mmol l-1). The cortisol concentrations ranged from 55-340 nmol l-1 (n = 30). Wide variations were recorded in the concentration of creatinine as well as in the activities of the various enzymes. PMID- 3508208 TI - The use of ketamine hydrochloride in the immobilisation of the Cape vulture Gyps coprotheres. AB - Ketamine hydrochloride was successfully used at a dosage rate ranging from 7.5 28.8 mg kg-1 to immobilise Cape vultures Gyps coprotheres (n = 7). PMID- 3508209 TI - Serum biochemical and haematological parameters in the Cape vulture Gyps coprotheres. AB - Serum concentrations of total proteins, albumin, glucose, alkaline phosphatase, alanine transaminase, aspartate transaminase, gamma-glutamyltransferase, lactate dehydrogenase, creatine kinase, urea, creatinine, total calcium, ionised calcium, total magnesium, sodium chloride, potassium, phosphorus, cortisol, parathormone, 25-hydroxy-VitD3 and insulin as well as the results of haematological investigations in Cape vultures (n = 10) are presented. PMID- 3508210 TI - [Bursitis calcarea]. PMID- 3508211 TI - [Pulpy kidney in the suckling lamb]. PMID- 3508212 TI - Proceedings of the Buffalo Symposium. Pretoria, 15 November 1985. Abstracts. PMID- 3508213 TI - Crisis in health care. PMID- 3508214 TI - Acquired immune deficiency syndrome--to operate or not to operate? PMID- 3508215 TI - Electrocardiogram analysis in adult patients with sickle cell disease. AB - This study is an analysis of the electrocardiograms (ECGs) of 87 adult patients taken during hospital admission for sickle cell disease (homozygous S). The age range was 18 to 55 years: 38 were men and 49 were women. Seventy-two percent of all patients had abnormal ECGs. Nonspecific ST-T (NS-ST-T) wave abnormalities (53 percent) and QT interval prolongation (12 percent) were frequent. Seventy-five percent of the normal ECGs occurred in women (P < .05); and 74 percent of those with left ventricular hypertrophy (LVH) were men (P < .05). Fifteen of 21 (71 percent) patients with arrhythmias had NS-ST-T abnormalities. Systemic hypertension and ECG evidence for right-sided heart disease were rare, as was the incidence of LVH by ECG. PMID- 3508216 TI - Diagnostic criteria and efficient use of outpatient cultures. AB - The authors conducted an eight-year longitudinal study to evaluate the effect of diagnostic criteria on efficient use of outpatient cultures. Efficiency was determined by monitoring alterations in culture use, yield (percent positive), and charges for four common ambulatory diseases: Group A streptoccocal pharyngitis; gonococcal urethritis and cervicitis; bacterial cystourethritis; and acute enterocolitis.The study demonstrated that the use of diagnostic criteria resulted in more efficient use of laboratory tests as reflected in the immediate and sustained decrease in culture use and associated charges, an increase in yield (percent positive), and a corresponding decrease in charge per test. PMID- 3508217 TI - Effects of meprobamate on plasma lipids, lipoproteins, and experimental atherosclerosis. AB - The effects of the tranquilizer meprobamate (Equanil) on plasma lipids, lipoproteins, and atherogenesis in cockerels fed an atherogenic diet have been investigated. Gross gradings (visually assessed blindly) of the atherosclerosis of the thoracic and abdominal aortas of the meprobamate-treated plain mash were significantly more severe than the untreated plain mash controls. There were no significant differences in the gradings of thoracic and abdominal aortic lesions in the atherogenic groups, whether treated with meprobamate or not. Microscopic examination of the coronary arteries of birds on the atherogenic regimen treated with meprobamate revealed that these birds had atherosclerosis similar to the atherogenic diet group. PMID- 3508218 TI - Overweight and obesity in black women: a review of published data from the National Center for Health Statistics. AB - Overweight is a major health problem for black women in the United States. The age-adjusted prevalence of overweight was 47.1 percent in 1960-1962, 46.8 percent in 1971-1974, and 48.1 percent in 1976-1980 for black women aged 25 to 74 years, much higher than that of white women or men of either race. Black women born in later decades tended to be more overweight than those born earlier. Black women were first clearly more obese than white women in the third decade of life. Overweight was inversely related to family income and education. Rural and southern women were more overweight than their urban, northern, and western counterparts. More research is needed upon which to base efforts to control and prevent overweight in black women. PMID- 3508219 TI - Intussusception in Nigerian adults. AB - Eleven Nigerian adult patients with intussusception were seen at the Lagos University Teaching Hospital, Lagos, Nigeria, between 1973 and 1985. The average age of the patients was 43.2 years +/- 13.5 SD. The most common types of intussusception encountered were the ileoileal and cecocolic. The cause of the intussusception was idiopathic in four patients (36.3 percent) and malignant in only one patient (9 percent). Malignancy as a cause of intussusception in Nigerian adults is rare, but resection without reduction still appears to be the safest surgical approach because most patients came late to surgery. PMID- 3508220 TI - Controlling the intake of calories with the intake of food. AB - The author presents a dietary program for weight reduction based not on the substitution of a low calorie meal for a high calorie meal, but on the pre-meal ingestion of low calorie bulk beverages that are pleasant to taste and space filling, thereby compromising the capacity of the stomach to accommodate much of the higher calorie foods of the regular meals. This method makes any form of fasting unnecessary, as the intake of calories is already limited. Because of this method, few changes need to be made in food selection for regular meals. PMID- 3508221 TI - Treatment of blepharospasm with botulinum A toxin. PMID- 3508222 TI - Histopathological changes in the extraocular muscles after retrobulbar anesthesia. PMID- 3508223 TI - Intraocular pressure after extracapsular cataract extraction with implantation of posterior chamber lenses. PMID- 3508224 TI - Prostaglandin E in rabbit aqueous humor after Nd-YAG laser photodisruption of the iris and the effect of topical indomethacin pretreatment. PMID- 3508225 TI - Clinical evaluation of severe penetrating injury involving vitreous gel treated with pars plana vitrectomy. PMID- 3508226 TI - Intrastromal nonpigmented epithelial cyst of the iris. PMID- 3508227 TI - A case of congenital orbital teratoma. PMID- 3508228 TI - The effect of colchicine on fibroblast proliferation after glaucoma filtering surgery. PMID- 3508229 TI - The long-term effects of experimental total retinectomy. PMID- 3508230 TI - The effects of ouabain on the ERG c-wave. PMID- 3508231 TI - Fluorescent low density lipoprotein and acetylated low density lipoprotein labeling of cultured bovine trabecular endothelial cells. PMID- 3508232 TI - Simulation of proliferative vitreoretinopathy in pigmented rabbits. PMID- 3508233 TI - Ammonia toxicity: comparative protective effect of various arginine and ornithine derivatives, aspartate, benzoate, and carbamyl glutamate. AB - Ornithine and arginine compounds were highly effective in preventing an increase in blood ammonia and in preventing or minimizing encephalopathy after acute subcoma, coma-inducing, or lethal doses of NH4+. Similar protection was seen after subacute loading with glycine. Ornithine ketoacid derivatives were no more effective than ornithine alone or ornithine glutamate. Ornithine appeared to be a little more effective than arginine, but the differences were slight. Aspartate and glutamate alone were ineffective. Carbamyl glutamate was much less effective than either ornithine glutamate or arginine glutamate. Orotic acid excretion was markedly increased in the presence of excess NH4+. This increment was eliminated with ornithine or arginine, although the reduction with arginine was unpredictably erratic. Aspartate increased the orotic acid excretion and the amount of urea formed. Sodium benzoate was borderline in its effect on the blood ammonia and on orotic acid excretion. PMID- 3508234 TI - Glycerol as an indicator of lipid degradation in bicuculline-induced seizures and experimental cerebral ischemia. AB - Glycerol, the end product of phospholipid degradation, was measured in cat brains under pathophysiological conditions known to cause activation of lipolysis, namely, bicuculline-induced seizures, permanent focal cerebral ischemia (2 hr of middle cerebral artery occlusion), and global cerebral ischemia (15 min of complete cerebral ischemia with or without 2 hr of recirculation). In addition, ATP and lactate were measured in order to correlate the activation of lipid degradation with disturbances in the energy-producing metabolism. A highly significant increase in the tissue glycerol content was observed after 1 hr of bicuculline-induced seizures (from 0.29 +/- 0.07 mumol/g in control animals to 1.30 +/- 0.06 mumol/g in seizure animals; P less than 0.001) or after 15 min of complete cerebral ischemia (from 0.29 +/- 0.07 to 1.17 +/- 0.14 mumol/g; P less than 0.01). Furthermore, a close correlation was found between the increase in glycerol and the increase in lactate or decrease in ATP after permanent focal ischemia. In contrast, following recirculation after complete cerebral ischemia, restoration of the energy pool did not lead to a reduction of the glycerol formed during ischemia. It is concluded that glycerol is a useful indicator of lipid degradation under pathological conditions. Since glycerol formed during vascular occlusion is trapped in brain cells, presumably owing to low glycerol kinase activity, it can be used as a stable postischemic indicator of ischemia-induced lipid degradation. PMID- 3508235 TI - Brain monoamines after portacaval anastomosis. AB - Norepinephrine, dopamine, and serotonin, as well as the serotonin metabolite, 5 hydroxyindoleacetic acid, were measured in whole-brain extracts from rats with a portacaval shunt or sham operation. Norepinephrine, serotonin, and 5 hydroxyindoleacetic acid were significantly higher after shunting. There was no difference in dopamine. The results support the idea that brain indole metabolism is increased during chronic hepatic encephalopathy. However, they provide evidence against suggestions that hepatic encephalopathy in general is accompanied by a shortage in the whole-brain content of the catecholamines norepinephrine and dopamine. PMID- 3508236 TI - Regional glucose and beta-hydroxybutyrate use by developing rat brain. AB - Rates of glucose and D-beta-hydroxybutyrate use were determined in five brain regions of 20-day-old rats. The regions studied were cerebral cortex, thalamus, striatum, cerebellum, and brain stem. The tracers for determining rates of substrate use were [3H]fluorodeoxyglucose and [3-14C]-D-beta-hydroxybutyrate. Two or five minutes after isotope administration the animals were sacrificed in a 6 kW, 2450-MHz focused microwave device. Ten minutes prior to isotope administration the animals were injected intraperitoneally with normal saline or DL-beta-hydroxybutyrate (10 mmol/kg). Blood D-beta-hydroxybutyrate levels averaged 0.21 mumol/ml in saline-injected and 3.13 mumol/ml in hyperketonemic rats. Rates of glucose utilization were significantly heterogeneous between regions in both groups: thalamus greater than cerebral cortex greater than or equal to striatum greater than brain stem greater than cerebellum. These rates were 20-35% lower in hyperketonemic rats. Rates of D-beta-hydroxybutyrate use varied significantly between regions only in the saline group, with the brain stem rate being significantly lower than that in cortex or cerebellum. Regional rates of D-beta-hydroxybutyrate use did not correlate significantly with regional rates of glucose use in either the saline or the hyperketonemic groups. Regional rates of glucose use were strongly and positively correlated between conditions, as were regional rates of D-beta-hydroxybutyrate use. Thus, in 20-day-old rats, the regional heterogeneity of brain glucose use is similar to that in adult rats. D-beta-Hydroxybutyrate use is much less regionally heterogeneous.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3508237 TI - Regional blood-brain barrier transport of glucose after portacaval anastomosis. AB - The regional influx of glucose across the blood-brain barrier was measured in rats 5 to 6 weeks after a portacaval anastomosis or sham operation. D [14C]Glucose was infused intravenously for 15 sec while arterial blood was sampled continuously for measurement of plasma radioactivity and glucose concentration. Brain tissue radioactivity was measured by quantitative autoradiography. Glucose influx and plasma clearance (permeability times surface area; PS) were calculated from the net disintegrations per minute per gram in brain, the plasma radioactivity integral, and the plasma glucose concentration. In shunted rats influx was decreased by about 22% (in the brain as a whole) compared to that in controls. This decrease was almost entirely due to the decrease in plasma glucose concentrations (27%). The PS, normalized to take plasma concentrations into account, showed a slight decrease in most of the brain except the telencephalon. For the brain as a whole this decrease amounted to 11%. The regional PS and glucose utilization are known to be coupled and the relationship between these was the same in sham-operated and shunted rats. The decrease in PS observed in shunted rats was commensurate with their lower rates of glucose use; thus, the transport process of glucose from plasma to brain appeared to be unaffected by portacaval shunting. PMID- 3508238 TI - Effects of acute hyperosmolar NaCl or urea on brain H2O, Na+, K+, carbohydrate, and amino acid metabolism in weanling mice: NaCl induces insulin secretion and hypoglycemia. AB - This study compares early and late effects of the injection of hyperosmolar NaCl and urea of equal osmolarity on selected aspects of brain water, electrolyte, carbohydrate, amino acid, urea, and energy metabolism in normal suckling-weanling mice. One hour after treatment, salt-treated mice were critically ill, while the behavior of urea-treated animals could not be distinguished from that of controls. This clinical difference could not be explained on the basis of differences in plasma osmolality, the brain water content, or the degree of hemorrhagic encephalopathy. The injection of NaCl induced a 14-fold increase in plasma insulin and a progressive fall in the plasma glucose concentration (a reduction of 66% at 1 hr). In contrast, plasma glucose levels in urea-injected mice were unchanged. Prior to the fall in plasma glucose levels, metabolite changes in the brains of NaCl-injected mice were compatible with facilitation of transfer of glucose from the blood to the brain, increased metabolic flux in the Embden-Meyerhof and Krebs citric acid cycle pathways, and increased energy production. With the exception of the glucose content (unchanged), similar metabolite changes were seen in brain soon after urea injection. In the brains of the hypoglycemic NaCl-treated mice, glucose levels were reduced 80%, and glycogen 41%. Other metabolite changes were compatible with decreased glycolysis and metabolic flux through the Krebs citric acid cycle. In contrast, with few exceptions, at a similar time after injection, metabolite levels had returned to normal in the urea-treated mice. Permeability of the brain to urea was also examined. Brain urea reached high levels at 2 hr but returned to near baseline at 6 hr. Both hyperosmolar solutions increased the brain content of aspartic and glutamic acids 1 hr after injection. The failure of hypoglycemic mice with hypernatremia and elevated plasma osmolality (range, 416-434 mOsm/kg H2O) to respond to 1 M glucose (30 ml/kg) may have been due to the ill effects of the additional hyperosmolar load. The possibility remains that the encephalopathy induced by hyperosmolar NaCl, but not by hyperosmolar urea, is in some way related to the sudden elevation of brain Na+ and/or Cl- ions. PMID- 3508239 TI - Cerebral metabolic effects of organophosphorus anticholinesterase compounds. AB - Rats treated intravenously with an organophosphorus anticholinesterase compound, paraoxon or soman, were sacrificed 2 to 131 min later, using 0.7 sec of focused microwave irradiation (25 kW at 915 MHz). Brain regional rates of glucose utilization during 3-min intervals were determined with labeled glucose and fluorodeoxyglucose as tracers. Levels of glucose, lactate, ATP, and creatine phosphate were assayed in the same samples. The two compounds differed markedly in their effects on brain metabolism. Paraoxon (0.8 LD50) depressed rates of glucose use in all brain regions, without causing consistent changes in brain metabolite levels. This depressant effect was most pronounced during the first 30 min after toxin exposure and had largely disappeared by 2 hr. Soman (0.8-0.95 LD50) was variable in its effects. Animals that showed seizure-like behavior had marked increases in glucose use in diencephalon and cerebrum but no changes in cerebellum or brain stem. Rapid rates of glucose use were associated with high levels of lactic acid and lower levels of creatine phosphate. In cerebrum, but not diencephalon, levels of ATP fell by as much as 50% in strongly affected animals by 30-130 min after soman. All of these effects were reversible with atropine. Soman-treated animals that did not have seizure-like activity did not exhibit these brain metabolic changes. These results and those of others show that cholinergic compounds vary greatly in their effects on brain glucose and energy metabolism. Although noncholinergic mechanisms are a possibility, the most parsimonious explanation for these findings is that cholinesterase inhibitors vary in their affinity for different central nervous system (CNS) acetylcholine receptor populations. PMID- 3508240 TI - Dietary supplementation of undernourished rats with soy or safflower oil: effects on myelin polyunsaturated fatty acids. AB - Undernourished suckling rats were administered, by gastric intubation, either soy oil (which is rich in both linoleic and linolenic acids) or safflower oil (which is rich in linoleic acid but deficient in linolenic acid) to determine (1) if dietary supplementation would offset the hypomyelination characteristic of the undernourished, developing brain and (2) to compare myelin fatty acids in normal, undernourished, and oil-supplemented rats. Myelin recovery was not increased by supplementation with either oil. The proportions of C22:4 and C22:6 fatty acids were reduced in myelin of the undernourished rats. Undernourished rats supplemented with either soy or safflower oil had higher than normal proportions of polyunsaturated fatty acids (C20:4 and C22:6). The triene-tetraene ratio in the oil-supplemented rats was lower than in normal controls, indicating that the oil-supplemented rats were not deficient in essential fatty acids. No significant differences were observed between the oil-supplemented groups. PMID- 3508241 TI - Restraint stress during late pregnancy in rats elicits early hypermyelination in the offspring. AB - Female rats were subjected to a regular, daily schedule of 2 hr of restraint stress during the final 6 days of pregnancy. During the first 2 postnatal weeks, adrenal weights were greater than normal in the offspring of the stressed dams. The concentration of brain myelin was higher than control at 14 and 21 days of age but similar to normal by day 40. Early hypermyelination may be partly responsible for early motor development, as previously observed in prenatally stressed rats. PMID- 3508242 TI - Regional metabolite profiles in early stages of global ischemia in the gerbil. AB - The present experiments were designed to determine the short-term regional changes in the cyclic nucleotides, certain glucose metabolites, high-energy phosphates, gamma-aminobutyric acid (GABA), glutamate, and glutamine in the gerbil brain following bilateral ligation of the common carotid arteries. The brains of the animals were microwaved at 20, 40, 60, 90, 120, and 300 sec of ischemia and the metabolites were measured in the cerebral cortex, hippocampus, and striatum. There were significant decreases in ATP, P-creatine, and glucose within the first 20 sec of ischemia in all three regions examined, whereas the increases in phosphate and lactate, as well as the loss of glycogen, were evident only after 40 sec of ischemia. The high-energy phosphates were essentially depleted (less than 15% of control values) in all three regions by 2 min of ischemia, indicating that the energy imbalance elicited by ischemia was comparable in the three regions. In contrast, the magnitude of the changes in the cyclic nucleotides was greater in the hippocampus than in the cerebral cortex or striatum. In addition, the decrease in cyclic GMP levels at 20 sec of ischemia preceded the increases in cyclic AMP observed at 40 sec in all three regions. The use of microwave irradiation to fix the gerbil brains not only provides a more accurate assessment of the time course of the metabolite changes but also permits studies on the deeper regions of the brain than is possible with freezing techniques. PMID- 3508244 TI - Synthesis and acylation of myelin proteolipid protein in quaking mouse brain. AB - The synthesis and acylation of proteolipid proteins where investigated in tissue slices prepared from 19-day-old quaking and normal littermate mouse brain. The mutant CNS had a normal rate of total protein synthesis but synthesis of the myelin-specific proteins, proteolipid protein (PLP) and intermediate protein (IP), was impaired to approximately 50% of control. The acylation of myelin proteins with labeled palmitate was reduced to only about 20% of control. The acylation of two nonmyelin proteolipid proteins was also significantly reduced. The incorporation of palmitate into phospholipids was identical in control and mutant. The results indicate impaired synthesis of PLP and IP and a general deficit in protein acylation in quaking brain. PMID- 3508243 TI - Cerebral aminoacids in portal-systemic encephalopathy: lack of evidence for altered gamma-aminobutyric acid (GABA) function. AB - Construction of an end-to-side portocaval anastomosis in the rat resulted, 4 weeks later, in sustained hyperammonemia and two- to threefold increases in brain ammonia. Measurement of cerebral amino acids using a sensitive double-isotope dansyl microtechnique revealed substantial increases in the glutamine content of cerebral cortex and brain stem. Glutamate levels were found to be concomitantly reduced in both brain regions compared to those of sham-operated controls. The gamma-aminobutyric acid (GABA) content of cerebral cortex and brain stem was unaffected by portocaval shunting, as were activities of the GABA nerve-terminal marker enzyme glutamic acid decarboxylase (GAD). These findings suggest that impaired GABA function may not play a major role in the pathogenesis of hepatic encephalopathy associated with portocaval shunts. Preliminary evidence suggests that decreased cerebral glutamate may reflect its loss from the releasable (neurotransmitter) pool. PMID- 3508245 TI - Modulation of ischemic-induced damage to cerebral adenylate cyclase in gerbils by calcium channel blockers. AB - It has been previously established that prolonged bilateral carotid occlusion followed by recirculation produces damage to the synaptic enzyme adenylate cyclase in the frontal cortex of the gerbil. Since calcium entrance into the brain may account in part for the deleterious consequences of stroke, the present study examined whether pretreatment with calcium channel blockers would modify the effects of 60 min of bilateral ischemia plus 40 min of reflow on various parameters of cortical adenylate cyclase activation. In this context activation of cerebral homogenates by norepinephrine with or without 5'-guanylyl imidodiphosphate was preserved by pretreatment of ischemic gerbils with verapamil but worsened by flunarizine. In contrast, in particulate fractions (treated with EGTA to reduce metallic ion levels) the damage to the Mn2+-sensitive catalytic site of adenylate cyclase was prevented only by flunarizine. Pretreatment with the two calcium channel blockers resulted in an elevated basal activity of the enzyme, thereby reducing the response in the homogenate preparation to forskolin. Gerbils pretreated with verapamil tended to have an increased ability for survival resulting from the ischemic episode. Under in vitro conditions the enzyme preparations were not markedly influenced by either drug. PMID- 3508246 TI - Energy metabolism in delayed neuronal death of CA1 neurons of the hippocampus following transient ischemia in the gerbil. AB - The delayed death of CA1 neurons in the gerbil has been reported to occur at 4 days of reflow following 5 min of bilateral ischemia. Samples of the CA1 and CA3 somal region of the hippocampus, as well as of the parietal cortex, were dissected from frozen dried sections of gerbil brains frozen in situ between 1.5 and 96 hr of reflow following 5 min of bilateral ischemia and the concentrations of the adenylates, P-creatine, glucose, glycogen, and lactate were determined. The values for high-energy phosphates were restored by 1.5 hr of recirculation in all three regions and remained at or above control in the CA3 region and cortex for up to 96 hr. In contrast, the P-creatine and ATP decreased in the CA1 region at 48 and 96 hr of reflow, respectively. The total adenylates also decreased in the CA1 region at 96 h, but the normal energy charge in this area indicated that the surviving tissue was metabolically viable. A glucose overshoot was exhibited in the three regions at all time periods except 6 and 96 hr. At 6 hr of reflow, there was a transient return of glucose levels toward those of control. By 96 hr, the glucose in the CA3 region and cortex was not significantly different from control but was elevated in the CA1 region. The lactate levels were depressed from 1.5 to 12 hr of recirculation in all areas, but the decrease was significant only in the cerebral cortex. The concentration of glycogen was significantly elevated at 6 hr in all regions, then was restored by 24 to 48 hr, only to increase once again in the affected CA1 region. The results clearly indicate that metabolic perturbations persist for long periods of time after ischemic durations that are compatible with the survival of the animal but that the loss of the CA1 neurons cannot be attributed to a failure in energy metabolism. PMID- 3508248 TI - Intramural diverticulosis simulating aphthous ulceration of the colon. PMID- 3508247 TI - Glucose metabolism in human gliomas: correspondence of in situ and in vitro metabolic rates and altered energy metabolism. AB - The rates of disappearance of glucose from the medium of 13 human glioma-derived cell lines and one cultured of normal human cortical astrocytes were determined by fluorometric techniques. High-grade glioma-derived cultures showed a range of glucose consumption between 1 and 5 nmol/min/mg protein. Normal astrocyte cultures and cultures derived from grades I-III gliomas had a glucose consumption rate of 2-3 nmol/min/mg protein. Seven high-grade glioma lines were derived from surgical samples taken from patients who had been scanned by 18F-2-deoxy-d glucose positron computed tomography. The rate of glucose consumption in these high-grade glioma-derived lines was close to the maximum local cerebral metabolic rate for glucose (LCMRglc) measured in situ in the tumors from which the cultures were derived. In cultured glioma-derived lines, approximately one-half of the glucose consumed was recovered as lactate and pyruvate, suggesting a reliance of glioma cells on aerobic glycolysis. ATP and phosphocreatine (PCr) levels were variable in the glioma-derived lines, and ATP was lower in the glioma-derived lines than in the normal astrocytes. Levels and regulation of glycogen differed significantly among the various glioma-derived cell lines. Glycogen content did not diminish as glucose was consumed, suggesting that glycogen utilization is not tightly regulated by the glucose metabolic rate. These results suggest that human glioma-derived cell cultures (1) adequately reflect the metabolic capacity of gliomas in situ and (2) are significantly altered in several aspects of their glycolytic metabolism. PMID- 3508249 TI - Patient recall systems. PMID- 3508250 TI - Pediatrics, hemophilia and AIDS. PMID- 3508251 TI - Postponing the December of life. PMID- 3508252 TI - Practice information book cuts phone calls, patient irritation. PMID- 3508253 TI - Delayed postoperative pericardial tamponade. PMID- 3508254 TI - Acute alcoholic myopathy and ruptured popliteal cysts. The pseudothrombophlebitis syndrome revisited. PMID- 3508255 TI - Voice your opinion on HB 1596. PMID- 3508256 TI - Reporting communicable diseases provided by the Missouri Department of Health. PMID- 3508257 TI - The doctor-patient relationship. PMID- 3508258 TI - Recognizing common innocent heart murmurs in infants and children. PMID- 3508259 TI - Colonic intrahepatic fissural herniation and hepatodiaphragmatic interposition. Significance and diagnosis. PMID- 3508260 TI - Hybrid formation within the genus Leishmania? AB - Leishmanial organisms isolated from a desert rodent (Psammomys obesus) and a feral dog (Canis familiaris) in the Eastern Province of Saudi Arabia were isoenzymically distinct from Leishmania major and L. arabica, organisms usually associated with human and wild animal cutaneous leishmaniasis in this area. Further examination of isoenzyme banding patterns of cloned populations of these organisms, together with karyotyping using orthogonal field alternation gel electrophoresis and the use of highly specific kinetoplast DNA probes, has produced evidence suggesting that these organisms isolated from the dog and the rodent are hybrids of L. major and L. arabica. PMID- 3508261 TI - Breeding places of Phlebotomus ariasi in the cevennes focus of leishmaniasis in the south of France. AB - In a search for sandfly breeding sites in the Cevennes, France, six larvae of Phlebotomus ariasi were found in rotted manure in a cellar housing goats, and six adult flies of the same species were collected from emergence traps, one in the same cellar and five on a disused refuse dump. No sandflies were found emerging from holes of long-tailed field mice (Apodemus spp.) and no sandfly larvae were extracted from 77 kg (dry weight) and 130 kg (undried weight) of samples of soil or litter from different places. Total catches and the proportions of male flies in CDC miniature light traps were much higher in peridomestic than silvatic stations. About 15% of males caught in 3 peridomestic stations had unrotated genitalia. It is concluded that the larval breeding sites of P. ariasi are probably peridomestic and have a high content of organic matter. Observations on colonized P. ariasi show that, although immature stages of this fly need moisture, their requirements are comparatively low. It is suggested that female P. ariasi choose oviposition sites by sensing the presence of immature stages already in an optimal place. PMID- 3508262 TI - Adult behaviour of members of the Anopheles gambiae complex in the Gambia with special reference to An. melas and its chromosomal variants. AB - Polytene chromosome studies on the member species of the Anopheles gambiae complex in The Gambia and surrounding areas in Senegal led to comparative observations on bionomics of sympatric populations of An. melas and An. gambiae. Moreover, inversion polymorphisms have been analyzed in An. melas and their possible relationships with behavioural variations in endophily and anthropophily have been considered. An. melas shows a remarkably short dispersal from typical larval breeding places associated with mangrove swamps and it is definitely more zoophilic and exophilic than An. gambiae. Only a very small fraction of An. melas biting outdoor on animals rests indoors and consequently the human blood index is largely overestimated if based on the examination of house samples alone. Differences in the frequencies of 2Rn inversion karyotypes of An. melas were observed between parallel samples obtained from animal shelters and houses, from night catches on man outdoor and from night catches on main indoor and on animal outdoor. Further differences were shown by blood meal identification between human and animal fed subsamples from the same house resting samples. Non-uniform feeding and/or resting behaviour between carriers of alternative 2Rn inversion karyotypes is postulated to explain these data. PMID- 3508263 TI - Theory-based intervention: a case study using Sullivan's interpersonal theory of psychiatry. AB - The essence of the schizophrenic dynamism is a confusion in the interpersonal relations by the appearance in awareness of referential processes ordinarily excluded from awareness (Sullivan, 1956; 361). Its etiology can be traced to a pathological symbiotic relationship with the mothering one in which there is an overwhelming degree of anxiety transmitted to the infant. A consistent, frequent, nonthreatening and non-demanding approach is the basis for all nursing interventions. The emphasis of treatment is on identifying and strengthening the patient's assets and raising self-esteem. Interventions are directed toward the patient's resocialization and reality-testing. Staff effort is required to create a milieu in which it is desirable and possible for patients to learn autonomy. Patients should be encouraged to look at their feelings in the light of their past experiences, but with a recognition that the past is over and beyond their control. What happens in the future depends on their efforts now. Finally, nurse therapists need to be secure, thoughtful, and empathic in treating schizophrenic patients. The challenge for staff is to be absolutely consistent and communicate acceptance and positive regard whatever the patients' behavior. PMID- 3508264 TI - A guide to photography in educational and counseling settings. PMID- 3508265 TI - Depression: it happened to me! PMID- 3508266 TI - The role of the faculty-nurse ombudsman for nursing students. PMID- 3508267 TI - Alzheimer's disease and psychiatric nursing: treating the depression. PMID- 3508268 TI - Patient musturbation: a challenge for the psychiatric nursing community. PMID- 3508269 TI - Signs and symptoms of depression and principles of nursing intervention. AB - Depression is a universal experience, which affects approximately 15 percent of the population at any one time. Depression can be conceptualized as occurring on a continuum from first-level transitory to middle-level to severe-level depression. It involves an alteration in mood characterized by feelings of sadness and loss of interest or pleasure in all, or almost all, the client's usual activities and pastimes. Alterations in thought, motor activity, somatic sensations, and social relationships are also associated with depression. Severe depression can also be associated with delusional thought patterns. Finally, depression can vary in length of duration; it can be transitory and short-lived or ongoing and chronic. Assessment of individual, family, and community factors is important in identifying the factors relevant to planning individualized care for the depressed client and his/her family. Nursing diagnosis includes problems of low self-esteem, feelings of despondency, suicidal thoughts/impulses, and vegetative signs of depression. Nursing interventions are guided by certain principles, and are best evaluated when expected client behaviors have been projected. In conclusion, the overwhelming majority of those who experience depression recover and achieve a higher level of wellness than before the depression; that is, if they use the opportunity to develop a more realistic view of self, others, and their world relationships. PMID- 3508270 TI - The "holiday blues" as a stress reaction. PMID- 3508271 TI - The dysthymic patient. PMID- 3508272 TI - Patient suicide: its impact on the therapeutic milieu of a psychiatric unit. PMID- 3508273 TI - Divisionistic generation of skin hue and the change of shade in the scalycheek damselfish, Pomacentrus lepidogenys. AB - In addition to melanophores and xanthophores, there existed two types of iridophore in the dermis of the scalycheek damselfish, Pomacentrus lepidogenys. There are dendritic iridophores which reflect white light-rays by Tyndall scattering, and the round or somewhat ellipsoidal iridophores which reflect rays with a relatively narrow spectral peak from blue to green through the non-ideal thin-film interference. Most of the dendritic iridophores were covered with xanthophores and were situated over melanophores, thus constituting a kind of chromatophore unit which produces a yellow or yellowish-green color. The characteristic yellowish-green hue of the integument results from a compound effect of small contributions by more elementary colors. During color changes of the skin, the position of the spectral peak does not shift. Unlike the iridophores of the blue damselfish, both types of iridophore of the scalycheek damselfish were found to be inactive. It appears, therefore, that the aggregation and dispersion of pigment within the melanophores is the primary mechanism responsible for the changes in color of this species. PMID- 3508274 TI - Eumelanin causes DNA strand breaks and kills cells. AB - Synthetic eumelanin prepared by autooxidation of D,L-DOPA causes DNA strand breaks, as determined by alkaline elution after cell lysis with detergent and proteolysis, in B16CL4 mouse melanoma cells. The melanin is toxic to the cells in the range of doses that causes strand breaks. When the melanin was incubated with the cells at 37 degrees C in tissue culture medium, it was maximally effective after 15 to 20 min at causing strand breaks in the DNA. The extent of damage is concentration dependent, but the effect plateaus at 1 mg/ml. The nature of the interaction of the cellular DNA with melanin is consistent with strand breaks, not DNA-DNA crosslinks. The strand break damage is repaired, even in the continued presence of melanin, but repair is more rapid if the cells are washed and the melanin is removed. The form of the melanin is important for obtaining the effect. Sonication for 3 min abrogates the effect to a considerable extent, and repeated cycles of sonication can completely destroy the activity. Lost activity returns slowly with storage at 4 degrees C. Melanin is more effective at damaging DNA in a protein-free medium. It is also DNA-damaging at 4 degrees C, but less so than at 37 degrees C. Preliminary studies indicate that the strand breaks caused by melanin are additive with those caused by ionizing radiation. The extent of DNA strand breaks and alkali-labile sites caused by several other melanins was also determined. Some melanins did not cause frank strand breaks, but were active in causing alkali-labile sites.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3508275 TI - Migration of epidermal melanophores to the dermis through the basement membrane during metamorphosis in the frog, Rana japonica. AB - The number of epidermal melanophores of the skin decreases dramatically during metamorphosis in the frog, Rana japonica. This decrease may represent an adaptation for rapid color change, a property which the animal acquires after metamorphosis. We concluded that the decrease was due to the migration of epidermal melanophores to the dermis. Epidermal melanophores and epidermal cells are tightly associated with each other in the young tadpole. The association becomes looser at the metamorphic stage and, occasionally, small breaks in the basement membrane are seen. These breaks may facilitate the migration. The migration was observed exclusively at the metamorphic stage, in spite of careful observation of other stages under the electron microscope. The migration of epidermal melanophores was induced by treatment with thyroxine of cultured skin from tadpoles at stage 15, and this hormone may act directly on epidermal melanophores. Until now, the increase in the number of dermal melanophores during metamorphosis has been explained by the differentiation of dermal melanophores from melanoblasts and by their mitotic division. Our results show that the migration of epidermal melanophores to the dermis may be a factor which accounts for the increase in the number of dermal melanophores. PMID- 3508277 TI - Melanophore differentiation in the periodic albino mutant of Xenopus laevis. AB - That embryonic ventral truck tissue might play a role in expression of the periodic albino mutant phenotype (ap/ap) in Xenopus laevis was suggested from the experiments of MacMillan (1980). In contrast, the present experiments, involving the culture of isolated regions of Xenopus embryos, have demonstrated that both mutant and wild-type melanoblasts differentiate independently of a ventral trunk factor. A similar conclusion, that mutant melanoblasts differentiate independently of a ventral trunk factor, is derived from observations on neural crest cultures, wherein melanization of neural crest cells in both wild-type and mutant cultures occurred in a manner consistent with their genotype. PMID- 3508276 TI - Studies on cellular adhesion of Xenopus laevis melanophores: modulation of cell cell and cell-substratum adhesion in vitro by endogenous Xenopus galactoside binding lectin. AB - We have investigated cell-cell and cell-substratum adhesion of Xenopus laevis neural crest cells at various stages of melanophore differentiation. Single-cell suspensions were obtained by trypsinization and aggregated in a cell-cell adhesion assay. Unpigmented cells did not adhere while the rate of adhesion of melanophores correlated with the degree of melanization. Melanophore cell-cell adhesion decreased significantly in the presence of beta-galactosidase, which suggests that cell-surface galactose is involved. Beta-galactoside-binding lectin has been isolated and purified from embryos at the stage of neural crest migration. When added to aggregating cells smaller, looser clusters formed compared to controls. When lectin was added to cells in stationary culture to test cell-substratum adhesion, melanophores spread more smoothly and formed more regular spacing patterns. These results suggest that this lectin can modulate receptors used in cell-cell and cell-substratum adhesion of melanophores. PMID- 3508278 TI - Observations on the pigmentation of the pigeon iris. AB - There are three genetically controlled iris types found in the pigeon, two of which contain stromal pigment cells, the third lacks pigment cells. The yellow (gravel) and white (pearl) iris types have pigment cells that contain birefringent pigment granules (crystals) and are ultrastructurally similar to iridophores of poikilothermic vertebrates. Both these iris types contain guanine as a major "pigment" and, in addition, the yellow iris contains at least two yellow fluorescing pigments that are tentatively identified as pteridines. The pigment cells of the yellow and white irises are structurally identical differing only in the presence or absence of these yellow pigments. The stromal pigment cells of the white iris correspond in structure and pigment chemistry to classical iridophores although they lack strong irridescence and are therefore perhaps best considered leucophores. The pigment cells of the yellow iris can be considered "reflecting xanthophores" having the combined properties of both classical xanthophores and iridophore/leucophores. PMID- 3508279 TI - An algorithm for protein secondary structure prediction based on class prediction. AB - An algorithm has been developed to improve the success rate in the prediction of the secondary structure of proteins by taking into account the predicted class of the proteins. This method has been called the 'double prediction method' and consists of a first prediction of the secondary structure from a new algorithm which uses parameters of the type described by Chou and Fasman, and the prediction of the class of the proteins from their amino acid composition. These two independent predictions allow one to optimize the parameters calculated over the secondary structure database to provide the final prediction of secondary structure. This method has been tested on 59 proteins in the database (i.e. 10,322 residues) and yields 72% success in class prediction, 61.3% of residues correctly predicted for three states (helix, sheet and coil) and a good agreement between observed and predicted contents in secondary structure. PMID- 3508280 TI - The design of a biochip: a self-assembling molecular-scale memory device. AB - A design for a biochip memory device based on known materials and existing principles is presented. The fabrication of this memory system relies on the self assembly of the nucleic acid junction system, which acts as the scaffolding for a molecular wire consisting of polyacetylene-like units. A molecular switch to control current is described which is based on the formation of a charge-transfer complex. A molecular-scale bit is presented which is based on oxidation-reduction potentials of metal atoms or clusters. The readable 'bit' which can be made of these components has a volume of 3 x 10(7) A3, and should operate at electronic speeds over short distances. PMID- 3508281 TI - The determination of the three-dimensional structure of barley serine proteinase inhibitor 2 by nuclear magnetic resonance, distance geometry and restrained molecular dynamics. AB - The solution structure of the 64 residue structured domain (residues 20-83) of barley serine proteinase inhibitor 2 (BSPI-2) is determined on the basis of 403 interproton distance, 34 phi backbone torsion angle and 26 hydrogen bonding restraints derived from n.m.r. measurements. A total of 11 converged structures were computed using a metric matrix distance geometry algorithm and refined by restrained molecular dynamics. The average rms difference between the final 11 structures and the mean structure obtained by averaging their coordinates is 1.4 +/- 0.2 A for the backbone atoms and 2.1 +/- 0.1 A for all atoms. The overall structure, which is almost identical to that found by X-ray crystallography, is disc shaped and consists of a central four component mixed parallel and antiparallel beta-sheet flanked by a 13 residue alpha-helix on one side and the reactive site loop on the other. PMID- 3508282 TI - Comparison of the solution and X-ray structures of barley serine proteinase inhibitor 2. AB - A comparison of the solution n.m.r. structures of barley serine protease inhibitor 2 (BSPI-2) with the X-ray structures of both subtilisin complexed and native BSPI-2 is presented. It is shown that the n.m.r. and X-ray structures are very similar in terms of overall shape, size, polypeptide fold and secondary structure. The average atomic rms difference between the 11 restrained dynamics structures on the one hand and the two X-ray structures on the other is 1.9 +/- 0.2 A for the backbone atoms and 3.0 +/- 0.3 A for all atoms. The corresponding values for the restrained energy minimized mean dynamics structure are 1.5 and 2.4 A, respectively. PMID- 3508283 TI - Protein surgery. PMID- 3508284 TI - The prediction of helix-turn-helix DNA-binding regions in proteins. PMID- 3508285 TI - Prediction of DNA-binding regulatory proteins in bacteriophage T7. AB - The high-resolution structure of several specific DNA-binding proteins have been determined, and they display a common structural motif which mediates their binding to DNA. This motif consists of two alpha-helices connected by a sharp turn, and its amino acid sequence has several distinguishing features. A computer search of the proteins coded by the genome of bacteriophage T7 has been performed in an attempt to identify those proteins that potentially contain this motif. Eight proteins were found to have regions similar to that of the motif. Of these, three are relatively small, have no known function and are good candidates for being DNA-binding regulatory proteins. The methods described use commonly available computer programs and databases, and are therefore easy to implement. PMID- 3508286 TI - Knowledge based modelling of homologous proteins, Part I: Three-dimensional frameworks derived from the simultaneous superposition of multiple structures. AB - An approach is described for modelling the three-dimensional structure of a protein from the tertiary structures of several homologous proteins that have been determined by X-ray analysis. A method is developed for the simultaneous superposition of several protein molecules and for the calculation of an 'average structure' or 'framework'. Investigation of the convergence properties of this method, in the case of both weighted and unweighted least squares, demonstrates that both give a unique answer and the latter is robust for an homologous family of proteins. Multi-dimensional scaling is used to subgroup of the proteins with respect to structural homology. The framework calculated on the basis of the family of homologous proteins, or of an appropriate subgroup, is used to align fragments of the known protein structures of high sequence homology with the unknown. This alignment provides a basis for model building the tertiary structure. Different techniques for using the framework to model the mainchain of various globins and an immunoglobulin domain in the structurally conserved regions are investigated. PMID- 3508287 TI - Knowledge based modelling of homologous proteins, Part II: Rules for the conformations of substituted sidechains. AB - This paper describes a rapid, automated procedure which can be used for model building sidechains using (i) spatial information from sidechains in topologically equivalent positions as far as such a correlation is observed, and then (ii) most probable conformations of the sidechains in the respective secondary structure type. Analysis of topologically equivalent residues in the structurally conserved regions of a family of proteins implies that the spatial positions of the atoms in the sidechains rather than conformations should be considered when model building. Rules for the modelling of all 20 side-chains from each other in alpha-helical, beta-sheet and loop regions--a total of 1200- are established. Cluster analysis is used on positional data from the sidechain atoms of structurally equivalent residues in an homologous family to guide modelling. The most probable conformation for the sidechain is used for modelling atoms where no useful guidance is obtainable from equivalent sidechains of the homologous proteins. In order to test the procedure we have modelled the sidechains of the residues in the structurally conserved regions of myoglobin from four other globins. The automated procedure described here has been incorporated into the program COMPOSER. PMID- 3508289 TI - Artifacts in the application of linear free energy analysis. PMID- 3508288 TI - Structural identity between the iron- and manganese-containing superoxide dismutases. AB - We have recently reported the first complete amino acid sequence of an iron containing superoxide dismutase. The iron enzyme is thought to be closely homologous to the manganese-containing superoxide dismutases. The availability of complete amino acid sequence information for four manganese superoxide dismutases and the crystal structures for two iron and two manganese superoxide dismutases prompted us to investigate the degree of homology between the two proteins at various levels. We report that it is not possible to clearly distinguish the two proteins on the basis of their secondary or tertiary structures. It would appear that a small number of single site substitutions are responsible for conferring distinguishing properties between the two proteins. Substitution of glycine 77 and glutamine 154 by a glutamine and an alanine respectively in Photobacterium leiognathi iron superoxide dismutase may distinguish the kinetic and other particular properties of this protein from the manganese protein (and other iron superoxide dismutases). Furthermore the primary structure of both the iron and manganese proteins does not appear to have any homology with any other known amino acid sequence. PMID- 3508290 TI - Linear free energy relationships are valid! PMID- 3508291 TI - Linear free energy relationships are valid; using plots of log k versus log (k/k') to prove their existence is not. PMID- 3508292 TI - Patentability of engineered proteins. PMID- 3508293 TI - The 3.0 A crystal structure of xylose isomerase from Streptomyces olivochromogenes. AB - The crystal structure of xylose isomerase [E.C. 5.3.1.5] from Streptomyces olivochromogenes has been determined to 3.0 A resolution. The crystals belong to space group P22(1)2(1) with unit cell parameters a = 98.7, b = 93.9, c = 87.7. The asymmetric unit contains half of a tetrameric molecule of 222 symmetry. The two-fold axis relating the two molecules in the asymmetric unit is close to where a crystallographic two-fold would be if the space group were I222. This causes the diffraction pattern to have strong I222 pseudo-symmetry, so all data were collected in this pseudo-space group. Since the sequence of this enzyme has not been reported, a polyalanine backbone has been fitted to the electron density. Xylose isomerase has two domains: the N-terminal domain is an eight-stranded alpha/beta barrel of 299 residues. The C-terminal domain is a large loop of 50 residues which is involved in intermolecular contacts. Comparison of xylose isomerase with the archetypical alpha/beta barrel protein, triose phosphate isomerase, reveals that the proteins overlap best when the third (alpha beta) strand of xylose isomerase is superimposed on the first (alpha beta) strand of triose phosphate isomerase. This same overlap has also been found between the muconate lactonising enzyme and triose phosphate isomerase [Goldman et al. (1987) J. Mol. Biol., in press]. PMID- 3508294 TI - Comparison of backbone structures of glucose isomerase from Streptomyces and Arthrobacter. AB - The C alpha backbones of the glucose isomerase molecules of Streptomyces rubiginosus and Arthrobacter have been determined by X-ray crystallography and compared. Each molecule is a tetramer of eight-stranded alpha/beta barrels, and the mode of association of the tetramers is identical in each case. The Arthrobacter electron density shows four additional amino acids at the carboxyl terminus. There is also an insertion of six amino acids at position 277, and two individual insertions at about positions 348 and 357 (numbering according to the Streptomyces structure). There is a close structural homology throughout the whole molecule, which is most accurate up to position 325. The r.m.s. displacement for 315 homologous C alpha positions up to this position is 0.92 A. PMID- 3508295 TI - Relationship of protein flexibility to thermostability. AB - Thermostability of proteins arises from the simultaneous effect of several forces, which in fact lead to decreased flexibility of the polypeptide chain. This is verified by flexibility indices, which are derived from normalized B values of individual amino acids in several refined three-dimensional structures. Flexibility indices show that overall flexibility is reduced when thermostability is increased. Protein molecules require both flexibility and rigidity to function, but the higher the temperature optimum and stability the more rigid is the structure needed to compensate for increased thermal fluctuations. Flexibilities of proteins performing the same catalytic activity seem to be about the same at their temperature optima, but the more rigid thermostable proteins reach the flexibility of thermolabile proteins at higher temperatures. In several proteins such as allosteric enzymes, some local sites of flexibility are highly conserved. The relevance of reduced flexibility to overall stability of proteins is also discussed. Flexibility indices and profiles can be used in the design of more stable proteins by site-directed mutagenesis. PMID- 3508296 TI - Expression in COS cells of a mouse-human chimaeric B72.3 antibody. AB - B72.3 is a mouse hybridoma cell-line secreting an IgG1 antibody which recognises an epitope on a tumour-associated antigen, TAG-72. This high molecular weight mucin-like molecule is found on a variety of human neoplasms, including colon, breast and ovarian carcinomas. Chimaeric immunoglobulin genes with the B72.3 specificity have been constructed by joining the mouse variable regions from cDNA clones to human genomic constant regions using recombinant DNA techniques. The chimaeric heavy and light chain immunoglobulin genes were placed under the control of a strong viral promoter, and co-transfected into COS-1 cells. SDS-PAGE analysis of the 35S-labelled products demonstrated that the transiently expressed antibodies were correctly synthesised and assembled. The specific binding characteristics of the parent B72.3 antibody were retained by the chimaeric antibody in an antigen-based ELISA. This system gave sufficiently high transient expression of the chimaeric antibody molecules to allow rapid physical and immunological characterisation of the engineered gene products. PMID- 3508297 TI - [Bile salts, copper, ceruloplasmin in meal test]. AB - Biliary salts determination after meal test is an useful liver function test. We evaluated both biliary salts and copper-ceruloplasmin after meal test in different liver diseases. Copper-ceruloplasmin determination does not seem to be useful in the diagnosis of liver diseases because copper has only partial hepatic clearance. PMID- 3508298 TI - [Cervico-vaginal pathogens and contraception: microbiological observations]. AB - The authors relate the results about 172 vaginal and cervical swabs, in women with or without oral/local (IUD) contraception, with or without vaginosis/vaginitis. Gardnerella vaginalis was always prevalent; the authors observed an high correlation between cervical IUD and vaginal Gardnerella, more than IUD and cervical Chlamydia trachomatis. Bacterial associations in Gardnerella vaginalis (Mobiluncus, obligate anaerobes) are related; incidence of Candida and Trichomonas vaginalis are reported; correlation between these microbial agents and contraception are discussed. PMID- 3508299 TI - [Hyperglycemia in acute myocardial infarct]. AB - The author values with the glycosylated haemoglobin assay if the hyperglycaemia during acute myocardial infarction is due to the myocardial necrosis or is, on the contrary, a signal of undiagnosed diabetes. PMID- 3508300 TI - [Computerized management of information in the microbiology section of a hospital laboratory. Personal experience]. AB - We installed in our microbiology laboratory a new computerized management system with a dedicated software for the needs of the department. The system allow us to give to the clinician the reports of microbiological data in a shorter time and to store them permanently. The computer system doesn't modify the existing organization of work, samples acceptance, execution of microbiological and serological tests and the report of the results, but make them faster, safer and more efficient. The system also shows the possibilities of epidemiological researches and statistical studies. These data are very interesting and useful for the relationship between the laboratory and general wards. PMID- 3508301 TI - [Frequency of microalbuminuria in children]. AB - Urinary samples overnight collected from 550 pediatric patients with normal urine analysis and normal serum levels of creatinine, urea and glucose were tested for the presence of microalbuminuria by a latex test. Only 3 cases (0.6%) were positive even with RIA method; the difference with the percentage observed in adults (4.5%) is highly significant. PMID- 3508302 TI - [Evaluation of a latex test for determining the fibrinogen/fibrin D-dimer (XDP)]. AB - In this study an agglutination assay, by a monoclonal antibody coated latex particles, has been used for measuring specifically D-dimer fibrinogen/fibrin concentrations in twenty patients with various thrombotic diseases; the authors have analyzed the test reliability and the possible interferences caused by conditions of specimens collection and preparation. PMID- 3508303 TI - [Associated hepatitis B virus forms and analysis of immunologic configurations in histologically typified chronic diseases of the liver. Epidemiologic aspects and development factors]. AB - We report histological aspect of population, expression of middle classes of Lombardia (Italy), affected by hepatomegaly with or without marks of biohumoral compromised. After classification in groups, according to a minutely explained scheme, we investigate the hepatitis B virus (HBV) immunological aspect and the frequency of the several configurations in every group. We have found HBV positive almost half hepatopathies classified as metabolic according to histological features and 70% of the liver cirrhosis without histological signs of inflammation. The immunological shape showed by last group is identical to the shape of the group with typical histological signs of persistent chronic hepatitis. Another epidemiologic factor as age marks the different histological groups and leads to advance hypotheses of consecutiveness. Distribution of the different histological forms with reference to sex allows the same considerations on pathogenetic factors of progression. PMID- 3508304 TI - [Immunoenzymatic test for the study of anti-cardiolipin antibodies. Evaluation of a commercial kit]. AB - ELISA is a sensitive method extensively used to detect anticardiolipin antibodies, but up to now there is no standardization of the assay to make a reliable comparison in the results obtained from various laboratories. For that it appears more useful to use a commercial kit for detecting these antibodies. The authors have carried out a comparison between this commercial kit and an ELISA prepared in laboratory in order to evaluate its usefulness. There is a significant correlation between the two tests, but the ELISA prepared in laboratory reveals more positive cases than the commercial kit. Many factors may explain these different results. PMID- 3508305 TI - [Prevalence of anemia caused by iron deficiency in Mapuchean infants fed breast milk]. PMID- 3508306 TI - [Normal serum concentrations of magnesium and calcium in mothers and their newborn infants]. PMID- 3508307 TI - [Pediatric referral to child psychiatry]. PMID- 3508308 TI - [Is hemophilia a disabling disease?]. PMID- 3508309 TI - [Enteroparasitosis in day care centers in Vallenar]. PMID- 3508310 TI - [Renovascular hypertension in childhood]. PMID- 3508311 TI - [Bartter's disease: why do they get undernourished?]. PMID- 3508312 TI - [Lumbar disk hernia in children]. PMID- 3508313 TI - [Nephrocalcinosis]. PMID- 3508314 TI - [Acute phenol poisoning]. PMID- 3508315 TI - [Embolic cerebral infarct probably of cardiac origin]. PMID- 3508316 TI - [Accidents in school children covered by an accident insurance]. PMID- 3508317 TI - [The foster home as an integral recovery system for undernourished and severely undernourished infants (COFADE program)]. PMID- 3508318 TI - [Post-neonatal mortality in Chile]. PMID- 3508319 TI - Purification and immunological characterization of a soluble antigen of rubella virus by gel precipitation. PMID- 3508320 TI - Comparison of cellular fatty acids composition between Staphylococcus aureus and Staphylococcus aureus subsp. anaerobius. PMID- 3508321 TI - [Microbial kinetics: experiences with Staphylococcus aureus ATCC 25 293 and bacteriostatic drugs]. PMID- 3508323 TI - [Production of solasodine by microbial hydrolysis of the glycoalkaloids of Solanum eleagnofolium Cav. A comparative study with chemical hydrolysis]. PMID- 3508322 TI - [Biotransformation of sugarcane phytosterols into pharmaceutical intermediates]. PMID- 3508324 TI - [Passive agglutination for the diagnosis of cerebral cysticercosis]. PMID- 3508325 TI - Effect of dressing on the microbiological quality of lettuce. PMID- 3508326 TI - Naprosyn (naproxen) after 12 years: a current update on safety. Proceedings of a symposium. Paris (post-EULAR, July 12, 1987). PMID- 3508327 TI - Kidney function during naproxen therapy in patients at risk for renal insufficiency. AB - The effects of naproxen on renal function in 34 patients with minimally elevated serum creatinine (Scr) or subnormal creatinine clearance (Ccr) were evaluated in a parallel-design study. All patients received open-label naproxen 375 mg twice daily for 2 weeks (phase I); patients were then randomly assigned to receive naproxen 750 mg twice daily (n = 26) or to continue naproxen 375 mg twice daily (n = 8) double-blind for an additional 2 weeks (phase II). Renal function was assessed by Scr, Ccr, and BUN measurements at baseline and at the end of each treatment phase. Neither treatment group had a clinically meaningful change in median laboratory values between baseline and the end of phase I, or between baseline and the end of phase II. During the first 2 weeks of treatment with naproxen 375 mg twice daily, there was no change in Scr. At the time of the first Scr measurement following the increase in naproxen dose to 750 mg twice daily, 13 of 26 patients had Scr levels of 1.1 mg/dL or higher, but four days later, only three patients had Scr levels of 1.1 mg/dL or higher, suggesting that a transient increase in Scr may accompany dosage increase. Chronic administration of naproxen 375 mg twice daily in patients at risk for renal insufficiency based on laboratory evidence of renal impairment was not associated with further deterioration in renal function. An increase in dosage to 750 mg twice daily in such patients appeared to be associated with only small, transient changes in laboratory measures of renal function. PMID- 3508328 TI - Naproxen: antirheumatic efficacy and safety in patients with pre-existing gastrointestinal disease. AB - Nonsteroidal antiinflammatory drugs (NSAIDs) effectively reduce pain and inflammation of rheumatoid arthritis (RA). To further refine the appropriate uses of NSAID therapy, NSAIDs have been evaluated for possible gastrotoxicity, particularly in patients who have pre-existing gastrointestinal (GI) disease. In the present study, 58 such RA patients (36 women, 22 men) treated long-term with naproxen were monitored for periods up to 2.5 years to determine if any gastrotoxicity were induced by naproxen. We found an extremely low incidence of fecal occult blood, patient complaints of GI discomfort, complications documented by GI studies, and patient discontinuance of naproxen therapy because of complaints. Studies reported in the medical literature support our observations that naproxen can be well tolerated and is effective as long-term RA treatment when patients who have clinically significant pre-existing GI disease are managed with conventional treatments and appropriate monitoring. PMID- 3508329 TI - Steady state pharmacokinetics of naproxen in young and elderly healthy volunteers. AB - The pharmacokinetic properties of naproxen (375 mg twice daily and 750 mg twice daily) were evaluated in 23 young (age range, 19 to 32 years) and 25 elderly (age range, 65 to 74 years) healthy male volunteers. After an initial screening examination, each subject received 15 doses of naproxen in this double-blind parallel study. Comparison of trough plasma naproxen concentrations (12 hours after each of the last two morning doses) verified steady state and provided no evidence of drug accumulation in either age or dosage group beyond that achieved after seven days of naproxen administration. Plasma naproxen concentrations determined at 0, 0.5, 1, 2, 4, 8, 12, and 24 hours after the final dose revealed no statistically significant differences between age groups, at either dosage, with respect to total area under the 12-hour time-concentration curve or peak plasma naproxen concentrations. Terminal plasma half-life was longer in the elderly group at each dosage, but these differences are probably not clinically important since the steady state area under the curve was similar in the two age groups. There were no statistically significant changes in serum creatinine levels (monitored as an indicator of kidney function) in either group at either dosage. These results suggest that advanced age per se does not alter naproxen pharmacokinetics in any clinically significant way. PMID- 3508330 TI - [What is the significance of posterior boot edge fracture in Alpine skiing?]. AB - Lower leg fractures have decreased in number in alpine skiing since the winter season 1970/71. Yet it seems that the fracture rate remains at a 4% level since 1982/83. In this study we analysed 266 lower leg fractures treated in a period between october 1982 to october 1986 at the Department of Traumatology of the University of Innsbruck. When listing up the various types of lower leg fractures the numerous posterior boot top fractures were evident. These bending fractures with a dorsal wedge make up 82.1 percent of the open lower leg fractures. Radiological evaluation of the fracture type and the personal accident description give evidence of the fall mechanism. The dorsal bending fracture at the crossing of the middle to the distal third of the tibia is caused by a backward fall when the toepiece of today's ski-binding does not release the ski boot in the vertical plane. The high and stiff ski boot has no protective function in a backward fall and the so called "safety effect" of the calf muscles is not effective in such a case. This fracture occurs mainly in the 20 to 25 years age group. To avoid such serious lower leg fractures a toepiece of the ski binding has to be found which releases not only in the transversal plane but also in the vertical plane, that is multidirectionally. PMID- 3508331 TI - [Stress on the Achilles tendon in Alpine skiing]. AB - In an attempt to gain more systematic knowledge of the biomechanical mechanism involved in the genesis of injuries caused by a fall during skiing, we undertook a comprehensive analysis of more than 100 experimental ski falls simulated under controlled conditions. The well-known relation between speed, release time of the ski binding and injury risk of the lower extremity was confirmed by our experimental results. The EMG investigations revealed the central importance of the musculus triceps surae, and hence of the Achilles tendon, during a fall. The results of our biomechanical model indicate that the present method of setting the ski binding according to the tibial strength, is rather questionable, to say the least. PMID- 3508332 TI - [Hand injuries in Alpine skiing]. AB - In the Innsbruck University Clinic for Traumatology during the years 1978-1985, altogether 17,999 patients received initial treatment for injuries incurred through Alpine skiing. 3240, or 18% of these injuries were trauma to the hand. The most frequently injured area was the thumb, with 1995, or 61.6% of the cases. The most common hand injury in skiing is the socalled "ski thumb", the lesion of the ulnar ligament of the metacarpal-phalangeal joint. Finger injuries accounted for 262 cases, or 8%. The capsule-ligament lesions predominated, especially the palmar capsule lesion of the proximal interphalangeal joint. The most common ligament lesion was the rupture of the radial collateral ligament of the metacarpal-phalangeal joint of the small finger. The metacarpal region was involved in 192 (6%) of the patients. The 4th and 5th metacarpal fractures were often combined with volar dislocation of the caput; the 2nd and 3rd metacarpals showed more often torsion fractures. Luxated fractures were found in all carpal metacarpal joints. Carpal injuries were the least common, with 2.2%; the bony and ligamentous injuries in this region were, however, more serious. 40 scaphoid fractures were found, along with fractures of the triquetrum, trapezium, hamatum, and pisiform, as well as luxations and luxated carpus fractures. The injuries of the wrist are worthy of more attention. They include lesions of the distal radial ulnar joint and distal radius fractures, and made up 22.2% of all hand injuries. More emphasis should be placed on diagnostic, therapeutic, and prophylactic measures for these injuries. PMID- 3508333 TI - [Wrist para-articular radius fractures in winter sports]. AB - Winter sport is of great importance in the Alpine countries. In 1980 3600 persons (10.24%) of all new admittances hospitalized in our hospital were injured when practicing winter sports. In 1983 they lessened to 2597 (7.73%) and in 1985 2999 (5.74%). Analysis of all injuries caused by winter sport activities shows that the number of injured persons is decreasing, severity of the injuries however, increasing. A comparison of the distal radius fractures in 1980, 1983 and 1985 indicates that extraarticular metaphyseal fracture types have decreased, intraarticular fracture with multiple fragments however, have increased. Mainly younger patient suffer from severe fractures. We regard the high pace-risk of the age group as the main course of this fact. PMID- 3508334 TI - [Ice hockey injuries. Studies of the highest West German league]. AB - Ice hockey is the speediest team sport and also considered to be one of the roughest of all sports. Due to the high rate of injuries and the lack of competent studies in the Federal Republic of Germany, we started recording the First League in connection with injuries and their causes via a thorough questioning of the players. The results of the hitherto evaluated 88 out of a total of 207 First League Players - i.e. 42.5% - show that head injuries are most frequent; however, lesions of shoulders and upper and lower extremities are far more portentous ++ to the affected players in many respects. The association with causes and mechanisms of the different kinds of injuries make it clear that a marked tightening of the rules and an improvement in the protective clothing would offer good possibilities to reduce the rate of injuries drastically in ice hockey a kind of sport that is steadily getting more and more popular. PMID- 3508335 TI - [Dynamic measurement of pressure distribution with flexible measuring mats--an innovative measuring procedure in sports orthopedics and traumatology. Development--use--value]. AB - The results of this study provide the basis for an on-target use of measurement of pressure distribution with flexible mats in sports orthopaedics and traumatology and adjacent overlapping fields. Dynamic measurement of pressure distribution using a flexible mat as a capacitor can yield valuable additional information not available so far in this form, on the static and dynamic stress acting on the human locomotor system. In the future this method can be used to prevent injuries and to optimise performance in many disciplines of sport and will make a significant contribution to optimised treatment concepts with pressure-adjusted shoes or insoles, as well as to the control of functional surgery results in traumatology. The fundamentals are presented via a detailed description of the development, standardization and testing of this innovative measuring method. The questions of applicability, practicability and information supplied are discussed on the basis of extensive studies on reproducibility, on the amount of time and technical effort required for each measurement, and on a critical comparison with other methods. For the two fields of application presented here it was possible to standardize the working procedure enabling a largely problem-free application in practice. The first useful results were obtained in sports orthopaedics (alpine ski boots and sportshoe design). By applying the measuring of pressure distribution in alpine ski sports the influence the construction of ski boots on the stress exercised on the human leg could be objectively quantified in man for the first time. Marked differences were found between models where the heel can be turned down on entering, to conventionally fastened ski boots. This, as well as the results on the influence temperature, height of shaft and shaft stability or rigidity on the pressure distribution along the tibia, provide the basis for a new guideline for the testing of ski boots. A new method was developed for the quality testing of shoes, insoles and sport shoes. This method enables for the first time dynamic pressure measurements inside the shoe and under the foot within the shoe. First results have been obtained with different insoles and arch supports or instep raisers, or with different shoe constructions in general. These results are discussed in respect of their importance for an assessment of the stress exercised on the human body, for a timely detection of unfavourable stress distribution, and for optimizing the performance by means of selecting the appropriate material and suitable design and construction. PMID- 3508336 TI - [Dislocation of the peroneal tendons]. AB - Dislocations of the peroneal tendons are more common than they are diagnosed. Probable reasons for misinterpretation of the injury are the hidden position of the peroneal tendons behind the malleolus lateralis and the tendency to self reduction of the peroneal tendons. Insufficient treatment leads to a chronic recurrent peroneal tendon dislocation which is not necessarily accompanied by pain. However, if the instability of the peroneal tendons is painful, surgical treatment is advised. Various surgical methods are described in the literature. Nearly all report good postoperative results. In case of chronic recurrent peroneal tendon dislocation, we prefer the surgical management described by Viernstein, namely, mobilisation of connective tissue of the region, leading it over the peroneal tendons and suturing it in a bone pouch of the malleolus lateralis. The advantages of this surgical method are that it does not damage important anatomical structures of the region and that no second operation to extract implants is necessary. We treated 13 patients by the method described by Viernstein. 12 of 13 patients have resumed sports activities. We have not seen any redislocation of the peroneal tendons. PMID- 3508337 TI - [Epiphysiolysis of the distal radius epiphysis in weight lifting]. AB - In this paper we describe a case of epiphysiolysis of the distal radius epiphysis by a weight lifter and we point out also the importance of x-rays by young athletes. PMID- 3508338 TI - [Selective paralysis of the infraspinatus muscle, caused by compression of the infraspinatus branch of the supraspinatus muscle]. AB - This is the case of a thirty-year-old athlete suffering from a painful right shoulder while moving and working with his right arm and showing a massive atrophy of his right infraspinatus muscle. After careful examination an isolated compression of the inferior branch of the suprascapular nerve was suspected. The entrapment of the nerve at the spinoglenoid notch by a large and hypertrophied ligament was demonstrated by an open revision. PMID- 3508339 TI - The need for characterization of pathogenicity genes of recombinant DNA viruses used as human vaccines. PMID- 3508340 TI - Vaccinia virus recombinants expressing rabiesvirus glycoprotein protect against rabies. AB - Six recombinants of New York Board of Health (NYBH) vaccinia virus containing cDNA for Challenge Virus Standard (CVS) rabiesvirus glycoprotein (G) were produced by directing gene insertion into the vaccinia thymidine kinase (TK) locus. To regulate expression of G the promoter P7.5 (functions at early and late times postinfection) from the gene for the vaccinia 7.5 kilodalton (kD) protein was used in two of the recombinants; late promoter P11 of the vaccinia 11 kD protein was used in four recombinants. The six differed in nucleotide sequences flanking the translation start codon; in two constructs the encoded signal peptide of G was fused to several additional amino acids. Cells infected with each recombinant made G that reacted with G-specific antibodies, comigrated with authentic G, and was transported to the plasma membrane. The highest amounts of G were made with fusion or standard versions of G with P11 provided that the mRNA leader sequences were identical to the natural gene. Each recombinant in mice and one in dogs induced rabiesvirus neutralizing antibodies and protection against lethal rabiesvirus challenge. PMID- 3508342 TI - Treatment of Parkinson's disease in adult patients by transplantation of human fetal brain tissue obtained from elective abortions. PMID- 3508344 TI - Psychological implications of fetal diagnosis and therapy. AB - Virtually nothing is known about the psychological implications of fetal diagnosis and therapy. This paper discusses some of the possible implications in light of the known psychological responses to fetal diagnosis by amniocentesis and genetic pregnancy termination. These are discussed against the background of the meaning of a pregnancy to the couple, the impact of the changes forced upon a couple by the discovery of a defect, and the likely approaches to decision making when the available options are presented. PMID- 3508343 TI - Intraperitoneal fetal transfusion: paralysis inhibits red cell absorption. AB - This study was undertaken to determine whether differences in fetal activity could account for the unpredictability of absorption of red blood cells from the peritoneal cavity of fetuses with alloimmune hydrops. The absorption of red cells from the peritoneal cavity of fetal lambs was studied in 7 pregnant ewes. In 3 nonparalyzed fetuses, uptake of donor red cells was complete by 80 h. In 4 fetuses given pancuronium for 4 days to abolish breathing and body movements, the absorption of red cells was markedly diminished at 92 h, but was complete 3-4 days after fetal movement resumed. This study demonstrates that fetal movements are essential in ensuring the normal absorption of red cells from the peritoneal cavity. Variability in fetal movements, particularly fetal breathing movements, may explain the unpredictability of absorption of red cells from the peritoneal cavity in fetuses with hydrops fetalis. PMID- 3508341 TI - Human RNA polymerase II can prematurely terminate transcription of the adenovirus type 2 late transcription unit at a precise site that resembles a prokaryotic termination signal. AB - Premature termination of transcription has been demonstrated by eukaryotic RNA polymerase II at specific sites in the major late transcriptional unit of SV40 and in one of the transcriptional units of the parvovirus, minute virus of mice (MVM) (Y. Aloni and N. Hay, CRC Critical Reviews of Biochem., 18:327-383, 1985). In both cases the prematurely terminated (attenuated) RNA can be folded into a hairpin structure followed by U-residues that resemble a termination signal in prokaryotes. The experiments presented herein demonstrate premature termination of transcription 185 nucleotides (nt) downstream from the major late promoter of adenovirus type 2 (Ad2) in vivo, and in vitro in isolated nuclei and in HeLa whole cell extract. As in SV40 and MVM the attenuated RNA of Ad2 can be folded into a hairpin structure followed by U-residues. Transcription-termination was significantly reduced when ITP replaced GTP and when Br-UTP replaced UTP in the transcription reaction mixture, indicating that RNA secondary structure and the rU-dA interactions, respectively, are parts of the termination signal. Moreover, in isolated nuclei transcription-termination at the attenuation site occurred when the reaction mixture contained between 50-150 mM NaCl but not when it contained 300 mM NaCl. These results indicate that, at least in isolated nuclei, attenuation can be regulated. The possible involvement of termination factor(s) in the regulation of attenuation is discussed. PMID- 3508345 TI - Ethical guidelines in fetal medicine. AB - The ethical guidelines in the clinical practice of fetal medicine are discussed, largely from the point of view of early prenatal diagnosis. The discussion concentrates on several specific aspects including counselling, good procedure, prenatal screening, disclosure of results including fetal sex, experimentation and assessment of new technologies and health education. The emphasis is placed on the importance of informed consent, choice and understanding on the part of the patient, and the professional competence of the doctor and other professionals she may meet. PMID- 3508346 TI - Differential diagnosis of paroxysmal myoglobinuria. A case report. PMID- 3508347 TI - Headache in nasal hyperreactivity. PMID- 3508349 TI - A polygraphic test for the diagnosis of amyotrophic choreo-acanthocytosis. PMID- 3508348 TI - HLA and multiple sclerosis in Italy. Two population studies in northern and insular Italy. PMID- 3508350 TI - Pudendal nerve SEPs in myelopathies. PMID- 3508351 TI - Cardiac autoptic histopathology consequent to head injuries and/or subarachnoid hemorrhages. PMID- 3508352 TI - Anatomical study of basilar trunk in human fetus and report of a case of double basilar artery. PMID- 3508353 TI - Quadriceps myopathy. Study of a case with autosomic dominant transmission. PMID- 3508354 TI - A case of "Milles variant" of the Sturge-Weber disease with von Hippel-Lindau defective disease. PMID- 3508355 TI - Choreo-acanthocytosis with myopathy. Report of a case. PMID- 3508356 TI - Rupture of a cerebral arteriovenous malformation due to a spontaneous occlusion of the venous drainage. PMID- 3508357 TI - Neurophysiological findings in headache patients. Psychogalvanic reflex investigation in migraineurs and tension headache patients. PMID- 3508358 TI - Chronic symptomatology revealing vertebro-basilar fusiform aneurysm. Report of five cases. PMID- 3508359 TI - Single cerebral metastasis mimicking a colloid cyst of the third ventricle. PMID- 3508360 TI - Spontaneous subdural hematoma in two cancer patients. PMID- 3508361 TI - Extracranial internal carotid artery aneurysm. PMID- 3508362 TI - [Use of computerized tomography as a guide in thoracic needle biopsies]. PMID- 3508363 TI - [Nodular manifestations in rheumatoid arthritis. Description of a particularly interesting case]. PMID- 3508364 TI - [A rare case of intrabronchial myxochondroma removed during fibrobronchoscopy]. PMID- 3508365 TI - [Thrombosis due to a Carpentier-Edwards bioprosthesis of the mitral valve without significant alteration of the leaflet in the Mono-2D echocardiography]. PMID- 3508366 TI - [Preliminary results of the use of multiple functional parameters during tests of bronchial provocation]. PMID- 3508367 TI - [Recurrent respiratory infections in subjects with common variable immunodeficiency]. PMID- 3508368 TI - [A case of triple association: pulmonary fibrosis, Dupuytren's disease and bilateral laryngocele]. PMID- 3508369 TI - [The lungs in acquired immunodeficiency syndrome: on various histopathologic aspects]. PMID- 3508370 TI - [Relation of bronchial and specific cutaneous response in asthmatic patients sensitized to dermatofagoides pteronissimus]. PMID- 3508371 TI - [Hemocoagulative disorders and course of cancer of the lung]. PMID- 3508372 TI - [Precapillary arterial pulmonary hypertension and hemorrheologico-coagulation changes]. PMID- 3508373 TI - [Evaluation of bronchial reactivity through analysis of the respiratory cycle]. PMID- 3508374 TI - Parents' acceptability ratings of alternative treatments for use with mentally retarded children. PMID- 3508375 TI - Reduction of disruptive mealtime behavior by facial screening. A case study of a mentally retarded girl with long-term follow-up. PMID- 3508376 TI - Suppression of pica by water mist and aromatic ammonia. A comparative analysis. PMID- 3508377 TI - Behavioral contracting to increase chest physiotherapy. A study of a young cystic fibrosis patient. PMID- 3508378 TI - Stability of food preferences during weight control. A study with 8- to 12-year old children and their parents. PMID- 3508379 TI - Masculine gender role stress. Scale development and component factors in the appraisal of stressful situations. PMID- 3508380 TI - Overcorrection of oral reading errors. A comparison of individual- and group training formats. PMID- 3508381 TI - Temperature-biofeedback treatment of migraine headache. Specific effects and the effects of "generalization training". PMID- 3508382 TI - Behavioral medicine. PMID- 3508383 TI - Recent advances in behavioral medicine. PMID- 3508384 TI - Behavioral and cognitive-behavioral treatment of anorexia nervosa and bulimia nervosa. PMID- 3508385 TI - Behavioral and cognitive-behavioral treatments of anorexia nervosa and bulimia nervosa. Current status, circa 1986. PMID- 3508386 TI - Sex differences in nerve growth factor levels in superior cervical ganglia and pineals. AB - The current studies were undertaken to determine whether males or neonatally testosterone-treated rats of either gender have elevated endogenous levels of NGF in the SCG and one of its targets, the pineal gland. The ages studied were 5 days postnatal, which is at the peak of normal neuron death in the SCG but before a significant gender difference is present; 15 days, when normal neuron death is largely complete and males have more SCG neurons than females; and 30 days, when target innervation has matured. At 5 days, while neuron death is occurring, but before there is a significant gender difference in neuron number in the SCG, pineal glands and SCGs of males had higher NGF content than those of females. The increased NGF in the ganglia of males at the time that these neurons are undergoing neuron death may play a role in the development of the sex difference in SCG neuron numbers. At 15 days, females had more NGF in their pineal glands and SCGs than did males, even though males have significantly more SCG neurons at this age than do females. This gender difference in the developmental course of NGF content could promote the survival of different populations of neurons in males and females. By 30 days, SCG and pineal NGF content of males was almost twice that of females. This is consistent with the presence of more neurons in the SCGs of males at this age. Both the pineal gland and the SCG showed a loss of approximately 80% content of NGF during the first postnatal month(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3508387 TI - Cerebrospinal fluid contacting neurons and openings of the central canal in rabbits and monkeys--light and electron microscopic observation. PMID- 3508388 TI - Adult T-cell leukemia (ATL) cells internalize latex beads. PMID- 3508389 TI - Super-high density barium sulfate for mucosal examination of the stomach--a trial product based on rheological studies. PMID- 3508390 TI - Clinical investigation on serum ceruloplasmin levels in tumors of the hematopoietic organs. PMID- 3508391 TI - Studies on muscle structural protein in motor neuron disease. PMID- 3508392 TI - Semen selenium in male infertility. PMID- 3508393 TI - [Factors affecting the pathogenesis of tumors of the large intestine]. PMID- 3508394 TI - [The effect of stress on catecholamines in the plasma and urine in children]. PMID- 3508395 TI - [Diagnostic and therapeutic possibilities in the Zollinger-Ellison syndrome]. PMID- 3508396 TI - [Detection of carcinoembryonic antigen in diseases of the gastrointestinal tract]. PMID- 3508397 TI - [Seroconversion of HBeAg into anti-HBe in chronic hepatitis type B]. PMID- 3508399 TI - Posterior vitrectomy in eyes with diabetic retinopathy. PMID- 3508398 TI - Pathophysiology and pharmacology of anterior segment surgery. PMID- 3508400 TI - [The CT scanning of 54 cases of orbital cavernous hemangioma]. PMID- 3508401 TI - [Orbital metastasis--report of 5 cases]. PMID- 3508402 TI - [Ocular Manson's plerocercoid disease (OMPD)]. PMID- 3508403 TI - Endocrine exophthalmos conservative management. PMID- 3508404 TI - [Morphological appearance and measurement of retinal microvasculature in the macula]. PMID- 3508405 TI - [The observation of light damage to the retina. 1. The changes of electroretinogram]. PMID- 3508406 TI - [Comparison of tests between visual electrophysiology and psychophysiology for the evaluation of visual function in aging macular degeneration]. PMID- 3508407 TI - [Ganzfeld electroretinogram in aging macular degeneration]. PMID- 3508408 TI - [The observation of VEP in aging macular degeneration]. PMID- 3508409 TI - [Contrast sensitivity versus visual acuity in aging macular degeneration]. PMID- 3508410 TI - [The color vision in aging macular degeneration]. PMID- 3508411 TI - [Senile macular degeneration: a clinical study of 7 cases]. PMID- 3508412 TI - [Retinoblastoma and esterase D. I. The esterase D activity of RBC of retinoblastoma patients]. PMID- 3508413 TI - [Retinoblastoma and esterase D II. The oncogenesis of retinoblastoma and the phenotype of esterase D]. PMID- 3508414 TI - [Congenital absence of lacrimal puncta-10 cases]. PMID- 3508415 TI - [Genetic optic papilla hollow]. PMID- 3508416 TI - Cataract surgery in mobile eye hospital. PMID- 3508417 TI - Guidelines and standards for surgery at eye camps. PMID- 3508418 TI - [An analysis of the reasons for intolerance of wearing corneal contact lens]. PMID- 3508419 TI - [A preliminary study of short-term efficacy of Nd: YAG laser peripheral iridotomy in patients with primary angle closed glaucoma]. PMID- 3508420 TI - [Axenfeld-Rieger syndrome--a report of 10 cases]. PMID- 3508421 TI - [Clinical applications of NMRI in ophthalmology]. PMID- 3508422 TI - [Surgical treatment in the cases of complicated retinal detachment]. PMID- 3508423 TI - [Treatment of acquired distichiasis]. PMID- 3508424 TI - Lipid peroxidation in the cortex and medulla of rabbit kidneys subjected to cold ischaemia and the value of protective agents. AB - The storage of rabbit kidneys for 24 hr at 0 degrees C in isotonic saline resulted in significantly increased rates of lipid peroxidation, as measured by the formation of thiobarbituric acid-reactive material and Schiff bases during in vitro incubation of homogenates prepared from the cortex and medulla. In addition, the content of thiobarbituric acid-reactive material in the medulla was also significantly elevated as a result of cold storage for 24 hr. The effects of antioxidants (vitamin E), iron-chelation (desferrioxamine) and inhibitors of arachidonic acid oxidation (indomethacin and dazmegrel) on the rate of lipid peroxidation in homogenates prepared from ischaemic kidneys were studied. This demonstrated that lipid peroxidation in the cortex was predominantly non-specific and iron-catalysed whereas in the medulla approximately 50% of the TBA-reactive material was formed enzymically from arachidonic acid by cyclooxygenase. PMID- 3508425 TI - Red blood cell anti-oxidant parameters in healthy elderly subjects versus silicosis patients. AB - The anti-oxidant phenotype was determined in red blood cell haemolysates of 62 healthy elderly persons (Mean age: 56) and a number of male silicosis patients (Mean age: 65, n = 19). Moreover, analysis of water-soluble fluorescent substances in plasma, recently introduced as a new test for in vivo lipid peroxidation, was included. Within the control group results were analyzed on the effect of smoking (no effect), use of medication (lowered GSH-content) or gender (no differences apart from haemoglobin content). No simple relationship between any pair of the measured parameters in erythrocytes was present. When comparing the male control persons with the silicosis group a significantly higher red blood cell GSH-level was observed in the latter. Moreover, some factors of the anti-oxidant system are strongly correlated in the diseased, but not in the healthy subjects. PMID- 3508426 TI - Are toxic oxygen radicals involved in the pathogenesis of reflex sympathetic dystrophy? AB - A crossover study was performed for patients with RSD to evaluate the therapeutic efficacy of the hydroxyl radical scavenger DMSO. All patients were given DMSO locally 5 times a day during one week, and a placebo during one week. Before and after each treatment, subjective evaluation was performed by both the patient and the examinor as to clinical activity of RSD, and measurement was performed of the range of motion (ROM) of all joints in the affected extremity. DMSO was the most effective treatment as to improvement of ROM (p = 0.035) and as to overall improvement (p = 0.001). The efficacy of the hydroxyl radical scavenger DMSO indicates that RSD primarily involves an inflammatory process rather than a sympathetic reflex. As during the last 20 years no single report was published studying RSD in terms of inflammation, it is suggested that such studies are urgently needed to elucidate the real nature of RSD. PMID- 3508427 TI - Free radicals in the atmosphere. AB - Like the oxidation in a flame, the oxidation in the atmosphere is mediated by free radicals. Unlike a flame, however, atmospheric oxidation needs an external source of energy: the sun light. In fact the most important radical acting in the lower atmosphere, the hydroxyl radical, OH, is produced following the UV photolysis of ozone, O3, which yields an excited oxygen atom, O1D: O3 + h nu--- .O1D + O2; lambda less than or equal to 320 nm .O1D + H2O----.OH + .OH OH reacts with most atmospheric trace gases, in many cases as the first and rate determining step in the reaction chain leading to oxidation. In this way a host of various other radicals (e.g. peroxy radicals), most of them very short lived, are generated. Usually these oxidation reactions form chains which regenerate OH, thus maintaining OH at a relatively high concentration level on the order of 10(6) cm-3 during the day. The reactions which control the OH concentration will be discussed in detail. During the night radical formation is greatly diminished. It proceeds, for example, through the reaction of olefines with O3, and, in dry air, through reaction of olefines and aldehydes with the nitrate radical, NO3. PMID- 3508428 TI - Metastable oxygen molecules in the troposphere. AB - The sources and steady-state concentration of singlet oxygen in the atmosphere are assessed in view of potential effects on the biosphere. Collision-induced absorption of sunlight by molecular oxygen in 1 atm of air produces O2 (a1 delta g) at a rate P = 1.6 x 10(9) cm-3 s-1 in bright sunlight. Less than 10% are added to this purely natural source by the photolysis of ozone, and by anthropogenic sensitizers (SO2, NO2, volatile aromatics). Collisional quenching of O2 (a1 delta g) by ground state oxygen establishes a steady-state concentration of ca. 1.7 x 10(8) cm-3. Reactions of singlet oxygen with other atmospheric pollutants are entirely negligible when compared with the concurrent reactions of ambient OH and O3. Potential effects of atmospheric singlet oxygen on the biosphere are limited by the deposition rate F less than or equal to 0.051 P, which depends on the production rate P of O2 (a1 delta g) in the air layer immediately above the flat surface. PMID- 3508429 TI - Investigations on spruce decline in the Bavarian forest. AB - The primary damaging reactions in spruce needles may operate as follows: 1) Trees under "stress" produce the plant hormone ethylene. 2) Ethylene and ozone react extremely fast forming hydrogen peroxide and formaldehyde, compounds which may damage the wax layer. 3) Ozone as a very aggressive oxidant will inactivate membrane bound enzymes through oxidation of their thiol groups. Thus the translocation of sugars from the chloroplast into the phloem may be inhibited or blocked. The result will be an "over-reduction" of the electron transport chain resulting in the formation of reactive oxygen species in the light. These reactive oxygen species will induce lipid peroxidation and pigment co-oxidation. 4) The visible effects are bleached needles and an impairment of structural resistance against fungal infections. 5) In addition ozone will directly reduce the content of antifungal compounds such as p-HAP. 6) Furthermore p-HAP may be involved in the bleaching reaction after its release from picein. 7) Finally, fungi may penetrate the needles and eventually grow faster in bleached needles. Infected needles will become necrotic and abscise. PMID- 3508430 TI - Alcohol-induced hepatotoxicity: a role for oxygen free radicals. AB - Perfusion of isolated rat livers with ethanol at a concentration of 2 g/l (%o) resulted in a release of glutamate-pyruvate-transaminase (GPT) and sorbitol dehydrogenase (SDH) into the perfusate as markers of toxicity. Inhibition of alcohol dehydrogenase by 4-methylpyrazole or of aldehyde dehydrogenase by cyanamide totally abolished ethanol hepatotoxicity despite of a severalfold increase in acetaldehyde concentration in the perfusate. Addition of superoxide dismutase or catalase clearly suppressed the ethanol-induced release of GPT and SDH, suggesting that .O2- and H2O2 are involved in this process. Also, chelation of iron ions by means of desferrioxamine displayed a clear inhibitory action, suggesting the involvement of an iron-catalyzed Haber-Weiss-reaction leading to the formation of .OH radicals in the hepatotoxic response to ethanol. Our data suggest that during the metabolism of acetaldehyde primary reactive oxygen species (.O2-, H2O2) are produced which may interact to yield hydroxyl or .OH like radicals, which possibly represent the hepatotoxic principle of ethanol. PMID- 3508431 TI - Induction of ascorbate peroxidase and glutathione reductase activities by interactions of mixtures of air pollutants. AB - The response of ascorbate peroxidase and glutathione reductase activities in peas (Pisum sativum var. Waverex) was investigated after three weeks of exposure to mixed fumigations with SO2, NO2 and O3 (0.050 parts per million each) and increasing concentrations of O3 (0-0.150 parts per million). The results show that plants respond similarly to a high concentration (0.150 parts per million) of a single air pollutant (ozone) and to mixtures of air pollutants (SO2, NO2 and O3) when individual concentrations are low (0.050 parts per million each). In both cases, levels of ascorbate peroxidase and glutathione reductase activities were approximately twice those to be found in plants grown in charcoal-filtered air (p less than 0.01). PMID- 3508432 TI - Atmospheric oxidation of hydrocarbons. AB - Hydrocarbon oxidation in the atmosphere proceeds generally by the following sequence of reactions: hydrocarbon + OH----alkyl radical + H2O, alkyl radical + O2 (3 sigma)----alkylperoxy radical, alkylperoxy radical + NO----alkoxy radical + NO2, alkoxy radical + O2 (3 sigma)----aldehyde + HO2. The atmospheric lifetimes of hydrocarbons are determined by their reactivity towards OH as well as by the average OH concentration level. They are compound specific and vary from several hours to several years. Hydrocarbon oxidation chains couple with other trace gases (Ox, HOx and NOx). For the conditions of the average continental atmosphere an increase of the oxidative potential (HOx, Ox) is predicted through hydrocarbon oxidation. PMID- 3508433 TI - Modulation of iron-mediated oxidant damage in erythrocytes by cellular energy levels. AB - In this work we have investigated the effects of iron-induced oxidative stress on erythrocytes and their membranes, the importance of haemoglobin oxidation and of the maintenance of the metabolic properties of the cells. The results show that by maintaining the energy requirements of the erythrocyte, methaemoglobin production is minimised under conditions of iron-stress. However, in this situation, the membranes of the erythrocytes become more susceptible to the oxidative damage and increased lipid peroxidation ensues. PMID- 3508434 TI - Investigation of lipid peroxidation in human low density lipoprotein. AB - Human plasma low density lipoprotein (LDL) exposed to oxygen saturated buffer becomes depleted of alpha-tocopherol within 3 to 6 hours. Thereafter, lipid peroxidation commences as evidenced by the loss of 18:2 (67 nmol/mg LDL) and 20:4 (12 nmol/mg LDL) and the concomitant formation of 4-hydroxynonenal (0.28 nmol/mg LDL) and fluorescent compounds. The major fluorophor in apo B of oxidized LDL has an excitation maximum at 355 nm and an emission maximum at 430 nm. A fluorophor with the same spectral properties is produced in apo B, if LDL is incubated with 4-hydroxynonenal, whereas malonaldehyde gives a fluorophor with excitation and emission maxima at 400/470 nm. Three-dimensional fluorescence spectroscopy proved to be an useful tool in analysing the complex fluorescence of apo B. PMID- 3508435 TI - The relationship between lipid composition of red blood cells and their susceptibility to lipid peroxidation. AB - Red blood cells from 31 healthy donors were examined for the cholesterol content, the fatty acid composition, and the susceptibility to lipid peroxidation induced by either hydrogen peroxide or phenylhydrazine. Lipid peroxidation was monitored by the release of pentane and ethane. In addition, plasma fatty acids were measured in order to find out, whether plasma and red cell fatty acids were correlated. In experiments with hydrogen peroxide, a significant positive correlation was found between the proportion of arachidonic acid (C 20:4n - 6; r = 0.57, p less than 0.01) and docosahexaenoic acid (C 22:6n - 3; r = +0.71, p less than 0.01), and the release of pentane and ethane, respectively. A significant negative correlation was found between the membrane cholesterol content and the pentane release (r -0.44, p less than 0.05). In experiments performed with phenylhydrazine, red cell membrane lipid composition did not influence the susceptibility of red cells to lipid peroxidation. A close correlation was found between plasma and red cell fatty acids (palmitic acid, r = +0.46, p less than 0.01; linoleic acid, r = +0.41, p less than 0.05; arachidonic acid, r = +0.59, p less than 0.01; docosahexaenoic acid, r = +0.67, p less than 0.01). The results demonstrated that the degree of peroxide-induced oxidation of erythrocyte lipids depends on the content of polyunsaturated fatty acids in the membrane, which on the other hand, is determined by plasma fatty acids. It is suggested that dietary variations may influence the susceptibility of red cells to lipid peroxidation. PMID- 3508436 TI - Recognition of cervical neoplasia by the estimation of a free-radical reaction product (octadeca-9,11-dienoic acid) in exfoliated cells. AB - The molar ratio between a diene-conjugated linoleic-acid isomer (18:2(9,11)) and the parent linoleic acid (18:2(9,12)), both esterified as phospholipids, was significantly different in exfoliated cells from normal cervices and from cervices with colposcopic and cytological evidence of precancer. The measurement may provide a simple and perhaps improved alternative to cytological screening. PMID- 3508437 TI - Lipid peroxidation in choline-methionine deficiency. AB - A deficiency of choline and methionine is hepatocarcinogenic and is associated with an apparent increase in lipid peroxidation. In this study the susceptibility of microsomes and nuclei to ferritin-dependent lipid peroxidation is examined together with the status of the peroxidation-protective systems. Choline methionine deficiency caused an increase in Se-independent GSH peroxidases (GSH transferase subunit 2) and membrane vitamin E but a decrease in Se-dependent GSH peroxidase and microsomal GSH peroxidase activity. Choline-methionine deficient microsomes and nuclei were 4-fold more susceptible to lipid peroxidation induced in vitro by physiological concentrations of ferritin/ascorbate/ADP; and the peroxidation was less effectively inhibited by GSH and soluble GSH peroxidases than controls. The results indicate that a decreased level of Se-dependent and membrane GSH peroxidases is involved in the increase in lipid peroxidation observed in choline-methionine deficiency. PMID- 3508438 TI - Pro-hemolytic effect of aldehydic products of lipid peroxidation. AB - In order to evaluate the pro-hemolytic action exerted by different classes of biogenic aldehydes, normal red cells obtained from human beings of both sexes were incubated at 37 degrees C under iso or hypo-osmotic conditions in the presence of hydroxyalkenals or alkanals, in a concentration compatible with those actually recovered during red cell lipid peroxidation. None of the tested aldehydes showed a direct hemolytic effect, i.e. red cell lysis in iso-osmotic conditions. Conversely, almost all assayed alkanals and hydroxyalkenals exhibited a pre-lytic damage of human erythrocytes, as detected in the red cells suspended in hypo-osmotic medium. The highest pro-hemolytic effect was displayed by hexanal, nonanal, 2-nonenal and 4-hydroxynonenal. PMID- 3508439 TI - Lipid peroxidation induced by N-nitrosodimethylamine (NDMA) in rats in vivo and in isolated hepatocytes. AB - To investigate the role of carcinogenic chemicals as a possible cause for oxidative damage, rats were treated with N-nitrosodimethylamine (NDMA) and various measures of lipid peroxidation were followed. As an indication of enhanced peroxidative processes in vivo, NMDA treatment produced rapidly an increase in the rate of ethane exhalation. A single i.p. or p.o. injection of 10 mg/kg b.w. elevated ethane exhalation by 13-14 fold; a single dose of 0.5 mg/kg of NDMA (the smallest dose tested) increased 5-fold the amount of ethane exhaled. Similarly, lipid peroxidation in the liver of NDMA-treated rats (measured by diene conjugation, chemiluminescence, the production of fluorescent and TBA reactive material) was found to be increased rapidly showing a peak already 20 min after dosing. Simultaneously, NDMA-treatment slightly decreased antioxidant enzyme activities and GSH contents in the liver. In isolated rat hepatocytes the lucigenin-dependent chemiluminescence, as well as H2O2 release, were increased by micromolar concentrations of NDMA. Finally, it was shown that the rate of NADPH stimulated ethane production by hepatic microsomes, prepared from untreated rats, was increased in the presence of NDMA. Thus, our results demonstrate that the alkylating NDMA can induce oxidative stress in rodents. Whether the same is true for other classes of carcinogens and processes known to affect tumor initiation/progression is presently under investigation. PMID- 3508440 TI - The decisive pO2-levels in haloalkane-mediated liver cell injury. AB - The model hepatotoxin carbon tetrachloride (CCl4) was used to study haloalkane free radical-induced lipid peroxidation in isolated rat hepatocytes at steady state oxygen partial pressures (pO2) between 0.2 and 100 mmHg. Equilibrium oxygen conditions were achieved by using an oxystat system. Monitoring of hepatocellular oxygen uptake, malondialdehyde-formation and low-level chemiluminescence during incubations of CCl4-supplemented hepatocytes indicated a drastic stimulation of lipid peroxidation at pO2-levels between 1 and 10 mmHg. Above and below this pO2 region the potency of CCl4 to induce lipid peroxidation sharply decreased. The evaluation of cellular damages by determining trypan blue exclusion and lactate dehydrogenase leakage revealed that in the presence of CCl4 hepatocellular injury was significantly increased at those pO2-levels which were optimal for CCl4 mediated lipid peroxidation. The present results demonstrate that CCl4 is a potent inducer of lipid peroxidation also in the intact hepatocyte, provided that the pO2 is maintained at distinct low levels. The coincidence of lipid peroxidation and loss of cell viability at the same pO2-range provides further evidence for the assumption that the haloalkane-mediated liver cell injury is due to a peroxidative process which primarily occurs at the hypoxic end of the physiological pO2-levels (1-70 mmHg) in liver. PMID- 3508441 TI - Two mechanisms of CCl4-induced fatty liver: lipid peroxidation or covalent binding studied in cultured rat hepatocytes. AB - With cultured hepatocytes it was studied whether CCl4-induced inhibition of secretion of VLDL and HDL from liver cells is a consequence of covalent binding of CCl4 metabolites (i.e. CCl3; CCl3OO.) to cell constituents or of membrane damage by lipid peroxidation. Comparing the kinetics of inhibition of lipoprotein secretion with that of CCl4-bioactivation it was found, that covalent binding of (14C)-CCl4 occurred at early time points (5 min) after CCl4 administration and inhibited the lipoprotein secretion. At 100 microM CCl4 it was depressed by 53% within 60 min. Incubations of CCl4-treated cells with increasing concentrations of vitamin E blocked lipid peroxidation, but lipoprotein secretion was still inhibited. Piperonyl butoxid, a radical scavenger, protected against CCl4-induced inhibition of lipoprotein section, lipid peroxidation and covalent binding. These results show that during the early phases of CCl4 poisoning fat accumulation is the consequence of covalent binding of CCl4 metabolites to cell structures. PMID- 3508442 TI - Oxidative stress as a defense mechanism against parasitic infections. AB - Many parasites--including the causative agents of malaria, Chagas' disease and schistosomiasis--are more susceptible to reactive oxygen species (ROS) than their hosts are. This is manifested by one or more of the following criteria: 1. Susceptibility of the parasite to ROS in vitro; 2. macrophage-based defense mechanisms against the parasite in vivo; 3. successful therapy using agents which lead to oxidative stress; 4. selection advantage (with respect to parasite infections) of human populations whose antioxidant capacity is impaired by a gene defect or by strong oxidants in their staple food. Our laboratory is involved in developing inhibitors against antioxidant enzymes thus mimicking natural experiments. Since glutathione reductase is a protein of known atomic structure the methods of drug design by receptor fit (DDRF) can be applied for this enzyme. Another promising target enzyme is trypanothione reductase which was found so far only in trypanosomatids, and specifically, not in their hosts. Consequently the trypanothione pathway may be a general target in the design of drugs against diseases caused by trypanosomes and leishmanias. PMID- 3508443 TI - Virus-induced formation of reactive oxygen intermediates in phagocytic cells. AB - Viruses cause disease by a wide variety of mechanisms. These include the impairment of differentiated host cell functions and the killing of infected cells. The latter is referred to as cytopathic effect and is exemplified by Polio virus infection where paralysis results from the loss of neurons killed by the virus. Host immune response as a factor contributing to disease is evident in the skin rashes in measles and rubella. Virus-immune complexes occur in many infections and may be associated with glomerulonephritis and arthropathy. We describe two mechanisms by which viruses activate the generation of reactive oxygen intermediates (ROI) in polymorphonuclear leukocytes. The first is mediated by antiviral antibody and hence is controlled by the immune system. The second mechanism depends on a direct interaction of viral antigen with the plasma membrane of the phagocyte. It is suggested that the direct activation of ROI generation by paramyxo- and influenza viruses may be related to their well-known toxic effects in vivo. PMID- 3508444 TI - Xanthine oxidase is not responsible for reoxygenation injury in isolated-perfused rat heart. AB - The massive leakage of intracellular enzymes which occurs during reoxygenation of heart tissue after hypoxic or ischemic episodes has been suggested to result from the formation of oxygen radicals. One purported source of such radicals is the xanthine oxidase-mediated metabolism of hypoxanthine and xanthine. Xanthine oxidase (O form) has been suggested to be formed in vivo by limited proteolysis of xanthine dehydrogenase (D form) during the hypoxic period (Granger et al., Gastroenterology, 81, 22 (1981)). We measured the activities of xanthine oxidase in both fresh and isolated-perfused (Langendorff) rat heart tissue. Approximately 32% of the total xanthine oxidase was in the O form in fresh and isolated perfused rat heart. This value was unchanged following 60 min of hypoxia and 30 minutes of reoxygenation. The infusion of 250 microM allopurinol throughout the perfusion completely inhibited xanthine oxidase activity but had no effect on the massive release of lactate dehydrogenase (LDH) into the coronary effluent upon reoxygenation of heart tissue subjected to 30 or 60 min of hypoxia. Protection from 30 min of hypoxia was also not obtained when rats were pretreated for 48 h with allopurinol at a dose of 30 mg/kg/day and perfused with allopurinol containing medium. Superoxide dismutase (50 units/ml), catalase (200 units/ml), or the antioxidant cyanidanol (100 microM) also had no effect on LDH release upon reoxygenation after 60 min of hypoxia. Xanthine oxidase activity was detected in a preparation enriched in cardiac endothelial cells while no allopurinol inhibitable activity could be measured in purified isolated cardiomyocytes. It is concluded that xanthine dehydrogenase is not converted to xanthine oxidase in hypoxic tissue of the isolated perfused rat heart, and that the release of intracellular enzymes upon reoxygenation in this experimental model is mediated by factors other than reactive oxygen generated by xanthine oxidase. PMID- 3508445 TI - Ferroxidase II activity and serum cholesterol. AB - Ferroxidase II (Fox II) was developed in serum by acid incubation for 24 h. The resulting activity showed a strong positive correlation with the serum cholesterol concentration in normal subjects and patients with hyperlipidaemia. The potentiating effect of cholesterol on developed Fox II has been confirmed by the in-vitro addition of cholesterol to serum. There was no significant correlation between developed Fox II and caeruloplasmin (ferroxidase I) or between cholesterol and caeruloplasmin. PMID- 3508446 TI - Hyaluronic acid degradation by ascorbic acid and influence of iron. AB - The effects of ascorbic acid, iron and ADP on hyaluronic acid, a compound present in inflamed joints, were investigated in an in vitro system. Ascorbic acid induces degradation of hyaluronic acid which increased in the presence of FeCl3 and which is additionally stimulated by ADP chelated ferric ions. The hyaluronic acid degrading reactions induced by the Fe-III/ADP/ascorbic acid system were inhibited by catalase and formate to various extents whereas the presence of superoxide dismutase did not exert any inhibitory effect. Desferrioxamine, a specific iron chelator, completely inhibited hyaluronic acid depolymerisation by ascorbic acid as well as in combination with FeCl3 or FeCl3/ADP, respectively. We suggest that the ultimate hyaluronic acid degrading species is OH, generated via the Fe-III/ADP catalysed Haber Weiss reaction. There is also an indication for the involvement of perferryl or/and ferryl species in the degradation process. PMID- 3508447 TI - The role of glycolysis and hexose monophosphate pathway in the hypoxic toxicity of misonidazole. AB - The metabolic activation of misonidazole (MISO) and its effects on the hexose monophosphate pathway (HMP) and clonogenicity were studied in hypoxic EMT6/Ro, wildtype Chinese hamster ovary (CHO) and mutant CHO cells deficient in glucose-6 phosphate dehydrogenase. In all three cell lines metabolic activation of MISO, as indicated by the binding of 14C-MISO to the acid-insoluble fraction of these cells, was increased by the presence of glucose. In EMT6/Ro cells and wildtype CHO cells, MISO caused a significant stimulation of the activity of the HMP while in the mutant CHO cells no HMP activity was measurable, even in the presence of MISO. Loss of clonogenicity induced by MISO occurred markedly earlier in EMT6/Ro cells than in the CHO cells. In the latter cells, however, only a small difference was observed between the wildtype and mutant cell line. From these results it is concluded that not only the HMP but also glycolysis and other, glucose-independent, metabolic pathways are able to provide electrons for the reductive activation of MISO and hence contribute to the hypoxic toxicity of this compound. PMID- 3508448 TI - The effect of systemic heparinisation and haemodialysis on plasma octadeca-9,11 dienoic acid (9,11-LA'). AB - Systemic heparinisation induces a sharp rise not only in plasma total free fatty acids but also in 9,11-LA' concentration and in the 9,11-LA'/9,12-LA molar ratio. This "heparin effect" is enhanced by haemodialysis with cuprophan membranes but not with polycarbonate membranes. PMID- 3508449 TI - Isolation and nucleotide sequence of rat Cu/Zn superoxide dismutase cDNA clones. AB - Superoxide dismutase (SOD: EC 1.15.1.1) catalyzes the dismutation of oxygen radicals and is thought to protect cells against free radical damage. We have isolated and sequenced cDNA clones of the rat Cu/Zn SOD, and have used these clones to map the rat genomic sequences coding for this enzyme. Rat Cu/Zn SOD is coded for by a single copy gene which is transcribed into an mRNA species of approximately 800 bases. Comparison of the nucleotide sequences of rat and human SOD cDNAs shows that they are homologous over 83% of the coding sequences and that in the 3'-untranslated region the extent of homology drops to 66%. The predicted rat SOD amino acid sequence is very similar to that of other eukaryotic SODs, showing 70% homology with the SODs of other mammals. Sequence conservation is particularly high in domains believed to be of functional importance. PMID- 3508450 TI - Charge transfer-oxy radical mechanism for anticancer agents: mAMSA derivatives, rhodamine 123, and nickel salicylaldoximate. AB - The proposal is advanced that many anticancer agents may function via redox reactions resulting in generation of toxic oxy radicals which destroy neoplastic cells. Cyclic voltammetry was performed with some of the main types: iminium ions (protonated mAMSA derivatives), quinone derivatives (rhodamine 123) and metal complexes (nickel(II) salicylaldoximate). In addition, relevant literature data are provided. A rationale is offered that relates electrochemical data to physiological activity. PMID- 3508451 TI - Effect of silibinin on the activity and expression of superoxide dismutase in lymphocytes from patients with chronic alcoholic liver disease. AB - The in vitro and in vivo effects of the naturally occuring flavolignan hepatoprotective agent silibinin on the expression and activity of superoxide dismutase (SOD) enzyme were studied in lymphocytes from patients with chronic alcoholic liver disease. In vitro incubation with silibinin in a concentration corresponding to the usual therapeutic dosage markedly increased the SOD- expression of lymphocytes as measured by flow-cytofluorimetry following staining with monoclonal anti-Cu, Zn-SOD--antibody and FITC-conjugated anti-mouse Ig. In vivo treatment with the drug restored the originally low SOD activity of the patients' lymphocytes. These data indirectly suggest that antioxidant activity might be one of the important factors in the hepatoprotective action of silibinin. PMID- 3508452 TI - Free radical and cytotoxic effects of chelators and their iron complexes in the hepatocyte. AB - In a comparative screening study of chelators intended for clinical use eleven iron chelators have been tested for their ability to mobilize (59Fe) iron from 59Fe-labelled ferritin and from hepatocytes of rats labelled with 59Fe transferrin. The toxic effects of the chelators were also studied using microsomal lipid peroxidation induced by Fe3+/ADP and NADPH. From these tests it was shown that 1,2-dimethyl 3-hydroxypyrid-4-one (L1) and mimosine were the most effective iron chelators in iron mobilization and did not catalyse lipid peroxidation. In conclusion it can be stated that besides to investigate the iron binding capacity of new chelators also their ability to catalyse lipid peroxidation has to be ruled out. PMID- 3508453 TI - Comparative anti-inflammatory activity of different superoxide dismutases and liposomal SOD in ischemia. AB - Comparison of superoxide dismutases from different sources with respect to biological activity in the rat tourniquet poditis model shows that anti-ischemic activity is very variable although all the enzymes have the same specific enzymic activity. Both bovine Cu-SOD and E. coli Mn-SOD have excellent properties whereas yeast Cu-SOD and the homologous rat Cu-SOD show zero activity. The results confirm earlier demonstrations that (1) "All superoxide dismutases are equal but some are more equal than others", (2) at the dose levels used (compatible with possible clinical use) homologous enzyme is inefficient and hence human Cu-SOD may not be effective in humans, (3) liposomal encapsulation of bovine Cu-SOD greatly enhances biological efficacity, provides a slow release mechanism of the enzyme and provides a powerful drug for the treatment of ischemic injury. PMID- 3508454 TI - The Environmental Protection Agency's risk assessment guidelines. PMID- 3508455 TI - In-depth exposure assessments. PMID- 3508456 TI - Developmental toxicity guidelines critique. PMID- 3508457 TI - Genetic risk assessment. PMID- 3508458 TI - Health risk assessment of chemical mixtures. PMID- 3508459 TI - Air pollutant emissions from the incineration of hospital wastes. The Alberta experience. PMID- 3508460 TI - The philosophy of continuing education. PMID- 3508461 TI - Acute Lantana camara toxicity in cattle. AB - An outbreak of acute Lantana camara poisoning in cattle is described in which 10 out of 91 animals died. The affected cattle became icteric and voided soft, black faeces. Necropsies were performed on three steers, and the macro- and microscopical changes in their livers and kidneys were compatible with those of L. camara poisoning. Changes were similar in two steers that developed typical signs after being dosed with fresh L. camara collected in the toxic camp. Clinical pathological changes in experimental animals included elevated serum urea and creatinine concentrations. PMID- 3508462 TI - A comparison of health parameters in two different canine populations. Part 1: Haematological data. AB - Blood samples were collected on a random basis from two canine populations. The haemoglobin concentration, erythrocyte count, haematocrit, leucocyte count and differential leukocyte count were investigated in a population of kennelled dogs and a population of dogs of a rural township in a developing country. The means of five of the nine haematological parameters evaluated were found to be statistically significantly different between the two groups. It is postulated that these differences were due to the difference in diet, type and severity of disease, parasites present in the population, and to a lesser extent to breed and age differences. PMID- 3508463 TI - The use of a diffusion test for the detection of antibiotics in the tissues of slaughter stock. AB - The Brilliant Black Reduction Test Kit (BR Test), which is widely used to detect antimicrobial residues in milk, was adapted to detect residues in the meat and tissues of slaughter stock. The adaptation consisted of placing kidney and muscle tissue samples into 2.5ml diffusion cups containing 0.4ml media plus Bacillus stearothermophilus spores and brilliant black indicator. A preliminary trial undertaken to test the lower limits of sensitivity of the adapted BR Test to a number of the more common antibiotics used in food animals, was followed by a survey involving 943 pigs slaughtered at one abattoir. Samples were tested from 87 suppliers of which 11 regularly marketed pigs with detectable antimicrobial residues. Most of these pigs came from large pig producing units. Three suppliers marketed pigs with suspicious reactions. No residues could be detected in pigs from the remaining 73 suppliers. The BR Test was found to be a quick, inexpensive, practical screening test which could be utilized for the routine detection of antimicrobial residues in slaughter stock at all South African abattoirs. PMID- 3508464 TI - Successful surgical repair of a vascular shunt of the corpus cavernosum penis and penile fibropapillomata in a bull. AB - A single vascular connection between the corpus cavernosum penis and the superficial penile vasculature was diagnosed in an 18-month old Holstein bull with a history of acquired failure to maintain penile erection. Previously normal serving ability had been documented. Multiple penile fibropapillomata were also found. The vascular shunt was identified by contrast cavernosography and ligated, and the fibropapillomata excised. The bull returned to normal function within three months after surgery, and no recurrence of either problem had been experienced by 12 months after surgery. PMID- 3508465 TI - Fatal disseminated cryptococcosis and concurrent ehrlichiosis in a dog. AB - Laboratory findings in an adult bull terrier presented with a history of anorexia and weight loss included the following: severe anaemia, leukocytosis, neutrophilia, lymphopaenia, thrombocytopaenia, Ehrlichia canis morulae in monocytes, hypergammaglo-bulinaemia, a bleeding tendency, icterus and proteinuria. In addition, a high Haemobartonella canis parasitaemia, non encapsulated yeasts on urinalysis and a localised Demodex canis infestation were present. Treatment for ehrlichiosis was initiated but the dog died. Lesions found were a severe cryptococcal granulomatous pneumonia and cryptococcal colonies in the lungs, bronchial lymph nodes, kidneys, liver, spleen, heart, meninges, eyes and thoracic cavity. In addition, hyphal forms resembling Filobasidiella neoformans, the teleomorph of Cryptococcus neoformans, were seen in lung fine needle aspiration smears, impression smears and lung sections. C. neoformans was cultured from urine, lung and liver. Lung and kidney also yielded Salmonella typhimureum. Cortical atrophy with T-cell depletion of lymph nodes as well as splenic lymphoid follicular atrophy, typical of chronic ehrlichiosis-induced cell mediated immunosuppression, could have predisposed to the fatal disseminated cryptococcis. PMID- 3508466 TI - Parasitic pneumonia in a dog caused by a lung fluke of the genus Paragonimus. AB - Post mortem examination of a dog that died after a spell of respiratory distress revealed about 20 randomly distributed cystic lesions in the lungs. Those examined each harboured 2 light-brownish conical flukes approximately 10 mm in length. Histopathological examination of such a lesion revealed the presence of Paragonimus (lung fluke) embedded in it. The parasite had a typical spiny integument as well as other characteristics typical for the genus. Typical pigmented operculated eggs were embedded in the surrounding tissues. The life cycle of the parasite is briefly discussed. PMID- 3508467 TI - Practical small animal dermatology. I: Structure and function of the skin. AB - The structure and function of the canine and feline skin is reviewed. Comparisons in tubular form have been made of certain aspects where confusion may arise. PMID- 3508468 TI - Changes in lung ATP concentration in the rat after low-level phosgene exposure. AB - Inhibition of mitochondrial respiratory activity and decreased lung adenosine triphosphate (ATP) concentration occur following exposure to 240 ppm.min phosgene. To determine the relationship between energy stores and the onset of phosgene-induced pulmonary edema, we measured the ATP concentration in rapidly frozen rat lung tissue before and during pulmonary edema. Male Sprague-Dawley rats were exposed to phosgene for four hours at concentrations of 0.05 to 1.0 ppm (12, 30, 60, 120, and 240 ppm.min). Lung wet and dry weight and ATP concentration were measured immediately after exposure and for three days postexposure. The accumulation of lavage fluid protein (LFP) was also measured as an index of damage or edema due to phosgene. Lung dry weight was significantly elevated one day postexposure to 0.5 ppm phosgene, while the LFP was elevated by 0.2 ppm phosgene. Time course studies at these doses of phosgene showed that decreased ATP levels preceded the onset of edema or increase in lung weight. The ATP values expressed on a per-lung basis showed that ATP levels were significantly lowered immediately following phosgene exposure, suggesting that the ATP changes were not the result of edema. This study is the first demonstration of a biochemical change that occurs following exposure to phosgene at a level significantly below the threshold limit value for this gas. PMID- 3508469 TI - Kinetic parameters of the inhibition of red blood cell aminolevulinic acid dehydratase by triethyl lead and its reversal by dithiothreitol and zinc. AB - In chronic or acute exposure to triethyl lead, a de novo synthesis of aminolevulinic acid dehydratase (delta-ALAD) in bone marrow and an increased activity in circulating red blood cells can be demonstrated by activating the enzyme with dithiothreitol (DTT) and zinc. We determined the median inhibitory concentration and the apparent inhibition constant for triethyl lead on delta ALAD. After dosing with triethyl lead, in vivo inhibition of ALAD only occurred at the high dose, but activation analysis in vitro showed increased ALAD activity to be present at all dose levels in a dose-dependent fashion. The use of an activation assay for red blood cell ALAD may have value as a bio-effects monitor of exposure to organic lead. PMID- 3508470 TI - Effect of nickel(II) on DNA-protein binding, thymidine incorporation, and sedimentation pattern of chromatin fractions from intact mammalian cells. AB - Nuclear uptake and chromatin binding of nickel(II) was investigated in Chinese hamster ovary (CHO) cells. The cytoplasmic:nuclear ratio of nickel immediately following treatment was 5:1, but by 24 and 48 hours this ratio decreased to 4:1 and 2:1, respectively, indicating that nickel is retained longer in the nucleus than cytoplasmic nickel. Chromatin was fractionated by sonication and centrifugation into fast-sedimenting, magnesium-insoluble, or magnesium-soluble components. The magnesium-insoluble portion bound more nickel ions and retained the metal longer than either the magnesium-soluble or the fast-sedimenting fractions. Treatment of cells with nickel chloride (NiCl2) decreased the amount of DNA in the magnesium-insoluble fraction but increased the amount of DNA in the fast-sedimenting chromatin fraction. The magnesium-insoluble fraction isolated from nickel-treated cells contained approximately ten times more [35-S] methionine-labeled protein per milligram DNA compared with untreated cells. The magnesium-soluble and the fast-sedimenting fractions isolated from the nickel treated cells did not exhibit a similar increase in [35-S]-methionine-labeled protein per milligram of DNA. Nickel treatment suppressed [14-C]-thymidine incorporation into total DNA by 30% compared with untreated cells. However, the magnesium-insoluble chromatin fraction from nickel-treated cells had a tenfold to 20-fold increase in thymidine incorporation, while the other chromatin fractions did not exhibit an increase in thymidine incorporation. These findings indicate that nickel induced widespread alterations in chromatin conformation and preferentially interacted with an Mg-insoluble component of chromatin. PMID- 3508472 TI - Significance of mirex-caused hypoglycemia and hyperlipidemia in rats. AB - Treatment of rats with mirex (40 ppm in diet) caused hypoglycemia, liver enlargement, and inhibition of adrenal corticosteroid-synthesizing enzyme activity. At toxic dosages (20,000 ppm mirex in diet, which has a lethal toxicity 50 [LT-50] of ten days) poisoned female rats showed severe hypoglycemia, fatty liver, adrenal hyperplasia, hypophagia, lipid mobilization, and body weight (bw) loss. A 50 micrograms/kg intraperitoneal (IP) dose of 2,3,7,8-tetrachlorodibenzo p-dioxin (TCDD) in male rats caused similar effects two days posttreatment. Hypoglycemia could be overcome by prednisone (which also inhibited adrenocorticoid-synthesizing enzyme activities) but not by streptozotocin treatment, indicating that hypoglycemia may be related to glucocorticoid deficiency resulting from inhibition of their synthesis and not by direct effects on pancreatic beta-cells. Glucocorticoid deficiency could also cause increased release of adrenocorticoid hormone (ACTH), which may enhance fat mobilization caused by hypophagia. PMID- 3508471 TI - Role of cellular calcium homeostasis in toxic liver injury induced by the pyrrolizidine alkaloid senecionine and the alkenal trans-4-OH-2-hexenal. AB - The pyrrolizidine alkaloid senecionine has been shown to be hepatotoxic, genotoxic, and cytotoxic. However, the biochemical mechanism by which senecionine produces hepatocellular toxicity remains to be elucidated. The role of calcium homeostasis in toxic liver injury was examined in isolated rat hepatocytes treated with senecionine and trans-4-OH-2-hexenal (t-4HH), a microsomal metabolite of senecionine, and appropriate cofactors. Hepatocytes treated with senecionine and t-4HH demonstrated greater cytotoxicity (leakage of lactate dehydrogenase) when incubated in the absence of extracellular Ca2+ than in its presence. Both compounds elicited an increase in cytosolic Ca2+ levels of isolated hepatocytes in the presence of extracellular Ca2+. In the following study, senecionine and t-4HH depleted intracellular glutathione levels and induced lipid peroxidation and cytotoxicity in isolated hepatocytes. Pretreatment with the thiol-group reducing agent dithiothreitol prevented depletion of intracellular glutathione and protected hepatocytes against senecionine and t-4HH induced lipid peroxidation and cytotoxicity. Both compounds also depleted intracellular ATP and NADPH levels. These results suggest that hepatotoxicity induced by senecionine and t-4HH is not dependent on the influx of extracellular Ca2+; however, alterations in intracellular Ca2+, possibly associated with depletion of intracellular glutathione, NADPH, and ATP, may play a critical role. PMID- 3508473 TI - Allylisopropylacetamide induces rat hepatic ornithine decarboxylase. AB - In rat liver, allylisopropylacetamide (AIA) treatment strongly induced (25-fold) the activity of rat hepatic ornithine decarboxylase (ODC). By either the oral or the subcutaneous route, AIA produced a long-lasting induction (30 to 40 hours) of hepatic ODC activity. Three analogs of AIA, propylisopropylacetamide (PIA), allobarbital, and allylbenzene, were active ODC inducers while a fourth, allylacetate, was not. Although induction of hepatic aminolevulinic acid (ALA) synthetase activity and the accumulation of hepatic porphyrins depend on the allyl moiety of AIA, this is not the case with hepatic ODC induction. Allylisopropylacetamide did not elevate serum alanine aminotransferase (SGPT) nor did it cause DNA damage, as measured by the alkaline elution assay. Thus, hepatic cell death is not a likely explanation of AIA's long-lasting induction of ODC. As AIA does not belong to any of the common categories of ODC inducers, it may be the chemical prototype of a new class of hepatic ODC inducers. PMID- 3508474 TI - Attenuation of 2-methoxyethanol and methoxyacetic acid-induced digit malformations in mice by simple physiological compounds: implications for the role of further metabolism of methoxyacetic acid in developmental toxicity. AB - The ethylene glycol ether 2-methoxyethanol (ME) and its oxidation product methoxyacetic acid (MAA) are selective embryotoxins and equipotent as inducers of digit malformations when given by gavage to pregnant Crl:CD-1 ICR BR mice on gestation day 11. Earlier observations showed that the teratogenic effects were attenuated by delayed administrations of ethanol given at a time when all ME is already converted to MAA. That outcome suggested that acetate from ethanol catabolism might compete with methoxy-acetate in biosynthetic reactions relevant to MAA-induced malformations. Furthermore, 14C derived from [1,2-14C]-ME or [1 14C]-MAA is incorporated into all macromolecular fractions of the embryo, and 14C is exhaled by the dam in 14CO2. Those data indicate that 14C derived from 14C-ME catabolism enters into many metabolic reactions. The present study examined acetate and other simple physiological compounds with close relationships to carbon and one-carbon moiety metabolic pathways for their ability to attenuate digit malformations upon concomitant dosing with ME. All of the agents examined reduced the teratogenic effect significantly with a potency rank order of formate much greater than acetate = glycine much greater than D-glucose. The common link for their efficacy may be the one-carbon moiety oxidation pathway that involves tetrahydrofolic acid as a catalyst of one-carbon transfer into purines and thymidylate. Carbon from all of the attenuators administered is incorporated into those bases and then into DNA. It appears as if methoxyacetate enters into biochemical reactions analogous to those of acetate. This speculation is supported by the metabolic fate of 14C from 14C-ME in dam and embryo. Based on the indirect evidence obtained with all of the simple compounds that attenuate the ME-induced digit malformations, we postulate that abnormal macromolecules are generated by anabolic reactions and that those products disrupt normal paw development. PMID- 3508475 TI - Effects of metal cations on pituitary hormone secretion in vitro. AB - Increased body burdens of metal cations are known to affect adversely reproductive function in several species. The effects of these metals on gonadal function are well documented. In contrast, little is known about their possible direct effects on pituitary hormone release. The purpose of this study was to determine, in vitro, the effects of nickel, cadmium, and zinc (50 microM) on both baseline and potassium chloride (KCl)-stimulated pituitary luteinizing hormone (LH), prolactin (Prl), and thyroid-stimulating hormone (TSH) release. Anterior pituitary fragments from adult male Long-Evans rats were evaluated using a continuous-flow perifusion system. Baseline and stimulated LH releases were unaffected by nickel and zinc; however, cadmium caused an increase in baseline LH secretion. Baseline Prl release was decreased by zinc, while cadmium resulted in increased release of this hormone. Stimulated Prl release was lower during exposure to zinc but unaltered by nickel and cadmium. Following exposure to zinc, a rebound in stimulated release was noted for all three hormones measured. These results showed that the metal cations tested did have a direct effect on pituitary hormone release at a dose lower than those reported to alter testicular function in vitro. Furthermore, the changes in pituitary hormone secretion varied depending upon the metal and hormone being evaluated. PMID- 3508476 TI - Biochemical interactions of carbamates and ecothiophate with the activated conformation of nicotinic acetylcholine receptor. AB - Purified Torpedo nobiliana electric organ acetylcholine receptor (AChR) was reconstituted into membranes containing natural phospholipids supplemented with cholesterol (25% w/w). The reconstituted system facilitates the study of the effects of drugs on the regulation of the AChR channel complex under both resting and carbachol (carb)-stimulated conditions. Neostigmine (Neo) was the only carbamate to induce activation of [3-H]-phencyclidine ([3-H]-PCP) binding to the channel sites, acting as a weak agonist. The activation of [3-H]-PCP binding is dependent upon the nature of the reconstituted systems, with carb/Neo activation ratios of 8, 3, and 1 for the intact purified AChR vesicles fraction (PVF), the PVF reconstituted in phospholipid/cholesterol (CRPVF), and the PVF reconstituted in phospholipid (RPVF), respectively. The carbamates Neo, physostigmine (Physo), and pyridostigmine (Pyrido) inhibited carb-activated [3-H]-PCP binding with Ki values of 10, 20, and 1,600 microM, respectively. The inhibition was mixed competitive-noncompetitive in nature. The characteristic response of CRPVF to carb-stimulated [22-Na] influx was inhibited by the three carbamates, with IC-50 values of 6, 50, and 1,000 microM for Neo, Physo, and Pyrido, respectively. The quaternary ammonium organophosphate ecothiophate (Eco) inhibited carb-stimulated [22-Na] influx with potency similar to that of Neo. Preincubation of AChR preparation with the carbamates and ecothiophate caused a reduction in the binding of [125-I]-alpha-bungarotoxin ([125-I]-alpha-BGT) with the following decreasing order of potency: Neo less than Physo less than Eco less than Pyrido. Calcium has a direct modulatory role on the time-course inhibition of [125-I] alpha-BGT binding by these drugs. While we observed a high potency of Neo and Physo in inhibiting [125-I]-alpha-BGT binding, it was undetectable for the carbamate insecticide 2-methyl-2-(methylthio)propionaldehyde-O (methylcarbamoyl)oxime (aldicarb). These data suggest that the potent anticholinesterase carbamate agents interact differently with the AChR and its ionic channel. Their interactions with the nicotinic AChR channel system can be described as (a) weakly agonist, (b) directly acting on the open conformation of the channel, and (c) blocking the AChR-binding sites. PMID- 3508477 TI - Age and growth-related changes in cyclopiazonic acid-potentiated lipophilic cation accumulation by cultured cells and binding to freeze-thaw lysed cells. AB - In a previous study (1) we demonstrated that increased tetraphenylphosphonium (TPP) uptake by renal epithelial cells (LLC-PK1) exposed to the fungal metabolite cyclopiazonic acid (CPA) was not a result of hyperpolarization across the plasma membrane even though CPA-potentiated TPP uptake could be totally inhibited by the depolarizing agent carbonylcyanide-m-chlorophenylhydrazone (CCCP). We now demonstrate that CPA potentiates TPP accumulation by proliferating skeletal muscle (L6) and LLC-PK1 cells but not by nonproliferating primary rat hepatocytes. In LLC-PK1 cells, CPA-potentiated TPP accumulation is observed in cells at all ages. In L6 cells, CPA-potentiated TPP accumulation is maximal soon after subculturing, and as the cells age they become less sensitive to CPA until TPP accumulation by CPA-treated cells approaches that of untreated cells. The temporal change in sensitivity of L6 cells to CPA may be related to biochemical and/or metabolic changes which occur as the cells age in culture. Hepatocytes, LLC-PK1 cells, and L6 cells permeabilized by freeze-thaw lysis, all exhibit CPA potentiated TPP partitioning, even in the presence of CCCP. This result indicates that both TPP and CPA must have access to the intracellular space in order for potentiated TPP partitioning to be observed. We hypothesize that the site of interaction between CPA and TPP is intracellular and probably associated with the cytoplasmic side of the plasma membrane and possibly the mitochondria. PMID- 3508478 TI - Cerebral glucose and glycogen metabolism in diazinon-treated animals. AB - The intraperitoneal (IP) treatment of rats with diazinon (40 mg/kg) resulted in a variety of changes in the brain. Glycogen was depleted, but there was an increase in the activities of glycogen phosphorylase, phosphoglucomutase, hexokinase, lactate dehydrogenase, and fructose 1,6 diphosphatase. The activity of glucose-6 phosphatase was unaffected while that of cholinesterase was significantly reduced. Lactic acid content was increased, while that of pyruvate was not altered. Animals developed tremors and convulsions, which were maximal two hours after treatment. The induced changes may be compensatory mechanisms to provide extra energy to cerebral tissue as a result of the stimulatory effects in diazinon-treated animals. PMID- 3508479 TI - Induction of single-strand breaks and interstrand cross-links in liver DNA after the administration of 2-acetylaminofluorene and trans-4-acetylaminostilbene to rats. AB - 2-Acetylaminofluorene (AAF) or trans-4-acetylaminostilbene (AAS) was orally or intraperitoneally administered to female Wistar rats. DNA from liver cells was analyzed for single-strand breaks by the alkaline elution assay. Only borderline effects were observed with doses (100 mumol/kg) used in animal carcinogenesis experiments. Even high doses of AAF (1,000 mumol/kg) were not effective. Methyl methanesulfonate (MMS) in vivo and gamma irradiation in vitro were shown to produce dose-dependent DNA single-strand breaks (positive control). Only a marginal effect was obtained with 100 mumol/kg MMS. The elution rate of DNA was increased by a factor of 34 in liver cells in vitro with 400 rad of gamma irradiation. Only a fraction of this rate could be demonstrated immediately after irradiation in vivo, and no lesions were found two hours later. This strongly indicates the rapid repair of single-strand breaks. Additional experiments showed that AAS, a nonhepatocarcinogen, produced more interstrand cross-links in the rat liver DNA than did AAF. PMID- 3508480 TI - Characterization of cadmium-binding proteins detected in rat liver by the western blotting technique. AB - Out of the three cadmium-binding proteins (CD-BPs) in rat liver parenchyma (40K, 29K, and 24K CdBPs), the 40K Cd-BP showed the highest affinity for cadmium (Cd), with a dissociation constant (KD) of 1.2 x 10(-8) M. This is in between the affinity of human serum albumin KD = 3.8 x 10(-5) M) and metallothionein (KD = less than 10(-11)). These Cd-BPs may be responsible for hepatic sequestration of cadmium. PMID- 3508481 TI - Embryotoxicity induced by diethylstilbestrol in vitro. AB - The embryotoxic potential of diethylstilbestrol (DES) was examined in a whole embryo culture system containing a P-450-dependent bioactivating system. Sprague Dawley rat embryos were explanted on day 10 and cultured for 24 hours. Concentration-dependent effects of DES on embryonic growth parameters, viability, and embryotoxicity were observed. Concentrations of DES greater than 0.26 mM (final concentration) produced 100% embryolethality, while those below 0.15 mM were without significant effects. At a final concentration of 0.19 mM, DES produced only a slight increase in embryolethality. The same concentration elicited a marked increase in observed embryotoxicity, including prosencephalic hypoplasia, incomplete axial rotation, and open neural tubes. In addition, reductions in embryonic length, somite number, and protein and DNA content were observed. An exogenous P-450-dependent hepatic biotransforming (catechol generating) system failed to alter either the incidence of observed toxic effects or measured growth parameters. Likewise, exposure of cultured embryos to 20% carbon monoxide (CO) failed to reduce DES-induced embryotoxicity, indicating a lack of participation of an endogenous P-450-dependent embryonic bioactivating system. Arachidonic acid (0.20 mM) and/or indomethacin (0.50 mM) also had no observable effect on DES-induced embryotoxicity, suggesting that prostaglandin synthase was not involved in the embryotoxic activity of DES, as has been proposed to explain its carcinogenic effect. The antioxidants N-acetylcysteine (1.14 mM) and alpha-tocopherol (0.08 mM) failed to protect against DES-induced embryotoxicity, while the anti-estrogen tamoxifen (up to 0.85 mM) actually enhanced this effect of DES in culture. The DES analogs Z,Z-dienestrol (DIES, 0.10 mM) and hexestrol (HES, 0.48 mM) were both embryotoxic in vitro. The presence of an exogenous P-450-dependent hepatic biotransforming system appeared to protect against HES-induced embryolethality but had little effect upon DIES induced embryotoxicity. The results were consistent with a direct effect of DES independent of either estrogenicity or exogenously generated metabolites. PMID- 3508482 TI - Alterations in platelet aggregation and microsomal benzo-alpha-pyrene hydroxylase activities after exposure of rats to a Prudhoe Bay crude oil. AB - Administration of a Prudhoe Bay crude oil (PBCO) to rats has been shown to (a) inhibit platelet aggregation induced by adenosine diphosphate (ADP), arachidonic acid, or epinephrine and (b) induce benzo-alpha-pyrene hydroxylase (BPH) in the liver and small intestine. Maximum inhibition of aggregation (90%) was seen 12 to 16 hours subsequent to dosing. However, substantial inhibition was observed as early as four hours and as late as 48 hours after dosing. Of particular interest was the sensitivity of the platelet response compared with the putatively sensitive response of monooxygenase induction in liver. As little as 0.1 ml of PBCO per kilogram body weight (bw) caused an inhibition of aggregation with all three agonists. A similar inhibition of the release of ADP from platelets in the presence of arachidonic acid or epinephrine was also observed. In contrast, hepatic BPH activity showed only a modest increase (67%) over the control value even after administration of 2 ml of PBCO per kilogram body weight. Small intestine BPH activity was more sensitive, showing a gradual increase of up to 19 fold 24 hours after dosing with 2 ml of PBCO per kilogram body weight. The sensitivity of the platelet response is of general environmental interest and evaluating platelet aggregation in humans may be important as a noninvasive assay for exposure to either accidental or "acceptable" levels of petroleum hydrocarbons in the occupational environment. PMID- 3508483 TI - The role of complement in inflammation during experimental pneumococcal meningitis. AB - The mechanism whereby an effective bactericidal inflammatory reaction develops in the subarachnoid space is not clearly defined. While normal cerebrospinal fluid is deficient in complement, immunoglobulin and leukocytes, these serum components appear in cerebrospinal fluid (CSF) during the course of bacterial meningitis. Using a rabbit model of pneumococcal meningitis we examined the role of the alternate complement pathway in three early events important to the defense of the subarachnoid space: leukocyte chemotaxis, phagocyte mediated bacterial killing, and clearance of bacterial components from the cerebrospinal fluid space. Rabbits treated with cobra venom factor to deplete complement were inoculated intracisternally with encapsulated (type II or XIX) pneumococci. Following complement depletion, there was a dramatic (at least 100-fold) decrease in the LD50 for these strains. Nevertheless, complement depletion did not affect the magnitude of CSF leucocytosis or the rate of clearance of bacterial particles from CSF. A short delay in the appearance of leukocytes in CSF was found in the absence of complement. The major effect of complement depletion, however, was to diminish the efficiency of leukocyte mediated killing of encapsulated bacteria in the CSF. Although the short delay in the onset of leukocytosis in the complement depleted animals is consistent with a chemotactic role of complement in the normal animal, the quantitatively normal leukocytosis in the complement depleted rabbits clearly indicates that important chemotaxins other than complement function in CSF. Inhibition of leukocytosis by indomethacin and diclofenac suggests that metabolite(s) of the arachidonic acid pathway may perform such a chemotactic role. A major role of complement in the defense of the subarachnoid space appears to be as an opsonin needed for the effective bactericidal activity of leukocytes. It is the lack of this function that best explains the greatly decreased LD50 value of encapsulated pneumococci in the complement depleted animal. PMID- 3508484 TI - Effect of antibody to interferon on genital herpesvirus infection in mice. AB - The effect of anti-mouse interferon (IFN) antibody on the course of genital herpes infection was studied in C57B1/6J mice. As we have previously described, intravaginal inoculation of C57 mice with herpes simplex virus type 2 (HSV-2) results in the development of genital lesions, subsequent encephalitis and death, with the mortality rate dependent on virus dose. In the present study, we found that intravaginal application of 1 x 10(5) units of anti-mouse (alpha/beta) IFN antibody did not significantly affect the course of infection. However, intraperitoneal or intravenous injection (the latter to a lesser extent) of anti IFN antibody resulted in increased morbidity and mortality. In addition, intraperitoneal injection of anti-IFN antibody decreased the level of detectable endogenous IFN in peripheral blood and at the site of infection. The clear effect of anti-IFN antibody during early stages of infection points to the possible significance of early endogenous IFN production in ameliorating HSV-2 genital infection. PMID- 3508485 TI - Inactivation of the alpha-haemolysin gene of Staphylococcus aureus 8325-4 by site directed mutagenesis and studies on the expression of its haemolysins. AB - S. aureus strain 8325-4 was shown to produce alpha-, beta-, delta- and gamma haemolysins by haemolytic assays and immunoblotting. Hybridization experiments indicated that a single copy of the alpha-haemolysin gene (hla) resides in the chromosome. Site-directed mutagenesis was used to inactivate the hla gene. This gene, which had previously been cloned in E. coli, was inactivated in vitro by inserting a fragment carrying an erythromycin resistance marker. Shuttle plasmids were constructed and transformed into 8325-4 and non-haemolytic recombinants enriched by a plasmid incompatibility technique. A previously isolated Tn551 insertion defective in alpha-haemolysin was not located in hla. It had pleiotropic defects in expression of alpha-, beta- and delta-haemolysins. Expression of alpha-haemolysin from a plasmid-located hla gene was very low. In contrast, hla-erm mutants were deficient only in alpha-haemolysin and allowed high level expression of the plasmid-borne hla gene. The Tn551 insertion is probably located in a gene encoding a positive regulatory element required for expression of several exoproteins. An hla-erm mutant was less virulent than the otherwise isogenic 8325-4 hla+ strain in a mouse peritonitis model, confirming that alpha-haemolysin is an important virulence factor. PMID- 3508486 TI - Selection of mutants of mumps virus with altered structure and pathogenicity by passage in vivo. AB - The neurotropic Kilham strain of mumps virus was serially passaged in newborn hamster brains in order to assess possible changes in viral characteristics. Two modes of passage were employed, one with a 4-5 day interval between inoculation and harvest and the other with a 10-12 day interval. After 10 and 8 passages, respectively, two viral variants were isolated which differed in antigen characteristics and in pathogenicity. In Vero cell cultures the variant derived from the short-term passage, designated as RK, showed much greater fusion capacity than the other, designated as SK. The highly fusing variant was highly lethal and caused much more extensive necrosis and grew to higher titers in the brain. With a series of monoclonal antibodies directed against the structural proteins of mumps virus marked differences between the variants could be detected in the nucleocapsid (NP) protein and also slight changes in the hemagglutinin neuraminidase (HN) and phospho- (P) proteins. Differences were found in the preference of the viral variants to infect various regions of the brain. The RK variant heavily infected the caudate nucleus whereas the SK variant did not. This study demonstrates that different modes of passage can affect characteristics of virion components and disease pattern. PMID- 3508487 TI - Production of a monoclonal antibody to human interferon-alpha (IFN-alpha) and its use to identify IFN-alpha-producing cells in virus infection in vivo. AB - A monoclonal antibody to human interferon-alpha (IFN-alpha) was produced using affinity-purified IFN-alpha, that reacted with recombinant human IFN-alpha 2, but not with IFN-alpha 1, IFN-alpha M1 or IFN-beta. Indirect immunofluorescence using this monoclonal (designated 6C3) and anti-IFN-alpha polyclonal antibodies identified cells expressing IFN-alpha. After Sendai virus induction of normal human buffy-coat cells the proportion of monocytes and lymphocytes expressing IFN alpha rose progressively from 0% to 50% and 34% respectively, preceding peak IFN alpha titres in the culture supernatants. Around 80-90% of polymorphs were IFN alpha-positive using both antisera, with or without IFN induction, although very little IFN bioactivity was released to the supernatant of polymorph cultures after IFN induction. Sections of hepatitis B virus infected human liver tissue showed foci of IFN-alpha-positive infiltrating mononuclear cells and (to a lesser extent) fibroblasts in patients who had active cirrhosis and evidence of virus replication. These findings suggest that polymorphs constitutively express IFN alpha 2 related antigenic activity, whose biological activity is at present unknown; and demonstrates the identification of IFN-alpha-expressing cells in sections of tissue undergoing natural virus infection. PMID- 3508488 TI - Central nervous system and genital infection with reactivation of latent herpes simplex virus type 2 in mice. AB - To establish a reactivation model of genital and central nervous system infection, 3- to 12-week-old outbred or BALB/c mice were inoculated vaginally with the HG-52 strain of herpes simplex virus type 2 (HSV-2). Primary infection was confirmed by serially positive vaginal cultures. Mortality in 6- and 12-week old infected mice was about 20%. In survivors, clearance of infectious virus was confirmed in serially negative vaginal cultures. At 6 weeks, immunosuppression of survivors with cyclophosphamide and antilymphocyte serum was begun. Recurrent virus shedding, monitored by daily vaginal cultures, was detected in the majority of animals. All mice became moribund or died, usually during the third to fifth weeks of immunosuppression. Brains and spinal cords from which all sensory ganglia had been removed were homogenized and inoculated onto cultures. One or both central nervous system (CNS) samples were virus-positive in nearly half of these mice, and cell-free virus was isolated from most positive brain and cord supernatants tested. Three-fourths of mice had evidence of virus reactivation with immunosuppression, as indicated by vaginal or CNS isolations, and by failure to isolate virus by identical means in matched infected, non-immunosuppressed controls. Vaginal, spinal cord and brain isolates occurred independently of one another in many immunosuppressed mice, and could not be predicted from presence or absence of external genital lesions during primary infection. These experiments show that with immunosuppression, reactivations of latent HSV-2 infections in mice can be detected in the genital tract and CNS, and provide a model to study productive, recurrent CNS infection and disease. PMID- 3508489 TI - Virulence plasmid-associated HeLa cell induced cytotoxicity of Yersinia pseudotuberculosis. AB - A virulent plasmid-containing strain and an isogenic plasmid-free avirulent derivative strain of Y. pseudotuberculosis were compared with respect to the interaction with cultured HeLa cells. No difference in the ability to adhere to HeLa cells was observed. Both strains invaded the HeLa cells to the same degree. The internalized bacteria did not multiply over a 24-h period. When incubated at 37 degrees C HeLa cells infected with the virulent plasmid-containing strain YPIII(pIB1) showed morphological changes in contrast to the avirulent plasmid free strain YPIII which showed no such effect. This cytotoxic effect was recorded after about 2 hours of incubation at 37 degrees C. This event could be prevented by addition of gentamicin 1 hour before the predicted time of the morphological changes of the HeLa cells. A number of transposon Tn5 derived plasmid mutants were analyzed and a correlation was found between virulence and ability to induce cytotoxicity. The cytotoxic effect was not absolutely linked to Ca2+-dependence because one Ca2+-independent mutant was found to be cytotoxic. This mutant was able to express the temperature-inducible plasmid-coded outer membrane proteins (YOPs) as well as the V-antigen. On the molecular level a strong correlation was found between expression of some of the YOPs, the V-antigen and the cytotoxic effect. However, one of these YOPs, YOP1, could be eliminated as being an important determinant of cytotoxicity because an insertion mutant of the corresponding structural gene was still able to induce cytotoxicity. PMID- 3508490 TI - A new subtype of a natural viral inhibitor (CVI) that is stable in the gastrointestinal tract. AB - A virus inhibitor found in gastric secretions and in extracts from gastrointestinal tissues is described. The inhibitor shares a number of characteristics with the recently described contact-blocking virus inhibitor (CVI), which is produced by unstimulated cells in culture, and occurs naturally in some body fluids. The new inhibitor, which we have designated gastrointestinal CVI (GI-CVI) is similar to the originally described CVI in its resistance to denaturation by acid and alkali, stability at 100 degrees C, and broad antiviral action. GI-CVI can be distinguished from the previously described material by its resistance to proteolytic inactivation and enhanced heat stability, however. This new virus inhibitor has been found in significant titers in gastrointestinal secretions and tissue extracts from three mammalian species. PMID- 3508491 TI - Antigenic changes in gp70 associated with the adult variant of Gross murine leukemia virus, WB91. AB - Gross murine leukemia virus (GV) is not leukemogenic in adult mice whereas a variant of GV, WB91, is highly leukemogenic regardless of the age of the inoculated animal. FACS and SDS-PAGE analysis have demonstrated that these viruses differ at least with respect to the env-encoded gp70 molecule. FACS analysis of virus infected or virus transformed cells with a type specific monoclonal antibody (mAb #55) indicated a difference in determinants associated with gp70 expressed by the two viruses. Rat antisera raised against GV- or WB91 induced tumor cells demonstrated that there were no crossreactive determinants between the gp70 molecules expressed on these tumor cells as recognized by the rat antisera. This difference in the gp70 molecules encoded by WB91 and GV may account for the ability of the WB91 virus to induce leukemia in adult mice, possibly by affecting the immunogenicity of the virus. PMID- 3508492 TI - Strong biotype and serotype cross-protective antibacterial and antitoxic immunity in rabbits after cholera infection. AB - We studied whether immunity evoked by infection with classical or El Tor V. cholerae 01 organisms in rabbits (the RITARD model) also gives protection against cholera caused by V. cholerae of heterologous biotype as well as serotype, and whether such protection is antibacterial and/or antitoxic. A primary infection with a classical Ogawa or El Tor Inaba strain resulted in intestinal colonization and diarrheal disease in a dose-related manner though the El Tor strain was more virulent. As few as 10(3) El Tor organisms gave disease in more than 90% of the rabbits as compared to 10(9) classical organisms (ED90); the El Tor strain also gave rise to diarrhea with earlier onset and of greater severity and longer duration. The primary infection induced strong protective immunity against later challenge with either the homologous or the heterologous strain in doses that corresponded to 1,000 x ED90. Protection was associated with marked inhibition of colonization, and when rabbits convalescing from cholera infection were challenged with graded doses of bacteria or purified toxin in ligated intestinal loops significant antibacterial as well as antitoxic immunity was evident. Titer rises in serum vibriocidal and anti-lipopolysaccharide antibodies were similar after infection with either strain, whilst antitoxin titer rises were more marked after El Tor infection. During infection V. cholerae 01 organisms seem to express protective antigens that stimulate immunity which extends across both biotype and serotype barriers. PMID- 3508493 TI - Lysosomal involvement in cellular intoxication with Clostridium difficile toxin B. AB - The process of internalisation of Clostridium difficile toxin B into human lung fibroblasts was further studied, with the aim of elucidating the fate of endocytosed toxin. Development of the toxin-induced cytopathogenic effect was reversibly inhibited at 18 degrees C and in the presence of 200 mM KCl or 1-20 mM benzyl alcohol, i.e. at conditions when the fusion between endosomes and lysosomes is prevented. Fibroblasts treated with toxin at 37 degrees C but transferred to 18 degrees C within 10 min were also completely protected, whereas transfer to 18 degrees C later during the latency resulted in only partial protection. KCl was also protective upon addition after the toxin binding step. Inhibitors of lysosomal proteases, such as chymostatin, leupeptin and antipain, prevented the appearance of the cytopathogenic effect, when present during toxin exposure or added after the toxin binding step. Chinese hamster ovary cell mutants, defective in acidification of their endosomes, were resistant to toxin B, whereas wildtype cells were sensitive. The resistance was not overcome by applying a low extracellular pH. The results suggest that exposure to a low pH compartment is necessary but not sufficient for entry of active toxin B to the cytosol. In addition to a low pH, a fusion of toxin-containing endosomes with lysosomes and a further processing of the toxin by lysosomal proteases is required for cellular intoxication. PMID- 3508494 TI - Comparative studies of wild-type and cold-mutant (temperature-sensitive) influenza virus: detection of mutations in all genes of the A/Ann Arbor/6/60 (H2N2) mutant vaccine donor strain. AB - Direct biochemical evidence has been obtained for the existence of mutations in all eight RNA segments of the A/Ann Arbor/6/60 cold-adapted (ca) mutant influenza virus strain as compared with its wild-type (wt) progenitor. Polyacrylamide gel electrophoresis (PAGE) of viral RNA revealed a change in the electrophoretic migration of RNA 2 (PB1). T1 oligonucleotide mapping revealed changes in two polymerase genes (the PB2 and PA genes), the hemagglutinin (HA) gene and the nucleoprotein (NP) gene. Analysis of S1 nuclease-treated RNA hybrids on polyacrylamide gels detected changes in the HA and neuraminidase (NA) genes. Partial DNA sequence analysis demonstrated a base sequence change in the matrix (M) protein gene that predicts an amino acid change in the M2 protein and a silent mutation in the non-structural (NS) protein gene. In addition, analysis of viral polypeptides by PAGE has so far revealed changes in the viral protein, PA. These findings directly demonstrate the existence of multiple mutations in the ca vaccine strain, a property that may provide reliably and stably attenuated vaccines that derive their six internal genes from the ca A/Ann Arbor/6/60 donor strain. PMID- 3508495 TI - Comparison of the nucleotide sequences of the genes for the thermostable direct hemolysin and the thermolabile hemolysin from Vibrio parahaemolyticus. AB - The nucleotide sequences of genes encoding the thermostable direct (TSD) hemolysin and the thermolabile (TL) hemolysin of Vibrio parahaemolyticus were determined. From the nucleotide sequence of the TSD hemolysin gene, it was revealed that the preprotein and the mature protein consisted of 189 amino acids and 165 amino acids, and that the molecular weights were 21.1 kDa or 18.5 kDa, respectively. Our data regarding TSD hemolysin were in complete agreement with previously published data. From the nucleotide sequence of the TL hemolysin gene, it was revealed that the preprotein and the mature protein consisted of 418 amino acids and 398 amino acids, and that the molecular weights were 47.5 kDa and 45.3 kDa, respectively. The GC content of the TSD hemolysin gene was 35.6%, while that of the TL hemolysin gene was 47.6% which is almost the same as that of V. parahaemolyticus genome. Maxicell analysis revealed that the molecular weights of the proteins encoded by the TSD hemolysin gene were 22.0 and 19.5 kDa, and that of the protein encoded by the TL hemolysin gene was 45.5 kDa, and that the promoters of these two hemolysin genes of V. parahaemolyticus were functional in Escherichia coli. PMID- 3508496 TI - Biological studies of the fusion function of California serogroup Bunyaviruses. AB - Like other enveloped viruses, La Crosse virus is capable of inducing membrane fusion after exposure to mild acid. This function is known to have biological significance at the level of the whole organism, since it has been related to infection in a mouse model. In this report the process of fusion-from-within (FFWI) for LAC and other members of the California serogroup of Bunyaviruses is characterized. Like fusion-from-without, FFWI is dependent on pH, temperature, and number of virus particles present in the supernatant of fusing cells. Electron micrographs demonstrate that LAC mediated cell membrane fusion is a rapid, multi-point event, and that other than fusion of their plasma membranes, the cells do not show any morphological change. In agreement with theory, lysosomotropic agents were capable of inhibiting La Crosse virus infection. This inhibition was not due to non-specific toxic effects on infected cells. Finally, fusion studies of other California serogroup members revealed minor differences in the pH of fusion induction in some strains. These differences were consistent with the known subtyping within the serogroup. PMID- 3508497 TI - Salmonella cytotoxin: a component of the bacterial outer membrane. AB - Salmonella cytotoxin present in cell-free sonic lysates causes rounding and detachment of Chinese hamster ovary (CHO) cells. Although the precise role of this toxin in the pathogenesis of salmonellosis is unclear, cytotoxin production by Salmonella could account for tissue damage or possibly, facilitate invasion. A variety of other bacteria (e.g. Shigella, Escherichia, Legionella) have been shown to form soluble cytotoxins, many of which may be involved in pathogenesis. The data in this report indicate that the Salmonella cytotoxin in cell-free sonic lysates is firmly associated with cell membrane fragments that can be pelleted by ultracentrifugation (270,000 g for 2.4 h). Furthermore, lysozyme treatment of filter-sterilized sonic extracts of Salmonella species followed by isopycnic sucrose gradient ultracentrifugation allowed separation of the outer and inner membrane components. The outer membrane (OM) peak contained the cytotoxic activity when assayed for detachment of CHO cells. The importance of these data resides in the observation that the Salmonella cytotoxin is an outer membrane component. Its mere location places it in a position of direct contact with host cells and suggests a possible role in cell damage and/or invasion. Furthermore, ultracentrifugation provides a method by which much of the Salmonella cytotoxin in sonic extracts can be removed allowing expression of the Salmonella enterotoxin, whose CHO cell elongation effect is usually obscured by the presence of the cytotoxin causing cell rounding and detachment. PMID- 3508499 TI - Salivary and serum antibodies in patients with Yersinia enterocolitica infection. AB - The systemic and secretory antibody response in patients with yersiniosis was studied by measuring Yersinia antibodies of various isotypes (IgG, IgA and IgM) and the total concentrations of the corresponding Ig classes in serum and saliva. Specific antibody activities of IgG (IgG antibody concentration divided by IgG concentration) were almost identical in serum and saliva of all patients although the pair of values varied from patient to patient. Almost all salivary IgG of these patients was therefore probably a transudate from the blood. Specific antibody activities of IgA and of IgM, on the other hand, varied independently in serum and saliva. Occasional great differences between serum and saliva values indicate that most of the salivary IgA and IgM (more than 90%) is produced locally at least in some individuals. The local anti-Yersinia response was restricted to IgA in some individuals, to IgM in others, whilst yet other patients produced salivary antibodies of both isotypes. PMID- 3508498 TI - Analysis of a surface protein of Streptococcus pneumoniae recognised by protective monoclonal antibodies. AB - Using two monoclonal antibodies which protect mice from a fatal challenge with S. pneumoniae, we have identified a surface protein antigen on the pneumococcus. These antibodies recognised components of 84 and 76 kD in a cell wall extract of the nonencapsulated strain, R36A, against which they were made. Absorption experiments indicated that both of the antibodies recognised the same two proteins. The proteins detected by the antibodies in the encapsulated type 2 strain D39 and type 3 strain WU2, exhibited different molecular weights than those proteins detected from R36A. Using a colony blot procedure and a quantitative ELISA, we have shown that these antibodies react with 6 of the 21 pneumococcal strains tested. There was no association between reactivity with these anti-protein antibodies and the capsular serotype of the pneumococcal isolates tested. PMID- 3508500 TI - Molecular cloning and expression of the epidermolytic toxin A gene of Staphylococcus aureus. AB - The gene coding for serotype A of epidermolytic (exfoliative) toxin has been cloned from Staphylococcus aureus in Escherichia coli phage lambda and plasmid vectors. The coding sequence for eta was localised by subcloning and transposon Tn5 mutagenesis experiments. The eta gene was probably expressed from its natural promoter in E. coli. The protein synthesised in E. coli was located predominantly in the periplasm. It was immunochemically indistinguishable from the toxin purified from S. aureus culture supernatants and had the same molecular weight. Furthermore, subcutaneous injection of this material caused epidermal splitting (the Nikolsky reaction) showing that it was biologically active. An eta shuttle plasmid was transformed into protoplasts of S. aureus. The level of expression of toxin in strain 8325-4 was shown to be dependent on the integrity of the agr gene which is known to be required for the expression of several exoproteins. PMID- 3508501 TI - Detection of viral-specific nucleic acid and intracellular virions in ventral horn neurons of lactate dehydrogenase-elevating virus infected C58 mice. AB - C58 mice which have been immunosuppressed by treatment with cyclophosphamide (200 mg/kg) one day prior to infection with the C strain of lactate dehydrogenase elevating virus (LDV-C) develop poliomyelitis. Using in situ hybridisation, we found that some ventral horn neurons in these mice contain cytoplasmic viral specific nucleic acid. Viral-specific nucleic acid was also found within a few small cells located near inflammatory foci. In addition, mature virus particles were observed by electron microscopy in some ventral horn neurons, indicating that these cells are productively infected in C58 mice. Neither viral nucleic acid nor virions were found in the ventral horn neurons of poliomyelitis resistant mouse strains or C58 mice that were not immunosuppressed prior to infection. Ventral horn neurons which contained viral nucleic acid or virions within cytoplasmic vesicles generally were normal in appearance and were not located within poliomyelitis inflammatory foci. Our data are consistent with the hypothesis that infected neurons first replicate virus and subsequently are attacked and cleared by inflammatory cells. PMID- 3508502 TI - ["In vitro" evaluation of the sealing capacity of different root canal obturation technics using 0.2% Rodamine B dye infiltration]. PMID- 3508503 TI - [The computer and psychological assistance]. PMID- 3508504 TI - [Treatment of the hypertrophic labial frenum. Report of a case]. PMID- 3508505 TI - [Human intestinal parasites in Subsaharan Africa. I. Eastern Boe and Canhabaque Island (Guinea-Bissau)]. AB - A coprological survey was carried out in 1982-1983 in East Boe and in Canhabaque Island, (Bijagos Islands), where 289 and 288 specimens of stools, respectively, have been collected. The samples were taken from apparently healthy subjects, of both sexes and of different age groups. The tests were made according to the modified Ritchie technique. The following results were obtained: A) East Boe: 1) Protozoa: E. coli 68.9%, E. nana 24.6%, G. intestinalis 8.7%, I. buetschlii 5.9%, E. histolytica 1.7%, E. hartmanni 0.7%, T. intestinalis 0.7%. b) Helminths: Ancylostomatidae 69.2%, T. trichiura 38.4%, S. stercoralis 6.2%, Taenia sp. 1.7%, H. nana 0.7%, S. haematobium 0.7%, S. mansoni 0.7%, S. fuelleborni 0.7%. B) Canhabaque: a) Protozoa: E. coli 85.1%, I. buetschlii 14.9%, E. nana 12.5%, G. intestinalis 8.3%, C. mesnili 7.3%, E. hartmanni 1.4%, E. histolytica 1.0%, T. intestinalis 0.4%. b) Helminths: Ancylostomatidae 87.9%, T. trichiura 9.4%, S. stercoralis 7.9%, S. fuelleborni 2.8%, Trichostrongylus sp. 1.4%, A. lumbricoides 0.7%, H. nana 0.4%. Eggs of Capillaria sp. probably pseudoparasites, were found in 8.7% of samples. The high prevalence of Ancylostomatidae infections appears to be related to the heavy fecal pollution all over the examined territory. The utilization of antihelminthic drug of popular medicine, which has a specific action on A. lumbricoides, could explain the lack and the low prevalence, respectively, of A. lumbricoides infections in both examined areas. In the past, other authors emphasized the low prevalence of this parasite for other Guinea Bissau regions which have a different geomorfological constitution. The cases of S. fuelleborni and H. nana are the first reported for Guinea Bissau. PMID- 3508506 TI - [Human intestinal parasites in Subsaharan Africa. II. Sao Tome and Principe]. AB - In 1983 the authors carried out a survey in the Democratic Republic of Sao Tome and Principe, analysing 1050 specimens of stools collected among the population from apparently healthy subjects chosen at random and in a number proportional to the distribution of the population in the regions of the country (about 1% of the population was examined). The examined subjects were divided into 3 age groups (0 3, 4-12, more than 12 years old), to have homogeneous groups in relation principally to modalities of life and nutritional patterns. There were 488 male subjects and 562 females. The survey was preceded by a sensitization of the people to the problem of intestinal parasites and by two preliminary surveys about the number of existing latrines and about people's believes and attitudes in relation to helmintiasis. The tests were made according to the modified Ritchie technique on fecal specimens preserved with 10% formol solution. The following results were found: a) Protozoa: Entamoeba coli, 43.0%; Iodamoeba buetschlii, 9.0%; Giardia intestinalis, 8.8%; Endolimax nana, 7.0%; E. histolytica, 5.5%; E. hartmanni, 2.5%; Chilomastix mesnili, 2.3%; Trichomonas intestinalis, 0.2%; Balantidium coli, 0.1%. b) Helminths: Trichuris trichiura, 87.7%; Ascaris lumbricoides, 64.3%; Ancylostomatidae, 40.5%; Strongyloides stercoralis, 6.8%; Hymenolepis diminuta, 0.3%; H. nana, 0.2%; Schistosoma haematobium, 0.2%. In 28.2% of the specimens (with more than 50% of subjects in some villages) eggs of Heterophyidae were found, very similar to Metagonimus yokogawai, but not yet identified by us, with the following characteristics: elliptical shape, average size 25 mu (22.2-27.7) X 18.5 mu (17-21), thick wall, operculum difficult to see, not sticking out from the outline but visible by focusing being in a different refractiveness, presence of a small polar knob, colour slightly brownish, asymmetric miracidium. Further investigations are necessary to identify the species of this trematode and to understand if it is a true human parasite or a pseudoparasite. The general results show the existence of a heavy fecal pollution all over the territory of the D.R. of Sao Tome and Principe, connected with unhygienic life conditions, dangerous for health. This suggests to start urgently a sanitation program. PMID- 3508507 TI - [Human intestinal parasites in Subsaharan Africa. III. Pemba Island (Zanzibar Tanzania)]. AB - The authors carried out a coprological survey in Pemba Island, analysing, by modified Ritchie technique, 413 stools samples. The specimens were collected among the population from apparently healthy subjects chosen at random in a number equal to 2% of the whole population. The examined subjects were divided in 3 age groups, 211 were males, 202 females. The following results were obtained (in order of prevalence): a) Protozoa: Entamoeba coli 35.6%, Giardia intestinalis 5.6%, Endolimax nana 4.3%, E. histolytica 3.1%, Chilomastix mesnili 2.9%, Iodamoeba buetschlii 4.3%, E. hartmanni 0.7%; b) Helminths: Trichuris trichiura 87.9%, Ancylostomatidae 67.5%, Ascaris lumbricoides 39.7%, Strongyloides stercoralis 18.9%, Schistosoma haematobium 1.9%, S. mansoni 0.2%, S. fuelleborni 0.2%, Enterobius vermicularis 0.2%. The high moisture of soil and the rain distribution during the year could be favouring the high prevalence of T. trichiura and Ancylostomatidae. The case of schistosomiasis due to S. mansoni reported, seems to be imported from the Mainland, while the case of S. fuelleborni could be autochtonous. Totally, 392 subjects (94.4%) were found positive for pathogenic species (Helminths and Protozoa). PMID- 3508508 TI - Parasitological study of a population of Tiber River eels (Anguilla anguilla). AB - A study was conducted on the parasitofauna of Anguilla anguilla caught in the section of the Tiber river south of Rome (Italy). The sample examined consisted of 417 specimens that were classified by stage (elver, young yellow eel, yellow eel and silver eel) and season of sampling. The following species were identified: Trypanosoma granulosum, Eimeria anguillae, Myxidium giardi, Sphaerospora reichenowi, Myxobolus sp., Trichodina anguilli, Ichthyohodo sp., Gyrodactylus anguillae, Bothriocephalus claviceps, Proteocephalus macrocephalus, Raphidascaris acus, Acanthocephalus clavula. Each parasite species was considered in its prevalence according to stage and season. For some parasite the pathogenic effect was also examined in a histological study of serial sections. The results of the statistical analysis of the single parasitic infection as related to different seasons pointed to marked seasonal trends only in some species (Trypanosoma granulosum and Gyrodactylus anguillae). The intensity of infection assessed for acanthocephalan infection only was found to affect neither weight nor condition index (weight/length3). No difference in weight or condition index was found to be ascribable to the presence or absence of a species. An attempt to find a rule-of-thumb algorithm to gauge the overall effect to parasitic diseases failed to give sufficiently significant results. PMID- 3508509 TI - [Genetic differentiation of the Trichinella genus with isoenzymatic analysis]. AB - Twenty-six Trichinella isolates have been examined by the isoenzyme typing of ten enzyme systems (LDH, ME, 6PGDH, G6PDH, GOT, AK, PGM, ACON, MPI, GPI). Four different zymodemes were obtained. All the examined isolates have shown an electrophoretic behaviour like one or other of four reference strains. The isolates from Italy and Yugoslavia have an electrophoretic mobility like T. nelsoni reference strain. The isolates from France, Holland, Great Britain, Poland and USA have an electrophoretic mobility like T. spiralis reference strain. For T. nativa and T. pseudospiralis we have tested only the reference strains. These results support the validity of the taxonomy of Trichinella genus in four good species. PMID- 3508510 TI - [New filaria of the Cercopithifilaria genus, parasite of an African carnivore]. AB - Description of Cercopithifilaria corneti sp. n., a parasite of the subcutaneous tissues of Nandinia binotata, is given. With its 16 species parasitizing a variety of mammals from all over the world, the genus Cercopithifilaria has a homogeneous morphology and a uniform biology (dermal microfilariae, ixodid vectors). It is suggested that the unexpected host range is the consequence of particular speciation phenomena in relation to the biology of Ixodidae. PMID- 3508511 TI - [Cucculanus bioccai n. sp. (nematoda: cucullanidae), parasite of Mugil cephalus L]. AB - Cucullanus bioccai n. sp. described from the intestine of Mugil cephalus caught in Lake Sabaudia (Latina, Italy) is compared with C. dodsworthi and C. mugili parasites of mullets. It differs from C. dodsworthi mainly for the position of the 1st pair of precloacal papillae, the position of vulva, the shape of gubernaculum, the measurements of eggs; from C. mugili for the number of papillae, the position of the 1st pair of precloacal papillae, the conformation of cloaca and the position of vulva. PMID- 3508512 TI - Morphological variations in nematode parasites after a radioactive fall out: preliminary results. AB - Preliminary results from a survey of abomasal parasites of wild ruminant Rupicapra rupicapra are reported. The study was carried out after the fall out of radioactive contamination from the nuclear accident at Chernobyl (May 1986) and showed the high prevalence of teratologic forms in representatives of Ostertaginae (3.1% of the entire population of male worms). PMID- 3508514 TI - Genetical investigations on zoophilic and exophilic Anopheles arabiensis from Antananarivo area (Madagascar). AB - The presence of markedly zoophilic and exophilic Anopheles arabiensis at Alasora, near Antananarivo, Madagascar, is confirmed. This population of An. arabiensis appears clearly different in its feeding and resting behaviour when compared to those from Continental Africa, which, especially in West Africa, show rather high degrees of anthropophily and endophily. Genetical observations were carried out on material from Alasora including polytene chromosome studies, multilocus genetic analysis and crossing experiments with a West African strain of An. arabiensis. The results support the hypothesis of a conspecific status of An. arabiensis from Madagascar and Continental Africa. PMID- 3508513 TI - [Comparative analysis of the rhythm of cercariae emergence in three strains of Schistosoma bovis (trematoda: Schistosomatidae)]. AB - A comparative experimental study of the rhythmic shedding of three geographic strains of Schistosoma bovis cercariae (Sardinian, Sudanese and Spanish) by Bulinus truncatus showed a significant difference in the emergence patterns. The results support the existence of a genetic variability of the emergence rhythms. The origin of the variability is discussed and could be found in the pastoral practice and the ecological characteristics of the different transmission foci. PMID- 3508515 TI - [Heart weight of the cattle (Bos taurus L.) in the middle and late periods of fetal development]. AB - The weight heart Y-weight body relationship was studied on 219 Black-White cattle fetuses (107 females and 112 males; weight range of 1000-31,300 g). 1. The relationship in the consecutive growth periods are described by the following regression equations: middle fetal period (IIa and IIb)--IIa (n = 88, weight range 1000-3490 g) logY = 0.97 logX -- 2.05, r = 0.96; IIb (n = 68, weight range 3500-7990 g) logY = 1.04logX -- 2.29, r = 0.89; -- late fetal period III (n = 63, weight range 8000-31,300 g) logY = 1.07logX -- 2.39, r = 0.98. 2. The relationship for all fetuses, together with I prenatal period (earlier work of these authors) examined is described by the regression equation (n = 287, weight range 80-31,300 g) logY = logX -- 2.13, r = 0.99 (r -- correlations coefficient). 3. The relative heart weights are attained: IIa -- 0.72%, IIb -- 0.71%, III -- 0.77%. PMID- 3508516 TI - [Amino acid and carbohydrate levels in Trichophyton verrucosum and homologous purified trichophytin]. AB - The object of this study was to determine of aminoacids and sugar contents of T. verrucosum mycelium and of homologous purified trichophytin Tv-GP. The analysis of aminoacids contents was performed by ion-exchange chromatography on Czechoslovak analyser (type AAA-881) in acid and alkaline hydrolizates. Sugar were identified on gas chromatograph (PYE-105) by Sawerdeker and Sloneker technique. Seventeen identical aminoacids were determined in mycelium and trichophytin, but some quantity differences were observed. In mycelium there was 40.8% aminoacid nitrogen and 59.2% aminosaccharide nitrogen. In trichophytin, however, 93.5% nitrogen originated from aminoacids and only 6.5% from aminosaccharides. In both analized materials hexoses dominated: mannose, glucose and galactose. Besides trace quantities of D-glycero-D-mannoheptose, L-glycero-D mannoheptose and L-glycero-D-glucoheptose were identified. PMID- 3508517 TI - [Fungicidal effect of iodophor preparations on dermatophyte arthrospores]. AB - The purpose of the investigations was to determine antifungal activity of iodophores: Pollena-Jod K and Mycofix. In vitro studies 3 strains of Trichophyton mentagrophytes from Sabouraud liquid medium and arthrospores of this fungus in skin scrapings obtained from sick foxes were examined. The in vivo fungicidal effect of the iodophores was studied in foxes and in young bulls, where 5 and 10% solutions of the preparations were used three times. It was found that the exact inactivation of arthrospores is possible when 8-fold or even 10-fold higher concentrations of the preparations were used than that used for inactivation of vegetative cells. After 1 h exposition vegetative cells were destroyed by 0.4% solution of Pollena-Jod K or Mycofix, however, 5% solution of Pollena-Jod K and 3% solution of Mycofix destroyed arthrospores. In the field studies Mycofix revealed higher fungicidal effects. The index of isolation of the fungus from skin scrapings for animals treated with Mycofix was lower by 38% in comparison to that for animals treated with Pollena-Jod K. Despite three times application of 5% and 10% solutions of the examined iodophores on fungal foci in animals, a part of arthrospores survived. For the determination of fungicidal activity of antimycotic drugs used to prevent or control of dermatomycoses, arthrospores present in skin scrapings of sick animals may be used. PMID- 3508518 TI - Evaluation of selected metabolic indices for cattle in copper deficient regions. AB - The experiment comprised soil, herbage, and 3 groups of cattle from Cu deficient regions. Samples of blood, rumen contents, hair, urine and feces, while after slaughter, samples of the liver, kidney, brain, skeletal muscles and long bones were taken from animals under study. Low contents of copper, molybdenum, ceruloplasmin and lipid peroxides, approximately normal contents of zinc, iron, calcium, phosphorus, vitamin E and ascorbic acid, and increased concentration of sulphur were demonstrated. The highest activity of superoxide dismutase was found in the youngest animals. PMID- 3508519 TI - [Studies on acid-base equilibrium in cows during indoor care and nutrition with addition of various mineral mixtures]. AB - Studies were carried out in the period of indoor rearing (January-May) on 86 cows near to calving and their calves. The cows were silage fed with deficient bulky concentrated feeding. The measurements of the parameters (pH, pCO2, SB) determining the acid-base equilibrium in the blood of the cows and their calves were based on Astrup's micromethod by utilizing Siggaard-Anderson's nomograph. The purpose of the studies was to learn the values of acid-base equilibrium indices in conditions of indoor rearing and silage feeding of cows near to calving with deficient bulky dry and concentrated feeds. The effect of the mineral mixture MM added to the diet on acidbase equilibrium in the blood of the cows was also studied, as well as the relationship between the indices of this equilibrium in mothers and their calves and the animal age. The studies showed that cows near to calving fed with 20-30 kg of silage per head a day with irregularly balanced feeding did not reveal any distinct deviations in the acid base equilibrium of blood. However, most mean pH values were near the lower limit of the assumed standard. The commonly used mixture MM used in feeding did not affect distinctly the parameter values of acid-base equilibrium in the blood of the cows and their calves. A relationship was found between acid-base equilibrium in the blood of calves and in that of their mothers on the day of delivery. With the age of cows pH reaction showed a tendency to shift towards alkalinity. On the seventh day before calving and on the day of calving a tendency in cows was observed to increase the acidity of their blood, which, however, did not exceed the physiological standards. PMID- 3508520 TI - [Allergy in Trichophyton infection in the cattle]. AB - The examinations have been performed with glycoproteidic fractions of Trichophyton verrucosum (Tv-GP) and T. mentagrophytes (Tm-GP) purified by a method of gel chromatography. Trichophytins were intradermally injected at a dose of 2.0 ml (1.0 mg of protein) and the results were estimated after 24 and 72 h on the basis of differences in skin fold thickness (RGFS). In animals infected with lice or scabies in a farm free of trichophytosis the median value of RGFS was below 1.0 mm and maximal value was 2.0 mm. In a farm where trichophytosis caused by T. verrucosum was diagnosed positive reactions (RGFS above 4.0 mm) against the two trichophytins appeared in 90% of sick animals, 95% of convalescents and in 20% of animals without skin lesions but kept together with sick animals. In a part of diseased animals and exposed to infection apart from local reactions also appeared so called focal reactions characterized by appearance of fungal lesions followed by opening and crushing the crusts. There is a lack of relationship between intensity of allergic skin reaction and rate of fungal lesions. The animals infected with T. verrucosum cross-reacted with trichophytins Tv-GP and Tm GP, allergic state persisted in convalescent animals after idiopatic disappearance of clinical symptoms. The performed studies point to a possibility of the use of allergic skin tests with a standardized trichophytins to evaluate immunological state in cattle with trichophytosis. PMID- 3508521 TI - [The role of the cholinergic system in the regulation of blood flow through the reproductive organs of swine during the estrous cycle]. AB - The flow in uterine artery (ua) and ovarian artery (oa) of isolated reproductive organs of sows (100-130 kg/head) perfounded with animal own blood and Krebs Henseleit fluid at the constant pressure of 100 mm Hg was measured. Together with measuring the flow, the tension of the smooth muscle of organ was controlled. Applying acetylocholine (ACh), atropine (A), hexamethonium (H) and phentolamine (F) the analysis of the functions of muscarine (M) and nicotine (N) receptors of the cholinergic system in regulation of blood flow through the reproductive organs during the oestrous cycle was carried out. It was found that application of 0.3 microgram ACh into ua, and 0.5 microgram ACh into oa causes slight increase in the blood flow. Application of ACh in doses of 1 microgram into these vessels causes decrease of the flow and increase in tension and motorics of the organ. A eliminates the influence of ACh upon the tension and motorics of the studied organ and potencializes the decreasing influence of ACh applied in the dose of 1 microgram upon the blood flow. A decreases the flow limiting action of 1 microgram ACh upon the flow, and also eliminates the effect of decrease of flow caused by application of 1 microgram ACh after A. H potencializes the influence of small doses of ACh increasing the flow in ua and oa, but does not influence the flow limiting and tension increasing action of 1 microgram dose of ACh. Both A and H in doses applied cause increase in blood flow in the vessel areas under study. The results of the research indicate that changes in the blood flow through the areas under investigation induced by application of ACh are the resultant of three factors. 1. The vasodilatative effect resulting from the stimulation of the receptor M. 2. Stimulation of the cholinergic receptor N and connected with it freeing catecholamines responsible for the tension of vessels and contraction of smooth muscles of the organ. 3. Pressing influence upon the vessels of contracting smooth muscles connected with stimulation of M and N receptors. The sensitivity of vessels in the oa area to M-cholinergic stimulation is lower than that in the ua artery and it is higher in the luteal phase than in pre- and post-ovulation phases in both vessel areas. The magnitude of nicotine reaction of endogenous catecholamines freeing does not undergo significant changes during the oestrous cycle. PMID- 3508522 TI - [Effect of the bile and bile acids on the motility of the innervated rabbit colon]. AB - The studies have been carried out in vitro on the colons of 25 rabbits. The material was collected according to the Garry and Gillespie technique. The preparations consisted of the distal region of the colon together with the branches of parasympathetic nerves (pelvic ones) and with the sympathetic nerve (hypogastric). The conductivity was studied by the method of stimulation of these nerves branches with the 10 V impulses, 5 s long frequency 50-100 Hz, every 2-4 minutes. Spontaneous colon motoricity was registered on the kymograph in the chamber with oxyzenized Krebs fluid, according to the Magnus method. 0.3-10.0 ml of the bile per 1 l of the Krebs fluid was administered to the chamber. The same quantities of the physiological salt solution were administered to the chamber as the control. As for the chemically pure biliary acids, the cholic, deoxycholic and chenodeoxycholic acids (Light) were administered in quantities 500-1500 mumoles/l of the Krebs solution, as well as litocholic acid (Serva) in the concentration 300-500 mumoles/l. The control was carried out exactly as previously described. It has been found out that bile can inhibit or stimulate the colon motoricity and the nerves conductivity, depending on its concentration. At the small concentration (0.3 ml/l of the Krebs fluid) the bile stimulated the spontaneous colon motoricity and the conductivity of the sympathetic as well as the parasympathetic nerves. The high concentration (10 ml/l) had the inhibition effect on the colon motoricity and suppressed the nerves conductivity. As for the biliary acids, the strongest inhibitory effect had the litocholic acid, the weaker inhibitory effect had the cholic and deoxycholic acids. The chenodeoxycholic acid suppressed the nerves conductivity but stimulated the colon motoricity and increased the constriction amplitude. PMID- 3508523 TI - N-(2-cyanoethyl)tranylcypromine, a potential prodrug of tranylcypromine: its disposition and interaction with catecholamine neurotransmitters in brain. AB - The disposition of the N-cyanoethyl analogue of tranylcypromine (TCP) and the TCP formed from it have been studied in the rat brain following intraperitoneal (ip) administration (0.1 mmol/kg) and the resultant data compared with those obtained following an equimolar dose of TCP. Brain concentrations of the neurotransmitter amines dopamine (DA) and noradrenaline (NA) have also been determined, as well as the percentage inhibition of monoamine oxidase (MAO) types A and B. Our results indicate that the N-cyanoethyl analogue may be a useful prodrug of TCP, providing lower but more sustained concentrations of TCP in brain. Brain levels of DA were increased in a similar pattern after CE-TCP or TCP. Brain levels of NA were decreased by TCP at most time intervals, while CE-TCP produced a much less pronounced effect. Both CE-TCP and TCP inhibited MAO-A and MAO-B, with maximum inhibition occurring 60 min after CE-TCP dosing and 30 min after dosing with TCP, times at which brain concentrations of CE-TCP and TCP were at the maximum. PMID- 3508525 TI - A reversed-phase high-performance liquid chromatography assay procedure for progabide and its related metabolic derivatives. AB - A reversed-phase high-performance liquid chromatography (HPLC) assay procedure for Progabide, its active acid metabolite (PGA), and its hydrolytic degradation product (SL79.182) has been developed. This highly specific technique has allowed the simultaneous determination of these drugs in aqueous samples, and when coupled with a single and easy extraction step, spiked plasma samples could also be analyzed. The method had a sensitivity of about 30, 45, and 100 ng/ml for Progabide, SL79.182, and PGA, respectively. PMID- 3508524 TI - Synthesis and hypolipidemic activity of 3-imino-1-oxoisoindolines in rodents. AB - A series of substituted 3-imino-1-oxoisoindolines derivatives demonstrated significant hypolipidemic activity, lowering both serum cholesterol and triglycerides levels after 16 days of dosing at 20 mg/kg/day ip in CF1 mice. 2 Butyl-3-butylimino-1-oxoisoindoline lowered serum cholesterol levels 52% and serum triglyceride 42%. 2-Pentyl-3-imino-1-oxoisoindoline lowered serum cholesterol levels 42% and serum triglyceride 61%. These derivatives resulted in better activity than the parent compound, 3-imino-1-oxoisoindoline. These studies showed that compounds with N-alkyl substitution of nitrogen atoms in the ring and outside the ring possessed potent hypolipidemic activity at the low dose of 20 mg/kg/day ip in normolipidemic CF1 mice. Studies with 2-butyl-3-butylimino-1 oxoisoinodine in rats showed that serum cholesterol was reduced 60% and serum triglyceride 43% after 14 days of dosing at 20 mg/kg/day, orally. Treatment with this agent lowered lipid levels in the liver and aorta tissue, with increases in lipid levels in the small intestine tissue. Higher levels of cholesterol and phospholipids were excreted in the feces of treated animals compared to the control. Cholesterol levels of the very low-density lipoprotein (VLDL) and high density lipoprotein (HDL) fractions were reduced, whereas the HDL cholesterol levels were elevated significantly. This ratio of low-density lipoprotein (LDL) cholesterol:HDL cholesterol levels suggests that the agent may be effective in treating hyperlipidemic states in humans. PMID- 3508526 TI - Targeted drug delivery--some pharmacokinetic considerations. PMID- 3508527 TI - Dose-dependent pharmacokinetics of a new oral cephalosporin, cefixime, in the dog. AB - Cefixime (CL 284,635; FK 027) is a new third-generation oral cephalosporin. To study dose-dependent pharmacokinetics of cefixime in dogs, two balanced four-way crossover studies were conducted. In the first study, oral doses of 50, 100, and 200 mg/kg and an intravenous dose of 50 mg/kg cefixime were administered. In the second study, oral doses of 6.25, 12.5, and 25 mg/kg and an intravenous dose of 12.5 mg/kg cefixime were administered to the same dogs. A period of 1 month separated the two studies. When the two intravenous doses were compared (i.e., 12.5 and 50 mg/kg), a twofold increase in clearance and volume of distribution was observed after the higher dose. The oral systemic bioavailability in the dose range 6.25-50 mg/kg was 55%. It decreased to 44% at 100 mg/kg and 27% at 200 mg/kg. The average peak serum concentrations ranged from 15.8 micrograms/ml at 6.25 mg/kg to 119 micrograms/ml at 200 mg/kg. Within this concentration range, the fraction of free drug in serum (unbound to proteins) increased from 7 to 25%. This concentration-dependent protein binding was primarily responsible for changes in total clearance, volume of distribution, and bioavailability of the drug in dogs. PMID- 3508528 TI - Stability of lidocaine in aqueous solution: effect of temperature, pH, buffer, and metal ions on amide hydrolysis. AB - The degradation of lidocaine in aqueous solution obeys the expression kobs = (kH+[H+] + ko) [H+]/([H+] + Ka) + k'oKa/([H+] + Ka) where kH+ is the rate constant for hydronium ion catalysis, and ko and k'o are the rate constants for the spontaneous (or water-catalyzed) reactions of protonated and free-base lidocaine. At 80 degrees C, the rate constants for these processes are 1.31 x 10( 7) M-1 sec-1, 1.37 x 10(-9) sec-1, and 7.02 x 10(-9) sec-1; the corresponding activation energies are 30.5, 33.8, and 26.3 kcal mol-1, respectively. It was found that the room temperature pH of maximum stability is approximately 3-6 and that lidocaine is more reactive in the presence of metal ions such as Fe2+ and Cu2+. The dissociation constant, Ka, for lidocaine at 25-80 degrees C was also measured at 0.1 M ionic strength and a plot of pKa versus 1/T gave a slope of (1.88 +/- 0.05) x 10(3) K-1 and intercept 1.56 +/- 0.16. PMID- 3508529 TI - Improved radioreceptor assay of opiate narcotics in human serum: application to fentanyl and morphine metabolism. AB - A recently developed radioreceptor assay (RRA) (1) that employs 3H-naloxone and rat brain membrane homogenates was improved two ways. First, the brain membranes were preincubated in the presence of sodium ions, and second, manganase-II ions were added to the sample incubations. These changes enhanced the assay sensitivity and reproducibility with stored membrane preparations and reduced the effects of serum constituents (Na+) on ligand-receptor binding. Patient sera were assayed by radioimmunoassay (RIA) and RRA after fentanyl administration and by high-performance liquid chromatography (HPLC) and RRA after morphine administration. The results with both fentanyl assays were comparable, and no fentanyl metabolites were detectable by RRA after HPLC of serum extracts. In contrast, preliminary results with the HPLC-RRA procedure suggest the presence of an active morphine metabolite of unknown structure in sera obtained from patients on morphine therapy. PMID- 3508530 TI - Subcellular distribution of basic drugs accumulated in the isolated perfused lung. AB - To clarify the mechanism by which basic drugs accumulate in the lung, the binding selectivity of drugs to different subcellular structures of the perfused rat lung was examined. Imipramine, quinine, and metoclopramide were used as examples of basic drugs. The accumulation of basic drugs was highest in the mitochondrial fraction. The drug accumulation in the lung mitochondrial fraction increased with increasing lipid solubility and was dose dependent. These results suggest the presence of specific binding sites for basic drugs in mitochondria and that mitochondria play an important role as a reservoir for basic drugs. PMID- 3508531 TI - Application of moment analysis to nonlinear drug disposition described by the Michaelis-Menten equation. AB - An equation for the mean residence time (MRT) of drug in the body is derived for the system where drug is injected intravenously into a one-compartment model and eliminated by a single, capacity-limited process. This MRT is a complex function of dose, volume, Vm, and Km but degenerates into the classical volume/clearance expression under limiting low-dose conditions (Km much greater than C0). The equation was validated by comparison of the MRT obtained by direct calculation versus numerical area estimation for simulated data. The equation may be useful analytically in the estimation of the fundamental Michaelis-Menten parameters, Vm and Km, from experimental data. PMID- 3508532 TI - Dissociation of the natriuretic and antikaliuretic properties of triamterene derivatives by dose-response experiments. AB - Several derivatives of triamterene were synthesized with the aim of obtaining physicochemical properties superior to those of triamterene. Their effects on electrolyte excretion were tested with dose-response curves in rats: a dissociation of ED50 values of Na+ excretion from those of K+ retention was found; while the ED50 values of natriuresis were structure independent, the ED50 values for potassium retention depended highly on the charge of the side chain of triamterene derivatives. Acidic compounds displayed low and amines high K+ retaining potencies. Hence we postulate that there are at least two sites of action of the tested compounds in the kidney. (i) The first is the Na+ difference; this is the main driving force for K+ secretion. The affinity to the Na+ conductance is not correlated with the basic/acidic properties of the compounds. (ii) The second site is the finite K+ conductance of the luminal membrane of the distal tubule. The affinity of the drugs to this K+ conductance depends strongly on the charge of the molecule. Only pteridine derivatives with a basic side chain, i.e., with a high pKa value, block the membrane K+ conductance and are therefore potent potassium-retaining drugs. PMID- 3508533 TI - Drug release from tablets containing cellulose acetate phthalate as an additive or enteric-coating material. AB - A formulation containing cellulose acetate phthalate for preparing enteric-coated granules was developed with the use of granulation and microencapsulation techniques. Drug release from tablets or tableted microcapsules was measured in a disintegration apparatus and an in vitro variable-pH release simulator of the flow type. The release mechanism for the tablets or tableted microcapsules was determined with the Higuchi matrix model, a first-order kinetic model, and the Weibull distribution function. Adding acetone directly to the mixture of sulfamethoxazole and cellulose acetate phthalate resulted in enteric-coated granules with more prolonged release than other granulation methods. Microencapsulation of the granules significantly delayed the drug release and enhanced the effectiveness of the enteric coating. Microencapsulated granules show release patterns that are sustained and can be simulated with three different release models, i.e., with square-root time plotting, diffusional first order plotting, and Weibull distribution plotting. The enteric-coating behavior of the tablets was more clearly demonstrated with the variable-pH release stimulator than with a fixed-pH dissolution method. PMID- 3508534 TI - The effect of density on the gastric emptying and intestinal transit of solid dosage forms: comments on the article by Davis et al. PMID- 3508535 TI - Validation of fiber-optic Doppler anemometry (FODA) for characterizing the droplet size of emulsions. AB - Fiber-optic Doppler anemometry (FODA) is a useful tool to characterize polydisperse systems such as emulsions. The mean droplet radius of a model emulsion determined by FODA matched the mean radius determined by sizing droplets from a freeze-fractured freeze-etched scanning electron photomicrograph. The mean droplet radius determined by the Coulter technique was four times too large because the small droplets were not detected. The utility of FODA was further illustrated by its ability to accurately size droplets and monitor the coalescence upon aging of an intravenous lipid emulsion. PMID- 3508536 TI - Coupling of naltrexone to biodegradable poly(alpha-amino acids). AB - The narcotic antagonist naltrexone (I) was modified at the 3 and 14 hydroxyl positions and covalently coupled to a biodegradable poly(alpha-amino acid) backbone through a labile bond. Selective acetylation of I with acetic anhydride gave naltrexone-3-acetate (II), which was subsequently succinoylated to naltrexone-3-acetate-14-hemisuccinate (III) with succinic anhydride. The polymeric backbone chosen for initial coupling experiments was poly-N5-(3 hydroxypropyl)-L-glutamine (PHPG). The side-chain hydroxyl functionality permitted covalent bonding of III through an ester linkage. Hydrolysis of covalently bound drug to give naltrexone or its derivatives (II and III) should be much slower than diffusion of drug through the polymer matrix. While hydrolysis of naltrexone from the polymer side chain is first order, release of drug from the matrix can be zero order due to the geometry of the device and the physical and chemical interactions between naltrexone and the polymer matrix. In vitro studies of PHPG-naltrexone conjugate in disk form did not show constant release because of the hydrophilic nature of the polymer backbone and the changing local chemical environment upon hydrolysis of drug-polymer linkages. The conjugated system was made more hydrophobic by coupling drug to copolymers of hydroxypropyl-L-glutamine (HPG) and L-leucine. Conjugates of III coupled with copoly(HPG-70/Leu-30) demonstrated a nearly constant, but slightly declining release rate of naltrexone and its derivatives for 28 days in vitro. PMID- 3508537 TI - Computer-aided dosage form design. I. Methods for defining a long-acting first order delivery system of maximum formulating flexibility. AB - The method provides an a priori assessment of the maximum allowable flexibility in the rate of release from a prolonged-release formulation. The clinical pharmacokinetic parameters describing the drug candidate are employed to calculate the ranges of rate constants and doses required for the formulation to provide a selected therapeutic duration. For a given patient, there may be an infinite number of combinations of release rate constants and dose sizes which will maintain steady-state plasma drug concentrations within a desired range when the formulation is administered at the selected dosing interval. Computer simulations of steady-state plasma concentrations are employed to establish the ranges for all of the acceptable rate constants and doses for each member of a group. The entire group is then examined to define the range of release rate constants and doses which would provide a useful formulation for every member in the group. Literature values for theophylline clinical pharmacokinetics in children and adults have been employed to illustrate the application of this method. The method is unique in that it provides an entire range of release rates on which to gauge the feasibility for success. PMID- 3508538 TI - N-Mannich-base prodrugs of 5-iodo-2'-deoxycytidine as topical delivery enhancers. AB - Two Mannich-base prodrugs of 5-iodo-2'-deoxycytidine (5-IDC) have been synthesized. The prodrugs exhibit increased lipid solubility compared to 5-IDC and rapidly revert to 5-IDC in buffer. One of the prodrugs delivered about twice as much 5-IDC from isopropyl myristate (IPM) through hairless mouse skin in diffusion-cell experiments as did 5-IDC from IPM. Subsequent applications of theophylline/propylene glycol onto the diffusion cells to determine the effect of prodrug/IPM, 5-IDC/IPM, or IPM on the resistance of the skins to subsequent applications showed that the prodrug/IPM had no more effect than IPM itself. PMID- 3508539 TI - Synthesis and biological activity of isodithiobiurets, dithiobiurets, and dithiazoles. AB - A series of isodithiobiurets, dithiobiurets, and dithiazoles was synthesized and tested for biological activity. Generally, the compounds potentiated the hypnosis induced by pentobarbitone (50 mg/kg ip) in albino mice and exhibited antifungal and insecticidal activity against Fusarium oxysporum and Periplanata americana, respectively. Some compounds showed anticonvulsant and analgesic activity in albino rats. PMID- 3508540 TI - High-performance liquid chromatographic (HPLC) assay using fluorescence detection for the simultaneous determination of gallopamil and norgallopamil in human plasma. AB - Gallopamil is a calcium-channel antagonist with reported activity in experimental animals three to five times higher than that of verapamil. An automated high performance liquid chromatographic (HPLC) method with fluorescence detection is described for the simultaneous determination of gallopamil and its metabolite norgallopamil in plasma. Gallopamil was well resolved from norgallopamil and other metabolites, allowing simultaneous quantitation of both drugs. The detection limit for both gallopamil and norgallopamil was 0.9 ng/ml. This method has been successfully used for the determination of gallopamil and norgallopamil following the administration of 25-, 37.5-, and 50-mg oral doses of drug. PMID- 3508541 TI - Temperature and pH dependence of fluocinolone acetonide degradation in a topical cream formulation. AB - We investigated the degradation of fluocinolone acetonide (FA) incorporated into an oil-in-water cream base. The study examined the influence of temperature (23 to 80 degrees C) and cream pH (pH 2.3 to 6) on FA degradation rates. FA degradation followed pseudo-first-order kinetics and adhered to the Arrhenius expression over the entire temperature range investigated. At all temperatures, the pH strongly influenced the observed degradation rate constant (kobs) values, with rate minima observed near pH 4. The FA log(degradation rate)-pH profiles were consistent with a reaction mechanism requiring drug hydrolysis catalyzed by hydroxide and hydrogen ions. Taking into account both the temperature and the pH dependence of FA degradation permits calculating kobs values from the following equation: kobs = exp[22.5 - (17,200/RT)] + exp[38.7 - (22,200/RT)] x [H+] + exp[49.5 - (21,100/RT)] x [OH-] where the three bracketed terms represent Arrhenius expressions for neutral, acid-catalyzed, and base-catalyzed hydrolysis reactions. FA degradation in the cream base parallels the degradation of a related steroid (triamcinolone acetonide) in an aqueous alcohol solution. The equivalence between FA and triamcinolone acetonide kinetics in the different reaction media suggests that in the cream base, FA degradation is limited to an aqueous phase largely unperturbed by the presence of nonaqueous constituents that comprise the cream formulation. PMID- 3508542 TI - Effects of formulation and food on the absorption of hydrochlorothiazide and triamterene or amiloride from combination diuretic products. AB - The absorption of three combination formulations of hydrochlorothiazide and either triamterene or amiloride was studied over a 5-year period in seven separate investigations under varying conditions of food and fasting. The most widely prescribed combination, containing 25 mg of hydrochlorothiazide and 50 mg of triamterene, demonstrated impaired absorption in the fasting state that was partially corrected by the addition of a breakfast high in fat. The increase in the fat content of the food appeared to correlate directly with the amount of both drugs absorbed from this formulation. The second formulation studied, a new combination formulation of 50 mg of hydrochlorothiazide and 75 mg of triamterene, demonstrated acceptable absorption in the fasting state that was not altered by the concurrent administration of a high-fat breakfast. The absorption of the third formulation, a combination of 50 mg hydrochlorothiazide and 5 mg amiloride, was acceptable in the fasting state and demonstrated a slight reduction in the absorption of the amiloride component when administered concurrently with a high fat meal. The clinical and biopharmaceutic implications of these observations are discussed. PMID- 3508543 TI - Microbial transformation of tamoxifen. PMID- 3508545 TI - Emerging trends in biotechnology: a perspective from the pharmaceutical industry. PMID- 3508544 TI - Binding of piroxicam to human serum albumin: effect of piroxicam on warfarin and diazepam binding. PMID- 3508546 TI - Development of acute tolerance to bumetanide: bolus injection studies. AB - Bumetanide was administered intravenously to four mongrel dogs, in a random crossover fashion, at doses of 0.05 mg/kg (I), 0.15 mg/kg (II), and 0.5 mg/kg (III) where urinary losses were replaced with lactated Ringer's solution at 1.5 ml/min (hydropenic conditions) or at a dose of 0.5 mg/kg (IV) where urinary losses were replaced with lactated Ringer's solution isovolumetrically (euvolemic conditions). Serial plasma and urine samples were assayed for bumetanide by high performance liquid chromatography (HPLC) and for sodium by flame photometry. There were no significant differences in the pharmacokinetic parameters of bumetanide among Treatments I-IV. The dynamic parameters Emax (maximum effect attributable to the drug) and s (slope factor) were not different between treatments. However, a consistent, demonstrable increase in ER50 (urinary excretion rate of drug producing 50% of Emax) was observed among Treatments I (2.34 micrograms/min), II (3.92 micrograms/min), and III (6.54 micrograms/min); also, a significant decrease in ER50 was observed between Treatment III (6.54 micrograms/min) and Treatment IV (2.66 micrograms/min). These results show that hydration status has a marked effect on natriuretic and diuretic response and that tolerance can rapidly develop within a single intravenous dose of bumetanide. PMID- 3508547 TI - Computer-aided dosage form design. II. Methods for defining a zero-order sustained-release delivery system of maximum formulating flexibility. AB - Classical methods employing pharmacokinetic data to calculate zero-order release rates for sustained release products require that a constant-rate drug delivery system must have a duration which is exactly equal to the desired dosage interval. This traditional approach fails to establish the minimum acceptable duration and also fails to provide any flexibility in the formulation goal. While it does calculate one pair of duration and dose values, there are infinite pairs of values capable of maintaining the desired plasma concentrations using the selected dosing interval. In the current method, computer simulations are used to establish the boundary conditions within which any pair of duration and dose values will maintain the desired levels when administered on the chosen dosing interval. By comparing the boundary conditions for every subject in a group, a single set of conditions which would work for the entire group can be selected. These final limits represent the broadest specifications for zero-order drug delivery system design for that particular drug combined with the plasma concentration goals and the desired dosing interval. The method is illustrated using theophylline pharmacokinetics. PMID- 3508548 TI - Diketopiperazine formation, hydrolysis, and epimerization of the new dipeptide angiotensin-converting enzyme inhibitor RS-10085. AB - The degradation kinetics, products, and mechanisms of RS-10085(1), 2-[2-(1 ethoxycarbonyl)-3-phenylpropyl]amino-1-oxopropyl]-6,7- dimethoxy-1,2,3,4 tetrahydroisoquinoline-3-carboxylic acid(S,S,S), in aqueous solution were investigated at 40, 60, and 80 degrees C from pH 1 to pH 13. Pseudo-first-order kinetics were observed throughout the pH range studied and the log(rate)-pH profiles reflected four kinetic processes (ko, k'o, k'o, and kOH) as well as the two pKa's of 1. Excellent (greater than 98%) mass balance was obtained through products 2-5. At pH 4 or below, intramolecular cyclization leading to diketopiperazine 5 accounted for greater than 93% of the observed neutral- or water-catalyzed processes (ko and k'o). At pH levels greater than 5, hydrolysis giving 2 predominated and was responsible for the observed neutral- or water catalyzed (k''o) and specific base-catalyzed (kOH) kinetic processes. Some epimerization leading to the S,S,R drug isomer (4) was also observed at pH levels greater than 7. The relative acidity of the protons at the three chiral centers of 1 was qualitatively compared and was used to explain the observed specificity in epimerization. PMID- 3508549 TI - Multiple-dose pharmacokinetics of clozapine in patients. AB - After a 2-day buildup, patients were dosed continuously with clozapine solution at three ascending dose levels (37.5, 75, and 150 mg bid for 7 days at each dose level). Following the morning administration on the twenty-third day of dosing a drug holiday was instituted which lasted for a minimum of 48 hr. Serial plasma samples were obtained during each of the periods and during the drug holiday for the calculation of the steady-state parameters AUCSS, CSSmax, and CSSmin at each dose level as well as for the assessment of the terminal elimination rate. Mean parameter values for AUCSS, CSSmax, and CSSmin showed a linearly increasing response with the dose, well described by a straight line passing through the origin. The terminal elimination appeared to follow linear kinetics and had a mean half-life of 15.8 hr (range, 5.8-33 hr). PMID- 3508550 TI - Bioavailability and pharmacokinetics of a new sustained-release potassium chloride tablet. AB - The bioavailability of a new sustained-release potassium chloride (KCl) tablet, designed for once-a-day dosing, was compared to a KCl elixir using urinary excretion data. The study utilized 25 male volunteers dosed in a crossover design in a dietary/activity-controlled environment. The regimens consisted of a total of 80 mEq of potassium in three equally divided doses of elixir every 6 hr and a single 80-mEq dose using four 20-mEq sustained-release (SR) tablets. The mean time to maximum rate of potassium urinary excretion was 2.2 hr for the first elixir dose and 5.5 hr after the SR tablet (P less than 0.01), thereby supporting the prolonged-release properties of this formulation. After correction for baseline urinary potassium excretion, the mean total 24-hr urinary potassium excretion was 42.18 mEq for the elixir and 40.41 mEq for the SR tablet. The results indicate that the absorption pattern from the SR tablet is equal to three doses of KCl elixir dosed 6 hr apart. PMID- 3508551 TI - Quantitative analysis of hydroxyurea and urea by proton nuclear magnetic resonance (NMR) spectroscopy. AB - Quantitative 1H-nuclear magnetic resonance (NMR) procedures are described for measuring hydroxyurea and urea. Dimethylsulfoxide-d6 is used as the solvent for both assays; the internal standards employed are urea and p-dichlorobenzene for hydroxyurea and urea, respectively. The analysis for hydroxyurea is based on the comparison of the area of the -NH2 peak of hydroxyurea with the area of the urea NH2 peak area. The analysis of urea is based on the comparison of the -NH2 peak of urea with the area of the p-dichlorobenzene singlet. The 1H-NMR assays yield results that are precise and agree well with results of the more cumbersome and less specific USP procedures. PMID- 3508552 TI - Analysis of in vitro dissolution of whole vs. half controlled-release theophylline tablets. AB - Controlled-release (CR) drug products dissolve more slowly than conventional release products, reflecting their quality of sustaining a prolonged therapeutic effect. A frequent practice with scored tablets when only half the dosage is desired is to divide the tablet at the score mark and administer only half of the product. The dissolution characteristics of the divided tablets are unknown. It is only an assumption that the halved tablet behaves similarly to the whole tablet both in vitro and in vivo. A series of in vitro dissolution analyses was performed on whole and half CR theophylline tablets from different manufacturers. Statistical tests were carried out between the dissolution results of whole and those of halved tablets to determine whether the mean overall percentages dissolution (averaged over sampling times) were similar and whether the patterns of percentage dissolution over time were similar. The dissolution of halved tablets was slightly faster compared to that of intact (whole) tablets. However, these small differences were not large enough to cause concern or to require bioavailability studies. PMID- 3508553 TI - Dose-proportional absorption of etretinate after doses of 25, 50, 75, and 100 mg. AB - Twelve healthy male subjects received single oral doses of etretinate, ranging from 25 to 100 mg (1 to 4 x 25-mg capsules) in an open-label, four-way randomized crossover design. Plasma concentrations of etretinate and two active metabolites were determined by a specific high-performance liquid chromatographic (HPLC) method. Analysis of variance and orthogonal contrasts were used to assess dose proportionality. Mean (+/- %CV) maximum concentrations after 25- to 100-mg doses were 133 (50), 195 (33), 261 (53), and 446 (65) ng/ml, whereas AUC0-12 values were 581 (46), 1090 (39), 1500 (52), and 2440 (63) ng.hr/ml, respectively. The test for proportionality indicated that Cmax and AUC0-12 increased proportionally with an increase in dose (P greater than 0.05). PMID- 3508554 TI - Polymorphism of 1,2-dihydro-6-neopentyl-2-oxonicotinic acid: characterization, interconversion, and quantitation. AB - Two polymorphs of 1,2-dihydro-6-neopentyl-2-oxonicotinic acid have been characterized by X-ray diffraction (XRD), infrared spectroscopy (IR), differential scanning calorimetry (DSC), and thermal (hot-stage) microscopy (HSM). In batch-scale preparation, form I was crystallized in ethanol-water (3:1), while form II was obtained by recrystallization from acetone-water (2:1). The melting points for forms I and II are 193 and 196 degrees C, respectively. Thermal studies (DSC and HSM) showed that form II melts at 196 degrees C, while form I melts at 193 degrees C, immediately followed by a resolidification and remelt at 196 degrees C. The conversion of form II to form I was accomplished by recrystallization from ethanol or methanol, and the form I-to-form II transition was obtained by controlled heating of form I around 194 degrees C. Quantitative XRD was used to determine the polymorphic composition, with a detection limit of less than 1% of the minor form and a linearity of 0-10% form I in form II (correlation coefficient of 0.999). PMID- 3508555 TI - Pharmacokinetics of pentoxifylline during concomitant theophylline administration to rats. PMID- 3508556 TI - Electrode material in iontophoresis. PMID- 3508557 TI - Mechanisms of mucoadhesion of poly(acrylic acid) hydrogels. AB - It has been proposed that mucoadhesives which adhere to the gastric mucus layer may be used to prolong gastric retention time of oral dosage forms. Preliminary studies, using acrylic hydrogels, have established that the density of carboxyl groups on the polymer chain is important for mucoadhesion. To understand the role(s) of the carboxyl groups in mucoadhesion, acrylic acid-acrylamide random copolymers [P(AA-co-AM)] were synthesized, and the adhesion strength of the cross linked polymers to the gastric mucus layer was examined as a function of the pH, initial concentration of the cross-linking agent, degree of swelling, and carboxyl-group density. From the study on mucoadhesion of various P(AA-co-AM), it was found that at least 80% of the vinyl groups of the polymer must possess carboxyl groups in the protonated form. The dependence of mucoadhesion on pH and carboxyl-group density suggests that mucoadhesion occurs through hydrogen bonding. In addition, the density of the cross-linking agent significantly affects mucoadhesion. As the density of the cross-linking agent is lowered, the mucoadhesive strength increases, although the density of carboxyl groups in the test surface area is reduced. It is concluded that for mucoadhesion to occur, polymers must have functional groups that are able to form hydrogen bonds above the critical concentration (80% for vinyl polymers), and the polymer chains should be flexible enough to form as many hydrogen bonds as possible. PMID- 3508558 TI - The preparation and evaluation of drug-containing poly(dl-lactide) microspheres formed by the solvent evaporation method. AB - Several compounds such as caffeine, diazepam, hydrocortisone, progesterone, quinidine, quinidine hydrochloride, quinidine sulfate, and theophylline were evaluated for incorporation into poly(dl-lactide) (PLA) microspheres using the solvent evaporation technique. The process is generally limited to the entrapment of water-insoluble drugs. Adjustment of the pH of the aqueous phase to minimize drug solubility resulted in increased drug contents within the microspheres in the case of ionizable drugs. The release profile of quinidine from the microspheres was characterized by three different release phases, a lag time with no drug release, a burst effect of rapid drug release within a short period of time, and a slow release phase, respectively. The structure of the microsphere surface layer, which was a function of the pH of the aqueous phase at preparation, strongly influenced the rate and amount of drug released. Thermal analysis of quinidine-loaded microspheres revealed three thermal events, corresponding to the glass transition temperature of the polymer and to the recrystallization and melting of quinidine. PMID- 3508559 TI - Hypolipidemic activity of o-(N-phthalimido)acetophenone in Sprague Dawley rats. AB - o-(N-Phthalimido)acetophenone has proven to be an effective hypolipidemic agent in rats at 20 mg/kg/day orally. The agent suppressed the activity of the rate limiting enzyme of the liver involved in de novo synthesis of triglycerides. The synthetic rate-limiting enzyme for cholesterol esters was also inhibited by the drug in vivo. o-(N-Phthalimido)acetophenone lowered cholesterol in the liver and the aorta wall and generally caused an increase in phospholipids in body tissues. Serum lipoproteins were modulated by the drug with a decrease in cholesterol and triglycerides in the chylomicron, very low-density lipoproteins (VLDL), and low density lipoproteins (LDL) and an increase in high-density lipoprotein (HDL) cholesterol. The phospholipid content was increased in the chylomicron, VLDL, and LDL fractions. In hyperlipidemic rats, o-(N-phthalimido)acetophenone lowered elevated blood lipid levels at 20 mg/kg/day orally after 3 weeks of administration. The hypolipidemic rat after drug treatment had a lower LDL cholesterol and a higher HDL cholesterol content, which is therapeutically desirable to protect against cardiovascular disease. PMID- 3508560 TI - Investigation of the gastrointestinal transit and in vivo drug release of isosorbide-5-nitrate pellets. AB - An oral formulation of controlled-release isosorbide-5-nitrate pellets has been used to investigate the location of pellets in the gastrointestinal (GI) tract and, in parallel, to measure the drug absorption from these locations. Using the method of gamma scintigraphy the transit times and spreading of pellets in the GI tract have been determined. The method of numeric deconvolution was applied to calculate the drug input into the systemic circulation. The results indicate that a well-absorbed substance such as isosorbide-5-nitrate is absorbed from the stomach and small intestinal in a manner that is controlled by the properties of the pellets. Drug absorption is reduced in the colon. The average transit time from mouth to colon is 6 to 8 hr, which represents the maximum acceptable time for drug release for this oral controlled-release preparation. Taking into account these relations an isosorbide-5-nitrate pellet formulation with a bioavailability of 84% has been developed that maintained the minimal therapeutic plasma level for more than 16 hr after application. PMID- 3508561 TI - Correlation of ibuprofen bioavailability with gastrointestinal transit by scintigraphic monitoring of 171Er-labeled sustained-release tablets. AB - External gamma scintigraphy was used to monitor the gastrointestinal (GI) transit of radiolabeled sustained-release tablets containing 800 mg ibuprofen in eight fasted healthy volunteers. Ibuprofen serum concentrations were determined from blood samples drawn sequentially over a 24-hr period. Serum concentrations and related parameters were correlated to the position of the dosage form in the GI tract from the scintiphotos. The sustained-release tablets were radiolabeled intact utilizing a neutron activation procedure, by incorporating 0.18% of 170Er2O3 (enriched to greater than 96% 170Er) into the bulk formulation. After manufacture of the final dosage forms, the tablets were irradiated in a neutron flux (4.4 x 10(13) n/cm2.sec) for 2 min, converting the stable 170Er to radioactive 171Er (t1/2 = 7.5 hr). Each tablet contained 50 microCi of 171Er at the time of administration. The scintigraphy studies suggested that the greatest proportion of ibuprofen was absorbed from this dosage form while the tablet was in the large bowel. The dosage forms eroded slowly in the small bowel and appeared to lose their integrity in the large bowel. In vitro studies showed only minimal effects of the neutron irradiation procedure on the dosage form performance. PMID- 3508562 TI - Tissue tolerance of intramuscular injectables and plasma enzyme activities in rats. AB - The local tissue damage after intramuscular injection caused by various commercially available injection solutions was determined in the albino rat, by measuring plasma activities of creatine phosphokinase, aspartate aminotransferase, and lactic dehydrogenase, the tissue activity of creatine phosphokinase, and macroscopic changes in the muscle at the injection site (gastrocnemius muscle). The plasma enzyme activities were determined 2, 6, 18, and 28 hr after the injection. After 28 hr the animals were sacrificed for macroscopic inspection of the injection site and for the determination of tissue enzyme activity. The tissue injury caused by the test substances correlated well with the elevated creatine phosphokinase activity (2 hr). The elevations of aspartate aminotransferase (18 hr) and lactate dehydrogenase (2 hr) activity as well as the loss of tissue creatine phosphokinase activity were less indicative of differences between test preparations. The i.p. administration of some of the test preparations caused increased enzyme activity without muscle damage, which could interfere with the test results. The creatine phosphokinase determination indicates the damage occurring immediately after the administration of the test solution, and the macroscopic inspection offers the possibility to obtain some information on the evolution of the muscular lesion. PMID- 3508563 TI - In vivo efficacy of antifungal oxoaporphine alkaloids in experimental disseminated candidiasis. AB - The efficacy of three antifungal oxoaporphine alkaloids, liriodenine, liriodenine methiodide, and oxoglaucine methiodide, was determined in a mouse model of disseminated candidiasis. Mice infected with a lethal dose of Candida albicans NIH B311 were administered varying doses of each drug intraperitoneally or intravenously 7 hr postinfection. Reductions in the number of colony-forming units (CFU) recovered per milligram of kidney tissue were observed in drug treated animals compared to vehicle-treated control mice. Significance was determined by the Wilcoxon nonparametric rank sum test. Intravenous administration of both liriodenine and liriodenine methiodide resulted in a significant reduction in the number of recovered CFU, while there was no significant response to treatment with oxoglaucine methiodide. PMID- 3508564 TI - Between-lot and within-lot comparisons of bioavailability of macrocrystalline nitrofurantoin capsules. AB - Comparative bioavailability studies should be designed and the resulting data evaluated based on estimates of both intersubject and intrasubject variances in the kinetic parameters for the particular drug products(s) being studied. This report presents the results of two comparative bioavailability studies. In the first study, three production lots of macrocrystalline nitrofurantoin capsules (Macrodantin) were compared in 21 subjects, and in the second study, capsules from one production lot were administered to 21 different subjects on three occasions. Both model-independent kinetic parameters for urinary excretion and a one-compartment model with zero-order absorption were used to evaluate both the rate and the extent of bioavailability. Overall the results showed a very low variance between and within production lots and a relatively large intersubject variance in the rate and extent of absorption. PMID- 3508565 TI - Measurement of the particle size of tablet excipients with the aid of video recording. AB - A method for the determination of the particle size of tablet excipients involving the use of video recording of microscopic examination of powders is described. The projected area of the particle profile was measured, and Feret's diameter and shape factors such as the elongation ratio, bulkiness factor, and surface factor were determined. Starch particles are the smallest among the excipients studied. Primojel particles are two to three times larger (Feret's diameter) and have up to 10 times greater projected areas. Particles of Avicel PH101, Ac-Di-Sol, Nymcel ZSD16 and ZSB10, and Polyplasdone XL have an irregular surface which results in large differences between the projected area diameter and the perimeter diameter. Particles of Nymcel and Ac-Di-Sol have the highest elongation ratio because of their cylindrical shape. Both Primojel and Starch have a low surface factor because of their spherical shape. This video-recording method is a simple system to observe, record, store, and retrieve particle-size data from microscopic examination of tablet excipients. PMID- 3508566 TI - Effect of hydralazine on the elimination of antipyrine in the rat. AB - The concomitant administration of hydralazine with metoprolol or propranolol substantially increases the oral bioavailability of these beta-blockers, presumably via reduction of the first-pass effect. It has been suggested that this effect may be secondary to a decrease in the intrinsic clearance of propranolol, possibly by inhibition of oxidative metabolism. To examine the possibility that hydralazine alters oxidative metabolism in vivo, the effect of hydralazine on the pharmacokinetics of antipyrine was examined in the rat. The oral administration of hydralazine hydrochloride, 7.5 mg/kg, 15 min prior to antipyrine administration reduced antipyrine clearance from 9.66 +/- 1.18 to 8.19 +/- 0.76 ml/min/kg (P less than 0.05). Hydralazine was observed to cause substantial hypothermia. The study was repeated in temperature-regulated animals and no alteration in antipyrine clearance was found. Two doses of hydralazine in temperature-regulated rats also failed to alter antipyrine clearance. Thus, it appears that the effect of hydralazine on antipyrine clearance is secondary to the hypothermic effect of hydralazine and not due to a direct inhibition of cytochrome P-450-mediated enzyme activity. PMID- 3508567 TI - Percutaneous absorption and elimination of the penetration enhancer Azone in humans. AB - The percutaneous absorption and elimination of Azone, a new penetration enhancer, were investigated in humans. The distribution and accumulation of Azone in the skin were studied by means of tape stripping. These studies reveal that pure Azone is poorly absorbed. Furthermore, what little Azone is absorbed appears to be rapidly cleared from the circulation by the kidneys. In order to explain the urinary excretion profile, the formation of at least one metabolite is suggested. No accumulation of Azone in the skin was observed. PMID- 3508568 TI - Radiolabeling of intact dosage forms by neutron activation: effects on in vitro performance. AB - Compressed tablets containing various quantities of stable isotopes of Ba, Er, and Sm for use in neutron activation studies were evaluated for the effect of stable isotope incorporation on tablet hardness and disintegration times. At concentrations likely to be used in scintigraphic studies employing neutron activation as a radiolabeling method, no significant effect on in vitro parameters were observed. While the incorporation of stable isotopes influenced tablet hardness to a greater degree than disintegration time, irradiation of tablets in a neutron flux of 4.4 x 10(13) n/cm2 sec had a direct effect on tablet disintegration time. Thus, future neutron activation studies should focus on minimizing the amount of stable isotope to be incorporated with the formulation while using the shortest feasible irradiation time. PMID- 3508569 TI - Kinetics of potassium excretion following oral supplements: evidence of induced natriuresis. AB - Twenty-four healthy normal volunteers were given 40 mEq of three oral formulations of K+ as potassium chloride in a three-way Latin square design. Pharmacokinetic characteristics of potassium disposition were determined using urinary excretion data. Potassium was absorbed almost instantaneously from the 10% (w/v) solution, while a slow first-order absorption could explain the slow release of potassium from Slow-K and the new slow-release tablet. A biphasic elimination of potassium observed during the first 24 hr of urinary excretion suggested the body's adaptive process of changes in rates of elimination of potassium to maintain homeostasis. There was no significant difference (P = 0.25) in total recoveries of potassium in urine during 48 hr of urinary collection among the three formulations (mean +/- SE: solution, 35 +/- 7.1 mEq; Slow-K, 38.1 +/- 7.8 mEq; and new formulations, 33.5 +/- 6.8 mEq). An increased excretion of sodium was observed and correlated with increased potassium excretion following oral potassium administration which could not be explained by changes in urine flow rate. The clinical significance of such an increase in natriuresis is yet to be determined. PMID- 3508570 TI - Assessment of variance in bioavailability studies: comments on the article by McNamara et al. PMID- 3508571 TI - [The effect of various Ca++ antagonist on smooth muscles from different areas]. PMID- 3508572 TI - [Changes induced by vasointestinal peptide (VIP) and diltiazem on bronchoreactivity specific and aspecific aspects]. PMID- 3508573 TI - [The effect of physical activity on urinary excretion of catecholamines in normal subjects and asthma patients]. PMID- 3508575 TI - [Infant arterial pressure]. PMID- 3508574 TI - Serum retinol levels in liver and gastrointestinal diseases. PMID- 3508576 TI - [Coronary thromboembolism in hepatic sarcoma following myocardial infarct]. PMID- 3508577 TI - Mediterranean-soy diet: hypocholesterolemic effects in FH E3/E2 heterozygous and type III patients. PMID- 3508578 TI - High platelet counts in heterozygous beta-thalassaemia. PMID- 3508579 TI - [Hyperbilirubinemia in heterozygous beta-thalassemia]. PMID- 3508580 TI - [Gastric leiomioblastoma associated with adenocarcinoma of the rectum. Personal observation]. PMID- 3508581 TI - [Iridogoniodysgenesis associated with somatic anomalies]. PMID- 3508582 TI - [Norfloxacin in chronic renal insufficiency]. PMID- 3508583 TI - Differences in cytochrome P-450 levels between isolated hepatocytes and hepatic microsomes from phenobarbital treated rats. PMID- 3508584 TI - The behaviour of plasma catecholamines in liver cirrhosis. PMID- 3508586 TI - A protocol for the study of the drug interactions in the treatment of diabetes mellitus. PMID- 3508585 TI - Serum retinol binding protein in post-necrotic liver diseases. PMID- 3508587 TI - [Incidence of thalassemic trait in patients with diabetes mellitus]. PMID- 3508588 TI - [Gastric leiomyoblastoma]. PMID- 3508589 TI - Familial segregation of inv (12) (p11;q15) through three generations. PMID- 3508590 TI - [Fetal meconium peritonitis. Case report]. PMID- 3508591 TI - [Infantile arterial pressure]. PMID- 3508592 TI - [Stomach cancer in pregnancy]. PMID- 3508593 TI - Post-SAH vasospasm in patients treated with oral nimodipine. PMID- 3508594 TI - Hypertension in the elderly. A retrospective study in institutionalized subjects. PMID- 3508595 TI - 201 thallium-chloride use in the radioisotopic pre-operative study of the lymphnodes of the neck. PMID- 3508596 TI - [Tumors of the submandibular gland]. PMID- 3508597 TI - Single dose clotrimazole vaginal cream (10%) in the treatment of vaginal candidiasis. PMID- 3508598 TI - [Specific therapy of allergic respiratory syndrome. Practical note]. PMID- 3508600 TI - Usefulness of cyclophenyl in the treatment of morphea. PMID- 3508599 TI - In vitro effects of epinephrine on Na influx into brush border vesicles from the rat kidney. PMID- 3508601 TI - Gastric intestinal metaplasia: endoscopic and histologic study of 179 cases. PMID- 3508602 TI - 1% bifonazole cream in the treatment of Candida balanitis: a clinical trial. PMID- 3508604 TI - [Infant nutrition drug the first year of life. Investigation of a sample of infants from a Roman outpatient clinic and day-care nursery]. PMID- 3508603 TI - Epidermal nevus syndrome. Report of a case. PMID- 3508605 TI - [HBV and HDV infection in chronic hemodialysis treatment patients]. PMID- 3508606 TI - [Parasitology in anti-HIV positive and AIDS subjects]. PMID- 3508607 TI - [Cefatrizine in the ambulatory treatment of recurring chronic bronchial infections]. PMID- 3508608 TI - [Hyposensitivity therapy in perennial allergic rhinitis from Dermatophagoides pteronyssinus: effect of combination with ketotifen]. PMID- 3508609 TI - [Clinical-therapeutic evaluation of a new dermatologic preparation for topical use with a base of alcyonide and neomycin]. PMID- 3508610 TI - [Topical therapy of acute osteo-muscular lesions with a combination of heparin soludexide]. PMID- 3508611 TI - [Penetration of labeled rifampicin into the rat parotid gland]. PMID- 3508612 TI - Beta-glucuronidase activity in gastric cancer. PMID- 3508613 TI - Preservation of myocardial ultrastructural integrity following ischemic arrest. Clinical use of nifedipine cardioplegia. Preliminary report. PMID- 3508614 TI - [Coronary heart disease in working women]. PMID- 3508615 TI - [Viral hepatitis B and pregnancy. Prevention of perinatal transmission with passive-active immunization]. PMID- 3508616 TI - [Ca 125 for the diagnosis of ovarian carcinoma]. PMID- 3508617 TI - [Fetal alcohol syndrome. Description of a clinical case. Note on pathogenesis]. PMID- 3508618 TI - [Laryngopharyngeal cysts: 10 year's clinical therapeutic experience]. PMID- 3508619 TI - [Cholesterol: olive oil or seed oil]. PMID- 3508620 TI - [AIDS "plague" of the twentieth century]. PMID- 3508622 TI - Gastroenterology in West Africa. Proceedings of the IXth biennial international conference and 20th anniversary celebrations of the West African Society of Gastroenterology. Port Harcourt, Nigeria, 9-11 April 1986. PMID- 3508621 TI - [Essential arterial hypertension: therapeutic experience with "nifedipine A. R."]. PMID- 3508623 TI - Observations on the presentation and management of peptic ulcer disease in Nigeria. PMID- 3508624 TI - The water/food consumption relationships of severely underfed immature rats. AB - To determine the water and food consumption relationships of immature rats during severe undernutrition, water and food consumption rates and ratios of 35 male albino rats underfed from birth and re-fed starting at 20, 30, 40 and 50 days of age (6 rats in each group) or not re-fed (11 rats) were estimated between the ages of 25 and 70 days and compared with those of 30 age-mate control rats. Severely underfed rats consumed water at rates near the maximum for their body size and out of proportion with the food consumed. The water/food consumption ratio (mean 2.09 +/- 0.07) was significantly higher than that of the control rats (mean 1.47 "0.01 (P less than 0.0012). During re-feeding, the food consumption rate increased more (62%) than the water consumption rate did (9%); and the water/food consumption ratio decreased to a level (1.40 +/- 0.04 not significantly different from that of the control rats. Thus, during periods of severe underfeeding and re-feeding, water and food consumption rates of immature rats may change fairly independently of each other, leading to variations in the water/food consumption relationships. PMID- 3508625 TI - Liver biopsy: experience at Enugu, eastern Nigeria. AB - A retrospective analysis of liver biopsies done at the University of Nigeria Teaching Hospital, Enugu, between January 1980 to December 1985 was done to determine the indications, level of preparation and investigation of the patients, biopsy techniques and failure rate, complications and histopathological results. The register of all biopsies sent to the Morbid Anatomy Department and the clinical records of the patients were used for the analysis. Of the 154 biopsies done, the Menghini technique was used in 128 cases (83.1%), the rest was by exploratory laparotomy. The commonest indication was unexplained hepatomegaly with or without splenomegaly 46 cases (29.8%). Adult cases accounted for 132 cases (85.7%) with male/female distribution of 3:1. Histologically proven cases of hepatocellular carcinoma accounted for 38 cases (14.2%). Pain requiring analgesics occurred in 8 cases (5.2%). The need for adequate clinical documentation of patients is emphasized. PMID- 3508626 TI - Buffering capacity of some Nigerian food-substances. AB - The buffering capacity of some Nigerian local food substances was investigated using a modification of Toveys method (1974), Beans (red, and white), maize, rice (unprocessed with hull) and rice (unpolished) appeared to have high buffering capacity while yam, cassava and polished rice all showed weak buffering capacity. According to the analysis of Nigeria's foods and food-stuffs by Oyenuga, (1968)2 the former group of food substance incidentally have high phosphorus contents and relatively higher iron, calcium and protein contents. (The index of the buffering capacity is the number of millitres of acid that was mopped up before attaining pH 1.9). The buffering capacity was prominent at a higher pH range in the strong buffers than in the weak ones. This study would therefore encourage ulcer patients to eat more of beans especially the red type since it showed the greatest buffering capacity. PMID- 3508627 TI - Neonatal necrotizing enterocolitis in Lagos. AB - The records of 14 infants in whom the diagnosis of Neonatal Necrotizing Enterocolitis was made between 1978 and 1984 were studied. The distance appeared in the second week of life of the majority (57%) of the babies, and was equally prevalent in preterm and term babies. Infections seemed to be the predisposing factor in all cases although no transmissable pathogens were identified. Abdominal distention (57%), rectal bleeding (21%) and bowel perforation (14%) were the main presenting features. The only three survivors were among the babies treated medically including intravenous metronidazole. The only baby that survived bowel resection succumbed three months later to jejunostomy diarrhoea. Extended medical management including intravenous metronidazole is being suggested as the treatment for acute NNEC in developing countries while surgical treatment is reserved only for perforation and uncontrollable rectal bleeding. PMID- 3508628 TI - Conjugated bile acid and cholesterol levels in pregnant Africans and Caucasians. AB - Pregnancy serum glycochenodeoxycholic acid (GCDA) and taurochenodeoxycholic acid (TCDA) were simultaneously assayed by solid-phase fluoroimmunoassay (FIA) for apparently healthy Nigerians and caucasians domiciled in Nigeria and London respectively. Serum cholesterol values were also obtained for the same gestational period, that is, the second and third trimesters. The bile acid and cholesterol values were compared with those of their respective non-pregnant counterparts. Although there was a considerable fluctuation in the mean bile acid concentrations throughout this period for both pregnant groups, the mean bile acid value for each group was, however, within the normal range. The mean bile acid concentration for the pregnant African was significantly lower than that of her Caucasian counterpart, a notable factor in the assessment of hepatobiliary function for the African during pregnancy. Furthermore, a progressive rise in serum cholesterol during pregnancy, previously observed by other workers, was confirmed for both groups of women. But the increase in cholesterol concentration, which was greater in the Caucasian than the African, did not, however, appear to have affected the bile acid concentration during pregnancy. PMID- 3508629 TI - Anti-ulcer drugs and intrinsic factor secretion. AB - Twelve healthy volunteers were randomly allocated to take two of the following treatments; cimetidine, misoprostol (a prostaglandin E1 analogue) and carbenoxolone, for two weeks. A further four subjects took ranitidine. Gastric aspirates were collected before and on the 14th day of therapy for each drug, and analysed for intrinsic factor concentration and total output. Both randitine and cimetidine inhibited pentagastrin stimulated output by 47% and 27% respectively in comparison to control, but had no effect on stimulated mean intrinsic factor concentrations. No changes were observed with misoprostol and carbenoxolone treatment. PMID- 3508630 TI - Plasma ascorbic acid levels in Nigerian children of Niger delta region of Nigeria. AB - The plasma level of ascorbic acid has been used as a measure of both dietary intake and body reserve of the vitamin. In growing children, ascorbic acid is particularly important for the enhancement of the formation of bone matrix. Although the occurrence of scurvy in the tropics is exceptional and rarely reported in children, available data on plasma ascorbic acid level in children especially in Nigeria is almost non-existent. An earlier report found the mean plasma ascorbic level for Nigerian children to be 0.25mg/100ml. Using a modification of Kuther's method, blood plasma from 50 subjects was analysed for plasma ascorbic acid concentration. The subjects were primary school children in the Niger Delta Region of Nigeria, both sexes, aged between 8 and 12 years. Their mean plasma ascorbic acid level was found to be 0.71mg/100ml with a standard deviation of 0.118mg/100ml.68% of them were normal and 32% subnormal. None was deficient. There was no relationship among the children, between plasma ascorbic level and sex, age, weight or environment. PMID- 3508631 TI - Duodenal obstruction in Nigerian newborns and infants. AB - Experience with the management of congenital duodenal obstruction in a tropical environment is analysed with a view to highlighting some of the problems and suggesting solutions. 30 infants with duodenal obstruction were treated at the Lagos University Teaching Hospital between 1978 and 1985. 15 (50%) infants had duodenal atersia. 7 (23%) had Ladd's bands, 6 (20%) had duodenal diaphragm and there was one bay with partial duodenal obstruction caused by a duplication cyst. The associated abnormalities encountered in 7 infants are distal bowel atresia (3), partial situs inversus (3) and Trisomy 21 (1). Delay in presentation and inadequate facilities constituted the major constraints. 7 of the 25 infants that had corrective surgery died, a mortality of 28%. All the infants that were treated within the first 8 days of life survived. After this period survival was restricted to those with incomplete obstruction. Mortality can be reduced by the provision of adequate facilities and health education. PMID- 3508632 TI - The serum and gastric juice lactic dehydrogenase levels in healthy Nigerians. AB - To define the pattern of serum and gastric lactic dehydrogenase (LDH) in Nigerians. Levels of this glycolytic enzyme were estimated in 60 (49M, 20F) healthy Nigerians using the spectrophotometric techniques. The mean serum LDH levels were 181.2 +/- 43.9 i.u./L and 157.05 +/- 37.82 i.u./L in males and females respectively. The difference related to sex was significant (P greater than 0.05). The mean gastric juice LDH levels in males and females were 17.39 +/- 7.94 i.u./L and 15.75 +/- 7.50 i.u./L. There was no correlation between the serum and gastric juice LDH levels. The levels in the healthy Nigerians are comparable to the observed values in the caucasians. PMID- 3508633 TI - Lactic dehydrogenase levels in patients with duodenal ulcer, gastric ulcer, gastric polys and gastric carcinoma. AB - LDH is found in many body fluids and tissues. Its level is elevated in many diseases. Thus the levels of LDH in serum and gastric juice were determined in both benign and malignant disease of the upper gastro-intestinal tract using the spectrophotometric techniques. 45 patients were included in the study (duodenal ulcer 19; gastric ulcer 6; gastric polyps 5; and gastric carcinoma 15). Serum LDH levels were not significantly elevated. However, the gastric juice LDH levels were significantly elevated in gastric polyps and gastric carcinoma. The mean levels were 96.81 +/- 14.31 and 443.2 +/- 58.1 i.u./L respectively. Serial estimation of gastric juice LDH in patients with gastric polyps showed a remarkable elevation at the time of malignant transformation. PMID- 3508635 TI - Anthropometric estimation of basal metabolic rate in Nigeria children and adolescents of Niger delta region of Nigeria. AB - Most data on basal metabolic rates (BMR) obtained are from developed countries of the world and a few from Asian countries. No literature is available on BMR in Nigerian children, hence this investigation was carried out in a total of 801 randomly sampled human subjects 606 of whom are children (ages 6 to 17 years) and 195 adolescents' (ages 14 to 19 years). Among the children, 264 were boys while 342 were girls. In adolescents, 119 were boys and 76 were girls. It was found that the BMR in Nigerian children ranged between 33.3 and 58.42 in males, 37.54 and 53.42 in females. The BMR's were higher at lower age groups than in the older children. The BMR's were higher than those of their counter part caucasian or Asian children. But the results were within the 15% deviation set as normal standards by Mayo foundation standard charts of BMR. PMID- 3508634 TI - Complete rectal prolapse in Enugu, Nigeria. AB - The case records of thirty patients (21 male and 9 female) aged 8 to 62 years treated for complete rectal prolapse by operation over 5 years were studied. The results of treatment were compared with those in seven consecutive patients treated more recently by posterior rectopexy. Thiersch operation has been attended by an unacceptable high rate of reoccurrence, recurrent sepsis and faecal impaction. We recommend that is use should be abandoned. Anterior resection, usually more successful, is also associated with significant morbidity. We consider it too formidable an operation for a benign condition. We have found posterior rectopexy to be simple, safe and effective and we recommend it for the surgical treatment of complete rectal prolapse. PMID- 3508636 TI - Motility abnormality in dogs with gastrojejunostomy. AB - Motility related to gastrojejunostomy were studied in seven dogs which were prepared with a gastric cannula and platinum electrodes placed in the antrum, duodenum, jejunum and ileum. Five dogs were equipped with gastrojejunostomy at the time of electrode implantation and the two remaining dogs were used as control. Myoelectric activity recorded revealed several abnormal findings and occasionally spike activity occurred simultaneously in the duodenum, jejunum and ileum or it retropropagated from lower ileum to reach the stomach. The study suggests that the dyspeptic symptoms observed in patients after gastrojejunostomy may be associated with similar motility abnormalities as observed in these dogs. PMID- 3508637 TI - Cytoprotective effect of pirenzepine and palm wine on rats gastric mucosa. AB - Pirenzepine (Gastrozepin--Boechringer Ingelheim) is selective antimuscarinic blocker (MI-blocker) which has been used in the treatment of peptic ulcer because of its ability to reduce gastric acid secretion. But pirenzepine has also been found to have a cytoprotective effect on gastric mucosa in rats. The aim of the present investigation was to find out if palm wine also has any cytoprotective effect on rat gastric mucosa. Gastric mucosal ulcerations were induced with absolute ethanol. It was found that Pirenzepine induced 57% cytoprotection while palm wine induced 24% cytoprotection in rat gastric mucosa. The protection with the latter substance was not statistically significant, while the effect with pirenzepine was significant. PMID- 3508638 TI - Serendipity in cholangiography. AB - Seventeen of 107 consecutive direct cholangiography demonstrated serendipitous and unusual but significant contrast collections. The indications for and routes of cholangiography, correlative imaging procedures and outcome were retrospectively analysed. There was 6 bilomas, 3 aberrant bile ducts, 3 hepatic and 3 subphrenic abscesses and 2 gastrobiliary fistulae. Other contrast deposits were intra, perivascular, paraductal, interstitial and gastric reflux. While cholangiography cannot be proposed as the primary imaging modality in any of the above entities, the described incidental but significant cholangiographic features should be recognised, to optimize the total diagnostic yield (particularly in centres in developing economies, where cross-sectional imagers are scarce), redirect diagnostic endeavours to the real source of patients' problems, and discriminate normal and procedure-related from concurrent pathological accumulations, which may require specific therapy. PMID- 3508639 TI - Isolated smooth muscle cells preparation. AB - Detached smooth muscle cells from rat gastric antrum were isolated by incubation with collagenase and examined for viability and motility. Each stomach yielded about 10(7) muscle cells and were judged as intact and viable by the trypan blue dye exclusion. It is concluded that isolated smooth muscle cells of the rat gastric antrum by the technique of incubation with collagenase are judged viable and suitable for characterization of receptors on the surface membranes of these cells. PMID- 3508640 TI - Endoscopic healing stages of peptic ulcer: experience at Ife University Teaching Hospitals Complex. AB - A great deal of information has been accumulated since 1829 on the clinical and pathological aspects of ulcer, yet there are still many variables and unknowns in the causes, healing, relapses and chronic changes, that it is almost impossible to predict precisely the outcome of an ulcer diathesis. The purpose of this communication is not to compare the efficacy of the more recent drugs in treatment of duodenal ulcers but it is to document our observations of the healing process of ulcers to the terminal scarring stage in sequence. Four hundred and twelve patients, 297 males and 115 females with endoscopic diagnosed duodenal ulcers were treated with ranitidine (50%), pirenzepine (36.40%) and rennie (13.60%). They were scoped at weekly interval till the end of the 8 week study. After 8 weeks 98.05% of the ranitidine group, 76% of the pirenzepine group and 33.92% of rennine fulfilled the endoscopic criteria of healed ulcer. It was established that there were two healing patterns of ulcers, namely the concentric and unidirectional. Deformity is commonly found in ulcers that healed unidirectionally. Those healed concentrically have only few cases of deformity. Based on our experience, it is being suggested that ulcers that healed with deformity will require a very long maintenance treatment. Whereas those that healed without deformity, will require a short-term maintenance treatment. PMID- 3508641 TI - Inflammatory bowel disease around the world, personal impression from an ongoing OMGE survey and plans for future. PMID- 3508642 TI - The surgical treatment of gastro-oesophageal reflux. PMID- 3508643 TI - The effect of cola acuminata and cola nitida on gastric acid secretion. AB - Cola nuts are obtained from cola trees growing both wild and cultivated in the equatorial rain forest belf of Nigeria and the rest of West Coast of Africa. There are two common species namely cola accuminata which is multicotyledonous and cola nitida which is dicotyledonous. The cola nitida has two subspecies, alba and rubra (white and red respectively). The cola accuminata is more popular in the Ibo and Igedde tribes of the Eastern and Middle Belt regions respectively in Nigeria, while cola nitida is preferred by the Hausa-Fulani tribes of the Northern part of Nigeria. Both cola species contain xanthines--the same type of alkaloids found in tea and coffee. Common among these xanthine derivatives are caffeine, theophylline and theobromine. These xanthines are known to stimulate gastric acid secretion. We therefore decided to find out the effect of both species of the cola on gastric acid secretion, since this has not been reported previously. We found that both cola species significantly induced gastric acid secretion. This corroborates our clinical advice to peptic ulcer patients not to eat cola nuts. PMID- 3508644 TI - The changing pattern of cholelithiasis in Lagos. AB - Colo-rectal carcinoma, diverticular disease and cholecystitis which are prevalent in the industrialised world are very rare in the African population. The last two decades have, however witnessed a big socio-economic change with incorporation of western dietary items, especially in the Nigerian urban areas. Collection of 69 cases of cholecystitis over a five year period contrasts sharply with the earlier reports in Nigeria. The female to male ratio is 5.3 to 1. The age range is 10-66 years, median female 36.9 +/- 11.3 S.D., and male 49 +/- 7.1 S.D. Probable factors contributing to the increased occurrence may include increased admittance to hospitals, incorporation of the western dietary items in the diet of the urbanised Nigerians and oral contraceptive pills. PMID- 3508645 TI - Dose response studies of gastric acid secretion in Nigerians using pentagastrin stimulation. AB - To determine the does of pentagastrin required for maximal gastric acid secretion, 6, 8, and 10 micrograms/kg body weight of intramuscular pentagastrin were given to twenty Nigerian subjects (ten controls and ten duodenal ulcer patients). The different doses of pentagastrin were administered to each subject on different days. 8 micrograms/kg body weight of pentagastrin caused the highest gastric acid output in all the subjects followed by 6 and lastly 10 micrograms/kg body weight. Significant differences in the mean stimulated acid output by 6 and 8 micrograms/kg body weight to pentagastrin were found only in the duodenal ulcer patients (Maximal Acid Output (M.A.O.). PMID- 3508646 TI - Gastric acid secretion studies in Enugu, using pentagastrin stimulation. AB - Mean acid output was studied in forty-three Nigerian subjects (twenty controls and twenty-three duodenal ulcer patients). 6 micrograms/kg body weight of pentagastrin was given to each after 1 hour basal acid output (B.A.O.) collection. Maximal and peak acid outputs (M.A.O. and P.A.O.) were measured in mmol/hr using the indicator-titration method. Gastric juice volume was measured in mls. For the control the B.A.O., M.A.O. and P.A.O. in mmol/hr were (Mean 1 S.D.) 1.7 +/- 1.6; 13.5 +/- 4.61 and 15.1 +/- 5.3 respectively. The corresponding figures for the duodenal ulcer patients was 3.2 +/- 2.7; 25.1 +/- 8.5; 28.4 +/- 11.1. P less than 0.05, P less than 0.001 and P less than 0.001 respectively). The mean stimulated gastric juice volume of 131.3 +/- 29.6 ml in the controls differed significantly from the volume 198.2 +/- 54.9 in the duodenal ulcer patients (P less than 0.001). 182 mls of gastric juice was found to be the volume above which is duodenal ulcer may be suspected. Acid values are compared with published data and reasons for any differences discussed. PMID- 3508647 TI - The inhibitory effect of phlorhizin and phloretin on hexose transport in the liver. AB - The inhibitory effect of phlorhzin on renal tubular glucose absorption has been known for a long time now. But its aglycone, phloretin is almost completely devoid of such an action in the kidney although it is more active than phlorhzin on sugar transport mechanism in human erythrocytes. The present investigation was designed to find out the effects of these two chemically related substances on hexose transport in the liver. The effect of 1mM phlorhzin or ImM phloretin on the transport of D-stereoisomers of glucose, galactose and fructose using the first pass extraction technique. It was found that phloretin was a better inhibitor of hexose transport in the liver. The difference between the effect of phlorhizin, and the phloretin was highly significant. The inhibitory pattern of the two chemical substances on the three hexoses indicate a discrimination between galactose transport and glucose or fructose transport in the liver. PMID- 3508648 TI - Effect of Nigerian bottled palm wine on gastric acid secretion. AB - Palm wine is the sap of palm tree (family Palmeae) obtained as the fermentation product of a 24 hour tapping. The effect was studied in 40 albino rats of both sexes. It was found that palm wine per orally caused 21.8% decrease in gastric acid secretion (P less than 0.01). But 4% ethanol caused significant increase, while 12% sucrose caused significant decrease in gastric acid secretion in rats. This inhibitory effect of palm wine may be of clinical significance in the management of peptic ulcer patients and ulcer prone subjects in this region. PMID- 3508649 TI - The liver in kwashiorkor. PMID- 3508650 TI - Gastrointestinal toxicity of melos conquer mixture in rats. AB - GIT effects of Melos Conquer Mixture were investigated - using albino wister rats. Conquer Mixture was administered orally at different concentrations whereas the control group received water. The experiment lasted from 3 to 21 days. Pathological examination was carried out on the dead animals. The animals showed (1) loss of weight and appetite (2) weakness (3) faeces was soft (4) out of 10 animals which received 1.20 ml/kg died on day 5(5) the Glt of the dead rats was virtually empty except in the colon, (6) pieces from various parts of GIT revealed evidence of acute and sub acute inflammatory cellular reactions. The results indicate that Conquer Mixture may be toxic to the gastrointestinal tract and suggest that a re-evaluation of the therapeutic usefulness of the drug in the management of malaria is warranted. PMID- 3508651 TI - Experiences with acellular pertussis vaccine in Japan and epidemiology of pertussis. AB - In 1975, with two successive cases of death shortly after whole cell pertussis vaccine, administration of pertussis vaccine was temporarily suspended. The vaccine was soon resumed, but setting the vaccination age at over two years for group vaccination. This caused the fall in pertussis vaccine acceptance rates until 1980, resulting in a nationwide epidemic of pertussis infection, with the peak of the epidemic in 1979. Acellular pertussis vaccine was developed and introduced in 1981, since then the coverage rate with the three-time pertussis vaccination have retained the levels of more than 80%. The number of cases of pertussis infection decreased steadily since 1980 and in 1985, the number of total pertussis patients was as low as those observed before 1974. However, incidence of pertussis patients aged less than 2 year remained higher. Dramatical decrease in side effects of pertussis vaccination was observed after the elevation of the age of the vaccination at mass immunization clinic to two years. Side effects has decreased further after the introduction of acellular pertussis vaccine. PMID- 3508652 TI - Report of a case with chronic myelomonocytic leukemia: demonstration of leukemic monocytes lacking nonspecific esterase by flow cytometry using monoclonal antibodies. AB - Chronic myelomonocytic leukemia (CMML) is a rare leukemia, which is now included in myelodysplastic syndromes. In a small number of patients with CMML, problems in the diagnosis have been reported, especially when atypical morphological features in both monocytic and granulocytic cells due to dysmyelopoiesis are prominent, or when cytochemical characteristics are lost in the leukemic cells. The case history of a sixty-seven year-old male patient with CMML is described. The diagnosis of CMML in the patient was supported by the following evidence: chronic course of his disease; increased monocyte-like cells without other cause; normocytic anemia; immature granulocytic cells with hypogranular feature and giant platelets were observed in the peripheral blood. The bone marrow showed myeloid hyperplasia. Serum muramidase and vitamin B12 levels were increased, while neutrophil alkaline phosphatase score was low in the peripheral blood. Ph' chromosome was negative. The monocyte-like cells completely lacked nonspecific esterase. However the cells were confirmed as monocytic cells by flow cytometry using monoclonal antibodies to monocytes (OKM5). PMID- 3508653 TI - Local control rate of split-course irradiation combined with chemotherapy for head and neck cancer. AB - Between 1976 and 1984, 99 patients were treated with radical external irradiation (RT) for squamous cell carcinoma of the head and neck excluding the glottis and paranasal cavity. Twenty-six out of 55 patients (47%) on chemotherapy (CT) were treated by split-course (split) RT, mainly because of acute mucositis. Only 8 out of 44 patients (18%) not on CT were treated by split RT. Although the group given split RT alone rested for 14 days and received 35 Gy, the split RT + CT group rested for 16 days and received a lower dose (30.5 Gy). The mean total doses for each treatment modality were 64 Gy in the continuous course (contin.) of RT alone, 63 Gy in contin. RT + CT, 67 Gy in split RT, and 62 Gy in split RT + CT. The observed/predicted (by a Radiation Therapy Oncology Group) control ratios of primary lesions at 2 yrs were 61/80 (0.76), 72/83 (0.87), 75/73 (1.03), and 69/71 (0.97), respectively. Among patients with a predicted rate of over 80%, the observed rates were almost identical (72%, 74%, 4/4, and 75%, respectively). However, for patients with predicted rates of 50-80%, the observed rate was 71% (12/17) in the group given combined therapy against 50% (5/10) in RT alone group. Among patients with predicted rates under 50%, the observed rate was 57% (4/7) in split RT + CR and only 25% (1/4) in contin. RT; there were no cases in contin. RT + CT. Split RT + CT is considered to be favorable for patients with poor prognostic factors. PMID- 3508655 TI - Evaluation of mumps antibodies after measles-mumps-rubella (MMR) vaccines. AB - Mumps antibody titers before and after administration of MMR trivalent combined vaccines from 3 different company were evaluated by mumps IgG Enzyme Linked Immunosorbent Assay (ELISA) and by neutralizing antibody test (NT). Seroconversion rates determined with the ELISA were around 90% in all 3 different vaccines. The seroconversion by NT test ranged from 63% to 77%. The mumps ELISA is more sensitive method of determination of antibodies against mumps virus than NT. Since ELISA is a much simpler and easier method of determining antibodies than NT, it will be a method of choice in many clinical laboratories. PMID- 3508654 TI - The Japanese characteristic of type A behavior pattern. AB - This was a retrospective study of 285 patients with coronary heart disease and 393 healthy subjects. They were administered a questionnaire composed of 15 items regarding traditional coronary risk factors and 45 items concerning behavior patterns. The 45 multiple-choice questions were computed by multiple regression analysis to develop a coronary-prone behavior pattern score. As a result, the traditional risk factors were reconfirmed and the behavior pattern scores were found to be significantly different between the two groups. The behavior pattern scores were uncorrelated with other risk factors except for cigarettes smoked daily by 40-49 year-old males. Hence, specific behavior patterns can be said to be an independent coronary risk factor also among the Japanese. In order to investigate the relationship between those behavior patterns and the Type A behavior pattern, factor analysis (normal varimax method) was conducted. Comparing three major factors among Americans, Japanese-Americans and Japanese, hard-working and workaholic tendencies were found to be more stressed rather than the hard-driving and competitive components among the Japanese. This property might be a reflection of the Japanese culture which stresses harmonious relationships rather than individualism and competitiveness. As such, it is seen that Type A behavior pattern is necessarily modified according to culture and nationality. Therefore, the authors propose the term "Japanese Type A behavior pattern" for distinction of the modified form of Type A behavior pattern. PMID- 3508656 TI - Clinical application of biofeedback treatment with a microvibration transducer. AB - This article demonstrates one clinical application of biofeedback treatment with a microvibration (MV) transducer to relieve functional tremors. A MV transducer, a kind of accelerometer, was originally developed to detect invisible tremors from the body surface but this equipment is also utilized to detect visible tremors to convert them to auditory signals. Our method uses almost the same procedure as electromyographic biofeedback treatment. The threshold level for production of auditory signals should be determined as high as possible between the superimposed amplitudes of essential MV and tremor components. As the sessions progress, the predeterminate threshold level should be gradually lowered to almost the same amplitude as MV itself. In determining the threshold, it is more appropriate to utilize records of the frequency band in which the tremor components are described more clearly, in order to remove noises or MV waves of different frequency ranges. Because of the high sensitivity of this accelerometer, such "tremor feedback" treatment can be recommended only if the tremor is present while the patient is resting or remains still. PMID- 3508657 TI - Effect of growth hormone on epiphyseal growth plates in zinc deficiency. AB - This study was carried out on 18 albino rats. The control group, consisting of six rats, was fed a normal diet and tap water. The other rats were given a zinc deficient diet and deionized water. Two weeks later the latter group was again divided into two into smaller groups. The first of these groups was given an given an additional 100 ppm of zinc acetate. From the fifteenth day onwards, the human growth hormone (Nanormon) was injected intra-peritoneally to each group at a dose of 80 micrograms/day for two weeks. At the end of the experiment, it was found that body weights were markedly increased in the control and zinc-added groups compared with the zinc-deficient rats. In the zinc-deficient group, serum zinc, hair zinc levels, alkaline phosphatase activity and serum protein levels were lower than those of the control and zinc-added groups. The zinc-deficient group had narrower tibial epiphyseal growth plates than those of the control group. The count of hypertrophied cells was also less in the zinc-deficient group. Based on these data, our conclusion was that the growth hormone becomes ineffective under conditions of zinc deficiency. This means that zinc deficiency has multidimensional effects on growth hormone activity. PMID- 3508658 TI - A case of intestinal myiasis in Japan. AB - A case of intestinal myiasis caused by larvae of Sarcophaga peregrina (Japanese name: senchi-nikubae) is reported. The patient passed stools containing live fly larvae for 2 days, but was otherwise asymptomatic. The patient seems to have been infested accidentally as a result of having eaten "yakitori" in which the fly had deposited its larvae. This paper is the first report of intestinal myiasis caused by the 3rd instar of this species. PMID- 3508659 TI - [Liposarcoma of the spermatic cord (presentation of a case)]. AB - Liposarcoma of the spermatic cord is a rare tumour, usually well differentiated, that generally resembles a lipoma and undergoes a slow, progressive enlargement. Most patients with liposarcoma do not experience any recurrence after local excision. Due to the rare occurrence of this tumour it seems appropriate to document one case that came to our observation in recent years. PMID- 3508660 TI - [Diabetic foot: practical management of an old recurrent problem]. AB - A simplified approach to the management of major lesions of the diabetic foot is presented. Two nosological types, the angiopathic foot and the neuropathic foot, are proposed, on the basis of diagnostic, therapeutic, prognostic and preventive criteria. A ten years personal experience is discussed. PMID- 3508661 TI - [Total cranio-facial anatomical model of plio-pleistocene hominids]. AB - For a correct assessment of the fossil specimens are analysed ten characters or structural complexes of neuro - and splancno - cranium. Not individual characters but a total pattern, according to Le Gros Clark's original concept, provide a positive identification of hominid single taxon. Following items are examined: 1) facial prognathism; 2) mid-facial architecture; 3) nasal bone, fronto-nasal and fronto-maxillary suture; 4) frontal region morphology; 5) temporal lines and cranial cresting; 6) occipital and nuchal plane; 7) steepness of nuchal plane, foramen magnum position; 8) skull base diagrams; 9) mastoid process and neighbouring regions; 10) size and form of mandibular fossa. To conclude: it is possible a taxonomic classification of plio-pleistocenic hominid specimens on the basis of an analysis of the "total morphological pattern". PMID- 3508662 TI - [Neonatal respiratory assistance: technics and modalities]. AB - The authors describe the most common techniques of mechanical ventilation in the newborn's respiratory distress syndrome (RDS) and the most qualified modalities in the different pathological situations. PMID- 3508663 TI - [Assistance procedures and physiologic balance in newborn infants]. AB - The authors assume that an appropriate sensory input care can improve the conditions of the very-low-birth-weight (VLBW) infant with RDS. The VLBW preterm infant, in the intensive care unit, takes advantage both medically and developmentally of an individualized behavioral care. The authors present their positive experience with the auditory, visual and tactile stimulations of the preterm infant, after the period of intensive care, with the method of Brazelton. PMID- 3508664 TI - [Evaluation problems and indications for handling premature infants (VLBW)]. AB - The authors present their approach to the care of the preterm very-low-birth weight infant. They consider the importance of the handling of the preterm infant in the Neonatal Intensive Care Unit (NICU) and the co-operation among the neonatologist, the physiotherapist and the parents in the individualized care, both in the NICU and in the follow-up. PMID- 3508665 TI - [Evaluation of a new method for identification of anti-erythrocyte antibodies]. AB - The polibrene manual test was evaluated by using three different incubation time periods and its efficacy was compared to other techniques currently in use in our center. We found that when this technique is carried out with a 15 minute incubation period and the addition of antiglobulin, it is decidedly sensitive and can be employed in urgent compatibility testing preceded by "type and screen". PMID- 3508666 TI - [Laboratory and therapeutic control of oral anticoagulant treatment]. AB - In our hospital, 199 patients following oral anticoagulant therapy were studied and controlled. They were divided into two groups according to the follow-up period. The first group was treated for 24-40 weeks. The second group was treated for 6-24 weeks. In the first group, 169 (98.3%) of the 172 patients studied maintained therapeutic range INR (2.1-4.8) for a period of 70%-100% of the total observation time, whereas 3 patients (1.7%) did not have a valid therapeutic response. The percentage of subjects within therapeutic range in the second group of 27 patients was decidedly inferior. Five of these patients were not able to achieve the desired results, probably because of a too brief period and undertreatment. PMID- 3508667 TI - [Diagnosis of pulmonary maturity in the fetus]. AB - The various biochemical and biophysical methods to assess fetal lung maturity are reviewed. So far the most widely used biochemical method is the L/S ratio, but in complicated pregnancies mainly in diabetes mellitus, the determination of the lung profile (including PG) must be carried out to reduce false immature ratios. Biophysical methods, like foam stability tests and optical density, are easy and quick, but less precise. PMID- 3508668 TI - [Cutaneous leiomyosarcoma (description of a case)]. AB - Cutaneous leiomyosarcoma is a rare tumour arising in dermis or subcutaneous tissue. Diagnosis is usually made by microscopic examination on the basis of marked cellular atypia and mitoses. We report one case of leiomyosarcoma of the gluteus with precocious lung metastases in a 65-year-old female. PMID- 3508669 TI - Evoked potentials in comatose children: auditory brainstem responses. AB - Auditory brainstem responses (ABRs) were studied retrospectively in 80 children (ages 4 days to 19 years) with coma of various etiologies to determine their value as a predictor of outcome. The ABRs performed shortly after admission were analyzed with respect to initial neurologic status and final outcome. Of the 49 patients with initial Glasgow Coma Scale scores of less than 7, only 21 had severely abnormal ABRs. Eighteen had normal ABRs. Of these 18 patients, 10 died, and 8 were neurologically abnormal. Prolonged interpeak latencies were seen in 16 patients who experienced a range of clinical severity. Of the total of 17 children with absent ABRs or only the presence of waves I/III, three children survived, two with minimal neurologic abnormalities and one in a vegetative state. The efficacy of ABRs in comatose children as an early prognostic indicator was not confirmed by this study. PMID- 3508671 TI - Cerebrospinal fluid lactate levels in term infants with perinatal hypoxia. AB - The prognostic value of cerebrospinal fluid (CSF) lactate concentration after an hypoxic-ischemic brain insult was evaluated. Three groups of neonates were studied and followed. Group 1A included 19 asphyxiated neonates who subsequently developed normally, Group 1B included 6 asphyxiated neonates who died or developed neurologic sequelae, and Group 2 consisted of 20 control (comparison) infants. A CSF sample was obtained within the first day of life for cytochemical analysis, culture, and lactate determination with simultaneous determination of serum lactate. The mean CSF lactate level in Group 1B (4.5 mmol/L) was significantly higher than in Group 1A (2.5 mmol/L) (p less than .001). In comparison to the highest CSF lactate concentrations in the normal range in Group 2 (2.7 mmol/L), all Group 1B neonates had elevated CSF lactate levels, and eight neonates (34%) of Group 1A had increased levels. A correlation was found between blood and CSF lactate levels in asphyxiated infants (r = .42, p less than .05), but its meaning is uncertain. We conclude that CSF lactate determinations may be helpful in the evaluation of perinatal hypoxic-ischemic encephalopathy. PMID- 3508670 TI - Dominant recurrent ataxia and vertigo of childhood. AB - Four families are described with an autosomal dominant illness characterized by the childhood onset of recurrent attacks of prolonged ataxia, server vertigo, and vomiting. The attacks often begin in infancy. On the average, attacks occur monthly, and last between one hour to more than a week. Variations in severity occur within families. During an attack, consciousness is unaltered, but severe vertigo makes walking impossible and vomiting is frequent and severe. An attack is marked by horizontal and vertical jerk nystagmus, accompanied by vertigo which is sometimes worsened by position; however, there is no muscular weakness. During an attack, blood gases, ammonia, and amino acid studies are normal. Between attacks patients manifest combinations of slight horizontal or vertical jerk nystagmus or mild clumsiness. Cochlear and labyrinthine studies and neurologic investigations were noncontributory. Conventional therapies for vertigo, epilepsy, and migraine were ineffective, but acetazolamide (250-500 mg/day) stopped the attacks. PMID- 3508672 TI - Radionuclide cerebral imaging for confirmation of brain death in children: the significance of dural sinus activity. AB - Radionuclide cerebral imaging revealed no cortical flow, but recorded persistent dural sinus activity in 14 of 55 clinically brain dead children. Of these 14 children, 13 had isoelectric electroencephalograms. Postmortem liquefactive necrosis was present in 7 cases. Although studies that demonstrated the absence of flow were confirmatory of brain death, dural sinus radioactivity in the delayed static images persisted in the presence of brain death. PMID- 3508673 TI - Acute, severe, central and peripheral nervous system combined demyelination. AB - Acute disseminated encephalomyelopathy and Guillain-Barre syndrome are both immunologically mediated para-infectious demyelinating disorders, the former affecting the central nervous system and the latter affecting the peripheral nervous system. The term encephalo-myelo-radiculo-neuropathy was introduced to describe cases in which major involvement of one system, most commonly the peripheral, was associated with mild involvement of the other. We present a case of acute severe demyelination simultaneously affecting both the central and the peripheral nervous systems in a 10-year-old female. This clinical picture combines acute disseminated encephalomyelopathy and Guillain-Barre syndrome, both of which are extremely severe. PMID- 3508674 TI - Unusual biochemical and clinical features in a girl with ornithine transcarbamylase deficiency. AB - A girl, ultimately diagnosed as having profound ornithine transcarbamylase (OTC) deficiency, presented as a neonate with feeding intolerance, irritability, and seizures without concurrent hyperammonemia. Developing normally until ten months of age, the girl subsequently experienced two episodes of hyperammonemia, which were associated with focal seizures and residual hemiparesis. She continued to have profound neurologic impairment and seizures and died at 26 months of age, despite appropriate dietary protein restriction, sodium benzoate, and arginine supplementation. Symptomatic OTC deficiency has not been previously reported unassociated with hyperammonemia. The recurrent cerebrovascular episodes are distinctly uncommon in patients with urea cycle enzymopathies. PMID- 3508675 TI - Joubert syndrome associated with unilateral ptosis and Leber congenital amaurosis. AB - Two siblings are described with clinical features of Joubert syndrome associated with unilateral ptosis, severe visual disturbances with normal appearing fundi, and an occipital meningocele; one child also had polydactyly. Neither child manifested responses to electroretinography and one did not manifest visual evoked potentials. The siblings were considered to have characteristics of Leber congenital amaurosis and Joubert syndrome as well as unilateral ptosis. The presence of these findings in siblings suggests a genetic basis for their disease. Careful investigations should be conducted on infants with dysplasia of the cerebellar vermis, including tests for respiratory irregularities, retinal abnormalities, and renal abnormalities to further clarify the interrelationships of these conditions. PMID- 3508676 TI - Spinal and radicular pain in pseudotumor cerebri. AB - A 4 1/2-year-old girl presented with cervical spine and radicular pain with hypoactive biceps and brachioradialis stretch reflexes. A diagnosis of pseudotumor cerebri was made. The patient's symptoms resolved following the reduction of the elevated intracranial pressure. Abnormalities of the cervical spine and spinal cord were not detected. A mechanism to explain this "false localizing" sign is discussed. PMID- 3508677 TI - Cerebral embolism resulting from an intracardiac tumor in tuberous sclerosis. AB - Tuberous sclerosis was diagnosed in an infant girl during the first 3 days of life on the basis of electrocardiographic and cranial computed tomographic abnormalities. At 19 months of age, neurologic deterioration occurred and repeat computed tomography documented several new cortical lesions while the subaortic mass was markedly reduced in size. The sequence of events suggested cerebral embolization by the cardiac tumor. PMID- 3508678 TI - Hemorrhagic cerebral infarction in pediatric patients. AB - Two patients with ischemic strokes, presumably due to embolism, developed spontaneous hemorrhagic cerebral infarctions which were detected by follow-up cranial computed tomography. Clinical deterioration was associated with hemorrhagic transformation in one patient. In each case, immediate anticoagulant therapy was considered but was deferred. Implications of the use of anticoagulant therapy in pediatric patients with acute embolic stroke are discussed. PMID- 3508679 TI - Bobble-head doll syndrome due to trapped fourth ventricle and aqueduct. AB - The bobble-head doll syndrome has been associated with third ventriculomegaly due to cysts or aqueductal stenosis. A case is described in which the aqueduct and fourth ventricle are enlarged, but the third ventricle is not. The unifying pathogenesis for this and previous cases is pressure on the dorsomedial red nucleus. PMID- 3508680 TI - Post-traumatic vertigo in children: a diagnostic approach. AB - The relatively high incidence of persistent post-traumatic headache and vertigo in children and adolescents presents a diagnostic and therapeutic challenge. It is often difficult to differentiate between functional complaints generated by psychological trauma or compensation-seeking and symptoms reflecting an organic etiology. The clinical and laboratory findings of 22 patients with post-traumatic headaches and vertigo were delineated into five major diagnostic categories: labyrinthine concussion, whiplash syndrome, basilar artery migraine, vertiginous seizures, and a non-specific post-traumatic dizziness. Patients with post traumatic hearing loss were excluded from this study because they represent a group with different diagnostic problems and more recognizable organic pathology. Each patient had a complete neurologic evaluation including specific clinical vestibular tests (i.e., stepping test, reinforced Romberg, past-pointing evaluation, and positional tests using the Nylen-Hallpike maneuver. Laboratory studies included skull x-ray, computed tomography, electroencephalography, electronystagmography, and audiologic assessment. Symptoms, signs, and tests were evaluated in each category of post-traumatic vertigo to help establish the diagnosis and initiate treatment. PMID- 3508681 TI - Urinary sialic acid screening in neurologic disorders. AB - Urine sialic acid was measured in 246 patients evaluated for possible neurodegenerative disorders. Total, free, and bound sialic acid excretion declined significantly with patients' ages. Among 11 patients (4.5%) with age related excretion rates greater than 2 standard deviations above the mean, 5 had the following disorders: free sialic acid storage disease, mucolipidosis type II, pseudohypoparathyroidism, sinus histiocytosis, and probable Sanfilippo syndrome. Although the remaining 6 were undiagnosed, 2 exhibited deteriorating courses and the other 4 presented variable combinations of organomegaly, developmental delay or mental retardation, seizures, facial dysmorphism, or bony abnormalities. Thus, these individuals also may have metabolic disorders with abnormal excretions of sialic acid-containing compounds. With awareness of age-related excretion rates, sialic acid screening is most useful for the sialidoses, mucolipidoses, and disorders of free sialic acid metabolism. PMID- 3508682 TI - Magnetic resonance and CT imaging correlated with clinical status in SSPE. AB - Five patients afflicted with subacute sclerosing panencephalitis were studied with computed tomography and magnetic resonance imaging. Computed tomography documented changes of nonspecific cerebral atrophy and low attenuation in the subcortical white matter. Magnetic resonance imaging revealed bilateral, symmetric, and diffuse abnormal increased signal in the white matter of the cerebral hemispheres with normal posterior fossa structures in 4 of 5 patients. Magnetic resonance imaging was superior to computed tomography in demonstrating the total extent of abnormality and may be the imaging modality of choice for this childhood disease. PMID- 3508683 TI - Carnitine prevents Reye-like syndrome in atypical carnitine deficiency. AB - A patient with repeated episodes of a Reye-like syndrome was studied. Serum and muscle carnitine levels were normal, but there was an apparent accumulation of muscle lipid and glycogen. Ragged-red fibers were present in the muscle. Prolonged fasting (20 hours) induced hypoglycemia, lactic acidosis, an increase in free fatty acids, and hyperammonemia. There was an accompanying sizeable reduction in the serum free carnitine level. Fasting with L-carnitine administration resulted in milder changes in these laboratory measures. Administration of L-carnitine, (100 mg/kg/day) led to clinical improvement as evidenced by fewer attacks and a normal Gowers sign. PMID- 3508684 TI - Carnitine status in Reye and Reye-like syndromes. AB - Fourteen children with the following Reye and Reye-like syndromes were studied to determine each patient's carnitine status: valproate-induced Reye-like attack, ornithine transcarbamylase deficiency, systemic carnitine deficiency, methylmalonic acidemia, and propionic acidemia. Reduced free carnitine and increased serum and urine acylcarnitine levels were found in all patients except for 2 with Reye syndrome, in whom serum creatinine levels were mildly elevated and serum free carnitine levels were not reduced. The renal free carnitine reabsorption rate was reduced in all cases. The free carnitine content of autopsied liver samples were reduced in 2 Reye syndrome patients, 2 OTC deficiency patients, and in a single systemic carnitine deficiency patient. The observed secondary free carnitine deficiency may be a factor in the pathogenesis of Reye and Reye-like syndromes. PMID- 3508685 TI - Muscle weakness in infants with rickets: distribution, course, and recovery. AB - We describe the distribution, progression, and resolution of muscle weakness, wasting, and hypotonia in three infants with rickets due to different causes. Progressive muscle weakness affecting preferentially the proximal muscles of the legs and failure to gain weight were the presenting symptoms. The skeletal signs appeared later in the course of the illness and the time for resolution of the neuromuscular findings varied with the etiology of the disorder. PMID- 3508686 TI - Improvement in auditory brainstem response of hyperbilirubinemic infants after exchange transfusions. AB - Auditory brainstem response tests were performed before and after exchange transfusions in 6 infants with hyperbilirubinemia. The latencies of Waves I, II, and V decreased significantly after the exchange transfusions (p less than .05, p less than .02, p less than .005, respectively) and I-V interpeak latencies also were decreased (p less than .01). However, the latencies of Wave I both before and after exchange transfusions were within normal limits. The central conduction times were prolonged by hyperbilirubinemia, but the peripheral auditory pathways were not impaired. These auditory brainstem response abnormalities became normal with decreased serum bilirubin concentration. Neonatal hyperbilirubinemia is associated with transient brainstem lesions which are reversible in the early stages. Auditory brainstem response testing is an effective and readily available technique for detecting bilirubin neurotoxicity. PMID- 3508687 TI - Cortical visual impairment following birth asphyxia. AB - Visual defects are often poorly recognized in children with multiple neurologic problems due to perinatal hypoxic-ischemic encephalopathy. We report the clinical, radiologic, and electrodiagnostic characteristics of 20 children with cortical visual impairment secondary to birth asphyxia. Clinical diagnosis often was delayed. Ten patients recovered vision during the first two years of life. Four infants had coexisting damage to the pregeniculate visual pathway. Useful investigations included cranial computed tomography and visual evoked potential mapping. Electroencephalographic abnormalities were nonspecific. The classical definition of cortical blindness must be modified for children. PMID- 3508688 TI - Myopathy in an infant with a fatal peroxisomal disorder. AB - An infant with neonatal adrenoleukodystrophy experienced extreme hypotonia and virtually continuous convulsions at four months of age and died. Light and electron microscopic examination revealed evidence of myopathy and the presence of mitochondrial inclusions. Concentrations of very long-chain fatty acids were elevated in blood and fibroblasts and the oxidation of 14C-labeled fatty acids was defective. Urinary pipecolic acid content was increased. Activity of the peroxisomal dihydroxyacetone phosphate acyltransferase, which catalyzes the first step in plasmalogen synthesis, was decreased. PMID- 3508690 TI - Cerebral perfusion pressure monitoring in premature newborns. AB - Cerebral perfusion pressure (CPP), believed to be a major determinant of neurologic outcome, was monitored at the bedside of high-risk premature newborns during the first few days of life. Intraventricular hemorrhage was presumed to have occurred in only one of the seven infants and was associated with ventriculomegaly and early death. The other infants had good neurologic outcomes at age 18 months despite low mean CPPs (less than 30 mm Hg). These low CPPs were determined to be dependent on mean arterial blood pressures and not on intracranial pressures which were low in all infants (and even lower in more premature infants with apnea). Methylxanthine treatment of apnea of prematurity did not apparently change CPP, despite hypothetical effects on cerebral and peripheral vascular tone. Although fairly low CPP can be associated with good neurologic outcome, it may not be useful in monitoring newborn infants. PMID- 3508689 TI - Ventricular shapes, distortions, and deformities: mirrors of past cerebral insults. A study based on early sonographic follow-up studies. AB - Ventricular distortions and deformities often represent the endpoint of neuropathologic reactions that evolve early in life. Once fully developed, they may offer no clues as to preceding etiologic agents or pathogenesis. Serial sonography in the neonatal period of 14 patients with periventricular leukomalacia provided documentation of the evolution of certain ventricular patterns. When recognized early, these ventricular changes have prognostic significance because periventricular leukomalacia can produce serious neurologic sequelae. If found later in childhood, periventricular leukomalacia can be suggested as the original pathology. Ventricular deformities can be generalized (12 patients) or focal (11 patients); the various types of distortions are seen frequently in combination. The generalized form of ventricular expansion consisted of uniform expansion of the parieto-occipital components (hydroporencephaly), following extensive periventricular white matter necrosis. Hydroporencephaly is a new form of ex vacuo hydrocephalus in the pediatric age group. Focal changes are caused by more localized white matter cavitations with ventricularization of ensuing porencephalic cysts. These changes result in a footprint-shaped ventricular pattern (10 patients) or in frontal/occipital (polar) ventricular pointing (4 patients). White matter necrosis in other areas may lead to ventricles with bumpy contours (5 patients). PMID- 3508691 TI - Prognostic utility of visual evoked potentials in term asphyxiated neonates. AB - The prognosis for term infants with birth asphyxia is variable and does not correlate well with the acute clinical state. Diagnostic tools such as electroencephalography or imaging techniques have not been satisfactory predictors of outcome. Visual evoked potentials (VEPs) have changed acutely in birth asphyxia and may provide information for long-term prognosis. We studied VEPs serially in 25 term infants with documented birth asphyxia. The VEPs were classified into three categories: normal, mildly abnormal, or severely abnormal, and then compared to each infant's acute clinical state and outcome at age six months. Eight of the nine infants with normal or mildly abnormal VEPs were normal when examined subsequently. All the patients with severely abnormal VEPs died, or suffered severe neurologic sequelae. The VEPs demonstrated good correlation with neurodevelopmental outcomes in infants with birth asphyxia and may be useful prognostically. PMID- 3508692 TI - Empty sella syndrome in childhood. AB - The empty sella syndrome is common in middle-aged women, usually presenting with headache, and only occasionally associated with endocrine or visual abnormalities. It is rare in childhood. Childhood cases tend to present either with endocrine disturbances, visual symptoms, or with craniofacial syndromes. We present three cases of complete empty sella with childhood onset, each discovered unexpectedly during evaluation of endocrine or visual dysfunction. PMID- 3508693 TI - The use of phenacemide for intractable partial complex epilepsy in children. AB - Phenacemide monotherapy controlled seizures in four children with intractable partial complex epilepsy. No toxicity occurred. Previous fatalities caused abandonment of this antiepileptic drug, although it is not established that the drug was at fault. PMID- 3508694 TI - Drug-induced dystonia in neuronal ceroid-lipofuscinosis. AB - Neuroleptic-induced tardive dystonia is frequently refractory to therapy. We describe a 13-year-old girl with neuronal ceroid-lipofuscinosis who developed dystonia after beginning treatment with thioridazine for acute psychosis. Although anticholinergic drugs and benzodiazepines were ineffective, the patient improved with baclofen. Patients with certain degenerative diseases of the central nervous system may be at increased risk for the development of drug induced dystonia, and we caution against the use of neuroleptics in these patients. PMID- 3508695 TI - Pseudotumor cerebri associated with obstructive nephropathy. AB - We report two infants with pseudotumor cerebri associated with renal disease. The pathogenesis of increased intracranial pressure in this clinical setting is unclear, but may be mediated by one or more of the conditions commonly associated with pseudotumor cerebri, including sinus thrombosis, increased intravascular fluid volume, anemia, and endocrine disturbances resulting in abnormal calcium and phosphorus metabolism. The onset of pseudotumor cerebri also may be related to changes in vasopressin levels that affect brain water permeability. PMID- 3508696 TI - Infantile myositis: a case diagnosed in the neonatal period. AB - Infantile myositis is an inflammatory myopathy occurring in children under one year of age. This condition is extremely rare in the neonatal period and may be confused with other causes of generalized weakness. Creatine kinase activity is usually markedly elevated and electromyography demonstrates low amplitude, polyphasic motor unit activity. Muscle biopsy, necessary for diagnosis, documents characteristic findings of perifascicular atrophy and the presence of perivascular inflammatory cells. The diagnosis should be followed by corticosteroid treatment. The patient presented is the youngest biopsy-proved case of infantile myositis. In this report, his symptoms and clinical course are compared with those of previously described patients. The role of infectious agents and the immune state in the etiology of infantile myositis is considered. PMID- 3508697 TI - Hyperdense cerebral lesion in childhood tuberous sclerosis: computed tomographic demonstration and neuropathologic analysis. AB - A child with focal intractable seizures and electroencephalographic evidence of a highly epileptogenic focus was found to have a high-density, wedge-shaped lesion in the left parietal region on cerebral computed tomography. The lesion extended from the ventricular to the pial surfaces and did not enhance after contrast infusion. Biopsy confirmed the diagnosis of tuberous sclerosis. Atypical features of tuberous sclerosis on computed tomography are reviewed and the possible pathogenesis of the lesion is discussed. PMID- 3508698 TI - Deep tendon reflexes in premature infants. AB - Ten classic deep tendon reflexes (DTRs) were evaluated in 62 premature infants of greater than 27 weeks post-conceptional age. The pectoralis major was the most readily elicitable reflex in all infants (100%), regardless of maturity. Achilles, patellar, biceps, thigh adductors, and brachioradialis reflexes also were obtained in at least 98% of babies of greater than 33 weeks gestation. Among these reflexes, less mature infants (less than 33 weeks gestation) had decreased elicitation rates for patellar and biceps reflexes and overall had diminished reflex intensity when compared to older infants (33-36 weeks gestation). By order of decreasing rate, finger flexors, jaw, crossed adductors, and triceps reflexes were less frequently elicited in both groups. Equal DTRs were obtained often in healthy and previously ill infants of less than 33 weeks gestation. Head position had no apparent affect on the ability to elicit reflexes. Theophylline therapy tended to intensify the Achilles reflex and the quiet, wakeful state appeared to be the most optimal state for the elicitation of DTRs. PMID- 3508699 TI - Benign familial neonatal seizures: clinical and electroencephalographic characteristics. AB - Two families with benign familial neonatal seizures evident over three generations are presented with emphasis on clinical and electroencephalographic features. Benign familial neonatal seizures represent a disorder with the onset of frequent generalized seizures during the first weeks of life. Family history reveals autosomal dominant inheritance of this disorder. The neonates are neurologically normal and outcomes are usually benign. In our families, none of the patients had seizures after the first ten months of life, with long-term follow-up ranging from 10 months to 56 years. The use of antiepileptic medication seems to have little effect on course or eventual outcome. The electroencephalograms, both initially and subsequently, ranged from normal to epileptiform and did not correlate with risk for further seizures in infancy or subsequent epilepsy. Benign familial neonatal seizures are a distinct clinical entity whose key features and favorable prognosis should be appreciated by all those caring for sick neonates. This recognition would result in an early diagnosis and conservative treatment. PMID- 3508700 TI - Bacterial meningitis as an etiology of perinatal cerebral infarction. AB - Despite significant improvement in mortality rate, survivors of neonatal bacterial meningitis experience a significant incidence of neurodevelopmental sequelae. Neuropathologic studies have demonstrated vasculitis, arachnoiditis, and ventriculitis with secondary edema and encephalomalacia. Areas of cerebral infarction, most commonly thought to be venous in origin, have been reported as well. We performed cranial computed tomographic scans on all eight neonates with bacterial meningitis admitted to our Newborn Special Care Unit within the past 36 months and demonstrated abnormalities in seven. Six of these infants were found to have large areas of infarction related primarily to major arterial vascular distributions. We suggest computed tomographic studies for all neonates with bacterial meningitis and subsequent scans at 4-6 months of age in those with abnormal neonatal scans in order to plan better for early intervention services. PMID- 3508701 TI - A variant of Fukuyama congenital muscular dystrophy in a non-Japanese child. AB - We report a case of Fukuyama congenital muscular dystrophy with inflammatory infiltrate on muscle biopsy in an American girl of non-Japanese ancestry. The child was hypotonic, had decreased muscle strength in all extremities, and poor head control. Her mental and motor development were delayed. She developed generalized seizures at 19 months of age. Her muscle enzymes were abnormal; cranial computed tomography demonstrated hypoplasia of the cerebellum. Electromyogram was normal. Deltoid muscle biopsy documented scattered basophilic regenerating myofibers and focal atrophic fibers with focal increases of endomysial connective tissue, small endomysial foci of inflammatory cells, and occasional perimysial, perivenular lymphocytic infiltrates. Prednisone therapy produced some decrease in serum muscle enzyme levels. PMID- 3508702 TI - Delayed traumatic intracerebral hemorrhage in children. AB - This report describes delayed traumatic intracerebral hemorrhage in five pediatric patients. The phenomenon has been considered extremely rare in children. Cranial computed tomography preceding and following the ictal hemorrhages provides the best documentation of this phenomenon and suggests some insights into the pathogenic mechanism. PMID- 3508703 TI - Clinical correlations in partial hypoxanthine guanine phosphoribosyltransferase deficiency. AB - Erythrocyte assays for hypoxanthine guanine phosphoribosyltransferase (HGPRT) activity performed on two male half-siblings with hyperuricemia, produced results consistent with classic Lesch-Nyhan syndrome. Due to the absence of neurologic abnormalities, cognitive deficits, or self-mutilation, HGPRT activity was measured by intact fibroblast assay which revealed partial enzyme deficiency. The presence of an unstable mutant enzyme may have led to the discrepancy between the erythrocyte and fibroblast studies. This discrepancy emphasizes the difficulty in assaying this enzyme solely utilizing red blood cell studies to determine a patient's course. In order to provide an accurate prognosis and relevant genetic counseling, measurement of this enzyme utilizing intact fibroblasts is critical after establishing a diagnosis of HGPRT deficiency in a hyperuricemic male lacking typical clinical manifestations of Lesch-Nyhan syndrome, but having enzyme activity of erythrocytes consistent with the diagnosis. PMID- 3508704 TI - Optic glioma associated with Beckwith-Wiedemann syndrome. AB - A 6-year-old boy with decreased vision was found to have Beckwith-Wiedemann syndrome with an associated glioma involving the intracranial optic nerves, chiasm, and optic tracts. The association of this syndrome with visceral and central nervous system neoplasms is discussed. PMID- 3508705 TI - Intradural spinal hematoma in an infant with cystic fibrosis. AB - An 8-month-old male infant with cystic fibrosis developed quadriplegia secondary to spinal cord compression. Surgery revealed an extensive intradural hematoma from C3 to T9. An underlying structural source of bleeding was not identified and the patient did not have a coagulopathy. Repeated chest physiotherapy was the only known trauma that the infant had sustained. Spinal subarachnoid and subdural bleeding is a rare form of cord compression that apparently has not been described previously in association with cystic fibrosis. The current vigorous physiotherapeutic approach to cystic fibrosis necessitates awareness of the possible complications of this therapy. PMID- 3508706 TI - Tumor embolism in tuberous sclerosis. PMID- 3508707 TI - Seizures and infarction in neonates with persistent pulmonary hypertension. AB - Seizures and cerebral infarction were observed in 10 near-term (greater than 36 weeks gestation) and term infants who had experienced moderate to severe peripartum asphyxia which resulted in persistent pulmonary hypertension. No patient received extracorporeal membrane oxygenation. Eight were outborn. Five patients were diagnosed initially with seizures during electroencephalography; electrical status epilepticus was demonstrated in five patients. The location of electrical seizures corresponded to the area of infarction in seven patients; the two remaining patients had white matter infarction. Prompt recognition of seizures and infarction in patients with persistent pulmonary hypertension is essential because of the higher probability of later neurodevelopmental difficulties. PMID- 3508708 TI - Carbamazepine-exacerbated epilepsy in children and adolescents. AB - Forty-nine children and adolescents whose seizures reportedly worsened while receiving carbamazepine (CBZ) were studied retrospectively. Twenty-six patients met criteria for excellent documentation of carbamazepine-exacerbated seizures. Four epileptic syndromes were particularly affected: childhood absence epilepsy; focal symptomatic, frontal lobe epilepsy; Lennox-Gastaut syndrome; and severe myoclonic epilepsy of infancy. Eight of the 26 patients developed new-onset absence seizures and three patients with established absence epilepsy experienced absence status. Other seizure types, including atonic, tonic-clonic, and myoclonic, developed in eight patients treated with CBZ, and new generalized spike-and-wave discharges were observed in electroencephalograms of nine patients. CBZ is a widely used, effective antiepileptic drug, particularly for partial or partial complex seizures; however, if uncontrolled, generalized seizures occur after CBZ is prescribed for children or adolescents with absence or mixed seizures, a trial of CBZ discontinuation is warranted. The data reported here do not permit calculation of the incidence of this phenomenon. PMID- 3508709 TI - Malignant hyperthermia susceptibility in X-linked muscle dystrophies. AB - To evaluate malignant hyperthermia (MH) susceptibility in X-linked muscular dystrophies, halothane and caffeine contracture tests were performed on muscle fiber bundles from five patients with Duchenne muscular dystrophy (DMD) and two patients with Becker muscular dystrophy (BMD). Two DMD patients and one BMD patient had positive contracture tests. Since a positive contracture test is currently the best indicator of anesthetic susceptibility in the MH population, and episodes of MH in dystrophic patients have been reported, patients with DMD and BMD may be at risk for developing similar anesthetic complications. Awareness of this potential anesthetic risk is of importance because orthopedic interventions are increasingly more common in these patients. PMID- 3508710 TI - Travel vision: "collicular visual system"? AB - Two visually impaired children with occipital infarctions are presented. One patient has profound impairment of his primary visual pathway but has good vision for traveling, while the other child presented with the symptoms in reverse. We believe that these two patients provide further evidence that the primary visual pathway is used for conscious visual analysis and that the collicular visual system serves as the subconscious visual guidance for locomotion. PMID- 3508711 TI - Role of MRI scanning in the diagnosis of cerebral visual disturbance. AB - Visual dysfunction as part of cerebral palsy may be due to lesions of the retrochiasmatic visual pathways. Cranial computed tomography can reveal conspicuous and characteristic abnormalities in most patients presenting with the condition; however, in some patients the abnormalities may appear so subtle on computed tomography that they can be easily overlooked or their true significance questioned. Magnetic resonance imaging has proved to be of great value in demonstrating the neuroanatomic anomalies underlying the visual handicap of this latter group of patients, allowing for early diagnosis and precise management. PMID- 3508712 TI - Atypical spasmus nutans as an initial sign of thalamic neoplasm. AB - A patient is described who presented with dissociated nystagmus (atypical spasmus nutans) and an underlying pulvinar-tectal lesion. Atypical spasmus nutans is discussed and clinicians are alerted to a spectrum of possible etiologies. PMID- 3508713 TI - Spinal cord involvement in encephalocraniocutaneous lipomatosis. AB - Encephalocraniocutaneous lipomatosis is a rare hamartomatosis involving the craniofacial region and the central nervous system. The most prominent clinical features are large areas of scalp alopecia, soft subcutaneous craniofacial masses, lipomas, connective tissue nevi of the eyelids and surrounding areas, pterygium-like choriostoma of the ocular conjunctiva, mental retardation, motor deficit, and seizures. Of the eight patients reported previously, three had spinal cord evaluations and two had evidence of lipomatosis. We report the third patient with this association, review the literature of encephalocraniocutaneous lipomatosis, and stress the importance of spinal cord evaluation during the newborn period. PMID- 3508714 TI - Effects of vitamin D deprivation and 1,25-dihydroxyvitamin D3 treatment on ion release from rat tibiae in vitro. AB - Skeletal effects of dietary vitamin D and of 1,25-dihydroxyvitamin D3[1,25(OH)2D3] in vivo and in vitro were investigated using bones from vitamin D deficient suckling rats. Tibiae from 19- to 21-day-old pups were incubated for up to 8 h in a defined medium and the net releases of Ca, inorganic phosphate (Pi) and Mg into and from the bones were determined. The pups were delivered and nursed by mothers fed either a diet containing vitamin D3 (+D) or a D-free diet ( D) starting on the sixth day of pregnancy. Effects of metabolic inhibition with iodoacetic acid (IAA, 1 mM); of elevated medium Pi concentration (2 mM); and of 1,25(OH)2D3 in vitro (2 and 10 ng/ml of medium) or in vivo (500 ng/mother ip, 2x) were evaluated. Although no effects of vitamin D on glucose metabolism or net Pi release were seen, tibiae from -D pups showed a marked decrease in net Ca release (up to 70%), while net Mg release was increased by 27%. IAA completely inhibited net Ca release in this system, had no effect on net Pi release, and reduced lactate production and net Mg release by 86 and 33%, respectively. Elevating the medium Pi concentration from 1 to 2 mM did not affect the differences between +D and -D bones. Treatment with 1,25(OH)2D3 in vitro and in vivo returned ion releases by the -D tibiae partly or completely to the +D levels. The results support the following conclusions: (1) vitamin D deficiency during suckling reduces net Ca release and increases net Mg release from bone which may contribute to the changes in circulating concentrations of these ions seen in D deficiency; (2) these effects on bone appear to be specific for Ca and Mg, since the vitamin has little or no effect on net Pi release; (3) net Ca and Mg release from rat bone in vitro presumably are energy-dependent processes, while net Pi release is not; and (4) 1,25(OH)2D3 can affect net Ca and Mg release from -D bones by a direct action. PMID- 3508715 TI - Two modes of action of bisphosphonates on osteoclastic resorption of mineralized matrix. AB - Pretreatment of a long bone explant with P-C-P can prevent the osteoclastic resorption of its mineralized matrix, when it is entirely dependent upon activation and accession of extra-osseous osteoclast precursors. When treatment of the explant is postponed until after the development of mature osteoclasts, the P-C-P dose required for an inhibitory effect is increased 100-fold for the amino bisphosphonate APD, but not for EHDP and Cl2MDP. It is concluded that high doses of all P-C-Ps inhibit the resorbing osteoclast, but that low dose of the amino P-C-P can specifically inhibit the accession of osteoclast precursors to mineralized matrix. Both actions require P-C-P binding to the mineral. The relative potencies of the P-C-Ps in the precursor-dependent system correspond to their relative potencies in vivo. This suggests that inhibition of accession underlies the high potency which the aminobisphosphonate has in vivo. PMID- 3508716 TI - Structural analysis of parathormone fragments elaborated by cells cultured from a hyperplastic human parathyroid gland. AB - Parathyroid cells were obtained by collagenase digestion of 2 g of human parathyroid tissue obtained at surgery from a patient with end stage renal failure and hypercalcemia. Cells were placed into monolayer culture in supplemented Waymouth's MB752/1. Secretion of parathyroid hormone (PTH) from monolayer cultures was inhibited for 3 weeks by 2.5 mM compared to 0.5 mM calcium. The inhibition was 50% on day 3 of culture, and decreased to 19% by day 21. When cultures were incubated with [3H]leucine, radioactive PTH and COOH terminal PTH fragments were secreted. Sequence analyses were performed on material in radioactive and immunoreactive peaks following gel filtration and high performance liquid chromatography of media. The results indicated that cleavage of PTH or fragments thereof occurred at the 23-24, 27-28, and 33-34 peptide bonds. NH2-terminal fragments of PTH were not detected in media. PMID- 3508717 TI - Hyperphosphatemia as a detectable laboratory manifestation of glucocorticoid withdrawal syndrome. AB - We found hyperphosphatemia in five patients who had undergone unilateral adrenalectomy (ADX) for resection of cortisol-producing adenomas. The mean (+/- SEM) serum inorganic phosphorus level, theoretical renal phosphorus threshold and percent tubular phosphorus reabsorption rose from the preoperative level of 3.3 +/- 0.2 mg/dl, 2.6 +/- 0.2 mg/dl and 82.1 +/- 0.6%, to 6.0 +/- 0.2 mg/gl, 7.4 +/- 0.4 mg/dl and 95.9 +/- 1.0%, respectively, after ADX (P less than 0.001, P less than 0.001, P less than 0.001). Urinary phosphorus excretion decreased from 549 +/- 40 to 294 +/- 108 mg/day after ADX (P less than 0.05). Changes in serum calcium, serum sodium, serum potassium, serum chloride and creatinine clearance were not significant after ADX. Hyperphosphatemia may be the only abnormality found in serum electrolytes in glucocorticoid deficiency. It thus seems that hyperphosphatemia may be regarded as one of the clinical manifestations of the glucocorticoid withdrawal syndrome. PMID- 3508718 TI - Effects of decreasing serum calcium on circulating parathyroid hormone and vitamin D metabolites in normocalcaemic and hypercalcaemic patients treated with APD. AB - The changes of parathyroid hormone (PTH) and of vitamin D metabolites after intravenous administration of the bisphosphonate APD were studied in ten patients with Paget's disease of bone and in ten patients with tumour-induced hypercalcaemia. After APD all patients with Paget's disease became hypocalcaemic and showed an increase in both N-PTH and C-PTH values. Patients with malignancies had a nearly six-fold greater decrease in serum calcium but rises in N-PTH and C PTH were observed only in those who developed hypocalcaemia. Overall, a clear rise in PTH was found when serum calcium fell below 2.20 mmol/l. Basal 25-hydroxy and 24,25-dihydroxyvitamin D concentrations were similar in the two groups and showed no change after APD treatment. Circulating 1,25-dihydroxyvitamin D, however, increased in all patients with Paget's disease and in six of the hypercalcaemic patients. It is concluded that the main regulator of PTH secretion is the concentration of calcium per se rather than the magnitude or the rate of its change. The production of 24,25-dihydroxyvitamin D is not affected by wide variations in serum calcium while that of 1,25-dihydroxyvitamin D is sensitive to these changes. PMID- 3508719 TI - Age-related loss of bone mineral density in non-athletic and athletic women. AB - Single and dual photon absorptiometry were performed at the mid-radius, distal radius and lumbar spine in 1105 non-athletic and 124 athletic Caucasian women aged 18-98 years. An age-related loss of bone mineral density in mg/cm2 (BMD) occurred at the three skeletal sites. It was first demonstrated that a single break in the regression line (BMD versus Age) best fit the data. The break represented the approximate age at which an increase in the rate of bone density loss occurred. This break is termed the 'cutpoint'. The approximate (average) age at which the cutpoint occurred was determined by segmented regression analysis with bone density as the dependent variable. The age range studied was between 45 and 55 years. At all three bone sites, the cutpoints in non-athletic women occurred between 47 and 52 years of age, corresponding roughly to the time of menopause. Following this cutpoint the rate of bone loss increased at all three locations in non-athletic women. In athletic women no cutpoint in BMD values could be demonstrated for this age range for the two radial sites. The number of lumbar spine measurements in this group was too small for analysis. The absence of a significant change in rate of bone loss in athletes could have been due to the relatively small number of subjects. It could also suggest that regular sustained exercise programs may delay or minimize the increased rate of loss of BMD which occurs in non-athletic women in the perimenopausal period. PMID- 3508720 TI - Monoclonal antibodies against osteoclasts inhibit bone resorption in vitro. AB - Several recently-derived monoclonal antibodies (mcabs) that bind with a high degree of specificity to membrane antigens of osteoclasts were tested for their effects on the function of giant cells from osteoclastomas. None of the antibodies stimulated bone resorption when incubated with giant cells on bone slices, nor did we find any evidence that the mcabs were able to block calcitonin inhibition of bone resorption. However, three of the mcabs strongly inhibited bone resorption. This inhibition was unaccompanied by impaired survival or morphological evidence of toxicity, but the same mcabs induced a state of cytoplasmic quiescence we have previously found to be characteristic of the response of osteoclasts to local and systemic inhibitors of osteoclastic bone resorption. These results suggest that the mcabs bind to antigens of functional importance in bone resorption or its regulation, and the similarity between the response of giant cells to mcabs and hormonal inhibitors of bone resorption raises the possibility that the mcabs may bind to and cause activation of surface receptors for one or more of these hormones. Whether this is so or not, the mcabs which influence giant cell function may represent valuable probes for an analysis of the mechanism and regulation of osteoclastic bone resorption. PMID- 3508721 TI - Circulating concentrations of 1,25-dihydroxyvitamin D3 in patients with primary hyperparathyroidism. AB - Vitamin D metabolism was studied in 65 patients with surgically proven primary hyperparathyroidism. The mean concentration of 1,25-dihydroxyvitamin D3 was 51.7 +/- 34 pg/ml (mean +/- SD) and was not significantly different from normal. Renal function was normal in 60 of these patients and in this group circulating 1,25 dihydroxyvitamin D3 was below the lower limit of normal in three and elevated in 17; it was related to the serum concentrations of amino-terminal parathyroid hormone, but was independent of serum calcium and the urinary excretion of calcium. The incidence of nephrolithiasis or hyperparathyroid bone disease or combined nephrolithiasis and bone disease in these patients was not related to the circulating concentration of 1,25-dihydroxyvitamin D3. In the remaining five patients, in whom renal impairment was present, circulating 1,25-dihydroxyvitamin D3 was below the lower limit of normal in four. Thus, in primary hyperparathyroidism the circulating concentration of 1,25-dihydroxyvitamin D3 is elevated in only a minority of patients and appears to be unrelated to the occurrence of nephrolithiasis or bone disease. PMID- 3508722 TI - Circulating parathyroid hormone concentrations in normal and vitamin D-deprived rat pups determined with an N-terminal-specific radioimmunoassay. AB - Plasma PTH concentrations were determined in rats with an antiserum to human PTH (1-34) that cross reacts with rat PTH in order to evaluate the effects of growth, vitamin D deficiency and dietary modulations of plasma calcium. Displacement curves for synthetic rat PTH (1-34) and diluted rat plasma were parallel with curves for the hPTH (1-34) standards and hPTH (1-84). Parathyroidectomy in 33-day old rats resulted in a fall in iPTH from (mean +/- SE) 8.1 +/- 0.5 to 5.4 +/- 0.5 pg/ml in an assay in which the lowest detectable concentration was 3 pg/ml. Elevation of plasma Ca by 0.7 mg/dl by dietary calcium supplementation in 25-day old pups led to a plasma iPTH level of 4.4 +/- 0.7 pg/ml compared with 9.9 +/- 0.7 pg/ml in controls. There were no significant changes in iPTH in control rats fed a complete diet containing 0.4% Ca and 0.4% P over the age range 14-56 days. Rat pups (-D) suckling vitamin D-deprived mothers had plasma Ca and iPTH values of 7.76 +/- 0.16 mg/dl and 173 +/- 27 pg/ml, respectively, at 25 days of age and 5.8 +/- 0.2 mg/dl and 677 +/- 85 pg/ml, respectively, at 56 days. The -D pups that had access to their mothers' calcium-supplemented diet (1.6% Ca and 1.4% P) had a mean plasma Ca value that was 0.5 mg/dl above that of the control group and a mean plasma iPTH level of 6.7 +/- 0.8 pg/ml. We suggest that the RIA for PTH measures mostly, if not entirely, bioactive PTH. We conclude that plasma iPTH (a) remains essentially unchanged in normal rats during the rapid growth period, (b) can increase up to 75-fold in hypocalcemic vitamin D-deficient rats, and (c) can be suppressed to barely detectable levels when plasma Ca is raised less than 1 mg/dl above the level of normal control rats. PMID- 3508723 TI - Mitochondrial calcium and bone mineralization in the rat fetus. AB - The initial mineralization of the tibial bone collar of 17-day-old rat fetuses has been investigated. Images obtained after glutaraldehyde-paraformaldehyde-OsO4 fixation were compared to those obtained after K-pyroantimonate (PAO) fixation. Ca, P and Sb were identified and Ca/P intensity ratios evaluated by wavelength dispersive X-ray microanalysis. Alkaline phosphatase was detected on decalcified sections. Some osteoblasts showed degenerative changes and free mitochondria could be seen within the osteoid on the prolongation of their cytoplasmic processes. The mitochondria contained mineralized granules and clusters. Similar granules, numerous clusters and few matrix vesicles were observed within osteoid. The Ca/P intensity ratios (PAO fixed sections) of mitochondrial mineral (11.5 +/- 2.54) were different from the ratio of crystalline mineral in matrix vesicles (1.52 +/- 0.07). Alkaline phosphatase was present along plasmalemma of osteoblasts and around mineral deposits. These results show that in the rat fetus osteoblast mitochondria may be extruded from the cells, and that mitochondrial granules may represent the first mineral deposits in osteoid. PMID- 3508724 TI - En recherche de la difference (P less than 0.05). PMID- 3508725 TI - Development-related regulation of plasma 1,25(OH)2D3 concentration by calcium intake in rat pups. AB - Circulating 1,25(OH)2D3 was determined in female rats between ages 1 and 20 weeks and in male rats between ages 5 and 12 weeks while the rats consumed diets containing vitamin D (5 U/g diet) and calcium concentrations of either 0.04, 0.4 or 1.6% Ca. When consuming the 0.4% Ca diet female rats had mean (+/- SE, pg/ml) serum 1,25(OH)2D3 values of 45 +/- 7 at 2 weeks, 272 +/- 23 at 4 weeks, 221 +/- 18 at 5 weeks and 51 +/- 6 and 49 +/- 4 at 13 and 20 weeks, respectively. Circulating 1,25 (OH)2D3 levels in the males at 4.5, 8 and 12 weeks were insignificantly higher than the levels for the females at comparable ages. There were no significant changes in plasma calcium over the ages examined in either sex. In order to test the efficiency of regulation of circulating 1,25(OH)2D3, 3 week-old female rats were given the 0.04% Ca diet for 2 or 6 weeks. At ages 5 and 9 weeks, serum 1,25(OH)2D3 values were 640 +/- 82 and 604 +/- 39 pg/ml, respectively, and therefore at least 3-fold higher than the values in rats consuming the 0.4% Ca diet. Plasma Ca concentrations in the calcium-deprived rats were 8.7 +/- 0.2 and 6.5 +/- 0.1 at 5 and 9 weeks, respectively. When the 0.04% Ca diet was introduced at 5 weeks of age, plasma Ca fell only 0.5 mg/dl and plasma 1,25(OH)2D3 rose to 1265 +/- 48 pg/ml. In contrast, plasma 1,25(OH)2D3 rose to only 176 +/- 19 pg/ml and plasma Ca fell 0.5 mg/dl when 12-week-old rats were given the 0.04% Ca diet for 5 weeks. When suckling rats were given access to the 1.6% Ca diet and continued to consume this diet after weaning, circulating 1,25(OH)2D3 concentrations were approximately one half the value of the rats consuming the 0.4% Ca diet at 3,4,5 and 6 weeks. We conclude that rats have a biphasic serum 1,25(OH)2D3 curve between the ages of 2 and 16 weeks regardless of the dietary calcium content. Circulating plasma 1,25(OH)2D3 is regulated by dietary calcium as early as the third week of life, before weaning. We suggest that the high serum 1,25(OH)2D3 concentrations are due to increased 1 alpha-OHase activity. However, the factor(s) responsible for changes in the 1 alpha-OHase remain(s) unknown, since plasma Ca does not change, and since the plasma level of other regulators of 1,25(OH)2D3, such as phosphate and parathyroid hormone do not correlate with 1,25(OH)2D3. PMID- 3508726 TI - A recombinant IGF-1 analogue stimulates [3H]thymidine incorporation in human epiphyseal growth cartilage in vitro. AB - The effect of a recombinant analogue of IGF-1 on human cartilage of different ages has been investigated in vitro. Addition of 100 ng/ml IGF-1 to articular and epiphyseal growth plate cartilage (9 months to 16 years) resulted in an increase in [3H]thymidine incorporation to a mean of 130 +/- 4% (SE) and 378 +/- 53% of controls, respectively. In costal and growth cartilage from normal fetuses of 15 18 weeks gestation, [3H]thymidine incorporation was increased to 119 +/- 3 and 133 +/- 11% of controls, respectively, when 100 ng/ml IGF-1 was added. The mitogenic effect of recombinant IGF-1 in vitro extends to human cartilage and is most notable in postnatal epiphyseal growth plate. PMID- 3508727 TI - PGE2 induces regional remodeling changes in haversian envelope: a histomorphometric study of fractured ribs in beagles. AB - A histomorphometric study was carried out in the region of healing defects in the ribs of Beagles. A transverse fracture was made in the left 9th and 10th ribs. Eleven Beagles received either ethanol vehicle (n = 6) or PGE2 orally (n = 5) for the 30 day period from surgery to time of necropsy. Double-pulsed labels were given with each of two fluochrome markers, calcein prior to surgical treatment and oxytetracycline hydrochloride prior to euthanasia. The objectives were to determine the effects of fracture on regional remodeling in the haversian envelope; to determine the effects of PGE2 on the regional remodeling changes in the haversian envelope; and to determine the systemic effects of PGE2 on remodeling changes of the contralateral matching sites. The remodeling changes after surgically induced fracture were relatively insignificant between the injured and uninjured sides in the non-treated dogs as well as in the PGE2 treated group. This may be attributable to the global effect of a fracture. However, there were significantly slower rates of mineral apposition (P less than 0.05) and a longer period for osteon formation time (P less than 0.05) on the injured side compared to the uninjured side of the PGE2 treated dogs. The remodeling activities were increased on both sides in the PGE2 treated dogs when compared to the non-treated ones with more remodeling sites per unit cortical area (P less than 0.01), and a higher turnover rate (shorter total remodeling period in days) with a faster resorption rate and a net increase in mineral apposition rates at the end of the experiment (P less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3508729 TI - Fine structures of cerebrospinal fluid-contacting neurons with mitochondria containing bulbs in the primate spinal cord. PMID- 3508728 TI - Mononuclear phagocytes secrete a protein that directly resorbs devitalized bone particles. AB - The radiolabelled bone particle assay was used as an in vitro model of bone resorption. Normal human peripheral blood monocytes and the monoblastic cell line, U937, increased 45Ca release from the devitalized bone particles. In contrast, normal human peripheral blood neutrophils, resting or stimulated, did not increase 45Ca release. Exposure of monocytes to gamma interferon (INF-gamma) stimulated secretion of hydrogen peroxide and inhibited 45Ca release from bone particles. U937 cells incubated with 1,25(OH)2D3 and lymphokines had increased secretion of oxygen reduction products and increased 45Ca release. Medium conditioned by incubation with U937 cells stimulated 45Ca release to the same extent as the U937 cells. The 45Ca releasing activity in the medium was resistant to extremes of temperature and acidification. This activity is not dependent on the presence of disulfide bonds and was not inhibited by collagenase or trypsin inhibitors. Exposure to a proteolytic agent reduced the activity by over 50%. These findings are consistent with the concept that mononuclear phagocytes secrete a substance, presumably a protein, which acts directly on the bone particles. The isolation and identification of this substance may increase our understanding of the mechanisms of bone loss associated with inflammatory processes. PMID- 3508730 TI - Experimental studies on kernicterus in thiamine-deficient Gunn rats. PMID- 3508731 TI - An experimental study on the healing of fracture of the condylar process of the mandible--the course after malunion. PMID- 3508732 TI - [Buerger's disease and obliterative atherosclerosis. 2 different diseases]. PMID- 3508733 TI - [Prevention of development of tetracycline-induced changes in the teeth of children with the use of sodium fluoride]. PMID- 3508734 TI - [BCG immunotherapy in localized forms of breast carcinoma]. PMID- 3508735 TI - Impotence and sclerodermic syndromes. PMID- 3508736 TI - Half-life of thyroxine in dogs: explanation for the diurnal plasma level variations? PMID- 3508737 TI - Circadian rhythm of the liver of male rats dosed with phenobarbital--I. Organ weight, cellular structures, glycogen contents and mitotic activity. AB - The circadian rhythm of the liver, namely organ weight, cellular structures (by light-microscopy), glycogen content (by periodic acid-Schiff (PAS) reaction) and mitotic activity, was studied in 166 male Sprague-Dawley rats orally treated daily at 0800-0900 with 70 (study 1) or 50 (study 2) mg/kg phenobarbital (PB) for 7 days. Thereafter, eight (study 1) or five (study 2) rats each were studied at 4 hr intervals at 1000, 1400, 1800, 2200, 0200, 0600 and 1000 through till the following day. The lighting schedule in the colony was 12:12, light:dark (light from 0600 to 1800). The liver weight was raised in PB-treated rats at all times of the day compared to controls and showed a distinct circadian rhythm with a peak at 1000 and a minimum at 2200 in PB-treated rats and the controls. The circadian rhythm of cellular structures was closely related to the hepatic glycogen content which was in good agreement with the controls, but at 1400 and 1800 the glycogen particles were more distinctly diminished in the enlarged centrilobular hepatocytes of PB-treated rats. The mitotic activity of hepatocytes was markedly increased in rats treated with PB but showed the same circadian rhythm as controls with a peak at 1000. PMID- 3508738 TI - Circadian rhythm of the liver of male rats pre-treated with phenobarbital--II. Hexobarbital sleeping time and lipids content in liver and serum. AB - The circadian rhythm of hexobarbital sleeping time and lipids content in liver and serum were studied in 226 male Sprague-Dawley rats pretreated daily at 0800 0900 with 70 mg/kg (study 1 or 3) or 50 mg/kg (study 2) phenobarbital (PB) orally for 7 days. Thereafter, eight (study 1) or five (study 2 and 3) rats each were studied at 4-hr intervals at 1000, 1400, 1800, 2200, 0200, 0600 and 1000 through the following day. The lighting schedule in the colony was 12:12 +/- light:dark (light from 0600 to 1800). The hexobarbital sleeping times of PB-pretreated rats were generally shortened compared to the controls and no circadian rhythm was observed. PB-treatment increased slightly the liver content of cholesterol, and significantly that of triglycerides and phospholipids. Liver cholesterol and phospholipids showed circadian rhythms with peaks during the dark phase. No circadian rhythm of liver triglycerides existed. In serum, levels of triglycerides and phospholipids were slightly lowered by PB-treatment, while levels of cholesterol and beta-lipoprotein were not influenced. Serum values did not exhibit circadian rhythms. PMID- 3508739 TI - Effects of pregnancy and parturition on free-running circadian activity rhythms in the rat. AB - Alterations in circadian rhythms have previously been associated with estrous and seasonal changes in reproductive state. In the present study we explored the effects of the reproductive events of pregnancy and parturition on free-running circadian activity rhythms in the rat. Free-running rhythms were monitored before mating, during pregnancy, and following parturition and removal of pups. Systematic and long-lasting alterations of the period of the free-running activity rhythm were seen following parturition. The effects of estrous, seasonal, and gestational reproductive states on circadian rhythms may be mediated by the endocrine events which accompany these states. PMID- 3508740 TI - Novel fraction collector for studying the oviposition rhythm in the turnip moth. AB - Turnip moths, Agrotis segetum (Schiff.) (Lepidoptera: Noctuidae), were held in a transparent plastic box with a window opening to a rotating paper drum upon which the females could lay eggs. A novel fraction collector, consisting of a standard 24-hr wall timer and simple electronic circuit, served to rotate the paper in hourly increments. The entire apparatus was housed in an environmental chamber on a 16 hr light: 8 hr dark photoperiod at constant 23.7 degrees C and 55% r.h. Under these conditions a circadian rhythm of egg laying was indicated with a mean activity time 0.2 hr before dark and standard deviation of 2.1 hr. The relative egg productions during the second to seventh day of oviposition peaked on the third day. Differences in the circadian rhythm of egg laying was indicated with a mean activity time 0.2 hr before dark and standard deviation of 2.1 hr. The relative egg productions during the second to seventh day of oviposition peaked on the third day. Differences in the circadian rhythms of mating and oviposition are considered in terms of ecological fitness. PMID- 3508741 TI - Circadian and circahemidian rhythms in plasma prolactin of the ram: seasonal changes. AB - The existence of a circadian rhythm in plasma prolactin of the ram is controversial. Differences among authors can be related to both data sampling (e.g. interindividual changes, time of day, time of year, sampling interval among others) and statistical analyses. To test this hypothesis six adult "Prealpes du Sud" rams were studied individually during 72 hr in January (8 hr of light-16 hr of darkness), April (13L-11D), June (16L-8D) and September (13L-11D). Blood was sampled (vacutainer) from a jugular vein every hour, centrifuged and plasma samples stored at -20 degrees C until prolactin determinations (radioimmunoassay) were made. Individual time series were analysed according to three complementary methods: display of raw data (chronogram), best fitting cosine functions with different period tau (iterative cosinors) and power spectra. Seasonal changes in the 24 hr mean (peak time in June) were confirmed. A circahemidian rhythm (tau = 12 hr) and a circadian rhythm (tau = 24 hr) were validated, respectively in January and April while time series documented in June and September exhibited no rhythmic organization. It seems, therefore, that animals adjusted their rhythmic patterns of prolactin secretion to the increasing (January, April) rather than decreasing (June, September) photofraction (duration of the light span/24 hr). PMID- 3508743 TI - Effects of illumination on the rabbit's EEG during the two phases of its circadian rhythm. AB - After exposure to a LD 12:12 regimen for several weeks, rabbits exhibit a programmed circadian rhythm in the RMS values of their occipital and frontal EEG's during 54-hr recordings in constant darkness. Illumination at levels of 80, 160 and 230 Lx raises these RMS values in both phases of the rhythm. The induced rise is large in the phase with low RMS values and small in the other, whereas light-induced changes in spectral composition of the EEG's are slight in either phase. Bilateral optic nerve sectioning results in similar changes in properties of the EEG and in the amplitude of its rhythm. The results are discussed with reference to the influence exerted by steady illumination on the overall-level of retinal maintained "dark" discharge. PMID- 3508742 TI - Induction of early seasonal sensitivity to melatonin in Suffolk-Cross ewes. AB - Anoestrous Suffolk-Cross ewes can be induced into early seasonal ovarian activity by administration of melatonin at the appropriate time of day or by melatonin implants. This treatment is successful if commenced in June, but not earlier in April or May and suggests that a critical period of long days may be necessary before artificial short-day melatonin profiles act as winter time-cues. We have investigated whether the lack of sensitivity to melatonin in April could be overcome in ewes in which breeding activity had been artificially moved forward the previous season. The results indicate that this was indeed the case and that the breeding season in untreated ewes which also previously experienced an early induced breeding season reverted to the normal timing for the Suffolk-Cross breed. PMID- 3508744 TI - Effects of a mild and prolonged restriction in sodium or food intake on the circadian rhythm of aldosterone and related variables. AB - The effect of a mild reduction in dietary sodium intake (-30 mEq/24 hr) and body weight (-2 kg/2 months) on circadian rhythms of urinary aldosterone (UA), sodium (UNa), potassium (UK), creatinine (UC) and volume (UV) have been investigated in nine clinically healthy subjects. The mild reduction in dietary sodium is associated with: (1) a decrease in the 24-hr excretion rate of UNa, UK and UV, and an increased mesor of UA and UC; (2) a lowered extent of the circadian variation for UNa, UK, UV and a greater amplitude for UA and UC (3) a later crest in the temporal phase for UK, UA, UC, an earlier phasic wave for UNa. The mild reduction in calorie intake resulting in a body weight loss is associated with a more pronounced decrease in the 24-hr excretion rate of UNa and UK, and in the extent of circadian fluctuation for UNa. Peculiar events are: (1) the decreased 24-hr excretion rate for UA, and the increased mesor for UV; (2) the extent variability increased for UV, decreased for UC. Such effect may have a practical resonance for heuristic physiology since the role of dietary sodium and food intake has been better clarified. Dietary sodium and food can be regarded as 'chronomodulatory agents' for the adrenal cortex since their adrenotropic influence is extended to the tonic as well as phasic secretion of aldosterone. PMID- 3508745 TI - Chronobiological aspects of weight loss in obesity: effects of different meal timing regimens. AB - A series of short- and long-lasting experimental protocols of different meal timing regimes were performed in obese subjects to assess the possible occurrence of (1) a different metabolic fate of nutrients; (2) a phase shift of circadian rhythms of metabolic and hormonal parameters strictly related to nutrition; (3) a different weight loss. (A) In a short-lasting protocol (3 days) 15 obese subjects were fed a hypocaloric diet (684 kcal/day) (a) at 10 hr only, (b) at 1800 hr only; (c) at 1000 hr, 1400 hr and 1800 hr, or (d) studied during a 36-hr fasting. Measures of calorimetry (R.Q., CHO and lipid oxidations, energy expenditure), hormones (plasma cortisol, insulin, HGH, urinary catecholamines), urinary electrolytes (Na, K) and vital parameters (body temperature, heart rate, blood pressure) were carried out at 4-hr intervals for three days. A significantly higher lipid oxidation and a lower CHO oxidation were documented with the meal at 1800 hr, in comparison with the meal at 1000 hr. CHO and lipid oxidation circadian rhythms appeared the most affected by meal timing. (B) In a long lasting protocol (18 days) 10 obese subjects were fed the same hypocaloric diet (a) at 1000 hr only and (b) at 1800 hr only. Calorimetric measures were performed every other day for 2 hr preceding each meal. Before and after the 18-days single meal period, body temperature, plasma cortisol, PRL and TSH were recorded (delta t = 4 hr). A higher lipid oxidation and a lower CHO oxidation were again demonstrated with the meal at 18 hr. Minimal changes of hormonal circadian rhythms were documented suggesting that the hypothalamus-hypophysis network is scarcely affected by meal timing. Weight loss did not vary in both short- and long-term protocol. PMID- 3508746 TI - Field survey of circadian rhythm in PEF of electronics workers suffering from colophony-induced asthma. AB - Twenty-two British electronics workers suffering from occupationally-induced asthma due to their exposure to colophony fumes self-recorded their peak expiratory flow (PEF) every 1-2 hr throughout the waking span for at least two weeks, both during work and vacation periods. Data were analyzed by a two-step procedure using the statistical techniques of Single and Population Mean Cosinor analyses. The objective endpoints of mesor (24-hr mean), amplitude (measure of 24 hr rhythmic variation) and acrophase (peak time along the scale of 24 hr) for the time-spans of the work-week (Monday-Friday), weekend after work (Saturday-Sunday) and vacation weekdays and vacation weekends were compared. The PEF data of four workers who participated in the study for nearly one year also were evaluated for seasonal variation. A statistically significant difference (P less than 0.04) was detected in the PEF amplitude between work and vacation weeks; the difference in the PEF mesor and acrophase between work-weekdays and work-weekends achieved near or statistical significance (P = 0.07 and 0.05, respectively). The at-work amplitude was higher and the acrophase earlier timed. There was no statistically significant difference between work-week and weekend-after-work PEF mesors. Winter PEF mesors were significantly lower than summer ones in the four subjects self-measuring their bronchial patency over the year. Overall, the findings indicate that data obtained through employee surveys, using lightweight portable and inexpensive PEF Wright meters and analyzed by statistical analyses used in the field of biological rhythm research, yield objective evidence of occupationally associated decrements in pulmonary function resulting from colophony fume exposure. PMID- 3508747 TI - Circadian variations of heart rate and premature beats in healthy subjects and in patients with previous myocardial infarction. AB - Chronobiological analysis of the circadian variations of heart rate, ventricular and atrial ectopies, was carried out on 11 patients with previous myocardial infarction matched with 11 controls. Individual circadian rhythms in heart rate were seen in all the control subjects but only in 6 patients with previous myocardial infarction. The behaviour of the individual circadian rhythms of premature beats was not significantly different between the two groups. A significant group rhythm in ectopies was not demonstrated, nevertheless a trend to higher frequency of arrhythmias during the activity span was detected. These results do not allow to postulate a circadian pattern of arrhythmias common to all the subjects examined. Therefore, the individual circadian behaviour of premature atrial and ventricular beats should be recognized for monitoring antiarrhythmic therapy. A significant group rhythm in heart rate was demonstrated for the two populations studied and linear discriminant analysis showed that the amplitude of this rhythm was significantly lower in patients than in controls. Possibly, myocardial infarction may affect the sinus node function producing a "flattened" range of heart rates during the 24 hours. PMID- 3508748 TI - The influence on survival of season of onset of childhood acute lymphoblastic leukemia (ALL). AB - Rhythmicity has been found to be an important characteristic of leukocytes. We tested, therefore, whether rhythmicity could be found to be reflected in one or more of the developmental stages of childhood acute lymphoblastic leukemia. The patient material comprised 205 children 96 girls and 106 boys) whose disease was diagnosed in Israel during the years 1976-1981. Their mean age was 5.9 years +/- 3.94. No seasonal onset of disease was found, either in the whole group or in subgroups divided by sex or lymphocyte surface markers. Survival analyses however, revealed that the season of diagnosis influenced survival. Excluded from the study were 9 cases (4.4%) due to lack of some items. The follow-up period was between 1 and 72 months (median 26 months). It appeared that the life table curves were running in their temporal order, each following curve representing a consecutive 3-month period. The difference between the curves was statistically significant (p = 0.025/0.009). The survival percentages at the end of the follow up increased steadily, from a trough during November-January (56.5%) to a peak in August-October (80.0%). Analysis by sex and white blood cell (WBC) count showed that the difference between the life table curves was primarily due to girls presenting less than 50,000 cells per cumm (n = 73, p = 0.005/0.0028). The survival percentages in the same order as mentioned earlier were: 47.1%, 68.4%, 89.5% and 94.4%. The steady rise in the different female time series suggests a circannual pattern.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3508749 TI - International Symposium on Lung Sounds. Synopsis of proceedings. PMID- 3508750 TI - Effect of a 0.05% neutral NaF mouthrinse on coronal and root caries of adults. PMID- 3508751 TI - Age-related changes in rat sublingual salivary gland morphology. PMID- 3508752 TI - Incisor abnormality of senescence accelerated mouse (SAM). PMID- 3508754 TI - Presidential address. All India Ophthalmological Society. PMID- 3508753 TI - Dementia of the Alzheimer type: an oral and biochemical study. PMID- 3508755 TI - All India Ophthalmological Society. Proceedings of the 45th annual conference. Hyderabad, 1987. PMID- 3508756 TI - Immunoassay of serum muramidase (lysozyme) in ocular diseases. AB - Serum levels of muramidase activity were measured in 162 patients with different ocular diseases and 84 healthy subjects by electro-immuno-diffusion technique. We demonstrated for the first time that electro-immuno-diffusion technique could be successfully applied for the estimation of serum muramidase concentrations. Serum muramidase was found to be high in significant number of cases with granulomatous uveitis, tuberculous keratitis, central serous retinopathy and Eales' disease. Tuberculosis was presumed to be the cause in them by the process of exlusion. Patients with high serum muramidase activity were subjected to anti-tubercular treatment with a marked clinical improvement. It is suggested that high serum muramidase could be an useful parameter in deciding the line of treatment in patients with ocular diseases of uncertain etiology. Serum muramidase concentrations showed return to normal levels with the clinical improvement of the diseases with treatment. It increased again with the re-appearance of the activity of the diseases. PMID- 3508757 TI - Combined photocoagulation and cryotherapy in treatment of Eales' retinopathy. Preliminary report. AB - This is a preliminary report of Eales' disease study (EDS). Compilation of two years data shows that combined xenon are photocoagulation and peripheral cryotherapy has beneficial effects in treatment of Eales' disease with grade II and grade III retinopathy. In very advanced stage of the disease (grade IV retinopathy) the treatment has no beneficial effects and untreated also it leads to vitreous haemorrhage and traction retinal detachment. The Eales' disease study (EDS) is still an on-going project and recruitment of the patients is continuing. Over another year we hope to have a larger number of patients, accumulate enough data and cover a longer follow-up period to substantiate these preliminary findings. PMID- 3508758 TI - Effect of electric and magneticfields on cornea. PMID- 3508759 TI - Pathobiology of keratoconus. PMID- 3508760 TI - Evaluation of precorneal tear film in leprosy. AB - The present study analyses the precorneal teat film using schirmer's test and tear film breakup time (BKUT) in 400 eyes of patients with various types of leprosy. An abnormal tear film BKUT (47.2%) was observed to be much more informative in the present series than the study of schirmer's test alone (25.4%). In patients with lagophthalmos an abnormal tear film BKUT (70%) was higher as compared to an abnormal schirmer's test (40%); while in cases of lagophthalmos with ectropion an abnormal schirmer's test was seen less frequently (26.8%) than in cases of lagophthalmos without ectropion (58.3%). This implied an increase in the aqueous content of the tear film in cases of lagophthalmos with ectropion on the basis of an associated chronic conjunctivitis. Lagophthalmos and ectropion have been identified as additional factors contributing to corneal morbidity. There was a statistically significant difference in the tear film abnormality in different types of leprosy, the maximal difference being in the lepromatous variety. PMID- 3508761 TI - Cornea thickness and tear glucose levels in diabetes mellitus and normal persons. AB - The central corneal thickness as well as tear and blood glucose levels were significantly increased in diabetic patients as compared to normal persons. The tear glucose level of 9.0 mg/ld or less suggested good control of D.M. PMID- 3508762 TI - Treatment of pseudomonas keratitis using topical antibiotics and heparin. PMID- 3508763 TI - Application of betadine (povidone iodine) to infected corneal ulcer. AB - A new approach of touching betadine directly to infected corneal ulcers in addition to customary treatment is suggested. A report of 35 cases of infected corneal ulcers and keratitis where it was done is studied. PMID- 3508764 TI - Comparative study of acyclovir and 5 I.D.U. in the management of viral corneal ulcer. AB - Thus, we found that the role of Acyclovir in the treatment of viral corneal ulcer is definitely better and quicker. It takes less time for healing of corneal ulcer and as a result less hospitalisation is needed. PMID- 3508765 TI - A comparative study of anti-fungal drugs in mycotic corneal ulcer. AB - From our clinical trials of different available antifungal drugs for the cases of keratomycosis, we conclude that Econazole 1% ointment is a safe and effective antifungal agent having a wide range of antifungal activity. With rising incidence of mycotic ulcer particularly in rural population where facilities for laboratory diagnosis and drug sensitivity tests for antifungal drugs are lacking Econazole can be useful as a broad spectrum antifungal agent for the cases of keratomycosis and also could be used as a prophylactic in cases of traumatic corneal ulcer as those are particularly at risk. PMID- 3508766 TI - Serum immunoglobulins in mycotic keratitis--an interim report. AB - Serum immunoglobulins were estimated in 34 patients selected randomly and 6 controls. 27 had fungal corneal ulcers and seven had bacterial corneal ulcers. The IgM was low in 7 patients who had fungal keratitis. One patient who had IgM only 25 mgs./100cc of serum immunoglobulin, developed fungal ulcer in both eyes (fusarium in one eye) within a year. IgG was increased in 16 patients. No control had rise of IgG or fall of IgM. PMID- 3508768 TI - Results of scientific approach to radial keratotomy. PMID- 3508767 TI - Dr. P. Siva Reddy Oration. Diabetic keratopathy. AB - Diabetes mellitus, which affects millions of people all over the world, produces significant ocular morbidity. Corneal complications such as tear film dysfunction, elevated glucose in tears, different forms of epitheliopathy, neurotrophic ulcers, corneal edema, wrinkles in Descemet's membrane and decrease in corneal sensitivity have been reported. While a few reports described altered epithelial morphology as the possible basis for epithelial disease, all other clinical phenomena have been unexplained thus far. In this first-ever multifaceted approach to study the pathogenesis of diabetic keratopathy, striking abnormalities were observed in corneal nerves, corneal epithelium and corneal endothelium of diabetics. We have clearly demonstrated the existence of neuropathy in diabetic cornea, both in an animal model and in the humans, -- the first demonstration of such an abnormality. Our in vivo specular microscopic observations on epithelium confirmed in vitro observations in our study as well as of others while the analysis of endothelium provided the basis for the problems noticed in the diabetic cornea following intraocular surgical procedures. Our observations should help the clinician in the understanding of diabetic keratopathy and in developing better prophylactic and therapeutic strategy against some recalcitrant forms of corneal disease in this group of individuals. PMID- 3508769 TI - Ideal number of incisions in radial keratotomy--an experimental study. AB - The operation is very simple and safe and best for simple myopia. 16 ideal incisions give higher correction. Uniformity in depth of incision and steroid drops used post operatively brings higher correction. PMID- 3508770 TI - Anterior segment reconstruction and membranectomy through the pars plana. Rajnikantha and Sankara Nethralaya Group, Madras. AB - The surgical procedure, observations, results, complications and advantages of anterior segment reconstruction and membranectomy procedure through the parsplana route are discussed in this paper. PMID- 3508771 TI - Corneal changes in pseudo-exfoliation. PMID- 3508772 TI - Clinical evaluation of cyanoacrylate glue in corneal perforations. AB - Our experience of the use of Cyanoacrylate glue in 50 cases of perforation or impending perforation of cornea has been presented. The method of application has been described. Quite encouraging and useful results have been obtained. PMID- 3508773 TI - A study of the trace elements in human cataractous lenses and sera. PMID- 3508774 TI - Morphology of UV and IR irradiated lens. PMID- 3508775 TI - Lens glycoproteins in cataracts in non-diabetics and diabetics. PMID- 3508776 TI - Endothelial cell counts--in normal and post-operative eyes. PMID- 3508777 TI - Genetic appraisal of congenital cataract. AB - A total of 45 congenital cataract cases were studied for chromosomal aberrations and dermatoglyphic patterns. Whereas parents showed no marked differences, patients showed marked differences in different dermatoglyphic traits as compared to age-sex matched controls. Out of all the patients Rubella, hereditary and undetected actiology groups showed variations differently, SCE were seen in all cataracts irrespective of their aetiology as compared to controls. PMID- 3508779 TI - Pars plana lensectomy--review of 170 cases. PMID- 3508778 TI - Combined approach of intra-ocular lens implantation and pars plana lensectomy for congenital and traumatic cataracts. PMID- 3508780 TI - IOL power determination by retinoscope. AB - IOL power prediction was performed by streak retinoscopy on the operating table after taking the previous refractive status of the patient into consideration. In 180 eyes posterior chamber lenses were implanted after determining the power of the IOL by retinoscopy on the table and selecting a suitable lens. The method though not so accurate as A scan ultra sonography and use of the SRK formula and the Colebrander formula is a good substitute to these methods particularly for avoiding high post operative refractive errors. PMID- 3508781 TI - Intraoperative induced miosis in posterior chamber I.O.L. implantation. PMID- 3508783 TI - Intraocular lenses in children. PMID- 3508782 TI - Endothelial cell loss with Bss plus and Ringer lactate in posterior chamber lens implantation: a specular microscopic evaluation. PMID- 3508784 TI - Experience with over 100 anterior chamber intraocular implants. PMID- 3508785 TI - Intraocular lens implantation in capsular bag. PMID- 3508787 TI - Problems of anterior and posterior chamber implant surgery in Indian conditions. AB - This study shows lens implant surgery is fairly safe and can be done in Indian conditions. PMID- 3508786 TI - The fromberg-Verma (FV) silicone lens--a series of 75 cases. PMID- 3508788 TI - Primary congenital glaucoma clinical presentation and evaluation of modified trabeculectomy. AB - Primary congenital glaucoma is a relatively rare condition. A study on this subject to observe the mode of clinical presentation in our country and to evaluate the role of modified technique of trabeculectomy was undertaken. 30 eyes of 17 patients having primary congenital glaucoma were studies. The examination under general anaesthesia included (a) Anterior segment examination under operating microscope, (b) Corneal diameter measurement, (c) Fundus examination (d) IOP measurement and (e) Gonioscopy. The patients were subject to modified trabeculectomy operation. The assessment of the surgery was done during post operative examination carefully. This paper includes an analysis of various clinical features of this condition. The observations revealed that the presenting symptoms are slightly different in our country compared to those in the developed countries. The overall success rate with our modified technique of trabeculectomy was 72.4 percent. Since most of our patients present with corneal opacity, we feel that modified trabeculectomy is a very effective surgical method for such cases. PMID- 3508789 TI - Irrigating needle goniotomy. PMID- 3508790 TI - Assessment of visual evoked response in chronic simple glaucoma. AB - 1. The largest number of VEP abnormalities were found in check size 16 and alterate 1.88 cycles/sec. 2. With check size 32 and alt/sec. 1.88. (a) Delayed latency (BA) was found in 18.2% eyes without field defect (statistically nearly significant). (b) Delayed latency (BA) was found in 38.5% eyes with field defect (statistically significant (P less than 0.05). 3. When the check size 16 and alt. rate 1.88 cycles/sec. delayed VEP latency (BA) was found in 23.1% eyes with glaucomatous field defect (which is statistically significant (P less than 0.05). 4. When the check size is 32 and alt/sec. 7.5 delayed VEP latency (BT) was found in 30.2% eyes with glaucomatous field defect (showing statistically significant mean difference). PMID- 3508791 TI - Ocular bioavailability of pilocarpine with different vehicles. PMID- 3508792 TI - Glaucoma triple procedure. PMID- 3508793 TI - Argon laser iridotomy in angle closure glaucoma. AB - Argon laser iridotomy was successfully performed in 30 eyes of glaucoma patients. A modified two stage procedure has been described to achieve a successful iridotomy in pigmented eyes. At the chosen site of laser iridotomy, partial thickness burns were applied in the first stage followed by a penetrating burns in the second stage. This minimised the complications associated with laser iridotomy and decreased the incidence of subsequent closure. At the end of 6 months follow up the success rate was 93.3 percent. PMID- 3508794 TI - Argon laser iridoplasty. AB - We performed laser iridoplasty on 15 eyes, 7 of which had medically unbreakable attacks of angle closure glaucoma and 8 eyes had plateau iris configuration. We were successful in controlling intraocular pressure in 13 of the 15 eyes. The procedure was performed in O.P.D. under topical anaesthesia with minimal complications. As is evident from our results, iridoplasty is a safe and effective procedure, rapidly gaining favour with the ophthalmologists to treat certain difficult conditions. However long term and larger studies are required to further evaluate this procedure. PMID- 3508795 TI - Argon laser iridectomy. AB - By using a continuous wave argon laser, successful iridectomy was achieved in 41 out of 51 phakic eyes selected for the procedure. Three of the successful procedures required multiple sittings. The procedure was performed on an out patient basis under topical anaesthesia, usually required less than one-half hour for completion with a negligible complication rate. Therefore, where available ArLI appears to present a viable alternative to surgical iridectomy for the definitive treatment of angle closure glaucoma. PMID- 3508796 TI - A new thinking in management of thrombotic glaucoma. AB - This new line of thinking may open up a horizon for management of usually an unrewarding problem. The role of drainage surgery in early cases is stressed as a first line of action, followed if necessary by pan-retinal photocoagulation. PMID- 3508797 TI - Role of pars plana filtration in management of intractable glaucoma. PMID- 3508798 TI - Retinal toxicity of trace elements. AB - Acute toxicity of lead, nickel and cobalt on rabbit retina was studied. It was found that all these metals produced similar photoreceptor degenerative changes, but lead produced extensive degenerative changes at ganglion cell layer also. Electroretinographically nickel group showed statistically (by analysis of variance) significant prolongation of 'b' wave implicit time as seen in autosomal dominant retinitis pigmentosa. PMID- 3508799 TI - Measurement of the retinal blood vessel calibre and plasma layer on fluorescein angiography. PMID- 3508800 TI - Ascorbic acid and physico-chemical properties of vitreous humour. PMID- 3508801 TI - Contralateral eye in central serous retinopathy. PMID- 3508802 TI - Silicone oil-technique of use, advantages, limitations and post-operative management in cases of proliferative vitreoretinopathy. PMID- 3508803 TI - SF6--internal tamponade. PMID- 3508804 TI - Treatment of background diabetic retinopathy. PMID- 3508805 TI - Iris angiography in diabetic retinopathy. PMID- 3508806 TI - Management of giant retinal breaks. AB - A retrospective study involving 40 eyes of 40 patients with giant retinal break is presented. A comparison is attempted between cases where silicone oil is used and in cases where it was not used. The final success rate was found to be same in the two groups on long term follow-up. PMID- 3508807 TI - Wedge scleral buckling in prevention of fish mouth phenomenon in retinal detachment surgery. AB - Wedge scleral buckling done in 45 eyes of 43 patients with ballooning detachment and large horseshoe tears where fish-mouth phenomenon was anticipated pre operatively is analysed. In all of the cases, the retinal break settled on the wedge buckle after drainage of sub-retinal fluid and there was no radial retinal folds over the buckle nor was there fish-mouthing of the tears. The final success rate was 89%. There were no significant operative or post-operative complications and in none of the cases was there extrusion of implant or infection. PMID- 3508808 TI - Management of retinal detachment with proliferative vitreo-retinopathy with healon (Sodium hyaluronate). PMID- 3508809 TI - Prevalence of cystoid macular oedema in aphakia. PMID- 3508810 TI - How many laser burns. PMID- 3508811 TI - Adjustable squint surgery under general anaesthesia. PMID- 3508812 TI - Inferior oblique--weakening procedure. PMID- 3508813 TI - Anterior segment ischaemia following muscle transposition procedures--(an experimental study on monkeys). PMID- 3508814 TI - Evaluation of the faden operation. PMID- 3508815 TI - Saccadic eye velocity in concomitant divergent squint. AB - Study was conducted on 10 normal subjects, 20 cases of unilateral divergent squint and 20 cases of alternating divergent squint. In unilateral divergent squint cases lateral rectus of nondominant eye showed overactivity on fixation with dominant eye. In the alternating divergent squint cases which had onset of squint at or after the age of 2 years showed increased saccadic velocity of medial rectus of non-dominant eye on fixation with dominant eye. Working hypothese have been suggested to explain these phenomena. PMID- 3508816 TI - Anterior segment reconstruction following trauma. AB - In summary, this discussion reiterates the basic principles and techniques of reconstructive surgery following severe anterior segment trauma. Clearly, visual rehabilitation is a direct concomitant of anatomical restoration. Thus, definitive efforts to remove and replace damaged ocular surface tissue, as by conjunctival transplantation or pannus stripping, followed by penetrating keratoplasty with particular attention to restoration of iris and angle structures are well within the capability of anterior segment surgeons. Given the remarkable plasticity of ocular anterior segment tissues, particularly conjunctiva and iris, the straight forward application of these techniques can frequently yield both aesthetically satisfying and visually satisfactory results. PMID- 3508817 TI - Unilateral traumatic cataract and intraocular lens implantation. PMID- 3508818 TI - Visilon and perforated corneal injuries. PMID- 3508820 TI - Intraocular foreign bodies--relationship between localisation and functional prognosis. PMID- 3508819 TI - Management of chemical injuries of the eye. AB - The extreme morbidity that a severe chemical burn produces makes it imperative that immediate treatment be instituted for the purpose of restoration of the integrity and transparency of the cornea. The evolution of cicatrisation in severe chemical injuries especially alkali, takes an unfavourable course. Release of collagenase from the newly formed epithelium and fibroblasts of the stroma and lack of required levels of ascorbate in the aqueous humour causes fibroblasts to develop a denatured weak collagen. PMID- 3508821 TI - Clinical evaluation of Topcon auto refractometer. PMID- 3508822 TI - Accuracy of automated refractors--experience with NIKON NR-1000 F auto refractor. PMID- 3508823 TI - The intraocular magnet in clinical use. PMID- 3508824 TI - Prognostic value of retinal interferometry. PMID- 3508825 TI - What laser to select. PMID- 3508826 TI - Computers in ophthalmology. PMID- 3508828 TI - Health education is the beginning, the middle & end of NPCB. PMID- 3508827 TI - Primary school teachers in delivery of eye health care. PMID- 3508829 TI - Our experience with extended wear contact lenses. AB - The follow up of the patients was short and there may be failures later because of frequent lens loss or deposits on the lenses. In this study the failures which occurred did so within the first few weeks. It is probable that we can advise our patients that Extended Wear Contact Lenses are worn successfully by 70% of the patients with gratifying results. PMID- 3508830 TI - Ocular and orbital metastasis from systemic malignancies. AB - One hundred and seventy adult patients and one hundred and forty-eight children with systemic malignancies were examined for ocular and/or orbital metastases. Thirty-six patients (11.3%) had intraocular and/or orbital metastasis. Twenty nine of the 36 patients (80.5%) had orbital metastasis, five patients (13.9%) had intraocular and two patients (5.5%) had intraocular and orbital metastasis. The commonest malignancy producing ocular metastasis was carcinoma breast in females and carcinoma bronchus in males. Eight of the 17 children had orbital deposits from leukaemia (47%) and six from neuroblastoma (35%). One child had uveal infiltration from acute lymphatic leukaemia. Ophthalmic metastasis were treated by external irradiation and/or combination chemotherapy whenever possible. The mean survival was five months for intraocular metastasis and 15.6 months for the orbital metastasis in adults. Prognosis was very poor in children. PMID- 3508831 TI - Quantitative profile of small vessels over optic nerve head. PMID- 3508832 TI - Nerve fibre bundle defects and their perimetric correlation. AB - The importance of red-free fundus examination in revealing functional loss of the retinal nerve fibre layer is highlighted in some optic nerve diseases as corroborated by a good correlation observed between NFBDs and visual field defects. Red-free fundus examination could predict the site of a visual field defects, thus enabling the perimetrist to concentrate on that area and to detect field defects which were missed in a previous field examination. In cases of optic atrophy, the extent of nerve fibre layer loss correlated better with the functional loss in terms of visual acuity rather than the pallor of the disc, which was quite often misleading as an indicator of functional damage of the optic nerve. The technique of red-free fundus photography employed was fairly inexpensive and simple. PMID- 3508833 TI - Chronic ocular lesions in Bhopal gas tragedy. AB - A comprehensive eye checkup programme was carried out in 1140 cases of affected community to evaluate the exposure response and exposure effect with Methyl Isocynate on human eyes. The final evaluation of these cases was made with standard control group of same socioeconomic status in a non-gas affected slum area of Bhopal. The main chronic lesions noticed were chronic conjunctivitis, refractive changes, deficiency of tear secretion and persistent corneal opacities of various forms. PMID- 3508834 TI - Steroid induced tear film abnormality--role of mucous in its pathogenesis. PMID- 3508835 TI - Adenwalla Oration. The elusive passages. PMID- 3508836 TI - Silver sulphadiazine--a new drug for keratomycosis. PMID- 3508837 TI - New test for determining distant visual acuity in children. PMID- 3508838 TI - Glucose oxidase as an adjunct to penicillin on penicillin resistant staphylococcal isolates. AB - The study was carried out to find out the efficacy of glucose oxidase as an adjunct to penicillin and its comparison with cloxacillin on fifty penicillin resistant staphylococcal isolates. There is an unequivocal evidence that the combined use of glucose oxidase and penicillin is superior in controlling penicillin resistant coagulase positive staphylococcal infections in comparison to cloxacillin. PMID- 3508839 TI - Massive perfusion with vasodilators for ischaemic retinopathy and optic nerve diseases--a new approach. PMID- 3508840 TI - Herpetic keratitis newer modality of better approach (study of 440 cases/460 eyes). PMID- 3508841 TI - Fracture of the proximal metaphysis of the tibia in children. AB - Forty children seen consecutively with fractures of the proximal tibial metaphysis were reviewed to assess the frequency of the types of fracture and likelihood of developing progressive valgus deformity. The incidence of this fracture was 5.6 per 100,000 children per year. There were 17 fissure and buckle fractures, 15 greenstick fractures and 8 complete fractures. Valgus deformity was not seen after fissure or buckle fractures. Only 15 per cent of the greenstick and complete fractures progressed to valgus deformity. Predisposing factors were a young age and persistent valgus at the fracture site at union. PMID- 3508842 TI - The classification and prognosis of epiphyseal injuries. AB - Because of the difficulty of assessing prognosis, a clinical and radiological review of 103 injuries of growth plates was performed. Thirteen patients showed retardation of growth and in 4 it was clinically obvious. In addition, external deformity occurred because of failure of remodelling in 1 case. In 9 cases there appeared to be slight stimulation of growth. The correlation between the Salter Harris classification and retardation of growth was not always clear, especially in Salter-Harris type IV injuries, wherein prognosis varied with site. At the distal end of the tibia two groups of type IV injury were identified having respectively a 0 and 62.5 per cent incidence of retardation of growth. A new classification of distal injuries of the tibia is proposed, with superior predictive value for retardation of growth than that of Salter and Harris. This is valuable as a guide to prognosis and may facilitate treatment. PMID- 3508843 TI - Progressive valgus deformity after juxta-epiphyseal fractures of the upper tibia in children. AB - Four cases of progressive valgus deformity following a juxta-epiphyseal fracture of the proximal end of the tibia are presented. We suggest that the deformity is due to asymmetrical growth of the physis. Since this type of fracture tends to create a deformity, an anatomical or even overcorrected reduction is required. Long follow-up is necessary. PMID- 3508844 TI - Complications of external fixation of open fractures of the tibia. AB - Forty-two cases of open fractures of the tibia treated by external fixation are presented. Forty-three per cent of patients developed sepsis around one or more pins. Pin track sepsis occurred in 78 per cent of cases involving transfixion pins through muscle and bone but in only 17 per cent of cases using transcutaneous half-pins. Malalignment of more than 5 degrees in any plane was seen in 38 per cent of cases, almost half of which increased in plaster after removal of the fixator. PMID- 3508845 TI - The effects of medullary reaming on the torsional strength of the femur. AB - The authors have investigated the effect on the torsional strength of the bone of reaming the medulla of the femur from 12 to 16 mm in steps of 1 mm. Five groups of femurs, with 10 pairs in each, were tested comparatively in torsional loading and the torque required to cause fracture and the angle through which the bone had twisted at fracture were directly recorded for each pair. The results of maximum torque at failure (expressed as a proportion of the same parameter for the unreamed femur) plotted against the ratio of bone shaft diameter to reamed diameter showed a good correlation. The proportional maximum torque was found to range from 0.63 (at 12 mm) to 0.36 (at 16 mm) with a sharp transition between 14 and 15 mm. This drastic reduction was felt to be important for both the surgeon and the patient. PMID- 3508846 TI - The long and the short of medullary nailing. AB - One hundred and forty-seven medullary nailings of the femur have been studied to assess a new method of estimating the nail's length preoperatively, using the patient's height. PMID- 3508847 TI - Late results after meniscectomy in children. AB - Seventy-five children undergoing 77 meniscectomies have been reviewed from 1 to 30 years (mean 15) after operation in order to determine the late results of meniscectomy. Arthroscopy of the patients with a poor result was performed at the follow-up. In 30 per cent osteoarthrosis was diagnosed, all with follow-up times from 19 to 25 years. Delay in operation resulted in worse results. The younger the patient the worse the result. The benefit of operation was less in girls than in boys. Bucket-handle lesions and peripheral tears produced the best results after meniscectomy. Fifty-eight per cent of men and 26 per cent of women had symptom-free knees at follow-up. Removing a meniscus is not a benign procedure. Only 44 per cent of patients in whom a damaged meniscus and 17 per cent in whom a normal meniscus had been removed were without symptoms. These results stress the need for making an accurate diagnosis by careful examination and arthroscopy before embarking on meniscectomy in children. Efforts to preserve the meniscus in children must be made whenever possible. PMID- 3508848 TI - Computerized tomography of injury to the thoracolumbar spine. AB - We have reviewed the appearances of 35 patients with 51 fractures of the thoracic and lumbar spine who were seen over the past 3 years; all received plain film radiography and computerized tomography (CT). The types and distribution of fractures are similar to those in series already reported. The severity of each fracture can be described using a three-column model for the functional anatomy of the spine. The liability to orthopaedic instability or late neurological damage can be accurately assessed by computerized tomography. CT demonstrates many fractures of parts of vertebrae not seen on plain films. We propose a classification which is clinically relevant and simple. PMID- 3508849 TI - Unstable fractures of the thoracic and lumbar spine: the audit of an 8-year series with early reduction using Harrington instrumentation. AB - A series of 112 patients with acute unstable fractures of the thoracic or lumbar spine managed uniformly by early reduction using Harrington's instrumentation was analysed. The level of injury was T6-T11 in 19, T12-L1 in 67 and L2-L5 in 26 patients. On admission, 28 patients had complete paraplegia corresponding to the level of the lesion, 55 had partial lesions and 29 no neural damage. The policy of management comprised reduction by dual distraction rods and simultaneous short posterolateral fusion as an emergency procedure. Anterior decompression of the spinal canal, if required, was performed subsequently. The duration of the postoperative period in bed was 6 weeks. The rods were removed after 9-12 months. The radiographical result and neurological recovery were assessed after an average personal follow-up for 3.1 years. The height of the fractured vertebra was initially well restored, the mean angle of kyphosis being 14 degrees on admission and 5 degrees immediately postoperatively. However, gradually the fractured vertebral body and the intervertebral discs collapsed slightly and at follow-up the mean angle of kyphosis was 12 degrees. On the other hand, the reduction of the initial sagittal displacement of the fractured vertebral body into the spinal canal, could be maintained and a good anatomical end-result was achieved in most cases. The ultimate radiographical results were better after injuries of the thoracic spine and the thoracolumbar junction than after those of the lumbar spine. Improvement of neural function was seen in 28 patients (34 per cent of those with a deficit). Complications of clinical importance occurred in 29 patients.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3508850 TI - Off-the-road motorcycling injuries 1982-1985. PMID- 3508851 TI - Conservative treatment of fingertip injuries. AB - In a prospective investigation of 81 consecutive patients with fingertip injuries conservative treatment was evaluated. Fingertip injuries were defined as lesions greater than or equal to 1 cm2 in the terminal phalanx without injury to the tendons or joints. All fingertip injuries were cleaned and covered by Vaseline gauze and left to heal. If less than 2 mm of soft tissue covered the bone a few millimetres of bone were nibbled away to allow good cover with soft tissue. The majority of injuries (64 per cent) occurred at work. The average healing time was 25 days. The main later complaints were intolerance of cold (36 per cent), numbness (36 per cent) and tenderness (26 per cent). None of the patients had stiff joints. On average, the two-point discrimination had increased by 1 mm in the injured fingertip. Conservative treatment is recommended as a safe and simple treatment of fingertip injuries, even when bone is exposed in the wound. PMID- 3508852 TI - Traumatic hemipelvectomy: a further case report and comments on management. AB - The fourteenth case of survival following traumatic hemipelvectomy is presented. Several features of these massive injuries are illustrated by this case report and provide an opportunity to suggest guidelines of surgical management, based on standard and new criteria. PMID- 3508853 TI - Second arthroplasty of the knee combined with medullary nailing for non-union of fracture of the femur: a case report. PMID- 3508854 TI - Fracture of the dens in ankylosing spondylitis. PMID- 3508855 TI - Arterial injury complicating fracture of the fibula: a case report. PMID- 3508856 TI - Gas gangrene of the scalp: a case report. PMID- 3508857 TI - An unusual high-pressure penetrating thoracic injury: a case report. PMID- 3508858 TI - Extension injuries of the neck. PMID- 3508859 TI - Extension injuries of the cervical spine resulting in tetraplegia. PMID- 3508860 TI - Hyperaesthesia associated with hyperextension injuries of the neck. PMID- 3508861 TI - The importance of early internal fixation in multiply injured patients to prevent late death due to sepsis. AB - Three hundred and seventy-one multiply injured patients with 1063 fractures, who were admitted to our service over an 8-year period (1978-1985), were studied retrospectively. The impact of early osteosynthesis on the overall, and especially of the late, mortality due to sepsis was analysed. The patients were divided into two groups depending on whether they were treated with osteosynthesis (group I) or underwent conservative fracture treatment (group II). The late mortality (more than 7 days after injury) due to sepsis fell to 1.8 per cent in patients treated with osteosynthesis compared with 13.5 per cent (P less than 0.001) in patients treated conservatively. The best results were obtained when the osteosynthesis was performed within 24 hours after injury; less than 1 per cent died from late sepsis. We feel that fractures in multiply injured patients should be treated with early osteosynthesis in order to reduce the late mortality from sepsis. PMID- 3508862 TI - Delayed treatment of complicated fractures in war wounded. AB - The initial treatment of complicated fractures several days old when first seen in Afghan war wounded is reported for 52 limbs in 47 patients. External fixation was the method of choice for stabilizing fractures in adults. In children, traction and plaster-of-Paris were preferred. In 30 cases (58 per cent) tissue damage was classified as moderate. With radical wound toilet and delayed closure, infection could be controlled in most of these limbs. In 15 fractures (29 per cent) there was severe laceration and exposure of bone. After operation, deep infection persisted in three-quarters of these cases and the fate of these limbs often seemed doubtful. The patients usually refused amputation. However, of seven limbs (13 per cent) in which the fracture was associated with an arterial injury, only one could be saved. The brief period of observation of only 11 weeks does not permit assessment of time to healing, frequency of late osteitis or definitive amputation rate. It seems, however, that in spite of the lack of any proper first aid for these severe injuries, a functional limb could be salvaged in over two-thirds of the cases, even with our modest resources. PMID- 3508863 TI - Accelerated fracture union in association with severe head injury. AB - Union occurred unusually rapidly in 13 fractures of long bones in 11 patients who had sustained severe head injuries. Possible metabolic mechanisms for this are discussed and it is suggested that respiratory alkalosis associated with severe head injury or its treatment affects the rate of deposition of callus by modifying the pH at the fracture site. Fractures in patients with severe head injuries should be restored to an acceptable position early in order to avoid malunion. PMID- 3508864 TI - Problems associated with transfer of patients to a regional burns unit. AB - A prospective survey was conducted of all patients requiring admission to the Regional Burns Centre for South East Scotland at Bangour Hospital and the Royal Hospital for Sick Children in Edinburgh. All patients admitted between May 1983 and April 1984 were studied. Details were obtained about the cause and extent of the burn, the immediate first aid measures provided, causes for delay in arrival at the Burns Centre and, when appropriate, the initial care and its adequacy before transferring the victim from another hospital. A total of 276 patients were studied, of whom 152 were transferred. Early management by referring hospitals was often far from ideal, with errors in initial care that should have been avoided. PMID- 3508865 TI - Injuries caused by personal violence. AB - Injury is the leading cause of death for Americans from infancy to middle age. Thirty-seven per cent of injuries admitted to this faculty are the result of personal violence. A prospective pilot study sought to elucidate the circumstances of such injuries. Medical records of all admissions for gunshot wounds, stab wounds or assault during a 30-day period were reviewed (N = 105). A subset (N = 32) were interviewed and given psychometric tests. Distribution by mode of injury was assault, 46 per cent; stabbing, 42 per cent; shooting, 12 per cent. Single, black males aged 18-44 dominated the sample. Injuries tended to occur in or near bars (82 per cent), between 1800 and 0600 hours (79 per cent) and were accompanied by alcoholic intoxication (63 per cent). Un- or underemployment was prevalent (56 per cent). Thirty-eight per cent of incomes were below the official poverty level. Some victims were illiterate. Histories of previous violent encounters (mean number = 22) during the year before the injury and hospital treatment for previous injury were common (56 per cent). Those interviewed reported high frequencies of recent and developmental stresses. The yearly cost of the acute care of patients with injuries caused by violence and treated at this hospital is estimated to be $8,000,000. Of this 80 per cent is paid for with public funds. Personal violence is a serious but neglected part of public health. PMID- 3508866 TI - Resection of the lateral end of the clavicle following osteolysis, with emphasis on non-traumatic osteolysis of the acromial end of the clavicle in athletes. AB - Preoperative radiographs of 38 patients who had undergone resection of the lateral end of the clavicle were reviewed. Seven cases of osteolysis of the lateral end of the clavicle were found, of which four followed severe injury of the shoulder girdle. Three of the cases were young male athletes, with nontraumatic osteolysis. One additional patient with this disorder, in whom resection has not yet been performed, was also included. All four had practised weightlifting and benchpressing as part of their training. Hence, a feasible explanation for the osteolytic process seems to be repeated microfractures due to stresses imposed by these activities. Several conservative regimens provided only temporary relief. After resection, the symptoms ceased and the patients were able to return to competitive sport. With the increasing interest in bodybuilding, non traumatic osteolysis of the acromial end of the clavicle should be borne in mind in cases of pain in the shoulder in athletes. PMID- 3508867 TI - Should comminuted trochanteric fractures of the hip in the elderly be reduced before fixation? AB - Twenty patients with comminuted trochanteric fractures underwent fixation in the position of deformity. We explain the principles and rationale of this technique and analyse our results. PMID- 3508868 TI - New problems in old bones: closed nailing of the shaft of the femur. AB - Closed medullary nailing is now established as a routine treatment of fractures of the shaft of the femur. However, the quality of the bone in elderly patients is such that serious technical difficulties may arise during the operation. Three typical cases illustrate the problems that may occur and point the lesson that closed nailing in the elderly ought not to be undertaken by the inexperienced surgeon. PMID- 3508869 TI - Wrinkle corner. A splint for the metacarpophalangeal joint of the thumb. AB - We describe an effective splint for sprains of the metacarpophalangeal joint of the thumb. PMID- 3508870 TI - Care of the injured in the Third World--what can we learn? AB - There is a need to put more emphasis on primary surgical care centred on provincial and district hospitals in the developing world using simple equipment which needs little maintenance and low running costs. The general duty doctors and paramedicals who are at the first point of contact with the patient, need practical on-site instruction in dealing with common surgical emergencies, of which injury forms a large part. To achieve this change in emphasis, provision should be made for surgical trainees and experienced surgeons from the United Kingdom or else where to work in selected provincial and district hospitals where support services can be adequately provided. The experience they would gain, would in turn benefit their patients in the National Health Service. If this activity is to have any chance of success, the training and research potential must be recognized by the Royal Colleges as valid experience in higher surgical training programmes. The National Health Service and the Health Authorities must accept these periods overseas as integral parts of a career in the National Health Service. This would include provision for superannuation, encouraging proleptic appointments to consultant posts, and secondment or early retirement of Consultants. Funding should be sought from international and national agencies for a pilot project based on a direct link between a district hospital in this country and a selected district or provincial hospital in a developing country.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3508871 TI - The radiological deformity of Colles' fractures. AB - The behaviour of the bony deformity in Colles' fractures and factors influencing this were prospectively investigated in 187 patients over the age of 55. Radiographic assessment was made throughout a 13-week period and during this time the deformity progressively recurred, even after the plaster cast had been removed. Radial length and radial deviation reverted virtually to their positions before reduction. Only those fractures with a volar tilt greater than -15 degrees when first seen showed any improvement. In all fractures the initial deformity clearly influenced the final radiological result whereas the quality of reduction was not of critical importance. The extent of dorsal comminution and quality of the bone influenced the final anatomical result in those fractures which were not manipulated. PMID- 3508872 TI - Early use of corticosteroids in severe closed chest injuries: a 10-year experience. AB - Because of the controversy about the treatment of injured patients with steroids, each doctor treating closed chest injuries at Ulleval Hospital, Oslo, has been free to decide whether to use steroids. However, if steroids were to be used, early administration was recommended. Thus, on admission methylprednisolone 30 mg/kg body weight was given to 107 patients having at least four rib fractures or a flail chest. The dose was repeated after 8 and 16 hours. The patients treated with steroids were compared with 159 patients not receiving steroids, but who otherwise were treated identically. Three-quarters of the patients had multiple injuries and 219 patients (82 per cent) had intrathoracic injuries such as pneumothorax (39 per cent), haemothorax (37 per cent) or contusion of the lung (59 per cent). Forty-six patients (17 per cent) were in shock on admission. Most patients could be managed with intravenous infusion, oxygen, relief of pain and chest drains. Early thoracotomy was performed in 10 patients and 91 patients needed artificial ventilation. Analysis of the two groups of patients revealed a significantly lower hospital mortality of 11.2 per cent for those treated with steroids as against 23.3 per cent for those without. Comparison of the two groups demonstrated no differences which could explain the difference in mortality. The mean Injury Severity Score (ISS) was 24.0 for the steroid treated group and 21.4 for the control group. The steroid treatment was not associated with any increase in the incidence of infection. The present analysis indicates that steroids, when given early, may improve the clinical course of patients sustaining severe closed injuries of the chest.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3508873 TI - Unemployment, alcohol and injury in west Belfast. AB - The relationship of being employed or not to alcohol consumption and subsequent injury which necessitated hospital treatment was evaluated prospectively in 116 patients coming to the Accident and Emergency Department of a large teaching hospital. Details relating to employment, category and situation of injury were collected prospectively on a standard form and breath alcohol content was evaluated in all subjects. Employment or not was related to alcohol consumption and subsequent associated accidents: 40 per cent of unemployed subjects sustained accidents related to alcohol compared with 8 per cent of employed patients (P less than 0.01 by the chi 2 test). Accidents related to alcohol also tended to occur in public places. These findings represent previously unrecognized associations between employment, alcohol consumption and subsequent accidents. PMID- 3508874 TI - Time from injury to death (survival time) among fatally injured pedestrians. AB - This study examines the survival time after injury and its relationship to age and Injury Severity Score (ISS) among 322 fatally injured pedestrians. Long survival times were associated with older age and with lower ISS. The association of long survival time with older ages remained present after adjustment for ISS. People with untreatable severe injuries (as defined by the Abbreviated Injury Scale) and people who died of potentially survivable injuries had markedly different survival times. Therefore, in analyses of data relating to survival time, combining the two groups should be avoided. PMID- 3508875 TI - How accurately are fractures of the skull diagnosed in an accident and emergency department. AB - Over a 9-month period 3424 patients with a head injury were examined in the Accident and Emergency Department of Monklands District General Hospital. Casualty officers diagnosed 66 fractures of the skull on radiographs but 27 of these were subsequently reported by a radiologist as not being fractures. Of the 45 fractures reported by the radiologist 6 had been missed by the casualty officer. This study demonstrates the performance of junior medical staff who have no formal training in radiology. It emphasizes the need to instruct such staff when they are assigned to work in accident and emergency departments. PMID- 3508876 TI - What does it feel like to be brain damaged? PMID- 3508877 TI - CSF rhinorrhoeae: significance of the glucose oxidase strip test. AB - Many authoritative medical textbooks recommended use of glucose oxidase reagent strips to distinguish cerebrospinal fluid rhinorrhoea from clear nasal discharge following head injury. A study of 50 subjects with clear nasal and lacrimal secretions, demonstrated a large proportion of positive results for glucose (44 per cent). Thirteen secretions (26 per cent) contained glucose in a concentration within the normal range for CSF. The recommended use of glucose oxidase test strips for differentiating CSF leakage from other clear nasal secretions is therefore without foundation. PMID- 3508878 TI - Unstable cervical spine injuries in rugby--a 20-year review. AB - A study of a well-defined group of rugby players was undertaken in Wales to determine whether there has been an increase in the number of serious neck injuries during the past 20 years. None such occurred until a single incident in 1964 and not again until 1974. Since then the injuries have continued at a steady rate of about two per year. The mechanism of the injuries was analysed but no single factor could be identified as being responsible for this sudden increase although tactics in the scrummage played an important part. The importance of flexion injuries is emphasized but it is likely that not all the responsible factors have yet been identified. PMID- 3508879 TI - Traumatic spondylolisthesis of the axis. AB - A prospective study of 39 patients with traumatic spondylolisthesis of the axis is reported. Classification of the fracture was based on the criteria of White and Punjabi (1978). In previous studies (Effendi et al., 1981; Levine and Edwards, 1985) stability of the undisplaced and slightly displaced fracture was based on flexion/extension radiographs. Union was obtained in all fractures without using a rigid cervical orthosis. We feel that assessing stability dynamically soon after injury when there is marked muscle spasm does not provide an accurate assessment, nor does it not alter the management of these injuries, as shown in this study. PMID- 3508880 TI - Thyroid hormone alterations in patients with shock and injury. AB - Serum concentrations of total T3 and T4, free T4, rT3, TSH, TBG and cortisol were measured on arrival in hospital in 33 adult injured patients, 26 of whom were received directly from the accident. Serum cortisol levels and all thyroid indices, except TBG, were altered substantially by injury. Compared with values from 57 healthy volunteers, statistically significant (P less than 0.01) decreases were found in the mean serum free and total T4 concentrations and the rT3 level. Similarly significant (P less than 0.001) increases were seen in the mean serum T3, TSH and cortisol concentrations. Repeated assessment of thyroid function in six patients suggested a biphasic response to injury by TSH, T3 and rT3. The first phase was of short duration (1-2 h). Serum levels of TSH and T3 were above normal, and rT3 was decreased. These data suggest participation by the thyroid in the 'fight-or-flight' response to life-threatening stress. The second phase was fully established 6-18 h after injury and was characterized by reductions in serum TSH, T3 and total and free T4 and a rise in rT3. This pattern persisted throughout the 2-week period of measurement. Thus, as in other critical illnesses, the 'low T3' syndrome is common in severely injured patients. However, changes in thyroid hormone metabolism after injury are of greater intensity and longer duration. PMID- 3508881 TI - Penetrating injury on an artificial ski slope. PMID- 3508882 TI - An unusual presentation of tuberculosis--'injury TB'. AB - Thirteen patients are presented who developed tuberculosis at the site of injury. They were all immigrants from areas where tuberculosis is endemic. The presence of injury caused a delay in diagnosis and therefore appropriate treatment. In an immigrant with an injury that pursues an unusual or protracted course, tuberculous infection should be considered. PMID- 3508883 TI - Local muscle flaps in the treatment of chronic osteomyelitis--the introduction of new vasculature. AB - Four cases of chronic osteomyelitis successfully managed with local muscle flaps after sequestrectomy are reported. The success of this method in controlling chronic osteomyelitis lies in the introduction of a new vasculature, which provides nutrients, sufficient antibiotics, host defence system and osteoprogenitor cells to the post-sequestrectomy bed. The osteoprogenitor cells are responsible for the incorporation of residual avascular bone into the adjacent living bone by creeping substitution. PMID- 3508884 TI - A case of primary repair of pancreatic transection. PMID- 3508885 TI - A case of traumatic diaphragmatic hernia presenting as acute tension pneumothorax. PMID- 3508886 TI - Toxic shock syndrome following repair of a ligament of the knee. PMID- 3508889 TI - Bloodshed and its estimation. PMID- 3508887 TI - Volar perilunar dislocation of the carpus--a case report. PMID- 3508888 TI - Irreducible subluxation of the tibio-talar joint due to a fracture of the calcaneus. PMID- 3508890 TI - The use of peritoneal lavage and urological studies in major fractures of the pelvis--a reassessment. AB - Fifty patients with major fractures of the pelvis (Trunkey's classification types I and II) treated in an urban Level I Trauma Center were analysed to assess the role of peritoneal lavage and urological studies in the initial evaluation. The mechanisms of injury were automobile v. pedestrian (44 per cent), falls from heights (44 per cent), and motor vehicular accidents (12 per cent). Important hypotension was present in 46 per cent of patients on arrival. Peritoneal tap or lavage was selectively used in 11 patients (22 per cent). Four patients in refractory hypotension despite vigorous resuscitation had positive results. There were no false-positive results or missed intra-abdominal injuries in any of the 50 patients. Laparotomy was carried out in 10 of 50 patients. IVP or cystography was performed in 25 of 50 patients. However, injuries of the urinary tract requiring operative correction (eight injuries in six patients) were all associated with gross haematuria. Urological studies were negative in patients with 1 to 3+ microscopic haematuria. Peritoneal lavage is recommended on a selective basis in patients with pelvic fractures. Microscopic haematuria does not warrant contrast studies of the urinary tract. PMID- 3508891 TI - Treatment of unstable intertrochanteric fractures with Sarmiento valgus osteotomy and acrylic cement augmentation. AB - Seventy unstable intertrochanteric fractures (Kyle III) were treated by Sarmiento valgus osteotomy, fixation with a sliding hip-screw and plate, and augmentation of the posteromedial upper femoral defect with acrylic cement. Immediate full weight bearing walking was started after the operation. Forty-two patients were followed up for more than 1 year (average 21.4 months). Excellent or good results were obtained in 71.4 per cent. However, there was mechanical failure in which the hip screw cut out of the femoral head superolaterally in 8.6 per cent. Comparison was made between the results of the present technique and our previously reported technique which consisted of Dimon-Hughston medial displacement osteotomy, fixation with sliding hip screw and acrylic cement augmentation to the upper posteromedial femoral defect. It was found that the result of the latter technique is slightly better, probably because of the more rigid reduction. PMID- 3508892 TI - Early experience with closed interlocking medullary nailing of the femur. AB - We report on the first 14 patients treated with the Grosse Kempf femoral locking nail in our hospital. As with simple closed nailing of the femur attention to detail in the operating theatre is important. To date there have been only a few minor complications with the procedure, apart from one non-union. It allows stabilization of complicated fractures of the femoral shaft particularly in patients with multiple and often bilateral injuries caused by high velocity. It is concluded that it is an excellent procedure for complicated unstable fractures of the femoral shaft which would otherwise be treated on traction, and that the procedure can be safely performed in any centre where closed intramedullary nailing is commonly practised. PMID- 3508893 TI - Soft-tissue swelling following fractures of the ankle. AB - One hundred and thirty-six consecutive fractures of the ankle were assessed over a 2-year follow-up period in order to determine the rate at which soft-tissue swelling subsides. The effect of anatomical and non-anatomical reduction by both open and closed methods was compared. The results showed that soft-tissue swelling following external rotation fractures of the lateral malleolus treated by closed methods subsides initially over a 3-month period. Anatomical reduction, whether achieved by open or closed methods, in bi- and trimalleolar fractures results in a rapid resolution of the swelling over 3 months, followed by a slower return to normal over the ensuing 6 months. Persistent soft-tissue swelling remains when these intra-articular fractures are not anatomically reduced. The swelling is more marked and persists for 2 years or more in those fractures treated by open methods with poor anatomical restoration compared with poor reduction achieved by closed methods. PMID- 3508894 TI - Treatment of fractures of the shaft of the humerus accompanied by paralysis of the radial nerve. AB - This paper reports the results of treatment of 17 patients with fractures of the shaft of the humerus accompanied by paralysis of the radial nerve in a series of 111 patients with fractures of the shaft of the humerus. In early operative explorations in 14 cases the radial nerve appeared undamaged in 13 cases. In cases where spontaneous recovery of the function of the radial nerve failed to occur, no evidence has been found that the delay in exploration influenced eventual motor recovery. The high incidence of undamaged nerves at exploration suggests that a conservative approach by collar and cuff or Sarmiento bracing is justified in such cases of fractures of the shaft of the humerus. Paralysis of the radial nerve associated with fractures of the shaft of the humerus is, in our opinion, not an indication for early operative treatment. PMID- 3508895 TI - Shot in the neck in Spain (a rare cause of an isolated Horner's syndrome). AB - Horner's syndrome is rare. A bullet wound in the neck is a rare cause of the syndrome, and it is exceedingly uncommon for a Horner's syndrome to be the sole noteworthy clinical result of a gunshot wound of this part of the anatomy. Two cases of bullet injury of the neck are described wherein a permanent Horner's syndrome was the only important sequel. PMID- 3508896 TI - Diaphragmatic rupture following closed injury--a pitfall of supine chest radiology. PMID- 3508897 TI - Deceleration injury causing a left chylothorax associated with a left vocal cord paralysis. PMID- 3508898 TI - The post-pericardiotomy syndrome and penetrating injury of the chest. AB - The post-pericardiotomy syndrome is an uncommon complication of chest trauma. We present a case of recurrent pleural and pericardial effusions, pyrexia, pain in the chest and ECG changes of pericarditis in a young man with a penetrating chest injury. PMID- 3508899 TI - Appendicectomy following plate-glass injury. PMID- 3508900 TI - Missed carpometacarpal dislocation of the thumb in motorcyclists. AB - Three cases of missed dislocation of the thumb's metacarpal in major motorcycle injury are presented. We postulate a mechanism of injury and discuss the significance. PMID- 3508901 TI - Bilateral simultaneous sleeve fractures of the patella in secondary hyperparathyroidism. PMID- 3508902 TI - Late treatment of non-union of fracture of the olecranon. PMID- 3508903 TI - Salter type 2 fracture separation of the proximal epiphysis of the fibula. PMID- 3508904 TI - Neurovascular injury complicating displaced proximal fractures of the humerus. AB - Three cases with injury of the axillary artery and brachial plexus complicating a displaced proximal fracture of the humerus are presented. In two patients the arterial injury was not recognized on admission. Vascular repair had to be carried out in all three cases. Two patients showed a persistent neurological deficit. In two of the cases, the arterial injury may have been caused by an attempt at closed reduction of the fracture. The possibility of axillary arterial injury should be considered in proximal fractures of the humerus with severe medial displacement of the shaft of the humerus. PMID- 3508905 TI - Ano-rectal injury causing extraperitoneal and subcutaneous emphysema. AB - Extraperitoneal emphysema is a rare clinical finding, usually reported in association with iatrogenic injuries to the rectum. Minor degrees of 'extraperitoneal emphysema' may be seen in other perforations but insufflation of air seems to be the major contributory factor. This report describes an unusual case that developed after a straddle-injury. PMID- 3508906 TI - False aneurysm of the axillary artery as a complication of the modified Bristow procedure. PMID- 3508907 TI - Popliteal vessel injury caused by a plastic bullet. PMID- 3508908 TI - A Salter type 3 fracture of the proximal epiphysis of the humerus. PMID- 3508909 TI - Inhibitors and dipeptide substrates for a microsomal tyrosylsulfotransferase from rat brain. AB - The sulfotransferase associated with a microsomal fraction from rat brain was previously shown to transfer sulfate groups from 3'-phosphoadenosine 5' phosphosulfate (PAPS) to peptides derived from the cholecystokinin (CCK) molecule. Three tyrosine-containing dipeptide derivatives, i.e., Cbz-Glu-Tyr, Cbz Gly-Tyr and Ac-Phe-Tyr are shown here to accept the [35S] sulfate group from [35S] PAPS under the action of this sulfotransferase. The sulfotransferase activity evaluated with either any of these dipeptide derivatives or CCK-8 as acceptors is similarly inhibited by a series of compounds, i.e., lipophilic polycyclic compounds like fluphenazine, tyrosine derivatives like Boc-O-benzyl tyrosine and phenolsulfotransferase inhibitors like 4,4-di-isothiocyano 2',2' disulfonic acid stilbene. PMID- 3508910 TI - Evidence for inhibitors of the cell surface protease guanidinobenzoatase. AB - Guanidinobenzoatase is a protease present on the surface of tumour cells. The present study describes the isolation of a protein inhibitor of guanidinobenzoatase obtained from extracts of liver and pancreas and purified by affinity techniques. Pancreatic acinar cells have been shown to possess a latent form of guanidinobenzoatase and this latency is due to complex formation with the inhibitor. A fluorescent marker has been employed to demonstrate the presence or absence of the inhibitor on sections of pancreatic tissue. The inhibitor has been shown to be exchangeable with liver and pancreatic inhibitors obtained from different species. It is postulated that these inhibitors may play a role in enzyme control. PMID- 3508911 TI - Kinetic studies on the major form of aldehyde reductase in ox kidney: a general kinetic mechanism to explain substrate-dependent mechanisms and the inhibition by anticonvulsants. AB - The inhibition of the major form of ox kidney aldehyde reductase (AR 1) by sodium barbitone revealed linear mixed kinetics. This behaviour is distinct from the non linear intercept effect we reported for valproate [Daly and Mantle (1982) Biochem. J. 205, 381]. 4-Carboxybenzaldehyde exhibits partial uncompetitive substrate inhibition. These results are discussed in terms of a model that involves nucleotide-induced isomerization and an additional flux (with some substrates and inhibitors) through an enzyme.nucleotide.substrate/inhibitor ternary complex. PMID- 3508912 TI - Inactivation of GABA aminotransferase by 3-nitro-1-propanamine. AB - 3-Nitro-1-propanamine is a close structural analog of the neuro-transmitter GABA. The nitro compound is a good substrate for the GABA aminotransferase from porcine brain. However, it inactivates the GABA aminotransferase from GABA-grown Pseudomonas fluorescens in a slowly reversible reaction. Both enzymes are inactivated by the homolog 4-nitro-1-butanamine. PMID- 3508913 TI - Rat striatal synaptosomes as a model system for studying the inhibition of dihydropteridine reductase activity. AB - The distribution of dihydropteridine reductase between soluble and particulate fractions in synaptosomes parallels that of lactate dehydrogenase, but not monoamine oxidase. Ki and I50 values for inhibitors obtained with the enzyme-rich P2 fraction and its twice-washed fraction (P2W2) were essentially the same, and were similar to those obtained with highly purified human liver enzyme. Dihydropteridine reductase inhibitory potency of multi-ring compounds containing a catechol-moiety was greater than that of single ring catecholic compounds, which in turn was greater than that of p-hydroxy-phenolic compounds. The P2 fraction of rat striatal synaptosomal preparations may serve as a convenient source of dihydropteridine reductase for studying the inhibition of this enzyme. PMID- 3508914 TI - The role of inhibitors in the fluorescent staining of benign naevus and malignant melanoma cells with 9-amino acridine and acridine orange. AB - Guanidinobenzoatase is a trypsin-like protease capable of degrading fibronectin. An inactive form of guanidinobenzoatase is present on the surface of benign naevus cells and these cells stain very weakly with 9-aminoacridine, a known competitive inhibitor of guanidinobenzoatase. Malignant melanoma and metastatic malignant melanoma cells exhibit strong surface staining with 9-aminoacridine and also exhibit strong staining of cytoplasmic RNA with acridine orange. These simple fluorescent techniques have been used to distinguish benign naevus cells from malignant melanoma cells in human skin sections. This difference in cell surface staining with 9-aminoacridine has been demonstrated to be caused by the presence or absence of an inhibitor. The inhibitor can be displaced from the cell surface enzyme and then replaced by an affinity purified inhibitor obtained from fresh liver homogenates. It is proposed that the inhibition or control of cell surface guanidinobenzoatase may be one of the regulatory mechanisms by which benign naevus cells are prevented from developing into malignant melanoma cells. PMID- 3508915 TI - Kinetics of protein modification reactions: analysis of modification-induced protein unfolding. AB - A mathematical treatment of a two-sited, modification-induced protein unfolding model is presented, and it is shown that the dependence of the concentration of modified protein groups on reaction time is described by a linear, second-order, differential equation with nonzero right hand side. The analytic solution of this equation consists of a summation of exponential functions of reaction time. By assigning arbitrary values to the modification and isomerization rate constants of these equations, simulated cases of protein modification are presented, and the apparent end-point of the reaction is determined graphically. It is found that the apparent end-point of the reaction is, in most cases studied, different from the true value of two groups modified per protein molecule, and is a function of both the modification, and isomerization rate constants of the model. The first derivative of the protein modification reaction, at the start of the reaction, [E]'mod (0), is determined, for the same simulated cases of protein modification, by two different analytical methods. It is found that the [E]'mod(0) value, obtained from graphical and numerical analysis data, is in most cases in good agreement with the value expected from first principles. Finally, the different irreversible enzyme inhibition forms, contingent upon the different kinds of the enzyme inactivation-protein modification relationships of the protein modification model under consideration, are presented and discussed. PMID- 3508916 TI - [Color flow mapping 2-D Doppler in determining surgical indication for congenital heart disease]. AB - Real-time two-dimensional Doppler echocardiography (2-D Doppler) is established as an effective diagnostic tool for cardiovascular diseases. However, in determining indications for surgery of congenital heart disease (CHD), the possibility of avoiding preoperative cardiac catheterization including radiographic angiography, has not been fully discussed since the clinical introduction of 2-D Doppler. We evaluated 278 patients with CHD by 2-D Doppler including ASDs (75 patients), VSD (76 patients), TOF (23 patients), TGA (12 patients), PDA (23 patients), ECD (13 patients), and 60 miscellaneous types of CHD during 27 months. The diagnosis of the 278 patients were confirmed by catheterization and/or surgery. Of these, 114 patients underwent corrective surgery (83 patients) or palliative procedures (31 patients). Preoperative cardiac catheterization was performed for 88 patients (Group A), and omitted in 26 patients (Group B). The 2-D Doppler diagnosis was correct in 79 patients of Group A (89.8%) and in 26 patients of Group B (100%). The surgical procedures scheduled according to the preoperative 2-D Doppler diagnosis were performed for these 105 patients (92.7%) without any corrections by cardiac catheterization diagnosis or by surgical findings. However, 2-D Doppler failed to establish the preoperative diagnosis for six patients in Group A (two patients with ASD, three with PDA, and one with TOF) and failed to detect associated cardiac abnormalities for three patients in Group A (two with PAPVC, one with Azygos connection). Results of this study suggest that preoperative cardiac catheterization could be omitted in a maximum of about 90% of surgical candidates with CHD. However, to omit cardiac catheterization 2-D Doppler echocardiographic criteria for indications for surgery in each group of CHD must be established, and any associated coronary artery abnormalities must be ruled out. PMID- 3508917 TI - [Immunotherapy of cancer and immunodeficiency]. PMID- 3508918 TI - [Vascular architecture and the mechanism of erection]. PMID- 3508919 TI - [Preventive medicine in urology]. PMID- 3508920 TI - [Management of urinary incontinence]. PMID- 3508921 TI - [Multidisciplinary treatment of renal cell carcinoma]. PMID- 3508922 TI - [Basic and clinical studies on malformations of the genito-urinary tract]. PMID- 3508923 TI - [Complementation analysis of ts mutants of the temperate phage 59 of Erwinia carotovora 268]. PMID- 3508924 TI - [Transformation of Streptomyces sp. 1912-8 protoplasts using plasmid pSG 1912 DNA]. PMID- 3508925 TI - [The utilization of iron of various substrates by Yersinia pestis]. PMID- 3508926 TI - [Survivability and adaptation of individual fungal species of the genus Fusarium Lk.: Fr. at low soil temperatures]. PMID- 3508927 TI - [IR spectra of polysaccharides in Corynebacterium michiganense]. PMID- 3508928 TI - [Streptococci of the nasopharynx in healthy persons]. PMID- 3508929 TI - [Antagonistic action of autonomous human skin flora on staphylococci]. PMID- 3508930 TI - [Changes in the chitin content of the mycelium of Hyphomycetes with promise for the bioconversion of plant substrates]. PMID- 3508931 TI - [Kinetic characteristics of the alpha-mannanase of Rhodococcus erythropolis 19]. PMID- 3508932 TI - [The assimilation of ethyl alcohol by bacteria and yeasts]. PMID- 3508933 TI - [Antimicrobial properties of 1,4-bis-(N,N-methyl-N,N decoxycarbonylmethylene)piperazinium dibromide]. PMID- 3508934 TI - [The lipopolysaccharide composition of phytopathogenic bacteria of the genus Pseudomonas, serologic group VI]. PMID- 3508935 TI - [Variability of Staphylococcus aureus membranes depending on the growth phase of the culture]. PMID- 3508936 TI - [Biological properties of staphylococci resistant to salvin]. PMID- 3508937 TI - [Effect of environmental factors on the destruction of petroleum products by associative microorganism cultures]. PMID- 3508938 TI - [Interrelations of bdellovibrios with host bacteria in the coastal zone of the northeastern Black Sea]. PMID- 3508939 TI - [The toxigenic potential of Fusarium Lk.: Fr. species--producers of trichothecene group-B mycotoxins]. PMID- 3508940 TI - [The action of protein-vitamin preparations from micromycetes on fur-bearing animals]. PMID- 3508941 TI - [L-transformation of the causative agents as one of the routes for the realization of a chronic Pseudomonas bacterial carrier state]. PMID- 3508942 TI - [Properties of the polysaccharide synthesized by an Acinetobacter sp. culture]. PMID- 3508943 TI - [The monosaccharide composition of Erwinia carotovora subsp. carotovora cells]. PMID- 3508944 TI - [Reproduction and morphogenesis of phage E105 of Erwinia carotovora 268]. PMID- 3508945 TI - [Lipopolysaccharides of the S- and R-forms of Pseudomonas syringae pv. phaseolica]. PMID- 3508946 TI - [Isolation of antimicrobial substances from arenarin]. PMID- 3508947 TI - [Structuro-functional research on polysaccharides of Corynebacterium michiganense subsp. sepedonicum]. PMID- 3508948 TI - [The action of microbial antagonists on the autonomous flora of human skin]. PMID- 3508949 TI - [The distribution of gram-positive aerobic cocci in the environment]. PMID- 3508950 TI - [Anaerobic bacteria in pathology of the lungs and pleura]. PMID- 3508952 TI - [The role of a nonclassical virus in the etiology of human amyotrophic leukospongiosis]. PMID- 3508951 TI - [Tumor formation in the lungs of mice of various strains during virus-chemical cocarcinogenesis and the action of immunostimulants]. PMID- 3508953 TI - [A simple method for determining the molecular weight of proteins in their native state]. PMID- 3508954 TI - [An accelerated method of determining diaminopimelic acid in bacterial cells]. PMID- 3508955 TI - [Theoretical evaluation of the ratio of endo- and exogenous respiration in yeasts using the balance of macroergic compounds]. PMID- 3508956 TI - [Chemical and immunochemical research on the polysaccharide of Corynebacterium michiganense subsp. insidiosum 1589]. PMID- 3508957 TI - [The Institute of Microbiology and Virology of the Academy of Sciences of the Ukrainian SSR on the 70th anniversary of the Great October Revolution]. PMID- 3508958 TI - [Effect of associated microflora on cobalamin genesis by Propionibacterium shermanii]. PMID- 3508959 TI - [Validation of new taxa and taxonomic combinations in the genus Fusarium Lk.: Fr]. PMID- 3508960 TI - [Antagonistic action of the autonomous flora of the skin of the breasts on staphylococci in pregnant women]. PMID- 3508961 TI - [Fatty acids of the total lipids in representatives of the genus Erwinia and other enterobacteria]. PMID- 3508962 TI - Children after divorce. Wounds that don't heal. PMID- 3508963 TI - Case management and follow-up of a chemically impaired nurse. PMID- 3508964 TI - When the nurse psychotherapist is pregnant (implications for transference countertransference). PMID- 3508965 TI - Absence of clinical abnormalities suggesting renal involvement during the long term course of visceral leishmaniasis. PMID- 3508966 TI - [Sub prosthetic bacterial plaque in removable dentures (2)]. PMID- 3508967 TI - [Photoelastic analysis of pressure in the deciduous occlusion]. PMID- 3508968 TI - [Ultrastructural findings in a case of diphenylhydantoin gingival hyperplasia]. PMID- 3508969 TI - [New technics in the use of filled resins in tooth fractures]. PMID- 3508970 TI - [Orthopedic-functional treatment of a dental and basal Class II]. PMID- 3508971 TI - [The use of helmets by motorcyclists. Laboratory test and our clinical experience]. PMID- 3508972 TI - [Instrumental diagnosis of lesions of the oral mucosa]. PMID- 3508973 TI - [Cytology of the oral cavity: still a current technic?]. PMID- 3508974 TI - [Carcinoma of the lingual margin]. PMID- 3508975 TI - [Mandibular metastasis of renal tumors: report of 2 cases]. PMID- 3508976 TI - [Carcinogenesis in the oral cavity: oncogenic risk factors. 1]. PMID- 3508977 TI - [Carcinogenesis in the oral cavity: oncogenic risk factors. 2]. PMID- 3508978 TI - [Ultrasonic root canal preparation: comparative S.E.M. study with manual treatment]. PMID- 3508979 TI - [The use of subsonics in endodontics: comparative study with traditional technic]. PMID- 3508980 TI - [Physiopathology and therapy of pain in pulp disease]. PMID- 3508981 TI - [Sialo-orthopantomography in the diagnosis of pathology of the salivary glands]. PMID- 3508983 TI - [Force composition and equivalent systems in orthodontics]. PMID- 3508982 TI - [Craniofacial injuries: emergency treatment and elective treatment]. PMID- 3508985 TI - A transparent nasal hood--the centra comfort cushion. PMID- 3508984 TI - [Ketamine in oral surgery: clinical experience]. PMID- 3508986 TI - Anaesthetic support and resuscitation officer--a new role for the dentist in the Army. PMID- 3508987 TI - Long-acting analgesic or long-acting local anesthetic in controlling immediate postoperative pain after lower third molar surgery. PMID- 3508988 TI - [Comparison of maxillofacial injuries during the 5-year period from 1946-51 and 1982-6 treated at the University Clinic for Maxillofacial and Oral Surgery in Ljubljana]. PMID- 3508989 TI - [Treatment of fracture of facial bones at hospital in Celje from 1981-1987]. PMID- 3508990 TI - [Development of oral surgery in Maribor]. PMID- 3508991 TI - [Oral surgical activity in the region of Novo Mesto]. PMID- 3508992 TI - [Oral surgery in Pomurje]. PMID- 3508993 TI - [Presentation of oral surgery activity in the region of Koroska]. PMID- 3508994 TI - [25 years of experience in treatment of bilateral clefts with the Celesnik method]. PMID- 3508995 TI - [The purpose and the effects of the presurgical orthopedic treatment of children with complete cleft of the lip, alveolus and palate]. PMID- 3508996 TI - [40 years of aesthetic surgery at our clinic]. PMID- 3508997 TI - [Clinical experience with double metal-porcelain transdental implant of domestic production]. PMID- 3508999 TI - [A case of an operative separation at a fusion of an upper lateral incisor with a supernumerary tooth]. PMID- 3508998 TI - [What to do with impacted teeth?]. PMID- 3509000 TI - [Diseases of salivary glands]. PMID- 3509001 TI - [Anaesthesia at extensive operations in maxillofacial surgery]. PMID- 3509002 TI - [Sanitary measures at dentistry institutions]. PMID- 3509003 TI - [Cytodiagnosis using fine-needle aspiration in otorhinolaryngologic pathology]. PMID- 3509004 TI - [Fine needle aspiration in otorhinolaryngologic pathology. Cases and results]. PMID- 3509005 TI - [Fine needle aspiration in otorhynolaryngologic pathology. Cases and results at the Desenzano del Garda Hospital]. PMID- 3509006 TI - [Eustachian tube surfactant: morphology, physiopathology and pharmacologic aspects]. PMID- 3509007 TI - [Presence of phospholipid material in the eustachian tube epithelium of rabbits]. PMID- 3509008 TI - [Identification and determination using HPLC of phospholipids present in the lavage fluid of the Eustachian tube of rabbits]. PMID- 3509009 TI - [Incorporation of labeled phospholipids in Eustachian tube surfactant]. PMID- 3509010 TI - [Surfactant in the upper airways: a preliminary plan of study]. PMID- 3509011 TI - Detection of atmospheric OH radicals. AB - The detection of atmospheric OH radicals by laser long path absorption spectroscopy is described. This technique is specific to OH and easily calibrated. In various field measurements from below the detection limit (5*10(5)/cm3) up to 8.7*10(6) OH radicals/cm3 have been observed. Measurements of meteorologic parameters and mixing ratios of other trace gases simultaneously with OH allow comparison of observed OH levels with reaction kinetic model calculations. PMID- 3509012 TI - Botulinum A-toxin treatment of spasmodic entropion of the lower eyelid. PMID- 3509013 TI - Pre- and postoperative evaluation of diplopia and ocular motility in patients with orbital fractures. PMID- 3509014 TI - An epidemiological study on actinic effect of light in Sardinia. PMID- 3509015 TI - Evaluation of macular function by laser interferometry. PMID- 3509017 TI - Preliminary reports on the 8 mm Galand disc lens. PMID- 3509016 TI - Vertical anterior capsulotomy for extracapsular cataract extraction. PMID- 3509018 TI - Pain after intra-ocular operations. PMID- 3509019 TI - The rehabilitation of pilocarpine. PMID- 3509020 TI - Unilateral Peters' syndrome. PMID- 3509021 TI - Regional choroidal atrophy and alopecia. A new syndrome. PMID- 3509022 TI - Post-photocoagulation retinitis. PMID- 3509023 TI - Ruthenium applicators in the treatment of choroidal melanomas. PMID- 3509024 TI - [Malignant glioma of the chiasma in adults]. PMID- 3509025 TI - Haemangioma of the optic disc or hyperplasia of the pigment epithelium. A clinicopathological correlation. PMID- 3509026 TI - The retinotoxic effects of oncological agents. PMID- 3509028 TI - [Human dirofilariasis: observation of an ocular form]. AB - Several cases of human dirofilariasis has been recently reported in literature; the localization of parasite was especially in subcutaneous tissues. A case of ocular dirofilariasis observed in a woman living in a country near Turin is described. The worm was an immature female with characters in agreement with the description of Dirofilaria conjunctivae (Addario, 1885), nematode responsible of an high percentage of canine filariasis. PMID- 3509027 TI - [Immunologic characteristics of a polyvalent vaccine]. AB - A lot of bacterial vaccines show a very interesting immunostimulating profile. The AA. studied the effects of a polyvalent vaccine on the phagocytosis, on the cellular immunity and on the IgA production. They also investigated its capacity to reactivate the response to the C tetani toxin (Booster effect), both "in vitro" and in human volunteers. The results show a significant improvement in the immunity response to specific and aspecific stimuli. PMID- 3509029 TI - Rapid dot-immunobinding for detecting antibodies to Toxoplasma gondii in human serum. AB - A modified dot-immunobinding assay is described for the rapid, specific and reliable screening of human sera for Toxoplasma gondii immunity status. This simple, rapid and sensitive assay proved to be a practical diagnostic technique since it can be performed in 3 hours employing a small amount of antigen (0.3 micrograms/microliters). PMID- 3509030 TI - [Cefonicid toxicity. I. Effects on the reactivity of the specific immune system]. AB - The degree of toxicity of the antibiotic Cefonicid on the cellular reactivity of the immune system was evaluated. The effects on some lymphokine (IL-2 and IFN gamma) production and the degree of proliferation of splenic lymphocytes following mitogen stimulation have been considered. Our results show that Cefonicid does not impair the immune response, except at very high doses (500 micrograms/ml). PMID- 3509031 TI - [Aztreonam: monocenter microbiological study with prevention experience in surgery]. AB - Aztreonam is a monobactam antibiotic active against aerobic gram-negative bacteria. The susceptibility of 127 urinary tract isolates to aztreonam, cefotaxime, cefonicid and ceftazidime was determined. Aztreonam showed good antibacterial activity even against Pseudomonas spp. Only 7 bacterial strains were resistant to aztreonam. The clinical efficacy and pharmacokinetics of aztreonam were assessed in two patients treated for urinary tract infections. The concentrations of aztreonam in serum and urine are reported. Aztreonam safety was evaluated on 20 patients given aztreonam immediately prior to an elective abdominal, urinary or gynecological operation. The results provide support for the use of aztreonam for prophylaxis. PMID- 3509032 TI - [Antibiotic resistance at a hospital environment. Observations from 1980 to 1986]. AB - A total of 1659 bacteria Strains were examined for susceptibility to different drugs by the Kirby-Bauer method. The isolates came from the General Medicine ward of Castellamonte's hospital (USSL 40). The results were retrospectively studied and statistically elaborated. The study lasted from 2 to 7 years depending on the antibiotic considered. The isolates included: Escherichia coli, Klebsiella spp., Serratia spp., Citrobacter spp., Proteus mirabilis, Proteus IND+, Pseudomonas aeruginosa, Pseudomonas spp., Staphylococcus aureus, Staphylococcus spp., Streptococcus faecalis. Penicillines, Cefalosporines, Aminoglycosides, Quinolones, Tetraciclines, Nitrofurantoin, Macrolides, Rifampins, Lincosides and peptide antibiotics were tested. The results of this study can be useful for the choice of the antibiotics in non-specific therapy of infectious diseases and show the frequency of isolation of resistant strains from hospitalized patients. Furthermore it would be important to constitute a regional-epidemiological centre of Infectious Diseases. PMID- 3509033 TI - [Stability of specific antibodies in blood collected on filter paper disks]. AB - Immunoglobulin G (IgG) and M (IgM) stability in serum samples collected on filter paper disks and stored at different temperatures was evaluated. IgG and IgM concentration measured by immunonephelometry was fairly stable for 4 weeks at 4 degrees C, whereas it decreased to about 50% of total at room temperature and at 37 degrees C. By ELISA, no significative loss in antibody activity of IgG was observed after 6 months at 4 degrees C. At 37 degrees C the loss was greater but still acceptable. Antibody activity of IgM decreased more rapidly than that of IgG: IgM were stable at -20 degrees C, whereas had a significative loss of activity after 5 weeks both at 4 degrees C and 37 degrees C. Finally, it is to note that a storage in saturated water vapour seems not to interfere with immunoglobulins stability. PMID- 3509034 TI - Prevalence of hepatitis B surface antigen and antibody in the Cook Islands with reference to difference in rates between islands. PMID- 3509035 TI - A case of duodenal leiomyoma. PMID- 3509036 TI - Prevention of cerebral vasospasm: experimental studies on the degradation of oxyhemoglobin by ascorbic acid. PMID- 3509037 TI - Leukemic colony formation from patients with acute leukemia: evidence of the identity in karyotype of the colonies from patients with cytogenetic abnormalities. PMID- 3509038 TI - [Current trends in AIDS research]. PMID- 3509039 TI - [29th meeting of the Japanese Society of Nephrology. Tokyo, 13-15 November 1986. Proceedings]. PMID- 3509041 TI - The management of advanced malignant disease. PMID- 3509040 TI - The epidemiology of hypertension. PMID- 3509042 TI - Multiple sclerosis. PMID- 3509043 TI - The surgery of stroke. PMID- 3509044 TI - [A longitudinal study using the survival table method in carcinoma of the oropharynx]. PMID- 3509045 TI - [Our experiences concerning the etiology and treatment of laryngo-tracheal stenosis]. PMID- 3509046 TI - [The stapedial reflex in multiple sclerosis]. PMID- 3509047 TI - [Rebound nystagmus: clinical aspects]. PMID- 3509048 TI - [Neurotoxicity following intra-arterial cisplatin chemotherapy: 4 cases of cranial nerve impairment]. PMID- 3509049 TI - [Temporal bone of the rabbit in the otologic microsurgery training]. PMID- 3509050 TI - Effect of erythrocyte spectrin on actin self-association. AB - The polymerization of pyrene-labelled skeletal muscle actin has been monitored in the presence of chromatographically purified spectrin dimers and tetramers. A small but consistent effect of spectrin binding on the critical concentration was observed for actin polymerized in the presence of 1 mM MgCl2. These data were analysed using the principle of linked functions. Spectrin binds exclusively to the filamentous form of actin, and thereby stabilizes F-actin with respect to the G-form. The decrease in the critical concentration for actin polymerization, in the presence of spectrin, has been shown to be consistent with an equilibrium constant for the binding of spectrin to individual promoters within F-actin of approximately 8 X 10(5) M-1 at 23 degrees C, and an ionic strength of 7 mM. PMID- 3509051 TI - Structural differentiation and fluid reabsorption in the ductuli efferentes testis of the rat. AB - The ductuli efferentes testis of the rat form a cord which is embedded in adipose tissue. The cord is anatomically differentiated into a proximal cylindrical region, the initial zone, and an ampulla, the coni vasculosi. The initial zone contains six or seven ductuli which leave the rete testis and run in a sinuous path, roughly parallel with one another. However, the ductuli in the coni vasculosi are more sinuous than in the initial zone and they anastomose; pairs join together to form ultimately a single, common ductulus efferens. Stereological studies of paraffin sections and electron micrographs showed that the differentiation of the ductuli into two parts can be recognized at tissue and cellular levels of organization. Stereological and micropuncture studies showed that the ductuli efferentes reabsorb most of the fluid leaving the testis and it was concluded that most reabsorption occurred in the initial zone. It was estimated that the rate of fluid absorption is greater in the ductuli efferentes than in the proximal convoluted tubules of the kidney. The mechanism of fluid transport across the mucosa of the ductuli is considered in the Discussion. It is concluded that transport in vesicles and vacuoles could not account for the rate of fluid reabsorption and that the main mechanism of transport probably involves the coupling of water and active salt transport. PMID- 3509052 TI - The effect of long-term marrow culture on the nonadherent Philadelphia chromosome positive clone in chronic myelogenous leukemia: preliminary observations. AB - To evaluate the effect of long-term culture on the Philadelphia chromosome positive nonadherent hemopoietic clone in chronic myelogenous leukemia, bone marrow aspirates from five patients were grown in culture for three to four weeks. In addition to control cultures, samples were incubated with recombinant alpha-interferon. Cytogenetic studies performed on the nonadherent hemopoietic cells demonstrated suppression of the Philadelphia chromosome-positive clones, and appearance of cells with normal diploid karyotype in two of the five patients studied; cells from the remaining three patients showed persistent Philadelphia chromosome-positive cells in 100% of the metaphases. Exposure to alpha-interferon did not enhance the suppression of the Philadelphia chromosome-positive clones. A good correlation was noted between in vitro results and in vivo cytogenetic response: the two patients whose in vitro studies showed diploid clones achieved complete hematologic remission and suppression of Philadelphia chromosome positive metaphases with therapy. Our data suggest that long-term culture favors the growth of normal clones over Philadelphia chromosome-positive clones in the nonadherent hemopoietic cells of some patients with chronic myelogenous leukemia. The value of the procedure as an in vitro predictive test for residual normal stem cells and response to therapy and for autologous marrow in vitro purging needs further exploration. PMID- 3509053 TI - The eosinophilic variant of acute myelomonocytic leukemia developing as a secondary leukemia in a patient with mycosis fungoides. PMID- 3509054 TI - Glass ionomer bases and liners. PMID- 3509055 TI - The Willi's glas crown: a new solution in the dark and shadowed zones of esthetic porcelain restorations. PMID- 3509056 TI - Strategies of effective human resource management in the dental laboratory. PMID- 3509057 TI - A comparison of some properties of denture base acrylic resins polymerized by dry and wet curing systems. PMID- 3509058 TI - Ralph W. Phillips, M.S., D.Sc., talks about dental materials and current trends in dental technology. Interview by W. Patrick Naylor. PMID- 3509059 TI - Esthetic characterization of ceramic restorations. PMID- 3509060 TI - Removal of denture stains associated with porcelain teeth: an alternative method. PMID- 3509061 TI - Gordon J. Christensen, D.D.S., M.S.D., Ph.D. talks about new materials and techniques in dental technology. Interview by W. Patrick Naylor. PMID- 3509062 TI - The aqueous binder: Refractive Index Linked (RIL) combination building technique. PMID- 3509063 TI - The brush-on and/or integrated application of the DTC Color System. PMID- 3509064 TI - Effects of debrisoquin and haloperidol on plasma homovanillic acid concentration in schizophrenic patients. AB - Plasma levels of the dopamine metabolite homovanillic acid (pHVA) may potentially reflect upon central dopamine activity. This study examines the effects of debrisoquin, haloperidol, and the two drugs combined on pHVA concentrations of schizophrenic patients. Debrisoquin is a drug that suppresses the peripheral formation of homovanillic acid without affecting the central formation. Acute haloperidol administration consistently increased pHVA concentrations in patients pretreated or not pretreated with debrisoquin, suggesting that this increment reflects haloperidol's central and not peripheral effects. PMID- 3509065 TI - Reduced rapid eye movement latency. A predictor of recurrence in depression. AB - In this longitudinal study of 25 successfully treated depressed patients, rapid eye movement (REM) latency during an episode of depression was evaluated as a predictor of recurrence. Patients with reduced REM latency prior to treatment were more likely to develop another episode of depression during the follow-up period. PMID- 3509066 TI - The effect of melatonin on normal sleep. AB - We examined the effect of 1-mg and 5-mg oral dosages of melatonin on the electroencephalogram-recorded sleep of ten normal subjects in a randomized, double-blind design. Although high dosages of melatonin have previously been reported to be a sedative and to have behavioral effects, we could not find any change in onset or duration of sleep, or any effect on mood or alertness the following day using these low dosages. An increase in rapid eye movement (REM) latency was noted at the 5-mg dose, but no other parameter of REM sleep was changed. PMID- 3509067 TI - Neuropsychologic deficits and the risk for alcoholism. AB - The importance of genetic factors in alcoholism has prompted a search for trait or vulnerability markers of a predisposition toward this disorder. Responding to the diverse and at times persistent neuropsychologic impairments observed in alcoholics, several laboratories have documented possible neurocognitive deficits in young men with alcoholic biologic fathers. This paper begins with a review of this complex, and at times contradictory, literature and then presents original data comparing 24 sons of alcoholic fathers with 24 control subjects matched on demography and drinking histories. Among the present sample of students and working men aged 18 to 25 years, the sons of alcoholics demonstrated no significant levels of impairment on the Category Test, the Trail Making Test Part B, Body Sway, Word REcall, or the Missing Digit Test. Taken together with the literature, these negative findings call into question whether any specific array of neurocognitive or psychomotor test results will in the near future prove to be clinically relevant general markers of a risk for alcoholism. PMID- 3509068 TI - Modulation of gamma-aminobutyric acid uptake of rat brain synaptosomes by thyroid hormones. AB - The effects of thyroid hormones on gamma-aminobutyric acid (GABA) uptake were compared in homogenates and purified synaptosomes from rat cerebral cortex. L triiodothyronine (T3) and L-thyroxine (T4), but not reverse T3(rT3), blocked GABA uptake in homogenates when hormone and labeled GABA were added to the system simultaneously. Similar effects were obtained when homogenates were preincubated with hormone and washed to remove free hormone before addition of GABA. A competitive inhibitor of neuronal GABA uptake, diaminobutyric acid (DABA), blocked GABA uptake when added with GABA, but not after preincubation and washing. In purified synaptosomes, T3, T4, and rT3 blocked GABA uptake when added simultaneously with GABA and also after preincubation and washing before addition of GABA, thus indicating that binding of hormones had occurred. Other experiments suggested that hormone binding was not at the GABA recognition site and that the effect of T4 was not dependent on conversion to T3. PMID- 3509069 TI - Amphetamine alteration of amplitude and timing of cortical-neostriatal interactions. AB - Amphetamine (0.1 to 5.0 mg/kg, IV) altered frontal cortex stimulation evoked neostriatal potentials in rats. The amplitude of wave P1, which corresponds to an initial intracellular excitatory postsynaptic potential, was reduced, as was the latency to wave N3, which corresponds to the late rebound depolarization. Repetitive electric stimulation of the mesencephalic reticular formation at low currents (0.05 to 0.5 mA, 0.2-ms duration, 60 Hz square waves) produced similar effects. The peripherally acting sympathomimetics, norepinephrine (3 and 10 micrograms/kg, IV) and vasopressin (10 mU/kg, IV), increased blood pressure but did not alter the neostriatal evoked response. In rats with medial thalamic lesions induced by kainic acid, wave N3 was eliminated, and the effects of amphetamine and mesencephalic reticular formation stimulation on neostriatal evoked responses were reduced or eliminated. Thus many of the effects of systemic amphetamine on frontal cortex evoked neostriatal potentials may be mediated via extrastriatal sites, including the mesencephalic reticular formation and the medial thalamus. PMID- 3509070 TI - Cerebrospinal fluid neuropeptide Y in depression and schizophrenia. AB - Neuropeptide Y (a recently discovered brain peptide that is colocalized with norepinephrine within some adrenergic central nervous system neurons) was measured in the cerebrospinal fluid (CSF) from patients with major affective disorder, chronic schizophrenia, and in normal volunteers. No differences between diagnostic groups were found, suggesting that if this neuropeptide is involved in the pathogenesis of these disorders, an abnormality is not detectable in the CSF. PMID- 3509071 TI - In vitro corrosion of Ag-Pd-Cu-Au alloy in 0.9% NaCl solution. Part 1. Surface analysis of corrosion products. PMID- 3509072 TI - Bending strength of various composite resins. PMID- 3509073 TI - Three distinguishable phase changes during slow-cooling in commercial dental alloys for porcelain bonding. PMID- 3509074 TI - Microleakage of amalgam restoration with adhesive resin cement lining, glass ionomer cement base and fluoride treatment. PMID- 3509075 TI - Application of polarization resistance method to the corrosion rate measurement of Ni-Cr alloys. PMID- 3509076 TI - Photochemical studies on composite resins cured by visible light. PMID- 3509077 TI - Effects of laser irradiation on dentin. I. Effect on smear layer. PMID- 3509078 TI - An improved bite gauge. KOM gauge. PMID- 3509080 TI - Wear of posterior composite resins. PMID- 3509079 TI - Mechanical and physical properties of 2, 2'-Bis (4-methacryloxy polyethoxyphenyl) propane polymers. PMID- 3509081 TI - Pore structures and mechanical properties of the porous Zr-Ti implants. PMID- 3509082 TI - Evaluation of a new adhesive liner as an adhesive promoter and a desensitizer on hypersensitive dentin. PMID- 3509083 TI - [Proposal of the biological monitoring of inhalation anesthetics]. AB - The long-term occupational exposure to inhalation anaesthetics might represent a health hazard; mainly it may have an adverse effect on the reproductive outcome. Nitrous oxide is the anaesthetic employed in the largest amount during general anaesthesia and it can be used as an indicator of occupational exposure to all the components the mixture; but if the pattern of dispersion of them (when leaking into the operating theater) are not the same, two indicators should be used: N2O (gas) + another component the mixture (vapour). Our results concern practically 5 points: --Analysis of N2O by means of a diffusive personal sampler (comparison with a conventional sampling method) --Analysis of N2O in urine collected after 4 hours of exposure during routine anaesthetic work (headspace method) --Comparison of environmental and biological data concerning N2O - Comparison of environmental and biological data concerning a component of the anaesthetic mixture, forane --Proposal of biological exposure indices for nitrous oxide and forane. A close relationship between air and urine was found in 363 subjects occupationally exposed to N2O and 45 subjects exposed to forane (r: 0.95 and 0.90 respectively). On the basis of such a relationship the biological exposure index for N2O corresponding to an ambient concentration of 100 ppm (European limit) turned out to be 55 micrograms/L; the ones for forane corresponding to ambient concentrations of 2 or 10 ppm are respectively 3.4 or 14.5 micrograms/L (urinary concentrations in samples collected after 4 hours of exposure). PMID- 3509084 TI - The effect of prolonged occupational exposure to the low concentrations of nitrogen oxides in combination with ammonia on chronic bronchitis and the lung function. AB - The purpose of this study was the assessment of the effect of low concentrations of nitrogen oxides and ammonia on the appearance of the chronic bronchitis symptoms and lung function. The material in total consisted of 183 workers employed in the Chemical Factory in Tarnow (Poland). The study methods encompassed the environmental factors in all places of work and the questionnaire based interviews with the lung function testing of the workers. The results obtained prove that prolonged effect of the exposure to nitrogen oxides, even below the accepted safety level, causes a more frequent appearance of chronic bronchitis symptoms and lower FMF values. This may signal the narrowing of bronchiole as a result of the exposure to nitrogen oxides, independent of the effects on the mucous membranes of the bronchi, demonstrated by the excessive prevalence of chest symptoms. There is no reason to believe, as based on the results of this study, that the effects of nitrogen oxides could be in any way dependent on the tobacco smoking or on the accompanying concentrations of NH3. PMID- 3509085 TI - [Health status of shift workers in oil refineries]. AB - Within a cross-sectional epidemiologic study in an oil refinery the "mean health score" in shift and daily workers was estimated, following a method developed by the authors and based on the mean health score technique processed by M. Koller for an Austrian refinery. No significant difference was observed in the mean health score between the shift-workers and the daily-workers. However analysis of the results shows, some meaningful trends to be considered: the mean health score would seen higher in shift-workers than in daily ones for lower class of age (30; 30-40 years), while an inverse trend is observed in higher class of age. In the Austrian refinery the shift-workers mean health score is uniformly lower in all class of age. The difference observed in the study refinery could be due to the lower class of length of employment of the young shift workers with regard to the young daily ones, while in the Austrian refinery the greater damage for the shift workers state of health could be due to a greatly more irregular shift with less adaptability. PMID- 3509086 TI - Fellowship training in geriatric psychiatry. PMID- 3509088 TI - Use of words to describe aged or elderly: a factor analysis. PMID- 3509087 TI - A problem-based, student-centered approach to teaching geriatrics in the classroom. PMID- 3509089 TI - The effects of cognitive and behavioral strategies in enhancing behavioral functioning among residents of a nursing home. PMID- 3509090 TI - Retailing students learn about gerontology. PMID- 3509091 TI - Implementing student field placements in aging. PMID- 3509092 TI - Family medicine and primary care internal medicine residents' attitudes toward care of the elderly. PMID- 3509093 TI - A programmatic framework for designing gerontological field practical in community senior centers. PMID- 3509094 TI - Inpatient geriatric consultative teams. PMID- 3509095 TI - A comparison of graduates with bachelor's and master's degrees in gerontology. PMID- 3509097 TI - Practitioner perceived needs as the basis for university gerontology programming. PMID- 3509096 TI - Functional assessment and housestaff behavior with the elderly. PMID- 3509098 TI - [Clinical and epidemiological study of asymptomatic autoimmune thyroiditis]. PMID- 3509099 TI - [A case of non-secretory multiple myeloma showing definite bone healing]. PMID- 3509100 TI - [Leiomyosarcoma of the inferior vena cava with Budd-Chiari syndrome]. PMID- 3509101 TI - [A case of systemic lupus erythematosus complicated with vascular occlusion of the aorta and renal artery]. PMID- 3509102 TI - [Light synchronization of the circadian rhythm of blood pressure and plasma cortisol concentration in a case of Shy-Drager syndrome in an apallic state]. PMID- 3509103 TI - [Primary malignant lymphoma of the brain following immunosuppressive therapy of systemic lupus erythematosus]. PMID- 3509104 TI - [A case of Sjogren's syndrome associated with hypokalemic myopathy due to glycyrrhizin]. PMID- 3509105 TI - [Asymptomatic primary biliary cirrhosis (A-PBC) associated with so-called "Hashitoxicosis"]. PMID- 3509106 TI - Effects of low-pull traction to the mandibular first molars on craniofacial growth in Macaca irus monkey. PMID- 3509107 TI - Experimental periodontitis. PMID- 3509108 TI - Endodontic therapy for a permanent maxillary lateral incisor having two roots. PMID- 3509109 TI - Proceedings of the International Symposium on Insect Physiology, Biochemistry and Control. Rio de Janeiro, Brazil, November 10 to 13, 1987. PMID- 3509110 TI - The vitellogenin gene family of Aedes aegypti. AB - We have been interested in identifying genes that play a role in reproduction of the mosquito Aedes aegypti. Our interests are currently focused on the vitellogenin genes which in the mosquito are expressed only in the fat body in response to the insect steroid hormone, 20-hydroxyecdysone. Four of the five vitellogenin genes in the genome have been cloned. We have examined the relationships between these genes and find that they form a small gene family exhibiting different levels of relationship. PMID- 3509111 TI - The study of insect blood-feeding behaviour. 2. Recording techniques and the use of flow charts. AB - This paper continues a discussion of approaches and methodologies we have used in our studies of feeding in haematophagous insects. Described are techniques for directly monitoring behaviour: electrical recording of feeding behaviour via resistance changes in the food canal, optical methods for monitoring mouthpart activity, and a computer technique for behavioural event recording. Also described is the use of "flow charts" or "decision diagrams" to model interrelated sequences of behaviours. PMID- 3509112 TI - The potassium impermeable apical membrane of insect epithelia: a target for development of safe pesticides. AB - Columnar cell apical membranes (CCAM) in series with goblet cell apical membranes (GCAM) form an electroosmotic barrier separating the midgut lumen from epithelial cell cytoplasm. A unique K+ ATPase in GCAM generates three gradients across this barrier. A greater than 180 mV electrical gradient (lumen positive) drives amino acid uptake through voltage-dependent K+ symports. A greater than 1000-fold [H+] gradient (lumen alkaline) and a greater than 10-fold [K+] gradient (lumen concentrated) are adaptations to the high tannin and high K+ content, respectively, in dietary plant material. Agents which act on the apical membrane and disrupt the PD, H+, or K+ gradients are potential insecticides. Insect sensory epithelia and mammalian stria vascularis maintain similar PD and K+ gradients but would not be exposed to ingested anti-apical membrane insecticides. Following the demonstration by Sacchi et al. that Bacillus thuringiensis delta endotoxin (Bt) induces specifically a K+ conductance increase in CCAM vesicles, we find that the K+ channel blocking agent, Ba2+, completely reverses Bt inhibition of the K+-carried short circuit current in the isolated midgut of Manduca sexta. Progress in characterizing the apical membrane includes finding that fluorosulfonylbenzoyladenosine binds specifically to certain GCAM polypeptides and that CCAM vesicles can be mass produced by Ca2+ or Mg2+ precipitation from Manduca sexta midgut. PMID- 3509114 TI - Reducing your collection costs. PMID- 3509113 TI - On the mechanism of sphingomyelin interaction with solubilized membrane proteins. AB - Studies on the high-affinity receptor for IgE from rat basophilic leukemia cells (RBL-2H3) have shown that the phospholipid sphingomyelin remains attached to the protein complex during washing of the affinity immobilized complex under solubilizing conditions. Here we extended these findings and compared the species distribution patterns in sphingomyelin and phosphatidylcholine of the receptor bound lipids to those of the plasma membrane lipids. FC epsilon-receptor-bound sphingomyelin but not phosphatidylcholine was enriched in long-chain fatty acids. We then examined other membrane proteins with respect to sphingomyelin enrichment. RBL-2H3 cell surface proteins, immobilized on concanavalin A Sepharose and washed under solubilizing conditions, also showed a two- to six fold enrichment in the associated sphingomyelin. Similar observations were also derived from other cell types, such as the mouse fibroblast cell line A-9 and the pig kidney epithelial cell line PK-1. Since this has been observed in all the three cell sources, it was suggested that sphingomyelin enrichment in FC epsilon receptor preparations, although reproducible, was not specific for this protein. That this phenomenon was not specific for a particular protein might also be concluded from experiments that have shown nonhomogenous distribution of sphingomyelin in protein-free lipid-detergent mixtures. These results are compatible with a model whereby the interaction between sphingomyelin and soluble membrane proteins results from preference to nonmicellar phases or to structures with extended hydrophobic domains, probably due to the imperfect fitness of the detergent micelles to properly accomodate these lipids. This feature makes long chain sphingomyelin a plausible candidate for the lipid responsible for the stabilizing effect that crude lipid preparations exert on the structural and functional properties of some membrane protein, e.g., FC epsilon R. PMID- 3509115 TI - Kawasaki disease presenting in an adult as inflammatory diarrhea. PMID- 3509116 TI - Transient pancytopenia as an initial manifestation of hereditary spherocytosis. A case report. PMID- 3509117 TI - Cervical conization. Laser vs. cold knife. PMID- 3509118 TI - A stand against drug testing. PMID- 3509119 TI - Missouri's medically indigent. PMID- 3509120 TI - The telephone: servant or tyrant--you decide. PMID- 3509121 TI - Nose pain and syncope in a patient with coronary artery disease. PMID- 3509122 TI - Diabetic neuropathic cachexia and hypothyroidism in a woman. PMID- 3509123 TI - Back office tips. PMID- 3509124 TI - Acquired methemoglobinemia. A case report. PMID- 3509125 TI - Juvenile polyposis. Not always a benign, self-limiting disease. PMID- 3509126 TI - How to meet the competition. PMID- 3509127 TI - Endoscopic sinus surgery. A functional approach. PMID- 3509128 TI - Neurotropic melanoma of the head and neck. PMID- 3509129 TI - Severe head injury. Stabilization and neurological evaluation. PMID- 3509130 TI - America's health policy agenda. PMID- 3509131 TI - Time management. PMID- 3509132 TI - Primary melanoma of the esophagus. A case report. PMID- 3509133 TI - Water vapor sorption of water-soluble substances: studies of crystalline solids below their critical relative humidities. AB - Water vapor sorption on unground and ground samples of sodium chloride and sodium salicylate at relative humidities below RHo, that at which deliquescence is initiated, has been measured. Sorption isotherms, expressed as the amount sorbed per unit area of solid surface, were different for unground and ground samples. Measurement of specific surface area for samples previously exposed to various relative humidities revealed no change with unground samples but a significant reduction with ground samples beyond about 20% relative humidity. Correcting isotherms for this change in area brings the results with ground and unground samples into closer agreement. These studies reveal that relatively low levels of water vapor sorption on crystalline water-soluble solids, below RHo, can give rise to some form of "surface dissolution" when the solid had been subjected to various forms of mechanical disturbance. PMID- 3509134 TI - Identification of prescription drugs in adulterated Chinese herbal medications. AB - Analytical difficulties involved in the detection of a wide range of suspected polar and nonpolar drugs in botanical matrices have been solved by adopting a multipronged approach. Preliminary screening of Chinese herbal medications can be accomplished by a combination of thin-layer chromatography and gas chromatography/mass spectrometry and/or the employment of liquid chromatography/mass spectrometry as a probe introduction technique. PMID- 3509135 TI - Prostaglandin derivative PGBx improves neurologic recovery after ischemic spinal injury. AB - Neurological dysfunction resulting from an ischemic insult in the central nervous system (CNS) is believed to be an indirect outcome of impaired energy production. Recent studies suggest that prostaglandin Bx (PGBx), an oligomer of PGB1 and 15 keto-PGB1, may be beneficial in protecting mitochondrial function after ischemic insults by preventing uncoupling of oxidative phosphorylation. In the present study, PGBx had a significant influence on neurological outcome after ischemic injury in the rabbit spinal cord. These findings suggest that PGBx may be beneficial in the treatment of CNS ischemic injuries. PMID- 3509136 TI - A high-performance liquid chromatographic microassay employing a liquid-solid extraction technique for etintidine in plasma. AB - This paper describes a new, rapid solid extraction method for the determination of etintidine in plasma. The method employs a semiautomatic sample preparation system. Plasma samples and the internal standard (cimetidine) were applied onto octyl-bonded silica extraction columns. The extraction columns were then subjected to Tris buffer and water wash and were subsequently loaded onto an automatic sample injection system. The contents of the extraction columns were eluted on-line with a mobile phase of acetonitrile:methanol:0.1% ammonium hydroxide (85:10:5, by volume) onto a silica analytical column and detected by UV absorption at 229 nm. The chromatographic condition separates etintidine from some of its metabolites and other endogenous components in plasma. The detection limit for etintidine was 0.02-0.05 microgram/ml when 0.2 ml of plasma was used. This method has been used for the determination of plasma etintidine levels in humans and mice after oral administration of etintidine and was found to be suitable for pharmacokinetic/bioavailability studies of etintidine in humans and animals. The method can also be used for the quantitative determination of cimetidine and certain metabolites of etintidine. PMID- 3509137 TI - The solid-state decarboxylation of the diammonium salt of moxalactam. AB - This paper reports studies of the solid-state chemistry of the diammonium salt of moxalactam. The methods employed include X-ray crystallography, molecular mechanics calculations, thermogravimetric analysis, and high-pressure liquid chromatography. The crystal structure shows that the malonic acid amide functionality in crystals of the diammonium salt is not planar. If the common decarboxylation mechanism is operating, then considerable rotation would be required for this functionality to attain coplanarity. Simultaneous HPLC and thermogravimetric analysis studies indicate that the decarboxylation of the diammonium salt of moxalactam is preceded by desolvation. Molecular mechanics calculations indicate that the barrier to rotation of the malonic acid amide functionality is relatively small in the dehydrated crystals, perhaps explaining the facile decarboxylation of this antibiotic. Alternatively, the amorphous desolvated crystals may allow enough molecular freedom for the malonic acid amide functionality to attain coplanarity and decarboxylate. PMID- 3509138 TI - Binding of basic drugs to rat lung mitochondria. AB - The role of the mitochondria in the accumulation of basic amine drugs in the rat lung was studied. Drug binding to the mitochondria was rapid and reached maximum levels after 2.5 min of incubation. Lipophilic basic drugs accumulated in the mitochondria more than nonlipophilic basic drugs and nonbasic drugs, and the accumulation was dose dependent. Schatchard plots revealed at least two independent sets of binding sites for basic drugs in the mitochondria. The binding was competitively inhibited by other basic drugs but not nonbasic drugs. The degree of inhibition by competing basic drugs was correlated with their lipid solubilities. These findings with isolated mitochondria agree with previous results obtained with the perfused lung preparation and indicate that the mitochondria play an important role in the accumulation of basic drugs in the lung. PMID- 3509139 TI - Influence of tablet dissolution on furosemide bioavailability: a bioequivalence study. AB - In order to evaluate the in vitro dissolution and in vivo bioavailability relationship for furosemide, a bioequivalence study was carried out. Furosemide (40 mg) was administered orally to 12 normal volunteers in a 6 x 6 crossover design using six products (five tablets and one solution) obtained from three pharmaceutical companies. Plasma and urine concentrations of furosemide were quantitated by high-performance liquid chromatography (HPLC). Plasma furosemide profiles were analyzed by non-compartmental methods. Compared to the oral solution, all of the formulations exhibited lower peak furosemide concentrations, longer mean residence times, and, in some cases, diminished bioavailability (range, 66-96%). Similar results were obtained when the reference product (a rapidly dissolving tablet) was used as the standard. All of the products failed the 75/75 rule when compared to either reference standard, apparently because of large intersubject variability. The total amount of furosemide excreted in urine could be associated with the percentage drug dissolved (in vitro) at 30 min. The pH 5.6 dissolution medium (compared to pH 4.6) appears to be an appropriate test medium for assuring batch uniformity and bioequivalence of furosemide products. PMID- 3509140 TI - A novel method for the synthesis of kyotorphin, Tyr-Arg, and 3H-Tyr-Arg, catalyzed by tyrosyl-tRNA synthetase from Bacillus stearothermophilus. AB - A novel method of dipeptide synthesis is described that can be carried out in aqueous solution and does not require complicated protecting and deprotecting procedures. An analgesic neuropeptide named kyotorphin, H-Tyr-Arg-OH, was synthesized from unprotected tyrosine and arginine in a new enzymatic reaction catalyzed by immobilized tyrosyl-tRNA synthetase from Bacillus stearothermophilus. The reaction could be a useful tool in the syntheses of radioisotope-labeled oligopeptides to be used in receptor binding assays. 3H Kyotorphin was prepared by this method at a yield of 72% and could be used in receptor binding assays after a single chromatographic separation. PMID- 3509141 TI - Phenolic cyclization of epinephrine, metaproterenol, metaraminol, phenylephrine, and terbutaline with formaldehyde. AB - An exploratory study of the rates of cyclization of the title compounds, all 3 hydroxyphenalkanolamines, with formaldehyde to 1,2,3,4-tetrahydroisoquinolines (THIQs) was performed using high-performance liquid chromatographic (HPLC) methods. Reactions occur quantitatively and practically instantaneously at room temperature and neutral pH; thus, rates were measured at acid pH. Cyclization occurs ortho or para to the 3-phenolic function, so that all but the 3,5 dihydroxyphenyl derivatives, metaproterenol and terbutaline, gave two THIQs. Terbutaline reacted significantly slower than the other compounds. Formaldehyde occurs in pharmaceutical systems and it serves as a model for other aldehydes that occur in sugars and flavors. The pharmaceutical implications of the reaction are discussed. PMID- 3509142 TI - Synthesis and pharmacological activity of N-alkyl-1,2-diphenylethanolamines. AB - A series of N-alkyl-1,2-diphenylethanolamines were synthesized and their pharmacological activities evaluated on various mammalian organs and systems. All compounds produced a generalized inhibitory effect on smooth and cardiac muscles and an increase in coronary flow as well as a brief reduction in rabbit blood pressure. The latter effect was not prevented by pretreatment of the animals with atropine, propranolol, or metoprolol. The compounds were devoid of local anesthetic activity and their inhibitions of the contraction of the isolated rabbit intestine and perfused heart were reversed by exogenous calcium ions. It is proposed that the compounds produce their effects through calcium-channel blockade. The inhibitory effects of some of these compounds were comparable to those of a known calcium-channel blocker. PMID- 3509144 TI - Managing potential conflicts of interest in university-industrial partnerships. PMID- 3509143 TI - In vitro and in vivo interactions of furosemide and sucralfate. PMID- 3509145 TI - The pathology and treatment of interstitial pneumonitis in two infants with AIDS. AB - Two infants with AIDS who presented with interstitial pneumonitis, failure to thrive, lymphadenopathy, and hypergammaglobulinemia have been studied. Antibody to human T-lymphotropic retrovirus (HTLV-III) was identified by ELISA and Western blot analysis in serum samples from both patients. The T4/T8 ratios of peripheral blood T-lymphocytes in both patients were mildly decreased, with normal absolute numbers of lymphocytes and positive T4 cells. Lung biopsies from both patients demonstrated similar histopathologic features with features of lymphocytic interstitial infiltrates and accumulation of macrophages in the air spaces. Immunoperoxidase studies of the lung biopsy from 1 patient revealed that the lymphocytic infiltrate was composed predominantly of T cells of the T8 subset. Each patient was treated with prednisone, with improvement or resolution of pulmonary symptoms, hepatosplenomegaly, lymphadenopathy, and growth failure. Neither patient has had any opportunistic infections. One patient has been followed for more than 4 years and the other for 8 months. PMID- 3509146 TI - Diagnosis of thoracic splenosis by tru-cut needle biopsy. AB - We present a case of thoracic splenosis diagnosed by tru-cut needle biopsy, which yielded histologically normal splenic tissue. This is the first report of a diagnosis of thoracic splenosis by needle biopsy. The patient had a history characteristic of thoracic splenosis. Autotransplanted splenic tissue functions and may provide some defense against serious infections. A conservative approach to diagnosis offers the advantages of preserving splenic tissue and avoiding thoracotomy. PMID- 3509147 TI - A look from the inside. PMID- 3509148 TI - Evaluation of impairment/disability secondary to respiratory disorders. American Thoracic Society. PMID- 3509149 TI - Reference equations for the single-breath diffusing capacity. PMID- 3509150 TI - [The teaching of nuclear medicine at medical schools]. PMID- 3509151 TI - [Intra-arterial chemotherapy of metastatic liver tumors and tumors in the sub hepatic area]. PMID- 3509152 TI - [Post-irradiation changes in the in vitro incorporation of 32P into phospholipids in blood platelets]. PMID- 3509153 TI - [The effect of benflurone (VUFB) on the growth of human rectal carcinoma xenotransplanted into athymic nu/nu mice]. PMID- 3509154 TI - [Hemostatic effect of traumacel P in rats]. PMID- 3509156 TI - [Proceedings: "Competencies and responsibilities of the physician and medico legal obligations in the health surveillance of workers. Current operational problems". Brescia, 28 February 1987]. PMID- 3509155 TI - [The effect of prostaglandin E2 (made by Spolana K.P., Neratovice) on hematologic values in rats]. PMID- 3509157 TI - [Health surveillance of workers]. AB - The paper deals with the concepts of environmental monitoring and health surveillance, which include the following tasks: biological monitoring, health information, pre-employment and periodical medical examinations. Biological monitoring permits evaluation of the degree of exposure and its early effects. The early effects can be detected with specific tests exploring initial biological alterations while the organism is still capable of compensating such changes. Application of biological monitoring requires a profound knowledge of toxicology and health surveillance in general terms requires a solid basis of occupational medicine in order to set objectives and make judgements concerning fitness for specific jobs. Details are given of the measures the occupational health physician must take and when he must take them in the case of development of an occupational disease. Particular attention is given to the removal of the subject from exposure, the first certificate of occupational disease, the notification to the Local Health Unit and the diagnosis. PMID- 3509158 TI - [The occupational health physician in the factory]. AB - In the absence of specific legislation, the role of the factory doctor is based on the employer's responsibilities and consists in practice of establishing a health surveillance programme for the exposed workers, using diagnostic protocols appropriate to the risks involved. It is important to supply information to users and the Local Health Units; the factory doctor must also be fully competent, especially for the purposes of assessment of results, which then dictate the direct measures he must take. PMID- 3509159 TI - [The occupational health physician in the public health structure]. AB - The paper deals with the relationship between duties and professional responsibility of the Occupational Health Physician in the Local Health Units. The Local Health operating in the field of Health protection in the workplace must guarantee: - generally acceptable management both qualitatively and quantitatively as regards knowledge and actions in the respective territories; up dating of the information system in order to plan and check actions according to the degree and extent of risks in all possible working environments: industry and agriculture, service industry, construction industry, ect., and according to the health status of the working population. - unequivocal, timely and scientifically correct information of the public. The Health Protection in the Workplace Units should be responsible for these duties, transforming them into objective planning choices and setting up operative models of action based on typically interdisciplinary activities and tasks. In our opinion, health practice in community service should be mainly of an epidemiological and organisational nature rather than diagnostic and clinical. The main activities are therefore: - control and coordination of periodical and prescribed health examinations: the protocols must be suitable for and consistent with the risks involved and deontological and legal requirements must be respected. - establishment via epidemiological investigations of the health status of the workers in a community; this can also be achieved by means of direct health investigations (by industrial sector, by risk). - Training and information, health education. PMID- 3509160 TI - [The concept of disease and causality relations]. AB - The author recalls the doctrinal and jurisprudential evolution of the concept of disease, with particular reference to the time of onset of the pathological state during the period in which workers are under health surveillance. It is strongly recommended to provide insurance coverage in situations where the worker is transferred for purely preventive purposes and it is equally important to make a strictly accurate assessment of the relationship of causality between exposure to the pathogenic noxious agent and the onset of disease, particularly for penal law purposes. PMID- 3509161 TI - [The professional responsibility of the factory physician]. AB - The author briefly reviews the present trends in jurisprudence concerning the professional liability of the physician in penal and civil law and, in the light of the much discussed decree issued by the Court of Cassation (Court of Appeal) (Decree No. 2799/86 - Labour Section), discusses the juridical position of the factory doctor, the juridical relationship between the doctor and the workforce, his contractual obligations, his role and his duties. The aspects that are more specifically appropriate to assessment of the professional liability of the factory doctor are described, commenting on the various criteria that may justify, in matters other than industrial accidents, recognition of the existence of an occupational disease. PMID- 3509162 TI - [Tasks and responsibilities of the occupational health physician employed in health services]. AB - The paper describes and comments on the juridical role and duties of the occupational health physician operating in Local Health Units, drawing attention to the peculiar and complex structure of the health measures taken in the workplace, which must often be extended from strictly medical and preventive aims to regulations and sanctions in respect of the enterprise and obligation of notification to the legal authorities. In order to fulfill these duties of public administrator and legal inspector, the occupational health physician requires a specific and integrated cultural background, i.e., in clinical medicine and biological science, jurisprudence and forensic medicine. Such cultural background is indispensable to ensure a correct "modus operandi", where the safeguarding of health in the interests of both the individual and the community is inextricably bound up with fundamental juridical and regulatory requirements. PMID- 3509163 TI - [Obligations and penal responsibilities of physicians, especially factory doctors, in regard to the protection of workers' health]. AB - The paper comments on the role of health surveillance as a tool for the safeguarding of workers' health on the basis of constitutional principles. The author discusses the concept of health status and disease from the forensic medicine and juridical viewpoint and describes the obligations that are common to all medical practitioners (diagnosis, notification to the Local Health Unit) and the particular obligations of some categories of physicians, especially factory doctors. The responsibility of the physician in the case of crimes of omission of duty is considered. In responsibility for crimes of injury, the author deals with the professional responsibility of both the general practitioner and of the factory doctor in particular, the general liabilities of the employer, and the relationship between the liabilities of the employer and the physician. The paper conclude with comments on some aspects of negligence of the physician appointed to carry out health surveillance of the workers. PMID- 3509164 TI - [Complex evaluation of ambulatory rehabilitation of patients based on long-term observation]. PMID- 3509165 TI - [Multifactorial analysis of clinical features related to very short survival time of patients treated for acute myeloblastic leukemia]. PMID- 3509166 TI - [Changes of the serum levels of the main immunoglobulin classes in children with bronchial asthma]. PMID- 3509168 TI - [Ventricular relaxation indices and hemodynamics during a relief of cardiac tamponade]. PMID- 3509167 TI - [Clinical features of left main trunk disease. Analysis of 15 cases]. PMID- 3509169 TI - [Predisposing factors for the development of malignant essential hypertension]. PMID- 3509170 TI - [Cutaneous plasmacytoma with eventual development into multiple myeloma]. PMID- 3509171 TI - [Complete recovery from severe organic brain damage in a patient with systemic lupus erythematosus]. PMID- 3509172 TI - [13 trisomy born to a mother with galactorrhea-amenorrhea syndrome]. PMID- 3509173 TI - [A patient with gnathostomiasis exhibiting myocardial infarction due to coronary vasospasms]. PMID- 3509174 TI - [A case of metastatic leiomyosarcoma of the heart originating in the uterus]. PMID- 3509175 TI - [Acute myelocytic leukemia in two cases following exposure to asbestos]. PMID- 3509176 TI - [Periorbital ecchymoses without evidence of amyloid deposition as the initial sign in multiple myeloma]. PMID- 3509177 TI - Proceedings: International Symposium on Schistosomiasis. I reuniao nacional de esquistossomose. Rio de Janeiro, Brazil, October 25 to 30, 1987. PMID- 3509178 TI - Immunological aspects of host-schistosome relationships. AB - The complex immunological relationships between schistosomes and their vertebrate hosts are considered to be conveniently divisible into four distinct, though interrelated categories: the parasite's vulnerability to, its evasion of, and its exploitation of the host's immune response, and its stimulation of the host's immune response to produce immunopathology. Some significant recent advances in the first three categories are discussed, as well as their relationships to the fourth category of immunopathology. PMID- 3509179 TI - Competitive displacement of Biomphalaria glabrata by B. straminea. AB - Data on the interaction between populations of closely related species of Biomphalaria, B. glabrata and B. straminea, are presented in the current paper. Laboratory and field observations and experiments have shown that B. straminea has competitive advantages over B. glabrata. PMID- 3509180 TI - The significance of variation in the susceptibility of Schistosoma mansoni to the antischistosomal drug oxamniquine. AB - Clinical and laboratory evidence is reviewed which shows that there is a great deal of variation in the susceptibility of Schistosoma mansoni to oxamniquine. This variation occurs both among endemic regions and within endemic regions in Brazil and Kenya. It is genetically controlled. It is suggested that the parasite possesses a large capacity for developing resistance to the drug and that resistance will develop where sufficient drug pressure is maintained. PMID- 3509181 TI - Acetylcholinesterase of Schistosoma mansoni--an antigen of functional implications. PMID- 3509182 TI - The intermediate snail-host: an agenda for future study. AB - The strategy for the control of schistosomiasis has shifted from one directed towards the interruption of transmission to one of reducing morbidity. As a consequence of this change, it appears prudent to reassess the role of the malacologist and malacology and identify the future direction to be taken by the discipline. The present paper addresses these concerns; first, by reviewing the role of the snail-hosts in the epidemiology and control of schistosomiasis, and, secondly, by suggesting areas for future study. The possible application of newer methods in biotechnology for the resolution of malacological problems are discussed. PMID- 3509183 TI - Analysis of the interacting components between larval Schistosoma mansoni and schistosome-susceptible and resistant Biomphalaria glabrata. AB - Cell-free hemolymph (serum) and hemocytes from Schistosoma mansoni-susceptible (PR albino M-line) and resistant (10-R2) strains of Biomphalaria glabrata were compared by SDS-PAGE, immunoblotting and radioiodination. Whole serum of both snail strains is dominated by hemoglobin (Hb) (MW = 160 Kd). SDS-PAGE. of Hb depleted serum indicated that the 10-R2 strain has dominant polypeptides in the 50 to 30 Kd range whereas PR albino snails have few low MW proteins. Antibodies raised to whole PR albino and 10-R2 serum, and the 160 Kd (Hb) band reacted similarly in immunoblot assays. Analysis of hemocytes revealed that 10-R2 snails have a surface-exposed protein at about 80 Kd which is not present on PR albino hemocytes. An examination of primary cultured sporocysts indicated the presence of four major surface proteins (40, 50, 55, 70 Kd) and two minor surface-exposed polypeptides (92, 170 Kd). Antibodies raised against live, intact sporocysts reacted almost exclusively with sporocyst-surface proteins when tested by immunoblotting. PMID- 3509184 TI - Schistosoma mansoni: migration patterns in normal and immunized Swiss Webster mice, by means of autoradiographic analysis. PMID- 3509185 TI - [Health education in the control of endemic diseases]. PMID- 3509186 TI - Population dynamics of aquatic snails in Pampulha reservoir. AB - An attempt was made to determine more accurately the density of molluskan populations in the Pampulha reservoir, using the quadrate method, intending to detect the fluctuation of the populations density, the habitat conditions and the possible competitive interactions among Biomphalaria tenagophila, Melanoides tuberculata, Pomacea haustrum and Biomphalaria glabrata, through the analysis of populational parameters. Among the most significative facts observed in the reservoir it has to be mentioned: the almost disappearance of B. glabrata; the invasion, colonization, fixation and fast growing of M. tuberculata population until reaching about 11,000 individuals/m2; the density fluctuations of B. tenagophila, P. haustrum and M. tuberculata alives and deads; differences on the habitat preference of these three molluskan species at the edge (at the limit earth-water, at 0.70m and 1.40m from the shore line); monthly mortality rates and reproduction seasons of the species. PMID- 3509187 TI - Biomphalaria tenagophila feeding behavior. PMID- 3509188 TI - [Ecological observations on Biomphalaria straminea (Dunker, 1848) in areas of the northeast, Brazil]. AB - The different climatic regions determine the zoogeographic distribution of various animal species depending on their particular conditions and ecological preferences. The host schistosomiasis planorbid is one of these species. This paper deals with the distribution of Biomphalaria straminea in northeast Brazil. It starts from the analysis of different climatic peculiarities in this region, associated to limnological observation done by the author in three different hydric collections in the state of Sergipe. It has been concluded that this is an "eurioioca" species. Its broad ecological valence permits this species to survive in regions where climate asperties are evident, requiring behavior and physiological adaptations. The species survives in all northeast region, from "zona da mata", in the coast, to the semi-arid "sertao". PMID- 3509189 TI - Effects of Laurus nobilis (Lauraceae) on Biomphalaria glabrata (Say, 1818). AB - Experiments were carried out using aqueous extracts from leaves and flowers of Laurus nobilis on Biomphalaria glabrata. Treatments were performed on blastula stage (+/- 15 h after first cleavage) and on adult snails (11-18 mm). In both instances they were exposed for 24 h to different concentrations of the extracts on snails (200 to 2500 ppm) and embryos (20 to 300 ppm) at 25 +/- 1 degree C. The embryos were observed for a period of 20 days after treatment and the snails for 10 days. Results obtained with leaf aqueous extracts have shown a degree of toxicity on embryos starting at a concentration of 125 ppm, the flower extract being effective at 35 ppm. The malformation obtained with the different concentrations falls into the unespecific type category, however some cephalic and shell malformations were found in embryos treated with concentrations over 50 ppm (leaves) and 25 ppm (flowers). The LD90 on adult snails obtained by treatments with flower and leaf extract was observed at concentrations of 340 ppm and 1900 ppm respectively. PMID- 3509190 TI - [Action of a molluscacide (Bayluscide-SRB) from the Dynatech R/D Company in lakes of northeastern Brazil--Sergipe, Brazil]. AB - To study the action of molluscicide nine ponds were selected: 3 of them lying in Maruim municipality, 29 km far from north Aracaju, the State capital, and 6 ponds in Itabaianinha municipality, 118 km far from south Aracaju. This study was carried out for 16 months. Environmental parameters observed were those thought to have any influence on the planorbids and/or the molluscicide: water temperature, transparence, salinity, pH, dissolved oxygen, CO2, and the nutrients phosphorus, nitrogen, potassium and calcium. Plancton microorganisms were also considered to observe Bayluscide action on them. SRB was used in a concentration of 6.25 kg per 1.000 m3 water, to achieve 1.0 ppm Bayluscide concentration according to the producer's instruction in Massachussett-USA. PMID- 3509191 TI - Schistosoma mansoni: structural damage after treatment with oxamniquine. AB - The effects of a single dose (100 mg/kg-body weight of mouse) of oxamniquine on the worm's tegument and paranchyma in relation to the process of immunological granulomatous reaction of the host's liver are described under light and electron microscopy (EM). The lesions caused by the drug are sequentially and simultaneously described in form of swelling, surface bulble and disruption with erosions. Ulceration in the tubercules with loss of spines is often more extensive and severe in male worms and concentration of host's mononuclear cells is observed. The possible role of host's immune response is discussed. PMID- 3509192 TI - Abdominal angiostrongyliasis--an under-diagnosed disease. PMID- 3509193 TI - Some aspects of fetal biology. AB - Fetal blood sampling under ultrasound control is rapidly expanding the study of human fetal biology. Pure fetal blood is required for prenatal diagnosis, establishment of reference ranges for biologic measurements and assessment of fetal welfare. Hematological, biochemical and immunological parameters were selected on blood of normal fetuses sampled between the 18th and 36th week of gestation. They were referred to us for various prenatal diagnosis (mainly toxoplasmosis) but were well and confirmed healthy at birth. These data indicate a slower metabolism in fetuses compared to their mother, a lower level of energy requirement and a relative liver immaturity. An important point concerns the evolution of some parameters all along the pregnancy. The correlation observed between the different biological levels either in cord or maternal sera (or between both) paves the way for future studies concerning fetal metabolism. These normal values of fetal biology will improve our knowledge of physiology and help to determine the specific values of a test in fetal pathology. PMID- 3509194 TI - Measurement of the fetal urine production rate using real-time ultrasound in fetuses with bilateral hydronephrosis. AB - The fetal urine production rate (FUPR) in 147 normal fetuses after 27 weeks of gestation and 5 with bilateral hydronephrosis was measured using real-time ultrasound. Later, the correlation between FUPR and renal function was evaluated postnatally. In the normal fetuses, FUPR (mean +/- 2 SD) increased gradually from 1.9 +/- 1.6 at 27-28 weeks of gestation to 7.5 +/- 4.5 ml/10 min at 37-38 weeks of gestation. In the 5 cases with bilateral hydronephrosis, FUPR was within normal ranges and increased with advances in gestation. Intrauterine intervention was not performed in any of the cases, and, at present, renal insufficiency is nil. PMID- 3509195 TI - Congenital diaphragmatic hernia: current controversies in prenatal and postnatal management. AB - A prenatal diagnosis of congenital diaphragmatic hernia (CDH) is associated with a poor prognosis, especially if diagnosed early in gestation and associated with polyhydramnios. Although uncommon, it is important to rule out associated anomalies, so that elective termination can be considered. If CDH is an isolated anomaly, the outcome is related to the degree of pulmonary hypoplasia caused by viscera displacing the lung in utero. Unfortunately, our ability to assess lung size, and thus prognosis, is limited. Most babies with CDH either die shortly after birth or survive to lead normal lives, so that continuation of the pregnancy is extremely unlikely to produce a chronically ill pulmonary cripple. The fetus should be followed with periodic ultrasounds and delivered at a perinatal center with appropriate neonatal and surgical expertise. There is no evidence that altering the timing or mode of delivery affects outcome. The only way to alter outcome and save the severely affected fetus is to remove the viscera from the chest and allow the fetal lung to develop before birth. Despite the fact that fetal repair of CDH makes sense physiologically, however, it remains a highly experimental technique. Postnatal management of CDH involves resuscitation, paralysis, and positive pressure ventilation. The practice of emergency repair is not supported by pathophysiology, and operation should be delayed until the patient has been stabilized. Mortality is often due to pulmonary hypoplasia, but in some cases, there is a period of deterioration due to pulmonary hypertension resulting in right-to-left shunting (persistent fetal circulation). Pharmacological agents are often used to decrease pulmonary vascular resistance and increase cardiac output.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3509196 TI - Fetal echocardiography: a review of six years experience. AB - Between January 1982 and January 1988, 2,060 pregnant patients were scanned for congenital heart defects (CHD). In 76.5% of these patients, there was an increased risk of CHDs in their offspring. In this group there were 27 CHDs, 17 of which were correctly diagnosed prenatally. In the remaining 23.5% of the patients, the indication for cardiac studies was fetal pathology in the present pregnancy (fetal cardiac arrhythmia, polyhydramnios, severe intrauterine growth retardation, fetal ascites and suspected structural anomalies). In this group there were 82 CHDs, 79 of which were correctly diagnosed prenatally. The incidence of abnormal karyotype was 35%. When a CHD is diagnosed, a realistic prognosis can be given and appropriate obstetric measures taken according to the degree of disease. In cases with a good prognosis careful follow-up may be offered resulting in the delivery of an infant in optimal condition. Reassurance can be given to patients when abnormalities are excluded. PMID- 3509197 TI - A clinical basis for fluoride dentifrice use by children. PMID- 3509198 TI - [A quantitative evaluation of skeletal maturity of the orthognathous and disgnathous cases]. PMID- 3509199 TI - [The relationship between the rotational growth of the upper and lower jaw in cases with Class I, II, and III malocclusions]. PMID- 3509200 TI - [Surgical treatment of congenital palatopharyngeal incompetence]. PMID- 3509201 TI - [Osteogenesis imperfecta congenita]. PMID- 3509202 TI - [Relationship between malocclusions and speech]. PMID- 3509203 TI - [Mechanical principles in orthodontics]. PMID- 3509204 TI - [An analysis of the mandibular growth rotation]. PMID- 3509205 TI - [Science as art--art as science]. PMID- 3509206 TI - [A contribution to a better reproducibility of Bolton point]. PMID- 3509207 TI - [Physical maturity of the orthognathous and disgnathous cases]. PMID- 3509208 TI - [Correlation between indicators of biologic maturity stage in children with malocclusions]. PMID- 3509209 TI - [Effect of juvenile rheumatoid arthritis on the growth of facial skeleton]. PMID- 3509210 TI - [Results of treatment with straight wire appliance]. PMID- 3509211 TI - [An epidemiological study on the health of masticatory system in teenagers of Taiwan area]. PMID- 3509212 TI - Dental caries experience in a selected population of dental students. PMID- 3509213 TI - [Free palatal masticatory mucosal graft--saw-like extension method]. PMID- 3509214 TI - [The multiple nevoid basal cell carcinoma syndrome - a case report]. PMID- 3509215 TI - [Composite resin in operative dentistry]. PMID- 3509216 TI - [Development and pathologic progression of dissecting aortic aneurysm--a description for surgeons]. PMID- 3509217 TI - [Surgical indications in severe heart valve diseases and postsurgical prognosis]. PMID- 3509218 TI - [Surgical treatment of pulmonary atresia with ventricular septal defect]. PMID- 3509220 TI - [Treatment of recurrent esophageal cancer]. PMID- 3509219 TI - [Basic and clinical studies of tracheal and bronchial reconstruction]. PMID- 3509221 TI - [Physiopathology and treatment of multiple major organ failure developing after thoracic surgery]. PMID- 3509222 TI - [Problems and methods of the care of postoperative patients with cancer of the thoracic esophagus]. PMID- 3509223 TI - [The emergency circulatory care system]. PMID- 3509224 TI - [Care and health education of coronary patients]. PMID- 3509226 TI - [Risk factors in coronary disease]. PMID- 3509225 TI - [Epidemiology of coronary disease]. PMID- 3509227 TI - [Coronary disease prevention programs]. PMID- 3509228 TI - [Equipment and instruments used in the diagnosis and treatment of coronary disease]. PMID- 3509229 TI - [A list of drugs used in the treatment of coronary disease]. PMID- 3509230 TI - [Morphology of the coronary system]. PMID- 3509231 TI - [Pathology and physiopathology of coronary disease]. PMID- 3509232 TI - [Progress in methods of diagnosing coronary artery disease]. PMID- 3509233 TI - [Clinical presentation of angina pectoris]. PMID- 3509234 TI - [Physiology of coronary circulation]. PMID- 3509235 TI - [Clinical presentation of myocardial infarction]. PMID- 3509237 TI - [Progress in coronary surgery]. PMID- 3509236 TI - [Pharmacology of coronary circulation]. PMID- 3509238 TI - [Rehabilitation in myocardial infarction]. PMID- 3509239 TI - [Body fluids]. PMID- 3509240 TI - [Tests for water-electrolyte metabolism and acid-base equilibrium]. PMID- 3509241 TI - [Diuretics]. PMID- 3509242 TI - [Infusion fluids]. PMID- 3509244 TI - [Body fluids: recent progress in research and management. The osmoregulatory system]. PMID- 3509243 TI - [Body fluids: recent progress in research and management. The volume control system]. PMID- 3509245 TI - [Body fluids: recent progress in research and management. Acid-base equilibrium]. PMID- 3509246 TI - [Body fluids: recent progress in research and management. Water-electrolyte transport]. PMID- 3509247 TI - [Symptoms related to body fluid physiology--definition, classification, differential diagnosis, and management]. PMID- 3509248 TI - [Water-electrolyte metabolism and acid-base imbalance in major diseases]. PMID- 3509249 TI - [Bedside tests in clinical practice]. PMID- 3509250 TI - [Need and significance of bedside tests]. PMID- 3509251 TI - [Selection of bedside tests. General tests--examination of the urine, feces, pleural effusion, and ascitic fluid]. PMID- 3509252 TI - [Selection and understanding of bedside tests. Observation of general conditions]. PMID- 3509253 TI - [Selection and understanding of bedside tests. Neuro-motor symptoms]. PMID- 3509254 TI - [Selection and understanding of bedside tests. Circulatory symptoms]. PMID- 3509256 TI - [Selection and understanding of bedside tests. Digestive symptoms]. PMID- 3509255 TI - [Selection and understanding of bedside tests. Respiratory symptoms]. PMID- 3509257 TI - [Selection and understanding of bedside tests. Hepato-biliary symptoms]. PMID- 3509258 TI - [Selection and understanding of bedside tests. Pancreatic symptoms]. PMID- 3509259 TI - [Selection and understanding of bedside tests. Symptoms involving the kidney and urinary tract]. PMID- 3509260 TI - [Selection and understanding of bedside tests. Metabolic and endocrinologic symptoms]. PMID- 3509261 TI - [Selection and understanding of bedside tests. Hematologic and hematopoietic symptoms]. PMID- 3509262 TI - [Selection of bedside tests. Hematologic tests]. PMID- 3509263 TI - [Selection of bedside tests. Blood chemistry]. PMID- 3509264 TI - [Selection of bedside tests. Serodiagnosis]. PMID- 3509265 TI - [Rapid bedside tests for ambulatory patients]. PMID- 3509266 TI - [Selection of bedside tests. Bacteriologic tests]. PMID- 3509267 TI - [Selection of bedside tests. The circulatory system--non-invasive cardiac function tests]. PMID- 3509269 TI - [Selection of bedside tests. Respiratory function tests]. PMID- 3509268 TI - [Selection of bedside tests. Neurologic tests]. PMID- 3509270 TI - [General outline of erythrocyte membrane proteins]. PMID- 3509271 TI - [A thought on erythrocytes]. PMID- 3509272 TI - [Morphology and deformability of the erythrocyte]. PMID- 3509273 TI - [Isolation of a peptide containing the active center of anion transport: an experiment on the isolation of hydrophobic peptides]. PMID- 3509274 TI - Effects of glucose and fructose added to the intraocular irrigating solutions on the rabbit ERG in vitro. AB - The addition of various concentrations of glucose to intraocular irrigating solutions for the retina was studied electrophysiologically using an in vitro eye cup in the pigmented rabbit. Comparison of b-wave amplitudes demonstrated that, glucose at a concentration of 20 mM/l yielded the highest values. With this concentration, the b-wave amplitude was markedly enhanced to 250% at 90 minutes. With 5 mM/l glucose (normogycemic) solutions, the b-waves were decreased to below 20% at 60 minutes. A 40 mM/l glucose solution also increased the b-waves but to a lesser extent than 20 mM/l. These results might be due to the detrimental effects of osmolarity. However, under hypoxic conditions the amplitudes of b-waves obtained with 40 mM/l glucose solutions were greater than those with 20 mM/l glucose solutions. The addition of 10 mM/l fructose to the control solution had no remarkable effects suggesting that fructose is not a direct energy source for the in vitro retina. PMID- 3509275 TI - Giant cell arteritis with normal erythrocyte sedimentation rate: a management dilemma. AB - Two patients with cranial arteritis and normal erythrocyte sedimentation rates of 13 mm/hr. and 26 mm/hr. are presented. One patient became totally blind awaiting temporal artery biopsy. The other patient was a challenge in titrating increased steroid dose with cardiovascular complications against decreased steroid dose with worsening of visual and neurologic problems. Available tests may be negative in active disease. The clinical picture is paramount in decision making, and a high index of suspicion is mandatory. Since a delay of twenty-four hours may be critical, steroids usually should be started as soon as an erythrocyte sedimentation rate has been drawn, without waiting for a biopsy. Once steroid therapy has been started, temporal artery biopsy should be performed conveniently soon, regardless of the erythrocyte sedimentation rate. PMID- 3509276 TI - Bovine RPE heterotransplants simulate proliferative vitreoretinopathy (PVR) in rabbits. AB - A model of proliferative vitreoretinopathy (PVR) is described. This is the first reported model based on the transplantation of heterologous retinal pigment epithelium cells into the vitreous cavity of rabbits. Freshly isolated cells or short-term primary cultures of bovine pigment epithelium are employed. Strands develop in the vitreous cavity and, with a frequency now approaching 100%, traction retinal detachments develop by 3-4 weeks. Light and electron microscopic features of this model parallel those found for transplanted autologous RPE cells; there are no overt signs of rejection. Examination of the strands should prove useful in identifying strategies of therapeutic value. This model permits such studies, since retinal detachments in adequate numbers are readily produced. The model resembles human PVR. PMID- 3509277 TI - Scintillating scotoma as the first symptom of systemic lupus erythematosus. AB - We reported a case where scintillating scotoma was the first and only symptom of systemic lupus erythematosus. The patient was diagnosed as having classic migraine and was given cafergot and phenytoin with no effect. During this treatment, severe myocardial infarction occurred and SLE was found to be the underlying disease responsible for scintillating scotoma. Scotoma attacks disappeared by steroid treatment but his general condition remained poor. PMID- 3509278 TI - Comparative diets of a idiopathic senile cataract and normal population: dietary risk factors in cataractogenesis. AB - A survey was carried out contrasting the diets of population with senile cataracts and control populations. Results failed to confirm the reports of others suggesting that ingestion of moderate amounts of seafood containing mercury or excess amounts of milk and milk products represent risk factors for senile cataractogenesis. Several dietary differences were noted lending credence to the prophylatic values of riboflavin enrichment to decrease risk of cataractogenesis and suggesting areas for further study. PMID- 3509279 TI - Electron microscopic study of Bitot's spots. AB - The histological and structural features of Bitot's spots are described. Light microscopy revealed squamous metaplasia with keratinization. Electron microscopy showed severe loss and attenuation in height of microvilli as well as widening of the intercellular spaces. The amorphous material overlying the conjunctiva was composed of cellular debris containing edemetous endoplasmic reticular membranes and lysozomes. PMID- 3509280 TI - Lectins for the identification of ocular bacterial pathogens. AB - In a preliminary in vitro investigation, fluorescein-conjugated lectins were used in the identification of bacteria commonly involved in ocular infections. Clinical isolates of Staphylococcus aureus, Staph. epidermidis, Streptococcus pneumoniae, Strep. pyogenes, Pseudomonas aeruginosa, Hemophilus influenzae, and Proteus mirabilis were incubated with each of eleven lectins using a slide technique. Bacterial fluorescence was readily observed with a fluorescence microscope. All clinical isolates bound wheat germ agglutinin. The Gram-positive isolates bound Concanavalin A, while the Gram-negative isolates did not, with rare exceptions. Streptococcal species isolates reacted with Dolichos biflorus agglutinin, while staphylococcal species isolates did not. Lectins may be useful in furthering the initial identification of causative organisms in bacterial ocular infections. PMID- 3509281 TI - Surgical flattening of retinal fold of stage III cicatricial retrolental fibroplasia (RLF). AB - Flattening of detached macula in both eyes of a 10-month-old baby with traction retinal detachment in stage III RLF was achieved surgically. The surgical procedure is described and the rationale for such intervention is discussed. PMID- 3509282 TI - An equation for the systemic availability of drugs undergoing simultaneous enterohepatic cycling, first-pass metabolism, and intestinal elimination. AB - A relationship between systemic availability and its determinants has been derived for a physiologically realistic model of drug disposition that includes enterohepatic cycling (EHC), gallbladder emptying (with an arbitrary time course), first-pass metabolism to noncycling metabolites, and fecal excretion. Systemic availability (F) has been shown to be determined by the fraction of the dose initially absorbed (f*a), the fraction of the drug excreted into the GI tract that is reabsorbed with each cycle (fa), the hepatic extraction ratio (E), and the fraction of extracted drug that is transported to the gallbladder for EHC (fg) according to the relationship F = f*a(1 - E)/(1 - fafgE) The implications of the above relationship are that (1) systemic availability is dependent on EHC, (2) values of F calculated to be greater than unity cannot be explained simply by the presence of EHC, (3) calculations of E based on the usual expression F = f*a(1 - E) are erroneous for drugs subject to EHC, and (4) a compound that has a high systemic availability and is subject to EHC is not necessarily inefficiently metabolized. The quantitative interrelationship of systemic availability and its determinants is illustrated using a contour plot. Slices through the surface are used to demonstrate that the presence of EHC changes the sensitivity of F to changes in E. PMID- 3509283 TI - Synthesis and properties of haptens for the development of radioimmunoassays for thioridazine, mesoridazine, and sulforidazine. AB - For the separate development of radioimmunoassay procedures for thioridazine and its two major active metabolites, mesoridazine and sulforidazine, three haptens, respectively, 2-methylthio-, 2-methylsulfinyl-, and 2-methylsulfonyl-substituted 10-[2-[1-(2-carboxyethyl)-2-piperidinyl]ethyl]-10H-phenothiazine, were synthesized and characterized. Thioridazine hapten was coupled to bovine serum albumin, whereas the haptens for mesoridazine and sulforidazine were coupled to porcine thyroglobulin. The number of hapten residues per mole of carrier protein was determined in each case by an ultraviolet spectrophotometric method. Polyclonal antibodies to each hapten-protein conjugate were obtained in rabbits, and titers of the antisera were checked by evaluating their binding characteristics to the appropriate tritiated analyte. A hapten for the ring sulfoxide metabolite of thioridazine was also synthesized. PMID- 3509284 TI - Kinetics and mechanism of zinc ion-mediated degradation of cephalosporins in tromethamine solution. AB - Earlier studies of the hydrolysis and aminolysis of penicillin, in the presence of zinc ion and tromethamine (Tris), revealed a very rapid catalysis mediated by a ternary complex in which the metal ion brought the reactants into close proximity in a suitable configuration for reaction. In the present work similar studies with a group of cephalosporins show not only much slower rates of reaction but a different mechanism in which the zinc ion-tromethamine complex functions as a nucleophile in a bimolecular reaction. Evidence for the differences in mechanism includes not only the different dependence of rate upon tromethamine concentration, but comparable rates of reaction of methyl esters of a penicillin and a cephalosporin and the reaction products observed by high performance liquid chromatography. PMID- 3509285 TI - Cosolvency and cosolvent polarity. AB - The solubilities of three poorly soluble drugs, phenytoin, benzocaine, and diazepam, in cosolvent-water mixtures have been previously shown to be approximated by the log-linear solubility equation; log (Sm/Sw) = sigma f, where Sm and Sw represent the solubilities of the drug in the solvent mixture and water, respectively, f is the volume fraction of cosolvent, and sigma is the slope of a plot of log (Sm/Sw) vs f. In this study, the slopes, sigma, of the solubility plots were related to indexes of cosolvent polarity including the dielectric constant, solubility parameter, surface tension, interfacial tension, and octanol-water partition coefficient. Those polarity indexes that reflect the cohesive properties of the solvents such as the solubility parameter and interfacial tension resulted in the highest correlations with the slope, sigma. The hydrogen bonding ability of the neat cosolvent, expressed as the density of proton donating groups (HBD) or acceptor groups (HBA), was also found to be highly correlated with sigma. Additional relationships derived from theories involving solubility parameters and interfacial tension provide improved correlations between the cosolvent polarity and sigma. These results and analysis provide the basis for the estimation from physicochemical parameters of the appropriate type and amount of cosolvent needed to solubilize nonpolar drugs. PMID- 3509286 TI - Cosolvency and deviations from log-linear solubilization. AB - The solubilities of three nonpolar drugs, phenytoin, diazepam, and benzocaine, have been measured in 14 cosolvent-water binary mixtures. The observed solubilities were examined for deviations from solubilities calculated by the equation log Sm = f log Sc + (1 - f) log Sw, where Sm is the solubility of the drug in the cosolvent-water mixture, Sc is the solubility of the drug in neat cosolvent, f is the volume fraction of cosolvent, and Sw is the solubility of the drug in water. When presented graphically, the patterns of the deviations were similar for all three drugs in mixtures of amphiprotic cosolvents (glycols, polyols, and alcohols) and water as well as nonpolar, aprotic cosolvents (dioxane, triglyme, dimethyl isosorbide) and water. The deviations were positive for phenytoin and benzocaine but negative for diazepam in mixtures of dipolar, aprotic cosolvents (dimethylsulfoxide, dimethylformamide, and dimethylacetamide) and water. The source of the deviations could not consistently be attributed to physical properties of the cosolvent-water mixtures or to alterations in the solute crystal. Similarities between the results of this study and those of previous investigations suggest that changes in the structure of the solvent play a role in the deviations from the expected solubilities. PMID- 3509287 TI - Identification of phenolic antioxidants in elastomers for pharmaceutical and medical use. AB - Phenolic antioxidants were identified by thin-layer chromatography (TLC) in 102 samples of pharmaceutical and medical rubber articles. Despite the large number of antioxidants proposed for elastomers, only eight compounds were found in the articles analyzed. The choice of antioxidants apparently does not depend on the sterilizing processes or on the use or brand of articles. PMID- 3509289 TI - Adsorption of inorganic and organic ions to polycarbophil as a means of sustained release dosage formulation. AB - The adsorption and desorption of drugs and inorganic ions to and from polycarbophil (PC), a polymer, were investigated to determine if PC would be a suitable carrier for sustained-release dosage formulations. Both in vitro and in vivo experiments with a polycarbophil-atropine sulfate complex demonstrated the gradual-release properties of this system. Adsorbed Cr3+ ions, like atropine, are released slowly. In contrast, 51CrO4(2-) ions are predominantly bound in an irreversible manner. A third group of drugs minimally adsorbed to PC under the conditions studied. We conclude that PC under both in vitro and in vivo conditions is able to bind certain ions and drugs and then release them over a period of time in a predictable and repeatable manner. PMID- 3509288 TI - Kinetics of drug action in disease states. XXII. Effects of contraceptive steroids on the pharmacodynamics of ethanol in rats. AB - This investigation was designed to determine the effect of treatment with contraceptive steroids on the central nervous system depressant activity of ethanol. Adult female rats received oral doses of ethynyl estradiol (0.1 mg kg-1 day-1), ethynyl estradiol and norethindrone (0.1 and 10 mg kg-1 day-1), or vehicle only for 14 days. Ethanol was then infused slowly iv until the animals lost their righting reflex. The concentrations of ethanol at that time in serum and cerebrospinal fluid were statistically significantly higher in rats treated with the estrogen-progestin combination than in control animals. Ethanol concentrations in rats treated only with the estrogen were intermediate and did not differ significantly from control values. These results indicate that treatment with an estrogen-progestin combination is associated with a decreased sensitivity of the central nervous system to the hypnotic activity of ethanol. This evidence of a pharmacodynamic interaction between contraceptive steroids and ethanol in rats is consistent with a recent clinical report of significant contraceptive steroid-related improvement in tolerance to ethanol with no apparent effect on the pharmacokinetics of ethanol. PMID- 3509290 TI - Effects of hypothermia on drug absorption. AB - The in situ rat gut technique was used to study the effects of hypothermia on the intestinal absorption of a 1 mg/ml solution of sodium pentobarbital in 0.01 M phosphate buffer (pH 6.0). Male Sprague-Dawley rats weighing between 300 and 370 g were exposed to an atmosphere of helox (helium:oxygen, 80:20) at 0-4 degrees C for 5 hr. This procedure lowers the rectal temperature of the rats from 38 to 20 degrees C. The animals were prepared for surgery using ether as anesthetic after their rectal temperature reached 20 degrees C. Water flux in and out of the intestinal lumen was estimated from tritiated polyethylene glycol 4000 concentrations in the perfusate. The disappearance rate constant of pentobarbital from the intestinal lumen was 0.0638 +/- 0.007 min-1 for hypothermic rats, in comparison to 0.114 +/- 0.0123 min-1 for normothermic rats. PMID- 3509291 TI - Effect of amiodarone and desethylamiodarone on the pharmacokinetics of antipyrine in the rat. AB - The effect of amiodarone on hepatic drug metabolism in vivo was examined in the rat using antipyrine as a model substrate. Pretreatment with oral amiodarone hydrochloride, 100 mg/kg/day, for 5 days resulted in a 19% reduction in antipyrine clearance and a 22% increase in half-life. The administration of single oral doses of amiodarone hydrochloride, 100 mg/kg, 1 or 5 hr prior to antipyrine administration had no significant effect on antipyrine pharmacokinetics. The administration of a single intravenous dose of amiodarone hydrochloride, 50 mg/kg, reduced antipyrine clearance by 32% and increased the half-life by 46%. The desethyl metabolite of amiodarone was also found to reduce antipyrine clearance (21%) after a single oral dose of 100 mg/kg. PMID- 3509292 TI - Preformulation salt selection. Physical property comparisons of the tris(hydroxymethyl)aminomethane (THAM) salts of four analgesic/antiinflammatory agents with the sodium salts and the free acids. PMID- 3509293 TI - Analysis of the antimalarial sesquiterpene artemisinin in Artemisia annua by high performance liquid chromatography (HPLC) with postcolumn derivatization and ultraviolet detection. PMID- 3509295 TI - [82d meeting of the Japanese Society of Psychiatry and Neurology. 21-23 May 1986, Morioka]. PMID- 3509294 TI - A reversed-phase high-performance liquid chromatographic (HPLC) assay for the determination of biotin in multivitamin-multimineral preparations. PMID- 3509297 TI - [Ethics in medicine]. PMID- 3509296 TI - [Study of the psychiatric personality]. PMID- 3509298 TI - [Medicine and human rights]. PMID- 3509299 TI - [The architecture of plant cells]. PMID- 3509300 TI - [Gene expression by direct DNA transfer]. PMID- 3509301 TI - [Protein analysis using the immunoblot techniques]. PMID- 3509302 TI - [Anti-calmodulin antibody]. PMID- 3509303 TI - [Amyloplast]. PMID- 3509304 TI - [Preparation of etioplasts]. PMID- 3509305 TI - [Hemoglobins]. PMID- 3509307 TI - [Separation and analysis of hemoglobins by isoelectric focusing and high performance liquid chromatography]. PMID- 3509306 TI - [Spectrophotometric determination of hemoglobin in blood]. PMID- 3509308 TI - [Energy calculation on conformational change of myoglobin and hemoglobin]. PMID- 3509309 TI - Inter-examiner variability in diagnosis of enamel mottling. PMID- 3509310 TI - Melanin pigment in calcifying odontogenic cysts. PMID- 3509311 TI - Morphometry of tumor content in the ameloblastoma. A preliminary study. PMID- 3509312 TI - Periodontitis in children, adolescents and young adults. The changing concepts: 1. Nomenclature and clinical features. PMID- 3509313 TI - Adenomatoid odontogenic tumour: report of a case. PMID- 3509314 TI - Dental health of the handicapped at the Selangor Spastic Centre. PMID- 3509315 TI - Monocyte-lymphocyte adhesion to three zinc oxide and eugenol-based endodontic cements: an in vitro assay. PMID- 3509316 TI - Developmental disturbances of the oral mucosa: an epidemiological study in a young male population from Argentina. PMID- 3509317 TI - Chemical composition of a phenol-extracted material from periodontally involved cementum. PMID- 3509318 TI - Effects of polynucleotide inhibitors on transcriptional events of influenza virions. AB - Polynucleotide inhibitors of the influenza virion transcriptase, which is activated in vitro by detergent, can be divided into two categories. Polyribonucleotides comprised of adenine and guanine bases or adenine and uracil bases inhibit initiation but not elongation events of transcription. In contrast, polyribonucleotides containing cytidine and uracil or inosine and uracil block both initiation and elongation. Effects on elongation are apparent on addition of polynucleotides at either 5 or 10 min post-initiation. Dose-response studies with these and other polynucleotides have shown that the concentrations causing 50% inhibition of transcription vary considerably with the most potent inhibitor being the modified polymer, poly(C,S4U10). PMID- 3509319 TI - New drug opportunities based on neuropeptides? A personal view. AB - Most work on the function of peptides in neurons attempts to establish their role in transmission. Evidence in support of an alternative role in the growth and development of neurons and other cell types is discussed, and applied specifically in speculation concerning the etiology of chronic pain. Opportunities arise in the design of new types of drugs. PMID- 3509320 TI - Improved delivery through biological membranes. Synthesis, distribution, and neurochemical effects of a tryptamine chemical delivery system. AB - Enhanced central delivery of tryptamine was proposed by application of a dihydropyridine in equilibrium pyridinium salt redox system. This drug delivery method, which relies on biochemistry similar to that which occurs in the NAD+ in equilibrium NADH coenzyme system, required synthetic derivatization of tryptamine. When the resulting tryptamine chemical delivery system (TCDS) was systematically administered, it passed the blood-brain barrier intact and then oxidized. The resulting quaternary form (TQ+) accumulated in the brain of rats relative to most peripheral organs. The only organ in which a more rapid efflux was not demonstrated was the heart. Intestinal administration of the TCDS showed the ability of the system to undergo absorption and to survive the first pass through the liver. The TCDS caused central neurochemical changes consistent with central delivery of tryptamine. Possible applications of the TCDS are discussed. PMID- 3509321 TI - Intranasal administration of beta-interferon in rabbits. AB - beta-Interferon (IFN) administered intranasally in solution or as a powder without surfactants was not absorbed in rabbits. However, absorption occurred after the addition of surfactants (non-ionic, anionic and amphoteric). Maximum concentrations of IFN in plasma were dependent on the surfactant used, sodium glycocholate being the most effective. Total absorption of IFN following nasal administration with sodium glycocholate was 2.2% of that following intravenous administration. PMID- 3509322 TI - Studies on improvement of pharmaceutical preparations prescribed in hospitals. II: Study on pharmaceutical manufacturing of dibekacin sulfate gauze tampon. AB - A gauze tampon, which contains an ointment incorporating dibekacin sulfate, was prepared and investigated as a device to prevent bacterial infection after operation of chronic sinusitis. It was proved that no loss of potency occurred upon heat sterilization and that it was stable even after storage for a long period. This gauze tampon was easy to insert into the paranasal sinuses, achieving satisfactory therapeutic efficacy in terms of hemostasis and disinfection. No adverse reactions have been observed. PMID- 3509323 TI - Tazadolene succinate: a structurally novel non-opioid analgesic with antidepressant properties. PMID- 3509324 TI - The influence of 1,2,4-benzotriazine derivatives on the apparent viscosity of human blood. AB - Some benzotriazines markedly reduce human whole-blood viscosity. Viscosity was measured electronically with a novel capillary viscosimeter. Because of the increasing interest in hemorheologically active drugs, the compounds merit further investigation. PMID- 3509325 TI - Use of chitosan and hydroxypropylchitosan in drug formulations to effect sustained release. AB - This study was an attempt to develop implantable sustained release forms of drugs, based on formulations containing chitosan, a biodegradable polymer from a natural source, and hydroxypropylchitosan (HP-chitosan), its water-soluble derivative. The possibilities were explored using uracil as a model for anticancer drugs. Enzymatic degradation of chitosan and HP-chitosan was first confirmed in vitro (using lysozyme) and in vivo by implanting both materials subcutaneously into the backs of rats. Then, using an in vitro dissolution test, we found that the release rate of uracil from chitosan membranes could be altered by the addition of HP-chitosan. Film- and stick-type implantable dosage forms of chitosan containing uracil were prepared by the 'Extrusion-in-Air' method. These gave rise to sustained release of uracil in vitro and in vivo. We conclude that chitosan and HP-chitosan have a potential as biocompatible and biodegradable vehicles in the preparation of implantable sustained release dosage forms of anticancer drugs. PMID- 3509326 TI - Synthesis, tissue distribution and cytostatic properties of two new daunorubicin derivatives of 2-thiouracil containing a guanidine bridge. AB - In further attempts to utilize the affinity of 2-thiouracil for melanin-producing tissues in the design of drugs active against malignant melanomas, guanidine bridged adducts of the anthraquinone drug daunorubicin (1a) with 2-thiouracil were prepared (Scheme 3). The expected adduct (4), and a by-product in its preparation (5) (Scheme 3), were inactive against murine melanoma, in vivo, and did not show affinity for melanin-producing tissues. They were efficient DNA intercalating agents, but were much less cytostatic than daunorubicin against Cloudman melanoma, and were inactive, in vitro, against human cervical carcinoma MS 751. The coupling chemistry employed may have application in current attempts to effect binding of drugs to high molecular weight targeting antigens. PMID- 3509327 TI - Correlation between mechanistic biotransformation and biochemical toxicology of some antihypertensive drugs. AB - Mechanistic biochemistry (consideration of metabolism in the context of knowledge of contemporary biochemistry) was applied to propanolol (1), hydrochlorothiazide (2), hydralazine (3), and triamterene (4), representative of the main types of anti-hypertensive drugs in common use. Three routes of metabolism, that is, acetylation, generation of free radicals (leading to peroxidation of lipids), and osazone formation were considered in relation to the structures of these drugs. The possibility that acetylation can lead to hepatic toxicity, lipid peroxidation to membrane lesion, and osazone formation to glucose and energy depletion was highlighted. Hydralazine, with its potential for osazone formation and great susceptibility to acetylation and free radical formation, was judged most capable of giving rise to these side effects, in agreement with reported toxicity. Triamterene was judged less susceptible than hydralazine to acetylation and free radical formation, and hydrochlorothiazide even less so. Propanolol is immune to any of these consequences. PMID- 3509328 TI - Comparison of the metabolism of diltiazem following percutaneous, subcutaneous, oral and intravenous administration. AB - The metabolism of diltiazem hydrochloride following percutaneous administration was compared with that following administration orally and by injection, to ascertain possible advantages in the percutaneous administration of ionizable, water-soluble drugs. The various routes of administration gave rise to markedly differing ratios of diltiazem and deacetylated diltiazem in plasma. The ratio of the AUC values for the two substances was 0.3 (intact skin) and 0.5 (stripped skin) following percutaneous administration, 0.2 following injection, and 0.8 following oral administration of diltiazem. Our results suggest that metabolism may be reduced in routes of administration that lead to very rapid drug absorption and/or rapid clearance from blood. HPLC chromatograms of plasma showed that the number and amounts of metabolites were less when diltiazem was given percutaneously rather than orally. PMID- 3509329 TI - Studies on improvement of pharmaceutical preparations prescribed in hospitals. IV. Dibekacin sulfate viscous solution for treatment of mouth and throat wounds. AB - For the purpose of preventing suppuration of wounds of the oral cavity and throat, we attempted to develop a viscous solution of dibekacin sulfate (DKB) as a suitable medication. Solutions of different viscosity and antibacterial potency were prepared by mixing DKB, sodium carboxymethyl cellulose (CMC-Na), and water in varying proportions. Studies were then performed to ascertain relationships between the concentration of CMC-Na pH and viscosity, and between the viscosity and diffusion of DKB. The concentration of CMC-Na giving rise to optimal clinical efficacy was determined, and the concentration of DKB necessary for clinical treatment was estimated on the basis of the ionic binding constant between DKB and CMC-Na. As a result, the optimum CMC-Na concentration was found to be 2%, while the optimum DKB concentration was estimated to be 100 micrograms/ml. PMID- 3509330 TI - Studies on improvement of pharmaceutical preparations prescribed in hospitals. V. Nifedipine hollow type suppository. AB - Nifedipine is a calcium antagonist used for the treatment of hypertension and angina pectoris. However, commercial nifedipine preparations are only available in forms suitable for oral administration, e.g. soft capsules and tablets. Therefore, we developed a suppository form in which the drug was incorporated into a hollow type suppository. The suppository preparation was administered to humans for evaluation of the clinical and commercial usefulness. It was as fast acting as the soft capsule, but the blood concentration of nifedipine immediately after administration was lower than that seen with the soft capsule. It was considered to be superior to the soft capsule and similar to the tablet in terms of its long-acting effect. Thus, the hollow type suppository form of nifedipine should have useful clinical applications. PMID- 3509331 TI - Use of soybean protein for controlled release of drugs administered orally. AB - The influence of soybean protein (SBP) on the release of drugs from per-oral formulations was investigated, using dl-propranolol as model drug. Directly compressed tablets of SBP/lactose containing more than 40% of SBP did not disintegrate and kept their shape for long periods. Then, dissolution tests (JPX) were carried out with similar tablets containing dl-propranolol hydrochloride as active ingredient. The dissolution profiles showed sustained release of the drug, the dissolution rate being prolonged with increasing amounts of added SBP. Dissolution was affected by the pH of the test medium and accelerated by addition of pancreatin to the test medium. Our results suggest that interaction between SBP, drug and lactose may influence the dissolution rate. Dissolution was unaffected by varying compressional pressure (100-300 kg/cm2) in the preparation of tablets. PMID- 3509332 TI - Per-oral controlled release dosage form of theophylline using soybean protein. AB - The potential of powdered soybean protein (SBP) as a vehicle for controlled drug release was investigated, using theophylline as the model drug, an in vitro dissolution test and in vivo absorption studies in beagle dogs. The results of the dissolution test demonstrated that the addition of SBP to the tablet brought about retarded dissolution of theophylline. In the in vivo absorption study, Tmax values for theophylline-SBP tablets were larger than those for tablets containing only theophylline; there was no difference in AUC between the two tablets. In addition, there was no detectable difference in the results with theophylline-SBP and Theodur tablets. The practical usefulness of SBP as a vehicle for controlled release tablets was confirmed not only from our in vitro experiment, but also from our in vivo absorption test using beagle dogs. PMID- 3509334 TI - Synthesis of the 4-oxygenated retinoid metabolites. AB - The efficient synthesis of 4-hydroxylated metabolites of various retinoids is described. Allylic bromination of beta-ionone, retinal, and methyl retinoate followed by treatment with aqueous AcOH and saponification afforded the 4-hydroxy analogues in 64-79% yields. With the conjugated polyenes, retinal and methyl retinoate, about 25% of the products were found to be the 13-cis isomers. Purification of isomer mixtures by HPLC permitted stereochemical assignments after 1H NMR analysis. PMID- 3509333 TI - Synthesis and platelet antiaggregatory activity of trimetoquinol analogs as endoperoxide/thromboxane A2 antagonists. AB - Trimetoquinol (TMQ) has activity as a beta-adrenergic agonist and as a platelet antiaggregatory agent. Recent reports from this and other laboratories have focused on the mechanism of inhibition of platelet function by TMQ and its analogs. Based on its competitive and stereoselective inhibition of thromboxane mimetic agents, TMQ was proposed as an endoperoxide/thromboxane A2 receptor antagonist; however, this mechanism has been questioned. A radiolabeled TMQ analog with high specific activity would aid in the elucidation of the actual mechanism of action. In the current research, modifications of the trimethoxy ring system of TMQ have been investigated. Replacement of one or two of the methoxy groups with iodine atoms leads to retention of platelet antiaggregatory activity and agonist blocking activity. Thus, these analogs have promise as potential radioligands since iodide exchange labeling can provide 125I-labeled compounds. Further, replacement of a methoxy group with either a nitro or amino functionality leads to decreased activity in platelet systems. These results suggest that the putative sites of interaction for the trimethoxy ring system of TMQ in platelet systems will tolerate large, lipid soluble groups but will not tolerate large changes in the electronic characteristics of the ring system. PMID- 3509335 TI - Isolation, identification and synthesis of a metabolite of tazadolene succinate. AB - Metabolism of tazadolene (1), a novel non-opioid analgesic with antidepressant properties, affords the 4-hydroxy and 3-methoxy-4-hydroxy derivatives (phenyl ring) of the drug, and N-[2-(phenylmethylene)cyclohexyl]-beta-alanine (4). The isolation, identification and synthesis of the latter metabolite is described. PMID- 3509336 TI - Synthesis and antinociceptive activity of dezocine degradation products. AB - Three degradation products of dezocine were synthesized and tested for possible antinociceptive activity. 13-Amino-5,6,7,8,9,10-hexahydro-5-methyl-5,11 methanobenzocyclodecen+ ++-3-ol demonstrated antinociceptive properties comparable to morphine. PMID- 3509337 TI - Glutathione, glutathione S-transferase and glutathione reductase in human erythrocytes and lymphocytes as a function of sex. AB - We review the role of glutathione (GSH) and its metabolizing enzymes, glutathione S-transferase (GST) and glutathione reductase (GSR) in drug metabolism and in the elimination of foreign compounds. Levels of GSH and the activity of these enzymes may be greatly influenced by drugs and other substances in the body. We therefore determined GSH levels and the activities of GST and GSR in human erythrocytes and lymphocytes in males and females in three age groups. There was no significant difference between males and females in the three age groups in respect of GSH levels and GST and GSR activities. GSH levels in erythrocytes were higher than those in lymphocytes when expressed per mg protein, but lower than those in lymphocytes when expressed per 10(6) cells. The activities of both GST and GSR were found to be higher in lymphocytes than in erythrocytes. PMID- 3509338 TI - Gel ointment of verapamil for percutaneous absorption. AB - A gel ointment of verapamil designed for systemic action by transdermal absorption was prepared. The amount of drug released in vitro decreased progressively when increasing amounts (from 20 to 50%) of ethanol-propylene glycol (2:1, v/v) were incorporated into the ointment. Transdermal absorption of the drug in vivo was studied in rats. Verapamil was found in the systemic circulation, and plasma drug levels were maintained at a plateau for 12 hours after application. The effect of two additives on absorption was also examined. Azone, a cycloheptanone derivative, increased plasma levels of verapamil up to tenfold, the effect being greatly dependent on the amount of alcohols in the formulation. Isopropyl myristate did not influence systemic absorption, but it effectively increased absorption into skin. We conclude that the gel ointment can be used for transdermal drug delivery when an adequate absorption promoter is added. PMID- 3509339 TI - Sustained release tablets based on chitosan and carboxymethylcellulose sodium. AB - Chitosan and mixtures of chitosan with carboxymethylcellulose sodium (CMC-Na) were examined as vehicles for sustained release tablets of water-insoluble drugs. Prednisolone (PDS) was selected as a model of a water-insoluble drug for this study. Sustained release of PDS from tablets prepared by direct compression of chitosan and CMC-Na was demonstrated in model JP X fluids. Furthermore, the release rate of PDS could be controlled by changing the relative amounts of chitosan and CMC-Na, or the amount of PDS in the tablets, and by certain extra additives. Such chitosan/CMC-Na mixtures are a promising basis in the design of sustained release dosage forms of water-insoluble drugs. PMID- 3509340 TI - Antihypertensive ergoline derivatives. AB - Novel ergolines were synthesized and screened in spontaneous hypertensive rats (SHR) with the aim of finding a new class of ergot related antihypertensives. Their prolactin inhibitory effect (measured as nidation inhibition in rats), acute toxicity (LD50) and interference with CNS function (Irwin test) were also evaluated as a measure of selectivity and safety. Modification of the C8 side chain enhanced antihypertensive activity selectively, while the introduction of substituents in other positions of the ergoline skeleton generally yielded unfavourable results, either by decreasing selectivity or by increasing toxicity. PMID- 3509341 TI - Enhanced percutaneous absorption of homogenized tolnaftate/beta-cyclodextrin polymer ground mixture. AB - The absorption of tolnaftate after external application of tolnaftate cyclodextrin polymer homogenized ground mixtures was investigated in comparison with that of tolnaftate alone and non-homogenized mixtures. To evaluate their percutaneous absorption, samples were applied to the shaved back skin of mice. It was found that homogenized ground mixture samples showed the highest level of percutaneous absorption, and also resulted in the highest blood level concentrations. PMID- 3509343 TI - Effect of a non-hygroscopic surfactant coating upon fluorescein absorption from the respiratory tract. AB - The influence of a hydrophobic coating upon the absorption of fluorescein from the canine respiratory tract has been evaluated. Lauric acid was adsorbed onto the surface of micronized disodium fluorescein powder suspended in non-aqueous solutions of the fatty acid. A 0.24 g lauric acid coating for each gram of dye was sufficient to prevent hygroscopic growth in a 40 sec period at 37 C at 97% relative humidity. When this powder was aerosolized and administered by inhalation to Beagle dogs, fluorescein absorption proceeded at similar rates to that of the uncoated dye. PMID- 3509342 TI - Relationship between metabolism and pharmacologic activity of SQ 27,786, an angiotensin converting enzyme inhibitor with potent diuretic activity. AB - SQ 27,786 is a sulfhydryl-containing angiotensin converting enzyme (ACE) inhibitor, which also possesses potent diuretic activity in dogs after intravenous administration. The absorption, distribution, metabolism and elimination of 35S-labeled SQ 27,786 was studied in dogs to determine if the observed pharmacologic activities were intrinsic to this compound or the result of metabolism to separate ACE-inhibitory and diuretic moieties. The poor pharmacologic activity observed after oral administration was found to be due to poor absorption of the ACE-inhibitory-diuretic compound. The results of this study indicated that SQ 27,786 was excreted largely intact, either as the parent compound, the symmetrical disulfide of the parent compound, or as mixed disulfides of the parent compound with endogenous sulfhydryl compounds (e.g., SQ 27,786-L-cysteine) in a manner similar to captopril. It was concluded that the observed diuretic and ACE inhibitory activities were the result of intact SQ 27,786 and not of metabolites resulting from cleavage of the molecule to separate diuretic and ACE inhibitory moieties. PMID- 3509344 TI - Degradation of a tetragastrin analogue by a membrane fraction from rat gastric mucosa. AB - Our previous work on the effect of modification of peptide bonds in gastrin-like peptides led us to speculate that cleavage of the bond between the Met and Asp residues occurs in gastric mucosal membranes, and that this cleavage may have functional significance. In agreement with this speculation, we now show that the tetragastrin analogue BOC-Trp-Leu-Asp-Phe-NH2 (1) is degraded by a membrane fraction from rat gastric mucosa, and that the main products are BOC-Trp-Leu and Asp-Phe-NH2. Pseudo-peptide analogues in which the peptide bonds are replaced by CH2NH had differing stabilities; BOC-Trp-Leu-Asp-psi (CH2NH)-Phe NH2 (4) and BOC Trp-Leu-psi(CH2NH)-Asp-Phe-NH2 (3) were stable under the incubation conditions, whereas BOC-Trp-psi(CH2NH)-Leu-Asp-Phe-NH2 (2) was degraded. The peptide and pseudo-peptide which were degraded (1 and 2) have been shown to stimulate gastric acid secretion in rats, in vivo, whereas 3 and 4 (which were not hydrolyzed) were inactive in stimulating gastric acid secretion and were found to antagonize the action of gastrin. PMID- 3509346 TI - Multivariate statistical analysis of L-dopa esters as potential anti-parkinsonian prodrugs. AB - This paper reports a QSAR study of thirteen L-DOPA esters previously synthesised and examined for their physicochemical, biochemical and behavioural properties. Multivariate statistical analysis (principal component analysis, cluster analysis, simple and multiple linear regression) reveals favourable and unfavourable structural features of L-DOPA prodrugs. Some of the many biochemical and behavioural activities investigated are shown to be redundant. These indications may contribute to the design of novel L-DOPA prodrugs. PMID- 3509345 TI - GABA uptake inhibitors. Synthesis and effects on audiogenic seizures of ester prodrugs of nipecotic acid, guvacine and cis-4-hydroxynipecotic acid. AB - The pivaloyloxymethyl esters 4 and 5 of the amino acid GABA uptake inhibitors guvacine and nipecotic acid, respectively, were synthesized as potential prodrugs. The half-lives of 4 and 5 for conversion into the parent amino acids were determined under approximate physiological conditions in the presence or absence of human serum. Under the former conditions the half-lives for 4 and 5 were 6.3 hr and 0.8 hr, and, in the absence of serum, 15.5 hr and 1.2 hr, respectively. The compounds 4 and 5 were administered intracerebroventricularly (i.c.v.) or intraperitoneally (i.p.) to DBA/2 mice and their effects on audiogenic seizures determined. In agreement with earlier findings for 5, all phases of the seizure response of the animals were suppressed by compound 4 at doses above 2mmol/kg i.p. At anticonvulsant doses of compound 4, as well as of 5, side effects such as sedation and impairments of motor activities were observed. The ethyl and pivaloyloxymethyl esters 9 and 11 of cis-4-acetoxynipecotic acid, designed as 'double' ester prodrugs of the GABA uptake inhibitor cis-4-OH nipecotic acid, were synthesized and shown to have very weak anticonvulsant effects. Compounds 9 and 11 did, however, show a broad spectrum of cholinergic side effects. These apparent interactions of 9 and 11 with muscarinic cholinergic receptors have been explained on the basis of the similarity of the structures of 9 and 11 to that of the muscarinic agonist 1-methyl-4-acetoxypiperidine. Furthermore, the structural similarity of 9 and the muscarinic agonist nipecotic acid ethyl ester may, to some extent, underlie the cholinergic profile of 9. PMID- 3509347 TI - Synthesis and antiinflammatory activity of N-substituted-dihydropyridylacetic acids, esters, and amides. AB - A group of N-substituted-1,4-dihydropyridylacetic acids (13-16), esters (4-12), and amides (17-23) were synthesized in order to investigate the effect of 4 substituents (R2 = Ph, n-Bu or Me) and alpha-substituents (R3 = H, Me) on antiinflammatory activity. In the acetic ester class of compounds, the relative activities (R2-substituents) were Ph greater than n-Bu greater than Me. The presence of an R3 methyl substituent enhanced activity. Increasing the length of the alkyl ester substituent enhanced activity, since the tri-ester (7) was more active than the bis-ester (6), and the bis-ester (11) was more active than the mono-ester (10). The relative order of antiinflammatory potency was generally ester greater than amide greater than acid. Methyl 2-methyl-2-(-1-[4-phenyl-3 (4,4-dimethyloxazolin-2-yl)-1,4-dihy dropyridyl]) acetate (9) was the most active antiinflammatory agent in the series, reducing inflammation 73.9% at 3 hr after a 100 mg/kg po dose. PMID- 3509349 TI - [Facial fractures. Incidence in the FAEPU Dental Hospital in 1984/85]. PMID- 3509348 TI - Preparation of bovine serum albumin nanospheres as drug targeting carriers. AB - Bovine serum albumin nanospheres (BSA-NS) of mean diameter about 170 nm were prepared by means of the tanning method with glutaraldehyde, and their efficacy as drug targeting carriers was evaluated. To gain insight of biodegradability, BSA microspheres (BSA-MS) were first administered to rats and their distributions in the lungs and liver were observed by a scanning electron microscope. A large amount of BSA-MS was found in the lungs and their surface was slightly degraded at 1 week after the administration. For investigating biocompatibility, the weight increase of the spleen and liver was measured after the administration of the BSA-NS to mice. The spleen weight of the group receiving BSA-NS was equivalent to that of the control group, though the liver weight was significantly increased. It was observed that conjugates of BSA-NS with antibody selectively concentrated on the surface of Sepharose beads which were coated with antigen. PMID- 3509351 TI - [Epidemiological survey of dental caries in a rural area of Uberlandia-Minas Gerais. The role of a model oral health program]. PMID- 3509350 TI - [Geographic distribution of cysticercosis in cattle slaughtered in Uberlandia, Minas Gerais]. PMID- 3509352 TI - [Appropriate technology. A proposal for simplified dental equipment (E.S.-I)]. PMID- 3509353 TI - [Autogenic transplants of third molars with complete root formation in humans]. PMID- 3509354 TI - [Rabies; epidemiological aspects of animal attacks and frequency reported to the anti-human rabies service in Araguari, Minas Gerais]. PMID- 3509355 TI - [Report of 2 cases of polioencephalomalacia in cattle intoxicated with Pallicourea marcgravii-St. Hill]. PMID- 3509356 TI - [Isolation and identification of Leishmania braziliensis braziliensis, in human cases and domestic dog, in the state of Sao Paulo]. PMID- 3509357 TI - The neuropathology of Alzheimer disease. Proceedings of a workshop presented by the John Douglas French Foundation for Alzheimer's Disease. November 6-7, 1986. Abstracts. PMID- 3509358 TI - Some personal thoughts on the nature and management of recurrent headaches. PMID- 3509359 TI - Recurrent meningitis due to nonsteroidal anti-inflammatory drugs. AB - Two additional cases of nonsteroidal anti-inflammatory drug induced meningitis are reported. Consideration should be given to this etiology in all cases of meningitis in which a specific etiology is not found, especially if the meningitis is recurrent. PMID- 3509360 TI - Cerebral infarction due to radiation accelerated arteriosclerosis. AB - Radiation therapy may cause accelerated arteriosclerosis of carotid and vertebral vessels which can cause cerebral infarction. This is a late complication which usually occurs several years after therapy and often affects vessels in locations where severe arteriosclerotic change is uncommon. PMID- 3509361 TI - Outcome prediction after severe closed head injury in adults. AB - Disability after severe closed head injury (CHI) differs from that of penetrating trauma or other causes of more focal cerebral damage, but its symptoms can be understood in terms of the pathophysiology and the usual pathology of CHI. Outcome can be quantified by means of specific, narrowly-defined measures, which may fail to reflect other serious sequelae, or by means of functional rating scales, which bear little logical relation to CHI pathophysiology and lump together patients with diverse deficits. The choice of appropriate intake measures of CHI severity in turn depends on which aspects of outcome are to be determined. As the cardinal symptom of CHI is altered consciousness, logical intake measures of CHI severity include measures of the depth and the duration of the abnormal state of consciousness. Confounding factors in outcome prediction include secondary complications of CHI, premorbid characteristics, and effects of acute and rehabilitative therapy. Most research has focused on functional outcome predictions based on simple intake measures obtained shortly after injury, but intake measures that permit accurate prediction of rehabilitation potential or of specific cognitive and behavioral outcomes are also needed. PMID- 3509362 TI - Transcortical sensory aphasia in China. AB - Three cases of transcortical sensory aphasia in Chinese speakers were associated with left parieto-temporal junction strokes. The possibility that this relatively rare aphasia syndrome is more common in the Chinese is raised and a theoretical explanation based on differences in Oriental written language is presented. PMID- 3509363 TI - Susceptibility of 89,517 gram-negative isolates to aztreonam and other antibiotics. PMID- 3509364 TI - In vitro activity of aztreonam against Pseudomonas: epidemiological aspects. PMID- 3509365 TI - In vitro activity of Ro 17-2301, a new monobactam, against gram-negative bacteria resistant to aminoglycosides. PMID- 3509366 TI - New automated methods in microbial diagnosis and chemosensitivity testing. PMID- 3509367 TI - Sensitivity of hospital strains to amikacin. PMID- 3509369 TI - In vitro activity of ciprofloxacin, norfloxacin, and ofloxacin against multi resistant Enterobacteriaceae. PMID- 3509368 TI - In vitro study of synergistic activity between netilmicin and tobramycin combined with ceftriaxone versus Pseudomonas and Serratia species. PMID- 3509370 TI - Visualization of the bactericidal action of ciprofloxacin by light microscopy. PMID- 3509371 TI - External otitis in divers: etiology and in vitro activity of ciprofloxacin and local agents. PMID- 3509372 TI - Influence of sonicated bacteria on antimicrobial activity of ciprofloxacin and gentamicin. PMID- 3509373 TI - In vitro activity of E-3846, a new fluoroquinolone, against gram-negative and gram-positive bacteria. PMID- 3509374 TI - Comparative activity of three new fluoroquinolones. PMID- 3509375 TI - Activity of erythromycin on chlamydial strains recovered in pharynx: study on a pediatric group. PMID- 3509376 TI - Comparative in vitro activities of four macrolides: josamycin, erythromycin, spiramycin and roxithromycin, against 424 anaerobic bacteria. PMID- 3509377 TI - Biochemical characteristics and pathogenicity of periodontal pathogens. PMID- 3509378 TI - Further microbiological investigations of flurithromycin against gram-positive bacteria and mycoplasmas. PMID- 3509379 TI - In vitro activity of coumermycin in comparison to other non-beta-lactam antibiotics against staphylococci, streptococci, and Clostridium difficile. PMID- 3509380 TI - Gilvomycin, a new antibacterial antibiotic. PMID- 3509381 TI - Stramineofungin, a new antifungal antibiotic. PMID- 3509382 TI - Preliminary studies on in vitro antimycotic activity of 10 benzofuranyl imidazoles. PMID- 3509383 TI - Some studies of the antischistosomal drug, metrifonate. PMID- 3509384 TI - Antibacterial activity and pharmacokinetics in mice of two new derivatives of norfloxacin. PMID- 3509385 TI - 1-Chloropiperazinic derivative (ER 311) of norfloxacin: antibacterial activity in vitro and pharmacokinetic properties in mice. PMID- 3509386 TI - Staphylococci--the cause of hospital infections in an orthopedic department. PMID- 3509387 TI - Combination of antibiotics. General and in vitro aspects. PMID- 3509388 TI - Mechanisms of antibiotic resistance in bacteria. PMID- 3509389 TI - Alterations in microbial structure and function induced by exposure to antimicrobial agents: implications for host response to infection. PMID- 3509390 TI - Effect of piperacillin on some cellular and humoral factors of the immune system. PMID- 3509391 TI - Impact of growth environment on phagocytosis of microorganisms. PMID- 3509392 TI - Direct action of antibiotics and immunomodulating agents on phagocytosis. PMID- 3509393 TI - Comparison of serum bactericidal activities of three experimental antibiotic regimens against Corynebacterium group JK. PMID- 3509394 TI - Uptake of antimicrobial agents by phagocytic cells. PMID- 3509395 TI - Aztreonam uptake by professional phagocytic cells. PMID- 3509396 TI - Methodology and evaluation of pharmacokinetic in vitro models of antimicrobial chemotherapy. PMID- 3509397 TI - Optimization of pharmacokinetic documentation for new antibacterial agents. PMID- 3509398 TI - Microbiological and pharmacokinetic evaluation of cefonicid, a long-acting cephalosporin. PMID- 3509399 TI - Pharmacokinetics of antibiotics in pre-term and full-term neonates. PMID- 3509400 TI - A rapid high-performance liquid chromatography method for determining beta-lactam antibiotics in biological fluids and tissues. PMID- 3509401 TI - Pharmacokinetics of intravenous mezlocillin in elderly patients. PMID- 3509402 TI - Pharmacokinetics of azlocillin in bronchial secretions. PMID- 3509403 TI - Pharmacokinetic studies in gynecological surgery using preoperative azlocillin. PMID- 3509404 TI - Penetration of imipenem-cilastatin into the lung tissue and pericardial fluid of thoracotomized patients. PMID- 3509405 TI - Pasteurellosis and bacteria EF 4, M5 and II J: pathogenic role in man following animal bites and bacterial sensitivity. PMID- 3509407 TI - Concentration of ceftriaxone in relation to the time of administration. PMID- 3509406 TI - Pharmacokinetic data in gynecological surgery using preoperative augmentin. PMID- 3509408 TI - Ticarcillin plus clavulanic acid: pharmacokinetic study in renal failure. PMID- 3509409 TI - Pharmacokinetics of ceftriaxone in continuous ambulatory peritoneal dialysis patients after intraperitoneal administration. PMID- 3509410 TI - Ceftriaxone pharmacokinetics during cardiopulmonary bypass. PMID- 3509411 TI - Pharmacokinetics of ceftriaxone after intravenous administration to CAPD-patients with and without peritonitis. PMID- 3509412 TI - Biliary excretory kinetics of cefotetan in healthy volunteers. PMID- 3509413 TI - Pharmacokinetic and microbiological profile of aztreonam. PMID- 3509414 TI - Pharmacokinetics of aztreonam in critical patients. PMID- 3509415 TI - Ciprofloxacin concentrations in human tissues and body fluids. PMID- 3509416 TI - Susceptibilities of Salmonella species to different antimicrobial agents. PMID- 3509417 TI - Penetration of ciprofloxacin in the pleural fluid. PMID- 3509418 TI - Biliary excretion of orally administered ciprofloxacin. PMID- 3509419 TI - Penetration activities of ciprofloxacin into muscle, skin and fat following oral administration. PMID- 3509420 TI - Study on the bioequivalence of ciprofloxacin 500 mg orally versus 200 mg i.v. PMID- 3509421 TI - V Mediterranean Congress of Chemotherapy. 26 October-1 November 1986, Cairo, Egypt. Proceedings. PMID- 3509422 TI - Diffusion of ofloxacin in human tissues. PMID- 3509423 TI - Steady-state pharmacokinetics of pefloxacin administered once and twice daily. PMID- 3509424 TI - Pharmacokinetics of pefloxacin and amikacin administered simultaneously to patients undergoing resuscitation. PMID- 3509425 TI - Cerebrospinal fluid and serum concentrations of rifampin in meningeal tuberculosis after intravenous administration. PMID- 3509426 TI - Multiresistant strains of enteric pathogens cultured from stools of acute cases of diarrhea in Cairo, Egypt. PMID- 3509427 TI - Metronidazole kinetics and liver function in hepatic cirrhosis. PMID- 3509428 TI - Ofloxacin pharmacokinetics in renal failure. PMID- 3509430 TI - The biochemical basis of niridazole toxicity. PMID- 3509429 TI - Aztreonam: absence of neuromuscular blocking activity. PMID- 3509431 TI - Effects of spiramycin on gastrointestinal motility. PMID- 3509432 TI - Interaction of aminoglycoside antibiotics with calcium channel blockers at the smooth muscles of the isolated tracheal rings of the rat. PMID- 3509433 TI - Investigations on the effects of ciprofloxacin on epinephrine- and collagen induced platelet aggregation in vitro. PMID- 3509434 TI - Influence of ciprofloxacin on collagen- and ADP-induced platelet aggregation in vitro. PMID- 3509435 TI - Intestinal microsomal enzyme induction by rifampicin. PMID- 3509436 TI - Effects of cefotetan on hemostasis. PMID- 3509437 TI - Comparative regenerative response of rat kidney cortex after treatment with therapeutic doses of aminoglycosides. PMID- 3509438 TI - Patterns of phospholipids in renal cortex and urine of gentamicin-treated rats. PMID- 3509439 TI - Toxic side effects of antibiotics in the neonate. Problems of oto- and nephrotoxicity of the aminoglycosides. PMID- 3509440 TI - Drug interactions with spiramycin: lack of influence on antipyrine pharmacokinetics. PMID- 3509442 TI - New trends in macrolide research. PMID- 3509441 TI - The influence of erythromycin and flurithromycin on the normal gastrointestinal flora of humans. PMID- 3509443 TI - Infectious diseases in the Mediterranean region: a report by the WHO Collaborating Centre for Health and Disease Surveillance in Europe. PMID- 3509444 TI - Visceral leishmaniasis in Alexandria. A report of 27 cases. PMID- 3509445 TI - Impact of leprosy on the family and intimate relationships. PMID- 3509447 TI - Nosocomial bacteremia at a Swedish county hospital. PMID- 3509446 TI - Therapeutic response of modern chemotherapy in hansenology. PMID- 3509448 TI - Non-Salmonella bacteremia presenting as fever of undetermined origin. PMID- 3509449 TI - Present-day susceptibility of urinary pathogens. PMID- 3509451 TI - Clinical experience with aztreonam in the treatment of nosocomial infections. PMID- 3509450 TI - Cefotetan in the treatment of internal medicine infections in diabetic patients. PMID- 3509453 TI - Aztreonam for severe infections. PMID- 3509452 TI - The efficacy of ceftriaxone in the treatment of severe infections in hospitalized patients. PMID- 3509454 TI - The efficacy of amikacin in the treatment of severe infections in a renal unit. PMID- 3509456 TI - An assessment of ciprofloxacin per os in treatment of serious infections. PMID- 3509455 TI - Aztreonam in the therapy of severe gram-negative infections. PMID- 3509457 TI - Pefloxacin in the treatment of 24 suppurative infections. PMID- 3509458 TI - Cefoperazone for infections in cancer patients. PMID- 3509459 TI - Monotherapy with pefloxacin in neutropenic febrile patients. PMID- 3509460 TI - Ceftriaxone treatment of neonatal sepsis. PMID- 3509461 TI - Aztreonam in gram-negative infections in children. PMID- 3509462 TI - A study on the etiology of purulent meningitis. PMID- 3509463 TI - Etiology of meningitis in Portugal. PMID- 3509464 TI - Therapy of neonatal meningitis. PMID- 3509465 TI - Aerobactin production in Enterobacteriaceae of clinical origin. PMID- 3509466 TI - A preliminary study on erythromycin activity in a pediatric population with Chlamydial pharynx infection. PMID- 3509467 TI - Imipenem in the treatment of post-traumatic osteitis. PMID- 3509468 TI - Antibiotic therapy in patients with post-traumatic osteitis. PMID- 3509469 TI - Clinical efficacy of the new quinolones in lower respiratory infections. PMID- 3509470 TI - Antimicrobial combinations in the treatment of endocarditis. PMID- 3509471 TI - Patient stratification in intra-abdominal infection. PMID- 3509472 TI - Antibiotic treatment of abdominal infections. PMID- 3509473 TI - Ceftriaxone in biliary and pancreatic abscesses. PMID- 3509474 TI - Therapeutic effect of cefotetan plus netilmicin in the treatment of bacterial peritonitis. PMID- 3509475 TI - Cefotetan monotherapy in the treatment of intra-abdominal infection. PMID- 3509476 TI - Management of peritonitis related to chronic ambulatory peritoneal dialysis (CAPD) using two daily intraperitoneal injections of 400 mg pefloxacin. PMID- 3509477 TI - Are aminoglycosides essential in the treatment of continuous ambulatory peritoneal dialysis (CAPD) peritonitis? PMID- 3509478 TI - Ciprofloxacin treatment of chronic Salmonella excretors. PMID- 3509479 TI - Antimicrobial susceptibility patterns of anaerobic bacteria in relation to therapy. PMID- 3509480 TI - Survey among general practitioners in the Suez Canal area on urinary tract infections. PMID- 3509481 TI - Retrospective two-year study of urinary tract infection in the Ismailia area of Egypt. PMID- 3509482 TI - Nosocomial urinary tract infections in neoplastic and non-neoplastic diseases. PMID- 3509483 TI - Post-instrumentation urinary tract infection. PMID- 3509484 TI - Treatment of pyelonephritis with amoxicillin twice daily. PMID- 3509485 TI - Imipenem in the treatment of complicated urinary tract infection. PMID- 3509486 TI - Therapeutic evaluation of the ticarcillin-clavulanic acid combination in severe nephrourologic infections. PMID- 3509487 TI - Carumonam in the treatment of severe and complicated urinary tract infections. PMID- 3509489 TI - Bacteriological and clinical experiences with ofloxacin in urinary tract infections. PMID- 3509488 TI - Ciprofloxacin in the treatment of complicated urinary tract infections. PMID- 3509490 TI - Acute prostatitis: which antibiotic to use first? PMID- 3509491 TI - Therapeutic results with mezlocillin in acute prostatitis. PMID- 3509492 TI - Patient compliance and efficacy of low-dose, long-term prophylaxis in patients with recurrent urinary tract infection. PMID- 3509493 TI - Cefotetan in the treatment of post-operative infections following obstetric and gynecological surgery. PMID- 3509494 TI - Discrepancies in the effect of protein binding on beta-lactam antibiotics. PMID- 3509495 TI - Lack of disturbance of the gut flora associated with the use of aztreonam for the treatment of gonorrhea. PMID- 3509496 TI - Efficacy of a new quinolone in acute male gonorrhea. PMID- 3509497 TI - Ceftriaxone in the treatment of chancroid. AB - The treatment of non-complicated or complicated (by a bubo) chancroid with 1 single i.m. injection of 250 mg ceftriaxone gave excellent results. Treatment is simple and economical. This is particularly profitable in countries where chancroid is endemic. PMID- 3509498 TI - Deviations in the time of administration of antibiotics by nurses. PMID- 3509499 TI - Management of rhinoscleroma, a new concept. PMID- 3509500 TI - The decreasing incidence of postoperative infection rates. PMID- 3509502 TI - The increasing incidence of post-operative infection rates. PMID- 3509501 TI - Binding of clavulanic acid to the penicillin-binding proteins of Aeromonas hydrophila. PMID- 3509503 TI - Open study of different perioperative prophylactic regimens with mezlocillin/metronidazole in proctectomy. PMID- 3509504 TI - The results of perioperative prophylaxis in thoracic surgery. PMID- 3509505 TI - Critical evaluation of common clinical parameters of postoperative pneumonia after thoracic surgery with perioperative prophylaxis. PMID- 3509506 TI - Perioperative prophylaxis and postoperative treatment of pneumonia with oxacillin and acylureidopenicillin in thoracic surgery. PMID- 3509507 TI - Prophylactic use of mezlocillin in acute cholecystitis. PMID- 3509508 TI - Single-dose prophylaxis with ceftriaxone and ornidazole in elective colon surgery. PMID- 3509509 TI - Comparative activity against Enterobacteriaceae and gram-positive bacteria. PMID- 3509510 TI - Epidemiological aspects of human immunodeficiency virus infection in Milan. PMID- 3509511 TI - Prevalence of anti-LAV/HTLV-III in Portuguese drug addicts and hemodialyzed patients. PMID- 3509512 TI - Plaque-forming cell response in short-term cultures of peripheral blood lymphocytes from AIDS patients, HTLV-III/LAV-positive patients without AIDS or ARC, and normal controls. PMID- 3509513 TI - Therapeutic trials with HPA23, alpha-IFN and ribavirin in AIDS patients. PMID- 3509514 TI - Comparative activity of new beta-lactams against anaerobes. PMID- 3509515 TI - The problem of viral hepatitis and its control in countries like Pakistan. PMID- 3509516 TI - Hepatitis B virus DNA in serum from patients with acute or chronic HBV infection. PMID- 3509518 TI - Antiviral drugs: clinical evaluation. PMID- 3509517 TI - Evaluation of the correlation between hepatitis B virus markers in pregnant women and risk factors. PMID- 3509519 TI - Immunopharmacological studies of ribavirin, a broad-spectrum antiviral agent. PMID- 3509520 TI - In vitro chemosensitivity testing to predict outcome of therapy in acute leukemia. PMID- 3509521 TI - Doxorubicin activity on MS2 fibrosarcoma evaluated by classic chemosensitivity tests and alkaline elution assay. PMID- 3509522 TI - Influence of calcium antagonists on the antitumor activity and the cardiac toxicity of doxorubicin in the rat. PMID- 3509523 TI - Anthracycline cardiotoxicity in the rat: relationship between ECG changes and morphologic effects induced by different analogues. PMID- 3509524 TI - Hyperthermia plus methotrexate combination modality treatment in transplanted Walker sarcoma. PMID- 3509525 TI - A proposition for a rational nomenclature of tumor evolution for rational treatment steps: past results work-up of so-called "adjuvant therapies" and rational perspectives. PMID- 3509526 TI - Adjuvant treatment in breast cancer. I. PMID- 3509527 TI - Adjuvant treatment in breast cancer. II. PMID- 3509528 TI - Preliminary results with an alternating combination in non-Hodgkin's malignant lymphomas. Greek Lymphoma Research Group. PMID- 3509529 TI - In vitro antibacterial activity of mezlocillin against anaerobic bacteria. PMID- 3509530 TI - Treatment of poor prognosis acute myeloid leukemia with aggressive and non aggressive chemotherapy. PMID- 3509531 TI - Combination chemotherapy versus melphalan and prednisone in multiple myeloma. PMID- 3509532 TI - Chemotherapy of resistant multiple myeloma with vincristine, adriamycin and dexamethasone (VAD). PMID- 3509533 TI - The effect of chemotherapy on the gastrointestinal tract. PMID- 3509535 TI - Assessment of the oral condition of cancer patients submitted to chemotherapeutic treatment. PMID- 3509534 TI - Oral complications in cancer patients. PMID- 3509536 TI - Round cell neoplasms of children: value of electron microscopy in their diagnosis. PMID- 3509537 TI - Plasma protein fractions and alpha 1-acidglycoprotein as tumor markers in acute lymphoblastic leukemia. PMID- 3509538 TI - Immune deficiency in malignant lymphomas. PMID- 3509539 TI - Varicella-zoster infection in patients with neoplastic diseases. PMID- 3509540 TI - Ro 15-8075 (cefetamet pivoxyl), a new oral cephalosporin: in vitro activity of the free acid Ro 15-8074 and regression line analyses. PMID- 3509541 TI - In vitro antibacterial activity of cefotetan against Bacteroides fragilis group clinical isolates. PMID- 3509542 TI - Comparative in vitro study of the antibacterial effect of cefotetan against gram positive and gram-negative aerobic and anaerobic strains from fresh clinical isolates. PMID- 3509543 TI - In vitro interactions between cefotetan and aminoglycosides on Klebsiella, Enterobacter and Serratia species. PMID- 3509544 TI - Structure-activity relationships in the cefpirome (HR 810) series: synthesis and antibacterial activity of 7 alpha-methoxy and 7 alpha-formylamino analogues of HR 810. PMID- 3509546 TI - [Root canal preparation: clinical aspects related to access]. PMID- 3509547 TI - [Molar morphology for location of retentive pins in restorations]. PMID- 3509548 TI - [Developing of dental radiographic film: criteria for density evaluation]. PMID- 3509545 TI - In vitro activity of RO 19-5247 (T-2525) against intestinal pathogens, glucose non-fermentative gram-negative rods, Legionella and Serratia. PMID- 3509549 TI - [Cheiloplasty for the correction of microstomia secondary to chemical burn]. PMID- 3509551 TI - A cephalometric appraisal of the results of orthodontic treatment on fifty five unsuccessfully corrected difficult Class II malocclusions. PMID- 3509550 TI - A cephalometric appraisal of the results of orthodontic treatment on one hundred fifty successfully corrected difficult Class II malocclusions. PMID- 3509552 TI - The control of horizontal planes in Class II treatment. PMID- 3509553 TI - The Class II division II malocclusion analysis and case report. PMID- 3509554 TI - The good direction in orthodontics. PMID- 3509555 TI - Class II division I treatment utilizing the twelve-two system of directional force. A case report. PMID- 3509556 TI - Orthodontic solutions for Class II malocclusions. PMID- 3509557 TI - Tweed occlusion and occlusal function. PMID- 3509558 TI - Anchorage preparation for the minimally cooperative patient. PMID- 3509559 TI - Serum and urine fluoride levels in toothpaste users. PMID- 3509560 TI - Hypohidrotic hereditary ectodermal dysplasia, report of two cases. PMID- 3509561 TI - Verruca-vulgaris of oral cavity. PMID- 3509562 TI - Analysis of fractured mandible and fractured middle third of the face in road traffic accidents. PMID- 3509563 TI - Fluoride varnish versus acidulated phosphate fluoride for schoolchildren in Manipal. PMID- 3509564 TI - Stereometric cephalometry--a radiological study. PMID- 3509565 TI - Herpes zoster of facial structures. PMID- 3509566 TI - The antibacterial efficacy of 50% citric acid and 5.25% sodium hypochlorite in infected root canal therapy. PMID- 3509567 TI - Vascular changes in the gingiva of young insulin dependent diabetics. PMID- 3509568 TI - The effectiveness of a fortnightly mouthrinsing programme in the prevention of dental caries in school children. PMID- 3509569 TI - Efficacy of electrical pulp testing. PMID- 3509570 TI - Whither orthodontics. PMID- 3509571 TI - Dentist with AIDS rarely wore gloves. PMID- 3509572 TI - Assessment of treatment needs of periodontal disease using CPITN in Uttar Pradesh population. PMID- 3509573 TI - Evaluation of biting force in mentally retarded children. PMID- 3509574 TI - Developmental anomalies of teeth in Himachal school children--a prevalence study. PMID- 3509575 TI - Nitrous oxide-oxygen analgesia and psychosedation for apprehensive children. PMID- 3509576 TI - Comparative evaluation of conventional toothbrushing and digital cleaning in preschool children. PMID- 3509577 TI - Changing trends of dental caries and enamel mottling after change of fluoride content in drinking water in endemic fluoride belt. PMID- 3509578 TI - Objective assessment of speech in repaired cleft cases as related to timing of palatal surgery. PMID- 3509579 TI - The New Zealand periodontal awareness campaign. 2. A report on progress 1986 1987. PMID- 3509580 TI - Smoking and periodontal disease. PMID- 3509581 TI - Periodontal treatment from the patient's viewpoint. PMID- 3509582 TI - The New Zealand periodontal awareness campaign: 1. Preliminary awareness by dentists and the public. PMID- 3509583 TI - The significance of fibro-osseous tissue in blade implantology. PMID- 3509584 TI - Eight-year study of alumina tooth implants in baboons. PMID- 3509585 TI - Expect the unexpected--report of an interesting case. PMID- 3509586 TI - 14-year case report: subperiosteal implant after resection of a mandible. PMID- 3509587 TI - A comparative analysis of fibro-osteal and osteal integration and other variables that affect long term bone maintenance around dental implants. PMID- 3509588 TI - A unique method of oral implantology education. PMID- 3509589 TI - Multi-type, bio-alloplastic and biologic implants. PMID- 3509590 TI - Early clinical evaluation of the Denar Steri-Oss Implant System. PMID- 3509591 TI - Osseointegration vs. fibro-osseous integration. Biomechanical considerations. PMID- 3509592 TI - Method of reinforcing pulpless anterior teeth. PMID- 3509593 TI - The impact of vascular surgical training on vascular surgical care. PMID- 3509594 TI - Shear stress regulation of artery lumen diameter in experimental atherogenesis. AB - We studied the adaptive response of the arterial wall and intimal thickening under conditions of increased flow in an atherogenic model. Blood flow was increased by construction of an arteriovenous fistula between the right iliac artery and vein in six cynomolgus monkeys fed a diet containing 2% cholesterol and 25% peanut oil. The left iliac artery served as the control. Serum cholesterol increased from 135 +/- 22 mg/dl to 880 +/- 129 mg/dl during the experiment. After 6 months, blood flow in the right iliac artery (420 +/- 95 ml/min) was 10 times greater than in the left iliac artery (44 +/- 9 ml/min, p less than 0.005). Flow velocity in the right iliac artery (31 +/- 6 cm/sec) was more than twofold greater than in the left (12 +/- 1 cm/sec, p less than 0.05). Despite the marked difference in blood flow and flow velocity, calculated wall shear stress was the same in both the right (16 +/- 4 dynes/cm2) and left iliac vessels (15 +/- 2 dynes/cm2) because of a twofold increase in lumen diameter (p less than 0.001) of the right iliac artery. Shear stress in the aorta was also normal (12 +/- 2 dynes/cm2). There was no difference in plaque deposition or mean intimal thickness between the right and left iliac arteries. In the right iliac artery there was a twofold increase in media cross-sectional area (p less than 0.001) but no change in media thickness or total wall thickness. Tangential wall tension and tangential wall stress were two times greater on the right than on the left (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3509595 TI - Improved management of aortic graft infection: the influence of operation sequence and staging. AB - To investigate the influence of operation sequence and staging on the outcome of aortic graft infection, we studied the mortality and amputation rates and incidence of new graft infection involving the extra-anatomic bypass (EAB) among 101 patients treated for secondary aortoenteric fistula (N = 43) or primary perigraft infection (N = 58). Patients were retrospectively grouped according to the operative treatment technique. Seven patients underwent infected graft removal (IGR) followed immediately by EAB (traditional). Fifty-seven patients were revascularized first, followed by immediate IGR in 38 patients (sequential) or by delayed IGR in 19 patients (staged). The median interoperative interval for the staged group was 5 days (range 2 to 31 days). Twenty patients underwent simultaneous IGR and in-line autogenous reconstruction (synchronous) and finally in 15 patients treatment consisted of IGR only with no extremity revascularization (none). The mean follow-up interval for all patients was 36.8 months. There was no statistically significant difference in mortality rate (traditional, 43%; sequential, 24%; and staged, 26%) or incidence of new graft infection (traditional, 43%; sequential, 18%; or staged, 16%) among those patients treated with EAB, although there was a trend toward an improved outcome with either sequential or staged treatment. There was a significantly lower amputation rate among sequential patients (11%) (p = 0.038) but not staged patients (16%) (p = 0.171) when compared with traditional treatment (43%). Staged operative treatment was associated with significantly less physiologic stress than sequential treatment as reflected by multiple perioperative metabolic variables (95% confidence limits). The treatment groups were comparable in the incidence of aortoenteric fistulas, culture-negative infections, emergent procedures, and appropriate antibiotic use. We conclude that reversed sequence or staged operative treatment of infected aortic grafts can be performed with no increased patient risk. Although traditional or sequential treatment may be required in the setting of acute hemorrhage, the staged operative approach is recommended for the treatment of chronic aortic graft infections. PMID- 3509596 TI - Influence of sequential pneumatic compression on postoperative venous function. AB - Sequential external pneumatic compression (SEPC) has been reported to decrease the incidence of acute deep venous thrombosis in postoperative patients by a direct mechanical action on the lower extremity veins and/or by inducing alterations in systemic fibrinolysis. To evaluate the effect of SEPC on venous function in the postoperative patient, pre- and postoperative venous capacitance (VC) and outflow (VO) were measured in a series of general surgical patients. In phase I, 17 limbs were evaluated in patients who had been fully ambulatory preoperatively and at complete bed rest postoperatively. VC decreased from 3.19 +/- 0.43 cc/100 cc of tissue (mean +/- standard error of the mean) preoperatively to 2.08 +/- 0.34 cc/100 cc of tissue postoperatively (p less than 0.05) and VO decreased from 87.2 +/- 10.6 cc/100 cc of tissue/min preoperatively to 58.1 +/- 8.7 cc/100 cc of tissue/min postoperatively (p less than 0.025). In phase II SEPC was begun preoperatively and continued for 24 hours postoperatively on one limb of 20 patients. SEPC prevented the decrease in VC and VO both in the pumped leg (VC-2.65 +/- 0.26 cc/100 cc of tissue preop, 2.40 +/- 0.18 cc/100 cc of tissue postop, p greater than 0.2; VO-72.3 +/- 5.9 cc/100 cc of tissue/min preop, 66.2 +/- 5.3 cc/100 cc of tissue/min postop, p greater than 0.2) and in the unpumped limb (VC-2.85 +/- 0.18 cc/100 cc of tissue preop, 2.41 +/- 0.24 cc/100 cc of tissue postop, p greater than 0.05; VO-66.1 +/- 5.2 cc/100 cc of tissue/min preop, 66.7 +/- 6.7 cc/100 cc of tissue/min postop, p greater than 0.5).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3509597 TI - One surgeon's ten-year experience with abdominal aortic aneurysm surgery in smaller community hospitals. AB - The results of one surgeon's 10-year experience with surgical treatment of abdominal aortic aneurysms are reviewed. There were 64 elective operations, eight operations on expanding aneurysms, and 19 procedures done for frank rupture. The mortality rate was 4.2% for the nonruptured aneurysm group compared with 36.8% for those patients with rupture. It may be suggested from this study that surgical treatment of abdominal aortic aneurysms can be done safely in low volume in smaller community hospitals and that such surgery need not be regionalized to larger institutions. PMID- 3509598 TI - Accessory nerve injury during carotid endarterectomy. AB - Injury to the accessory nerve (cranial nerve XI) during carotid endarterectomy is rare; to date only three cases have been reported in the literature. Traction on the sternocleido-mastoid muscle was the proposed mechanism of injury in all three cases. Four cases of accessory nerve palsy occurred in 850 carotid endarterectomies performed between 1978 and 1986 at this institution, an incidence of 0.47%. All four patients had classic signs and symptoms of accessory nerve injury, which developed between 20 and 60 days after operation. The three most recent cases were examined specifically for accessory nerve injury in the immediate postoperative period and exhibited normal trapezius function. None had any other central nervous system dysfunction. Two of these patients regained full accessory nerve function and the most recent case is showing signs of reinnervation with conservative therapy. Isolated central nervous system and spontaneous accessory nerve palsies are exceptionally rare, and since any traction injury or transection should have been detected by postoperative examinations in three of four patients, we propose surgical scar formation as a mechanism of accessory nerve palsy after carotid endarterectomy. If such a palsy develops in the postoperative period, we recommend conservative therapy. PMID- 3509599 TI - Symptomatic internal carotid thrombosis after carotid endarterectomy. AB - During a study period from 1977 through 1984, 11 (0.4%) of 2651 patients who had undergone carotid endarterectomy at The Cleveland Clinic had early, symptomatic thrombosis of the internal carotid artery (ICA) and underwent urgent reoperations. With only two exceptions, neurologic deficits occurred after lucid intervals when the patients had recovered from general anesthesia and were discovered within the first 8 hours in three patients, within 8 to 24 hours in five patients, and on the second postoperative day in one patient. Surgical management consisted of thrombectomy alone in two patients, thrombectomy and vein patch angioplasty in eight patients, and thrombectomy of the external carotid artery with ligation of the ICA in a single patient in whom retrograde ICA flow could not be reestablished. Eight (73%) of the 11 patients recovered substantial neurologic function after reoperations, six of whom had complete or nearly complete resolution of their symptoms. One patient (9%) sustained a fatal hemorrhagic cerebral infarction. In a collected series of 41 patients from this study and other reports, prompt surgical treatment of thrombosis occurring after carotid endarterectomy was associated with clinical improvement in 61% of patients and appears to be the preferred approach to this catastrophic complication. PMID- 3509600 TI - Recurrent carotid stenosis: operative strategy and late results. AB - From 1957 to 1985, 116 consecutive operations for recurrent carotid stenosis were performed in 99 patients at the University of California, San Francisco. Ninety four patients underwent 103 reoperations for primary recurrent stenosis (nine patients had bilateral repairs). Seventy-two operations (70%) were performed to relieve cerebrovascular symptoms whereas the indication for 31 operations (30%) was high-grade stenosis. The cause of primary recurrent stenosis was myointimal hyperplasia (MIH) in 47 cases, whereas 56 were caused by recurrent atherosclerosis (ASO). Secondary recurrent stenosis developed in six patients from our own series (5.8%) and an additional six patients were referred after reoperation elsewhere. The 12 lesions in this group were evenly divided between MIH (six) and recurrent ASO (six). MIH resulted in a single tertiary recurrent stenosis. Myointimectomy or repeat endarterectomy and vein patch angioplasty were the most commonly used techniques for repair of a primary recurrent stenosis. Secondary recurrent stenosis necessitated resection of the carotid bifurcation and graft interposition when caused by MIH. Secondary recurrent stenosis caused by ASO could be treated by repeat endarterectomy and vein patch angioplasty in five of six cases. Five strokes occurred in the entire series (4.3%), resulting in two deaths. There were 23 cranial nerve palsies, which rarely persisted beyond 3 months. The morbidity and mortality rates for primary and secondary carotid reoperation are comparable to the original procedure and should not deter the vascular surgeon from reoperative carotid reconstruction whenever indicated. PMID- 3509601 TI - Glossopharyngeal nerve injury complicating carotid endarterectomy. AB - Injury can occur to several of the cranial nerves during carotid endarterectomy. Among these, glossopharyngeal nerve injury is an uncommon complication because it is remote from the field of dissection in most carotid procedures. From more than 2000 carotid operations four cases of symptomatic ninth cranial nerve injury were identified. Analysis revealed that dissection cephalad to the level of the hypoglossal nerve was a common feature of each and severe functional disability can result from glossopharyngeal nerve paresis. When mobilization of this nerve and division of the posterior belly of the digastric muscle and styloid process become necessary for additional exposure, the risk of glossopharyngeal nerve injury increases. Specific recommendations are made regarding management and maneuvers to help reduce the incidence of this uncommon, yet potentially serious, complication. PMID- 3509602 TI - Isolated hypogastric artery revascularization after previous bypass for aortoiliac occlusive disease. AB - Patients with recurrent buttock claudication and/or impotence occurring after aortoiliac reconstruction, whose resting and postexercise vascular laboratory values are normal, represent an uncommon and poorly recognized problem resulting from occlusion of the bypassed iliac segments and ischemia isolated to the distribution of the hypogastric artery. This paradox and its solution are exemplified by two patients reported herein. In each instance flow was reestablished after thromboendarterectomy of the proximal hypogastric artery by connecting the artery to the functioning bypass. PMID- 3509603 TI - Seizures following subclavian-carotid bypass. AB - Seizures are uncommon after carotid endarterectomy. Patients at greatest risk for having this complication are those with high-grade carotid stenosis and possibly those with recent stroke or severe hypertension. The most favored theory regarding the pathophysiology is hyperperfusion caused by failure of cerebral autoregulation. This article describes our experience with the management of a patient suffering focal motor seizures after subclavian-carotid bypass performed to treat common carotid occlusion. PMID- 3509604 TI - Postoperative Pseudomonas urinary tract infections as a source of bacterial contamination of an autogenous vein graft. AB - The infection of autogenous vascular grafts from blood-borne contaminants is distinctly unusual. Two cases are reported in which a urinary tract infection caused by Pseudomonas aeruginosa occurred after autogenous saphenous vein bypass grafting. Despite appropriate intravenous antibiotic therapy for 10 days with clearing of both blood and urine, the patients subsequently had significant complications from graft infections. The factors thought to have contributed to this are discussed and the literature reviewed. Recommendations are made concerning the modification of the standard therapy in this situation. PMID- 3509605 TI - Acute dissection originating in the abdominal aorta. AB - A primary abdominal aortic dissection was encountered in a 53-year-old hypertensive man who was admitted with a 2-week history of back pain. Treatment with an infrarenal aortic bifurcation graft complemented by reconstruction of the proximal aortic cuff was curative. PMID- 3509607 TI - Tibiotibial vein bypass grafts: a new operation for limb salvage. PMID- 3509606 TI - A modified extrathoracic approach to the treatment of dysphagia lusoria. AB - The management of patients with esophageal compression by an anomalous right subclavian artery (dysphagia lusoria) has been controversial. A classic approach involves left thoracotomy, with resection of the aberrant subclavian artery from its origin to the right border of the esophagus. To prevent possible ischemic complications, most surgeons favor revascularization of the distal subclavian artery. Thoracotomy has been the traditional approach for division or reimplantation of the aberrant right subclavian artery. We describe a modification (right supraclavicular incision) of an extrathoracic approach, which was first described by Orvald in 1972, to simplify simultaneous correction of dysphagia lusoria and revascularization of the right upper extremity. PMID- 3509609 TI - [Orthodontic anomalies and otorhinolaryngology]. PMID- 3509608 TI - Suggested standards for reports dealing with lower extremity ischemia. PMID- 3509610 TI - [The exposure of ignorance]. PMID- 3509611 TI - [The ideal arch]. PMID- 3509612 TI - [The shape of the arch in normal occlusion]. PMID- 3509613 TI - [The shape of the arch: an individualized record]. PMID- 3509614 TI - [1st order curves. Their development in the functional phases of treatment]. PMID- 3509615 TI - [Symphyseal morphology and mandibular growth]. PMID- 3509616 TI - [The condylar-meniscal complex]. PMID- 3509617 TI - [Statural, bone and dental growth in Greek girls of the Athenian region]. PMID- 3509618 TI - [The ideal arch as defined by the patient]. PMID- 3509619 TI - [An esthetic appreciation test of the faces of patients treated with a combination of orthodontics and maxillofacial surgery]. PMID- 3509620 TI - [Early tooth injuries and impaction of the permanent central incisor with root abnormalities]. PMID- 3509621 TI - [The hypoplastic condyle treated with an activator appliance (apropos of 2 cases)]. PMID- 3509622 TI - [Class II, division 1 malocclusion in a skeletal pattern of a Class II, division 2]. PMID- 3509623 TI - [The condylar test in orthodontics and gnathology]. PMID- 3509624 TI - [Functional orthodontics. Prevention. Social dentistry]. PMID- 3509625 TI - [Trial of a personalized coherent chart]. PMID- 3509626 TI - [Mesial movement of the arc of the mandibular molars using the Edgewise technic]. PMID- 3509627 TI - [Esthetics and orthodontics]. PMID- 3509628 TI - [From the architecture of the nose to nose-chin relations: morphology and esthetics--the finality of corrective surgery]. PMID- 3509629 TI - [A lecture on the craniofacial architecture as an element of prediction]. PMID- 3509630 TI - [Agenesis of the maxillary lateral incisors: what treatment?]. PMID- 3509631 TI - [Diagnostic value and limit of cephalometry in cases of prognathism]. PMID- 3509632 TI - [An epidemiologic survey of treated and non-treated occlusion]. PMID- 3509633 TI - [Dental odontogenic trajectories, in the gorilla, in the vestibular 3-dimensional reference plane]. PMID- 3509634 TI - [Significance of the curve of the sagittal odontogenic trajectory of facial points during odontogenesis in the gorilla, in the vestibular plane]. PMID- 3509635 TI - [Multifactorial analysis of the facial parameters of the adult gorilla]. PMID- 3509636 TI - [Therapeutic requirements as a function of the position of the incisors and of relative macrodontia]. PMID- 3509637 TI - [The measurement of lingual pressure during phonation and deglutition: methods and initial results]. PMID- 3509638 TI - Patterns of stress among dentists. PMID- 3509639 TI - Temperature variations around periodontal pathological lesions. PMID- 3509640 TI - Diurnal mucosal temperature variations. PMID- 3509641 TI - [Incidence and clinical appearance of cleft deformities in the Transvaal]. PMID- 3509642 TI - Maxillary midline diastema and its association with ritual extraction of mandibular incisors in the Herero-speaking people of Kaokoland. PMID- 3509643 TI - Lower incisors and mandibular movement. PMID- 3509644 TI - Resistance to inspiratory nasal airflow in Herero-speaking males. PMID- 3509645 TI - The palatal vault of the Bushman (San), Vassekela and Himba. PMID- 3509646 TI - General practitioner's radiology casebook. II. PMID- 3509647 TI - Workshop on Drug Disposition and Metabolism in Aquatic Species. August 20, 1984, Gaithersburg, Maryland. Proceedings. PMID- 3509648 TI - Use of erythromycin in reducing vertical transmission of bacterial kidney disease. AB - Studies were conducted in 1980-1982 to determine uptake and retention of erythromycin when eggs of chinook salmon (Oncorhynchus tshawytscha) were water hardened for 1 hr in 2 ppm of the antibiotic as a means of preventing vertical transmission of bacterial kidney disease (BKD). Although eggs absorbed up to 1 ppm during water hardening, they retained the drug less than 24 hr. Injection of adult female chinook salmon with 11 mg of erythromycin/kg of body weight to prevent prespawning mortality from BKD resulted in deposition of drug in the eggs. Erythromycin persisted in the eggs at concentrations up to 0.6 ppm for 30 to 60 d postinjection--a period that would allow prolonged contact of drug with the causative agent of BKD, Renibacterium salmoninarum. Injection of prespawning female chinook salmon with erythromycin seemingly is potentially more effective than the water hardening of eggs in erythromycin in preventing vertical transmission of BKD. PMID- 3509649 TI - Fate and distribution studies of some drugs used in aquaculture. AB - Residue concentrations of drugs that are administered to fish by bath immersion are related primarily to passage of the drugs across the gills. The elimination of these chemicals by fish can be mediated by biotransformation, but the route of elimination depends on physical characteristics of the chemicals or on their biotransformation products. Uptake of the anesthetics tricaine methanesulfonate, benzocaine, Piscaine, and quinaldine is rapid because they are lipophilic. Loss of their residues also is rapid after the fish are removed from anesthetic solutions because the gradient of concentration favors passage back across the gills. Among therapeutants, uptake and loss of malachite green residues in fish follow the same general pattern as the anesthetics, although at much slower rates; the residues accumulate in the eggs of gravid female salmon after treatment and are detectable in eggs and newly hatched fry. In fish treated with formalin, residues of formaldehyde cannot be detected by currently available analytical methodology. Sulfonamides are metabolized in fish by acetylation and conjugation; however, the free form of the drug appears to be eliminated more rapidly than the acetylated form. PMID- 3509650 TI - Pharmacokinetics and tissue residues in channel catfish, Ictalurus punctatus, given intracardiac and intramuscular injections of gentamicin sulfate. AB - We studied the rate of absorption, distribution and elimination of gentamicin sulfate in the channel catfish, Ictalurus punctatus. It was determined that the plasma half-life of immunoreactive gentamicin was 12 to 15 hours in the catfish and the rate of elimination from fish after intracardiac and intramuscular (im) routes are not significantly different. Compared to mammals, the very extended half-life is probably the result of a greater unionized fraction of drug in the central compartment and increased reabsorption of drug from the alkaline urine of the fish. Tissue levels at the end of one dose experiments approximate what was predicted based on the intracardiac microconstants. A dosage regimen was established on a 24 hr interval that would keep peak plasma concentration between 10-13 micrograms/ml and allow trough concentrations of 3-4 micrograms/ml. Intramuscular gentamicin appears to have a bioavailability of approximately 37%. Finally, a renal lesion was produced by giving gentamicin im at 10 mg/kg every 33 hr for 6 treatments. The lesion was identical to that described for other mammals and was reversible even while medication was continued. PMID- 3509651 TI - In vivo metabolism and disposition of drugs by aquatic species. AB - The model system developed in the dogfish shark was reviewed to determine the kinds of studies that can be done on in vivo metabolism and disposition of drugs. Biliary and urinary sampling provided a compilation on the distribution and pharmacokinetics of 16 drugs and model compounds. The major transport and excretory and metabolic parameters in this fish were similar to those found in mammals. The use of such studies for scientific and regulatory purposes is considered. PMID- 3509652 TI - Stress factors that can affect studies of drug metabolism in fish. AB - The effects of environmental stress conditions on the defense response of rainbow trout following a four week exposure to subacute levels of un-ionized ammonia or temperatures 5 C above and 5 C below the temperature optimum (15 C) were investigated. These experimental studies can serve as a model to evaluate the metabolic response of fish to external agents (e.g., drugs, vaccines) under environmental conditions seen in the culture of fish. Blood and tissue immune parameters measured include hematocrits, antibody levels and differentiation of white blood cell populations in tissue imprints of the anterior kidney. These analyses were compared to the growth parameter, average percent weight gain. Fish given primary and secondary immunization with a bacterial vaccine (Aeromonas hydrophila) were exposed to sublethal concentrations of un-ionized ammonia of 0.2, 0.3 or 0.4 mg/ml. Fish exposed to the higher concentrations of ammonia showed a decrease in growth compared to control fish. Several significant changes were observed in the leukocytes of the anterior kidney at the various concentrations of ammonia tested. A decrease in antibody titers to A hydrophila was seen at the two higher concentrations of ammonia. In a second study, the effects of non-optimum temperature conditions (10 C and 20 C) were compared with an optimum temperature (15 C). Fish held at sub-optimum temperatures had significantly lower hematocrits than the control fish maintained at 15 C. Several significant changes were also seen in the anterior kidney leukocytes. Antibody titers to A hydrophila were significantly lower at the end of the stressing period in the trout maintained at 10 C compared to the immunized controls at 15 C. In contrast, fish held at 20 C had significantly higher antibody titers than did the immunized controls. Compared to controls, fish growth was increased at 10 C and decreased at 20 C. These studies confirm that environmental factors can induce stress and affect the metabolism and health of the fish. PMID- 3509653 TI - Recent experiences with the drug approval process: need and role for drug metabolism data. AB - Some of the problems of obtaining drug efficacy data under field conditions in extensively cultured fish (catfish) are considered. The variable water quality conditions, feeding and management practices encountered in this type of fish culture demonstrate a need for innovative methods to evaluate drug efficacy. Data on drug metabolism and disposition can provide valuable information necessary to evaluate efficacy for the drug regulatory agencies and give the fish producer a better basis for utilizing drugs in fish health management. PMID- 3509654 TI - [Mass spectometry and personal computer in the study of pulmonary gas exchange]. PMID- 3509655 TI - [Caseload and epidemiologico-statistic findings about cases of spontaneous hemothorax at the A. Tanzarella Hospital of Ostuni from 1978 to 1986]. PMID- 3509656 TI - [Mezlocillin in bronchopneumopathy caused by neoplasm obstruction]. PMID- 3509657 TI - [Mezlocillin in the treatment of acute and chronic exacerbated respiratory infections]. PMID- 3509658 TI - [Use of mezlocillin in the treatment of bacterial infections of the lower respiratory tract]. PMID- 3509659 TI - [Invasive diagnosis and therapeutic program for solitary nodules of the lung]. PMID- 3509660 TI - [Invalidating incidence of cardiovascular diseases according to article 1 (subsections 1 and 2) of law number 222 of 12-6-1984. Evaluation guidelines]. PMID- 3509661 TI - [Gaseous exchanges in pleural effusions]. PMID- 3509662 TI - Development of language and communication skills in hearing-impaired children. PMID- 3509663 TI - Development of language and communication skills in hearing-impaired children. Introduction. PMID- 3509664 TI - Communication skills of mainstreamed hearing-impaired children. PMID- 3509665 TI - Interrelationships among the speech and language measures. PMID- 3509666 TI - The development of language in young hearing-impaired children. PMID- 3509667 TI - Development of syntactic comprehension. PMID- 3509668 TI - A computer-based syntactic analysis of the written language of hearing-impaired children. PMID- 3509669 TI - The effects of hearing status of the family and age of intervention on receptive and expressive oral language skills in hearing-impaired infants. PMID- 3509670 TI - Communication skills of hearing-impaired children in schools for the deaf. PMID- 3509672 TI - Production, binding characteristics, and immunogenicity of heterologous anti idiotypic antibody to herpes simplex virus glycoprotein C. AB - A monoclonal antibody specific for glycoprotein C (gC) of herpes simplex virus type 1 (HSV-1) was used to prepare a heterologous anti-idiotypic antibody in rabbits. After absorption with normal mouse immunoglobulin (NMS) the anti idiotypic (anti-id) antibody retained binding activity for MoAb D4.1, the immunogen. The anti-id (anti-id C) also demonstrated a cross-reactive binding activity, as shown by ELISA, for MoAb D4.2 and MoAb D4.8 which was specific for glycoprotein D (gD) and glycoprotein B (gB) of HSV-1, respectively. Also, anti-id C bound to and eluted from MoAb D4.2 and MoAb D4.8 affinity columns retained the ability to bind all three monoclonal antibodies. This cross-reactive anti-id could inhibit the binding of each of the three monoclonal antibodies to their respective proteins, suggesting an antigen combining site specificity. Subsequently, the idiotope on MoAb D4.8 was shown to be outside the antigen combining site, since anti-id C recognized MoAb D4.8 complexed with gB. The anti id, however, did not bind MoAb D4.1 or MoAb D4.2, if these monoclonals were bound to gC or gD, respectively, suggesting the cross-reactive determinant was paratopic on those two monoclonals. Immunization of mice with anti-id C could prime splenocytes in vivo to proliferate in response to HSV antigen stimulation in vitro. Thus, spleen cells involved in the HSV immune response in vitro recognized the anti-idiotypic antibody in vivo. PMID- 3509671 TI - Characterization of variable-region genes and shared crossreactive idiotypes of antibodies specific for antigens of various influenza viruses. AB - Several syngeneic monoclonal anti-idiotypic antibodies were obtained against PY206, a monoclonal antibody specific for X-31 (H3N2) influenza virus hemagglutinin. This idiotype was found in the sera of BALB/c mice immunized with various influenza viruses. Adsorption experiments indicated that the PY206 Id was borne by antibodies specific for viral hemagglutinin (HA) and/or neuraminidase (NA). This idiotype was identified on other monoclonal antibodies specific for various influenza HAs (H3 and H1). Study of the variable-region (V) genes of these monoclonal antibodies showed that its expression is independent of variable kappa (VK)21 light-chains and that the heavy-chains of the strongly idiotype positive hybridomas derive from either the variable heavy (VH) J558 or VH 7183 family. Finally, Western blot analysis demonstrated that PY206 idiotypic determinants are located exclusively on the heavy chain. PMID- 3509673 TI - Autologous and allogeneic antibody responses to canine distemper virus isolates from dogs with chronic neurological diseases. AB - We describe the antibody responses to three strains of canine distemper virus (CDV) isolated from dogs with chronic neurological disease in the Los Angeles area using the naturally occurring sera and cerebrospinal fluids (CSFs) of these animals as probes for comparison. CDV/CDE-2 was derived from a dog with chronic distemper encephalitis, and CDV/ODE-8 and CDV/ODE-10 were derived from dogs with old dog encephalitis. Sera and CSFs were used in autologous (same dog) and allogeneic (different dog) combinations to immune precipitate the [35S] methionine-labelled H, P, NP, F1, and M polypeptides of the virus-infected cell cultures. The polypeptides were separated by SDS-PAGE and detected by fluorography. There was decreased recognition by the CSF and sera of the polypeptides of the viral isolates in several autologous as well as allogeneic combinations. It is concluded that the immune responses to the CDV strains are not identical, and it is likely that viral mutations occurred after the animals were infected. Some mutations may have contributed to the pathogenesis of distemper encephalitis in these animals and some may have occurred during subsequent passage of the viruses in cell culture. This may explain the decreased recognition of the polypeptides of the viral isolates by the CSF and sera. PMID- 3509674 TI - Effect of syngeneic anti-idiotypic antibody on influenza virus neuraminidase antibody response. AB - Influenza viruses possess two major surface glycoproteins - hemagglutinin (HA) and neuraminidase (NA). Py203, a monoclonal antibody (Ab) specific for the neuraminidase of the PR8 (H1N1) influenza virus, was used to prepare syngeneic monoclonal anti-idiotypic (anti-Id) Abs. From a BALB/c mouse immunized with Py203 (anti-N1), we obtained RM1, a monoclonal anti-Id Ab. The Py203-Id was detected in a significant fraction of immunoglobulins (Igs) in the primary and secondary responses elicited by PR8 (H1N1) and X31 (H3N2) viruses. In animals injected with minute amounts of RM1 and subsequently boosted with an identical dose of RM1, no detectable anti-NA activity was noted, but a significant increase in Py203-Id bearing Igs was observed. In the sera of animals injected with minute amounts of RM1 and subsequently boosted with PR8 (H1N1) or X31 (H3N2) viruses, an increase in anti-NA activity and in the level of Py203-Id was noted. Animals injected with large amounts of RM1 and boosted with PR8 and X31 showed a marked suppression of the Py203-Id but no alteration in the anti-NA response. The anti-Id recognizes an idiotope (the Py203 idiotope) shared by antibodies specific for the N1 and N2 neuraminidase variants. PMID- 3509675 TI - Modulation of porcine peripheral blood-derived macrophage functions by in vitro infection with African swine fever virus (ASFV) isolates of different virulence. AB - Macrophages play an important role in defense against invading pathogens and neoplastic diseases. Their ability to maintain their functional characteristics is also important in the survival of the host. Loss of macrophage function during infection may be important in determining resistance or susceptibility of a host species. In this communication, we describe the effect of ASFV replication, in macrophages in vitro, on the functional characteristics of these cells. Infection with ASFV did not alter the expression of Fc receptors nor their ability to mediate ADCC. However, African swine fever virus was shown to modulate antibody mediated phagocytosis, chemiluminescence and chemotaxis. Similar modulation of certain macrophage functions was observed with ASFV isolates that differed in their virulence. We were therefore, unable to correlate the virulence of ASFV with the ability to alter macrophage function. PMID- 3509676 TI - Relation of serum antibody to glycoproteins of respiratory syncytial virus with immunity to infection in children. AB - Immunity in relation to passively transferred maternal and naturally-induced serum antibody to the viral proteins was determined in 34 children who were followed from birth through three years of age for respiratory syncytial virus infection (RSV). Sera were tested by immunoglobulin class-specific enzyme-linked immunosorbent assay using the attachment and fusion proteins of the Long strain. The basis for immunity for maternal antibody in primary infection was assessed by a comparison of the distribution of antibody titers in a) 7 children who had an upper respiratory illness to 12 whose illness was accompanied by lower respiratory disease and of b) 13 children with an RSV-associated illness in the first 6 months of life who were age-matched as to month and approximate day of birth with 11 not infected in the same period. Infection induced immunity was evaluated by a comparison of antibody titers in 19 children who were reinfected with RSV in the year following their primary infection to 15 in whom reinfection was not documented. A statistical analysis of titers revealed that antibody to the fusion protein is an important correlate of immunity. In all three comparisons, the children with less RSV disease had significantly higher IgG anti F titers prior to infection. No differences were observed between IgA anti-F or IgG and IgA anti-G titers. PMID- 3509677 TI - Modulation of murine coxsackievirus-induced myocarditis utilizing anti-idiotypes. AB - Pre-treatment of syngeneic mice with polyclonal populations of Protein-A separated anti-idiotypic antibodies prepared against anti-CVB3 viral idiotypes resulted in reduction of inflammatory myocarditis in virus-challenged mice. Cellular immunity as assessed by cell-migration-inhibition resulted in specific cell-mediated sensitivity against anti-Ids (CVB3) as well as viral preparations. Animals pre-treated with anti-idiotypic preparations developed an anamnestic anti viral antibody response, with antibodies capable of specifically binding CVB3 virus antigen in an ELISA assay; but without CVB3 viral neutralizing capability. Adoptive transfer of limited numbers of syngeneic anti-Id immunized lymphoid cell populations failed to alter the course of inflammatory myocarditis in CVB3 virus challenged animals. Cellular binding studies utilizing anti-Ids suggested increased, but nonspecific binding of anti-Ids to lymphoid and myocyte populations in CVB3 infected animals. The data suggest an immunomodulatory role of idiotype-anti-idiotype interactions in the development of myocarditis. PMID- 3509678 TI - Antibodies to HTLV-1 in saliva of seropositive individuals from Japan. AB - Secretory antibodies protect mucosal surfaces against transmission of many viruses. Human T-lymphotropic Virus, Type I (HTLV-I) is transmitted via blood products and via sexual contact across mucosal surfaces. We investigated the presence of HTLV-I-specific antibodies in whole saliva samples from 10 seronegative and 28 seropositive volunteers from a hospital in southern Japan. Antibodies directed to HTLV-I antigens were found in the salivas from 22 of 28 (79%) of the seropositive subjects. None of the seronegative individuals showed evidence of salivary antibodies. Antibodies directed to the envelope antigens of the virus were found in 21 of 22 positive saliva samples. Secretory antibodies may be important in preventing mucosal transmission. PMID- 3509679 TI - Characterization of the antibody response in vaccinated mice protected against Coxsackievirus B3-induced myocarditis. AB - Adolescent male CD-1 mice can be rendered resistant to coxsackievirus B3 (CVB3m) induced myocarditis following inoculation as neonates with a single dose of a temperature-sensitive mutant virus (ts1), derived from the prototype parent virus (CVB3m). Previously, anti-CVB3 neutralizing antibodies were not detected in sera of adolescent ts1 vaccinees by a standard plaque-reduction assay (Gauntt et al 1983. Infect. Immun. 39:851). However, a more sensitive cytopathic effects reduction assay permitted detection of low titers of anti-CVB3m neutralizing antibodies of the IgG class prior to challenge with CVB3m. Following CVB3m challenge, serum anti-CVB3m neutralizing antibody titers of ts1 vaccines declined on days 1-2 post-inoculation (p.i.) then increased over the next 6 days. The neutralizing antibodies were of both the IgG and IgM classes. Normal mice challenged with CVB3 did not produce detectable serum anti-CVB3m neutralizing antibody until day 4 p.i. and by 8 days p.i. the neutralizing antibody was only of the IgM class. Thus, adolescent murine ts1 vaccines mount a secondary antibody response to CVB3m in both neutralizing IgG and IgM, but resistance to CVB3m induced myocarditis is due to the presence of low levels of anti-CVB3m IgG neutralizing antibody in serum at the time of challenge with CVB3m. PMID- 3509680 TI - [Advancement in hypertrophic cardiomyopathy. Presented at the 31st meeting of the Cardiography Society. Nagoya, September 27-29, 1985]. PMID- 3509681 TI - [Hypertrophic cardiomyopathy: mode of death and pathological findings]. AB - To ascertain relationships between modes of death and various pathological parameters in hypertrophic cardiomyopathy (HCM), quantitative analysis of the disarray, fibrosis, and size of myocytes was performed in 22 autopsied subjects with HCM. According to mode of death, the subjects were categorized as three groups; (1) a sudden death group (10 patients), (2) a heart failure group (7 patients) and (3) a control group (5 patients). The group consisted of patients with HCM who were over 55 years old and who died of other diseases (e.g., cancer 3) or from accidents. The hearts were fixed in 10% formalin and sectioned from the base to the apex at 1 cm intervals. A section with maximal septal hypertrophy was histologically examined. The histologic findings in the interventricular septum (VS) and the left ventricular free wall (FW) were quantitatively analyzed using an image analyzer (Olympus VIP-21). The extents of fibrosis and disarray were greater in the sudden death group (fibrosis: VS/FW = 16 + 3/11 + 5%, disarray: VS/FW = 58 + 18/32 + 17%) than in the control group (fibrosis: VS/FW = 7 + 2/6 + 4%; disarray: VS/FW = 24 + 7/8 + 6%), but there were no significant differences in the various parameters of hypertrophy (heart weight, wall thickness, degree of asymmetric septal hypertrophy and size of myocytes) between these two groups. The heart failure group consisted of four hearts with dilated LV cavities and two hearts with small LV cavities. The former showed extensive replacement fibrosis (VS/FW = 37 + 7/25 + 5%) and disarray of residual myocytes (VS/FW = 20 + 16/14 + 6%).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3509682 TI - [Left ventricular function at rest and during exercise and the effects of propranolol in patients with hypertrophic cardiomyopathy]. AB - To determine left ventricular function during the stress of exercise and to evaluate the effects of propranolol on it in patients with hypertrophic cardiomyopathy (HCM), the ECG-multigated blood pool cardiac scintigraphy was performed in 12 without (HNCM) and 10 with (HOCM) left ventricular outflow obstruction at rest and during bicycle ergometer loading. The results were compared to those in 13 normal subjects. 1. Control measurements: Resting and exercise heart rates and blood pressures did not significantly differ between patients with hypertrophic cardiomyopathy and normal subjects. Ejection fraction (EF) was normal or higher in HCM than in normal subjects at rest, but during exercise it failed to increase normally. The increment in cardiac output was half of the normal value. Responses of count-derived end-diastolic volume (EDV) and stroke volume (SV) were different between HOCM and HNCM. They were unchanged during exercise in HNCM and declined in HOCM. End-systolic volume (ESV) was unchanged in HNCM and slightly decreased in HOCM. Responses of the peak ejection rate (PER) and time to the peak ejection rate (TPE) were not significantly different from normal subjects. Left ventricular (LV) ejection time (ET) and TPE/ET were not different from normal subjects. The peak filling rate (PFR) was significantly higher than normal in HOCM at rest and during exercise. The time to peak filling rate was prolonged at rest in HOCM, but not during exercise. 2. Effects of propranolol: Heart rates significantly decreased especially after intravenous propranolol administration. Cardiac output (CO) and SV were unchanged. EDV and ESV increased significantly. The PER was unchanged. The PFR decreased, but not significantly. TPE, time to the PFR (TPF) and ET were prolonged. The ratio of TPE/ET decreased initially, but abruptly increased later. In conclusion, in the control state of HCM patients, the responses of LVEF, EDV and ESV to exercise were abnormal and CO remained half of the normal. There was no difference between patients with and without obstruction. The effect of propranolol on left ventricular function was more obvious in patients with obstruction than without obstruction, especially in ESV, EDV, PFR and TPF. Propranolol did not improve LV systolic and diastolic functions, but the double product decreased depending on the decrease of heart rate maintaining CO by Frank Starling mechanism due to increased EDV, which may play a part in improving subjective complaints. PMID- 3509683 TI - [Left ventricular systolic and diastolic functions in hypertrophic cardiomyopathy: with special reference to clinical symptom and the effects of calcium blocking agent (nifedipine)]. AB - To assess left ventricular (LV) diastolic function in hypertrophic non obstructive cardiomyopathy (HCM), biplane angiograms and pressures (catheter-tip manometer) were analyzed in 23 patients with HCM and 10 normal subjects (N). The effects of calcium antagonist on LV diastolic function was also evaluated by sublingual administration of 20 mg of nifedipine in 17 patients with HCM. Frame by-frame (20 msec) analysis of angiograms was performed. LV relaxation was assessed by the time constant (T) of isovolumic LV pressure decline. 1. As compared with N, HCM showed greater increase in LV end-diastolic pressure and time constant (T). There was a significant prolongation of time from end-systole to the peak filling rate (PFR) during rapid filling period in HCM, while PFR did not differ between N and HCM. Left and upward shifts of LV diastolic pressure volume relations were noted in HCM. Thus, abnormal LV diastolic function in HCM was characterized by impaired relaxation, delayed early diastolic filling and decreased LV compliance. 2. Clinical symptom of chest pain in HCM was associated with a decreased normalized PFR (PFR/SV and PFR/EDV). This finding suggested that an abnormal LV diastolic filling may be one of the contributing factors of chest pain in HCM. 3. Sublingual nifedipine (20 mg) did not always improve impaired relaxation and diminished LV compliance in HCM. Further study will be needed in the treatment of abnormal LV diastolic function in HCM with calcium blocking agents. PMID- 3509684 TI - [Cardiac function and prognosis in hypertrophic cardiomyopathy]. AB - To assess pathophysiological changes and prognoses in hypertrophic cardiomyopathy (HCM), the clinical courses of 190 patients with HCM between 1968 and 1985 were reviewed and analyzed. Their average follow-up period was 4.0 years. During the course of follow-up, 24 patients died of heart disease at annual mortality of 3.3%; 22 sudden death, and two congestive heart failure. Among the 190 cases, 70 were studied by echocardiography with an average follow-up period of 4.4 years. The subjects were categorized in three groups: 10 who died suddenly (SD group), 16 with ventricular tachycardia (VT group) and the remaining 44 without ventricular tachycardia (non-VT group). Initially, the VT group had significantly greater left ventricular end-diastolic dimension (LVDd), smaller % fractional shortening (FS), and normalized rapid felling rate (RFR) compared with the other two groups. However, there were no significant differences in the echocardiographic parameters between the SD and non-VT groups. During the follow up period, no changes in echocardiographic parameters were observed in the non-VT group. However, LVDd was increased in both the SD and VT groups, and normalized RFR and atrial filling rate (AFR) were decreased in the SD group. These results suggested that close observations using echocardiography are useful for evaluating the natural history and prognoses of HCM. PMID- 3509685 TI - Limited maximal vasodilator capacity of forearm resistance vessels in hypertrophic cardiomyopathy. PMID- 3509687 TI - Fifth International Workshop on In Vitro Toxicology. Schloss Elmau, West Germany, November 1988. Proceedings. PMID- 3509686 TI - [Relationships between distribution of disorganized cardiac muscle cells and disease state in hypertrophic cardiomyopathy]. AB - Congestive heart failure is rare in hypertrophic cardiomyopathy (HCM). Therefore, disorganization of the cardiac muscle cells, a histological hallmark of HCM, has not been associated with reduced ventricular contraction. We performed a clinicopathological study of 18 patients with HCM to determine whether disorganization contributes to dilatation and impaired contraction of the ventricles, resulting in affecting the disease condition. The subjects were classified into Group A (11 patients) without dilatation of the ventricular cavities after formalin fixation at autopsy (left 11.9 ml and right 19.1 ml), Group B (two patients) with dilatation of the left but without of the right ventricular cavity (left 31.9 ml and right 25.6 ml), and Group C (five patients) with biventricular dilatation (left 38.6 ml and right 36.8 ml). Various parameters were compared among the three groups. The mean age of the patients was 44.0 years for Group A, 18.5 for Group B and 10.2 section for Group C. The mean cardiothoracic ratio was 51.8% (n = 7) for Group A, 53% (n = 1) or Group B, and 74.0% section for Group C. Obstruction of the left ventricular outflow tract was observed in 100% (n = 8) of the Group A patients, in 0% section of the Group B patients, and in 20.0% section of the Group C patients. The mean left ventricular ejection fraction was 81.0% (n = 5) in Group A, 65.5% in Group B and 39.0% section (n = 2) in Group C. None of the Group A patients had chronic congestive heart failure, whereas all Group C patients died of this condition. Using transverse and longitudinal tissue sections from the ventricles, and a quantitative method employing light microscopy, we determined the area of the myocardium characterized by disorganization and interstitial fibrosis. Septal disorganization was observed in 67.4%, 83.4% and 91.1% section of the transverse sections in Groups A, B and C, respectively, and in 17.0%, 24.9% and 63.5% section of the longitudinal sections in the respective groups. As for the left ventricular free wall, disorganization involved 21.2%, 69.4% section and 90.8% section of the transverse sections and 15.9%, 34.9% section and 38.1% section of the longitudinal sections in Groups A, B and C, respectively. In the right ventricular free wall, there was disorganization in 17.7%, 20.4% and 84.3% section of the transverse sections in 12.4%, 11.5% and 57.0% section of the longitudinal sections in the respective groups.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3509688 TI - Toxicity of paracetamol in human hepatocytes. Comparison of the protective effects of sulfhydryl compounds acting as glutathione precursors. AB - The hepatotoxicity of N-acetyl-p-aminophenol (acetaminophen, paracetamol) was investigated in hepatocyte cultures obtained from eight different human liver biopsies. Incubation of hepatocytes with paracetamol resulted in a dose- and time dependent glutathione depletion. Glutathione decreased linearly for 8 h, reaching a minimum after 12 h of exposure. Cytotoxicity, assessed as loss of cellular protein from plates, was observed only when glutathione decreased below 20% for more than 12 h. However, in one donor, cytotoxicity was observed with even a moderate glutathione decrease. Prestimulation of hepatocytes with 1 mM phenobarbital or 2 microM methylcholanthrene for 48 h did not lead to a significant increase of paracetamol toxicity, although the glutathione levels in 3-methylcholanthrene-treated cells were somewhat lower. Several metabolic precursors were examined in vitro for their ability to increase intracellular glutathione and the results showed the following sequence: N-acetylcysteine greater than thioproline greater than cysteine greater than 2-oxo-4-thiazolidine carboxylic acid greater than methionine. However, only N-acetylcysteine, thioproline, and cysteine substantially increased glutathione levels when 1 mM paracetamol was present in the incubation medium and thus prevented its toxicity. N-acetylcysteine elevated glutathione even after 24 h of preexposure to paracetamol. The fact that cell damage did not correlate with glutathione levels in all human cultures suggests that glutathione depletion may not be the only determinant of paracetamol toxicity in human hepatocytes. PMID- 3509689 TI - Biotransformation enzymes in two renal epithelial cell lines (LLC-PK1 and RK-L). AB - The activities of smooth endoplasmic reticulum (SER) and cytosolic xenobiotic metabolizing enzymes were studied in two established renal tubular cell lines, LLC-PK1 and RK-L (rat kidney, Lubeck). The glutathione content in both cell lines was about 20-fold higher than in rat kidney homogenates; this is explained by a 20- to 50-fold lower activity of gamma-glutamyl transpeptidase in the cell lines. Among SER enzymes, the cytochrome P-450-dependent dimethylhydrazine demethylase was in the same range in both cell lines as compared with rat kidney S9 fraction. Pretreatment with phenobarbital (0.1 mM in the culture medium for 3 d) did not induce SER or cytosolic enzyme activities. The glutathione content in both epithelial cell lines can be modified by an inhibitor of GSH synthesis (buthionine sulfoximine, BSO), whereas inhibition of gamma-glutamyl transpeptidase (acivicin) did not significantly increase the GSH-concentration. Despite these biochemical characteristics, the utility of the new RK-L-line needs to be evaluated in experimental studies on renal transport processes and metabolism as well as cytotoxicity and genotoxicity of xenobiotics. PMID- 3509690 TI - Cyclosporine A nephrotoxicity studied by the combined application of kidney cell lines, hepatocytes, and endothelial-platelet cocultures. AB - Established renal epithelial cell lines of human, pig, and dog origin (293, LLC PK1, MDCK) were examined in terms of nephrotoxicity and ability to biotransform cyclosporine A (CsA). All three cell lines exhibited a comparable concentration dependent cytotoxicity to CsA treatment. Alterations in cell function included a decreased transport of lysine, an inhibition of growth, and an activation of lysosomal and mitochondrial activity as indicated by the increased uptake of neutral red (NR) and increased reduction of the tetrazolium dye MTT at 1-6 microM CsA. Increased leakage of lactic dehydrogenase and activities of gamma-glutamyl transpeptidase (GGT) and N-acetyl-beta-D-hexosaminidase were observed at 48 h and 12 microM CsA. A discrimination between CsA and the less nephrotoxic cyclosporine (CsH) was shown for DNA synthesis and NR uptake. The contribution of extrarenal parameters on kidney cell function was studied by the addition of medium from hepatocytes exposed to CsA to the kidney cell lines. A more potent inhibition of DNA synthesis and enhanced reduction of MTT resulted than by addition of equimolar CsA directly to the kidney cells. These data indicate that hepatocyte constituents present in the medium due to CsA treatment affect kidney cell function; additionally, the presence of CsA metabolites may contribute to the CsA induced nephrotoxicity. The vascular nephrotoxicity induced by CsA, an increased deposition of platelets in the renal arterioles, was mimicked by cocultures of endothelial cell monolayers and platelets. CsA increased the aggregability and adherence of platelets to the endothelial cell monolayers, whereas CsH had no effect. PMID- 3509691 TI - Induction and activity of several isoenzymes of cytochrome P-450 in primary cultures of rat hepatocytes, in comparison with in vivo data. AB - Changes in cytochrome P-450 isoenzymes were studied in rat liver and in primary cultures of rat hepatocytes after treatment with compounds belonging to various classes of inducers, including phenobarbital (PB), beta-naphthoflavone (BNF), and clofibrate/clofibric acid (CLOF/CLOFA). The enzyme activity toward specific substrates was measured, and the presence of apoprotein of several P-450 isoenzymes was determined semiquantitatively by Western blotting. In untreated cultures the P-450 content and activities of 7-ethoxyresorufin O-deethylation (EROD) and aniline 4-hydroxylation (AH) declined with time at different rates. In cultures treated with BNF, the protein levels of isoenzyme P-450IA1 and P-450IA2 were elevated, as in vivo. This induction was reflected in a markedly increased EROD activity. CLOFA enhanced the AH and EROD activity in primary cultures at the same level as in vivo. The monooxygenase activity pentoxyresorufin O depentylation (PROD) was stimulated by PB and CLOF in vivo, which correlated with the enhanced protein level of P-450IIB1/2. In contrast, the PROD activity was not induced when cultures were treated with PB or CLOFA, although we could detect apoprotein of P-450IIB1/2 by immunoblotting. PMID- 3509692 TI - Do we find relevant parameters for in vitro cytotoxicity testing? AB - The current strategy for the design of cytotoxicity tests is briefly reviewed in light of goals that need to be reached, and in the capacity of in vitro tests to fulfill the high public expectations for alternative methods to animal testing. Various cytotoxicity tests and parameters used for the assessment of topical toxicity and of neurotoxicity are chosen as examples and their relevance is discussed. Past experience with in vitro and short-term tests for mutagenicity shows not to look for one single supertest. A proposition for reasonable safety testing implies that a combined approach must be developed that integrates the results from a battery of cell tests and from structure-activity analyses as well as from kinetic and metabolic studies. The relevance of such an integrated approach must be aimed directly at the organisms that may be exposed. PMID- 3509693 TI - Antikinetochore antibodies and flow karyotyping: new techniques to detect aneuploidy in mammalian cells induced by ionizing radiation and chemicals. AB - For a possible detection of aneuploidy induction by chemicals and ionizing radiation, fluorescein-bound antikinetochore antibodies (CREST-scleroderma antibodies) were used to discriminate between micronuclei deriving from acentric fragments or from chromosome loss induced in Chinese hamster cells. The cells were treated with aphidicolin, adriamycin, Hoechst 33258, colcemid, the alkylating agent diethyl sulfate, and ionizing radiation. The frequency of micronucleated cells, the fraction of kinetochore-positive and -negative micronuclei per cell, and the fraction of kinetochore-positive micronuclei was measured using immunofluorescence staining of kinetochores in micronuclei. Of the micronuclei and fragmented nuclei induced by colcemid, 99% contained kinetochores, whereas ionizing radiation induced only 4% of kinetochore-positive micronuclei. The other drugs induced variable, in some cases also cell-cycle dependent, fractions of kinetochore positive micronuclei. With this technique a discrimination between clastogenic effects and effects that occur at the level of spindle formation of the agent studied seems to be possible. Flow karyotyping was used to study the induction of stable homogeneous and numerical aberrations in diploid Chinese hamster cell clones that had survived a dose of 15 Gy gamma radiation. All analyzed clones showed deviations in their flow karyotypes: the mean number was 9.2 deviations per clone, compared to 1.1 deviations per clone in unirradiated control clones. PMID- 3509694 TI - Development of cytotoxicity tests for assessment of the toxicity of water samples taken from the environment. AB - Different methods of measuring cytotoxicity have been investigated in order to establish a test system for assessment of the toxicity of water samples. Ideally this should be highly sensitive and rapid to perform. Four variations of the neutral red uptake test have been compared with the MTT test and ATP determination. Chinese hamster V79/4 cells were used as the test system with 10 model toxins. All tests gave essentially similar results, with linear regression analysis producing correlation coefficients in excess of .93. No single test was most sensitive to all 10 compounds. The neutral red uptake and MTT tests could be performed in a single working day (approximately 8 h) if test compound and cells were plated out simultaneously. These tests are preferable to ATP determination, which is a complex and lengthy procedure, requiring expensive reagents. PMID- 3509695 TI - New methods for cytotoxicity testing: quantitative video microscopy of intracellular motion and mitochondria-specific fluorescence. AB - The aim of this study is to qualify the application the new microscopic methods fluorescence and AVEC-DIC (Allen video-enhanced contrast differential interference contrast) microscopy for toxicity testing. The effects of 2-OH-ethyl methacrylate (HEMA), a toxic acrylic monomer, on human fibroblasts was tested. The HEMA concentrations used were 0.01-1% at incubation times of 1-24 h. The cells were observed with AVEC-DIC microscopy and fluorescent staining to evaluate the velocity of lysosomal movement, the number and morphology of the mitochondria, and the fine structure of the cell. In the samples treated with the toxic compound the lysosomal movement changed, as did the morphology of the mitochondria and of the whole cells. The results are compared and discussed with regard to the results of conventional cytotoxicity tests performed in parallel. The new methods proved to be more sensitive and yielded more specific information on the cellular changes caused by the compound. PMID- 3509696 TI - Effect of chlorhexidine on Madin Darby canine kidney cells. AB - Sheets of MDCK cells were severely damaged by the commonly used antiseptic, chlorhexidine. Damage was indicated by changes in the characteristic blister formation normally observed in sheets of these cells growing on the base of culture flasks. Results are given for reduction in blister number with increasing chlorhexidine concentration. Damage was indicated also by increasing transport of radiolabeled inulin across the sheets after treatment with increasing concentrations of chlorhexidine. The mechanism of chlorhexidine damage is discussed. The conclusion is that chlorhexidine could be an important contributory factor in the failure of ultrafiltration in peritoneal mesothelial cells, and its use should be avoided with magnesium-containing dialysis fluids in kidney-failure patients. PMID- 3509697 TI - Hepatotoxicity of the opioids morphine, heroin, meperidine, and methadone to cultured human hepatocytes. AB - Adult human hepatocytes in chemically defined culture conditions were incubated with morphine, heroin, meperidine, and methadone to investigate their potential hepatotoxicity to human liver. Cytotoxic effects were observed at about 100 times the plasma concentrations required to produce analgesia in human nonaddicts. Concentrations of 1 mM morphine, heroin, and meperidine reduced the glycogen content by 50%, while even 0.2 mM methadone produced a depletion of 70% after 24 h of treatment. Concentrations of 0.8 mM morphine and heroin, 0.4 mM meperidine, and 0.005 mM methadone inhibited the albumin synthesis by about 50% after 24 h of pretreatment. Intracellular glutathione was reduced to 50% of that of controls after 2-3 h of incubation with 2 mM morphine and 1 mM heroin, while 1 mM meperidine and 0.2 mM methadone produced a reduction of about 30% after 6 h incubation. The results show that therapeutic doses of the opioids is unlikely to produce irreversible damage to human hepatocytes, but opiate doses during tolerance or abuse may be a cause of liver dysfunction. PMID- 3509698 TI - Videomicroscopic measurements in living cells: dynamic determination of multiple end points for in vitro toxicology. AB - The possibility of digitization and processing of microscope images in "real time" (i.e., at video rates) has opened a variety of ways to dramatically improve the quality of microscopic images and to create new applications of light microscopy. One of the new techniques, video-enhanced contrast (VEC) microscopy, enables one to increase contrast and magnification to the extent that positions and movements of biological objects as small as 15-20 nm (e.g., small membrane bounded vesicles and microtubules) can be analyzed in living cells. Organelle motion can be quantitatively described by a number of parameters such as velocity, straightness of path, and reversals of direction. The second group of videomicroscopic techniques is based on the measurement of fluorescence intensities of intracellular compounds by monochromatic light microscopy or using other low-light signals (video-intensified microscopy, VIM). The resulting images are two-dimensional arrays of fluorescence or absorption spectroscopy measurements and contain information on the amounts of intracellular metabolites or exogenous agents. Typical parameters for VIM measurements include Ca2+ concentration, pH value, metabolites and membrane potentials. Specific nontoxic dyes are also available to verify the identity of the organelles seen by the VEC techniques and to quantitate their abundance. The whole battery of new tests based on videomicroscopy can be applied at selected time intervals to a given set of cultured cells to obtain simultaneous measurements of multiple end points. However, since quantitative data for these parameters can be calculated from the live images in real time and encoded in the form of gray-shaded or pseudocolor images, they can also be continuously recorded and yield video films of the complete sequence of intracellular events during and after exposure to toxic or pharmacological agents. Videomicroscopy allows multiparametric studies to be performed with cultured cells, yielding a wealth of information that could be reached in the past only in animal experimentation. In addition, videomicroscopy enables us to observe directly and quantitate metabolic, physiological, and morphological parameters in the living cell that were not accessible by animal experimentation. It is therefore to be expected that videomicroscopy in the near future will catalyze a major shift from animal to in vitro experimentation in the fields of toxicology, pharmacology, and experimental pathology. PMID- 3509699 TI - Brain reaggregate cultures in neurotoxicological investigations: adaptational and neuroregenerative processes following lesions. AB - In vitro neural systems can be predictive for CNS neurotoxicity, except where xenobiotics primarily affect the blood-brain barrier. The wide range of systems now used in neurobiological studies is available for mechanistic neurotoxicological investigations although the choice of system is generally arbitrary. A more rational approach may now be justified. There are many culture systems available including neural cell lines, organotypic explant or reaggregation cultures, and primary monolayer cultures of individual neural cell types: neurons, astrocytes, and oligodendrocytes. Of these models much success has recently been achieved using the organotypic explant culture type. Similarly in our laboratories, using rat whole-brain reaggregate cultures, we have demonstrated good in vitro/in vivo correlations for the cholinergic neurotoxicant ethylcholine mustard aziridinium (ECMA) where specific cholinergic lesions are produced using low concentrations of ECMA (12.5 microM). Higher concentrations (25-50 microM) were more cytotoxic, as shown, for example, by nonspecific effects on cerebellar glutamatergic granule neurons. Treatment of reaggregates lesioned with the cholinotoxin with a neurotrophic factor, nerve growth factor (NGF), did not reverse the lesion but treatment of control cells with NGF (50 ng/ml) elevated both choline acetyltransferase (ChAT) activity and muscarinic receptor binding. The "lesioned" reaggregate culture system may thus be of future value in evaluating potential therapeutic agents that could reverse such lesions in the CNS. By supplementing the information gained in the reaggregate system with tests using primary monolayer cultures of neurons or astrocytes we can propose a stepwise screening system for potential neurotoxicants in vitro. In its simplest form this is (1) screen initially using tumor-derived neural cell line, (2) test selected compounds in whole-brain reaggregates, and (3) supplement information with primary monolayer cultures of individual neural cell types. PMID- 3509700 TI - Validation of the red blood cell test system as in vitro assay for the rapid screening of irritation potential of surfactants. AB - An in vitro red blood cell assay (RBC assay) is presented that allows one to estimate irritation potentials of tensides and detergents. The estimation is based on the differentiation between cell membrane lysis and cell protein denaturation. Both effects are measured photometrically by use of the inherent native dye oxyhemoglobin (HbO2). Besides hemolysis (H50) as a test parameter, the denaturation index DI is introduced, which is defined to be equal to 100% at a concentration of 30 mol sodium dodecylsulfate (SDS) per mole HbO2 as internal standard. The HbO2 release (H50), its denaturation (DI), and the ratio of both parameters (L/D ratio) are used to characterize the in vitro effects of surfactants. All data, including the L/D ratio are compared with in vivo data on eye irritancies, evaluated according to OECD Guideline #405 for testing chemicals, and with other published results from in vivo experiments. The good correlation of the L/D ratio of a broad range of 100 marketable shampoos with their corresponding Draize data (r = .806, p less than .0001) allows one to predict eye irritation potentials from another 20 commercially available shampoos in a blind trial with highly significant rank correlations to their in vivo irritancies (rs = .911, p less than .0001). Nearly similar good correlations were obtained by comparing ranks of in vivo and in vitro data of 16 anionic surfactants. All correlations found were significant (rs greater than .80 and p less than .0001). The RBC assay is an inexpensive, rapid, irritancy screening test that provides reliable results with good reproducibility. The test helps to reduce or even avoid animal testing in this application. PMID- 3509701 TI - Validation of alternative toxicity test systems: lessons learned and to be learned. AB - Validation in the context of in vitro toxicity tests is defined, and various aspects of the validation process are discussed, including the design and conduct of interlaboratory validation schemes; the selection of tests, participating laboratories, and test chemicals; the selection and use of in vivo data; in vivo/in vitro data comparison; the question of "false" results; in vitro cytotoxicity as a predictor of actual lethal toxicity; and the validation of alternatives to the Draize eye irritancy tests. It is concluded that a thorough reevaluation of current practice is essential if the promise and potential of nonanimal toxicity tests are to be fully realized and if valid alternative tests acceptable to regulatory agencies are to be developed. PMID- 3509702 TI - Comparison of in vitro cell toxicity with in vivo eye irritation. AB - The effects of 26 different cosmetic ingredients (e.g., permanent wave and hair dye compounds, emulsifiers, resins, and detergents such as quats) were assessed by four end points indicative for qualitatively and quantitatively different cytotoxicity: (1) neutral red uptake reduction after 24 h of treatment (NR-90 and NR-50); (2) cell detachment from culture dish after 4 h of treatment (CD-25); (3) growth inhibition after 48 h of treatment (GI-50); and (4) membrane permeability measured by fluorescent dye retention (fluorescence shift FS-25) and dye exclusion (viability ratio VR-25). The cytotoxicity potentials of the test agents were ranked for each in vitro test and compared with the in vivo eye irritation in guinea pigs (Draize test) after application of 5 or 2.5% (w/v) solutions of the same test batches. Strong irritants could be easily detected by most of the in vitro tests, but the neutral red uptake assay (especially NR-50) was the only one that was able to distinguish the minimally irritating test agents from strong irritants as well as from nonirritants. (I) All three extremely irritating quaternary ammonia compounds were identified as the strongest cytotoxic agents. (II) Nine out of 12 minimally irritating substances (mainly emulsifiers and resins) were ranked in the intermediate group. (III) Eight out of 11 non-or practically nonirritating chemicals (mainly permanent wave compounds) showed cytotoxic effects at very high concentrations only. The distinction of these three groups was better by means of NR-50 than by NR-90 data. At least two of the other cell tests (CD-25, GI-50, FS-25, and VR-25) had to be considered to allow an adequate interpretation of in vitro cytotoxicity. PMID- 3509703 TI - Comparison of the in vitro cytotoxicities and acute in vivo toxicities of 59 chemicals. AB - The in vitro cytotoxicities of 59 chemicals, expressed as ID50 values (i.e., concentrations of test chemicals that reduced the final cellular protein content of test cultures by 50% in comparison with appropriate solvent control cultures) and obtained using murine 3T3-L1 cells and the FRAME kenacid blue method, have been compared with rat oral and mouse intraperitoneal (ip) LD50 values. A better in vivo/in vitro correlation was obtained for the 59 chemicals with mouse ip LD50 values (r = .80) than with rat oral LD50 values (r = .76), but the best in vivo/in vitro correlation was found when the most toxic of the rat and mouse values were used in the comparison (r = .81). PMID- 3509704 TI - Prediction of phototoxic potential using human A431 cells and mouse 3T3 cells. AB - An assay using established cell lines, human A431 epidermal cells and mouse 3T3 fibroblasts, has been developed to predict the phototoxic potential of compounds. The test determines the viability of the two cell lines in response to UV light in both the presence and absence of the test compound. The end point for cytotoxicity is determined from the mitochondrial dehydrogenase conversion of a tetrazolium salt (MTT) to a colored formazan product. The cytotoxicity of the test compound is established prior to UV exposure, and the highest no-effect concentration observed is then applied to cells that are subsequently exposed to different periods of UVA and UVA plus UVB light. A phototoxic effect is considered to have occurred when a biologically significant enhancement of toxicity is shown for the UV light with the compound present when compared to that of UV light alone. The test system has been validated with 30 compounds classified as strong, idiosyncratic, and negative based on the frequency of reported adverse reactions in humans. The in vitro phototoxicity assay was able to highlight the potential for phototoxicity in the strong category of phototoxic compounds and several of the idiosyncratic compounds. Only one of the negative compounds produced any activity in the assay in terms of enhancing UV toxicity. Some of the compounds were shown to protect the cells from the toxic effects of UV exposure. PMID- 3509705 TI - Assessment of two alternative methods for predicting the in vivo toxicities of metallic compounds. AB - The FRAME in vitro cytotoxicity assay and a physicochemical parameter for metal ions (i.e., "softness," sigma p) were assessed for their ability to predict the in vivo acute toxicities of 52 metallic compounds. The in vitro assay was found to be more useful, since it measures the toxicity of the whole compound, as does the in vivo method. The softness parameter applies to the metal ion only, so it cannot be used to predict the toxicity of compounds containing relatively nontoxic metal ions and toxic anions (e.g., potassium fluoride). The in vitro toxicity values (expressed as ID50 values, i.e., concentrations of test chemicals that reduced the final cellular protein content of test cultures by 50% in comparison with appropriate solvent control cultures) correlated better with mouse ip LD50 values than with rat oral LD50 values. PMID- 3509706 TI - Validation project of alternatives for the Draize eye test. AB - The Federal Health Office (BGA) has started in June 1988 a national interlaboratory study to validate alternatives to the Draize test. It is supported by grants of the Department of Research and Technology (BMFT) of West Germany. The aim of this collaborative study is to validate the classification of chemicals with regard to their irritation potential using the neutral red/kenacid blue (NR/KB) cytotoxicity assay and the hen's egg test-chorioallantoic membrane (HET-CAM) assay, according to Lupke. Under the current research scheme, which is coordinated by the West German Public Health Office (BGA), 14 toxicology laboratories in the chemical industry, universities, the BGA, and other research institutions are to study 44 substances with a variety of chemical, biochemical, and toxicological characteristics. The validation test is intended to provide comparative data for the development of an alternative routine test scheme. The collaborative study is performed under routine laboratory conditions. The results should allow a decision on whether and to what extent the results of the NR/KB and the HET-CAM assay can replace the Draize test. PMID- 3509707 TI - A framework for coping with stress and its application in patient care. PMID- 3509708 TI - Essays on the art of caring in nursing: I. The human spirit in stress management. PMID- 3509709 TI - Sexual counseling of couples after a mastectomy or myocardial infarction. PMID- 3509710 TI - Helping patients cope with the stress of myocardial infarction. AB - The victims of myocardial infarction pose a real challenge to nursing. Effective nursing intervention is based on an understanding of human responses to the stress of heart disease and the series of behavioral changes individuals undergo in an attempt to cope with the stress. Cardiac teaching is an essential aspect of this intervention. After a myocardial infarction, patients first go through two stages on the way to recovery--independency and dependency--before they are receptive to teaching. It is during the next two stages--interdependency and self dependency--that nurses can use specific behavioral changes of the patients to plan health teaching and to negotiate contracts with them to effect learning and permanent behavioral change. PMID- 3509711 TI - An apologist's theories for the nursing profession: adaptation and art. PMID- 3509712 TI - Two-tier wage systems: nurses and nurse administrators be aware of the consequences. PMID- 3509713 TI - Aortocoronary bypass surgery in patients 65 years of age and older. PMID- 3509714 TI - T-cell depletion does not affect long-term human bone marrow culture. AB - Bone marrow long-term cultures were studied for 8 weeks in four experiments before and after T-cell depletion with a mixture of monoclonal antibodies directed against CD2, CD5 and CD7. No differences in cellularity or granulomonocytic progenitor numbers appeared during the period of culture. We conclude that in vitro treatment in itself is not likely to explain non-take or graft rejection associated with T-depleted bone marrow transplantation. PMID- 3509715 TI - Endophthalmitis and pars plana vitrectomy. PMID- 3509716 TI - Comparative trial of a new antidepressant. PMID- 3509717 TI - [Intramural hematoma of the duodenum following car accident--case report]. PMID- 3509718 TI - IgA nephropathy: a clinicopathological study with emphasis on both nephrotic syndrome and complements. PMID- 3509719 TI - Population dynamics of the murine lymphokine activated killer system: precursor frequency and kinetics of maturation and renewal. AB - The proliferation kinetics and population renewal of recombinant interleukin-2 (rIL-2)-induced murine lymphokine activated killers (LAK) arising from splenic precursors was studied. Extensive proliferation has been shown to accompany the de novo generation of LAK cytotoxicity. In this report, a thymidine 'hot pulse' suicide technique was employed to examine the sensitivity of LAK progenitors during various time periods following culture initiation. Hot pulse during the first 24 hr of culture resulted in a 30-35% reduction in lytic activity when assayed on day 5. Pulse periods between days 1 and 4 resulted in almost complete inhibition (90-95%) of lytic function when assayed on day 5. Proliferation of LAK progenitors was documented by limiting dilution analysis comparison of splenic precursors and functionally mature LAK cultures. These studies showed a 75- to 80 fold enrichment of LAK progenitors after 3 days culture in rIL-2. By flow cytometric cell cycle analysis, we demonstrated that the number of cells in the S/G2/M phase increased with the length of rIL-2 culture and represented approximately 40% of the cells by day 4. Finally, we used the rate of decay of lytic activity following irradiation as a factor to define the mean life span of a cytotoxic effector in the absence of cellular input. An exponential decrease to approximately 50% of controls was observed within 8-9 hr after irradiation. Taken together, these results suggest that the LAK system is highly dynamic and requires continuous cellular proliferation for its maintenance. PMID- 3509720 TI - Proliferation kinetics of human B- and T-lymphocytes. AB - Human peripheral blood B- and T-lymphocytes, highly purified by immunological methods, were supplemented with gamma-irradiated unseparated autologous mononuclear cells to restore helper functions and stimulated with pokeweed mitogen and phytohaemagglutinin, respectively. Proliferation kinetics of the cell populations were investigated using 5-bromodeoxyuridine (BrdU) labelling of the cell cultures and chromosome preparation at different times after stimulation. The percentages of metaphase cells having replicated for one, two or three generations in the presence of BrdU were determined following sister chromatid differential staining. In all donors, the changes in these percentages were faster in B- than in T-lymphocytes, indicating a longer cell cycle time in the latter population. PMID- 3509721 TI - [Recurrent respiratory diseases and specific immunity]. PMID- 3509722 TI - HLA associations with multiple sclerosis in Sicily and Malta. AB - The islands of Sicily and Malta have very different prevalence rates for multiple sclerosis (MS): at least 44 per 100,000 in Sicily and only 4 per 100,000 in Malta. In Northern Europe, MS is associated with HLA-DR2/Dw2. The other components of the commonest DR2-containing haplotype of this region, HLA-A3-B7 DR2-Dw2, also tend to be present at higher frequency in MS patients. HLA Class I and II antigen frequencies and associations in controls and MS patients from Sicily and Malta were studied to discover whether they might account for the difference in MS prevalence. In Sicilian MS patients, DR2 is increased in frequency compared with controls and four out of five DR2-positive patients also type as Dw2. In the Maltese population, DR2 is present at high frequency but approximately half of the DR2 positive individuals do not type as Dw2 so that DR2 is probably most commonly present as part of Class II haplotypes other than those commonly associated with MS. Additional differences in HLA profile of the Sicilian and Maltese populations were found when HLA-A, -B, and B-DR antigen associations were examined. Therefore, some of the difference in MS prevalence might be explained by genetic factors. PMID- 3509723 TI - Evidence for a protective influence of blood group A phenotype on X-ray signs of ankylosing spondylitis in HLA-B27 positives. AB - A total of 148 cases of HLA-B27 positive cases of suspected early ankylosing spondylitis were investigated for the influence of ABH-phenotypes. The 70 patients sharing X-ray signs of the disease had a significantly lower frequency of the A-phenotype, the 78 X-ray negatives showed an A excess. The positive protective effect of phenotype A on the development of the disease in HLA-B27 positives is discussed. PMID- 3509724 TI - MHC-linked genetic factors (HLA-B35) influencing recurrent circumoral herpetic lesions. AB - The frequencies of HLA-A, B, C, DR, and DQ lymphocyte alloantigens were determined in 31 Sicilian patients with recurrent herpetic lesions (RHL) and compared to frequencies observed in normal individuals. A significant negative association was found for HLA-B35 (pc = 0.049). The relationships between HLA and immune responses to viral infections are discussed in light of the results revealed by the present investigation suggesting that HLA-linked genetic factors may play a role in the pathogenesis of RHL. The results seem to indicate that genes in the major histocompatibility complex (MHC) are influential against developing RHL. PMID- 3509725 TI - Long-term results by epidural spinal electrical stimulation (ESES) in patients with inoperable severe lower limb ischaemia. AB - Arterial reconstruction is the treatment of choice for patients with severe lower limb ischaemia, but may at times be technically impossible. Thirty-two consecutive patients with impending (n = 24) or already established (n = 8) distal arteriosclerotic or diabetic lower limb gangrene, in whom vascular surgery was either technically impossible or had failed, were treated with epidural spinal electrical stimulation (ESES) for 27 +/- 16 (S.D.) months. All patients had severe rest pain, which was reduced by ESES in 91% of the cases. Improved ulcer healing was noted in 58% of the patients who had skin ulceration. Eighty three percent of those patients who did not have established gangrene when ESES was started, retained their leg after 1 year, and 54% after 3 years. These results suggest that ESES often provides pain relief and improves skin healing in patients with impending arteriosclerotic or diabetic gangrene in whom vascular surgery is impossible or has failed. Epidural spinal electrical stimulation (ESES) does not affect the progression of established gangrene but may provide pain relief. The observed outcome of severe limb ischaemia in this study could be used to compare with those after arterial reconstruction performed in patients with poor run-off vessels, and may allow us to examine the natural history of this disease when adequate pain relief is provided. The results reported here and the previously reported enhancement of cutaneous blood flow in severely ischaemic extremities by ESES may suggest, that ESES enhances limb salvage by improving skin blood flow. PMID- 3509726 TI - Effects of topical diclofenac sodium in a rabbit model of ocular inflammation and leukotaxis. AB - A useful model that combines paracentesis with administration of a leukotactic factor was developed in order to study the effects of topical diclofenac sodium on various aspects of ocular inflammation. The increases in intraocular pressure (IOP) and secondary aqueous humor protein concentration induced in rabbits by anterior chamber paracentesis, as well as leukocyte accumulation in the anterior chamber induced by formyl-methionyl-leucyl-phenylalanine, were significantly reduced by topical application of diclofenac sodium at concentrations of 2 mM (0.064%, w/v) and higher. Lower doses consistently affected only IOP and secondary protein concentrations. A slight paracentesis-induced miosis was refractory to diclofenac sodium. That this potent inhibitor of prostaglandin synthesis can reduce important signs of ocular inflammation is well supported in this model. PMID- 3509727 TI - Effect of calcium antagonist compound nisoldipine on transepithelial electrical parameters in the isolated frog cornea. AB - The new calcium antagonist, nisoldipine, inhibited short circuit current and transcorneal potential difference in the isolated frog cornea (a chloride transporting epithelium). Transepithelial resistance increased. The effects of nisoldipine were dose-dependent. Nisoldipine did not change the stimulation of short circuit current induced by epinephrine. Intracellular membrane potential across both the apical and basolateral cell membrane were decreased by nisoldipine. The data indicate that intracellular calcium seemed to modulate chloride transport of the cornea by changing cell membrane permeability. PMID- 3509728 TI - Infection of a three-toed sloth (Bradypus variegatus) by a Pneumocystis-like organism in Panama. PMID- 3509730 TI - [Incidence of rotavirus in pediatric patients hospitalized with gastroenteric symptoms]. AB - In winter, for four months from November 1986 to February 1987, in one hundred samples of stool from children admitted at Pediatric Department of Prato Civil Hospital with gastroenteric symptoms, was performed the research of rotavirus. This study revealed data strictly close to the ones reported in literature: 34% of children were found positive; from these, 55.9% were under one year old, 38.2% from one to five, and 5.9% from five to twelve. The symptoms were: diarrhoea in 94%, fever in 70.5%, vomit in 47% and respiratory disturbances in 32%. It is emphasized the utility of the research of rotavirus chiefly in children under one year, even if gastroenteric disease begins with respiratory symptoms. PMID- 3509729 TI - Recent observations on increases in morbidity and mortality from asthma. AB - There are nearly 20 million persons in the United States suffering from asthma. Nearly 5 million of these are children. This represents an increase in the prevalence of the condition in the past twenty years. In the same time period hospitalization rates for asthma have increased dramatically in the pediatric and adult population. Of greater concern, is a significant increase of deaths due to asthma in the past eight years. PMID- 3509731 TI - [Muco-purulent cervicitis: a frequent but little-known pathology. Clinical and laboratory considerations]. AB - In order to assess the frequency of cervicitis, to investigate its aetiological causes and to open the debate upon this subject, the authors examined 144 not hospitalized women aging between 18 and 47. They were all in their fertile period and not pregnant. The diagnosis of MPC was given on the basis of the evaluation of the number of polymorphonuclear leukocytes (PNL) found on the endocervical smears, which had been previously coloured by the Gram method: the patients with an average number of PNL greater than 10 per microscopical field at a magnification of 1,000 were considered suffering from MPC, while those with a number of PNL less than 10 formed a group of control. Statistical methods were applied to the two different groups to verify the existence of any relationship between clinical, anamnestic and microbiologic features and MPC. The two groups were compared even after excluding those patients with a presence of Trichomonas vaginalis or yeasts and those suffering from bacterial vaginosis (BV). No significant relationship was found between the isolated microorganisms and MPC, while BV turned out to be related negatively. The objective signs of ectopia and erythema and the pH of the vaginal secretion turned out to be related significantly only after excluding from the selection those patients with a vaginal pathology, while including them, the association turned out to be significant only as to ectopia. The authors point out that: a) MPC represents the most frequent clinical condition; b) the greater part of MPC appears to have an unknown aetiology. PMID- 3509732 TI - Endoscopic lymphoscintigraphy. A new tool for target surgery of rectal cancer. AB - To define the "in vivo" lymphatic drainage from the rectum and the anal canal, 79 subjects (normal controls and patients with rectal cancer) underwent endoscopic rectal lymphoscintigraphy. This method consists of endoscopically injecting a radiolabelled colloid into the rectal and anal submucosa. The diffusion of the tracer, which is drained preferentially by the lymphatic vessels, was determined by means of a computerized gamma camera. Our results suggest a different pattern of lymphatic drainage from the rectum as compared to traditional anatomical studies. Moreover, analysis of our data yields a new hypothesis about the lymphatic spread of rectal cancer. Therefore, lymphoscintigraphy could be employed in the preoperative assessment of "N" staging of these neoplasms. This should provide better selection of patients for different surgical approaches and for adjuvant therapy. The results of 2 years of experience and possible future applications of this technique are discussed. PMID- 3509733 TI - A new sclerosant cocktail. PMID- 3509734 TI - Electrohydrothermal probe. PMID- 3509735 TI - Strongyloidiasis. An unusual cause of colonic pseudopolyposis and gastrointestinal bleeding. AB - This report describes a recent case in which colonoscopy of a patient with the presenting complaint of rectal bleeding revealed the right colon to be carpeted with 50-100 pseudopolyps, each 3-4 mm in diameter. Biopsy specimens taken during colonoscopy revealed the presence of Strongyloides stercoralis in the bowel wall. This diagnosis should be considered in any patient with gastrointestinal complaints and a history of travel to an endemic area. PMID- 3509736 TI - Reduced efficacy of chemotherapy of Plasmodium chabaudi in T cell-deprived mice. AB - Immunologically intact and T cell-deprived CBA mice were infected with Plasmodium chabaudi and treated with chloroquine, pyrimethamine or quinine. Chloroquine and pyrimethamine rapidly reduced the levels of parasitaemia in both types of host, but whereas the normal mice remained free of blood parasites thereafter, the deprived mice suffered recrudescences of the infection. Quinine was therapeutically more effective in the intact mice than in the deprived mice early after initiation of treatment and, while the normal mice suffered a transient recrudescence after quinine, the deprived mice retained a high parasitaemia during and after treatment. The results indicate that the immune response may contribute to effective chemotherapy of malaria. PMID- 3509737 TI - Upper gastrointestinal bleeding due to benign tumours of the stomach. AB - Benign tumours of the stomach are usually asymptomatic and are discovered incidentally during radiology, endoscopy or pathological examination. In some cases, however, these tumours produce overt clinical symptoms. The authors report eight patients with significant upper gastrointestinal bleeding due to benign gastric tumours, who required surgical resection of their lesion. Histologically, the growths proved to be leiomyoma in five cases, polyps in two and lipoma in one. Surgical treatment consisted in local excision in three patients and subtotal gastrectomy in five patients. Bleeding was stopped in all cases and there was no operative mortality. PMID- 3509738 TI - Lymphokine-induced cytotoxic cell generation in thymus and spleen cell cultures. AB - The effect of a supernatant (SN-A) obtained from PMA-stimulated IL-2 producing EL 4 cells on cytotoxic cell induction in thymocyte and splenocyte cultures was evaluated. SN-A, but not recombinant IL-2 alone, induced cytotoxic cell differentiation in thymus cell cultures, thus indicating that factors distinct from IL-2 are required for effector cell generation. INF-gamma takes part in the process, and Ia+ accessory cell presence is also strictly required in thymus cultures for lymphokine-induced cytotoxic cell generation. Cytotoxic activity in thymocyte cultures was due only to Thy 1+ Lyt 2+ cells having a broad spectrum of target cell specificity, while in spleen cell cultures an effector population with NK activity was also generated. PMID- 3509739 TI - Activity of ornithine decarboxylase and creatine kinase in soft and hard tissue of vitamin D-deficient chicks following parenteral application of 1,25 dihydroxyvitamin D3 or 24R,25-dihydroxyvitamin D3. AB - We investigated the stimulation of creatine kinase (CK) and ornithine decarboxylase (ODC) by 1,25-dihydroxyvitamin D3 [1,25(OH)2D3] and 24R,25 dihydroxyvitamin D3 [24R,25(OH)2D3] in doses ranging from 1.625 to 6500 pmol in 4 week-old vitamin D-deficient chicks. Enzyme activities were monitored for 72 h. 1,25(OH)2D3 but not 24R,25(OH)2D3 enhanced the activity of ODC in duodenum and bone. The time course of ODC activity in bone was biphasic, with an increase after 1 h and a higher peak after 24 h. Diaphyses and epiphyses responded equally well after a dose of 6500 pmol. The kidney, liver, and lung showed 1.5-3.8-fold increase in CK activity following 1,25(OH)2D3, reaching a maximum between 3-5 h. However, sustained stimulation of CK activity could still be demonstrated after 72 h, and the 48-h levels in the lung even exceeded the 5-h values. No change of activity of either enzyme was noted in heart and brain after application of 1,25(OH)2D3. There was no coincidence of stimulation of ODC and CK by 1,25(OH)2D3 in the same tissue, and the dose-responsiveness of both enzymes differed considerably. Near maximum activities of ODC were achieved with 19.5 pmol 1,25(OH)2D3 in duodenum and pancreas, while maximum responses of CK occurred in the liver at 195 pmol and in lung and kidney at 6500 pmol. 24R,25(OH)2D3 failed to produce any consistent effects of either enzyme in all tissues examined. These results, particularly the lack of response to 24R,25(OH)2D3, are different from those reported in rats. PMID- 3509740 TI - Binding of calcitonin and calcitonin gene-related peptide to calvarial cells and renal cortical membranes. AB - Binding of calcitonin (CT) and calcitonin gene-related peptide (CGRP) to rat hemicalvariae and renal membranes was examined in an effort to determine whether CT and CGRP interact with the same bone cell binding site, and to see whether the binding pattern was similar for bone and renal cortex. Specific binding of 125I salmon CT to rat calvariae was inhibited by unlabeled salmon, porcine, or human CT, but not by rat CGRP. Binding of 125I-rat CGRP to calvariae was inhibited by CGRP and high doses of salmon CT, but not by human or porcine CT. Binding of 125I salmon CT to renal membranes was inhibited by unlabeled salmon CT or rat CGRP, but no specific binding of 125I-rat CGRP could be detected. The results suggest that separate bone cell receptors for CT and CGRP exist and that CGRP can interact with renal receptors for CT. PMID- 3509741 TI - Serum bone GLA-protein in growth hormone deficient children. AB - Serum bone GLA-protein (BGP), a sensitive and specific marker of bone formation, was measured in 54 normal children and in 50 children with growth disorders. In normal children, the pattern of variations of serum BGP with age was similar to the pattern of variations of the growth velocity. Mean serum BGP was very high during the first year of life (25.3 +/- 8.5 ng/ml), decreased to 14.8 +/- 2.2 ng/ml from 2 to 6 years, increased to 18.4 +/- 4.1 ng/ml from 7 to 10 years and to 18.8 +/- 6.5 ng/ml from 11 to 14 years. After puberty, mean sBGP decreased to 12.9 +/- 5.4 ng/ml from 15 to 18 years and to 6.5 +/- 1.4 ng/ml in young adults. In 32 patients with untreated growth hormone (GH) deficiency, mean sBGP was markedly lower than in age matched controls (6.8 +/- 4.4 ng/ml vs. 17.5 +/- 4.9 ng/ml, p less than .001). In 19 patients with GH deficiency who were undergoing treatment with human GH, sBGP was higher than in untreated patients (20.5 +/- 9.3 ng/ml vs. 6.8 +/- 4.4 ng/ml, p less than .001) and was not different from controls. Repeated measurements performed in 14 GH-deficient patients under chronic GH therapy showed that serum BGP: (1) increased in most patients during treatment (p less than .005); (2) was correlated with the duration of treatment (p less than .001); (3) decreased to pretreatment values after discontinuing therapy.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3509742 TI - Effect of vitamin D metabolites on the expression of alkaline phosphatase activity by epiphyseal hypertrophic chondrocytes in primary cell culture. AB - The effects of three vitamin D3 metabolites, 25-hydroxyvitamin D3 (25-(OH)D3), 1 alpha,25-dihydroxyvitamin D3 (1 alpha, 25-(OH)2D3), and 24R,25-dihydroxyvitamin D3 (24R,25-(OH)2D3) on the activity of alkaline phosphatase (AP), a key enzyme involved in biomineralization, have been studied in primary cultures of chicken epiphyseal growth plate chondrocytes. Dosages of 1 alpha, 25-(OH)2D3 (10(-12) to 10(-7) M) caused a progressive, dosage- and time-dependent decrease in cellular AP levels, IC50 occurring at approximately 10(-12) M. In contrast, 24R,25-(OH)2D3 at 10(-13) to 10(-10) M stimulated cellular AP activity, half-maximal stimulation occurring at about 10(-13) M. At higher levels (10(-10) to 10(-7) M), 24R,25 (OH)2D3 caused progressive reduction in AP activity. Maximal effects of 24R,25 (OH)2D3 were evident 48 h after administration of the metabolite. 25-(OH)D3 initially (24 h) caused a weak, dosage-dependent decrease in cellular AP activity, but after 48-72 h, low levels (10(-13) to 10(-11) M) caused a dosage dependent increase in AP activity. Higher levels of 25-(OH)D (greater than 10( 10) M) were clearly inhibitory to AP. These findings reveal that the AP activity of growth plate chondrocytes is exquisitely sensitive to both 1 alpha,25- and 24R,25-(OH)2D3 but the response to each is in opposite directions. The paradoxical response of the cells to 25-(OH)D3 can be explained if the metabolite is slowly metabolized by a 24-hydroxylase to 24R,25-(OH)2D3 leading to stimulation of cellular AP.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3509743 TI - Serum osteocalcin (BGP) in tumor-associated hypercalcemia. AB - Serum osteocalcin (BGP) is a new marker of bone turnover that reportedly evaluates bone formation. Thus, its measurement could assess the bone formation rate in tumor-associated hypercalcemia. We measured concentrations of BGP and other parameters of bone metabolism in 54 untreated hypercalcemic cancer patients as compared to 109 healthy subjects. Primary tumor sites were breast (19), lung (11), head and neck (6), multiple myeloma (3), kidney (2), and various (11) or multiple (2). Mean BGP levels were higher in the hypercalcemic subjects, 4.6 +/- 0.4 (SEM) ng/ml, than in the normal subjects, 3.6 +/- 0.1 ng/ml (p less than .05), and were normalized in the 22 patients who could be reevaluated after successful treatment of hypercalcemia with intravenous aminohydroxypropylidene diphosphonate (APD). There was no correlation of BGP levels with age, sex, or renal function. Compared with the Gaussian distribution in the normal subjects, there was a considerable scatter of the data in hypercalcemic patients, suggesting the existence of defined subgroups with abnormally low or abnormally high values. However, we found no significant relationship of BGP concentrations with tumor site or histology or with bone metastatic involvement. We found also no significant correlation between concentrations of serum BGP and total or ionized calcium, alkaline phosphatase, parameters of bone resorption, and indices of parathyroid function. In summary, serum BGP levels were slightly elevated in tumor-associated hypercalcemia and were normalized after successful treatment of hypercalcemia. More importantly, BGP concentrations varied widely even in the subgroups of patients with hypercalcemia accompanying massive bone metastatic involvement or in the patients without detectable skeletal metastases.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3509744 TI - Effect of acute increases in bone matrix degradation on circulating levels of bone-Gla protein. AB - Serum bone Gla-protein (BGP), also called osteocalcin, is a specific and sensitive measure of bone turnover in a variety of metabolic bone disorders. Although some BGP diffuses into the circulation after synthesis by osteoblasts, most is incorporated into bone matrix where it remains until bone is resorbed. Thus, serum BGP could reflect bone formation, bone resorption, or a combination of both. The relationship of serum BGP to the components of bone turnover was evaluated in 18 normal women (mean age 48 yr; range 30-70) who received a continuous 24-h intravenous infusion of the 1-34 synthetic fragment of bovine parathyroid hormone. Mean +/- SE for urinary hydroxyproline excretion, an index of bone resorption, increased (from 22.7 +/- 2.2 to 38.5 +/- 3.7 micrograms/100 ml glomerular filtrate [GF], p less than .001), whereas levels of serum alkaline phosphatase, an index of bone formation, were unchanged (from 20 +/- 1 to 20 +/- 1 U/liter, NS). Despite the increase in bone resorption, levels of serum BGP decreased (from 8.8 +/- 0.8 to 6.8 ng/dl, p less than .001). The data suggest that circulating levels of BGP are a measure of bone formation but, at least in subjects with normal renal function, not a measure of bone resorption. Presumably BGP in bone matrix is degraded during osteoclastic resorption into fragments that either are not recognized by an antiserum raised against the native molecule or are rapidly cleared from the circulation. PMID- 3509745 TI - Renal, volume, and hormonal changes during therapeutic administration of recombinant interleukin-2 in man. AB - Changes in blood pressure, renal function, and fluid balance were studied in 12 patients receiving intravenous recombinant interleukin-2 (IL-2) (100,000 units/kg every eight hours) over five days for treatment of metastatic melanoma and renal and colorectal cancers. The IL-2 regimen produced progressive hypotension, azotemia, and sodium avidity (fractional excretion of sodium = 0.20 +/- 0.07 percent) despite massive fluid administration (mean: 18.4 liter per five days) and weight gain (mean: 4.0 kg). Plasma renin activity rose. Hypoalbuminemia developed rapidly (3.6 +/- 0.1 g/dl to 2.2 +/- 0.1 g/dl, p less than 0.01) with widespread edema formation despite normal central venous pressures. Hematocrit did not change during the IL-2 period, consistent with a "capillary-leak." Hemodynamic and renal functional changes reversed after the IL-2 regimen was discontinued, but hypoalbuminemia and elevated urinary n-acetyl-glucosaminidase levels persisted after six days. These studies demonstrate widespread hemodynamic and vascular effects of IL-2 administration that limit its safe use and suggest a possible role for the lymphokine in mediating cardiovascular instability under other circumstances, such as endotoxic shock. PMID- 3509747 TI - Patient education in the rheumatic diseases--pros and cons. PMID- 3509746 TI - An autoradiographic study on the effect of epidermal growth factor on cell proliferation in erupting mouse incisors. AB - Epidermal growth factor (EGF) is a small polypeptide that induces precocious eyelid opening and incisor eruption in newborn mice; it stimulates cell proliferation in various cell types in vitro and in vivo. EGF was injected twice daily into newborn mice (0.4 microgram/g) and tritiated thymidine was injected subcutaneously 6 h before killing the mice. Longitudinal sections of the lower incisors showed significantly more thymidine-labelled mitoses in the pre odontoblast and pre-ameloblast layers at the basal ends of incisors in EGF treated mice than in control mice. Although these results indicate that the EGF induced precocious tooth emergence is associated with a stimulation of cell proliferation in the root sheath, this tissue may not be the target for the actions of EGF. Earlier studies have shown that root growth is not a factor in the generation of the eruptive force and, as neither the pre-ameloblasts nor pre odontoblasts express EGF-receptors, the stimulation of cell proliferation in the root-sheath region appears to be a result and not a cause of accelerated tooth eruption, i.e. the increase in root growth may meet the need to maintain the tooth positionally during the accelerated eruptive process. PMID- 3509748 TI - [Ambulatory ECG in the peroperative period]. AB - The clinical recognition of perioperative myocardial necrosis represents one of the clue factors in the management of cardiac surgical patients (pts). This study was performed to determine whether there is any relationship between reperfusion ventricular fibrillation and/or ST-segment elevation and postoperative enzymatic release. Serum enzyme levels and ECG were monitored during and after cardiac operations in 23 pts (15 for valvular replacement and 8 for aortocoronary bypass graft). After aortic unclamping only 6 pts showed stable rhythm. Of the 17 pts who developed ventricular fibrillation 10 showed ST-segment elevation (83% of the 12 pts with ST-segment elevation). Although no significant difference was observed, pts with ST-segment elevation showed higher average enzyme (CK, CKMB) levels. Pts who had valvular replacement showed significantly higher serum CK and CKMB levels. Of the 4 pts who showed a second enzymatic peak, one died and another one presented complex ventricular arrhythmias. No correlation was observed between electrocardiographic data and post-operative enzymatic release. New theories concerning oxygen free radical generation during and after cardiopulmonary by-pass, with the related therapeutic perspectives, are discussed. PMID- 3509749 TI - Histiocytic necrotizing lymphadenitis without granulocytic infiltration (Kikuchi's lymphadenitis). Morphological and immunohistochemical study of eight cases. AB - Eight examples of histiocytic necrotizing lymphadenitis without granulocytic infiltration (Kikuchi's lymphadenitis) are described. They occurred in young or middle-aged women who usually complained of latero-cervical lymphadenopathy. Serology revealed significant titres for Epstein-Barr virus and Yersinia enterocolitica serogroup 9 in one of eight and one of six tested. All patients fully recovered within 2 months. On histological examination of the lymph nodes large foci of infiltration were observed in the cortex and/or paracortex: they consisted of variable numbers of small lymphocytes, immunoblasts, macrophages and so-called plasmacytoid T-cells; granulocytes were absent. Necrotic changes varied from single pyknotic cells to extensive areas of necrosis. Immunohistochemistry showed that within the lesion the number of macrophages was inversely proportional to the number of peripheral T-lymphocytes and 'plasmacytoid T cells'. The latter displayed a phenotype (CD4+, CD10+, CD45+) which, in the absence of macrophage-associated antigens, seemed in keeping with their supposed lymphoid nature. In seven cases peripheral T-lymphocytes predominantly expressed the cytotoxic/suppressor phenotype, while in one remaining case a mild predominance of the helper/inducer subset was observed. In the areas with less extensive tissue necrosis, numerous T-immunoblasts expressed both markers of activation and the proliferation-associated nuclear antigen Ki-67. The results of the present study expand the spectrum of our knowledge and allow speculation as to the biology of this disease. PMID- 3509750 TI - Immunohistochemical heterogeneity of macrophage subpopulations in human lymphoid tissues. AB - The mononuclear phagocytic system is composed of cells which display a marked immunohistological heterogeneity. In the present study we have investigated the immunohistochemical and enzymatic features of macrophages and accessory cells present in human lymph nodes and spleen and, as control tissues, in thymus, liver, skin and heart. Our investigation has demonstrated that macrophages present in germinal centres display an immunophenotype different from that of macrophages populating T-dependent areas. Furthermore, cells lining lymph node sinuses and splenic sinusoids express endothelial and macrophage markers, and are able to modulate their immunophenotype according to different reactive conditions. These data suggest, on immunohistochemical grounds, that macrophages populating B- and T-dependent areas as well as sinuses of human peripheral lymphoid tissues, may modulate their immunophenotype according to environmental and antigenic influences. PMID- 3509751 TI - Ploidy, proliferative activity, cluster differentiation antigen expression and clinical remission in high-grade non-Hodgkin's lymphoma. AB - Using a large range of monoclonal antibodies to specific cluster differentiation antigens the phenotypes of a series of high-grade non-Hodgkin's lymphomas of B- and T-cell type were investigated. Cell ploidy and proliferative fraction were assessed by fluorescent staining of DNA and flow cytometry and data on the incidence of complete clinical remission were obtained. With the exception of some lymphoblastic lymphomas, high-grade B-cell lymphomas normally expressed the pan B-cell antigens CD19 and CD22 but only immunoblastic lymphomas consistently expressed the pan B marker CD20. Variable, generally weak expression of CD21 was observed whilst CD23 expression was most prevalent in rapidly proliferative cases and in Burkitt's and centroblastic lymphomas. A rapidly proliferative, multilobated B-cell lymphoma displayed phenotypic properties intermediate between centroblastic and immunoblastic lymphomas. The T-cell lymphomas generally showed low proliferative activity and expression of CD4 prevailed over CD8. Most cases also showed CD2 and CD5 positivity with some also showing CD3 and CD7 expression. Patients with rapidly proliferative diploid or DNA aneuploid tumours obtained complete remission more readily than patients with lowly proliferative diploid tumours. An excess of early deaths occurred among T-cell cases. PMID- 3509752 TI - Psychosocial factors influencing return to work after coronary artery bypass surgery (CABS). PMID- 3509753 TI - Restoration of grasping functions in quadriplegic patients by Functional Electrical Stimulation (FES). PMID- 3509754 TI - State of the art of implanted multichannel devices to mobilize paraplegics. PMID- 3509755 TI - HLA antigens in Sicilian patients affected by chronic myelogenous leukaemia. AB - HLA antigens were investigated in Sicilian patients with chronic myelogenous leukaemia (CML) and in Sicilian healthy controls. The frequency of the HLA-DRw6 antigen was significantly decreased in the group of patients. These results suggest that DRw6 may be a marker for decreased susceptibility to the etiological or pathogenic mechanism(s) which produce CMLs. PMID- 3509756 TI - Murine candidiasis. III. Host inflammatory responses are regulated in part by class I MHC genes. AB - Host responses to experimental Candida albicans infection in mice have been shown previously to be regulated by genes in the major histocompatibility complex (MHC). Results reported here show that at least part of this control can be mapped to class I MHC genes. PMID- 3509757 TI - Ocular anti-inflammatory actions of matrine. AB - Matrine is an alkaloid isolated from the root of Sophora subprostrata (Leguminosae) which has been used as a Chinese medicine for the treatment of inflammation. Instillation of 50 microliter of 1% matrine showed significant inhibition of ocular inflammation induced by lens proteins. Unlike corticosteroids, matrine did not facilitate the IOP recovery in rabbit eyes nor did it change the electrical potential difference across rabbit iris-ciliary body. These results indicate that matrine could become a safer ocular antiinflammatory agent than corticosteroids. Further, matrine was found to markedly increase the reaction time of a mouse placed on a hot plate. These results indicate that matrine could be used as an analgesic as well. PMID- 3509758 TI - The induction of tolerance by cyclosporine-G in experimental autoimmune uveitis in the Lewis rat. AB - Cyclosporine-G inhibits retinal S-antigen-induced experimental autoimmune uveitis in a manner similar to Cyclosporine-A (CsA). In sufficiently high doses it induces a state of tolerance in the animal which persists after cessation of therapy. PMID- 3509759 TI - [Inhibition of natural killer and interleukin 2-activated natural killer cell cytotoxicity by monosaccharides and lectins]. AB - NK cell receptors may be saturated and inhibited by a serial monosaccharides and lectins. Subsequently, NK cytotoxicity diminished in different ratios. Phosphorylated mannose and galactose were the major inhibitors. Also, the most of the lectins have NK cell inhibitory capacity. Normal lymphocyte may be activated by IL-2 within 72 hours culture. Those activated lymphocytes exerts high cytotoxicity and wide recognition capacity for the tumor targets. Besides, their receptors are less sensitive for the sugar inhibition. Lectins, have strong inhibition capacity even the lymphocytes are activated by IL-2. PMID- 3509760 TI - The electrospinal treatment of idiopathic scoliosis in the adolescent. AB - The transcutaneous electrospinal treatment adds another approach to the conservative treatment of small and moderate idiopathic scoliotic curves. The method presented here is readily accepted by both the adolescent and the parents. It is inexpensive, and allows flexibility as to the location and number of electrodes to be used and the curve treated. The data presented here, collected over a five-year period of clinical monitoring and recording, indicate that results are favorable, therefore, the method is acceptable. PMID- 3509761 TI - Contact neodymium:YAG laser surgery in gastroenterology. An updated report. AB - Eighty-eight patients have been successfully treated endoscopically without complications using contact neodymium yttrium aluminum garnet: (YAG) laser probes (endoprobes) for tumors and bleeding and during open surgery (laser scalpel) to perform hepatic and pancreatic resections. The contact probes, made from a synthetic sapphire crystal with its optical properties, geometric design, thermal conductivity, and high melting temperature (2030 degrees C), have proven to be more effective than the current conventional non-contact method of delivering laser energy through a quartz fiber. Advantages include greater precision, sterility, avoidance of the tip melting, and lower neodymium: YAG laser energy required, resulting in reduced tissue damage. The configuration of the probes allows coagulation, cutting, or vaporization, depending on the clinical condition being treated. PMID- 3509762 TI - Endoscopic aspects of aortointestinal fistula. AB - The etiology, diagnostic difficulties and treatment of five cases of aortointestinal fistulas are presented. In all of them, endoscopy played a major diagnostic role. Early diagnosis is essential for elective surgery since reconstruction in the massive bleeding stage has a mortality of up to 80%. PMID- 3509763 TI - Aromatase activity in normal breast and breast tumor tissues: in vivo and in vitro studies. AB - Infusions of isotopically labeled [3H] androstenedione with measurement of [3H] estrone in normal breast and breast tumor tissue have been carried out in an attempt to determine the contribution that aromatization makes to the estrogen content of breast tissues. After infusion of [3H] androstenedione for 12h there was significant uptake of this steroid by normal breast and breast tumors. [3H] Estrone was detected in all samples of normal breast tissue examined so far but not in all tumors. Aromatase activity when measured in vitro was found to be higher in breast tumors than in fat next to the tumor or normal breast fat. Studies in which we have examined the effect of epidermal growth factor on aromatase activity in cultured breast adipose tissue suggests that the response may be influenced by a subject's menopausal status. Results from these preliminary studies suggest that the aromatization of androgens may make a significant contribution towards the estrogen content of some breast tumors and that growth factors may also be involved in regulating aromatase activity. PMID- 3509764 TI - Mycosis fungoides. Detection of OKT6+ cells by cytofluorographic analysis in one case. AB - An 86-year-old woman had a subjective history of pruritus and intermittent fever. The clinical diagnosis of mycosis fungoides was confirmed by cutaneous and lymph node biopsies. Immunohistochemical, cytofluorographic, and ultrastructural analysis was performed. According to immunohistochemical findings the lymphoid cells infiltrating the skin and lymph nodes were phenotypically T-helper cells. Cytofluorographic and ultrastructural analysis of the peripheral blood detected a small number of cerebriform lymphoid cells. By immunohistochemistry, these cells showed the same phenotype that was found in the skin and lymph nodes. OKT6+ cells, which are not usually present, were also found in the peripheral blood. These findings may suggest a functional relationship between the skin and the lymphoid system. PMID- 3509765 TI - Serum colony stimulating activity and colony forming cells in murine brucellosis: relationship to immunopathology. AB - Intravenous injection of mice with Brucella abortus vaccine strain 19, results in a chronic infection, immunity to which is dependent on T cell activation of the macrophages. A major feature of the infection is splenomegaly characterized by massive numbers of macrophages. We report here investigations of the haemopoietic precursors of macrophages, the colony forming cells (CFC), and the growth factors, colony stimulating factors (CSF), controlling their production. Comparison was made amongst three mouse strains, CBA, BALB/c and C57B1/10, as well as the F1 (CBA x BALB/c), which differ in the degree of splenomegaly developed and their ability to rid themselves of infection. The proportion of colony forming cells in the spleen peaked 2 to 3 weeks after infection and was higher in those strains which developed stronger splenomegaly. On the other hand there was no relation between colony forming cells and ability to control infection. Serum CSF also peaked 2-3 weeks post infection, with similar titres in all mouse strains studied. Bone marrow exhibited an early loss of total cellularity after infection followed by recovery. There was a sharp peak in the proportion of colony forming cells in the bone marrow 2 weeks post infection. Spleen and bone marrow CFC and serum CSF all returned to normal levels before infection was resolved. PMID- 3509766 TI - Combined retroperitoneal and mediastinal fibrosis associated with variceal haemorrhage. PMID- 3509767 TI - Rationale for simultaneous carotid endarterectomy and aortocoronary bypass. AB - Seventy-eight patients were treated for coexistent carotid and coronary stenosis by simultaneous reconstructions. Five patients died (6.4%), one from a stroke contralateral to the carotid reconstruction. Four others suffered a perioperative stroke (total stroke incidence 6.4%). Three myocardial infarctions occurred (3.8%) including one fatal infarct. Analysis of the most recent 36 combined reconstructions indicates that the extramorbidity in this group increased the stroke or death rate for all carotid endarterectomies carried out in the same period by only 1%. Alternatively if these patients had been operated upon by aortocoronary grafting alone the mortality would have increased by 0.1% assuming no neurologic complications. Since these 36 patients had severe carotid stenosis and would have been refused carotid endarterectomy as an isolated procedure the results seem better than would have been achieved by staged operations. PMID- 3509768 TI - Late results of coronary bypass in patients presenting with lower extremity ischemia: the Cleveland Clinic Study. AB - Cardiac catheterization was performed in a prospective series of 1000 patients under consideration for elective peripheral vascular reconstruction from 1978 1982. Of these, 381 (mean age 62) presented primarily because of lower extremity ischemia. Severe, surgically correctable coronary artery disease (CAD) was documented in 79 (21%) of the leg group, and 68 (18%) received myocardial revascularization, with three fatal complications (4.4%). In this subset, 39 patients have had uneventful aortoiliac, femoropopliteal or distal extremity procedures, compared to an operative mortality of 23% for 13 others with uncorrected or inoperable CAD (p = 0.015). A total of 286 patients have undergone 407 peripheral vascular operations with eight early deaths (2.8%). An additional 114 patients (30%) died during the late follow-up interval, including 48 (13%) with cardiac events. Both the cumulative 5-year survival (72%) and cardiac mortality (16%) after coronary bypass are superior to comparable figures (21% and 56%, respectively) among 36 other patients with severe, uncorrected or inoperable CAD (p = 0.0001). Five-year survival appears to be improved by myocardial revascularization in men (p = 0.0027), hypertensives (p = 0.0001), nondiabetics (p = 0.0002) and those over 60 years of age (p = 0.0072). PMID- 3509769 TI - [Report from the Minister of Health]. PMID- 3509770 TI - Cytogenetic studies on prolymphocytic leukemia. 1. B-cell prolymphocytic leukemia. AB - We describe clonal chromosome abnormalities in 13 new cases of B-cell type prolymphocytic leukemia (B-PLL) investigated using pokeweed, lipopolysaccharide B, TPA (phorbol ester), and Epstein-Barr virus (EBV) as mitogens. B-PLL showed a much better response to all four mitogens when compared with B-cell chronic lymphocytic leukemia (B-CLL). A 14q+ was the most frequent abnormality and was observed in 7 of the 13 cases. A t(11;14)(q13;q32) was observed in 2 patients in this series and in 2 cases from a previous series of 9 patients studied in this laboratory, giving an incidence in B-PLL of 18% for this abnormality. The more frequent rearrangement of both IgH genes in B-PLL when compared to B-CLL may predispose to a higher incidence of 14q+ in B-PLL. Trisomy 12 which is a feature of B-CLL was observed in one case in the present series. Other abnormalities of chromosome 12 included 12p-(p12-13) in 2 cases and t(12;14)(q22;q32) in 1 case. The t(6;12) previously described as a specific abnormality in B-PLL was not observed in the 22 cases (13 present series, 9 previous series) studied in our laboratory. PMID- 3509771 TI - [Effects of cartilage-derived factor (CDF) on proliferation and expression of the differential phenotype of cultured chondrocytes]. PMID- 3509772 TI - [Effect of local tumor irradiation on immunity in tumor-bearing mice - immunological study on radiation-damaged tissue]. PMID- 3509773 TI - [The phenotypic and functional analysis of T cells in the inflamed gingiva and peripheral blood of adult periodontitis]. PMID- 3509774 TI - Blepharospasm and autoimmune diseases. AB - We studied two patients, one with systemic lupus erythematosus and the other with myasthenia gravis, both of whom had coexistent blepharospasm. The blepharospasm occurred during exacerbations of the autoimmune diseases and improved with immunosuppressive therapy. These cases illustrate the possible association of blepharospasm and autoimmune disorders. PMID- 3509775 TI - Regional cerebral glucose metabolism in SLE chorea: further evidence that striatal hypometabolism is not a correlate of chorea. AB - The pathophysiology of chorea in systemic lupus erythematosus (SLE) is uncertain. Pathologic examination has not identified a specific location for the causative lesion(s) and immunologic mechanisms have been suggested in its etiology. In other choreic disorders, such as Huntington's disease and benign hereditary chorea, glucose hypometabolism in the striatum has been demonstrated by positron computed tomography (PCT) using [18F]deoxyglucose. With this technique we have studied four patients with chorea secondary to SLE. In these patients the regional distribution of cerebral glucose metabolism was normal. In particular, striatal glucose metabolism was within the normal range, even though the ratio of striatal to cortical glucose metabolism was increased. Our results show that striatal hypometabolism, as seen in other disorders manifesting chorea, is not the PCT correlate of the dyskinesia. PMID- 3509776 TI - Levodopa-induced regional cerebral blood flow changes in normal volunteers and patients with Parkinson's disease. Lack of correlation with clinical or neuropsychological improvements. AB - Single photon emission computed tomography was used to measure regional cerebral blood flow in six normal subjects and 12 patients with Parkinson's disease, before and after acute oral administration of levodopa. The drug induced a significant increase in cerebral blood flow both in controls and patients. Before levodopa, there was no significant difference between the groups, either in flow values or in their pattern. The clinical effects of levodopa were not related to the hemodynamic changes. The results suggest that measuring the flow response to levodopa is not appropriate to demonstrate variations in central dopaminergic receptor sensitivity in man. PMID- 3509777 TI - [Personal experience in the treatment of urinary incontinence with maximum electrostimulation]. PMID- 3509778 TI - [Cell populations of the deep lung and circulating blood in silicosis. Contribution to physiopathological concepts]. PMID- 3509779 TI - [Pulmonary histiocytosis X. Pseudo-tumor forms]. PMID- 3509780 TI - Coronary artery disease in patients with aortic aneurysm: a classification of 302 coronary angiograms and results of surgical management. AB - In an attempt to reduce early and late mortality caused by myocardial infarction in patients with aortic aneurysms, coronary arteriography and, when indicated, myocardial revascularization were performed prior to elective aortic reconstruction in 302 patients with infrarenal (289) or thoracoabdominal (13) aortic aneurysms. Severe correctable coronary artery disease (CAD) was identified in 31% of the entire series, whereas severe inoperable CAD was seen in another 5%. Severe, correctable CAD was documented in 42% of patients suspected to have CAD by standard clinical criteria and in 19% of those in whom CAD was not suspected. The overall mortality for 89 cardiac and 227 infrarenal aortic surgical procedures was 4,4%. Fatal complications after infrarenal aneurysm resection occurred in only one (1.6%) of 61 patients who had had preliminary myocardial revascularization. PMID- 3509781 TI - The use of spinal cord stimulation for severe limb-threatening ischemia: a preliminary report. AB - Spinal cord stimulation has been shown to control ischemic pain. We have applied spinal cord stimulation to nine patients with rest pain, non-healing ulceration, or digital gangrene to evaluate its effect on limb salvage. The patients had a mean age of 69 years. Six were diabetic, and all had previous major complications of their atherosclerotic disease. Stimulation was obtained by placing an electrode on the spinal cord under local anesthesia. Seven patients experienced marked reduction in their ischemic pain immediately after stimulation. These patients also had improved healing of ulcers documented by direct measurement. No significant change in ankle/brachial Doppler indices could be measured in any patient. One patient became suddenly worse and required amputation after one year of good pain relief and ulcer improvement. Two patients were not helped and went on to amputation within one month of stimulation. We conclude from these preliminary data that spinal cord stimulation effectively relieves ischemic pain and is associated with improved ulcer healing. PMID- 3509782 TI - The influence of 1 alpha,25- and 24(R),25-dihydroxyvitamin D3 on bone constituents during early mineralization in the rat. AB - The influence of vitamin D metabolites on intramuscular implants of bone matrix in rachitic rats was investigated. Recipient rats with rickets were injected daily with 1 alpha,25(OH)2D3,24(R),25(OH)2D3 or a combination of both metabolites. The presence of 1 alpha,25(OH)2D3 increased significantly the alkaline phosphatase activity, and slightly increased the activity of acid phosphatase. 24(R),25(OH)2D3 had no effect on the activity of the measured enzymes. The results of inductively coupled plasma emission spectrometric determination of bone elements revealed that: (a) 1 alpha,25(OH)2D3 stimulated the incorporation of magnesium and decreased the phosphorus content of bone implants when compared with rats given both vitamin D metabolites; (b) 1 alpha,25(OH)2D3 as well as 24(R),25(OH)2D3 had antagonistic effects on bone carbonate content. The values for 1 alpha,25(OH)2D3 treated animals were significantly higher, and 24(R),25(OH)2D3 treated rats had a significantly lower carbonate content of implants when compared to the controls. Time-dependent CO2 liberation diagrams indicated a differently bound bone carbonate in 1 alpha,25(OH)2D3 treated rats; (c) when plotted against time, the diagrams for both the values for zinc and the activity distribution of the measured enzymes had a similar appearance, indicating zinc incorporation into bone enzymes during early mineralization. It is concluded that 24(R),25(OH)2D3 should not be compared to 1,25(OH)2D3 on the basis of the same effects, since other effects of 24(R),25(OH)2D3 on the developing bone exist, opposite to those of 1,25(OH)2D3; and these could be important for protecting bone from different agents and in determining the nature of early mineral deposited. PMID- 3509783 TI - Vitamin D metabolites do not alter parathyroid hormone secretion acutely. AB - Evidence to date has failed to show a consistent effect of vitamin D metabolites on PTH secretion. This study was undertaken to assess the possible direct, acute effects of vitamin D metabolites on PTH secretion in vitro. Ethanol has been used in several published studies as the vehicle for vitamin D metabolites. We found that 0.2-1.0% ethanol inhibited PTH release from dispersed bovine parathyroid cells (PTC). Our experiments with vitamin D metabolites used ethanol as a vehicle at a concentration less than 0.1%. When compared to ethanol treatment, 10-100 nM 1,25-dihydroxyvitamin D3 (1,25(OH)2D3), 25 and 100 nM 24,25-dihydroxyvitamin D3 (24,25(OH)2D3) and 100 nM 1,24,25-trihydroxyvitamin D3 (1,24,25(OH)3D3) had no effect on PTH release from PTC incubated for up to 4 h. A combination of 1,25(OH)2D3 and 24,25(OH)2D3 (each 25 or 100 nM) was without effect. Also, 100 nM 1,25(OH)2D3 had no effect on PTH release from either bovine parathyroid gland slices or from parathyroid glands from either vitamin D-replete (+D) or vitamin D deficient (-D) rats incubated for up to 4 h. The i.v. injection of 1 microgram 1.25(OH)2D3 into -D rats had no effect on either serum PTH or calcium (Ca), either 0.5 or 1.0 h after treatment. Parathyroid glands from -D rats incubated with 0.75 mM Ca secreted more PTH than glands of similar weight from rats given 25 micrograms vitamin D3 3 days earlier, suggesting that vitamin D or a metabolite of vitamin D may modulate the sensitivity of the parathyroid gland to medium Ca. In summary, we found no evidence for a direct, acute effect of vitamin D metabolites on PTH secretion under diverse experimental conditions. PMID- 3509784 TI - Plasma bone Gla-protein: assessment of its clinical value as an index of bone formation in hemodialyzed patients. AB - Plasma bone-Gla protein was measured in 27 non-selected patients on chronic hemodialysis or hemofiltration with no overt radiological bone disease. Individual values ranged from normal to 10-times the upper limit of the normal range. Plasma bone-Gla protein correlated with the histomorphometric parameters of bone turnover and bone formation and with plasma parathyroid hormone and alkaline phosphatase. When patients were classified according to their Bone Formation Rate, plasma bone-Gla-protein allowed a better distinction between high and low bone formation rates than did alkaline phosphatase or plasma parathyroid hormone. PMID- 3509785 TI - Low serum osteocalcin in acute alcohol intoxication: a direct toxic effect of alcohol on osteoblasts. AB - A direct effect of alcohol on bone cells has not been convincingly demonstrated, but numerous studies have postulated that alcohol inhibits osteoblastic activity. Since osteoblasts synthesize osteocalcin, we studied the serum levels of this protein in 15 patients with acute alcoholic intoxication to determine if alcohol has an effect on these cells, whether direct or indirect. We found lower osteocalcin levels in our alcoholics than in 15 normal individuals of similar age and sex (3.1 +/- 1.0 vs. 6.6 +/- 0.8 ng/ml; P less than 0.0001), evidence of the influence of alcohol on osteoblasts. This effect seems to be direct rather than mediated. PMID- 3509786 TI - Effects of NaCl variation in the adapting solution of the tongue on taste nerve activity. PMID- 3509787 TI - Variation in taste nerve response pattern with changes in stimulus quality and concentration. PMID- 3509788 TI - [Afferent signalling patterns from the frog oral mucosa in response to flow tactile stimulation]. PMID- 3509789 TI - In vitro transport of sodium across the frog tongue epithelium. PMID- 3509790 TI - [Prevalence of oral diseases in dental students]. PMID- 3509791 TI - T cell-dependent proliferative response, delayed-type hypersensitivity and antibody formation to syngeneic serum modified with various medicaments. PMID- 3509792 TI - [Dental health education for schoolchildren and its evaluation by visible plaque index and gingival bleeding index]. PMID- 3509793 TI - Fine structure and degeneration of the horny teeth and the epidermis of the labial ridge of the anuran tadpole. PMID- 3509794 TI - [Osteolysis of the distal phalanges of the hand and systemic disease]. PMID- 3509795 TI - Intrahepatic cholestasis associated with co-trimoxazole. PMID- 3509796 TI - Serum osteocalcin, bone alkaline phosphatase isoenzyme and plasma tartrate resistant acid phosphatase in patients on chronic maintenance hemodialysis. AB - Biochemical indices of bone formation (serum osteocalcin and bone alkaline phosphatase isoenzyme) and osteoclastic function (plasma tartrate resistant acid phosphatase) were measured in 43 patients undergoing chronic hemodialysis and in 27 patients with primary hyperparathyroidism. The mean values for bone alkaline phosphatase isoenzyme and plasma tartrate resistant acid phosphatase but not for osteocalcin were significantly higher in primary hyperparathyroidism as compared with dialyzed patients. A significant positive correlation was found between the biochemical indices of osteoblasts and osteoclasts both in primary hyperparathyroidism and in dialyzed patients, indicating biological coupling between bone resorption and formation under these conditions. The regressions of osteocalcin vs bone alkaline phosphatase isoenzyme and/or plasma tartrate resistant acid phosphatase in dialyzed patients paralleled those in primary hyperparathyroidism but their distance differed significantly. It is concluded that in patients with renal failure, an increase in circulating osteocalcin by a relatively constant portion reflects decreased renal clearance. Any additional increase in osteocalcin serum level indicates an increased skeletal production of osteocalcin. The clinical value of bone alkaline phosphatase isoenzyme and plasma tartrate resistant acid phosphatase appears to be comparable with that of serum osteocalcin in primary hyperparathyroidism, and more exact than osteocalcin in renal failure. PMID- 3509798 TI - Organization and operation of large-scale population-based surveys of human intestinal parasitoses in rural communities. PMID- 3509797 TI - Growth of osteoclast precursor-like cells from whole mouse bone marrow: inhibitory effect of CSF-1. AB - We studied the growth of mononuclear phagocytes (MPs) and mononuclear osteoclast precursor-resembling (OCP-like) cells from freshly isolated whole mouse bone marrow. Expression of tartrate-resistant acid phosphatase (TRAcP) served as a general marker for the identification of OCP-like cells. Bone resorbing capacity of the cultured cells was studied in a coculture assay with periost-free fetal bone rudiments. Freshly isolated mouse bone marrow contained approximately 30 OCP like cells and 1100 MPs per 10(6) nucleated bone marrow cells. OCP-like cell numbers did not increase in suspension cultures containing macrophage-colony stimulating factor (CSF-1), in contrast to the number of MPs which increased strongly. OCP-like cell numbers however did increase in monolayer cultures, which also allowed anchorage-dependent growth of bone marrow fibroblasts. Strongest increase of OCP-like cells occurred in monolayer cultures in the absence of CSF 1. Dermal fibroblasts of fetal mice did not enhance OCP-like cell growth. OCP like cell density was strongly correlated with the number of osteoclast nuclei formed in cocultures with periost-free bone rudiments. These data indicate that mononuclear cells, cytochemically and functionally resembling osteoclast precursors, may be grown from mouse bone marrow. CSF-1 inhibited growth of OCP like cells, indicating that osteoclast precursors differ from mononuclear phagocytes in growth requirements. PMID- 3509799 TI - The incidence of profound deafness in childhood: a three-year survey. PMID- 3509800 TI - Oxidative ionic metabolites of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP): correlation of electroreduction with physiological behavior. AB - Electrochemical studies (reduction potential and reversibility) were performed on 1-methyl-4-phenylpyridinium (MPP+) and 1-methyl-4-phenyl-2,3-dihydropyridinium (MPDP+). MPP+ gave reduction potentials in the range of -1.09 to -1.11 V in organic solvents in a process which was reversible. The reduction potential of MPDP+ was -0.64 V (irreversible). Possible relationships involving the electrochemical properties, oxy radical formation, and biological activity of these and related iminium species are discussed. PMID- 3509801 TI - Anti-inflammatory activity of superoxide dismutases: studies on adjuvant induced polyarthritis in rats. AB - The anti-arthritic activities of various superoxide dismutases and of liposomal bovine Cu-SOD have been compared in the adjuvant induced Lewis Inbred Rat model. Various approaches, including plethysmometric measurements, red cell sedimentation rates, while cell counts, levels of IgA and IgG immunoglobulins and scoring by visual, radiographic and scintigraphic techniques all concord in a demonstration of different activities for different SODs. The most efficient are liposomal bovine Cu-SOD and E. coli Mn-SOD, a moderate activity being shown by free bovine Cu-SOD. Poor or zero results are obtained with human Mn-SOD, human Cu SOD or the homologous rat Cu-SOD. PMID- 3509802 TI - Lymphocyte populations with different sensitivity to cyclosporin have different plasma membrane potentials. AB - Cyclosporin A (CsA), a clinically potent immunosuppressive agent, shows preferential biologic activity against certain lymphocyte subsets. To investigate this activity, we used flow cytometry to separate two distinct lymphocyte populations from unfractionated human peripheral blood lymphocytes, based on their different binding affinity for a biologically active fluorescent, dansylated cyclosporin (dans-CsA) derivative. The separate lymphocyte populations demonstrated different resting plasma membrane potentials. The two lymphocyte populations also had different levels of interleukin-2 (IL-2) receptors and shifted plasma membrane potential differently upon treatment with cyclosporin and lymphokine IL-2. The cell population that bound more dans-CsA contained the cells which possessed IL-2 receptors and responded to CsA and IL-2 with changes in membrane potential. The cell population that did not effectively bind dans-CsA lacked IL-2 receptors and did not respond to CsA or IL-2 with immediate membrane potential changes. Furthermore, stimulation studies of these separated two lymphocyte populations with phytohemagglutinin in the presence and absence of CsA revealed that only the population which binds a low level of dans-CsA shows a marked difference in membrane potential between the cells stimulated in the presence and absence of CsA. We concluded that ion flux changes caused by CsA affect the activation process of naive lymphocytes but not that of already stimulated ones. It can also be postulated that the ion flux changing property of CsA could constitute its primary or main mode of action. PMID- 3509803 TI - Immunohistochemical study of neurons containing corticotropin-releasing factor in Alzheimer's disease. AB - In the brains of controls and individuals with Alzheimer's disease (AD), antisera to corticotropin-releasing factor (CRF) were used to immunostain neurons and their processes. In AD, we identified abnormal CRF-immunoreactive axons as well as neurites associated with deposits of amyloid in brain regions showing senile plaques. The number of immunoreactive fibers was decreased in individuals with AD. In contrast, CRF immunoreactivity was markedly increased in some neurons located within the paraventricular nucleus (PVN) of the hypothalamus. These findings support previous neurochemical studies indicating that certain CRF systems are affected in AD. PMID- 3509804 TI - [A prevalence research on dental health care in primary schoolchildren in Ankara. Part II. Dental health care at Tandogan Primary School]. PMID- 3509805 TI - [Morphologic and functional characteristics of thymus cells of the mouse during combined radiation injury]. PMID- 3509806 TI - Alcohol consumption among Israeli adolescents: a decade of research. PMID- 3509807 TI - Immunological changes after hyposensitization in house-dust-sensitive asthmatic children: a review. AB - Patients with allergic diseases are characterized by the presence of elevated total serum IgE and specific IgE antibodies against a variety of environmental allergens. To explore the causes for augmented IgE antibody production and the working mechanisms of hyposensitization (HS), a series of studies has been conducted on house-dust-sensitive, newly diagnosed, and hyposensitized asthmatic children and normals. The specific IgE and IgG antibodies were measured by radioallergosorbent test; the lymphoproliferative capability was measured by 3H thymidine incorporation; the allergen-specific suppressor activity was determined by the extent of house-dust-activated, interleukin-2 (IL-2)-expanded lymphocytes to suppress the allergen-induced proliferation of autologous mononuclear cells (MNC); and IL-2 was produced by stimulating MNC with allergen or phytohemagglutinin (PHA) and quantitated by its capability to support the proliferation of mouse IL-2-dependent cytotoxic T-cell line. The results showed: 1) HS was effective in 90% of patients in terms of decreased attacks and medication taken; 2) the patients were defective in suppressor T-cell function for IgE production; 3) HS was able to restore the regulatory T-cell function and increase the production of IgG-blocking antibody; and 4) IL-2 production may be used as an indicator for initiation and discontinuation of HS. Therefore, hyposensitization is an effective and specific treatment for allergic bronchial asthma and can partially correct an immunoregulatory aberration in atopic individuals. PMID- 3509809 TI - Fluoxetine in the treatment of cataplexy. PMID- 3509808 TI - HLA antigens and immunoglobulin allotypes in myasthenia gravis. PMID- 3509810 TI - [Use of the right marginal coronary artery to compose sequential saphenous vein bypasses]. PMID- 3509811 TI - Effects on immune responses by chronic stress are modulated by aging. AB - Male Fischer-344 rats at 5, 11, and 18 months of age were exposed to chronic stress for 6 months and subsequently allowed a 1-month interval with no stress before examination of splenic lymphocyte proliferative responses, IL-2 secretion by T cells, and NK cell activity in stressed and age- and sex-matched control animals. All four responses declined as a function of age in control rats. Stress exposure significantly decreased concanavalin A and lipopolysaccharide proliferative responses in 12- and 18-month-old compared to control rats without altering IL-2 secretory capacity. NK cell activity was slightly depressed by stress only in 18-month-old rats. By contrast, in 25-month-old animals that already demonstrated immune response levels lower than those of younger animals, stress did not significantly affect the responses examined. Thus, younger rats were more susceptible to a decline in host-defense responses induced by long-term chronic stress than older rats. Overall, the data suggest that aging significantly and differentially modulates the ability of environmental stress to influence the immunocompetent status of the organism. PMID- 3509812 TI - Effects of Newcastle disease virus administration to mice on the metabolism of cerebral biogenic amines, plasma corticosterone, and lymphocyte proliferation. AB - Newcastle disease virus (NDV) administration to mice increased concentrations of plasma corticosterone, with a maximal effect at 8 h. This elevation of plasma corticosterone concentrations was not observed in hypophysectomized animals in which the completeness of the hypophysectomy was verified by functional tests. NDV administration consistently increased concentrations of free tryptophan in all brain regions examined (prefrontal cortex, hypothalamus, and brain stem). It also caused an activation of cerebral catecholamine and indoleamine metabolism as determined by measurement of the amines and their catabolites. 3-Methoxy,4 hydroxyphenylethyleneglycol (MHPG), the major catabolite of norepinephrine (NE), homovanillic acid (HVA), a major catabolite of dopamine (DA), and 5 hydroxyindoleacetic acid (5-HIAA), the major catabolite of serotonin (5-HT), were all increased in both hypothalamus and brain stem. Ratios of catabolites to the parent amine, considered to be an index of utilization of the neurotransmitters, were increased for NE, DA, and 5-HT in the hypothalamus and for DA and 5-HT in the brain stem. This pattern of changes resembles that observed following stressors such as footshock or restraint. There were also significant increases of tryptophan, HVA, dihydroxyphenylacetic acid (DOPAC), and 5-HIAA in hypophysectomized relative to sham-operated mice. The NDV treatment also increased thymus weights and markedly decreased the proliferative responses of isolated spleen cells to phytohemagglutinin, concanavalin A, pokeweed mitogen, and Escherichia coli lipopolysaccharide. These changes were not caused by increased circulating corticosterone because they were present at equal magnitude in hypophysectomized mice. Thymosin alpha 1 concentrations in the plasma were not altered by NDV or hypophysectomy. These results indicate that administration of NDV to mice can initiate neurochemical and endocrine responses like those observed during stress and can also cause immunosuppression. They are thus consistent with the hypothesis that a virus can be a stressor. PMID- 3509813 TI - [A case of Sheehan's syndrome with gingival bleeding]. PMID- 3509814 TI - [Studies on production of bone resorption-enhancing factor by human peripheral blood leukocytes]. PMID- 3509815 TI - [Immunobiological characterization of Actinobacillus actinomycetemcomitans lipopolysaccharide: inducing activity of interleukin-1 production]. PMID- 3509816 TI - The clinical efficacy of wooden interdental cleaners in gingivitis reduction. PMID- 3509817 TI - Vitamin A deficiency: a public health problem in eastern Sudan. PMID- 3509818 TI - Some common human intestinal nematodes at the Wonji/Shoa Sugar Estate: a five year study. PMID- 3509819 TI - Epidemiology of trachoma in north-western Ethiopia. PMID- 3509820 TI - The role of ionic signals in early gene induction during T cell activation. PMID- 3509821 TI - [Dielafoy's ulcer: a case report]. PMID- 3509822 TI - Treatment of a nonunion fracture of the tibia in a Chinese water dragon, including stimulation of osteogenesis with direct electric current. PMID- 3509823 TI - [T cells modulate T-independent polyclonal B cell activation and enhance IgG synthesis]. PMID- 3509824 TI - [Fecal alpha 1-antitrypsin in infants. Reference values and in acute diarrheal syndrome]. PMID- 3509825 TI - [The characteristics of homicides in subjects under 21 of the metropolitan region]. PMID- 3509826 TI - [Nocardiosis: clinical and bacteriological aspects. Experience in 16 cases]. PMID- 3509827 TI - [Epidemiological aspects of chronic rheumatic diseases in Chile]. PMID- 3509828 TI - [A method for quick freezing of muscles in tetanic contraction]. PMID- 3509829 TI - [Low-frequency currents in the treatment of persistent trigeminal neuralgia]. PMID- 3509830 TI - Chromosome aberrations and transforming genes in leukemic and non-leukemic patients with a history of atomic bomb exposure. AB - To investigate leukemogenesis in atomic bomb (A-bomb) survivors, chromosome aberrations in bone marrow cells, and T- and B-lymphocytes from 135 healthy persons who had been exposed within 1,000 m of the hypocenter of the Hiroshima A bomb were sequentially examined. Leukemic marrow cells from 468 patients with acute or chronic type of leukemias, including 25 acute leukemias exposed to 1 rad or more of radiation were also studied cytogenetically. Analysis of breakpoints observed in T-lymphocytes with stable types of abnormalities revealed a nonrandom distribution, and clustering in specific regions of chromosomes such as 22q1, 14q3, and 5q3. Statistical analysis revealed a higher incidence of translocations in 50 bands, including those containing cellular oncogenes such as 8q22, 8q24, and 9q34. Of these 50 bands, 20 were matched with bands specific for leukemia and cancer and 14 with constitutive fragile sites. In leukemic marrow, all 10 patients who had been exposed to radiation of more than 200 rad and then developed acute non-lymphocytic leukemia had chromosome aberrations. Their aberrations were more complex than those in patients exposed to less than 200 rad (33 patients) and in the non-exposed patients (134 patients). DNA samples extracted from bone marrow cells of 13 survivors, including 4 healthy survivors with more than 30% chromosome abnormalities in the bone marrow and 9 leukemia patients were used for in vivo selection assay of transforming genes. Tumor formation in nude mice was observed in 3 of the 4 healthy survivors and 9 leukemia patients. All of the transfectants were shown to contain Alu sequences. The transforming N-ras gene was detected for the first time in the bone marrow cells from 3 heavily exposed survivors and from 7 leukemia patients with a history of radiation exposure. PMID- 3509831 TI - [Comparison of two-dimensional echocardiography with 201T1-single photon emission computed tomography for evaluating the myocardial infarct zone]. AB - The reliability of measuring the myocardial infarct zone by two-dimensional echocardiography (2 DE) was compared with that by regional myocardial blood flow as evaluated by single photon emission computed tomography (SPECT) in 47 patients with old myocardial infarction, with ventricular aneurysm (An group; n = 15), and without ventricular aneurysm (Non-An group; n = 32). Short-axis images of the left ventricle at the level of the mitral valve, the papillary muscles, and the apex were obtained both by 2DE and SPECT. The left ventricular wall was divided into 36 segments in 2DE and 40 segments in SPECT with reference points at the posterior end of the right side of the interventricular septum. The segments in which the radial shortening on 2DE and the 201Tl uptake index on SPECT were below one standard deviation from the means of 10 normal subjects were defined as those with abnormal wall motion and hypoperfused areas, respectively. The relationships between these findings were studied. The extent of apical movement was measured by left ventricular cineangiography in each case, and was compared between the An and Non-An groups. 1. Wall motion abnormalities on 2DE and hypoperfusion on SPECT showed a correspondence of 81% in the An group and 78% in the Non-An group at the level of the mitral valve, and 78% in the An group and 76% in the Non-An group at the papillary muscle level. However, a better correspondence was observed in the An group (84%) as compared to the Non-An group (64%) at the level of the apex. 2. Apical movement assessed by cineangiography showed more extensive changes in the Non-An group than in the An group (2.3 +/- 0.9 mm vs 4.1 +/- 1.7 mm in the RAO view, 2.4 +/- 1.9 mm vs 5.3 +/- 2.1 mm in the LAO view). From these observations, it was suspected that the cause of disparity between radial shortening and the 201Tl uptake index at the level of the apex is related to the cardiac movement of the apex toward the base during systole. 3. Since wall motion abnormalities demonstrated by radial shortening (2DE) and hypoperfusion indicated by the 201Tl uptake index (SPECT) generally corresponded well, 2DE was thought to be a useful method for evaluating myocardial infarct zone. PMID- 3509832 TI - [Regional myocardial blood flow quantitatively measured using O-15 water and dynamic positron emission tomography]. AB - This study was performed to measure regional myocardial blood flow (MBF) quantitatively using dynamic positron emission tomography (PET) and O-15 water. The subjects consisted of two normal volunteers, four patients with normal coronary angiograms (CAG), two patients with angina pectoris (3-vessel disease) and three patients with myocardial infarction. O-15 water (15-20 mCi) was injected via the cubital vein in a bolus, and dynamic PET was performed. MBF was calculated according to the method of Iida. The region of interest (ROI) was selected on the left ventricular wall (septum, anterior and lateral walls) and MBF was calculated in each ROI. In normal volunteers, MBF was 1.07 to 1.17 ml/g/min. It was 0.96 to 1.02 ml/g/min in patients with normal CAG, and 0.53 to 0.64 ml/g/min in patients with angina pectoris in the ischemic area. In patients with myocardial infarction, MBF was so diminished in the infarcted area as detected by 2-DE or ECG that the absolute value was almost 0 ml/g/min. In patients with angina pectoris, there was no definite defect on the MBF image, but we could estimate the severity of coronary stenosis by quantifying the MBF. The clinical advantages of this method include estimation of the severity of coronary arterial stenosis in the resting state. PMID- 3509833 TI - [Problems related to tracer concentration and wall thickness: pitfalls in positron CT diagnosis]. AB - Positron emission computed tomography (PET) is regarded an excellent technique for quantitative measurements. However, its accuracy is related to the spatial resolution of the system. The relation between myocardial wall thicknesses as measured by X-ray CT or MRI and the radioactivity as measured using PET was studied in 37 patients. 1. In patients with transmural infarction, the infarcted myocardium was imaged as a region of low radioactivity. However, the myocardium usually exhibited wall thinning, so that partial volume effects must be taken into account in evaluating the radioactivity. 2. In the infarcted regions, the regions of the low radioactivity tended to be larger than those of wall thinning. 3. There were cases with the regional low radioactivity without wall thinning in myocardial infarction and in hypertrophic cardiomyopathy. Because patients with myocardial infarction frequently had regional wall thinning, it seems necessary to correct partial volume effects for the infarcted regions which differ from the normal. It was concluded that, to estimate regional myocardial blood flow or metabolism using PET, it is necessary to supplement another morphological diagnostic method to evaluate myocardial wall thickness. PMID- 3509834 TI - Trends in stroke mortality and in antihypertensive treatment in Finland from 1972 to 1984 with special reference to North Karelia. AB - Trends in antihypertensive treatment and stroke mortality were analysed in the province of North Karelia where the first systematic hypertension control programme in Finland was started in 1972. Surveys carried out in random samples of the middle-aged population of North Karelia showed that the control of hypertension was better than in the reference area, especially from 1972 to 1977. From 1972 to 1984, mortality from stroke fell on average 6.3% and 7.6% per annum, in North Karelian men and women aged 35-64 years. These declines were steeper than those observed in the rest of Finland. In the age group of 65-74 years the decline in stroke mortality was also steeper in North Karelia. From 1978 to 1984 the self-reported awareness of hypertension and the proportion of people receiving antihypertensive drug treatment decreased in the middle-aged population in Finland, suggesting lesser efforts at detection and treatment. During the same period, the steep national decline in stroke mortality levelled off, but the mortality rate remained higher than in the USA and in other Western European countries. Prevention of stroke through hypertension control in the community still remains a major challenge for health care. PMID- 3509835 TI - Table salt and blood pressure in Greek children. AB - The habit of adding table salt was studied in a random sample of 2209 children 6 18 years old. Of these 10% routinely added table salt to prepared food before tasting it (group A), 29% after tasting it (group B) and 61% ate their food as it was prepared, without additional use of table salt (group C). Group A had higher blood pressure (BP), prevalence of systolic BP greater than or equal to 130 mmHG and body mass index (BMI) than groups B and C (P less than 0.0001). These differences were also observed in group B versus C (P less than 0.0001). PMID- 3509836 TI - Geographic distribution of HBsAg subtypes in Brazil. AB - HBsAg positive serum samples (896) from five brazilian regions were analysed for HBsAg subtypes. The presence of five different subtypes (ayw2, ayw3, ayw4, adw2 and adw4) was detected. In Northern region subtypes adw4 (41.2%) and adw2 (37.2%) were predominant. In the North East only subtype adw2 was encountered. In Central West, South-East and South, subtypes ayw2, ayw3, adw2 and adw4 were present, with predominance of adw2 in Central West and South East (84.3% and 69.4% respectively) whereas in the South the predominant subtype was ayw3 (41.9%) followed by ayw2 (36.4%). Subtypes ayw1, ayr and adr were not found among the samples studied. These results show the difference in the incidence of HBsAg subtypes in the different regions of Brazil and their significance in relation to the colonization and migrations in this country. PMID- 3509837 TI - Compensated polarised microscopy: a simple and cheap modification. PMID- 3509838 TI - Coronary artery bypass grafting in the elderly. Experience in a community hospital. PMID- 3509839 TI - Interactions between retinal glial cells and immune mononuclear cells. PMID- 3509840 TI - Immunopathogenic mechanisms of experimental autoimmune uveoretinitis in rats. PMID- 3509841 TI - [The changes of prostaglandin E1 in the aqueous humor and the pathology in infectious and anaphylactic endophthalmitis]. PMID- 3509842 TI - [Congenital colour-blindness and deficiency of glucose-6-phosphate dehydrogenase]. PMID- 3509843 TI - [Intradental diffusion of amalgam components. Immunological pulp reaction]. PMID- 3509844 TI - Positron emission tomography: principles and applications in pediatrics. PMID- 3509845 TI - [Dental extractions in patients hypersensitive to conventional anesthetic agents]. PMID- 3509846 TI - [Lesions of erosive and ulceronecrotic character originated during the treatment with chemotherapeutics and antipyretics]. PMID- 3509847 TI - [Clinical results from Gramurin application in the complex treatment of hemorrhagic periodontosis]. PMID- 3509848 TI - [Histiocytosis X]. PMID- 3509849 TI - Cadmium produces a delayed mitogenic response and modulates the EGF response in quiescent NRK cells. AB - Recent studies have shown that cadmium, at subtoxic levels, may induce a response characteristic of that elicited by a type of growth factor that supports the anchorage independent growth of cells that are not fully transformed. That is, Cd++ was found to replace transforming growth factor beta in supporting soft agar growth of NRK-49F cells. To test the extent to which Cd++ further mimics transforming growth factor beta in its effects and to establish response patterns that suggest possible molecular mechanisms of action, we have determined the effects of Cd++ and/or epidermal growth factor (EGF) on DNA synthesis in quiescent NRK-49F cells. We found that subtoxic doses of Cd++ modulate EGF induced DNA synthesis in a dose-dependent fashion. Although Cd++ effects on early (16-24 hr) EGF-induced DNA synthesis are primarily inhibitory, later effects involve stimulation as well. Subtoxic doses of Cd++ did not stimulate DNA synthesis in quiescent cells within 24 hr of addition. At later times (40 or 64 hr), however, an increase in DNA synthesis of up to threefold was induced by 0.25 microM Cd++. This pattern of mitogenic response, involving inhibition of early growth-factor induced DNA synthesis and stimulation of late DNA synthesis, is consistent with that reported to be effected in some instances by transforming growth factor beta. Because a defined pattern of gene expression also is associated with the mitogenic responses to transforming growth factor beta, future studies at the molecular level can definitively test the degree to which Cd++ and transforming growth factor beta effects are common. PMID- 3509850 TI - Follicular characteristics associated with viable pregnancy after in vitro fertilization in humans. AB - The aim of this study has been the development of a noninvasive method of predicting the pregnancy potential of human oocytes and embryos intended for in vitro fertilization and embryo replacement. A multifactorial system which distinguishes, with a high degree of accuracy, between normal pregnancy, abnormal pregnancy, and non-pregnancy-producing embryos is reported. The variables included are (1) follicular fluid proteins alpha 1-antitrypsin, complement C3, immunoglobulin IgG2, and total protein, and total proteoglycan level separated by isoelectric focusing; (2) follicular volume; and (3) an embryo appearance rating. The study group consisted of (1) follicles which produced embryos of known performance after transfer (a) when the number of embryos transferred = the number of implantations and, (b) where one embryo transferred = no pregnancy; (2) follicles which produced oocytes which did not cleave after insemination; and (3) follicles from which no oocyte was aspirated. Canonical discriminant analysis of follicular fluid variables and follicular volume has been used to characterize the oocyte performance groups. Correct classification was achieved in 69% of normal pregnancy, 70% of abnormal pregnancy, 33% of no pregnancy, and 47% of no cleavage oocytes. An embryo appearance rating was included with the above variables for a separate discriminant analysis of only those oocytes which had formed embryos after insemination. Correct classification was achieved in 81% of normal-pregnancy, 70% of abnormal-pregnancy, and 70% of no-pregnancy embryos. PMID- 3509851 TI - Rodent-ectoparasite association in selected biotopes of Mirzapur and Varanasi Districts of Uttar Pradesh. PMID- 3509852 TI - Clinico-epidemiological study of cutaneous leishmaniasis in Bikaner (Rajasthan). PMID- 3509853 TI - Viral hepatitis in females in Delhi. PMID- 3509854 TI - Prevalence of intestinal parasitic infections in Delhi. PMID- 3509855 TI - Epidemiology of measles in western Rajasthan. PMID- 3509857 TI - Pre-B cells. PMID- 3509856 TI - Seroprevalence of HIV infection in high risk groups in Manipur. PMID- 3509858 TI - Limited genetic diversity of Haemophilus influenzae (type b). AB - 170 strains of Haemophilus influenzae (serotype b), isolated largely from patients with invasive disease from differing temporal and geographic origins were characterized using the combined approaches of DNA hybridization and outer membrane protein classification. Hybridization of a DNA probe to a region of the chromosome involved in the expression of type b capsular polysaccharide revealed that 163 (96%) isolates had one of three distinct, but closely related, chromosomal restriction fragment length polymorphisms (RFLPs). Each polymorphism was associated with its own distinctive set of outer membrane protein subtypes, indicating that the majority of H. influenzae (type b) isolates have evolved from common ancestors, giving rise to globally distributed organisms that have clonal characteristics. PMID- 3509859 TI - Pathogenesis of Rift Valley fever virus (RVFV) in inbred rats. AB - The pathogenesis of Rift Valley fever in adult rats from 3 inbred strains (LEW, MAXX, WF) was investigated. WF rats all died by day 2 postinoculation with viral tissue titers reaching 9 log10 PFU/g. LEW and MAXX rats were resistant to liver disease, but fatal necrotising encephalitis developed in 16 and 44% of the rats, respectively. Detection of serum neutralising antibody on day 3 coincided with clearance of virus from serum and liver, although infectious virus was detected in spleen homogenates as late as day 19 postinfection. Viral titers in LEW and MAXX rats did not exceed 4.5 log10 PFU/g. Cyclophosphamide immunosuppression of LEW rats led to death 5-9 days postinfection; early patterns of viral replication were not affected, but continued growth in the liver resulted in fatal hepatitis. These animals could be protected by passive antibody therapy administered on days 2-5 postinfection to mimic the serum neutralising antibody pattern seen in unmanipulated infected LEW rats. Thus, RVF virus replication and spread is rapid in the WF rats tissues, whereas in LEW and MAXX rats viral growth is less due to an intrinsic mechanism which allows sufficient time for an immune response to terminate infection. A slightly diminished immune response may lead to the development of encephalitis more frequently in MAXX than LEW rats. These rat strains should be useful in elucidating those mechanisms of resistance which limit RVFV-induced hepatitis and encephalitis. PMID- 3509860 TI - Role of divalent cations, pH, cytoskeleton components and surface charge on the adhesion of Trichomonas vaginalis to a polystyrene substrate. AB - The process of adhesion of three different strains of Trichomonas vaginalis to a polystyrene substrate was analysed. The process of adhesion was dependent on the time of incubation and the pH of the phosphate-buffered solution (PBS) in which the parasites were suspended. The highest indices of adhesion were observed after an incubation time of 60 min at pH 6.6. The adhesion index increased when the parasites were incubated in the presence of culture media or when Ca++ or Mg++ was added to the PBS solution, whereas cytochalasin B, trypsin or neuraminidase reduced adhesion. Incubation of the parasites in the presence of poly-L-lysine facilitated the process of adhesion. Incubation of the parasites or polystyrene beads in the presence of poly-L-lysine led to important changes in their surface charge. PMID- 3509861 TI - Clinical features of 12 cases of acquired immune deficiency syndrome. Experience at the University of Missouri-Columbia. PMID- 3509862 TI - Penicillin-degrading enzymes in sites associated with adult periodontitis. PMID- 3509863 TI - Altered specificities of genetically engineered alpha 1 antitrypsin variants. AB - Seven active site variants of human alpha 1-antitrypsin (alpha 1AT) were produced in Escherichia coli following site-specific mutagenesis of the alpha 1AT complementary DNA. alpha 1AT (Ala358), alpha 1AT (Ile358) and alpha 1AT (Val358) were efficient inhibitors of both neutrophil and pancreatic elastases, but not of cathepsin G. alpha 1AT (Ala356, Val358) and alpha 1AT (Phe358) specifically inhibited pancreatic elastase and cathepsin G respectively. The most potent inhibitor of neutrophil elastase was alpha 1AT (Leu358), which also proved to be effective against cathepsin G. The alpha 1AT (Arg358) variant inactivated thrombin with kinetics similar to antithrombin III in the presence of heparin. Electrophoretic analysis showed that SDS-stable high mol. wt complexes were formed between the mutant inhibitors and the cognate proteases in each case. These data indicate that effective inhibition occurs when the alpha 1AT P1 residue (position 358) corresponds to the primary specificity of the target protease. Moreover, alteration of the P3 residue (position 356) can further modify the reactivity of the inhibitor. Two of the variants have therapeutic potential: alpha 1AT (Leu358) may be more useful than plasma alpha 1AT in the treatment of destructive lung disorders and alpha 1AT (Arg358) could be effective in the control of thrombosis. PMID- 3509864 TI - [Sexually transmitted diseases in Poland 1984]. PMID- 3509865 TI - The electroretinographic change by the acute effects of N-methyl-4-phenyl-1,2,3,6 tetrahydropyridine. PMID- 3509866 TI - [Comparison of the effect of pharmacological muscle relaxation and relaxation by means of sinusoid currents in edentulous patients with disorders of the motor part of the stomatognathic system]. PMID- 3509867 TI - [Epidemiology of sports injuries. A 15 year analysis of sports orthopedic ambulatory care]. AB - Analysis of a special outpatient department of sports orthopaedics covers a 15 year period (1972-1986); the department studies by us was initially part of the Orthopaedic Hospital of the University of Heidelberg, whereas later on we continued our studies at the Sports Clinic in Stuttgart-Bad Cannstatt. A grand total of 13,296 sportsmen treated in these departments was assessed, having a total of 15,212 injuries or lesions/damage due to sports activities. All cases were systematically recorded right from the beginning. In 1986, 19.3 million Federal German sportsmen were members of the Federal German Sports Association (DSB), i.e. 31.4% of the populations. The number of sports-related accidents that occurred per year is estimated at 1.5 million, i.e. more than 15% of the total number of accidents. The absolutely highest incidence rate of accidents is seen in popular sports such as football (i.e. "soccer", the most widely practised sport in the Federal Republic), skiing, handball, volleyball, track-and-field athletics, and gymnastics and physical training. The major part of the accidents involves the lower extremities (66.6%), followed by the arms (22.8%) and the vertebral column (4.7%). In respect of diagnoses, lesions of capsular ligaments are by far the most frequent ones. "Distortions" are stated to occur in 32.9% of the cases, severe injuries such as fractures, luxations and ruptures of ligaments representing a total of 33.6%. The incidence rate of contusions is increasing (12.6%), and so is that of lesions of the muscles and tendons (10.4%). 76.5% of the injured persons are men, with an age bracket peak at 20-29 years, followed by the group of 10-19 years. Analysis of the lesions yields valuable pointers to possibilities of accident or injury prevention within the individual sports categories. PMID- 3509868 TI - Association of HLA antigens with chronic active hepatitis (CAH) in children. AB - HLA-A and -B antigen frequencies were investigated in a group of 46 children with chronic active hepatitis (CAH) and in a control group of 100 healthy children. The diseased group comprised 43 HBsAg positive and 3 HBsAg negative children. From the antigen frequencies relative risks (RR) were calculated according to the method of Woolf. The A1 and B8 antigens, known to be associated with autoimmune diseases, were only moderately more frequent in the CAH group than in the control. The relative risk for B8 antigen was 2.23 which is near to a significance level of p = 0.05. When the calculations were performed for 43 HBsAg positive CAH children the RR decreased to 1.70. Additionally, observations were performed on associations of HLA antigens with the occurrence of antinuclear antibodies (ANA) and anti-smooth muscle antibodies (SMA). Positive associations were found for ANA with B13 antigen (RR = 14.13) and for SMA with B5 antigen (RR = 13.66) with X2 4.85, and 5.51 respectively, at 1 degree of freedom. The p values, situated between 0.05 and 0.01 were insignificant after the correction for the number of antigens studied. PMID- 3509869 TI - Analysis of p-aminobenzoic acid and its metabolites in urine and plasma by ion pair HPLC in the NBT-PABA pancreatic function test. AB - An ion pair HPLC method which can simultaneously detect the major metabolites of an exocrine pancreatic function testing agent (NBT-PABA) in plasma and urine has been developed. This assay has been applied to a pharmacokinetic study of PABA and its metabolites in 3 healthy adult volunteers following the oral administration of 1 g NBT-PABA. The 6 h testing period currently used to collect urine following the NBT-PABA ingestion is adequate for the recovery of PABA and its metabolites. Plasma determination of these compounds may provide an improved evaluation of the pancreatic performance in patients with abnormal liver or kidney function. PMID- 3509870 TI - The National Football Head and Neck Injury Registry: 14-year report on cervical quadriplegia (1971-1984). AB - The specter of catastrophic cervical neurotrauma resulting from athletic participation, although infrequent, has been consistently associated with football, water sports, gymnastics, rugby, and ice hockey. Injury involving intracranial hemorrhage can result in death or permanent neurologic impairment, whereas certain fractures and dislocations of the cervical spine are associated with quadriplegia. Athletic injuries to both the central nervous system and spinal cord demand our attention as an active area of clinical and basic injury. A review of the available literature reveals changing injury patterns as well as current concepts regarding the mechanism responsible for most athletic injuries to these structures. Accurate descriptions of the mechanism(s) responsible for a particular injury transcend simple academic interest. In order that preventive measures be implemented, the manner in which injury occurs must be accurately defined. The purpose of this article is to describe how the application of this principle resulted in the significant reduction of cervical spine injuries associated with quadriplegia that have occurred in tackle football since 1976. PMID- 3509871 TI - [A late complication of couching--phacolytic glaucoma, report of 10 cases (11 eyes)]. PMID- 3509872 TI - The trigeminal ganglion in human embryos at stage 15 (5th week). PMID- 3509873 TI - Physical activity and high-density lipoprotein cholesterol and subfractions among young black adults. AB - Limited information is available regarding the relationship between physical activity and blood lipids in black populations. To assess the association, the authors measured high-density lipoprotein cholesterol (HDL-C) and subfractions (HDL(2)-C, HDL(3)-C), physical activity (Harvard Alumni Survey), height, weight, cigarette, alcohol, and oral contraceptive use (questionnaire) in a sample of 173 black freshmen college students at the University of Pittsburgh (59 male, 55 female) and Paine and Augusta colleges in Georgia (14 male, 18 female).Results indicated HDL-C, HDL(2)-C, and HDL(3)-C were significantly higher among women compared with men after adjustment for age, body mass index, alcohol consumption, physical activity, and oral contraceptive use. No significant sex differences were noted for physical activity, however a significantly greater proportion of women reported low physical activity levels (<2000 kcal/wk, 54 percent female, 31 percent male, P < .05). Physical activity was univariately associated with HDL-C (r = .32, P < .01) and HDL(2)-C (r = .29, P < .05) among women. No significant correlations among physical activity and lipid variables were noted among men. The results from stepwise multiple linear regression models (variables included were age, body mass index, physical activity, and oral contraceptive use) revealed that among women physical activity was the only significant independent predictor of both HDL-C and HDL(2)-C explaining 11 and 9 percent of the variance in HDL-C and HDL(2)-C, respectively. Physical activity was not a significant predictor of any of the lipid variables among men.If confirmed, the study finding of a significant association between physical activity and HDL-C and HDL(2)-C among black women suggests that increased physical activity may be an important intervention for the reduction of cardiovascular risk in this high-risk group. PMID- 3509874 TI - Recombinant-derived interleukin-1 alpha stabilized against specific deamidation. AB - Recombinant-derived human interleukin-1 alpha (IL-1 alpha), purified from Escherichia coli, was resolved by isoelectric focusing on polyacrylamide gels into two species of isoelectric points (pI) 5.45 and 5.20, which constituted approximately 75% and approximately 25% of the total IL-1 alpha protein respectively. The pI 5.45 and pI 5.20 species were separated by chromatofocusing and subjected to N-terminal sequence analysis. The pI 5.45 species contained the expected Asn residue at position 36 of the mature protein sequence whereas the pI 5.20 species contained an Asp residue at the same position. A mutant protein in which Asn-36 was substituted for a Ser residue was isolated from E. coli and shown to be homogeneous on isoelectric focusing analysis with a pI = 5.45. 1H n.m.r. and circular dichroism analyses of wild-type and the mutant IL-1 alpha indicated a similar conformation which was also indicated by the identical receptor binding affinities of IL-1 alpha with Asn, Asp or Ser in position 36. The mutant protein was stabilized against specific base-catalysed and temperature induced deamidation, and may be more suitable than the wild-type position for physical and structural studies. PMID- 3509875 TI - [Evaluation of hyperuricemia caused by fructose in a status of altered uric acid metabolism]. AB - It's reported that oral administration of fructose in normal and gouty patients causes a rise in serum uric acid (see "References": Stirpe et al.). The changes in serum uric acid after administration of fructose to gouty patients and to children of gouty patients were significantly different from the changes observed in normal subjects, both for the extent and for the duration of hyperuricaemia. In this study the authors verify if the fructose-induced hyperuricaemia can help to identify gouty patients from people with different metabolic alteration of serum uric acid levels (i.e. chronic leukaemias and some neoplastic diseases). PMID- 3509876 TI - A panel discussion on the safety of nonsteroidal antiinflammatory drugs. PMID- 3509877 TI - [The ski accident in the last 15 years. Correlations with equipment]. AB - In the region of Davos/Klosters an extensive epidemiological study has been performed on winter sports-accidents, especially from alpine skiing during the last 15 years. The ski-accidents have been related to the skiers activity, measured by the kilometers of altitude (vertical drop) in downhill-skiing. The injuries are still mainly located on the extremities, fractures of the lower leg have significantly decreased but serious ligamentous injuries of the knee have replaced them in high numbers. The severity of the injuries has been evaluated considering multiple factors and a decrease could be noted. Permanent disability does occur but fortunately only rarely. The incidence of ski-accidents as well as the high costs of treatment highly demand continuation of research activities for the benefit of the safety of the skiers. PMID- 3509879 TI - [Evaluation of T lymphocytes and lymphocyte subpopulations in patients with pleural effusion]. PMID- 3509878 TI - High affinity interleukin 2 receptors in HTLV-1-infected T cells can mediate signals for gene expression. AB - The expression of transcripts of the c-myb and c-myc protooncogenes and the interleukin 2 receptor (IL-2R) gene in human T cells infected with human T-cell leukemia virus type 1 (HTLV-1) after exposure to interleukin 2 (IL-2) were examined. Infection with HTLV-1 is known to be associated with constitutive expression of IL-2R, although infected cells do not require IL-2 for growth. Northern blot analysis showed that expression of the mRNAs of the c-myb, c-myc, and IL-2R genes were markedly increased by addition of IL-2 into the cultures, indicating that IL-2R transduced signals for gene expression in these cells as in normal T cells. Studies on distinct HTLV-1-infected T cell clones that differed in numbers of high-affinity IL-2R, showed that the extents of increase in mRNA expression by IL-2 were correlated with the number of high-affinity IL-2R. This correlation was confirmed by demonstration that the levels of mRNA expression were proportional to the numbers of IL-2-bound high-affinity but not low-affinity receptors. Thus, the signals induced by IL-2 for gene expression may be through high-affinity IL-2R. PMID- 3509880 TI - [Aging macular degeneration in Uighur]. PMID- 3509881 TI - [Aging macular degeneration in Tibetan and Han]. PMID- 3509882 TI - Effects of alpha-tocopherol on carbon tetrachloride metabolism in rat liver microsomes. AB - alpha-tocopherol is the major lipid-soluble radical-scavenging antioxidant in rat liver. It has long been used as a putative protective agent in CCl4 induced liver injury but with variable results. We have used alpha-tocopherol loaded rat liver microsomes to study the effect of this vitamin on CCl4 metabolism in vitro. As expected, alpha-tocopherol inhibits CCl4-dependent microsomal lipid peroxidation and, at a very high concentration, will inhibit the covalent binding of CCl3 to microsomal protein by up to 50%. No inhibitory effect was observed towards CCl3 production as measured by the electron spin resonance technique of spin-trapping but this apparent discrepancy may represent a limitation of the technique. The high levels required to inhibit covalent binding probably preclude the likelihood of alpha-tocopherol significantly affecting that phenomenon at endogenous concentrations but may be relevant to other experiments employing high doses of alpha-tocopherol as an experimental hepatoprotective agent. PMID- 3509883 TI - Cell-mediated immune responses to influenza virus antigens expressed by vaccinia virus recombinants. AB - Recombinant vaccinia viruses enable studies of immune recognition of antigens expressed from single viral genes. We have constructed recombinants expressing the haemagglutinin (HA) and nucleoprotein (NP) genes of the influenza virus A/PR/8/34 (H1N1). These recombinant viruses together with a recombinant expressing the HA from influenza virus A/JAP/305/57 (H2N2) have been used to examine the cytotoxic T lymphocyte (CTL) response to these influenza virus antigens. Both antigens are recognised by murine CTL and recognition of HA is influenza virus subtype-specific, whereas recognition of NP is crossreactive. In limiting dilution studies approximately 10% of the influenza CTL response is HA specific, while approximately 30% of the response is NP-specific. Despite the ability of NP to stimulate a significant CTL response, mice immunised with the NP vaccinia recombinant are not as well protected from subsequent lethal challenge with influenza virus, as mice immunised with the HA vaccinia recombinant. These studies demonstrate that viral antigens expressed from vaccine recombinants can provide protective immunity and that the influenza-poxvirus recombinants can provide data on protective immunity generated by individual viral proteins. PMID- 3509884 TI - Contribution of lipopolysaccharide to pathogenicity of Haemophilus influenzae: comparative virulence of genetically-related strains in rats. AB - The elaboration of type b capsule plays an important role in determining virulence of Haemophilus influenzae but the contribution of lipopolysaccharide to pathogenicity of this organism remains undefined. Using DNA from a virulent type b H. influenzae donor strain and a capsule-deficient recipient (Rd:01), we constructed capsular transformants having lipopolysaccharide characteristics either similar to (strain Rd/b+:01), or different from (strain Rd/b+:02), the recipient strain. These two type b transformants had similar type b capsule and outer membrane proteins. Comparative virulence studies in rats showed that strain Rd/b+:02 was more virulent than Rd/b+01 as assessed by magnitude of bacteraemia, incidence of meningitis and mortality. Similarly, strain Rd/b-:02 exhibited greater pathogenicity in C3-depleted rats than its genetically-related strain Rd:01. We conclude that lipopolysaccharide composition plays a significant role in mediating the potential of H. influenzae to cause invasive infections. In addition, the findings suggest that there is linkage of virulence genes involved in lipopolysaccharide and capsule expression. PMID- 3509885 TI - A chemically defined medium induces resistance to lipopolysaccharide antibody in Haemophilus influenzae type b. AB - Haemophilus influenzae type b was more resistant to killing by lipopolysaccharide (LPS) antibody and complement after growth in defined medium than in conventional broths. Resistance correlated with decreased binding of LPS antibody, as determined by whole-cell enzyme-linked immunosorbent assay. An inhibition radioimmunoassay was used to determine that bacteria grown in defined medium contained about 2.5 times more capsule than bacteria grown in conventional broth. No major differences were noted in the electrophoretic patterns of outer membrane proteins or LPS. The defined medium did not increase the resistance of a capsule deficient mutant. Resistance and increased encapsulation could be reproduced after growth in conventional broth supplemented with magnesium, glutamic acid, and aspartic acid. Thus, the growth medium may influence the content of capsule on H. influenzae type b, and may in turn, influence the binding and bactericidal activity of LPS antibody to the cells. PMID- 3509886 TI - In vitro inhibition of Trichomonas vaginalis growth by some ortho-phenacyloxy benzyl alcohols and their derivatives. AB - Some phenacyl ethers of different ortho-hydroxy-benzyl alcohols and analogues have been synthesized and tested for the in vitro activity towards Trichomonas vaginalis. The most active compounds had a minimum inhibitory concentration of 6.25 micrograms/ml and appeared to be of a certain interest as representative of a new type of anti-Trichomonas substances not containing a nitro group. PMID- 3509887 TI - Validation of a flow-through diffusion cell for use in transdermal research. AB - A flow-through finite-dose diffusion cell has been designed for use in transdermal drug delivery research. The diffusion cell consists of an upper donor chamber and a lower receiver compartment through which a continuous supply of fresh solvent flows. The flow is directed to an automatic fraction collector. To validate the flow-through cell, its performance was compared directly against that of a conventional single-reservoir Franz cell. Homologous alkyl p aminobenzoates were diffused through dimethylpolysiloxane membranes, and permeability coefficients increased with increasing chain length, reaching a plateau at the butyrate ester for both types of cells. This behavior suggests a shift from membrane-controlled diffusion to boundary layer control. Permeation of the butyrate and valerate compounds was significantly faster when the flow through cell was used, suggesting that better mixing is obtained through the flow through cell design. Considering the advantages offered in terms of time and labor saved through its use, the flow-through cell with automatic fraction collector appears to be a viable alternative to the conventional Franz cell. PMID- 3509888 TI - [Evaluation of the efficacy and tolerability of miocamycin in the treatment of otorhinololaryngologic infection by sensitive micro-organisms]. PMID- 3509889 TI - [Clinical and bacteriological evaluation of miocamycin in some respiratory tract infections]. PMID- 3509891 TI - Epidermal growth factor EGF in human saliva: effect of age, sex, race, pregnancy and sialogogue. AB - Saliva samples were obtained from volunteers either by spontaneous expectoration or after stimulation with citric acid (5%) and EGF was measured by a homologous radioimmunoassay. The mean +/- SEM of salivary human epidermal growth factor (hEGF) concentration in 70 males (aged 19-41) was 368.71 +/- 28.55 pmol/1 and 417.67 +/- 37.61 pmol/1 in 55 females (aged 19-45), P0.5. Values were found undetectable (32 pmol/1 in 6 prepubertal children. There was a tendency for hEGF to rise with age from about middle age but no significant racial or pregnancy related changes were observed. Stimulated sallivation with citric acid caused a fall in hEGF through a dilution effect. These results show that age has an important influence on the hEGF concentration of resting saliva. PMID- 3509890 TI - Radiological and endoscopic correlation in upper gastrointestinal haemorrhage and malignancy. AB - Conventional barium meal and endoscopic findings were compared in 75 patients with upper gastrointestinal (UGIT) haemorrhage and 43 patients with clinically suspected UGIT malignancy. Conventional barium meal missed 3 cases of malignancy and gave a false positive haemorrhage, barium meal helped to locate the source of bleeding correctly in 38 patients only 50.7%). While efforts should continue to be made to improve radiological yield, endoscopy, where a available, should be preferred in investigating UGIT diseases. PMID- 3509892 TI - HLA-DR2 in childhood narcolepsy. AB - A 6-year-old boy with behavioral changes was found to have clinical and electrographically defined narcolepsy. He has HLA-DR2 as do virtually all adult narcoleptics. This finding raises new diagnostic, etiopathogenetic, and future therapeutic issues. PMID- 3509893 TI - Vitamin D metabolites in patients with established non-union of fracture. AB - The serum concentrations of vitamin D metabolites and biochemical markers of bone metabolism were measured in 15 patients with established non-union of fracture and in 15 age- and sex-matched controls. No significant differences between the two groups were observed in the concentrations of 25-hydroxyvitamin D, 1,25 dihydroxyvitamin D3 and 24,25-dihydroxyvitamin D3; or in the biochemical indices of skeletal metabolism. These results suggest that patients with established non union have normal bone turnover with no evidence of disturbed production or utilization of 24,25-dihydroxyvitamin D3 or other major vitamin D metabolites. Disturbances in vitamin D metabolism are unlikely therefore to make a major contribution to the maintenance of non-union of fracture. PMID- 3509894 TI - Keratomycosis in corneal sepsis. AB - 510 cases of corneal ulceration were studied for the presence of fungus as a causative organism. Fungus was found in 87 (17.5%) most common fungus found was aspergillus. Mucor was found in 16 cases (18.1%) which is higher than earlier reports. History of trauma specially with vegetative matter and the application of steriods for one purpose or the other is a factor of importance as noted in this study. PMID- 3509895 TI - Pseudophakic retinal detachment. PMID- 3509897 TI - Pre, intra and postoperative prophylaxis to prevent endophthalmitis. PMID- 3509896 TI - Post-operative management of endophthalmitis: definition, incidence and etiopathogenesis. PMID- 3509898 TI - Incidence of post-operative endophthalmitis in India. PMID- 3509899 TI - Clinical signs, symptoms and course of endophthalmitis. PMID- 3509900 TI - Challenging problems in diagnosis and management of fungal endophthalmitis. PMID- 3509901 TI - Post-operative management of endophthalmitis: surgical intervention when, how and the results. PMID- 3509902 TI - Management of post operative inflammation in lens implant surgery. PMID- 3509903 TI - Prevention of endophthalmitis with special reference to mobile eye camps. PMID- 3509904 TI - Experimental evaluation of intra-vitreal therapy using various antibiotics with and without steroids. PMID- 3509905 TI - [Dynamic function studies with positron computed tomography: measurements of regional myocardial blood flow in hypertrophic cardiomyopathy]. AB - A major attribute of positron computed tomography (PCT) is its ability to dynamically measure physiologic processes of the heart. However, quantitative data acquisition and analysis are limited by three major problems: bidirectional activity-cross contamination between the myocardium and the blood, the partial volume effect, and the lower temporal resolution of PCT devices. In the present study, we performed serial six-second PCT scans (fast dynamic study) using 13N ammonia, and evaluated measurements of regional myocardial blood flow. Six patients with hypertrophic cardiomyopathy (HCM) and five normal subjects were observed. 13N ammonia (4.2-13.0 mCi) was intravenously injected as a bolus, and serial six-second PCT scans were initiated at the times of the tracer injections. The results were as follows: 1. Initial passage of the tracer through the right and left sides of the heart were observed with serial six-second images. 2. In patients with HCM, Myocardial 13N activity was determined by assigning a region of interest (ROI) over the myocardium of greater than 25 mm wall thickness as measured by contrast enhanced CT. In these ROIs, corrections for the partial volume effect and spillover of radioactivity from the blood were not necessary. Arterial 13N activity was determined noninvasively by assigning a ROI over the left atrium. 3. The temporal relationships between the arterial input function and myocardial tracer concentrations were demonstrated. Arterial 13N activity was greatest in the second or third frame, and it rapidly declined thereafter. Myocardial 13N activity increased rapidly, reaching a plateau from the sixth to the ninth frame.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3509906 TI - [Assessment of myocardial circulation and metabolism using positron CT]. AB - Positron CT measurement can provide valuable information of myocardial circulation and metabolism. Our institute has participated in the development and use of this measurement since April 1983. At present, we can assess the circulation and metabolism of myocardium using a position CT device (HEADTOME III) and some radiopharmaceuticals labeled with positron emitters. In this paper, we introduced our method about its measuring device, radiopharmaceuticals and theoretical model, and also indicated the clinical usefulness of the measurement. PMID- 3509907 TI - Diffuse idiopathic skeletal hyperostosis as reflected in the paleontologic record: dinosaurs and early mammals. PMID- 3509908 TI - International reference polyspecific anti-human globulin reagents. ISBT/ICSH Working Party. International Society of Blood Transfusion. International Committee for Standardization in Haematology. PMID- 3509909 TI - Malposition of the Binkhorst all-in-the-bag lens. PMID- 3509910 TI - Minor colour vision defects: sib-sib correlations and relation to unique colours. PMID- 3509911 TI - The management of herpes zoster ophthalmicus. PMID- 3509912 TI - Structural brain pathology in schizophrenia revisited. Prefrontal cortex pathology is inversely correlated with cerebrospinal fluid levels of homovanillic acid. AB - Computed tomography scan analysis of 35 schizophrenic patients, 26 medical patients, and 31 normal controls revealed significantly larger ventricular brain ratios and structural changes consistent with cortical atrophy in both schizophrenic and medical patients in comparison with normal controls. The schizophrenic patients, however, differed from both control groups in terms of greater prefrontal cortical markings consistent with prefrontal atrophy, and this finding correlated inversely with levels of cerebrospinal fluid homovanillic acid. Results from this study, in addition to replicating previous findings and addressing methodologic issues concerning controls, provide new evidence implicating abnormality of the prefrontal cortex in schizophrenia and link this abnormality to central nervous system dopaminergic function. PMID- 3509913 TI - The joint effect of overweight and familial predisposing factors on the occurrence of hypertension in the industrial population. The Pavia study. AB - The main purpose of the study was to assess the effect of overweight and predisposing familial factors on the occurrence of hypertension in the industrial population. The data were based on large sample (1523 males and 438 females) of workers employed in the petrochemical industry. The results of the cross sectional study show that the prevalence of hypertension and borderline hypertension was significantly related to age, obesity and cardiovascular familial history. The effect of obesity alone was slightly stronger than the impact of family history on the occurrence of hypertension among men, but inverse relationship has been found in women Relative excess risk due to interaction between obesity and heredity was 0.60 in males and 2.75 in females. Total proportion of hypertension cases attributable to overweight and heredity together or singly in men was 71.5% and in women 79.4%. That part of the disease attributable to interaction between both factors was 17.1% in men and 56.7% in women. PMID- 3509914 TI - [Procainamide- and hydralazine-induced antinuclear antibodies in Japanese]. PMID- 3509915 TI - Endoscopic sclerotherapy as early treatment in bleeding esophageal varices. A preliminary report. PMID- 3509916 TI - The role of L3T4 in T cell activation: L3T4 may be both an Ia-binding protein and a receptor that transduces a negative signal. AB - The T cell surface molecules Lyt-2 and L3T4 are strongly correlated with the class of MHC gene product recognized by the T cell bearing them. The L3T4 molecule has been proposed to play a role in enhancing recognition of antigen:Ia by specific T cells. In the present experiments, we have explored the role of L3T4 in T cell activation by examining the effects of the L3T4-specific monoclonal antibody GK1.5 on T cell responses in the presence or absence of class II-MHC gene products. Our studies show that GK1.5 inhibits T cell activation in the absence of class II-MHC gene products, while antibodies to other T cell surface molecules do not transduce negative signals to the same cells. We interpret our results as suggesting a signaling role for L3T4 and, by inference, for Lyt-2 as well. We would propose that L3T4 molecules on the class II restricted T cell initiate the interaction between the L3T4+ T cell and its class II-MHC gene product bearing target cell (B cell, APC). This initial contact is important in allowing a finite time for antigen, Ia, and the T cell receptor to form an activating complex, which in turn transduces a dominant on signal to the cell. In the absence of specific antigen, or if the class II-bearing cell is of the wrong MHC genotype, so that the antigen:Ia receptor is not aggregated, then the association of L3T4 with class II molecules transduces a net negative signal to the T cell. We suggest that this negative signal is responsible for T cell:target cell deconjugation under these circumstances. Thus, we would propose that L3T4 initiates T cell:Ia-bearing cell interactions and, a finite time later, signals the T cell to discontinue the interaction unless a stimulating level of the antigen:Ia complexes for which the T cell's receptor is specific is present. PMID- 3509917 TI - Recycling class I MHC antigens: dynamics of internalization, acidification, and ligand-degradation in murine T lymphoblasts. AB - We have previously shown that activated T lymphocytes spontaneously internalize their own surface class I MHC antigens and that this phenomenon is specific for these cells since it does not occur in B lymphocytes even after activation. The present work was aimed at defining the quantitative aspects of this phenomenon and, in particular, at the elucidation of the route of the internalized class I MHC antigens. We intended to determine if the internalized molecules are delivered to the lysosomal compartment and digested there or if instead they are brought back to the plasma membrane in a recycling pathway similar to that described for various cell surface proteins known to be engaged in the process of receptor-mediated endocytosis. We have devised a flow cytometric assay based on the use of fluorochrome-labeled monoclonal anti-H-2K antibodies to measure the kinetics of H-2K internalization. Comparison of the time necessary for the internalization of one-half of the surface H-2K molecules in activated T lymphocytes, which is approximately 1 hour, with the half-life of these molecules on the same cells, which is 14 hours, clearly indicates that the internalized molecules are not degraded but are instead recycled. The recycling takes place in an endosomal compartment with an average pH of about 5.6. The monoclonal anti-H 2K antibody used in these studies was not eluted from the H-2K molecules at this pH and is recycled along with them. On the other hand, protein A bound to the Fc of the anti-H-2K antibody was eluted at the low pH of the endosomes, delivered to lysosomes, and digested. We have therefore defined a novel phenomenon, namely the recycling of class I MHC antigens, which occurs selectively in T lymphocytes. The features of this phenomenon are similar to the recycling of surface receptors which mediate the endocytosis of a variety of extracellular ligands in different cells. However, no physiological extracellular ligand is known for class I MHC antigens. It is a reasonable speculation that upon activation T lymphocytes recycle their own surface class I MHC antigens as part of the complex machinery whereby these lymphocytes recognize and respond to non-self moieties on the plasma membranes of presentor or target cells. PMID- 3509918 TI - The syngeneic T-T lymphocyte reaction (STTLR). I. Induction of primary T anti-T cell proliferative responses in T cell cultures stimulated with self- and antigen reactive T cells. AB - The generally accepted "Gershonian" view of immunoregulation attributes T cell mediated regulation of immune responses to the activities of discrete T cell subsets with specialized functions such as help, suppression, and contrasuppression. Several observations made in our laboratory are not compatible with this paradigm. For instance, careful quantitations of carrier-specific T cell help to hapten-specific B cells in an adoptive transfer system yielded complex dose-response curves that could not be explained on the basis of interactions between discrete subsets of helper and suppressor cells. Rather, the results were most easily interpreted according to a model based on the following assumptions: (1) Regulation of helper T cell activity is a dose-dependent, dynamic property of T cell populations that exhibit a high degree of connectivity (self-recognition) and (2) helper T cells have the ability to perform different functions, depending on the current activity of other interacting lymphocytes. A good example of cloned T cells capable of performing multiple immunoregulatory functions was provided by the IEk-specific self-reactive Lbd line which provided help, suppression, and contrasuppression to T cell dependent PFC responses (see Quintans et al., 1986). Since these effects were strictly dependent on the levels of antigen-specific T cell help, we hypothesized that Lbd cells interacted with other T cells to modulate their function. In this paper, we directly test the hypothesis that activated T cells can interact directly with resting T cells and describe the proliferative component of a syngeneic T cell anti-T cell response induced by antigen and self-reactive helper and cytotoxic T cells. In a follow-up report, we will describe the effector component of the T anti-T cell response.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3509919 TI - The syngeneic T-T lymphocyte reaction (STTLR). II. Induction of primary T anti-T cell cytotoxic responses in vitro in T cell cultures stimulated with syngeneic self-reactive T cells. AB - In the previous paper in this series, we described a form of self-reactivity among T cells called the "syngeneic T-T lymphocyte reaction" (STTLR). The phenomenon involves responder T cells that are stimulated to proliferate by irradiated antigen or self-reactive cloned T cell lines. The proliferative STTLR occurs in cultures rigorously depleted of conventional APC and is inhibitable by anti-Ia antibodies of the appropriate specificity. We also showed that both L3T4+ Lyt2- and L3T4- Lyt2+ T cell subsets participate in the STTLR-induced by the IEk specific Lbd T cell line. In this paper, we report our studies on the effector phase of STTLRs, in particular, the cytotoxic responses induced by Lbd cells. We demonstrate that uncloned and cloned lines (called Dbl) of anti-Lbd cytotoxic cells are L3T4- Lyt2+ effector cells that kill Lbd, antigen-reactive T cells, and syngeneic B cells stimulated with LPS. They also kill syngeneic splenic cells stimulated with Con A for 72 h or less; longer culture periods in the presence of Con A yield Dbl-resistant T cells. Resting T cells are also resistant to Dbl cells. Using LPS-induced splenic B cells from H-2 congenic mice, we map the anti self specificity of uncloned and cloned anti-Lbd cells to the Kk + IAk regions of the MHC. Seemingly concordant results were obtained using L transformants expressing IAk molecules on their surface. However, control studies with fibroblast lines and UV-induced fibrosarcoma cells unexpectedly revealed a high susceptibility to lysis by Dbl cells among certain Ia- cell lines. These results suggested that the antigen recognized by Dbl cells is not IAk itself but either an MHC-encoded or MHC-regulated gene product expressed by activated T and B cells and certain tumor cells. The target antigen is important in immunoregulation because Dbl cells suppress both the proliferation of Lbd cells to syngeneic cells and primary T cell-dependent anti-SRC PFC responses. From an immunoregulatory viewpoint, the existence of Lbd-Dbl cells offers several appealing features. Since Lbd cells cannot activate resting B cells or replace antigen-specific helper cells, they cannot initiate immune responses nonspecifically. In the presence of the appropriate antigen-specific helper T cells, Lbd and other self reactive cells can amplify an immune response and thus facilitate its exponential growth. Since the self-reactive cells activate the Dbl cytotoxic circuit described above, they also provide the stimulus required to terminate immune responses quickly.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3509920 TI - An essential role for interleukin 1 and a dual function for interleukin 2 in the immune response of murine B lymphocytes to sheep erythrocytes. AB - The macrophage-derived lymphokine interleukin 1 (IL-1) and the T cell-derived lymphokine interleukin 2 (IL-2) help B lymphocytes to generate antibodies against sheep erythrocytes in vitro. It has been difficult to determine whether these factors act on antigen-reactive B cells directly or via accessory cells, since it is not technically feasible to prepare completely homogenous cell populations. Therefore we examined the question of lymphokine action on B cells using an indirect approach. First we determined effects of the two factors in the phenotypic differentiation assay, a short-term culture of cloned B cells certainly free of accessory cells. Next, we investigated whether the effects seen in this assay could be related to results obtained in the long-term (four-day) assay of antibody production. Interleukin 1 induced cloned 70Z/3 B lymphocytes to express new cell surface markers in the phenotypic B cell differentiation assay. IL-2 rendered these B cells refractory to differentiation caused by IL-1. In the antibody production assay, IL-1 controlled, as was shown previously, an early phase of the response in which B cells become responsive to T cell-derived helper factors. In order to demonstrate the requirement for IL-1, it was necessary to rigorously prevent endogenous IL-1 production. Synergy between IL-1 and IL-2 was observed when IL-2 was given as late as day 2 of a four-day culture period. This synergy was seen over a broad dose range of IL-2 (10-1,000 U/ml). However, IL-2, when added in high concentrations (200-1,000 U/ml) during the early (IL-1 dependent) phase of the B cell response inhibited antibody production.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3509921 TI - Lymphoma models for B cell activation and tolerance. V. Anti-Ig mediated growth inhibition is reversed by phorbol myristate acetate but does not involve changes in cytosolic free calcium. AB - B cell lymphomas which can be growth inhibited by crosslinking their surface IgM receptors by anti-Ig reagents provide models for normal B cell regulation and tolerance. WEHI-231 and CH31 are two independently derived lines that are exquisitely sensitive to negative signalling by antibodies specific for mu or kappa chains, but are unaffected by antibodies against MHC class 1 or 2 antigens. In order to determine the mechanism of this growth inhibition as a model for tolerance, we have examined the roles played by protein kinase C activation and calcium mobilization/influx during negative signalling in these cells. We found that growth inhibition caused by anti-mu crosslinking was reversed in the presence of either phorbol myristate acetate (PMA) or by lipopolysaccharide (LPS) from E. coli. The effect of PMA on negative signalling was a true reversal since phorbol esters could be added after anti-mu treatment, thus allowing nearly normal cellular progression into the S phase of the cell cycle. In contrast, pretreatment with PMA did not provide protection against the growth inhibition from anti-mu. Indeed, a "desensitization" protocol demonstrated that PMA pretreatment actually decreased reversal by both PMA and LPS of the effects of anti-mu on B lymphoma growth. These studies suggest that both LPS and PMA act via at least one common intermediate, which is assumed to involve activation and translocation of protein kinase C. Analysis of changes in calcium ion concentration after treatment with anti-Ig reagents showed both mobilization from internal stores and influx via calcium channels in WEHI-231, as has been reported for normal B cells. However, these changes did not correlate with negative signalling for the several reasons. Firstly, anti-mu inhibition of the growth of WEHI-231 could be induced in the relative absence of extracellular Ca++ or in quin-2 loaded (buffered) cells. Secondly, pretreatment with high concentrations of PMA ablated calcium mobilization, yet failed to modulate growth inhibition in WEHI-231 cells. Moreover, LPS provided protection from the effects of anti-mu yet did not alter cellular [Cai++]. In addition, PMA posttreatment (under conditions causing a reversal of the effects of anti-mu) can be applied as long as four hours after the initial exposure to anti-mu and the rapid measurable changes in calcium flux. Indeed, such changes in intracellular free calcium occurred in elutriated WEHI-231 lymphoma cells at all phases of the cell cycle, although we have previously identified early G1 as the only critical period in which negative signalling can be delivered.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3509922 TI - Molecular basis for the inhibition of LPS induced differentiation by anti immunoglobulin. AB - The inhibition of mitogen induced differentiation by antibodies directed against cell surface immunoglobulins has been used as a polyclonal model system for the study of immune complex mediated down-regulation of the B cell response. The mechanism of this inhibition may also be similar to the ability of gamma globulins coupled to haptens to induce hapten specific B cell tolerance. By biosynthetic labeling of newly synthesized mRNA and of polypeptide chains, the molecular level of inhibition of lipopolysaccharide (LPS) induced B cell differentiation by whole anti-immunoglobulins (anti-Ig) has been examined. It was found that neither blast transformation nor initiation of DNA synthesis is prevented. However, the specific enhancement of transcription of the mu and kappa chain genes induced by LPS is inhibited resulting in the total abrogation of the increase in steady state level of mu s mRNA. In contrast, the basal level of transcription necessary for maintenance of the synthesis of mRNA for membrane IgM and IgD is not affected. Accordingly, it is the specific inhibition of enhanced initiation of RNA polymerases at the mu-delta gene complex which results in the previously documented decrease in IgM secretion. Moreover, since there is also no detectable C gamma transcription in cells stimulated with LPS in the presence of anti-Ig, the further differentiation of IgG secretion in LPS stimulated cells is also prevented. PMID- 3509923 TI - Polyclonal B-cell activation by a B-cell differentiation factor B151-TRF2. IV. B151-TRF2-responsive F1 B cells consist of two separate populations capable of recognizing only one of the parental I-A products expressed on B cells. AB - Polyclonal IgM PFC responses of unstimulated B cells induced by a B cell differentiation factor, B151-TRF2, have been shown to involve an Ia-dependent process which is inhibitable by anti-Ia monoclonal antibody (mAb). Moreover, we have demonstrated that when T cell-depleted (B10 x B10.BR)F1 (H-2b/k) spleen cells are fractionated based on their ability to bind to a B10 (H-2b) monolayer, the B151-TRF2 responses of the adherent and nonadherent cell fractions are markedly inhibited by anti-I-Ab and anti-I-Ak mAbs, respectively. From these results, we hypothesized that B cell-recognition of self-I-A products expressed on B cells is involved in the B151-TRF2-induced polyclonal B cell activation. The present study examined the genetic and cellular requirements for the successful separation of F1 B cells with parental monolayers in order to prove recognition by B cells of self-I-A products expressed on B cells. The experiments utilizing monolayers from H-2 congenic strains revealed that identity at the I-A subregion of the H-2 complex between responding F1 B cells and monolayer cells was necessary and sufficient for the successful separation of F1 B cells. In support of this conclusion, purified B cells and B cell lines expressing only parental I A products on the surface could function effectively as monolayers. Masking of I A determinants expressed on the monolayer with anti-I-A mAb almost completely abolished the successful separation of F1 B cells, whereas pretreatment of Ia antigens on responding F1 B cells with anti-Ia mAbs did not affect the subsequent separation, indicating involvement of receptor-I-A product interaction rather than like-like interaction in the separation of F1 B cells by the monolayer. The B151-TRF2 responses of purified B cells obtained from athymic nude mice were specifically inhibited by the relevant anti-I-A mAb but not by anti-L3T4 and anti LFA-1 mAbs, both of which were inhibitory to the Ia-restricted T cell responses. In addition, anti-Thy1.2 mAb plus complement-treated spleen cells from athymic F1 nude mice were successfully fractionated with parental monolayer into two separate populations with restriction specificity for only one of parental I-A products. These results negate the involvement of Ia-restricted T cells in the Ia dependent process of the B cell activation. Finally, it was demonstrated that there was no apparent difference in the expression of respective parental I-A products between F1 B cell subpopulations adherent and nonadherent to parental monolayers.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3509924 TI - Activation of murine B cells from different tissues with different mitogens. II. Isotype distribution of secreted immunoglobulins in the presence and absence of IL-4-containing T cell supernatants. AB - In the accompanying report, we have compared a B cell-specific protein mitogen, Salmonella thyphimurium mitogen (STM), to lipopolysaccharide (LPS), dextran sulfate (DxS), and the combination of LPS/DxS with regard to their ability to induce B cell proliferation and differentiation. The results of these studies demonstrated that STM, LPS, and LPS/DxS induce significant expression of cytoplasmic immunoglobulin (Ig). In this report, we have analyzed the distribution of isotypes induced by each of these mitogens in the presence or absence of interleukin-4 (IL-4) containing T cell supernatants (SN), since IL-4 increases the secretion of IgG1 and IgE and decreases the secretion of IgG3 and IgG2b in LPS-stimulated splenic B cells. These experiments were designed to determine whether LPS was unique in its ability to "program" B cells to respond to IL-4 by secreting IgG1, as has been suggested in our previous studies. The current experiments also addressed the issue of whether splenic B cells were unique in their response to IL-4 by using B cells from other tissues. The efficiency of induction of cytoplasmic Ig measured in the preceding report was STM greater than LPS/DxS greater than LPS. DxS did not induce a significant level of cell proliferation, cytoplasmic Ig, or secreted IgM and inhibited the LPS induced IgM response by approximately 50%. In contrast, STM induced an extremely high level of IgM secretion in splenic B cells. In this report, we demonstrate that the addition of IL-4-containing T cell SN to splenic B cells stimulated with LPS, LPS/DxS or STM increased the level of IgG1 and reduced the level of IgM, IgG3, and IgG2b secretion.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3509925 TI - Molecules recognized by anti-idiotypic monoclonal antibodies to the B cell lymphoma, BCL1. AB - Monoclonal and polyclonal antibodies to the variable portions of antigen receptors (anti-idiotypes and anti-idiotopes) are often employed to study the molecular nature and the biological role of these antigen receptors. Such antibodies are operationally defined as those antibodies which bind to a particular immunoglobulin but not to other immunoglobulins of the same class in a radioimmunoassay or ELISA. The monoclonal antibodies 32D1 and 31D1 were initially defined as anti-idiotypic as they recognized an immunoglobulin preparation from the murine B cell lymphoma BCL1, but not other immunoglobulins of the same isotype as assessed by a radioimmunoassay. A potential artifact in defining anti idiotypic antibodies in this way is the possibility of copurification of antigen and antibody, resulting in the tentative identification of anti-antigen as anti idiotype. Previous studies have demonstrated that BCL1-IgM is involved in binding of murine leukemia virus (MuLV), and BCL1 immunoglobulin and MuLV-gp70 apparently co-purified as an immune complex. Disruption of the immune complexes with SDS and sucrose gradient purification of the immunoglobulin was adequate to prepare BCL1 immunoglobulin free of gp70 as assessed by radioimmunoassay with the monoclonal anti-gp70 RA3-4A3. This preparation of immunoglobulin was used to show that 31D1 does not bind to BCL1 immunoglobulin, but to the contaminating gp70 in the BCL1 immunoglobulin preparation. However, MAb 32D1 was definitively proven to be anti idiotypic as it recognized SDS sucrose density gradient purified IgM and immunoisolated heavy chain and light chain from BCL1 immunoglobulin. Several other lymphomas were recognized by mAb 32D1, including the T cell lymphoma UNC1 and the B cell lymphoma Balenlm17. To determine whether mAb 32D1 recognized immunospecific receptors on these lymphoma cell lines immunoprecipitation studies were performed. Immunoisolation and molecular analysis revealed that mAb 32D1 did not recognize the antigen receptor on these two cells, but instead recognized a cell-specific gp70. This observation demonstrates that monoclonal antibodies to known antigens (in this case an anti-idiotype) can crossreact with apparently unrelated molecules. The potential significance of this cross reaction to the antigens recognized by B cell lymphomas is discussed. PMID- 3509926 TI - Expression of human IL 1 alpha and beta messenger RNAs and IL 1 activity in human peripheral blood mononuclear cells. AB - The macrophage-derived lymphokine interleukin 1 (IL 1) plays a critical role in modulating immune (cellular and humoral) and nonimmune responses. For example, the relative expression of IL 1 alpha and beta under various states may be crucial to the success of the immune system in response to infection. Until recently, a comparative study of IL 1 mRNA expression and IL 1 biological activity was not possible. We have cloned both IL 1 alpha and beta cDNAs and employed them as probes in Northern blot analysis to determine in mitogen stimulated peripheral blood mononuclear cells the steady-state expression of their cognate mRNAs with respect to IL 1 activity. IL 1 was determined by the lymphocyte-activating factor (IL 1/LAF) and the mononuclear cell factor (IL 1/MCF) activities. In lectin-stimulated PBMC, maximum cell-associated activities whereas detected at 12 and 24 hr after stimulation whereas maximum extracellular activities appeared between 24-48 hr. In the same cultures, the kinetics of IL 1 mRNA steady-state expression were determined by Northern gel blot analysis with IL 1 alpha and beta cDNA probes. IL 1 mRNAs were undetectable in noncultured freshly isolated PBMC (time zero). Both IL 1 mRNAs appeared as early as 4 hr after lectin stimulation as did IL 1 beta mRNA in unstimulated cultures. Both IL 1 alpha and beta mRNA steady-state levels were barely detectable by 48 hr. At all time points, IL 1 mRNA levels were considerably lower in unstimulated cultures. IL 1 beta mRNA was always considerably more abundant than IL 1 alpha mRNA. The less abundant IL 1 alpha mRNA showed a decrease in its stead-state levels prior to the reduction in the levels of IL 1 beta mRNA. TNF alpha activity and mRNA were not detected under these culture conditions. Poly(A) + RNA injected into Xenopus oocytes revealed that the Northern blot detected IL 1 mRNAs were biologically active. To understand the precise nature of IL 1 in immune and nonimmune events, we felt it necessary to first study the kinetics of IL 1 mRNA steady-state levels with respect to its cell-associated and extracellular biological activities. The data presented here may allow for a better understanding of the etiology of various immune and nonimmune responses that are modulated through the expression of IL 1. PMID- 3509927 TI - Generation and use of an antigen-specific hybrid to study B-cell function. AB - Several important events are known to occur following the crosslinking of membrane-associated immunoglobulin (mIg) on B-lymphocytes. Among these include the internalization and re-expression of mIg. We have addressed two questions regarding the re-expression of mIg following an antigen-induced clearance of this B-cell receptor. 1) How long does it take for a cell to re-express its receptors after the first or second exposure to antigen, and 2) is this re-expression dependent upon the synthesis of new mIg? These questions, which in the past have been addressed primarily with heterogeneous populations of cells and using anti immunoglobulin instead of antigen, are vital to understanding B-cell activation as well as antigen processing events. In order to address these questions, we have produced and characterized an antigen-specific B-cell hybrid 2C3E1 that expresses a membrane-associated form of immunoglobulin. A hybrid specific for a charged hapten (phthalate) was selected to avoid the possibility of nonspecific hydrophobic interactions of the binding ligand with the plasma membrane. After establishing the presence of mIg biochemically and demonstrating the ability of phthalate-keyhole limpet hemocyanin to induce the clearance of the phthalate specific receptor from the plasma membrane, it was determined that re-expression of antigen-specific receptors was detected within one hour and completed by six hours after the first or second pulse with antigen and that this re-expression did not require the synthesis of new receptors. This later finding is novel and suggests that B-cell receptors are re-utilized or that a presynthesized pool of mIg exists within the cytoplasm of these cells. During the characterization of the 2C3E1 cell line, it was determined that this hybrid also produced a secreted form of the phthalate-specific immunoglobulin (sIg). An unexpected subsequent observation was that sIg was found associated with the cell surface in addition to membrane Ig. A likely source of this unexpected surface-associated sIg was observed as a vesicle on the surface of many cells that is associated with a high concentration of sIg. This finding and its possible relevance to Ig secretion per se are considered further in the paper which follows this one. PMID- 3509928 TI - Biochemical and ultrastructural characterization of a novel cell structure associated with immunoglobulin secretion in B-lymphocytes. AB - In the companion paper, it was established that a secretory form of immunoglobulin, sIg, is present at or near the cell surface. This unexpected occurrence of sIg was postulated to be due to the labelling of sIg which remains temporarily associated with the cell packaged in a vesicle which appears to bud from the plasma membrane at a single pole of the cell. The question that is addressed in this report is whether or not this polar accumulation of sIg represents a common pathway for the exit of this protein which is used by antibody-producing cells. This question is important since, in spite of the fact that the intracellular events associated with immunoglobulin synthesis (processing and movement between subcellular compartments) have been defined, very little data exists on how or where immunoglobulin finally leaves the plasma cell. This question was approached here by first demonstrating that the polar immunoglobulin secretory vesicles (ISV) are associated with several sIg-producing cells including other hybridomas, B-cell lines, and mitogen-activated spleen cells. The second approach was to characterize the ISV on the cell ultrastructurally and to establish that these vesicles are released from the cell carrying with them sIg. Isolated vesicles released from biosynthetically labeled Ig-producing cells were analyzed by SDS-PAGE in order to confirm the presence of sIg and to determine the number of other proteins associated with the ISV, their molecular weights, and the degree of disulfide crosslinking of the molecules comprising this structure. Finally, the kinetics of sIg release was established by a pulse chase protocol for biosynthetically labeled cells, and by monitoring the release of radioactive Ig from surface iodinated cells. As was predicted from our biochemical studies of the ISV, we observed a very slow phase of sIg release as well as a rapid release phase. Our studies have established that at least one of the pathways for the release of Ig from hybridomas, B-cell lines, and normal splenic B-cells is via a polar multivesiculated structure that we have termed ISV, and that the sIg can be released either as a free form of the protein or packaged within a satellite vesicle which may release the sIg later and perhaps at considerable distance from the cell that produced it. PMID- 3509929 TI - Alterations of idiotypic profiles: the cellular basis of T15 dominance in BALB/c mice. AB - Phosphorylcholine (PC) is a component of cell walls and membranes from a variety of widely distributed microorganisms. It is highly immunogenic in mice and most murine strains have circulating anti-PC antibodies which are known to confer protection against certain bacterial infections. BALB/c mice offer a striking example of a high responsiveness to PC, a propensity to generate PC-binding myelomas, and a great restriction of idiotype expression in anti-PC antibodies; in fact, most BALB/c anti-PC IgM antibodies express the T15 idiotype marker. Although it has been suspected that T15 dominance is somewhat related to the continuous antigenic load presented by microorganismal flora found in conventional mice, a complete experimental account of how antigenic selection brings about such extreme idiotypic dominance is not yet available. In the studies presented below, we investigated the role played by the host environment, T cells, and antigen in affecting the generation of the anti-PC T15 idiotype profile in lethally irradiated adoptive hosts reconstituted with syngeneic neonatal liver cells. The results presented herein indicate that the transfer of mature carrier-primed T cells with neonatal liver cells does not influence the generation of the T15 idiotype profile. We also demonstrated that anti-T15 idiotype suppressed mice, used as lethally irradiated hosts of immature immunocompetent cells, allow an increased rate of reconstitution of the anti-PC response when compared to nonsuppressed hosts. Since the administration of a T15+ anti-PC antibody inhibits both reconstitution and idiotype expansion, we conclude that T15+ B cells do not self-promote themselves. In contrast, we observed that exposure of adoptive hosts to PC antigens can enhance the anti-PC response and alter the idiotypic profile in favor of T15-bearing clones. The failure of T15 idiotype and the success of PC antigens in promoting T15 dominance led us to search for an "antigen inside" which might play a role in the ontogeny of T15 expression. To this end, we produced isologous anti-T15 hybridomas and selected one BH8 binding IgM hybridoma, 15B1, as a potential carrier of an internal image of PC. In vivo tests involving the administration of this antibody to irradiated adoptive hosts immediately prior to the transfer of neonatal liver cells indicate that T15 expression in adoptive transfer can be enhanced by this antibody. Finally, we discuss a model to account for the generation of T15 dominance in normal adult BALB/c mice and its loss in adult BALB/c mice used as adoptive hosts for syngeneic immature immunocompetent cells.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3509930 TI - [Peripheral blood T- and B lymphocytes in children with bronchial asthma]. PMID- 3509931 TI - [Selection of surgical procedures in A-C bypass]. PMID- 3509932 TI - In vitro evaluation of CM 40876, a new third-generation cephalosporin. PMID- 3509933 TI - In vitro inhibitory activity of spiramycin against Haemophilus influenzae. PMID- 3509934 TI - The use of in vitro kinetic models in the evaluation of beta-lactamase inhibitors. PMID- 3509935 TI - Beta-lactamase activity of Mycobacterium fortuitum. PMID- 3509936 TI - Determination of healing response by immunostimulant therapy (levamisole) in cutaneous leishmaniasis. PMID- 3509937 TI - The effects of coumarin derivatives on the immunological system of man. PMID- 3509938 TI - Effect of miocamycin on theophylline kinetics in asthmatic children. PMID- 3509939 TI - Therapy of amine-vaginitis by a single dose of ornidazole (Tiberal); serum and tissue (vagina) concentrations of ornidazole after vaginal or rectal application. PMID- 3509940 TI - Treatment of herpes virus ocular pathology with acyclovir. PMID- 3509941 TI - Treatment of resistant non-Hodgkin's lymphomas with cisplatin, etoposide, vindesine, methotrexate with leucovorin rescue. Greek Lymphoma Research Group. PMID- 3509942 TI - IgG, IgA and alpha 1-antitrypsin as tumor markers in acute lymphatic leukemia. PMID- 3509943 TI - Bilateral renal artery embolism: a diagnostic and therapeutic problem. AB - A case of bilateral renal artery embolism in a patient occurring after coronary artery bypass operation is reported, describing the diagnostic techniques and therapeutic aspects of management of this unusual disease. The diagnosis should be suspected in patients with underlying cardiovascular disease who have acute renal failure. PMID- 3509944 TI - [Equality and symmetry in the use of vestibular orientation]. PMID- 3509945 TI - T cell cross-reactivity among viruses of the paramyxoviridae. AB - Blastogenesis and delayed-type hypersensitivity assays were used to examine mouse T cell responses to five viruses representing the three genera of the Paramyxoviridae. Cross-reactive T cell responses were observed in a lympho proliferative assay for measles, mumps, respiratory syncytial, canine distemper and parainfluenza type 3 virus. Confirmation of T cell cross-reactivity among measles, mumps and respiratory syncytial virus was obtained with a delayed-type hypersensitivity test. These results show that T cell cross-reactivity is common for Paramyxoviridae viruses, even though these viruses show virtually no inter genus antibody cross-reactivity. The cross-reactivity among respiratory syncytial, measles and mumps virus at the T cell level may have implications for usage of the attenuated measles/mumps/rubella (MMR) vaccine. Respiratory syncytial virus is contacted by many children before they receive the MMR vaccine and T cells induced by respiratory syncytial virus may influence subsequent development of immunity to measles and/or mumps virus. PMID- 3509946 TI - Induction of measles virus-specific human cytotoxic T cells by purified measles virus nucleocapsid and hemagglutinin polypeptides. AB - The measles virus polypeptide specificity of human measles virus-specific, HLA class II restricted cytotoxic T cells have been examined. Measles virus-specific CTL have been generated using purified measles virus nucleocapsid and hemagglutinin polypeptides during a primary, in vitro stimulation of bulk cultures. Both the purified preparations of measles virus nucleocapsid and hemagglutinin polypeptides were effective in stimulating a measles virus-specific CTL response. The measles virus nucleocapsid-induced CTL response could be blocked by an anti-HLA class II monoclonal antibody but not an anti-HLA class I antiserum. Moreover, considerably less measles virus nucleocapsid was required to stimulate a comparable CTL response than the measles virus hemagglutinin which suggests that the CTL response to measles virus may be skewed towards internal viral determinants of measles virus. These studies indicate that both internal and external components of measles virus are effective in inducing measles virus specific CTL. The recognition of internal viral components may represent an important part of the T cell mediated immune response to viruses. PMID- 3509947 TI - Induction in chimpanzees of antibodies inhibiting receptor-mediated cell fusion by HIV glycoprotein. AB - Cell fusion of HTLV-IIIB-infected EBV-transformed B cells and CD4+ T cells was inhibited by sera from eight of nine HIV infected chimpanzees. Syncytia formation was reduced by sixty percent relative to control after only 5 minutes of preincubation of the HIV infected cells with immune primate serum, indicating that these antibodies have high affinity for HIV protein on the surface of infected cells. Serum dilutions that blocked formation of syncytia irreversibly within 24 hrs also blocked expression of HIV antigens by the target CD4+ cells. Three of four animals inoculated with the LAV or HTLV-IIIB strain of HIV developed antibodies inhibiting CD4-dependent cell fusion by HIV glycoprotein (CFI-antibodies) 2-3 months after inoculation coincident with development of HIV specific IgG antibodies. Similar early CFI-antibody responses occurred in two second passage chimpanzees. In contrast, a chimpanzee infected with a third passage of LAV had a delayed CFI-antibody response, indicating that variants of HIV with divergent CFI epitopes did eventually emerge. Delayed development of CFI antibodies (6-11 months after inoculation) relative to HIV specific IgG ELISA antibody was also seen in a chimpanzee on primary passage and a chimpanzee on second passage of HTLV-IIIB. No CFI-antibodies were detected in a chimpanzee following inoculation with human brain tissue, while antibodies to other structural proteins were recognized by immunoblotting. These results indicate that changes in CFI epitopes occur under immune pressure and that the appearance of CFI-antibodies depends on the time after infection and on the degree to which CFI epitopes of the inoculum strain diverge from those of the test strain. PMID- 3509948 TI - Bovine peripheral blood leukocyte subpopulation dynamics following a primary bovine herpesvirus-1 infection. AB - Population dynamics of bovine peripheral blood leukocyte subpopulations were quantitated following a primary bovine herpesvirus-1 (BHV-1) infection. Percoll isolated peripheral blood mononuclear cell (PBMC) subpopulations were analyzed using flow cytometry (FC) and cytochemical stains. Between days two to eight post infection (PI) there was a significant decrease in the percentage of T-cells and nonT/nonB cells which was accompanied by an increased percentage of B-cells and monocytes. These percentages were extrapolated to the number of Percoll isolated PBMC during this period. A decrease in the T-cell population was the primary cause of the observed lymphopenia and a relative increase in the percentage of B cells. The increased percentage of monocytes was caused by an increased number of circulating monocytes. These monocytes were characterized by an increase in Fc receptor expression, a decrease in plastic and Sephadex-G10 adherence and no apparent change in the level of class II MHC antigen (Ia) expression. Serum cortisol was significantly elevated on day 2 PI and may have been responsible for both the reduction in circulating T-cells and a decrease in the in vitro viability of peripheral blood lymphocytes. The percentage of Ia positive PBMC was increased significantly on day 4 PI. However, on days 4 and 6 PI the summated percentages of monocytes and B-cells (total Ia expressing population) exceeded significantly the actual percentage of Ia positive cells. This apparent suppression of Ia expression did not coincide with the elevated serum prostaglandin E2 concentrations on days 8 and 10 PI. PMID- 3509949 TI - T lymphocyte population dynamics and function following a primary bovine herpesvirus type-1 infection. AB - Following a primary bovine herpesvirus-1 (BHV-1) infection the concanavalin A (Con A) induced proliferative responses of peripheral blood T lymphocytes were suppressed. This suppression occurred in the absence of detectible serum suppressor factors, suppressor cell activity or decreased accessory cell function. However, regression analysis demonstrated a significant correlation between the percentage of T lymphocytes present within the peripheral blood mononuclear cell (PBMC) population and the amplitude of Con-A-induced lymphocyte proliferative responses (LPR). Direct evidence that a numerical deficit of responder T lymphocytes was limiting LPR was obtained by using an immunomagnetic microsphere (IMM) negative enrichment protocol to produce a PBMC population with a constant percentage (75 +/- 6%) of T lymphocytes. The Con-A-induced LPR of these enriched T lymphocytes remained constant following BHV-1 infection. Flow cytometric (FC) analysis of PBMC indicated that the decreased percentage of circulating T lymphocytes, associated with BHV-1 infection, was caused primarily by a selective depletion of the BoT8 subset. These FC data were consistent with the indirect evidence of increased TH activity, as indicated by elevated Con A induced IL-2 production. Thus, 2 to 5 days following viral infection, the circulating T lymphocytes were activated as shown by elevated IL-2 production, increased recombinant bovine IL-2 (rBo PMID- 3509950 TI - Abdominal pain and seizures in a young man. PMID- 3509951 TI - Breathing patterns during sleep in patients with nocturnal asthma. AB - Breathing patterns early and late in the night, at the same sleep stage, were compared in six healthy subjects and 15 adults with nocturnal asthma, to try to identify changes of overnight bronchoconstriction, and breathing patterns at different sleep stages, to see whether there were changes related to sleep stages that were indicative of bronchoconstriction. Despite an average 31% fall in FEV1 overnight in the patients with asthma, neither breathing frequency nor expiratory time, which might be expected to change during bronchoconstriction, was different early in the night from late in the night, nor did they differ between sleep stages. There was no evidence of asynchronous movement of the chest and abdomen in any patient. This study did not identify any abnormality of breathing pattern that would indicate the development of nocturnal asthma without the need to awaken the patient. PMID- 3509952 TI - Effects of 6-nitro substitution on 5-methylchrysene tumorigenicity, mutagenicity and metabolism. AB - 6-Nitro-5-methylchrysene was prepared by nitration of 5-methylchrysene and the mutagenic and tumorigenic activities of the two compounds were compared. Whereas 5-methylchrysene was a strong tumor initiator on mouse skin, no tumors were observed in the mice treated with 6-nitro-5-methylchrysene. In Salmonella typhimurium TA100, both compounds were mutagenic in the presence, but not in the absence, of rat liver 9000 g supernatant. The major metabolite of 6-nitro-5 methylchrysene in rat liver in vitro was trans-1,2-dihydro-1,2-dihydroxy-6-nitro 5-methylchrysene. In view of the ready conversion of 6-nitro-5-methylchrysene to a 1,2-dihydrodiol, its apparent lack of tumorigenicity in mouse skin was intriguing. PMID- 3509953 TI - Metabolism of the aromatase inhibitor 4-hydroxyandrostenedione in vivo. Identification of the glucuronide as a major urinary metabolite in patients and biliary metabolite in the rat. AB - 4-Hydroxyandrost-4-ene-3,17-dione (HAD) is a potent and selective inhibitor of the enzyme complex aromatase, both in vitro and in vivo. The glucuronide is a major metabolite in the urine of patients and in the bile of rats given HAD and it was identified by chemical ionization-MS of the permethylated derivative. HAD glucuronide was quantified by first converting it enzymically into HAD, then determining HAD by capillary column GC-MS of the perfluorotolyl derivative using 4-hydroxyandrost-2,4-diene-3,17-dione as internal standard. PMID- 3509954 TI - [Effect of peptides--structural analogs of NH2-terminal sites of fibrin alpha- and beta-chains--on specific binding of the NH2-terminal disulfide bond of fibrin with fibrinogen]. AB - Peptides Gly-Pro-Arg-Pro and Gly-His-Arg-Pro (fibrin alpha- and beta-chain NH2 terminal analogs, respectively) are studied for their effect on fibrinogen (F) and fibrin NH2-terminal disulphide knot (N-DSK) specific binding. Both peptides are found to inhibit the formation of soluble and insoluble F-N-DSK-complexes through inhibition of the interdomain D-E-binding. Gly-Pro-Arg-Pro is much more potent inhibitor than Gly-His-Arg-Pro. Lowering the insoluble F-N-DSK-copolymer quantity by concentration-dependent way these peptides do not change its composition described by the formula [F(N-DSK)2]n. Invariability of fibrinogen and N-DSK copolymer structure is asserted. In this structure neighbouring fibrinogen molecules are bound by two N-DSK molecules via the D1-E1 and D2-E2 binding sites. PMID- 3509955 TI - Ibotenic acid analogues. Synthesis and biological testing of two bicyclic 3 isoxazolol amino acids. AB - The bicyclic 3-isoxazolol amino acids (RS)-3-hydroxy-4,5,6,7 tetrahydroisoxazolo[4,5-c]pyridine-4-carboxylic acid (5, 4-HPCA) and (RS)-3 hydroxy-4,5,6,7-tetrahydroisoxazolo[4,5-c]pyridine-6-carboxylic acid (11, 6-HPCA) were synthesized as model compounds for studies of the structural requirements of central excitatory amino acid neurotransmitter receptors. 4-HPCA was synthesized via introduction of a methoxycarbonyl group into the 4-position of the lithiated N-nitroso intermediate 1. The key reaction in the synthesis of 6-HPCA is an intramolecular N-alkylation of the appropriately substituted acetamidomalonate derivative 7 using sodium hydride as a base. On the basis of the pKA values for 4 HPCA the existence of an intramolecular hydrogen bond in the zwitterionic form of this amino acid is proposed. 6-HPCA was shown by 1H NMR spectroscopy to adopt preferentially a conformation with the carboxylate group in an equatorial position. 4- and 6-HPCA were tested as agonists and antagonists at excitatory amino acid receptors on neurones in the cat spinal cord using microelectrophoretic techniques. Neither compound showed significant effects at these receptors. PMID- 3509956 TI - Development and application of organic reagents for analysis. VIII. Determination of biological thiols with a new fluorogenic thiol-selective reagent, N-(p-[2-(6 dimethylamino)benzofuranyl]phenyl)maleimide. PMID- 3509957 TI - Covalent binding of a mercaptan S-sulfate to hepatic cytosolic proteins and its inhibition by glutathione. AB - 4-Nitrobenzyl mercaptan (NBM) S-sulfate, a new type of the sulfate conjugate enzymatically formed from NBM in the presence of 3'-phosphoadenosine 5' phosphosulfate in rat liver cytosol, bound covalently to rat liver cytosolic proteins at pH 7.4. The protein binding of NBM S-sulfate was strongly retarded by GSH. GSH not only played a role as a scavenger for NBM S-sulfate with formation of NBM and GSSG via S-(4-nitrobenzyl)thioglutathione, but also cleaved the covalent bonds, possibly disulfides formed from NBM S-sulfate and sulfhydryl groups of the cytosolic proteins. Thus, evidence was provided that NBM S-sulfate be a new type of the reactive metabolite. PMID- 3509958 TI - 3-Dimethylallylindole: an antibacterial and antifungal metabolite from Monodora tenuifolia. PMID- 3509959 TI - The effect of amino acid derivative of clofibric acid (WKLB-5), and theophylline monoester of nicotinic acid (ME1) on the development of experimental atherosclerosis in rabbits. AB - In order to determine the efficacy of new compounds--an amino acid derivative of clofibric acid (WKLB-5), and a theophylline monoester of nicotinic acid (ME1)--a high fat diet (HFD) was applied to rabbits for 3 months, with or without the above mentioned compounds. The HFO included coconut oil, cholesterol and cholic acid. A substantial hypolipemic activity of those compounds was demonstrated; however, the studied lipid fractions did not undergo normalization, except FFA whose level after ME1 administration was distinctly lower than in control animals. Sudanophilic changes were found on 83% of surface of the interior membrane of aorta in rabbits kept on the HFD only, on 35% of surface--in rabbits treated with the HFD + WKLB-5, and on 75% of surface--in rabbits treated with the HFD + ME1. Thus in those animals no parallelism between the hypolipemic and antiatherosclerotic activities was observed. PMID- 3509960 TI - Rhamnetin-3-O-neohesperidoside, a new flavonoid from the leaves of Derris trifoliata. PMID- 3509961 TI - Effect of neuroactive agents on cholecystokinin release from the isolated, perfused porcine duodenum. AB - To elucidate the mechanisms involved in the regulation of CCK release from the small intestine, the effect of neuroactive agents on the release of CCK from the isolated, perfused porcine duodenum has been studied. CCK in the venous effluent was measured by three radio-immunoassays specific for the N-terminus, the tyrosine-o-sulphated region and the C-terminus of CCK-33. Gastrin-releasing peptide (GRP) at concentrations of 10(-10) and 10(-9) M in the arterial line increased the CCK output by about 100 and 500%, respectively, as measured with the assay specific for the sulphated region of CCK. Pilocarpine and physostigmine at concentrations of 10(-5) M reduced the CCK output to 24 and 40% of basal, respectively, and also abolished the GRP-stimulated CCK response. Atropine (10( 6) M) increased CCK output about 100%. The results suggest that both stimulatory and inhibitory nervous impulses may be transmitted to the intestinal CCK cell, mediated by intramural GRP neurons and cholinergic pathways, respectively. PMID- 3509962 TI - Pharmacokinetics of the oral cephalosporin cefetamet pivoxyl (Ro 15-8075) and its microbiologically active metabolite cefetamet (Ro 15-8074). PMID- 3509963 TI - Hypoparathyroidism and T cell immune defect in a patient with 10p deletion syndrome. PMID- 3509964 TI - Mixed-model analysis of a censored normal distribution with reference to animal breeding. AB - A mixed-model procedure for analysis of censored data assuming a multivariate normal distribution is described. A Bayesian framework is adopted which allows for estimation of fixed effects and variance components and prediction of random effects when records are left-censored. The procedure can be extended to right- and two-tailed censoring. The model employed is a generalized linear model, and the estimation equations resemble those arising in analysis of multivariate normal or categorical data with threshold models. Estimates of variance components are obtained using expressions similar to those employed in the EM algorithm for restricted maximum likelihood (REML) estimation under normality. PMID- 3509965 TI - Binomial regression in GLIM: estimating risk ratios and risk differences. AB - Although an estimate of the odds ratio adjusted for other covariates can be obtained by logistic regression, until now there has been no simple way to estimate other interesting parameters such as the risk ratio and risk difference multivariately for prospective binomial data. These parameters can be estimated in the generalized linear model framework by choosing different link functions or transformations of binomial or binary data. Macros for use with the program GLIM provide a simple method to compute parameters other than the odds ratio while adjusting for confounding factors. A data set presented previously is used as an example. PMID- 3509966 TI - Long-term ileostomy complications in patients with ulcerative colitis and Crohn's disease. AB - Ileostomy complications in 203 patients operated on with proctocolectomy and ileostomy for ulcerative colitis and Crohn's disease were investigated prospectively. The patients were examined at regular intervals by interview and thorough examination of the stoma. Stomal dysfunction was carefully assessed and patients presenting with surgical complications were admitted for reconstruction. The crude rate of ileostomy complications necessitating reconstruction was 34% and significantly higher in patients with Crohn's disease compared with patients with ulcerative colitis. The cumulative rate of surgical revision after 8 years was 75% in the former group and 44% in the latter. Ileostomy stenosis and sliding recession were the two most common indications for reconstruction. Eighty-three per cent of the revisions were performed as local procedures, making a formal laparotomy unnecessary. Causative factors such as surgical technique, length of concomittant ileal resection and postoperative weight gain were analysed for possible influence on the rate of reconstruction, but no significant association was identified. PMID- 3509967 TI - Clinical and microbiological effects of fixed orthodontic appliances. AB - The purpose of this clinical and microbiological study was to evaluate longitudinally the changes occurring in the subgingival microbiota in children following the placement of orthodontic bands in the absence of a prophylactic oral hygiene program. A total of 12 children in the age between 10 and 15 years were selected for the study. The experimental group (E) consisted of 6 subjects scheduled for orthodontic treatment including the placement of fixed appliances. They were seen 1 week before and just prior to the placement of orthodontic bands. The control group (C) involved 6 children in the maintenance phase of orthodontic therapy in which removable retainers were used. All subjects were examined at 3-5 week intervals for a period of 4 months. At each examination, microbiological subgingival plaque samples were collected by means of sterile paper points. Plaque and gingival index scores as well as pocket probing depth at the site of sampling were determined. The microbiological samples were processed using continuous anaerobic culturing techniques and were plated on non-selective and selective media. Differential counts and biochemical characterization of isolates were performed according to the methods described by Kornman and Loesche. Following tooth-banding, an increase in pocket probing depth was observed, while the P1I and GI scores remained unaffected. A statistically significant increase from baseline values (p less than 0.05) was found for the %s of black-pigmented bacteroides, the B. intermedius and A. odontolyticus species, concomitantly with a decrease of the anaerobe/facultative bacteria ratio in the experimental, but not the control sites.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3509968 TI - Quality control for manufacturing standardized allergen extracts. Manufacturers criteria for in-house references. PMID- 3509969 TI - Regulatory status in the Federal Republic of Germany. PMID- 3509970 TI - Selection of reference preparation. IUIS reference preparation criteria. International Union of Immunological Societies. PMID- 3509971 TI - Animal consumption of antibiotics and chemotherapeutic drugs in Sweden during 1980, 1982 and 1984. AB - The total animal consumption of antibiotic and chemotherapeutic drugs in Sweden during 1980, 1982 and 1984 has been studied. The study also included coccidiostatic, antiparasitic and antimycotic drugs. The total animal consumption during the years mentioned was 66.1, 68.8 and 72.6 tons of active substance, respectively, and the amount of antibacterial drugs for therapy was 28.7 (43.4%), 29.1 (42.5%) and 34.1 (47.0%) tons, respectively. Tetracycline, penicillin, sulphonamide and aminoglycoside were the four major groups of antibiotics used for therapy of bacterial infections in animals. The consumption was related to the metabolic bodyweights of animals which were the potential consumers. A comparison was also made with the corresponding human consumption during 1980. The data on antibiotic consumption can be divided by county and compared to the animal population and disease situation in each county. This study thus offers a good base for further investigations on different aspects of the use of antibiotics. PMID- 3509972 TI - [Experimental production of mitral valve and papillary muscle lesions by cervical vagus stimulation in rabbits]. AB - Mitral valve and papillary muscle lesions were experimentally produced in rabbits by cervical vagal stimulation or compression of the abdominal aorta. The involvement induced the similar findings to mitral valve prolapse in human beings including mid-systolic clicks and a late systolic or holosystolic murmur. Extrasystoles were also common. Necropsies disclosed papillary muscle swelling, bleeding and edematous change in the mitral valve, swelling of the myocardial cells and interstitial fibrosis. Further, bacterial endocarditis was induced in such rabbits by injecting pseudomonas alkaligenes. Possible connection of experimentally-induced lesions of the mitral complex and mitral valve prolapse in human beings was discussed. PMID- 3509973 TI - [Assessment of regional myocardial blood flow and energy metabolism]. AB - Regional myocardial perfusion and metabolism were evaluated in coronary artery disease with positron emission computed tomography (PET). Regional myocardial perfusion was assessed after the intravenous administration of 13N-ammonia at rest and during exercise loading, using a supine ergometer. In some cases, 18F FDG was administered at rest, and compared with 13N-ammonia. 13N-ammonia revealed hypoperfusion in coronary artery disease, in 73% of cases at rest and in 97%, during exercise study. Increased accumulations of 18F-FDG were observed in the peri-infarcted areas with decreased perfusions, and in the regions with normal perfusions at rest, where the exercise study showed transient ischemia. These results indicate that PET can detect regional myocardial ischemia with superior sensitivity, and that it provides a means of evaluating myocardial metabolism in vivo. PMID- 3509974 TI - Neonatal morphometrics and perinatal outcome: who is growth retarded? AB - To evaluate the relationship between neonatal morphometrics and poor neonatal outcome resulting from fetal malnutrition, we prospectively examined 355 sequential live-born, singleton neonates greater than 35 weeks' gestational age. Birth weight, neonatal ponderal index, and midarm circumference to head circumference ratio were measured. A birth weight, ponderal index, or midarm circumference to head circumference ratio less than or equal to tenth or greater than or equal to ninetieth percentiles for gestational age was considered abnormal. Poor outcome was defined as operative delivery for fetal distress, 5 minute Apgar score less than 7, meconium aspiration, polycythemia, or hypoglycemia. Thirty-three (9.3%) neonates had perinatal morbidity. Although morbidity was not increased among neonates that were large by any of the criteria, five (25%) of 20 with low birth weight had poor outcome and 18 (26%) of 70 with low ponderal index or midarm circumference to head circumference ratio suffered morbidity. Of the 33 neonates with morbidity, 18 (54.5%) had low ponderal index or midarm circumference to head circumference ratio, but only five (15.2%) had low birth weight. Therefore, low ponderal index and midarm circumference to head circumference ratio are more sensitive predictors of outcome than is birth weight. As such, ponderal index and midarm circumference to head circumference ratio are more appropriate end points for antenatal diagnostic studies than is birth weight. PMID- 3509975 TI - DNA reactivity and in vitro cytotoxicity of the novel antitumor agent 1,5,2,4 dioxadithiepane-2,2,4,4-tetraoxide (NSC-348948) in human embryo cells. AB - 1,5,2,4-Dioxadithiepane-2,2,4,4-tetraoxide (cyclic-SoSo) is structurally a novel synthetic compound but may functionally act as an alkylating agent. The effects of cyclic-SoSo on DNA were studied in IMR-90 and VA-13 human embryo cells by means of DNA alkaline elution analysis. In contrast to a number of bifunctional alkylating agents, cyclic-SoSo produced no DNA-DNA interstrand cross-links in either cell line, even at concentration which produced a greater than 3 log cell kill. At equimolar concentrations cyclic-SoSo induced DNA-protein cross-links in both cell lines to a similar extent. Frank DNA breaks and alkali-labile DNA lesions were detected in both cell lines. A greater quantity of strand breaks appeared in the IMR-90 than in the VA-13 cell line after exposure to cyclic-SoSo. However, cyclic-SoSo was more cytotoxic to the VA-13 cell line in vitro than to the IMR-90 cell line. Thus cyclic-SoSo may not be a typical bifunctional alkylating agent in that its mechanism of action does not appear to involve DNA interstrand cross-linking. PMID- 3509976 TI - The effects of the anilinonaphthalenesulfonates on the alkylation of tubulin: correlation between the appearance of sulfhydryl groups and apolar binding sites. AB - We have previously found that the sulfhydryl groups of tubulin are sensitive reporters of the effects of ligands on the tubulin molecule. In this study, we examined the effects of three anilinonaphthalenesulfonates on the interaction of tubulin with iodo[14C]acetamide and N, N'-ethylenebis(iodoacetamide). We found that 1,8-anilinonapthalensulfonate (1,8-ANS) and 2,6-anilinonaphthalenesulfonate (2,6-ANS) had no effect on the reaction with iodo[14C]acetamide. In contrast, bis(1,8-anilinonaphthalenesulfonate) (BisANS), an inhibitor of microtubule assembly, had a complex effect. Low concentrations of BisANS, where presumably only the high-affinity binding site was saturated, had little or no effect on alkylation. Higher concentrations of BisANS caused a strong enhancement of alkylation. None of these compounds had any effect on the reaction with N,N ethylenebis(iodoacetamide). Our results suggest that the binding of BisANS, 2,6 ANS and 1,8-ANS to tubulin is complex and very different from that of the other anti-tubulin drugs. The correlation between the effects of drugs on alkylation of tubulin and the binding of BisANS is consistent with a model whereby the alkylatable sulfhydryls are located in apolar regions of the tubulin molecule. PMID- 3509977 TI - [The dental arch in 5-year-old Chinese children]. PMID- 3509978 TI - Bactericidal activity of LY 146032. PMID- 3509979 TI - [Characterization of an enzyme associated with a bacteriophage that depolymerizes the capsular polysaccharide of Klebsiella pneumoniae K-8]. PMID- 3509980 TI - McArdle's & Hers' diseases: glycogen phosphorylase transcriptional expression in human tissues. AB - We have cloned the cDNA encoding human liver glycogen phosphorylase (glycogenosis type VI) from a fetal brain cDNA library. Liver(L) and muscle(M) phosphorylase cDNA probes were used to determine the relative abundance of mRNA encoding the L- and M-isozymes of phosphorylase in human fetal and adult tissues. The transcript encoding the M-isozyme is 3.4 kb; the L-isozyme transcript is 3.3 kb. Transcriptional expression of the L-isozyme in human and primate tissues was found to differ from the isozyme's reported tissue specificity in non-primate mammals. Furthermore, using degenerate oligonucleotide probes to two different coding regions of M-phosphorylase, a novel 4.1-kb transcript was demonstrated to be present in human fetal and adult brain. PMID- 3509981 TI - Inhibition of antigen-induced airway hyperresponsiveness by a thromboxane synthetase inhibitor (OKY-046) in allergic dogs. AB - To determine the role of thromboxane A2 in the airway hyperresponsiveness induced by antigen challenge, we studied the effect of a thromboxane synthetase inhibitor, OKY-046, i.e., sodium (E)-3-[4-(1-imidazolylmethyl)-phenyl]-2 propanoate, in 6 ragweed-sensitized dogs. Airway responsiveness was assessed with dose-response curves of acetylcholine aerosol versus total pulmonary resistance before and 6 and 24 h after inhalation with ragweed antigen. This procedure was repeated in each dog during intravenous infusion of OKY-046 (100 micrograms/kg/min). OKY-946 did not alter the acute increase in total pulmonary resistance after antigen. At 6 h, there was a 7-fold increase in airway responsiveness, an effect that was prevented by OKY-046 (p less than 0.001). At 24 h, 18 h after OKY-046 was stopped, hyperresponsiveness was still significantly inhibited. OKY-046 did not alter the influx of neutrophils recovered by bronchoalveolar lavage performed at 6 h after antigen challenge. Antigen-induced airway hyperresponsiveness in dogs may depend upon the thromboxane A2 generation from inflammatory cells (e.g., neutrophils). PMID- 3509982 TI - Employers armed for direct negotiations: are hospitals ready? PMID- 3509983 TI - Rheumatoid lymphedema. AB - Edema of the upper limbs is described in 3 men with rheumatoid arthritis. In all cases abnormal lymph vessels were documented on lymphography. Lymphangitis may explain the anomaly. PMID- 3509984 TI - Tetanus and blood group relationship. PMID- 3509985 TI - Rabies--an unusual observation. PMID- 3509986 TI - "Post infective polyradiculoneuropathy with bilateral recurrent laryngeal nerve palsy". PMID- 3509987 TI - Site-site interaction in the phospholipid activation of D-beta-hydroxybutyrate dehydrogenase. AB - D-beta-Hydroxybutyrate dehydrogenase is a lipid-requiring enzyme with absolute specificity for phosphatidylcholine (PC). The enzyme devoid of lipid, the apodehydrogenase, inserts spontaneously into phospholipid vesicles where it exists as a tetramer. We now find the lipid activation to be limited by the mole fraction of PC in the total phospholipid. These studies suggest that the concentration of the enzyme-PC complex, which is essential for enzymic activity, becomes diffusion limited at lower PC concentration. The lipid activation and the tryptophan fluorescence of purified D-beta-hydroxybutyrate dehydrogenase were studied in the presence of a constant "bilayer background" of approximately 100 nonactivating phospholipid molecules/enzyme monomer. Activation by PC was half maximal at 20 PC molecules/enzyme monomer. This value was doubled when the amount of "background" phospholipid was doubled. Activation proceeded with positive cooperativity having a Hill coefficient of approximately 2.4. These data indicate interactions between at least three PC-binding sites. The quenching of tryptophan fluorescence by the phospholipid activator, 1-palmitoyl-2-(1-pyrenyl)-decanoyl-PC (2-pyrenyl-PC), gives a saturation curve with half-maximal quenching of 6 quencher molecules/enzyme monomer. This value is equivalent to an apparent phospholipid-protein dissociation constant in the two-dimensional membrane and corresponds to approximately 6 mol % of total phospholipid. In distinct contrast to the phospholipid activation curve, the fluorescence quenching saturation curve was hyperbolic and there was no specificity for PC. The fluorescence quenching by 2-pyrenyl-PC could be diminished by using a several-fold excess of PC or other phospholipids so as to reduce the mole fraction of quencher in the bilayer. It would appear that formation of enzyme-PC complex is a dynamic process consisting of at least two discernible steps: 1) a primary interaction, as measured by tryptophan quenching, which is hyperbolic and not specific for lecithin. This interaction is independent from and precedes 2) phospholipid activation of D-beta hydroxybutyrate dehydrogenase, which is cooperative in nature and specific for lecithin. PMID- 3509988 TI - [Hypocrellin A-sensitized cross-linking of erythrocyte membrane proteins]. PMID- 3509989 TI - [Use of a new gel tear substitute in ophthalmology and intensive medicine]. PMID- 3509990 TI - A radiosensitive T-lymphocyte associated with resistance of DBA/2 mice harboring Friend leukemia virus-dormant infections to transplantable Friend leukemia virus erythroleukemia cells. AB - The immunobiology of Friend erythroleukemia virus (FLV) has been the focal point of much research into immunological control of leukemia. We have been studying a murine model in which a rapidly fatal FLV infection of DBA/2 mice is suppressed to a dormant state by treatment with statolon, a double stranded RNA extract of Mycoplasma stoloniferum. We report here that mice with FLV-dormant infections resist the accumulation of transplanted FLV-transformed erythroleukemia cells (FLC-745) and that FLC-745 cells persist in the spleen for a prolonged period. Winn assays revealed that the spleen of FLV-dormant mice contain radiosensitive T lymphocytes with anti-FLC-745 cell activity. Whole body irradiation of FLV dormant mice abrogated their resistance to transplanted FLC-745 cells and confirmed the radiosensitivity of the protective immune response. PMID- 3509991 TI - Use of growth-stimulatory hormones to improve the in vitro therapeutic index of doxorubicin for human breast tumors. AB - Tumor-specific growth factors that increase the proliferative rate of tumor cells should, in theory, enhance the efficacy of cytotoxic drugs that have cell-cycle dependent activity. To test this hypothesis, we measured the cytotoxicity of doxorubicin for clonogenic breast tumor cells in the presence and the absence of hormones that stimulate their in vitro growth (17 beta-estradiol, epidermal growth factor, hydrocortisone, and insulin). These growth factors increased the sensitivity to doxorubicin of the clonogenic cell populations from 20 of 25 breast tumors. Their effect was greatest on tumors from hormone-responsive patients. In contrast, these hormones increased the clonogenicity and sensitivity to doxorubicin of bone marrow progenitor cells to a much lesser degree. Hence, under the effect of these growth factors, the in vitro therapeutic index of doxorubicin improved for most of the tumors tested, while tamoxifen citrate, a tumor growth-inhibitory hormone, had the opposite effect. We conclude that tumor tissue-specific growth-stimulatory hormones can improve the in vitro efficacy of cell cycle-active anticancer drugs. PMID- 3509992 TI - Induction of rat liver O6-alkylguanine-DNA alkyltransferase following whole body X-irradiation. AB - The promutagenic DNA lesion O6-alkylguanine can be enzymically removed from cellular DNA by an O6-alkylguanine-DNA alkyltransferase (O6-AT) which transfers the alkyl group from the O6-position of guanine to a cysteine residue contained within its sequence. We report that whole body X-irradiation induces the O6-AT activity in the liver of adult Wistar rats. In vivo repair activity was assessed by radiochromatographic determination of the persistence of O6-methylguanine in hepatic DNA of irradiated rats following a single i.p. injection of N-nitroso [14C]dimethylamine (2 mg/kg). In addition, the O6-alkylguanine repair capacity was assayed in vitro by incubation of extracts from whole liver, hepatocytes, or hepatic cell nuclei with 3H-methylated DNA and high performance liquid chromatography analysis of this DNA substrate. We found that whole body X irradiation increased in a dose-dependent manner the O6-AT activity over a range of 100-800 R. The repair induction was first detectable 12 h after X-ray exposure, reached a maximum level at 72 h, and declined to control values within 12 days. Deoxythymidine incorporation into hepatic DNA was significantly reduced during the initial 72 h following application of 500 R. In a split dose irradiation schedule with daily doses of 15 R, a delayed enzyme induction occurred after a 30-day treatment period. Pretreatment of rats with the translational inhibitor cycloheximide completely suppressed the O6-AT stimulation. This indicates that the induction of hepatic O6-alkylguanine repair is due to de novo synthesis of alkyltransferase molecules. PMID- 3509993 TI - Nuclear substructure antigens. Monoclonal antibodies against components of nuclear matrix preparations. AB - We describe two monoclonal antibodies, I-2 and I-14, which recognize, respectively, proteins of 36 and 40 kD. By immunofluorescence microscopy on chick embryo fibroblasts, both antigens were found to be located within a nuclear substructure which excludes nucleoli and part of the nucleoplasm; hence we refer to these antigens as nuclear substructure antigens. By immuno-electron microscopy on chick liver sections, the I-14 antigen was identified predominantly in clusters of interchromatin granules and in perichromatin fibrils. The two substructure antigens share a remarkable resistance to sequential extraction of nuclei with DNase I, RNase A, non-ionic detergent and high salt, indicating that they constitute part of an operationally defined residual nuclear matrix. Finally, both substructure antigens are virtually absent from the nuclei of adult erythrocytes. These properties suggest that substructure antigens may be involved in RNA transcription, processing or transport, possibly by contributing nucleoskeletal support. PMID- 3509994 TI - Presence of asialoglycoprotein receptors in the Golgi complex in the absence of protein synthesis. AB - In rat hepatocytes the Golgi complex contains a considerable amount of receptors for asialoglycoproteins (ASGP-R). To establish whether the presence of ASGP-R in the Golgi complex originate from de novo synthesis isolated rat hepatocytes were incubated with 100 micrograms/ml cycloheximide to stop protein synthesis. Provided that protein synthesis was completely inhibited by cycloheximide, uptake and degradation of ligand (asialo-orosomucoid) were unaffected. Also intracellular transport of newly synthesized proteins, as determined by monitoring biosynthesis and intracellular transport of albumin and ASGP-R, was not affected. After culturing the cells for 3.5 h in the presence of cycloheximide, no more albumin could be detected in the Golgi complex with immunofluorescence microscopy. However, immunocytochemical assessment showed that the ASGP-R was still in the Golgi complex. These results suggest that the Golgi complex contains a pool of ASGP-R which is independent of neosynthesis for several hours. PMID- 3509995 TI - Co-operation between the p53 protein tumor antigen and platelet-poor plasma in the induction of cellular DNA synthesis. AB - Plasmids containing DNA sequences coding for p53 were microinjected into quiescent Swiss 3T3 cells. Three constructs were used, carrying either the whole gene sequence, a full-length cDNA, or a hybrid between the gene and the cDNA. All of them stimulated DNA synthesis when cells were incubated with platelet-poor plasma (PPP) following injection. The p53 gene stimulated DNA synthesis to a lesser extent, also in the absence of PPP. Several negative results were obtained with different plasmids, including deletion mutants in the p53 coding region. However, a deletion mutant in which the p53 reading frame ended in the middle of the coding part of the p53 gene still stimulated DNA synthesis in co-operation with PPP. The stimulation of DNA synthesis induced by p53 cDNA was more synchronous and more limited than that induced by serum. The present data suggest that p53 may act as a competence factor in cell cycle progression. PMID- 3509996 TI - A network of 2-4 nm filaments found in sea urchin smooth muscle. Protein constituents and in situ localization. AB - In this report the coisolation of two proteins from sea urchin smooth muscle of apparent molecular weights (Mr) 54 and 56 kD respectively, as determined on SDS PAGE, is described. Like the intermediate filament proteins, these two proteins are insoluble in high ionic strength buffer solution. On two-dimensional gel electrophoresis and by immunological methods it is shown that these proteins are not related (by these criteria) to rat smooth muscle desmin (54 kD) or vimentin (56 kD). Furthermore, in conditions where both desmin and vimentin assemble in vitro into 10 nm filaments, the sea urchin smooth muscle proteins do not assemble into filaments. Ultrastructural studies on the sea urchin smooth muscle cell show that the thin and thick filaments organization resembles that described in the vertebrate smooth muscle. However, instead of 10 nm filaments, a network of filaments, 2-4 nm in diameter, is revealed, upon removal of the thin and thick filaments by 0.6 M KCl treatment. By indirect immunofluorescence microscopy, and in particular by immunocytochemical electron microscopy studies on the sea urchin smooth muscle cell, it is shown that the antibodies raised against both 54 and 56 kD proteins appear to specifically label these 2-4 nm filaments. These findings indicate that both the 54 and 56 kD proteins might be constituents of this category of filaments. The possible significance of this new cytoskeletal element, that we have named echinonematin filaments, is discussed. PMID- 3509997 TI - American Gastroenterological Association. Our new President--Jerry S. Trier. PMID- 3509998 TI - Local immune mechanisms in inflammatory bowel disease and colorectal carcinoma. Natural killer cells and their activity. AB - Mononuclear cell (MNC) populations isolated from intestinal mucosa, mesenteric lymph nodes, and peripheral blood have been assessed for their natural killer (NK) (Leu-7+) cell proportions and NK cell activity against K-562 erythroleukemic target cells. In peripheral blood, normal proportions of Leu-7+ cells were found in patients with Crohn's disease or ulcerative colitis, whereas increased proportions in colorectal carcinoma may have been related to the higher mean age of these patients. Low proportions of Leu-7+ cells (less than 3%) were present in intestinal MNCs in Crohn's disease, ulcerative colitis, colon cancer, and miscellaneous intestinal diseases. All groups of patients had diminished NK activity of peripheral blood MNCs compared with a group of healthy controls. Intestinal NK cell activity from histologically normal mucosa correlated with autologous peripheral blood NK cell activity (p less than 0.001) but no such correlation was seen for patients with inflammatory bowel disease. Mucosal or nodal NK cell activity showed a wide range of activity but did not relate to the underlying disease, mucosal histopathology, drug therapy, or, in patients with cancer, Dukes' grading. Intestinal MNCs from all patient groups responded to stimulation with lymphoblastoid interferon, except in a small number of patients whose unstimulated activity was not detectable. In conclusion, the NK cell on intestinal mucosa behaves similarly in various intestinal diseases. However, the disparity between NK activity of autologous peripheral blood and intestinal MNCs in inflammatory bowel disease highlights the difficulty in extrapolating peripheral blood findings to mucosal immune events. PMID- 3509999 TI - Nude mice bearing human primary hepatocellular carcinoma that produces hepatitis B surface, core, and e antigens, as well as deoxyribonucleic acid polymerase. AB - A primary hepatocellular carcinoma, from a patient carrying hepatitis B virus, was transplanted to athymic nude mice, and maintained through eight passages involving 39 mice. Hepatitis B surface and e antigens were detected in the circulation of tumor-bearing mice. Hepatitis B surface, core, and e antigens were demonstrated in tumor cells. Hepatitis B core particles were visualized in the tumor extract by immune electron microscopy, and they exhibited an activity of deoxyribonucleic acid polymerase. In the tumor tissue, deoxyribonucleic acid of hepatitis B virus was present both in integrated and extrachromosomal forms. Nude mice carrying the tumor would provide opportunities for studying the replication of hepatitis B virus and the expression of its various proteins, and also for evaluating the efficacy of virustatic drugs in interrupting the persistent infection. PMID- 3510000 TI - Hepatic glucose production and splanchnic glucose exchange in hyperthyroidism. AB - Hepatic glucose production (HGP) and net splanchnic glucose balance (NSGB) were simultaneously determined in the basal state in 8 hyperthyroid patients and 10 normal subjects using iv infusion of [3H]3-glucose and the hepatic venous catheter technique. Splanchnic glucose uptake (SGU) was calculated as the difference between the HGP and NSGB. SGU was also measured by determining the splanchnic extraction ratio of [3H]3-glucose across the splanchnic bed. In 5 hyperthyroid patients and 5 normal subjects a renal vein was also catheterized in the basal state. The influence of increased endogenous insulin secretion [stimulated by a low rate iv infusion of glucose (2 mg/kg . min)] on splanchnic and hepatic glucose exchange was also examined. Basal HGP (measured with [3H]3 glucose) was increased by 20% in the hyperthyroid patients [14.2 +/- 0.6 (SEM) mumol/kg . min] as compared to normal subjects (11.9 +/- 0.6, P less than 0.02). In marked contrast, NSGB output was slightly but not significantly decreased in the hyperthyroid group. SGU in the hyperthyroid patients, as determined with both techniques, was more than 2-fold higher than in the normal group (P less than 0.02-P less than 0.005). Splanchnic uptake of gluconeogenic precursors (lactate, pyruvate, glycerol) was increased by 20-120% in the patient group. During iv infusion of glucose, plasma insulin levels increased more in the hyperthyroid group (66% vs. 37%, P less than 0.05). Nevertheless, HGP and NSGB were less markedly suppressed in the patients as compared to the normal subjects (P less than 0.01), whereas the augmented SGU in the hyperthyroid patients reverted to normal. Splanchnic uptake of gluconeogenic precursors was unchanged in both groups. No net renal glucose production could be demonstrated in either group in the basal state. We conclude that in hyperthyroidism, increased HGP occurs in the face of an unchanged or slightly reduced rate of net glucose delivery to extrasplanchnic tissue. This discrepancy can be ascribed to augmented splanchnic uptake of glucose. These findings raise the possibility of futile cycling of glucose in the liver as a mechanism of increased oxygen consumption in hyperthyroidism. The data also demonstrate a diminished inhibitory effect of endogenous insulin on splanchnic glucose production, suggesting the presence of hepatic resistance to insulin in hyperthyroidism. PMID- 3510001 TI - Biochemical diagnosis and management of corticosterone methyl oxidase type II deficiency. AB - Corticosterone methyl oxidase deficiency type II (CMO type II deficiency) is an autosomal recessive disorder characterized by a defect in the terminal step of aldosterone biosynthesis. Previous reports emphasized the diagnostic utility of elevated urinary ratios of 18-hydroxytetrahydro-compound A to tetrahydro aldosterone, which are primary metabolites of 18-hydroxycorticosterone (18-OHB) and aldosterone, respectively. Limited data suggest that plasma ratios of 18-OHB to aldosterone are also abnormal in affected individuals. We report serum steroid profiles in two siblings with CMO type II deficiency. Serum levels of aldosterone precursors were elevated in both patients before treatment. In particular, the serum ratios of 18-OHB to aldosterone were greatly elevated and declined to normal levels during mineralocorticoid replacement. The possibility of heterozygote detection using this ratio is suggested. We also confirm previous reports of a detrimental effect on linear growth rate after cessation of mineralocorticoid therapy despite maintenance of normal serum electrolytes. This effect is associated with biochemical evidence of chronic salt depletion. Based on our observations, we recommend that serum 18-OHB to aldosterone ratios be routinely measured for the diagnosis and management of patients with CMO type II deficiency. PMID- 3510002 TI - Characterization of circulating insulin in insulin autoimmune syndrome. AB - We examined the forms of circulating insulin in three patients with the insulin autoimmune syndrome by a method combining gel filtration and reverse phase high performance liquid chromatography (RP-HPLC). Insulin bound to circulating antibody was dissociated by molecular sieve chromatography at acid pH. The free insulin peak eluted from a Sephadex G-50 column was subsequently chromatographed on a Bio-Gel P-30 column. In all three patients, insulin coeluted with normal human insulin. However, when the partially purified insulins, obtained by gel filtration, were applied to RP-HPLC, an abnormally migrating insulin was found in two of three patients. The insulins were more hydrophobic than normal human, porcine, or bovine insulin, but were different from each other. A third patient had only a single insulin peak on RP-HPLC which corresponded to normal insulin. In contrast, the insulin from insulin-treated diabetic patients with antibodies to exogenous insulin corresponded to either porcine or bovine and normal human insulin. The antibodies in the circulation of these patients with the autoimmune syndrome were of the immunoglobulin G type and contained kappa and lambda-chains in the same proportions as antibodies in insulin-treated patients. Autoantibodies could not be distinguished from those secondary to exogenous insulin treatment on the basis of displacement of binding by human, beef, or pork insulin. These results suggest that in certain patients with the insulin autoimmune syndrome, there may be a molecular abnormality of circulating insulin. Whether this comprises a cause for the syndrome or is a result of posttranslational processing of insulin remains to be determined. PMID- 3510003 TI - p150,95, the third member of the Mac-1, LFA-1 human leukocyte adhesion glycoprotein family. AB - Monoclonal antibodies specific for p150,95, a third member of the Mac-1 and lymphocyte function-associated antigen-1 (LFA-1) leukocyte adhesion protein family, have been identified and used to study the biochemistry and cellular expression of p150,95. p150,95 is a noncovalently associated heterodimer containing alpha X and beta subunits of Mr = 150,000 and 95,000 respectively. Findings suggest that the p150,95 alpha X beta complex shares a common beta subunit with the alpha L beta LFA-1 and alpha M beta Mac-1 complexes. Co precipitation experiments demonstrated identity between the p150,95 molecule precipitated by anti-beta MAb and by p150,95-specific MAb. Patients with a previously demonstrated genetic deficiency in Mac-1 and LFA-1 fail to express p150,95. Deficiency of the Mac-1, LFA-1, and p150,95 alpha beta complexes on the surface of patient cells appears due to a defect in the common beta subunit. The lack of cross-reaction of p150,95-specific MAb with LFA-1 and Mac-1, which appear to utilize identical beta subunits, suggests that the determinant is specified by the alpha X rather than the beta subunit of p150,95. The data suggest that alpha X is yet a third member of a family of alpha subunit proteins that associate with a common beta subunit, are differentially regulated in leukocyte differentiation, and function in adhesion reactions. p150,95 is normally expressed on blood monocytes and granulocytes. Chemoattractants such as f-Met-Leu-Phe stimulate a rapid, fivefold increase in surface expression that is not dependent on protein synthesis and appears to reflect mobilization of an intracellular latent pool. The intimate relation between the lack of chemoattractant-stimulated upregulation of p150,95 and Mac-1 by patient granulocytes and their failure to upregulate adhesiveness to these same stimuli in vitro, or to diapedese and migrate into inflammatory sites in vivo, is discussed. PMID- 3510004 TI - Immunofluorescent patterns of spectrin in lymphocyte cell lines. AB - Spectrin, a membrane-associated cytoskeletal protein, has been observed in all of 45 lymphoid and myeloid cell lines examined. For these experiments, formalin fixed cells from randomly selected lines propagated by using conventional tissue culture procedures were examined by immunofluorescence, using an antibody directed against chicken erythrocyte alpha-spectrin. Two distinct immunofluorescent patterns of spectrin distribution were identified. In most lines examined (16 mouse and 18 human lymphoid or myeloid lines), spectrin was symmetrically distributed near the submembranous region of the plasma membrane. In the remainder of the cell lines examined, a second pattern was observed; in these cultures, the cells contain a polar submembranous aggregate of spectrin with little staining at the rest of the plasma membrane. Long-term T lymphocyte cell lines in which greater than 60% of the cells expressed a polar submembranous aggregate of spectrin (PSA-S) include mouse cell lines EL-4, LBRM-33, CT-6X, NIXT, 22CM-37, and 7ON-2 and human lines JM and PEER. Other established cultures in which PSA-S were observed included the human macrophage-like line U-937 and gibbon T cell line MLA-144. Phorbol myristate acetate or mezerin caused a reversible alteration in the distribution of spectrin in these cell lines. These drugs, which increase membrane fluidity, caused a complete but temporary symmetrical redistribution of the spectrin aggregate. Our results indicate that the pattern of spectrin distribution, either aggregated or evenly dispersed, is a stable characteristic (but one that can be altered) in various cell lines, and that because similar variations in pattern have been noted in situ, it is likely that the pattern present in any given cell line reflects a characteristic associated with a particular stage of a cell's maturation. It is anticipated that these cell lines, positive and negative for the expression of natural polarity of spectrin distribution, will provide useful models for future studies to define further the role of spectrin in lymphocyte plasma membrane functions. PMID- 3510005 TI - Degradation of human anaphylatoxin C3a by rat peritoneal mast cells: a role for the secretory granule enzyme chymase and heparin proteoglycan. AB - Purified human C3a was iodinated (125I-C3a) and used to study the interaction of labeled peptide with rat peritoneal mast cells (RMC). Cellular binding of 125I C3a occurred within 30 sec, followed by a rapid dissociation from the cell. Both the binding of 125I-C3a and the rate of dissociation from the cell were temperature dependent. At 0 degrees C, the binding of 125I-C3a was increased and the rate of dissociation reduced, as compared with 37 degrees C. Once 125I-C3a was exposed to RMC, it lost the ability to rebind to a second batch of RMC. Analysis of the supernatants by trichloroacetic acid (TCA) precipitation and electrophoresis in sodium dodecyl sulfate polyacrylamide gels (SDS PAGE) revealed a decrease in the fraction of 125I precipitable by TCA and the appearance of 125I C3a cleavage fragments. Pretreatment of RMC with enzyme inhibitors specific for chymotrypsin, but not trypsin, abrogated the degradation of 125I-C3a. Treatment of RMC bearing 125I-C3a with bis (sulfosuccinimidyl) suberate (BS3) covalently cross-linked the 125I-C3a to chymase, the predominant enzyme found in the secretory granules. Antiserum directed against chymase precipitated 125I-C3a from extracts of RMC treated with BS3. Indirect immunofluorescence of RMC by using the IgG fraction of goat anti-rat chymase showed that chymase is present on the surface of unstimulated cells. Neither purified chymase nor heparin proteoglycan alone had any appreciable effect on 125I-C3a, but together they resulted in prompt degradation of the 125I-C3a. Immunoabsorption of RMC sonicates with specific antibody for chymase completely abrogated the ability of these sonicates to degrade 125I-C3a. The results indicate that 125I-C3a binds to RMC and is promptly degraded by chymase in the presence of heparin proteoglycan. PMID- 3510006 TI - A study of anti-group A streptococcal monoclonal antibodies cross-reactive with myosin. AB - Anti-group A streptococcal monoclonal antibodies were obtained from BALB c/BYJ mice immunized with purified membranes from M type 5 Streptococcus pyogenes. Two of the anti-streptococcal monoclonal antibodies were previously shown to cross react with muscle myosin. In this study the monoclonal antibodies were reacted with tissue sections of normal human heart and skeletal muscle. Antibody binding was estimated by indirect immunofluorescence and immunoperoxidase techniques. Both of the monoclonal antibodies (36.2.2 and 54.2.8) investigated in this report reacted with heart and/or skeletal muscle sections. When evaluated by immunofluorescence, monoclonal antibody 54.2.8 demarcated the periphery of cardiac striated muscle cells and reacted to a lesser degree with subsarcolemmal components. Monoclonal antibody 36.2.2 failed to react with heart sections, but both of the monoclonal antibodies reacted strongly with skeletal muscle sections. Results similar to those observed with indirect immunofluorescence were obtained with the immunoperoxidase technique. By Western immunoblotting and competitive inhibition assays, monoclonal antibodies 36.2.2 and 54.2.8 both were found to react with the heavy chain of skeletal muscle myosin. However, only 54.2.8 reacted with the heavy chain of cardiac myosin. The specificity of the monoclonal antibodies for subfragments of skeletal muscle myosin indicated that monoclonal antibody 36.2.2 was specific for light meromyosin fragments, whereas 54.2.8 reacted with both heavy and light meromyosin. The data demonstrated that two monoclonal antibodies against streptococci were specific for skeletal muscle and/or cardiac myosin and for subfragments of the myosin molecule. The reactions of the monoclonal antibodies with human tissue sections were consistent with the immunochemical reactions of the monoclonal antibodies with both denatured and native myosin. PMID- 3510007 TI - Functional analysis of the immunosenescence of the human B cell system: dissociation of normal activation and proliferation from impaired terminal differentiation into IgM immunoglobulin-secreting cells. AB - The abilities of B cells from 24 young (mean 26 yr) and 24 elderly (mean 86 yr) humans to proliferate and differentiate into immunoglobulin-secreting cells (ISC) were investigated. Initial studies in young subjects demonstrated that a Staph protein A (SpA)-driven system could simultaneously assess the proliferative and differentiative capabilities of B cells resulting in IgM production. B cell proliferative responses were found to be partially T cell-dependent, whereas differentiation was absolutely T cell-dependent. Also, no significant differences could be detected in the abilities of nonproliferating allogeneic and autologous T cells to support B cell responsiveness. Although B cells from elderly subjects continuously exposed to SpA displayed proliferative responses equal to young subjects, the differentiation of B cells from elderly subjects into IgM ISC was markedly reduced as compared to young subjects. Analyses of results from co culture experiments showed that the differentiation impairments of B cells from some elderly subjects could be partially corrected by allogeneic T cells from young subjects, whereas the impairments of others were more refractory. Moreover, T cells from elderly subjects were able to promote the differentiation of B cells from young subjects. Other experiments in elderly subjects showed that significant impairments of B and T cell functions rarely coexisted and that compensatory increases in B or T cell function were not evident. Thus, B cells from certain elderly humans have intrinsic impairments of differentiation required for optimal IgM production even though activation and proliferation remain normal in the presence of SpA. These impairments in differentiation are sometimes improved by T cells from young subjects, although in some elderly individuals, the differentiative impairments fail to be reversed. PMID- 3510008 TI - Human skeletal muscle cells synthesise a neuronotrophic factor reactive with spinal neurons. AB - Retrograde trophic influences originating in the skeletal musculature have been postulated to be involved in regulating survival and differentiation of embryonic motor neurons and reactive terminal sprouting of mature motor fibres. We have previously described the use of a quantitative immunoassay for neurofilament protein to bioassay in vitro the cell-type-specific neuronotrophic activity of nerve growth factor (NGF) on sensory ganglion neurons. In the present study, the effect of media conditioned by adult human muscle cells (MCM) on the in vitro development of chicken spinal neurons has been studied using a similar approach. Significant increases in neurofilament protein levels in 7-day chicken embryonic spinal cord cultures were found with doses of MCM protein as low as 0.4 microgram/ml, with a dose-response relationship yielding maximal and half-maximal effects at 4 and 1 microgram/ml, respectively. Maximal increases in neurofilament protein levels were associated with an approximate two-fold increase in neuronal cell survival. MCM also induced increases in choline acetyltransferase activity in chick spinal cord cultures. In both the absence and presence of NGF, MCM did not increase neurofilament protein expression in primary cultures of sensory neurons. PMID- 3510009 TI - Monoclonal antibodies to rat brain acetylcholinesterase: comparative affinity for soluble and membrane-associated enzyme and for enzyme from different vertebrate species. AB - Seven unique monoclonal antibodies were generated to rat brain acetylcholinesterase. Upon density gradient ultracentrifugation, immunoglobulin complexes with the monomeric enzyme appeared as single peaks of acetylcholinesterase activity with a sedimentation coefficient approximately 3S greater than that of the free enzyme. This behavior is consistent with the assumption of one binding site per enzyme molecule. Apparent dissociation constants of these antibodies for rat brain acetylcholinesterase calculated on the basis of this assumption ranged from about 10 nM to more than 1,000 nM. Some of the antibodies were less able to bind the membrane-associated enzyme that required detergent for solubilization than the naturally soluble acetylcholinesterase of detergent-free brain extracts. Species cross-reactivity was investigated with crude brain extracts from mammals (human, mouse, rabbit, guinea pig, cow, and cat) and from other vertebrates (chicken, frog, and electric eel). Three antibodies bound rat acetylcholinesterase exclusively; one had nearly the same affinity for all mammalian acetylcholinesterases investigated; the remaining three showed irregular binding patterns. None of the antibodies recognized frog and electric eel enzyme. Pooled antibody was found to be suitable for specific immunofluorescence staining of large neurons in the ventral horn of the rat spinal cord and smaller cells in the caudate nucleus. Other potential applications of these antibodies are discussed. PMID- 3510010 TI - Long-term follow-up in London Transplant Group recipients of cadaver renal allografts. The influence of HLA matching on transplant outcome. AB - The London Transplant Group followed 1341 patients with cadaver renal transplants, none of whom received cyclosporine, for six months to 14 years to determine the effect on graft survival of matching donor and recipient for HLA Class I antigens (HLA-A, -B, and -C) and Class II antigens (HLA-DR, -MT, and DQ). Long-term graft survival was greatly improved by matching for HLA Class I antigens, especially HLA-B. Transplants that could not be matched for both B locus antigens but were completely matched for Bw4/Bw6 also did very well. In addition, since 1978, excellent results have been obtained with HLA-DR and DRw52/53 (HLA-MT) matching, but not with HLA-DQ matching. Multivariate analysis using the Cox regression model confirmed that combination Class I and Class II matching produced significant improvements in graft survival. Thus, transplants matched for HLA-DR plus HLA-B and those matched for HLA-MT plus HLA-B had excellent results--even better than those reported with cyclosporine treatment. Double HLA-MT incompatibilities yielded the poorest results. We conclude that this approach of combining the broad and narrow specificities of Class I and II is extremely practical and that appropriate matching of tissue types is clinically important. PMID- 3510011 TI - Intraoperative real-time ultrasonography during intrauterine tandem placement. AB - Real-time ultrasound is used in the operating room as an aid in the placement of the intrauterine tandem. This method provides excellent imaging of the ongoing procedure, facilitating final tandem placement in the endometrial cavity even in the most difficult case. PMID- 3510012 TI - Definition, detection, and management of gestational diabetes. AB - The Second International Workshop-Conference on Gestational Diabetes was held in Chicago, IL on October 25-27, 1984 as an invitational meeting sponsored by the American Diabetes Association with the cooperation of the American College of Obstetricians and Gynecologists, the American Academy of Pediatrics, and the Diabetic Pregnancy Study Group of the European Association for the Study of Diabetes. The meeting was convened to collate existing information about gestational diabetes mellitus and to use state-of-the-art appraisals to achieve consensus about definitions, prognoses, and strategies for success, diagnosis, and intervention. The invited presentations documented that gestational diabetes mellitus is a heterogeneous disorder with varying incidence in various parts of the world. The increased obstetric and perinatal risk of undetected gestational diabetes was supported. The reports clearly established that more than half of the women with gestational diabetes mellitus ultimately develop permanent diabetes. Mounting evidence also suggests the possibility of long-range complications such as increased obesity and diabetes in the offspring. The available experiences with a variety of therapies such as diet and insulin were reviewed. The meeting highlighted the importance of gestational diabetes mellitus as a distinct entity deserving of increased recognition, treatment, long-range follow-up, and research. PMID- 3510013 TI - Prolactin and glucose tolerance in normal and gestational diabetic pregnancy. AB - The relationship between the deterioration of glucose tolerance and plasma prolactin (PRL) levels was investigated in 15 normal pregnant women and in 15 women with gestational diabetes mellitus. Oral glucose tolerance tests were performed in late pregnancy and postpartum, and the insulin, glucagon, and PRL responses were measured. In late pregnancy the gestational diabetics revealed significantly elevated fasting glucose levels compared with the normal pregnant women and after the glucose challenge their insulin responses were significantly diminished and the suppression of glucagon less pronounced. These differences in glucose metabolism were markedly reduced early postpartum. There was no difference in basal PRL concentrations between the two groups neither in pregnancy nor postpartum. The PRL levels were not altered during the oral glucose tolerance tests and no correlation between the deterioration of glucose tolerance and the PRL concentrations could be demonstrated in either group. These results indicate that abnormal PRL levels are not of pathophysiologic importance for the development of gestational diabetes mellitus. PMID- 3510014 TI - Comparison of lavage or intravenous antibiotics at cesarean section. AB - The route of administration of prophylactic antibiotics was studied in a randomized prospective trial. Cefoxitin was administered to high-risk patients at cesarean section by three treatment regimens: intravenous antibiotic (2 g) for eight doses, irrigation of uterus and peritoneum with 2 g of antibiotic, and a combination of intravenous and irrigation as described. A control group received no antibiotic prophylaxis. The incidence of febrile morbidity was similar in each treatment group: intravenous, two of 39 (5%); irrigation, three of 42 (7%); intravenous and irrigation, two of 38 (5%), and were all significantly lower than the control group 14 of 39 (36%) (P less than .05). Similar results were found when prevention of endometritis was the end point: intravenous, two of 39 (5%); irrigation, two of 42 (5%); intravenous and irrigation, two of 38 (5%) compared with 13 of 39 (33%) in the control group (P less than .05). Administration of antibiotics by irrigation is equally effective in preventing postoperative febrile morbidity and endomyometritis as intravenous dosing and a combination of intravenous and irrigation. This affords a potential cost savings. PMID- 3510015 TI - Routine ultrasound screening for antenatal detection of intrauterine growth retardation. AB - This prospective screening program of a large obstetric population was designed to determine the effectiveness of ultrasonic biometry to diagnose intrauterine growth retardation. The results of 3616 pregnancies were analyzed. All pregnancies were dated before the 24th week by ultrasonic measurements. The study compared the effectiveness of three ultrasonic growth parameters: biparietal diameter (BPD), head circumference, and abdominal circumference, to detect intrauterine growth retardation and to determine the optimal gestational age to perform the scan for this purpose. To maintain a high sensitivity required in a screening program, all ultrasonic measurements below the 25th percentile for gestational age were considered abnormal. The predictive value of a positive test in this situation ranged from 0.25 to 0.55, depending on the week of gestation in which the scan was performed. Accuracy of predictions improved greatly when the scans were performed within two weeks of delivery. Abdominal circumference measurements were more predictive of intrauterine growth retardation than either head circumference or BPD measurements or the combination of these parameters. In view of the sensitivity of the test and the prevalence of the disorder, it is concluded that 34 +/- 1 weeks of gestation is the optimal time to screen patients ultrasonically for intrauterine growth retardation. PMID- 3510016 TI - Educational intervention by computer in childhood asthma: a randomized clinical trial testing the use of a new teaching intervention in childhood asthma. AB - To affect asthma-related knowledge, behavior, and morbidity, researchers tested a new educational intervention for children with asthma: an asthma-specific computer game called Asthma Command, which was specifically designed for this study. Sixty-five children with moderately severe asthma were randomly assigned to one of two groups, and 54 completed the study. Both groups were seen approximately six times during the 1 year of the study. Control subjects (n = 29) played routine computer games. Experimental subjects (n = 25) played Asthma Command. Compared with children in the control group, experimental subjects showed improvement in knowledge about asthma (P less than .001), behavior related to the management of asthma (P less than .008), and a trend toward the reduction of acute visits due to asthma (P less than .13). Children in the experimental group also scored higher on the assessment of behaviors related to the management of asthma that were specifically addressed by the intervention provided by Asthma Command (P less than .01). Differences between the control and experimental groups showed a greater improvement in the experimental group in 21 (84%) of the 25 outcome variables in the study (P = .004, Sign test). The study indicates that an asthma-specific computer game can significantly affect knowledge and behavior and may potentially affect morbidity in childhood asthma. PMID- 3510017 TI - Improving the delivery of prenatal care and outcomes of pregnancy: a randomized trial of nurse home visitation. AB - We evaluated a comprehensive program of prenatal and postpartum nurse home visitation. The program was designed to prevent a wide range of health and developmental problems in children born to primiparous women who were either teenagers, unmarried, or of low socioeconomic status. During pregnancy, women who were visited by nurses, compared with women randomly assigned to comparison groups, became aware of more community services; attended childbirth classes more frequently; made more extensive use of the nutritional supplementation program for women, infants, and children; made greater dietary improvements; reported that their babies' fathers became more interested in their pregnancies; were accompanied to the hospital by a support person during labor more frequently; reported talking more frequently to family members, friends, and service providers about their pregnancies and personal problems; and had fewer kidney infections. Positive effects of the program on birth weight and length of gestation were present for the offspring of young adolescents (less than 17 years of age) and smokers. In contrast to their comparison-group counterparts, young adolescents who were visited by nurses gave birth to newborns who were an average of 395 g heavier, and women who smoked and were visited by nurses exhibited a 75% reduction in the incidence of preterm delivery. (P less than or equal to .05 for all findings.) PMID- 3510018 TI - Capitation reimbursement for pediatric primary care. AB - A feasibility analysis of capitation reimbursement for a primarily Medicaid population in The Johns Hopkins Pediatric Primary Care Clinic was conducted. The utilization of all inpatient and outpatient care of 2,261 patients was monitored for a 6-month period. As a result, per capita rates based on charges were determined for each group of patients according to type of insurance. Blue Cross and private insurance patients had capitation rates three times that of the Medicaid patients and over ten times that of self-pay patients This variation in utilization was attributed to the selection of enrollees, the morbidity of the population, and the varying services covered by payor group. Administrative issues regarding establishing a pediatric health maintenance organization are also discussed. Close supervision of house staff in treating patients, including admissions, length of stay, and specialty referral is of utmost importance in containing costs in this clinic setting. PMID- 3510019 TI - The current radiological approach to renal cysts. AB - The radiologic diagnosis of renal cysts (and their differentiation from renal neoplasms) has come a long way since the 1950s when the approach was surgical exploration, unless clinically contraindicated, for every renal mass detected using urography. Nephrotomography, renal angiography, and cyst puncture have contributed over the ensuing years to the differentiation of cyst from tumor. However, for the most part, sonography and CT (or a combination of these when necessary) have become the main diagnostic techniques for evaluating renal masses, and with their use we have never been more accurate, noninvasive, and relatively economically efficient. The more widespread use of CT has enabled serendipitous discovery of many small renal carcinomas, the removal of which should result in an improvement in the overall cure rate of patients with renal parenchymal neoplasms. On the other hand, we are also discovering many more cysts than we have previously. We must be on guard, therefore, against discovering lesions for which we are unable to establish a radiologic diagnosis of benignity, because this will only increase the need for exploratory surgery once again. It is thus imperative that imaging studies be performed with great care, that diagnoses be based on rigid criteria, and that more experience with difficult lesions be gained so that the proper approach to treatment will be determined. If we are able to accomplish this, then the present radiologic age can be remembered as a time when great advances in the evaluation of renal masses were made, with resultant improved patient management and cure of disease. PMID- 3510020 TI - Indwelling ureteral stents: percutaneous management of complications. AB - Complications of indwelling ureteral stents were managed percutaneously in 13 patients. These complications consisted of three fractured, three heavily encrusted, and seven migrated stents. While most ureteral stent malfunctions are routinely managed with retrograde techniques, the percutaneous approach allows effective clinical management in selected cases in which extensive renal stone material or brittle intrarenal stent fragments are present or when previous surgery or ureteral strictures do not permit a retrograde approach. Fluoroscopically guided removal of migrated stents and percutaneous endoscopic techniques, for complex cases such as those requiring stone removal, were successful and without complications. PMID- 3510021 TI - Twin and singleton growth patterns compared using US. AB - Sonography has been used widely in the evaluation of singleton fetal growth. Twin gestations, however, have received less careful attention. In a statistical study of 103 twin pregnancies, the growth patterns of twin biparietal diameter (BPD), fetal femur length (FFL), and abdominal circumference (AC) were compared with those of singletons. The results of the study revealed a decrease in twin BPD growth after 31 to 32 weeks of gestation relative to singletons. Twin AC growth rate decreases after 32-33 weeks of gestation relative to singletons, but the twin FFL growth pattern does not deviate from that of singletons throughout gestation. Because of the significant difference in growth patterns of BPD and AC between twins and singletons in our population, new growth charts for twin BPD and AC are proposed. PMID- 3510022 TI - Hydrothorax, ascites, and right diaphragmatic hernia. AB - Hydrothorax and/or ascites may be the most striking finding in children with right diaphragmatic hernia. The clinical, radiographic, and pathologic findings of five children with right diaphragmatic defects through which the liver had herniated are described. Three presented with a right hydrothorax, one with a right hydrothorax and ascites, and another with ascites. All four children with large right hydrothoraxes were found to have an incarcerated peritoneal sac filled with fluid in the right side of the chest at surgery or autopsy. Lymphatic congestion and obstruction was the probable cause for the fluid collection, which tended to enlarge with time. This condition may be life threatening, and two of the four patients died soon after birth because of hypoplasia of the lungs. Fetal ultrasonography in both had disclosed right intrathoracic cystic masses, and in one, intrauterine aspiration to decompress the lungs had been attempted. The other two patients are alive and well following surgical repair at 1 week and 7 months of age. Ascites was present in two patients and was believed to be due to hepatic venous obstruction, a mechanism similar to that responsible for the Budd Chiari syndrome. PMID- 3510023 TI - Carotid artery disease: new criteria for evaluation by sonographic duplex scanning. AB - Use of established criteria in duplex sonographic screening for internal carotid artery disease resulted in low sensitivity (52%) and efficiency (82%). Analysis of duplex velocity data in 51 patients (102 vessels) led to the development of two new criteria for significantly diseased vessels: the ratio of the right to left peak systolic average velocities in the common carotid arteries (Vrcca/Vlcca) of less than 0.7 or greater than 1.3, and a peak systolic average velocity in the common carotid artery (Vcca) of less than 25 cm/sec. Addition of these criteria improved our sensitivity and efficiency to 95% and 94%, respectively. PMID- 3510025 TI - The thyroid gland with low uptake lesions: evaluation by ultrasound. PMID- 3510024 TI - Intraarterial digital subtraction arteriographic evaluation of extremity tumors: comparison with conventional arteriography. AB - Conventional arteriography and intraarterial digital subtraction arteriography (IADSA) were compared in 36 patients with primary bone or soft-tissue tumors of the extremities. The sensitivity of IADSA was at least equal to conventional arteriography for demonstrating normal or abnormal major arteries and feeding arteries, equal to or superior for depicting tumor stains or draining veins, but slightly inferior for revealing minute tumor vessels. An increase of the matrix size from 256 X 256 to 512 X 512 improved these sensitivities. IADSA with 15% diatrizoate contrast material eliminated the contrast material-induced pain in all patients. With a computer-controlled iris setting, an average of 5 minutes of procedure time and 1.7 R of radiation (0.44 mC kg) per examination could be saved. IADSA reduced the cost of an examination by an average of $67. The results indicate that IADSA was diagnostic in all instances and can replace conventional arteriography for the evaluation of extremity tumors. PMID- 3510026 TI - Integrated imaging of hepatic tumors in childhood. PMID- 3510027 TI - Differentiation of pulmonary parenchymal consolidation from pleural disease using the sonographic fluid bronchogram. AB - The nature of pleural-based thoracic collections may be sonographically confusing. To help lessen this confusion, the fluid bronchogram, a useful sonographic sign of pulmonary parenchymal consolidation, is described. Bronchi containing fluid in consolidated lung can be identified using ultrasound. PMID- 3510029 TI - Vernix in amniotic fluid: sonographic detection. AB - We investigated the possibility of using sonography to detect vernix caseosa, a complex fatty substance derived from desquamated epithelial cells and sebaceous material. In one of our cases, the sonographic appearance of vernix was dramatic, and its presence was confirmed at amniocentesis. PMID- 3510028 TI - Hepatic artery pseudoaneurysm: diagnosis with real-time and pulsed Doppler US. AB - Duplex ultrasonography (US), consisting of real-time and pulsed Doppler US, was used to identify a pseudoaneurysm in a patient with recurrent bleeding and chronic pancreatitis. The authors present a case that illustrates the limitations of real-time US in evaluating sonolucent masses in pancreatitis and the need for using pulsed Doppler technique. PMID- 3510030 TI - Prostatic evaluation by transrectal endosonography: detection of carcinoma. AB - Transrectal endosonography is one of the most sensitive techniques to evaluate prostatic disease and is far more accurate than conventional sonography. A retrospective review of sonographic characteristics of the prostate was made in an attempt to define the ability of the technique to distinguish benign from malignant disease. Analysis included evaluation of the capsule (smoothness, regularity, and/or invasion), abnormal foci (echogenicity, margination, brightness, thickness, and symmetry), and presence of acoustic shadowing and/or enhancement from the abnormal foci. Evaluation of 443 pathologically proved cases (the majority being large lesions) showed that differentiation between benign and large and/or invasive malignant disease may be suggested by results of transrectal endosonography. However, there is still great overlap of the sonographic appearances. PMID- 3510031 TI - Prostatic evaluation by transrectal sonography: criteria for diagnosis of early carcinoma. AB - Over a 7-month period, from a total of 417 transrectal ultrasound (US) studies, 45 transperineal biopsies of the prostate were performed in the radiology department. Transrectal US guidance and local anesthesia were used. Twenty-two of 32 hypoechoic lesions, located within the peripheral zone tissue of the gland, were proved by histologic study to be cancerous. Hyperechoic lesions were all histologically benign hyperplasias. The patients experienced no major complications necessitating hospitalization or increased length of hospital stay as a result of the procedure. PMID- 3510033 TI - A simple rapid technique for vena cava clip replacement. AB - A method to facilitate clipping of the inferior vena cava is presented. The inferior surface of the clip is protected by a red rubber catheter while being passed behind the vena cava. This avoids any trauma to the posterior wall that may be caused by the serrations or sharp edges of the clip and facilitates passage. Once in place, this catheter is then advanced off the clip and a previously placed silk tie is secured. The operation is then finished expeditiously. Although inferior vena caval clipping has become a less frequently used method of vena cava interruption, definite indications remain for its use and it must be kept in the armanentarium of the surgeon. This method should facilitate the execution of this procedure. PMID- 3510032 TI - Prostatic evaluation by transrectal sonography with histopathologic correlation: the echopenic appearance of early carcinoma. AB - Fifty-two patients with clinical stage A and B carcinomas of the prostate were imaged by ultrasound (US) transrectally with a 5-MHz linear array transducer and transabdominally with a 3-MHz sector scanner prior to radical prostatectomy. The fresh specimens of 44 prostate glands were scanned in a water bath with a 5-MHz linear array transducer in multiple planes. In all cases, histopathologic correlation was obtained. Prostatic carcinoma presented as an echopenic lesion in 54% of the specimens, as a slightly hypoechoic area in 22%, and could not be identified in 24% because of its isoechoic characteristics. In contrast to many previous reports, no instance of echogenic cancer was observed. PMID- 3510034 TI - Refinement of a surgical technique using angulated needle holders and surgical instruments. AB - Surgical techniques can be refined and dexterity improved by using angulated needle holders and instruments. This allows the surgeon to place his or her hand in the position of function while suturing either retrograde or antegrade, thus permitting flexion, extension, abduction, adduction, pronation and supination with circumduction to occur without restriction. Under normal circumstances abduction, pronation and extension are limited by anatomic factors, such as the greater mulitangular abutting the longer styloid process of the radius and the stronger ulnar collateral ligament restricting abduction. The chief indication for using angulated needle holders is in retrograde suturing, such as placing posterior row sutures in anastomosing blood vessels, intestine and the ureter. These instruments are not substitutes for straight needle holders but are chiefly an adjunct that permit the surgeon to perform movements with his hand at the wrist joint that are not allowed with the use of straight needle holders which require greater torque in performing operative procedures. They allow better exposure by improving visibility to the area being sutured since the surgeon is not looking down the barrel of the needle holder and has a clear unobstructed view. The instruments permit clamping and suturing of tissues and vessels in small deep wounds that do not readily admit nonangulated hemostats and needle holders, such as those in urologic and gynecologic operations. Instrument tying is easily accomplished because of the short shaft of the instrument, especially in plastic or surface surgical procedures. Furthermore, with angulation, one is able to grasp the needle holder between the thumb and volar aspect of the second and third digits, thus allowing easy retrograde movements that one experiences in grasping a thumb forceps. From the standpoint of medical egonometrics, hand fatigue is reduced since the needle holder does not have to be locked by closing the rings and engaging the serations each time the needle is handed to the surgeon for placement of sutures. PMID- 3510035 TI - A new method of stomal reconstruction in patients with retraction of conventional ileostomy. AB - A new method of stomal reconstruction has been evaluated in three patients with retraction of a conventional ileostomy associated with special problems. A polyglactin 910 mesh has been used for remodeling of the ileostomy. The observation times vary from 20 to 37 months. There has been no recurrence of retraction in any of the patients during this period. PMID- 3510036 TI - End colostomy and Brooke's ileostomy constructed by surgical stapler. AB - A technique for making an end colostomy and a Brooke's ileostomy using the surgical stapler is described. The resulting stoma is geometrically perfect. No complication or wound infection occurred in a series of 26 stomas observed for up to ten months. The cost of the cartridge may be considered recovered if this technique decreases the operating time by 13 minutes. PMID- 3510037 TI - The use of the skin stapler for drape fixation during operations. AB - Skin staplers used in drape fixation have been found to be effective and safe in a study of 75 patients seen over a period of one year. They are an alternative to the tedious suturing of surgical drapes. PMID- 3510038 TI - Sonographic appearance of the torcular Herophili. AB - The sonograms of 12 infants aged 2 days to 7 months were evaluated to determine if the torcular Herophili could be demonstrated routinely on cranial sonography. Sonography, which was performed for a variety of indications (prematurity, seizures, hydrocephalus, sepsis, congenital anomalies, and subarachnoid hemorrhage) demonstrated the torcular Herophili in all cases. It appeared as a variable-sized, anechoic, and triangular or elongated structure inferior to the occipital lobes, posterior to the cerebellum, and just inside the cranial vault. Correlation with computed tomographic scans was available in four patients. A detailed description of the normal anatomy of the torcular Herophili is provided. Knowledge of the variable sonographic appearance of the torcular Herophili is important to distinguish it from a pathologic entity. PMID- 3510039 TI - Cystic neuroblastoma in infants: radiographic and pathologic features. AB - Cystic neuroblastoma is a rare form of neuroblastoma. Three cases of cystic neuroblastoma in the infant are reported with emphasis on the sonographic findings. In two cases, the tumor was demonstrated in the fetus. The pathologic features of the tumors are described. Development of cysts may be related to a prominent microcystic arrangement of tumor nests. PMID- 3510040 TI - Hepatic artery thrombosis after liver transplantation: radiologic evaluation. AB - Hepatic artery thrombosis after liver transplantation is a devastating event requiring emergency retransplantation in most patients. Early clinical signs are often nonspecific. Before duplex sonography (combined real-time and pulsed Doppler) capability was acquired in October 1984, 76% of all transplants in this institution referred for angiography with a clinical suspicion of hepatic artery thrombosis had patent arteries. In an effort to reduce the number of negative angiograms, CT, real-time sonography, and pulsed Doppler have been evaluated as screening examinations to determine which patients need angiography. Of 14 patients with focal inhomogeneity of the liver architecture detected by CT and/or real-time sonography, 12 (86%) had hepatic artery thrombosis, one had slow arterial flow with hepatic necrosis, and one had a biloma with a patent hepatic artery. In 29 patients undergoing duplex sonography of the hepatic artery, six (21%) had absence of a Doppler arterial pulse. All six had abnormal angiograms: Four had thrombosis, one had a significant stenosis, and one had slow flow with biopsy-proven ischemia. Of 23 patients with a Doppler pulse, two had hepatic artery thrombosis at surgery. However, real-time sonography demonstrated focal inhomogeneity in the liver in both cases. Our data demonstrate that pulsed Doppler of the hepatic artery combined with real-time sonography of the liver parenchyma currently is the optimal screening test for selecting patients who require hepatic angiography after liver transplantation. A diagnostic algorithm is provided. PMID- 3510041 TI - Angiographic and interventional radiologic considerations in liver transplantation. AB - Of 46 liver transplantations performed, 15 patients are alive at follow-up intervals from 2 to 50 months. The most common indications for liver transplantation were biliary atresia, cirrhosis, and neoplasia. About 50% of the patients had pre- and/or postoperative angiograms. Additional material was available from pretransplant workups in patients subsequently shown to be unsuitable for transplantation. Of 13 preoperative angiographic studies, portal vein patency was confirmed in two, inferior vena caval (IVC) patency was confirmed in two, and diffuse neoplasm was identified in three. These patients subsequently had transplants. Conditions precluding liver transplantation in six patients were inadequate portal vein size (less than 5 mm) in two, occluded IVC or portal vein in one each, nonvisualized portal vein in one, and neoplasm localized to one lobe in one. Postoperatively 18 vascular studies identified hepatic arterial compromise in nine, postbiopsy arteriovenous fistula in two, and bleeding from a right adrenal artery in one. Postoperative venography showed thrombosis or occlusion of the IVC in five, portal vein thrombosis in one, and splenic vein thrombosis in one. Of the 18 postoperative angiograms, 12 demonstrated findings considered threatening to the transplants' survival. Six of 18 studies demonstrated findings considered compromising to the transplant. Of the nine postoperative cholangiographic studies, six diagnoses were considered threatening to transplant survival: obstruction of the biliary-enteric anastomosis in four, leakage from the biliary-enteric anastomosis in one, and an abscess from biliary leakage in one. PMID- 3510042 TI - CT body stereotaxis: an aid for CT-guided biopsies. AB - A new body stereotaxic system used to facilitate CT-guided biopsies is described. By scanning through a triangle placed on the patient's skin, the method defines an entry point for the biopsy. An articulating arm is then used to aim the needle at the entry point and hold the needle at the correct angle. The arm can be angled so that complex approaches from one scan plane to another can be made in order to take biopsies of lesions beneath the diaphragm. Using the system, 23 of 25 lesions were hit on the first needle manipulation; two manipulations were needed for each of the other two lesions. In comparison with previous experience, procedure time was decreased and the numbers of needle manipulations and localization scans were decreased 75% and 90%, respectively. PMID- 3510043 TI - The effect of barium suspension viscosity on the delineation of areae gastricae. AB - The viscosity of a barium suspension is an important and controllable variable that influences the quality of mucosal detail demonstrated by double-contrast upper gastrointestinal examination. High-density barium suspensions show a notable viscosity response to seemingly trivial changes in the amount of water added. A double-blind trial involving 600 patients used E-Z-HD of the same batch number suspended with 65-70 ml water. Overall, areae gastricae covering at least 25% of the stomach surface were seen in 68.3%; no or minimal areae gastricae were seen in 31.7%. The corresponding figures for the suspension of optimal viscosity were 80% and 20%, respectively. PMID- 3510044 TI - Floating gallstones in bile without added contrast material. AB - Floating gallstones can occur without the administration of contrast material to increase the specific gravity of bile. This was observed in three patients in 17 months. After a long fast, a large stone was noticed to float because of the high specific gravity of inspissated bile. This stone sank after the patient resumed food intake. In another patient, some stones floated while others sank due to their difference in specific gravity. Sonographic demonstration of a floating stone, however, requires certain strict criteria. PMID- 3510045 TI - Sonography of the hypertrophied column of Bertin. AB - A prospective sonographic analysis of kidneys in 136 adults without clinical or radiologic evidence of renal disease revealed 22 cases of large columns of Bertin. Most were located in the middle third of the kidney, more frequently on the left side. They were bilateral in 18%. Water bath sonograms of normal cadaver kidneys and subsequent anatomic correlation revealed hypertrophied columns and confirmed the sonographic findings seen in vivo. The following are characteristic of a hypertrophied column of Bertin: It is a projection of cortex into the renal sinus (and therefore is isoechogenic with it). The sinus may engulf it in a clawlike fashion. The renal contour is smooth. Sonography is characteristic and obviates further investigation. PMID- 3510046 TI - Abdominal CT in acquired immunodeficiency syndrome. AB - Acquired immunodeficiency syndrome (AIDS) is a lethal infectious disease that has reached epidemic proportions in urban centers of the United States. Intraabdominal opportunistic infections and malignancies are common features of this syndrome. A prodromal phase or possibly milder form of infection is known as the AIDS-related complex. Abdominal computed tomography (CT) in patients with AIDS-related complex often demonstrates a triad of mild retroperitoneal and mesenteric adenopathy, splenomegaly, and perirectal inflammation. Lymph node enlargement greater than 1.5 cm is unusual in the AIDS-related complex and should prompt CT-guided biopsy. Abdominal adenopathy (greater than 1.5 cm) in AIDS, in our experience, is most commonly related to non-Hodgkin lymphoma, Kaposi sarcoma, or infection with Mycobacterium avium-intracellulare. In most instances, CT guided biopsy with appropriate staining technique can readily distinguish these entities. However, the subtyping of non-Hodgkin lymphoma by fine-needle aspiration biopsy alone remains controversial. Unusual features of abdominal malignancies are common in AIDS. These include a purely lymphadenopathic form of AIDS-related Kaposi sarcoma and a predilection for extranodal sites of lymphoma in AIDS. In general, patients with AIDS-related lymphoma present with advanced stages of disease with highly malignant histologic subtypes. Abdominal CT may be useful clinically for diagnosing intraabdominal complications of AIDS. PMID- 3510047 TI - Modern imaging and endoscopic biopsy techniques in Egyptian mummies. AB - Egyptian mummies have been popular subjects of radiographic investigation since 1896. Computed tomography (CT) and magnetic resonance imaging (MRI) have recently been added to the growing list of modern techniques used to study these relics. The Minnesota Mummy Project was organized to examine four well preserved Egyptian mummies dating from the XVIIIth (1575-1308 B.C.) and XXVth (715-663 B.C.) Dynasties. Plain radiographs and CT scans were obtained on all specimens. One individual was selected for additional endoscopic and microscopic correlation with CT findings in the thoracic cavity. The collapsed heart was identified by CT. A percutaneous biopsy of the heart was then performed with a flexible fiberoptic endoscope, passed through a small hole drilled into the chest wall. Microscopy of prepared ventricular specimens revealed striated muscle fibers consistent with myocardium. These results emphasize the utility of CT as a noninvasive paleoradiologic tool. Another mummy was examined by MRI to search for minute quantities of residual moisture possibly trapped within the desiccated tissues. Only a free-induction-decay signal could be obtained, but this was insufficient to generate an image. Thus, it appears that present MRI is not suitable for the paleopathologic investigation of dehydrated structures. PMID- 3510048 TI - Cranial computed tomography in the abused child with head injury. AB - Cranial computed tomographic (CT) findings are described in 37 children with head injuries resulting from physical abuse. CT findings included subarachnoid hemorrhage (27 patients), cerebral edema (24), cerebral hemorrhage (11), and subdural hematoma (nine). Intravenous contrast material was administered in 10 children in whom there were neurologic symptoms or signs but no history or physical signs of trauma or abuse. In five of these children, increased vascularity was seen in areas that later showed infarction. Eight children were studied by both CT and sonography. Sonography detected 50% fewer abnormalities than did CT. It was found that children with skull fracture had the same range of injuries as children without fracture, and they had a higher incidence of subarachnoid hemorrhage. In acutely traumatized children, cranial CT should be the method of choice to provide the most accurate diagnosis and documentation of injury. Skull radiographs should also be obtained because they sometimes show fractures not recognized by CT. PMID- 3510049 TI - Composite lymphoma with immunoblastic features and Langerhans' cell granulomatosis (histiocytosis X). AB - A 50-year-old male with a history of tonsillar and right axillary lymph node enlargement due to atypical lymphoid hyperplasia presented two years later with marked bilateral axillary and inguinal lymphadenopathy. The lymph node biopsy showed a composite lymphoma (follicular, mixed, small and large cell plus B immunoblastic sarcoma) with associated focal Langerhans' cell granulomatosis (LCG) (Histiocytosis X). The diagnosis of composite lymphoma was supported by the immunohistochemical demonstration of two different monoclonal patterns in the follicular and diffuse areas. The typical Birbeck's granules were demonstrated ultrastructurally in LCG areas, which also stained with S-100 protein. LCG may coexist with malignant lymphoma, however, it appears to be confined to the neoplastic nodes with no tendency to systemic spread. It is important to recognize this association so that the impact of this apparently benign lesion (LCG) not be overestimated and that the subsequent management of the patient be directed according to the type of the coexisting malignant lymphoma. PMID- 3510050 TI - Anaerobiospirillum succiniciproducens. Two case reports. AB - Anaerobiospirillum succiniciproducens is a little-known spiral bacterium. Presented here are two septicemia cases similar in that both occurred in rural northern Virginia, both patients presented with dental infection, and in both cases the organism was first suspected to be Campylobacter. The morphology, motility, biochemical, and growth characteristics of Anaerobiospirillum are further defined. PMID- 3510051 TI - Detection of Chlamydia trachomatis in genital specimens by the Microtrak direct specimen test. AB - The conventional cell culture method for detection of Chlamydia trachomatis requires two to six days and is technically difficult to perform. The authors evaluated a new, relatively simple, non-culture method (MicroTrak, Syva Co., Palo Alto, CA) that requires less than one hour to complete. Two hundred fifty-one cervical and 209 male urethral specimens from three Richmond health clinics were read by direct immunofluorescence staining and compared with cell culture technics using iodine staining. Patient specimens were applied directly onto microscope slides (8 mm well) and stained with a fluorescein-labeled monoclonal antibody. Slides were examined for 10-15 minutes at X1,000 using an AO epifluorescent microscope and were considered positive if five or more typical elementary bodies were seen. The sensitivity, specificity, positive and negative predictive values for the direct smear were 89%, 97%, 85%, and 98% for males, and 93%, 96%, 85%, and 98% for females, respectively. The rapid direct specimen test appears to be a satisfactory method for detecting chlamydia in male and female genital specimens. PMID- 3510052 TI - Social medicine vs professional dominance: the German experience. AB - This article describes the efforts by German workers' groups and pioneering social physicians to design health care services oriented to prevention and cost effective treatment. Jews played a key role in developing these prototypes of today's health maintenance organizations (HMOs) and preferred provider organizations (PPOs). The growing success of these services threatened private practitioners in a number of ways. They formed a trade union and took militant action. Stage by stage, the profession asserted its dominance, culminating in an alliance with the National Socialists and Hitler to take over these services and to purge them of socialist and Jewish physicians. Medical societies assisted Hitler in his policies of "purification," and the health care delivery systems shifted from being local, patient-centered, and health-oriented to being national, physician-centered, and focused on curing illness. After World War II, these changes were not reversed as part of denazification, and 40 years later, social medicine has yet to recover. PMID- 3510053 TI - Captopril-induced renal insufficiency. PMID- 3510054 TI - A new Vibrio species, Vibrio cincinnatiensis, causing meningitis: successful treatment in an adult. PMID- 3510055 TI - Intractable hiccups associated with high-dose intravenous methylprednisolone therapy. PMID- 3510057 TI - Inappropriate use of the cerebrospinal fluid Venereal Disease Research Laboratory (VDRL) test to exclude neurosyphilis. AB - Only 3 of 2536 cerebrospinal fluid (CSF) VDRL tests ordered at the Johns Hopkins Hospital in 1980 were positive. Of patients on whom the test was ordered, 226 had a positive or borderline serum fluorescent treponemal antibody absorption test. Records from 156 (69%) of these patients, including all 3 with positive CSF-VDRL tests, were reviewed and showed that the diagnosis of neurosyphilis had been considered only in 44 (28%). One third of records lacked notations of historical and physical findings characteristic of neurosyphilis. Forty seropositive patients who had lumbar puncture to rule out asymptomatic neurosyphilis had negative CSF-VDRL tests; none had neurosyphilis diagnosed. Use of the CSF-VDRL test seemed to represent predominantly "box-checking" on the requisition to rule out neurosyphilis. Yet the test performs better when "ruling in" rather than ruling out neurosyphilis. The Centers for Disease Control should reevaluate its recommendation to rule out neurosyphilis in asymptomatic patients with untreated syphilis of greater than 1 year's duration, given the costs, risks, and dubious benefits. PMID- 3510056 TI - Carcinoembryonic antigen. AB - The level of carcinoembryonic antigen (CEA) is often elevated in the serum of patients with cancer. This article reviews the clinical usefulness of this observation. Carcinoembryonic antigen is not useful for detecting asymptomatic cancer; its sensitivity and specificity are not high, particularly for early stages of disease, so in populations with low prevalence of disease there are many false-positive and false-negative results. Similarly, the antigen level cannot, by itself, provide enough diagnostic certainty to confirm or rule out suspected cancer. For some cancers, antigen levels at the time of diagnosis provide more precise prognosis than staging alone, but this information does not lead to more effective treatment. Serial measurement of CEA levels after surgery in patients with colorectal cancer can detect recurrences early, but few lives can be saved by this approach. Thus, CEA assays provide accurate information about some aspects of cancer but rarely lead to better outcomes for patients. PMID- 3510058 TI - Histopathologic examination in osteochondrodysplasia. Time for standardization. PMID- 3510059 TI - Amyloid formation in prolactinoma. AB - Amyloid deposits within a prolactin-secreting pituitary adenoma were investigated with light and electron microscopy. The appearance of amyloid with Congo red revealed amorphous and round green-yellow birefringence under polarized light. Spheroidal concretions disclosed prolactin-positive areas by immunohistochemistry. The amyloid commonly exhibited a structure of fine fibrils of 10 to 13 nm in width, with a hollow core. The fibrils were usually grouped in compact, stout bundles. Some bundles were present in extracellular space, others were obviously within the adenoma cells. Extracellular amyloid fibrils frequently gathered in a stellate arrangement to make a round body. The presence of intracellular amyloid fibrils in adenoma cells may represent that the source of the amyloid is neoplastic cells rather than mesenchymal cells. In addition, prolactin-positive parts in round bodies presumably exemplify that the amyloid fibrils are formed by hormone-relating proteins. PMID- 3510060 TI - Reduction by the gut microflora of animals and man. PMID- 3510061 TI - The biological properties of reduced nitroheterocyclics and possible underlying biochemical mechanisms. PMID- 3510062 TI - Modification of human low-density lipoprotein by the lipid peroxidation product 4 hydroxynonenal. AB - The effects of the lipid peroxidation product 4-hydroxynonenal on freshly prepared human low-density lipoprotein (LDL) were studied. At a fixed LDL concentration (5.7 mg/ml) the amount of 4-hydroxynonenal incorporated into the LDL increased with increasing aldehyde concentration from 28-30 (0.2 mM) to 140 (1 mM) mol per mol LDL, whereas at a fixed aldehyde concentration (0.2 mM) its incorporation into LDL decreased with increasing LDL concentration from 48 (1 mg LDL/ml) to 26 (12 mg LDL/ml) mol 4-hydroxynonenal bound per mol LDL. Of the total hydroxynonenal taken up 78% was bound to the protein and 21% to the lipid moiety; the remaining 1% was dissolved as free aldehyde in the lipid fraction. Amino acid analysis of the apolipoprotein B revealed that 4-hydroxynonenal attacks mainly the lysine and tyrosine residues and to a lesser extent also serine, histidine and cysteine. Treatment of LDL with 4-hydroxynonenal results in a concentration dependent increase of the negative charge of the LDL particle as evidenced by its increased electrophoretic mobility. Moreover, 4-hydroxynonenal treatment leads to a partial conversion of the apolipoprotein B-100 into higher molecular weight forms most probably apolipoproteins B-126 and B-151. Compared to malonaldehyde, 4 hydroxynonenal exhibits a much higher capacity to modify LDL and it is therefore believed that this aldehyde is a more likely candidate for being responsible for LDL modification under in vivo lipid peroxidation conditions. PMID- 3510063 TI - Stimulation of the methylation pathway for phosphatidylcholine synthesis in rat lungs by choline deficiency. AB - The methylation of phosphatidylethanolamine (PE) to form phosphatidylcholine (PC) was investigated using the isolated rat lung perfused with radiolabeled ethanolamine. Lungs from choline-deficient rats showed increased incorporation of radiolabel into PC at 2 h of perfusion. Increased PC synthesis from PE was also observed with lungs from rats fed a lipotrophic (choline plus methionine deficient) diet when methionine was added to the lung perfusate. These results indicate increased activity of the methylation pathway for lung PC synthesis during choline deficiency. PMID- 3510064 TI - Lipoprotein lipases and stress hormones: studies with glucocorticoids and cholera toxin. AB - The intravenous injection of cholera toxin in rats 17 h prior to experimentation results in increased levels of insulin and corticosterone in the blood. This is accompanied by a rise in lipoprotein lipase activity in muscle and a decrease in adipose tissue. Pre- and postheparin blood levels of the enzyme are increased, representing the higher overall muscle activity. Hepatic lipase is decreased by cholera toxin treatment. These enzyme changes are accompanied by increased levels of non-esterified fatty acids, ketone bodies and unesterified cholesterol in the blood, whereas triacylglycerol levels are lowered. The lipoprotein triacylglycerol secretion is not affected by cholera toxin, suggesting increased triacylglycerol removal from the blood. On the other hand the unesterified cholesterol removal may be decreased due to the decreased hepatic lipase activity. Administration of excess glucocorticoid 2 days prior to blood and tissue sampling also resulted in a rise in lipoprotein lipase, a decrease in hepatic lipase activity and an increase of non-esterified fatty acids. In contrast to the effect of cholera toxin, the triacylglycerol levels were increased. Adrenalectomy, whether by inhibition of 11-beta-steroid hydroxylase or by surgical intervention, did not abolish the choleratoxin effects. It is concluded that corticosterone increase is not essential to the cholera toxin effects. Corticosterone itself probably causes an increase of cyclic AMP and/or Ca2+ levels, as is discussed. PMID- 3510065 TI - Platelet-derived growth factor does not stimulate prostacyclin synthesis by cultured endothelial cells. AB - We examined the effect of highly purified platelet-derived growth factor (PDGF) on prostacyclin (PGI2) release by cultured human umbilical vein and bovine aortic endothelial cells. PDGF tested at concentrations equal to or exceeding those observed in serum did not increase endothelial cell PGI2 synthesis as measured by radioimmunoassay of its metabolite, 6-keto-PGF1 alpha. In contrast, cells incubated with 20% human whole blood serum (WBS) demonstrated significantly increased PGI2 production (fivefold stimulation). Addition of anti-PDGF antibody to the 20% WBS did not attenuate the increased synthesis of PGI2. Incubation with 20% plasma-derived serum (PDS) that was deficient in PDGF produced stimulation of PGI2 release similar to 20% WBS. These results demonstrate that PDGF does not cause increased PGI2 synthesis in cultured human endothelial cells of human or bovine origin, and further suggest that the stimulation observed with serum is not due to a platelet-release product. PMID- 3510066 TI - The risks of central nervous system relapse and leukoencephalopathy in patients receiving marrow transplants for acute leukemia. AB - The records of 415 patients who received allogeneic marrow transplants for acute leukemia were reviewed to assess the risk of central nervous system (CNS) relapse and leukoencephalopathy after marrow transplantation. The Kaplan-Meier estimates of the probability of CNS relapse posttransplant were 13% for patients with acute lymphoblastic leukemia (ALL) and 2% for patients with acute nonlymphoblastic leukemia (ANL). Previous CNS disease was significantly correlated with an increased risk of CNS relapse in patients transplanted for ALL but not for ANL. In contrast, bone marrow involvement with leukemia at the time of transplant was associated with an increased risk of CNS relapse in patients with ANL but not in patients with ALL. Seventy-one patients with ALL did not receive posttransplant intrathecal methotrexate (IT-MTX) and 127 did. The probability of CNS relapse in these two groups was 38% and 7%, respectively (P less than .02). This protective benefit from IT-MTX was present in patients both with and without a history of CNS involvement or marrow involvement at the time of transplant. In patients with ANL, 116 patients did not receive posttransplant IT-MTX and 101 patients did, but no protection from CNS relapse was observed from IT-MTX irrespective of a patient's previous CNS history or marrow status at the time of transplant. Leukoencephalopathy was seen exclusively in patients who had received radiation and/or intrathecal chemotherapy to the CNS before preparation for marrow transplantation and posttransplant IT-MTX. In such patients the risk of leukoencephalopathy was 7%. From our data, it appears that posttransplant IT-MTX is a significant benefit for ALL patients in preventing CNS relapse after marrow transplantation. A similar benefit from posttransplant IT-MTX for ANL patients cannot be established from this study. In both groups, increasing total CNS therapy was associated with an increasing risk of leukoencephalopathy. PMID- 3510067 TI - Fracture of a polyethylene acetabular cup: a case report. AB - Fracture of a polyethylene acetabular cup is rare. Current theories of its cause emphasize wear of the component. The case reported illustrates the presence of a loosening membrane in association with cup fracture. Histologic study of the loosening membrane indicated a foreign-body reaction to polyethylene and acrylic wear particles. The authors propose a theory relating micromotion of the acetabular component to the production of particles of wear with a subsequent foreign-body reaction followed by further loosening. The erosion of bony support leads to the concentration of stress at the junction of the supported and unsupported segments. This may ultimately result in fracture of the cup. PMID- 3510068 TI - Hemorrhagic colitis due to Escherichia coli O157:H7. A rare disease? PMID- 3510069 TI - Postpartum psychiatric disorders. AB - Postpartum blues, postpartum neurotic depression and puerperal psychoses have distinct clinical features; they affect women in all social classes and in all cultures, and despite numerous studies they have not been linked definitively with any biologic or psychosocial variables. The only possible exception is puerperal psychosis, which emerges much more often in women with a personal or family history of a bipolar affective disorder than in women without, a finding that probably explains the reluctance of some researchers to recognize puerperal psychotic episodes as distinct from psychotic episodes at other times. If postpartum blues last longer than 2 weeks and are disabling they are classified as neurotic depression and warrant treatment, often requiring both psychosocial approaches and psychotropic drug therapy. Antidepressants, major tranquillizers, electroconvulsive therapy and lithium have proved effective in the treatment of postpartum psychoses, depending on the symptoms. Both lithium and diazepam have been reported to cause deleterious side effects on breast-fed infants, and as the side effects of other psychotropic drugs given to a nursing mother are imperfectly understood, bottle feeding seems prudent. PMID- 3510070 TI - Sporadic occurrence of hemorrhagic colitis associated with Escherichia coli O157:H7 in Newfoundland. AB - During a 9-month period in 1984, 113 fecal samples obtained from 92 patients with diarrheal illness were cultured for Escherichia coli serotype O157:H7 to determine the occurrence of this agent in diarrheal illness in Newfoundland. E. coli O157:H7 was isolated in almost pure culture from 12 stool specimens obtained from 7 (15%) of the 47 patients who had grossly bloody diarrhea; none of the 12 yielded any of the usual enteric pathogens. The agent was not isolated from the stool specimens obtained from the remaining 45 patients, who did not have bloody diarrhea. All seven patients whose specimens were positive for E. coli O157:H7 had clinical manifestations typical of hemorrhagic colitis, but the syndrome was clinically suspected and a specific test requested in only two cases. The seven cases were not clustered geographically or temporally, and no common exposure was identified. To determine whether hamburger meat was the source of E. coli O157:H7, 66 samples obtained from various retail outlets were tested; none were found to be positive. Hemorrhagic colitis may be a common disease, and E. coli O157:H7 should be considered as an agent in bloody diarrheal illness. PMID- 3510071 TI - Hemorrhagic colitis in a nursing home in Ontario. PMID- 3510072 TI - Early invasive carcinoma in colonic polyps. A review of the literature with emphasis on the assessment of the risk of metastasis. AB - The proper treatment of adenomatous colonic polyps containing small foci of invasive cancer is controversial because the metastatic potential of these lesions is not precisely known. This article critically reviews all known English language studies of this lesion. Before the introduction of colonoscopic polypectomy, the estimated incidence of metastasis from this lesion was 10.4% (based on 12 studies containing 347 polyps), with a confidence interval (95% level) of 7.4 to 14.1. The incidence of metastasis estimated from lesions removed via colonoscopic polypectomy was 10.1% (based on 13 studies containing 188 polyps), with a confidence interval of 5.9 to 14.8. Differences in the definitions of the involved lesions, study designs, and indications for resection cause problems with case selection bias and make comparison of studies difficult. These problems are discussed in detail. Most studies had broad confidence intervals for the estimated incidence of metastasis because of small sample size. The histopathologic criteria, as reflected in the literature, for considering polypectomy alone as adequate treatment for this lesion are summarized and discussed. PMID- 3510073 TI - Communicating with hospitalized children. PMID- 3510074 TI - Kinetics of thermotolerance in normal and tumor tissues: a review. AB - Thermotolerance is a phenomenon in which cells become resistant to elevated temperatures as a result of prior or continuous exposure to hyperthermia. Thermotolerant cells exhibit a decreased slope of the cell survival curve. Recent studies disclosed that thermotolerance developed in rodent tumors and normal tissues as well. Thermotolerance develops during the treatment at a temperature below approximately equal to 43.0 degrees C, or it develops rapidly after the first heat treatment. The decay of thermotolerance is slow and is incomplete over 7 days in many normal tissues, while it appears to be completed in murine tumors. The kinetics of thermotolerance is modified by various factors. In general, the greater the initial heat damage (independently of temperature), the greater is the magnitude of thermotolerance and the longer is the time to reach maximum and the time to decay. Although thermotolerance develops less extensively in cultured cells in low pH medium and the average tumor tissue pH is lower than the normal tissue pH, the magnitude of thermotolerance in tumors thus far examined is at least equal to that in the normal tissues. Data on the interaction between thermotolerance and radiosensitivity are contradictory, although thermotolerance appears to reduce thermal radiosensitization. The kinetics of reduced sensitization is similar to that of thermotolerance. The interaction between chemotherapeutic agents and thermotolerance appears to depend on the drug and the temperature. Experimental data on this topic are still sparse and extensive studies are required. PMID- 3510075 TI - Monoclonal antibody-directed analysis of cytochrome P-450-dependent monooxygenases and mutagen activation in the livers of DBA/2 and C57BL/6 mice. AB - Monoclonal antibodies (MAb 1-7-1 and Mab 2-66-3) specific for cytochrome P-450 (cyt. P-450) isozymes inhibited the metabolism of carcinogens, other xenobiotics, and endogenous compounds in two strains of mice. Postmitochondrial liver supernatant (S9) was prepared from untreated, 3-methylcholanthrene-treated, phenobarbital-treated, and pregnenolone 16 alpha-carbonitrile-treated C57BL/6 (B6) and DBA/2 (D2) mice. The modifying effect of two types of MAb to a 3 methylcholanthrene-induced cyt. P-450 and a phenobarbital-induced cyt. P-450 was investigated for: (a) S9-mediated mutagenicity of aflatoxin B1, benzo(a)pyrene 7,8-dihydrodiol, 2-acetylaminofluorene, and N-nitrosomorpholine in Salmonella typhimurium strains; and (b) the activity of aryl hydrocarbon hydroxylase, ethoxycoumarin O-deethylase, ethoxyresorufin O-deethylase, aminopyrine N demethylase, and testosterone 6 beta-, 7 alpha-, and 16 beta-hydroxylases. With certain S9s, MAb-1-7-1 inhibited only those cytochrome P-450 isozymes involved predominantly in activity of aryl hydrocarbon hydroxylase, ethoxyresorufin O deethylase, and ethoxycoumarin O-deethylase and mutagenicity of 2 acetylaminofluorene and benzo(a)pyrene 7,8-dihydrodiol; MAb 2-66-3 inhibited only those involved in aminopyrine N-demethylase and testosterone 6 beta-, 7 alpha, and 16 beta-hydroxylase activity and aflatoxin B1 mutagenicity. Both Mab 1-7-1 and MAb 2-66-3 inhibited cytochrome P-450 isozyme(s) implicated predominantly in testosterone 7 alpha-hydroxylation in S9 from pregnenolone 16 alpha-carbonitrile treated B6 mice. MAb 1-7-1 did not inhibit N-nitrosomorpholine mutagenicity and MAb 2-66-3 increased it by 2- to 6-fold depending on the source of S9. Using these MAbs, it is thus possible to identify the contribution of the epitope defined single or class of cyt. P-450 to specific metabolic reactions in S9 from untreated and inducer-treated mice. PMID- 3510076 TI - Immunohistochemical localization of placental alkaline phosphatase, carcinoembryonic antigen, and cancer antigen 125 in normal and neoplastic human lung. AB - Human placental alkaline phosphatase (HPLAP), carcinoembryonic antigen (CEA), and cancer antigen 125 (CA 125) were localized immunohistochemically in paraffin sections of normal lung tissue from 16 patients, using monoclonal antibodies and an indirect avidin-biotin-peroxidase staining procedure. HPLAP and CEA were present in epithelial cells of respiratory bronchioli and alveolar type I pneumocytes. CEA was also observed in the tracheal, bronchial, and bronchiolar epithelium. CA 125 was present in the tracheal, bronchial, bronchiolar, and terminal bronchiolar epithelium; in the tracheal and bronchial glands; and in the pleural mesothelium. Normal and hyperplastic type II pneumocytes were negative for HPLAP, CEA, and CA 125 but were histochemically positive for nonspecific alkaline phosphatase. Fetal lung tissue between 11 and 15 weeks of gestation was negative for HPLAP, CEA, and CA 125. The fetal tracheal and bronchial epithelium, tracheal glands, and pleural mesothelium were positive for CA 125. For ten malignant pulmonary tumors investigated, HPLAP staining was observed in five, CEA in nine, and CA 125 in seven. The localization of HPLAP, CEA, and CA 125 in apparently normal constituents of all pulmonary specimens is in disagreement with the concept that the expression of these substances in the lung is indicative of abnormal cellular activity. PMID- 3510077 TI - Insertion of an R1 plasmid into the origin of replication of the E. coli chromosome: random timing of replication of the hybrid chromosome. AB - A 16 bp BgI II fragment was deleted in vitro from the minimal origin of replication of the Escherichia coli chromosome, oriC, and was replaced by a 10 kb R1 miniplasmid, pKN1562, containing the basic R1 replicon and a kanamycin resistance gene. The deletion-insertion was transferred by homologous recombination into the chromosome of a dnaA(ts) strain. P1 transduction separated the origin "mutation" from the dnaA46 allele. Integration of mini-R1 into oriC was verified by Southern blotting and by analysis of the R1 incompatibility phenotype. It was possible to isolate normal R1 miniplasmids from the integrated R1. Chromosome replication was initiated at random times after a short delay. The constructed strains grew 20%-30% slower than the wild type and showed more heterogeneous cell sizes. PMID- 3510078 TI - Biological and biochemical properties of human rasH genes mutated at codon 61. AB - Using site-directed mutagenesis, we have introduced mutations encoding 17 different amino acids at codon 61 of the human rasH gene. Fifteen of these substitutions increased rasH transforming activity. The remaining two mutants, encoding proline and glutamic acid, displayed transforming activities similar to the normal gene. Overall, these mutants vary over 1000-fold in transforming potency. Increased levels of p21 expression were required for transformation by weakly transforming mutants. The mutant proteins were unaltered in guanine nucleotide binding properties. However, all 17 different mutant proteins displayed equivalently reduced rates of GTP hydrolysis, 8- to 10-fold lower than the normal protein. There was no quantitative correlation between reduction in GTPase activity and transformation, indicating that reduced GTP hydrolysis is not sufficient to activate ras transforming potential. PMID- 3510079 TI - Normal stoichiometry of histone dimer sets is necessary for high fidelity of mitotic chromosome transmission. AB - To identify gene products that function stoichiometrically in mitotic chromosome transmission, genes were cloned on high copy number plasmids and transformed into yeast cells, and the transformants were examined for an increase in the frequency of mitotic chromosome loss or recombination resulting from the gene imbalance. When either pair of the yeast histone genes H2A and H2B, or H3 and H4 was present on high copy number plasmids, both chromosomes V and VII exhibited an increased frequency of chromosome loss. The rate of chromosome loss was not elevated when the histone genes were present on single copy plasmids, when their transcription from high copy plasmids was repressed, or when frame-shift mutations were present in the coding sequence. This method for the identification of genes circumvents some of the limitations of traditional mutational analysis and yields the cloned gene. PMID- 3510080 TI - Isolation of two genes that affect mitotic chromosome transmission in S. cerevisiae. AB - Two DNA sequences that reduce mitotic fidelity of chromosome transmission have been identified: MIF1 and MIF2. MIF1 is a unique sequence located on the right arm of chromosome XII that stimulates loss and recombination for both chromosomes V and VII when present in a high copy number plasmid. MIF1 is not essential for cell division but is necessary for the normal fidelity of chromosome transmission. MIF2 is a unique sequence located 15 cM distal to HIS6 on chromosome IX that induces a high frequency of chromosome VII loss and a lower frequency of chromosome V loss when present in high copy number; it has no effect on mitotic recombination. Disruption of the genomic MIF2 locus was lethal and cells lacking this function arrested division with a terminal phenotype characteristic of a block in DNA replication or nuclear division. PMID- 3510081 TI - A gene required for the separation of chromosomes on the spindle apparatus in yeast. AB - We describe the phenotypes caused by a cold-sensitive lethal mutation (ndc1-1) that defines the NDC1 gene of yeast. Incubation of ndc1-1 at a nonpermissive temperature causes failure of chromosome separation in mitosis but does not block the cell cycle. This defect results in an asymmetric cell division in which one daughter cell doubles in ploidy and the other inherits no chromosomes. The spindle poles are properly segregated to the two daughter cells. The primary visible defect is that the chromosomes remain associated with only one pole, and are thus delivered to one daughter cell. Meiosis II, but not meiosis I, is sensitive to the ndc1-1 defect, suggesting that NDC1 is required for some feature common to mitosis and meiosis II. ndc1-1 appears to define a new class of cell cycle gene required for the attachment of chromosomes to the spindle pole. PMID- 3510082 TI - Chromosome size polymorphisms in Plasmodium falciparum can involve deletions and are frequent in natural parasite populations. AB - A comparison of independent cultured isolates of Plasmodium falciparum revealed that while chromosome number was constant, the sizes of analogous chromosomes varied widely. We show here that chromosome size polymorphisms are not generated during differentiation of the asexual blood stages, as the molecular karyotype of a cloned parasite line is constant through this part of the life cycle. Experiments using whole P. falciparum chromosomes as hybridization probes to examine polymorphisms within two independent parasite populations indicate that the polymorphisms observed here are not the consequence of large-scale interchromosomal exchanges, and imply that deletions/duplications represent one mode of generating chromosome length polymorphisms. Although the deletions probably involve repetitive DNA, we show here that structural genes for P. falciparum antigens can also be lost. Furthermore, these dramatic size polymorphisms occur not only in cultured lines of P. falciparum, but with surprising frequency in natural malarial infections. PMID- 3510083 TI - Prevention of coronary heart disease--propaganda, promises, problems, and prospects. PMID- 3510084 TI - Comparative accuracy of two-dimensional echocardiography and Doppler pressure half-time methods in assessing severity of mitral stenosis in patients with and without prior commissurotomy. AB - This study was undertaken to compare the accuracies of the two-dimensional echocardiographic (2DE) and Doppler pressure half-time methods for the noninvasive estimation of cardiac catheterization measurements of mitral valve area in patients with pure mitral stenosis both with and without a previous commissurotomy. Data were retrospectively obtained from 74 consecutive patients who underwent cardiac catheterization within a 30 month period for evaluation of mitral stenosis, and who had two-dimensional echocardiograms performed before catheterization. Six patients (8.1%) had technically inadequate 2DE images and their data were excluded from analysis. Two of these patients had undergone commissurotomy, while the remaining four had not. Continuous-wave Doppler echocardiographic examinations were attempted in 45 patients and adequate measurements of pressure half-times were obtained in all patients studied. Mitral valve area by two-dimensional echocardiography was measured as the planimetered area along the inner border of the smallest mitral orifice visualized during short-axis scanning, while pressure half-time was calculated as the interval between the peak transmitral velocity and velocity/square root 2 as measured from the envelope of the Doppler spectral signal. Calculations from catheterization represented the minimal valve area at rest as derived from the Gorlin formula with the use of pressure gradients and thermodilution measurements of cardiac output. Thirty-seven of the patients had had a previous mitral commissurotomy a mean of 11.2 +/- 5.4 years before, while the remaining 37 patients were previously unoperated. Mean valve area as determined at catheterization for the total group of patients ranged from 0.37 to 2.30 cm2 (mean = 1.08 +/- 0.42 cm2).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3510085 TI - Immediate and short-term hemodynamic effects of diltiazem in patients with hypertension. AB - The immediate effects of intravenous diltiazem effects and short-term (4 weeks) of the oral drug on systemic and regional hemodynamics, cardiac structure, and humoral responses were evaluated by previously reported methods in nine patients with mild-to-moderate essential hypertension and in one patient with primary aldosteronism. Diltiazem was first administered in three intravenous doses of 0.06, 0.06, and 0.12 mg/kg, respectively; patients were then treated for 4 weeks with daily doses ranging from 240 to 360 mg (average 300 mg). Intravenous diltiazem immediately reduced mean arterial pressure (from 115 +/- 3 to 96 +/- 3 mm Hg; p less than .01) through a fall in total peripheral resistance index (from 37 +/- 3 to 23 +/- 2 U/m2; p less than .01) that was associated with an increase in heart rate (from 66 +/- 2 to 77 +/- 3 beats/min; p less than .01) and cardiac index (from 3.3 +/- 0.3 to 4.3 +/- 0.4 liters/min/m2; p less than .01). These changes were not associated with changes in plasma levels of catecholamines or aldosterone or in plasma renin activity. After 4 weeks the significant decrease in mean arterial pressure persisted (104 +/- 3 mm Hg; p less than .01) and there were still no changes in the humoral substances or plasma volume. Renal blood flow index increased (from 368 +/- 52 to 462 +/- 57 ml/min/m2; p less than .01) and renal vascular resistance index decreased (from 0.37 +/- 0.06 to 0.26 +/- 0.04 U/m2; p less than .01), while splanchnic hemodynamics did not change.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3510086 TI - Digitalis--a new controversy regarding an old drug. The pitfalls of inappropriate methods. PMID- 3510087 TI - Is catch-22 alive and well and living at NHLBI? Reactions to 'digitalis--a new controversy regarding an old drug'. PMID- 3510088 TI - The effects of changes in physical activity on major cardiovascular risk factors, hemodynamics, sympathetic function, and glucose utilization in man: a controlled study of four levels of activity. AB - The effects of four levels of activity on heart rate, blood pressure, cardiac index, total peripheral resistance index (TPRI), norepinephrine (NE) spillover rate, insulin sensitivity, and levels of lipids and some hormones were studied in 12 normal subjects. The randomized periods were (1) 4 weeks of below-sedentary activity, (2) 4 weeks of sedentary activity, (3) 4 weeks of 40 min of bicycling three times per week, and (4) 4 weeks of similar bicycling seven times per week. Exercise three times per week reduced resting blood pressure by 10/7 mm Hg (p less than .01) and it was reduced by 12/7 mm Hg after exercise seven times per week (both p less than .01). This was associated with reduction in TPRI, an increase in cardiac index, and cardiac slowing. At the highest level of activity, NE spillover rate, an index of sympathetic activity, fell to 35% of the sedentary value (p less than .001) in eight of 10 subjects. In two other subjects NE spillover rate rose, although blood pressure and TPRI were reduced. Metabolic changes included lowering of total cholesterol, but high-density lipoprotein level was unchanged. Insulin sensitivity rose by 27% after exercise three times per week, but declined to sedentary levels with seven times per week exercise. Maximum oxygen uptake increased linearly with activity. Exercise performed three times per week lowers blood pressure and should reduce cardiovascular risk. The same exercise seven times per week enhances physical performance with little further reduction in cardiovascular risk factors. Exercise is potentially a major nonpharmacologic method of lowering blood pressure. PMID- 3510089 TI - Cardiac Doppler flow velocities in human fetuses. AB - Cardiac Doppler flow velocity studies were performed in normal human fetuses between 18 and 40 weeks of gestation. Two-dimensional linear array and sector scanning techniques were used for the initial evaluation of the fetuses, which included a standard ultrasound examination to determine normal anatomy and estimated gestational age and weight. Fetal cardiac ultrasound examination was then performed, with four-chamber, short-axis/great vessel, long-axis/left ventricular outflow tract, and aortic arch views obtained. Pulsed echo Doppler instrumentation was used to obtain flow velocity measurements through the tricuspid, pulmonary outflow, mitral, and aortic outflow regions. Calculation of transvalve volume flow for mitral and tricuspid valves was performed by combining the valve anulus sizes and calculated mean temporal velocities for the valves. Maximal flow velocities were greater through the tricuspid (mean maximal velocity 51 +/- 1.2 [SE] cm/sec) than through the mitral (47 +/- 1.1 cm/sec; p less than .05) valve regions, with a wide range of scatter for results between fetuses but less than 6% average variation in the individual fetuses during gestation. For 18 fetuses, right heart dimensions and volume flows (mean 307 + 30 ml/kg/min) were greater than left heart dimensions and volume flows (232 +/- 25 ml/kg/min). Doppler echocardiography may prove to be useful as an adjunct to imaging echocardiography for evaluation of fetal cardiac anatomy and function. PMID- 3510090 TI - Competitive solid-phase enzyme immunoassay for measuring digoxin in serum. AB - In this clinically useful enzyme immunoassay of digoxin in serum, we mix sample, beta-galactosidase-labeled digoxin, and anti-digoxin Fab fragments for 30 min at room temperature, then use Sepharose-bound second antibody for phase separation, and measure the unbound enzyme activity directly in the supernate of the equilibrium reaction mixture. The immunoassay buffer--phosphate-buffered isotonic saline with added rabbit globulin (4 g/L), hydrolyzed gelatin (2 g/L), Brij 96 detergent (5 g/L), glycerol (0.25 mol/L), and N-acetyl-8-anilinonaphthalene-1 sulfonic acid (2 mmol/L)--minimizes serum matrix effects for convenient measuring of unbound enzyme--digoxin conjugate. The immunoassay developed with Fab fragments has better displacement characteristics than that with intact antibody. Performance of the assay compares favorably with that of other manual digoxin immunoassays; in comparison studies with EMIT involving 110 clinical specimens, the coefficient of correlation was 0.97. PMID- 3510091 TI - Plasma cholinesterase phenotyping with use of visible-region spectrophotometry. AB - A method that overcomes the difficulties of the 240-nm benzoylcholine method for phenotyping plasma cholinesterases has been developed. After a timed reaction, under the same reaction conditions as in the classic procedure, choline is detected at 500 nm by use of choline oxidase coupled with the peroxidase/phenol/aminoantipyrine system. Cholinesterase activity measurements, calibrated by use of choline iodide as standard, are linearly related to results obtained with propionylthiocholine as substrate at 25 degrees C (y = 0.14x + 0.17, n = 30, r = 0.98). Results of differential inhibition with dibucaine and fluoride are virtually identical with those obtained by the ultraviolet method (y = 0.97x + 4.3, r = 0.995, and y = 0.93x - 0.5, r = 0.987, respectively) and give the same classification of homo- and heterozygotes for the usual, atypical, and fluoride-resistant variants. The new method has substantial advantages in that it eliminates the difficulties associated with measuring small changes in high absorbances at a suboptimal wavelength on a steep portion of the absorption curve. PMID- 3510092 TI - Enzyme immunochromatographic assay of phenytoin in capillary and venous blood compared with fluorescence polarization immunoassay of plasma from epileptic patients. PMID- 3510093 TI - Ivar Christian Bang (1869-1918), founder of modern clinical microchemistry. PMID- 3510094 TI - Samuel Natelson, clinical chemist. PMID- 3510095 TI - Stability of insulin in normal whole blood. PMID- 3510096 TI - Digoxin--issues and controversies. AB - This review deals briefly with the clinical pharmacology of digoxin and reviews in some depth the problems inherent in methods of digoxin measurement. Digoxin like factors (materials that cross react in digoxin immunoassays) are discussed, and some current evidence suggesting the existence of a new hormone, endoxin (endogenous digoxin), is summarized. PMID- 3510097 TI - Plasma lipase properties as related to pancreatic condition. AB - We examined the sensitivity to colipase of two types of lipase (EC 3.1.1.3) activity in plasma. Results were very similar for plasma lipase corresponding to that found in cases of acute pancreatitis and for swine pancreas lipase, whereas we found some differences between "pancreatitis lipase" and lipase from healthy subjects. Gel-filtration experiments suggest that the two forms of lipase in plasma have different relative molecular masses; moreover, their avidity for antibodies against human pancreatic lipase differs. Guided by these studies, we propose optimal conditions for nephelometry of "pancreatitis" lipase. PMID- 3510098 TI - Direct enzymic measurement of glycerides in serum and in lipoprotein fractions. AB - A simple two-step procedure is now available for directly measuring triglycerides in whole serum and in lipoprotein fractions. I tested the performance of the assay, using pooled serum stored frozen, freshly prepared lipoprotein fractions, and pure glyceride standards. A parabolic concentration-response curve ensured linearity well beyond total glycerol concentrations of 10 mmol/L, but gave rise to misleading results for massively lipemic samples. Within-day CVs averaged 2.2% for the stored-frozen serum pools; mean day-to-day variation was 2.4%. Analytical recoveries of triglycerides, after lipoprotein fractionation, ranged between 101.9 and 103.7%. Aqueous glyceride standards gave results equivalent to between 95 and 105% of their glycerol content. PMID- 3510099 TI - Cells involved in the immune response. XXXI. The role of the spleen in the primary and secondary immune responses in the normal adult outbred rabbit: the initial localization of memory cells to the spleen and their subsequent dissemination to the thymus and peripheral lymph nodes. AB - Normal adult outbred rabbits were immunized intravenously (iv) with sheep erythrocytes (SRBC). At varying times thereafter, the different lymphoid organs were investigated for spontaneous and culture-induced antibody secreting cells by the aqueous hemolytic plaque-forming cell (PFC) technique. During the phase of active antibody formation (Days 3 to 30), immediate PFC, indicative of spontaneous antibody synthesis and secretion, were detected principally in the spleen. In the early postimmune memory period (Days 30 to 90), memory cells capable of generating PFC following secondary immunization in in vitro culture with SRBC were detected only in the spleen. However, by 4 months postimmunization, memory cells were detected in the thymus and popliteal lymph node (PLN) as well as in the spleen. The number of memory cells in the thymus and PLN was significantly higher by 6 months postprimary iv immunization and was even further elevated by 9 months postprimary iv immunization. Following in vivo secondary immunization by the iv injection of SRBC 2 or 6 months postprimary immunization, immediate PFC were detected in large numbers in the spleen, the bone marrow, and the blood, marginally in the PLN and not at all in the thymus. Similar results were obtained at 9 months following primary immunization with SRBC with the exception that large numbers of immediate PFC were detected in the PLN following secondary iv immunization. Following culture of these lymphoid cells for 5 days in vitro with SRBC, the thymus and PLN cells, as well as the spleen cells, generated large numbers of PFC. Since immediate PFC were never detected among the freshly isolated thymus cells whereas thymic cell cultures 6 and 9 months postprimary iv immunization invariably generated large numbers of PFC following secondary immunization in vitro, the thymus memory cells would appear to be inaccessible to particulate antigen injected intravenously; they can only be detected following activation by the antigen in culture. The PFC generated by thymus memory cells (and spleen and PLN) were totally inhibited by the inclusion of sheep anti-rabbit IgG into the PFC assay. This finding demonstrates unequivocally that the plaques induced by thymus cells, just as the plaques induced by spleen and PLN cells, are antibody mediated and not false plaques. Therefore, the thymic PFC cells must be antibody-secreting B-memory cells since T cells do not synthesize or secrete immunoglobulins. PMID- 3510100 TI - T-cell subsets and natural killer activity in Plasmodium falciparum-infected children. AB - Thirty children acutely infected by Plasmodium falciparum and suffering either benign uncomplicated malaria (17 cases), or cerebral malaria (13 cases), were investigated for T-cell number and subset distribution among peripheral blood mononuclear cells using OKT3, OKT4, and OKT8 monoclonal antibodies, and for natural killer (NK) activity using K562 cells as targets. They were compared to a group of 16 age- and sex-matched healthy Senegalese children. OKT8 cell percentage was found increased in both groups of patients with a decrease of OKT4 cell percentage in cerebral malaria patients only. Both groups thus exhibited a decreased OKT4/OKT8 ratio, which was slightly lower in cerebral malaria cases than in benign cases. NK activity was found elevated in uncomplicated cases of malaria, in contrast to patients suffering cerebral malaria, who exhibited a profound depression of NK activity. PMID- 3510101 TI - Chlamydia trachomatis (L2 serovar) binds to distinct subpopulations of human peripheral blood leukocytes. AB - We have previously shown that infants with pneumonitis caused by Chlamydia trachomatis, an obligate intracellular bacterium, possess increased percentages of B lymphocytes but not T lymphocytes in their peripheral blood. It was then demonstrated that chlamydiae induce proliferation in vitro of human peripheral blood B lymphocytes and, in the presence of T cells, differentiation of B cells to immunoglobulin-secreting cells. In this study, we show that C. trachomatis (L2 serovar) binds preferentially to 50% of human B lymphocytes from peripheral blood but only to a small percentage, if any, of T cells. Both monocytes and granulocytes bind and ingest chlamydiae. Despite chlamydial binding to B cells and ingestion by monocytes, no uptake by B cells and limited growth (fewer than 0.5% inclusion-containing cells) in monocytes occur. There is a dramatic decrease in the percentage of cells associated with the bacteria after culture. These results are the first demonstration of binding of C. trachomatis (L2 serovar) to lymphocytes and represent a direct step toward correlating physical interactions between bacteria and lymphocytes with specific immunostimulatory activities in vitro. PMID- 3510102 TI - Flow cytometric analysis of lymphocyte phenotypes in AIDS using monoclonal antibodies and simultaneous dual immunofluorescence. AB - Simultaneous dual immunofluorescence and flow cytometry was used to study sixteen lymphocyte phenotypes in 209 men including: healthy homosexuals, lymphadenopathy patients (LAN), and AIDS patients. Significant differences between the distribution of lymphocytes in healthy homosexuals and healthy heterosexuals were decreased percentages of helper/inducer T cells (Leu 3), increased cytotoxic/suppressor T cells (Leu 2), and consequently a decreased Leu 3/Leu 2 ratio. The increased Leu 2 cells were identified as functionally cytotoxic subset Leu 2+ 15- phenotype rather than suppressor cells which are Leu 15+. Leu 2 and Leu 3 bearing cells exhibited an excess of membrane-bound immunoglobulins which were easily elutable at 37 degrees C. An increased percentage of an HLA-DR framework determinant bearing T cells were also detected. Within the NK cell family, Leu 7 cells were moderately increased and the functionally unidentified Leu 2+ 7+ population was strikingly elevated. LAN or AIDS patients were compared to healthy homosexual controls. Lower percentages of Leu 3 cells and higher percentages of Leu 2 cells were evident in LAN patients. These subsets were similar in LAN and AIDS patients. The increase in Leu 2+ cells was due to the Leu 2+ 15- cytotoxic subset. Fewer T cells had immunoglobulin in LAN and AIDS. A definite increase in Leu 2+ DR+ cells but not Leu 3+ DR+ cells occurred in AIDS compared to LAN or healthy controls. NK cell changes already present in healthy homosexuals persisted in LAN and AIDS patients. No differences in the distribution of B cells was detected in any intergroup comparisons. Changes in monocytes or pan-T cells were relatively insensitive measures of immunologic alterations among any of the groups. These results indicate many of the changes in lymphocyte subsets seen in AIDS and LAN subjects are already present in a carefully screened population of healthy homosexuals in San Francisco. Many of the changes in Leu 2 and NK family of cells suggest a possible adaptive response to viral or neoplastic challenge. Whether these interesting phenotypic alterations relate to functional changes in response to such challenge of the identified subsets waits further investigation. PMID- 3510103 TI - Dimethyl sulfoxide (DMSO): a review. AB - Dimethyl sulfoxide (DMSO) is a very simple compound that has stimulated much controversy in the scientific and popular literature. Fig. 1 It is an aprotic solvent. Therapeutic and toxic agents that are not soluble in water are often soluble in DMSO. DMSO has a very strong affinity for water; on exposure to air, pure DMSO is rapidly diluted. DMSO's physiologic and pharmacologic properties and effects are incompletely understood. Properties that are considered to be particularly important to its therapeutic and toxic effects include: its own rapid penetration and enhanced penetration of other substances across biologic membranes; free radical scavenging; effects on coagulation; anticholinesterase activity; and DMSO-induced histamine release by mast cells. DMSO's systemic toxicity is considered to be low. Combinations of DMSO with other toxic agents probably constitute its greatest toxic potential. The scientific literature is reviewed with particular attention to mechanisms underlying DMSO's reported therapeutic and toxic effects. Currently approved, veterinary applications of DMSO are limited. DMSO's potential value in specific, approved and unapproved veterinary applications is discussed. PMID- 3510104 TI - High risk of nosocomial infection in the pediatric critical care patient. AB - During this one-year prospective study, 61 (13.7%) of 444 patients admitted to the pediatric ICU at the University of Virginia Hospital developed nosocomial infections. By comparison, general medical/surgical ward patients had an overall 4.8% risk of acquiring an infection during their hospital stay. Patients who had prolonged ICU stays and those on plastic surgery, neurosurgery, and pediatric surgery services were more likely to become infected. The four bloodstream pathogens isolated in five episodes of hospital-acquired bacteremia were Staphylococcus epidermidis, S. aureus, Escherichia coli, and Serratia liquifaciens. PMID- 3510105 TI - Evaluation of extravascular lung water by single thermal indicator. AB - Much attention has been directed to developing early therapy that might prevent or ameliorate incipient adult respiratory distress syndrome (ARDS) before respiratory failure ensues. The relationship between increased extravascular lung water (EVLW) and pulmonary microvascular pressure has been used by numerous investigators to confirm alterations in the permeability of the alveolar capillary membrane. In the present study, EVLW was measured in 40 critically ill patients by an indicator dilution technique utilizing thermal indicator alone. Injection of cold saline distinguished intravascular and extravascular compartments with a sensitivity similar to that of the thermal-dye double indicator dilution technique but without the withdrawal of blood, dye densitometry, or the preparation of special injectate. Both absolute volumes and volume changes over time measured by the single thermal indicator method compared favorably (p less than .001) to EVLW values determined simultaneously by the conventional thermal-dye double-indicator dilution technique. These results suggest that the single thermal indicator technique may help identify the earliest phase of ARDS when fluid is starting to accumulate in the lung interstitium. PMID- 3510106 TI - Thermodilution cardiac output--an in vitro model of low flow states. AB - The accuracy and reproducibility of thermodilution cardiac output measurements were examined in vitro at low flows, using the Edwards cardiac output computer. For each of 18 different volumetrically measured flows between 130 and 1035 ml/min, three cardiac outputs were determined for each of four different injectate volumes (1,2,3, and 5 ml) at two different temperatures (0 degrees C and room temperature). There was a significant (p less than .001) correlation between measured flow and cardiac output for all injectate volumes at both temperatures. The slopes of the regression lines ranged between 0.97 and 1.25, and the y-intercepts were all greater than 0. Although this thermodilution technique overestimated cardiac output, it was a reproducible means of measuring cardiac output in this low-flow in vitro model. PMID- 3510107 TI - Pulmonary venous air embolism in the neonate. PMID- 3510108 TI - Long-term clinical trials in pulmonary hypertension. Long overdue. PMID- 3510109 TI - Does cholecystectomy predispose to colorectal cancer? A case control study. AB - A case-control study of 598 patients with colorectal cancer (296 men, 302 women) admitted from January 1974 to October 1983 was undertaken. Patients were matched for age and sex, with controls admitted for unrelated conditions. All information was obtained from the hospital records. In men, there was no evidence of an increased risk of colonic cancer after cholecystectomy relative to men without cholecystectomy. There was some evidence of an increased risk in women (relative risk = 1.7; 95 percent confidence interval, 1.0 to 3.1) and this was highest when the tumor was in the right colon (P less than 0.005). This study confirms previous observations that cholecystectomy leads to an increased risk of right sided colonic tumors in women but not in men. The apparent difference between the sexes may be explained by the low rate of cholecystectomy in the men examined. PMID- 3510110 TI - Classic articles in colonic and rectal surgery. Joannis Scultetus 1595-1645. PMID- 3510111 TI - A randomized trial of photocoagulation or injection sclerotherapy for the treatment of 1 degree and 2 degrees hemorrhoids. PMID- 3510112 TI - [Pericardial tamponade following sternal puncture: ultrasound-guided decompression as emergency measure]. PMID- 3510113 TI - [Weaning of ventilated patients from the respirator]. PMID- 3510114 TI - Tioconazole. A review of its antimicrobial activity and therapeutic use in superficial mycoses. AB - Tioconazole is a substituted imidazole antimicrobial agent structurally related to other drugs in this group. It has been shown to have a broad spectrum of activity in vitro against dermatophytes and yeasts, as well as against some chlamydia, trichomonads and Gram-positive bacteria. Both open and controlled clinical trials have clearly demonstrated the efficacy and safety of topical preparations of tioconazole for treating superficial dermatophyte or yeast infections of the skin and vaginal candidiasis. In comparative studies it was at least as effective as alternative imidazole antifungal drugs, and in a few trials significantly greater efficacy has been reported for tioconazole, compared with clotrimazole, miconazole, econazole and systemic ketoconazole. Preliminary studies in other clinical areas suggest tioconazole may be useful for treating onychomycosis (in a special nail formulation), napkin-rash due to Candida albicans, impetigo, and vaginal trichomoniasis, although comparative studies are needed in each of these settings to clearly assess its relative place in therapy. Thus, tioconazole is an effective and well tolerated treatment for vaginal candidiasis and superficial fungal infections of the skin. PMID- 3510115 TI - Heparin 1986. Indications and effective use. AB - Heparin is a complex polysaccharide, consisting of repeating dissacharide subunits, which exerts its anticoagulant effect by potentiating the inhibition of activated clotting proteins by the naturally occurring inhibitor antithrombin III. The primary indication for its use is venous thromboembolic disease where an average 20,000 to 40,000 USP units are initially administered by constant infusion over 24 hours to prevent extension of an established thrombus. Subsequent treatment is based on the therapeutic response, usually monitored by a global clotting test such as the activated partial thromboplastin time (APTT). The chromogenic assay based on heparin-induced inhibition of activated factor X (Xa) is a particularly useful alternative monitoring test where thrombosis complicates pregnancy or is associated with the lupus anticoagulant. Subcutaneous heparin has also been used for the primary treatment of venous thrombosis but is more frequently used either for primary or secondary prophylaxis. Primary prophylaxis schedules usually employ a low dose (5000 units) administered 8- or 12-hourly without anticoagulant control, but a titrated subcutaneous heparin regimen has been successfully reported in elective hip surgery. Although arterial thrombosis is primarily initiated by platelet aggregates forming in vivo, heparin is commonly administered for acute arterial thromboembolism including peripheral arterial occlusion and repeated transient cerebral ischaemic events. The potential efficacy of heparin in disseminated intravascular consumption (DIC) remains to be firmly established, but is indicated where symptomatic thrombotic complications occur. Thrombocytopenia and haemorrhagic side effects may complicate heparin therapy, but bleeding complications may be minimised with the development of modified low molecular weight heparin which is currently undergoing clinical trial. PMID- 3510116 TI - Phospholipase C and melittin enhancement of glucose-induced electrical activity. AB - The influence of exogenous phospholipase C and melittin on electrical activity in islet B cells was determined to assess the extent to which polyphosphatidylinositol turnover serves to generate components that influence the electrical events in the plasma membrane. Phospholipase C hydrolyzes polyphosphatidylinositol to diacylglycerol and polyphosphoinositol, whereas melittin increases the susceptibility of phospholipids to phospholipases and increases the permeability of the membrane to ions. Application of both 20 mU/ml phospholipase C or 0.5 mg/ml melittin to 11.1 mM glucose elicited a time dependent enhancement of glucose-induced electrical activity that stabilized after 10 min. Phospholipase C increased both the active phase fraction and the burst frequency, whereas melittin only increased the burst frequency. These results indicate that both compounds, which disrupt the phospholipid environment of the plasma membrane, play a role in modulating the oscillatory pattern of electrical activity in the B cell, although melittin is obviously not influencing the factors controlling the ionic events in the same manner as phospholipase C. PMID- 3510117 TI - Insulin content and insulinogenesis by the perfused rat pancreas: effects of long term glucose stimulation. AB - The dynamic response of the perfused pancreas differed between pancreases from fed and fasted rats. Insulin secretion was significantly lower in pancreases from fasted rats during the first 40 min of perfusion at glucose levels of 200 and 300 mg/dl. Thereafter, from 40-90 min, insulin secretion was similar by pancreases from both fed and fasted rats. The typical biphasic insulin secretory profile, consisting of a transient spike of insulin secretion followed by a slowly rising secretory phase, was observed in pancreases from fasted rats. In contrast, the transition from first to second phase secretion was accelerated in pancreases from fed rats. This suggests that transport of intracellular insulin stores may be accentuated due to the fact that insulinogenic sites (e.g. Golgi) in pancreases from fed rats may be fully primed for optimal secretion. Total pancreatic insulin measurements support this concept. Total pancreatic insulin content was determined under fed and 24-h fasted conditions after various times of perfusion (0, 60, and 90 min and 6 h) and in response to various glucose levels (0, 200, and 300 mg/dl). Fasting resulted in a significant decrease in insulin content at zero time compared with pancreases from fed rats (39.2 +/- 2.4 vs. 61.6 +/- 9.8 micrograms). In the fed rat pancreases, total insulin content decreased slightly after a 60-min glucose stimulus of 300 mg/dl, but returned to the basal level after 90 min and remained at that level during a 6-h period of perfusion. In the fasted state, insulin content remained constant as a function of time until 60 min, but increased by 90 min to a level comparable to that in pancreases from fed rats. The response to lower levels of glucose stimulation (200 mg/dl) was qualitatively similar by pancreases from fed and fasted rats compared to the response to a higher glucose dose (300 mg/dl), except that secretion was less. Insulin content remained relatively constant for periods of perfusion up to 60 min. Insulinogenesis (defined as de novo synthesis and conversion of existing preproinsulin and proinsulin to insulin, less intracellular degradation of insulin) was increased as a function of glucose concentration and differed temporally as a function of the food intake of the animal. At no time of perfusion with any level of glucose stimulation did the insulin content exceed the zero time value in pancreases from fed rats. This suggests that insulin secretion is the rate-limiting step for insulinogenesis. PMID- 3510118 TI - Effect of trifluoperazine on the action of insulin in rat adipocytes. AB - Trifluoperazine (TFP), a potent inhibitor of calmodulin action, at a concentration of 12 microM decreased the stimulating effects of insulin on 1) fat cell pyruvate dehydrogenase (PDH) activation, 2) generation/action of PDH activator by adipocyte plasma membranes, and 3) insulin-induced loss of insulin receptors, without altering spermine-induced activation of fat cell PDH or preventing insulin stimulation of glucose oxidation. In addition to these effects on insulin action, TFP abolished several biological actions of the insulin generated PDH stimulator from liver particulate fractions. These actions include fat cell PDH activation and decrease in receptors. These data indicate that TFP inhibits both membrane-associated and intracellular components of insulin action. The results suggest involvement of calcium-binding protein (calmodulin) and/or phospholipid dependent-calcium activated protein kinase C in some of the actions of insulin in fat cells. The insulin effect on glucose oxidation appears to be less dependent on these mediators. PMID- 3510119 TI - High performance liquid chromatographic analysis of insulin degradation by rat skeletal muscle insulin protease. AB - The degradation of [125I]iodoinsulin (A14) by insulin protease (EC 3.4.22.11) was studied using HPLC. A reverse phase HPLC method is presented which allows the separation and quantitation of insulin degradation products. After incubation of [125I]iodoinsulin (A14) with insulin protease, there was an initial rapid loss of radioactivity from the [125I] iodoinsulin (A14) peak, which was quantitatively accounted for by the appearance of radioactivity in 11 different peaks, but was not accompanied by a proportional increase in the solubility of the sample in trichloroacetic acid. Two of the peaks showed appreciable accumulation before the others, and all but the first-eluted peak plateaued by 20 min. After 20 min of incubation, the amount of radioactivity present as the first-eluted peak, solubility in trichloroacetic acid, and insulin loss continued to increase at a steady, but slowed, rate. The order of appearance suggests that insulin protease acts on insulin in an ordered sequence of steps to generate a number of intermediates that are precipitable by trichloroacetic acid, but are subsequently degraded to material that is soluble in trichloroacetic acid. Sulfitolysis of 5 major peaks and subsequent HPLC analysis of the fragments showed none of the peaks to possess intact A chains. Peptide sequencing of 2 of the peaks indicates that the A-chain is cleaved in at least 2 positions, one beyond the 14th position, and one between the 13th and 14th amino acids (leucine and tyrosine). PMID- 3510120 TI - Endocrine modulation of gamma-aminobutyric acidergic innervation in the rat fallopian tube. AB - The present study investigates the effect of different endocrine manipulations on the gamma-aminobutyric acid (GABA)-ergic system in the rat fallopian tube. Either hypophysectomy or ovariectomy induced a significant decrease of glutamic acid decarboxylase (GAD) activity and of GABA levels in in situ tubes. This effect was completely reversed by either gonadotropins or combined estrogen-progesterone administration, respectively. Estrogen or progesterone alone proved less effective than the administration of both steroids in counteracting the effect of ovariectomy on GAD activity. The in vitro incubation of ovariectomized rat fallopian tubes with estrogen-progesterone for 1 h failed to counteract the reduction of the GAd activity induced by surgical manipulation. The in vivo effect of estrogen-progesterone administration on the GABA-ergic system seems to be specific since steroid treatment induced the synthesis of an enzyme which was immunologically identical to the GAD present in the fallopian tube and brain of normal diestrous rat. Autotransplantation of the fallopian tube under the skin brought about a decrease of GAD activity similar to that obtained after ovariectomy. In this situation, however, estrogen-progesterone administration did not counteract the decrease of GAD activity induced by fallopian tube deafferentation. The present results demonstrate that an interaction between the GABA-ergic system and the hypothalamo-pituitary-gonadal axis seems to be operative at the level of the rat fallopian tube. However, the physiological meaning of this interrelationship between the endocrine and the peripheral nervous systems remains to be clarified. PMID- 3510121 TI - A complex noncoordinate regulation of alpha-lactalbumin and 25 K beta-casein by corticosterone, prolactin, and insulin in long term cultures of normal rat mammary cells. AB - The concentrations of PRL, corticosterone, and insulin required by long term cultures of normal rat mammary cells to produce alpha-lactalbumin (alpha LA) and the 25,000 mol wt beta-casein were evaluated with a variety of hormone ratios and concentrations. For these studies a double antibody RIA for beta-casein capable of measuring 0.5 ng beta-casein/100 microliter growth media was developed and used along with our previously reported RIA for alpha LA. PRL was active at physiological levels (0.05-0.15 micrograms/ml) and quantitatively stimulated beta casein more than alpha LA, whereas physiological levels of corticosterone (0.05 0.15 micrograms/ml) quantitatively stimulated alpha LA more than beta-casein. The concentration of corticosterone greatly altered the magnitude of the cells' response to insulin and PRL for alpha LA output by cells from either virginal or midpregnant rats. Insulin also enhanced production of these milk proteins, but very little effect was measured in the physiological range. alpha LA was increased more by insulin than by PRL, and beta-casein was enhanced more by insulin than by corticosterone. Cells from midpregnant rats required less insulin to stimulate beta-casein production than to stimulate alpha LA. Cells from virginal rats required a supraphysiological insulin level to stimulate both beta casein and alpha LA under these conditions. These cells generally require 5-6 weeks to achieve a steady-state rate of milk protein output. The complexities of our observations help explain some of the conflicting reports in the literature concerning which hormone is of prime importance for quantitatively increasing the synthesis of a particular milk protein, particularly since high hormone levels are often employed and time in culture varies considerably among reports. We conclude that lower levels of all these hormones can and should be used in vitro. Our messenger RNA (mRNA) studies using cloned complementary DNA probes for two rat casein mRNAs show that cells grown for 2 months with hormones contain significant amounts of both alpha- and beta-casein mRNAs. Simultaneous quantification of beta-casein mRNA levels and rates of beta-casein protein production in these long term cell cultures indicated that a substantial portion of their beta-casein protein production is regulated by the amount of its mRNA. This could be controlled by mRNA synthesis and/or mRNA degradation.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3510122 TI - The development of insulin receptors and responsiveness is an early marker of differentiation in the muscle cell line L6. AB - After reaching confluence, mononucleated L6 myoblasts fuse into multinucleated contracting myotubes. This process is accompanied by the synthesis of characteristic skeletal muscle proteins, such as myosin heavy chain and the MM isoenzyme of creatine kinase. We have studied the development of insulin receptors and insulin responsiveness during differentiation in the L6 cells. Insulin was bound to high affinity receptors in both myoblasts and differentiated myotubes. The binding showed characteristics typical for insulin binding in other cell types, including high affinity, appropriate specificity, an upwardly concave Scatchard plot, and down-regulation. In the logarithmic growth phase, the myoblasts exhibited a low level of insulin binding, but on initiation of cell fusion, the resulting myotubes progressively developed a 2-fold increase in specific [125I]iodoinsulin binding as a result of a 2-fold increase in receptor number. The increase in insulin binding was an early differentiation event, preceding the accumulation of creatine kinase by 24 h. The development of insulin binding during differentiation correlated closely with an increased ability of the hormone to stimulate maximal 2-deoxy-D-glucose and alpha-aminoisobutyric acid uptake at physiological concentrations. The L6 cells are a useful model for studying the binding and effects of physiological insulin concentrations in skeletal muscle before and after differentiation. PMID- 3510123 TI - The stimulation of sugar transport in heart cells grown in a serum-free medium by picomolar concentrations of thyroid hormones: the effects of insulin and hydrocortisone. AB - Chick embryo heart cells were propagated in a defined serum-free medium. They formed a confluent, synchronously contracting monolayer that is not different from myocytes grown in serum containing media. The uptake of 2-deoxy-D-[1 3H]glucose in these cells was stimulated by exposure to physiological concentrations of T3 (1 pM) and T4 (10 pM). Actinomycin-D and puromycin did not block the stimulation of 2-deoxy-D-[1-3H]glucose uptake when given with T3 throughout a 6-h incubation period. Cells grown in the absence of both insulin and hydrocortisone were unresponsive to T3. Insulin at 200 nM restored the sensitivity of the cells to 0.1 pM T3. Addition of 10 nM hydrocortisone to the growth medium enhanced the effects of T3 synergistically. The T3-stimulated sugar uptake was completely blocked by 5 X 10(-6) M cytochalasin B, suggesting that T3 acts, like insulin, by the translocation of glucose transporters to the plasma membrane. PMID- 3510124 TI - Evidence for gamma-aminobutyric acid modulation of ovarian hormonal effects on luteinizing hormone secretion and hypothalamic catecholamine activity in the female rat. AB - Recent evidence suggests that gamma-aminobutyric acid (GABA)-containing neurons may inhibit LH release under certain circumstances. The present experiments tested whether GABA agonists block the LH surge induced in ovariectomized rats by estradiol benzoate (EB) plus progesterone (P) treatment and whether these agents affect the concentration and turnover of hypothalamic catecholamines, assessed from the depletion that occurs after synthesis inhibition. Ovariectomized rats received EB, followed 2 days later by P. Simultaneously with P, rats received either saline or one of the GABA agonists, baclofen or muscimol. Other agonist treated rats received a second injection 4 h later or were additionally treated with the postsynaptic GABA antagonist bicuculline. Additional experiments tested the effects of these agents on LH release in response to exogenous LHRH. The LH surge induced by EB plus P was blocked by administration of either baclofen or muscimol in a dose-dependent manner. Bicuculline did not prevent the effect of baclofen, but partially prevented the effect of muscimol. Neither baclofen nor muscimol significantly affected LH release in rats receiving LHRH. In a second set of studies in EB plus P-treated rats, baclofen and muscimol decreased the steady state concentrations of norepinephrine in the medial preoptic area and medial basal hypothalamus for several hours and markedly decreased the turnover rate of norepinephrine in these areas. The concentrations and turnover of epinephrine were also decreased by these GABA agonists in the medial basal hypothalamus. The drugs had no effect on dopamine levels or turnover in either structure. These results support the hypothesis that a GABAergic system regulates LH release via modulation of noradrenergic and adrenergic systems that control LHRH secretion. PMID- 3510125 TI - Pizotifen (Sanomigran) in childhood migraine. A double-blind controlled trial. AB - Forty-seven children with migraine have been included in a double-blind cross over study with pizotifen and placebo. The children received either pizotifen for 3 months followed by placebo or vice versa. Thirty-nine children completed the trial and there was no significant difference between active and placebo treatment as regards reduction of number of attacks, total and mean duration of attacks and duration of longest attacks. Pizotifen was well tolerated by the children. PMID- 3510126 TI - Therapeutic effect of lisuride in advanced Parkinson's disease. AB - The therapeutic effects of lisuride hydrogen maleate, a central dopamine agonist, were examined in 15 patients with advanced Parkinson's disease no longer satisfactorily responding to levodopa. A significant improvement (p less than 0.01) in the total Parkinson's disease disability score was obtained by the addition of lisuride to levodopa therapy. The clinical assessment in the follow up was performed with 2 different disability scales that yielded a more precise evaluation of the efficacy of lisuride, an efficacy that, as with other dopaminergic drugs, showed a slight decrease in time after a mean of 3 months. No important adverse effects were noticed. The only limitation of the use of lisuride was the occurrence of reversible psychic disturbances. It is concluded from this study that lisuride is a valuable tool in the management of advanced Parkinson's disease that allows for a reduction of the side effects of levodopa therapy in the long-term treatment of the disease. PMID- 3510127 TI - The roles of HPr and FPr in the utilization of fructose by Escherichia coli. AB - A mutant impaired in FPr activity was isolated. The altered gene (fpr), which was located near min. 44 on the E. coli genome, was transferred by phage-mediated transduction to appropriate recipients that lack HPr (ptsH), or Enzyme IIman (ptsM), or neither. The rates of growth on fructose of such transductants indicate that phosphate from PEP is transferred predominantly via FPr to fructose that enters the cells by Enzyme IIfru, but that HPr can play a role in transferring phosphate to fructose taken up via Enzyme IIman. PMID- 3510128 TI - Comparative studies on lens neutral endopeptidase and pituitary neutral proteinase: two closely similar enzymes. AB - A neutral endopeptidase (EC 3.4.24.5) previously thought to be unique to the eye lens has been found to be closely similar if not identical in native molecular size, component polypeptides and antigenic structure to a neutral proteinase from pituitary. Here we investigated some subtle differences in properties of the two enzymes, such as the effects of temperature, divalent cations and SDS on their activities with respect to different substrates. We conclude that the pituitary enzyme may have a relatively more compact structure requiring relaxation by low SDS concentration or higher temperature for maximum activity. PMID- 3510130 TI - Nonenzymatic radiolabeling of protein by 32P-containing nucleotides. AB - We report a nonenzymatic reaction which results in the radiolabeling of proteins by 32P-containing nucleoside triphosphates. The labeling reaction does not require any cofactors, but is greatly enhanced by the presence of alcohols. Even under optimal conditions, less than 1% of the protein molecules undergo modification. This nonspecific labeling represents a serious artifact which may become significant in systems involving low levels of specific labeling, such as photoaffinity labeling. Since the reaction is not limited to specific proteins, this may, however, provide a simple and rapid procedure for the preparation of labeled proteins. PMID- 3510129 TI - T7 and E. coli share homology for replication-related gene products. AB - Recently, the complete nucleotide sequence of the bacteriophage T7 genome was determined and 50 genes were identified on the genome. We compared amino acid sequences of all the gene products of T7 and replication-related gene products of E. coli. As a result, we found that T7 and E. coli share homology for each pair of exonuclease, DNA primase and helix-destabilizing protein. For E. coli, these gene products are known to be involved in the process of discontinuous DNA replication. These observations suggest that T7 and E. coli have a common origin for a part of their replication systems. PMID- 3510131 TI - Endotoxin-mediated pulmonary endothelial cell injury. AB - Infusion of endotoxin into sheep results in physiological and structural damage to the pulmonary endothelium. It is uncertain whether complement activation and granulocyte sequestration in the pulmonary microcirculation and the ensuing granulocyte migration into the interstitium seen with endotoxemia contribute to the endothelial damage. We have shown that infusion of complement-activated plasma into sheep, although causing the same degree of granulocyte sequestration in the lungs, results in only modest and transient endothelial damage. In addition, migration or chemotaxis of granulocytes across the endothelial layer of intimal explants is not accompanied by either structural evidence of endothelial damage or a detectable increase in vascular permeability. Such studies indicate that neither complement/granulocyte activation nor granulocyte migration across a vessel wall is entirely responsible for the severe endothelial damage seen with endotoxin. In vitro studies of bovine pulmonary endothelial monolayers indicate that endotoxin can cause direct damage to the endothelium; the damage is dose dependent and more severe in the presence of serum. Structural studies show endothelial cell retraction, pyknosis, and sloughing. Prostacyclin production and lactic dehydrogenase release are increased, as are permeability to small solutes and hydraulic conductance across the endothelium. It seems that endotoxin can cause a direct injury to pulmonary endothelium but complement and granulocyte activation may enhance the damage. PMID- 3510132 TI - Lung vascular injury induced by chemotactic factors: enhancement by bacterial endotoxins. PMID- 3510133 TI - Structure of the human erythrocyte insulin receptor. AB - The structure of the insulin receptor in intact human erythrocytes was defined using the techniques of disuccinimidyl suberate (DSS) cross-linking of 125I insulin and surface [125I]iodination followed by receptor immunoprecipitation. In contrast to a recent report, we found the erythrocyte insulin receptor to be similar in structure to that in classic target tissues for insulin, consisting of at least three species of molecular weight approximately 295,000, 265,000, and 245,000, containing disulfide-linked subunits of molecular weight approximately 130,000 and 95,000. The interconversion of the three oligomeric forms could mediate changes in receptor affinity as postulated in other tissues. The 95,000 subunit was detected by immunoprecipitation only if surface iodination was performed in a Tris/Hepes buffer using lodogen and not if phosphate-buffered saline or lactoperoxidase iodination was used. These findings indicate that the lack of a bioeffect of insulin in erythrocytes is not explained by a gross defect in the structure of their insulin receptors. The apparent identity of the insulin receptor structure in erythrocytes and insulin target tissues provides a firmer basis for the use of erythrocytes in some circumstances to reflect insulin receptor status. PMID- 3510134 TI - Immunochemical studies of an insulin-like material in the parotid gland of diabetic BB rats. AB - Immunocytochemical and radioimmunoassay studies were performed on pancreatic and parotid tissues from diabetic BB and control Wistar rats. Compared with those of normoglycemic controls, the pancreata of diabetic BB rats generally lacked insulin-containing B-cells. Extracts from the parotid glands of diabetic rats contained less immunoassayable insulin-like material than was present in parotid extracts of controls. However, the parotid glands of both groups of animals contained numerous cells displaying insulin-like immunoreactivity. These insulin immunoreactive cells, located mainly in the intercalated portion of the duct system, were comparable to those we reported recently in the parotid glands of normal and streptozocin-diabetic Sprague-Dawley rats. The presence of an insulin like material in the parotid salivary gland of two types of diabetic animals suggests that such cells may be spared, in part, from the effects of both chemical and hereditary diabetogenic factors. PMID- 3510135 TI - Low frequency of the large insertion in the human insulin gene in Japanese. AB - We have studied the restriction fragment-length polymorphism in the 5'-flanking region of the human insulin gene in 47 nondiabetic Japanese subjects and in 52 subjects with non-insulin-dependent diabetes (NIDDM) to elucidate the ethnic variation of the genetic polymorphism and its relationship with NIDDM. Allelic frequencies in the nondiabetic subjects were 0.957 in class 1 (Bgl l fragments of 2800 +/- 300 bp), 0 in class 2 (fragments of 3500 +/- 300 bp), and 0.043 in class 3 (fragments of greater than 3900 bp with a mean of 4500 bp). Corresponding frequencies in the NIDDM subjects were 0.962, 0, and 0.038, respectively. Four subjects with NIDDM who had the class 3 allele did not exhibit any particular clinical characteristics compared with the rest of the patients. Thus, the class 3 allele or the large insertion of the human insulin gene is much less frequent in Japanese than reported in other races, including Caucasians, and this class of allele is not associated with NIDDM in Japanese. Ethnic homogeneity is, thus, important in the analysis and interpretation of the genetic polymorphism. PMID- 3510136 TI - Effects of anti-insulin receptor antibodies (AIRA) on downregulation and turnover of insulin receptors on cultured hepatocytes. AB - We have studied the effects of two polyclonal anti-insulin receptor antibodies (AIRA) on insulin receptor downregulation and turnover in rat hepatocytes in primary culture. Downregulation was determined by measurement of insulin binding after acid washing of cells to remove AIRA. Insulin receptor turnover was estimated by measurement of insulin binding after inhibition of synthesis of functional receptors with tunicamycin (0.5 micrograms/ml). Exposure of hepatocytes to AIRA (both sera were of comparable effectiveness) resulted in progressive, time- and dose-dependent losses of insulin binding (maximal loss was about 55% after 24 h of incubation with AIRA diluted 1:25). Cycloheximide (100 microM) prevented AIRA-mediated downregulation. The t1/2 of disappearance of cell surface insulin binding capacity determined with tunicamycin was 8.0 h. Addition of insulin (1000 ng/ml) or AIRA to tunicamycin reduced the t1/2 to 2.6 h (insulin), 2.2 h (patient B10), and 2.0 h (patient 1). These data suggest that AIRA downregulated insulin receptors on cultured hepatocytes by accelerating their rate of disappearance, inhibition of protein synthesis prevented AIRA mediated downregulation, and downregulation by AIRA of insulin binding may be partially responsible for the desensitization of target cells to some of the insulin-like actions of these autoantibodies. PMID- 3510137 TI - Familial insulin resistance and acanthosis nigricans. Presence of a postbinding defect. AB - Type A insulin resistance, associated with acanthosis nigricans and menstrual irregularity, has been ascribed to a decreased concentration of insulin receptors. We now report four affected females from one family, a mother and three daughters (including identical twins) who appear to have the type A syndrome. Two of the kindred had no apparent ovarian dysfunction, while the other two had hyperprolactinemia without other findings of polycystic ovary disease, suggesting a genetic disease with variable penetrance. All had normal erythrocyte and monocyte insulin binding. Insulin dose-response studies to assess glucose metabolism and insulin sensitivity were performed in the affected twins. The dose response to insulin was shifted to the right with a decrease in maximal response. These results are consistent with a postbinding defect in insulin action in these patients. PMID- 3510138 TI - Opioid peptides in rat islets of Langerhans. Immunoreactive met- and leu enkephalins and BAM-22P. AB - Previous studies have shown that met- and leu-enkephalins are present in extracts of whole pancreas obtained from guinea pigs and human cadavers. The present studies demonstrate that immunoreactive methionine (met)- and leucine (leu) enkephalins present in rat pancreas are localized in islets of Langerhans. Immunohistochemical staining of fixed, whole pancreas indicated that only islet endocrine cells were heavily stained when any of four different met- and leu enkephalin-directed antisera or an anti-BAM-22P (bovine adrenal medulla docosapeptide) antiserum was used. The peptides were characterized by a combination of gel-filtration chromatography, high-performance liquid chromatography (HPLC), and specific radioimmunoassay. Free met-enkephalin content in extracts of rat islets was 90-fold enriched over content in extracts of whole pancreas (1.72 +/- 0.35 versus 0.019 +/- 0.007 pmol/mg protein). Treatment with trypsin and carboxy-peptidase-B of high-molecular-weight peptides extracted from pancreas or islets resulted in release of additional met-enkephalin immunoreactivity, which was 39-fold enriched in islets compared with pancreas (5.90 +/- 0.58 and 0.153 +/- 0.032 pmol/mg protein, respectively). Total islet content (per milligram protein) of met-enkephalin-containing peptides was similar to that reported elsewhere for bovine hypothalamus. The immunohistochemical data as well as the enrichment of extractable enkephalins in islets compared with whole pancreas indicate that essentially all the met-enkephalin present in pancreas is localized in islets, while the presence of BAM-22P immunoreactivity in islets is consistent with biosynthesis of enkephalins in islet cells via a preprohormone, such as that described in the bovine adrenal medulla and rat brain. PMID- 3510139 TI - Calcitonin inhibition of insulin release from isolated rat pancreatic islets. AB - Calcitonin is known to inhibit secretion of gastrin and insulin in vivo. The objective of this study was to determine whether calcitonin can act directly on pancreatic islets in vitro to inhibit insulin release. Isolated islets were obtained from collagenase-treated rat pancreas, and three peptides (gastrin releasing peptide, cholecystokinin-8, bombesin) and glucose were used to stimulate insulin release. All agents caused a significant increase in insulin secretion and calcitonin inhibited these responses, but had no consistent effect on basal release. This study provides evidence that calcitonin is an effective inhibitor of insulin secretion and acts directly on islet tissue. PMID- 3510140 TI - Effects of tolbutamide pretreatment on the rate of conversion of newly synthesized proinsulin to insulin and the compartmental characteristics of insulin storage in isolated rat islets. AB - Tolbutamide (1 g/kg body wt) was administered to male rats for 3 days to determine the effects of this pretreatment on subsequent insulin biosynthesis and compartmental storage characteristics of freshly isolated islets. Islets were isolated 16 h after the last tolbutamide administration, at a time when fed plasma glucose concentrations were normal. Islet glucagon was unchanged but insulin content was significantly reduced (38 +/- 1.2 ng IRI/islet from seven untreated rats versus 7.9 +/- 1.2 ng IRI/islet from eight treated rats). After tolbutamide pretreatment, the rate of incorporation of 3H-leucine into islet proinsulin was unchanged, but the t1/2 of labeled proinsulin-to-insulin conversion was significantly (P less than 0.001) decreased from 36 to 20 min. After treatment, actual rates of glucose-stimulated insulin secretion were 50% lower, however, because due to the proportionately greater depletion of islet insulin content, the fractional rate of secretion was increased two-fold. After treatment, there was evidence of compartmental, heterogeneous insulin storage, and glucose still marked newly synthesized insulin for preferential release; however, the differential release of new and old insulin converged rapidly with time. Mathematical integration of the data suggested dilution of the newly synthesized insulin compartment with unlabeled insulin during the chase period, but additionally indicated more rapid mixing of newly synthesized with previously stored, unlabeled insulin. Thus, tolbutamide-treated rats partially compensated for acute insulin depletion by increasing the rate of proinsulin-to-insulin conversion, but not increasing the rate of proinsulin biosynthesis; doubling the glucose-stimulated fractional secretory rate of the depleted cellular insulin storage compartment; and retaining compartmental storage characteristics but mixing newly synthesized insulin more rapidly with the compartment of previously stored, unlabeled insulin. PMID- 3510141 TI - The glucokinase glucose sensor in human pancreatic islet tissue. AB - The enzyme glucokinase controls glucose metabolism in islets and is proposed to be the glucose sensor in pancreatic beta-cells. This concept was developed from studies with rodents and it remained to be explored whether it also applies to man. Studies in man were hampered, however, by the difficulty in obtaining well preserved pancreatic islet tissue and also because the high activity of hexokinase made it difficult to measure glucokinase. To overcome these obstacles, quantitative histochemical sampling techniques were developed allowing precise dissection of pure human islet tissue and a newly designed radiometric microassay was used, avoiding hexokinase interference, and providing the sensitivity necessary to measure the relatively low glucokinase activity in small samples of tissue obtained from brain-dead tissue donors. The present data indicate that glucokinase is present in human pancreatic islet tissue and is not found in the exocrine pancreas. The enzyme's Vmax with D-glucose as substrate was similar to the Vmax for glucose utilization reported previously for intact, isolated human islets and the enzyme's Km for D-glucose was about 5 mM. Since glucokinase was also present in islet tissue of hamster, mouse, and rat, it is suggested that the glucokinase-glucose sensor concept has general applicability and that it could explain many aspects of the physiology and pathology of glucose homeostasis. This well-defined pancreatic islet glucokinase-glucose sensor should, therefore, be incorporated in any comprehensive model of glucose homeostasis. PMID- 3510142 TI - A human monoclonal antibody to insulin. AB - To elucidate the immune aspects of insulin-dependent diabetes mellitus (IDDM), we attempted to generate human monoclonal anti-insulin antibodies by fusing peripheral blood lymphocytes obtained from 10 insulin-treated IDDM patients with cells from a human lymphoblastoid cell line. Hybridomas that secreted immunoglobulins appeared in 9 of 400 wells. One of these hybridomas secreted anti insulin antibody of the IgM class. The lymphocytic partner of this hybridoma was obtained from an IDDM patient who had undetectable levels of antibodies to insulin in his serum. Thus, by employing the hybridoma technique, it was possible to reveal the presence of insulin-sensitized B-lymphocytes in a patient who was serologically negative for anti-insulin antibodies. The monoclonal antibody recognized intact human insulin and insulins of other species, but not isolated A and B-chains. This indicates that the antibody was functionally an autoantibody directed to an epitope formed by the native conformation of a highly conserved portion of the insulin molecule. This is the first report of a human hybridoma antibody to insulin. PMID- 3510143 TI - Pathogenesis and prevention of the dawn phenomenon in diabetic patients treated with CSII. AB - The mechanism of the dawn phenomenon was studied in 12 C-peptide-negative type I diabetic patients (age 30 +/- 2 yr) treated with continuous subcutaneous insulin infusion. During constant basal infusion, nocturnal glycemia remained constant until 4 a.m., but began to rise thereafter in 10/12 patients, with the mean rise from 4.6 +/- 0.4 mmol/L to 6.1 +/- 0.7 mmol/L (P less than 0.01) by 8 a.m. In these patients the rate of glucose production (Ra, 2.14 +/- 0.04 mg/kg/min, 3-H3 glucose infusion) exceeded the rate of utilization (Rd, 1.89 +/- 0.03 mg/kg/min, P less than 0.02). When the patients were restudied after the infusion rate was increased by 49 +/- 7%, Ra fell to 1.75 +/- 0.03 mg/kg/min (P less than 0.01) and the dawn phenomenon was abolished. However, both Ra and Rd remained higher in the diabetic subjects (P less than 0.05) than in eight healthy control subjects, in whom Ra (1.66 +/- 0.02 mg/kg/min) was equal to Rd with glycemia remaining unchanged. Peripheral free insulin levels in the diabetic patients were similar during constant (12.3 +/- 0.5 mU/L) and increased infusion rate (11.3 +/- 0.4 mU/L), and higher than those of the control subjects (5.2 +/- 0.2 mU/L, P less than 0.05). A diurnal rise in serum cortisol levels occurred 1 h earlier in the diabetic than in the control subjects, and Ra was directly proportional to serum cortisol concentration (r = 0.61, P less than 0.01). Serum growth hormone levels were also slightly higher in the diabetic than the control subjects.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3510144 TI - Plasma gastrin and gastric enterochromaffinlike cell activation and proliferation. Studies with omeprazole and ranitidine in intact and antrectomized rats. AB - Unoperated female rats were subjected to daily oral treatment with omeprazole (10 or 400 mumol/kg body wt), ranitidine (175 + 175 + 350 mumol/kg body wt), or vehicle and antrectomized rats were treated with omeprazole (400 mumol/kg body wt) or vehicle. After 10 wk of treatment, plasma gastrin levels were high in unoperated rats treated with the high omeprazole dose and with ranitidine, and low in antrectomized controls. Plasma gastrin levels were slightly higher in the low-dose omeprazole group than in the intact controls. In antrectomized rats treated with the high dose of omeprazole, the plasma gastrin level was in the same range as in intact control rats. A close correlation (r = 0.89, p less than 0.0001) was found between the plasma gastrin level and the oxyntic mucosal enterochromaffinlike cell density (as well as the tissue levels of histidine decarboxylase and histamine in the oxyntic mucosa) in all groups. The somatostatin cell density in the oxyntic mucosa was not altered by the various treatments. During a recovery period of 10 wk after the 10-wk treatment, the enterochromaffinlike cell density and histamine concentration decreased by 30% 40% in the rats treated with the high dose of omeprazole, whereas the corresponding values increased by 50% and 40%, respectively, in the control rats. The difference between the two groups, however, was still statistically significant. Plasma gastrin levels and gastric histidine decarboxylase activity returned to control values during recovery. The results suggest that the observed changes in enterochromaffinlike cell density are related to the plasma gastrin levels and that they are reversible. it is concluded that neither omeprazole nor ranitidine per se is likely to induce proliferation of enterochromaffinlike cells. PMID- 3510145 TI - Ketoconazole-resistant Candida esophagitis in patients with acquired immunodeficiency syndrome. AB - Although ketoconazole has been shown to be effective in treating esophageal candidiasis in other immunodeficiency states, similar studies have not been reported in patients with acquired immunodeficiency syndrome. Six patients with acquired immunodeficiency syndrome and oral and esophageal candidiasis who had been treated with ketoconazole for more than 2 mo were evaluated with barium esophagram and endoscopy with biopsy and brush cytology. All of the patients had persistent Candida esophagitis. In 2 patients, fungal cultures and sensitivity testing indicated Candida albicans resistant to ketoconazole in vitro. In patients with acquired immunodeficiency syndrome, esophageal candidiasis may not resolve with up to 6 mo of ketoconazole therapy and may require more vigorous antifungal therapy than in patients with other immunodeficiency states. PMID- 3510146 TI - Azathioprine and hepatic venocclusive disease in renal transplant patients. AB - We report 3 cases of hepatic venocclusive disease occurring in renal transplant patients receiving azathioprine and combine our experience with 4 other previously reported cases. The data suggest a clinical syndrome characterized by (a) delayed clinical onset, (b) striking male predominance, (c) presentation with jaundice followed by evidence of portal hypertension, and (d) poor prognosis. One of our patients, who is still alive 40 mo after the first onset of symptoms of liver disease, showed striking clinical improvement with discontinuation of azathioprine and subsequent deterioration on reinstitution. We suggest that azathioprine may be closely linked with the development of venocclusive disease in renal transplant patients and that the frequency of this disorder may be more common than previously reported. To attempt to prevent a fatal outcome, this group of patients should be closely monitored for the earliest signs of hepatic venocclusive disease through periodic serum bilirubin and alkaline phosphatase determinations. Patients with abnormal tests should undergo liver biopsy. If hepatic venocclusive disease is found, prompt withdrawal of azathioprine is indicated. PMID- 3510147 TI - Intestinal and hepatic complications of human bone marrow transplantation. Part I. PMID- 3510149 TI - Azathioprine and prognosis in primary biliary cirrhosis. PMID- 3510148 TI - Ulcer complications during short-term therapy of duodenal ulcer with active agents and placebo. PMID- 3510150 TI - Immunoreactive gonadotropin-releasing hormone-like material in the brain and the pituitary gland during the periovulatory period in the brown trout (Salmo trutta L.): relationships with the plasma and pituitary gonadotropin. AB - In fish there are few data on the gonadotropin-releasing hormone (Gn-RH) neurosecretory activity, which could explain long- and short-term variations of the gonadotropin secretion. There is no biological species specificity between mammal and fish Gn-RH; although there is a structural difference, they are, on the contrary, characterized by a high immunological specificity which does not allow measurement of fish Gn-RH using radioimmunoassay for LH-RH. We have synthesized salmon Gn-RH according to the formula recently proposed by Sherwood (N. Sherwood, L. Eiden, M. Brownstein, J. Spies, J. Rivier, and W. Vale, 1983. Proc. Natl. Acad. Sci. USA 80, 2794-2798). Its activity has been tested by its ability to stimulate the gonadotropin hormone (GtH) secretion in vivo in testosterone-implanted juvenile rainbow trout, and for the recognition of synthesized Gn-RH (s-Gn-RH) perykaria by a specific antibody raised against the s Gn-RH in regions of the brain described as containing LH-RH immunoreactive-like material. A radioimmunoassay has been developed for the salmon Gn-RH, and its specificity to measure trout Gn-RH has been tested. Using this assay, the brain and pituitary Gn-RH contents have been measured throughout the final phases of maturation and ovulation. Brain Gn-RH increases from the end of vitellogenesis (8.9 +/- 0.76 ng/brain) to ovulation (more than 15 ng/brain). Pituitary Gn-RH is lower (1.58 +/- 0.69 ng/pituitary) at the end of vitellogenesis and follows a similar profile as in the brain, except for a significant decrease just prior the beginning of oocyte maturation. The correlations between Gn-RH levels and GtH pituitary and plasma levels show that total brain Gn-RH is never correlated to the GtH, suggesting that the increase in the brain Gn-RH content is related to a Gn-RH system closely related to maturation and ovulation, which remains to be investigated. On the contrary, pituitary Gn-RH levels are well correlated with pituitary and plasma GtH levels, indicating that pituitary Gn-RH levels might represent a good index of the Gn-RH neurosecretory activity in the fish hypothalamohypophysial complex, given the absence of a portal system in teleost. PMID- 3510151 TI - Estrogen-binding sites in the liver of sexually mature male and female brown trout, Salmo trutta L. AB - Binding sites with characteristics conforming to those of a putative estrogen receptor have been identified in the liver of sexually mature male and female brown trout. [3H]Estradiol is bound with high affinity (kD in the 10(-9) M range) and limited capacity (less than 400 fmol mg-1 protein) to a proteinaceous moiety in liver cytosol. Binding is highly specific, only estradiol and estrone displace specifically bound [3H]estradiol. Cortisol, testosterone, 11-ketotestosterone, and 17 alpha, 20 beta-dihydroxyprogesterone are inactive. Labeled cytosol is retained on DNA-cellulose columns, eluting with 0.1 M NaCl. The liver of a sexually mature female brown trout contains more than twice as many binding sites as that of the male (168 +/- 15 fmol mg-1 protein cf. 69 +/- 4 fmol mg-1 protein), and no difference in kD is observed between males and females (2.6 +/- 0.2 10(-9) M and 2.9 +/- 0.3 10(-9) M, respectively). Plasma from both male and female brown trout was also found to bind [3H]estradiol, but with lower affinity (kD in 10(-8) M range) and higher capacity (4000-11,000 fmol mg-1 protein) and with less specificity. Estradiol, testosterone, and 11-ketotestosterone all displaced plasma-bound [3H]estradiol. It is concluded that cytosol and plasma binding of estradiol in brown trout are distinct, and indicative of the presence of an intracellular hepatic estrogen receptor and a plasma sex-steroid-binding protein. PMID- 3510152 TI - Topical absorption of gonadotropin-releasing hormone (GnRH) in goldfish. AB - The studies reported here show that exogenous GnRH can be absorbed by goldfish from the intraperitoneal (ip) cavity, gill surface, or surrounding water. Mammalian rather than teleost GnRH was applied in order to ensure that GnRH measurement in plasma did not reflect the native form. A radioimmunoassay (RIA) specific to mammalian GnRH was used to measure the concentration of absorbed GnRH; validation for this approach was provided by HPLC and cross-reactivity studies in which mammalian GnRH was shown not to be present in control goldfish brain or pituitary extracts. Plasma concentration of GnRH was highest at the first sampling time, 4 min after administration, for all three routes. For intraperitoneal injection, plasma concentration was halved in 12 min, a period comparable with the half-life in rats. The pituitary content of GnRH also increased rapidly during the first 4 min after ip injection and remained high for 60 min. Absorption of GnRH from the gill was equally effective with water or dimethyl sulfoxide (DMSO) as vehicle. PMID- 3510154 TI - Concern over DRG rates continues to loom large. PMID- 3510155 TI - State activity brings Medicaid under scrutiny. PMID- 3510153 TI - Recent findings on decubitus ulcer pathology: implications for care. AB - Vasodilators are ineffective therapy for decubitus ulcers because blood vessels are absent in the necrotic areas. Systemic application of vasodilating drugs actually decreases the nutritional blood flow through the damaged zone. Protracted healing of decubitus ulcers may be explained by an altered nutrient transport rate to the cells caused by fibrin thrombi in the capillaries and fibrin deposits in the intercellular space, resulting from decreased fibrinolytic activity. PMID- 3510156 TI - Wrangling stalls physician payment reform. PMID- 3510157 TI - HCFA plays 'keep away' with SNFs' payments. PMID- 3510158 TI - Gramm-Rudman: hospitals' budget nightmare. PMID- 3510159 TI - PROs retain stronghold on Medicare review. PMID- 3510161 TI - A method for estimating the centroid of an organ based on double integrals on serial cross sections. PMID- 3510160 TI - A stochastic model of the backscattered Doppler ultrasound from blood. PMID- 3510162 TI - Characterization of cerulenin-resistant mutants of Candida albicans. AB - Cerulenin, an inhibitor of fatty acid biosynthesis, has been used to study the role of the plasma membrane in germination of Candida albicans. To further elucidate this association, spontaneous, cerulenin-resistant mutants of C. albicans were isolated. Two of the mutants, 4918-2 and 4918-10, were compared biochemically with wild-type cells (4918). All strains grew equally well at 37 degrees C and synthesized fatty acids at comparable rates in the absence of the drug. In the presence of cerulenin, wild-type cells did not proceed through a logarithmic growth stage and exhibited a significantly impaired ability to incorporate [3H]acetate into newly synthesized lipid material. All strains were examined ultrastructurally. Alterations were observed in the membranous structures of cerulenin-treated wild-type cells. Such changes were not observed in cerulenin-treated mutant strains. Further examination of mutant strains revealed differences in cell wall protein and polysaccharide compositions when compared with those of wild-type cells. These apparent alterations in cell surface components may be correlated with the reduced abilities of mutant strains to adhere, in vitro, to mammalian cells. PMID- 3510164 TI - Plasmodium berghei malaria: effects of acute-phase serum and erythrocyte-bound immunoglobulins on erythrophagocytosis by rat peritoneal macrophages. AB - Acute-phase serum (APS) collected from Plasmodium berghei-infected rats inhibited phagocytosis of trypsinized rat erythrocytes and of erythrocytes from P. berghei infected rats. Macrophages (M phi) incubated with APS or heat-aggregated acute phase serum (HAAPS) for 6 h, followed by 18 h incubation in serum-free medium, exhibited significantly higher levels of phagocytosis than M phi similarly cultured but with normal rat serum. When APS was present at the time of assay, it inhibited erythrophagocytosis by M phi which had been in culture for 0 or 24 h. M phi activation by HAAPS was inhibited by 2-deoxy-D-glucose, which suggests that activation by HAAPS is Fc-receptor mediated. Adsorption of APS with staphylococcal protein A abrogated the ability of APS to inhibit phagocytosis and that of HAAPS to effect M phi activation, suggesting that immune complexes are involved in both processes. Surface-bound immunoglobulins eluted from erythrocytes of P. berghei-infected rats promoted phagocytosis of trypsinized erythrocytes by HAAPS-activated M phi but not by resting M phi. These results indicate that the immunoglobulins which bind to infected or damaged erythrocytes during malarial infections promote erythrophagocytosis by activated M phi and that the immune complexes in serum from rats with acute malaria may inhibit erythrophagocytosis early in the infection but may, over time, induce changes in the M phi which later facilitate erythrophagocytosis. PMID- 3510163 TI - Development and characterization of monoclonal antibodies to Pneumocystis carinii. AB - Hybridoma-producing monoclonal antibodies against Pneumocystis carinii were produced by the fusion of nonsecreting mouse myeloma cells (P3X63-Ag8.653) with splenocytes from BALB/c mice that had been immunized with partially purified preparations of P. carinii. Of 227 hybridoma clones producing antibodies against P. carinii, as measured by an enzyme-linked immunosorbent assay, 12 monoclonal antibodies showing the highest reactivity in the enzyme-linked immunosorbent assay were further characterized. The majority (11 of 12) of the monoclonal antibodies did not cross-react with Candida albicans, Cryptococcus neoformans, Histoplasma capsulatum, or Mycobacterium avium as determined by absorption experiments. By using the indirect immunofluorescence assay, serological reactivity was shown for these antibodies with titers ranging from 1:40 to 1:10,240. By using a competitive binding assay, these 12 monoclonal antibodies could be divided into seven groups, each group reacting with a different antigenic determinant of P. carinii. Sodium dodecyl sulfate-polyacrylamide gradient gel electrophoresis of P. carinii, followed by Western immunoblot analysis, allowed the identification of one major antigen with an apparent molecular weight of 110,000 by all 12 monoclonal antibodies. Other minor bands with molecular weights of approximately 116,000, 90,000, 55,000, and 35,000 were recognized by several of the monoclonal antibodies. PMID- 3510165 TI - Abilities of human oligodendroglial cells and mouse Schwann cells to phagocytose Mycobacterium leprae and other mycobacteria. AB - Human oligodendroglial KG-1-C cells derived from human cerebral mixed glioma and mouse Schwann cells derived from dorsal root ganglion were studied with respect to their abilities to phagocytose various mycobacteria, especially Mycobacterium leprae, and other microorganisms. KG-1-C cells phagocytosed M. leprae at a markedly higher rate than BALB/3T3, BHK 21, HeLa S3, mKS-A TU-7, XC, TSV-5, N-18, and Schwann cells but at a lower rate than peritoneal macrophages. Schwann cells also exhibited substantial phagocytic ability against M. leprae, and their phagocytic rate against M. leprae was much higher than that of N-18 cells, derived from neurons. KG-1-C and Schwann cells phagocytosed mycobacteria other than M. leprae, and their phagocytic patterns with various mycobacteria were similar, thereby suggesting that their abilities to phagocytose mycobacteria were based on the same cellular mechanism. The time course of phagocytosis of M. leprae by KG-1-C cells markedly differed from that by macrophages, indicating differences in the cellular mechanisms of M. leprae phagocytosis. KG-1-C cells also ingested microorganisms other than acid-fast bacilli, such as Staphylococcus aureus, Listeria monocytogenes, Bacillus subtilis, and Escherichia coli but not Candida albicans. They also phagocytosed latex beads (0.8-micron diameter) but not sheep erythrocytes. Microscopically, most mycobacterial cells were ingested in the perikaryon of KG-1-C cells and Schwann cells. PMID- 3510166 TI - Experimental infection of infant rabbits with verotoxin-producing Escherichia coli. AB - To study the pathogenesis of diarrheal disease due to verotoxin (VT)-producing Escherichia coli, 3-day-old rabbits were inoculated intragastrically with live E. coli O157:H7 (high VT producer), E. coli O113:K75:H21 (low VT producer), or O157:H45 (VT negative) and were examined for clinical symptoms, bacterial colonization, presence of detectable free VT in the intestines, and histological changes. Diarrhea developed consistently with 10(8) bacteria of E. coli O157:H7 but was observed only infrequently with even a higher dose of E. coli O113:K75:H21. VT-negative strains failed to cause diarrhea under the same experimental conditions. E. coli O157:H7 was recovered from the colon of infected animals in a significantly higher concentration than from the small intestine, and the clinical symptoms correlated with the presence of detectable free VT in the colon. Histological changes were seen mainly in the mid- and distal colon; these changes were characterized by a vast increase in apoptosis in the surface epithelium, increased mitotic activity in the crypts, mucin depletion, and a mild to moderate infiltration of neutrophils in the lamina propria and epithelium. Multiple foci of attached bacteria were seen on the surface epithelium of the gut associated lymphoid tissue, cecum, and colon. Bacteria were never seen in epithelial cells or the lamina propria. These mucosal abnormalities as well as clinical symptoms were reproduced in infant rabbits by the intragastric administration of VT alone. These results are consistent with the hypothesis that VT plays a major role in the pathogenesis of diarrhea caused by E. coli O157:H7 and other VT-producing E. coli. PMID- 3510167 TI - Mechanisms of phagocytosis of Mycobacterium leprae and other mycobacteria by human oligodendroglial cells. AB - The mechanisms by which human oligodendroglial cells, KG-1-C cells, phagocytose mycobacteria, especially Mycobacterium leprae, were studied. The ability of glial cells to phagocytose M. leprae was inhibited by azide, dinitrophenol (inhibitors of oxidative phosphorylation), and iodoacetamide but not fluoride (both are inhibitors of glycolysis). Thus, the energy metabolism dependency is somewhat different from that of peritoneal macrophages and polymorphonuclear leukocytes, the phagocytic capacities of which are mainly dependent on glycolysis. Phagocytosis of M. leprae by KG-1-C cells was markedly suppressed by a microfilament inhibitor (cytochalasin B) but not microtubule inhibitors (colchicine and vinblastine), as with macrophages. The phagocytosis of M. leprae by KG-1-C cells was dependent on the lipid and somewhat on the sugar ligands of the organism. Moreover, the phagocytosis of a given mycobacterium by KG-1-C cells correlated well with its hydrophobicity, thus revealing the importance of some lipid moieties on the surface of bacteria in the establishment of rigid binding interaction of bacteria with KG-1-C cells, before the onset of engulfment. Electric charge of a given microorganism did not correlate with its phagocytosis by KG-1-C cells. PMID- 3510168 TI - Molecular specificities of monoclonal antibodies directed against virulent Treponema pallidum. AB - Radioimmunoprecipitation (RIP) and Western blot analyses with specific anti Treponema pallidum subsp. pallidum monoclonal antibodies were used to identify antigens with apparent masses of 102, 84, 54, 53, 52, 47, 32, 29, and 24 kilodaltons (kDa). Cross-reactivity of these antibodies with T. pallidum subsp. pertenue antigens and lack of cross-reactivity with T. phagedenis biotype Reiter, T. vincentii, T. refringens, T. scoliodontum, and T. denticola were also demonstrated by RIP and Western blot analyses. Reactivities in the T. pallidum immobilization test, along with the RIP of lactoperoxidase-catalyzed iodination products, suggested that the identified antigens were surface associated. The abundance and surface association of the 47- and 84-kDa antigens were supported by reactivity in the microhemagglutination test for T. pallidum and by strong reactivity of monoclonal antibodies upon indirect immunofluorescence assays with rabbit-cultivated T. pallidum subsp. pallidum, respectively, but not with T. phagedenis biotype Reiter. Anti-47-kDa and anti-84-kDa monoclonal antibodies were also reactive in indirect immunofluorescence assays using treponemes found in dark-field-positive smears of human genital ulcers. PMID- 3510169 TI - Lipopolysaccharide structures of Campylobacter fetus are related to heat-stable serogroups. AB - To determine whether lipopolysaccharide (LPS) structures of Campylobacter fetus are related to the three known heat-stable serogroups, proteinase K-treated whole cell lysates obtained from strains of each serogroup were electrophoresed in polyacrylamide gels. All strains had smooth-type LPS with multiple high-molecular weight repeating units. The profiles of serogroup A from C. fetus subsp. fetus and from C. fetus subsp. venerealis were identical, but they were different from those of C. fetus subsp. fetus serogroups B and AB. When we immunoblotted the LPS of these serogroups with normal or immune rabbit serum we found homologous recognition between serogroups A from C. fetus subsp. fetus and C. fetus subsp. venerealis. Similarly, serogroups AB and B from C. fetus subsp. fetus showed homologous recognition. However, antiserum against serogroup A did not recognize serogroups B and AB and vice versa. Absorption studies confirmed the identity of LPS from all serogroup A C. fetus strains and cross-reactivity of the serogroup B and AB strains with one another. Serogroup A strains were resistant to the bactericidal activity in normal human serum, whereas serogroup B and AB strains generally were susceptible; isolates from humans predominantly belonged to serogroup A. Results of these studies suggest that the LPS composition forms the basis for the heat-stable serotyping system for C. fetus and that the structural and antigenic variants are associated with differential serum susceptibility. PMID- 3510170 TI - Immunogenic proteins of Trichomonas vaginalis as demonstrated by the immunoblot technique. AB - Fifteen clinical isolates of Trichomonas vaginalis were evaluated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis with transfer to nitrocellulose and by immunoblots probed with human sera. All T. vaginalis isolates showed similar banding patterns by Coomassie brilliant blue and silver staining of the electrophoresis gels and by amido black staining of the nitrocellulose. However, by the immunoblot technique, differences in banding patterns were noted, particularly in the high-molecular-weight zone (greater than 1.5 X 10(5], which were consistent in numerous experiments. A common immunogenic band was noted at a molecular weight of approximately 100,000 in all T. vaginalis isolates probed with six sera reactive in an enzyme-linked immunosorbent assay but was not seen or was only faintly visible when isolates were probed with sera considered to be nonreactive by the assay. Many other bands were identified, some of which appeared common to all isolates, but were not recognized by all sera tested. These studies demonstrate the antigenic heterogeneity of T. vaginalis and show that different individuals appear to respond immunologically to different T. vaginalis antigens. PMID- 3510171 TI - Clonal analysis of Escherichia coli O2:K1 isolated from diseased humans and animals. AB - Forty-six Escherichia coli isolates of serotype O2:K1 from human urinary tract infections, chicken sepsis, and bovine mastitis were obtained from laboratories in England, Denmark, Sweden, and Finland. The bacteria were compared for outer membrane protein (OMP) pattern, lipopolysaccharide pattern, electrophoretic mobilities of enzymes, and flagellar serotype and were tested for fimbriation, biotype, hydroxamate production, hemolysin production, antibiotic resistance, plasmid content, colicin production, and virulence in neonatal rats. Isolates from humans were assigned to two clonal groups; poultry isolates belonged to one of these clonal groups, whereas bovine isolates belonged to the other. Poultry and human isolates of the same clonal group could be distinguished only by their plasmid content. Strains within this group were heterogeneous with respect to biotype, fimbriation, virulence, and flagellar serotype. Human and bovine isolates of the second clonal group were distinguished by a minor change in OMP pattern and by their plasmid content. It is concluded that meaningful clonal groupings are best recognized by the combination of OMP and electrophoretic enzyme patterns. The O:K serotype can aid in the recognition of important subclones, whereas the other microbiological properties tested can vary widely within clonal groupings. Furthermore, we conclude that certain O:K serotypes can contain very different clonal groupings having little genetic relatedness. PMID- 3510172 TI - Sodium dodecyl sulfate-polyacrylamide gel electrophoresis and monoclonal antibodies as tools for the subgrouping of Escherichia coli lipopolysaccharide O18 and O23 antigens. AB - The lipopolysaccharide (LPS) of Escherichia coli O18 isolated from a wide variety of sources was analyzed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE). Four different LPS types, designated O18A, O18A1, O18B, and O18B1, were identified. Most O18 strains possess O18A, O18A1, or O18B LPS types, and these types are clonally associated. A reference test strain with the classical O18ab designation possessed O18B LPS, while two reference O18ac strains possessed O18A and O18A1 LPS, respectively. A panel of 15 anti-O18A B cell hybridomas was isolated. Enzyme-linked immunosorbent assays revealed that some of the monoclonal antibodies produced by these cells recognize different epitopes. Four of these antibodies suffice to distinguish the four O18 types. Numerous strains whose LPS had been typed by SDS-PAGE were tested by agglutination with seven monoclonal antibodies whose specificities had been determined by enzyme-linked immunosorbent assays. The results indicated a perfect correlation between the two methods. Rabbit antisera raised against O18A bacteria agglutinated boiled bacteria of each of the O18 LPS types efficiently. The antisera were adsorbed with bacteria possessing each of the LPS types. The adsorbed sera only distinguished between two groups: O18A and O18A1 versus O18B and O18B1, as shown by agglutination assays and Western blotting. E. coli O4 and O23 and Serratia marcescens O8 antigens, which are reputed to cross-react with O18, were also analyzed. One O4, one O8, and four O23 strains were tested. All made an LPS which was distinguishable from O18 LPS types by SDS-PAGE. Each O23 strain synthesized a different LPS, and three of them synthesized only few short chains. Some of the monoclonal antibodies reacted with O4, O8, and O23A LPSs. The results are interpreted as indicating that numerous E. coli O serogroups will prove to be chemically heterogeneous and that future analyses of subgroup heterogeneity should be guided by results from SDS-PAGE and rely preferentially on monoclonal antibodies as opposed to rabbit hyperimmune sera. PMID- 3510173 TI - Rapid killing of monocytes in vitro by Candida albicans yeast cells. AB - To study the interaction between Candida albicans blastoconidia and human phagocytes, we incubated peripheral leukocytes with fungi for 1 h at 37 degrees C and stained the cells with fluorescent vital stains ethidium bromide (EB) and fluorescein diacetate. Fungi that had been phagocytosed showed little staining; however, some leukocytes containing blastoconidia exhibited nuclear staining with EB, even though their cell membranes showed no signs of penetration by fungi. The number of EB-positive leukocytes was related to viability of the yeast cells and the temperature at which they were maintained before use. Because efforts to quantitate EB-positive leukocytes microscopically were frustrated by cell aggregation, we labeled the leukocytes with 51Cr and measured isotope release. We determined that leukocytes incubated with viable fungi released significantly more isotope than cells incubated alone or with killed blastoconidia. Furthermore, 51Cr release correlated directly with concentration of fungi in the assay, time of incubation, and temperature at which fungi were maintained before use. Using a number of isolates of C. albicans and several other species of Candida, we found that all exhibited cytotoxic activity against leukocytes, but the level of activity varied among organisms. Finally, we depleted or enriched peripheral leukocytes for specific cell populations and determined that only monocytes released more 51Cr after incubation with viable blastoconidia. Blastoconidia can lyse phagocytic cells through germination and penetration of cell membranes within 1 to 2 h, but the cytotoxic phenomenon we describe occurs within 15 to 30 min after yeast cells have been phagocytosed. Therefore, this capacity may represent a more immediate response by blastoconidia against phagocytosis and killing by monocytes. PMID- 3510174 TI - Ultrastructural and biochemical studies of two dynamically expressed cell surface determinants on Candida albicans. AB - Variability in the expression of two different cell surface carbohydrate determinants was examined with two agglutinating immunoglobulin M monoclonal antibodies (H9 and C6) and immunoelectron microscopy during growth of three strains of Candida albicans. A single strain of Candida parapsilosis did not express either antigen at any time during growth. Antigens were detected on the surface of C. albicans by agglutination tests with either H9 or C6 over a 48-h growth period. The difference in specificities of the monoclonal antibodies was demonstrated by Ouchterlony double-diffusion tests with solubilized antigens and by variabilities in the reactivity of the agglutinins among yeast strains. The antigenic determinants were isolated by specific immunoprecipitation and protease digestion and characterized by methods including high-pressure liquid chromatography, gas-liquid chromatography, and mass spectroscopy with both chemical and electron ionization. These determinants both contain mannose and glucose. In the case of antigen H9, an additional carbohydrate was detected with gas chromatography and mass spectroscopy. The location of antigens on individual cells was determined by indirect labeling of the determinants, first reacting cells with H9 or C6 followed by goat anti-mouse antibody conjugated with 20-nm colloidal gold particles. Transmission electron microscopy was used to examine cells. The antigens that were reactive with the monoclonal antibodies were associated with a flocculent surface layer. Expression of this layer and expression of the antigens is a dynamic process which is growth phase and strain dependent. The antigens were not expressed on very young cells and disappeared from the cell surface of most C. albicans strains with age. The use of monoclonal antibody to cell surface determinants may allow characterization of cell surface antigens of C. albicans and be helpful in establishing receptors which mediate adherence. PMID- 3510175 TI - Variability in expression of cell surface antigens of Candida albicans during morphogenesis. AB - The location and expression of two different cell surface antigens on germinating and nongerminating Candida albicans cells was examined by using transmission electron microscopy after labeling with monoclonal antibodies (H9 or C6) and immunocolloidal gold. Immunodeterminant expression of the two carbohydrate antigens was followed from early germination events through 20 h of development. The determinant detected by H9 antibody, which was initially lost from the mother cell surface and preferentially expressed only on hyphae during the first 4 h of germination, reappeared on the mother cell by 20 h, whereas the antigen detected by antibody C6 was continually expressed on mother cells and germ tubes throughout germination. PMID- 3510176 TI - Transfer of resistance to syphilitic infection from maternal to newborn guinea pigs. AB - Partial protection against cutaneous syphilis and dissemination of treponemes to the regional lymph nodes was achievable in Treponema pallidum-infected neonatal strain 2 guinea pigs having syphilis-immune mothers. This evidence for enhanced resistance was associated with the natural transfer of antitreponemal, maternally derived immunoglobulins before parturition. PMID- 3510177 TI - Characterization of the T-cell proliferative response to a purified glycopeptide antigen (GP-25) present on the Trypanosoma cruzi cell surface. AB - A glycoconjugate (GP-25) was previously purified from Trypanosoma cruzi and shown to be a major immunogenic constituent of the parasite cell surface, capable of inducing specific humoral responses in the vast majority of patients with Chagas' disease. In the present study, the T-cell proliferative response to GP-25 was studied in mice immunized with T. cruzi fractions or whole parasites. Recognition of GP-25 by proliferating T cells requires the participation of syngeneic, accessory spleen cells and is specifically blocked by anti-la antibodies. Furthermore, recognition of GP-25 is influenced by the MHC haplotype of accessory antigen-presenting cells. Short-term, GP-25-specific T-cell lines were used to demonstrate the specificity of anti-GP-25 T cells and to show that this glycoconjugate is not involved in T-cell cross-reactivity with heart antigens. T cells primed with nonpathogenic trypanosomatids are able to recognize the purified T. cruzi GP-25 molecule, indicating that T cells recognize a GP-25 epitope which is shared among trypanosomatids. PMID- 3510178 TI - Outer membrane proteins from Legionella pneumophila serogroups and other Legionella species. AB - Outer membranes were isolated from eight serogroups of L. pneumophila and five other Legionella species. The protein composition of the membranes was characterized by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. A single, disulfide stabilized protein with a molecular size of 29,000 to 30,000 daltons was found to be the major outer membrane protein (MOMP) of all the serogroups. The equivalent of the L. pneumophila MOMP was not observed in any of the other Legionella species examined. Silver staining of sodium dodecyl sulfate polyacrylamide gel electrophoresis gels revealed distinctive patterns for each serogroup and other Legionella species that were not observed by staining with Coomassie blue and may result from the presence of lipopolysaccharide in the membrane preparations. The MOMP from serogroup 1 was isolated by exposing crude peptidoglycan to detergent in the presence of heat and reducing agent and was found to be tightly associated with lipopolysaccharide. Antibodies to this complex were used to probe the outer membranes of the remaining, L. pneumophila serogroups and other Legionella species by Western blotting. Serogroup 1 anti MOMP antibodies were found to react with the MOMP from the remaining seven serogroups examined, whereas antibodies directed against the lipopolysaccharide of serogroup 1 only reacted with lipopolysaccharide from two of the remaining seven serogroups. PMID- 3510179 TI - Characterization of an antigen from rat male accessory glands. AB - An isolated soluble antigen involved in the autoimmune response against rat male accessory glands migrated as a double band when it was submitted to analytical disc polyacrylamide gel electrophoresis and as a homogeneous molecular species in SDS electrophoresis. The purified antigen had a molecular weight of approximately 78 K by SDS electrophoresis and 80 K by gel filtration chromatography. The antigen was identified as a protein and displays androgen dependency. The purified fraction was pathogenically active in microgram doses and induced humoral and delayed-type hypersensitivity responses. Besides, lesions were observed in the target organ. The cellular infiltration was located in prostate glands according to the localization of antigen by immunofluorescence findings. PMID- 3510180 TI - The combined effect of DBE and X-rays on the induction of somatic mutations in Tradescantia. AB - The induction of somatic mutations in the stamen hair cells of Tradescantia KU 9 has been used to investigate the effects of combined exposure to 1,2 dibromoethane (DBE) and X-rays. At low radiation doses a synergistic interaction has been found between the two agents for both DBE exposure followed by acute X rays and chronic simultaneous exposures. The synergism is discussed in terms of an interaction of single strand lesions in the DNA. It is concluded that although this type of interaction should not be too important for radiological protection, it could be of significance in evaluating the effects of chemicals at low exposure rates. PMID- 3510181 TI - The development of radiation late effects to the bone marrow after single and chronic exposure. AB - The marrow is a tissue distributed in numerous skeletal parts and works as an organ which is composed of a haemopoietic cell parenchyma and a supporting stroma. The pathophysiological mechanisms involved in the radiation-induced late effects depend mainly on the damage produced to each of these elements. Parenchymal cell damage ends with a failure of the stem cell pool to supply an adequate number of highly differentiated functional blood cells and is clinically manifested as aplastic anaemia or leukaemia. The effects of radiation on the haemopoietic stem cell can be measured by means of spleen colony forming units (CFU-S) in rodents. The self-maintaining capacity of the CFU-S was found to be lower than normal 16 weeks after a dose of 0.64 Gy. In larger animals it is only possible to measure the activity of some of the progenitor cells, estimating the number of granulocyte-macrophage colonies in culture (CFU-GM) as an indicator of stem cell changes. Their number in the blood is about 50 per cent of normal even 160 days after about 0.78 Gy. The stromal cells are also radiosensitive if measured with respect to their capacity to support long-term cell replication in vitro. Marrow fibrosis develops after single, repeated and chronic radiation exposure, and a dose of 40 Gy impairs the capacity of the marrow to support haemopoiesis. PMID- 3510182 TI - Effects of corneal extracts on rabbit corneal stromal cells in culture. AB - Rabbit corneal tissues were treated sequentially with phosphate buffered saline (PBS) and 4 M guanidine hydrochloride (GuHCl), dialyzed, and lyophilized. The interaction of the individual PBS and the GuHCl extracts with cultured rabbit corneal stromal cells was assessed. The PBS extract stimulated stromal cell growth. These cells had a thinner spindle-shaped appearance, a greater tendency toward multilayer formation, and a approximately 40-60% higher final density than the controls. The cells subjected to the GuHCl extract exhibited no such changes. When the PBS extract was heated to 80 degrees C, the stimulatory activity was replaced by an inhibitory activity, indicating that the PBS extract contained both the stimulatory and the inhibitory factors. Using a high performance liquid chromatograph system, such factors could be separated. The effects of corneal extracts on connective tissue synthesis were examined after labeling confluent stromal cultures with either (35S)sulfate or (3H)proline for 20 hr. The PBS and the GuHCl extracts significantly promoted the incorporation of (35S)sulfate into glycosaminoglycans. Neither extract altered the types of glycosaminoglycans synthesized or the collagen synthesis of stromal keratocytes in culture. PMID- 3510183 TI - GAL3 gene product is required for maintenance of the induced state of the GAL cluster genes in Saccharomyces cerevisiae. AB - The activities of the first three enzymes for galactose catabolism normally become detectable within 15 min after the addition of galactose into a culture of the yeast Saccharomyces cerevisiae. In S. cerevisiae with a recessive mutation termed gal3, a longer-than-normal lag is observed before the appearance of the enzyme activities (O. Winge and C. Roberts, C. R. Trav. Lab. Carlsberg Ser. Physiol. 24:263-315, 1948). I isolated two S. cerevisiae mutants with temperature sensitive defects in the GAL3 gene. Temperature shift experiments with one of those mutants led to the conclusion that the GAL3 function is required not only for the initiation of enzyme induction but also for the maintenance of the induced state in galactose-nonfermenting S. cerevisiae because of a defect in any of the genes for the galactose-catabolizing enzymes, such as gal1 or gal10. In contrast, the GAL3 function is phenotypically dispensable in galactose metabolizing S. cerevisiae. Thus, the normal catabolism of galactose can substitute for the GAL3 function. PMID- 3510184 TI - Nucleotide sequence corresponding to five chemotaxis genes in Escherichia coli. AB - The nucleotide sequence of DNA which contains five chemotaxis-related genes of Escherichia coli, cheW, cheR, cheB, cheY, and cheZ, and part of the cheA gene was determined. Molecular weights of the polypeptides encoded by these genes were calculated from translated amino acid sequences, and they were 18,100 for cheW, 32,700 for cheR, 37,500 for cheB, 14,100 for cheY, and 24,000 for cheZ. Nucleotide sequences which could act as ribosome-binding sites were found in the upstream region of each gene. After the termination codon of the cheW gene, a typical rho-independent transcription termination signal was observed. There are no other open reading frames long enough to encode polypeptides in this region except those which code for the two previously reported genes tar and tap. PMID- 3510185 TI - Transcriptional analysis of promoter mutations in the Klebsiella pneumoniae nifHDKY operon. AB - Previously isolated promoter mutations that allow expression of the Klebsiella pneumoniae nifHDKY operon in the absence of nifA (R. Bitoun, J. Berman, A. Zilberstein, D. Holland, J.B. Cohen, D. Givol, and A. Zamir, Proc. Natl. Acad. Sci. USA, 80:5812-5816, 1983) were further characterized. pRB1 and pRB5, containing, respectively, point and duplication mutations in the nifHDKY regulatory region, were transformed into Escherichia coli and K. pneumoniae hosts with different nifA and ntrA backgrounds. nif transcription start sites were determined by nuclease S1 mapping. The results indicated that nifA-independent expression from both mutants did not require ntrA. Transcription from pBR5 started 3 base pairs (bp) upstream of the start site of nif-regulated transcription and could stem from a canonical promoter sequence generated at the junction between the two copies of the duplicated sequence. In the presence of nifA-ntrA, transcription from pRB5 started predominantly at the site characteristic of the nif-regulated promoter. The site of constitutive transcription initiation in pRB1 was located 33 bp upstream of the point mutation and 40 bp upstream of the start of nifA-ntrA-activated transcription. Low-level transcription from the upstream site was also evident, in the absence of nifA or nifA or both, with the plasmid containing the wild-type nifHDKY regulatory region. However, when nifA and ntrA were present to activate transcription from the major nif promoter, no activity was evident from the upstream site in either pRB1 or the parental plasmid. Thus, the mutation enhanced the activity of a pre existing constitutive promoter, the activity of which was repressed on nifA-ntrA activation of the major nif promoter. PMID- 3510186 TI - Posttranscriptional autoregulation of Escherichia coli threonyl tRNA synthetase expression in vivo. AB - Five mutations in thrS, the gene for threonyl-tRNA synthetase, have been characterized, and the sites of the mutations have been localized to different regions of the thrS gene by recombination with M13 phage carrying portions of the thrS gene. Quantitative immunoblotting shows that some of these mutations cause the overproduction of structurally altered threonyl-tRNA synthetase in vivo. The amounts of in vivo thrS mRNA as measured by quantitative hybridization are, however, the same as wild-type levels for each mutant. These results demonstrate that the expression of threonyl-tRNA synthetase is autoregulated at the posttranscriptional level in vivo. PMID- 3510187 TI - Cloning, nucleotide sequencing, and expression of tetanus toxin fragment C in Escherichia coli. AB - The amino acid sequence of the first 30 residues of fragment C of tetanus toxin was determined, and a mixture of 32 complementary oligonucleotides, each 17 bases long, was synthesized. A 2-kilobase (kb) EcoI fragment of Clostridium tetani DNA was identified by Southern blotting and was cloned into the Escherichia coli plasmid vector pAT153 with the 32P-labeled oligonucleotide mixture as a probe. A second 3.2-kb Bg/II fragment was identified and cloned with the 2-kb EcoRI fragment as a probe. The nucleotide sequence of 1.8 kb of this DNA was determined and was shown to encode the entire fragment C and a portion of fragment B of tetanus toxin. The tetanus DNA was expressed in E. coli with pWRL507, a plasmid vector containing the trp promoter and a portion of the trpE gene. The trpE tetanus fusion proteins were visualized by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and were shown to react with anti-fragment C antibody. PMID- 3510188 TI - Specific location of penicillin-binding proteins within the cell envelope of Escherichia coli. AB - This communication deals with the location of penicillin-binding proteins in the cell envelope of Escherichia coli. For this purpose, bacterial cells have been broken by various procedures and their envelopes have been fractioned. To do so, inner (cytoplasmic) and outer membranes were separated by isopycnic centrifugation in sucrose gradients. Some separation methods (Osborn et al., J. Biol. Chem. 247:3962-3972, 1972; J. Smit, Y. Kamio, and H. Nikaido, J. Bacteriol. 124:942-958, 1975) revealed that penicillin-binding proteins are not exclusively located in the inner membrane. They are also found in the outer membrane (A. Rodriguez-Tebar, J. A. Barbas, and D. Vasquez, J. Bacteriol. 161:243-248, 1985). Under the milder conditions for cell rupture used in this work, an intermembrane fraction, sedimenting between the inner and outer membrane, can be recovered from the gradients. This fraction has a high content of both penicillin-binding proteins and phospholipase B activity and may correspond to the intermembrane adhesion sites (M. H. Bayer, G. P. Costello, and M. E. Bayer, J. Bacteriol. 149:758-769, 1982). We postulate that this intermembrane fraction is a labile structure that contains a high amount of all penicillin-binding proteins which are usually found in both the inner and outer membranes when the adhesion sites are destroyed by the cell breakage and fractionation procedures. PMID- 3510189 TI - Calcium-sensitive cls4 mutant of Saccharomyces cerevisiae with a defect in bud formation. AB - A calcium-sensitive cls4 mutant of Saccharomyces cerevisiae ceased dividing in the presence of 100 mM CaCl2, producing large, round, unbudded cells. Since its DNA replication and nuclear division still continued after interruption of normal budding, the cls4 mutant had a defect in bud formation in Ca2+-rich medium. Its calcium content and calcium uptake activity were the same as those of the wild type strain, suggesting that the primary defect of the mutation was not in a Ca2+ transport system. Genetic analysis showed that the cls4 mutation did not complement the cdc24-1 mutation, which is known to be a temperature-sensitive mutation affecting bud formation and localized cell surface growth at a restrictive temperature. Moreover, cls4 was tightly linked to cdc24, and a yeast 3.4-kilobase-pair DNA fragment carrying both the CLS4 and CDC24 genes was obtained. These results suggest that the cls4 mutation is allelic to the cdc24 mutation. Thus, Ca2+ ion seems to control bud formation and bud-localized cell surface growth. PMID- 3510190 TI - Asparaginase II of Saccharomyces cerevisiae: selection of four mutations that cause derepressed enzyme synthesis. AB - A positive selection method was used to isolate four Saccharomyces cerevisiae mutations that cause derepressed synthesis of asparaginase II. The four mutations (and1, and2, and3, and4) were neither closely linked to each other nor linked to previously characterized mutations (asp3, asp6) which cause the complete loss of asparaginase II activity. One of the new mutations (and4) was shown to be allelic to gdh-CR, a pleiotropic mutation which causes derepressed synthesis of a number of enzymes of nitrogen catabolism. PMID- 3510192 TI - Isolation and morphological characterization of a mycelial mutant of Candida albicans. AB - In this paper we describe the isolation of a novel strain of Candida albicans which is a mycelium at ambient temperatures. Mutagenesis of C. albicans ATCC 10261 with N-methyl-N-nitro-N-nitrosoguanidine followed by plating on solid media at 28 degrees C yielded colony morphology variants which were characterized by a raised, rough-surfaced colony of irregular outline in marked contrast to the flat, shiny circular colonies of the parental 10261 strain. One mutant colony, hOG301, was studied in detail. Strain hOG301 was stable and exhibited mycelial morphology over a wide temperature range (5 to 40 degrees C) in several media. The hyphae comprising hOG301 mycelium were examined by light microscopy, scanning electron microscopy, and transmission electron microscopy and showed morphological features described in the literature as being typical of both true hyphae and pseudohyphae. In contrast to 10261, hOG301 was not pathogenic after intraperitoneal injection in mice. This is the first report of a mycelial C. albicans that is stable at ambient temperatures. PMID- 3510191 TI - Mutations in tar suppress defects in maltose chemotaxis caused by specific malE mutations. AB - Maltose-binding protein (MBP), which is encoded by the malE gene, is the maltose chemoreceptor of Escherichia coli, as well as an essential component of the maltose uptake system. Maltose-loaded MBP is thought to initiate a chemotactic response by binding to the tar gene product, the signal transducer Tar, which is also the aspartate chemoreceptor. To study the interaction of MBP with Tar, we selected 14 malE mutants which had specific defects in maltose taxis. Three of these mutants were fully active in maltose transport and produced MBP in normal amounts. The isoelectric points of the MBPs from these three mutants were identical to (malE461 and malE469) or only 0.1 pH unit more basic than (malE454) the isoelectric point of the wild-type protein (pH 5.0). Six of the mutations, including malE454, malE461, and malE469, were mapped in detail; they were located in two regions within malE. We also isolated second-site suppressor mutations in the tar gene that restored maltose taxis in combination with the closely linked malE454 and malE461 mutations but not with the malE469 mutation, which maps in a different part of the gene. This allele-specific suppression confirmed that MBP and Tar interact directly. PMID- 3510193 TI - Plasmid segregation into minicells is associated with membrane attachment and independent of plasmid replication. AB - The role of plasmid replication in the segregation of plasmids into Escherichia coli minicells was investigated with temperature-sensitive replication mutants derived from E. coli plasmids ColE1 and pSC101. For as long as six generations of growth, at permissive or nonpermissive temperatures (when greater than 80% of plasmid replication was inhibited), the same amount of previously 3H-labeled plasmid DNA segregated into minicells. Density gradient separations of wild-type and temperature-sensitive plasmid DNA from both replicons segregated into the minicells showed that about 20 to 25% was stably associated with the minicell membrane at both temperatures. Electron microscopy showed this DNA to consist of circular plasmid molecules attached to the minicell membrane. These combined findings suggest that segregation of plasmids into minicells and their association with the minicell membrane are interrelated and independent of plasmid replication. PMID- 3510194 TI - Highly mobile DNA segment of IncI alpha plasmid R64: a clustered inversion region. AB - When R64 DNA was digested with EcoRI, two DNA fragments not equimolar to the plasmid DNA were produced. A DNA region including these fragments was cloned (pKK009), and the pKK009 DNA sample was found to be a mixture of six or more DNA species with EcoRI, PstI, and AvaI cleavage sites at different positions, suggesting a complex rearrangement of DNA. When a part of the pKK009 DNA was removed by HindIII digestion, 33 different types of plasmids (pKK010-series plasmids) were obtained out of 58 clones tested, but no DNA rearrangement could be observed. On the basis of a comparison of the detailed restriction maps of these pKK010-series plasmids, we propose a model in which four DNA segments invert independently or in groups within the 1.95-kilobase region of R64, so that the arrangements of these four segments change randomly. The fixed pKK010-series plasmid DNA was again rearranged in the presence of R64, indicating that trans acting gene function may be present to mediate the DNA rearrangement. The gene (tentatively designated as rci) was located on a 4.5-kilobase E9' fragment of R64. PMID- 3510195 TI - The dexamethasone suppression test and response to somatic treatment: a review. AB - The dexamethasone suppression test (DST) has been primarily investigated as an aid in diagnosing endogenous depression; yet, its major clinical use has been as a predictor of treatment response. It is commonly held that 1) an abnormal DST predicts response to somatic (and not psychologic) therapies, 2) an abnormal DST predicts response to noradrenergic antidepressants, and 3) a normal DST predicts response to serotonergic agents. The DST predicted response to somatic therapies in only 6 of 16 published studies. No single methodologic factor, such as population variables, DST technique, or study design, can explain the marked discrepancy in study results. Only two of seven studies examining the DST and response to neurotransmitter-specific antidepressant groups found a positive relationship. The evidence that the DST predicts response to noradrenergic agents is weak. The DST does not predict acute response to somatic treatment in general or response to specific antidepressants. The selection of the appropriate treatment for depressed patients is still best made using clinical criteria. PMID- 3510196 TI - Alprazolam as an adjunct to propranolol in anxious outpatients with stable angina pectoris. AB - A double-blind crossover comparison is reported of the effects of alprazolam and placebo on anxiety and angina in 27 ambulatory outpatients with angina pectoris stabilized on propranolol. Alprazolam was shown to be a safe treatment when combined with propranolol in these patients. Patients receiving alprazolam with propranolol reported more improvement on their targeted symptoms than did patients receiving placebo with propranolol. The side effect most often reported was moderate drowsiness or sedation; no unusual side effects emerged. There was no evidence that alprazolam compromised the patients' response to propranolol. PMID- 3510197 TI - Role of the laboratory in the evaluation of suspected drug abuse. AB - Despite the high incidence of substance abuse, it remains a common cause of misdiagnosis. In patients who have abused or who are currently abusing drugs, symptoms of a psychiatric illness may be mimicked by either the drug's presence or absence. The laboratory can aid in making a differential diagnosis and eliminating drugs from active consideration as a cause of psychosis, depression, mania, and personality changes. Treatment planning and prevention of serious medical consequences often rest on the accuracy of the admission drug screen. Testing is widely used to assess improvement in substance abuse in both inpatient and outpatient settings. In occupational settings, testing has been used as an early indicator that a problem exists and as a successful prevention tool. The appropriate use of analytic technology in drug abuse testing requires an understanding of available test methodologies. These include drug screens by thin layer chromatography, comprehensive testing using enzyme immunoassay, and computer-assisted gas chromatography-mass spectrometry (GC-MS). Testing for specific drugs considered likely causes or precipitants of "psychiatric" complaints is available with enzyme assays, radioimmunoassay, or definitive forensic-quality testing using GC-MS. PMID- 3510198 TI - Alterations in the tyrosine kinase activity of the insulin receptor produced by in vitro hyperinsulinemia. AB - The tyrosine kinase activity of the insulin receptor was examined in fat cells made insulin resistant by hyperinsulinemia. Adipocytes previously treated for 16 h in vitro with 0.1 microM insulin were markedly insensitive to insulin as shown by the requirement of 2.3-fold higher concentration of insulin to stimulate half maximal activation of glucose metabolism (glucose oxidation and glucose conversion to lipids). A similar rightward shift in the insulin dose-response curve was also evident for an insulin action not dependent on glucose metabolism, i.e. the inhibition of hormone-stimulated lipolysis. The almost 60% loss of insulin sensitivity occurred in conjunction with a 37% loss in insulin-binding activity, an alteration caused by a reduction in the number of insulin receptors. Studies of tyrosine kinase activity demonstrated a preferential alteration in this insulin receptor property, in addition to the receptor loss. The insulin stimulated Vmax for the phosphorylation of the artificial substrate, Glu80-Tyr20, was significantly reduced by almost 40%, when the activity was expressed per insulin binding and measured in a receptor preparation purified by wheat germ affinity chromatography and immunoprecipitation. An elevation in basal tyrosine kinase activity was also present, which correlated with a lower apparent Km for ATP (0.025 mM) in comparison to the Km of 0.070 mM for the receptors from control cells. These findings indicate the presence of two types of alterations that involve the insulin receptor and hyperinsulinemia: one constituted by a modest reduction in receptor number and a second by modifications in the tyrosine kinase activity of the remaining receptors. Both alterations are required to explain the magnitude of the insulin resistance that develops after 16 h of insulin treatment. PMID- 3510199 TI - Protein kinase activity of FSV (Fujinami sarcoma virus) P130gag-fps shows a strict specificity for tyrosine residues. AB - A number of oncogenic viruses encode transforming proteins with protein kinase activities apparently specific for tyrosine residues. Recent evidence has raised questions as to the substrate specificity of these kinases in general and the physiological relevance of tyrosine phosphorylation in particular. The P130gag fps transforming protein of Fujinami sarcoma virus (FSV) is strongly phosphorylated at 2 tyrosine residues in FSV-transformed cells of which 1 (Tyr 1073) is also the major site of P130gag-fps intermolecular autophosphorylation in vitro. We have investigated the specificity of the protein kinase activity intrinsic to FSV P130gag-fps by using site-directed mutagenesis to change the codon for Tyr-1073 to those for the other commonly phosphorylated hydroxyamino acids, serine and threonine. This approach has some advantages over the use of synthetic peptides to define protein kinase recognition sites in that the protein containing the altered target site can be expressed in intact cells. In addition it allows higher order as well as primary structure of the enzyme recognition site to be considered. Neither serine nor threonine were phosphorylated when substituted for tyrosine at position 1073 of P130gag-fps indicating a stringent specificity for tyrosine as a substrate of the P130gag-fps protein kinase autophosphorylating activity. Consistent with the suggestion that tyrosine phosphorylation is of functional significance we find that these and other FSV Tyr-1073 mutants have depressed enzymatic and oncogenic capacities. PMID- 3510200 TI - Immunological quantitation of phospholipid/Ca2+-dependent protein kinase and its fragments. Tissue levels, subcellular distribution, and ontogenetic changes in brain and heart. AB - Levels of phospholipid/Ca2+-dependent protein kinase (protein kinase C, 80 kDa) and its presumed proteolytic fragments were quantified in a variety of animal tissues and cultured human leukemic cell lines (HL60 and K562) using an immunoblot analysis technique. Of many tissues examined, the rat brain and HL60 cells were by far the richest sources of the 80-kDa native enzyme, with its concentration estimated to be about 2-3 microM in both tissues. The major enzyme species detected in most tissues, however, was the 67-kDa fragment; the 80-kDa native enzyme was present in a smaller amount except in spleen which contained nearly equal amounts of both enzyme species. It was also found that HL60 and K562 leukemic cells contained the 50-kDa species instead of the 67-kDa species. A study of the subcellular distribution of the 80- and 67-kDa species showed the enzyme to be localized predominantly in the soluble fraction for some tissues (e.g. heart) and nearly equally distributed between soluble and particulate fractions in others (e.g. spleen). In the brain, however, the majority of the enzyme was present in the particulate fraction, in agreement with the findings made with immunocytochemical localization of the enzyme. The total enzyme content in developing rat brain and heart increased during the first 2 to 4 weeks following birth and decreased to 60% of peak levels in the adult. The present immunological method, showing for the first time that the tissue levels of phospholipid/Ca2+-dependent protein kinase and its fragments can be quantitated, would be useful for studies on the regulation of cellular events and pathophysiology of tissues thought to be involved in this multi-functional protein phosphorylation system. PMID- 3510201 TI - Localization and purification of two enzymes from Escherichia coli capable of hydrolyzing a signal peptide. AB - The signal peptide generated during the maturation of prolipoprotein by the purified prolipoprotein signal peptidase can be isolated in substrate amounts (Dev, I. K., and Ray, P. H. (1984) J. Biol. Chem. 259, 11114-11120). This signal peptide is degraded predominantly from the carboxyl terminus by cell-free extracts of Escherichia coli. The signal peptide is degraded (at least 300-fold) more rapidly than other cellular proteins in E. coli. Greater than 90% of the signal peptide hydrolase activity is localized in the cytoplasm. Two enzymes from the cytoplasmic fraction responsible for the degradation of the signal peptide have been identified and purified to near homogeneity. The major activity is associated with a monomeric protein with a molecular weight of 68,000 (S.E. 3,400) as determined by gel filtration and by sodium dodecyl sulfate polyacrylamide gel electrophoresis. This enzyme appears to be similar to the oligopeptidase (Vimr, E. R., Green, L., and Miller, C. G. (1983) J. Bacteriol. 153, 1259-1265) that hydrolyzes N-acetyl tetra alanine. The second protein represents approximately 5% of the total cytoplasmic activity and has been shown to be a dimer with a monomer molecular weight of 81,000 (S.E. 5,300). This enzyme is similar to protease So (Chung, H. C., and Goldberg, A. L. (1983) J. Bacteriol. 154, 231-238). PMID- 3510202 TI - Isolation of differentiated membrane domains from Escherichia coli and Salmonella typhimurium, including a fraction containing attachment sites between the inner and outer membranes and the murein skeleton of the cell envelope. AB - Cell envelopes of Salmonella typhimurium and Escherichia coli were disrupted in a French pressure cell and fractionated by successive cycles of sedimentation and floatation density gradient centrifugation. This permitted the identification and isolation of several membrane fractions in addition to the major inner membrane and murein-outer membrane fractions. One of these fractions (fraction OML) accounted for about 10% of the total cell envelope protein, and is likely to include the murein-membrane adhesion zones that are seen in electron micrographs of plasmolyzed cells. Fraction OML contained inner membrane, murein, and outer membrane in an apparently normal configuration, was capable of synthesizing murein from UDP-[3H]N-acetylglucosamine and UDP-N-acetylmuramylpentapeptide and covalently linking it to the endogenous murein of the preparation, and showed a labeling pattern in [3H]galactose pulse-chase experiments that was consistent with its acting as an intermediate in the movement of newly synthesized lipopolysaccharide from inner membrane to outer membrane. The fractionation procedure also identified two new minor membrane fractions, with characteristic protein patterns, that are usually included in the region of the major inner membrane peak in other fractionation procedures but can be separated from the major inner membrane fraction and from contaminating flagellar fragments by the subsequent floatation centrifugation steps. PMID- 3510203 TI - Mechanism of galactosylation in the Golgi apparatus. A Chinese hamster ovary cell mutant deficient in translocation of UDP-galactose across Golgi vesicle membranes. AB - The biochemical defect in the mutant Chinese hamster ovary cell lines Clone 13 (Briles, E. B., Li, E., and Kornfeld, S. (1977). J. Biol. Chem. 252, 1107-1116) and Lec8 (Stanley, P. (1980) ACS Symp. Ser. 128, 214-221) was examined. These two mutants, which belong to the same genetic complementation group, were shown in previous studies to exhibit an 80-90% reduction in galactosylation and sialylation of proteins and lipids when compared to wild-type cells. The same studies, however, demonstrated that the mutants were not deficient in the corresponding sugar nucleotides, glycosyltransferases, and endogenous acceptors for these transferases. We now provide evidence strongly suggesting that the primary defect in Lec8 and Clone 13 cells is their inability to translocate UDP galactose into the lumen of the Golgi apparatus. Golgi vesicles from Lec8 and Clone 13 CHO glycosylation mutants translocate in vitro UDP-galactose at only 3 5% the rate of vesicles from wild-type CHO cells. The deficiency is specific because vesicles from the mutant cells can translocate adenosine 3'-phosphate 5' phosphosulfate, UDP-N-acetylglucosamine, and UDP-N-acetylgalactosamine at rates comparable to those of vesicles from wild-type cells. These studies also suggest that sugar nucleotides sharing a common uridine nucleotide utilize different translocators present in the Golgi membrane in vivo. The consequence of the above described mutations and the resulting block in galactosylation of macromolecules in vivo on the translocation of CMP-sialic acid into the Golgi lumen was also examined. As expected, Golgi apparatus vesicles from Lec8 cells were unable to incorporate sialic acid into (endogenous) macromolecules. However, the vesicles were able to transport CMP-sialic acid into their lumen, although the rate of translocation was only 17% of that of wild-type-derived Golgi vesicles. PMID- 3510204 TI - Purification and properties of a diheme cytochrome b561 of the Escherichia coli respiratory chain. AB - A new b-type cytochrome, cytochrome b561 (Murakami, H., Kita, K., Oya, H., and Anraku, Y. (1984) Mol. Gen. Genet. 196, 1-5) was purified to near homogeneity from the cytochrome b561-amplified Escherichia coli K12 strain HM204/pAM5029. The purified cytochrome b561 was a single polypeptide with a molecular weight of 18,000, determined by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Its isoelectric point was determined to be 9.6. The difference spectrum of the cytochrome at 77 K shows a major alpha-absorption peak at 561 nm and a minor peak at 555 nm. The absolute spectrum at room temperature of the oxidized form of the cytochrome had an absorption peak at 414 nm, and that of the reduced form had peaks at 562, 530, and 428 nm. The oxidation-reduction potential of the cytochrome was estimated to be +20 mV. The cytochrome contained 91.2 nmol of heme/mg of protein, showing that it was a cytoplasmic membrane-bound, b-type diheme cytochrome. PMID- 3510205 TI - The role of the maltodextrin-binding site in determining the transport properties of the LamB protein. AB - We have examined by the liposome swelling technique the permeability properties of the modified LamB proteins isolated from mutants of Escherichia coli K12 with altered affinities toward starch and/or maltose (Ferenci, T., and Lee, K-S. (1982) J. Mol. Biol. 160, 431-444). The results revealed the following. A mutant strain exhibiting a markedly lowered affinity toward starch produced a LamB protein that has lost the ability to permeate longer maltodextrins. This protein retained a nonspecific pore for a wide variety of small sugars. A mutant strain with partially reduced affinity for starch produced a LamB protein which still permeated maltodextrins, maltose, and non-maltose sugars but had also gained an ability to permit the diffusion of sucrose and raffinose; in this strain sucrose and raffinose could now compete for the starch-binding site. A mutant with enhanced affinity for both maltose and starch produced a protein which exhibited elevated rates of diffusion for longer maltodextrins but still permeated other small sugars. Two other mutants with altered affinities showed relatively minor changes in the diffusion of maltose and non-maltose sugars. It could be concluded from these studies that the LamB proteins form pores allowing the diffusion of a wide variety of monosaccharides irrespective of the presence or the absence of affinity of a binding site for maltodextrins. However, the presence of a sugar binding site is crucial in determining the rate of the diffusion of maltodextrins or other oligosaccharides. PMID- 3510206 TI - Chemical synthesis and expression in yeast of a gene encoding connective tissue activating peptide-III. A novel approach for the facile assembly of a gene encoding a human platelet-derived mitogen. AB - A synthetic gene encoding the platelet-derived factor, connective tissue activating peptide-III (CTAP-III) (Castor, C.W., Miller, J.W., and Walz, D.A. (1983) Proc. Natl. Acad. Sci. U. S. A. 80, 765-769), has been expressed and secreted from Saccharomyces cerevisiae by using a yeast expression vector and an alpha-factor leader segment. Mitogenic activity reported for naturally derived CTAP-III has been demonstrated here for recombinant CTAP-III. Active CTAP-III has been purified to apparent homogeneity. Structural studies have confirmed its identity. A general approach for the facile synthesis of genes is presented which has permitted the assembly of the entire structural gene and flanking regions (280 base pairs) from 20 oligomers in a single annealing and ligation reaction pool. PMID- 3510207 TI - Radiation inactivation of assimilatory NADH:nitrate reductase from Chlorella. Catalytic and physical sizes of functional units. AB - Assimilatory NADH:nitrate reductase from Chlorella is a homotetramer which contains one of each of the prosthetic groups FAD, heme, and Mo6+ per 100-kDa subunit. At low protein concentrations, this tetramer dissociates to a fully active dimer. To further elucidate the possible relationship between quaternary structure and activity, the functional size of nitrate reductase was determined by radiation inactivation analysis at high and low concentrations of enzyme where the principal physical species would be either tetrameric or dimeric, respectively. In both cases, the size obtained by this method was 100 kDa, suggesting that each subunit in the tetramer or dimer can function independently. These results confirm earlier results which indicated that the subunits are identical and that each contains a full complement of prosthetic groups. We also found that the functional sizes of the partial activities NADH:cytochrome c reductase, NADH:ferricyanide reductase, and reduced methyl viologen:nitrate reductase were fractions (approximately 58 kDa, 47 kDa, and 28 kDa, respectively) of the subunit molecular mass, suggesting that these domains are functionally independent. PMID- 3510208 TI - Chemical cross-linking of thioredoxin to hybrid membrane fraction in Escherichia coli. AB - Thioredoxin was cross-linked to a membrane fraction in vivo using the heterobifunctional photoreactive cross-linking reagent p-azidophenacyl bromide, chosen to couple thioredoxin via its highly reactive thiol. Under mild reaction conditions, a significant amount of thioredoxin (30%) was rapidly cross-linked to the crude membrane fraction. The cross-linking reaction was selective, with thioredoxin purified 15-fold in the cross-linked membrane fraction. Membrane fractionation studies showed that thioredoxin associated with the inner membrane and with a hybrid membrane fraction. This hybrid membrane fraction banded at a density between the inner and outer membranes. This result is consistent with the localization of thioredoxin in association with the bacterial membrane adhesion sites first described by Bayer (Bayer, M. (1968) J. Gen. Microbiol. 53, 395-404). Association of thioredoxin with the membrane adhesion sites defines a structure corresponding to the osmotically sensitive cytoplasmic compartment (Lunn, C. A., and Pigiet, V. (1982) J. Biol. Chem. 257, 11424-11430). PMID- 3510209 TI - Receptor aggregation is necessary for activation of the soluble insulin receptor kinase. AB - Purified polyclonal human antibodies (B-8) against the receptor for insulin (anti R IgG), and their F(ab')2 and Fab' fragments, were used to study a possible role of receptor aggregation in the process that couples insulin binding with the activation of the insulin receptor kinase. Anti-R IgG, F(ab')2, and Fab' fragments were shown to inhibit insulin binding to solubilized partially purified receptor preparations from rat liver. This suggests that the antibodies and fragments bind near or at the insulin-binding site. Only anti-R IgG and its bivalent F(ab')2 fragments were capable of stimulating the receptor kinase activity. Monovalent Fab' fragments were completely devoid of such activity. Cross-linking of anti-R Fab' with goat anti-human Fab' restored the capability of the Fab' fragments to activate the receptor kinase. These data strongly suggest that receptor cross-linking or aggregation constitutes a sufficient trigger to activate the insulin-receptor kinase and could, therefore, be an important step in the transmembrane signaling process. This step presumably precedes the activation of the receptor kinase and the resulting phosphorylation of its protein substrates. PMID- 3510210 TI - The effects of N-ethylmaleimide on the phosphorylation and aggregation of insulin receptors in the isolated plasma membranes of 3T3-F442A adipocytes. AB - We have examined the insulin-dependent phosphorylation of the insulin receptor in the isolated plasma membranes of 3T3-F442A adipocytes. Phosphorylation of the insulin receptor is detected readily in the plasma membrane of these cells by two dimensional sodium dodecyl sulfate-polyacrylamide gel electrophoresis. In the presence of sodium dodecyl sulfate and under nonreducing conditions, the predominant species of phosphorylated insulin receptor has an apparent molecular mass of 350,000 daltons with the beta-subunit (92,000 daltons) being phosphorylated. The phosphorylation of the insulin receptor in the isolated plasma membrane is absolutely dependent on insulin; tyrosine residues and, to a lesser extent, serine residues of the receptor are phosphorylated. Treatment of the plasma membrane with N-ethylmaleimide (NEM) has two effects; 1) NEM prevents the formation of a larger form (greater than 350,000 daltons) of the phosphorylated insulin receptor. The formation of this larger form of the receptor involves sulfhydryl oxidation which occurs at 37 degrees C under nondenaturing conditions, but does not occur at 0 degrees C or at room temperature even in the presence of sodium dodecyl sulfate. These results indicate that the larger form of the phosphorylated receptor can occur under physiological conditions and suggest that this process may be relevant to aggregation of the receptor-ligand complex. 2) Prior to treatment with insulin, NEM enhances the phosphorylation of the insulin receptor. Phosphopeptide analysis indicates that the site(s) of phosphorylation of the receptor is identical in the presence or absence of NEM. PMID- 3510211 TI - Leiomyosarcoma of the hand and wrist. Report of two cases. PMID- 3510212 TI - Candida infection after implant arthroplasty. A case report. PMID- 3510213 TI - Massive allografting for severe failed total hip replacement. AB - We are presenting the cases of five patients that illustrate the uses of large, frozen bone and osteoarticular allografts in dealing with severe structural deficiency about the hip joint associated with prior failed total hip replacement. The status of the grafts was assessed at a minimum follow-up of twenty-four months (average, thirty months). In four patients extensive grafts in the proximal part of the femur in conjunction with total hip-replacement components were used, and in the fifth patient a matched whole-joint transplant of the proximal part of the femur and the acetabulum was employed. The short-term clinical advantage of these massive grafts is clear, but the long-term results are uncertain. PMID- 3510214 TI - A comparison of Keller's arthroplasty and distal metatarsal osteotomy in the treatment of adult hallux valgus. AB - A prospective trial is reported which compares distal osteotomy of the first metatarsal with Keller's arthroplasty in the treatment of adult hallux valgus. A total of 33 patients attended for review at least three years after operation. Symptomatic improvement, as assessed by patient satisfaction, pain relief, cosmetic improvement and restoration of function, was similar in the two groups. Objective measurement showed that the range of movement of the metatarsophalangeal joint was better maintained after osteotomy, as was the relationship of the sesamoid bones to the head of the first metatarsal. Correction of the valgus deformity also was significantly better in the patients who underwent osteotomy and in these patients the first intermetatarsal angle was reduced to within normal limits. There was no evidence that initial degenerative changes or subluxation at the metatarsophalangeal joint compromised a successful result from osteotomy. PMID- 3510215 TI - An investigation into contamination of operative suction. AB - A study of the contamination of suckers used during total hip replacement has been undertaken. Thirty suckers used throughout the operation had their tips cultured: from 11 of these bacteria were grown. The organisms found were those which have previously been implicated in deep infection of total hip replacements. In subsequent operations a further 31 suckers were used for cleaning only the femoral shaft; of these only one was contaminated. This suggests that sucker contamination is related to how long the sucker is in use; consequently it is recommended that a new sucker be used for the preparation of the femoral shaft. PMID- 3510216 TI - Tectoplasty for painful dislocation or subluxation of the hip. Long-term evaluation of a new acetabuloplasty. AB - Tectoplasty is a new acetabuloplasty which aims to provide an extra-articular weight-bearing surface in cases of dysplastic acetabulum, hip subluxation or dislocation with a false acetabulum. The lateral wall of the iliac bone at the lateral edge of the affected acetabulum is raised as a proximally-based flap and massive bone grafts are inserted to provide a congruous, non-absorbable roof for the capsule and femoral head. An advantage is that the weight-bearing surface can be formed away from the original acetabulum, wherever the dislocated or subluxated femoral head may lie. Of 34 hips with congenital dislocation or severe subluxation treated by this method, 27 were evaluated after an average follow-up of 12 years. At review the patients averaged 35 years of age and satisfactory results with good relief of pain had been obtained in 78%. The results were unsatisfactory when degenerative changes had already developed before operation. Tectoplasty is indicated for pain due to congenital subluxation or dislocation of the hip under the age of thirty, in the absence of advanced osteoarthritis. PMID- 3510217 TI - Neuropathic osteonecrosis of the lateral femoral condyle in childhood. A report on four cases. AB - Four children are described, each with spontaneous osteonecrosis affecting nearly one-third of the lateral femoral condyle. All the children had a motor and a sensory deficit in the affected limb: two had been previously treated for neuroblastoma of the spine, one for an infected lumbar dermoid cyst and one had spina bifida. We consider that these disorders, singly or in combination, may lead to repeated excessive loading of the lateral femoral condyle, which cannot be appreciated in a knee that is not protected by normal sensation. PMID- 3510218 TI - The molecular organization of myosin in stress fibers of cultured cells. AB - Antibodies to chicken gizzard myosin, subfragment 1, light chain 20, and light meromyosin were used to visualize myosin in stress fibers of cultured chicken cells. The antibody specificity was tested on purified gizzard proteins and total cell lysates using immunogold silver staining on protein blots. Immunofluorescence on cultured chicken fibroblasts and epithelial cells exhibited a similar staining pattern of antibodies to total myosin, subfragment 1, and light chain 20, whereas the antibodies to light meromyosin showed a substantially different reaction. The electron microscopic distribution of these antibodies was investigated using the indirect and direct immunogold staining method on permeabilized and fixed cells. The indirect approach enabled us to describe the general distribution of myosin in stress fibers. Direct double immunogold labeling, however, provided more detailed information on the orientation of myosin molecules and their localization relative to alpha-actinin: alpha-actinin, identified with antibodies coupled to 10-nm gold, was concentrated in the dense bodies or electron-dense bands of stress fibers, whereas myosin was confined to the intervening electron-lucid regions. Depending on the antibodies used in combination with alpha-actinin, the intervening regions revealed a different staining pattern: antibodies to myosin (reactive with the head portion of nonmuscle myosin) and to light chain 20 (both coupled to 5-nm gold) labeled two opposite bands adjacent to alpha-actinin, and antibodies to light meromyosin (coupled to 5-nm gold) labeled a single central zone. Based on these results, we conclude that myosin in stress fibers is organized into bipolar filaments. PMID- 3510219 TI - Localization of filamin in smooth muscle. AB - The distribution of contractile and cytoskeletal proteins in smooth muscle has been mapped by immunocytochemical methods, with special reference to the localization of the actin-binding protein, filamin. Immunolabeling of ultrathin sections of polyvinylalcohol-embedded smooth muscle distinguished two domains in the smooth muscle cell: (a) actomyosin domains, made up of continuous longitudinal arrays of actin and myosin filaments, and (b) longitudinal, fibrillar, intermediate filament domains, free of myosin but containing actin and alpha-actinin-rich dense bodies. Filamin was found to be localized specifically in the latter intermediate filament-actin domains, but was excluded from the core of the dense bodies. Filamin was also localized close to the cell border at the inner surface of the plasmalemma-associated plaques. In isolated cells the surface filamin label showed a rib-like distribution similar to that displayed by vinculin. It is speculated that the two domains distinguished in these studies may reflect the existence of two functionally distinct systems: an actomyosin system required for contraction and an intermediate filament-actin system, with associated gelation proteins, that is responsible, at least in part, for the slow relaxation and tone peculiar to smooth muscle. PMID- 3510220 TI - A novel intermediate filament-associated protein, NAPA-73, that binds to different filament types at different stages of nervous system development. AB - The antigen recognized by the E/C8-monoclonal antibody is expressed in various avian embryonic cell types known also to express neurofilament (NF) immunoreactivity. To determine whether the E/C8-antigen corresponds to any of the known NF components, we compared their subcellular locations, immunocross reactivities, and electrophoretic behaviors. We found that the E/C8-antibody binds to NF bundles in electron microscope preparations of neurons, but does not correspond to any of the known NF proteins by immunological or electrophoretic criteria. Immunoadsorption with the monoclonal antibody resulted in co purification of a 73,000-D protein with one of the known NF proteins in homogenates from 20-d embryonic chick brains, but with vimentin intermediate filament protein in similarly prepared homogenates from 4-d embryonic chicks. We suggest that the E/C8-antigen is an intermediate filament-associated protein that binds to different filament types at different stages of development. We have named it NAPA-73, an acronym for neurofilament-associated protein, avian specific, 73,000 D, on the basis of its binding specificity in mature neurons. PMID- 3510222 TI - Insulin internalization and degradation in adipocytes from normal and type II diabetic subjects. AB - We studied the ability of isolated adipocytes from normal and type II diabetic subjects to internalize and process [125I]insulin. Adipocytes were incubated with [125I]insulin at 16 or 37 C, and at various times total cell-associated, surface bound, and intracellular insulin were quantitated using an acid-barbital extraction technique which quickly removes cell surface insulin, leaving behind the intracellular insulin. Insulin internalization was slow in normal adipocytes at 16 C, such that only 13% of total cell-associated insulin was intracellular after 2 h of incubation. In contrast, internalization was rapid at 37 C, such that the intracellular pool of insulin was near maximal by 30 min and accounted for approximately 40% of the total cell-associated insulin. Sephadex G-50 column chromatography of the intracellular insulin demonstrated that more than 95% of this pool coeluted with native insulin. In adipocytes from the diabetic subjects, approximately 45% of total cell-associated insulin was intracellular after 30 min of incubation at 37 C. After 60 min of incubation at 37 C, the percentages of total cell-associated and surface-bound insulin were significantly lower in adipocytes from diabetic compared to normal subjects [1.81 +/- 0.31% (+/- SEM) vs. 2.92 +/- 0.24% (P less than 0.05) and 0.97 +/- 0.14% vs. 1.72 +/- 0.15% (P less than 0.01), respectively]. The percentage of insulin in the intracellular compartment was also slightly lower in adipocytes from diabetic compared to normal subjects (0.84 +/- 0.19% vs. 1.20 +/- 0.16%; P greater than 0.05). The lysosomotropic agent chloroquine increased total cell-associated insulin, and this was due entirely to an increase in intracellular insulin. In adipocytes from normal subjects, chloroquine increased intracellular insulin by 32% at 30 min, by 89% at 60 min, by 140% at 90 min, and by 178% at 120 min. In comparison to the normal adipocytes, the chloroquine-mediated increase in intracellular insulin was lower in adipocytes from the diabetic subjects (-8.1% at 30 min, 37% at 60 min, 58% at 90 min, and 63% at 120 min; P less than 0.05 at all time points). These results indicate that insulin is rapidly internalized in human adipocytes at 37 C such that approximately half of total cell-associated insulin is intracellular the intracellular insulin is largely intact; and intracellular processing of insulin by a chloroquine-sensitive pathway(s) is impaired in adipocytes from type II diabetic subjects. PMID- 3510221 TI - Biochemical and immunological analyses of cytoskeletal domains of neurons. AB - We have used cultured sympathetic neurons to identify microtubule proteins (tubulin and microtubule-associated proteins [MAPs]) and neurofilament (NF) proteins in pure preparations of axons and also to examine the distribution of these proteins between axons and cell bodies + dendrites. Pieces of sympathetic ganglia containing thousands of neurons were plated onto culture dishes and allowed to extend neurites. Dendrites remained confined to the ganglionic explant or cell body mass (CBM), while axons extended away from the CBM for several millimeters. Axons were separated from cell bodies and dendrites by dissecting the CBM away from cultures, and the resulting axonal and CBM preparations were analyzed using biochemical, immunoblotting, and immunoprecipitation methods. Cultures were used after 17 d in vitro, when 40-60% of total protein was in the axons. The 68,000-mol-wt NF subunit is present in both axons and CBM in roughly equal amounts. The 145,000- and 200,000-mol-wt NF subunits each consist of several variants which differ in phosphorylation state; poorly and nonphosphorylated species are present only in the CBM, whereas more heavily phosphorylated forms are present in axons and, to a lesser extent, the CBM. One 145,000-mol-wt NF variant was axon specific. Tubulin is roughly equally distributed between CBM and axon-like neurites of explant cultures. MAP-1a, MAP 1b, MAP-3, and the 60,000-mol-wt MAP are also present in the CBM and axon-like neurites and show distribution patterns similar to that of tubulin. In contrast, MAP-2 was detected only in the CBM, while tau and the 210,000-mol-wt MAP were greatly enriched in axons compared to the CBM. In immunostaining analyses, MAP-2 localized to cell bodies and dendrite-like neurites, but not to axon-like neurites, whereas antibodies to tubulin and MAP-1b localized to all regions of the neurons. The regional differences in composition of the neuronal cytoskeleton presumably generate corresponding differences in its structure, which may, in turn, contribute to the morphological differences between axons and dendrites. PMID- 3510223 TI - Multiple factors contribute to the pathogenesis of hypertension in Cushing's syndrome. AB - The mechanisms causing high blood pressure in patients with Cushing's syndrome were investigated by measurements of humoral factors and pharmacological maneuvers. Twelve patients with adrenal adenomas were studied. The mean systolic and diastolic pressures of the patients were 171 +/- 28 and 109 +/- 15 mm Hg (+/- SEM), respectively, which were significantly higher than those of normal subjects. PRA, plasma renin concentration, plasma renin substrate, plasma cortisol, plasma aldosterone, urinary kallikrein, and urinary prostaglandin E2 were measured as the humoral factors. PC values were markedly elevated in patients with Cushing's syndrome. Among the components of the renin-angiotensin system, only plasma renin substrate was increased. Urinary kallikrein and prostaglandin E2 were decreased in patients with Cushing's syndrome. Oral administration of captopril lowered blood pressure, but infusion of an angiotensin II analog did not. Furthermore, the pressor responses to infusion of both norepinephrine and angiotensin II were increased. We conclude that blood pressure is elevated in patients with Cushing's syndrome because they have enhanced pressor responses to vasoactive substances, suppression of depressor systems, and some abnormalities of the renin-angiotensin system. PMID- 3510224 TI - Gastric inhibitory polypeptide responses and glucose turnover rates after natural meals in type II diabetic patients. AB - Gastric inhibitory polypeptide (GIP) has insulinotropic actions in the presence of hyperglycemia. However, its extrapancreatic effects on glucose homeostasis are controversial. We have studied the relationships between GIP and immunoreactive insulin (IRI) and glucose turnover rates (D3H-3 glucose technique) in five poorly controlled type II diabetic patients and five normal subjects before and after a breakfast containing 500 kcal including 42 g sucrose. Mean fasting serum glucose levels and glucose responses were significantly (P less than 0.001) higher in the diabetic patients than in normal subjects. Mean basal serum IRI levels were similar in both groups [12.8 +/- 2.9 (SEM) vs. 11.8 +/- 2 microU/ml, P = NS]. After meal ingestion, mean IRI levels rose significantly to a peak at 20 min in the normal subjects but the responses were blunted in the diabetic patients (74 +/- 10 vs. 24 +/- 6 microU/ml, P less than 0.001). At all other times studied (60 180 min), mean serum IRI levels were similar in the diabetic patients and the normal subjects except at 180 min. Mean basal serum GIP levels were similar in the diabetic patients and the normal subjects (538 +/- 100 vs. 400 +/- 50 pg/ml, P = NS). After meal ingestion, mean GIP levels rose between 0-60 min but were significantly higher in the diabetic patients only at 20 min (1200 +/- 190 vs. 566 +/- 76 pg/ml, P less than 0.01). Mean basal hepatic glucose output was higher (P less than 0.01) in the diabetic patients. However, the mean basal MCR values were similar. After meal ingestion, total splanchnic glucose output and rates of glucose utilization (RU) were significantly higher in the diabetic patients compared with the normal subjects (P less than 0.001, and P less than 0.001, respectively). Postmeal MCR values were not statistically different in both groups. There were significant positive correlations between postmeal splanchnic glucose output and both IRI (r = 0.805, P less than 0.005) and GIP (r = 0.749, P less than 0.02) in the diabetic patients but not in the normal subjects (r = 0.10, P = NS for both). Whereas no relationships existed between RU and IRI in either group, RU correlated strongly with GIP (r = 0.810, P less than 0.005) only in the diabetic patients. We hypothesize that GIP may play a compensatory role to improve both impaired beta-cell insulin release and peripheral glucose utilization which are the recognized pathogenetic mechanisms underlying type II diabetes mellitus. PMID- 3510225 TI - Inhibitory effect of bromocriptine treatment on luteinizing hormone secretion in polycystic ovary syndrome. AB - In order to investigate a possible common role of central dopaminergic mechanisms in the release of PRL and LH in patients with the polycystic ovary syndrome (PCO), plasma LH pulsatile profiles and the response to GnRH were studied in a group of 12 PCO patients before and after 3 months of treatment with bromocriptine, 2.5 mg twice daily. They were divided into two groups of six patients according to the occurrence or not of hyperprolactinemia (plasma PRL, 30.3 +/- 2.7 (SE) ng/ml vs. 9.5 +/- 0.8 (SE) ng/ml). Integrated LH secretion significantly decreased in hyperprolactinemic [2537 +/- 371 (SE) vs. 907 +/- 102 mIU/ml X min] as well as in normoprolactinemic (2847 +/- 460 vs. 901 +/- 152 mIU/ml X min) patients, but there was no difference in the response of the two groups. The LH increment after a bolus injection of 100 micrograms GnRH was reduced (P less than 0.01) to the same extent in both groups. These results indicate a dopaminergic component in the control of LH release in PCO patients, independent of the mechanism governing PRL secretion. Since bromocriptine reduced LH secretion, it may be useful for the management of this condition. PMID- 3510226 TI - Effect of age on the renin-angiotensin-aldosterone system in normal subjects: simultaneous measurement of active and inactive renin, renin substrate, and aldosterone in plasma. AB - To investigate the effect of aging on the renin-angiotensin-aldosterone system, plasma renin substrate concentrations (PRSC); plasma total, active, and inactive renin concentrations (TRC, ARC, and IRC); PRA; and plasma aldosterone concentrations (PAC) were measured simultaneously in 60 normal subjects, 18-84 yr old. PRSC was measured by the addition of excess human renal renin. ARC and TRC after trypsin activation were measured by adding sheep renin substrate; IRC was calculated by subtracting ARC from TRC. The active renin ratio was calculated as follows: ARC/TRC X 100%. PRA and PAC were measured by RIA. There were no significant changes in PRSC, TRC, IRC, and PRA to PAC ratio with aging. Both ARC and active renin ratio fell significantly with aging (r = 0.46 and P less than 0.01; and r = 0.54 and P less than 0.01, respectively). PRA and PAC also tended to decrease with aging (r = 0.35 and P less than 0.01; and r = 0.59 and P less than 0.01, respectively). A significant positive correlation was found between PRA and ARC (r = 0.72; P less than 0.001). PRA was also correlated with PAC. In conclusion, the age-related decrease in PRA is not due to the change in PRSC, but is mainly due to the fall in ARC. Decreased conversion of inactive to active renin might be responsible in part for the reduced ARC in the elderly. PMID- 3510227 TI - Monoclonal antibodies as molecular probes to study structural heterogeneity between human and animal renins and other aspartyl proteinases. AB - Monoclonal antibodies may be helpful in comparing the structural homology of renins of various animal species as well as other aspartyl proteinases. We obtained four hybridoma lines secreting monoclonal antibodies that inhibited 3 Goldblatt mU human renin enzymatic activity with apparent IC50 of 1.1 X 10(-6)-4 X 10(-8) M. Each antibody was specific for human renin and did not cross-react either with other proteins tested nor with renins of other species in an immunoradiometric assay. These antibodies did not inhibit the enzymatic activities of nonprimate renins or nonrenin aspartyl proteinases tested. These data indicate that certain structural determinants of human renin activity may be uniquely different from those of nonprimate renins or nonrenin aspartyl proteinases. PMID- 3510228 TI - Novel antigens at the neuromuscular junction. AB - Three novel components of neuromuscular junctions have been identified by use of monoclonal antibodies (McAb) against glycoproteins obtained from a mouse neuroblastoma X human dorsal root ganglion cell hybrid line. Antigen distribution was assessed by fluorescent immunohistochemistry on frozen sections of human intercostal muscle counterstained with labeled alpha-bungarotoxin to identify neuromuscular junctions. Antigen SOS 6 stained exclusively in the neuromuscular junction, whereas antigens SOS 5 and SOS 13 were highly enriched in the junction but also stained extrasynaptic regions. These antigens can be distinguished from previously described components of the neuromuscular junction by their molecular weights, insensitivity to collagenase treatment, and solubility in 0.1% Triton X 100. Indirect evidence suggests that these species-specific antigens are located in the postsynaptic muscle membrane, but location in the junctional basal lamina or subsarcolemmal region cannot be excluded. PMID- 3510229 TI - Induction of chondrogenesis in muscle, skin, bone marrow, and periodontal ligament by demineralized dentin and bone matrix in vivo and in vitro. AB - Induction of chondrogenesis in vivo by rolls of demineralized dentin implanted in muscle, subcutaneous connective tissue of skin, medullary cavity of femur, and periodontal ligament of rat was investigated. Specimens were examined at various times up to 21 days after implantation, using light microscopy and morphometric analysis. Induction of cartilage occurred most quickly in muscle, followed by subcutaneous connective tissue of skin and medullary cavity of femur, and most slowly in periodontal ligament. Significantly more cartilage was found in muscle than in subcutaneous connective tissue of skin and medullary cavity of femur at the times examined, and least of all in periodontal ligament. Outgrowth of cells from rat muscle, dermis and subcutaneous tissue, bone marrow and periodontal ligament cultured in vitro on demineralized bone matrix for up to 35 days produced similar results. PMID- 3510231 TI - Keloids: scar revision. AB - The treatment of keloids can be a long-term, and at times, vexing, dermatologic surgical management problem arising in both white and non-white patients. This paper reviews a number of conventional, as well as novel, therapeutic approaches for the management of this disease of uncontrolled scar growth. Additionally, fundamental aspects of this disease are covered, including clinical, histologic, biochemical, immunologic, endocrinologic, and epidemiologic factors. An understanding of these latter aspects may be useful to the clinician in realizing the best possible therapeutic results. It must be emphasized that, regardless of the technique employed, an observation period of at least 2 years is necessary to effectively limit the chance and degree of recurrence. PMID- 3510230 TI - The nature of early caries lesions in enamel. AB - Since 1935, various mechanisms have been suggested for the formation of subsurface lesions and, in particular, the surface layer covering enamel lesions. The relatively intact mineral-rich and porous surface layer is most likely caused by kinetic events. The suggested mineral-rich outer layer in sound enamel, the organic matrix, the pellicle, or a non-uniform ion distribution have all been shown to be non-essential for surface layer formation; they may, however, influence the rate of surface layer formation. Models based on outer surface protection by adsorbed agents, the dissolution-precipitation mechanism, and combinations of these two models, as well as models based on porosity or solubility gradients, are discussed in this paper together with their advantages and disadvantages. Most models have not explained some important recent experimental observations on initial in vivo caries lesion formation: e.g., initial enamel lesions formed in vivo do not have a surface layer initially but develop this mineral-rich layer later on; and the fact that the F- level in the solid sound enamel is not determining the subsurface lesion formation. Furthermore, the observations that in vitro fluoride ions in the liquid at very low levels (approximately equal to 0.02 ppm) determine surface layer formation are difficult to explain. A new kinetic model for subsurface lesion formation is described, in which inhibitors such as F- or proteins play an important role. The model predicts that if lesions depth and demineralization period are denoted by df and t, lesion progress can be described by: dfp = alpha t + c, where alpha and c are constants with 1 less than or equal to p less than or equal to 3, depending on the lesion formation conditions. If lesion progress is entirely diffusion controlled, p = 3, corresponding to low inhibitor concentrations; if the inhibitor content is so high that the progress is controlled by processes at the crystallite surface, p = 1. A kinetic mechanism for surface layer formation in vivo is proposed, based on the assumption that F- is a main inhibitor in the plaque-covered acidic in vivo situation. The inhibiting fluoride, adsorbed onto the crystallite surfaces at OH- vacancies, originates from the so-called fluoride in the liquid phase (FL) between the enamel crystallites. Under acidic conditions (plaque), we have, due to an influx of fluoride from the saliva or plaque as FL, an aqueous phase in the enamel supersaturated with respect to the mineral for a small distance (x*) only.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3510232 TI - Effect of propranolol in patients with myocardial infarction and ventricular arrhythmia. AB - The Beta-Blocker Heart Attack Trial was a placebo-controlled, randomized, double blind clinical trial of the long-term administration of propranolol hydrochloride to patients who had had at least one myocardial infarction. Among 3,837 patients followed up for an average of 25 months, 3,290 (85.7%) had 24 hour ambulatory electrocardiograms performed at the baseline examination. Four classifications of arrhythmia were examined. One of these, the presence of complex ventricular arrhythmias (at least 10 ventricular premature beats/h, or at least one pair or run of ventricular premature beats or multiform ventricular premature beats) was the subgroup of major interest. Regardless of the classification, the presence of arrhythmia identifies a group of patients with a higher risk of total mortality, coronary heart disease mortality, sudden cardiac death and instantaneous cardiac death. The a priori subgroup hypothesis that sudden death would be preferentially reduced by propranolol in patients with complex ventricular arrhythmias was not supported. The relative benefit of propranolol in reducing sudden death for this subgroup was 28 versus 16% for the subgroup without ventricular arrhythmia (relative risk of 0.72 versus 0.84, a nonsignificant relative difference of 14%). There were similar findings for two of the three other classifications of arrhythmia and for the other response variables. Although propranolol does not appear to be of special relative benefit in patients with ventricular arrhythmia, the presence of the arrhythmia does identify a high-risk group. The mechanism by which propranolol reduces mortality is still unclear, but is probably not solely an antiarrhythmic one. PMID- 3510233 TI - Causes of sudden death in competitive athletes. AB - Cardiovascular diseases responsible for sudden unexpected death in highly conditioned athletes are largely related to the age of the patient. In most young competitive athletes (less than 35 years of age) sudden death is due to congenital cardiovascular disease. Hypertrophic cardiomyopathy appears to be the most common cause of such deaths, accounting for about half of the sudden deaths in young athletes. Other cardiovascular abnormalities that appear to be less frequent but important causes of sudden death in young athletes include congenital coronary artery anomalies, ruptured aorta (due to cystic medial necrosis), idiopathic left ventricular hypertrophy and coronary artery atherosclerosis. Diseases that appear to be very uncommon causes of sudden death include myocarditis, mitral valve prolapse, aortic valve stenosis and sarcoidosis. Cardiovascular disease in young athletes is usually unsuspected during life, and most athletes who die suddenly have experienced no cardiac symptoms. In only about 25% of those competitive athletes who die suddenly is underlying cardiovascular disease detected or suspected before participation and rarely is the correct clinical diagnosis made. In contrast, in older athletes (greater than or equal to 35 years of age) sudden death is usually due to coronary artery disease, and rarely results from congenital heart disease. PMID- 3510234 TI - Exercise: a risk for sudden death in patients with coronary heart disease. AB - Although sudden arrhythmic death is usually unrelated to exertion, there is more than anecdotal evidence that strenuous exercise in patients with coronary heart disease carries an additional risk for sudden death. When cardiac arrest has been observed after exercise stress testing or within seconds after collapse associated with exertion, ventricular fibrillation has usually been present and has responded to the prompt application of a defibrillatory shock. Exertion related cardiac arrest is typically a "primary" arrhythmic event not due to acute myocardial infarction. As estimated here, the additional risk of exercise for cardiac arrest may be more than 100-fold during or after a few minutes of vigorous exertion. PMID- 3510235 TI - Mitral valve prolapse: definition and implications in athletes. AB - Mitral valve prolapse is probably the most common cardiac valve disorder, affecting approximately 5% of the population. Although it is genetically determined, its clinical manifestations do not usually become evident before adulthood. In the setting of a cardiology referral center, a mitral valve prolapse syndrome, consisting of nonspecific symptoms, repolarization changes on the electrocardiogram and arrhythmias, has been identified. However, doubt has recently been expressed about the existence of such a syndrome. The prognosis of mitral valve prolapse is generally favorable but infrequent complications do occur and include transient ischemic attacks, progression of mitral regurgitation with or without ruptured chordae tendineae, infective endocarditis and sudden death. The symptoms and the complications are not usually related to physical activity. A permissive attitude toward participation of patients with mitral valve prolapse in competitive athletics is probably warranted; however, it would appear reasonable to disqualify athletes with mitral valve prolapse in the following circumstances: history of syncope; disabling chest pain; complex ventricular arrhythmias, particularly if induced or worsened by exercise; significant mitral regurgitation; prolonged QT interval; Marfan's syndrome; and family history of sudden death. PMID- 3510236 TI - The continuing problem of retracted papers. PMID- 3510237 TI - On the occasion of the two hundredth anniversary of publication of "An account of the foxglove" by William Withering. PMID- 3510238 TI - Vasospastic angina: a continuing search for mechanism(s). PMID- 3510239 TI - Coronary flow reserve provided by sequential internal mammary artery grafts. AB - Although internal mammary artery bypass grafts have a high patency rate, the adequacy of blood flow through such conduits, particularly if used sequentially, has been questioned. To evaluate this issue, coronary flow reserve was studied in 20 patients after coronary bypass surgery. Nine patients had sequential internal mammary grafts to the diagonal and left anterior descending coronary arteries; five had a single internal mammary graft to the left anterior descending artery and six had sequential saphenous vein grafts. Fifteen additional single vein grafts were also placed in these patients. Coronary flow reserve was measured after contrast-induced hyperemia by a digital subtraction angiographic technique an average of 25 days after surgery. There was no difference in coronary flow reserve between the proximal and distal anastomotic regions in either the sequential internal mammary graft group (2.14 +/- 0.50 versus 2.29 +/- 0.68, n = 8, p = NS) or the sequential vein group (1.77 +/- 0.49 versus 2.08 +/- 0.78, n = 6, p = NS). In addition, the flow reserve provided to either vascular bed of the sequential internal mammary graft was not different from that provided by a single internal mammary graft (1.64 +/- 0.39, n = 5), a single vein graft (1.95 +/- 0.95, n = 15) or nonstenotic native coronary arteries (2.04 +/- 0.87, n = 34). No cases of intracoronary steal were observed. Although some patients had unequal flow reserves between the proximal and distal anastomotic zones, these occurred in the setting of residual coronary stenoses distal to the site of graft insertion or prior myocardial infarction in the grafted distribution.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3510240 TI - Tooth loss, mastication, and nutrition: an overview. PMID- 3510241 TI - Nutritional contributors to cardiovascular disease in the elderly. AB - Cardiovascular disease, so common in the elderly, has become an urgent public health concern. Major contributing factors include hypertension, dyslipidemia, impaired glucose tolerance, physical indolence, and cigarette smoking. Diet plays a major role in atherogenesis by its influence in blood lipids, blood pressure, and glucose tolerance, although its impact in the elderly is speculative owing to a paucity of direct evidence. But a rationale exists. Most cardiovascular risk factors are more prevalent in the elderly than in the young adult. The rise in blood pressure and blood lipids with advancing age is not inevitable. Diet may contribute to hypertension through an excess of calories, saturated fat, cholesterol, or salt and a deficiency of potassium, calcium, and magnesium. Antiatherogenic diets low in saturated fat and cholesterol, rich in fiber, and with substitution of polyunsaturated fat and restricted calories tend to normalize serum lipids and to cause lesions to involute. Emphasis on vegetable protein and fiber-rich food has merit because they provide more fiber, polyunsaturated fatty acids, magnesium, selenium, complex carbohydrate, potassium, and copper, and less cholesterol, saturated fat, and sodium. The recommended fat-modified diets are adequate in protein, vitamins, and minerals and need not be deficient in any nutrient or economically nonfeasible. The accelerating decline in cardiovascular mortality, which has included the elderly, indicates that such disease is controllable and not inevitable, even in the elderly. The decrease has occurred concurrently with reduced consumption of saturated fat and cholesterol, increased use of vegetable oils, and improved levels of cardiovascular risk factors. PMID- 3510242 TI - Treatment-resistant depression in the elderly. PMID- 3510243 TI - Intergenerational perspectives on impaired elders' support networks. AB - The purpose of this paper was to compare impaired elders' and their adult children's reports of the elders' caregiving and decision-making support networks. The two generations (n = 101 each) generally agreed on the primary person in each network and on the overall hierarchy of sources of support, but they differed on the two networks' size, specific composition, and members' relative centrality. Decision-making networks were consistently smaller, more highly centralized, and more restricted to immediate family, suggesting the need to distinguish this network from the general caregiving network. Our discussion focuses on possible explanations for intergenerational differences in perspectives on elders' social support and on the desirability of taking these differences into account in both research and practice. PMID- 3510244 TI - Regulation of insulin secretion by glucose during aging. AB - The purpose of this study was to investigate the sensitivity of insulin secretion to glucose and its possible relationship to changes in islet glucose utilization during aging. Pancreatic islets of Langerhans were isolated from male Sprague Dawley rats aged 2- to 24-months and perifused in vitro with glucose. Insulin concentration was determined by radioimmunoassay. Glucose utilization was assessed by measuring the rate of conversion of 3H-5-D-glucose to 3H-H20. The sensitivity of isolated, perifused islets to glucose was reduced during aging. Less glucose metabolism, however, may be required to elicit comparable release of insulin by islets from old than from young rats. PMID- 3510245 TI - Aged blacks' choices for an informal helper network. AB - Research on the support networks of impaired elderly adults suggests that membership in sociodemographic subgroups influences use of specific informal helpers. This study explored the relationships of sociodemographic, health, and family factors to informal helper choice among a nationally representative sample (N = 581) of older (55 years and above) blacks (National Survey of Black Americans). Nine categories of helpers were examined: spouse, son, daughter, father, mother, brother, sister, friend, and neighbor. Logistic regression analyses revealed that marital status is important in selecting the categories of sister, friend, and neighbor. Presence of children decreased the likelihood that siblings and friends would be chosen. Perceived family closeness facilitated the selection of siblings but inhibited the choice of friends. Regional differences suggest a greater likelihood of selecting the categories of sister, friend, and neighbor among Southern residents. PMID- 3510246 TI - Combination of immunocytochemistry and in situ hybridization in the same tissue section of rat pituitary. AB - A procedure is described for combining avidin-biotinylated horseradish peroxidase immunocytochemistry, for localizing peptides or proteins, with in situ hybridization for localizing mRNA autoradiographically in the same cryostat section of paraformaldehyde-fixed rat pituitary. Protection against enzymatic degradation of target mRNAs during the immunocytochemical step was necessary and was accomplished by including an RNase inhibitor, 0.04% diethylpyrocarbonate, in primary and secondary antisera. This combination of methods may be useful in other tissues, as well, for (a) determining the relation of protein content to the concentration of its encoding mRNA, (b) proving the synthetic capacity of a cell in which a protein has been localized, (c) determining immunological or nucleic acid probe specificity, or (d) as an alternative to double-labeling immunocytochemical methods. PMID- 3510247 TI - Models for the self-assembly of basement membrane. AB - Basement membranes contain a number of intrinsic macromolecular components which are unique to these structures and which cooperatively assemble into specific heteropolymeric matrices. Type IV collagen triple helical monomers bind together at their amino-terminal, carboxy-terminal, and lateral domains to form a lattice like array. Laminin, in a two-step process, binds to itself at its terminal globular domains to form polymers and also binds collagen at two distinct sites along the collagen chain. Heparan sulfate proteoglycan has been found to bind both collagen and laminin, suggesting a reversible crosslinking function. On the basis of the data derived from self-association studies, it is possible to begin considering models for the assembly and structure of these ubiquitous matrices. PMID- 3510248 TI - Reorientation and fusion of cytotoxic T lymphocyte granules after interaction with target cells as determined by high resolution cinemicrography. AB - The interaction of murine cytotoxic T lymphocyte (CTL) clones with human lymphoblastoid target cells was studied in thin preparations by using high resolution cinemicrography. CTL not bound to target cells were morphologically polar, possessing a broad leading edge containing the nucleus, and a tapered tail containing a large number of granules. The CTL were observed to move by the extension of pseudopods from the leading edge. Initial contact with a target cell was made via the leading edge of the CTL. If the human target cell expressed the appropriate HLA antigen, distinct morphologic changes occurred in the CTL as early as 2 min after initial contact. The CTL rounded up, and the nucleus moved from a position adjacent to the zone of contact to be replaced by the cytoplasmic granules. Redistribution of the granules was completed as early as 10 min after initial contact was made. These morphologic changes did not occur when the CTL made contact with other CTL, or with target cells that did not express the appropriate HLA antigens. In studies that make use of Nomarski optics, an apparent fusion of CTL cytoplasmic granules with the membrane in the vicinity of the target cell contact area was observed 4 min after binding, and before granule reorientation was complete. These data provide direct evidence for the occurrence of both reorientation of the cytoplasmic contents and granule fusion in CTL with a time course similar to that of administration of the lethal hit. PMID- 3510249 TI - Two major classes of mitogen-reactive B lymphocytes defined by life span. AB - The relative numbers of short- and long-lived mitogen-reactive B cells in the peripheral pool were evaluated by studying the decay of lipopolysaccharide (LPS) reactive B lymphocytes in LPS nonresponder, histocompatible hosts for periods of up to 3 wk after cell transfer. The results obtained demonstrate the existence of two major classes of mitogen-reactive B cells defined by life span. The "short lived" cell component comprises about 80 to 90% of the reactive cells and decays with a life expectancy of 18 to 24 hr. The long-lived cell component, with life expectancies of 10 to 20 days, comprises about 10 to 20% of the reactive cells and is preferentially enriched in circulating B cells. The present ratio for short- and long-lived B cells implies a highly dynamic state for the immune system which must be advantageous in the selection of available repertoires. PMID- 3510250 TI - Autoantibodies to creatine kinase in rabbits infected with Treponema pallidum. AB - Sera from rabbits infected intratesticularly with Treponema pallidum (Nichols) for 30 days were examined for autoantibody reactivity against muscle and testis extracts by Western immunoblotting. Syphilitic sera (30 day) reacted with an autoantigen of 43,000 daltons in muscle extracts. The antigen was shown to be creatine kinase (CK). Studies with the use of an anti-CK ELISA showed that the autoantibody to CK first appeared 3 wk after infection, declined by 7 wk infection, and was absent in rabbits "mock"-infected with heat-killed T. pallidum. CK activity was not detected in sonicated or intact, washed T. pallidum, suggesting that the antibody was not produced in response to treponemal CK. PMID- 3510251 TI - Macrophage-mediated fungistasis in vitro: requirements for intracellular and extracellular cytotoxicity. AB - Macrophage cytotoxicity for Cryptococcus neoformans was investigated by culturing mouse peritoneal macrophages with a thin-capsuled clone of cryptococcus under conditions permitting efficient phagocytosis. Yeast replication was quantitated by electronic particle counting after detergent lysis of macrophages, and viability was determined by quantitative plate counts. Under appropriate conditions, reproduction was completely inhibited; stasis began at 2 hr after addition of yeasts and lasted for 30 hr. During this time organisms in medium alone proliferated rapidly, doubling their number every 2.5 hr. After removal from macrophages, 60 to 100% of macrophage-inhibited cryptococci formed colonies, indicating that the cytotoxic effect was primarily fungistatic. When yeast cells were removed from macrophages, replication recommenced within 5 hr. Supernatant medium from fungistatic co-cultures was not inhibitory for fresh yeast cells. Conditions required for complete fungistasis were 1) peritoneal macrophages induced by peptone from BCG-infected mice, 2) endotoxin in nanogram per milliliter range added to serum-containing cell culture medium, 3) confluent macrophage monolayers, and 4) macrophage:cryptococci ratios of 20 to 100:1. Fungistasis occurred without phagocytosis but was more efficient when cryptococci were engulfed. For efficient fungistasis, macrophages must differentiate to and be maintained in the activated state. These results with yeast cells agree with the known requirements for macrophage effector function against neoplastic target cells. PMID- 3510252 TI - Natural cytotoxic effector cell activity against Shigella flexneri-infected HeLa cells. AB - Virus and facultative intracellular bacteria both replicate within a host cell. The recognition and killing of virus-infected cells by natural killer (NK) cells is thought to be an important host immune function. However, little is known about immune recognition of bacteria-infected cells. In this report, we show for the first time that human peripheral blood lymphocytes (PBL) and large granular lymphocytes (LGL) purified from PBL have significant levels of cytotoxic activity against Shigella flexneri-infected HeLa cells. This cytotoxic activity was dependent on bacterial invasion of the HeLa cells, because HeLa cells pretreated with a noninvasive isogenic variant of S. flexneri or soluble bacterial products were not killed. Pretreatment of PBL with interleukin 2 (IL 2) or interferon alpha greatly enhanced the cytotoxic activity of PBL against Shigella-infected HeLa cells. Cytotoxic activity present in PBL or in PBL pretreated with IL 2 was shown to be associated with both Leu-11+ and Leu-11- cell populations. These results suggest that NK cell killing of bacteria-infected cells may play an important role in host defense against facultative intracellular bacterial infections. PMID- 3510253 TI - Production of a fibroblast-stimulating factor by Schistosoma mansoni antigen reactive T cell clones. AB - Fibrosis in schistosomiasis is the terminal event of a complex pathophysiologic cascade involving interactions between fibroblasts and both host and parasite products. In the present study, the effect of lymphokines produced by cloned Schistosoma mansoni antigen-reactive T cells on the proliferation of murine fibroblasts was investigated. These T cells previously have been shown to proliferate, produce lymphokines, mediate delayed-type hypersensitivity responses, and generate in vitro granulomas in response to soluble egg antigen (SEA). T cells, co-cultured with irradiated antigen-presenting cells and pulsed with SEA, produced levels of fibroblast-stimulating factor (FSF) comparable to equivalent numbers of dispersed hepatic granuloma cells isolated from infected mice. Supernatants of cloned T cells pulsed with Con A (in the absence of macrophages) contained no detectable interleukin 1 activity, but did stimulate fibroblast activation and growth. T cell FSF activity was trypsin-sensitive, was stable at 56 degrees C but not to boiling, and was retained by Con A Sepharose. Activity was associated with HPLC fractions corresponding to an m.w. of 10,000 to 40,000. Neither recombinant interferon-gamma nor affinity-purified interleukin 2 was capable of stimulating fibroblast proliferation. In functional studies, the degree of fibroblast proliferation was related to the length of exposure to the factor. In addition, quiescent fibroblasts were maximally stimulated by T cell FSF only if a second co-factor such as insulin or epidermal growth factor was present. The synergism between T cell FSF and known progression factors suggests that FSF-T may provide a competence signal to fibroblasts. The present results suggest that a direct molecular link may exist between T cells and fibroblasts in schistosomiasis. PMID- 3510254 TI - Differences between basophils and mast cells: failure to detect Charcot-Leyden crystal protein (lysophospholipase) and eosinophil granule major basic protein in human mast cells. AB - Human eosinophils contain several distinctive proteins including eosinophil granule MBP and the membrane-associated CLC protein (lysophospholipase). Human basophils also contain these proteins, indicating biochemical similarities between eosinophils and basophils. To determine whether MBP or CLC protein is present in connective tissue mast cells, we studied human lung and cutaneous mast cells by immunofluorescence by utilizing specific antibodies to CLC and MBP. Cytocentrifuge slides of enriched lung mast cells and mast cells in sections of formalin-fixed, paraffin-embedded cutaneous tissue from urticaria pigmentosa lesions were stained for CLC and MBP. Neither pulmonary nor cutaneous mast cells stained for CLC protein or MBP. In contrast, lung and cutaneous eosinophils in the same preparations showed bright staining for both proteins. The failure to find CLC protein and MBP in mast cells provides additional evidence of dissimilarity between mast cells and basophils, and an immunochemical means to distinguish between them. PMID- 3510255 TI - Immunochemical analysis of the Ia polymorphisms among the family of DR7 associated HLA-D specificities. AB - Among cells that bear the serologically defined Ia alloantigen DR7, four T cell defined HLA-D specificities have been described: Dw7, Dw17, Dw11, and Dw7L. Ia molecules expressed by cells homozygous for these specificities have been compared by using immunofluorescence and two-dimensional gel electrophoresis in order to identify the DR and DQ polymorphisms among the family of DR7-associated HLA-D specificities. Cells homozygous for each of the four HLA-D specificities have in common one DR molecule that is indistinguishable by these methods. Two DR specific monoclonal antibodies, IIIE3 and 109d6, detect a second distinct DR molecule on Dw7, Dw17, and Dw7L cells. This second DR molecule is also very similar from cells of the three specificities. In contrast, a second DR molecule was not detected on four Dw11 homozygous cells. Therefore, these data raise the possibility that all DR homozygous cells do not express the same number of DR molecules. The DQ molecules expressed by DQw2-positive Dw7, Dw17, and Dw7L cells are also very similar, whereas DQw3-positive Dw11 DQ molecules are structurally different. Therefore, no DR or DQ structural polymorphisms were detected to correlate with the Dw7, Dw17, and Dw7L T cell-defined Ia polymorphisms. PMID- 3510256 TI - Detection of antibodies to Rickettsia conorii with a latex agglutination test in patients with Mediterranean spotted fever. PMID- 3510257 TI - Diagnosis of Mediterranean spotted fever by using an immunofluorescence technique. PMID- 3510258 TI - Incidence of human infection with Yersinia enterocolitica serotypes O3, O8, and O9 and the use of indirect immunofluorescence in diagnosis. PMID- 3510259 TI - Germling protoplast antigens of Candida albicans in the serodiagnosis of invasive candidosis. PMID- 3510260 TI - Pathogenesis of labyrinthitis associated with Haemophilus influenzae type b meningitis in infant rats. AB - The pathogenesis of labyrinthitis associated with bacterial meningitis was studied by histopathologic examination of inner ears of 114 rats with Haemophilus influenzae type b meningitis produced by ip inoculation of one of 13 clinical isolates. Findings consisted of inflammation of the perilymphatic spaces of the cochlea and semicircular canals with sparing of the endolymphatic space, cochlear nerve fibers, and middle ear. The degree of inflammation peaked at 48 hr after inoculation, then declined by 96 to 144 hr. No interstrain differences in type or degree of pathology were observed. Immunofluorescent staining of cochleae from 15 animals demonstrated that bacteria were present in areas of inflammation and also in the endolymphatic space and organ of Corti. One isolate displayed a tendency to accumulate in the perilymphatic spaces in larger numbers than those seen with three other isolates. These findings suggest that, in this model, inflammation reaches the inner ear by spreading from the subarachnoid space. Bacterial invasion of the organ of Corti may be one mechanism by which deafness occurs in bacterial meningitis. PMID- 3510261 TI - Human adenoid organ culture: a model to study the interaction of influenza A with human nasopharyngeal mucosa. AB - Previous studies of infections with influenza A in animal models have stressed the tropism of this virus for the upper respiratory tract. To assess the interaction of influenza A virus with human respiratory tissue, we maintained adenoids, consisting of ciliated epithelium with underlying lymphoid follicles, in organ culture. When the organ cultures were inoculated with wild-type influenza A/Alaska (H3N2), epithelial damage and migration of inflammatory cells from the follicles into the lamina propria were seen. Growth of the virus and ciliary damage in infected organ cultures from seronegative donors were significantly greater than that seen in organ cultures from seropositive donors. Adenoidal lymphocytes were then studied to determine which factors might modulate infectivity. Specific in vitro production of antibody to influenza A/Alaska was demonstrated by adenoidal lymphocytes from seropositive donors, whereas lymphocytes from seronegative donors did not produce antibody. The human adenoid organ culture provides an attractive model to study the pathogenesis of influenza A infections and the resultant local immune response. PMID- 3510262 TI - Streptococcus pneumoniae-induced alterations in levels of circulating thromboxane and prostacyclin: dissociation from granulocytopenia, thrombocytopenia, and pulmonary leukostasis. AB - The role of thromboxane (Tx) A2 in Streptococcus pneumoniae-induced granulocytopenia, thrombocytopenia, and pulmonary leukostasis is unclear. Rabbits were injected with 0.85% NaCl, nonviable pneumococci, or nonviable pneumococci after pretreatment with TxA2 synthetase inhibition. Blood was obtained immediately before and at times after injection for granulocyte and platelet counts and assays of TxB2 and 6-keto prostaglandin F1 alpha (6-ketoPGF1 alpha). Animals were evaluated for pulmonary leukostasis histologically and biochemically (myeloperoxidase activity). Pneumococcal challenge induced significant granulocytopenia (P less than .001), thrombocytopenia (P less than .001), and elevations in levels of both TxB2 (P less than .05) and 6-ketoPGF1 alpha (P less than .001) as well as pulmonary leukostasis (P less than .001). TxA2 synthetase inhibition blocked the pneumococcus-induced elevation in level of TxB2 without significantly altering levels of circulating granulocytes, platelets, or 6 ketoPGF1 alpha. Pulmonary leukostasis was not blocked. In another group of pneumococcus-challenged animals, no significant transpulmonary gradients of either TxB2 or 6-ketoPGF1 alpha were found. PMID- 3510263 TI - Antibiotic therapy of infections due to Pseudomonas aeruginosa in normal and granulocytopenic mice: comparison of murine and human pharmacokinetics. AB - An effort was made to elucidate the limits of drug-activity tests in small animals. Human plasma kinetics of gentamicin, netilmicin, ticarcillin, ceftazidime, and ceftriaxone were approximated in normal and in granulocytopenic mice infected with various strains of Pseudomonas aeruginosa in the thigh muscle or intraperitoneally. The effect of such dosing on bacterial time-kill curves and on survival was compared with the effect of identical amounts of drug given as a single-bolus injection. With beta-lactams, a highly significant superiority of fractionated dosing (simulated human kinetics) over bolus injections (murine plasma kinetics) was demonstrated, whereas with aminoglycosides it was a single bolus injection that tended to be more active. Thus, when tested in conventional small-animal models, aminoglycoside activity may be overestimated, whereas beta lactam activity may be underestimated in respect to humans. These differences found in vivo most probably reflect the different pharmacodynamics between aminoglycosides and beta-lactam drugs (time-kill curves, dose-response curves, and postantibiotic effect) similar to those previously observed in vitro. PMID- 3510264 TI - Relation of structure to function for the U. S. reference standard endotoxin after exposure to 60Co radiation. AB - The structure and function of the highly purified U.S. reference standard endotoxin (RSE) were studied after exposure to ionizing radiation from a 60Co source. With increasing doses of radiation, the trilaminar ribbon-like structure of untreated endotoxin exhibited focal swelling, after which only spherical particles were seen by electron microscopy. These morphological changes were paralleled by the respective loss of O-side chain repeating units and pieces of the R-core from the lipopolysaccharide molecules, as demonstrated by electrophoresis. The biologic function of the irradiated endotoxin was assessed with a variety of tests. At higher doses of radiation, a direct relation was observed between the degradation of the molecular and supramolecular structure and the loss of biologic function. At lower doses of radiation, however, there was variability among the functional assays in their rate of change with progressive irradiation of the RSE. The results suggest that the carbohydrate moiety plays an important role both in determining the supramolecular structure and in modulating certain biologic activities of bacterial endotoxins. PMID- 3510265 TI - Serum antibodies from patients with Crohn's disease and from their household members react with murine lymphomas induced by Crohn's disease tissue filtrates. AB - Injection into athymic nude mice (nu/nu) of filtrates of Crohn's disease tissue produces lymphoid hyperplasia and lymphomas, which react with serum antibody from other patients with Crohn's disease. We examined for such antibodies in sera of 14 patients with Crohn's disease and 25 of their household members and compared results with sera from 36 healthy unselected controls and from 14 patients with ulcerative colitis and 19 of their household members. Sera from all patients with Crohn's disease and ulcerative colitis and household members were collected in Michigan, coded, and examined by an indirect immunofluorescence assay against two primary nu/nu lymphomas and one transmitted lymphoma produced by three Crohn's disease tissue filtrates. Seven patients with Crohn's disease had antibodies against antigen(s) in the Crohn's disease lymphomas. Seven household members of patients with Crohn's disease and no household members of patients with ulcerative colitis (P less than 0.05) reacted with Crohn's disease lymphomas. However, none of the patients with ulcerative colitis (P less than 0.01) and no control healthy subjects (P less than 0.005) demonstrated immunoreactivity against nu/nu lymphomas. None of the sera reacted with a control nu/nu lymphoma. Five household members who had positive assay results were first-degree blood relatives, and the other two were spouses of patients with Crohn's disease. These results suggest that a common environmental factor may be associated with Crohn's disease, that there is a familial association in Crohn's disease, and that nu/nu mice are an important model to study the pathogenesis of Crohn's disease. PMID- 3510266 TI - Binding of the adhesive protein complex (LFA-1/Mac-1/p150,95) to concanavalin A. AB - At least 30 proteins from human PMNL plasma membranes capable of binding concanavalin A (Con A), can be identified after surface labeling with 125I and subsequent sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE). Immunoprecipitation of the labeled proteins after solubilization in non-ionic detergents, with monoclonal antibodies (MAbs) directed against a family of leukocyte membrane proteins (LFA-1, Mac-1, p150,95, and the beta subunit these glycoproteins share), indicated that Mac-1 and p150,95 were bound by Con A. Dissociation of the alpha and beta subunits with sodium dodecyl sulfate, electrophoresis, transfer to nitrocellulose paper, and subsequent binding of these proteins by Con A demonstrated Con A retention by Mac-1-alpha, p150,95 alpha, and the common beta subunit. Affinity of Con A for LFA-1-alpha from human peripheral blood PMNL could not be confirmed by direct binding or electroblotting. Similar experiments in a patient deficient in LFA-1, Mac-1, p150,95, and the beta subunit confirmed that Mac-1-alpha and the beta subunit were important Con A-binding proteins. PMID- 3510267 TI - Studies of thymocytopoiesis in rats and mice. I. Kinetics of appearance of thymocytes using a direct intrathymic adoptive transfer assay for thymocyte precursors. AB - We describe a quantitative intrathymic (i.t.) adoptive transfer system for detecting thymocyte precursor cells in rats and mice. In this system, the generation of donor-origin thymocytes is analyzed on the FACS after the injection of test cells directly into the thymus of sublethally irradiated, histocompatible, RT-7 (rat) or Ly-1 (mouse) alloantigen-disparate recipients. Like the standard i.v. adoptive transfer assays for prothymocytes, the i.t. transfer assay is time, dose, and irradiation dependent. However, unlike the i.v. assays, the i.t. assay is highly sensitive, independent of cell migration, and specific for T-lineage precursor cells. Thus, the i.t. system requires between 25 and 50-fold fewer precursor cells than do the i.v. systems to generate a given number of donor-origin thymocytes; it detects nonmigratory as well as migratory subsets of precursor cells; it detects prethymic and intrathymic precursor cells with equal facility; and it produces a discrete, self-limited wave of donor origin thymocytes and peripheral T cells. Moreover, neither hemopoietic nor lymphopoietic stem cell chimerism occurs at extrathymic sites. Comparison of the kinetics of thymocytopoiesis in the i.t. and i.v. transfer systems suggest that the seeding efficiency of prothymocytes in the i.v. assay approximates 0.04; the lag phase of the time-response curve is not due to a delay in the entry of prothymocytes into the thymus; and the relative amount of thymocyte precursor activity in various lymphohemopoietic tissues is highest in bone marrow, lowest (or absent) in lymph node, and intermediate in spleen, blood, and thymus. Moreover, the occurrence of saturation kinetics in the dose-response curve of the i.t. system supports the hypothesis that a finite number of microenvironmental niches for prothymocytes may exist in the thymus. These initial observations will require confirmation and extension in future studies. However, based on the present findings and related observations, we anticipate that the i.t. adoptive transfer system will contribute importantly to the definitive analysis of both normal and abnormal thymocytopoiesis. PMID- 3510268 TI - Are antihistamine-decongestants of value in the treatment of acute otitis media in children? AB - Acute otitis media is the most common bacterial infection of childhood. The effectiveness of oral antihistamine-decongestant mixtures in the treatment of this illness remains controversial in clinical practice. In a double-blind randomized study, 82 children (aged under 15 years) with acute otitis media were treated with amoxicillin and either a decongestant-antihistamine mixture (Dimetapp) or placebo. All diagnoses required agreement between a family practice resident and the supervising family physician. Clinical course was assessed by symptom diaries completed by parents and by follow-up examination at approximately two weeks, which included pneumatic otoscopy. No statistically significant benefit of the antihistamine-decongestant mixture was shown in terms of resolution of the symptoms or prevention of the complications of acute otitis media. It is recommended that antihistamine-decongestants not be routinely added to an antibiotic in the treatment of acute otitis media in children. PMID- 3510269 TI - Computerized axial tomography scans and subtypes of schizophrenia. A review of the literature. AB - Since the initial reports of ventricular enlargement in schizophrenics, attempts have been made to define a subgroup of patients with brain atrophy on computerized axial tomography (CAT) scans. The authors reviewed this literature for clinical, biochemical, and environmental correlates of lateral and third ventricular enlargement as well as cortical and cerebellar atrophy and brain density. It is concluded that CAT abnormalities are useful markers in delineating a group of schizophrenics characterized predominantly by neuropsychological impairment, poor premorbid adjustment, global monoamine disturbance, poor treatment response to neuroleptics, lack of positive symptoms, and predominance of negative symptoms. A proposal for further classification of these patients is given both in terms of the dopamine hypothesis and Kraepelin's dementia praecox. PMID- 3510270 TI - Schwann cell marker defined by a monoclonal antibody (224-58) with species cross reactivity. I. Cellular localization. AB - We have demonstrated by indirect immunofluorescence the cellular localization of a monoclonal antibody (mAb 224-58), produced after immunization of a mouse with human central nervous system (CNS) myelin. Serologically, mAb 224-58 was found to be specific for 3'-sulfomonogalactosylglycolipids, namely 3' sulfogalactosylceramide (SGC) and 3'-sulfogalactosyl 1-O-alkyl ether 2-O acylglycerol (seminolipid). This mAb did not bind to SGC-containing tissues such as kidney, liver, spleen, or brain, nor to muscle. However mAb 224-58 did stain positively mouse, rat, and human peripheral nerve sections. In these latter sections, mAb 224-58 was bound to Schwann cell bodies and processes. The specificity of mAb 224-58 for Schwann cells was ascertained on teased rat sciatic nerves and rat Schwann cell cultures. Cells positive for mAb 224-58 were also positive for laminin, and negative for Thy 1-1 antigens both in teased fibers and Schwann cell cultures. In addition, in teased nerve preparations, mAb 224-58 positive cells were also galactosylceramide (GalC)- and SGC-positive. Isolated Schwann cells also expressed 224-58 antigen, even after prolonged time in culture. On testis sections, which contain both SGC and seminolipid, the SGC positive cells, i.e., the spermatogonia, were always 224-58-negative. But the other germinal cells were 224-58-positive. This suggests that although 224-58 does not discriminate between SGC and seminolipid in serological tests, these lipids in their naturally occurring membrane acquire a spatial configuration that renders them distinguishable to their respective antibody. PMID- 3510271 TI - Bony fish myelin: evidence for common major structural glycoproteins in central and peripheral myelin of trout. AB - Peripheral nervous system (PNS) myelin from the rainbow trout (Salmo gairdneri) banded at a density of 0.38 M sucrose. The main myelin proteins consisted of (1) two basic proteins, BPa and BPb (11,500 and 13,000 MW, similar to those of trout central nervous system (CNS) myelin proteins BP1 and BP2), and (2) two glycosylated components, IPb (24,400 MW) and IPc (26,200 MW). IPc comigrated with trout CNS myelin protein IP2 in sodium dodecyl sulfate-polyacrylamide gel electrophoresis, whereas trout CNS myelin protein IP1 had a lower molecular weight (23,000). Following two-dimensional separation, however, both IPb and IPc from PNS showed two components; the more acidic component of IPc comigrated with IP2 from CNS. PNS tissue autolysis led to the formation of IPa (20,000 MW), consisting of two components in isoelectric focusing of which again the more acidic one comigrated with the CNS autolysis product IP0. Limited enzymatic digestion of isolated IP proteins from PNS and CNS led to closely similar degradation patterns, being most pronounced in the case of IP2 and IPc. Immunoblotting revealed that all IP components from trout PNS and CNS myelins reacted with antibodies to trout IP1 (CNS) and bovine P0 protein (PNS) whereas antibodies to rat PLP (CNS) were entirely unreactive. All BP components from trout PNS and CNS myelins bound to antibodies against human myelin basic protein. On the basis of these studies trout PNS and CNS myelins contain at least one common IP glycoprotein, whereas other members of the IP myelin protein family appear closely related. In the CNS myelin of trout the IP components appear to replace PLP.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3510272 TI - Homology and diversity between intermediate filament proteins of neuronal and nonneuronal origin in goldfish optic nerve. AB - The predominant intermediate filament proteins of the goldfish optic nerve have molecular weights of 58K. They can be separated into a series of four major isoelectric variants of neuronal (ON1 and ON2) and nonneuronal (ON3 and ON4) origin. The extent of homology between the goldfish 58K intermediate filament proteins themselves and to rat optic nerve vimentin and glial fibrillary acidic protein (GFAP) was investigated. Unlabeled and [32P]orthophosphate-labeled proteins were subjected to partial hydrolysis by V8 protease, chymotrypsin, and CNBr. The results show that the goldfish intermediate filament proteins share with vimentin and GFAP a 40K chymotrypsin-resistant core fragment. Phosphorylated moieties appear to be located outside the core region since they are preferentially cleaved off by chymotrypsin and not found associated with the 40K core. In addition, the goldfish ON proteins contain the antigenic site within the core that is common to most intermediate filaments. V8 or CNBr digestion indicates that many fragments that are common to ON1 and ON2 are clearly distinct from fragments that are common to ON3 and ON4. In addition, structural variability is observed between the goldfish intermediate filament proteins and vimentin and GFAP. The results are discussed in terms of intermediate filament structure and their possible role in nerve growth. PMID- 3510273 TI - Infection of cultured rat myotubes and neurons from the spinal cord by rabies virus. AB - Rabies virus multiplication was investigated in cultured primary rat myotubes and neurons. The susceptibility of these two cell types to fixed rabies challenge virus strain (CVS) was monitored by fluorescence and virus titration. Differentiated rat myotubes were susceptible to rabies virus infection, and showed an increasing accumulation of viral material from day one to day four. However, these cells did not release infective viral particles, nor did they accumulate infectious virions in the cytoplasm. In contrast, infected neurons released large amounts of infectious particles. Electron microscopy observation of infected myotubes showed minor alterations and the presence of typical viral inclusions in the cytoplasm without mature virions assembling viral membranes. Competition binding experiments show that alpha-bungarotoxin inhibits rabies virus infection from 10(-5) to 10(-7) M, whereas lower toxin concentrations failed to have any effect. These data do not confirm the hypothesis of a fixed rabies virus amplification step at the site of the viral entry. On the other hand, the high susceptibility of peripheral neurons to rabies virus infection is an argument for the direct uptake of virions by these cells. The restrictive viral multiplication in the myotubes is an alternative explanation for the local persistence of rabies virus at the site of inoculation. PMID- 3510274 TI - Phosphorylated neurofilament antigens in neurofibrillary tangles in Alzheimer's disease. AB - Neurofibrillary tangles (NFT) are a hallmark of Alzheimer's disease (AD), and their presence correlates with the presence of dementia. A major constituent of NFT is the insoluble paired helical filament which shares some antigenic relationships with normal cytoskeletal elements, particularly neurofilaments. If neurofilament proteins (200, 145-160, and 68 kilodaltons [kd]) participate in the formation of NFT, the distribution of these constituents might be expected to be abnormal. To examine this issue, we used immunocytochemical methods to localize phosphorylated and nonphosphorylated epitopes of neurofilament proteins in hippocampal neurons of controls and patients with AD. Normally, the 200-kd neurofilament protein is not phosphorylated in the perikarya of neurons. However, in AD, many pyramidal neurons contained immunoreactive phosphorylated neurofilaments. Patterns of immunoreactivity (linear, flame-shaped, or skein-like within perikarya) greatly resembled the appearance of silver-stained NFT. This pattern of immunoreactivity was not present in hippocampal pyramidal neurons in controls, except in one aged patient in whom adjacent silver-stained sections revealed a few NFT. Patterns of immunoreactivity with antibodies for nonphosphorylated neurofilament proteins were similar in control and AD neurons. Our results indicate that some NFT are associated with abnormal distributions of high molecular weight phosphorylated neurofilament proteins. One domain of the 200-kd protein is believed to be a component of the side arms which link neurofilaments and interact with microtubules. Abnormal interactions of perikaryal neurofilaments could play a role in the genesis of NFT, and this abnormality of the cytoskeleton could contribute to the dysfunction of neurons at risk in AD. PMID- 3510275 TI - The Philadelphia chromosome and Philadelphia chromosome mosaicism in chronic granulocytic leukemia. PMID- 3510276 TI - Chemotherapy for gastric cancer. PMID- 3510277 TI - Analysis of survival by tumor response. PMID- 3510279 TI - Crossing the bridge from hematologic malignancies to solid tumors. PMID- 3510278 TI - A randomized trial of the four most active regimens for metastatic non-small-cell lung cancer. AB - Between October 1981 and June 1983, the Eastern Cooperative Oncology Group (ECOG) conducted a prospectively randomized trial (EST 1581) of the four most active chemotherapy regimens for metastatic non-small-cell lung cancer (NSCLC). Four hundred eighty-six good performance status patients (PS 0 or 1; 81%) were randomized to receive cyclophosphamide, doxorubicin, methotrexate, and procarbazine (CAMP); mitomycin, vinblastine, and cisplatin (MVP); etoposide and cisplatin (VP-P); or vindesine and cisplatin (VDA-P). All regimens were administered in the doses and schedules originally reported. Complete response (CR) plus partial response (PR) rates for the four regimens were CAMP, 17%; MVP, 31%; VP-P, 20%; and VDA-P, 25%. The response rate for MVP was significantly higher in patients with squamous and adenocarcinoma histologies, but there was no impact on median survival (overall, 24.5 weeks). The duration of response did not differ by treatment as previously suggested for VDA-P. There were 15 CRs (CAMP, one; MVP, six; VP-P, two; VDA-P, six), and 12 patients have survived more than 2 years. Toxicity was significant with 20 treatment-related deaths. CAMP was significantly less toxic than the other regimens (P less than .001). VDA-P demonstrated significantly more life-threatening (seven) and lethal (three) episodes of nephrotoxicity (P less than .001) despite an aggressive hydration program that in itself caused significant morbidity. Analysis of the toxicity data showed, however, that most of the severe toxicity occurred in the 19% of patients who were initially PS 2, suggesting that they are not appropriate candidates for trials of new agents or combinations. None of these regimens can be recommended as a standard therapy for metastatic NSCLC. PMID- 3510280 TI - Ifosfamide in refractory male germ cell tumors. AB - We conducted a phase II clinical trial using ifosfamide (IFX) as a single agent in cisplatin-refractory male germ cell tumor. Thirty patients with measurable disease were treated with IFX, 2 g/m2 intravenously (IV) for 5 consecutive days every 3 weeks. N-acetylcysteine, 2 g orally every 4 hours, was given as a uroprotective agent. All patients had previously been treated with cisplatin, vinblastine, and bleomycin, and all except two also had previously received etoposide. There were six partial responses (PR) and one complete response (CR) for an overall objective response rate of 23%. The median duration of response was 3.5 months (range, 2 to 5.5 months). The median survival time was 3.5 months (range, 2 to 14+ months). The toxicity of the regimen consisted of hematuria (65% of the patients), nausea and vomiting (43%), neutropenia (WBC less than 2,000; 52%), thrombocytopenia (platelet count less than 50,000; 20%), and nephrotoxicity (12%). Hematuria was dose related, occurring in 48% of courses using 2 g/m2/d v only 5% of courses at lower doses. Serious nephrotoxicity (creatinine level greater than 6.0 mg/mL) was observed in three patients with an elevated pretreatment serum creatinine level. In conclusion, IFX is an active agent in this heavily pretreated population with advanced refractory germ cell tumor. PMID- 3510281 TI - High-dose intensification therapy with autologous bone marrow support for limited small-cell bronchogenic carcinoma. AB - The efficacy and toxicity of high-dose chemotherapy with autologous bone marrow transplantation (ABMT) was studied in 32 patients with untreated limited small cell bronchogenic carcinoma (SCBC). Ten patients received three courses of induction therapy consisting of vincristine (VCR) (1.5 mg X 2), ifosfamide (5 g/m2), and Adriamycin (Ad; Adria Laboratories, Columbus, Ohio) (60 mg/m2). Patients then received two courses of intensification therapy with cyclophosphamide (CYT) (4.5 g/m2), 4' demethyl-epipodophyllotoxin-d-D-ethylidene glucoside (VP-16-213) (600 mg/m2) and VCR (2 mg) with ABMT. Another 22 patients received induction therapy with VCR, CYT (600 mg/m2), Ad (50 mg/m2), and VP-16 213 (180 mg/m2). All 22 patients also received intensification therapy of the same dose of CYT (4.5 g/m2) and VP-16-213 (600 mg/m2). Nine patients also received high-dose methotrexate (MTX), four patients received Ad (40 to 60 mg/m2), and two patients received both Ad and MTX. After intensification, patients received elective prophylactic brain irradiation (3,000 rad) and chest irradiation (5,000 rad). After induction therapy, there were 13 (41%) complete remissions (CR) and 17 (53%) partial remissions (PR). After intensification therapy, there were 22 CRs (69%) and 10 PRs (31%). Median survival for all patients was 14 months (range, 5 to 59+). Of the 13 patients who received intensification therapy in CR, five remain disease free (DF), four for 4 years or longer. Of the nine patients to achieve CR with intensification, only one is DF. No patient died during intensification. In conclusion, intensification with high dose chemotherapy can increase the CR rate, and this approach is most likely to show long-term benefits in patients with minimal disease (CR) at the beginning of intensification therapy. PMID- 3510282 TI - Prospective evaluation of carcinoembryonic antigen levels and alternating chemotherapeutic regimens in metastatic breast cancer. AB - Ninety-seven eligible and evaluable women with metastatic breast cancer were placed on a prospective clinical protocol to evaluate the use of continuous cyclic therapy with dibromodulcitol, doxorubicin, vincristine, tamoxifen, and fluoxymesterone (DAVTH) v DAVTH alternating with cyclophosphamide, methotrexate, 5-fluorouracil, and prednisone (CMFP); and the use of pretreatment and serial carcinoembryonic antigen (CEA) levels in these patients. Continuous DAVTH and DAVTH/CMFP were equivalent therapies with respect to response rates, time to treatment failure (TTF), and survival. Pretreatment CEA levels were elevated (greater than 5 ng/mL) in 42/97 patients and less than 5 ng/mL in the remaining patients. Patients with elevated pretreatment CEA levels were more likely to be estrogen receptor (ER) positive (P = .006), to have prolonged disease-free intervals (P = .017), to have hepatic (P = .004) and/or osseous (P = .01) metastases, and to have multiple sites of metastatic disease (P = .004). Pretreatment CEA levels did not significantly predict for overall response rates, TTF, or survival; nonetheless, those patients with low pretreatment CEA levels had more complete responses (CRs) (16/55 v 4/42; P = .02). Serial CEA levels during therapy revealed a number of interesting patterns. During the first 4 months of treatment, serial CEA levels in responding patients either (1) progressively declined (15/29 women with elevated pretreatment CEA levels), or (2) initially rose significantly (mean, 243% of pretreatment value) and then declined (14/29 women with elevated pretreatment CEA levels). Peak CEA levels in the latter patients were seen 27 to 135 days following initiation of cytotoxic therapy. In some patients the initial increase in the CEA level was incorrectly interpreted as evidence of impending disease progression. CEA levels frequently increased around the time of clinical disease progression. However, rising CEA levels rarely provided a clinically meaningful lead time before the appearance of other clinical evidence of disease progression. These data suggest that routine pretreatment and monthly serial CEA levels in metastatic breast cancer patients have minimal use in clinical practice. Two further noteworthy findings were observed in this prospective study. First, patients with an unknown ER status had a prolonged median survival when compared with patients with ER positive or negative tumors; this appeared to be related to prolonged disease-free intervals in ER unknown patients. Second, two case of secondary acute leukemia were seen in patients treated with continuous DAVTH therapy. PMID- 3510284 TI - Prognostic factors and staging in multiple myeloma: a reappraisal. AB - To assess the important factors in the prognosis and staging of multiple myeloma (MM), we have correlated the presenting clinical features of 147 previously untreated patients with MM with the survival duration using multiple regression analyses. We have included the three major available myeloma-staging systems (MSS), ie, Durie-Salmon (DS), Medical Research Council (MRC), and Merlini Waldenstrom-Jayakar (MWJ), plus two new variables related to disease activity: the serum beta 2-microglobulin level (S beta 2M) and the instantaneous rate of bone resorption. Our study confirms the validity of the three MSS in the prediction of survival duration, with a slight but significant advantage for the DS MSS. Among single variables, S beta 2M was the most powerful indicator of prognosis (P less than .0001), serum albumin level being the only variable adding to this significantly (P = .02). Of major interest, S beta 2M alone was a better indicator than MRC and MWJMSS. Finally, S beta 2M and the serum albumin level, variables not included in the three MSS, were better indicators than the classical DS MSS and could be combined simply to give a very powerful system of stratification. PMID- 3510283 TI - Lymphoblastic lymphoma in adults. AB - Fifty-one patients with lymphoblastic lymphoma (LBL) treated with one of five successive intensive chemotherapy protocols for acute lymphoblastic leukemia (ALL) since 1971 were reviewed. The patients were divided into leukemic and nonleukemic groups, and their clinical and laboratory parameters compared. The projected 5-year survival rate for all patients treated with the L10/17 protocols was 45% for both leukemic and nonleukemic LBL. The response to treatment was compared with that of 111 patients with ALL and was nearly identical. Poor prognostic factors were age beyond 30, WBC greater than 50,000/microL, failure to achieve a complete response (CR), and a late CR during induction. Leukemia at presentation, T cell surface markers, and the presence of a mediastinal mass did not adversely affect survival. The use of intensive chemotherapy protocols has proven to be a significant advance in the treatment of LBL. PMID- 3510285 TI - Antiemetic effect of oral versus intravenous metoclopramide in patients receiving cisplatin: a randomized, double-blind trial. AB - In a study of the antiemetic effectiveness of high-dose oral metoclopramide, 66 previously untreated patients receiving 60 mg/m2 cisplatin were entered into a double-blind randomized trial. Patients were stratified according to age and tumor type, then randomized to receive either oral or intravenous (IV) high-dose metoclopramide. Patients were evaluated for antiemetic protection, toxicity, affect (anxiety, hostility, and depression), and autonomic arousal (pulse rate and blood pressure) at three-hour intervals on the day of their chemotherapy. Metoclopramide serum levels were measured by high-performance liquid chromatography. Results indicated no significant differences between the oral and IV groups on any measurement of antiemetic protection, affect, or autonomic arousal. There were also no significant differences in side effects except for frequency of stools; patients who received oral metoclopramide had significantly more stools than patients who received IV metoclopramide. The mean (+/- SD) serum metoclopramide level at four hours achieved orally was 1,171 +/- 660 ng/mL; the mean (+/- SD) level achieved IV was 1,030 +/- 392 ng/mL (P = .498). We conclude that high-dose oral and IV regimens of metoclopramide as administered in this study have equivalent antiemetic efficacy in previously untreated patients receiving 60 mg/m2 cisplatin. PMID- 3510286 TI - Effect of high-dose dexamethasone on outcome from severe head injury. AB - The conflicting evidence concerning the influence of high-dose steroids on intracranial pressure (ICP) and outcome following severe head injury has led to the institution of the prospective double-blind controlled trial reported here. Severely head-injured patients admitted to intensive care during a 3-year period were randomly allocated to a dexamethasone- or placebo-treated group. Adults in the steroid group received dexamethasone, 50 mg intravenously, as a bolus on admission to the neurosurgical unit, then 100 mg on Days 1, 2, and 3, 50 mg on Day 4, and 25 mg on Day 5 on continuous intravenous infusion. Children received proportionate intravenous dosages calculated on a weight basis. Severity of head injury was assessed from admission Glasgow Coma Scale (GCS) scores and the appearance of the admission computerized tomography scan. Intracranial pressure (ICP) was monitored in all patients from the surface subarachnoid space. Outcome at 6 months was assessed using the Glasgow Outcome Scale. Steroid and placebo groups were similar in terms of admission GCS score, intracranial pathology, incidence of associated injuries, and time interval from injury to admission to intensive care. The ICP generally increased during the first 48 hours of intensive therapy; there was no difference in this trend between the steroid and placebo groups. A poorer outcome was observed in patients with elevated ICP who received steroids. No increase in the incidence of pulmonary, gastrointestinal, or other extracranial complications was seen in the steroid group. The 6-month outcome did not differ between the steroid and placebo groups. No advantage of high-dose dexamethasone on ICP trends or clinical outcome in the treatment of severe head injury has emerged from this study. PMID- 3510288 TI - Bilateral urinothorax identified by technetium-99m DPTA renal imaging. AB - A case of unilateral urinary tract obstruction with extravasation resulting in bilateral pleural effusions is presented. The fluid within the pleural cavities was established to originate from the kidney using [99mTc]diethylenetriaminepentaacetic acid and scintillation camera imaging. PMID- 3510287 TI - Quantitative analysis of stress thallium-201 myocardial scintigrams: a multicenter trial. AB - Previously we validated a method for quantification of 201TI myocardial stress distribution and washout in which the patient's stress and washout circumferential profiles are compared with observed normal limits. The present study reports the results of a multicenter trial in which this method, utilizing normal limits from our institution, was employed to evaluate the presence, location, and extent of coronary artery disease (CAD). The normal limits utilized were generated from 49 patients having a low likelihood of CAD. The study population included 157 patients from four centers in the United States and Canada as well as a comparative prospective population from Cedars-Sinai Medical Center (CSMC) of 51 patients with CAD, 30 patients with normal coronary arteriograms, and 30 additional low-likelihood normals. The results in the combined centers regarding overall detection of CAD revealed a sensitivity of 84% and a frequency of test normality in the patients with low likelihood of CAD of 88%, compared to a sensitivity of 82% and true normalcy rate of 83% obtained in the prospective CSMC population. The sensitivity for detecting disease increased according to the extent of angiographic CAD in both the multicenter sites and the prospective CSMC group. Regarding localization of disease, similar sensitivities and specificities for detecting disease in individual coronary arteries were found in the multicenter sites and the prospective CSMC population. The results indicate that our method for quantifying 201TI stress-redistribution scintigrams utilizing standard normal limits can be applied at other institutions using a variety of scintillation cameras with similar accuracy to that currently obtained at our institution. PMID- 3510289 TI - Use of autogenous cranial bone grafts in maxillofacial surgery: a preliminary report. AB - In conventional reconstruction of the facial skeleton, bone grafts are usually harvested from distant sites such as the ilium or ribs. Because of the morbidity associated with the use of these sites, the calvarium was studied as an alternate donor site. Twenty-three patients underwent bone grafting using autogenous calvarial bone. Reconstructive procedures included alveolar cleft grafts, Le Fort I osteotomies, midface onlay grafts, and grafting of a mandibular continuity defect. Intraoperative and postoperative morbidity associated with the bone donor site was minimal, and there was good incorporation of all the grafts. Long-term follow up is necessary before definitive conclusions about the response of the grafted bone can be made, but short-term results were promising. PMID- 3510290 TI - Repair of the mandibular nerve by autogenous grafting after partial resection of the mandible. AB - Ten patients who had ameloblastoma of the mandible underwent surgery for resection of the tumor followed by immediate mandibular reconstruction with free autogenous nerve grafting using the greater auricular nerve. One year after surgery pain perception and tactile sensibility were completely restored in eight of the ten patients. PMID- 3510291 TI - Indium-111 imaging in osteomyelitis and neuroarthropathy. Review and case report. PMID- 3510292 TI - Cutaneous necrotic arachnidism. A case report. PMID- 3510293 TI - Foot pain in later life. Some psychological correlates. PMID- 3510294 TI - A retrospective study of 195 patients with heel pain. PMID- 3510295 TI - Unicameral bone cyst in the calcaneus with pathologic fracture. A literature review and case report. PMID- 3510296 TI - Antimalarial activity of neplanocin A with perturbations in the metabolism of purines, polyamines and S-adenosylmethionine. AB - Neplanocin A, a novel carbocyclic analog of adenosine, was found to be a mixed type inhibitor of S-adenosylhomocysteine hydrolase of human red blood cells with a Ki of 2 nM and an inactivating constant, Ki, of 3 nM. When tested against Plasmodium falciparum cultured in human red blood cells, neoplanocin A inhibited malarial growth with an ED50 of 3 microM. Above 2.5 microM, some red blood cells showed morphological aberrations and became echinocytes (spiculated red blood cells). In infected red blood cells, neplanocin A caused an elevation of the concentrations of S-adenosylmethionine and S-adenosylhomocysteine in a dose dependent manner. Concurrently, a new analog of S-adenosylmethionine, S neplanocinylmethionine, was formed. Analysis of polyamines showed that only putrescine was decreased significantly; the others were not changed. Purine analyses showed two putative neplanocinyl nucleotides, possibly the di-and the triphosphates. Neplanocin A most likely exerted its in vitro antimalarial effect via the inhibition of S-adenosylhomocysteine hydrolase and the attendant perturbation of methylation reactions. PMID- 3510297 TI - Synthesis and structure-activity relationships of naftifine-related allylamine antimycotics. AB - Naftifine (1) is the first representative of the new antifungal allylamine derivatives. Its biological activity is strictly bound to specific structural requirements that are unrelated to those of known antifungals. A tertiary allylamine function seems to be a prerequisite for activity against fungi. By systematic variation of the individual structural elements in 1, detailed structure-activity relationships are defined in which the phenyl ring is the structural feature permitting the widest variations. Versatile synthetic routes to allylamine derivatives and comparative biological data are presented. PMID- 3510298 TI - Synthesis and structure-activity relationships of antibacterial phosphonopeptides incorporating (1-aminoethyl)phosphonic acid and (aminomethyl)phosphonic acid. AB - Phosphonodipeptides and phosphonooligopeptides based on L- and D-(1 aminoethyl)phosphonic acids L-Ala(P) and D-Ala(P) and (aminomethyl)phosphonic acid Gly(P) at the acid terminus have been synthesized and investigated as antibacterial agents, which owe their activity to the inhibition of bacterial cell-wall biosynthesis. A method for large-scale synthesis of the potent antibacterial agent L-Ala-L-Ala(P) (1, Alafosfalin) is described. Structure activity relationships in the dipeptide series have been studied by systematic variation of structure 1. L stereochemistry is generally required for both components. Changes in the L-Ala(P) moiety mostly lead to loss of antibacterial activity, but the phosphonate analogues of L-phenylalanine, L-Phe(P), and L serine, L-Ser(P), give rise to weakly active L-Ala-L-Phe(P) and L-Ala-L-Ser(P). Replacement of L-Ala in 1 by common and rare amino acids can give rise to more potent in vitro antibacterials such as L-Nva-L-Ala(P) (45). Synthetic variation of these more potent dipeptides leads to decreased activity. Phosphonooligopeptides such as (L-Ala)2-L-Ala(P) have a broader in vitro antibacterial spectrum than their phosphonodipeptide precursor, but this is not expressed in vivo, presumably due to rapid metabolism to 1. Stabilized compounds such as Sar-L-Nva-L-Nva-L-Ala(P) (46) have been developed that are more potent in vivo and have a broader in vivo antibacterial spectrum than the parent phosphonodipeptide. PMID- 3510299 TI - Quantitative structure-activity relationship of the mutagenicity of substituted N nitroso-N-benzylmethylamines: possible implications for carcinogenicity. AB - The relative mutagenicities of substituted N-nitroso-N-benzylmethylamines have been reexamined from a quantitative structure-activity relationship point of view. Most of the compounds were mutagenic toward Salmonella typhimurium TA 1535 with Aroclor-induced male hamster liver S9 activation. The dose-response data were subjected to a multiple linear regression equation calculated in a stepwise manner, which found that the differences in mutagenicities could be explained primarily by differences in the three-bond path molecular connectivity index, with smaller contributions from sigma and pi. Moreover, a polynomial regression analysis showed that the maximum mutagenicity could be explained by an optimal amount of electron withdrawal by the substituent which would cause a weakening, or activation, of the methylene C-H bond. The possible relevance of these observations to carcinogenesis is discussed. PMID- 3510300 TI - An application of computers to curriculum review and planning. AB - A computer-based curriculum data base was developed at the University of Toronto Faculty of Medicine to provide curriculum planners accurate information on what was being taught, who was teaching, and where in the curriculum subjects were being taught. In this paper, the authors report the use of the curriculum data base, its implications for curriculum management and planning, and plans for its further development and use. Applications that address problems of curriculum overlap, integration, and correlation are discussed. The results indicate that the medical school curriculum can be successfully stored and analyzed by computer and that the data base and system can provide valid descriptions of curriculum content in nonclinical courses. PMID- 3510301 TI - Burn care: a specialty in evolution--1985 presidential address, American Burn Association. PMID- 3510302 TI - Selective aggressive burn excision for high mortality subgroups. AB - Traditional teaching recommends major burn procedures be limited to successive 20% total body surface area (TBSA) excision and grafting procedures. This format theoretically reduces the surgical stress and limits the transfusion requirements to a level reasonably tolerated by patients. We have treated 14 patients with thermal burns involving greater than 30% TBSA. These patients underwent excisions ranging from 30 to 70% TBSA at the initial operative escharectomy. Tangential and fascial excisions were employed, depending upon the depth of injury, and autografts and/or allografts were utilized for wound closure. The results of this technique yielded an overall 71% survival. Time from burn to last autograft and hospital stay tended to be shortened or unchanged when compared to national averages. This series demonstrates the feasibility of performing early major escharectomy in a selected burn population without apparent increased surgical risk compared to patients treated by conventional staged excision. Although burn wound sepsis and mortality appeared favorably affected by this technique, the small population size was unsuitable for adequate statistical analysis. PMID- 3510303 TI - Effect of anesthesia and positive pressure ventilation on early postburn hemodynamic instability. AB - Our purpose was to determine the effect of anesthesia and positive pressure ventilation, PPV, on early postburn (1-12 hr) cardiopulmonary changes. Adult sheep were given a 40% full-thickness TBS burn not involving chest wall. Halothane anesthesia and PPV alone decreased cardiac output by 20% but also decreased oxygen demands by 30% from the awake state. Systemic vascular resistance, SVR, was increased by 40% over the awake state in the first several hours postburn: cardiac output was decreased despite baseline filling pressures. Low molecular weight dextran, LMWD, prevented the increased SVR by decreasing resistance to flow. A continued decrease in cardiac output was evident during the next 6-12 hr postburn with anesthesia while awake sheep values returned to baseline. Fluid requirements to maintain filling pressures also increased by 30% over the awake state. Static lung compliance, CSTAT, decreased from a baseline of 43 +/- 5 to 32 +/- 4 ml/cm H2O with anesthesia and ventilation. This was due to nonburn chest wall edema: lung water was normal. The 7-cm H2O increase in inspiratory pressure necessary to maintain constant volume was the cause of the decreased cardiac output, because maintaining pressure constant resulted in no decrease in cardiac output. VO2 remained relatively constant due to increased O2 extraction. LMWD prevented the CSTAT changes and, in turn, the decreased output. We conclude that both the increase in SVR and decrease in CSTAT postburn resulted in a significant decrease in cardiac output with anesthesia not seen in the awake burn state. The decreased output was, however, in large part compensated for by decreased O2 demands and increased O2 extraction. PMID- 3510304 TI - Immunosuppressive effects of burn injury and nonspecific blood transfusion. AB - Burn injuries and blood transfusions both have been implicated as causes of suppressed immune responses. Skin allograft survival in a burned mouse model was studied to determine the relationships among burn injury, blood transfusion, and phlebotomy before transfusion as they affected immunocompetence. At 7 days after 20% TBSA full-thickness burn injury, allograft skin survival was prolonged compared to nonburned control. When increasing volumes of blood were transfused, allograft survival times decreased accordingly. Phlebotomy before transfusion tended to enhance this response. Similar results were seen at 14 days after burn injury, although phlebotomy before transfusion did not further decrease allograft survival time at 14 days. This study demonstrated that blood transfusions were not additively immunosuppressive over burn injury alone. Increased amounts of transfused blood restore allogeneic responsiveness. Phlebotomy may enhance this response when performed early after burn injury. PMID- 3510305 TI - Reduction of blood loss using tourniquets and 'compression' dressings in excising limb burns. AB - Excessive blood loss can limit the area of burn excised per sitting, lead to selection of en bloc rather than tangential excision, and increase the number of surgical procedures required per patient. Twenty-four burned extremities were studied to measure blood loss, complications, and effectiveness of a technique for tangentially excising burns of extremities using tourniquet hemostasis followed by application of steel-wool-pad 'compression' dressings before tourniquet release. An average of 7.3 days postburn (PB), a mean of 7% body surface area (BSA) burn was excised per extremity with a mean blood loss of 29 ml/% BSA burn excised (less than one fifth of recently published values). Graft take averaged 91%. There was no evidence of neurocirculatory injury or other complications. When applied as described and carefully monitored, hemostatic tourniquets followed by 'compression' dressings can safely reduce blood loss associated with the exclision of limb burns and allow larger areas to be excised at each operation. PMID- 3510306 TI - Excision and grafting of large burns: operation length not related to increased morbidity. AB - In order to study the relation between length of operation and postoperative morbidity in patients with burns greater than 30% TBSA a retrospective review was done. Seven categories of morbidity were chosen and points assigned for significant change from the preoperative state. There were no intraoperative or immediate postoperative deaths. The overall morbidity was 19%. The eventual mortality was 19%. There was no correlation between length of operation and postoperative morbidity. PMID- 3510307 TI - Transfusion-induced sensitization to skin allografts in burned mice. AB - Blood transfusions are known to improve allograft survival times, and this effect is enhanced with recipient immunosuppression. The focus of the present study was to determine the effect of pretransplant and perioperative donor-specific (DST) or nonspecific (NST) blood transfusion on skin allograft survival in thermally injured mice. Allogeneic immune responsiveness was suppressed in 20% TBSA burned mice, but not to a degree which was protective against DST-induced sensitization. Pretransplant DST resulted in accelerated graft rejection in burned recipients, although high-dose cyclosporine partially reversed this sensitization. Additionally, burn-related immunosuppression in this model did not enhance perioperative transfusion-induced graft prolongation. However, when burn-injured perioperatively transfused mice were further immunosuppressed with cyclosporine, significant graft prolongation occurred. These data suggest that perioperative NST may contribute to prolonged skin graft survival in burned recipients, provided that the mice are sufficiently immunosuppressed. PMID- 3510308 TI - Selection and nonoperative management of pediatric blunt trauma patients: the role of quantitative crystalloid resuscitation and abdominal ultrasonography. AB - One hundred thirty-nine pediatric blunt trauma patients 12 years of age or less were cared for using a protocol designed to identify which patients require aggressive surgical therapy and those who can be managed nonoperatively. Sixteen patients (average MISS score, 33) failed to respond to an estimated 20 cc per kilogram of crystalloid fluid resuscitation. Fifteen died, a mortality rate of 94%. One hundred twenty-three patients (average MISS score, 11) responded to less than or equal to 20 cc crystalloid fluid per kilogram with return of normal blood pressure, pulse rate, and nail bed capillary refill. Six died, a mortality rate of 5%, all from central nervous system injuries. Sixty-seven of these patients underwent ultrasound examination for suspected intra-abdominal injuries. Seventeen studies were positive. There were two complications (12%), but all 17 patients in this group were successfully managed nonoperatively. Our data suggest that quantitative crystalloid fluid resuscitation can identify pediatric blunt trauma patients suitable for nonoperative management and that ultrasound is a reliable tool for assessing intra-abdominal injury. PMID- 3510309 TI - Delayed rupture of the spleen presenting as a scrotal hematoma. AB - A case of a delayed rupture of the spleen presenting as a left scrotal mass (hematoma) is described. This interesting association was made with computerized axial tomographic scanning, ultrasound, and surgical exploration. When a scrotal mass is suspected to be a hematoma, abdominal pathology as a cause must be ruled out. PMID- 3510310 TI - Transposition of the sartorius muscle for reconstruction of the extensor apparatus of the knee. AB - A case of transposition of the sartorius muscle is presented. This method was successfully used for treatment of an exposed knee joint with subtotal loss of the extensor apparatus of the knee. A proximally based muscle flap proved very efficient for coverage of the knee joint and restoration of function. PMID- 3510311 TI - Hepatitis B virus polypeptide X: expression in Escherichia coli and identification of specific antibodies in sera from hepatitis B virus-infected humans. AB - Sequence analysis of the hepatitis B virus (HBV) genome revealed the presence of an open reading frame (ORF X) which has the potential to encode a 154-amino acid polypeptide. A fusion protein containing 145 of the amino acids encoded by ORF X and 8 amino acids of beta-galactosidase was expressed and characterized in bacterial extracts. Immunoprecipitations with the ORF X fusion protein as a radioactively labeled antigen were performed to screen sera of humans infected with HBV for the presence of antibodies against ORF X-encoded determinants (anti X). Such antibodies were identified in 9 samples from a set of 26 sera characterized as positive for HBV surface antigen but were not found in 16 normal human sera. The data reported here demonstrate that sera from some patients with markers of HBV infection contain antibodies directed against the polypeptide encoded by ORF X. As such, these findings represent evidence that ORF X constitutes a gene, or a portion of a gene, which is expressed during HBV infection. Although there does not appear to be a direct relationship between anti-X and any individual markers of HBV infection, our data suggest that anti-X is more prevalent in HBV-positive sera containing antibodies to HBe3 antigen (anti-HBe3). PMID- 3510312 TI - Calcium stone disease: an overview. PMID- 3510313 TI - Uterus didelphys with unilateral imperforate vagina and ipsilateral renal agenesis. AB - Uterus didelphys with unilateral imperforate vagina is rare. Interestingly, in all reported cases in which the urinary tract was investigated renal agenesis was found on the side of the obstructed hemivagina. We report 2 cases of this unusual and interesting condition, and review the embryogenesis of mullerian duct abnormalities associated with renal agenesis, as well as the clinical findings, diagnosis and management. We stress the importance of prompt and accurate diagnosis, and treatment as a means to avoid unnecessary surgical procedures. PMID- 3510314 TI - Spontaneous resolution of bilateral renal artery dissection: a case report. AB - We report a case of simultaneous bilateral dissection of the renal arteries with partial renal infarction. Of interest is the fact that the dissection resolved spontaneously during the 1-year followup. The radiology, including angiography, computerized tomography and ultrasonography, findings are described. The etiology and treatment of isolated dissection of the renal artery also are discussed. PMID- 3510315 TI - Extensive pelvic malacoplakia: observations on management. AB - A case of malacoplakia of the bladder is described. During a 4-year interval the disease progressed from a small intravesical lesion to a large pelvic mass. The disease eventually was controlled by carefully supervised antibiotic treatment of the recurrent urinary tract infections. Patients with urinary malacoplakia require careful long-term followup to control urinary tract infections and help prevent the occasionally aggressive course of this disease. PMID- 3510316 TI - Urinary tract infection in percutaneous surgery for renal calculi. AB - Percutaneous extraction of renal stones is associated with a risk of infection, which sometimes can be severe as a result of the intraoperative introduction of a ureteral catheter, the nephroscopy itself and the fact that a nephrostomy tube sometimes is left in place. It generally is accepted that patients with a preoperative urinary tract infection should be covered during the operation by an appropriate antibiotic. However, the need for routine prophylactic antibiotic treatment in patients with sterile urine preoperatively still is a subject of debate. We report the bacteriological results of 126 cases of percutaneous extraction of renal stones. Of the patients 107 had sterile urine preoperatively and deliberately did not receive prophylactic antibiotics so that the mechanisms of urinary tract infection after percutaneous nephrolithotomy could be studied. Of these patients 37 (35 per cent) suffered a postoperative urinary tract infection, usually owing to Escherichia coli, streptococcus or staphylococcus. The responsible organism was isolated in the bladder urine only in 22 cases, in the nephrostomy tube in 2 and in both sites in 13. Eleven patients (10 per cent) presented with a fever of 38.5C or more. All of the infected patients received appropriate antibiotic therapy and there were only 2 bacteriological failures on long-term followup (5 per cent). A total of 19 patients had a urinary tract infection preoperatively. All 19 patients received appropriate antibiotic therapy starting at least 24 hours preoperatively and continuing for a minimum of 3 weeks. Five patients (26 per cent) presented with a fewer but there were no serious septic complications. All of the patients were discharged from the hospital with sterile urine and there was only 1 long-term bacteriological failure (5 per cent). Both patients with Pseudomonas infection were cured. The risk of clinical infection following percutaneous nephrolithotomy is low despite the fact that 35 per cent of the patients have bacteriuria postoperatively, provided a careful bacteriological examination is performed preoperatively and the patients with urinary tract infection are treated appropriately. These results are in favor of short-term prophylactic antibiotics adapted to the bacterial ecology. PMID- 3510317 TI - The effects of chronic cystitis on vesicoureteral reflux in an animal model. AB - The purpose of this study was to determine if chronic cystitis interferes with maturation of the ureterovesical junction, thus prolonging vesicoureteral reflux in infant rhesus monkeys (Macaca mulatta). Serial implantations of a Proteus infested silastic pellet into the bladder wall ensured continued infection as demonstrated by urine culture. Chronic cystitis as evidenced by pathological findings at surgery and sacrifice was created in a group of infant monkeys who had initial spontaneous vesicoureteral reflux. There was no evidence of pyelonephritis. Four animals represent a short term study since they were followed from four months to one year of age. Three animals were long term studies and were evaluated for at least 21/2 years. In no animals did chronic cystitis delay the normal disappearance of vesicoureteral reflux that is commonly seen in these animals as the ureterovesical junction matures, as demonstrated by serial cystograms. In two animals reflux (after initial clearing) reappeared when a bladder calculus formed in these chronically infected animals. Renal damage occurred only in these animals. In conclusion, this animal model failed to demonstrate interference with normal vesicoureteral junction maturation in the face of a chronic bladder infection. PMID- 3510318 TI - Failure of immunotherapy for metastatic renal cell carcinoma. AB - Prompted by reports of tumor regression among patients with metastatic renal cell carcinoma treated by injection of an aggregated autologous or allogeneic tumor antigen with a nonspecific adjuvant, we studied the efficacy of this therapy in 23 patients. Following nephrectomy or excision of a metastatic lesion 16 patients were treated with an aggregated autologous tumor antigen combined with Candida albicans antigen. There were only 2 minimal responses. Seven patients judged unsuitable for an operation were treated with an aggregated allogeneic antigen. There were no objective responses. We conclude that these treatment regimens have minimal activity against metastatic renal cell carcinoma. PMID- 3510319 TI - Treatment of invasive bladder cancer with a neodymium:YAG laser. AB - In a controlled setting a neodymium:YAG laser is capable of producing a transmural coagulation of the bladder wall without perforation. A total of 21 patients with known muscle-invading bladder cancer underwent treatment with transurethral endoscopic application of neodymium:YAG laser energy. One patient suffered a sigmoid colon perforation that possibly was treatment-related but no other complications were observed. Four of 5 patients with clinical stage B1 and 3 of 6 with stage B2 lesions have had normal post-treatment biopsies. Local tumor control has been achieved in only 1 of 4 patients with a clinical stage C tumor and none of 6 with metastatic cancer, although palliative debulking was accomplished. PMID- 3510320 TI - Short-term prophylactic antibiotics in patients undergoing prostatectomy: report of a double-blind randomized trial with 2 intravenous doses of cefotaxime. AB - The effect of short-term antibiotic prophylaxis on postoperative infection with 2 injections of cefotaxime begun preoperatively was evaluated in a double-blind, randomized, placebo-controlled trial at 1 center on 181 patients with preoperative sterile urine undergoing transurethral resection (90) or open prostatectomy (91). Antibiotic prophylaxis reduced the number of urinary infections significantly in both groups without altering the level of resistant pathogens. Cefotaxime lowered the incidence of postoperative infection in the early postoperative period from 30 to 4 per cent in the transurethral resection group and from 46 to 4.5 per cent in the open prostatectomy group. A significant difference was found between the 2 treatment groups in the incidence of perioperative bacteremia and postoperative fever. Among the patients undergoing an open prostatectomy a reduced rate of wound infection and a shorter duration of hospital stay were witnessed in the treated group. Thus, short-term chemoprophylaxis by cefotaxime is of benefit in reducing morbidity and hospital cost for prostatectomy by either procedure. PMID- 3510321 TI - Real-time renal sonography in spinal cord injury patients: prospective comparison with excretory urography. AB - A prospective blinded comparison of real-time renal sonography and excretory urography was done in 202 urologically asymptomatic patients with spinal cord injury who underwent periodic evaluation. Sonography identified 31 of 31 renal masses (100 per cent) (30 cysts and 1 xanthogranulomatous pyelonephritis), whereas excretory urography identified 14 of 31 masses (45 per cent). Of the 398 kidneys evaluated hydronephrosis owing to an obstructive etiology was noted in 7, all of which (100 per cent) were identified on excretory urography and 6 (86 per cent) were identified on sonography. Only 12 of the 48 kidneys (25 per cent) with typical changes of chronic pyelonephritis on excretory urography were diagnosed correctly by ultrasound. Sonography identified 18 of 23 kidneys (78 per cent) with calculi compared to 20 of 23 (87 per cent) by excretory urography. Although 127 abnormalities were noted in 202 patients, only 21 dictated a change in management. Thirteen abnormalities were visible on a plain film of the kidneys, ureters and bladder (3 kidneys with stones, 1 ureteral stone and 9 bladders with stones). We conclude that sonography and excretory urography are excellent diagnostic modalities for the evaluation of the kidneys. Sonography, plain radiograph of the abdomen and post-contrast injection x-rays on excretory urography frequently offer complementary diagnostic information. The noninvasive nature of ultrasound examination and lack of x-ray exposure combined with no need for special patient preparation make ultrasound examination extremely attractive in this patient population. It is recommended that real-time renal ultrasound and a plain radiograph of the abdomen be used on an alternate basis with excretory urography for the routine followup of spinal cord injury patients. PMID- 3510322 TI - Modified pubovaginal sling in girls with myelodysplasia. AB - A pubovaginal sling provides excellent urethral compression in girls with intractable incontinence owing to proximal urethral nonfunction. Provided patients are selected by simple urodynamic criteria, an improvement in incontinence can be achieved by an operation. PMID- 3510324 TI - Surgical treatment of venous obstruction and insufficiency. AB - Direct venous reconstruction is being applied to patients with chronic venous stasis disease. Crosspubic bypass and saphenopopliteal bypass have proved to be satisfactory procedures whereas valve reconstructions by valvuloplasty, segment transfer, and autotransplantation are being explored. These procedures add to the surgeon's armamentarium in dealing with chronic venous stasis disease. PMID- 3510323 TI - Six-year prospective multicenter randomized comparison of autologous saphenous vein and expanded polytetrafluoroethylene grafts in infrainguinal arterial reconstructions. AB - Autologous saphenous vein (ASV) and polytetrafluoroethylene (PTFE) grafts were compared in 845 infrainguinal bypass operations, 485 to the popliteal artery and 360 to infrapopliteal arteries. Life-table primary patency rates for randomized PTFE grafts to the popliteal artery paralleled those for randomized ASV grafts to the same level for 2 years and then became significantly different (4-year patency rate of 68% +/- 8% [SE] for ASV vs. 47% +/- 9% for PTFE, p less than 0.025). Four-year patency differences for randomized above-knee grafts were not statistically significant (61% +/- 12% for ASV vs. 38% +/- 13% for PTFE, p greater than 0.25) but were for randomized below-knee grafts (76% +/- 9% for ASV vs. 54% +/- 11% for PTFE, p less than 0.05). Four-year limb salvage rates after bypasses to the popliteal artery to control critical ischemia did not differ for the two types of randomized grafts (75% +/- 10% for ASV vs. 70% +/- 10% for PTFE, p greater than 0.25). Although primary patency rates for randomized and obligatory PTFE grafts to the popliteal artery were significantly different (p less than 0.025), 4-year limb salvage rates were not (70% +/- 10% vs. 68% +/- 20%, p greater than 0.25). Primary patency rates at 4 years for infrapopliteal bypasses with randomized ASV were significantly better than those with randomized PTFE (49% +/- 10% vs. 12% +/- 7%, p less than 0.001). Limb salvage rates at 3 1/2 years for infrapopliteal bypasses with both randomized grafts (57% +/- 10% for ASV and 61% +/- 10% for PTFE) were better than those for obligatory infrapopliteal PTFE grafts (38% +/- 11%, p less than 0.01). These results fail to support the routine preferential use of PTFE grafts for either femoropopliteal or more distal bypasses. However, this graft may be used preferentially in selected poor-risk patients for femoropopliteal bypasses, particularly those that do not cross the knee. Although every effort should be made to use ASV for infrapopliteal bypasses, a PTFE distal bypass is a better option than a primary major amputation. PMID- 3510326 TI - Diagnosis of chronic venous insufficiency. AB - An orderly diagnostic approach is needed to establish specific anatomic and etiologic diagnoses in patients with chronic venous insufficiency. It begins with the history and physical examination, including Doppler examination of the veins, in the office. When the severity of the problem warrants further investigation, the vascular laboratory can be used to assess the degree of physiologic change via pressure, volume, and flow studies. Diagnosis of obstructive and incompetent states can be established, and the one distinguished from the other. Ascending phlebography is used to demonstrate the anatomy of the veins, competence of the perforators, and the presence of postthrombotic deep vein changes. Descending phlebography is used in selected cases to diagnose specific incompetence of the valves in the superficial femoral, deep femoral, and greater saphenous veins. A complete venous evaluation defines which veins are patent, where the valves are located and if they are competent, and provides physiologic pressure and volume studies to correlate with the clinical state. Problems caused by primary valve incompetence are separated from those caused by postthrombotic recanalization or occlusion. On the basis of these findings, specific therapy can be tailored to the problem at hand. PMID- 3510325 TI - The diagnosis and management of primary lymphedema. AB - Although the clinical features of lymphedema are often distinctive, it is essential to confirm the diagnosis with an objective test. Isotope lymphography is simple and 95% accurate for defining deficient lymph clearance. It is particularly useful for separating venous from lymphatic edema. Definition of the precise abnormality--peripheral lymphatic obliteration, proximal lymph node obstruction, or valvular incompetence--can only be made with lymphangiography. The mainstay of treatment is the reduction of edema by regular elevation and massage and external compression with elastic stockings. Pneumatic leggings are also helpful. Gross edema caused by peripheral obliteration may be reduced surgically by simple excision (Homans' operation) or complete excision and skin grafting (Charles' operation). Reflux through incompetent vessels may be prevented by vessel ligation. Obstruction by the iliac lymph nodes may be bypassed with an enteromesenteric pedicle. PMID- 3510327 TI - Vascular anastomoses with laser energy. AB - Laser-assisted arterial and venous anastomoses are now feasible. A microscope guided CO2 laser was used to deliver 60 to 100 mW to anastomose end to end 44 rabbit carotid arteries (1.5 to 2.0 mm) and 27 rabbit vena cavae (4 to 6 mm). These were compared with control arteries repaired with interrupted suture technique. Anastomoses were examined from between 24 hours and 19 weeks. Laser carotid anastomoses yielded 93% patency (41 of 44) and 9% aneurysms (4 of 44), whereas hand-sewn carotid anastomoses produced 91% patency (40 of 44) and no aneurysms. In the vena cava, 26 of 27 laser anastomoses were patent (96%) compared with 19 of 20 (95%) sutured controls. Venous aneurysmal dilatation was seen in 2 of 27 laser (7%) and in 3 of 20 (15%) hand-sewn anastomoses. Histologic examination of laser-assisted anastomoses showed local full-thickness thermal injury. Repair was by fibroblast and myofibroblast proliferation, and luminal cell coverage was complete by 14 days in both laser and sutured repairs. Laser arterial and venous anastomoses are attractive because of their simplicity and rapidity of performance. Their patency is comparable to sutured anastomoses, but arterial aneurysms remain a hazard despite use of extremely low laser energy. PMID- 3510328 TI - Distribution of venous valvular incompetence in patients with the postphlebitic syndrome. AB - The records of 122 patients who underwent Doppler evaluation for the postphlebitic syndrome were reviewed to determine the relationship between location of venous valvular incompetence and severity of clinical signs. Categorized according to the most severe physical finding, there were 35 limbs with perimalleolar ulcers, 113 with stasis pigmentation, 26 with swelling, and 70 with no overt signs. Incompetent veins, either deep or superficial, were present in 93% of the symptomatic and 59% of the asymptomatic limbs. Proximal (iliofemoral) deep venous incompetence was not strongly correlated with disease severity (p less than 0.10), but distal (popliteotibial) deep venous and superficial venous incompetence were (both, p less than 0.0005). The relative frequency of isolated proximal incompetence appeared to diminish with increasing disease severity; whereas that of distal incompetence, with or without associated proximal venous incompetence, increased. Isolated proximal venous incompetence was found in only 5% of limbs with severe disease (ulcers or pigmentation). In limbs with severe signs, distal venous incompetence was present in 67% of those with proximal venous incompetence and in 57% of those in which the proximal valves were competent. These findings cast doubt on the potential value of proximal venous valvular reconstruction, especially in limbs with combined proximal and distal insufficiency. PMID- 3510329 TI - Cold virus spurs range of remedies. PMID- 3510330 TI - Do it to yourself section: surgery. PMID- 3510331 TI - Vesicular eruption. A local complication of concentrated acyclovir infusions. PMID- 3510332 TI - The treatment of the pregnant diabetic. PMID- 3510333 TI - Acute esophageal variceal sclerotherapy. Results of a prospective randomized controlled trial. AB - Within 48 hours of variceal hemorrhage, 82 patients were randomly assigned to conventional treatment including balloon tamponade or to conventional treatment supplemented by sclerotherapy. The prerandomization general clinical characteristics of the two groups were similar. Seventy-nine percent of patients were alcoholic and 57% were in Child's class C. In the sclerotherapy group of 44 patients, sclerotherapy was performed twice in 28 patients and thrice in 13 patients over the two weeks of follow-up. The number of patients who rebled was significantly lower in the sclerotherapy group than in the group treated conventionally (23% vs 53%). The number of bleeding episodes also was significantly lower in the sclerotherapy group (15 vs 32). Moreover, blood transfusion requirements were significantly decreased in the sclerotherapy group. This was true even for patients who were bleeding at the time of randomization or who were in Child's class C, but this primarily was because fewer patients who underwent sclerotherapy (10 of 24 vs 18 of 23) required transfusions. Although there was no difference in survival between the two groups, we conclude that sclerotherapy is better than conventional treatment in the acute management of variceal bleeding. PMID- 3510334 TI - An approach to the management of hyperlipoproteinemia. AB - Recent clinical trials indicate that reduction of plasma cholesterol concentrations in individuals with increased levels of low-density lipoproteins reduces their risk of myocardial infarction and death. Therefore, the question of "whether to treat" should be shifted to "whom to treat" and "how best to treat". The understanding of normal lipid transport via the plasma lipoproteins has grown to a sophisticated level over the past 20 years. Plasma cholesterol, required for cellular membrane integrity, and plasma triglycerides, the primary mammalian energy source, are carried in lipoprotein particles that vary in size, density, lipid composition, and apolipoprotein content. Some lipoprotein particles (low density lipoproteins) play a causal role in the atherosclerotic process, while other particles (high-density lipoproteins) appear to prevent this process. Utilizing this understanding of the plasma lipoproteins, a systematic approach to the management of the patient with hyperlipoproteinemia has been developed which may lead to the normalization of plasma lipoprotein concentrations in the majority of hyperlipoproteinemic patients. PMID- 3510335 TI - Cellular proliferation in the rat mammary gland during pregnancy and lactation. AB - Cellular proliferation during different stages of pregnancy and lactation in the rat mammary gland was studied by use of autoradiography at the ultrastructural level or in combination with immunocytochemistry. The study consisted of two groups of animals, young 45-day-old rats undergoing their first pregnancy and old multiparous rats undergoing their third pregnancy. Both groups of animals were injected with [3H]thymidine, 2 hours before sacrifice. The timing of proliferative activity through pregnancy and lactation was similar in the two groups. A peak level of proliferation was observed on the 5th day of gestation and the rate of proliferation was at its lowest at the end of gestation. A second small peak was observed on the 3rd day of lactation. In virgin animals, both epithelial and myoepithelial cells showed a high level of proliferative activity. The epithelial cells continued to divide during all stages of their differentiation, throughout pregnancy and lactation. Myoepithelial cells showed active division in early pregnancy but their rate of proliferation declined as the cells acquired abundant cytoplasmic filaments for their contractile function. Intra-alveolar dendritic cells, which have been recently identified in the lactating rat breast, showed a high proliferative rate at the end of gestation. PMID- 3510336 TI - Evaluation of a short-time, oxygen carrier-free perfusion model in rat liver: mitochondrial energy metabolism and insulin effect. AB - Livers of rats fasted for 18 hr were perfused for 60 min at 37, 35, and 32 degrees C in a simple noncirculating system with a carbogen (95%, 5% CO2) equilibrated, oxygen carrier-free, glucose-containing (200 mg X dl-1) cristalloid perfusate (pH 7.4, 280 mosmol X kg-1) without or with the addition of insulin (10 U X hr-1), and analyzed for tissue ATP, ADP, AMP, acetoacetate, and beta hydroxybutyrate as well as for parameters of the energy metabolism of isolated mitochondria. Perfusion without insulin at 37 degrees C caused significant alterations: ATP and total adenine nucleotides (TAN) dropped to 62 and 74% of the control values (3.33 and 4.57 mumol X g-1), respectively. The energy charge potential ECP decreased from 0.842 to 0.713. Also, the mitochondrial phosphorylation rate (PR), the respiratory control ratio (RC), and the state 3 respiration rate (ST 3) were significantly depressed to 62, 54, and 72% of the control values. Perfusion with insulin maintained a normal metabolic pattern: ATP 105%, TAN 97%, ECP 0.877, PR 94%, RC 69%, and ST 3 105%. The metabolic deterioration during insulin-free perfusion was decreased at 35/32 degrees C: ATP 67/82%, PR 72/95%, RC 74/87%. At 35 degrees C, insulin ameliorated the metabolic pattern, but normal ranges were no longer reached. At 32 degrees C, insulin had no effect. PMID- 3510337 TI - Immunobiological consequences of splenectomy: a review. PMID- 3510338 TI - A method for improved exposure of the mitral valve: cannulation of innominate vein and division of superior vena cava for extended left atriotomy in mitral valve operations. AB - A method of improved exposure of the mitral valve and subvalvular apparatus is described. Cannulation of the left innominate vein and division of the superior vena cava allow excellent exposure of the mitral valve and subvalvular apparatus. This method is particularly useful in patients with a small left atrium or deep chest. PMID- 3510339 TI - Surgical management of the failed gastroplasty. AB - Gastroplasty has been used in surgical management of reflux for 25 years. The creation of a gastric tube before fundoplication complicates further corrective procedures should the original operation fail. Experience has been gained with 51 patients, 34 having partial fundoplication gastroplasty and 17 having total fundoplication, who have had major persistent or recurrent symptoms. All were evaluated by history, radiology, endoscopy, manometry with pH, and acid perfusion testing before surgical management. The patients undergoing partial fundoplication gastroplasty had heartburn (85.3%), reflux (70.6%), and dysphagia (94.1%). Radiologic recurrence was present in 26.5%, endoscopic incompetence in 94.1%, and a stricture in 26.5%. The patients who had a total fundoplication gastroplasty had heartburn (52.9%), reflux (29.4%), and dysphagia (82.4%). Radiologic recurrence was present in 29.4%, endoscopic incompetence in 35.3%, and a stricture in 5.9%. On average, these patients had had 2.3 prior operations (range one to five operations). The dominant cause of failure (in the absence of anatomic recurrence) with partial fundoplication gastroplasty was continued or recurrent reflux and with total fundoplication gastroplasty, too tight or too long a fundoplication. All patients had a thoracoabdominal revision total fundoplication gastroplasty and a 1 cm completion fundoplication. Pyloromyotomy was added if not previously performed. There were no deaths or major morbidity. Follow-up in 51 patients averages 4.2 years (range 0.3 to 8.8 years). None has radiologic recurrence, one has minor reflux, one a traumatic diverticulum, and one has moderate esophageal obstruction. Of these patients, 82.4% are asymptomatic, 13.7% have minor symptoms, and 3.9% (two patients) have significant residual symptoms. This conservative surgical approach avoids the higher mortality of resection with interposition and provides satisfactory results. PMID- 3510340 TI - Charles Proteus Steinmetz: pioneer in research on electric motors. PMID- 3510341 TI - Results of computer-assisted stereotactic laser resection of deep-seated intracranial lesions. AB - A computer-assisted stereotactic system has been developed for the precise resection of deep-seated intracranial neoplasms. After the tumor volume is reconstructed from computed tomographic and magnetic resonance imaging data, a computer-monitored, stereotactically directed carbon dioxide laser is used to vaporize the intracranial tumor. A computer graphics terminal is used to monitor the position of the laser in relationship to the planar slices through the tumor, which are reformatted orthogonally to the surgical plane of view. This procedure produced satisfactory postoperative neurologic results in 36 of the 41 patients who underwent treatment. The system provides precise surgical control in three dimensional space for the safe resection of substantial amounts (as assessed by postoperative computed tomography) of intra-axial neoplasms. PMID- 3510342 TI - Glaucoma: an overview. AB - Glaucoma is a potentially blinding ocular disease that commonly affects elderly persons. In this review, we discuss the range of clinical findings, appropriate diagnostic tests, and available medical, laser, and surgical treatment options. New developments in the evaluation of the optic nerve and in visual field testing may facilitate the early detection of glaucoma, and new therapeutic agents hold promise for the future. PMID- 3510343 TI - Elevation of carcinoembryonic antigen in cerebrospinal fluid among patients with meningeal carcinomatosis. AB - The concentration of carcinoembryonic antigen (CEA) in cerebrospinal fluid (CSF) was determined by using an enzyme immunoassay for 204 patients with various nonneoplastic neurologic disorders, 8 patients with systemic infectious diseases, 19 patients with systemic neoplastic diseases without involvement of the nervous system, and 35 patients with neoplastic neurologic disorders. The highest CEA level in CSF among patients without neoplastic neurologic disorders was 0.6 ng/ml. Of 35 patients with neoplastic neurologic disorders, 10 had CEA levels in CSF that exceeded 0.6 ng/ml, the highest level being 70.5 ng/ml. All 10 patients had carcinomas. Among 14 patients with neoplastic meningitis, 5 of 8 patients with meningeal carcinomatosis had elevated CEA concentrations. Although the efficacy of the assay for CEA in CSF must be compared with that of other laboratory tests such as cytologic examination and the assay for beta glucuronidase--and any potentially false-positive results should be ruled out by determination of the serum CEA level--the CEA concentration in CSF can be used as an adjunctive diagnostic procedure for detection of meningeal carcinomatosis. PMID- 3510344 TI - Cutaneous T cell lymphoma. AB - Cutaneous T cell lymphoma is a malignancy of helper T cells, which have a propensity to infiltrate the skin. The incidence of the disease appears to exceed that of Hodgkin's disease, making it the most common lymphoma of adults. Advances in our knowledge of the biology of the malignant T cells should facilitate new and more effective forms of treatment. PMID- 3510345 TI - The role of tissue typing in cutaneous oncology. AB - The typing of cells in the skin with specific monoclonal antibodies is now routine. Such tissue typing appears to play a critical role in the early diagnosis, accurate classification, and therapeutic decisions for cutaneous oncology, especially lymphomas. Identification and production of tumor-specific antibodies will further enhance the potential of these reagents in oncology. PMID- 3510346 TI - Cutaneous side effects of cancer chemotherapy. AB - Chemotherapeutic agents are used with increasing frequency to treat a wide variety of neoplastic and inflammatory disorders. These drugs may inadvertently affect the skin, mucous membranes, hair, and nails, producing many undesirable reactions including alopecia, stomatitis, hyperpigmentation, hypersensitivity reactions, and photosensitivity. Awareness of these relatively common complications may help physicians caring for patients on these medications. PMID- 3510347 TI - Melanocytic precursors of cutaneous melanoma. Estimated risks and guidelines for management. AB - There are several recognizable melanocytic precursors of cutaneous melanoma. These precursors include lentigo maligna, dysplastic melanocytic nevi, congenital nevi (of any size), and darkly pigmented lesions of acral surfaces and mucous membranes. Lentigo maligna is an uncommon melanocytic dysplasia, present in 3 per 1000 individuals over the age of 50 years and accounting for 4 percent of all cutaneous melanomas. Dysplastic melanocytic nevi are present in 2 per cent of white adults, and may account for at least a fifth of cases of cutaneous melanoma. Congenital nevomelanocytic nevi are present in 1 per cent of newborns; the vast majority of congenital nevi are smaller than 3 to 4 cm in diameter, while very large congenital nevi are present in 1 in 20,000 to 1 in 500,000 newborns. Very large congenital nevi account for less than 0.1 percent of cutaneous melanomas, whereas small varieties of congenital nevi may account for 15 percent of cutaneous melanomas. If individuals with lentigo maligna live long enough, possibly a third to a half are said to develop melanoma. This figure may be biased high. Persons with dysplastic melanocytic nevi in the familial melanoma setting have an estimated lifetime risk of developing melanoma approaching 100 per cent. Persons with dysplastic melanocytic nevi in other settings may have a lifetime melanoma risk of 18 per cent. Persons with congenital nevi of any size may have a lifetime melanoma risk of at least 5 per cent. Early recognition of these precursor melanocytic tumors, particularly in high-risk individuals (i.e., those with a personal or family history of melanoma), and careful photographic follow-up or prophylactic excision of these lesions may be the most effective means of reducing the morbidity and mortality of cutaneous melanoma. The impact of routine screening and excision of presumed melanoma precursors is unknown. Clinical judgment is required to balance the theoretical risk of melanoma associated with a given precursor and the known risks of surgery and anesthesia for a given individual. It must be kept in mind that the vast majority of acquired melanocytic nevi in adults are harmless. Probably even the majority of dysplastic nevi and small congenital nevi will remain unchanged throughout life. The simple recognition of the existence of melanoma precursors will heighten suspicion for these lesions and raise awareness of the earliest signs of malignant change.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3510348 TI - The clinical recognition and prognostic factors of primary cutaneous malignant melanoma. AB - The incidence of melanoma continues to increase. In the absence of a defined and preventable etiology, early recognition and proper management offer the best hope for prolonged survival and cure. Clinically suspect lesions must be biopsied for diagnostic confirmation and histologic information. Reliable prognostic information can be gained from histologic and clinical parameters, which are described. PMID- 3510349 TI - The histology of malignant melanoma. AB - A brief review of the histology of malignant melanoma is presented, including various prognostic indicators of the biologic behavior of this neoplasm. Reproducible criteria are outlined in an attempt to provide for a more accurate diagnosis and subsequent treatment of this life-threatening disease. PMID- 3510350 TI - Therapy of primary cutaneous melanoma. AB - The essential tenets of early recognition, biopsy, and appropriate surgical treatment of melanoma are reviewed. The controversies of elective regional lymph node dissection and isolated limb perfusion are discussed, as well as the newer modalities of immunotherapy. PMID- 3510351 TI - Systemic therapy of malignant melanoma. AB - To date, the therapeutic challenge of improving the poor prognosis of malignant melanoma has not been met by adjuvant therapy for disseminated disease. But the tedious determination of ineffective therapy has closed some lines of research and opened others. Disseminated melanoma is a fertile field for application of new drugs and phase II studies. An effective drug for advanced disease is the key to defining adjuvant therapy. In the next years, clinical application of antimelanoma monoclonal antibodies will be feasible to determine efficacy. Viral oncolysate, a new and promising agent, will also be studied in prospective randomized trials. Continuing research to define an effective systemic therapy for malignant melanoma is warranted. PMID- 3510352 TI - Basal cell carcinoma and squamous cell carcinoma. Recognition and treatment. AB - Although they are common, careful attention is necessary to detect basal cell carcinomas and squamous cell carcinomas early on. Suggestions for easier detection, as well as proper selection of therapy, are discussed. PMID- 3510353 TI - Fascial pulley: cross-commissure lip reanimation for inferior division facial nerve paralysis. AB - The risks of causing further harm to the facial nerve are greater in surgery for partial facial paralysis. We present a new active and passive reconstruction technique for paralysis of the buccal-mandibular divisions of the facial nerve. Our fascial pulley technique of reanimation and suspension of the oral commissure produces no further injury to the facial nerve and the eyelids. In addition, it adds a better technique to the armamentarium of the reconstructive surgeon dealing with partial lower facial nerve paralyses. PMID- 3510354 TI - Avoiding problems in tracheotomy. AB - The surgeon can minimize postoperative problems that may develop after tracheotomy by 1. ligating the veins that cross the midline (over-dependence on cautery often results in postoperative bleeding); 2. dividing and suture-ligating the thyroid isthmus; 3. avoiding sharp dissection or blind clamping at the sternal notch; 4. leaving the deep layers of the wound open, to avoid subcutaneous or mediastinal emphysema; 5. avoiding a low horizontal skin incision; and 6. using guide sutures at tracheal opening in the infant. PMID- 3510355 TI - The intrinsic vasculature of the cat facial nerve. AB - Treatment of facial nerve disorders is based in part on assumptions regarding the intrinsic blood supply of the nerve. This study was designed to comprehensively delineate the intrinsic facial nerve microcirculation and its relation to the extrinsic circulation in an animal model. Twenty-eight cat facial nerves were removed intact from brain stem to stylomastoid foramen following intravital fixation. Specimens were studied by gross dissection, silicone injection and tissue clearing, complete vessel counts on serial cross sections of individual nerves, and scanning electron microscopy or transmission electron microscopy. The labyrinthine segment of the cat facial nerve contains strikingly fewer intrinsic blood vessels than the mastoid and tympanic segments. The geniculate ganglion, however, has a distinct, rich vascular plexus. The ultrastructure of the intrinsic facial nerve vessels is similar to other small vessels of the body with tight junctions of the endothelium and overlapping spiral smooth muscle fibers of arterioles, as well as surrounding pericytes. PMID- 3510356 TI - [Complex evaluation of pancreatic function in insulin-dependent diabetes mellitus]. AB - The time course of the concentration of immunoreactive insulin (IRI) and C peptide in the plasma and erythrocytes and the blood sugar level in GTT per os were investigated. Altogether 73 healthy persons and 52 patients with a severe form of insulin-dependent diabetes mellitus were examined. To define the time course of changes in the concentration of the above values a rate gradient determined as a difference of changed concentration rate for the 1st and 2nd hour after load for each examined person, was proposed. The most significant differences in the healthy persons and patients were noted in the plasma IRI basal level and blood sugar basal levels. The rate gradient defined most completely the time course of carbohydrate metabolism. The gradients C-peptide had maximum difference in healthy persons and patients. The hormone and blood sugar levels characterized the condition of the examined persons, and rate gradients were indicative of the state of the blood sugar regulation system. PMID- 3510357 TI - [Radiotherapy of neoplasm metastases in the liver]. PMID- 3510358 TI - [Radioimmunologic studies in the outpatient detection of oncologic diseases]. PMID- 3510359 TI - The morbid anatomy of the human genome: a review of gene mapping in clinical medicine (1). PMID- 3510360 TI - Glucoregulation in alloxan-diabetic dogs. AB - In order to establish whether a prolonged subnormal secretion of insulin may affect glucoregulation against hypoglycemic stimuli, the level of plasma glucose was decreased in alloxan-diabetic dogs by the infusion of either 50 micrograms/kg . min phlorizin (PHL), ie, reducing the concentration of plasma glucose without hyperinsulinemia; or with 7 mU/kg . min insulin (combined hyperinsulinemia and hypoglycemia). The concentration of glucose, immunoreactive glucagon (IRG), and insulin (IRI) and catecholamines were followed in the plasma. Hepatic glucose production (Ra) and the overall rate of glucose removal from the circulation were calculated by a tracer method. During a 200-minute infusion of PHL plasma glucose fell from 328 +/- 29 to 114 +/- 16 mg/dl, while IRG rose from a mean of 470 +/- 123 to 623 +/- 200 pg/mL, however this increase was significant only in 3 out of 6 dogs. There was no change in the plasma level of epinephrine. Plasma IRI decreased significantly, the IRI/IRG ratio remained low, and Ra did not increase. When the animals were treated with insulin for one week, plasma glucose was restored to normal, while plasma IRI and the IRI/IRG ratio were raised above the normal level. Under these circumstances the infusion of PHL increased plasma IRG significantly from 59 +/- 5 to 110 +/- 32 pg/mL, decreased IRI slightly, and increased Ra by an average of 50 +/- 16%. No measurable change in plasma glucose was observed indicating the restoration of nonhypoglycemic glucoregulation. In diabetic dogs during a 95-minute infusion of insulin, plasma glucose dropped from a mean of 338 +/- 5 to 74 +/- 24 mg/dL.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3510361 TI - Effect of physical training on norepinephrine turnover in tissues of normal and diabetic rats. AB - This study was designed to examine the influence of physical training on the norepinephrine turnover rate in heart, pancreas, liver, and gastrocnemius muscles of normal and diabetic male rats at rest. Diabetes was induced with the IV injection of streptozotocin (45 mg/kg) and physical training was done on a treadmill according to a ten-week program. Norepinephrine turnover rate of tissues was estimated by following over time the decay in the specific activity of norepinephrine after a single IV bolus of tritiated norepinephrine (30 microCi/kg). Plasma glucose, insulin, and glucagon levels were also measured at the time of death. Although training caused a reduction in the plasma glucose values of diabetic rats, no changes in norepinephrine turnover rate were observed after the conditioning program. On the other hand, diabetes was associated with a significant 30% to 40% decrease in the pancreatic norepinephrine turnover rate. It is concluded that the beneficial effects of physical training on diabetes mellitus cannot be explained by adaptive changes in the sympathetic nervous system activity and that further work will be necessary to elucidate the mechanism whereby streptozotocin diabetes diminishes the pancreatic norepinephrine turnover. PMID- 3510362 TI - Genotype dependency of the thermic effect of a meal and associated hormonal changes following short-term overfeeding. AB - The purpose of this experiment was to assess the effects of short-term overfeeding (mixed diet) on the thermic effect of a meal (TEM) and associated hormonal changes and to investigate the role of the genotype in the observed changes. Six pairs of male sedentary monozygotic (MZ) twins consumed an extra 1,000 kcal per day over their individual level of energy expenditure while maintaining a sedentary existence. Resting metabolic rate (RMR) and TEM following a 4.2 MJ meal challenge was measured before and after 22 days of overfeeding. RMR did not change significantly (7% elevation) in response to the positive caloric stimulus, whereas significant increases (P less than 0.01) in TEM were observed. Moreover, postprandial insulin and glucose responses were not modified. Overfeeding did not significantly alter catecholamine levels but induced significant elevations in plasma levels of T3 and T4 (P less than 0.05). Changes in RMR exhibited moderate but nonsignificant within twin pair resemblance in response whereas significant within pair resemblance was noted in the magnitude of TEM changes induced by overfeeding (P less than 0.05). Hormonal responses exhibited a weaker genotype dependency. These results suggest that short-term overfeeding can induce an elevation in TEM with accompanying increases in T3 and T4. Large individual response variation in metabolic and hormonal measures were observed. The similarity of response within twin pairs suggests that sensitivity to change in TEM induced by short-term overfeeding is genetically influenced. PMID- 3510363 TI - Nitrogen conservation in starvation revisited: protein sparing with intravenous fructose. AB - The provision of small amounts of glucose during fasting is known to spare body protein and to attenuate markedly the metabolic response to starvation. These actions, which are not shared by fat, are generally thought to depend on the ability of exogenous glucose to stimulate insulin secretion. To determine whether fructose, a very weak insulin secretagogue, will also conserve nitrogen and alter the response to fasting, we infused small amounts of fructose, 100 g/d (375 kcal), into 7 obese subjects during a 10-day fast: 4 received fructose days 7 to 10, and 3 received fructose days 1 to 7. Fructose virtually abolished (all P less than 0.05-0.01) the fasting induced: (a) fall in glucose and insulin and rise in glucagon, (b) fall in triiodothyronine, (c) ketosis and acidosis, (d) increased ammonia excretion, (e) hyperuricemia (and hypouricosuria), and (f) fall in plasma alanine and rise in branched chain amino acids. Fructose also significantly reduced urinary sodium loss. Moreover, fructose exerted a prominent protein sparing action, even though plasma insulin concentrations never exceeded postabsorptive levels. Excretion of total nitrogen was reduced by 40% to 50% during periods of fructose infusion, reflecting significant suppression of both urea and ammonia generation (all P less than 0.05-0.01). Most plasma glucogenic amino acids rose significantly during fructose administration. We conclude that low-dose fructose infusion essentially abolishes the entire hormone-substrate response to fasting, and spares body protein without raising insulin above postabsorptive levels.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3510364 TI - Effect of ciglitazone on glucose uptake and insulin sensitivity in skeletal muscle of the obese (ob/ob) mouse: distinct insulin and glucocorticoid effects. AB - The oral hypoglycemic agent, ciglitazone, (5-[4-(1 methylcyclohexylmethoxy)benzyl]-thiazolidine-2,4-dione), was fed for nine days to genetically obese (ob/ob) mice aged 5 to 6 weeks. This treatment resulted in a lowering of plasma glucose and circulating insulin levels, but did not cause a fall in plasma corticosterone levels. Basal 2-deoxy-D-glucose uptake by the perfused hindquarters of ob/ob mice was unchanged by ciglitazone feeding. In the presence of 0.1 mU/mL insulin in the perfusion medium, there was a significant increase in the uptake rate of 2-deoxy-D-glucose by the skeletal muscle of ciglitazone-treated ob/ob mice, while there was no insulin effect in untreated ob/ob mice. Insulin at a concentration of 1 mU/mL caused a further stimulation of 2-deoxy-D-glucose transport. However, this response was significantly lower than the maximal stimulation in lean mice. Ciglitazone feeding did not have any effect on [5-3H]-glucose metabolism by the perfused muscle which remained subnormal, suggesting that the posttransport metabolism of glucose was limited by substrate availability. In the perfused mouse liver, net [14C]-glucose production from [14C]-lactate was unchanged by ciglitazone treatment while gluconeogenesis from [14C]-alanine was reduced. These findings show that ciglitazone produces its hypoglycemic effect by improving the insulin sensitivity in skeletal muscle, as others have reported in the adipose tissue. The presence of elevated plasma levels of corticosterone and lower levels of insulin in ciglitazone-treated ob/ob mice suggests that the adrenal glucocorticoids are responsible for the basal defects in glucose transport and the hyperinsulinemia is responsible for the insulin insensitivity. PMID- 3510365 TI - Nutrition, somatomedins, and the brain. AB - Conditions of decreased nutrient supply (malnutrition) and/or decreased nutrient utilization (diabetes) are attended by impairment of growth despite an increase in circulating levels of growth hormone (GH). Growth involves the actions of somatomedins, circulating insulinlike polypeptides with anabolic effects on cartilage, fat, and muscle. In malnutrition and diabetes, mechanisms of growth impairment appear to include a decrease in GH-induced generation of somatomedins, together with an increase in somatomedin inhibitors, factors which antagonize somatomedin action. Brain mediation of these alterations involves a rise in GH secretion due to decreased negative feedback from somatomedins, perhaps accentuated by blunting of feedback via actions of somatomedin inhibitors. In combination these processes lead to shunting of metabolic fuels toward vital processes and away from growth (via decreased somatomedin action) and to protein sparing and increase in alternate metabolic fuels (via direct GH actions on muscle and fat). Further study of involved hypothalamic and pituitary mechanisms should yield additional insights into the role of the brain in metabolic homeostasis. PMID- 3510366 TI - Rapidly progressive dementia with ataxia. PMID- 3510367 TI - Interventional ultrasound in obstetrics and gynaecology. PMID- 3510368 TI - Constant infusion therapy for ambulatory patients. Experiment with caution. PMID- 3510369 TI - Mutations in Salmonella typhimurium recovered from livers and spleens of mice. AB - Balb/c mice were inoculated intraperitoneally with TA2662, a smooth derivative of the Salmonella typhimurium Ames tester strain (TA102) which carries the mutable hisG locus on a multicopy plasmid, or TA103, which carries the same hisG gene on the chromosome. The bacteria were recovered at various times from the livers and spleens of the infected mice. Total numbers of bacteria were determined and the mutant frequency was estimated. The frequency of occurrence of histidine prototrophs in experiments using TA2662 was substantially above the frequency found with this strain grown in vitro. The mutant frequencies in experiments using TA103 recovered from mice were also highly significantly increased above background. We did not identify factors which might suggest selection in vivo for histidine prototrophs. There is sufficient histidine in body fluids of the host for the growth of His- bacteria. The His- and His+ derivatives were found to grow equally well in vitro in the presence of amounts of histidine approximating concentrations known to exist in vivo. It is probable that mutations in TA2662 are greatly underestimated, since the hisG-containing plasmid is lost at relatively high frequency during incubation in a variety of conditions. PMID- 3510370 TI - RecBC enzyme activity is required for far-UV induced respiration shutoff in Escherichia coli K12. AB - Shutoff of respiration is one of a number of recA+ lexA+ dependent (SOS) responses caused by far ultraviolet (245 nm) radiation (UV) damage of DNA in Escherichia coli cells. Thus far no rec/lex response has been shown to require the recB recC gene product, the RecBC enzyme. We report in this paper that UV induced respiration shutoff did not occur in either of these radiation-sensitive derivatives of K12 strain AB1157 nor in the recB recC double mutant. The sbcB gene product is exonuclease I and it has been reported that the triple mutant strain recB recC sbcB has near normal recombination efficiency and resistance to UV. The sbcB strain shut off its respiration after UV but the triple mutant did not show UV-induced respiration shutoff; the shutoff and death responses were uncoupled. We concluded that respiration shutoff requires RecBC enzyme activity. The RecBC enzyme has ATP-dependent double-strand exonuclease activity, helicase activity and several other activities. We tested a recBC+ (double dagger) mutant strain (recC 1010) that had normal recombination efficiency and resistance to UV but which possessed no ATP-dependent double-strand exonuclease activity. This strain did not shut off its respiration. The presence or absence of other RecBC enzyme activities in this mutant is not known. These results support the hypothesis that ATP-dependent double-strand exonuclease activity is necessary for UV-induced respiration shutoff. PMID- 3510371 TI - Inducible error-prone repair in yeast. Suppression by heat shock. AB - The production of reversion mutations in wild-type, diploid Saccharomyces cerevisiae by the alkylating agents N-methyl-N'-nitro- N-nitrosoguanidine (MNNG) and methylnitrosourea (MNU) was suppressed in cells previously treated with a heat shock, or the protein synthesis inhibitor, cycloheximide. The same cells previously treated with a heat shock, or the protein synthesis inhibitor, cycloheximide. The same treatment after mutagen exposure did not lower the induced mutation frequency. In split-dose experiments, a first MNNG exposure prevented subsequent heat (or cycloheximide) treatment from blocking mutation by a second, later mutagen exposure. These data suggest that, in yeast, MNNG or MNU induces an error-prone DNA-repair system, and that this induction is blocked by protein-synthesis inhibitors. The specificity of this system for different types of DNA damage was investigated using a variety of other mutagenic agents. A prior heat shock did not suppress mutation produced by exposure to ethyl methanesulfonate, ethylnitrosourea, 8-methoxypsoralen + UVA, or gamma-radiation. Partial suppression was observed in cells exposed to methyl methanesulfonate or to 254-nm ultraviolet light. These results indicate that, unlike the SOS system of E. coli, this inducible error-prone process of yeast is responsive to only certain mutagens. Heat shock suppression of mutation produced by MNNG exposure was also demonstrated in wild-type haploid cells, as well as haploid strains mutant in representative genes of the RAD52 epistasis group (rad52, rad53, rad54), the RAD3 epistasis group (rad1, rad2, rad3) and the RAD6 epistasis group (rad9, rad18). The rad6 mutant itself was immutable with MNNG and therefore untestable by these techniques. These data indicate that this error-prone repair system is not absolutely dependent on the integrity of the RAD52 (recombination) or the RAD3 (excision) systems, or on at least some parts of the RAD6 system. PMID- 3510372 TI - The molecular basis of the origin of complete and mosaic mutants. AB - To study the molecular basis of the origin of complete and mosaic mutants, pBR322 plasmids with damage to one or both DNA strands were constructed by limited chemical modification of plasmid DNA. Damage to one strand of DNA resulted in the induction of predominantly mosaic mutants. Data were obtained indicating that complete mutations arise as a result of damage to both strands in the region of the mutated gene. PMID- 3510373 TI - Postreplicational formation and repair of DNA double-strand breaks in UV irradiated Escherichia coli uvrB cells. AB - The number of DNA double-strand breaks formed in UV-irradiated uvrB recF recB cells correlates with the number of unrepaired DNA daughter-strand gaps, and is dependent on DNA synthesis after UV-irradiation. These results are consistent with the model that the DNA double-strand breaks that are produced in UV irradiated excision-deficient cells occur as the result of breaks in the parental DNA opposite unrepaired DNA daughter-strand gaps. By employing a temperature sensitive recA200 mutation, we have devised an improved assay for studying the formation and repair of these DNA double-strand breaks. Possible mechanisms for the postreplication repair of DNA double-strand breaks are discussed. PMID- 3510374 TI - Review of literature on chemical-induced aneuploidy in mammalian male germ cells. AB - 80 papers published between 1970 and 1984 were evaluated for results pertaining to chemical-induced aneuploidy in mammalian male germ cells. Diverse assays and end points were represented. The assays considered to involve direct measures of aneuploidy were based upon chromosome counts in premeiotic, meiotic, and embryonic cells, and the male pronucleus, or upon phenotypic expression of X linked genetic markers. Assays in which indirect measures were interpreted as evidence for aneuploidy included those primarily assessing chiasma frequencies, univalent frequencies, and spermatid/sperm sex chromosome body counts. An initial screening to reject studies with insufficient data and those which did not involve a single chemical test agent led to the elimination of 39 papers from further review. The remaining 41 papers reported effects from 46 different chemicals. These papers were rigorously assessed for adequacy of experimental protocols, relevance of end points as direct measures of aneuploidy, and completeness of data presentation and statistical analysis. Criteria specific to each assay were also considered. 4 chemical tests were considered to provide reliable positive or negative aneuploidy data. Cyclophosphamide and chloral hydrate each caused metaphase II hyperploidy when injected into mice. Very limited analyses of trenimon and isoniazid provided negative results. Test findings for 44 chemicals were viewed as inconclusive. It was concluded that standardization of tests to evaluate chemical-induced aneuploidy in male germ cells and the application of these tests towards increasing the data base are badly needed. PMID- 3510375 TI - Genetic activity profiles of chemicals selected from the Aneuploidy Data Base. PMID- 3510376 TI - The detection of chemically induced aneuploidy in Saccharomyces cerevisiae: an assessment of mitotic and meiotic systems. AB - Several systems have been evaluated for their ability to detect aneuploidy. Chromosome gain can be detected in mitotic haploid cells as well as meiotically derived haploid spores. Both chromosome gain and loss are detectable in mitotic diploid cells. Several chemicals have been identified that clearly induce aneuploidy in at least one or more of the systems. PMID- 3510377 TI - Systems and results of tests for chemical induction of mitotic malsegregation and aneuploidy in Aspergillus nidulans. AB - In Aspergillus several types of test systems have been developed for detection of chemicals which induce aneuploidy and/or malsegregation of chromosomes. Results from 23 papers were reviewed in which numerical data for 42 chemicals had been reported. The test systems fall into two groups. One group includes all purely genetic tests that detect euploid mitotic segregants from heterozygous diploids and identify these either as products of malsegregation of chromosomes or as products of crossing-over (13 papers, several reviewed in detail previously; Kafer et al. (1982) and Scott et al. (1982)). The other group includes tests that treat haploid or diploid strains and detect aneuploids as unstable abnormally growing segregants which can be identified as specific disomics or trisomics by their characteristic phenotypes. In addition, such tests characterize abnormal segregants from heterozygous diploids by correlating phenotypes with patterns of genetic segregation in spontaneous euploid sectors. This analysis makes it possible to distinguish between induced primary aneuploidy of whole chromosomes and partial tri- or monosomy resulting from chromosome breakage and secondary spontaneous malsegregation (10 papers). Based on results of both types of tests, it is postulated that chemicals which cause increases of euploid malsegregants, but not of crossovers, normally induce aneuploids as primary products (as shown for 7 of the 14 cases). These include compounds which damage spindles or membranes (especially the well-known haploidizing agents) and generally are effective only when growing cells are exposed. (8 chemicals that may belong in this category could not be classified for certain, because information was insufficient.) On the other hand, chemicals which cause increases of all types of euploid segregants (11 cases), mostly induce drastic mutations and aberrations as primary effects and cause spontaneous malsegregation or crossing-over only as secondary events (as demonstrated for radiation-induced abnormals). In addition, a few chemicals were negative, because they increased only crossing-over or showed no increased segregation at all at concentrations which reduced survival or growth rate (9 cases). Recommendations are made for standardization of methods and protocols. New tester strains and specific procedures are outlined which should be useful for conclusive tests of chemicals that may induce aneuploidy. PMID- 3510379 TI - Sensitivity of DNA-repair-deficient strains of Escherichia coli to rifampicin killing. AB - We have analyzed the role of RNA polymerase in DNA repair using the antibiotic rifampicin which binds specifically to the beta subunit of the enzyme. Several DNA-repair-deficient strains such as recA, uvr, and polA, and their isogenic parents were used for this study. All repair-deficient strains were found to be hypersensitive to rifampicin killing. Compared to the isogenic parent strains, recA strains are about 50 times more sensitive and the polA strain is about 100 times more sensitive to rifampicin killing. UvrA and uvrB strains are slightly more sensitive to rifampicin than the wild-type strains. The hypersensitivity of repair-deficient strains to rifampicin killing is totally abolished by the introduction of rifampicin-resistant mutations into these strains. We have examined the effect of rifampicin on RNA and protein synthesis in repair deficient and -proficient strains. RNA and protein synthesis were found to be inhibited by rifampicin to the same extent among all the strains tested. The results also show that the resumption of DNA synthesis was significantly disrupted in DNA-repair-deficient strains following drug removal. Taken together these results suggest that RNA polymerase plays an essential role in DNA metabolism and such function may be replaced by polA and recA gene products and to a lesser extend by uvrA and uvrB gene products. PMID- 3510378 TI - Studies on mutagenesis and repair induced by platinum analogs. AB - Mutagenesis and cytotoxicity were studied in Escherichia coli by iproplatin and carboplatin, two analogs of cisplatin (CDDP) currently undergoing clinical trial. As with CDDP, mutagenesis by these agents was mediated by the umuDC gene product. In contrast to CDDP, however, mismatch repair did not substantially contribute to survival of cells after exposure to these agents since dam-3 E. coli were not more sensitive than wild type E. coli. UvrA- E. coli, however were more sensitive to these analogs demonstrating that as with CDDP, uvr endonuclease-mediated excision contributes to the repair of DNA damage induced by platinum compounds. PMID- 3510380 TI - Methylation of DNA guanine via the 1-carbon pool in dimethylnitrosamine-treated rats. AB - Treatment of rats with radioactive methionine and nonradioactive dimethylnitrosamine resulted in the formation of radioactive 7-methylguanine in rat-liver DNA. By comparing the specific activity of administered [14C-Me] dimethylnitrosamine to the specific activity of isolated 7-methylguanine it was determined that following 20 mg/kg dimethylnitrosamine DNA methylation via the 1 carbon pool may account for up to 30% of the total 7-methylguanine formed. PMID- 3510381 TI - Influence of retinoids on the mutagenicity of cigarette-smoke condensate in Salmonella typhimurium TA98. AB - The effects of 3 different retinoids (all-trans-retinol, all-trans-retinoic acid, and all-trans-retinyl acetate) on the mutagenic activity of cigarette-smoke condensate were investigated in Salmonella typhimurium TA98. Neither an enhancing nor an inhibitory effect of the retinoids on the mutagnicity of cigarette-smoke condensate was observed. PMID- 3510382 TI - Asymptomatic blood donor with a false positive HTLV-III Western blot. PMID- 3510383 TI - Hemodynamically mediated acute renal failure. PMID- 3510384 TI - A controlled trial of methylprednisolone in the emergency treatment of acute asthma. AB - Ninety-seven acutely ill patients with bronchial asthma were enrolled in a double blind, placebo-controlled, randomized trial of intravenous methylprednisolone (125 mg), given on presentation in the emergency room in addition to standard emergency treatments for asthma. Subjective and spirometric indexes of the severity of the asthma were similar on entry into the study in all patients, but only 9 of 48 patients (19 percent) treated with methylprednisolone required hospital admission, as compared with 23 of 49 patients (47 percent) in the control group (P less than 0.003). Our results suggest that prompt use of glucocorticoids in the emergency treatment of severe asthma can prevent significant morbidity, reduce the number of hospitalizations, and effect substantial savings in health care costs. PMID- 3510385 TI - Identification and treatment of low-risk patients after acute myocardial infarction and coronary-artery bypass graft surgery. PMID- 3510386 TI - Treatment of clonidine rebound syndrome with sublingual captopril. PMID- 3510387 TI - Rejection reaction after stopping prednisolone in kidney-transplant recipients taking cyclosporine. PMID- 3510388 TI - Bone marrow transplantation for patients with chronic myeloid leukemia. AB - Between February 1981 and December 1984 we treated 52 patients with chronic myeloid leukemia in the chronic phase and 18 patients with more advanced disease by high-dose chemoradiotherapy followed by allogeneic bone marrow transplantation using marrow cells from HLA-identical sibling donors. In addition, the 40 patients who had not previously undergone splenectomy received radiotherapy to the spleen. To prevent graft versus host disease, cyclosporine was given either alone or in conjunction with donor marrow depleted of T cells. Of the 52 patients treated in the chronic phase, 38 are alive after a median follow-up of 25 months (range, 7 to 50); the actuarial survival at two years was 72 percent, and the actuarial risk of relapse was 7 percent. Of the 18 patients with more advanced disease, 4 have survived; the actuarial two-year survival was 18 percent, and the actuarial risk of relapse was 42 percent. We conclude that the probability of cure is highest if transplantation is performed while the patient remains in the chronic phase of chronic myeloid leukemia. T-cell depletion may have reduced the incidence and severity of graft versus host disease. The value of irradiation to the spleen before transplantation has not been established. PMID- 3510389 TI - A randomized clinical trial of propranolol for the prevention of initial bleeding in cirrhosis with portal hypertension. PMID- 3510390 TI - A suggested rapid test for corneal herpes simplex. PMID- 3510391 TI - Digoxin therapy and mortality after myocardial infarction. Experience in the MILIS Study. AB - Recent studies have led to controversy about whether long-term digoxin therapy after confirmed or suspected myocardial infarction increases mortality. We analyzed the mortality experience in 903 patients enrolled in the Multicenter Investigation of Limitation of Infarct Size (MILIS). As in previous studies, the decision to treat or not to treat with digoxin was made by the patient's personal physician on the basis of the usual clinical indications. Cumulative mortality was 28 percent for the 281 digoxin-treated patients as compared with 11 percent for the 622 patients who did not receive digoxin (P less than 0.001; follow-up interval, six days to 36 months; mean, 25.1 months). However, patients treated with digoxin had more base-line characteristics predictive of mortality than did their counterparts. Adjustment for these differences with two separate applications of the Cox method yielded P values of 0.14 and 0.34 for tests of difference in mortality, providing no evidence for a significant excess mortality associated with digoxin. Thus, the findings in the MILIS population do not support the assertion that digoxin therapy is excessively hazardous after infarction, but the existence of an undetected harmful effect can only be excluded with a randomized study. Until the results of such a study are available, we recommend careful consideration of whether any treatment of ventricular dysfunction is actually needed, consideration of alternatives to digoxin therapy, and restriction of digoxin use to the subgroup of patients (with severe chronic congestive failure and a dilated left ventricle) previously shown to have a beneficial clinical response. PMID- 3510392 TI - Experience with the routine use of erythromycin for chlamydial infections in pregnancy. AB - In an effort to prevent perinatal acquisition of Chlamydia trachomatis, we offered treatment with erythromycin ethylsuccinate (400 mg four times a day for seven days, given at 36 weeks' gestation) to 184 pregnant women with cervical chlamydial infections. Thirty-two women refused treatment; 24 of their infants were followed and served as the controls. Therapy was discontinued by 5 of 10 women who had gastrointestinal disturbances. Forty-seven women who completed therapy refused infant follow-up; in four (9 percent) of these women, therapy had failed to eradicate the infection. Sixty women and 59 infants completed the entire protocol; 55 (92 percent) of the women had negative cultures for chlamydia at follow-up. Chlamydial infection developed in 4 (7 percent) of the 59 infants of treated mothers, as compared with 12 (50 percent) of the 24 infants of untreated mothers; this difference was significant (P less than 0.001). With a success rate of 92 percent (98 of 107 patients) in treating maternal infection and with a relatively low intolerance rate (3 percent; 5 of 152), this regimen appears to be an effective, although not ideal, therapy for chlamydial infection in pregnant women. We conclude that in settings in which the prevalence of chlamydia infection is high, a routine program of screening pregnant women for cervical C. trachomatis, followed by treatment of those infected, would be cost effective and would reduce infant morbidity. PMID- 3510393 TI - Antibody response to preexposure human diploid-cell rabies vaccine given concurrently with chloroquine. AB - We conducted a randomized controlled trial to evaluate the antibody response of freshman veterinary students to intradermal human diploid-cell rabies vaccine administered concurrently with chloroquine, a drug frequently used for chemoprophylaxis against malaria. Fifty-one students who had not been vaccinated against rabies were enrolled: 26 received 300 mg of chloroquine base per week (the recommended dose for malaria prophylaxis); 25 did not receive chloroquine and served as controls. All subjects received 0.1 ml of rabies vaccine intradermally on days 0, 7, and 28. Chloroquine was administered weekly to the treatment group, beginning nine days before the first dose of vaccine and continuing until day 48. The mean rabies-neutralizing antibody titer for the chloroquine group was significantly lower than that for the control group on each day of testing--i.e., day 28 (P = 0.0094), day 49 (P = 0.0008), and day 105 (P = 0.0002)--although both groups had neutralizing antibody titers on days 49 and 105, according to the criteria of the Centers for Disease Control. The blood concentrations of chloroquine and desethylchloroquine (the major metabolite of chloroquine, which also has antimalarial properties) were negatively associated with log antibody titers. These results indicate that chloroquine taken in the dose recommended for malaria prophylaxis can reduce the antibody response to primary immunization with intradermal human diploid-cell rabies vaccine. PMID- 3510394 TI - Variations in the use of medical and surgical services by the Medicare population. AB - We measured geographic differences in the use of medical and surgical services during 1981 by Medicare beneficiaries (age greater than or equal to 65) in 13 large areas of the United States. The average number of Medicare beneficiaries per site was 340,000. We found large and significant differences in the use of services provided by all medical and surgical specialties. Of 123 procedures studied, 67 showed at least threefold differences between sites with the highest and lowest rates of use. Use rates were not consistently high in one site, but rates for procedures used to diagnose and treat a specific disease varied together, as did alternative treatments for the same condition. These results cannot be explained by the actions of a small number of physicians. We do not know whether physicians in high-use areas performed too many procedures, whether physicians in low-use areas performed too few, or whether neither or both of these explanations are accurate. However, we do know that the differences are too large to ignore and that unless they are understood at a clinical level, uninformed policy decisions that have adverse effects on the health of the elderly may be made. PMID- 3510395 TI - More on reducing medical school classes. PMID- 3510396 TI - Potent ulcerogenic actions of platelet-activating factor on the stomach. AB - Platelet-activating factor (PAF) is an endogenous phospholipid which has been implicated as a mediator of allergic and inflammatory processes. It is synthesized and released by neutrophils, platelets, macrophages, monocytes, basophils and endothelial cells, and is a potent platelet-aggregating agent, a vasodilator, increases vascular permeability, stimulates neutrophil aggregation and degranulation and induces release of lysosomal enzymes. A role for PAF in the hypotension associated with endotoxin shock and in necrotizing enterocolitis has recently been suggested. As there is an association between septic shock and acute gastric damage, we propose that PAF is an endogenous mediator of ulceration in the stomach. Indeed, as reported here, intravenous (i.v.) infusion of PAF to rats, at doses of 20-200 pmol per kg per min, resulted in the formation of extensive haemorrhagic erosions in the gastric mucosa. The ulcerogenic actions of PAF are not attributable solely to its hypotensive actions and were not mediated via effects on platelets or cyclooxygenase products, nor via histamine H1, H2 or alpha-adrenergic receptors. PAF is the most potent gastric ulcerogen yet described and its endogenous release may underlie or contribute to certain forms of gastric ulceration. PMID- 3510397 TI - Human T-cell clones recognize a major M. leprae protein antigen expressed in E. coli. AB - Leprosy is a chronic infectious disease caused by Mycobacterium leprae. As with other intracellular parasites, protective immunity is dependent on T cells and cell-mediated immunity. In animal models, immunization with killed armadillo derived M. leprae elicits strong T-cell responses, delayed-type hypersensitivity and protection against viable challenge. We have recently shown that killed M. leprae can induce delayed-type hypersensitivity in healthy human volunteers. Identification of the M. leprae antigens that are recognized by T cells and may be involved in protection has been hampered by the inability to cultivate the organism in vitro and by difficulties in antigen purification from limited quantities of armadillo-derived bacillus. Because genes for the major protein antigens of M. leprae as seen by mouse monoclonal antibodies have been isolated, it has become possible to test whether these individual antigens are recognized by T cells. We screened crude lambda gtll phage lysates of Escherichia coli containing individual M. leprae antigens using M. leprae-specific T-cell clones isolated from M. leprae-vaccinated volunteers. Using this method, we find that nearly half of the M. leprae-specific T-cell clones are stimulated to proliferate by lysates containing an epitope of a M. leprae protein of relative molecular mass 18,000 (18K). PMID- 3510398 TI - Human N-myc is closely related in organization and nucleotide sequence to c-myc. AB - N-myc, a cellular gene related to the c-myc proto-oncogene, was originally identified on the basis of its very frequent amplification and overexpression in a restricted set of tumours, most notably human neuroblastomas. That N-myc may have a causal role in the genesis of these tumours is suggested by the observation that in the rat embryo fibroblast co-transformation assay it has a transforming potential similar to that of c-myc. The apparent structural and functional homology of N-myc and c-myc suggests that they may be members of the same protooncogene family. However, despite these apparent similarities, expression of the two genes appears to be dramatically different with respect to tumour specificity, as well as tissue and developmental stage specificity. To further elucidate the common and unique aspects of N-myc and c-myc gene structure and function in normal and transformed cells, we have determined the organization of human N-myc and the nucleotide sequence of its messenger product, and we report here that N-myc and c-myc have a similar intron/exon structure and that their protein products share regions of significant homology. PMID- 3510399 TI - Leprosy vaccine. PMID- 3510400 TI - Exercise capacity in hemodialysis, CAPD, and renal transplant patients. AB - Eighteen hemodialysis, 12 chronic ambulatory peritoneal dialysis (CAPD), and 20 renal transplant patients performed maximal treadmill exercise tests. Heart rates and blood pressures were determined every minute and maximal oxygen consumption was measured directly. Exercise capacity as measured by VO2 max is low in dialysis patients and similar to sedentary normal individuals in renal transplant patients. Maximal heart rates were significantly lower in hemodialysis patients than transplant recipients. The lower exercise tolerance in end-stage renal disease indicates that most patients regardless of the treatment mode could benefit from attempts through exercise training to increase physical working capacity. PMID- 3510401 TI - A comparison of fine needle aspiration cytology and tru-cut tissue biopsy in the diagnosis of acute renal allograft rejection. AB - Simultaneous Tru-cut biopsies and fine needle aspirations (FNAs) performed over a 2-year period on patients following renal transplantation were assessed by independent pathologists. When there was histological evidence of rejection, FNAs also demonstrated cellular features of rejection in 83% of cases, and this increased to 92% with repeated sampling. The presence of monocytes and histiocytes in FNAs correlated with vascular features of rejection on biopsy and failure to reverse the rejection process with steroids. PMID- 3510402 TI - No evidence of failure of the renin-angiotensin system in focal glomerulosclerosis in man. PMID- 3510403 TI - Vasoactive intestinal polypeptide immunopositive neurons in the paraventricular nucleus of homozygous Brattleboro rats. AB - Colchicine treatment reveals a population of vasoactive intestinal polypeptide (VIP) positive cell bodies in the hypothalamic paraventricular nucleus (PVN) of the vasopressin-deficient Brattleboro rat. These immunoreactive perikarya in the PVN cannot be detected in colchicine-treated Long-Evans animals. When Brattleboro rats are administered vasopressin, there is a significant decrease in the number of VIP-immunopositive cell bodies in the PVN. Evidently, an alteration in the synthesis and/or release of VIP occurs in the absence of the antidiuretic hormone. PMID- 3510404 TI - Incidence of multiple sclerosis in Macomer, Sardinia, 1912-1981: onset of the disease after 1950. AB - Intensive search of all cases of MS occurring in the Sardinian commune of Macomer since 1912 indicated that MS was absent up to the early 1950s. All 13 ascertained cases had clinical onset in the years 1952-1981. During this period, the average annual incidence was 4.8 per 100,000; the highest incidence was found in the period 1957-1961, slowly decreasing up to 1981. MS was probably introduced after 1945, when the centuries-old isolation of Macomer ended and the native population came into contact with individuals from high- and medium-risk areas. PMID- 3510406 TI - What's news in insulin? PMID- 3510405 TI - Hysteroepilepsy in the nineteenth century: Charcot and Gowers. PMID- 3510407 TI - Cardiac surgery with cardiopulmonary bypass during pregnancy. PMID- 3510408 TI - Catamenial pneumothorax--a literature review and report of an unusual case. AB - As already mentioned, only a few cases of CPT were described in the international medical literature, though there probably are some publications in languages unknown to us. It is quite possible that this syndrome is much more common than known to us, but until now there has been a lack of awareness of it. It may be presumed that in some of the cases of women complaining of some discomfort during menstruation, thorough examination would reveal a mild spontaneous pneumothorax which doesn't require any special treatment and is self-resolving; but most gynecologists are not thoroughly aware of this entity. While examining the clinical findings it is possible to demonstrate that this syndrome has its own clinical characteristics, totally different from those of spontaneous pneumothorax in the population as a whole. One of the characteristics of the syndrome is the assumption that women who do not ovulate, as women during the menarche, pregnant women and women taking contraceptive medications, are not subject to CPT. A case described in this review contradicts this assumption, although treatment with ovulatory suppressants, successfully used so far, should not be undervalued. The etiology and pathogenesis of this syndrome was and still is enigmatic. The accumulated knowledge so far does not point to any one etiologic factor. Therefore the suggested treatment, before definitive operative treatment, is so far experimental only, and its chances of success in any particular case are unpredictable. PMID- 3510409 TI - Rare events associated with tubal sterilizations: an international experience. AB - The results from previous analyses of an international data set collected by Family Health International are reviewed in relation to the incidence, severity, risk factors, and outcomes of rare events associated with tubal sterilization. The rare events included for review, by sequence of their relationship to the tubal sterilization procedure are: luteal phase pregnancy, intraoperative complications (uterine perforation, unintended laparotomy required for completion of the laparoscopic procedure, and technical failure in tubal ring sterilization), deaths, early readmission following laparoscopic sterilization, hysterectomy after laparoscopic sterilization, and pregnancy (intrauterine and ectopic) conceived after tubal sterilization. The widespread use of this method of contraception has important public health implications, and awareness of these events will help clinicians minimize such incidences and better deal with them when they arise. PMID- 3510410 TI - Single, high-dose intravenous dexamethasone as an antiemetic in cancer chemotherapy. AB - The antiemetic effect of graded, single high-dose intravenous dexamethasone was studied in 27 patients receiving combination chemotherapy with either doxorubicin (50 mg/m2) or cis-platinum (100 mg/m2). A total of 57 cycles were individually evaluated, utilizing a detailed rating system. Nausea and vomiting did not occur in 20 of 57 cycles; in 17, the chemotherapy was doxorubicin-based, and in 3 it was cis-platinum-based. Of the 37 cycles associated with nausea and vomiting, 32 contained cis-platinum and 5 doxorubicin. The average dexamethasone dosages for doxorubicin and platinum-containing combinations were 40 and 95 mg/m2, respectively. Side effects included a dose-dependent sensation of perineal pruritus (11 patients, 17 cycles) lasting for several minutes, and subjective feelings of increased appetite and well-being. Dexamethasone administered intravenously 15 min prior to chemotherapy in a dose of 40 mg/m2 apparently provides highly effective antiemetic protection for patients receiving treatment cycles containing doxorubicin; however, for patients receiving regimens containing cis-platinum, the antiemetic effect of dexamethasone as a single agent is limited. PMID- 3510411 TI - The endocrine cells of the gastrointestinal tract. The normal endocrine cells and their hyperplasias. Part I. PMID- 3510412 TI - The histologic diversity of osteosarcoma. PMID- 3510413 TI - Multicentricity in breast cancer: a submacroscopic study. AB - One hundred human female breasts surgically removed by radical mastectomy for clinical cancer were analyzed under a dissecting microscope to search for other submacroscopic (less than 0.5 cm) foci collateral to and independent from the clinical one. These foci were found in 36 percent of cases, either in situ (17 percent), or infiltrating (12 percent), or both in situ and infiltrating (7 percent). This high percentage of multiple cancer confirms previous data, suggesting the wide intramammary distribution of breast cancer disease. Multicentricity appears to be significantly associated with the incidence of familial breast cancer (p less than 0.05) and advanced patient age in the range between 71 and 80 years (p less than 0.005). Axillary lymph node metastases are significantly associated with collateral foci of in situ cancer (p less than 0.025), but not with submacroscopic foci of infiltrating cancer and the general character of the mammary glandular parenchyma, tumor size or histologic type of the clinical neoplasm. The critical question is whether multicentricity makes a difference clinically and especially to women who do not have their entire breast removed. Radical mastectomy results in a severe cosmetic and functional problem for patients. According to many authors, the goal of the treatment should be the removal of breast cancer by conservative surgical techniques (lumpectomy, subcutaneous mastectomy, quadrantectomy), using adjuvant radiotherapy and/or chemotherapy. The use of radiotherapy as primary treatment of early breast cancer has been also suggested. There is disagreement about surgical management of breast cancer. In fact, some investigators emphasize that the natural biologic history of multicentric cancers has not been documented by any adequate follow-up series in women who do not have their entire breast removed. Thus far, no difference has been seen in disease-free or overall survival between groups of patients with early breast cancer treated by an alternative therapeutic procedure and patients treated by radical mastectomy. However, Veronesi et al. (1981) refer to 4 second primary tumors of the ipsilateral breast in the 352 cases of small cancers treated by quadrantectomy, axillary dissection, and adjuvant radiotherapy. Moreover, Hellman et al. (1980), using radiation therapy without mastectomy for the primary treatment of 176 patients with early breast cancer, found 1 case of new cancer in a separate quadrant. Further evaluation is necessary to establish the long-term results of the alternative treatments of breast cancer and for the understanding of the clinical significance of microscopic multifocal tumor in the mammary gland. PMID- 3510414 TI - The midline granuloma syndrome. AB - We propose that the term midline granuloma be used to designate a syndrome and not specific forms of disease. We present a classification and terminology that divides the entities previously grouped under "midline granuloma" into four main categories: Wegener's granulomatosis, idiopathic midline destructive disease, lymphomatoid granulomatosis, and angiocentric lymphoma. Except in the case of idiopathic midline destructive disease, which is exclusively limited to the upper respiratory tract, the other forms can be localized or disseminated. In most cases the histopathologic distinction between these forms can be reliably made and provides guidance for therapy. PMID- 3510416 TI - Tumor-host interactions as prognostic factors in the histologic assessment of carcinomas. AB - Many of these observations appear to define a reasonable hypothesis. High-grade or poorly differentiated malignant neoplasms have a shorter tumor-doubling time, are less cohesive, often with irregular borders, and tend to invade by small aggregates and individual tumor cells. The observation of the pattern of invasion provides considerable information on the aggressiveness of the neoplasm. The pattern of invasion appears to correlate with tumor cell cohesiveness, motility, loss of contact inhibition, excretion of enzymes, and other factors associated with aggressiveness in experimental models. It is clear that the pattern of tumor host interaction indirectly reflects many of these parameters and provides major clues to the biologic potential of human carcinomas. These observations should be used to supplement the histologic and cytologic features commonly used to derive a tumor grade. Aggressive tumors are usually larger and are associated with a greater blood supply. Vascular invasion is more common in this situation and large veins may be invaded by tumor by intravascular growth. Penetration of small lymphatic and blood vessels is associated with a poor prognosis and involvement of large veins with intravascular extensions of tumor have the potential of releasing tumor cell aggregates or emboli into the venous circulation. These large tumor cell aggregates have been demonstrated to be associated with a higher efficiency of metastasis formation and infer a poorer prognosis. Why have I bothered with all this detail about the occurrence of circulating tumor cells and their relation to the development of metastases? It must be stressed that many malignant cells are being released into the circulation of cancer patients and few, if any, ever successfully complete the complex sequence leading to a metastatic focus. This has been termed "metastatic inefficiency." Other investigators have referred to the unique cells that have mastered the intricate sequence of steps required to establish metastases as winners of the metastases decathlon. The observations of vascular (lymphatic or blood) invasion in random tissue sections and their relation to patient prognosis can be best explained by our basic knowledge of cancer biology. The finding of occasional small aggregates of single tumor cells in vascular spaces statistically implies that a considerable number of cells must be entering the vascular compartment.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3510415 TI - Pathologic and clinical considerations in the evaluation of major head and neck specimens resected for cancer. Part I. PMID- 3510417 TI - Immunoglobulin-containing cells in gastrointestinal pathology--diagnostic applications. PMID- 3510418 TI - Infanticide in eighteenth-century England. William Hunter's contribution to the forensic problem. PMID- 3510419 TI - Divergent differentiation in neoplasms. Pathologic, biologic, and clinical considerations. AB - In this rather brief review, we have illustrated and discussed selected examples of dual or multiple differentiation within certain neoplasms. In so doing, we have attempted to present those cases which highlight common diagnostic problems and which have important biologic and clinical implications. We have shown how tumors arising in many organs such as the lung, gastrointestinal tract, and thyroid can simultaneously manifest combined endocrine-nonendocrine differentiation, and we have addressed this phenomenon in relation to the "parent cell of origin" theory. We have emphasized that while many tumors do in fact resemble the tissues in which they arise, the possession of a particular phenotype, such as endocrine, does not necessarily imply that the tumor in question was derived from an endocrine progenitor cell. To reinforce the concept that the histomorphologic, biochemical, and functional properties of tumor cells reflect ongoing differentiation events rather than a static situation, we have presented examples of tumors in which changes in phenotype have been observed during the course of disease, e.g., small cell carcinomas of the lung and prostate, as well as tumors in which divergent differentiation reflects similar lines of differentiation occurring in normal tissues, e.g., certain neurogenic tumors. Finally we have considered important clinical implications of mixed differentiation and changing phenotype and their impact on the pathologist. PMID- 3510420 TI - Conceptualizing historical research. PMID- 3510421 TI - Ethics in nursing--an annotated bibliography. 2. PMID- 3510422 TI - Relaxation training and response to cardiac catheterization: a pilot study. AB - This pilot study evaluated the effects of relaxation-via-letting-go training on patients' state anxiety, observer-reported distress, and self-reported distress during cardiac catheterization. The sample consisted of 30 adults, 15 subjects in the relaxation training group and 15 subjects in the control group. A comparison of the control and relaxation training groups on the demographic variables of age and education, the preintervention variables of state anxiety and worry about the procedure, and number of days in the hospital prior to catheterization showed no differences between the groups. Relaxation training subjects did not indicate less anxiety prior to catheterization nor were they seen as less distressed during the procedure than control subjects. In addition, relaxation subjects did not report having less distress than control subjects. PMID- 3510423 TI - Selecting methods to measure nutritional outcomes. PMID- 3510424 TI - Mechanical ventilation. Physiology, equipment design, and management. AB - The major goals of mechanical ventilation are the prevention of significant respiratory acidosis and the correction of arterial hypoxemia. Ventilators are categorized as negative- or positive-pressure types, depending on their effect on airway pressure. Positive-pressure ventilators, which are used in the treatment of acute respiratory failure, may be subclassified as pressure-, volume-, or time cycled. Volume types provide stable tidal volumes and inspiratory oxygen concentrations over the range of changing ventilatory conditions seen in acute respiratory failure. Ventilation may be provided in a number of modes. No clear cut advantage of intermittent mandatory ventilation over assisted mechanical ventilation has been demonstrated. By following simple guidelines, the clinician can initiate mechanical ventilation that provides an ideal ventilatory pattern. PMID- 3510425 TI - Fad diets. Evaluation of five common types. PMID- 3510426 TI - Factitious hypoglycemia. Clues to identifying an elusive disorder. AB - Factitious hypoglycemia is similar in presentation to insulinoma and occurs most commonly in persons with ready access to insulin. Diagnosis previously was based on circumstantial evidence but now can be confirmed by demonstration of high insulin levels and low C-peptide levels in the presence of hypoglycemia. Treatment is primarily psychiatric, and success so far is limited. PMID- 3510427 TI - Complications in premature infants. Technology-related problems to watch for. PMID- 3510428 TI - Natural populations of Trypanosoma cruzi, the agent of Chagas disease, have a complex multiclonal structure. AB - We have studied 15 gene loci coding for enzymes in 121 Trypanosoma cruzi stocks from a wide geographic range--from the United States and Mexico to Chile and southern Brazil. T. cruzi is diploid but reproduction is basically clonal, with very little if any sexuality remaining at present. We have identified 43 different clones by their genetic composition; the same genetic clone is often found in very distant places and in diverse hosts. There is much genetic heterogeneity among the different clones, and they cannot be readily classified into a few discrete groups that might represent natural taxa. These findings imply that the biological and medical characteristics need to be ascertained separately for each natural clone. The evidence indicates that clonal evolution is very ancient in T. cruzi. We propose two alternative hypotheses concerning the relationship between the biochemical diversity and the heterogeneity in other biological and medical characteristics of T. cruzi. One hypothesis is that the degree of diversity between strains simply reflects the time elapsed since their last common ancestor. The second hypothesis is that biological and medical heterogeneity is recent and reflects adaptation to different transmission cycles. A decision between the two hypotheses can be reached with appropriate studies, with important medical consequences. PMID- 3510429 TI - Presynaptic transmitter content controls the number of quanta released at a neuro neuronal cholinergic synapse. AB - In the buccal ganglion of Aplysia the overloading of the cholinergic presynaptic neuron by exogenous acetylcholine (AcCho) led to an enhancement of the postsynaptic response. The deprivation of choline in the presynaptic neuron by extra- and/or intracellularly applied choline oxidase to prevent AcCho synthesis resulted in a decrease of the postsynaptic response. In both cases, the size of the calculated miniature postsynaptic current (i.e., the size of the quantum) remained unchanged. It was concluded that, for a given stimulation, the number of quanta released (i.e., the quantal content) is directly related to the quantity of AcCho available for release in the presynaptic neuron. PMID- 3510430 TI - Detection and identification of activated oncogenes in spontaneously occurring benign and malignant hepatocellular tumors of the B6C3F1 mouse. AB - Species- and strain-specific spontaneously occurring tumors have been observed in rodents maintained under normal laboratory conditions. Elucidation of the molecular mechanisms associated with the development of these spontaneous tumors may provide a better understanding of tumor development associated with exposure to chemical carcinogens. In view of the high frequencies of oncogene activation shown in rodent tumors induced by known chemical carcinogens, we have investigated oncogene activation in spontaneous tumors of the B6C3F1 mouse and Fischer 344/N rat by DNA transfection techniques. A marked difference in the presence of activated oncogenes in spontaneous rat tumors versus spontaneous mouse liver tumors was observed in this study. All rat tumors tested failed to yield activated oncogenes (0/29), whereas 30% (3/10) of mouse hepatocellular adenomas and 77% (10/13) of hepatocellular carcinomas scored positive by DNA transfection. These transforming genes were identified as an activated Ha-ras gene in all the adenoma transfectants and in 8 of the 10 carcinoma transfectants. The two remaining hepatocellular carcinomas contained transforming genes that appear not to be members of the known ras gene family. The B6C3F1 mouse liver system might provide a very sensitive assay not only for assessing the potential of a chemical to activate a cellular proto-oncogene, but also for detecting various classes of proto-oncogenes that are susceptible to mutational activation. PMID- 3510431 TI - Mechanism of the idling-turnover reaction of the large (Klenow) fragment of Escherichia coli DNA polymerase I. AB - The mechanism of the idling-turnover reaction catalyzed by the large (Klenow) fragment of Escherichia coli DNA polymerase I has been investigated. The reaction cycle involved is one of excision/incorporation, in which the 3' deoxynucleotide residue of the primer DNA strand is partitioned into its 5'-mono- and 5' triphosphate derivatives, respectively. Mechanistic studies suggest the 5' monophosphate product is formed in the first step by simple 3'----5' exonucleolytic cleavage. Rapid polymerization follows with the concomitant release of inorganic pyrophosphate. In the second step, the 5'-triphosphate product is generated by a pyrophosphorolysis reaction, which, despite the low concentration of pyrophosphate that has accumulated, occurs at a rate that is comparable with that of the parallel 3'----5' hydrolysis reaction. PMID- 3510432 TI - DNA hybridization electron microscopy: ribosomal RNA nucleotides 1392-1407 are exposed in the cleft of the small subunit. AB - The ribosomal sequence corresponding to Escherichia coli 16S rRNA nucleotides 1392-1407 (the "1400 region") is phylogenetically conserved and is in a functionally important region of the subunit. Using the technique of DNA hybridization electron microscopy, we have mapped this sequence on the surface of the small ribosomal subunit. In this procedure a synthetic oligodeoxynucleotide probe, complementary to a specific rRNA sequence and carrying an attached marker molecule, is hybridized to ribosomal subunits in order to determine the dimensional site of attachment. In the E. coli ribosome, the 1400 region is located at the level of the neck, near the cleft and most likely on the head of the small subunit. The related sequence in yeast 18S rRNA, nucleotides 1618-1633, is located in the topological equivalent of the E. coli site. The location of this region, which has been crosslinked to the anticodon of a peptidyl-site-bound tRNA, indicates that this part of the cleft of the small subunit has a similar three-dimensional organization in phylogenetically diverse organisms and suggests that it is the site of the codon-anticodon interaction. PMID- 3510433 TI - Evidence for a contact between glutamine-18 of lac repressor and base pair 7 of lac operator. AB - Glutamine-18 of the lac repressor (lacR) has been substituted by glycine, by serine, and by leucine. The specificities of wild-type lacR and of the three substituted lacR variants have been analyzed with respect to base pairs 5, 6, 7, 8, 9, and 10 of the lac operator (lacO). The data indicate that [Gly18]lacR, [Ser18]lacR, and [Leu18]lacR lose the ability to distinguish between the O+ base pair G . C and the Oc base pairs T . A and A . T at position 7 of lacO (KdOc/KdO+ approximately equal to 1). In contrast, the three substituted variants retain the ability to discriminate O+ from Oc at each other position, by factors of 9 to 37. Therefore, I propose that glutamine-18 contacts base pair 7 of lacO. These data suggest that the interaction between the helix-turn-helix motif and DNA may be very similar or identical in lacR and the catabolite gene activator protein. PMID- 3510434 TI - The mitotic stability of deletion derivatives of chromosome III in yeast. AB - We have constructed a series of deletion derivatives of chromosome III in yeast. Two telocentric chromosomes, one with a deletion of about 100 kilobases (kb) from the left arm and another with a deletion of about 240 kb from the right arm, are mitotically stable, showing only a 2- to 3-fold decrease in stability compared to a normal chromosome III. Chromosomes as small as 100 kb with deletions on both the left and right arms show only slight decreases in mitotic stability. Slight decreases in size in chromosomes smaller than 100 kb produce dramatic decreases in mitotic stability. In general, deletion chromosomes of similar size but different structure display similar stabilities. We find no evidence for the existence of any new cis-acting elements [besides the centromere, autonomously replicating sequences (ARS elements) and telomeres] essential for the stabilization of chromosome III. PMID- 3510435 TI - Unusual association of beta 2-microglobulin with certain class I heavy chains of the murine major histocompatibility complex. AB - Class I products of the major histocompatibility complex (MHC) comprise a heavy chain of about 45 kDa noncovalently linked to a 12-kDa beta 2-microglobulin (beta 2m) light chain encoded on a different chromosome. We find that class I products of some mouse strains include an additional 62-kDa molecule which on the following evidence consists of a heavy chain linked covalently with beta 2m. Production of the 62-kDa protein invariably accorded with the occurrence of cysteine at position 121 of the heavy chain (Kb,Kbm1,Kbm3,Dd, and Ld). Substitution of arginine at position 121 invariably accorded with absence of the 62-kDa protein (Kbm6,Kbm7,Kbm9,Kd, and Db). On the basis of observed production versus nonproduction of the 62-kDa molecule, predictions are made regarding residue 121 in class I products for which this is not yet known; namely, Kk, Ks, and Dk, which produce the 62-kDa molecule, as compared with Kj, Qa-2, and TL, which do not. Reported differences in immunologic reactivity between Kb mutant strains with Arg-121 in place of Cys-121 imply that the occurrence of 62-kDa class I products in mice of Cys-121 genotype has functional consequences. PMID- 3510438 TI - Johannes Fredericus Samuel Esser: innovative "structive" surgeon (1877-1946). PMID- 3510437 TI - A simplified lead oxide cadaver injection technique. AB - A simple, inexpensive injectable substance is reported for analysis of the arterial circulation in fresh human or animal cadavers. The technique is a modification of that reported by Salmon in 1936 and utilizes lead oxide and gelatin. This combination is highly radiopaque; it perfuses the small radicles of the vascular tree and sets to a firm rubbery consistency to fascilitate dissection. PMID- 3510436 TI - Design of a photoreactive analogue of the Escherichia coli heat-stable enterotoxin STIb: use in identifying its receptor on rat brush border membranes. AB - The Escherichia coli heat-stable enterotoxin, STIb was prepared by solid-phase peptide synthesis and purified to homogeneity by high-pressure liquid chromatography. This analogue was iodinated and shown to bind specifically to rat intestinal membranes. The radiolabeled peptide was derivatized at the amino terminus with the photoreactive heterobifunctional crosslinking agent N hydroxysuccinimidyl p-benzoylbenzoate. This photoreactive probe also exhibited binding specificity. It was mixed with rat intestinal brush border membranes and photolyzed in the presence or absence of excess unlabeled STIb. Polyacrylamide gel electrophoresis performed in the presence of sodium dodecyl sulfate and 2 mercaptoethanol indicated that the peptide probe was crosslinked specifically to two molecular species of 57 and 75 kDa. One or both of these molecules appear to constitute the enterotoxin receptor or to be in close proximity to it. PMID- 3510439 TI - Mons pubis as donor site for skin grafts. PMID- 3510441 TI - Cholecystitis: detection with MR imaging. AB - The role of magnetic resonance (MR) imaging in the detection of gallbladder disease was evaluated in 39 individuals (16 healthy, five with asymptomatic gallstones, and 18 with clinical symptoms of gallbladder disease). MR imaging was performed after they fasted for 12 hours. Imaging sequences included a combination of repetition times (TR) of 0.5 and 1.5 sec and echo times (TE) of 28 and 56 msec. On the images obtained at TR = 0.5 sec and TE = 56 msec, gallbladder bile was hyperintense compared with the liver in all healthy and asymptomatic subjects and was hypointense (n = 9), isointense (n = 4), or hyperintense (n = 5) in symptomatic patients, eight of whom had surgical confirmation of cholecystitis. Comparison of normal versus pathologically proved cases for the presence of gallbladder disease yielded a specificity of 100%, sensitivity of 75%, and a significant difference of P less than .01. Thus, with a pulse sequence of TR = 0.5 sec and TE = 56 msec, MR was sensitive in detecting gallbladder disease. However, the role of MR in the radiologic workup of gallbladder disease will be determined by more experience with this modality. PMID- 3510440 TI - Axillary lymph node metastases in breast cancer: preoperative detection with US. AB - The importance of axillary node status in the prognosis of breast cancer led the authors to conduct a prospective study comparing the value of clinical examination with ultrasound (US) performed by a transpectoral approach. All 60 patients examined underwent axillary dissection. Sensitivity was 45.4% for clinical examination versus 72.7% for US. US provides valuable information for breast cancers treated solely by irradiation, after insufficient dissection, and for large tumors not amenable to primary surgery. When the nodal region is treated by surgery and/or radiotherapy, local monitoring with US appears unnecessary owing to the low incidence of nodal recurrence. PMID- 3510442 TI - Pancreatic necrosis: CT manifestations. AB - Pancreatic necrosis is a potential sequela of acute pancreatitis, which pathologically represents a collection of devitalized tissue. Appropriate therapeutic planning requires definition of this irreversibly damaged gland, the presence of which is not consistently diagnosed on the basis of clinical and laboratory data. Over an 18-month period, 22 patients with pancreatic necrosis were studied by one or more computed tomographic (CT) examinations. Retrospective analysis showed the findings to vary with the developmental stage of the necrotizing process. During the acute phase, there was considerable morphologic overlap of necrosis and pancreatic phlegmon. Typical findings were seen in the subacute and chronic stages and included diffuse enlargement of the gland with largely decreased central density. A thick, smooth surrounding rim produced a characteristic saclike configuration. CT-guided aspiration for culture material was performed in four patients with suspected superinfection. Negative gram stain and culture results in two patients allowed surgery to be performed on a more elective basis. PMID- 3510443 TI - Renal allografts in acute rejection: evaluation using duplex sonography. AB - Sixty-nine duplex sonographic studies were performed in 24 patients who had received renal allografts. After a prospective qualitative analysis of the Doppler waveforms, results were correlated with biopsy material and each patient's clinical course. Increased pulsatility of the Doppler waveform of intrarenal arterial flow constituted an abnormal study, indicating acute rejection. Overall sensitivity varied with the histologic form of rejection, with a 60% sensitivity for acute interstitial rejection with or without vascular rejection and an 82% sensitivity for acute vascular rejection. Overall specificity was 95% and 96%, respectively. Early rejection was also accurately detected in three patients less than 48 hours following kidney transplantation. Duplex sonography has a useful role in evaluating posttransplantation renal failure. Abnormal study results may obviate the need for biopsy and help in guiding clinical management. PMID- 3510444 TI - Abnormal pregnancy: early diagnosis by US and serum chorionic gonadotropin levels. AB - Simultaneous sonography and quantitative serum human chorionic gonadotropin (HCG) levels from 126 women with threatened abortion were compared. Of 56 women with normal outcome, 39 (70%) had a gestation sac greater than or equal to 5 mm in mean sac diameter, and in each case the HCG level was 1,800 milli-international units (mIU/ml) or greater. The serum HCG levels strongly correlated with the gestation sac sizes to a mean sac diameter of 25 mm. Of 70 abnormal pregnancies, 31 demonstrated a gestation sac. Of these, 20 women (65%) had disproportionately low HCG levels relative to sac size, including 12 in whom the HCG level was less than 1,800 mIU/ml. One woman with an early molar pregnancy had a disproportionately elevated HCG level. Correlation of sonograms with a simultaneous measurement of serum HCG level is a useful method for evaluating threatened spontaneous abortion. A disproportionately low HCG level relative to gestation sac size is evidence for an abnormal pregnancy. PMID- 3510445 TI - Threatened abortion: sonographic distinction of normal and abnormal gestation sacs. AB - In an attempt to determine whether sonographic evaluation alone can distinguish normal from abnormal gestation sacs, a retrospective analysis was performed of ultrasound (US) scans from 168 women with threatened abortion. Gestation sacs were judged to be abnormal on the basis of specific sonographic criteria including large size (greater than or equal to 25 mm mean sac diameter) without an embryo; distorted shape; thin (less than or equal to 2 mm), weakly echogenic, or irregular choriodecidual reaction; absence of a double decidual sac; and low position. Two criteria - large sac and distorted shape - had 100% specificity and were called major criteria. The remaining criteria were individually less specific, although 100% specificity was achieved when three or more of these minor criteria were demonstrated. When one major or three minor criteria were present, 53% of abnormal gestations were correctly identified without any false positive diagnoses. The authors conclude that experienced sonographers can reliably identify many abnormal gestation sacs on a single examination. PMID- 3510446 TI - Extratesticular hemorrhage associated with torsion of the spermatic cord: sonographic demonstration. AB - Using ultrasound (US), we studied seven patients with torsion of the spermatic cord associated with a large amount of extratesticular hemorrhage. In each case, US showed a large echogenic or complex extratesticular mass caused by the hemorrhage, in addition to a hypoechoic testis and scrotal skin thickening. This appearance should be recognized as part of the spectrum of sonographic appearances that can be seen in torsion. PMID- 3510447 TI - Hodgkin disease and non-Hodgkin lymphomas in children: utilization of radiological modalities. AB - If costs of medical care are to be reduced, the choice of which imaging modality to use must be made as carefully as possible. This study was done to show how radiological modalities were used to evaluate patients with Hodgkin disease and non-Hodgkin lymphoma. We kept a record of every radiological study performed on 66 children with both diseases seen in the past 6 1/3 years. The results of these studies were analyzed to see which areas of the body were studied, which imaging modality was used, how frequently the studies were repeated, and how frequently the studies gave abnormal results. Our findings disclosed that radiological studies have been appropriately performed in anatomic regions of the body in which disease is present. New imaging modalities have been introduced, and the use of some of the older modalities has been decreased. With some modalities, such as skeletal survey, liver/spleen scan, whole-lung tomography, contrast studies of the bowel, and excretory urography, utilization is higher than it ought to be in view of the fact that the yield of positive results is low and the information is obtainable in many cases from other more sensitive procedures. These studies should not be performed as a routine on initial evaluation or follow-up of all patients with Hodgkin or non-Hodgkin lymphomas. On initial presentation all patients should undergo chest radiography and CT scanning of both chest and abdomen. A problem area is that the timing of follow-up studies has been somewhat erratic, with some inappropriate studies particularly 3 or 4 years after diagnosis. Too many imaging procedures have probably been done in follow-up of our patients. PMID- 3510448 TI - Caroli disease: high-frequency US and pathologic findings. AB - Three infants with nonobstructive bile duct dilatation (Caroli disease) are described. The bile duct pathology was associated with autosomal recessive polycystic kidney disease in two patients and with severe destruction of the renal parenchyma of unknown origin in the other. Sonograms of the liver showed, besides bile duct dilatations, intraluminal bulbar protrusions, bridge formation across dilated lumina, and portal radicles partially or completely surrounded by dilated bile ducts. Liver biopsy was performed in two patients, and in one patient, the biopsy sample confirmed the findings noted on sonograms. These findings support the hypothesis that the normal embryogenesis of intrahepatic bile ducts is arrested in the pathogenesis of this disease. PMID- 3510449 TI - Average fetal depth in utero: data for estimation of fetal absorbed radiation dose. AB - To estimate fetal absorbed dose from radiographic examinations, the depth from the anterior maternal surface to the midline of the fetal skull and abdomen was measured by ultrasound in 97 pregnant women. The relationships between fetal depth, fetal presentation, and maternal parameters of height, weight, anteroposterior (AP) thickness, gestational age, placental location, and bladder volume were analyzed. Maternal AP thickness (MAP) can be estimated from gestational age, maternal height, and maternal weight. Fetal midskull and abdominal depths were nearly equal. Fetal depth normalized to MAP was independent or nearly independent of maternal parameters and fetal presentation. These data enable a reasonable estimation of absorbed dose to fetal brain, abdomen, and whole body. PMID- 3510450 TI - Academic uroradiology: the future. AB - Radiologic education, research, and the practice of radiology will be of the highest quality in the future if academic departments stress organ-system subspecialization while continuing to integrate and interface with technique based specialists. Planning should begin now to effect an orderly progression to an organ-system-based subspecialty structure for radiology training in general and for uroradiology specifically. Uroradiologists should remain as central consultants to their clinical counterparts, working collaboratively with urologists in clinical endeavors of mutual relevance. More fellowships in uroradiology should be offered that attempt to incorporate all imaging methods and procedures into the curriculum. These issues are addressed in the context of patient care, service, education, and cost containment. PMID- 3510451 TI - Stress inoculation: an illustration of coping skills training. PMID- 3510452 TI - Human monoclonal antibodies to Pf 155, a major antigen of malaria parasite Plasmodium falciparum. AB - Pf 155, a protein of the human malaria parasite Plasmodium falciparum, is strongly immunogenic in humans and is believed to be a prime candidate for the preparation of a vaccine. Human monoclonal antibodies to Pf 155 were obtained by cloning B cells that had been prepared from an immune donor and transformed with Epstein-Barr virus. When examined by indirect immunofluorescence, these antibodies stained the surface of infected erythrocytes, free merozoites, segmented schizonts, and gametocytes. They bound to a major polypeptide with a relative molecular weight of 155K and to two minor ones (135K and 120K), all having high affinity for human glycophorin. The antibodies strongly inhibited merozoite reinvasion in vitro, suggesting that they might be appropriate reagents for therapeutic administration in vivo. PMID- 3510453 TI - The 1985 Nobel Prize in physiology or medicine. PMID- 3510454 TI - Modification of the active site of alkaline phosphatase by site-directed mutagenesis. AB - The catalytically essential amino acid in the active site of bacterial alkaline phosphatase (Ser-102) has been replaced with a cysteine by site-directed mutagenesis. The resulting thiol enzyme catalyzes the hydrolysis of a variety of phosphate monoesters. The rate-determining step of hydrolysis, however, is no longer the same for catalysis when the active protein nucleophile is changed from the hydroxyl of serine to the thiol of cysteine. Unlike the steady-state kinetics of native alkaline phosphatase, those of the mutant show sensitivity to the leaving group of the phosphate ester. PMID- 3510455 TI - Effect of antibodies to recombinant and synthetic peptides on P. falciparum sporozoites in vitro. AB - Antibodies were raised in mice immunized with several recombinant and synthetic peptides of the circumsporozoite protein of Plasmodium falciparum. The antibodies were evaluated for protective activity in a human hepatocyte culture system. They exerted their protective effect against the parasite at three points: sporozoite attachment to the hepatocyte surface, entry, and subsequent intracellular development. Inhibition of attachment and entry were found to be related to the antibody titer against the authentic circumsporozoite protein on the sporozoite surface, especially when peptides were administered with alum or complete Freund's adjuvant. Even when invasion was not totally inhibited, the presence of abnormal trophozoites and a frequent inhibition of schizont development in long term cultures suggested continued activity of antibodies at the intracellular level after sporozoite penetration had been completed. PMID- 3510456 TI - The context effect does not require a fourth base pair. AB - The translational activity of a transfer RNA at a codon varies at different message sites, although the codon does not vary. The source of this effect, which may help to determine the level of gene expression, is generally agreed to be in nearby message sequences. By making every possible nucleotide combination between position 33 of the transfer RNA and the major context nucleotide of the message, it was shown that base-pairing between the two nucleotides is not the source of this context effect on translation in vivo. PMID- 3510457 TI - Mutagenicity of spy dust. PMID- 3510458 TI - A comparison of buprenorphine and pentazocine for the relief of postoperative pain. AB - The analgesic potency, efficacy, duration of action and side-effects of buprenorphine (Temgesic) 0.3 mg and 0.6 mg were compared with those of pentazocine (Sosegon) 30 mg and 60 mg in 100 male patients who had undergone orthopaedic surgical procedures. The drugs were given by intramuscular injection 30 minutes before completion of the surgical procedure, and the quality of pain relief and incidence of side-effects were assessed at 30-minute intervals for at least 6 hours. Buprenorphine was shown to be safe, to be more potent and to have a longer duration of action than pentazocine, and to result in less nausea, vomiting and euphoria, but it was associated with a higher incidence of postoperative sedation than pentazocine. PMID- 3510459 TI - Prostate cancer--some aspects of epidemiology, risk factors, treatment and survival. AB - In Western populations prostate cancer was probably rare in the past, yet in many populations the mortality rate has risen 3-5-fold since 1910. The disease now affects 1 man in 20. While the incidence in Third World populations living traditionally remains low, it increases with urbanization and prosperity, as in South African blacks. While the disease is age-related, more common in married than in single men and family-orientated, knowledge of specific aetiological factors is meagre. Abnormal hormonal status may well be involved, and possibly diet (Western v. Third World diet). There is a strong hormonal influence on tumour development. Treatment, according to the stage of the disease, includes prostatectomy, hormonal manipulation, external irradiation and chemotherapy; 70% of patients are surgically incurable at the time of presentation. Survival is greatly affected by the stage at diagnosis; the percentage surviving 5 years is 3 times higher for patients at stage A than for those at stage D. Little can be done to avoid prostate cancer because of inadequate understanding of risk factors. Annual rectal examination between 40 and 65 years is urged, since surgical cure is possible when metastases are absent. PMID- 3510460 TI - Bullous systemic erythematosus. A case report. AB - Bullous disease in patients with systemic lupus erythematosus (SLE) has been previously described but characterization has been difficult. A case of bullous eruption that is an unusual manifestation of SLE rather than a primary vesiculobullous eruption is described. The patient was successfully treated with dapsone. PMID- 3510461 TI - Simulation of posterior fossa cyst by normal, hypo-echoic white matter on cranial ultrasonography. AB - Ultrasonography in the diagnosis of fetal abnormalities is well documented, and improvements in technology have made possible detailed visualization of the intracranial anatomy. Ten per cent of major fetal abnormalities involve the head and neck. A case of simulation of a posterior fossa cyst by normal, hypoechoic white matter on cranial ultrasonography is presented. Potential pitfalls and the differential diagnosis of intracranial abnormalities in utero are discussed. PMID- 3510462 TI - Genetic and teratological considerations in the analysis of concordant and discordant abnormalities in twins. AB - Results from monozygotic (MZ) and dizygotic (DZ) twin research are often used in an attempt to gain a clearer understanding of the 'nature v. nurture' dilemma. Discordance between MZ twins has been considered to be environmental, and greater concordance in MZ compared with DZ pairs to be genetic. Current genetic and teratological theories considerably complicate the interpretation of concordance and discordance of abnormalities. The high rate of discordant intra-uterine death recently demonstrated in twins may profoundly influence the value of epidemiological studies usually performed in later life. Furthermore, indirect zygosity estimations based on sex ratios in DZ twins may be flawed because it is now recognized that increasing numbers of conditions are genetically heterogeneous. Emphasis is laid on problems of interpretation of discordance and concordance for developmental abnormalities in twins, and some possible mechanisms for their induction are discussed. Basic genetic concepts relevant to the expression of abnormalities in twins are outlined. PMID- 3510463 TI - The insulin and glucose response to an oral glucose load in non-insulin-dependent diabetes in the young. A study of 4 families. AB - Four Indian families with three-generation transmission of non-insulin-dependent diabetes were studied. Only 30% of the siblings were diabetic. The mean age of onset of diabetes was 20,1 years; 25% of the diabetics were obese, while all non diabetic family members were of normal weight. All consenting living family members (12 diabetics and 16 non-diabetics) were subjected to an oral glucose tolerance test. After glucose administration, the 12 diabetics displayed a delayed and attenuated insulinaemic response. The area under the insulin curve and the insulin-glucose ratio were lower in the diabetics. PMID- 3510464 TI - Noninvasive tests in the diagnosis and management of thromboembolic disease. PMID- 3510465 TI - The current status of recognition and treatment of severe necrotizing pancreatitis. AB - The diagnosis and treatment of severe necrotizing pancreatitis poses a major controversy in the realm of surgery of the upper gastrointestinal tract. Certainly all investigators are in agreement that the patient with severe necrotizing pancreatitis who responds promptly and effectively to intensive resuscitative efforts and general support measures should not be operated upon. The role of therapeutic percutaneous peritoneal lavage is not well delineated, but probably does not represent any risk to the patient, and should be attempted in patients in whom the response to nonsurgical measures is questionable or transient or in whom sepsis has not supervened. Operation must be undertaken in patients who do not respond to intensive resuscitative efforts, with or without peritoneal lavage, in the first 24 to 36 hours of management, or in whom the initial response is followed by deterioration of vital organ function, specifically pulmonary, renal, and hepatic function. The presence of gallstones associated with pancreatitis that does not respond to therapy promptly also makes early operation mandatory. Although the results in the alcoholic patient are not satisfactory, the results of early operation in nonalcoholic patients with severe necrotizing pancreatitis has been most gratifying, and has yielded far superior survival rates than the nonsurgical approach. PMID- 3510466 TI - The current status of obesity surgery: constructive criticism. PMID- 3510467 TI - Conservative surgery in Crohn disease. AB - As with any disease of unknown etiology, treatment must be based on clinical experience. The principles of conservative surgical treatment outlined offer a compromise between the apparently conflicting interests of symptomatic treatment of a progressive disease and the nutritional consequences thereof. Until more specific etiologic data are available and reliable prognostic indicators characterized, we must base our therapeutic advice on principles that will achieve the maximum symptomatic benefit with the minimum of metabolic and nutritional consequences. PMID- 3510468 TI - Plasma component therapy: new trends. PMID- 3510469 TI - The contribution of Robert Lawson Tait to the development of abdominal surgery. PMID- 3510470 TI - Injection sclerotherapy for esophageal varices: an update. PMID- 3510471 TI - Stress ulceration: importance of blood flow and acid-base balance. PMID- 3510472 TI - Anterior cervical epidural abscess: the use of intraoperative spinal sonography. AB - A case of acute cervical epidural abscess is presented. The use of intraoperative spinal sonography is discussed as a valuable adjunct in the evaluation and treatment of these uncommon lesions. PMID- 3510473 TI - Emile Laine. PMID- 3510474 TI - Osman Sorour. PMID- 3510475 TI - Oxacillin prophylaxis in cerebrospinal fluid shunt procedures: results of a randomized open study in 60 hydrocephalic patients. AB - A 27-month open randomized trial (October 1981-January 1984) was carried out to study the prophylactic efficacy of antibiotics in 60 hydrocephalic patients being shunted for the first time. The treatment group received oxacillin at a dosage of 200 mg/kg/day by six bolus intravenous injections, beginning with anesthetic induction and continuing for 24 hours after the operations. The minimum postoperative observation was 6 months. Six patients in the control group developed cerebrospinal fluid infections (20%) as compared with only a single patient in the oxacillin group (3.3%); this difference was statistically significant (p less than 0.05). Time of development of cerebrospinal fluid infection was brief (86% at 6 weeks), and as usual staphylococci were the pathogens most frequently implicated. This study would appear to confirm the choice of oxacillin for prevention of meningitis. Nevertheless, the frequency of methicillin-resistant staphylococci, which account for 20% of nosocomial staphylococcal infections, constitutes a limiting factor for such prevention. PMID- 3510476 TI - "Closed-open" arterial embolectomy. AB - Peroperative evaluation of the success of thromboembolectomy is achieved with a technique that employs interrupted horizontal mattress sutures. Angled traction on the sutures functionally closes the transverse arteriotomy while restoration of circulation is assessed. The arteriotomy may be opened for repassing embolectomy catheters by relieving the traction; if circulation is satisfactory the sutures are tied. PMID- 3510478 TI - Re: Plasma amino acids in liver transplantation: correlations with clinical outcome. PMID- 3510477 TI - Agenesis of the gallbladder: case report and familial investigation. AB - In this article we report a case of gallbladder agenesis, confirmed at laparotomy, and the subsequent investigation of that patient's family for others with evidence of agenesis. Ultrasonography was chosen as the principal diagnostic tool, and of the eight family members available for study, one was found to have no demonstrable gallbladder by either ultrasonography or oral cholecystography. The overall incidence of gallbladder agenesis is said to approximate 0.01% to 0.04%. However, in each of the four existing familial studies a much higher incidence is noted. With regard to gallbladder agenesis, these data strongly suggest the existence of a familial hereditary trait. PMID- 3510479 TI - Washing with or without chloramphenicol in the treatment of peritonitis: a prospective, clinical trial. AB - One hundred one suitable patients with peritonitis of diverse origin were randomized into two groups. In each patient in group 1 (50 patients), the abdomen was washed after the appropriate surgical procedure with normal saline solution, and 2 gm chloramphenicol was introduced before abdominal closure; in each patient in group 2 (51 patients), the abdomen was washed as in group 1, but chloramphenicol was not instilled. All patients were given 1 gm chloramphenicol intramuscularly either preoperatively or intraoperatively and 3 gm daily for 3 days. Chloramphenicol was selected on the basis of its activity against aerobic and anaerobic bacteria and its demonstrated stimulating effect on peritoneal macrophages in vitro. All explorations were done through the midline, and the skin and subcutaneous tissues were closed secondarily 3 to 4 days after operation. No drains were used. The two groups were roughly comparable, but results were significantly better for all parameters studied in patients receiving chloramphenicol locally. Blood dyscrasias were not observed. It is suggested that the combination of washing and local antibiotics is superior to washing alone; in addition to its parenteral administration, chloramphenicol is of considerable value if instilled in the area of peritonitis after washing; and besides its bacteriostatic action, chloramphenicol may have a local stimulating effect on peritoneal defenses and may therefore be the drug of choice for local use in generalized peritonitis. PMID- 3510480 TI - Pancreatic proteases and oxygen-derived free radicals in acute ischemic enteropathy. AB - The specific susceptibility of the intestinal mucosa to low blood flow states is related to the "physiologic" makeup of the intestinal milieu. Pancreatic proteases appear to play a crucial role in the ischemic autodigestion of the intestinal mucosa. Moreover, trypsin can activate the conversion of xanthine dehydrogenase into superoxide radicals producing xanthine oxidase. Oxygen-derived free radicals account for at least part of the damage to the postischemic intestinal mucosa. PMID- 3510481 TI - Splenectomy and donor-specific blood transfusion in rat cardiac allografts. PMID- 3510482 TI - Prolonged allograft survival resulting from donor pretreatment with phytohemagglutinin-P. PMID- 3510483 TI - Prolonged survival of rhesus fetal skin grafts on nonimmunosuppressed allogeneic hosts. PMID- 3510485 TI - Plasma fibronectin after bone marrow transplantation. PMID- 3510484 TI - The beneficial effect of pretransplant third-party blood transfusions on allograft rejection in HLA-identical sibling kidney transplants. PMID- 3510486 TI - Chronic graft-versus-host disease complicated by micronodular cirrhosis and esophageal varices. PMID- 3510487 TI - Successful renal transplantation despite a positive fluorescence-activated cell sorter crossmatch following plasma exchange of donor-specific anti-HLA antibodies. PMID- 3510488 TI - Short-course antithymocyte globulin for treatment of renal transplant rejection in children. PMID- 3510489 TI - In vitro characterization of a donor-specific cytolytic T cell line established from human lymphocytes homing in a rejected kidney allograft. PMID- 3510490 TI - Mouse skin graft prolongation with donor-strain bone marrow and antilymphocyte serum. Effect of bone marrow cell storage. AB - Significant extended survival of C3H/He skin grafts in antilymphocyte serum (ALS) treated B6AF1 mice can be brought about by the injection of donor-strain bone marrow on day 6 or 7 after grafting. In the present study, survival of the active graft-prolonging bone marrow cells under several storage conditions was investigated. The bone marrow cells retained their effectiveness if stored at 4 degrees C in 10% fetal calf serum for 18 hr prior to injection, but not if maintained at 37 degrees C under standard lymphocyte culture conditions. Freezing the cells for 10 days in a cryoprotective medium preserved the ability of the cells to prolong graft survival. In fact, freeze-thawed cells were more effective than fresh cells. Extension of the ALS-bone marrow treatment protocol to human transplantation is expected to be facilitated by frozen and short-term refrigerated storage of the donor bone marrow. PMID- 3510491 TI - Impairment of renal slice function following brain death, with reversibility of injury by hormonal therapy. AB - The effects of the agonal period and subsequent donor management on renal slice function, using the K+ - Na+ ratio, have been studied in the pig. Brain ischaemia or death resulted in a reduction in renal slice function, whether the pig was maintained normovolemic or hypovolemic by i.v. fluid and dobutamine therapy. This deterioration in function was, however, reversed or prevented by a period of therapy with thyroxine (T3), insulin, and cortisol. A period of 24 hr storage of the kidney slice in a low ionic strength solution in ice resulted in a further deterioration in slice function in all groups studied. PMID- 3510492 TI - Analysis of cytotoxic T lymphocyte response in rejecting allografted canine kidneys. AB - The involvement of cytotoxic T lymphocytes (CTL) in the rejection process of allografted canine kidneys was studied. The frequency of donor-specific (precursor) CTL was determined with a sensitive limiting dilution assay. Longitudinal sampling of peripheral blood and kidney aspiration biopsies were used to obtain information on the CTL response toward the graft. An accurate analysis of CTL kinetics in both kidney and peripheral blood of allografted dogs appeared to be technically possible. During the first days after transplantation precursor CTL (CTLp) frequencies decreased in both blood and kidney. A minimum CTLp frequency of 5-15% of the pretransplant value was reached in the peripheral blood at day 4 after transplantation. The cause of this decrease, which was observed in all 5 allografted dogs is discussed. CTLp frequencies increased after day 4 and showed an exponential rise in the kidney before serum creatinine increased due to loss of kidney function caused by rejection. The data obtained with the quantitative study of CTL show that rejection of a canine kidney allograft is accompanied by a rise in CTL numbers in the kidney. The methodology developed permits extensive functional analysis of cellular processes in allografted organs. PMID- 3510493 TI - Toxic effects of cyclosporine on the endocrine pancreas of Wistar rats. AB - The widely used immunosuppressive drug cyclosporine exerts toxic effects on various parenchymal organs including the liver and kidney. This study was performed with the aim of testing whether cyclosporine also affects the endocrine pancreas. Daily cyclosporine doses of 50 mg/kg body weight over 3 weeks in rats enhanced the serum bilirubin and creatinine concentrations, led to light microscopic destruction in the liver and kidneys, and resulted in the development of an impaired glucose tolerance--and, later on, of hyperglycemia. The pancreatic insulin content decreased to 33% of values observed in vehicle-treated controls, which can be ascribed to a 50% decrease of beta-cell volume and a slightly smaller reduction of islet insulin content. The reduction of the cyclosporine dose to 15 mg/kg body weight daily, which also reduced the popliteal lymph node weight gain after allogeneic stimulation, was not accompanied by serochemical or morphological alterations of livers or kidneys in the rats when treated for 3 weeks. However, the animals had already developed an impaired glucose tolerance, accompanied by a decrease in pancreatic insulin content (to 50% that of controls), a decrease of islet insulin content (to 70%) and a reduced pancreatic beta cell volume (to 72%). The findings let us conclude that pancreatic beta cells are sensitive to toxic effects of cyclosporine in vivo. We suggest that the measurement of glucose tolerance, as a sensitive parameter of a toxic cyclosporine action, should be included in the monitoring of grafted patients under cyclosporine treatment. PMID- 3510494 TI - Correlation of hypomagnesemia with the onset of cyclosporine-associated hypertension in marrow transplant patients. AB - Cyclosporine is known to cause hypertension, and we have recently reported that it causes hypomagnesemia and renal magnesium wasting in marrow transplant recipients. We performed a case-control study to ask whether hypomagnesemia might be related to this form of drug-induced hypertension. The charts of 188 patients treated with cyclosporine were evaluated for the development of hypertension. The 32 patients who became hypertensive were age, sex, and disease-matched with 32 cyclosporine-treated controls. Baseline serum Mg levels were normal in both groups. However at the time of development of hypertension, the hypertensive patients had a mean (+/- SD) Mg of 1.22 +/- 0.20 mEq/L versus controls 1.40 +/- 0.33 mEq/L (P less than 0.01). Serum calcium, albumin, creatinine, potassium, and cyclosporine concentrations were not different between the two groups. This study may indicate that hypertension and hypomagnesemia are coincident toxicities in cyclosporine-treated patients. Alternatively, our data support the hypothesis that acquired derangements in magnesium metabolism may contribute to the development of hypertension. Magnesium replacement may prove beneficial in the treatment and/or prevention of cyclosporine-associated hypertension. PMID- 3510495 TI - Reduction of azathioprine in renal transplant patients with chronic hepatitis. AB - To determine whether prolonged reduction of azathioprine in renal transplant recipients with chronic hepatitis affected the progression of liver disease without an adverse effect on graft survival we studied all transplant patients with a raised serum glutamic oxaloacetic transaminase level greater than normal for more than 1 year who had azathioprine reduced below 100 mg/day for longer than 1 year. Six HBsAg-positive patients had chronic hepatitis for 67 +/- 7 (SE) months before reduction of azathioprine and were followed for a further 49 +/- 14 months. None of the six patients remitted, 3 patients died from liver disease, and none returned to dialysis. In the group of 12 patients who did not have azathioprine reduced, none remitted, 4 died from liver disease, and none returned to dialysis during a follow-up of 115 +/- 9 months. Seven HBsAG-negative patients had chronic hepatitis for 32 +/- 11 months before reduction of azathioprine and were followed for a further 46 +/- 8 months. One of the seven remitted, none died from liver disease and one returned to dialysis. In the group of 15 patients who did not have azathioprine reduced 5 patients remitted, none died from liver disease, and none returned to dialysis. We conclude that prolonged reduction of azathioprine does not slow the progression of liver disease in renal transplant recipients with HBsAg-positive or HBsAg-negative chronic hepatitis, nor does it predispose to graft failure. However reduction of immunosuppression early in the course of hepatitis B disease may be necessary to prevent adverse long-term sequelae. PMID- 3510496 TI - Cotton-wool exudates not observed in recipients of renal transplants treated with cyclosporine. AB - Retinal cotton-wool patches, not previously observed in bone marrow recipients, have been reported in three patients who received Sandimmun (cyclosporine) as prophylaxis for graft-versus-host-disease after bone marrow transplantation. These patients all had acute lymphoblastic leukemia and had received, in addition to the standard conditioning regimen, central nervous system irradiation before transplantation. We were thus prompted to examine 55 renal transplant recipients (15 of them prospectively) who were receiving cyclosporine for evidence of similar fundal changes. No cotton-wool patches were found in any of the renal transplant recipients. PMID- 3510497 TI - Radiation nephritis following total-body irradiation and cyclophosphamide in preparation for bone marrow transplantation. AB - Two children prepared for bone marrow transplantation with total-body irradiation and cyclophosphamide developed hypertension, microscopic hematuria, proteinuria, diminished renal function, and anemia six months after transplantation. Light microscopy of the kidneys revealed mesangial expansion, glomerular capillary wall thickening, and lumenal thrombosis. Electron microscopy demonstrated widening of the subendothelial space due to the deposition of amorphous fluffy material. In one patient, immunofluorescence microscopy revealed glomerular capillary wall deposition of fibrin and immunoglobulins. The clinical and histologic findings support the diagnosis of radiation nephritis. Patients prepared for bone marrow transplantation with total-body irradiation and cyclophosphamide should be followed closely after transplantation for the development of hypertension, proteinuria, and renal insufficiency. PMID- 3510498 TI - Requirement for both MHC and non-MHC antigens residing on the same erythrocyte for donor erythrocyte-mediated prolongation of rat renal allograft survival. AB - Transfusions of highly purified LEW erythrocytes (E) administered to BN recipients prior to insertion of LEW kidneys markedly prolonged the survival of these allografts (greater than 35 days). Administration of E from syngeneic (BN), third-party (PVG), and MHC-congenic LEW.1N or BN.1L rats did not improve LEW kidney graft survival to the same extent (less than 14 days). BN.1L E were shown to carry at least the same quantity of LEW MHC antigens on their surface as LEW E, thus the failure to prolong LEW kidney graft survival is due to the absence of LEW non-MHC antigens from BN.1L E. Attempts to substitute for this deficiency by mixing LEW.1N E to BN.1L E prior to transfusion failed to restore the beneficial effect, demonstrating that donor E-mediated prolonged renal allograft survival requires the presence of both MHC and non-MHC alloantigens on the same E. PMID- 3510499 TI - Accuracy of a pulse-echo boundary tomogram. AB - An ultrasonic tomogram was developed with a view to providing the outline of a cross section of the ulna in vivo. The construction and design of the instrument was undertaken to obtain a resolution as close as possible to theoretical limits. The apparatus was constructed to be used in conjunction with a system for assessing bone mineral content using a conventional clinical x-ray set. It had been expected that the information from the two instruments would make it possible to obtain a precise spatial plot of bone density. It was thought that the tomograph would respond only to reflections at the bone--soft tissue interface, where there is a large change in acoustic impedance, but in vivo trials have shown that other soft tissue interfaces give rise to reflection, which makes the performance unsatisfactory. However, some interesting results have been obtained from solid objects in water, which have shown that there is a limitation on the accuracy of the plot depending on the angle of incidence of the ultrasonic beam and not dependent on errors of mechanical or electronic origin. Some theory is put forward to account for irregularities in plots for these objects. PMID- 3510500 TI - Adaptive filtering for reduction of speckle in ultrasonic pulse-echo images. AB - Current medical ultrasonic scanning instrumentation permits the display of fine image detail (speckle) which does not transfer useful information but degrades the apparent low contrast resolution in the image. An adaptive two-dimensional filter has been developed which uses local features of image texture to recognize and maximally low-pass filter those parts of the image which correspond to fully developed speckle, while substantially preserving information associated with resolved-object structure. A first implementation of the filter is described which uses the ratio of the local variance and the local mean as the speckle recognition feature. Preliminary results of applying this form of display processing to medical ultrasound images are very encouraging; it appears that the visual perception of features such as small discrete structures, subtle fluctuations in mean echo level and changes in image texture may be enhanced relative to that for unprocessed images. PMID- 3510501 TI - Ultrasound evaluation of scrotum in pediatrics. AB - Scrotal abnormalities are difficult to assess using clinical criteria alone. Ultrasound provides an accurate means of demonstrating the scrotal contents so that appropriate therapy may be instituted. In a retrospective study, 119 ultrasound examinations of 96 patients (aged 4 days to 23 years) have been compared with the clinical diagnosis, surgical/pathologic findings, and other imaging modalities. The gamut of disease identified included congenital anomalies, neoplasm, trauma, torsion, varicocele, hydrocele, epididymo-orchitis, epididymal cyst/spermatocele, and post-radiation fibrosis. The ultrasound findings correlated well in 93/96 patients. In inconclusive cases, sequential imaging helps differentiate traumatic and inflammatory lesions from neoplastic processes. PMID- 3510502 TI - Diagnostic ultrasound of scrotum. AB - Ultrasound is a proved, safe diagnostic procedure. Its efficacy in the evaluation of 54 cases of scrotal pathology is reviewed. Ultrasound was 100 per cent accurate in the evaluation of hydroceles, hematoceles, and paratesticular masses, but less informative in testicular abscesses (80%) and epididymo-orchitis (77%). PMID- 3510503 TI - Empiric antimicrobial therapy of serious urinary tract infections. AB - Parenteral therapy is recommended for empiric treatment of serious urinary tract infections. The approach to antimicrobial selection is reviewed with consideration given to newly available agents. PMID- 3510504 TI - Proceedings from a workshop symposium of the 14th International Congress of Chemotherapy. Kyoto, Japan, June 23-28, 1985. PMID- 3510505 TI - Characterization of large surface proteins of hepatitis B virus by antibodies to preS-S encoded amino acids. AB - The major surface protein of HBV, the 226-amino-acid HBsAg, is encoded in the 3' proximal segment of the preS-S gene of 389 codons. To identify gene products from the 5' proximal preS sequence, DNA fragments from the preS region were expressed in Escherichia coli as fusion proteins. Antisera prepared against these fusions were used to screen serum proteins of HBV-infected individuals, and found to react specifically with the two large HBV surface proteins of 39 and 42 kDa. The presence of these proteins could be correlated with acute HBV infection. Analysis by Western blotting using the preS sequence-specific antisera and HBV particles separated into spheres, filaments, and Dane particles confirmed that these proteins were associated with the native virus. Dane particles containing active DNA polymerase could be immune precipitated by the preS-specific antibodies, showing that the preS-coded part of these surface proteins is located on the surface of the virion. PMID- 3510506 TI - Transhiatal esophagectomy without thoracotomy for carcinoma of the esophagus. PMID- 3510507 TI - In utero surgery. PMID- 3510509 TI - In-situ saphenous vein arterial bypass for the treatment of limb ischemia. PMID- 3510508 TI - Proximal gastric vagotomy: the first 25 years. PMID- 3510510 TI - Vascular access for dialysis and cancer chemotherapy. PMID- 3510511 TI - Sonographic recognition of idiopathic arterial calcification of infancy. PMID- 3510512 TI - Retroperitoneal mass with intradural extension: value of magnetic resonance imaging in neuroblastoma. PMID- 3510513 TI - Magnetic resonance imaging of thoracic aortic aneurysms: comparison with other imaging methods. AB - Fifteen patients with thoracic aortic aneurysms had magnetic resonance images (MRI) and at least one additional diagnostic image study: thoracic aortography, computed tomography (CT), or two-dimensional echocardiography. Twenty aneurysms were demonstrated by MRI, 19 by the other studies. One small saccular aneurysm was missed by CT. There was complete agreement between MRI and other studies regarding aneurysm morphology, and good correlation in diameter measurements of the aneurysms and at multiple additional aortic levels. PMID- 3510514 TI - Oriental cholangiohepatitis: diagnostic imaging and interventional management. AB - Diagnostic and therapeutic radiologic experience with six patients who had oriental cholangiohepatitis is described. These patients combined had 10 prior operations. Postoperatively each had recurrent cholangitis, numerous stones, concretions, and/or bile duct strictures. Diagnostically, sonography was valuable in the detection of intra- and extrahepatic stones and extrahepatic dilatation of ducts. An important pitfall in sonography was poor visualization of intrahepatic ductal dilatation (due to echogenic sludge filling the ducts) in most patients. CT was helpful diagnostically in all respects. Interventional procedures used postoperatively included percutaneous transhepatic intrahepatic stones, and flushing techniques. Most patients were treated during multiple sessions as outpatients. Cholangitis was the only complication from the procedures. Sectional imaging and interventional radiology perform valuable diagnostic and therapeutic roles in the pre- and postoperative management of patients with oriental cholangiohepatitis. PMID- 3510515 TI - Value of sonographic screening for gallstones in patients with chest pain and normal coronary arteries. AB - The prevalence of sonographically detectable gallstones in patients with chest pain and normal coronary arteries was compared with the prevalence of gallstones in patients referred to sonography for nonbiliary disease. Among 545 patients with chest pain and normal coronary arteriograms, 101 (18.5%) were referred for sonographic examination of the gallbladder. This test group was compared to a matched control group (n = 101) undergoing abdominal sonography for nonbiliary disease. Six patients (5.9%) in the test group and eight patients (7.9%) in the control group were found to have gallstones by accepted sonographic criteria. Studies based on oral cholecystogram screening of healthy populations have claimed a prevalence of cholelithiasis of 2.3%-6.2% for males and 2.3%-12% for females. The authors were unable to demonstrate a higher prevalence of sonographically identified gallstones in patients with chest pain and normal coronary arteries than in patients examined for nonbiliary disease. The frequency of gallstones in this test group is comparable to that reported for a screened population of healthy men and women. PMID- 3510516 TI - Pancreatic sonography: enhancement by metoclopramide. AB - Abdominal sonograms were obtained before and after intravenous metoclopramide administration in 25 patients with a wide variety of abdominal complaints. Visualization of the pancreas was improved by this pharmacologic treatment in 44% of those patients in whom gas obscured the pancreatic bed. There was no improvement when fat was the primary prevention of visualization of the pancreas. There were no significant side effects of metoclopramide administration. PMID- 3510517 TI - The anechoic crescent in abdominal aortic aneurysms: not a sign of dissection. AB - In six cases, abdominal aortic aneurysms simulated dissections because an anechoic crescent was seen peripheral to the echogenic intraluminal thrombus. Thrombus can easily be identified by sonography, but the layered echogenic and anechoic appearance has not been described. Three of these cases are presented to illustrate this sonographic pattern of thrombus so that it will not be misinterpreted as a dissection. CT scans were performed on all three patients and an arteriogram and surgery in one, all of which confirmed that these were not dissections but two layers of thrombus with the intima peripheral to the anechoic layer. At surgery, the anechoic layer medial to the intima in one case proved to be serosanguinous fluid and, therefore, likely liquefaction of the clot. PMID- 3510519 TI - Rupture of echinococcal cysts: diagnosis, classification, and clinical implications. AB - The authors classify rupture of echinococcal cysts into three types: contained, communicating, and direct. Contained rupture occurs when only the parasitic endocyst ruptures and the cyst contents are confined within the host-derived pericyst. When cyst contents escape via biliary or bronchial radicles that are incorporated in the pericyst, the rupture is communicating. Direct rupture occurs when both the endocyst and the pericyst tear, spilling cyst contents directly into the peritoneal or pleural cavities or occasionally into other structures. Communicating and direct forms have more serious clinical implications than contained rupture, but even contained rupture should have prompt surgical attention to prevent it from developing into one of the other forms. Untreated communicating rupture of a liver cyst can lead to obstruction of the biliary system with a 50% mortality rate. Direct rupture may cause anaphylaxis, and it should be managed surgically, possibly with adjunctive treatment with antihelminthic drugs to decrease the possibility of metastatic hydatosis. PMID- 3510518 TI - Incidental detection of impalpable testicular neoplasm by sonography. PMID- 3510520 TI - Restless legs syndrome. AB - Patients with restless legs syndrome often have difficulty describing their symptoms. Three features characterize the classic syndrome: an unusual, almost indescribable sensation in the lower extremities; an irresistible urge to move the legs, and the exclusive occurrence of the symptoms at rest, with their relief by movement. Restless legs syndrome may cause severe insomnia. Variants of the syndrome, as well as numerous associated conditions, have been described. The etiology is unknown. Clonazepam and carbamazepine are reported to be effective in treating this syndrome. PMID- 3510521 TI - Traumatic diaphragmatic injuries. AB - The anatomic distribution of diaphragmatic injuries varies. Over 95 percent of patients have a serious associated injury. A high index of suspicion and a routine chest x-ray are keys to the diagnosis. Diaphragmatic injuries may be divided into acute, latent and obstructive phases. Acute-phase mortality ranges from 11 to 37 percent, while obstructive-phase mortality is 30 to 66 percent. Early surgical repair of a diaphragmatic injury is required, regardless of the phase in which the defect is discovered. PMID- 3510523 TI - Demonstration of the "no-reflow" phenomenon by digital coronary arteriography. PMID- 3510522 TI - Dysrhythmias after direct-current cardioversion. AB - The success rate of direct-current (DC) countershocks and postshock arrhythmias are of concern for the design of automatic devices. Results of 112 DC shocks for induced ventricular tachycardia/fibrillation (VT/VF) (n = 99) or atrial fibrillation (AF) were analyzed. Clinical and arrhythmia characteristics were related to the success rate of DC shocks as well as postshock arrhythmias. Sixty one patients were men and 14 were women; mean age was 52 +/- 15 years. Coronary artery disease was present in 56 patients and cardiomyopathy in 4. The other patients had no apparent structural heart disease. The success rate of transchest DC shocks for VT and VF were identical. The first DC shock interrupted 80% of VT and VF episodes. All episodes were terminated by 4 or fewer DC shocks. A single DC shock changed morphologic pattern or rate of 4 episodes of VT. Asystole after VT/VF (1,900 +/- 960 ms) was longer than after atrial fibrillation (1,150 +/- 470 ms, p less than 0.01). VT/VF recurred (within 3 minutes) after 26 of 99 initially successful DC shocks, requiring repeat shocks in 2 cases. Sinus bradycardia (n = 18) or high degree atrioventricular block (n = 11) necessitated rate support pacing in 10 patients. Antiarrhythmic drugs did not prevent postshock tachycardias, but facilitated the development of bradycardias. In conclusion, reliable and continuous analysis of cardiac rhythm after discharge is mandatory to enable automatic devices to correct unsuccessful discharges or recurring VT/VF. In addition, demand pacing capability is desirable to prevent severe bradycardia after DC shocks in patients receiving antiarrhythmic drugs. PMID- 3510524 TI - Comparison of nicardipine and propranolol for chronic stable angina pectoris. AB - In a double-blind, randomized, crossover clinical trial, a new calcium antagonist, nicardipine (90 mg/day in 3 divided doses), was compared with propranolol (120 mg/day in 3 divided doses) in 25 patients with chronic stable angina. The mean weekly frequency of angina episodes decreased from 7.8 +/- 1.2 (+/- standard error of the mean) with placebo to 3.8 +/- 1.2 with nicardipine treatment and 3.5 +/- 1 with propranolol treatment (p less than 0.001). With exercise testing, 5 patients receiving nicardipine and 3 receiving propranolol had no angina or ST-segment changes. Comparing paired samples of both drugs with placebo, significant improvement occurred in exercise duration (nicardipine, 1.3 +/- 0.3 minutes, p less than 0.001; propranolol, 1.0 +/- 0.4 minutes, p less than 0.01), time to onset of angina (nicardipine, 1.5 +/- 0.4 minutes, p less than 0.001; propranolol, 1.5 +/- 0.5 minutes, p less than 0.001), maximal ST-segment changes (nicardipine, 0.7 +/- 0.1 mm, p less than 0.01; propranolol, 0.06 +/- 0.1 mm, p less than 0.01) and time to 1 mm of ST depression (nicardipine, 2.5 +/- 0.4 minutes, p less than 0.01; propranolol, 2.0 +/- 0.3 minutes, p less than 0.01). One patient receiving propranolol and 2 receiving nicardipine withdrew from the study because of transient side effects. Mild side effects occurred in 10 patients receiving propranolol and 5 receiving nicardipine. Nicardipine proved to be safe and effective for patients with chronic stable angina; it had fewer side effects than propranolol in the doses used. PMID- 3510525 TI - Efficacy and safety of sustained-release diltiazem in stable angina pectoris. AB - The safety and efficacy of a sustained-release preparation of diltiazem (diltiazem-SR), with dose levels of 240 and 360 mg/day, were assessed in 18 patients with stable angina of effort. A double-blind, placebo-controlled, randomized, crossover protocol was used. Diltiazem-SR, when given twice daily, reduced the frequency of weekly anginal attacks from 9.3 +/- 10.4 with placebo to 3.7 +/- 4.7 with 240 mg/day and to 3.1 +/- 4.7 with 360 mg/day (both p less than 0.01 compared with placebo). Treadmill time was increased from 410 +/- 180 seconds during the placebo phase to 519 +/- 177 seconds during the 240-mg/day dose and to 506 +/- 182 seconds during the 360-mg/day dose of diltiazem-SR (both p less than 0.01 compared with placebo). The time to the onset of angina and ischemic ST-segment depression were similarly prolonged by both doses of diltiazem-SR. The beneficial effects of diltiazem-SR appeared partly due to a reduction in the heart rate during submaximal exercise. Diltiazem-SR is effective and safe for the treatment of angina of effort when given twice daily. PMID- 3510526 TI - An anomalous postprandial increase in erythrocyte insulin receptor affinity associated with hyperinsulinemia. AB - Whereas the expected decrease in the binding of 125I-insulin to erythrocytes 4.5 h after a standard mixed breakfast was seen in six young nonobese normoglycemic controls (delta % bound/free = 2.0 +/- 0.5 SEM), 10 obese hyperglycemic subjects showed an increase (0.54 +/- 0.43) and eight obese normoglycemic subjects of similar age and weight, no change in binding (0 +/- 0.31), both being significantly different from the controls (p less than 0.05) but not from each other. Of the total 18 obese subjects, the 11 with fasting hyperinsulinemia (23 +/- 1.4 mU/l) showed an increase in binding of 0.82 +/- 0.40, significantly different (p less than 0.05) from the decrease of 0.30 +/- 0.25 shown by the seven normoinsulinemic (11 +/- 1.4 mU/l) subjects, despite their similar age, weight, and blood glucose concentrations. These changes in binding were explained by alterations in receptor affinity. Thus, an anomalous postprandial increase in erythrocyte insulin receptor affinity occurs in some obese subjects with or without diabetes, and is related to hyperinsulinemia rather than hyperglycemia. PMID- 3510527 TI - Comparison of MAST with radioallergosorbent and skin tests for diagnosis of allergy in children. AB - The multiple allergosorbent test system (MAST) is a method for measuring total and allergen-specific IgE levels, using autoradiography and densitometry. The purpose of this study was to compare the results of MAST tests with those of radioallergosorbent (RAST) and skin tests as an adjunct to the diagnosis of allergy in children. Twenty children, aged 4 to 19 years, were studied. Total serum IgE level measured by the paper radioimmunosorbent test (PRIST) method ranged from 7 to 1,333 units/mL (geometric mean, 155 units/mL). Total serum IgE level by MAST significantly correlated with the PRIST IgE level. Quantities of allergen-specific IgE measured by MAST and RAST were also significantly correlated. When the diagnostic levels by MAST and RAST were compared with skin test reactions for ragweed, grass, house dust, and mite, MAST had a sensitivity of 59%, a specificity of 97%, and an efficiency of 72%, compared with 67%, 97%, and 78%, respectively, for the RAST analysis. We conclude that MAST and RAST are similar in their ability to measure allergen-specific IgE level, but that neither method is as sensitive as skin tests for detection of allergen-specific IgE. PMID- 3510528 TI - Free perforation in Crohn's disease: a report of 33 cases and review of literature. AB - Thirty-three patients with free perforation in Crohn's disease are described. There are 14 males and 19 females in this series with ages ranging from 14 to 79 years. The sites of perforation were 22 of the ileum, nine colonic, one jejunal, and one gastroduodenal. Toxic megacolon coexisted in two. Reperforation occurred in three. Free perforation was the presenting sign of the disease in three. Steroid therapy coexisted in 16 patients but in five was administered for less than 10 days before perforation. Obstruction coexisted in only three patients. There were two deaths. Twenty-two patients were treated with resection and diversion, nine patients with resection and drainage, and two with plication only. No relationship between steroid therapy, duration of disease, toxic dilatation, or obstruction with perforation could be established. Resection of the perforated disease segment is necessary when possible. In contradistinction to previous literature, free perforation in Crohn's disease is not as unusual as heretofore believed. PMID- 3510529 TI - Urinary kallikrein excretion in chronic liver disease and effect of indomethacin. AB - Urinary kallikrein excretion was found as compared with 22 normal subjects (0.88 +/- 0.05 mumol/min/day) to be significantly reduced in 15 cirrhotics without ascites (0.42 +/- 0.04; p less than 0.01) and in 23 cirrhotics with ascites (0.15 +/- 0.02; p less than 0.01), and further, showed a significant difference between the two groups (p less than 0.01), but did not significantly change in 14 patients with chronic active hepatitis. Urinary kallikrein excretion in cirrhotics showed a positive correlation with serum albumin, indocyanine green disappearance rate, cholinesterase, and prothrombin, and an inverse correlation with bilirubin. After indomethacin administration to 13 cirrhotics with ascites, not only plasma renin activity and plasma aldosterone decreased significantly (p less than 0.01), but urinary kallikrein excretion also showed a small but statistically significant decrease (p less than 0.05). These results suggest that urinary kallikrein excretion decreases almost parallel to the severity of liver damage and is mediated via prostaglandins or the renin-angiotensin-aldosterone system, which may be involved in the reduction of renal blood flow in patients with liver cirrhosis. PMID- 3510530 TI - The Conrad L. Pirani festschrift. PMID- 3510531 TI - Adriamycin-induced glomerulosclerosis in the rat. AB - To evaluate long-term effect of sustained proteinuria induced by a single injection of adriamycin (ADR) on occurrence of focal segmental glomerulosclerosis (FSG), we treated 50 Sprague-Dawley (SD) rats, weighing 250 g with 5 mg/kg body weight of ADR. After six months of heavy proteinuria, 40% of ADR-treated rats did not develop FSG. In the remaining 60% of animals, a mild FSG was observed associated with the presence of large tubular casts and interstitial inflammation. Glomerulosclerosis was never observed in absence of tubulointerstitial lesions. Nine months after ADR, all rats exhibited FSG with renal insufficiency but the severest changes were restricted to the tubulointerstitial level. Our results indicate that chronic proteinuria induced by ADR is a relatively good model of glomerular sclerosis, however, the cause of glomerular sclerosis is probably different from that operating in other experimental models of FSG. Both sclerotic changes and progression of disease seem to be dependent on formation of tubular casts with consequent interstitial changes. This study raises the question of the relative role of tubulointerstitial changes in the subsequent development of FSG. PMID- 3510532 TI - Nephrotic syndrome, progressive irreversible renal failure, and glomerular "collapse": a new clinicopathologic entity? AB - Six patients are reported with nephrotic syndrome and relatively rapid progression to irreversible renal failure. The renal histologic findings are unusual. The most striking changes are collapse of glomerular capillary loops, such as might occur with glomerular hypoperfusion; significant tubulointerstitial damage is also seen. These patients appear to have a clinicopathologic entity hitherto unreported. Its differentiation from other causes of progressive glomerular damage, and particularly from focal and segmental glomerulosclerosis, is discussed. PMID- 3510533 TI - Glomerular changes in renal allografts. AB - The renal allograft is host to a number of injuries and all its structural components are prone to damage. The glomeruli respond to these varied stimuli in many ways. The fibrinoid necrosis, thrombosis, and polymorphonuclear cell exudation that accompany hyperacute or accelerated rejection are well-recognized. The transplant may also be afflicted by forms of de novo or recurrent glomerulonephritis. Apart from these, there are other patterns of reaction. The mesangium is often the site of a rapidly reversible change; it expands readily. Arterial changes initiate ischemia and collapse of glomerular capillary spaces. Glomerulitis accompanies cases of acute rejection, but when seen as a predominant feature, usually antedates chronic rejection. Heavy proteinuria may be associated with profound alterations in the peripheral capillary basal lamina including irregular thickening, interposition of mesangial cell cytoplasm, and lamellation. Allografts with these glomerular changes eventually fail. PMID- 3510534 TI - Scanning electron microscopy of immune complexes in membranous glomerulopathy. AB - Scanning electron microscopy (SEM) was done on seven cases of membranous glomerulopathy (MG) in order to describe the morphologic appearance of the immune complexes that are deposited in the glomerular basement membranes, as previous SEM studies on the human glomerulus primarily focused on the changes in the podocytes. The diagnosis of membranous glomerulopathy of idiopathic form or secondary to systemic lupus erythematosus was confirmed by conventional light and transmission electron microscopy and immunofluorescent microscopy. By SEM, the external surfaces of the basement membranes were covered by immune complexes that appeared as a network of "lumpy-bumpy" deposits. They were arranged in anastomosing cords imparting a "swiss cheese" pattern. The immune-complex nature of these anastomosing cords of deposits is confirmed by our preliminary immunoscanning electron-microscopic study. The exact mechanism for immune complexes to be localized on the external surface of the basement membrane remains to be elucidated. PMID- 3510535 TI - Nephropathy of familial lecithin-cholesterol acyltransferase deficiency: report of a case. AB - A ninth Japanese patient afflicted with lecithin-cholesterol acyltransferase (LCAT) deficiency is described with emphasis on renal pathology. The most striking feature is massive deposition of lipid material in the glomeruli, particularly in the glomerular basement membrane (GBM) and in the mesangial region. The glomerular changes appear to be similar to that seen in some cases with cirrhosis of the liver. Lipid material contains a large amount of apolipoprotein-B detected by immunohistology. In two renal biopsies, taken three years apart, renal pathology is essentially the same and glomerular pathology is most characteristic. It is suggested that lipid deposition in glomeruli in this patient is rather slow. Family study of the present case reveals consanguinous marriages in the previous two generations suggesting the exaggerated gene expression of LCAT deficiency in this family. PMID- 3510536 TI - Progressive glomerular sclerosis in experimental antiglomerular basement membrane glomerulonephritis. AB - A model of chronic progressive glomerular sclerosis in experimental antiglomerular basement membrane (anti-GBM) glomerulonephritis was developed in Wistar rats. Wistar rats given the accelerated form of anti-GBM anti-body glomerulonephritis initially developed significant proteinuria and renal insufficiency associated primarily with a decrease in glomerular filtration rate (GFR) with normal renal clearance of para-aminohippuric acid and with markedly reduced filtration fraction. The glomerular functional abnormalities were associated with marked glomerular hypercellularity due to leukocytic infiltration as well as proliferation of intrinsic glomerular cells with crescent formation. Late in the course of the disease, by day 21, GFR had fallen further, associated with a parallel decrease in the clearance of para-aminohippuric acid and a normal filtration fraction. At this stage, glomerular hypercellularity had diminished and was replaced by glomerular sclerosis. The model appears to be a reproducible form of chronic glomerulosclerosis and demonstrates that the chronic phase of glomerular basement membrane (GBM) glomerulonephritis is distinctly different from that of the acute phase. It provides a controllable setting to study the glomerular sclerotic process independent of the initial inflammatory changes. PMID- 3510537 TI - Tricuspid valve Candida endocarditis. Successful treatment with valve-sparing debridement and antifungal chemotherapy in a multiorgan transplant recipient. AB - Tricuspid valve Candida albicans endocarditis developed in a multiple-organ transplant recipient six months after successful treatment of Candida peritonitis. She has had no recurrence or valvular incompetence two years after valve-sparing debridement of the vegetation and prolonged therapy with amphotericin B. This is the second report of long-term success following valve sparing debridement for tricuspid valve Candida endocarditis. In selected patients without annular involvement or gross valve destruction, excision of the fungal vegetation may allow for long-term cure and a competent valve. PMID- 3510538 TI - Nonsurgical treatment of splenic hemorrhage in an adult with infectious mononucleosis. Case report and review. AB - A case is presented of a young adult with splenic hemorrhage secondary to infectious mononucleosis. The patient was managed successfully without surgery and has done well over the long term with progressive resolution of the hematoma on ultrasound. The implications of this case for the management of patients with this syndrome are discussed. PMID- 3510539 TI - Phenytoin and acute mountain sickness on Mount Everest. AB - Twenty-one climbers who were members of the American Ultima Thule Everest Expedition participated in a double-blind, randomized clinical trial of phenytoin prophylaxis for acute mountain sickness during the approach to the northeast ridge of Mount Everest. The study was carried out between Beijing and base camp at 16,800 feet. Time spent ascending from Beijing to base camp averaged 13 days. High-altitude symptom questionnaires were filled out beginning in Lhasa at 11,800 feet and in Xigatse at 12,000 feet, in Xegar at 14,000 feet, and at base camp. Computer analysis of the questionnaire answers performed by an impartial analyst revealed that climbers who took phenytoin were less likely to have headaches at base camp. No other statistically significant differences were observed, but the power of the sample size was low. PMID- 3510540 TI - Treatment of acute asthma. Is combination therapy with sympathomimetics and methylxanthines indicated? AB - The role of bronchodilator regimens combining a sympathomimetic and a methylxanthine in the treatment of acute exacerbations of asthma remains controversial. This report describes the outcome of 157 emergency room visits for asthma in which patients were randomly assigned to single-drug therapy with intravenous aminophylline, subcutaneous epinephrine, or inhaled isoproterenol or to one of three regimens combining a sympathomimetic and a methylxanthine. The increase in one-second forced expiratory volume after one hour of treatment with the two-drug combinations (0.79 +/- 0.07 liter) was significantly greater than for epinephrine alone (0.57 +/- 0.08 liter; p less than 0.05) but did not differ significantly from that occurring with therapy with isoproterenol alone (0.72 +/- 0.09 liter; p = NS). This disparity reflects the greater bronchodilation effected by isoproterenol as a single agent than by epinephrine, in the dosing schedules and routes of administration chosen. Among patients presenting with severe airflow obstruction (one-second forced expiratory volume 35 percent or less of normal), the bronchodilator response to isoproterenol alone was 0.88 +/- 0.14 liter versus 0.51 +/- 0.11 for epinephrine alone (p less than 0.05). It is concluded that the observed benefit derived from use of combination therapy depends on the dosage and potency of the particular sympathomimetic to which a methylxanthine is added, and on the severity of the airflow obstruction at presentation. PMID- 3510541 TI - Glomerular lesions in lymphomas and leukemias. AB - Renal lesions in lymphoid malignancies are rare, with most lesions observed in association with Hodgkin's disease. In two large series of patients with Hodgkin's disease, only 0.4 percent had minimal-change lesion whereas 0.1 percent had amyloidosis. The non-Hodgkin's lymphomas and leukemias comprise large and heterogeneous groups with equally diverse renal lesions. As in Hodgkin's disease, the most frequent lesion is minimal-change nephrotic syndrome. Also recognized are rare reports of renal disease associated with the atypical lymphoid proliferations of angioimmunoblastic lymphadenopathy, giant lymph node hyperplasia syndrome, and acquired immune deficiency syndrome. Broad generalizations regarding the pathogenesis of renal disease in these syndromes are difficult, partly due to the paucity and sporadic reporting of such cases. Mechanisms proposed to explain the renal pathologic findings include autologous nontumor antigens, tumor antigens, fetal antigen expression, immune complex deposition, viral antigens, and disordered T cell function. PMID- 3510542 TI - Chronic eosinophilic pneumonia. Evidence for eosinophil degranulation and release of major basic protein. AB - A patient with chronic eosinophilic pneumonia associated with ulcerative colitis and asthma is described. Exacerbations and remissions of these disorders paralleled each other. Pleural fluid and lung tissue contained high levels of eosinophil granule major basic protein, a substance with toxic effects on cells and tissues. The results indicate that eosinophils degranulate in the lung in eosinophilic pneumonia and point to the possibility that granule constituents damage lung tissue in the course of the disease. PMID- 3510543 TI - Calcium blocker diltiazem inhibits platelet activation and stimulates vascular prostacyclin synthesis. AB - The effects of slow channel calcium blocker diltiazem on platelet aggregation and on the generation of vasoactive prostanoids, thromboxane A2 and prostacyclin were examined. Diltiazem, in therapeutic concentrations (50-200 ng/ml), inhibited human platelet activation induced by cumulative subthreshold concentrations of calcium ionophore A 23187 plus ADP or epinephrine. However, platelet activation induced by cumulative effects of ADP plus epinephrine was inhibited by diltiazem only in very high concentrations (greater than 5 micrograms/ml). These data indicate that platelet aggregation mediated only through calcium flux is inhibited by diltiazem in therapeutic concentrations. In other experiments, diltiazem significantly potentiated prostacyclin release from human umbilical veins. These effects of diltiazem may contribute to efficacy of this compound in ischemic heart disease. PMID- 3510544 TI - Oncogenes in retroviruses, malignancy, and normal tissues. AB - Oncogenes are genes with a proven cancer association that appear to function primarily in the regulation of cellular proliferation and differentiation. The preliminary work leading to their discovery, their association with retroviruses, the retrovirus life cycle, and the use of retroviruses to find and characterize oncogenes is discussed in detail. Chromosomal abnormalities are discussed using Burkitt's lymphoma and the myc oncogene as prototypes. Finally, the normal (nonmalignant) functioning of oncogenes is discussed in terms of embryogenesis and hepatic regeneration. PMID- 3510545 TI - Comparative immediate hemodynamic and hormonal effects of amrinone and captopril in patients with severe chronic heart failure. AB - To compare the responses to oral inotropic and vasodilator drugs, maximally effective doses of amrinone (300 mg over 3 hours) and captopril (25 mg orally) were administered to 21 patients with severe chronic heart failure, who had not received either agent previously. Despite similar decreases in systemic vascular resistance with both drugs, amrinone produced greater increases in cardiac index (+ 0.56 vs. + 0.41/min/m2, p less than 0.05) and smaller decreases in mean arterial pressure (-11.1 vs. -15.2 mm Hg, p less than 0.05) than did captopril; three patients became symptomatically hypotensive with captopril, but none did so after amrinone. These differences were due to a significant decrease in heart rate with captopril (-6.3 beats/min, p less than 0.01), whereas heart rate increased with amrinone (+ 4.3 beats/min, p less than 0.01); the increases in stroke volume index with both drugs were similar. Despite similar decreases in left ventricular filling pressures, the decrease in mean right atrial pressure with amrinone was greater than with captopril (-5.6 vs. -3.2 mm Hg, p less than 0.01). This difference was the result of the greater decrease in pulmonary arteriolar resistance, and hence in right ventricular afterload, with amrinone than with captopril, (-33% vs. -16%, respectively), p less than 0.01. Despite these superior hemodynamic responses to amrinone, when patients received sequential long-term treatment with both drugs during the follow-up period, only 12% of patients benefitted during therapy with amrinone, whereas 64% improved clinically with captopril.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3510546 TI - Eccentric corneal grafts. PMID- 3510547 TI - A simple technique to tighten loose sutures during strabismus surgery. PMID- 3510548 TI - Clinicopathologic studies of keratoplasty eyes obtained post mortem. AB - Thirty eyes of 25 patients who had undergone penetrating keratoplasties were examined post mortem. Available corneal buttons and donor rims were evaluated for irregularities of the trephine margins. Of 26 eyes with clear grafts, visual acuity had been 20/80 or better in 13, worse than 20/100 in six, and was unknown in seven. In four eyes with cloudy grafts, visual acuity had been 20/400 or worse. Twenty-three eyes had had one keratoplasty and seven eyes had had two or three transplants. Microscopic examination disclosed frequent overriding wound edges with Bowman's layer incarceration in the wound in 11 eyes and Descemet's membrane incarceration in 22 eyes. Wound abnormalities were correlated with the presence and degree of astigmatism. A retrocorneal fibrous tissue layer was localized at the wound in 16 eyes, extended peripherally in 11, and extended centrally in one. Iris and vitreous incarceration in the wound occurred in 14 and eight eyes, respectively. Histopathologic features contributing to visual loss included cystoid macular edema (three eyes), senile macular degeneration (four eyes), and preretinal membranes (four eyes). PMID- 3510549 TI - Ocular concentration of gentamicin after penetrating keratoplasty. AB - To determine if the storage of corneal tissue in a preserving medium containing gentamicin results in therapeutically effective concentrations of antibiotics in the ocular tissues after penetrating keratoplasty, we stored rabbit donor corneas in McCarey-Kaufman medium containing 100 micrograms of gentamicin per milliliter for three days before surgery. Gentamicin concentrations were determined by agar diffusion bioassay in ocular tissues one, two, three, four, and six hours after surgery. On the average, the concentration of antibiotic one hour after surgery was 8.8 micrograms of gentamicin per gram of donor cornea, 6.25 micrograms of gentamicin per milliliter of iris, and 2.8 micrograms of gentamicin per milliliter of aqueous humor. The minimal inhibitory concentration for sensitive strains of Pseudomonas aeruginosa is 1.6 micrograms of gentamicin per milliliter of medium. Thus, gentamicin levels sufficient to inhibit the growth of sensitive bacteria were still present in the donor cornea three hours and in the iris two hours after penetrating keratoplasty. By six hours, only trace amounts of gentamicin were found in the donor cornea and aqueous humor. The presence of gentamicin in ocular tissues after penetrating keratoplasty appears to prolong the antibacterial effect of the preserving medium, and to provide tissue concentrations of antibiotic effective against intraoperative contamination. PMID- 3510550 TI - Electrothermal debracketing. Part I. An in vitro study. AB - The contemporary techniques of bracket removal require shearing or compression forces. The force necessary to separate the bracket from the tooth is sufficient to cause deformation of the bracket and, in some cases, is capable of damaging the tooth. An alternative to conventional bracket removal is electrothermic debracketing (ETD). ETD is the technique of removing bonded brackets from enamel surfaces with a cordless battery device that generates heat. The heat is transferred to the bracket by a blade that is placed in the bracket slot. The bracket is firmly held by a thumb-activated lock-on arm of the ETD unit. When the heat applied to the bracket is transferred to and deforms the adhesive-bracket interface, the bracket can be gently lifted from the enamel surface without distortion of the bracket or excessive force to the underlying enamel. Part I of this study measured the in vitro rise in temperature at the pulpal wall when ETD is used. These data are correlated with established primate threshold temperatures that have been reported to cause pulpal pathosis. All ETD procedures in the sample elicited pulpal wall temperatures that were significantly below the primate baseline. When water spray was used in conjunction with ETD, the mean ultimate increase in pulpal wall temperature was less than 1 degree C. PMID- 3510551 TI - The American Board of Orthodontics--then and now. PMID- 3510552 TI - Direct effects of E coli endotoxin on structure and permeability of pulmonary endothelial monolayers and the endothelial layer of intimal explants. AB - The direct structural, metabolic, and physiologic effects of Escherichia coli endotoxin on bovine pulmonary endothelial monolayers and on the intact endothelial layer of bovine pulmonary artery intimal explants were examined. Endothelial monolayers exposed to E coli endotoxin (0.001, 0.01, 0.1, 1.0, and 10 micrograms/ml) for 24 hours in the absence of bovine fetal calf serum (FCS) showed a dose-dependent response, as demonstrated by number of pyknotic cells and lactate dehydrogenase release that was enhanced by addition of FCS. Prostacyclin production was increased only in the presence of FCS. Endotoxin also caused an increase in permeability. Endothelial cells on nitrocellulose filters placed in chemotaxis chambers with radioactive tracers in the upper well showed a significant 25% increase in rate of equilibration (counts in lower well/counts in upper well) of 3H-water after 2 and 3 hours' incubation with endotoxin (3 hours' endotoxin = 0.89 +/- 0.03 m +/- SE; no endotoxin = 0.69 +/- 0.05) and a 40% increase in equilibration of 125I-albumin at three hours (3 hours' endotoxin = 0.40 +/- 0.03; no endotoxin = 0.27 +/- 0.02). An increase in hydraulic conductance was also seen at 1 hour. Electron microscopy of the endothelial layer of intimal explants showed dilatations in the intercellular junctions and cellular changes representing contraction--increased prominence of cytoplasmic filaments, nuclear crenation, and cytoplasmic protrusions--at 30 and 60 minutes. From 2 hours evidence of cell death was found. Thus, endotoxin causes structural and metabolic changes in pulmonary endothelial cells and an increase in permeability of the endothelial layer. The injury occurs in the absence of FCS but is enhanced by its addition. PMID- 3510553 TI - Platelet interaction with a pancreatic ascites tumor. AB - The mechanism leading to the hypercoagulability in pancreatic carcinoma is unclear. The rapid progress of the disease after its diagnosis and the inaccessibility of the tumor make studies on the mechanism difficult in man. With the successful induction of this malignancy and conversion of it into an ascites tumor in Syrian golden hamsters, interactions between isolated tumor cells and individual hemostatic components can be investigated. In this paper, studies on in vitro tumor cell-platelet interactions and some hemostatic changes in hamsters following intravenous injection of isolated tumor cells are described. Freshly isolated tumor cells and tumor-cell sonicates, but not those that had been kept at 4 or -70 C overnight, induced comparable aggregation of human platelets in both heparinized and citrated platelet-rich plasmas (hPRP and cPRP). The aggregation was not followed by clot formation; a specific synthetic thrombin inhibitor had no effect on the aggregation in either hPRP or cPRP. Washed and gel filtered platelets, even in the presence of 5% of citrated or heparinized platelet-poor plasma (cPPP or hPPP) failed to be aggregated by tumor cells. Tumor cell-induced platelet aggregation was accompanied by thromboxane formation and serotonin release, both of which were several orders of magnitude greater in cPPP than in hPRP. Aspirin, apyrase, and PGI2 all inhibited tumor-cell-induced platelet aggregation in both PRPs, but the inhibition by aspirin was minimal. Intravenous infusion of isolated tumor cells into normal hamsters resulted in a 50% reduction of platelet count and a 20-30% decline in antithrombin III and fibrinogen. Platelet aggregates and fibrin strands were seen in the lungs of these animals. PMID- 3510555 TI - Stress protein systems of mammalian cells. AB - Living organisms are known to react to a heat stress by the selective induction in the synthesis of several polypeptides. In this review we list the major stress proteins of mammalian cells that are induced by heat shock and other environments and categorize these proteins into specific subgroups: the major heat shock proteins, the glucose-regulated proteins, and the low-molecular-weight heat shock proteins. Characteristics of the localization and expression of proteins in each of these subgroups are presented. Specifically, the nuclear/nucleolar locale of certain of the major heat shock proteins is considered with respect to their association with RNA and the recovery of cells after a heat exposure. The induction of these major heat shock proteins and the repression of the glucose regulated proteins as a result of reoxygenation of anoxic cells or by the addition of glucose to glucose-deprived cultures is described. Changes in the expression of these protein systems during embryogenesis and differentiation in mammalian and nonmammalian systems is summarized, and the protective role that some of these proteins appear to play in protecting the animal against the lethal effects of a severe heat treatment and against teratogenesis is critically examined. PMID- 3510554 TI - Distribution of basement membrane antigens in glomeruli of mice with autoimmune glomerulonephritis. AB - Glomerulonephritis was induced in mice by the repeated injection of human glomeruli or purified glomerular basement membrane. The glomerular basement membranes of nephritic animals were observed to develop subepithelial extensions, "spikes." Although normally Type IV collagen is found throughout the full thickness of basement membranes, the "spikes" reacted with antibodies to laminin but not with antibodies to Type IV collagen. It is proposed that in murine autoimmune glomerulonephritis, the visceral epithelial cells produce an excess of laminin. PMID- 3510556 TI - Electrophysiological characterization of single pregnant rat myometrial cells in short-term primary culture. AB - Smooth muscle cells were isolated from the longitudinal layer of pregnant rat myometrium (18-19 days) and studied either freshly dissociated or during short term primary culture (until 30 h) using intracellular microelectrode techniques and direct microscopic observation. The isolated myometrial cells excluded trypan blue vital stain and could repetitively contract in response to various stimuli. Electrophysiological studies at 37 degrees C showed normal resting potential ( 54.5 +/- 7.5 mV, n = 71). Action potentials with overshoot (+7.8 +/- 4.6 mV, n = 71) could be elicited by intracellular stimulation. Moreover, the membrane potential was largely dependent on the external K+ concentration. The action potential was suppressed in a Ca2+-free solution [with 0.1 mM ethyleneglycol bis(beta-aminoethylether)-N,N'-tetraacetic acid], and the overshoot amplitude was clearly Ca2+ dependent. The action potential was inhibited by Mn2+ ions (1 mM), Co2+ ions (1 mM), and D 600 (1 microM) but was unaffected by tetrodotoxin (2 microM) and external Na+ removal. Tetraethylammonium chloride (TEA, 10 mM) and 4 aminopyridine (4-AP, 10 mM) increased both overshoot amplitude and duration of the electrical responses. When the cell surface area was measured with light microscopy, the mean specific membrane resistance was 14.8 +/- 4.6 k omega . cm2 (n = 14), and the mean specific membrane capacitance was 2.3 +/- 0.7 microF/cm2 (n = 14). Outward-going rectification was consistently observed in all cells examined. This was either inhibited by TEA and 4-AP (10 mM each) or reduced in the presence of 1 mM Mn2+.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3510557 TI - Rate-limiting steps for insulin-mediated glucose uptake into perfused rat hindlimb. AB - To determine the glucose and insulin concentrations at which glucose transport is rate limiting for insulin-mediated glucose uptake and metabolism in muscle, glucose clearance was determined in the presence of glucose concentrations ranging from trace to 20 mM and in the absence or presence of insulin in the perfused rat hindlimb. In the absence of insulin and at submaximally stimulating insulin concentrations glucose clearance was constant up to 7 mM glucose and then decreased as the glucose concentration was raised. At maximally stimulating insulin concentrations glucose clearance was constant up to 2 mM glucose and then decreased. The decrease in glucose clearance between 2 and 7 mM glucose in the presence of maximally stimulating insulin concentrations could not be accounted for by competition among glucose molecules for the glucose transport system. The results suggest that at physiological glucose concentrations in the presence of maximally stimulating insulin concentrations the rate-limiting step for insulin mediated glucose uptake and metabolism in muscle shifts from glucose transport to some step beyond transport. PMID- 3510558 TI - Insulin dose-dependent reductions in plasma amino acids in man. AB - The quantitative relationship between insulin and plasma amino acid (AA) levels were characterized in five healthy young men during euglycemic insulin infusions (6, 10, 30, and 400 mU . m-2 . min-1). The endogenous production and disposal of glucose were determined for the 6 mU . m-2 . min-1 insulin infusion using 6,6 dideuteroglucose. While 8 of 10 AA decreased in a dose-responsive pattern to increasing levels of insulin, alanine and glycine concentrations remained unaffected. For isoleucine and proline, the insulin levels required for a half maximal response were less than for glucose disposal (P less than 0.05), but, for all other insulin-influenced AA, the levels required were similar to those for glucose disposal. These studies indicate that insulin sensitivity of AA is similar to that of glucose disposal and that AA responses to insulin exhibit a physiologically relevant, dose-response relationship. PMID- 3510559 TI - Potentiation of hemorrhage-evoked catecholamine release by prior blood loss in cats. AB - The effect of prior blood loss on the plasma catecholamine response to acute hemorrhage (H) was assessed in alpha-chloralose-urethane anesthetized cats. Animals sustained an initial H period of 0 (samples only), 10, or 20% H total blood volume. Ninety minutes after reinfusion of the shed blood, all animals sustained a rapid 20% H. The catecholamine and arterial pressure responses to this second 20% H were assessed every 2 min for 20-min duration. Plasma norepinephrine increased modestly in the 0/20% group (+0.63 +/- 0.13 ng/ml) and 10/20% group (+0.66 +/- 0.07 ng/ml), whereas the 20/20% group showed a much larger (P less than 0.01) mean increase of 3.58 +/- 1.16 ng/ml. Plasma epinephrine did not increase after 0/20% (+0.05 +/- 0.02 ng/ml), increased slightly after 10/20% H (+0.10 +/- 0.05 ng/ml), and demonstrated a large significant increase after 20/20% H (+0.48 +/- 0.18 ng/ml). The differential effect of 20% H on catecholamine release, depending on the magnitude of prior blood loss, was not the result of altered mean arterial or pulse pressure responses to H. Correlation analyses revealed that the mean increases in epinephrine and norepinephrine during the post-H sampling period were well correlated in each animal (r = 0.864, P less than 0.001). The data indicate that the priming effect of prior blood loss on H evoked catecholamine release: requires an initial blood loss of 20% of total blood volume; occurs rapidly, as it is seen by 90 min after the initial H period; and affects epinephrine and norepinephrine similarly. We conclude that the immediate past secretory history of the sympathoadrenal system affects its responsiveness to subsequent blood loss. PMID- 3510560 TI - Dog inactive renin: biochemical characterization and secretion into renal plasma and lymph. AB - It has been suggested that the dog is a useful model for studies of inactive renin (IR). However, the nature and origin of the trypsin-activated angiotensin forming activity in dog plasma have not been fully defined. We characterized dog IR using renin-specific antibody, immunoaffinity, and Affigel blue chromatography. Activated IR resembles renal and plasma active renin in biochemical and immunological properties. IR was detected in renal lymph, arterial and venous plasma, as well as renal extracts. At basal state, there was a significant renal venous-arterial gradient of IR indicating secretion from the kidney. Furthermore, a sixfold higher concentration of IR was demonstrated in renal lymph than in plasma. Our data provides evidence for two possible routes of IR secretion from the kidney and supports the contention that the dog is a good model for studies of IR secretion and regulation. PMID- 3510561 TI - Pancreaticobiliary factors in the modulation of small intestinal enterokinase in the rat. AB - Chronic pancreaticobiliary diversion was employed to study the modulation of enterokinase in the small intestine of adult rats. Diversion resulted in apparent trophic changes of the proximal bypassed portion of the intestinal mucosa. An almost complete loss of mucosal enterokinase activity in the proximal duodenum but no increase of enterokinase in the segments distal to reentry of the common duct was found in the pancreaticobiliary-diverted rats. The effect on the enterokinase activity in the proximal segment was specific in that no other brush border enzymes measured in that segment were decreased. The decrease in enterokinase was partially prevented by dietary supplementation with pancreatic trypsinogen and completely avoided with the addition of a combination of bile acids and trypsinogen. Supplementation with bile acid alone did not preserve the enterokinase levels in the bypassed rats. The results suggested that trypsinogen is the primary factor responsible for modulating enterokinase levels in the proximal small intestine, with bile acids acting as a modifier. PMID- 3510562 TI - Structural-functional relationships along the distal nephron. AB - The distal tubule, which includes the thick ascending limb (TAL), the macula densa, and the distal convoluted tubule (DCT), and the collecting duct are structurally heterogeneous, thus reflecting the functional heterogeneity that is also present. As the TAL ascends from medulla to cortex, the surface area of the apical plasma membrane increases while that of the basolateral membrane decreases. The structure of the DCT resembles that of the medullary TAL. An excellent correlation exists between structure, Na-K-ATPase activity, and NaCl reabsorptive capacity in the distal tubule. The collecting duct is subdivided into the initial collecting tubule (ICT), and cortical (CCD), outer medullary (OMCD), and inner medullary (IMCD) collecting ducts. Between the distal tubule and the collecting duct is a transition region termed the connecting segment or connecting tubule (CNT). Considerable structural heterogeneity exists along the collecting duct within the two major cell populations, the intercalated cells and the principal cells. In the CNT, the ICT, and the CCD, potassium loading and mineralocorticoids stimulate Na-K-ATPase activity and cause proliferation of the basolateral membrane of CNT cells and principal cells, thus identifying the cells responsible for mineralocorticoid-stimulated potassium secretion in these regions. Finally, at least two morphologically distinct populations of intercalated cells exist, types A and B. In the rat, type A predominates in the CNT and the OMCD and is believed to be responsible for H+ secretion, at least in the OMCD. Type B predominates in the CCD, where it may be involved in bicarbonate secretion. PMID- 3510563 TI - Effects of ouabain on autoregulation of renal blood flow in dogs. AB - Effects of ouabain on the autoregulation of renal blood flow (RBF) and renin release were examined in filtering and nonfiltering kidneys of anesthetized dogs. Autoregulation of RBF was observed in both kidneys; however, autoregulation in the nonfiltering kidney was comparatively less efficient. These findings indicate that both the myogenic mechanism via a sensor element in the afferent arteriole, a so-called baroreceptor, and the tubuloglomerular feedback mechanism via the macula densa are essential for complete autoregulation. In both the control and nonfiltering kidney, intrarenal arterial infusion of ouabain abolished the autoregulation of RBF and glomerular filtration rate, with no change in the renal vascular sensitivity to vasoactive substances or in renin release induced by pressure reduction. Since various vasoactive drugs elicited a normal vascular response, it appears that the site of action of ouabain was not the vascular contractile elements; at least, an impairment of autoregulation during ouabain infusion was apparently not due to a defect in these elements. These results suggest the possible existence of another mediator, a sensor element in the afferent arteriole that is affected by ouabain. Ouabain may abolish the autoregulation of RBF and renin release via a modification of this baroreceptor in the afferent arteriole as well as through inhibition of the macula densa. PMID- 3510564 TI - Sites of insulin and glucagon metabolism in the rabbit nephron. AB - Uptake and degradation of peptide hormones have been demonstrated in proximal convoluted tubules (PCT), but the contribution of other regions of the nephron to renal hormone metabolism is unknown. In the present study we used micromethods to determine for the first time the degradation of radiolabeled insulin and glucagon by each segment of the rabbit nephron and examined some characteristics of this process in proximal convoluted and cortical collecting tubules (CCT). Degradation of insulin (8-10 fmol . cm-1 . h-1) and glucagon (13-15 fmol . cm-1 . h-1) was maximal in proximal convoluted and straight tubules, but occurred to a substantial degree (approximately 25-30% of PCT) in all other segments of the nephron except the thin descending limb. In PCT degradation of both hormones was maximal at physiological pH, and competition studies suggested that it is brought about by both specific and nonspecific proteases. Most of the degrading activity (insulin, 86%; glucagon, 73%) was in the cytosol or could be eluted off the cell membrane or organelles. In the CCT, a representative segment of the distal nephron, the characteristics of insulin degradation were similar to those observed in the PCT, whereas glucagon degradation appeared to be due chiefly to nonspecific proteases. In conclusion, the metabolism of insulin and glucagon by isolated rabbit tubules occurs chiefly in the proximal convoluted and straight tubules, but up to one-third of the degrading capacity of the proximal nephron is also present in distal nephron segments.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3510565 TI - Glomerular blood flow after single nephron obstruction in the rat kidney. AB - This study examined the effects of kidney tubule lumen obstruction on glomerular blood flow (GBF) in anesthetized rats. GBF was estimated using microspheres having 9 micron diameter and averaged 239 +/- 10 nl/min in normal nephrons of 41 control rats. Tubule blockade with either paraffin wax or castor oil produced identical results. GBF after 1-2 h of obstruction did not differ from normal. After 1 day, GBF averaged two-thirds of normal, and after 1 wk GBF averaged one third of normal. The hemodynamic changes produced by obstruction for 1 wk were diminished by chronic administration of high doses of the converting enzyme inhibitor captopril or acute administration of the angiotensin antagonist saralasin. The results suggest that angiotensin contributes to the vasoconstriction produced by prolonged obstruction. Nephrons blocked with castor oil contained oil 1 wk later, had a GBF of 88 +/- 24 nl/min, and were atrophied. We conclude that chronic single nephron obstruction produces progressive vasoconstriction, that this response is in part angiotensin mediated, and that the end result is nephron atrophy. PMID- 3510566 TI - Role of the vasoconstrictor and antidiuretic activities of vasopressin in inhibition of renin secretion in conscious dogs. AB - The nature of the activity of vasopressin that is responsible for the inhibition of renin secretion was studied in normally hydrated conscious dogs using intravenous infusions of vasopressin and analogues of vasopressin with selective antidiuretic and vasoconstrictor activity. Vasopressin (1.0 ng . kg-1 . min-1) increased mean arterial pressure (MAP) from 106 +/- 2 to 115 +/- 3 mmHg (P less than 0.05) and decreased heart rate (HR) from 81 +/- 6 to 56 +/- 5 beats/min (P less than 0.001). Plasma renin activity (PRA) decreased from 4.4 +/- 1.1 to 2.4 +/- 0.8 ng . ml-1 . 3 h-1 (P less than 0.05). A specific antagonist of the vasoconstrictor activity of vasopressin, d(CH2)5MeTyrAVP (10 micrograms/kg), completely blocked the cardiovascular and renin responses to vasopressin. A selective vasoconstrictor agonist, 2-phenylalanine-8-ornithine oxytocin (1.0 ng . kg-1 . min-1), increased MAP from 112 +/- 4 to 128 +/- 6 mmHg (P less than 0.001) and decreased HR from 69 +/- 3 to 47 +/- 4 beats/min (P less than 0.001). PRA decreased from 5.5 +/- 1.1 to 2.7 +/- 0.2 ng . ml-1 X 3 h-1 (P less than 0.001). In contrast, a selective antidiuretic agonist, 1-deamino-8-D-arginine vasopressin (1.0 ng . kg-1 . min-1) did not alter PRA, MAP, or HR. These results demonstrate that the acute inhibition of renin secretion by vasopressin in normally hydrated conscious dogs is due to vasoconstrictor rather than antidiuretic activity. PMID- 3510567 TI - Reversibility of diabetic cardiomyopathy with insulin in rabbits. AB - Diabetes mellitus causes a cardiomyopathy in human subjects, independent of atherosclerotic coronary artery disease. Ventricular papillary muscle function studies in chronically diabetic rats and rabbits have shown diminished contractility and a prolonged duration of contraction. In rats there was complete reversibility of these changes with insulin therapy. However, the effects of insulin on the myocardial mechanics of diabetic rabbits have not been studied. Therefore, rabbits diabetic for 3-4 mo (after alloxan injection) were treated with PZI insulin for 3-4 mo, and the mechanical performance of their right ventricular papillary muscles was compared with that of untreated diabetic animals and age-matched controls. Insulin therapy normalized serum glucose concentration. All abnormalities in papillary muscle function were completely reversed in insulin-treated animals. Norepinephrine (NE) dose responses were also evaluated in muscles from all groups. There were no differences in the positive inotropic effects of NE between groups. However, the data suggested, in diabetic animals a blunted response of peak relaxation rate to NE; this abnormality was reversed in muscles from treated animals. These findings indicate that previous work on diabetic rats can be extended to diabetic rabbits and suggest that chronic insulin therapy completely reverses the contractile alterations in hearts from these diabetic animals. PMID- 3510568 TI - Multiple tracer dilution estimates of D- and 2-deoxy-D-glucose uptake by the heart. AB - Permeability-surface area products of the capillary wall, PSc, and the myocyte sarcolemma, PSpc, for D-glucose and 2-deoxy-D-glucose were estimated via the multiple indicator-dilution technique in isolated blood-perfused dog and Tyrode perfused rabbit hearts. Aortic bolus injections contained 131I-albumin (intravascular reference), two of three glucoses: L-glucose (an extracellular reference solute), D-glucose, and 2-deoxy-D-glucose. Outflow dilution curves were sampled for 1-2.5 min without recirculation. The long duration sampling allowed accurate evaluation of PSpc by fitting the dilution curves with a multiregional axially distributed capillary-interstitial fluid-cell model accounting for the heterogeneity of regional flows (measured using microspheres and total heart sectioning). With average blood flow of 1.3 ml . g-1 . min-1, in the dog hearts the PSc for D-glucose was 0.72 +/- 0.17 ml . g-1 . min-1 (mean +/- SD; n = 11), and PSpc was 0.57 +/- 0.15 ml . g-1 . min-1. In the rabbit hearts with perfusate flow of 2.0 ml . g-1 . min-1 (n = 6), PSc was 1.2 +/- 0.1 and PSpc was 0.4 +/- 0.1 ml . g-1 . min-1. PSc for 2-deoxy-D-glucose was about 4% higher than for D glucose and L-glucose in both preparations. Relative to L-glucose, there was no measurable transendothelial transport of either dextroglucose, indicating that transcapillary transport was by passive diffusion, presumably via the clefts between cells. The technique allows repeated measurements of D-glucose uptake at intervals of a few minutes; it may therefore be used to assess changes in transport rates occurring over intervals of several minutes. PMID- 3510569 TI - Corticosteroids and plasma restitution after hemorrhage and hypothalamic lesions. AB - The effects of electrolytic ablation of the anteroventral portion of the third ventricle (AV3V) on plasma volume (PV) restitution and adrenal corticosteroid responses after hemorrhage were determined. After recovery from AV3V ablation or control surgeries, animals were implanted with a catheter in the femoral artery. PV was determined before and either 2 or 24 h after moderate hemorrhage (1.4% body wt for controls; 1.3% body wt for AV3V lesion) by calculating dilution of 125I-labeled serum albumin. Other rats with AV3V lesions and control animals were used to measure concentrations of renin, aldosterone, and corticosterone 0.5 or 2 h after similar hemorrhage. The percent of shed PV restored was similar in rats with AV3V lesions and control-operated animals both 2 and 24 h after hemorrhage. Furthermore, the restitution of plasma protein mass was not different. Rats with AV3V lesions showed a similar increase in plasma renin concentration after hemorrhage, but they showed a smaller increase in the concentration of plasma aldosterone and no increase in the concentration of plasma corticosterone. These data demonstrate that electrolytic ablation of AV3V periventricular tissue does not alter either the short- or long-term phase of PV restitution, even though concentrations of plasma corticosterone are not increased. PMID- 3510570 TI - An etiologic model of alcoholism. AB - As we await a successful model of the etiology of alcoholism, research and intervention strategies founder. The author critically reviews the present etiologic models, particularly those bearing on alcoholic personality. The central shortcoming of these models is that they pay only lip service to the multidimensional etiology of alcoholism. Hereditary, environmental, and psychostructural risk factors have never been adequately integrated into any one design. The author explains the difficulties that this problem and others have introduced into the previous etiologic research. In the conclusion, he constructs a new model from the positive findings thus far. This, in turn, suggests the studies needed next and has definite diagnostic and therapeutic implications. PMID- 3510571 TI - Continuation drug therapy for major depressive episodes: how long should it be maintained? AB - A major problem for the practitioner is the lack of satisfactory guidelines as to how long continuation drug treatment of depressive episodes must be maintained to ensure that the episode is over. This often leads to either premature withdrawal of the drug and subsequent relapse or unnecessarily prolonged treatment. Results from a collaborative project of the National Institute of Mental Health provide the first study-derived guidelines on the length of continuation therapy. Findings indicate that withdrawal of such therapy is safe only after the patient has been free of significant symptoms for 16 to 20 weeks and that focusing on mild as well as severe symptoms is critical in this decision. PMID- 3510572 TI - Antidepressant effects of carbamazepine. AB - Thirty-five depressed patients diagnosed by DSM-III criteria participated in a double-blind study of the acute antidepressant effects of the anticonvulsant carbamazepine, at average doses of 971 mg/day, achieving mean +/- SD blood levels of 9.3 +/- 1.9 micrograms/ml (range, 3-12.5 micrograms/ml). Twenty patients (57%) showed at least mild improvement, and 12 showed more substantial improvement. Possible clinical predictors of antidepressant response to carbamazepine are discussed. These preliminary data suggest that carbamazepine has some acute antidepressant efficacy in addition to the growing evidence that it has acute antimanic and longer-term prophylactic efficacy in both phases of manic depressive illness. PMID- 3510573 TI - The hemodynamic effects of positive end-expiratory pressure. PMID- 3510574 TI - Bag-mask ventilation. PMID- 3510575 TI - A history of resuscitation. AB - In the 1950s, researchers devised the best methods of ventilation. In the 1960s, a method of maintaining circulation and ventilation simultaneously was introduced. In the 1970s, refinements of the understanding of the mechanisms of blood flow during CPR were defined and were accompanied by an aggressive research effort to identify means to improve brain protection during and after cardiac arrest. It is hoped that the fruits of this work will lead to knowledge of better ways to effect resuscitation and will maximize the quality of life in survivors of cardiac arrest. PMID- 3510576 TI - Crisis in graduate medical education. PMID- 3510577 TI - Nonspecific airway reactivity in cigarette smokers. Relationship to airway pathology and baseline lung function. AB - To examine the relationship of cigarette smoking, starting airway caliber, and airway pathology to nonspecific airway reactivity, we performed inhalation dose response curves in 40 patients prior to lung surgery. Airway reactivity was assessed by the provocative concentration of methacholine (n = 30) or histamine (n = 10) resulting in a 20% fall in FEV1 (PC20). All patients had measurements of maximal expiratory flow, diffusing capacity, and lung volumes preoperatively. After resection, the specimens were graded for small and large airways pathology and emphysema. The patients were divided into 4 groups: PC20 less than or equal to 1 mg/ml (n = 6), PC20 1 mg/ml to less than or equal to 4 mg/ml (n = 11), PC20 4 mg/ml to less than or equal to 16 mg/ml (n = 14), and PC20 greater than 16 mg/ml (n = 9). Subjects with PC20 less than or equal to 1 mg/ml had reduced measurements of maximal expiratory flow (FEV1, FEV1/FVC, Vmax50, and Vmax25). There were no differences in measurements of cartilaginous airway disease among the 4 reactivity groups. We found significant independent correlations of cigarette consumption, membranous bronchiole inflammation, and maximal expiratory flow rates (FEV1 and Vmax50) to PC20. The data suggest that cigarette smoking, starting airway caliber, and airway inflammation are associated with nonspecific airway reactivity and that each exerts an effect on airway reactivity that is not dependent on the contribution of the other 2 factors. PMID- 3510578 TI - Prognosis in chronic obstructive pulmonary disease. AB - We recruited 985 patients with COPD but without hypoxemia or other serious disease, treated them in a standard fashion, and followed them closely for nearly 3 yr. At the time of recruitment the patients were carefully characterized as to symptom severity, lung function, exercise tolerance, and quality of life, and studies of lung function were repeated during follow-up. Overall mortality was 23% in 3 yr of follow-up. Patient age and the initial value of the FEV1 were the most accurate predictors of death; when FEV1 before bronchodilator was used, the response to bronchodilators was directly related to survival, but this relationship became nonsignificant when postbronchodilator FEV1 was used as a primary predictor. After adjustment for age and FEV1, mortality was related positively to TLC, resting heart rate, and perceived physical disability, and related negatively to exercise tolerance. These relationships, though significant, were relatively weak. When standardized for age and FEV1, mortality in the present series was less than that of a previous series (4), and the same as that of hypoxemic patients with COPD who received continuous home O2 therapy. Changes in FEV1 with time averaged -44 ml/yr, but the standard deviation was large. Patients with low initial values of FEV1 showed relatively little further decline, probably indicating a survivor effect. In patients with well-preserved initial FEV1, rate of decline correlated negatively with bronchodilator response, symptomatic wheezing, and psychological disturbances. PMID- 3510579 TI - Animal models of emphysema. PMID- 3510580 TI - Effect of corticosteroids on bronchial responsiveness to methacholine in asthmatic children. PMID- 3510581 TI - Asbestos exposure--quantitative assessment of risk. AB - Methods for deriving quantitative estimates of asbestos-associated health risks are reviewed and their numerous assumptions and uncertainties described. These methods involve extrapolation of risks observed at past relatively high asbestos concentration levels down to usually much lower concentration levels of interest today--in some cases, orders of magnitude lower. These models are used to calculate estimates of the potential risk to workers manufacturing asbestos products and to students enrolled in schools containing asbestos products. The potential risk to workers exposed for 40 yr to 0.5 fibers per milliliter (f/ml) of mixed asbestos fiber type (a permissible workplace exposure limit under consideration by the Occupational Safety and Health Administration (OSHA) ) are estimated as 82 lifetime excess cancers per 10,000 exposed. The risk to students exposed to an average asbestos concentration of 0.001 f/ml of mixed asbestos fiber types for an average enrollment period of 6 school years is estimated as 5 lifetime excess cancers per one million exposed. If the school exposure is to chrysotile asbestos only, then the estimated risk is 1.5 lifetime excess cancers per million. Risks from other causes are presented for comparison; e.g., annual rates (per million) of 10 deaths from high school football, 14 from bicycling (10 14 yr of age), 5 to 20 for whooping cough vaccination. Decisions concerning asbestos products require participation of all parties involved and should only be made after a scientifically defensible estimate of the associated risk has been obtained. In many cases to date, such decisions have been made without adequate consideration of the level of risk or the cost-effectiveness of attempts to lower the potential risk. PMID- 3510582 TI - Reduction of total hemolytic complement activity with Naja haje cobra venom factor does not prevent endotoxin-induced lung injury in sheep. AB - We studied the effects of reducing total hemolytic complement activity with Naja haje cobra venom factor on the lung injury caused by intravenously infused endotoxin in 5 unanesthetized sheep with lung lymph fistulas. In normal sheep, infusions of lipopolysaccharide W from Escherichia coli (1.0 micrograms/kg) intravenously over 30 min caused increases in protein-rich lung lymph flow as well as the appearance in plasma and lung lymph of complement (C5)-derived chemotactic activity for polymorphonuclear leukocytes. Reduction of total hemolytic complement activity by treatment with Naja haje cobra venom factor (12 to 17 U/kg intraperitoneally) did not prevent the lung injury caused by endotoxin and also did not prevent the appearance in plasma and lung lymph of chemotactic activity. We conclude that although complement appears to be activated following intravenously infused endotoxin in sheep, a completely intact complement system is not necessary for endotoxin-induced lung injury. PMID- 3510583 TI - Julian John Chisolm, M.D. Confederate surgeon. PMID- 3510584 TI - The first 70 years experience managing cardiac disruption due to penetrating and blunt injuries at the University of Louisville. AB - Survival of patients with cardiac injuries requires prompt intervention and cardiography. Approximately 50 years ago, Dr. R. Arnold Griswold instituted a treatment plan for the management of cardiac injuries. Many of the tenets he espoused are still in use today. We have been able to collect data on 266 patients with heart wounds from 1913 to 1982 at Louisville General Hospital. Trends in the evolution of injury patterns and their treatment will be discussed. PMID- 3510585 TI - Dormancy in tropical insects. PMID- 3510586 TI - [Interleukin-2 and cancer treatment]. AB - Interleukin-2 (IL-2) is a type of the lymphokine which Morgan et al. found in 1976 to be a specific growth factor of T lymphocytes. Initially, it was called the T cell growth factor (TCGF), but it was renamed interleukin-2 (IL-2) in 1979. IL-2 is an essential factor for the differentiation and growth of T cell and NK cell, and it is involved in the adaptive immune reaction through such cells. Thus, IL-2 can be expected to play an important role in the improvement of the immunologic adaptive function in various immune system failure type disease and in malignant tumors among others. With the recent production of recombinant IL-2, the latter's biological and immunological functions are gradually coming to light, and its clinical applicability is also being seen in terms of effectiveness. Thus, administration of IL-2 alone, the induction of IL-2 dependent, tumor-specific CTL (cytotoxic T lymphocyte), or the induction and growth by IL-2 of lymphokine-activated killer (LAK) cell, have paved the way for adoptive immunotherapy. The clinical phase I study of IL-2 (TGP-3) has been completed, and the second phase study is now in progress. A pilot study is also under way using LAK cells. PMID- 3510587 TI - Cutaneous shigellosis. PMID- 3510588 TI - LDA-1 monoclonal antibody. An excellent reagent for immunofluorescence mapping studies in patients with epidermolysis bullosa. AB - To determine the diagnostic usefulness of a monoclonal antibody to the LDA-1 antigen, a newly defined noncollagenous component of the lamina densa of human basement membrane, we examined skin specimens from 20 patients with epidermolysis bullosa (simplex type, eight patients; junctional type, four patients; dystrophic type, eight patients) by the indirect immunofluorescence technique. We compared this antibody to polyclonal antibodies with three other antigens routinely examined in diagnostic immunofluorescence mapping studies. The antigen defined by the LDA-1 monoclonal antibody was expressed normally in all specimens examined, regardless of the type of epidermolysis bullosa present. Furthermore, no disparity was noted between the LDA-1 monoclonal antibody and a polyclonal antibody to type IV collagen in the microscopic localization of binding within induced skin blisters. These findings suggest that the LDA-1 monoclonal antibody is an excellent immunoreagent for diagnostic immunofluorescence mapping studies. PMID- 3510589 TI - Immunoglobulin disposition in the skin. PMID- 3510590 TI - Effects of bombesin on fasting bile formation. AB - Adult dogs were previously prepared by cholecystectomy, ligation of the lesser pancreatic duct, and insertion of cannulae into the duodenum and stomach. After a 2-week period of postoperative recovery and an overnight fast, bile ducts were cannulated, gastric cannulae placed to open drainage and sodium taurocholate 500 mg hr-1 was administered to replace bile acids lost from the interrupted enterohepatic circuit. Bombesin was infused IV for 1 hour over the dose range, 0.625-10 ng kg-1 min-1. In control experiments 0.15 N NaCl was infused. Bombesin caused a significant increase in fasting bile flow, 3.0 +/- 0.2 ml/15 min to 4.2 +/- 0.3 ml/15 min (40%). Bile acid and phospholipid outputs were unchanged during bombesin. Bile cholesterol output decreased significantly during bombesin, 1029 +/- 142 micrograms/15 min to 856 +/- 109 micrograms/15 min (17%). The increase in bile flow was linearly related to the logarithm of the bombesin dose. In dogs with pyloric occlusion, to prevent acid from reaching the duodenum, bombesin increased bile flow and bicarbonate output but had no effect on 14C erythritol biliary clearance. Bombesin stimulated ductular bile acid independent bile formation in a dose-dependent manner. Bombesin also inhibited bile cholesterol output. PMID- 3510591 TI - Prophylactic platelet administration during massive transfusion. A prospective, randomized, double-blind clinical study. AB - Prior studies at Harborview Medical Center have suggested that dilutional thrombocytopenia is a major etiology of microvascular, nonmechanical bleeding (MVB). We undertook a prospective randomized double-blind clinical study to compare the prophylactic effects of 6 units of platelet concentrates (PLT) versus 2 units of fresh frozen plasma (FFP) administered with every 12 units of modified whole blood in patients undergoing massive transfusion (12 or more units in 12 hours). After exclusions, three of 17 patients who received PLT and three of 16 patients who received FFP developed MVB, an incidence no different from our previous findings. Regression lines of platelet counts during transfusion were no different between groups, and both groups had higher platelet counts than predicted from a standard washout equation. Only one patient had evidence of dilutional thrombocytopenia as a cause for MVB. Prophylactic platelet administration is not warranted as a routine measure to prevent MVB. PMID- 3510592 TI - Abdominal aortic aneurysmectomy in renal transplant patients. AB - Five patients who had undergone renal transplantation 3 months to 23 years ago were operated on successfully for an abdominal aortic aneurysm. In the first case, dating from 1973, the kidney was protected by general hypothermia. In the remaining patients, no measure was used to protect the kidney. Only one patient showed a moderate increase of blood creatinine in the postoperative period; renal function returned to normal in 15 days. All five patients have normal renal function 6 months to 11 years after aortic repair. Results obtained in this series show that protection of the transplant during aortic surgery is not necessary, provided adequate surgical technique is used. Such a technique is described in detail. Its use simplifies surgical treatment of such lesions and avoids the complex procedures employed in the seven previously published cases. PMID- 3510593 TI - The first open-heart repairs of ventricular septal defect, atrioventricular communis, and tetralogy of Fallot using extracorporeal circulation by cross circulation: a 30-year follow-up. AB - From March 26, 1954, to July 19, 1955, 45 patients with major cardiac malformations not previously correctable underwent open repair utilizing cross circulation between patient and donor without donor deaths. All operations were carried out at normothermia with lowered flow rates based on azygos flow studies. Twenty-seven patients, more than half of them infants, had ventricular septal defects closed. There were 8 hospital deaths, and there have been only 2 late deaths in 30 years. Fourteen (87.5%) of 16 who underwent recatheterization have closed defects. The 17 30-year-survivors are all in New York Heart Association Functional Class I. Five patients 4 months to 10 years old were operated on for atrioventricular canal (complete form). All had intractable failure, and 4 had pulmonary hypertension. Two of the 3 hospital deaths were due to heart block. The long-term survivor, a 15-month-old infant at the time of operation (severe pulmonary hypertension, 90/50 mm Hg), underwent repair 31 years ago and is now married with 3 children. Recatheterization disclosed normal pulmonary pressure (20/4 mm Hg), no shunts, and mild mitral regurgitation. Ten cyanotic tetrads 13 months to 14 years old were operated on with 5 hospital deaths. Of the 3 late deaths, 1 was accidental at 17 years, 1 occurred suddenly at home 13 years after operation in infancy for atresia, and the third occurred at reoperation 10 years later. The 2 remaining patients (1 the first patient operated on) are in excellent health. The surgical methods used and the physiological advantages of cross-circulation (temporary placenta) that made these results possible at a time when surgical knowledge was primitive are described. PMID- 3510594 TI - Ultrastructural myocardial preservation during coronary artery surgery: a controlled, prospective, randomized study in humans. AB - Potassium cardioplegia was compared with normothermic, intermittent ischemic arrest in 30 patients undergoing multiple coronary artery bypass grafts. Group 1 comprised 15 patients in whom cold potassium cardioplegia with St. Thomas' Hospital solution was used. In Group 2 were 15 patients who underwent intermittent ischemic arrest during the construction of the distal anastomoses. Two myocardial transmural left ventricular biopsies were done in each patient. There was no operative mortality. Electron microscopical examination showed normal myocardial ultrastructure in both groups. In particular, mitochondria were well preserved in all samples. The postoperative electrocardiogram demonstrated a new Q wave in 1 patient in Group 2 whose level of the myocardial isoenzyme of creatine phosphokinase (CPK-MB) was within the normal range. The peak CPK-MB release in Group 1 was 23.2 +/- 20.1 IU and in Group 2, 19.9 +/- 15.1 IU. This difference was not statistically significant. The mean period of anoxic arrest in Group 1 was 49.5 +/- 15 minutes and in Group 2, 25.5 +/- 8 minutes (p less than 0.001). Total cardiopulmonary bypass time in Group 1 was 114.5 +/- 20 minutes and in Group 2, 90.2 +/- 16 minutes (p less than 0.01). It is concluded that both techniques can preserve myocardial subcellular architecture during multiple coronary artery bypass grafting in patients with normal left ventricular function. PMID- 3510595 TI - Sodium and hypertension. A review. AB - Abnormal sodium metabolism may be critical in the causation of certain forms of hypertension, particularly salt-sensitive hypertension. Long-term restriction of sodium intake in patients at high risk for the development of hypertension may reduce the chances of established hypertension occurring later. These high-risk patients in whom subsequent hypertension may be prevented include normotensive patients with family histories of hypertension, elderly patients, black patients, and those with low-renin hypertension. Treatment of hypertension with moderate sodium restriction to 70 mEq/day will significantly reduce blood pressure in a large percentage of patients, particularly known salt-sensitive hypertensive patients. This degree of restriction is also an effective adjunctive therapy for patients receiving antihypertensive medications. There is convincing experimental, epidemiologic, and clinical evidence that moderate sodium restriction helps prevent and assists in the treatment of hypertension in those patients who are genetically predisposed to develop primary hypertension or who already have hypertension. There is no evidence that this degree of sodium restriction is harmful. PMID- 3510596 TI - Chronic cough and the use of captopril: unmasking asthma. PMID- 3510597 TI - More on donor's choice or Hobson's choice. PMID- 3510598 TI - Bone loss in hypothyroidism with hormone replacement. A histomorphometric study. AB - To determine the influences of hormone replacement on bone tissue in primary hypothyroidism, a histomorphometric study on undecalcified transiliac bone specimens was performed before treatment in ten patients, during the first month of treatment in 16 patients, and after more than six months of treatment in 15 patients. There were no obvious clinical or biologic signs of excessive replacement therapy. Before treatment, trabecular resorption surfaces were lower and bone cortical thickness was increased. From as early as the first month of treatment, trabecular resorption surfaces and cortical porosity were higher than normal but cortical thickness was still increased. After more than six months of treatment there was a significant loss of trabecular (decreased trabecular bone volume) and cortical (normal mean cortical width; increased porosity) bone with hyperremodeling (increased trabecular resorption surfaces and trabecular osteoid surfaces). This osteoporosis is similar to that observed in hyperthyroidism. PMID- 3510599 TI - Treatment of acute obstructive renal failure with high-dose methylprednisolone. AB - High-dose methylprednisolone sodium succinate (Solu-Medrol) therapy was administered to two patients with acute renal failure and anuria secondary to cancer-related urinary tract obstruction. Following the administration of intravenous methylprednisolone, obstruction was relieved, as evidenced by increased urinary flow and improvement of renal function. The salutary effect of methylprednisolone is probably related to the relief of obstruction secondary to a decrease in tumor-associated edema similar to the effect obtained in patients with brain tumors and spinal cord compression by epidural metastases. The temporary improvement in renal function allowed time for more definitive therapy to be instituted under more favorable clinical conditions. PMID- 3510600 TI - Transportability of a decision rule for the diagnosis of streptococcal pharyngitis. AB - Use of existing decision rules could improve management of streptococcal pharyngitis, but the validity of such rules outside their original patient population is not known. We applied a four-item decision rule derived at the Medical College of Virginia, Richmond, to 516 patients at the University of Nebraska, Omaha, to test how accurately it would predict outcome of throat culture. After correction for differences in the prevalence of a positive culture (17% in Virginia, 26% in Nebraska), the rule closely predicted the frequency of positive cultures in five subgroups based on the presence of clinical findings. We conclude that this rule transported well to a different patient population and would have been useful in identifying patients with pharyngitis who had a high likelihood of throat cultures positive for group A streptococci. PMID- 3510601 TI - Imipramine and chlordiazepoxide in depressive and anxiety disorders. I. Efficacy in depressed outpatients. AB - We randomly assigned 425 outpatients, independently classified as primarily depressed by two trained psychiatrists, to double-blind treatment with Imipramine hydrochloride, chlordiazepoxide hydrochloride, or placebo. Those patients who remained at least moderately depressed (following a two-week placebo washout period) were treated for an additional eight weeks. An endpoint analysis of 387 patients who completed two or more weeks of medication disclosed early therapeutic advantages of chlordiazepoxide. By week 4 of treatment, however, imipramine produced more improvement than did placebo and chlordiazepoxide. By six and eight weeks a general, marked therapeutic advantage was found for imipramine relative to placebo and to chlordiazepoxide on measures of depression, anxiety, anger-hostility, interpersonal sensitivity, and global improvement. Chlordiazepoxide-treated patients generally did significantly better on sleep difficulty but significantly worse on anger-hostility and interpersonal sensitivity than did imipramine- or placebo-treated patients. PMID- 3510602 TI - Imipramine and chlordiazepoxide in depressive and anxiety disorders. II. Efficacy in anxious outpatients. AB - A double-blind, placebo-controlled comparison at three collaborating university sites included 242 patients diagnosed as having anxiety disorders. A two-week placebo washout period preceded random assignment to eight weeks of imipramine hydrochloride, chlordiazepoxide hydrochloride, or placebo treatment. Antianxiety effects of imipramine were superior to those of the other two agents by the second treatment week; these effects became more clearly significant thereafter and were independent of degree of both baseline depression and anxiety. Excluding patients with possible panic-phobic syndromes from the analyses removed most significant antiphobic and antidepressant effects of imipramine but left intact imipramine's significantly superior antianxiety effects. PMID- 3510603 TI - Muscle-contraction headaches in multiple-pain patients: treatment under worsening baseline conditions. AB - A total of 55 muscle-contraction headache patients were divided into four groups which received frontalis EMG biofeedback, relaxation training, combined biofeedback-relaxation training, or no-treatment control. All patients were compensation patients undergoing assessment and brought to a high level of activity for the first time since going into chronicity. In all cases, onset or aggravation of the headaches coincided with the compensation-related injury. All treatment modalities led to significant but similar levels of improvement in headaches, while the control group worsened. PMID- 3510604 TI - Intestinal bacteria translocate into experimental intra-abdominal abscesses. AB - Experimental intra-abdominal abscesses were initiated by surgical implantation of a fibrin clot contaminated with either Bacteroides fragilis, Bacteroides thetaiotaomicron, or B fragilis-Escherichia coli. Seven days after surgery the numbers of bacteroides (per gram) in B fragilis and B thetaiotaomicron abscesses were typically log10 8.4 +/- 0.5 (n = 6) and log10 6.4 +/- 0.6 (n = 4), respectively; B fragilis-E coli abscesses typically contained log10 8.9 +/- 0.5 B fragilis and log10 7.6 +/- 0.6 E coli (n = 5). Of 38 B fragilis abscesses, 14 B fragilis-E coli abscesses, and nine B thetaiotaomicron abscesses, additional intestinal bacteria were recovered from 21 (55%), 13 (93%), and seven (89%) abscesses, respectively. The additional organisms, in decreasing order of frequency, were enterococci, E coli, staphylococci, alpha-streptococci, lactobacilli, and Proteus species in numbers ranging from 2.5 log10 to 7.9 log10 per gram of abscess. Histologic sections of contaminated abscesses adherent to the intestine, liver, or spleen revealed normal tissue histology and no breakdown of the abscess wall. Thus, intestinal bacteria translocated into intra-abdominal abscesses by a mechanism that did not appear to be surgical soilage. PMID- 3510605 TI - Radiologic diagnosis of an intra-abdominal abscess. Do multiple tests help? AB - A review was made of the charts of 94 patients who underwent ultrasonography (US), computed tomography (CT), and gallium citrate Ga 67 (Gall) scan to rule out intra-abdominal abscesses. Of all the clinical and laboratory data, only the presence of pain and tenderness differentiated patients with and without abscesses. A review of radiologic data showed that CT was superior to US, and that US was superior to Gall scan with regard to sensitivity, specificity, accuracy, and positive and negative predictive values. When multiple radiologic tests were performed, results agreed in 72% of cases; therefore, the additional tests were essentially redundant. When radiologic test results disagreed, accuracy rates were CT, 0.86; US, 0.00; and Gall scan, 0.44. These findings suggest that, except to rule out pelvic abscesses in the presence of pelvic inflammatory disease, CT is usually the only special radiologic test that should be performed to localize a suspected intra-abdominal abscess. PMID- 3510606 TI - In vitro reversal of cardiac deterioration in septic shock with tetraethylammonium chloride. AB - Overwhelming sepsis associated with cardiac failure continues to be a major clinical problem. This is commonly associated with a failure to respond to conventional pharmacologic therapy. This study was undertaken to see if manipulations of the electrophysiologic defects previously described by treatment with tetraethylammonium chloride (TEA) would be advantageous. Septic shock was induced in rabbits by a lethal dose of Escherichia coli. Peak tension and velocities of contraction and relaxation were measured in papillary muscle with and without 5mM TEA. Exposure to this compound improved peak tension and velocities of contraction and relaxation to normal values. The action of TEA is not specific to septic tissue as values in normal muscles are similarly improved. Tetraethylammonium chloride or other drugs that decrease outward potassium current and prolong the action potential duration may be helpful in treating cardiac dysfunction that accompanies sepsis. PMID- 3510610 TI - Failed epikeratophakia graft. PMID- 3510608 TI - Studies on Autographa californica nuclear polyhedrosis virus replication in Spodoptera littoralis cells including virus-induced protein synthesis. AB - The replication of the Autographa californica nuclear polyhedrosis virus in Spodoptera littoralis cells has been investigated. Various cytopathic changes were detected by light and electron microscopy and progeny enveloped virus particles, some occluded within polyhedra, were later seen in the nucleus of infected cells. Infectious virus was released into the growth medium and increased exponentially from ca. 10 to 24 hours post infection and then slowly increased over the next 4 days. In comparison, virus was released ca. 3.5 hours earlier from Spodoptera frugiperda cells. Total rates of DNA and protein synthesis were drastically reduced during the late stages of virus replication when cell death was occurring. By ca. 18 hours post infection, a clear switch from host to virus induced protein synthesis had occurred and a total of 39 virus induced polypeptides of M.W. 12 to 120 X 10(3) were detected. These included polyhedrin of M.W. 33 X 10(3), which was particularly prominent during the late stages of virus replication, and a major virus structural protein of M.W. 42 X 10(3). PMID- 3510609 TI - Cardiogenic brain embolism. Cerebral Embolism Task Force. AB - One in six ischemic strokes is due to cardiogenic embolism. The current knowledge about the natural history, diagnosis, prevention, and treatment of cardioembolic stroke is reviewed. Nonrheumatic atrial fibrillation is the most frequent substrate for brain embolism; patients with this dysrhythmia have a fivefold increase in the risk of stroke. Ischemic heart disease (25%), rheumatic mitral stenosis (10%), and prosthetic cardiac valves (10%) are other major sources of cardioembolic stroke. Mitral annulus calcification and calcific aortic stenosis infrequently serve as cardioembolic sources. As cardiac sources of embolic stroke are often identifiable prior to stroke, many of these strokes are potentially preventable. PMID- 3510611 TI - History of fluorescein angiography corrected. PMID- 3510607 TI - Monoclonal antibodies: implications for virology. Brief review. PMID- 3510612 TI - Betaxolol vs timolol. A six-month double-blind comparison. AB - Betaxolol hydrochloride (0.5%) and timolol maleate (0.5%) were compared in a six month randomized, double-blind study involving 29 patients with glaucoma. The two drugs were comparable with regard to efficacy in lowering intraocular pressure. Betaxolol effected an average reduction of 7.6 mm Hg (26%); timolol, 8.4 mm Hg (29%). No patient required adjunctive medications during this study. Ocular side effects were mild and similar for both treatments. Neither drug affected corneal sensitivity, visual acuity, basal tear production, or pupil size. Since betaxolol has been shown to have little effect on the cardiopulmonary system, it should be strongly considered for the treatment of glaucoma. PMID- 3510613 TI - An update of the indications for penetrating keratoplasty. 1979 through 1983. AB - We performed a retrospective analysis of the clinical and pathologic diagnoses of 497 corneal buttons that had been submitted to the Estelle Doheny Eye Pathology Laboratory, Los Angeles, during the five-year period 1979 through 1983. The leading indications, in order of decreasing frequency, were pseudophakic bullous keratopathy (17.5%), regrafts (15.1%), aphakic bullous keratopathy (10.9%), corneal trauma (9.3%), and Fuchs' endothelial dystrophy (9.1%). The emergence of pseudophakic bullous keratopathy as the most common cause for penetrating keratoplasty correlates well with the dramatic increase in the number of cataract extractions with intraocular lens implantations performed since the mid-1970s. Less frequent indications for penetrating keratoplasty included the following: corneal scars (6%); active ulcerative keratitis (7%); keratoconus (6%); keratitis secondary to virus (5%); non-Fuchs' corneal dystrophies (3%); congenital corneal opacities (3%); interstitial keratitis (2%); and chemical burns (1%). PMID- 3510614 TI - Risk factors for changes in aorto-iliac arterial compliance in healthy men. AB - Doppler ultrasound was used to measure pulse wave velocity down the aorta and iliac arteries. Arterial wall compliance was calculated from pulse wave velocity in 45 apparently healthy men. Their arterial compliance fell significantly with advancing age, raised blood pressure, increased serum cholesterol and triglyceride levels, and reduced serum high density lipoprotein cholesterol levels. The correlation between compliance and age was independent of the other risk factors, and the correlation between compliance and lipid status was independent of age and blood pressure. There was no significant correlation between compliance and area under the glucose tolerance curve. PMID- 3510615 TI - Behavioral antecedents of coronary heart disease and atherosclerosis. AB - Over 50 epidemiologic, clinical, and experimental studies of behavioral influences on atherosclerosis and CHD have been reviewed; of these investigations, no more than five were published prior to 1975. Despite some inconsistencies and occasional conceptual and methodologic problems in the studies comprising this relatively young literature, the preponderance of available evidence indicates that psychosocial variables play a significant role in coronary disease. To summarize briefly, the Type A behavior pattern has been found predictive of new CHD in nearly all prospective studies of initially healthy individuals, and therapeutic modification of Type A has been shown to reduce risk of recurrent nonfatal MI. Among most prospective studies of post-MI patients and of persons at heightened risk for CHD due to elevations in traditional risk factors, however, Type A has not been found to predict, respectively, recurrence of MI or initial clinical events. Additionally, Type A individuals have shown more extensive coronary artery atherosclerosis on angiographic examination than Type Bs in a minority of studies, and, generally, only where Type A behavior has been measured by the SI. It is noted that many of these clinical studies may be faulted, though, for their use of small and heterogeneous patient samples and for possible biases in the selection and recruitment of subjects. In contrast to the globally defined Type A pattern, a high potential for hostility and an inability or unwillingness to express anger (anger-in) have emerged as significant predictors or correlates of coronary disease in all epidemiologic and clinical studies in which these variables have been examined. These consistent results suggest that a predisposition to hostility and anger, and the inhibited expression of such feelings, represent a "toxic" component of the Type A pattern. Several recent prospective investigations indicate also that high levels of life stress and possession of poor or inadequate social resources are predictive of CHD. The concepts of life stress, social network, and social support, as well as relationships among these variables, are not well-understood, however, and much additional work is needed to identify specific pathogenic and protective attributes of the social environment. In addition to studies of the psychosocial antecedents of CHD in human beings, there now are several published studies of behavioral influences on the development of coronary lesions in animal models.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3510616 TI - Subendothelial proteins and platelet adhesion. von Willebrand factor and fibronectin, not thrombospondin, are involved in platelet adhesion to extracellular matrix of human vascular endothelial cells. AB - Endothelial cell matrix contained von Willebrand factor (VWF), fibronectin, and thrombospondin. The role of these proteins in the adhesion of platelets was investigated by preincubation of the matrix with specific antibodies and subsequent perfusion with human blood. When perfusions were performed with platelets in a human albumin solution (HAS) platelet adhesion was similar to that with normal plasma, indicating that proteins in the matrix can fully support adhesion. Preincubation of the matrix with a monoclonal antibody to VWF and perfusion with HAS showed a nearly complete inhibition of platelet adhesion at 1300 s-1, indicating a role for matrix-bound VWF at high shear rates and no requirement for VWF in plasma. Preincubation of the matrix with antihuman fibronectin F(ab')2 showed a slight inhibition of adhesion. The same result was obtained with perfusions with fibronectin-free plasma, and an untreated matrix. Preincubation with antifibronectin F(ab')2 and perfusion with fibronectin-free plasma showed a significant inhibition of platelet adhesion at all shear rates. These results indicate that fibronectin is required for adhesion at all shear rates. Preincubation of the matrix with different antibodies against human platelet thrombospondin showed no inhibition of platelet adhesion at all wall shear rates. Thrombospondin in the matrix is evidently not required for platelet adhesion. PMID- 3510617 TI - Calcium antagonists in the prevention of motion sickness. AB - Flunarizine is a calcium antagonist which has proved clinically useful in controlling chronic vertigo. In a double blind crossover trial 10 subjects were used to compare the electronystagmic responses to motion in patients taking flunarizine, prochlorperazine maleate, or placebo. Flunarizine is shown to be a powerful peripherally acting labyrinthine suppressant, with application in the prevention of motion sickness. Flunarizine produces none of the central depressive side effects characteristic of antihistamines and anticholinergics, which are the conventional anti-motion sickness drugs. PMID- 3510618 TI - The effects of +Gz on the coronary circulation: a review. AB - The exposure of the human body to +Gz acceleration produces dramatic effects on the cardiovascular system. For example, during +Gz stress, heart rate has been reported to increase in excess of 200 b . min-1 and left ventricular pressure has been estimated to reach 300 mm Hg. Several reviews have dealt with the overall effects of +Gz stress on the cardiovascular system. However, none of these reviews has dealt specifically with the effects of +Gz on the coronary circulation and on the ability of the coronary circulation to maintain adequate perfusion of the heart. A common misconception exists within the aeromedical community that coronary blood flow must be compromised during +Gz due to the high heart rates and stress levels encountered during +Gz exposures. The purpose of this review is to deal with this issue by reviewing available information about basic coronary physiology, acceleration physiology, and their interaction. The current state of our understanding of basic coronary function will first be summarized. Serious students of coronary physiology are referred to other reviews for more detailed discussion. The current understanding of normal coronary function will then be integrated with the available information about the effects of +Gz on the heart and coronary circulation. Finally, potential chronic effects of +Gz and its interrelationships with cardiac and cardiovascular pathology in relation to the coronary circulation will be briefly considered. PMID- 3510619 TI - The effect of skill on performance under an environmental stressor. AB - This paper examines the effect of individual skill level upon task performance in transient extreme heat. A summary of published data suggests that individuals who are skillful at the task are better able to withstand the detrimental effect of the stress exposure than their unskilled counterparts. Three theoretical explanations of such performance superiority are reviewed: behavioral arousal; attentional capacity; and automatic and controlled processing. It is concluded that the automatic and controlled information processing approach holds the greatest potential to account for this effect at the present time. It is suggested that the ability of skilled subjects who are able to resist the effect of heat stress may be a more general attribute of personnel who operate under a variety of non-optimal environmental conditions. PMID- 3510620 TI - The role of nitrosamines in cancer formation. PMID- 3510621 TI - On the antioxidant hypothesis with regard to arteriosclerosis. PMID- 3510622 TI - Sequential inhibitory effects of antitumor agents related to levodopa and dopamine upon DNA synthetic enzymes. AB - Novel antitumor agents related to levodopa and dopamine exhibit a selective and rapid inhibition of DNA synthesis as measured by thymidine incorporation. Our investigations have attempted to determine the biochemical basis of the selective inhibition of tumor cells and in this present study we examined the effects of these agents on thymidylate synthase. The dihydroxybenzene derivatives were found to inhibit thymidylate synthase in situ at concentrations ranging between 100 and 800 microM. The quinols did not inhibit partially purified thymidylate synthase, although the oxidized quinones did cause inhibition at concentrations between 10 and 100 microM. Time course experiments suggested that the inhibition of thymidylate synthase in situ by the dihydroxybenzene derivatives occurs after the inhibition of thymidine incorporation, indicating that an earlier event was critical to the inhibition of DNA synthesis. With the use of a novel in situ assay which measured the release of [3H]water from [5-3H] uridine in intact cells, we were able to show that one of the earliest biochemical events is the inhibition of ribonucleotide reductase and that the inhibition of thymidylate synthase, which is delayed by approximately 30 min, was indirectly mediated possibly through effects on ribonucleotide reductase. PMID- 3510623 TI - Spinal cord astrocytomas of childhood. AB - The author has carried out gross total excision of an intramedullary spinal cord astrocytoma in 120 consecutive patients. This experience has led to the following conclusions: Holocord widening occurs in 60% of cases, and is diagnostic of a cystic astrocytoma. Despite the absence of a surgical plane of dissection, these neoplasms may be removed from "inside out" until a glia-tumor interface is recognized. Radical tumor excision is compatible with partial or total recovery of neurological function. The success of surgery is directly related to the preoperative neurological status of the patient. Paralysis or near paralysis was never improved, while mild to moderate preoperative neurological dysfunction often recovered. While this experience has established the efficacy of radical surgery, there is no information to suggest the duration of remission, or the likelihood of permanent cure. This will only become known at the time of retrospective analysis many years from now. PMID- 3510624 TI - Selective amygdalohippocampectomy: indications, investigative technique and results. PMID- 3510625 TI - The genesis of American occupational health nursing. Part II. PMID- 3510626 TI - Candidiasis in very low birthweight infants. Ultrasonography in the diagnosis of renal involvement. AB - Systemic candidiasis is a serious infection in very low birthweight infants. Its diagnosis is difficult to make and is often missed. Renal involvement may be diagnostic, consisting of mechanical obstruction by fungus masses in the renal pelvis. A case is presented which demonstrates the importance of carrying out multiple ultrasonographic examinations of patients at risk. PMID- 3510627 TI - The holoacardius acephalus twin: prenatal diagnosis. PMID- 3510628 TI - Relation between fetal heart rate accelerations, fetal movements, and fetal breathing movements. AB - The presence of fetal heart rate (FHR) accelerations is considered a sign of fetal well-being. Fetal body and breathing movements, as visualized by real-time ultrasound, were correlated to FHR accelerations in 16 high-risk pregnancies. The association between FHR accelerations (greater than 15 beats/min lasting 15 sec or more) and the different fetal behavioral states is described. PMID- 3510629 TI - Acute development of oligohydramnios in a pregnancy complicated by chronic hypertension and superimposed pre-eclampsia. AB - Perinatal mortality is significantly increased in pregnancies where pre-eclampsia is superimposed on chronic hypertension. Oligohydramnios and intrauterine growth retardation are common in this setting. Although oligohydramnios generally has been assumed to occur gradually the following report pertains to a case of a rapid development of oligohydramnios. PMID- 3510630 TI - Association of paroxysmal supraventricular tachycardia and periventricular leukomalacia. AB - Periventricular leukomalacia, a condition characterized by hpoxic-ischemic infarction of deep cerebral white matter, can now be recognized by cranial sonography. The case presented here demonstrates the association of periventricular leukomalacia present at birth with intrauterine paroxysmal supraventricular tachycardia. PMID- 3510631 TI - Relationship of placental grade to fetal pulmonary maturity and respiratory distress syndrome. AB - Real-time sonographic placental grading was performed on 215 patients who had amniocentesis for determination of fetal pulmonary maturity between 26 and 42 weeks of gestation. The results of this placental grading were correlated with clinical gestational age and fetal pulmonary maturity, assessed by lecithin sphingomyelin ratio, phosphatidylglycerol, and the subsequent presence or absence of respiratory distress syndrome. This study showed a statistically significant correlation of placental grade with gestational age, pulmonary maturity, and respiratory distress. Grade 3 placentas were seen in 20% of the cases studied, and in every instance was associated with an absence of subsequent neonatal respiratory distress. Placental grade appeared to be an accurate predictor of fetal pulmonary maturity in the population studied. PMID- 3510632 TI - Prenatal diagnosis of hypoplastic left ventricle. AB - A case of prenatal diagnosis of hypoplastic left ventricle by means of echocardiography is presented. The method of detecting this syndrome is described and the importance of its prenatal diagnosis emphasized. PMID- 3510633 TI - Computer assisted estimation of fetal weight by real-time ultrasound. PMID- 3510634 TI - Software design for computerized analysis of obstetric and gynecologic ultrasound examinations. PMID- 3510635 TI - Intrauterine malnutrition and computer-assisted processing of serial ultrasound data. PMID- 3510636 TI - A pocket computer program for obstetric ultrasound calculations. AB - A pocket computer program is currently being used to perform complicated obstetric ultrasound calculations at the Medical Center Hospital of Vermont. The program calculates decimal weeks between dates, gestational age from biparietal diameter, crown-rump length or femur length, total intrauterine volume, head abdominal circumference ratios, projected gestational age from previous measurements, and estimated fetal weight. Calculations can be printed for a permanent record. The pocket computer program provides a convenient, accurate, and affordable method of obstetric ultrasound analysis. PMID- 3510637 TI - A microcomputer-based real-time system for measurement and analysis of umbilical flow velocity waveforms obtained by Doppler ultrasound. AB - A microcomputer-based system for real-time acquisition and analysis of umbilical arterial blood flow velocity waveforms is described. The spatial peak umbilical flow velocity is transduced by a pulsed Doppler flowmeter and digitized by the microcomputer. The computer allows for coherent averaging of flow velocity over several heart cycles in order to minimize noise that is uncorrelated with the fetal heart beats. In addition, it can compute flow velocity indices that do not require knowledge of the angle of beam incidence or umbilical arterial cross sectional area. The averaged waveform as well as the computed indices may be displayed in real time. Further, these results may be saved on disk along with other relevant clinical information to be subsequently merged into a relational data base covering all patients monitored. Not only does the system facilitate accurate measurement of umbilical flow velocity waveforms, but the relational data base may also be used to evaluate the clinical significance of these measurements in a patient population. PMID- 3510638 TI - Cefazolin vs moxalactam? A double-blind randomized trial of cephalosporins in head and neck surgery. AB - Cefazolin and moxalactam were compared in a prospective randomized double-blind trial of 118 patients undergoing oncologic head and neck surgery. Both antibiotics were given 2 g every four hours for four doses. Five infections were encountered in the cefazolin group (8.5%) and two infections in the moxalactam group (3.4%); this difference was not statistically significant. This assessment does not indicate, however, that the two regimens are equally efficacious. PMID- 3510639 TI - Septal perforation closure utilizing the external septorhinoplasty approach. AB - Nasal septal perforations can be technically difficult to close permanently, particularly if they are large, located posteriorly, or associated with little residual septal cartilage and bone. By allowing direct access to the usually undisturbed dorsal septum, septal flaps are easier to elevate with the external septorhinoplasty approach. Also, better visualization and more room in which to work are afforded by this approach, enabling the surgeon to close perforations that might be more technically difficult to close using standard intranasal incisions. The technique of external septorhinoplasty combined with septal mucoperichondrial advancement flaps and a supporting graft of mastoid periosteum, cartilage, or ethmoid bone was used to close perforations up to 4 cm in diameter in 22 patients from 1981 to 1983 with a 77% (17/22) complete closure rate. Symptomatic improvement was noted by all patients. PMID- 3510640 TI - Quantitative study of goblet cells in the upper lobe of the normal human lung. AB - Goblet-cell density and distribution were studied in ten specimens of the human adult lung. The bronchial tree of the left upper lobe was dissected, and the bronchial mucosa separated and stained by the whole-mount periodic acid Schiffalcian blue method. There was a significant fall in the goblet-cell density from the proximal to the distal airways. In the upper division, the number decreased from 144 cells per field (second generation) to 80 cells per field (14th generation), and in the lingular division it decreased from 137 (fourth generation) to 77 cell (18th generation). The overall goblet-cell density for the upper lobe was 113 cells per field, corresponding to 6,400 cells per square millimeter. No particular pattern in cell distribution was noticed; the cells were irregularly distributed all along the bronchial tree without any well defined distribution pattern. In the ten lung specimens studied, goblet-cell density did not correlate with smoking habit, sex, or age. PMID- 3510641 TI - An extract from The French Stage by Heinrich Heine. Confidential letters addressed to M. August Lewald. PMID- 3510642 TI - Conversion of paroxysmal atrial fibrillation to sinus rhythm by intravenous pirmenol. A placebo controlled study. AB - The efficacy of pirmenol (a class I antiarrhythmic agent) as a converter of paroxysmal atrial fibrillation was investigated. Forty patients without congestive heart failure or a history of sinus node disorder were randomly allocated to receive either intravenous pirmenol (50-100 mg) or placebo in a double blind trial. In 12 of 20 patients sinus rhythm was restored 2-16 minutes after pirmenol, and in 3 of 20 patients in the control group it returned within one hour. A nodal escape rhythm was seen during sinus slowing in one patient, but in other patients there was no sinus arrest, atrioventricular conduction disturbance, or hypotension. The ventricular rate was slightly increased in patients in whom sinus rhythm was not restored by pirmenol. The results indicate that pirmenol has an antifibrillatory effect on the atria. Sinus rhythm was restored rapidly after intravenous administration. It was well tolerated in patients with atrial fibrillation of recent onset. PMID- 3510643 TI - Intravenous captopril treatment in patients with severe cardiac failure. AB - The effect of intravenous captopril was studied in 26 patients with severe chronic heart failure. Fourteen patients received a 25 mg intravenous bolus dose and 12 patients were given a series of incremental intravenous doses over the range 0.3125-45 mg. After the 25 mg bolus dose there was a rapid reduction in systemic vascular resistance and systemic blood pressure. The effect was greatest five minutes after the dose when cardiac output was increased by 20%. Mean right atrial pressure and pulmonary end diastolic pressure fell more slowly and reached their nadir 60 minutes after administration. Plasma free captopril concentration was significantly correlated with percentage reduction in systemic vascular resistance 15 minutes after the bolus injection, but was not correlated with either changes in right atrial or pulmonary artery pressures. With the series of incremental doses there was a progressive fall in systemic vascular resistance until a cumulative dose of 5.0 mg was reached; beyond this there was no further significant change. The rapid response to intravenous captopril indicates that it may be useful in the treatment of patients with severe heart failure who require intensive treatment. After intravenous injection of captopril haemodynamic responses in patients with heart failure were greatest at plasma concentrations of 100 g/ml to 150 ng/ml. This is considerably higher than the plasma free captopril concentrations found after conventional oral doses of captopril. PMID- 3510644 TI - Improvement in angina pectoris with alpha adrenoceptor blockade. PMID- 3510645 TI - Advances in respiratory support. PMID- 3510646 TI - Cardiogenic shock and the haemodynamic effects of arrhythmias. PMID- 3510647 TI - Hypovolaemic shock. PMID- 3510648 TI - Specific problems of drug intoxication. PMID- 3510649 TI - Management of liver failure. PMID- 3510650 TI - Egg and milk exclusion diets in atopic eczema. AB - Fifty-three patients with atopic eczema took part in a double blind controlled cross-over trial of an egg and cow's milk exclusion diet. Response to the diet was assessed in terms of areas affected, day and night time itch, and topical steroid usage. Twenty-five percent of the patients failed to comply adequately with the trial regime and were excluded from the analysis. Of the remaining 40 patients, ten appeared to benefit from the diet and were advised to continue egg and milk avoidance. This response rate to the diet was not statistically significant. PMID- 3510651 TI - Pyoderma gangrenosum, subcorneal pustular dermatosis and IgA paraproteinaemia. PMID- 3510652 TI - The histopathology of localized lipoatrophy. AB - We studied 11 patients with the clinical diagnosis of lipoatrophy and found two histopathological subsets. Six patients presented with a distinctive picture, which we termed 'involutional' fat, consisting of lobules of small lipocytes embedded in hyaline connective tissue with numerous capillaries. Five of these six patients had a single lesion, usually of the upper arm. Serological studies were normal, and direct immunofluorescence, performed in three cases, showed immunoreactants in the blood vessels in only one. The four patients with inflammation of the fat had multiple areas of localized lipoatrophy. Three had biopsies for direct immunofluorescence and all three showed immunoreactants involving the basement membrane zone (two cases) or blood vessels (one case); and three had serological abnormalities. We suggest that the involutional histopathological pattern is a distinctive subset of localized lipoatrophy. PMID- 3510653 TI - Photosensitive dermatitis with actinic reticuloid syndrome: an immunohistological study of the cutaneous infiltrate. AB - Cryostat sections of skin biopsies from five patients with chronic photosensitivity dermatitis with actinic reticuloid syndrome (PDAR) have been examined immunohistologically by the alkaline phosphatase:anti-alkaline phosphatase staining technique using a panel of 24 monoclonal antibodies against lymphoid cells and their subsets. The lymphoid infiltrates in all cases had an essentially identical cellular composition, containing a mixture of T lymphocytes, T-cell accessory cells (Langerhans cells) and other types of HLA-DR positive dermal macrophages. In two patients there was an excess of T helper/inducer cells relative to T-suppressor cells, while in the other three patients the numbers of T-cells in these two subsets were approximately equal. Many of the infiltrating T-cells expressed activation (HLA-DR, interleukin-2 receptor) or proliferation (the Ki67 nuclear antigen, transferrin receptor) associated markers. These data indicate that a T-cell immune response is operative in cutaneous PDAR lesions. PMID- 3510655 TI - Red cell associated IgG in patients suffering from Plasmodium falciparum malaria. AB - Quantitation of red cell associated IgG in 62 Gambian patients with P. falciparum malaria and 23 normal adult controls was carried out, using a purified 125I labelled anti IgG. The number of IgG molecules per red cell was found to be between 90-897 molecules for patients with malaria and 100-233 for controls. 12 patients with malaria had raised levels of RBC associated IgG. There was no correlation between severity of anaemia and RBC associated IgG levels in patients with malaria nor was there a correlation between reticulocytosis and RBC associated IgG levels. It is concluded that although immune haemolysis may occur in some patients with malaria who have high levels of IgG or activated complement components on their red cells, other factors such as marrow suppression or ineffective erythropoiesis play an important role in the pathogenesis of the post malaria anaemia. PMID- 3510654 TI - Cutaneous immunological studies in diagnosis of acute graft-versus-host disease. AB - A comparative study of the healthy skin of patients who had undergone bone marrow grafting and not developed graft-versus-host disease (GVHD) and of patients with cutaneous lesions of acute GVHD has been carried out. The aim of this study was to assess the diagnostic value of cutaneous immunopathology in the diagnosis of acute GVHD. A double-labelling immunofluorescence technique was used with a panel of monoclonal antibodies. The results showed a lack of specificity for GVHD in the distribution of Langerhans cells, but confirmed the diagnostic value of HLA DR staining of epidermal keratinocytes. Cellular polymorphism of the T cell infiltrate in the dermis was observed (T helpers 40% and T suppressors 20%). The expression of the 55-57 Kd keratin polypeptide and of bullous pemphigoid antigen showed modification during acute GVHD while that of pemphigus antigen remained unchanged. PMID- 3510656 TI - Anaphylactic reaction to cyclosporin in a bone marrow transplant recipient. PMID- 3510657 TI - Pretreatment serum beta 2-microglobulin in multiple myeloma. AB - Serum beta 2-microglobuline (S-beta 2m) was evaluated in 121 untreated patients with multiple myeloma. Values greater than 3 mg/l were found in 82% of the patients. Mean S-beta 2m values of the total group of patients correlated with clinical stage. However, there was no correlation if values were corrected for S creatinine. Seventy-nine patients had normal (less than or equal to 106 mumol/l) and 52 patients abnormal S-creatinine. Patients with S-beta 2m values below 7 X 6 mg/l had an estimated median survival of 44 months compared to 12 months for patients with levels above 7 X 6 mg/l. If S-beta 2m values in patients with normal S-creatinine were combined with values corrected for S-creatinine from patients with elevated S-creatinine a beta 2m cut off level of 6 X 6 mg/l gave a median probable survival of 43 months compared to 14 months. We conclude that pretreatment S-beta 2 microglobulin is a useful marker for predicting survival in multiple myeloma. The problem of the relationship between S-beta 2m and S creatinine is discussed. PMID- 3510658 TI - Phorbol ester-induced production of beta-2-microglobulin in B-CLL cells: relation to IgM secretory response and disease activity. AB - Earlier studies have indicated that serum beta 2m levels correlate with the disease activity, estimated tumour cell mass and prognosis of CLL. We have therefore analysed the spontaneous and phorbol ester (TPA)-induced capacity of CLL cells to produce beta 2m in vitro in relation to disease activity. Cell cultures (greater than 90% B cells) from 15 patients with active disease contained significantly higher (P less than 0.001) levels of beta 2m (0.22 +/- 0.09 mg/l) than cultures from 17 patients with inactive CLL (0.08 +/- 0.06). When TPA-induced CLL cell cultures were compared, this difference was even more striking (0.48 +/- 0.18 versus 0.13 +/- 0.09). The capacity of TPA-treated B-CLL cells to export beta 2m was positively correlated with their capacity to secrete monoclonal IgM (r = 0.73; P less than 0.001). Cell depletion experiments showed that the beta 2m export by B-CLL cells is enhanced by accessory T cells. Four individual CLL patients were followed for 14 months and repeatedly investigated for signs and symptoms of active disease, and the CLL cells were tested for in vitro production of beta 2m. Fluctuations in the clinical activity of the leukaemia were paralleled by similar switches in CLL cell production of beta 2m. PMID- 3510659 TI - Urinary oestrogen levels and follicle ultrasound measurements in clomiphene induced cycles with an endogenous luteinizing hormone surge. AB - Total oestrogen in urine and the ultrasonic size of the follicles were measured in relation to the onset of the endogenous luteinizing hormone (LH) surge (day 0) in 18 cycles induced with clomiphene citrate in an in-vitro fertilization programme. Oestrogen values in urine (microgram/24 h) increased progressively during the late follicular phase up to the day of the onset of the surge. The mean maximum follicle diameter (22.3, SD 4.7 mm) estimated by ultrasound was measured on day 0. At the onset of the LH surge, the values of urinary total oestrogen showed a better relation with the total volume of the first three follicles in order estimated by ultrasound (r = 0.71) than with the mean ultrasonic diameter of the leading follicle (r = 0.56). A wide range of individual values for both urinary oestrogen and follicle size was found. In another group of 32 women treated with clomiphene for recovery of oocytes used for research purposes, a good correlation was found between the mean ultrasonic follicle diameter 16 h before the laparoscopy and the follicle diameter calculated from the fluid volume at aspiration (r = 0.80). These results suggest that the decision when to give human chorionic gonadotrophin (hCG) in an in-vitro fertilization programme remains arbitrary in many individual cases. Apart from the oestrogen levels, the calculation of the size of all follicles, instead of only the leading one, may give further help in timing the hCG. PMID- 3510661 TI - The value of ultrasound and clinical trials in obstetrics. PMID- 3510660 TI - Co-treatment of the male partner in vaginal candidosis: a double-blind randomized control study. AB - In a double-blind study, 117 non-pregnant women with vaginal candidosis were treated for 3 days with 200 mg-tablets of ketoconazole taken once, twice or three times daily. The incidence of predisposing factors or of a recurrence history did not differ between treatment groups. Their male partners were randomly assigned to receive ketoconazole, 200 mg twice daily or placebo for 3 consecutive days. Cure and recurrence rates were not different in the three treatment groups, with or without simultaneous treatment of the male partner. Treatment of the sexual partner in the three dose-regimen-groups proved not to have influenced the therapeutic effect. PMID- 3510662 TI - On the aetiology of malocclusion. The Northcroft lecture, 1985 presented to the British Society for the Study of Orthodontics, Oxford, April 18, 1985. PMID- 3510663 TI - Lower incisor position in treatment planning. AB - Attention has been focused on the position of the lower incisors in treatment planning. Determination of a stable incisor position around which to plan treatment is an important consideration. In the light of increasing use of fixed appliances in this country it is felt of value to present in detail the various methods available for planning lower incisor position. A brief appraisal of each is given and the literature relating to them discussed. It is concluded that whilst no particular method is ideal, the use of Ricketts' A-Po line in giving an indication of permitted direction of movement, tempered by a cautious approach as advocated by Mills should achieve a compromise between improved aesthetics and stability in most cases. A detailed study is required to assess more fully their practical application. PMID- 3510664 TI - Identification of neighbouring proteins by cross-linking of intact 70 S ribosomes from Escherichia coli. AB - 70 S ribosomes from Escherichia coli have been reacted with the bifunctional reagent 1,4-phenyldiglyoxal under near physiological conditions. As a result of the cross-linking reaction a number of high-molecular-weight protein fractions with altered electrophoretic mobility could be isolated. A new chemical procedure has been introduced to reverse the cross-links between proteins at least partially. The cleavage reaction did not affect the gel electrophoretic mobility of the proteins. Thus a direct identification of cross-linked proteins using one- or two-dimensional gels was made possible. Two protein trimers, S3-S4-S5 and L1 S4-S5, as well as five protein dimers, S3-S4, L6-L7/12, L10-L7/12, S9-L19 and L18 L19 could be identified as close neighbours in the E. coli 70 S ribosome. The protein pairs S9-L19 and L18-L19 had previously not been identified as near neighbours using cross-linking studies. PMID- 3510665 TI - Specificities of extracellular and ribosomal serine proteinases from Bacillus natto, a food microorganism. AB - The specificities of extracellular and ribosomal serine proteinase from Bacillus natto, a food microorganism, were investigated. Both proteins have highly restricted and characteristic specificities. With the extracellular serine proteinase, initial cleavage site was observed at Leu15-Tyr16, secondary site at Ser9-His10 and additional cleavage sites at Gln4-His5 and His5-Leu6 in the oxidized insulin B-chain. Hydrolysis of proangiotensin with the extracellular serine proteinase was observed primarily at Phe8-His9 and secondary at Tyr4-Ile5. The extracellular serine proteinase has a Km of 0.08 mM and kcat of 3 S-1 for angiotensin hydrolysis. With the ribosomal proteinase, initial cleavage site of the oxidized insulin B-chain was observed at Leu15-Tyr16 and additional cleavage site at Phe24-Phe25. Hydrolysis of proangiotensin was observed at Tyr4-Ile5 bond with the ribosomal proteinase. PMID- 3510666 TI - Monoclonal antibodies against salt-resistant rat liver lipase. Cross-reactivity with lipases from rat adrenals and ovaries. AB - To obtain monoclonal antibodies against rat salt-resistant liver lipase, mice were immunized with enzyme purified from heparin-containing rat liver perfusates. Hybridomas were screened for antibody production by means of an enzyme-linked immunosorbent assay (ELISA) and an immunoprecipitation assay. Five hybridoma cell lines secreting antibodies against rat liver lipase indicated as A, B, C, D and E, have been obtained. All antibodies possess gamma one (gamma 1) heavy chains and kappa (kappa) light chains. The antibodies precipitate salt-resistant lipase from rat post-heparin plasma, are positive in ELISA, inhibit liver lipase activity and bind monospecifically with the enzyme as shown by immunoblotting. The monoclonal antibodies showed no significant reactivity with human liver lipase. The salt-resistant lipases of rat adrenals and ovaries are also precipitated by the monoclonal antibodies directed against the liver enzyme. Therefore, the heparin-releasable lipases of the liver, adrenals and ovaries possess identical epitopes. PMID- 3510667 TI - Maturation and secretion of lipoprotein lipase in cultured adipose cells. II. Effects of tunicamycin on activation and secretion of the enzyme. AB - The effects of N-linked glycosylation on the activation and secretion of lipoprotein lipase were studied in Ob17 cells. The cells were first depleted of any activity and enzyme content by cycloheximide treatment and of precursors of oligosaccharide chains by tunicamycin. The repletion of lipoprotein lipase content was studied in these cells maintained in the presence of tunicamycin after cycloheximide removal. During the repletion phase, the EC50 values of inhibition by tunicamycin (approx. 0.2 microgram/ml) of the incorporation of labeled glucose, mannose or galactose into trichloroacetic acid-insoluble material were found to be identical. Under these conditions, the rate of protein synthesis was maximally decreased by 30%. The results showed clearly that the recovery in lipoprotein lipase activity was parallel to the recovery in hexose incorporation, no activity being recovered in the absence of glycosylation. An inactive form of lipoprotein lipase from tunicamycin-treated cells was detected by competition experiments with mature active lipoprotein lipase for the binding to immobilized antilipoprotein lipase antibodies, as well as by immunofluorescence staining. SDS-polyacrylamide gel electrophoresis and Western blots of cellular extracts and of extracellular media, obtained after tunicamycin treated cells were exposed to heparin, revealed a single immunodetectable Mr 52 000 protein, whereas a single Mr 57 000 protein was detected in control cells. Therefore, the results indicate that the acquisition by lipoprotein lipase of a catalytically active conformation is linked directly or indirectly to glycosylation. Despite this lack of activation, the lipoprotein lipase molecule was able to migrate intracellularily and to undergo secretion after heparin stimulation of the tunicamycin-treated cells. PMID- 3510668 TI - Intracellular localization of lipoprotein lipase in adipose cells. AB - Subcellular localization of lipoprotein lipase has been examined in differentiated Ob17 adipose cells. No patent activity is detectable in carefully homogenized cells. All latent activity can be unmasked by disrupting membrane structures with neutral detergents. The sequestration of lipoprotein lipase in closed membrane structures is supported by experiments of immunotitration with anti-lipoprotein lipase antibodies and by experiments showing a full protection of the masked activity against proteolytic attack by trypsin. The intracellular distribution of lipoprotein lipase investigated by immunofluorescence staining and by isopycnic centrifugation indicates that a large proportion of the enzyme is located in the Golgi apparatus, in which the activation of the enzyme is likely to take place (C. Vannier et al. (1985) J. Biol. Chem. 260, 4424-4431). Altogether, the results are in favor of a localization of lipoprotein lipase in adipose cells as being typical of that of a secretory protein and underline the absence of lipoprotein lipase in the cell cytoplasm. PMID- 3510669 TI - Characterization of the lipoprotein lipase in the functional pool of rat heart by immunoblotting. AB - Rat hearts were perfused with heparin for 2 min at 4 degrees C. The lipoprotein lipase activity in the perfusate was inhibited by antiserum to rat adipose tissue lipoprotein lipase. By immunoblotting, the lipoprotein lipase derived from the functional pool of the heart was found to be a protein with an apparent Mr of 69 000. After incubation of the perfusate at 37 degrees C for 24 h an immunologically reactive protein with an apparent Mr of 28 000 was found. This protein is not a physiological derivative of the enzyme but a degradation product. PMID- 3510670 TI - Quantitation of muscle glycogen phosphorylase mRNA and enzyme amounts in adult rat tissues. AB - Mammalian glycogen phosphorylases comprise a family of isozymes that are expressed selectively in a variety of cell types. As an initial step towards understanding the molecular processes that regulate the differential expression of the phosphorylase family, we have begun a quantitative examination of isozyme expression in vivo. In this paper, we report quantitative estimates of the amounts of the muscle (M) isozyme and its mRNA in adult rat tissues. Quantitative estimates of the amount of M-phosphorylase were obtained by an analysis involving electrophoretic transfer of proteins from polyacrylamide gels to nitrocellulose filters and sequential treatment with M-isozyme specific antibody and radioactively- labeled protein A. M-phosphorylase mRNA amounts were determined by an analysis involving transfer of RNA from agarose gels to nitrocellulose filters and subsequent hybridization with radioactively labelled rat M-phosphorylase cDNA. These studies indicate that M-phosphorylase is present in all tissues tested with the possible exception of liver. These are skeletal muscle, heart, brain, stomach, lung, kidney, spleen and testis. Quantitation of M-phosphorylase amounts indicate that there is a wide spectrum of variation (over 1000-fold range) in the relative amounts of the M-isozymes in these tissues. Relative mRNA levels parallel isozyme levels indicating that the major control of expression of this isozyme is governed by mRNA accumulation. PMID- 3510671 TI - An aspartic proteinase from human erythrocytes is immunochemically indistinguishable from a non-pepsin, electrophoretically slow moving proteinase from gastric mucosa. AB - Antiserum raised against an erythrocyte membrane-attached aspartic proteinase precipitates a non-pepsin gastric proteinase. With a monospecific antiserum raised against the non-pepsin gastric proteinase the two enzymes show immunochemical identity. The isoelectric points of both are between 4.5 and 4.6. By SDS-polyacrylamide gel electrophoresis the two proteinases behave the same way. Under non-reducing conditions the main components show molecular weights around 90 000 and after reduction about 58 000. The proteinase may tentatively be classified as cathepsin E. PMID- 3510672 TI - A pathway for putrescine catabolism in Escherichia coli. AB - Escherichia coli mutants able to grow in putrescine have been isolated from gamma aminobutyrate mutants. These mutants show putrescine-alpha-ketoglutarate transaminase and gamma-aminobutyraldehyde dehydrogenase activities. Both enzymes have been characterized, the first of them showing an apparent Km for putrescine of 22.5 microM and the second an apparent Km of 37 microM for NAD and 18 microM for delta-1-pyrroline; the optimum pH values were 7.2 and 5.4, respectively, for the two enzymes. PMID- 3510673 TI - [Immunoenzyme determination of antibodies to the surface of islands of Langerhans in autoimmune destruction of the insular apparatus]. AB - Enzyme-linked immunosorbent assay (ELISA) was applied for detection of human islet cell surface antibodies (ICSA) to rat islet target cells. In 23 healthy controls without hereditary diabetes the findings were on the upper normal limit (mean value of optical density + 3 SEM). The results above the limit were considered positive. 11 out of 18 insulin-dependent (Type I) diabetics with the disease duration less than 5 years were ICSA-positive. All 9 patients with insulin-independent (Type 2) diabetes were ICSA-negative. 3 out of 18 healthy subjects (siblings and children of probands with type II diabetes) were strongly ICSA-positive, although all the members of this risk group had unimpaired oral glucose tolerance test. Thus, ELISA screening of ICSA may be useful for discriminating patients with different types of diabetes and revealing nonaffected individuals at high risk according to their beta-cell integrity. PMID- 3510674 TI - [The state of gametes and the type of maturation of follicular oocytes in rats neonatally androgenized by LH-RH-induced ovulation]. AB - The character of follicular oocyte maturation and the state of gametes in androgenized rats was studied after LH-RH stimulation. The induction of ovulation with LH-RH has been shown to increase the number of rats with nonovulatory follicules and reduce the number of oocytes maturing prior to the onset of metaphase II. After the induction of ovulation the rate of chromosomal aberrations became higher than in intact animals. Ovulated oocyte population was characterized by the increased number of degenerated gametes. This increase was paralleled by decreased incidence of chromosomal aberrations in ovulated cells. PMID- 3510675 TI - [Prostacyclin control of thrombocyte-vascular hemostasis in irradiation]. AB - Disorders in prostacyclin control of the functional state of thrombocyte-vascular wall system are associated rather with decreased PGI2 stability in the blood flow, its accelerated decomposition and as a result with its shorter and weaker effect on thrombocyte-vascular hemostasis, than with the decline in PGI2 synthesis. It is suggested that rapid PGI2 decomposition in irradiation may significantly limit its therapeutic effect, requiring adequate correction of PGI2 dosage and mode of administration. PMID- 3510676 TI - [Glycerol models of the ciliated epithelium of bronchial mucosa and their use in the diagnosis of chronic nonspecific lung diseases]. AB - The method of extraction of ciliated epithelium from biopsy samples of human bronchial mucosa with glycerol is suggested. Permeabilized cilia of glycerol extracted cells can be easily reactivated by exogenous ATP. This method was used for the study of ciliary dyskinesia in patients with chronic lung diseases. It was shown that in patients with Kartagener's syndrome neither freshly-isolated, nor glycerol-extracted ATP-treated cilia were motile. On the other hand, in some patients with bronchial asthma ATP reactivated glycerol-extracted cilia, while cilia of freshly-isolated cells remained immotile. The study shows that glycerol permeabilization and reactivation by ATP can be used for the analysis of cilial contractile apparatus in patients with chronic lung disease. PMID- 3510677 TI - [Reaction of loose connective tissue fibroblasts after poly-4-vinylpyridine administration]. AB - Mice were injected with poly-4-vinylpyridine at a dose known to be effective for immunogenesis stimulation. Within 24 hours after the injection fibroblasts reacted by dendrit production, cytoplasm vacuolization and clasmocytosis. 2-3 days after the polymer injection the fibroblast cytoplasm was restored. The immunofluorescence employed rabbit serum natural antibodies to fibroblast antigens. The reaction observed may be used for the estimation of biological polymer activity. PMID- 3510678 TI - Influence of the calcium-sensitive fluorophore, Quin 2, on platelet function. AB - Recent investigations using Quin 2, a fluorophore used to monitor cytosolic free calcium shifts, have shown that strong agonists cause a dramatic dose-dependent increase in platelet fluorescence. However, weak agonists stimulated little or no increase in light emission of Quin 2-loaded platelets, suggesting that calcium flux is not involved in activation by these agents. The present study has sought an alternative explanation for the failure of weak stimuli to cause a rise in cytosolic free calcium in platelets containing Quin 2. Conditions used to prepare, wash, load, gel-filter, and evaluate the fluorophore-filled cells were examined for their compatibility with retention of sensitivity to activation by weak agonists. The technique used to measure shifts in cytosolic calcium with Quin 2 requires multiply washed, unstirred platelets. Under these conditions, platelets do not aggregate or secrete in response to weak agonists. Quin 2, at concentrations greater than 40 mumol/L, inhibits the response of platelets to strong agonists, and completely blocks their reaction to weak agonists. Quin 2 inhibition of platelet function appears related to high buffering capacity for free calcium, although other mechanisms cannot be ruled out. This suggestion is supported by the observation that Quin 2-induced blockade can be overcome by membrane modulation, which is a calcium-dependent process. However, since both agonists are weak, significant elevation in cytosolic calcium concurrent with functional restoration could not be demonstrated under the experimental conditions used for monitoring calcium. Thus, the conditions used to prepare platelets for Quin 2 evaluation and Quin 2 itself appear to be responsible for the failure of weak agonists to cause evidence of a calcium shift in fluorophore loaded cells. PMID- 3510679 TI - Altered stem cell (CFU-S) function following infection of hematopoietic cells with a virus carrying V-src. AB - Long-term murine bone marrow cultures were used to support the growth and development of hematopoietic cells. After hematopoiesis was established, the cultures were infected with a recombinant murine amphotropic virus carrying the avian sarcoma virus src gene and the CFU-S kinetics were examined. The CFU-S from the src-infected cultures displayed a reduced seeding efficiency in the standard spleen colony assay. The self-renewal capacity of these CFU-S was tested by their ability to reestablish hematopoiesis when serially transplanted on irradiated bone marrow cultures and by serial passage in spleens of irradiated mice. In both tests, cells from the src-infected cultures exhibited an enhanced ability to sustain a high level of self-renewal. The other property of stem cells which may be measured is the probability of self-renewal at each cell division which dictates the distribution between stem cells and differentiated type progeny. CFU S from the src-infected cultures had higher average probabilities of self-renewal and therefore reduced differentiation. These differences suggest that expression of src had indirectly or directly altered the normal differentiation program of the stem cells. PMID- 3510680 TI - Incomplete antigenic cross-reactivity between platelets and megakaryocytes: relevance to ITP. AB - Immune thrombocytopenias are usually associated with normal or increased numbers of megakaryocytes in the marrow. Therefore, the mechanism(s) responsible for the destruction of circulating platelets may not affect megakaryocytes in the same way. One of the possibilities which could account for the differential effect on the cells would be the development of antibodies to components of platelet membranes which are not exposed on the surface of all megakaryocytes. To investigate this possibility, a rabbit antiserum specific for mouse platelets was tested against fresh and cultured mouse megakaryocytes by indirect immunofluorescence. This antiserum cross-reacted with 46% of fresh murine megakaryocytes and 54% of cultured megakaryocytes. Phase-contrast microscopy revealed the reacting megakaryocytes to be fully granulated with irregular contours and in the process of releasing platelets. Nonreactive megakaryocytes demonstrated smooth contours and lacked morphological evidence of thrombocytopoiesis. Electron microscopy showed that only in megakaryocytes (MK) with an irregular contour had the demarcation membrane system (DMS) reached continuity with the plasma membrane. Ultrastructural analysis of megakaryocytes from patients with ITP showed approximately 25% to 50% of megakaryocytes without evidence of injury, whereas 50% to 75% had extensive damage. In undamaged cells, platelet territories had not yet reached the peripheral zone. The DMS of damaged megakaryocytes opened to the exterior elaborating platelets. The observations suggested that some platelet antibodies react only with megakaryocytes which have reached the stage of thrombocytopoiesis. Relevant target antigens may not be exposed on all megakaryocytes before cytoplasmic fragmentation occurs. PMID- 3510681 TI - HLA-haploidentical bone marrow transplantation for severe combined immunodeficiency using E rosette fractionation and cyclosporine. AB - Eight patients with severe combined immunodeficiency received bone marrow cells from their HLA haplotype-identical fathers after bone marrow T cell depletion by rosetting with neuraminidase-treated sheep red cells. Because the method led to the infusion of a small percentage of T lymphocytes (0.1% to 0.3%), cyclosporin was given by continuous intravenous infusion for two months in order to prevent the occurrence of graft-v-host disease (GVHD). Three patients who did have residual nonfunctional T lymphocytes received busulfan and cyclophosphamide before transplantation. Engraftment was observed in seven patients, and severe GVHD was not seen. Two patients died early after the bone marrow transplantation because of prior infections, and a third died at day 90 from a B cell lymphoproliferative syndrome. The five other patients are doing well. Stable engraftment has been achieved with reconstitution of cell-mediated immunity in 5/5 and humoral immunity in 4/5 patients. PMID- 3510682 TI - Elimination of Daudi lymphoblasts from human bone marrow using avidin-biotin immunoadsorption. AB - Biotinylated antibodies and an avidin-Sepharose 6MB column were utilized in a novel approach to deplete selected cell populations from human bone marrow. Fluorescein-labeled Daudi lymphoblasts were mixed with bone marrow mononuclear cells in a model system, and removal of Daudi cells was quantitatively assessed with an inverted fluorescent microscope. Treatment using the biotinylated monoclonal antibody 2H7 reactive with Bp32 antigen (expressed on Daudi cells) followed by passage over avidin-Sepharose produced greater than two logs of Daudi cell removal from bone marrow. An alternative method was tested by treating cells successively with nonbiotinylated monoclonal antibody and biotinylated goat antimouse immunoglobulin followed by passage over avidin-Sepharose. Up to three logs of Daudi cells could be eliminated from bone marrow with quantitative recovery of hematopoietic progenitors. The use of biotinylated goat antimouse immunoglobulin eliminates the need to prepare a biotin conjugate of each individual monoclonal antibody. The clinical application of cellular immunoadsorption using the avidin-biotin system may prove useful in bone marrow transplantation. PMID- 3510683 TI - Ultraviolet irradiation of blood prevents transfusion-induced sensitization and marrow graft rejection in dogs. AB - In a canine model using DLA-identical littermate pairs, we have shown that a regimen of three transfusions of donor blood given 24, 17, and 10 days before transplant uniformly leads to marrow graft rejection, presumably due to sensitization to minor (non-DLA) histocompatibility antigens. Untransfused dogs uniformly achieve sustained engraftment. In the present study, we investigated whether the exposure of blood to ultraviolet (UV) light (220-300 nm) prior to transfusion prevented sensitization of the recipient and allowed for successful marrow engraftment. Ten dogs were each given three pretransplant transfusions from the marrow donor. Each transfusion consisted of 50 mL of whole blood exposed in vitro to UV light for a total of 1.35 J/cm2. All ten dogs achieved engraftment. In contrast, all four dogs that had received sham-exposed transfusions rejected their grafts. In vitro studies revealed that although cell viability was not affected, leukocytes contained in UV-exposed blood were unable to function as stimulator cells in mixed leukocyte cultures or as accessory cells in mitogen-stimulated cultures. These data are consistent with the hypothesis that accessory cells are involved in transfusion-induced sensitization. We conclude that in vitro exposure of blood to UV light before transfusion prevents sensitization and allows for subsequent marrow engraftment. PMID- 3510684 TI - Thrombospondin in essential thrombocythemia. AB - Essential thrombocythemia is a myeloproliferative disorder characterized by frequent bleeding and thrombotic complications. On a molecular level, two abnormalities of platelet thrombospondin have been identified: abnormal glycosylation of the intact 185,000-dalton chain has been detected and a shortened form of the thrombospondin chain is present. We have used two monoclonal antibodies and Lens culinaris lectin to probe the structure of thrombospondin in the platelets from three patients with essential thrombocythemia; one patient with polycythemia vera and two patients with secondary thrombocytosis. The presence of abnormal thrombospondin fragments with molecular weights of 160,000 and 30,000 was detected in the intact platelets and in the supernatant from thrombin-treated platelets, in all of the individuals except one of the secondary thrombocytosis patients. Monoclonal antibody binding studies indicate that both fragments are produced by proteolysis at a single site, which results in the removal of a 30,000-dalton fragment from the NH2 terminal. Lens culinaris lectin-binding studies revealed that some of the carbohydrate moieties of thrombospondin are near this cleavage site. The results are consistent with the hypothesis that the abnormal thrombospondin fragments observed under conditions of increased platelet production are due to increased susceptibility to proteolysis which, in turn, may be due to defective glycosylation. PMID- 3510685 TI - Clinical advantages from measurement of IgM-rheumatoid factor by enzyme immunoassay. AB - Two enzyme immunoassays for rheumatoid factor (RF) were compared with the traditional latex agglutination test. Preference is expressed for an ELISA specific for IgM-RF because it yields specific, quantitative results. Variability of this assay was least in sera containing moderate levels of RF and it was less precise at low concentrations. Survey of a random selection from the local population showed a similar prevalence of IgM-RF positivity as revealed by previous surveys using agglutination techniques. We conclude that measurement by ELISA yields no great increase in the discriminative ability of RF testing. PMID- 3510687 TI - A double-blind study of the simple analgesic nefopam in rheumatoid arthritis. AB - The role of pure analgesics in the management of rheumatoid arthritis (RA) remains uncertain. In a double-blind cross-over study of 27 patients, nefopam was a more effective analgesic than placebo when given as a supplement to anti inflammatory drugs. Both early morning stiffness and grip strength were also improved, suggesting that these are associated with pain perception rather than any other aspect of inflammation. Side-effects occurred in 9 (35%) on nefopam and none on placebo. The results suggest a valuable supplementary role for analgesics such as nefopam in the treatment of RA. PMID- 3510686 TI - Multicentre study of piroxicam versus naproxen in juvenile chronic arthritis, with special reference to problem areas in clinical trials of nonsteroidal anti inflammatory drugs in childhood. AB - Clinical trials of nonsteroidal anti-inflammatory drugs (NSAIDs) are necessary in juvenile chronic arthritis (JCA) but pose certain problems highlighted and discussed in this study, including recruitment, the assessment of efficacy, and the heterogeneity of the disease. In a multicentre 8-week double-blind cross-over study using the double-dummy technique, piroxicam was compared with naproxen in 47 children with seronegative JCA aged 5-16 years. No significant difference between the two treatments was found in either the clinical variables measured or the parent/patient and physician preference at the end of the study. Side-effect profiles of the two drugs were similar, mainly gastrointestinal disturbances. Piroxicam may be a useful alternative NSAID in JCA, particularly in view of its once-daily dosage. PMID- 3510688 TI - Topography of choline acetyltransferase immunoreactive neurons and fibers in the rat spinal cord. AB - The topography of choline acetyltransferase immunoreactivity was studied in the rat spinal cord with a monoclonal antibody. Cholinergic fibers were most prominent in lamina III of the dorsal horn and originated from cholinergic neurons within the spinal cord. Lamina X, which was rich in cholinergic neurons and fibers, provided cholinergic interconnections between the dorsal, intermediate and ventral gray. Within the ventral gray, choline acetyltransferase immunoreactive boutons were found on motor neurons. This study suggests that the cholinergic innervation of the spinal cord arises from neurons intrinsic to the spinal cord. The cholinergic neurons within the spinal cord may provide several, overlapping levels of regulation of spinal cord neurons. PMID- 3510689 TI - Ultrastructural localization of enkephalin immunoreactivity in the substantia nigra of the monkey. AB - Localization of enkephalin-like immunoreactivity in the substantia nigra of the Japanese red-faced monkey was investigated by light and electron microscopy using the peroxidase-anti-peroxidase method. Immunoreactive precipitates were predominantly distributed in the nerve fibers of the substantia nigra pars reticulata but not in the perikarya, and a low density of immunoreactive enkephalin was found in the pars compacta of this nucleus. Electron microscopic observations showed that enkephalin-immunoreactive precipitates were located in axon terminals containing numerous small clear vesicles either with or without labeled large granular vesicles and formed predominantly axo-dendritic synapses. PMID- 3510690 TI - Focal axonal swellings in rat cerebellar Purkinje cells during normal development. AB - Focal axonal swellings are characteristic of a wide range of neuropathies. Three neuron-specific monoclonal antibodies have been used to identify focal axonal swellings in the normal developing rat cerebellar cortex. Between 7 and 15 days postnatal, swellings are a common feature of the granular layer and white matter tracts. Using a Purkinje cell-specific antibody, the majority of swellings were shown to occur in Purkinje cell axons. Focal axonal swellings therefore seem to be a normal adjunct of Purkinje cell maturation. PMID- 3510691 TI - Immunocytochemical localization of aspartate aminotransferase and glutaminase immunoreactivities in the cerebellum. AB - The distributions of glutaminase and aspartate aminotransferase were studied immunocytochemically in the cerebellum of the guinea pig and the rat. In the granule cell layer, both antibodies gave a similar staining pattern. Granule cell bodies were labeled, but staining was also found to lie outside the cell body, associated with what appear to be synaptic processes. In the molecular and Purkinje cell layers, aspartate aminotransferase was concentrated in stellate and basket cell bodies and in terminal baskets beneath Purkinje cells. Glutaminase, however, was not concentrated in these structures. PMID- 3510692 TI - Specific detection of noradrenaline in the rat brain by using antibodies. AB - Noradrenaline (NA) was conjugated to different protein carriers with glutaraldehyde. During the catecholamine conjugate synthesis, precautions were taken in order to preserve the structure of NA. Anti-NA antibodies were raised in rabbits and tested using a modified enzyme-linked immunosorbent assay and immunocytochemistry. The most immunoreactive antigen was found to be the reduced NA conjugate. The octopamine conjugate was recognized by the NA antiserum 16 X less than the reduced NA conjugate. The other conjugates, dopamine, L dihydroxyphenylalanine and adrenaline were poorly recognized by the anti-NA antibodies. A good correlation was found between results obtained using the in vitro enzyme-linked immunosorbent assay and immunocytochemistry. PMID- 3510694 TI - Review articles: 2. The literature jungle. PMID- 3510693 TI - John Donne's sickness. PMID- 3510695 TI - Hemorrhagic colitis due to Escherichia coli O157:H7 (correction) PMID- 3510696 TI - Rapid identification of group A beta-hemolytic streptococci in throat swabs. Infectious Diseases and Immunization Committee, Canadian Paediatric Society. PMID- 3510697 TI - Mengele's conduct: who was responsible? PMID- 3510699 TI - Jean Frances Webb. PMID- 3510698 TI - Vaginitis: current microbiologic and clinical concepts. AB - Infectious vaginitis occurs when the normal vaginal flora is disrupted; it may arise when saprophytes overwhelm the host immune response, when pathogenic organisms are introduced into the vagina or when changes in substrate allow an imbalance of microorganisms to develop. Examples of these types of vaginitis include the presence of chronic fungal infection in women with an inadequate cellular immune response to the yeast, the introduction of trichomonads into vaginal epithelium that has a sufficient supply of glycogen, and the alteration in bacterial flora, normally dominated by Lactobacillus spp., and its metabolites that is characteristic of "nonspecific vaginitis". The authors review microbiologic and clinical aspects of the fungal, protozoal and bacterial infections, including the interactions of bacteria thought to produce nonspecific vaginitis, that are now recognized as causing vaginitis. Other causes of vaginitis are also discussed. PMID- 3510700 TI - Phase I clinical trial and pharmacokinetics of carboplatin (NSC 241240) by single monthly 30-minute infusion. AB - Carboplatin (diammine [1,1-cyclobutanedicarboxylate(2-)-O,o']platinum) is a second generation platinum coordination complex. It has a spectrum of activity that is similar to that of cisplatin and is less nephrotoxic and emetogenic in experimental animals. Fifty-two 30-minute infusions of carboplatin were given to 20 evaluable patients with a variety of solid tumors. Maximum tolerated dose was 440 mg/m2. Thrombocytopenia (less than 100,000/mm3) occurred in six of seven patients; two patients experienced a leukocyte count less than 2000/mm3. Platelet and leukocyte count nadirs occurred on day 21. No nephrotoxicity was seen. Blood urea nitrogen, serum creatine levels, and creatinine clearances remained normal, and no consistent elevation of urinary beta 2-microglobulin, leucine aminopeptidase, or N-acetyl-beta-glucosaminidase occurred. Nausea and vomiting were mild to moderate. A single patient developed mild peripheral neuropathy. No auditory toxicity was noted. The recommended dose for Phase II studies is 400 mg/m2 every 28 days for good risk patients; heavily pretreated patients should receive 320 mg/m2. PMID- 3510701 TI - Large noncleaved follicular center cell lymphoma. Clinical features in 53 patients. AB - To clarify the clinical characteristics of large noncleaved lymphoma (LNC-FCC; intermediate grade, large cell, noncleaved, Working formulation), 53 patients were studied. Thirty-one were male and 22 female. Median age was 54 years. Initial symptoms included lymphadenopathy (40%), pain (34%), and B symptoms (21%). Stage I disease was present in 6, Stage II in 9, Stage III in 14, and Stage IV in 24 (72% Stage III or IV). Gastrointestinal (GI) tract involvement was present in 13. Central nervous system (CNS) disease was present at diagnosis in two patients, occurred during therapy in two, and was the sole site of relapse in two. Bone marrow involvement was found in 7 of 50 patients (14%). Complete remission was attained in 60% of all patients. Twenty-nine Stage III and IV patients received intensive multiagent chemotherapy; complete remission (CR) was attained in 69%. In contrast, zero of nine patients with Stage III or IV disease who did not receive an anthracycline-containing regimen, attained CR. Median survival for the entire group was 25 months. It was concluded that, in our patients with LNC-FCC, GI involvement was prominent (25%) and CNS disease was not uncommon (11%). Long-term disease-free survival may be achieved in patients with more advanced disease after the administration of anthracycline-containing combination chemotherapy. PMID- 3510702 TI - Improved understanding of mammary cancer. AB - Interest in cancer of the breast has begun to yield a concentrated sequence of specific information as to its basic nature, dietary influences, and its hormonal and genetic determinants. Clearly, the advent of improved early diagnosis has allowed the presentation to the clinician of a more favorable aspect of the tumor than has previously been seen, and has altered the overall clinical character of the disease. These advances open the possibilities of greatly expanded and enhanced treatment options, both for the informed physician and the inquiring patient. The rewards of early diagnosis include the possibilities of functional reconstruction, which may alter the potential patient attitude to such an extent that even earlier diagnosis will be achieved in years ahead. The complex issues of multimodality therapy and the honest and valid stratification of patients are the key issues in the further study of this challenging illness. PMID- 3510703 TI - Characterization of a new monoclonal antibody to a cell surface antigen on colorectal cancer and fetal gut tissues. AB - Murine hybridoma were raised against the human colon carcinoma cell line CL-187. One clone was found to secrete a monoclonal antibody (ND-1) that recognizes a large external antigen (LEA) on human colon carcinoma cells. With indirect immunofluorescence on formaldehyde-fixed cells, more than 90% of the human colorectal carcinoma cell lines tested expressed LEA. Almost all of the 46 human noncolorectal and nonhuman cell lines tested did not express LEA, including cancer cell lines from other endodermally derived tissues. Staining of frozen sections from human colorectal tumors, noncolorectal tumors, normal adult, and normal fetal tissues showed expression of the antigen on colorectal cancer tissue, fetal colon, and fetal biliary epithelium. LEA can also be detected in the serum and ascites of colorectal cancer patients. Double indirect immunofluorescence with rabbit anti-carcinoembryonic antigen (CEA) antibody and ND-1 monoclonal antibody on a human colorectal carcinoma cell line showed that LEA is distinct from CEA. Physicochemical analysis of LEA showed that it has a large molecular weight, is resistant to extraction from the cell surface, and that sialic acid is an important component of the antigenic site. Because of the specificity for colorectal cancer tissue along with certain biochemical properties, LEA appears to be unique when compared with other tumor-associated antigens. Further research is needed to define the clinical usefulness of LEA in either the diagnosis or treatment of colorectal carcinoma. PMID- 3510704 TI - A prospective randomized study of sutured versus stapled bowel anastomoses in patients with cancer. AB - Eighty-eight cancer patients with the presence of one or more adverse factors for healing (carcinomatosis, adhesions, prior chemotherapy and radiation therapy, bowel obstruction, anemia, and low leukocyte count or albumin value) were prospectively randomized to undergo conventional two-layer hand suturing (45 patients) or mechanical stapling with a GIA/TA instrument (U.S. Surgical Corp., Norwalk, CT) (43 patients) of the large or small bowel anastomosis. Age, sex, complete blood count findings, and all biochemical plasma values were comparable in both groups. The anastomosis took an average of 19 minutes for the sutured and 9 minutes for the stapled technique (P = 0.0001), but the average length of operation, postoperative return of bowel function, and hospital stay were comparable in both groups. Bowel fistula was seen in one case of stapled anastomosis (P = not significant). The pulmonary and wound complication rates were the same in both groups. Of the four deaths (4.5%) due to causes unrelated to bowel anastomosis, three occurred in the stapled and one in the sutured group. It was concluded that a stapled anastomosis is as safe as a sutured one in patients with advanced-stage cancer. It saves time in anastomosis, but does not save time in postoperative return of the bowel function and hospital stay. PMID- 3510705 TI - Breast cancer 1985. What have we learned? AB - A popular misconception infers that all breast cancers are systemic from their inception, that variations of primary therapy will not affect prognosis, and that an effective systemic therapy is already available. This is not so. Moderate improvement in long-term survival of breast cancer patients has occurred during the last three decades, and particularly more recently, due to increased detection of "early" disease. More patients are being encountered with early Stage I lesions that are confined to the breast or with minimal axillary involvement. These patients have a minimal risk of occult systemic spread, and the majority can anticipate long-term disease-free survival through adequate primary therapy that achieves total local control. The great majority of our patients who are free of disease 15 years following aggressive primary therapy remain so thereafter. Although adjuvant multichemotherapy has prolonged disease free survival, its effect on long-term patient survival has been marginal. Optimum control of breast cancer is achieved through early detection (most important) and aggressive primary therapy that aims to achieve total local control, plus the use of the best available systemic therapy for patients with high risk of occult systemic disease. PMID- 3510706 TI - Cardiac angiosarcomas. A review and a case report. AB - Forty-five cases of cardiac angiosarcomas were reviewed, and the data were compared with those of a 1968 review of 41 other cases which revealed these tumors to be typically located within the right atrium as large symptomatic masses and to be rapidly fatal, with the diagnoses usually determined only at autopsy. The relationship of these tumors to Kaposi's sarcoma was also examined. The findings paralleled those of the previous review. Additionally, the following points emerged: With the aid of newer imaging techniques, localization, biopsy diagnosis and resection of the atrial tumors are now being achieved more often, with some improvement in survival. Like angiosarcomas of other organs, atrial angiosarcomas exhibit highly variable histologic patterns, which often overlap those of Kaposi's sarcoma, and may also present metastatic patterns simulating widespread Kaposi's sarcoma or malignant melanoma. In reported cases of classical, endemic, or epidemic Kaposi's sarcoma, cardiac lesions are uncommon and typically are small, asymptomatic, restricted to the epicardium/or pericardium and, thus, are clearly different, both clinically and pathologically, from the atrial tumor group. The justification for designating cases of the latter group as "primary cardiac Kaposi's sarcoma" is open to debate. A case report illustrates many of the above points. PMID- 3510707 TI - Immunocytochemical assay of estrogen receptors in endometrial carcinoma with monoclonal antibodies. Comparison with biochemical assay. AB - Specimens of endometrial adenocarcinoma, surgically obtained from 18 women, were analyzed for distribution of estrogen receptors by an immunocytochemical assay, employing monoclonal anti-estrophilin antibodies and the peroxidase antiperoxidase technique. Results were compared with biochemical receptor analyses, and were in concordance in 83% of them. Marked tumor cell and tissue receptor heterogeneity were apparent with the immunocytochemical method, and a variety of patterns of nuclear staining in positive tissue samples were revealed. These results indicate that the immunohistologic method will provide a number of entirely new variables that may eventually be correlated with both clinical and pathologic features of this malignancy, and may prove to be of value in the prediction of clinical endocrine response. PMID- 3510708 TI - Intracardiac infections due to coagulase-negative Staphylococcus associated with Hickman catheters. AB - Three bone marrow transplant recipients experienced right-sided intracardiac infection due to coagulase-negative Staphylococcus infection associated with Hickman catheter use. In each case, multiple blood cultures yielded coagulase negative Staphylococcus organisms, and echocardiography demonstrated mass lesions or vegetations in the right atrium. Two patients appeared to have infected intracardiac thrombi without definite valvular involvement, whereas one had both an atrial mass and a tricuspid valve vegetation. All patients were treated with catheter removal and 4 weeks of antibiotic therapy, and one patient required cardiac surgery after failure of antibiotic therapy and an apparent paradoxic embolus to the central nervous system. Intracardiac infection is a rare but potentially fatal complication of Hickman catheter use. Echocardiography may be useful in establishing the diagnosis in suspected cases. PMID- 3510709 TI - Transrectal ultrasonography for prostatic cancer. II. The response of the prostate to definitive radiotherapy. AB - Transrectal ultrasonography was used to monitor the response of adenocarcinoma of the prostate to radiotherapy before and 6 to 15 months after treatment combining implantation of radioactive gold seeds with external beam irradiation. Data gathered before and after irradiation therapy suggested that the two most sensitive measures for monitoring the primary tumor are the calculated volume of the prostate and the integrity of the prostatic capsule. The calculated volume of the prostate decreased significantly in all patients by 6 months after radiotherapy. The rate and degree of reduction correlated significantly (P less than 0.05) with the histologic grade of the tumor (poorly differentiated tumors shrinking most rapidly), as well as with the outcome of treatment (P less than 0.05). However, there was no such correlation with stage. After treatment, the average number of sites of capsular disruption decreased steadily, reaching 50% of the pretreatment number by 15 months. Transrectal ultrasonography is a practical, inexpensive, noninvasive tool for monitoring the response of prostatic cancer to definitive radiotherapy, and may provide a means of identifying patients who will respond poorly to treatment. PMID- 3510710 TI - Head and neck aspergillosis in patients undergoing bone marrow transplantation. Report of four cases and review of the literature. AB - Aspergillus infection can be a major cause of morbidity in immunocompromised patients, especially when there is pulmonary involvement. Diagnosis of aspergillosis is often complicated by the varied clinical presentation and compromised medical status of such patients. Four cases of head and neck Aspergillus infections in bone marrow transplant patients are presented. Involvement predominantly was limited to the oral cavity and/or sinuses, and in one case, the ear. Two cases were successfully managed with a combined antibiotic and surgical approach, and one case with antibiotics only. The fourth case was managed with antibiotics and surgery, but fatal hemorrhage secondary to sinus involvement developed. PMID- 3510711 TI - Changes in breast self-examination behavior in a cohort of 8214 women in the Canadian National Breast Screening Study. AB - A study cohort of 8214 women was formed from all participants in the Canadian National Breast Screening Study who attended their first three screens after the introduction of a structured evaluation protocol involving eight criteria for breast self-examination (BSE). Self-reported BSE frequency was collected by questionnaire at all three screens. Breast self-examination instruction preceded breast exam at each screen but BSE evaluation occurred only at the second and third screen. Reported monthly BSE frequency increased from 18% to 51% to 55% on first, second, and third screens, respectively. The proportion claiming to do no BSE fell correspondingly: 52%, 16%, and 11%. Compliance with each of the seven other BSE criteria was significantly greater at the third screen than at the second. The mean number of these criteria performed at screen 3 was 5.1 compared with 4.4 at screen 2; older women performed as well as younger. The mean number of criteria performed was associated with BSE frequency at screen 3. The authors conclude that women's BSE behavior can be altered, and that integration of BSE evaluation and instruction into routine medical exams seems feasible and potentially useful. PMID- 3510712 TI - A culture technique for chromosome analysis in human myeloid leukemias. AB - A simple culture technique for the study of cells from myeloid leukemias and other blood disorders of myeloid series is described. The procedure is the same with that of the ordinary cultures, except for the addition of colony stimulating factor. A large number of mitotic cells can be obtained, and they are quite suitable for banding treatments. Clear banding patterns are consistently obtained. PMID- 3510713 TI - Cytogenetic findings in acute monocytic leukemia in a renal allograft recipient. AB - Chromosome analysis of bone marrow cells from a patient with acute monocytic leukemia, who had had a renal transplant followed by immunosuppressive treatment 45 months prior to the onset of leukemia, showed an unusual karyotype: 48,XX,+8,+8, t(1q12----pter::11q12----qter), t(4p12----qter::6p11----pter),t(7p22 ---qter::12q23 ----qter?), t(1q11----qter::17p11----11qter). PMID- 3510714 TI - Persistence of t(4;11) in cytologically normal bone marrow treated ex vivo with Asta-Z. AB - The chromosomal anomaly t(4;11) is closely related to a specific type of acute leukemia: occurrence in young children, hyperleukocytosis with a particular immunologic phenotype, and poor response to therapy. Allogeneic bone marrow (BM) transplantation has been done in a few cases. We report a case in which a complete remission was obtained after intensive therapy. Because no donor was available, an autologous BM transplantation was performed after purge ex vivo of the BM collection by Asta-Z. Relapse occurred at day 45. PMID- 3510715 TI - Cytogenetic markers in allogeneic bone marrow transplantation. AB - Engraftment after bone marrow transplantation (BMT) can be monitored with genetic markers. Cytogenetic markers are the ones that can be studied earliest. Of 27 patients studied, 16 had a sex-mismatched donor, and in 8 cases, there were discriminative markers identified with regular Giemsa and Q-banding. In one case, there was a rather slight polymorphism of the C-bands of chromosomes #9. Thus, donors' cells were identifiable in 25 of 27 cases (93%). The markers studied easiest are the sex chromosomes #3 and characteristic satellites of acrocentric chromosomes are rather frequent and also well suited to discriminate donors' from patients' cells. Nonprominent variabilities (fluorescence of the centromeric regions of chromosomes #4 and #6 after Q-banding), rare polymorphisms (pericentric inversions of chromosomes #1 and #9), and difficult to evaluate polymorphisms (heterochromatic regions of chromosomes #1, #9, and #16) are not very practical for the routine monitoring of engraftment after BMT. PMID- 3510716 TI - Chromosomal changes in a documented case of malignant histiocytosis: significance of polyploidy. AB - A case of malignant histiocytosis was studied by cytology, cytochemistry, electron microscopy, and cytogenetics. It was shown that the malignant cells expressed a fully differentiated histiocytic pattern with high macrophagic activity. This correlated with the presence of polyploid metaphases. The significance of polyploid cells in the definition of malignant histiocytosis is discussed. PMID- 3510717 TI - Mutagenicity and DNA-excision repair induced by isoniazid after metabolic activation by isolated human and rat hepatocytes. AB - The mutagenic potency of isoniazid (INH) (a widely used antitubercular drug) towards Salmonella typhimurium strain hisG46 was studied in the Salmonella/hepatocyte suspension-assay, comprising isolated human or rat hepatocytes as metabolic system. The potency of INH to induce DNA-excision repair in these hepatocytes was also measured. With rat hepatocytes, INH appeared to be only weakly mutagenic and did not induce significant increases in hepatocellular DNA-excision repair. With isolated hepatocytes of two human subjects, INH appeared also only weakly mutagenic. However, with hepatocytes of two other human subjects, INH was found to be highly mutagenic. Comparable results were obtained for the induction of hepatocellular DNA-excision repair. PMID- 3510718 TI - Effect of irradiation on ethyl nitrosourea induced neural tumours in Wistar rat. AB - Wistar rats received 2 Gy whole body irradiation followed immediately by 10 mg/kg of ethyl nitrosourea (ENU) on the day of birth. Out of 33 rats which were given ENU alone 14 developed 22 tumours of the nervous system, out of which 15 (68.2%) were gliomas and 7 (31.8%) were Schwannomas. Out of 34 rats which were given both irradiation and ENU 12 were found to harbour 15 neural tumours out of which 14 (93.3%) were gliomas and 1 (7.1%) was a Schwannoma. The pretreatment with irradiation seems to have resulted in selective suppression of Schwannoma induction. PMID- 3510719 TI - Macrophage tumoricidal activity as a possible antitumor mechanism associated with the local injection of allogeneic spleen cells into rats. AB - The in vivo antitumor effect of i.p. injection of allogeneic spleen cells was investigated. ACl rats were inoculated i.p. with 10(4) AMC-60 syngeneic fibrosarcoma cells and given injections i.p. of 4 X 10(7) Wistar spleen cells once a week for 3 wk from 1 day after tumor inoculation. This treatment significantly prolonged the survival period of the tumor-bearing rats. A similar effect was obtained by i.p. injections of Lewis spleen cells. Injection i.p. into ACl rats of spleen cells of these rat strains resulted in the apparent augmentation of cytolytic activity of peritoneal adherent but not of nonadherent cells against AMC-60 tumor cells. The cytotoxicity was exhibited nonspecifically to cells of a variety of tumor lines but not to concanavalin A blasts of ACl spleen cells and was inhibited by the addition of carrageenan. Irradiation (2000 R) of Lewis spleen cells or fractionation of the allogeneic spleen cells using nylon wool columns revealed that a radiosensitive and nylon wool-passed cell population, presumably a T-cell population, of the allogeneic spleen cells is responsible for the augmentation of peritoneal macrophage tumoricidal activity in ACl rats. Further, Lewis spleen cells irradiated at 2000 R neither augmented peritoneal macrophage cytotoxicity nor prolonged the survival period of ACl rats bearing AMC-60 tumor, suggesting that the augmentation of peritoneal macrophage cytotoxicity plays a major role in the in vivo antitumor effect of the allogeneic spleen cell transfer. ACl rats were given injections i.p. of 4 X 10(7) Lewis spleen cells. Two days after injection, cells including peritoneal cells of the ACl rats and Lewis spleen cells remaining in the peritoneal cavities were obtained by peritoneal lavages and then incubated for 5 days. Significant blastogenic proliferation was observed, and the supernatant of the culture was shown to be able to render thioglycollate-induced peritoneal macrophages of ACl rats cytotoxic to AMC-60 tumor cells, indicating that a certain cell population of the cell mixture produced a lymphokine(s) resembling macrophage activating factor (MAF) during the incubation. When ACl rats were given injections i.p. of irradiated Lewis spleen cells, neither the blastogenic proliferation nor the generation of MAF activity in the culture supernatant was observed. Indirect immunofluorescence analysis using rabbit anti-ACl and anti-Lewis antisera revealed that as many irradiated Lewis spleen cells were remaining in the peritoneal cavities as normal Lewis spleen cells 2 days after injection into ACl rats.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3510720 TI - Elimination of clonogenic tumor cells from human bone marrow using a combination of monoclonal antibody:ricin A chain conjugates. AB - Effective autologous bone marrow transplantation for leukemia and lymphoma is likely to depend upon the selective removal in vitro of malignant cells from normal human bone marrow precursors. Highly specific cytotoxic conjugates formed by coupling ricin A chain to monoclonal antibodies might prove useful for the selective elimination of malignant cells. Consequently, ricin A chain conjugates have been prepared with several different murine monoclonal antibodies and tested for their ability to eliminate clonogenic Burkitt's lymphoma cells from an excess of human bone marrow. The most active reagents included an antibody:A chain conjugate which bound to the nonpolymorphic chain of the la molecule and another which reacted with the mu heavy chain of cell surface immunoglobulin. Conjugates formed with anti-common acute lymphoblastic leukemia antigen, anti-Mr 26,000 glycoprotein, and anti-B1 were much less active on these Burkitt's cells, contrasting with results of complement-dependent tumor cell lysis. Tumor cell kill was partially inhibited by the addition of greater than 2 X 10(6) human bone marrow cells/ml but could be potentiated by increasing the concentration of conjugate or by the addition of 10 mM ammonium chloride. In the presence of ammonium chloride, at least 4 logs of clonogenic tumor cells could be eliminated within 24 h from a 20-fold excess of bone marrow using 10(-7) M ricin A chain linked to one or two different antibodies. Similar treatment of normal human bone marrow temporarily inhibited granulocyte-macrophage colony-forming units (cell) formation but did not compromise establishment of continuous bone marrow cultures. The degree of selective elimination of tumor cells with A chain antibody conjugates was comparable to that achieved with 4 hydroperoxycyclophosphamide or with multiple monoclonal antibodies and complement. PMID- 3510721 TI - Monoclonal antibody identification and characterization of a Mr 43,000 membrane glycoprotein associated with human breast cancer. AB - A monoclonal antibody (323/A3) with a high degree of selectivity for binding to breast cancer cells was produced by immunization of mice with MCF-7 human breast cancer cells. The antigen recognized by 323/A3 on MCF-7 appears to be surface localized, and by enzyme-linked immunosorbent assay, the antibody was found to bind strongly with four of six breast cancer cell lines examined while no binding was detectable with nonbreast cancer cell lines. In vivo distribution of the 323/A3 antigen was screened by immunoperoxidase staining of formalin-fixed paraffin sections of normal human tissues and tumors. Among breast tissues, positive staining was detected with 75% (6 of 8) of metastatic lymph nodes, 59% (76 of 128) of primary breast tumors, 20% (13 of 63) of benign breast lesions, and 0% (0 of 10) of normal breast. No immunostaining was detected with a large variety and number of other normal human tissues with the exception of staining observed with epithelium of normal colon. Antigen distribution appears not to be disease specific, since positive staining was also observed with adenocarcinomas other than breast. The antigen recognized by the 323/A3 antibody was identified by Western blot analysis as a Mr 43,000 protein. The glycoprotein nature of the antigen was demonstrated by its binding to concanavalin A, specific elution with sugar, and immunoprecipitation of a Mr 43,000 radiolabeled protein from extracts of MCF-7 cells after pulse labeling with [3H]glucosamine. The 323/A3 antigen appears to be the same Mr 43,000 protein in cell lines as in breast tumors in vivo. Based on a comparison with the molecular weights of other known tumor associated antigens and with their immunocytochemical tissue distribution, the Mr 43,000 glycoprotein described here represents a tumor-associated antigen previously undescribed in breast cancer or in other tumors. Since the Mr 43,000 glycoprotein is present on the surface of most breast cancer cells and is either absent or expressed at very low levels in most normal tissues including normal breast, the monoclonal antibody described here may have potential applications in diagnosis and management of breast cancer. PMID- 3510722 TI - Elastases in human breast carcinoma cell lines. AB - Elastosis, the deposition of large amounts of elastin, is characteristic of the desmoplastic reaction to human breast carcinoma. Dissolution of the elastin often occurs following treatment regimens that involve steroid hormones or their antagonists. Elastinolytic activities must be invoked to account for the loss of this elastin-cotaining stroma. We have utilized a tissue culture model to explore the molecular aspects of this phenomenon. The elastases of several human fibroblast and breast carcinoma cell lines were examined. The tumor cells had 10- to 30-fold higher elastase activity than did the fibroblasts. Three separate elastinolytic activities were observed in the tumor cell lines, and partial purification was achieved. The effect of steroid hormones on these elastases was examined. No stimulation of activity was found with any of the hormones, in any combination. However, there was marked inhibition of elastase with estradiol, progesterone, and dexamethasone of the ZR75-1 cell line. This is the estrogen receptor positive line that is estrogen responsive. The corticosteroids also inhibited the elastases of the estrogen receptor positive, non-responder cell line ZR75-30. No effect was seen on the elastases of receptor negative cells ZR75 31A with any of the steroid hormones. Stimulation of elastinolytic activities in these tumor cells must occur by some as yet unidentified pathway. PMID- 3510723 TI - Enhancing hyperthermic cytotoxicity in L929 cells by energy source restriction and insulin exposure. AB - When L929 cells are maintained in medium containing only glutamine, heat shock protein (HSP) induction by heat shock is suppressed and sensitivity to killing by hyperthermia progressively increases for at least 3 days. Maintenance in medium containing only glucose has similar, but much less pronounced, effects on HSP synthesis and sensitivity to hyperthermic cytotoxicity. Pyruvate reverses the suppression of HSP induction by glucose or glutamine deprivation and increases resistance to killing significantly, but it does not revert the survival curves to those obtained if both glucose and glutamine are available. Insulin further suppresses HSP inducibility in the systems containing glucose or glutamine alone, and greatly increases hyperthermic cytotoxicity. These effects on cytotoxicity appear to be due to nontransport mediated actions of the hormone and do not correlate exactly with effects on HSP induction. Although insulin completely blocks the pyruvate dependent enhancement of HSP inducibility, pyruvate affords protection to killing similar to that seen in the absence of insulin. Thus, the energy source requirements for HSP induction are established in detail and suggest that perturbed energy source utilization may be exploited to enhance hyperthermic cytotoxicity. This system, in which insulin has profound effects in the absence of glucose, may also be useful for studying the nontransport mediated actions of the hormone. PMID- 3510724 TI - Interaction of two second generation platinum antitumor drugs with mouse thymocytes. AB - The effects of two second generation platinum drugs, cis-diammine-1, 1 cyclobutane dicarboxylate platinum(II) and cis-dichloro-trans dihydroxybis(isopropylammine)platinum(IV) , were studied on thymocyte nucleosomes, calf thymus DNA, and intact murine thymocytes. In contrast to cis dichlorodiamineplatinum(II) (cis-DDP), the binding of cis-diammine-1,1 cyclobutarol dicarboxylate platinum(II) or cis-dichloro-trans dihydroxybis(isopropylammine)platinum(IV) to nucleosomes or DNA was markedly diminished at commonly used pharmacological doses. Since comparable amounts of the drugs were bound to whole thymocytes, we investigated possible membrane sites of action. The fluorescent probes diphenylhexatriene and trimethylammoniumdi phenylhexatriene were used to measure membrane fluidity. In the whole cell, marked decreases in anisotropy constants of 1-(4-trimethylammonium)-6-phenyl 1,3,5-hexatriene-p-toluene sulfonate were observed after treatment with cis diammine-1,1-cyclobutarol dicarboxylate platinum(II) and cis-dichloro-trans dihydroxybis(isopropylammine)platinum(IV) , but not cis-DDP, at 37 degrees C at therapeutic drug concentrations. This effect was observed only in intact thymocytes, not in isolated plasma membranes or liposomes treated similarly with the drugs. The fluorescent properties of the phospholipid probe, 1-acyl-2-(N-4 nitrobenzo-2-oxa, 1,3-diazole)aminocaproylphosphatidylcholine, were altered only by cis-DDP, whereas those of 1-acyl-2-(6-[(7-nitro-2-1,3-benzoxadiazol-4 yl)amino]caproyl ) phosphatidylethanolamine were altered by all three drugs. The increase in the fluorescence intensity per cell after reaction with the drugs was measured with the flow cytometer. The results suggest that alterations in membrane fluidity are produced by the hydrophobic second generation drugs, whereas changes observed via the probe based on phosphatidylcholine were produced only with cis-DDP. Since cis-DDP has a known avidity for proteins, the observed effects may be related to an altered protein-phospholipid (phosphatidylcholine) interaction. The changes in membrane structure described here may relate directly to cytotoxicity or may effect changes enabling the drug to enter the cell to find its intracellular targets. PMID- 3510725 TI - Etoposide induced blood-brain barrier disruption in rats: duration of opening and histological sequelae. AB - The intracarotid infusion of the antineoplastic compound etoposide enhances blood brain barrier (BBB) permeability. In a rat model system, the functional reversibility and anatomic sequelae of etoposide induced BBB disruption were investigated. Etoposide, in a dose range from 3.0 to 22.5 mg/kg, was infused into the left internal carotid artery of Sprague-Dawley rats. BBB disruption was evaluated by the appearance in the infused hemisphere of systemically administered Evans blue dye and quantitatively by the ratio of counts of the technetium labeled chelate of diethylenetriaminepentaacetic acid in the infused to the noninfused hemisphere. Functional reversibility of altered BBB permeability was investigated at three dose levels of etoposide (3.0, 15.0, and 22.5 mg/kg) by the administration of Evans blue dye at the time of etoposide infusion and the administration of the technetium labeled chelate of diethylenetriamine-pentaacetic acid at varying time intervals after etoposide infusion. Fourteen groups of 12 rats each were studied to define the time course of altered BBB permeability at these three doses. The anatomic sequelae of etoposide induced BBB disruption were investigated at varying time intervals (up to 3 weeks) after intracarotid etoposide infusion. Nineteen rats were examined after sacrifice by intracardiac fixation perfusion with 10% formalin. Each brain was sectioned coronally and examined under light microscopy after hematoxylin and eosin staining. Evidence of BBB disruption was seen at all dose levels of etoposide. The degree of BBB disruption increased with increasing doses of etoposide. The duration of altered BBB permeability increased from less than 1 day at 3.0 mg/kg to between 3 and 4 days at 22.5 mg/kg. Histological studies revealed no evidence of parenchymal damage, although at 4 days postdisruption, a mild perivascular lymphocytic infiltration was noted in the infused hemisphere. Etoposide infusion and subsequent BBB disruption were well tolerated by all test animals. In a rat model system the intracarotid infusion of etoposide is capable of producing prolonged reversible BBB disruption. PMID- 3510726 TI - Malignant transformation of a preneoplastic hamster epidermal cell line by the EJ c-Ha-ras-oncogene. AB - We have investigated whether the activation of endogenous ras genes is associated with the immortalization or malignant transformation of primary hamster epidermal cells by chemical carcinogens. We have also asked whether transfection of a cloned c-Ha-ras oncogene (pEJ) into a nontumorigenic cell line established from hamster epidermal cells by N-methyl-N'-nitro-N-nitrosoguanidine treatment can induce conversion to a malignant phenotype. DNA from the nontumorigenic epidermal cell line (H5-MNNG) and from two neoplastic cell lines transformed by benzo(a)pyrene was not capable of transforming NIH/3T3 cells. This result suggests that these cells do not contain an activated (mutated) ras gene. However, when H5-MNNG cells were cotransfected with pEJ and pSV2-gpt, a plasmid containing the dominant selectable marker gene Ecogpt, seven of nine clones of Ecogpt transformants formed carcinomas in nude mice and colonies in soft agar. Southern blot analysis of BamHl-digested genomic DNA from the Ecogpt-transformed clones indicated that rapid malignant transformation was associated with integration of a complete copy of the 6.6-kilobase fragment of pEJ containing the activated c-Ha-ras gene. Furthermore, DNA from the malignant clones transformed NIH/3T3 cells in a secondary transfection assay. These studies demonstrate that a mutated c-Ha-ras gene, under the transcriptional control of its normal cellular promoter, can rapidly transform a nontumorigenic epidermal cell line. This result suggests that activation of an endogenous c-ras gene can function as the final completing event in the progression of epithelial cells to the malignant phenotype. Thus, preneoplastic cell lines of both mesenchymal and epithelial origin have now been shown to be susceptible to malignant conversion by a single mutation in a c-Ha-ras proto-oncogene. PMID- 3510727 TI - Expression of p21 ras oncoproteins in human cancers. AB - The expression of proteins encoded by ras oncogenes was examined in 52 fresh human tumors of 19 different types using antibodies generated to different peptide domains of ras proteins of molecular weight 21,000 (p21). Proteins related to ras genes were detected in 90% of tested tumors. In 21% of tumors there were high levels of ras p21 of greater than 40% of the level in a Harvey murine sarcoma virus transformed cell line. Predominance of either cellular Ha ras or other ras p21s was found in 20 and 14% of tumors, respectively, and predominance of p21 other than Ha-ras was frequent in breast cancers. Abnormal electrophoretic mobility of p21 was observed in two cancers, and a novel rapidly migrating ras p21 was found in a rare malignant fibrohistiocytoma. PMID- 3510728 TI - Expression of Lewisa, Lewisb, X, and Y blood group antigens in human colonic tumors and normal tissue and in human tumor-derived cell lines. AB - Serological and immunopathological analysis of the expression of Lea, Leb, X, and Y blood group antigens on cell lines and tissues was performed using a panel of mouse monoclonal antibodies. The distribution of the antigens was determined on 155 malignant tumor cell lines of various types and 10 short term cultures of normal fibroblasts and kidney cells. Among colon cancers, all four blood group antigens were expressed on the majority of cell lines. On lung, breast, bladder, and ovarian cancer cell lines, X and Y antigens were the main specificities found, whereas few of the renal and hematopoietic tumor cell lines demonstrated any of the four blood group antigens. No blood group antigens could be detected on astrocytoma or melanoma cell lines. The expression of the antigens was also analyzed on frozen sections of colon carcinoma and adjacent normal colon tissue from 42 patients using the immunoperoxidase method. Lea and X were detected throughout the normal colon and on most colonic tumors. In poorly differentiated colon cancer and in metastatic cancer, decrease of Lea antigen was observed. Leb and Y expression was observed in only 20-45% of normal tissue samples but in almost all colonic carcinoma tissues. A selected number of tumor and normal specimens from patients whose secretor status was known were examined in more detail. Both the staining of the tissues and the reactivity of blood group glycolipids from the same specimens were determined. These studies confirmed the above findings and demonstrated the unexpected ability of tumors of nonsecretors to express Leb and/or Y antigens. In such individuals, in whom the expression of Leb and Y antigens in normal tissues is absent or minimal, these antigens provide possible targets for immunodiagnosis and therapy. PMID- 3510729 TI - Laboratory models and clinical cancer. Dedicated to Dr. Frank M. Schabel, Jr. PMID- 3510730 TI - Unresolved issues in combination chemotherapy. PMID- 3510731 TI - Application of theoretical models to chemotherapy protocol design. AB - The somatic mutation model of cancer chemotherapy predicts that under certain conditions some sequences of chemotherapy drug administration will be superior to others. Alternation between two non-cross-resistant combinations that are equivalent in effectiveness is one such sequence. This method was utilized in a number of clinical trials based primarily on intuitive perceptions on how treatment failure due to drug resistance can be minimized. A survey of a number of recently published trials employing some form of alternating chemotherapy indicates that a majority of them suggested an advantage to this approach compared to sequential therapy, although in most studies this benefit was small. Most of the studies, whether or not supportive of the concept of alternating therapy, could not be considered a fair test of the theory. Reference to theoretical models of chemotherapeutic action may provide assistance in devising clinical trials that will rigorously test the concept of alternating chemotherapy to see to what extent this technique will improve treatment results in selected neoplasms. PMID- 3510732 TI - The Norton-Simon hypothesis revisited. PMID- 3510733 TI - The preclinical screening laboratory: evaluation of immunomodulatory and therapeutic properties of biological response modifiers. PMID- 3510734 TI - Pathogenesis of metastatic disease: implications for current therapy and for the development of new therapeutic strategies. AB - Different tumor cell subpopulations coexisting within the same tumor exhibit varied susceptibilities to antineoplastic agents. Tumor cell heterogeneity is now recognized as the principal cause of treatment failure in cancer, and is a formidable obstacle to effective therapy and to the development of drug delivery systems for selective targeting of antineoplastic agents to tumor cells. Recent insights into the genesis of tumor cell heterogeneity during progressive tumor growth reveal new complexities that raise challenging questions about the adequacy of certain approaches to the current therapy of metastatic disease and impose challenging criteria for the development of improved therapeutic strategies. Many of the experimental approaches used in the search for new antineoplastic agents and targeted drug delivery systems ignore the pathogenesis of metastasis and the problem of tumor cell heterogeneity. The adoption of more relevant assay systems is an urgent priority. These include the greater use of metastatic tumor models and the increased use of human tumor cells to replace rodent cell systems which have been of limited predictive value in identifying effective anticancer agents. In contrast to current strategies for the development of new antineoplastic drugs which seek to identify agents with activity against a broad range of histologically diverse tumors, greater success may be achieved by seeking agents active only against specific cell lineages. Many established human tumor cell lines may not be suitable for this purpose because of extensive phenotypic change produced by prolonged passage ex vivo. Development of histiotype-specific human tumor cell screens will require an extensive research effort to identify target cells that display demonstrable phenotypic relatedness to tumor cells in neoplastic lesions. Major advances in the therapy of metastatic disease are considered unlikely in the next few years, and progress will stem from improved use of existing agents in refined combination therapy protocols in which greater attention is given to the duration, frequency, and sequence of therapy with different agents to limit emergence of tumor cell variants resistant to one or more antineoplastic agents. Advances in molecular biology offer exciting prospects for the identification of new therapeutic targets in human tumor cells, for the induction of alterations in tumor cells that could serve as therapeutic targets, and for the elucidation of the mechanisms responsible for the rapid phenotypic diversification of tumor cells.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3510736 TI - Biochemical modulation: application of laboratory models to the clinic. PMID- 3510735 TI - Induction of tumor cell differentiation as a therapeutic approach: preclinical models for hematopoietic and solid neoplasms. PMID- 3510737 TI - Preclinical selection of new anthracyclines. PMID- 3510738 TI - Adjuvant chemotherapy--clinical trials and laboratory models. PMID- 3510739 TI - GABA neurones in retinas of different species and their postnatal development in situ and in culture in the rabbit retina. AB - The localisation of GABA immunoreactive neurones in retinas of a variety of animals was examined. Immunoreactivity was associated with specific populations of amacrine neurones in all species examined, viz. rat, rabbit, goldfish, frog, pigeon and guinea-pig. All species, with the exception of the frog, possessed immunoreactive perikarya in their retinal ganglion cell layers. These perikarya are probably displaced amacrine cells because GABA immunoreactivity was absent from the optic nerves and destruction of the rat optic nerve did not result in degeneration of these cells. GABA immunoreactivity was also associated with the outer plexiform layers of all the retinas studied; these processes are derived from GABA-positive horizontal cells in rat, rabbit, frog, pigeon and goldfish retinas, from bipolar-like cells in the frog, and probably from interplexiform cells in the guinea-pig retina. The development of GABA-positive neurones in the rabbit retina was also analysed. Immunoreactivity was clearly associated with subpopulations of amacrine and horizontal cells on the second postnatal day. The immunoreactivity at this stage is strong, and fairly well developed processes are apparent. The intensity of the immunoreactivity increases with development in the case of the amacrine cells. The immunoreactive neurones appear fully developed at about the 8th postnatal day, although the immunoreactivity in the inner plexiform layer becomes more dispersed as development proceeds. The immunoreactive horizontal cells become less apparent as development proceeds, but they can still be seen in the adult retina. The GABA immunoreactive cells in rabbit retinas can be maintained in culture.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3510740 TI - The morphology and cell culture of the striated musculature of the rat azygos vein. AB - The azygos vein of the rat can be divided into three regions: The proximal cardiac region, where the wall is composed of two and sometimes three layers of cardiac muscle and a thin discontinuous layer of smooth muscle cells. Vascular casts of this region demonstrate layers of capillaries closely following the orientation of the cardiac fibres. A transitional zone, where both cardiac and smooth muscle cells interdigitate. In this zone, close associations between smooth muscle and cardiac muscle cells can be observed, however, gap junctions do not appear to be present. Beyond this transitional zone the vessel resembles a typical thin-walled vein. The cells of the media of the entire length of azygous vein have been isolated and grown in culture and two separate viable populations identified corresponding to smooth and cardiac muscle. PMID- 3510741 TI - A self-splicing RNA excises an intron lariat. AB - We have investigated the in vitro self-splicing of a class II mitochondrial intron. A model pre-mRNA containing intron 5 gamma of the oxi 3 gene of yeast mitochondrial DNA undergoes an efficient intramolecular rearrangement reaction in vitro. This reaction proceeds under conditions distinct from those optimal for self-splicing of class I introns, such as the Tetrahymena nuclear rRNA intron. Intron 5 gamma is excised as a nonlinear RNA indistinguishable from the in vivo excised intron product by gel electrophoresis and primer extension analysis. Studies of the in vitro excised intron product strongly indicate that it is a branched RNA with a circular component joined by a linkage other than a 3'-5' phosphodiester. Two other products, the spliced exons and the broken form of the lariat, were also characterized. These results show that the class II intron products are similar to those of nuclear pre-mRNA splicing. PMID- 3510742 TI - Formation of lariats and circles in self-splicing of the precursor to the large ribosomal RNA of yeast mitochondria. AB - Self-splicing of the precursor to large ribosomal RNA of yeast mitochondria leads not only to circles but also to lariats, structures that have not been observed before as products of self-splicing. Lariats were studied by electron microscopy after hybridization with an RNA complementary to the 3' half of the precursor. This leads to differentiation in at least two classes of lariats that vary in the position of the branch point. In all lariats the tail carries the 3' end, which suggests that a 5' end is used for branch formation with an internal nucleotide. The circles are formed from excised introns. They lack only three nucleotides encoded by mitochondrial DNA along with the 5'-terminal G added in the course of self-splicing. The diverse number of self-splicing products arising in vitro testifies to the considerable reactivity of this intron. The formation of lariats in an RNA catalyzed reaction may have implications for views on the mechanism of splicing of nuclear pre-mRNAs. PMID- 3510743 TI - Detailed analysis of the mouse H-2Kb promoter: enhancer-like sequences and their role in the regulation of class I gene expression. AB - Sequencing and deletion analyses of the H-2Kb promoter have suggested that several regions may be important for expression and regulation of this gene. Two of these regions are conserved inside the promoter of several genes coding for classical transplantation antigens, but not in the promoter of class I genes located in the Qa region. They display enhancer-like activity in cells that express H-2 genes, but show some tissue specificity in that they function very poorly in undifferentiated embryonal carcinoma cells in which H-2 genes are not expressed. They also have been shown not to be the target of the adenovirus-12 induced repression of class I gene expression recently demonstrated by Schrier et al. The promoter of the beta 2-microglobulin gene also contains a sequence with enhancer-like activity, but shares no homology with the H-2Kb promoter region. PMID- 3510744 TI - Structure of the 30 nm chromatin fiber. PMID- 3510745 TI - In vitro establishment is not a sufficient prerequisite for transformation by activated ras oncogenes. AB - Activated ras genes transform REF52 cells only at low frequencies and adenovirus early region 1A collaborates with ras oncogenes to convert REF52 cells to a tumorigenic phenotype. While failure to transform did not result from an absence of ras gene expression, E1A appeared to enhance expression of transfected ras genes by approximately tenfold. However, enhanced ras expression alone does not account for collaboration by E1A since overexpression of T24 Ha-ras p21 induced morphological crisis and cell growth arrest rather than stable transformation. These results indicate that E1A contributes complementing biochemical activities that enable ras genes to transform REF52 and suggest that the role of E1A in primary cell transformation may extend beyond facilitating in vitro establishment. PMID- 3510746 TI - Identification of the DNA adduct formed by metabolism of 1,8-dinitropyrene in Salmonella typhimurium. AB - The incubation of [3H]1,8-dinitropyrene with Salmonella typhimurium TA98NR followed by isolation of the DNA from these cells, hydrolysis of the DNA to nucleosides, butanol extraction of the hydrolysate and purification by reversed phase liquid chromatography afforded a single product. Calf thymus DNA, after treatment with N-hydroxyl-1-amino-8-nitro-pyrene, was hydrolyzed, extracted and purified in a similar fashion to give a single compound which was shown to be the deoxyguanosine derivative 1-N-(2'-deoxyguanosin-8-yl)-amino-8-nitropyrene by a combination of proton n.m.r. and u.v.-vis. spectroscopy and fast atom bombardment mass spectrometry. The DNA adducts formed in vivo and in vitro exhibited identical chromatographic and chemical behavior. Under acidic or basic conditions in the vivo and in vitro adducts were converted to identical products. Reduction of the adduct gave a new, highly fluorescent product that had a fluorescence emission spectrum identical to that of 1,8-diaminopyrene. PMID- 3510747 TI - Immunohistochemical localization of DNA adducts in rat liver tissue and phenotypically altered foci during oral administration of 2-acetylaminofluorene. AB - Histological studies using paired immunofluorescence staining and peroxidase-anti peroxidase staining were performed on sections of rat livers with an antiserum specific for the 2-acetylaminofluorene (AAF)-DNA adduct N-deoxyguanosin-(8-yl) aminofluorene (dG-8-AF). This is the predominant adduct in rat liver DNA at 5 (80%) and 28 (100%) days of AAF feeding. Nuclear staining was observed in livers of male Fischer rats fed 0.02% AAF for these time periods, and was not present in livers of animals fed control diet or detected when specific antiserum, first absorbed with the immunogen adduct, was utilized. In addition, nuclear staining was unchanged after incubation with RNase and abolished after incubation with DNase. Adducts were not readily detectable when whole-liver adduct concentrations were less than an average of 10(5) adducts per cell (30-50 fmol/micrograms DNA). The overall pattern of adduct distribution in livers of AAF-fed animals was distinctly non-uniform. A predominance of nuclear staining was found in the periportal areas by both immunofluorescence and immunoperoxidase procedures. In contrast, staining was very weak in the centrilobular areas. When animals were fed AAF for 28 days and control diet subsequently for 7, 14, 21 or 28 days, the overall intensity of the immunohistochemical staining decreased with time on control diet. However, the pattern of localization remained the same as in livers of rats fed AAF for 28 days, with the predominance of adducts being in the periportal areas. In male rats fed 0.02% AAF for 8 weeks, foci positive for gamma glutamyltranspeptidase (GGT) became apparent, and the nuclei in these areas showed no immunofluorescence, indicating the absence of detectable levels of the dG-8-AF adduct. Twenty adduct-negative areas in the median lobes of three rat livers were positive for GGT, which suggests that loss of ability to form adducts in these regions occurs concomitantly with early phenotypic changes. PMID- 3510748 TI - 7-Methylbenz[c]acridine: mutagenicity of some of its metabolites and derivatives, and the identification of trans-7-methylbenz[c]-acridine-3,4-dihydrodiol as a microsomal metabolite. AB - The presence of the proposed proximate carcinogen, trans-3,4-dihydro-3,4 dihydroxy-7-methylbenz[c]acridine (7MBAC-3,4-DHD) among the liver microsomal metabolites of 7-methylbenz[c]acridine (7MBAC) has been demonstrated using gas chromatography mass spectrometry (GCMS) and by co-chromatography with synthetic standards on reverse and normal phase h.p.l.c. 7MBAC-3,4-DHD represented 2.2-3.4% of the total ethyl acetate-extractable metabolites formed from 7MBAC by liver microsomes prepared from untreated and induced rats. About 2.3-2.7% of metabolites formed by lung microsomes was identified as 7MBAC-3,4-DHD. Mutagenicity studies with 7MBAC-3,4-DHD have been carried out in bacterial and mammalian systems using S9 fractions derived from rats pre-treated with Aroclor and guinea pigs pre-treated with 3-methylcholanthrene. Comparative data with other 7MBAC derivatives are also reported. The 7MBAC-3,4-DHD and the analogous dihydro derivative of 7MBAC were the most potent mutagens of those compounds requiring metabolic activation. The data imply that the 3,4-dihydrodiol is metabolised to a bay region diol epoxide as the ultimate carcinogen. In support of this anti-1,2-epoxy-trans-3,4-dihydroxy-7-methyl-1,2,3,4- tetrahydrobenz[c]acridine was a potent mutagen in the Ames and V79 cell systems without activation. The syn-isomer was less active. PMID- 3510750 TI - Identification and mutagenicity of metabolites of aristolochic acid formed by rat liver. AB - The rat liver 9000 g supernatant mediated metabolism of the carcinogenic aristolochic acid, which consists of aristolochic acid I (AAI) and aristolochic acid II (AAII), was investigated. Under anaerobic conditions the major metabolites were the corresponding aristolactams for both AAI and AAII. In contrast under aerobic conditions AAII was not detectably metabolized and the only metabolite found for AAI was the O-demethylated derivative aristolochic acid Ia (AAIa). The metabolites were identified by their u.v., mass and n.m.r. spectra and by comparison with reference standards. The mutagenic activities of the three metabolites were determined in Salmonella typhimurium strains TA1537 and TA 100. The aristolactams were mutagenic in both strains when a metabolizing system was present. These results indicate that AAI or AAII and their aristolactams exert their effect via a common reactive intermediate, probably the corresponding hydroxylamine. AAIa was only very weakly mutagenic and this metabolite may therefore not be regarded as a major mutagenic metabolite of AAI. These findings suggest that the acids are preferentially metabolized by two totally different pathways in vitro, namely an oxidative pathway for AAI and a reductive pathway for AAII. PMID- 3510749 TI - Characterization of covalent binding of N'-nitrosonornicotine in rat liver microsomes. AB - The metabolism of the carcinogenic nitrosamine, N'-nitrosonornicotine (NNN), to reactive intermediates which bind covalently was assessed using male Sprague Dawley rat liver microsomes. The NADPH-dependent covalent binding of [14C]NNN was linear with time up to 90 min and protein concentration up to 3.0 mg/ml. The apparent Km and Vmax of the binding were determined from the initial velocities and found to be 0.91 mM and 4.7 pmol/min/mg protein, respectively. Although NNN is not a hepatocarcinogen, this amount of NADPH-dependent covalent binding is 7 fold greater than that reported for dimethylnitrosamine, a potent hepatocarcinogen. Extensive covalent binding of [14C]NNN to liver and muscle microsomal protein was also present in the absence of an NADPH-generating system and in the presence of 50% methanol, indicating a non-enzymatically mediated reaction. Addition of the nucleophiles glutathione, cysteine and N-acetylcysteine significantly decreased (p less than 0.01) the non-NADPH-dependent binding, but did not affect NADPH-dependent binding. In vitro addition of the cytochrome P-450 inhibitors metyrapone, piperonyl butoxide and SKF-525A significantly decreased (p less than 0.05) NADPH-dependent binding of [14C]NNN by 27-40%. NADH did not replace NADPH in supporting covalent binding. Replacement of an air atmosphere with nitrogen or CO:O2 (8:2) significantly decreased (p less than 0.05) NADPH dependent binding of [14C]NNN by 40 and 27%, respectively. Aroclor 1254 pre treatment of the rats did not enhance the NADPH-dependent binding of [14C]NNN. These data indicate that cytochrome P-450 is at least in part responsible for the metabolic activation of the carcinogen NNN but also suggest additional mechanisms of activation. PMID- 3510751 TI - Synthesis and mutagenicity of 1-nitro-6-nitrosopyrene and 1-nitro-8 nitrosopyrene, potential intermediates in the metabolic activation of 1,6- and 1,8-dinitropyrene. AB - 1,6-Dinitropyrene and 1,8-dinitropyrene are environmental contaminants which are mutagenic in bacteria and cultured mammalian cells. Since nitroreduction, and possibly O-acetylation, have been implicated in the metabolic activation of these compounds, the reduced intermediates, 1-nitro-6-nitrosopyrene and 1-nitro-8 nitrosopyrene, were synthesized and their mutagenicity examined in Salmonella typhimurium and Chinese hamster ovary (CHO) cells. Nitration of 1 acetylaminopyrene yielded a mixture of 1-acetylamino-6-nitropyrene and 1 acetylamino-8-nitropyrene, which was separated by flash chromatography. Following deacetylation, the amino-nitropyrenes were oxidized to the desired nitronitrosopyrenes with m-chloroperoxybenzoic acid. Both nitronitrosopyrenes showed similar levels of mutagenicity in S. typhimurium strain TA98 and a nitroreductase-deficient analogue, TA98NR, but much lower activity in the esterificase-deficient strain, TA98/1,8-DNP6, which suggested that reduced metabolites require further activation by O-acetylation. In contrast, the analogous compound, 1-nitrosopyrene, was equally mutagenic in all three strains while its parent compound, 1-nitropyrene, demonstrated a much reduced mutagenicity in strain TA98NR. In CHO cells, 1-nitropyrene was not mutagenic and the dinitropyrenes were only weakly active, while all three nitrosopyrene derivatives were highly mutagenic. These data support the hypothesis that nitrated pyrenes are metabolized to mutagens through nitroreduction. In Salmonella the limiting step in the metabolic activation of 1-nitropyrene appears to be the initial reduction to 1-nitrosopyrene, while with the dinitropyrenes subsequent esterification of the reduced intermediates seems critical. With CHO cells, the initial reduction to nitroso derivatives is the limiting step for all nitropyrenes, and esterification does not appear to occur in the activation sequence. PMID- 3510752 TI - Effects of the co-carcinogen catechol on benzo[a]pyrene metabolism and DNA adduct formation in mouse skin. AB - We have studied the effects of the co-carcinogen catechol (1,2-dihydroxybenzene) on the metabolic activation of [3H] benzo[a]pyrene (BaP) in mouse skin, in vivo and on the binding of BaP metabolites to DNA and protein at intervals from 0.5-24 h. Upon topical application of 0.015 mg [3H]BaP and 0.25 or 0.5 mg catechol per mouse, catechol had little effect on the total amount of [3H]BaP metabolized in mouse skin, but it affected the relative proportions of [3H]BaP metabolites. Catechol (0.5 mg/mouse) decreased the proportion of water-soluble [3H]BaP metabolites, ethyl acetate-soluble polar metabolites and quinones, but doubled the levels of unconjugated 3-hydroxy-BaP at all measured intervals after treatment. Catechol also caused a small increase in the levels of trans-7,8 dihydroxy-7,8-dihydroBaP and trans-9,10-dihydroxy-9,10-dihydroBaP 0.5 h after treatment. Two hours after treatment, the levels of these metabolites subsided to those of the controls. Catechol did not affect the levels of glutathione conjugates of BaP. However, it caused a decrease in glucuronide and sulphate conjugate formation from BaP. Catechol caused an approximately 2-fold increase in the formation of anti-7,8-dihydroxy-9,10-epoxy-7,8,9,10-tetrahydroBaP (BPDE) DNA adducts and elevated the ratio of anti-syn-BPDE-DNA adducts 1.6 to 2.9-fold. Catechol treatment increased the radioactivity associated with epidermal proteins after [3H]BaP application. Because catechol increased levels of 3-hydroxyBaP, we considered the possibility that 3-hydroxyBaP might enhance the tumor initiating activities of BaP or BPDE in mouse skin; a bioassay demonstrated that this was not the case. The results of this study indicate that one important effect of catechol related to its co-carcinogenicity is its ability to enhance formation of anti-BPDE-DNA adducts in mouse skin. PMID- 3510753 TI - Characterization of insulin receptors in isolated epithelial cells of rat ventral prostate: effect of fasting. AB - Insulin receptors have been characterized in rat prostatic epithelial cells by using [125I]insulin and a variety of physicochemical conditions. The binding data at equilibrium (2 h at 15 degrees C) could be interpreted in terms of two populations of insulin receptors: a class of receptors with high affinity (Kd = 2.16 nM) and low binding capacity (28.0 fmol mg-1 protein), and another class of receptors with low affinity (Kd = 0.29 microM) and high binding capacity (1.43 pmol mg-1 protein). Proinsulin exhibited a 63-fold lower affinity than insulin for binding sites whereas unrelated peptides were ineffective. The specific binding of insulin increased by about 50 per cent after 96 h of fasting; this increase could be explained by an increase of both the number of the high affinity-low capacity sites and the affinity of the low affinity-high capacity sites. These results together with previous studies on insulin action at the prostatic level strongly suggest that insulin may exert a physiological role on the prostatic epithelium. PMID- 3510754 TI - Enzymic heterogeneity of normal canine articular cartilage. AB - Articular cartilage is generally considered to be an homogeneous tissue. It has now been shown that, although different regions of the medial tibial cartilage of the dog have very similar oxidative enzymic activities, each region is heterogeneous with respect to these activities. The conventional histological delineation of this cartilage has been modified, to take into account a narrow band (designated zone 2a), just below the most superficial spindle-shaped cells, that has higher oxidative enzymic activity than any other. Changes in the activity in this zone might be diluted by the lack of change in other zones if measured by conventional biochemical procedures which could not measure the activities of the different zones separately. PMID- 3510755 TI - Ultrastructural studies of experimental endotoxin shock in the liver and spleen: therapeutic effects of low-dose heparin on reticuloendothelial disturbances. AB - To determine the effects of low-dose heparin on the reticuloendothelial system in shock, rats were subjected to intraperitoneal administration of E coli endotoxin. Alterations such as degeneration and necrosis of the Kupffer cells and sinusoidal endothelial cells were observed in the livers of the non-heparin-treated animals 4 hours after the administration of the endotoxin. These changes progressed with time. Kupffer cells in the heparin-treated rats appeared undisturbed up to 8-12 hours post endotoxin challenge. Phagocytosis of cell remained slight in the heparin-treated rats. The mortality rate of the heparin-treated group was 10% with LD50 endotoxin (7.6 mg/kg). The mortality rate of the untreated control group 24 hours after administration was 50%. However, when endotoxin was administered in a dosage of 30 mg/kg (MLD), the mortality rate of the heparin treated rats was 60%--10% greater than that of controls (P less than 0.05). PMID- 3510756 TI - Lipolytic patterns in isolated adipocytes of continuously endotoxemic rats. AB - Lipolytic patterns were studied in adipocytes isolated from rats after 6 and 30 hr of continuous Escherichia coli endotoxin (ET) or saline infusion via a subcutaneously implanted osmotic pump. By 6 hr, ET cells responded to norepinephrine (NE) stimulation with significantly greater increase above basal rates of glycerol and free fatty acid (FFA) release than did control adipocytes. By 30 hr of continuous infusion, basal glycerol release was enhanced; the in vitro lipolytic response evoked by NE was significantly reduced in ET cells compared to rates on the previous day, and NE-stimulated lipolysis in ET cells was significantly below that of controls. At the same time, the in vitro antilipolytic effect of insulin was attenuated. We conclude that 1) an initial metabolic response can be observed within a few hours of a continuous, low dose ET infusion, 2) the biphasic nature of the sequential changes in lipolysis is likely to reflect alterations in the hormonal environment in vivo, and 3) these features are consonant with some aspects of the metabolic profile of septic patients. PMID- 3510757 TI - Regional blood flow and metabolism in canine endotoxin shock before, during, and after infusion of glucose-insulin-potassium (GIK). AB - Glucose-insulin-potassium infused (GIK) during endotoxin shock causes increased cardiac output (CO) accompanied by decreased systemic vascular resistance. We have studied the effects of GIK on the distribution of cardiac output with radioactive microspheres to see if this decrease in resistance is equally distributed over all organs. GIK resulted in increased CO and increased flow to heart, splanchnic bed, kidneys, adrenals, and skeletal muscle, but fractional flow to these organs did not change. Thirty minutes after the GIK infusion, CO and organ flow had fallen again and differences between the endotoxin and control groups were no longer significant. GIK thus increases CO during endotoxin shock but does not influence its distribution. Systemic oxygen transport increased after GIK, but oxygen extraction decreased. Myocardial and splanchnic oxygen consumption did not change significantly. Oxygen extraction also diminished in these areas after GIK. GIK did not influence serum lactate: In both groups lactate increased significantly. PMID- 3510758 TI - Biventricular function during volume loading in porcine E. coli septic shock, with emphasis on right ventricular function. AB - In 14 anesthesized pigs, the effect of E. coli (2 X 10(8)/kg) and volume loading on hemodynamics and right and left ventricular performance were studied. Autologous red cells were labeled in vitro with 99mTC (15-20 mCi). Gated blood pool studies and hemodynamics were performed simultaneously. E. coli infusion resulted in an abrupt increase in pulmonary artery pressure, whereas systemic blood pressure fell gradually. Gated studies showed a transient increase in right ventricular end-diastolic volume (RVEDV) after 1 hour; left ventricular end diastolic volume (LVEDV) declined gradually during sepsis. During volume loading, RVEDV and LVEDV both increased. As estimated from the altered Frank Starling relation between preload and SW, a depressed performance of both left and right ventricle was found. We conclude that volume expansion in porcine E. coli septic shock results in a uniform increase of left and right preload despite a substantial increase in pulmonary vascular resistance. PMID- 3510759 TI - The control of sugar uptake by metabolic demand in isolated adult rat heart cells. AB - To investigate the control of sugar uptake by metabolic demand, we used isolated quiescent adult rat heart cells in suspension, under conditions similar to those found during anoxia. Metabolic demand was varied by exposing cells to rotenone plus various levels of p-trifluoromethoxyphenylhydrazone. Without glucose, the time taken for half of the cells to undergo contracture was inversely proportional to the metabolic demand as measured by the rate of lactate production. For any metabolic demand, the onset of contracture was preceded by a sudden drop in adenosine triphosphate. The permeability of contracted cells to glucose was investigated using 3-O-methylglucose. The rate of 3-O-methylglucose uptake by such cells was strongly dependent on the time taken for half the cells to undergo contracture, with low rates at low times to half contracture, and insulin-like rates at high times to half contracture. This suggests that the full induction of glucose transport by metabolic demand can be prematurely curtailed by the loss of adenosine triphosphate. This phenomenon appeared to limit glucose utilization in cells with a high metabolic demand when glucose was present: such cells underwent contracture unless insulin was also present, the rate of glucose uptake as measured with 2-deoxyglucose was inhibited, and the rate of lactate production was inhibited. Isoproterenol depressed glucose transport by two mechanisms. First, by stimulating the basal metabolic demand of the cell it reduced the time taken for half the cells to undergo contracture and, hence, the level of induced sugar transport. Second, it significantly delayed the onset of sugar permeability with respect to the contracture event.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3510760 TI - Clinical trials evaluating platelet-modifying drugs in patients with atherosclerotic cardiovascular disease and thrombosis. AB - Aspirin has been convincingly shown to reduce stroke and death in men with transient ischemic attacks (it may possibly be beneficial to women also), myocardial infarction and death in patients with unstable angina, thromboembolic complications associated with artificial heart valves in patients receiving oral anticoagulants (although gastrointestinal bleeding is prohibitive with this combination), and thrombotic occlusion of silicone rubber arteriovenous cannulae in uremic patients undergoing hemodialysis. In addition, aspirin may possibly decrease occlusion of saphenous vein aortocoronary grafts and venous thrombosis in men after hip replacement, although these reports require confirmation. Aspirin is ineffective in the secondary prevention of stroke and has unproven benefit in the secondary prevention of myocardial infarction. Dipyridamole in combination with oral anticoagulation decreases the thromboembolic complications associated with mechanical heart valves. The combination of aspirin and dipyridamole prevents both early and late occlusion of saphenous vein aortocoronary bypass grafts and protects renal function in patients with membranoproliferative glomerulonephritis. The relative importance of combining aspirin and dipyridamole compared with either agent used singly remains to be established. Sulfinpyrazone reduces the thrombotic occlusion of arteriovenous cannulae and early occlusion of saphenous vein aortocoronary grafts. The reported benefit in the secondary prevention of myocardial infarction is controversial. PMID- 3510761 TI - Interaction of platelets with the vessel wall in the pathophysiology of sudden cardiac death. AB - The occurrence of ventricular fibrillation after occlusion of the circumflex coronary artery in the conscious dog was examined as one preparation for sudden cardiac death arising from coronary artery disease. The incidence of ventricular fibrillation after after circumflex occlusion was reduced from 53% to 6% (p less than .01) by the infusion of prostacyclin in doses that do not alter cardiac output or peripheral resistance. This effect of prostacyclin led to the evaluation of two structurally different inhibitors of thromboxane synthase in this preparation; RO 22-4679 and U-63557A reduced ventricular fibrillation by 82% and 100%, respectively (p less than .05). The inhibition of ventricular fibrillation by U-63557A was abrogated by pretreatment with indomethacin, suggesting that a metabolite of the endoperoxide that accumulated during thromboxane synthase inhibition was responsible for the protection from ventricular fibrillation. PMID- 3510762 TI - Role of platelets and platelet inhibitors in aortocoronary artery vein-graft disease. AB - To study the prevention of occlusion of aortocoronary-artery bypass grafts, we conducted a prospective, randomized, double-blind trial comparing long-term administration of dipyridamole (begun 2 days before operation) plus aspirin (begun 7 hr after operation) with placebo in 407 patients. Results at 1 month and at 1 year showed a reduction in the rate of graft occlusion in patients receiving dipyridamole and aspirin. On the basis of our clinical trial and our experimental studies in dogs and pigs, we describe four consecutive phases of aortocoronary artery bypass vein-graft disease: an early postoperative phase of platelet thrombotic occlusion, which is significantly prevented by platelet inhibitor therapy when started in the perioperative period; in addition, occlusion rates are presently decreasing, perhaps related to better surgical and technical experience; an intermediate phase of platelet-related intimal hyperplasia, within the first postoperative year, which is not prevented with platelet inhibitor therapy; a late phase of occlusion, toward the end of the first postoperative year, in which intimal hyperplasia or complicating platelet thrombi superimposed on the intimal hyperplasia may contribute to occlusion; platelet inhibitor therapy is of significant benefit in the prevention of this thrombotic type of occlusion; a phase of atherosclerotic disease, after the first postoperative year, in which the role of platelets and of platelet inhibitor therapy is under investigation. PMID- 3510763 TI - Pathophysiology of coronary occlusion in acute infarction. AB - Coronary angiography has proved beyond doubt that complete coronary occlusion is the rule in the very early hours of infarction. The 60% to 80% rate of coronary recanalization after thrombolytic therapy has proved that thrombosis is a major component of the occlusion at the time when the procedure is performed a few hours after the onset of symptoms. However, the trigger for coronary thrombosis and the causes of failure of thrombolytic therapy are still a matter of speculation. The relatively rare occurrence of acute coronary occlusion in the life of an individual with even severe coronary disease can be explained on the basis of the necessity of either extremely powerful isolated stimuli, which only occurs rarely, or the casual simultaneous presence in one coronary arterial segment of multiple unfavorable events, such as plaque fissuring, enhanced reactivity of coronary smooth muscle to constrictor stimuli and displacement of the thrombotic-thrombolytic equilibrium toward thrombosis. Coronary artery constriction possibly caused by vasoconstrictor substances released by thrombus, represents the potential element of a vicious cycle causing persistent coronary occlusion and reocclusion when reflow occurs with thrombolysis. PMID- 3510765 TI - The role of programmed electrical stimulation in evaluation of investigational antiarrhythmic drugs. PMID- 3510764 TI - Effect of the addition of propranolol to therapy with nifedipine for unstable angina pectoris: a randomized, double-blind, placebo-controlled trial. AB - The value of the addition of beta-blockers to coronary vasodilator therapy in the treatment of patients with unstable angina at rest is controversial. We conducted a double-blind, randomized, placebo-controlled 4 week trial of propranolol in 81 patients with unstable angina, 39 of whom were assigned to placebo and 42 of whom received propranolol in a dose of at least 160 mg daily. All patients were also treated with coronary vasodilators, including 80 mg nifedipine daily and long acting nitrates. The incidences of cardiac death, myocardial infarction, and requirement for bypass surgery or coronary angioplasty did not differ between the two groups (propranolol = 16; placebo = 18). The propranolol group had a lower cumulative probability of experiencing recurrent resting angina than the placebo group (p = .013), and over the first 4 days of the trial the mean number of clinical episodes of angina (propranolol 0.9 +/- 0.2, placebo 1.8 +/- 0.3, p = .036), duration of angina (propranolol 15.1 +/- 4.3 min, placebo 38.1 +/- 8.4, p = .014), and nitroglycerin requirement (propranolol 1.1 +/- 0.3 tablets, placebo 3.5 +/- 0.8, p = .003) were also fewer. Continuous electrocardiographic recording for ischemic ST segment changes revealed fewer daily ischemic episodes in the propranolol group (2.0 +/- 0.5) than in the placebo group (3.8 +/- 0.7, p = .03), and a shorter duration of ischemia (propranolol 43 +/- 10 min, placebo 104 +/- 28 min, p = .039). Thus propranolol, in patients with unstable angina, in the presence of nitrates and nifedipine is not detrimental and reduces the frequency and duration of symptomatic and silent ischemic episodes. PMID- 3510766 TI - Historic perspectives--electrical stimulation of the heart. PMID- 3510767 TI - Criteria for selection of patients for programmed electrical stimulation. PMID- 3510768 TI - Does therapy directed by programmed electrical stimulation provide a satisfactory clinical response? PMID- 3510769 TI - Ambulatory electrocardiographic monitoring in the evaluation of new antiarrhythmic drugs. PMID- 3510770 TI - Evaluation of antiarrhythmic drugs by sudden death trials. PMID- 3510771 TI - Pharmacokinetics of the bipyridines amrinone and milrinone. AB - The pharmacokinetics of milrinone were studied in sequential ascending doses in New York Heart Association Class III and IV patients receiving oral and intravenous medication. The parameters determined after parenteral administration were estimated by fitting the plasma concentration data to an open two compartment body model. After oral medication, regression-independent parameters were determined. After either oral or parenteral administration of milrinone, plasma levels were dose dependent and the drug had an apparent first-order terminal elimination half-life of approximately 2 hr. The apparent volume of distribution was approximately 400 to 500 ml/kg, and total body clearance was approximately 130 ml/kg/hr. These values obtained in patients receiving milrinone were compared with those obtained for milrinone in volunteers, as well as those noted with the other inotropic bipyridine, amrinone. Milrinone's elimination from the blood stream patients was slower that that in normal healthy subjects and faster than amrinone's elimination in patients with congestive heart failure. Milrinone's pharmacokinetic parameters in these patients were unchanged after approximately 30 days of continuous oral medication. PMID- 3510772 TI - Effects of milrinone on left ventricular performance and myocardial contractility in patients with severe heart failure. AB - The potent vasodilating properties of the bipyridine derivatives confounds the assessment of changes in contractility as measured by peak positive left ventricular dP/dt and explains why the positive inotropic action of these agents has not been consistently demonstrated in patients with ventricular dysfunction. Therefore we studied the individual dose-response effects of intravenous milrinone on myocardial contractility as measured by peak positive left ventricular dP/dt in the context of concurrent changes in ventricular filling pressure. Incremental doses of milrinone caused a dose-related increase in peak positive left ventricular dP/dt in six of 11 patients. Peak positive left ventricular dP/dt was unchanged in four patients and reduced in one patient, all of whom experienced a substantial fall in left ventricular filling pressure. Thus milrinone has a definite inotropic effect in addition to its potent vasodilating properties. PMID- 3510773 TI - Milrinone, dobutamine, and nitroprusside: comparative effects on hemodynamics and myocardial energetics in patients with severe congestive heart failure. AB - To assess their comparative effects on hemodynamics and myocardial energetics, we administered nitroprusside (1.5 +/- 0.6 microgram/kg-min), dobutamine (10 +/- 3 micrograms/kg-min), and milrinone (67 +/- 13 micrograms/kg-min) sequentially to 10 patients with severe (NYHA class III or IV) congestive heart failure. Each agent led to a significant (p = .001) increase in cardiac index (1.9 +/- 0.5 to 2.7 +/- 0.6 liters/min/m2; 1.7 +/- 0.4 to 2.6 +/- 0.6 liters/min/m2; and 1.8 +/- 0.5 to 2.7 +/- 0.5 liters/min/m2, for nitroprusside, dobutamine, and milrinone, respectively). Dobutamine did not produce a significant change in the pulmonary capillary wedge pressure (27 +/- 5 to 24 +/- 6 mm Hg, NS) nor in mean arterial pressure (83 +/- 9 to 86 +/- 10 mm Hg, NS), but caused a significant rise in heart rate (85 +/- 16 to 99 +/- 17 beats/min, p = .001) and in myocardial oxygen consumption (8.7 +/- 2.1 to 11.1 +/- 3.8 ml O2/min, p = .03). In contrast, nitroprusside and milrinone each caused a significant (p = .001) fall in the pulmonary capillary wedge pressure (27 +/- 6 to 19 +/- 7 mm Hg and 26 +/- 6 to 19 +/- 9 mm Hg, respectively), without significantly increasing either the heart rate (87 +/- 18 to 85 +/- 17 beats/min and 86 +/- 17 to 89 +/- 17 beats/min, respectively) or myocardial oxygen consumption (8.8 +/- 2.3 to 7.6 +/- 2.1 ml O2/min and 8.8 +/- 2.1 to 8.4 +/- 2.1 ml O2/min, respectively).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3510774 TI - Milrinone and dobutamine in severe heart failure: differing hemodynamic effects and individual patient responsiveness. AB - Milrinone and dobutamine were compared in 15 patients with New York Heart Association functional class III and IV congestive heart failure. Dobutamine and milrinone were administered intravenously according a graded titration schedule up to maximum doses (14 micrograms/kg/min and 75 micrograms/kg, respectively) or until increased ventricular ectopy or a reduction in left ventricular end diastolic pressure to 10 mm Hg or less occurred. Although both agents markedly increased cardiac index, milrinone caused a significantly greater reduction in left and right heart filling pressures and mean arterial pressure than did dobutamine, and for any given increase in dP/dt, milrinone caused a greater reduction in systemic vascular resistance than did dobutamine. Thus, the hemodynamic effects of milrinone are best represented by a combination of the actions of dobutamine, a positive inotropic agent, and a vasodilator such as nitroprusside, which causes both arterial and venous dilation. The positive inotropic responses of individual patients to dobutamine (5 micrograms/kg/min) and milrinone (25 micrograms/kg) were compared. The increases in dP/dt with both agents were variable, and correlated poorly (r = .50; p = .059). Patients were divided into two groups: Group I consisted of eight patients in whom the ratio of the increase in dP/dt with dobutamine vs milrinone was greater than 1.0 (good dobutamine responders); group II consisted of seven patients in whom this ratio was less than 1.0 (poor dobutamine responders).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3510775 TI - Clinical effects of intravenous amrinone in patients with congestive heart failure. AB - Hemodynamic effects of intravenous administration of amrinone include increases in dP/dt, cardiac output, and stroke work with decreases in left ventricular filling pressure and systemic vascular resistance. Unlike other injectable positive inotropic agents, it does not increase myocardial oxygen consumption, a distinct advantage in patients with coexisting ischemic disease. Amrinone does not have deleterious effects on atrioventricular conduction and appears to have little arrhythmogenic potential. Side effects of intravenous administration are generally minor but include a reversible thrombocytopenia. Additional studies conducted in short-term low-output states are needed to define more completely its role in the treatment of this condition. PMID- 3510776 TI - Assessment of long-term therapy with milrinone and the effects of milrinone withdrawal. AB - To assess the long-term efficacy of milrinone in patients with severe congestive heart failure, we obtained hemodynamic measurements (systemic arterial and right heart catheterization) in 13 patients at baseline and after intravenous administration of milrinone. After continuous oral milrinone therapy of 8 +/- 4 months duration, repeat hemodynamic study was performed in patients on oral milrinone therapy, after withdrawal of milrinone, and after readministration of milrinone intravenously. Comparison of initial baseline and withdrawal hemodynamic measurements for the group as a whole showed no interval progression of heart failure, as reflected by the pulmonary capillary wedge pressure (27 +/- 8 to 24 +/- 12 mm Hg, NS) or the cardiac index (2.0 +/- 0.4 to 2.1 +/- 0.8 liters/min/m2, NS). Individual comparisons of milrinone-free hemodynamics revealed that five patients had improved hemodynamically, three patients were unchanged, and five patients had deteriorated, four of whom manifested dependence on milrinone with a progressive hemodynamic decline after milrinone withdrawal which required readministration of milrinone on an emergency basis. Continued efficacy of milrinone was observed on readmission after withdrawal: pulmonary capillary wedge pressure fell from 27 +/- 8 to 16 +/- 10 mm Hg (p = .001) initially and from 24 +/- 12 to 13 +/- 11 mm Hg (p = .001) at readministration, while cardiac index rose from 2.0 +/- 0.4 to 2.8 +/- 0.5 liters/min/m2 (p = .001) initially and from 2.1 +/- 0.8 to 2.7 +/- 0.5 liters/min/m2 (p = .005) upon readministration.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3510777 TI - Milrinone for long-term therapy of severe heart failure: clinical experience with special reference to maximal exercise tolerance. AB - Thirty-seven patients with severe chronic heart failure were entered into an open ended trial with milrinone at an initial daily dose ranging form 20 to 30 mg. Mean duration of treatment was 48 weeks and ranged from 1 to 134 weeks. Twenty five patients (67%) reported a substantial improvement in well-being with less dyspnea or fatigue, but this was not associated with a significant increase in maximal oxygen uptake: 10.2 +/- 2.9 vs 10.7 +/- 2.4 ml/kg/min (NS). At intervals ranging from 6 to 54 weeks, they experienced a recurrence of symptoms that was partially reversed by increasing the dose of milrinone to a maximum of 50 mg/day. In 15 patients whose symptoms could not be controlled by milrinone alone, captopril was added. The combination of captopril and milrinone was well tolerated and produced a symptomatic improvement in 10 of the 15 patients (67%). Maximal oxygen uptake, however, was not significantly increased by addition of captopril to milrinone: 10.6 +/- 2.7 vs 11.6 +/- 3.3 ml/kg/min. Twenty-four patients died: 12 of sudden death and 12 of gradual worsening of heart failure. During prolonged administration of milrinone, no patient experienced overt clinical adverse reactions directly attributable to the drug. Left ventricular end-diastolic dimension increased from 3.6 +/- 0.7 to 4.1 +/- 0.9 cm/m2 (p less than .05) after a mean duration of 50 weeks of milrinone therapy. Accordingly, long-term therapy with milrinone appears to improve functional status without eliciting overt clinical adverse reactions. However, the possibility that milrinone might have contributed to the high mortality noted during this therapeutic trial cannot be excluded.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3510778 TI - Persistent hemodynamic effects without long-term clinical benefits in response to oral piroximone (MDL 19,205) in patients with congestive heart failure. AB - Piroximone (MDL 19,205), a new phosphodiesterase inhibitor with positive inotropic and vasodilating properties, was administered orally to 12 patients with severe congestive heart failure (NYHA class III to IV). After a mean dose of 1.7 +/- 0.4 (SD) mg/kg, cardiac index increased from 2.0 +/- 0.5 to 3.0 +/- 0.6 liters/min/m2 while pulmonary wedge pressure decreased from 23 +/- 6 to 15.6 +/- 7 mm Hg and systemic vascular resistance from 1520 +/- 370 to 1000 +/- 320 dyne sec-cm-5. Mean arterial pressure was slightly reduced from 80 +/- 13 to 75 +/- 11 mm Hg and forearm blood flow increased by 79% (all p less than .01). Eleven patients were selected for long-term treatment. Two patients received a heart transplant soon after the treatment was started. The remaining nine patients were followed for a mean of 5.6 months (range 2 to 10). Severe congestive heart failure recurred in eight of these nine patients, resulting in the death of three patients within 4 months. The remaining six patients underwent repeat hemodynamic evaluation 2 months after the initiation of the treatment. A short-term hemodynamic response to the drug in this group demonstrated that piroximone retains its circulatory effect during continuous therapy. Nevertheless, three more patients of this group died within 8 months and two required heart transplants. Of the nine patients receiving long-term treatment, only one had sustained subjective improvement and increased exercise capacity. Therefore long term therapy with piroximone did not appear to benefit patients with severe congestive heart failure. A drug-related deterioration of their clinical status cannot be excluded. PMID- 3510779 TI - Historical perspectives on inotropic agents. AB - Although early experiments in animals and humans suggested that digitalis glycosides increased cardiac output only in the failing heart, later studies showed that these cardiotonic agents increase intraventricular systolic pressure and decrease relaxation time in the normal animal. The controversy concerning the peripheral vascular or direct cardiac effects of digitalis was finally resolved when new methods were applied to the study of the effects of this drug on intraventricular pressures and cardiac contractile force. Other positive inotropic agents, such as the adrenergic agonists, have also been tested for the treatment of heart failure. However, during long-term oral or intravenous therapy, the effectiveness of these drugs appears to diminish. Clinical studies of glucagon, a polypeptide with positive inotropic and chronotropic effects, have revealed its potential for causing side effects and its reduced activity in patients with chronic heart failure. With the discovery of several new types of inotropic agents, i.e., the bipyridines and the imidazole and benzimidazole derivatives, interest in revising our therapeutic approach to congestive heart failure has increased. This review discusses recent developments in this area. PMID- 3510780 TI - Differentiating muscle damage from myocardial injury by means of the serum creatine kinase (CK) isoenzyme MB mass measurement/total CK activity ratio. AB - We immunoenzymometrically measured creatine kinase (CK) isoenzyme MB in extracts of myocardium and in homogenates of five different skeletal muscles. CK-MB concentrations in the former averaged 80.9 micrograms/g wet tissue; in the skeletal muscles it varied widely, being (e.g.) 25-fold greater in diaphragm than in psoas. CK-MB in skeletal muscles ranged from 0.9 to 44 ng/U of total CK; the mean for myocardium was 202 ng/U. In sera from 10 trauma and 36 burn patients without myocardial involvement, maximum ratios for CK-MB mass/total CK activity averaged 7 (SEM 1) ng/U and 18 (SEM 6) ng/U, respectively. Except for an infant (220 ng/U), the highest ratio we found for serum after muscular damage was 38 ng/U. In contrast, the mean maximum ratio determined in 23 cases of acute myocardial infarction exceeded 200 ng/U. Among seven determinations performed 8 to 32 h after onset of symptoms, each infarct patient demonstrated at least one ratio greater than or equal to 110 ng/U. Ratios observed after infarct were unrelated to treatment received during the acute phase. We propose a CK-MB/total CK ratio of 80 ng/U as the cutoff value for differentiating myocardial necrosis from muscular injury. PMID- 3510781 TI - Homogeneous substrate-labeled fluorescent immunoassay for disopyramide in human serum: semi- and fully automated procedures. AB - In this immunoassay for disopyramide in serum, to form the label, disopyramide is covalently attached to a fluorogenic enzyme substrate, 7-beta-galactosylcoumarin 3-carboxylic acid, which is nonfluorescent under the conditions of the assay. Hydrolysis, catalyzed by beta-galactosidase, yields a fluorescent product. As a result of competitive protein binding reactions between drug and label for limited antibody binding sites, this fluorescence is proportional to disopyramide concentration. The assay is sensitive to less than 0.5 mg of disopyramide per liter. Results obtained with either the semi-automated procedure (Ames TDA) or the fully automated (Optimate) procedure correlated well with those obtained by liquid chromatography (r = 0.98 and 0.99). For commercial controls containing various concentrations of the drug, the respective coefficients of correlation were 1.00 and 0.99 for the TDA and Optimate procedures. Within-run CVs for the two procedures were less than or equal to 5.1%, overall CVs less than or equal to 6.5%. PMID- 3510782 TI - What is the most efficient way to evaluate immunoglobulins? PMID- 3510783 TI - Evaluation of Beta Quik Stat kit test for pregnancy for whole blood, serum, plasma, and urine. PMID- 3510784 TI - More on the dilution dependence of the Coomassie Brilliant Blue technique for urinary protein. PMID- 3510785 TI - Urinary osmolarity and pH and lysozyme stability. PMID- 3510786 TI - Elimination of labetalol-induced false positives in drug analyses. PMID- 3510787 TI - Analysis of histiocytosis X infiltrates with monoclonal antibodies directed against cells of histiocytic, lymphoid, and myeloid lineage. AB - Surface markers expressed on histiocytosis X (HX) cells were studied using 18 monoclonal antibodies (McAbs) and an in situ indirect immunoperoxidase technique. Specimens of skin (five biopsies from three cases) and lymph node (one case) were studied. Our study confirmed previous findings of an OKT6+ HLA DR+ Leu 3a+ phenotype of HX cells in skin and indicated that lymph node HX cells can also have this phenotype. A mixture of cells expressing T markers/T subset, monocyte/macrophage, and killer/natural killer (K/NK) markers was also present in two cases. However, one case with an aggressive course showed no detectable HNK 1+ (K/NK) or Leu 2A (suppressor) cells in the cutaneous infiltrates and no detectable HNK 1+ lymphocytes in an affected lymph node. The significance of these findings in relation to prognosis and therapy is discussed. PMID- 3510788 TI - Flecainide: a new antiarrhythmic drug. AB - Flecainide acetate is a new class 1 c antiarrhythmic drug. It slows conduction in the working myocardium and the specialized conduction system and may depress sinus node activity in patients with pre-existing sinus node disease. Its hemodynamic effects are minimal. The drug is completely absorbed and shows a half life of 7-22 hours. Elimination is mainly through the kidneys. Flecainide is highly effective in the treatment of ventricular arrhythmias, pre-excitation syndromes and AV reentry tachycardias. Side effects are mild and consist mostly of dizziness, visual disturbances, and nervousness. They rarely require discontinuation of therapy. Proarrhythmic effects have been reported. Caution is required in patients with congestive heart failure, AV block, and/or bundle branch block or sinus node dysfunction. PMID- 3510789 TI - Suprarenal abscess in the neonate. Technetium-99m glucoheptonate imaging. AB - Although suprarenal abscess in a newborn is rare, a prompt diagnosis is essential for proper patient management. The findings obtained with Tc-99m glucoheptonate renal imaging in a newborn with a right adrenal abscess are reported. A radionuclide renal imaging sequence over a 15-hour period demonstrated a "rim sign" which can be used to suggest the diagnosis. Radionuclide and ultrasound imaging of neonatal adrenal masses is discussed. PMID- 3510790 TI - Renocutaneous inflammatory tract shown during technetium-99m DTPA imaging. AB - During a Tc-99m DTPA study, activity simultaneously appeared in the kidneys and in a right lateral band. This was due to an inflammatory tract and not to urinary drainage. PMID- 3510791 TI - Ureteral reflux of recipient's own kidneys. A potential source of error in renal transplant evaluation. AB - After transplantation, pre-existent vesicoureteral reflux caused a hot paravesical area mimicking urine extravasation. PMID- 3510792 TI - Visualization of the uterus on evaluation of transplanted kidneys. AB - A vascular blush was noted in the pelvis during flow studies in two women with kidney transplants. The vascular structure was noted to be due to the uterus. In one patient, the activity in the area of the uterus could have been mistaken for excretion of agent into the bladder. PMID- 3510793 TI - Clinical experience with the use of Culturette Brand 10-Minute Group A Strep ID kit in the early diagnosis of streptococcal pharyngitis. PMID- 3510794 TI - Familial juvenile nephronophthisis. A review and differential diagnosis. AB - Familial juvenile nephronophthisis (FJN) is a frequent cause of chronic renal failure in children and adolescents. Typically it presents after 6 years of age through adolescence, but may become apparent in early childhood. The clinical presentation is insidious, and the early symptoms of polyuria and polydipsia are often overlooked in the presence of a relatively normal urinalysis and in the absence of proteinuria, azotemia, and hypertension. Thus most patients are not diagnosed until after the onset of renal failure. These children are excellent candidates for properly selected transplantation. PMID- 3510795 TI - Effects of combination therapy with captopril and nifedipine in severe or resistant hypertension. AB - To assess the effect of potent vasodilator therapy in patients with severe or resistant hypertension, 10 patients underwent therapy with captopril and nifedipine alone and in combination. Blood pressure (BP), heart rate, and blood chemistry values were monitored for 4 weeks during captopril monotherapy and after 8 weeks during combination therapy with captopril and nifedipine. Compared with baseline, the BP decreased during captopril monotherapy (180 +/- 11/98 +/- 7 vs. 209 +/- 16/118 +/- 12 mm Hg; P less than 0.005). After the addition of nifedipine, the BP was further reduced (148 +/- 23/85 +/- 16 mm Hg), but there was no change in heart rate. In three patients not achieving the diastolic BP goal during combination therapy with dosing every 8 hours, automatic 24-hour ambulatory BP monitoring demonstrated lack of antihypertensive control for only the last 2 to 3 hours of the dosing interval. These data demonstrate that combination therapy with captopril and nifedipine is effective in patients with severe hypertension, but frequent dosing intervals are necessary for adequate antihypertensive control. PMID- 3510796 TI - Treatment of childhood hyperactivity with desipramine: plasma drug concentration, cardiovascular effects, plasma and urinary catecholamine levels, and clinical response. AB - Twenty-nine boys with attention deficit disorder/hyperactivity were randomly assigned to receive desipramine (DMI; n = 17) or placebo (n = 12) for 14 days in a noncrossover, double-blind study. There was immediate behavioral improvement with DMI at day 3 that was sustained for 2 weeks; behavioral improvement did not correlate with plasma concentrations of DMI, hydroxy-DMI, or their sum at either days 3 or 14. There were no untoward side effects; there was a drug-induced increase in pulse and diastolic blood pressure. During drug therapy, the urinary excretion of norepinephrine, vanillymandelic acid, and 3-methoxy-4 hydroxyphenylglycol (MHPG) was decreased at both days 3 and 14. The plasma MHPG level was decreased at days 3 and 14 and (standing) plasma NE levels increased at day 14. The decreases in both urinary and plasma MHPG levels showed significant correlations with behavioral improvement during the second week. These data corroborate previous findings on sympathomimetic effects of tricyclic antidepressants in children and support a noradrenergic mechanism in the mediation of drug effects on attention deficit disorder/hyperactivity. PMID- 3510797 TI - Ketorolac and acetaminophen for orthopedic postoperative pain. AB - In a double-blind, single-dose, parallel-group study, ketorolac (5, 10, or 20 mg) was compared with acetaminophen (500 or 1000 mg) when taken by mouth for postoperative orthopedic pain. Analgesic measurements were made by trained nurse observers who used standard verbal rating and visual analog scales. Acetaminophen, 1000 mg, was statistically superior to 500 mg acetaminophen, demonstrating assay sensitivity. Ketorolac, 20 mg, was distinguished from 500 mg acetaminophen, 5 mg ketorolac, and 10 mg ketorolac, but not from 1000 mg acetaminophen. The higher doses of ketorolac induced a longer lasting peak analgesic effect than did acetaminophen, but the magnitude of the peak pain relief was changed little by an increased ketorolac dose. Overall, 10 mg ketorolac appeared equivalent to 1000 mg acetaminophen. Acetaminophen, 500 mg, induced less sedation than the higher doses of ketorolac, but neither drug caused untoward side effects. PMID- 3510798 TI - The antihypertensive action of hydrochlorothiazide and renal prostacyclin. AB - To investigate whether chronic hydrochlorothiazide (HCTZ) therapy increases synthesis of tissue vasodilator prostaglandins (PG), we used intravenous furosemide as a standardized stimulus of renal PG synthesis before and after HCTZ dosing. Sixteen subjects with mild hypertension received placebo for 4 weeks, followed by HCTZ, 50 mg/day, and potassium chloride, 60 mmol/day, for 4 weeks. Nine subjects had decreased mean arterial pressure (-12.2 +/- 0.9 mm Hg) after HCTZ (responders), while seven others had no antihypertensive effect (nonresponders). Responders increased their excretion of the prostacyclin (PGI2) hydrolysis product 6-keto-PGF1 alpha in the first 10 minutes after furosemide, from 17.8 +/- 2.7 ng after placebo to 34.9 +/- 7.5 ng (P less than 0.05) after HCTZ, whereas nonresponders showed no such increase. These groups could not be distinguished on the basis of sex, age, or pretreatment plasma renin activity. After HCTZ dosing, responders showed evidence of increased action of PGI2 by increased plasma renin activity 10 minutes after furosemide (6.10 +/- 1.06 vs. 3.39 +/- 0.4 ng/ml/hr; P less than 0.05). Furthermore, creatinine clearance was maintained in responders (while decreasing slightly in nonresponders) despite lower blood pressure, a finding consistent with increased vasodilator effect. We conclude that an antihypertensive response to HCTZ is accompanied by an increase in renal PGI2 synthesis and action. PMID- 3510799 TI - Regional blood flow and neurohormonal responses to milrinone in congestive heart failure. AB - We measured systemic hemodynamics, regional blood flow, and neurohormonal parameters in 13 patients with severe chronic congestive heart failure before and after 1 month of therapy with oral milrinone, a bipyridine cardiotonic agent. After milrinone there were significant reductions in pulmonary wedge pressure (27 +/- 2 to 19 +/- 3 mm Hg; P less than 0.02) and systemic vascular resistance (1866 +/- 152 to 1393 +/- 93 dyne X sec/cm5; P less than 0.05) that were associated with increases in cardiac index (1.85 +/- 0.15 to 2.47 +/- 0.20 L/min/m2; P less than 0.02). There was a marked improvement in forearm blood flow (1.98 +/- 0.14 to 3.02 +/- 0.16 ml/min/dl; P less than 0.01) and a reduction in forearm vascular resistance (45 +/- 3 to 30 +/- 3 U; P less than 0.01). Overall there was no significant change in renal blow flow, renal vascular resistance, or glomerular filtration rate. However, there was a heterogeneous response of renal blood flow and glomerular filtration rate, such that both were directly correlated with the magnitude of increase of cardiac index (r = 0.587 [P less than 0.05] and r = 0.721 [P less than 0.01], respectively). After milrinone there were no significant overall or subgroup changes in urinary sodium excretion, blood volume, plasma renin activity, urinary aldosterone levels, plasma or platelet vasopressin levels, or plasma norepinephrine levels. Thus 1 month of therapy with milrinone improves systemic and forearm hemodynamics, but its effects on renal blood flow and function were heterogeneous. These heterogeneous effects on regional blood flow may depend on the relative vasodilator and inotropic effects of milrinone. PMID- 3510800 TI - Analgesic and antidepressive effects of low-dose amitriptyline in relation to its metabolism in patients with chronic pain. AB - The analgesic and antidepressive effects of amitriptyline (AT) in relation to its kinetics and metabolism were studied in 19 outpatients with chronic pain who received a daily dose of 75 mg AT for at least 6 weeks. Riboflavin was added to the medication to check compliance. On days 0, 4, and 8 and weeks 3, 6, 9, and 12 after the start of dosing, blood samples were drawn from the patients 10 +/- 1 hours after the first morning dose and a sample of the first morning urine was taken to check riboflavin. Serum levels of AT and its metabolites, especially nortriptyline (NT) and E-10-hydroxy-nortriptyline (E-10-OH-NT), were measured by HPLC. On day 0 and at 3, 6, and 12 weeks the severity of depression was scored by means of a self-rating depression scale and pain intensity scores were measured. In addition, after 6 weeks of dosing patients estimated their percentage of pain in comparison with baseline. Mean (+/- SD) steady-state concentrations of AT, NT, and E-10-OH-NT were 36 +/- 23.5, 28 +/- 14.9, and 52 +/- 23.7 micrograms/L, respectively, in male patients (n = 8; age 45 +/- 7.4 years) and 34 +/- 14.6, 45 +/- 25.1, and 40 +/- 15.6 micrograms/L, respectively, in female patients (n = 11; age 46 +/- 6.8 years). There was a significant sex-related difference in the NT/AT ratio, which was higher in women.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3510801 TI - Evaluation of glycerol as an osmotic agent for continuous ambulatory peritoneal dialysis in end-stage renal failure. AB - Six patients established on continuous ambulatory peritoneal dialysis entered a trial of treatment with dialysis fluid containing glycerol instead of glucose as the osmotic agent in an attempt to decrease the energy load. They were observed for a further 6 months after reconversion to glucose-based dialysis. During the 6 month control period fluid balance was achieved mainly with a solution containing 76 mmol of glucose/1. Fluid balance was maintained during the 6 month period of treatment with glycerol only by the increased use of solutions containing a high concentration of glycerol (152 mmol/l and 272 mmol/l). Thus the energy value of the absorbed osmotic agent did not differ at a mean of 1607 kJ (384 kcal)/day using glycerol and 1669 kJ (399 kcal)/day using glucose as the osmotic agent. In five subjects, fasting and peak blood glycerol levels did not change over the 6 months, but one subject, who accumulated glycerol, developed symptoms of hyperosmolality after 2 months and glycerol therapy was discontinued. In a further subject glycerol-based dialysis was terminated at 3 months when increasing angina was reported. Mean fasting plasma triglyceride concentrations were 50% higher during the 6 months on glycerol (3.12 +/- 1.12 mmol/l) than on glucose (2.19 +/- 0.97 mmol/l) (P less than 0.05). There was a small rise in very low density lipoprotein-cholesterol concentrations with glycerol dialysis but total cholesterol levels were unchanged.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3510802 TI - Effects of packed cell volume reduction on renal haemodynamics and the renin angiotensin-aldosterone system in patients with secondary polycythaemia and hypoxic cor pulmonale. AB - Polycythaemia was corrected by erythrapheresis in ten patients with hypoxic cor pulmonale who were stable on regular diuretic therapy. Renal haemodynamics, renal function and the renin-angiotensin-aldosterone system were assessed before and afterwards. Before erythrapheresis effective renal plasma flow (ERPF) was reduced (63% predicted) but glomerular filtration rate (GFR) was preserved (88% predicted) by a rise in filtration fraction (FF) (138% predicted). A negative correlation existed between ERPF and packed cell volume (r = -0.723; P less than 0.02) and also between ERPF and PaCO2 (r = -0.710; P less than 0.05). Polycythaemia was sufficient to maintain renal oxygen delivery (97% predicted). After erythrapheresis systemic blood pressure, blood volume and blood viscosity all decreased. ERPF increased by 18% (P less than 0.02). FF fell by 11% (P less than 0.05) and GFR was unchanged. Renal oxygen delivery diminished by 25% (P less than 0.001). Plasma renin activity was increased in five patients and plasma aldosterone increased in two patients before erythrapheresis. No sustained fall occurred in plasma renin activity or plasma aldosterone, possibly because the haemodynamic consequences of the procedure had opposing actions on renin secretion. Although the reduction in FF would per se tend to enhance renal sodium and water excretion, a diuresis or natriuresis did not occur consistently. PMID- 3510803 TI - Effect of changes in posture on circulatory homeostasis in patients with the nephrotic syndrome. AB - To assess whether the upright posture causes circulatory hypovolaemia in patients with the nephrotic syndrome (NS), we studied 12 subjects with NS and 12 healthy subjects during recumbency, 110 min of standing, followed again by recumbency. Control blood-pressure was 134/88 +/- 4/3 mmHg in the patients and 113/75 +/- 2/3 mmHg in the normal subjects (P less than 0.01), and remained higher in the patients throughout the procedure. Heart rate was continuously higher in the patients (P less than 0.05), but acceleration on standing was normal. The blood volume, which was not different during recumbency, had fallen below that in normal subjects after 25 min of standing (P less than 0.05), due to excessive plasma volume reduction (-16.8 +/- 0.8% in the patients against -11.7 +/- 1.2% in the normals, P less than 0.02). Plasma renin activity (PRA) was higher in the patients while recumbent (P less than 0.001) but not during standing, due to a blunted response in some. No significant differences in plasma noradrenaline were found, but four patients reacted with an excessive rise in plasma noradrenaline and heart rate. This subset, which had high PRA levels as well, comprised the only subject who experienced orthostatic hypotension. It is concluded that during standing an excessive drop in plasma volume leads to a lowered blood volume in NS patients. This forms a paradox with the heart rate acceleration and noradrenaline levels, which were mostly normal, and with the blood-pressure, which remained slightly elevated. Even in a few patients with enhanced stimulation of heart rate and noradrenaline, blood-pressure was found to be high in the majority of cases. PRA was usually found to be increased but, in part, independent of posture. PMID- 3510804 TI - Pulmonary clearance of inhaled 99mTc-DTPA: effect of surfactant depletion in rabbits. AB - We examined the effect of surfactant depletion on the rate of pulmonary clearance of inhaled 99mTc-diethyl-triamino-penta-acetate (DTPA). 99mTc-DTPA was administered as a fine aerosol to four control animals and to four animals after wash-out of pulmonary surfactant. Care was taken to minimize structural damage to the lavaged lungs. Clearance of 99mTc-DTPA was measured over the right lung by external counting. The clearance rate was substantially increased in the lavaged animals compared to the control animals. We conclude that the pulmonary surfactant system is a rate-limiting factor for the absorption of inhaled 99mTc DTPA. Measurement of the pulmonary clearance of 99mTc-DTPA may provide a new means for studying the pathogenetic role of the surfactant system in a variety of lung diseases. PMID- 3510805 TI - Rapid screening and microbiologic processing of pediatric urine specimens. AB - Urinary nitrite and leukocyte esterase dipstick tests were evaluated as rapid screening procedures to select probable culture-positive urines for direct identification (AutoMicrobic System urine cards) and modified Kirby-Bauer susceptibility testing. Approximately 73% of significant culture-positive (greater than 10(5) organisms per milliliter, pure culture) urine specimens could be selected by nitrite testing alone with very high specificity (approximately 99%). The leukocyte esterase test detected 85% of culture-positive urines when used alone and approximately 91% when used in combination with nitrite testing (if either test was positive it was considered a positive screening); however, the esterase test was significantly less specific for bacteriuria than the nitrite test. Based on these results, the nitrite test was selected for use as the screening test. Rapid, direct identification and susceptibility tests on screen-positive urines showed 97% correlation with standard testing methods. Significant positive urines processed in this manner could be reported with quantitation, identification, and susceptibility results within 24 hr. PMID- 3510806 TI - Recurrent salmonella infection with a single strain in the acquired immunodeficiency syndrome. Confirmation by plasmid fingerprinting. AB - Five weeks before the development of acquired immunodeficiency syndrome (AIDS), a 38-yr-old homosexual man had symptomatic gastroenteritis that resolved without antibiotic treatment. His stool culture was positive for Salmonella typhimurium at that time. The patient subsequently developed Pneumocystis carinii pneumonia and received a 10-day course of intravenous trimethoprim-sulfamethoxazole. He developed salmonella bacteremia 4 months later. The salmonella isolates from the stool and blood were susceptible to trimethoprim-sulfamethoxazole. Comparison of cryptic plasmids showed a pattern identical to the initial salmonella infection, so infection with a new strain did not cause the bacteremia. This finding illustrates the utility of plasmid fingerprinting as a diagnostic tool, and suggests that persons with AIDS, or those at high risk with prodromal symptoms, should receive prompt, effective therapy for nontyphoidal salmonella gastroenteritis. PMID- 3510807 TI - Irrelevance of growth phase with respect to the Bay n 7133 and ICI 153,066 susceptibilities of Candida albicans. AB - Miconazole at 10(-5)-10(-4) M can kill Candida albicans in the logarithmic phase, but ketoconazole, the only established oral antifungal azole, cannot. Lethal potential in relation to growth phase was studied with Bay n 7133 and ICI 153,066, two recently developed oral triazoles. Each was strictly fungistatic regardless of phase of growth and was almost identical in effect to ketoconazole. PMID- 3510808 TI - Microtubule proteins in neuronal differentiation. PMID- 3510809 TI - Developmental changes in the activities of enzymes related to methyl group metabolism in sheep tissues. AB - The activities of choline oxidase and betaine-homocysteine methyltransferase increased markedly in pre-ruminant lamb liver after birth and subsequently decreased when the lambs reached the ruminant state, while the developmental changes in hepatic 5-methyl-H4folate-homocysteine methyltransferase were negatively correlated with those of betaine-homocysteine methyltransferase. Hepatic phospholipid methyltransferase was elevated almost four-fold by the 10th postnatal day, but declined thereafter. Hepatic glycine methyltransferase in one day-old lambs increased 55-fold, compared with that of fetuses, and thereafter decreased dramatically with age. Guanidoacetate methyltransferase, glycine methyltransferase and betaine-homocysteine methyltransferase in sheep pancreas increased markedly with age and were many times higher than the hepatic enzymes in adult sheep. Choline oxidase, betaine-homocysteine methyltransferase, cystathionine beta-synthase and glycine methyltransferase in adult sheep liver were much lower than those in rat. These results illustrate the conservative features of methyl group metabolism in postruminant sheep. PMID- 3510810 TI - Heme synthesis in Trypanosoma cruzi: influence of the strain and culture medium. AB - The activity of the following enzymes involved in the biosynthesis of porphyrins was determined in two strains of Trypanosoma cruzi (Y and CL) grown in two culture media (LIT and Warren): succinyl coenzyme A synthetase (Suc.CoA-S), 5 aminolevulinate synthetase (ALA-S), 4,5-dioxovaleric acid transaminase (DOVA-T), 5-aminolevulinate dehydratase (ALA-D), porphobilinogenase (PBGase), deaminase and heme synthetase (Heme-S). The amount of 5-aminolevulinic acid (ALA) and porphobilinogen, porphyrins and heme was also determined. ALA and PGB were detected in both strains of T. cruzi. However, ALA was not detected in epimastigotes of the Y strain grown in the LIT medium. The content of ALA and PBG varied according to the strain and the growth medium. No free porphyrins and heme were detected in both strains of T. cruzi. The activity of Suc.CoA-S and DOVA-T was markedly influenced by the strains of the parasite and the growth medium. No significant DOVA-T activity was detected in epimastigotes of the CL strain grown in the Warren's medium. No significant activity of ALA-D, PBGase and deaminase was detected in T. cruzi. Activity of Heme-S was detected in both strains of T. cruzi when mesoporphyrin, protoporphyrin or deuteroporphyrin was used as substrate. The enzyme activity was influenced by the strain of the parasite, the growth medium and the substrate used. PMID- 3510812 TI - T-piece injector assembly for continuous positive airway pressure. AB - A T-piece injector assembly delivers a blended oxygen/air mixture proximally via the side-arm of the T-piece, while continuous positive airway pressure (CPAP) is independently regulated by an injector adapted distally to the open end of the reservoir tubing. The system can provide different CPAP levels without significant fluctuations in the airway pressure and/or the inspired oxygen concentrations, and it maintains the original simplicity and safety of the T piece. PMID- 3510811 TI - Effectiveness of continuous positive airway pressure in the treatment of bronchomalacia in infants: a bronchoscopic documentation. AB - Continuous positive airway pressure (CPAP) was used to treat severe respiratory distress in four infants with bronchomalacia. Fiberoptic bronchoscopy diagnosed the area of bronchomalacia, documented the effects of CPAP on the airway, and helped determine an effective level of CPAP. CPAP immediately decreased respiratory distress, and was correlated with improved airway patency in the formerly collapsed airways. All four infants, including three who had required prolonged mechanical ventilation, maintained spontaneous ventilation on CPAP. PMID- 3510813 TI - Fellowship programs in critical care medicine 1986. Edited and compiled by the Society of Critical Care Medicine. PMID- 3510814 TI - Evaluation of two different extubation criteria: attributes contributing to success. AB - We evaluated extubation criteria in 48 postoperative general surgical and trauma patients receiving ventilatory support with intermittent mandatory ventilation (IMV) and continuous positive airway pressure (CPAP). Extubation criteria based on conventional respiratory mechanics demonstrated at 48% false-negative prediction of outcome, while those based on gas exchange values correctly predicted outcome in 94% of patients. Thus, conventional respiratory-mechanics extubation criteria may prolong mechanical airway and ventilatory support when used with IMV/CPAP in these patients. PMID- 3510815 TI - Combined continuous-flow, normal, and high-frequency ventilation. AB - Ten anesthetized, paralyzed dogs were ventilated at 10 breath/min and 100 cycle/min with a valveless ventilator. When fresh respiratory gas was supplied at the carina or insufflated into the bronchi, there was a significant (p less than .05) reduction in PaCO2, which was maximal during high-frequency ventilation (HFV) with twice normal minute volume. There was no statistically significant advantage in using a more complicated system for bronchial insufflation compared with supplying the fresh gas through a single tube near the carina. The improvement in ventilation and oxygenation during HFV with gas at the carina was reduced markedly when normal lungs were injured by oleic acid. Thus, when peak airway pressure was minimized during HFV, there was a further improvement in gas exchange without an appreciable increase in airway pressure when the gas was supplied at the carina. PMID- 3510816 TI - A nonpulmonary complication of high-frequency oscillation. AB - High-frequency ventilation (HFV) has been suggested as an alternative to standard positive-pressure ventilation with positive end-expiratory pressure (PPV/PEEP) in the treatment of infants with hyaline membrane disease. To assess the relative safety and efficacy of HFV, we compared standard PPV to HFV delivered by oscillation (HFO) and HFV delivered by a flow interrupter (HFFI) in a previously validated preterm baboon model of hyaline membrane disease. At necropsy, the livers of several animals were unexpectedly found to have severe fatty change and/or cytoplasmic vacuolization and edema. There was a strong correlation between use of HFO and the development of liver lesions. The hepatic lesion may reflect decreased cardiac output with a concomitant fall in splenic perfusion and/or alterations in normal intrathoracic pressure that increase resistance in the hepatic vasculature. Although the etiology cannot be determined precisely, these data suggest the potential for nonpulmonary complications of HFV in the immature newborn and mandate further investigation before its widespread clinical application. PMID- 3510817 TI - A comparative evaluation of three neonatal ventilators. AB - The comparative reliability of three neonatal ventilators was evaluated using an infant model lung to simulate airway resistance and lung compliance. The ventilators tested were the Bourns BP200, the Healthdyne TI-11, and a positive pressure ventilator called the PREEMIE (not commercially manufactured) used in several neonatal units in the Milwaukee area. The Bourns and Healthdyne ventilators generated similar airway and alveolar pressures while the PREEMIE produced alveolar, peak inspiratory, and positive end-expiratory pressures that exceeded the respective ventilator pressure settings by up to 11 cm H2O. The simple method described here should be generally useful for the evaluation of neonatal ventilator output. PMID- 3510818 TI - Decision-making in critical care: is the law an impediment or a scapegoat? PMID- 3510819 TI - Computed tomography of end-stage renal transplant rejection. AB - The late computed tomography appearance of a case of acute, irreversible renal transplant rejection demonstrated replacement of normal renal architecture by homogeneous low-density tissue surrounded by a rim of increased attenuation, mimicking abscess or neoplasm. Calcification was not found in the kidney, as in the only previously reported case of long-term renal transplant rejection. PMID- 3510820 TI - Efficacy of inhaled metaproterenol and orally-administered theophylline in patients with chronic airflow obstruction. AB - To evaluate comparative bronchodilator efficacy with chronic airflow obstruction (CAO), we randomly administered to ten patients week-long treatments consisting of: inhaled metaproterenol from a metered dose canister (1.30 mg six times a day) and doses of a sustained-release theophylline formulation sufficient to achieve plasma levels of 10-15 micrograms/ml; metaproterenol-placebo; theophylline placebo; or placebo-placebo. At the end of each period, treatment responses were evaluated by spirometric tests, by exercise tolerance (12 minute walk and progressive cycle ergometry) and by subjective perception of dyspnea (oxygen cost diagram and breathlessness rating). Metaproterenol as a single treatment caused statistically significant improvements in spirometric variables and in the breathlessness rating. Theophylline as a single treatment caused significant changes in none of the test variables, though favorable trends were observed. Combined drug therapy was significantly better than metaproterenol only in the case of the breathlessness rating. We conclude that in the treatment of patients with CAO, inhaled metaproterenol is superior to oral theophylline. Our results permit no definite conclusion concerning added benefits of combined drug therapy. PMID- 3510821 TI - The effect of eating on thallium myocardial imaging. AB - To determine if eating between initial and delayed thallium images alters the appearance of the delayed thallium scan, a prospective study was performed; 184 subjects sent for routine thallium imaging were randomized into two groups, those who ate a meal high in carbohydrates between initial and delayed thallium myocardial images (n = 106), and those who fasted (n = 78). The 201Tl images were interpreted in blinded fashion for global myocardial and pulmonary clearance of 201Tl myocardial defects. The eating group had a significantly lower incidence of transient myocardial defects compared to the noneating group (7 percent vs 18 percent, respectively; p less than 0.05). The time between initial and delayed images and the incidence of exercise-induced ischemic ST-segment depression or pathologic Q waves on the electrocardiogram were not significantly different between the two groups. These data suggest that eating a high-carbohydrate meal between initial and delayed 201Tl images causes increased 201Tl myocardial clearance rates and may alter 201Tl myocardial redistribution over time. PMID- 3510823 TI - Randomized double-blind placebo-controlled comparison of nicardipine and nifedipine in patients with chronic stable angina pectoris. AB - Forty-one patients were studied in a randomized double-blind placebo-controlled crossover trial to compare the antianginal actions of nicardipine 30 mg thrice daily and nifedipine 10 mg thrice daily. Efficacy was assessed using objective criteria from computer-assisted multistage graded exercise testing, performed after a two-week placebo run-in period and at the end of each four-week active treatment period. Thirty-seven patients completed both legs of the crossover trial. The mean (+/- standard error of the mean) baseline exercise time to development of angina was 6.7 +/- 0.4 min and this increased to 9.5 +/- 0.6 min on nicardipine (p less than 0.001) and 9.5 +/- 0.5 min on nifedipine (p less than 0.001 vs baseline; NS vs nicardipine). Both drugs significantly prolonged the time to the development of 1mm ST segment depression. The baseline resting heart rate of 83 +/- 2 beats/min increased to 87 +/- 3 beats/min during nicardipine (p less than 0.05) and remained unaltered at 83 +/- 2 beats/min during nifedipine therapy (p = NS vs baseline and p less than 0.02 vs nicardipine). Similarly, both drugs increased significantly the maximal heart rate at peak exercise. One patient was lost to follow-up during the placebo run-in period and four patients (two each on nicardipine and nifedipine) were withdrawn due to adverse effects. Our results indicate that nicardipine is comparable in efficacy to nifedipine and has a similar adverse effect profile and can also be considered a useful therapeutic agent for the treatment of chronic stable angina pectoris. PMID- 3510822 TI - Oxitropium bromide. Dose-response and time-response study of a new anticholinergic bronchodilator drug. AB - The efficacy and side effects of oxitropium bromide, a new anticholinergic bronchodilator drug, were tested in a double-blind placebo-control study. Twenty four men, aged 58 to 72 years, with chronic partially reversible obstruction of the airways were used as subjects. Three doses of oxitropium were tested (100 micrograms, 200 micrograms, and 300 micrograms) to determine the optimum dose by metered-dose inhaler. A comparison was also made between oxitropium, fenoterol (400 micrograms), and a combination of oxitropium (200 micrograms) and fenoterol (400 micrograms). Fenoterol produced a greater degree of maximal bronchodilatation than each of the three doses of oxitropium, and its effect was more rapid in onset (30 vs 120 minutes to peak effect); however, the duration of action of oxitropium was greater than that of fenoterol (ie, the forced expiratory volume in one second [FEV1] remained within 5 percent of peak FEV1 for three hours, compared to one hour). Oxitropium in the 100 micrograms dose was inferior to 200 micrograms and 300 micrograms in subjective efficacy scores, peak percent change in FEV1, forced vital capacity, (FVC), mean forced expiratory flow over the middle half of the FVC, and duration of action; there was no difference between 200 micrograms and 300 micrograms. The oxitropium-fenoterol combination had a rapid onset of action, and a greater peak effect was achieved than for oxitropium alone. The main unwanted effect was a mildly unpleasant taste. Anticholinergic effects were not seen in this group of elderly men. Oxitropium bromide therefore is an effective bronchodilator with slow onset but prolonged activity and few side effects when used in patients with moderately severe obstruction of the airways. An appropriate dose appears to be 200 micrograms. Addition of oxitropium to fenoterol appears to offer even greater efficacy. PMID- 3510824 TI - Structure and function in pulmonary hypertension. New perceptions. PMID- 3510825 TI - "Therapeutic range" for oral anticoagulant therapy. PMID- 3510826 TI - Hemorrhagic complications of long-term anticoagulant therapy. PMID- 3510827 TI - Antithrombotic therapy for venous thromboembolic disease. PMID- 3510828 TI - Antithrombotic therapy in valvular heart disease. PMID- 3510829 TI - Dose antiplatelet agents; the relationship among side effects, and antithrombotic effectiveness. PMID- 3510830 TI - Antithrombotic therapy in mechanical and biological prosthetic heart valves and saphenous vein bypass grafts. PMID- 3510831 TI - Antithrombotic agents in coronary artery disease. PMID- 3510832 TI - Antithrombotic therapy in atrial fibrillation. PMID- 3510833 TI - Cerebral embolism. PMID- 3510834 TI - Immunoperoxidase staining of carcinoembryonic antigen as a prognostic indicator in colorectal carcinoma. AB - Immunoperoxidase staining for carcinoembryonic antigen (CEA) was performed on 192 colorectal carcinomas to determine: whether tissue staining can be substituted for preoperative serum CEA levels, and whether patient survival can be predicted by these parameters. The overall incidence of positive tissue staining was 75 percent, which was similar to the elevated serum level percentage of 73 percent. Both the serum CEA level and the CEA tissue stain correlated with patient survival in Dukes' stage C patients. There was no correlation between tissue CEA stain and tumor differentiation. Positive tissue stain and elevated preoperative serum CEA identified patients with poor prognosis in Dukes' stage D only. This study shows that tissue staining with immunoperoxidase may be substituted for preoperative serum levels for CEA. The combination of these two parameters, however, does not identify patients at greater risk for recurrence than either procedure alone. PMID- 3510835 TI - Rectal carcinoma in a renal transplant patient. Long-term complication of immunosuppression? AB - The occurrence of a rectal adenocarcinoma in a 48-year-old man 11 years after he received a cadaveric renal transplant is reported. Since his operation, the patient had been receiving prednisone and azathioprine for immunosuppression. The occurrence of rectal carcinoma in this patient at an early age, after a decade of immunosuppression, suggests an association between the malignancy and his altered immunologic state. Although an increased incidence of skin and reticuloendothelial malignancies in the first five years following renal transplantation has been well documented, few colorectal carcinomas have developed in these patients. Follow-up of transplant patients, however, is only now passing ten years in large numbers of patients. This case suggests that there may be a ten year latency period before transplant patients develop colorectal carcinoma. Such a time course would be similar to that seen in patients with chronic ulcerative colitis, in whom colorectal carcinomas are found. Surveillance colonoscopy for transplant patients beginning ten years after surgery may be necessary. PMID- 3510836 TI - Cefazolin-induced pseudomembranous colitis resulting in perforation of the sigmoid colon. AB - The seventh case of probable cefazolin-induced pseudomembranous colitis is reported. Perforation of the colon necessitated sigmoid resection. The postoperative course was protracted, and illustrates the difficulty of managing advanced pseudomembranous colitis when the oral route of antibiotic administration is not available. Although rare, pseudomembranous colitis related to cefazolin administration is a potentially fatal complication. The routine use of prophylactic antibiotics must be weighed against this possibility. PMID- 3510837 TI - Classic articles in colonic and rectal surgery. Frank Thomas Paul 1851-1941. Colectomy. PMID- 3510838 TI - Ischemic colitis and immunosuppression. An experimental model. AB - The incidence of ischemic colitis in renal transplant recipients approaches 1 percent. The mortality in these patients with ischemic colitis is nearly 70 percent. Immunosuppressive agents have been implicated in the development of ischemic colitis. To study the effect of immunosuppressive agents on ischemic colitis, a 4-cm segment of the colon was devascularized in 27 male Fischer rats. The animals were divided into one control and two treatment groups. One treatment group received methylprednisolone and the other, azathioprine, in doses similar to those of renal transplant recipients. Both experimental groups, either separately or combined, showed significantly greater areas of colonic ischemic changes than did the control group. This study demonstrates that systemic administration of immunosuppressive agents may augment the development of ischemic colitis. PMID- 3510839 TI - The effect of peritoneal lavage with tetracycline solution on postoperative infection. A prospective, randomized, clinical trial. AB - A prospective randomized trial was performed to determine the value of tetracycline lavage in addition to systemic antibiotic prophylaxis in 159 patients undergoing elective and emergency intestinal operations. Tetracycline lavage was associated with a significant overall reduction in postoperative infection rates in 25 of 74 patients (34 percent) receiving saline lavage compared with 15 of 85 patients (18 percent) having tetracycline lavage (P less than 0.05). Tetracycline lavage was associated with a significant reduction in the counts of aerobic and anaerobic bacteria in the peritoneal fluid at the end of the operation (P less than 0.05 and P less than 0.01, respectively) and with a significant reduction of aerobes 24 hours postoperatively (P less than 0.02). Tetracycline lavage would appear to confer clinical benefit in preventing postoperative infection. PMID- 3510840 TI - Classic articles in colonic and rectal surgery. John Miller Turpin Finney 1863 1942. Gastro-enterostomy for cicatrizing ulcer of the pylorus. PMID- 3510841 TI - Hormonal control of sphincter of Oddi. PMID- 3510842 TI - Defects in prostaglandin synthesis and metabolism in ulcer disease. AB - Ulcers occur because of an imbalance between mucosal protective resistance and damaging luminal factors, allowing the latter to predominate. The primary injurious elements are acid and peptic activity. Bile reflux, drugs, and gastroduodenal stasis may alter the luminal milieu and act together with acid peptic activity to produce injury, weaken mucosal resistance, or both. Since prostaglandins modulate several key mucosal protective mechanisms, and since some exogenous prostaglandins and their derivatives accelerate peptic ulcer healing, it seems plausible that prostaglandin deficiency may contribute to the development of peptic ulcers. At the present time, however, evidence for this postulate is mostly indirect and can be summarized as follows: (1) Defects of mucosal protective mechanisms modulated by prostaglandins have been found in different forms of ulcer disease. Such defects include impaired duodenal bicarbonate secretion, deficient secretion or accelerated degradation of mucus, and reduced mucosal cell proliferation. (2) Drugs that inhibit cyclooxygenase, the key enzyme in tissue prostaglandin synthesis, have ulcerogenic activity. Presumably, in this situation, reduced prostaglandin production renders the mucosa more vulnerable to the action of acid and pepsin, or reduces the capability of the mucosa to repair itself. (3) Decreased mucosal prostaglandin synthesis or prostaglandin content has been found in patients with ulcer disease. Several studies have provided quantitative evidence of disturbed prostaglandin metabolism in some forms of ulcer disease. These studies are of high interest, but they need to be interpreted with caution given the present scientific debate regarding the physiological role of different prostanoids, as well as uncertainty as to the specific cellular source of prostaglandins in gastroduodenal mucosa. PMID- 3510843 TI - Postpericardiotomy syndrome. AB - Postpericardiotomy syndrome, a frequent complication of open-heart surgery, is characterized by fever, chest pain, and pericardial and pleural effusions. These signs may develop 1 to 12 weeks after intracardiac surgery in approximately 30 percent of patients. Although the etiology of the syndrome is unknown, evidence points to a viral and/or autoimmune cause. Postpericardiotomy syndrome is diagnosed after excluding other conditions such as endocarditis and pneumonia. In many cases, the syndrome is self-limiting and occurs only once, but in other cases the symptoms have recurred as many as eight times. When the symptoms recur, management is more difficult because optimal pharmacologic treatment is not known. Antiinflammatory agents, such as salicylates and steroids, represent the drugs most commonly used. Although analgesics with codeine or oxycodone are important for the patients' symptomatic relief, early recognition of the syndrome is the key to limiting the discomfort and possible complications associated with this condition. PMID- 3510844 TI - Treatment of adrenocortical carcinoma: a case report and review of the literature. AB - A case report of adrenocortical carcinoma is presented, and its natural history and treatment are discussed. Adrenocortical carcinoma is a rare malignant disease. The mean survival time for untreated patients is less than three months. The tumor is classified as functioning or nonfunctioning depending on biochemical and clinical evidence of steroid overproduction. Surgical resection of the tumor is the primary treatment. Chemotherapy is indicated for antitumor and antihormonal effects. Mitotane is a direct adrenolytic, and is the only drug currently available that has extended survival in patients with this disease. Its clinical usefulness is limited by its gastrointestinal and neurological toxicity. Aminoglutethimide inhibits steroid synthesis by blocking the conversion of cholesterol to pregnenolone. It has no antitumor effect in adrenocortical carcinoma, but is effective in relieving the signs and symptoms of excessive hormone production in functioning tumors. Both mitotane and aminoglutethimide have complex mechanisms of action. Their combined use in the treatment of adrenocortical carcinoma requires a complete understanding of their individual actions and awareness of the potential for additive effects, both therapeutic and toxic. PMID- 3510845 TI - An eleven-year review of the pharmacy literature: documentation of the value and acceptance of clinical pharmacy. AB - The primary objectives of the article were accomplished by providing both a bibliography of articles dealing with clinical pharmacy services in acute-care facilities and summaries of those constituting original research reports on clinical pharmacy services. However, in the process, we made the following interesting observations. We found that articles reporting impacts on cost, quality, and attitude numbered 48, 58, and 24, respectively. Most articles relating to drug therapy monitoring, with minor exceptions, dealt with either the quality or cost-savings impact or a combination of both. Also, articles concerning drug therapy monitoring comprised almost half of all those summarized (40 articles). Articles detailing drug information and education (category 2) numbered 28 and dealt mainly with attitudes or quality impacts with minor reference to cost-savings. It was also interesting, albeit expected, to observe that the bulk of attitudinal studies fell in category 2. We found category 5, controlling medication administration, had 13 articles, primarily concerned with cost and or quality. Category 4, reporting and detection of adverse drug reactions, contained a total of eight articles mainly studying the impact on quality. The other categories contained very few, if any, articles. From these results, it is evident that the profession has made significant strides in building a strong scientific data base to support the value of its clinical services. However, there is ample room for additional original research reports. Although it can be argued that alone many of the studies could not justify clinical pharmacy as cost-effective, organized as one reference they provide an invaluable resource. Although it might be unreasonable to expect each pharmacy department to be able to cost-justify its existence, this work presents the background data needed to begin or develop such efforts. PMID- 3510846 TI - High-dose moxalactam in gram-negative pneumonia. PMID- 3510847 TI - [Different healing tendencies of reflux esophagitis following omeprazole and ranitidine. Results of a German-Austrian-Swiss multicenter study]. AB - The effectiveness of a single, morning oral dose of 40 mg omeprazole or a twice daily oral dose of 150 mg ranitidine was compared in a randomized endoscopically controlled double-blind trial at 37 clinics in Austria, Germany and Switzerland. A total of 178 out-patients in stages I-IVa (after Savary and Miller) were entered into the trial: 78 in stage I, 60 in stage II, 27 in stage III, and in 13 in stage IVa. As early as at the end of the third treatment week there was a significantly higher rate of complete healing or reduction into a lower stage with omeprazole than ranitidine (85% vs 67%; P less than 0.02). After six treatment weeks, healing tendency after omeprazole compared with ranitidine was 85% vs 45% (P less than 0.04). Omeprazole also brought earlier improvement in symptoms. The difference was statistically significant for heartburn (pyrosis): P less than 0.01. Both drugs were equally well tolerated and there were no clinically significant side-effects. This is the first demonstration that the ATPase inhibitor omeprazole is superior to the H2-receptor antagonist ranitidine in the treatment of reflux oesophagitis. PMID- 3510849 TI - [Reversible panmyelopathy following captopril treatment]. AB - In a 46-year-old female patient suffering from renal hypertension due to polycystic kidney degeneration with creatinine values between 3 and 5 mg/dl leucopenia developed 3 weeks after beginning antihypertensive therapy with the angiotensin-converting-enzyme inhibitor captopril. On continuation of treatment signs of haemorrhagic diathesis appeared 7 months later. Cytology and histology led to the diagnosis of panmyelopathy which, from the clinical findings and the close patient follow-up, was to be regarded as captopril-induced. Bone-marrow regeneration could be shown 6 months after discontinuing the drug. In renal insufficiency, captopril treatment should be monitored using regular haematological tests and the drug withdrawn when leuco- or thrombocytopenia occurs. PMID- 3510848 TI - [Prevention of nausea and emesis during cytostatic therapy. Antiemetic efficacy of high-dosage oral metoclopramide without and with prednisone]. AB - In a randomized trial of 58 cancer patients receiving strongly emetogenic cytostatic drugs (cisplatin or comparable cytostatic agents, alone or in combination), the anti-emetic action of oral metoclopramide was tested, alone or combined with prednisone. Patients of group A (33 during 46 treatment cycles) received three times 50 mg metoclopramide and three times 25 mg prednisone. Those of group B (25 patients during 35 cycles) received three times 50 mg metoclopramide. The drug was given two hours before as well as two hours and six hours after administration of the cytostatic drugs. Good or satisfactory prophylaxis of nausea and vomiting (no or at most three vomits) was achieved during 37 cycles (80.5%) of group A patients and 30 (85.7%) of group B patients. Complete absence of vomiting was obtained in 52% of cycles in group A, 46% of cycles in group B; complete absence of nausea in 39% and 32%, respectively. There was no statistically significant difference between the two treatments in their preventive action. Three times 50 mg metoclopramide (with or without prednisone) four hours apart during one cytostatic-drug cycle was well tolerated by patients in both groups and can be recommended as a simple, practical prophylaxis of nausea and vomiting in the course of strongly emetogenic treatment of cancer. PMID- 3510850 TI - [Cryptosporidiosis--causative agent, epidemiology, clinical picture and diagnosis]. PMID- 3510851 TI - [Surgical indications for scintigraphically cold thyroid nodules in relation to clinical, scintigraphic, sonographic and cytologic findings]. AB - The frequency of indication for surgical resection of goitre was retrospectively analysed for 2100 thyroid examinations. During 1974/75 (group I) only scintigraphy was available in addition to clinical examination; in 1979/80 (group II) cytological criteria were added, and in 1983/84 (group III) ultrasound findings were available as well. There were 700 patients in each group. The proportion of scintigraphically negative nodules was largely the same in the three groups (I and II: 21%; III: 22%). Indication for operation was less common after the introduction of ultrasound (I: 56%; II: 55%; III: 44% of patients with scintigraphically cold nodules). In particular, there was a decrease in the proportion of those nodules not definitely considered benign which would have required histological diagnosis (I: 32%; II: 18%; III: 8%). The results underline the special place of small-needle biopsy and, especially, ultrasound examination of the thyroid, in addition to clinical and scintigraphic findings, in providing the indication for and planning of operative nodular goitre resection. PMID- 3510852 TI - Estrogen induction of very low density apolipoprotein II synthesis, a major avian liver yolk protein, involves the recruitment of hepatocytes. AB - The mechanism of steroid hormone action was studied in the cockerel liver. Very low density apolipoprotein II (apo-VLDL-II), a yolk protein, is a low molecular weight apolipoprotein that is inducible by estrogen. The intracellular apo-VLDL II messenger RNA (mRNA) concentration under various hormonal conditions was examined by a dot-blot assay. The concentration was very low in untreated cockerels (approximately 0.5 molecule per cell). It increased to 8,000 molecules per cell within 24 h of estrogen treatment and reached a maximum level of approximately 70,000 molecules per cell after 14 daily doses of estrogen. The distribution of hepatocytes harboring apo-VLDL-II and its mRNA was studied by immunohistochemistry and by in situ nucleic acid hybridization to cloned [3H]apo VLDL-II complementary DNA (cDNA). The number of cells containing the immunoreactive protein and the hybridizable mRNA increased from extremely low (0.3% and 0.27%, respectively) to substantial (11% and 10%, respectively) at 24 h after estrogen treatment and to extremely high (94% and 92%, respectively) in maximally treated animals. Our studies indicate that, in addition to enhanced transcription and stabilization of mRNA, the recruitment of liver cells previously not engaged in the synthesis of apo-VLDL-II is an important mechanism by which the hormone induces the hepatic production of this protein. The phenomenon of recruitment and the heterogeneity of the functional capacity of individual hepatocytes to respond to estrogen may be important to our understanding of estrogen action in the liver. PMID- 3510853 TI - A decline in endogenous opioid influence during the steroid-induced hypersecretion of luteinizing hormone in the rat. AB - Studies were undertaken to evaluate the influence of endogenous opioid peptides (EOP) on the LH hypersecretion induced in ovariectomized rats by estradiol benzoate (EB) or EB plus progesterone (EBP). Naloxone (0.1-15.0 mg/kg) was injected before (1200 h) and during (1400 and 1530 h) the LH surge induced by EBP treatment and during the LH surge after EB treatment (1600 h). The opiate antagonist readily stimulated LH secretion before the LH surge in EBP-treated rats at 1200 h and during the LH surge in EB-treated rats at 1600 h, but was much less effective during the LH hypersecretion induced by EBP treatment at 1400 and 1530 h. This decline in the LH secretory response to naloxone during the EBP induced LH surge was not due to changes in the response of pituitary to LHRH. These studies indicate that during the period of LH hypersecretion induced by the sequential administration of EB plus P, the influence of EOP neuronal systems on LH secretion is diminished. Thus, EOP neurons may play a role in the timing and magnitude of the LH surge in EBP-treated rats. PMID- 3510855 TI - Severe hepatic and peripheral insulin resistance as evidenced by euglycemic clamps in genetically obese fa/fa rats. AB - The action of insulin on glucose metabolism and hepatic glucose production was studied in vivo over a wide range of insulin concentrations in lean and genetically obese (fa/fa) rats, using the euglycemic clamp technique. While total glucose metabolism was stimulated 3-fold by insulin in lean animals (half-maximal stimulation at 400 microU/ml insulin), the hormone had no significant effect on glucose metabolism in obese animals, whatever the concentration used. In lean rats, the endogenous (i.e. hepatic) glucose production was completely suppressed at a steady state insulin concentration of about 360 microU/ml. In obese rats, an insulin concentration as high as 10,000 microU/ml was needed to suppress the hepatic glucose production. These results suggest that, in obese rats 1) basal plasma insulin levels appear to maximally stimulate peripheral glucose metabolism, and the presence of postreceptor defects prevents any further stimulatory effect of the hormone on glucose metabolism; 2) grave impairments of the action of insulin on hepatic glucose production are present, despite a normal responsiveness obtained at pharmacological concentrations of the hormone. These hepatic alterations could be due to postbinding and/or intracellular defects, as well as to defects, yet to be defined, of the homeostasis of insulin counterregulatory hormones. PMID- 3510854 TI - Dexamethasone binding sites and steroid-dependent stimulation of glycogenesis by insulin in cultured fetal hepatocytes. AB - The binding of [3H]dexamethasone and the effect of insulin on [14C]glucose incorporation into glycogen were studied in cultures of fetal rat hepatocytes transplanted from 15 and 18 days of gestation, i.e. before and just at the critical stage of glucocorticoid-dependent maturation of the rat fetus. Both types of cell cultures contained approximately 50,000 specific glucocorticoid receptors per cell, with an affinity of 6 nM. Glycogenesis was hardly stimulated by insulin at the time of transplantation, especially in 15-day-old fetal hepatocytes. The stimulatory effect of insulin increased in the presence of dexamethasone (100 nM) to reach, after 40 h of treatment, 270% and 440% of the control values in 15- and 18-day-old fetal hepatocytes, respectively. A shortening of the exposure time to steroid necessary to trigger the insulin response was observed with 18-day-old cells (20 h). The half-maximal insulin induced stimulation of glycogenesis was obtained with a lower concentration of dexamethasone in 18-day-old than in 15-day-old hepatocytes (3.2 +/- 0.32 vs. 7.9 +/- 0.29 nM, n = 5; P less than 0.001). Although high affinity dexamethasone binding sites exist in fetal rat hepatocytes before the critical stage of glucocorticoid influences, some maturation occurs between the 15th and the 18th day of gestation, which is associated with an increase in cell sensitivity to dexamethasone and in the amplitude of the steroid-induced glycogenic response to insulin. PMID- 3510856 TI - Peptide histidine isoleucine amide stimulates thyroid hormone secretion and coexists with vasoactive intestinal polypeptide in intrathyroid nerve fibers from laryngeal ganglia. AB - Peptide histidine isoleucine amide (PHI) and vasoactive intestinal polypeptide (VIP) are fragments of the same precursor molecule, prepro-VIP, and coexistence of the two peptides is, therefore, to be expected. Nerve fibers displaying PHI and VIP immunoreactivity occurred around blood vessels and follicles in the thyroid gland of several species. Sequential staining with antibodies against PHI and VIP revealed coexistence of the two peptides in the same population of nerve cell bodies in ganglia situated along the laryngeal nerves and in intrathyroid nerve fibers. Chemical sympathectomy (6-hydroxydopamine treatment), surgical sympathectomy (removal of the superior cervical ganglia), and unilateral cervical vagotomy (removal of the nodose ganglion) failed to affect the number and distribution of PHI/VIP fibers in the thyroid gland. Taken together, the findings suggest that both the perivascular and interfollicular PHI/VIP fibers originate in laryngeal ganglia. PHI weakly stimulated basal thyroid hormone secretion in mice in vivo, but did not influence the response to TSH or VIP. PHI had no effect on calcitonin secretion in rats. Like VIP, PHI may play a physiological role in the regulation of thyroid hormone secretion. PMID- 3510857 TI - Localization of cells containing LHRH-like mRNA in rat forebrain using in situ hybridization. AB - Using in situ hybridization, we localized cells in the rat forebrain which contain mRNA that hybridizes with a radiolabeled, synthetic oligodeoxyribonucleotide (59-mer) complementary to human LHRH mRNA in the region which includes the coding sequence for the decapeptide. These brain areas have been shown previously to contain immunoreactive LHRH cell bodies. PMID- 3510858 TI - Simulation of the normal glucopenia-induced decline in insulin partially restores the glucagon response to glucopenia in isolated perfused pancreata of streptozotocin-diabetic rats. AB - To determine if the loss of the glucagon response to glucopenia that follows destruction of beta cells is at least in part a consequence of the absence of the normal glucopenia-induced decline in insulin secretion, pancreata from insulin requiring streptozotocin-diabetic rats were studied. In the absence of insulin, a reduction in perfusate glucose concentration from 150 to 25 mg/dl failed to elicit a rise in glucagon concentration. When insulin was co-perfused at 30 mU/ml, the estimated within-islet concentration of insulin under these circumstances, but discontinued during the glucopenic interval, reducing the insulin concentration in the pancreatic venous effluent from approximately 26 mU/ml to less than 100 microU/ml, a prompt and significant rise in glucagon was observed until glucose and insulin levels were raised to their original concentrations. The rise in glucagon, which was approximately 25% of the normal response, did not occur when insulin concentration in the perfusate was maintained at 30 mU/ml during the glucopenic period. Nor did it occur when insulin was perfused at 360 microU/ml and discontinued during the glucopenic period, thereby lowering insulin in the venous effluent from 300 microU/ml to 5 microU/ml. It is concluded that the decline in insulin from its normal concentrations within the islets makes a modest but significant contribution to the rise in glucagon that occurs during glucopenia. PMID- 3510859 TI - Bacterial mutagenicity and chemical analysis of polycyclic aromatic hydrocarbons and some nitro derivatives in environmental samples collected in West Germany. AB - Snow and air particulate samples collected in Upper Frankonia, Federal Republic of Germany, have been analyzed for nitro-polycyclic aromatic hydrocarbons (PAH) and PAH content. A novel clean-up technique has been developed enabling interfering organochlorine environmental contaminants to be removed prior to analysis of the hydrocarbons by GC-MS. Mass fragmentation patterns are presented for 1-nitropyrene, 6-nitrobenzo(a)pyrene, 6-nitrochrysene, and 3 nitrofluoranthene. The level of these compounds found in air samples was in the range of 0.2-2.0 ng.m-3 with the exception of 6-nitrobenzo(a)pyrene, which was not detected. This compares with PAH values of between 1 and 6 ng.m-3. The freshly fallen snow sample collected at the side of a motorway had no detectable PAHs or nitro-PAHs. Parallel studies on the bacterial mutagenicity of the collected air samples using Salmonella typhimurium TA98 and TA100 in the presence and absence of aroclor-induced rat liver "S9" revealed both "direct" and "indirect" activity. Larger numbers of mutants were induced in the presence of S9 than in its absence. The snow sample was devoid of mutagenic activity. These studies show the utility of the biological approach to screen environmental samples prior to expensive and time-consuming chemical analysis. PMID- 3510860 TI - Chemically induced aneuploidy in mammalian cells: mechanisms and biological significance in cancer. AB - A growing body of evidence from human and animal cancer cytogenetics indicates that aneuploidy is an important chromosome change in carcinogenesis. Aneuploidy may be associated with a primary event of carcinogenesis in some cancers and a later change in other tumors. Evidence from in vitro cell transformation studies supports the idea that aneuploidy has a direct effect on the conversion of a normal cell to a preneoplastic or malignant cell. Induction of an aneuploid state in a preneoplastic or neoplastic cell could have any of the following four biological effects: a change in gene dosage, a change in gene balance, expression of a recessive mutation, or a change in genetic instability (which could secondarily lead to neoplasia). To understand the role of aneuploidy in carcinogenesis, cellular and molecular studies coupled with the cytogenetic studies will be required. There are a number of possible mechanisms by which chemicals might induce aneuploidy, including effects on microtubules, damage to essential elements for chromosome function (ie, centromeres, origins of replication, and telomeres), reduction in chromosome condensation or pairing, induction of chromosome interchanges, unresolved recombination structures, increased chromosome stickiness, damage to centrioles, impairment of chromosome alignment, ionic alterations during mitosis, damage to the nuclear membrane, and a physical disruption of chromosome segregation. Therefore, a number of different targets exist for chemically induced aneuploidy. Because the ability of certain chemicals to induce aneuploidy differs between mammalian cells and lower eukaryotic cells, it is important to study the mechanisms of aneuploidy induction in mammalian cells and to use mammalian cells in assays for potential aneuploidogens (chemicals that induce aneuploidy). Despite the wide use of mammalian cells for studying chemically induced mutagenesis and chromosome breakage, aneuploidy studies with mammalian cells are limited. The lack of a genetic assay with mammalian cells for aneuploidy is a serious limitation in these studies. PMID- 3510861 TI - The reproductive effects assessment group's review of the mutagenicity of vinylidene chloride. AB - A large number of studies indicate that vinylidene chloride is mutagenic to bacteria and that this activity is largely dependent on microsomal activation. Vinylidene chloride gave positive results for gene reversion and conversion in yeast that was also dependent on metabolic activation, and was positive in tradescantia. In mammalian systems, vinylidene chloride failed to induce gene mutations in V79 cells at two separate loci, failed to induce chromosomal aberrations in mouse bone marrow in vivo, and failed to induce dominant lethals in either mice or rats. Vinylidene chloride was found to alkylate DNA of mice exposed through inhalation and may have caused unscheduled DNA synthesis in kidneys of similarly exposed mice. The studies on the mutagenicity of vinylidene chloride are evaluated in this review. PMID- 3510862 TI - Mutagenicity of fine (less than 2.5 microns) airborne particles: diurnal variation in community air determined by a Salmonella micro preincubation (microsuspension) procedure. AB - A simple modification of the Salmonella liquid incubation assay previously developed for detecting mutagens in urine was used to determine mutagenic activity of airborne particulate matter. The modification consists of adding ten times more bacteria (approximately 10(9) per incubation tube) and five to ten times less metabolic enzymes compared to the plate incorporation method. The mixture volume is approximately 0.2 ml, and the mixture is incubated for 90 min before pouring it according to the standard protocol. The modified procedure (micro preincubation or microsuspension) was approximately ten times more sensitive than the standard plate incorporation test for detecting mutagens in air particulate extracts and approximately ten to 31 times more sensitive for the chemical mutagens 2-nitrofluorene, 4-nitroquinoline-N-oxide, 2-aminofluorene, and benzo(a)pyrene in bacterial strain TA98. Mutagenic activity was detected in particle extracts obtained from 1 m3 of air (17 micrograms of extract) or less. This microsuspension procedure was applied to air particulate samples collected with low-volume (15-50 liters per min) virtual-dichotomous air samplers. Mutagenic activity was associated exclusively with fine particles (aerodynamic diameters of less than 2.5 microns). Diurnal patterns of mutagenic activity (TA98 revertants per cubic meter air) were investigated by measuring filter extracts from 2-hr samples collected in three San Francisco Bay Area cities during the summer or fall of 1982. Four criteria pollutants--lead, nitrogen dioxide, ozone, and sulfur dioxide--were simultaneously sampled at one location. Mutagenicity from fine particles sampled at this location was highly correlated with lead and much less correlated with nitrogen dioxide, ozone, and sulfur dioxide. The microsuspension procedure is applicable in testing samples of limited mass. PMID- 3510863 TI - Isolation of a highly mutagenic aminophenanthrene from a coal gasification process tar. AB - A major portion of the mutagenic activity associated with products and by products of coal conversion can be ascribed to nitrogen-containing bases. We improved the extraction efficiencies for three- to five-ring aromatic bases by extracting them with a mixture of methanol and aqueous HCl, rather than with aqueous HCl alone. A complex mutagenic basic fraction of a coal gasification process tar was successively fractionated using cation exchange and reversed phase high-performance liquid chromatography. The fractions were assayed for mutagenic activity and were chemically analyzed by gas chromatography and gas chromatography-mass spectrometry. Aminophenanthrenes were identified as major contributors to the mutagenicity of the basic fraction. Aminonaphthalenes, aminobiphenyls, and their alkyl homologs were also present but were not detected as principal mutagens. PMID- 3510864 TI - Shigellaemia in adults: case reports and literature review. PMID- 3510865 TI - Detergent-solubilization, purification, and characterization of membrane-bound 3 hydroxy-3-methylglutaryl-coenzyme A reductase from radish seedlings. AB - 3-Hydroxy-3-methylglutaryl-CoA reductase (NADPH) was solubilized with polyoxyethylene ether (Brij) W-1 from a heavy-membrane fraction, sedimented at 16000 X g from a cell-free homogenate of four-day-old, dark-grown radish seedlings (Raphanus sativus L.). Approximately 350-fold purification of the solubilized enzyme activity was achieved by (NH4)2SO4 precipitation followed by column chromatography on DEAE-Sephadex A-50, blue-dextran-agarose and HMG-CoA hexane-agarose. The presence of detergent, which was required at all times to maintain activity, did not interfere with the chromatographic procedures used. Sucrose density centrifugation suggested an apparent molecular mass of 180 kDa with subunits of 45 kDa (polyacrylamide gel electrophoresis in the presence of sodium dodecylsulphate). The enzyme was stable at 67.5 degrees C for 30 min in the presence of glycerol, dithioerythritol and detergent. Studies of enzyme stability and activation indicate that the enzyme is a hydrophobic protein with free thiol groups that are essential for full activity. The activation energy was estimated to be 92 kJ (Arrhenius plot). Antibodies raised against rat liver and yeast hydroxymethylglutaryl-CoA (HMG-CoA) reductase failed to bind or inactivate the radish enzyme. When both HMG-CoA and NADPH concentrations were varied, intersecting patterns were obtained with double-reciprocal plots. The apparent Km values determined in this way are 1.5 microM [(S)-HMG-CoA], and 27 microM (NADPH). Concentrations of NADPH greater than 150 microM caused substrate inhibition at low HMG-CoA concentrations resulting in deviations from linearity in secondary plots. Analysis of these data and the product inhibition pattern suggest a sequential mechanism for the reduction of HMG-CoA to mevalonic acid with HMG-CoA being the first substrate binding to the enzyme, followed by NADPH. PMID- 3510866 TI - Isolation of a domain of villin retaining calcium-dependent interaction with G actin, but devoid of F-actin fragmenting activity. AB - Villin is an F-actin binding protein located in the microfilament bundle of intestinal epithelial cell microvilli. Extensive in vitro proteolysis with Staphylococcus aureus V8 protease results in the production of a stable domain (apparent Mr 44000) which can be isolated due to its Ca2+-dependent interaction with G-actin bound to immobilized DNase-I, the standard procedure for the purification of villin. This 44-kDa fragment retains a single Ca2+ binding site with an apparent Kd = 2 X 10(-6) M, binds to G-actin, and inhibits the rate of actin polymerization. However, the 44-kDa domain does not shown any Ca2+ activated severing activity nor does it compete with villin for F-actin binding. These results suggest that villin contains three domains: headpiece containing an F-actin binding site, 44-kDa fragment containing a G-actin binding site, and an amino-terminal fragment responsible for the Ca2+-dependent severing activity. PMID- 3510867 TI - Metabolic incorporation of 9-(2-anthryl)-nonanoic acid, a new fluorescent and photoactivable probe, into the membrane lipids of Chinese hamster ovary cells. AB - 9-(2-Anthryl)-nonanoic acid is a new fluorescent and photoactivable probe, which has been designed for studying the lateral diffusion rate and the lateral distribution of lipids in biological membranes by means of the anthracene photodimerization reaction. It is shown that this anthracene fatty acid is metabolically incorporated into the glycerophospholipids (phosphatidylcholine, phosphatidylethanolamine, phosphatidylserine, phosphatidylinositol) of the eukaryotic Chinese hamster ovary cells in culture. Under our culture conditions (Eagle's minimal essential medium plus delipidized fetal calf serum) this incorporation proceeded with a very good rate (up to 45 mol/100 mol, after two days culture) and could be easily modulated depending on the way the cells were fed with the anthracene fatty acid. It occurred to a similar extent at the sn-1 (55 +/- 5%) or at the sn-2 (45 +/- 5%) position on the phospholipid glycerol backbone, without any degradation or elongation. No double labelling at the sn-1 and sn-2 positions was detected. Although incorporation of the anthracene fatty acid affected the cell growth rate (generation time of 48 h compared to a generation time of 21 h for control cells) it did not bring about cell mortality. This incorporation took place not only into the phospholipids but also into the triglycerides with, as a consequence, the appearance of strongly fluorescent lipid vesicles inside the cells. It affected the whole cell fatty acid composition by slightly increasing the amount of palmitic acid and markedly decreasing the amount of stearic and oleic acids. PMID- 3510868 TI - Further characterization and amino acid sequence of m-type thioredoxins from spinach chloroplasts. AB - The complete primary structure of m-type thioredoxin from spinach chloroplasts has been sequenced by conventional sequencing including fragmentation, Edman degradation and carboxypeptidase digestion. As already reported [Tsugita, A., Maeda, K. & Schurmann, P. (1983) Biochem. Biophys. Res. Commun. 115, 1-7] these thioredoxins contain the same active-site sequence as thioredoxins from other sources. Based on the amino acid sequence thioredoxin mc contains 103 residues, has a relative molecular mass of 11425 and a molar absorption coefficient at 280 nm of 19 300 M-1 cm-1. The spinach thioredoxin mc has an overall homology of 44% with the thioredoxin from Escherichia coli mainly due to differences in the N terminal and C-terminal regions. PMID- 3510869 TI - Kinetic studies on ribosomal peptidyltransferase. The behaviour of the inhibitor blasticidin S. AB - In a cell-free system derived from Escherichia coli, the reaction between Ac[3H]Phe-tRNA and puromycin (S) is inhibited by blasticidin S (I). In this reaction Ac[3H]Phe-tRNA is part of the Ac[3H]Phe-tRNA--poly(U)--ribosome complex (C). After preincubating the complex C with I and then adding S, the degree of inhibition is greater than that observed when C reacts with a mixture of S and I. Without preincubation, the inhibition is competitive giving a Ki of 2 X 10(-7) M. After preincubation the inhibition becomes of the mixed non-competitive type. A first-order kinetic analysis of the reaction between C and excess S, in the presence or in the absence of I, with or without preincubation, suggests that I acts as a modifier decreasing the catalytic rate constant of ribosomal peptidyltransferase (the putative enzyme that catalyzes the reaction between C and S). The effectiveness of I cannot be expressed by an equilibrium constant such as the above-mentioned Ki. A model is proposed which explains the results obtained. In this model, in the presence of I, C is converted to a modified species C, which is still able to react with S but with a lower catalytic rate constant. This is a novel concept, in which the ribosome can be subjected to modulation of its activity by small ligands. It can be useful in studies on translational control of protein synthesis. PMID- 3510870 TI - Regulation and interconversion of the potassium transport systems of Saccharomyces cerevisiae as revealed by rubidium transport. AB - The kinetics of Rb+ transport in Saccharomyces cerevisiae depended on the K+ content of the cells and on K+ starvation, as follows. In cells with normal K+ (grown at millimolar K+), Rb+ transport was regulated by internal K+. The loss of K+ first decreased the Km and later increased the Vmax of Rb+ transport. K+ starvation of normal-K+ cells for 4-5 h decreased the Km of Rb+ transport below the minimum observed after K+ loss. During this time Eadie-Hofstee plots of Rb+ transport suggest that the existing system was converted into a new one with a higher affinity. Growth at 10 microM K+ only required the system triggered by K+ loss, and the system expressed in K+-starved cells was not expressed under these conditions. PMID- 3510871 TI - The phosphoenolpyruvate:glucose phosphotransferase system of Salmonella typhimurium. The phosphorylated form of IIIGlc. AB - Enzyme IIIGlc of the phosphoenolpyruvate: sugar phosphotransferase system (PTS) of Salmonella typhimurium can occur in two forms: phosphorylated and nonphosphorylated. Phosphorylated IIIGlc (P-IIIGlc) has a slightly lower mobility during sodium dodecyl sulphate/polyacrylamide gel electrophoresis than IIIGlc. In bacterial extracts both phosphoenolpyruvate (the physiological phosphoryl donor of the PTS) as well as ATP can phosphorylate IIIGlc. The ATP-catalyzed reaction is dependent on phosphoenolpyruvate synthase, however, and is due to prior conversion of ATP to phosphoenolpyruvate. The phosphoryl group of phosphorylated IIIGlc is hydrolysed after boiling in sodium dodecyl sulfate but phosphorylated IIIGlc can be discriminated from IIIGlc if treated with this detergent at room temperature. We have used the different mobilities of IIIGlc and P-IIIGlc to estimate the proportion of these two forms in intact cells. Wild-type cells contain predominantly P-IIIGlc in the absence of PTS sugars. In an S. typhimurium mutant containing a leaky ptsI17 mutation (0.1% enzyme I activity remaining) both forms of IIIGlc occur in approximately equal amounts. Addition of PTS sugars such as glucose results, both in wild-type and mutant, in a dephosphorylation of P IIIGlc. This correlates well with the observed inhibition of non-PTS uptake systems by PTS sugars via nonphosphorylated IIIGlc. PMID- 3510872 TI - Structural homology between elongation factors EF-Tu from Bacillus stearothermophilus and Escherichia coli in the binding site for aminoacyl-tRNA. AB - Elongation factor EF-Tu (Mr approximately equal to 50 000) and elongation factor EF-G (Mr approximately equal to 78 000) were isolated from Bacillus stearothermophilus in a homogeneous form. The ability of EF-Tu to participate in protein synthesis is rapidly inactivated by N-tosyl-L-phenyl-alanylchloromethane (Tos-PheCH2Cl). EF-Tu X GTP is more susceptible to the inhibition by Tos-PheCH2Cl than is EF-Tu X GDP. Tos-PheCH2Cl forms a covalent equimolar complex with the factor by reacting with a cysteine residue in its molecule. The labelling of EF Tu by the reagent irreversibly destroys its ability to bind aminoacyl-tRNA, which in turn protects the protein from this inactivation. This indicates that the modification of EF-Tu by Tos-PheCH2Cl occurs at the aminoacyl-tRNA binding site of the protein. To identify and characterize the site of aminoacyl-tRNA binding in EF-Tu, the factor was labelled with [14C]Tos-PheCH2Cl, digested with trypsin, the resulting peptides were separated by high-performance liquid chromatography and the sequence of the radioactive peptide was determined. The peptide has identical structure with an Escherichia coli EF-Tu tryptic peptide comprising the residues 75-89 and the Tos-PheCH2Cl-reactive cysteine at position 81 [Jonak, J., Petersen, T. E., Clark, B. F. C. and Rychlik, I. (1982) FEBS Lett. 150, 485-488]. Experiments on photo-oxidation of EF-Tu by visible light in the presence of rose bengal dye showed that there are apparently two histidine residues in elongation factor Tu from B. stearothermophilus which are essential for the interaction with aminoacyl-tRNA. This is clearly reminiscent of a similar situation in E. coli EF Tu [Jonak, J., Petersen, T. E., Meloun, B. and Rychlik, I. (1984) Eur. J. Biochem. 144, 295-303]. Our results provide further evidence for the conserved nature of the site of aminoacyl-tRNA binding in elongation factor EF-Tu and show that Tos-PheCH2Cl reagent might be a favourable tool for the identification of the site in the structure of prokaryotic EF-Tus. PMID- 3510873 TI - X-ray crystallographic and biochemical characterization of single crystals formed by proteolytically modified human fibrinogen. AB - Large single crystals (0.7 mm X 0.4 mm X 0.3 mm) of human fibrinogen, modified with a crude exoprotease from Pseudomonas aeruginosa, have been obtained. The crystals are orthorhombic, space group P212121, with a = 9.5 +/- 0.1 nm, b = 11.1 +/- 0.1 nm, c = 44.0 +/- 0.4 nm. Their X-ray diffraction patterns extend to beyond 1.0 nm resolution. The asymmetric unit contains one fragment of 245 kDa molecular mass made up of an intact gamma chain, a slightly shortened beta chain and an N-terminal part (about one-third) of the alpha chain. In electron micrographs of rotary-shadowed samples the crystallized particles are very similar in size and shape to the well-known trinodular form of native fibrinogen. From the unit-cell dimensions and the intensity pattern a model is proposed in which the molecules consist of two halves related by a local twofold rotation axis, and are aligned with a displacement of multiples of 1/4 of their length giving a pseudohexagonal packing scheme. PMID- 3510874 TI - Therapeutic efficacy of the transplantation of isolated hepatocytes in rats with surgically induced acute hepatic failure: a study of the mechanism. AB - In this study, the beneficial effect of intrasplenic transplantation of hepatocytes or splenocytes was shown in animals with 75% hepatectomy and portacaval shunt but not in animals with total dehepatization by hepatic vascular exclusion. No enhancement of the phagocytic activity was observed in the animals with 75% hepatectomy and portacaval shunt after injection of hepatocytes or splenocytes. This study confirms the efficacy of hepatocytes for the treatment of experimental liver failure but shows that nonhepatic cells may be equally as effective. Metabolic activity of the transplanted cells and stimulation of the phagocytic activity of the reticuloendothelial system probably do not explain the therapeutic effect of the transplanted cells. PMID- 3510875 TI - Mechanisms involved in acute lung edema induced in dogs by oleic acid. AB - We investigated mechanisms related to the development of acute lung edema, as induced by oleic acid in adult mongrel dogs. The intravenous injection of oleic acid (0.04 ml/kg) was considered to induce a permeability edema, as an enhancement of transvascular protein clearance was observed after the injection. The effects of oleic acid injection on systemic blood pressure (SBP), pulmonary arterial pressure (PAP), pulmonary arterial wedge pressure (PAWP), cardiac output (CO) and airway pressure (AWP) were measured. A significant decrease in CO and increase in AWP were evident after the injection, but there were no changes in SBP, PAP and PAWP. Treatment of the animals with prostaglandin I2 (PGI2) did not alter the induction of edema by oleic acid. However, the decrease in CO and increase in AWP were normalized by treatment with PGI2. Blood platelet count was not affected by oleic acid given in a dose of 0.04 ml/kg. To determine the direct effect of oleic acid on the vascular endothelium, the agent was injected through a catheter placed in the pulmonary artery. Electron microscopic examination revealed severe vacuolation on the endothelium of the pulmonary artery after only 1 min of exposure to oleic acid. Increased permeation of Evans blue into the subendothelial tissue was also observed with oleic acid treatment, compared with findings in the controls. These results indicate that the lung edema induced by oleic acid is due to an increased protein clearance, probably through a direct toxic effect on the vascular endothelium rather than an indirect toxic effect of chemical mediators released from the aggregated platelets. PMID- 3510876 TI - Abdominal heart transplantation: description of a new allograft extrathoracic pump. AB - This study describes a new kind of abdominal heart transplantation for left ventricular assistance carried out in a series of 12 experiments in pigs weighing 15-25 kg. This was achieved making three connections between the donor's left atrium, aorta and pulmonary artery with the recipient's aorta, still aorta and inferior vena cava, respectively. The hemodynamic data were satisfactory, the best survival rate with a transplanted working heart was 1 month. The low output of the recipient's left ventricle was obtained by ligation of the left anterior descending (LAD) coronary artery. In all animals, the highest peak of the pressure of the transplanted left ventricle was at least 20 mm Hg higher (ranging from 20 to 60 mm Hg) than the pressure in the recipient's left ventricle, and corresponded with the peak of the systemic arterial pressure. The cardiac output of the transplanted hearts showed a good hemodynamic response with support of the circulation after ligation of the LAD coronary artery in the recipient's heart. PMID- 3510877 TI - The Tatro case: who gets what and why. PMID- 3510878 TI - Eukaryotic DNA metabolism. Are deoxyribonucleotides channeled to replication sites? AB - DNA precursor biosynthesis is closely coordinated with DNA replication itself. In prokaryotic systems, firm evidence supports the idea that this coordination is achieved through the action of multienzyme complexes that physically link the synthesis of deoxyribonucleotides with their utilization in DNA replication. Much evidence favors a similar channeling mechanism in eukaryotes. However, recent studies suggest strongly that in mammalian cells DNA precursors are synthesized in cytoplasm and are then transported into the nucleus. This article reviews the pertinent evidence, attempts to reconcile contradictory findings, and highlights areas that need further investigation. PMID- 3510879 TI - Reversal of transformed phenotype by monoclonal antibodies against Ha-ras p21 proteins. AB - The transforming activities of p21 ras proteins have been determined by micro injection of these proteins into NIH3T3 cells. In order to facilitate functional studies on the effect of ras proteins on malignant transformation and normal cellular growth, analysis has been made with three monoclonal antibodies (YA6 172, Y13-238 and Y13-259) as originally reported by Furth et al. (J virol 43 (1982) 294). Purified immunoglobulin of Y13-259 has the highest titer of binding to bacterially synthesized p21 ras proteins. Experimental analyses indicate that only Y13-259 antibody will neutralize the transforming activity of the co injected bacterially synthesized ras protein and the neutralization effect was blocked by co-injection of excess ras protein. In addition, micro-injection of Y13-259 immunoglobulin into transformed NIH3T3 cells (obtained by DNA transfection of NIH3T3 cells with molecularly cloned ras gene) reversed their transformed phenotypes. These results indicate that both bacterially synthesized p21 ras proteins and the natural ras proteins produced in NIH3T3 cells were neutralized by Y13-259 antibody. PMID- 3510880 TI - Repopulation of a human alveolar matrix by adult rat type II pneumocytes in vitro. A novel system for type II pneumocyte culture. AB - This paper describes the preparation of lung acellular alveolar matrix fragments and culture of rat type II pneumocytes directly on the alveolar epithelial basement membrane, thereby permitting study of the effect of lung basement membrane on the morphology and function of type II cells. Collagen types I, III, IV and V, laminin and fibronectin were located by immunofluorescence in the lung matrix with the same patterns as those described for the normal human lung. Transmission electron microscopy (TEM) of the fragments revealed intact epithelial and endothelial basement membranes. The matrix maintained the normal three-dimensional alveolar architecture. Glycosaminoglycans were still present by Alcian Blue staining. Isolated adult rat type II pneumocytes cultured on 150 micron thick fragments of acellular human alveolar extracellular matrix undergo gradual cytoplasmic flattening, with loss of lamellar bodies, mitochondria, and surface microvilli. These changes are similar to the in vivo differentiation of type II pneumocytes into type I pneumocytes. The type II pneumocyte behaviour on the lung epithelial basement membrane contrasted sharply with that of the same cell type cultured on a human amnionic basement membrane. On the latter surface the cells retained their cuboidal shape, lamellar bodies and surface microvilli for up to 8 days. These observations suggest that the basement membranes from different organ systems exert differing influences on the morphology and function of type II pneumocytes and that the alveolar and amnionic basement membranes may have differing three-dimensional organizations. The technique of direct culture of type II cells on the lung basement membrane provides a useful tool for studying the modulating effect of the basement membrane on alveolar epithelial cells. PMID- 3510881 TI - Isolation and characterization of rat-mouse somatic cell hybrids secreting growth hormone and prolactin. AB - Interspecific somatic cell hybrid clones have been isolated and characterized in order to study growth hormone (GH) and prolactin (PRL) gene expression. Rat pituitary tumor cells (GH3, 69 chromosomes) secreting rat GH and PRL were grown for 48 h together with nonhormone secreting, aminopterin-sensitive murine fibroblast cells (LMTK-, 55 chromosomes) and fused using polyethylene glycol. Resultant heterokaryons were selected in hypoxanthine-aminopterin-thymidine (HAT) medium and cloned. Five clones produced rat GH and PRL. Hormone-producing hybrids morphologically resembled the mouse parent fibroblast. Hybrids grew in monolayers and contained 80-142 chromosomes, and marker chromosomes for both rat (small submetacentric) and mouse (bi-armed and large true metacentric) were identified. The interspecific nature of the hybrids was further confirmed by the presence of both rat and mouse adenosine deaminase and superoxide dismutase isozymes. Using specific antisera and indirect immunoperoxidase staining, both hybrid clones and GH3 rat parental cells stained positively for rat GH and PRL, while the murine fibroblast parental cells were negative. Hormone production by the hybrids has been sustained for over twenty subcultures; secretion rates were initially 150 ng PRL and 321 ng GH/10(6) cells/24 h and are currently 100 ng PRL and 90 ng GH/10(6) cells/24 h. Parental GH3 rat cells secreted 720 ng PRL and 660 ng GH/10(6) cells/24 h. Exposure of hybrids to KCl (50 mM) resulted in acute stimulation of rat PRL, but not rat GH release, and long-term incubation with thyrotropin-releasing hormone (TRH, 80 nM) stimulated PRL secretion. Hormone dependent modulation of PRL secretion was transferred to the hybrid cell thus enabling the model to be used in studying regulation of PRL gene expression. PMID- 3510883 TI - Synthesis and intracellular localization of chick acid alpha-glucosidase in chick erythrocyte-human fibroblast heterokaryons. A model system for the study of lysosomal enzyme synthesis. AB - The synthesis and localization of chick acid alpha-glucosidase has been studied in chick erythrocyte-human fibroblast heterokaryons. Monospecific antibodies raised against purified chick liver acid alpha-glucosidase were used. It was found that the acid alpha-glucosidase in the heterokaryons is of chick origin, and is localized in the same lysosomes as the human lysosomal enzymes. It is concluded that chick erythrocyte-human fibroblast heterokaryons provide a useful model system for the study of lysosomal enzyme synthesis and routing. PMID- 3510882 TI - Heterogeneity and contact-dependent regulation of hormone secretion by individual B cells. AB - A reverse hemolytic plaque assay was developed to visualize insulin release from individual adult pancreatic B cells. Cells obtained by mechanical dispersion of isolated rat islets of Langerhans were mixed with protein A-coated sheep red blood cells and incubated in the presence of an anti-insulin serum, under conditions known to affect insulin release. The cell mixture was further incubated with complement and finally fixed. Insulin release was revealed by the presence of hemolytic plaques which resulted from the complement-mediated lysis of red blood cells bearing insulin-anti-insulin complexes bound to protein A. Quantitation of hemolytic plaques around trypan blue-unstained and immunohistochemically identified B cells showed that stimulation of insulin release results in the recruitment of increasing numbers of secreting B cells as well as in the enhanced response of individual B cells. Reverse changes occur upon inhibition of insulin release. Comparison of freshly dispersed and one-day cultured preparations did not reveal significant differences in the secretory response of undamaged B cells. In both preparations, single B cells responded to secretagogues in smaller proportions and to a lesser extent than clusters in which B cells had either maintained or restored contacts and junctional communication with their neighbours. However, the overall preponderant response of clusters was less than expected from the number of individually secreting B cells they contained. The data show that B cells are heterogeneous in terms of their ability to release insulin and provide evidence that cell-to-cell adhesion and/or junctional communication regulate hormone secretion from individual B cells. PMID- 3510885 TI - Proteolytic response to nutritional step-down in Tetrahymena. AB - The ciliate Tetrahymena thermophila is usually grown in a medium containing proteose peptone and yeast extract as organic nutrients. When the ciliate is transferred to step-down conditions, i.e., an inorganic medium, it is shown that the cells respond by rapidly and drastically increasing their rate of protein degradation. A method for measuring the response to step-down conditions is presented, and the response is characterized. The types of proteinases involved are indicated by the use of specific inhibitors. It is concluded that Tetrahymena reacts in much the same way as mammalian cells, and provides a suitable system for investigating the regulation of protein degradation. PMID- 3510884 TI - Further characterization of a murine temperature-sensitive mutant, tsFT20 strain, containing heat-labile DNA polymerase alpha-activity. AB - tsFT20 cells, which have temperature-sensitive DNA polymerase alpha-activity, were characterized mainly at the cellular level. The cells lost their ability to synthesize DNA immediately after a shift to non-permissive temperature. The extent of decrease in the activity of DNA polymerase alpha in whole-cell extracts was the same as that of the decrease in the DNA replication ability determined by [3H]thymidine incorporation. At 39 degrees C, tsFT20 cells lost most of their colony-forming ability in one doubling time (16 h). The cells could not grow at higher than 38 degrees C, but could grow at 37 degrees C. When tsFT20 cells were synchronized at the G1/S boundary and incubated at 39 degrees C, they could not complete the S phase, ceasing cell cycle progression in mid-S phase. A temperature shift (33 degrees C----39 degrees C) experiment indicated that the whole S phase was temperature-sensitive, whereas the G2 and M phases were not. These results confirmed that DNA polymerase alpha plays a key role in DNA replication in mammalian cells. PMID- 3510886 TI - Immunofluorescent localization of a monoclonally defined carbohydrate cell surface antigen (IIC3) during mouse development. AB - A monoclonal antibody (anti-IIC3), raised against F9 embryonal carcinoma cells, detects an antigen which is first expressed at the compacted morula stage and segregates with the trophectoderm of the mouse blastocyst. We have further examined the expression of this antigen during embryonic development. Immunofluorescence experiments on sectioned embryos demonstrate that IIC3 expression is associated with the differentiation of extra-embryonic cell types. It is expressed at the cell surface of the trophectoderm of the attaching blastocyst and differentially by the two derivatives of this layer. The primary and secondary trophoblastic giant cells label intracellularly, whereas the cells of the ectoplacental cone and labyrinth placenta label at the cell surface. IIC3 is also expressed by the primitive endoderm of the blastocyst and subsequently by the visceral endoderm. The parietal endoderm does not express IIC3. Partial characterization of the IIC3 antigen with sugar hapten inhibition and glycosidase digestion experiments, suggests that the antigen is a lactosaminoglycan-like molecule, with galactose and N-acetylgalactosamine residues representing part of the antigenic determinant. Neuraminidase and fucosidase treatment exposed additional anti-IIC3-antigenic sites on the extra-embryonic ectoderm and chorion. A possible role for IIC3 in normal embryonic-uterine interactions is discussed. PMID- 3510887 TI - Early effect of growth factors (EGF + insulin) upon ATP turnover in 3T3 cells. Inhibition by cytochalasin B and D. AB - We have demonstrated previously a rapid increase in ATP turnover soon after adding epidermal growth factor (EGF) and insulin to quiescent cultures of Swiss 3T3 cells. In the present work, we tried to determine whether this increase could be correlated with the early stimulation by growth factors of cell movements. We showed that cytochalasin B (CB), in complete or glucose-free medium, inhibited this early increase caused by growth factors, in phosphate incorporation in small organic acid-soluble compounds (Po). Cytochalasin D (CD) specifically inhibited the stimulation caused by growth factors of Po labelling and ATP turnover, but lacked all inhibitory effect on unstimulated cells. The inhibitory effect of CD was transient. We hypothesize that addition of EGF and insulin to quiescent 3T3 cell cultures induces a rapid and transient change in cell movements, which could be responsible for about half of the early increase in ATP degradation and turnover. PMID- 3510888 TI - Microtubules are not altered in the dystrophic chicken. AB - The association of an altered cytoplasmic microtubule complex in cells of the dystrophic chicken was investigated. Dystrophic chickens of lines 304 and 413 were compared with their genetically matched control, 412 (obtained from UC, Davis). Explants and trypsin-dissociated tissues were prepared from breast and heart muscles of chickens at 1, 3, 7, 14, 20, 40, 80 and 120 days ex ovo. The cells were cultured for 7 days and then processed for antitubulin immunofluorescence. Over 90% of the cells displayed an extensive cytoplasmic microtubule complex, although there was significant elevation of creatine phosphokinase in the dystrophic chickens after 20 days ex ovo. In both dystrophic and control preparations, one to two distinct functionally intact microtubule organizing centers per cell were observed. Dystrophic and control chicken brain extracts demonstrated essentially the same extent of microtubule assembly as assayed by turbidity increase and protein in sedimentable polymer. SDS-PAGE revealed no significant differences in the microtubule proteins polymerized from the dystrophic and control brains. These results suggest that no significant alteration occurs in the structure, assembly or distribution of cytoplasmic microtubules in the cells of the dystrophic chicken. PMID- 3510889 TI - Exchange of proteins during immunofractionation of chromatin. AB - The migration and rearrangement of chromosomal proteins during immunofractionation of chromatin has been investigated. Oligonucleosomes from two different chromatins, chicken erythrocyte or rat liver, were mixed with oligonucleosomes from the other species which had been depleted of histones H1/H5 and high mobility group proteins (HMGs). The mixture was treated with buffers of various ionic strengths and immunofractionated on an anti-H1 degrees/H5 or anti HMG-17 IgG-Sepharose column. The type of DNA, which was retained as the bound fraction on the column, was determined by slot blot analysis using nick translated repetitive DNA probes from either chicken or rat. The results indicate that in low ionic strength buffers (i.e., below 40 mM NaCl), there is very little exchange of either histone H5 or HMG-17 among nucleosomes and therefore we suggest that it is possible to fractionate nucleosomes according to their antigenic content. PMID- 3510890 TI - Effect of 1,25 dihydroxyvitamin D3 and retinoic acid on normal human pluripotent (CFU-mix), erythroid (BFU-E), and myeloid (CFU-C) progenitor cell growth and differentiation patterns. AB - The modulatory effect of 1,25 dihydroxyvitamin D3 (vit D) and 13 cis retinoic acid (retinoic acid) on the growth and differentiation of normal human pluripotent stem cell, erythroid, and myeloid progenitor cell growth was studied using semisolid methylcellulose clonal assay. Dose response curves showed that maximal increments of myeloid colony (CFU-C) growth (150%) occurred with vit D at 2 X 10(-9) -2 X 10(-8) M and with retinoic acid (184%) at 1 X 10(-7) M. Vit D caused a 134% increase in macrophage colonies (CFU-M) and a decrease in granulocytic (CFU-G) and granulocyte-macrophage colonies (CFU-GM) (50% and 58%, respectively, as compared to the control). Retinoic acid did not alter the differentiation pattern of myeloid colonies (CFU-M, CFU-G, and CFU-GM). Vit D at 2 X 10(-8) M had an inhibitory effect on BFU-E (62% growth of control) and did not affect CFU-mix growth. Retinoic acid at 10(-7) M did not alter the growth of either BFU-E or of CFU-mix. Cellular differentiation studies in liquid suspension showed that vit D caused a 213% increase in monocyte-macrophages and a 56% and 26% decrease in immature and mature granulocytes, respectively. Retinoic acid caused a marked (79%) decrease in immature granulocytes whereas the percentage of mature granulocytes and monocyte-macrophages was not changed. Assessment of phagocytosis and killing of Candida albicans (C.A.) by cultured monocyte macrophages and granulocytes exposed to vit D and retinoic acid demonstrated that treated cells had the same capability to phagocytose and kill C.A. as did untreated cells. PMID- 3510891 TI - Standardization of procedures for ectopic marrow grafting: I. Influence of sex of recipient. AB - Bone marrow plugs implanted beneath the renal capsule of a normal syngeneic mouse recipient develop, within a few weeks, into a shell of marrow-containing bone. The marrow stromal microenvironment of the implant is reported to be of donor origin and therefore the technique has the potential for development into a quantitative assay of the stroma, or stroma-forming, capacity of the implanted marrow. A surprising difference has been shown, however, in that the female mouse does not permit the development of such an ectopic implant to the same extent as does a male recipient. The suppression of development of the implant is particularly dramatic when marrow from a male donor is implanted into a female recipient, but is strongly operative even upon donor marrow from a syngeneic female. The effect is partly strain dependent, being more pronounced in C57B1/6 and B6D2F1 mice than in DBA/2 or Balb/c. Castration and ovariectomy do not abrogate or modify the suppression. On the other hand, exposure of recipients to 6 Gy 137Cs gamma-radiation before implantation results in bigger implants developing in male recipients, and the suppressive effect of the female recipient upon the graft is reduced considerably or eliminated altogether. Marrow plugs were implanted into chimeras made by transplanting marrow from syngeneic male or female donors, i.e., into heavily irradiated B6D2F1 mice of the same or opposite sex. In female mice repopulated with marrow cells from male donors, the ectopic implants contained 2-3 times as many spleen colony-forming units (CFU-S) as did those in female mice populated by female marrow cells. Ectopic implants into male mice repopulated with female marrow cells contained fewer CFU-S than implants into male recipients having a male marrow, though the differences are smaller than those found in female recipients and may not be significant. PMID- 3510892 TI - Human myeloid precursor cells do not possess or produce procoagulant activity (PCA). AB - The procoagulant cellular activity (PCA) of human myeloid precursor cells was evaluated after fractionation of normal bone marrow cells over a discontinuous albumin density gradient. No PCA was documented in any of the six freshly isolated fractions (F1-F6); significant amounts of PCA were instead produced, after a 4-h endotoxin preincubation, in fractions F1 and F2, which, unlike the other fractions, contained up to 5% monocyte-macrophages. After removal of the latter by plastic adherence, the PCA was abolished. This study shows that PCA can be produced only by monocyte-macrophages upon endotoxin activation, while myeloid precursor cells, at all stages of differentiation, are incapable of PCA. The PCA demonstrated in some human acute myeloid leukemias, other than that of the monoblastic subgroup, appears therefore to be related to the neoplastic transformation rather than to a maturation arrest or to a toxemic stimulation. PMID- 3510893 TI - Treatment of severe aplastic anemia. AB - A total of 100 patients with severe aplastic anemia were treated and evaluated in a prospective study at our hospital between January 1976 and October 1983: 28 patients had an HLA-identical sibling donor and were treated with bone marrow transplantation, and 72 patients without an HLA-identical sibling donor were given antilymphocyte globulin followed by oral low-dose androgen therapy. At 1 1/2-9 years after treatment, 13 patients (46%) survive in the transplant group and 45 patients (75%) survive in the second group. All except one in the second group have self-sustaining hematopoiesis without need for transfusions. There is one major difference between the two therapies. Marrow transplantation restores bone marrow function completely and no late hematologic complications have been seen in this group. The majority of patients treated with antilymphocyte globulin in contrast have residual abnormalities of hematopoiesis: macrocytosis, mild granulocytopenia, and mild thrombopenia. Relapse (11 of 72 patients) and clonal hematologic disorders, such as paroxysmal nocturnal hemoglobinuria (four patients) and leukemia (one patient) can occur years after complete bone marrow reconstitution with antilymphocyte globulin. These late disorders are of concern. Despite this, we conclude that antilymphocyte globulin treatment is an effective therapy with low early mortality and morbidity and a high chance for a long, sustained remission. Results are better or at least equivalent to bone marrow transplantation and patients with donors should be given the option of transplant or antilymphocyte globulin. PMID- 3510894 TI - Reduction and repopulation of recipient T4+ and T8+ T-lymphocytes in allogeneic bone marrow transplantation. AB - In eight recipients of allogeneic bone marrow grafts who had sex-mismatched donors, the reduction and subsequent repopulation of T4+ and T8+ T-lymphocytes of recipient origin were studied. The origin of the donor-recipient T4+ and T8+ T cells was studied using quinacrine staining of Y chromatin combined with T-cell typing for T4 and T8. Following chemoradiotherapy and bone marrow transplantation (BMT), T cells reached their nadir at a median of five (range 1-8) days after BMT. T8+ T cells decreased at a faster rate from the peripheral blood than T4+ T cells. The first T cells that appeared in the circulation at day 12 were predominantly T4+, and a large number of them were of recipient origin. Thereafter, they gradually decreased, and the numbers of T cells of donor origin increased. In the patients who had no or only minor complications, T4+ and T8+ T cells of donor origin repopulated the blood at similar rates. This pattern, however, was modified by severe graft-versus-host disease or by cytomegalovirus infection. PMID- 3510895 TI - Erythropoietic reserve in marrow-transplanted dogs. AB - The effect of marrow transplantation on erythropoiesis was studied in three normal dogs (T0), three irradiated dogs receiving compatible marrow (T1), and three irradiated dogs (T2) who donated their marrow to a recipient animal and then at a later date underwent a marrow transplant from the initial marrow recipient. Plasma iron turnover was measured (a) under basal conditions, (b) after plasma iron was elevated by iron infusion, and (c) after hemolytic anemia had been produced by phenylhydrazine. Basal plasma iron turnover in T0, T1, and T2 animals averaged 1.3, 1.0, and 1.3 mg/dl whole blood/day. Turnover of the three groups increased to 7.1, 6.2, and 6.4 mg/dl whole blood/day after the induction of anemia by phenylhydrazine. These values were converted from the transferrin saturation present at the time of the measurement to the calculated turnover at 100% saturation, thereby expressing the maximum capacity of tissues to assimilate iron. After this correction, the calculated maximum uptake was shown to be increased over basal by 3.7, 4.0, and 3.8 times. To validate this approach, an additional comparison was made between baseline turnovers at elevated levels of plasma iron and anemic animals at similarly elevated plasma iron levels. The increment of the three groups was shown to be 3.7, 3.9, and 4.0 times basal. These studies illustrate the use of a refined method of ferrokinetic evaluation of erythropoiesis and indicate that the proliferative reserve in transplanted animals is unimpaired. PMID- 3510897 TI - More on the need for circadian, circaseptan and circannual optimization of cyclosporine therapy. AB - Cyclosporine chronotherapy of pancreas-allotransplanted rats revealed, beyond a circadian stage-dependence of equal daily doses, further gain in graft function from doses varying from day to day with an about 7-day periodicity, the first highest dose being given on the 3rd or 5th day after surgery. PMID- 3510896 TI - Circadian rhythms and their mechanisms. AB - Recent work concerning the number, site(s) and means of adjustment to the 24-h day of internal clocks is reviewed. Work on humans is considered wherever possible though much of the work involving ablation and in vitro techniques necessarily involves other species, particularly rodents. It is concluded that, though recent advances have been impressive and present techniques appear likely to continue to produce results and stimulate discussion, more attention should be directed to considering the circadian system as a whole rather than as an assemblage of individual components. PMID- 3510898 TI - Comparison of the time courses of luteinizing hormone (LH) secretion rates during continuous stimulation by LH-releasing hormone (LH-RH) in vivo and in vitro. AB - The patterns of LH secretion during constant stimulation of the pituitary glands of estradiol-treated ovariectomized rats with a maximally stimulating amount of LH-RH in vivo and in vitro correspond with each other qualitatively and quantitatively. In vitro the changes with time of the LH secretion rate are somewhat retarded, especially the occurrence of desensitization. PMID- 3510899 TI - Ribosome-inactivating proteins up to date. AB - Ribosome-inactivating proteins (RIPs) from plants inactivate eukaryotic ribosomes, as far as studied by rendering their 60 S subunit unable to bind elongation factor 2. These proteins seem widely distributed and possibly ubiquitous in plants. They are either type 1, those consisting of a single polypeptide chain, or type 2 (ricin and related toxins), those consisting of two chains, one of which is a galactose-binding lectin. The literature on RIPs from 1982 has been reviewed with respect to the chemical and biological properties of RIPs, their use for the preparation of immunotoxins and new perspectives. PMID- 3510900 TI - Effects of ciglitazone on insulin resistance and thermogenic responsiveness to acute cold in brown adipose tissue of genetically obese (ob/ob) mice. AB - Genetically obese (ob/ob) mice develop a marked insulin resistance in brown adipose tissue soon after weaning, and this is paralleled by a fall in the acute activation of the mitochondrial proton conductance pathway in the tissue on cold exposure. Treatment of ob/ob mice with ciglitazone, a new oral hypoglycaemic, led to a restoration of insulin sensitivity in brown adipose tissue. The amelioration of insulin resistance was accompanied by a normalization of the acute, cold induced increase in mitochondrial GDP binding. These results support the hypothesis that the development of insulin resistance in brown adipose tissue is an important factor in the impaired thermogenic responsiveness of obese mice. PMID- 3510901 TI - GACcodonGGC: a very favorable context for translation errors? AB - A survey of the literature on the effect of condon context on translation fidelity suggests that contexts such as GACcodonGGC are strong, but not unique, promotors of several types of translation errors. PMID- 3510902 TI - Mechanism of translational initiation in prokaryotes. IF3 is released from ribosomes during and not before 70 S initiation complex formation. PMID- 3510903 TI - The prohormone processing activity is enriched in a low-density subpopulation of chromaffin granules. AB - Bovine adrenomedullary chromaffin granules can be separated into two subpopulations by differential centrifugation. The subpopulation which sediments at the interface of two sucrose layers, 1.6 and 1.8 M respectively, is found to be enriched about 10-times in prohormone processing activity, as measured by in vitro degradation of synthetic peptide substrates. The enhanced proteolytic activity is not due to lysosomal contaminations which are very low and only slightly increased in the more active fraction. The low density of the enriched subpopulation suggests that we are dealing with immature granules. The physiological implications of this finding are discussed. Furthermore, the enriched fraction can be used as the starting material for the isolation of proenkephalin processing enzymes. PMID- 3510904 TI - Specific inhibition of human granulocyte elastase with peptide aldehydes. AB - The kinetic features of human granulocyte elastase, chymotrypsin, porcine pancreatic elastase and elastomucoproteinase were compared. Amino acyl ester substrates were assayed and Km and kcat values were defined. Aldehyde analogues of the p-nitroanilide substrates designed for granulocyte elastase as optimal for Km appeared to be potent inhibitors. Suc-D-Phe-Pro-valinal (Ki = 40 microM) was found to inhibit granulocyte elastase competitively and specifically when measured with synthetic substrates, and the Ki was 3 microM with the natural protein substrate, elastin. PMID- 3510905 TI - t-Butyl-4-hydroxyanisole, a novel respiratory chain inhibitor. Effects on Trypanosoma cruzi epimastigotes. AB - t-Butyl-4-hydroxyanisole, an antioxidant food additive, inhibited the growth of Trypanosoma cruzi by almost 100% at 0.5 mM concentration. This compound inhibited 70% of oxygen consumption of epimastigotes. The redox level of NAD(P) was shifted to a more reduced state and inversely the redox level of cytochrome b changed to a more oxidized state. This hydroxyanisole thus is a new electron transport chain inhibitor. This compound and related ones, or the respiratory chain of T. cruzi, may be important in the design of antichagasic drugs. PMID- 3510906 TI - Energetics of interaction of oligopeptide (lac 53-57) with DNA base sequences and origin of sequence-specific recognition. AB - Computer model building with a dynamic energy minimization procedure is used here to study the interaction of a pentapeptide sequence from the lac repressor headpiece (lac 53-57) with different base sequences of DNA. The peptide fragment for this purpose was considered in the classical beta-antiparallel as well as the beta-associated conformation. The model of its interaction with DNA was optimised for various binding positions and base sequences. Partitioning of energy is analysed for different dielectric constant values and the main contributing factors to sequence-specific binding are discussed. PMID- 3510907 TI - The excess GTP hydrolyzed during mistranslation is expended at the stage of EF-Tu promoted binding of non-cognate aminoacyl-tRNA. AB - The system of translation of Sepharose-bound poly(U) in which all ribosomes are active in peptide elongation was used to determine the stoichiometry of GTP hydrolysis at the stage of EF-Tu-promoted aminoacyl-tRNA binding. The ratio of GTP hydrolyzed at this stage per peptide bond was assayed during codon-specific elongation (polyphenylalanine synthesis) and misreading (polyleucine synthesis). It was demonstrated directly that the excess GTP hydrolyzed during misreading [(1984) FEBS Letters 178, 283-287] is expended at the stage of Ef-Tu-promoted binding of non-cognate aminoacyl-tRNA. PMID- 3510908 TI - Designed inhibitors of horse liver alcohol dehydrogenase. Effect of active-site metal ion substitution. AB - 3-(p-Butoxyphenyl)propionamide, -thioamide and -hydrazide and the formamide of p butoxybenzylamine were tested as inhibitors of cadmium(II) and cobalt(II) active site substituted alcohol dehydrogenase. The results agree with a direct coordination of these inhibitors except for the hydrazide to the active-site metal ion, in the enzyme-NADH-inhibitor complex. The hydrazide might be situated at some distance from the metal ion without a direct coordination bond. PMID- 3510909 TI - Antibody-coated liposomes. The role of non-specific antibody adsorption. AB - Incubation of small unilamellar liposomes composed of equimolar phospholipid and cholesterol with mouse IgG or mouse monoclonal IgG1 for up to 24 h resulted in considerable (34-89%) adsorption of the protein onto the liposomal surface. Immunoglobulin remained adsorbed after exposure to mouse plasma and, in the case of monoclonal (anti-HBSAg) IgG1, was able to mediate association of the liposomes with the antigen. Extensive immunoglobulin adsorption suggests caution in interpreting covalent linkage values obtained upon prolonged incubation of chemically modified antibodies with liposomes. It may also be a preferred alternative in preparing targeted liposomes for intravenous use when chemically modified antibodies promote premature clearance of the antibody-liposome complex from the circulation. PMID- 3510910 TI - Direct evidence for a coupling between synthesis and export of PhoS in E. coli. AB - The accumulation of pre-PhoS under conditions of PhoS overproduction has been previously described. It is now demonstrated that during the induction of PhoS, a delay in the completion of polypeptide chain elongation can be detected. This delay is related to the extent of jamming of export sites by pre-PhoS or by other exported proteins. These results suggest that a component required for completion of pre-PhoS polypeptide becomes limiting, being titrated by the excess of nascent chains bearing signal peptides. This component thus probably acts at an early step in the export pathway. PMID- 3510911 TI - Neutrophil-dependent mediation of microvascular permeability. AB - Macromolecular extravasation induced by the chemoattractants N-formyl methionylleucylphenylalanine (FMLP), complement fragment C5a, and leukotriene B4 (LTB4) has been reported to be neutrophil dependent. A review of experimental evidence argues against mechanical disruption of the endothelial barrier as a likely mechanism for enhanced microvascular permeability. Other proposed mechanisms attribute macromolecular efflux to extracellular liberation of granule constituents or granule-independent neutrophil release products (e.g., oxygen radicals) that can undermine vascular integrity by direct or indirect actions on endothelial cells or other components of vascular walls (glycocalyx, basement membrane). The cytotoxic potential of neutrophil-release products on endothelial cells prompts consideration of a transcellular pathway for macromolecular transport. Further studies are needed to clarify the precise nature of endothelial injury and its resolution to better understand the physiology behind the transient effects of these mediators on vascular permeability. PMID- 3510912 TI - Nutritional parameters that alter hepatic drug metabolism, conjugation, and toxicity. AB - A major concern of contemporary medicine is the adverse effects resulting from the use of prescribed and over-the-counter pharmacologic agents. In many cases more than one drug is taken at the same time, which increases the risk of overloading the detoxification mechanisms. If the individual has poor nutritional status, the system becomes even more inefficient. The liver contains the most important of these detoxification systems: the cytochrome P-450-dependent mixed function oxidase (MFO) and several conjugation enzymes, e.g., sulfotransferase, glucuronyl transferase, and glutathione transferase, which convert lipophilic compounds to more water-soluble products to enhance their excretion. The balance of these reactions determines the rate of metabolism and clearance of xenobiotic agents, and regulates in part the degree of intracellular damage. Nutritional factors, including proteins, carbohydrates, fats, vitamins, and minerals, affect the efficiency of these reactions. Changes in intracellular metabolism can alter not only the enzyme levels but also the availability of their cofactors, e.g., NADPH, UDPGA (uridine diphosphate glucuronic acid), PAPS (3'-phosphoadenosine-5' phosphosulfate), and GSH. Diets restricted in calories, protein, or essential fatty acids, as well as those having low quality protein or high sugar content, can affect the component enzymes, cytochrome P-450 and the cytochrome P-450 reductase, and the MFO activity toward a variety of drugs. In addition, deficiencies of specific vitamins (riboflavin, ascorbic acid, and vitamins A and E) and minerals (iron, copper, zinc, and magnesium) affect the components and activities of the system in unique ways. Insight into the regulation of the hepatic detoxification mechanism can be gained by using nutrient variables to perturb the system. PMID- 3510913 TI - Nutrient influences on toxicity and carcinogenicity. AB - Essential nutrients and toxicants often coexist in the diet of humans and animals. Interactions among nutrients and chemicals in the diet may alter the toxicity of the chemical or the requirement for or availability of specific nutrients. Such interactions have been demonstrated among toxins and dietary protein, trace elements, and vitamins. Certain nutrients may also alter the response to certain drugs, and some drugs, such as oral contraceptives, may alter the availability of some nutrients. The carcinogenicity of some compounds and the subsequent promotion of tumor growth are affected by nutrients such as fat, vitamins, and lipotropes and by such minor dietary constituents as naturally occurring indoles and synthetic preservatives. In this paper we review such interactions as well as the mechanisms responsible for them. PMID- 3510914 TI - Contractile elements in the regulation of macromolecular permeability. AB - The leakage of macromolecules from the vasculature to the interstitium is greatly accentuated by mediators of edema such as histamine and bradykinin. The mechanism for this effect is not well delineated although many agents that affect smooth muscle tone may also affect macromolecular leakage. Leakage occurs primarily from the small venules. The demonstration that mediators of edema produce interendothelial gaps in the venules as well as changes in the shape of the endothelial nuclei has led to the hypothesis that a contraction of a vascular wall component may be responsible for the observed leakage of macromolecules. This component does not appear to be the vascular smooth muscle itself. Two other elements of the vascular wall, the endothelium and the pericytes, have been shown to contain many of the same elements of the contractile machinery present in smooth muscle. Most recent studies have presumed that endothelial cell contraction is responsible for the formation of the interendothelial gaps through which the macromolecules move. However, endothelial contraction has been difficult to demonstrate experimentally. Alternatively, inasmuch as pericytic processes can end near endothelial junctions and there is an abundance of fibronectin between the pericytes and the endothelium, it may be a pericytic contraction that causes the interendothelial gap formation. PMID- 3510915 TI - Physiological and pharmacological evidence for the regulation of permeability. AB - Local intraarterial infusions of histamine-type mediators produce increases in microvascular pressure (Pmv), protein efflux, and net fluid filtration that promote edema formation. The rise in Pmv is not the primary determinant of edema formation inasmuch as mediator-stimulated edema formation develops without an increase in Pmv. The inflammatory mediators increase the hydraulic conductivity of the microvascular membrane as evidenced by a large increase in the capillary filtration coefficient (CFC) subsequent to an increase in permeability. The development of inflammatory edema is primarily attributable to the increase in protein efflux, which decreases the lymph-to-plasma total-protein ratio (L/P ratio), virtually eliminating the transmural colloid osmotic pressure gradient. Hence, fluid filtration is increased at almost any level of Pmv. Noninflammatory vasodilators and venous occlusion produce increases in Pmv and protein clearance, but fail to increase the L/P ratio. The increase in protein efflux and L/P ratio is attributable to a nonhemodynamic action of the inflammatory mediators, an increase in microvascular permeability to macromolecules. The increase in protein efflux, CFC, and net fluid filtration produced by various inflammatory mediators is largely inhibited by cooling, treatment with endothelial cell stabilizers, or perfusion with blood from hemorrhaged animals. This inhibition is independent of changes in hemodynamics and must be ascribed to a direct effect on the microvascular membrane, providing evidence for a variable macromolecular transport pathway. In contrast, increases in protein clearance produced by increasing Pmv are not inhibited by these maneuvers, which provides evidence for a static macromolecular transport pathway. These findings correlate well with those from microscopic studies supporting the concept that macromolecular permeability may be directly regulated at the level of the venular endothelial cell subsequent to the modulation of interendothelial cell junction gap size. PMID- 3510917 TI - A model for testing compounds influencing porphyrin synthesis. AB - The yeast Saccharomyces cerevisiae cultivated semi-anaerobically in a synthetic medium was used as a model to establish (a) total porphyrin synthesis, (b) ratio of intracellular to extracellular porphyrin concentrations. The antimalarials used for the therapy of porphyria cutanea tarda, chloroquine and pyrimethamine, reduced the total synthesis of porphyrins, pyrimethamine being more effective than chloroquine, like in porphyric patients. Both drugs exerted an antagonistic influence on the release of porphyrins from cells. Chloroquine reduced the concentration ratio of porphyrins while pyrimethamine increased it, apparently through inhibition of permeation of porphyrins. Combined treatment with the two compounds may hold promise for the therapy of porphyria cutanea tarda. PMID- 3510916 TI - Pregnancy termination: techniques, risks, and complications and their management. PMID- 3510918 TI - Chromosome condensation activity in the cytoplasm of anucleate and nucleate fragments of mouse oocytes. AB - The activity of maturation promoting factor (MPF) which causes chromosome condensation and subsequent oocyte maturation was investigated in mouse oocytes using polyethylene-glycol-mediated cell fusion technique. Fully grown oocytes were bisected at germinal vesicle (GV) stage or shortly after germinal vesicle breakdown (GVBD) into anucleate and nucleate fragments. After 2-3 or 15-17 hr of culture these fragments were fused with interphase blastomeres from two-cell embryos. It was found that almost all the anucleate oocyte fragments cultured for a short term (2-3 hr), regardless of whether they were produced at GV stage or after GVBD, induced premature chromosome condensation in the blastomere nuclei, whereas only about 20% of those cultured for a long term (15-17 hr) could do so. On the other hand, the nucleate fragments always retain the cytoplasmic activity to induce chromosome condensation. Thus we suggested that the MPF initially could appear in mouse oocytes independently of the GV, that the mixing of GV material with the oocyte cytoplasm following GVBD had no effect on the activity of MPF in anucleate fragments, and that oocyte chromosomes or some components associated with them could play a significant role in maintaining the MPF activity. PMID- 3510919 TI - Characterization of binding and phosphorylation defects of erythrocyte insulin receptors in the type A syndrome of insulin resistance. AB - The type A syndrome of insulin resistance and acanthosis nigricans is characterized by severe insulin resistance due to a cellular defect in insulin action. To better understand the molecular nature of this defect, we have investigated insulin binding to circulating monocytes, erythrocytes, and the Triton X-100-solubilized erythrocyte receptor, and insulin-stimulated receptor autophosphorylation using cells and receptor from three type A patients. Insulin binding in both circulating cells and the soluble extract of erythrocytes indicated a heterogeneity of defects. Patients A1 and A2 both presented a major decrease in tracer insulin binding to intact cells and soluble insulin receptor. Determination of stoichiometric binding parameters using a cooperative model indicated that in patient A1 this was due to a reduction in the number of receptors, whereas in patient A2 the affinity constant for binding was decreased. Patient A3 presented near-normal insulin binding to erythrocytes and normal binding in intact monocytes, solubilized erythrocyte receptors, and cultured fibroblasts. Affinity labeling of erythrocyte receptor from this patient revealed a normal alpha-subunit and also a normal relative distribution of the higher molecular-weight, nonreduced oligomeric forms of the receptor. Receptor autophosphorylation was measured using the solubilized insulin receptor from erythrocytes. The maximal stimulated phosphorylation was reduced by 79%, 76%, and 52% in patients A1, A2, and A3, respectively, relative to the simultaneous control. In all three patients, the autophosphorylation was stimulated only 1.0 3.5 times the basal level compared with controls, in which the stimulation was 5.7-fold +/- 1.2 (mean +/- 1 SD, P less than 0.005). In addition, in patients A1 and A2 a decrease in basal phosphorylation was observed and in patient A2 there was a rightward shift of the dose-response curve for insulin stimulation. These data and the correlation of coupling of receptor phosphorylation with the fractional occupancy of the receptor measured in the same extract suggest that these patients exhibit three types of defects. In patient A1, there is a loss in receptor number manifested by a parallel decrease in insulin binding and receptor phosphorylation. In patient A2, there is an additional decrease in the affinity constant leading to a decrease in both binding and receptor phosphorylation with an almost linear coupling between receptor occupancy and receptor phosphorylation.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3510920 TI - Autoimmunity to insulin, beta cell dysfunction, and development of insulin dependent diabetes mellitus. AB - Circulating insulin autoantibodies (INSAAb) were measured in discordant monozygotic twins, first-degree relatives, and other groups at "high risk" for the development of insulin-dependent diabetes mellitus (IDDM), and these results correlated with both islet cell antibody (ICAb) status and beta cell function. INSAAb were positive in 31.6% (12 of 38) ICAb-positive subjects but in only 3.1% (3 of 97) ICAb-negative subjects (X2 = 22.4; P less than 0.001). Elevated levels of INSAAb tended to correlate with younger age and were observed in individuals irrespective of the prevailing degree of their beta cell function. Eight of 15 subjects detected to be INSAAb positive have thus far progressed to clinical IDDM (X2 = 18.3; P less than 0.001). Thus, autoantibodies reactive with the insulin molecule (1) appear to constitute an additional serologic marker of ongoing autoimmunity and development of IDDM, and (2) may reflect heterogeneity in the pathogenesis of IDDM. PMID- 3510921 TI - Functional characteristics of decreased insulin receptors on fibroblasts obtained from a subject with severe insulin resistance and acanthosis nigricans. AB - In a patient with severe insulin resistance and acanthosis nigricans, a decrease in the number of insulin receptors has been found on freshly isolated monocytes and cultured fibroblasts compatible with a primary or genetic decrease in cell surface insulin receptors. To determine the functional characteristics of the remaining receptors on these cells, insulin-stimulated glucose uptake, insulin internalization, and insulin-induced receptor loss were evaluated in monolayer fibroblasts obtained from this subject. Maximal insulin stimulation of 2 deoxyglucose was markedly blunted, compatible with abnormal insulin responsiveness due to a functional impairment of the remaining receptors. In the presence of chloroquine, the acanthotic subject's fibroblasts internalized more insulin per available receptor compared with the normal cell line, suggesting an accelerated rate of insulin internalization. When the rate of insulin internalization was more directly determined by assessing the rate of appearance of acid-resistant, cell-associated radioactivity at 37 degrees C, a similar increase in insulin internalization rate was evident. When downregulation was assessed, insulin's ability to induce receptor loss in the acanthotic subject's cell line was augmented. Thus, a primary or genetic decrease in insulin receptors on cultured fibroblasts from a patient with acanthosis nigricans and insulin resistance is associated with functional impairment of the remaining receptors leading to significant alterations in ligand processing and subsequent insulin action. PMID- 3510923 TI - Glucose utilization rates and insulin sensitivity in vivo in tissues of virgin and pregnant rats. AB - In vivo studies have shown that insulin resistance in late pregnancy results from a decreased sensitivity of liver and peripheral tissues. In the present study, measurements of the rates of glucose utilization by skeletal muscles (soleus, extensor digitorum longus, epitrochlearis, and diaphragm), white adipose tissue, and brain of virgin and 19-day pregnant rats were performed in the basal condition and during a euglycemic, hyperinsulinemic (400 microU/ml) clamp to quantify the partition of glucose utilization and to identify the tissues other than liver responsible for insulin resistance. Fetal and placental glucose utilization rates were also measured in pregnant rats. The fetal glucose utilization rate (22 mg/min/kg) was very high and was not stimulated by physiologic maternal hyperinsulinemia. By contrast, the placental glucose utilization rate (29 mg/min/kg) was increased by 30% during hyperinsulinemia. The glucose utilization rate of the conceptus represented 23% of the maternal glucose utilization rate in the basal state. Glucose utilization rates in the basal condition were not statistically altered by pregnancy in brain, skeletal muscles, and white adipose tissue. During hyperinsulinemia (400 microU/ml), glucose utilization rates in extensor digitorum longus, epitrochlearis, and white adipose tissue were 30-70% lower in pregnant than in virgin rats. Insulin sensitivity of glucose metabolism in all the tissues tested other than brain was 50% lower in pregnant than in virgin rats. We conclude that skeletal muscles and, to a smaller extent, adipose tissue are involved in the insulin resistance of late pregnancy. PMID- 3510922 TI - Metabolic consequences of very-low-calorie diet therapy in obese non-insulin dependent diabetic and nondiabetic subjects. AB - To determine the effects of very-low-calorie diets on the metabolic abnormalities of diabetes and obesity, we have studied 10 obese, non-insulin-dependent diabetic (NIDDM) and 5 obese, nondiabetic subjects for 36 days on a metabolic ward during consumption of a liquid diet of 300 kcal/day with 30 g of protein. Rapid improvement occurred in the glycemic indices of the diabetic subjects, with mean (+/- SEM) fasting plasma glucose falling from 291 +/- 21 to 95 +/- 6 mg/dl (P less than 0.001) and total glycosylated hemoglobin from 13.1 +/- 0.7% to 8.8 +/- 0.3% (P less than 0.001) (normal reference range 5.5-8.5%). Lipid elevations were normalized with plasma triglycerides reduced to less than 100 mg/dl and total plasma cholesterol to less than 150 mg/dl in both groups. Hormonal and substrate responses were also comparable between groups with reductions in insulin and triiodothyronine and moderate elevations in blood and urinary ketoacid levels without a corresponding rise in free fatty acids. Electrolyte balance for sodium, potassium, calcium, and phosphorus was initially negative but approached equilibrium by completion of the study. Magnesium, in contrast, remained in positive balance in both groups throughout. Total nitrogen loss varied widely among all subjects, ranging from 70 to 367 g, and showed a strong positive correlation with initial lean body mass (N = 0.83, P less than 0.001) and total weight loss (N = 0.87, P less than 0.001). The nondiabetic group, which had a significantly greater initial body weight and lean body mass than the diabetic group, also had a significantly greater weight loss of 450 +/- 31 g/day compared with 308 +/- 19 g/day (P less than 0.01) in the diabetic subjects. The composition of the weight lost at completion was similar in both groups and ranged from 21.6% to 31.3% water, 3.9% to 7.8% protein, and 60.9% to 74.5% fat. The contribution of both water and protein progressively decreased and fat increased, resulting in unchanged caloric requirements during the diet. This study demonstrates that short-term treatment with a very-low-calorie diet in both obese diabetic and nondiabetic subjects results in: safe and effective weight loss associated with the normalization of elevated glucose and lipid levels, a large individual variability in total nitrogen loss determined principally by the initial lean body mass, and progressive increments in the contribution of fat to weight loss with stable caloric requirements and no evidence of a hypometabolic response. PMID- 3510924 TI - Insulin sensitivity and exogenous insulin clearance in Graves' disease. Measurement by the glucose clamp technique and continuous indirect calorimetry. AB - Insulin sensitivity was measured in a group of seven thyrotoxic patients and in a group of seven normal subjects by means of the glucose clamp technique. Infusion of insulin at a rate of 0.80 +/- 0.05 mU/kg X min in the hyperthyroid patients and of 0.55 +/- 0.04 mU/kg X min in the control group was performed to obtain a steady-state plasma insulin concentration of approximately 50 microU/ml. Substrate oxidation rates were measured in the postabsorptive state and during the 2 h of the clamp by means of continuous indirect calorimetry. In the postabsorptive state, hyperthyroid patients presented a preferential oxidation of lipids. During the period 60-120 min of the clamp, mean plasma glucose (92 +/- 2 versus 93 +/- 2 mg/dl), insulin (50 +/- 5 versus 58 +/- 3 microU/ml), and total glucose metabolism (5.8 +/- 0.7 versus 6.1 +/- 0.3 mg/kg X min) were similar in the hyperthyroid patients and the control subjects. The rate of glucose oxidation was higher in hyperthyroid patients than in control subjects (4.3 +/- 0.5 versus 2.2 +/- 0.2 mg/kg X min, P less than 0.001), while that of lipid oxidation was similar in both groups (0.6 +/- 0.2 versus control 0.7 +/- 0.1 mg/kg X min). The calculated metabolic clearance rate of insulin was markedly higher in the hyperthyroid patients (1144 +/- 132 ml/min) than in the normal subjects (812 +/- 56 ml/min, P less than 0.025). It is concluded that insulin sensitivity is not altered in the thyrotoxic state. The major route of insulin-stimulated glucose disposal in the hyperthyroid patients appears to be glucose oxidation. PMID- 3510925 TI - T-lymphopenia and T-cell imbalance in diabetic db/db mice. AB - The diabetic db/db mice of the C57 BL/KsJ strain display anti-islet immunity, thymic dysfunction, and lymphopenia. In the present work, lymphocytes, T-cells, and T-cell subsets were enumerated in thymus and spleen from diabetic db/db mice and their db/ + heterozygote littermates from the 10th day to the 10th month of life. A significant lymphopenia was detected in thymus and spleen from the second month on, involving specifically the T-cell compartment, as assessed by use of a monoclonal anti-Thy1 antibody in indirect fluorescence. The study of T-cell subsets by monoclonal anti-Lyt1 and anti-Lyt2 antibodies revealed a significant increase in Lyt1+ cells and a decrease in Lyt2+ cells, with a corresponding increase of the Lyt1+/Lyt2+ ratio. These anomalies appeared early in life, and were apparently linked neither with the degree of hyperglycemia nor with weight loss or infection. The T-cell depletion in thymus was more pronounced in young male (less than 3 mo) than in young female db/db mice. These alterations may correspond to an increase in the helper/suppressor-cytotoxic ratio and could be linked with the thymic anomalies present in these mice, contributing to the development of anti-islet autoimmunity. PMID- 3510926 TI - Control of blood glucose levels in alloxan-diabetic rabbits by iontophoresis of insulin. AB - Cathodal iontophoresis was used to deliver insulin in 23 alloxan-diabetic, male, New Zealand white rabbits. Currents of 0.2-0.8 mA were used to deliver insulin from reservoirs containing insulin concentrations of 10-500 U/ml in aqueous solution. Regardless of the level of current used, within 1 h of turning the current on, blood glucose levels decreased and serum insulin concentrations increased. Moreover, in most cases, blood glucose levels continued to decrease and serum insulin concentrations continued to increase after the current was turned off, suggesting that iontophoresis could be used to accumulate insulin in the skin and subcutaneous tissues. The amount of insulin that was delivered by iontophoresis could be controlled by the level of current used up to 0.4 mA; increasing the current to 0.8 mA did not deliver more insulin. This may have been due to greater production of hydroxide ions at 0.8 mA, which competed with insulin to carry the current, thus slowing the movement of insulin. The amount of insulin delivered could also be controlled by the amount of insulin available for iontophoresis, i.e., as the insulin reservoir concentration increased, more insulin was delivered at the same current level. Finally, skin preparation was also important in controlling insulin delivery. To deliver enough insulin to reduce blood glucose levels, the stratum corneum had to be disrupted or removed by gentle scraping. PMID- 3510928 TI - Effects of D-glucose, L-leucine, and 2-ketoisocaproate on insulin mRNA levels in mouse pancreatic islets. AB - To elucidate a possible mechanism for regulation of insulin mRNA levels in the pancreatic B-cell, isolated mouse pancreatic islets were cultured in the presence of either glucose, leucine, or 2-ketoisocaproate, and insulin mRNA levels were compared with insulin biosynthesis, insulin release, and islet O2 uptake. It was observed that leucine or 2-ketoisocaproate was as effective as 20 mM glucose in supporting high insulin mRNA levels, high basal rates of insulin release or insulin synthesis, and rapid O2 uptake. Furthermore, islets cultured with either leucine or 2-ketoisocaproate could be stimulated to increase their insulin biosynthesis by a high glucose concentration. In addition the insulin release and respiration of such islets could be increased by exposure to 2-ketoisocaproate + glutamine. It is concluded that the maintenance of high concentrations of insulin mRNA levels and high rates of insulin biosynthesis and release are all processes correlated with metabolic fluxes in islets rather than the presence of the glucose molecule per se. PMID- 3510927 TI - Skeletal growth in fetal rats. Effects of glucose and amino acids. AB - The modified hyperglycemia-hyperinsulinism hypothesis, which characterizes intrauterine growth of diabetic pregnancy, was studied in fetal rats. From day 19 to day 21 postconception, pregnant rats were constantly infused with saline, amino acids, or glucose. In the fetus, serum somatomedin activity was determined, with the porcine bioassay and the incorporation of 3H-thymidine into rib cartilage and isolated chondrocytes in vivo in response to serum from normal maternal or fetal rats. In comparison with control fetuses, body weights were decreased in glucose-exposed fetuses (4.66 +/- 0.25 versus 3.75 +/- 0.99, N = 121; P less than 0.001), and increased (4.87 +/- 0.57, N = 105; P less than 0.05) in amino acid-exposed fetuses. Serum somatomedin activity (U/ml) was higher in glucose-treated (0.79 +/- 0.40, N = 11; P less than 0.05) and amino acid-treated animals (0.90 +/- 0.16, N = 10; P less than 0.001) than in controls (0.55 +/- 0.04, N = 13). In vivo labeling with thymidine resulted in a higher radioactivity of cartilage in small fetuses compared with large fetuses when the dams had been infused with saline (r = -0.531, N = 56; P less than 0.001) or amino acids (r = 0.292, N = 52; P less than 0.01). Opposite results were obtained in hyperglycemic animals (r = 0.542, N = 54; P less than 0.001). When isolated chondrocytes were incubated with serum from normal fetal rats, the incorporation of thymidine was about 10 times higher into cells from small fetuses than from large fetuses, irrespective of the infusion regimen.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3510929 TI - Direct identification of electrophysiologically monitored cells within intact mouse islets of Langerhans. AB - Cells found to be electrically active within microdissected mouse islets of Langerhans perifused with high (greater than or equal to 11.1 mM) glucose concentrations were labeled by injecting Lucifer yellow through the recording electrode. After fixation, these cells were located by fluorescence microscopy on sections serially cut throughout the islets and were subsequently identified by immunofluororescence staining with specific anti-islet hormone sera. Electrophysiologic control confirmed that the electrode tip had remained within the same cell throughout the experiment and showed that Lucifer yellow labeling did not affect the electrical activity of the impaled cell. Upon individual impalements, Lucifer yellow labeled either the impaled cell alone or this cell and some of its neighbors to which it was dye coupled. Immunofluorescence staining of the Lucifer yellow-labeled cells revealed that glucose-induced electrical activity was recorded from individual B-cells or groups of dye-coupled B-cells as well as from A-cells coupled to B-cells. PMID- 3510930 TI - Islet cell antibodies identify latent type I diabetes in patients aged 35-75 years at diagnosis. AB - One hundred fifty-four selected patients with nonketotic diabetes diagnosed between the ages of 35 and 75 yr and treated with diet or oral hypoglycemic agents for at least 1 yr were investigated for parameters of glycemic control (weight loss, blood glucose, and glycosylated hemoglobin), islet cell function (fasting and glucagon-stimulated C-peptide responses), and immunologic markers of insulitis (total ICA and CF-ICA) or autoimmunity (thyroid and gastric antibodies). These parameters were all repeated in 9 of 22 ICA-positive patients after a 2-yr follow-up and correlated with secondary drug failure. The antibody tests were also done on 51 nondiabetic controls matched for age and body weight. The 22 (14%) diabetic subjects having positive islet cell antibodies (ICA) included more women than men with a shorter duration of symptoms, lower body weight, more associated thyroid autoimmunity, and a tendency to have more type I diabetes in their families, although glycemic control, age at onset, and family history of type II diabetes were the same as in the 132 ICA-negative cases. Patients with ICA had lower initial C-peptide levels and showed little rise after glucagon stimulation. Beta cell function deteriorated significantly during the 2 yr follow-up in 9 of 22 positive patients and more ICA-positive patients required insulin. It is suggested that these latent type I diabetic patients are characterized by persistent ICA, progressive loss of beta cells, and a high frequency of thyrogastric autoimmunity. The determination of ICA may be of clinical value in the diagnosis and treatment of nonketotic diabetes with onset in later life. PMID- 3510931 TI - Quantitative autoradiographic evidence for insulin receptors in the choroid plexus of the rat brain. AB - Techniques of in vitro receptor autoradiography were used to visualize binding of 125I-insulin on slices of frozen rat brain. Slide-mounted sections of frozen rat brain were incubated in 0.05 nM porcine 125I-monoiodoinsulin, alone or mixed with 1 microM unlabeled porcine insulin, ribonuclease, or glucagon, for 2 h at 22 degrees C. The labeled brain slices were apposed to LKB Ultrofilm to generate autoradiograms. The method permitted equal access of labeled insulin to both sides of the blood-brain barrier and localization of insulin binding sites in small anatomic regions. Quantitative estimates of specific iodoinsulin binding were made by computer digital image densitometry of the autoradiographic film images. High concentrations of specific binding sites for iodoinsulin were present in the choroid plexus of the lateral (26.9 +/- 2.0 X 10(-3) fmol/mm2), fourth (18.3 +/- 3.0 X 10(-3) fmol/mm2), and third (13.2 +/- 1.5 X 10(-3) fmol/mm2) ventricles (insulin binding is expressed per unit area of autoradiographic image). Binding to the third ventricular choroid plexus was similar to the concentrations observed for liver slices and the external plexiform layer of the olfactory bulb. Specific binding of iodoinsulin in the cingulate cortex and other surrounding regions was less than in choroid plexus. Ribonuclease or glucagon had no measurable effect on binding when mixed with labeled insulin. The results support the hypothesis that the choroid plexus has a high density of receptors for insulin, and suggests that the choroid plexus may be a target of CSF insulin action and/or a site of insulin transport into the CSF. PMID- 3510932 TI - Ultrasound in acute pancreatic trauma. AB - The ultrasound findings are reviewed in 4 patients with surgically proven acute pancreatic trauma. Despite technically adequate sonograms, pancreatic injuries were not prospectively diagnosed in any of the patients. Computed tomography (CT) performed shortly after ultrasound demonstrated changes of traumatic pancreatitis in each case. Because of the subtlety of the ultrasound findings, CT appears to be the preferred method for evaluating suspected pancreatic trauma. PMID- 3510933 TI - Ultrasound in postoperative acalculous cholecystitis. AB - Eleven patients were examined by ultrasound before undergoing cholecystectomy (n = 9) or cholecystostomy (n = 2) for acalculous cholecystitis after abdominal surgery. The ultrasound images were analyzed retrospectively and compared with the surgical and histologic findings. The results indicate several established ultrasound criteria of cholecystitis to be less reliable than usual. Although 10 of 11 patients were on parenteral hyperalimentation, gross distention of the gallbladder was observed in only 3. In 4 of 7 patients, in whom pericholecystic fluid was observed, no gallbladder perforation was found at surgery. However, thickening of the gallbladder wall was displayed in 10 of 11 cases, combined with a sonolucent intramural layer in 6. Furthermore, intraluminal nonshadowing echogenic densities correlated with empyema or hemorrhage in 5 of 8 cases. In conclusion, despite several limitations, ultrasound can be of considerable help when one is deciding to perform repeat laparotomy when acalculous cholecystitis is suspected. PMID- 3510934 TI - Clinical significance of focal echogenic liver lesions. AB - During a 4-year period, 53 focal echogenic liver lesions were demonstrated by sonography in 41 patients, in whom there was no evidence of metastatic origin. Most of the lesions were hemangiomas. One of the purposes of this study was to determine the characteristic ultrasound features for liver hemangioma. Small (less than 2 cm), homogeneous, echogenic, well-circumscribed, subcapsular lesions almost prove their hemangiomatous nature. Lesions with a diameter of more than 2 cm are usually more lobulated and heterogeneous. They are located more centrally in the liver and nearly all show a close anatomical relation with 1 of the hepatic veins. Very large lesions (greater than 5 cm) with a heterogeneous and irregular aspect suggest focal nodular hyperplasia, which must be proven by a Tc isotopic liver scan. PMID- 3510935 TI - Ultrasonically guided percutaneous transhepatic transcholecystocholangiography in the nondilated biliary tree. AB - Five patients with CT or ultrasound-proven nondilated intrahepatic biliary radicles underwent ultrasound-guided percutaneous transhepatic transcholecystocholangiography (PTHTCC) for visualization of the biliary tree following failed endoscopic retrograde cholangiography. In no instance were more than 2 passes of a 22-gauge needle necessary to enter the gallbladder. Visualization of the biliary tree was excellent in all cases, and there were no complications. Therefore, PTHTCC is a safe and reliable method of visualizing the nondilated biliary tree. PMID- 3510936 TI - Demonstration of cavernomatous transformation of the portal vein by magnetic resonance imaging. AB - A case of cavernomatous transformation of the portal vein demonstrated by magnetic resonance (MR) imaging is reported. Correlative images on scintigraphy and ultrasound are included. As in other vascular abnormalities, MR imaging is capable of depicting the findings noninvasively. PMID- 3510937 TI - Rectal histology in acute bacillary dysentery. AB - A recent epidemic of acute Shigella dysentery in West Bengal (India) provided us with an opportunity to examine the rectal mucosal abnormalities seen in this condition. One hundred two patients were investigated using sigmoidoscopy, rectal biopsy, and rectal swab for culture. Pure culture of Shigella was obtained in 37 cases, and the rectal biopsy specimens from these patients were assessed in detail. The mean (+/- SD) duration of illness was 47.8 +/- 27.4 h (range 8-120 h), and most patients (31 of 37, 84%) had diarrhea with blood and mucus in the stools. Significant findings at histology were as follows. (a) Cellular infiltrate was predominantly round cell or mixed round cell and neutrophilic in the majority of patients (27, 73%). (b) Disorganization of crypts was seen in as many as 31 patients (84%); in most subjects the distorted architecture was mild, but in a few the defect was severe with crypt branching and dilatation. (c) In the majority of patients the inflammatory process extended to the muscularis mucosae and submucosa; edema with or without increased cellular infiltrate was seen in the muscularis mucosae in 92% and in the submucosa in 80%. (d) There was no difference in the rectal histology of patients with a short history of disease (less than 48 h) compared with those with a longer history, except for goblet cell depletion which was more in those with diarrhea for more than 48 h. (e) The mucosal abnormalities in patients with watery diarrhea were, in general, milder than in those with dysentery, although the difference was statistically not significant; 2 of 6 patients with watery diarrhea had severe colitis. (f) The mucosal abnormalities were more severe in patients with Shigella dysenteriae infection compared with Shigella flexneri. PMID- 3510938 TI - Increased synthesis of systemic prostacyclin in cirrhotic patients. AB - Urinary excretion of two prostacyclin metabolites was investigated in 48 subjects: 8 controls and 40 cirrhotics (9 without ascites, 22 with ascites and preserved renal function, and 9 with functional renal failure). Urinary 6-keto prostaglandin F1 alpha (6-keto-PGF1 alpha), believed to reflect renal prostacyclin production, was significantly increased in patients without ascites and in ascitic patients with preserved renal function, but cirrhotics with renal failure showed rates similar to controls. Excretion of 2,3-dinor-6-keto-PGF1 alpha (PGI-M), the major urinary metabolite of systemic prostacyclin, was increased in all groups of patients, including those with renal failure. A single dose of sulindac, a renal-sparing prostaglandin synthesis inhibitor, reduced PGI M but not 6-keto-PGF1 alpha in 5 cirrhotic patients. This would be consistent with the predicted renal origin of the latter and the systemic origin of the former. Ascitic patients with high urinary excretion of PGI-M (above the median value) showed significantly lower mean arterial pressure and higher plasma renin activity and aldosterone than patients with excretion below the median. Urinary 6 keto-PGF1 alpha was higher in patients with low PGI-M. Finally, creatinine clearance corrected excretion of PGI-M, as an estimation of relative plasma levels correlates both with plasma renin activity and plasma aldosterone in the 31 subjects who presented with ascites. It is suggested that enhanced synthesis of systemic prostacyclin may influence hemodynamic changes in patients with liver cirrhosis. Overproduction of systemic prostacyclin in the absence of increased renal prostacyclin synthesis appears to be characteristic of patients with functional renal failure. PMID- 3510939 TI - Intrahepatic versus extrahepatic cholestasis. Discrimination with biliary scintigraphy combined with ultrasound. AB - Biliary scintigraphy and ultrasound imaging were performed in 52 patients with suspected biliary tract pathology. Results were correlated with the findings of direct cholangiography. Several new innovations in scintigraphic technique were used. The combination of ultrasound imaging and scintigraphy correctly identified biliary tract obstruction in 17 of 19 patients, 12 of whom had dilated bile ducts on ultrasonography. Intrahepatic cholestasis was correctly diagnosed in 11 of 13 patients. Accurate discrimination between intrahepatic and extrahepatic cholestasis was achieved in 28 of 32 patients (88%) with the combined studies. Scintigraphy also provided a correct diagnosis of acute cholecystitis in all 9 patients with surgically confirmed disease. Eleven additional patients with gallbladder or pancreatic disease had normal bile ducts at scintigraphy, which was confirmed with cholangiography. When combined with ultrasound imaging, modern biliary scintigraphy can (a) provide excellent discrimination between intrahepatic and extrahepatic cholestasis and (b) help determine the need for subsequent invasive diagnostic studies in selected patients. PMID- 3510940 TI - Intestinal and hepatic complications of human bone marrow transplantation. Part II. PMID- 3510941 TI - Royal Alexander Brink (1897-1984). PMID- 3510942 TI - A two-locus neutrality test: applications to humans, E. coli and lodgepole pine. AB - The expected disequilibrium between two loci with k alleles at one locus and l alleles at the other is given for a sample of size n drawn from a population under neutrality equilibrium. Three different measures of disequilibrium with 95% intervals are tabulated for combinations of n, k, l and 4Nc, where N is the effective population size and c is the amount of recombination between the loci. The extent and pattern of disequilibrium are strongly dependent upon 4Nc and are somewhat dependent on n, k and l. The 95% intervals are large, particularly for low numbers of alleles and low values of 4Nc. As examples, observed disequilibrium from histocompatibility loci in humans (HLA) and electrophoretic data in E. coli and lodgepole pine were compared to these theoretical values. Using information about recombination rates, the HLA data showed more disequilibrium than neutrality expectations, whereas electrophoretic data from E. coli and lodgepole pine had somewhat less disequilibrium than neutrality expectations. PMID- 3510943 TI - Psychosocial adjustment after renal retransplants. AB - Twenty-four patients who underwent more than one kidney transplant were interviewed to assess their psychosocial adaptation. Of these 24, we found 15 patients with a functioning kidney and 9 patients with a nonfunctioning transplant who were back on hemodialysis. In both groups, approximately 50% of the patients had life satisfaction ratings of "good" and "very good." The groups differed in two respects. Those with a functioning kidney had a higher employment rate and a better sexual functioning than the group on dialysis. We found many similarities in all other scored parameters (optimism, object relationships, coping devices, psychologic functioning). Denial was commonly used by most of the patients, but the group of patients who scored "good" and "very good" on life satisfaction more frequently utilized other coping devices, such as altruism, "feeling chosen," inner control, and activity than patients with "fair" or "poor" life satisfaction. PMID- 3510944 TI - Chemotherapy of advanced ovarian adenocarcinoma: a randomized comparison of combination versus sequential therapy using chlorambucil and cisplatin. AB - Three hundred and sixty-nine patients with advanced ovarian adenocarcinoma were treated in a prospective randomized trial comparing combination versus sequential therapy with chlorambucil and cisplatin. Initial tumor response rates were similar but combination chemotherapy was associated with significantly prolonged time to first disease progression (median 28 weeks for chlorambucil and 42 weeks for combination chemotherapy). Second-line treatment with cisplatin in patients failing initial chlorambucil caused tumor response in 16.9%. Overall time to ultimate disease progression was similar between the treatment groups. The surgically documented complete response rate (second-look surgery at approximately equal to 12 months) and the survival was similar in the two treatment arms. Multivariate analysis of prognostic factors for survival in this trial showed that bulk of residual disease at time of starting therapy and the development of myelosuppression during therapy were the most important. PMID- 3510945 TI - A pilot study of high dose abdominopelvic radiotherapy following surgery and chemotherapy for stage III epithelial carcinoma of the ovary. AB - Ten patients with FIGO stage III carcinoma of the ovary received abdominopelvic radiotherapy using the abdominal bath technique in combination with surgery and intravenous cyclophosphamide and cis-platinum. The mean midplane dose to the abdominal cavity was 3120 cGy which is significantly higher than other series. Despite this high dose, there was no serious morbidity from radiation hepatitis, enteritis, and nephritis, and the treatment was tolerable. The actuarial survival of the group at 37 months was 30%. PMID- 3510946 TI - Potentiation of radiotherapy by cis-dichlorodiammine platinum (II) in advanced cervical carcinoma. AB - Forty-five patients with Stages II and III cervical carcinoma were randomized to receive either radiation or cis-dichlorodiammine platinum (II) (cis-DPP) with radiation. Cis-DPP was administered in bolus injections of 25 mg/m2 at weekly intervals until completion of radium application. Complete response was noted in 11/20 (55%) patients in the radiochemotherapy group compared to 5/25 (20%) patients in the radiation group (P less than 0.025). No enhanced toxicities were observed with the addition of cis-DPP to radiation. The combined use of cis-DPP and radiotherapy offers promising potential in improving local-regional control of advanced cervical carcinoma. PMID- 3510947 TI - Terlipressin in bleeding esophageal varices: a placebo-controlled, double-blind study. AB - The effect of terlipressin (N-alpha-triglycyl-8-lysine-vasopressin) in bleeding esophageal varices was evaluated in a prospective placebo-controlled study. Fifty bleeding episodes from esophageal varices in 34 patients were randomized. Standard therapy with transfusions, fluid and electrolyte correction, and lactulose was performed in both groups. Balloon tamponade was used in 20 bleeding episodes in the terlipressin group and in 19 bleeding episodes in the control group. In the terlipressin group, hemorrhage was controlled in all bleeding episodes (25/25) whereas in the placebo group, only 20 of 25 bleeding episodes could be stopped within 36 hr (p less than 0.05). Sclerotherapy was performed in five bleeding episodes in the terlipressin group and in seven bleeding episodes in the placebo group. Treatment failures, including patients who required sclerotherapy, occurred in five bleedings in the terlipressin group and in 12 in the control group (p less than 0.05). The hospital mortality rate was 12% (3/25) in the terlipressin group and 32% (8/25) in the control group. Patients in the terlipressin group required fewer transfusions, the balloon needed to be inflated for a shorter time and the duration of bleeding was shorter than in the control group. However, these differences were not significant. These data do not allow conclusions concerning monotherapy with terlipressin, but they indicate that the addition of terlipressin to standard therapy may increase the control rate in acute variceal hemorrhage. PMID- 3510948 TI - Gonadal consequences of alcohol abuse: lessons from the liver. PMID- 3510949 TI - Vasopressin analogs in portal hypertension: different molecules but similar questions. PMID- 3510950 TI - Expression of beta 2-microglobulin on hepatocytes in acute and chronic type B hepatitis. AB - beta 2-Microglobulin display was examined in 131 liver biopsies from patients with acute and chronic type B hepatitis, using an indirect immunoperoxidase method. Enhanced expression of beta 2-microglobulin on hepatocyte membranes was observed in patients with acute hepatitis, chronic active hepatitis with moderate to severe activity and cirrhosis, when compared with normal liver. In acute hepatitis, beta 2-microglobulin-positive hepatocytes were mainly observed in perivenular areas in association with bridging necrosis. In chronic hepatitis, beta 2-microglobulin-positive hepatocytes were observed mainly in periportal zones and in some areas of lobular activity. Diffuse-enhanced display of beta 2 microglobulin on hepatocytes was observed in 5 of 6 patients treated with lymphoblastoid interferon as part of a trial of antiviral therapy. The mechanism by which beta 2-microglobulin display is enhanced on hepatocytes in patients not treated with interferon is uncertain. However, display of beta 2-microglobulin on hepatocytes probably reflects display of HLA-A, B and C antigens and may influence the course of hepatitis B virus infection by increasing susceptibility of the affected cells to T cell-mediated immune attack. PMID- 3510951 TI - Liver biopsy immunotyping to characterize lymphoid malignancies. AB - To determine the feasibility of liver biopsy immunotyping to characterize hepatic lymphoid malignancies, we employed a panel of monoclonal antibodies on snap frozen hepatic tissue from 18 patients. Six patients proved to have a histologic diagnosis of lymphoid malignancy. By using free avidin and biotin-blocking reagents to block endogenous biotin, followed by standard immunochemistry, immunotyping was successful in all six cases. Serial section typing allowed delineation of complex B cell phenotypes. Furthermore, architecture was preserved allowing discernment of disease patterns (e.g., sinusoidal, hairy cell leukemia vs. portal, follicular small-cleaved cell lymphoma. Unexpectedly, we found striking expression of common ALL antigen in normal bile canaliculi, which may prove of diagnostic or therapeutic relevance. This study establishes the utility of immunohistochemical techniques applied to hepatic biopsies as a valuable adjunct to histologic diagnosis as well as a tool in revealing the immunobiology of the liver. PMID- 3510953 TI - A review of biofeedback for mental disorders. AB - Although biofeedback was developed by psychologists, it has been most widely used in the treatment of psychophysiological and medical disorders and less frequently used to control symptoms of psychopathology and mental disorders. The authors review studies in which biofeedback was used in the treatment of patients with schizophrenia, depression, anxiety disorders, insomnia, alcohol and drug dependence, and tardive dyskinesia. The studies indicate that biofeedback can help selected patients modify specific responses or response patterns associated with a mental disorder. It appears to be most suitable for patients and disorders in which physiological processes can be identified as relevant. However, the findings offer little support for biofeedback as the treatment of choice for any mental disorder. PMID- 3510952 TI - A comparative study of the effects of insulin/glucagon infusions, parenteral amino acids and high dose corticosteroids on survival in a rabbit model of acute fulminant hepatitis. AB - Acute fulminant hepatitis was induced in 55 healthy adult male rabbits with the potent hepatotoxin galactosamine hydrochloride (3.75 mmoles per kg i.v.). Control rabbits (n = 27) were divided into three groups: Group I (n = 10) underwent sham surgery for placement of an indwelling central venous catheter; Group II (n = 9) received 5% dextrose and water via an indwelling central venous catheter, and Group III (n = 8) received daily intramuscular injections of 0.9% sodium chloride. Treated rabbits (n = 28) also consisted of three groups: Group IV (n = 9) received 12-hr intravenous infusions of insulin (0.029 units per kg per hr) and glucagon (2.86 micrograms per kg per hr) daily; Group V (n = 10) received a continuous infusion of parenteral amino acids (Travasol), and Group VI (n = 9) received daily intramuscular methylprednisolone (0.69 mg per kg). In each case, treatment was initiated 16 hr following galactosamine injection. Serum aminotransferase activity was determined on Days 0, 1, 4 and 10 of the 10-day study. Liver histology was obtained immediately after death and graded under code on a scale of 1 to 4 for severity of hepatitis. Rabbits surviving 10 days were sacrificed on Day 10 for histologic examination. The extent of galactosamine induced hepatic injury was similar in all six groups as manifest by peak mean SGPT (range: 2,662 to 3,568 IU per liter), SGOT (range: 4,435 to 5,625 IU per liter) levels and hepatic histologic findings. The overall survival rate in controls was 6/27 (22%); in insulin/glucagon-treated animals 2/9 (22%), and in the amino acid-treated group 2/10 (20%).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3510954 TI - The epidemiology of mental illness in Afro-Americans. AB - The epidemiologic study of mental illness among Afro-Americans has progressed since the antebellum period when the rate of mental illness among free Afro Americans living in the North was inflated to justify continued slavery. Community-wide surveys conducted after World War II demonstrated that when socioeconomic variables were controlled, the rate of mental illness among Afro Americans was no higher than that of other groups. The rates of mental illness and substance abuse of Afro-Americans vary according to socioeconomic class and are also related to differential family structure, early performance in school, and antisocial behavior of fathers. Despite progress, undersampling of middle class Afro-Americans and poor, unemployed, young, urban Afro-American males are consistent deficiencies of surveys that even the ambitious NIMH Epidemiologic Catchment Area Program seems to share. PMID- 3510955 TI - Posttraumatic stress disorder among black Vietnam veterans. AB - Because of racism in the military and racial and social upheaval in the United States during the Vietnam War years, as well as limited opportunities for blacks in the postwar period, black veterans of the Vietnam War often harbor conflicting feelings about their wartime experiences and have difficulty rationalizing brutality against the Vietnamese. As a result, black veterans suffer from posttraumatic stress disorder (PTSD) at a higher rate than white veterans. Diagnosis and treatment of PTSD in black veterans is complicated by the tendency to misdiagnose black patients, by the varied manifestations of PTSD, and by patients' frequent alcohol and drug abuse and medical, legal, personality, and vocational problems. The author presents his and others' recommendations about ways to treat black veterans with PTSD. PMID- 3510956 TI - Problems in diagnosing schizophrenia and affective disorders among blacks. AB - In this country schizophrenia has been consistently overdiagnosed and affective disorders underdiagnosed, particularly among blacks and lower socioeconomic groups. The general causes of such misdiagnoses include overreliance on the classic thought disorder symptoms as pathognomonic of schizophrenia and, for affective disorders, lack of clearly defined boundaries between normal and abnormal mood and failure to realize that patients with affective illness can manifest cognitive symptoms. In addition to the above factors, misdiagnosis among blacks results from such factors as cultural differences in language and mannerisms, difficulties in relating between black patients and white therapists, and the myth that blacks rarely suffer from affective disorders. Clinicians and researchers must pay more attention to the effects of cultural differences on diagnosis, and baseline behaviors and symptomatology for blacks must be established. PMID- 3510957 TI - Development of self-concept in Afro-American children. AB - Studies of self-concept in Afro-American children differ in their findings according to whether the research was conducted before or after the civil rights movement of the 1960s. While the earlier studies reported that the Afro-Americans had lower self-esteem than Caucasians, studies conducted after the height of the civil rights movement do not support that finding. The development of self concept in Afro-American children is influenced by the strengths and weaknesses of the family, extended family, or community; individual perceptions of untoward events or environments; and the ability to devise mechanisms to ward off threats to self-esteem. The author stresses that those who study self-esteem among Afro Americans should examine developmental processes within the individual's social context and reference groups rather than from the perspective of the dominant group. PMID- 3510958 TI - HMOs: a shake-up (and shakeout) on the horizon? PMID- 3510959 TI - Quayle spurs capital payment reform. Interview by Michael Lesparre. PMID- 3510960 TI - Medicaid changes may not be all bad for hospitals. PMID- 3510961 TI - List of high-share hospitals a shock. PMID- 3510962 TI - Planning must refocus on the medical staff. Interview by Frank Sabatino. PMID- 3510963 TI - Primary B-cell gastric lymphoma. AB - A detailed clinicopathologic and immunocytochemical study was performed in 12 cases of primary gastric lymphoma in which fresh tissue was available for study. The patients ranged in age from 18 to 76 years; persistent epigastric symptoms had led to endoscopy (often on multiple occasions) and biopsy in each case. The endoscopic appearances rarely suggested malignancy. The histologic appearances of the gastrectomy specimens covered a spectrum, from changes normally considered characteristic of "pseudolymphoma" to those of florid malignant lymphoma, with evidence of extragastric spread in four cases. Formation of follicular centers characterized each case, and diffuse interfollicular infiltrates of centrocyte like cells were also present. Plasma cells were also consistently present. Immunocytochemical studies showed the same light chain restriction of follicular center cells and centrocyte-like cells in all cases and of plasma cells in five cases. Follicular center cells and centrocyte-like cells were otherwise phenotypically distinct. This study yielded criteria for the objective diagnosis of gastric B-cell lymphoma in biopsy and resection specimens; the results suggest that the term pseudolymphoma should no longer be used. PMID- 3510964 TI - Extraosseous osteosarcoma presenting with intestinal hemorrhage: case report and literature review. AB - A 23-year-old man presented with intestinal bleeding due to an extraosseous osteosarcoma of the jejunum. A lesion was also found in the deltoid muscle, and other metachronous soft tissue sites developed subsequently. The presence of malignant osteoid was documented by immunohistochemical studies of one of the lesions. The patient died of metastatic disease 19 months after diagnosis, despite surgical resections and adjuvant chemotherapy. This unique presentation is discussed, and the literature concerning extraosseous osteosarcoma is reviewed. PMID- 3510965 TI - MURCS association with additional congenital anomalies. AB - The postmortem findings in a patient with the MURCS association (mullerian duct aplasia/hypoplasia, renal agenesis or ectopy, and cervicothoracic somite dysplasia) are reported. This is the first autopsy study since the syndrome was recognized. The autopsy revealed abnormalities of the venous, pulmonary, and central nervous systems that had not been reported previously in patients with this syndrome. A review of the literature suggested that although the MURCS association usually occurs sporadically, as in this case, a familial association is occasionally present. In some cases the MURCS association may be a genetically determined pleiotropic condition. PMID- 3510967 TI - Immune response mediated by liposome-associated protein antigens. IV. Modulation of antibody formation by vesicle-encapsulated methotrexate. AB - Large unilamellar reverse-phase evaporation vesicles (REV) were used as a heterobifunctional carrier for a pharmacologically active agent and a protein antigen. Methotrexate (MTX) was encapsulated in the hydrophilic compartment of liposomal REV with or without surface-conjugated bovine serum albumin (BSA) antigen. The administration of MTX encapsulated within BSA-coated vesicles (MTX.REV-BSA) could either enhance or depress the anti-BSA plaque-forming cell (PFC) response in mice. On the other hand, the administration of MTX entrapped in plain vesicles (MTX.REV) produced essentially a suppressive effect on the PFC response stimulated by the simultaneous injection of a separate antigen, e.g. vesicle-conjugated BSA (REV-BSA). This suppression of the antibody response occurred, whether MTX.REV was injected 1 day before, during, or 1 day after the immunization with an antigen. These results indicate that liposome-encapsulation of a very limited drug dose can modify the immunobiological effect of the drug which, when presented in its free form at the same dose, exerts no appreciable action on the engendered immune response. Thus, the modulation of the immune response by a liposome-encapsulated drug appears to be influenced by the drug dose can modify the immunobiological effect of the drug which, when presented in its free form. PMID- 3510966 TI - Identification of trophoblast in chorionic villi biopsy samples. AB - We have investigated a test for rapid discrimination between foetal and maternal origin of chorionic villi biopsy samples. A monoclonal antibody named H315 reacting against a specific antigen present on the surface of foetal trophoblastic cells, plus a double-colour staining technique (FITC + PI), have been used for the identification of foetal cells (H315-positive) and for visualization of nucleate (PI-positive) and anucleate (PI-negative) structures of chorionic villi. This test could be useful in differentiating foetal and maternal cells in chorionic villi biopsy samples currently used for prenatal diagnostic purposes. PMID- 3510968 TI - Ontogenic development of T and B cells and non-lymphoid cells in the white pulp of human spleen. AB - The ontogenic development of lymphoid and non-lymphoid cells in human splenic white pulp was studied histologically with immunoperoxidase technique, together with that of lymphoid cells from fetal liver, bone marrow and thymus by membrane immunofluorescence assay. The primitive white pulp, which appeared as small accumulations of lymphocytes around arterioles at 14 weeks of gestation (g.w.), was mainly composed of B1 antigen-positive B cells. After the appearance of follicular structure accompanied by follicular dendritic cells (FDC) stained with anti-DRC1 antibody at 26 g.w., these perivascular structures of B cells were located in the periphery of the white pulp areas. A large number of B cells composing the perivascular structure had surface IgM (sIgM) and IgD (sIgD) from the earliest stage (14 g.w.), although this type of B cell with mature phenotype was seldom observed in fetal liver or bone marrow at this stage. It was suggested that the spleen is an important site for B-cell maturation from sIg-negative B cells observed in 10-14 g.w. fetal liver, and that FDC are not involved in this development of B cells. The organization of 9.6 antigen-positive T cells around arterioles developed 4 weeks later than that of B cells, at 18 g.w., although 11 g.w. fetal thymocytes already showed a phenotype very similar to that of infants. Interdigitating reticulum cells (IDC) stained with anti-S-100 protein serum appeared from 14 g.w. before the T-cell organization, suggesting that IDC may play an essential role in the homing of T cells. PMID- 3510969 TI - Germinal centre formation and follicular antigen trapping in the spleen of lethally X-irradiated and reconstituted rats. AB - In this study, the relationship between germinal centre formation and the follicular trapping of immune complexes in the rat spleen was investigated. Lethally (9 Gy) X-irradiated rats were reconstituted with thoracic duct lymphocytes and subsequently challenged with sheep red blood cells to induce germinal centre formation. Rats were killed at daily intervals from 1 to 8 days after reconstitution and antigenic stimulation. Antigen trapping capacity during this interval was assessed by intravenous injection of HRP-anti-HRP immune complexes, 24 hr before killing of the animals. Germinal centre formation could be observed from Day 4 onwards. The follicular trapping capacity, which had been abolished by the X-irradiation, however, returned 2 days later (i.e. by Day 6). Apparently, in these experiments, early germinal centre formation could occur without an intact follicular trapping mechanism. It was, therefore, concluded that in this transfer system follicular immune complex trapping is not a prerequisite for the induction of de novo germinal centre formation. Previous studies have shown that both follicular dendritic cells and marginal zone B cells may play a role in the follicular antigen trapping mechanism. FDCs, as detectable with mAB MRC OX 2 in immunoperoxidase-stained frozen sections, were present in spleens at any time after irradiation and reconstitution; the impaired follicular trapping of HRP-anti-HRP immune complexes was therefore not due to an absence of FDCs. Marginal zone B cells, however, were almost absent until 5 days after reconstitution, as observed by immunohistochemical staining with anti-B cell mABs (HIS 14 and HIS 22) and a polyclonal anti-IgD antiserum. Our data suggest that regeneration of follicular antigen trapping capacity is dependent on the presence of marginal zone B cells. PMID- 3510970 TI - The role of H-2 and non-H-2 antigens and genes in the rejection of murine cardiac allografts. AB - Genes of the major histocompatibility complex (MHC) in the mouse (H-2 complex) have been shown to be an important factor in determining the immune responsiveness of various strains of mice to isolated antigens (e.g., lysozyme). The role of MHC genes in controlling the responsiveness of mice to multiple alloantigens is less well-defined, and although non-MHC genes have been shown to be important in determining responsiveness in some systems (e.g., haptens), they have not been demonstrated as yet to influence the rejection of vascularized organ allografts. In this study, the responsiveness of mice to vascularized cardiac allografts transplanted across well-defined major (H-2) and minor (non-H 2) histocompatibility barriers was investigated using congenic mice in 32 different donor/recipient combinations. The results show that both H-2 and non H 2 gene products can act as target alloantigens for rejection. At the responder level, they may interact to effect responsiveness of a recipient strain to multiple alloantigens. In no case in this study has any one gene or group of genes been found to confer universal high or low responder status. PMID- 3510971 TI - A murine cell line defective in expression of several class I molecules. PMID- 3510972 TI - 111Indium leukocyte scanning: is it a useful clinical tool? PMID- 3510973 TI - Effect of dietary chloride on salt-sensitive and renin-dependent hypertension. AB - We have previously reported that 1) selective dietary sodium loading (without chloride) does not produce hypertension in rats of the Dahl salt-sensitive strain (DS) and 2) selective chloride loading (without sodium) lowers plasma renin activity in the intact Sprague-Dawley rat maintained on a low NaCl diet. The present study examined the effect of selective dietary chloride loading on two models of hypertension: the DS and the renin-dependent one-kidney, one clip Sprague-Dawley rat. The DS were pair-fed (n = 7/group) a "normal" NaCl, a high NaCl (4%), or a "normal" sodium-high chloride diet for 11 weeks. From Week 7 until the end of the experiment, the high NaCl-fed animals had higher (p less than or equal to 0.05) blood pressures than animals fed either the normal NaCl or normal sodium-high chloride diet, which were not different from each other. Thus, in the DS, hypertension depends on high dietary intakes of both sodium and chloride. In one-kidney, one clip hypertensive rats, selective chloride loading failed to lower plasma renin activity (9 +/- 1 vs 7 +/- 1 ng angiotensin I/ml/hr) or to prevent hypertension (160 +/- 10 vs 166 +/- 9 mm Hg). Thus, selective dietary chloride loading (without sodium) does not alter blood pressure in either salt-sensitive or renin-dependent hypertension. PMID- 3510974 TI - New insights into the medical management of primary aldosteronism. PMID- 3510975 TI - Lithium infusion to study sodium handling in unanesthetized hypertensive rats. AB - To investigate renal tubular handling of sodium in various types of experimental hypertension, sodium, lithium, and inulin clearances were measured simultaneously in unanesthetized rats. Fractional excretion of lithium was used as an index of proximal sodium reabsorption. Eight groups of animals, all of the Wistar-Kyoto strain, were studied. Three were hypertensive: spontaneously hypertensive rats (SHR), rats with two-kidney, one clip renal hypertension, and uninephrectomized rats with deoxycorticosterone-salt hypertension. The five normotensive control groups included animals given normal, low, or high dietary sodium loads and rats with reduced renal mass. Fractional excretion of lithium was not influenced by moderate changes of glomerular filtration rate, but was sharply enhanced by sodium loading. Increased blood pressure was associated with enhanced urinary sodium excretion in uninephrectomized deoxycorticosterone-salt hypertensive and two-kidney, one clip hypertensive rats, as a result of decreased distal tubular reabsorption ("pressure natriuresis"). In contrast, SHR showed reduced sodium excretion and decreased fractional excretion of lithium, which suggests that increased sodium reabsorption in the proximal tubule may contribute significantly to the maintenance of hypertension. PMID- 3510976 TI - Multiplication of Shigella flexneri within HeLa cells: lysis of the phagocytic vacuole and plasmid-mediated contact hemolysis. AB - Virulent strains of Shigella flexneri invade HeLa cells with high efficiency. This crucial step in the pathogenic process is encoded by a 140-megadalton plasmid which induces phagocytosis of the bacteria by host cells. In this report we used pWR100, the virulence plasmid of S. flexneri serotype 5, and pHS4108, a 32-megadalton subclone of pWR100, to demonstrate that the plasmid is also responsible for rapid intracellular growth of the bacteria. The ability to replicate intracellularly was not correlated with induction of Shiga toxin. However, plasmid-mediated intracellular multiplication was strongly correlated with the ability of the bacteria to rapidly and efficiently lyse the phagocytic vacuole and replicate freely in the cytoplasm. Temperature-regulated plasmid mediated contact hemolytic activity strongly correlated with both phagosomal membrane lysis and efficient intracellular multiplication. We propose this virulence plasmid-associated hemolysin to be an important factor in the invasion and proliferation of Shigella spp. in mammalian cells. PMID- 3510977 TI - Molecular cloning of a genetic determinant for Congo red binding ability which is essential for the virulence of Shigella flexneri. AB - A DNA sequence of about 1.0 kilobase (kb) derived from a 230-kb (140-megadalton) plasmid in a fully virulent Shigella flexneri 2a strain, YSH6000, was cloned into Escherichia coli K-12 by selecting for the ability to bind Congo red (Pcr+ phenotype). It was mapped and localized within the SalI restriction fragment F on the plasmid. This clone converted an S. flexneri strain which is avirulent as a result of a small deletion in the plasmid to full virulence but did not convert those without the 230-kb plasmid or with a plasmid bearing a more extensive deletion. This indicates that there are more than two virulence determinants on the plasmid. Thus, this sequence contains a genetic determinant which is essential but not sufficient for full virulence and expression of the Pcr+ phenotype in S. flexneri but is essential and sufficient for expression of the Pcr+ phenotype in E. coli K-12. We noted that there exist some other regions on the 230-kb plasmid which express the Pcr+ phenotype in E. coli K-12. Although these regions express the Pcr+ phenotype less markedly than the region cloned in the present study, they do hybridize with it. PMID- 3510978 TI - Enhanced recovery of murine alveolar macrophages: morphological and functional characteristics following intravenous injection of heat-killed Mycobacterium bovis BCG. AB - The kinetics of induction of the bronchoalveolar cell population (i.e., alveolar macrophages [AM], lymphocytes, and polymorphonuclear leukocytes) was studied in mice inoculated intravenously with heat-killed Mycobacterium bovis BCG. Injection of BCG at 100 and 500 micrograms but not at 10 micrograms per mouse resulted in an increase in the total number of bronchoalveolar cells (threefold) and in the number of AM (sixfold) recovered by bronchoalveolar lavage in a time-dependent manner, as compared with control mice. A significant increase in the number of lymphocytes was also observed between days 2 and 4 after injection, but this number returned to normal levels by day 8, whereas the number of polymorphonuclear leukocytes was not significantly altered. AM were characteristically phagocytic and stained positively for nonspecific esterase. AM recruited in response to BCG injection were activated, as indicated by elevated levels of acid phosphatase activity and decreased levels of membrane 5' nucleotidase activity. However, both resident and BCG-induced AM suppressed the in vitro plaque-forming cell response of sheep erythrocyte-primed mice to the same extent. These results indicate that injection of heat-killed BCG induced increased numbers of activated AM, which appeared to be functionally similar to resident AM in their ability to phagocytize and modulate in vitro immune responses. PMID- 3510979 TI - Strain variations in the murine cellular immune response to the phenolic glycolipid I antigen of Mycobacterium leprae. AB - The cellular immune response to the Mycobacterium leprae-specific phenolic glycolipid I was examined in inbred mice immunized with M. leprae by in vivo delayed cutaneous hypersensitivity and in vitro lymphocyte proliferation. Whereas all mouse strains responded to M.leprae-induced delayed-type hypersensitivity and lymphocyte proliferation, only BALB.K was responsive in both assays to the glycolipid. Responsiveness was determined in part by non-H-2 genes, while the influence of H-2 genes was not apparent. Among congenic BALB/c mice differing only at Igh-C allotype loci, variations in responsiveness were found in both delayed-type hypersensitivity and lymphocytes proliferation assays, indicating a possible role for Igh-C loci-linked genes. Unresponsiveness in the lymphocyte proliferation assay to the glycolipid was inherited as a dominant trait in one set of responder X nonresponder F1 progeny. We conclude that after immunization with M. leprae organisms, the cell-mediated responses to the glycolipid, endowed with a single carbohydrate epitope, are under polygenic control, predominantly non-H-2-linked genes. PMID- 3510980 TI - Release of fibronectin-lipoteichoic acid complexes from group A streptococci with penicillin. AB - Fibronectin binds to Streptococcus pyogenes, and this binding is inhibited by lipoteichoic acid (LTA). Previous studies have shown that LTA can be released from S. pyogenes by treatment with penicillin. Penicillin released LTA from both S. pyogenes and Staphylococcus aureus; however, the binding of fibronectin correlated with the amount of LTA released only in the case of S. pyogenes. Contrarily, clindamycin decreased the ability of S. aureus to bind fibronectin without affecting the binding of fibronectin to S. pyogenes. Further studies indicated that LTA does not inhibit the binding of fibronectin to S. aureus. Fibronectin bound to S. pyogenes could be released from the cell surface by penicillin. Immunological analysis of the released fibronectin indicated that LTA was the only surface component which could be detected as a soluble complex with the released fibronectin. These studies suggest that LTA plays a central role in the binding of fibronectin to S. pyogenes and is not involved in the binding of fibronectin to S. aureus. PMID- 3510981 TI - Correlation of natural killer cell activity and clearance of Cryptococcus neoformans from mice after adoptive transfer of splenic nylon wool-nonadherent cells. AB - Previous reports demonstrate that natural killer (NK) cells inhibit the growth of Cryptococcus neoformans in vitro, but conclusive evidence supporting the effectiveness of NK cells in host resistance to cryptococci is not available. The objective of these studies was to assess the ability of NK cells to clear C. neoformans from the lungs, livers, and spleens of infected mice. CBA/J mice were depleted of NK cells, as well as other natural effector cells, by an intraperitoneal injection of cyclophosphamide (Cy), 240 mg/kg of body weight. One day later, 7.5 X 10(7) nylon wool-nonadherent (NWN) spleen cells, either untreated or treated with anti-asialo GM1 and complement to remove NK cells, were adoptively transferred to Cy-pretreated mice. On day 2 after Cy treatment, the mice were injected intravenously with 2 X 10(4) cryptococci. At 4 and 6 days after Cy treatment, tissues were assayed for NK reactivity, using a 4-h 51Cr release assay, and for in vivo clearance of cryptococci as reflected by mean log10 CFU per organ. We observed that Cy treatment depleted NK activity against YAC-1 targets and reduced in vivo clearance of C. neoformans from the tissues of infected mice. Additionally, Cy treatment depleted the total lung and spleen cellularity and the total number of peripheral blood lymphocytes when compared with those in normal untreated control mice. Also, spleen weights were significantly decreased in comparison with those of untreated animals 4 days after Cy treatment. Adoptive transfer of untreated NWN spleen cells into Cy depressed mice restored the NK cell activity which correlated with enhanced clearance of cryptococci from lungs, livers, and spleens. In contrast, treatment of NWN spleen cells with anti-asialo GM1 and complement before adoptive transfer abrogated the ability of these cells to restore NK activity or reduce the numbers of cryptococci present in tissues of infected mice. Taken together, these data indicate that NK cells are the cells effective in diminishing the numbers of cryptococci in tissues of infected mice. Consequently, NK cells may play a role in first-line host resistance against C. neoformans. PMID- 3510982 TI - Antibody-dependent natural killer cell-mediated growth inhibition of Cryptococcus neoformans. AB - Previous data from this laboratory indicate that normal murine nylon wool nonadherent splenic cells with characteristics of natural killer (NK) cells effectively inhibit in vitro growth of Cryptococcus neoformans, a yeastlike pathogen. Since NK cells have been shown to be involved in antibody-dependent, cell-mediated cytotoxicity against immunoglobulin G (IgG)-coated tumor cells and xenogenic erythrocytes, we were interested in assessing the effects of the IgG fraction of rabbit anticryptococcal serum on NK cell-mediated inhibition of C. neoformans growth. Early in the study it became apparent that the conventional method of determining the numbers of CFU that was used previously for assessment of viable cryptococci at the end of the growth inhibition assay was not reliable for these studies, owing to minor clumping of the organisms in the presence of anticryptococcal antibody. Therefore, the BACTEC radiometric system was evaluated and determined to be a reliable replacement for the CFU count method. Using the BACTEC methodology, we showed that the anticryptococcal antibody significantly augmented the in vitro ability of NK cells to inhibit the growth of C. neoformans compared with normal rabbit serum or tissue culture medium. Furthermore, the antibody alone did not have an adverse effect on the organism, confirming that reduced growth indices obtained from test wells containing antibody, NK cells, and cryptococci were due to the effects of the NK cells. Maximum anticryptococcal activity of the NK cells was observed in the presence of 16 micrograms of IgG per ml; however, significant augmentation of anticryptococcal activity was seen with antibody concentrations as low as 3 micrograms/ml. Using different populations of murine splenic cells which had varying degrees of NK cell activity, we were able to show that NK cell activities, as determined by 51Cr release from YAC-1 targets, directly correlated with antibody-dependent, cell-mediated growth inhibition against cryptococci, suggesting that NK cells were effector cells in the antibody-dependent assays. Furthermore, in every case, the antibody-dependent activity of NK cells against C. neoformans was higher than the spontaneous activity of NK cells against the organism, emphasizing that NK cell activity against cryptococci can be augmented by specific antibody. When NK cell numbers were enriched by Percoll fractionation of nylon wool nonadherent splenic cells, antibody-dependent and spontaneous growth inhibitory activities of the effector cells were concomitantly augmented, confirming that NK cells were the effector cells in antibody-dependent growth inhibition of cryptococci.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3510983 TI - Environmental modulation of lipopolysaccharide chain length alters the sensitivity of Escherichia coli to the neutrophil bactericidal/permeability increasing protein. AB - We have shown previously that the sensitivity of Escherichia coli to the neutrophil bactericidal/permeability-increasing protein (BPI) depends mainly on the polysaccharide chain length of outer membrane lipopolysaccharides (LPS) (J. Weiss, S. Beckerdite-Quagliata, and P. Elsbach, J. Clin. Invest. 65:619-628, 1980). Thus, rough strains of E. coli producing only short-chain LPS are more sensitive to BPI than smooth strains that produce LPS with varied chain lengths. We now show that changes in the bacterial growth environment can modify BPI sensitivity of smooth E. coli as much as 30-fold depending on the bacterial strain and the growth conditions examined. Changes in BPI sensitivity paralleled differences in binding affinity of E. coli for BPI and closely correlated with changes in the chain length of LPS produced under different growth conditions, as assessed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. No concomitent changes in either the number of LPS molecules per cell or the bacterial protein profile were detected. Rough strains showed little or no growth dependent variation in BPI sensitivity, further indicating that subtle alterations in bacterial constituents other than LPS do not significantly affect bacterial sensitivity to BPI. Thus, the BPI sensitivity of E. coli can be modulated not only by the genotypic conversion of the LPS phenotype, but also by environmental effects on LPS-polysaccharide formation in wild-type strains. PMID- 3510984 TI - Plasmids coding for colonization factor antigens I and II, heat-labile enterotoxin, and heat-stable enterotoxin A2 in Escherichia coli. AB - Colonization factor antigens I and II (CFA/I and CFA/II) are important in the pathogenesis of diarrhea in humans caused by some enterotoxigenic Escherichia coli (ETEC). Plasmid DNA from 16 CFA/I+ and five CFA/II+ ETEC were examined by Southern blot analysis with enterotoxin gene probes and were compared with plasmid DNA from derivatives of the same ETEC that had lost the ability to produce these colonization factors. Among the 16 CFA/I+ ETEC strains, the loss of CFA/I was accompanied by the loss of a plasmid of between 34 and 68 megadaltons (MDa) coding for heat-stable enterotoxin A2 (ST-A2) in 12 strains, by the loss of a 60-MDa plasmid coding for heat-labile enterotoxin (LT) and ST-A2 in one strain, or by deletions of a segment of DNA encoding for ST-A2 in three strains. Among five CFA/II+ ETEC strains, the loss of CFA/II was associated with the loss of a plasmid of 75 MDa coding for LT and ST-A2 in three strains, with the loss of genes coding for LT and ST-A2 from a 68-MDa plasmid in one strain, or with no discernible loss of a plasmid or DNA sequences coding for enterotoxins in the remaining strain. The loss of CFA/I and CFA/II production was associated with the loss of DNA sequences encoding for ST-A2 in 20 of 21 ETEC examined. PMID- 3510985 TI - The use of mice in the Sereny test as a virulence assay of shigellae and enteroinvasive Escherichia coli. AB - We examined the possibility that mice could be used in the Sereny test instead of guinea pigs or rabbits. Although the reactions in mice were more transient and not as pronounced as those in guinea pigs, mice indeed could be used to distinguish even macroscopically between virulent and avirulent shigellae. Virulent enteroinvasive Escherichia coli strains were also positive for the mouse Sereny test. We described the macroscopic and microscopic appearance of the mouse eyes. Thus, mice are recommended for use in the Sereny test, particularly when a large number of samples are to be tested. PMID- 3510986 TI - Plasmids coding for drug resistance and localized adherence to HeLa cells in enteropathogenic Escherichia coli O55:H- and O55:H6. AB - Plasmids coding for drug resistance and localized adherence (LA) to HeLa cells were found in two enteropathogenic Escherichia coli strains belonging to serotypes O55:H- and O55:H6. Strain 49-81 HSJ (O55:H-) carries two plasmids, one coding for both ampicillin resistance (Apr) and LA (pMS49). Strain 71-82 HSJ (O55:H6) harbors only one plasmid, coding for resistance to sulfadiazine, chloramphenicol, kanamycin, ampicillin, and LA (pMS71). Plasmids pMS49 and pMS71 were transferred to E. coli K-12 711 and from this strain to E. coli K-12 J53. Curing with acridine orange of an Apr LA+ transconjugant showed that both characteristics were lost simultaneously. The plasmids have a molecular weight of approximately 55 X 10(6) and are the first naturally recombinant plasmids coding for adherence and drug resistance described in enteropathogenic E. coli. PMID- 3510987 TI - Analysis of structural polypeptides of the lymphoproliferative disease virus (LPDV) of turkeys. AB - The polypeptide composition of the lymphoproliferative disease virus (LPDV) of turkeys was shown to comprise several polypeptides with apparent molecular weights of 76, 31, 28, 20 and 15 kDa. This polypeptide pattern is distinctly different from the protein profiles of avian leukosis viruses, reticuloendotheliosis virus, or murine leukemia viruses. Moreover, LPD virions contain 2 major structural proteins (p31 and p28), in contrast to only one major internal protein present in most other retroviruses. The 76 kDa protein was established as the major viral envelope glycoprotein. The uniqueness of the LPDV polypeptide pattern is consistent with the lack of genetic relatedness of LPDV genome to other retroviruses, establishing LPDV as a representative of a distinct group of retroviridae. PMID- 3510988 TI - The role of digital angiography in the evaluation of coronary artery disease. PMID- 3510989 TI - Complete atrioventricular block after sublingual isosorbide dinitrate. AB - A 71-year-old woman, admitted for chest pain, received a 5 mg dose of isosorbide dinitrate sublingually. Within 2 min she became pale and diaphoretic and soon after lost consciousness. A monitor electrocardiographic lead showed sinus bradycardia followed by ventricular asystole. Sinus rhythm was restored by a precordial thump and intravenous administration of atropine. Our patient was receiving lidocaine intravenously because of ventricular premature beats. Its interaction with isosorbide is suspected of having caused the asystole. PMID- 3510990 TI - The cell cycle concept and its application. A symposium held in memory of Dr. Alma Howard. PMID- 3510991 TI - Molecular biology of the cell cycle. AB - Genes and cDNA clones have been identified in animal cells that are cell cycle regulated, i.e. they are preferentially expressed in a phase of the cell cycle. Some of these genes, including four oncogenes, are induced when G0 cells are stimulated to proliferate. Four approaches are described to identify the genes that regulate the transition of cells from a resting to a growing stage. The interrelationship among cell cycle-regulated genes, oncogenes, growth factors and receptors for growth factors points the way to a genetic dissection of cell cycle progression. PMID- 3510992 TI - Autoradiographic analysis of the cell cycle: Howard and Pelc to the present day. AB - Although flow cytometry has become the popular way to examine the kinetics of cell proliferation, the technique of labelled mitoses remains an important and central technique. This is particularly the case when it is the durations of cell cycle phases that are required. Through simulation analysis it is possible to identify discrepancies that imply the existence either of artefacts or of unsuspected properties of the cell system under investigation: the implications of these discrepancies have often been inadequately explored. An important function of the modelling approach is to seek to identify aspects of the data that cannot be fitted, and to pursue the discrepancies either by eliminating artefacts or by seeking to describe a more comprehensive model. PMID- 3510993 TI - Cell cycle analysis using flow cytometry. AB - This manuscript reviews the utility of flow cytometry for the study of cell proliferation. The applications of univariate DNA distribution analysis to cytokinetic studies of asynchronous and perturbed cell populations are discussed briefly. The newly developed technique for simultaneous flow cytometric measurement of cellular DNA content and amount of incorporated bromodeoxyuridine is discussed in more detail. The cytochemistry required for this analysis is reviewed as are its applications to: determination of the fractions of cells in the G1-, S- and G2 + M-phases of the cell cycle; determination of the G1-, S- and G2 + M phase durations and dispersions and growth fraction for asynchronous cells; detection of ara-C resistant cells present at low frequency in an otherwise sensitive population; and analysis of the cytokinetic response of a solid murine tumour to treatment in vivo with a cell cycle specific agent. PMID- 3510994 TI - Cell cycles in cell hierarchies. AB - In the replacing tissues of the body, namely the bone marrow, testis, and the surface epithelia with their appendages, cell replacement would appear to be achieved using an hierarchically organized proliferative compartment with relatively few ultimate stem cells producing dividing transit cells which eventually differentiate and mature into the functional cells of the tissue. The cell cycle times of the various constituents of the hierarchy differ, and the stem cells apparently have a longer cell cycle than the transit cells. There may be variations in the cell cycle as cells pass through the transit population in some cases, e.g. in the bone marrow, while in others the cycle time remains fairly constant, e.g. in the testis. The difference in the cell cycle time between stem cells and transit cells is not completely unequivocal, and there is little or no difference in cycle time in the epithelium on the dorsal surface of the tongue while in other cases the experimental evidence for long stem-cell cycles is somewhat imprecise. However, the epithelium in the small intestine and the spermatogonia in the testis have been fairly extensively studied and here the evidence clearly shows a lengthening of the cell cycle as more primitive cells are considered. PMID- 3510995 TI - Considerations in the design of possible cell cycle effective drugs. AB - Antineoplastic agents are known to induce differential cytotoxic and cytostatic effects throughout the cell cycle. Many drugs have greater toxicity for cycling cells and act selectively at one or more phases of the cycle and may cause partial synchrony of surviving cells. However, these observations have been generally carried out on in vitro systems only and present a variety of complexities and pitfalls. Furthermore, human tumours are often characterized by a relatively low fraction of proliferating cells and present a large cellular heterogeneity as far as their cytogenetic, cytokinetic, and clonogenic features and their responses to drugs are concerned. Therefore, resistance to chemotherapy is due to various factors characterizing, in some instances, each individual tumour. In spite of the advent of technological advances such as flow cytometry, it is still difficult to design kinetic-orientated therapies especially for the treatment of solid tumours. Consequently, it is also difficult to design protocols based on cell cycle effective drugs. The possibility remains, at least for the moment, to stratify tumours according to their cellular heterogeneity. Different protocols could then be assigned to classes of tumours. Such an approach could be completed by further advances in the cellular monitoring of individual tumours. PMID- 3510996 TI - Experimental chemotherapy and concepts related to the cell cycle. AB - Scheduling of chemotherapy is limited by damage to normal tissues, and tolerated schedules are dependent on normal tissue recovery. Most anticancer drugs are more toxic to proliferating cells and the fall and recovery of granulocyte counts after chemotherapy may be explained by the effect of drugs on rapidly proliferating precursor cells in the bone marrow. It is argued that serious toxicity due to myelosuppression most often occurs because of damage to proliferating precursors that may be recognized in bone marrow rather than to stem cells. In contrast, therapy that is aimed at producing cure or long-term remission of tumours must be directed at killing tumour stem cells. The evidence that tumours contain a limited population of cells which can repopulate the tumour after treatment (and are therefore tumour stem cells) is reviewed critically. While there is quite strong evidence for a limited population of target cells, evidence from studies on metastases suggests that the tumour cells which may express this stem cell property may change with time. The stem cell concept has major implications for predictive assays. Although colony-forming assays appear to have a sound biological background for predicting tumour response, technical problems prevent them from being used routinely in patient management. Cells in tumours are known to be heterogeneous and at least three types of heterogeneity may influence tumour response to drug treatment: the development of subclones with differing properties including drug resistance; variation in cellular properties due to differentiation during clonal expansion; and variation in properties due to nutritional status and micro-anatomy. Heterogeneity in drug distribution within solid tumours may occur because of limited drug penetration from blood vessels, and nutrient-deprived cells in solid tumours may be expected to escape the toxicity of some anticancer drugs as well as being resistant to radiation because of hypoxia. This may occur both because nutrient-deprived cells have a low rate of cell proliferation, and also because of poor drug penetration to them. There is a need for improved understanding of the mechanisms that lead to cell death in tumours. If these mechanisms were understood, it might be possible to simulate them by therapeutic manoeuvres. Recent research from our laboratory suggests that the combination of low extracellular pH and hypoxia may be very toxic to cells in nutrient-deprived regions. Drugs which limit the cell's ability to survive in regions of acid pH may provide strategy for therapy of nutrient-deprived cells. PMID- 3510997 TI - Cell kinetics and radiation biology. AB - The cell cycle, the growth fraction and cell loss influence the response of cells to radiation in many ways. The variation in radiosensitivity around the cell cycle, and the extent of radiation-induced delay in cell cycle progression have both been clearly demonstrated in vitro. This translates into a variable time of expression of radiation injury in different normal tissues, ranging from a few days in intestine to weeks, months or even years in slowly proliferating tissues like lung, kidney, bladder and spinal cord. The radiosensitivity of tumours, to single doses, is dominated by hypoxic cells which arise from the imbalance between tumour cell production and the proliferation and branching of the blood vessels needed to bring oxygen and other nutrients to each cell. The response to fractionated radiation schedules is also influenced by the cell kinetic parameters of the cells comprising each tissue or tumour. This is described in terms of repair, redistribution, reoxygenation and repopulation. Slowly cycling cells show much more curved underlying cell survival curves, leading to more dramatic changes with fractionation, dose rate or l.e.t. Rapidly cycling cells redistribute around the cell cycle when the cells in sensitive phases have been killed, and experience less mitotic delay than slowly proliferating cells. Reoxygenation seems more effective in tumours with rapidly cycling cells and high natural cell loss rates. Compensatory repopulation within a treatment schedule may spare skin and mucosa but does not spare slowly proliferating tissues. Furthermore, tumour cell proliferation during fractionated radiotherapy may be an important factor limiting the overall success of treatment. PMID- 3510998 TI - Retinal microvessel extracellular matrix: an immunofluorescent study. AB - The vasculature of the retina functions within a sheath of extracellular matrix (ECM). Unfortunately, little is known about the biochemical composition of this matrix. Abnormalities in the ECM of the retinal microvasculature are important in diabetic retinopathy as well as vasculopathies associated with connective tissue disorders. The ECM of unfixed frozen human retinal blood vessels was examined by indirect immunofluorescence using antibodies raised against collagen types I, II, III, IV, and V as well as the structural glycoproteins laminin and fibronectin. Antisera against collagen types I and IV as well as laminin and fibronectin stained a broad spectrum of retinal vessels, from large thick-walled vessels down to microvessels less than 10 micron in diameter. In contrast, antibodies against types III and V collagen were seen to stain primarily the walls of the larger vessels. Antibodies against type II collagen did not react with retinal vessels. Preincubation with the appropriate antigen or preimmune serum eliminated staining of the vessels by the antisera. PMID- 3510999 TI - Single photon emission computed tomography (SPECT). Part II: Clinical applications. AB - The clinical applications of SPECT are just beginning to be defined since complete systems have only recently become available. SPECT studies are more difficult to perform than planar imaging studies, and close attention to quality control is important to obtain optimal studies. SPECT has higher lesion contrast and is able to detect smaller lesions than planar imaging in Tc-99m sulfur colloid liver studies. Preliminary results of SPECT T1-201 studies are encouraging, but further work comparing SPECT and planar imaging of T1-201 is needed. SPECT does give more information than planar imaging in certain bone imaging cases such as suspected avascular necrosis of the hip. Although interesting results have been published using SPECT in brain and lung perfusion studies, the clinical utility of this work has not been determined. The development of certain radiopharmaceuticals would enhance the future of SPECT. Technetium-99m labeled brain and myocardial perfusion agents would be ideally suited for SPECT studies. The ability to quantitate lesion volume (eg, in liver metastases) has not been studied and could be useful in following patents on chemotherapy. SPECT could give additional information if monoclonal antibodies labeled with I-123 or Tc-99m can be demonstrated to have appropriate sensitivity. The advantages of SPECT over planar imaging will be greater as new agents are developed. PMID- 3511000 TI - The spectrum of sonographic findings of fibroadenoma of the breast. AB - There are a number of sonographic findings seen in fibroadenoma of the breast. In a retrospective study, we examined the biopsy results of 59 masses given the sonographic diagnosis of fibroadenoma. We also reviewed the sonograms of an additional 26 biopsy-proven fibroadenomas that were not diagnosed as such with ultrasound. The ultrasound diagnosis was correct in 50 of 76 fibroadenomas (65.8%). Only 12 of the 76 biopsy-proven fibroadenomas had the classic sonographic appearance of a smooth round or oval mass with homogeneous internal echoes. Fourteen fibroadenomas were not visible on the sonograms, even in retrospect. The remaining 50 biopsy-proven fibroadenomas demonstrated one or more "atypical" signs of border irregularity, lobulation, inhomogeneous internal echo texture, or posterior shadowing. There were nine sonographic false positives: five patients had other benign lesions on histology, and four masses believed to be sonographically compatible with fibroadenoma were found to be carcinomas. While breast sonography is frequently a useful modality for breast mass detection, particularly as an adjunct to x-ray mammography, the common overlap in characteristics of benign and malignant masses makes histologic evaluation of all solid masses essential. PMID- 3511001 TI - Sonography of the sole of the foot. Evidence for loss of foot pad thickness in diabetes and its relationship to ulceration of the foot. AB - The hypothesis that loss of tissue mass in the foot contributes to foot ulceration in diabetics has never been quantitated. We developed normal criteria for the thickness of the sole of the foot at the heel, and the five metatarsal heads of both feet, using high-resolution ultrasound (10 MHz). We studied 24 normal patients ranging in weight from 125 to 250 lbs. We examined the soles of the feet of 38 diabetics without foot ulcers and 11 diabetics with foot ulcers or a history of foot ulcers who were in the same weight range as the normals. Of statistical significance, the heel thickness in controls was greater than that of the diabetics, which in turn was greater than that of the diabetics with foot ulcers. The thickness of the sole over the first and second metatarsals was also greater in the controls compared with diabetics. We conclude that high-resolution ultrasound is an effective determinant of the thickness of the sole of the foot and that diabetics have variations from the norm in the heel and at the first and second metatarsal heads. PMID- 3511002 TI - The sonographic fat/muscle ratio. AB - A wide variety of biochemical and morphometric parameters have been applied to estimation of nutritional status. A-mode ultrasound has been used to estimate subcutaneous fat thickness in humans; similar studies are reported in the veterinary literature. We applied B-mode ultrasonography to the triceps region of the nondominant arm. Subcutaneous fat and triceps muscle thickness were measured and the ratio of fat to muscle calculated. PMID- 3511003 TI - Small dense kidneys in a 7-year-old. PMID- 3511004 TI - 1985 Founders Award presented to Ronald L. Kathren. PMID- 3511005 TI - 1985 Elda E. Anderson Award presented to Michael J. Slobodien. PMID- 3511006 TI - 1985 Distinguished Scientific Achievement Award presented to Roy C. Thompson. PMID- 3511008 TI - Saying no and other ethical dilemmas. PMID- 3511007 TI - Interactions of Escherichia coli and marine bacteria with 241Am in laboratory cultures. AB - In nutrient media, Escherichia coli and selected strains of marine facultative anaerobes accumulated significant amounts of the transuranic radioisotope 241Am. The pattern of uptake varied among strains and was dependent upon pH, culture media and growth stage of the population. Desorption of 241Am to montmorillonite was significantly less in filtered media from some bacterial cultures than in "unconditioned" control media, suggesting that bacterial exometabolites may form complexes with Am thereby increasing its solubility. PMID- 3511009 TI - Cerebral vasospasm after an intracranial aneurysmal subarachnoid hemorrhage: a nursing perspective. PMID- 3511010 TI - Brain resuscitation. PMID- 3511011 TI - Physiologic principles and clinical sequelae of cardiopulmonary bypass. AB - CPB has been a key element in the safe and effective practice of cardiac surgery since its inception more than 30 years ago. Refinements in the apparatus, methods of tissue preservation, and innovations in technique have lowered the morbidity and mortality rates from these procedures. Despite these factors, the pump oxygenator apparatus itself and the processes of hemodilution, hypothermia, and anticoagulation, which are intrinsic to its operation, effect temporary physiologic derangements in organ system functions. Although all of these phenomena resolve spontaneously, some require treatment while others do not. Therefore, appropriate clinical management of this group of patients, must be based on an understanding of CPB techniques and the anticipated physiologic sequelae. Hypertension should mostly be controlled because high systemic vascular resistance exacerbates the tendency for bleeding and stresses fresh anastomoses. Volume, urine flow, and potassium loss must be monitored strictly and treatment initiated promptly. Cardiac dysfunction requires cautious, individualized pharmacologic, and sometimes mechanical support in the perioperative and postoperative periods. Laboratory values should never be treated routinely. CPB is not without intrinsic risk of serious clinical complication, and these must be anticipated after surgery. The potential for complication increases when CPB exceeds 2 hours and rises sharply when pump time is prolonged more than 3 to 4 hours. Excessive pump time exacerbates blood trauma, produces abnormal capillary membrane permeability, and predisposes the patient to tissue anoxia. The potential for embolism and pulmonary complications is increased. Permanent organ system damage can be avoided through strict attention to myocardial and tissue preservation, meticulous filtration, precise technique, and avoidance of prolonged extracorporeal circulation. PMID- 3511012 TI - The effect of prophylactic positive end-expiratory pressure on mediastinal bleeding after coronary revascularization surgery. PMID- 3511013 TI - Postoperative nursing management in patients undergoing myocardial revascularization with the internal mammary artery bypass. AB - The IMA is being utilized with increasing frequency as the graft of choice for myocardial revascularization. Certain postoperative management requirements differ in patients with the internal mammary bypass, which are often challenging. Because it is important that the nursing staff have a thorough understanding of the peculiarities of postoperative care in patients with IMA grafts, this article was prepared to review the anatomic, pathologic, physiologic, and clinical aspects of the IMA in myocardial revascularization. A retrospective comparative chart review of patients with IMA grafts and SVGs was also performed to better define the specific postoperative nursing problems of hemorrhaging, pulmonary support, and pain control that are encountered in these patients. PMID- 3511014 TI - The postoperative adverse effects of inhalational anesthetics. AB - Inhalational general anesthetics can contribute to postoperative morbidity (Table II). Postoperative effects of inhalational anesthetics on the central nervous system are speculative. The "toxic" effects of these agents during the postoperative period are most often an extension of their pharmacologic and physiochemical properties. Inhalational anesthetics may produce a number of varied changes in mental status after surgery such as headache, emergence excitement, and delirium. It is very important for health professionals to be aware of the risk of perioperative myocardial infarction in patients with preexisting heart disease if early detection and treatment are to occur. Relative to the common postoperative problems of atelectasis, pneumonia, and aspiration, inhalational agents may have a contributory role especially in patients with preexisting pulmonary disease. Postoperative nausea and vomiting are other common problems in which inhalational agents may have a role in their development. Although extensively investigated, suspected halothane hepatoxicity is a very rare complication if it exists at all. The renal effects of inhalational anesthetics are usually mild and transitory, although the use of methoxyflurane can produce direct nephrotoxicity. The evidence to support a clinically significant direct immunosuppressant effect of inhalational anesthetics after surgery is inconclusive. A concensus exists that any minor, short-lived effects are in all probability overshadowed by the nonspecific stress of surgery itself. By reducing this stress, anesthetics undoubtedly have a protective effect. There are probably no major mutagenic or carcinogenic effects of inhalational anesthetics under normal conditions. Inhalational anesthetics should be avoided during pregnancy because of their teratogenic potential and their effects on the uterus.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3511015 TI - The influence of prior total body irradiation on the tissue distribution of mouse lymphoma/leukemia. AB - The effect of a single dose of 10 Gy X rays on the distribution of subsequently injected mouse lymphoma/leukemia cells was studied. The organ distribution of an acute myeloid leukemia (A46) was not affected by prior (90 days) administration of 10 Gy X rays. A T-cell lymphoblastic lymphoma/leukemia (A55) and a B-cell lymphoblastic lymphoma/leukemia (A31) produced enhanced infiltration of the lung when 10 Gy of total body irradiation (TBI) was given 90 days before the tumor cells. The infiltration was predominantly in the peribronchiolar and perivascular spaces. Enhancement was not seen in any tissues other than lung. The possibility is raised that in those acute lymphoblastic leukemia patients whose treatment includes TBI, residual circulating cells may be encouraged to infiltrate the lung. PMID- 3511016 TI - Perfluorochemicals and hyperbaric oxygen in radiation therapy. AB - It has been postulated that tumors contain hypoxic cells of decreased radiation sensitivity, which limit curability with radiation therapy. Hyperbaric oxygen has been used in an attempt to improve tumor oxygenation. The nature of the oxygen concentration-radiation sensitivity relationship (oxygen increases the slope of the radiation cell survival curve) suggests that a small number of hypoxic cells, as few as one in one million, would limit tumor curability. Oxygen moves by diffusion from the capillary into the tumor. An increase in partial pressure in the capillary will increase the effective diffusion distance. To improve tissue oxygenation effectively the partial pressure of oxygen in blood must be significantly increased throughout the length of the capillary, in particular at the venous end. Theoretical considerations indicate that hyperbaric oxygen as presently used in radiation therapy, 3 ATA, would lead to only marginal improvement. PartO2 may be as much as 0.8 atm below that of the inspired gas; this plus the consumption of oxygen along the length of the capillary lead to predictions of values for PEnd CapO2 of less than twice normal. Such considerations explain the rather limited success of hyperbaric oxygen with radiation therapy. Thus it is unnecessary to postulate an absence of hypoxic cells to explain this clinical observation. In the presence of perfluorocarbon micelles the non-hemoglobin-bound oxygen carrying capacity of blood is significantly increased. Theoretical considerations predict that the difference between PartO2 and PO2 of the inspired gas should be decreased. Furthermore, the nonhemoglobin-bound oxygen carrying capacity should be adequate to satisfy tissue consumption requirements without unloading hemoglobin, thereby avoiding the "PO2 buffering effect of hemoglobin" and permitting a significant increase in PO2 throughout the capillary length. This effect has been demonstrated using a rodent tumor model. PMID- 3511017 TI - A randomized trial of oral iron on tests of short-term memory and attention span in young pregnant women. AB - Recent studies suggest that infant behavior and psychological test performance are impaired by iron deficiency and may be improved by iron. Comparable studies have not been performed in older populations. Young women early in pregnancy whose nutritional intake may be impaired by poverty constitute a high-risk population. Women aged 14-24 years coming for prenatal care at or before 16 weeks gestation whose hematocrits were greater than or equal to 31% were randomized in a double-blind trial to receive vitamins supplemented with iron (experimental group) or vitamins alone (controls). Hematologic status and tests of short-term memory and attention span were assessed at entry and conclusion of the one-month treatment period. The experimental group showed significant improvement on the most sensitive measure of short-term memory and three subtests. On comparison of the change between initial and final scores, the experimental group showed significant or borderline greater improvement than controls on three tests. These results indicated a beneficial effect of iron therapy on psychometric test-score performance. PMID- 3511018 TI - Sjogren's syndrome in an adolescent. AB - Sjogren's syndrome is a chronic autoimmune disorder characterized by keratoconjunctivitis sicca, xerostomia, and recurrent enlargement of the salivary glands. Most commonly noted in adults, it rarely affects adolescents. We describe a 15-year-old adolescent with recurrent parotid enlargement as an initial manifestation of this disease. PMID- 3511019 TI - High technology diagnostics: detection of enterotoxigenic Escherichia coli, using DNA probes. AB - A relatively new technique termed colony blot hybridization appears to be a reliable replacement for the ligated porcine gut loop assay previously used to detect stable toxin-B producing Escherichia coli. The highly reproducible blot assay enables screening of large numbers of isolants for the presence of E coli stable-B toxin genes, thus avoiding variations in phenotypic expression and poor repeatability inherent in the in vivo assays. Availability of this diagnostic test can aid practitioners in identifying enterotoxigenic E coli related disease in swine and in determining the benefits of vaccination programs. PMID- 3511020 TI - American Society of Andrology. Its beginnings. PMID- 3511021 TI - Effects of static and fluctuating airway pressure on intact pulmonary circulation. AB - The direct effects on the pulmonary circulation of static and fluctuation airway pressure were compared in intact close-chest infant lambs with reactive pulmonary vasculature under alpha-chloralose anesthesia. A preparation developed to permit independent ventilation of right and left lungs and independent measurement of right and left lung blood flow was employed to separate direct from indirect effects of unilateral airway pressure changes on pulmonary vascular resistance (PVR). Both static and fluctuating unilateral airway pressure interventions directly elevated ipsilateral PVR. For purposes of comparison mean alveolar pressure (PA) was estimated for both static and fluctuating trials. Fluctuating interventions increased PVR more than did static trials at comparable levels of PA. Substantially less PA was needed to double ipsilateral PVR by fluctuating than by static interventions (16 vs. 26 mmHg, respectively). These data indicate that, in the intact animal with reactive pulmonary vasculature, both PA and the waveform of airway pressure applied can influence PVR. PMID- 3511022 TI - Effects of inspiratory resistance loading on lung fluid balance in awake sheep. AB - Because pulmonary edema has been associated clinically with airway obstruction, we sought to determine whether decreased intrathoracic pressure, created by selective inspiratory obstruction, would affect lung fluid balance. We reasoned that if decreased intrathoracic pressure caused an increase in the transvascular hydrostatic pressure gradient, then lung lymph flow would increase and the lymph to-plasma protein concentration ratio (L/P) would decrease. We performed experiments in six awake sheep with chronic lung lymph cannulas. After a base line period, we added an inspiratory load (20 cmH2O) and allowed normal expiration at atmospheric pressure. Inspiratory loading was associated with a 12 cmH2O decrease in mean central airway pressure. Mean left atrial pressure fell 11 cmH2O, and mean pulmonary arterial pressure was unchanged; calculated microvascular pressure decreased 8 cmH2O. The changes that occurred in lung lymph were characteristic of those seen after other causes of increased transvascular hydrostatic gradient, such as increased intravascular pressure. Lung lymph flow increased twice base line, and L/P decreased. We conclude that inspiratory loading is associated with an increase in the pulmonary transvascular hydrostatic gradient, possibly by causing a greater fall in interstitial perimicrovascular pressure than in microvascular pressure. PMID- 3511023 TI - Effect of PEEP and type of injury on thermal-dye estimation of pulmonary edema. AB - We investigated the effect of positive end-expiratory pressure (PEEP) on the extravascular thermal volume of the lung (ETV) determined by the thermal-dye technique in three canine models of pulmonary edema created by injection of alpha naphthylthiourea (ANTU) or oleic acid (OA) into the pulmonary circulation or intrabronchial instillation of hydrochloric acid (HCl). ETV was determined before, during, and after ventilation with 14 cmH2O PEEP, and final ETV was compared with the extravascular lung mass (ELM) determined postmortem. Final ETV correctly estimated ELM in 12 animals with ANTU injury, ETV/ELM = 1.04 +/- 0.13, but underestimated after HCl injury (n = 5), ETV/ELM = 0.61 +/- 0.23, and OA injury (n = 6), ETV/ELM = 0.73 +/- 0.19. Whereas PEEP had no consistent effect on extravascular thermal volume in ANTU edema, there was a reversible increase in ETV during PEEP in animals with HCl or OA injury and underestimation of ELM. The increase in ETV during PEEP averaged 9.3 +/- 3.8 ml/kg (62 +/- 42%) over the mean of the pre- and post-PEEP values after HCl injury (P less than 0.01) and 6.7 +/- 4.4 ml/kg (47 +/- 35%) after OA injury (P less than 0.02). There was an inverse correlation between the change in ETV during PEEP and the ETV/ELM ratio for animals with HCl and OA injury (r = -0.94). We conclude that PEEP produces a reversible increase in ETV in some models of lung injury by allowing for distribution of thermal indicator through a larger fraction of the lung water and that this response may be useful to detect underestimation when gravimetric measurements are not available. PMID- 3511024 TI - A rapid rebreathing method for measurement of pulmonary gas volume in humans. AB - We have developed a rapid gas-dilution technique, with which pulmonary gas volume can be measured in only 20 s, even in the presence of maldistribution of ventilation. The subject rebreathes from a 0.75-liter anesthetic bag filled with 10% He and 30% O2 in argon. Breath-by-breath flow-weighted inspired concentrations of all gases present are calculated from continuous measurement by mass spectrometry. Insoluble gas concentrations are corrected continuously for shrinkage of the system volume. By use of these corrected values a mathematical extrapolation predicts the equilibrium concentration for He in the absence of complete mixing. Validation of the technique was carried out by comparing volumes calculated from the predicted equilibrium value with those obtained by whole-body plethysmography in 7 normal subjects and 12 patients with lung disease. In normal subjects equilibrium was usually attained within the 20 breaths and no extrapolation was required. In most of the patients, however, equilibrium was not reached and the use of the extrapolation technique increased the proportion of the lung volume measured by gas dilution from 0.82 +/- 0.16 (SD) to 0.95 +/- 0.12 of that measured by plethysmography. PMID- 3511025 TI - Density indicator method to measure pulmonary blood flows. AB - The injection of plasma, saline, or erythrocyte (RBC) concentrate into the pulmonary circulation produces a change in the gravimetric density of the blood outflow similar to the dilution curve of dye. We used an improved density measuring system to assess the flow of these density indicators through the lung in vivo and in vitro perfused dog lobe. From the in vitro density-dilution curves of plasma and RBC concentrate we calculated the pulmonary flow rate and found it to be 1.04 +/- 0.02 (SD) times the measured one. The outflow-dilution curves of gravimetric density were not as broad as those of optical density following in vivo injection of plasma bolus containing indocyanine green, and the gravimetric measurements dipped to base line, whereas the optical measurement did not. The density-dilution curves of isotonic saline injection are similar to that of plasma. Following injection of RBC concentrates with the dye, density changes in the pulmonary outflow lag behind the emergence of the dye. This was presumably related to RBC aggregation in the concentrates. In reference to the injected plasma, no loss in the density indicators for saline and RBC injection was observed. Based on these results and the similarity of the density indicators to the blood, we conclude that the plasma and isotonic saline are good density indicators to be used for the determination of pulmonary blood flows. PMID- 3511026 TI - Gas bubbles in the circulation of divers after ascending excursions from 300 to 250 msw. AB - The occurrence of intravascular bubbles in arteries and veins has been studied using pulsed Doppler ultrasound in six subjects who performed two ascending excursions each from 300 to 250 meters of seawater (msw) during a heliox saturation dive. Following decompression, high-intensity reflections could be observed not only in the venous system but also in the arteries, most notably in the carotid artery. Intravascular bubbles were more numerous during the first ascent than during the second. The arterial bubbles most probably come from the venous side of the circulation, indicating that the pulmonary filter is not as effective as previously thought during saturation diving. PMID- 3511027 TI - Growth and differentiation in cultured human thyroid cells: effects of epidermal growth factor and thyrotropin. AB - Human thyroid cells were grown and subcultured in vitro to examine their responses to known hormones and growth factors, and to serum. The cells were obtained from surgical specimens and were either neoplastic or nonneoplastic. The effects of culture conditions on cell growth were measured by changes in cell numbers and by stimulation of [3H]thymidine incorporation. The results showed that serum (0.5%) was essential for cell proliferation, and that a mixture of insulin (10 micrograms/ml), transferrin (5 micrograms/ml), hydrocortisone (10 micrograms/ml), somatostatin (10 ng/ml), and glycyl-histidyl-lysine (10 ng/ml) enhanced the effect of serum. Maximum growth of the cells was obtained when epidermal growth factor was present at 10(-9) M. Differentiation was measured by production of thyroglobulin, which was found to be stimulated by thyrotropin. This system provides a means to study the hormonal control of growth and differentiation in human thyroid cells. PMID- 3511028 TI - Cloning of genes that encode a new heat-labile enterotoxin of Escherichia coli. AB - The genes for a new enterotoxin were cloned from Escherichia coli SA53. The new toxin was heat labile and activated adenylate cyclase but was not neutralized by antisera against cholera toxin or E. coli heat-labile enterotoxin. Subcloning and minicell experiments indicated that the toxin is composed of two polypeptide subunits that are encoded by two genes. The two toxin subunits exhibited mobilities on polyacrylamide gels that are similar to those of cholera toxin and E. coli heat-labile enterotoxin subunits. A 0.8-kilobase DNA probe for the new enterotoxin failed to hybridize with the cloned structural genes for E. coli heat labile enterotoxin. PMID- 3511029 TI - Cloning, overproduction, and purification of the B2 subunit of ribonucleoside diphosphate reductase. AB - The nrdB gene, which encodes the B2 subunit of Escherichia coli ribonucleotide reductase (EC 1.17.4.1), was cloned into multicopy plasmid pSPS2. This vector, which contains the pL promoter of bacteriophage lambda and the tetracycline resistance gene of pBR322, was transformed into a lysogenic host with a thermolabile repressor. In the newly constructed strain, subunit B2 constituted approximately 25% of the soluble protein after heat induction, an overproduction of several hundredfold relative to the wild-type strain. Purification to homogeneity of the overproduced protein was accomplished by using DEAE and quaternary aminoethyl ion-exchange resins. PMID- 3511030 TI - Strain variation in bacteriocuprein superoxide dismutase from symbiotic Photobacterium leiognathi. AB - Photobacterium leiognathi ATCC 25521 (the type strain and light-organ symbiont of ponyfish) is one of the few bacteria that produces a copper-zinc superoxide dismutase, termed bacteriocuprein. We enzymologically and immunologically characterized the bacteriocuprein superoxide dismutases in sonicates from the type strain and nine additional strains of P. leiognathi, each isolated from the light organ of a separate ponyfish specimen, representing seven ponyfish species. The results indicate considerable strain variation. (i) The level of bacteriocuprein enzymatic activity varied greatly among strains from different species of ponyfish. In four of the nine strains, activity was low or undetectable, while in five strains it was comparable to that in the type strain. (ii) The bacteriocuprein in one strain had a specific activity much lower than that of the type strain, and in another strain, no bacteriocuprein activity and no cross-reactive polypeptide were detectable. (iii) A new electrophoretic variant, which migrated slower than that of strains from fish captured in Thailand and Japan, was identified in strains from fish captured in the Philippine Islands. (iv) Enzymological and immunological differences were observed in bacteriocupreins of strains from male and female specimens of the same ponyfish species, for the two species in which specimens of both sexes were examined. These observations raise the possibility that specific variations in the bacteriocupreins of P. leiognathi might be characteristic of the species, geographical source, or sex of the ponyfish host. Thus, the data indicate that the possibility of strain variation should be considered when other species are screened for bacteriocupreins. PMID- 3511031 TI - Identification of new cell division genes in Escherichia coli by using extragenic suppressors. AB - To facilitate the analysis of the cell division control apparatus in Escherichia coli, we studied extragenic suppressor mutations of a previously characterized temperature-sensitive division mutation, ftsM1. Cells of strain GD40 which harbor this mutation were spread on agar plates and incubated at 42 degrees C, and the surviving cells were analyzed for the presence of a suppressor mutation. One group of suppressed mutants had acquired a new mutation which, by conjugation, was found to be located in the 30- to 40-min region of the E. coli genetic map. The other group comprised revertants carrying a suppressor which appeared to map between thr and leu. This suppressor gene, called sftA, was cloned with a mini-Mu derived in vivo cloning system by selection for suppression of temperature sensitivity in GD40 cells. Subsequent subcloning of a fragment of the chromosomal DNA from the mini-Mu plasmid into pBR325 resulted in the delineation of the suppressor gene on a 1.8-kilobase XhoI-PvuI fragment. A strain, CV514, which does not express the temperature sensitivity phenotype of the ftsM1 mutation, was found to harbor a natural suppressor of this mutation. UV sensitivity, another known phenotype of the ftsM1 mutation, was also corrected by the presence of the sftA suppressor in the cell. Thus, the characterization of extragenic suppressors may allow the identification of new genes involved in the control of cell division. PMID- 3511032 TI - Host cell variations resulting from F plasmid-controlled replication of the Escherichia coli chromosome. AB - Cell size and DNA concentration were measured in Escherichia coli K-12 ET64. This strain carries a dnaA (Ts) mutation that has been suppressed by the insertion of the F plasmid into the chromosome. ET64 can grow in a balanced steady state of exponential growth at the restrictive temperature for its dnaA allele (39 degrees C), in which chromosome replication is controlled by the F plasmid, and at the permissive temperature (30 degrees C), in which chromosome replication is controlled by dnaA-oriC. When cells grown at the indicated temperatures were compared, it was observed that at 39 degrees C, the cell mass increased and the amount of cellular DNA decreased slightly; therefore, the DNA concentration was strongly reduced. These changes can neither be explained by the reduction of the generation time (which is only 10-15%) nor from observed changes in the replication time and in the time between DNA synthesis termination and cell division. Variations were mainly due to the increase in cell mass per origin of replication, at initiation, in cells grown at 39 degrees C. Control of chromosome replication by the F plasmid appears to be the reason for the increase in the initiation mass. Other possible causes, such as the modification of growth temperature, the generation time, or both, were discarded. These observations suggest that at one growth rate, the F plasmid replicates at a particular cell mass to F particle number ratio, and that this ratio is higher than the cell mass to oriC ratio at the initiation of chromosome replication. This fact might be significant to coordinate the replication of two different replicons in the same cell. PMID- 3511033 TI - Regulation of peptide transport in Escherichia coli: induction of the trp-linked operon encoding the oligopeptide permease. AB - Growth of Escherichia coli in medium containing leucine results in increased entry of exogenously supplied tripeptides into the bacterial cell. This leucine mediated elevation of peptide transport required expression of the trp-linked opp operon and was accompanied by increased sensitivity to toxic tripeptides, by an enhanced capacity to utilize nutritional peptides, and by an increase in both the velocity and apparent steady-state level of L-[U-14C]alanyl-L-alanyl-L-alanine accumulation for E. coli grown in leucine-containing medium relative to these parameters of peptide transport measured with bacteria grown in media lacking leucine. Direct measurement of opp operon expression by pulse-labeling experiments demonstrated that growth of E. coli in the presence of leucine resulted in increased synthesis of the oppA-encoded periplasmic binding protein. PMID- 3511034 TI - Acetohydroxy acid synthase I, a required enzyme for isoleucine and valine biosynthesis in Escherichia coli K-12 during growth on acetate as the sole carbon source. AB - Escherichia coli K-12 has two acetohydroxy acid synthase (AHAS) isozymes (AHAS I and AHAS III). Both of these isozymes catalyze the synthesis of alpha-aceto-alpha hydroxybutyrate and alpha-acetolactate, which are key intermediates of the isoleucine-valine biosynthetic pathway. Strains lacking either isozyme but not both activities have been previously shown to grow well in minimal media in the absence of isoleucine and valine on any of several commonly used carbon sources (e.g., glucose or succinate). We report the characterization of mutants that were unable to grow on either acetate or oleate as a sole carbon source due to a defect in isoleucine-valine biosynthesis. The defect in isoleucine-valine biosynthesis was expressed only on these carbon sources and was due to the loss of AHAS I activity, resulting from lesions in the ilvBN operon. Previously identified ilvBN mutant strains also failed to grow on acetate or oleate minimal media. Our results indicated that AHAS I is an essential enzyme for isoleucine and valine biosynthesis when E. coli K-12 is grown on acetate or oleate as the sole carbon source. AHAS III was expressed during growth on acetate or oleate but was somehow unable to produce sufficient amounts of alpha-aceto-alpha hydroxybutyrate and alpha-acetolactate to allow growth. PMID- 3511035 TI - Precursor for elongation factor Tu from Escherichia coli. AB - The tufA gene, one of two genes in Escherichia coli encoding elongation factor Tu (EF-Tu), was cloned into a ColE1-derived plasmid downstream of the lac promoter operator. In cells carrying this plasmid, the synthesis of EF-Tu was increased four- to fivefold upon the addition of isopropyl-beta-D-thiogalactopyranoside (an inducer of the lac promoter). This condition led to the synthesis of a novel protein, called pTu, which comigrated with EF-Tu on a sodium dodecyl sulfate polyacrylamide gel but could be separated on an isoelectric focusing gel, since pTu is slightly more basic than EF-Tu. The synthesis of pTu could also be induced by the synthesis of a hybrid protein containing just the amino-terminal half of the EF-Tu protein. Genetic data suggest that pTu is the product of the tufA and tufB genes. The pTu protein was shown to be related to EF-Tu by gel electrophoresis of tryptic peptides. Pulse-chase experiments suggest that pTu is a precursor of EF-Tu. Interestingly, in a classic membrane fractionation procedure, EF-Tu was found in the cytosolic fraction, whereas pTu was partitioned with the outer membrane. PMID- 3511036 TI - Immunological homology between the membrane-bound uptake hydrogenases of Rhizobium japonicum and Escherichia coli. AB - Two polypeptides present in aerobic and anaerobic cultures of Escherichia coli HB101 were shown to cross-react with antibodies to the 30- and 60-kilodalton (kDa) subunits of the uptake hydrogenase of Rhizobium japonicum. The cross reactive polypeptides in a series of different E. coli strains are of Mrs ca. 60,000 and 30,000, and both polypeptides are present in proportion to measurable hydrogen uptake (Hup) activity (r = 0.95). The 60-kDa polypeptide from E. coli HB101 comigrated on native gels with detectable Hup activity. The exact role of the 30-kDa polypeptide in E. coli is unclear. E. coli MBM7061, a natural Hup- variant, grown anaerobically or aerobically lacked detectable Hup activity and failed to cross-react with the antisera against the hydrogenase from R. japonicum. Anaerobically cultured E. coli MBM7061, however, did express formate hydrogenlyase activity, indicating that the hydrogenases involved in the oxygen dependent activation of hydrogen and the formate-dependent evolution of hydrogen are biochemically distinct. PMID- 3511038 TI - Effect of a 2-methylthio-N6-isopentenyladenosine deficiency on peptidyl-tRNA release in Escherichia coli. AB - We examined the effect of miaA, a mutation conferring a deficiency in 2 methylthio-N6-isopentenyladenosine in tRNA, on patterns of peptidyl-tRNA accumulation in Escherichia coli strains deficient in peptidyl-tRNA hydrolase activity. A specific reduction in peptidyl-tRNA accumulation was seen for tRNAs which normally contain the 2-methylthio-N6-isopentenyladenosine modification. These results provide new evidence in support of the ribosome editor model, which links peptidyl-tRNA release to mistranslation events. PMID- 3511037 TI - Chlamydia trachomatis elementary bodies possess proteins which bind to eucaryotic cell membranes. AB - Chlamydia trachomatis proteins were electrophoresed and then transferred to nitrocellulose paper to detect chlamydial proteins which bind to eucaryotic cell membranes. Resolved polypeptides of C. trachomatis serovars J and L2 were reacted with iodinated HeLa cell membranes and autoradiographed. Infectious elementary bodies of both serovars possess 31,000- and 18,000-dalton proteins which bind to HeLa cells. In contrast, noninfectious reticulate bodies do not possess eucaryotic cell-binding proteins. Both proteins are antigenic when reacted with hyperimmune rabbit antisera in immunoblots and antisera raised against the 31,000 and 18,000-dalton proteins are inhibitory to chlamydia-host cell association. In addition, these antisera exhibit neutralizing activity. Our data suggest that these putative chlamydial adhesins play a key role in the early steps of chlamydia-host cell interaction and that antibody directed against them may be protective. PMID- 3511039 TI - Discontinuity in DNA replication during expression of accumulated initiation potential in dnaA mutants of Escherichia coli. AB - Potential for initiation of chromosome replication present in temperature sensitive, initiation-defective dnaA5 mutants of Escherichia coli B/r incubated at nonpermissive temperature was expressed by shifting to a more permissive temperature (25 degrees C). Upon expression of initiation potential, the rate of [3H]thymidine incorporation varied in a bimodal fashion, i.e., there was an initial burst of incorporation, which lasted 10 to 20 min, then a sudden decrease in incorporation, and finally a second rapid increase in incorporation. Analyses of this incorporation pattern indicated that a round of replication initiated upon expression of initiation potential, but DNA polymerization stopped after replication of 5 to 10% of the chromosome. This round of replication appeared to resume about 30 min later coincident with initiation of a second round of replication. The second initiation was unusually sensitive to low concentrations of novobiocin (ca. 1 microgram/ml) when this inhibitor was added in the presence of chloramphenicol. In the absence of chloramphenicol, novobiocin at this concentration had no detectable effect on DNA replication. It is suggested that cis-acting inhibition, attributable to an attempted second initiation immediately after the first, caused the first round to stall until both it and the second round could resume simultaneously. This DNA replication inhibition, probably caused by overinitiation, could be a consequence of restraints on replication in the vicinity of oriC, possibly topological in nature, which limit the minimum interinitiation interval in E. coli. PMID- 3511040 TI - Captopril in the treatment of psychogenic polydipsia. PMID- 3511041 TI - On the mechanism of pairing of single- and double-stranded DNA molecules by the recA and single-stranded DNA-binding proteins of Escherichia coli. AB - The pairing of single- and double-stranded DNA molecules at homologous sequences promoted by recA and single-stranded DNA-binding proteins of Escherichia coli follows apparent first-order kinetics. The initial rate and first-order rate constant for the reaction are maximal at approximately 1 recA protein/3 and 1 single-stranded DNA-binding protein/8 nucleotides of single-stranded DNA. The initial rate increases with the concentration of duplex DNA; however, the rate constant is independent of duplex DNA concentration. Both the rate constant and extent of reaction increase linearly with increasing length of duplex DNA over the range 366 to 8623 base pairs. In contrast, the rate constant is independent of the size of the circular single-stranded DNA between 6,400 and 10,100 nucleotides. No significant effect on reaction rate is observed when a single stranded DNA is paired with 477 base pairs of homologous duplex DNA joined to increasing lengths of heterologous DNA (627-2,367 base pairs). Similarly, heterologous T7 DNA has no effect on the rate of pairing. These findings support a mechanism in which a recA protein-single-stranded DNA complex interacts with the duplex DNA to produce an intermediate in which the two DNA molecules are aligned at homologous sequences. Conversion of the intermediate to a paranemic joint then occurs in a rate-determining unimolecular process. PMID- 3511042 TI - A new erythrocyte membrane-associated protein with calmodulin binding activity. Identification and purification. AB - A new protein that binds calmodulin has been identified and purified to greater than 95% homogeneity from the Triton X-100-insoluble residue of human erythrocyte ghost membranes (cytoskeletons) by DEAE chromatography and preparative rate zonal sucrose gradient sedimentation. This ghost calmodulin-binding protein is an alpha/beta heterodimer with subunits of Mr = 103,000 (alpha) and 97,000 (beta). The protein exhibits a Stokes radius of 6.9 nm and a sedimentation coefficient of 6.8 S, corresponding to a molecular weight of 197,000. Moreover, the protein is cross-linked by Cu2+/phenanthroline to a dimer of Mr = 200,000. The Mr = 97,000 beta subunit was identified as the calmodulin-binding site by photoaffinity labeling with 125I-azidocalmodulin. A 230 nM affinity for calmodulin was estimated by displacement of two different concentrations of the 125I azidocalmodulin with unmodified calmodulin and subsequent Dixon plot analysis. This calmodulin-binding protein is present in erythrocytes at 30,000 copies/cell and is associated exclusively with the membrane. It is tightly bound to a site on red cell cytoskeletons and is totally solubilized in the low ionic strength extract derived from red cell ghost membranes. Visualization of this calmodulin binding protein in the electron microscope by rotary shadowing, negative staining, and unidirectional shadowing indicates that it is a flattened circular molecule with a 12.4-nm diameter and a 5.4-nm height. Affinity-purified antibodies against the calmodulin-binding protein identify a cross-reacting Mr = 100,000 polypeptide(s) in brain membranes. PMID- 3511043 TI - Evidence for a thiol ester in duck ovostatin (ovomacroglobulin). AB - The structure and the mechanism for proteinase inhibition of the egg white protein ovostatin (ovomacroglobulin) are similar to those of plasma alpha 2 macroglobulin, but previous studies have shown that chicken ovostatin lacks a reactive thiol ester (Nagase, H., and Harris, E. D., Jr. (1983) J. Biol. Chem. 258, 7490-7498). Here we show that duck ovostatin has conserved such a thiol ester and is capable of inhibiting both metallo- and serine proteinases stoichiometrically. Evidence for thiol esters was established by the following results with duck ovostatin: 1) autolysis into fragments of Mr = 123,000 and 60,000 occurred by heating in sodium dodecyl sulfate, but was prevented by treatment with CH3NH2; 2) covalent linkages were formed with proteinases on complex formation; 3) reaction with CH3NH2 generated 3.6 SH groups/mol, and 3.9 mol of [14C]CH3NH2 were incorporated per mol of protein; and 4) saturation with a proteinase liberated 3.8 SH groups/mol of the inhibitor. Conformational rearrangement of duck ovostatin upon reacting with CH3NH2 or proteinases was demonstrated by an increased mobility of the protein in polyacrylamide gel electrophoresis. CH3NH2-treated duck ovostatin was able to bind and inhibit proteinases without forming covalent bonds, but, unlike unmodified ovostatin, its inhibitory activity was destroyed by freezing and thawing. Complexes formed between CH3NH2-treated duck ovostatin and a proteinase were not dissociable except under denaturing conditions. These results and other evidence indicate that covalent bond formation through reaction with a thiol ester is a separate process from the trapping and inhibition of proteinases by this family of proteins. PMID- 3511044 TI - A potent synthetic peptide inhibitor of the cAMP-dependent protein kinase. AB - As an important new reagent for studying the cAMP-dependent protein kinase, a 20 residue peptide has been synthesized that corresponds to the active site of the skeletal muscle inhibitor protein. This synthetic peptide inhibits the protein kinase competitively with a Ki = 2.3 nM; its sequence, Thr-Thr-Tyr-Ala-Asp-Phe Ile-Ala-Ser-Gly-Arg-Thr- Gly-Arg-Arg-Asn-Ala-Ile-His-Asp, is that of a peptide previously reported by us which was derived from the native inhibitor protein by V8 protease digestion (Cheng, H. C., Van Patten, S. M., Smith, A. J., and Walsh, D. A. (1985) Biochem. J. 231, 655-661). Studies with analogues of this peptide show that its high affinity binding to the protein kinase (as also of the inhibitor protein) appears to be due to it mimicking the protein substrate by binding to the catalytic site via the arginine-cluster basic subsite (Formula: see text), and also to a critical contribution from one or more of the 6 N terminal residues (Formula: see text). The availability of this high affinity synthetic peptide should open up a variety of avenues to probe the cellular actions of cAMP. PMID- 3511045 TI - Characterization of the monovalent cation activator binding site of S adenosylmethionine synthetase by 205Tl NMR of enzyme-bound Tl+. AB - The structure of the binding site for the monovalent cation activator of S adenosylmethionine (AdoMet) synthetase from Escherichia coli has been characterized by 205Tl NMR of enzyme-bound Tl+. The chemical shift of the enzyme Tl+ complex is 176 ppm downfield from aquo Tl+, a shift which is typical only of Tl+ complexes with solely oxygen ligands. The 205Tl resonance shifts upfield to 85 ppm in the enzyme-Mg(II)-Tl+ complex, to 38 ppm in the enzyme-Tl+-AdoMet complex and to 34 ppm in the enzyme-Tl+-AdoMet-Mg(II) complex. The 205Tl chemical shift of enzyme-bound Tl+ was not altered by binding of either methionine, or the Mg(II)-ATP analog Mg(II)-adenyl-5'-yl imidodiphosphate, or Mg(II)-pyrophosphate to the enzyme-Tl+-Mg(II) complex. The NMR data suggest that the substrates or products of the enzyme do not coordinate to the monovalent cation activator and imply that monovalent cation activation results from alterations in protein conformation. PMID- 3511046 TI - Complete nucleotide sequence of type 6 M protein of the group A Streptococcus. Repetitive structure and membrane anchor. AB - The DNA sequence of the gene for type 6 M protein of Streptococcus pyogenes contains two extended tandem repeat regions and one nontandem repeat region. We suggest that the duplication and deletion of these repeats generates the observed diversity in size and sequence among the family of M proteins in the group A streptococci. In addition, the DNA sequence reveals the presence of a 42-amino acid signal peptide, a region rich in proline that is thought to be located in the cell wall, and a membrane anchor sequence at the carboxyl-terminal end of the protein. Signals similar to the consensus sequences recognized for the initiation of transcription and translation in Gram-positive bacteria have been identified in the DNA sequence. Codon usage is similar to that of other Gram-positive bacteria and significantly different from that of Escherichia coli. PMID- 3511047 TI - Equilibrium binding of insulin to rat white fat cells at 15 degrees C. AB - Equilibrium binding of insulin to isolated rat epididymal fat cells was investigated. A temperature of 15 degrees C was chosen for the study to minimize lysosomal degradation of insulin. Indeed, medium insulin lost only 1% of its precipitability in trichloroacetic acid during the 4-h incubation required to approach equilibrium. Binding was measured by a method that did not perturb the equilibrium of the system. A new formalism for analyzing binding data in general was introduced. A correction for trapping of insulin in the interstitial space of cell pellets was both necessary and sufficient to derive specific binding data from raw observations. Thus, so-called "nonspecific binding" was unmasked as a misnomer, and the expression "correction for trapping" was proposed as a substitute. Equations for one and two independent classes of binding sites were fit to the data by the method of maximum likelihood, and the best fit was selected based on Akaike's information criterion, as adapted for a constant fractional error. More than 99.7% of the binding sites were found to be describable by a simple binding isotherm with Kd,app = 8.8 multiplied by over divided by 1.3 nM. Less than 0.3% sites had a higher affinity (Kd approximately equal to 8 multiplied by over divided by 3 pM). There were 99,000 x/divided by 1.6 binding sites/cell. These equilibrium parameters are in agreement with values derived from a kinetic analysis, presented in the subsequent paper (Lipkin, E. W., Teller, D. C., and de Haen, C. (1986) J. Biol. Chem. 260, 1702-1711). PMID- 3511048 TI - Kinetics of insulin binding to rat white fat cells at 15 degrees C. AB - The kinetics of insulin binding to isolated rat epididymal fat cells was investigated at 15 degrees C, at which temperature the system was simplified by the absence of lysosomal insulin degradation. The data were fit by maximum likelihood criteria with differential equations describing a number of models for the interaction of insulin and cells. Among those models that yielded a fit, the selection criteria were minimization of the Akaike information criterion and compatibility of the overall equilibrium constant for the system calculated from rate constants with the previously obtained experimental value. The results of the analysis indicated that insulin, I, first reversibly bound to cell surface receptors, R, whereupon this initial insulin-receptor complex, RI, reversibly altered its state or cellular location to R'I, according to the following equation. (Formula: see text) No evidence was found that insulin could either associate or dissociate from R'I directly. The association rate constant was kappa 12 = 1.6 x/divided by 1.4 X 10(5) liter mol-1 s-1, a value shown to be incompatible with diffusion control. The other rate constants were: kappa 21 = 3.4 x/divided by 1.6 X 10(-3) s-1, kappa 23 = 3.2 x/divided by 1.5 X 10(-4) s-1, and kappa 32 = 2.0 x/divided by 1.5 X 10(-4) s-1. From these rate constants, an equilibrium constant of 8.4 x/divided by 1.5 nM was calculated, in excellent agreement with the previously measured value of 8.8 x/divided by 1.3 nM (Lipkin, E. W., Teller, D. C., and de Haen, C. (1986) J. Biol. Chem. 260, 1694-1701). The kinetic analysis also yielded receptor numbers similar to those obtained by equilibrium binding studies. The nature of the R'I state is discussed in terms of an internalized state, in terms of insulin receptor complex in caveolae, in terms of receptor aggregates, and in terms of being a Michaelis complex between insulin bound to the receptor and cell surface-bound insulin protease. PMID- 3511049 TI - The major excreted protein of transformed fibroblasts is an activable acid protease. AB - Malignant transformation of mouse cells by a variety of agents or treatment with the tumor promoter 12-O-tetradecanoylphorbol 13-acetate or platelet-derived growth factor results in increased synthesis and secretion of a 39,000-dalton protein termed major excreted protein (MEP). We report here that secreted MEP is an acid-activable protease. The secreted precursor form of the protease is auto activated at low pH and is able to digest a variety of proteins, including the extracellular matrix proteins fibronectin, collagen, and laminin. MEP protease activity has pH optimum of 3.3-3.6 and is temperature- and concentration dependent. The activity is inhibited by sulfhydryl protease inhibitors such as leupeptin and iodoacetic acid and not by metallo-, seryl-, or carboxyprotease inhibitors. The MEP-derived protease has characteristics distinct from the cathepsins previously reported and thus may be a new acid-protease of mouse cells. PMID- 3511050 TI - Reconstitution of quinone reduction and characterization of Escherichia coli fumarate reductase activity. AB - Resolution of the fumarate reductase complex (ABCD) of Escherichia coli into reconstitutively active enzyme (AB) and a detergent preparation containing peptides C and D resulted in loss of quinone reductase activity, but the phenazine methosulfate or fumarate reductase activity of the enzyme was unaffected. An essential role for peptides C and D in quinone reduction was confirmed by restoration of this activity on recombination of the respective preparations. Neither peptide C nor peptide D by itself proved capable of permitting quinone reduction and membrane binding by the enzyme when E. coli cells were transformed with plasmids coding for the enzyme and the particular peptides. Transformation of a plasmid coding for all subunits resulted in a 30 fold increase in membrane-bound complex, which exhibited, however, turnover numbers for succinate oxidation and fumarate reduction that were intermediate between the high values characteristic of chromosomally produced complex and the relatively low values found for the isolated complex. It is also shown that preparations of the isolated complex and membrane-bound form of the enzyme, as obtained from anaerobically grown cells, are in the deactivated state owing to the presence of tightly bound oxalacetate and thus must be activated prior to assay. PMID- 3511051 TI - Biochemical and functional heterogeneity of rat adipocyte glucose transporters. AB - We have studied the biochemical mechanism of insulin action on glucose transport in the rat adipocyte. Plasma membranes and low-density microsomes were prepared by differential ultracentrifugation of basal and insulin-stimulated cells. The photochemical cross-linking agent hydroxysuccinimidyl-4-azidobenzoate was used to covalently bind [3H]cytochalasin B to the glucose transporter which migrated as a 45-50-kDa protein on sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Isoelectric focusing of the eluted 40-55-kDa proteins revealed two peaks of D glucose-inhibitable [3H]cytochalasin B radioactivity focusing at pH 6.4 and 5.6 when low-density microsomes were used as the starting material. In contrast, only one D-glucose inhibitable peak, focusing at pH 5.6, was found in plasma membranes. Pretreatment of the cells with insulin led to a marked redistribution of the pH 5.6 form of the glucose transporter from low-density microsomes to plasma membranes with no effect on the pH 6.4 form of the glucose transporter. Following isolation from the isoelectric focusing and sodium dodecyl sulfate polyacrylamide gels, both glucose transporter isoforms were shown to cross-react with an antiserum raised against the purified human erythrocyte glucose transporter. Following incubation of [3H]cytochalasin B-labeled low-density microsomal and plasma membranes with neuraminidase, the pH 5.6 transporter isoform was shifted on isoelectric focusing to a more basic pH, while the pH 6.4 isoform was not affected. These data demonstrate that: there is a heterogeneity of glucose transporter species in the intracellular pool while the plasma membrane transporters are more uniform in structure. The pH 5.6 glucose transporter isoform is translocated by insulin from the low-density microsomes to the plasma membrane but the pH 6.4 isoform is not sensitive to insulin. Differential sensitivity of the glucose transporter isoforms to neuraminidase suggests that the heterogeneity is at least partially due to differences in glycosylation state. PMID- 3511053 TI - A photoaffinity-labeled allosteric site in Escherichia coli ribonucleotide reductase. AB - The B1 subunit of Escherichia coli ribonucleotide reductase is coded for by the nrdA gene, of determined structure. Protein B1 contains two types of allosteric binding sites. One type (h-sites) determines the substrate specificity while the other type (l sites) governs the overall activity. The effectors dGTP and dTTP bind only to the h-sites while dATP and ATP bind to both the h- and the l-sites. Protein B1 has been photoaffinity-labeled with radioactive dTTP and dATP using direct UV irradiation. Following tryptic digestion of labeled protein B1 only one peptide labeled with dTTP was found, while several peptides were labeled with dATP. One of the dATP-labeled peptides had chromatographic properties very similar to that labeled with dTTP and this peptide most likely forms part of the h-site of protein B1. Labeling of the l-site could not be conclusively shown since substantial non-specific labeling occurred with dATP. CNBr fragments of dTTP-labeled protein B1 were used to localize the region of nucleotide binding in the deduced primary structure of the nrdA gene. The dTTP label was further localized to a tryptic octapeptide with the sequence Ser-X-Ser-Gln-Gly-Gly-Val Arg. The labeled amino acid was found at position 2, but the residue itself could not be directly identified. Unexpectedly, this sequence was not found in the earlier reported primary structure of the nrdA gene. However, a recent revised structure of the gene identifies the labeled residue as Cys-289 and fully confirms the rest of the peptide sequence. Thus the present result clearly defines one of the allosteric binding sites in ribonucleotide reductase. PMID- 3511052 TI - Effect of amino acid substitutions at the signal peptide cleavage site of the Escherichia coli major outer membrane lipoprotein. AB - The requirement for the glycine residue at the COOH terminus of the signal peptide of the precursor of the major Escherichia coli outer membrane lipoprotein was examined. Using oligonucleotide-directed site-specific mutagenesis, this residue was replaced by residues of increasing side chain size. Substitution by serine had no effect on the modification or processing of the prolipoprotein. Substitution by valine or leucine resulted in the accumulation of the unmodified precursor, whereas threonine substitution resulted in slow lipid modification and no detectable processing of the lipid modified precursor. The results indicate that serine is the upper limit on size for the residue at the cleavage site. Larger residues at this position prevent the action of both the glyceride transferase and signal peptidase II enzymes, indicating that the cleavage site residue plays a role in events prior to proteolytic cleavage. The upper limit on size of the cleavage site residue is similar to that found for exported proteins cleaved by signal peptidase I, as well as eucaryotic exported proteins. The possibility that the cleavage site residue may have a role other than active site recognition by the signal peptidase is discussed. PMID- 3511054 TI - DARPP-32, a dopamine- and cyclic AMP-regulated neuronal phosphoprotein. Primary structure and homology with protein phosphatase inhibitor-1. AB - The complete amino acid sequence of bovine brain DARPP-32, a dopamine- and cyclic AMP-regulated neuronal phosphoprotein, which is a potent and specific inhibitor of the catalytic subunit of protein phosphatase-1, has been determined. The S-14C carboxymethylated protein was subjected to enzymatic cleavage by endoproteinase Lys-C, endoproteinase Arg-C, trypsin, chymotrypsin, and Staphylococcus aureus V8 protease, and to chemical cleavage by cyanogen bromide. The overlapping sets of peptides were purified by high performance liquid chromatography and subjected to amino acid sequencing by automated Edman degradation to deduce the complete sequence. The protein consists of a single NH2-terminal blocked polypeptide chain of 202 residues, with a calculated molecular mass of 22,591 daltons, excluding the unidentified NH2-terminal blocking group. This molecular mass is significantly lower than earlier estimates based on sodium dodecyl sulfate polyacrylamide gel electrophoresis or hydrodynamic measurements. The threonine residue that is phosphorylated by cyclic AMP-dependent protein kinase (Hemmings, H. C., Jr., Williams, K. R., Konigsberg, W. H., and Greengard, P. (1984) J. Biol. Chem. 259, 14486-14490), and that must be phosphorylated for the expression of inhibitory activity, is located at position 34. The molecule contains only 1 cysteine residue and 1 tryptophan residue, at positions 72 and 161, respectively. DARPP-32 is very hydrophilic, and contains a stretch of 16 consecutive acidic residues from position 119 to 134. The predicted secondary structure suggests the presence of 47% alpha-helix, 7% beta-sheet, and 46% random coil, with 11 beta turns. Comparison of the complete amino acid sequence of bovine DARPP-32 with that of rabbit skeletal muscle protein phosphatase inhibitor-1 revealed a significant amount of sequence identity in the NH2-terminal regions of these two proteins. The active region of inhibitor-1 has been localized to an NH2-terminal fragment (Aitken, A., and Cohen, P. (1982) FEBS Lett. 147, 54-58), the part of the molecule that is most similar to DARPP-32. These data suggest that these two protein phosphatase inhibitors may share a common structural basis for their inhibitory activity and may be related by a common ancestral gene. PMID- 3511055 TI - Isolation, characterization, and preliminary X-ray diffraction data for a serine protease from Penicillium cyclopium. AB - The major extracellular protein of Penicillium cyclopium has been isolated from its culture media and purified by ammonium sulfate fractionation, gel, and ion exchange chromatography. We show this secreted protein to be endopeptidase. The molecular weight is approximately 32,000, the pI is 5.0, and the pH optimum using a variety of protein and synthetic substrates is around 7.0. Inhibition studies show that the protease is not inhibited by pepstatin nor by p chloromercuribenzoic acid, indicating, respectively, that it is not an aspartyl protease nor a thiol protease. Complete inhibition is observed, however, with phenylmethanesulfonyl fluoride. Three crystal forms suitable for high resolution x-ray diffraction studies have been obtained from this purified protease with reflections being observed to well beyond 3.0 A resolution. One form having a needle morphology is of the orthorhombic crystal class and has space group P2(1)2(1)2(1). The unit cell dimensions are a = 41.9 A, b = 43.2 A, and c = 111.5 A with 1 molecule of the protease occurring in the asymmetric unit. The second form grown at pH values less than 6.0 has a plate morphology, is of orthorhombic space group P2(1)2(1)2(1), and has unit cell dimensions a = 59.12 A, b = 62.33 A, and c = 70.62 A. The third form is polyhedral in habit, is also of space group P2(1)2(1)2(1), and appears when the pH of the mother liquor is greater than 7.0. The cell dimensions of this crystal form are a = 57.07 A, b = 58.82 A, c = 70.79 A, and again there is 1 molecule/asymmetric unit. Three-dimensional structural analysis by x-ray diffraction is now underway. All crystal forms are somewhat denser than the norm having mass to volume ratios of 1.58, 2.00, and 1.85 A3/dalton, respectively. PMID- 3511056 TI - Hormonal triggering of the diurnal variation of sterol carrier protein. AB - Rat liver sterol carrier protein (SCP) is a major intracellular protein regulating lipid metabolism and transport. During a dark-light cycle, SCP undergoes a dramatic diurnal variation in synthesis and level, reflecting translational events. Several hormones participate in the control of SCP synthesis. Insulin was implicated when the circadian rhythm of SCP was lost in both diabetes and fasting, states where insulin is low. After a 12-h fast the amplitude of the diurnal rhythm is diminished; after a 48-h fast it disappears, although SCP synthesis and level remain high. When endogenous insulin secretion is increased in fasted rats by glucose administration, SCP increases 2-fold in less than 30 min. When food intake is manipulated, but the dark-light cycle is unchanged, the circadian rhythm of SCP corresponds to feeding patterns and not light cycling. During feeding, increases in SCP are triggered following the expected increase in serum insulin. However, SCP is rapidly and significantly elevated in response to insulin only when glucocorticoids are normally high or increased by injection of the synthetic glucocorticoid, dexamethasone. Hepatocyte SCP levels are also induced by a combination of insulin and dexamethasone (2.3 fold) or insulin alone (1.3-fold). Dexamethasone alone causes a striking depression of SCP (2.4-fold). Thus, insulin is a major regulator of the diurnal variation of SCP synthesis. Glucocorticoids and other hormones (e.g. triiodothyronine) are also essential for maximum induction of SCP but play permissive roles. PMID- 3511057 TI - Insulin receptor processing as a function of erythrocyte age. A kinetic model for down-regulation. AB - The effects of cell aging on insulin binding and on insulin receptor processing in human erythrocytes were studied. Erythrocytes were found to exponentially lose equal proportions of both high and low affinity receptors as a function of age. The affinities of remaining surface receptors did not change significantly. The maximum extent of insulin receptor down-regulation that could be induced decreased linearly with age over the range studied. Together with dose-response and time course studies, these age-related changes in insulin binding and receptor down-regulation were used to develop a kinetic model in which receptor internalization is a function of surface receptor concentration. The ability of the model to predict the behavior of a heterogeneous population suggests that changes in receptor processing with age may be attributed to changes in the surface receptor concentration. PMID- 3511058 TI - The novel microtubule-associated protein MAP3 contributes to the in vitro assembly of brain microtubules. AB - MAP3 is a novel microtubule-associated protein found in brain and a variety of other tissues (Huber, G., Alaimo-Beuret, D., and Matus, A. (1985) J. Cell Biol. 100, 496-507). In this study, monoclonal antibodies were used to assess its influence on the polymerization of brain tubulin. When added to unpolymerized brain microtubules, anti-MAP3 IgG produced a dose-related inhibition of subsequent assembly. Under the same circumstances, nonimmune mouse IgG did not influence either the rate or the extent of tubulin polymerization. We also used immobilized antibodies to deplete brain MAPs selectively in either MAP3 or MAP1. MAP3-depleted MAPs showed a reproducible decrease in activity compared to control preparations that had been exposed to immobilized nonimmune IgG. MAP1-depleted MAPs did not differ significantly in performance from the nonimmune treated controls. We conclude that MAP3 contributes to the net assembly of brain microtubules observed in vitro. This may be particularly relevant in neonatal animals where brain MAP3 is more abundant than in the adult. PMID- 3511059 TI - Characterization of the DNA-binding protein antigen Ku recognized by autoantibodies from patients with rheumatic disorders. AB - We have characterized the biochemical nature of the Ku protein, the antigen recognized by autoantibodies from certain patients with scleroderma-polymyositis overlap syndrome. From extracts of HeLa cells labeled with [32P]orthophosphate, anti-Ku antibodies precipitated a high molecular weight nucleic acid identified as DNA because of sensitivity to DNase I and resistance to RNase. From extracts of cells labeled with [35S] methionine, these antibodies precipitated two polypeptides of 70,000 and 80,000 Da. These proteins were purified using immunoaffinity column chromatography. In immunoblots most sera containing anti-Ku antibodies recognized both Ku proteins but one serum bound only to the 70,000-Da subunit. When nucleosomal segments of chromatin were used as antigen, anti-Ku antibodies precipitated dinucleosomes and larger forms of chromatin but not mononucleosomes. Thus, the Ku antigen is a novel DNA-binding protein that is at least partially exposed on nucleosomal segments of chromatin. PMID- 3511060 TI - The ribosomal binding domain of the Escherichia coli release factors. Modification of tyrosine in the N-terminal domain of ribosomal protein L11 affects release factors 1 and 2 differentially. AB - Ribosomal protein L11 is one of only two ribosomal proteins significantly iodinated when Escherichia coli 50 S subunits are modified by immobilized lactoperoxidase, and the major target has been shown previously to be tyrosine at position 7 in the N-terminal domain. This modification reduces in vitro termination activity with release factor (RF)-1 by 70-90%, but RF-2 activity is less affected (30-50%). The loss of activity parallels incorporation of iodine into the subunit. The 50 S subunits from L11-lacking strains of bacteria have highly elevated activity with RF-2 and low activity with RF-1. The iodination does not affect RF-2 activity but reduces the RF-1 activity further. Ribosomal proteins, L2, L6, and L25, are significantly labeled in L11-lacking ribosomes in contrast to the control 50 S subunits. L11 has been modified in isolation and incorporated back efficiently into L11-lacking ribosomes. This L11, iodinated also predominantly at Tyr 7, is unable to restore RF-1 activity to L11-lacking ribosomes in contrast to mock-iodinated protein. These results suggest the involvement of the N terminus of L11 in the binding domain of the bacterial release factors and indicate that there are subtle differences in how the two factors interact with the ribosome. PMID- 3511061 TI - Evolutionary shift in the site of cleavage of prelysozyme. AB - Sequences are presented for the signal peptides of prelysozymes from 6 species of birds and compared to the known sequence for chicken prelysozyme c. The sequencing was done with synthetic oligonucleotides as primers and oviduct mRNA as the template, obviating the need to clone DNA from these species. Ring-necked pheasant prelysozyme c differs from all other prelysozymes c and pre-alpha lactalbumins examined by being cleaved in vivo between amino acid residues 17 and 18 instead of between residues 18 and 19. The feature unique to the signal peptide of pheasant prelysozyme c is proline at position 17. Besides showing that proline is acceptable as the carboxyl-terminal amino acid of the signal peptide, our finding implies that it cannot occur as the penultimate amino acid in the signal peptide. This supports the view that unless a polypeptide has the proper secondary structure, signal peptidase will not cleave it, and that this secondary structure is a beta-turn. Another outcome of this comparative study is an estimate that the mean rate of sequence evolution in the prelysozyme signal peptide is 1%/two million years of divergence, similar to that calculated for the insulin signal peptide. Because this rate is a third of the silent substitution rate, it is likely that one out of every three amino acid substitutions is compatible with signal peptide function. PMID- 3511062 TI - Purification, substrate specificity, and classification of tripeptidyl peptidase II. AB - An extralysosomal tripeptide-releasing aminopeptidase was recently discovered in rat liver (Balow, R.-M., Ragnarsson, U., and Zetterqvist, O. (1983) J. Biol. Chem. 258, 11622-11628). In the present work this tripeptidyl peptidase is shown to occur in several rat tissues and in human erythrocytes. The erythrocyte enzyme was purified about 80,000-fold from a hemolysate while the rat liver enzyme was purified about 4,000-fold from a homogenate. Upon polyacrylamide gel electrophoresis in sodium dodecyl sulfate under reducing conditions more than 90% of the protein was represented by a polypeptide of Mr 135,000 in both cases. In addition, the two enzymes eluted at similar positions in the various chromatographic steps, showed similar specific activity, and had a pH optimum around 7.5. A tryptic pentadecapeptide from the alpha-chain of human hemoglobin, Val-Gly-Ala-His-Ala-Gly-Glu-Tyr-Gly-Ala-Glu-Ala-Leu-Glu-Arg, i.e. residues 17-31, was found to be sequentially cleaved by the erythrocyte enzyme into five tripeptides, beginning from the NH2 terminus. Chromogenic tripeptidylamides showed various rates of hydrolysis at pH 7.5. With Ala-Ala-Phe-4-methyl-7 coumarylamide, Km was 16 microM and Vmax 13 mumol min-1 . mg-1, comparable to the standard substrate Arg-Arg-Ala-Ser(32P)-Val-Ala values (Km 13 microM and Vmax 24 mumol . min-1 . mg-1). The tripeptidyl peptidase of human erythrocytes was classified as a serine peptidase from its irreversible inhibition by phenylmethanesulfonyl fluoride and diisopropyl fluorophosphate. The rate of inhibition was decreased by the presence of an efficient competitive inhibitor, Val-Leu-Arg-Arg-Ala-Ser-Val-Ala (Ki 1.5 microM). [3H]Diisopropylphosphate was incorporated to the extent of 0.7-0.9 mol/mol of Mr 135,000 subunit, which confirms the high purity of the enzyme. PMID- 3511063 TI - Giant-cell tumor of bone. AB - Our experience involving 221 consecutive patients with giant-cell tumor who were treated from 1960 to 1982 is reported. Of one group of 146 patients, twenty-seven who were initially treated by wide resection and 112 who had thorough curettage had a recurrence rate of 23 per cent after an average length of follow-up of seven years. All thirty-three recurrences were noted less than six years after operation, and twenty-seven were noted within the first three years postoperatively. Over-all, the type of surgical removal was the most significant factor in recurrence. The recurrence rate was 34 per cent in the patients who had curettage of the lesion and 7 per cent in those who had a wide resection. In a second group of seventy-five patients, initially treated by us for a recurrent tumor, there were fifteen subsequent recurrences, after an average length of follow-up of seven years. Curettage and bone-grafting, with preservation of function of the joint, is the preferred treatment for most patients. PMID- 3511064 TI - Surgery of the innominate artery. AB - The authors describe their experience with the surgical treatment of 28 patients with obliteration or stenosis of the innominate artery. In 18 (64.3%) patients an intrathoracic operation was done and in three of these a multiple bypass from the aorta to the affected trunks was carried out. In the remaining 10 patients (35.7%) extrathoracic operations were carried out. Immediate results were good in 24 (85.7%) of cases. Thrombosis occurred in 3 during the first 30 days after operation. One patient suffered thrombosis of the bypass and following removal of this became comatose and subsequently died. Long term results were good inasmuch as at 5 years 94.8% of patients survived with a patent reconstruction. The clinical procedures reviewed as is the topography of associated lesions of the other supra-aortic trunks together with the different techniques employed and their indications. The authors express their preference for the technique of an end to side graft in the aorta and end to end in the innominate artery, when the distal portion of this artery is patent and the age and general state of the patient permits a thoracic approach. This technique assures revascularization of the right carotid and vertebral areas, apart from complying with optimal hemodynamic conditions. PMID- 3511065 TI - The investigation and surgery of the post-thrombotic syndrome. AB - This paper reviews the problems encountered in the diagnosis and management of the post-thrombotic syndrome. The functional abnormalities found in this condition and the various methods available for their investigation are described. Past methods of treatment are reviewed and the necessity for objective functional assessment of new operations is stressed. The methods of operative treatment are outlined and the results so far reported are evaluated. The relative roles of surgery and conservative treatment are discussed. PMID- 3511066 TI - A new technique for vascular anastomoses. AB - Vascular anastomoses are invariably performed manually and may be difficult technically particularly in smaller calibre vessels. This may be even more pronounced when an emergency situation exists and a surgeon relatively inexperienced in vascular surgery has to deal with the problem. A technique is described allowing for rapid anastomosis of vessels ranging upwards from a diameter of 2.5 mm using incomplete adjustable metal rings. The technique is simple and can be applied by surgeons with minimal vascular training. This could be extremely useful in the emergency situation, particularly when critical ischemia exists. Also, anastomoses of small calibre vessels such as in arterio venous fistula may be more simply performed by the aid of the described rings. PMID- 3511067 TI - Candida immunity in patients undergoing surgical treatment for heart valve disease. AB - The appearance of Candida antigen (Latex agglutination method), Candida antibodies (indirect immunofluorescence) and positive fungal cultures as well as the lymphocyte transformation response to Candida antigen "in vitro" was studied in a series of 37 successive patients before and after heart valve replacement. The Candida antigen test was positive preoperatively in 11/36 (31%) and postoperatively in 14/36 (39%) of the patients and in 2/200 (1%) of the controls (blood donors). The differences in the frequencies of positive tests between the patient group and the control group are significant (p less than 0.001). The lymphocyte response to Oidiomycin (Candida albicans) preoperatively was greater than the mean control value in 6/11 (54.5%) of the patients showing a positive Candida antigen test, but only in 4/25 (16.0%) of the patients who were Candida antigen negative. The total number of lymphocytes and the number of ANAE positive (T) cells as well as the lymphocyte response to Oidiomycin (OID), tuberculoprotein (PPD) and phytohaemagglutinin (PHA) decreased markedly postoperatively. Candida antibody titres were positive (greater than or equal to 1:128) in 3/37 (8%) of the postoperative patients and in 2/84 (2.4%) of the controls. This difference is not significant. Positive Candida antibody titres were found postoperatively in 15/37 (41%) of the patients, which is a significantly higher frequency than that seen preoperatively (p less than 0.005). More positive fungal cultures from throat specimens (p less than 0.005) were found in the patient group before surgery than in the control group (hospital personnel). After surgery the number of positive fungal cultures in these cases decreased (p less than 0.001) due to the use of oral antifungal prophylaxis with nystatin tablets.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3511068 TI - Nerve growth factor enhances expression of neuron-glia cell adhesion molecule in PC12 cells. AB - The neuron-glia cell adhesion molecule (Ng-CAM) has been identified in mammalian brain tissue and PC12 pheochromocytoma cells as Mr 200,000 and Mr 230,000 species, respectively. When PC12 cells were treated with nerve growth factor (NGF), the amount of Ng-CAM at the cell surface was increased approximately threefold, whereas the amount of the neural cell adhesion molecule (N-CAM) remained unchanged. An NGF-inducible large external glycoprotein (NILE) has been previously identified by its enhanced expression in NGF-treated PC12 cells. Ng CAM and NILE are similar in molecular weight, expression during development, and responsiveness to NGF in PC12 cells, suggesting that the two molecules are related. In addition, antibodies to Ng-CAM and NILE cross-reacted and the molecules had similar peptide maps after limited proteolysis. Moreover, antibodies to Ng-CAM inhibited fasciculation of neurites, a functional property shared with NILE. The results show that cell adhesion molecules can respond selectively to growth factors and suggest that NILE is, in fact, mammalian Ng CAM. PMID- 3511069 TI - Expression of several adhesive macromolecules (N-CAM, L1, J1, NILE, uvomorulin, laminin, fibronectin, and a heparan sulfate proteoglycan) in embryonic, adult, and denervated adult skeletal muscle. AB - Levels of the neural cell adhesion molecule N-CAM in muscle are regulated in parallel with the susceptibility of muscle to innervation: N-CAM is abundant on the surface of early embryonic myotubes, declines in level as development proceeds, reappears when adult muscles are denervated or paralyzed, and is lost after reinnervation (Covault, J., and J. R. Sanes, 1985, Proc. Natl. Acad. Sci. USA, 82:4544-4548). Here we used immunocytochemical methods to compare this pattern of expression with those of several other molecules known to be involved in cellular adhesion. Laminin, fibronectin, and a basal lamina-associated heparan sulfate proteoglycan accumulate on embryonic myotubes after synapse formation, and their levels change little after denervation. L1, J1, nerve growth factor inducible large external protein, uvomorulin, and a carbohydrate epitope (L2/HNK 1) shared by several adhesion molecules are undetectable on the surface of embryonic, perinatal, adult, or denervated adult muscle fibers. Thus, of the molecules tested, only N-CAM appears on the surface of muscle cells in parallel with the ability of the muscle cell surface to accept synapses. However, four antigens--N-CAM, J1, fibronectin, and a heparan sulfate proteoglycan--accumulate in interstitial spaces near denervated synaptic sites; regenerating axons traverse these spaces as they preferentially reinnervate original synaptic sites. Of particular interest is J1, antibodies to which block adhesion of central neurons to astrocytes (Kruse, J., G. Keihauer, A. Faissner, R. Timpl, and M. Schachner, 1985, Nature (Lond.), 316:146-148). J1 is associated with collagen and other fibrils in muscle and thus may be an extracellular matrix molecule employed in both the central and peripheral nervous systems. PMID- 3511070 TI - A functional assay for proteins involved in establishing an epithelial occluding barrier: identification of a uvomorulin-like polypeptide. AB - A functional assay has been developed to identify cell surface proteins involved in the formation of epithelial tight junctions. Transepithelial electrical resistance was used to measure the presence of intact tight junctions in monolayers of Madin-Darby canine kidney (MDCK) cells cultured on nitrocellulose filters. The strain I MDCK cells used have a transmonolayer resistance greater than 2,000 ohm . cm2. When the monolayers were incubated at 37 degrees C without Ca2+, the intercellular junctions opened and the transmonolayer resistance dropped to the value of a bare filter, i.e., less than 40 ohm . cm2. When Ca2+ was restored, the cell junctions resealed and the resistance recovered rapidly. Polyclonal antibodies raised against intact MDCK cells inhibited the Ca2+ dependent recovery of electrical resistance when applied to monolayers that had been opened by Ca2+ removal. Cross-linking of cell surface molecules was not required because monovalent Fab' fragments also inhibited. In contrast, a variety of other antibodies that recognize specific proteins on the MDCK cell surface failed to inhibit the recovery of resistance. Monoclonal antibodies have been raised and screened for their ability to inhibit resistance recovery. One such monoclonal antibody has been obtained that stained the lateral surface of MDCK cells. This antibody, rr1, recognized a 118-kD polypeptide in MDCK cell extracts and an 81-kD fragment released from the cell surface by trypsinization in the presence of Ca2+. Sequential immunoprecipitation with antibody rr1 and a monoclonal antibody to uvomorulin showed that this polypeptide is related to uvomorulin. The role of uvomorulin-like and liver cell adhesion molecule (L-CAM) like polypeptides in the establishment of the epithelial occluding barrier is discussed. PMID- 3511071 TI - Endogenous lectins from cultured cells: subcellular localization of carbohydrate binding protein 35 in 3T3 fibroblasts. AB - In previous studies, a lectin designated as carbohydrate-binding protein 35 (CBP35) has been isolated from cultured 3T3 fibroblasts. In the present study, rabbit antibodies directed against CBP35 were used to analyze the subcellular distribution of CBP35 in 3T3 cells. Several lines of evidence indicate that CBP35 is found externally exposed at the cell surface: immunofluorescent staining of live 3T3 cells; agglutination of suspension of 3T3 fibroblasts by specific antibodies; and isolation, by immunoaffinity chromatography, of a Mr 35,000 component from cells surface-labeled with 125I. In addition to the plasma membrane, CBP35 could also be found intracellularly, as revealed by immunofluorescence studies of fixed and permeabilized 3T3 cells. The staining pattern showed the presence of CBP35 on the nucleus and in the cytoplasm. These results are consistent with the finding that among several subcellular fractions, CBP35 can be found by immunoblotting procedures in the nuclear pellet, the soluble fraction, and the plasma membrane fraction of the postnuclear supernatant. PMID- 3511072 TI - Endothelial cell membranes contain podocalyxin--the major sialoprotein of visceral glomerular epithelial cells. AB - Podocalyxin is the major sialoprotein in the glycocalyx of glomerular podocytes. Here we report on its extraglomerular localization, using a monospecific antibody which was obtained by affinity purification of IgG on nitrocellulose transfers of glomerular podocalyxin. By indirect immunofluorescence, podocalyxin was found in the blood vessels of several organs (lung, heart, kidney, small intestine, brain, pancreas, aorta, the periportal blood vessels in liver, and the central arteries of follicles of the spleen, but not in the endothelia that line the sinusoids of the latter organs). By immunoelectron microscopy--using immunogold conjugates in diffusion ("pre-embedding") and surface ("postembedding") procedures--podocalyxin was localized on the luminal membrane domain of endothelial cells, in a patchy distribution. The presence of podocalyxin was confirmed in SDS extracts of lung tissue by immunoblotting. We conclude that (a) podocalyxin is a widespread component of endothelial plasma membranes, (b) it is restricted to the luminal membrane domain, and (c) it is distributed unevenly on the endothelial cell surface. PMID- 3511073 TI - Secretion of a cytoplasmic lectin from Xenopus laevis skin. AB - The skin of Xenopus laevis contains a soluble beta-galactoside-binding lectin with a approximately 16,000-mol-wt subunit. It resembles similar lectins purified from a variety of tissues from other vertebrates, and differs from two other soluble X. laevis lectins from oocytes and serum that bind alpha-galactosides. The skin lectin is concentrated in the cytoplasm of granular gland and mucous gland cells, as demonstrated by immunohistochemistry with the electron microscope. Upon injection with epinephrine, there is massive secretion of the cytoplasmic lectin from the granular gland cells. PMID- 3511074 TI - Study of the transit of an integral membrane protein from secretory granules through the plasma membrane of secreting rat basophilic leukemia cells using a specific monoclonal antibody. AB - The monoclonal antibody 5G10 reacted specifically with an 80-kD integral membrane protein in rat basophilic leukemia (RBL) cells. Immunofluorescence microscopy studies of RBL cells, fixed and permeabilized, revealed that the 80-kD protein was located in the membrane of cytoplasmic vesicles. The vesicles were identified as secretory granules by their content in immunoreactive serotonin. Expression of the 5G10 antigen on the surface of unstimulated RBL cells was low. However, RBL cells stimulated to secrete with anti-dinitrophenyl IgE followed by dinitrophenyl bovine serum albumin or with the Ca2+ ionophore A-23187 displayed an increased expression of the antigen on their surface. Surface exposure of the 5G10 antigen was maximal at 5 min after stimulation of secretion. Removal of dinitrophenyl bovine serum albumin from the incubation medium resulted in internalization of 50% of the antigen within 10 min. PMID- 3511075 TI - End-to-end annealing of microtubules in vitro. AB - Mixtures of pre-formed microtubules, polymerized from chicken erythrocyte and brain tubulin, rapidly anneal end-to-end in vitro in standard microtubule assembly buffer. The erythrocyte tubulin segments in annealed heteropolymers can be distinguished by an immunoelectron microscopic assay that uses an antibody specific for chicken erythrocyte beta-tubulin. An annealing process is consistent with the following observations: (a) Microtubule number decreases while the polymer mass remains constant. (b) As the total number of microtubules declines, the number of heteropolymers, and the number of segments contained in each heteropolymer, increases. (c) The size of the segments determined after annealing and antibody labeling is the same as the original microtubule polymers. (d) Points of discontinuity in the annealing heteropolymers can be observed directly by electron microscopy, and correspond to type-specific polymer domains. The junctions probably represent initial contact points during the annealing process. Microtubule annealing occurs rapidly in vitro and may be significant for determining properties of microtubule dynamics in vivo. PMID- 3511076 TI - Immunofluorescence examination of beta tubulin expression and marginal band formation in developing chicken erythroblasts. AB - Chicken erythrocyte beta tubulin, a tubulin variant with unique biochemical and assembly properties, is found to be specifically contained in two chicken blood cell types--erythrocytes and thrombocytes. The beta tubulin variant is absent or present in low amounts in a variety of white blood cell types and other body tissues, as determined by immunofluorescence microscopy and a semi-quantitative immunoblotting procedure. During differentiation in the marrow the beta tubulin variant appears suddenly in mid-stage erythroblasts at the onset of hemoglobin synthesis, and forming marginal bands are seen in all subsequent polychromatophilic erythroblast stages. The developmental sequence of events in marginal band formation entails microtubule nucleation at the centrosome, followed by microtubule elongation, consolidation of loose parallel microtubules into a compact bundle, and microtubule association with the cell membrane. PMID- 3511077 TI - Spreading ciliary arrest in a mussel gill epithelium: characterization by quick fixation. AB - Spreading ciliary arrest, induced by local laser microinjury, in freshwater mussel (e.g., Elliptio) gill lateral (L) cell cilia, has been characterized by quick fixation with osmium tetroxide, which permits the correlation of known features of the response with structural features of the gill epithelium. Quick fixation reliably preserves the state of the epithelium including the activity state of the L cilia at the moment of fixation. From a disrupted region, the stimulus that triggers arrest spreads outward along an undamaged filament preferentially from L cell to L cell for more than 300 microns to either side of the lesion. In physiological salt solutions transverse spread across the filament via heterologous cells is insufficient to elicit L ciliary arrest on the opposite side of the filament. The spread of arrest is dependent upon the structural integrity of the L epithelium, normally terminates at a boundary between adjacent L cells, and does not spread past a focal break. Arrest occurs asynchronously because cilia in different stroke positions respond to the stimulus with different time courses. The cilia stop in a uniform "hands up" position, i.e., pointing frontally. The arrest response is inhibited by reducing the concentration of extracellular Ca2+ (less than 10(-7) M) or by adding extracellular La3+ (1 mM) or K+ (15 mM). Recovery begins at the margin of a segment of arrested L cilia and spreads back toward the lesion at a constant initial velocity of ca. 60 microns/sec. About 300 microns from the lesion the recovery velocity rapidly falls to ca. 5 microns/sec. Recovery of ciliary beat precedes the recovery of metachronal coordination. Neither spread of the stimulus nor recovery require ciliary beat. The data support the hypothesis that the microinjury-induced arrest is initiated by an injury potential that triggers a graded regenerative depolarization that is propagated electrotonically along the epithelium from L cell to L cell, triggering Ca2+ influx into the axoneme and consequent Ca2+-induced L ciliary arrest as it spreads. A temporary non-linear gradient of intracellular Ca2+ concentration is established along the injured L epithelial tract. As individual cells recover, they lower their intracellular Ca2+ concentration from pCa 5 to pCa 7 in about 10 seconds. PMID- 3511078 TI - Adhesion of T lymphocytes to human endothelial cells is regulated by the LFA-1 membrane molecule. AB - Human T lymphocyte adhesion to human endothelial cells is the initial event in T cell migration to areas of extravascular inflammation. The molecular basis for T cell-endothelial cell adhesion was investigated using two different cell-cell adhesion assays: a) a fluorescein cell-cell adhesion assay using nonadherent endothelial cells and fluorescein-labeled T lymphocytes, and b) a radionuclide cell-cell adhesion assay using adherent endothelial cells and 51Cr-labelled T cells. Both assay systems demonstrated comparable quantitative assessment of cell cell adhesions. The assays were performed at 22 degrees C and adhesions were maximal at 30 min. The results of these adhesion assays confirmed previous reports that T cells adhere to endothelial cells. In addition, we have shown that T cells adhere only marginally to foreskin fibroblasts or bone marrow derived fibroblasts. T cell-endothelial cell adhesions were significantly stronger than either monocytes or B lymphoblastoid cells adhesion to endothelial cells. To demonstrate the molecular mechanisms involved in regulating T cell-endothelial cell adhesions, a panel of function-associated monoclonal antibodies (MAb) were tested for their ability to inhibit T cell adhesion. MAb reactive with the leukocyte surface glycoprotein LFA-1 significantly inhibited T cell-endothelial cell adhesions in both assay systems. In contrast, MAb directed at other surface antigens did not inhibit T cell adhesion. The involvement of the LFA-1 glycoprotein in T lymphocyte adhesion to endothelial cells suggest that the LFA-1 molecule may be important in the regulation of leukocyte interactions. PMID- 3511079 TI - Glutamine is responsible for stimulating glycolysis by L929 cells. AB - L929 cells synthesize relatively little lactate when using glucose as their primary energy source, and neither glucose oxidation nor lactate production is highly sensitive to stimulation by insulin. Addition of glutamine to the system containing glucose and insulin markedly stimulates lactate production from glucose without inhibiting glucose oxidation. A mechanism in which reducing equivalents derived from glutamine oxidation are used to drive lactate production is discussed. PMID- 3511080 TI - Evaluation research and public policy: lessons from the National Hospice Study. PMID- 3511082 TI - Gonadotropin-releasing hormone neurosecretion in the human hypothalamus: in vitro regulation by dopamine. AB - An in vitro perifusion system was used to investigate GnRH release from adult human hypothalami in response to dopamine (DA) and the DA receptor antagonist haloperidol (HAL). Administration of a 1-microM pulse of DA consistently elicited a mean +/- SE 218 +/- 59% increase (P less than 0.05; n = 5) in GnRH release, whereas 1 microM HAL had no effect. Administration of 1 microM DA during three perifusions in which 1 microM HAL was added to the medium failed to alter basal GnRH release. In contrast, DA did evoke an acute 98 +/- 39% increase (P less than 0.06) in GnRH release during three matching perifusions with medium containing the alpha-adrenergic antagonist phentolamine. These studies demonstrate that DA can stimulate in vitro release of GnRH from the adult human hypothalamus by a DA receptor-mediated mechanism. PMID- 3511081 TI - An alternative in terminal care: results of the National Hospice Study. AB - Hospice is a program of supportive services for terminally ill patients and their families, provided either at home or in designated inpatient settings, which is purported to improve patient and family quality of life at lower cost than conventional terminal care. The National Hospice Study was a multi-site, quasi experimental study to compare the experiences of terminal cancer patients and their families in hospices with those of similar patients and families receiving conventional terminal care. The results indicate that, although care is different in hospices, e.g. lesser utilization of aggressive interventional therapy and diagnostic testing, patients' quality of life is similar in the hospice and conventional care systems with the exception of pain and symptom control, which may be better in the inpatient hospice setting. Hospice patients are more likely to die at home and their families are satisfied with that outcome. Otherwise, no consistent superiority of family outcome was associated with the hospice approach. The cost of hospice care is less than that of conventional terminal care for patients in hospices without inpatient facilities, but the cost of hospice appears to be equivalent to conventional care for patients in hospices having beds. PMID- 3511083 TI - Activation of plasma and amniotic prorenin by metalloprotease and trypsin. AB - Human renin occurs in a latent form as prorenin in blood and amniotic fluid. We found that the metalloprotease thermolysin is a more potent activator of amniotic and plasma prorenin than trypsin, provided the thermolysin alpha 2-macroglobulin plasma inhibitor was inactivated. Thermolysin fully activated amniotic prorenin at a 23-fold lower molar concentration than trypsin, and renin activated by thermolysin was more stable than when activated by trypsin. Thermolysin also activated plasma prorenin at a 16-fold lower concentration than trypsin in the presence of methylamine (100 mM). Thermolysin activated prorenin directly, because added inhibitors of other endogenous proteases did not block the activation. The maximum activation values obtained after incubation with trypsin or thermolysin in plasma samples from 17 normotensive and 58 hypertensive subjects were similar. The mean renin concentration did not differ significantly in normotensives and hypertensives, but after activation, total renin was significantly higher in hypertensive subjects (89.8 vs. 53.4 ng angiotensin I/h . ml). The Km of the substrate, angiotensinogen, was about the same with both active renin and activated prorenin (281-290 nM). The mol wt of prorenin was 60,000 after gel filtration; activation by thermolysin reduced it to 51,000. Thus, thermolysin, which has a different peptide bond specificity than trypsin, is another model for a prorenin activator. PMID- 3511084 TI - Reduced plasma high density lipoprotein-cholesterol concentrations need not increase when hyperglycemia is controlled with insulin in noninsulin-dependent diabetes mellitus. AB - The ability of intensive insulin treatment to increase plasma high density lipoprotein (HDL)-cholesterol levels was evaluated in 12 patients with noninsulin dependent diabetes mellitus. Patients were treated for 6 weeks with one daily morning injection of ultralente insulin, in combination with administration of regular insulin before breakfast, lunch, and dinner. The mean (+/- SEM) fasting plasma glucose concentration fell from 289 +/- 21 to 122 +/- 9 mg/dl (P less than 0.001), and the mean hourly postprandial glucose concentration fell from 313 +/- 24 to 102 +/- 7 mg/dl (P less than 0.001). In addition, insulin treatment was associated with a reduction in both fasting plasma triglyceride (256 +/- 45 to 137 +/- 18 mg/dl; P less than 0.001) and cholesterol (224 +/- 25 to 199 +/- 19 mg/dl; P less than 0.05) concentrations. However, plasma HDL-cholesterol concentrations, which were low to begin with, did not rise in association with excellent glycemic control. These results demonstrate that hyperglycemia and hypertriglyceridemia can be effectively reduced by an aggressive program of insulin treatment in patients with noninsulin-dependent diabetes mellitus, but this intervention need not lead to an improvement in the abnormal HDL-cholesterol metabolism in these patients. PMID- 3511085 TI - Characterization of the anti-neural antibodies in the sera of leprosy patients. AB - Sera from 43 leprosy patients were tested for antibodies that bound to normal human nerve. Thirty-eight percent showed positive staining as demonstrated by indirect immunofluorescence. Only 1 out of 30 control sera tested displayed similar staining. Western blots of myelin and neural intermediate filament (IF) proteins were tested with patient sera. Two of the anti-neural antibody (ANeAb) positive leprosy sera bound to the P0 protein of PNS myelin. All 17 ANeAb positive leprosy sera displayed 2 or more bands in the molecular weight range of Mr 45 000-55 000, when tested against IF proteins. One explanation for these findings is that leprosy patients produce antibodies to intermediate filament (IF) proteins released subsequent to the bacterial invasion of the peripheral nerves. The importance of these autoantibodies in the pathogenesis of leprosy is discussed. PMID- 3511086 TI - Functional studies of pluripotential hemopoietic stem cells in mouse brain. AB - The report of pluripotential hemopoietic stem cells (PHSC) in the murine brain, as detected in the colony-forming unit (CFUs) assay (Bartlett 1982), prompted us to investigate the functional significance of these cells. Although we confirmed that the transfer of brain cells into irradiated hosts produced CFUs, they did not reconstitute erythropoietic or immune functions. Failure to reconstitute immune function was corroborated by FACS analysis. To test whether the injection of brain cells stimulates self-reconstitution, the effect of host irradiation on CFUs production was studied. CFUs frequencies resulting from the transfer of brain or irradiated brain cells were similar and significantly higher in 800 R vs. 1200 R recipients at 10 days. Our experiments do not support the existence of PHSC in the brain, and suggest that colony formation after brain cell transfer may be the result of an adjuvant effect. PMID- 3511087 TI - Neuronal differentiation of cloned human teratoma cells in response to retinoic acid in vitro. AB - We have analysed immunocytochemically the differentiation in vitro of clones of the human teratoma cell line Tera-2. The proliferating stem cells expressed Thy-1 and N-CAM/D2-CAM antigens. On treatment with 5 X 10(-5) M retinoic acid in either monolayer or aggregate cultures they began to express receptors for tetanus toxin and McAb A2B5. Three weeks after initiating retinoic acid treatment, the cultures contained a variety of cell morphologies, including about 3% of cells with a neuron-like morphology. These cells were reactive with tetanus toxin, McAb A2B5, and antibodies against Thy-1 and N-CAM/D2-CAM. They also expressed 55 000 and 210 000 Da neurofilament subunits. PMID- 3511088 TI - Human-human hybridoma autoantibodies with both anti-DNA and rheumatoid factor activities. AB - Human hybridomas have been produced by fusing peripheral blood lymphocytes from patients with rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) with the GM 4672 human cell line. 262 hybridoma clones from the fusions of four RA and five SLE patients were screened for binding to denatured DNA (dDNA), native DNA, and the Fc fragment of human IgG (HIgG). Of the 17 hybridoma antibodies (nine RA, eight SLE) selected for strong binding to denatured DNA, Fc, or both, five reacted with dDNA only, one with Fc only, and eight with both dDNA and Fc. Hybridoma supernatants exhibiting dual reactivity were absorbed over HIgG and bovine serum albumin (BSA)-Sepharose immunoabsorbent columns. The reactivities to both DNA and HIgG were completely removed by the HIgG column but unaffected by passage over the BSA column, and both DNA binding and rheumatoid factor activities were recovered in the acid eluates from the Sepharose-IgG column. The binding of dual reactive hybridoma autoantibodies to the Fc fragment of HIgG was specifically competed by dDNA and HIgG, providing additional evidence that one antibody may be capable of reacting both as a rheumatoid factor and as an anti-DNA antibody. PMID- 3511089 TI - A human lung mast cell chymotrypsin-like enzyme. Identification and partial characterization. AB - We have used a high performance liquid chromatography assay, which detects chymotryptic cleavage of the phe8-his9 bond of angiotensin I to yield angiotensin II, in order to examine human lung mast cells for the presence of chymotryptic activity. Mast cells, purified from human lung by enzymatic dispersion, countercurrent elutriation, and Percoll gradient centrifugation, were lysed or challenged with goat anti-human IgE. In multiple experiments angiotensin II converting activity was detected in lysates of 10-99% pure mast cell preparations. Regression analysis of net percent release values of histamine and the angiotensin I-converting activity from dose-response experiments demonstrated a correlation between the two parameters, indicating that the chymotrypsin-like enzyme is a constituent of the mast cell secretory granule. The chymotryptic activity was completely inhibited by 10(-3) M phenylmethylsulfonylfluoride but not by 10(-3) M Captopril, and the pH optimum of activity was 7.5-9.5. Gel filtration of released material separated the activity from tryptase and demonstrated an approximate molecular weight of 30-35,000. The mast cell enzyme, like a human skin chymotrypsin-like proteinase, can be distinguished from leukocyte cathepsin G by lack of susceptibility to inhibition by bovine pancreatic trypsin inhibitor. Thus, an enzyme with limited chymotryptic specificity is present in human lung mast cells. The Michaelis constant of the enzyme for angiotensin I of 6.0 X 10(-5) M is similar to that of endothelial cell angiotensin-converting enzyme and is consistent with a reaction of physiologic importance. PMID- 3511092 TI - Persistence of regional left ventricular dysfunction after exercise-induced myocardial ischemia. AB - To determine whether regional myocardial dysfunction occurring after exercise induced ischemic might be caused by continued abnormalities of myocardial blood flow in the post-exercise period, nine dogs were instrumented with ultrasonic microcrystals for determination of circumferential segment shortening, circumflex artery electromagnetic flow probes, and hydraulic coronary artery occluders. Dogs performed treadmill exercise during partial inflation of the coronary artery occluder. When the stenosis was maintained after exercise (persistent stenosis), subendocardial flow = 0.79 +/- 0.42 ml/min per g vs. 1.39 +/- 0.43 ml/min per g control), and this was associated with continued dysfunction in the ischemic zone (segment shortening 45.4 +/- 36.9% of resting control). When the stenosis was released immediately after exercise (temporary stenosis), however, flow was markedly increased 1 min post-exercise (mean transmural flow 4.24 +/- 1.22 ml/min per g; subendocardial flow 4.18 +/- 1.52 ml/min per g), and this was associated with a transient increase in segment shortening to 104.5 +/- 9.3% of resting control. 5 min after exercise, however, moderate reductions in ischemic segment shortening were noted after both temporary stenosis and persistent stenosis runs, and these persisted for 30 min post-exercise. It is concluded that regional left ventricular dysfunction may persist for a significant period of time after exercise-induced ischemia. Furthermore, early after exercise, dysfunction is related to persistent abnormalities of myocardial blood flow, whereas late after exercise it is independent of primary reductions in myocardial blood flow. PMID- 3511090 TI - Glucoregulation during exercise: hypoglycemia is prevented by redundant glucoregulatory systems, sympathochromaffin activation, and changes in islet hormone secretion. AB - During mild or moderate nonexhausting exercise, glucose utilization increases sharply but is normally matched by increased glucose production such that hypoglycemia does not occur. To test the hypothesis that redundant glucoregulatory systems including sympathochromaffin activation and changes in pancreatic islet hormone secretion underlie this precise matching, eight young adults exercised at 55-60% of maximal oxygen consumption for 60 min on separate occasions under four conditions: (a) control study (saline infusion); (b) islet clamp study (insulin and glucagon held constant by somatostatin infusion with glucagon and insulin replacement at fixed rates before, during and after exercise with insulin doses determined individually and shown to produce normal and stable plasma glucose concentrations prior to each study); (c) adrenergic blockage study (infusions of the alpha- and beta-adrenergic antagonists phentolamine and propranolol); (d) adrenergic blockade plus islet clamp study. Glucose production matched increased glucose utilization during exercise in the control study and plasma glucose did not fall (92 +/- 1 mg/dl at base line, 90 +/- 2 mg/dl at the end of exercise). Plasma glucose also did not fall during exercise when changes in insulin and glucagon were prevented in the islet clamp study. In the adrenergic blockade study, plasma glucose declined initially during exercise because of a greater initial increase in glucose utilization, then plateaued with an end-exercise value of 74 +/- 3 mg/dl (P less than 0.01 vs. control). In contrast, in the adrenergic blockade plus islet clamp study, exercise was associated with glucose production substantially lower than control and plasma glucose fell progressively to 58 +/- 7 mg/dl (P less than 0.001); end-exercise plasma glucose concentrations ranged from 34 to 72 mg/dl. Thus, we conclude that: (a) redundant glucoregulatory systems are involved in the precise matching of increased glucose utilization and glucose production that normally prevents hypoglycemia during moderate exercise in humans. (b) Sympathochromaffin activation, perhaps sympathetic neural norepinephrine release, plays a primary glucoregulatory role by limiting glucose utilization as well as stimulating glucose production. (c) Changes in pancreatic islet hormone secretion (decrements in insulin, increments in glucagon, or both) are not normally critical but become critical when catecholamine action is deficient. (d) Glucoregulation fails, and hypoglycemia can develop, both when catecholamine action is deficient and when changes in islet hormones do not occur during exercise in humans. PMID- 3511091 TI - Regulation of C-myc expression during growth and differentiation of normal and leukemic human myeloid progenitor cells. AB - C-myc proto-oncogene transcripts from serially harvested, colony-stimulating activity (CSA)-stimulated, normal progenitor-enriched human bone marrow cells were compared to those of the promyelocytic leukemia cell line HL-60 and to those of freshly obtained human myeloid leukemic cells. During the early culture period both normal and leukemic cells expressed the c-myc oncogene. In normal cells maximal expression occurred after 24 h of culture and did not occur in the absence of CSA. At this time, progranulocytes predominated in the cultured cells. Although cellular proliferation occurred for 96 h in vitro, c-myc expression ceased after 24-36 h. Terminally differentiated cells predominated in these cultures by 120 h. In contrast, although leukemic cells also expressed c-myc in vitro, transcription persisted throughout the culture period and, in the case of HL-60 cells, occurred in the absence of exogenous CSA. We also noted that normal cells with only one diploid gene copy exhibited, after 24 h of culture, only twofold fewer transcripts than did HL-60 cells in which there were 16 myc copies. Furthermore, c-myc mRNA degradation rates were similar in normal cells and in HL 60 cells. We conclude that c-myc transcription is a normal event in granulopoiesis linked to proliferative activity as well as to primitive developmental stage. Furthermore, the most consistent abnormality in leukemic cells in vitro is their failure to suppress transcriptional activity of this gene. We suggest that c-myc transcription in HL-60 cells may be appropriate for cells arrested at that developmental stage and that the amplified genes in HL-60 cells are quiescent relative to c-myc in normal cells at the same differentiation stage. The techniques described herein may be of value in identifying mechanisms by which normal hematopoietic cells suppress c-myc expression and aberrancies of these mechanisms in leukemic cells. PMID- 3511093 TI - Dependence of highly enriched human bone marrow progenitors on hemopoietic growth factors and their response to recombinant erythropoietin. AB - Human bone marrow cells were sequentially fractionated by three negative selection steps to remove adherent cells and Fc receptor-bearing cells, followed by immune adsorption (panning) to deplete maturing cells that react with a panel of monoclonal antibodies. This nonadherent Fc receptor and antibody negative fraction could be further enriched by a positive selection "panning" step, using an antibody to HLA-DR antigen; 12-27% of the cells formed erythroid burst-forming unit (BFU-E), erythroid colony-forming unit, granulocyte-monocyte colony-forming unit, and erythroid and granulocyte and/or monocyte colony-forming unit-derived colonies with recovery of 0.5-1% of the cells and 20-100% of the colony-forming cells. Sequential fractionation resulted in increasing dependence of a subset of BFU-E-derived colonies on exogenous burst-promoting activity (BPA) for proliferation in culture, but the most enriched progenitor fraction still contained a proportion of accessory cell or BPA-independent BFU-E that responded to either natural or biosynthetic erythropoietin when added to cultures on day 0 in the absence of BPA. If the addition of erythropoietin was delayed until day 3, the data suggest that this population of BFU-E either died or became unresponsive to erythropoietin. Delayed addition of erythropoietin to cultures of enriched progenitors provided a sensitive BPA assay, since BPA-independent but erythropoietin-responsive BFU-E were eliminated. The surviving BFU-E that were dependent for their proliferation on the presence of both BPA and erythropoietin showed a characteristic dose response to increasing BPA concentrations. PMID- 3511094 TI - Use of biosynthetic human C-peptide in the measurement of insulin secretion rates in normal volunteers and type I diabetic patients. AB - We undertook this study to examine the accuracy of plasma C-peptide as a marker of insulin secretion. The peripheral kinetics of biosynthetic human C-peptide (BHCP) were studied in 10 normal volunteers and 7 insulin-dependent diabetic patients. Each subject received intravenous bolus injections of BHCP as well as constant and variable rate infusions. After intravenous bolus injections the metabolic clearance rate of BHCP (3.8 +/- 0.1 ml/kg per min, mean +/- SEM) was not significantly different from the value obtained during its constant intravenous infusion (3.9 +/- 0.1 ml/kg per min). The metabolic clearance rate of C-peptide measured during steady state intravenous infusions was constant over a wide concentration range. During experiments in which BHCP was infused at a variable rate, the peripheral concentration of C-peptide did not change in proportion to the infusion rate. Thus, the infusion rate of BHCP could not be calculated accurately as the product of the C-peptide concentration and metabolic clearance rate. However, the non-steady infusion rate of BHCP could be accurately calculated from peripheral C-peptide concentrations using a two-compartment mathematical model when model parameters were derived from the C-peptide decay curve in each subject. Application of this model to predict constant infusions of C-peptide from peripheral C-peptide concentrations resulted in model generated estimates of the C-peptide infusion rate that were 101.5 +/- 3.4% and 100.4 +/- 2.8% of low and high dose rates, respectively. Estimates of the total quantity of C-peptide infused at a variable rate over 240 min based on the two-compartment model represented 104.6 +/- 2.4% of the amount actually infused. Application of this approach to clinical studies will allow the secretion rate of insulin to be estimated with considerable accuracy. The insulin secretion rate in normal subjects after an overnight fast was 89.1 pmol/min, which corresponds with a basal 24-h secretion of 18.6 U. PMID- 3511095 TI - Control of heme metabolism with synthetic metalloporphyrins. AB - Studies with synthetic metal-porphyrin complexes in which the central iron atom of heme is replaced by other elements indicate that those heme analogues that cannot be enzymatically degraded to bile pigments possess novel biological properties that may have considerable clinical as well as experimental value. Such studies have revealed the important role that the central metal atom plays in determining the physiological and pharmacological properties of metal porphyrin complexes; and they have demonstrated that the form in which animals and humans are exposed to trace metals, i.e., inorganic, organified, porphyrin chelated, etc., can be of great importance in determining the biological responses that such elements elicit, especially with respect to actions on heme synthesis and degradation and cytochrome P-450 formation and function. Study of the biological properties of synthetic metalloporphyrins represents a potentially fruitful area of research and the results may have significant value for basic as well as clinical disciplines. PMID- 3511096 TI - Distribution of cardiac myosin isozymes in human conduction system. Immunohistochemical study using monoclonal antibodies. AB - To determine the presence and distribution of cardiac myosin isozymes in the human conduction system, we performed an immunohistochemical study using monoclonal antibodies CMA19 and HMC14, which are specific for myosin heavy chains of human atrial type (alpha-type) and ventricular type (beta-type), respectively. Serial frozen sections of human hearts were obtained from autopsy samples and examined by indirect immunofluorescence. Alpha-type was found in all myofibers of sinus node and atrio-ventricular node, and in 55.2 +/- 10.2% (mean +/- SD, n = 5) of the myofibers of ventricular conduction tissue, which consists of the bundle of His, bundle branches, and the Purkinje network. In contrast, beta-type was found in all myofibers of the atrio-ventricular node and ventricular conduction tissue, whereas almost all myofibers of the sinus node were unlabeled by HMC14. Although the number of ventricular myofibers labeled by CMA19 was small, the labeled myofibers were more numerous in the subepicardial region than in the subendocardial region. These findings show that the gene coding for alpha-type is expressed predominantly in specialized myocardium compared with the adjacent ordinary working myocardium. PMID- 3511098 TI - Three human chromosomal autoantigens are recognized by sera from patients with anti-centromere antibodies. AB - We have identified 39 individuals with anti-centromere antibodies (ACA) in our patient population, all of whom have Raynaud's syndrome or disease. We have used sera from the ACA-positive patients and from 123 controls (22 normal individuals and 101 additional patients with either Raynaud's disease or Raynaud's syndrome plus an associated connective tissue disease) to screen the proteins of highly purified human (HeLa) mitotic chromosomes by sodium dodecyl sulfate polyacrylamide gel electrophoresis and immunoblotting. Three antigens were recognized by the sera from the ACA-positive patients. These were centromere protein (CENP)-B (80,000 mol wt--recognized by all ACA-positive sera), CENP-A (17,000 mol wt--recognized by 38 of 39 ACA-positive sera), and CENP-C (140,000 mol wt--recognized by 37 of 39 ACA-positive sera). None of these antigens were recognized by any of the 123 control sera, although binding was occasionally seen to other chromosomal antigens. Therefore the ACA response is highly uniform in our patient population. Antibody to CENP-B shows a 100% correlation with anti centromere staining by indirect immunofluorescence. PMID- 3511097 TI - Relationship between protein C antigen and anticoagulant activity during oral anticoagulation and in selected disease states. AB - Protein C is a natural vitamin K-dependent plasma anticoagulant, deficiencies of which have been found in patients with recurrent thrombosis and warfarin-induced skin necrosis. To appreciate more fully the role of protein C in disease states and during oral anticoagulation, a new functional assay for protein C involving adsorption of plasma protein C on a Ca+2-dependent monoclonal antibody, elution, quantitative activation, and assessment of plasma anticoagulant activity, has been developed. When oral anticoagulation is initiated, the anticoagulant activity of protein C decreases to a greater extent than either the amidolytic or immunologic levels. During stabilized warfarin treatment, there is no correlation between either amidolytic or antigenic levels and the functional protein C activity, suggesting that measurement of protein C anticoagulant activity may be necessary to reflect adequately the anticoagulant protection afforded by this protein. In contrast, there was a strong correlation between anticoagulant and amidolytic and immunologic levels in liver failure and disseminated intravascular coagulation. Two patients with thromboembolic disease have been identified who exhibit a marked decrease in anticoagulant activity, but who have normal immunologic and amidolytic levels. Thus, this assay permits assessment of protein C in individuals who have received anticoagulant treatment and identification of a new class of protein C-deficient individuals. PMID- 3511099 TI - Diabetes due to secretion of a structurally abnormal insulin (insulin Wakayama). Clinical and functional characteristics of [LeuA3] insulin. AB - We have identified a non-insulin-dependent diabetic patient with fasting hyperinsulinemia (90 microU/ml), an elevated insulin:C-peptide molar ratio (1.68; normal, 0.05-0.20), normal insulin counterregulatory hormone levels, and an adequate response to exogenously administered insulin. Insulin-binding antibodies were absent from serum, erythrocyte insulin receptor binding was normal, and greater than 90% of circulating immunoreactive insulin coeluted with 125I-labeled insulin on gel filtration. The patient's insulin diluted in parallel with a human standard in the insulin radioimmunoassay, confirming close molecular similarity. The patient's insulin was purified from serum and shown to possess both reduced binding and ability to stimulate glucose uptake and oxidation in vitro. Analysis of the patient's insulin by high-performance liquid chromatography (HPLC) revealed two products: 7.3% of insulin immunoreactivity coeluted with the human standard, while the remaining 92.7% eluted as a single peak with increased hydrophobicity. Family studies confirmed the presence of hyperinsulinemia in four of five relatives in three generations, with secretion of an abnormal insulin documented by HPLC in the three tested. Leukocyte DNA was harvested from the propositus and the insulin gene cloned. One allele was normal, but the other displayed a thymine for guanine substitution at nucleotide position 1298 from the putative cap site, resulting in a leucine for valine substitution at position 3 of the insulin A chain. Insulin Wakayama is therefore identified as [LeuA3] insulin. PMID- 3511101 TI - Hemangioendothelioma of the gingiva. Histopathologic and therapeutic considerations. AB - The hemangioendothelioma is a benign neoplasm, rarely observed in the mouth. In the literature, reports on the treatment and on the therapeutic results are lacking. This type of gingival neoplasm was observed in a young adult male. It was located in the attached gingiva in the upper and in the lower jaw, covering almost the entire coronal part of the anterior teeth. An exhaustive internal and neurological examination revealed no associated general disease. The gingival biopsies displayed the typical characteristics of a hemangioendothelioma: proliferation of the blood vessels, with a reduced lumen surrounded by swollen endothelial cells. The treatment consisted of a meticulous mechanical plaque control, chlorhexidine rinses, gingivectomy procedures and a monthly professional prophylaxis. 3 years after the periodontal treatment, the gingival structures remained clinically healthy. In the biopsies, only a small amount of inflammatory cells could be detected. This report shows a case of benign gingival neoplasms of unknown etiology in which meticulous plaque control, combined with extensive gingivectomies and repeated professional prophylaxis may have prevented or, at least, retarded the recurrence of the lesion. PMID- 3511102 TI - Periodontal ligament areas and occlusal forces in dentitions restored with cross arch unilateral posterior two-unit cantilever bridges. AB - This investigation was undertaken in order to analyse to what extent the magnitudes of chewing and biting forces in dentitions restored with cross-arch unilateral posterior two-unit cantilever bridges are correlated to the area of the periodontal tissue supporting the abutments. 12 subjects, whose dentitions were periodontally treated and prosthetically restored, participated in the study. The chewing and biting forces, simultaneously measured in various parts of, as well as over the entire dentition, were correlated to the periodontal ligament areas of the abutments supporting the bridge constructions. A strong positive correlation (r = 0.83; P less than 0.01) was found between the total remaining periodontal ligament area and the mean total chewing force. A positive correlation (r = 0.57; P = 0.05) was also found between the local remaining periodontal ligament area of the posterior end abutment tooth and the local chewing force in that region. No positive correlation was found between the amount of periodontal tissue support and the magnitude of the forces developed during biting with maximal strength in habitual occlusion either totally or locally, although there was a strong tendency (r = 0.54; 0.6 greater than P greater than 0.5) towards decreasing total maximal bite force with decreasing total remaining periodontal ligament area. A strong positive correlation (r = 0.74; P less than 0.01) was found on the end abutment side between the local remaining periodontal ligament area of the end abutment tooth and the local forces in that region during biting with maximal strength over a limited area at a time.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3511100 TI - Metabolic acidosis stimulates protein degradation in rat muscle by a glucocorticoid-dependent mechanism. AB - Metabolic acidosis is associated with enhanced renal ammonia-genesis which is regulated, in part, by glucocorticoids. The interaction between glucocorticoids and chronic metabolic acidosis on nitrogen utilization and muscle protein metabolism is unknown. In rats pair-fed by gavage, we found that chronic acidosis stunted growth and caused a 43% increase in urinary nitrogen and an 87% increase in urinary corticosterone. Net protein degradation in incubated epitrochlearis muscles from chronically acidotic rats was stimulated at all concentrations of insulin from 0 to 10(4) microU/ml. This effect of acidosis persisted despite supplementation of the media with amino acids with or without insulin, indomethacin, and inhibitors of lysosomal thiol cathepsins. Acidosis did not change protein synthesis; hence, the increase in net protein degradation was caused by stimulation of proteolysis. Acidosis did not increase glutamine production in muscle. The protein catabolic effect of acidosis required glucocorticoids; protein degradation was stimulated in muscle of acidotic, adrenalectomized rats only if they were treated with dexamethasone. Moreover, when nonacidotic animals were given 3 micrograms/100 g of body weight dexamethasone twice a day, muscle protein degradation was increased if the muscles were simply incubated in acidified media. We conclude that chronic metabolic acidosis depresses nitrogen utilization and increases glucocorticoid production. The combination of increased glucocorticoids and acidosis stimulates muscle proteolysis but does not affect protein synthesis. These changes in muscle protein metabolism may play a role in the defense against acidosis by providing amino acid nitrogen to support the glutamine production necessary for renal ammoniagenesis. PMID- 3511103 TI - The effect of mouthrinses on parameters characterizing human periodontal disease. AB - The objective of the present clinical trial was to assess the efficacy of mouthwashes containing antiseptic agents on established and developing plaque and periodontal disease in adult subjects using a newly described clinical research model. The study was carried out in 21 patients with periodontal disease. At the baseline examination, all tooth surfaces-sites were studied with regard to dental plaque, gingivitis, bleeding on probing to the base of the pocket and probing pocket depths. The patients were subsequently randomly assigned to 1 of 3 groups, each consisting of 7 individuals. Group A rinsed with a 0.01% solution of Sanguinarine, group B rinsed with a 0.2% solution of chlorhexidine and group C rinsed with a placebo solution. No instructions regarding mechanical plaque control measures or information regarding the etiology and pathogenesis of periodontal disease were given to any of the patients during the course of the 6 weeks of trial. The clinical examination was repeated after 2 weeks use of the mouthwash preparations. Following the re-examination, all patients were subjected to scaling and root planing in 2 jaw quadrants chosen at random. After another 2 weeks, the 2nd re-examination was performed and the teeth in the 2 remaining jaw quadrants were thoroughly scaled. The final examination was performed 2 weeks later. During the 4 weeks of rinsing, without adjunctive professional mechanical debridement, the frequency distribution of plaque Index scores 2 + 3 did not change in the group of patients using the placebo solution, but was significantly reduced in both the chlorhexidine and the Sanguinarine groups.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3511104 TI - Clinical and microbiologic effects of single-dose metronidazole or scaling and root planing in treatment of adult periodontitis. AB - Sites affected with adult periodontitis were observed for 3 months to compare their clinical and microbiologic responses to a single 2 g dose of metronidazole, scaling and root planing, or no treatment. 2 sites with probing depths greater than or equal to 5 mm in each of 18 female subjects (6 in each treatment group) were evaluated clinically (plaque and bleeding indices, probing depth, attachment loss) and microbiologically (%s of cocci, motile rods, non-motile rods and spirochetes, and of obligate anaerobic colony-forming units, black-pigmented Bacteroides, Fusobacterium and Actinobacillus actinomycetemcomitans in subgingival plaque). No significant differences in these variables existed between the 3 groups at baseline. The no-treatment (control) group showed no substantial clinical or microbiologic changes during the study. After 1 month, scaling and root planing had effected significant clinical improvement and significant shifts in the subgingival flora to a pattern more consistent with periodontal health; these changes were still evident at 3 months. In contrast, 1 month after metronidazole, there was some clinical improvement and a significant increase in cocci and a decrease in motile rods, but at 3 months these changes were no longer evident. The results show that the benefits of scaling and root planing are sustained for at least 3 months. However, the benefits of a single 2 g dose of metronidazole are both few and transient, indicating that this regimen, while effective against anaerobic infections in other organ systems, is not clinically or microbiologically effective in the treatment of adult periodontitis. PMID- 3511105 TI - MR imaging of spinal lymphoma. AB - Magnetic resonance findings are described in a patient with spinal lymphoma using a high field strength magnet and surface coil technique. Using this noninvasive technique, it was possible to visualize both tumor growth and extent in the spinal canal. The infiltration into the canal through a neural foramen and into bone was also visualized as well as the extent of the paraspinal tumor component. None of the currently used imaging modalities--myelography, plain radiography, CT, or radioisotope studies--could provide the same information alone. PMID- 3511106 TI - Hepatic plasmocytoma: sonographic and CT findings. AB - The sonographic and CT features of a case of solitary plasmocytoma of the liver are described. Dynamic CT findings of the tumor differ only slightly from those encountered in cavernous hemangiomas. Liver biopsy under ultrasound or CT guidance followed by immunohistochemical procedure can provide prompt diagnosis of this rare solitary liver tumor. PMID- 3511107 TI - Mesenchymal hamartoma of the liver: computed tomography and ultrasonography. AB - Mesenchymal hamartoma of the liver is a relatively uncommon lesion that occurs with greatest frequency in infants and children. Two cases are presented, one as a predominantly cystic mass and the other as a predominantly solid mass. PMID- 3511108 TI - Acetabular alterations in untreated congenital dysplasia of the hip: computed tomography with multiplanar re-formation and three-dimensional analysis. AB - The alterations in acetabular morphology that occur in untreated congenital hip dysplasia (CDH) were evaluated in 29 prehistoric and four modern hemipelvis specimens using inspection, sectioning, conventional radiography, CT, and multiplanar re-formation with three-dimensional image reconstruction. Three major patterns of acetabular morphology were recognized, each reflecting a different grade of severity of dysplasia. Type I (positionally unstable or subluxatable) hips were characterized by acetabular deepening with prominent circumferential ossification within the transverse acetabular ligament and everted limbus. Type III (dislocated) hips demonstrated definite false acetabula separated from triangular remnants of the true acetabula by ossified inverted limbi. Type II (subluxated) hips revealed an intermediate pattern, with acetabular elongation and ossification of deformed limbi, but without definite pseudoacetabula. Computed tomography, particularly with three-dimensional analysis, was extremely useful in characterizing the abnormal acetabular morphology of untreated CDH. An awareness of the secondary osseous alterations of this disorder facilitates understanding the spectrum of hip instability and its soft tissue abnormalities. PMID- 3511109 TI - IgE in postsecretory ameloblasts suggesting a hypersensitivity reaction at tooth eruption. AB - The clinical symptoms associated with the eruption of primary teeth resemble a mild hypersensitivity reaction. Light microscopic examination showed that IgE accumulated in postsecretory ameloblasts. The formation of IgE was elicited by enamel matrix proteins, which are chemotactic for mast cells. PMID- 3511110 TI - Kinin generation in the gingival inflammatory response to topically applied bacterial lipopolysaccharides. AB - A water-soluble lipopolysaccharide from Salmonella enteritidis and a phenol soluble lipopolysaccharide from Leptotrichia buccalis were applied topically to the healthy marginal gingivae of beagle dogs. Saline was applied to contralateral areas as an internal control. Increases in vascular permeability were monitored by measurement of gingival fluid, and the collected gingival fluid samples were assayed for kininogenase and kinin activities. Both lipopolysaccharides induced an inflammatory response, as indicated by increased gingival fluid flow. Kininogenase-kinin activities paralleled the increases in gingival fluid flow, with the highest values being associated with peak increases in gingival fluid. The results indicate that both lipopolysaccharides, although different in lipid solubility, penetrate healthy sulcular epithelium and initiate an inflammatory response which is mediated in part by the kallikrein-kinin system. Interrelationships between this system and other inflammatory mediators suggest that kinin generation not only plays a role in the early phases of acute gingival inflammation, but may also contribute to the activation of other mediators appearing later in the response and in chronic inflammatory lesions. PMID- 3511112 TI - The far-near/near-far suture. PMID- 3511111 TI - Fracture resistance of teeth restored with class II bonded composite resin. AB - The purpose of this study was to determine whether composite resin bonded to enamel or to both enamel and dentin can increase the fracture resistance of teeth with Class II cavity preparations. Extracted maxillary pre-molars with MOD slot preparations were restored with composite resin bonded to enamel (P-30 and Enamel Bond) or composite resin bonded to enamel and dentin (P-30 and Scotch-bond). Teeth in a control group were prepared but left unrestored. All teeth were loaded occlusally in a universal testing machine until they fractured. Means of forces required to fracture teeth in each of the three groups were statistically compared (one-way ANOVA and Bonferroni t test). Teeth restored with combined enamel- and dentin-bonded composite resins were significantly more resistant to fracture than were similarly prepared but unrestored teeth and also than teeth restored with enamel-bonded composite resin (p less than 0.05). A significant difference was not demonstrated between the enamel-bonded group and the unrestored group. Further testing is needed to determine the durability of the bonds between tooth and restoration in the clinical setting. PMID- 3511113 TI - Marsupial minigrafts for alopecia following surgical procedures of the scalp repaired by split-thickness skin grafts. AB - A technique is described for treating the alopecia resulting from scalp surgery repaired by split-thickness skin grafts with the method of marsupial minigrafts. This procedure provides an uncomplicated outpatient approach for treating this type of alopecia. PMID- 3511114 TI - Repigmentation of stable leukoderma by autologous minigrafting. AB - The technique known as autologous minigrafting is reviewed. This procedure has proven useful and reliable for repigmenting diverse types of leukoderma. A few refinements of this technique are described. These refinements were used in six patients who were successfully repigmented. Causes of pigment loss in these cases included thermal burns, contact with monobenzyl ether of hydroquinone, chronic discoid lupus erythematosus, and segmental vitiligo. PMID- 3511115 TI - Prediction of tissue composition from ultrasonic measurements and mixture rules. AB - A methodology is presented for predicting the composition of tissues from measurements of the density, sound velocity, and acoustic nonlinear parameter, using mixture laws for the density, compressibility, and nonlinear parameter. It is shown that the mixture law for the nonlinear parameter plays an essential part in this methodology, which leads to the prediction of the volume fractions of water, protein, and fat in a given tissue. Data from the literature for solutions, blood, normal tissue, and cancerous tissue are investigated, and predicted fractions are consistent with tissue compositional information available in handbooks. More experimental work is needed with tissues of known composition in order to more fully test the proposed methodology. PMID- 3511116 TI - The presidents. Harvey Benson Washburn 1947-1948. PMID- 3511117 TI - Timepieces. Continuum. PMID- 3511118 TI - Chemical agents for the reduction of plaque. PMID- 3511119 TI - The use of a clear, pliable film to form a fiberglass-reinforced splint. PMID- 3511120 TI - Dentistry on stamps. PMID- 3511121 TI - Afferent reinnervation of the autotransplanted heart in dogs. AB - Patients have been observed with a chest pain syndrome after cardiac transplantation. For this pain to be cardiac in origin the afferent nerves carrying sensory information from the heart would have to reinnervate the heart. A previous study in dogs indicated that afferent reinnervation is uncommon during the first 2 years after transplantation. The purpose of this study was to determine whether afferent reinnervation of the heart occurs in the long term. The decreases in arterial pressure and renal nerve activity resulting from chemical stimulation of left ventricular sensory receptors with vagal afferents with cryptenamine (veratrum alkaloid) were assessed in three dogs 8 to 12 years and in four dogs 6 to 8 weeks after cardiac autotransplantation and in six sham operated dogs (thoracotomy-pericardiotomy 6 to 8 weeks before study). Responses of renal nerve activity to physiologic stimulation of cardiac receptors by volume expansion were also determined. Left ventricular cryptenamine inhibited renal nerve activity by 72 +/- 8% in dogs with long-term and by 10 +/- 6% in dogs with short-term autotransplantation and by 92 +/- 5% in sham-operated dogs. Decreases in mean arterial pressure in these groups were 34 +/- 4, 11 +/- 3 and 67 +/- 16 mm Hg, respectively. Volume expansion inhibited renal nerve activity in long-term autotransplant (43%) and sham-operated (48%) groups but less in the short-term transplant group (33%) for comparable increases in cardiac filling pressure. It is concluded that in dogs there is extensive afferent reinnervation of the long term autotransplanted heart that results in relatively normal cardiopulmonary baroreflex responses to volume expansion.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3511123 TI - Right atrial flow topography in healthy subjects studied with real-time two dimensional Doppler flow imaging technique. AB - The pattern of normal blood flow in the right atrial cavity was studied using the newly developed real-time two-dimensional Doppler flow imaging technique as a standard reference for the Doppler diagnosis of heart diseases with intracardiac shunts at the atrial level. The study was performed primarily with use of the apical four chamber and the parasternal right ventricular inflow tract views in 21 healthy subjects. The following patterns were observed: blood from the inferior vena cava flowed up along the posterior wall of the right atrium and joined with blood from the superior vena cava in the posterocranial part of the right atrial cavity; the flow then coursed along the roof of the right atrium toward the tricuspid valve in the atrial relaxation phase. This flow was always noted along the interatrial septum in the four chamber view. During and after mid systole of the right ventricle, additional blood flow away from the tricuspid valve appeared, moving from the valve to the central part of the right atrial cavity, that is, at the lower right of the preceding inflow; this flow was interpreted as arising from eddy currents caused by the preceding inflow. In early diastole of the right ventricle, the flow signal area along the interatrial septum and the roof of the right atrium extended into the right ventricular cavity through the tricuspid valve. In the atrial contraction phase only the blood near the tricuspid valve in the right atrial cavity appeared to flow into the right ventricular cavity. Inflow from the coronary sinus was almost undetectable.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3511122 TI - Myocardial norepinephrine, epinephrine and dopamine concentrations after cardiac autotransplantation in dogs. AB - Myocardial norepinephrine is markedly reduced after cardiac transplantation because of interruption of postganglionic cardiac sympathetic nerves. There are also substantial stores of dopamine in the myocardium, but the influence of cardiac denervation on dopamine remains unknown. The effect of cardiac transplantation was determined and, thus, the effect of denervation on myocardial norepinephrine, dopamine and epinephrine. Myocardial catecholamines were measured with high-performance liquid chromatography with electrochemical detection in five dogs 6 to 8 weeks and in four dogs 8 to 12 years after cardiac autotransplantation and in six sham-operated dogs with intact cardiac innervation. Norepinephrine, dopamine and epinephrine levels were determined from samples obtained from the right and left atria and ventricles. Samples from the left ventricular apex and base were analyzed separately. There was a striking depletion of norepinephrine in all cardiac chambers after short-term autotransplantation. The norepinephrine content of the left atrium in sham operated dogs (1,659 +/- 219 ng/g) was significantly higher than that of dogs with long-term autotransplanted hearts (754 +/- 372 ng/g). Sham-operated dogs and dogs with long-term autotransplanted hearts had statistically significant (p less than 0.05) differences in norepinephrine content in the left ventricular apex (480 +/- 197 versus 294 +/- 198 ng/g), left ventricular base (876 +/- 2204 versus 654 +/- 156 ng/g) and right ventricle (766 +/- 133 versus 247 +/- 29 ng/g). In contrast to norepinephrine, dopamine concentrations were relatively preserved in the short-term group despite the virtual depletion of myocardial norepinephrine.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3511124 TI - Coronary artery spasm: the pendulum continues swinging. PMID- 3511125 TI - Blinded comparison of maxillary sinus radiography and ultrasound for diagnosis of sinusitis. AB - The correlation of Waters view radiographs and A-mode ultrasound for diagnosing sinusitis was evaluated in 75 subjects with allergic rhinitis who presented with signs and symptoms suggesting sinus disease. All patients had Waters view radiographs, which were read by a radiologist (E. G.) who was not provided with historical information. Ultrasound tracings were obtained by registered nurses who were trained to perform this procedure. Tracings were interpreted by two representatives of American Electromedics Corporation, the manufacturer of the Echosine ultrasound machine used in this study. Most common symptoms among the patients were cough and rhinorrhea. The complaint of headache correlated negatively (p = 0.001) with an abnormal radiograph, whereas physical findings of copious and purulent rhinorrhea correlated positively (p = 0.05 and 0.001, respectively). Middle ear abnormalities on examination and tympanometry were more common in those with abnormal radiographs, p less than 0.05 and p less than 0.01, respectively. If the radiograph is considered to be a "gold standard," sensitivity of ultrasound varied from 44% to 58% and specificity from 55% to 61%, dependent on which criteria are applied to the radiograph to consider it normal. A-mode ultrasound is not sufficiently comparable to radiography to be used as its substitute for diagnosing sinus disease. PMID- 3511126 TI - Imaging of the paranasal sinuses: current status. PMID- 3511127 TI - Compliance of patients with asthma with an experimental aerosolized medication: implications for controlled clinical trials. AB - A Nebulizer Chronolog, a portable device that houses a standard nebulizer canister, was used in a unique method to measure compliance with aerosolized medication. Each actuation is tabulated to within 4 minutes of the actual time of usage and can subsequently be displayed in a day-hour-minute format. Of the 19 patients studied for 12 weeks with a cromolyn-like agent, appropriate usage four times a day ranged from 4.3% to 94.8%. Underusage exceeded overusage and ranged from 5.2% to 95% of the study days. Younger subjects and male subjects were less likely to use the aerosol appropriately. Patients failed to write the truth in their diaries with overreporting of appropriate usage more than 50% of the times. Lack of compliance with aerosolized medication represents an important medical issue for the physicians caring for patients with asthma. The Nebulizer Chronolog elicits new insight into the disparity between reported and observed compliance. PMID- 3511128 TI - Acute rheumatic fever: an elusive enigma. PMID- 3511129 TI - Specialized formulas and feedings for infants with malabsorption or formula intolerance. AB - The composition of specialized formulas for infants who experience malabsorption or formula intolerance is described in detail. The limited studies of efficacy, as well as a rationale for selecting an appropriate formula for infants with malabsorption or formula intolerance, are discussed. Infants with symptoms of diarrhea or emesis may have intolerance to milk lactose or milk protein. Soy formulas contain no lactose or cow's milk and should be the first choice of an alternative feeding because of cost and convenience. Some infants may be intolerant of soy as well as cow's milk protein. They benefit from formula containing neither cow's milk nor soy protein or from a specially processed milk based formula containing hydrolyzed casein. A carbohydrate-free formula to which the desired type of carbohydrate is added may be helpful in the diagnosis and treatment of disaccharidase deficiencies and monosaccharide intolerances. Infants with extensive intestinal resections or intractable diarrhea may require specialized infant formulas with qualitative/quantitative modifications of fat, carbohydrate, and protein. Formulas with medium-chain triglycerides may be useful for infants with steatorrhea. "Preterm" formulas or milk from the infant's mother are preferred for preterm infants, since such feedings promote improved fat and carbohydrate absorption and better meet the infant's nutrient requirements. PMID- 3511130 TI - History of foods in the caries process. AB - Food has a definite role in the initiation and advancement of dental caries. A number of early investigators recognized that food had an effect in the development of tooth decay; however, it was not until this century that food properties and components that contribute to dental caries have been identified and investigated. Many factors influence the cariogenic potential of foods, which makes ranking cariogenic potential quite difficult. This article highlights the slow historical recognition of the role of foods in the caries process, emphasizing current research and implications for the dietitian. PMID- 3511131 TI - Systolic hypertension in the elderly program (SHEP). The first three months. PMID- 3511132 TI - Geriatrics: an updated bibliography. PMID- 3511133 TI - Preparation of suspensions of pancreatic islet cells: a comparison of methods. AB - A comparative study for preparation of cell suspensions from pancreatic islets has been performed using mechanical or enzymatic dissociation with proteolytic enzymes such as trypsin, dispase, and pronase. Treatment of isolated pancreatic islets from neonatal rats with these enzymes proved to be superior to a mechanical dissociation method. The enzymatic dissociation was performed by fractionated treatment of pancreatic islets with low concentration of enzymes in Hanks' solution for 2-3 min at room temperature. With the exception of trypsin the percentage of single cells was consistently higher with dispase and pronase treatment, being 83-92%. Cell viability (dye exclusion) was more than 90%. Mechanical disintegration of pancreatic islets resulted in a low yield of single cells, and cell viability was considerably reduced in comparison with the enzymatic methods. Labeling of islet cells with Na2 51CrO4 and measurement of the basal 51Cr-release demonstrated superior membrane preservation after pronase or dispase treatment. Islet cells isolated either by fractionated dispase or pronase treatment were found to be well preserved and very suitable for the detection of circulating cell surface antibodies and their cytotoxic effects to islet cells. PMID- 3511134 TI - Oral ibuprofen: evaluation of its effect on peritendinous adhesions and the breaking strength of a tenorrhaphy. AB - In a study of 21 primates, treatment with oral ibuprofen significantly reduced the force required for tendon gliding following flexor tendon injury in zone II. Tendons that were partially lacerated but not repaired required less force for tendon motion than those repaired. Ibuprofen also reduced the breaking strength of completely divided and repaired extensor tendons. The addition of a piece of chromic suture buried across the extensor tenorrhaphy site significantly increased the breaking strength of the repair in control and treated animals alike. These findings were observed at 4 and 6 weeks after tendon injury and repair. No adverse reactions to the medication were observed. PMID- 3511136 TI - Lashley's shift from bacteriology to neuropsychology, 1910-1917, and the influence of Jennings, Watson, and Franz. AB - From 1910 to 1917, Karl S. Lashley's research moved from bacteriology to neuropsychology through intermediate stages of zoology, comparative psychology, and the psychology of learning. This shift is examined with particular reference to Lashley's associations with John B. Watson, Shepherd I. Franz, and Herbert S. Jennings. Watson's impact was substantial, for he attracted Lashley to comparative psychology and was the source of many of his later research interests. The bridge to neuropsychological research was provided by Franz who trained Lashley in the lesion method of investigating the brain bases of learning. The influence of Jennings, Lashley's Ph.D. supervisor, was most evident in the divergence of the post-1915 interests of Lashley and Watson. Lashley's search for brain mechanisms of learning, as contrasted with Watson's concern with behavioral prediction and control, mirrored a similar earlier difference between Jennings and Jacques Loeb. PMID- 3511137 TI - The science of language and the evolution of mind: Max Muller's quarrel with Darwinism. AB - For Darwinism to succeed as a general theory of the development of life, it had to account for at least the rudiments of all human characteristics. Thus Darwin and his colleague G. J. Romanes had to make "mental evolution" the basis for scientific psychology. F. Max Muller, Oxford's professor of comparative philology, drew on Kant's work, Romantic Naturphilosophie, and his views on the history of language and the relation of language to thought to maintain that language showed a difference not in degree but in kind between man and the lower primates. In his debate with Romanes, he argued that the study of language, not Darwinist natural history, should be the basis for a science of human psychology. However, the two authors had such different definitions of the key terms in their discussion that their differences were not only unresolved but irresolvable. PMID- 3511138 TI - Did Franz Boas witness an act of cannibalism? AB - Franz Boas has been used as an authority for the existence of cannibalism among the Kwakiutl of British Columbia, as cited in Patterns of Culture. There is reason to think, however, that all his evidence is hearsay, and that he himself never witnessed an act of cannibalism. One indication is that he eliminated all references to such acts in his final overview, published posthumously as Kwakiutl Ethnology. PMID- 3511139 TI - Reversible embedment cytochemistry (REC): a versatile method for the ultrastructural analysis and affinity labeling of tissue sections. AB - Reversible embedment cytochemistry (REC) is a new method for revealing cellular ultrastructure and for improving access of intracellular targets to macromolecular affinity labels. Fully polymerized polymethylmethacrylate was dissolved in dichloromethane and infiltrated into fixed tissue-culture cells and tissues. After evaporation of the solvent, samples were left in hard plastic. Samples were thus embedded without exposure to chemical polymerization reactions that might damage tissue ultrastructure or antigenicity. Glass or diamond knives fitted with water troughs were used to cut sections 30-1000 nm thick. Since polymethylmethacrylate is composed of linear polymers that are not covalently crosslinked, the plastic was easily extracted from the sections by immersion in solvent. Subsequently, various preparative methods, including negative staining, critical point-drying, and platinum-carbon rotary shadowing, were used to provide detailed images of well-preserved cell structure for conventional and high voltage transmission electron microscopy. Fluorescein-conjugated affinity labels were used to obtain subcellular distributions of target molecules in semi-thick sections of cultured cells and tissues for light microscopy. Colloidal gold labeled antibodies were used to localize microtubules in sections of cultured cells by electron microscopy. REC is a versatile method that should find wide application in many studies of cellular function. PMID- 3511140 TI - Post-embedding direct immunogold detection of a protein antigen in insect tissue. AB - An immunocytochemical study was performed to localize the site of hemoglobin synthesis in larvae and embryos of the insect Chironomus thummi. Heterologous antisera specific for C. thummi hemoglobins were prepared using a highly purified hemoglobin extract. Tissue samples were prepared by glutaraldehyde fixation of whole dissected larvae or whole embryos without osmium tetroxide postfixation. Epoxy resin-embedded thin sections were labeled with a direct immunogold conjugate. Immune label was localized in rough endoplasmic reticulum of fat body cells of larvae. Immune label was also present in embryos. The technique, which did not require chemical etching of the sections, proved very useful for demonstration of this intracellular protein antigen. PMID- 3511141 TI - Immunohistochemical localization of pancreatic secretory trypsin inhibitor in fetal and adult pancreatic and extrapancreatic tissues. AB - Pancreatic secretory trypsin inhibitor (PSTI) has been thought to be only a secretory trypsin inhibitor of human pancreas, but the serum content of immunoreactive PSTI is elevated without pancreatic disease. Using the peroxidase antiperoxidase method, immunoreactive cells for PSTI were found in human pancreas, stomach, duodenum, appendix, colon and urinary tract of both fetus and adult, adult gall bladder, and fetal lung. PSTI-immunoreactive cells were identified in fetal pancreas at the tenth gestational week, and in extrapancreatic tissues at the sixteenth (gastrointestinal and urinary tract) and twentieth weeks (lung). PSTI-immunoreactive cells of fetal lung were present in neuroepithelial bodies. Strongly positive cells in fetal duodenum were argyrophilic and resembled endocrine cells. Immunohistochemical study was also performed on tissues associated with inflammatory diseases of gastrointestinal tract. The distribution pattern of immunoreactive cells in the stomach varied in accordance with chronic gastritis. Immunoreactive cells were also found in endocrine micro-nests and in a carcinoid tumor associated with fundic gastritis. These results suggest that PSTI may play some physiological role other than secretory trypsin inhibition of the pancreas. PMID- 3511142 TI - Lectin binding to parietal cells of human gastric mucosa. AB - A light microscopic and ultrastructural analysis of lectin receptors on parietal cells from human gastric mucosa was performed utilizing 12 biotinylated lectins in conjunction with an avidin-biotin-peroxidase complex. Peanut agglutinin conjugated directly to peroxidase was also used. Several fixatives and fixation regimens were evaluated for optimal preservation of parietal cell saccharide moieties. Formalin proved to be the most practical fixative for light microscopic studies. A periodate-lysine-paraformaldehyde (PLP) combination provided good preservation of lectin binding capacity but yielded relatively poor ultrastructure. Conversely, glutaraldehyde provided excellent preservation of ultrastructure but a somewhat diminished lectin binding activity, which was overcome by using long incubation times and high concentrations of reagents. Parietal cells reacted strongly with Bandieraea simplicifolia, Dolichos biflorus, peanut agglutinin, and soybean agglutinin (all specific for galactosyl/galactosaminyl groups) and weakly with Ulex europaeus (specific for fucose). At the light microscopic level a beaded, perinuclear staining pattern was observed which, ultrastructurally, corresponded to an intense staining of intracytoplasmic canaliculi. The membranes of the intracytoplasmic canaliculi were characterized by an abundance of galactosyl residues, a paucity of fucosyl groups, and a lack of mannosyl and glucosyl residues. The biochemical and physiological significance of these findings is discussed. PMID- 3511143 TI - Restoration of in vitro responsiveness of xid B cells to TNP-Ficoll by 8 mercaptoguanosine. AB - 8-Mercaptoguanosine (8sGuo) has been reported to enhance responses of normal mice to the type 2 antigen trinitrophenol (TNP)-Ficoll. In this report, we demonstrate that this immune adjuvant restores the immune responsiveness of B cells from mice with the x-linked immune defect (xid), which are nonresponsive to the type 2 antigen TNP-Ficoll. The data demonstrate that TNP-Ficoll, which by itself cannot stimulate anti-TNP responses in CBA/N mice, is able to initiate the initial steps of cell activation in xid B cells and render them sensitive to the subsequent differentiative effects of 8sGuo. We propose that the unresponsiveness of xid B cells to type 2 antigens reflects not the inability of these antigens to stimulate xid B cells from G0 to G1, but rather the inability of these antigen activated cells to respond to a second signal to which these immune defective B cells are poorly responsive and can be substituted for by 8sGuo. PMID- 3511144 TI - A monoclonal antibody to the desmosomal glycoprotein desmoglein I binds the same polypeptide as human autoantibodies in pemphigus foliaceus. AB - Recent studies have demonstrated that antibodies from about half of patients with pemphigus foliaceus (PF) bind to a 160 kd polypeptide ("PF antigen") in sodium dodecyl sulfate (SDS) extracts of normal human epidermis. Desmoglein (DG) I, a glycoprotein enriched in desmosomal cores, is approximately the same m.w. as PF antigen. To demonstrate that PF autoantibodies bind to DG I, we used a monoclonal IgG antibody (MmDGI-1) that was raised against bovine muzzle desmosomal cores, and that specifically binds DG I. Double immunofluorescence labeling was performed on the same section of normal human skin with PF antibodies, detected by fluorescein-conjugated goat anti-human IgG, and MmDGI-1, detected by rhodamine conjugated goat anti-mouse IgG. The pattern of reactivity with both antibodies was identical. Immunoblotting studies on proteins extracted from normal human epidermis and separated by SDS-polyacrylamide gel electrophoresis demonstrated that PF antibodies and MmDGI-1 bound co-migrating polypeptide bands of approximate m.w. 160,000. To confirm that these were identical polypeptides, we performed immunoblots of these epidermal extracts that were separated by two dimensional gel electrophoreses (isoelectric focusing followed by SDS-PAGE). PF antibodies and MmDGI-1 bound identical spots with pI approximately 5.4 to 5.7 and m.w. approximately 160,000. These studies demonstrate that autoantibodies from certain patients with PF, a disorder of cell adhesion, bind to DG I, a desmosomal core glycoprotein. PMID- 3511145 TI - Characterization of the formyl peptide chemotactic receptor appearing at the phagocytic cell surface after exposure to phorbol myristate acetate. AB - We examined the biochemistry and subcellular source of new formyl peptide chemotactic receptor appearing at the human neutrophil and differentiated HL-60 (d-HL-60) cell surface after stimulation with phorbol myristate acetate (PMA). Formyl peptide receptor was analyzed by affinity labeling with formyl-norleu-leu phe-norleu-[125I]iodotyr-lys and ethylene glycol bis(succinimidyl succinate) followed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and densitometric analysis of autoradiographs. PMA, a specific granule secretagogue, increases affinity labeling of formyl peptide receptors on the neutrophil surface by 100%, and on d-HL-60, which lack specific granule markers, by 20%. Papain treatment markedly reduces surface labeling of formyl peptide receptor in both neutrophils and d-HL-60, and results in the appearance of a lower m.w. membrane-bound receptor fragment. PMA stimulation of papain-treated cells increases uncleaved surface receptor on neutrophils by 400%, and on d-HL-60 by only 45%. This newly appearing receptor is the same apparent m.w. (55,000 to 75,000 for neutrophils; 62,000 to 80,000 for d-HL-60) and yields the same papain cleavage product (Mr, 31,000 for neutrophils; Mr, 29,000 for d-HL-60) as receptor on the surface of unstimulated cells. Formyl peptide receptor detected by affinity labeling in neutrophil specific granule-enriched subcellular fractions is identical to receptor found on the surface of unstimulated cells appearing as equal amounts of two isoelectric forms (isoelectric points, 5.8 and 6.2) at Mr 55,000 to 70,000. There is twice as much receptor present in the specific granule enriched fraction per cell equivalent compared with plasma membrane. Azurophil granules contain trace amounts of receptor. Similar analysis of neutrophils treated with papain before subcellular fractionation shows that papain cleaved receptor fragment is detectable almost exclusively in the plasma membrane enriched fraction. Most of the affinity-labeled formyl peptide receptor present in specific granule enriched fraction is present in membranes other than plasma membrane or Golgi membrane, because specific granule-enriched fraction contains only a small amount of plasma membrane marker and an amount of Golgi membrane marker equal to that found in plasma membrane-enriched fraction.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3511146 TI - Antibodies isolated by using cloned surface antigens recognize antigenically related components of Legionella pneumophila and other Legionella species. AB - We studied the antigenic cross-reactivity of surface proteins among various strains of Legionella pneumophila and other Legionella species by using a novel method of antibody purification. Anti-bacterial antibodies in hyperimmune sera were adsorbed to and eluted from the surface of recombinant E. coli cells that express individual L. pneumophila antigens on their surface. These affinity purified antibodies were then used to probe protein immunoblots prepared from the test strains to detect cross-reactive domains. We found that antigenic proteins are generally conserved in all L. pneumophila serogroups. Although some of these antigenic domains are shared with members of other Legionella species, they are associated with proteins of different molecular mass. Our approach to the study of antigenic cross-reactivity has potential advantages over similar studies that use either monoclonal antibodies or monospecific antibodies prepared by immunization with purified antigens. PMID- 3511148 TI - Measurement of skin swelling in the tuberculin test by ultrasonography. AB - A new method is described for non-invasive measurement of the thickness of the skin at the site of a skin test from the echo pattern of a pulsed ultrasonic (15 MHz) A-mode scanner. In tuberculin tests on normal volunteers, the skin thickness increased rapidly during days 1 and 2 and was usually greatest at day 4. The echogram measurements can be used to calculate the increase in skin volume and this is disproportionately greater than would be expected from measurements of the diameters of erythema and induration. PMID- 3511147 TI - A spectrum in the susceptibility of leishmanial strains to intracellular killing by murine macrophages. AB - The susceptibility of 26 strains and clones of Leishmania to in vitro killing by lymphokine (LK)-activated macrophages was determined. A spectrum in the susceptibility of Leishmania to macrophage killing was observed. Some leishmanias were completely resistant to killing, including some but not all of the L. mexicana strains studied. This resistance was expressed in amastigotes and stationary growth-phase promastigotes, but not in logarithmic promastigotes. In contrast, some L. braziliensis parasites failed to survive within either activated or nonactivated macrophages. Between these two extremes were strains that survived within nonactivated macrophages, but were readily killed within activated macrophages. These included L. donovani, L. major, and some L. mexicana strains. Finally, one L. mexicana strain (WR357) was found to be susceptible to killing at high LK concentrations, but was relatively resistant at lower LK concentrations or at cutaneous temperatures. The observed differences in susceptibility to macrophage-mediated microbicidal activity may explain, in part, the variable pathogenesis of leishmanial infections. PMID- 3511149 TI - Immunoassay of tryptase from human mast cells. AB - A sandwich ELISA was developed for the measurement of tryptase. The assay utilizes the mouse monoclonal anti-tryptase antibody, termed G5 (IgG2b kappa) in the solid phase and monospecific goat IgG anti-tryptase antibody together with tryptase in the fluid phase. The immunoassay will quantify 0.1 ng-5.6 ng of tryptase per 100 microliters of sample solution to within 0.1 ng. Intra-assay coefficients of variation were determined at 0.3 ng, 1.0 ng and 3.0 ng of tryptase per assay, respectively, to be 19%, 7% and 4% with buffer and 10%, 4%, and 4% in the presence of 20% plasma. Inter-assay coefficients of variation at the same respective levels of tryptase were 22%, 18% and 15% with buffer and 18%, 11% and 14% with 20% plasma. Net absorbance values obtained with a standard amount of tryptase in buffer alone and up to 50% (v/v) normal human citrate treated plasma were within 10% of one another, indicating nearly complete detection of tryptase added to plasma. This represents the first sensitive immunoassay for a preformed mediator specific for human mast cells. PMID- 3511150 TI - Turbidimetric microassay for macrophage-mediated antibody-dependent cellular cytotoxicity. AB - An improved microassay for quantitation of murine macrophage-mediated antibody dependent cellular cytotoxicity (ADCC) has been developed. The method is based on the turbidimetric measurement of sheep erythrocyte or nucleated (L1210) target cell suspensions at 630 nm with an automatic microtiter plate densitometer. The novel method was applied to demonstrate dose-related increases in murine macrophage mediated ADCC with varying antibody concentration, effector:target ratio, and incubation time. Advantages of the turbidimetric method were shown over the 51Cr-labeled target cell method by direct comparisons in that the new method was 2-4 times more sensitive and allowed repeated readings of the same plate after various incubation time intervals. The method provides further advantages of (1) elimination of the need for expensive and hazardous radioactive materials, (2) relative ease and rapidity in which experiments may be performed and quantitated, (3) sensitivity and reproducibility, and (4) versatility of the assay for measuring cytotoxicity of either erythrocyte or nucleated target cells. PMID- 3511151 TI - An enzyme-linked immunosorbent assay (ELISA) for anti-chlamydial secretory immunoglobulin A in guinea pig tears. AB - A method is described which permits the assay of specific secretory immunoglobulin A (sIgA) antibodies produced by guinea pigs in response to ocular infection with the guinea pig inclusion conjunctivitis strain of Chlamydia psittaci (GPIC agent). The enzyme-linked immunosorbent assay (ELISA) developed was shown to be more sensitive and less subjective than the micro immunofluorescence assay as a means of assaying specific antibody. PMID- 3511152 TI - A fast and objective assay for cell mediated intra- and extracellular killing of Leishmania promastigotes. AB - An in vitro radiometric assay is described for the detection of cytolytic activity against the obligate intracellular parasite Leishmania enriettii. The assay system can be equally well applied to non-cellular (humoral), cellular non phagocytic, and cellular phagocytic effector situations. Leishmania promastigote organisms are DNA-labeled with [methyl-3H]thymidine [( 3H]dThd) with high efficiency. Spontaneous label release remains very low even in non-ideal culture conditions. We have modeled a leishmanicidal situation by co-cultivating L. enriettii with starch-elicited murine peritoneal macrophages for different time periods. At an effector-to-target ratio of 1:6 a highly significant [3H]dThd release can be observed after 4 h of co-cultivation, reaching 60% after 18 h. The principle advantages of this assay system are speed, high sensitivity and objectivity. This makes it suitable for mass screening of, e.g., immunomodulatory or parasiticidal agents and equally useful in both phagocytic and non-phagocytic situations. PMID- 3511153 TI - Identification of a particular antigen from a parasite cDNA library using antibodies affinity purified from selected portions of Western blots. AB - Portions of nitrocellulose filters containing blotted electrophoresed antigens of Schistosoma japonicum adult worms were reacted with polyclonal rabbit antisera raised to this human parasite. Eluted antibodies were used as probes for detection of antigen-positive clones in an Escherichia coli lambda gt11 amp3 expression library of adult worm cDNA. Several cloned antigens corresponding to a S. japonicum antigen of Mr 26 000, being sought as a candidate vaccine molecule in a mouse model of schistosomiasis japonica, were identified using this approach. The method provides an antibody reagent that is an attractive alternative to other more tedious means of producing oligospecific antibodies, including monoclonal antibodies, for screening of expression libraries. PMID- 3511154 TI - Detection of low molecular weight cysteine proteinase inhibitors by time-resolved fluoroimmunoassay. AB - A time-resolved fluoroimmunoassay was developed for the detection of 3 human low molecular weight cysteine proteinase inhibitors, ACPI (cystatin A), NCPI (cystatin B), and gamma-trace (cystatin C). Polystyrene tubes or polystyrene microtitration strips were used as solid phase. The rabbit anti-inhibitor immunoglobulins were used as the capture antibody, and, when labelled with europium, also as the detector antibody. The threshold sensitivity of the tests was 0.1 ng/ml for NCPI and 1 ng/ml for the others. All the 3 cysteine proteinase inhibitors, ACPI, NCPI, and gamma-trace, were detected in pooled serum samples of patients with kidney failure. gamma-Trace seemed to be quantitatively the major and ACPI the minor inhibitor. No other low molecular mass cysteine proteinase inhibitor was detected after isoelectric focusing of the 12 kDa area of gel filtered human serum. PMID- 3511155 TI - Evaluation of fluorescence excitation transfer immunoassay for measurement of specific proteins. AB - Fluorescence excitation transfer immunoassay is a suitable technique for the measurement of serum IgG and CRP. The reagents, once reconstituted, are stable for at least 3 months. The method shows no interference due to bilirubin, lipaemia or haemolysis up to high levels. The assay is simple to perform, reliable and offers considerable advantages over manual techniques such as radial immunodiffusion or electroimmunoassay. PMID- 3511156 TI - Affinity purification of human antibodies directed against cloned antigens of Plasmodium falciparum. AB - A technique has been developed for the affinity purification of antibodies recognizing cloned antigens of the malaria parasite Plasmodium falciparum expressed in bacteria. Adsorbents prepared by coupling bacterial lysates to Sepharose were used to isolate monospecific antibodies from human immune sera. Production of an abundant stable fused polypeptide by the bacteria was not a prerequisite for the success of this approach. Also the procedure permits the characterization of antigens which elicit the production of very low levels of antibodies. Affinity-purified human antibodies were used to characterized the corresponding P. falciparum antigens by immunoblotting and a number of antigens identified in this way illustrate some commonly observed features of P. falciparum antigens. Several of these antibody preparations recognized multiple bands in the electrophoretic patterns. Studies on a number of isolates of P. falciparum indicate that many antigens exhibit size polymorphisms. Production of some antigens was shown to be restricted to particular stages of the asexual blood cycle of the parasite while others appear to be specifically processed during the life cycle. Affinity-purified antibodies have also been used to locate antigens within the infected erythrocyte and to delineate subsets of antibodies recognizing different epitopes of a single antigen. PMID- 3511158 TI - A comparative study of enterotoxin gene probes and tests for toxin production to detect enterotoxigenic Escherichia coli. AB - Escherichia coli isolated from children with diarrhea were tested for enterotoxin production and for hybridization with gene probes for heat-labile (LT) and heat stable (ST-H and ST-P) enterotoxin. Fecal specimens were also examined directly for genes coding for enterotoxins. E. coli that hybridized with the cloned enterotoxin gene probes was identified by colony hybridization from 46 children, by enterotoxin production from 38 children, and by specimen hybridization from 37 of 304 children examined. Eighty-six percent (473 of 550) of E. coli that hybridized with the cloned DNA probes produced enterotoxins. Four E. coli that hybridized with the LT and 73 E. coli that hybridized with the ST-H probes were nonenterotoxigenic. These isolates were subsequently shown not to hybridize with other constructions of the same probes and did not hybridize with synthetic single-stranded oligonucleotides directed against the LT or ST genes. PMID- 3511157 TI - Impairment of antibacterial defense mechanisms of the lung by extrapulmonary infection. AB - To determine whether extrapulmonary infection alters antibacterial defenses of the lung, we challenged mice with peritonitis due to Escherichia coli by aerosol inhalation with either Staphylococus aureus or Pseudomonas aeruginosa. In animals without peritonitis, 14% +/- 5% and 11% +/- 1% of the initially deposited viable S. aureus and P. aeruginosa, respectively, remained in the lungs at 4 hr. In contrast, in mice with peritonitis, at 4 hr 45% +/- 9% of the staphylococci were recoved, and the P. aeruginosa had increased to 948% +/- 354% of the initial inoculum. Proliferation of P. aeruginosa in mice with peritonitis was associated with impaired recruitment of polymorphonuclear neutrophils (PMNs) into the lungs. In contrast, a noninfectious stimulus induced more PMNs into the peritoneal cavity than did intraabdominal sepsis but only minimally impaired PMN recruitment into the lungs after aerosol challenge with P. aeruginosa. Sterile intraperitoneal stimulation did not significantly impair intrapulmonary killing of P. aeruginosa. Levels of antigenic C3 and functionally active C5 were significantly depleted in mice with peritonitis due to E. coli. We conclude that the systemic effects of sepsis, including complement depletion, contribute to the decreased pulmonary PMN recruitment and to impaired intrapulmonary bacterial killing of animals with peritonitis due to E. coli. PMID- 3511160 TI - Beta-lactamase-producing Eikenella corrodens in an intraabdominal abscess. PMID- 3511161 TI - Visualization of the multimeric structure of von Willebrand factor using a peroxidase-conjugated second antibody. AB - We describe a technique for visualizing the multimeric structure of von Willebrand factor that does not require use of radioisotopes. This procedure uses a previously described discontinuous dodecyl sulfate agarose gel electrophoretic method followed by transfer of the protein to a nitrocellulose filter and detection by a double-antibody technique in which the second antibody is conjugated to horseradish peroxidase. In the presence of H2O2 and 4-chloro-1 napthol, the antigen appears as a series of about 15 colored bands. This method results in resolution of the high molecular weight components, does not require the use of radioisotopes, and can be completed in 2 days. It should be useful for diagnostic and investigational studies in clinical and research laboratories. PMID- 3511159 TI - Typhoid fever: successful therapy with cefoperazone. AB - We compared cefoperazone with chloramphenicol in a randomized trial involving the treatment of 25 children with severe typhoid fever. The clinical characteristics of the two treatment groups were comparable on entry into the study. Four patients died (three receiving chloramphenicol, one cefoperazone), and an additional two patients received dexamethasone (one per group). Excluding these six patients, the response of the cefoperazone group was comparable or superior to that of the chloramphenicol group in terms of the number of days from initiation of therapy to becoming afebrile (P less than .055) and the number of days until negative blood cultures were obtained (P less than .19). There were no relapses or treatment failures in either group. We conclude that cefoperazone is as effective as chloramphenicol in the treatment of severe typhoid fever. PMID- 3511162 TI - Silastic coated incus in tympanoplasty: a preliminary report. AB - In 54 ears lacking the stapedial arch and the long process of the incus, ossiculoplasty was performed with a shaped auto- or homologous incus as columella. In 29 of the ears, the deep, slender part of the columella was coated with a silastic tube in order to prevent adhesions and dislocation. One year after the operation the functional results were similar in patients with silastic coating of the incus to those without. It is concluded that the less satisfactory results of tympanoplasty in such ears are primarily caused by factors outside the niche of the oval window. Possible ways of improving the results are discussed. PMID- 3511164 TI - [List of the members of the French College of Vascular Pathology. January 1986]. PMID- 3511163 TI - The use of free tissue transfer in reconstruction following head and neck tumour resection. AB - Experience in the use of free vascularised tissue flaps in reconstruction following major head and neck resections for malignant disease has been described. The benefits of the use of free flaps are improved function and cosmesis with more rapid rehabilitation and reduced in-patient stay in a group of patients, many of whom had a limited life expectancy. The disadvantages of this technique are the need for special equipment and for medical and nursing staff trained and experienced in this type of work. PMID- 3511165 TI - Early postoperative changes after desobliteration of the carotid artery. Subsequent diagnostic control using a high resolution ultrasonic-real-time-duplex scanner. AB - The ultrasonic morphology of the carotid artery following 55 endarterectomies in 50 patients (36 males, 14 females, mean age 68 (53-83) years) was studied using a high resolution ultrasound duplex system (HUDS). The examinations were done 1-3 days before as well as 2-4 days and 1, 2, 4 and 8 weeks after surgery, respectively. The following typical appearance after carotid endarterectomy was found: At the site of endarterectomy the new vessel wall showed the following details: lack of the "sonographic tunica intima" the thickness of the vessel wall was reduced with less pronounced ultrasonic structure compared with healthy subjects the surface toward the lumen was less smooth "ultrasonic soft" thrombotic layers with irregular surface, individual distribution (sometimes only spots) and thickness (0.5 to 4.0 mm) were seen in the majority of patients. The edge of the tunica intima was always visible in the common carotid (edge of endarterectomy) whereas in the internal carotid artery there was often an interference of the jaw. The change of caliber at the site of the edge of the tunica intima was dependent on the thickness of the "sonographic intima" as well as on the layer of the vessel wall in which endarterectomy was done. At the site of arterial clamping, intramural hematomas, lesions of the tunica intima with thrombotic layers causing some stenosis were observed after 9 of 55 procedures. Vascular sutures were always visible as bright spots. A "normalization" of local flow patterns could be seen in dependence on the morphological "normalization".(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3511166 TI - Autologous intestinal smooth muscle for bypass grafting in cases of infected alloplastic implants. PMID- 3511167 TI - Pancreatic alpha cell function in the fetal and newborn pig. AB - Plasma glucagon concentrations were measured in chronically catheterized fetal pigs during the last third of gestation and compared with the values observed in anaesthetized fetuses of similar gestational age. The mean plasma concentration of glucagon in the chronically catheterized fetuses was 10.0 +/- 1.4 (S.E.M.) pmol/l (n = 11; term = 114 +/- 2 days). Concentrations were increased after catheterization and fell to baseline values within 48 h of surgery. Arginine infusion evoked a rapid release of glucagon in chronically catheterized fetuses between 105 and 108 days of gestation; the mean maximum increment in plasma glucagon was 15.4 +/- 4.5 pmol/l (n = 5). Plasma glucagon concentrations increased with increasing gestational age in both anaesthetized and chronically catheterized fetuses. Between 95 and 110 days of gestation, glucagon levels were significantly higher in anaesthetized fetuses than in chronically catheterized animals with similar normal pH values. Catheterization and prematurity had no apparent effect on plasma glucagon levels at birth. The plasma concentrations at birth were similar to those observed in the chronically catheterized fetuses in utero provided the piglets did not become acidotic during delivery. Significantly higher plasma levels of glucagon were found in newborn piglets with acidaemia (pH less than 7.3) than in piglets with normal pH values at birth (pH greater than 7.3). When all the data from the newborn piglets were combined, there was a significant negative correlation (r = -0.79, n = 39, P less than 0.01) between blood pH and the plasma concentration of glucagon at birth. These observations demonstrate that the fetal alpha cells are functional and responsive in utero and at birth. PMID- 3511168 TI - Characterization of the insulin-binding sites in turtle thyroid microsomes. AB - The characteristics of the specific binding of labelled insulin to turtle thyroid microsomes were investigated. Binding experiments were performed in Krebs-Ringer bicarbonate buffer (pH 7.4) at 25 or 4 degrees C for different periods of time. Dissociation of the labelled insulin from the binding sites was also evaluated. It was found that the binding is dependent on time, temperature and microsomal protein concentration, with an optimum pH of 8.0. Unlabelled insulin and pro insulin competed with the labelled insulin, binding in direct proportion to their biological activities, while glucagon and growth hormones did not compete for the binding sites. Scatchard plot analysis established the presence of binding sites of high and low affinities, and the rate of dissociation of bound insulin was considerably increased by the addition of unlabelled insulin. Both results are compatible with a negative co-operativity site-site interaction model. Trypsin abolished the insulin binding. These findings indicate that the microsomes from the turtle thyroid gland contain specific binding sites for insulin. However, pre incubation of microsomes with phospholipase C or S-adenosyl-L-methionine (SAM), or incubation in the presence of 2 mol NaCl/l did not increase the specific insulin binding. Therefore, the binding properties are similar to those observed in mammalian insulin-responsive tissues except for the absence of the effects of 2 mol NaCl/l, phospholipase C or SAM, which suggests the absence of masked insulin-binding sites. PMID- 3511169 TI - Immunocytochemical localization of corticosteroid-binding globulin in rat tissues. AB - Previous studies utilizing steroid-binding assays have suggested that corticosteroid-binding globulin (CBG)-like glucocorticoid binding sites are present in various tissues of the rat. It is not known, however, whether such binding reflects the intracellular presence of CBG derived from serum or a special class (type III) of receptors. In order to elucidate this problem, immunocytochemical localization of rat CBG was carried out using a specific antiserum prepared against rat serum CBG and the peroxidase-antiperoxidase technique. Positive staining was found in certain cells of the liver, the distal and/or convoluted tubules of the kidney, the uterus, the follicular cells of the thyroid, and some cells of the anterior pituitary. Other tissues including heart, muscle, thymus, hypothalamus, supraoptic and paraventricular nuclei, and diaphragm were negative. The presence of immunoreactive CBG in specific cells of some glucocorticoid-responsive tissues and not others raises interesting questions concerning the transport of glucocorticoids and their mechanism of action. PMID- 3511170 TI - Mta, the maternally transmitted antigen, is determined jointly by the chromosomal Hmt and the extrachromosomal Mtf genes. AB - Mus spretus from four stocks, originating in Spain, Portugal, and Morocco, were tested for the maternally transmitted antigen, Mta. All expressed a variant form not found in other species of mice. Analysis of appropriate crosses with inbred mice showed that the spretus form of Mta is determined by a new allele, c, of the Hmt gene. The Hmtc allele has been isolated in coupling with four different H-2 haplotypes. It is possible to raise CTL specific for the spretus form of Mta. The maternally transmitted factor, Mtf alpha s, of spretus mice determines, in conjunction with the Hmta allele of C57BL/6, an Mta that is indistinguishable from the common form found in C57BL/6 and most other inbred mice. Our experiments show that the specificity of the cell surface antigen Mta is governed jointly by the cytoplasmic gene Mtf and the chromosomal gene Hmt. We propose that Hmt encodes a class I histocompatibility antigen that acts as a restricting element for the Mtf gene product, thus meeting the requirements of T killer cell recognition. PMID- 3511171 TI - Use of a novel colony assay to evaluate the cytotoxicity of an immunotoxin containing pokeweed antiviral protein against blast progenitor cells freshly obtained from patients with common B-lineage acute lymphoblastic leukemia. AB - We report a novel colony assay for B-lineage progenitor cells in acute lymphoblastic leukemia (ALL). The primary plating efficiency of blast progenitors freshly obtained from common B-lineage ALL patients varied between 0.09 and 2.63%. Morphological, cytochemical, and immunological analyses of cells from day 7 colonies provided the evidence that they are B-lineage lymphoblasts. Immunological marker analyses of cultured blasts using BA-2 (anti-CD9), BA-3 (anti-CD10), BA-1 (anti-CD24), and B43 mAb have allowed us to define two distinct immunological groups. The first group had BA-2+, BA-3+, BA-1+, B43+ marker profiles, consistent with the phenotype of uncultured bone marrow blasts. The second group differed in that the cells in the blast colonies were BA-3 (anti CD10)-negative, although many of the cells in the bulk population were BA-3+ before culture. Blasts from both groups were able to proliferate and form secondary colonies when recultured. A pan-B immunotoxin was synthesized by linking B43, a human B cell-specific mAb, to pokeweed antiviral protein (PAP). This study showed that B43-PAP can effectively eradicate leukemic progenitor cells freshly obtained from patients with common B-lineage ALL. B43-PAP eliminated greater than 99.96% of blast progenitors under conditions in which only minimal inhibition of normal bone marrow progenitor cells (CFU-GM, CFU-E, CFU-MK, CFU-GEMM) was observed. Our results establish that the surface determinant recognized by B43 is expressed on B-lineage progenitor cells in ALL, and that these cells are sensitive to PAP at the ribosomal level. To our knowledge, B43-PAP is the first IT to prove effective against common B-lineage ALL cells. PMID- 3511172 TI - Dendritic cells with antigen-presenting capability reside in airway epithelium, lung parenchyma, and visceral pleura. AB - In this study, we identified a population of dendritic cells (DC) that exists throughout human and mouse pulmonary tissues, including the trachea, bronchi, alveoli, and visceral pleura. In human tissue, these DC were shown to be positive for HLA-DR and T200 antigens. In the mouse, the DC expressed not only Ia and the T200 antigen, but also Fc-IgG and C3bi receptors. Unlike alveolar macrophages, the DC were negative for nonspecific esterase staining and shared ultrastructural similarities with the DC described by Steinman (1), and with Langerhans' cells, even though they did not contain Birbeck granules. We were able to demonstrate that mouse pulmonary DC function in antigen presentation, as observed with the other DC. Thus, the respiratory tract contains DC that are capable of functioning in antigen presentation and that may be important in pulmonary immune responses. PMID- 3511173 TI - Immunogenicity and crossreactivity of specificity-associated markers on alloreactive T cells. Confirmation based on the model of tolerance abolition by adoptive transfer. AB - Syngeneic or parental strain T cells adoptively transferred into hybrid rats tolerant of third party alloantigens (L/DA tolerant of BN), in numbers insufficient to abolish tolerance, induce instead an active resistance to tolerance abolition with larger, usually effective dosages of donor cells. Of particular interest is the finding that immunization with T cells from one parental strain donor (e.g., DA) inhibited the tolerance-abolishing alloreactivity (anti-BN) of subsequently transferred T cells from the same (DA) and the other (L) parental strain donor. We conclude that anti-MHC receptors on T cells from different genetic backgrounds reactive to the same third party alloantigens share the same conserved immunogenic specificity-associated markers (SAM). The nonpolymorphism of anti-MHC receptors shown here in the transplantation tolerance model is a confirmation of the same conclusion drawn from earlier studies with the GVHD-resistance model, and it therefore suggests that these two models of T cell MHC interactions involve very similar mechanisms of T cell idiotypic regulation. PMID- 3511174 TI - Detective magazines: pornography for the sexual sadist? AB - The origins of detective magazines can be traced to 17th and 18th century crime pamphlets and to 19th century periodicals that Lombroso called "really criminal newspapers." Content analysis of current detective magazines shows that their covers juxtapose erotic images with images of violence, bondage, and domination; that their articles provide lurid descriptions of murder, rape, and torture; and that they publish advertisements for weapons, burglary and car theft tools, false identification, and sexual aids. Six case histories of sexual sadists illustrate the use of these magazines as a source of fantasy material. We postulate that detective magazines may contribute to the development of sexual sadism, facilitate sadistic fantasies, and serve as training manuals and equipment catalogs for criminals. We recommend that detective magazines be considered during policy debates about media violence and pornography. PMID- 3511175 TI - Tolerance at high blood alcohol concentrations: a study of 110 cases and review of the literature. AB - One hundred ten consecutive alcoholics who voluntarily entered a detoxification center were studied to determine their ability to perform certain designated functions (a) while under the influence of alcohol at admission and (b) four days later, after they had undergone detoxification. Their blood alcohol concentrations (BACs) within an hour of admission were determined by using the DuPont Automated Clinical Analyzer (ACA), following standard procedures. The results of the tests performed by these subjects were then studied to ascertain the level of psychomotor impairment in alcoholics at elevated BACs. The results were broken down by age, sex, race, and BAC. The findings indicate that alcoholics develop an increased tolerance to alcohol at BACs, which are extremely high, including levels generally considered to be potentially fatal. PMID- 3511176 TI - The use of bone histomorphometry in skeletal identification: the case of Francisco Pizarro. AB - Two lines of approach are utilized in a histomorphometric analysis of a rib sample from the postcranial remains believed to be those of Francisco Pizarro. Using a newly developed age predicting formula, age at death is estimated to be 62 years. This age agrees with several ages reported in historical documents. The histomorphometry of cortical area/total area (C/T) ratio, mean osteonal cross sectional area, and mean annual Haversian bone formation rate conform to those of a healthy individual in his early sixties. PMID- 3511177 TI - Dulcin: a centennial perspective. AB - The discovery of dulcin, the second synthetic sweetener, has been traced to the work of J. Berlinerblau. Early studies of this sweetener revealed a very effective sweetener that showed toxicity at high doses. Dulcin never achieved great recognition nor usage but was utilized slightly until a long-term study clearly pointed out its toxicity under sustained use with small doses. PMID- 3511178 TI - Medicolegal investigations in Hollywood. PMID- 3511179 TI - Viral infections in domestic animals as models for studies of viral immunology and pathogenesis. PMID- 3511180 TI - 5S RNA and tRNA-like molecules are associated with killer virus dsRNA of yeast. AB - A population of oligonucleotides co-purified with the dsRNA genomic segments of the killer virus of Saccharomyces cerevisiae during electrophoresis through agarose gels. These smaller RNA molecules must be separated from the viral genome in order to determine the structure of the dsRNA molecules. Sequence analysis of these isolated oligonucleotides showed that the population contained tRNA-like molecules, as well as 5S RNA, which are presumably encoded by the host cell genome. PMID- 3511181 TI - Oral bromovinyldeoxyuridine therapy for herpes simplex and varicella-zoster virus infections in severely immunosuppressed patients: a preliminary clinical trial. AB - Twenty-five patients with haematological diseases were treated orally with the highly potent and selective anti-herpes agent, bromovinyldeoxyuridine (BVDU), in a dosage of 7.5 mg/kg/day (divided over three or four doses a day) for 5 days for an intercurrent mucocutaneous herpesvirus infection. Of these 25 patients, 8 were severely granulocytopenic at the time of the viral infection, and 12 recently had undergone bone-marrow transplantation; 5 were under cytotoxic therapy for a lymphoproliferative disorder; 13 had herpes simplex virus type 1 (HSV-1); 1 had herpes simplex virus type 2 (HSV-2); and 11 had varicella-zoster virus (VZV) infection. In all but two patients, BVDU arrested progression of the HSV or VZV infection within 1-2 days after treatment was started. One of the two patients who failed to respond to BVDU had an HSV-2 infection. The other had an HSV-1 infection, which was highly sensitive to BVDU in vitro; BVDU may have failed in this patient because of incomplete drug intake or profuse diarrhoea, or both. The results of this preliminary uncontrolled clinical trial suggest that BVDU may be an effective and safe drug for the oral treatment of HSV-1 and VZV infections in severely immunosuppressed patients. PMID- 3511182 TI - A controlled trial for evaluating two live attenuated mumps-measles vaccines (Urabe Am 9-Schwarz and Jeryl Lynn-Moraten) in young children. AB - A prospective, randomised clinical trial was conducted to evaluate the efficacy of two live attenuated mumps-measles vaccines, the Urabe Am 9-Schwarz and the Jeryl Lynn-Moraten vaccine, in 400 young children aged 9 months-4.5 years (median 13.4 months). Antibody responses to both vaccine components were measured by the enzyme-linked immunosorbent assay (ELISA); 96.9% of the seronegative children who received the Urabe Am 9-Schwarz vaccine showed satisfactory mumps antibody responses compared to 90% of the Jeryl Lynn-Moraten vaccine recipients (P less than .01). Similar proportions of both groups, 98.5% and 96.8%, respectively, developed measles virus specific antibodies. Both vaccines were equally well tolerated and clinically acceptable. PMID- 3511183 TI - Clinical trial of recombinant leukocyte A interferon as initial therapy for favorable histology non-Hodgkin's lymphomas and chronic lymphocytic leukemia. An Eastern Cooperative Oncology Group pilot study. AB - Twenty patients with disseminated favorable histology non-Hodgkin's lymphomas (16 patients) or chronic lymphocytic leukemia (four patients) who had not received previous chemotherapy were treated with recombinant leukocyte A interferon (IFL rA) (Hoffmann-La Roche, Nutley, NJ). Treatment was administered in a moderate dose (12 X 10(6) U/m2) by intramuscular (IM) injection three times weekly for 8 weeks, followed by weekly maintenance therapy for an additional 16 weeks in patients responding to therapy. Five patients with stable disease at 8 weeks received four additional weeks of three-times-weekly treatment at an escalated dose (25 X 10(6) U/m2). Interferon was tolerated without severe toxicity by most patients, although treatment was discontinued prematurely due to side effects in four patients. Objective tumor responses (one complete response [CR] and six partial responses [PRs]) were seen in seven of 16 patients with lymphoma (44%). One of four patients with chronic lymphocytic leukemia also experienced a PR. Median time-to-progression from initiation of therapy among responding patients was 26 + weeks (range, 7 + to 84 + weeks). This study has demonstrated single agent antitumor activity of IFL-rA given in a tolerable outpatient dosage regimen in patients with advanced favorable histology non-Hodgkin's lymphomas, and serves as a basis for further trials of IFL-rA combined with chemotherapy as initial therapy for such patients in the future. PMID- 3511185 TI - Interpretation of results of chemotherapy trials in metastatic breast cancer. PMID- 3511184 TI - Randomized trial of bilateral oophorectomy versus tamoxifen in premenopausal women with metastatic breast cancer. AB - A randomized clinical trial was performed to compare the efficacy of bilateral oophorectomy with that of tamoxifen at a dose of 10 mg twice daily in premenopausal women with metastatic breast cancer, and to examine the efficacy of each as a crossover treatment. Initial treatment responses were seen in ten of 27 patients (37%) treated with oophorectomy and seven of 26 patients (27%) treated with tamoxifen. The difference was not statistically significant. Crossover responses were seen in five of 15 patients (33%) treated with oophorectomy, including three responses in ten prior tamoxifen nonresponders; and two of 18 patients (11%) treated with tamoxifen. Time to progression distributions were not significantly different during initial treatment, and no significant differences in survival were noted. Thus, there was no overall disadvantage to the use of tamoxifen as opposed to oophorectomy as initial hormonal therapy, and a failure to respond to tamoxifen did not preclude a response to subsequent oophorectomy. Exploratory data analysis within subsets indicated consistent differential treatment effects in the visceral dominant patients. Of the 16 such patients treated with oophorectomy, eight (50%) experienced objective responses but there were no responses in the 14 patients treated with tamoxifen. In the nine visceral dominant crossover patients who had not responded to initial tamoxifen, three (33%) subsequently responded to oophorectomy. Time to progression distributions within the visceral dominant subset appeared to be better for the patients treated initially with oophorectomy. However, one must be very cautious in drawing conclusions from exploratory subset analyses, especially with the small sample size. Further studies would be required to test any hypothesis of differential organ site responsiveness. PMID- 3511186 TI - Randomized trials in rare tumors. PMID- 3511187 TI - Antiemetic efficacy of dexamethasone. PMID- 3511188 TI - Localization of a filamin-like protein in glia of the chick central nervous system. AB - Monoclonal antibody 5E10 binds to Muller cells in the chick retina and radial glia in the optic tectum. Biochemical and immunohistochemical experiments indicate that the 5E10 antigen is related to, but may not be identical to, filamin, a high-molecular-weight, actin-binding protein. Developmental studies show that the 5E10 antigen is present in all neuroepithelial cells very early in development, but disappears by about Embryonic Day 10. These results suggest that neurons developmentally regulate not only the type of intermediate filament proteins they express, switching from vimentin to neurofilaments, but also the type of actin-binding proteins. PMID- 3511189 TI - Differentiation of astrocytes and oligodendrocytes from germinal matrix cells in primary culture. AB - Primary cultures derived from neonatal rat forebrain grow almost entirely as glial cultures, with a large astrocytic preponderance and smaller numbers of oligodendrocytic cells. Although both astrocytic and oligodendrocytic characteristics are acquired in vitro, the origins of both types of glia in primary cultures have not been determined. We tested the hypothesis that glia differentiate in vitro from immature neuroectodermal cells by following the fate of germinal zone cells in primary cultures. A monoclonal antibody that binds GD3 ganglioside was used as a marker for cells of the subventricular zone (SVZ), since antibody binding in newborn rat forebrain could be detected by immunofluorescence only in the SVZ of newborn rats (Goldman et al., 1984). We followed the expression of glial fibrillary acidic protein (GFAP), an astrocytic marker; galactocerebroside (GC), an oligodendrocytic marker; and GD3 during the first several weeks of culture. Both GFAP and GC expression were first detected in cells that bound the GD3 antibody. Astrocytes developed during the first week in vitro; eventually, they lost the ability to bind the GD3 antibody and most became GD3-/GFAP+ cells. In high-density cultures, a population of small cells that resided on top of the astrocytic monolayer retained GD3 expression. GC antibody binding was first observed in these cells of the upper layer, although it was not readily apparent until the second week of culture. Few GC+ cells were seen in cultures grown at low density, however.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3511191 TI - Edgar A. Kahn, M.D., 1900-1985. PMID- 3511190 TI - NIF (neurite-inducing factor): a novel peptide inducing neurite formation in PC12 cells. AB - Neurite-inducing factor (NIF) is a novel protein that has been partially purified from mouse submaxillary glands. NIF induces neurite formation in PC12 pheochromocytoma cells, and the NIF-induced neurites are indistinguishable from NGF-induced neurites in both their morphology and the time course of their formation. Neurite-inducing activity can be recovered at a position corresponding to a molecular weight of 20,000 Da after fractionation of partially purified preparations via SDS-PAGE. Partially purified preparations of NIF are about half as potent as pure beta NGF, and since the neurite-inducing activity does not correspond to any of the major proteins in this fraction, specific activity of purified NIF will probably be significantly greater than the 60 ng/ml found for our partially purified material. NIF is distinct from beta NGF by four criteria: (1) antibodies to beta NGF can block the activity of beta NGF, but not the activity of NIF; (2) beta NGF can induce ornithine decarboxylase (ODC) in PC12 cells at concentrations significantly below those required to induce neurites, while NIF induces ODC only at concentrations greatly in excess of those required to induce neurite formation; (3) by the criterion of SDS-PAGE, there is insufficient beta NGF in our partially purified preparations of NIF to explain the biological activity of this fraction; and (4) the biological activity of NIF has a molecular weight (20,000 Da) that is distinct from beta NGF (13,000 Da). We conclude that NIF is probably a novel peptide that is very active in promoting morphological differentiation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3511192 TI - JONA's Semiannual Directory of Consultants to Nursing Administration. PMID- 3511193 TI - Selenium compounds and the prevention of cancer: research needs and public health implications. PMID- 3511194 TI - John B. Youmans (1893-1979). Biographical sketch. PMID- 3511195 TI - Current concepts in the aetiology, diagnosis and treatment of TMJ and muscle dysfunction. AB - The complexity of managing TMJ and muscle dysfunction is reflected in the variety of treatment modalities that are continually being advocated. The multidimensional nature of the problem is readily appreciated in a TMJ Oral Facial Pain Clinic where most of the referred patients represent a broad spectrum of treatments that have failed. Where such a clinic has been present for several decades the introduction of new ideas, or the reintroduction of old forms of treatment, are readily seen as well as the quantity and quality of treatment successes and failures. A major shift in ideas concerning the natural history of TMJ/muscle dysfunction, and an explosion of treatment problems and failures related to mandibular repositioning appliances and surgery suggest the need to reconsider various approaches to the diagnosis and treatment of TMJ and muscle dysfunction. Guidelines for diagnosis and treatment of these disorders are discussed. PMID- 3511196 TI - Comparison of the strengths of aluminous porcelain fired on to platinum and palladium foils. AB - The disc strengths of aluminous porcelain fired on to both platinum and palladium foil matrices have been determined. Also, the effect on strength of removing the matrices has been measured. The appearance of the separated metal and porcelain surfaces has been studied using scanning electron microscopy, and energy dispersive X-ray analysis has been used to evaluate the chemical composition of these surfaces. Reasons for the increase in strength observed when the matrix is left intact are discussed. Practical suggestions for obtaining stronger jacket crowns are presented. PMID- 3511197 TI - Six months clinical evaluation of prefabricated veneer restorations after partial enamel removal. AB - Thirty-three preformed plastic laminate veneers were placed in maxillary anterior teeth of twenty-one subjects. The indications for veneer placement were intrinsic staining of large conventional composite restorations or discolouration caused by previous endodontic therapy. The veneer restorations were evaluated clinically over a 6-month period for retention, colour match, surface texture, marginal integrity and gingival response. Twenty-nine restorations were available for evaluation at 6 months. Three restorations exhibited bonding failure during the study period, giving an overall retention rate of about 91%. Deep brown discolouration in two teeth could not be adequately matched with the opaquer and shader pastes supplied with the kit. Only one patient exhibited any change in veneer surface texture during the study period. Slight, but clinically inconsequential deterioration of marginal integrity was also noted in several restorations. The gingival response to the veneer restorations was uniformly excellent. It was concluded that restoration with preformed veneers, using the enamel reduction and heat adaptation techniques, provided an aesthetic, conservative and functional alternative to fixed prosthodontic therapy in selected cases. PMID- 3511198 TI - Occlusal force pattern during chewing and biting in dentitions restored with fixed bridges of cross-arch extension. I. Bilateral end abutments. AB - The pattern of axially directed occlusal forces, i.e. magnitude, distribution, duration and frequency of occlusal forces perpendicular to the occlusal plane, was studied during chewing, swallowing and biting in twelve subjects whose dentitions were periodontally treated and prosthetically restored with fixed, cross-arch bridges whose periodontal support included bilateral end abutments. The measuring devices consisted of four strain gauge transducers bilaterally mounted into pontics of maxillary bridges to represent the posterior and anterior regions. The forces could thus be studied in various parts of as well as over the entire dentition simultaneously. All subjects exhibited a rhythmic chewing pattern with preference of one side as chewing side. Local chewing and biting forces were always larger in the posterior than in the anterior regions and largest in the posterior region of the preferred chewing side. The total chewing and swallowing forces were about 100 Newtons (N) whereas the total maximal bite force in habitual occlusion amounted to 320 N. On average 37% of the total maximal bite force in habitual occlusion was utilized during chewing (and swallowing). The capacity of the periodontal tissues on the preferred chewing side to withstand transient occlusal forces was utilized to an average of 25% during chewing and swallowing and to an average of 57% during biting with maximal strength in habitual occlusion. The mean duration of that part of the chewing cycle during which the teeth were subjected to occlusal forces was 240 ms. The duration of the occlusal forces during swallowing was about three times longer. It is concluded that the periodontal tissues can withstand transient occlusal forces which are much larger than those generally operating during chewing, swallowing and biting with maximal strength in habitual occlusion. However, when the bite force is concentrated to a limited area of the tooth-arch, its magnitude seems to be limited by feedback mechanisms evoked in the periodontal tissues of that region. PMID- 3511199 TI - Safety and antibacterial properties of controlled release SnF2. AB - Two clinical studies were performed to evaluate the safety and efficacy of an intracoronal device for the controlled release of SnF2. SnF2-polycarboxylate cement, containing approximately 72 mg F-, was placed in subjects' molars requiring two-surface restorations. In the trial for safety, eight subjects had the restoration in place for 34 days. The salivary fluoride levels were elevated to a mean of 0.3/10(6) over the experimental period. Urinary fluoride levels were only above baseline levels during the first few days. The restoration's physical properties were adequate; however, subjects experienced gingival irritation in areas where the restoration was contacted with gingiva. In the trial for efficacy, fourteen subjects had either a SnF2-polycarboxylate or a placebo restoration placed in a molar tooth during a 2 week period of no oral hygiene. During the experimental period, the control subjects had higher levels of salivary total CFU, Streptococcus sanguis and Streptococcus mutans: while the subjects with the SnF2 restoration had increased S. sanguis and decreased S. mutans levels. No differences in G.I. or PL 1 scores were noted between groups. Further development of this controlled release system should include using the SnF2-polycarboxylate restoration in more than one tooth per subject to increase the fluoride reservoir, and not allowing the restoration to contact gingival tissues. PMID- 3511200 TI - An investigation into the compatibility of some irreversible hydrocolloid impression materials and dental gypsum products. Part I. Capacity to record grooves on the international standard die. AB - Some alginate impression materials produce rough, chalky, soft surfaces on gypsum casts. This is recognized by various standards, which include tests for an alginate's compatibility with gypsum, and its capacity to record details and impart these to a gypsum cast. These qualities were looked at in this study. The method used closely followed that laid down by International Standard ISO 1563 1978(E) for alginate impression materials. Ten alginates and seven gypsum products were tested. Using the criteria specified by this Standard, it was found that none of the materials tested was able to record the finest (0.020 mm) line on the test block. However, two elastomeric impression materials tested in the same manner also failed to reproduce this line, as did all the gypsum products when tested directly against the block. These findings cast some doubt on the efficacy of utilising such a fine line in the classification of these materials. Only thirty-four of the seventy possible combinations were able to reproduce the 0.050 mm line. Eight combinations reproduced the 0.075 mm line as the finest line, and the remainder (thirty-eight) failed to record any of the lines. Some of the alginate materials were treated with fixing solutions of varying concentrations of potassium sulphate and alum. The results obtained varied, sometimes producing marked improvement, sometimes deterioration in the surface quality of the subsequent gypsum casts, despite the fact that none of the manufacturers of the alginates recommended the use of fixing solutions. PMID- 3511201 TI - Epithelial membrane antigen in normal and proteinuric glomeruli and in damaged proximal tubules. AB - Epithelial membrane antigen was detected in normal glomeruli by a polyclonal antiserum to the antigen and by the monoclonal antibodies Ca 1, DAKO-EMA and HMFG 2, but not HMFG 1, using an indirect immunoperoxidase method. The antigen was in the form of a thin ring or collar at the junction of glomerulus and tubule. In a series of 47 renal biopsies from patients with proteinuria, the antigen could still be seen in glomeruli, provided that there were adequate numbers of glomeruli in the sections. The main object of study was the glomerular tip lesion, in which tip adhesions were seen to be just adjacent to the patch of epithelial membrane antigen. This suggested that the antigen may be important in pathogenesis of the lesion. Normal proximal tubules did not express epithelial membrane antigen but it was detected on the luminal border of acutely damaged proximal tubules. Thus the distribution of epithelial membrane antigen in the kidney is more complex than was previously thought. PMID- 3511203 TI - Management of children with hyperbilirubinemia and green teeth. PMID- 3511202 TI - Immunologic basis for increased susceptibility of the neonate to infection. AB - Neonatal infection with the GBS occurs in a small fraction of exposed infants who lack specific antibody. Diminished influx of PMNs to sites of infection as a result of abnormalities in chemotaxis, bone marrow exhaustion, and to a lesser degree relative complement deficiency and decreased microbicidal activity of PMNs may be additional predisposing factors. Infection with HSV occurs more often in infants born to mothers with primary rather than secondary infection; the lack of passively acquired antibody in such infants is a possible but unproved susceptibility factor. The failure of neonates to control HSV may also be related to decreased production of or response to interferon or to decreased activity of nonimmune and immune cellular cytotoxic mechanisms. Similarly, infection with Toxoplasma and intracellular bacterial pathogens, such as Listeria, may be more severe because of the decreased generation of lymphokines and interleukins, which attract macrophages to the site of infection and enable them to kill these organisms. Much of this analysis based on in vitro and animal studies summarizes current information in a rapidly changing field rather than stating established fact. The precise age at which most of the immune functions discussed reach maturity is unknown. However, the risk of severe infection with these pathogens appears to wane by 2 to 3 months of age. Although this may partly reflect decreased exposure, we might hypothesize that immune functions that are mature by this age are those most critical for protection. Future studies focusing on changes in immune function during the first months of life may provide useful insights into the immunobiology of these diseases and direct attention to the most fruitful areas for immunologic intervention. PMID- 3511204 TI - Isolation of viruses from specimens submitted for direct immunofluorescence test for respiratory syncytial virus. PMID- 3511205 TI - Klebsiella pneumoniae septicemia and Schistosoma infestation. PMID- 3511206 TI - Allogeneic bone marrow transplantation for erythrophagocytic lymphohistiocytosis. PMID- 3511208 TI - Cord blood insulin concentration in premature infants with respiratory distress syndrome. PMID- 3511207 TI - Neurologic outcome in premature infants with transient asymptomatic hyperammonemia. AB - We studied the short-term and long-term effects of transient asymptomatic neonatal hyperammonemia on neurologic function in 21 preterm infants with normal ammonium levels and 25 with hyperammonemia (range 40 to 72 mumol/L) during the first weeks of life. The hyperammonemic infants were prospectively randomized to treatment with orally administered arginine free base 1 to 2 mmol/kg/day for 2 months (n = 13) or to a no-treatment control group (n = 12). Cortical function was assessed by auditory response and habituation during the first month of life. An auditory response was shown by 64% of the hyperammonemic infants and 43% of the normoammonemic infants (P not significant). Plasma ammonium levels at the time of examination bore no consistent relationship to whether an infant responded to an auditory stimulus. Number of trials to reach auditory habituation was also not different, and plasma ammonium level did not correlate with the presence or absence of habituation. IQ testing at 6, 12, 18, and 30 months showed no significant differences between groups. Early plasma ammonium levels did not have an effect on 30-month IQ scores. These findings suggest that transient asymptomatic hyperammonemia in premature infants is not associated with short term or long-term neurologic deficits through 30 months of age. This study does not support the need for treatment of transient asymptomatic hyperammonemia in the premature infant. PMID- 3511209 TI - Rheumatic fever recurrences: controlled study of 3-week versus 4-week benzathine penicillin prevention programs. AB - To compare the merits of 3-week versus 4-week injections of benzathine penicillin G in preventing recurrence of rheumatic fever, 179 patients aged 4 to 19 years were assigned to one of the two programs. Age, weight, cardiac status, and streptococcal infections among the patients and their family members studied in each program were comparable. Eight-two patients and their family members were monitored for streptococcal infections. Compliance in the two programs was comparable. Of the 63 patients who stayed in the 4-week program, RF recurred in six, as a result of prophylaxis failure in five and associated with partial compliance in one. Of the 90 patients in the 3-week program, RF recurred in one, associated with partial compliance; no failures occurred (P = 0.01). We recommended that for RF chemoprophylaxis in individuals at great risk, regardless of age, benzathine penicillin injections should be administered every 3 rather than every 4 weeks. PMID- 3511210 TI - Therapeutic interventions to prevent intracerebral hemorrhage in preterm infants. PMID- 3511211 TI - Gallbladder wall thickening in acute hepatitis. AB - Massive gallbladder wall thickening in association with hepatitis was diagnosed in a 13-year-old hemophiliac boy. The gallbladder returned to normal with improvement of clinical symptoms, illustrating the nonsurgical nature of this problem in pediatrics. PMID- 3511212 TI - Ultrastructural and biochemical changes in human jejunal mucosa associated with enteropathogenic Escherichia coli (0111) infection. AB - A case of prolonged diarrhoea following Escherichia coli 0111 gastroenteritis is reported. Electron microscopy of the jejunal biopsy revealed effacement of the brush border and attachment of bacteria by pedestal formation. Specific activities of brush border enzymes showed marked depression of disaccharidases, zinc-resistant alpha-glucosidase, and alkaline phosphatase. In contrast, marker enzymes for basolateral membranes and endoplasmic reticulum were unaffected. The biochemical changes support the pathogenic mechanism suggested by ultrastructural studies previously reported. PMID- 3511213 TI - Enterocolitis in Hirschsprung's disease: a controlled study of the etiologic role of Clostridium difficile. AB - Cytopathic toxin neutralized by Clostridium sordellii antiserum was found in the feces of seven out of 13 children with Hirschsprung's disease complicated by enterocolitis (54%). Clostridium difficile was isolated from ten of these 13 children (77%). The frequency of fecal toxin positivity, the magnitude of toxin titers, and the isolation rate of C difficile were all significantly greater in children with Hirschsprung's enterocolitis than in children whose Hirschsprung's disease was not complicated by enterocolitis or in children without Hirschsprung's disease. It is suggested that C difficile may be causally related to enterocolitis in Hirschsprung's disease, but the age distribution of positive results indicates that the major etiologic role is confined to children under three years of age. Vancomycin was found to be an effective form of treatment in the children with enterocolitis in whom it was employed. PMID- 3511214 TI - Quadrant mucosal stripping and muscle pleating in the management of childhood rectal prolapse. AB - A new operation that has been found effective in the treatment of frequently recurring rectal prolapse in children is described. It involves excision of narrow strips of mucosa at three or four quadrants and inserting nonabsorbable sutures in the denuded area to pleat the prolapsed segment. The technique is simple, safe, and effective for both mucosal prolapse and full-thickness rectal prolapse. It is free from major complications. The controversy surrounding the predisposing factor, the nature of the prolapse, and the various suggested treatments are highlighted. PMID- 3511215 TI - Surgical correction of incomplete penoscrotal transposition associated with hypospadias. AB - A surgical technique for correction of incomplete penoscrotal transposition associated with hypospadias is presented. An inverted omega skin incision is made around the scrotal skin, and the base of the penis and scrotal flaps are brought beneath the penis. The operation is performed after the completion of hypospadiac repair. This technique was applied to 20 cases and cosmetic results were satisfactory. PMID- 3511216 TI - Diagnosis and management of massive hepatic hemangiomas in childhood. AB - Twelve patients diagnosed as having hepatic hemangiomas during 1960 to 1982 at the Royal Children's Hospital, Melbourne are reviewed. This rare benign vascular tumor can present considerable problems in both diagnosis and management and has a high reported mortality. Our experience over this 23-year period demonstrates some of the difficulties in diagnosis and suggests a plan of management. Eight patients were diagnosed when five weeks of age or less, the youngest was 24 hours old. One was diagnosed at four months of age. In the remaining three patients, the diagnosis was made at postmortem. Ten patients had prominent hepatomegaly, nine had congestive cardiac failure and in one of these the onset was delayed four weeks. Thrombocytopenia was present in five and jaundice in four patients. Four patients had associated cutaneous or visceral hemangiomas. Seven patients underwent selective hepatic arteriography, and two of these had prior ultrasound examinations of the liver. Management of congestive cardiac failure included steroids, radiotherapy, hepatic resection, and in one patient, hepatic artery ligation. One patient with diffuse hepatic hemangiomas did not require any specific therapy and resolved spontaneously over two years. The four patients in whom hepatic resection was performed survived. PMID- 3511217 TI - A 7-month study of sulcular fluid flow in the assessment of healing after debridement of deep pockets. AB - The purpose of this investigation was to assess the value of sulcular fluid flow (SFF) measurements in evaluation of the healing of deep periodontal pockets after scaling and root planing. Fourteen adult patients with advanced periodontal disease received supragingival prophylaxis and instructions in oral hygiene. Immediately after baseline examination, meticulous scaling and root planing were performed. One to five selected pockets per patient were monitored on Days 0, 30, 120 and 210. Subgingival microbial proportions, sulcular fluid flow, probing depth, Gingival Index and bleeding after probing were assessed and recorded. The subgingival microbial proportions were determined with darkfield microscopy. The periodontal conditions were markedly improved by Day 210 as depicted by the microbial proportions. The proportion of motile micro-organisms was reduced from 51% at baseline to 9% on Day 30. This result was sustained until Day 210. Healing was also evident from the changes in Gingival Index scores and bleeding after probing. Probing depth was reduced from a mean of 8.3 to 4.5 mm. Correlations between the individual means recorded for the clinical parameters and bacterial proportions were calculated for the pooled data of all four examinations. Sulcular fluid flow did not correlate with the clinical parameters. Gingival Index, bleeding after probing or probing depth. The latter three parameters correlated significantly with the microbial proportions and each other. When the pooled tooth surface recordings of Days 30, 120 and 210 were divided into two groups according to the proportion of motile bacteria (the groups with less than 18% of spirochetes and motile rods and the groups with greater than 18% of spirochetes and motile rods), a significant difference in the mean amount of sulcular fluid flow (P less than 0.01) and mean probing depth (P less than 0.001) could be demonstrated between the two groups. PMID- 3511218 TI - The alteration in gingival basement membrane antigens in chronic periodontitis. AB - The gingival basement membrane antigens, Type IV collagen, bullous pemphigoid antigen and epidermolysis bullosa acquisita antigen were studied by indirect immunofluorescence in 11 gingival specimens from patients with periodontitis and 2 normal gingival specimens. In the normal control gingival specimens, the antigens were all present and stained with a continuous linear pattern. In periodontitis, alterations occurred in the gingival basement membrane antigens in the apical portion of the pockets. These included thinning, interruptions, partial or complete absence involving one or more rete pegs and fragmentation. These alterations may result form the disease process or play a role in the pathogenesis. PMID- 3511219 TI - Cicatricial pemphigoid. A case of onset at age 5. AB - Cicatricial pemphigoid is a chronic subepidermal bullous dermatosis which primarily involves the mucous membranes. It is a disease found almost exclusively middle-aged and elderly persons. This report describes a case of cicatricial pemphigoid with onset at age 5 and involving primarily the mucous membranes of the mouth and eyes. The patient cleared well on 40 mg of Prednisone and has been maintained on a regimen of 7.5 mg of Prednisone every other day. PMID- 3511220 TI - Extracellular strontium substitutes for calcium in in vitro renin secretion. AB - It has been shown previously that ouabain, vanadate, angiotensin II and 0 and 60 mM KCl media have Ca-dependent inhibitory effects on renin secretory rates of rat renal cortical slices. In the present experiments, replacing extracellular CaCl2 with SrCl2 did not impair the inhibitory effects on renin secretion in this preparation. Moreover, methoxyverapamil antagonized the inhibitory effect of K depolarization. The inhibitory effects and methoxyverapamil-induced antagonism of the inhibitory effect of K-depolarization, suggest that increased intracellular Sr++ can lead to inhibition of renin secretion, perhaps directly or perhaps by causing the release or mobilization of Ca++ from intracellular sites of binding or sequestration. These results add to the growing evidence that Ca++ plays an inhibitory second messenger role in the renin secretory process. PMID- 3511221 TI - Insulin stimulation of ornithine decarboxylase activity in developing rat heart. AB - Ornithine decarboxylase (ODC; EC 4.1.1.17) is an important enzyme in the synthesis of polyamines and is associated with growth and differentiation. Insulin stimulation of cardiac ODC has been proposed as a marker of the functional completion of the sympathetic pathway to the rat heart. However, earlier studies, using subsaturating substrate concentrations and a single time point measurement after insulin treatment, have been inconsistent concerning the postnatal age at which significant insulin stimulation of ODC occurs. The present study, using a validated near-saturating substrate assay, examines more thoroughly early neonatal insulin induction of cardiac ODC with respect to both the magnitude and the time course of response. Insulin (20 IU/kg s.c.) significantly increased ODC activity at several time points at each postnatal age measured (days 2, 5, 8, 15 and 22), with maximum ODC activity occurring by 2.5 to 3 hr after insulin injection at all ages. Insulin-stimulated ODC activity was increased over control levels by 86, 84, 87, 150 and 127% on days 2, 5, 8, 15 and 22, respectively. These results demonstrate that age is not a variable in the time of peak insulin stimulation of ODC activity and, in contrast to earlier reports, show that significant insulin induction of cardiac ODC activity occurs reliably across ages in the early postnatal period. The inconsistency of earlier studies may be due to a number of factors, including the use of subsaturating enzyme assays only, known to be subject to several types of error. PMID- 3511222 TI - Occlusal variations for reconstructing the natural dentition. PMID- 3511223 TI - Improved accuracy by reheating addition-reaction silicone impressions. AB - Addition-reaction silicone impressions were made at 37 degrees C in two cylindrical trays of a truncated-cone-shaped chromium-steel die. One tray size was used to obtain impressions with 1 mm thickness from tray to the buccal and lingual surface of the steel die while the second tray permitted a thickness of 4 mm. Stone dies were made from impressions after (1) cooling to 22 degrees C for 10 minutes or (2) cooling to 22 degrees C for 10 minutes and reheating to 37 degrees C for 30 minutes. Results revealed that reheating the impressions to mouth temperature before pouring the dies improved their accuracy. PMID- 3511224 TI - Recasting a nickel-chromium alloy. PMID- 3511225 TI - Effect of latex gloves on setting time of polyvinylsiloxane putty impression material. PMID- 3511226 TI - Factors affecting the seating and fit of complete crowns: a computer simulation study. PMID- 3511227 TI - Attitudes toward abutment preparation for removable partial dentures. AB - A questionnaire was sent to 58 dental schools to determine what type of abutment preparation is being used in conjunction with removable partial dentures. Responses from 43 schools indicate that enamel modification and cast restorations are still the primary type of abutment preparations. Amalgam alloys are widely used, and composite and acid-etched retained restorations are also being used. PMID- 3511228 TI - Improved method to alter casts in partial denture impression making. PMID- 3511229 TI - An improved method to maintain proper tooth relation while processing distal extension denture bases. PMID- 3511230 TI - Use of the personal computer to design processing conditions for improving dental die accuracy. PMID- 3511231 TI - Interim immediate complete denture. PMID- 3511232 TI - Die spacer removal. PMID- 3511233 TI - Method to avoid adherence of irreversible hydrocolloid to teeth during impression making. PMID- 3511234 TI - Effect of metal etching on crown retention. PMID- 3511235 TI - Tissue retraction for esthetic ceramometal crowns. AB - The placement of subgingival margins in ceramometal restorations has been discussed. A method of visualizing the attachment and managing the gingival tissues during tooth preparation has been presented. PMID- 3511236 TI - Influence of laboratory variables on the resin bond strength of an etched chrome cobalt alloy. PMID- 3511237 TI - Restoration of endodontically treated teeth: a review of the literature. AB - Once the individual components of the Richmond crown were isolated from the post core-crown complex, each was subjected to scrutiny. Consensus declared that the core portion should resemble the ideal preparation for a vital tooth. Current techniques allow the dentist to create an "ideal" preparation to accommodate clinical conditions such as occlusion and esthetics. Post construction evaluation can be divided into two categories: retention and stress distribution. Research has demonstrated that threaded posts screwed into tapped post holes were the most retentive, followed by cylindrical posts, and the tapered posts were the least retentive. In photoelastic stress distribution studies, cylindrical posts showed the most favorable patterns, with screw posts demonstrating the least desirable configurations. There is no exclusive technique that satisfies all criteria for success. Compromise is common and the method with more advantages and fewer disadvantages is chosen. Stress distribution is of greater importance than retention because a post can be recemented if dislodged from a tooth. However, if the root fractures, the tooth is commonly lost. Cementation of posts has received limited attention. Some posts with vents are commercially available, but there is little evidence that this effectively decreases hydrostatic pressures during cementation. An important consideration is the choice of materials. Traditionally, pulpless teeth were restored with cast gold posts covered with either complete gold crowns or gold crowns with acrylic resin veneers. These materials had a similar modulus of elasticity and coefficient of thermal expansion.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3511238 TI - Anchored core for the rehabilitation of posterior teeth. AB - Thin and flexible cable-type dowels are presented to successfully retain cores in roots of posterior teeth. An analysis of the mechanical principles has been suggested. PMID- 3511239 TI - Recording dowel pin position with plastic logs. AB - Six readily available plastic materials were evaluated for use as a log for locating the ends of die dowel pins. Seven criteria were divided into two main categories of adherence qualities of the material and useability. Cost was the third category evaluated and compared. Color and availability were also considered. Forty-two sophomore dental students accomplished 84 evaluations. Plasticine and Weatherstrip Caulking Cord were found to meet all criteria best. PMID- 3511240 TI - Using ultrasonic scalers to remove fractured root posts. AB - The removal of an existing cast or cemented stainless steel post has proved difficult, time consuming, and to require excessive removal of tooth structure. The use of the ultrasonic scaler alone and in combination with other techniques provides a conservative, efficient method for retrieval of broken posts from root canal spaces. The primary advantage of these techniques in the removal of posts is the conservation of remaining tooth structure. PMID- 3511241 TI - Effects of temporary cements on crown-to-composite resin core bond strength. PMID- 3511242 TI - Movement of three removable partial denture clasp assemblies under occlusal loading. AB - This investigation indicates that the design of the clasp assembly affects the magnitude of movement of the abutment tooth adjacent to an extension base but generally does not affect the direction of movement. Some clasp assemblies (distal rest) moved more than other clasp assemblies (wrought wire or I-bar), and hence, the abutment tooth moved more. The design of the clasp assembly did not seem to affect the magnitude of movement in the apical direction. PMID- 3511243 TI - Influence of polishing on cast clasp properties. AB - During the polishing of clasps, two possible changes that could affect their properties are thinning of the clasp and work hardening of the alloy. Two distinctly different clasp pattern forms were selected and 20 samples of each were cast. They were then divided into two groups, polished and unpolished, in an effort to determine the total influence of the polishing procedure on clasp behavior. The results indicate that polishing produces a slightly more flexible clasp. Any influence resulting from possible work hardening is offset by the reduction of clasp thickness. Effects of width/thickness ratios and magnitude of deflections on finishing and polishing techniques may also alter clasp flexibility in the polished clasp. PMID- 3511244 TI - Maxillofacial prosthetic rehabilitation following self-inflicted gunshot wounds to the head and neck. AB - Management of gunshot wounds to the head and neck is a challenge for the maxillofacial prosthodontist. Care of these patients can be divided into early, intermediate, and definitive phases. Psychologic management is often the most important aspect of treatment in ultimately resolving patient needs. PMID- 3511245 TI - Mandibular resection guidance prostheses: a literature review. PMID- 3511246 TI - Clinical evaluation of ramus frame and staple bone implants. AB - Atwood pointed out that "variability of human response (resistance to infection, susceptibility to bone resorption, and psychologic capacity) demands more basic research and clinical trials to improve success." This study can serve as a baseline for further longitudinal studies and controlled clinical research. Barring tissue or systemic complications, the prosthodontist must take the responsibility through sound treatment principles and awareness to ensure continued satisfaction and success of these implant systems. PMID- 3511247 TI - Prefabricated coping-bar patterns for the mandibular transosteal staple bone plate implant. PMID- 3511248 TI - Initial bone-implant interfaces of submergible and supramergible endosseous single-crystal sapphire implants. AB - Three types of bone-single-crystal sapphire implant interfaces were histologically determined in submergible and supramergible implant: direct bone apposition (type I), thin connective tissue with poor collagen fibers (type II), and dense fibrous connective tissue (type III). Type I interface was predominant and type III interface was sparsely seen in submergible implants. In contrast to these findings, type III interfaces frequently appeared in supramergible implants, primarily at the apical region. These differences were considered to occur by the biomechanical variable of postoperative healing. PMID- 3511249 TI - Investigation of coronary artery disease. PMID- 3511250 TI - Inflammatory bowel disease and food intolerance. PMID- 3511251 TI - Modern methods of diagnosis of muscle diseases. PMID- 3511252 TI - Sensory recovery in replanted digits and transplanted toes: a review. AB - A review of replanted digits has indicated that excellent sensory function can be recovered in replants that are distal, in which the mechanism of injury has been a sharp cut, in which the patient's age is young, and in cases where the patient receives postoperative sensory re-education. It appears that poor sensory recovery in replanted digits is most directly attributable to crush or avulsion type injuries and lack of sensory re-education in the postoperative period. The level of sensory recovery in toe-to-thumb transfers appears to be better than in the donor toe and better than in replanted digits. The explanation for this most likely lies in the sharp "mechanism of injury" in the toe-to-thumb transfer and in the "extra" postoperative rehabilitation such cases receive. Future improvements in recovery of sensation in replanted digits may come from increased use of nerve grafting in those digits that have been crushed or avulsed, and by instituting routine sensory re-education in the postoperative period. PMID- 3511253 TI - Comparison of continuous and interrupted suture techniques in microvascular end to-side anastomosis. AB - To compare the speed and patency rates of the continuous and interrupted suture techniques in microvascular end-to-side anastomosis, 10 anastomoses utilizing each technique were performed using a femoral artery-superficial epigastric vein bypass model in Sprague-Dawley rats. The continuous suture technique was found to be almost twice as fast as the interrupted technique with no functional compromise. Patency for both techniques was 100 percent. These results are similar to those of several recent reports comparing the two techniques in end-to end anastomosis and suggest that the continuous suture technique may be the most efficient technique for end-to-side anastomosis as well. PMID- 3511254 TI - Effect of LHRH immunoneutralization on follicular development, the LH surge and luteal function in the stumptailed macaque monkey (Macaca arctoides). AB - A dose of 100 microliter of a potent ovine LHRH gamma globulin inhibited ovulation in the cyclic rat when administered at 12:00 h on the day of pro oestrus. A dose of 10 ml of the preparation was administered i.v. to female stumptailed macaques to achieve circulating antibody titres 3-4-fold higher than in the rat. In an ovariectomized macaque, this caused a marked fall in serum concentrations of LH to less than 10% of pretreatment values and also a significant, though less pronounced, fall in FSH. Six monkeys were treated with the LHRH gamma globulin during the mid-late follicular phase of the cycle. In 2 monkeys in which serum oestradiol concentrations were less than 100 pg/ml at the time of antibody administration, the rising oestradiol levels were abruptly suppressed and the normal mid-cycle LH surge failed to occur. Serum concentrations of LH and FSH declined to low levels for 8-10 days after which time normal follicular development occurred. In the remaining 4 monkeys in which follicular development was more advanced as indicated by serum oestradiol concentrations of greater than 100 pg/ml, the antibodies induced either a transient decline or had no effect on the rising serum concentration of oestradiol. An LH/FSH surge followed by a rise in serum progesterone occurred in these macaques. When the antibodies were administered to a further 6 macaques, which had also been treated with oestradiol benzoate during the early follicular phase to induce an LH surge, the neutralization of LHRH again failed to block the surge even when the dose of antibody was increased to 20 ml. The results show that LHRH antibodies were unable to block the LH surge in the macaque. They contrast with results obtained with LHRH immunoneutralization in the sheep, rat, hamster, mouse and bird and suggest that the ability of oestrogen to induce an LH surge by acting directly on the LHRH-primed anterior pituitary gland is more dominant in the primate. PMID- 3511256 TI - Use of progesterone 11-glucuronide-alkaline phosphatase conjugate in a sensitive microtitre-plate enzymeimmunoassay of progesterone in milk and its application to pregnancy testing in dairy cattle. AB - A simple direct-addition microtitre plate enzymeimmunoassay (EIA) for progesterone in whole milk is described. The assay used antiserum raised against 11 alpha-hydroxyprogesterone 11-hemisuccinate (progesterone 11-hemisuccinate) and a heterologous label prepared by conjugation of 11 alpha-hydroxyprogesterone 11 glucuronide (progesterone 11-glucuronide) with alkaline phosphatase using an active ester procedure. The sensitivity, analytical recovery, linearity of response and precision of the assay compared favourably with radioimmunoassay (RIA). Results from EIA of milk samples were compared with determinations made after isolation of progesterone by HPLC (r = 0.910). Milk samples (200) were assayed by RIA at both the Milk Marketing Board and the Cattle Breeding Centre and the results were correlated with EIA performed at the Cattle Breeding Centre (r = 0.890 and r = 0.833 respectively). Calving data were obtained from a further 110 cows for which the milk progesterone EIA had provided a pregnancy test 24 days after AI; 46 cows were correctly identified as non-pregnant and 58 as pregnant and there were 4 false positive and 2 inconclusive results. PMID- 3511255 TI - Progesterone pretreatment has a direct effect on GnRH-induced preovulatory follicles to determine their ability to develop into normal corpora lutea in anoestrous ewes. AB - In two experiments carried out during seasonal anoestrus, Romney Marsh ewes were treated with small-dose (250 ng) multiple injections of GnRH at 2-h intervals with and without progesterone pretreatment. In Exp. 1, 8/8 progesterone-primed ewes ovulated and produced functionally normal corpora lutea compared with 2/9 non-primed ewes. Follicles were recovered from similarly treated animals 18 or 28 h after the start of GnRH treatment (at least 14 h before the estimated time of the LH peak) and assessed in terms of diameter, granulosa cell number, oestradiol, testosterone and progesterone concentrations in the follicular fluid, oestradiol production in vitro and binding of 125I-labelled hCG to granulosa and theca. There were no significant differences in any of these measures in 'ovulatory' follicles recovered from the progesterone-pretreated compared to non pretreated animals. In Exp. 2, follicles were removed from similar treatment groups just before and 2 h after the start of the LH surge. Unlike 'ovulatory' follicles recovered from the non-pretreated ewes, those recovered from progesterone-pretreated ewes responded to the LH surge by significantly increasing oestradiol secretion (P less than 0.01) and binding of 125I-labelled hCG (P less than 0.05) to granulosa cells. Overall there was also more (P less than 0.05) hCG binding to granulosa and theca cells from progesterone-pretreated animals. Non-ovulatory follicles recovered from progesterone-primed ewes had more (P less than 0.05) binding of 125I-labelled hCG to theca and a higher testosterone concentration in follicular fluid (P less than 0.05) than did those from non-primed ewes. These results suggest that inadequate luteal function after repeated injections of GnRH may be due to a poor response to the LH surge indicative of a deficiency in the final maturational stages of the follicle. PMID- 3511257 TI - Seasonal effects on sexual maturation of male bank voles (Clethrionomys glareolus). AB - The weights of the testes and accessory glands, and the degree of morphological and functional development of the seminiferous tubules, were used as indicators of sexual maturation in male bank voles. Males reared under constant laboratory conditions showed a significant relationship between the seasons and sexual maturation. Young males reached maturity most rapidly in the reproduction season (mid-April to mid-October), while adult males matured earlier, in the spring season (mid-January to mid-April). The influence of season on animals reared in outdoor cages was much more pronounced. One of the important factors was the photoperiod: animals reared from 3 to 12 weeks of age in a short photoperiod (8L:16D) matured less rapidly than did those reared in 16L:8D. PMID- 3511258 TI - Optic nerve hypoplasia in infancy. AB - Certain features of optic nerve hypoplasia (ONH), its systemic associations and investigation are exclusive to infancy. These include the facility to use cranial ultrasound, difficulties in assessing ocular features and visual function, and neonatal hypoglycaemia and jaundice. Six infants with ONH are presented; cerebral abnormalities were demonstrated by cranial ultrasound in five. Neonatal cholestatic jaundice and hypoglycaemia occurred in one infant. Two died and represent a group likely to remain undetected unless routine ophthalmic examination of neurologically abnormal neonates is undertaken. In infancy, both ocular and systemic aspects of ONH can be investigated simply and without sedation. PMID- 3511259 TI - Measurement of bone mass by total body calcium: a review. PMID- 3511260 TI - John A.D. Cooper lecture. What is immediate past is prologue--unfortunately. PMID- 3511261 TI - The Abraham Flexner Award for Distinguished Service to Medical Education. John A. D. Cooper, M.D. PMID- 3511262 TI - The AAMC Award for Distinguished Research in the Biomedical Sciences. Eric R. Kandel, M.D. PMID- 3511263 TI - Program for increasing use of computers in medical education. PMID- 3511264 TI - Coggeshall revisited: a reaffirmation of the AAMC's purpose. PMID- 3511265 TI - Microvascular reconstruction after electrical and deep thermal injury. AB - Six cases are presented demonstrating uncomplicated primary healing following early microvascular reconstruction for complex electrical and deep thermal injuries. We advocate early preservation of eschar and the prevention of infection with the use of penetrating topical antibacterial agents, removal of the soft-tissue eschar when clinically indicated, and immediate coverage of the undebrided bone through the provision of well-vascularized tissue. Microvascular free tissue transfer should be considered as a primary method of reconstruction for complex electrical or thermal injury whenever clinically feasible. These reconstructive techniques offer an early, reliable means of definitive reconstruction, preserving function, providing uncomplicated healing, and promoting early rehabilitation. PMID- 3511266 TI - Comparison of serial debridement and autografting and early massive excision with cadaver skin overlay in the treatment of large burns in children. AB - Thirty-two children admitted from 1977 through 1981 were treated by serial debridement of their burn wounds with 1:1.5 to 3:1 meshed autografting of granulating tissue as it became available. Thirty-two burned children treated from 1981 to 1984 were treated by early total excision to fascia with application of 4:1 expanded autograft and cadaver skin for complete closure. The ages (6.8 +/ 0.6 years), sex distribution, and mean per cent third-degree burn (64 +/- 1%) were the same in both groups. There were seven deaths in each group. Overall operating time (10.3 +/- 0.8 hours) and units of blood loss (28.3 +/- 3.5) were indistinguishable in the survivors of both groups. The survivors of the early excision group underwent fewer operative procedures, (5.8 +/- 0.5 vs. 7.6 +/- 0.5) and had a greatly decreased length of hospital stay (57 +/- 5 vs. 97 +/- 8). The ultimate functional and aesthetic consequences of the two techniques must be compared. PMID- 3511268 TI - Combined auto- and alloosteochondral grafts for large defects. AB - A 19-year-old male patient with a traumatic loss of the lateral femoral condyle underwent surgery where combined osteochondral auto- and allograft was used. Biopsy of the grafted cartilage at 1 1/2 years after transplantation revealed complete replacement of the hyaline cartilage by fibrocartilage. In spite of this finding the clinical and functional results were excellent. PMID- 3511267 TI - Topical ibuprofen decreases thromboxane release from the endotoxin-stimulated burn wound. AB - A full-thickness burn wound in adult sheep releases prostanoids when they are injected locally with E. coli endotoxin, 2 micrograms/kg, resulting in an increase in pulmonary artery pressure (Ppa) from 20 +/- 3 to 34 +/- 5 mm Hg, and a decrease in mean arterial oxygen tension (PaO2) from 88 +/- 6 to 70 +/- 5 torr; this corresponds to an increase in venous plasma TxB2 content from a baseline of 220 +/- 79 pg/ml to 440 +/- 90 pg/ml. Burn prostanoid production, measured in lymph, increased ten- to fifteen-fold for both thromboxane A2, measured as TxB2, and prostacyclin, 6-keto-PGF1 alpha. The intravenous administration of ibuprofen, 12.5 mg/kg, eliminated both the increase in Ppa and decrease in PaO2 as well as the increase in burn lymph prostanoids. However, plasma prostanoids were also decreased below baseline, a potentially deleterious effect. A topical ibuprofen cream, 5% ibuprofen in a water-soluble ester, was applied to the burn hide every 6 hrs x 4 after which endotoxin was again injected below the hide. The pulmonary dysfunction was prevented as was the increase in plasma TxB2 with the value remaining at baseline. Burn lymph levels were only increased three- to five fold. Ibuprofen levels in burn lymph were maintained at 1-2 mcg/ml. The addition of the cream to the burn, however, did increase the wound bacterial content to 10(5) 10(7) bacteria/gram of tissue compared to 10(2)-10(3) for the dry, untreated burn, probably due to softening of the burn. Topically applied ibuprofen, therefore, can decrease burn wound prostanoid production from local endotoxin, preventing lung dysfunction.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3511269 TI - Accuracy of dynamic ultrasonography in the diagnosis of malignant liver lesions. AB - In order to assess the diagnostic accuracy of dynamic ultrasonography of malignant liver processes, 350 patients suspected of having malignant liver disease who had been examined sonographically were retrospectively classified as to the true diagnosis at the time of scanning. The true diagnosis was obtained in 218 cases. The prevalence of malignant lesions was 38 per cent. Comparison with the ultrasonographic findings yielded two false positive, five false negative, and eight inconclusive answers. The predictive diagnostic values were 97 and 96 per cent for positive and negative findings, respectively. It is concluded that in hospitals with an experienced ultrasound staff and modern dynamic gray-scale equipment, ultrasonography is the examination of choice in cases of suspected liver processes. PMID- 3511270 TI - Sonography of intestinal lymphangiectasia. AB - Real-time ultrasonography was used to evaluate three pediatric patients with biopsy-proven intestinal lymphangiectasia. The sonographic findings were ascites, diffuse bowel wall thickening, mesenteric edema, dilated mesenteric lymphatics, and thickened walls of the gallbladder and urinary bladder. Recognition of the sonographic pattern of intestinal lymphangiectasia is useful since ultrasonography is often the first imaging examination performed in children with abdominal disorders. PMID- 3511271 TI - The effect of ventricular dilatation upon biometry of the fetal head. AB - The ultrasonograms of 15 patients with moderate to marked fetal hydrocephalus were evaluated retrospectively in an attempt to determine the effect of ventricular dilatation upon biometry of the fetal head in the latter half of pregnancy. In 13 of the 15 cases the age based upon biometry of the fetal head was within one week of the clinical estimate of gestational age based upon the last menstrual period. As accurate head measurements may be useful even in cases of hydrocephalus, these measurements should not be dismissed as being invalid particularly when commensurate with a clinical estimate of gestational age. PMID- 3511272 TI - Simple tailored microcomputer system for the obstetrical ultrasound laboratory. AB - As more sophisticated ultrasound instrumentation has become available, more complete and detailed examinations, including computer-manipulated data sheets, have been demanded by referring clinicians. In order to fill the clinical need, many suppliers have designed and promoted computer systems of unfortunately prohibitive costs. The purpose of this paper is to demonstrate the simplicity of designing a personally tailored data sheet and ease of programming one of the current commercially available microcomputers to perform the manipulations. Their use is outlined and encouraged. PMID- 3511273 TI - The design and implementation of a computer-based ultrasound data system. AB - A detailed description of the development of a computer-based ultrasound data system is presented to provide the background for those physicians interested in developing or using such a system. The system was found to be highly useful for acquisition and organization of ultrasound data, and proved to be an aid both teaching and patient care. PMID- 3511274 TI - Echinococcal matrix: computed tomographic, sonographic, and pathologic correlation. PMID- 3511275 TI - Prenatal sonographic diagnosis of Hirschsprung's disease. AB - The prenatal sonographic presentation of Hirschsprung's disease is described. This report strongly suggests that bowel distention in Hirschsprung's disease may begin in the late third trimester of intrauterine life. The importance of early diagnosis and treatment cannot be overemphasized. Sonography may greatly contribute to the early diagnosis of Hirschsprung's disease. PMID- 3511276 TI - Sonographic findings in mediastinal embryonal carcinoma. PMID- 3511277 TI - Prenatal and postnatal sonographic delineation of gastrointestinal abnormalities in a case of the VATER syndrome. PMID- 3511279 TI - Immobilization for pediatric ultrasonography. PMID- 3511278 TI - Hepatic pseudotumors in patients with ascites. AB - Echogenic hepatic pseudotumors have been described in three patients with cirrhosis and ascites. A nodular liver surface surrounded by a non-uniform depth of ascites causes a focal concave area to transmit sound in a manner analogous to the posterior wall of a cyst. The area of increased echogenicity, caused by decreased attenuation, is demarcated from adjacent liver tissue by a refractive artifact. This echogenic pseudomass should not be interpreted as representing pathologic change. One can verify that this is an artifact by changing the transducer angle and position. When the entering sound does not traverse the ascites, the liver echogenicity becomes homogeneous. PMID- 3511280 TI - Sonographic visualization of the normal postmenopausal ovary. AB - The pelvic sonograms of 30 postmenopausal women who demonstrated no pathology in 8-18 months of clinical follow-up were reviewed. In 19 cases both ovaries were visualized. Only one ovary was seen in three patients and neither ovary identified in eight patients. Ovarian volumes were all less than or equal to 2.5 cm3. The authors suggest that, contrary to previous experience, a large proportion of normal postmenopausal ovaries can be depicted sonographically. Further data are necessary before definite normal volumes are known but sonography may be useful to screen patients to help detect early ovarian carcinoma. PMID- 3511281 TI - Augmentation and substitution enterocystoplasty. PMID- 3511282 TI - Transurethral ultrasonography in bladder cancer. AB - Bladder tumors were staged preoperatively by transurethral ultrasonography in 62 patients. The technique enabled us to determine the degree of tumor invasion of the bladder wall and was useful to help select appropriate therapy. Other applications included the monitoring of transurethral resection to determine its adequacy as a treatment modality. PMID- 3511283 TI - Bacillus Calmette-Guerin for superficial transitional cell carcinoma of the bladder. AB - Pasteur strain bacillus Calmette-Guerin was used to treat superficial transitional cell carcinoma of the bladder in 28 patients. Patients selected for treatment had an incomplete resection, positive selected site biopsies and/or post-resection positive cytology findings. Complete response required negative histology and cytology findings at cystoscopic followup 4 to 8 weeks after completion of treatment. Of the patients 20 (71 per cent) demonstrated a complete response, including all 6 with carcinoma in situ. Results converted to negative in 16 of 17 patients with positive urine cytology findings and 4 with positive prostatic urethral biopsies. Of the responders 8 had received prior treatment with thiotepa. The treatment regimen of 120 mg. Pasteur strain bacillus Calmette Guerin weekly for 6 weeks was well tolerated. It was necessary to limit the number of treatments to 5 because of local irritative effects in only 3 patients. No chronic bladder disability has been noted during followup of 3 to 30 months. This experience supports the efficacy of bacillus Calmette-Guerin as a cost effective, well tolerated treatment modality for patients with superficial transitional cell carcinoma of the bladder. PMID- 3511284 TI - Long-term effect of intravesical bacillus Calmette-Guerin on flat carcinoma in situ of the bladder. AB - Intravesical bacillus Calmette-Guerin is effective therapy for multifocal carcinoma in situ of the bladder. The duration of this favorable response and its effect on disease progression are the subject of this report. Between March 1978 and July 1981, 47 patients with diffuse, often symptomatic, carcinoma in situ were treated with intravesical bacillus Calmette-Guerin and followed every 3 to 4 months with cystoendoscopy, biopsy and urine cytology for 3 to 6 years. All patients had had prior or concurrent superficial papillary tumors controlled initially by transurethral resection and fulguration 2 to 3 weeks before bacillus Calmette-Guerin treatment. Of the 47 patients 23 were entered into a randomized study, and received intravesical and percutaneous bacillus Calmette-Guerin. Another 24 patients with carcinoma in situ were treated with intravesical bacillus Calmette-Guerin alone. Bacillus Calmette-Guerin (Pasteur strain) was given intravesically (120 mg. in 50 ml. saline) weekly for 6 weeks. Of the 47 patients 32 (68 per cent) are free of disease (negative urine cytology, cystoendoscopy and biopsy): 15 (65 per cent) after combined bacillus Calmette Guerin for a median duration of 51 months (range 37 to 75 months) and 17 (71 per cent) after intravesical bacillus Calmette-Guerin alone for a median of 45 months (range 36 to 53 months). Of the 23 patients in the randomized study 4 (17 per cent) have required cystectomy for local progression of disease compared to 17 of 26 controls (65 per cent) who were randomized to transurethral resection and fulguration alone. Cystectomy was performed 3 to 27 months after bacillus Calmette-Guerin treatment and in 3 patients tumor was localized to the prostate gland (no tumor found within the bladder). These data indicate that intravesical bacillus Calmette-Guerin is capable of producing long-term remissions of carcinoma in situ in high risk patients and may prevent or delay progression of disease necessitating cystectomy. PMID- 3511285 TI - Prognostic value of purified protein derivative skin test and granuloma formation in patients treated with intravesical bacillus Calmette-Guerin. AB - We evaluated the prognostic value of purified protein derivative skin test reactivity and a granulomatous response in intravesical bacillus Calmette-Guerin therapy. We treated 62 patients with intravesical bacillus Calmette-Guerin once a week for 6 weeks. Purified protein derivative skin tests were performed before and after therapy. Cold cup bladder biopsies were examined in a blind retrospective manner for the presence of granulomas 6 weeks after completion of therapy. A significant correlation between status free of tumor and the presence of either granulomas or positive purified protein derivative skin tests was observed for the total patient population. Of 25 patients whose purified protein derivative test was converted from negative to positive 19 (77 per cent) remained free of tumor, while only 11 of 32 (34 per cent) whose test did not convert to purified protein derivative positive remained free of tumor (p equals 0.0006, chi square). Similarly, 28 of 37 patients (77 per cent) who had a granulomatous response remained free of tumor, while only 8 of 25 (32 per cent) without a granulomatous response remained free of tumor (p less than 0.003, chi-square). The correlation was similar for each parameter when the total patient population was subdivided into patients treated for carcinoma in situ, residual tumor or prophylaxis. Calculation of predictive values showed that neither purified protein derivative responsiveness, granuloma formation nor a combination of both provided a highly accurate predictive index of therapeutic response in individual patients. False positive or negative rates, ranging from 23 to 24 per cent and 32 to 39 per cent, respectively, were observed. These results suggest that a link between immunological responsiveness and response to therapy exists but that neither the purified protein derivative skin test nor the granulomatous response exhibits sufficient immunological specificity to serve as accurate prognostic indicators in individual patients. PMID- 3511286 TI - Complications of bacillus Calmette-Guerin immunotherapy in 1,278 patients with bladder cancer. AB - Our series of 195 patients, plus 134 reported on in the literature and 949 reviewed by various physicians provide 1,278 patients for review of bacillus Calmette-Guerin therapy complications. Cystitis occurred in 91 per cent of the patients. Complications identified included fever more than 103F in 50 patients (3.9 per cent), granulomatous prostatitis in 17 (1.3 per cent), bacillus Calmette Guerin pneumonitis or hepatitis in 12 (0.9 per cent), arthritis or arthralgia in 6 (0.5 per cent), hematuria requiring catheterization or transfusion in 6 (0.5 per cent), skin rash in 5 (0.4 per cent), skin abscess in 5 (0.4 per cent), ureteral obstruction in 4 (0.3 per cent), epididymo-orchitis in 2 (0.2 per cent), bladder contracture in 2 (0.2 per cent), hypotension in 1 (0.1 per cent) and cytopenia in 1 (0.1 per cent). Most of the severe irritative side effects and subsequent systemic complications can be prevented with prophylactic isoniazid given for 3 days, beginning the morning of treatment. Patients with life threatening systemic bacillus Calmette-Guerin infection or anaphylaxis should receive 500 mg. cycloserine twice daily for 3 days in addition to combination antituberculous therapy because the rapid action of this drug may be life-saving. Direct intralesional bacillus Calmette-Guerin immunotherapy can produce sepsis and death, and should be avoided but intravesical bacillus Calmette-Guerin generally is well tolerated and has produced no complication in more than 95 per cent of the patients treated. PMID- 3511287 TI - Hypospadias repair without a bladder drainage catheter. AB - We report on 44 consecutive patients who underwent 1-stage hypospadias repair based on a urethral splent (silicone pleated stent). The severity of hypospadias ranged from subcoronal in 12 cases and distal in 23 to midshaft in 4 and penoscrotal in 5. In the first 15 patients of this series the splent was used with a suprapubic tube. All patients were able to void within the first 36 hours postoperatively. The next 29 patients underwent repairs without the use of a bladder catheter, including 15 who had outpatient procedures. None of the 44 patients has required subsequent catheterization or hospitalization. There have been 2 fistulas in this series. The urethral splent permits normal voiding through and drainage of the neourethra in a variety of hypospadias repairs. The splent expands and contracts with the degree of edema and permits catheterization should this be necessary. The advantages of hypospadias repair without bladder drainage, such as short hospital stay, total ambulation, and decreased potential for infection and bladder spasm, can be realized with the use of a urethral splent. PMID- 3511288 TI - Bacillus Calmette-Guerin in the management of bladder cancer. PMID- 3511289 TI - Acute lobular nephronia. AB - Acute lobular nephronia is an unusual form of localized renal infection, which has a characteristic computerized tomographic and ultrasonographic appearance, and should be distinguished from abscess or other renal masses. Treatment is nonoperative, consisting of intensive antibiotic therapy. PMID- 3511290 TI - Renal angiomyolipoma: 6 case reports and literature review. AB - We report 6 cases of renal angiomyolipomas and review the pertinent literature concerning this disease. One case involved the rare association of tuberous sclerosis and pregnancy. Another patient without tuberous sclerosis had renal cell carcinoma and later suffered a contralateral angiomyolipoma. The pathological conditions of renal angiomyolipomas with and without tuberous sclerosis are discussed. Since angiomyolipomas present with multiple clinical similarities to renal cell carcinoma, the primary task for the clinician is to differentiate this hamartoma from carcinoma. The distinguishing characteristics and the clinical management of renal angiomyolipomas are discussed. PMID- 3511291 TI - Intravesical bacillus Calmette-Guerin therapy and associated granulomatous renal masses. AB - We report a case of clinically symptomatic renal granulomas occurring during intravesical and intracutaneous bacillus Calmette-Guerin therapy for bladder cancer. The patient responded to antituberculous triple therapy. We emphasize the rarity of such extravesical infectious complications and discuss the possible routes of renal inoculation. PMID- 3511292 TI - Nephrogenic adenoma associated with intravesical bacillus Calmette-Guerin treatment: a report of 2 cases. AB - Nephrogenic adenoma, a rare metaplastic change of urothelium, was observed in 2 patients after intravesical bacillus Calmette-Guerin instillation. The lesion has not been reported previously in relation to bacillus Calmette-Guerin immunotherapy. We discuss the pathogenesis of nephrogenic adenoma and suggest that the marked prolonged cystitis induced by bacillus Calmette-Guerin has an etiological role. PMID- 3511293 TI - Condylomata acuminata and verrucous carcinoma of the bladder: case report and literature review. AB - Condylomata acuminata and verrucous carcinoma are 2 lesions rarely seen in the bladder. Condylomata of the bladder can be treated successfully by local therapy but underlying carcinoma must be considered if the lesion is extensive or progressive in nature. Vigorous biopsies of the base of the lesions are necessary to eliminate the possibility of malignancy. If verrucous carcinoma is found the patient should be treated surgically. A case of condylomata acuminata of the bladder undergoing malignant change to verrucous carcinoma is reported. PMID- 3511294 TI - Angiosarcoma of the prostate: report of 2 cases and review of the literature. AB - We report 2 cases of angiosarcoma of the prostate gland. The patients were 42 and 60 years old, which is in sharp contrast to the presentation of rhabdomyosarcoma, which occurs primarily in children. Immunoperoxidase staining for factor VIII associated antigen was positive in both cases, and was particularly useful in confirming the diagnosis in 1 case that was otherwise poorly differentiated. One patient is alive without evidence of recurrence 2 years after surgical excision, while the other presented with unresectable tumor and died 6 months after presentation. Angiosarcoma represents less than 2 per cent of sarcomas of the prostate but it should be considered in the differential diagnosis of poorly differentiated sarcomas, particularly those occurring in adults. PMID- 3511295 TI - Blood group isoantigens ABO (H) in transitional carcinoma of the bladder: a clinicopathological study. AB - Blood group A, B and H antigens were investigated in 183 paraffin embedded biopsies from 58 patients with transitional cell carcinoma of the urinary bladder, by a modified specific red cell adherence test, direct immunofluorescence with Ulex Europeus lectin and indirect immunoperoxidase method with monoclonal antibodies against blood group antigens. The results were correlated with pathological grade and stage and with the clinical course of patients evaluating the recurrence index and clinical state. Histological findings were roughly correlated with the expression of red cell tissue antigens but not with the presence of precursor H substance in biopsies from patients of blood group A or B, in which a higher proportion of H positive results was appreciated. The clinical course was also related to the presence or absence of blood group antigens in referential biopsies: 90 per cent of negative biopsies corresponded to patients who had high recurrence index whereas 75 per cent of positive biopsies corresponded to patients who had low recurrence index or did not have recurrence for five years; 25 per cent of recurrences observed in patients with referential positive biopsy were invasive whereas the proportion of invasive tumor in recurrence from negative biopsies rises to 73 per cent. In addition, all the final biopsies from patients who died of bladder tumor were negative for blood group antigens. The diagnostic and prognostic significance of these tissue antigens in transitional cell carcinoma of the urinary bladder is discussed, and we conclude that the analysis of blood group antigens in bladder biopsies by established techniques is a useful tool in clinical pathology for the screening and followup of bladder tumors, as previously suggested. PMID- 3511296 TI - The mode of action of prostaglandin E2, F2 alpha and prostacyclin on vesicourethral smooth muscle. AB - Interactions of prostaglandin E2 (PGE2), F2 alpha (PGF2 alpha) and prostacyclin (PGI2) with Ca2+ on the isometric contraction of rabbit detrusor muscle strips were studied using two types of Ca2+ antagonists of different mechanisms of action: verapamil and sodium nitroprusside (NP). The effects of PGI2 on vesicourethral smooth muscle and their relationship with cholinergic, adrenergic receptors and nervous activity were also investigated. PGE2 and F2 alpha (3 X 10( 8) to 3 X 10(-5) M) caused dose-dependent contraction of the strips. Pretreatment of the strips with verapamil (10(-7) to 10(-5)M) significantly inhibited PGs induced contraction in a dose-dependent manner, whereas NP(10(-7) to 10(-5)M) failed to suppress the contraction. Relaxation of the preparations once contracted by PGE2 and F2 alpha (3 X 10(-6)M) was induced completely by addition of verapamil (10(-5)M), and incompletely by NP(10(-5) to 10(-3)M). Washing of the strips with Ca2+-free solution containing 0.01 mM EGTA completely eliminated spontaneous activity and diminished basal tension, but replenishment of Ca2+ (0.5 to 10 mM) to the medium caused dose-related contraction and spontaneous activity of the strips. Addition of PGE2 and F2 alpha to the Ca2+-free medium enhanced Ca2+-induced contraction and spontaneous activity during Ca2+ replenishment, which were significantly inhibited by pretreatment with verapamil (10(-7) to 10( 5)M) in a dose-dependent manner, but not affected by NP (10(-7) to 10(-5)M). In Ca2+-free medium containing 0.1 mM EGTA, PGE2 and F2 alpha caused a slight degree of tension increase of the strips dose-dependently at the higher concentration exceeding 3 X 10(-6)M. PGI2 (10(-9) to 3 X 10(-4)M) caused dose-dependent contraction of the strips from the bladder body, base and the urethra. The contractile action of PGI2 was greatest on the bladder body, less on the base and minimal on the urethra. The effect of PGI2 was less potent than those of PGE2 and F2 alpha. The PGI2-induced contraction was slow in onset, short lasting, and not affected by pretreatment with phentolamine, propranolol, atropine, hexamethonium, hemicholinium-3 and tetrodotoxin. The interactions of PGI2 with Ca2+ were similar to those of PGE2 and F2 alpha.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3511297 TI - Percutaneous techniques for the management of urological renal transplant complications. AB - Percutaneous techniques were used to manage 13 renal transplant recipients with urological complications and long-term followup now is available. Three patients had urinary fistulas and 10 had ureteral obstruction. In 2 of the patients with ureteral fistulas and 5 with ureteral obstruction the percutaneous procedures provided definitive management and obviated the need for an open operation. In the 6 other patients the percutaneous procedures proved to be valuable adjuncts to subsequent planned open operative reconstruction. While there were 4 significant complications related to the percutaneous procedures, none resulted in graft loss or patient death. We conclude that percutaneous techniques provide valuable alternatives to immediate open operative intervention in renal transplant recipients with ureteral obstruction or fistula formation. Furthermore, these techniques may obviate entirely the need for subsequent operative intervention. PMID- 3511298 TI - High resolution sonography in diagnosing testicular neoplasms: clinical significance of false positive scans. AB - We describe the use of high resolution real-time ultrasound to evaluate scrotal masses. From August 1980 to September 1984, 249 patients underwent scrotal ultrasound using high resolution real-time scanners with 10 mHz. transducers to evaluate scrotal abnormalities. The ultrasound diagnosis was consistent with a testicular neoplasm in 20 patients. Pathological and surgical confirmation was available in all 20 patients. Only 10 of 20 patients had malignant tumors, whereas 10 had benign lesions (false positive rate of 50 per cent). Testicular lesions producing false positive studies were principally hypoechoic in 8 patients and hyperechoic in 2. Testicular neoplasms characteristically were hypoechoic with or without focal hyperechoic areas. There was 1 false negative ultrasound study. Our results suggest that radical orchiectomy should not be performed indiscriminately in all patients with testicular lesions that are sonographically suspicious for neoplasm. In selected cases with hyperechoic sonographic features associated frequently with benign testis lesions open testicular biopsy and a testis-sparing operation may be indicated. PMID- 3511299 TI - Successful renal transplantation in a patient with a neurogenic bladder managed by clean intermittent catheterization. AB - Successful renal transplantation was accomplished in a patient with spina bifida and a neurogenic bladder, who previously had been continent after bladder neck reconstruction and institution of chronic intermittent bladder catheterization. Satisfactory bladder emptying and renal functional preservation have been maintained during a 4-year followup. PMID- 3511300 TI - Bilateral neonatal testicular torsion: ultrasonographic evaluation. AB - We report a case of neonatal bilateral spermatic cord torsion, and present the sonographic and radioisotope findings. Real-time ultrasound scans performed at 2 hour intervals showed changes highly suggestive of the acute nature of the torsion rather than that of a process that had occurred in utero. PMID- 3511301 TI - Simultaneous bilateral testicular tumors, one side clinically occult: detection by ultrasonography. AB - The majority of bilateral testicular tumors are discovered sequentially. Some of these second tumors may be present subclinically at the time the initial contralateral tumor is diagnosed and their simultaneous detection with ultrasound screening would obviate the inherent problems of an otherwise sequential bilaterality. We report a case of simultaneous bilateral seminomas in which 1 of the 2 tumors was subclinical and detected with ultrasound. The various problems encountered with these asynchronous second tumors in contrast to those diagnosed simultaneously are discussed. PMID- 3511302 TI - The natural history of endothelial structure and function in arterialized vein grafts. AB - When the saphenous vein is used in the in situ position for arterial bypass surgery, it is associated with more optimal preservation of the endothelial lining and with improved graft patency compared with reversed vein grafts. However, it is not clear whether preservation of endothelial integrity persists after arterialization. The goal of this study was to establish whether preservation of the endothelium before arterialization is a critical factor in the development of late functional and morphologic abnormalities of autogenous vein grafts. Paired reversed and in situ vein grafts were created in 75 mongrel dogs. Veins to be used in the reversed position were excised and stored in either heparinized whole blood at 37 degrees C or saline solution at 4 degrees C. Veins were studied before and after arterialization. The veins were arterialized by anastomosis to the carotid artery and excised at intervals of 1 day to 12 weeks for studies of the luminal production of prostacyclin and thromboxane A2 in addition to luminal morphology. Before arterialization, normothermic whole blood preserved biochemical function of the endothelium significantly better than hypothermic saline solution, but not as well as the in situ vein procedure. Soon after arterialization, all three vein grafts showed significant functional and morphologic abnormalities consistent with injury of the vein graft. Morphologic healing of the endothelial monolayer progressed slowly back to normal; however, the biochemical capacity of the vein graft never matched that of the prearterialized vein, nor that of normal host arteries. Regardless of surgical technique, all vein grafts exhibited a period of abnormal structure and function, which exposed them to the risk of thrombogenesis. This period of potential leukocyte or platelet interaction with the vein wall could lead to release phenomena as well as proliferative changes in the vessel wall. PMID- 3511303 TI - The effect of predetermined thrombotic potential of the recipient on small caliber graft performance. AB - This study was designed to establish the influence of the recipient's thrombotic potential on the patency of small-caliber prostheses and to evaluate the subsequent improvement of graft performance by medicinally altering the prostaglandin balance in subjects predisposed to graft occlusion. Mongrel dogs were pretested and classified as low and high responders according to their thrombotic potential, measured as prostaglandin metabolite balance and platelet aggregability. High responders were randomly divided into two groups. Those assigned to serve as the medicated subjects were pretreated 1 week before surgery with a single oral daily administration of combined dazmegrel (UK-38,485) and aspirin in equal dosages of 3 mg/kg. Medication was continued throughout the experiment. Dacron grafts were implanted bilaterally in the carotid artery site in all subjects. Following a 3-week implantation period, the patency rate for the group with low thrombotic potential was 100%. In the animals with high thrombotic potential the patency rate was 10% for nonmedicated subjects and 100% for medicated subjects. These data support the concept that the thrombotic potential largely determines the capacity of the recipient's blood to thrombose small caliber prostheses. Effective medicinal alteration of prostaglandin balance results in exceptionally increased patency of synthetic grafts. PMID- 3511304 TI - Jugular venous reconstruction: a technique to minimize morbidity of bilateral radical neck dissection. AB - Disfiguring facial edema and elevated intracranial pressure often accompany ligation and excision of the internal jugular veins (IJV) during simultaneous or staged bilateral radical neck dissection. To minimize this morbidity, unilateral reconstruction of the IJV was undertaken at the time of second-side neck dissection in 11 patients. Five patients underwent reconstruction with the spiraled saphenous vein (SVG) and in six patients 10 mm externally supported polytetrafluoroethylene (e-PTFE) was used. Prebypass jugular venous stump pressures (JVPs) were measured and ranged from 28/17 to 75/54 mm Hg with mean pressures of 17 to 62 mm Hg. Two patients had simultaneous neck dissections and nine had staged dissections. The staged interval ranged from 0.3 to 33 months. Six of nine staged reconstructions were right-sided and three of nine were left sided. Low molecular weight dextran was started intraoperatively, regional heparinization was used in all but two cases, and platelet inhibitors were continued postoperatively in all patients. Additional time in the operating room was 45 minutes (mean). All patients have been followed up 2 to 18 months postoperatively. B-mode ultrasonography, Doppler spectrum analysis, CT scan with contrast, and magnetic resonance imaging were used to assess patency. Four of five SVGs and three of six e-PTFE grafts have remained functional, which resulted in an overall patency rate of 64%. Four grafts (one SVG, three e-PTFE) failed in the immediate postoperative period. All grafts in patients who had a mean JVP greater than 30 mm Hg remained patent, whereas those in patients with lower stump pressures thrombosed.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3511305 TI - Abdominal aortic aneurysm causing duodenal and ureteric obstruction. AB - We report a unique case of an abdominal aortic aneurysm complicated by both duodenal and ureteric obstruction and review the literature on these conditions. Duodenal obstruction is a consequence of compression of the duodenum in its fixed retroperitoneal course between the aneurysmal aorta and the superior mesenteric artery. Treatment should be based on replacement of the aneurysm as gastrointestinal bypass alone does not resolve the risk of aneurysm rupture. Ureteric obstruction is related to encasement of the ureters in an inflammatory perianeurysmal fibrosis of unresolved etiology rather than secondary to aneurysm compression. Although urinary tract symptoms are often seen with aortic aneurysms, they tend to be nonspecific and are often overlooked. As many as 71% of patients with abdominal aortic aneurysms may have radiologic evidence of ureteric involvement. Although aneurysm replacement alone may resolve the perianeurysmal fibrosis with resultant relief of ureteric obstruction, most authors advise simultaneous ureterolysis. Aortic aneurysm should be considered as a possible cause of duodenal or ureteral obstruction in the elderly, especially in the presence of a pulsatile abdominal mass. PMID- 3511306 TI - The use of prostaglandins PGE1 and PGI2 in peripheral arterial ischemia. PMID- 3511307 TI - The role of aspirin in enhancing arterial graft patency. PMID- 3511308 TI - Antihypertensive treatment with metoprolol or hydrochlorothiazide in patients aged 60 to 75 years. Report from a double-blind international multicenter study. AB - In a randomized double-blind study (N = 562), a traditional treatment schedule, starting antihypertensive treatment in elderly hypertensive patients (60 to 75 years old) with 25 mg of hydrochlorothiazide once daily and doubling the dose if a satisfactory response was not achieved, was compared with antihypertensive treatment of 100 mg of metoprolol once daily, adding 12.5 mg of hydrochlorothiazide for patients whose response was not satisfactorialy achieved with metoprolol alone. Systolic and diastolic blood pressure was significantly reduced with both regimens. The frequency rates of responders (diastolic blood pressure, less than or equal to 95 mm Hg) in the metoprolol group and the hydrochlorothiazide group were 50% and 47% after four weeks and 65% and 61% after eight weeks, respectively. There were no significant differences in total symptom score or single symptoms between the regimens, but significantly more patients had hypokalemia and hyperuricemia with the hydrochlorothiazide regimen. Thus, we conclude that beginning antihypertensive treatment with 100 mg of metoprolol once daily and adding a small dose of hydrochlorothiazide (12.5 mg) in patients whose response is not satisfactory with metoprolol alone appears to be effective and safe in elderly hypertensive patients. PMID- 3511309 TI - Technology spurt resolves growth hormone problem, ends shortage. PMID- 3511310 TI - The formation of the first black medical society. PMID- 3511311 TI - A randomized clinical trial of the insulin pump vs intensive conventional therapy in diabetic pregnancies. AB - Improved perinatal outcome is associated with the prevention of hyperglycemia during pregnancy in diabetic women. To determine whether the method of insulin administration influences the degree of diabetic control obtained, we randomized 22 pregnant diabetic women to intensive conventional insulin therapy (N = 11) and insulin pump therapy (N = 11). Frequent outpatient visits; home glucose monitoring, at least six times daily; and frequent telephone contact were offered to all subjects. Patients were hospitalized in the inpatient clinical research center each trimester for a 24-hour metabolic profile. There were no differences between the two treatment groups with respect to outpatient mean glucose levels, symptomatic hypoglycemia, or glycosylated hemoglobin levels, or with respect to inpatient mean glucose level, glycemic excursions, chemical hypoglycemia, or hyperglycemia. Excellent metabolic control was achieved with both treatment methods. PMID- 3511312 TI - A trial of amitriptyline and fluphenazine in the treatment of painful diabetic neuropathy. AB - We conducted a double-blind, placebo-controlled, crossover study of the effectiveness of amitriptyline and fluphenazine in alleviating the pain of diabetic peripheral neuropathy in six diabetic patients. Pain was evaluated by the patients with a graphic rating scale. A placebo response was found, but no additional effect of amitriptyline and fluphenazine was seen. Although the statistical power of this study was low, these data, when combined with a reevaluation of previous trials of amitriptyline and fluphenazine in the treatment of painful diabetic neuropathy, indicate that there is no justification for the use of these agents in the treatment of painful neuropathy outside of large, controlled clinical trials. Depression as a possible cause of this condition should not go unnoted or untreated. PMID- 3511313 TI - Laboratory test analysis near the patient. Opportunities for improved clinical diagnosis and management. AB - New developments in laboratory technology have produced complex analytic systems that are simple to operate, relatively reliable, and inexpensive. These systems allow the office practitioner to perform test analyses in an office laboratory and can provide timely information useful for diagnostic and clinical management decisions. This article reviews the clinical applications and analytic systems available for use in urine analysis, blood cell analysis, determination of the sedimentation rate, coagulation testing, biochemical analysis, and bacteriologic and virologic testing. Although these analytic systems are generally designed to be used by nonprofessional laboratory staff, there is only limited information available about their reliability when used in this manner. Physicians, in bringing this technology into their office laboratories, must be cognizant of a new area of medical practice because they will now be the professionals responsible for the laboratory's function. It will be important that they develop new skills as the office laboratory directors and develop consultative relationships with laboratory professionals to ensure that the information used in patient care is both timely and reliable. PMID- 3511314 TI - Cassel: physician advocate for the elderly. PMID- 3511316 TI - Rejected landmarks: the smoke goes on. PMID- 3511315 TI - Pregnancy following renal transplantation in class T diabetes mellitus. AB - Nine cases of pregnancy complicated by diabetes and prior renal transplantation are reviewed. Maternal and fetal death occurred in a patient with foot and leg ulcers associated with preexisting peripheral vascular disease. Pregnancy-induced hypertension occurred in six cases. Spontaneous weight-bearing fractures occurred in two patients. No episodes of renal allograft rejection occurred. Evidence of fetal compromise was present in six cases. All fetuses were delivered by cesarean section prior to term, with live births occurring from 31 1/2 to 36 weeks' gestation. A single case of hypospadias was the only congenital defect. Prepregnancy screening for complications of diabetes and renal transplantation is advised and euglycemia should be achieved before and during pregnancy. Advanced diabetic vascular disease puts these gestations at significant risk. PMID- 3511317 TI - The Well-Felix test is archaic and misleading. PMID- 3511318 TI - Tobacco product liability. PMID- 3511319 TI - Health effects of smokeless tobacco. Council on Scientific Affairs. AB - Tobacco in various forms has been used for centuries. Using snuff and chewing tobacco was popular in the United States during the 18th and 19th centuries, but current data on their use are limited. Pharmacologic and physiologic effects of snuff and chewing tobacco include the gamut of cardiovascular, endocrinologic, neurologic, and psychological effects that are associated with nicotine. A review of studies appearing in the scientific literature involving various populations and approaches indicates that the use of snuff or chewing tobacco is associated with a variety of serious adverse effects and especially with oral cancer. The studies suggest that snuff and chewing tobacco also may affect reproduction, longevity, the cardiovascular system, and oral health. One group estimated that the relative risk of oral cancer in longtime users of snuff varied from 1.8 to 48 times that of its occurrence in nonusers. But few of the studies have fully utilized accepted scientific and epidemiologic methods. The Council on Scientific Affairs concludes there is evidence demonstrating that the use of snuff or chewing tobacco is associated with adverse health effects such as oral cancer, urges the implementation of well-planned and long-term studies that will further define the risks of using snuff and chewing tobacco, and recommends that the restrictions applying to the advertising of cigarettes also be applied to the advertising of snuff and chewing tobacco. PMID- 3511320 TI - Hickman catheter complications in marrow transplant recipients. AB - The complications associated with the insertion and use of 95 single lumen and 312 double lumen Hickman right atrial catheters in 357 marrow transplant recipients were retrospectively analyzed. Three-hundred (84%) first inserted catheters were in place for a median of 93 days (range, 16-209) without complications and were removed electively. Thirty-nine (9.6%) of all catheters were removed for infections and 24 (5.9%) for mechanical complications. Ninety five patients (26.6%) had 111 episodes of septicemia involving 128 separate organisms and 25 patients had 25 episodes of localized catheter infection with 26 separate organisms. The most frequently isolated organism was coagulase-negative staphylococcus. Twelve of 24 removals due to mechanical complications were caused by accidental pulling of the catheter by the patient. PMID- 3511321 TI - Endotoxin protects against hyperoxic decrease in membrane fluidity in endothelial cells but not in fibroblasts. AB - We evaluated the ability of endotoxin to protect against hyperoxic depression of plasma membrane fluidity in endothelial cells and fibroblasts in culture. Second- to-fifth passage porcine aortic endothelial cells and human newborn foreskin fibroblasts with 20 ng/ml of endotoxin or diluent in the culture medium were exposed to 20% O2 (control) or 95% O2 (hyperoxic) in 5% CO2 for 4 hours. After exposure, cells were labeled with 1,6-diphenyl-1,3,5-hexatriene (DPH), an aromatic hydrocarbon that partitions into the hydrophobic core of lipid bilayer membranes, or transparinaric acid (TPA), a natural, conjugated fatty acid that orients parallel to fatty acyl chains of membrane phospholipids. Membrane fluidity was monitored by measuring changes in the steady state fluorescence anisotropies (rs) for DPH and for TPA by using fluorescence spectroscopy. Reductions in membrane fluidity increase the value of rs. Addition of endotoxin to the culture medium of control endothelial cells and fibroblasts had no effect on rs for DPH or TPA. In hyperoxic endothelial cells, rs for DPH and rs for TPA were increased (p less than 0.001). Addition of endotoxin to the medium of hyperoxic endothelial cells prevented the increases in rs for DPH and TPA. Hyperoxia increased rs for DPH (p less than 0.003) but not rs to TPA in fibroblasts, and endotoxin failed to prevent this increase. These results indicate that hyperoxia decreases plasma membrane fluidity in endothelial cells and fibroblasts and demonstrate that endotoxin prevents the decrease in plasma membrane fluidity in endothelial cells, but not in fibroblasts. These membrane protective effects may represent an alternative mechanism by which endotoxin protects against hyperoxic cellular injury, and this mechanism may be specific for hyperoxic injury to endothelial cells. PMID- 3511322 TI - Monoclonal and polyclonal antibodies for the immunohistochemical detection of S 100 protein in paraffin embedded human tissues. PMID- 3511323 TI - Cell-mediated hyperacute rejection. VI. Prolonged survival of heterotopic mouse heart transplants. AB - The survival of heterotopically transplanted mouse hearts was enhanced in recipients who were sensitized intraperitoneally to give rise to cell-mediated hyperacute rejection, a T-cell-mediated response characterized by very rapid sensitization and rejection of allogeneic skin grafts. PMID- 3511324 TI - Renal prostaglandins. AB - Contradictions persist as to the role of PG in the regulation of renal blood flow and function. Many conflicting data can now be explained by the fact that anesthetized animals often yield different results from conscious, chronically instrumented animals. Further utilization of conscious animals and the continued development of more specific assays and inhibiting agents promises to better characterize the actions of these hormones. PMID- 3511325 TI - Extravascular lung water measurement in septic sheep. AB - Sheep were prepared with a chronic lung lymph fistula and studied unanesthetized following septicemia by infusion of live Escherichia coli 10(9) ml/kg bw or injection of oleic acid 0.05 ml/kg bw. Extravascular lung water (EVTV) was measured with thermal-dye technique and compared to gravimetrically measured lung water (EVWV). Septic sheep had increased pulmonary artery pressure, reduced mean arterial blood pressure and reduced cardiac output. In control animals there was a correlation between EVTV-EVWV of r = 0.70. In animals given oleic acid lungs were macroscopically edematous and the correlation was r = 0.93. In septic sheep, however, no correlation could be found between EVTV and EVWV (r = -0.25). The thermal-dye technique was found to give erroneously high values. This finding could probably be due to erythrostasis and leukocyte plugging with uneven perfusion and prolonged transit times due to reduced cardiac output. PMID- 3511326 TI - Carcinoma of eccrine sweat gland: experience with chemotherapy, autopsy findings in a patient with metastatic eccrine carcinoma, and a review of the literature. AB - Carcinoma of sweat glands is a very rare neoplasm of dermal appendages that is difficult to diagnose clinically and histologically. It has a potential for rapid growth and metastasis. Carcinoma of eccrine sweat glands, also known as eccrine carcinoma, is a distinct histologic subtype of sweat gland carcinoma. We report our autopsy findings and experience with chemotherapy in a patient with metastatic eccrine carcinoma. The pertinent literature and histologic classification of eccrine carcinomas are reviewed. PMID- 3511327 TI - Plantar verrucous carcinoma (epithelioma cuniculatum): case report with review of the literature. AB - Verrucous carcinoma is a rare highly keratinizing variant of squamous cell carcinoma that is a slow-growing, locally aggressive, and rarely metastasizing tumor. It may involve various body sites including oral, genital, and plantar areas. The tumor has a characteristic gross appearance with multiple sinuses opening on the surface and may present a difficult diagnostic problem. Multiple biopsies and close clinical correlation are frequently required before a definite diagnosis is possible. The differential diagnosis is especially difficult if only fragments or superficial portions of the lesion are submitted for histological evaluation. Reviewing surgical material from our institution from 1976 to 1983, we located four cases of verrucous carcinoma of the foot. These four cases were diagnosed on the bases of clinical, gross, and microscopic appearances. One of the cases had bilateral lesions. One of the cases is described with review of the literature. PMID- 3511328 TI - Complement activation during cardiopulmonary bypass. Comparison of bubble and membrane oxygenators. AB - A prospective randomized trial involving 91 patients undergoing cardiopulmonary bypass compared the effects of bubble oxygenators (with and without methylprednisolone sodium succinate) and membrane oxygenators on complement activation and transpulmonary sequestration of leukocytes. Patients were divided as follows: Group I, 30 patients, bubble oxygenator; Group II, 31 patients, bubble oxygenator and methylprednisolone sodium succinate (30 mg/kg); Group III, 30 patients, membrane oxygenator. In Group I, C3a increased from 323 +/- 171 ng/ml during cardiopulmonary bypass to 1,564 +/- 785 ng/ml at 25 minutes after bypass (p less than 0.0001). A significant decrease in C3a was found in Groups II and III compared to Group I (p less than 0.0001). C5a did not change significantly during cardiopulmonary bypass in any group. Reestablishment of pulmonary circulation at the end of bypass produced significant transpulmonary leukocyte sequestration in Group I; the median cell difference was 1,700/microliter. Transpulmonary sequestration was significantly (p less than 0.0001) less in Group II (median cell difference = 200/microliter) and in Group III (median cell difference = 400/microliter) than in Group I. We conclude that cardiopulmonary bypass with a bubble oxygenator alone initiates significantly (p less than 0.0001) more C3a activation and leukocyte sequestration than when methylprednisolone sodium succinate (30 mg/kg) is given 20 minutes before the start of cardiopulmonary bypass with a bubble oxygenator or when a silicone membrane oxygenator is used. PMID- 3511329 TI - An assay for macrophage activating factor based on the adherence of oil-elicited guinea pig macrophages: characterization of a lymphokine-induced release of hydrogen peroxide from elicited macrophages. AB - A convenient procedure is described for assaying guinea pig macrophage activating factor (MAF) in lymphokine preparations. The assay utilizes oil-elicited peritoneal macrophages from strain 2 guinea pigs and measures the capacity of macrophage cultures pretreated with lymphokine or medium to release hydrogen peroxide (H2O2) in the presence and absence of phorbol myristate acetate (PMA). The PMA-induced release measures a maintenance of macrophage adherence and activation. A novel aspect is a lymphokine-dependent release of H2O2 which occurs in the absence of PMA and which differs from the PMA triggered release. The differentiation process into lymphokine responsive cells has been studied using macrophages elicited from 2-21 days after oil injection. In addition macrophage responsiveness was examined in different strains of guinea pigs. PMID- 3511330 TI - Progress in the diagnosis and management of aortic dissection. AB - A 36-year-old man sought medical attention because of pressure in his head and distention of the veins in his neck. Physical examination disclosed a murmur of aortic insufficiency, and a chest roentgenogram showed a dilated ascending aorta. Two-dimensional echocardiography and angiography demonstrated a large intimal tear in the ascending aorta and aortic insufficiency. The patient underwent a surgical procedure, which revealed that his symptoms were caused by compression of the superior vena cava by the dilated ascending aorta. The aortic dissection was successfully repaired by replacement of the aortic root with a composite graft into which the coronary ostia were reimplanted. After further assessment of the patient, including elicitation of a similar history in some paternal relatives, Marfan's syndrome was diagnosed. Physicians should be aware of the clinical manifestations, pathogenesis, and treatment of aortic dissection. With aggressive treatment, 60 to 90% of patients survived aortic dissection in 1985, whereas only 40 years ago, this entity was rarely recognized premortem or treated successfully. PMID- 3511331 TI - Edwin Howard Armstrong--inventive genius. PMID- 3511332 TI - Italian physicist-mathematician invents the barometer. PMID- 3511334 TI - The Valsalva maneuver and response revisited. AB - The Valsalva maneuver is a time-honored technique that is commonly used at the bedside for the evaluation of heart murmurs. It is also a valuable adjunct in the evaluation of left ventricular function and autonomic dysfunction. In this article, we describe the normal and abnormal responses to the Valsalva maneuver and provide insight into the underlying hemodynamics in conditions that provoke an abnormal response. PMID- 3511333 TI - Electrical activity of the stomach: clinical implications. AB - Disorders of gastrointestinal motility are increasingly being recognized with the aid of such innovative techniques as gastrointestinal manometry and radioscintigraphy. Applications of these techniques have expanded and refined our present understanding of the gut motility both in health and in disease. Recent studies have shown that disturbances of motility can be limited to a specific segment of the gut such as the stomach or can affect the entire gastrointestinal tract. Because gastrointestinal motility is controlled by electrical activity, increasing efforts are being made to characterize and quantify the underlying electrical disturbances in various disorders of gastrointestinal motility. In this article, we review the electrical basis of gastric motility and the clinical implications of gastric dysrhythmia. PMID- 3511335 TI - Deaths in childbed from the eighteenth century to 1935. PMID- 3511336 TI - C.G. Paine and the earliest surviving clinical records of penicillin therapy. PMID- 3511337 TI - Lam Qua and the development of a westernized medical iconography in China. PMID- 3511338 TI - Difficulties in diagnosing infantile scurvy before 1878. PMID- 3511339 TI - Illustrations from the Wellcome collections. A Graeco-Roman speculum in The Wellcome Museum. PMID- 3511340 TI - Platt versus Pickering: an episode in recent medical history. By J. D. Swales, editor. An essay review. PMID- 3511341 TI - [Single-dose treatment of uncomplicated cystitis and asymptomatic bacteriuria--a review]. PMID- 3511342 TI - Anatomical investigation of the corticonuclear projections to the facial nerve nucleus in the cat. AB - The present study was performed to demonstrate a cortical projection to the facial nucleus of the cat. The right facial nucleus of 16 cats was injected with the retrograde tracer horseradish peroxidase (HRP). After allowing 36 hours for the retrograde transport of HRP, the animals were sacrificed by perfusion. The cortex, midbrain, and brain stem were removed, frozen sectioned, and reacted for HRP activity. Labeled pyramidal type cells were found bilaterally in layer V of the anterior sigmoid, presylvian, and coronal gyri of the frontal cerebral cortex. A significantly greater number of labeled cells were present in the contralateral motor cortex. Labeled cells were also found in the contralateral red nucleus, ipsilateral oculomotor nucleus, and periaqueductal gray substance of the midbrain. PMID- 3511343 TI - The disease of Emperor Frederick III. AB - The disease and death of German Emperor Frederick III has often been described in historical and medical treaties. These were all based on official political and medical reports published during 1887-1888, the time of the disease. The assertion of laryngologists, made while Frederick III was still alive, that the laryngeal carcinoma developed from a specific syphilitic infection is examined here. On the basis of the relevant laryngological literature, as well as less well-known sources, the probability of this assumption, the particular symptoms, and the fulminant course of the disease are documented. The behavior and the personality of Sir Morell Mackenzie is accordingly seen in a different light than in the past. PMID- 3511344 TI - Corticosteroid receptor in type II pneumocytes of the rat. AB - Glucocorticoid receptor in rat type II pneumocytes has been characterized. The Scatchard plot analysis of 3H-dexamethasone binding to type II cells showed a single class of binding sites. The apparent Kd of 3H-dexamethasone binding by a whole cell assay was 9.1 nM and the maximal binding capacity was 78.0 f mol/10(6) cells (0.31 pmol/mg cytosol protein). PMID- 3511345 TI - Characterization of a vasopressor substance generated in human plasma by incubation. AB - Incubation of human plasma at 37 degrees C for several hours leads to the formation of a non-dialysable vasopressor substance termed the active pressor principle. Some of the chemical and physical natures of active pressor principle were investigated in anesthetized and ganglion blocked rats. It was found to have properties characteristic of protein. The substance was crudely purified to about 25-fold in alcoholic trichloroacetic acid solution after placing the plasma in a boiling water bath for 5 minutes ("active fraction"). After treatment of the vasoactive plasma or "active fraction" with Pronase, the pressor activity was almost abolished. The molecular weight of this fraction as determined by gel filtration was about 68,000. With addition of diisopropyl fluorophosphate before incubation of the plasma, no vasopressor substance was generated. After treatment of the rat with captopril, an angiotensin converting enzyme inhibitor, the pressor effect of incubated plasma was not inhibited. These findings suggest that a vasoactive protein, which is clearly different from renin, is generated during simple incubation of plasma, and that a serine protease is involved in the formation of this substance. PMID- 3511346 TI - Effect of naloxone on exercise-induced angina pectoris: a randomized double blind crossover trial. AB - To determine whether endogenous opioids play a role in modulating the appreciation of chest pain in angina pectoris, the specific opioid antagonist, Naloxone, was used. The hypothesis was that the appearance time of ischemic myocardial pain should decrease after Naloxone if centrally mediated pain perception is significantly influenced by the endorphin system in angina pectoris. A randomized double blind clinical trial was conducted in 5 men with effort-induced angina pectoris associated with ST segment changes. Three multi stage exercise tests, using the Bruce protocol were performed on the same day and time, on three successive weeks. Chest pain was reported 4.3 +/- 0.3 (SEM) minutes after starting exercise on the first or baseline test. On subsequent tests patients received either Naloxone 2 mg IV or a similar volume of saline placebo. Angina pectoris occurred significantly (p. less than 0.05) earlier (1.6 +/- 0.2 minutes) after Naloxone compared to placebo. There were no significant differences in myocardial ischemia indicated by ST segment changes and no significant differences in resting or exercise blood pressure and heart rate between Naloxone and placebo. Thus, these data focus attention on a neglected area of myocardial ischemic pain and suggest that endogenous opioids play a significant role in the recognition of the pain of effort-related angina pectoris. PMID- 3511347 TI - In vitro effects of ethanolamine on insulin secretion. AB - The effects of ethanolamine on insulin secretion by the perfused rat pancreas were examined. During the second phase of glucose-induced insulin secretion 5 minute perfusions of ethanolamine at final concentrations of 0.1, 1 and 10 mM inhibited insulin release in a dose-related manner. When given throughout the experiment the highest dose of ethanolamine markedly suppressed both phases of glucose-induced insulin release. The inhibitory effect of ethanolamine was blunted in the presence of phentolamine. It is concluded that ethanolamine inhibits glucose-induced insulin secretion by the perfused rat pancreas and that alpha-adrenergic receptors play a role in its actions on insulin output. PMID- 3511348 TI - Prediction of individual patient prognosis: value of computer-aided systems. AB - Physicians take both diagnosis and prognosis into account when allocating treatment. However, by "prognosis" physicians usually imply a somewhat vague impression concerning large groups of patients. One possible task for decision support studies is to design and construct systems that accurately predict individual patient prognoses. The authors constructed and tested such systems in three areas of medicine (inflammatory bowel disease, upper gastrointestinal tract hemorrhage, and acute chest pain). In each area, the individual patient's symptoms were compared with a computer-held database of information via a Bayesian analysis, prior and conditional probabilities being derived from large scale real-life surveys. Prospective trials designed to test these predictive systems by reference to test series comprising over 4,000 patients indicate that a firm prognostic prediction can generally be made; where made, the accuracy of prediction is over 90%. Ways in which this type of prediction may be of clinical value are discussed. PMID- 3511349 TI - Feasibility of physician-developed expert systems. AB - The authors developed an experimental domain-independent "expert system generator" intended for direct use by physicians. They then undertook a four-year study to determine whether physicians could use such a system effectively. During this period they taught the use of the expert system generator to 70 medical students, who utilized it to build two small medical expert systems. At the conclusion of the course, students were examined on decision-making concepts and completed anonymous questionnaires. Performance scores, a composite of test and project grades, were calculated for each student. There was no significant association between previous computer experience and performance score. Thirty two of 47 students responding felt the expert system generator was easy to use; 15 felt it was of moderate difficulty. Forty-three of 47 thought it a useful teaching aid. These data support the conclusion that physicians can learn to use domain-independent software to implement medical expert systems directly, without a knowledge engineer as an intermediary. PMID- 3511350 TI - Infusion of synthetic human C-peptide does not affect plasma glucose, serum insulin, or plasma glucagon in healthy subjects. AB - We studied six healthy male subjects to determine whether a four-hour infusion of synthetic human C-peptide sufficient to achieve mean (+/- SD) peripheral plasma concentrations of 1.3 +/- 0.7 pmol/mL affected plasma glucose, serum insulin, or plasma glucagon. Subjects were studied in a fasting state and following an oral glucose load during four-hour 0.9% NaCl (control) and C-peptide (mean dose: 70 nmol) infusions. No differences were observed between saline and C-peptide infusions for mean values of fasting plasma glucose (94 +/- 6 v 87 +/- 5 mg/dL), serum insulin (3 +/- 1 v 2 +/- 1 microU/mL), or plasma glucagon (124 +/- 65 v 112 +/- 70 pg/dL). Following oral glucose ingestion no differences were detected between saline and C-peptide infusions for mean peak values of plasma glucose (168 +/- 18 v 168 +/- 31) and serum insulin (59 +/- 6 v 57 +/- 21) or mean nadir values of plasma glucagon (80 +/- 73 v 75 +/- 70). There was a slight delay in the insulin rise following oral glucose on the C-peptide infusion day, but differences between mean values for individual sampling times were not statistically significantly different. PMID- 3511351 TI - Strict nocturnal diabetic control diminishes subsequent glycemic escape during acute insulin withdrawal. AB - Five Type 1 (insulin dependent) diabetic patients with no endogenous insulin secretion and very low antiinsulin antibody levels (IBC less than 4%) were studied twice. Nocturnal plasma glucose was maintained by intravenous insulin just beyond each extreme of the normal range, either "hypoglycemic," at 2.71 +/- 0.03 mmol/L, or "hyperglycemic," 8.59 +/- 0.13 mmol/L. Glucose turnover measurements were performed before and after insulin was discontinued the following morning. The steady state plasma glucose concentration achieved during subsequent glycemic escape was significantly lower following nocturnal hypoglycemia, (16.1 +/- 0.3 v 20.2 +/- 0.03 mmol/L; P less than 0.01). The initial rate of rise of plasma glucose was identical in both groups. Free insulin levels, although significantly higher in the hypoglycemic study, before withdrawal, 24.3 +/- 6.0 v 13.3 +/- 0.8 mU/L, (P less than 0.01), fell to similarly low levels 1 hour after insulin withdrawal. Free fatty acid and total ketone concentrations were normalized during hypoglycemia, but remained elevated in the hyperglycemic group. Lactate concentrations were not different in the two studies. During glycemic escape glucose appearance rate (Ra) rose faster following hypoglycemia, but similar final rates were achieved in each group. When related to plasma glucose concentration glucose uptake (Rd) was normal following hypoglycemia and remained persistently greater than the hyperglycemic group throughout the 5 hours following insulin withdrawal. Plasma cortisol, pancreatic glucagon, and growth hormone levels were not significantly different in the two groups following withdrawal. It is suggested that the persistent normal glucose uptake, following glycemic control that has been sufficient to normalize plasma metabolites, will limit glycemic excursions caused by acute reductions in plasma free insulin concentration.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3511352 TI - Amiloride-sensitive regulation of intracellular pH in B-cells: activation by glucose. AB - Alterations in intracellular pH (pHi) generated by metabolism of glucose has been proposed to be a transduction device for controlling changes in K+ conductance in the plasma membrane of the B-cell leading to depolarization and cyclic variations in the membrane potential associated with spike activity. The influence of permeable weak acids or bases and amiloride inhibition of H+ extrusion by a Na:H exchanger on glucose-induced electrical activity has suggested that the electrical events are pH-sensitive. In order to document that these conditions alter pHi, we determined the influence of glucose, propionic acid, and NH4Cl, in the presence or absence of amiloride on pHi of rat islets using [14C] DMO. Glucose, 2.8 mmol/L decreased pHi by .09 unit compared to the absence of glucose (pHi = 7.08 +/- .01, M +/- SEM) and 16.7 mmol/L glucose reduced pHi by .19 unit. The glucose dose-related decrease in pHi yielded a half-maximal response at 4 mmol/L. The addition of 0.1 mmol/L amiloride had no influence on pHi without glucose and decreased pHi in the presence of 2.8 mmol/L glucose by .14 unit. The addition of 20 mmol/L propionic acid to 2.8 mmol/L glucose reduced pHi to 6.85 +/ .05, whereas 20 mmol/L NH4Cl increased pHi to 7.27 +/- .07. The addition of amiloride did not further lower the reduction in pHi elicited by 20 mmol/L propionic acid or 16.7 mmol/L glucose. These results suggest that the amiloride sensitive Na:H exchanger plays a major role in regulation of pHi, but another modality for pHi regulation exists to compensate for inhibition of Na:H exchange under conditions of an acid load. PMID- 3511353 TI - Hospital information systems in Japan. PMID- 3511354 TI - Single-dose therapy in the management of urinary tract infections. PMID- 3511355 TI - Side-effects of corticosteroid agents. AB - Anti-inflammatory corticosteroid drugs are powerful therapeutic agents for a wide range of disorders. However, they do have recognized side-effects, most of which are related to the dose and the duration of therapy. Thus, short courses of even high doses of corticosteroid drugs have very few adverse effects. A detailed knowledge of the long-term side-effects of corticosteroid agents and their incidence will assist the physician in making informed judgements on the potential benefits of treatment with these drugs. PMID- 3511356 TI - Frederick III of Germany. PMID- 3511357 TI - Cancer risks and the contraceptive pill. What is the evidence after nearly 25 years of use? PMID- 3511358 TI - Repetition strain injury: a review of current understanding. AB - "Repetition strain injury" (RSI) is a controversial condition and has become a major occupational health problem in Australia. It seems to be a disorder that is consequent to the introduction of new technology without due concern for human performance. The introduction of mechanized and partly automated processes apparently has made physical workloads lighter but has resulted in an increased regularity of physical movement with workloads that frequently are concentrated locally. Mechanization and automation have also produced an increased rate of work. A combination of several factors, each of which in itself is seemingly tolerable, may lead to this occupational hazard. Physical, psychological and ergonomic aspects may contribute to the condition but there are no useful diagnostic investigations. The pathology is unknown. Management of the condition requires carefully supervised treatment of the patient and his or her environment. The prevention of RSI necessitates improved organizational and ergonomic control in the work environment. Fundamental research into its causes, natural history and pathophysiology is essential for the development of scientifically based preventive strategies and patient therapy. PMID- 3511360 TI - A few distinct 'molecular sandwiches' are basis for structural and functional similarities of subspecies of interferon alpha and of families of growth promoting hormones. AB - 'Molecular sandwiches' composed of two aromatic amino acids separated by a hydrophilic one were found on eleven subspecies of human interferon alpha, on murine interferon alpha 2, and human interferon beta 1. In addition, another type of the sandwiches was found on several species of interferon. This confirms and extends the observations concerning the similarities between some interferons and several classical hormones. Furthermore, we are presenting evidence that a distinct type of the 'molecular sandwiches': Tyr-Cys...Cys and/or Cys...Cys Cys...Cys, that participate in formation of disulfide bonds, is a characteristic marker of most, if not all of the growth-promoting hormones including growth factors. The 'sandwiches' appear to be important for receptor binding. PMID- 3511359 TI - Human hair follicle cells in culture: the development of a new culture system and its potential applications. PMID- 3511361 TI - Specific binding affinity for DNA of the L phage (Salmonella typhimurium) in extracts of Escherichia coli. AB - The repressor gene cII of the L phage was cloned into plasmid pHC624 and expressed in E. coli. Two separate binding affinities for L phage DNA were identified during fractionation of protein extract of that strain. The activity that salts out in low concentration of ammonium sulphate belonged to the repressor, the activity that salts out in high concentrations of (NH4)2SO4 was proved to be of E. coli origin. Binding sites for the two proteins are located on different fragments of the L phage genome. PMID- 3511362 TI - Study of the amniotic fluid from smokers and non-smokers in the Ames test. AB - Amniotic fluid from smokers and non-smokers was tested by the Salmonella/mammalian microsome test. Concentrated amniotic fluid from heavy smokers at term showed an increase in the number of revertants with increasing exposure to tar. However, some of the non-smokers had a higher number of revertants than the smokers. No significant differences were found between second trimester samples from smokers and non-smokers, but the limited volumes available at this stage of pregnancy may be a source of error. PMID- 3511363 TI - The bacterial mutagenicity of nitropolychlorinated dibenzo-p-dioxins. AB - The bacterial mutagenicity of 2-nitrodibenzo-p-dioxin, a mixture of 2-nitro-7 chloro- and 2-nitro-8-chlorodibenzo-p-dioxin, 7-nitro-2,3-dichloro-, 8-nitro 2,3,7-trichloro-, 2-nitro-1,3,7,8-tetrachloro- and 3-nitro-1,2,4,7,8 pentachlorodibenzo-p-dioxin was determined using Salmonella typhimurium tester strains TA98 and TA100 with and without rat hepatic S9 for metabolic activation. All the nitro-PCDDs exhibited some direct-acting mutagenicity with both tester strains, however, the activity was significantly lowered in the presence of exogenous S9 and the compounds were more mutagenic to tester strain TA98. The mutagenicity of the nitro-PCDDs was also dependent on structure because there was a marked decrease in activity with increasing chlorine content. Because nitro PCDDs have recently been identified as incomplete combustion products of municipal waste, this study confirms that this new class of compounds contains some bacterial mutagens. PMID- 3511364 TI - Bacterial mutagenicity of the tranquilizing constituents of Valerianaceae roots. AB - The valepotriates valtrate/isovaltrate and dihydrovaltrate are considered to be the main tranquilizing constituents of drugs derived from the roots of several Valerianaceae. The decomposition products of valtrate and isovaltrate include the metabolites baldrinal and homobaldrinal, respectively, whereas the decomposition products of dihydrovaltrate do not include baldrinal-like metabolites. Purified valtrate/isovaltrate, dihydrovaltrate, baldrinal and homobaldrinal were investigated for their genotoxic activity in the Salmonella/microsome test and the SOS-chromotest. The valepotriates developed mutagenic activity in these test systems only in the presence of S9 mix, whereas both baldrinals showed mutagenic effects in both tests with and without metabolic activation. PMID- 3511365 TI - High levels of mutagenic activity in chlorinated drinking water in Finland. AB - The organic extract from the drinking water of Kuopio, Eastern Finland, turned out to be highly mutagenic in the Ames test. The direct mutagenic activities of the acid/neutral fractions of 48 drinking water samples were on an average 1700 net revertants/l in strain TA100. The highest activities were more than 6000 net revertants/l, and one drinking water sample exceeded 10 000 net revertants/l. The drinking water of Kuopio is produced from lake water which has a relatively high content of humic substances. Water processing involved two chlorination phases. The organic constituents of the water samples were isolated either by continuous liquid-liquid extraction or by absorption on XAD 8 resin. PMID- 3511366 TI - Genotoxicity of 'shamma', a chewing material suspected of causing oral cancer in Saudi Arabia. AB - 'Shamma', also known as Yemeni snuff, is frequently used as a chewing material in Yemen and some parts of Saudi Arabia. Preliminary clinical observations indicated that long-term users of 'shamma' may develop oral cancer. A battery of in vitro bioassays were, therefore, used to test genotoxicity of this substance. The test systems included the histidine reversion assay in Ames' Salmonella strains, induction of aberrant colonies and tryptophan gene conversion in the D7 diploid strain of Saccharomyces cerevisiae, and oncogenic transformation of C3H mouse embryo 10T1/2 cells. Data indicated that direct-acting mutagen(s) were present in a chloroform extract of the powdered 'shamma' resulting in positive effects in all of the test systems used. Using high-performance liquid chromatography (HPLC), three major fractions were separated from the extract, of which two were found to be mutagenic. PMID- 3511367 TI - Chlorophyllin: a potent antimutagen against environmental and dietary complex mixtures. AB - Chlorophyllin, the sodium and copper salt of chlorophyll, was tested for its ability to inhibit the mutagenic activity of a variety of complex mixtures- extracts of fried beef, fried shredded pork, red grape juice, red wine, cigarette smoke, tobacco snuff, chewing tobacco, airborne particles, coal dust and diesel emission particles--in strain TA98 of Salmonella typhimurium. Chlorophyllin was highly effective against the mutagenicity (90-100% inhibition) of 8 of these 10 mixtures. The mutagenicity of the other 2 mixtures was inhibited 75-80% at the highest concentration of chlorophyllin studied. Control and reconstruction experiments showed that chlorophyllin was not toxic to Salmonella at the concentrations used. The antimutagenic activity of chlorophyllin was heat-stable. The mechanism of the antimutagenicity of chlorophyllin in these experiments is not known; however, chlorophyllin is an antioxidant. Scavenging of radicals and/or interaction with the active group of mutagenic compounds may be responsible for its antimutagenic activity. The data reported here indicate that chlorophyllin is potentially useful as an antimutagenic agent. PMID- 3511368 TI - Isolation of glutathione-deficient mutants of the yeast Saccharomyces cerevisiae. AB - Glutathione-deficient (gsh-) mutants of the yeast Saccharomyces cerevisiae were isolated after UV treatment using MNNG as selective agent. For genetic and biochemical characterization 5 mutant strains were chosen which exhibited considerably decreased residual GSH contents varying from 2 to 6% of the wild type levels. All 5 isolates showed a 2:2 segregation of the gsh-:GSH+ phenotypes alluding to a monogenic recessive mutation. Complementation analysis indicates that all gsh- mutants belong to one complementation group. PMID- 3511369 TI - The relationship between survival and mutagenesis in Escherichia coli after fractionated ultraviolet irradiation. AB - The relationship between survival and mutagenesis in Escherichia coli after fractionated ultraviolet (UV) irradiation was studied. The cells were incubated either in buffer or nutrient media. Regardless of incubation conditions, greater survival is observed after fractionated irradiation than after acute irradiation. When the cells are incubated in buffer, UV mutagenesis decreases with an increase in the number of dose fractions. However, when the cells are cultivated in nutrient media, the increased survival (i.e., the enhanced capacity for repair) is coupled with the enhanced capacity for UV mutagenesis. We, therefore, assume that during incubation in nutrient media, fractionated irradiation leads to full and prolonged expression of all UV-inducible (SOS) genes, including those required for mutagenesis. PMID- 3511370 TI - 1-Nitropyrene: a mutagenic product induced by the action of near ultraviolet light on 1-aminopyrene. AB - A solution of 1-aminopyrene in dimethyl sulfoxide exposed to an artificial source of near ultraviolet light (600 kJ/m2) induced significant direct-acting mutagenicity in the Ames/Salmonella plating assay utilizing strain TA98. High performance liquid chromatography of this solution resulted in a fraction that was mutagenic on TA98 but inactive on a nitroreductase-deficient strain of Salmonella (TA98NR). This observation suggested the presence of a nitro containing compound. Mass spectral analysis confirmed that 1-nitropyrene was the active photoproduct in this fraction. These data implicate photochemical transformation of primary aromatic amines as an alternative mechanism by which nitroaromatic compounds can be formed in the environment. PMID- 3511371 TI - What is the role of histidine in studies of faecal mutagenicity? AB - Mutagenicity testing can be used to assay faeces for genotoxic substances and the results are reported to correlate with population risk for colorectal cancer (Ehrich et al., 1979). It has been suggested that histidine in faeces may cause false positive results (Venitt and Bosworth, 1983). To determine the relationship between histidine and false positive mutagenicity assays aliquots of non mutagenic faecal extract and saline were supplemented with histidine and subjected to the Ames Salmonella/mammalian microsome mutagenicity assay (Ames et al., 1975). Using high-pressure liquid chromatography the analytical recovery of histidine from water and faecal extract supplemented with histidine was equivalent (r = 0.998, p less than 0.001). Histidine was measured in faecal extracts (1 in 10 dilutions) from 35 volunteers, 10 patients with inflammatory bowel disease and 4 with rectal cancer. These extracts were also assayed for mutagens using the Salmonella/mammalian microsome mutagenicity assay. None of the faecal extracts gave mutagenicity ratios above 2. Faecal extracts from volunteers were free of detectable histidine. Although 9 of those from inflammatory bowel disease patients contained histidine (mean +/- SEM 255 +/- 34 mumoles l-1) as did 1 extract from a rectal cancer patient (50 mumoles l-1), none contained sufficient histidine to give a false positive Salmonella/mammalian microsome mutagenicity assay result (800 mumoles l-1 in test solution). Our results do not implicate histidine as a cause of error in faecal mutagenicity testing by the Salmonella/mammalian microsome mutagenicity assay. PMID- 3511373 TI - Use of a prosthetic ventricle as a bridge to cardiac transplantation for postinfarction cardiogenic shock. PMID- 3511372 TI - Therapy of lupus nephritis. Controlled trial of prednisone and cytotoxic drugs. AB - We evaluated renal function in 107 patients with active lupus nephritis who participated in long-term randomized therapeutic trials (median follow-up, seven years). For patients taking oral prednisone alone, the probability of renal failure began to increase substantially after five years of observation. Renal function was better preserved in patients who received various cytotoxic-drug therapies, but the difference was statistically significant only for intravenous cyclophosphamide plus low-dose prednisone as compared with high-dose prednisone alone (P = 0.027). The advantage of treatment with intravenous cyclophosphamide over oral prednisone alone was particularly apparent in the high-risk subgroup of patients who had chronic histologic changes on renal biopsy at study entry. Patients treated with intravenous cyclophosphamide have not experienced hemorrhagic cystitis, cancer, or a disproportionate number of major infections. We conclude that, as compared with high-dose oral prednisone alone, treatment of lupus glomerulonephritis with intravenous cyclophosphamide reduces the risk of end-stage renal failure with few serious complications. PMID- 3511374 TI - Artificial hearts--permanent and temporary. PMID- 3511375 TI - Antibodies to HTLV-III/LAV in Venezuelan patients with acute malarial infections. PMID- 3511376 TI - Absence of therapeutic benefit from antacids or cimetidine in non-ulcer dyspepsia. AB - We randomly assigned 159 patients with non-ulcer dyspepsia, defined as chronic or recurrent epigastric pain without concomitant symptoms of the irritable bowel syndrome and with no evidence of organic disease, to treatment for three weeks with an antacid suspension one and three hours after meals, 400 mg of cimetidine twice a day, or placebo, according to a double-blind, double-dummy model. The intensity and duration of epigastric pain were recorded by the patients four times daily during a one-week period without therapy and during the three weeks of treatment. The mean reduction in pain intensity after three weeks in the placebo group was 25 percent. Neither antacid nor cimetidine treatment resulted in more than a 4 percent better effect. The reduction of pain was statistically significant (P less than 0.01) in all three groups. The time course of the pain scores in the groups receiving active drugs followed closely those in the placebo group, and there were no significant differences between the groups at any stage of the treatment. We conclude that the neutralization or suppression of gastric acid is of no clinical value in patients with this syndrome. PMID- 3511377 TI - Medical consequences of persistent viral infection. PMID- 3511378 TI - Bone marrow transplantation for glycogen storage disease type II (Pompe's disease) PMID- 3511379 TI - Fatal asthma. PMID- 3511380 TI - Effect of cyclosporine on total lymphocyte and T-cell counts in renal-transplant recipients. PMID- 3511381 TI - Possible interaction between cyclosporine and erythromycin. PMID- 3511382 TI - Plasma exchange in chronic inflammatory demyelinating polyradiculoneuropathy. AB - Plasma exchange has been reported to be efficacious in chronic inflammatory demyelinating polyradiculoneuropathy. We performed a prospective double-blind trial in which patients with static or worsening disease were randomly assigned to plasma exchange (n = 15) or to sham exchange (n = 14) for three weeks. After three weeks, we observed statistically significant differences in combined measurements of nerve conduction (total, motor, proximal, velocity, and amplitude) favoring patients who had received plasma exchange. Improvement to a greater degree than for any patient receiving sham exchange was detected in the neurologic-disability score in five patients (P = 0.025) and in subset scores for weakness and reflex in four patients (P less than 0.057). We conclude that for some patients with chronic inflammatory demyelinating polyradiculoneuropathy, plasma exchange has an ameliorating effect on neurologic dysfunction and nerve conduction, but in others no improvement is observed. Because plasma was replaced with normal serum albumin, a humoral factor or factors may have a role in the neurologic deficit of this disorder. PMID- 3511383 TI - Long-term pathological follow-up of cerebral arteriovenous malformations treated by embolization with bucrylate. AB - We examined 17 intracranial arteriovenous malformations that were resected after treatment by embolization using bucrylate (isobutyl-2-cyanoacrylate). In nine specimens removed 5 days to 16 months after embolization therapy, a series of pathologic changes was seen, including patchy mural angionecrosis (adjacent to bucrylate fragments) up to six weeks after embolization, the presence of bucrylate in vessel walls and fibromuscular intimal cushions, and the occurrence (after several months) of entirely extravascular bucrylate. Occasional parts of recanalized vascular malformations were identified. Bucrylate was present within arteriovenous malformations as late as 16 months after embolization, although the amount appeared to be diminished. These findings suggest a specific sequence of events in the interaction between bucrylate and mural components within the malformations and may explain some important complications of embolization therapy (e.g., delayed hemorrhage after embolization). PMID- 3511384 TI - The pathogenesis of atherosclerosis--an update. PMID- 3511385 TI - Diagnosis of Creutzfeldt-Jakob disease by Western blot identification of marker protein in human brain tissue. AB - We tested purified preparations of brain tissue from 39 patients with Creutzfeldt Jakob disease, Gerstmann-Straussler-Scheinker syndrome, or kuru, and from 32 patients with a variety of nonspongiform degenerative diseases, with the use of Western blots against an antiserum to a similarly purified fraction made from scrapie-infected hamster brain. Positive reactions occurred in 81 percent of the 31 specimens from the patients with Creutzfeldt-Jakob disease (and in all of the 7 specimens that were stored frozen for less than one year), in 3 of the 4 specimens from the patients with kuru, in 3 of the 4 specimens from the patients with Gerstmann-Straussler-Scheinker syndrome, and in none of the specimens from the patients with other neurologic degenerative disorders, including familial or sporadic Alzheimer's disease; dementia associated with myoclonus, motor neuron disease, or parkinsonism; and acquired-immunodeficiency-syndrome encephalopathy. Immunologic testing has thus begun to provide a useful and rapid adjunct to neuropathological examinations and animal-transmission experiments for the diagnosis of the spongiform encephalopathies. PMID- 3511386 TI - Blastomycosis: leave it to beaver. PMID- 3511387 TI - Expression of the c-myb proto-oncogene during cellular proliferation. AB - In several cell types, messenger RNA levels of the nuclear proto-oncogene c-myb vary as a function of cellular proliferation; a transient increase in c-myb steady-state mRNA, mediated by post-transcriptional mechanisms, occurs during cell-cycle progression. In contrast, both quiescent and proliferating immature thymocytes contain exceptionally high levels of c-myb mRNA as a consequence of increased c-myb transcription. PMID- 3511388 TI - Restricted recognition of beta 2-microglobulin by cytotoxic T lymphocytes. AB - Recognition of foreign antigen by cytotoxic T lymphocytes (CTL) is restricted by class I major histocompatibility complex (MHC) products. Class I heavy chains (relative molecular mass (Mr) 45,000-48,000) are reversibly and noncovalently associated with beta 2-microglobulin (beta 2M, Mr = 12,000). Cells expressing human or murine class I heavy chains can exchange their native beta 2M for exogenously added free beta 2M, which is present in serum. Two allelic forms of beta 2M exist among the common laboratory mouse strains, beta 2M-A and beta 2M-B, which are represented in BALB and C57BL mice, respectively. The two forms differ at a single amino acid at position 85, the gene (beta 2m) is located on chromosome 2 linked to a minor histocompatibility (H) region, H-3. It has been proposed that one of the H-3 loci is identical with beta 2m, and that CTL raised across certain H-3 incompatibilities are actually specific for beta 2M. Here we describe CTL raised in such a combination which recognize endogenous as well as exogenous beta 2M-B in the context of H-2Kb. This represents a unique case of CTL recognition, as CTL usually recognize antigens inserted into the membrane, and it is the first molecular identification of the product of a minor H locus. PMID- 3511390 TI - The hen's egg versus the horse's brain: how equine encephalomyelitis vaccine established the Dorothy and Joseph Beard Foundation. PMID- 3511389 TI - Stimulation of bone resorption and inhibition of bone formation in vitro by human tumour necrosis factors. AB - When leukocytes are exposed to mitogens or antigens in vitro, they release bone resorbing activity into the culture supernatants which can be detected by bioassay. Like many lymphocyte-monocyte products, this activity has been difficult to purify because of its low abundance in activated leukocyte cultures and the unwieldy bioassay required to detect biological activity. Partially purified preparations of this activity inhibit bone collagen synthesis in organ cultures of fetal rat calvariae. Recent data suggest that both activated lymphocytes and monocytes release factors which could contribute to this activity. Recently, monocyte-derived tumour necrosis factor alpha (TNF-alpha) and lymphocyte-derived tumour necrosis factor beta (TNF-beta) (previously called lymphotoxin), two multifunctional cytokines which have similar cytotoxic effects on neoplastic cell lines, have been purified to homogeneity and their complementary DNAs cloned and expressed in Escherichia coli. As both of these cytokines are likely to be present in activated leukocyte supernatants, we tested purified recombinant preparations for their effects on bone resorption and bone collagen synthesis in vitro, and report here that both cytokines at 10(-7) to 10( 9) M caused osteoclastic bone resorption and inhibited bone collagen synthesis. These data suggest that at least part of the bone-resorbing activity present in activated leukocyte culture supernatants may be due to these cytokines. PMID- 3511391 TI - Etiology and pathogenesis of hypertension following renal transplantation. AB - Hypertension is a common feature of end-stage renal disease (ESRD) and constitutes a major risk factor for accelerated cardiovascular disease and premature death. While a reduction in the incidence and severity of hypertension is one potential benefit of kidney transplantation, hypertension often remains as a problem after transplantation, even in recipients of wellfunctioning allografts. Despite many studies of the underlying etiologic factors, the mechanisms implicated in post-transplant hypertension are still incompletely understood. A number of variables, including status of the diseased native kidneys, steriod therapy, rejection, recurrence of original disease, activation of the renin-angiotensin system, sodium and calcium metabolism, and transplant renal artery stenosis may play a role in the etiology of hypertension after transplantation. Patients with persistent high blood pressure for more than 3 months after transplantation should be thoroughly investigated, with controlled sodium intake so that proper medical or surgical therapy can be implemented. Since sodium restriction, radionuclide renal scanning, renin levels, or responses to saralasin or captopril may not provide a clear index of various possibilities, an accurate differential diagnosis my also require invasive procedures such as arteriography and/or renal biopsy. PMID- 3511392 TI - The effect of prostaglandin inhibition on the clinical course of chronic hemodialysis. AB - We studied the hypothesis that dialysis hypotension may be triggered by dialysis induced release of prostaglandin/prostacyclin. Indomethacin (50 mg 5 X in 30 h) was given before dialysis to 10 stable, chronic hemodialysis patients, comparing it to placebo in a double-blind, crossover manner. Mean arterial blood pressure (MAP) before dialysis was 106.6 +/- 17.7 and 99.7 +/- 10.4 (SD) mm Hg for indomethacin and placebo, respectively. MAP after dialysis was 95.4 +/- 13.9 and 85.2 +/- 11.0 mm Hg for indomethacin and placebo, respectively. Ultrafiltration, expressed as a weight loss, was 1.82 +/- 1.1 kg for indomethacin and 1.38 +/- 1.29 kg for placebo dialysis. The amount of saline given during dialysis was 339 +/- 139 ml for indomethacin and 388 +/- 83 ml for placebo. Although indomethacin treatment resulted in more ultrafiltrate, less saline infusion, and higher MAP before and after dialysis, none of these differences were statistically significant. This preliminary trial indicates that prostaglandin/prostacyclin inhibition by indomethacin does not alter the clinical course of hemodialysis of chronic stable patients. PMID- 3511393 TI - Endotoxin level of sterile injection solutions and substitution fluid for hemofiltration in Japan and Australia. AB - The endotoxin contamination levels of sterile distilled water and saline solutions used for injection and hemofiltration in Japan and Australia were examined with a colorimetric limulus test using a chromogenic substrate. The endotoxin levels of injection solutions in most products from both countries measured against E. coli 0111:B4 endotoxin or USP reference standard endotoxin were less than 0.2 pg or 0.0006 endotoxin units (EU) X ml-1. Only 2 solutions in 30 from both countries showed higher levels: 7.7 and 10.8 pg for E. coli 0111:B4 endotoxin X ml-1 (0.02 and 0.03 EU X ml-1). Even these higher values were well below the level recommended by the draft guideline published by the United States Food and Drug Administration (FDA). The endotoxin contamination level of a Japanese hemofiltration substitution fluid ranged from 8.2 to 9.2 pg E. coli 0111:B4 endotoxin X ml-1 (0.024-0.027 EU X ml-1). PMID- 3511394 TI - Progression of chronic pyelonephritis in the rat. AB - Thirteen of 20 female Wistar rats developed perihilar kidney scars 6 weeks after ascending infection with Escherichia coli 078. After removal of the lesser scarred kidney from 6 of the animals, all animals were followed for 54 weeks. Proteinuria (greater than 18 mg/24 h) developed at 20 weeks in the uninephrectomised infected rats and at 34 weeks in the 2-kidney infected model. In 10 uninephrectomised controls significant proteinuria did not appear until 52 weeks. In 9 2-kidney controls proteinuria did not develop at all. The speed of onset and severity of proteinuria was related to the extent of the renal parenchymal loss. Pyelonephritic scars did not show macroscopic progression over the 54-week observation period, even though the original renal infection persisted. Uninephrectomised animals with infected scars developed a highly significant rise of creatinine/body weight (p less than 0.02) and of heart weight/body weight p less than 0.02) ratios compared with the non-infected controls. Their kidneys showed focal and segmental hyalinosis and sclerosis of the glomeruli adjacent to the scars. Immunofluorescent staining for serum proteins was negative, but mesangial deposits of Tamm-Horsfall protein were found in the glomeruli between the scars in animals with renal impairment. These findings establish that progressive renal impairment in rats with infected kidney scars is associated with the development of proteinuria and a glomerulopathy. The cause of the glomerulopathy is not clear, both glomerular hyperfiltration and deposition of Tamm-Horsfall protein in glomerular mesangial cells may be involved. PMID- 3511395 TI - Relation between plasma aldosterone concentration and renal handling of sodium and potassium in alcoholics during the withdrawal phase. PMID- 3511396 TI - Risk factors in aluminum toxicity in children with chronic renal failure. PMID- 3511397 TI - End-stage renal failure after donor nephrectomy. AB - A 52-year-old man, who had undergone donor nephrectomy 14 years previously, recently developed end-stage renal failure himself. The recipient of the donated kidney still has normal renal function associated with marked proteinuria. This deterioration of kidney function emphasizes the need for meticulous pre-operative evaluation of potential kidney donors and for the long-term post-operative follow up of the donor as well as the recipient. PMID- 3511398 TI - Asymmetric hypertrophy of renal graft after transplantation. PMID- 3511399 TI - Subarachnoid hemorrhage and the heart. AB - Electrocardiographic abnormalities, both morphological and rhythmic, are frequently seen in association with spontaneous subarachnoid hemorrhage. These changes, which often reflect subendocardial damage, seem to be caused by hypothalamic stimulation leading to an acute increase in sympathetic tone. As a result, potentially life-threatening ventricular arrhythmias may develop in subarachnoid hemorrhage patients. These arrhythmias have responded to sympathetic blocking agents, which may also have a protective effect on subendocardial tissue in this setting. There is no evidence that the prophylactic administration of propranolol or other autonomic blockers significantly alters outcome in these patients. Ultimate morbidity and mortality are clearly related to the degree of intracerebral-intraventricular hemorrhage and vasospasm. This article reviews experimental and clinical evidence regarding the causes of cardiac abnormalities after subarachnoid hemorrhage, the types of abnormalities most frequently seen, their relationship with subendocardial lesions, and the role of autonomic blockers. PMID- 3511400 TI - Ernest Sachs (1879-1958): the first secretary--the power behind the throne. PMID- 3511402 TI - Progabide for refractory partial epilepsy: a controlled add-on trial. AB - Progabide, an experimental GABA-ergic antiepileptic drug, was given in a placebo controlled double-blind cross-over trial to 19 adult patients with chronic partial epilepsy refractory to previous high-dose antiepileptic drug therapy. A mean daily dose of 32 mg/kg (range, 16 to 63) of progabide did not significantly change the seizure frequency. In patients with a therapeutic response, progabide led to an increase in the plasma concentration of phenytoin and phenobarbital. Comedication with carbamazepine was associated with a poor response to progabide. Side effects were mild except for a several-fold increase of SGOT and SGPT, which required withdrawal of progabide in one patient. Progabide does not seem to be the drug urgently needed for failures of previous high-dose drug therapy. PMID- 3511401 TI - Torsion dystonia: a double-blind, prospective trial of high-dosage trihexyphenidyl. AB - We studied trihexyphenidyl in the treatment of torsion dystonia in a prospective, double-blind crossover protocol. Thirty-one patients completed the protocol. Twenty-two (71%) had a clinically significant response. After a mean follow-up of 2.4 years, 68% of patients continued to take trihexyphenidyl, and 42% continued to show a considerable or dramatic benefit. The 30-mg dose used was generally well tolerated. High-dosage trihexyphenidyl therapy is effective in the management of torsion dystonia. PMID- 3511403 TI - The secret life of James Parkinson (1755-1824): the writings of Old Hubert. PMID- 3511404 TI - High-dose intravenous methylprednisolone in the treatment of multiple sclerosis: clinical-immunologic correlations. AB - We conducted a double-blind trial of high-dose parenteral 6-methylprednisolone (MP) and placebo on 23 patients with acute MS. After the double-blind trial, the patients were given corticosteroids in gradually decreasing doses. The frequency of improvement was significantly higher and the bout duration significantly lower in the MP group than in the placebo group. The first signs of improvement (3 to 6 days after starting MP) were associated with a marked decrease in the rate of CNS IgG synthesis, but IgG CSF oligoclonal bands did not change. CNS IgG production slowly returned toward baseline despite progressive clinical improvement. PMID- 3511406 TI - [Evaluation of the effects of citicoline in chronic cerebrovascular diseases]. AB - A double-blind random block trial was carried out on 58 patients suffering from chronic cerebrovascular diseases as defined by the "Ad Hoc Committee, Paris 1980". The trial was carried out to assess the effects of citicoline on chronic cerebrovascular disease. Particular attention was paid to the selection of the assessment tools (neuropsychological and psychological tests). Citicoline treatment brought about an improvement in awareness and perceptive-motor faculties. This effect can be attributed to an overall drug action on neural energy metabolism. PMID- 3511405 TI - Low-dose bromocriptine therapy in Parkinson's disease: double-blind, placebo controlled study. AB - Twenty-one de novo parkinsonian patients in stage I to III of the Hoehn and Yahr scale completed a 6-month, double-blind, placebo-controlled study. Low-dose bromocriptine (15 mg daily) was effective. Rigidity improved more than tremor or bradykinesia. Sustained satisfactory benefit was seen only in patients with mild Parkinson's disease. PMID- 3511407 TI - [Evolution and current uses of telematics in medicine. Future prospectives of telemedicine]. AB - The medical use of data transmission has become a basic element in the application of telecommunications to medical practice. Hence the development of medical telematics i.e. the application of socalled "telematics" derived from the combined use of information science and telecommunications in medicine. In historical terms the foundations for medical telematics were laid in Italy in 1935 with the creation of the International Radiomedical Centre in Rome and more recently with the direct and indirect application of telematics to the flight and medical staff of the Air Rescue Service planes as well as the use--in space medicine--of special sensors computer-recorders, telecameras, etc., for the collection and long-distance transmission of data on the behaviour of men and animals during long space missions over the past 20 years. Other recent techniques enabling the long-distance transmission of data required for the long distance treatment of the sick are also reviewed with the emphasis on cardiology, neurology, radiology, radiodiagnosis, nuclear medicine, oncology, nephrology, ophthalmology, haematology, laboratory diagnosis, etc. There are many other objectives of supreme human and social value that efficiently organised medical telematics can attain to solve the many difficult problems involved in the gradual development of a truly effective health service for all. PMID- 3511408 TI - [Diagnosis of thyroid nodules]. AB - The basic features of the most common endocrine pathology, the thyroid nodule are analysed. After a brief assessment of the incidence of the condition the problem of clinical and instrumental diagnosis is tackled with the aim of demonstrating the value and possibility of sub-clinical diagnosis of micronodules. The present work aims to identify the fastest, most efficient and cheapest diagnostic procedure. PMID- 3511409 TI - [Controlled study of the effect of long-term administration of canrenoate potassium in cirrhotic ascites]. AB - Two groups of patients with water retention due to ascites in cirrhosis of the liver were treated with antialdosterone diuretics (42 cases with K-canrenoate and 48 cases with spironolactone) for prolonged periods of time (an average of more than 5 months). Both substances were seen to be active, re-equilibrating sodium and water balance, bearing in mind a few methodologic limitations described in the text. Investigation of possible side effects showed that the incidence of gynecomastia, which is fairly common with spironolactone, was considerably reduced or practically absent with K-canrenoate. PMID- 3511410 TI - [Controlled study of the analgesic effect and tolerability of buprenorphine in cancer patients]. AB - The analgesic efficacy and tolerability of a morphine agonist-antagonist buprenorphine are evaluated. The drug is compared to pentazocin. For this purpose, the drugs were randomly administered to 42 patients suffering from pain caused by advanced cancer. Buprenorphine demonstrated a significantly higher analgesic effect than pentazocin and was better tolerated. PMID- 3511411 TI - Comparison of tensile and shear strength of new and recycled orthodontic metal brackets. PMID- 3511412 TI - Effect of exercise on puberty, periods and pregnancy. PMID- 3511413 TI - Sanford E. Klein. President of the DSSNY, 1986: a profile. PMID- 3511414 TI - Pathophysiology and management of postcesarean endomyometritis. AB - Endomyometritis is the most common complication associated with cesarean delivery. The incidence varies from 5 to 85%, depending upon the patient population surveyed. The major risk factors for postcesarean endomyometritis are young age, low socioeconomic status, and extended duration of labor and ruptured membranes. The principal microorganisms responsible for infection are group B streptococci, aerobic gram-negative bacilli, anaerobic gram-positive cocci, and anaerobic gram-negative bacilli. The mean incidence of bacteremia in patients with endomyometritis is 10%. Less than 2% of infected patients develop life threatening complications such as septic shock, pelvic abscess, or septic pelvic thrombophlebitis. Antibiotics of proved value in treatment of postcesarean endomyometritis include the newer broad-spectrum cephalosporins and ureidopenicillins and the combination regimen of clindamycin plus aminoglycoside. PMID- 3511415 TI - Use of absorbable staples for closure of proximal end of ileal loops. AB - The use of the GIA stapler has reduced dramatically the operative time for the creation of urinary division ileal and colonic loops. It is widely known that steel staples in the urinary tract prompt stone formation around a foreign body. A case of stone formation around a GIA stainless steel staple is presented. A possible solution to this potential problem by the use of the new Polysorb Lactimer absorbable TA55 stapler is presented. PMID- 3511416 TI - Eccrine adenocarcinoma of the vulva producing isolated alpha-subunit of glycoprotein hormones. AB - A rare case of adenocarcinoma of the sweat glands of the vulva producing isolated alpha-subunit of glycoprotein hormones is reported. By an immunohistochemical method, eccrine gland adenocarcinoma tissues obtained from the right vulva and from its metastatic lesion in the right subclavicular lymph nodes were found to react with human chorionic gonadotropin (hCG), alpha-hCG but not beta-hCG. The concentrations of alpha-subunit in the serum and urine were markedly elevated to 6000 ng/mL and 55,000 ng/mL, respectively, just before the death of the patient. PMID- 3511417 TI - Anatomy and pathology of tubal pregnancy. AB - The prevalence of tubal pregnancy has increased markedly during the past decade. The reasons for this are obscure. A systematic gross and histopathologic study of 25 consecutive ectopic pregnancies has been performed using a clearing method not used previously for this purpose. In addition, the presence of the corpus luteum and its location in reference to the tubal pregnancy are documented. Results indicate that trophoblastic spread was predominantly intraluminal in 67% of cases. Intratubal hemorrhage, generally in parallel to trophoblastic spread, often led to marked tubal destruction. Histologic evidence of salpingitis was noted in only seven of 24 specimens (29%). The corpus luteum was contralateral to the ectopic pregnancy in five of 21 cases (23.8%). Clinical correlates and areas of future research are discussed. Results indicate that segmental resection of the tubal pregnancy is appropriate in selected cases. PMID- 3511418 TI - Spontaneous abortion and pregnancy outcome after normal first-trimester ultrasound examination. AB - The aim of the study was to assess the spontaneous abortion rate and pregnancy outcome in a population of women with a normal first-trimester ultrasound examination. Gestational age or bleeding was the indication for 90% of the ultrasound scans. The spontaneous abortion rate increased with advancing maternal age. Other factors affecting the rate were indication for the scan and gestational age at the time of the scan. In the overall group, disregarding maternal age, the spontaneous abortion rate was 2.3%. This background rate of spontaneous abortion can be used to assess the added risk of chorionic villus sampling or other first- or second-trimester procedures. The incidence of antepartum and intrapartum complications in these pregnancies corresponded well with published figures. PMID- 3511419 TI - Cefoxitin versus clindamycin and gentamicin in the treatment of postcesarean section infections. AB - Cefoxitin, a cefamycin derivative, has demonstrated activity against a broad spectrum of aerobic and anaerobic bacterial pathogens. The efficacy and safety of cefoxitin were compared with that of the combination of clindamycin and gentamicin in the treatment of postcesarean section infection. Ninety-eight patients were evaluated. Cefoxitin cured 36 of 48 patients (75%); clindamycin/gentamicin cured 38 of 50 (76%) (P greater than .05). Febrile degree hours and length of hospital stay did not differ between the two study groups. No patient experienced abscess formation or septic pelvic thrombophlebitis. Both therapies were well tolerated. In the authors' experience, cefoxitin as a single agent was as effective in the treatment of postoperative pelvic infection as the combination of clindamycin and gentamicin. PMID- 3511420 TI - Ultrasonic assessment of fetal response to second-trimester amniocentesis. AB - Twenty-three patients undergoing second-trimester amniocentesis were ultrasonically monitored for 30 minutes before and 30 minutes after the amniocentesis. Fetal movements were recorded as movements of limbs, trunk, or combined limb-trunk movements. Fetal heart rates were determined at ten-minute intervals before and after the amniocentesis. No significant increase in total fetal movements, limb movements, trunk movements, or heart rate were found. A significant increase in combined fetal movements was observed. The authors conclude that amniocentesis in the second trimester elicits a change in fetal movement pattern. PMID- 3511421 TI - Effect of maternal glucose ingestion compared with maternal water ingestion on the nonstress test. AB - Ninety-three nonstress tests were performed on 57 nondiabetic patients at greater than 34 weeks' gestation. Maternal whole blood glucose levels were measured before beginning the nonstress test and within five minutes of the second fetal heart rate acceleration. There was a significant rise in maternal whole blood glucose levels in the maternal glucose ingestion group but not in the maternal water ingestion group. There was no significant difference in the mean time to reactivity between the two groups. These results suggest that maternal glucose ingestion does not affect time to reactivity or the incidence of reactive nonstress tests. PMID- 3511422 TI - Evaluation of the OvuSTICK urinary luteinizing hormone kit in normal and stimulated menstrual cycles. AB - The rapid analysis of luteinizing hormone (LH) in urine would provide a useful clinical tool in the diagnosis and treatment of infertility in women. Urinary LH levels were measured in midday and evening specimens collected during 75 normal and stimulated menstrual cycles (55 women) using a rapid, visual, semiquantitative enzyme immunoassay dipstick test (OvuSTICK) and compared with basal body temperature (BBT) records, visualization of follicular collapse by daily ultrasonography, and serum hormone levels. In all 75 cycles studied, an LH surge (or its absence) in urine was associated with a biphasic (or monophasic) BBT record and/or serum progesterone. In addition, when serum and urine samples were obtained simultaneously, the day of the LH surge (or its absence) in the urine and serum correlated 100%. Discrepancies between ovulation as diagnosed by ultrasound and the LH surge in urine and/or serum in several patients suggested that individual factor(s) may affect the interpretation of ultrasound imaging. It appears that a simple, rapid, clinically reliable colorimetric method such as the OvuSTICK urinary LH test is an important parameter for predicting the time of ovulation. PMID- 3511423 TI - Obstetric management of conjoined twins. AB - Three cases of conjoined twins are presented: two thorocopagus and one craniopagus. The diagnosis of conjoining varied from late second trimester to time of term delivery. Delivery mode was both by vaginal and cesarean routes, and occurred at both level one and level three hospitals. Antenatal diagnostic procedures and issues in obstetric management are discussed. A suggested obstetric management sequence for conjoined twins is proposed. PMID- 3511424 TI - Intrauterine membranous cyst: a report of antenatal diagnosis and obstetric aspects in two cases. AB - A large, intrauterine membranous cyst originating from the subchorionic layer of the placenta was diagnosed by ultrasound in two pregnancies. The cyst was attached in both cases near the cord insertion. In one pregnancy this condition resulted in fetal growth retardation and diminution of umbilical circulation, but both of the deliveries were uncomplicated. This abnormality indicates careful monitoring of pregnancy and labor. PMID- 3511425 TI - Lipomyelomeningocele: prenatal diagnosis and management. AB - Spina bifida is one of the many congenital malformations possibly detectable in utero with ultrasound. Prenatal diagnosis can be useful in planning prompt, appropriate neonatal care of the infant. Lipomyelomeningocele (lipomyeloschisis) is a common subtype of spinal dysraphism. Prognosis for the infant with this skin covered lesion is very good if appropriate care is provided early. Neonatal resection of these congenital lipomatous tumors is necessary to prevent tethering of the spinal cord that might lead to irreversible neurologic damage if not released. The prenatal ultrasonic appearance of lipomyelomeningocele is illustrated and the clinical presentation, implications, and neonatal neurosurgical care are reviewed. PMID- 3511426 TI - Myospherulosis of the alveolus secondary to the use of Terra-Cortril and Gelfoam. Report of a case. AB - Myospherulosis is a recently discovered disease apparently caused by the placement of mineral oil- or petrolatum-based products into various tissues. Terra-Cortril (a tetracycline/steroid ointment in a petrolatum base) on Gelfoam has been placed in the sockets of surgically removed third molars in an attempt to eliminate the occurrence of dry sockets. The case report presented here documents the radiographic progress of the disease for 6 years, showing an attempt by the bone to repair itself. A surgical procedure was performed to remove the affected tissue, and photographs were taken to illustrate the clinical appearance of the disease. The specimen consisted of a black, tarlike material which was completely encased in bone. Histologic examination was consistent with a diagnosis of myospherulosis. PMID- 3511427 TI - Oral herpes simplex infection in bullous pemphigoid. AB - A case of recurrent oral herpes simplex virus infection complicating bullous pemphigoid is described. The possibility of herpesvirus infection should always be considered in immunosuppressed patients with oral ulceration, including those patients with bullous disorders. PMID- 3511428 TI - A practical classification of acute cervical spine injuries. AB - This article presents a practical classification of acute cervical spine injuries based on terminology with generally accepted and understood definitions, published results of experimentally produced acute injuries of the cervical spine, and the correlation of the radiographic and pathologic characteristics of the laboratory models with acute clinical injuries. PMID- 3511429 TI - [The pioneer of gynecologic surgery in Transylvania (Gabor Engel)]. PMID- 3511430 TI - [Prostacyclin metabolism disorders in the hemolytic uremia syndrome in the blood of children and members of their family]. PMID- 3511431 TI - [In memoriam Sandor Rex]. PMID- 3511432 TI - [Possibilities of real-time sonography in the diagnosis of acute complications of aneurysm of the abdominal aorta]. PMID- 3511433 TI - [Intraoperative localization of kidney stones by real-time ultrasound]. PMID- 3511434 TI - HMC nurses care for Penn State artificial heart recipient. Interview by Eunice Cole. PMID- 3511436 TI - Pericardial effusion presenting as an anterior mediastinal mass. AB - The authors present a case of pericardial effusion in a patient with previous cardiac surgery. Because the pericardium is opened and not reclosed during surgery, fluid can extend superior to the normal upper reflections of the pericardium and simulate an anterior mediastinal mass. PMID- 3511435 TI - Ultrasound in the diagnosis of systemic candidiasis (renal and cranial) in very low birth weight premature infants. AB - Premature infants, (in whom prolonged hyperalimentation long term indwelling catheters are used), serve as the ideal hosts for overwhelming Candida sepsis. Two cases of disseminated Candidiasis were studied. Case 1 had sonographically enlarged and highly echogenic kidneys. Case 2 had diffusely enlarged echogenic kidneys with actual fungus balls in the collecting system. This infant also developed hydrocephalus with debris in the ventricular system and abnormal brain parenchymal echogenicity. PMID- 3511437 TI - Real-time ultrasound in Crohn's disease: characteristic features and clinical implications. AB - Thirty-two children with Crohn's disease were evaluated by real-time ultrasonography. The typical pattern of Crohn's disease caused by bowel wall thickening is the "bull's eye phenomenon", the elongated tubular stiff bowel loop with narrowing of the lumen and the small bowel conglomerate tumor. In indefinable abdominal complaints sonography may lead to the correct diagnosis. The differential diagnosis of similar sonographic features and the limitations of ultrasound in gastrointestinal disease must be considered. In proven Crohn's disease the findings in follow-up match the clinical course and may delineate complications, such as ileus, abscess, hydronephrosis, gallstones or involvement of parenchymal organs, as seen in 15 patients. Thus ultrasound will restrict repeated x-ray studies and support patient management. PMID- 3511438 TI - Shard-like calcifications in retroperitoneal teratomas. AB - Retroperitoneal teratomas can have characteristic roentgenographic findings. Three children with that neoplasm had roentgenographic assessments of the tumor which revealed similar "shard-like" calcifications. The effect of the tumor on the kidneys produced hypertension in all the patients which abated post operatively. Extensive imaging evaluations in similar patients seems unnecessary since the findings are virtually pathognomonic. Only a single urinary tract study and plain film investigation of the abdomen are advised prior to expeditious surgery. PMID- 3511439 TI - Digoxin- and digitoxin-like immunoreactive substances in amniotic fluid, cord blood, and serum of neonates. AB - Using four different digoxin kits, it was disclosed that the majority of various samples including amniotic fluid, cord blood, and serum from neonates contained substantial levels of digoxin-like immunoreactive substance. The differences in data seemed to be due to the range of epitopes which are recognized by antidigoxin antiserum. The day-to-day studies on sera serially obtained from infants at birth to 48 days old revealed that the level of the substance (0.31 +/ 0.12 ng/ml) in sera of the 1-day-old neonates rapidly declined to the level of 0.1 ng/ml by the 2nd postnatal wk and thereafter gradually declined. The immunological specificity and accuracy of the detection of digoxin-like immunoreactive substance was confirmed by a sample dilution test, a recovery test for standard digoxin, and an absorption test with antidigoxin antiserum. The amniotic fluid and cord blood also contained four to eight times more of a digitoxin-like immunoreactive substance than they did digoxin-like immunoreactive substance. A significant correlation was observed between the levels of digoxin like immunoreactive substance and of digitoxin-like immunoreactive substance (p less than 0.01). PMID- 3511440 TI - Role of glucose in the regulation of endogenous glucose production in the human newborn. AB - The role of plasma glucose concentration in the regulation of endogenous glucose production in the human newborn was examined by infusing glucose at 2.6-4.6 mg/kg . min as a continuous infusion to eight normal term appropriate for gestational age infants, five preterm, and six small for gestational age infants. All infants were healthy, had no overt clinical problems and were studied 6 h after their last feed. Glucose production rates were measured during the basal state and during glucose infusion by tracer dilution using [6,6(2)H2]glucose. The rate of glucose production during the basal state was similar in preterm and term appropriate for gestational age infants (appropriate for gestational age 3.53 +/- 0.32, preterm 3.49 +/- 0.38 mg/kg . min, mean +/- SD), while it was higher in the small for gestational age infants (4.25 +/- 0.98, p less than 0.03) as compared with appropriate for gestational age. During glucose infusion, the peak glucose concentration was related to the rate of glucose infusion. The endogenous glucose production rates during glucose infusion were variable in the three groups. However, a negative correlation between peak glucose concentration and endogenous glucose production rate was observed (r = 0.59, p = 0.006). The insulin response to glucose infusion was comparable in all infants. In addition, three small gestational age and one preterm infants, who had become hypoglycemic in the immediate newborn period, were studied while they were receiving parenteral glucose and their plasma glucose had stabilized at 55.5 +/- 10.25 mg/dl. Tracer kinetic studies showed persistence of endogenous glucose production in these infants even though they were receiving high rates of exogenous glucose infusion.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3511441 TI - Glucocorticoid-mediated alteration of fluidity of brush border membrane in rat small intestine. AB - The normal biophysical properties of the maturing mammalian enterocyte membrane are poorly understood. While the effects of glucocorticoids on maturation of intestinal enzyme function has been intensively investigated, their effects on membrane biophysical properties are not known. We used 1,6-diphenyl-1,3,5 hexatriene as a probe in fluorescence anisotropy studies to determine the fluidity of rat brush border membrane. Maturational changes and the effects of glucocorticoids administered antenatally or postnatally were determined. Fluorescence anisotropy values for 1,6-diphenyl-1,3,5-hexatriene in mature brush border membranes were higher than those values in membranes obtained from younger animals reflecting a less fluid membrane. Glucocorticoids administered to suckling rats increased the anisotropy values of 1,6-diphenyl-1,3,5-hexatriene in the membranes compared to saline-administered littermates. The anisotropy of intestinal brush border membrane was also increased in fetal rats whose mothers received dexamethasone. These alterations may relate to protein-binding properties and permeability characteristics of the enterocyte membrane. PMID- 3511442 TI - Tissue and serum concentrations of somatomedin-C/insulin-like growth factor I in fetal rats made growth retarded by uterine artery ligation. AB - To study the role of somatomedin-C/insulin-like growth factor I (Sm-C/IGF I) in fetal growth, intrauterine growth retardation was induced by uterine artery ligation on day 17 of gestation in pregnant rats. Fetuses of the nonligated horns served as appropriately grown controls. On day 21 of gestation, fetal serum, liver, and lung were obtained and analyzed for Sm-C/IGF I by radioimmunoassay. Serum insulin was determined by radioimmunoassay and serum glucose by a glucose oxidase method. Fetal weight, serum concentrations of glucose, insulin and Sm C/IGF I, and liver Sm-C/IGF I concentrations were reduced in fetuses from uterine artery ligated horns, as compared to those from nonligated control horns. Fetal weight was correlated with serum glucose (r = 0.703; p less than 0.001), liver Sm C/IGF I (r = 0.682; p less than 0.001), and serum Sm-C/IGF I (r = 0.452; p less than 0.001). Stepwise linear regression demonstrated that these three factors in combination correlated highly with fetal weight (r = 0.836). No correlation was found for serum insulin or lung Sm-C/IGF I and fetal weight. Serum insulin concentrations correlated with serum, but not liver, Sm-C/IGF I concentrations, making a direct effect of insulin on Sm-C/IGF I synthesis appear unlikely. However, serum glucose concentrations correlated with liver (r = 0.404; p less than 0.001) and with serum Sm-C/IGF I (r = 0.308; p less than 0.002) concentrations, implicating fetal glucose delivery in the regulation of Sm-C/IGF I synthesis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3511443 TI - Opsonic and protective activity of immunoglobulin, modified immunoglobulin, and serum against neonatal Escherichia coli K1 infection. AB - Because modified immune serum globulin (M-ISG) has been proposed for therapy in neonatal bacterial sepsis, we evaluated it in a suckling rat model of Escherichia coli K1 sepsis. We compared a M-ISG preparation (lot 2581), which was protective against group B streptococcal (GBS) sepsis, with other M-ISG, standard ISG preparations and with adult and cord serum. All immune serum preparations and sera demonstrated opsonic activity against E. coli K1 and were superior to saline in protecting against death due to E. coli K1 sepsis. Survival rates were higher for one M-ISG preparation (lot 2581) than for randomly selected standard immune serum globulin and cord sera but were similar to adult sera in these protection studies. Therapeutic and opsonic activity of standard immune serum globulin and M ISG prepared from the same donors were similar, suggesting that the different processes used for their manufacture did not affect these activities. Because the M-ISG preparation studied showed protective activity to both GBS and E. coli K1, we studied it further by adsorbing the preparation with GBS and E. coli K1. Opsonic activity to E. coli K1 was removed by E. coli adsorption but not by adsorption with GBS, indicating that this activity was not due to a single cross reacting antibody. Empirical therapy with M-ISG prescreened for opsonic activity to both E. coli K1 and GBS may be of clinical value. Trials appear warranted to study the pharmacology and efficacy of M-ISG in septic newborns. PMID- 3511444 TI - Bone marrow transplantation experience for children with aplastic anemia. AB - From May 1971 through December 1981, 81 children (22 months to 17 years of age) received allogeneic bone marrow grafts for severe aplastic anemia. All donors were HLA-identical family members. Fifty-seven of the 81 (70%) are still alive. Twenty-three untransfused patients were conditioned with cyclophosphamide, 50 mg/kg/d, for four days, and 19 (83%) have survived from 5 to 12 years. All 58 transfused patients were conditioned with cyclophosphamide, 50 mg/kg/d, for four days, 11 received additional immunosuppression, and 19 received posttransplantation donor buffy coat cells. Thirty-eight (65%) have survived from 3 to 13 years (P = .1). In a multivariate analysis, the only factor significantly associated with increased survival among patients with sustained grafts was the absence of significant graft v host disease (P less than .0001). The factors significantly related to increased rejection were low bone marrow cell dose (P less than .05) and positive relative response in mixed leukocyte culture (P less than .0001), but the addition of buffy coat cells did not significantly influence graft rejection. The development of grades II to IV acute graft v host disease was associated with random donor platelet refractoriness (P less than .05) and donor/recipient sex differences (P less than .05). Patients at highest risk for chronic graft v host disease were those patients who developed significant acute graft v host disease (P less than .01) and who received buffy coat infusions (P less than .025). All patients who were untransfused had a negative relative response and were not refractory to random donor platelets. PMID- 3511445 TI - Long-term outcome of group B streptococcal meningitis. AB - Group B Streptococcus is a common cause of neonatal sepsis and meningitis. The purpose of this study was to evaluate the neurologic, psychologic, and academic status of children who had group B streptococcal meningitis and to compare these children with their siblings. Seventy-four children who acquired group B streptococcal meningitis between one day and 6 months of life formed the study population. Survivors were 3 to 18 years old at the time of their follow-up evaluations. Twenty children (27%) died, two were institutionalized, one severely affected child died at age 2 years, 15 were assessed by phone interview, and two were lost to follow-up. Thirty-four children and 21 siblings were comprehensively evaluated with physical and neurologic examinations, hearing tests, and tests of intellectual, perceptual-motor, and behavioral-adaptive functions. Of the total population, nine children (12%) had major neurologic sequelae (spastic quadraplegia, profound mental retardation, hemiparesis, deafness, or blindness). Six children had acute hydrocephalus; two were doing well after shunt placement. In general, those children surviving group B streptococcal meningitis without major sequelae appeared to be functioning normally or comparably to their sibling in intellectual, social, and academic matters. PMID- 3511446 TI - The current status and portability of our sequence handling software. AB - I describe the current status of our sequence analysis software. The package contains a comprehensive suite of programs for managing large shotgun sequencing projects, a program containing 61 functions for analysing single sequences and a program for comparing pairs of sequences for similarity. The programs that have been described before have been improved by the addition of new functions and by being made very much easier to use. The major interactive programs have 125 pages of online help available from within them. Several new programs are described including screen editing of aligned gel readings for shotgun sequencing projects; a method to highlight errors in aligned gel readings, new methods for searching for putative signals in sequences. We use the programs on a VAX computer but the whole package has been rewritten to make it easy to transport it to other machines. I believe the programs will now run on any machine with a FORTRAN77 compiler and sufficient memory. We are currently putting the programs onto an IBM PC XT/AT and another micro running under UNIX. PMID- 3511447 TI - Thymine glycol lesions terminate chain elongation by DNA polymerase I in vitro. AB - Single-strand circular DNA from bacteriophage M13mp9 was chemically modified with osmium tetroxide to introduce specifically cis-thymine glycol lesions, a major type of DNA damage produced by ionizing radiation. An oligonucleotide primer was extended on damaged and undamaged templates using either the large fragment of E. coli pol I or T4 DNA polymerase. The reaction products were analysed by electrophoresis alongside a DNA sequence ladder. Synthesis on the damaged templates terminated at positions opposite thymine bases in the template. These results indicate that cis-thymine glycol lesions in single-strand DNA constitute blocks to synthesis by DNA polymerases in vitro. Surprisingly, replication halts after the correct nucleotide, dAMP, is inserted opposite the lesion. These results imply that the primary effect of the thymine glycol lesion is suppression of DNA synthesis and that the lesion is not a potent mutagen. PMID- 3511448 TI - Influence of the polyamines spermine and spermidine on yeast tRNAPhe as revealed from its imino proton NMR spectrum. AB - A comparison of imino proton NMR spectra of yeast tRNAPhe recorded at various solution conditions indicates, that polyamines have a limited effect on the structure of this tRNA molecule. Polyamines are found to catalyse the solvent exchange of several imino protons in yeast tRNAPhe not only of non hydrogen bonded imino protons, but also of imino protons of the GU and of some AU and tertiary base pairs. It is concluded that at low levels of catalysing components the exchange rates of the latter protons are not determined by the base pair lifetime. In the presence of high levels of spermidine the solvent exchange rates of imino protons of several base pairs in the molecule were assessed as a function of the temperature. Apparent activation energies derived from these rates were found to be less than 80 kJ/mol, which is indicative for (transient) independent opening of the corresponding base pairs. In the acceptor helix the GU base pair acts as a dynamic dislocation. The AU base pairs at one side of the GU base pair exhibit faster transient opening than the GC base pairs on the other side of this wobble pair. The base pairs m2GC10 and GC11 from the D stem and GC28 from the anticodon stem show relatively slow opening up to high temperatures. Model studies suggest that 1-methyladenosine, an element of tRNA itself, catalyses imino proton solvent exchange in a way similar to polyamines. PMID- 3511449 TI - Dream sense. PMID- 3511450 TI - War memories. PMID- 3511451 TI - Colonic perforation in Shigella dysenteriae 1 infection. PMID- 3511452 TI - Bilateral neonatal group A streptococcal hydrocele infection associated with maternal puerperal sepsis. PMID- 3511453 TI - BCG skin infection. PMID- 3511454 TI - Vaccine prevention of Haemophilus influenzae type b disease: past, present and future. AB - In little more than half a century we have come a long way toward the eventual elimination of invasive Hib disease as a major threat to children in the United States. The Haemophilus b polysaccharide vaccine has provided the first tool for large scale public health intervention efforts in specific target groups of children older than 18 months of age who are likely to benefit from immunization. Immunization programs using the currently available vaccine represent an interim measure that is likely to be replaced within the next few years by new programs utilizing an improved vaccine with greater potential for preventing invasive Hib disease in susceptible infants and young children. Prospects appear good that an improved second generation vaccine that will provide protective efficacy in infants during the first year of life will become available in the near future. PMID- 3511455 TI - Pharmacology of erythromycin in adults. PMID- 3511456 TI - Chlamydial infections in pediatrics: diagnostic and therapeutic considerations. PMID- 3511457 TI - Neutrophils and antiviral defense. PMID- 3511458 TI - Cholera: a worldwide perspective. PMID- 3511459 TI - Diarrhea associated with Aeromonas hydrophila. PMID- 3511460 TI - Detection of Cryptosporidium sp. infections using a direct immunofluorescent assay. PMID- 3511462 TI - Immunoassays for the diagnosis and study of viral gastroenteritis. PMID- 3511461 TI - Pediatric diarrhea: the challenge of prevention. PMID- 3511463 TI - Classical bacterial diarrhea: perspectives and update--Salmonella, Shigella, Escherichia coli, Aeromonas and Plesiomonas. AB - Impressive advancements in our understanding of the mechanisms of diarrhea production and of the epidemiologic importance of these "classical" bacterial enteropathogens have been accomplished, but many areas are in need of further exploration. The recent development of gene probes and enzyme-linked immunosorbent assays for the identification of EPEC, ETEC and EIEC will enhance immeasurably the ability to carry out large scale epidemiologic studies which are still needed to clarify the global importance of these pathogens in infantile diarrhea. For some of these organisms pathogenic mechanisms remain incompletely understood and the role of antibiotics is not well-established. The delineation of virulence factors, immunity and the construction of attenuated strains through DNA recombination technology are bringing the worthy goal of prevention through vaccination into view. These advances should not, however, detract attention from the primary reason that these bacteria continue to be a major cause of childhood morbidity and mortality in the developing world, which is lack of adequate sanitation. Efforts to provide clean water, safe waste disposal and hygiene education need to proceed in conjunction with development of vaccines. PMID- 3511464 TI - Proliferative responses of rat ventral prostate: effects of variations in organ culture media and methodology. AB - Effects of variations in organ culture media and methodology on the proliferative activity of rat ventral prostate and its response to testosterone were investigated quantitatively by using the incorporation of [125I]-iododeoxyuridine (125I-UdR) to monitor DNA synthesis. In serum-free medium, maximal increases in DNA synthesis occurred when testosterone was introduced during the first 48 hours of the culture. Supplementation of the medium with 5% fetal calf serum did not alter the responses in control or testosterone-treated cultures, whereas the addition of insulin (3 micrograms/ml) alone or in combination with serum promoted cell proliferation in testosterone-free cultures and enhanced the stimulatory effect of testosterone. Unlike grid-supported cultures, suspension cultures of rat ventral prostate exhibited increased proliferative activity both in the presence and absence of testosterone. Thus, variations in experimental procedure may account for differences in the proliferative activity of rat prostate between organ culture studies. PMID- 3511465 TI - Common bacterial pneumonitis in infants. Determining the etiology and tailoring the treatment. AB - In infantile pneumonia, we recommend close attention to the history and physical examination. Baseline studies, including CBC, ESR, blood cultures, and chest film, should be performed at onset and repeated as warranted. Nasopharyngeal secretions or washings should be drawn by means of gentle suction and specimens sent for Gram stain, fluorescent antibody stain for respiratory syncytial virus, and culture for bacteria and for viruses if possible. Acute and convalescent serum specimens should be obtained in serious cases to search for antibodies to RSV, adenovirus, influenza, parainfluenza, cytomegalovirus, and Chlamydia. Serum and urine specimens may be collected for countercurrent immunoelectrophoresis and latex agglutination testing for Hemophilus influenzae type B, Streptococcus pneumoniae, and if indicated, group B streptococcus. If deterioration continues and all tests are negative, the clinician should consider a more invasive procedure such as flexible fiberoptic bronchoscopy, needle aspiration, or open lung biopsy. While awaiting identification of the pathogen, the physician should institute empiric therapy with optimum doses of antimicrobials and monitoring of serum levels of drug. Often the clinician is faced with deterioration and a negative workup. In this situation, other agents may be added, such as antifungal, antiviral, antiprotozoan, and antituberculous agents, as well as various antibiotics, to cover rare and unusual pathogens. Further consultation, even by phone, may at this point provide some insight into an otherwise confusing case. PMID- 3511466 TI - Geisinger: a tradition of service, a commitment to the future. PMID- 3511467 TI - Tissue expansion. A fascinating frontier of reconstructive surgery. PMID- 3511468 TI - Coping with insomnia. Helping patients manage sleeplessness without drugs. AB - Sleep, a vital ingredient in life, is often taken for granted until something goes awry and sleep no longer comes easily. Occasional bouts of sleeplessness are normal, but for some persons, perhaps as much as 20% of the adult population, insomnia is a recurring problem for which they may turn to over-the-counter or prescription sleeping pills as a solution. In all but the most extreme cases, however, medication is not necessary and nondrug remedies are sufficient for lulling the patient back to sleep. In this article, Dr Fletcher describes what everyone should know about the complex process of sleep and offers suggestions, including some familiar old-fashioned home remedies, on what to do when sleep is evasive. PMID- 3511469 TI - Escherichia coli as cause of ecthyma gangrenosum. PMID- 3511470 TI - Hyperbaric oxygen therapy. Promoting healing in difficult cases. AB - Inhalation of pressurized 100% oxygen is a helpful adjunctive treatment for certain patients, because the increased oxygen carried by the blood to the tissue enhances new growth of microcirculation and, thus, healing. Patients with tissue breakdown after radiation therapy, refractory osteomyelitis, gas gangrene, soft tissue infection with necrosis from mixed aerobic and anaerobic organisms, crush injuries resulting in acute ischemia, and compromised skin grafts or non-healing wounds are likely to benefit from hyperbaric oxygen therapy. PMID- 3511471 TI - Evolution and organization of the human protein C gene. AB - We have isolated overlapping phage genomic clones covering an area of 21 kilobases that encodes the human protein C gene. The gene is at least 11.2 kilobases long and is made up of nine exons and eight introns. Two regions homologous to epidermal growth factor and transforming growth factor are encoded by amino acids 46-91 and 92-136 and are precisely delimited by introns, as is a similar sequence in the genes for coagulation factor IX and tissue plasminogen activator. When homologous amino acids of factor IX and protein C are aligned, the positions of all eight introns correspond precisely, suggesting that these genes are the product of a relatively recent gene duplication. Nevertheless, the two genes are sufficiently distantly related that no nucleic acid homology remains in the intronic regions and that the size of the introns varies dramatically between the two genes. The similarity of the genes for factor IX and protein C suggests that they may be the most closely related members of the serine protease gene family involved in coagulation and fibrinolysis. PMID- 3511472 TI - Short synthetic oligodeoxyribonucleotide leader sequences enhance accumulation of human proinsulin synthesized in Escherichia coli. AB - Enhanced accumulation of human proinsulin synthesized in Escherichia coli has been achieved by inserting a short leader of homooligopeptide at the amino end of proinsulin. Out of 20 amino acid oligomers studied, (Ala)6, (Asn)6, (Cys)7, (Gln)7, (His)6, (Ser)6, and (Thr)6 leaders were the most effective, with the yield of proinsulin ranging between 6% and 26% of the total bacterial protein. These constructions were made by inserting a synthetic oligodeoxyribonucleotide duplex, coding for a small homooligopeptide, between a synthetic proinsulin gene and an eight-codon beta-galactosidase gene residue in vector pUC8. Cyanogen bromide cleavage of the 102 amino acid fused polypeptide yielded a species identical to authentic proinsulin, as judged by NaDodSO4/PAGE and radioimmunoassay. PMID- 3511473 TI - Purification of microsomal signal peptidase as a complex. AB - We report here the purification to near homogeneity of signal peptidase from canine pancreatic microsomes. Purification was monitored using an improved post translational assay. A 42-fold enrichment over starting membranes was achieved by selective solubilization in nonionic detergent/high-salt buffer followed by gradient sievorptive anion and cation exchange chromatography, hydroxylapatite chromatography, gel filtration, and sucrose gradient velocity sedimentation. When examined by NaDodSO4/PAGE, the purified enzyme consisted of a complex of six polypeptides with apparent molecular masses of 25, 23, 22, 21, 18, and 12 kDa. The 22- and 23-kDa subunits were shown to be glycoproteins based on their sensitivity to endoglycosidase H and their ability to bind concanavalin A. We suggest that only one subunit of this complex carries out signal peptide cleavage. The structural association of the other subunits in stoichiometric amounts may reflect their requirement in chain translocation across the microsomal membrane. PMID- 3511474 TI - Plasma high density lipoprotein is increased in man when low density lipoprotein (LDL) is lowered by LDL-pheresis. AB - Plasma high density lipoprotein (HDL) concentrations were increased in five hypercholesterolemic normoglyceridemic patients after removal of plasma low density lipoprotein (LDL) by LDL-pheresis. In each patient up to 80% of circulating LDL was removed by passing plasma through immunoadsorption columns containing antibody to apolipoprotein B immobilized to Sepharose. Rebound of LDL was slow after the procedure: 5-7 days in four non-familial hypercholesterolemic patients and greater than 14 days in one patient with homozygous familial hypercholesterolemia. Plasma HDL rose above the pretreatment baseline during the interval between treatments in four of the five patients. When treatments were repeated weekly, time-averaged plasma LDL was lowered by 40-70%, while plasma HDL cholesterol and apolipoprotein AI were increased up to 2-fold, depending on the degree of LDL lowering. Plasma HDL concentrations fell back to their baseline values when LDL-pheresis was stopped and rose again when treatment was restarted. Thus, LDL-pheresis may augment the therapeutic effectiveness of LDL lowering by raising plasma HDL levels and the concentration of HDL relative to LDL. PMID- 3511476 TI - Antibodies to surface antigens of pigmented cells in animals with vitiligo. AB - All of 24 animals (dogs, cats, and horses) with vitiligo were found to have antibodies to pigmented cells that could be detected by specific immunoprecipitation of radioiodinated, detergent-soluble surface macromolecules, and by indirect immunofluorescence on viable cells. These antibodies were not detected in 17 normal animals of the same species. The antibodies were directed to an 85-kDa surface antigen selectively expressed by pigmented cells that was not present on nonpigmented control cells. These observations suggest that vitiligo in animals is an autoimmune disease mediated to pigmented cells. PMID- 3511475 TI - Insulin-like growth factor I/somatomedin C: a potent inducer of oligodendrocyte development. AB - Cell cultures established from cerebrum of 1-day-old rats were used to investigate hormonal regulation of the development of oligodendrocytes, which synthesize myelin in the central nervous system. The number of oligodendrocytes that developed was preferentially increased by insulin, or by insulin-like growth factor I (IGF-I), also known as somatomedin C. High concentrations (5 micrograms/ml) of insulin were required for substantial induction of oligodendrocyte development, whereas only 3.3 ng of IGF-I per ml was needed for a 2-fold increase in oligodendrocyte numbers. At an IGF-I concentration of 100 ng/ml, oligodendrocyte numbers were increased 6-fold in cultures grown in the presence of 10% fetal bovine serum, or up to 60-fold in cultures maintained in serum-free medium. IGF-I produced less than a 2-fold increase in the number of nonoligodendroglial cells in the same cultures. Type I IGF receptors were identified on oligodendrocytes and on a putative oligodendrocyte precursor cell population identified by using mouse monoclonal antibody A2B5. These results indicate that IGF-I is a potent inducer of oligodendrocyte development and suggest a possible mechanism based on IGF deficiency for the hypomyelination that results from early postnatal malnutrition. PMID- 3511477 TI - 2-Methyl-3,3-diphenyl-3-propanolamine (2-MDP) selectively antagonises N-methyl aspartate (NMA). AB - Using electrophoretic application to rat central neurones in vivo, and bath application to frog spinal cord in vitro, 2-methyl-3,3-diphenyl-3-propanolamine was found to be a selective antagonist of N-methyl-DL-aspartate, but not of quisqualate or kainate. In this respect the (-) isomer proved to be about three times more potent than the (+) in both preparations. PMID- 3511478 TI - Ultrasound therapy of subacromial bursitis. A double blind trial. AB - Ultrasound (US) is used widely to treat patients with supraspinatus tendinitis, subacromial bursitis, or adhesive capsulitis (SSA). No double blind studies of US in the treatment of SSA, however, have been conducted. This study was designed to determine whether the addition of US can further decrease pain and increase range of motion in those receiving the usual courses of ROM exercises and nonsteroidal anti-inflammatory drugs (NSAIDs) or ROM exercises in patients with SSA. Twenty patients with SSA were randomized to receive true or sham US three times a week for four weeks. All other aspects of treatment remained constant (ROM exercises and NSAIDs or ROM exercises). The physician, the physical therapist, and the patients were blinded throughout the study regarding the delivery of the true or sham US. Of the multiple variables analyzed (pain, ROM, and function), no significant difference was found between the sham or true US groups. Although the study group was small, the results suggest that US is of little or no benefit when combined with ROM exercises and NSAIDs or ROM exercises in the treatment of SSA. PMID- 3511479 TI - Mechanisms of cellular nutrition. PMID- 3511480 TI - Translation of sensory signals into commands for control of saccadic eye movements: role of primate superior colliculus. AB - Afferent signals that guide orienting movements converge in the deeper layers of the SC in a wide variety of animals. The sensory cells are arranged topographically according to their receptive-field locations and, thereby, form maps of sensory space. Maps of visual, somatosensory, and/or auditory space have been obtained in the iguana, mouse, hamster, barn owl, chinchilla, cat, and monkey. The deeper layers of the SC also contain neurons involved in the generation of movements of the eyes, head, vibrissae, and pinnae. Thus the SC, a site containing multiple sensory maps and perhaps multiple motor maps, has been selected by many investigators as a structure for investigating the problem of sensorimotor integration. In the mammalian nervous system, emphasized in this review, much remains to be learned about the structure, organization, and function of the SC. While anatomical studies continue to add to the knowledge of the sources of afferent projections, their pattern of laminar termination, and the source and destination of efferent projections, relatively little is known about the intrinsic organization of the colliculus, especially the deeper layers. Recently, electrophysiological studies have moved from an emphasis on the sensory and motor properties of collicular neurons to an examination of the maps of auditory and somatosensory space and the correspondence of these maps. In the future, major efforts aimed at identifying the functional properties of cells that project to the SC from diverse brain regions as well as the functional properties that project to the various structures receiving input from the colliculus are needed. A combination of anatomical and electrophysiological methods is required to describe the signal transforms that occur between the SC and motor areas (such as the paramedian pontine reticular formation) closer to the final common pathway. Conceptual and empirical work is needed to develop and test models of how the dynamic visual and auditory maps found in the primate SC are generated. In general, new and/or improved models of the role of the SC in sensorimotor integration are needed as guides for future research. A point of view emphasized here is that it may be fruitful to examine the function of the SC from a motor perspective. The nature of the motor command imposes constraints on the configuration of signals that can initiate movements and thereby determines the required transformation of sensory signals. PMID- 3511481 TI - Differentiation of mammalian embryonic gonad. AB - Formation and differentiation of a gonad depend on finely controlled interactions between germ cells and various types of somatic cells. These interactions already begin when the germ cells start migrating toward the gonadal ridge. Reaching the presumptive gonadal area on the mesonephros, the germ cells join with the mesonephric-derived cells. These mesonephric cells are probably the precursors of the steroid-producing cells. A crucial event for gonadal function is the enclosure of germ cells and somatic cells in specific germ cell compartments. Survival and differentiation of the germ cells depend on this separation. Differentiation of the steroid-producing cells depends in turn on remaining outside the cell compartments. The mechanisms directing the gonad to develop into a testis or an ovary are still obscure, but specific gene products from the sex chromosomes probably play a basic role in gonadal sex differentiation. PMID- 3511482 TI - Cyclosporine and experimental skin allografts: long-term survival in rats treated with low maintenance doses. AB - Although cyclosporine (CsA) is a powerful immunosuppressive agent in organ transplantation, its efficacy in skin transplantation has not been examined completely. We have tested it as primary immunosuppression in a rat skin allograft model. Histoincompatible Brown-Norway skin grafts are rejected in untreated Lewis hosts within 9 +/- 1 days but survive for 22 +/- 3, 34 +/- 2, or 41 +/- 8 days after 7, 14, or 21 days of CsA treatment (15 mg/kg per day subcutaneously), respectively (p less than 0.001). Animals treated daily for 4 weeks died from drug toxicity; however, an initial 2-week course followed by a low maintenance dose (15 mg/kg every fourth day) produced indefinite (greater than 150 days) graft acceptance without side effects. The long-surviving grafts were supple, grew long hair, and showed normal histology. When the drug was stopped at any time during this maintenance period, early signs of rejection (hair loss, epidermal breakdown, and localized ulceration) occurred, which could be reversed completely by a short CsA "pulse" (15 mg/kg per day for 7 days). These experimental data support the potential application of CsA immunosuppression in human skin allotransplantation. PMID- 3511483 TI - Early surgical intervention in Apert's syndactyly. AB - The hand deformities in Apert's syndrome are among the most complex congenital hand problems to reconstruct due to the skeletal malalignment, symphalangism, and progressive functional deficits with growth. Ten children with Apert's syndactyly underwent early surgical intervention (mean age 8.4 months) as part of a staged program of digital separation leading to completion of both hands by the age of 2 years. The incidence of major complications was low, rate of revision (18 percent) acceptable, and the aesthetic result very satisfactory. Long-term functional results tend to reflect the effect of progressive intrinsic disease despite preservation of skeletal alignment and digital form with growth. However, the aesthetic improvement and potential for greater functional gains at a young age support the concept of early surgical intervention in this syndrome. PMID- 3511484 TI - Reconstruction of the tip of the nose and ala by load cycling of the nasal skin and harnessing of extra skin. AB - Reconstruction for loss of the nasal tip, adjoining columella, and left ala was largely accomplished by means of load cycling of the skin of the nose. The harnessing of the skin's viscoelastic properties can yield a fairly significant amount of extra skin, thus enabling a rather complicated problem to be dealt with by a relatively simple maneuver. PMID- 3511485 TI - Reconstruction of the cleft earlobe with preservation of the perforation for an earring. AB - A simple method of repairing a complete or incomplete cleft of the earlobe with preservation of a hole for an earring is described. The results have been excellent, and the technique is very simple. PMID- 3511486 TI - External cranioplasty: historical perspectives. AB - Selective external cranial vault remodeling has been practiced since antiquity. The variations, methods, and desired results of external cranioplasty are as pervasive as the practice is old. PMID- 3511487 TI - The perfect nasal packing. PMID- 3511488 TI - Effects of stimulus intensity on autonomic responding: the problem of differentiating orienting and defense reflexes. PMID- 3511489 TI - Duration of initial heart rate assessment in Psychophysiology: current practices and implications. PMID- 3511490 TI - Psychophysiological responsiveness to auditory stimulation during transcendental meditation. PMID- 3511491 TI - Sodium lactate infusions and panic attacks: a review and critique. AB - Response to sodium lactate infusions has been proposed as an experimental model and a biologic marker for panic attacks. Several authors have claimed that patients suffering from panic attacks, but not normal controls, "panic" in response to lactate. A careful review of methods and results of 13 studies, however, reveals serious methodologic problems, lack of specificity and sensitivity, and a failure to consider cognitive variables. When baseline differences are ruled out, the responses of patients and controls may not differ. So far, response to lactate cannot be interpreted as a model and marker for panic attacks and does not provide evidence for their underlying biologic distinctness from other types of anxiety. Known biologic mechanisms do not sufficiently explain the effects of lactate. Instead, an interaction of peripheral physiologic changes, past experience, environmental cues, and their appraisal as threatening or dangerous seems to be a more appropriate model. PMID- 3511492 TI - A reconsideration of specificity in psychosomatic medicine: from olfaction to the lymphocyte. PMID- 3511493 TI - Long-term endocrinologic changes in subjects practicing the Transcendental Meditation and TM-Sidhi program. AB - The Transcendental Meditation (TM) and a more advanced program, the TM-Sidhi program, have been reported to produce a number of acute and long-term metabolic and electrophysiologic changes. To investigate the possibility that the practice of these techniques may be associated with long-term endocrinologic changes, we prospectively evaluated 11 male subjects before and over a 3-year period after starting the TM-Sidhi program. A progressive decrease in serum TSH, growth hormone, and prolactin levels occurred over the 3 years while no consistent change in cortisol, T4, or T3 levels was observed. These results suggest that the long-term practice of the TM and TM-Sidhi program may have effects on neuroendocrine function. Further studies using 24-hr monitoring with frequent blood sampling will, however, be needed to fully assess the significance of the simultaneous decline of the anterior pituitary hormones with maintenance of levels of hormones from peripheral endocrine glands. PMID- 3511494 TI - Three studies of the psychologic changes in chronic headache patients associated with biofeedback and relaxation therapies. AB - Three separate, but similar, studies are described in which the psychologic effects (depression, anxiety, and overall degree of psychosomatic distress) of nonpharmacologic treatment (relaxation and/or biofeedback training) for three kinds of chronic headache (tension, migraine, and mixed migraine and tension) were evaluated. Results showed consistently (across all three studies) significant reductions in depression and trait-anxiety associated with receiving treatment, regardless of headache type or treatment outcome. The significant reduction for overall degree of psychosomatic distress was not differentially related to receiving treatment and thus could have been due to prolonged monitoring of headaches or test-retest regression effects. PMID- 3511495 TI - A semiquantitative probe for radiation-induced normal tissue damage at the molecular level. AB - Sheep antibodies to bovine type I collagen were employed in the immunohistochemical detection of type I collagen in lung tissue sections of irradiated LAF1 mice. A video image digitizing system was developed to estimate collagen levels, by assigning a numerical value (0-63) to each of approximately 53,800 picture elements (pixels) in the microscope field, according to the collagen-dependent fluorescence intensity at each locus. For lungs harvested 52 weeks subsequent to graded doses of 60Co gamma radiation between 0 and 10 Gy, a dose-dependent increase in type I collagen was observed in the alveolar walls. A reproducible increase was evident for doses as low as 5 Gy: doses of 7 to 10 Gy elicited type I collagen levels significantly elevated with respect to those of age-matched controls. These results are consistent with a role for type I collagen in the development of radiation-induced pulmonary fibrosis. The assay system developed here will be used to explore the role of connective tissue macromolecules in the development of radiation pneumonitis and fibrosis. PMID- 3511496 TI - Mutation induction in Escherichia coli WP2 uvrA by Cerenkov emission associated with 137Cs gamma irradiation. AB - Evidence is presented for the mutation of the tryptophan-requiring bacterial strain Escherichia coli WP2 uvrA from auxotrophy to prototrophy, and from streptomycin sensitivity to resistance, by Cerenkov emission associated with 137Cs gamma irradiation. Furthermore, the data strongly suggest a more than additive interaction between the gamma-induced damage and that induced by Cerenkov emission for both mutations scored. An additional observation is that mutant yields (expressed as mutants/10(7) survivors) show a dependence on the number of viable cells plated for both uv (254 nm) and Cerenkov-induced mutations, but not for those induced by gamma irradiation. This demonstrates another similarity between uv- and Cerenkov-induced damage. PMID- 3511497 TI - Lipomatous tumors of the liver: evaluation with CT and US. AB - Seven cases of lipomatous masses within the liver parenchyma were demonstrated with computed tomography (CT). Five of these cases were obtained from a retrospective review of 50 cases of renal angiomyolipoma in which the liver was adequately demonstrated. The other two cases were from the files of the Armed Forces Institute of Pathology and had no associated renal lesions. Three of the five cases were associated with tuberous sclerosis. In all seven cases, the fatty tumors appeared on CT scans as a well-defined, 0.8-13-cm mass, with attenuation coefficients of less than -30 HU. On ultrasound studies, the lesions were well circumscribed, highly echogenic, and similar to hemangiomas. While distinctly rare lesions, these lipomatous masses are not as unusual as the literature would indicate. One may anticipate such masses in patients with renal angiomyolipomas and in a relatively high percentage of those with tuberous sclerosis. PMID- 3511498 TI - Mesenchymal hamartoma of the liver: radiologic-pathologic correlation. AB - Mesenchymal hamartoma of the liver (MHL) is an uncommon cystic mass of infancy that is a developmental anomaly rather than a neoplasm. Fourteen cases of MHL were retrospectively reviewed. Grossly, MHL is a solitary mass with cystic spaces of variable size. Patients are seen initially with painless progressive abdominal enlargement. On plain films, MHL appears as a large, noncalcified mass in the right upper quadrant. Scintigraphy is helpful in confirming its hepatic origin. Ultrasonography and computed tomography demonstrate a large multiloculated mass with considerable variation in the size of septa and cystic spaces. Angiographically, MHL is avascular or hypovascular. Recognition of these radiographic findings allows a correct diagnosis to be made in many cases. With resection, the prognosis is excellent. PMID- 3511499 TI - Pancreatic insufficiency: role of CT evaluation. AB - The medical records of all patients discharged over a 3-year period with a diagnosis of pancreatic insufficiency were reviewed. In some patients, abdominal radiographs or sonograms provided adequate information. However, computed tomography (CT) was a key diagnostic tool in understanding the cause of pancreatic insufficiency in 11 of the 13 patients in whom it was performed. CT study detected previously undiagnosed carcinoma in one patient, enabled diagnosis of chronic pancreatitis in five, confirmed complete surgical removal of the pancreas in two, and--despite optimal use of contrast material and 5-mm contiguous sections--was unable to detect any pancreatic tissue in three patients, suggesting complete idiopathic atrophy. Pancreatic insufficiency is a difficult clinical diagnostic problem. CT scanning should be employed early if abdominal radiographs or sonograms do not detect an abnormality. PMID- 3511500 TI - Pancreatic cystosis in cystic fibrosis. AB - Two patients with cystic fibrosis and pancreatic cystosis are described who had complete replacement of the pancreas by multiple macroscopic cysts. The possible causes and clinical significance of this condition are discussed. PMID- 3511501 TI - Adnexal structures: MR imaging. AB - Magnetic resonance (MR) images of the pelvis in 63 women (40 healthy and 23 with various adnexal diseases) were assessed retrospectively. When imaged with contiguous sections without gaps, adnexa were demonstrated bilaterally in 13 of the 15 healthy women of reproductive age, but in only seven of the 15 healthy postmenopausal women. Normal adnexa demonstrated low to medium signal intensity on images obtained with short repetition time (TR) (0.5 sec) and echo delay time (TE) (28 or 30 msec). Their signal intensity approached that of fat on images with a long TR (2.0 sec) and TE (56 or 60 msec). The adnexal origin of the pelvic masses was correctly identified in every case. Lesions containing fluid with little or no protein, fat, or blood content (simple fluid) had characteristically long T1 and T2 relaxation times and low signal intensity on images obtained with a short TR (0.5 sec) and TE (28 or 30 msec); they could be readily differentiated from all the other types of lesions. PMID- 3511502 TI - Renal obstruction in patients with ileal loops: US evaluation. AB - Ultrasound (US) is often employed as a screening test for hydronephrosis in the nondiverted kidney and has been used recently to evaluate the diverted kidney, specifically ileal loops, for obstruction. The utility of US in evaluating obstruction in patients with ileal loops has apparently not been previously explored. During a 2-year period, 87 kidneys drained by an ileal loop diversion were examined with US because of clinical indications of possible renal obstruction. In 33 kidneys, no hydronephrosis was seen on sonograms, and no obstruction was later proved; in 51 kidneys, shown by US to be hydronephrotic, only 19 (37%) were obstructed. Three left kidneys were not visualized with US. The percentage of hydronephrotic kidneys subsequently shown to be obstructed increased rapidly as the US appearance progressed from grade 1 (20%) to grade 3 (80%). In this series, US had a 100% sensitivity and a 50% specificity in evaluating patients with ileal loops for renal obstruction. Thus, for the adult patient, a direct contrast evaluation of the collecting system is suggested; for the pediatric patient, initial use of US is justified as a means to avoid radiation exposure. PMID- 3511503 TI - Lymph nodes of the neck: evaluation with US. AB - Ultrasound (US) proved highly effective for detection, localization, and delineation of enlarged lymph nodes of the neck. Infiltration of adjacent structures, specifically the common, internal, and external carotid arteries, and the neck muscles was reliably demonstrated. Benign and malignant lymph node enlargement could not be differentiated. US examinations changed the operative course of 56% of patients studied. In 41%, a more radical operative procedure was performed than was previously planned; in 14%, US demonstrated inoperability. Small-parts US is a very useful adjunct to current imaging techniques of cervical lymph node disease. PMID- 3511504 TI - Tongue and tonsil cancer: staging with US. AB - A prospective study on the value of ultrasound (US) for the staging of 70 cases of cancer of the tongue and tonsil was performed. A real-time, high-frequency transducer was used, and the examination was often coupled with endobuccal palpation. US did not visualize the tumor in nine of 42 cases of tongue cancer (seven stage T1 and two anterior stage T2 tumors); US accurately defined tumor size in 33 cases. The degree of in-depth extension and the location with respect to the median line (only four false results) were evaluated correctly. With regard to 28 tonsil cancers, US depicted extension from the tonsillar fossa to the tongue in all cases but one (13 of 14 cases). US is valuable for the detection of cervical lymph nodes associated with both tongue and tonsil tumors and is a safe and helpful technique for the follow-up of medium-size lesions. The major limitations of US include the nonvisualization of superficial lesions, reduced accuracy for evaluation of the extension of large tumors, and analysis of posterior pharyngeal extension. PMID- 3511505 TI - Fetal lumbar spine: measuring axial growth with US. AB - Ultrasound (US) can be used to visualize vertebral segments, suggesting a quantitative means of studying vertebral column growth in utero and thus a means of detecting developmental abnormalities. US images of the lumbar spine were obtained in 128 clinically normal fetuses between the gestational age of 11 through 41 weeks. A large-aperture, dynamically focused US system capable of regional magnification was used. Average lumbar spacing was calculated from distance between centrums of at least four lumbar bodies. The average distance between lumbar centrums increased nearly linearly throughout the second and third trimesters (r2 = 0.98). Enhanced anatomic display implies new capabilities for recognizing developmental abnormalities antenatally. PMID- 3511506 TI - Congenital diaphragmatic hernia: US diagnosis prior to 22 weeks gestation. AB - Two cases of congenital diaphragmatic hernia diagnosed sonographically in utero at 18 and 21 weeks gestation are described. In previous reports, this diagnosis has been made at 28 weeks or more. Recognition of this severe abnormality in the second trimester affords two options. The parents can interrupt the pregnancy, or a surgical attempt at correction in utero may be possible and be early enough to allow adequate lung development to take place. PMID- 3511507 TI - In-bath filming during extracorporeal shock wave lithotripsy. AB - Extracorporeal shock wave lithotripsy (ESWL) is now the preferred method for treating most renal calculi. We designed a cassette and grid holder and a technique for filming in the water bath. The excellent film quality permits initial localization of small or faint calculi and confirmation of satisfactory fragmentation during ESWL. The technique facilitates patient treatment and throughput and should reduce the repeat treatment rate. PMID- 3511508 TI - Basic concepts of digital angiography. PMID- 3511509 TI - Veterans Administration Cooperative Study of medical versus surgical treatment for stable angina--progress report. Section 5. The five-year effect of coronary artery bypass surgery on relief of angina. PMID- 3511510 TI - Veterans Administration Cooperative Study of medical versus surgical treatment for stable angina--progress report. Section 6. Symptom severity and prognosis. PMID- 3511511 TI - Veterans Administration Cooperative Study of medical versus surgical treatment for stable angina--progress report. Section 7. Effect of medical versus surgical treatment on exercise performance at five years. PMID- 3511512 TI - Veterans Administration Cooperative Study of medical versus surgical treatment for stable angina--progress report. Section 8. Prognostic value of baseline exercise tests. PMID- 3511513 TI - Veterans Administration Cooperative Study of medical versus surgical treatment for stable angina--progress report. Section 9. Effect of medical versus surgical treatment on resting left ventricular ejection fraction at five years. PMID- 3511514 TI - Veterans Administration Cooperative Study of medical versus surgical treatment for stable angina--progress report. Section 10. Factors associated with long-term graft patency after coronary artery bypass surgery. PMID- 3511515 TI - Veterans Administration Cooperative Study on medical versus surgical treatment for stable angina--progress report. Section 11. The effect of coronary artery bypass surgery on the incidence of myocardial infarction and hospitalization. PMID- 3511516 TI - The role of the complement system in hemostasis. PMID- 3511517 TI - Behavioral aspects of iron deficiency. PMID- 3511518 TI - Neonatal polycythemia. PMID- 3511519 TI - Blood transfusions and their influence on renal allograft survival. PMID- 3511521 TI - [The role of calcitonin in the treatment of algoneurodystrophy]. PMID- 3511522 TI - [Armand Trousseau (1801-1867) and the placebo effect]. AB - In 1834 Armand Trousseau (1801-1867) used a placebo, consisting of pills containing only starch, to show that these pills were as effective as homeopathic dilutions. On another occasion he claimed to have produced marked diuresis in patients with edema by cutaneous application of digitalis and scilla solutions; in fact the diuresis resulted from prior high-dose oral digitalis therapy. Complete ignorance of pharmacokinetics at that time was largely responsible for his error. PMID- 3511523 TI - [Management of hypercholesteremia by extracorporeal immune adsorption]. AB - Reduction of plasma cholesterol by extracorporeal immune elimination of low density lipoproteins (LDL) as an efficient approach to the treatment of familial hypercholesterolemia is described. LDL was removed from the plasma by immune adsorption on Sepharose-bound sheep antibodies against apo B, the protein fraction of LDL. To prevent the possibility of sensitization by the sheep antibodies, F(ab')2 fragments were used and the antibody containing Sepharose was underlaid by LDL containing Sepharose. Within a treatment time of 4 1/2-5 hours a reduction of the total plasma cholesterol by 70-80% was obtained. The mean reduction of the cholesterol concentration was more than 40% with a 14-day interval between two treatments. The concentration of other plasma proteins was not affected. The 11 treatments achieved so far were well tolerated and no side effects could be observed. PMID- 3511520 TI - Exercise in coronary heart disease. AB - Population levels of habitual activity have probably contributed to both the recent epidemic of cardiovascular disease and its waning. Evidence supporting the exercise hypothesis can be drawn from comparisons of individuals with differing levels of occupational and leisure activity. Both suggest that regular, endurance type activity may halve the incidence of cardiac morbidity and mortality. This is an important prophylactic benefit, although Bradford Hill's criteria of a causal association have yet to be fully satisfied. Following the onset of clinical disease, both uncontrolled and randomised controlled trials suggest that progressive exercise rehabilitation improves prognosis by a useful 20 to 30%, but formal statistical proof is again difficult for technical reasons. Although over enthusiastic vigorous physical activity can cause an immediate rise of cardiovascular events, this disadvantage is substantially outweighed by long term gains from regular physical activity. Classical epidemiology has proven its case by the experimental step of removing exposure to the causal agent. It is difficult to carry out such an analysis linking physical activity with the recent epidemic of ischaemic heart disease, although the recent waning of the disease may be attributed in part to an increase of habitual physical activity in many western nations. Evidence linking exercise to the prevention of clinical disease ('secondary prevention') is derived from large scale surveys of groups with supposed differences in occupational activity, athletic participation, active leisure pursuits or overall lifestyle. The majority of occupational comparisons have shown advantages to active workers in terms of deaths from cardiac disease, sudden death, cardiac morbidity, ECG abnormalities, and cardiac abnormalities at postmortem. However, concerns have been raised with regard to the accuracy of job classification, the intensity of occupational activity relative to active leisure, the adequacy of disease classification, and confounding influences due to differences of social class, stress and potential alienation. Studies comparing athletes and non-athletes have been faulted on grounds of initial selection for sport by body-build and uncertainties regarding continuing differences of endurance activity between recognised university athletes and their classmates. In general, no advantage of life expectancy has been seen in athletes, Karvonen and associates reported a 4 to 5 year advantage of longevity in Finnish cross-country skiing champions, although this might be attributable to other facets of their lifestyle.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3511524 TI - [New findings on the pathogenesis of diabetes mellitus]. AB - Diabetes mellitus is a heterogeneous syndrome. Insulin-dependent type 1 diabetes is characterized by progressive deterioration of B-cells in the islets of Langerhans resulting in a fall in insulin secretion. According to recent studies, autoimmune mechanisms are the reason for the B-cell destruction. These mechanisms can be triggered by viral infections which result in expression of HLA-DR antigens in macrophages and possibly in B-cells of the islets. B-cells are destroyed by cytotoxic T-lymphocytes; plasma cells form islet cell antibodies. The autoimmune process probably starts months to years before clinical manifestation of the disease. A viral infection immediately before clinical manifestation may reactivate the autoimmune process and lead to overt diabetes. T lymphocytes reject pancreatic B-cells in type 1 diabetics throughout life. Pilot studies using cyclosporin as immunosuppressive agent in newly diagnosed type 1 diabetics have demonstrated that after discontinuation of this treatment diabetics again became insulin-dependent. Type 2 diabetics are usually elderly and non-insulin-dependent; there is a predominant defect in insulin action on peripheral tissues but also a concomitant impairment of B-cell secretion. Fasting plasma insulin levels are normal or increased; fasting C-peptide concentrations may be used to distinguish this type of diabetes from type 1 diabetes. Plasma fasting C-peptide concentrations less than 300 pmol/l usually indicate type 1 diabetes and levels above 300 pmol/l type 2 diabetes. Classification of diabetics according to pathogenesis is important, since different therapeutic and preventive measures are necessary. PMID- 3511525 TI - [Intensified insulin therapy by multiple injections or by pump]. AB - A relationship exists between metabolic control and the development of late complications of diabetes. Recently, new strategies of insulin therapy have been developed to normalize blood glucose control, with a view to preventing late complications of diabetes and increasing patients' well-being. Intensified insulin therapy can be performed by multiple insulin injections or by continuous subcutaneous insulin infusion with a pump; regular self-monitoring of blood glucose is mandatory with these types of treatment. Results obtained with both forms of insulin therapy are comparable, although in some cases pump treatment is superior. Intensified insulin therapy is principally aimed at young, motivated and compliant diabetic patients without advanced complications, and at diabetic women before and during pregnancy. The potential risks of intensified insulin therapy are reviewed. PMID- 3511526 TI - Organic solvents and presenile dementia (the painters' syndrome). A critical review of the Danish literature. AB - Since 1971 a series of Danish medical articles have been published which concludes that the occupational inhalation of organic solvents can induce a chronic cerebral disease manifesting itself in a presenile syndrome. As the articles have mainly dealt with the exposure of painters, the disease has also been called "the painters syndrome". The publications have brought about, by law, an almost exponential recognition of "the painters syndrome" as an occupational disease. It has therefore become necessary to undertake a critical scientific analysis of the Danish publications which appeared between 1972 and February 1983. The conclusion of this evaluation is, that the Danish articles do not prove that occupational exposure to organic solvents produces a presenile demens. The indications that it does are very slender. The importance of adhering strictly to present regulations of working conditions is emphasized. PMID- 3511527 TI - Obesity, overeating, and rapid gastric emptying in rats with ventromedial hypothalamic lesions. AB - Measurements confirm the quantitative theoretical prediction that the autonomic nonendocrine abnormality of rapid daytime gastric emptying is the major primary cause of the obesity resulting from ventromedial hypothalamic lesions in rats. Therapy for obesity could include slowing of stomach emptying. PMID- 3511528 TI - Molecular basis for the auxin-independent phenotype of crown gall tumor tissues. AB - The transfer of specific Ti (tumor-inducing) plasmid sequences, the T-DNA, from Agrobacterium tumefaciens to a wide range of plants results in the formation of crown gall tumors. These tissues differ from most plant cells in that they can be grown in vitro in the absence of added phytohormones. Here, data are presented that offer an explanation for the auxin-independent phenotype of crown gall tissues. It is shown that crude cell-free extracts prepared from three bacterial species harboring pTiA6 gene 1 could convert L-tryptophan to indole-3-acetamide; control extracts lacking gene 1 could not carry out the reaction. Other reports indicate that the pTiA6 gene 2 product can convert indole-3-acetamide to indole-3 acetic acid, a naturally occurring auxin of plants. It is concluded that the auxin-independent phenotype of crown gall tissue involves the introduction of Ti plasmid sequences encoding a two-step pathway for auxin synthesis. PMID- 3511529 TI - Functional role of aspartic acid-27 in dihydrofolate reductase revealed by mutagenesis. AB - The crystal structures and enzymic properties of two mutant dihydrofolate reductases (Escherichia coli) were studied in order to clarify the functional role of an invariant carboxylic acid (aspartic acid at position 27) at the substrate binding site. One mutation, constructed by oligonucleotide-directed mutagenesis, replaces Asp27 with asparagine; the other is a primary-site revertant to Ser27. The only structural perturbations involve two internally bound water molecules. Both mutants have low but readily measurable activity, which increases rapidly with decreasing pH. The mutant enzymes were also characterized with respect to relative folate: dihydrofolate activities and kinetic deuterium isotope effects. It is concluded that Asp27 participates in protonation of the substrate but not in electrostatic stabilization of a positively charged, protonated transition state. PMID- 3511530 TI - An ancient developmental induction: heat-shock proteins induced in sporulation and oogenesis. AB - Every eukaryotic and prokaryotic organism tested to date synthesizes a small number of heat-shock proteins in response to heat and other forms of stress. A particular pattern of heat-shock gene expression was observed during ascospore development in Saccharomyces: heat-shock proteins hsp26 and hsp84 were strongly induced nor inducible by heat shock. Instead, two proteins related to hsp70 were induced. A strikingly similar pattern of expression occurs during oogenesis in Drosophila, suggesting that it may be one of the earliest developmental pathways to evolve in eukaryotic cells. PMID- 3511532 TI - Positron emission tomography imaging--technical considerations. AB - Positron imaging instrumentation has improved rapidly in the last few years. Scanners currently under development are beginning to approach fundamental limits set by positron range and noncolinearity effects. This report reviews the latest developments in positron emission tomography (PET) instrumentation, emphasizing the development of coding schemes that reduce the complexity and cost of high resolution scanners. The relative benefits of using time-of-flight (TOF) information is discussed as well. PMID- 3511531 TI - Biosynthesis of the Torpedo californica acetylcholine receptor alpha subunit in yeast. AB - Yeast cells were transformed with a plasmid containing complementary DNA encoding the alpha subunit of the Torpedo californica acetylcholine receptor. These cells synthesized a protein that had the expected molecular weight, antigenic specificity, and ligand-binding properties of the alpha subunit. The subunit was inserted into the yeast plasma membrane, demonstrating that yeast has the apparatus to express a membrane-bound receptor protein and to insert such a foreign protein into its plasma membrane. The alpha subunit constituted approximately 1 percent of the total yeast membrane. The alpha subunit constituted approximately 1 percent of the total yeast membrane proteins, and its density was about the same in the plasma membrane of yeast and in the receptor rich electric organ of Electrophorus electricus. In view of the available technology for obtaining large quantities of yeast proteins, it may now be possible to obtain amplified amounts of interesting membrane-bound proteins for physical and biochemical studies. PMID- 3511533 TI - Hypervascularity on cerebral radionuclide angiogram. PMID- 3511534 TI - Blood component therapy in the treatment of platelet disorders. PMID- 3511535 TI - Human megakaryocytopoiesis. PMID- 3511536 TI - The role of platelets in the development and complications of atherosclerosis. AB - Although lipids have received most attention in relation to atherosclerosis, vessel injury also has a role in the development of atherosclerotic lesions. Thrombi that form at sites of injury can be incorporated into the wall, causing thickening, and platelets that adhere to damaged vessel walls release a growth factor (PDGF) that stimulates smooth muscle cell proliferation. The early lesions of atherosclerosis are focal and develop around vessel orifices and branches in relation to the patterns of blood flow and areas of increased permeability and endothelial cell damage. Platelets also contribute to the complications of advanced atherosclerosis caused by occlusive thrombi, thromboembolism, and spasm. The causes of vessel wall injury are not established, although there is evidence pointing to disturbed blood flow, hypertension, antigen--antibody complexes, complement, materials originating from platelets and white blood cells, bacteria, endotoxin, viruses, smoking, dietary lipids, homocystinemia, diabetes, other metabolic disorders, and stress. Platelets do not adhere to intact endothelium, but they adhere to the constituents of the subendothelium, release the contents of their granules (including PDGF), and form thromboxanes. If blood flow is disturbed, platelet--fibrin thrombi can form at sites of injury. Platelet adherence to a damaged wall does not require von Willebrand factor except under conditions of high wall shear. Repeated injury of a vessel wall leads to the development of lipid-rich atherosclerotic lesions, even in normocholesterolemic animals, but these lesions do not form if the experimental animals are made thrombocytopenic before injury is induced. Measurable changes in platelets that are associated with the clinical complications of atherosclerosis include shortened survival, release of granule contents (platelet factor 4, beta thromboglobulin, thrombospondin), formation of thromboxanes, and decreased buoyant density. "Antiplatelet drugs" such as aspirin are proving to be beneficial in selected groups of patients, such as those with unstable angina. Thromboxane synthetase inhibitors and agents that block the thromboxane receptor on platelets are under investigation. Long term administration of "antiplatelet drugs" to affect the rate of development of atherosclerosis seems neither feasible nor desirable. Modification of dietary and smoking habits and control of hypertension are more likely to be beneficial for most individuals. PMID- 3511537 TI - Pyogenic liver abscesses in nonimmunocompromised children. AB - Pyogenic liver abscesses are rare in previously healthy children. This review reports ten such cases of pyogenic abscess seen between 1963 and 1984. The mean age in these children was 6.3 years. One child died. Of the nine survivors, five had successful open surgical drainage. Two abscesses were drained percutaneously. Another abscess drained spontaneously into the biliary system, and one abscess was treated with antibiotics alone. The single most helpful diagnostic test was abdominal ultrasonography. Our experience is evaluated in the context of other reports of pyogenic abscesses in children. PMID- 3511538 TI - Emphysematous pyelonephritis: diagnosis and treatment. AB - Emphysematous pyelonephritis is a rare life-threatening bacterial infection usually occurring in patients with diabetes mellitus and producing gas within the renal parenchyma and/or perirenal tissue. We add four cases to the 62 previously reported in the literature. The overall mortality is 38%, with only 29% survival for those treated medically compared to 71% for those given both medical and surgical treatment. Early diagnosis with the aid of renal ultrasonography and/or computerized axial tomography and aggressive early combined medical-surgical management are emphasized. PMID- 3511539 TI - Noninvasive evaluation of peripheral vascular disease: recent advances and future implications. AB - Noninvasive diagnostic techniques have become a recognized adjunct in screening and follow-up of patients with peripheral arterial, venous, and cerebrovascular diseases. These techniques provide physiologic information at little or no risk to patients. Although primarily of diagnostic intent, these studies are also expanding our knowledge base about the natural history of peripheral vascular diseases and the efficacy of various interventions. Advances in radiology have complemented but not replaced the need for the noninvasive peripheral vascular laboratory. It is incumbent upon all physicians to appreciate the diagnostic value and recognize the limitations of these noninvasive techniques. Intelligent use of these modalities may enhance patient care without significantly increasing health care costs. Further prospective studies of the cost benefit or effectiveness of these techniques are indicated. PMID- 3511540 TI - New Medicare criteria for hospital admission. PMID- 3511541 TI - Depression in primary care: evolving concepts and approach to therapy. AB - Depression is one of the most commonly encountered maladies in clinical practice. Most depressed patients are seen first by nonpsychiatrist physicians who frequently overlook or ignore the depression. Many depressed patients can and should be treated by primary care physicians if those physicians are aware of diagnostic and management principles. These principles include knowledge of the clinically useful classifications, the wide variety of typical and atypical manifestations, the medical illnesses associated with depression, the neuroendocrinologic manifestations of major depression, and the use of aggressive, effective therapy. With those tools, the physician can effectively intervene in the course of an illness that affects a large portion of the population and causes considerable psychologic and physical anguish. PMID- 3511542 TI - Recurrent varicella-zoster infection after acyclovir therapy in immunocompromised patients. AB - Varicella-zoster virus (VZV) infection is a late complication of bone marrow transplantation in almost half of the long-term survivors. We have reported the clinical relapse of VZV infection in two marrow transplant recipients treated with standard regimens of acyclovir, a new antiviral agent with activity against VZV. Since most VZV infections occur after discharge from a transplant center, primary care physicians must be alert to the possibility of relapse of VZV infection after acyclovir therapy. PMID- 3511543 TI - Detection, frequency, and stability of cotransformants expressing nonselectable human enzymes. AB - We cotransformed mouse 3T3 cells with total genomic human DNA and the dominant selectable bacterial gene Neo and analyzed 121 NeoR clones for expression of 15 human "housekeeping" enzymes which can be distinguished from their murine homologs. The estimated frequency of expression of unlinked human genes was 1 in 360 NeoR clones and at least three different human enzymes (peptidase D, phosphoglucomutase 1, and acid alpha glucosidase) were detected. We further examined the frequency and stability of cotransformation for one of these enzymes, acid alpha glucosidase (GAA). We tested approximately 4000 NeoR clones and found 25 clones expressing human GAA, as determined by rocket immunoelectrophoresis (RIE) specific for human GAA. Transformants progressively became negative on continued growth and retesting by RIE, with only two clones still expressing GAA at the eighth testing. This apparent loss of expression was not due to nonclonality of the original isolates. In one subclone examined, loss of expression was accompanied by loss of both Neo-derived pBR322 and human Alu repetitive sequence DNA. Thus, under the conditions utilized, cotransformants expressing homomeric housekeeping enzymes were found at relatively high frequency but were progressively lost even under conditions selective for expression of the dominant vector. PMID- 3511544 TI - Human luteinizing hormone-releasing hormone gene (LHRH) is located on short arm of chromosome 8 (region 8p11.2----p21). AB - Luteinizing hormone-releasing hormone (LHRH) is synthesized by hypothalamic neurons and affects the release of gonadotropic hormones from the anterior pituitary gland. A cDNA clone encoding the human LHRH precursor molecule was used to assign the LHRH gene to a human chromosome by in situ hybridization and Southern blot analysis. Metaphase spreads from two normal individuals were hybridized with 3H-labeled LHRH-specific sequence. Of 120 cells analyzed, 33 had silver grains over the p11.2----p21 bands of chromosome 8. No other chromosomal site was labeled above background, indicating the presence of a single site for LHRH sequences in the human genome. Independent confirmation for this location of the human LHRH gene on chromosome 8p was provided by analysis of DNA from human X Chinese hamster somatic cell hybrids. DNA samples were digested with EcoRI, blotted, and hybridized with the 32P-labeled human LHRH precursor cDNA probe. The single 11.5-kb human-specific band was detected only in hybrids containing human chromosome 8. Also, hybridization was observed in DNA from hybrids in which a portion of human chromosome 8 (region 8pter----8q21) had been spontaneously translocated onto a Chinese hamster chromosome. PMID- 3511545 TI - Tolerability and efficacy of isoprodian-containing antituberculosis regimens. PMID- 3511546 TI - Unusual failure of the Manley Blease ventilator. PMID- 3511547 TI - Transplantation of kidneys from related living donors at Johannesburg Hospital. AB - The Johannesburg Hospital kidney transplantation unit's experience with 111 kidney donations from living relatives between 1966 and December 1984 is reviewed. The 1-year patient survival rate for those who received transplants up to the end of 1982 was 93%. Donor surgery only caused 1 instance of serious illness and no deaths. The justification for and procedure of donor transplantation are discussed and the psychological reward to the donor highlighted. PMID- 3511548 TI - Renal function after nephrectomy for donor organs. AB - Thirty-three living related kidney donors were investigated at a mean of 5.8 years after donor nephrectomy (range 3-18 years) to detect late adverse effects. They were evaluated for hypertension, the presence of proteinuria and renal dysfunction as assessed by serum creatinine value and creatinine clearance. There was a significant rise in both diastolic blood pressure and serum creatinine levels and a trend towards significance in the decline in creatinine clearance. Eleven individuals had diastolic blood pressure greater than or equal to 90 mmHg but only 1 required treatment. Although the rise in serum creatinine reached significance the mean serum creatinine (104.91 mumol/l) remained within the normal range. Two patients showed a minimal rise in proteinuria. The overall results confirm that kidney donation is safe and indicate that there are no significant late sequelae. PMID- 3511549 TI - Cancer of the larynx: current concepts of diagnosis and treatment. AB - Cancer of the larynx is a potentially fatal disease. Familiarity with current treatment, however, makes it potentially curable. This article discusses the available therapeutic options and their consequences. PMID- 3511550 TI - Cancer of the paranasal sinuses. AB - Cancers of the paranasal sinuses, although rare, continue to cause the death of more than half of patients afflicted with them. The use of combined therapy (surgery and irradiation) has effected some improvement in control, particularly with better surgical and radiation techniques. Unfortunately, better results will not be obtained until earlier diagnoses can be achieved. PMID- 3511551 TI - Thyroid carcinoma. AB - The issue of appropriate management for thyroid neoplasms remains unsettled. Confusion concerning histology and classification, controversy as to appropriate therapy, the relative indolence of most differentiated thyroid tumors, and various levels of surgical skill have contributed to the prejudice of various approaches to the management of such neoplasms. It appears unlikely that the controversy will be resolved in the immediate future. If total thyroidectomy can be performed by a skilled surgeon with minimal complications, this approach seems theoretically justifiable for the management of most differentiated tumors, facilitating follow-up postoperatively. Conclusive evidence for improved survival with this rationale is insufficient. PMID- 3511553 TI - Management of complications of radiotherapy of the head and neck. AB - It can be seen from this short review that radiation therapy is a double-edged sword--truly life saving and cancer curing but carrying with it the certainty of morbidity. In the majority of patients treated by irradiation, this morbidity is minimal. In the unusual patient in whom there is a significant complication of irradiation, there will be an alteration in quality of life that cannot be documented by words or figures but rather requires caring for this patient. My only request of the reader is that he or she recognizes that the use of irradiation to treat cancer of the head and neck carries with it lifetime implications for both patient and physician and therefore should not be chosen without due thought and indication. PMID- 3511552 TI - Complications in head and neck surgery. AB - Complications of the surgery for head and neck cancer may be catastrophic or noncatastrophic. Recognition of this is frequently as important as the method of resolution. A general classification of complications as anatomic, physiologic, technical, and functional will aid in recognition and prevention of these problems in this difficult group of patients. PMID- 3511554 TI - The use of percutaneous nephrostomy in patients with ureteric obstruction undergoing renal transplantation. AB - The use of percutaneous nephrostomy with or without placement of a ureteric stent has been of increasing aid in treating both acute and chronic ureteral obstruction in recipients of renal allografts. Eight patients who underwent transplantation, had ureteric obstruction develop and were treated by this means are reported herein. The technique is standard and can be performed in an arteriography suite. Once a catheter is inserted into the allograft collecting system, a nephrostomy tube or a stent, or both, is easily inserted. Three of the patients had acute ureteric obstruction secondary to clot forming after needle biopsy of the transplant kidney. Percutaneous nephrostomy tubes were passed, the renal pelvis and ureter irrigated and the clots lysed. Operation was unnecessary. In five patients with declining renal function secondary to chronic obstruction, percutaneous nephrostomy placement allowed return of renal function to base line levels, while placement of a stent through the ureter into the bladder facilitated location of the ureter at operation for ureteral reimplantation. The technique of percutaneous nephrostomy is simple, convenient and allows patient recovery preoperatively. It has become part of our standard armamentarium in transplant recipients. PMID- 3511555 TI - Endoscopic hemostasis of bleeding of the upper gastrointestinal tract by local injection of ninety-eight per cent dehydrated ethanol. AB - Endoscopic dehydrated ethanol injection was attempted in 48 patients with substantial bleeding of the upper gastrointestinal tract; most of the patients had associated serious medical conditions. The causes of bleeding were: gastric ulcer in 17; duodenal ulcer in 11; gastric or duodenal vascular ectasias, or both, in five; Mallory-Weiss tear in three; acute gastric mucosal lesion in six; esophageal ulcer in two; marginal ulcer in two; gastric leiomyoma in one, and carcinoma of the stomach in one. The mean age was 57 years old (a range of 18 to 91 years old). The mean amount of blood loss prior to time of injection was 4.5 units (a range of 3 to 10 units). Ethanol injection was initially successful in 45 of 48 patients but rebleeding occurred within 72 hours in three of these patients. All instances of treated vascular ectasia disappeared by the time of follow-up endoscopy. No complications were attributable to the injections. Endoscopic local ethanol injection may be the treatment of choice in selected patients with bleeding of the upper gastrointestinal tract. PMID- 3511556 TI - Chemotherapy for soft tissue sarcoma. AB - Adriamycin is the only active single agent for patients with metastatic sarcoma; combination chemotherapy regimens that omit Adriamycin are ineffective in adults. Despite early success with CYVADIC, there have been recent doubts regarding its efficacy. No other chemotherapeutic combination has provided consistently better results than CYVADIC. As complete responses occur in less than 15 per cent of patients there is a need for further evaluation of new regimens. It is necessary to evaluate new regimens in prospective, randomized studies. Response criteria should be consistent and reproducible. Attenuation schedules and data relating to the total administered dosage should be provided. It would also be beneficial to analyze prognostic variables so that patients liable to an unfavorable outcome could be identified before commencement of treatment. PMID- 3511557 TI - The effects of new technologies on the surgical management of brainstem tumors. AB - Nuclear magnetic resonance, real-time and A-scan ultrasonography, and computerized CO2 lasers were recently introduced for diagnosis and surgical treatment of brainstem tumors. These new technologies offer many advantages: safe but aggressive surgery on the brainstem, the possibility of performing a correct histologic diagnosis, and an exact indication for radiotherapy. Eleven tumors were operated on in our series: seven were intrinsic and four protruded out from the axis. Patients with high-grade malignant tumors died from 5 to 12 months after treatment, whereas those with pilocytic astrocytoma are still alive and leading useful lives. PMID- 3511558 TI - Historical development of spinal cord cooling. PMID- 3511559 TI - Dose response relationships for radiation induced chromosome aberrations in human lymphocytes in vivo and in vitro. AB - Chromosome aberrations have been analysed in cultured lymphocytes from a patient undergoing whole-body treatment with split doses of gamma-rays up to a cumulative dose of 1.4 Gy. The dependence on dose of the yield of dicentrics was best fitted to the linear-quadratic relationship with a linear component predominating in the low dose range (below 0.56 Gy). These observations were compared with the data obtained when blood samples were exposed in vitro to low acute doses of gamma rays (from 0.05 up to 2.0 Gy). The frequencies of induced chromosome aberrations were similar in both cases and little deviation was found between the dose response curves (a/b ratio equal to 0.56 and 0.69 Gy, respectively in vivo and in vitro). These results confirm that in vitro calibration curves can be utilized confidently for the biological estimate of an in vivo absorbed dose. PMID- 3511560 TI - Hemodynamic determinants of mortality in human septic shock. AB - To assess the relative importance of cardiac versus peripheral vascular failure in patients dying of septic shock, a series of 42 patients with documented septic shock was retrospectively evaluated. Patients were included in the study if serial hemodynamic and metabolic studies had been performed: the first one within 12 hours after onset of septic shock and the last one within 12 hours (median 2 hours; range 0.1 to 12 hours) before death in nonsurvivors. Nonsurvivors were included only if they died in shock. From the patient records the first, highest, and last measured cardiac indexes (CI) (t = 1, t = 2, and t = 3) with concomitant hemodynamic and metabolic variables were obtained. Group I (n = 21) consisted of survivors and group II (n = 21) of nonsurvivors. Group II was divided into three subgroups: group IIa (n = 4) consisted of nonsurvivors with liver cirrhosis, group IIb (n = 9) patients with final CI less than 4 1 X min-1 X m-2, and group IIc (n = 8) patients with final CI greater than 4 1 X min-1 X m-2. At t = 1 no significant differences in hemodynamic variables were found between groups I and II, and all patients, whether surviving or not, were able to increase CI to similar levels. At t = 3 group II showed a marked decrease in mean arterial pressure and systemic vascular resistance index compared with group I (p less than 0.001), whereas CI did not differ significantly. The nonsurvivors showed progressive lactic acidemia. Even group IIb patients showed persistent vasodilation despite a decrease in CI. Our data suggest that many patients in septic shock die as a result of peripheral vascular rather than cardiac failure, since persistent vasodilation, irrespective of CI, was a major hemodynamic determinant in nonsurvivors, of whom 57% maintained a high CI until shortly before death. PMID- 3511561 TI - Improved survival in free skin flap transfers in rats. AB - We have demonstrated previously that oxygen-derived free radicals are important mediators of tissue injury in experimental island skin flaps that have been subjected to prolonged ischemia (vascular occlusion) followed by reperfusion. In this study the role of oxygen free radicals in ischemia/reperfusion injury has been investigated in free flap transfers. Groin skin flaps were harvested, stored at room temperature for 21 to 24 hours, and transplanted to the contralateral groin. These free flap transfers normally exhibit a high incidence of complete necrosis. Treatment before the onset of reperfusion with a single dose of superoxide dismutase (SOD), a scavenger of superoxide radicals, increased the survival rate of these skin flaps from 38% in the control group to 76% (p less than 0.025). Tissue levels of SOD were measured before ischemia, after ischemia but before reperfusion, and 30 minutes after reperfusion: untreated flap tissues, which were destined to undergo necrosis, exhibited a significant decrease in SOD activity after reperfusion, whereas SOD-treated flap tissues, destined to survive, demonstrated increased enzyme activity. High levels of tissue SOD activity thus appeared to be associated with improved flap survival. The results have significant clinical implications with regard to organ preservation and transplantation. PMID- 3511562 TI - Medicine in Texas: the historical literature. PMID- 3511563 TI - [Mycotic placentitis in cattle]. AB - Two cases of bovine mycotic placentitis are reported. The two cows did not show any clinical symptoms before or during premature delivery of two clinically normal calves. In both placentas a severe placentitis accompanied by extensive necrosis and a large number of hyphae was present in two placentas. Aspergillus fumigatus was isolated in one case. The literature on bovine mycotic placentitis is reviewed in the discussion. PMID- 3511564 TI - [Resistance to antibiotics in Salmonella]. AB - Approximately 20,000 strains of Salmonella were screened annually for resistance to tetracycline, chloramphenicol, kanamycin and ampicillin since 1959, and also to trimethoprim since 1978. Tetracycline-resistant strains increased in human subjects and pigs from 1961. After the ban on incorporation of tetracycline in animal feeds for nutritive purposes in 1974, the proportion of tetracycline resistant strains in pigs and human subjects decreased. In veal calves, the number of strains of S. typhimurium and S. dublin resistant to multiple drugs increased from 1972. Strains resistant to multiple antibiotics in man were mainly isolated from adoptive children from Indonesia. No further spread of these strains was observed. So far, strains similar to those in calves resistant to multiple drugs were only incidentally isolated from human patients. PMID- 3511565 TI - The progression of adriamycin-induced nephrotic syndrome in rats and the effect of captopril. AB - The progression of adriamycin-induced nephrotic syndrome in rats was studied over a 3-month period. The effect of an angiotensin-converting enzyme inhibitor, captopril, on this model of renal disease, was also studied. Two weeks following a single iv injection of adriamycin, rats were divided into two treatment groups: one received a daily po dose of captopril and the other received a placebo. Measurements of renal function were performed at 4, 8, and 11 weeks following the initiation of therapy. Necropsies and light microscopic evaluation of the kidneys were performed at the end of the treatment period. Functional and morphologic alterations in both groups of rats were compared to each other and to normal age/weight-matched control rats studied over the same time period. At 13 weeks following the administration of adriamycin, both treatment groups had significant renal dysfunction when compared to normal controls. In addition to severe proteinuria, rats receiving adriamycin exhibited polyuria, polydipsia, increased plasma urea nitrogen and plasma creatinine, and decreased endogenous creatinine clearance. They had severe generalized kidney lesions characterized by tubular dilation and atrophy, cast formation, interstitial fibrosis and lymphocytic infiltration, and focal, global glomerulosclerosis. The histopathologic ranking of the kidneys was correlated with some antemortem laboratory parameters but not with the degree of proteinuria. Captopril had no ameliorating effects on the progression of renal disease. Certain findings indicate that captopril may actually have promoted the deterioration of renal function. We conclude that adriamycin-induced nephrotic syndrome in the rat is a progressive disease resulting in generalized renal dysfunction, and that captopril, at the dose given in this experiment, is unable to slow the progression of the disease. PMID- 3511566 TI - Effects of smoking and nicotine on human prostacyclin and thromboxane production in vivo and in vitro. AB - We studied the effects of smoking and nicotine on the production of proaggregatory thromboxane A2 (TxA2), antiaggregatory prostacyclin (epoprostenol, PGI2), and on lipid peroxidation in vivo and in vitro. In the in vivo study, serum concentrations of thromboxane B2 (TxB2), a stable metabolite of TxA2, increased immediately after smoking three cigarettes but not after smoking the equivalent amount of tobacco in a pipe, whereas serum lipid peroxide values did not change in either group. In vitro, nicotine (2 X 10(-3) mol/liter) inhibited pulmonary TxB2 production by 70% and simultaneously stimulated the production of 6-keto-prostaglandin F1 alpha, a stable metabolite of PGI2, by 40%, which suggest that nicotine does not exert its effect at the cyclooxygenase level. During aggregation in platelet-rich plasma, TxB2 production was inhibited by 53% with 2 X 10(-3) mol/liter of nicotine, and during whole blood clotting the inhibition was 34% with 2 X 10(-4) mol/liter of nicotine. Thus the rise in cigarette smokers' serum TxB2 was probably caused by some constituent of cigarette smoke other than nicotine. The increased production of TxA2 following cigarette smoking may provide one explanation for the increased incidence of atherosclerosis and its complications in cigarette smokers. PMID- 3511567 TI - EC/IC Bypass Study. PMID- 3511569 TI - Hepatic transplant: the last hope for some patients. PMID- 3511568 TI - Hemorrhagic complications of long-term anticoagulant therapy for ischemic cerebral vascular disease. AB - The main complication of anticoagulant therapy is bleeding. Although the use of long-term oral anticoagulants in patients with transient cerebral ischemia and/or minor stroke is controversial, anticoagulants are still used in some instances. We have carried out a literature review of the risk of hemorrhage during long term oral anticoagulant therapy in patients with cerebrovascular disease to determine the rate of bleeding and the clinical and laboratory risk factors which predispose patients to bleeding. The risk of bleeding was substantial with major bleeding episodes ranging from 2% to 22% per year and fatal bleeds from 2% to 9% per year. Only hypertension emerged as an identifiable risk factor and its presence increased the relative risk of bleeding to more than two fold. Major bleeding was almost always intracranial, possibly because of associated hypertension or because of cerebrovascular disease per se. We could not detect a relationship between bleeding and the intensity of anticoagulant therapy, although major bleeding occurred frequently even with only moderately intense anticoagulant therapy. The net gain or loss in efficacy rate of treating patients with minor stroke with long-term oral anticoagulant therapy was examined and it was concluded that in order for such treatment to be beneficial, a risk reduction of more than 50% in stroke rate, and a major bleeding rate of less than 2% per year are required. Since the risk reduction for stroke and death with anticoagulant therapy is unlikely to be 50% and the risk of major bleeding likely to be more than 2%, the present evidence does not support the use of anticoagulant therapy in minor stroke. PMID- 3511570 TI - Use of radioisotopically-labeled platelets to determine the survival properties of stored platelets. An overview of the present status. PMID- 3511571 TI - Gerbich (Ge) antibody classification using enzyme-treated red cells. PMID- 3511572 TI - Logical issues in interpreting studies in platelet survival. PMID- 3511573 TI - Donor variables affecting survival of autologous platelets. AB - While platelet survival studies have been carried out by numerous laboratories for many years, general agreement has not been reached on a single method or for the value of this test. Available data indicate that in spite of certain difficulties, reliable comparisons can be obtained using relatively small numbers of donors. Indeed, a difference in platelet survival of as little as 10 percent can be detected by using eight donors, whereas only four donors are required if one wishes to detect a 20 percent change. Should studies be done using donors preselected according to strict criteria of age, sex, health, etc.? It might be that less scatter among the data points would be observed and perhaps even fewer donors would be required to obtain significant values. In surveying the available information, it is clear that many investigators do have data on normal controls which could be extracted and analyzed to provide an answer to this question. Such information would be of great value in determining the criteria for selection of donors for autologous platelet survival studies. PMID- 3511574 TI - Survival curves of incompatible red cells. An analytical review. PMID- 3511575 TI - Poststorage platelet viability in thrombocytopenic recipients is reliably measured by radiochromium-labeled platelet recovery and survival measurements in normal volunteers. PMID- 3511576 TI - Use of blood components containing red cells by donors of allogeneic bone marrow. AB - Bone marrow transplantation is performed for an increasing number of disorders. Although much has been written about blood transfusion in bone marrow recipients, there is little information dealing with blood transfusion in bone marrow donors. We examined the records of 129 consecutive allogeneic bone marrow transplants to determine blood use by bone marrow donors. We attempted to correlate blood transfusion requirements with a number of variables in both donors and recipients of bone marrow. The volume of marrow harvested correlated closely with the number of units of blood transfused (r = 0.82). When these two variables were expressed as a percent of estimated blood volume, the correlation improved slightly (r = 0.85). Although the volume of marrow correlated highly with the total number of mononuclear cells harvested (r = 0.92), the correlation between total cells harvested and number of units of blood transfused was not as high (r = 0.75). By knowing the number of marrow cells the recipient requires for transplantation, the volume of donor marrow required and donor blood transfusion requirements can be estimated. In most instances, autologous blood could be used exclusively, thus eliminating the risks associated with homologous blood transfusion. PMID- 3511577 TI - Local treatment of renal allografts, a promising way to reduce the dosage of immunosuppressive drugs. Comparison of various ways of administering prednisolone. AB - A method is described for continuous administration of immunosuppressive drugs directly into rat renal allografts. The drug is given via a catheter, introduced into the suprarenal or testicular artery of the transplanted kidney. The cannula is connected to an implantable osmotic minipump that delivers an immunosuppressive drug with continuous flow for 13 days. It is demonstrated that the technique as such has no detrimental or enhancing effects on renal allograft survival. Depending upon the pharmacokinetic properties of the drug administered, this technique allows a more or less selective treatment of renal allograft rejection. The method was used to test the effect of intrarenal administration of prednisolone on renal allograft survival. Intrarenal administration of this drug appeared to be superior to any other way of administration tested. A low dose of 4 mg/kg body weight per day given by continuous intrarenal infusion results in significant prolongation of graft survival, whereas continuous systemic administration of this dose is not effective. To induce prolongation of graft survival by i.p. administration the prednisolone dose had at least to be doubled. The results prove that during graft rejection local events within the graft are vulnerable to prednisolone. It is concluded that local treatment of allograft rejection is possible and that this approach represents a potentially important way to manipulate the immune response. PMID- 3511578 TI - The role of major and minor histocompatibility antigens in active enhancement of rat kidney allograft survival by blood transfusion. AB - Rats given a blood transfusion do not reject a subsequent kidney allograft from the same donor strain. This effect is strain-specific so that pretransplant blood transfusion from a LEW (RT1l) rat will protect a LEW kidney in a DA (RT1a) recipient but not a PVG/c (RT1c) kidney. The same is true in other combinations. Using DA or PVG.RT1a congenic recipients we have shown that sharing of all or part of the MHC or of minor alloantigens by the blood transfusion and kidney transplant donors is sufficient to prolong allograft survival. Activation of suppression against minor alloantigens appears to require two signals: one is the minor alloantigen and the other may be a major histocompatibility complex alloantigen. PMID- 3511579 TI - Cyclosporine as an alternative to cyclophosphamide in the treatment of chronic graft-versus-host disease. AB - Four patients with progressive extensive chronic graft-versus-host disease or dose-limiting toxicity on conventional therapy (cyclophosphamide + prednisolone) were treated with a regimen of cyclosporine + prednisolone as induction therapy and cyclosporine as maintenance therapy. All 4 showed clinical improvement and 3 of 4 are alive at 9 months. The incidence of infections was not affected by this regimen, but steroid requirements were reduced. PMID- 3511580 TI - Spontaneous anti-tubular-basement-membrane antibody production by lymphocytes isolated from a rejected allograft. AB - The immunological events mediated by, and antigen specificity of, allograft-bound lymphocytes (ABLs) are poorly understood. To further define the role of antibody mediated rejection, a rejected allograft from a patient with primary anti-TBM disease was sterilely minced and pressed through a microscreen. The ABLs were isolated by density gradient centrifugation. Using this technique, 8.5 X 10(6) ABLs were isolated. Then 1 X 10(6) washed ABLs/ml were suspended in RPMI 1640 with 20% fetal calf serum and cultured in microtiter plates with media only, or with pokeweed mitogen (PWM) (100 micrograms/culture). The cells were incubated for 7 days and supernatants were collected and assayed for total IgG and IgM by a solid-phase enzyme immunoassay (EIA) and reactivity with normal human kidney targets by indirect immunofluorescence (IF) and immunoperoxidase (IP) techniques. Total IgG production was 500 ng/ml for both spontaneous and PWM stimulated cells. No IgM production was detected. IF and IP studies demonstrated IgG-anti-TBM antibodies in the spontaneous supernatants only. IgG antibodies reactive with peritubular capillaries (anti-PTC) were also noted. IgG-anti-TBM anti-bodies and antibodies reactive with arterioles were subsequently demonstrated by direct immunofluorescence techniques in the rejected allograft. Analysis of serum samples obtained at the time of allograft rejection showed no IF or IP reactivity with the kidney targets. Subsequent analysis of anti-TBM production by the patient's peripheral blood mononuclear cells (PBMs) showed IgM-anti-TBM only. These studies suggest that the IgG-anti-TBM and IgG-anti-PTC antibodies reactive with the allograft resulted from in situ antibody production by ABLs; the role of anti-TBM antibodies in mediating the AR is unclear, but their presence suggests recurrence of the original disease in the allograft. Anti-PTC antibodies could be important in mediation of the vascular AR. PMID- 3511581 TI - The effects of delayed function on recipients of cadaver renal allografts. A study of 158 patients randomized to cyclosporine or ALG-azathioprine. AB - We randomized 158 recipients of cadaver renal allografts to cyclosporine prednisone (83) or antilymphocyte globulin-azathioprine-prednisone (75) to evaluate: the effects of immunosuppression and pretransplant risk factors on the incidence of delayed graft function, the effects of immunosuppression on the resolution of delayed graft function, and the effects of delayed graft function and pretransplanted risk factors on patient and graft survival. Cyclosporine did not increase the incidence of delayed graft function, compared with ALG azathioprine-treated patients (33% versus 27%, P = 0.550) but doubled the mean (+/- SD) duration of oliguria (11.8 +/- 11.0 versus 5.9 +/- 3.2 days, P = 0.002) and the number of required dialyses (6.6 +/- 7.6 versus 3.2 +/- 1.3, P = 0.031). Retransplanted patients had a higher incidence of delayed graft function that recipients of primary grafts in both the cyclosporine (82% versus 25%, P = 0.001) and ALG-azathioprine (55% versus 22%, P = 0.025) treatment groups. The presence of delayed function reduced one-year graft survival from 89% in all patients without delayed function to 72% (P = 0.011) in all patients with delayed function. Cyclosporine-treated patients had a slightly, but not significantly better one-year graft survival rate than ALG-azathioprine treated patients both with (73% versus 68%, P = 0.750) and without (92% versus 82%, P = 0.069) delayed graft function. A preservation time longer than 24 hr did not increase the incidence of delayed graft function in cyclosporine-treated patients (34% versus 32%, P = 0.811) or ALG-azathioprine-treated patients (27% versus 27%, P = 0.902). Cyclosporine-treated patients given kidneys with greater than 24 hr of preservation time had reduced graft survival only when delayed graft function occurred (67% versus 92%, P = 0.009). In conclusion, (1) cyclosporine did not increase the incidence of delayed graft function over ALG-azathioprine treatment; (2) cyclosporine did significantly slow recovery of kidneys with delayed function; (3) delayed graft function correlated with poorer graft survival rate in both treatment groups; but (4) prolonged preservation time did not increase the incidence of delayed graft function or reduce graft survival. PMID- 3511582 TI - The decreased incidence of aseptic necrosis in renal transplant recipients--a case control study. AB - Before 1971 the incidence of aseptic necrosis in renal transplant recipients was 29%, and after 1971 it was 5%. To investigate the reasons for this decreased incidence and to elucidate the causes of aseptic necrosis we studied all 26 transplant patients with aseptic necrosis and 42 controls matched for year of transplantation, age, and sex. Development of aseptic necrosis was not related to duration of dialysis before transplant, severity of uremia at the time the patient started dialysis, adequacy of dialysis before transplantation, transplant dysfunction at the time aseptic necrosis was diagnosed, hyperparathyroidism before or after transplantation, lack of Vitamin D supplementation after transplantation, or fatty infiltration of liver. Total steroid dose 1 month after transplantation was actually lower in aseptic necrosis compared with the control group (2.47 +/- 0.3 g vs. 3.6 +/- 0.3 g SEM g) and was similar after 4 months (6.72 +/- 0.55 g vs. 7.14 +/- 0.6 g), as were total numbers of i.v. doses of methylprednisolone or hydrocortisone. However, blood urea nitrogen (BUN) during the dialysis period was significantly higher in the aseptic necrosis group. Of the aseptic necrosis group, 27% had a previous transplant compared with 5% of controls. Half the aseptic necrosis group (5/10) had parenchymal iron on liver biopsy one year after transplant compared with 15% (2/13) of those without aseptic necrosis. Patients transplanted before 1971 (with and without aseptic necrosis) received significantly more i.v. hydrocortisone and less i.v. methylprednisolone, had higher BUN levels at the time of starting dialysis, and had lower serum calcium and higher serum phosphate at transplantation compared with patients transplanted in or after 1971. The incidence of aseptic necrosis following transplantation has decreased during the past 13 years for reasons that are unclear. Risk factors for aseptic necrosis may include previous transplantation, severe iron overload that may lead to marrow fibrosis and osteopenia, and increased protein catabolism/turnover during dialysis. PMID- 3511583 TI - Allograft rejection and immune responses against allogeneic antigens in neonatally thymectomized mice. AB - Skin allograft survival and immune responses against allogeneic antigens homologous to skin grafts were observed in BALB/c Cr Slc (BALB) mice (H-2d) thymectomized at 1 day after birth and grafted with skin from major histocompatibility complex (MHC)-incompatible, fully allogeneic C3H/HeN (C3H) (H 2k) or MHC-compatible allogeneic DBA/2 Cr Slc (DBA) mice (H-2d), at 14 weeks of age. In neonatally thymectomized (NTx) BALB mice, survival of C3H skin grafts was not prolonged at all, but survival of DBA skin grafts was prolonged significantly, although the survival periods of DBA skin grafts were very different among individual recipients. In NTx recipients grafted with C3H skin, delayed foot-pad reaction (DFR) was not reduced, but cytotoxic lymphocyte (CTL) activity and cytotoxic antibody (CTAb) production were appreciably depressed. CTL and CTAb were reduced profoundly and consistently in all NTx mice grafted with DBA skin, while DFR was reduced to various degrees in each. The degrees of depression of DFR in these NTx mice correlated well with the prolongation of DBA skin survival, although the sample number was small. The rejection of skin allografts appears to be attributable largely to a T cell subset, the function of which can be expressed as DFR. Thymus dependency in the ontogenic development is low as compared with other T cell subsets. PMID- 3511584 TI - The relative immunogenicity of corneal epithelium, stroma, and endothelium. The role of major histocompatibility complex antigens. AB - Corneal allografts have been shown to give rise to immune responses, but the role and relative importance of individual corneal cell populations in evoking such responses remain unclear. We dissected ACI (RT1a) rat corneas into separate epithelial, stromal, and endothelial components by a method that yields pure cell populations in tissue culture, and grafted these components separately to groups of fully allogeneic PVG (RT1c) recipients). Grafts of corneal stroma elicited strong cellular cytotoxic immune responses in a cell-mediated lymphocytotoxic assay, but corneal epithelium failed to generate any detectable response. Grafts of corneal endothelium alone, however, evoked a potent cellular cytotoxic response. Using congenic rats, it was found that grafts from PVG.1A (RT1a) donors to PVG (RT1c) recipients (which differ at both the RT1.A and B loci) yielded identical results. However, no corneal component graft from PVG.R1 (RT1rl) donors to PVG recipients (which differ only at RT1.A) generated a detectable immune response. Use of target lymphoblasts from congenic strains established that at least part of all responses detected were directed against class I (RT1.A) major histocompatibility complex antigens. These findings indicate that there is differential immunogenicity of specific corneal tissue components in the rat that may be further influenced by the degree of MHC disparity between donor and recipient. PMID- 3511585 TI - The graft-versus-host reaction and immune function. IV. B cell functional defect associated with a depletion of splenic colony-forming units in marrow of graft versus-host-reactive mice. AB - Studies were conducted to determine whether a functional B cell defect occurred in the bone marrow of mice experiencing a GVH reaction (GVHBM). GVH reactions were induced in AxCBA F1 adult mice by an injection of A strain lymphoid cells. The GVH reaction was confirmed by immunosuppression and thymus histology. At various intervals after GVH induction, GVHBM was tested for its ability to restore B cell function in adult thymectomized irradiated mice reconstituted with normal thymocytes. GVHBM cells obtained seven days after GVH induction restored but slightly the plaque forming cell (PFC) response to sheep erythrocytes and the mitogen response to lipopolysaccharide (LPS). GVHBM cells obtained 10 days or later failed to reconstitute the PFC or LPS responses. GVHBM cells suppressed neither the T or B cell function of normal spleen cells nor the LPS mitogen response of normal bone marrow cells. In addition, the splenic colony-forming units (CFU-s) in GVHBM were slightly decreased by day 10 after GVH induction and markedly depressed by day 22 after GVH induction. These results suggest that the GVH reaction may affect two different events in B cell differentiation. The early decrease in functional B cells that occurs before there is any change in the CFU s population suggests a direct effect on B cell production, whereas the later absence of functional B cells could be due to the marked decline in stem cell production (CFU-s). PMID- 3511586 TI - Late cellular rejection in renal transplant recipients. PMID- 3511587 TI - Successful treatment with infrared contact coagulation of excessive fluid leakage after spontaneous decapsulation of a renal allograft. PMID- 3511588 TI - Cyclosporine blood concentrations in the management of renal transplant recipients. PMID- 3511590 TI - Fourth annual meeting of the Canadian Transplantation Society. PMID- 3511589 TI - Thirteenth congress of the Scandinavian Transplantation Society. Stockholm, May 8 10, 1985. PMID- 3511591 TI - Pre- and postnatal ultrasonographic diagnosis of congenital obstructive uropathies. AB - Ultrasonography has proved particularly effective in evaluating the neonate with an abdominal mass, poor renal function, and an abnormal perinatal ultrasound scan. As a noninvasive, nonionizing, and relatively inexpensive examination, it can often make the preliminary diagnosis, streamline the work-up, and be used for follow-up studies. PMID- 3511592 TI - Congenital obstructive uropathies. Pre- and postnatal treatment. AB - The evolution of sonographic techniques that allow accurate prenatal diagnosis of obstructive uropathies has led to consideration of specific therapeutic options in the care of such lesions. After briefly reviewing historical developments, the authors examine recent clinical experience with the prenatal treatment of congenital obstructive uropathies and consider possible clinical criteria for selecting appropriate candidates for such interventions. PMID- 3511593 TI - Historic notes on the development of the computer. AB - A summary of some of the major historic achievements in the development of the computer is detailed from the ancient efforts represented by Stonehenge through the development of the transistor. PMID- 3511594 TI - Physician use of on-line databases. AB - All in all, the amount of information and the potential use to the physician are difficult to overstate. Still, possibly one of the most amazing things about this area of computers in medicine is that this is only the beginning. PMID- 3511595 TI - Absorption of anticancer drugs through bladder epithelium. AB - Fundamental and clinical evaluations of ten anticancer drugs were performed. The required qualities of an anticancer drug ideal for bladder instillation therapy are thought to be as follows: (1) a high sensitivity for bladder tumor cells; (2) a pKa which provides a high percentage of nonionized molecules in a pH 6-7 solution; (3) a log P in the range from -0.4 to -1.2 or from -7.5 to -8.0; and (4) a molecular weight over 200. PMID- 3511596 TI - Modified technique of urethral meatotomy in males. PMID- 3511597 TI - Cystoscopic transvesical placement of sutures for repair of posterior urethral strictures. PMID- 3511598 TI - Some memories of Frederic Eugene Basil Foley. PMID- 3511599 TI - Controversies in management of urinary tract infection. PMID- 3511600 TI - Immunohistochemical identification of generalized AA-amyloidosis in a mountain gazelle (Gazella gazella). AB - Generalized amyloidosis was diagnosed post-mortem in a mountain gazelle (Gazella gazella). To test whether the amyloid deposits consisted of amyloid-A fibril protein a series of monoclonal and polyclonal antibodies directed against amyloid A fibril protein of different species was applied to formalin-fixed paraffin sections using the indirect immunoperoxidase technique. The immunohistochemical results showed a moderate cross-reaction of gazelle amyloid with human, murine, hamster, and canine amyloid-A fibril protein. A strong cross-reaction, however, was found with one of two monoclonal anti-human amyloid-A antibodies and with an antiserum against bovine amyloid-A fibril protein, the amyloid fibril protein of another ungulate. These results demonstrate the presence of amyloid-A fibril protein in the gazelle amyloid and illustrate the diagnostic value of cross reacting anti-amyloid-A antibodies for the identification of amyloid-A amyloidosis in species and in individuals in which amyloid has not yet been examined. PMID- 3511601 TI - Prevalence of Leptospira interrogans serovar hardjo in the genital and urinary tracts of non-pregnant cattle. AB - In a bacteriological investigation of 60 cows and heifers from an abattoir Leptospira interrogans serovar hardjo was isolated from 39 (65 per cent) animals. The genital tract (57 per cent) appeared to be as important a site of hardjo localisation as the urinary tract (62 per cent). This is believed to be the first report of genital hardjo infection in naturally infected cattle. PMID- 3511602 TI - Flunixin meglumine in calves with natural bovine respiratory syncytial virus infection. AB - Twenty-three calves (three to eight months of age) with serological evidence of bovine respiratory syncytial virus infection were used in this study. The calves originated from four herds with respiratory tract disease. In a double blind trial the calves were injected intravenously with either flunixin meglumine (2 mg/kg body weight) or with a placebo. The effect on the course of disease was measured using the PO2 in capillary blood samples from the ears of the calves and by the effect on body temperature and respiratory rate. Mean body temperature fell significantly in the flunixin meglumine treated group. Statistically significant differences were not found between the treated and control group during the seven-day examination period. PMID- 3511603 TI - Field trials with cefoperazone in the treatment of bovine clinical mastitis. AB - A single dose of 250 mg cefoperazone in an oil based suspension infused into bovine quarters suffering from clinical mastitis resulted in an overall clinical cure of 82 per cent in 597 cases, as assessed by veterinarians in four countries (Sweden, Denmark, France and the United Kingdom). Of those cases for which adequate bacteriological data were available 69 per cent of 434 cases were cured. There were no reports of adverse reactions following therapy of an affected quarter. The introduction of single dose treatment represents an advance in mastitis therapy as it offers a simpler and shorter treatment than most present day mastitis therapeutics when used according to recommendations. PMID- 3511604 TI - Ultrasonic diagnosis of pregnancy. PMID- 3511605 TI - Studies on the association of Aspergillus fumigatus with ocular infections in animals. AB - The occurrence and aetiological significance of Aspergillus fumigatus, an opportunistic pathogen, have been studied in 93 animals with various ophthalmological problems. A total of 93 eye swabs collected from 35 mules, 26 dogs, 13 fowl, 11 cattle, five buffaloes and three camels were investigated mycologically for the presence of A fumigatus. The pathogen was isolated in pure and heavy growth from the swabs from two dogs, one bull, one mule and one fowl. The fungus was also demonstrated directly in clinical material by the potassium hydroxide technique. A fumigatus could not be cultured from the buffaloes and camels. All the five cases had been treated with broad spectrum antibiotics and cortisone and two had received traumatic injury to the eyes (one mule and a bull). The organism was not isolated in pure culture from the conjunctival swabs of 22 apparently healthy animals (11 dogs, six mules, three fowl and two cattle). Many other saprophytic fungi were recovered in mixed cultures but were considered to be contaminants. The clinical signs and diagnostic criteria of oculomycosis have been discussed. PMID- 3511607 TI - Distribution of hemagglutinin and neuraminidase on influenza virions as revealed by immunoelectron microscopy. AB - Monoclonal antibodies specific for the hemagglutinin (HA) or the neuraminidase (NA) of influenza viruses were used in immunoelectron microscopic studies to determine the distribution of the two surface spikes on the virion. Indirect immunogold staining revealed that the HA is uniformly distributed on the virion while the NA occurs in discrete areas. Crosslinking and low temperature studies argue against redistribution of the HA and NA after antibody attachment and indicate that the NA on influenza virus occurs in patches. PMID- 3511606 TI - Effects of anthelmintics on Haemonchus contortus (Nematoda: Trichostrongylidae). AB - The review summarizes and evaluates recent information about the effects of anthelmintics on Haemonchus contortus. The topic is discussed under the headings effects of drugs on the absorptive surfaces, effects of drugs on metabolism, effects of drugs on the neuromuscular system, effects of drugs on developmental stages, anthelmintic efficacy, and resistant strains. Possible future lines of work are suggested in the conclusions. PMID- 3511609 TI - [Malignant tumors of the genitalia in girls]. AB - A review of the literature and analysis of 40 cases of genital malignancies girls are presented. 31 patients had ovarian tumor, 2--cervical, 4--vaginal and 3- tumor of the vulva. Most embryonal rhabdomyosarcoma of the vagina or the vulva occurred in patients under 4 whereas ovarian neoplasms (mostly germ and sex cord tumors) were observed at prepubertal and pubertal age. Early dissemination and unfavorable prognosis were typical of rhabdomyosarcoma of the vagina and vulva. Stage I dysgerminoma and granulosa cell tumor usually make the case for sparing surgery whereas stage II and III malignancies--for a radical one, irrespective of histological pattern. Prognosis is better when surgery is supplemented with individually-tailored chemotherapy. PMID- 3511608 TI - Functional expression in Escherichia coli of cloned reovirus S1 gene encoding the viral cell attachment protein sigma 1. AB - A cDNA clone encompassing the complete reovirus (serotype 3) S1 gene was constructed using two partial clones containing overlapping sequences. The gene (with the first 15 bases at the 5' end up to and including the first ATG removed) was then inserted in frame into the lac cloning site of the pUC13 plasmid and expressed in Escherichia coli as a fusion product under control of the lac promoter. The expressed product can be immunoprecipitated as a 47,000-mol wt (47K) protein using several monoclonal anti-sigma 1 antibodies. Like authentic soluble sigma 1 from reovirus-infected cells, the expressed protein is capable of attaching to mammalian cells (mouse L fibroblasts) in a specific manner and of competing with reovirus particles for cell surface receptors. Lysates prepared from the recombinant plasmid-transformed, but not those from pUC13-transformed E. coli cells, were also found to exhibit hemagglutinating (HA) activity. Such hemagglutination was inhibited by a monoclonal anti-sigma 1 antibody previously shown to inhibit reovirus HA activity. It is concluded that both the host cell attachment domain and the hemagglutination domain on the expressed protein are functionally intact. PMID- 3511610 TI - [Mathematical dose-effect models in the study of carcinogenesis]. PMID- 3511611 TI - Use of the cytocentrifuge for electron microscopy investigations. AB - A simple method of cytocentrifugally processing cell suspensions for conventional and histochemical investigations at the ultrastructural level is described. Fixed sediments from cell-poor suspensions are resuspended in an albumin-buffered solution. A few drops of the albumin cell solution are cytocentrifuged, leaving a cell disc on a plastic support. A brief dipping in a paraformaldehyde glutaraldehyde mixture transforms the cell disc into a compact thin fragment attached to the plastic support. Cytocentrifugation of cell-rich suspensions, on the other hand, produces a thicker cell disc, which can be easily detached from the plastic slide. In both cases, the postfixation, dehydration and infiltration are directly carried out on the cell disc. The present method is particularly useful for the ultrastructural study of cell-poor suspensions and can also be performed on cell suspensions previously stained with several histochemical procedures. PMID- 3511612 TI - The nucleus basalis-neostriatum complex in the goose (Anser anser L.). PMID- 3511613 TI - The expanding spectrum of beta-lactam antibiotics. PMID- 3511615 TI - New approaches to outcome assessment: the AIMS questionnaire for arthritis. PMID- 3511614 TI - Lyme disease: infectious in origin, rheumatic in expression. PMID- 3511616 TI - Control of rejection of transplanted organs. PMID- 3511617 TI - Pulmonary embolism: a review. PMID- 3511618 TI - The natural history and management of sarcoidosis. PMID- 3511619 TI - Clinical proteinuria. PMID- 3511620 TI - Hyperkalemia. PMID- 3511621 TI - Polyglandular autoimmunity. AB - Although target tissues or glands differ, several common threads have begun to emerge that link the diseases of the autoimmune endocrine syndromes. In the polyglandular syndrome type II, a defect resides in one of the genes of the major histocompatibility locus which, in concert with other gene(s), results in susceptibility. Genetic susceptibility is necessary but not sufficient to produce the disorder. This is illustrated by the lack of 100% concordance of disease in identical twins. This lack of concordance has led to the search for environmental influences or "triggers" of the autoimmune process. These "triggers" have not been well defined, but may include amiodarone or other iodine-containing medications for thyroid autoimmunity and congenital rubella for some patients with diabetes and thyroiditis. The autoimmune destruction of most target glands appears to be a slow process with a long preclinical prodrome that may last for years. During this period, autoantibodies, lymphocyte abnormalities, and subclinical endocrine defects are usually present. As knowledge of target antigens has progressed, it appears that despite polyendocrine disease, within each gland specific antigens are the targets of the autoimmune process. When the genetic defect(s) and environmental influences of organ specific autoimmunity are better understood, it may be possible to devise specific "replacement" or corrective therapies. In the absence of this knowledge, therapies directed at partial immunosuppression are currently being studied in Type I diabetes and Graves' ophthalmopathy. Given the similar features of many of the organ-specific autoimmune disorders, it is likely that if immunotherapeutic modalities are successful in one disease, they may be of benefit in related disorders. PMID- 3511622 TI - Diabetic vascular disease. PMID- 3511624 TI - The management of common duct stones. PMID- 3511623 TI - Treatment of cirrhotic ascites. PMID- 3511625 TI - Scintigraphic techniques for the study of gastrointestinal motor function. AB - A variety of scintigraphic techniques has been added to the gastroenterologist's armamentarium for the evaluation of motor dysfunction of the upper gastrointestinal tract and hepatobiliary tree. These methods include: esophageal transit scintigraphy for the measurement and quantitation of aboral movement of liquids through the esophagus, and for the measurement of esophageal clearance; gastroesophageal reflux scintigraphy for the detection and quantitation of gastroesophageal reflux, gastric scintigraphy for the physiological measurement of the simultaneous rates of emptying of liquids and solids from the stomach; hepatobiliary scintigraphy for the detection of acute cholecystitis, biliary tract obstruction, bile leaks; and enterogastric reflux scintigraphy for the detection and quantitation of bile reflux from the small bowel into the stomach. Each of these methods is relatively physiologic in comparison to other modalities in that none requires intubation or other nonphysiologic maneuvers. Each offers the practicing internist, surgeon, and gastrointestinal physiologist, the ability to measure normal and abnormal function in patients. Because of the low radiation burdens involved and high patient acceptance, these methods are suitable for serial studies in the same patient, particularly before and after the application of various therapeutic modalities. PMID- 3511626 TI - Nuclear magnetic resonance (NMR) in clinical diagnosis. AB - In this chapter, we have briefly reviewed the techniques of in vivo NMR spectroscopy and chemical shift imaging. These techniques are complementary, and both are of great potential clinical significance. Most of the data presented here is limited to 31P and 1H NMR, but with additional refinements, 13C and 19F NMR will likely be studied in the near future. PMID- 3511627 TI - Echocardiography in the diagnosis of a cardiac mass: are we seeing too much or too little? PMID- 3511628 TI - Neuromuscular effects of monoamine oxidase inhibitors. AB - The MAOI class of drugs is known to produce neuromuscular effects at therapeutic and toxic doses when given alone or in combination with other drugs. These effects range from muscle tension and twitches in their mild form to forceful myoclonic jerks. These effects may also be part of a more pervasive toxic syndrome that includes autonomic and mental symptoms as well. There is meager direct and substantial indirect evidence that serotonergic mechanisms play a role in mediating the neuromuscular effects of MAOIs. We have hypothesized that MAOIs produce a condition of heightened neuromuscular excitability due to a combination of increased serotonergic tone and central disinhibition of alpha-motor neuron mediated spinal activity. Further study is needed utilizing objective pharmacologic and neurophysiologic measures. PMID- 3511629 TI - Excessive startle syndromes: startle disease, jumping, and startle epilepsy. PMID- 3511630 TI - Somatosensory evoked potentials in myoclonus. PMID- 3511631 TI - Electrophysiology of somatosensory reflex myoclonus. PMID- 3511632 TI - Motor activity and the brain serotonin system. PMID- 3511633 TI - Early history of myoclonus. AB - The term myoclonus is a shortened form of the name paramyoklonus multiplex used by Nikolaus Friedreich to describe the involuntary movements of a patient whom today would be said to have a form of essential myoclonus. The details of this case and Friedreich's discussion of it have been reviewed. Other early cases and the initial classification scheme of H. Lundborg have been described. PMID- 3511634 TI - Incremental dynamic computed tomography: practical method of imaging the carotid bifurcation. AB - A simple, practical method of applying incremental dynamic computed tomography (CT) to the imaging of 20 carotid bifurcations is described. The results are compared with those obtained by conventional carotid angiography and intravenous digital subtraction angiography (DSA). Conventional angiography provided additional information about the carotid bifurcation in only one of 14 cases, while incremental dynamic CT provided information not available from intravenous DSA in two of eight cases. Conventional brain CT is being used increasingly in the workup of patients with transient ischemic symptoms, and dynamic CT scanning at 3-mm increments requires only an extra 5 min of scanner time. The addition of incremental dynamic CT through the carotid bifurcation to the conventional brain CT scan procedure may obviate other screening tests before more definitive angiographic procedures. PMID- 3511635 TI - Prevalence of "compressed" and asymmetric lateral ventricles in healthy full-term neonates: sonographic study. AB - The premature infant brain has been thoroughly studied by sonography, and normal standards for ventricular size have been established. Whether these apply to normal full-term infants is uncertain. Fifty-three healthy full-term infants were electively examined by real-time sonography through the anterior fontanelle on the first to sixth days of life. Nine had asymmetric lateral ventricles; two of these had unexpected evidence of intracranial hemorrhage, while a third had a ventricular cyst. Forty-four infants had symmetric ventricles, but in 36 the ventricles had little or no cerebrospinal fluid. Vaginal delivery had a statistically significant association with these "compressed' lateral ventricles. This study indicates that seemingly healthy infants may have unsuspected intracranial hemorrhage, that asymmetric ventricular size may be normal, and that shortly after birth most healthy infants have "compressed" lateral ventricles that should not be interpreted as cerebral edema. PMID- 3511636 TI - Sonographic detection of postsurgical recurrence of Crohn disease. AB - Sonography, contrast radiography, and endoscopy of the small and large intestine were performed in 32 patients, who had already undergone one or more intestinal resections for Crohn disease, with the aim of detecting possible relapses. Eleven patients proved to have had relapses; sonography revealed nine cases, with two false negatives and no false positives. Sensitivity proved to be 82%, specificity 100%, and overall accuracy 93.7%. Sonography enables the operator to distinguish between inflammatory and neoplastic lesions by means of structural study of the thickened bowel wall, paying particular attention to integrity of its layers. PMID- 3511637 TI - Regenerating nodules in cirrhosis: sonographic appearance with anatomic correlation. AB - A sonographic-anatomic correlation study was undertaken to define the sonographic appearance of regenerating nodules in cirrhotic livers. Three cirrhotic livers with multiple regenerating nodules were obtained from patients undergoing liver transplantation. Sonograms of the resected livers were made and correlated directly with the anatomic specimens. Using a 3-MHz transducer, no discrete alterations in the echo texture of the livers were seen to correspond to the regenerating nodules. With a 7.5-MHz transducer, discrete islands of liver parenchyma were identified corresponding to regenerating nodules anatomically. The nodules were recognized because of visualization of thin, slightly more echogenic borders, which corresponded pathologically to fibrous and fatty connective tissue surrounding and separating the nodules. PMID- 3511638 TI - Renal sonography in American Burkitt lymphoma. AB - Renal involvement is a common finding at necropsy in patients with American Burkitt lymphoma, but its in vivo sonographic features have received little attention in the literature. Of 29 patients with American Burkitt lymphoma who underwent sonography, 10 were found to have renal involvement. The 10 patients demonstrated a range of abnormalities, notably renomegaly (nine patients), diffuse increase in cortical echogenicity (six), and focal renal masses (three). The focal infiltrations were, unexplicably, hypoechoic in two patients and hyperechoic in one. Hydronephrosis was seen in five patients. One patient had evidence of calcium phosphate renal stones. Response to therapy can be assessed by changes in renal size and cortical echogenicity, as well as disappearance of focal lesions. PMID- 3511639 TI - Pitfalls of rotator cuff sonography. AB - Experience with rotator cuff sonography in 106 patients was analyzed to identify the causes of scan misinterpretation. Possible interpretive errors may be classified into four categories: those from failure to recognize normal anatomy, those caused by soft-tissue abnormalities, those caused by bony abnormalities, and those caused by technical limitations of the study. Errors in recognition of normal anatomy are easily overcome by experience and comparison to the normal, contralateral rotator cuff. Errors resulting from soft-tissue abnormalities were seen in two patients with calcific tendinitis simulating rotator cuff tears. Problems in interpretation resulting from fractures in two patients and inferior glenohumeral subluxation in two other patients could have been avoided by review of the plain films before performing sonography. The major technical limitation of the study arises from the inability to image the rotator cuff beneath the acromion. Fortunately, rotator cuff tears are rarely isolated in this location, and passive maneuvers often allow otherwise hidden parts of the cuff to be imaged. PMID- 3511640 TI - Sonography of the postoperative rotator cuff. AB - In experienced hands, high-resolution real-time sonography has been shown to be an accurate noninvasive method for diagnosis of rotator cuff tears. The sonographic appearance of the postoperative rotator cuff has not been previously reported. Forty postoperative patients were studied sonographically 1 week to 6 years after rotator cuff repair. The postoperative rotator cuff is abnormally echogenic and can be very similar in appearance to a small rotator cuff tear in a nonoperated patient. Soft-tissue planes about the tendon are distorted or absent. Criteria for diagnosis of retear must be different from those used in detecting new tears in a nonoperated cuff. Postoperative echogenicity is normal, but the finding of a defect or gap within the rotator cuff tendon is the only accurate sign of a recurrent rotator cuff tear. PMID- 3511641 TI - Fatal outcome after ethanol renal ablation in child with end-stage kidneys. PMID- 3511643 TI - Noninvasive evaluation of neonatal aortic thrombosis secondary to umbilical artery catheterization. PMID- 3511642 TI - Sonography of neck masses in children. AB - The sonograms and medical records of 49 patients were reviewed to determine if there is a characteristic sonographic appearance for certain neck masses. Neck masses included: inflammatory masses (12), noninflammatory masses (23), and thyroid masses (14). Four entities including thyroglossal duct cyst, fibromatosis colli, cystic hygroma, and multiple lymphadenopathy showed characteristic sonographic appearance. Thyroglossal duct cysts were seen as midline or slightly off midline cystic masses. A sinus tract extending superiorly was nicely demonstrated in one patient. The mass in fibromatosis colli (neonatal torticollis) appeared as a well defined mass clearly within the sternocleidomastoid muscle, uniformly echogenic, but less echogenic than the normal surrounding muscle, without good through-transmission. A cystic or primarily cystic mass with linear septations was the characteristic finding of the cystic hygroma. Multiple lymphadenopathy demonstrated multiple discrete, oval, relatively hypoechoic masses along the cervical lymphatic chain. The sonographic appearance of inflammatory masses was variable, being either inhomogeneously echogenic or of mixed echogenicity. Hemangiomas were either echogenic with cystic vascular spaces or linear septations or relatively homogeneously echogenic. Intrinsic thyroid masses could be distinguished from extrinsic masses in most cases. The demonstration of calcification in a mass was useful in narrowing the differential diagnosis. Although it is not a specific finding, the presence of calcification highly suggests a neoplastic lesion, particularly neuroblastoma or teratoma. Not only can the location, extent, and internal characteristics of a mass be determined, but in certain entities, the sonographic appearance is characteristic and an accurate diagnosis can be made. PMID- 3511644 TI - Sonographic "parallel channel" sign in obstructive jaundice. PMID- 3511645 TI - Outpatient DSA using transbrachial approach. PMID- 3511646 TI - Assessing gestational age. AB - Decision making in obstetrics is based on accurate knowledge of fetal gestational age. Menstrual dating based on the last menstrual period is an accurate method for estimating gestational age. Other reliable indicators are fundal height, quickening, the date that the fundus reaches the umbilicus and the date that fetal heart tones are first auscultated. Combinations of these data approach the reliability of menstrual dating. Biochemical assays are useful in early pregnancy. Ultrasound is indispensable when the clinical situation is questionable. PMID- 3511647 TI - Self-monitoring of blood glucose. AB - Many diabetic patients can achieve a normal blood glucose level throughout the day by self-monitoring of blood glucose. Improved control reduces the complications of pregnancy and the development of microvascular disease. Multiple doses of insulin are usually necessary for tight control of blood glucose in patients with insulin-dependent diabetes. In the absence of insulin resistance, 1 u of regular insulin lowers the blood glucose by 30 mg per dL in 90 minutes. PMID- 3511648 TI - Systematic correlation of continuous-wave Doppler and hemodynamic measurements in patients with aortic stenosis. AB - The purpose of this study was to compare estimates of pressure gradients obtained from continuous-wave (CW) Doppler recordings with direct pressure measurements derived from cardiac catheterization in patients with aortic stenosis. Forty patients who underwent cardiac catheterization for evaluation of aortic stenosis were prospectively studied with CW Doppler spectral recordings of the aortic valve prior to catheterization. Thirty-three patients underwent a second Doppler examination simultaneously with pressure recordings in the catheterization laboratory. Nineteen of the patients had catheterization pressures measured using high-fidelity, micromanometer-tip catheters. Doppler and pressure tracings were digitized using a microprocessor-based computer with a software program which allowed for calculation of maximal instantaneous, mean, and peak-to-peak gradients, plus ejection and acceleration times. Maximal instantaneous gradient by CW Doppler showed an excellent correlation with maximal instantaneous catheterization gradient (r = 0.93, SEE = 9 mm Hg). The correlation of maximal instantaneous Doppler gradient with peak-to-peak catheterization gradient was also linear (r = 0.85, SEE = 12 mm Hg), but there was a consistent overestimation of peak-to-peak gradient in 38 of 40 cases (mean = 17 mm Hg). Mean gradient as calculated by the two techniques correlated best of all measurements performed (r = 0.95, SEE = 6 mm Hg). When patients were grouped into subsets of mild (0 to 25 mm Hg), moderate (25 to 50 mm Hg), and severe (greater than 50 mm Hg) levels of stenosis, the correlation of maximal instantaneous Doppler and peak-to-peak catheterization gradients were r = 0.22, 0.44, and 0.77, respectively.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3511649 TI - The role of renal hemodynamics in the antihypertensive effect of captopril. AB - To evaluate the role of regional hemodynamics in mediating the long-term depressor effect of the converting enzyme inhibitor, captopril, at a low dose (37.5 mg/day), for 2 weeks, its systemic, renal, and forearm circulatory actions were determined in 12 patients with mild to moderate essential hypertension. After administration of captopril, there was a significant decline in mean blood pressure (average -12.1 +/- 1.9%) accompanied by a decrease in systemic vascular resistance (-9.1 +/- 3.3%), but cardiac output did not change. Although forearm vascular resistance was not altered, renal vascular resistance decreased considerably (-17.1 +/- 5.0%). Moreover, there was a highly significant (r = 0.891) correlation between the changes in mean blood pressure and renal vascular resistance. Plasma renin activity increased after therapy as plasma aldosterone decreased, while plasma norepinephrine slightly increased. The change in renal vascular resistance significantly (r = -0.617) correlated with the pretreatment level of plasma renin activity. These findings suggest that suppression of the renin-angiotensin system in essential hypertension induces selective vasodilation in the renal vasculature, which may play an important role in the long-term antihypertensive effect of the converting enzyme inhibitor. This renal vasodilator action appears to be the feature that distinguishes the converting enzyme inhibitor from conventional vasodilator drugs. PMID- 3511650 TI - Comparative hypotensive effects of acebutolol and hydrochlorothiazide in patients with mild to moderate essential hypertension: a double-blind multicenter evaluation. AB - A double-blind multicenter study compared oral acebutolol (n = 182) with hydrochlorothiazide (n = 178) in the treatment of mild to moderate essential hypertension (diastolic blood pressure 95 to 114 mm Hg). Both agents produced significant and comparable reductions in systolic, diastolic, and mean arterial blood pressures of 15.9, 14.9, and 15.3 mm Hg on acebutolol, and 15.2, 13.3, and 11.8 mm Hg on hydrochlorothiazide (p = 0.001). Acebutolol induced a significant reduction in resting heart rate of 9.3 bpm (p = 0.001) from baseline. The mean effective doses of acebutolol and hydrochlorothiazide were 757 and 68 mg, respectively. Significantly fewer patients on acebutolol experienced arrhythmia, anorexia, and flatulence, although an equal number of patients (14) in each group discontinued therapy prematurely due to side effects. More hydrochlorothiazide treated patients developed abnormalities in the levels of serum glucose, uric acid, blood urea nitrogen (BUN), serum potassium, and chloride. No clinically significant trends in laboratory parameters were seen on acebutolol, although a small number of patients (11 on acebutolol and 3 on hydrochlorothiazide) developed asymptomatic positive antinuclear antibody (ANA) tests of low titer. The data show that acebutolol is as effective as hydrochlorothiazide in the treatment of hypertension, is as well tolerated, and produces fewer biochemical abnormalities. PMID- 3511651 TI - The role of calcium channel blockers in the treatment of hypertension. PMID- 3511652 TI - Cellular mechanism of action of loop diuretics: implications for drug effectiveness and adverse effects. AB - The loop diuretics inhibit a transport system that moves sodium, potassium and chloride across cell membranes of many tissues, including the thick ascending loop of Henle. This inhibitory effect is responsible for their natriuretic effect. Of the agents available for clinical use, bumetanide is the most powerful; it has an in vitro transport inhibitory potency and an in vivo natriuretic effectiveness that is approximately 50-fold that of furosemide. This increased potency and the consequent decreased dose requirement give bumetanide the potential for increased effectiveness and decreased incidence of adverse effects. PMID- 3511653 TI - An overview of national patterns and preferences in diuretic selection. PMID- 3511654 TI - Disposition and response to bumetanide and furosemide. AB - Bumetanide and furosemide are potent loop diuretics; the former is 40 to 50 times more potent than the latter on a weight basis. Bumetanide is absorbed more quickly than furosemide and is twice as bioavailable. Both drugs exhibit changes in elimination in the presence of renal insufficiency as well as changes in the time course of absorption in congestive heart failure. More data are needed to assess potential differences between them in various clinical conditions. PMID- 3511655 TI - Diuretic use in critical care. AB - Diuretics have found wide application in critical care medicine. The use of mannitol and loop diuretics in a variety of life-threatening disorders is reviewed. The combined venodilatory and natriuretic effects of bumetanide, furosemide and ethacrynic acid relieve congestive symptoms in pulmonary edema. Although commonly administered to prevent development of acute tubular necrosis or in varying stages of evolving disease, few data are available to demonstrate the efficacy of mannitol or loop diuretics. An approach to the oliguric patient with acute tubular necrosis is described. The dangers of hyponatremia are reviewed, and the rational use of loop diuretics and hypertonic saline is outlined. The 3 loop-active agents inhibit calcium reabsorption in the thick ascending limb of Henle's loop and therefore have proved useful in treating hypercalcemia. A practical approach to the diuretic-saline treatment of severe hypercalcemia is outlined. The kaliuretic effect of loop diuretics can be used to advantage in patients with acute or chronic hyperkalemia. A guide to such therapy is described. PMID- 3511656 TI - Diuretic use in the elderly: potential for diuretic-induced hypokalemia. AB - The more potent "loop" diuretics are being used with increasing frequency. The elderly constitute a growing portion of the population undergoing treatment with diuretics. The alterations in renal function and pharmacokinetics in the elderly (over 60 years of age) may result in the development of certain adverse effects. In patients over 70 years old, there is a progressive decline in overall renal function, resulting in a more than 50% decrease in glomerular filtration rate. Most of the pharmacokinetic changes in the elderly consist of alterations resulting in enhanced plasma levels of any given drug; diminished hepatic drug extraction, detoxification/metabolism or prodrug conversion; decreased renal excretion of drug; and diminished volume of distribution of drug. Adverse reactions to diuretics may be grouped into metabolic changes (e.g., hypokalemia), physiologic alteration (e.g., volume contraction), toxic manifestation (e.g., interstitial nephritis) and allergic or idiosyncratic phenomena (e.g., rash or thrombocytopenia). There is general agreement that significant hypokalemia, particularly among elderly patients receiving digitalis glycosides, is significant and requires therapy. Diuretic-associated hypokalemia reflects the potency and duration of action of a diuretic, factors modulating potassium balance including dietary intake and concurrent medical processes. The short duration of action and greater natriuresis relative to kaliuresis characteristic of loop diuretics may result in a lesser degree of hypokalemia than that seen with traditional thiazide diuretics. PMID- 3511657 TI - Diuretic therapeutics in the pediatric patient. AB - Careful management of fluid and electrolytes has long been an intrinsic part of pediatric practice. However, the augmentation of these manipulations through the rational use of diuretic agents requires considerable skill. In pediatric medicine, the regulation of pharmacokinetic processes and their interface with pharmacodynamic processes show dramatic age-related changes. These ontogenetic processes and their modification by various disease states must be considered carefully before selection and application of diuretic agents. The available data concerning the ontogeny of renal function and the attempts to apply diuretic therapy to pediatric disease are reviewed. It is concluded that results obtained to date suffer from the absence of a rigorous attempt to answer the fundamental therapeutic questions: What drug? What dose? What duration of therapy? A rational "target-effect" strategy is proposed for the application of diuretic agents to pediatric medicine. PMID- 3511658 TI - Clinical pharmacologic implications in diuretic selection. AB - Logical and comprehensive diuretic therapy is based on a sound knowledge of renal physiologic principles. Knowledge of the sites within the nephron at which the currently available diuretics work and their modes of action provide the clinician with a basis upon which to arrive at therapeutic decisions. True diuretic resistance is uncommon, but when it occurs, sequential nephron blockade can frequently reverse the refractoriness initially exhibited by the patient. PMID- 3511659 TI - Evaluation of the patient with congestive heart failure and ventricular arrhythmias. AB - Although vasodilators and new inotropic agents have been shown to improve ventricular function and reduce symptoms, their effect on mortality is uncertain. In view of our failure to reduce mortality in patients with congestive heart failure (CHF), the identification and amelioration of potentially reversible factors that might alter survival are crucial before initiating therapy. The first step is to establish the diagnosis of CHF and the presence or absence of dilated congestive cardiomyopathy. The extent of myocardial dysfunction, both right and left, must also be evaluated. In post-myocardial infarction patients, left ventricular ejection fraction is an important indicator of prognosis during the first 1 to 2 years. However, in patients with chronic CHF and dilated cardiomyopathy, right ventricular ejection fraction may be a more effective predictor of survival. The presence, frequency and complexity of ventricular arrhythmias must be determined, because these arrhythmias may independently increase the risk of sudden cardiac death in patients with ischemic cardiomyopathy. Their role in patients with idiopathic cardiomyopathy is less certain. In addition, myocardial ischemia, left ventricular dyskinesis or aneurysm, occult myocarditis and neurothrombosis formation must be ruled out. Detection and correction of serum electrolyte and neurohumeral abnormalities are essential. Our failure to reduce mortality in patients with CHF may not entirely lie in the lack of effective therapeutic agents but rather in our failure to apply properly the diagnostic and therapeutic approaches now available. PMID- 3511660 TI - Diltiazem as monotherapy for systemic hypertension: a multicenter, randomized, placebo-controlled trial. AB - A multicenter, randomized, placebo-controlled, parallel group study of diltiazem in essential hypertension was carried out in 77 patients (40 diltiazem, 37 placebo) with stable supine diastolic blood pressure (BP) between 95 and 110 mm Hg. Patients were withdrawn from previous antihypertensive therapy for at least 4 weeks, titrated to the optimal dose, and followed for a total of 12 weeks during therapy. A diltiazem dose of 360 mg/day was required in 85% of the patients. Average BP in all positions was significantly (p less than 0.0001) reduced by diltiazem compared with placebo. With diltiazem, average supine BP fell from 156/100 mm Hg at baseline to 141/87 at end titration and 145/90 mm Hg at week 12, whereas average standing BP fell from 152/101 mm Hg to 136/90 and 143/91 mm Hg, respectively, at those times. There was no significant change in heart rate at week 12. Diltiazem tended to be more effective in older patients, but caused no increase in orthostatic BP drop. There were no statistically significant changes in BP in the placebo group. Two patients receiving placebo and 1 patient receiving diltiazem discontinued therapy as a result of adverse effects, and overall, side effects were only slightly more common with diltiazem treatment. Thus, diltiazem was effective and well tolerated single therapy for mild to moderate systemic hypertension and appears to compare favorably to most agents being used. PMID- 3511661 TI - Hemodynamic effects of a new type III phosphodiesterase inhibitor (CI-914) for congestive heart failure. AB - Hemodynamic response after intravenous and oral administration of a new phosphodiesterase inhibitor, CI-914, was studied in 13 patients with severe congestive heart failure. Comparable significant increases in cardiac index of 26% (p less than 0.01) and 19% (p less than 0.02) after intravenous and oral administration were observed. Systemic vascular resistance, right atrial and pulmonary artery wedge pressure decreased significantly after intravenous drug administration. Although similar changes occurred after oral administration, they were not statistically significant. Peak CI-914 plasma concentration occurred 2.3 +/- 2.2 hours after oral drug administration and exhibited measurable hemodynamic effects for up to 10 to 12 hours. Seven of the 13 patients received long-term oral CI-914 for as long as 12 weeks and exhibited an improvement in New York Heart Association functional class and exercise capacity. Five patients died with progressive heart failure, 1 patient died suddenly and 1 died of sepsis. The drug was well tolerated and appears to have potential as a cardiotonic agent. PMID- 3511662 TI - Effects of antihypertensive therapy on blood lipid levels. PMID- 3511663 TI - Epidemiology of atherosclerosis: an updated overview. AB - Ongoing epidemiologic research continues to provide new insight into the multifactorial etiology of atherosclerosis and coronary artery disease (CAD). Cigarette smoking remains a primary risk factor; low tar and nicotine cigarettes have apparently not contributed to a reduced incidence of CAD and cardiovascular death. The stepwise risk of increasing levels of diastolic blood pressure to cardiovascular death is well known; however, elevated systolic blood pressure may be a more potent risk factor. The benefits of treating diastolic blood pressure greater than or equal to 115 mm Hg are indisputable; the benefits of treating milder hypertension, i.e., diastolic blood pressure between 90 and 114 mm Hg, probably outweigh the risks, but controversy persists. Low-density lipoprotein cholesterol, which comprises approximately 70% of total cholesterol, is strongly associated with CAD. Studies continue to relate hypercholesterolemia and CAD, showing approximately a 2% reduction in disease for each 1% reduction in total cholesterol. The influences of diabetes mellitus, thrombosis and psychosocial factors in the genesis of CAD are reviewed, as well as the evidence supporting the synergistic hazard presented by risk-factor clusters. High-density lipoprotein cholesterol bears an inverse, protective relation to CAD. Factors affecting high-density lipoprotein levels, e.g., obesity/exercise, cigarette smoking, alcohol consumption and postmenopausal use of estrogen in women, are also reviewed in light of recent findings. Additional investigation is necessary to clarify the benefits and risks associated with the treatment or modification of known risk factors and to identify others. PMID- 3511664 TI - Atherosclerosis and lipoprotein metabolism: role of reverse cholesterol transport. AB - To understand the complexity of lipoprotein metabolism and its influence on atherosclerosis, one must be aware of the physiologic characteristics and functions of the different lipoprotein classes, apolipoproteins and enzymes. Understanding of the dynamics of cholesterol and lipoprotein metabolism, especially reverse cholesterol transport, will aid in finding a means of preventing and reversing the atherosclerotic process. PMID- 3511665 TI - Exercise capacity in the elderly. AB - One of the primary manifestations of ageing is a reduced ability to respond to physiologic challenges. With aging, the ability to perform exercise and physical work declines and is reflected in the reduction in maximal oxygen consumption. Although this decline is influenced to some degree by the state of health and age, it seems that maintenance of regular physical activity significantly counteracts the loss of aerobic capacity. In healthy old age, the cardiovascular system is able to compensate for certain age-associated declines in cardiac function. A program of endurance training, even when begun in old age, can restore more youthful levels of physical fitness and results in tangible improvements in certain resting, submaximal and maximal indicators of exercise capacity. With comprehensive preexercise clinical screening, physical training can be conducted safely with minimal musculoskeletal problems in the aged. The long-term effects of exercise on morbidity, mortality and psychologic function in old age are unknown. PMID- 3511666 TI - From irritable heart to mitral valve prolapse: World War I, the British experience and James Mackenzie. PMID- 3511667 TI - William Dock as I knew him. PMID- 3511668 TI - Usefulness of echocardiography and radionuclide ventriculography for diagnosing buckling of the innominate artery in children. PMID- 3511669 TI - Using hypnotic phenomena for physiological change. PMID- 3511670 TI - A brief history of the influence of trace elements on brain function. AB - From this brief review of history it is evident that lead, mercury, iodine, cobalt, iron, copper, manganese, and zinc have important influences on brain development and function. Identity of thresholds at which effects occur is needed for determination of safe and/or essential levels of these elements in diets. Such knowledge will help define human needs for essential elements, and the hazards of toxic elements. PMID- 3511671 TI - Distribution of GICA in normal gastrointestinal and endocervical mucosae and in mucinous ovarian cysts using antibody NS 19-9. AB - Through the immunoperoxidase method using antibody 19-9, we demonstrated the presence of gastrointestinal cancer-associated antigen (GICA) in normal gastrointestinal and endocervical mucosae and in benign mucinous ovarian cysts of pure endocervical type in Le(a+b-) and Le(a-b+) patients exclusively. However, GICA was more quantitatively expressed in Le(a+b-) than in Le(a-b+) patients. GICA was always encountered in the ducts of esophageal glands, Wirsung's ducts, goblet cells of villosities near the ileo-colonic junction, and the mucus columnar cells of the endocervical mucosae or ovarian mucinous tumor epithelium. In other areas of the gastrointestinal tract, GICA was sometimes found in the mucus cells of esophageal glands, near the neck cells of gastric mucosae, in goblet cells of the upper part of the small intestinal villosities, and in colonic Lieberkuhn glands, especially in the cell maturation compartment. GICA therefore appears to be a normal component of gastrointestinal and endocervical mucosae. PMID- 3511672 TI - Neoplastic angioendotheliomatosis: immunopathologic and morphologic evidence for intravascular malignant lymphomatosis. AB - Neoplastic angioendotheliomatosis (NAE) is a rare entity characterized by multifocal, intravascular proliferation of large pleomorphic cells within small vessels of most organs, with a particular affinity for the central nervous system. Clinically, patients with NAE present with focal neurologic signs and a progressive decline in mental status, followed by death in a few months. The histogenesis of NAE is controversial but has been previously thought to represent a malignant proliferation of endothelial cells. Three autopsy cases with clinical and histologic features of NAE were investigated by electron microscopic, standard histochemical, and immunohistochemical technics that included the use of three panleukocyte monoclonal antibodies (PLA), the endothelial-cell-specific reagents, FVIII-RAG anti-sera and Ulex europaeus agglutinin (UEA), and muramidase. The NAE cells in all three cases were stained positively by the PLA, whereas the adjacent endothelial cells and not the NAE cells were stained by FVIII-RAG and UEA. Muramidase by immunoperoxidase technic and nonspecific esterase (chloracetate) were not present in NAE cells. These results indicate that NAE is a leukocyte-derived neoplasm and not a malignant endothelial cell neoplasm. Based on these findings and on a review of the literature, it is proposed that NAE represents intravascular malignant lymphomatosis (IML). IML appears to be a primary manifestation and/or a major secondary form of disseminated malignant lymphoma. This would explain the spectrum of findings in previously reported cases. PMID- 3511673 TI - Identification of chlamydia in cervical smears by immunofluorescence: technic, sensitivity, and specificity. AB - Immunofluorescent staining was compared to cell culture for the diagnosis of Chlamydia trachomatis infections in the female genital tract. By culture, the incidence in the 496 patients in the study was 12.3%. Immunofluorescence demonstrated organisms in 90% of the culture-positive cases, with a specificity of 99.3%. This method appears to be a successful replacement for culture for general screening. PMID- 3511674 TI - Cell surface antigen identification by a modified fluorescein immunosphere method. AB - Fluorescein immunospheres may be used in an indirect technic to label lymphocyte cell surface antigens. Wright's counter-staining allows simultaneous identification of fine morphology and surface antigen properties. Studies designed to determine methods for separating cells with bound immunospheres from free immunospheres revealed that removal of unbound immunospheres by flotation over cold protein solution creates excessive numbers of false negatives. Glutaraldehyde cross-linking of the primary and secondary antibodies linking immunospheres to the lymphocyte stabilizes the complex. This modification of the fluorescein immunosphere method compares favorably with flow cytometry. PMID- 3511675 TI - Resistant hypertension associated with a renin-producing ovarian Sertoli cell tumor. AB - A 17-year-old girl with refractory, but nonmalignant, hypertension and hypokalemia is presented. A state of primary hyperreninism and secondary hyperaldosteronism was found to exist, together with a renin-producing Sertoli cell ovarian tumor. Upon removal of the tumor, this patient attained both a normotensive and a normokalemic state. A brief review is given of renal and nonrenal renin-producing tumors. PMID- 3511676 TI - Educational strategies to improve compliance with an antibiotic regimen. PMID- 3511677 TI - Gallium citrate Ga 67 scintigraphic detection of chronic osteomyelitis in children with leukemia. AB - Chronic osteomyelitis producing unexplained fevers without localizing symptomatology may present difficulty in detection and differentiation in patients with leukemia. Gallium citrate Ga 67 scintigraphy offers a method of detection and localization of both the osseous and extraosseous manifestations of such a process. Once identified, further evaluation by conventional radiographic or sectional imaging techniques may further define the process. We describe three patients with leukemia and unexplained fever in whom occult chronic osteomyelitis was diagnosed by 67Ga scintigraphy, which offers an ideal screening procedure and should be utilized in this clinical setting. PMID- 3511678 TI - Hepatitis A, B, and delta infection in Ethiopia: a serologic survey with demographic data. AB - A total of 500 individuals from five different regions of Ethiopia were studied. Demographic and clinical data were recorded and serologic tests were carried out to detect antigen and antibody markers of hepatitis B virus, hepatitis A virus, and the delta agent. Data on the economic status, number of rooms per household, number of persons per household, type of water supply, and mode of excreta disposal revealed that the majority of the population surveyed lived with economic hardship, overcrowding and poor hygiene. Only 36 persons gave a past history of jaundice. The mean carrier rate of hepatitis B surface antigen (HBsAg) was 6.2%, the mean overall hepatitis B virus marker prevalence was 42%, and in those over 14 years of age it was 76%. Among those who were positive for HBsAg, there was a tendency for hepatitis B e antigen (HBeAg) to decrease and the corresponding antibody (anti-HBe) to increase with advancing age. No woman more than 15 years of age had demonstrable hepatitis B e antigen in serum. Antibody to hepatitis A virus was detected in 84%. Three positive individuals were found to have antibody to the delta agent. PMID- 3511679 TI - Respondents' attitudes regarding participation in an epidemiologic study. PMID- 3511680 TI - Analysis of the causative pathogens in uncomplicated CAPD-associated peritonitis: duration of therapy, relapses, and prognosis. AB - We analyzed the frequency with which certain bacteria caused uncomplicated peritonitis in an adult continuous ambulatory peritoneal dialysis (CAPD) program that continued patients on this modality of therapy despite frequent infections. All infections were treated with a commonly employed 10- to 14-day course of narrow spectrum intraperitoneal antibiotics. Although the distribution of bacterial pathogens was similar to previous reports (coagulase-negative staphylococci, 43%; Staphylococcus aureus, 13%), we observed no episodes of fungal peritonitis. Twenty percent of our infections were associated with either "no specimens obtained" or "no growth," a finding similar to the CAPD registry. When the data were available, two thirds of all infections were caused by the same pathogen (genus and species) as in the most immediately preceding infection. Twenty-two of 96 episodes of uncomplicated peritonitis occurred within three weeks of a preceding infection. In all 11 cases where organisms were isolated from both paired episodes, the infecting agent was the same as in the preceding infection and was a staphylococcus. This high rate of apparent relapse and the absence of fungal infections may relate to our treatment protocol and possible explanations are discussed. Lastly, the occurrence of coagulase-negative staphylococcal peritonitis is a harbinger of future episodes of peritonitis caused by a variety of organisms. PMID- 3511681 TI - Role of antibodies directed against tubular basement membranes in human renal transplantation. AB - Direct immunofluorescence studies of graft biopsies from 662 renal transplant recipients demonstrated linear IgG deposition along tubular basement membranes (TBM) in 18 cases. In ten of them, circulating anti-TBM antibodies, whose detectable levels varied from 1/4 to 1/100, were demonstrated by indirect immunofluorescence on normal human kidneys. These antibodies reacted with every human kidney tested and in two cases, it could be demonstrated that they recognized the TBM of the patient's own end-stage kidney. Hence, they reacted as autoantibodies. Circulating anti-TBM antibodies were detected within the first 6 months after transplantation, remained present for an average of 3 months, and never recurred once they had disappeared. Serial biopsies demonstrated the loss of IgG linear fixation on TBM. Neither tubular nor interstitial injury was significantly associated with the presence of anti-TBM antibodies, and the transplant survival was not different in these patients who developed anti-TBM antibodies compared to our entire population of transplant biopsies. PMID- 3511682 TI - The William Allan Memorial Award presented to Yuet Wai Kan. PMID- 3511683 TI - Prostaglandins and nonsteroidal anti-inflammatory drugs. Effects on renal hemodynamics. AB - Renal prostaglandins are important modulators of renal hemodynamic function. Their synthesis from arachidonic acid precursor is regulated by neurohumoral vasoactive substances as well as by intrarenal factors. Endogenous renal prostaglandins exert little influence on renal blood flow and glomerular filtration rate in the basal state. In contrast, inhibition of cyclooxygenase dependent arachidonic acid metabolism with nonsteroidal anti-inflammatory drugs in states of decreased renal perfusion causes marked alterations in these variables. Thus, clinical states characterized by decreased intravascular volume (decreased effective blood volume) with decreased renal perfusion augment the activity of various neurohumoral vasoactive systems and result in an increased dependence of renal hemodynamics on endogenous renal prostaglandin synthesis, which is stimulated, in a compensatory manner, by these same systems. The development of newer drugs that undergo biotransformation in the kidney between active and inactive forms may permit a lesser degree of renal cyclooxygenase inhibition, with the possibility of a reduction in the adverse effects on renal blood flow and glomerular filtration rate. Appropriate clinical use of nonsteroidal anti-inflammatory drugs requires careful consideration of the potential deleterious consequences of prostaglandin synthesis inhibition. Prostaglandins are considered to be autacoids and, as such, they exert their physiologic actions close to or at the site of synthesis. Therefore, production of prostaglandins, thromboxanes, and, possibly, leukotrienes in the renal cortex by the constituent cells of the glomeruli and the arterioles would be anticipated to influence their hemodynamic functions, that is, glomerular filtration rate, renal blood flow, renal vascular resistance, and juxtaglomerular granular cell renin release. PMID- 3511684 TI - Renal prostaglandins and the control of renal function in liver disease. AB - Recent evidence suggests that renal prostaglandins play a major role in the control of renal hemodynamics and function in patients with advanced liver disease. The available data suggest that alterations in renal prostaglandin metabolism participate in the pathogenesis of at least three prominent renal complications of liver disease: sodium retention, impaired renal diluting ability, and the hepatorenal syndrome. Nonsteroidal anti-inflammatory agents that inhibit cyclooxygenase activity favor sodium retention and diminish renal plasma flow and glomerular filtration rate in patients with decompensated cirrhosis. The clinical caveat emerging from these observations is that nonsteroidal anti inflammatory agents, which inhibit cyclooxygenase activity, should not be prescribed for sodium-retaining patients with decompensated liver disease. PMID- 3511685 TI - Prostaglandins and hypertension. AB - Generalized arteriolar vasoconstriction is the dominant element in essential hypertension. Although the proximate cause of this process remains elusive, several lines of evidence suggest that abnormalities in prostaglandin and thromboxane metabolism may contribute to the pathophysiology of hypertension. Diminished endogenous synthesis of vasodilator prostaglandins and enhanced formation of the vasoconstrictor thromboxane may participate in this process, particularly in the kidney. The use of nonsteroidal anti-inflammatory drugs, which inhibit prostaglandin synthesis, may aggravate blood pressure control, especially when used with certain diuretics and other antihypertensive medications. Attempts to enhance endogenous synthesis of prostaglandin metabolites expressing potent vasodilator properties by supplementation of the diet with polyunsaturated fatty acids may provide a new strategy to control blood pressure. PMID- 3511686 TI - Drug-drug and drug-disease interactions with nonsteroidal anti-inflammatory drugs. AB - Nonsteroidal anti-inflammatory drugs may cause a number of drug interactions. They can displace other drugs from serum proteins, and some can affect the metabolism or decrease the renal elimination of other drugs. In addition, they can attenuate the pharmacologic effect of other drugs, such as diuretic and antihypertensive agents, without affecting their disposition. Lastly, many disease states and aging can affect the handling of nonsteroidal anti inflammatory drugs, mandating dose adjustment of some of these agents in certain clinical conditions. Some drugs may require more of these adjustments than others. PMID- 3511687 TI - Token swap test of significance for serial medical data bases. AB - Established tests of statistical significance are based upon the concept that observed data are drawn randomly from a larger, perhaps infinite source population. The significance value, p, is the probability that the observations are drawn from a source population satisfying the null hypothesis; if p is small enough (less than 5 percent, 1 percent, etc.), then the null hypothesis is rejected. Serial medical data bases, such as a hospital clinic intake or autopsy case accessions, often do not have an identifiable source population from which they are randomly drawn. In an effort to make a reasonable interpretation of these less-than-ideal data, this report introduces a "token swap" test of significance, in which the usual paradigm of repeated drawing from a source population is replaced by a paradigm or misclassification within the observed data themselves. The token swap test consists of rearranging the data into a balanced distribution, and determining the disparity between the observed and the balanced distribution of data. In a two-by-two contingency table, patients are represented as "tokens" distributed into four "cells." Significance is determined by the proportion of "token swaps" that are able to transform the balanced table into the observed table. The token swap test was applied to three series of autopsy observations, and gave results roughly comparable to the corresponding (two-tail) chi-square and one-tail Fisher exact tests. The token swap test of significance may be a useful alternative to classic statistical tests when the limiting assumptions of a retrospective, serial medical data base are present. PMID- 3511688 TI - Carcinoembryonic antigen in breast cancer. Clinical review. AB - Carcinoembryonic antigen is widely used as a tumor marker for gastrointestinal neoplasms. Its role in the management of other tumors is poorly defined. This review considers the place of carcinoembryonic antigen measurement in the management of breast cancer and concludes that sufficient data exist to support its use in clinical practice. Of the many potential uses, the major role for carcinoembryonic antigen measurement in breast cancer is in following patients with advanced disease, especially patients with bone metastases. PMID- 3511689 TI - Effects of two antihypertensive agents on lipids, lipoproteins, and apoproteins A and B. Comparison of prazosin and atenolol. AB - To compare the effects of prazosin and atenolol on plasma lipid concentrations, 60 patients with arterial hypertension (diastolic 90 to 120 mm Hg, systolic 160 to 200 mm Hg) were allocated at random to one of two treatment groups. The lipid profile included the determination of total cholesterol and triglyceride levels by ultracentrifugation, and assays of apoproteins A1 and B by laser immunonephelometry. Determinations were performed 30 days before and on the first, 90th, and 180th days of treatment. Both drugs had similar reducing effects on blood pressure. A significant decrease in total cholesterol, low-density lipoprotein cholesterol, and apoprotein B, and an increase in high-density lipoprotein cholesterol and apolipoprotein A1 were observed in patients receiving prazosin, whereas patients receiving atenolol exhibited opposite changes in plasma lipids. Although the clinical significance of these findings is uncertain, such metabolic effects should be taken into account when evaluating the risk/benefit ratio of antihypertensive treatments. PMID- 3511690 TI - Metabolic effects of a change in antihypertensive treatment. AB - Twenty hypertensive men, aged 58 to 62 years, who had been treated with a combination of different drugs for many years, had their therapy changed in a stepwise manner to a combination of 50 mg of atenolol per day and 2 to 15 mg of prazosin per day. The effects of each change of treatment were assessed separately five to six months after the change. Serum lipids and high-density lipoprotein concentrations were determined, and an intravenous glucose tolerance test was performed at the start of the study and after each change. In the group in which therapy was changed from a diuretic to prazosin, serum cholesterol and triglyceride concentrations decreased significantly by 11 and 42 percent, respectively, but in the group in which therapy was changed from hydralazine to prazosin, there were no alterations in serum lipids or lipoproteins. The changes in therapy had no overall effects on glucose or insulin parameters evaluated with an intravenous glucose tolerance test. However, prazosin was associated with an increase in the fasting blood glucose level and a decrease in the peak insulin value after glucose injection, both of which were dose-related effects. The data indicate that the glucose turnover was at least as good after a switch from diuretic to prazosin treatment as before at lower insulin values. In those patients in whom therapy was switched from propranolol to 50 mg of atenolol per day, the serum triglyceride concentration decreased by about 10 percent, whereas in the group in which therapy was changed from 100 to 50 mg of atenolol per day, there were no serum lipid or lipoprotein alterations. The results show that a combination of 50 mg of atenolol per day and prazosin has metabolic advantages over combined diuretic and propranolol treatment. Such advantages may be of importance in the long-term treatment of hypertensive patients. PMID- 3511691 TI - Initial antihypertensive therapy. Comparison of prazosin and hydrochlorothiazide. AB - Increasing awareness of the hazards of diuretic therapy has cast doubt on the appropriateness of its uniform use as initial treatment for hypertension. To establish the relative efficacy and acceptability of alternative forms of initial therapy, prazosin and hydrochlorothiazide were prospectively compared. In a one year study, 62 patients with a diastolic blood pressure greater than or equal to 100 mm Hg were randomly allocated to receive one of the two agents. Twenty of 32 (63 percent) patients receiving prazosin and 17 of 30 (57 percent) receiving hydrochlorothiazide satisfied the year-long study requirements. For the most part, the dropout rate was not drug related. The percentages of subjects completing the study with the initial drug, without addition of a second drug, were identical in both groups (prazosin: 10 of 32 [31 percent] and hydrochlorothiazide: nine of 30 [30 percent]). In both treatment groups, blood pressure declined similarly and significantly (p less than 0.001) by the end of the study. The blood pressure of subjects receiving prazosin decreased from 150.3/105.8 mm Hg to 135.3/90.3 mm Hg, whereas the blood pressure of subjects receiving hydrochlorothiazide declined from 147.3/103.8 to 130.0/89.1 mm Hg. A reduction in diastolic blood pressure to less than 95 mm Hg was achieved in 80.0 percent of patients started with prazosin and in 78.6 percent of those started with hydrochlorothiazide. A further reduction to less than 90 mm Hg was achieved in 45.0 and 64.3 percent, respectively (not significant). Patients who completed the study with single-drug therapy in both treatment groups showed nonsignificant decreases in mean potassium levels from initial to final readings when compared with baseline readings (prazosin: 0.21 meq; hydrochlorothiazide: 0.41 meq). However, patients receiving prazosin had 11.5 percent of their readings less than or equal to 4.0 meq, whereas those receiving hydrochlorothiazide had 38.1 percent of their readings similarly distributed (p less than 0.05). Furthermore, four patients receiving hydrochlorothiazide had potassium levels less than or equal to 3.5 meq; none of those receiving prazosin had levels in that range. At baseline, no patient in the study had potassium levels of less than 4.0 meq. Prazosin treated patients whose initial fasting blood glucose was less than 110 mg/dl had 3.7 percent (one of 27) of subsequent measurements greater than or equal to 110 mg/dl. These abnormal levels were found 18.2 percent (six of 33) (not significant) of the time in similar hydrochlorothiazide-treated subjects. Symptomatic side effects were primarily mild and transient in those receiving either drug alone.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3511692 TI - Oslo Study Diet and Antismoking Trial. Results after 102 months. AB - The five year (60-month) results from the Oslo Study Diet and Antismoking Trial were published in the Lancet in December 1981. The trial involved 1,232 healthy men, aged 40 to 49 years, at high risk for coronary heart disease, with serum cholesterol values in the range of 7.5 to 9.8 mmol/liter (enzymatic method: 6.9 to 9.0, mean value 7.8 mmol/liter). Eighty percent of the men were daily cigarette smokers at the start of the study, and all participants were normotensive, i.e., systolic blood pressure was less than 150 mm Hg. Subjects were randomly assigned to either a control or intervention group. Follow-up visits were scheduled every six months for the intervention group and yearly for the control group. Once the trial was completed, the regular six-month follow-up visits were discontinued, but eight to nine years (96 to 108 months) after the start of the trial, participants were called for a new follow-up. Risk factors were recorded, and clinical events were diagnosed according to the same procedure as during the trial. The mean serum cholesterol levels in the intervention group remained unchanged three years after the end of the trial, but the cholesterol levels in the control group declined. Daily cigarette smoking increased in the intervention group but remained stable in the control group. At the new follow up, the difference in incidence of fatal and nonfatal myocardial infarction and sudden coronary death was the same as at the end of the trial three years earlier, yielding significant differences between the two groups for sudden death, total coronary death, and total coronary events. Although the study was not designed to show differences in total mortality, this difference became marginally significant, with 19 deaths in the intervention group and 31 in the control group. It is concluded that although net differences in risk factors between the two groups had been reduced during the three years after the regular intervention period, the significant difference in coronary events and sudden death was maintained. PMID- 3511693 TI - Comparison of the effects of prazosin versus propranolol on plasma lipoprotein lipids in patients receiving hemodialysis. AB - A prospective, crossover study was used to evaluate the effects of prazosin and propranolol on lipid metabolism in 10 hypertensive patients receiving long-term hemodialysis therapy. Adequate blood pressure control was achieved with either agent (mean predialysis blood pressure was 144/77 mm Hg). Total triglyceride levels increased by 27 +/- 4 percent during propranolol therapy but decreased during prazosin therapy by 8 +/- 2 percent (p less than 0.05). These changes were accounted for by a 21 +/- 1.5 percent increase in very-low-density lipoprotein triglyceride during propranolol therapy and a 6 +/- 2 percent decrease in very low-density lipoprotein triglyceride during prazosin therapy (p less than 0.05). Although no change in total cholesterol occurred with either agent, a significant decrease (19 +/- 1 percent, p less than 0.01) in high-density lipoprotein cholesterol occurred with propranolol therapy and an increase of 16 +/- 4 percent occurred during treatment with prazosin (not significant). The high-density lipoprotein2 cholesterol levels decreased by 22 +/- 4 percent after treatment with propranolol and increased by 4 percent after prazosin therapy. Propranolol reduced high-density lipoprotein3 cholesterol levels by 18 +/- 2 percent, whereas prazosin increased these values by 19 +/- 2 percent (p less than 0.01). These changes were associated with a reduction in tissue lipoprotein lipase activity after propranolol therapy (2.4 +/- 0.3 percent) and an increase after prazosin therapy (2.5 +/- 1 percent, p less than 0.05). These data suggest that treatment with propranolol may be associated with unfavorable changes in the lipid profile that are not observed after treatment with prazosin. PMID- 3511694 TI - Effects of prazosin, atenolol, and thiazide diuretic on plasma lipids in patients with essential hypertension. AB - The effects of prazosin and atenolol monotherapy on plasma lipid concentrations were compared in 51 patients with mild to moderate essential hypertension. Prazosin monotherapy (mean dose 5.4 +/- 5.3 mg per day) resulted in a significant decrease in total and low-density lipoprotein cholesterol concentrations; these changes were evident at three months and at six to 12 months. Atenolol monotherapy (mean dose 66 +/- 23 mg per day) resulted in a significant increase in plasma triglyceride concentration that persisted during one year of treatment. The deletion of thiazide from the regimen of prazosin plus thiazide resulted in a small stepwise decrease in plasma triglyceride concentration over 12 months of observation. The addition of polythiazide (0.5 mg two to three times weekly) to the regimen of patients in whom acceptable blood pressure was not attained with prazosin or atenolol monotherapy resulted in a decrease in blood pressure, averaging 18.8 mm Hg for systolic and 10.3 mm Hg for diastolic, and a small, though significant, increase in the concentration of low-density lipoprotein cholesterol. It is suggested that the effects of prazosin on plasma lipid composition may be mediated, at least in part, by blocking an action of either the sympathetic nervous system or circulating catecholamines that normally modulate lipoprotein metabolism and might mediate the lipid alterations induced by thiazide diuretics. PMID- 3511695 TI - Calcium channel blocking agents in congestive heart failure. PMID- 3511696 TI - Role of cardiac transplantation in the management of congestive heart failure. PMID- 3511697 TI - Vasodilator therapy. AB - Vasodilators are a group of drugs with various degrees of arteriolar or venous dilatation used in the treatment of congestive heart failure when symptoms persist after digoxin and diuretic therapy. Nitrates and captopril provide the most consistent improvement in symptoms. Reduced mortality rates in congestive heart failure with vasodilator therapy has not been demonstrated, and prediction of clinical response to therapy is difficult. PMID- 3511698 TI - Isolated asymptomatic hematuria in the adult. AB - The term "isolated asymptomatic hematuria," as it relates to both gross and microscopic hematuria, is defined; and the pros and cons of detection techniques used to localize the source of the hematuria are discussed. An algorithm is provided to optimize detection of structural defects and intrinsic renal disease in an effort to avoid subjecting the patient with this difficult-to-diagnose problem to unnecessary invasive tests. Although invasive tests should be performed where deemed necessary in the clinician's aggressive search to detect any structural abnormality, controversial areas of the evaluation of these patients are addressed. To justify various branch points of the algorithm, a discussion of both renal cell carcinoma and primary renal hematuria is proffered. PMID- 3511700 TI - Effect of intraperitoneal insulin on solute kinetics in CAPD: insulin kinetics in CAPD. AB - The authors evaluated the transport kinetics of insulin and inulin administered intraperitoneally to six diabetic patients undergoing continuous ambulatory peritoneal dialysis. The mass transfer coefficients (MTC) calculated from dialysate to blood for 1.5% and 4.25% dextrose dialysate were (ml/min): insulin 2.9 +/- 0.9, 2.0 +/- 0.5; inulin 3.3 +/- 1.4; 2.9 +/- 1.7, respectively. The MTC for inulin calculated from blood to dialysate was 2.0 +/- 0.7 ml/min. Because insulin disappears from the peritoneal cavity at a rate similar to inulin, it suggests that insulin transport can be defined by diffusion. The derived MTC values for glucose were not altered by the addition of intraperitoneal insulin. The derived MTCs for eight diabetic to thirteen nondiabetic patients were compared. The MTC derived for urea was less among the diabetics (16.6 +/- 2.2 vs. 24.6 +/- 2.6 p less than 0.05), but there were no differences for creatinine, uric acid, glucose, inulin, and protein. The derived values were found to be normally distributed and patients in the upper quartile for one solute were generally in the upper quartile for other solutes. PMID- 3511699 TI - Cigarette smoking and lung disease. AB - Despite major changes in the patterns of cigarette consumption in the United States in the last two decades, cigarette smoking remains a widespread practice. Many studies show a strong association between cigarette smoking and chronic obstructive lung disease, but only recently have mechanisms been elucidated to explain this association, particularly in the case of emphysema. The exact mechanism of chronic bronchitis is less well defined. The mortality rate for lung cancer continues to increase in this country, particularly among women. Compelling evidence associates lung cancer with cigarette smoking, although animal models have not been very successful. Recently, concern has been raised about the effects of passive smoking. There are substantial data available to suggest that passive smoking results in pulmonary infections and abnormal pulmonary function in children of smokers. The data are less clear-cut for pulmonary functional impairment in adults and for lung cancer in the spouses of smokers. Although the concept of "safer" cigarettes has been widely accepted by the American public, these cigarettes may not be as safe as is widely assumed. Clearly, they are far inferior to total smoking cessation. Nevertheless, smoking cessation remains difficult for many Americans, despite a number of methods that have been used to help smokers quit. Nicotine chewing gum, which has recently become available for use in the United States, has shown some efficacy in helping well-motivated, nicotine-dependent smokers quit smoking. Although some inroads have been made into the occurrence of smoking related diseases in the United States, many unnecessary deaths continue to occur. PMID- 3511701 TI - Broken sleep. PMID- 3511702 TI - Vaginal colonization with Escherichia coli in healthy women. Determination of relative risks by quantitative culture and multivariate statistical analysis. AB - The rate of vaginal colonization with Escherichia coli in 495 healthy women was 12% in a prospective study with use of selective media and semiquantitative culture techniques. Computer-assisted multivariate analysis revealed that vaginal E. coli was significantly associated with the menstrual phase of the cycle, prior use of antibiotics, use of diaphragm or cervical cap for contraception, history of previous urinary tract infection, and coisolation of Staphylococcus aureus that was positive for the toxic shock syndrome toxin-1 (p less than 0.05, multiple stepwise logistic regression analysis). No significant association was observed with tampon use or brand, other contraceptive methods, sexual activity, genital symptoms, recent vaginal infection, or other personal habits. Quantitative cultures obtained sequentially throughout the menstrual cycle in 12 unselected women confirmed higher E. coli counts in menstrual or midcycle samples compared to paired premenstrual specimens (p less than 0.05, Wilcoxon paired rank sign test). These data emphasize the hormonal and other host determinants in vaginal colonization by E. coli and may explain the high rate of vaginal E. coli (64%), in addition to toxicogenic S. aureus, in acute toxic shock syndrome and the higher incidence of urinary tract infection in women with diaphragm or cervical cap for contraception compared to other contraceptive methods. PMID- 3511703 TI - Effect of weight loss and antiandrogenic therapy on sex hormone blood levels and insulin resistance in obese patients with polycystic ovaries. AB - This study was performed in two randomly defined groups of obese patients with polycystic ovaries to investigate the overall effects of hypocaloric diet combined (group 2) or not combined (group 1) with an antiandrogenic therapy (cyproterone acetate, 50 mg/day, plus ethinyl estradiol, 0.05 mg/day) on sex hormone plasma levels, insulin secretion and resistance, and body weight loss and on their reciprocal interrelationships. All obese patients with polycystic ovaries showed elevated luteinizing hormone and androgen levels, hyperinsulinemia, and marked insulin resistance. After an average period of 3 months both groups showed a similar weight loss and a similar reduction in the insulin-resistant state. During treatment in group 1 three patients had a greater frequency of menstrual bleeding, and in one of them an ovulatory cycle was documented. Whereas, no changes in gonadotropin and sex steroid levels were found in group 1, a significant fall was observed in group 2. No relationships were observed between these changes and those which occurred on insulin levels. We conclude that hyperandrogenism in obese patients with polycystic ovaries does not appear to be a primary factor leading to the insulin-resistant state. PMID- 3511704 TI - Ovarian pregnancy with a contralateral corpus luteum: case report. AB - A case is described of a woman who was found to have an ovarian pregnancy on the left with a corpus luteum on the right ovary. This was determined by both pelvic sonography and laparotomy. The case did fulfill the four criteria of Spiegelberg. PMID- 3511706 TI - Antenatal phenobarbital for the prevention of neonatal intracerebral hemorrhage. AB - Forty-six pregnant women less than 35 weeks of gestation were enrolled in a prospective randomized controlled study evaluating the effects of antenatal phenobarbital on neonatal intracerebral hemorrhage. The women were randomly assigned to control (n = 22) or treatment (n = 24) groups; the treatment group received 500 mg of phenobarbital intravenously. The time interval between the dose of phenobarbital and delivery was 5.5 +/- 4.8 hours (mean +/- SD). The infants in the control group (n = 23) and those in the phenobarbital-treated group (n = 25) were comparable regarding birth weight, gestational age, and other obstetric and neonatal risk factors associated with intracerebral hemorrhage. The incidence of intracerebral hemorrhage was 56.5% (13 of 23 infants) in the control group and 32% (eight of 25 infants) in the phenobarbital-treated group (p = 0.08). Moderate or severe hemorrhage was diagnosed in six of 13 control infants and in none of the phenobarbital-treated infants (p less than 0.01). The mortality rate was significantly lower in the phenobarbital-treated group (two of 25 infants) than in the control group (eight of 23 infants; p less than 0.05). Our study suggests that antenatal phenobarbital administration results in a decrease in mortality and in the severity of intracerebral hemorrhage in the preterm neonate. PMID- 3511705 TI - Fibrocystic breast disease: pathophysiology, pathomorphology, clinical picture, and management. AB - The pathophysiology of fibrocystic breast disease is determined by estrogen predominance and progesterone deficiency that result in hyperproliferation of connective tissue (fibrosis), which is followed by facultative epithelial proliferation; the risk of breast cancer is increased twofold to fourfold in these patients. The clinical correlate of fibrocystic disease is reflected by breast and axillary pain or tenderness in response to development of fibrocystic plaques, nodularity, macrocysts, and fibrocystic lumps. The disease progresses with advancing premenopausal age and is most pronounced in women during their 40s. Fibrocystic changes regress during the postmenopausal period. Medical treatment of fibrocystic disease is accomplished: by suppression of ovarian estrogen secretion with a low-estrogen oral contraceptive, whereby the action of estrogen on breast tissues is opposed by the oral contraceptive's progestin component (19-nortestosterone derivatives), or by cyclic administration of a progestogen (progesterone, medroxyprogesterone acetate) that modulates the mammary effects of estrogen. These treatment modalities are equally as effective as or superior to danazol therapy, which entails side effects in the majority of patients. Adjuvant therapy of fibrocystic breast disease with vitamin E is of value in patients with borderline or abnormal lipid profiles (low plasma levels of high-density lipoprotein and high plasma levels of low-density lipoprotein). With thorough diagnostic evaluation, appropriate medication, and close follow-up, treatment success can be achieved in almost every patient. Needle aspiration biopsy should be performed in patients with macrocysts and whenever clinical, ultrasonic, and/or mammographic examinations are suspicious for carcinoma. Patients at high risk of breast cancer (breast cancer in mother and/or sister) should have clinical examinations at 4- to 6-month intervals and mammography every 1 to 2 years; needle aspiration should be performed when the slightest suspicion arises. Fibrocystic breast disease is not a "harmless nondisease" but a distinct clinical entity that requires treatment to bring about relief to the patient, to reduce the incidence of breast surgical procedures, and to diminish the risk of breast cancer. PMID- 3511707 TI - Amniostat-FLM: an initial clinical trial with both vaginal pool and amniocentesis samples. AB - Amniostat-FLM, a new rapid slide agglutination test, was compared with thin-layer chromatography as a method for detecting phosphatidylglycerol in amniotic fluid. This is the first reported use of Amniostat-FLM to evaluate vaginal pool and contaminated vaginal pool amniotic fluid. One hundred one of 161 amniotic fluid samples were collected from the vaginal pool. Thirty-nine of these were contaminated. Vaginal pool amniotic fluid, whether contaminated or not, did not adversely effect the ease of performance, reliability, or interpretation of Amniostat-FLM. This test seems ideally suited to institutions where 24-hour availability of thin-layer chromatography is not available. In institutions where it is available, Amniostat-FLM could be used as a screening test. Amniostat-FLM was found to be significantly less sensitive when compared with thin-layer chromatography in detecting the presence of phosphatidylglycerol. At our institution the screening of amniotic fluid samples with Amniostat-FLM before use of thin-layer chromatography was only cost effective at greater than or equal to 34 weeks of gestation. PMID- 3511708 TI - Plasma catecholamine responses to physiologic stimuli in normal human pregnancy. AB - The dynamic response of the sympathoadrenal system was evaluated during and after pregnancy in 13 healthy women with a protocol that compared cardiovascular parameters and plasma catecholamine levels during the basal state, after postural maneuvers, and following isometric exercise. Plasma epinephrine and norepinephrine levels were similar during and after gestation when the women rested on their sides, but heart rate was greater in pregnancy. Ten minutes of supine recumbency produced minimal changes, but attenuation of the anticipated increases in heart rate and plasma norepinephrine levels during standing and isometric exercise were observed during pregnancy. In contrast, alterations in plasma epinephrine appeared unaffected by gestation. Plasma renin activity and aldosterone levels were, as expected, greater during pregnancy; however, increments in response to upright posture were similar in pregnant and postpartum women. To the extent that circulating catecholamines may be considered indices of sympathoadrenal function, these data suggest that normal pregnancy alters cardiovascular and sympathetic nervous system responses to physiologic stimuli. PMID- 3511709 TI - Adjunctive erythromycin treatment for idiopathic preterm labor: results of a randomized, double-blinded, placebo-controlled trial. AB - Pathogenesis and optimal treatment and prevention of preterm labor remain incompletely understood. Entry of cervical/vaginal microorganisms into lower uterine tissues has been implicated in preterm labor and may be amenable to specific therapy. Fifty-eight women with less than 34 completed weeks of gestation and without other obstetric complications, who were receiving intravenous tocolytics because of uterine contractions and who had cervical alteration (less than 5 cm dilated), were enrolled in a prospective randomized, double-blinded evaluation of 7 days of adjunctive therapy with enteric-coated erythromycin base (333 mg three times daily by mouth) versus placebo. Microbiologic examination included cultures for Neisseria gonorrhoeae, Chlamydia trachomatis, and group B streptococcus. Fifty-eight women with singleton pregnancies (29 erythromycin; 29 placebo) completed the protocol. Among women with cervical dilatation greater than or equal to 1 cm at the beginning of treatment, mean time until delivery was 32.5 days with erythromycin and 22.4 days with placebo treatment (p = 0.027). Of the erythromycin-treated women, seven of eight were delivered at greater than or equal to 37 weeks and only three of nine placebo-treated women were delivered at greater than or equal to 37 weeks (p = 0.035). Orally administered enteric-coated erythromycin as adjunctive treatment of pregnant women in labor less than or equal to 34 weeks is well tolerated. Adjunctive erythromycin given to women treated for preterm labor less than or equal to 34 weeks is associated with prolongation of pregnancy and delivery at 37 weeks only in women with cervical dilatation at the beginning of treatment. PMID- 3511710 TI - Fetal cystic hygroma colli: antenatal diagnosis, significance, and management. AB - Twenty-four cases of fetal cystic hygroma colli were diagnosed by ultrasound. In two patients, the diagnosis was not confirmed at autopsy. Ten of these were cases of Turner's syndrome, one was a case of Turner's mosaicism, three had other aneuploidies, four had normal chromosomes, and six had a failed chromosome culture. The diagnosis, management, and future counseling of these patients are discussed. PMID- 3511711 TI - Biophysical profile scoring in the management of the postterm pregnancy: an analysis of 307 patients. AB - Management and outcome were reviewed in 307 consecutive postterm pregnancies assessed by biophysical profile scoring. Twice-weekly scores accurately differentiated normal fetuses from those at risk for intrauterine hypoxia. When the profile score is normal, waiting for spontaneous labor results in healthy neonates and a much lower cesarean section rate (15% versus 42% for "prophylactic" induction). Confident conservative management of postterm pregnancy is possible. PMID- 3511712 TI - Hyperinsulinemia in hyperthecosis of the ovaries. AB - Fasting insulin concentrations and the insulin response to an oral glucose tolerance test were measured in six virilized women with ovarian hyperthecosis and six weight-matched normal women. For comparison, six women with polycystic ovarian disease were also studied. The diagnosis of hyperthecosis was confirmed in all six virilized women by histologic examination of the ovaries. The fasting insulin concentrations were increased in all of the hyperthecosis patients (84 +/ 32 microU/ml). Insulin response to an oral glucose tolerance test was greatly increased (p less than 0.01) in comparison to normal women and women with polycystic ovarian disease. Significant positive correlations were found between peripheral insulin concentrations and ovarian vein testosterone (r = 0.879, p less than 0.02), dihydrotestosterone (r = 0.866, p less than 0.03), and androstenedione (r = 0.992, p less than 0.01) levels. Insulin resistance persisted after removal of the ovaries even though androgen levels returned to normal. These results suggest that a significant degree of insulin resistance exists in women with hyperthecosis and that insulin stimulates ovarian stromal androgen synthesis and thus may play a role in the pathogenesis of ovarian hyperthecosis. PMID- 3511713 TI - Improving the yield of direct chorionic villus slide preparations. AB - Low cytogenetic yields in the processing of small chorionic villus sampling have in some instances, limited its applicability. We have modified "standard" techniques to increase the number of interpretable metaphases by (1) using a gravity method for cell suspension spreading and (2) using a special high-quality slide glass. Both modifications reduce cell damage and increase interpretable mitotic figures and may allow a cytogenetic diagnosis in some instances in which a diagnosis might not otherwise be possible with standard methods. PMID- 3511714 TI - Glucose threshold for macrosomia in pregnancy complicated by diabetes. AB - We analyzed 205 diabetic women treated with insulin during pregnancy to assess the effects of several maternal factors on the development of fetal macrosomia. A total of 95 women were selected for study because they had clearly defined gestational criteria, two or more daytime glucose profiles during the third trimester, and no other complications known to affect fetal growth. The incidence of macrosomia was not found to increase significantly until the mean glucose concentration reached 130 mg/dl; macrosomia occurred in 65% of mothers with glucose values greater than or equal to 130 mg/dl compared with 27% in those with lower values. Other factors strongly associated with fetal macrosomia were maternal weight and insulin dosage. Multiple logistic analysis was performed to control for each risk factor and to obtain estimates of the relative risk for macrosomia. The risk of macrosomia was two times greater in women with mean glucose concentrations greater than or equal to 130 mg/dl, approximately threefold in women whose weight exceeded 80 kg, and one and one half times greater in women with insulin dosages more than 80 units/day. We conclude that several maternal factors in addition to glucose concentration play important roles in the development of fetal macrosomia among diabetic women and that the glucose concentration threshold for macrosomia may exceed 130 mg/dl. PMID- 3511715 TI - The effects of retinal detachment repair on clear corneal grafts. AB - Seven patients who underwent retinal detachment surgery after penetrating keratoplasty all achieved successful reattachment, but one graft failed (14%) within six months. Four of the seven eyes were aphakic or pseudophakic and three, including the one in which the graft failed, were phakic at the time of retinal detachment. All patients had scleral exoplant buckling procedures and three had external drainage of fluid. PMID- 3511716 TI - Electrothermal debracketing. Part II. An in vivo study. AB - Part I of this study described the procedure of electrothermal removal of brackets (ETD) that were bonded on human teeth. The temperature generated at the pulpal wall due to ETD was significantly lower than an established primate threshold. Part II of the study investigated the histologic features of the pulp after ETD. There was some cellular modification that corresponded to placement of the extraction forceps, but there was no evidence of cellular pathosis or modification due to ETD. The data in Parts I and II of this study suggest that ETD is a physiologically acceptable alternative to conventional debracketing techniques. PMID- 3511717 TI - A profile of accomplishment: James Edward Brophy. PMID- 3511718 TI - Abnormal increases of lysosomal cysteinine proteinases in rimmed vacuoles in the skeletal muscle. AB - Skeletal muscle obtained from a patient with distal myopathy with rimmed vacuole formation (DMRV) was examined by a new direct labeled antibody enzyme method of immunohistochemistry. Abnormal increases of cathepsins B and H, capable of degrading the myofibrillar proteins, were demonstrated to be localized at the site of vacuoles and other intramyofibral portions and not to be associated with concomitant increases of their endogenous inhibitors. Autodigestion by these intramyofibral lysosomal proteinases may be of major importance in focal destruction of myofibers and formation of vacuoles, because no myofiber necrosis with invasion of macrophages, overt myositis, and neuropathy was seen in the muscle. These findings provide the first reasonable explanation of myofibral breakdown and atrophy in DMRV, and should be helpful in further studies on the mechanism of myofibral breakdown in various vacuolar myopathies and other myopathies of so far unknown pathogenesis. PMID- 3511719 TI - L&H variants of Reed-Sternberg cells express sialylated Leu M1 antigen. AB - Anti-Leu M1 generally does not stain the lymphocytic and histiocytic (L&H) variants of Reed-Sternberg cells in the lymphocyte predominant type of Hodgkin's disease. However, the authors found that after neuraminidase treatment for removal of sialic acid, the L&H cells in more than half of the cases studied could be stained by anti-Leu M1. This result strongly suggests that L&H cells differ from the Reed-Sternberg cells in other types of Hodgkin's disease in their unique capacity to sialylate the 150-kd Leu M1 antigen. PMID- 3511720 TI - Ultrastructural localization of type III procollagen in baboon liver. AB - The localization of the extension aminopropeptides of Type III procollagen was studied in baboon liver by the immunoperoxidase method. The aminopropeptides were localized along the collagen fibrils around terminal hepatic venules, in the space of Disse, and in portal tracts of control baboons as well as of alcohol-fed animals. The labeling showed a characteristic periodicity of 60-70 nm, corresponding to the D (67 nm) stagger of collagen fibrils. The data indicate that some extension aminopropeptides of Type III procollagen are not cleaved from procollagen prior to its incorporation into collagen fibrils but that they exist as constituents of mature fibrils. PMID- 3511721 TI - Phenotypes and phorbol ester-induced differentiation of human histiocytic lymphoma cell lines (U-937 and SU-DHL-1) and Reed-Sternberg cells. AB - Hodgkin's mononuclear cells, Reed-Sternberg (H-RS) cells, and U-937 and SU-DHL-1 histocytic cell lines were induced to differentiate by phorbol ester in cultures. The phenotypes of cells were determined by a panel of antibodies specific for monocytes, histiocytes, and interdigitating reticulum cells. Before induction, SU DHL-1 cells and H-RS cells expressed similar markers, such as HeFi-1, 2H9, 1A2, and 1E9. In addition, SU-DHL-1 cells were also stained by Tac and Leu M5. Other monocyte markers, including OK M1, Co Mo2, BRL Mo1, BRL Mo2, and Leu M3 were consistently negative in both types of cells. After induction, SU-DHL-1 cells conserved the same phenotype, but H-RS cells became negative for HeFi-1, 1A2, and 2H9. The U-937 cells expressed Leu M1 and Co Mo2 and became positive for Leu M5, OK M1, Co Mo2, BRL Mo2, 2H9, and 1E9 after phorbol ester induction. The U-937 cells did not express HeFi-1 or 1A2. The marker expression of H-RS cells, SU-DHL 1 cells, and U-937 cells were compared with those of histiocytes or interdigitating reticulum cells in lymphoid tissues and with neoplastic cells in true histiocytic lymphoma and malignant histiocytosis. It is concluded that SU DHL-1, U-937, and H-RS cells are derived from or most closely related to fixed histiocytes, free histiocytes, and interdigitating reticulum cells, respectively. Our study further confirms the diagnosis of SU-DHL-1 as true histiocytic lymphoma but reveals that U-937 is a case of malignant histiocytosis rather than the previously diagnosed histiocytic lymphoma. The phenotypes and induction properties of SU-DHL-1 cells are quite different from those of U-937 cells, which suggests that true histiocytic lymphoma and malignant histiocytosis are two distinct disease entities. PMID- 3511722 TI - Glomerular injury in mice induced by Agkistrodon venom. AB - Glomerular injury was produced in mice after a single LD50 intravenous dose of purified 100-pace snake venom (Agkistrodon acutus). Characteristic features in glomeruli where the venom was demonstrated immunohistochemically included cystic lesions of the capillary tufts, thrombosis, subsequent proliferative and sclerotic changes, and crescent formation. Venom was recognized immunohistochemically in the glomerular endothelium, visceral basement membrane, mesangium, epithelium, and Bowman's capsule. Venom transfer across the basement membrane or into cells required less than 2 hours. Within this period mesangiolysis occurred due to the protease activity of the venom. Cystic lesions with fibrin thrombi then developed, which were replaced by proliferative and sclerotic changes after 3 days. Crescent formation began within 48 hours and was completed within a few days. Microangiography revealed hemodynamic changes in the intrarenal vasculature after venom treatment. Immune complex deposition was not found in any tissue. The study demonstrates the moderately constant potency (LD50) of Agkistron acutus venom, and documents it as a useful tool for quantitative studies of renal lesions. PMID- 3511723 TI - The reduction of inflammatory responses in lipopolysaccharide-tolerant eyes. AB - The development of tolerance induced by subcutaneous or intraocular injections of lipopolysaccharide (LPS, Escherichia coli) in rat eyes has been studied. In addition, the ocular inflammatory responses to the reversed passive Arthus (RPA) reaction in the tolerant eyes were investigated. The tolerance in the eye after a single injection of LPS persisted for at least 42 days. Up to 42 days, vasodilatation, disruption of the blood-aqueous barrier, and leukocyte accumulation in the anterior chamber after a second injection of LPS were inhibited. Unilateral intraocular injection of LPS produced local tolerance, which was not observed in the contralateral eyes. The inflammatory reactions in response to RPA in the LPS-tolerant eyes were also significantly attenuated. It was also found that inflammatory reactions induced by RPA or 16,16-dimethyl prostaglandin E2 had no inhibitory effect on the responses to subsequent RPA or LPS administration, which indicated that initial inflammatory reactions do not render the tissues refractory to the response to a second stimuli. The results of this study suggest that some, as yet unknown, local changes in the ocular tissues caused by LPS may be involved in the development of tolerance. PMID- 3511724 TI - Thymic epithelium in AIDS. An immunohistologic study. AB - The authors investigated by immunofluorescence the thymic epithelium from AIDS patients, using several structural and functional markers of this tissue. In AIDS thymus, the epithelial reticular pattern was lost; and instead, clusters of round or spindle-shaped cells (assessed by their keratin content) were found. In addition, regions of epithelial necrosis, with loss of cell limits, were frequently observed. Thymulin content was decreased, and a partial loss of differentiation antigens of the thymic epithelium was also detected. The authors showed the presence of immunoglobulins and elements of the complement system directly bound to AIDS thymic epithelium, but not in any of the controls studied, including thymuses from patients who died after a long period of agony. These data suggest that the thymic epithelium can be included among the target tissues in AIDS, possibly by an indirect mechanism of autoimmune destruction. PMID- 3511725 TI - Experimental transmission of the delta virus to a hepatitis B chronic carrier chimpanzee with the development of persistent delta carriage. AB - A delta virus (DV) infection was experimentally transmitted to a hepatitis B chronic carrier chimpanzee. The infection was monitored by the examination of liver biopsy materials with the use of FITC-labeled human anti-delta IgG or by an indirect immunoperoxidase staining technique and by measurement of the serum alanine aminotransferase (ALT) activity. Three different antibody enzyme immunoassays (EIAs) were developed for assessment of the serologic response: 1) blocking assay, 2) IgM-specific capture assay, and 3) IgG-specific capture assay. An antigen-specific EIA was also developed for monitoring delta antigen in the serum. The results indicate that a superinfection with the DV produced a biphasic ALT response concomitant with the appearance of the delta antigen in biopsy materials. The persistence of these markers over the observation period (350 days) indicates the development of a persistent DV infection. PMID- 3511726 TI - Pathologic and ultrastructural changes of acute and chronic delta hepatitis in an experimentally infected chimpanzee. AB - A hepatitis B surface antigen (HBsAg) chronic carrier chimpanzee experimentally superinfected with delta virus (DV) developed chronic DV infection. Over a period of 12 months, serologic and biochemical changes were correlated with morphologic abnormalities of the liver. Severe hepatic necrosis and inflammation accompanied the initial acute episode of hepatitis on Day 35 after inoculation, followed by complete resolution of these lesions over the next 3 months. A second episode of hepatitis occurred on Day 145, and severe necrosis and inflammation recurred along with the reappearance of delta antigen in the hepatocytes. Delta antigen persisted in the liver following the second episode of hepatitis and has remained positive throughout the observation period of 1 year. During the initial acute episode, the hepatocytes exhibited foamy cytoplasmic changes resembling microvesicular fat. However, ultrastructural studies of the same cells revealed only vacuolization of the cytoplasm without evidence of fat droplets. The inflammatory infiltrate during both episodes of hepatitis demonstrated a striking predominance of macrophages over lymphocytes. Hepatocyte abnormalities observed by electron microscopy included vacuoles, proliferated endoplasmic reticulum, and tubules similar to those seen in posttransfusion non-A, non-B hepatitis. However, the tubular and reticular abnormalities coincided with delta antigen expression in liver biopsies detected by direct immunoperoxidase staining and abnormal alanine aminotransferase levels in the serum, which suggests a possible causal relationship. Nuclear abnormalities were not seen. PMID- 3511727 TI - Comparison of inflammatory reactions induced by intraarticular injection of bacterial cell wall polymers. AB - Cell wall polymers isolated from group A streptococci, as well as lipopolysaccharide from Salmonella typhimurium and synthetic muramyl dipeptide, were injected into the ankle joints of rats. The inflammatory responses were assessed by gross and histologic examination, and edema was measured by accumulation of radiolabeled albumin in the limbs. The isolated group-specific polysaccharide induced extensive edema of the articular and periarticular tissue immediately after injection, and this resolved in 24 hours. The peptidoglycan moiety did not produce early edema, but induced an acute exudative reaction followed by a proliferative synovitis which resolved after 5 days. Reactions induced by covalently bound complexes of peptidoglycan and the group-specific polysaccharide (PG-APS) varied, depending on the size of the complex. Small fragments, derived from mutanolysin digestion, caused both an acute edematous reaction and transient arthritis. Larger fragments did not cause the immediate edematous reaction, but induced an acute arthritis that appeared within 24 hours and evolved into a chronic process. Episodes of recurrent inflammation, a distinctive feature of joint inflammation induced by systemic injection of PG-APS polymers, were not observed following intraarticular injection of any of the cell wall polymers. The relative susceptibility of different rat strains to arthritis induced by intraarticular injection paralleled the responses to systemic injection of PG-APS. These results demonstrate that variations in arthropathogenicity are due, in part, to inherent differences in the phlogistic activities of different cell wall polymers, and that the genetic control of susceptibility involves regulation of the inflammatory responses rather than the quantity of cell wall distributed to the joint. PMID- 3511728 TI - Surfactant-anti-surfactant immune complexes in infants with respiratory distress syndrome. AB - The authors sought to determine whether treatment of respiratory distress syndrome (RDS) with human surfactant resulted in the formation of detectable circulating immune complexes. Preterm infants with severe RDS were divided into two groups: one group received human surfactant by intratracheal instillation and the other group did not. Both groups received ventilatory management involving intermittent mandatory ventilation. Plasma samples were drawn from these babies prior to treatment and at intervals thereafter. The authors developed an ELISA assay specific for surfactant-anti-surfactant immune complexes and analyzed the plasma samples for such immune complexes. Complement levels were also measured. They found that with time plasma from RDS infants in both groups showed evidence of surfactant-anti-surfactant immune complex formation. The concentrations of immune complexes generally peaked within the first week of life and then appeared to diminish over 1-4 weeks after birth in RDS infants. There was no evidence at any time in either group of immune-complex-mediated injury or of decreased serum complement levels. It is concluded that circulating immune complexes between surfactant and antibodies to surfactant are probably found in most neonates with respiratory distress syndrome, that they do not produce pulmonary damage detectable by clinical and serologic means, and that treatment of neonatal RDS with human surfactant similarly does not produce lung injury as determined with these techniques. PMID- 3511729 TI - Professeur Dr. Georges Portmann--Bordeaux, France 1908-1985. PMID- 3511730 TI - Informed consent: history, theory, and practice. PMID- 3511731 TI - An enigmatic hypoplastic defect of the deciduous canine. AB - A roughly circular hypoplastic defect restricted to the labial enamel surface of the deciduous canine is described. This pathology is quite common in available samples of Upper Paleolithic and Neolithic children and a cadaver sample of recent Calcuttans, affecting 44% to 70% of individuals. It is rare in a Neanderthal sample and in children from a clinical practice in Vancouver. The lesion occurs twice as commonly in the lower jaw. The defect appears to commence at or after birth owing to localized pressure on thin or nonexistent alveolar bone overlying the bulging crypt of the deciduous canine. Population differences in the incidence of the pathology probably reflect innate and acquired variation in hard and soft tissue thicknesses in this region. PMID- 3511732 TI - Roles of urea production, ammonium excretion, and amino acid oxidation in acid base balance. AB - Atkinson and colleagues recently proposed several concepts that contrast with traditional views: first, that acid-base balance is regulated chiefly by the reactions leading to urea production in the liver; second, that ammonium excretion by the kidney plays no role in acid-base homeostasis; and third, that ammonium does not stimulate ureagenesis (except indirectly). To examine these concepts, plasma ions other than bicarbonate are categorized as 1) fixed cations (Na+, K+, Ca2+, and Mg2+, symbolized M+) and anions (Cl-), 2) buffer anions (A-), 3) other anions (X-), and 4) ammonium plus charged amino groups (N+). Since electroneutrality dictates that M+ + N+ = Cl- + HCO3- + A- + X-, it follows that delta HCO3- = delta(M+ - Cl-) - delta A- - delta X- + delta N+. Therefore acid base disturbances (changes in HCO3-) can be categorized as to how they affect bodily content and hence plasma concentration of each of these four types of ions. The stoichiometry of ureagenesis, glutamine hydrolysis, ammonium and titratable acid excretion, oxidation of neutral, acidic, and basic amino acids, and oxidation of methionine, phosphoserine, and protein are examined to see how they alter these quantities. It is concluded that 1) although ureagenesis is pH dependent and also counteracts a tendency of amino acid oxidation to cause alkalosis, this tendency is inherently limited by the hyperammonemia (delta N+) that necessarily accompanies it, 2) ammonium excretion is equivalent to hydrogen excretion in its effects on acid-base balance if, and only if, it occurs in exchange for sodium or is accompanied by chloride excretion and only when the glutamate generated by glutamine hydrolysis is oxidized.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3511733 TI - Angiotensin II inhibition on blood pressure and renal hemodynamics in pregnant rats. AB - Late-pregnant (18-20 days) and virgin rats were studied under anesthesia or while awake to investigate the effect of acute angiotensin II (ANG II) inhibition (with saralasin or captopril) on mean arterial blood pressure (AP) and renal hemodynamics. ANG II inhibition had no effect on AP in either anesthetized or awake virgin rats. Saralasin produced no effect on renal hemodynamics although with captopril small increases in renal plasma flow rate (RPF) and decreases in renal vascular resistance (RVR) occurred in virgins. In anesthetized pregnant rats, ANG II inhibition evoked marked decreases in AP. In some rats receiving saralasin, AP was only mildly depressed and RVR fell, leading to increases in glomerular filtration rate and RPF. In others, saralasin produced large decreases in AP, and indices of renal function became unmeasurable because of near cessation of urine flow. All late-pregnant anesthetized rats receiving captopril showed increased RPF irrespective of the magnitude of the fall in AP. In awake pregnant rats no effect on AP was seen with ANG II inhibition. Saralasin had no effect on renal hemodynamics although with captopril a small increase in RPF was observed. These data indicate that the stress of acute surgery and anesthesia produces a dependence of AP on ANG II in the pregnant but not the virgin rat. Under normal pregnant (awake) conditions, however, ANG II inhibition has no net effect on AP. PMID- 3511734 TI - Role of renal nerves in rats with low-sodium, one-kidney hypertension. AB - This study examined the role of the renal nerves in both the maintenance and developmental phases of hypertension produced by sodium restriction in one-kidney rats. Results indicate that mild hypertension is sustained through 6 wk after unilateral nephrectomy in rats fed a sodium-deficient diet, with the greatest increase in systolic blood pressure occurring within the first 2 wk. Six weeks after nephrectomy, renal denervation was performed in the sodium-restricted, hypertensive rats, and the blood pressure returned to normotensive levels. Plasma renin activity (PRA) was elevated fourfold after 6 wk of sodium restriction and was unchanged by renal denervation. In another series of experiments that examined the development of hypertension in this experimental model, contralateral renal denervation was performed at the time of nephrectomy, and this prevented the subsequent development of hypertension. PRA was significantly attenuated in these low-sodium, renal-denervated rats that failed to become hypertensive when compared with PRA in hypertensive low-sodium, sham-denervated rats. Kidney norepinephrine content was reduced by 96% after renal denervation in both phases of the hypertension. These data demonstrate that intact renal nerves are necessary for both the development and maintenance of mild hypertension after sodium restriction in one-kidney rats. The pressor contribution of the renal nerves to the hypertension in this experimental model appears to be related, at least in part, to the activation of the renin-angiotensin pressor mechanism. PMID- 3511735 TI - Neurogenic antinatriuresis during development of acute cardiac tamponade. AB - Renal function was measured during the development of cardiac tamponade in anesthetized dogs. Tamponade was induced by infusion of isotonic saline (37 degrees C) into the pericardial space. Step increases in pericardial fluid volume in 20-ml increments from 0 to 160 ml increased renal efferent nerve activity by a total of 140 +/- 58% of control (from 205 +/- 70 microV/s). Since renal nerve traffic was elevated by pericardial fluid volume infusion prior to any changes in arterial pressure, renal function was determined before and after increasing pericardial pressure (PCP) by approximately 5 and 10 mmHg. Increasing PCP by 5 mmHg decreased urinary sodium excretion and increased renin secretion rate without changing mean arterial pressure, renal blood flow, or glomerular filtration rate (GFR). Further elevation of PCP to approximately 10 mmHg also decreased urinary sodium excretion as well as arterial pressure and GFR. Renal denervation prevented both of these antinatriuretic responses to elevated PCP. In a third group of dogs, similar antinatriuresis was induced by increasing PCP by approximately 5 and 10 mmHg. Bilateral cervical vagotomy abolished the antinatriuretic response to increased PCP by 5 mmHg but was ineffective when PCP was increased by 10 mmHg, which was accompanied by decreased arterial pressure. These results demonstrate that elevation of pericardial fluid volume, and consequently PCP, reflexly decreases urinary sodium excretion via activation of renal sympathetic outflow. Early reflex antinatriuresis results primarily from activation of cardiopulmonary or splanchnic receptors with vagal afferents, whereas, at larger PCP, reflex antinatriuresis may result from hypotension and unloading of high pressure baroreceptors.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3511736 TI - Microcomputer-assisted metabolic studies of voluntary diving of Weddell seals. AB - Utilizing a microprocessor-controlled peristaltic withdrawal pump, arterial blood samples were obtained from Weddell seals (Leptonychotes weddelli) while diving voluntarily under the sea ice at McMurdo Sound, Antarctica. Plasma concentrations of glucose, lactate, free fatty acids, urea, and amino acids were determined in seals at various times during rest, diving, and recovery. In addition, radiolabeled palmitate, glucose, lactate, p-aminohippurate, inulin, galactose, and cholate were injected into the descending aorta of seals in the resting state or during voluntary diving at sea. Sequential plasma samples were collected, and the kinetics of wash-in and clearance of each component were determined. Under resting conditions, the change in specific activity of palmitate, glucose, and lactate after bolus injection followed smooth multiexponential decay kinetics as in terrestrial animals. Similar decay curves for the clearance of organ-specific compounds were also obtained in seals at rest. If, during voluntary diving, Weddell seals were analogous to exercising animals, the wash-in and clearance kinetics of all metabolites and organ-specific compounds would be qualitatively similar to those observed at rest. In contrast, wash-in and clearance appeared to be qualitatively and quantitatively modified in a way consistent with utilization of the classical Scholander diving response in both short and long dives. PMID- 3511738 TI - Metabolic response to a specific lipid-depleting factor in parabiotic rats. AB - Parabiosis has been used as a technique for demonstrating the existence of a humoral factor in the control of body fat. The timing and metabolic basis for specific loss of fat from parabiotic partners of obese rats were examined. One member of a pair received 200% control intake, by stomach tube, for 8, 23, 39, or 57 days. Their partners ate 9.8 +/- 0.1 g/day. Members of ad libitum-fed pairs ate 9.6 +/- 0.1 g/day. All rats received the same diet. After 39 days, body fat in partners of obese rats was 6 +/- 1 g/rat compared with 17 +/- 1 g/rat in members of ad libitum pairs. Body protein was not different. In vitro hepatic fatty acid synthesis (FAS) and esterification (FAE) and inguinal FAS, FAE, and glycerol release suggested that fat loss was due to inhibition of adipose FAE. Partners of overfed rats and members of ad libitum pairs were then compared after 27 days of tube feeding when loss of fat was expected to be most rapid. Hepatic FAS, FAE, and fatty acid oxidation were the same for both groups. Inguinal FAS and FAE were decreased in partners of obese rats. An unidentified "lipid depleting" agent, originating in obese rats, appears to inhibit adipose FAS and FAE in their partners independently of changes in feeding. PMID- 3511737 TI - Interference with central actions of angiotensin II suppresses sodium appetite. AB - We have proposed that sodium appetite is aroused by a synergy in the brain of angiotensin II and aldosterone. This hypothesis was tested with 1) chronic intracerebroventricular infusion of captopril, which blocks the conversion of angiotensin I to angiotensin II, or 2) intracerebroventricular injection of eight substituted analogues of angiotensin II, which block its receptors. Both treatments resulted in a suppression of the sodium appetite induced by sodium deficiency. The suppression was specific for the deficiency-induced appetite, because spontaneous ingestive behaviors were not changed nor was sodium excretion. In addition, the rats continued to express a sodium appetite aroused by pharmacological doses of deoxycorticosterone acetate when they received the highest dose of chronic intracerebroventricular captopril. These results offer compelling evidence for the idea that angiotensin II action in the brain is necessary for expression of sodium appetite. PMID- 3511739 TI - Genetic and clinical implications of alcoholism and affective disorder. AB - The association between alcoholism and affective disorders is complex and has fomented much debate. Problems occur because of confusion in definitions (e.g., the distinction between drinking and alcoholism on the one hand and sadness and major affective disorders on the other) and because sadness and even intense temporary secondary affective episodes are often seen in the course of alcoholism. The author notes five possible factors contributing to the confusion between these two disorders and points out several ways to approach the problems of patients who have more than one concurrent clinical syndrome. Using the data from a literature review, he concludes that alcoholism and affective disorder appear to be independent diseases with some overlap in clinical symptoms. PMID- 3511741 TI - DSM-III and Schreber's case. PMID- 3511740 TI - An early "study" of seasonal depression. PMID- 3511742 TI - Antidepressant effect of a tryptophan hydroxylase activation inhibitor, AGN 2979. PMID- 3511744 TI - Identification of functional Fasciola hepatica antigens in experimental infections in rabbits. AB - Studies done comparing the reactivity of serum from an infected rabbit at different intervals of infection with a Fasciola hepatica crude tegument extract, F. hepatica excretory-secretory (ES) products and Fh arc 2 by ELISA show that the first 2 antigen preparations offer a better sensitivity for detecting acute infection, especially in its early stages (3 weeks). The ES proteins from F. hepatica adult worms were identified by the enzyme-linked immunotransfer blot (EITB) in order to define the antigens recognized by the sera from rabbits with experimental fascioliasis. A group of 7 polypeptides with molecular weights of 23 28 Kd were the major antigens recognized. Reactivity to these antigens is maximum at 8-10 weeks of infection by EITB. As the infection progresses, reactivity to the 23-28 Kd antigens decreases but does persist through 52 weeks of infection. At least 5 other polypeptides of 120, 84, 58, 52, 39 and 33 Kd were recognized by the sera of infected rabbits from 6 to 52 weeks of infection. A different pattern was observed in parallel studies done with these same sera by immunoprecipitation of ES antigens. In addition to a 33 Kd antigen, which was detected by both techniques, a 62 Kd antigen was detected early in infection (5 weeks) and 3 major antigens of 38, 40 and 44 Kd were prominent by immunoprecipitation from 9 weeks onward. This implies the presence of multiple Fasciola antigens with serodiagnostic potential. The expression of these antigens during development and their possible role in immunity is discussed. PMID- 3511743 TI - Introduction to the epidemiological aspects of explosive volcanism. PMID- 3511745 TI - The identification of eggs of Echinococcus by immunofluorescence using a specific anti-oncospheral monoclonal antibody. AB - A relatively simple and specific test has been developed to distinguish eggs of Echinococcus from those of other morphologically identical taeniid species. A specific anti-Echinococcus oncosphere monoclonal antibody was produced which binds in an indirect immunofluorescence test to egg-derived oncospheres of E. granulosus but not to those of other taeniid species, such as Taenia hydatigena, T. saginata, T. pisiformis, T. ovis, T. multiceps, or T. taeniaeformis. Specific fluorescence was obtained with oncospheres of E. granulosus derived from either hatch/activated viable eggs using artificial intestinal fluid or from hypochlorite/detergent treated eggs. The potential use of this test in the study of the transmission of Echinococcus in Turkana, Kenya, is discussed. PMID- 3511746 TI - The effects of cortisone on immunity during chronic rodent malaria. AB - The temporal effects were studied of a single dose of hydrocortisone acetate on the development and expression of immune responses to Plasmodium berghei in mice with chronic infections. Cortisone administration prior to primary infection reduced malaria-specific secondary humoral and cellular responses, as well as the ability to survive parasite challenge. Once protective humoral immunity was established after chemotherapy of primary infection, cortisone treatment did not disrupt its expression. Administration of cortisone during subpatent chronic infection resulted in a transient recrudescence of parasitemia not apparent in untreated mice. Clearance of recrudescence or parasite challenge was associated with a rapid cortisone-resistant antibody response. During subpatent chronic infection, malaria-specific antibody levels were reduced, whereas delayed-type hypersensitivity (DTH) to malaria antigens and heterologous antigens was well developed. At least two systems of immunity to malaria appear to be present during chronic infection. Recrudescence of parasitemia may be prevented by antibody-independent, cortisone-sensitive cellular immunity. Once parasitemia becomes overt after cortisone treatment, or parasites are reintroduced with challenge, cortisone-resistant humoral immunity appears to mediate parasite clearance. Regulation of these systems may be a dose-dependent phenomenon which results in the persistence of parasites, albeit at subpatent levels. PMID- 3511747 TI - Anti-Plasmodium falciparum antibodies acquired by residents in a holoendemic area of Liberia during development of clinical immunity. AB - Sera from 48 children and adolescents (2-15 years of age), residing in a malaria holoendemic area of Liberia were investigated for specificities and isotypes of anti-P. falciparum antibodies. No clear-cut relationship to the development of clinical immunity was found when the overall antibody activities to total parasite antigens were determined by enzyme-linked immunosorbent assay (ELISA). Although there was a certain rise of IgM, total IgG- and IgG2 antibody activities, this was most pronounced at ages when a clinical but nonsterile immunity is already present. When the sera were investigated by immunoprecipitation of 35S-methionine labeled parasite polypeptides, the total number of parasite antigens precipitated was similar at all ages. Analysis by indirect immunofluorescence (IFA), registering antibodies to intracellular parasite antigens, revealed no age-dependent changes in antibody titers. In contrast, when the sera were assayed by a novel IFA, specific for a restricted number of parasite antigens in the membrane of infected erythrocytes, the frequency of positive sera as well as the anti-P. falciparum titers rose in parallel with the development of clinical immunity. Thus, these antigens appeared to be important inducers of protective immune responses and may be suitable candidates for a vaccine against the asexual blood stages of P. falciparum. PMID- 3511748 TI - The epidemiology of malaria in a population surrounding Madang, Papua New Guinea. AB - Malaria is prevalent throughout coastal and lowland Papua New Guinea. Recent changes, including a shift from predominance of Plasmodium vivax to Plasmodium falciparum, appearance of chloroquine-resistant P. falciparum and decreased effectiveness of vector control programs have been observed. Epidemiological features of malaria were studied through four six-month surveys of a population of 16,500 in Madang Province from 1981-1983. Baseline data on parasitology, splenic enlargement, serology, hemoglobin levels, prevalence of 4 aminoquinolines, utilization of mosquito nets and incidence of fever were collected for use in future evaluation of malaria control measures including possible field trials of an antimalarial vaccine. Prevalence of parasitemia (all species, all ages) varied from 35.0% to 42.7% over the four surveys each of which covered a random sample of 25% of the population. The ratio of parasite species was: P. falciparum 70:P. vivax 25:P. malariae 5 in the dry seasons, shifting slightly in favor of P. falciparum during the wet seasons. Intense year-round transmission was indicated by decreasing parasite prevalence and splenic enlargement with age, low density asymptomatic parasitemias and high prevalence of antimalarial antibodies (i.e., greater than 80% of the population over five years of age was ELISA-positive). Levels of endemicity varied geographically, presence of 4-aminoquinolines in urine samples was relatively common (12.7% positive) and chloroquine resistance was widespread (81.6% in vitro, 46.6% in vivo). PMID- 3511749 TI - Membrane-associated electron-dense material of the asexual stages of Plasmodium falciparum: evidence for movement from the intracellular parasite to the erythrocyte membrane. AB - Electron-dense material (EDM) appears at the parasite plasma membrane with trophozoites of several strains of Plasmodium falciparum cultured in vitro. The EDM is also seen associated with unit membrane-bounded Maurer's clefts in K+ P. falciparum-infected erythrocytes. The cytoplasmic clefts lack the EDM with K- parasites. Some EDM have the same density and appearance as the material located under knobs at the erythrocyte membrane. The EDM at the parasite plasma membrane is absent with schizonts when expression of new knobs at the erythrocyte membrane appears to have ceased. This electron microscopic study suggests that the parasite-derived EDM is transported from the parasite plasmalemma to the erythrocyte membrane via Maurer's clefts in the erythrocyte cytoplasm. PMID- 3511750 TI - Rhoptry secretion of membranous whorls by Plasmodium falciparum merozoites. AB - Multilamellar membranous whorls were localized, by electron microscopy, in elements of the rhoptry-microneme complex from glutaraldehyde-tannic acid (TA) fixed merozoites of the human malarial parasite, Plasmodium falciparum. These multilaminate structures, which have a dark line-to-dark line periodicity of approximately 5 nm, were also found in the nuclear envelope and closely apposed to the external surface of merozoites. Segmented schizonts, which contain intracellular merozoites, often showed membranous whorls within their parasitophorous vacuoles and closely apposed to the external surface of the parasitophorous vacuole membrane. Whorls were not found in trophozoites, immature schizonts, and uninfected erythrocytes. Most rhoptries in merozoites fixed in glutaraldehyde-TA were electron-lucent whereas rhoptries fixed in glutaraldehyde alone were electron-dense. Some merozoites fixed in glutaraldehyde-TA had both an electron-dense and an electron-lucent rhoptry. These findings suggest that TA induces the premature extrusion of rhoptry materials. Our findings support previous suggestions in the literature that phospholipid materials secreted from merozoite rhoptries are involved in merozoite interaction with host erythrocytes. PMID- 3511751 TI - Infection of mosquitoes with Plasmodium vivax from chimpanzees using membrane feeding. AB - Six splenectomized chimpanzees were infected with the Chesson or the North Korean strains of Plasmodium vivax. Heparinized blood taken from the animals was fed to approximately 45,000 mosquitoes using parafilm membranes. High-level mosquito infections were obtained with the blood from 4 animals. One animal infected mosquitoes only at a very low level. The other chimpanzee failed to produce a parasitemia high enough to warrant mosquito feeding. PMID- 3511752 TI - Effects of Fansidar on chloroquine-resistant Plasmodium falciparum in Pakistan. AB - Fansidar (SP), a combination of sulfadoxine and pyrimethamine, was evaluated for its usefulness as a curative agent for treating individual malaria patients and for reducing the community reservoir of Plasmodium falciparum in 4 villages near Lahore, Pakistan, where resistance of 4-aminoquinolines has recently been reported. Following the end of the major malaria transmission season, we carried out a month-long mass treatment campaign during which SP was given to all available villagers who had parasitemias detected during a concurrent house-to house malaria blood film survey. Of the 82 falciparum patients followed for 14 days after SP treatment, 80 (97.5%) had parasites sensitive to the investigated drug. Parasitemia clearance time after SP was remarkedly short (1.25 +/- 0.53 days; mean +/- SD). However, we were unable to reduce the parasite reservoir of P. falciparum and P. vivax in these villages, probably because we treated only 337, about one-third, of the parasitemic patients. We conclude that SP is an effective drug for treating individual malaria patients from areas in Pakistan where 4-aminoquinoline-resistant parasites are present, but that more research is needed for assessing its usefulness in reducing community reservoirs of malaria. PMID- 3511753 TI - Malaria transmitted to humans by mosquitoes infected from cultured Plasmodium falciparum. AB - Malaria was transmitted to six normal human volunteers by mosquitoes infected from cultured gametocytes of Plasmodium falciparum. This method, which offers advantages over other methods of infecting volunteers, will be useful for evaluating the efficacy of human malaria vaccines. PMID- 3511754 TI - What of the next 25 years? AB - The early history of the Society for Surgery of the Alimentary Tract has been reviewed, and the remarkable progress in gastrointestinal surgery over the first 25 years of its existence has been acknowledged. The challenging dimensions of the problems that remain unsolved have been emphasized, and the directions that fruitful research may take in the next quarter century have been suggested. The alimentary tract surgeon will be called upon to adapt to change, and to move into new fields of clinical physiology and surgery. The discoveries and progress to be anticipated in the years to come are vast. PMID- 3511755 TI - Reflections on gastrointestinal surgery. PMID- 3511756 TI - Cholestatic jaundice after hepatic transplantation. A nonimmunologically mediated event. AB - Serial liver biopsy and close clinical monitoring in 55 consecutive hepatic allografts have disclosed a syndrome of cholestatic jaundice that simulates rejection. This syndrome is associated with distinct histologic findings and resolves spontaneously without modification of immunosuppressive management. The cause of the cholestasis is probably related to subcellular organelle damage produced by cold ischemia, and its importance stems from the confusion it creates with regard to rejection diagnosis. Recognition of this syndrome can result in decreased immunosuppression in hepatic allograft recipients, a secondary decrease in infectious complications, and improvement in the survival rate. PMID- 3511757 TI - Pathophysiology of hepatic ischemia in cardiogenic shock. AB - The hepatic hemodynamic response to cardiogenic shock was investigated in a porcine model produced by pericardial tamponade to better understand the pathophysiology of postshock hepatic insufficiency. Reductions of cardiac output to 50 percent of baseline levels produced marked hepatic ischemia by causing disproportionate reductions in blood flow through the celiac and hepatic arteries and portal vein. These were due to selective vasoconstriction of the splanchnic resistance vessels that was mimicked without tamponade by the infusion of angiotensin II, ablated by angiotensin-converting enzyme blockade, unaffected by alpha-adrenergic ablation, and correlated closely with levels of plasma renin activity. The ischemic liver injury of cardiogenic shock appears to be largely due to an exquisite responsiveness of the splanchnic vascular smooth muscle to endogenously released angiotensin II. PMID- 3511758 TI - The first total pancreatectomy. PMID- 3511759 TI - Duration of antibiotic prophylaxis. An experimental study. AB - An animal wound model was used to evaluate single dose cefazolin, multiple dose cefazolin, and single dose cefonicid in the prevention of wound infection. Incisions made in Swiss-Webster mice were contaminated with either Staph. aureus (1.94 X 10(8) colony forming units) or E. coli (4.39 X 10(8) colony forming units). Five experimental groups were studied. Group I encompassed control animals given saline solution, Group II animals given 10 mg cefazolin preoperatively, Group III animals given 10 mg of cefazolin preoperatively and postoperatively, Group IV animals given 10 mg of cefonicid preoperatively, and Group V animals given 20 mg of cefonicid preoperatively. All medications were given by intraperitoneal injection. Antibiotics were given 1 hour before operation. Postoperative doses were given 4 hours after operation. Incisions were opened 48 hours after surgery and wound bacterial concentrations were determined. After both Staph. aureus and E. coli contamination, each of the four cephalosporin regimens significantly reduced the mean wound bacterial concentrations compared with that of the control animals (p less than 0.001). Each of the four cephalosporin regimens also significantly reduced the number of infected wounds compared with that of the control subjects (p less than 0.001). No significant differences were noted among the four antibiotic regimens with respect to mean wound bacterial concentration or infection rate. In the context of this model, a single dose of cefazolin seems to be equally effective as multiple doses of the drug for surgical prophylaxis. Extended half-life cephalosporins, like cefonicid, do not appear to be more effective than a single dose of cefazolin, which is a much less expensive antibiotic. PMID- 3511760 TI - Anaerobic coverage for wound prophylaxis. Comparison of cefazolin and cefoxitin. AB - An experimental wound model has been used to evaluate the effectiveness of cefazolin and cefoxitin in the prevention of wound infection. Incisions were contaminated with Staph. aureus, E. coli, or a standardized fecal suspension. Regardless of the contaminant employed, the prophylactic use of either cefazolin or cefoxitin yielded lower wound bacterial concentrations and fewer infections compared with treatment with placebo. Cefazolin proved just as effective as cefoxitin in preventing infection when wounds were contaminated with Staph. aureus or E. coli. Although cefoxitin is the only cephalosporin that offers anaerobic coverage, its prophylactic administration when wounds were contaminated with a standardized fecal suspension did not significantly alter wound bacterial concentrations or infection rates compared with cefazolin. The data from our animal wound model suggest that prophylactic anaerobic coverage is not necessary. PMID- 3511761 TI - Biliary disease in pregnancy: strategy for surgical management. AB - Acute biliary tract disease complicated intrauterine pregnancy in 26 patients seen during a 5 year period. Biliary symptoms were distinct and occurred during the first trimester in 7 patients, the second trimester in 5 patients, the third trimester in 12 patients, and in two early postpartum patients. Nine patients had marked hyperamylasemia which resolved with medical management, and no severe cases of pancreatitis occurred. Ultrasonography was used to confirm the presence of gallstones in 18 patients and demonstrated dilated intrahepatic ducts in one of two patients with surgically proved choledocholithiasis. Nineteen patients had cholecystectomy and cholangiography, and 4 had common bile duct explorations. Only two of seven patients who presented in the first trimester had term pregnancy. Diagnosis of cholelithiasis in pregnancy by ultrasonography is accurate and reliable. The risk to the fetus of radionuclide scanning and conventional radiography is not justified. Secondary hyperamylasemia is common but responds to conservative therapy. Operation may be delayed until delivery in most patients, with urgent exploration reserved for uncertainty in diagnosis, choledocholithiasis, or acute cholecystitis that does not resolve with medical measures. PMID- 3511762 TI - A new concept of the anatomy of the anal sphincter mechanism and the physiology of defecation. Reversion to normal defecation after combined excision operation and end colostomy for rectal cancer. AB - Twenty-one patients with combined excision operation for rectal cancer were subjected to electromyographic study of the levator ani muscle, the puborectalis muscle, and the external anal sphincter. Myoelectric activity of the puborectalis and levator ani muscles was detected in 12 patients, 6 of whom had normal activity of both muscles. Of the remaining six patients, there was reduced activity of the levator ani muscle in four and of the puborectalis muscle in all six. These patients underwent training and electric stimulation of these muscles. To verify the myoelectric findings, 15 specimens removed at combined excision operation were examined grossly and microscopically for the muscles removed at operation. Eight specimens were found to be free of the levator and puborectalis muscles, which indicated that these muscles were not excised. The 12 patients with myoelectrically active levator and puborectalis muscles were operated on to restore defecation by way of the normal perineal route. The technique comprises freeing of the colostomy and mobilization of the entire left side of the colon. The perineal scar is then excised and the colonic end fixed to the perineal skin and thus is controlled by the levator and puborectalis muscles. Full fecal control was achieved in seven patients and incomplete control in five. It is concluded that excision of the levator ani muscle, the puborectalis muscle, and the external anal sphincter should not be considered a standard part of the radical operation for cancer of the lower or middle third of the rectum, and that a combined excision operation has no place in the treatment of rectal cancer. PMID- 3511763 TI - Third generation cephalosporin antibiotics in surgical practice. AB - The new third generation cephalosporins have a significantly greater spectrum of action against gram-negative bacteria likely to be encountered in surgical infections. This expanded spectrum may permit these drugs to be used in place of combination therapy in patients with polymicrobial infections; however, current evidence does not indicate superior results with these agents over earlier generation choices for surgical prophylaxis. The toxicity profile of these drugs warrants close monitoring for serious complications. PMID- 3511764 TI - Alfred Kirstein. Pioneer of direct laryngoscopy. AB - Autoscopy is, therefore, a difficult morsel; until it is thoroughly absorbed into the life-blood of laryngology it will cause many a digestive disturbance. PMID- 3511765 TI - Stanley Rowbotham. Twentieth century pioneer anaesthetist. AB - Stanley Rowbotham was born in 1890 and spent the first years after qualification in 1915 with the Royal Army Medical Corps (RAMC). His career in anaesthesia began after the Armistice, when he was posted with Ivan Magill to Harold Gillies's plastic surgery unit at Sidcup. Together, they laid the foundations of tracheal anaesthesia. A versatile and inventive anaesthetist, Stanley Rowbotham later pioneered in the fields of thyroid anaesthesia, basal narcosis, local and intravenous analgesia and in the use of muscle relaxants. He also introduced cyclopropane into this country. PMID- 3511766 TI - Cryoanalgesia for pain after herniorrhaphy. AB - The effect of freezing the ilioinguinal nerve on postoperative pain relief was examined in a double blind study in 36 patients undergoing herniorrhaphy, randomly allocated into two groups. Patients in the experimental group had their ilioinguinal nerves frozen during surgery and were compared with the patients in the control group who did not have cryoanalgesia. Pain relief was assessed over a 48-hour period in three ways, namely the linear analogue pain scale, peak expiratory flow rates and the amount of analgesic drugs required by patients in the two groups. We conclude that cryoanalgesia of the ilioinguinal nerve alone does not produce significant early post herniorrhaphy pain relief. PMID- 3511767 TI - Epidural buprenorphine for postoperative analgesia. A controlled comparison with epidural morphine. AB - In a double-blind controlled study, epidural buprenorphine 0.3 mg was compared with 4 mg of epidural morphine for postoperative pain relief the first 24 hours after major orthopaedic surgery. The degree of analgesia was equal and satisfactory in both groups. Duration of action was 620 minutes with buprenorphine and 580 minutes with morphine, which was not significantly different. The only serious side effects were recorded in the morphine group, with two patients complaining of pruritus and five of urinary retention. In conclusion, epidural buprenorphine did not offer any advantages in preference to morphine for postoperative pain relief following orthopaedic surgery. PMID- 3511768 TI - Competitive heterogeneous enzyme immunoassay for digoxin with electrochemical detection. PMID- 3511769 TI - Proteolytic enzyme modified metal oxide electrodes as potentiometric sensors. PMID- 3511770 TI - High-frequency, small-volume ventilation during thoracic surgery. AB - Surgical conditions during conventional mechanical ventilation (CMV) and pulmonary gas exchange were compared with those during high-frequency ventilation (HFV) in 24 patients undergoing anesthesia for intrathoracic surgery. HFV at an oscillatory frequency of 3 Hz and a delivered gas volume of 1.3-1.9 ml/kg provided excellent surgical conditions for peripheral lung procedures. However, surgical conditions for procedures on the major airways or mediastinal structures were unsatisfactory during HFV. Adequate pulmonary gas exchange was achieved with HFV when the chest was open. Further evidence is presented for expiratory flow limitation during HFV. Expiratory flow limitation seems to occur particularly in patients with chronic obstructive airway disease, leading to increased lung volume. Currently, the authors do not recommend HFV for routine use during anesthesia for thoracic surgery. PMID- 3511771 TI - Bradycardia and hypotension associated with baclofen used during general anesthesia. PMID- 3511772 TI - Felodipine-induced dilatation of epicardial coronary arteries. A randomized, double-blind study. AB - Dilatation of large coronary arteries is of potential value in the treatment of angina pectoris. In this double-blind study, the acute effect of felodipine or placebo on coronary artery dilatation was studied in patients with severe angina pectoris with the aid of coronary arteriography. There were two parallel groups, one with 9 patients who received felodipine, the other with 12 patients who received placebo. Measurements of vessel diameters were performed at a proximal position of the affected artery, at the site of the stenosis, and distal to the lesion. The mean plasma felodipine concentration was 17+/-6 nmol/l. The systolic blood pressure was reduced from 156+/-15 to 145+/-13 mm Hg after felodipine (p less than 0.05), but was unaffected by placebo. The heart rate and arterial catecholamine levels were basically unchanged in both groups of patients. The proximal arterial segment was dilated 7% after felodipine (p = 0.05), the stenosis area 9% (N.S.) and the distal part of the vessel 7% (p less than 0.05). There were no changes in coronary diameters in the placebo group. In conclusion, felodipine dilates large coronary arteries, and this mode of action may be valuable in the treatment of patients with coronary artery disease, especially in cases where coronary spasm is a prominent feature. PMID- 3511773 TI - Evaluation of the effects of vasoactive drugs on cutaneous microcirculation by laser Doppler velocimetry. AB - The effects provoked in different points of skin circulation by a vasoactive drug injected in the femoral artery of patients affected by chronic obliterative arterial disease at clinical stage 2, were evaluated using the laser Doppler velocimeter. At the same time, by means of strain gauge plethysmography, measurements were taken of the relative variations of volume and amplitude of the pulse waves in the hallux and of blood flow in the calf. After administration of the drug, a number of phenomena were observed, the most notable of which was a rapid and intense shift of blood from skin to muscle, followed by an increase in the global perfusion of the limb. Considering the physio-pathological importance of regional blood redistribution between skin and muscle and the high frequency rate of skin lesions in vascular diseases of the limbs, the possibility of evaluating, with a practical, non-invasive technique, the effects of drugs at the skin level is of great interest. PMID- 3511774 TI - Effects of prostaglandins on the pulmonary vascular bed of newborn rats with chronic hypoxia. AB - We investigated the effects of prostaglandins (PG) E1, I2 and D2 on the pulmonary vascular bed of newborn rats subjected to chronic hypoxia. Forty seven newborn rats were exposed to chronic hypoxia (10% oxygen) for 23 days and divided into five groups which received PGE1 (N = 10), PGI2 (N = 9), PGD2 (N = 11), placebo (N = 9) or served as controls (N = 8). The PG's were administered by implanting slow release subcutaneous pellets delivering an average daily dose of 1 microgram. Thirteen newborn rats in room air received either placebo or served as controls. All rats were killed after 23 days and heart-lung preparations were perfusion fixed with glutaraldehyde. Appropriate blocks were processed for quantitative morphometry of the pulmonary parenchyma, arteries and arterioles. For analysis the pulmonary vessels were grouped by external diameter, i.e. 30-50 mu and 50-100 mu. External diameter/lumen diameter, an index of medial smooth muscle mass, was 1.39 +/- 0.02 in room air controls, this index of medial muscle mass was significantly increased (p less than 0.01) to 1.53 +/- 0.03 in hypoxic controls and the PGD2 and PGI2 groups. However, the PGE1 group did not have medial hypertrophy evidenced by a medial muscle mass index of 1.34 +/- 0.04, similar to room air controls. These findings suggest that PGE1 may prevent the development of medial hypertrophy that occurs in chronic hypoxia. PMID- 3511775 TI - Clinical and pharmacokinetic concerns of 24-hour dosing with theophylline. AB - Selection of the dosing interval for oral theophylline must consider the product's absorption rate, the patient's elimination rate, and the tolerated fluctuation in serum concentration. Attempts to produce formulations with ultra slow absorption for "once daily" marketing have thus far resulted in incomplete and erratic absorption. PMID- 3511776 TI - Duration of action of oral albuterol in an asthmatic population. AB - In a randomized, double-blind, two-way crossover study in four centers, 124 patients received single doses of 4 or 6 mg of albuterol and placebo on two separate visits. Pulmonary function tests were performed at intervals up to ten hours. Both dosages produced peak bronchodilation responses which occurred at two hours and significant activity was maintained for at least eight hours. Adverse experiences were typical of adrenergic agents. PMID- 3511777 TI - Use of A-mode ultrasound for diagnosis of sinus disease in young children. AB - A-mode ultrasound appears to objectively measure mucoperiosteal thickening and presence or absence of fluid with as much accuracy as Water's view radiographs. This technique affords the office practitioner a fast, reliable, and objective means of assessing sinus disease and plotting the course of its treatment without unnecessary ionizing radiation. PMID- 3511778 TI - Anaphylactoid and systemic reactions following saline enema administration. Six case reports. AB - This report describes six children with spina bifida who have experienced a total of 13 episodes of generalized hives, angioedema and in two cases, anaphylactoid reactions immediately following saline enema infusions. The enemas were administered using a kit comprised of a plastic bag, tubing, and rectal end piece. The reactions always occurred with the first use of new kits. A third child developed a systemic reaction with only the rectal end-piece in situ and without infusion of fluid. An in-hospital challenge using a new end-piece in one patient, who was clinically the most sensitive, produced an acute anaphylactoid reaction implicating the end-piece as the most likely source of the problem. The definitive mechanism(s) of the reactions and the agent(s) responsible for them presently remain unknown. PMID- 3511779 TI - Serum sickness. PMID- 3511780 TI - Bone marrow failure: immunologic implications and treatment modalities. PMID- 3511781 TI - A rapid method of theophylline assay in the physician's office. AB - A competitive fluorescent enzyme immunoassay for theophylline is described which employs a theophylline monoclonal antibody. Fifty-two samples were assayed by this method and by high pressure liquid chromatography. The coefficient of correlation contrasting the methods equaled 0.979. The coefficient of determination was 0.959. The standard error of the correlation coefficient was 1.392. The bias of the immunoassay method versus high pressure liquid chromatography was 0.8 with 95% confidence limits of 0.4 to 1.2. In the same 52 patients, the precision of 1.6 with 95% confidence limits of 1.3 to 1.9 was obtained. There are numerous advantages of this new method compared with high pressure liquid chromatography. For the practicing physician, the rapid immunoassay for theophylline described here is proper for office application. PMID- 3511782 TI - Postcountershock pulseless rhythms: response to CPR, artificial cardiac pacing, and adrenergic agonists. AB - Clinically, countershock of ventricular fibrillation (VF) may result in asystole or a pulseless rhythm in more than 50% of attempts. We conducted a study to assess the effects of immediate artificial pacing, CPR, and adrenergic drug therapy in the management of postcountershock pulseless rhythms. Thirty-four episodes of VF followed by countershock were studied in eight anesthetized dogs. Transducer-tipped catheters were positioned in the ascending aorta (Ao) and right atrium (RA). A bipolar pacing catheter was advanced to the apex of the right ventricle and a catheter for measurement of coronary sinus blood flow (CSQ) (continuous thermodilution technique) was positioned in the coronary sinus. VF was induced electrically and a countershock at 400 J was given two minutes later; CPR was not performed during VF episodes. Countershock was followed by asystole or a pulseless rhythm in all animals. Immediate endocardial pacing (0.1 to 5 mA) of bradyarrhythmias produced electrical capture but did not result in arterial pressure pulses in any animal. After pacing, CPR was performed for two minutes or until restoration of spontaneous circulation (ROSC). During CPR, the diastolic coronary perfusion gradient (Ao-RA) was 20 +/- 7 mm Hg (mean +/- SD) and CSQ was 14 +/- 7 mL/min/100 g (53% +/- 43% of control). ROSC followed CPR of less than two minutes duration in 24% of VF study episodes. If ROSC did not follow two minutes of CPR, 1 mg epinephrine, or 50 micrograms or 100 micrograms isoproterenol was given IV.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3511783 TI - Transcutaneous and transvenous cardiac pacing for early bradyasystolic cardiac arrest. AB - Emergency transcutaneous cardiac pacing was studied prospectively in 19 patients presenting to the emergency department with a bradyasystolic cardiopulmonary arrest of 20 minutes duration or less. Pacing was initiated when conventional advanced cardiac life support (including atropine administration) and a fluid challenge failed to restore a pulse. Seventeen patients also had placement of transvenous pacemaker electrodes for cardiac pacing. Transcutaneous cardiac pacing rapidly established a blood pressure in the two patients who for clinical reasons did not receive a transvenous pacemaker. Five patients were transcutaneously paced within five minutes of cardiac arrest (Group 1) and the remaining 14 were paced between five and 20 minutes following cardiac arrest (Group 2). Two of the Group 1 patients were admitted and subsequently recovered full neurological and prearrest cardiac function. Fewer Group 2 patients developed a blood pressure (P = .04), and there were no patients with full neurologic recovery in this group (P = .06). Similar results were found for transvenous cardiac pacing; there was a greater incidence of a palpable pulse and measurable blood pressure (P = .05 for both) in the Group 1 patients than in the Group 2 patients. No difference in clinical outcome was noted between the two pacing techniques. These results support the concept that cardiac pacing must be initiated early if the outcome of bradyasystolic cardiac arrest is to be altered. PMID- 3511784 TI - Rapid diagnosis of group A strep pharyngitis in the emergency department. AB - Two ten-minute rapid tests for diagnosing Group A streptococcal pharyngitis in 147 emergency department patients with a complaint of sore throat were evaluated using positive throat cultures as the marker for disease. Treatment was initiated solely on the basis of clinical judgment. Sensitivity and specificity were 78% and 93%, respectively, for the rapid test and 69% and 56%, respectively, for clinical judgment. The rapid test was significantly better than clinical judgment alone in determining the presence of disease (P less than .05). The predictive values of the positive and negative and were 78% and 93%, respectively, for the rapid test and 38% and 85%, respectively, for clinical judgment. In the ED setting in which adequate followup is difficult, the rapid test can identify more accurately than can clinical judgment alone those patients who need therapy. PMID- 3511785 TI - Diagnosis of complex acid-base disorders: physician performance versus the microcomputer. AB - Patients with acid-base disturbances that are often complex frequently present to the emergency department. The sometimes hectic nature of the ED can preclude the appropriate quantitative analysis required by these disorders, especially when mixed disturbances are present. A computer program using generally accepted acid base and electrolyte formulae was developed for use on the Apple II+ or IBM-PC microcomputer. Each of a series of 35 acid-base disturbances incorporating single, double, and triple disorders was correctly identified by the computer in less than 45 seconds. Problem sets based on the same 35 disturbances were presented to 21 physician-subjects at various levels of training from the emergency medicine, internal medicine, pediatrics, surgery, and family practice specialties. Although the physicians were given unlimited time and the necessary formulae to reach a diagnosis, they were requested to perform their analyses in the same fashion used in the ED. Although times varied widely, no physician spent more than five minutes on any problem. The physician correct response rates were 86%, 49%, and 17% for single, double, and triple disorders, respectively. The primary disorder correct response rate was 89% for double disorders and 94% for triple disorders. The primary and secondary disorder correct response rate was 58% for triple disorders. The data suggest that the microcomputer may be beneficial in the rapid assessment of complex disorders. PMID- 3511786 TI - High-yield radiographic considerations for cervical spine injuries. AB - A clinical and academic imperative has developed to define high-yield criteria for cervical radiography in the emergency department setting. Presented is a review of key literature, including discussions of epidemiologic and biomechanic considerations; previously derived criteria and their value; and the limitation of the radiograph as a diagnostic tool. We conclude that the identification of truly high-yield criteria will be defined in future prospective, multicenter studies. PMID- 3511787 TI - Chest radiography in the emergency department. AB - A review of the medical literature was carried out to determine guidelines for cost-effective and safe use of chest radiography in the emergency department. Screening radiographs are indicated in specific populations in the search for occult tuberculosis or carcinoma and in routine or preoperative cases. Radiography is clinically indicated in the asthmatic patient, the elderly patient, and the symptomatic patient, and its indications are modified by the patient's age and presenting signs and symptoms. Based on the information reviewed, rational guidelines for the use of chest radiography are presented. PMID- 3511788 TI - Indications for plain abdominal radiography in the emergency department. AB - Despite the proliferation of new imaging methods, plain abdominal radiographs remain the first films ordered in a significant number of emergency department patients. Several small studies suggest that abdominal films are ordered unnecessarily. Over-ordering takes two forms: inappropriate indications and poor choice of the number and/or types of views ordered. Criteria for obtaining plain abdominal radiographs are suggested based on the likelihood of radiographic findings and the probability of a change in management resulting from the findings. Benefit versus risk in fertile women is considered. Recommendations are made for the selection of views based on clinical suspicion and initial film review. There is a need for studies using larger sample sizes to confirm these conclusions. PMID- 3511789 TI - Indications for retrograde cystourethrography in trauma. AB - Injuries to the lower genitourinary tract may occur with penetrating or severe blunt lower abdominal trauma. Commonly associated findings are pelvic fractures and gross hematuria or a bloody urethral discharge. Retrograde cystourethrography should be performed in all cases of penetrating trauma when lower genitourinary tract injury is suspected. We recommend retrograde urethrography in male patients with a pelvic fracture or significant lower abdominal or perineal trauma without a fracture when associated with gross hematuria, a bloody urethral discharge, inability to void, swelling, ecchymosis or hematoma of the perineum or penis, or a "high-riding" or boggy prostate. Cystography should follow urethrography after a urethral injury has been excluded. PMID- 3511790 TI - Computed tomography of the abdomen. PMID- 3511791 TI - Emergency radionuclide scans. AB - Radionuclide diagnostic imaging is an important adjunct to the diagnosis and treatment of several conditions that present to the emergency department. The emergency physician should be able to properly apply these tests. A normal radionuclide perfusion lung scan can reliably rule out pulmonary embolism. The use of the radionuclide ventilation lung scan may help interpretation of a perfusion lung scan that is of intermediate probability for pulmonary embolism. A radionuclide venogram of the lower extremities is both sensitive and accurate for detecting the presence of deep venous thrombosis. A radionuclide testicular scan is invaluable in the workup of the acute scrotum, as long as the test is available in a timely manner and the diagnosis has not been established by another means. A multiple-gated acquisition cardiac scan can help make the diagnosis of cardiac contusion after other causes of cardiac instability have been corrected. The renal radionuclide scan is useful in the workup of obstructive uropathy, especially if intravenous pyelography is contraindicated. The hepatobiliary nuclear scan is able to help differentiate acute cholecystitis from other causes of right upper quadrant pain. Proper and timely use of these tests can prevent serious sequelae from a missed diagnosis, and in some cases eliminate the need for invasive tests, dangerous treatment, or even exploratory surgery when it is unwarranted. PMID- 3511792 TI - Abdominal ultrasound. AB - Abdominal ultrasound is an extremely useful diagnostic tool in the evaluation of the patient with abdominal symptoms. Its advantages include its being noninvasive, portable, and not requiring the use of radiographic contrast material. Sonography has great utility in the diagnosis of abdominal aortic aneurysm. For purposes of diagnosing ectopic pregnancy, ultrasound is best used in conjunction with beta-HCG radioimmunoassay. With respect to the patient with right upper quadrant abdominal pain, ultrasonic scanning has become the method of choice for visualizing the gallbladder and identifying cholelithiasis. The choice of ultrasound for demonstrating urinary obstruction due to ureterolithiasis is somewhat more controversial. Its use should particularly be considered in patients to whom the administration of radiographic contrast material is inadvisable. PMID- 3511793 TI - Use of blood cultures in the emergency department. AB - While the use of blood cultures to detect septicemia is a time-honored and valuable laboratory technique, guidelines for obtaining such cultures are vague. Several controversies exist regarding the utilization of blood cultures in the ambulatory setting, including when and on whom cultures should be obtained, how many cultures should be obtained, and how much blood should be obtained with each venipuncture. The guidelines have become slightly more confusing with the recognition of an entity known as occult bacteremia. A number of studies that bear relevance to these issues are reviewed. The utility of obtaining blood cultures in the ambulatory setting is examined, and guidelines are offered for obtaining blood cultures in adult and pediatric populations. Areas in which further research may be appropriate also are noted. PMID- 3511794 TI - Cerebrospinal fluid cultures and analysis. AB - Prompt and accurate diagnosis of acute central nervous system infections is of vital importance to the emergency physician. With the advent of modern antimicrobial therapy, the nearly uniformly fatal outcome of untreated bacterial meningitis can be reduced substantially. Proper test selection is crucial in arriving at a correct and timely diagnosis. A variety of tests are currently available for evaluation of the patient with an acute central nervous system infection. We review the current state of the art in central nervous system testing. Cost considerations and an algorithm for efficient selection of appropriate tests are presented. PMID- 3511795 TI - Pathogen identification of abscesses and cellulitis. AB - The goal of culturing abscesses and/or cellulitis is to identify the offending pathogen in order to understand and treat the infection. Abscesses respond to incision and drainage. Antibiotics are not indicated in the patient with normal host defense, and thus in these patients cultures and Gram stains are not indicated. In immunocompromised patients, in patients with abscesses of the central face, and in those with abscesses that contain gas or involve muscle or fascia, Gram stain, culture, and antibiotics are necessary. The Gram stain is a reliable indicator of sterile abscesses, abscesses in pure culture (especially Staphylococcus aureus), and those in mixed anaerobic culture. Location and odor of abscesses are clues to offending bacteria. Cultures of tissue or blood in patients with cellulitis usually are positive in less than 40% of cases, regardless of the technique used. Hemophilus influenzae cellulitis in pediatric patients is an exception; blood cultures are positive in more than two-thirds of cases. Although not specific, certain types of cellulitis show different clinical characteristics. Treatment with elevation, warm soaks, and antibiotics is still the mainstay of therapy. Gram stain and culture are limited to those patients who do not respond to initial therapy or who are immunocompromised. PMID- 3511796 TI - Urethral and endocervical culturing: gonorrhea and chlamydia. PMID- 3511797 TI - Stool examination: culture versus Gram stain. AB - Presented is a methodology for efficient, cost-effective collection, transport, culture, and microscopic examination of infectious diarrhea. A critical review of the literature is included, as are guidelines for workup and management of the disease complex in the emergency department. PMID- 3511798 TI - Serum alcohol levels, toxicology screens, and use of the breath alcohol analyzer. AB - The emergency physician sees a large number of patients with problems related to the ingestion of alcohol, drugs, and toxins, and must be prepared to deal with them in an efficient and cost-effective manner. This article discusses a rationale for ordering serum alcohol levels and toxicology screens, as well as use of the breath alcohol analyzer. A serum alcohol level should be reserved for patients in whom the alcohol level is necessary to confirm a diagnosis or to guide treatment. An alcohol level is indicated when alcohol use is combined with a significant alteration in mental status, multiple drug overdose, head injury, coma, major trauma, seizures, or psychosis. The breath alcohol analyzer is useful when rapid determination of alcohol levels is desired, particularly with coma or coexisting head trauma. A low or negative level in this case rapidly alerts the physician to the presence of another condition that may require additional testing. Toxicology screening should be performed when suspected drug or toxin ingestion is combined with coma, convulsions, head injury with altered mental status, unstable vital signs, alterations in acid-base or electrolyte status, or psychosis. The screen also may be used to determine the need for a specific antidote or means of increasing excretion of a toxin, or to determine the presence of a drug that should be quantified to guide management. Open communication with the laboratory and the use of rapid screening tests markedly increase the benefit of toxicology screening. PMID- 3511799 TI - Use of cardiac enzymes in the evaluation of acute chest pain. AB - Diagnosis of acute myocardial infarction (AMI) rests upon detailed clinical evaluation of the patient, careful examination of the ECG, and utilization of cardiac enzymes only in those patients admitted to rule out this diagnosis. Any tendency by physicians to diminish emphasis on either of these first two diagnostic criteria, or to inappropriately utilize cardiac enzymes as a screening device, contributes to costly and inefficient errors in diagnosis and disposition of patients with chest pain. Utilization of recently developed mathematical models may prove effective in enhancing clinical judgment and presenting such errors. PMID- 3511800 TI - Electrolytes, BUN, creatinine: who's at risk? AB - Electrolytes, BUN, and creatinine are some of the most frequently ordered laboratory tests. The use of these tests in emergency practice has not been studied critically, and few investigations of their use in other disciplines have been performed. A review of the available literature and an analysis of medical problem solving, costs, and complications is presented. Indications based on physiological principles, clinical experience, and limited studies are suggested and areas of future research are outlined. PMID- 3511801 TI - CBC or not CBC? That is the question. AB - The complete blood count (CBC) is the laboratory test most frequently ordered by emergency physicians. This is often not cost effective because of the relative inaccuracy of the white blood cell (WBC) and differential cell counts. The WBC and differential counts do not reliably distinguish between bacterial and viral infections because they lack specificity in many patients, nor do they reliably correlate with the severity of disease because they lack sensitivity in some patients. This article briefly summarizes the laboratory, physiologic, and pathophysiologic causes of variations in the WBC and differential counts; reviews some of the literature on pediatric patients with fever and appendicitis and on adult patients with appendicitis and abdominal pain; and presents suggestions for future research into the reliability and cost effectiveness of the CBC. PMID- 3511802 TI - Glucose analysis: indications for ordering and alternatives to the laboratory. AB - Cost considerations mandate that the emergency physician consider the use of test strips for glucose analysis. Presented are medical criteria for glucose analysis, a description of available test strips and reflectance meters, and data from studies which compare performance and cost of the strips with laboratory methods. Emergency physicians should study the test strips and their indications more comprehensively. In general, glucose test strips provide a clinically acceptable means for blood glucose determinations. PMID- 3511803 TI - Diagnosis of bovine respiratory syncytial virus infections improved by virus detection in lung lavage samples. AB - The potential of lung lavage to diagnose and study infections with bovine respiratory syncytial virus (BRSV) was investigated. The technique was simple to perform under field conditions, and even in calves with respiratory tract disease, serious drawbacks were not observed. In 9 epizootics of respiratory tract disease, BRSV infection was diagnosed in 1 or more calves. The BRSV was detected from a total of 21 of 32 calves by immunofluorescence in cells recovered from lavage fluids, and the virus was recovered by cell culture from 17 of these. In the 4 remaining calves, infectious bovine rhinotracheitis virus or parainfluenza type 3 virus was isolated. In calves with high levels of maternally derived antibodies, direct demonstration of the virus was found to be essential for making a diagnosis of BRSV. In 3 of the 9 epizootics, the majority of 4- to 8 month-old calves had a significant increase in antibody concentration against BRSV, whereas only a few 1- to 2-month-old calves present during the other 6 epizootics did so. However, at least in 4 of the 6 herds with younger calves, direct detection of the virus in 2 or more calves indicated that BRSV was involved in the epizootic. Cytologic examination of wash fluids from BRSV infected animals identified an increased neutrophil/large mononuclear cell ratio. Occasionally, bronchiolar casts and syncytial giant cells with inclusion bodies were seen. In lung lavage fluids of 4 experimentally infected specific-pathogen free calves, BRSV-containing cells were detected by immunofluorescence for 12 to 18 days after inoculation. PMID- 3511804 TI - Studies on the pathogenesis of Salmonella typhimurium and Salmonella choleraesuis var kunzendorf infection in weanling pigs. AB - Twenty-six 4-week-old pigs were randomly allotted to 4 groups: group 1--orally inoculated with Salmonella typhimurium; group 2--orally dosed with S choleraesuis; and groups 3 and 4, with surgically constructed intestinal loops- loops inoculated with either S typhimurium or S choleraesuis. One pig each from groups 1 and 2 was killed at 8, 12, 24, 48, 72, 96, and 120 hours after inoculation. One pig each from groups 3 and 4 was killed at 2, 4, 6, 8, 12, and 24 hours after intestinal loop inoculation. Inoculation of S typhimurium resulted in acute enterocolitis of variable severity, whereas inoculation of S choleraesuis resulted initially in septicemia followed by formation of large necrotic and ulcerative lesions in the colonic mucosa. The most consistent systemic lesion of S choleraesuis infection was interstitial pneumonia and multifocal hepatic necrosis. Salmonella typhimurium and S choleraesuis were ultrastructurally within enterocytes of ligated ileal loops. Intracellular bacteria were morphologically intact, occurred free in the cytoplasm and membrane bound, and caused no detectable cytotoxic effect to the cell. Both S typhimurium and S choleraesuis penetrated the intestinal mucosa and were isolated from mesenteric lymph nodes at 2 hours after inoculation. PMID- 3511805 TI - Deep cuts expected from Gramm-Rudman act. PMID- 3511806 TI - Prostaglandin D2 potentiates airway responsiveness to histamine and methacholine. AB - In the bronchi of asthmatic subjects many bronchoconstrictor mediators and neurotransmitters might be released together, and therefore, potential interactions might occur that could be important in airway hyperreactivity. We have studied the effect of inhaled methacholine, bradykinin, and prostaglandin D2 (PGD2) on bronchial reactivity to inhaled histamine in 6 mild asthmatic subjects, 22 to 36 yr of age. All of the test spasmogens were given at equivalent bronchoconstricting concentrations. Simultaneous dosing with PGD2 caused a significant increase in reactivity to histamine, mean dose of histamine causing a 35% fall in specific airway conductance being 0.72 mumol before, and 0.32 mumol with, PGD2; (p less than 0.01). This was not seen with histamine itself, methacholine, or bradykinin. Prostaglandin D2 caused a similar increase in bronchial reactivity to inhaled methacholine, suggesting a postreceptor potentiation of airway smooth muscle contractility. This positive interaction between inflammatory mediators known to be released in asthma has important implications for understanding bronchial hyperreactivity. PMID- 3511807 TI - Occurrence of the adult respiratory distress syndrome in neutropenic patients. AB - Neutrophils are believed to play an essential role in the pathogenesis of the adult respiratory distress syndrome (ARDS). This concept is largely based on the observation that neutrophil depletion protects against altered pulmonary vascular permeability in several models of acute lung injury produced in laboratory animals. Four patients who developed ARDS during periods of profound neutropenia are presented. These patients met commonly accepted clinical and roentgenographic criteria for the syndrome, and each had the characteristic findings of diffuse alveolar damage by lung histologic examination. The failure of this degree of neutropenia to protect against ARDS in humans raises questions about whether neutrophils or neutrophil products are essential in the pathogenesis of the syndrome. PMID- 3511808 TI - Drug-induced pulmonary disease. Part 1: Cytotoxic drugs. AB - Numerous pharmacologic agents used in the treatment of cancer have been linked to pulmonary toxic side effects. Mechanisms of damage by these drugs include direct pulmonary toxicity and indirect effects through enhancement of inflammatory reactions. Risk factors for development of pulmonary damage have been elucidated for some agents but they remain unclear for others. Clinical features are similar for most categories of cytotoxic agents, and the most common associated clinical syndrome is chronic pneumonitis/fibrosis. Treatment and outcome vary with each particular agent. In Part 1 of this review, clinical aspects and pathogenic mechanisms of cytotoxic drug-induced pulmonary disease are discussed. PMID- 3511809 TI - The current management of choledochal cyst. AB - The diagnosis and treatment of choledochal cysts have changed dramatically in the past decade. Although history and physical exam remain paramount in arousing clinical suspicions, the classic triad of abdominal pain, jaundice, and a palpable mass is present infrequently. Ultrasonography can readily identify and precisely locate upper abdominal masses and distinguish between intrahepatic, extrahepatic, renal, and gastrointestinal cystic and solid masses. Use of the new iminodiacetic acid tracers then allows visualization of these cysts even in the presence of significant jaundice or abnormal liver function tests. For many years choledochal cystenterostomy was considered the treatment of choice because of the high morbidity and mortality originally associated with attempts at total excision. Over the years, evaluation of cystenterostomy has revealed an unacceptable rate of recurrent jaundice, ascending cholangitis, stone formation, and anastamotic stricture. In addition, a disturbing incidence of highly malignant biliary duct carcinoma that increases with the passage of time has been reported. Total excision of choledochal cysts has been reported in the English and Japanese literature with minimal morbidity and mortality and has become the treatment of choice. The authors' recent experience of two patients with this relatively rare condition confirms these changing trends and will be reported here. PMID- 3511810 TI - Marrow transplantation for the treatment of chronic myelogenous leukemia. AB - One hundred ninety-eight patients with chronic myelogenous leukemia received marrow transplants after intensive chemotherapy and total body irradiation. Multivariate analysis showed disease status at time of transplantation to be the most powerful predictor of survival. The probability of long-term survival for allogeneic graft recipients was 49% for 67 patients in the first chronic phase, 58% for 12 in the second chronic phase, 15% for 46 in the accelerated phase, and 14% for 42 in the blastic phase. The major cause of death was interstitial pneumonia for patients in the chronic phase, and relapse for those in the blastic or accelerated phases. Factors favoring survival were early transplantation, age less than 30 years, and absence of severe graft-versus-host disease. Splenectomy or spleen size did not influence survival. For recipients of syngeneic grafts survival probability was 87% for 16 patients in the chronic phase, 27% for 7 in the accelerated phase, and 12% for 8 in the blastic phase. Of the 198 patients, 71 are alive without Philadelphia chromosomes 1 to 9 years after receiving their graft. All but 4 long-term disease-free survivors have Karnofsky performance scores of 80% or better. PMID- 3511811 TI - High-dose cyclophosphamide, carmustine, and etoposide and autologous bone marrow transplantation for relapsed Hodgkin's disease. AB - Thirty patients with relapsed Hodgkin's disease were treated with high-dose cyclophosphamide, carmustine, and etoposide (CBV) and autologous bone marrow transplantation. The median age of the patients was 28 years, and 18 were male. More than half had extranodal sites of relapse and constitutional symptoms. Most had been heavily pretreated with multiple salvage chemotherapy regimens and radiotherapy. At the time of transplantation, 23 patients were having progressive disease despite salvage chemotherapy. High-dose CBV chemotherapy induced complete responses in 15 patients and partial responses in 10 patients. Eleven patients are still in complete remission, 1 of whom has had an unmaintained remission for more than 44 months. Toxicity was moderate; all patients had severe myelosuppression requiring supportive therapy, and 1 patient failed to reconstitute her bone marrow. High-dose CBV chemotherapy and autologous bone marrow rescue proved to be effective as salvage therapy for a select group of heavily pretreated patients with relapsed Hodgkin's disease. PMID- 3511812 TI - Interstitial pneumonitis after bone marrow transplantation. Assessment of risk factors. AB - Data from 932 patients with leukemia who received bone marrow transplants were analyzed to determine factors associated with an increased risk of developing interstitial pneumonitis. Interstitial pneumonitis developed in 268 patients for a 2-year actuarial incidence of 35 +/- 4% (SD) and with a mortality rate of 24%. Six factors were associated with an increased risk: use of methotrexate rather than cyclosporine after transplantation (relative risk, 2.3; p less than 0.0002); older age (relative risk, 2.1; p less than 0.0001); presence of severe graft versus-host disease (relative risk, 1.9; p less than 0.003); long interval from diagnosis to transplantation (relative risk, 1.6; p less than 0.002); performance ratings before transplantation of less than 100% (relative risk, 2.1; p less than 0.0001); and high dose-rates of irradiation in patients given methotrexate after transplantation (relative risk, 3.2; p less than 0.03). The risk of developing interstitial pneumonitis ranged from 8% in patients with none of these adverse risk factors to 94% in patients with all six. These findings may help to identify patients at high risk for this complication. PMID- 3511813 TI - Urinalysis and urine culture in women with dysuria. AB - In caring for women with acute dysuria, clinicians traditionally have relied on clinical findings to distinguish between acute pyelonephritis and "cystitis"; they have ordered urinalysis and urine culture regularly for patients with suspected acute pyelonephritis and ordered these tests inconsistently for patients with suspected "cystitis." Recent evidence indicates that "cystitis" may actually be any of six different clinical conditions, each of which is managed differently; subclinical pyelonephritis, lower urinary tract bacterial infection, chlamydial urethritis, other forms of urethritis, vaginitis, or dysuria without any urinary tract or vaginal infection. The distinction between these entities is made primarily from clinical findings. Urinalysis is also of great value in symptomatic patients; the presence of pyuria (and possibly indirect quantitation of pyuria by the leukocyte esterase test) is a reliable indicator of treatable infection, and its absence indicates infection is not present. In contrast, urine culture is of clear value only in patients with acute pyelonephritis or subclinical pyelonephritis. PMID- 3511814 TI - The various presentations of thyroiditis. Diagnostic considerations. AB - The syndromes of thyroiditis include five disorders. Hashimoto's thyroiditis, the commonest, is an autoimmune disease whose principal manifestations are goiter and hypothyroidism. Subacute granulomatous thyroiditis is probably viral in origin and usually presents with a tender goiter. Subacute lymphocytic thyroiditis is of unknown pathogenesis, but the postpartum form may be autoimmune. Its principal manifestations are goiter and spontaneously reversible hyperthyroidism. Acute suppurative thyroiditis results from bacterial or fungal infection causing abscess. Riedel's struma, a disease of unknown cause, presents with a goiter and thoracic inlet obstruction. Thyroiditis may require differentiation from other diseases. The goiter may resemble that of Graves' disease or thyroid lymphoma. Thyroid nodules may resemble neoplasms. Hyperthyroidism may suggest Graves' disease or other hyperthyroid syndromes with low radioactive iodine uptake. Neck pain can also occur with some thyroid malignancies. Local abscess is usually infectious but may be undifferentiated thyroid carcinoma. Finally, hypothyroidism may be transient or permanent. PMID- 3511815 TI - Guidelines on authorship of medical papers. PMID- 3511816 TI - Online systems for searching MEDLINE. PMID- 3511817 TI - Captopril and impaired renal function. PMID- 3511818 TI - Idiopathic hypovolemia. AB - Eleven patients with orthostatic intolerance had, for no detectable reason, a marked reduction in blood volume (73 +/- 2.29% [SE] of normal). Head-up tilt caused a pronounced increase in heart rate (+ 39 +/- 6 beats/min); one patient had a vasovagal episode after the initial tachycardia. Extensive diagnostic study excluded pheochromocytoma, hypoaldosteronism, or any obvious cause for hypovolemia (total plasma catecholamines, 372 +/- 53 ng/L; plasma aldosterone level, 14.5 +/- 2.56 ng/100 mL; plasma cortisol level, 18.5 +/- 2.4 ng/100 mL). The supine hemodynamic pattern (decreased cardiac output and increased total peripheral resistance with normal ejection fraction and mean transit time) was markedly different from that of hyperbeta adrenergic states. Acute plasma volume expansion (+ 11 +/- 2%) in ten patients using human serum albumin improved both their symptoms and heart rate response to tilt. After long-term blood volume expansion with florinef (E.R. Squibb, Princeton, New Jersey), 0.1 mg twice a day, and a high-salt diet, the head-up tilt test was repeated in five patients. The response was normal in four patients. These observations outline a syndrome of marked idiopathic hypovolemia with symptomatic labile hypertension and intolerance to head-up tilt, alleviated by volume expansion. PMID- 3511819 TI - Rapid lysis of coronary artery thrombi with anisoylated plasminogen: streptokinase activator complex. Treatment by bolus intravenous injection. AB - The ability of anisoylated plasminogen: streptokinase activator complex (APSAC) to induce coronary artery reperfusion after bolus intravenous injection (2 to 4 minutes) was assessed in 29 patients with acute transmural myocardial infarction and complete coronary artery occlusion. A 5-mg dose resulted in reperfusion in 3 of 14 patients (21%); a 5-mg plus 10-mg regimen was successful in 3 of 7 (43%); and a 30-mg dose induced reperfusion in 9 of 15 (60%). Rethrombosis occurred in only 1 of 15 patients (7%) who received 30 mg, as determined by repeat angiography at 24 hours. The mean interval after injection until reperfusion was 35 minutes with the 30-mg dose, and bleeding occurred at the femoral artery catheterization site in only 3 of 15 patients (20%). Intracoronary streptokinase therapy achieved reperfusion in only 2 of the 6 patients in whom the 30-mg dose failed, indicating that this dose of APSAC was sufficient by itself in 9 of 11 (83%) successfully treated patients. Because therapy can be completed within 2 to 4 minutes, APSAC appears to be a most suitable fibrinolytic agent for early treatment of the coronary artery thrombosis associated with acute transmural myocardial infarction. PMID- 3511820 TI - Antiguanosine antibodies: a new marker for procainamide-induced systemic lupus erythematosus. AB - Antinuclear antibodies are present in most patients receiving procainamide. To ascertain whether IgG antiguanosine antibodies are associated with the development of the symptoms of systemic lupus erythematosus, we compared the levels of these antibodies in the sera of 65 patients receiving procainamide: 18 with procainamide-induced symptoms and 47 asymptomatic patients. Antinuclear antibodies measured by immunofluorescence were present in the 18 patients with drug-induced symptoms but also in 24 asymptomatic patients. Similarly, elevated serum levels of antibodies to single-stranded DNA were found in 15 patients with symptoms and in 20 asymptomatic patients. In contrast, levels of IgG antiguanosine antibodies were elevated in 15 patients with drug-induced symptoms, but in only 3 asymptomatic patients. Antiguanosine antibodies binding to single stranded DNA were found primarily in patients with arthritis, pleuritis, and pericarditis. These results suggest a strong association between IgG antiguanosine antibodies and major manifestations of procainamide-induced systemic lupus erythematosus. PMID- 3511821 TI - Excess prevalence of Pneumocystis carinii pneumonia in patients treated for lymphoma with combination chemotherapy. AB - A significantly greater prevalence of interstitial pulmonary infiltrates and Pneumocystis carinii pneumonitis occurred on one arm of a randomized study comparing ProMACE-CytaBOM (prednisone, methotrexate with leucovorin, doxorubicin, cyclophosphamide, etoposide; cytarabine, bleomycin, vincristine, methotrexate with leucovorin) to ProMACE-MOPP (ProMACE, mechlorethamine, vincristine, prednisone, procarbazine) chemotherapy in patients with lymphoma. Of the 37 patients receiving ProMACE-CytaBOM, 13 (35.1%) developed an interstitial pulmonary infiltrate compared with 3 of 32 (9.4%) patients receiving ProMACE-MOPP (p2 = 0.02). Of the 13 patients receiving ProMACE-CytaBOM who had infiltrates, open lung biopsy in 7 showed P. carinii; 5 others had clinically suspected P. carinii pneumonia, and 1 had blastomycosis. No patient receiving ProMACE-MOPP had documented or suspected P. carinii pneumonia. Of patients with infiltrates, 3 of 13 on ProMACE-CytaBOM but 0 of 3 on ProMACE-MOPP died. Two other patients on ProMACE-CytaBOM who had P. carinii pneumonia died. Groups did not differ in predisposing risk factors or patient history. The exact cause for the increased prevalence of P. carinii infection in patients receiving ProMACE-CytaBOM was not ascertained. These data emphasize that new drug regimens may lead to unanticipated complications. PMID- 3511822 TI - Syphilis tests in diagnostic and therapeutic decision making. AB - Predictive value calculations were used to derive diagnostic guidelines for syphilis. Specificity of the VDRL (Venereal Disease Research Laboratory) and treponemal tests is high in healthy persons but less in elderly and ill persons. Sensitivity of the VDRL test is high in secondary and early latent syphilis but reduced in primary and late syphilis or in cerebrospinal fluid evaluations. Primary syphilis should be diagnosed by darkfield microscopy, with VDRL confirmation for atypical lesions. Screening of asymptomatic persons with the VDRL test, followed by treponemal test confirmation on positive sera, is recommended for all pregnant women, contacts of persons with infectious syphilis, and other high-risk groups. Quantitative VDRL assessment at 3, 6, and 12 months after treatment should be used to assess the adequacy of treatment for both late latent and early syphilis. Cerebrospinal fluid VDRL assessment and cell count should be restricted to seropositive persons with a high risk of neurosyphilis. PMID- 3511823 TI - Liver transplantation today. AB - Orthotopic liver transplantation is a therapeutic option for patients with end stage liver disease in whom conventional forms of medical therapy have failed. Since the first successful liver transplantation in 1967, more than 1000 have been done in North America and Europe. Improvements in patient selection, operative technique, and immunosuppression--most importantly, the introduction of cyclosporine--have resulted in an overall 1-year survival rate of 68%. Immediate postoperative problems are ischemic graft injury, acute rejection reactions, and technical problems with biliary and vascular anastomoses. Later complications include sepsis from bacterial, fungal, or viral pathogens due to immunosuppression. Late morbidity and mortality occur primarily because of chronic rejection or recurrence of primary liver disease. Despite the problems, liver transplantation is an exciting, nonexperimental therapy for patients with end-stage liver disease and offers hope to many patients for whom no treatment was previously available. PMID- 3511824 TI - Aspirin and the stomach. AB - Aspirin often causes acute gastric mucosal damage that can be seen endoscopically or assessed indirectly (for example, by measuring increased gastrointestinal blood loss). The occurrence of most adverse effects is apparently related to the dose administered. This dose-response effect, evident in both endoscopic and microbleeding studies done after acute or short-term aspirin administration, is also associated with the risk of developing chronic gastric ulcer. The occurrence of gastric adaptation, or lessening injury with continued treatment, obscures the interpretation of results from studies of acute administration. Moreover, evidence of dose-response effects has frequently been ignored when lists of complications and side effects are compiled. The absence of symptoms does not correlate with acute or chronic mucosal damage and appears to have no predictive value. Endoscopic studies linking the extent and degree of acute mucosal injury to various nonsteroidal anti-inflammatory drugs have little or no value in predicting the frequency or severity of chronic gastric ulcer or gastrointestinal bleeding. PMID- 3511825 TI - Acetaminophen hepatotoxicity in alcoholics. A therapeutic misadventure. AB - We have treated 6 chronic alcoholics and identified an additional 19 reported in the literature who developed severe hepatotoxicity from acetaminophen taken in apparently moderate doses. The clinical disease in these 25 patients had a characteristic pattern: mild to moderate jaundice; mild to severe coagulopathy; and strikingly abnormal aminotransferase levels, values inconsistent with either acute alcoholic hepatitis or viral hepatitis. The possible causes for the injury from ostensibly nontoxic drug levels appear to be either the induction by chronic alcohol intake of the cytochrome P-450 system responsible for converting acetaminophen to a toxic metabolite, or the effect of alcoholism and the associated malnutrition in reducing the glutathione concentration, responsible normally for preventing hepatotoxicity by conjugation with the toxic metabolite. The research data pertaining to the apparent enhanced toxicity from chronic alcoholism are reviewed. Despite the low frequency of ethanol-potentiated acetaminophen hepatotoxicity, alcoholics should be cautioned about the use of acetaminophen while they persist in heavy consumption of alcohol. PMID- 3511826 TI - Homeless persons and health care. AB - Health care is generally unavailable for the homeless. This heterogeneous group of men and women, including long-term street dwellers, residents of shelters, the chronically mentally ill, the economically debased, and alienated youth, are subject to a broad range of acute and chronic diseases, intensified by unsuitable living conditions, stress, and sociopathic behavior. Trauma, pulmonary tuberculosis, infestations, and peripheral vascular disease are common problems among the homeless; incomplete and fragmentary medical care permits exacerbation of chronic disorders. Outreach programs imaginatively constructed by teams of physicians, nurses, and social workers can effectively reestablish and maintain health services for these disenfranchised persons. PMID- 3511827 TI - Prophylaxis for infective endocarditis: an update. AB - The American Heart Association has updated its recommendations for prevention of bacterial endocarditis. The major changes are less emphasis on administration of parenteral agents and a reduction of the period of prophylaxis. The simplified new recommendations should make compliance easier and should be assiduously implemented by dental and medical practitioners. However, several changes are suggested for possible consideration: Because of the relatively low risk, prophylaxis may not be needed for persons with mitral valve prolapse (unless there is a holosystolic murmur) or for most gastrointestinal endoscopic procedures. Consideration should be given to using a single oral 3-g dose of amoxicillin for dental procedures in all patients at risk and for genitourinary and gastrointestinal tract procedures in patients at risk who have natural cardiac valves. Vancomycin should probably be the agent of choice for prophylaxis in cardiac valve surgery. PMID- 3511828 TI - Socialist health care in Tanzania: a view from Kilimanjaro Christian Medical Centre. PMID- 3511829 TI - Choosing the appropriate habilitative track for the newly identified hearing impaired child. AB - Based on prospective longitudinal data collected on 38 hearing-impaired infants, this study addresses the question, "What constitutes adequate progress in habilitation of the young deaf child?" The components of the newly developed Diagnostic Early Intervention Program aimed at selecting the most appropriate habilitative-educational track for the hearing-impaired infant will be described, together with data from the first 15 children who have completed the 6-month program. The results of a multidisciplinary medical evaluation completed on these children, including audiology, otolaryngology, aural rehabilitation, pediatrics, neurology, radiology, and genetics, will illustrate the important assistance these findings provide to the decision-making process of the habilitative educational team. PMID- 3511830 TI - Is it acute cholecystitis? AB - In a prospective study of 100 patients presenting with acute right hypochondrial pain and diagnosed clinically by a qualified surgeon as having acute cholecystitis, we have shown that the diagnostic error can be considerable. Twenty-five of these patients were found to have a different diagnosis on subsequent investigation and in a further 11 patients, no definite diagnosis could be established. This emphasises the need for careful investigation of patients with this presenting complaint. PMID- 3511831 TI - The accuracy of ultrasound in the diagnosis of breast disease. AB - The accuracy of breast ultrasound using all purpose static beta-scanning equipment has been compared with mammography. Ultrasound was found to be both more sensitive (93%:82%) and specific (95%:89%) in a large retrospective series of 1000 patients undergoing investigation for symptomatic breast disease. In a smaller prospective and consecutive series of 142 patients undergoing surgery where histological proof was obtained ultrasound was also found to be more sensitive (91%:81%) and specific (81%:69%). In both studies, the greater accuracy of ultrasound was attributed to its ability to diagnose lesions hidden in X-ray dense breasts and where mammography had revealed featureless asymmetical densities of uncertain nature. In these instances ultrasound may have a significant role to play as an adjunct to mammography in the preoperative assessment of breast lesions. PMID- 3511832 TI - Robert John McNeill Love 1891-1974. PMID- 3511833 TI - Alginate dressing as a donor site haemostat. AB - An alginate fibre dressing has been used to reduce blood loss from skin graft donor sites. Significant haemostasis has been achieved in the immediate post surgery phase and no adverse reactions observed. PMID- 3511834 TI - The history and evolution of surgical instruments. V needles and their penetrating derivatives. PMID- 3511835 TI - Assessment of the distal lower limb arteries: a comparison of arteriography and Doppler ultrasound. AB - Simple Doppler was compared with routine arteriography in assessing patency of the arteries at the ankle and the pedal arch. Fifty-six limbs were evaluated--29 with rest pain or trophic lesions, 20 with claudication, and 7 without symptoms. On Doppler examination 177 of 220 (80%) vessels were assessed patent, compared with 127 of 220 (58%) on arteriography. Of the 49 judged occluded on arteriograms, 59% were patent by Doppler and of 44 in which arteriograms were inadequate 82% had Doppler signals. Doppler signals could be heard in 20 of 177 (11%) vessels only with the feet dependant. This prospective, double-blind study provides numerical data to support the observation that a simple Doppler probe can detect patent distal vessels which may not be demonstrated by routine arteriography. This allows selection of patients for further more detailed arteriograms or for operative exploration with a view to distal bypass grafting. PMID- 3511836 TI - Hamilton Bailey 1894-1961. PMID- 3511838 TI - Precautions in handling tissues, fluids, and other contaminated materials from patients with documented or suspected Creutzfeldt-Jakob disease. Committee on Health Care Issues, American Neurological Association. PMID- 3511837 TI - Reference intervals for toxic metals: problems and prospects. Abraham J. Gitlitz memorial lecture. AB - The problems of assigning reference values in laboratory medicine are particularly thorny in relation to metal concentrations in body fluids and tissues. Exposures to toxic metals are extremely variable, and a proper reference population and sampling strategy may be difficult to define. More importantly, current environmental exposures, especially to lead, methylmercury, and cadmium, may be associated with adverse effects. The question therefore arises of how to define and estimate an upper limit which provides a margin of safety. In addition, the relevance of a lower limit of the reference interval for non essential metals may be questioned. Further, the levels of several toxic metals occurring in body fluids and tissues frequently appear to be considerably increased owing to anthropogenic exposures. Thus, reference intervals for "natural" metal concentrations would be of interest as a reflection of the levels to which Homo sapiens originally adapted. Limited information in this area is available. In addition, interpretation is sometimes hampered by possible laboratory contamination of samples and insufficient validity of metal determinations at low concentration levels. Major progress has been made during recent years, but the scientific basis for evaluating individual results of metal determinations in body fluids and tissues is still unsatisfactory. PMID- 3511839 TI - [Comparative study of the chemotherapeutic effectiveness of mecillinam, ampicillin and their combination in coli bacillary pyelonephritis in rats]. AB - The chemotherapeutic effect of mecillinam and ampicillin was studied comparatively on rats with hematogenic obturation colibacillary pyelonephritis. The antibiotics were administered intragastrically in a dose of 100 mg/kg for 7 days. The treatment was started 24 hours after infection. When the drugs were used in combination their doses were twice as lower. When used alone mecillinam and ampicillin had a significant effect which was practically the same. A marked increase in the therapeutic effect was observed with the use of the antibiotics in combination: sterilization of the tissues of the affected kidney and prevention of development of macroscopic lesions in it in all the animals. PMID- 3511840 TI - [Pharmacokinetics of antibiotics as a basis for their dosage in children]. PMID- 3511841 TI - The 18O isotope effect in 13C nuclear magnetic resonance spectroscopy: mechanistic studies on asparaginase from Escherichia coli. AB - The mechanism of the enzyme asparaginase (L-asparagine amidohydrolase, EC 3.5.1.1) from Escherichia coli was examined using 13C NMR spectroscopy. The pH dependent oxygen exchange reactions between water and aspartic acid were followed by use of the 18O isotope-induced shift of the resonance positions of directly bonded 13C nuclei. Both L-1- and L-1,4-[13C]aspartic acid were used in experiments with previously 18O-labeled aspartic acid, or in experiments involving the use of 18O-labeled solvent water. Asparaginase catalyzes a relatively efficient exchange between the oxygens of water and those on one carboxyl group of aspartic acid. Exchange at C-4 occurs rapidly but, within experimental error, no exchange at C-1 could be detected. These and related experiments involving the position of 18O incorporation during hydrolysis of aspartic acid beta-methyl ester are all consistent with possible acyl-enzyme mechanisms involving C-4, but do not support a free aspartic acid anhydride mechanism. PMID- 3511842 TI - Role of plasma and serum proteases in the degradation of elastin. AB - Accelerated proteolysis of tropoelastin and elastin occurs in the major arteries of chicks fed copper-deficient diets. Signs of elastin degradation are not obvious in normal arteries of copper-supplemented chicks. It is proposed that the sources of proteases that effect elastin degradation are from plasma and serum. Both calcium-dependent proteases and kallikrein were effective in degrading tropoelastin and partially crosslinked insoluble elastin into peptides similar to those detected in aortic extracts from copper-deficient chicks. As dietary copper deficiency progresses it is also possible to detect elastin peptides in plasma. PMID- 3511843 TI - Spatial relationship between the intrinsic metal in the beta subunit and cysteine 132 in the sigma subunit of Escherichia coli RNA polymerase: a resonance energy transfer study. AB - Fluorescence excited-state energy transfer measurements were carried out between the N-(1-pyrene)maleimide (PM)-labeled sigma subunit and Co in the beta subunit of Co-Zn RNA polymerase (RPase). sigma subunit with or without PM labeling was cleaved with 2-nitro-5-thiocyanobenzoic acid, and the reaction products were analyzed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. One molecule of the fluorescent probe (PM) was found to be attached to the cysteine 132 residue of the sigma subunit. When excited at 340 nm, the fluorescence emission bands from 380 to 420 nm of PM-labeled sigma overlap with the charge transfer absorption band of Co-Zn RPase around 400 nm. Based on Forster's equation, the R0 values for the donor-acceptor pair were calculated to be 21.5 and 22 A in the absence and presence of template analog (dA-dT)60, respectively. Using these R0 values and the observed energy transfer efficiencies, the distance between the cysteine-132 of the sigma subunit and Co located at the initiation site of the beta subunit was calculated to be 22 A with or without the template present, indicating that no major conformational change of the enzyme was induced upon template binding. However, a small but significant change in the above distance was observed upon the addition of ATP to RPase in the presence (dA-dT)60 but not in the absence of (dA-dT)60 template. The biological implications of these observations are discussed. PMID- 3511844 TI - Carbonyl reductase of dog liver: purification, properties, and kinetic mechanism. AB - A carbonyl reductase has been extracted into 0.5 M KCl from dog liver and purified to apparent homogeneity by a three-step procedure consisting of chromatography on CM-Sephadex, Matrex green A, and Sephadex G-100 in high-ionic strength buffers. The enzyme is a dimer composed of two identical subunits of molecular weight 27,000. The pH optimum is 5.5 and the isoelectric point of the enzyme is 9.3. The enzyme reduces aromatic ketones and aldehydes; the aromatic ketones with adjacent medium alkyl chains are the best substrates. Quinones, ketosteroids, prostaglandins, and aliphatic carbonyl compounds are poor or inactive substrates for the enzyme. As a cofactor the enzyme utilizes NADPH, the pro-S hydrogen atom of which is transferred to the substrate. Two moles of NADPH bind to one mole of the enzyme molecule, causing a blue shift and enhancement of the cofactor fluorescence. The reductase reaction is reversible and the equilibrium constant determined at pH 7.0 is 12.8. Steady-state kinetic measurements in both directions suggest that the reaction proceeds through a di iso ordered bi-bi mechanism. PMID- 3511845 TI - Enzymatic bases for the fatty acid positioning in phospholipids of Brevibacterium ammoniagenes. AB - Positional distribution of fatty acids in phospholipids from Brevibacterium ammoniagenes was analyzed to find that phosphatidylethanolamine consisted mainly of 1-saturated acyl 2-unsaturated acyl species while phosphatidylglycerol consisted mainly of 1-unsaturated acyl 2-saturated acyl species. Three acyltransferase systems were characterized in a membrane preparation--the acylations of glycerophosphate, 1-acyl-glycerophosphate, and 2-acyl glycerophosphate--which appeared to be catalyzed by different enzymes. The distribution of fatty acids in the phosphatidylethanolamine molecule was not correlated simply with the specificities of these enzymes, but the relatively high specificity for palmitoyl-CoA of the glycerophosphate acyltransferase system to form 2-acyl-glycerophosphate, followed the relatively high specificity for oleoyl-CoA of the 2-acyl-glycerophosphate acyltransferase system, provided a basis for producing the major molecular species of phosphatidylglycerol. PMID- 3511846 TI - Deoxyribonucleotide biosynthesis in yeast: assay and properties of ribonucleotide reductase in permeabilized Saccharomyces cerevisiae cells. AB - Yeast cells permeabilized by freeze-thaw cycles in a sorbitol-containing medium provide an experimentally favorable system for the study of ribonucleotide reduction in a small number of cells or in mutant strains. Ribonucleotide reductase activities determined in such cells are about twice those found in cell extracts but properties of the enzyme, except pH optimum, are closely comparable in both assay procedures. In contrast with other organisms, the activities measured in permeabilized cells from both diploid or haploid strains exceed the demand for deoxyribonucleotide formation during replication of the yeast genome. The method has been applied to yeast cultures growing in the presence of the ribonucleotide reductase inhibitor hydroxyurea and a twofold increase of enzyme activity has been established in such cells. On the other hand, analysis of a series of hus mutants, selected for hydroxyurea sensitivity in the laboratory of Singer and Johnston did not reveal obvious alterations of the enzyme vs the parental strains, suggesting that the hus phenotype may be due to lesions other than in ribonucleotide reductase. PMID- 3511847 TI - Enzyme-substrate interactions in the hydrolysis of peptide substrates by thermitase, subtilisin BPN', and proteinase K. AB - Peptide substrates of the general structure acetyl-Alan (n = 2-5), acetyl-Pro-Ala Pro-Phe-Alan-NH2 (n = 0-3), and acetyl-Pro-Ala-Pro-Phe-AA-NH2 (AA = various amino acids) were synthesized and used to investigate the enzyme-substrate interactions of the microbial serine proteases thermitase, subtilisin BPN', and proteinase K on the C-terminal side of the scissile bond. The elongation of the substrate peptide chain up to the second amino acid on the C-terminal side (P'2) enhances the hydrolysis rate of thermitase and subtilisin BPN', whereas for proteinase K an additional interaction with the third amino acid (P'3) is possible. The enzyme subsite S'1 specificity of the proteases investigated is very similar. With respect to kcat/Km values small amino acid residues such as Ala and Gly are favored in this position. Bulky residues such as Phe and Leu were hydrolyzed to a lower extent. Proline in P'1 abolishes the hydrolysis of the substrates. Enzyme substrate interactions on the C-terminal side of the scissile bond appear to affect kcat more than Km for all three enzymes. PMID- 3511848 TI - Differential sensitivities of the subunits of mammalian ribonucleotide reductase to proteases, sulfhydryl reagents, and heat. AB - Ribonucleotide reductase catalyzes the rate-limiting step in the formation of 2' deoxyribonucleoside 5'-triphosphates. It consists of two nonidentical protein subunits, the nonheme iron subunit, and the effector-binding subunit. It has previously been shown that these two components making up the active enzyme species are not coordinately synthesized or degraded. It was found that the effector-binding subunit was more sensitive to proteolysis by chymotrypsin, to heating at 55 degrees C, and to the sulfhydryl reagents, pCMB and NEM. The nonheme iron subunit was more sensitive to trypsin treatment. ATP and dATP protected the effector-binding subunit from proteolytic inactivation. Neither ATP nor CDP protected the effector-binding subunit from inactivation by the sulfhydryl reagents. These data indicate that the protein properties of the two subunits of mammalian ribonucleotide reductase are significantly different. PMID- 3511849 TI - Precocious induction of hepatic glucokinase and malic enzyme in artificially reared rat pups fed a high-carbohydrate diet. AB - Glucokinase and NADP:malate dehydrogenase (malic enzyme) first appear in liver when rat pups are weaned from milk which is high in fat to lab chow which is high in carbohydrate. To examine the influence of diet during the early neonatal period, before developmental changes in the circulating concentrations of thyroid and adrenocortical hormones occur, high-carbohydrate formula (56% of calories from carbohydrate), isocaloric and isonitrogenous with rat milk, was intermittently infused via gastrostomy starting on the second day of life. Pups had no further access to their dams. Body weights attained by these pups were at least 90% of those attained by mother-fed pups, which served as controls. In artificially reared rats fed the high-carbohydrate formula, on Day 4, glucokinase and malic enzyme were 30 and 18% of adult activity, respectively; on Day 10, glucokinase and malic enzyme were 71 and 96% of adult activity, respectively. On Days 4 and 10 glucose-6-phosphate dehydrogenase was elevated four- to fivefold in pups fed the high-carbohydrate formula compared to mother-fed pups. A second isocaloric formula, with 22% of calories from carbohydrate but low in protein, resulted in intermediate levels of all three enzymes on Day 10. Pups fed the high carbohydrate formula has plasma insulin concentrations four- to fivefold greater than mother-fed pups on both Days 4 and 10. Triiodothyronine administration (1 microgram/g body wt) on Day 1 enhanced the induction of malic enzyme but not glucokinase on Day 4 in pups fed the high-carbohydrate formula. The results demonstrate that neonatal rat liver is competent to respond to high carbohydrate intake by induction of glucokinase and malic enzyme. PMID- 3511850 TI - Expression of hydrogenase activity in barley (Hordeum vulgare L.) after anaerobic stress. AB - Germinated seeds of barley, after anaerobic treatment, produce considerable amounts of hydrogen. The anaerobic stress induces hydrogenase activity, as measured by the ability to evolve hydrogen from reduced methyl viologen. Several pieces of evidence, including bacteriological controls and induction in axenic calluses, indicate that the hydrogenase activity is induced by the plant itself and not by contaminant microorganisms. The hydrogenase is selectively induced in roots and to a lower extent in hypocotyls, but no hydrogenase activity can be detected in leaves. PMID- 3511851 TI - An insulin-stimulated (ribosomal S6) protein kinase from soluble extracts of H4 hepatoma cells. AB - Insulin stimulates the phosphorylation of the 40 S ribosomal subunit protein, S6, in intact 32P-labeled H4IIE-C3 cells, a rat hepatoma line. Cell-free cytosolic extracts from H4 cells exhibit a 5- to 10-fold increase in S6 protein kinase activity (measured by transfer of 32P to exogenous 40 S rat liver ribosomal subunits) when prepared from cells exposed to insulin prior to homogenization. Stimulation of S6 phosphorylation in intact cells and activation of S6 protein kinase in cell-free extracts are both detectable within 2 min after insulin, and are maximally stimulated by 10 min. Half-maximal stimulation is observed at 10( 11) M insulin. The stimulated S6 kinase activity requires ethylene glycol bis(beta-aminoethyl ether)-N,N,N',N'-tetraacetic acid to be present during the kinase assay for full expression. Despite the presence of a 5- to 10-fold increase in S6 protein kinase activity, the extracts from insulin-treated cells exhibit no stimulated kinase activity toward casein, histone, or ATP-citrate lyase assayed under the conditions employed for S6. Thus, insulin mediates the rapid activation of protein kinase specific for ribosomal protein S6 by an as yet unidentified mechanism. PMID- 3511852 TI - The self-association of insulin: determinations based on a differential gel adsorption procedure. AB - Self-association properties of zinc-insulin were investigated using a differential gel adsorption procedure based on the microcentrifuge desalting method of E. Helmerhorst and G. B. Stokes (1980, Anal. Biochem. 104, 130-135). This differential gel adsorption procedure offered a quick semiquantitative method for examining insulin association under a wide range of different conditions using simple equipment. Nonspecific adsorption effects with the gel matrix at low insulin concentrations were minimized by the presence of 0.1% bovine serum albumin. This procedure was based on the observation that the monomer species of insulin was separated from insulin aggregates due to its interaction with the devoided gel matrix of Sephadex G-25 and remained on the column following centrifugation. A residue with an apparent pK of 11.1 +/- 0.1 was shown to be critically responsible for the adsorption of monomer insulin to the gel matrix, thus implicating the tyrosyl residue(s) of insulin in this interaction. The proportion of monomer was simply computed from the recovery of insulin off the gel using [125I] monoiodoinsulin to monitor recovery. Insulin association was studied over the range of insulin concentrations from physiologically circulating levels (nM) to storage concentrations (mM). Our data are in agreement with monomer being the predominant form of the hormone in vivo. Our estimates for the Gibbs free energy change, enthalpy, and entropy for the formation of dimers and the effects of pH, ionic strength, and temperature on the equilibrium constant for the formation of dimers were in good agreement with the literature. This differential gel adsorption procedure may have application to other protein-associating systems with suitable adsorption characteristics. PMID- 3511853 TI - Hepatic subcellular distribution of short-chain beta-ketoacyl coenzyme A reductase and trans-2-enoyl coenzyme A hydratase: 25- to 50-fold stimulation of microsomal activities by the peroxisome proliferator, di-(2-ethylhexyl)phthalate. AB - The present study demonstrates unequivocally the existence of short-chain trans-2 enoyl coenzyme A (CoA) hydratase and beta-ketoacyl CoA reductase activities in the endoplasmic reticulum of rat liver. Subcellular fractionation indicated that all four fractions, namely, mitochondrial, peroxisomal, microsomal, and cytosolic contained significant hydratase activity when crotonyl CoA was employed as the substrate. In the untreated rat, based on marker enzymes and heat treatment, the hydratase activity, expressed as mumol/min/g liver, wet weight, in each fraction was: mitochondria, 684; peroxisomes, 108; microsomes, 36; and cytosol, 60. Following di-(2-ethylhexyl)phthalate (DEHP) treatment (2% (v/w) for 8 days), there was only a 20% increase in mitochondrial activity; in contrast, peroxisomal hydratase activity was stimulated 33-fold, while microsomal and cytosolic activities were enhanced 58- and 14-fold respectively. A portion of the cytosolic hydratase activity can be attributed to the component of the fatty acid synthase complex. Although more than 70% of the total hydratase activity was associated with the mitochondrial fraction in the untreated rat, DEHP treatment markedly altered this pattern; only 11% of the total hydratase activity was present in the mitochondrial fraction, while 49 and 29% resided in the peroxisomal and microsomal fractions, respectively. In addition, all four subcellular fractions contained the short-chain NADH-specific beta-ketoacyl CoA (acetoacetyl CoA) reductase activity. Again, in the untreated animal, reductase activity was predominant in the mitochondrial fraction; following DEHP treatment, there was marked stimulation in the peroxisomal, microsomal, and cytosolic fractions, while the activity in the mitochondrial fraction increased by only 39%. Hence, it can be concluded that both reductase and hydratase activities exist in the endoplasmic reticulum in addition to mitochondria, peroxisomes, and soluble cytoplasm. PMID- 3511854 TI - Partial reassembly of yeast 60 S ribosomal subunits in vitro following controlled dissociation under nondenaturing conditions. AB - Previously it has been shown that 12 of the yeast ribosomal proteins were extractable from 60 S subunits under a specific nondenaturing condition [J. C. Lee, R. Anderson, Y. C. Yeh, and P. Horowitz (1985) Arch. Biochem. Biophys. 237, 292-299]. In the present paper, we showed that these proteins could be reassembled with the corresponding protein-deficient core particles to form biologically active ribosomal subunits. Effects of time, temperature, and varying concentrations of monovalent cations, divalent cations, cores, and ribosomal proteins on reconstitution were examined. Reconstitution was determined by binding of radiolabeled proteins to the nonradiolabeled cores as well as activity for polypeptide synthesis in a cell-free protein-synthesizing system. The optimal conditions for reconstitution were established. Whereas the core particles were about 10-20% as active as native 60 S subunits in an in vitro yeast cell-free protein-synthesizing system, the reconstituted particles were 80% as active. The activity of the reconstituted particles was proportional to the amount of extracted proteins added to the reconstitution mixture. About 55 +/- 7% of the core particles recombined with the extracted proteins to form reconstituted particles. These reconstituted particles cosedimented with native 60 S subunits in glycerol gradients and contained all of the 12 extractable proteins. PMID- 3511855 TI - Sore throat, a first symptom in laryngeal cicatricial pemphigoid. PMID- 3511856 TI - Immunofluorescent studies of gastrointestinal tract mucosa in bullous pemphigoid. PMID- 3511857 TI - Bacterial adherence, colonization, and pathogenicity. PMID- 3511858 TI - Mechanism-oriented assessment of isotretinoin in chronic or subacute cutaneous lupus erythematosus. AB - Eight of ten patients with chronic or subacute cutaneous lupus erythematosus completed 16 weeks of oral isotretinoin therapy (80 mg/day). All eight patients noted an excellent clinical response without significant side effects. (Two patients did not return to initial two-week follow-up.) Peripheral blood B- and T cell counts were unaffected by therapy. Therapy was associated with resolution of routine histopathologic abnormalities, conversion of abnormal lesional direct immunofluorescence microscopy to normal, normalization of the epidermis on electron microscopy, and reduction of all T cells near the dermoepidermal junction without change in ratio of T-helper/inducer cells to T suppressor/cytotoxic cells. Isotretinoin is a clinically effective short-term therapy for chronic or possibly for subacute cutaneous lupus erythematosus. The primary mechanism of action remains unestablished. PMID- 3511859 TI - Port-wine stains. A disease of altered neural modulation of blood vessels? AB - Port-wine stains result from a progressive ectasia of the cutaneous superficial vascular plexus. One hypothesis for the pathogenesis of this lesion is an abnormal neural regulation of blood flow. Biopsy specimens of 11 port-wine stains, seven hemangiomas, and 17 benign lesions were stained for S100 protein using immunoperoxidase techniques. All specimens were of facial biopsies or excisions and were evaluated for vessels per square millimeter, nerves per square millimeter, vessel-to-nerve ratio, and frequency of vessels coursing within 0.03 mm of nerves. These variables were evaluated in the superficial 0.8 mm of dermis, a zone that includes almost all abnormal port-wine-stain vessels. Controls showed 18.3 +/- 2.8 vessels/sq mm (+/- SD), 21.1 +/- 9.2 nerves/sq mm, 0.9 +/- 0.3 vessels to nerves, and 75% +/- 11% of vessels coursing within 0.03 mm of nerves, values that did not alter with age. Port-wine stains had a significant decrease in nerve density and increase in vessel-to-nerve ratio when compared with normal skin; only 17% +/- 3% of vessels were associated with nerves in port-wine stains. These findings document a deficit in the number of perivascular nerves in port wine stains and raise the possibility that a lack of neural modulation of vascular flow may be involved in the pathogenesis of port-wine stains. PMID- 3511860 TI - Severe infantile epidermolysis bullosa simplex. Dowling-Meara type. AB - We encountered eight patients with epidermolysis bullosa (EB) simplex of the Dowling-Meara type, who presented in infancy with severe blistering and were originally clinically thought to have recessive dystrophic EB. One infant died in the neonatal period, and the others have had reduced blistering with advancing age. However, in two of the three older patients, the development of severe disabling hyperkeratosis of the palms and soles has been a prominent feature. The correct diagnosis of EB simplex was initially not made in five patients, because, on routine histologic examination, the blister was apparently subepidermal. Electron microscopy confirmed the correct diagnosis of EB simplex by demonstration of basal cell cytolysis. There was clumping of tonofilaments in seven patients. Immunofluorescence demonstrated a cleft above the basal layer in three cases. The findings of severe extensive blistering at birth that improves with age, milia formation, acral distribution with herpetiform groups of blisters in older children, intraoral lesions, absence of scarring, and intraepidermal clefting due to basal cell cytolysis and clumping of tonofilaments within these basal cells as seen on electron microscopic examination present a subtype of EB simplex similar to that described by Dowling and Meara. This has been recognized in the European but not in the American literature and is probably more frequent than has been previously reported. PMID- 3511861 TI - Azathioprine in giant cell arteritis/polymyalgia rheumatica: a double-blind study. AB - The ability of azathioprine to reduce the maintenance prednisolone requirement of 31 patients with polymyalgia rheumatica (PMR) or giant cell arteritis (GCA), or both, was tested in a double-blind placebo controlled study over one year. Clinical and laboratory assessments were made at four-weekly intervals over a period of 52 weeks. A statistically significant difference (p less than 0.05) in mean prednisolone dose was noted between the two groups at the end of 52 weeks, there being a fall in steroid requirement in the azathioprine treated group. PMID- 3511862 TI - Corticosteroids in rheumatoid arthritis: is a trial of their 'disease modifying' potential feasible? PMID- 3511863 TI - Growth of human B cell colonies from peripheral blood of patients with systemic lupus erythematosus. AB - Human B cell colonies were grown from peripheral blood of 12 patients with systemic lupus erythematosus (SLE) and from 12 healthy control subjects. The SLE group showed a large increase (p less than 0.001) in the number of colony forming cells (CFC) present in peripheral blood as compared with controls. The CFC were of the pre-B cell type. There was also a loss of OKT8+ cell inhibition of B cell colony growth in the SLE group compared with control subjects. PMID- 3511864 TI - The prognostic value of the modifications of the Dukes' C class of colorectal cancer. An analysis of the NSABP clinical trials. AB - This study was carried out in an effort to resolve the dilemma created by three proposed modifications of the Dukes' C class of colorectal cancer. Each modification is based on a separate prognostic discriminant characterized by: the level of histologically positive nodes, the depth of tumor penetration, and the number of histologically positive nodes. Data were derived from 844 patients with Dukes' C lesions randomized into two prospective clinical trials of the NSABP; the mean time on study was 41 months. Analysis of the three modifications as independent variables without regard for possible confounding effects disclosed that each had a highly significant predictive capacity. When each discriminant was examined, this time adjusting for the contribution of the other two discriminants, the effect attributable to the level of positive nodes was markedly attenuated. Thus, the level of positive nodes provided little information over and above that of depth of tumor penetration and the number of positive nodes. Of the two latter discriminants, although both were significant predictors of survival, the number of positive nodes appeared to be the strongest factor. Using both depth of penetration and the number of positive nodes, a unique Dukes' C subset of patients could be identified with a prognosis at least as good as Dukes' B lesions; this group was characterized by partial tumor penetration and the presence of 1-4 positive nodes. It is concluded that both depth of penetration and the number of positive nodes represent appropriate modifications of the initial Dukes scheme, and one discriminant should not be used to the exclusion of the other. The data raise serious doubts relative to the propriety of newly proposed TNM classification schemes that fail to utilize the number of positive nodes as a predictive discriminant. PMID- 3511865 TI - The reversal of an Adriamycin induced healing impairment with chemoattractants and growth factors. AB - Rats treated with 8 mg/kg Adriamycin intravenously 4 days prior to chamber implantation develop impaired wound healing in a wound chamber model. In this study, the effects on healing of supplemental platelet derived growth factor (PDGF), transforming growth factor-beta (TGF-beta), epidermal growth factor (EGF), and insulin were evaluated in chambers extracted from Adriamycin-treated rats 10 and 20 days after implantation. The effects of individual factors, combinations of factors, and different concentrations of TGF-beta were evaluated. The parameters evaluated included collagen content, protein content, cellular proliferation rate, chamber histology, and collagen types. Supplemental TGF-beta alone reversed much of the healing deficit noted. A minimum concentration of 100 ng/ml TGF-beta was required to significantly reverse this deficit. PDGF and EGF alone had no effect. Addition of PDGF and TGF-beta in combination stimulated a significantly higher level of collagen deposit than TGF-beta alone. Addition of EGF in combination with PDGF and TGF-beta restored collagen deposition to 86% of normal. No synergism was seen between TGF-beta and EGF unless PDGF was also present. These data suggest that growth factors contained in platelets may play key roles in initiating the wound healing response and may have clinical utility in healing deficit states. PMID- 3511866 TI - Intra-abdominal infections in pancreas transplant recipients. AB - During a 7-year period, 116 pancreas transplants were performed in 98 diabetic patients (49 with and 49 without previous kidney transplants) at the University of Minnesota. The posttransplant clinical course of 26 recipients (22%) was complicated by an intra-abdominal infection (8 with and 18 without previous kidney transplants). Infections occurred in 19/57 cases (33%) in which exocrine secretions were managed by enteric drainage, in 5/15 cases (33%) managed by free drainage into the peritoneal cavity, in 1/39 cases (3%) in which the duct was injected with a synthetic polymer, and in 1/2 cases (50%) in which a pancreaticocystostomy was performed. The organisms Escherichia coli, enterococci, bacteroides, and several anaerobes were cultured from the patients with enteric drainage, while staphylococci were associated with the open duct drainage. Fungal infections with Candida were found with all techniques. Surgical and percutaneous drainage was performed in all patients. In 14 patients, functioning and, in four patients, nonfunctioning grafts were removed. In five patients, the infection resolved while the grafts were functioning, and these patients are currently alive and well. Seven of the 26 patients with infections died (27% mortality rate), five after graft removal and two with the graft still in place (1 with and 1 without function), five in the open-duct, and one each in the enteric and urinary drainage categories. In the 90 cases without intra-abdominal infection, only six patients died (4 cardiovascular, 1 anaphylaxis, 1 cytomegalovirus infection), for a mortality rate of 7%. PMID- 3511867 TI - Preoperative staging with computerized axial tomography and biochemical laboratory tests in patients with hepatic metastases. AB - Preoperative biochemical liver function tests and computerized axial tomographic (CAT) scans were performed on 100 patients as part of a prospective randomized study of treatments for liver metastases from colorectal cancer. The CAT scans reliably reflected the presence of disease in most patients but only accurately demonstrated the number and location of metastases in 43% of the patients. Extrahepatic metastases were present in 35 patients but were only seen on the CAT scans in three of these patients. The biochemical tests, which were useful for detecting hepatic metastases, were alkaline phosphatase (AP), lactic dehydrogenase (LDH), and carcinoembryonic antigen (CEA). When hepatic disease was minimal, these tests were less likely to be elevated than when there was extensive disease. Even with the combination of late generation CAT scans and biochemical tests, the accurate quantification and location of hepatic metastases and extrahepatic disease require a surgical assessment. PMID- 3511868 TI - Endomyocardial biopsy in the cardiac allograft recipient. A review of 570 biopsies. AB - The morphologic abnormalities present in 570 endomyocardial biopsies from 39 cardiac allograft recipients and 16 autopsy hearts are described, and criteria pertinent to the diagnosis of rejection discussed. Entirely normal myocardium was apparent in 16% of the biopsies. Abnormalities related to biopsy of previous biopsy site occurred in 69%, and mononuclear infiltrates of varying intensity were present in 64% of the biopsies. Acute rejection was diagnosed in 17 (43.6%) patients in 32 (5.6%) of the biopsies and five hearts at autopsy. Seven of the biopsies with acute rejection were follow-up biopsies after a previous diagnosis of acute rejection and represented ongoing acute rejection. Similarly, three patients with rejection at autopsy died with ongoing rejection. The overall frequency of acute rejection was thus 0.70 episodes per patient. The most reliable histologic feature in the diagnosis of acute rejection in cyclosporine immunosuppressed recipients was a diffuse mononuclear infiltrate, apparent at low magnification. Myocyte necrosis, said to be critical in the diagnosis of rejection in cyclosporine-treated patients, was not a reliable indicator in the authors' experience. PMID- 3511869 TI - Mortally ill patients and excellent survival following cardiac transplantation. AB - Cardiac transplantation was resumed in 1980 at the University Health Center of Pittsburgh. Generally accepted criteria for selection of patients were used, one being the expectation that survival would not reach 6 months. All of the initial recipients were in New York Heart Association Functional Class IV, but many were ambulant. We soon saw patients who were more clearly terminally ill. They were characterized by a systolic arterial pressure of less than 80 mm Hg, a cardiac index of less than 2 L/min/m2, evidence of reduced blood flow as indicated by urine output of less than 20 ml per hour, impaired mental function, and signs of decreased peripheral perfusion. The initial success of cardiac transplantation in these patients prompted us to reconsider selection criteria to include them among less strikingly ill candidates and to develop a therapeutic protocol designed to maintain peripheral perfusion and adequate renal and hepatic function until transplantation could be accomplished. Actuarial survival at 30 months for the group of terminally ill patients was 75% compared with 67% for the less critically ill group. Actuarial survival at 30 months for the combined group of 77 patients was 67%. Twenty-nine of the 33 mortally ill patients were alive and active at the time of writing, January, 1985. PMID- 3511870 TI - Combined tracheal transection and innominate artery disruption from blunt chest trauma. AB - Both transection of the trachea and injury of the aorta and its arch vessels can occur after blunt chest trauma; however, the combination of these injuries in 1 patient is exceedingly rare. This report of a patient with distal trachea transection and proximal innominate artery disruption from blunt chest trauma reviews some of the important factors to be considered in managing these injuries. Management of the airway must be planned before the operative procedure is begun and can be facilitated by the use of a sterile anesthesia circuit passed on to the operative field. Exposure of tracheal injuries as low as the carina can be achieved through sternotomy incision if this approach is indicated for repair of the associated vascular injury. The use of prosthetic materials should be avoided in vascular injury repair due to contamination of the field from the associated airway disruption. Attention to postoperative bronchial hygiene is mandatory for successful outcome after tracheal anastomosis. PMID- 3511871 TI - Mediastinal assessment for staging and treatment of carcinoma of the lung. AB - Invasive diagnostic procedures for mediastinal assessment, such as mediastinoscopy, are necessitated by the importance of staging lung cancers, both to plan the treatment and to estimate the prognosis. Other noninvasive techniques may complement or be substituted for mediastinoscopy under certain specific clinical settings. Thus with the introduction of newer diagnostic technologies, such as computed axial tomography, the strategy for mediastinal assessment should be continually reevaluated. In this review, the diagnostic sensitivity, specificity, and overall accuracy of various techniques reported in the literature are examined to elucidate their current roles in assessing the mediastinal involvement in patients with lung cancer. PMID- 3511872 TI - Clinical evaluation of determinants of glycemic control. A new approach using serum glucose, C-peptide, and body mass indexes in type II diabetic patients. AB - We evaluated the clinical characteristics and relationships between values of serum glucose, C-peptide, and body mass index (BMI) in 40 type II diabetic patients. Patients were divided into three groups according to the drug therapy: group A (n=16), oral sulfonylurea agent; group B (n=16), insulin alone; and group C (n=8), combined insulin and oral agent. The relationships between the various factors were expressed as ratios (C-peptide/BMI, glucose/BMI, and C peptide/glucose scores). Using glycosylated hemoglobin (HbA1) value of less than 10.5% to denote response to therapy, each group was subdivided into responders and nonresponders. Comparing the data in group A, mean (+/-SEM) fasting serum glucose levels were significantly lower in responders vs nonresponders. The mean HbA1 levels were 8.59+/-0.54% vs 1 2.34+/-0.34%, respectively. The C-peptide/BMI scores were 7.4+/-1.0 vs 8.14+/-1.2; C-peptide/glucose scores, 1.73+/-0.27 vs 0.81+/-0.12; and glucose/BMI scores, 493+/-54 vs 1,082+/-168, respectively. The responders and nonresponders in group B had values similar to those of group A. Group C patients had data A and B. The responders in each group were characterized by serum glucose levels less than 200 mg/dL, C-peptide/glucose score greater than 1, and glucose/BMI score less than 700. T he 200 mg/dL, C peptide/glucose score less than 1, and glucose/BMI score greater than 700. These simple calculated scores validate the importance of glucose/C-peptide/BMI interrelationships in ambulatory diabetic patients. PMID- 3511873 TI - Control of overt maternal diabetes during pregnancy in a county hospital. AB - Tight metabolic control of manifest diabetes during pregnancy was attempted in 51 clinic referrals to a county hospital. Starting before the 28th week of gestation, a good control of diabetes was achieved with the help of initial hospitalization, regular home blood glucose monitoring, and frequent clinic visits. Mean preprandial plasma glucose level was 96.4 +/- 22.6 mg/dL. A mean preprandial plasma glucose level of less than 110 mg/dL was achieved in 42 (82%) of the 51 patients. Total perinatal mortality was 7.7% (4/52). When we excluded major maternal morbidity unrelated to diabetes that accounted for fetal loss, the corrected perinatal loss was 3.8%. Significant maternal hypoglycemia was uncommon. Major congenital malformations in the fetus, neonatal hyperbilirubinemia, and neonatal hypoglycemia each occurred in fewer than 5%. These results suggest that good metabolic control of diabetes is achievable in patients in a general hospital and it may lower fetal loss and morbidity associated with overt maternal diabetes. PMID- 3511874 TI - Escherichia coli sepsis from contaminated platelet transfusion. AB - Transfusion of pooled platelet concentrate (PC) caused a septic reaction characterized by sustained hypotension, high cardiac output, and low systemic vascular resistance. Investigation demonstrated the same strain of Escherichia coli in the patient's blood, the transfused pooled PC, and recalled packed red blood cells separated from the same unit of whole blood as one of the platelet units in the contaminated pool. Five hundred other units of PC from the same supplier were cultured prospectively, and 7% were bacterially contaminated. The level of contamination was 20 or fewer colony-forming units per milliliter in all except one unit, the only one associated with a febrile transfusion reaction. This episode illustrates the continuing importance of sepsis as a cause of platelet transfusion reactions and demonstrates the usefulness of appropriate cultures and epidemiologic information in assessing the source. PMID- 3511875 TI - Clinical investigative neuro-oncology. PMID- 3511876 TI - Advances in the diagnosis and treatment of primary immunodeficiency diseases. PMID- 3511877 TI - Anorexia nervosa. Treatment efficacy of cyproheptadine and amitriptyline. AB - Patients with anorexia nervosa have concurrent problems of emaciation and depression. Therefore, treatment with medications affecting both weight gain and depression seemed reasonable. Seventy-two anorectic patients were randomly assigned in a double-blind study to receive cyproheptadine hydrochloride, a weight-inducing drug, amitriptyline hydrochloride, a tricyclic antidepressant, or placebo. Overall, cyproheptadine had a marginal effect on decreasing the number of days necessary to achieve a normal weight. There was a differential drug effect present in the bulimic subgroups of the anorectic patients: cyproheptadine significantly increased treatment efficiency for the nonbulimic patients and significantly impaired treatment efficiency for the bulimic patients when compared with the amitriptyline- and placebo-treated groups. The differential cyproheptadine effect on the anorectic bulimic subgroups is the first pharmacologic evidence of the validity of these subgroups. Cyproheptadine had an anti-depressant effect demonstrated by a significant decrease in the Hamilton depression ratings. PMID- 3511879 TI - Tardive dyskinesia and glucose metabolism. PMID- 3511878 TI - Treating bulimia with desipramine. A double-blind, placebo-controlled study. AB - A controlled study in patients with bulimia demonstrated a significant benefit from desipramine hydrochloride treatment (91% decrease in binge frequency) in contrast to the results from a placebo (19% increase in frequency). When patients originally taking the placebo crossed over to desipramine therapy, their frequency of binges decreased 84%, so that the overall improvement was 87% fewer binges. Global clinical status improved 3.5 scales, Zung depression scores improved 8.0 points, and a bulimia symptom scale improved 14.7 points. Fifteen (68%) of 22 patients attained complete abstinence from binge eating and purging. The presence or absence of previous episodes of anorexia nervosa did not influence the treatment response. One-month follow-up data indicated persistence of the benefit attained. PMID- 3511880 TI - Ectopic beta-human chorionic gonadotropin production by bladder urothelial neoplasia. AB - Endocrine manifestations are rarely observed in bladder urothelial neoplasia. To our knowledge, only 11 cases of choriocarcinoma have been reported in this site, and recently the production of beta-human chorionic gonadotropin has been demonstrated in these tumors by applying the immunoperoxidase technique. Of 104 transitional cell neoplasms of the bladder, we demonstrated by the indirect immunoperoxidase technique beta-human chorionic gonadotropin production in 12 neoplasms, 11 of which were grade 3 and 4 transitional cell carcinomas. PMID- 3511881 TI - Peanut lectin binding sites in human fetal colon. AB - We studied peanut lectin (PNA) binding sites in human fetal colons (9 to 19 weeks' gestational age). Peanut lectin has a specificity for beta-D-galactose(1- 3)N-acetyl-D-galactosamine (beta-D-Gal [1----3]-D-GalNac) that is the purported determinant for the T-blood-group antigen (TAg) and a precursor of MN-blood-group substance, lacking only in a terminal sialic acid. In the normal adult human colon, PNA fails to bind to the actual goblet theca but does have binding sites localized to the supranuclear portion of both columnar and goblet cells. This represents the detection of nascent oligosaccharides prior to addition of terminal sialic acid. Neuraminidase treatment of adult colons localized PNA to the goblet theca itself and to the apical and/or glycocalyx region of columnar cells. Fetal colons localized PNA to the region of the glycocalyx of columnar cells while the goblet theca itself failed to express PNA binding sites. After treatment of fetal colon sections with neuraminidase, PNA binding was noted in the goblet theca itself. Goblet cells of the human fetal colon exhibit a PNA binding pattern somewhat similar to adult goblets; however, fetal columnar cells have a PNA binding pattern as reported in colonic adenocarcinomas. This pattern of complete and incomplete synthesis of MN-blood-group substances in goblet and columnar cells, respectively, has also been demonstrated in adenomas of the human colon. PMID- 3511882 TI - Extramedullary plasmacytoma associated with angiofollicular lymph node hyperplasia. AB - We report a case of hyaline-vascular type of angiofollicular lymph node hyperplasia involving the left pulmonary lymph nodes and lung. It clinically presented as an obstruction of the left lower lobe main bronchus secondary to the development of an extramedullary plasmacytoma in the lesion. An immunoperoxidase stain revealed a monoclonal IgG-lambda pattern of the tumor, contrasting with the polyclonal plasma cell population of the angiofollicular lymph node hyperplasia. This case demonstrates the neoplastic potential of angiofollicular lymph node hyperplasia. PMID- 3511883 TI - Impact of organ transplant program on the Clinical Chemistry Laboratory at the University of Pittsburgh. AB - The success of cyclosporine in immunosuppressive therapy in organ transplantation suggests that such existing programs may expand in scope, and new programs may be initiated at institutions that currently do not have them. Significant clinical laboratory support and the allocation of laboratory resources are necessary to sustain an organ transplant program. At the University of Pittsburgh, the number of transplant-related clinical chemistry procedures (primarily cyclosporine and liver and renal function tests) increased from 1.4% of the total chemistry tests in 1979-1980 to 21% of the total in 1983-1984. There was a concomitant increase in cost for transplant chemistry tests as follows: $47,000 in the fiscal year 1979-1980 to $1,250,000 in the fiscal year 1983-1984. Measurement of blood cyclosporine levels alone can consume a large fraction of a total laboratory budget; from being a negligible expense at the end of March 1983, it escalated to almost $300,000 by October 1984. Our experience in this regard indicates that it is difficult to gauge the magnitude of necessary laboratory resource commitment to such a program a priori with any degree of certainty. In this context, the capacity to be flexible in assigning laboratory resources appears critical. PMID- 3511884 TI - Immunocytochemical markers of benignancy and malignancy. Do they exist? PMID- 3511885 TI - Transitional (cylindric) cell carcinoma with endodermal sinus tumor-like features of the nasopharynx and paranasal sinuses. Clinicopathologic and immunohistochemical study of two cases. AB - We report two cases of adult patients with primary tumors in the nasopharynx and paranasal sinuses, which were characterized histologically by areas of transitional cell (cylindric or "schneiderian") carcinoma and other foci virtually indistinguishable from endodermal sinus tumor (yolk sac carcinoma). Immunohistochemical studies supported the impression of yolk sac differentiation. Both patients were treated with irradiation and multidrug chemotherapy. One patient died of uncontrollable recurrence of tumor, whereas the other developed locally recurrent, transitional cell carcinoma in the absence of yolk sac tumor. The concurrence of these patterns of carcinoma, which has been undescribed previously to the best of our knowledge, seems to be associated with more aggressive biologic behavior than pure transitional cell carcinomas of this region. PMID- 3511886 TI - Antibiotics fail to prevent abscess formation secondary to bacteria trapped in fibrin clots. AB - We inoculated 120 rats with 2 X 10(9) Escherichia coli or 2 X 10(9) Bacteroides fragilis suspended in normal saline solution or incorporated into fibrin clots. In the control group, all animals died after inoculation with E coli, but none died after the inoculation with B fragilis; both were suspended in normal saline solution. Escherichia coli entrapped in fibrin did not cause mortality but did result in abscess formation in all animals. Bacteroides fragilis incorporated into fibrin clots resulted in abscess formation in the majority of animals. Treatment with gentamicin sulfate, ampicillin sulfate, and cefoxitin sodium completely abolished the mortality secondary to E coli suspended in normal saline solution but did not influence the rate of abscess formation secondary to E coli incorporated into fibrin clots. Similarly, cefoxitin and clindamycin phosphate did not significantly change abscess formation secondary to B fragilis incorporated into fibrin clots. We conclude that systemic antibiotics are ineffective in the prevention of abscesses secondary to bacteria trapped in fibrin, either because they do not reach bactericidal levels in the fibrin clot, as in the case of gentamicin, ampicillin, and clindamycin, or, as in the case of cefoxitin, because of the inoculum effect caused by the high number of bacteria. Fibrinogen or fibrin itself do not afford any protection of bacteria against the action of antibiotics. PMID- 3511887 TI - Both inflammatory and endocrine mediators stimulate host responses to sepsis. AB - Host responses to sepsis and trauma are complex and their mediators are not well understood. To examine the roles of "endocrine" and "inflammatory" mediators, we studied healthy volunteers in four experimental groups: continuous 72-hour infusion of normal saline; continuous 72-hour infusion of hydrocortisone, glucagon, and epinephrine; daily intramuscular injection of the inflammatory agent etiocholanolone; and combined etiocholanolone injection--hormone infusion. In this model hypermetabolism, hyperglycemia, hyper-insulinemia, insulin resistance, negative nitrogen balance, and accelerated protein flux were mediated predominantly by infusion of the counterregulatory hormones. Etiocholanolone injection resulted in fever, acute-phase--protein synthesis, and hypoferremia. Leukocyte, temperature, and C-reactive--protein responses reflected major interactions between these stimuli. Both inflammatory and endocrine mediators are necessary for the complete manifestation of host responses to critical illness. PMID- 3511888 TI - Oxygen as an antibiotic. A comparison of the effects of inspired oxygen concentration and antibiotic administration on in vivo bacterial clearance. AB - Since prophylactic antibiotics and changes in tissue partial pressure of oxygen may affect bacterial clearance by different mechanisms, we tested the effects of hypoxia, hyperoxia, and normoxia with and without antibiotic administration on bacterial clearance. We found that improving tissue oxygenation by administration of normobaric oxygen decreased infectious necrosis as effectively as prophylactic antibiotic administration and that improved tissue oxygenation and antibiotic administration had an additive effect. We believe that a fraction of inspired oxygen of 45% should be added to prophylactic antibiotics as standard perioperative and postoperative care. PMID- 3511890 TI - Intraoperative assessment of in situ saphenous vein arterial grafts using pulsed Doppler spectral analysis. AB - Errors in anastomotic construction, retained competent valves, and arteriovenous fistulas can cause both early and delayed failure of in situ saphenous vein arterial grafts. Pulsed Doppler spectral analysis of midstream flow was compared with arteriography in 50 consecutive in situ saphenous vein bypasses for the detection of unsuspected technical error. Based on spectral changes in the velocity waveform indicating flow disturbance, intact valve cusps could be distinguished from arteriovenous fistulas, and technically unsatisfactory anastomoses were identified. Competent valve cusps were identified in nine (5%) of 180 valve-incision sites, and six anastomoses (6%) were judged unsatisfactory. The presence of severe flow disturbance was always associated with an anatomic defect on arteriography. Incision of missed valve cusps and anastomotic revisions corrected associated flow disturbances. Doppler flow analysis readily located high-flow arteriovenous fistulas, thereby reducing operative time and the need for multiple arteriograms. The high sensitivity of this method (no false-negative assessments) makes it an ideal screening test, resulting in the selective use of operative arteriography. PMID- 3511889 TI - Prostaglandin and complement interaction in clinical acute respiratory failure. AB - This study investigated the interaction of plasma levels of circulating prostaglandins and activated complement in clinical acute respiratory failure (ARDS). Fifty patients at risk for ARDS were followed up for up to ten days. Arterial blood gases and plasma levels of complement components C3a and C5a, thromboxane B2 (TxB), and prostaglandin 6-keto-F1 alpha (PGI) and granulocyte aggregation (GA) were measured daily. Seventeen patients (34%) developed ARDS, with mortality of 41% vs 23% for patients without ARDS. Compared with patients without ARDS, the ARDS group had significantly increased plasma C3a (1,130 +/- 750 vs 636 +/- 368 ng/mL) and granulocyte aggregation (48 +/- 10 vs 17 +/- 4 percentage of the maximum light transmission [% max T]). Plasma C5a, TxB, or PGI did not change significantly with or without ARDS. No measured variable was significantly associated with mortality. Regression analysis revealed significant correlations between GA, TxB, PGI, and arterial oxygenation. Plasma C3a and GA are increased in ARDS, suggesting systemic complement activation. A complex series of interactions between the prostaglandins, complement, and GA appears to be involved in ARDS. PMID- 3511891 TI - Beta-adrenergic blockade increases the hepatic extraction of glucose in sepsis. AB - To determine the relationship between hepatic glucose clearance and elevated epinephrine levels in sepsis, dogs with gangrenous cholecystitis were anesthetized and received either propranolol hydrochloride (mean dose, 0.29 mg/kg) or saline solution before intraduodenal glucose injection (2.5 g/kg). The amounts of glucose, insulin, and glucagon in the portal vein, the hepatic artery, and the hepatic vein were determined from the concentrations and the blood flows in these vessels over a two-hour period. Normal dogs served as controls. The amounts of glucose, insulin, and glucagon reaching the livers of both septic groups were the same. However, propranolol treatment increased the percent of glucose extracted by the liver without affecting the extractions of insulin or glucagon. Propranolol reverses the limitation of hepatic glucose extraction in sepsis by a direct effect. Whether the extracted glucose is utilizable as an energy substrate needs to be established. PMID- 3511893 TI - Stroke in renal transplant recipients. AB - Cerebrovascular events are the most common neurological complications seen in renal transplant recipients. Cerebral infarction and transient ischemic attacks are the most common events and may occur years after transplantation. Recipients older than 40 years at the time of transplantation and those with diabetes mellitus are at greater risk. No instances of aneurysmal subarachnoid hemorrhage occurred among 31 patients with polycystic kidney disease who had undergone transplantation. PMID- 3511892 TI - Further characterization of an alkaline protease activity associated with iridescent virus type 6. Brief report. AB - Iridescent virus type 6 infecting Galleria mellonella larvae contained an associated alkaline protease activity which appeared to be tightly bound to the virions and essentially localized on the outside of the viral particle. Under alkaline conditions the virus was degraded by proteolytic cleavage of viral envelope proteins. Proteolytic activity was not present in virus propagated in a permissive insect cell line or when purified from isolated larval fat-bodies instead from whole larvae. The results suggest that the protease associated with Iridescent virus type 6 is of larval origin. PMID- 3511894 TI - The Charcot-Bouchard controversy. AB - Charles Bouchard, an ambitious and industrious man, was one of Jean Martin Charcot's first pupils. With his mentor's support, he rapidly ascended the academic ladder and became a full professor at the school of medicine in Paris. After Bouchard attained professorship, his relationship with Charcot gradually deteriorated. Their strong personalities, their ambition to have schools of their own, and their competition to become the most influential man in the medical school resulted in antagonism between them. The most tragic consequence of this antagonism took place in 1892 when Bouchard presided over the competitive examinations for agregation, in which Joseph Babinski, one of Charcot's youngest pupils, was a candidate. Charcot wanted his pupil to be nominated but Bouchard eliminated him in order to nominate his own pupils. The nominations were appealed but finally Bouchard's decision was upheld. Babinski did not retake the examination and never became a professor at the medical school. PMID- 3511895 TI - Detection of early xerophthalmia by impression cytology. AB - Vitamin A deficiency causes blindness, increased systemic morbidity, and increased mortality among preschool children in many developing nations. Presently, there is no simple, reliable test to detect early, physiologically significant vitamin A deficiency. We used conjunctival impression cytology results to evaluate children with early xerophthalmia before treatment and again three to eight weeks later. Subsequently, we modified our technique. We then compared children with early xerophthalmia to normal children. Conjunctival impressions from children with xerophthalmia all showed complete loss of goblet cells and the appearance of enlarged, partially keratinized epithelial cells. Conjunctival impressions from treated and normal children showed normal goblet cells and sheets of small epithelial cells. These results suggest impression cytology may represent the first simple, objective, diagnostic test for the detection of early vitamin A deficiency. PMID- 3511896 TI - Bilateral total corneal and conjunctival choristomas associated with epidermal nevus. AB - A 4-year-old boy had been noted from birth to have bilateral masses obscuring the entire outer portion of the eyes. Systemic findings included mild growth retardation, multiple cortical lesions of the distal metaphyseal ends of the lower extremities, and diffuse skin pigmentation of the right side of the body. The epibulbar lesions were excised; on the right side, there was a thin cornea that necessitated corneal transplantation. The diagnosis of composite epibulbar choristomas associated with linear epidermal nevus was established by pathologic examination. This case report as well as a literature review establish the association of epibulbar choristomas with cutaneous linear nevi of the epidermal and sebaceous types. PMID- 3511897 TI - Antibacterial effect of donor corneas stored in gentamicin-enriched McCarey Kaufman medium. AB - Penetrating keratoplasty was performed on five pairs of rabbit eyes; one eye of each animal received a donor cornea stored in McCarey-Kaufman (M-K) medium containing gentamicin, and the contralateral eye received a donor cornea stored in M-K medium without gentamicin. At the end of surgery, dilutions of Pseudomonas aeruginosa were introduced into the anterior chamber of both eyes. The eyes receiving gentamicin-enriched corneas showed mild to moderate infection; the contralateral eyes showed significantly more severe infection. The results indicated that donor corneas stored in gentamicin-enriched M-K medium inhibit the growth of bacteria acquired at the time of surgery and thus may improve the safety of such transplantation procedures. PMID- 3511898 TI - Subconjunctival administration of ceftazidime in pigmented rabbit eyes. AB - The ocular kinetics of ceftazidime, a third-generation cephalosporin, were examined in phakic and aphakic pigmented eyes of rabbits following subconjunctival injection (100 mg). Peak ceftazidime concentrations (mean +/- SE, n = three to five rabbits per determination) were as follows: phakic eyes, 40.2 +/- 7.3 mg/L in aqueous humor and 11.2 +/- 0.6 mg/L in vitreous humor at one hour; aphakic eyes, 30.5 +/- 4.8 mg/L in aqueous humor and 15.8 +/- 2.4 mg/L in vitreous humor at one hour. The ability of ceftazidime to eliminate an incipient bacterial infection was also studied. Ten aphakic rabbits received intravitreal injections of 50 colony-forming units (cfu) of Pseudomonas aeruginosa. Six of the ten immediately received a subconjunctival injection of ceftazidime (100 mg). At 48 hours following injections, four of four control eyes yielded bacterial counts greater than 6.2 X 10(6) cfu/mL. Of the six that received ceftazidime, five were sterile and one yielded 10 cfu/mL. PMID- 3511899 TI - Expression in Escherichia coli of functional precursor to the rat liver mitochondrial enzyme, ornithine carbamyl transferase. Precursor import and processing in vitro. AB - cDNA encoding the full-length cytosolic precursor of rat liver ornithine carbamyl transferase, a mitochondrial matrix enzyme, was inserted into pKK223-3 and expressed under the control of the tac promoter. Following transformation of E. coli strain JM105 and induction by isopropylthiogalactoside, a polypeptide was synthesized which reacted with antibody against ornithine carbamyl transferase and co-migrated in SDS-polyacrylamide gels with authentic enzyme precursor (pOCT, Mr = 40,000 kDa); it constituted approximately 0.1% of total E. coli protein. pOCT was synthesized in vitro by coupled transcription-translation of the recombinant plasmid in an E. coli S30 extract; upon subsequent addition of purified rat liver or heart mitochondria, the precursor was imported and processed to mature form. Synthesis of pOCT in a bacterial system, therefore, results in production of a functional precursor polypeptide which does not require additional cytosolic factors from eukaryotic cells to support its uptake and processing by mitochondria in vitro. PMID- 3511900 TI - A method for determining the intracellular distribution of enzymes in yeast provides no evidence for the association of hexokinase with mitochondria. AB - A simple procedure based upon the principle discovered by Durr et al. (Arch. Microbiol. (1975) 105, 319-327) was used to measure the intracellular distribution of enzymes in S. cerevisiae grown under both glucose repression and derepression. No substantial hexokinase activity was found to be associated with cellular organelles. The result does not support the hypotheses that reversible binding of hexokinase to mitochondria is important in regulation of glycolysis and cell growth. PMID- 3511901 TI - Phytohemagglutinin (PHA) activated human T-lymphocytes: concomitant appearance of insulin binding, degradation and insulin-mediated activation of pyruvate dehydrogenase (PDH). AB - Binding and degradation of A14125I-Insulin as well as the effect of insulin on pyruvate dehydrogenase (PDH) activation were studied in non-stimulated and phytohemagglutinin (PHA)-stimulated thymic-derived lymphocytes (T-lymphocytes) of man under varying conditions of time, temperature, and cell concentration. The nonstimulated viable T-lymphocytes exhibited neither binding, degradation, nor PDH activation in response to insulin. With PHA stimulation, a time and temperature-dependent binding was noted in T-lymphocytes which paralleled the appearance of cell-associated insulin degrading activity. Concomitant with the emergence of insulin binding and degrading activities in these cells, PDH activation was observed which was responsive to as little as 5.0 microU/ml of insulin. We conclude that in PHA-activated T-lymphocytes of man the process of insulin binding and degradation is closely related to insulin sensitive activation of PDH. These activated cells may serve as a useful model in which to study insulin binding and processing, as well as effects of insulin on postreceptor events. PMID- 3511902 TI - Insulin-like growth factors (IGF I and IGF II) mimic the effect of insulin on plasma protein synthesis and glycogen deposition in cultured hepatocytes. AB - Monolayer cultures of chick embryo hepatocytes were used to compare the effects of insulin-like growth factors, IGF I and IGF II, with insulin on two hepatic functions: plasma protein production and glycogen deposition. Just as with exposure of the cells to insulin, addition of either IGF I or IGF II to the otherwise hormone-free medium elicited a dramatic change in the production of secretory proteins as well as the development of glycogen deposits equivalent to in vivo (fed) levels. No major differences between insulin, IGF I or IGF II were observed in terms of the degree of stimulation or potency of the hormones. PMID- 3511903 TI - Human renin: a new class of inhibitors. AB - A new class of human renin inhibitor is described, containing a novel analogue of the peptide bond. High inhibitory potency was observed for octapeptide-length substrate analogues but inhibition progressively weakened as the molecule was shortened from the amino terminal end. PMID- 3511904 TI - Specific purification of elongation factor 2 and isolation of its antibody. AB - Elongation factor 2 (EF-2) was purified from rat liver extracts by affinity chromatography using fragment A of diphtheria toxin as the ligand. Purified EF-2 has a molecular weight of 96,000 and isoelectric point of 6.6-6.8. The sequence of the nineteen N-terminal amino acid is Val-Asn-Phe-Thr-Val-Asp-Gln-Ile-Arg-Ala Ile-Met-Asp-Lys-Lys-Ala-Asn and the C-terminal amino acid is leucine. Purified rat EF-2 modified with ADP-ribose was injected into rabbits to prepare antibodies against EF-2. The anti-EF-2 antibodies can immunoprecipitate with EF-2 from various eukaryotic cells. PMID- 3511905 TI - Chromosomal assignment of human genes for gastrin, thyrotropin (TSH)-beta subunit and C-erbB-2 by chromosome sorting combined with velocity sedimentation and Southern hybridization. AB - Human genes for gastrin, thyrotropin (THS)-beta subunit and c-erbB-2 were assigned to specific chromosomes using a single-laser cell sorter. For this purpose, condensed human chromosomes prepared from a karyotypically normal lymphoblastoid cell line were preliminarily fractionated by velocity sedimentation, and then sorted using a fluorescence-activated cell sorter. DNA was then extracted from the chromosomes, cleaved by restriction enzymes, and subjected to Southern hybridization using gene-specific radioactive probes. When the assignment of specific chromosomes was not possible due to chromosomal size overlapping, sorted chromosomes from cell lines carrying chromosomal translocation or from hybrid cells carrying known human chromosomes were used in addition. The results indicate that human genes for gastrin, TSH-beta, and c-erbB 2 are located on chromosomes 17, 1 and 17, respectively. PMID- 3511906 TI - Muscle proteins related to microtubule associated protein-2 are substrates for an insulin-stimulatable kinase. AB - High molecular weight muscle protein(s), present as a "doublet" (approximately 320 and approximately 290 kDa apparent molecular weight) in partially purified preparations of inhibitor-2 from rabbit skeletal muscle, and homogeneous bovine brain microtubule associated protein-2 are both in vitro substrates for a soluble insulin-stimulatable serine/threonine kinase in 3T3-L1 adipocytes. The high molecular weight muscle substrate "doublet" was specifically immunoprecipitated by affinity-purified anti-microtubule associated protein-2 antibody. PMID- 3511907 TI - Purification of 6-pyruvoyl-tetrahydropterin synthase from human liver. AB - The enzyme which catalyzes the first step in the conversion of dihydroneopterin triphosphate to tetrahydrobiopterin has been purified approx. 40,000-fold from human liver to apparent homogeneity. The enzyme has a native molecular weight of approximately 83,000 and consists of four identical subunits, each of which has a molecular weight of approximately 19,000. It contains carbohydrates and is remarkably stable to heat treatment. In the presence of purified sepiapterin reductase, Mg2+, and NADPH, this enzyme catalyzes efficiently the formation of tetrahydrobiopterin from dihydroneopterin triphosphate. This indicates that these two proteins are sufficient for the overall conversion. PMID- 3511908 TI - p60c-src activity detected in the chromaffin granule membrane. AB - Using monoclonal antibodies specific for p60c-src we have detected high levels of this kinase in adrenal medullary chromaffin tissue and in highly purified chromaffin granule (secretory vesicle) membranes. An immune complex kinase assay was applied to fractions of adrenal medullary tissue resolved on sucrose density gradients. Thirty-seven per cent of the total tissue p60c-src activity was found in association with chromaffin granule or granule membrane markers. Localization of a significant fraction of total cellular p60c-src activity to this secretory vesicle membrane suggests that the kinase may function in the regulation of neurotransmitter release. PMID- 3511910 TI - Conversion of angiotensin-1 to angiotensin-2 by a latent endothelial cell peptidyl dipeptidase that is not angiotensin-converting enzyme. AB - Cultured bovine pulmonary artery endothelial cells contain a second peptidyl dipeptidase, distinct from angiotensin-converting enzyme, present in an inactive form associated with a non-dialyzable inhibitor. Partial purification by glycine affinity chromatography separates enzyme from inhibitor to yield a preparation which hydrolyzes angiotensin-1, bradykinin, substance P, atriopeptin-2, enkephalin and Hip-His-Leu. This enzyme is resistant to inhibition by lisinopril, captopril, thiorphan, phosphoramidon, soybean trypsin inhibitor, PMSF and aminopeptidase and carboxypeptidase inhibitors, but is inhibited by EDTA. PMID- 3511909 TI - Two types of growth inhibitor in rat platelets for primary cultured rat hepatocytes. AB - Rat platelets contain two types of growth inhibitor of adult rat hepatocytes in primary culture. One, named platelet derived growth inhibitor (PDGI)-alpha, is a heat- and acid-labile protein with a molecular weight of over 200 KD that is not released on thrombin treatment. The other, named PDGI-beta, is a heat- and acid stable factor with a molecular weight of 24 KD that is released by thrombin. Both PDGI-alpha and -beta were inactivated by treatment with dithiothreitol. They both caused dose-dependent inhibition of DNA synthesis stimulated by insulin plus epidermal growth factor. These inhibitions were closely correlated with marked decrease in the labeling index. Neither PDGI-alpha nor -beta had a cytotoxic effect as judged by phase-contrast microscopic examination of the cells nor inhibition of protein synthesis. The properties of PDGI-beta suggest that it may be identical with transforming growth factor-beta. These results indicate that rat platelets contain not only a growth factor (HGF), but also growth inhibitors that affect adult rat hepatocytes. PMID- 3511911 TI - Specific inhibition of post proline cleaving enzyme by benzyloxycarbonyl-Gly-Pro diazomethyl ketone. AB - N-Benzyloxycarbonyl-Gly-Pro-diazomethyl ketone (Z-Gly-Pro-CHN2) was synthesized and tested as inhibitor of the post proline cleaving enzyme from bovine brain. The compound was found to inactivate the enzyme completely and irreversibly at low concentrations (0.3 microM) without affecting other proteolytic enzymes such as post proline dipeptidyl aminopeptidase, pyroglutamate aminopeptidase or trypsin. Substrates of post proline cleaving enzymes such as luliberin (LH-RH; pyroGlu-His-Trp-Ser-Tyr-Gly-Leu-Arg-Pro-Gly-NH2) and Benzyloxycarbonyl-Gly-Pro Ala protected the enzyme from the reaction with Z-Gly-Pro-CHN2. Thus, Z-Gly-Pro CHN2 seems to be an active site directed, specific inhibitor of post proline cleaving enzyme. When administered intraperitoneally to rats, this inhibitor (8 mg/kg) completely inactivated the post proline cleaving enzyme in all tissues studied including brain. Therefore, Z-Gly-Pro-CHN2 should be a valuable tool for studies on the physiological function of this enzyme within the metabolism of neuropeptides. PMID- 3511912 TI - Quantitative immunoprecipitation of the lactose transporter from Escherichia coli confirms stoichiometry of substrate binding. AB - A procedure is presented for the immunoprecipitation of the E. coli lactose transporter which may be applicable to other membrane protein antigens. Antibodies to its chemically synthesized C-terminal decapeptide specifically precipitate 6.0 +/- 0.2% of the radioactivity from solubilized [14C]amino-acid labeled total cell envelopes of the transporter-overproducing strain T206 corresponding to 1.0 +/- 0.1 nmol transporter/mg total membrane protein. Comparison with galactoside binding yields a stoichiometry of 1.1 +/- 0.2 mol galactoside bound/mol transporter. PMID- 3511913 TI - A metalloprotease involved in the processing of mitochondrial precursor proteins. AB - A protease that cleaves the precursor of ornithine carbamoyltransferase (EC 2.1.3.3), a mitochondrial matrix enzyme, has been partially purified from the matrix fraction of rat liver mitochondria. The protease cleaved the precursors of several other matrix proteins at apparently correct sites. The protease was inhibited by 1,10-phenanthroline and EDTA, was reactivated by excess Mn2+ or Co2+, and did not cleave the alkali-denatured precursor proteins. These and other results indicate that this protease is responsible for the processing of at least several matrix protein precursors, and that the enzyme recognizes some three dimensional conformation of the precursors as well as the amino acid sequences around the cleavage sites. PMID- 3511914 TI - An endopeptidase associated with bovine neurohypophysis secretory granules cleaves pro-ocytocin/neurophysin peptide at paired basic residues. AB - The octacosapeptide sequence [Tyr18] pro-ocytocin/neurophysin (1-18)NH2 [pro OT/Np(1-18)NH2] was synthesized and used as substrate to detect endoprotease(s) possibly involved in the processing of this precursor in bovine hypothalamo neurohypophyseal tract. An endopeptidase (58 Kda) was detected in Lysates made from highly purified neurosecretory granules. This protease which cleaves the peptide bond on the carboxyl side of the Lys-Arg doublet, and no single basic residue, generates both OT-Gly10-Lys11-Arg12+Ala13-Val-Leu-Asp-Leu-Tyr18 (NH2) from the octacosapeptide substrate. In addition, a carboxypeptidase B-like activity converting OT-Gly10-Lys11-Arg12 into OT-Gly10 was detected in the same granule Lysates. It is hypothesized that a combination of these endoprotease and carboxypeptidase B-like activities together with the amidating enzyme of secretory granules might participate in the cleavage and processing of pro-OT/Np in vivo. PMID- 3511915 TI - Membrane fluidity changes in P. berghei-infected erythrocytes, investigated with a specific plasma membrane fluorescent probe. AB - Trimethylamino-diphenylhexatriene (TMA-DPH), a novel hydrophobic fluorescent probe with relevant photophysical properties for fluorescence anisotropy measurements in phospholipidic membranes, specifically labels the plasma membranes of whole living-cells, unlike earlier commonly used probes such as 1,6 diphenyl-1,3,5-hexatriene (DPH) and anthroyloxy fatty acids, which invade all hydrophobic regions of the cell. Using TMA-DPH, it was shown that mouse malaria parasite Plasmodium berghei induced a statistically highly significant increase (8%) in the plasma membrane fluidity of the host erythrocyte. The physical factors, which might critically influence the measurements in this study, i.e. the fluorescence lifetime of the probe and the contribution of scattered light, were carefully controlled. The effect observed is discussed on the basis of earlier established metabolic changes in the membrane following infection, namely phospholipidic and cytoskeleton modifications. PMID- 3511916 TI - A perspective on antimalarial action: effects of weak bases on Plasmodium falciparum. PMID- 3511917 TI - Enzymatic defense against radiation damage in mice. Effect of selenium and vitamin E depletion. AB - Radiation effects are mediated in part by the generation of oxygen-derived free radicals and hydrogen peroxide. Membrane polyunsaturated fatty acids are important biological targets of these toxic molecules which cause lipid peroxidation. Radiation damage to DNA is also known to result in base hydroperoxides, especially thymidine hydroperoxide. Glutathione (GSH) is known to inhibit lipid peroxidation both chemically and through its interaction with the selenium-dependent glutathione peroxidase (GSH-Px). Although cytosolic GSH-Px can metabolize organic lipid peroxides in solution, it cannot metabolize phospholipid peroxides in micelles. This may be due to the interference of phase differences between the aqueous cytosol and the membrane, or the result of steric hindrance. Recent studies have suggested the presence of a membrane-bound GSH-dependent peroxidase system. We examined the cytosolic versus membrane-associated GSH-Px, in various tissues of mice on a selenium and vitamin E deficient diet, and found significant differences among organs in the distribution of enzyme activity in these two subcellular fractions. The effect of single high-dose whole body irradiation did not appear to be related to the activity of these enzymes. PMID- 3511918 TI - Effects of the antitumor drugs 3-nitrobenzothiazolo[3,2-alpha]quinolinium and fagaronine on nucleic acid and protein synthesis. AB - 3-Nitrobenzothiazolo[3,2-alpha]quinolinium perchlorate (NBQ) has been shown to be active against in vivo experimental tumors of P388 and Ehrlich ascites cells. Furthermore, it has been established that NBQ binds to DNA by intercalation. In this work we describe its effects on DNA, RNA and protein syntheses both in KB cells and in cell-free synthesizing systems. Fagaronine, an alkaloid structurally related to NBQ, was studied also in an attempt to establish the basis for future studies on structure-activity relationships. Both NBQ and fagaronine inhibited DNA, RNA and protein syntheses in KB cells, with essentially equal effectiveness. Exposure of KB cells to NBQ for 2 hr caused irreversible inhibition of DNA, RNA and protein syntheses. Studies in cell-free systems showed that NBQ strongly inhibited Escherichia coli DNA polymerase I, whereas RNA polymerase activities were moderately affected. Furthermore, both drugs inhibited protein synthesis in cell-free systems derived from rabbit reticulocytes and Saccharomyces cerevisiae. Our results indicate that NBQ and fagaronine exert their cytotoxic activity by at least two independent mechanisms: inhibition of DNA activity by binding to this molecule, and inhibition of protein synthesis probably by interacting with the ribosomal system. PMID- 3511919 TI - Anticentriole antibody in a patient with progressive systemic sclerosis. PMID- 3511920 TI - Doctor Yvan: the father of Reiter's syndrome. PMID- 3511921 TI - The value of biopsy in patients with monarticular juvenile rheumatoid arthritis of recent onset. AB - The histopathology of arthroscopic biopsy material from the knees of 8 patients with monarticular juvenile rheumatoid arthritis (JRA) of recent onset and of 4 control patients was examined using a histochemical method for acid alpha naphthyl acetate esterase and an avidin-biotin-peroxidase complex method for different cell subtype-specific surface antigens. According to results of our prospective, single-blind study, nonspecific synovitis was observed in those biopsy samples obtained early in the course of disease. The samples were also characterized by cellular changes that are quite distinct from those described in patients with chronic rheumatoid synovitis. JRA must be considered the cause of symptoms if no orthopedic or infectious disease is found at arthroscopy in children with monarticular symptoms of recent onset and if nonspecific synovitis is observed in the histopathologic specimen. This pathologic description, however, does not correspond to that of classic rheumatoid synovitis. In our studies, we found that mononuclear cells displaying diffuse cytoplasmic esterase and surface Ia formed a large proportion of all inflammatory cells in situ. There were comparatively few activated Ia+ T cells and plasma cells. These observations suggest that exudative features and nonspecific cellular inflammation are prominent at onset of JRA. The immune response, in the form of immunocompetent T and B cells, seems to be more extensively involved in chronic JRA and may represent secondary features of the disease. PMID- 3511922 TI - Vivax malaria. AB - Malaria occurs in the United States infrequently and is found exclusively among immigrants and travelers returning from areas where the disease is endemic. Cases of acute relapses of Plasmodium vivax infection can present to the emergency department. Patients are often immigrants from developing countries who were symptom-free in this country for weeks or months preceding their illness. The clinical presentation and current treatment of malaria are reviewed. Malarial infection may become apparent months after leaving endemic areas despite adherence to prophylactic regimens. The disease usually responds to appropriate drug therapy with rapid and often dramatic results, but it can be fatal if unrecognized. PMID- 3511923 TI - Asystole following a conventional therapeutic dose of lidocaine. AB - Lidocaine is one of the most frequently used drugs to suppress ventricular arrhythmias; however, it has caused sinus arrest when given in excess or along with other antiarrhythmics (quinidine, phenytoin, amiodorane). A case of asystole after a conventional dose of lidocaine and resuscitation following discontinuance is reported. Although such complications are rare, the widespread utilization of this drug requires emergency physicians to recognize the potential for this problem. PMID- 3511924 TI - Emphysematous cholecystitis: an insidious variant of acute cholecystitis. AB - Emphysematous cholecystitis is an insidious and rapidly progressing disease that requires prompt surgical intervention. As the majority of the patients contracting this disease initially present to the emergency department with complaints of abdominal pain and often mild constitutional symptoms, it is important for the emergency physician to be aware of this clinical entity. Didactic cases have been presented that, in many ways, illustrate classic examples of emphysematous cholecystitis, the diagnosis of which can often be made in the emergency department using an upright abdominal radiograph. PMID- 3511925 TI - Surgical concepts for reconstruction of the auricle. History and current state of the art. AB - We compiled and evaluated the world literature on auricular reconstruction, for a total of over 400 publications, more than 200 authors, and over 3,300 reported cases. We found that partial reconstructions were already performed as early as 600 BC; total reconstructions were still considered impracticable in 1830. But since 1891, more than 40 different cartilaginous, osseous, and alloplastic frame materials have been described. Only eight of these were still being applied in the last decade, with autogenous costal cartilage and silicone as the leading substances. Results of the operation can be improved by special surgical manipulations, eg, the "fan-flap" technique. Taking into consideration the complication rate, the number of individual interventions, and the stability of the results, we devised a special point system that makes possible a limited assessment of the different surgical techniques. PMID- 3511926 TI - Cholinergic receptors in the upper respiratory system of the rat. AB - Radioligand receptor binding might give more detailed information on the innervation pattern of the nasal mucosa and the character of the various neuroreceptors involved. With respect to the cholinergic receptors, this technique reveals that specific binding of tritiated I-quinuclidinyl benzilate to rat nasal mucosa homogenates occurs to a homogeneous class of binding sites, with a dissociation constant of 0.06 +/- 0.02 nM and a receptor density of 8 +/- 2 pmole/g of tissue. Binding is stereoselectively inhibited by benzetimide hydrochloride enantiomers. Pirenzepine displacement (inhibition constant = 0.5 X 10(-6) M) classifies tritiated I-quinuclidinyl benzilate binding sites as M2 muscarinic receptors. Methylfurthrethonium inhibits tritiated I-quinuclidinyl benzilate binding at high concentrations, pointing to the presence of low affinity agonist binding sites, probably admixed with a small proportion of high affinity agonist binding sites. These data obtained in the rat open new perspectives for studying muscarinic receptors in the human nose to elucidate the supposed disturbance of autonomic nerve regulation in nasal hyperreactivity. PMID- 3511927 TI - 'Calcium hydroxide. Root resorption. Perio-endo lesions'. PMID- 3511928 TI - Aortic dissection during pregnancy. AB - Aortic dissection occurred in a nineteen year old woman during the thirty seventh week of pregnancy. Immediate elective delivery of a normal baby by caesarean section was followed by aortic root replacement 48 hours later. It was decided not to proceed immediately to operation on the aortic root because it was believed that the anticoagulation necessary for cardiopulmonary bypass might provoke dangerous haemorrhage from the raw placental site. PMID- 3511929 TI - Reproducibility of linear cardiac output measurement by Doppler ultrasound alone. AB - Inclusion of a pig aorta in an artificial circulation with pulsed blood flow allowed correlation of minute distance, measured in the aorta by Doppler ultrasound, and absolute blood flow, measured by timed blood-volume collection. The correlation coefficient was 0.99 with a standard error of prediction that was 5.4% of the minute distance predicted at a standard flow rate of 5 litres per minute. The horizontal distance between 95% confidence limits for a single prediction expressed as a percentage of 5 litres per minute was 33%, and this corresponded to the range of flow rates of 1.65 litres per minute that could give rise to the same measurement. In 142 patients duplicate measurements of minute distance were made with repositioning of the ultrasound transducer between recordings. The mean difference between paired readings, expressed as a percentage of the average (SD) of each pair was 5.4 (4.7)%. Thus, the non invasive measurement of linear cardiac output by Doppler ultrasound is similarly reproducible in vitro and in vivo and compares favourably with the measurement of volumetric cardiac output by thermodilution. PMID- 3511930 TI - Haemodynamic effects of pretreatment with metoprolol in hypertensive patients undergoing surgery. AB - Thirty hypertensive patients scheduled for cholecystectomy or hernia repair under general anaesthesia with thiopentone-fentanyl-nitrous oxide-pancuronium were divided into two groups of 15. One group received metoprolol tablets 200 mg in a slow release form, once daily for at least 2 weeks including the morning of surgery. In addition, metoprolol 15 mg was injected i.v. shortly before the induction of anaesthesia. The other group received placebo tablets and saline. Two patients in the treatment group and one patient in the placebo group were subsequently excluded, because of complications during treatment. Metoprolol significantly reduced arterial pressure both during undisturbed anaesthesia, during intubation and after extubation. A similar tendency was observed also during surgery, although it was not quite significant (P = 0.055). However, metoprolol had no effect on variations in systemic vascular resistance. Mean pulmonary arterial pressures during anaesthesia and surgery were significantly greater in the control, than in the metoprolol, group. Central venous pressure (CVP) and pulmonary arterial occlusion pressure (PAOP) increased significantly in both groups in response to the surgical stimulus. There was no significant difference between the groups in PAOP and CVP. One patient in the metoprolol group had marked bradycardia (minimum heart rate 26 beat min-1) after neostigmine and atropine; otherwise metoprolol pretreatment was tolerated well. PMID- 3511932 TI - Effects of the addition of potassium to prilocaine or bupivacaine. Studies on brachial plexus blockade. AB - A double-blind comparison of prilocaine and prilocaine plus potassium chloride, and of bupivacaine with bupivacaine plus potassium chloride, in brachial plexus blockade (axillary approach) was obtained in two groups of 20 patients. The addition of potassium chloride made no difference to the characteristics of the block with prilocaine, but resulted in a more rapid onset of sensory loss when added to bupivacaine. PMID- 3511931 TI - Metoprolol decreases the amount of halothane required to induce hypotension during general anaesthesia. AB - A double-blind, randomized and placebo-controlled study was undertaken to assess the effects of metoprolol on controlled hypotension during halothane anaesthesia. Nineteen patients under-going middle ear or nasal septum surgery were studied. The aim was to achieve a 25% reduction of the mean arterial pressure in both groups. Metoprolol was given by mouth on two occasions in the 10-12 h before operation. In the group pretreated with metoprolol the halothane concentration was reduced by 35.5%. The duration of bleeding and its degree were reduced significantly. The time to awakening was shorter and of better quality after pretreatment with metoprolol. Rate-pressure product was less after pretreatment with metoprolol, and rebound hypertension was well controlled. PMID- 3511934 TI - Detection of the c-myc oncogene product in colonic polyps and carcinomas. AB - The c-myc oncogene has been implicated in the processes of normal cell proliferation and differentiation. Elevated levels of c-myc mRNA and its gene product (p62c-myc), have been detected in a variety of solid tumours and cultured cel lines. Its precise role in normal cell function and in neoplastic transformation and progression has yet to be elucidated. We have used a monoclonal antibody, raised by peptide immunisation, to determine the distribution by immunoperoxidase staining of the c-myc oncogene product in archival specimens of colonic polyps and carcinomas. Samples from 42 patients with colon carcinoma, 24 with benign polyps and 15 normal colon biopsies were examined. Normal colon revealed maximum staining in the mid-zone of the crypts, corresponding to the zone of differentiation and maturation. The staining was predominantly cytoplasmic. Adenomatous polyps revealed the most intense pattern of staining in areas of dysplastic change. Colonic tumours showed a wide range of staining. Well differentiated tumours contained more cytoplasmic p62c-myc than poorly differentiated tumours. These findings suggest that the c-myc oncogene product may play an important role in the evolution of colonic neoplasia. PMID- 3511933 TI - The effect of liver microsomal enzyme inducing and inhibiting drugs on insulin mediated glucose metabolism in man. AB - The effects of hepatic microsomal enzyme inducing (phenobarbitone and flumecinol), and inhibiting (cimetidine) drugs, and placebo treatment on insulin mediated glucose metabolism (M) were investigated in 29 healthy volunteers. Phenobarbitone (50 mg for 10 days) increased M (30%), metabolic clearance rate of glucose (MCRg), and antipyrine clearance rate (33%). Fasting immunoreactive insulin (IRI) decreased while fasting blood glucose (BG) remained unaltered. Flumecinol, another inducer, tested in two doses (200 mg and 600 mg for 6 days), did not alter glucose or antipyrine metabolism. Fasting IRI reduced on treatment with 600 mg of flumecinol, but not with the smaller dose. Cimetidine (600 mg for 6 days) decreased M (19.5%), MCRg (26%), and antipyrine clearance rate (20%). The placebo did not alter glucose or antipyrine metabolism. The results indicate that the insulin mediated glucose disposal rate can be altered by drugs influencing hepatic microsomal enzyme activity. PMID- 3511935 TI - Specificity of antibodies to the purified Con A acceptor glycoproteins of cultured tumour cells. AB - Con A acceptor glycoproteins from the human Molt 4 (T cell leukaemia) and HeLa (endocervical adenocarcinoma) cell lines were purified by affinity chromatography and used for the preparation of rat antisera. Cross-absorption analysis showed that each antiserum contained antibodies which recognised cell surface antigens preferentially expressed by the donor cell line. Molt 4-associated antigens were fully expressed on T cell tumour lines and normal thymocytes, but not on non T cell tumour lines, peripheral blood lymphocytes or other blood cells. Immunofluorescence studies showed that the antigens were preferentially expressed on a sub-population of immature thymocytes. HeLa-associated antigens were only fully expressed on one other epithelial tumour cell in a panel of 17 cell lines. Immunofluorescence studies showed that the HeLa-associated antigens were expressed on normal endocervical adenoepithelium but not on ectocervical, endometrial or intestinal epithelia. Thus purified Con A acceptor glycoproteins of cultured tumour cell lines are potent immunogens for the generation of antibodies recognising lineage-associated differentiation antigens. These antigens should be useful in tumour classification and in the study of normal differentiation. PMID- 3511936 TI - Once daily theophylline in childhood asthma. AB - A new sustained-release theophylline preparation has been designed with the purpose of providing 24-hour protection against bronchospasm in asthmatics when given as a single dose. Fifteen children with moderate asthma completed a double blind, placebo-controlled crossover trial of this product given once a day before bed. There was a significant fall in night symptoms (P less than 0.05), a rise in the mean early morning peak expiratory flow rate (PEFR) (P less than 0.01) and a fall in the number of mornings on which PEFR was less than 2 SD under the mean for height (P less than 0.01). An improvement in mean day symptom scores and evening PEFR was not significant. Thus we have shown that this product given once a day before bed is suitable for this way. PMID- 3511937 TI - The effect of indomethacin on breathlessness in patients with diffuse parenchymal disease of the lung. AB - We have shown in a previous study that indomethacin reduced breathlessness in normal subjects during exercise. In a double-blind randomized study we have determined the effects of both acute (50 mg) and chronic (25 mg twice daily for 7 days) oral treatment with indomethacin on breathlessness induced by exercise in patients with diffuse parenchymal disease of the lung. The relationship of breathlessness, as measured on a visual analogue scale, to ventilation was not significantly altered by either acute or chronic treatment with indomethacin compared to placebo. There was no significant change in the distance walked in 6 minutes after any of the treatments. Possible explanations for the differing effects on breathlessness observed in normal subjects and in patients are discussed. PMID- 3511938 TI - Cellular basis of host defence in pyelonephritis. I. Chronic infection. AB - Infection persists for long periods in chronic pyelonephritis, but the cellular basis of the host-parasite relationship is poorly understood. We have obtained quantitative data on the relationship between the pathogen (E. coli) and cellular defence mechanisms. Depletion of cellular components was carried out using whole body irradiation, methylprednisolone, cyclophosphamide or carrageenan and silica particles. A system of administering cyclophosphamide and methylprednisolone through the use of a slow release carrier, as well as graded doses of irradiation, was then developed to allow the controlled reduction of cellular competence. Quantitative studies in a host with chronic pyelonephritis and normal cellular defence reserves showed that severe depletion of granulocytic cells is necessary before host defence mechanisms are adversely affected. This finding conflicts with the observation that microorganisms survive and persist in the kidney for extended periods. Additionally, noncellular factors may also limit bacterial growth. PMID- 3511940 TI - Human osteoclast-specific antigens are expressed by osteoclasts in a wide range of non-human species. AB - A series of monoclonal antibodies have been developed which react specifically with human osteoclasts in human fetal bone and a range of neoplastic and non neoplastic bone lesions. We have examined whether such antibodies retain reactivity and specificity with osteoclasts isolated from the bone of newborn non human mammals and embryonic chickens. Of seven osteoclast-specific monoclonal antibodies, three retain their reactivity with rabbit and two with guinea-pig; none react with mouse or rat osteoclasts; two antibodies detect avian osteoclasts. The extensive retention of some osteoclast antigens during phylogeny suggests that they might represent functionally important molecules in the regulation of osteoclast activity. Moreover, the existence of antibodies capable of defining multi- and mononuclear osteoclasts, from species where osteoclast function is well characterized, suggests possible experimental routes towards the isolation, and hence study of purified populations of osteoclasts and their precursors. PMID- 3511939 TI - Passive immunization of mice against Klebsiella aerogenes. AB - Klebsiella vaccines were isolated by mild diafiltration techniques from culture filtrates of nine capsular types of K. aerogenes (K1, K2, K3, K15, K20, K35, K36, K44 & K63). The bacteria were grown in a chemically defined medium in standardized conditions in a fermenter. The vaccines had a molecular weight of more than 20 000, a carbohydrate content of 40-89%, a protein content of between less than 1 and 16% and small amounts (0.6-1.2%) of lipopolysaccharide. Antisera raised in rabbits to the nine klebsiella vaccines were standardized by passive haemagglutination, immunoglobulin G enzyme-linked immunosorbent assay and by autologous passive protection tests. Each rabbit antiserum when passively transferred to mice showed a variable capacity to passively protect mice against lethal infections by a panel of ten capsular types of K. aerogenes (K1-K10). Seven of the rabbit antisera protected mice against more than half of the challenge strains. A pool of six rabbit antisera (anti-K1, K2, K3, K20, K35 & K44) passively protected mice against lethal infections from strains of bacteria representing each of 77 capsular types of K. aerogenes. PMID- 3511941 TI - Current understanding of the aetiology and clinical implications of cutaneous graft-versus-host disease. PMID- 3511942 TI - Mononuclear cell subpopulations in the skin defined by monoclonal antibodies after HLA-identical sibling marrow transplantation. AB - Mononuclear cell subpopulations present in the skin of 36 recipients of HLA identical sibling marrow transplants were defined by immunoperoxidase using a battery of monoclonal antibodies to cell surface differentiation antigens. The T4 positive (T4+) (helper-inducer T cells), T8+ (cytotoxic-suppressor T cells) and the T6+ (Langerhans cells) decreased in number early post transplant and returned towards normal numbers from day 42 onwards. There was no evidence that either the T4+ or the T8+ subset was involved in cell-to-cell contact damage in acute graft versus-host disease (GVHD). The paucity of lymphoid cell infiltration of the epidermis in acute GVHD suggested the possibility of a soluble factor being responsible for basal layer damage. In patients with chronic GVHD there was no evidence of T4+ lymphocyte involvement, but T8+ lymphocytes were present in increased numbers, suggesting a role for the T8+ population in the skin lesions of chronic GVHD, or possibly a reflection of the pattern of T4+ and T8+ cell reconstitution in the blood post-transplant. Finally, our study provided no evidence that BI+ (B cells), Leu 7+ (natural killer cells), OKMI+ (histiocytes) or OKT1O+ cells were involved in cell-to-cell contact damage in either acute or chronic GVHD. PMID- 3511943 TI - Eosinophilic pustular folliculitis. Studies on possible chemotactic factors involved in the formation of pustules. AB - Eosinophilic pustular folliculitis (EPF) is a dermatosis of unknown aetiology, characterized by repeated development of pruritic follicular papulopustules with a tendency to form an annular configuration on the face and other seborrhoeic areas, and by palmoplantar pustular lesions in one-fifth of the patients. Both types of lesions are infiltrated mainly by eosinophils with some polymorphonuclear leukocytes (PMN). To elucidate the mechanisms underlying pustule formation, we studied the chemotactic activity for leukocytes of the skin surface lipids (SSL) obtained from seborrhoeic areas. No specific chemotactic activity was detectable in stored SSL from patients with EPF. However, fresh SSL collected from the seborrhoeic areas of normal adults contained chemotactic substances for eosinophils and PMN which were labile on storage in air. In stratum corneum extracts from palmoplantar lesions of patients with EPF we demonstrated the presence of a 13000 molecular weight chemoattractant factor for PMN, the activity of which was partially inhibited by antiserum against C5a, and a low molecular weight lipid-soluble chemotactic factor for eosinophils, the activity of which was also lost on storage in air. Our findings suggest that these chemotactic factors play a role in the production of the characteristic pustular lesions of EPF. PMID- 3511944 TI - Comparison of two occlusive bandages in the treatment of venous leg ulcers. AB - A randomized controlled study was performed in 34 patients with venous leg ulcers. No difference was found in the healing rate between a new hydrocolloid dressing plus compression, and a double layer bandage, consisting of an inner paste bandage (i.e. a stocking impregnated with zinc oxide paste) and an outer elastic bandage. The parameters chosen for objective evaluation were stereophotogrammetric measurement of ulcer area and volume, and bacterial counts. PMID- 3511945 TI - Dermatitis herpetiformis. PMID- 3511946 TI - Enumeration of absolute numbers of T lymphocyte subsets in B-chronic lymphocytic leukaemia using an immunoperoxidase technique: relation to clinical stage. AB - An immunoperoxidase technique has been used to identify and enumerate helper and suppressor T-cell subsets, as defined by reactivity with Coulter T4 and OKT8 monoclonal antibodies in 54 patients with B chronic lymphocytic leukaemia (B-CLL) and in the same number of matched controls. The ratio of T4+ to T8+ cells was significantly reduced in the B-CLL group as a whole (P less than 0.001) and in each stage of the three clinical staging systems. There was an increase in the median absolute level of T8+ cells in the whole CLL group (P less than 0.001). However, subdivision of the CLL group by clinical staging systems revealed a large group (28 patients) in which median T8+ cell levels were not raised and median T4+ cell levels were low (P less than 0.01). There was no significant decrease in T4+:T8+ ratio, increase in T8+ cells or decrease in T4+ cells with progression of clinical stage. Absolute numbers of E+ cells were significantly raised in all staging systems as were E+ T4- T8- cells (P less than 0.001). A significant alteration in either of these populations with progression of clinical stage was not present. PMID- 3511947 TI - Status of major red cell blood group antigens on neutrophils, lymphocytes and monocytes. AB - Previous investigators have reported that a number of red cell (RBC) antigens are found on neutrophils (PMN) and lymphocytes. However, there is a lack of consensus in the literature. Furthermore, few data are available concerning the occurrence of RBC antigens on monocytes. To address this problem, leucocyte fractions prepared from donors of known RBC antigen phenotype were analysed by fluorescence flow cytometry. Based on recent reports that PMN do not express ABH antigens and on the data presented here, the occurrence of major RBC antigens on leucocytes may be defined as follows: (1) lymphocytes express A, B. Lea and Leb antigens, depending on the ABH secretor (Se) status of the donor; (2) ABH and Lewis antigens cannot be detected on monocytes and PMN regardless of Se status; (3) D, E, e, C, c, Fya, Fyb, Fy5, Jka, Jkb, Jk, K, k, M, N, S, s, U, Vel, Coa, Lan, Jk3Yta, Dib, Ge, Sc:1 or Lub antigens were not detected on lymphocytes, monocytes and PMN; (4) lymphocytes, monocytes and PMN all express I, i, P and P1 antigens. The absence of selected Rhesus, Duffy, Kell, Kidd and other antigens on PMN is at variance with some previous reports. Furthermore, the distribution of RBC antigens on lymphocytes and monocytes has not been previously characterized using immunofluorescence flow cytometry. PMID- 3511948 TI - Evaluation of a new enzyme-linked immunoassay for terminal deoxynucleotidyl transferase in haematologic malignancies. AB - We have evaluated a new solid phase enzyme immunoassay (EIA) for detection of terminal deoxynucleotidyl transferase (TDT). The EIA is greater than 100 times more sensitive than previously used tests for enzyme activity. In 284 clinical specimens of human peripheral blood and bone marrow, the EIA detected TdT antigen in 97% of peripheral blood and 100% of bone marrow samples that were positive for enzymatic activity. The excellent sensitivity and specificity of this new test suggests that it can be used in clinical situations where quantitative TdT measurements are desired. PMID- 3511949 TI - Influence of graft-versus-host disease prophylaxis on early T-lymphocyte regeneration following allogeneic bone marrow transplantation. AB - An early decrease in the ratio between T4+ and T8+ T lymphocytes has been shown to correlate with the development of grade II-IV GVHD in allogeneic bone marrow transplant (BMT) recipients receiving methotrexate (MTX) as prophylaxis for acute graft-versus-host disease (GVHD). This study compares the onset of T-cell regeneration in patients receiving cyclosporin A (CyA) with those receiving MTX. Firstly, lymphoid recovery occurred at a significantly faster rate in the patients on CyA. Secondly, in those patients, the repopulation of T4+ and T8+ T cells started simultaneously, whereas in patients on MTX the repopulation of the T8+ subset lagged about a week behind that of the T4+ subset. Thirdly, the decrease in the T4/T8 ratios as a function of the lymphocyte counts occurred at a significantly slower rate in the patients on CyA than in those on MTX. Thus, the differences in the onset of T-cell regeneration in BMT recipients on CyA as compared with those on MTX abolished the correlation of the T4/T8 ratio changes with grades II-IV GVHD as described in patients receiving MTX. PMID- 3511950 TI - The significance of host haemopoietic cells detected by cytogenetic analysis of bone marrow from recipients of bone marrow transplants. AB - Bone marrow from 39 patients who received a bone marrow transplant (BMT) from a matched donor of different sex were studied by chromosome analysis for evidence of mixed haemopoietic chimaerism (MC). Recipient metaphases were detected in the bone marrow of 10 patients after BMT. Patients in whom MC was detected within 6 weeks of BMT did not all have a poor outcome. Two of seven are disease-free survivors at greater than 470 and greater than 632 d. All three patients in whom MC was diagnosed more than 6 weeks after BMT subsequently relapsed. Four factors appear to be important in determining the probability of relapse when MC is detected in a patient after BMT: the timing of detection of residual recipient cells; the proportion of these cells in the bone marrow; persistence of these cells in increasing proportions; and the karyotype of the recipient metaphases detected. Cytogenetic assessment may provide the earliest indication of relapse in these patients. In addition, this study provides further evidence that cyclophosphamide and total body irradiation, as used in these patients, may be inadequate conditioning therapy for BMT. PMID- 3511951 TI - Is asbestos or asbestosis the cause of the increased risk of lung cancer in asbestos workers? PMID- 3511952 TI - A statistical examination of the accuracy of combining femoral length and biparietal diameter as an index of fetal gestational age. AB - The use of femur length (FL) and biparietal diameter (BPD) for estimation of gestational age (GA) was investigated using 1123 ultrasound measurements between the 14th and 41st week of gestation. Femur length was found to provide a more accurate index than BPD for the entire range of gestational age considered. If an interval of approximately +/- 2.5 weeks is considered 'satisfactory', the accuracy of FL past the 31st week is not sufficient to justify its use. Combining the FL and BPD measurements via the formula: GA = 9.565 + (0.0414) FL + (0.0024573) FL2 + (0.15209) BPD - (0.00015827) BPD2 provides an index of gestational age accurate to approximately +/- 2.5 weeks up to the 32nd week of gestation and accurate to approximately +/- 2.75 weeks up to the 34th week of gestation. This is the first time that combining FL and BPD in a statistically rigorous manner has been proposed as an index of gestational age, and we suggest that this combination be used as a routine tool in its assessment. PMID- 3511953 TI - Conceptual dating using ultrasonically measured fetal femur length and abdominal diameters in early pregnancy. AB - The association between fetal anthropometric measurements and conceptual age was determined for the femur length and the mean of two abdominal diameters for conceptual ages between 10 and 20 completed weeks. The conceptual age used for reference was determined by the fetal crown-rump length measured at an earlier examination. Two equations are presented for the calculation of conceptual age from isolated estimations of the femur length or the mean of two abdominal diameters. Mean abdominal diameter and femur length measurement values were found to have similar precisions of dating. PMID- 3511954 TI - Estimation of gestational age by last menstrual period, by ultrasound scan and by SP1 concentration: comparisons with date of delivery. AB - The date of delivery in 62 normal pregnant women was predicted by last menstrual period, by ultrasound scan and by the serum concentration of Schwangerschaftsprotein 1 (SP1). It was found that SP1 concentration in the first trimester gave as reliable an indication of when labour would occur as did the last menstrual period or ultrasound scan. PMID- 3511955 TI - Birthweight-for-gestational age charts based on early ultrasound estimation of gestational age. AB - Birthweight-for-gestational age charts were based on the analysis of 3888 consecutive births in which the gestational age was estimated by measuring the fetal biparietal diameter before the 20th week of gestation. The data showed, in contrast to previous studies, a linear relation between gestational age and birthweight without inflection after term. The regression parameters showed a strongly significant difference between girls and boys. Thus, boys were 1.5% heavier than girls at 190 days gestation and 3.6% heavier at 300 days gestation. The linearity in the birthweight-for-gestational age charts could be due to the more reliable gestational age based on early ultrasound. PMID- 3511956 TI - A syndrome of liver damage and intravascular coagulation in the last trimester of normotensive pregnancy. A clinical and histopathological study. AB - Six women without hypertension or proteinuria, admitted for severe upper abdominal pain in the third trimester of pregnancy had elevated serum liver enzymes (SGOT, SGPT), markedly increased serum LDH levels, thrombocytopenia and abnormal blood coagulation tests, in particular low antithrombin III levels, indicating disseminated intravascular coagulation (DIC). Liver biopsies showed periportal and/or focal parenchymal lesions with large fibrin deposits, comparable to the liver lesions in eclampsia. Immunofluorescence (IF) showed microthrombi and large fibrin deposits. Three of the six women recovered spontaneously before delivery; in the remaining three all signs and symptoms rapidly disappeared after delivery. Perinatal outcome was poor. Seven women with pregnancy-induced hypertension and elevated serum liver enzymes constituted a reference series. Histopathological examination of liver biopsies in the reference group revealed periportal and/or focal parenchymal lesions in three whereas IF showed fibrin deposition in all seven, but less extensive than in the study group. The present findings indicate that upper abdominal pain in the last trimester of pregnancy can be caused by a syndrome of (pre)-eclamptic liver damage and DIC, even when hypertension and proteinuria are lacking. PMID- 3511957 TI - A comparison of fetal heart rate monitoring and umbilical artery waveforms in the recognition of fetal compromise. AB - Antenatal fetal heart rate monitoring was compared with the study of umbilical artery flow velocity waveforms for the recognition of fetal compromise in 170 patients considered at high fetal risk. In 53 patients the infant had a 5-min Apgar score of less than 7 and/or a birthweight less than 10th centile of weight for gestation. Fetal heart rate traces were classified as reactive or non reactive and also assessed with a modified Fischer score. The systolic/diastolic A/B ratio was measured in the umbilical artery waveform. Fetal compromise was more efficiently recognized by study of the umbilical artery waveforms. The sensitivity of assessment by umbilical artery waveforms was 60% compared with 17% and 36% respectively, for the two methods of scoring fetal heart rate traces. This was not associated with an increase in false-positive results as the predictive value of both positive (64% compared with 69 and 58%) and negative (83% compared with 72 and 75%) results was similar when umbilical artery waveform analysis was compared with the two methods of scoring fetal heart rate traces. Specificity was also similar (85% compared with 97 and 88%). PMID- 3511958 TI - The use of a birthroom: a randomized controlled trial comparing delivery with that in the labour ward. AB - A randomized controlled trial of two environments for delivery was conducted at Queen Charlotte's Maternity Hospital. A total of 253 parous women expecting to have a labour ward delivery were invited to participate in the trial but only 148 agreed. These women were randomly allocated to be delivered either with standard labour ward management (n = 72) or in the birthroom--a small bedroom decorated in a homely manner, without facilities for epidural analgesia or electronic fetal monitoring (n = 76). Eleven women in the birthroom group and 10 in the labour ward group withdrew from the trial before labour and four were transferred from the birthroom to the labour ward when in labour. A questionnaire sent in the postnatal period to the women who completed the trial was returned by 80%. In the birthroom group there was significantly (i) decreased admission-to-delivery interval (ii) less analgesia (iii) more freedom of movement (iv) less suturing (v) increased rooming-in. No difference was found in the assessment of difficulty of labour nor in the method of subsequent infant feeding. PMID- 3511959 TI - Photokeratoscopy in fitting contact lens after penetrating keratoplasty. AB - The formula based on keratometric readings which is generally used is unsatisfactory for fitting contact lenses after penetrating keratoplasty, possibly owing to lack of information on the peripheral corneal toricity. In these studies a photokeratoscope was used to examine the entire graft topography. In all cases the corneal configuration became more normal after suture removal, but a considerable toricity still remained, especially near the graft-host junction. One month after removal of sutures spherical hard contact lenses (polymethylmethacrylate, PMMA) were fitted to 30 patients in accordance with data obtained by computerised analysis of the photokeratograms. Of the 30 patients (contact lens wearers) 27 (90%) obtained a stable vision of better than 20/30 for eight hours daily, and 24 (80%) achieved a stable vision of 20/20 for their full waking hours. After one year the contact lens wearers showed a significant decrease in the extent of astigmatism when compared with the non-contact-lens wearers (10 patients). These results suggest that the photokeratoscope can be more useful than ordinary keratometers in fitting contact lenses after keratoplasty, and that hard contact lenses have moulding effects on the graft topography. PMID- 3511960 TI - Multiple cotton wool spots following bone marrow transplantation. PMID- 3511961 TI - IgG and IgA immune response against klebsiella in HLA-B27-associated anterior uveitis. AB - Enteric infections with Gram-negative bacteria are thought to play an important part in HLA-B27-associated disease such as Reiter's syndrome and reactive arthritis. But the role of bacterial infections in HLA-B27-positive ankylosing spondylitis (AS) and acute anterior uveitis (AU) is still controversial. A special interest has recently been devoted to the role of klebsiella infection in HLA-B27-associated disease. We studied the humoral immune response against a 'cross-reactive' strain of Klebsiella pneumoniae in 62 patients with anterior uveitis and 33 healthy controls. The anterior uveitis patients were subdivided into 25 HLA-B27-negative patients without AS (B27- AU+ AS-), 17 HLA-B27-positive patients without ankylosing spondylitis (B27+ AU+ AS-), and 19 HLA-B27-positive patients with ankylosing spondylitis (B27+ AU+ AS+). Total serum IgA was higher in patients than in controls in both the B27+ AU+ AS+ and B27+ AU+ AS- patients but not in the B27- AU+ AS- group. No abnormalities were observed in the total serum IgG levels. The level of both the IgG and IgA klebsiella antibodies did not differ in the various patient groups tested as compared with the controls. Comparisons between the patient groups showed that the IgG anti-klebsiella response was higher in B27-positive patients patients without AS than in those with AS. These results suggest that stimulation of mucosal surfaces may play a role in HLA-B27-associated anterior uveitis. Whether klebsiella organisms are involved in this stimulation remains unclear. PMID- 3511962 TI - A novel suppressor tRNA from the dimorphic fungus Candida albicans. AB - Unfractionated tRNAs from a number of prokaryotes and eukaryotes were examined for their ability to promote termination codon readthrough in a cell-free system isolated from Saccharomyces cerevisiae. tRNA from the dimorphic fungus Candida albicans was found to have significant UGA and UAG readthrough activity and this activity was present in tRNA extracted from both the yeast and the hyphal phase of the fungus. Unusually the efficiency of readthrough activity in vitro was not affected by the [psi] determinant. C. albicans tRNA was fractionated by one dimensional and two-dimensional gel electrophoresis and both readthrough activities appeared to be associated with a single species of tRNA. PMID- 3511963 TI - The role of upstream sequences in determining the strength of an rRNA promoter of E. coli. AB - In vitro transcription experiments were carried out with recombinant plasmids containing the promoters of the rrnB gene of Escherichia coli, and with deletion mutants lacking various lengths of the AT-rich sequence upstream from the P1 promoter of that gene. The main conclusions are as follows: The in vitro transcriptional activity of the P1 and P2 promoters of the rrnB gene are an order of magnitude higher on closed-circular (supercoiled) templates than on linear DNA; the strong P1 and P2 promoters are heparin-sensitive on linear templates, and on circular DNA only P2 is heparin-resistant; removal of the upstream AT-rich region did not decrease the apparent in vitro strength of the P1 promoter under standard conditions (50 mM KCl, high RNA polymerase/DNA ratio); at higher salt concentrations, or with a lower RNA polymerase/DNA ratio, the deletion mutants displayed much lower in vitro transcriptional activity than the wild-type, and the apparent weakening of the P1 promoter was roughly proportional to the length of the deleted AT-rich sequence. The implications of these findings for the possible in vivo role of the AT-rich region are discussed. PMID- 3511964 TI - Mechanism of inhibition of dihydrofolate reductases from bacterial and vertebrate sources by various classes of folate analogues. AB - Different classes of folate analogues have been examined with respect to the mechanism of their inhibition of dihydrofolate reductases from Escherichia coli and chicken liver. In addition, the degree of synergism between the binding of these compounds and NADPH has been investigated. Methotrexate acts as a slow, tight-binding inhibitor of both enzymes whereas trimethoprim is a slow, tight binding inhibitor of the enzyme from E. coli and a classical inhibitor of the chicken-liver enzyme. Pyrimethamine, 2,4-diamino-6,7-dimethylpteridine, a phenyltriazine, folate and folinate exhibit classical inhibition. The degree of synergism between the binding of NADPH and the inhibitor varied from low for pyrimethamine and folate to very large for the phenyltriazine which binds to the chicken-liver enzyme almost 50 000-times more tightly in the presence of NADPH. The degree of synergism is reflected in the type of inhibition that the folate analogues yield with respect to NADPH. Compounds which exhibit slight synergism give noncompetitive inhibition whereas those with a high degree of synergism yield uncompetitive inhibition. With the exception of folinate, all compounds that act as classical inhibitors give rise to competitive inhibition with respect to dihydrofolate. Folinate exhibits competitive inhibition against NADPH and noncompetitive inhibition against dihydrofolate. These results are consistent with the formation of an enzyme-dihydrofolate-folinate complex. The (6S, alphaS) diastereoisomer of folinate was bound at least 1000-times more tightly than the (6R, alphaS)-diastereoisomer. Consideration has been given to the possible interactions that occur between residues on the enzyme and groups on the inhibitor that give rise to slow-binding inhibition. PMID- 3511965 TI - 63/65Cu and 1/2H2O isotope shifts in the low-temperature resonance Raman spectrum of fungal laccase. AB - Resonance Raman spectra are reported for the type 1 Cu site of fungal laccase at 295 and 77 K. The low-temperature spectra show enhanced resolution and reveal several weak bands not previously observed, as well as overtone and combination bands associated with the strong approximately equal to 400 cm-1 fundamentals. A novel low-temperature Raman difference technique has been used to obtain 63/65Cu and 1/2H2O isotope shifts. The strong band at 428 cm-1, and the moderate intensity bands at 408 and 387 cm-1 show small (under 0.6 cm-1 63/65Cu isotope shifts. The aggregate shift is substantially less than that expected for an isolated Cu-S(cys) stretch, implying a high degree of mixing of this coordinate with internal modes of the ligands. 1/2H2O shifts of 1.1 and approximately equal to 0.3 cm-1 are observed for the 387 and 428 cm-1 bands. The isotope shift patterns are quite similar for fungal and tree laccase, as are the frequencies of the dominant bands, indicating that the large differences in relative intensity are primarily associated with differences in the excited state potential. The frequency and isotope shift patterns are appreciably different, however, from those observed for azurin and stellacyanin. In contrast to the other 'blue' Cu proteins, fungal laccase shows no moderate intensity band near 270 cm-1 which can be associated with Cu-imidazole stretching; weak features are seen in this region, but the intensities are too low to determine their 1/2H2O sensitivity. The C-S stretching mode of fungal laccase is identified at 737 cm-1, shifting to 741 cm-1 at 77 K. It is about 10 cm-1 lower than for most 'blue' Cu proteins, and the difference is suggested to reflect smaller kinematic coupling between the C-S and Cu-S coordinates, associated with a smaller Cu-S-C angle. Combination modes of the approx. 400 cm-1 fundamentals are substantially stronger, relative to the overtones, than is predicted by first-order scattering theory, implying changes in the excited-state normal modes (Dushinsky effect) associated with force constant alterations. PMID- 3511966 TI - Size difference in catalytic polypeptides of two active forms of mouse DNA polymerase alpha and separation of the primase subunit from one form, DNA replicase. AB - There are two active forms of DNA polymerase alpha in mouse cells. One form (DNA replicase) is a DNA polymerase associated with primase activity and the other form (7.3 S polymerase) has no primase activity (Yaugar, T., Kozu, T. and Seno, T. (1982) J. Biol. Chem. 257, 11121-11127). The primase activity was dissociated from partially purified DNA replicase by hydroxyapatite column chromatography in buffer containing dimethyl sulfoxide and ethylene glycol. Nearly homogeneous primase, consisting of a 58 kDa polypeptide was obtained by glycerol gradient sedimentation and DEAE-cellulose column chromatography. Experiments on the effect of proteinase treatment and measurement of the molecular weight of the catalytic polypeptide of DNA replicase after its dissociation from the primase polypeptide indicated that the primase is not part of the DNA polymerase molecule, but an independent protein associated with DNA polymerase alpha, and that the latter is a 115 kDa catalytic polypeptide. The other form of DNA polymerase alpha, 7.3 S polymerase, consists of a 72 kDa catalytic polypeptide. Thus, the two forms of mouse DNA polymerase alpha have partially, if not completely, different catalytic polypeptide structures, suggesting that the 7.3 S polymerase is not simply formed from DNA replicase by dissociation of the primase subunit. PMID- 3511967 TI - Localization of intracellular triacylglycerol and cholesteryl ester transfer activity in rat tissues. AB - A triacylglycerol and cholesteryl ester transfer activity has been isolated from rat liver. After homogenization, the liver cells were subfractionated into the 10 000 X g pellet, microsomal fraction and postmicrosomal supernatant. Most of the transfer activity appeared to be associated with the microsomal fraction. Rough and smooth microsomes contained nearly equal transfer activities. When isolated microsomes were subject to proteolytic attack, the transfer activity was not inactivated, unless it had been released from the microsomes prior to proteolytic treatment. This indicates that the activity is probably located within the microsomal vesicles. Similar transfer activities were found in the intestinal mucosa of rats, whereas little or no activity was detected in the brain, heart, kidney, or plasma. PMID- 3511968 TI - Effects of the temperature range and the lack of beta-ketoacyl acyl-carrier protein synthase II on fatty acid synthesis in Escherichia coli K12 after shifts in temperature. AB - Escherichia coli K12 cells grown at higher temperatures and then subjected to lower temperatures produce fatty acids with higher unsaturated/saturated ratios than cells completely adapted to the lower temperatures (Okuyama et al. (1982) J. Biol. Chem. 257, 4812-4817). This hyper-response was not an artefact of chloramphenicol treatment and was observed when the shift-down was more than 20 degrees C in the cells grown at either 40 degrees C or 35 degrees C. In contrast, cells grown at either 25 degrees C or 30 degrees C showed no appreciable hyper response in terms of unsaturated/saturated ratio on temperature shifts to as low as 10 degrees C. By combining shift-down and shift-up experiments, we could show the presence of different types of temperature dependency in the fatty acid synthesizing systems of cells grown at various temperatures. Contrary to wild type cells which synthesized mainly cis-vaccenate on down-shift to 10 degrees C, a mutant strain lacking beta-ketoacyl acyl-carrier protein synthase II synthesized more palmitoleate (16:1) and less palmitate at 10 degrees C than at 40 degrees C. The average chain lengths of saturated and unsaturated fatty acids also changed, but differently, between the mutant and wild-type cells on shifts of temperature. Thus, the mutant strain has a temperature-dependent fatty acid synthesizing system qualitatively different from that seen in a wild-type strain. PMID- 3511969 TI - Sensitive enzyme-immunostaining and densitometric determination of ganglio-series gangliosides on thin-layer plate: pmol detection of gangliosides in cerebrospinal fluid. AB - An immunochemical method has been developed for sensitive detection and determination of ganglio-series gangliosides using thin-layer chromatography/enzyme-immunostaining. After chromatography of gangliosides, the plate was treated with Arthrobacter ureafaciens sialidase to remove all sialic acids from ganglio-series gangliosides. For the complete hydrolysis of gangliosides, sodium taurodeoxycholate was found to be required. The resulting asialo-glycolipids, GA2 and GA1 were reacted first with affinity-purified anti GA2 and anti-GA1, respectively, and second with horseradish peroxidase-conjugated anti-rabbit IgG. Being highly sensitive and reproducible, it allows the characterization of gangliosides in cerebrospinal fluid which cannot be detected by classical methods. PMID- 3511970 TI - Regulation of the synthesis of lipoprotein lipase in adipose tissue by dexamethasone. AB - The incorporation of [3H]leucine into lipoprotein lipase during incubations of rat epididymal fat-bodies in vitro was significantly stimulated by dexamethasone, whereas total protein synthesis was unaffected. The stimulation by dexamethasone required the presence of insulin. The results suggest that dexamethasone, in the presence of insulin, may specifically induce lipoprotein lipase synthesis in adipose tissue. PMID- 3511971 TI - Studies on the effect of the hepatocyte-stimulating factor on galactose-beta 1--- 4-N-acetylglucosamine alpha 2----6-sialyltransferase in cultured hepatocytes. AB - Rat hepatic Gal beta 1----4GlcNAc alpha 2----6 sialyltransferase is released into the blood at elevated levels following an inflammatory challenge: this is a typical response of the group of plasma proteins known as acute-phase reactants. In the present study, primary cultures of liver parenchymal cells are used to demonstrate that the same hepatic cell type that produces plasma proteins such as fibrinogen also produces and releases sialyltransferase. Hepatic production of sialyltransferase is stimulated by a major regulator of hepatic acute-phase reactant production, the hepatocyte-stimulating factor (HSF), while another monokine, interleukin-1, does not affect hepatocyte sialyltransferase production. The maximum increase in sialyltransferase occurs 48 h after exposure to HSF which is considerably later than the fibrinogen response. The sialyltransferase that is stimulated by HSF is the Gal beta 1----4GlcNAc alpha 2----6 isozyme. PMID- 3511972 TI - Studies on the specific activity of [gamma-32P]ATP in adipose and other tissue preparations incubated with medium containing [32P]phosphate. AB - The specific activity of the gamma-32P position of ATP was measured in various tissue preparations by two methods. One employed HPLC and the enzymatic conversion of ATP to glucose 6-phosphate and ADP. The other was based on the phosphorylation of histone by catalytic subunit of cAMP-dependent protein kinase (Hawkins, P.T., Michell, R.H. and Kirk, C.J. (1983) Biochem. J. 210, 717-720). The HPLC method also allowed the incorporation of 32P into the (alpha + beta) positions of ATP to be determined. In rat epididymal fat-pad pieces and fat-cell preparations the specific activity of [gamma-32P]ATP attained a steady-state value after 1-2 h incubation in medium containing 0.2 mM [32P]phosphate. Addition of insulin or the beta-agonist isoprenaline increased this value by 5-10% within 15 min. Under these conditions the steady-state specific activity of [gamma 32P]ATP was 30-40% of the initial specific activity of the medium [32P]phosphate. However, if allowance was made for the change in medium phosphate specific activity during incubations the equilibration of the gamma-phosphate position of ATP with medium phosphate was greater than 80% in both preparations. The change in medium phosphate specific activity was a combination of the expected equilibration of [32P]phosphate with exchangeable intracellular phosphate pools plus the net release of substantial amounts of tissue phosphate. At external phosphate concentrations of less than 0.6 mM the loss of tissue phosphate to the medium was the major factor in the change in medium phosphate specific activity. It is concluded that little advantage is gained in employing external phosphate concentrations of less than 0.6 mM in experiments concerned with the incorporation of phosphate into proteins and other intracellular constituents. Indeed, a low external phosphate concentration may cause depletion of important intracellular phosphorus-containing components. PMID- 3511973 TI - Insulin receptors and insulin effects on type II alveolar epithelial cells. AB - Type II alveolar epithelial cells (pneumocytes) were isolated to purity from adult rabbits and analyzed for the presence of cell surface insulin receptors and for effects of insulin on cells. Assays were performed on cells cultured for 24 h in Eagle's minimum essential medium. Insulin binding to cells in culture approached a steady-state level by 180 min at 15 degrees C and remained constant for at least 1 h. Competition experiments using native insulin, proinsulin and desoctapeptide supported specificity of binding. Scatchard analysis of binding revealed a class of high-affinity receptors with Kd = 1.5 X 10(-10) M and a low affinity component with Kd = 4 X 10(-9) M. The number of receptors was estimated at 2000-4000/cell. Insulin added to cell cultures of type II pneumocytes in concentrations from 5 X 10(-11) to 5 X 10(-8) M resulted in a dose-related increase in uptake of 2-deoxyglucose by cells. Insulin also stimulated the incorporation of choline and glucose into phosphatidylcholine and disaturated phosphatidylcholine. PMID- 3511974 TI - Identification and partial purification of the insulin-responsive glucose transporter from 3T3-L1 adipocytes. AB - The glucose transporter in 3T3-L1 adipocytes has been identified as a polypeptide of average Mr 51000 by means of its reaction with antibodies raised against the purified human erythrocyte glucose transporter and by photolabeling with [3H]cytochalasin B. The finding that the antibodies immunoprecipitated the photolabeled polypeptide demonstrated that both methods detected the same polypeptide. The 3T3-L1 adipocyte glucose transporter has been partially purified. The main steps in the purification procedure were the preparation of salt-washed cellular membranes, Triton X-100 solubilization, and immunoaffinity chromatography on affinity-purified antibodies against the human erythrocyte transporter. A simple method of affinity purification of these antibodies, which consists of adsorption from serum onto protein-depleted erythrocyte membranes and release with acid, and an assay for the 3T3-L1 adipocyte transporter polypeptide, which employs immunoblotting, have been developed. PMID- 3511975 TI - 3-O-methyl-D-glucose uptake in isolated bovine adrenal chromaffin cells. AB - The characteristics and regulatory nature of sugar transport in freshly isolated bovine adrenal chromaffin cells were investigated. Transport was measured by following the cell/medium distribution of non-metabolizable glucose analogue, 3-O methyl-D-glucose. The uptake of 3-O-methyl-D-glucose was was mediated by a saturable transport system with a Km of 8.2 mM and a Vmax of 0.69 nmol/mg protein per min. Basal 3-O-methyl-D-glucose transport was competitively inhibited by D glucose and a countertransport effect was demonstrated. Cytochalasin B and phloretin, which are specific inhibitors of carrier-mediated glucose transport, significantly decreased basal 3-O-methyl-D-glucose uptake. Basal transport was stimulated by 50 mU/ml insulin, an effect associated with an increase in Vmax. The stimulatory effect of insulin was depressed in medium lacking external Ca2+, or containing the Ca2+-antagonistic ion, La3+, or the Ca2+ channel blocker, methoxyverapamil (D-600). The data suggest that the uptake of 3-O-methyl-D glucose in freshly isolated bovine adrenal chromaffin cells is mediated by a specific facilitated diffusion mechanism, and is subject to regulation by insulin, thus resembling sugar transport in muscle. In addition, the insulin effect appears to depend on the presence of extracellular Ca2+. PMID- 3511976 TI - [Ecological and toxicological control over the status of the environment by the methods of physicochemical biology]. AB - Xenobiotic metabolism in the fish liver has been investigated with a view of developing test-system for biomonitoring based on multienzyme membrane-bound complexes. Extraction methods of xenobiotics from harmful pollutants and some biological tissue have been described using various sorbents and solvents. The own and literary data on the study of mutagenic effect of this contaminants and carcinogens in the Ames test-system in the presence of postmitochondrial fraction S9 from fish liver with 3-methylcholanthrene induced by microsomal oxidation system have been demonstrated. PMID- 3511977 TI - Evolution of the barrier effects against an exogenous drug-sensitive Escherichia coli strain after single or repeated oral administration to newborns and infants aged up to three months admitted to an intensive-care unit. AB - 60 neonates--42 newborns 0-30 days old and 18 infants 31-90 days old--without previous antibiotic treatment were chosen and randomized into three groups (A, B, C). The strain of Escherichia coli administered was antibiotic-sensitive and azide-resistant (E. coli AZ). The digestive implantation was quantified by an index. We studied the variations of this index between the single administration group (A) and the 5 administrations group (B) and with age in both groups. Drug resistant enterobacteria were also numbered in each stool, and their variations were studied by comparing groups A and B to a control group (C) receiving no administration. Multiple administrations did not lead to different results from the single ones. Age played a negative role in the colonizations after single administration, but a positive one after multiple administrations. Drug-resistant enterobacteria were not affected by any procedure. The drug susceptibility of E. coli AZ was lost in only 1 infant. PMID- 3511978 TI - Study of the circular dichroism of bacteriophage phi 6 and phi 6 nucleocapsid. PMID- 3511979 TI - [Efficacy of using litonit in the combined therapy of infectious-inflammatory kidney lesions in alcoholism]. AB - The results of 250 experiments suggest the advisability of using a new antialcoholic metabolite drug, litonit, in combined therapy of infectious inflammatory kidney disorders occurring in alcoholism. The course of litonit injections does not only increase considerably the content of oxidized and reduced nicotinamide coenzymes, but also normalizes the number of IgA, IgG and IgM. Certain drug-induced functional and immunological shifts are now believed to indicate the increase in the functional renal capacity and enhanced kidney resistance to inflammation. PMID- 3511980 TI - [Development and differentiation of bone marrow mechanocytes]. AB - Morphological studies in the model with the complete destruction of bone marrow in the diaphysis of the tubular bone have revealed the process of stromal elements regeneration. Within the first 24 hours after the trauma insignificant accumulations of fibroblast-like cells in the lumen of some vascular channels have been observed in cell-free cortical plates. In two days spheric cells with a large dense nucleus were detected in tissue-free bone-marrow diaphysis cavity. This fact seems indicative of the viability of the vascular channel cells. This was manifested in the regained tinctorial and biological properties (i.e. the ability to proliferate). The recovery of these properties are likely to be related to vessel pericytes in the microcirculatory net of the vascular channels. PMID- 3511981 TI - Structure, function, and molecular defects of factor IX. PMID- 3511982 TI - The detection of specific antibody formation to recall antigens after human bone marrow transplantation. AB - The results of this study show that donor-derived immunity can be detected and persists in long-term survivors with and without chronic graft-v-host disease (GVHD) after human marrow grafting. Seventy-one marrow recipients (60 long-term and 11 short-term survivors) were studied for the presence of specific serum IgG antibodies to tetanus toxoid (TT), and 46 marrow recipients (35 long-term and 11 short-term) were tested for antibodies to diphtheria toxoid (DT) and measles virus after marrow grafting using an enzyme-linked immunosorbent assay. Of the 60 long-term survivors, 31 were healthy and 29 had chronic GVHD. None of the recipients were immunized to the test antigens postgrafting. Most long-term healthy recipients exhibited antibody titers to the recall test antigens, whereas only a minority of those with chronic GVHD had antibody titers to recall antigens. In healthy long-term recipients (greater than or equal to one year postgrafting) whose donors were immune to the test antigens, 25 of 31 had titers to TT, 11 of 17 had titers to DT, and 12 of 20 had titers to measles. In recipients with C-GVHD, 13 of 29 had titers to TT, six of 15 had titers to DT, and six of 15 had titers to measles virus. Within 100 days postgrafting, 11 of 11 had anti-TT titers, ten of ten had anti-DT titers, and seven of eight had antimeasles virus titers. PMID- 3511984 TI - Cellular ras oncogene expression and cell cycle measured by flow cytometry in hematopoietic cell lines. AB - Human hematopoietic malignancies provide an excellent model for the study of the activity of cellular oncogenes in a context of known defects in cell proliferation and differentiation. A flow cytometric immunofluorescence assay was developed to quantitate the expression of the cellular ras oncogenes in relation to the cell cycle in individual leukemic cells. Specific binding of a monoclonal antibody to the 21-kd protein (p21ras) encoded by the Ha-ras, Ki-ras, and N-ras genes was measured by flow cytometry and confirmed by fluorescence microscopy. P21ras was detected in 416B, a murine hematopoietic precursor cell characterized by a high level of Ki-ras expression, and in the human leukemic cell lines P-12 and KG-1. The presence of p21ras in the cell lines was also shown by immunoprecipitation. Cellular DNA content was determined simultaneously to define cell cycle phases. There was an equal distribution of p21ras in G1, S, and G2M, with considerable heterogeneity of ras gene expression in the G1 compartment. The assay allows oncogene expression to be studied in populations of intact single cells in which cell heterogeneity is maintained, requires very few cells per sample, and directly correlates oncogene expression to cell kinetic data. PMID- 3511983 TI - Amplification of genes encoding human myeloid membrane antigens after DNA mediated gene transfer. AB - Spontaneous amplification of genes encoding two different human myeloid surface antigens was observed after DNA-mediated gene transfer of cellular DNA from the human myeloid cell line HL-60 into NIH-3T3 mouse fibroblasts. Transformed recipient cells with highly amplified expression of either of two donor membrane polypeptides, gp150 or p67, were isolated with a fluorescence-activated cell sorter (FACS), using monoclonal antibodies specific for human myeloid cells. Immunoprecipitation of enzymatically radioiodinated polypeptides from the surface of transformed NIH-3T3 cells confirmed that expression of these proteins was amplified tenfold to 20-fold in comparison to their expression on human myeloid cell lines. The cellular DNA of cloned secondary and tertiary transformants expressing high levels of gp150 and p67 contained amplified sets of DNA restriction fragments that hybridized with human repetitive DNA sequences. Cytogenetic analysis of subclones overexpressing gp150 revealed extrachromosomal double minutes (DMs), whose presence correlated with the unstable expression of the membrane polypeptide. Human sequences in gp150-positive clones did not localize to chromosomes, consistent with their association with extrachromosomal DMs. By contrast, p67-positive subclones stably expressed the antigen, and in situ hybridization to metaphase spreads demonstrated that amplified human DNA sequences were integrated into a specific marker chromosome. Cytogenetic analysis of the parental NIH-3T3 subclone used in these studies disclosed DMs in a low percentage of metaphases, suggesting that the recipient cells have a propensity for amplifying donor DNA. PMID- 3511985 TI - Acid phosphatase activity in mononuclear phagocytes and the U937 cell line: monocyte-derived macrophages express tartrate-resistant acid phosphatase. AB - Tartrate-resistant acid phosphatase (TRAcP) is used as a marker for osteoclasts, which are believed to be derived from phagocytic cells or phagocyte stem cell precursors. To further investigate the relationship between monocytic phagocytes and osteoclasts, acid phosphatase (AcP) activity was measured by three different techniques in human peripheral blood monocytes, monocyte-derived macrophages, and the U937 cell line. We found that cytochemistry and gel electrophoresis led to similar results, but that the colorimetric assay was inconsistent. Normal human peripheral monocytes expressed both tartrate-sensitive and -resistant AcP. In culture these cells formed polykaryons and expressed TRAcP activity that was further identified as an isoenzyme associated with bone tissue. In contrast, the U937 cells did not express TRAcP activity as measured by gel electrophoresis. Both U937 cells and monocytes possess material that interferes with interpretation of the colorimetric assay of AcP. The presence of TRAcP in monocyte-derived macrophages further supports the relationship between phagocytic cells and bone osteoclasts. PMID- 3511986 TI - Bone marrow transplantation in patients aged 45 years and older. AB - Increasing age has been reported to be a poor prognostic factor for survival after bone marrow transplantation. We evaluated causes of death and frequency and type of complications after marrow grafting in 24 syngeneic and 39 allogeneic recipients who were 45 to 68 years old at the time of transplant. Most patients were in an advanced stage of hematologic malignancy. Among patients given syngeneic transplants, actuarial disease-free survival at 7 years is 20%. The major causes of death were relapse of leukemia and idiopathic interstitial pneumonia. Among allogeneic recipients, 9 (23%) are currently alive, and actuarial disease-free survival at 7 years is 11%. Cytomegalovirus pneumonia and septicemia were the most frequent causes of death. Patients over 50 years of age had the poorest survival rate (1/13), but many of these were transplanted in an advanced stage of their disease. However, among 12 patients transplanted while in remission or at an early stage of their disease, 5 are surviving 65 to 1,160 days after transplantation, with an actuarial survival rate of 22% at 3 years. This is in contrast to those who received their transplant in relapse: 2 out of 20 patients (10%) became long-term survivors, with a probability of survival of 15% at 3 years. The actuarial incidence of grade II through IV acute graft-v-host disease (GVHD) was 30% for allogeneic recipients 45 to 50 years of age. This was not significantly different from the incidence in younger patients. In patients 51 to 62 years of age, the actuarial incidence of acute GVHD was 79%; however, this group included three partially HLA-mismatched transplants. Ten of 15 patients surviving at least 3 months developed chronic GVHD. These results suggest that marrow transplantation is feasible and should be considered in patients over 45 years, especially if recipients are in good clinical condition and are at an early stage of their disease, such as the chronic phase of chronic myelogenous leukemia and preleukemia. For patients more than 50 years of age, allogeneic marrow grafting cannot presently be considered first-line therapy. PMID- 3511987 TI - Application of hyperthermia to the treatment of human acute leukemia: purging human leukemic progenitor cells by heat. AB - The application of hyperthermia to the treatment of neoplastic disease has focused on solid tumors. Since the hyperthermic sensitivity of human acute leukemia cells is not known, we have studied the in vitro response of human leukemic progenitor cells (L-CFU) to hyperthermia using a quantitative assay system for L-CFU. Human L-CFU were found to be more sensitive than committed normal myeloid progenitor cells to hyperthermic killing (41 to 42 degrees C). In addition, in the five acute myelogenous leukemic patients studied, it was shown that their leukemic progenitor cells--all types were studied according to the French-American-British diagnosis--were unable to form colonies when exposed to a temperature of 42 degrees C for 60 minutes, whereas the residual normal clones suppressed by the leukemic cell population were found to recover and to form more colonies in vitro as compared with untreated leukemic marrows. This strongly suggests that in vitro hyperthermia may selectively purge residual leukemic cells, especially L-CFU in stored remission bone marrow before autologous bone marrow transplantation. PMID- 3511988 TI - Mixed hematologic chimerism after allogeneic marrow transplantation for severe aplastic anemia is associated with a higher risk of graft rejection and a lessened incidence of acute graft-versus-host disease. AB - Ninety-six patients with severe aplastic anemia who received a sex-mismatched, HLA-identical allogeneic sibling marrow transplant had sequential cytogenetic analyses performed to determine the incidence and implications of posttransplant mixed hematologic chimerism. Of the 96 patients, 56 (58.3%) became mixed chimeras with coexisting host and donor cells detected in peripheral blood or marrow 14 days or later after transplant, and 40 patients (41.7%) were complete chimeras with 100% donor-type hematopoietic cells. The incidence of mixed chimerism was independent of prior blood production transfusions and infusion of donor buffy coat. The rejection rate was significantly increased in the mixed chimeric group, particularly in patients not receiving buffy coat (14 of 36 rejecting), although overall, the majority (69.7%) retained their first graft. Rejection was seen almost exclusively in patients exposed to multiple transfusions before transplantation. If patients who reject their first graft are censored, the overall incidence of grades II through IV acute graft-v-host disease (GVHD) was significantly reduced in those with mixed chimerism. Transfused patients with mixed chimerism in particular were less likely to develop grades II through IV acute GVHD. The incidence of chronic GVHD was similar in the two groups and did not significantly influence survival. In this study, mixed chimerism persisted for up to 395 days posttransplant, either the first graft being rejected or, more commonly, hematopoiesis reverting to 100% donor-type cells. Mixed lymphohematopoietic chimerism may persist in patients with aplastic anemia who have received matched allogeneic marrow transplants for significant periods before hematopoiesis reverts to donor cell type. PMID- 3511990 TI - The use of jargon in medical school libraries. AB - The public services divisions of forty-seven medical school libraries participated in a survey to document jargon used by library staff and users in referring to information sources in the health sciences. The survey yielded 624 unique instances of jargon, 54% of which were acronyms of initialisms. Examples of problems created by the use of jargon are given and the importance of the librarian as a facilitator of communication, even in the presence of automated information systems, is discussed. Implications of the study for novice librarians are suggested. The body of jargon appears to serve as an effective cross-professions communications device. PMID- 3511989 TI - Pathways for the reduction of oxidized glutathione in the Plasmodium falciparum infected erythrocyte: can parasite enzymes replace host red cell glucose-6 phosphate dehydrogenase? AB - Plasmodium falciparum-infected human red cells possess at least two pathways for the generation of reduced nicotinamide adenine dinucleotide phosphate (NADPH): (1) the glucose-6-phosphate dehydrogenase (G6PD) pathway and (2) the glutamate dehydrogenase (GD) pathway using glutamate as a substrate. Uninfected erythrocytes lack the GD pathway. The NADPH generated can be used to reduce oxidized glutathione (GSSG), which accumulates in the presence of an oxidative stress. In red cell G6PD deficiency, this pathway is reduced or absent, and the host cells as well as the parasites within them are vulnerable to oxidant stress. In view of the presence of the GD pathway in parasitized red cells and the recent description of a parasite-derived G6PD enzyme, we have asked whether the pathways for the reduction of GSSG provided by the parasite can substitute for the host G6PD in red cells deficient in G6PD activity. We have devised a functional assay in which the reduction rate of GSSG is monitored in the presence of buffered infected or control red cell lysates and substrates. Infected G6PD-deficient erythrocytes were obtained from in vitro cultures after a single prior growth cycle of the parasites in G6PD deficient cells to eliminate contaminating normal red cells. The results show that only parasitized red cells can reduce GSSG via the GD pathway. In parasitized G6PD Mediterranean red cells (completely G6PD deficient), there is a detectable GSSG reduction via the G6PD pathway, not found in uninfected lysates from the same individual. In G6PD A- (African type, featuring partial deficiency), a small increment in the G6PD-dependent reduction of GSSG can also be detected. However, when compared to G6PD normal red cells, the activities from the parasite-derived pathways are small and could not be considered substitutes for normal host enzyme activity. It is concluded that while the plasmodium provides additional pathways for the generation of NADPH that may serve its own metabolic needs, the host red cells and hence the parasite itself remain vulnerable to oxidant stress. PMID- 3511991 TI - The atomization of information. AB - Electronic information may be transmitted over communications channels or distributed in electronic packages. New means of distribution lead to new forms of intellectual organization. Some implications for researchers, scholars, publishers, and libraries are discussed. PMID- 3511992 TI - End-user information utilities in the health sciences. AB - Electronic information utilities in the health sciences such as MINET (Medical Information Network) are increasingly important as it becomes more convenient for end users to retrieve data and use various online information services such as electronic mail from personal computer workstations. MINET is examined in depth as the most fully developed end-user utility. Several other end-user utilities and full-text databases in the health sciences are listed and described. PMID- 3511993 TI - Electronic publishing: implications for health sciences libraries and librarians. AB - Increasingly we hear of "electronic publishing" in the form of books and journals made available as databases, either through traditional online services or through electronic message services. This paper explores its potential impact on the medical library community and on the relationship between end user and librarian. The librarian's new roles as intermediary, facilitator, and advocate for end users are examined. The question of developing expertise for evaluating information as well as facilitating access is addressed. PMID- 3511994 TI - An implanted ultrasound Doppler probe for microvascular monitoring: an experimental study. AB - An experimental investigation is presented into the use of pulsed ultrasound Doppler flowmetry with a percutaneously implanted probe as a monitor of microvascular anastomotic patency. The method accurately indicated and distinguished between experimental arterial and venous occlusion in epigastric island flaps. In free flaps it had advantages over manipulative, intraoperative tests of anastomotic patency and was a reliable post-operative monitor of flap circulation in the experimental model. The technique appears to have great potential as a post-operative monitor for free flaps, including those without a visible surface. PMID- 3511995 TI - Successful treatment of a severely burned elderly patient with homografts from her identical twin sister. AB - A case is reported of the permanent survival of split skin homografts from the twin sister of a 65-year-old women with 50% burns. This is the first time this has been reported in the elderly. As the homo- and autografts demonstrated the same survival pattern, the conclusion was drawn that the patient and her sister were very probably monozygotic twins. This was confirmed later by the results of the tests for HLA-typing, mixed lymphocyte studies and red blood cell antigens. PMID- 3511996 TI - Aggressive pilomatrixoma in a child: a case report. AB - Calcifying epitheliomas of Malherbe (pilomatrixomas) are benign calcifying tumours that arise from the hair matrix and present as a slow-growing dermal or subcutaneous mass most commonly located in the head and neck. Recurrences after tumour removal are rare. There have been reports in the past of invasive pilomatrixoma in the pre-auricular area (Krausen et al., 1974; Rothman et al., 1976; Sasaki et al., 1976; Arole et al., 1983), as well as other locations such as the right arm (Gromiko, 1927) and the upper back (Lopansri and Mihm, 1980). Two cases were also reported in adults by Weedon et al. in 1980. None of these tumours has occurred in children. PMID- 3511997 TI - Henry Tonks and his contemporaries. PMID- 3511998 TI - The clavicular head of pectoralis major musculocutaneous free flap. AB - A new free flap is described based on the deltoid vessels of the acromiothoracic axis. The flap is comprised of the clavicular head of pectoralis major muscle with overlying skin. It is also possible to harvest vascularised clavicular bone with the flap. The vascular anatomy is reviewed and the technique of raising the flap described. Its clinical application is illustrated with five cases. Four of these were intra-oral reconstructions and the fifth a composite osteo musculocutaneous flap to a lower limb following trauma. PMID- 3511999 TI - The formation and early history of the Stoke Mandeville Plastic Surgery Unit. PMID- 3512000 TI - The "second set" phenomenon as first shown in skin allografts. An historical case which shows also the behaviour of cell free collagen. AB - A 2-year-old girl had granulating areas on her abdomen and thigh following burns. On these were placed two "sets" of homografts from her father at an interval of 13 days. The first set showed extensive growth in all directions, the second set showed little or none. Between dressings on the 23rd and 26th day after the first set was applied (10 and 13 days after applying the second set) all the epithelium of both sets disappeared. This strongly suggested that a reaction to the father's epithelium had reached an intensity where it destroyed all "homograft" epithelium on the body. The collagenous ghosts of the homografts remained, became grown over by host epithelium and remained visible below it until the end of the observation period of 2 months. PMID- 3512001 TI - Ultrasound of the hip: a review of the applications of a new technique. AB - In an attempt both to reduce gonadal irradiation incurred with conventional radiology, and to image the unossified structures of the neonatal hip, several groups have undertaken studies on aspects of hip ultrasound particularly with reference to the paediatric patient. The ultrasound anatomy of the unossified infant hip has been described by Graf in Austria. The same author has devised an ultrasonographic classification for hip dysplasias and dislocations which has gained widespread acceptance in mainland Europe. Two studies have appeared exploring the use of ultrasound for the measurement of femoral neck anteversion but as yet these have not been compared with CT or trigonometric methods of assessment. Ultrasound has been shown to be effective in the detection of hip joint effusions, but its role in the management of the "irritable hip" has yet to be defined. PMID- 3512002 TI - Focal sparing in fatty infiltration of the liver. AB - Four cases of focal sparing in otherwise diffuse fatty infiltration of the liver are reported. The characteristic features are described as shown at sonography, computed tomography (CT) and scintigraphy. It is emphasised that, with ultrasound, if the increased echogenicity of the majority of the liver is not appreciated, then the area of normal hepatic parenchyma may be misinterpreted as a pathological hypoechoic lesion. PMID- 3512003 TI - Parametric imaging using digital subtraction angiography. AB - Digital subtraction angiography following an injection of iodinated contrast material can regularly produce good quality images. In addition to the conventional anatomical information, the timed sequence of digital images also contains useful temporal information which hitherto has been largely ignored. A simple method of image processing is described which utilises this timing information and presents it as a colour-coded set of functional images. Three parameters MAX, T-MAX and T-1/2 MAX are extracted from time-density curves, analogous to the time-activity curves of Nuclear Medicine, on a pixel-by-pixel basis. These parameters are used as a measure of overall organ perfusion, blood transit time between different vascular compartments, and as an indication of the initial delivery of contrast material to an organ. They have found use in the analysis of myocardial perfusion, before and after pharmacological intervention, and in the examination of the cerebral and renal circulations. The potential advantages of this technique derive from its superior spatial, temporal and contrast resolution. PMID- 3512004 TI - Radioprotection by ascorbate in vitro: temperature-dependent uptake. PMID- 3512005 TI - Accuracy of radiological staging procedures in non-seminomatous testis cancer compared with findings from surgical exploration and histopathological studies of extirpated tissue. AB - Preliminary and reviewed statements describing results from abdominal CT and US were compared with surgical findings and with the report from the histopathological investigation of extirpated retroperitoneal tissue. No false positive diagnoses of retroperitoneal metastases were made by CT investigation, while US made one false positive but revealed metastases in one patient overlooked by CT. The overall accuracies (correct answers/all patients) were 81% with CT and 80% with US (31 and 21 patients in Group I respectively). Surgical exploration alone was no more sensitive than either of the two other methods. CT and US are highly reliable when positive but the risks of obtaining false negative results are considerable. PMID- 3512007 TI - Ultrasonography of hepatic portal venous gas due to diverticulitis. PMID- 3512006 TI - Contrast media in double-contrast arthrography of the knee: a comparison of ioxaglate and iothalamate preparations. AB - Hexabrix (sodium and meglumine ioxaglate) is a satisfactory medium for use in double-contrast knee arthrography. It shows no advantage over the ionic medium, meglumine iothalamate, in the quality of the immediate films, but it produces significantly better coating of the meniscus in delayed films and better results in knees which have an effusion. These advantages are to some extent counteracted by the fact that Hexabrix causes more pain or discomfort after the examination than meglumine iothalamate. PMID- 3512008 TI - The case of the bulging Bulgarian. PMID- 3512009 TI - Arthrosonography of the irritable hip in childhood: a review of 1 year's experience. AB - A retrospective study of 87 children presenting acutely with an "irritable hip" was undertaken to assess the role of arthrosonography of the hip joint. Arthrosonography detected 52 hip-joint effusions, of which 16 were aspirated and an effusion confirmed in 14 (88%). In 82 cases plain radiography was compared with arthrosonography for the detection of hip-joint effusions. Of 47 children with a positive ultrasound diagnosis, 28 (59%) showed abnormal findings on plain radiographs and, of 35 cases with negative ultrasound findings, 22 (63%) had a negative diagnosis by plain radiography. Patients with more severe clinical signs were more likely to have an ultrasonic diagnosis of an effusion (87%-100%) than those with mild clinical signs (25%). The ultrasonic measurement of the hip-joint capsule to femoral neck distance was 2.2 mm +/- 0.5 mm (mean +/- 1 SD) in normal hips and 6.3 mm +/- 1.5 mm in the joints with effusions. Our study suggests that arthrosonographically the normal capsular space is less than 3 mm and the difference between the two sides less than 2 mm. It is suggested that hip arthrosonography is a more accurate method for detecting hip-joint effusions than plain radiography; it may help select cases for hospital admission and should be performed before aspiration is attempted. PMID- 3512010 TI - Persistent sciatic artery. Report of three cases and literature review. AB - Persistence of the sciatic artery (SA) is a rare vascular anomaly, resulting from lack of regression of an embryonal artery to the lower extremity. Forty-nine cases have been published in the world literature since 1832. The persistent sciatic artery (PSA) is particularly prone to undergo aneurysm formation or atherosclerosis. It originates from the internal iliac artery, courses in close proximity to the sciatic nerve, and provides the main supply to the popliteal artery because a hypoplastic superficial femoral artery (SFA), contributing only collaterals to the knees, is usually associated with a PSA. This anomaly should be kept in mind in the clinical assessment of a pulsatile gluteal mass. It also presents a potential hazard during hip and renal transplant surgery. PMID- 3512011 TI - Renal artery stenosis: duplex Doppler evaluation. AB - The renal arteries of 40 patients without renal or renovascular disease were examined with duplex real-time Doppler sonography. Special views were employed to obtain adequate images and Doppler recordings from the renal arteries. Time limits were placed on the duration of the examination, the better to reflect common clinical practice. Velocity spectral analysis of the Doppler shift frequency was achieved in 82.5% of the arteries examined and a characteristic "Doppler signature" for the renal artery identified. This was compared with the Doppler signal from the renal arteries of eight patients with renal artery stenosis. Significant differences in spectral pattern were demonstrated in renal artery stenosis. These differences are illustrated and their potential for screening for renovascular disease in systemic hypertension is discussed. PMID- 3512012 TI - Renal carcinoma: duplex Doppler evaluation. AB - Doppler ultrasound has a clearly defined role in the assessment of carotid and peripheral vascular disease. In these situations vessel pathology produces alterations in velocity and volume flow and in the flow-velocity spectrum. Flow in the renal arteries is affected not only by disease of the renal vessels but also by the peripheral resistance to flow within the kidney. Alterations in this peripheral resistance resulting from renal disease are reflected in the Doppler flow spectrum analysis. In 14 patients with renal carcinoma, three different blood flow patterns were observed, reflecting the differing vascularity of the renal tumours. These were compared with blood flow in normal kidneys and in kidneys containing renal cysts. Doppler ultrasound adds further information to the study of renal carcinomas, allowing the prediction of tumour vascularity, and may be useful as a preliminary investigation prior to angiography and embolisation. PMID- 3512013 TI - Intravenous digital subtraction arteriography: a comparison of peripheral versus central contrast injection. AB - The diagnostic quality of intravenous digital arteriograms using peripheral and central injections in 50 patients were compared. No significant difference in diagnostic quality was noted. It is concluded that a peripheral injection is the most convenient method of performing an intravenous digital arteriogram. PMID- 3512014 TI - The effect of temperature on ultrasonic images in infant cadavers. PMID- 3512015 TI - Duodenal haematoma mimicking traumatic pancreatic pseudocyst. PMID- 3512016 TI - Unusual ultrasound appearance of the spleen--a case of hereditary spherocytosis. PMID- 3512017 TI - Ultrasound of the painful hip in children. PMID- 3512018 TI - Extracorporeal shockwave lithotripsy and percutaneous renal surgery. Comparisons, combinations and conclusions. AB - Although percutaneous nephrolithotomy (PCNL) and extracorporeal shockwave lithotripsy (ESWL) were introduced clinically at approximately the same time (1980-1981), their clinical progress appeared to progress along separate paths and to compete with each other. After 5 years it has become apparent that for optimal removal of nearly all renal stones by minimal or noninvasive techniques, PCNL and ESWL are required either separately or as combined procedures. This review traces the development, introduction and progress of these procedures and defines the current indications for extracorporeal, percutaneous and open renal stone surgery. PMID- 3512019 TI - Methotrexate, cisplatin and carboplatin as single agents and in combination for metastatic bladder cancer. AB - A review of 78 previously untreated patients with bidimensionally measurable metastatic bladder cancer who were entered into a series of studies of cytotoxic chemotherapy has shown that complete response occurred in 1 of 23 patients receiving methotrexate, none of 15 receiving cisplatin, none of 20 receiving the platinum analogue carboplatin and 3 (2 with histological confirmation) of 20 receiving methotrexate in combination with cisplatin. WHO/UICC performance status 3 and 4, though a prediction of lower response, did not provide a means for excluding patients who might benefit from chemotherapy. Studies using serial cytology showed that 5 of 8 responders according to standard criteria had complete loss of malignant cells from the urine compared with none of 10 non responders and there was a suggestion that duration of response was longer in those whose urine was negative for malignant cells than in those which remained positive. PMID- 3512020 TI - Pyeloureterostomy or ureteroneocystostomy in renal transplantation? AB - A retrospective comparison of pyeloureterostomy and external ureteroneocystostomy as methods of reconstructing the urinary tract in 128 renal transplants is presented. There was one urological complication in 52 pyeloureterostomies (1.9%) compared with 4 in the 76 ureteroneocystostomies (5.3%). 6/0 Polydioxanone (PDS) is preferred to Prolene for the anastomosis because of possible calculus formation on the latter. Wound sepsis is commoner in pyeloureterostomies undergoing concomitant nephrectomy, despite prophylactic antibiotics, though this is not statistically significant and the overall sepsis rate is higher for ureteroneocystostomy. Nephrectomy was avoided in 17 selected cases by simply ligating the recipient ureter where the pre-transplant urine output was low. Two of these patients developed hydronephrosis in the isolated kidney and required later nephrectomy. PMID- 3512021 TI - Controlled environment unit in the care of the below-knee amputation stump. AB - A controlled environment unit has been compared with plaster dressings in the management of the below knee stump in 60 patients undergoing amputation for advanced vascular disease. The main criteria were stump healing and the speed of rehabilitation. There were 30 patients in each group. Three patients died within 10 days of operation. Primary healing was obtained in 65 per cent, secondary healing in 22 per cent and revision to above knee was required in 13 per cent. There were no statistically significant differences between the two groups. Neither did they differ in the times taken to reach the various stages of rehabilitation from bed exercises to independent walking with final prosthesis. While the controlled environment unit was as effective as the plaster dressing it tended to impede the patients' early mobility and to hinder nursing care. In particular it is not recommended for patients who may be confused or restless in the early postoperative period. PMID- 3512022 TI - Simulation in surgical training using freeze dried material. AB - The acquisition of manual dexterity and surgical skills is usually achieved in the operating theatre under supervision. We describe an efficient way of learning intestinal anastomosis procedures with the use of gamma irradiated, lyophilized porcine or bovine tissues together with a purpose designed holding jig. Preliminary evaluation of this method with untrained subjects showed that they were able to improve their performance. Because the tissues are sterile, health hazards are avoided and no special laboratory facilities are required. This approach has promise as an aid to evaluation as well as training. PMID- 3512023 TI - Clearance technique for the detection of lymph nodes in colorectal cancer. AB - Lymph node metastases are an important determinant of prognosis following surgery for colorectal cancer. A xylene alcohol clearance technique has been employed in Guildford to facilitate the identification of lymph nodes in the mesorectum of rectal cancer specimens. The numbers of lymph nodes and lymph node metastases were compared with seven other centres and St. Mark's Hospital, where clearance techniques were not employed in patients undergoing a randomized trial of pre operative radiotherapy for rectal cancer. The total number of lymph nodes identified per patient in the mesorectum of patients at Guildford (mean = 23.1 +/ 1.18) was significantly higher when compared with patients at St. Mark's Hospital alone (mean = 13.1 +/- 0.86) and the seven combined "non-cleared' centres (mean = 10.5 +/- 0.6) (P less than 0.001). The number of lymph node metastases per patient was significantly higher in the Guildford series (mean = 3.21 +/- 0.58) when compared with the seven combined centres (mean = 1.9 +/- 0.3) (P less than 0.05). The numbers of lymph node metastases found in the lowest part of the specimen close to the levator ani were significantly higher in the Guildford patients (mean = 1.2 +/- 0.4) compared with St. Mark's Hospital (mean = 0.13 +/- 0.1) and the seven combined 'non-cleared' centres (mean = 0.56 +/- 0.1). This clearance technique identified not only a greater number of lymph nodes but also more metastases within those nodes, particularly in the supralevator area of the mesorectum. PMID- 3512024 TI - Incisional hernia. PMID- 3512025 TI - Randomized study of Corynebacterium parvum adjuvant therapy following surgery for (stage II) malignant melanoma. AB - One hundred and fifteen patients with histologically proven primary cutaneous melanoma were entered into a randomized prospective study following surgical removal of clinically obvious regional metastases. The study started in 1977 and was completed in June 1982. Fifty-eight patients (10 with regional skin metastases and 48 with regional node metastases) were in the control group and 57 (15 regional skin, and 42 regional node metastases) received adjuvant C. parvum. Other clinical features were well balanced for each group. C. parvum, 2 mg/m2 IV was repeated eight times at three weekly intervals. The schedule was based on previous work which indicated significant increase in killer cell activity. There was no serious toxicity and 22 patients exhibited tachyphylaxis. Seventeen patients in the control group (11 tumour free) are alive at 24-80 months, and 20 patients in the C. parvum group (12 tumour free) are alive 24-76 months from randomization. No statistically significant difference (P greater than 0.05) was observed between the two patient groups for overall survival (median 26 months) or relapse free survival (median 8 months) from the date of randomization. Nor was the overall survival from the date of primary surgery (median 52 months, range 4-237) or the relapse free survival, median 28 months, range 2-225, significantly different between the two groups of patients. The relapse pattern in the two groups, and survival after relapse were no different though the response rate to actinomycin D and DTIC chemotherapy was significantly higher in the control (48 per cent) than in the C. parvum (23 per cent) group. Toxicity to chemotherapy was not significantly affected by previous C. parvum treatment. Although there were trends for better survival, in the C. parvum patient group, statistically significant activity has not been noted in this study. PMID- 3512026 TI - Aspirate cellularity as a rapid indicator of renal allograft rejection. AB - No rapid and unequivocal test exists to diagnose renal allograft rejection. Despite advances in immunosuppression over the last 20 years, rejection is still the major problem in clinical organ transplantation. Most transplant centres report a renal graft survival rate of about 60 per cent at 5 years and the majority of graft losses are due to rejection. An influx into the graft of various cell types has been implicated in the diagnosis of rejection but it takes up to 24 h to obtain such information histologically. We have carried out fine needle aspiration biopsy of the allografts and estimated the number of white cells in the aspirate using a fluorescence activated cell sorter. Studies were performed in 34 cases of normal allograft function, 8 of rejection, 8 of acute tubular necrosis and 8 of cyclosporin nephrotoxicity. There was a statistically significantly higher cell number in the group undergoing rejection (P less than 0.01; Wilcoxon unpaired test) when compared to each of the other three groups. We believe that this technique, which takes only a few minutes to perform, could yield much valuable information. It deserves further study. PMID- 3512027 TI - Hepatic hydatid disease in Libya. AB - A series of 50 patients with hepatic hydatid disease all treated at the Central Hospital, Tripoli, Libya is presented to show the advantage of ultrasonography in pre-operative diagnosis and the advantages of complete resection or omentoplasty compared with removal of the endocyst and drainage. PMID- 3512028 TI - Gastric secretory responses to modified sham feeding (MSF) and insulin after vagotomy. AB - Modified sham feeding (MSF) and insulin tests were carried out in 28 patients after vagotomy. Basal and pentagastrin collections were also performed. Using the secretory data from 9 of the patients with endoscopically proven recurrent ulcer as a reference, 20 gastric secretory indices were studied and critical levels were chosen to provide the maximum sensitivity and specificity. The eleven most discriminating indices were then used to evaluate the remaining 19 patients. There was agreement between the responses to MSF and insulin as to the adequacy of vagotomy in 16 of the patients (84 per cent) and contradictory responses in 3 patients (16 per cent). Overall, MSF responses were as discriminating as the responses to insulin. A simplified ward test, based on crude volume measurements in response to MSF is proposed. PMID- 3512029 TI - Monitoring middle cerebral artery blood velocity during carotid endarterectomy. AB - Transcranial pulsed Doppler ultrasound and spectral analysis were used to monitor blood velocities in the middle cerebral artery of nineteen patients (mean age 61 +/- 9 years) during carotid endarterectomy. A Javid shunt was used in all patients. The intensity weighted mean Doppler frequency for each spectral sweep (at 5 ms intervals) was time-averaged over the cardiac cycle to obtain a mean value for blood velocity in the middle cerebral artery. The range of such values found in the 19 patients was: 12-38 cm s-1 after anaesthesia (baseline); 12-69 cm s-1 during diathermy; 0-30 cm s-1 during carotid clamping; 16-32 cm s-1 during shunting and 18-60 cm s-1 in the recovery room. The average change in middle cerebral artery blood velocity from baseline values showed significant increases during diathermy (P less than 0.005), shunting (P less than 0.05) and in the recovery room (P less than 0.005). Clamping of the internal carotid artery showed a significant decrease in middle cerebral artery blood velocities of all patients (P less than 0.005), three of whom showed no flow in the middle cerebral artery during clamping. Abnormally high amplitude Doppler signals at the commencement of shunting were detected in 17 of the 19 patients. Such Doppler signals are consistent with turbulent blood flow or the introduction of micro-air bubbles by the shunt. Backbleeding in the internal carotid artery before insertion of the shunt was associated with diminished flow in the ipsilateral middle cerebral artery of ten patients, oscillatory forward/reverse flow in three patients and cessation of flow in the remaining six patients. PMID- 3512030 TI - Gas in the hepatic portal veins. PMID- 3512031 TI - Low molecular weight heparin once daily compared with conventional low-dose heparin twice daily. A prospective double-blind multicentre trial on prevention of postoperative thrombosis. AB - In a randomized, prospective, double-blind multicentre trial, the effect of conventional low-dose heparin 5000 units twice daily, was compared with that of a low molecular weight heparin fragment (4000-5000) 5000 anti-factor Xa units once daily. Four hundred and thirty-two patients fulfilled the inclusion criteria and were analysed for development of deep vein thrombosis (125I-labelled fibrinogen test) and haemorrhagic complications. Thrombosis occurred in a 4.3 per cent of patients in the low-dose heparin group and in 6.4 per cent of patients in the heparin fragment group, a difference which is not significant. There was a significant delay in the onset of thrombosis in the heparin fragment group. Mortality did not differ between the groups, nor did peroperative blood loss or transfusion requirements or infectious complications. Haemorrhagic complications occurred significantly more often in the fragment group (11.6 per cent) than in the conventional heparin group (4.6 per cent). Patients in the heparin fragment group experienced local pain following the subcutaneous injection significantly less often. PMID- 3512032 TI - Immunocytochemical detection of vitamin D-dependent calcium-binding protein (CaBP 28K) in vestibular sensory hair cells and vestibular ganglion neurones of the cat. AB - Vestibular sensory hair cells, afferent fibres and vestibular ganglion neurones of the cat are intensely labelled by a specific antibody to rat kidney vitamin D dependent calcium-binding protein (CaBP-28K). Type I hair cells are more weakly CaBP immunoreactive than type II hair cells. Ganglion neurones also present a differential staining. The presence of calcium-binding protein in sensory hair cells could be of interest for the understanding of transductional mechanisms. PMID- 3512033 TI - Gamma-aminobutyric acid-immunoreactivity in the rat hippocampus. A light and electron microscopic study with anti-GABA antibodies. AB - The distribution of GABA-immunoreactive neurons and axonal varicosities was investigated in the hippocampal region of the rat brain by means of an indirect peroxidase immunocytochemical method with recently developed anti-GABA antibodies. The immunolabeling was found to be restricted to nervous structures: neuronal cell bodies, dendrites and axon terminals. Myelinated axons showing GABA immunoreactivity were also observed. GABA-immunoreactive neurons were found in great number in the stratum pyramidale, the superficial part of the stratum oriens and the deep part of the stratum radiatum in the Ammon's horn. Less were found in the other regions; rare labeled cells were observed in the superficial part of the stratum radiatum and the middle part of the stratum oriens. The dentate gyrus exhibited numerous labeled cells in the granular layer, few in the hilus, rare in the molecular layer. A high density of GABA-immunoreactive terminals was found at the limit of the stratum oriens with the alveus, in the stratum pyramidale and in the stratum lacunosum. A lower density of labeled fibers was observed in the other areas. The somata and proximal dendrites of pyramidal and granular cells were encompassed by characteristic pericellular arrangements of GABA-immunoreactive varicosities. Ultrastructural observations revealed a diffuse immunoreaction product spread over the cytoplasm and the nucleus without specific relationship with the organelles, and immunoreactive aggregates in the cytoplasm. Labeled dendrites often showed enlargements displaying the immunoreaction whereas thinner segments were devoid of it. They received numerous asymmetrical synapses from unlabeled axon terminals. GABA immunoreactive terminals were filled with small clear vesicles with immunopositive membranes and were observed in symmetrical contact with somata and dendrites. PMID- 3512034 TI - Immunocytochemical studies of neurofilament antigens in the neurofibrillary pathology induced by aluminum. AB - Intrathecal administration of aluminum salts induces accumulation of neurofilaments in axons and perikarya of motor neurons and is associated with impaired axonal transport of neurofilament proteins. Because phosphorylation of the 200-kilodalton (kd) neurofilament protein, thought to be a major component of the sidearms, seems to be important in interactions of neurofilaments with other cytoskeletal elements, we have postulated that aluminum may produce neurofibrillary pathology by altering patterns of neurofilament phosphorylation. To test this hypothesis, antibodies against phosphorylated and non-phosphorylated neurofilament epitopes were used for immunocytochemical analysis of spinal cord sections from aluminum-injected rabbits. In control animals, phosphorylated 200 kd neurofilament proteins were not demonstrable in perikarya of motor neurons. In experimental rabbits, perikarya and proximal axons of affected motor neurons showed striking accumulations of immunoreactivity of one phosphorylated epitope. The presence of phosphorylated 200-kd neurofilament proteins in these regions may have important consequences for the organization of the cytoskeleton and for the transport of neurofilaments. A similar, but not identical, pattern of accumulation of phosphorylated neurofilament immunoreactivity has recently been observed in neurofibrillary tangles in Alzheimer's disease. PMID- 3512035 TI - Calcitonin gene-related peptide-immunoreactive nerves in the tongue, epiglottis and pharynx of the rat: occurrence, distribution and origin. AB - The occurrence, distribution and nature of calcitonin gene-related peptide (CGRP) in the tongue, epiglottis and pharynx of the rat was investigated by immunocytochemistry and radioimmunoassay. Numerous CGRP-containing nerves were found to innervate and terminate freely within the epithelium of the tongue, epiglottis and pharynx. Immunoreactive fibres were also found in the muscle layer and around blood vessels in the tongue, and in motor end plates in the muscle of the epiglottis and pharynx. Section of the trigeminal nerve induced a marked reduction in the number of immunoreactive nerves in the anterior portion of the tongue, whereas glossopharyngeal denervation results in a depletion of CGRP immunoreactivity in the posterior portion of the tongue. Immunoreactive nerves of the epiglottis and pharynx were depleted only after superior laryngeal nerve section. A subpopulation of labelled primary sensory neurones were observed in trigeminal and glossopharyngeal ganglia following injection of True blue retrograde tracer in the tongue. Most of the labelled cells were also immunoreactive for CGRP. Following systemic treatment with capsaicin, a loss of intra- and subepithelial CGRP-immunoreactive nerves was observed in all investigated tissues, while immunoreactive motor end plates remained unchanged. PMID- 3512036 TI - Glutamic acid decarboxylase and enkephalin immunoreactive axon terminals in the rat neostriatum synapse with striatonigral neurons. AB - Synaptic interactions between striatal projection neurons and axon terminals containing immunoreactive glutamic acid decarboxylase (GAD) or Leu-enkephalin were examined in the rat neostriatum using a combined method of horseradish peroxidase retrograde transport from the substantia nigra and immunohistochemistry at the electron microscopic level. Results showed that numerous immunoreactive GAD and enkephalin boutons formed synapses with the cell bodies and dendrites of medium-sized striatonigral neurons. These findings demonstrate that within the neostriatum GABA and enkephalin directly influence caudate output pathways. PMID- 3512037 TI - Specific antibodies against aspartate and their immunocytochemical application in the rat brain. AB - An immunological approach to visualize aspartate in the rat brain was attempted by raising antibodies against this acidic amino acid. Using an adapted ELISA method, their specificity was tested by competition experiments between aspartate conjugated via glutaraldehyde to various protein-carriers and either non conjugated aspartate or conjugated amino acids, preincubated with anti-aspartate antibodies. Their titer and specificity were found high enough to allow their use in immunocytochemistry which demonstrated the presence of a large number of aspartate-containing cell-bodies in many areas of the brain. PMID- 3512038 TI - Localization of vasopressin-neurophysin and norepinephrine in the supraoptic nucleus of spontaneously hypertensive rats. AB - Histological analysis of the catecholaminergic innervation of vasopressin neurons in the supraoptic nucleus (SON) was performed using catecholamine histofluorescence and immunocytochemistry of vasopressin specific neurophysin (VP NP) in order to determine if spontaneously hypertensive rats (SHR) demonstrate alterations in the relationship between these two types of chemically defined neurons. Chronically hypertensive SHRs showed an increased density of catecholamine fluorescence particularly in the dorsal part of the SON in comparison to age-matched, normotensive, Wistar-Kyoto (WKY) rats, but not in comparison to age-matched Wistar rats. In addition, there was an increase in the area of distribution of VP-NP immunopositive neurons such that they extended into the dorsal portion of the nucleus in the SHR compared to the WKY. Comparator bridge analysis of immunocytochemical staining and catecholamine histofluorescence revealed a precise overlap of the two patterns in SHR. Thus, the more extensive distribution of catecholamine fluorescence in the dorsal SON in the SHR compared to WKY paralleled the more extensive distribution of VP neurons in this region. Quantitative analysis of the relative percentage of SON neurons which were VP-NP positive indicated that the increased representation of VP-NP positive neurons in the dorsal portion of the nucleus reflected a greater distribution of the VP-NP cell population throughout the SON rather than an increase in the number of VP-NP neurons in the SHR. In young SHRs (5 weeks old) the catecholamine fluorescence pattern in the SON was considerably smaller than that observed in older SHRs. This low density pattern, however, was comparable to that observed in young WKYs. Thus, the catecholamine fluorescence in the SON apparently increases in the SHR in parallel with the development of the hypertension. This observation and the finding of comparable catecholamine fluorescence in Wistars and SHRs suggest that the altered catecholamine innervation of VP neurons observed in chronically hypertensive SHRs is not causal to the hypertension but may reflect a response to the elevated blood pressure. A marked increase in the catecholamine innervation of cerebral arteries was also noted. PMID- 3512039 TI - Cardiovascular and neuroendocrine responses to behavioral stress after central or peripheral barodenervation in rats. AB - The cardiovascular and neuroendocrine responses to acute behavioral stress were evaluated in rats after disruption of the baroreflexes by electrolytic lesions of the nucleus tractus solitarii (NTS) or sinoaortic denervation (SAD). Rats with NTS lesions or SAD showed significantly greater increases in mean arterial pressure (MAP) and plasma norepinephrine (NE) concentrations than control rats during a single 30-min escape-avoidance test. In addition, the increases in MAP and plasma NE concentration of NTS lesion rats were significantly greater than those of SAD rats. However, NTS lesion rats showed no increase in plasma renin activity (PRA), as observed in the other groups. Thus, disruption of the baroreflexes by NTS lesions or SAD augments the arterial pressure and plasma NE responses to stress. Additionally, NTS lesions appeared to eliminate the neurons or fibers of passage participating in the sympathetically mediated increase in PRA. PMID- 3512040 TI - Quantitation and morphological characterization of rapid axon and dendritic growth from single cerebral hemispheric neurons in hydrated collagen lattice culture. AB - Quantitative and qualitative data are reported for single cerebral hemispheric neurons in a 3-dimensional hydrated collagen lattice (HCL) culture system. Individual neurons not in contact with other cells or cell processes, including synapses, rapidly displayed two morphologically distinct classes of processes that could be traced from origin to termination: long thin processes interpreted as being axons, and shorter tapering and sometimes branched processes interpreted as being dendrites. Axons and dendrites of single neurons that had at least one process longer than the cell body were measured on each of 3 days after plating using an image analysis system coupled to a phase-contrast microscope and a microcomputer. Mean lengths of axons and dendrites alone or combined as total new growth per neuron, increased 3- to 5-fold and were as high as 745, 694 and 1226 microns respectively after 3 days in HCL, although some individual axons measured over 1500 microns. Other indices of neuron growth and differentiation increased 1 to 5-fold including the number of primary processes, branch points, segments and growth cones. Phase-contrast microscopy, staining with Nissl and silver, and scanning and transmission electron microscopy demonstrated many single multipolar and other neurons with axons, dendrites and well-differentiated properties. The data show that individual central nervous system neurons have an inherent capacity to quickly express characteristic differentiated features and also to grow rapidly in HCL. PMID- 3512041 TI - GABAergic neurons in rat hippocampal culture. AB - The experiments described here were designed to study biochemical and histological measures of gamma-aminobutyric acid (GABA) uptake and glutamic acid decarboxylase (GAD) in primary dissociated cell cultures prepared from 17-21-day fetal rat hippocampus. Preparations from all ages of animals, except 21-day fetuses, were enriched in GABAergic neurons, when compared to the adult hippocampus in situ. These cells comprise 30-50% of the large, phase-bright, process-bearing cells in hippocampal cultures as estimated by autoradiography of GABA uptake and GAD immunocytochemistry. Neurons concentrate GABA by a relatively slow but high-affinity process (Km = 2.6 microM) that has considerably higher maximum velocity than glial uptake (Vmax = 479 pmol/mg protein/min for neurons and 31 pmol/mg protein/min for glia). No low-affinity uptake process was noted in neurons or glia. GABA uptake into neurons was competitively inhibited by cis-4-OH nipecotic acid (Ki = 39 +/- 11 microM). These cultures also possess considerable GAD activity, up to 6 nmol/mg protein/min in one-month-old cultures, which approximates that of the adult hippocampus. Both GABA uptake and GAD activity increased with time in culture. The enrichment of GABAergic markers indicates that this preparation may be useful for the detailed study of hippocampal GABAergic neurons. PMID- 3512042 TI - Expression and distribution of microtubule-associated protein 2 (MAP2) in neuroblastoma and primary neuronal cells. AB - We examined the expression and distribution of microtubule-associated protein 2 (MAP2) during the differentiation in culture of both mouse NB2a neuroblastoma and primary embryonic rat neurons. The differentiation of NB2a cells was induced with retinoic acid (RA) which stimulated the extension of a highly branched neuritic network and dibutyryl cAMP which stimulated the outgrowth of long bipolar or monopolar processes. We found that although monoclonal antibodies to MAP2 stained the cell bodies of control and differentiated cells, only the RA-induced neurites were positive for this antigen. These data support our ultrastructural studies indicating that the RA-induced neurites were dendrite-like and that the dibutyryl cAMP-induced processes were axon-like. Studies on the biosynthesis of MAP2 indicated that RA induced a 2-3-fold increase in MAP2 synthesis in 24 h; however, this effect was transient, with the synthesis of MAP2 in RA-treated cells returning to control level by 72 h. Although biosynthetic studies suggested the synthesis of species at 250-300 kdalton, the major molecular weight form in the neuroblastoma cells was 230 kdalton. Immunocytochemical analysis of primary neurons showed staining of neuronal cell bodies and of short processes, but virtually no staining of the long axon-like processes. The staining of neuronal cell bodies and processes was evident at all stages of cell differentiation. This finding was corroborated by immunoblots which showed significant amounts of MAP2 throughout cell development. The molecular weight of the immunoreactive material was ca. 300 kdalton in both primary neurons and rat brain. Immunoblots also revealed that embryonic neurons expressed only MAP2B as they differentiated in culture for 14 days. Biosynthesis studies suggested that early in culture there was a modest increase in MAP2 synthesis, but no detectable change was observed thereafter. We concluded therefore that both neuroblastoma cells and primary neurons can differentiate neuritic processes, which show dendritic properties in terms of morphology and preferential distribution of MAP2. PMID- 3512044 TI - Dental manpower supply and demand projections and changing demography and dental disease. PMID- 3512043 TI - The effects of dobutamine, nitroprusside, or volume expansion on cardiac output and lung water after CPPV. AB - Pulmonary microemboli can create an ARDS-like state in dogs (high pulmonary vascular resistance, pulmonary oedema and arterial hypoxemia). CPPV can correct the hypoxemia of pulmonary microemboli but reduces cardiac output (Q) and tissue oxygenation. This paper compares the effect of improving Q by infusing volume, reducing afterload, or increasing myocardial contractility. Four groups of seven dogs were studied. All had 0.125 g . kg-1 of starch microemboli (63-74 microns) infused and then CPPV at 15 cm H2O applied. The control group had no further treatment applied. In three other groups volume (dextran) or dobutamine or nitroprusside (NTP) was infused to return Q to the level before CPPV was applied. All treatments (volume, dobutamine and NTP) improved Q and O2 transport. Only the volume group had a significant increase in pulmonary microvascular pressure, Pmv = PLA + 0.4 (PPA - PLA) from 2.53 +/- 0.27 to 3.35 +/- 0.13 kPa, p less than 0.05. Only the volume group demonstrated a significant increase in lung water above (double) the control group as measured by a double indicator dilution technique (ETVL) and post mortem lung weights. We conclude volume infusions to improve a CPPV depressed Q may increase lung water and that better treatment would be to infuse NTP or dobutamine, thus maintaining a lower Pmv and therefore lung water. As a corollary the least CPPV should be applied to maintain adequate oxygenation and create the least need for interventions to improve Q. PMID- 3512046 TI - Dental manpower. An F.D.I./W.H.O. viewpoint. PMID- 3512047 TI - Strategies and possible solutions. PMID- 3512045 TI - Dentist unemployment. A Scandinavian reality and workforce issues in the United States. PMID- 3512048 TI - Dentist help thyself. PMID- 3512049 TI - Dental manpower. An Atlantic perspective. PMID- 3512050 TI - Manpower strategies. Possible solutions. PMID- 3512051 TI - The role of government. PMID- 3512052 TI - Statement presented by the Canadian Dental Hygienists' Association at the Canadian Dental Association Manpower Symposium. PMID- 3512053 TI - [Dental medicine and geriatric dentistry]. PMID- 3512054 TI - Why patients choose a particular dentist. PMID- 3512055 TI - A multidisciplinary approach to periodontics. PMID- 3512056 TI - Marketing management for dental students an experience. PMID- 3512057 TI - Anesthesia and sedation in the dental office. PMID- 3512058 TI - Applications of osseointegrated implants. A preliminary report on 35 cases. PMID- 3512059 TI - The role of extraction in periodontal therapy. PMID- 3512060 TI - Ectodermal dysplasia associated with cleft palate and lobster claw deformity of hands and feet. PMID- 3512061 TI - General medical journals: becoming learned with little effort. PMID- 3512062 TI - A framework for clinical evaluation of diagnostic technologies. AB - Most new diagnostic technologies have not been adequately assessed to determine whether their application improves health. Comprehensive evaluation of diagnostic technologies includes establishing technologic capability and determining the range of possible uses, diagnostic accuracy, impact on the health care provider, therapeutic impact and impact on patient outcome. Guidelines to determine whether each of these criteria have been met adequately are presented. Diagnostic technologies should be disseminated only if they are less expensive, produce fewer untoward effects and are at least as accurate as existing methods, if they eliminate the need for other investigations without loss of accuracy, or if they lead to institution of effective therapy. Establishing patient benefit often requires a randomized controlled trial in which patients receive the new test or an alternative diagnostic strategy. Other study designs are logistically less difficult but may not provide accurate assessment of benefit. Rigorous assessment of diagnostic technologies is needed for efficient use of health care resources. PMID- 3512064 TI - How to choose the online medical database that's right for you. PMID- 3512065 TI - The founding of Canada's Medical Research Council. PMID- 3512063 TI - Positron emission tomography in patients with clinically diagnosed Alzheimer's disease. AB - Fourteen patients who had clinically diagnosed Alzheimer's disease with mild to severe dementia (mean age 69.1 years) were evaluated by calculation of local cerebral metabolic rate for glucose (LCMR-gl) based on uptake of 18F-2-fluoro-2 deoxyglucose (FDG) detected with positron emission tomography (PET). PET scanning showed that the patients had significantly lower LCMR-gl values than 11 age matched neurologically normal volunteers (mean age 66.3 years). The differences were most marked in the temporal cortex, followed by the frontal, parietal and occipital cortex. In each case the LCMR-gl value was below the lowest control value in at least one cortical area and usually in several; the reduction in LCMR gl and the number of regions involved in the patients increased with the severity of the dementia. Deficits noted in neuropsychologic testing generally correlated with those predicted from loss of regional cortical metabolism. The patients with Alzheimer's disease were also examined with magnetic resonance imaging, computed tomography or both; the degree of atrophy found showed only a poor correlation with the neuropsychologic deficit. Significant atrophy was also noted in some of the controls. A detailed analysis of LCMR-gl values in selected cerebral regions of various sizes refuted the hypothesis that the reduction in cortical glucose metabolism in Alzheimer's disease is due to the filling by metabolically inert cerebrospinal fluid of space created by tissue atrophy. PMID- 3512067 TI - Psychosomatic medicine: past and present. Part I. Historical background. AB - Psychosomatic Medicine as an organized field of scientific inquiry and a mode of approach to patient care has existed for 50 years. It has focused on the study of the interaction of psychosocial and biological factors in health and disease. Despite its relatively recent origin, this field continues a long tradition in Western thought and medicine, one concerned with the reciprocal relationship of mind and body as two integral aspects of the human organism. That tradition goes back to ancient Greece and represents a counterpoint to the dualistic and reductionistic conceptions. Psychosomatic medicine merged as a reaction against them and as an organized attempt to subject various aspects of mind-body relationship in health and disease to scientific inquiry. Three major methodological approaches to such inquiry have been employed: the psychoanalytic, the psychophysiological, and the psychobiological. The author discusses the relative contributions of these approaches in the first phase in the development of psychosomatic medicine, i.e. between circa 1930 and 1960. PMID- 3512066 TI - Health effects of urea formaldehyde foam insulation: evidence of causation. AB - Studies of health effects of urea formaldehyde foam insulation (UFFI) were critically reviewed by means of accepted rules for evidence of causation. Three categories of health effects were examined: reported symptoms, primarily of the upper respiratory tract, lower respiratory tract disease and cancer. Most of the studies purporting to demonstrate health effects of UFFI failed to meet minimal methodologic criteria for evidence of causation. Evidence from the adequate studies provides little support for the hypothesis of a causative role of UFFI in health problems. PMID- 3512068 TI - Telepsychiatry: psychiatric consultation through two-way television. A controlled study. AB - Telepsychiatry (consultation carried out through 2-way interactive television) has been the object of a number of trials in the past twenty years, but to our knowledge there is no previous control study which compares CCTV and face-to-face interviews. Various aspects of the interviews carried out on CCTV were rated on a 5-point scale in questionnaires filled out by: (a) patients; (b) consultees and; (c) consultants. No significant difference was elicited with control interviews in respect to patients' diagnosis, age and sex. CCTV interview ratings by consultee and consultant were rated only slightly below those of the control group. Such findings should encourage a broader application of interactive CCTV, particularly as a complement to live consultations in distant areas. PMID- 3512069 TI - Focal malignant lymphoma in gastric pseudolymphoma. Histologic and immunohistochemical study of a case. AB - The authors report a case of a focal malignant lymphoma (ML), plasmacytic type, supervening in a gastric pseudolymphoma (PSL), diagnosed 6 years before and closely followed up. The diagnosis was made on endoscopic biopsy findings and confirmed by subtotal gastric resection. Immunohistochemical studies were performed both on surgical material and, retrospectively, on the initial series of biopsy specimens. The majority of the lymphoid cells of the PSL expressed the same immunoglobulin heavy and light chains as the cells of the ML, which were characterized by the presence of monoclonal mu and kappa chains. These results suggest a close relationship between the PSL and ML, and support the hypothesis of the prelymphomatous nature of the gastric pseudolymphoma. The possible existence of focal malignant lesions among PSL suggests reevaluation of the role of surgical resection in its management. Endoscopic examination allows its diagnosis on biopsy material, but it remains difficult to detect focal ML among the benign-appearing lesion. For this reason, surgical resection must be always performed, regardless of the circumstances of the initial diagnosis, both as a means of final diagnosis and as therapy. PMID- 3512070 TI - Randomized controlled study of chemoimmunotherapy of acute myelogenous leukemia (AML) in adults with Nocardia rubra cell-wall skeleton and irradiated allogeneic AML cells. AB - The effect of immunotherapy with Nocardia rubra cell-wall skeleton (N-CWS) on remission duration and survival of adults with acute myelogenous leukemia (AML) was studied in a prospective randomized controlled study. After having been induced into complete remission and having been consolidated, 73 patients were randomized either to maintenance chemotherapy or maintenance chemotherapy plus immunotherapy with N-CWS and irradiated allogeneic AML cells. Thirty-four patients in the chemotherapy group and 32 in the chemoimmunotherapy group were evaluable. Six months after the closure of the study, the immunotherapy showed a borderline beneficial effect on remission duration (P = 0.080) and on survival length (P = 0.098). When the data were analyzed at 30 months after the entry, there was a borderline significant difference in remission duration (P = 0.080) between the two groups, prolonging the 50% remission period by 110 days; but no significant difference in survival length (P = 0.314), although the 50% survival was 168 days longer in the chemoimmunotherapy group. However, there were 4 (18.2%) 5-year relapse-free survivors among 22 patients (11 in each group) who had been diagnosed more than 5 years before the time of the present analysis, and all of them belonged to the chemoimmunotherapy group (P = 0.090). Thus, immunotherapy with N-CWS and irradiated allogeneic AML cells seems to be active in the treatment of adult AML when used for maintenance therapy in combination with chemotherapy. PMID- 3512071 TI - Expression of the photoreceptor-specific S-antigen in human retinoblastoma. AB - This work presents an immunofluorescent study of the distribution of the photoreceptor-specific S-antigen in human retinoblastoma, using mouse monoclonal antibodies. Three cases of differentiated retinoblastoma displayed S-antigen immunoreactivity with various patterns of labeling which depended on the degree of differentiation of the area studied. Flexner-Wintersteiner rosettes and fleurettes were labeled only with monoclonal antibody S2D2, whereas undifferentiated areas were labeled with four different anti-S-antigen monoclonal antibodies, including S2D2. On the other hand, the three undifferentiated retinoblastomas did not show any labeling with these antibodies. The presence of S-antigen in differentiated retinoblastoma confirms that the origin of this tumor is from the photoreceptors, but the question remains unanswered for undifferentiated retinoblastoma for which another origin--glial or primitive neuroectodermal cells--may be proposed. PMID- 3512072 TI - Interferons in the treatment of malignant melanoma. A review of recent trials. AB - Malignant melanoma is one of the several human tumors against which interferons have demonstrated significant antitumor activity. Such activity was first observed in early clinical trials with natural human leukocyte interferon; 4 of 75 patients in different institutions achieved partial response to treatment and 5 patients showed minor regression of disease. Subsequently, in a number of trials conducted with recombinant leukocyte interferons, antitumor activity against melanoma was observed consistently. Recombinant interferons have also revealed remarkable activity against malignant melanoma in the human tumor stem cell assay, with 18 of 60 samples (30%) showing marked inhibition in tumor growth. Recombinant interferons from two different sources were tested in Phase I and Phase II trials against malignant melanoma. In one Phase I trial with interferon alfa-2b, 4 of 23 patients responded to treatment. In another Phase I study using recombinant interferon alfa-2a, 3 of 20 patients achieved objective responses. More recently, a number of Phase II trials were initiated and the detailed results of two Phase II studies have been published. In the first trial using recombinant leukocyte interferon at a dosage times a week, objective regression of tumor was observed in 7 of 31 patients, for a response rate of 22%. Because of severe toxicity associated with this dosage, a second Phase II trial was conducted using a dosage of 12 X 10(6) U/m2 three times a week, and 6 of 30 patients experienced objective regression of disease, for a response rate of 20%. Based on the results of these early trials with recombinant leukocyte interferon, a number of clinical trials using different species of interferon at different doses and treatment schedules were initiated. The preliminary results of these trials are reported here. PMID- 3512074 TI - Lack of reciprocal translocations in carcinomas. AB - Among the varied structural chromosomal aberrations present in the common forms of carcinoma, reciprocal translocations generally appear to be lacking. Although the breakpoints may be variable, the chromosomal changes nevertheless commonly result in the loss or gain of particular chromosomal segments. The possible implications of these observations are discussed, especially in relation to the thesis that some of the chromosomal changes in cancer cells are important because they lead to the expression of recessive genes. PMID- 3512073 TI - Cytogenetics and bone marrow transplantation. AB - The authors report hematologic and cytogenetic data on 19 patients treated with allogeneic bone marrow transplantation (BMT) for severe hematologic disorders: 8 patients with chronic myelogenous leukemia, 6 with acute leukemia, 3 with severe aplastic anemia, 1 with refractory anemia, and 1 with beta-thalassemia major. Cytogenetic assays were performed on marrow cells before conditioning, 30 days after BMT, and at subsequent times. The authors discuss the role of cytogenetic studies in the evaluation of bone marrow engraftment, leukemic transformation of the graft, and disease relapse. PMID- 3512075 TI - Experimental immunotherapy with NK-like cells. A preliminary report. AB - Natural killer (NK) cell activity was generated in the spleen of C3H/HeN mice by i.p. administration of poly I:C, while i.p. injection of BCG primarily promoted the generation of NK-like cells in peritoneal exudates (PE). A single injection of 10 mg of BCG 9 days before s.c. challenge with the MBT-2 murine bladder cancer was found to induce a 45% protection against tumor take. However, a single injection of 100 micrograms poly I:C 16 h before tumor cell challenge did not protect the animals against tumor take. Intratumoral injection of either PE cells from BCG-immunized or spleen cells from poly I:C-treated mice into mice developing tumor, was capable of suppressing tumor growth in vivo. The mean tumor diameters of these two experimental groups of animals on day 40 were significantly smaller (P less than 0.005) than in the controls, and they survived approximately 10 days longer than the controls. Since this in vivo tumor suppressive effect by the lymphoid cell population correlated with the increase in NK-like cell activity assayed in vitro, and most of the adherent cells had been removed before injection, it is suggested that the antitumor function of the lymphoid cell population may be mostly due to the presence of "activated" NK or NK-like cells. These results support the concept of NK therapy for cancer. PMID- 3512077 TI - Mechanism of cytotoxicity of anticancer platinum drugs: evidence that cis diamminedichloroplatinum(II) and cis-diammine-(1,1 cyclobutanedicarboxylato)platinum(II) differ only in the kinetics of their interaction with DNA. AB - The kinetics of the aquation reactions of cisplatin and carboplatin and their subsequent reactions with DNA, both in vitro and in vivo, have been measured. The results have been extrapolated to indicate the expected cytotoxicity of these compounds in cells obtained from human cancer patients. Rate constants for the aquation at 37 degrees C of cisplatin and carboplatin of 8 X 10(-5) and 7.2 X 10( 7) s-1, respectively, were calculated from the half-life of these compounds in phosphate buffer, pH 7. This difference in their rate of activation was matched by their rates of binding to DNA. By use of a 14C-labeled ligand, carboplatin was shown to bind monofunctionally to DNA, after which there was a time-dependent formation of difunctional interstrand cross-links, formed from some of these initially monofunctional adducts. A similar, although faster, accumulation of cross-links was seen when cisplatin was bound to DNA. The loss of the 14C-CBDCA ligand of carboplatin was calculated to occur with a rate constant of 1.3 X 10( 5) s-1 which was similar to that for the rate of formation of interstrand cross links and faster than that for the monofunctional reaction with DNA. It was concluded therefore that the CBDCA ligand becomes a more labile leaving group once carboplatin has been monoaquated. In contrast, both chloro-ligands of cisplatin were shown to leave at similar rates. The fact that other difunctional lesions were formed to the same extent, by equal bound doses of cisplatin or carboplatin, was indicated by the unwinding of supercoiled plasmid DNA. The effects of cisplatin and carboplatin on this DNA were the same once bound to the same extent. About a 100-fold larger dose of carboplatin was, as predicted by their rates of aquation, required to produce equivalent binding to plasmid DNA. In vivo, equal binding of the two drugs to DNA of various cell systems resulted in equal cytotoxicity. Again a much larger dose (20- to 40-fold) of carboplatin was required to produce this equal binding. In general a DNA bound platinum level of about 20 nmol/g reduced cell survival by 90%, although certain cell lines were shown to be much more sensitive to DNA bound platinum. Similar binding values, to those above, were obtained in the DNA extracted from cells of human cancer patients treated with cisplatin. It was inferred that the cytotoxic effect of this level of platinum on DNA would be (unless the cells were of a sensitive phenotype) about 90%.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3512076 TI - Methods of immunosuppression for study of growth and lung colony formation by human tumor cells in mice. AB - Mice that are immune-suppressed by thymectomy and by sequential treatment with 1 beta-D-arabinofuranosylcytosine and whole body irradiation may be used as hosts for generation of human tumor xenografts. We have studied the effect of various additional methods of immune suppression on the formation of tumors after i.m. injection and on the formation of lung colonies after i.v. injection with the human MGH-U1 bladder cancer cell line. Success of transplantation was improved by treatment of immune-suppressed animals with either heterologous antilymphocyte serum or a monoclonal anti-Thy-1.2 antibody. Success of lung colony formation was also improved by antilymphocyte serum but not by monoclonal anti-Thy-1.2 antibody. Admixture of heavily irradiated cells (10(6)) to the viable inoculum of tumor cells in addition to antilymphocyte serum treatment improved the success of i.m. transplantation but not that of lung colony formation. Treatment with corticosteroids or treatment with carrageenan to suppress macrophage activity added toxicity and did not improve the success of xenografting. Immune suppression decreased the natural killer cell activity of normal mice and treatment with antiinterferon to further suppress natural killer cells may also enhance xenograft formation. Administration of cyclosporin A to normal mice allowed the growth of a single xenograft but was not a useful method for immunosuppression. The success of xenografting into immune-deprived mice was superior to that for two strains of nude mice maintained in our laboratory, and i.v. injection of tumor cells did not lead to lung colonies in these nude mice. Immune-deprived mice are a useful alternative to nude mice for the study of xenografts derived from human tumor cell lines and may allow the study of experimental lung metastases. PMID- 3512079 TI - Interleukin-2 or autologous lymphokine-activated killer cell treatment of malignant glioma: phase I trial. AB - In a Phase I study, recombinant interleukin-2 (IL-2) or autochthohous lymphokine activated killer (LAK) cells were used to treat nine patients with malignant glioma. One patient received the combination of IL-2 and LAK cells. LAK cells were generated by culturing IL-2 with peripheral blood lymphocytes obtained from brain tumor patients. Escalating doses of LAK cells (10(8)-10(10) or recombinant IL-2 (10(4)-10(6) units) were administered by direct injection into the brain tissue surrounding the cavity left following operative tumor removal. There have been no signs of systemic or neurotoxicity following treatment. The tumor selective killing of the LAK cells used for these treatments was demonstrated by their ability to lyse glioma cells but not normal cells in vitro using a chromium release microcytotoxicity assay. PMID- 3512078 TI - Dye-mediated photosensitization of murine neuroblastoma cells. AB - The purpose of this study was to determine if photosensitization mediated by the fluorescent dye, merocyanine 540, could be used to preferentially kill murine neuroblastoma cells in simulated autologous remission marrow grafts. Simultaneous exposure of Neuro 2a or NB41A3 neuroblastoma cells to merocyanine 540 and white light reduced the concentration of in vitro-clonogenic tumor cells 50,000-fold. By contrast, the same treatment had little effect on the graft's ability to rescue lethally irradiated syngeneic hosts. Lethally irradiated C57BL/6J X A/J F1 mice transplanted with photosensitized mixtures of neuroblastoma cells and normal marrow cells (1:100 or 1:10) survived without developing neuroblastomas. It is conceivable that merocyanine 540-mediated photosensitization will prove useful for the extracorporeal purging of residual neuroblastoma cells from human autologous remission marrow grafts. PMID- 3512080 TI - Double-blind evaluation of the effects of mazindol on pain, depression, anxiety, appetite, and activity in terminal cancer patients. AB - In a double-blind, crossover study, mazindol (1 mg) at breakfast, lunch, and 4:00 PM was compared with a placebo to determine its efficacy for symptom control in 30 terminal cancer patients. In 26 evaluable patients, intensity of pain and analgesic consumption were significantly improved after mazindol, while anxiety, appetite, and food consumption were significantly worse. Activity and depression were not modified by mazindol. After the completion of the trial, mazindol was chosen as a more effective drug by the patients in ten cases (38%) and by the investigators in nine (35%); placebo was chosen by the patients in seven cases (27%) and by the investigators in 11 (42%). Two patients (7%) developed delirium that required discontinuation of treatment. At the present time, there are no clearcut indications for mazindol in terminal cancer patients. PMID- 3512081 TI - Carboplatin for advanced colorectal carcinoma: a phase II study. PMID- 3512082 TI - Variability, prediction and prognostic significance of chest pain in acute myocardial infarction. AB - The variability of chest pain is described in 389 patients with acute myocardial infarction. Whereas 17% were free from severe pain after arrival in hospital, 11% required more than 10 analgesic injections. In 27% of the series analgesics were given more than 24 h after arrival in hospital. Predictors for the severity of chest pain were the rate-pressure product and degree of chest pain soon after arrival in hospital as well as electrocardiographic signs of myocardial infarction at entry. Patients with more severe chest pain had a higher 2-year mortality rate and a higher incidence of ventricular fibrillation and congestive heart failure during hospitalization. PMID- 3512083 TI - Significance of the walk-through angina phenomenon during exercise testing. AB - Out of 3,900 patients who performed an exercise test at our clinic, 3 patients demonstrated a walk-through phenomenon (WTP), defined as the occurrence of mild angina during the first stages of exercise with disappearance of chest pain at higher workloads despite a greater pressure-rate product. 2 patients had variant angina, one with normal coronary arteries and the other with single vessel disease, while the third patient had stable exertional angina and a severe coronary artery disease with occlusion of two major vessels retrogradely filled by collateral channels. Repeat exercise tests failed to reproduce constantly the WTP in the 2 patients with variant angina, while in the third patient the phenomenon was repeatedly induced by exercise testing. Thus the WTP, although rarely found during exercise testing, can be observed in two subsets of patients. In variant angina the WTP is not reproducible and is probably due to coronary spasm, spontaneously subsiding during exercise. In patients with exertional angina and severe coronary artery disease, the WTP can be repeatedly observed during exercise and is likely to be secondary to a delayed vasodilation of collateral vessels. The clinical characteristics of the patients and the response to repeat exercise tests may be useful in identifying the different pathogenetic mechanisms. PMID- 3512084 TI - [Use of expert systems in health care]. PMID- 3512085 TI - [Expert systems--programs using the knowledge of experts for solving complicated problems]. PMID- 3512086 TI - [CODEX: an expert system for medical applications]. PMID- 3512087 TI - [Assistance of the CODEX expert system in the diagnosis of mental diseases]. PMID- 3512088 TI - [An expert system for the diagnosis of diabetes]. PMID- 3512089 TI - [Further development of the MYOPAT knowledge base for the differential diagnosis of progressive muscular dystrophy]. PMID- 3512090 TI - [Development of a knowledge base for the diagnosis of brain tumors and its analysis]. PMID- 3512091 TI - [Vraz at Pisek. The origin of the spa more than 50 years ago]. PMID- 3512092 TI - [The journal Casopis Lekaru Ceskych 100 years ago]. PMID- 3512093 TI - [Practical aspects of the serology and biology of legionellae]. PMID- 3512094 TI - The organization of serotonin-immunoreactive neuronal systems in the brain of the crested newt, Triturus cristatus carnifex Laur. AB - The distribution of serotonin (5-HT) immunoreactive structures has been investigated in the brain of the crested newt by means of indirect immunofluorescence, and unlabeled antibody peroxidase-antiperoxidase-complex (PAP) or biotin-avidin-system (BAS) techniques. In the newt, the bulk of the serotoninergic system extends from the raphe region of the medulla oblongata, through the isthmus, toward the mesencephalic tegmentum, and is characterized by pyriform neurons mainly located in a subependymal position, close to the midline. Also in the caudal hypothalamus, in addition to some 5-HT-positive adenohypophysial cells, many immunoreactive CSF-contacting neurons are found lining the paraventricular organ and the nucleus infundibularis dorsalis. A rich serotoninergic innervation was observed in the preoptic area and in the habenular complex. Concerning the telencephalon, immunopositive nerve fibers are encountered in the dorsal pallium, primordium hippocampi, striatum and olfactory bulbs. The general organization of serotoninergic systems in the newt brain exhibit close similarities to that described in higher vertebrates. PMID- 3512095 TI - Distributional pattern of serotonin-immunoreactive nerve fibers in the lateral geniculate nucleus of the rat, cat and monkey (Macaca fuscata). AB - The distribution of serotonin-containing nerve fibers in the lateral geniculate nucleus (LGN) of the rat, cat, and monkey (Macaca fuscata) was studied by use of the peroxidase-antiperoxidase method and an antiserum against serotonin. In all three species, the pattern of fibers was denser in the ventral portion of the LGN (LGNv) than in the dorsal nuclear portion (LGNd). In the LGNd of rat, serotonin immunoreactive fibers were evenly distributed in the form of a dense network, but in cat and monkey there were marked regional differences. Serotonin immunoreactive elements were most numerous in the C complex and medial interlaminal nucleus of cat, and in the S layer and interlaminar zones of Macaca fuscata. PMID- 3512096 TI - Alternative 5' exons in c-abl mRNA. AB - The cellular abl proto-oncogene encodes a protein-tyrosine kinase and is expressed in many cell types in two or three mRNA size species. Four types of mouse c-abl cDNAs have been cloned from 70Z/3 lymphoid cells that have different 5' sequences encoding predicted N-terminal regions of 20-45 amino acids. One of the four cDNAs has a predicted N-terminal sequence of met-gly-gln in common with the gag N terminus of v-abl. The 5' heterogeneity appears to be generated by alternative addition of 5' exons onto a common set of 3' exons. Alternative splicing occurs at the same site at which bcr sequences join to abl sequences in the Philadelphia chromosome translocation. PMID- 3512097 TI - Secretion in yeast: reconstitution of the translocation and glycosylation of alpha-factor and invertase in a homologous cell-free system. AB - A homologous cell-free system has been derived from the yeast Saccharomyces cerevisiae that allows the translation, translocation, and glycosylation of the precursors of yeast mating factor alpha and invertase. The precursors were translated in a yeast lysate from mRNA obtained by in vitro transcription of the MF alpha 1 and SUC2 genes. Inclusion of yeast microsomes resulted in the glycosylation of the alpha-factor precursor, which was demonstrated to be sequestered within the membrane vesicles. Similar results, including signal sequence cleavage, were observed for invertase. Processing of secretory proteins translated in a yeast lysate could not be achieved using microsomes derived from canine pancreas, nor were yeast microsomes active in a wheat germ translation system. PMID- 3512098 TI - A tandemly repeated sequence determines the binding domain for an erythrocyte receptor binding protein of P. falciparum. AB - Erythrocyte invasion by the malarial merozoite is a receptor-mediated process, an obligatory step in the development of the parasite. The Plasmodium falciparum protein GBP-130, which binds to the erythrocyte receptor glycophorin, is shown here to encode the binding site in a domain composed of a tandemly repeated 50 amino acid sequence. The amino acid sequence of GBP-130, deduced from the cloned and sequenced gene, reveals that the protein contains 11 highly conserved 50 amino acid repeats and a charged N-terminal region of 225 amino acids. Binding studies on recombinant proteins expressing different numbers of repeats suggest that a correlation exists between glycophorin binding and repeat number. Thus, a repeat domain, a common feature of plasmodial antigens, has been shown to have a function independent of the immune system. This conclusion is further supported by the ability of antibodies directed against the repeat sequence to inhibit the in vitro invasion of erythrocytes by merozoites. PMID- 3512100 TI - Swimmer's shoulder. AB - The shoulder is the joint most subjected to repetitive microtrauma in swimming. This results in clinical manifestations of subacromial encroachment. The anatomy, radiographic changes, clinical findings, and histopathology of this disease process are discussed. The role of conservative exercises used in prevention as well as the role of surgical decompression of the subacromial space is explained. PMID- 3512099 TI - Control of mammary gland fibroblast growth by insulin, growth hormone and prolactin. AB - Fibroblasts isolated from guinea pig mammary glands were cultured in 96 well culture plates in the presence of various concentrations of insulin, growth hormone and prolactin. Insulin (30 micrograms/ml increased uptake of tritiated thymidine by 30%. Higher concentrations of insulin did not result in any further increase in thymidine uptake. Growth hormone alone did not alter thymidine uptake in concentrations of 0 to 250 ng/ml. 300 ng/ml gave thymidine uptake of 136% of controls. In the presence of 20 g/ml insulin, growth hormone (250 ng/ml) increased thymidine uptake to approximately double that of controls. Prolactin alone (300 ng/ml decreased thymidine uptake by 19%. Insulin increased thymidine uptake, but the negative effect of prolactin was still evident above 150 ng/ml. PMID- 3512101 TI - Scoliosis in swimmers. AB - The high-repetition nature of competitive swimming causes imbalances of musculature in the adolescent athlete. Scoliosis as a musculoskeletal condition of the adolescent can be detected in high incidence among swimmers owing to the training phenomenon. PMID- 3512102 TI - Medical aspects of synchronized swimming. AB - Synchronized swimming is a low-injury competitive aquatic sport for all ages. It requires flexibility, kinesthetic awareness, and aerobic conditioning, with the ability to function anaerobically as well. Few acute injuries occur during participation in the sport, but overuse injuries are becoming more common as synchronized swimmers participate in longer, more strenuous workout programs. Most common among these injuries are knee pain associated with the eggbeater kick and shoulder pain associated with sculling. Synchronized swimmers are also prone to otitis externa ("swimmer's ear") and chemical conjunctivitis. Stress-related symptoms are common. PMID- 3512103 TI - Near-drowning: fresh, salt, and cold water immersion. AB - Near-drowning and immersion hypothermia are important, preventable causes of mortality and morbidity. The most important consequences of an immersion accident are hypoxia and its effects on the cardiovascular system and the CNS. The mammalian diving reflex and hypothermia may offer some protection to the CNS despite prolonged hypoxia. The initial management of a nearly drowned victim must be focused on reversal of hypoxemia and acidosis. Prompt and effective on-site CPR is of paramount importance in ensuring optimal survival. The presence of immersion hypothermia must be recognized. Hypothermic patients should be managed according to the severity and the duration of hypothermia. Active external rewarming is adequate for acute and mild hypothermia, whereas active core rewarming may be necessary for chronic and severe hypothermia. PMID- 3512104 TI - Medical problems of the swimmer. AB - A swimmer is often faced with medical problems such as asthma, epilepsy, skin disease, and external otitis. Adequate management of these conditions is extremely important for optimal performance by the athlete. PMID- 3512105 TI - Nutrition for swimmers. AB - Good nutrition is one of the elements of training and conditioning necessary for optimal performance. The athlete should consume a diet composed of a wide variety of foods to help ensure that nutrient needs are met, whereas maintenance of ideal competitive weight is the indicator of adequate calorie intake. The best diet is one that considers physiological, sociological, and psychological factors--an individualized diet. The precompetition meal should consist of foods the athlete likes, tolerates well, and usually eats. The main nutrition consideration during the all-day meet is fluid replacement, and swimmers should be encouraged to drink ample water, especially when in a hot environment. Foods and beverages the athlete likes, taken in small amounts throughout the day, can ward off hunger, provide needed calories, help maintain blood glucose levels, and meet fluid needs. Although vitamins and minerals taken at levels in excess of the RDA have been shown not to benefit performance, use of high levels of supplements is not uncommon among athletes. Athletes are often unaware that some nutrients can be toxic when taken in excess. PMID- 3512106 TI - The use of drugs in swimming. AB - The use of drugs to enhance athletic performance poses tremendous potential risk to amateur sport. The aquatic sports are not immune from this risk. Although the exact incidence of drug usage among aquatic athletes is not known, empirical evidence would suggest that there are indeed athletes who are using substances in an effort to enhance performance. A number of the commonly used substances have been discussed and their risks and side effects reviewed. Future success in eradicating drug usage in sport will only result from increased efforts directed at enhancement of athlete education, development of strict policies dealing with those athletes who use banned substances, and refinement of drug testing procedures. PMID- 3512107 TI - The art of cognitive self-regulation. AB - We like to think our minds were created to serve as truth-finding instruments, but it is difficult to imagine a mechanism that could do a worse job of straight thinking, and yet give the illusion of doing a first-class job. This article presents an instructional format to promote increased rationality of thinking as well as greater cognitive flexibility and cognitive self-regulation. PMID- 3512108 TI - [Ultrasonography of the paranasal sinuses]. PMID- 3512109 TI - [In memory of Dr. M. Bellova]. PMID- 3512110 TI - [In memory of 3 professors]. PMID- 3512111 TI - Efficient breakage of DNA apurinic sites by the indoleamine related 9-amino ellipticine. AB - The aromatic amine, 9-NH2-ellipticine, is a synthetic DNA intercalating derivative of the antitumor agent ellipticine, which breaks circular DNA containing apurinic sites. This breakage is inhibited when the apurinic (AP) sites are reduced. The concentration of 9-NH2-ellipticine required to get a significant effect (0.1 microM) is the lowest known among chemicals which induce the same breakage reaction. Comparison with the action of structurally related amines shows that the amino-indole structure is specific for AP sites. The ability of ellipticine derivatives to induce breakage in DNA containing apurinic sites is related to the nucleophile substituent in position 9. Two ellipticine derivatives with known antitumor activity, BD 40 and 9-OH-ellipticine, were able to break purified DNA at apurinic sites. PMID- 3512112 TI - Chemical structure and mutagenic activity of aminoimidazoquinolines and aminonaphthimidazoles related to 2-amino-3-methylimidazo[4,5-f]quinoline. AB - We have synthesized 11 heterocyclic aromatic amines with chemical structures related to that of 2-amino-3-methylimidazo [4,5-f] quinoline (IQ), a potent mutagen occurring in broiled sardines, fried beef and beef extract. The mutagenic activity of these IQ analogs was studied and compared with that of IQ using the Ames test with strain TA98 of Salmonella typhimurium in presence of a metabolic activation system (S9 mix) derived from rat liver. The mutagenic activities of the IQ analogs vary over a million-fold; structure-activity comparisons indicate major contributions of the methyl substitution in the imidazole ring and of the quinoline-N, and significant contributions of methylation of the exocyclic amino group and of the geometry of the entire ring system. PMID- 3512113 TI - Treatment of advanced neuroblastoma with high-dose melphalan and autologous bone marrow transplantation. AB - Fifteen children with advanced neuroblastoma according to Evans' classification (1 with stage III and 14 with stage IV) were treated with high-dose melphalan (HDM) followed by autologous bone marrow transplantation. Before HDM, all patients had been extensively treated with multimodality therapy for a median duration of 9 months. At the time of HDM, seven children were in partial remission (PR) with measurable residual tumor and 8 were in complete remission (CR) or good partial remission (GPR). No reduction in measurable tumor size was observed in any of the PR patients. However, when HDM was used as consolidation therapy (CR and GPR patients) survival appeared encouraging, since five of eight patients are alive with no evidence of disease at (NED) 29+ to 54+ months after HDM. Tolerance of this high-dose chemotherapy was satisfactory; gastrointestinal toxicity appeared to be the most important limiting factor. These results suggest that chemotherapy including high-dose melphalan is promising when used as consolidation therapy in patients who have already attained CR with conventional therapies. PMID- 3512114 TI - Very high dose chemotherapy with autologous bone marrow rescue in adult patients with resistant relapsed lymphoma. AB - Seventeen patients with advanced lymphoma were treated with high-dose chemotherapy with autologous bone marrow rescue. In 11 patients with non Hodgkin's lymphoma (NHL) there were 2 complete remissions (CRs) and 2 partial remissions (PRs), and in 6 patients with Hodgkin's disease there were 5 CRs. Three patients remain well in unmaintained remission (days 874, 446 and 351), and a further 2 are alive and still receiving treatment (days 650 and 558). This type of therapy appears useful and should now be considered earlier in the course of the disease. PMID- 3512115 TI - Phase I study of cyclohexylamine and lysine salt of mafosfamide. AB - Mafosfamide is a new oxazaphosphorine that breaks down spontaneously into 4 hydroxy-cyclophosphamide. A phase I trial with cyclohexylamine and lysine salts of mafosfamide was carried out in 16 patients, using weekly IV perfusion. Dose limiting toxicities were not hematological, but consisted in the development of severe pain along the vein during administration. A particular mucosal syndrome with sneezing and conjunctivitis was seen only after administration of the lysine salt. The dose of 700 mg/m2 per week represents the maximum tolerated dose with this weekly schedule. PMID- 3512117 TI - Interaction of the synthetic ultimate carcinogens, N-sulfonoxy- and N-acetoxy-2 acetylaminofluorene, and of enzymatically activated N-hydroxy-2 acetylaminofluorene with nucleophiles. AB - The interaction of four cellular nucleophiles with the putative ultimate carcinogens N-sulfonoxy-2-[ring-3H]acetylaminofluorene (N-sulfonoxy-2-AAF) and N acetoxy-2-[ring-3H] acetylaminofluorene (N-acetoxy-2-AAF), and with N-hydroxy-2 [ring-3H]acetylaminofluorene (N-hydroxy-2-AAF) activated to the ultimate carcinogens by enzymatic sulfonation or transacetylation was determined. The adducts were isolated and adduct formation was quantified by isotope dilution. The order of nucleophilicity of the acceptors was guanosine greater than tRNA congruent to polyguanylic acid (poly G) greater than N-acetyl-L-methionine when N sulfonoxy-2-AAF, N-acetoxy-2-AAF or N-hydroxy-2-AAF activated by transacetylation were the electrophiles. In the case of N-hydroxy-2-AAF activated by enzymatic sulfonation, the order of nucleophilicity was N-acetyl-L-methionine greater than guanosine congruent to tRNA greater than poly G. The increase in the reactivity of N-acetyl-L-methionine is hypothesized to be due to cytosolic enzyme(s) which facilitate transfer of the methionine residue from the nitrogen to carbon atoms 3 and 1 of the fluorene moiety. Of the two synthetic esters, N-sulfonoxy-2- AAF exhibited greater electrophilicity than N-acetoxy-2-AAF. The rate of adduct formation of N-sulfonoxy-2-AAF and of N-acetoxy-2-AAF with each nucleophile was a function of nucleophile concentration, indicative of a bimolecular reaction mechanism. The interaction is thought to involve attack of the nucleophile on the uncharged ultimate carcinogen, although interaction with an ion pair cannot be eliminated. The mutagenicity of N-sulfonoxy-2-AAF, N-acetoxy-2-AAF and of enzymatically activated N-hydroxy-2-AAF was evaluated by the Ames test. N Sulfonoxy-2-AAF was virtually inactive, while N-acetoxy-2-AAF exhibited weak mutagenicity. N-Hydroxy-2-AAF activated by enzymatic sulfonation exhibited greater mutagenicity than synthetic N-sulfonoxy-2-AAF. The mutagenicity and reactivity of ultimate carcinogens derived from N-hydroxy-2-AAF by enzymatic activation do not necessarily coincide with the mutagenicity and reactivity of the synthetic ultimate carcinogens. PMID- 3512116 TI - Mutagenic activation of carcinogenic N-nitrosopropylamines by liver S9 fractions from mice, rats and hamsters: evidence for a cytochrome P-450-dependent reaction. AB - The mutagenic potential of nine carcinogenic N-nitrosopropylamines was examined by Ames preincubation assay using liver 9000 g supernatant (S9) fractions from female rats and male hamsters and mice for metabolic activation. N-Nitrosobis(2 hydroxypropyl)amine, N-nitroso(2-hydroxypropyl)(2-oxopropyl)amine, N-nitrosobis(2 oxopropyl)amine, N-nitrosobis(2-acetoxypropyl)amine, N-nitroso-2,6 dimethylmorpholine, N-nitrosomethyl(2-hydroxypropyl)amine, N-nitrosomethyl(2 oxopropyl)amine, N-nitroso(2,3-dihydroxypropyl)(2-hydroxypropyl)amine and N nitrosomethyl(2,3-dihydroxypropyl)amine all showed positive mutagenicity in strain TA100 in the presence of liver S9 from three animal species pretreated with polychlorinated biphenyls or phenobarbital (PB). The S9-mediated mutagenicity of these N-nitrosamines was almost completely diminished by the removal of NADP+ from the assay system. All the activities were considerably decreased by preincubation in an atmosphere of carbon monoxide or adding cytochrome c to the S9 mixture. Metyrapone considerably inhibited mutagenicity, whereas 7,8-benzoflavone was totally lacking this effect. These results demonstrate a correlation between the mutagenicity of nine N-nitrosopropylamines mediated by liver S9 from three animal species and their known carcinogenicity in rodent in vivo experiments, and that the PB-inducible major cytochrome P-450 is selectively involved in the mutagenic activation. A relationship between mutagenic potencies of the N-nitrosamines and their known carcinogenic potencies in rats and hamsters is discussed. PMID- 3512118 TI - Mutagenicity of the mercapturic acid and other S-containing derivatives of hexachloro-1,3-butadiene. AB - The main metabolic pathway of the genotoxic environmental contaminant hexachloro 1,3-butadiene (HCBD) is the direct conjugation reaction with glutathione. To establish structure-effect relationships we studied the mutagenic activity of four S-containing HCBD conjugates with and without metabolic activating enzymes (S9 mix) in Salmonella typhimurium. The N-acetyl-S-pentachlorobutadienyl-L cysteine (mercapturic acid) was clearly mutagenic after metabolic activation; its mutagenic activity was 48.6 revertants/micrograms or 18.7 revertants/nmol, which is, on a molar basis, a mutagenic response 80 times greater than that of the parent compound HCBD. The mutagenic effect of the mercapturic acid rather decreased by addition to the pre-incubation system of pyridoxal 5'-phosphate, a co-factor of the enzyme beta-lyase. Methyl-N-acetyl-S-pentachlorobutadienyl-D,L homocysteinate, structurally closely related to mercapturic acid, exerted a weak mutagenic effect comparable to that of HCBD. The two S-containing HCBD metabolites (S-pentachlorobutadienyl-mercaptoacetic acid and pentachlorobutadienyl-methylthioether) did not reveal significant mutagenic effects. The results indicate the involvement of the enzyme N-deacetylase which catalyzes the conversion of mercapturic acid to the HCBD-cysteine conjugate. In addition a high substrate specificity of the C-S bond-cleaving enzyme beta-lyase was observed. PMID- 3512119 TI - Induction of DNA repair in rat spermatocytes and hepatocytes by 1,2 dibromoethane: the role of glutathione conjugation. AB - 1,2-Dibromoethane (EDB) is a widely used industrial chemical, and a well-known mutagen and carcinogen. EDB is biotransformed either by cytochrome P450-dependent oxidation, leading to the formation of bromoacetaldehyde, or by enzyme-catalyzed conjugation with glutathione, giving rise to reactive half-sulfur mustard compounds and their derivatives. In vitro mutagenicity and DNA binding studies suggest that the latter pathway is the primary source of genotoxic metabolites from EDB. In this study we have examined EDB-induced unscheduled DNA synthesis (UDS) in F-344 rat pachytene spermatocytes and hepatocytes. EDB (10-100 microM) induced UDS in both hepatocytes and spermatocytes in vitro. In contrast, only hepatocytes exhibited UDS when isolated from rats given EDB (100 mg/kg) 2 h earlier, and only then if the compound was given i.p. rather than orally. Preincubation of hepatocytes or spermatocytes with inhibitors of cytochrome P450 mediated oxidation had no effect on EDB induction of UDS in vitro. In contrast, depletion of cellular glutathione strongly inhibited EDB-induced UDS in both cell types in vitro. Treatment of rats with 175 mg metyrapone/kg (an inhibitor of hepatic mixed-function oxidases) 1 h prior to administration of EDB in vivo had no effect on EDB-induced UDS in hepatocytes, but led to a positive UDS response to EDB in spermatocytes in vivo. This suggests that the mixed-function oxidase pathway of metabolism is the primary route of clearance of EDB and that inhibition of cytochrome P450-mediated oxidation led to a more extensive tissue distribution of the parent compound. These data also suggest that the pathway which produces genotoxic metabolites from EDB in hepatocytes and spermatocytes, in vitro and in vivo, involves the conjugation of EDB to glutathione and its subsequent metabolism. PMID- 3512120 TI - Loss of nocturnal decline in blood pressure after cardiac transplantation. AB - Twenty-four hour noninvasive ambulatory blood pressure and heart rate monitoring was performed on patients who underwent orthotopic cardiac transplantation, as part of the investigation of the de novo hypertension that developes in such patients. Patients with essential hypertension served as control subjects. The results demonstrated a highly significant loss of the usual decline in blood pressure and heart rate during sleep in the transplant patients. A similar loss of nocturnal decline in blood pressure was noted in a group of 10 patients with autonomic neuropathy secondary to diabetes mellitus. The de novo hypertension associated with cardiac transplantation is probably multicausal. Impairment of renal function by cyclosporin-A with associated salt and water retention and persistent elevation of the systemic vascular resistance in the presence of a restored normal cardiac output by the "new" heart are major factors. In addition, loss of the normal nocturnal decline in blood pressure and heart rate, which probably is related to the denervated state of the transplanted heart, may play an important role in blood pressure control. PMID- 3512122 TI - Exercise-induced regional dysfunction with subcritical coronary stenosis. AB - The hypothesis was tested that regional myocardial contractile dysfunction can detect subtle regional coronary blood flow maldistribution induced by exercise. In seven dogs, left ventricular pressure (micromanometer), regional systolic wall thickening (WTh, sonomicrometry), and myocardial blood flow (MBF, microspheres) were measured when mild degrees of coronary artery stenosis were produced during treadmill exercise. During exercise without coronary stenosis, WTh increased by 21 +/- 12% (SD), and transmural MBF increased uniformly. In each dog, two levels of coronary stenosis were produced during exercise by adjusting the coronary hydraulic cuff: (1) St-Ex I, where WTh during exercise failed to increase significantly (average change 0 +/- 7%), and (2) St-Ex II, where WTh during exercise decreased moderately from the resting control value (average -20 +/- 8%). In the potentially ischemic zone coronary hyperemia occurred with each run: resting subendocardial MBF was 1.09 +/- 0.30 mg/g/min, and it was 3.04 +/- 0.83 during control exercise, 2.48 +/- 0.75 during St-Ex I, and 1.55 +/- 0.59 ml/g/min during St-Ex II (p less than .01 compared with control exercise and control area). The subendocardial-subepicardial blood flow ratio fell from 1.32 +/- 0.27 during control exercise to 1.07 +/- 0.20 (p less than .05) during St-Ex I, and to 0.64 +/- 0.15 (p less than .01) with St-Ex II. Changes in the subendocardial electrogram and reactive hyperemia occurred more consistently during St-Ex II than St-Ex I. Thus, failure of regional function to increase during exercise detected slight maldistribution of regional MBF, whereas reduction of regional function during exercise of 10% or more below the resting value was a reliable marker of a regional flow defect and was always associated with other evidence of ischemia. Therefore, regional dysfunction during exercise can detect subcritical but functionally significant coronary stenosis, which may allow regional wall motion to be used for detecting coronary artery disease at a relatively early stage. PMID- 3512121 TI - Differential long-term intrarenal and neurohormonal effects of captopril and prazosin in patients with chronic congestive heart failure: importance of initial plasma renin activity. AB - Fifty patients with congestive heart failure received, by infusion, 15 ml/kg body weight water load, and systemic hemodynamic, renal function, and neurohumoral parameters values were measured before, 2 days, and 1 month after randomly allocating patients to prazosin or captopril therapy. Both prazosin and captopril caused similar and persistent hemodynamic changes, but important differences existed between their renal and neurohumoral effects. After 1 month of continuous therapy, captopril increased creatinine clearance from 71 to 84 ml/min/1.73(2) (p less than .05), increased the water load excreted in 5 hr from 50% to 71% (p less than .005), and increased 5 hr sodium excreted from 6.8 to 14.7 meq (p less than .005), Captopril also caused a decrease in plasma norepinephrine from 568 to 448 pg/ml (p less than .005), in plasma epinephrine from 94 to 73 pg/ml (p less than .05), and in plasma aldosterone from 57 to 28 ng/dl (p less than .005), without changing plasma vasopressin. These beneficial effects were greater after 1 month of therapy than after 2 days. The only beneficial effect of prazosin was to increase water excretion from 49% to 59% (p less than .05). The long-term response to captopril was similar in patients with higher (greater than 2.5 ng/ml/hr) and lower renin levels. However, in patients with lower renin levels, prazosin decreased pulmonary capillary wedge pressure (24.8 to 21.8 mm Hg, p less than .05), decreased plasma arginine vasopressin (1.16 to 0.75 pg/ml, p less than .05), increased water excretion (62% to 85%, p less than .005), and decreased plasma epinephrine (81 to 46 pg/ml, p less than .05), while in patients with higher renin levels none of these beneficial effects were noted. We conclude that captopril produces long-term beneficial renal and neurohumoral effects that prazosin does not despite similar hemodynamic changes with the two drugs, that these effects are at least partially dependent on the initial neurohumoral and hemodynamic status of the patient, and that through hemodynamic improvement vasodilators may chronically interrupt vasopressin overstimulation. PMID- 3512123 TI - Efficacy of an automated external defibrillator in the management of out-of hospital cardiac arrest: validation of the diagnostic algorithm and initial clinical experience in a rural environment. AB - Automatic external defibrillators (AEDs) may have advantages over manual defibrillation in managing prehospital cardiac arrest, particularly in rural communities. We conducted a two-part evaluation of a commercially available AED. We first established the diagnostic accuracy of the AED's rhythm recognition algorithm by challenging it with 205 cardiac arrest rhythms previously recorded from actual patients in the field. The AED demonstrated 100% specificity and 92% sensitivity for ventricular fibrillation (VF) in this nonclinical setting. We then compared the clinical efficacy of AEDs in 18 small communities (study group) with that of manual defibrillation in 18 additional communities (control group) of similar size. Ambulance technicians using manual defibrillators correctly diagnosed VF more frequently than the AEDs (98% vs 83%; p less than .025). Specificity for VF was similar in the two groups (100% for AEDs vs 94% for technicians; p greater than .10). AEDs were able to deliver shocks more quickly than was possible with the manual defibrillators (1.56 vs 2.77 min; p less than .001). The ability of the AEDs to terminate VF was excellent, converting VF in 28 of 29 (97%) patients to some other rhythm compared with only 37 of 53 (70%) patients in the control group (p less than .01). Hospital admission and discharge rates were similar for the two groups. Ten of the 35 (29%) patients managed with AEDs achieved admission and six (17%) were ultimately discharged. In the control group 17 of 53 (33%) patients with VF were admitted and seven (13%) were discharged (p less than .75). AEDs are an effective alternative to manual defibrillation in small communities. PMID- 3512124 TI - Efficacy and safety of moricizine in patients with ventricular tachycardia: results of a placebo-controlled prospective long-term clinical trial. AB - This was a prospective, placebo-controlled, single-blind trial of moricizine (ethmozine) in a dose averaging 10 mg/kg/day in 50 patients, the single entrance criterion being the presence of 10 or more runs of nonsustained ventricular tachycardia (VT) on a screening 24 hr ambulatory electrocardiographic (ECG) recording. Electrophysiologic study was not included as part of this trial design. The placebo frequency of VT (average 3 days of recording) was 1036 +/- 479 runs of VT per day. Most patients (31/50) had coronary artery disease. The study population had a mean left ventricular ejection fraction (LVEF) of 36 +/- 16%; 20 patients also had a history of sustained VT. Protocol failure was defined as failure to achieve a 75% or greater reduction in runs of VT (as judged by ambulatory ECG recording) and/or recurrence of sustained VT while on moricizine. Among the 48 patients treated with moricizine, the drug was initially efficacious in 35 (73%), with two-thirds having total abolition of nonsustained VT. Although it was effective in reducing runs of nonsustained VT, moricizine was ineffective in preventing the recurrence of sustained VT (63% failure rate). Side effects were uncommon and the drug was well tolerated in most patients with LVEFs of 30% or less. PMID- 3512125 TI - Pulsed Doppler echocardiographic assessment of the pulmonary venous pathway after the Mustard or Senning procedure for transposition of the great arteries. AB - Pulsed Doppler evaluation of pulmonary venous flow was performed in three groups of patients who had undergone either a Mustard or Senning procedure. Group I consisted of 43 patients in sinus rhythm who had undergone the Mustard procedure 9 months or more before the Doppler examination and 16 who were evaluated immediately after surgery. Group II consisted of 12 patients in sinus rhythm who had undergone the Senning procedure 9 months or more before the Doppler evaluation. Group III consisted of eight patients with mid baffle obstruction of the pulmonary venous atrium and seven with isolated stenosis of the pulmonary vein of which all but one had previously had associated mid baffle obstruction. In those without obstruction, the pulmonary venous flow pattern mirrored the left atrial pressure trace, with peak forward flow occurring during the x and y descent. Obstruction produced a specific high-velocity turbulent pattern, whether at the mid baffle or pulmonary venous level. This technique provides reliable noninvasive information about pulmonary venous flow after the Mustard or Senning procedure. PMID- 3512126 TI - Rigid contact lens wear in the corneal transplant patient. PMID- 3512127 TI - Parathyrin (parathyroid hormone): metabolism and methods for assay. AB - Parathyrin (parathyroid hormone) radioimmunoassay is a commonly ordered endocrine assay. I discuss here of the metabolism of the hormone and the effect information on this metabolism has had on the development of radioimmunoassays for parathyrin. Although radioimmunoassay is the most widely accepted technique for the routine assay for parathyrin, "high-performance" liquid chromatography, cytochemical bioassay, and homologous bioassay have also been developed for this analyte. Accordingly, I briefly review the clinical utility of these assays in terms of their ability to assess the functional activity of the parathyroid gland. PMID- 3512128 TI - Statistical analysis of the stability of the standard curve for some Syva EMIT assays. AB - Derivation of standard curves for the EMIT therapeutic drug monitoring system involves several mathematical algorithms, all of which can be rewritten in the form of a linear equation y = mx + b. We examined the stability of the standard curve in terms of slope and y-intercept for three drug assays (procainamide, gentamicin, and carbamazepine) by generating calibration curves intermittently for periods as long as 90 days. Controls at three concentrations were assayed after each calibration to validate the standard curves. On the basis of 98% confidence intervals, the slopes of standard curves for procainamide, gentamicin, and carbamazepine were stable for 89, 80, and 57 days, respectively. Control values generated from standard-curve manipulations (adjustments to the y intercept) indicated consistent accuracy and precision throughout the entire study, as compared with control values determined after each calibration. The increased utility of the standard curve and reagents suggests that full recalibration on a regular basis is not always necessary. PMID- 3512129 TI - Radioimmunoassay for assessing exocrine pancreatic insufficiency, based on the differential enzymatic degradation of cobalamin-binding proteins. AB - Pancreatic proteases degrade the protein moiety of the R protein-cobalamin complex but not the intrinsic factor-cobalamin complex. Accordingly, we used these two proteins as substrates in an in vitro enzymatic assay to assess pancreatic function by incubating basal jejunal fluids with a mixture of intrinsic factor and cyano[57Co]cobalamin coupled to R-type protein and then using immunoprecipitation to determine the distribution of isotopically labeled cobalamin bound to the two proteins. With normal jejunal fluids, 91.2 (SD 6.1)% and 4.5 (SD 5.5)% of cyano[57Co]cobalamin was precipitated with antisera to intrinsic factor and anti-R protein, respectively. In the patients' jejunal fluids, the cyano[57Co]cobalamin precipitated with the respective antisera was 5.3 (SD 10.0)% and 96 (SD 6.2)%. In patients with other gastrointestinal problems, the sequestration of cobalamin was indistinguishable from that observed with the normal fluids. The clearcut discrimination this radioimmunoassay provided between abnormal and normal samples was confirmed by parallel comparative chromatographic analysis. PMID- 3512130 TI - New immunoenzymatic assay for human thyrotropin compared with two radioimmunoassays. AB - We have evaluated a new immunoenzymatic assay for human thyrotropin involving three monoclonal antibodies (Abbott HTSH EIA) and compared the results with those of two conventional nonequilibrium double-antibody radioimmunoassay (RIA) methods: Clinical Assays' RIA and a research RIA (J Clin Endocrinol Metab 1975; 41:676). Mean values for thyrotropin in 100 euthyroid serum samples were similar in the Abbott and Clinical Assays methods, but both sets were significantly higher than those by the research RIA. By all methods, values for hypothyroid patients were clearly higher than values for euthyroid subjects. Results for hyperthyroid and euthyroid subjects were resolved slightly better with the research RIA than with the Abbott kit. The new Abbott assay was far more sensitive than either the Clinical Assays RIA or our research RIA. The correlation of results of the Abbott assay with those of the Clinical Assays and the research RIA exceeded 90% for samples from hypothyroid patients. The Abbott assay replaces radioisotope counting with spectrophotometric detection. PMID- 3512131 TI - Mass-spectrometric determination of serum cortisol: comparison of data from two independent laboratories. AB - Isotope dilution and mass spectrometry were used in two independent laboratories to determine cortisol in 15 plasma and serum pools used in the British and German national schemes for the external quality assessment of routine assays. For the concentration range 240-700 nmol/L, differences between the data obtained by the two laboratories were generally less than 4% but were approximately 7% in two instances. The discrepancies are nevertheless small in comparison with the bias observed for many routine assays. PMID- 3512132 TI - Enzyme immunoassay of progesterone in human and bovine serum and in unextracted bovine skim milk. PMID- 3512133 TI - Calvarial hyperostosis: a benign X-linked recessive disorder. AB - We report a family with what appears to be a unique X-linked recessive disorder of isolated hyperostosis of the calvarium. Although irregularity of the calvarium and exophytic prominences of the frontoparietal bones were apparent in infancy, premature cranial suture closure did not occur and there was no evidence of increased intracranial pressure despite a Luckenshadel appearance of the skull. Other membranous bones and the tubular bones were not involved. Calvarial bone biopsy from one patient showed vacuolated histiocytes suggesting a storage disease; however, neurologic deterioration, hepatosplenomegaly, and dysostosis multiplex did not occur. The affected family members had normal stature, normal occipitofrontal circumference, and no other medical problems. The biochemical basis of this disorder is not known. Although storage of abnormal material is possible, the long-term prognosis seems favorable. PMID- 3512134 TI - Guinea pig complement fixation by tissues from hypocomplementaemic renal diseases. AB - Recently many studies have been done to identify complement pathway activation in renal tissue from patients with renal disease. We examined whether tissues obtained by renal biopsy from such patients would fix guinea pig complement. Nine out of 15 patients with systemic lupus erythematosus (SLE), 4 out of 7 patients with mesangiocapillary glomerulonephritis (MCGN), and 2 out of 7 cases with acute glomerulonephritis (AGN) fixed guinea pig C3. We found that tissues from 5 out of 9 guinea pig C3-positive SLE cases fixed guinea pig C4, while none of the guinea pig C3-positive tissues from patients with MCGN or AGN fixed guinea pig C4. These guinea pig C3-positive renal tissues were further studied for interaction with C4 deficient guinea pig serum, EDTA guinea pig serum, heated guinea pig serum, and EGTA Mg2+ guinea pig serum. The results indicated that activation of both the alternate and classical complement pathways occurred with tissues from patients with SLE, while activation of the alternate pathway occurred with MCGN and AGN. Results for tissues from AGN and MCGN patients indicated the presence of C3 convertase and protease which interacted with guinea pig C3. PMID- 3512135 TI - Extracranial mycotic aneurysms in infective endocarditis. AB - Nine of 217 (4.15%) patients with infective endocarditis who were followed from October 1978 to February 1984 had extracranial mycotic aneurysms (MA). Age range of patients was 6-43 years (mean of 24.8 years) and 7 were male. Etiologic agents were Streptococcus viridans (3 cases), Staphylococcus aureus (2 cases), Staphylococcus epidermidis (1 case), and Pseudomonas aeruginosa (1 case). Two patients had negative blood cultures. The MA involved the arteries of the limbs (5 cases), thoracic (3 cases), and abdominal (1 case) arteries. The diagnosis was made by means of physical examination (5 cases), chest roentgenogram (2 cases), ultrasound examination (1 case), and aortography (1 case), at hospital admission (2 cases), early or before antibiotic therapy (2 cases), and from two days to six months after finishing antibiotic therapy (5 cases). All but one patient were operated upon due to MA; bleeding occurred in three cases; surgery was an emergency procedure in one case and performed from 8 to 58 days after the diagnosis of the MA in the others. Signs of infection at surgery were found in one case. In the others, further antibiotic therapy was not administered. There were no limb losses in the peripheral MA. Four patients received surgical treatment for endocarditis. There was one in-hospital death and another one 6 months later due to heart failure. PMID- 3512136 TI - Disc dislodgment in Bjork Shiley mitral valve prosthesis: two successfully operated cases. AB - Two patients with Bjork Shiley mitral valve replacement had migration and embolization of the occluding disc. One patient suffered migration of the disc a few hours after surgery and the other had a strut fracture with disc translocation six years after the initial operation. Clinical signs in both cases were pulmonary edema, cardiogenic shock, and absence of prosthetic sounds. Both patients were reoperated on an emergency basis, recovering after a complicated postoperative course. They are on functional Class I, 8 and 1 years later, respectively, with their dislodged discs still in the abdominal aorta. The only hope for survival in these patients is emergency reoperation, once the prosthetic mitral valve dysfunction is confirmed. PMID- 3512137 TI - Andre F. Cournand: father of clinical cardiopulmonary physiology. PMID- 3512138 TI - Paul M. Zoll and electrical stimulation of the human heart. PMID- 3512139 TI - An immunocytochemical comparison of the glia-associated proteins glial fibrillary acidic protein (GFAP) and S-100 protein (S100P) in human brain tumors. AB - Immunostaining patterns of two glia-associated proteins, glial fibrillary acidic protein (GFAP) and S-100 protein (S100P), were compared using the peroxidase antiperoxidase (PAP) method on adjacent paraffin sections in 100 brain tumors including 52 astroglial tumors, 13 oligodendrogliomas, 14 ependymomas, 13 choroid plexus papillomas and 8 medulloblastomas. Most astroglial tumors showed similar immunoreactivity for both proteins. Fibrillary processes, however, showed a stronger and more crisp staining with anti-GFAP than with anti-S100P, whereas cell nuclei were labeled only for S100P. Focal dissociation of immunoreactivities for the two proteins was prominent in several malignant astroglial tumors including giant cell glioblastoma, and in subependymal giant cell astrocytoma. In oligodendrogliomas, GFAP-positive neoplastic oligodendrocytes also showed immunoreactivity for S100P; a smaller number of tumor cells were immunoreactive only for S100P, comparable to normal mature oligodendroglia. Most ependymomas were characterized by a similar distribution of cells immunoreactive for both proteins. In choroid plexus papilloma, absent or only focal immunoreactivity for GFAP contrasted with diffuse labeling for S100P in all cases; this seems of value for a differential diagnosis of papillary CNS tumors. In medulloblastoma, some tumor cells of a classical type were immunoreactive only for S100P; on the contrary, GFAP positive tumor cells with sparse or absent immunoreactivity for S100P were found in desmoplastic medulloblastomas. Similar immunoreactivities for both proteins in most tumors suggest a generally parallel production of both proteins by glial tumor cells.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3512142 TI - Children less than three-years-old with pharyngitis. Are group A streptococci really that uncommon? AB - During a 15-month period, 148 infants and children less than 3-years-old who presented with signs and/or symptoms of pharyngitis were monitored in a private pediatric practice. Clinical signs included fever (95 or 64%), tonsillar exudate (16 or 11%), and cervical adenopathy (5 or 3%). Beta-hemolytic streptococci (BHS) from group A were isolated from throat swabs in 37 (25%) instances. These isolations were more common among children 25-35 months old than among children less than 2 years old (35% vs. 19%, p less than 0.05), and were significantly more likely when overnight anaerobic culture techniques were used rather than conventional aerobic methods (23% vs. 11%, p less than 0.01). Group A BHS may be isolated relatively frequently from symptomatic children under 3-years-old. Whether these isolations reflect invasive infection or asymptomatic carriage is uncertain. PMID- 3512143 TI - Caustic ingestions. Pathophysiology, diagnosis, and treatment. AB - More than 5,000 caustic ingestions are estimated to occur each year. Liquid lye is associated with the greatest morbidity. Endoscopy is the only method for evaluating the extent of the injury; clinical signs and symptoms (e.g., vomiting, dysphagia, abdominal pain, oral burns, leukocytosis) are not reliable. In less severe burns (involving only mucosal irritation or ulceration), current therapy with antibiotics and steroids results in a very favorable prognosis. Circumferential or very deep burns have a much poorer outcome, with a greatly increased risk of stricture formation and/or perforation. The risk of developing esophageal carcinoma may be 1,000 times greater for individuals who have had a lye burn than in the general population. It cannot be overemphasized that prevention is still the key to decreasing this morbidity. PMID- 3512144 TI - Pharmacologic treatment of psychiatric and neurodevelopmental disorders in children and adolescents (Part 3). PMID- 3512140 TI - Clinical pharmacokinetics of the newer intravenous anaesthetic agents. AB - In the last 15 years the role of opioids in anaesthesia management has undergone dramatic change. Initially used as premedicants, or adjuvants to inhalation anaesthetic agents or as analgesics for postoperative pain relief, narcotics have now evolved into primary anaesthetic agents, primarily because of their ability to maintain cardiovascular stability especially in patients with compromised myocardial function. Sufentanil, alfentanil, and lofentanil are 3 new synthetic congeners of fentanyl. Sufentanil and alfentanil afford not only the haemodynamic stability but also the desirable anaesthetic properties of analgesia, and unconsciousness. Their major advantage lies in their pharmacokinetic behaviour; a rapid onset of action and short elimination half-life, allowing for greater flexibility in anaesthetic management. Sufentanil's pharmacokinetic profile is consistent with a 2-compartment model. Its elimination half-life is 149 minutes and its clearance is 11.3 ml/min/kg. Alfentanil's pharmacokinetic profile has been described by both 2- and 3-compartment models. Its distribution and redistribution are rapid, with an elimination half-life of 83 to 137 minutes and a clearance of 4.37 to 6.47 ml/min/kg in adult patients. Lofentanil, however, is an extremely long-acting narcotic analgesic. Presently, its use is justified only when prolonged mechanical ventilation is anticipated. Etomidate, a carboxylated imidazole, is rapidly distributed within a central compartment and then to peripheral compartments; its slow distribution and terminal elimination half lives are 28 and 273 to 330 minutes, respectively, and its clearance (11.6 to 25 ml/min/kg) is equal to its hepatic plasma flow. Its ability to maintain cardiovascular stability in patients with compromised myocardial function make it a useful induction agent. However, reports of increased mortality and inhibition of steroidogenesis in patients receiving either single injections or constant infusions have created controversies regarding its use. Minaxolone is a water soluble steroid whose pharmacokinetic profile is consistent with a 2-compartment model. Distribution is rapid with a mean half-life of 2.1 minutes and an elimination half-life of 47 minutes. There do not appear to be any cumulative effects. Plasma levels on recovery were similar in those patients receiving single bolus or continuous infusions. Midazolam and flunitrazepam are two new benzodiazepines. As a class of drugs, benzodiazepines provide the pharmacological properties of anxiolysis, sedation, hypnosis, muscle relaxation, amnesia and anticonvulsant activity.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3512141 TI - Clinical pharmacokinetics of methoxsalen and other psoralens. AB - The psoralen derivative methoxsalen and to a lesser extent some other furocoumarin congeners, including bergapten and trioxsalen, have acquired a place in the treatment of psoriasis and other dermatoses. They are inactive after oral or topical administration unless combined with irradiation with long-wave ultraviolet light (UVA). This combination is referred to as photochemotherapy or PUVA (psoralen plus UVA). Usually a standard dose of methoxsalen (0.5 to 0.7 mg/kg) is given 2 hours prior to irradiation, and the light dose is assessed individually. Differences in response are often due to the unpredictable pharmacokinetic behaviour of the drug. Reversed-phase high-performance liquid chromatography is the method of choice for determining methoxsalen concentrations in body fluids, but gas chromatography with electron capture detection and thin layer chromatography with fluorescence densitometry also give favourable results. The absorption of methoxsalen, and hence clinical response, is affected by concomitant food ingestion and by differences in drug formulation. A liquid preparation in soft gelatin capsules or a microenema give higher and more rapidly appearing maximum serum concentrations (Cmax) than crystalline methoxsalen in tablets or capsules. With a standard dose of tablets, Cmax is in the range of 50 to 250 micrograms/L and appears between 1 and 2 hours after ingestion. The drug has a high, but variable, intrinsic metabolic clearance and is almost completely metabolised. Serum elimination half-life is in the order of 0.5 to 2 hours. There is a large interpatient variability in the clearance of methoxsalen (40 to 650 L/h); the relative distribution volume ranges between 1 and 9 L/kg. Concentrations in suction blister fluid (sbf) are approximately one-third of Cmax in serum and remain relatively constant as long as the plasma concentration exceeds the suction blister fluid level. Individuals with a high methoxsalen clearance and low Cmax usually show less biological sensitivity to PUVA (in terms of minimal phototoxic dose of UVA) than low-clearance patients and frequently a less favourable clinical response. Hence Cmax can be used for the purpose of therapeutic drug monitoring and, in practice, this may be determined by measuring serum concentrations at least at 1, 2, and 3 hours after ingestion. Bergapten is somewhat less active than methoxsalen but has similar pharmacokinetic characteristics. The bioavailability of trioxsalen is poor after oral intake and this drug is mainly administered topically. PMID- 3512145 TI - Infective endocarditis following cardiac catheterization in infancy. A case report and review. AB - A 4.5-month-old infant with transposition of great vessels and large ventricular septal defect developed acute infective endocarditis following cardiac catheterization. Beta-hemolytic streptococcus was recovered from three blood cultures. The infant survived after 6 weeks intravenous antibiotic therapy. The occurrence of infective endocarditis following cardiac catheterization during infancy is briefly reviewed and discussed. The importance of distinguishing febrile episodes of infancy from infective endocarditis and the use of two dimensional echocardiography for diagnosis is re-emphasized. PMID- 3512146 TI - The cardiovascular risks of thiazide diuretics. PMID- 3512147 TI - A single-dose pharmacokinetic study of the antisickling agent cetiedil. AB - Cetiedil citrate is an antisickling agent shown to be effective in reducing the severity and duration of acute sickle cell crisis. With the use of a sensitive GC/MS assay, the pharmacokinetic profile of cetiedil was studied in normal men and in men with sickle cell anemia who were not in crisis at the time of study. A peak cetiedil concentration of 70 to 200 ng/ml was found immediately after a 30 minute drug infusion. The plasma level then gradually declined to approximately 10 ng/ml during a 3-hour distributive phase. Computer analysis of the data was most consistent with a three-compartment model. No pharmacokinetic differences were found between the normal men and the subjects with sickle cell. Because the cetiedil plasma levels achieved during this in vivo study are well below concentrations that exhibit antisickling activity in vitro, additional clinical studies will be necessary before an optimal dosing regimen can be established. PMID- 3512148 TI - Effects of quinidine on pharmacokinetics and pharmacodynamics of digitoxin achieving steady-state conditions. AB - Quinidine has been reported to increase digoxin plasma concentrations, which increases the risk of digoxin overdose. The effect of quinidine on digitoxin pharmacokinetics is still controversial because most studies were not performed with subjects achieving definite steady-state conditions. To determine whether quinidine affects digitoxin kinetics and cardiac efficacy, we measured glycoside plasma concentrations and renal excretion as well as ECG parameters and systolic time intervals before and during quinidine dosing in eight healthy subjects at steady state. Mean (+/- SD) digitoxin plasma concentrations and renal excretion increased from 13.6 +/- 2.2 ng/ml and 16.1 +/- 5.8 micrograms/24 hours before dosing to 19.7 +/- 3.1 ng/ml and 23.4 +/- 4.9 micrograms/24 hours, respectively, during quinidine dosing for 32 days. While renal digitoxin clearance was not noticeably changed by quinidine, total digitoxin clearance and extrarenal digitoxin clearance decreased by an average of 32% and 40.5%, respectively. The elimination t1/2 was prolonged from 150.3 +/- 20.6 to 202.6 +/- 37.5 hours. The increased digitoxin plasma level is pharmacodynamically active. We conclude that there is a clinically important interaction between digitoxin and quinidine, but it is to a lesser extent and is caused by different mechanism, in part, than the interaction between digoxin and quinidine. PMID- 3512150 TI - Serum ferritin. PMID- 3512149 TI - Comparison of oral nalbuphine, acetaminophen, and their combination in postoperative pain. AB - This double-blind, randomized, parallel, placebo-controlled study evaluated the analgesic effects of single oral doses of 30 mg nalbuphine, 650 mg acetaminophen, and the contribution of each to the efficacy of their combination in 128 hospitalized patients with postoperative pain. Subjective reports of patients evaluated each hour for 6 hours were used as indices of analgesic response. Both nalbuphine and acetaminophen were significantly superior to placebo for most measures of total and peak analgesia. The interaction contrast between nalbuphine and acetaminophen was not significant for any analgesic measurements, indicating an additive effect of the components. The combination was the most effective treatment, followed by nalbuphine, acetaminophen, and placebo. Effects of the combination were significantly different from those of acetaminophen at 4, 5, and 6 hours and from those of placebo at 1 to 6 hours. There was no significant difference in the frequency or intensity of side effects among the groups. The combination of nalbuphine and acetaminophen appears to be a therapeutically useful combination. PMID- 3512151 TI - Vasopressin, aldosterone and renin responses to volume depletion in heart transplant recipients. AB - Plasma arginine vasopressin (AVP), renin activity (PRA) and aldosterone (ALD) were measured immediately before and 60 min after intravenous administration of frusemide and passage from lying to standing in 10 untreated healthy subjects (group 1), eight asthmatic patients treated with prednisone (group 2) and 13 heart-transplant recipients treated with prednisone and cyclosporin (group 3). Three different tests for cardiac vagal innervation were performed in the study population. They confirmed that the patients of group 3 were denervated whereas those of groups 1 and 2 had an intact cardiac innervation. Plasma volume depletion after frusemide administration estimated from the rise in plasma proteins was 10-12%. Mean blood pressure was higher in the transplant recipients but did not change in the three groups. Heart rate was also greater in the transplant recipients as a result of vagal denervation. PRA and ALD increased in all the subjects: 2.8, 3.3 and 2.2 times basal value for PRA, 2.7, 4.6 and 2.1 times basal value for ALD in groups 1, 2 and 3 respectively. In contrast, plasma AVP increased only in the two control groups (x1.45 and x1.65 in groups 1 and 2 respectively) whereas it was unchanged in the group of heart-transplant recipients (x1.05). In order to better understand the etiology of the high basal AVP plasma levels observed in group 3, AVP response to a standard water load was studied in eight supplementary heart-transplant recipients: 81.5% of the water load was excreted over 3 h and plasma AVP fell significantly (x0.76).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3512152 TI - Chronic effects of oral sulindac on renal haemodynamics and hormones in subjects with chronic renal disease. AB - The effects of oral sulindac, 600 mg daily, on renal function and plasma hormones were studied in eight subjects with chronic renal failure. Renal function and plasma hormones were measured before drug administration and then after taking sulindac for 28 days. Effective renal plasma flow was reduced in all subjects after 28 days but the glomerular filtration rate did not change. Plasma renin activity, potassium and aldosterone concentrations and urinary sodium excretion did not change but urinary prostaglandin E2 excretion fell significantly. Sulindac may be a relatively renal-sparing drug in its effects on the hormonal control of glomerular function. PMID- 3512153 TI - Therapeutic considerations in using combinations of newer beta-lactam antibiotics. AB - The in vitro activity, pharmacokinetic interactions, and clinical efficacy of newer beta-lactam antibiotic combinations are reviewed. Combinations of beta lactam antibiotics offer an antimicrobial spectrum similar to that of aminoglycoside-beta-lactam combinations without the renal or eighth cranial nerve toxicity of aminoglycosides. Synergistic activity with beta-lactam combinations is demonstrable in vitro against a wide variety of aerobic gram-negative bacilli, but the frequency, with which it is found is substantially less than for aminoglycoside-beta-lactam combinations. Also, in vitro antagonism can be demonstrated, particularly with combinations containing an agent capable of inducing beta lactamase. Substantial alterations in the pharmacokinetics of cefotaxime and desacetylcefotaxime have been demonstrated by the concomitant administration of mezlocillin or azlocillin. In addition, the clearance of moxalactam has been shown to be reduced by concomitant administration of piperacillin, and the clearance of oxacillin is reduced by concomitant mezlocillin therapy. Dosage reductions of these drugs may be appropriate in certain situations. Several clinical trials comparing therapy with beta-lactam combinations versus aminoglycoside-containing regimens in neutropenic patients have shown no difference in overall efficacy between the two regimens, with the possible exception of infections in persistently granulocytopenic patients and perhaps in patients with Pseudomonas aeruginosa infections. beta-lactam combinations are generally less nephrotoxic, but potentially more costly when newer compounds are included, than amino-glycoside-containing regimens. These beta-lactam combinations should be reserved for use in patients at high risk for aminoglycoside toxicity. PMID- 3512154 TI - Current concepts in clinical therapeutics: intra-abdominal infections. AB - The etiology, pathophysiology, clinical presentation, and treatment of the two major types of intra-abdominal infections--peritonitis and abscesses--are described. Peritonitis of infectious origin is the acute response of the peritoneum to microorganisms; it is classified as primary (when the source of bacteria is not apparent) or secondary (usually involving perforation of a hollow structure of the GI tract with subsequent release of microbes). Peritonitis results in mortality because of fluid shifts and endotoxins that may cause hypovolemia and shock. Abscesses, purulent collections of fluid physically separated from the surrounding tissues, are the result of chronic inflammation following failure of the body to eradicate a pathogen completely. Secondary intra abdominal infections are often polymicrobial because of the diversity of organisms in the GI tract. The size of bacterial inocula and the number and types of species present substantially affect patient outcome. The patient with peritonitis usually presents in acute distress, with generalized abdominal pain and faint bowel sounds. The presentation of the patient with intra-abdominal abscess is more variable and less dramatic; pain and fever may be present. The treatment of these infections requires the coordinated use of prompt surgical intervention, support of vital functions, and appropriate antimicrobial therapy. Surgical procedures are used to stop continuing bacterial contamination of the peritoneum, remove foreign material from the abdomen, and drain purulent collections; it is the foundation of treating most types of intra-abdominal infections. Aggressive fluid therapy is required to assure adequate intravascular volumes in most patients. Generally, antimicrobial coverage for both aerobes and anaerobes must be started before culture results are available. Antimicrobial therapy for specific types of infections is given in the article. Surgical procedures are the foundation of treatment of most intra-abdominal infections; antimicrobial agents active against aerobic gram-negative bacilli and anaerobes are important adjuncts. PMID- 3512155 TI - Claude Bernard 1813-1878--a new physiology and philosophy. PMID- 3512156 TI - Exercise and physical training in the treatment of diabetes mellitus. AB - Regular exercise has been recommended for diabetic patients for many years, and was identified along with diet and insulin as one of the three components of good therapy by Eliot Joslin in the 1920s. Nevertheless, until recently, little effort had been made to determine the benefits and risks that result from exercise in the diabetic population, and there have been few attempts to define the specifics of an appropriate exercise prescription. With the recent popularity of exercise in the therapy for a variety of chronic diseases, there has been a renewed interest in the role of exercise in the therapy for diabetes. PMID- 3512157 TI - Insulin is a growth-promoter of the developing brain: possible implications for the infant of the diabetic mother. AB - The combination of diabetes mellitus and pregnancy was once associated with significantly increased morbidity and mortality for mother and baby. Advances in the obstetric management of the mother with diabetes and parallel advances in the management of the infant of the diabetic mother (IDM) have lowered the morbidity and mortality in many centers to near those for pregnancies in the non-diabetic woman. A significant increase still exists in the prevalence of congenital malformations in IDMs. Recent animal studies have shown that these malformations are related to maternal hyperglycemia early in the pregnancy, and that if it is controlled with insulin during the critical period of embryologic development, then the malformations may be prevented. PMID- 3512158 TI - Self-monitoring of blood glucose: an important adjunct to diabetes therapy. AB - Therapy for diabetes mellitus, especially type I diabetes mellitus, is changing rapidly. Several developments and discoveries have contributed to this change. Most important, the data relating to the relationship between vascular disease and neuropathy and control of blood sugar and the developments in monitoring of glucose control have had a major impact on concepts of therapy. The development of new and purer insulins and new delivery systems have also improved diabetic control. The major concept that has evolved in recent years has been that the vascular disease and neuropathy of diabetes are related to control of the blood glucose and, therefore, it is important to deliver insulin in a physiologic way that duplicates the pattern of control found in nature. Techniques to better accomplish this goal are now evolving. PMID- 3512159 TI - Computer-assisted diagnosis of acute azotemia. AB - We designed a computer program to make diagnostic suggestions in cases of acute azotemia. The performance of the program was tested in a retrospective manner on 63 patients with acute azotemia. The program correctly identified 90 of 94 diagnoses and made 20 false positive diagnostic suggestions. A revised version of the program correctly identified 94 of 94 diagnoses and made 4 false negative suggestions. The justification for this kind of diagnostic aid is discussed. PMID- 3512160 TI - ANEMIA: an expert consultation system. AB - Anemia is a knowledge-based consultation program for anemic states. It has been built using an artificial intelligence programming scheme, called EXPERT, which was developed at Rutgers University. At present, ANEMIA is able to provide assistance in the diagnosis and management of 64 disease entities. They include iron deficiency anemias, anemias due to chronic disorders, thalassemias, hemolytic anemias, arigenerative anemias, and a few other miscellaneous conditions. ANEMIA was tested against a data base of 220 retrospective and 100 new cases and the overall accuracy in the diagnostic performance was pretty good. Our intent is that ANEMIA ultimately will be able to serve as surrogate for the hematologist with the nonhematologist physician-user. PMID- 3512161 TI - Representation and semiautomatic acquisition of medical knowledge in CADIAG-1 and CADIAG-2. AB - CADIAG-1 and CADIAG-2 (Computer-Assisted DIAGnosis) are medical expert systems especially designed for ill-defined areas such as internal medicine. Both systems are being tested in the setting of a medical information system. With respect to their knowledge representation, CADIAG-1 has obvious advantages in totally ill defined areas such as syndromes in internal medicine, whereas CADIAG-2 seems more suited for domains with basic laboratory programs, e.g., hepatology or gall bladder and bile duct diseases. The formalization of relationships between medical entities led to first-order predicate calculus formulas in the case of CADIAG-1 and to a model based on fuzzy set theory in the case of CADIAG-2. In both systems two kinds of relationships between medical entities are considered: (1) necessity of occurrence and (2) sufficiency of occurrence. Statistical interpretations using the 2 X 2 table paradigm yield a way to calculate these relationships automatically from samples of patient data. Results obtained by exploiting 3530 patient records from a rheumatological hospital are presented. The described application is a machine-learning program that allows inductive learning from examples under statistical uncertainty. PMID- 3512162 TI - A hand-held decision-aid system designed for rural health workers. AB - A great part of the world's population is cared for by rural health workers who are also collecting data for epidemiological studies. These workers have a low level of medical training and are working in a poor technical environment. At the request of an international humanitarian and medical organization (Medecins Sans Frontieres), we have developed an integrated (hardware and software) system, TROPICAID, based on a hand-held computer and designed to increase rural health workers' efficiency. The software is easy to use and enables users to get information from an internal data base on 60 drugs. The decision-making module analyzes the patient's parameters (460 different symptoms are recognized) and indicates possible diagnoses (the system knows 210) and relevant treatments. In addition, the system facilitates the collection of medical data for elementary statistical analysis. The computer, which is lightweight (1.5 kg) and compact, runs on battery power for up to a week in normal use. The program which is written in Pascal and data are stored in high-capacity EPROMs. An early trial in Chad with Medecins sans Frontieres has shown the value of such a project as well as a few weaknesses to be overcome. PMID- 3512163 TI - Textile chemical finish dermatitis. AB - Chemicals used on fabrics to improve 10 different performance characteristics have resulted in irritant or allergic contact dermatitis. The most significant problem is due to formaldehyde and N-methylol compounds to produce durable press fabrics. Little is known about incidence of finish dermatitis or mode and amount of transfer of chemicals from fabric to skin. PMID- 3512164 TI - Kinetics of protein-nucleic acid interactions: use of salt effects to probe mechanisms of interaction. AB - The kinetics of protein-nucleic acid interactions are discussed with particular emphasis on the effects of salt concentration and valence on the observed rate constants. A general review is given of the use of experimentally determined salt dependences of observed kinetic parameters as a tool to probe the mechanism of interaction. Quantitative analysis of these salt dependences, through the application of polyelectrolyte theory, can be used to distinguish reactions which occur in a single step from those reactions which involve distinct intermediates. For those rate constants which display a large salt dependence, in either the association or dissociation reaction, this is due to the high concentration of counterions (e.g., Na+) in the vicinity of the nucleic acid which are subsequently released (or bound in the case of dissociation) at some point before the rate limiting step of the reaction. A general discussion of other features which affect protein-nucleic acid kinetics, such as nucleic acid length and the ratio of nonspecific to specific DNA binding sites (in the case of sequence specific binding proteins), is also given. The available data on the nucleic acid binding kinetics of small ligands (ions, dyes, oligopeptides), nonspecific binding proteins (T4 gene 32 protein, fd gene 5 and Escherichia coli SSB), and sequence specific binding proteins (lac repressor, RNA polymerase, Eco RI restriction endonuclease) are discussed with emphasis on the interpretation of the experimentally determined salt dependences. PMID- 3512165 TI - Genes for cytochrome P-450 and their regulation. AB - The capacity of the liver microsomal mixed-function oxidase system to metabolize a wide variety of exogenous as well as endogenous compounds reflects the participation of multiple forms of the terminal oxidase, cytochrome P-450, which have different broad, but overlapping, substrate specificities. Several of these isozymes accumulate in the liver after exposure of animals to specific inducing agents. Recent studies employing recombinant DNA techniques to investigate the genetic and evolutionary relatedness of various cytochrome P-450 isozymes as well as the molecular basis for the induction phenomenon are described. The conclusions from these investigations are presented in the context of the substantial body of data obtained from the characterization of specific cytochrome P-450 isozymes and from studies on the induction of specific isozymes or enzymatic activities during development or after treatment of animals with various inducing agents. PMID- 3512166 TI - Myoelectric control of prostheses. AB - The development of myoelectric control systems for powered limb prostheses has advanced rapidly in recent years. The main thrusts in this development have been in realizing self-contained prostheses and in realizing better prostheses control through improvements in the myoelectric signal processing techniques. This review considers the latter of these two areas. It first presents an historical look at myoelectric signal processing and identifies the problems. It then presents a general look at the myoelectric signal and those characteristics which give rise to these problems. A review of the literature related to various control strategies and signal processing techniques to overcome these problems is given. Finally, future trends to be expected in this area are discussed. PMID- 3512167 TI - Blood flow measurement by NMR. AB - The current status of blood flow measurement using nuclear magnetic resonance (NMR) techniques is reviewed. This includes both the continuous-wave method developed at the Medical College of Wisconsin and the Veterans Administration Medical Center and various pulsed methods, particularly those used in NMR Imagers. This is preceded by a brief review of the background of NMR blood flow measurement beginning in 1956 at the Laboratory of Technical Development of the National Heart, Lung, and Blood Institute. The importance of blood flow measurement and a quantitative analysis of the human vascular system are also presented. PMID- 3512168 TI - Fibronectin: applications to clinical medicine. AB - In summary, the role of fibronectin in clinical medicine is not yet certain. Correlation of sepsis and organ failure with decreased fibronectin levels is still to some degree questionable; controlled clinical trials are urgently needed. The risk of hepatitis, AIDS, and other transfusion-transmitted diseases must be balanced by data substantiating the clinical efficacy of fibronectin therapy. To date, no results from controlled trials using purified fibronectin have been reported. Final judgement must be reserved pending results of appropriate human studies. It is likely, however, that even if fibronectin is proven to be clinically useful, the patient population which will achieve some benefit from its use will be restricted to septic and/or critically ill patients. As noted by Mosher and Grossman however, physicians treating such patients would likely welcome any new and effective therapeutic intervention. PMID- 3512170 TI - Creatine kinase and its isoenzymes in neoplastic disease. AB - The CK-BB isoenzyme is ubiquitous in neoplastic tissue, but with low activity. Accordingly, it might be a nonspecific and insensitive tumor marker. Evaluation of BB isoenzyme in serum might indicate the extent of diseases or the response to therapy. The presence of CK-MB in patients with cancers may cause confusion with AMI. Serial determinations of both CK and lactate dehydrogenase isoenzymes are of great help in differential diagnosis. The presence of mit-CK is a poor prognostic sign in patients with malignancy. The greatest clinical significance of CK-BB and macro-CK isoenzyme lies in their effect on various assays for CK-MB. Macro-CK types 1 and 2 are much more heat stable than are CK-MB and CK-BB, and so by heating samples for 20 min at 45 degrees C the presence of thermostable macro types can be demonstrated. Macro-CK type 2 has a much higher activation energy than macro-CK type 1. If macro-CK is present, determination of the activation energy easily differentiates between types 1 and 2. CK-Bi seems to be glycosylated protein, and it is thought that glycosylation may be a general way of enzyme inactivation. If inactivation inside the cell is postulated, it has to be shown that enzymes indeed pass into the cell compartments where glycosylating enzymes are located. Another possible mechanism is within the circulation. Whether malignant cells themselves produce Ck-Bi or if inactivation occurs in the blood is still unknown. In this connection, one finding is that in plasma of cancer patients, CK-Bi can be reactivated to CK-BB by mercaptoethanol to 95%, whereas in plasma of normal persons there is no reactivation of the much lower CK Bi concentrations. PMID- 3512169 TI - Cholinesterase phenotyping: clinical aspects and laboratory applications. AB - The measurement of cholinesterase activity in human serum is an important investigation, especially in patients suspected of poisoning with organophosphate insecticides, or those experiencing prolonged paralysis following treatment with the short acting muscle relaxant succinylcholine. Appropriate clinical management of affected individuals can only be instituted if enzyme activity is measured using a method capable of clear interpretation and phenotypic ascription of cholinesterase, ascertained by use of selected enzyme inhibitors, is reliable. This review considers factors which lead to significant cholinesterase abnormalities and advises on the techniques most appropriate to their investigation. It is concluded that no one method is suitable both for measurement of activity and determination of genotype. The use of propionyl thiocholine is recommended for the first procedure and benzoyl choline for the latter. Those laboratories in which a request for the assessment of cholinesterase status is an unusual event should make greater use of assistance from colleagues whose experience with the problem is greater. PMID- 3512172 TI - High-resolution computed tomography in intracranial aneurysms. AB - High-resolution computed tomography in intracranial aneurysms is a highly valuable procedure. Its indications are as follows: to determine the presence of subarachnoid hemorrhage and to predict the location of aneurysms; to identify and characterize saccular and giant aneurysms; to assess the complications of aneurysm rupture; to evaluate operative maneuvers and postoperative complications. The technique of high resolution computed tomography consists of unenhanced and enhanced 10-mm-thick sections followed by 1.5mm thin sections through suspicious areas. A bolus of 100cc of 60% meglumine diatrizoate is given for the enhanced study. A repeat bolus of 60cc of contrast agent is administered prior to the thin sections. Direct coronal scanning and sagittal/coronal reformatting is frequently used. This review will detail the technique used in this procedure as well as present examples of the major indications listed above. This is the procedure of choice for patients suspected of having had a subarachnoid hemorrhage or harboring an intracranial aneurysm. PMID- 3512173 TI - Allergic diseases in the lungs. AB - Four basic immune reactions in the lung are fundamental to our understanding of allergic lung diseases. The first, immediate hypersensitivity, principally involves airway obstruction because of hypersecretion and bronchospasm. Resulting roentgenographic changes are those of large and small airway disease. The second reaction, cytotoxic antibody-mediated disease, produces air space filling by hemorrhage. The third form, immune complex-mediated hypersensitivity, causes mixed patchy consolidation and interstitial roentgenographic patterns caused by inflammation stimulated by antigen-antibody complexes. Fourth, cell-mediated immunity usually produces a granulomatous reaction, roentgenographically manifest by nodules, masses, and enlarged lymph nodes. Applying our understanding of these four basic reactions permits understanding the common allergic disease of the lungs: hypersensitivity pneumonitis, asthma, allergic bronchopulmonary fungal disease, chronic eosinophilic pneumonia, hypereosinophilic syndrome, Goodpasture's syndrome and idiopathic pulmonary hemosiderosis (IPH), Wegener's granulomatosis, and allergic granulomatosis (Churg-Strauss disease). The clinical, pathologic, and roentgenographic manifestations of these diseases are explained and related to the basic immune mechanisms. PMID- 3512171 TI - Hormones in saliva. AB - Since the collection of saliva is noninvasive, nonstressful and usually very convenient there have been many recent studies examining the clinical relevance of measuring various hormones in saliva. It now appears that the measurement of most unconjugated steroids in saliva will provide clinically useful data whereas the measurement of conjugated steroids, thyroid hormones, and protein hormones is unlikely to be clinically relevant. The key factors determining whether the salivary concentration of a hormone or drug is likely to be clinically relevant are the mechanisms by which the material enters the saliva; the "free to protein bound" ratio for the material; and the structure of the material, i.e., its molecular weight, polarity and the presence of ionizable groups. PMID- 3512174 TI - Nodes or no nodes: CT of adenopathy. AB - Computed tomography (CT) is the diagnostic modality of choice in the staging of abdominal malignancies. Metastatic disease in the lymph nodes is defined on CT as nodal enlargement. The presence of enlarged nodes does not preclude inflammatory involvement. There are clues that will indicate whether enlarged nodes are malignant or not (i.e., associated bony destruction). This paper will delineate normal nodal anatomy of the abdomen and pelvis. Clinical examples will be used to demonstrate normal structures simulating adenopathy and malignant adenopathy will be illustrated in lymphoma, seminoma, carcinoma of the cervix, prostate, and other pelvic malignancies. PMID- 3512176 TI - Therapeutic photomedicine: history, state of the art, and perspectives. PMID- 3512175 TI - Allogeneic bone marrow transplantation in leukemia patients. PMID- 3512177 TI - Applications of laser light of low power density. Experimental and clinical investigations. PMID- 3512178 TI - Combination phototherapy--a critical appraisal. PMID- 3512179 TI - Ultraviolet-induced pigmentary changes: benefits and hazards. PMID- 3512180 TI - Psoralen photochemotherapy--mechanisms, drugs, toxicity. PMID- 3512181 TI - Trace elements in development and disease. PMID- 3512182 TI - Microinjection studies of retroviral polynucleotides. PMID- 3512183 TI - Dermatology at the New Jersey Medical School (UMDNJ) and its forerunner, the Seton Hall College of Medicine and Dentistry. PMID- 3512184 TI - Electron microscopy of Mycobacterium leprae in cutaneous nerve components. AB - Cutaneous nerves in lepromatous lesions from ninety-six patients were observed by electron microscopy. The regenerative process of myelinated fibers was evident within lepromatous tissues. Intact or degenerative forms of Mycobacterium leprae were surrounded by the electron transparent substance within the axoplasm and Schwann cell cytoplasm. In contrast, the microenvironment of M. leprae in macrophages was characterized with fusing lysosomes and foamy structures. These results suggest that the electron transparent substance may be derived from bacterial metabolites and also that the foamy structure may originate from lysosomal substance. PMID- 3512185 TI - Sensitivity of methacholine testing in occupational asthma. PMID- 3512186 TI - Primary pulmonary hypertension and pregnancy. AB - Despite the preponderance of primary pulmonary hypertension (PPH) in young female subjects, documented cases of PPH in association with pregnancy are uncommon. During a 12-month period, 73 female patients with PPH were evaluated as potential recipients of a heart-lung transplant; and in six (8 percent), PPH appeared to be related to pregnancy. Histologic confirmation of the diagnosis was available in four patients, and other causes of pulmonary hypertension were excluded as far as possible in the remaining two patients. PMID- 3512187 TI - Absence of hyperresponsiveness to methacholine in a worker with methylene diphenyl diisocyanate (MDI)-induced asthma. AB - A 29-year-old man had a persuasive history of respiratory illness following exposures to methylene diphenyl diisocyanate (MDI). He was evaluated by measuring bronchial reactivity to methacholine, both before and after controlled laboratory exposures to MDI. Despite evidence of progressive declines in FEV1 with increasing (but subirritant) doses of MDI on three consecutive days, there was no bronchial hyperresponsiveness to methacholine, before or after MDI challenge. We conclude that the absence of nonspecific bronchial hyperresponsiveness does not exclude the possibility of isocyanate asthma. In the face of a compelling history, a negative result of methacholine challenge should not deter observation or laboratory testing for specific respiratory allergy to these chemicals. PMID- 3512188 TI - Optimal dose of fenoterol by metered-dose inhaler in asthmatic adults. AB - Three doses of fenoterol were administered by metered-dose inhaler to 20 adult subjects with asthma in order to determine the optimal dose for routine administration. Inhaled doses of 100 micrograms, 200 micrograms, and 400 micrograms of fenoterol with isoproterenol and placebo controls were administered in a randomized double-blind crossover regimen. We found that 200 micrograms of fenoterol by metered-dose inhaler produced a longer duration of action, greater peak response, and greater overall time-weighted responses in the forced expiratory volume in one second, in the mean forced expiratory flow during the middle half of the forced vital capacity, and in airway resistance than did the other drug regimens. The 400 micrograms dose of fenoterol produced no increase in response over that seen after the 200 micrograms dose. Side effects were minimal and no greater than with isoproterenol. PMID- 3512189 TI - Progressive sinobronchiectasis associated with the "bare lymphocyte syndrome" in an adult. AB - A Japanese adult lacking the expression of HLA-A, HLA-B, and HLA-C antigens on the lymphocyte (the "bare lymphocyte syndrome") had recurrent sinopulmonary infections and diffusely progressive bronchiectasis. Class I antigen and beta 2 microglobulin on the lymphocytes of the patient, his siblings, his father, and healthy subjects were assayed by using monoclonal antibodies against these surface markers. Class I antigen and beta 2-microglobulin were not found on the lymphocytes of the patient and the Daudi cells. In addition, lymphocytes of his siblings showed low fluorescence intensity. The HLA molecule on the lymphocyte plays an important role at the stage of recognition of immunogenic antigens. These results might suggest a correlation between sinobronchiectasis and the deficiency of HLA molecules, and the importance of the HLA system in the immune defense mechanism. PMID- 3512190 TI - Inhalation challenge with sulfidopeptide leukotrienes in human subjects. AB - What is the meaning of these findings to the practicing chest physician? First, leukotrienes are potent airway constrictors; they are capable of reproducing the type of airway constriction observed in asthma. The role of leukotrienes in this regard has yet to be established, but experiments to test the importance of these agents in this setting are likely to be performed soon. Specifically, several leukotriene receptor antagonists or synthesis inhibitors have been identified and may provide the tools needed to test this crucial hypothesis. Second, the leukotrienes are unique bronchoactive agents in that the degree of hyperresponsiveness between normal and asthmatic subjects varies markedly with the bronchoconstrictor index used to assess response. When one compares normal subjects to asthmatic subjects, there is substantial overlap in leukotriene sensitivity among groups when V30-P is used as the bronchoconstrictor index. However, when the FEV1 is used as the bronchoconstrictor index, there is little overlap in sensitivity between normal and asthmatic subjects, and the separation between the two groups is even more clearly made than it is with histamine or methacholine challenge. Thus, LTD4 inhalation challenge may replace the histamine and methacholine challenges in the diagnosis of cryptic shortness of breath. Third, the differential sensitivity of various bronchoconstrictor indices in both normal and asthmatic subjects when leukotrienes are used may provide clues as to the locus of airway hyperresponsiveness in asthma. Thus, leukotrienes hold the promise of new ways to treat and diagnose asthma, as well as providing new insights into the pathobiology of the disease itself. PMID- 3512191 TI - Heparin: do we understand its antithrombotic actions? PMID- 3512192 TI - Misled by the wedge? The Swan-Ganz catheter and left ventricular preload. PMID- 3512193 TI - Evaluation and management of congestive heart failure in a young individual. PMID- 3512194 TI - Scintigraphic evaluation of diffuse histiocytic lymphoma with sclerosis and primary mediastinal involvement. PMID- 3512195 TI - Kill kinetics of bacteria under fluctuating concentrations of various antibiotics. II. Description of experiments. AB - Differences in kill kinetics and regrowth patterns of bacteria under the influence of various antibiotics are frequently not represented by their MIC values. The area under the concentration curve represents antimicrobial activity more accurately than the peak concentration. Readministration of antibiotics should occur prior to bacterial regrowth for optimal efficacy. When administering antibiotics in combinations nonsimultaneous dosing is superior to simultaneous administration. PMID- 3512196 TI - Cytopress: automated slide preparation of cytologic material from suspension. AB - This paper describes a new automated system to prepare slides of cytological material from suspension. The system collects material on a filter tape by filtration and transfers it to glass slides by means of pressure-fixation. Using cervical cells as a model, results show that a well-defined cell number is evenly deposited over a standardized area, while a small number of cells is retained on the tape and a negligible number lost in the filtrate. Contamination is very small. Application of the system to other cytological material (fine needle aspirations, monolayer and cell suspension cultures, agar cultures, and isolated nuclei) is shown. In general, more than one slide can be made from one sample. Several histological staining procedures as well as immunofluorescence labeling protocols can be applied to the preparations obtained in this way. This system thus introduces a method that will standardize specimen preparation, is quick, saves operator time, and can be used for both diagnostic and research applications. PMID- 3512197 TI - Quantitation and sorting of vitally stained natural killer cell-target cell conjugates by dual beam flow cytometry. AB - We have detected formation of stable associations, or conjugates, between fluorescein diacetate-(FDA) stained human natural killer (NK) cells and Hoechst 33342-(HO342) stained tumor cells by dual laser flow cytometry. Conjugates in mixtures of effectors and targets emitted both green (FDA) and blue (HO342) fluorescence. This was confirmed by cell sorting. More than 90% of the conjugates included one target and one effector cell. Conjugate formation frequency was temperature independent between 4 and 37 degrees C, optimized by 10 min, and stable for 1 hr. Enrichment of effector populations for cells mediating lysis of standard NK targets and for cells reacting with OKM1, Leu-7, and Leu-11b monoclonal antibodies also enriched conjugate-forming cells. Lysis of either OKM1+, Leu-11b+ effector subpopulations with antibody and complement eliminated, but treatment with these antibodies alone had no effect on, conjugate formation. Effector pretreatment with Leu-4 or 3A1 and complement increased the frequency of conjugation slightly. Flow-determined frequencies of NK-conjugate formation with 14 target cell lines correlated well with data derived from standard microscopic assays. However, the flow method was more rapid, could be used when target and effector were of comparable size, and permitted isolation of conjugates by sorting. PMID- 3512198 TI - Physical discrimination between human T-lymphocyte subpopulations by means of light scattering, revealing two populations of T8-positive cells. AB - Light-scattering properties of human T-lymphocyte subpopulations selected by immunofluorescence were studied. Based on differences in orthogonal light scattering, two subpopulations of T8-positive cells can be distinguished. The first population (T8a) has the same orthogonal light-scattering properties as T4 positive cells, whereas the orthogonal light scattering of the second population (T8b) was about 70% larger. Orthogonal light scattering of Leu7-positive lymphocytes resembles that of the T8b population. We have studied the occurrence of the subpopulation in healthy individuals and we discuss their possible functional identification. Light-scattering properties of lymphocyte subpopulations in two patients with B-cell chronic lymphatic leukemia suggest that this observation is of clinical interest. PMID- 3512199 TI - Evaluation of echographic diagnosis of rectal cancer using intrarectal ultrasonic examination. AB - Ultrasonic examinations conducted in order to diagnose the depth of invasion and local lymph node metastases of rectal cancer. The intrarectal approach was performed preoperatively in 99 patients with rectal cancer, using either an Olympus-Aloka ultrasonic endoscopeTM (7.5 MHz) or other probes (Aloka, 7.5 MHz, 5 MHz). Through this method, intrapelvic organs were detected clearly, and hypoechoic findings due to tumors were detected in all patients. The normal rectal wall was echogenically divided into five layers, the third layer being the submucosal and the fourth layer being the proper muscle layer. In some cases, the proper muscle layer was divided into three layers in the echogram. In 79 of 88 patients, the diagnosis of depth of invasion, classified into three groups, was possible. Metastatic lymph nodes were shown as a hypoechoic round mass. In 52 of 71 patients proven to have local lymph node metastases in surgical specimens, lymph node metastases were diagnosed preoperatively. Thus, intrarectal ultrasonography provides valuable information concerning the choice of operating methods for rectal cancer. PMID- 3512200 TI - Classic articles in colonic and rectal surgery. Christian Albert Theodor Billroth 1829-1894. Discussion of problems in modern surgery and daily problems in surgery. Concerning enterorrhaphy. PMID- 3512202 TI - PGI2 may aid prevention of diabetic retinopathy. PMID- 3512203 TI - How accurate are insulin mixtures prepared by the patient? AB - The accuracy of mixing two types of insulin in one syringe was studied in 41 insulin-dependent diabetic patients who prepared a mixture of two fluids (saline and sterile water) with either a disposable, 1-ml plastic syringe with a fixed needle, i.e., with a small dead space, or one equipped with a separate needle. Syringes with fixed needles delivered the two components very accurately and were associated with only slight wastage of insulin of 0.011 ml per injection. The syringe with a separate needle delivered 0.033-0.065 ml more than the intended dose of the "first insulin" and correspondingly less of the intended dose of the "second insulin," since the total dose delivered was approximately correct. The magnitude of the insulin wastage of two daily injections was calculated to be 64 ml per patient annually, which could be reduced to 8 ml per patient if fixed needles were used. It is therefore recommended that patients preparing mixtures of two insulins in the same syringe abandon syringes with separate needles. PMID- 3512201 TI - Glucagon lowers canine biliary cholesterol output at physiologic doses. AB - Pharmacologic doses of glucagon affect canine bile secretion by increasing bile flow while simultaneously decreasing biliary cholesterol output. The present study was performed to determine if physiologic doses of glucagon reduce biliary cholesterol output. Awake dogs received both intravenous 1% sodium taurocholate (50 ml/hr) to stabilize bile flow and somatostatin (12 micrograms/kg/hr) to suppress endogenous pancreatic hormone release. Suppression was documented by significant decreases in portal plasma glucagon and insulin levels. During experimental trials, dogs received, in addition, glucagon (5 ng/kg/min) infused via a splenic vein catheter. Bile flow significantly decreased during the initial hour of somatostatin infusion but increased significantly only in experimental trials during subsequent glucagon infusion. Biliary cholesterol output showed no change during control studies (N = 9), but decreased significantly during glucagon infusion studies (N = 11). Biliary phospholipids and bile salts failed to show any changes during glucagon infusion. These data demonstrate that glucagon at physiologic levels influences both the volume and cholesterol content of bile and suggest the mechanism of decreasing cholesterol output must be independent of pathways for influencing bile salt or phospholipid secretion. PMID- 3512204 TI - Doppler ultrasound recognition of preclinical changes in arterial wall in diabetic subjects: compliance and pulse-wave damping. AB - Doppler ultrasound was used to detect early changes in arteries of the legs by two independent techniques. Pulse-wave velocity was measured to calculate arterial wall compliance and Fourier analysis was used to measure damping of the pulse-wave forms. Ten non-insulin-dependent diabetic men with no clinical evidence of peripheral arterial disease had significantly lower compliance and greater pulse-wave damping than 10 matched nondiabetic control subjects. There was a good correlation between the results for the two different techniques. PMID- 3512205 TI - Perioperative control of blood glucose in diabetic patients: a two-step protocol. AB - Perioperative control of blood glucose in patients with diabetes has been difficult due to frequent occurrence of hypoglycemia or hyperglycemia. We developed a two-step protocol for management of insulin-treated patients during general anesthesia. Regular insulin was given intravenously before anesthetic induction according to the step I formula (initial): initial blood glucose - 150/10 = U. Regular insulin was then given during surgery according to the step II formula (hourly): blood glucose 150-250 mg/dl = 2 U; blood glucose greater than 250 mg/dl = 4 U. Fluid replacement of 5% dextrose with lactated Ringer's solution, 3 ml/kg estimated ideal body weight, was given hourly and additional lactated Ringer's solution was given as indicated. Thirty patients received preoperative (long- or intermediate-acting) insulin and were managed by the two step protocol. Ten patients received preoperative (long- or intermediate-acting) insulin and were managed by a standard method used in the same institution. Thirty patients did not receive preoperative insulin and were managed by the two step protocol. All patients underwent retinal surgery under general anesthesia. In comparing the two groups pretreated with insulin, patients treated by the standard method had significantly higher (mean) blood glucose levels (360.2 +/- 100.4 mg/dl) than those treated with the two-step protocol (181.2 +/- 50.8 mg/dl) (P = 0.0001) at the end of surgery. Of the two-step protocol patients, those pretreated with one-half the usual morning dose of long- or intermediate-acting insulin had lower (mean) blood glucose levels (225 +/- 87 mg/dl) than patients not pretreated (310 +/- 130.8 mg/dl) (P = 0.0069) the morning after surgery.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3512206 TI - Effect of exchange of ham for boiled egg on plasma glucose and insulin responses to breakfast in normal subjects. AB - Blood glucose (BG) and plasma insulin (IRI) were measured during two breakfasts different only by the nature of proteins--egg (E) or ham (H)--in eight normal subjects. Compared with H, E led to a flattened BG response at 30, 40, and 50 min and to a sustained BG from 150 to 240 min. Integrated BG response was not significantly different between E and H. After E, the IRI response decreased at 90 min and 120 min (P less than 0.05). Integrated IRI response with E was significantly smaller than with H (P less than 0.025). The reasons for the effect of E ingestion on BG are not obvious; pancreatic and/or intestinal mechanisms may be involved. It is suggested that greater consideration be given to the protein composition of the test meals when they are used in studies of glucose homeostasis. PMID- 3512207 TI - Continuous subcutaneous insulin infusion does not provoke significant acute-phase response. AB - C-reactive protein (CRP), the classical acute-phase reactant, and serum amyloid A protein (SAA), the putative precursor of AA-type amyloid fibrils, were measured in 62 diabetic patients. They were all attending their regular clinic appointments and had been asymptomatic during the 2 wk preceding sampling. CRP and SAA levels were similar in 18 patients on continuous subcutaneous insulin infusion (CSII), 27 patients treated by conventional insulin therapy (CIT), nine treated by diet only, and eight treated by diet and oral hypoglycemic agents, and were almost entirely within the normal range. It is concluded that CSII does not provoke an acute-phase reaction in diabetic patients and, while caution should always be exercised with a new form of treatment, it does not seem likely that CSII will predispose to the development of reactive systemic amyloidosis. PMID- 3512208 TI - Abnormalities in insulin secretion in healthy offspring of Indian patients with maturity-onset diabetes of the young. AB - Serum C-peptide (CP) and immunoreactive insulin (IRI) responses were studied in 47 euglycemic offspring of patients with maturity-onset diabetes of the young (MODY). Mean IRI responses were not significantly different in nonobese offspring of MODY patients (O-MODY) but they were lower in obese O-MODY than in respective controls. Mean CP responses were low in both groups, the change being more pronounced in obese O-MODY. These findings indicate that alterations of secretion and metabolism of insulin can be detected even before glucose intolerance is seen in O-MODY. PMID- 3512209 TI - Acute insulin response to glucagon, tolbutamide, and glucose in non-insulin dependent diabetes of the young. AB - Acute insulin release in response to maximal intravenous doses of glucose (0.5 g/kg), tolbutamide (1 g), and glucagon (1 mg) was studied in 10 subjects with non insulin-dependent diabetes of the young (NIDDY) and 10 age-, sex-, and weight matched controls. Diabetic subjects had attenuated insulinemic responses to all three stimuli, in comparison with control subjects. However, insulin responses to glucagon and tolbutamide were higher than those obtained with intravenous glucose. This study demonstrates that the pancreatic beta-cell is more responsive to nonglucose secretagogues than to glucose stimuli in individuals with NIDDY. PMID- 3512210 TI - Personal computer programs to assist with self-monitoring of blood glucose and self-adjustment of insulin dosage. AB - We have developed computer programs in compiled BASIC for the IBM-PC and compatible microcomputers for use by physicians, paramedical personnel, and/or patients to assist with self-monitoring of blood glucose (SMBG) and self adjustment of insulin dosage. The programs can potentially assist with patient education and motivation, and provide: a customized "electronic notebook" for storage and retrieval of information on blood glucose, insulin dosage, hypoglycemic reactions, urinary ketones, diet, activity, weight, illness, apparent explanations for hypoglycemic reactions or glucose values outside target ranges, and comments; graphic displays of glucose and insulin versus date, and of a "glucose profile" versus time of day or versus day of the week; simple and detailed statistical analyses; a legible summary of data; a facility to permit the physician to prepare a "customized treatment plan" for each patient, involving a choice of six regimens, target levels for each of eight time periods, four supplement tables (when well or sick, before meals, or at bedtime), rules to reduce insulin in response to hypoglycemic reactions or documented hypoglycemia, rules to increase routine insulin doses in response to persistent unexplained hyperglycemia, and rules when the patient should call the physician; suggestions regarding compensatory supplements and adjustments of routine insulin dosage; explanations why various insulin dosages should or should not be altered, and why various glucose values should be tested; comparisons of the insulin dosage administered by the patient and the recommendations of the program, together with explanations for discrepancies offered by the patient, to help evaluate compliance. The program is "user-friendly," easy to learn, and easy to use.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3512211 TI - Is there a defect in the hepatic extraction of insulin in patients with NIDDY? PMID- 3512212 TI - Insulin-related hospital incidents. PMID- 3512213 TI - Insulin allergy. PMID- 3512214 TI - Management of rheumatoid arthritis. PMID- 3512215 TI - Toxic shock syndrome. PMID- 3512216 TI - Anterior ischemic optic neuropathy: sense and nonsense in diagnosis and treatment. AB - In 15 consecutive patients with AION the cause was found to be giant-cell arteritis in 3 cases and was thought to be local arteriosclerosis of the posterior ciliary arteries in 12 cases, in spite of rheumatic factors which were found initially. In 87% of cases symptoms or factors indicating generalised arteriosclerosis were found. In one case before the AION cilioretinal emboli had been found. It is reported that the second eye is affected after a varying interval of time in +/- 50% of cases. In our material the arteriosclerotic form of AION occurred bilaterally in +/- 40% of cases with an interval varying from a few days to 5 years. The average interval for this form of AION is 3 years. Cerebral angiography was of no help in tracing the cause of the AION. A fluorescein angiogram is often made too late to show the characteristic circulatory disturbance in the peripapillary choroid and is usually not necessary. Therapy should be started immediately, with large doses of corticosteroids in all cases of AION, until biopsy of the temporal artery proves negative or the ESR is practically normal. Hypertension and diabetes should be treated adequately as protection for the other eye in the arteriosclerotic form of AION. In addition long-term anticoagulant therapy should be considered: a prospective study into this aspect has been started. PMID- 3512217 TI - HLA-antigens in the human uvea. AB - With the use of monoclonal antibodies in an indirect immunofluorescence technique we studied the distribution of Class I (HLA-ABC and B27) and Class II (HLA-DR) antigens in the human uvea. W6/32, directed against the core of HLA-ABC antigens, was used to study the distribution of Class I antigens. The anterior border layer of the iris, the non-pigmented and pigmented epithelium and the external basement membrane of the ciliary body and the vascular endothelium in the uvea showed a positive staining for Class I antigens. B27/M1, directed against an epitope of the HLA-B27 antigen, and the control antibody A11/Aw24, which was directed against an epitope of HLA-A11, revealed the same distribution pattern in respectively HLA-B27 and HLA-A11 positive donor eyes. The intensity of their staining was much weaker than the staining with W6/32. Class II antigens were studied with OkIa1, an antibody directed against the core of HLA-DR antigens. HLA DR antigens were detectable on single cells scattered throughout the entire uvea. These cells did not seem to relate to any anatomical entity. No staining for Class II antigens was seen in the uveal blood vessel endothelium. The expression of HLA-antigens in the uvea is compatible with the distribution in other tissues. These findings suggest that the expression of HLA-B27 in the human uvea does not explain why the eye is one of the target tissues in HLA-B27 associated disease. PMID- 3512218 TI - CT-scan and intraocular tumours: detection and assessment of size and extrascleral growth of uveal melanomas. AB - Twenty-two patients, who were suspected of an intraocular tumour, were examined with the high resolution thin slice CT-scan (1.5 or 3 mm slices). The final diagnosis in 14 cases was an uveal melanoma, and in 3 cases in which an uveal melanoma was suspected a chorioretinal haemorrhage, an exudative macular degeneration type Junius Kuhnt and an intrascleral foreign body were respectively found. In 2 cases intraocular metastases were demonstrated, and in 2 other cases malignant lymphomata. One patient had a haemangioma. In 10 of the 14 patients with uveal melanomata enucleation was performed and 4 were treated by ruthenium application. The CT-scan was compared with ultrasonographic, operative and histological findings. From the study it appears that the CT-scan is useful for screening uveal melanomas. It is however difficult to distinguish the uveal melanoma from a secondary retinal detachment; differentiation from an exudative macular degeneration was not possible. The size of the tumour was only represented correctly on the CT-scan in half the cases. CT examination fails to demonstrate or exclude epi- and extrascleral growth. The multiple metastases and the haemangioma could only be seen with difficulty on the CT-scan; the latter was however clearly visible after the injection of contrast. The foreign body could be clearly seen without contrast. PMID- 3512219 TI - [Localization of the light chain (LC-1) of the microtubule-associated protein MAP 1 in the tubulin-binding portion of the molecule]. PMID- 3512220 TI - [Amino acids as immunogenesis stimulants]. PMID- 3512221 TI - [The effect of pre-radiation history of Escherichia coli WP2 cells on the effectiveness of the antimutagenic process in the rpsL(strA) locus]. PMID- 3512222 TI - Medical management of cholesterol gallstones. AB - Cholesterol gallstones are a significant cause of morbidity in the U.S. Methods used to treat gallstones include cholecystectomy or medical dissolution. The primary drugs used for the dissolution of cholesterol gallstones are two bile acids, chenodeoxycholic acid and ursodeoxycholic acid. Complete or partial gallstone dissolution rates using chenodeoxycholic acid have ranged from 30 to 80 percent. Factors affecting gallstone dissolution using the bile acids include the dosage and administration schedule, obesity, the stone characteristics, diet, and the duration of therapy. The adverse effects of chenodeoxycholic acid include gastrointestinal complaints, hepatotoxicity, and increased serum cholesterol. Ursodeoxycholic acid, which is investigational, differs from chenodeoxycholic acid in its mechanism of action. Ursodeoxycholic acid has similar efficacy with chenodeoxycholic acid, at a lower daily dosage, with less gastrointestinal and hepatic adverse effects. If appropriate patient selection is used, the response rate to medical therapy can range from 50 to 80 percent. PMID- 3512223 TI - Evaluation of the Ames Seralyzer for therapeutic drug monitoring of theophylline. AB - Dry reagent technology and reflectance photometry are combined in the Ames Seralyzer to offer a solid-phase plastic strip assay methodology. Light reflected from serum placed on the antibody-impregnated strip is quantitated with a two point standard curve to display a theophylline result in 90 seconds. The accuracy and precision of the Seralyzer for serum theophylline are compared to the enzyme multiplied immunoassay technique (Emit) which is commonly used to determine drug concentrations. Liquid calibrators (5 and 25 micrograms/ml) and liquid-spiked sera (10, 15, and 20 micrograms/ml) were measured six times daily simultaneously by both methods for twenty days. Eighty patient samples (theophylline range: 0-33 micrograms/ml) were measured twice each during the twenty days. Acceptable assay limits were established and maintained by measuring 15 micrograms/ml spiked sera prior to and during the evaluation period. All within-run and between-run means for the Seralyzer and Emit were within +/- 1 microgram/ml of the spiked value. All ranges of within-run and between-run means were within +/- 2 micrograms/ml of the spiked value. Mean between-run coefficients of variation for the Seralyzer at the 5, 10, 15, 20, and 25 micrograms/ml values were 11.5, 6.7, 4.9, 4.6, and 4.9 percent, respectively. Linear regression on the 80 patient samples gave a slope of 1.02, intercept of -0.28, and correlation of 0.984. The Seralyzer's accuracy and precision compare favorably with Emit for theophylline determinations greater than 7.5 micrograms/ml. PMID- 3512224 TI - Mitoxantrone. AB - Mitoxantrone is an anthraquinone antineoplastic agent with structural similarities to doxorubicin. It has a mechanism of action similar to the anthracyclines. Its primary elimination route is hepatic metabolism (only seven percent renal excretion) and it has a terminal half-life of approximately 40 hours. Mitoxantrone has significant activity in the treatment of metastatic breast cancer, acute leukemias, and non-Hodgkin's lymphoma. Some activity is reported in head and neck cancer, Hodgkin's, myeloma, bladder cancer, prostate cancer, non-small-cell lung cancer, and liver cancer. There is a suggestion of incomplete cross-resistance between mitoxantrone and the anthracyclines in certain neoplasms. Some activity is reported with mitoxantrone in patients refractory to the anthracyclines in breast cancer, acute leukemias, and non Hodgkin's lymphomas. The usual doses used in solid tumors and in lymphomas are mitoxantrone 12-14 mg/m2 iv q3-4wk and in leukemias is mitoxantrone 12 mg/m2/d X 5 d iv for initial induction. PMID- 3512225 TI - [Autoimmunity and viral infections in type-I diabetes mellitus]. AB - Cytoplasmic islet-cell antibodies, insulin antibodies, islet-cell surface antibodies and islet-cell specific cytotoxicity were determined in serum of the following groups: 131 patients with type I diabetes, 19 with type II diabetes, 29 with mumps, 29 with enterovirus infections, 18 with measles and 28 healthy controls. Cytoplasmic islet-cell antibodies were found predominantly in type I diabetics. Islet-cell surface antibodies, on the other hand, were relatively frequently (60-80%) present in sera of both diabetics and patients with various virus infections. Islet-cell specific cytotoxicity in vitro was found not only in sera of diabetics, but also of patients with mumps or enterovirus infections. Sera of five patients with measles, however, had cytotoxic reactions comparable to those of the controls. These results suggest that cytotoxic antibody reactions against islet cells in vitro occur also in sera of non-diabetic patients. Under certain circumstances, infections which induce such immune reactions may be of significance in the pathogenesis of diabetes. PMID- 3512226 TI - [Continuing anti-anginal effectiveness during chronic nitrate therapy in spite of the cessation of hemodynamic partial effects]. AB - A decrease or actual cessation of some of the haemodynamic effects of nitrate, such as fall in blood pressure and rise in heart rate on standing upright, was observed in ten patients with coronary heart disease during a four-week period of treatment with nonretard isosorbide dinitrate, 20 and 40 mg six times daily. Disappearance of the nitrate effect was also observed by ultrasound over arterial and central venous vessels. At the same time, a crossover double-blind randomized study demonstrated that the anti-anginal action persisted. This effect is thus to be taken as preventing anginal attacks. It is concluded that chronic nitrate administration maintains its full anti-anginal action, even though haemodynamic effects are diminished or even cease completely. PMID- 3512227 TI - [Spectral Doppler echocardiography. Diagnostic procedure and clinical potentials]. PMID- 3512228 TI - [Extracranial-intracranial anastomosis in the prevention of stroke. Results of the International EC-IC Bypass Study]. PMID- 3512229 TI - [The EC/IC Bypass Study. A therapeutic hope was not realized]. PMID- 3512230 TI - [New data on time factors in the development of myocardial infarction]. PMID- 3512231 TI - [Ultrasonic endoscopy. An assessment after 3 years]. AB - A high-resolution ultrasound head at the tip of an endoscope, used in 259 examinations of 232 patients, has been demonstrated in general to fulfill the expectations placed on it as an important diagnostic tool. PMID- 3512232 TI - [Single kidney--a risk or a tolerable loss of an organ?]. PMID- 3512235 TI - [Ultrasonic findings in hypoxic-ischemic encephalopathy of preterm and full-term infants]. PMID- 3512236 TI - [Ultrasound in the differential diagnosis of deep venous thrombosis of the leg]. PMID- 3512233 TI - Serotonin and the vascular system. Role in health and disease, and implications for therapy. AB - Serotonin released from aggregating platelets can reach sufficient concentrations to affect local vascular function in a number of ways. The monoamine can cause contraction of blood vessels by its direct action on smooth muscle or by potentiating the effect of other vasoconstrictor agents. It can also induce vasodilatation by a direct relaxing effect on smooth muscle, by inhibition of adrenergic nerves, and by release of an uncharacterized relaxing factor from endothelial cells. One of its most likely physiological roles is to aid in haemostasis by promoting platelet aggregation and by causing local vasoconstriction at sites of injury. It probably has a role in some forms of vascular pathology as well: it may contribute to vasospasm of cerebral, coronary, and digital arteries, particularly if there is endothelial dysfunction or damage. Much evidence has implicated serotonin (5-hydroxytryptamine) in the pathogenesis of migraine. Serotonergic agonists, such as ergotamine, and antagonists, such as methysergide and pizotifen, are both used in therapy of migraine. Promising but conflicting early results have not yet defined a place for serotonergic antagonists in other vasospastic disorders. The antihypertensive efficacy of one serotonergic antagonist, ketanserin, raises questions about the possible involvement of serotonin in either the initiation or the maintenance of the elevated peripheral vascular resistance in several forms of hypertension, including essential hypertension. PMID- 3512237 TI - [Proteolysis in the cells of malignant human and animal tumors]. AB - The data concerning proteolytic enzymes in human and animal malignant tumours are reviewed. The activity of these proteinases, its changes in the course of the disease, intracellular localization and secretion into the extracellular space and blood are discussed. The role of proteolytic enzymes including the role of plasminogen activator in tumour progress and during the metastasis development is considered. PMID- 3512238 TI - [Human leukemias studied with monoclonal antibodies to erythroid cells]. AB - Activity of monoclonal antibodies HAE3 and HAE9 specific for human erythroid cells to different leukemic cells is described. These monoclonals do not react with nonerythroid leukemic cells. HAE3 and HAE9 reactivities are similar to those of polyclonal monospecific antibodies against an antigen of erythroblasts--a surface antigenic marker of nucleated red cells and reticulocytes. Monoclonal antibodies HAE3 and HAE9 are proposed to be used in diagnosis of leukemias. PMID- 3512239 TI - [Clonogenic cells in human tumors and the sensitivity to chemotherapy]. AB - The current literature data on the cloning of human tumour cells, the use of clonal assays of tumour growth for studying biology, cell kinetics and cytogenetic analysis of human tumour cells, drug sensitivity and related clinical and preclinical studies are reviewed. PMID- 3512234 TI - Aztreonam. A review of its antibacterial activity, pharmacokinetic properties and therapeutic use. AB - Aztreonam (azthreonam; SQ 26,776) is the first member of a new class of beta lactam antibiotics, the monobactams. Aztreonam is selectively active against Gram negative aerobic bacteria and inactive against Gram-positive bacteria. Thus, in vitro, aztreonam is inhibitory at low concentrations (MIC90 less than or equal to 1.6 mg/L) against Enterobacteriaceae except Enterobacter species, and is active against Pseudomonas aeruginosa, 90% of pseudomonads being inhibited by 12 to 32 mg/L. Aztreonam is inactive against Gram-positive aerobic bacteria and anaerobes, including Bacteroides fragilis. Therefore, when administered alone, aztreonam has minimal effect on indigenous faecal anaerobes. Aztreonam must be administered intravenously or intramuscularly when used to treat systemic infections, since absolute bioavailability is very low (about 1%) after oral administration. Since elimination half-life is less than 2 hours, 6- or 8-hourly administration is used in the treatment of moderately severe or severe infections, although 12-hourly injection is adequate in less severe systemic and some urinary tract infections. Therapeutic trials have shown aztreonam to be effective in Gram-negative infections including complicated infections of the urinary tract, in lower respiratory tract infections and in gynaecological and obstetric, intra abdominal, joint and bone, skin and soft tissue infections, uncomplicated gonorrhoea and septicaemia. In comparisons with other antibiotics, aztreonam has been at least as effective or more effective than cefamandole in urinary tract infections and similar in efficacy to tobramycin or gentamicin. Where necessary, aztreonam and the standard drug have both been combined with another antibiotic active against Gram-positive and/or anaerobic bacteria. Aztreonam has been effective in eradicating pseudomonal infections in most patients (except in patients with cystic fibrosis), but the inevitably limited number of pseudomonal infections available for study prevents any conclusions as to the relative efficacy of aztreonam compared with other appropriate regimens against these infections. Thus, with an antibacterial spectrum which differs from that of other antibiotics, aztreonam should be a useful alternative to aminoglycosides or 'third generation' cephalosporins in patients with proven or suspected serious Gram-negative infections. PMID- 3512240 TI - Sodium. AB - Although the clinical manifestations of an abnormal serum sodium concentration are uncommon, imbalances in sodium and water occur frequently. The major indications for the determination of the serum sodium are those situations in which the signs and symptoms of hyponatremia or hypernatremia are likely. In other situations, unless the determination of the sodium concentration will change the clinical management of the underlying disorder, the serum sodium is not very useful, and consequently, should not be ordered as a routine test. Laboratory tests should primarily be used to confirm clinical suspicions. The majority of disorders in which imbalances in sodium and water occur can be diagnosed on clinical grounds, irrespective of the serum sodium concentration. PMID- 3512241 TI - Potassium. AB - Potassium homeostasis is dependent on many physiologic and metabolic factors. Potassium level testing by the clinical laboratory can aid the emergency physician in planning treatment in suspected cases of potassium depletion or excess. Familiarization with indications for ordering tests of potassium level and correct interpretation of test results is essential for appropriate patient care. PMID- 3512242 TI - Hemoglobin/hematocrit and other erythrocyte parameters. AB - The authors review erythrocyte physiology, blood collection, and laboratory methodology for enumerating blood cells. The clinical interpretation of abnormal erythrocyte parameters is discussed, and the emergency department approach to anemia and polycythemia is detailed. PMID- 3512243 TI - Chloride. AB - The clinical significance of chloride should place this ion on an equal basis with sodium, potassium, and bicarbonate in the evaluation of body fluid or acid base status. The rationale for ordering serum chloride determinations includes basically all the indications for requesting the other three electrolytes, particularly when there is concern about a patient's fluid, electrolyte, and/or acid-base status. PMID- 3512244 TI - Urinary electrolytes. AB - Urinary electrolytes can be a useful tool in the Emergency Department. For those patients with volume depletion, acute oliguria and hyponatremia, the determination of urinary sodium levels can aid in diagnosing the etiology of the presenting condition. Urinary potassium levels can aid the clinician in determining the cause of the potassium loss, either renal or extrarenal. For those patients with metabolic alkalosis, determination of the urinary chloride levels will allow the physician to determine if the alkalosis is chloride responsive or chloride resistant. It must be kept in mind that the measurement of any urinary electrolyte is relatively valueless unless it is interpreted with other data and/or observation of the patient. It should be noted also that a solitary value may not be adequate for making a diagnosis, and serial urinary electrolyte value assessment may be necessary. In the critically ill patient, it may be prudent to obtain a urine sample before the administration of a diuretic, the administration of potassium, or large amounts of saline. This procedure will allow for a more accurate assessment of the patient's pretreatment status. PMID- 3512245 TI - Glucose. AB - Disorders of glucose metabolism are commonly seen by practicing emergency physicians. Reagent strips such as Visidex and Chemstrip are useful as a quick and accurate method of glucose estimation provided the procedure is followed correctly. These reagent strips are particularly useful for rapid screening in the unresponsive patient. The accuracy of glucose analysis obtained from the clinical laboratory is improved when methods to prevent glycolysis are used and when enzymatic methods of glucose analysis are used. The common and important indications for routine glucose analysis include evaluation of symptomatically ill patients with known diabetes or patients with altered mental status or coma of unknown etiology; patients on insulin or sulfonylureas; sick neonates; patients with a variety of drug intoxications; and patients suffering from significant systemic illness or injury likely to manifest with physiologic stress expressed as glucose intolerance. PMID- 3512246 TI - White blood cell count and differential count. AB - Current methods for performing the white blood cell count and differential count along with recent technologic advances are discussed. Sources of error and variation in these tests are presented. The use of the white blood cell count and the differential count in a variety clinical situations is reviewed. PMID- 3512247 TI - Platelet count. AB - An estimate of the platelet count is usually given as part of the complete blood count (CBC). It should not be neglected when reviewing CBC results as it is a fair screening test and satisfactory for most purposes in the emergency department. It is a quantitative study, and the functional status of the platelet must always be considered in interpretation of clinical significance. Patients presenting with abnormal bleeding histories, particularly women with mucosal origin bleeding, should have an evaluation of platelet quantity by an accurate method and functional quality by a bleeding time. Though rarely used, the emergency physician should be familiar with the indication and mechanics of platelet transfusions. The laboratory charge for the platelet count is $17.00 to 18.00, whether it is automated or hand counted. PMID- 3512248 TI - Erythrocyte sedimentation rate/zeta sedimentation rate. AB - Sedimentation rates are a vital laboratory adjunct to the clinical skills of the emergency physician. A patient with an elevated rate in the emergency department needs further evaluation and appropriate referral. If the test is markedly elevated, there is a 95 per cent chance of an infectious, inflammatory, or neoplastic process as the underlying cause. PMID- 3512249 TI - Coagulation studies: prothrombin time, partial thromboplastin time, bleeding time. AB - Three coagulation tests available in the emergency department are described in this article. Methods, results, and implications in the bleeding patient are reviewed. PMID- 3512250 TI - Synthesis of placental protein 12 by human endometrium. AB - We have previously shown that placental protein 12 (PP12) is synthesized and secreted by human term pregnancy decidua in vitro. In the present study, fragments of proliferative and secretory phase endometrium were cultured in media in the presence and absence of progesterone (P) and 17 beta-estradiol (E2) for 96 h. The PP12 concentrations in the media and tissues were measured by RIA, and de novo synthesis was investigated by measuring the incorporation of [35S]methionine into PP12. Before culture, PP12 could not be detected in any proliferative endometria, whereas all secretory endometria contained PP12. All secretory endometria released PP12 into the medium in the presence and absence of added P and E2. Secretory endometria released significantly more PP12 than proliferative endometria. Three of seven proliferative endometria did not release PP12 in the absence of P, but all did so after P had been added. The addition of P to culture medium caused a 2.4-to over 71-fold increase in PP12 secretion over control values in proliferative endometria and up to a 3.5-fold increase in secretory endometrium. E2 had no significant effect. Cycloheximide totally inhibited the PP12 release induced by P from proliferative endometrium, and in secretory endometrium, it either totally blocked PP12 release or inhibited the stimulation due to P. [35S]Methionine was incorporated into immunoprecipitable PP12 in cultures of secretory and P-treated proliferative phase endometria. These results demonstrate de novo synthesis of PP12 by nonpregnant endometrium in tissue culture and suggest that the biosynthesis and secretion of PP12 by nonpregnant endometrium are regulated by P. PMID- 3512251 TI - Transient changes in the in vitro activity of the luteinizing hormone-releasing hormone pulse generator after ovariectomy in rats. AB - We examined in vitro LHRH release as a function of time after ovariectomy (OVX). Adult female rats (diestrous day 1 and 11-16, 61-68, and more than 120 days post OVX) were decapitated, and the suprachiasmatic-medial preoptic area-medial basal hypothalamus was removed and superfused in vitro. There was a statistically significant (P less than 0.05) 2-fold decrease in mean in vitro LHRH release 11 16 days post-OVX that returned to levels observed in diestrous day 1 females 60 days post-OVX. LHRH cycle amplitudes of 11- to 16-day ovariectomized rats were reduced and significantly lower (P less than 0.05) than those of more than 120 day ovariectomized rats. These results indicate a complex relationship between ovarian steroid hormone removal and LHRH pulse generator function that is only revealed after direct measurement of LHRH release. PMID- 3512252 TI - The effects of aging on glucose metabolism in adipocytes from Fischer rats. AB - We have studied glucose metabolism in adipocytes from younger (6 months) and older (24 months) Fischer rats. Insulin binding was similar in both groups, expressed per cell number (2.67 +/- 0.41% vs. 2.96 +/- 0.38%) or per cell surface area (4.59 +/- 0.70% vs. 4.15 +/- 0.53%) in the 6- and 24-month-old animals, respectively. Maximal insulin-stimulated 3-O-methylglucose transport was decreased by 40% in the older group (0.234 +/- 0.032) compared with that in the younger group (0.411 +/- 0.031 pmol/2 X 10(9) micron 2 X sec (P less than 0.01), with no change in basal rates of transport. The decrease in glucose transport was due to a 36% reduction in the maximum velocity (91 pmol/sec in the younger vs. 59 pmol/sec in the older group), with no change in the Km. Postglucose transport steps of glucose metabolism, including CO2 oxidation, triglyceride synthesis, and lactate production, were measured at a higher glucose concentration (2 mM), where glucose transport is not rate limiting. Overall maximal insulin-stimulated glucose metabolism was decreased by 45% in the older group (15.6 nmol) compared with that in the younger group (28.6 nmol/10(5) cells X h; P less than 0.05). Glucose oxidation was decreased by 42% (2.9 vs. 5.0 nmol/10(5) cells X h; P less than 0.05), triglyceride synthesis by 40% (5.9 vs. 9.8 nmol/10(5) cells X h; P less than 0.05), and lactate production by 47% (6.3 vs. 11.8 nmol/10(5) cells X h; P less than 0.05). We conclude that in adipocytes from aged Fischer rats, cellular insulin resistance is due to multiple post-binding defects involving the glucose transport system and more distal intracellular processes. PMID- 3512253 TI - Lectins as probes of insulin receptor carbohydrate composition: studies in glycosylation mutants of Chinese hamster ovarian cells with altered insulin binding. AB - We recently reported marked differences in insulin binding properties in Chinese hamster ovarian cell mutants with genetic defects in protein N-glycosylation. To further characterize the role of insulin receptor carbohydrates, we have now studied the effect of lectins on [125I]insulin binding to wild type (WT) Chinese hamster ovarian cells and to two mutant cell lines: B4-2-1, to which insulin was previously shown to bind with higher affinity than normal, and Lec 1, to which insulin binds with much lower affinity. The results show that of four lectins that bound to WT cells; only wheat germ agglutinin and phytohemagglutinin-E competed with insulin binding to these cells, while Concanavalin A (ConA) and Erythrina cristagalli agglutinin (ECA) did not. After solubilization of the cells, however, a potent inhibition of insulin binding was also seen with ConA and ECA. This suggests that sugar determinants for ConA and ECA are present on the insulin receptor, but are not accessible at the surface of the cells. Mutant B4-2-1 cells, which are deficient in mannosylphosphoryldolichol synthase and beta galactosidase, differed from WT cells in that ECA and ConA potently inhibited insulin binding in intact cells. This suggests that these lectin binding sites of or near the insulin receptor are more accessible at the cell surface in this mutant cell line. Mutant Lec 1 cells, deficient in N-acetylglucosaminyl transferase I, cannot process N-linked carbohydrates from their oligomannose to their complex forms. In these cells, marked differences in the pattern of lectin inhibition were observed compared to that in WT or B4-2-1 cells. ConA exerted a strong inhibition of insulin binding to solubilized cell preparations. Its effect on intact cells was modest however, suggesting that in this mutant line exposure of the insulin receptor at the cell surface is not different from that in the WT cells. Neither ECA nor PHA inhibited [125I]insulin binding to either intact or solubilized Lec 1 cells, suggesting that the absence of sugar determinants for these two lectins may play a role in the very low insulin binding affinity previously reported in this cell line. In conclusion, these indirect studies with lectins suggest that the carbohydrate units of the insulin receptor are heterogeneous. While some may be important for proper exposure of the receptor at the cell surface, others may play a role in more intrinsic receptor properties. PMID- 3512254 TI - Ovarian gonadotropin-releasing hormone-like protein(s): demonstration and characterization. AB - Both GnRH and prostaglandin F2 alpha inhibit LH-stimulated cAMP accumulation and progesterone secretion in isolated luteal cells. Moreover, since ovarian GnRH receptors have been demonstrated, this study was conducted to determine if GnRH like substances were present in the luteinized rat ovary. Detection of GnRH-like activity was based on a sensitive and specific ovarian membrane GnRH radioreceptor assay and an immunoassay specific for GnRH. Ovaries were extracted with an aqueous medium containing formic acid, HCl, trifluoroacetic acid, and NaCl. Material present in the supernatant fraction which adsorbed to Waters C18 Sep-Paks was subsequently eluted with acetonitrile and lyophilized. The redissolved ovarian extract showed substantial radioreceptor activity, but very little immunoassayable activity. The GnRH-like activity of the ovary was sensitive to proteolytic enzyme digestion and to incubations at 50 C for as little as 5 min, had an apparent mol wt greater than 1,000 but less than 10,000, and was not soluble in ether. Extracts of plasma did not exhibit radioreceptor or immunoreactive activity, whereas hypothalamic extracts exhibited both radioreceptor and immunoreactive activities. Liver and kidney extracts showed less radioreceptor activity than ovarian extracts and very little immunoreactive activity. Two peaks of radioreceptor activity appeared when the ovarian extract was further fractionated by reverse phase HPLC. The two peaks of GnRH-like activity were clearly separated from GnRH or [D-Ala6, des-Gly10] GnRH ethylamide, an analog used in this study, when these were included in ovarian extracts. It is concluded that rat ovaries contain a GnRH-like protein(s) with membrane binding properties similar to those of GnRH but with other characteristics distinctly different from those of GnRH. The ovarian GnRH-like protein is immunologically different from GnRH, sensitive to elevated temperatures which do not effect GnRH, and chromatographically different from GnRH during reverse phase HPLC. PMID- 3512255 TI - Role of insulin in the increase in serum 1,25-dihydroxyvitamin D concentrations in response to phosphorus deprivation in streptozotocin-induced diabetic rats. AB - To evaluate the role of insulin in the regulation of circulating 1,25 dihydroxyvitamin D [1,25(OH)2D] levels, serum 1,25(OH)2D concentrations in response to phosphorus (P) deprivation were examined in control, streptozotocin diabetic and insulin-treated diabetic rats. Dietary P deprivation for 1 week caused a marked increase in serum 1,25(OH)2D level from 75 +/- 4 pg/ml to 274 +/- 16 pg/ml in control rats. In contrast, serum 1,25(OH)2D level was significantly lower in diabetic rats on a normal P diet (20 +/- 2 pg/ml) compared to that in control rats and increased only slightly by P deprivation (33 +/- 4 pg/ml). Treatment of the diabetic rats on normal P diet with insulin caused an increase in serum 1,25(OH)2D concentration to a level (82 +/- 10 pg/ml) similar to that in control rats and restored the increase in serum 1,25(OH)2D concentration in response to P deprivation (315 +/- 38 pg/ml). Although there was a marked decrease in serum phosphate level by P deprivation in all groups of animals, the rise in serum calcium level by P deprivation seen in control rats was abolished in diabetic rats. In addition, while bone mineral contents decreased significantly in response to P deprivation in control rats, no significant changes in either bone calcium or P contents were observed after P deprivation in diabetic rats. Insulin treatment of the diabetic rats recovered the responsiveness to P deprivation in both serum calcium level and bone mineral contents. P deprivation did not affect plasma glucose or serum creatinine level in any group of rats. These results suggest that insulin, either directly or indirectly, is required for the increase in circulating 1,25(OH)2D concentrations in response to P deprivation, and that the rise in serum 1,25(OH)2D level may play a role in the hypercalcemic response to P deprivation. PMID- 3512256 TI - Retinoic acid enhances cell responses to epidermal growth factor in mouse mammary gland in culture. AB - Addition of epidermal growth factor (EGF) at up to 100 ng/ml to the medium of cultured explants of mouse mammary gland increased thymidine incorporation into DNA dose dependently. Addition of retinoic acid alone at 10 micrograms/ml to the medium had no significant effect on DNA synthesis, but addition of EGF with retinoic acid enhanced the EGF-stimulated DNA synthesis. Furthermore, pretreatment of mammary explants with retinoic acid enhanced the effect of EGF plus retinoic acid on cell growth. EGF inhibited the synthesis of casein and decreased alpha-lactalbumin activity of mammary explants in culture in the presence of insulin, cortisol, and PRL. Retinoic acid alone had no significant effect on the synthesis of casein, but suppressed alpha-lactalbumin activity dose dependently. Concomitant addition of retinoic acid with EGF had no significant effect on EGF-induced inhibition of casein synthesis, but enhanced EGF-induced inhibition of alpha-lactalbumin activity dose dependently. Measurement of specific binding of [125I]EGF to mouse mammary glands in culture demonstrated that pretreatment of the explants with retinoic acid slightly, but significantly, enhanced the specific binding of EGF to its cellular receptors. PMID- 3512257 TI - The mechanism of vagal nerve stimulation of glucagon and insulin secretion in the dog. AB - The mechanism of vagal nerve stimulation of glucagon (IRG) and insulin (IRI) secretion was investigated in halothane-anesthetized dogs. Both ventral and dorsal branches of the thoracic vagi were stimulated electrically (10 Hz, 5 msec, 13.5 mA, 10 min) below the heart. Arterial and superior pancreaticoduodenal venous plasma were sampled, superior pancreaticoduodenal venous plasma flow was measured, and net pancreatic output of IRG and IRI were calculated. During vagal nerve stimulation (n = 15) net pancreatic output of IRG doubled (delta = +0.83 +/ 0.28 ng/min, P less than 0.01; baseline = 0.81 +/- 0.15 ng/ min) and IRI quadrupled (delta = +3.5 +/- 1.5 mU/min, P less than 0.025; baseline = 1.1 +/- 0.3 mU/min). Arterial glucose levels increased by 7 +/- 2 mg/dl from 108 +/- 3 mg/dl (P less than 0.005). After atropine pretreatment (n = 7), the pancreatic IRI response to vagal nerve stimulation was +0.71 +/- 0.28 mU/min (P less than 0.025), a reduction of 80%. In contrast, atropine pretreatment changed neither the IRG response (delta = +0.87 +/- 0.36 ng/min; P less than 0.05) nor the arterial glucose response (delta = +9 +/- 3 mg/dl; P less than 0.025) to vagal nerve stimulation. Hexamethonium pretreatment (n = 9) abolished the pancreatic IRG response (delta = +0.13 +/- 0.11 ng/min; NS), the arterial glucose response (delta = +0.5 +/- 1.9 mg/dl; NS) and the pancreatic IRI response (delta = +0.16 +/- 0.31 mU/min; NS) to vagal nerve stimulation. It is concluded that vagal nerve stimulation in the dog produces a moderate increase of IRG secretion, mediated by a nonmuscarinic (peptidergic?) mechanism, and a marked increase of IRI secretion, mediated by a muscarinic mechanism. Both responses are dependent on nicotinic transmission. PMID- 3512258 TI - Purification, characterization, and in vitro differentiation of cytotrophoblasts from human term placentae. AB - Highly purified functional cytotrophoblasts have been prepared from human term placentae by adding a Percoll gradient centrifugation step to a standard trypsin DNase dispersion method. The isolated mononuclear trophoblasts averaged 10 microns in diameter, with occasional cells measuring up to 20-30 microns. Viability was greater than 90%. Transmission electron microscopy revealed that the cells had fine structural features typical of trophoblasts. In contrast to syncytial trophoblasts of intact term placentae, these cells did not stain for hCG, human placental lactogen, pregnancy-specific beta 1-glycoprotein or low mol wt cytokeratins by immunoperoxidase methods. Endothelial cells, fibroblasts, or macrophages did not contaminate the purified cytotrophoblasts, as evidenced by the lack of immunoperoxidase staining with antibodies against vimentin or alpha 1 antichymotrypsin. The cells produced progesterone (1 ng/10(6) cells . 4 h), and progesterone synthesis was stimulated up to 8-fold in the presence of 25 hydroxycholesterol (20 micrograms/ml). They also produced estrogens (1360 pg/10(6) cells . 4 h) when supplied with androstenedione (1 ng/ml) as a precursor. When placed in culture, the cytotrophoblasts consistently formed aggregates, which subsequently transformed into syncytia within 24-48 h after plating. Time lapse cinematography revealed that this process occurred by cell fusion. The presumptive syncytial groups were proven to be true syncytia by microinjection of fluorescently labeled alpha-actinin, which diffused completely throughout the syncytial cytoplasm within 30 min. Immunoperoxidase staining of cultured trophoblasts between 3.5 and 72 h after plating revealed a progressive increase in cytoplasmic pregnancy-specific beta 1-glycoprotein, hCG, and human placental lactogen concomitant with increasing numbers of aggregates and syncytia. At all time points examined, occasional single cells positive for these markers were identified. RIA of the spent culture media for hCG revealed a significant increase in secreted hCG, paralleling the increase in hCG-positive cells and syncytia identified by immunoperoxidase methods. We conclude that human cytotrophoblasts differentiate in culture and fuse to form functional syncytiotrophoblasts. PMID- 3512259 TI - In vitro degradation of bone particles by human monocytes is decreased with the depletion of the vitamin K-dependent bone protein from the matrix. AB - The bone vitamin K-dependent protein osteocalcin has been suggested to play a role in bone resorption. By administering sodium warfarin to rats, it is possible to inhibit the vitamin K-dependent addition of the their gamma-carboxyglutamic acid residues to osteocalcin. This results in reduced amounts of osteocalcin bone, probably because devoid of the calcium-binding Gla residues, the protein no longer accumulates in bone. Preparations of bone obtained from rats treated with sodium warfarin for 6 weeks contained only 0.2% of normal levels of osteocalcin and were 90% reduced in the concentration of Gla. This bone could not be degraded by human monocytes in vitro as well as control bone (only 54% of control; P less than 0.003). Defects in the movement of cells to the bone were documented by phase contrast microscopy. Only 60% as many monocytes attached to the osteocalcin depleted bone as to control bone in an in vitro attachment assay. These effects do not appear to be related to direct cellular toxicity. The degradation of bone in this in vitro system appears to be dependent on the osteocalcin content in matrix. This may result from defective movement of cells to bone and/or attachment to the bone. PMID- 3512260 TI - The immature rat ovary is innervated by vasoactive intestinal peptide (VIP) containing fibers and responds to VIP with steroid secretion. AB - The nature and role of the peptidergic innervation of the ovary were examined by determining the location and function of vasoactive intestinal peptide (VIP) containing nerve fibers in the immature rat ovary. Immunohistofluorescence analysis of prepubertal ovaries using a specific VIP antibody revealed sparse delicate VIP-immunoreactive fibers localized around veins and arterioles, in the interstitial tissue, and associated with the thecal layers of developing follicles. Radioimmunoassayable VIP content was found to be approximately 100 pg/ovary (3 nM). The VIP immunoreactivity coeluted with authentic VIP when subjected to Sephadex G-25 chromatography. VIP enhanced in vitro progesterone release from infantile (12 days old), juvenile (30 days old), and peripubertal ovaries and estradiol release during the two latter developmental periods. The maximal estradiol response to VIP occurred during the early and first proestrous phases of puberty. No response was observed during estrus or first diestrus. The progesterone response to VIP increased moderately between day 12 and first proestrus, and then strikingly at estrus and first diestrus. The stimulatory effect of VIP on ovarian steroid production was dose related, as determined in ovaries from PMSG-treated immature rats (ED50 = 215, 44, and 51 nM for estradiol, androgen, and progesterone, respectively). The specificity of the VIP effect was tested using five other gastrointestinal peptides (porcine peptide histidine isoleucine, gastric inhibitory polypeptide, secretin, motilin, and glucagon). Only peptide histidine isoleucine, which has the greatest sequence homology with VIP, enhanced ovarian steroid production at 50% of VIP effectiveness. VIPergic nerves thus appear to be involved in the developmental regulation of ovarian steroidogenesis. PMID- 3512261 TI - Endoscopic obliteration of large esophagogastric varices with bucrylate. AB - We report on three patients with severe recurrent bleeding from large esophagogastric varices which could not be controlled by conservative treatment or sclerotherapy. In these cases the bleeding was successfully arrested by intravascular injection of Bucrylate. PMID- 3512262 TI - The value of colonoscopy and ultrasonography in the diagnosis of chronic intussusception in childhood. AB - Ultrasonography and colonoscopy were diagnostic for chronic intussusception in a 6-year-old girl. After an episode of acute gastroenteritis the child developed non-specific recurrent abdominal symptoms, which were considered to be functional. While the ultrasonographic pattern alone was too unspecific to establish the correct diagnosis, the colonoscopic findings were diagnostic of intussusception. This case report demonstrates that ultrasonography and colonoscopy are complementary, radiation-independent but reliable diagnostic procedures for detecting organic bowel disorders in children presenting with recurrent abdominal symptoms. PMID- 3512263 TI - Plasma renin and aldosterone changes during twenty minutes' moderate exercise. Influence of posture. AB - The influence of posture on plasma renin and aldosterone changes during exercise performed at a constant relative work load (40%-50% maximal oxygen uptake) was studied in eight healthy men. Each subject carried out two 20-min exercises on an ergocycle at an interval of 8 days; the first exercise was performed in the normal sitting position (upright exercise), the second in a comfortable supine position (supine exercise). In both cases, heart rate and blood pressure were measured as well as plasma renin activity (PRA), aldosterone (ALDO) and osmolality, before and immediately after exercise, and 15 min following the end of exercise. An increase in heart rate, blood pressure, PRA, ALDO and osmolality was noted at the end of each exercise. This increase was greater in the supine exercise than when upright for PRA and ALDO; plasma osmolality and blood pressure showed identical increases for both types of exercise; increase in heart rate was greater when supine than when upright. PRA and ALDO were still elevated 15 min after the upright activity, but had regained their base values in that time after the supine exercise. Our results show that moderate, relatively brief periods of exercise stimulate the production of renin and aldosterone, but the response is less when supine than in the normal upright position. PMID- 3512264 TI - Plasma renin activity, aldosterone and catecholamine levels when swimming and running. AB - The purpose of this study was to determine the response of plasma renin activity (PRA), plasma aldosterone concentration (PAC) and catecholamines to two graded exercises differing by posture. Seven male subjects (19-25 years) performed successively a running rest on a treadmill and a swimming test in a 50-m swimming pool. Each exercise was increased in severity in 5-min steps with intervals of 1 min. Oxygen consumption, heart rate and blood lactate, measured every 5 min, showed a similar progression in energy expenditure until exhaustion, but there was a shorter time to exhaustion in the last step of the running test. PRA, PAC and catecholamines were increased after both types of exercise. The PRA increase was higher after the running test (20.9 ng AngI X ml-1 X h-1) than after swimming (8.66 ng AngI X ml-1 X h-1). The PAC increase was slightly greater after running (123 pg X ml-1) than swimming (102 pg X ml-1), buth the difference was not significant. Plasma catecholamine was higher after the swimming test. These results suggest that the volume shift induced by the supine position and water pressure during swimming decreased the PRA response. The association after swimming compared to running of a decreased PRA and an enhanced catecholamine response rule out a strict dependence of renin release under the effect of plasma catecholamines and is evidence of the major role of neural pathways for renin secretion during physical exercise. PMID- 3512265 TI - The complete amino acid sequence of vitelline coat lysin. AB - The vitelline coat lysin of a top shell, Tegula pfeifferi, is a single polypeptide consisting of 118 amino acid residues and having a relative molecular mass of 13800. The complete amino acid sequence of the vitelline coat lysin was determined by the analyses of five peptides obtained by cyanogen bromide degradation and three fragments obtained by Staphylococcus aureus protease digestion of the protein. The sequence showed the presence of microheterogeneities in the vicinity of the C-terminal half of the molecule and the existence of two homologous domain structures. PMID- 3512266 TI - Lipopolysaccharide-sensitive serine-protease zymogen (factor C) found in Limulus hemocytes. Isolation and characterization. AB - Bacterial endotoxin (lipopolysaccharide, LPS) induces coagulation of horseshoe crab hemolymph. Our previous studies had demonstrated that a hemolymph factor, designated factor B, was associated with the LPS-mediated activation of the Limulus clotting system [Ohki et al. (1980) FEBS Lett. 120, 318-321]. On further purification of factor B we found that an additional component, designated factor C, was required to generate factor B activity in the presence of LPS in order to activate the proclotting enzyme. To elucidate the role of factor C in the LPS mediated reaction, factor C was isolated and characterized from the hemocyte lysate under sterile conditions. The preparation exhibited a single band on sodium dodecyl sulfate/polyacrylamide gel electrophoresis (SDS-PAGE) in the absence of 2-mercaptoethanol, while two protein bands on SDS-PAGE were observed after reduction. Thus, factor C had a Mr of 123 000 consisting of a heavy chain of Mr = 80 000 and a light chain of Mr = 43 000. Factor C was converted to an activated form in the presence of LPS with a Mr = 123 000, designated factor C. Upon activation, cleavage of the light chain occurred resulting in the accumulation of two new fragments of Mr = 34000 and 8500 on reduced SDS-PAGE. A diisopropylfluorophosphate-sensitive active site was localized in the light chain (Mr = 34000) of factor C. The reconstitution experiments, using factor C, factor B, proclotting enzyme and LPS, demonstrated that all of these proteins are essential for the endotoxin-mediated coagulation system. On the basis of these results we propose that a cascade pathway of LPS-induced activation of the Limulus clotting system consists of three sequential activations of hemolymph serine protease zymogens. PMID- 3512267 TI - Nuclear-magnetic-resonance studies on the conformation of membrane-bound alpha mating factor. Transferred nuclear Overhauser effect analysis. AB - The C-H proton resonances of alpha-mating factor, yeast pheromone, in 2H2O solution were assigned. The phase transition temperature of perdeuterated dipalmitoylglycerophosphocholine (suspension) was found to be 35.5 degrees C. In the presence of vesicles of this phospholipid, the exchange broadening and transferred nuclear Overhauser effect (TRNOE) of peptide proton resonances (at 50 degrees C) were analyzed. The mode of binding of this peptide with the phospholipid bilayer was elucidated. The N-terminal nine residues (Trp1-Gly9) are tightly bound to the bilayer, while the C-terminal four residues (Gln10-Tyr13) are left free in aqueous phase. This is consistent with the previous observation that the C-terminal three residues (Pro11-Tyr13) are not essential for the activity of this pheromone [Masui, Y. et al. (1977) Biochem. Biophys. Res. Commun. 78, 534-538]. Furthermore, from the TRNOE analyses, the conformation of the membrane-bound N-terminal part of alpha-mating factor was elucidated; the residues Trp1-Gln5 form a compact helical structure while the residues Lys7-Gly9 form an extended structure. A similar TRNOE was also observed for an active decapeptide analog Trp1-Gln10. This confirms the previous conclusion that the physiological activities of this pheromone and analog peptides are correlated with the conformations of membrane-bound peptide molecules [Higashijima, T. et al. (1983) FEBS Lett. 159, 229-232]. PMID- 3512268 TI - Isolation of the low-molecular-mass form of catechol O-methyltransferase from rat liver and immunocytochemical localization of the enzyme in the glycogen compartment. AB - The low-molecular-mass form of two distinct catechol O-methyltransferase activities (S-adenosyl-L-methionine: catechol O-methyltransferase, COMT, EC 2.1.1.6) has been purified to homogeneity from rat liver using 40-70% ammonium sulfate precipitation, gel filtration on Sephadex G-100, adsorption on hydroxyapatite C and ion-exchange chromatography on DEAE-Sepharose CL-6B. The relative molecular mass Mr, determined by sodium dodecyl sulfate/polyacrylamide gel electrophoresis is 22 400 +/- 500. Irradiation of the enzyme in the presence of 8-azido-[methyl-3H]AdoMet results in the specific labeling of the catalytic site of the enzyme. Photolabeling was successful with crude COMT preparations and with the isolated enzyme. Immunocytochemical studies present new information about the localization of the low-molecular-mass form in the liver parenchyma. Subcellularly COMT immunoreactivity could be attributed exclusively to the compartment with glycogen granules. Nucleus, mitochondria and endoplasmic reticulum showed no immunostaining. PMID- 3512269 TI - The primary structure of the alpha subunit of human elongation factor 1. Structural aspects of guanine-nucleotide-binding sites. AB - The primary structure of the alpha subunit of elongation factor 1 (EF-1 alpha) from human MOLT 4 cells was determined by cDNA sequencing. The data show that the conservation of the amino acid sequence is more than 80% when compared with yeast and Artemia EF-1 alpha. An inventory of amino acid sequences around the guanine nucleotide-binding site in elongation factor Tu from Escherichia coli and homologous amino acid sequences in G proteins, initiation and elongation factors and proteins from the RAS family shows two regions containing conserved sequence elements. Region I has the sequence apolar-Xaa-Xaa-Xaa-Gly-Xaa-Xaa-Yaa-Xaa-Gly LYs-Thr(Ser)- -Xaa-Xaa-Xaa-Xaa-X-apolar. Except for RAS proteins, Yaa is always an acidic amino acid residue. Region II is characterized by the invariant sequence apolar-apolar-Xaa-Xaa-Asn-Lys-Xaa-Asp. In order to facilitate sequence comparison we have used a graphic display, which is based on the hydrophilicity values of individual amino acids in a sequence. PMID- 3512270 TI - The protein phosphatases involved in cellular regulation. Primary structure of inhibitor-2 from rabbit skeletal muscle. AB - The complete primary structure of inhibitor-2, a specific inhibitor of protein phosphatase-1, has been determined. The protein consists of a single polypeptide chain of 203 residues, and has a relative molecular mass of 22835 Da. This molecular mass is significantly lower than earlier estimates based on sodium dodecyl sulphate polyacrylamide gel electrophoresis. The threonyl residue phosphorylated by glycogen synthase kinase-3 is located at position 72. The molecule is very hydrophilic, lacks cysteine residues and the single tryptophanyl and phenylalanyl residues are at positions 46 and 139, respectively. The N terminal alanyl residue is N-acetylated. Digestion with Staphylococcus aureus V8 proteinase, trypsin, or cleavage with cyanogen bromide, destroyed the biological activity of inhibitor-2, demonstrating that many large fragments (e.g. 1-49, 49 92, 67-101, 108-134, 142-182 and 163-197) are inactive. Digestion with clostripain generated a peptide comprising residues 25-114 which retained 2% of the inhibitory potency of the parent molecule. There is no sequence homology between inhibitor-2 and inhibitor-1. PMID- 3512271 TI - Proteins from the prokaryotic nucleoid. A protein-protein cross-linking study on the quaternary structure of Escherichia coli DNA-binding protein NS (HU). AB - Escherichia coli DNA-binding proteins NS1, NS2 and NS (NS1 + NS2) react with the protein-protein bifunctional cross-linking reagents dimethylsuberimidate and dimethyladipimidate to yield oligomers up to hexamers. The former reagent, with the longer arm, is more efficient than the other shorter one. Both one- and two dimensional gel electrophoreses show that the cross-linked trimers are homogeneous, while the dimers appear heterogeneous, suggesting that at least two types of dimers but geometrically equivalent trimers are formed. In the presence of DNA, the cross-linking reaction with either reagent yields fewer dimers and more of the larger products. The yield of cross-linked products of various sizes was determined for NS1, NS2 and NS as a function of the protein concentration (0.03-3000 microM). From the results obtained in these experiments, we derived a model of quaternary structure in which dimers and tetramers are predominant in very solutions of the proteins. Above a critical concentration (10-50 microM), interactions among tetramers become increasingly important, yielding octamers and perhaps larger products. Our data do not support a recently proposed model in which the DNA is packaged around a protein disc consisting of 8-10 NS dimers. PMID- 3512272 TI - Structural features of the DNA template required for transcription in vitro by yeast RNA polymerase B (II). AB - Yeast RNA polymerase II initiates in vitro transcription at two sites located within the vector DNA and the cloned promoter, on a recombinant plasmid DNA containing the yeast iso1 cytochrome c promoter. Both initiation sites are found within a DNA fragment hypersensitive to osmium tetroxide modification. Using a series of yeast iso1 cytochrome c promoter deletions, we have characterized an upstream DNA sequence required for optimal transcription from this site and shown in this case a correlation between osmium sensitivity and the capacity of RNA polymerase to initiate. However, perturbation of the double helix is not sufficient to generate a transcription initiation site. Insertion of 28 alternating AT residues at the EcoRV site of pBR322 generates an site hypersensitive to osmium tetroxide modification, that does not serve as a transcription start site. PMID- 3512273 TI - Primary malignant melanoma of the female urethral meatus. AB - The case of a 79-year-old woman with a malignant melanoma of the urethral meatus is reported. Melanomas originating from the urethra are exceedingly rare. Histogenetic theories are reviewed. Clinical presentation and therapeutic approach are discussed. PMID- 3512274 TI - Spontaneous regression of renal transplant artery stenosis: a new case. AB - Stenosis of the renal graft artery is a relatively common complication in renal transplantation. Therapy consists of either transluminal angioplasty or surgical correction. Nevertheless some untreated cases show good spontaneous evolution. We describe a well-documented case of graft artery stenosis causing severe hypertension with declining renal function which experienced spontaneous resolution. PMID- 3512275 TI - An inherited deficiency of the third component of complement, C3, in guinea pigs. AB - Hereditary deficiency of the third component of complement, C3, is found very seldom in the human. C3 deficiency is associated with severe bacterial infections revealing the central role of C3 in complement activation via the classical or alternative pathway. We describe a new hereditary C3 deficiency in strain 2 guinea pigs. Serum from these animals had a markedly reduced lytic activity in a standard assay for complement-dependent, antibody-mediated cytotoxicity. In functional assays of individual components, the hemolytic activity of the components C4, C2, C5 and of factors B, D and H was in the normal range. The functional C3 titer, and similarly C3 antigenic activity in the serum of these C3 deficient animals (C3D) was on average only 5.7% of normal activity. Typing the animals with alloantisera or monoclonal antibodies to guinea pig Ia-antigens revealed that the C3D animals had the major histocompatibility complex-haplotype of inbred strain 2 guinea pigs (B.1, Ia.2,4). The C3 defect is not linked to the major histocompatibility complex and, in addition, is not linked to a C3a receptor deficiency. Macrophages and hepatocytes of the C3D animals have an unimpaired capacity for synthesis and secretion of C3 as measured by enzyme linked immunosorbent assay. There was no indication for hypercatabolism of normal C3 by the animals as shown by plasma clearance of 125I-radiolabeled C3. Thrombocytes of the C3D animals responded normally to stimulation with purified C3a in an ATP-release assay without an indication for a desensitization in vivo. Possibly the fault resides in an enhanced susceptibility of their own C3 to proteolysis. However, C3 partially purified from the plasma of the C3D animals or secreted by hepatocytes exhibited no obvious structural differences to purified normal C3 in sodium dodecyl sulfate-polyacrylamide gel electrophoresis or in immunoblotting. The C3D serum had a reduced bactericidal activity compared to normal or to C4-deficient serum. Nevertheless, the animals are apparently healthy without an indication for increased frequency of bacterial infections. These guinea pigs provide an unique model for analysis of the biological functions of C3 in vivo and in vitro without the need for artificial C3-depletion procedures with all their known and unknown side-effects. PMID- 3512276 TI - Prejunctional and postjunctional actions of prostaglandins F2 alpha and I2 and carbocyclic thromboxane A2 in isolated dog mesenteric arteries. AB - Prostaglandin (PG) F2 alpha in concentrations insufficient to alter the basal tone potentiated contractile responses of helical strips of dog mesenteric arteries to transmural electrical stimulation but did not alter the responses to norepinephrine. Carbocyclic thromboxane A2 (cTxA2) potentiated the response to transmural stimulation, norepinephrine, serotonin and angiotensin II. PGI2 (up to 10(-7) M) attenuated the contraction induced by transmural stimulation, norepinephrine and serotonin. The potentiating effect of PGF2 alpha was not antagonized by diphloretin phosphate, a PG antagonist, whereas the effects of cTxA2 and PGI2 were prevented. 3H Overflow evoked by transmural stimulation in superfused arterial strips previously soaked in media containing [3H]norepinephrine was increased by PGF2 alpha but was not altered by cTxA2 and PGI2. It may be concluded that PGF2 alpha potentiates the contractile response to adrenergic nerve stimulation by increasing the release of norepinephrine, and that cTxA2 potentiates the response by increasing arterial muscle contractility, whereas PGI2 attenuates contractility. Prejunctional effects of PGs appear to be mediated by receptive sites different from those located postjunctionally. PMID- 3512277 TI - Reduction and repopulation of T-lymphocytes after cytoreductive therapy with or without autologous bone marrow rescue. AB - The reconstitution of peripheral-blood T-lymphocytes following cytoreductive therapy in standard (11 patients) or in high dosages (ten patients) was compared with that after supralethal cytoreductive therapy followed by autologous bone marrow rescue (ABMR, 20 patients). Along with the increasing cytotoxic potential of the three therapy protocols, T-cell counts fell to lower levels. Following all three forms of cytoreductive therapy, T8+ T-cell counts decreased to lower levels than T4+ T-cell counts. The greater relative reduction of T8+ T cells may indicate that T8+ T cells are more sensitive to cytoreductive therapy than T4+ T cells, and/or that T8+ T cells have shorter survival times. The contribution of residual (mainly T4+) T cells to the T-cell repopulation was significant in the patients on standard-dosage chemotherapy, less important in those on high-dosage chemotherapy, and minor in those receiving supralethal cytoreductive therapy and ABMR. The repopulation rates of T8+ T cells following ABMR exceeded those observed after chemotherapy without ABMR. The T3- (T3 negative) T-cell subset, which comprises only 5%-10% of peripheral T cells in normal individuals, decreased rapidly to low levels and remained so for the entire six-week observation period in both chemotherapy groups. Following ABMR, however, those T3 T cells rapidly increased again to normal levels. Since the T cells in bone marrow biopsies have a large T3- fraction, that rapid recovery of T3- T cells may reflect the contribution of marrow precursors in the marrow grafts to the improved T-cell regeneration following ABMR. PMID- 3512278 TI - Recurrence of acute leukemia more than two years after allogeneic marrow grafting. AB - The records of 232 patients with acute leukemia in continuous complete remission at two years after a marrow graft from genotypically or phenotypically HLA identical family member were reviewed. With a followup time of 2-14.2 years, 17 patients have developed recurrent leukemia 2.0-6.3 years after grafting. No relapses have occurred beyond 6.3 years. Actuarial analysis shows a low but significant risk of recurrence of leukemia more than two years after grafting. These data suggest that the majority of the disease-free patients have had their original leukemic clone eliminated. It is important to study the leukemic cells in patients who suffer a relapse more than two years after grafting to determine whether the leukemia is of host or donor origin. PMID- 3512280 TI - Residual deficiencies in hemopoietic precursor cell populations after repeated irradiation of mice with x-rays or neutrons: dose-response relationships. AB - Persistent reductions in the femoral content of hemopoietic colony-forming cells (CFU-S and GM-CFC) were observed after four doses of irradiation, delivered with three weeks between doses. In general, the reductions were dose dependent, and similar reductions were produced by single doses and repeated doses using the same total dose. After the lowest doses investigated, 4 X 0.75 Gy 300-kVp x-rays or 4 X 0.38 Gy 14.7-MeV neutrons, the recovered levels remained at 60%-80% of control for at least one year after irradiation. The relative biological effectiveness (RBE) of neutrons is about 2 for these long-term hemopoietic deficiencies. PMID- 3512279 TI - Characterization of the hematopoietic defect in paroxysmal nocturnal hemoglobinuria. AB - We studied the relationship between paroxysmal nocturnal hemoglobinuria (PNH) and bone marrow failure using in vitro hematopoietic colony culture assays. Most of 17 patients with PNH showed decreased colony formation, by erythroid burst forming cells (BFU-E) and granulocyte-macrophage colony-forming cells (CFU-C) in methylcellulose, disproportionate to their degree of bone marrow biopsy cellularity. Only a minority of the hematopoietic progenitors were sensitive to complement-mediated lysis in vitro. In contrast, normoblasts from maturing erythroid bursts removed from culture and exposed to acidified serum were sensitive to complement-mediated lysis. The size of bursts and the sensitivity of their progeny correlated strongly, suggesting that the PNH defect was acquired in culture as a function of the generational age of erythroid precursor cells. In addition, BFU-E of PNH patients were very sensitive to 3H-thymidine suicide, in comparison with normal individuals and patients with other hemolytic anemias, indicating that a large proportion of primitive erythroid progenitors in PNH bone marrow were in cell cycle. All of these results imply that acquisition of the PNH defect during erythropoiesis may lead to intramedullary destruction of developing erythroid cells. The increased demand that results on the progenitor pool may lead to stem cell depletion and bone marrow failure. PMID- 3512281 TI - Short-course tuberculosis chemotherapy studies conducted in Poland during the past decade. AB - During the past decade, six short-course (6-month) chemotherapy regimens were studied in which drugs were given daily and intermittently. Four regimens containing isoniazid, rifampin, and ethambutol caused little toxicity but yielded relapse rates (8-21%) which were unacceptably high. The safety of giving rifampin (450 or 600 mg) twice weekly was confirmed, however, and there was evidence that daily therapy during the 4-month continuation phase was no more effective than twice weekly isoniazid and rifampin. Once weekly therapy during the continuation phase was clearly inadequate. The use of four drugs (isoniazid, rifampin, pyrazinamide, and streptomycin) given daily during the initial 2 months of therapy followed by 4 months of twice weekly isoniazid and rifampin resulted in a nearly 100% cure rate. However, this regimen was not well tolerated by patients. Deleting streptomycin improved the tolerability of the regimen but appears to have slightly increased the frequency of treatment failure and relapse. A suggested model for choosing treatment regimens is presented. PMID- 3512282 TI - High-dose inhaled budesonide in treatment of severe steroid-dependent asthma. AB - Forty-five steroid-dependent asthmatic outpatients were treated twice daily for 51 weeks with a new inhalation steroid, budesonide (BUD), using a 750 ml spacer. During the initial 15 weeks the prednisone-sparing effects of a high daily dose (1600 micrograms) and a conventional dose (400 micrograms per day) were compared in a double-blind randomized trial including 50 patients. During the remaining 36 weeks 45 patients were treated openly with 1600 micrograms daily. All patients used other antiasthmatic drugs which were maintained throughout the study, except for inhalations of beta-2 agonists that could be used whenever needed. All patients but 2 were able to reduce the daily dose of oral prednisone. The mean daily dose decreased from 13.9 mg to 5.3 mg. Eighteen patients (40%) were able to discontinue oral prednisone. Adrenal gland function improved considerably as prednisone intake decreased. Oropharyngeal thrush frequency showed no change. No severe side effects were observed. PMID- 3512283 TI - GABA-immunoreactive neurons in the dorsal lateral geniculate nucleus of the rat: characterisation by combined Golgi-impregnation and immunocytochemistry. AB - Identified neurons in the dorsal lateral geniculate nucleus (dLGN) of the rat were studied using a Golgi/EM procedure in combination with post-embedding GABA immunocytochemistry. The results of this investigation identify clearly the GABA immunoreactive nature of the two morphologically distinct neuronal populations found within the rat dLGN--thalamocortical relay cells are GABA-immunonegative whilst the putative 'interneurons' are GABA-immunopositive. This immunocytochemical evidence strongly suggests that 'interneurons' synthesize and use GABA to mediate their local inhibitory synaptic mechanisms within the dLGN of the rat. PMID- 3512284 TI - Localization of NPY-immunoreactivity in the cat's visual cortex. AB - Using a polyclonal antiserum against neuropeptide Y (NPY; J.M. Allen et al. 1983a) immunohistochemistry was carried out using the PAP method. Neurones displaying NPY-like immunoreactivity are seen mainly in cortical layers V/VI, adjacent white matter and corona radiata. Only few neurones occur in superficial layers II/III. Neurones are multipolar to bitufted with spineless dendrites; somata are either round (layers V, II/III) or spindle-like (layer VI, white matter) with diameters between 16 and 20 microns. Axons were identified by their initial smoother profiles, which are smaller in diameter than principal dendrites, by their typical branching pattern and the occurrence of terminal portions. It was found, that the degree of axonal ramification in proximal parts of axons is rather poor. Most NPY-neurones seem to project intracortically or even locally, except neurones in layers VI and the white matter. The latter neurones have ascending axonal branches terminating in layer VI and V, thus contributing to the dense NPY-plexus in these layers, whereas some layer VI neurones have axonal branches descending into the white matter. The axonal plexus in upper cortical layers is most probably fed by the ascending axons of layer V neurones, passing layer IVc in a strictly vertical direction. Fine smooth fibers of unknown origin which ascend from the white matter in a vertical direction through the grey matter also contribute to the plexus in layer II/III. In semithin sectioned material three terminal types were identified. Firstly, en passant boutons on immunonegative pyramidal neurones, secondly, perisomatically arranged, basket-like terminals, bending around unstained non-pyramidal neurones, and thirdly, about 60 microns long vertically oriented rows of boutons exclusively on apical dendrites of layer II/III pyramidal neurones. Due to the unconspicious axonal pattern and the frequently observed basket-like terminal form, we conclude that most NPY-ir neurones can be regarded as a class of unspecific local field basket cells; the origin of the vertically arranged bouton rows has been yet to determined. PMID- 3512285 TI - Induction of audiogenic seizure susceptibility by focal infusion of excitant amino acid or bicuculline into the inferior colliculus of normal rats. AB - N-Methyl-D-aspartate (NMDA) (10 to 20 nmol) or bicuculline (15 to 50 pmol) in 0.5 microliter was infused bilaterally into the inferior colliculus or the deep layers of superior colliculus (DLSC) in normal rats, and the response to high intensity acoustic stimulation was examined. Thirty-five percent of rats receiving NMDA infusions and 42% of animals receiving bicuculline infusions into the inferior colliculus exhibited sound-induced seizures exclusively that were behaviorally similar to audiogenic seizures displayed by genetically epilepsy prone rats. Rats receiving microinjections into the DLSC did not display sound specific seizures. A combined pattern of spontaneous and sound-induced seizures was seen in some rats with both drugs and loci of microinjection. These data and previous studies support a role for increased excitant amino acid action and decreased efficacy of GABA in the inferior colliculus as important mechanisms involved in genetic susceptibility to audiogenic seizures. PMID- 3512286 TI - A thiol protease of peritoneal macrophages in the guinea pig. AB - Proteolytic enzymes of the guinea pig peritoneal exudate macrophages were investigated using synthetic fluorogenic peptide substrates. Among several enzymes, t-butyloxycarbonyl-phenylalanyl-seryl-arginine 4-methylcoumaryl-7-amide cleaving enzymes had the highest activity, and the activity in exudate macrophages was about 3 times stronger than that in resident macrophages. The molecular weight of the enzyme was around 35,000 and optimal pH around 6.5-7.0. It was inhibited by thiol-blocking reagents, suggesting a thiol protease. PMID- 3512287 TI - The role of the autonomic nervous system in mediating pancreatic endocrine responses to arginine in the calf. AB - The release of insulin which occurred in response to arginine, in the conscious calf, differed from that which occurs in response to glucose in that it was not significantly affected by either adrenergic or muscarinic blocking agents. Release of pancreatic glucagon was reduced by pretreatment with phentolamine. PMID- 3512288 TI - Renal histamine increases in the streptozotocin-diabetic rat. AB - Renal histamine concentration, total histamine and protein contents were measured in rats made diabetic via iv streptozotocin injection and held for 13 weeks following diagnosis of diabetes. Insulin (7 U/day) or alpha-hydrazinohistidine (alpha-HH, 25 mg/kg/day) or both drugs were administered to diabetic subgroups the last 2 weeks of the holding period. Untreated diabetics developed significant increases of renal histamine concentration and total histamine content, up 45 and 46%, respectively. Drug interventions reduced the diabetic increases of histamine concentration and content (in order) as follows: diabetic-insulin, down 7 and 8%; diabetic-alpha-HH down 25 and 26%; diabetic-insulin + alpha-HH, down 35 and 36%. Renal tissue protein content was unchanged and qualitative proteinuria was present in all diabetic subgroups. The data indicate that in experimental diabetes there is an increase of the renal inducible histamine pool which is partially reduced by insulin and/or alpha-HH treatments. In view of the long recognized actions of histamine upon microvascular permeability, elevated renal histamine may be one pathophysiological mediator of the diabetic functional renal microangiopathy manifest as proteinuria. PMID- 3512289 TI - [Problems of immunotoxicology]. PMID- 3512290 TI - [Effect of drugs on the viability of a pedicled skin flap in mice]. AB - In experiments on random-bred white male mice it was shown that medicinal agents, applied for various purposes in dermatoplasty operations, exert different influence on the size of necrosis of a skin flap on a feeding pedicle. PMID- 3512291 TI - [Experimental tests for detecting substances that cause pathological habituation]. AB - The author describes methods for experimental testing of the ability of alcohol and drugs to induce pathological motivation. These methods are intended for testing barbiturates, tranquilizers, analgesics, hallucinogens and psychostimulants. As for ethanol, there is a possibility of screening "high risk groups". PMID- 3512292 TI - A plausible mechanism for flagellar rotation in bacteria. AB - A novel model for the action of the flagellar motor of bacteria is presented in which rotational motion is produced by conformational changes in a helically or rotationally symmetric multi-subunit component of the basal body. The model is consistent with the known properties of the motor, including its ability to rotate equally well clockwise and counterclockwise. Formally, the model is similar to mechanisms that have been proposed for other biologic transducers of free energy, such as active transporters. PMID- 3512293 TI - Fluorescence study of the RecA-dependent proteolysis of LexA, the repressor of the SOS system in Escherichia coli. AB - The fluorescence of the LexA protein, the common repressor of the SOS system in Escherichia coli decreases by about 30% upon incubation with the RecA protein, and its cofactors ATP [or its non-hydrolysable analogue adenosine-5'-O-(3 thiotriphosphate), ATP gamma S] Mg2+ and single-stranded DNA. In the absence of any one of these elements required for the RecA-dependent proteolysis of LexA, this fluorescence change was not observed. The final fluorescence change depends only upon the concentration of LexA regardless of that of RecA. The time course of the fluorescence decrease corresponds well with the kinetics of the decrease of intact LexA protein and the increase of its 2 proteolytic fragments as determined by SDS-polyacrylamide gel electrophoresis. These results allow us to use the fluorescence change as a signal for a detailed kinetic analysis. The velocity of the proteolysis (d[LexA]/dt) is proportional to the concentration of LexA and RecA indicating that the formation of the LexA-RecA complex is the limiting step. PMID- 3512294 TI - Chemical characterization and opioid activity of an exorphin isolated from in vivo digests of casein. AB - The in vivo formation of an opioid peptide (exorphin) derived from beta-casein has been proved for the first time. It was isolated from duodenal chyme of minipigs after feeding with the milk protein casein. The exorphin has been identified as a beta-casein fragment by end-group determinations and qualitative amino acid analysis of the purified peptide. This peptide, named beta-casomorphin 11, displayed substantial opioid activity in an opiate receptor-binding assay. PMID- 3512295 TI - Dimeric enzyme IImtl of the E. coli phosphoenolpyruvate-dependent phosphotransferase system. Cross-linking studies with bifunctional sulfhydryl reagents. AB - The occurrence of intermolecular dithiols on EIImtl has been studied with a number of thiol-specific cross-linking reagents. The reaction of EIImtl with bifunctional maleimide derivatives inactivates the enzyme. At the same time the enzyme is irreversibly cross-linked to a dimeric species. Under optimal conditions 50% of the protein is cross-linked upon reaction with the dimaleimides. The enzyme is also cross-linked under oxidizing conditions in the presence of CuCl2, presumably by oxidizing an intermolecular dithiol to a disulfide. This oxidation can be reversed by the addition of the reducing agent dithiothreitol. The reaction of phosphorylated EIImtl with the same sulfhydryl specific bifunctional reagents does not lead to any cross-linked product. The results are discussed in terms of the association state of the purified protein and the distribution of its thiol groups. PMID- 3512296 TI - Production of a novel tryptophan analog, beta-1-indazole-L-alanine with tryptophan synthase of Escherichia coli. AB - The tryptophan synthase alpha 2 beta 2 complex from Escherichia coli has been found to catalyze the beta-replacement reaction of L-serine with indazole, an indole analog which has a nitrogen atom at the 2-position (pyrazole ring). The reaction product was isolated and identified as beta-indazolealanine by mass spectrometric, elemental and NMR analyses. Careful assignment of 1H- and 13C signals with several NMR techniques revealed that the beta-carbon of the product alanine moiety was bound to the 1-N-position of the indazole ring. This is the first example of the beta-replacement reaction catalyzed by tryptophan synthase occurring at any other position than the 3-position of indole analogs. PMID- 3512297 TI - The effect of substrates on the inter-domain interactions of the hinge-bending enzyme 3-phosphoglycerate kinase. AB - A hinge-bending mechanism has been proposed for phosphoglycerate kinase, in which the two domains bend about the connecting 'waist' region. In partially denaturing concentrations of guanidinium chloride the substrate 3-phosphoglycerate stabilises one domain against denaturation and destabilises the other. The reduction of mutual stabilisation of the two domains on binding substrate indicates a freeing of the hinge to allow the protein to take up other states rather than a directive mechanism. The stabilisation of both domains at higher concentrations of ATP at which the enzyme is inhibited supports this mechanism. PMID- 3512298 TI - Active-site geometry of proteinase K. Crystallographic study of its complex with a dipeptide chloromethyl ketone inhibitor. AB - Proteinase K (EC 3.4.21.14) from the fungus Tritirachium album Limber is the most active known serine endopeptidase. The sequence of its 275-residue long polypeptide chain and its three-dimensional folding show a high degree of homology with the bacterial subtilisin proteases. Using difference Fourier methods, the binding mode of the synthetic carbobenzoxy-Ala-Ala-chloromethyl ketone inhibitor to the active site of proteinase K was determined. In several cycles of restrained least-squares, the enzyme-inhibitor complex was refined to a current R = 22% for 9400 X-ray diffraction data between 2.2 and 5.0 A resolution. The inhibitor is attached to proteinase K by two covalent bonds: one between the methylene carbon of the inhibitor and N epsilon 2 of the catalytic His 68, the other between the ketone carbon atom of the inhibitor and O gamma of the catalytic Ser 221. In addition, two hydrogen bonds donated by the peptide NH of Ser 221 and by the side chain NH2 of Asn 160 hold the hemiketal O- in the oxyanion hole. The peptide inhibitor is further hydrogen bonded to the proteinase polypeptide chain in a three-stranded antiparallel pleated sheet. PMID- 3512299 TI - Crystallization of the bifunctional proteinase/amylase inhibitor PKI-3 and of its complex with proteinase K. AB - One of the three wheat germ inhibitors of proteinase K is bifunctional and inhibits simultaneously proteinase K (or subtilisin but not enzymes of the trypsin family) and insect alpha-amylase. The molecular mass of this inhibitor called PKI-3 is 21 kDa, and the binding constant for proteinase K is 0.8 nM at pH 8.2, 25 degrees C, in 1:1 molar ratio. PKI-3 was crystallized by microdialysis against 10-12% polyethylene glycol 6000, 50 mM NaH2PO4, pH 6.7. The crystals have monoclinic space group P2(1) with a = 42.5, b = 65.3, c = 31.5 A, beta = 110 degrees, and diffract beyond 2.0 A resolution. The complex proteinase K X PKI-3 was crystallized by equilibrium vapor diffusion under the same conditions. The crystals are needle-shaped and still too small for X-ray analysis. Gel electrophoresis established the composition of the crystals. PMID- 3512300 TI - Increased basal gluconeogenesis in the aged rat. AB - Post-absorptive gluconeogenesis from lactate measured in vivo increases 3-fold in 24-month-old rats compared to 3-month-old animals. Fractional lactate turnover rates showed no significant differences between the two groups of animals. Lower plasma glucose concentrations and insulin-glucagon ratios may explain the increase in gluconeogenesis observed in aged rats. PMID- 3512301 TI - Identification of a 27-kDa enkephalin-containing protein associated with bovine adrenal medullary chromaffin granule membranes by immunoblotting. AB - An antiserum which recognizes high molecular mass enkephalin-containing proteins was used to compare proenkephalin intermediates in both the soluble and membrane components of bovine adrenal chromaffin granules by immunoblotting. While a range of molecular mass forms were identified in the soluble lysate the major form in the membranes corresponded to a 27-kDa enkephalin-containing protein. Enzymic digestion of bands of 27-kDa material and quantitation of the enkephalin released showed that 22% of this material was membrane-associated. High concentrations of chaotropic agents were required to extract this material from the membranes. Association of hormone and neuropeptide precursors with membrane components may be important for targeting of precursors to secretory granules or correct processing. PMID- 3512302 TI - Phosphorylation of HMG-CoA reductase induced by mevalonate accelerates its rate of degradation in isolated rat hepatocytes. AB - Incubation of rat hepatocytes with 10 mM mevalonate produces a decrease in HMG CoA reductase activity and in the rate of synthesis of both monomeric and dimeric HMG-CoA reductase, and an increase in the rate of degradation of the monomeric form without significant change in that of the dimeric form. Since mevalonate promotes a short-term phosphorylation of the monomeric form without affecting the dimeric form, it is suggested that the mechanism of degradation of reductase is controlled by its phosphorylation state. PMID- 3512303 TI - Localization of elongation factor Tu on the ribosome. AB - The EF-Tu-binding center of the E. coli ribosome has been localized by immunoelectron microscopy after cross-linking of the specific EF-Tu X 70 S ribosomal complex with dimethylsuberimidate. EF-Tu has been found to be in contact with the 50 S subunit in the region of the L7/L12 stalk and with the 30 S subunit in the upper part of its body on the side opposite the top of the ledge (the platform). The EF-Tu position on a model of the 70 S ribosome is presented. PMID- 3512304 TI - Are there proteins between the ribosomal subunits? Hot tritium bombardment experiments. AB - The hot tritium bombardment technique [(1976) Dokl. Akad. Nauk SSSR 228, 1237 1238] was used for studying the surface localization of ribosomal proteins on Escherichia coli ribosomes. The degree of tritium labeling of proteins was considered as a measure of their exposure (surface localization). Proteins S1, S4, S7, S9 and/or S11, S12 and/or L20, S13, S18, S20, S21, L5, L6, L7/L12, L10, L11, L16, L17, L24, L26 and L27 were shown to be the most exposed on the ribosome surface. The sets of exposed ribosomal proteins on the surface of 70 S ribosomes, on the one hand, and the surfaces of 50 S and 30 S ribosomal subunits in the dissociated state, on the other, were compared. It was found that the dissociation of ribosomes into subunits did not result in exposure of additional ribosomal proteins. The conclusion was drawn that proteins are absent from the contacting surfaces of the ribosomal subunits. PMID- 3512305 TI - The amino acid sequence of the blue copper protein of Alcaligenes faecalis. AB - The complete amino acid sequence of a blue copper protein from Alcaligenes faecalis S-6 has been determined. This protein is clearly homologous to pseudoazurins in Achromobacter cycloclastes and Pseudomonas AM1, more distantly related to plant plastocyanins, and markedly different from the azurin of Pseudomonas aeruginosa. Yet all of these proteins bind copper, and analogous ligands appear to be involved. PMID- 3512306 TI - Effect of the integrity of the myofibrillar structure on the tryptic accessibility of a hinge region of the myosin rod. AB - Limited proteolysis has been used to study the influence of actin, in the absence or presence of regulatory proteins of the thin filament (tropomyosin and troponin), as well as that of the myofibrillar structure on the tryptic cleavage of the heavy meromyosin (HMM)/light meromyosin (LMM) hinge region in myosin heavy chain. Cleavage at the HMM/LMM hinge is almost absent in myofibrils, whereas this hinge is accessible to tryptic digestion in actomyosin, in native thin filaments attached to myosin and in myosin heavy chain alone. This observation indicates that it is the myofibrillar structure which profoundly affects the tryptic accessibility of this specific hinge region of myosin. This provides a good example of the manner by which a highly organized supramolecular structure might affect the chemical properties of a specific site in a macromolecule. PMID- 3512307 TI - Heteroduplex stabilities in highly repetitive DNA. An hypothesis for the polymorphism of Plasmodium parasite antigenic response. AB - Codon repeats encountered in DNA sequences may formally lead to several double stranded structures of similar stabilities. This is observed in the highly repetitive sequences of some Plasmodium antigens (S-antigen, CS proteins). It is postulated that gene recombination may occur via various heteroduplex molecules thus leading to antigenic polymorphism of Plasmodium parasites. PMID- 3512308 TI - Killer toxin from Hansenula mrakii selectively inhibits cell wall synthesis in a sensitive yeast. AB - Hansenula mrakii secretes extracellularly a killer toxin which kills sensitive Saccharomyces cerevisiae. In protoplasts of this yeast, the killer toxin selectively inhibited the synthesis of alkali-insoluble acid-insoluble polysaccharides consisting mainly of beta-glucan, but did not inhibit either the synthesis of other cell wall polysaccharides, such as mannan, chitin and alkali insoluble acid-soluble polysaccharides, or the synthesis of protein. Consistent with these results, the toxin was inhibitory to the beta-(1,3)-glucan synthetase activity of a cell-free extract from sensitive S. cerevisiae. PMID- 3512309 TI - Type VI collagen is a major component of the human cornea. AB - Collagen type VI is shown to be present in the human cornea. This finding is based on comparative peptide mapping relative to type VI collagen isolated from placenta and on immunoblotting using antibodies specific for human type VI collagen. Scanning of polyacrylamide gels indicates that type VI collagen comprises as much as one quarter of the dry weight of the cornea. Indirect immunofluorescence shows this collagen to be distributed throughout the corneal stroma. Thus, type VI collagen must be considered a major component of the extracellular matrix of the human cornea. PMID- 3512310 TI - Synthesis and maturation of recombinant human tumor necrosis factor in eukaryotic systems. AB - The biosynthesis of human tumor necrosis factor (hTNF) was studied. The amino terminal extension of the hTNF precursor (26 kDa polypeptide) was not cleaved off in a cell-free system supplemented with dog pancreas microsomes. Correct maturation of pre-hTNF was nevertheless not restricted to the macrophage system: in the medium of a TNF-producing, transformed CHO cell line, a (weak) approximately 20 kDa, an approximately 18.5 kDa (doublet) and a 17 kDa TNF polypeptide, the latter corresponding to mature hTNF, were revealed by specific immunoprecipitation. Similar results were obtained with Xenopus laevis oocytes, injected with hTNF mRNA, except that the 20 kDa band was lacking. The results are discussed in relation to the secretion mechanism of hTNF. PMID- 3512311 TI - Analysis of clinical fertility trials: a methodologic review. PMID- 3512312 TI - Activity of gonadotropin-releasing hormone neurons during the preovulatory luteinizing hormone surge. AB - We assessed the frequency of luteinizing hormone (LH) pulsatility (reflecting the activity of gonadotropin-releasing hormone [GnRH] neurons in the hypothalamus) in six women during the periovulatory LH surge, in five women during the early follicular phase, and in seven women in the midfollicular phase (MFP) (calculated as being 3 to 8 days before the LH surge). Collection of blood at 5-minute, versus 15-minute, intervals allowed detection of a larger number of LH pulses in both the MFP (16, versus 27) and periovulatory phase (POP) (11, versus 22) groups of women, but it made no difference in the early follicular phase (EFP) (10 pulses with both methods). During the EFP, the mean number of LH pulses per 4 hours (detected by 5-minute sampling) was 2.0 +/- 0.7 (+/- standard deviation [SD]), and the mean LH amplitude (+/- SD) was 1.3 +/- 0.4 IU/l. There was a significant increase in the number of pulses in the MFP group (3.9 +/- 1.3 pulses/4 hours; P less than 0.05) but no significant change in pulse amplitude (1.1 +/- 0.1 IU/l). During the POP, the mean pulse amplitude was increased (8.5 +/- 1.4 IU/l; P less than 0.001), compared with the MFP and EFP groups, but the mean pulse frequency (3.7 +/- 1.2 pulses/4 hours) was not significantly different from the MFP frequency. We conclude that an acceleration of LH pulsatility occurs several days before the LH surge and does not change thereafter. However, there is an increase in LH pulse amplitude during the LH surge; we attribute this to the increase in pituitary sensitivity at this time.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3512313 TI - Primary and secondary closure of ampullary salpingotomy compared in the rabbit. AB - Because there is disagreement as to how linear ampullary salpingotomy should heal, primarily or secondarily, we compared the two methods with the use of rabbit oviducts in which conditions simulating ectopic pregnancy had been induced. Pregnancy rates (86% versus 75%), nidation indices (62% versus 54%), and percentage of adhesion-free tubes (50% versus 32%) were greater after primary closure, but these differences were not statistically significant. Ampullary tuboperitoneal fistulae occurred at the site of operation in 6.8% of tubes and impaired fertility (P less than 0.005). PMID- 3512314 TI - Persistence of insulin resistance in polycystic ovarian disease after inhibition of ovarian steroid secretion. AB - Six nonobese women with polycystic ovarian disease (PCOD) showed significant hyperinsulinemia, compared with controls after oral glucose (P less than 0.05). As an indicator of insulin sensitivity, in vitro proliferation of erythrocyte progenitor cells of PCOD subjects exposed to physiologic concentrations of insulin was significantly blunted (P less than 0.001). Monocyte insulin receptor binding was not impaired in the PCOD subjects. Three of the PCOD patients were treated with a long-acting gonadotropin-releasing hormone agonist for 6 months, which resulted in marked suppression of ovarian androgen secretion but no demonstrable changes in in vivo or in vitro indicators of insulin resistance. Thus insulin resistance in PCOD subjects appears to be unrelated to ovarian hyperandrogenism (or acanthosis or obesity). Although certain tissues are insulin resistant in PCOD patients, the ovary may remain sensitive and overproduce androgens in response to high circulating insulin levels. PMID- 3512316 TI - [Digital computer classification of orofacial developmental anomalies]. PMID- 3512315 TI - Demonstration of antispermatozoal antibodies in varicocele-related infertility with an enzyme-linked immunosorbent assay (ELISA). AB - To assess the existence of a possible immunologic factor in varicocele-associated infertility, we searched for antispermatozoal antibodies in serum, seminal plasma, and bound to spermatozoa in 32 infertile men with varicocele and 22 infertile patients without palpable varicocele, with the use of an enzyme-linked immunosorbent assay. In addition, we performed morphologic and microbiologic analyses of the semen and urethral smears for isolation of Chlamydia trachomatis. Twenty-nine men from the varicocele group (90.6%) demonstrated antispermatozoal antibodies, compared with only 9 men (40.9%) in the control group. The antibodies in both groups, when present, were mainly serum and seminal plasma immunoglobulins IgA and IgM. A significant quantitative difference between the varicocele and control groups was also observed for serum IgA, seminal plasma IgA and IgM, and sperm-bound IgG, IgA, and IgM. Oligozoospermia and asthenozoospermia were significantly more prevalent in the varicocele men. An asymptomatic genital tract infection with C. trachomatis, Ureaplasma urealyticum, and Escherichia coli was traced in 40.6% of the varicocele men and in 45.5% of the control group. No interaction could be demonstrated between the infection and antispermatozoal antibody formation. These data suggest that an immunologic factor may play a role in varicocele-associated infertility; however, its impact on reproduction has yet to be assessed. PMID- 3512317 TI - [Experience with the follow-up of fixed dentures]. PMID- 3512318 TI - [Experience in analyzing the functional structure of thermogenesis based on pharmacologic testing]. AB - In white rats both adapted and unadapted to cold and in lemmings the total heat production and skeletal muscles contractile activity under noradrenaline and propranolol were estimated at different ambient temperatures. In rats, the regulatory and adaptive changes of heat production occur due to a significant extension of adrenergically modulated part of contractile thermal effect in muscles, as well as to increased nonshivering thermogenesis. In lemmings, the adaptability to cold is maintained chiefly by nonshivering thermogenesis and leads to no alterations in muscle energetics. PMID- 3512319 TI - [Concepts of K. M. Bykov and modern research on regulation of the functions of the digestive system]. AB - Use of synthetic preparations of natural peptides in studies of control of functions of the digestive system organs revealed molecular basis of central mechanisms participating in control of the stomach and pancreas secretion. PMID- 3512321 TI - Gingival curettage. Is it a viable therapy alternative? PMID- 3512320 TI - [Oxygen transport by the blood (role of erythrocytes)]. PMID- 3512322 TI - They said it wouldn't last! PMID- 3512323 TI - 75 years. Meeting the challenge of change. PMID- 3512324 TI - From there to here. PMID- 3512325 TI - A bright future for women dentists. PMID- 3512326 TI - Prophylaxis against herpes labialis with acyclovir cream--a placebo-controlled study. AB - Patients with 6 or more recurrences per year of herpes labialis were entered into a randomized, double-blind, placebo-controlled, crossover study. During the trial, they applied acyclovir cream for 16 weeks and placebo cream for 16 weeks to all previously affected areas 4 times per day, and were subsequently observed for a further 16 weeks with no treatment. Results from the 23 evaluable cases showed that although recurrences did occur whilst on acyclovir treatment, patients suffered from significantly fewer days of disease and significantly fewer attacks of cold sores when compared with placebo. PMID- 3512327 TI - Merkel cells do not express bullous pemphigoid antigen. AB - Merkel cells (MC) are epithelial cells expressing cytokeratin-type intermediate filaments. They often are localized within the basal cell layer of the epidermis. Since basal cell layer keratinocytes synthetize basal membrane components, it was of interest to investigate whether or not MC could also do so. We used both double-labeling immunofluorescence and immune electron microscopy techniques with a panel of antibodies allowing the identification of MC as well as the staining of basal membrane zone components (including bullous pemphigoid antigen, laminin, type IV collagen and epidermolysis bullosa antigen). A specific loss of BP antigen expression was observed below all MC directly in contact with BMZ. This suggests that, although being an epithelial cell and in contrast to basal keratinocytes, MC does not secrete BP antigens. PMID- 3512328 TI - Immunohistochemical characterization of plasma cells in Zoon's balanoposthitis and (pre)malignant skin lesions. AB - A retrospective study in 9 patients with Zoon's balanoposthitis was done to determine the immunoglobulin class distribution in the plasma cellular infiltrate. This was carried out on paraffin-embedded specimens using an unlabelled antibody peroxidase-antiperoxidase method. In all lesions IgG producing plasma cells predominated. IgA- and IgD-positive cells were also present in about equal quantities but fewer than IgG. IgM-positive cells were either absent or present in very low numbers. Especially in erosive lesions a high number of plasma cells was noticed. The kappa/lambda ratio was variable with a preference for lambda in 5 of 8 cases. These findings are suggestive of a nonspecific polyclonal stimulation of B cells, which might be caused by a persistent infection. The above-mentioned findings were compared with premalignant and malignant skin lesions in which a major amount of plasma cells was present in the inflammatory infiltrate. Comparable results were obtained with slight variations. The role of plasma cells in these infiltrates is discussed. PMID- 3512329 TI - Necrobiosis lipoidica: clinical and immunofluorescent study. AB - Fourteen patients with necrobiosis lipoidica (NL) were carefully evaluated clinically and histologically. Ten of these patients (71%) had diabetes and most of them were treated with insulin (8 of 10 patients). Trauma was found as an immediate triggering factor in 6 patients (43%) and a possible preceding factor in 3 more cases. No immunoglobulins were found in the lesional skin of NL. Intradermal injections of histamine in healthy skin of legs led to deposition of immunoglobulins and complement (C3) in skin blood vessel walls in 4 of 12 patients studied (30%). These results suggest that immune complexes might be involved only in few cases of NL. Preceding trauma combined with metabolic and inflammatory changes could be an important triggering factor in the etiology of NL. PMID- 3512330 TI - Effect of extracellularly generated free radicals on the plasma membrane permeability of isolated pancreatic B-cells. AB - Previous experiments on alloxan diabetogenicity suggest that alloxan increases the permeability of B-cell plasma membranes by generation of noxious free radicals. Whether the radicals are generated intra- or extracellularly has however been disputed. To test if extracellularly generated free radicals could decrease trypan blue exclusion of dispersed islet cells, a radical-generating solution of xanthine oxidase/hypoxanthine was employed. The solution increased dye uptake by cells in the cell suspension. Superoxide dismutase and catalase but not scavengers of hydroxyl radicals protected against the increase in dye uptake. Both L- and D-glucose protected the cells from injury. It is concluded that extracellularly generated free radicals induce damage to the plasma membrane of islet cells. The result strengthens the hypothesis of plasma membrane damage by extracellularly generated free radicals as the primary event in alloxan diabetogenicity and may provide a link for explanation of damage caused by islet inflammation in juvenile diabetes. PMID- 3512331 TI - Morphological characterization of LH secretory granule response to LHRH and calmodulin inhibitor. AB - A quantitative electron microscopy study was carried out to characterize the luteinizing hormone (LH) contained secretory granules in response to exogenous luteinizing hormone releasing hormone (LHRH) alone or in combination with calmodulin inhibitor (W13) in orchidectomized rats pretreated with estrogen. The plasma LH concentration rose quickly 30 min after a single large LHRH injection, and then gradually increased further until 150 min. However, the rise was attenuated by supplemental administration of W13 30 min after LHRH exposure. The mean diameter of secretory granules quickly decreased inversely to the increase of plasma LH concentration after LHRH injection. However, the mean diameter increased significantly in accordance with the complete attenuation of the increase in LH release caused by administration of W13. There was an inverse correlation between the diameter of secretory granules and plasma LH concentration. Small secretory granules with low electron density frequently appeared in castration cells after LHRH injection. It is concluded that reduced size and density of secretory granules is the main morphological standard responsible for extraordinary LH secretion from gonadotrophs. PMID- 3512332 TI - The cytoskeleton, endocytosis and cell polarity in the mouse preimplantation embryo. AB - The process of cell polarization in mouse 8-cell embryos includes the formation of a polar cluster of cytoplasmic endocytotic organelles (endosomes) subjacent to an apical surface pole of microvilli. A similar polar morphology, supplemented by basally localized secondary lysosomes, is evident following division to the 16 cell stage in outside blastomeres, precursors of the trophectodermal lineage. The roles of microfilaments and microtubules in generating and stabilizing endocytotic and surface features of polarity (visualized by horseradish peroxidase incubation and indirect immunofluorescence labeling, respectively) have been evaluated by exposure of 8- and 16-cell embryos and 8-cell couplets to drugs (cytochalasin D, colcemid, nocodazole) that disrupt the cytoskeleton. The generation of endocytotic polarity is dependent upon intact microtubules and microfilaments, but the newly established endocytotic pole in blastomeres from compacted 8-cell embryos appears to be stabilized exclusively by microtubules. Polarized endocytotic organelles at the 16-cell stage are more resistant to drug treatment than at the 8-cell stage (probably due to microfilament interactions) indicating a maturation phase in the polar cell lineage. Microtubules are also responsible for the orientation of endocytotic clusters along the cell's axis of polarity. In contrast, the generation and stability of polarity at the cell surface appears relatively independent of cytoskeletal integrity. The results are discussed in relation to the mechanisms that may control the development and stabilization of polarization during cleavage. PMID- 3512333 TI - Distribution of laminin in the developing peripheral nervous system of the chick. AB - During axonal elongation in the developing peripheral nervous system, the temporal and spatial distribution of adhesive molecules in extracellular matrices and on neighboring cell surfaces may provide "choices" of pathways for growth cone migration. The extracellular matrix glycoprotein laminin appears in early embryos and mediates neuronal adhesion and neurite extension in vitro. In this study, we have examined the distribution of laminin at early periods of peripheral nervous system development. The distribution of laminin, demonstrated by immunostaining frozen sections of chick embryos, was compared to the distribution of fibronectin and of early peripheral neurites as revealed with an antibody to a neurofilament-associated protein. Laminin is present in the neural tube basement membrane, in early ganglia, and in developing dorsal and ventral roots, where the laminin staining pattern parallels that of neurofilaments. In early ganglia and nerve roots, laminin immunostaining defines loose "meshworks" rather than basement membranes, which seem to form slightly later in these structures. In contrast, fibronectin is absent in neural tube basement membrane, ganglia, and nerve roots, although it is present along neural crest migratory pathways and in intersomitic spaces. Our observations of laminin distribution are consistent with the possibility that laminin provides an adhesive surface for neurite extension at some stages of early peripheral nervous system development. PMID- 3512334 TI - Segmental appearance of type X collagen in the developing avian notochord. AB - To determine whether short-chain cartilage collagen, collagen type X, is a component of notochordal matrix, we have performed immunohistochemistry with a monoclonal antibody (X-AC9) previously shown to be specific for this molecule (Schmid and Linsenmayer (1984). J. Cell Biol. 100, 598-605). We have also examined different stages of embryos to establish the temporo-spatial appearance of the molecule. The data show that type X collagen is indeed a component of notochordal matrix, but that its developmental appearance is quite late compared to that of type II collagen, another cartilage matrix molecule found in notochord. It is detected only in embryos older than 12 days. The appearance of type X collagen within the notochord is preceded by its appearance within the surrounding hypertrophic cartilage matrix of the vertebral bodies. Spatially, within the notochord the appearance of type X collagen is initially restricted to sites at which the surrounding vertebral cartilage matrix is also reactive for type X. With subsequent development, the notochordal reactivity extends, in a decreasing gradient, anteriorly and posteriorly toward the intervertebral zones. However, the brightest immunofluorescence of notochordal type X is maintained at the midvertebral sites. The ultimate fate of the notochordal tissue at such midvertebral sites is to be removed during endochondral bone formation within the vertebrae. We have observed that type II collagen is also found within notochordal tissue, but this molecule has a distribution which is the converse of that of the type X collagen. The type II collagen is preferentially deposited at intervertebral sites (i.e., the locations of future intervertebral discs). That the type X collagen within the notochord is preferentially deposited at sites destined to be replaced is consistent with one of the hypotheses we previously raised for the function of the type X collagen molecule--it may "target" skeletal tissues for eventual removal. PMID- 3512335 TI - The fate of the small micromeres in sea urchin development. AB - We show that in sea urchin embryos, the daughter cells of the small micromeres become part of the coelomic sacs, in contrast to the long-held view that these sacs are purely of macromere origin. In addition, after prolonged mitotic quiescence, and following their incorporation into the coelomic sacs, these cells resume dividing, contrary to the previous view that they do not divide. Since coelomic sac cells give rise to much of the adult urchin, our results indicate that the small micromeres are founders of cell lineages involved in the formation of adult tissues. The setting aside of these cells in a nondividing state may be analogous to a phenomenon in Drosophila development, in which primordial imaginal and germ cells divide approximately once after the blastoderm stage and do not resume dividing until the larval stage. PMID- 3512336 TI - The effect of immediate polyethylene glycol precipitation on free insulin measurements in diabetic patients with insulin antibodies. AB - Free insulin (FI) measurements obtained by polyethylene glycol (PEG) precipitation within 3 min of drawing the blood sample (FI3) from four insulin treated diabetic subjects with a wide range of insulin antibodies were compared with published methods of FI estimation. Comparison of FI values obtained by PEG precipitation in assays of replicate samples of the same specimens (N = 9) stored at 4 degrees C for 24 h (EFI) and FI3 were 4.76 +/- 1.5 microU/ml (mean +/- SEM) and 17.13 +/- 4.7 microU/ml, respectively (P less than 0.005). Comparison of FI values obtained in six groups of replicate samples (N = 12, 18 per group, a total of 91 specimens) from these four patients assayed immediately after thawing to 18 degrees C, and incubated at 37 degrees C for 30, 60, and 120 min, and FI3 showed a significant difference in at least one of these four comparisons (mean +/- SEM) in each of these six sample groups. In 18 of 24 comparisons there was a loss of FI when stored samples were used with or without incubation (12 of these were significant at the P less than 0.05-0.001 level), but in 6 of the 24 comparisons there was an increase in the FI against FI3 (3 of these 6 significant at the P less than 0.05-0.01 level). There was a trend toward a greater loss of FI in stored samples with higher FI3 content. Loss of FI during incubation occurred in all groups irrespective of the FI3 content.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3512337 TI - Insulin induces progressive insulin resistance in cultured rat adipocytes. Sequential effects at receptor and multiple postreceptor sites. AB - We have examined the ability of insulin to regulate insulin action in primary cultured adipocytes, and found that insulin induces progressive insulin resistance in this target tissue. To assess effects at both receptor and postreceptor sites, we cultured cells in the absence (control) and presence of 100 ng/ml insulin, and, after various times, measured the dose response of insulin's ability to bind cell-surface receptors and stimulate 2-deoxyglucose transport. In control cells, insulin binding (0.2 ng/ml) was increased 10-13% due to an apparent increase in receptor affinity (6-24 h). A comparable increase in affinity was also observed in treated cells; however, concomitantly, insulin decreased the number of cell-surface receptors causing a slowly progressive net decrease in binding after a 6-10-h lag (maximal 30% at 24 h). When insulin action was assessed in control cells, the functional consequence of increased receptor binding was hypersensitization (i.e., increased insulin sensitivity) manifested by a leftward shift in the 2-deoxyglucose dose-response curve. On the other hand, in the treated cells, insulin produced insulin resistance initially by decreasing insulin sensitivity. The ED50 for insulin stimulation of glucose transport increased 84% from 0.31 to 0.57 ng/ml at 6 h without a net change in insulin binding; this was the result of a decrease in coupling efficiency between occupied receptors and the insulin effect. Receptor uncoupling progressively increased in severity, but before the full effect was reached insulin also caused a rapid decline in maximally stimulated glucose transport rates (between 6 and 10 h). This decrease in insulin responsiveness (maximal 52%) exacerbated overall insulin resistance, and was indicative of a postreceptor defect in the glucose transport system. Finally, insulin-induced receptor downregulation contributed, along with uncoupling, to a further decrease in insulin sensitivity, and constituted a more long-term regulatory mechanism. We also observed that insulin could regulate the basal glucose transport system by preventing a progressive rise in basal transport observed in control cells. In conclusion, primary cultured adipocytes can be used to study long-term regulation of insulin action. We found that insulin induces progressive insulin resistance with sequential effects at multiple sites in the insulin action pathway, including decreased coupling efficiency between occupied receptors and stimulated glucose transport, a postreceptor defect in insulin responsiveness of the glucose transport system, and receptor downregulation. These mechanisms may be relevant to the cellular defects in insulin action present i PMID- 3512338 TI - Triglyceride-lowering effect of dietary vitamin E in streptozocin-induced diabetic rats. Increased lipoprotein lipase activity in livers of diabetic rats fed high dietary vitamin E. AB - High vitamin E supplementation in the diets of streptozocin-induced diabetic rats eliminates accumulation of lipid peroxides in the plasma and the liver, returns the plasma triglycerides toward normal levels, and increases the activity of lipoprotein lipase. Vitamin E has no effect on the levels of insulin or glucose. These findings suggest that vitamin E increases the total hepatic triglyceride lipase activity by increasing the lipoprotein lipase activity possibly by protecting the membrane-bound lipase against peroxidative damage. PMID- 3512339 TI - Effects of obesity, hyperinsulinemia, and glucose intolerance on insulin action in adipose tissue of sixty-year-old men. AB - The relative effects of obesity alone, and in combination with fasting hyperinsulinemia and glucose intolerance, on the peripheral action of insulin in adipose tissue were investigated in twenty-four 60-yr-old men, who had been followed for 10 yr. They were divided into four groups of six subjects each on the basis of the following criteria: (1) normal body weight, normal fasting insulin level, and normal glucose tolerance; (2) moderate obesity, normal fasting insulin level, and normal glucose tolerance; (3) moderate obesity, fasting hyperinsulinemia, and normal glucose tolerance; and (4) moderate obesity, fasting hyperinsulinemia, and newly developed, moderate, untreated fasting hyperglycemia and/or glucose intolerance (i.e., mild type II diabetes mellitus). Specific adipocyte insulin binding and the effects of the hormone on adipose tissue lipolysis and glucose oxidation were determined. Insulin receptor binding per cell and per cell surface area were similar in all four groups. Regarding antilipolysis, the insulin sensitivity was the same in all groups and the maximum effect was significantly increased in the three obese groups, as compared with the normal-weight control group. In groups 1-3, insulin stimulated adipose tissue glucose oxidation in a dose-dependent way, and the sensitivity and responsiveness to insulin were comparable. In contrast, in the obese glucose-intolerant subjects (4) there was no significant effect of insulin on glucose oxidation when the hormone was added in increasing concentrations of less than or equal to 35 nmol/L. The basal glucose oxidation was similar in all four study groups. The in vivo insulin tolerance was gradually reduced in groups 2-4, as compared with the normal-weight control group.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3512340 TI - Islet cell proteins defined by monoclonal islet cell antibody HISL-19. AB - A monoclonal islet cell antibody, HISL-19, reactive with human, bovine, and porcine pancreatic islets has been used to identify and characterize a novel group of islet cell proteins (p120, p69, p67, and p56). Besides the islets, HISL 19-reactive antigenic determinants are also expressed on selected cell types, namely, gut endocrine cells, thyroid parafollicular cells (p120), anterior pituitary cells (p40 and p24), specific hypothalamic neuroendocrine cells, and a single layer of large pyramidal cells of the cerebral cortex, thus defining a new family of neuroendocrine molecules. PMID- 3512341 TI - In vivo deactivation of proinsulin action on glucose disposal and hepatic glucose production in normal man. AB - We have studied the deactivation of the in vivo actions of insulin and biosynthetic human proinsulin (recombinant DNA) to stimulate the glucose disposal rate (GDR) and to inhibit hepatic glucose output (HGO) in man. Twelve healthy, lean, young subjects were studied using a modification of the euglycemic glucose clamp technique. Subjects received 4-h infusions on separate occasions of insulin (15 mU/m2/min equivalent to 0.54 microgram/m2/min) or proinsulin (2.75 micrograms/m2/min), achieving steady-state serum levels of 32 +/- 3 microU/ml (equivalent to 0.23 +/- 0.02 pmol/ml) and 3.7 +/- 0.2 pmol/ml, respectively. Suppression of HGO was similar (83-84%) with proinsulin and insulin, but stimulation of GDR above basal was greater with insulin (3.41 +/- 0.43 versus 1.98 +/- 0.28 mg/kg/min, P less than 0.001). Following cessation of the hormone infusions, serum proinsulin concentration fell in a biphasic fashion with half times of 25 and 146 min for the two phases. Serum half-disappearance time for insulin was 5 min. Deactivation of the hormone's effects to stimulate GDR was 50% complete by 35 min after insulin and 71 min after proinsulin. In contrast, 50% of the recovery times for the effect on suppression of HGO were 55 min after insulin and 188 min after proinsulin. Serum glucagon levels did not differ significantly after the insulin and proinsulin infusions. In summary: (1) Deactivation of proinsulin and insulin's effects to suppress HGO proceeds more slowly than deactivation of their effects to stimulate GDR; and (2) There is a markedly prolonged and disproportionately delayed deactivation of proinsulin's effects on suppression of HGO. This later finding may prove of therapeutic value in the treatment of diabetes mellitus. PMID- 3512342 TI - Kinetics of biosynthetic human proinsulin action in isolated rat adipocytes. AB - The binding and biologic potencies of human biosynthetic proinsulin (HPro) were determined in isolated rat adipocytes. At both 16 degrees C and 37 degrees C, proinsulin was found to have 3% (on a molar basis) the potency of porcine insulin for displacing bound [(125I)TyrA14]-insulin from insulin receptors. Human biosynthetic proinsulin also had 3% of the molar potency of insulin for stimulation of deoxyglucose transport (EC50 = 8.8 +/- 0.05 X 10(-11) M for insulin and 2.9 +/- 0.55 nM for HPro). However, both hormones produced the same maximal effect on glucose transport. In order to determine if the delay in onset and persistence of proinsulin action seen in vivo was due to any differences at the cellular level, the time course of HPro action on glucose transport was determined. Biologically equivalent submaximal concentrations of insulin (0.166 nM) and HPro (4.44 nM) gave identical time courses for stimulation of deoxyglucose transport at 37 degrees C with half-maximal effects at 4 min and full effects by 30 min. Maximally stimulating concentrations of insulin (1.66 nM) and HPro (22.2 nM) also had superimposable time courses. Deactivation of stimulated glucose transport was determined by incubating equivalent concentrations of insulin (0.166 and 1.66 nM) and HPro (4.44 and 22.2 nM) until full stimulation was achieved, washing cells free of unbound hormone, and initiating dissociation and deactivation by resuspension in hormone-free buffer. Both the absolute activities of transport and rates of deactivation were the same for insulin and HPro. At the submaximal concentrations, 50% of the hormones' effects were lost by 20 min, while 50 min was required after maximal stimulation for 50% deactivation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3512343 TI - Reduction by morphine of human postprandial insulin release is secondary to inhibition of gastrointestinal motility. AB - The effect of morphine (0.1 mg/kg) on insulin secretion stimulated by oral, intraduodenal, or intravenous administration of glucose was studied in seven healthy volunteers. When glucose was given intravenously, morphine had no effect on plasma glucose, insulin, glucose-dependent insulinotropic polypeptide (GIP), or pancreatic glucagon. Following oral glucose, morphine slowed gastric emptying and reduced plasma concentrations of glucose, insulin, and GIP. During intraduodenal infusion of glucose, insulin concentrations in plasma were also decreased by morphine, an effect best explained by decreased small intestinal transit with delayed absorption of glucose and delayed release of GIP. We conclude that clinically relevant doses of morphine have no direct effect on insulin secretion and that the changes observed were secondary to slowed gastric emptying and small intestinal transit. PMID- 3512344 TI - The prevalence of islet cell antibodies in Japanese insulin-dependent and non insulin-dependent diabetic patients studied by indirect immunofluorescence and by a new method. AB - Islet cell antibodies (ICA) were measured in Japanese patients with insulin dependent diabetes mellitus (IDDM) and non-insulin-dependent diabetes mellitus (NIDDM) by a standard, indirect immunofluorescence method (IF method) and by a newly established, three-layer immunofluorescence method applying a biotin-avidin system (BAS method). In addition, the relationship between ICA and HLA was studied in IDDM patients. ICA titers detected by the BAS method correlated well with those determined by the standard IF method (rS = 0.987, P less than 0.01). The BAS method had about an eightfold higher sensitivity for ICA than the IF method. The overall prevalence of ICA detected by the BAS method (ICA-BAS) versus that by the IF method (ICA-IF) was 41% (82/198) versus 28% (56/198) in IDDM patients and 3% (19/593) versus 2% (14/593) in patients with NIDDM. In IDDM patients, ICA-BAS was all positive less than 1 mo after the onset of diabetes, while the prevalence of ICA-IF was 83% (20/24) during the same period. The prevalence of ICA-IF decreased rapidly with the duration of disease, reaching a value of 6% (3/55) in the patients with a disease duration of 10 yr or more. The incidence of ICA-BAS also decreased with the duration of disease, although to a lesser degree than ICA-IF. No association was found between HLA types and persistence of ICA-BAS or -IF.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3512345 TI - Renin secretion by the spontaneously diabetic rat. AB - Renal function studies and measurements of in vivo plasma renin activity (PRA), kidney renin content, and renin secretion by isolated, perfused kidneys were performed in spontaneously diabetic and nondiabetic BioBreeding/Worcester (BB/W) rats. Diabetic animals evidenced hyperglycemia, glycosuria, and plasma volume expansion. After dietary sodium deprivation, plasma volume fell to levels equivalent to those of sodium-deprived, nondiabetic rats. Dietary sodium deprivation evoked a larger proportional increase in PRA among diabetic than nondiabetic animals, although PRA before sodium restriction was equivalent in the two groups. Basal renin release (RR) was higher from isolated, perfused kidneys from diabetic rats than from nondiabetic kidneys. Diabetic kidneys, moreover, displayed increased kidney renin content (KRC). By contrast, while isoproterenol (10(-5) M) stimulated a nearly fivefold increment in RR from nondiabetic, perfused kidneys, a negligible effect was observed in diabetic kidneys. The dose response curve of renin secretion (as a proportion of total renal content) in response to isoproterenol was shifted downward. Hence, while KRC and spontaneous RR by isolated, perfused kidneys were increased, the increment in PRA with salt depletion and the renin-secretory response to isoproterenol in vitro were impaired. We propose that specific defects in renin secretion, in particular, the response to beta-adrenergic stimulation, may be operative in diabetes. PMID- 3512346 TI - The insulin sensitivity index in nondiabetic man. Correlation between clamp derived and IVGTT-derived values. AB - Although the minimal-model-based insulin sensitivity index (S1) can be estimated from the results of a simple 180-min intravenous glucose tolerance test (IVGTT), its relationship to widely accepted but technically more difficult clamp-based techniques has not been resolved in humans. Therefore we measured S1 by standard IVGTT, modified IVGTT, and clamp methods in 10 nondiabetic men with %IBW of 109 +/- 12 (mean +/- SD). In the euglycemic clamp studies, insulin was infused to bring insulin levels (IRI) from basal, 8 +/- 4 microU/ml, to plateaus of 21 +/- 5 and 35 +/- 6 microU/ml. S1[clamp], measured as the increase in glucose (G) clearance per increase in IRI [delta INF/(delta IRI X G)], averaged 0.29 +/- 0.09 ml/kg X min per microU/ml. In the IVGTT studies, 300 mg/kg G was given as an i.v. bolus, and G and IRI were measured for 180 min; in the modified (mod) IVGTT, tolbutamide (300-500 mg) was given i.v. 20 min after the G to observe the effect of an IRI peak on G removal after G level was free of initial "mixing" effects. The S1 estimated by computer did not differ significantly between standard [(6.9 +/- 3.4) X 10(-4) min-1 per microU/ml] and modified [(6.7 +/- 3.5) X 10(-4) min-1 per microU/ml] tests, indicating no bias due to the differing insulin patterns and levels. There was a strong positive correlation between S1 (mod IVGTT) and S1(clamp): r = 0.84; N = 10; P less than 0.002. The correlation between S1(standard IVGTT) and S1(clamp) was 0.54, suggesting the modified test is less "noisy." Nonetheless, in eight euglycemic women with a wider range of adiposity, S1(standard IVGTT) has been significantly correlated with %IBW (r = -0.72) and basal IRI (r = -0.84). The correlation between S1 measures by clamp and IVGTT methods provides one step toward validation of the minimal model for studies of insulin action in man. PMID- 3512347 TI - The third phase of in vitro insulin secretion. Evidence for glucose insensitivity. AB - In this study, in vitro B-cell models are described, which may be applicable for studying the reported B-cell desensitization produced by hyperglycemia in IDDM and NIDDM. Using a programmable perifusion/perfusion system, insulin secretion from perifused islets was measured at 10-30-min intervals for 24-50 h. After 3-4 h continuous glucose (11 mM), a new phase of insulin release occurs in which secretion declines to, and remains at, approximately 25% maximal release. Results were similar when using: perifused islets embedded in Cytodex 3, or Bio-Gel P-2, 100-200 mesh; batchincubated islets with hourly changes of medium; and the isolated pancreas perfused for 8 h. Three different media, Hana HB 104 (fortified, fully defined medium), RPMI-1640 + 10% FBS, and perfusion bufferalbumin, were used. Despite reduced secretion to continuous glucose, each system responded vigorously to an acute stimulation with glucose-forskolin. Decreased secretion was primarily caused by decreased secretagogue efficiency (reduced fractional secretion). Prolonged stimulation with glucose or glucose IBMX produced a similar waning of secretion regardless of the amount of insulin released. It is concluded that the third phase of insulin secretion may represent a secret-agogue-induced, signal desensitization of the B-cell, rather than exhaustion of a B-cell compartment of stored insulin. PMID- 3512348 TI - An ultrasonographic study of the organisation of sucking and swallowing by newborn infants. AB - Healthy infants' sucking, swallowing and breathing movements were observed ultrasonographically during breast- and bottle-feeding between two and five days after birth. Sucks were found to occur either on their own or in combination with a swallow. Swallows did not occur on their own. Younger babies' swallowing invariably was associated with a pause in breathing. Older babies generally showed better co-ordination of sucking, swallowing and breathing than younger ones, whether breast- or bottle-feeding. PMID- 3512349 TI - Body schema: does it depend on bodily-derived sensations? AB - Body image, as judged by estimation of lengths of parts of the body, was studied in 12 children with spina bifida who were matched for age, sex and IQ with 12 control children without spina bifida. With one exception, the estimations of the children with spina bifida did not differ significantly from those of the controls. The exception was that the children with spina bifida underestimated leg length less than the control children, but the authors believe that was a chance finding and that children with spina bifida develop an accurate representation of the body by means other than those depending on enteroceptive sensation. PMID- 3512350 TI - Assessing the impact of a child with spina bifida on the family. AB - This study examined the characteristics of families which may be more vulnerable than others to the impact of caring for a child with spina bifida. Morbidity and the use of health services were unexpectedly high. The impact on the family was related less to clinical diagnoses than to the characteristics of the child's functioning in the home and of the family. Major predictors of greater impact on the family were the number of the child's activities of daily living, parental perceptions of the child's health, low maternal educational attainment, low family income, the number of adults in the family, insurance status, the number of visits to a doctor in the month before the interview, and whether the adults in the family were employed. These results reinforce the need for assessments to include the child's function in the home, and for additional resources to help some families care for their child. PMID- 3512351 TI - 20 versus 30 mg omeprazole once daily: effect on healing rates in 115 duodenal ulcer patients. AB - In a double-blind, dose comparison multicenter trial 115 patients with duodenal ulcer were treated with either 20 or 30 mg oral omeprazole once daily for 4 weeks. There was no difference in the healing rates for the two groups after 2 and 4 weeks. After 2 weeks with 20 and 30 mg healing frequencies were 79.0 and 72.7%, after 4 weeks 96.5 and 92.7%. No difference was observed between the groups in the number of pain episodes during day and night. No side effects to the drug occurred. A daily dose of 20 mg omeprazole may be effective in ulcer therapy. PMID- 3512352 TI - Effect of a slow-release 5'-aminosalicylic acid preparation on disease activity in Crohn's disease. AB - A short-term double-blind controlled trial has been performed comparing a slow release 5'-aminosalicylic acid (5-ASA) tablet (Pentasa) with placebo in the outpatient treatment of mild and moderate active Crohn's colitis. The disease activity was measured objectively by quantitation of the faecal excretion of 111In-labelled autologous granulocytes, which directly reflects gut inflammation. Twelve patients were randomized to receive either Pentasa or placebo. After 10 days of treatment faecal granulocyte excretion fell in all patients receiving 5 ASA, while no consistent change was found in the placebo group. These results suggest that this slow-release preparation of 5-ASA should be tested in larger controlled therapeutic trials over a longer period of time. PMID- 3512353 TI - An introduction to unilateral sensorineural hearing loss in children. AB - This paper offers a general review of literature on issues pertinent to unilateral hearing loss in children. The paper focuses on such areas as demographic considerations, the importance of binaural hearing, the effects of noise on speech recognition, learning and educational factors, and auditory deprivation. It is concluded that there is sufficient evidence to suspect that children with unilateral sensorineural hearing loss can experience complications in communication and education. Finally, this paper presents the description of a research plan used in our study on unilateral sensorineural hearing loss in children. PMID- 3512354 TI - Hemodynamics of splenic artery aneurysm. AB - Blood flow volume of the portal venous system of 3 patients with splenic artery aneurysm, an uncommon disease, was measured using an ultrasonic duplex system. A huge increase in splenic blood flow volume was found in each case. A large portasystemic shunt through which the portal blood flowed hepatofugally was present in 2 cases. We suspect the shunt is partially responsible for an increase in splenic blood flow volume, which would lead to the formation of splenic artery aneurysm together with portal hypertension. PMID- 3512355 TI - Effect of liver function on the metabolism of prednisone and prednisolone in humans. AB - The systemic availability of total prednisone and unbound prednisolone, and the urinary excretion of 6 beta-hydroxyprednisolone, were measured after an oral dose of prednisone and an i.v. dose of prednisolone in 22 patients covering a wide range of liver function (galactose elimination capacity ranging from 3.3 mg/min X kg body wt to 9.2 mg/min X kg body wt). The area under the plasma concentration versus time curves of prednisolone and of prednisone decreased with increasing galactose elimination capacity. This dependency of the steroid concentrations on liver function was attributed to a decreased metabolic clearance and not to an increased systemic availability of the steroid given p.o. in patients with impaired liver function. The fractional excretion and the fractional clearance of 6 beta-hydroxyprednisolone declined with decreasing metabolic clearance rate of prednisolone or with decreasing galactose elimination capacity. Thus, the enzymes involved in the 6 beta-hydroxylation are not spared as liver function declines, and the exposure to the biologically active unbound prednisolone is increased in patients with impaired liver function in relation to the amount of prednisone or prednisolone administered. PMID- 3512356 TI - Does previous abdominal surgery alter the outcome of pediatric patients subjected to orthotopic liver transplantation? AB - The medical, anesthesia, and surgical records of 89 consecutive pediatric patients who underwent an orthotopic hepatic transplantation procedure at the University of Pittsburgh from February 1981 to May 1984 were reviewed to evaluate the effect of prior abdominal surgery upon the morbidity and mortality of orthotopic liver transplantation in children. Fifty-seven children (group 1) had had prior abdominal surgery, whereas 32 (group 2) had not. The group 1 subjects were younger (p less than 0.001), had better prothrombin times (p less than 0.01), and better platelet counts (p less than 0.02) than did those in group 2. No difference in the duration of anesthesia or intraoperative use of fresh frozen plasma or platelets was evident between the two groups. However, group 1 patients were given more red blood cells intraoperatively than were the group 2 patients (p less than 0.01). The group 1 patients had more total postoperative infections (p less than 0.05), which was due solely to a greater number of abdominal infections (p less than 0.05), but similar total hospital and intensive care unit stays as did the group 2 patients. When those in group 1 were divided into those having a previous Kasai procedure versus those who did not, no differences between the two groups were apparent except for age. Based upon these data, we conclude that prior abdominal surgery does not affect mortality, the duration of hospital or intensive care unit stay, plasma or platelet requirements, and total anesthesia time required for orthotopic liver transplantation, but does enhance the number of red blood cell transfusions and infections, particularly abdominal infections, in children undergoing this procedure. PMID- 3512357 TI - Measurement of gastric emptying rate in humans by real-time ultrasound. AB - Simultaneous studies of gastric emptying by ultrasound and scintigraphy were performed in 14 subjects to assess the use of ultrasound for the measurement of gastric emptying rate. The presence of air in the stomach prevented the acquisition of gastric emptying data by ultrasound in 3 of the 14 subjects. In the remaining 11 subjects there was no significant difference between values for the half-time (t1/2) of gastric emptying obtained by scintigraphy [for anterior imaging, mean t1/2 = 20.9 +/- 9.9 min (+/- SD); for anterior and posterior imaging, geometric mean t1/2 = 21.1 +/- 10.5 min (+/- SD)] compared with those derived by ultrasound [mean t1/2 = 20.2 +/- 10.0 min (+/- SD), p greater than 0.05 for each comparison]. A significant correlation between the t1/2 of gastric emptying derived by scintigraphy (anterior scanning and geometric mean of counts obtained by anterior and posterior scanning) and the t1/2 measured by ultrasound was obtained (r2 = 0.7, 0.69, respectively). These results imply that ultrasound can be used for the valid assessment of the gastric emptying rate in humans. PMID- 3512358 TI - Hydrostatic balloon dilation of gastrointestinal stenoses: a national survey. AB - Hydrostatic balloon dilation is being increasingly used for gastrointestinal stenoses, but few data are available regarding efficacy or side effects. A survey sent to 3000 A/S/G/E members showed that 22% of responding endoscopists used the balloon method. Data available on 1538 patients revealed an overall technical success rate for balloon dilation of 85%. Immediate symptomatic relief of obstructive symptoms was 85% for the esophagus, 76% for the stomach, 56% for the colon, 89% for the bile duct, and 67% for the pancreatic duct. Objective improvement at 3 months fell, respectively to 39%, 38%, 72%, 60%, and 62%. Six percent of total procedures were associated with complications, and these complications could not definitely be correlated with balloon size. Although the present survey defines current usage patterns, prospective studies over a long follow-up period are needed to define the place that hydrostatic balloons should play in the treatment of gastrointestinal stenoses. PMID- 3512359 TI - An endoscopic sewing machine. PMID- 3512360 TI - Patent umbilical vein and endoscopic sclerosis of esophageal varices. PMID- 3512361 TI - The slicing suture. PMID- 3512362 TI - Total colonoscopy--20 years old. PMID- 3512363 TI - Studies on endothelium-dependent vasorelaxation. AB - Recent studies on endothelium-dependent vasorelaxation have been briefly reviewed and analyzed. This mechanism, which might involve the release of metabolite(s) termed "endothelium-derived relaxing factor(s)" (EDRF), could play a major role in the regulation of vascular tone. PMID- 3512364 TI - Treatment for acquired palatal openings. PMID- 3512365 TI - Evaluation of abutment teeth: a confrontation with perplexity. PMID- 3512366 TI - Ageing and small-bowel mucosa: a morphometric study. AB - A direct effect of ageing in reducing mucosal surface area of the small intestine is still disputed. The aim of this study was to morphometrically evaluate a panel of jejunal biopsy specimens obtained from 16 elderly patients and 22 younger controls, all complaining of abdominal symptoms but without evidence of malabsorption and/or malnutrition in either group. Quantitative histology was performed by calculating the surface area to volume ratio of jejunal mucosa and the mean enterocyte height. The mean of surface to volume ratios in geriatric patients (97.6 +/- 18), although slightly reduced, did not significantly differ from that of younger controls (107.6 +/- 26) and no significant correlation was found between surface to volume ratio and age in years. The mean enterocyte height in the elderly group (30.1 +/- 1.2 microns) did not significantly differ from that of younger controls (31.3 +/- 2.3 microns). In conclusion, the frequent finding of malnutrition due to malabsorption in the elderly should not be attributed to a reduction of jejunal surface area as a mere consequence of age. PMID- 3512367 TI - The dilemma of cancer in the elderly. PMID- 3512368 TI - Clinical pharmacology of chemotherapeutic agents in old age. PMID- 3512369 TI - Conservative surgery and curative radiation therapy in cancer of the breast. PMID- 3512370 TI - Lung cancer in the elderly. PMID- 3512371 TI - Carcinoma of the prostate in the elderly. PMID- 3512372 TI - Leukemia and lymphoma in the elderly. PMID- 3512373 TI - Preventive cancer care for the elderly. AB - There is a great need for effective cancer prevention programs for the elderly. Unfortunately, the elderly have been omitted from most studies of cancer prevention; little is currently known concerning the benefits, risks, and feasibility of most primary and secondary cancer prevention measures in this segment of the population. Available data justify annual casefinding activities in the office of the primary care physician for breast cancer in elderly women and colorectal cancer in elderly persons of both sexes. PAP smear screening is also indicated for elderly women who have had few or no PAP smear in the past. There is some evidence that the health beliefs and practices of elderly persons and their physicians may impede the utilization of available cancer prevention measures. Further research is needed to define the efficacy of cancer prevention measures for the elderly and to improve the delivery of these measures to the elderly population. PMID- 3512374 TI - Geriatric medicine and the cancer patient. PMID- 3512375 TI - Immune function in the elderly. PMID- 3512376 TI - Cancer and aging--pathology. AB - The results of research in the areas of cytogenetics, molecular biology and cancer epidemiology have recently come together to provide insights into possible mechanisms whereby the aging process may be related to without being directly responsible for carcinogenesis. While the mechanism(s) of age-associated neoplasia have not been determined, current evidence suggests that: (1) Cancer does not appear to be the inevitable consequence of aging, that is a preprogrammed genetic time bomb ticking away just waiting to go off. (2) Cancer is an age-related disease that may arise in a hereditary form--usually in children, and in a sporadic form--usually in adults. (3) Chromosomal abnormalities associated with certain forms of cancer tend to be tumor specific and appear to be related to the activities of oncogenes. Age-related factors may mediate or modulate tumor production and progression, possibly through the conversion of proto-oncogenes to oncogenes. PMID- 3512377 TI - Surgical management of the elderly patient. Considerations. PMID- 3512378 TI - Chemical and hormonal therapies in the elderly. PMID- 3512379 TI - An improved procedure for fixation and embedding of whole, intact lens tissue for light microscopy. AB - Fixation and embedding of whole, intact lens tissue are often difficult. During studies of morphologic changes in various experimentally induced cataracts, an improved procedure was developed, utilizing isomolar fixative and water-soluble embedding medium (glycol methacrylate), while avoiding dehydration with organic solvents. Different rat and human cataractous lenses were processed in toto using this method, and the results were uniformly good upon light microscopic evaluation. The potential of this fixation-embedding procedure for lens research is discussed. PMID- 3512380 TI - [Method of accelerated detection of the causative agents of dysentery and their antigens in water]. PMID- 3512381 TI - Transcutaneous Doppler ultrasound measurement of superior mesenteric artery blood flow in man. AB - A duplex scanner which consists of a real time two dimensional scanner and a pulsed Doppler flowmeter was used to measure superior mesenteric blood flow in 70 healthy subjects. By processing the Doppler shift signals, the instantaneous average Doppler shift frequency and then the instantaneous average velocity of the flow rate were calculated. Both diameter of the vessel and angle between vessel and beam were measured from real time imaging. The mean (+/- standard error of the mean) of the superior mesenteric blood flow was 517 +/- 19 ml/min. There was neither significant difference in flow between sexes, nor correlation between flow and age (r = 0.042). The mean of coefficients of variability were 6.8% over the short term, and 8.2% in long term studies. PMID- 3512382 TI - Healing and recurrence of duodenal ulcer after treatment with tripotassium dicitrato bismuthate (TDB) tablets or cimetidine. AB - Eighty patients with duodenal ulcer were randomly allocated to treatment with tripotassium dicitrato bismuthate (TDB) tablets or cimetidine. Ulcers healed in 78% of patients treated with TDB and in 74% treated with cimetidine, supporting previous observations that the efficacy of these two agents is similar. Duodenal ulcer recurred in 43% of patients in the 12 months after treatment with TDB and in 78% of patients treated with cimetidine, with a significantly greater incidence of recurrence 6-12 months after cimetidine treatment. Tripotassium dicitrato bismuthate tablets may be preferable to cimetidine in the initial management of duodenal ulcer, because they offer a smaller likelihood of recurrence in the 12 months after successful treatment. PMID- 3512383 TI - Prediction of rebleeding from peptic ulcer experience with an endoscopic Doppler device. AB - An endoscopic Doppler device has been used to predict which patients with bleeding peptic ulcers will require surgery to stop their bleeding. The results show that if a Doppler signal can be elicited from an ulcer then the likelihood of rebleeding sufficient to require surgery or lead to death is increased very significantly. PMID- 3512384 TI - Effect of prostacyclin (PGI2) on water and solute transport in the human jejunum. AB - Prostacyclin is an arachidonic acid metabolite, synthesised throughout the gastrointestinal tract, which has different effects on water and electrolyte transport across a variety of mammalian gastrointestinal epithelia. Using a perfusion technique in the human jejunum of 11 healthy subjects in vivo, the effect of intravenous prostacyclin, 4 ng/kg/min, on jejunal water and solute transport from a glucose electrolyte solution was investigated. In the prostacyclin group (n = 5), prostacyclin was infused intravenously from 70-150 minutes, and buffer administered iv from 0-70 and 150-210 minutes. In the buffer group (n = 6), iv buffer was administered from 0-210 minutes. In the prostacyclin group, net jejunal absorption of water was inhibited from 90-120 min (p less than 0.05), 150-180 min (p less than 0.01) and 180-210 min (p less than 0.01), of sodium was inhibited from 90-120 min (p less than 0.05), 120-150 min (p less than 0.05), 150-180 min (p less than 0.01) and 180-210 min (p less than 0.01), and of chloride was inhibited from 90-120 min (p less than 0.05), 120-150 min (p less than 0.005), 150-180 min (p less than 0.01) and 180-210 min (p less than 0.01). Prostacyclin had no effect on net movement of glucose, potassium or bicarbonate. These results are consistent with a role for prostacyclin in the endogenous humoral regulation of water and electrolyte transport in the human jejunum. PMID- 3512385 TI - A historical perspective on the discovery of the accessory duct of the pancreas, the ampulla 'of Vater' and pancreas divisum. AB - The discovery of the accessory duct of the pancreas is usually ascribed to Giovanni Domenico Santorini (1681-1737), after whom this structure is named. The papilla duodeni (ampulla 'of Vater', or papilla 'of Santorini') is named after Abraham Vater (1684-1751) or after GD Santorini. Pancreas divisum, a persistence through non-fusion of the embryonic dorsal and ventral pancreas is a relatively common clinical condition, the discovery of which is usually ascribed to Joseph Hyrtl (1810-1894). In this review I report that pancreas divisum, the accessory duct and the papilla duodeni (ampulla 'of Vater') had all been observed and the observations published during the 17th century by at least seven anatomists before Santorini, Vater, and Hyrtl. I further suggest, in the light of frequent anatomical misattributions in common usage, that anatomical structures be referred to only by their proper anatomical names. PMID- 3512386 TI - Dispermy as the origin of partial moles as well as a nonmolar conception. AB - All 3 triploid conceptuses examined had a common, dispermic origin. When histological diagnoses were reconsidered in this light 1 conceptus turned out to be nonmolar. This supports recent case reports which indicate that dispermic triploids may be either molar or nonmolar. PMID- 3512387 TI - Factitious hypoglycemia in an insulin-dependent woman in the eighth week of gestation. AB - An extremely rare case of factitious hypoglycemia in a young insulin-dependent pregnant woman in the first trimester of pregnancy is reported. Pregnancy resulted in the birth of a normal child. The clinical and laboratory procedures used to ascertain this diagnosis together with the psychological dynamics of the case are discussed. PMID- 3512388 TI - [A new technic of nipple reconstruction]. AB - Many methods of reconstruction of the nipple have been described in the last few years, but none are completely satisfactory. The main objectives are reconstruction, size, forward projection of the nipple, and pigmentation of the areola comparable to the other side. The combination of a local dermal flap and a full-thickness skin graft from the inner thigh provides a solution to the problem while avoiding any interference with the opposite nipple. PMID- 3512389 TI - [Toe transfer to a mid-hand stump covered with abdominal skin]. AB - Following amputation of all four fingers from the hand, the cover of the amputation site with an abdominal flap gives a hand which is functionally inferior. This paper reports our experiences of three toe transfers to such a hand in two patients, one a 22-year-old man, the other, a 50-year-old woman. In our opinion, the toe transfer will be successful if the vessels, nerves and tendons are harvested to the level of the extensor retinaculum, giving a length in excess of the skeleton of some 12-15 cm. The routing of these structures beneath the abdominal flap is done in such a way as to avoid any ischemia and therefore, infection. In the first case, these latter considerations were not fully observed and in the third postoperative week, arterial thrombosis with loss of the transfer developed, following an infection. The two other transposed digits have survived with a good functional result. PMID- 3512390 TI - [Special technics for improving the results in replantation surgery]. AB - By integrating of special techniques of hand surgery, microsurgery, and plastic surgery into the case of replantations and severe crush amputations, a result can be achieved which improves the function and thus shortens the time of treatment. According to the extent of the injury this can be achieved by immediate reconstruction of bony defects, by bridging long vascular defects and by late primary soft tissue coverage. PMID- 3512391 TI - Relation of nitrite concentration to mutagen formation in soy sauce. AB - When soy sauce was mixed with nitrite solutions at pH 1.0 and 3.0, only mixtures containing nitrite concentrations above 250 ppm were mutagenic in the Salmonella/mammalian microsome test. In buffered aqueous solution (pH 3) the mutagen precursor, (-)-(1S,3S)-1-methyl-1,2,3,4-tetrahydro-beta-carboline-3 carboxylic acid [(1S,3S)-MTCA] and its stereoisomer ( - )-(1R,3S)-MTCA reacted with 10 ppm or more of sodium nitrite; but at least 250 ppm nitrite was required for them to react in soy sauce (pH 3). Similarly, another mutagen precursor, tyramine, did not react even with 2300 ppm nitrite in soy sauce (pH 1), although pure tyramine in aqueous solution (pH 1) reacted with as little as 50 ppm nitrite. Nitrite concentration in human saliva and gastric juice does not generally exceed 50 ppm. Therefore, the most probable source of mutagens- nitrosation of MTCAs and tyramine--is likely to be very restricted in vivo and soy sauce is unlikely to be significantly mutagenic. PMID- 3512392 TI - Identification, occurrence and mutagenicity in Salmonella typhimurium of two synthetic nitroarenes, musk ambrette and musk xylene, in Indian chewing tobacco and betel quid. AB - During N-nitrosamine analysis of extracts of betel quid with tobacco and of the saliva of chewers of betel quid with tobacco for N-nitrosamines using a Thermal Energy Analyzer, two unknown compounds were detected. They were identified as synthetic nitro musks, musk ambrette (5-tert-butyl-1,3-dinitro-4-methoxy-2 methylbenzene, CAS No. 83-66-9) and musk xylene, (1-tert-butyl-3,5-dimethyl-2,4,6 trinitrobenzene, CAS No. 81-15-2), by gas chromatography-mass spectrometry and Fourier transform nuclear magnetic resonance spectroscopy. These compounds were detected in several samples of betel quid with tobacco and in perfumed tobacco used for chewing in India in amounts ranging from 0.45-23.5 mg/g wet weight. Musk ambrette was found to be mutagenic in Salmonella typhimurium TA100 requiring metabolic activation by rat-liver postmitochondrial supernatant but musk xylene lacked mutagenicity. PMID- 3512393 TI - Inhibitory effects of flavourings on mutagenesis induced by chemicals in bacteria. AB - The antimutagenic potential of twenty-five flavourings was tested against the activity of several kinds of chemical mutagens in Escherichia coli and Salmonella typhimurium. Anisaldehyde, ethylvanillin and vanillin showed marked antimutagenic effects on mutagenesis induced by 4-nitroquinoline 1-oxide, furylfuramide (AF-2), captan or methylglyoxal in E. coli WP2s. However, they were not effective against mutations provoked by 3-amino-1-methyl-5H-pyrido[4,3-b]indole (Trp-P-2) or 2 amino-3-methylimidazo[4,5-f]quinoline (IQ) in S. typhimurium TA98. Despite the decrease in the number of mutants, a remarkable increase was observed in the survival of mutagen-treated WP2s cells after exposure to these flavourings. We assume that these compounds may act as bio-antimutagens by enhancing an error free recombinational repair system, because this reactivation of survival was strictly dependent on the recA gene function but not on the lexA and uvrA gene functions. PMID- 3512394 TI - Transfer from porcine insulin to human insulin in insulin-dependent diabetes mellitus: effects on insulin binding to IgG and glycemic control. AB - Thirty type I diabetic patients who were treated for at least 2 years with a combination of regular and lente monocomponent porcine insulins were allocated in a double-blind study to either continued porcine insulin treatment or a transfer to the corresponding semi-synthetic human insulins. Insulin binding to IgG measured by an immunoelectrophoretic method, was followed at 3-month intervals for 1 year, and did not change after the transfer. The glycemic control, as assessed by hemoglobin A1 levels, tended to deteriorate in the human insulin group during the first 3 months of the trial and then return to the baseline level. It is concluded that a transfer from highly purified porcine insulin to human insulin apparently does not change the insulin binding to IgG in already sensitized patients. PMID- 3512395 TI - Metabolic response to insulin induced hypoglycaemia in lean and obese subjects. AB - Metabolic response to insulin induced hypoglycaemia was examined in 8 lean and 11 obese subjects. The metabolic rate increased in lean and obese subjects during the hypoglycaemia. The mean response (as the sum of all the values above basal) was not significantly different between lean and obese subjects. The mean decrease in blood glucose and the mean hormonal response (increase in cortisol, adrenaline and noradrenaline) were not different between lean subjects and obese subjects. However, the metabolic response and noradrenaline response were variable in obese subjects and some obese subjects showed a poor response. These results suggest that in some obese subjects, there may be reduced thermogenic response to insulin induced hypoglycaemia. PMID- 3512396 TI - Effect of low-dose dopamine infusion on insulin and glucagon release in fasting normal man. AB - The effect of a low-dose infusion of dopamine on basal circulating concentrations of insulin, glucagon and glucose in six healthy male subjects is reported. Dopamine (0.1 microgram/kg/min) or placebo was given intravenously for 60 minutes. During infusion of the catecholamine, circulating plasma dopamine was 3.46 +/- 1 ng/ml. No change in circulating concentrations of insulin, glucagon and glucose were seen during infusion of dopamine when compared with placebo infusion. It is concluded that dopamine acting at a D2 receptor is unlikely to be of physiological importance in regulation of basal pancreatic islet cell function in man. PMID- 3512397 TI - Insulin hypoglycemia suppresses TSH secretion in man: studies with an immunoradiometric TSH assay. PMID- 3512398 TI - Response of plasma renin activity to postural change in vasovagal syncope in children, with observations on syncope. AB - 37 children aged 7-14 years with a history of repetitive fainting (vasovagal syncope) were studied. Plasma renin activity (PRA), blood pressure and heart rate were measured before and after standing for 15 min. Standing PRA was significantly higher in cases of fainting (n = 14) than in cases of nonfainting (n = 23). A significant positive correlation was observed between PRA and fall in systolic blood pressure on standing in cases of fainting, but not in cases of nonfainting. These findings suggest that the renin-angiotensin system may respond to the fall in blood pressure in children subject to fainting, unlike their adult counterparts previously reported. PMID- 3512399 TI - Medicare appeal notice troubles U.S. hospitals. PMID- 3512400 TI - Physician-incentive plans may be put on hold. PMID- 3512401 TI - Postacute care gaps: fueling discharge debate?. Interview by Clay Mickel. PMID- 3512402 TI - Directory of House of Delegates and Governing Councils of Sections for 1986. American Hospital Association. PMID- 3512403 TI - Strategic planning: less talk, more action. PMID- 3512404 TI - Providers assault Medicare capital reform. PMID- 3512405 TI - Miami's elderly: the future of health care? PMID- 3512406 TI - Medicaid HMO plans tackle quality questions. PMID- 3512407 TI - Payment changes could hurt HMOs. PMID- 3512408 TI - Know thy customer: Coca-Cola's Herbert. Interview by Suzanne Powills. PMID- 3512409 TI - Physiologic and pathologic manifestations of lymphokine action. PMID- 3512410 TI - Cell-mediated cytotoxic reactions. PMID- 3512411 TI - Cell-mediated immunity in renal disease. AB - It has been shown in experimental models that cell-mediated immunologic mechanisms can lead to glomerular as well as tubulointerstitial renal injury, with or without concomitant antibody-mediated effects. The glomerular lesions are characterized by varying combinations of monocyte and, to a lesser extent, lymphocyte influx, necrosis, and proliferation of intrinsic glomerular cells. The tubulointerstitial lesions have generally been characterized by interstitial infiltrates containing numerous T lymphocytes and, often, numerous macrophages, sometimes with invasion of tubules and tubular cell damage. Although similar renal abnormalities are seen in several human renal diseases, further evidence is obviously required to establish a pathogenetic role for cellular immunity. Analyses of infiltrating mononuclear cells by immunohistochemical methods, with monoclonal antibodies that identify subsets of T cells, have indirectly supported a role for delayed hypersensitivity reactions in tubulointerstitial nephritis resulting from drugs or associated with anti-TBM antibodies, as well as a role for both delayed hypersensitivity and cytolytic lymphocyte effects in renal allografts. However, only with the development of methods that permit the identification of subsets of lymphocytes with unique functions, as well as the identification of the antigen specificity of the cells, will it be possible to understand fully the renal lesions that are now suspected of being cell-mediated. PMID- 3512412 TI - Cell-mediated immunity in liver disease. AB - Four liver diseases in which cell-mediated immunity seems to be of major importance but in which the exact pathogenic event has been not fully clarified have been briefly discussed. More precise delineation of the phenotypes of mononuclear cells and the advent of in vitro techniques for the study of lymphocyte function and cytotoxicity have led to better understanding of the importance of cell-mediated immunity in some liver diseases. It seems that the liver itself may be variously affected by different immunologic reactions, not only in various diseases but also in different locations in the same disease. PMID- 3512413 TI - Lupus glomerulonephritis with thrombotic microangiopathy. AB - Well-documented cases of systemic lupus erythematosus (SLE) with thrombotic microangiopathy (TMA) are rare. Renal biopsy in a 25-year-old woman with SLE who was in renal failure demonstrated proliferative lupus glomerulonephritis with arteriolar thrombosis and the arterial intimal changes of TMA. No staining of vessels for immunoglobulins or complement was found by direct immunofluorescence. Fibrillar and flocculent deposits were seen in the widened and rarefied subendothelial space in a small artery and two glomeruli, one of which also contained electron-dense deposits. The vascular findings, which are those of TMA, are distinct from the immune complex vasculopathy of SLE. PMID- 3512414 TI - Cell-mediated immunity in autoimmune thyroid disease. AB - The initiation of an autoimmune response requires the establishment of an appropriate microenvironment. This, in turn, involves several requirements, including antigen expression on the membrane surface of the target cells, class II antigen expression on the antigen-presenting cell or target cell, a relative systemic or local increase in the helper/inducer subset of T cells, and/or a relative decrease in the suppressor subset of T cells. All of these conditions have been described in the thyroid gland. Appropriate cellular interactions result in the appearance of activated T cells and the generation of cytotoxic T cells. The pathologic alterations may be produced by the local production of antibody and subsequent formation of immune complexes, by direct lymphocyte damage, or by lymphokine production. Autoimmune thyroid disease remains, to our minds, the most instructive paradigm of the organ-specific autoimmune endocrinopathies. PMID- 3512415 TI - Cell-mediated immunity in rheumatic disease. AB - Rheumatoid arthritis, systemic lupus erythematosus, and systemic sclerosis are the three most common systemic rheumatic diseases in which disordered immune function is thought to play a pathogenetic role. Each disease has different and characteristic abnormalities of the cellular immune system. In rheumatoid arthritis the identified abnormalities of immunoregulation are largely limited to specific antigens: Epstein-Barr virus and collagen. Systemic lupus erythematosus is characterized by exuberant B-cell activity with exaggerated humoral response, a diversity of autoantibodies, non-antigen-specific loss of suppressor cell function, and general suppression of cell-mediated immunity. In systemic sclerosis systemic defects of cellular and humoral immune function are mild, but the release of lymphokines and monokines at sites of inflammatory lesions is thought to be important in the pathogenesis of the disease. Similar immune cell connetive tissue cell interactions are probably important in the propagation of rheumatoid synovitis. Thus, despite the many shared clinical and serologic features of these diseases as well as the presence of many patients who have clinically overlapping features of more than one of these entities, the immune defects and the immunopathogenesis of these disorders appear to be distinct. PMID- 3512416 TI - Sinus histiocytosis with massive lymphadenopathy simulating subacute thyroiditis. AB - A white woman who had sinus histiocytosis with massive lymphoadenopathy (SHML) presented with a painful goiter and tender cervical lymph nodes. She had biochemical evidence of hypothyroidism but remained clinically euthyroid. Histologic examination confirmed SHML in the thyroid and cervical lymph nodes. The disease remitted spontaneously. PMID- 3512417 TI - Effect of four serum components on survival of Treponema pallidum and its attachment to rabbit cells in vitro. AB - Transferrin and, to a lesser extent, insulin were two components of serum that enhanced the survival of Treponema pallidum in microaerophilic, acellular medium. These two components also enhanced the attachment of T pallidum to baby rabbit genital organ (BRGO) cells in both aerobic and microaerophilic tissue culture systems. Growth hormone and epidermal growth factor marginally enhanced the attachment of T pallidum to BRGO cells. PMID- 3512418 TI - Effect of short term treatment of non-gonococcal urethritis with minocycline. AB - Two hundred and forty four men with non-gonococcal urethritis (NGU) took part in a trial of minocycline. Chlamydiae were isolated from 34%, ureaplasmas from 47.1%, and Mycoplasma hominis from 10.2%. These micro-organisms were isolated least often from men suffering their third or more attack of NGU, and men in this group failed most often to respond to minocycline. Irrespective of the micro organisms isolated originally or the number of previous attacks, the failure rate (10%) for men receiving minocycline for 10 days was significantly less than for those receiving this antibiotic for one or two days. More than half of the men suffering third attacks from whom micro-organisms were not isolated failed to respond to these short regimens. One of the lowest failure rates (4%) after short term treatment, however, was seen in men experiencing first attacks who yielded only ureaplasmas with or without M hominis, which indicates the importance of ureaplasmas in this group of patients. Chlamydiae were not reisolated from any patient after treatment, irrespective of its duration, and the only ureaplasmas that were reisolated were from nine patients who carried tetracycline resistant strains. Reasons for the absence of chlamydiae and ureaplasmas in the presence of disease and the need to look for other microorganisms as a cause of NGU are discussed among other issues raised by these results. PMID- 3512419 TI - Acyclovir in first attacks of genital herpes and prevention of recurrences. AB - Sixty women patients experiencing a first attack of genital herpes were randomly treated with either oral acyclovir for 42 days or oral acyclovir for five days followed by placebo for 37 days. The median time to the first recurrence in patients receiving acyclovir for 42 days was 66.5 days compared with 24 days in those who received acyclovir for only five days (p less than 0.0001). This significant difference, however, was only observed for the treatment period. The frequency of recurrences was also reduced during the period of treatment in those who received prolonged treatment. During the subsequent follow up period, however, patients in both groups had a similar frequency of recurrences. Patients with infections due to herpes simplex virus type I (HSV I) had a significantly longer time to the first recurrence (p less than 0.001) and fewer recurrences (p less than 0.001) than those infected with HSV II, irrespective of treatment. PMID- 3512420 TI - Efficacy of oral treatment with acyclovir and co-trimoxazole in first episode genital herpes. AB - Forty patients presenting with first episode genital herpes were randomly allocated to seven day treatment with oral acyclovir alone, placebo alone, oral acyclovir plus co-trimoxazole, or placebo plus co-trimoxazole. Patients receiving acyclovir had significantly shorter periods of viral shedding (p less than 0.001), pain (p = 0.03), and times to lesion healing (p less than 0.05). Averaged over all patients there was no evidence that co-trimoxazole affected any of the variables, though in women cotrimoxazole was associated with a shorter time to lesion healing (p less than 0.01). Furthermore, the combination treatment gave significantly shorter times to lesion healing than acyclovir alone, placebo alone, or placebo and co-trimoxazole (p = 0.01) and good trends elsewhere (external lesions and duration of pain). Neither drug was associated with any adverse events or toxicity or influenced the subsequent recurrence rate. PMID- 3512421 TI - Reinforcement of health education and counselling by doctors in treatment and control of sexually transmitted disease. AB - The health education and medical counselling given by the social health worker to index patients with sexually transmitted disease (STD) attending our clinic were reinforced by a doctor attending a "treatment group" of patients in a randomised controlled trial. Sixty four patients were randomised into two groups of 32. Of the 96 follow up visits required four each group (three per patient), there were 20 defaults in the control group compared with only four in the patients whose health education had been reinforced by the doctor. Four of the control patients had been re-exposed to risk of infection during follow up compared with none in the reinforced group. Also five of the primary and none of the secondary sexual contacts of the control patients came for investigation and treatment (without the need for extra field contact tracing by the social worker) compared with eight primary and two secondary sexual contacts of the reinforced group. The appreciable impact of counselling reinforcement by a doctor shown in this study leads us to emphasise the importance of this practice, especially in developing countries where various infrastructural and cultural factors usually make contact tracing an unrewarding exercise. PMID- 3512422 TI - Genetic markers and malaria. Observations in Gujarat, India. AB - 189 healthy controls and 175 patients suffering from malaria vivax have been investigated with regard to associations between this disease and 22 genetic polymorphisms of the blood (ABO, MN, Ss, Rh, Kell, P, Lutheran, Kidd, Duffy, Diego, Xg; ABH-Secretor; Hp, Gc, Gm, Km; aP, AK, PGM1, 6-PGD, EsD; Hb variants) Significant associations could be demonstrated only for P and Hp systems, though in accordance with other investigations it cannot be excluded that the ABO system plays also a role in this connection. PMID- 3512424 TI - Expression of MHC class II antigens in human B-cell leukaemia, and increased levels of class II antigens and DR-specific mRNA after stimulation with 12-O tetradecanoyl phorbol-13-acetate. AB - Cells from the peripheral blood of B-cell chronic lymphocytic leukaemia (CLL) patients were examined serologically for the expression of cell surface MHC class II antigens with monoclonal antibodies (mAbs) specific for the products of HLA DP, -DQ and -DR genes, and mRNAs from the cells of three patients were analysed with a cDNA probe specific for DR beta chain genes. In 12 cases of CLL studied by indirect immunofluorescence and FACS analysis, a variable proportion of cells failed to express detectable levels of HLA-DP and HLA-DQ antigens at the cell surface, although greater than 90% of the cells had detectable expression of HLA DR antigens. In all cases, greater than 90% of the cells expressed MHC class I antigens and the majority of cells reacted with the Leu-1 (CD5) mAb. Cells from different patients expressed variable levels of MHC class II antigens, and this was reflected in the finding of variable levels of mRNA detectable with the cDNA probe. Culture of cells with the phorbol ester 12-O-tetradecanoyl phorbol-13 acetate (TPA) induced much increased levels of expression of MHC class II antigens. HLA-DP and -DQ antigens were expressed on greater than 90% of the cells in all cases studied after culture of the cells with TPA, and MHC class II specific mRNA transcripts were correspondingly increased. In a single case of plasma cell leukaemia studied, MHC class II antigens were not detectable at the cell surface and their expression was not induced after culture of the cells with TPA. PMID- 3512423 TI - Duct-associated lymphoid tissue (DALT) of minor salivary glands and mucosal immunity. AB - Minor salivary glands (MSG) play a substantial role in the secretory immunoglobulin A (sIgA)-mediated immunity of the oral cavity. There are two possibilities for the induction of this immunity: (i) an explicitly local antigenic stimulus, or (ii) a remote stimulus as part of the so-called 'common mucosal immune system'. This communication is an attempt to consolidate available evidence in support of both possibilities and to address the former in detail. Although there is strong circumstantial evidence supporting the feasibility of MSG functioning as a part of the common mucosal immune system, direct experimental evidence is yet to emerge. On the other hand, there is increasing structural and physiological evidence in support of MSG serving as a local immunological organ. The purely local response is attributed to the presence of MSG duct-associated lymphoid tissue (DALT), which is comparable to gut- or bronchial-associated lymphoid tissue (GALT or BALT) in origin, tissue organization and function. DALT is accessible to oral antigens by retrograde passage through MSG ducts. Repeated topical antigenic challenging via the oral mucosa may result in the appearance of interacinar plasma cells carrying specific homologous antibodies in MSG. Gut or enteric priming of the same antigen, by passing the oral mucosa by gastric intubation, need not evoke a remote immune response in MSG. Since DALT is more likely to occur in healthy, young growing individuals, who are less likely to undergo bioptic examination of MSG, it has not yet been documented in humans. The physiologically induced DALT is apt to be confused with focal accumulations of lymphoid tissue in pathologically altered MSG, as a consequence of local and some systemic autoimmune diseases. An attempt is made to demarcaate healthy and pathological MSG on the basis of currently available clinical, serological, immunological and genetic evidence. PMID- 3512425 TI - Macrophage heterogeneity in the rat as delineated by two monoclonal antibodies MRC OX-41 and MRC OX-42, the latter recognizing complement receptor type 3. AB - Two monoclonal antibodies, designated MRC OX-41 and MRC OX-42, have been shown to label subsets of macrophages. Using immunoperoxidase and immunofluorescence analysis, tissue macrophages were shown to be heterogeneous with respect to binding of MRC OX-41 and MRC OX-42 antibodies. Although both antibodies labelled subsets of macrophages, the antibodies also reacted with granulocytes and dendritic cells. The antigens recognized by these antibodies were identified by metabolic and cell surface labelling followed by immunoprecipitation and sodium dodecyl sulphate polyacrylamide gel electrophoresis (SDS-PAGE). MRC OX-41 recognized a surface protein of 110,000-120,000 MW, while MRC OX-42 immunoprecipitated three polypeptides with molecular weights of 160,000, 103,000 and 95,000. The Fab fragment of MRC OX-42 antibody inhibited complement-mediated rosette formation between sensitized erythrocytes and rat macrophages and granulocytes. Membrane molecules with similar biochemical and functional properties to MRC OX-42 antigen have been identified in mouse and man as the receptors for iC3b, and it is probable that MRC OX-42 antibody recognizes the rat homologue of the receptors in these other species. PMID- 3512426 TI - Rapid killing of actinomycin D-treated tumour cells by mononuclear phagocytes: reactivity in mouse strains with defective classical tumour cytotoxicity. AB - In confirmation of previous data, macrophages from C3H/HeJ, C57BL/10ScCR and A/J mice, exposed in vivo to BCG or in vitro to lymphokines, had little tumoricidal activity, as assessed in a 48-hr [3H]thymidine release assay against TU5 tumour cells, compared to macrophages from C3H/HeN, C57BL/6 and (BALB/c X DBA/2)F1 mice. Macrophages from these mouse strains were examined for their capacity to kill actinomycin D-pretreated WEHI 164 sarcoma cells in a 6-hr 51chromium release assay (drug-dependent cellular cytotoxicity, DDCC). Peptone-elicited macrophages from C3H/HeN, C57BL/6, (BALB/c X DBA/2)F1, C57BL/10ScCR and A/J mice had high DDCC activity, whereas C3H/HeJ macrophages expressed little cytotoxicity against actinomycin D-pretreated WEHI 164 cells. In vivo exposure to BCG or inactivated streptococci caused a modest augmentation of the DDCC effector function of C3H/HeJ macrophages, but levels of reactivity remained 20-fold less than those of similarly treated normal mice. Thus, C57BL/10ScCR and A/J macrophages have defective classical direct cytotoxicity but mediate DDCC efficiently, whereas C3H/HeJ macrophages are defective in both effector functions. PMID- 3512427 TI - Interaction between streptococcal IgG Fc receptors and human and rabbit IgG domains. AB - Groups A, C and G streptococci were tested for their ability to bind 125I labelled fragments of human and rabbit IgG in order to localize their sites of interaction with IgG domains. Among the Group A streptococci, strains with IgG Fc receptors bound 85% of the added IgG Fc fragments in the test systems, whereas these strains showed practically no reactivity with F(ab')2, Facb (F(ab')2 + C gamma 2 domains) or pFc' (C gamma 3 domains). The Group C and Group G strains bound 48-100% of IgG Fc, but could also bind up to 36% of the added F(ab')2 in accordance with a previously described 'alternative' Fab reactivity. However, unlabelled IgG F(ab')2 or Facb showed no, or only slight, inhibitory capacity for the binding of 125I-labelled IgG Fc to the C and G strains. Collectively, these results indicate that Groups A, C and G streptococci require both the C gamma 2 and C gamma 3 domains for interaction with IgG, and most probably also bind in the interface region between the C gamma 2 and C gamma 3 domains as has been shown for staphylococcal protein A. PMID- 3512429 TI - Does moderate sodium restriction lower blood pressure? PMID- 3512428 TI - Captopril modifies the hemodynamic and neuroendocrine responses to sodium nitroprusside in hypertensive patients. AB - To determine if clinically effective doses of the antihypertensive agent captopril affected the neuronal release of norepinephrine or baroreflex sensitivity, changes in plasma norepinephrine concentration and heart rate were related to the changes in mean arterial pressure seen during the intravenous infusion of stepwise incremental doses of sodium nitroprusside before and during captopril treatment in eight hypertensive men with normal or low plasma renin activity. At all times, significant linear correlations were found between the decrease in mean arterial pressure and the dose of sodium nitroprusside, the increase in heart rate and the decrease in mean arterial pressure, and the increase in plasma norepinephrine concentration and the decrease in mean arterial pressure. When the subjects were treated with captopril (25 mg t.i.d.) for 2 to 4 weeks, supine mean arterial pressure decreased from 130 to 114 mm Hg (-12%; p less than 0.05), heart rate did not change, supine and upright plasma renin activity increased, while supine plasma norepinephrine and epinephrine concentration decreased slightly. Therapy with captopril (25 mg t.i.d.) increased baroreflex sensitivity, as assessed by the slope of the regression line relating the increase in heart rate to the decrease in mean arterial pressure, and increased the responsiveness of the sympathetic nervous system, as assessed by the slope of the regression line relating the increase in plasma norepinephrine concentration to the decrease in mean arterial pressure. These increases were accompanied by a decrease in the slope of the regression line relating the decrease in mean arterial pressure to the dose of sodium nitroprusside and thus were associated with a decreased sensitivity to the vasodepressor effects of sodium nitroprusside.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3512430 TI - Effect of iron compounds on antibacterial function of human polymorphs and plasma. AB - Human plasma was bactericidal for small numbers of Klebsiella pneumoniae, but larger numbers grew slowly over a period of 24 h. Human polymorphs in a clot of autologous plasma had a bacteriostatic effect on relatively large numbers of bacteria for up to 24 h and were much more effective than plasma alone. The bactericidal effect of plasma could be abolished by saturating the plasma albumin and hemopexin with hematin, the haptoglobin with hemoglobin, and the transferrin with Fe3+. Stimulation of bacterial growth in the presence of polymorphs depended on the degree of saturation of the plasma proteins which bind the Fe3+ or heme compounds. Hematin bound to albumin appeared to be readily available to K. pneumoniae. Free hemoglobin stimulated bacterial growth but the organism could not utilize the haptoglobin-hemoglobin complex. In the presence of polymorphs the addition of Fe3+ to give 60% saturation of the transferrin with iron led to rapid growth after a long delay (19 h). Progressive increases in saturation above 60% gave correspondingly quicker growth, suggesting that the higher the saturation of transferrin, the easier it is for the bacteria to acquire iron. The antibacterial effect of the plasma appears to be critically dependent on the availability of iron for the bacteria, and this in turn affects the ability of the polymorphs to control bacterial growth. PMID- 3512431 TI - Purification and characterization of an extracellular protease of Legionella pneumophila. AB - An extracellular proteolytic enzyme of Legionella pneumophila was purified by sequential batch separation with DEAE-cellulose, hydrophobic interaction chromatography with octyl-Sepharose, and ion-exchange chromatography with DEAE Bio-Gel A (Bio-Rad Laboratories, Richmond, Calif.). The resulting protease preparation was determined to be homogeneous by polyacrylamide gel electrophoresis in the presence and absence of sodium dodecyl sulfate. Although free of contaminating proteins, the purified protease separated into two antigenically indistinguishable proteins both of which possessed proteolytic activity. The apparent masses of the proteins were 38 and 40 kilodaltons (kDa) as determined by polyacrylamide gel electrophoresis in sodium dodecyl sulfate, whereas gel filtration chromatography revealed a single mass of 34 kDa. Immunoblot analysis indicated that the 38-kDa protein probably originated from the 40-kDa protein during purification. The isoelectric points of the two protease species were 4.20 and 4.42. Enzyme activity, which was optimum between pH 5.5 and 7.5, was inhibited by various metal chelators; however, no effect was observed after treatment with phenylmethylsulfonyl fluoride, chymostatin, trypsin inhibitor, or dithiothreitol. Enzyme activity inhibited by metal chelators was restored upon the addition of various metal ions, including Zn2+, Fe2+, Mn2+, Cu2+, and Fe3+, but was not restored by Mg2+ or Ca2+. Atomic absorption analysis of the purified protease revealed a single gram-atom of zinc per mole of enzyme. Our findings indicate that the L. pneumophila protease resembles neutral zinc containing metalloproteases similar to those found in other bacterial species. PMID- 3512432 TI - Effect of macrophage activation on phagocyte-Plasmodium interaction. AB - We investigated the effect of both immune and normal sera on the binding of free Plasmodium berghei by resident and activated macrophages. Resident macrophages bound plasmodia to a greater extent than did activated macrophages, regardless of treatment. Resident macrophages bound free plasmodia, predominantly trophozoites, in the presence of normal serum by a mechanism inhibited by N-acetylglucosamine and N-acetylmannosamine. Macrophages activated through treatment with Propionibacterium acnes ("Corynebacterium parvum"), on the other hand, did not bind free plasmodia in the presence of normal serum through systems inhibited by N-acetylmannosamine or N-acetylglucosamine. The binding of free plasmodia by activated macrophages was greatest in the presence of immune serum and could be inhibited by immune complexes but not by N-acetylmannosamine or N acetylglucosamine. These results suggest that a receptor for a carbohydrate component of a normal serum opsonin mediates initial adherence of plasmodial antigen onto resident macrophages, triggering both the immunological cascade and macrophage activation. After activation, the macrophages no longer have the carbohydrate-specific receptor but do have functional Fc receptors which mediate the adherence of immune-serum-opsonized plasmodia. PMID- 3512433 TI - Inhibition of a penetration-enhancing factor of Toxoplasma gondii by monoclonal antibodies specific for rhoptries. AB - The anterior organelles of the coccidian parasite Toxoplasma gondii have long been suspected of playing a role in the ability of this organism to actively penetrate a wide range of host cells. A series of four monoclonal antibodies (produced by spleen cells from mice immunized with whole, killed T. gondii fused with Sp 2/0-Ag14 myeloma cells) recognized anterior organelles of T. gondii in indirect immunofluorescence assays. These antibodies (Tg 13, Tg 31, Tg 49, and Tg 112) were of the immunoglobulin G (IgG) class, had different enzyme-linked immunosorbent assay titers, and partially competed with each other in a solid phase immunoassay with whole, dried T. gondii as the antigen. It was observed by immunofluorescence that all antibodies detected anterior structures, which under some conditions of fixation and extraction appeared to be multiple rodlike organelles resembling rhoptries. As determined by ultrastructure immunocytology, Tg 49 recognized electron-dense bodies consistent with rhoptries or micronemes in parasites that had been fixed in 2% paraformaldehyde and extracted with Triton X 100 to allow antibody penetration. An assay of penetration enhancement, in which conditioned medium (from fibroblast monolayers completely lysed by T. gondii) increased the number of plaques produced by a standard inoculum of T. gondii on fresh monolayers, was inhibited by equal amounts of all four monoclonal antibodies, in degrees closely related to their enzyme-linked immunosorbent assay titers. These antibodies appeared to link a penetration-enhancing factor with the rhoptries of T. gondii. PMID- 3512434 TI - Reactivity patterns of human anticardiolipin and other antiphospholipid antibodies in syphilitic sera. AB - Sera from patients with proven cases of syphilis were tested for the presence of antibodies to structurally important phospholipids by using qualitative and quantitative assays. All 47 sera examined qualitatively contained antibodies to cardiolipin, phosphatidic acid, and phosphatidylserine, but not antibodies to other selected phospholipids. Such reactivity was not found in normal (Red Cross) sera. Although the degree of antibody binding to phospholipids varied in individual sera, reactivity was almost always greater with cardiolipin than with phosphatidic acid or phosphatidylserine. Binding saturability was found in sera as the cardiolipin concentration was increased over a constant area of nitrocellulose paper. Anti-cardiolipin binding measured by the protein A method gave results similar to the results measured by using anti-immunoglobulin G, which supports the conclusion that binding was to the Fab portion of the immunoglobulin molecule. When measured as a function of serum concentration and plotted in double-reciprocal fashion, the anti-cardiolipin binding data for two syphilitic sera had similar Kd values but different Bmax values. Stoichiometric calculations indicated that approximately 11,000 to 16,000 mol of cardiolipin appeared to be bound per mole of labeled second antibody. These observations may mean that the anti-cardiolipin antibody does not recognize the individual cardiolipin molecule as the antigenic site but recognizes some structural form of the phospholipid or that steric hindrance related to the interaction of the phospholipid with nitrocellulose paper prevented the bulk of cardiolipin molecules from reaching. The structural specificity of the antibodies identified excludes the possibility that these antibodies are directed against the phosphodiester linkage. These findings should give impetus to future study of a potential pathogenic or marker role for these antibodies in syphilis and in other syndromes in which membrane damage may be a primary event. PMID- 3512435 TI - Role of immune serum and complement in stimulation of the metabolic burst of human neutrophils by Plasmodium falciparum. AB - Interaction between human neutrophils (polymorphonuclear leukocytes [PMN]) and Plasmodium falciparum in the natural defense of the host remains to be elucidated. In patients with acute malaria, oxygen consumption (QO2) of PMN at rest and after stimulation by zymosan was significantly increased compared with that in the controls. With 10% immune serum, both QO2 and chemiluminescence of normal PMN were significantly increased after stimulation by a P. falciparum erythrocyte culture. This activation was not observed with a nonparasitized erythrocyte culture and was correlated with parasitemia. Immune serum and complement were required to trigger this metabolic activation of normal PMN. With normal serum or heat-inactivated immune serum, a parasitized erythrocyte culture did not significantly stimulate QO2 or chemiluminescence of normal PMN. The classical complement pathway was essential for this stimulation, whereas the alternate pathway was less involved. Hyperimmune sera from subjects residing in endemic areas were more able to trigger the metabolic burst than were immune sera from subjects from other sources. The use of synchronous cultures showed that PMN were more stimulated by cultures rich in merozoites than by the same cultures which contained only intraerythrocytic forms. Giemsa staining showed granules of hemozoin and occasional merozoites or parasitized erythrocytes within PMN. This increase in production of activated oxygen radicals could damage intra-or extraphagocytic parasitic forms. As P. falciparum is sensitive to oxidant stress and PMN is the phagocyte with the most intense metabolic burst, the role of PMN in defense against malaria should be considered. PMID- 3512437 TI - Salmonella typhimurium virulence genes necessary to exploit the Itys/s genotype of the mouse. AB - The studies described in this paper provide evidence that the pathogenesis of Salmonella typhimurium in mice is dependent on interactions between particular genotypes of the infected mice and the infecting Salmonella strain. This conclusion was based on data obtained by infecting a panel of BXD recombinant inbred mice with each of three S. typhimurium strains. One of the S. typhimurium strains was a transconjugant (WB500) produced in an interrupted mating between the two other strains, one (SR-11) of high and the other (LT2-Z) of low virulence for BALB/c mice. We found that strain WB500 appeared to have inherited from SR-11 a gene (or genes) which was required to exploit the Itys/s genotype in mice. However, WB500 apparently lacked other SR-11 virulence gene(s), whose effect on the in vivo growth of SR-11 was independent of the Ity genotype of the mouse. PMID- 3512436 TI - Plasmodium berghei sporozoite invasion is blocked in vitro by sporozoite immobilizing antibodies. AB - A monoclonal antibody directed against the circumsporozoite protein on the surface of Plasmodium berghei sporozoites inhibited sporozoite motility in vitro. These immobilized sporozoites could adhere to but not invade target cultured cells. Other sporozoite-immobilizing agents also inhibited sporozoite invasion into cultured cells and did not prevent sporozoite adherence. These results indicate that sporozoite invasiveness is associated with sporozoite motility. Thus, the immobilizing effect of this antibody could explain its functional activity against sporozoite invasion in vivo. PMID- 3512438 TI - Use of a two-sited monoclonal antibody assay to detect a heat-stable malarial antigen in the sera of mice infected with Plasmodium yoelii. AB - Antigens, circulating in the blood during malarial infections, have been implicated in immune protection, immunosuppression, and immune-complex formation. We used a monoclonal antibody (MAb 7H8) to identify an antigen (Ag-7H8) in the sera of mice infected with Plasmodium yoelii. The major form of the antigen has a molecular weight of approximately 120,000 in P. yoelii, with minor components of 220,000; 65,000 to 75,000; and 45,000. Ag-7H8 remains antigenic after boiling for 5 min. A two-sited assay was developed with MAb 7H8 that demonstrated that the Ag 7H8 has at least two similar epitopes per molecule. The two-sited assay was used to follow Ag-7H8 in the blood of mice during lethal (strain 17XL) and nonlethal (strain 17XNL) P. yoelii infections. Ag-7H8 appeared on days 6 and 7 after infection with 10(6) and 10(4) 17XL P. yoelii parasites, respectively, and remained until the animals died. It was in plasma samples between days 6 and 14 after 17XNL P. yoelii injections in several inbred strains of mice, regardless of the course of parasitemia. Thus, the kinetics of antigenemia correspond with early stages of infection and not with the number of circulating parasites. Indirect immunofluorescence assays demonstrated that MAb 7H8 detects a cross reactive antigen in other malarial parasites, including Plasmodium berghei and Plasmodium falciparum. Thus, this two-sited assay may have general application for the serodiagnosis of malaria and may be beneficial in determining the relationship of circulating antigens to malarial immunity. PMID- 3512439 TI - Mimicry of human histocompatibility HLA-B27 antigens by Klebsiella pneumoniae. AB - Anti-HLA-B27 monoclonal antibody M2, which was relatively specific for human histocompatibility antigen HLA-B27, was used to test several bacteria, some of which could potentially induce chronic arthritis in HLA-B27-positive individuals. Using the Western blot procedure, we observed positive reactions with 80,000- and 60,000-dalton antigens with one strain of Klebsiella pneumoniae. Reactivity was not observed with five other monoclonal antibodies which were not reactive with HLA-B27 antigens, nor was reactivity observed with seven other gram-negative bacteria, irrespective of their arthritis-causing potential. To test the validity of our observation, the 80,000-dalton Klebsiella cross-reactive antigen was isolated and used to generate an immune guinea pig serum. We found that the reactivity of this guinea pig serum with Klebsiella envelopes in an enzyme-linked immunosorbent assay was adversely affected by absorption with HLA-B27-positive cells. Our results support the existence of mimicry between HLA-B27 antigens and bacteria. PMID- 3512440 TI - Cell surface hydrophobicity of pigmented and nonpigmented clinical Serratia marcescens strains. AB - The cell surface hydrophobicity of 10 pigmented and 4 nonpigmented clinical Serratia marcescens strains was studied, based on the ability of the strains to adhere to hydrocarbons and to polystyrene. The cell surface hydrophobicity depended greatly on growth temperature; all of the strains tested were adherent following growth at 30 degrees C, whereas none was adherent following growth at 38 degrees C. In previous studies, the pigment prodigiosin has been cited as responsible for cell surface hydrophobicity in various Serratia strains. However, the observed ability of the nonpigmented strains to adhere to the test hydrocarbons and to polystyrene indicates that Serratia strains can possess hydrophobic surface properties in the absence of this pigment. Moreover, strain 1785 cells were adherent whether they were grown at 30 or 36.5 degrees C, even though pigment was not synthesized at the higher temperature. In Escherichia coli correlations have been noted between increased cell surface hydrophobicity and the presence of mannose-specific adhesins; no such relationship was found in the S. marcescens strains tested. The expression of cell surface hydrophobicity in clinical S. marcescens strains at 30 degrees C and the loss of hydrophobicity at host temperatures raise the possibility that infective cells from the environment are initially hydrophobic, but lose this property upon subsequent proliferation within a host. PMID- 3512441 TI - Neutrophil activity in abscess-bearing mice: comparative studies with neutrophils isolated from peripheral blood, elicited peritoneal exudates, and abscesses. AB - Intraabdominal abscesses were induced in mice by intraperitoneal inoculation of Bacteroides fragilis and Escherichia coli plus bran as the abscess-potentiating agent. Six- or seven-day-old abscesses were mechanically disaggregated in buffer, and the cells obtained were fractionated on discontinuous Percoll density gradients. Neutrophil populations of different density, each approximately 90% pure, were isolated. When the abscess-derived neutrophils were subsequently incubated with normal serum in vitro under aerobic conditions, the viability of the gram-negative bacteria that had been phagocytosed within the abscess did not change significantly. This anergy to intracellular bacteria (on subsequent incubation in vitro under optimal conditions for phagocytic killing) was also found for neutrophils that had been obtained from abscesses induced by a mixture that included Proteus mirabilis plus B. fragilis and from those induced by E. coli plus P. mirabilis. While unable to significantly kill intracellular organisms that had been phagocytosed in vivo, the abscess-derived neutrophils could engulf and kill organisms to which they were exposed in vitro. Neutrophils from abscesses induced by P. mirabilis only plus bran killed that organism introduced in vitro significantly more effectively than the organisms that had been engulfed in vivo. In contrast, neutrophils from abscesses induced by the gram-positive organism Staphylococcus aureus plus bran were able to kill their intracellular organisms on subsequent incubation in vitro as effectively as they could kill added S. aureus. Neutrophils isolated from the peripheral blood and from induced peritoneal exudates of abscess-bearing mice were able to phagocytose and kill organisms in vitro with greater efficiency than abscess-derived neutrophils. The mechanism whereby neutrophils from abscesses induced by the gram positive organism S. aureus can kill the organisms phagocytosed in vivo on subsequent in vitro incubation, in contrast to the relative anergy to their intracellular organisms displayed by neutrophils derived from abscesses induced by combinations of gram-negative bacteria, is not known. PMID- 3512442 TI - Characterization of polypeptides in Rickettsia tsutsugamushi: effect of preparative conditions on migration of polypeptides in polyacrylamide gel electrophoresis. AB - The polypeptide compositions and antigenic components of Rickettsia tsutsugamushi were analyzed by modifying the solubilization conditions prior to polyacrylamide gel electrophoresis and by using monoclonal antibodies in immunoblotting experiments. Several polypeptides were converted to larger or smaller molecules by using various conditions for rickettsial sample preparation. Solubilization of a sample in 2-mercaptoethanol-containing buffer resulted in conversion of high molecular-weight polypeptides to smaller polypeptides and conversion of some of the 43-kilodalton (43K) polypeptide to a 46K polypeptide. The heat modifiability of selected polypeptides was shown by heating samples at 100 degrees C. A major polypeptide on the rickettsial surface which showed strain-specific antigenicity appeared at the 43K position in samples solubilized at 37 degrees C but moved to the 56K position after samples were heated at 100 degrees C. Immunoblotting with an anti-56K polypeptide monoclonal antibody demonstrated that the reactive antigens existed predominantly as the higher-molecular-weight polypeptides. These polypeptides were converted to 43K polypeptides at 37 degrees C or the 56K polypeptides at 100 degrees C by cleavage of disulfide linkages with 2 mercaptoethanol treatment. PMID- 3512443 TI - Infection of gnotobiotic pigs with an Escherichia coli O157:H7 strain associated with an outbreak of hemorrhagic colitis. AB - Gnotobiotic pigs inoculated with an Escherichia coli O157:H7 strain isolated from a human with hemorrhagic colitis developed anorexia, lethargy, and watery diarrhea. Bacteria diffusely colonized the cecum and colon surfaces and the crypt epithelium. At bacterial attachment sites, microvilli were effaced, and epithelial cells were irregularly shaped, rounded, or detached. Submucosa, lamina propria, and mesentery were markedly edematous and contained many inflammatory cells. PMID- 3512444 TI - Development of increased serum immunoblot reactivity against a 45,000-dalton polypeptide of Treponema pallidum (Nichols) correlates with establishment of chancre immunity in syphilitic rabbits. AB - Rabbits developed chancre immunity 5.0 to 7.5 weeks after intradermal infection with 10(3) Treponema pallidum (Nichols). The serological response against T. pallidum antigen during this 2.5-week period was examined by Western immunoblotting. Sera from rabbits infected for 5.0 weeks contained antibodies against 7 of 13 major T. pallidum immunogens, with strongest binding detected against a polypeptide of Mr 47,000. By 7.5 weeks of infection, syphilitic rabbit sera recognized 10 of 13 antigens; the most evident increase in serological reactivity was directed against a polypeptide of Mr 45,000, suggesting that the development of a strong serological response against this polypeptide correlated with the onset of chancre immunity. PMID- 3512447 TI - Infertility in the bitch. PMID- 3512445 TI - Aerobactin-mediated iron uptake by Escherichia coli isolates from human extraintestinal infections. AB - A total of 516 strains of Escherichia coli were screened for the presence and expression of the aerobactin iron uptake system. The incidence was markedly higher among clinical isolates from patients with septicemia (68.8%), pyelonephritis (74.6%), and symptomatic (59.8%) and asymptomatic (63.2%) lower urinary tract infections than among normal human fecal isolates (34.3%). PMID- 3512448 TI - Respiratory management of the neurosurgical patient. PMID- 3512446 TI - Biological and chemical characterization of lipopolysaccharide from Selenomonas spp. in human periodontal pockets. AB - Pure lipopolysaccharide extracted from Selenomonas spp. isolated from human periodontal pockets was composed of 23.7% carbohydrate, 16.5% hexosamine, 1.2% 2 keto-3-deoxyoctonate, 0.7% heptose, 26.0% lipid, 1.8% protein, and 1.3% phosphorus. It was shown to be quite lethal, to have very active pyrogenicity, to give a typical biphasic-fever response, and to produce a positive local Shwartzman reaction. PMID- 3512449 TI - Respiratory management of the cardiovascular surgical patient. PMID- 3512450 TI - Upper airway obstruction in infants and children. PMID- 3512451 TI - Hemodynamic effects of pulmonary insufficiency. AB - Although far from complete, this discussion points to the more common relevant hemodynamic sequelae in patients with pulmonary insufficiency. Successful management of these patients requires careful attention to systemic interactions of both the primary pathophysiology and therapeutic interventions. PMID- 3512452 TI - Hyperreactive airway. PMID- 3512453 TI - Acid aspiration: pathophysiological aspects, prevention, and therapy. PMID- 3512454 TI - Care of the airway. PMID- 3512455 TI - High frequency ventilation. PMID- 3512456 TI - Extensive cross reactivity between Treponema pallidum and cultivable treponemes demonstrated by sequential immunoadsorption. AB - Extensive cross reactivity between Treponema pallidum and three nonpathogenic species of treponemes was demonstrated by the Western blot technique. Rabbit antiserum produced by adjuvant immunization with solubilized T. pallidum antigens reacted with 34 T. pallidum antigens and with approximately 30 antigens each of T. phagedenis biotype Reiter, T. noguchii and T. vincentii. Adsorption of the antiserum with T. phagedenis Reiter removed only about half of the cross-reacting antibodies. Sequential adsorption with all three nonpathogenic treponemes removed antibodies to all but three polypeptides of 36,000, 34,000 and 27,000 daltons. PMID- 3512457 TI - Effects of cyclosporin A, antilymphocyte serum and donor-specific transfusions on murine delayed-type hypersensitivity and skin graft survival. AB - The effect of immunosuppressive reagents cyclosporin A (CsA) and rabbit anti mouse antilymphocyte serum (ALS) on the response to alloantigens was studied in inbred mouse strains. Alloantigen was given either as a cell suspension which induced a delayed-type hypersensitivity reaction (DTH), or as a full-thickness skin graft. Dose-response studies showed that DTH reactions in CBA mice sensitised to BALB/c cells were reduced to background levels when recipient mice were treated with 100 mg/kg CsA on days 0, 4 and 6 after primary alloantigenic challenge. The response to a second challenge was significantly decreased by CsA treatment during primary or secondary exposure to alloantigen and CsA was as effective as ALS in abrogating both primary and secondary DTH reactions. Survival of full-thickness grafts of BALB/c skin on CBA mice was increased from 9 to 23 days by ALS treatment on days -1 and +2, with grafts given on day 0. Long-term treatment with CsA, from day -14 to +12, also prolonged graft survival from 9 to 18 days but donor-specific transfusions, with or without concomitant ALS or CsA treatment, decreased graft survival and often sensitised the recipients. This occurred with transfusions administered from -63 to -7 days and on the day of grafting. Thus, in H-2 mismatched mice, both CsA and ALS treatments produced a state of tolerance when administered during short-term exposure to alloantigen.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3512458 TI - The anti-Ro antibody system. PMID- 3512459 TI - Clinical variants of pemphigoid. PMID- 3512460 TI - Chronic bullous dermatosis of childhood in Singapore. AB - Five cases of chronic bullous dermatosis of childhood (CBDC), a rare bullous disease, are presented. Also known as linear IgA bullous dermatitis, it has significant immunofluorescence findings. Treatment with dapsone, 50 mg daily, is recommended. PMID- 3512461 TI - Malathion lotion as an insecticide and ovicide in head louse infestation. AB - A lotion containing 0.5% malathion was compared with its vehicle (control) in a double-blind, parallel-group study of 119 patients with head louse infestations confirmed by live ova in the hair. The lotions remained in place for 8 hours. The test preparation was superior to the control lotion by a highly significant margin (p less than 0.001) as determined by the numbers of patients with live lice at 24 hours and 7 days after removal of the respective materials. It also proved superior to the vehicle (p less than 0.001) as an ovicidal agent, judged by comparative differences in hatching rates between nits collected and incubated before treatment and those obtained and incubated after treatment. No adverse reaction occurred. PMID- 3512462 TI - Historical aspects of herpes simplex infections. Part 1. PMID- 3512463 TI - Donovanosis. Current concepts. PMID- 3512464 TI - Characterization of cleavage products in selected human lutropin preparations. A protease-sensitive site in human lutropin beta subunit. AB - Low molecular weight fragments derived from the beta subunit of human lutropin have been frequently observed. These fragments are detected by polyacrylamide gel electrophoresis in sodium dodecyl sulfate following reduction of the disulfide bonds. A sample of human lutropin was identified that had a major portion of its beta subunit showing this proteolytic nick. Over 83% of the subunit was nicked based on reduction, carboxymethylation, and isolation of the low molecular weight fragments. This preparation had 53% of the activity of an intact human lutropin (radioligand assay). The proteolytic nick in the subunit was shown by N-terminal sequencing of the C-terminal fragments to be derived from three clips in a hexapeptide region (residues 44-49) characterized by hydrophobic alkyl side chains. Specific clips were on the amino side of Leu-45 (8%), Val-48 (45%) and Leu-49 (47%). Thus the proteolytic activity, presumably derived from the pituitary during processing, has a substrate specificity reminiscent of the bacterial protease, thermolysin. PMID- 3512466 TI - Possible prevention of an outbreak of group A streptococcal infection by a prospective epidemiologic approach. PMID- 3512465 TI - Comparative effects of indomethacin and proglumetacin on 6-oxo-PGF1 alpha released ex vivo by rat gastric mucosa. AB - The authors compare the effect of indomethacin and proglumetacin on the production of prostacyclin in the rat gastric mucosa, and investigate the potential ulcerogenic effect elicited by the two drugs. The results show that indomethacin and proglumetacin, at doses giving similar inhibition of gastric protacyclin synthesis, drastically differ in their gastric ulcerogenic effects. PMID- 3512467 TI - Eikenella corrodens. AB - Eikenella corrodens is a microaerophilic gram-negative rod which is a normal inhabitant of human mucosal surfaces, particularly the oral cavity. Although an uncommon cause of infection, it is by no means rare. It is found most often as part of a mixed infection, particularly with streptococci, but is capable of independently causing serious infection in both normal and immunocompromised hosts. Given its slow growth, requirement for hemin when grown aerobically, and preference for CO2 enrichment, it is likely that the involvement of Eikenella in an infection is not always recognized, and it would be prudent to alert the laboratory in situations where isolation of Eikenella is likely (especially in head and neck infections or infected wounds caused by a human bite). Although mixed infections which include Eikenella may resolve with treatment directed at the other infecting organisms, treatment of such infections with antibiotics to which Eikenella is resistant may result in a pure Eikenella infection. Such an outcome may occur, for example, when a human bite wound is treated with clindamycin or metronidazole. Among the oral antibiotics, penicillin, tetracycline, and chloramphenicol are generally effective, whereas cephalexin, dicloxacillin and their relatives are not. Cefoxitin and the third-generation cephalosporins are highly effective against Eikenella. PMID- 3512468 TI - Postkeratoplasty contact lens fitting. PMID- 3512469 TI - Cytophysiology of the adrenal cortex. PMID- 3512470 TI - Distribution of R-cognin in late embryonic and post-hatching chicken retina. AB - The histological distribution of R-cognin in chick retinas was determined from embryonic day 8 through 13 wk post-hatching by indirect immunofluorescence using polyclonal anticognin. On embryonic day 8, at a developmental stage without distinct retina layers, most of the cells within the tissue exhibited fluorescence. By embryonic day 12, when the strata of the retina are delineating and initial synapses are beginning to form, R-cognin fluorescence became concentrated in the nascent ganglion cell, and to a lesser extent, inner nuclear layers. By embryonic day 16 (extending through post-hatching day 26), the staining of R-cognin was specific for the ganglion cell and nerve fiber layers. Fluorescence was prominent on the cell somal membranes but also was present on the processes of these cells at the ganglion cell layer-inner plexiform layer interface. Pre-immune serum and anticognin after preabsorption with R-cognin exhibited no fluorescence. The results demonstrated that the known decrease in R cognin found in the retina during the latter half of embryonic development in the chick is not uniform across the retina, but that R-cognin is preferentially retained on cells within the ganglion cell layer. While cells within the ganglion cell layer also exhibit alpha-bungarotoxin binding, the majority of the latter is found in the inner plexiform layer. Thus, the observations are consistent with a role for R-cognin in the formation or maintenance of functional cell-cell connections within the entire retina prior to developmental day 11, or in retinal ganglion cell layer formation or stability subsequent to embryonic day 11. PMID- 3512471 TI - Biographical sketches--60. MacMunn. PMID- 3512472 TI - Biopsy of intracranial lesions with computed tomography stereotactic guidance. AB - Thirteen cases of deep-seated intracranial lesions that were biopsied by the technique of CT (computed tomography) stereotactic guidance are presented. In 11 cases a diagnosis of brain neoplasm was made. One case of a cystic thalamic astrocytoma was treated by stereotactic insertion of a cannula attached to an s.c. reservoir. There was one complication related to a concomitant ventricular catheter placement. The technique is recommended for diagnosis of deep-seated intracranial lesions, where the risk of a conventional open operative approach is considerable. PMID- 3512473 TI - Pneumaturia: need for diagnostic alertness. AB - Pneumaturia, an air-filled urinary bladder with or without passage of gas in the urine, is a rare phenomenon in the general population, but is more frequent in defined high-risk subgroups. Relevant symptomatology may be hardly noticeable for a relatively long period; however, the outcome may be serious and sometimes fatal. We present three such cases and discuss diagnostic and therapeutic aspects. PMID- 3512474 TI - The renin-angiotensin-aldosterone system in human hepatic cirrhosis. AB - Changes in the renin-aldosterone axis have long been recognized as occurring in patients with liver cirrhosis; different patterns are encountered during the different stages of the disease. Patients in whom ascites has not yet developed usually show depressed plasma renin activity or concentration. The low levels may be due to effective extracellular fluid volume expansion, although this view is not accepted by all authors. According to the overflow theory of ascites formation, sodium retention should occur before the appearance of ascites and, hence, volume expansion should ensue. Since plasma aldosterone concentration is usually normal or even depressed at this stage, increased sodium retention can only be explained by an enhanced renal tubular sensitivity to mineral-corticoid hormone. Mounting evidence suggests that such an abnormality is present in nonascitic patients and progresses as the disease worsens. This abnormality also explains why greater than 50% of patients with ascites and avid renal sodium retention have plasma renin activity and aldosterone within the normal range. In the late stages of the disease, the development of massive compartmentalization of fluid as ascites, along with changes in cardiovascular homeostasis (reduced peripheral resistances, opening of arterovenous shunts, and reduced efficiency of the sympathetic nervous system), lead to striking activation of the renin angiotensin-aldosterone system. The system is responsible for sodium retention and for the maintenance of arterial pressure, and can be involved, at least in part, in reducing renal perfusion. PMID- 3512475 TI - The use of peritoneovenous shunting in unravelling the pathogenesis of ascites in cirrhosis. AB - In a series of studies, peritoneovenous shunting (PVS) has been used to dissect out some of the many factors involved in salt and water retention associated with hepatic ascites. Careful metabolic studies showed that, immediately following PVS, diuresis and natriuresis were associated with a marked rise in cardiac output, renal plasma flow and creatinine clearance, and a significant fall in the elevated serum aldosterone and plasma renin activity to within the normal range. Despite these changes, sodium excretion in these patients remained abnormal when challenged with a high salt diet. In contrast, an immediate increase in water excretion was not associated with a reduction in the elevated antidiuretic hormone (ADH) levels which do, however, decrease to some extent after 2 weeks. Thus, in the long term, these cirrhosis patients will have improved systemic and renal hemodynamics and function and normalization of the renin-aldosterone axis and ADH, yet will still have a "sodium-retaining lesion," the nature of which still needs to be elucidated. PMID- 3512476 TI - Cardiovascular function in obstructive jaundice: experimental observations. AB - Patients with obstructive jaundice are more susceptible to post-operative shock than are nonjaundiced patients. This paper reviews the presently available experimental information, and concludes that jaundice blunts the contractile response of cardiac and vascular smooth muscle to sympathetic stimulation. Moreover, the experimental studies indicate that altered peripheral catecholamine metabolism may account for these attenuated responses. PMID- 3512477 TI - Ultrasonic features of hepatic abscesses. AB - Twelve patients with hepatic abscesses were diagnosed by ultrasound. The ultrasonic features were nonspecific, varying from totally anechoic to echogenic lesions. All the abscesses showed acoustic enhancement. Five of the patients were treated successfully with percutaneous catheter drainage. PMID- 3512478 TI - Contribution of echocardiography to cardiac diagnosis. AB - In order to quantify information provided by echocardiography for residents in internal medicine and for cardiologists, 150 selected patients were studied by echocardiography, and the ultrasonic diagnosis was compared with the clinical evaluation. Among 144 patients with adequate visualization of the heart, echocardiography provided findings that were totally unexpected to the residents in 13 (9%) and to the cardiologist in 9 (6%) patients. Echocardiography also provided information relevant to the management of the patient in another one third of the cases. Both the residents and the cardiologist were able to correctly predict the cause of cardiomegaly and the mechanism of heart failure in most patients presenting with these findings. Despite the introduction of cross sectional echocardiography, the amount of information contributed by echocardiography has not increased since 1978, when a similar study was performed at our institution. This may reflect increased clinical skill among residents, probably due to long-term exposure to echocardiography during their training. PMID- 3512479 TI - Competitive strategy in the hospital industry. AB - Porter recently developed a framework for applying effective strategies in an increasingly competitive business environment. His framework can be adapted to the health care industry and can serve as a tool for success. PMID- 3512480 TI - Oakwood Hospital needs assessment for community health promotion. AB - A survey was conducted to determine community health concerns, interests, and perceived health needs. The survey data were used in the selection of health promotion interventions. An index of Concern/Information Need/Participation Willingness (CIP) was developed as a model for planning, implementing, marketing, and evaluating programs. PMID- 3512481 TI - HCMR interview: Barbara P. McCool. Interview by Montague Brown. PMID- 3512482 TI - [Detection of Chlamydia trachomatis antigen with an enzyme immunoassay]. AB - Urogenital swabs (571) were investigated with a solid-phase enzyme immunoassay for the detection of Chlamydia trachomatis antigen (Chlamydiazyme, Abbott). The results were compared with the conventional cell culture method (McCoy cell culture). Urogenital C. trachomatis infections were diagnosed with the cell culture in 14 of 122 male STD patients (12%), in 12 of 79 female STD patients (15%), in 23 of 89 prostitutes (26%), and in 3 of 115 asymptomatic males (3%). In comparison with cell culture, the sensitivity of Chlamydiazyme for urethral specimens from male STD patients was 86%. In female STD patients, for urethral specimens a sensitivity of 83% was found and for cervical specimens a sensitivity of 80%. The corresponding values for specimens from prostitutes were 60% and 100%, respectively. The specificity of Chlamydiazyme for urethral specimens of male STD patients reached 95%. With respect to urethral and cervical specimens of female STD patients, the specificity was 88% and 82%, respectively, and in prostitutes 92% each. The low specificity in female patients cannot be ascribed only to Chlamydiazyme since, after subcultivation and detection of inclusions by the use of fluorescein-labeled monoclonal antibodies, some of the false-positive Chlamydiazyme results turned out culture positive. This means that the specificity of Chlamydiazyme is actually higher. Because it can be performed rapidly and simply and reaches detection rates approaching those of the cell culture method, the enzyme immunoassay is an improvement in the diagnosis of C. trachomatis infections. PMID- 3512483 TI - Consumer knowledge of Medicare and supplemental health insurance benefits. AB - In this article, data from a recent study funded by the Health Care Financing Administration are used to examine the level of knowledge about health care insurance coverage among Medicare beneficiaries. Two related categories of this knowledge are analyzed: knowledge of the Medicare program itself and knowledge of supplemental health insurance policies owned by program beneficiaries. The results indicate that Medicare beneficiaries typically do not have high levels of knowledge either about Medicare or about their supplemental health insurance. Also analyzed are the factors that affect knowledge levels. PMID- 3512484 TI - The Veterans Administration Northwest Regional Health Services Research and Development Field Program: organization, activities, and early outcomes. AB - In 1982, the Veterans Administration established Health Services Research field programs in each of the six VA regions. Herein, we describe the historical origins, organization, responsibilities, activities, and early accomplishments of one of these programs--the Northwest Regional HSR&D field program. Special reference is made to this program's commitment to health services research relevant to geriatrics and gerontology, including the development of a system wide agenda for research, information syntheses in geriatrics-relevant health services research topics, and the conduct of funded projects pertinent to care of the elderly. The importance of a medical center location for the field programs is discussed, and early indications of institutional impact are described. PMID- 3512485 TI - Collaboration in health services research: on developing relationships between VA researchers and those in other institutions. AB - This article explores the potential for collaboration between investigators in institutions outside of the VA and those engaged in research within the VA. The focus is on the potential for collaborative work in health services research; our perspective is that of researchers in a freestanding HMO research center affiliated with the Veterans Administration's Northwest Health Services Research and Development Field Program. The paper begins with a review of the reasons that make collaboration between VA researchers and other health services researchers so appropriate at this time. An example of collaboration is presented, drawing on the experience of the Northwest Field Program and the Kaiser Permanente Center for Health Research. Finally, some difficulties inherent in collaboration between VA and other health services researchers are discussed. PMID- 3512486 TI - The effectiveness and cost of home care: an information synthesis. AB - The effect of home care on patient outcomes and costs of care has been controversial. This information synthesis summarizes results from studies of home care using experimental or quasi-experimental designs, explicitly including judgments of methodologic soundness in weighing the results. In 12 studies of programs targeted at chronically ill populations, home care services appear to have no impact on mortality, patient functioning, or nursing home placements. Across studies, these services either have no effect on hospitalization or tend to increase the number of hospital days; ambulatory care utilization may be increased by 40 percent. The cost of care either is not affected or is actually increased by 15 percent. The critical need at present is for better-designed studies to test the effects of different types of home care, targeted at various types of patients, on the outcomes assessed in the existing studies, as well as on other important outcomes such as family finances, quality of life, and quality of care. PMID- 3512487 TI - Differential prognosis and utilization patterns among clinical subgroups of hospitalized geriatric patients. AB - While screening elderly inpatients on acute Veterans Administration (VA) hospital wards for a special geriatric program, we prospectively classified all patients age 65 and over, who had been hospitalized at least a week, into five clinical subgroups using specific diagnostic, prognostic, and functional criteria. These five subgroups were "geriatric evaluation unit (GEU) candidate", "severely demented", "medical", "terminal", and "independent". Medical record data from the initial admission and a full year of follow-up were collected from random samples of each subgroup and of nonscreened patients who had been hospitalized for less than a week. Analysis revealed that each subgroup had a distinctive pattern of survival, living location, and use of institutional services during the follow-up period. For one major subgroup ("GEU candidate"), a specific intervention (the GEU) has proved very effective in reducing mortality, increasing patient functioning, improving placement, and decreasing use of institutional services. Moreover, there are specific treatment and intervention strategies appropriate for each of the other subgroups (e.g., hospital-based home care, hospice, respite, and day treatment programs), although these services are not universally available nor clearly proved effective. The process of identifying patient subgroups illustrated in this study may be useful in needs assessment, in planning new intervention programs for frail elderly patients, and for identifying appropriate patients for these programs. PMID- 3512489 TI - Critical care nursing education: an overview. PMID- 3512488 TI - Dental health status of an aging VA population: implications for a preventive dental health care program. AB - The purpose of this study was to describe the sociodemographic characteristics and dental health status of the largest eligible class of veterans (Class IV) within the Greater Miami catchment area. Only 43 percent of 4,882 Class IV patients within this area have sought VA dental care. Sociodemographic data were obtained from a randomized sample of both the VA-treated and non-VA-treated groups. The prevalence and incidence of dental diseases and actual dental treatment procedures completed for the VA-treated sample were determined from clinical records. Results indicated that periodontal disease and dental caries are substantial problems; small groups of patients account for the majority of treatment needs and associated costs; 71 percent of these patients are over 55 years of age; and the "average" Class IV patient is lower middle-class and retired. Study implications suggest that the best strategy for developing an effective VA dental health program would be one in which each patient would have a preventive regimen tailored to meet his needs and the ability to comply with the preventive program. The VA needs to determine the cost-effectiveness and dental health advantages of providing preventive dental health care services to eligible veterans. PMID- 3512490 TI - In-line filtration and infusion phlebitis. PMID- 3512491 TI - The adult respiratory distress syndrome--1986. PMID- 3512492 TI - Minimizing hypoxemia due to endotracheal suctioning: a review of the literature. PMID- 3512493 TI - Profit versus nonprofit: comparisons and considerations. PMID- 3512494 TI - [Traumatology of the midface--diagnostic and therapeutic guidelines for the practicing ENT physician from the viewpoint of the ophthalmologist]. AB - Fractures of the midface combined with orbital injuries endanger vision, binocular vision, and the lacrimal system. The best results of primary surgical management are advised if the surgeon adheres to a strict time schedule. For example, a perforating injury of the eye must be diagnosed as early as possible, and be repaired immediately. Otherwise, all manipulations necessary for reconstruction of the bone and soft tissue of the face worsen the condition of the opened eyeball, including loss of its contents and function. On the other hand, competent repair of the lacrimal system may be done at the end of the operation, and management of disordered eye mobility as seen in the "blow-out" fracture may sometimes be postponed for days or even weeks. The optimal chronological order of diagnostic and surgical management as seen from the ophthalmologist's view is given in tables, and discussed in detail. PMID- 3512496 TI - Annotated bibliography on various gastrointestinal and hepatic disorders. PMID- 3512495 TI - [Principles in the management of comminuted and defect fractures of the mandible]. AB - Advances in definitive primary surgery during peace time and the modern osteosynthesis techniques have contributed to an improvement in the treatment of comminuted and fractures with loss of bone. The procedure for mandibular reconstruction is described. The therapeutic aim is the complete rehabilitation of appearance and function including functional dentures. PMID- 3512497 TI - Viennese Zeitgeist and the economics of Sigmund Freud and the psychology of Austrian economics. PMID- 3512498 TI - The origins and development of Russian psychoanalysis, 1909-1930. PMID- 3512499 TI - [Contraception--with us and others]. PMID- 3512500 TI - 1986 report of the AVMA Panel on Euthanasia. PMID- 3512501 TI - Eikenella corrodens osteomyelitis of the axis in a foal. AB - Eikenella corrodens, a previously unrecognized pathogen in the horse, was isolated from the spinous process of the axis of a colt with signs of severe neck pain. Dorsal laminectomy (excising the infected spinous process and lamina) was performed and the colt was treated with antibiotics for 6 weeks. Recovery was uncomplicated. PMID- 3512502 TI - Clostridium botulinum type B toxicosis in a herd of cattle and a group of mules. AB - Clostridium botulinum type B toxicosis was diagnosed as the cause of generalized weakness and death in a group of cows and mules fed from the same batch of rye silage. One severely affected cow was treated and recovered, as did other less severely affected cows. All affected mules died. The remaining cattle in the herd were then vaccinated before continued feeding of the silage. PMID- 3512503 TI - Effects of cations, polyamines and other aminoglycosides on gentamicin C2. Binding to ribosomes from sensitive and resistant Escherichia coli strains. AB - Gentamicin C2 interacts cooperatively with ribosomes from a sensitive Escherichia coli strain in a multiphasic way with several classes of sites. It is shown that this binding is highly-dependent on Mg++ and natural endogenous polyamine concentrations. The differences observed between ribosomes from sensitive and resistant strains may be explained by the absence of specific cooperative gentamicin interactions with resistant ribosomes. The effects of other aminoglycoside antibiotics are discussed in terms of structure-activity relationships. PMID- 3512504 TI - Outer membrane permeability of imipenem in comparison with other beta-lactam antibiotics. PMID- 3512505 TI - New ansamycin antibiotics, naphthoquinomycins A and B, inhibitors of fatty acid synthesis in Escherichia coli. PMID- 3512506 TI - Improved screening for beta-lactam antibiotics. A sensitive, high-throughput assay using DD-carboxypeptidase and a novel chromophore-labeled substrate. AB - The very sensitive and specific method for the detection of beta-lactam antibiotics using DD-carboxypeptidase (DDCase) from Actinomadura strain R39 has been improved to meet the requirements of a high-throughput beta-lactam screening from culture broths of microorganisms. The method is based on a novel chromophor labeled substrate N alpha-acetyl-N epsilon-4-(7-nitrobenzofurazanyl)-L-lysyl-D-al anyl-D-alanine (ANLA2) which is converted by DDCase into ANLA1 with only one D alanine residue left. Both compounds are intensely yellow as well as highly fluorescent and can be separated by thin-layer chromatography. This allows easy determination of residual DDCase activity after reaction with beta-lactams by simple visual inspection of chromatograms. Also, many assays can be run at a time without sophisticated instrumentation. Details of the method as well as some results of a beta-lactam screening performed with this type of assay are described. PMID- 3512507 TI - Antibiotic prophylaxis in vascular reconstructive surgery: a double-blind placebo controlled study. AB - In a prospective randomized double-blind study of 141 patients referred for reconstructive vascular surgery on the abdominal aorta and the lower extremities, placebo was compared to antibiotic prophylaxis. The prophylaxis group received three doses of a combination of methicillin, 2 g and netilmicin, 200 mg. Antibiotic prophylaxis reduced postoperative wound infections as compared to placebo, i.e. 4/69 (5.8%) vs. 12/72, (16.7%) respectively (P = 0.04). No graft infections occurred. Two cases of postoperative septicaemia were seen in the placebo group, none in the antibiotic group. Among different procedures aortic femoral bypass operations showed the highest wound infection rates. The two treatment groups were comparable with regard to all other postoperative complications registered, including nephro- and ototoxicity. The antibiotic regimen was considered safe, but had only marginal value as prophylaxis in vascular reconstructive surgery on the abdominal aorta and the lower extremities. PMID- 3512508 TI - Beta-lactam antibiotics. PMID- 3512509 TI - Estimation of volume of epithelial lining fluid recovered by lavage using urea as marker of dilution. AB - Bronchoalveolar lavage is a powerful technique for sampling the epithelial lining fluid (ELF) of the lower respiratory tract but also results in a significant dilution of that fluid. To quantify the apparent volume of ELF obtained by bronchoalveolar lavage, urea was used as an endogenous marker of ELF dilution. Since urea diffuses readily through the body, plasma and in situ ELF urea concentrations are identical; thus ELF volume can be calculated using simple dilution principles. Using this approach, we determined that with a standard lavage procedure, the volume of ELF recovered from a normal human is 1.0 +/- 0.1 ml/100 ml of recovered lavage fluid. Time course experiments in which the saline used for lavage was permitted to remain in the lower respiratory tract for various "dwell times" suggested that diffusion of urea from sources other than recovered ELF can contribute to the total urea recovered resulting in an overestimate of the volume of ELF recovered. Thus, while reasonably accurate, the volume of ELF determined by urea must be considered an overestimate, or "apparent" volume. The ELF albumin concentration based on the apparent ELF volume was 3.7 +/- 0.3 mg/ml, a value that is in good agreement with direct measurements made by other techniques in experimental animals. The density of all inflammatory and immune effector cells on the epithelial surface of the lower respiratory tract, based on the apparent ELF volume, was 21,000 +/- 3,000 cells/microliter, a value that is twofold greater than that in blood.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3512510 TI - Effect of prostacyclin on pulmonary vascular response to thrombin in awake sheep. AB - We determined the effects of infusion of prostacyclin (PGI2) and 6-alpha-carba PGI2 (6-cPGI2), a stable PGI2 analogue, on pulmonary transvascular fluid and protein fluxes after intravascular coagulation induced by thrombin. Studies were made in control awake sheep prepared with lung lymph fistulas (n = 6) and in similarly prepared awake sheep pretreated with either 6-cPGI2 (n = 5) or PGI2 (n = 5). Both prostacyclin compounds (500 ng X kg-1 X min-1) were infused intravenously. All groups were challenged with 80 U/kg thrombin. Pulmonary arterial pressure (Ppa), pulmonary vascular resistance (PVR), pulmonary lymph flow (Qlym), lymph protein clearance (Qlym X lymph/plasma protein concentration ratio), and neutrophil and platelet counts were determined. In vitro tests assessed sheep neutrophil chemotaxis and chemiluminescence and platelet aggregation. In both 6-cPGI2 and PGI2 groups, the increases in Qlym after thrombin were less than those in the control group. The increase in lymph protein clearance in the 6-cPGI2 group was the same as that in control, whereas the increase in clearance in the PGI2 group was reduced. PVR and Ppa increased to a greater extent in the 6-cPGI2 group than in the control group, whereas the increases in PVR and Ppa were inhibited in the PGI2 group. Neutrophil and platelet counts decreased after thrombin in PGI2 and 6-cPGI2 groups, as they did in the control group. Neither 6-cPGI2 altered neutrophil chemotaxis induced by thrombin and chemiluminescence induced by opsonized zymosan. Both prostacyclin compounds inhibited platelet aggregation induced by ADP or thrombin.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3512511 TI - Muscle triglyceride utilization during exercise: effect of training. AB - The respiratory exchange ratio (RER) is lower during exercise of the same intensity in the trained compared with the untrained state, even though plasma free fatty acids (FFA) and glycerol levels are lower, suggesting reduced availability of plasma FFA. In this context, we evaluated the possibility that lipolysis of muscle triglycerides might be higher in the trained state. Nine adult male subjects performed a prolonged bout of exercise of the same absolute intensity before and after adapting to a strenuous 12-wk program of endurance exercise. The exercise test required 64% of maximum O2 uptake before training. Plasma FFA and glycerol concentrations and RER during the exercise test were lower in the trained than in the untrained state. The proportion of the caloric expenditure derived from fat, calculated from the RER, during the exercise test increased from 35% before training to 57% after training. Muscle glycogen utilization was 41% lower, whereas the decrease in quadriceps muscle triglyceride concentration was roughly twice as great (12.7 +/- 5.5 vs. 26.1 +/- 9.3 mmol/kg dry wt, P less than 0.001) in the trained state. These results suggest that the greater utilization of FFA in the trained state is fueled by increased lipolysis of muscle triglyceride. PMID- 3512512 TI - Hemodynamic effects of cardiac cycle-specific increases in intrathoracic pressure. AB - Changes in intrathoracic pressure (ITP) can influence cardiac performance by affecting ventricular loading conditions. Because both systemic venous return and factors determining left ventricular (LV) ejection may vary over the cardiac cycle, phasic increases in ITP may differentially affect preload or afterload if delivered at specific points within the cardiac cycle. We studied the hemodynamic effects of cardiac cycle-specific increases in ITP (pulses) delivered by a high frequency jet ventilator in an acute closed-chested canine model (n = 11), using electromagnetic flow probes to measure biventricular stroke volume. Measurements were taken during a control condition after the induction of acute ventricular failure (AVF) by propranolol hydrochloride and volume infusion. ITP was independently varied without changing lung volume by the inflation of thoracoabdominal binders. Although synchronous pulses had minimal hemodynamic effects in unbound controls, binding pulses timed to occur in early diastole resulted in decreases in LV filling pressure and left ventricular stroke volume (SVlv) (P less than 0.05). In the AVF condition, pulses increased LV performance, evidenced by increases in SVlv (P less than 0.01), despite decreases in LV filling pressure (P less than 0.05). This effect is maximized by binding and by timing the pulses to occur in systole. We conclude that cardiac cycle-specific increases in ITP can significantly affect cardiac performance. These effects appear to be related to the ability of such timed pulses to selectively affect LV preload and afterload. PMID- 3512513 TI - A defined medium for and the effect of insulin on the growth, amino acid transport, and morphology of Chinese hamster ovary cells, CHO-K1 (CCL 61) and the isolation of insulin "independent" mutants. AB - Insulin, FeSO4, or transferrin are major requirements together with HEPES buffer and selenium for the growth of CHO-K1 (CCL 61) in a modified F12 medium (M-F12). Insulin stimulates growth at 1 ng/ml to 10 micrograms/ml. In the defined medium minus insulin, CHO-K1 grows slowly as elongated, elliptical cells in parallel arrays typical of normal diploid fibroblasts in contrast to round-to-cuboid cells in loosely overlapping arrays in the presence of serum or insulin. During prolonged incubation in the absence of insulin the cells gather up into a large spherical cluster of viable cells. Insulin "independent" mutants have been isolated whose growth rate during exponential phase in the absence of insulin (48 h to 84 or 96 hrs) is 2.7 to 3.6 times that of the parental culture. Insulin stimulates the growth of these variants only during the first 48 h and is inhibitory at 50 to 500 ng/ml during the exponential phase. Insulin induction of the A system of amino acid transport occurs in about 8 h and requires both protein and RNA synthesis. PMID- 3512514 TI - Effects of peptides and steroid hormones on cell kinetic parameters of normal human breast tissue in organ culture. AB - Several studies have shown the importance of different hormones in the regulation of mammary tissue growth. The use of organ culture techniques has shown tremendous value for the knowledge of cell proliferation in human breast tissue. Therefore, the purpose of these studies was to analyze the length of the cell cycle, DNA-labeling index, mitotic index, and growth fraction under the effects of insulin, hydrocortisone, and 17-beta estradiol in 5-d organ culture. Normal tissues obtained from patients who underwent breast surgery for benign lesions were individually cultured at 37 degrees C (95% air: 5% CO2 in Medium 199). Autoradiographic studies indicated that the hormones shortened the length of cell cycle of normal breast tissue in 5-d organ cultures. From the growth fraction studies we concluded that the hormones may have stimulated the cells to reenter the cell cycle from Go because these values were increased by the hormones used. Estrogen can alter the S phase duration with a consequent increase in the rate of DNA synthesis which may explain the high DNA-labeling index observed in the present studies. PMID- 3512515 TI - Comparison of methodology for determination of ethylene dibromide in grains and grain-based foods. AB - Three commonly used methods for determination of ethylene dibromide (EDB) in grains and grain products have been compared. EDB residues were extracted by soaking in hexane, triple co-distillation with hexane from an aqueous sample solution, and soaking in acetone-water (5 + 1). Each method was used for triplicate analyses of 12 samples containing incurred residues of EDB ranging from about 10 to 1000 ppb and representing whole grains (wheat and oats) and intermediate grain-based products such as corn meal and flour. The 4-day hexane soaking method extracted the least EDB. In some cases, this was half of the amount determined by the other methods. Levels from soaking in acetone-water were equal to, or up to 25% greater than, those from distillation. Although soaking for 2 days is required for whole grains in the method, a period of only 16 h was found acceptable for ground products. Results were obtained faster with the distillation method, but more analyst time per sample was required. A single distillation recovered about 80% (40-60% from wheat) of total EDB extracted by triple distillation. Foaming was reduced by the addition of concentrated H2SO4 to the aqueous hexane-sample mixture, plus stirring during distillation, thereby allowing complete recovery of the hexane. PMID- 3512516 TI - Determination of ethylene dibromide in foods and grains by high resolution capillary gas chromatography with electron capture detection. AB - Ethylene dibromide (EDB) levels in food samples were determined by gas chromatography with a high-resolution capillary column and electron capture detector. The capillary column used was 3 mm id X 25 m cross-linked 5% phenylmethyl silicone. Column temperature was set at 40 degrees C by a coolant containing carbon dioxide gas. Optimum temperatures of the injection port and detector were 200 and 350 degrees C, respectively. The detection limit was 0.5 ppb and linear from 1 to 20 pg on the dynamic range. EDB residues in food samples were extracted with n-hexane by steam distillation. A few impurity peaks appeared near EDB on the chromatogram; however, the EDB peak was resolved. Recoveries of EDB from wheat and brown rice ranged from 66.1 to 99.6%. EDB was detected in 3 samples of imported wheat at a range of 0.74-1.70 ppb, and was not detected at all in 37 samples. The EDB remaining in EDB-fortified cookies after baking was examined. The amounts of EDB were reduced to 30 to 50% of the original amounts by kneading the dough, and to below 1.5% by baking. PMID- 3512517 TI - Inviability of dam recA and dam recB cells of Escherichia coli is correlated with their inability to repair DNA double-strand breaks produced by mismatch repair. AB - The molecular basis for the inviability of dam-3 recA200(Ts) and dam-3 recB270(Ts) cells was studied. The dam-3 recA200(Ts) cells were inviable in yeast extract-nutrient broth or in minimal medium at 42 degrees C. Although the dam-3 recB270(Ts) cells were inviable in yeast extract-nutrient broth at 42 degrees C, they were viable at 42 degrees C in minimal medium, in which the high salt content suppresses the mutant phenotype caused by the recB270(Ts) mutation at 42 degrees C. Under the growth conditions rendering dam rec cells inviable, the cells accumulated double-strand breaks in their DNA. Introduction of a mutL or mutS mutation restored the viability of dam-3 recB270(Ts) cells grown in yeast extract-nutrient broth at 42 degrees C and eliminated the formation of DNA double strand breaks in these cells. We conclude that the inability to repair DNA double strand breaks produced by the mismatch repair process accounts for the inviability of the dam recA and dam recB cells. PMID- 3512518 TI - Processing of Bacillus licheniformis penicillinases lacking a lipoprotein modification site in Escherichia coli. AB - We have previously shown that the penP Ser-27 prepenicillinase is processed into two forms, Ser-35-penicillinase and Asn-29 penicillinase. Two new penicillinase mutants, penP Ser-27 Pro-28 and penP Ser-27,23' (Pro-Asp)24', were derived from the penP Ser-27 mutant by oligonucleotide-directed site-specific mutagenesis. The penP Ser-27 Pro-28 mutant prepenicillinase was also processed into two forms, Ser 35-penicillinase and Gly-26-penicillinase. On the contrary, the penP Ser-27,23' (Pro-Asp)24' mutant prepenicillinase is unprocessed. PMID- 3512519 TI - Construction of an improved D-arabinose pathway in Escherichia coli K-12. AB - A ribitol catabolic pathway was transduced into Escherichia coli K-12 in an effort to determine whether the ribitol pathway would confer an advantage to D arabinose-positive mutants growing on D-arabinose as the sole carbon source. Competition studies in chemostats showed that ribitol-positive strains, with a selection coefficient of 9%/h, have a significant competitive advantage over ribitol-negative strains. Ribitol-positive strains grown in batch culture also exhibited a shorter lag period than did ribitol-negative strains when transferred from glucose to D-arabinose. Repeated transfer of a ribitol-positive strain of E. coli K-12 on D-arabinose yielded a strain with further improved growth on D arabinose. This "evolved" strain was found to constitutively synthesize L-fucose permease, isomerase, and kinase but had lost the ability to grow on L-fucose, apparently owing to the loss of a functional aldolase. This constitutive mutation is not linked to the fucose gene cluster and may be similar to an unlinked constitutive mutation described by Chen et al. (J. Bacteriol. 159:725-729, 1984). PMID- 3512520 TI - Properties of an ordered ring structure formed by recombinant Treponema pallidum surface antigen 4D. AB - Ultrastructural and biochemical studies of a recombinant Treponema pallidum surface antigen designated 4D have been conducted due to its likely biological significance. Electron microscopy demonstrated that the 190-kilodalton (kDa) 4D molecule is an ordered ring structure of 10-nm diameter. The 90-kDa proteinase K treated 4D is an ordered ring structure of 6-nm diameter. Evidence is presented that the 190-kDa ordered ring is maintained by noncovalent bonds; 19-kDa monomers can reassociate in vitro to reform a 190-kDa molecule. Amino acid composition analysis of 190-kDa 4D showed that the molecule is composed of 45% hydrophobic residues. Evidence relating the structure of the 4D ordered ring to its potential role in the pathogenesis of syphilis is discussed. PMID- 3512521 TI - Autoregulation by tandem promoters of the Salmonella typhimurium LT2 metJ gene. AB - Regulation of the Salmonella typhimurium metJ gene was examined by measuring beta galactosidase activity in Escherichia coli strains lysogenic for a phage carrying a metJ-lacZ gene fusion. The results indicated that the metJ gene is regulated by its own gene product and by methionine supplementation to the growth medium. This autoregulatory mechanism involved two tandem promoters, pJ1 and pJ2, separated by approximately 65 base pairs. Deletion analysis permitted the assessment of the activity of promoters pJ1 and pJ2 individually. Promoter Pj1 was negatively regulated by the metJ gene product and by methionine. Although Pj2 regulation remained unclear, evidence is presented which suggests that it is not negatively regulated like pJ1. PMID- 3512522 TI - Defect in expression of heat-shock proteins at high temperature in xthA mutants. AB - Escherichia coli mutants lacking exonuclease III (xthA) are defective in the induction of heat-shock proteins upon severe heat-shock treatment (upshift from 30 to 50 degrees C) but not mild heat-shock treatment (upshift from 30 to 42 degrees C). We show that this defect is due to the xthA mutation by complementation. Furthermore, increasing the gene dosage of xthA+ prolongs the synthesis of heat shock proteins seen after a shift to 42 degrees C. Increasing the gene dosage of htpR+ partially suppresses the defect of xthA mutants in the synthesis of heat-shock proteins at 50 degrees C. When an xthA strain was incubated at 42 degrees C before a shift to 50 degrees C, it was then able to carry out the synthesis of heat-shock proteins at 50 degrees C. PMID- 3512523 TI - Oxygen-regulated stimulons of Salmonella typhimurium identified by Mu d(Ap lac) operon fusions. AB - Using the technique of Mu d1(Ap lac)-directed lacZ operon fusions, several oxygen regulated genetic loci were identified in Salmonella typhimurium. Thirteen anaerobically inducible and six aerobically inducible operon fusions were identified. Based on control by the oxrA and oxrB regulatory loci, the anti-lacZ fusions were grouped into three classes: class I loci were regulated by both oxr loci, class II genes were regulated by oxrA only, and class III loci were not affected by either regulatory locus. Several of the anti-lacZ fusions required growth in complex medium before they exhibited the inducible phenotype. While the expression of some of these loci was repressed when organisms were grown in nitrate, others were stimulated by nitrate. Fusions into the hyd and phs loci were identified among the isolated anti-lacZ fusions. Six oxygen-inducible (oxi) operon fusions were also identified. Two of the oxi loci mapped near oxygen regulatory loci: oxiC near oxrA and oxiE near oxyR. However, neither fusion appeared to occur within the regulatory locus. The data presented serve to further define the aerobic and anaerobic stimulons of S. typhimurium but indicate additional regulatory circuits above those already defined. PMID- 3512524 TI - Cloning in Escherichia coli K-12 of a Na+-dependent transport system from a marine bacterium. AB - The transport of D-alanine by Escherichia coli K-12 neither requires nor is stimulated by Na+. The transport of D-alanine by the marine bacterium Alteromonas haloplanktis 214 requires Na+ specifically. Mutants of E. coli which were unable to transport D-alanine were isolated by enrichment for D-cycloserine resistance. One of the mutants was transformed with a gene bank of A. haloplanktis chromosomal DNA. Two transformants, E. coli RM1(pPM1) and E. coli RM1(pPM2) were able to transport D-alanine by a Na+-dependent mechanism. Li+ and K+ were unable to replace Na+. Both transformants contained chimeric plasmids with inserts which hybridized with A. haloplanktis but not E. coli chromosomal DNA or each other. Despite the lack of homology between the inserts, Na+-dependent D-alanine transport in the two transformants could not be distinguished either by kinetic studies or by differences in the capacity of various amino acids to compete for D alanine uptake. PMID- 3512525 TI - Choline-glycine betaine pathway confers a high level of osmotic tolerance in Escherichia coli. AB - Glycine betaine and its precursors choline and glycine betaine aldehyde have been found to confer a high level of osmotic tolerance when added exogenously to cultures of Escherichia coli at an inhibitory osmotic strength. In this paper, the following findings are described. Choline works as an osmoprotectant only under aerobic conditions, whereas glycine betaine aldehyde and glycine betaine function both aerobically and anaerobically. No endogenous glycine betaine accumulation was detectable in osmotically stressed cells grown in the absence of the osmoprotectant itself or the precursors. A membrane-bound, O2-dependent, and electron transfer-linked dehydrogenase was found which oxidized choline to glycine betaine aldehyde and aldehyde to glycine betaine at nearly the same rate. It displayed Michaelis-Menten kinetics; the apparent Km values for choline and glycine betaine aldehyde were 1.5 and 1.6 mM, respectively. Also, a soluble, NAD dependent dehydrogenase oxidized glycine betaine aldehyde. It displayed Michaelis Menten kinetics; the apparent Km values for the aldehyde, NAD, and NADP were 0.13, 0.06, and 0.5 mM, respectively. The choline-glycine betaine pathway was osmotically regulated, i.e., full enzymic activities were found only in cells grown aerobically in choline-containing medium at an elevated osmotic strength. Chloramphenicol inhibited the formation of the pathway in osmotically stressed cells. PMID- 3512526 TI - Selection, mapping, and characterization of osmoregulatory mutants of Escherichia coli blocked in the choline-glycine betaine pathway. AB - Osmotically stressed Escherichia coli cells synthesize the osmoprotectant glycine betaine by oxidation of choline through glycine betaine aldehyde (choline--- glycine betaine aldehyde----glycine betaine; B. Landfald and A.R. Strom, J. Bacteriol. 165:849-855, 1986. Mutants blocked at the level of choline dehydrogenase were isolated by selection of strains which did not grow at elevated osmotic strength in the presence of choline but grew when supplemented with glycine betaine. A gene governing the choline dehydrogenase activity was named betA. Mapping by P1 transduction, F' complementation, and deletion mutagenesis showed the betA gene to be located at 7.5 min in the argF-codAB region of the chromosome. Mutants carrying deletions of this region also lacked glycine betaine aldehyde dehydrogenase activity and high-affinity uptake activity for choline; these deletions did not influence the activities of glycine betaine uptake or low-affinity choline uptake, both of which were osmotically regulated. PMID- 3512527 TI - Plasmid inheritability and biomass production: comparison between free and immobilized cell cultures of Escherichia coli BZ18(pTG201) without selection pressure. AB - Maintenance of the plasmid pTG201 in Escherichia coli BZ18 was studied for both free and immobilized cells during chemostat culture, in the absence of the antibiotic against which resistance was plasmid encoded. Electron microscopic observations of immobilized proliferant cells within carrageenan gel beads showed high cell concentrations and growth into distinct cavities. The plasmid which coded for the catechol 2,3-dioxygenase activity was stably maintained during 80 generations in the case of immobilized cells. A theoretical analysis founded on the compartmentalization resulting from the immobilized growth conditions was described. However, the model still showed a plasmid stability inferior to that determined experimentally. Hypotheses dealing with physiological changes of immobilized cells were presented. In addition, the high cell concentrations obtained in the outer 50 microns of the carrageenan gel beads gave a biomass productivity within this useful volume which was 20 times higher than in free cell cultures. PMID- 3512528 TI - Acquisition of maltose chemotaxis in Salmonella typhimurium by the introduction of the Escherichia coli chemosensory transducer gene. AB - Escherichia coli and Salmonella typhimurium are closely related species. However, E. coli cells show maltose chemotaxis but S. typhimurium cells do not. When an E. coli chemotransducer gene (tarE), the product of which is required for both aspartate and maltose chemotaxis, was introduced by using a plasmid vector into S. typhimurium cells with a defect in the corresponding gene (tarS), the transformant cells acquired the ability for both aspartate and maltose chemotaxis. In contrast, when the tars gene was introduced into tarE-deficient E. coli cells, the transformant cells acquired aspartate chemotaxis but not maltose chemotaxis. These results indicate that the absense of maltose chemotaxis in S. typhimurium is a consequence of the properties of the tars gene product. PMID- 3512529 TI - Direct role of the Escherichia coli Dam DNA methyltransferase in methylation directed mismatch repair. AB - The T4 dam+ gene has been cloned (S. L. Schlagman and S. Hattman, Gene 22:139 156, 1983) and transferred into an Escherichia coli dam-host. In this host, the T4 Dam DNA methyltransferase methylates mainly, if not exclusively, the sequence 5'-GATC-3'; this sequence specificity is the same as that of the E. coli Dam enzyme. Expression of the cloned T4 dam+ gene suppresses almost all the phenotypic traits associated with E. coli dam mutants, with the exception of hypermutability. In wild-type hosts, 20- to 500-fold overproduction of the E. coli Dam methylase by plasmids containing the cloned E. coli dam+ gene results in a hypermutability phenotype (G.E. Herman and P. Modrich, J. Bacteriol. 145:644 646, 1981; M.G. Marinus, A. Poteete, and J.A. Arraj, Gene 28:123-125, 1984). In contrast, the same high level of T4 Dam methylase activity, produced by plasmids containing the cloned T4 dam+ gene, does not result in hypermutability. To account for these results we propose that the E. coli Dam methylase may be directly involved in the process of methylation-instructed mismatch repair and that the T4 Dam methylase is unable to substitute for the E. coli enzyme. PMID- 3512530 TI - Transport of p-nitrophenyl-alpha-maltoside by the maltose transport system of Escherichia coli and its subsequent hydrolysis by a cytoplasmic alpha maltosidase. AB - In wild-type Escherichia coli the activity of the maltose transport system is dependent on a periplasmic maltose-binding protein. It has been possible, however, to isolate mutants in which transport activity is mediated by the membrane components of the system and is no longer dependent on the periplasmic binding protein. In this manuscript we show that in these binding protein independent strains, p-nitrophenyl-alpha-maltoside is a potent inhibitor of maltose transport. In contrast, p-nitrophenyl-alpha-maltoside is only a weak inhibitor of maltose transport in wild-type bacteria. In addition, we show that p nitrophenyl-alpha-maltoside is transported by the binding protein-independent strains but not by wild-type bacteria. We were able to detect transport of this compound because there is a cytoplasmic enzyme that cleaves p-nitrophenyl-alpha maltoside. This enzyme has not previously been described. We show that although the synthesis of this enzyme is subject to the same regulation as the components of the maltose regulon, and is MalT dependent, it is not coded for by a known mal gene. We refer to this enzyme as alpha-maltosidase. These results strengthen our proposal that the membrane components of the maltose transport system comprise a recognition site for maltose and related substrates. PMID- 3512531 TI - In vitro biosynthesis and membrane association of photosynthetic reaction center subunits from Rhodopseudomonas sphaeroides. AB - The reaction center of Rhodopseudomonas sphaeroides is an integral membrane protein complex responsible for primary photochemical charge separation in photosynthesis. We report the synthesis of two of the three subunits of the photosynthetic reaction center using a DNA-directed in vitro transcription translation system prepared from R. sphaeroides. The in vitro-synthesized polypeptides, as resolved by sodium dodecyl sulfate-polyacrylamide gel electrophoresis, had apparent Mrs of 24,000 and 21,000 and were shown to be synthesized in equimolar amounts. This corresponds precisely to the in vivo reaction center subunits M and L, respectively. The in vitro-synthesized polypeptides were immunoprecipitated with antibody prepared against whole native reaction centers. In addition, the identity of the in vitro-synthesized polypeptides as L and M was verified by comparing the protease digestion products of in vivo- with in vitro-synthesized reaction center subunits. Both of the in vitro-synthesized polypeptides were also found to partition with the particulate material in the transcription-translation system and to associate with added membranes. PMID- 3512532 TI - S-methyl glutathione synthesis is catalyzed by the cheR methyltransferase in Escherichia coli. AB - The cheR methyltransferase, known to be necessary for the methyl esterification of receptors involved in chemotaxis, is shown to be essential to the synthesis of S-methyl glutathione from glutathione and S-adenosylmethionine in intact Escherichia coli. S-Methyl glutathione is not, however, found to be essential for chemotaxis. It is suggested that the synthesis of S-methyl glutathione may be due to a "parasitic" reaction of glutathione with S-adenosylmethionine bound to the methyltransferase. PMID- 3512533 TI - Genetic analysis of Bacillus stearothermophilus by protoplast fusion. AB - Efficient and reliable protoplasting, regeneration, and fusion techniques were established for the prototrophic strain Bacillus stearothermophilus NUB36. Auxotrophic mutants were isolated, and protoplast fusion was used to construct isogenic mutant strains and for chromosomal mapping. Markers were mapped using two-, three-, and four-factor crosses. The order of the markers was hom-1-thr-1 his-1-(gly-1 or gly-2)-pur-1-pur-2. These markers may be analogous to hom, thrA, hisA, glyC, and purA markers on the Bacillus subtilis chromosome. No analogous pur-1 marker has been reported in B. subtilis. The relative order of three of the markers (hom-1-thr-1-gly-1) was independently confirmed by transduction. PMID- 3512534 TI - Agoraphobia: relative and combined effectiveness of therapist-assisted in vivo exposure and imipramine. AB - Sixty-two chronically agoraphobic patients completed a controlled study to assess the effects of 1) imipramine up to 200 mg/day (mean = 130 mg/day), 2) 12 weekly therapist-assisted in vivo exposure sessions (flooding), and 3) imipramine plus flooding. The control group received systematic therapeutic instructions for self directed in vivo exposure (programmed practice). Clinical measures of global severity, phobia, panic, anxiety, depression, and behavioral performance tests were administered before treatment and at Weeks 4, 8, and 12 of treatment. Results revealed significant improvement in all groups on all measures over the course of treatment; almost a third of the control patients showed marked improvement. Imipramine had significant effects on improvement of phobias and markedly increased clinical response rates in patients receiving 150-200 mg/day. Less chronicity and severity of condition also predicted better clinical outcome. Flooding had limited effects above and beyond programmed practice, and no imipramine-flooding interactions effects were found. PMID- 3512535 TI - A comparison of parenteral loxapine and haloperidol in hostile and aggressive acutely schizophrenic patients. AB - In a parallel groups, double-blind study, 54 acutely psychotic schizophrenics were given loxapine or haloperidol parenterally for 24 to 72 hours, then orally for a total study period of up to 10 days. Dosage ratios of loxapine to haloperidol ranged from a minimum of 2.7:1 to a maximum of 4.4:1. Both groups showed significant and rapid improvement from baseline. Forty-eight percent of the loxapine patients and 33% of the haloperidol patients achieved and maintained a global severity of illness rating of mild or better. By the end of the study, 84% of the loxapine patients and 63% of the haloperidol patients had achieved an improvement rating of moderate or marked. This difference approached significance (p less than .10). The most frequently reported adverse experiences were dystonic reactions and akathisia. The number and severity of adverse experiences did not differ significantly between drug groups. Intramuscular loxapine was at least as effective as haloperidol in the initial management of hostile and aggressive schizophrenic patients. The maintenance of therapeutic response after conversion to oral concentrate was comparable with the two drugs. PMID- 3512536 TI - Protein PSII-G. An additional component of photosystem II identified through its plastid gene in maize. AB - An unidentified open reading frame, 248 or 255 amino acids in length, on the maize chloroplast DNA fragment Bam5 was sequenced. It encodes a protein which contains a high proportion of hydrophilic amino acids, of which 22% are hydroxylated, interrupted by hydrophobic domains. A synthetic peptide corresponding to a hydrophilic sequence was used to generate antibodies. Western blots of photosystem I and II complexes prepared from maize and spinach thylakoids indicate that the psbG gene product is a membrane-associated protein of the photosystem II complex that migrates as a 24-kDa species on polyacrylamide gel electrophoresis. PMID- 3512537 TI - A new mechanism of plasmid trimethoprim resistance. Characterization of an inducible dihydrofolate reductase. AB - The dihydrofolate reductase encoded by plasmid pUK1123, which confers only a moderate level of trimethoprim resistance on its host, has been isolated and characterized. This enzyme, designated type IV, differs markedly from all previously described plasmid dihydrofolate reductases. It has a relatively high molecular weight of 46,700 as measured by gel filtration and, unlike previous plasmid dihydrofolate reductases, its synthesis is induced in the presence of increasing concentrations of trimethoprim. It is only slightly resistant to trimethoprim but is competitively inhibited by this drug with an inhibitor binding constant of 63 nM. In addition, the enzyme has a relatively low affinity for the substrate, dihydrofolate (Km = 37 microM). This is the first report of a plasmid trimethoprim resistance mechanism resulting from the induced synthesis of a large molecular weight dihydrofolate reductase which is only slightly resistant to trimethoprim. The possible origins of the type IV enzyme are discussed. PMID- 3512538 TI - Negative control of yeast coproporphyrinogen oxidase synthesis by heme and oxygen. AB - Coproporphyrinogen oxidase (EC 1.3.3.3.) catalyzes the sixth enzymic step of the heme biosynthetic pathway. Coproporphyrinogen oxidase activity is increased in mutant cells of Saccharomyces cerevisiae deficient in heme synthesis and this effect can be partially reversed by the addition of exogenous hemin. A similar increase is found in wild type yeast cells grown anaerobically. The strain dependent increase varies between 5- and 40-fold. The activity changes are paralleled by similar changes in the steady-state amounts of coproporphyrinogen oxidase protein determined by immunoblotting and the steady-state concentrations of coproporphyrinogen oxidase mRNA estimated by in vitro translation/immunoprecipitation. This demonstrates that coproporphyrinogen oxidase synthesis is regulated by heme and oxygen at a pretranslational level in a negative fashion. PMID- 3512539 TI - A requirement for calcium in the transport of cobalamin across the outer membrane of Escherichia coli. AB - Cobalamin (Cbl) transport across the outer membrane of cells of Escherichia coli consists of high affinity Cbl binding to the btuB protein of the Cbl receptor, followed by the proton motive force- and tonB-dependent release of the Cbl into the periplasmic space. During a search for experimental conditions that would mimic this release in vitro with isolated cell envelope particles, we found that calcium was required for the high affinity Cbl binding, and subsaturating calcium concentrations resulted in the decreased affinity of the Cbl receptor for Cbl. The apparent affinity of the Cbl receptor for calcium (KD, approximately 30 nM at pH 6.6) decreased with decreasing pH, resulting in decreased affinity for Cbl at lower pH values. With suboptimal levels of calcium, Cbl binding was decreased by millimolar levels of magnesium. PMID- 3512541 TI - Paramagnetically shifted resonances in 1H NMR spectra of ribonucleotide reductase from Escherichia coli. AB - The 400-MHz 1H NMR spectra of the subunit B2 of ribonucleotide reductase from Escherichia coli show paramagnetically shifted resonances at 24 ppm (exchangeable protons) and at 19 ppm (nonexchangeable protons). The protein contains an antiferromagnetically coupled dimeric iron center and a tyrosyl free radical. The paramagnetically shifted resonances must be due to the iron center, since they remain essentially unchanged in protein B2 with and without free radical. In analogy with recently published results for hemerythrin from Phascolopsis gouldii, which has a similar iron center, the 24-ppm resonance is suggested to arise from histidine ligands to the iron ions. PMID- 3512540 TI - Solubilization and functional reconstitution of the proline transport system of Escherichia coli. AB - The membrane carrier for L-proline (product of the putP gene) of Escherichia coli K12 was solubilized and functionally reconstituted with E. coli phospholipid by the cholate dilution method. The counterflow activity of the reconstituted system was studied by preloading the proteoliposomes with either L-proline or the proline analogues: L-azetidine-2-carboxylate or 3,4-dehydro-L-proline. The dilution of such preloaded proteoliposomes into a buffer containing [3H]proline resulted in the accumulation of this amino acid against a considerable concentration gradient. A second driving force for proline accumulation was an electrochemical potential difference for Na+ across the membrane. More than a 10 fold accumulation was seen with a sodium electrochemical gradient while no accumulation was found with proton motive force alone. The optimal pH for the L proline carrier activities for both counterflow and sodium gradient-driven uptake was between pH 6.0 and 7.0. The stoichiometry of the co-transport system was approximately one Na+ for one proline. The effect of different phospholipids on the proline transport activity of the reconstituted carrier was also studied. Both phosphatidylethanolamine and phosphatidylglycerol stimulate the carrier activity while phosphatidylcholine and cardiolipin were almost inactive. PMID- 3512542 TI - The role of cell surface sialic acid in insulin receptor function and insulin action. AB - Removal of cell surface sialic acid from adipocytes with neuraminidase inhibits insulin action. Here, we have examined the effects of mild neuraminidase treatment (5 milliunits/ml, 12 degrees C, 15 min) on insulin receptor structure and function. Neuraminidase treatment sufficient to cause greater than 90% loss of insulin stimulatable lipogenesis had no effect on 125I-insulin binding, tyrosine kinase activity of partially purified insulin receptors, insulin receptor phosphorylation in intact cells, or insulin-induced receptor internalization. However, recycling of the insulin receptor to the plasma membrane was inhibited by 50%. Recycled receptors in neuraminidase-treated cells were unable to mediate insulin action in contrast to recycled receptors from non neuraminidase-treated cells. Furthermore, when insulin receptors were protected from exposure to neuraminidase, by inducing receptor internalization prior to neuraminidase treatment, the cells were still unable to respond to insulin. Analysis of the alpha and beta subunits of the receptor from neuraminidase treated cells, affinity-labeled with 125I-insulin, or labeled by autophosphorylation, and subjected to sodium dodecyl sulfate-polyacrylamide gel electrophoresis failed to indicate any changes in the holoreceptor or the individual subunits. This suggests there was no detectable release of sialic acid from the receptor. From this data we conclude that loss of sialic acid from nonreceptor glycoconjugates leads to loss of insulin action and inhibition of receptor recycling. The insulin receptor does not appear to be involved in this inhibitory effect. These findings suggest that an uncharacterized plasma membrane glycoprotein is essential in transmitting the "signal" of insulin binding to the cellular effector system. PMID- 3512543 TI - Partial purification and characterization of the Saccharomyces cerevisiae transcription factor TFIIIB. AB - Methods are described for the partial purification of the Saccharomyces cerevisiae class III gene transcription factor TFIIIB from yeast whole cell extracts. A major component (30% of the total protein) of our most highly purified TFIIIB preparation was a polypeptide with an apparent Mr = 60,000 when analyzed by denaturing polyacrylamide gel electrophoresis. This protein was purified by preparative sodium dodecyl sulfate-polyacrylamide gel electrophoresis, and polyclonal antibodies were raised against it. Using immunological methods it was shown that TFIIIB transcription factor activity was associated with this purified polypeptide. Furthermore, the polyclonal sera raised against the yeast TFIIIB polypeptide was also shown to specifically neutralize the activity of the human TFIIIB equivalent when it was added to a human KB cell S-100 in vitro transcription system. PMID- 3512544 TI - In vitro transcription and promoter strength analysis of five mitochondrial tRNA promoters in yeast. AB - The in vitro transcriptional initiation sites of four yeast mitochondrial tRNA genes have been investigated in a run-off transcription assay. Precise initiation originating within the 9-nucleotide mitochondrial promoter sequence was detected for the phenylalanine, initiator formyl methionine, cysteine, and one of the two threonine tRNA genes. The relative promoter strength of each of these tRNA promoters as well as that for the previously described glutamate tRNA promoter was determined in a competition assay. This assay measured the utilization of a particular tRNA promoter relative to the amount of transcription arising from a control 14 S rRNA promoter present in the same reaction. The competition strength of the tRNAPhe, tRNAMetf, and tRNAGlu promoters is 20-fold greater than that for the tRNAThrACN and tRNACys promoters. Comparison of the nucleotide sequences at the +2 and +3 positions in the transcripts reveals a homology among the strong promoters not duplicated in the weak promoters. PMID- 3512545 TI - Saccharomyces cerevisiae tRNA ligase. Purification of the protein and isolation of the structural gene. AB - The tRNA ligase protein of Saccharomyces cerevisiae is one of the components required for splicing of yeast tRNA precursors in vitro. We have purified this protein to near homogeneity using an affinity elution chromatographic step. Purified tRNA ligase is a 90-kDa protein that, in addition to catalyzing the ligation of tRNA half-molecules in the coupled splicing reaction, will also ligate an artificial substrate. Using this artificial substrate, we provide evidence for the existence of a previously predicted activated intermediate in the ligation reaction. The amino acid sequence of the amino-terminal end of the protein was determined, and we have used this information to isolate the structural gene from a library of yeast DNA. We prove that this DNA encodes the tRNA ligase protein by DNA sequencing and by demonstrating overproduction of the protein. PMID- 3512546 TI - Insulin antagonizes epinephrine activation of the membrane transport of fatty acids. Potential site for hormonal suppression of lipid mobilization. AB - Membrane transport of long chain fatty acids in the isolated rat adipocyte can be strongly stimulated by epinephrine (Abumrad, N. A., Perry, P. R., and Whitesell, R. R. (1985) J. Biol. Chem. 260, 9969-9971). We now report that insulin at physiological concentrations can completely block or reverse the epinephrine effect. Insulin was optimally effective at a concentration of about 0.1 nM in inhibiting transport activation by 0.3 and 3 microM epinephrine (0.1 and 1.0 microgram/ml). High concentrations of insulin (above 1 nM) were generally less effective and this was particularly true at the highest dose of epinephrine (1.0 microgram/ml). The insulin effect was shown to be on the transport process since insulin inhibited epinephrine activation of transport in both directions (influx and efflux). No effect of insulin on basal transport was observed over a wide range of concentrations (0.01-10 nM). Insulin's antagonism of transport activation by epinephrine appeared dependent on ATP metabolism since it was abolished by preincubating the cells with dinitrophenol (1 mM). Dinitrophenol, however, could not reverse the insulin effect when exposure to the hormone preceded that to dinitrophenol, consistent with an action of insulin at the transport step. The data indicate that regulation of the membrane transport of fatty acids is a potential site for insulin's action to suppress lipid mobilization. PMID- 3512547 TI - Communication between polypeptide chains in aspartate transcarbamoylase. Conformational changes at the active sites of unliganded chains resulting from ligand binding to other chains. AB - A largely inactive derivative of the catalytic subunit of Escherichia coli aspartate transcarbamoylase containing trinitrophenyl groups on lysine 83 and 84 was used to study communication between polypeptide chains in the holoenzyme and the isolated catalytic trimers. Addition of native regulatory dimers to the derivative yielded a holoenzyme-like complex of low activity which exhibited sigmoidal kinetics and was inhibited by CTP and activated by ATP. The binding of CTP and ATP to the regulatory subunits caused significant and opposite changes in the absorption spectrum resulting from changes in the environment of the sensitive chromophores at the active sites. In allosteric hybrid molecules containing one native and one trinitrophenylated catalytic subunit, along with native regulatory subunits, the binding of a bisubstrate analog, N (phosphonacetyl)-L-aspartate, to the native catalytic subunit resulted in a perturbation of the spectrum of the chromophore on the unliganded modified chains. Thus the conformational changes associated with the allosteric transition responsible for both heterotropic and homotropic effects are propagated from the sites of ligand binding to the active sites of unliganded distant chains. In addition to the communication from regulatory chains to catalytic chains and the cross-talk from one catalytic subunit to the other, communication between individual catalytic chains in isolated trimers was also demonstrated. By constructing hybrid trimers containing one trinitrophenylated chain and two native chains, we could detect a change in the environment of the chromophore upon the binding of the bisubstrate analog to the native chains. PMID- 3512548 TI - Molecular cloning and sequence analysis of human placental alkaline phosphatase. AB - The complete amino acid sequence of the precursor and mature forms of human placental alkaline phosphatase have been inferred from analysis of a cDNA. A near full-length PLAP cDNA (2.8 kilobases) was identified upon screening a bacteriophage lambda gt11 placental cDNA library with antibodies against CNBr fragments of the enzyme. The precursor protein (535 amino acids) displays, after the start codon for translation, a hydrophobic signal peptide of 21 amino acids before the amino-terminal sequence of mature placental alkaline phosphatase. The mature protein is 513 amino acids long. The active site serine has been identified at position 92, as well as two putative glycosylation sites at Asn122 and Asn249 and a highly hydrophobic membrane anchoring domain at the carboxyl terminus of the protein. Significant homology exists between placental alkaline phosphatase and Escherichia coli alkaline phosphatase. Placental alkaline phosphatase is the first eukaryotic alkaline phosphatase to be cloned and sequenced. PMID- 3512549 TI - Guanosine 5'-O-(3-thiotriphosphate) as an analog of GTP in protein biosynthesis. The effects of temperature and polycations on the accuracy of initial recognition of aminoacyl-tRNA ternary complexes by ribosomes. AB - Guanosine 5'-O-(3-thio)triphosphate (GTP gamma S) is a good analog of GTP in the reactions leading to the formation of a peptide bond in protein biosynthesis. It forms binary and ternary complexes with elongation factor Tu (EF-Tu), and with EF Tu and aminoacyl-tRNA (aa-tRNA). In addition, it stimulates aa-tRNA binding to ribosomes. Although GTP gamma S hydrolysis is more than three orders of magnitude slower than GTP hydrolysis, both reactions are dependent on the formation of a noncovalent complex (RS X TC) between mRNA-programmed ribosomes and ternary complex, and the complexes resulting from that hydrolysis are intermediates in peptide formation. The rate of dissociation of the ribosome X EF-Tu X GTP gamma S X aa-tRNA complex was determined from the rate of labeled peptide formation in the presence of an unlabeled ternary complex chase. This rate (2.2 X 10(-3) s-1) is similar to that determined previously (Thompson, R.C., and Karim, A.M. (1982) Proc. Natl. Acad. Sci. U.S.A. 79, 4922-4926) from the progress of GTP gamma S hydrolysis. The effects of temperature and polycation concentration on this rate constant and that for GTP gamma S hydrolysis are reported. The rate constants measured are consistent with a kinetic rather than thermodynamic limit on the accuracy of the aa-tRNA selection in vivo. PMID- 3512550 TI - Measurement of intracellular sodium concentration and sodium transport in Escherichia coli by 23Na nuclear magnetic resonance. AB - Escherichia coli is known to actively extrude sodium ions, but little is known concerning the concentration gradient it can develop. We report here simultaneous measurements, by 23Na NMR, of intracellular and extracellular Na+ concentrations of E. coli cells before and after energization. 23Na spectra in the presence of a paramagnetic shift reagent (dysprosium tripolyphosphate) consisted of two resonances, an unshifted one corresponding to intracellular Na+ and a shifted one corresponding to Na+ in the extracellular medium, including the periplasm. Extracellular Na+ was found to be completely visible despite the presence of a broad component in its resonance; intracellular Na+ was only 45% visible. Measurements of Na+ were made under aerobic and glycolytic conditions. Na+ extrusion and maintenance of a stable low intracellular Na+ concentration were found to correlate with the development and maintenance of proton motive force, a result that is consistent with proton-driven Na+/H+ exchange as a means of Na+ transport. In both respiring and glycolyzing cells, at an extracellular Na+ concentration of 100 mM, the intracellular Na+ concentration observed (4 mM) corresponded to an inwardly directed Na+ gradient with a concentration ratio of about 25. The kinetics of Na+ transport suggest that rapid extrusion of Na+ against its electrochemical gradient may be regulated by proton motive force or intracellular pH. PMID- 3512551 TI - Recycling of the glucose transporter, the insulin receptor, and insulin in rat adipocytes. Effect of acidtropic agents. AB - The notion of an insulin-dependent translocation of the glucose transporter in rat adipocytes was confirmed by immunoblotting and reconstitution of glucose transport activity of subcellular fractions. Quantitatively, however, significantly different results were obtained with these two techniques; when compared with reconstitution, immunoblotting detected translocation of a larger amount of the transporter from a low density microsome fraction to a plasma membrane fraction. The acidtropic agents chloroquine and dibucaine, which have been reported to inhibit the recycling of various receptors, were utilized to study the detailed translocation mechanism of the glucose transporter and the insulin receptor. These acidtropic agents caused accumulation of 125I-insulin in a subcellular fraction probably corresponding to lysosomes. They did not, however, significantly affect either the insulin-induced activation of glucose transport or the recycling of the transporter and the insulin receptor as detected by immunoblotting. About 50% of radioactivity released from adipocytes which were allowed to internalize insulin was due to intact insulin, and chloroquine did not change the release rate of intact insulin, raising the possibility of receptor-mediated exocytosis of insulin. The release of degraded insulin decreased with chloroquine treatment. The results are consistent with the idea that these acidtropic agents mainly act to inhibit degradation of insulin in lysosomes, and their effect on the recycling of the glucose transporter and the insulin receptor is minimal, indicating that the recycling of these membrane proteins proceeds irrespective of organelle acidification. Electron micrographs showed vesicles underneath the plasma membranes, with sizes similar to those of the low density microsome fraction where the internalized glucose transporter and the insulin receptor were located. PMID- 3512552 TI - Resolution of brewers' yeast pyruvate decarboxylase into two isozymes. AB - A novel purification method was developed for brewers' yeast pyruvate decarboxylase (EC 4.1.1.1) that for the first time resolved the enzyme into two isozymes on DEAE-Sephadex chromatography. The isozymes were found to be distinct according to sodium dodecyl sulfate polyacrylamide gel electrophoresis: the first one to be eluted gave rise to one band, the second to two bands. The isozymes were virtually the same so far as specific activity, KM, inhibition kinetics and irreversible binding properties by the mechanism-based inhibitor (E)-4-(4 chlorophenyl)-2-oxo-3-butenoic acid are concerned. This finding resolves a longstanding controversy concerning the quaternary structure of this enzyme. PMID- 3512553 TI - Properties of a serine hydroxymethyltransferase in which an active site histidine has been changed to an asparagine by site-directed mutagenesis. AB - Histidine 228 at the active site of Escherichia coli serine hydroxymethyltransferase was replaced with an asparagine. The mutant enzyme was expressed in a strain of E. coli that lacks wild type enzyme. Absorption spectra, circular dichroism spectra, and differential scanning calorimetry thermograms suggest that the amino acid change at the active site causes no detectable change in the tertiary structure of the enzyme. Kinetic studies demonstrated that kcat for the mutant enzyme is about 25% of the value for the wild type enzyme with either L-serine or allothreonine as substrate. Km or Kd values for amino acid substrates and reduced folate compounds were 2-10-fold larger with the mutant enzyme. The rate of interconversion of several enzyme-glycine complexes showed that the conversion of the external aldimine to the quinoid complex is not the rate-determining step for either the mutant or wild type enzyme in the presence of tetrahydrofolate. The binding of L-serine to the wild type enzyme gives a more thermally stable enzyme and increases its affinity for tetrahydrofolate. These effects are not found when L-serine binds to the mutant enzyme. The studies demonstrate that histidine 228 is not a catalytically essential residue and suggest that it is involved in interacting with either the amino acid substrate or the enzyme-bound pyridoxal phosphate. PMID- 3512554 TI - The in vivo cross-linking of proteins and DNA by heavy metals. AB - Cross-linking of proteins to DNA in live, intact Novikoff ascites hepatoma cells exposed in vitro to different concentrations of CuSO4, Pb(NO3)2, HgCl2, and AlCl3 was studied. Protein-DNA complexes were separated by high-speed centrifugation of cells solubilized in buffered 4% sodium dodecyl sulfate and assayed by electrophoretic separation of proteins associated with the DNA-containing pellets. Concentration dependence experiments showed that the optimal cross linking occurred at metal concentration of 0.5 mM for CuSO4, HgCl2, and AlCl3 while the optimal cross-linking for Pb(NO3)2 was at 5 mM. For some metals at concentrations higher than optimal, the amounts of cross-linked proteins decreased significantly. Immunochemical analysis of the cross-linked proteins using antibodies to matrix, chromatin, lamins, and cytokeratin fractions demonstrated that some, but not all, members of these protein families became cross-linked to the DNA. Each metal exhibited a cross-linking pattern of its own, different from those of the other metals. Radioactive labeling experiments showed that all the metals tested became associated with the DNA-protein pellets within 1 h after their addition to the incubation medium. However, hexavalent chromium required more than 2 h before appearing in the DNA-protein pellets in significant amounts. PMID- 3512555 TI - Intragenic reversion mutations that improve export of maltose-binding protein in Escherichia coli malE signal sequence mutants. AB - Escherichia coli strains harboring malE signal sequence point mutations accumulate export-defective precursor maltose-binding protein (MBP) in the cytoplasm. Beginning with these mutants, a number of spontaneous intragenic revertants have been obtained in which export of the MBP to the periplasm is either partially or totally restored. With a single exception, each of the reversion mutations resulted in an increase in the overall hydrophobicity of the signal peptide hydrophobic core by one of five different mechanisms. In some revertants, MBP export was achieved at a rate comparable to the wild type MBP; in other cases, the rate of MBP export was significantly slower than wild type. The results indicate that the overall hydrophobicity of the signal peptide, rather than the absolute length of its uninterrupted hydrophobic core, is a major determinant of MBP export competency. An alteration at residue 19 of the mature MBP also has been identified that provides fairly efficient suppression of the export defect in the adjacent signal peptide, further suggesting that important export information may reside in this region of the precursor protein. PMID- 3512556 TI - Structural and immunological characterization of the amino-terminal domain of mammalian neural cell adhesion molecules. AB - The neural cell adhesion molecules (N-CAMs) are a group of structurally and immunologically related glycoproteins found in vertebrate neural tissues. Adult brain N-CAMs have apparent molecular weights of 180,000 and 140,000 with an additional form at 120,000 in murine brain. In embryonic brain, N-CAMs are represented by a highly sialylated form with an apparent molecular weight greater than 180,000. We have used monoclonal antibodies that cross-react with N-CAMs of various mammalian species to purify N-CAMs from adult murine and bovine brains and from embryonic murine brains. We determined the amino acid sequences of the amino-terminal domains of these molecules: Leu-Gln-Val-Asp-Ile-Val-Pro-Ser-Gln Gly-Glu-Ile-Ser-Val-Gly-Glu-Ser. This sequence is highly conserved among all three forms of adult murine brain N-CAM as well as embryonic murine brain N-CAM and adult bovine brain N-CAM. Based on this sequence, we synthesized an undecapeptide and used it to raise a site-directed polyclonal antiserum. This antiserum reacted with the intact N-CAM in liquid phase radioimmunoassays, immunoblotting experiments, and immunofluorescent labeling of cells. The antiserum also reacted with N-CAMs in extracts of brain tissues from different species, confirming the highly conserved nature of the amino-terminal domain of mammalian N-CAMs. Immunofluorescence experiments indicated that this domain resides on the outer surfaces of cells that express N-CAMs, in both primary neuronal cell culture and in cell lines. PMID- 3512557 TI - The HLA-D-associated invariant chain binds palmitic acid at the cysteine adjacent to the membrane segment. AB - The highly polymorphic HLA-D antigens are associated with a nonpolymorphic polypeptide chain, designated invariant chain. This invariant chain is shown to incorporate fatty acid. Invariant chain metabolically labeled with [3H]palmitic acid releases its label after treatment with hydroxylamine indicating an ester linkage of the palmitic acid. The binding of fatty acid to the invariant chain inhibits the formation of S-S-linked dimers. This suggests that the sole cysteine residue of the invariant chain is blocked by binding of fatty acid. A peptide shared by [3H]palmitic acid- or [35S]cysteine-labeled invariant chain digests supports the hypothesis that the palmitic acid binds to the cysteine which is located close to the membrane-spanning domain on the cytoplasmic site. Inhibition of N-glycosylation with tunicamycin demonstrates binding of the fatty acid to the nonglycosylated precursor of the invariant chain. Additionally, blocking of fatty acylation by cerulenin inhibits further maturation of the invariant chain, as sialylation. PMID- 3512558 TI - The membrane proteins of the methanol-induced peroxisome of Candida boidinii. Initial characterization and generation of monoclonal antibodies. AB - Peroxisomes are massively induced when methylotrophic yeasts are cultured on methanol as the sole carbon and energy source. An analysis of the protein composition of the peroxisomal membrane and the generation of probes against two peroxisomal membrane proteins (PMPs) have been undertaken. Peroxisomes from Candida boidinii were obtained from sucrose gradients as previously described or from a novel one-step purification of the organelle on a Percoll gradient. The protein composition of the membranes from these two preparations was virtually identical. About 10 proteins comprise nearly all of its protein mass. The most prominent proteins have molecular masses of 120, 100, 47, 31-32 (a triplet), and 20 kDa; significant amounts of alcohol oxidase and dihydroxyacetone synthase, the two abundant matrix proteins, also remain associated with the membrane. Glycosylation of the membrane proteins could not be detected. Exposure of the membrane to chaotropes shows that PMPs 100 and 20 are the most easily removable, whereas PMP 47 appears to be the most tightly associated. Mice were injected with peroxisomal membrane, and hybridoma lines were isolated that produced antibody against PMP 20, PMP 47, and dihydroxyacetone synthase. Indirect immunofluorescence with these monoclonal antibodies confirmed that all three proteins are localized to the peroxisomal cluster. Immunoblotting experiments demonstrated that peroxisomal membrane as well as matrix proteins are induced by methanol. PMID- 3512559 TI - Identification of a glycoprotein involved in cell cycle progression in yeast. AB - The molecular events of start, the regulatory step that commits yeast cells to DNA replication, have recently begun to be investigated. One of the gene products required for completion of start has been found to have a significant structural homology with oncogenes endowed with protein kinase activity. Our experiments provide data on the biosynthetic pathway of a previously identified labile protein (p100, molecular weight 100,000, isoelectric point of approximately 4.8 5) involved in cell cycle progression at start, which appears to be specifically made during the release from cell cycle arrest of a temperature-sensitive mutant (cdc25) of Saccharomyces cerevisiae. On two-dimensional gel, p100 migrates very close to another 100-kDa labile protein (p100*) which behaves as a cell cycle modulated protein with reduced synthesis in G1. Pulse and chase labeling of protein with [35S]methionine suggests that both p100 and p100* are processed to a protein (p115) of slightly higher molecular weight (Mr = 115,000). Peptide mapping analysis indicates that p100 and p100 yield identical maps and that both p100 and p100* are very much similar to p115. p115 is a glycosylated protein as shown by a labeling experiment with [3H]glucosamine and by the fact that the synthesis of both p100 and p115 is inhibited if cells are cultured in the presence of tunicamycin. A protein having the same heterogeneous aspect of migration on sodium dodecyl sulfate-polyacrylamide gel and the same apparent molecular weight and isoelectric point of p115 is abundantly present in a preparation of membranes from S. cerevisiae and the isolated radioactive p115 comigrates with it. Taken together these results favor the idea that terminal glycosylation of both p100 and p100* gives rise to the fully glycosylated p115 protein which appears to be a membrane-associated protein. PMID- 3512560 TI - 15N-labeled tRNA. Identification of dihydrouridine in Escherichia coli tRNAfMet, tRNALys, and tRNAPhe by 1H-15N two-dimensional NMR. AB - The N3 imino units of dihydrouridine were identified in samples of 15N-labeled Escherichia coli tRNAfMet, tRNALys, and tRNAPhe by 1H-15N two-dimensional NMR. The peaks for dihydrouridine had high field 1H (9.7-9.8 ppm) and 15N (147.8-149.5 ppm) chemical shifts. Assignments were made by 1H-15N chemical shift correlation based on values obtained in model studies with tri-O-benzoyl- and tri-O acetyldihydrouridine. The rates of exchange of the imino protons with water suggest that the D-loop in tRNAfMet is less stable than the D-loops in tRNALys or tRNAPhe. Closely spaced peaks were observed for the two dihydrouridines in tRNAPhe in a high resolution spectrum. PMID- 3512561 TI - Regulation of renin angiotensins by gonadotropic hormones in cultured murine Leydig tumor cells. Release of angiotensin but not renin. AB - Renin and angiotensins coexist in various tissues. The mode of control of the extrarenal renin-angiotensin system is not clear. Whether it is renin or angiotensin that is secreted has not been identified. We have investigated gonadotropin-dependent synthesis and subsequent release of the components of the intracellular renin-angiotensin system in a cloned and cultured mouse Leydig tumor cell line (MA-10). Treatment of cultured Leydig cells with bovine luteinizing hormone (bLH, 100 ng/ml) or human chorionic gonadotropin (hCG, 25 ng/ml) resulted in greater than 150- and 40- fold increased formation of angiotensin I and angiotensin II. In cells incubated with bLH or hCG, the majority of AII (up to 90%) was found in the culture medium while most of angiotensin I (greater than 85%) was in the cell lysate. Treatment with gonadotropic hormones (bLH/ hCG) increased renin 35- to 40-fold. Renin activity was confined mainly in the cell lysate even after the stimulation by gonadotropins, and only 1-2% of the total renin activity was detectable in culture medium. These results were interpreted that, in these transformed cells, hormonally-induced renin functions to generate angiotensin I within the Leydig cell and it is the angiotensins which are secreted. PMID- 3512562 TI - Insulin stimulates fluid-phase endocytosis and exocytosis in 3T3-L1 adipocytes. AB - Fluid phase endocytosis by monolayers of 3T3-L1 adipocytes has been followed by measuring [14C]sucrose uptake, a well characterized pinocytic marker. Insulin, at a maximal stimulatory concentration, increased the pinocytic rate by 2-fold within 5 min of its addition; this activation persisted for at least 2 h. The dose-response curve for the enhancement of fluid-phase endocytosis by insulin was identical with that for the stimulation of hexose transport, as measured by the uptake of 2-deoxyglucose. The concentration of insulin eliciting half-maximal effects was 6 nM. These results suggest that activation of endocytosis and hexose uptake by insulin are triggered by the same signalling event. Insulin-activated pinocytosis was not dependent upon the increased metabolism of D-glucose that occurs in response to the hormone, since the stimulation of fluid-phase endocytosis occurred in the absence of 5 nM glucose. Fluid-phase exocytosis was examined by loading cells with [14C]sucrose for various times and then measuring tracer efflux. The rate of sucrose release was biphasic; a portion of the internalized sucrose was rapidly released from the cell (t1/2 approximately 5 min), whereas the remainder was released slowly (t1/2 approximately to 5 h). These results are consistent with a sequential two-compartment model in which the [14C] sucrose first enters a compartment from which about 70% of the sucrose is rapidly released back into the medium and the remaining 30% is transferred to a second compartment. Therefore, the true rate of endocytosis is much greater than the observed accumulation rates, except after short uptake times. Insulin increases the rate of sucrose efflux from both compartments as well as the rate of transfer from the first compartment to the second compartment by about 2-fold. Furthermore, insulin increased the apparent size of the first and second compartments by 1.6- and 3-fold, respectively. The lysosomotropic agent chloroquine (200 muM) had only a small effect on fluid movements in these cells. The rapid and prolonged stimulation of fluid-phase endocytosis and exocytosis by insulin are hitherto unrecognized effects of this hormone. PMID- 3512563 TI - The mechanism of Lactobacillus leichmannii ribonucleotide reductase. Evidence for 3' carbon-hydrogen bond cleavage and a unique role for coenzyme B12. AB - Reduction of [3'-3H, U-14C]UTP with ribonucleotide reductase showed isotope effects of 1.6, 1.8, and 1.8 at pH 6.1, 7.3, and 8.3, respectively. Similar studies with [3'-3H, U-14C]ATP gave effects of 2.1, 2.1, 1.7, and 1.9 at pH 5.5, 6.1, 7.3, and 8.3, respectively. During the course of the isotope effect determinations the samples were analyzed for the production of 3H2O. Reduction of [3'-3H]UTP at pH 6.1, 7.3, and 8.3 resulted in 0.08, 0.15, and 0.24% of the total 3H being volatilized at 50% reaction. Reduction of [3'-3H]ATP gave no detectable 3H2O at pH 6.1 or 7.3 and a maximum of 0.02% at pH 8.3. The isotope effects in conjunction with 3H2O production indicate that ribonucleotide reductase catalyzes cleavage of the 3' carbon-hydrogen bond of NTPs during the reduction to dNTPs. The role of the cofactor, adenosylcobalamin (AdoCbl), was also investigated. Incubation of [3'-3H]NTP with prereduced ribonucleotide reductase in the absence of reductant (one-turnover conditions) followed by isolation and analysis of AdoCbl for radioactivity indicated no 3H transfer from substrate to cofactor and no 3H2O production. Similar results were obtained in the presence of DTT (multiple turnover conditions). The role of AdoCbl was further investigated by examination of its potential to mediate hydrogen transfer between two substrates. Incubation of [3'-3H]UTP and unlabeled ATP with ribonucleotide reductase and isolation of the products produced indicated no 3H in dATP. These results allow us to postulate a unique role for AdoCbl in the ribonucleotide reductase reaction, that of a radical chain initiator rather than an intermediary hydrogen transfer agent. PMID- 3512564 TI - Preparation and properties of derivatives of bovine factor X and factor Xa from which the gamma-carboxyglutamic acid containing domain has been removed. AB - Limited proteolysis of bovine blood coagulation Factor X by chymotrypsin produces a derivative in which the light chain is cleaved between Tyr 44 and Lys 45. Two peptide products, residues 1-44 of the Factor X light chain and a modified zymogen, Factor X(-GD) have been isolated and characterized by sodium dodecyl sulfate-polyacrylamide gel electrophoresis, elution behavior on anion-exchange chromatography, amino acid composition, and by partial amino acid sequence determination. Factor X(-GD) no longer contains the 12 gamma-carboxyglutamic acid residues of the native zymogen and thus serves as a model for investigation of the properties conferred on Factor X by the presence of gamma-carboxyglutamic acid. Cleavage of Factor X at Tyr 44 by chymotrypsin is inhibited by Ca2+ and Mg2+ ions. Factor X(-GD) is activated by the coagulation factor activator of Vipera russellii venom, but at less than 1% of the rate of activation of native Factor X. The susceptibility of Tyr 44 to chymotryptic cleavage implies that this residue is on the surface of the light chain of Factor X. Factor Xa(-GD) is indistinguishable from native Factor Xa in its activity on Benzoyl-Ile-Glu-Gly Arg-p-nitroanilide, on prothrombin alone, and on prothrombin plus Factor Va. In the presence of phospholipid the rate of prothrombin activation catalyzed by Factor Xa(-GD) is the same as in the absence of phospholipid. PMID- 3512565 TI - Insulin stimulation of growth in diabetic rats. Synthesis and degradation of ribosomes and total tissue protein in skeletal muscle and heart. AB - Skeletal muscle and heart of diabetic rats show a substantial decline in the rate of protein synthesis associated with decreases in both the number and activity of tissue ribosomes. We have examined the reversal of these changes during the first 3 days of resumption of insulin therapy to rats that had been diabetic for 4 days. Rates of ribosome degradation, which had been elevated in both muscle and heart of the diabetic animals, were suppressed virtually to zero after 1 day of insulin treatment. Synthesis of ribosomes was stimulated, but this change occurred more gradually. Similar, but less dramatic, changes occurred in the rates of synthesis and degradation of total protein in these tissues. PMID- 3512566 TI - The role of subunit autolysis in activation of smooth muscle Ca2+-dependent proteases. AB - Ca2+-dependent proteases isolated from chicken gizzard and bovine aortic smooth muscle were compared with respect to subunit autolysis and the role of autolysis in modulating enzyme activity. The protease isolated from chicken gizzard was a heterodimer consisting of 80,000- and 30,000-dalton subunits. The protease isolated under identical conditions from bovine aorta consisted of 75,000- and 30,000-dalton subunits. In the presence of Ca2+, both enzymes underwent autolysis of their 30,000-dalton subunits with conversion to an 18,000-dalton species. In addition, the 80,000-dalton subunit of the gizzard protease was degraded to a 76,000-dalton form. The Ca2+ concentrations required for autolysis of the 30,000 dalton subunits were different for the two enzymes (i.e. gizzard: K0.5 Ca2+ = 335 microM; aortic: K0.5 Ca2+ = 1,250 microM) although in both cases, stimulation of autolysis by Ca2+ exhibited positive cooperativity. When compared with respect to kinetics of substrate degradation, the native forms of the smooth muscle Ca2+ dependent proteases (gizzard, GIIa = 80,000/30,000-dalton heterodimer; bovine aortic, IIa = 75,000/30,000-dalton heterodimer) exhibited a lag phase in product appearance. On the other hand, the autolyzed forms (gizzard, GIIb = 76,000/18,000 dalton heterodimer; bovine aortic, IIb = 75,000/18,000-dalton heterodimer) exhibited linear rates of substrate degradation. These results were analyzed in terms of autolysis of the 30,000-dalton subunits as determined by the conversion of this subunit to its 18,000 dalton form. For both enzymes, the time course for the autolytic transition, 30,000----18,000 daltons, and Ca2+-dependence of the apparent rate constants for this transition were found to correlate well with the lag phase in enzymatic activity. No such correlation could be established for the 80,000----76,000 dalton autolytic transition of the high molecular mass subunit of the gizzard protease. Our results suggest that catalytic activity of the Ca2+ dependent proteases isolated from gizzard and bovine aortic smooth muscle requires autolysis of the 30,000-dalton subunit. The native or unautolyzed forms of these enzymes appear to be proenzymes that can be activated by autolysis. PMID- 3512567 TI - Dityrosine is a prominent component of the yeast ascospore wall. A proof of its structure. AB - The yeast ascospore wall consists of four morphologically distinct layers. The hydrophobic surface layers are biogenically derived from the prospore wall and appear dark after OsO4 staining. They seem to be responsible for the stability of the spores against attack by lytic enzymes. By amino acid analysis of acid hydrolysates of ascospore walls, two new peaks were detected, which were shown to be the racemic and meso form, respectively, of dityrosine. The identity of this hitherto unknown component of the yeast ascospore wall with standard dityrosine was proven by 1H NMR and by mass spectrometry. A 13C NMR spectroscopic investigation of the structure of dityrosine confirmed that, in natural dityrosine, the biphenyl linkage is located ortho, ortho to the hydroxyl groups. Following digestion of the inner layers of isolated ascospore walls it was shown that dityrosine is very probably located only in the surface layers. The same conclusion was reached independently by an investigation of spores of a strain homozygous for the mutation gcn1, which lack the outermost layers of the spore wall and were practically devoid of dityrosine. In sporulating yeast, L-tyrosine was readily incorporated into the dityrosine of the ascospore wall. Control experiments involving vegetative a/alpha cells and nonsporulating alpha/alpha cells under sporulation conditions showed that dityrosine is indeed sporulation specific. PMID- 3512568 TI - Macromolecular organization of basement membranes. Characterization and comparison of glomerular basement membrane and lens capsule components by immunochemical and lectin affinity procedures. AB - The macromolecular components of bovine glomerular basement membrane (GBM) and lens capsules (anterior and posterior) solubilized by sequential extractions with denaturing agents were quantitated and characterized by polyacrylamide gel electrophoresis, CL-6B filtration, and DEAE-cellulose chromatography with the help of immunochemical techniques. Laminin, entactin, fibronectin, and heparan sulfate proteoglycan were primarily recovered (over 80%) from both basement membranes in a guanidine HCl extract which contained only a limited amount of the total protein (10-14%); most of the remainder of these noncollagenous components could be solubilized by the guanidine in the presence of reducing agent. Although a portion of the Type IV collagen could be obtained by these treatments, effective extraction of this protein depended on exposure to sodium dodecyl sulfate under reducing conditions. Immunoblot analysis revealed a remarkably similar pattern for GBM and lens capsule Type IV collagens with prominent bands of Mr = 390,000, 210,000, and 190,000 being evident. Fibronectin was present in much greater amounts in GBM than lens capsule while the reverse was true for entactin. In both GBM and lens capsules, the entactin (Mr = 150,000) exceeded laminin; the latter protein on immunoblotting was found to contain primarily the alpha-subunit (Mr = 200,000). The size of the heparan sulfate proteoglycan from anterior (Mr = 400,000) and posterior lens capsule (Mr greater than 500,000) was substantially larger than that from GBM (Mr = 200,000). During DEAE-cellulose chromatography under nonreducing conditions in a denaturing solvent, a portion of the Type IV collagen coeluted with the proteoglycan from these membranes. Considerable Bandeiraea simplicifolia I binding activity (alpha-D-galactose specific) was observed in GBM and lens capsule extracts and column fractions which could not be accounted for by laminin alone. Several components which reacted with this lectin were seen on transblots and among these Type IV collagen was identified. In contrast to the basement membranes from bovine tissues, the constituents from human GBM did not react with the B. simplicifolia I lectin. PMID- 3512569 TI - The preparation and physicochemical characterization of an injectable form of reconstituted, glutaraldehyde cross-linked, bovine corium collagen. AB - Pepsin-solubilized bovine corium collagen was purified, reconstituted, and treated with various levels of glutaraldehyde. Treatment of suspensions of fibrillar collagen with low concentrations of glutaraldehyde appeared to have little effect on the gross morphology of fibrils, as judged by electron microscopy, but did have a significant impact on their physicochemical stability. Fibrillar collagen treated with glutaraldehyde at a concentration equal to or greater than 0.0075% demonstrated significant decreases in neutral solubility at elevated temperatures as compared to noncross-linked controls. Differential scanning calorimetry provided a convenient and quantitative means to correlate increases in melting temperature with increases in glutaraldehyde treatment concentration. Fibrillar collagen cross-linked with glutaraldehyde concentrations as low as 0.0075% demonstrated a significantly greater resistance to proteolytic degradation than did noncross-linked fibrillar collagen samples. The residual, extractable aldehyde content of such preparations was between 1 and 3 ppm. Rheological measurements on such cross-linked suspensions demonstrated that they were non-Newtonian, shear-thinning fluids, and that they were two- to threefold more viscous than corresponding preparations of noncross-linked collagen. PMID- 3512570 TI - Allograft bone in spinal fusion for paralytic scoliosis. AB - To determine the efficacy of allograft bone in spinal surgery, a retrospective study was carried out on thirty-two patients who had had spinal fusion with banked bone from the femoral head between 1977 and 1983. The diagnoses were paralytic and neuromuscular scoliosis. At final follow-up (average, 3.7 years), the infection rate was 9.3 per cent. There were no pseudarthroses, and all patients had well marginated trabecular markings by eighteen months. The rates of complications and of fusion were comparable with or better than those obtained using autogenous bone graft. PMID- 3512571 TI - Ultrasonographic evaluation of the rotator cuff and biceps tendon. AB - Ultrasonography of the rotator cuff and biceps tendon was investigated in 106 patients who had been referred for arthrography of the shoulder. Both the sensitivity and the specificity of ultrasound in detecting a tear of the rotator cuff were 91 per cent. The predictive value of a negative sonogram was 95 per cent and the predictive value of a positive sonogram was 84 per cent. Ultrasonography proved to be superior to arthrography in the examination of the normal and abnormal biceps tendon. Sonographically detectable effusions from the tendon sheath of the biceps were present in 19 per cent of this population of patients. This finding was statistically highly associated (90 per cent) with rotator cuff tears and other soft-tissue abnormalities of the shoulder. Based on these results, it appears that ultrasonography can be used as the initial imaging test for many patients with suspected abnormalities of the rotator cuff or biceps tendon. PMID- 3512572 TI - Thrombosis of the iliofemoral artery during revision of a total hip replacement. A case report. PMID- 3512573 TI - Arthritis caused by Clostridium septicum. A case report and review of the literature. PMID- 3512574 TI - Errors in the differential diagnosis of incompetence of the popliteal vein and short saphenous vein by Doppler ultrasound. AB - Doppler Ultrasound is now routinely used to demonstrate valvular reflux in the venous system. Incompetence detected at the back of the knee is located either in the short saphenous vein or in the popliteal vein. Whether the incompetence is in the deep or superficial venous system can be differentiated by digital compression over the short saphenous vein in the upper calf; if reflux is abolished then the incompetence is assumed to be in the superficial vein but if it is not prevented it must be in the popliteal vein. Sometimes the reflux is not controlled when the deep system is normal. This has been shown to be due to variations in the anatomy of the short saphenous vein and especially the pattern of its termination. Examples with venography are given, showing that in the presence of incompetence at the sapheno-popliteal junction there may be no reflux in the short saphenous vein; instead the proximal tributaries are involved and reflux in these veins is not controlled by pressure over the short saphenous vein. This explains the false positive diagnosis of valvular incompetence in the popliteal vein. PMID- 3512575 TI - Pregnancy in patients with mechanical prosthetic heart valves. Our experience regarding 98 pregnancies in 57 patients. AB - Ninety-eight pregnancies in 57 patients with mechanical (ball or tilting disc) prosthetic heart valves are described. Sixty-one pregnancies developed in 36 patients with a mitral prosthesis, 12 pregnancies in 9 patients with an aortic prosthesis, 17 pregnancies in 10 patients with both mitral and aortic prostheses and 8 pregnancies in 2 patients with mitral and tricuspid prostheses. All patients were in I or in II NYHA class at conception and no significative change was noted during pregnancy. All the patients were treated with oral anticoagulant therapy at conception. Different kinds of antithrombotic and antiembolic prophylaxis were employed. There were 13 voluntary interruptions of pregnancy and 37 spontaneous abortions. In the 47 newborn 2 malformation complications (1 warfarin syndrome, 1 cleft palate) and 4 haemorrhagic complications (without sequelae) were noted. Two fatal thromboses of a mitral prosthesis occurred; systemic embolic complications were noted in 7 cases. These observations suggested different incidences of complications regarding the antithrombotic and anti-embolic prophylaxis. The authors point out the high risk of thrombotic and embolic complications and the low rate of successful outcome of pregnancy in these patients. PMID- 3512576 TI - Microtubule dynamics in interphase cells. AB - The sites of microtubule growth and the kinetics of elongation have been studied in vivo by microinjection of biotin-labeled tubulin and subsequent visualization with immunocytochemical probes. Immunofluorescence and immunoelectron microscopy demonstrate that injected biotin-labeled subunits are incorporated into new segments of growth which are contiguous with unlabeled microtubules. Rapid incorporation occurs by elongation of existing microtubules and new nucleation off the centrosome. The growth rate is 3.6 micron/min and is independent of the concentration of injected labeled tubulin. This rate of incorporation together with turnover of existing microtubules leads to approximately 80% exchange in 15 min. The observed kinetics and pattern of microtubule turnover allow for an evaluation of the relevance of several in vitro models for steady-state dynamics to the in vivo situation. We have also observed a substantial population of quasi stable microtubules that does not exchange subunits as rapidly as the majority of microtubules and may have specialized functions in the cell. PMID- 3512577 TI - Identification of a 34-kD polypeptide as a light chain of microtubule-associated protein-1 (MAP-1) and its association with a MAP-1 peptide that binds to microtubules. AB - We examined the association of a 34-kD light chain component to the heavy chains of MAP-1 using a monoclonal antibody that specifically binds the 34-kD component and labels neuronal microtubules in a specific and saturable manner. Immunoprecipitation of MAP-1 heavy chains together with the 34-kD component by the antibody indicates that the 34-kD polypeptide forms a complex with MAP-1 heavy chains. Both major isoforms of MAP-1 heavy chains (MAP-1A and MAP-1B) were found in the immunoprecipitate. Digestion of MAP-1 with alpha-chymotrypsin and analysis of the chymotryptic peptides reveals a 120-kD fragment of the MAP-1 heavy chain that binds to microtubules and is precipitable with the 34-kD light chain antibody, suggesting that the 34-kD light chain also binds to this domain of the molecule. Since microtubules that contain the 120-kD fragment lack the long lateral projections characteristic of microtubules with intact MAP-1, the 34 kD light chains may be localized at or near the microtubule surface. PMID- 3512578 TI - Monoclonal antibodies distinguish titins from heart and skeletal muscle. AB - Murine monoclonal antibodies specific for titin have been elicited using a chicken heart muscle residue as antigen. The three antibodies T1, T3, and T4 recognize both bands of the titin doublet in immunoblot analysis on polypeptides from chicken breast muscle. In contrast, on chicken cardiac myofibrils two of the antibodies (T1, T4) react only with the upper band of the doublet indicating immunological differences between heart and skeletal muscle titin. This difference is even more pronounced for rat and mouse. Although all three antibodies react with skeletal muscle titin, T1 and T4 did not detect heart titin, whereas T3 reacts with this titin both in immunofluorescence microscopy and in immunoblots. Immunofluorescence microscopy of myofibrils and frozen tissues from a variety of vertebrates extends these results and shows that the three antibodies recognize different epitopes. All three titin antibodies decorate at the A-I junction of the myofibrils freshly prepared from chicken skeletal muscle and immunoelectron microscopy using native myosin filaments demonstrates that titin is present at the ends of the thick filaments. In chicken heart, however, antibodies T1 and T4 stain within the I-band rather than at the A I junction. The three antibodies did not react with any of the nonmuscle tissues or permanent cell lines tested and do not decorate smooth muscle. In primary cultures of embryonic chicken skeletal muscle cells titin first appears as longitudinal striations in mononucleated myoblasts and later at the myofibrillar A-I junction of the myotubes. PMID- 3512579 TI - Further analysis of pemphigus autoantibodies and their use in studies on the heterogeneity, structure, and function of desmosomes. AB - Pemphigus is an autoimmune disease that causes blistering of human epidermis. We have recently shown that autoantibodies in the serum of three pemphigus patients bind to desmosomes (Jones, J. C. R., J. Arnn, L. A. Staehelin, and R. D. Goldman, 1984, Proc. Natl. Acad. Sci. USA., 81:2781-2785), and we suggested that pemphigus blisters form, at least in part, from a specific antibody-induced disruption of desmosomes in the epidermis. In this paper, experiments are described that extend our initial observations. 13 pemphigus serum samples, which include four known pemphigus vulgaris (Pv) and four known pemphigus foliaceus (Pf) serum samples, have been analyzed by both immunofluorescence and by immunoblotting using cell free desmosome preparations. Tissue sections of mouse skin processed for double indirect immunofluorescence using each of the pemphigus serum samples and a rabbit antiserum directed against a component of the desmosomal plaque (desmoplakin) show similar punctate cell surface staining patterns. This suggests that all 13 pemphigus serum samples contain autoantibodies that recognize desmosomes. These autoantibodies appear specific for stratified squamous epithelial cell desmosomes and do not recognize desmosomes of other tissues (e.g., mouse heart and mouse intestine). Cultured mouse keratinocytes, which possess well-defined desmosomes, were processed for indirect immunofluorescence using the pemphigus serum samples. Eight of the 13 sera (including the four known Pv samples but not the known Pf sera) stain desmosomes in these preparations. By double indirect immunofluorescence the desmoplakin antiserum stains a double fluorescent line along the contacting edges of cultured keratinocytes, whereas the positive pemphigus serum samples stain a single fluorescent line along this same border. We believe that these pemphigus autoantibodies recognize extracellular antigens located somewhere within the region between the two apposing membranes that comprise the desmosome. The pemphigus sera exhibit positive immunoblotting reactions with desmosome-enriched fractions obtained from bovine tongue epithelium. Three serum samples (including two of the four known Pf serum samples) react with 160- and 165-kD desmosome-associated polypeptides (Koulu, L., A. Kusimi, M. S. Steinberg, V. Klaus-Kovtun, and J. R. Stanley, 1984, J. Exp. Med., 160:1509-1518). Another eight serum samples (including the four known Pv sera) recognize a 140-kD desmosome-associated polypeptide. We propose that the antigens recognized by these human autoantibodies may play important roles in the adhesion of cells within the epidermis.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3512580 TI - Distribution of tyrosinated and nontyrosinated alpha-tubulin during mitosis. AB - The C-terminus of alpha-tubulin undergoes a reversible posttranslational tyrosination/detyrosination. The distributions of the tyrosinated (Tyr) and nontyrosinated (Glu) species during mitosis of cultured cells have been investigated by immunofluorescence using antibodies directed against the C terminus of either Tyr or Glu tubulin. The distribution of Tyr tubulin differed from that of Glu tubulin at each stage of mitosis; in general, the distribution of Tyr tubulin was similar to that of total tubulin, whereas Glu tubulin had a more restricted distribution. The Glu species was found in half-spindle fibers but was not detected in astral fibers at any stage and was seen in the interzone only during telophase. These results were confirmed by a direct comparison of the distributions of Tyr and Glu tubulin in cells double-labeled with the two antibodies. Evidence for the occurrence of Tyr and Glu tubulin in each class of half-spindle fibers (kinetochore and polar) was obtained from the staining patterns of the two antibodies in cold-treated cells. Immunoblots of extracts prepared from synchronous mitotic cells showed that Glu tubulin was a minor species of the total tubulin in the spindle; no changes in the amount of either Tyr or Glu tubulin were detected at any stage of mitosis. These results show that Tyr tubulin is the major species in the mitotic spindle and is found in all classes of spindle fibers, whereas Glu tubulin is present in small amounts and shows a more restricted distribution. The presence of two biochemically distinct forms of alpha-tubulin in the spindle may be important for spindle function. PMID- 3512581 TI - Distribution of N-CAM in synaptic and extrasynaptic portions of developing and adult skeletal muscle. AB - Previous studies of denervated and cultured muscle have shown that the expression of the neural cell adhesion molecule (N-CAM) in muscle is regulated by the muscle's state of innervation and that N-CAM might mediate some developmentally important nerve-muscle interactions. As a first step in learning whether N-CAM might regulate or be regulated by nerve-muscle interactions during normal development, we have used light and electron microscopic immunohistochemical methods to study its distribution in embryonic, perinatal, and adult rat muscle. In embryonic muscle, N-CAM is uniformly present on the surface of myotubes and in intramuscular nerves; N-CAM is also present on myoblasts, both in vivo and in cultures of embryonic muscle. N-CAM is lost from the nerves as myelination proceeds, and from myotubes as they mature. The loss of N-CAM from extrasynaptic portions of the myotube is a complex process, comprising a rapid rearrangement as secondary myotubes form, a phase of decline late in embryogenesis, a transient reappearance perinatally, and a more gradual disappearance during the first two postnatal weeks. Throughout embryonic and perinatal life, N-CAM is present at similar levels in synaptic and extrasynaptic regions of the myotube surface. However, N-CAM becomes concentrated in synaptic regions postnatally: it is present in postsynaptic and perisynaptic areas of the muscle fiber, both on the surface and intracellularly (in T-tubules), but undetectable in portions of muscle fibers distant from synapses. In addition, N-CAM is present on the surfaces of motor nerve terminals and of Schwann cells that cap nerve terminals, but absent from myelinated portions of motor axons and from myelinating Schwann cells. Thus, in the adult, N-CAM is present in synaptic but not extrasynaptic portions of all three cell types that comprise the neuromuscular junction. The times and places at which N-CAM appears are consistent with its playing several distinct roles in myogenesis, synaptogenesis, and synaptic maintenance, including alignment of secondary along primary myotubes, early interactions of axons with myotubes, and adhesion of Schwann cells to nerve terminals. PMID- 3512582 TI - Receptor-mediated endocytosis of asialoglycoproteins by rat hepatocytes: receptor positive and receptor-negative endosomes. AB - We have used combinations of subcellular fractionation, specific cytochemical tracers, and quantitative immunoadsorption to determine when, where, and in which intracellular structure internalized asialoglycoproteins (ASGPs) are segregated from their receptor. All membrane vesicles containing the receptor (R+ vesicles) were quantitatively immunoadsorbed from crude microsomes with Staphylococcus aureus cells and affinity-purified anti-ASGP receptor. Using this assay, we varied the time and temperature of exposure of perfused livers to 125I asialoorosomucoid (125I-ASOR) and followed the movement of ligand from R+ to R- vesicles. After 2.5 min at 37 degrees C, 98% of the internalized ligand could be immunoadsorbed and thus was in R+ vesicles. Over the next 12 min of continuous 37 degrees C perfusion with 125I-ASOR, an increasing fraction of the ligand was not immunoadsorbed and therefore was present in R- vesicles. A maximum of 30% of the ligand could be found in R- vesicles (14-44 min). When livers were maintained at 16 degrees C, ligand was internalized but remained in R+ vesicles. Furthermore, ligand accumulating in R- vesicles at 37 degrees C remained there when livers were cooled to 16 degrees C. R- endosomes could be separated from R+ endosomes by flotation on sucrose density gradients and visualized by the presence of sequestered ASOR-horseradish peroxidase (ASOR-HRP). These structures resembled those labeled by ASOR-HRP in situ: R+ vesicles were relatively dense (1.12 g/cc), frequently tubular or spherical and small (100-nm diam), corresponding to the peripheral and internal tubular endosomes; R- structures were of lower density (1.09 g/cc), large (400-nm diam), and resembled internal multivesicular endosomes (MVEs). Endocytosed ASOR-HRP was found in both the peripheral and internal tubular endosomes in situ under conditions where 95% of the ligand was present in R+ vesicles by immunoadsorption, whereas MVEs containing ASOR-HRP were predominant in situ when ligand was found in R- vesicles and were often in continuity with the tubular internal endosomes. All of these results suggest that complete segregation of ligand and receptor occurs after arrival in the Golgi lysosome region of the hepatocyte and that MVEs are R- and represent the final prelysosomal compartment. PMID- 3512584 TI - Assembly of the precursor and processed light-harvesting chlorophyll a/b protein of Lemna into the light-harvesting complex II of barley etiochloroplasts. AB - When the in vitro synthesized precursor of a light-harvesting chlorophyll a/b binding protein (LHCP) from Lemna gibba is imported into barley etiochloroplasts, it is processed to a single form. Both the processed form and the precursor are found in the thylakoid membranes, assembled into the light-harvesting complex of photosystem II. Neither form can be detected in the stromal fraction. The relative amounts of precursor and processed forms observed in the thylakoids are dependent on the developmental stage of the plastids used for uptake. The precursor as well as the processed form can also be detected in thylakoids of greening maize plastids used in similar uptake experiments. This detection of a precursor in the thylakoids, which has not been previously reported, could be a result of using rapidly developing plastids and/or using an heterologous system. Our results demonstrate that the extent of processing of LHCP precursor is not a prerequisite for its inclusion in the complex. They are also consistent with the possibility that the processing step can occur after insertion of the protein into the thylakoid membrane. PMID- 3512583 TI - Functional and mutational analysis of the light-harvesting chlorophyll a/b protein of thylakoid membranes. AB - The precursor for a Lemna light-harvesting chlorophyll a/b protein (pLHCP) has been synthesized in vitro from a single member of the nuclear LHCP multigene family. We report the sequence of this gene. When incubated with Lemna chloroplasts, the pLHCP is imported and processed into several polypeptides, and the mature form is assembled into the light-harvesting complex of photosystem II (LHC II). The accumulation of the processed LHCP is enhanced by the addition to the chloroplasts of a precursor and a co-factor for chlorophyll biosynthesis. Using a model for the arrangement of the mature polypeptide in the thylakoid membrane as a guide, we have created mutations that lie within the mature coding region. We have studied the processing, the integration into thylakoid membranes, and the assembly into light-harvesting complexes of six of these deletions. Four different mutant LHCPs are found as processed proteins in the thylakoid membrane, but only one appears to have an orientation in the membrane that is similar to that of the wild type. No mutant LHCP appears in LHC II. The other two mutant LHCPs cannot be detected within the chloroplasts. We conclude that stable complex formation is not required for the processing and insertion of altered LHCPs into the thylakoid membrane. We discuss the results in light of our model. PMID- 3512585 TI - Intracellular pathway followed by the insulin receptor covalently coupled to 125I photoreactive insulin during internalization and recycling. AB - After it interacts with a specific receptor on the cell surface, insulin is internalized in its target cell by an adsorptive endocytotic process and eventually degraded in lysosomes. It was also recently shown that the initial surface interaction between the hormone and its receptor is followed by an internalization of the receptor, which later is recycled back to the cell surface. In the present study the insulin receptor was tagged with a 125I photoreactive insulin analogue that can be covalently coupled to the insulin receptor by ultraviolet irradiation. Using this tool we could trace by quantitative electron microscope autoradiography the intracellular pathway followed by this labeled receptor. The quantitative analysis of the intracellular distribution of the labeled material as a function of incubation time at 37 degrees C supports the following sequence of events: association first with clear vesicles, second with multivesicular bodies, third with dense bodies, and fourth, a return to the cell surface via clear vesicles. This insulin receptor recycling process is inhibited by monensin but unaffected by cycloheximide. PMID- 3512586 TI - Analysis of bovine, porcine and human insulins in pharmaceutical dosage forms and drug delivery systems. PMID- 3512587 TI - Gas chromatographic determination of the fatty acid composition of endotoxins from different bacteria. AB - Endotoxins from four bacterial species extracted by three different procedures were acid-methanolyzed and the methyl esters of the fatty acids were analyzed by packed-column gas chromatography. There were qualitative and quantitative differences in the fatty acid profiles of the lipopolysaccharides isolated from four Gram-negative bacteria. Our data show considerable lot-to-lot variations in amounts of four methyl esters from the same bacterial serotype extracted by the same procedure and in the same bacterial serotype extracted by different procedures. These results indicate that extraction and perhaps culture conditions, as well as bacterial species, affect the fatty acid composition of endotoxins, hydrolyzed and derivatized by these procedures. PMID- 3512588 TI - Rainbow reviews: II. Recent publications of the National Center for Health Statistics. PMID- 3512589 TI - A prospective randomised trial of the value of rehousing on the grounds of mental ill-health. AB - A prospective randomised trial of medical priority for rehousing in local authority accommodation for those claiming such priority on the grounds of mental ill-health, showed a clear benefit to mental health as a result of rehousing up to a year after that rehousing. PMID- 3512590 TI - Prolonged action of regular insulin in diabetic patients: lack of relationship to circulating insulin antibodies. AB - We previously reported that in insulin-treated diabetic subjects the time course of action of regular insulin injected sc is different from that reported in standard textbooks. The present studies evaluated the role of insulin antibodies (Abs) in the altered pharmacokinetics of regular insulin by comparing the time course of insulin action in 10 patients receiving chronic insulin therapy and having insulin Abs with that in 15 previously untreated patients without detectable Abs. After an overnight fast, the patients were given an infusion of 5% dextrose in water at 100 ml/h. Regular insulin (15 U) was then injected sc in the deltoid region of the arm. The onset of action of sc insulin, as indicated by a 10% fall in serum glucose, was similar in both patient groups [1.9 +/- 0.1 (+/- SEM) hour in Ab-negative and 1.8 +/- 0.1 h in Ab-positive patients]. The peak effect of insulin action, as determined by the nadir of serum glucose, was 4.6 +/ 0.2 h in the previously untreated patients, not significantly different from the value in the diabetic patients with insulin Abs (5.2 +/- 0.4 h). The duration of action of insulin was also similar in both groups (14.7 +/- 0.7 vs. 14.4 +/- 1.0 h). No significant correlations were found between insulin Ab levels and any of these 3 parameters of insulin action. However, the peak effect and total duration of insulin action were significantly correlated with the baseline serum glucose levels. A possible role of insulin Abs was evaluated in these patients by repeating the studies over a 2-year period. During this time, the previously untreated patients were treated with highly purified pork insulin, to which they developed low titers of insulin Abs. The diabetic patients who had been chronically treated with insulin were changed from less purified insulin to highly purified pork insulin, and all had a significant reduction in their Ab titers. No changes in insulin pharmacokinetics were found in either group. These studies demonstrate that the prolonged action of sc injected regular insulin in diabetic patients is not related to the effect of circulating insulin Abs. PMID- 3512592 TI - Regulation of amino acid uptake and deoxyribonucleic acid synthesis in isolated human fetal fibroblasts and myoblasts: effect of human placental lactogen, somatomedin-C, multiplication-stimulating activity, and insulin. AB - We compared the abilities of human placental lactogen (hPL), somatomedin C/insulin-like growth factor I (SM-C/IGF-I), multiplication-stimulating activity (MSA), and insulin to induce a rapid anabolic event, the uptake of the nonmetabolizable amino acid [3H]alpha-aminoisobutyric acid ([3H] AIB) or the more long term action of increasing [3H]thymidine incorporation, as a measure of DNA synthesis, in isolated human fetal fibroblasts and myoblasts. Myoblasts were derived from skeletal muscle and fibroblasts from skin explants removed from human fetuses delivered between 12 and 19 weeks gestation after prostaglandin induced abortion. Each of the four peptides caused a dose-dependent increase in [3H]AIB uptake by both fibroblasts and myoblasts, with mean half-maximal concentrations (ED50) ranging from 0.9-1.9 nM. The concentration of each peptide required to stimulate [3H]thymidine uptake was significantly greater, with the exception of insulin, which was inactive. For myoblast cultures, the mean ED50 values were: hPL, 7.9 nM; SM-C/IGF-I, 2.0 nM; and MSA, 2.2 nM. For fibroblast cultures, the mean ED50 values were: hPL, 2.3 nM; SM-C/IGF-I, 3.3 nM; and MSA, 4.3 nM. Insulin did not stimulate [3H]thymidine incorporation into either cell type at concentrations up to 6.9 nM. Incubation in the presence of monoclonal antibody against SM-C/IGF-I abolished the ability of SM-C/IGF-I to stimulate either [3H]thymidine or [3H]AIB uptake into fetal fibroblasts. The antibody substantially inhibited the incorporation of [3H]thymidine by these cells in response to hPL, but was less effective in blocking hPL-stimulated [3H]AIB uptake. It did not inhibit the uptake of either radioisotope in response to MSA or [3H]AIB uptake in response to insulin. The actions of SM-C/IGF-I and hPL on thymidine incorporation were additive at submaximal concentrations, but not so at maximal individual concentrations. Their actions on AIB uptake were additive at both submaximal and maximal concentrations. The results suggest that hPL as well as the SMs may contribute to the growth stimulus in human fetal connective tissues. Since incubation with SM-C/IGF-I antibody reduced the mitogenic response of fetal cells to hPL, the actions on DNA synthesis may be partially mediated by local release of SM. However, the similar ED50 values with which these peptides stimulated [3H]AIB uptake during a short incubation, and their additive effects at maximal individual concentrations, suggest that hPL may also have direct actions. PMID- 3512591 TI - Familial hyperinsulinemia associated with secretion of an abnormal insulin, and coexistence of insulin resistance in the propositus. AB - A 45-yr-old muscular nonobese white man who had a 9-yr history of syncopal episodes was studied on several occasions between April 1979 and August 1984. Fasting glucose concentrations ranged between 74-115 mg/dl, and those of insulin ranged between 14-64 microU/ml. Reactive hypoglycemia 3-4 h after ingestion of glucose occurred in the first 2 yr. Glucose tolerance was impaired in 1979, from February 1982 through September 1983, and again in August 1984. The maximum plasma insulin response to glucose ranged between 475-1630 microU/ml. When studied in November 1982, insulin (0.1 U/kg) caused a fall in blood glucose concentration of only 25% (normal, greater than 50%), and maximal glucose utilization during the euglycemic hyperinsulinemic clamp was 7.5 mg/kg . min (normal, greater than 12 mg/kg . min). Plasma counterregulatory hormone concentrations were normal, and antibodies to insulin and the insulin receptor were absent. Binding of exogenous insulin to the patient's cellular receptors (monocytes, red blood cells, and skin fibroblasts) was normal. Insulin was purified from plasma by immunoaffinity and molecular sieve chromatography and was found to elute later than human insulin on reversed phase high performance liquid chromatography. It was more hydrophobic than normal human insulin and had only 10% of the activity of normal insulin in terms of ability to bind to and stimulate glucose metabolism in isolated rat adipocytes. The abnormal insulin was identified in two of three sons and a sister, but not in the mother, brother, or niece. Sensitivity to insulin was normal in the two sons who had abnormal insulin. These results suggest that in this family the abnormal insulin was due to a biosynthetic defect, inherited as an autosomal dominant trait. The hyperinsulinemia was not associated with diabetes in family members who had no insulin resistance. PMID- 3512593 TI - Absence of growth hormone response to L-dopa and bromocriptine in hyperprolactinemic women with pituitary microadenoma. AB - The administration of an amino acid precursor of both dopamine and norepinephrine, L-dopa, or of a dopamine agonist, bromocriptine, did not alter basal GH secretion in hyperprolactinemic women with pituitary microadenoma, whereas both significantly increased serum GH levels in normal women. The findings cannot be accounted for by decreased pituitary GH reserve, since in hyperprolactinemic women, insulin elicited an increase in GH levels similar to its action in normal women. Thus, the mechanism by which L-dopa or bromocriptine stimulates GH secretion appears to be different from that of insulin. PMID- 3512595 TI - [Recent advances in the surgical treatment of cerebral vascular disease]. PMID- 3512594 TI - The effects of proinsulin pretreatment on the combined actions of insulin and proinsulin in normal man. AB - With the recent availability of biosynthetic human proinsulin there has been a renewed interest in evaluating its metabolic effects, either alone or in combination with insulin. It has been suggested that pretreatment with proinsulin enhances the hypoglycemic response to subsequently administered insulin. On the other hand, the simultaneous administration of proinsulin and insulin has additive, not synergistic, effects. To clarify this question we used the euglycemic glucose clamp technique in 10 normal subjects to compare the steady state effects on glucose disposal of combined infusions of insulin (0.54 microgram/M2 . min, equivalent to 15 mU/M2 . min) and proinsulin (2.75 micrograms/M2 . min) given both simultaneously and sequentially. The mean +/- SEM steady state glucose disposal rates were similar whether the two hormones were given simultaneously (7.2 +/- 0.7 mg/min . kg), after proinsulin pretreatment (7.7 +/- 0.7 mg/min . kg), or after insulin pretreatment (7.1 +/- 0.7 mg/min . kg). The serum proinsulin concentration of 5.39 +/- 0.3 pmol/ml during the infusion of proinsulin alone was unchanged by the simultaneous infusion of insulin, suggesting that in the doses used, insulin did not affect proinsulin clearance. We conclude that in normal subjects there is no enhancement of the combined action of insulin and proinsulin to stimulate glucose disposal by pretreatment with proinsulin or insulin. PMID- 3512596 TI - Evaluation of the structural proteins of the hamster neurotropic strain of measles virus with monoclonal antibodies. AB - The virus-specified proteins produced by cells persistently infected with hamster neurotropic strain (HNT) of measles virus were assessed by a panel of monoclonal antibodies. In comparison to the Edmonston strain a number of differences were detected. The HA protein lacks epitopes identified by certain monoclonal antibodies. Some of the absent epitopes may relate to agglutination, because this biological phenomenon is not produced by HNT virus. Phosphoprotein (P) of the usual size (70 kDa) was not detected. Instead a protein with an approximate MW of 36 kDa which reacted with one monoclonal anti-P was identified. Although matrix protein (M) was not detected, mRNAs for P and M proteins were present. However, these in contrast to the mRNAs from Edmonston strain, did not translate in vitro. These abnormalities may relate to neurotropism and the capacity of HNT to produce persistent CNS infection. PMID- 3512597 TI - Early evolution and incidence of electroencephalographic abnormalities in Creutzfeldt-Jakob disease. AB - The clinical and EEG findings in patients in the literature with Creutzfeldt Jakob disease (CJD) were reviewed and compared with findings in 36 patients with CJD at the Massachusetts General Hospital (MGH). Twenty-one of the 36 MGH cases had histopathology, all with findings consistent with CJD. EEGs in 18 patients studied pathologically and in 10 without pathological investigation (28 of the 36) had periodic sharp wave complexes (PSWC) at some time during the clinical course. Of the other eight patients, two had only a single EEG early in the course of the illness, four experienced unusually long clinical courses, and two never showed PSWC despite numerous EEGs. PSWC made their appearance within 12 weeks of onset of clinical symptoms in 25 of 27 in whom EEGs were done during that period. In the early stages, EEGs in 14 of 28 showed focal PSWC or amplitude asymmetries of PSWC that corresponded well with focal myoclonus or other focal neurological abnormalities. In the literature, PSWC occurred within 12 weeks of the onset of the illness in 66 of 75 patients (88%) with CJD who had comparable clinical and neuropathological findings and adequate EEG data during the first 3 months of the illness. In the approximately 10% of patients who experienced unusually long courses, PSWC occurred in only about 55%. The presence of PSWC in association with the appropriate clinical, biochemical, cerebrospinal fluid, and neuroradiological findings is diagnostic of CJD. Brain biopsy is, therefore, unnecessary even when clinical therapeutic trials are undertaken and certainty of diagnosis is required. The absence of PSWC in the EEG after 12 weeks' duration of illness is a point strongly against the diagnosis of CJD unless it is a rare subtype of long duration. Only those patients without PSWC need to be biopsied. PMID- 3512598 TI - In vivo inflammatory activity of epidermal cell-derived thymocyte activating factor and recombinant interleukin 1 in the mouse. AB - Epidermal cell-derived thymocyte activating factor (ETAF), a cytokine produced by keratinocytes, has previously been shown to be biochemically and functionally very similar, if not identical, to interleukin 1 (IL-1). Both ETAF and IL-1 have been demonstrated to be chemotactic for neutrophils and mononuclear cells in vitro. In order to demonstrate that this activity has physiological relevance we have used a simple in vivo model. The present study demonstrates that injection of high-titer ETAF or purified recombinant murine IL-1 into the mouse footpad results in an influx of neutrophils into the site with peak accumulation at 4 h. Footpad swelling also occurs with a time course roughly paralleling that of the neutrophil accumulation. Injection of control proteins failed to reproduce this phenomenon. Margination of neutrophils within blood vessels was seen within 1 h of injection of ETAF or IL-1, followed by entry into the stroma by 4 h. This suggests that chemotactic activity and not merely increased adherence or inhibition of migration is occurring. 5-10 d of daily, subcutaneous injection of ETAF on the mouse flank resulted in an infiltrate of neutrophils, and to a lesser degree, mononuclear cells in association with epidermal hyperplasia, subcutaneous fibrosis, and focal muscle necrosis in the panniculus carnosus. These findings were not seen in control sites injected with media. These findings provide direct in vivo experimental evidence suggesting a physiologic role for ETAF/IL-1 in local inflammation. PMID- 3512599 TI - Retrograde perfusion as a model for testing the relative effects of glucose versus insulin on the A cell. AB - In order to determine whether the A cell may be directly suppressed by glucose in the absence of insulin, canine pancreata were perfused in vitro, both antegrade, through the arterial system and retrograde, through the venous system. Studies of the islet microvasculature have suggested that blood flows from the B cell core to the mantle; thus, the A cell may be tonically inhibited by intra-islet insulin. Retrograde perfusion may then be expected to prevent insulin from reaching the A cell, releasing it from inhibition. Retrograde perfusion with 88 mg/dl glucose markedly increased both insulin and glucagon secretion relative to antegrade levels. In a series of experiments, glucose concentrations were changed from 88 to 200 mg/dl. An antegrade glucose change resulted in increased insulin (134+/-21%; P less than 0.0025) and decreased glucagon (-26+/-9%, P less than 0.025) secretion. A retrograde glucose increase resulted in increased secretion of both insulin (91+/-15%; P less than 0.0005) and glucagon (23+/-9%; P less than 0.0125). To confirm that retrograde perfusion deprived the A cell of endogenous core derived, vascularly delivered insulin, possibly resulting in increased insulin sensitivity, 0.3 mU/ml exogenous porcine insulin was infused. Antegrade, 0.3 mU/ml insulin, had no effect on glucagon secretion (P less than 0.250), while retrograde infusion of 0.3 mU/ml insulin significantly inhibited glucagon secretion (-31 + 8%; P less than 0.0005). The results of our study support the concept that the direction of blood flow and of flow-dependent intra-islet hormone interactions are from the islet B cell core to the mantle. It was further concluded that the normal A cell may not be suppressed by glucose in the absence of insulin. PMID- 3512600 TI - Splanchnic and peripheral glucose and lactate metabolism during and after prolonged arm exercise. AB - Splanchnic and peripheral exchange of glucose and gluconeogenic substrates was examined in 12 healthy subjects during 2 h of arm or leg exercise on a bicycle ergometer and during a 40-min postexercise recovery period. The work intensity corresponded to 30% of the maximal pulmonary oxygen uptake. The regional exchange of substrates was evaluated using catheter technique and indicator dilution methods for blood flow measurements. Our findings indicate that prolonged arm exercise as compared with exercise with the legs results in a greater increase in heart rate (25-40%) and a more marked reduction in splanchnic blood flow (10-30%) as well as higher arterial concentrations of lactate, free fatty acids, and catecholamines. The respiratory exchange ratio was consistently higher with arm exercise. In addition, arm exercise results in a greater fractional extraction and utilization of glucose by exercising muscle as well as a greater hepatic gluconeogenesis from lactate and glycerol. During recovery from prolonged arm exercise, leg muscle becomes an important site of lactate release to the splanchnic bed, despite a lack of net glucose uptake by the leg. Simultaneously, arm muscle shows an increase in glucose uptake in the absence of a net release of lactate. These coincident but discordant processes in the leg and arm during recovery suggest the occurrence of a redistribution of muscle glycogen from previously resting (leg) muscle to previously exercising (arm) muscle. PMID- 3512601 TI - The source of the circulating aggregate of insulin in type I diabetic patients is therapeutic insulin. AB - Circulating insulin immunoreactivity (IRI) in type I diabetic patients (insulin dependent diabetes mellitus [IDDM]) includes a covalent aggregate about twice the size of insulin. These studies were designed to determine the source and conditions promoting the accumulation of this material. Among 31 IDDMs, the aggregate made up 28 +/- 3.6% of the mean fasting plasma IRI. Five of these patients were restudied after 5 d of treatment with equidose intravenous insulin. The relative amount of the aggregate during subcutaneous treatment (40 +/- 8.0%) was indistinguishable (P greater than 0.7) from that at the termination of intravenous treatment (41 +/- 6.8%). To determine whether previous exposure to therapeutic insulin influenced the appearance and accumulation of the aggregate, we intravenously or subcutaneously infused insulin for 5 h in nine healthy volunteers (euglycemic clamp). At the termination of the high-dose intravenous infusion (10 mU X kg-1 X min-1), the concentration of the aggregate was 81 +/- 18 microU/ml, and it accounted for 2.9% of total IRI. At the conclusion of the other infusion protocols, the absolute amounts of aggregate were somewhat less, but they accounted for similar percentages. On polyacrylamide gel electrophoresis, the circulating aggregate was indistinguishable from a material of similar molecular weight contaminating commercial insulin. We conclude that the insulin aggregate found in the blood of IDDMs originates in commercial insulin. Its appearance is independent of the route of insulin administration. Prolonged and continuous use of insulin may increase its concentration but is not necessary for its appearance. The potential biologic and immunologic consequences of the aggregate are important matters that need to be addressed. PMID- 3512602 TI - Abnormal antithrombin III with defective serine protease binding (antithrombin III "Denver"). AB - A hereditary (three family members) deficiency of antithrombin III (AT-III) in which AT-III antigen (AT-III ag) is normal in spite of low heparin cofactor and antithrombin activity is described. Plasma levels were: AT-III ag, 0.92-0.96 U/ml; AT-III heparin cofactor activity, 0.54-0.62 U/ml; progressive antithrombin activity index, 0.13-0.18; anti-Xa activity, 0.50-0.56 U/ml. Plasma crossed immunoelectrophoresis (CIE) patterns performed with and without added heparin were normal, but serum CIE revealed a decreased complex peak. Purification of the patient's plasma AT-III by heparin-sepharose affinity chromatography showed a normal protein recovery and elution profile, but the purified AT-III fraction showed only 50% of the normal progressive thrombin neutralization and anti-Xa activity. When thrombin-antithrombin (TAT) complexes were formed by incubating with excess thrombin, SDS-polyacrylamide gel electrophoresis (PAGE) analysis revealed that half the patient AT-III formed TAT complexes while the remainder migrated as free AT-III. All the control AT-III formed TAT complexes. The patient's nonreacting AT-III (AT-III "Denver"), isolated by affinity chromatography, showed CIE and SDS-PAGE migration patterns characteristic of normal AT-III but failed to bind thrombin or Xa. Calculations from turnover studies in one patient and normal subjects with autologous 131I-AT-III suggested that AT-III "Denver" is removed from the plasma slightly more rapidly than normal. These studies indicate that the patients' variant AT-III molecule was characterized by normal heparin interaction but defective binding and inhibition of thrombin and Xa. These characteristics allow isolation of the nonreactive variant molecule by heparin-sepharose affinity chromatography. PMID- 3512603 TI - Chronic hyperglycemia is associated with impaired glucose influence on insulin secretion. A study in normal rats using chronic in vivo glucose infusions. AB - We have proposed that chronic hyperglycemia alters the ability of glucose to modulate insulin secretion, and have now examined the effects of different levels of hyperglycemia on B cell function in normal rats using chronic glucose infusions. Rats weighing 220-300 g were infused with 0.45% NaCl or 20, 30, 35, or 50% glucose at 2 ml/h for 48 h, which raised the plasma glucose by 18 mg/dl in the 30% rats, 37 mg/dl in the 35% rats, and 224 mg/dl in the 50% group. Insulin secretion was then examined using the in vitro isolated perfused pancreas. Glucose-induced insulin secretion remained intact in the normoglycemic 20% glucose rats and it was potentiated in the mildly hyperglycemic 30% glucose rats. However, with even greater hyperglycemia in the 35% glucose group the insulin response to a high glucose perfusate was severely blunted, and it was totally lost in the most hyperglycemic 50% glucose rats. In a second protocol that examined glucose potentiation of arginine-stimulated insulin release, a similar impairment in the ability of glucose to modulate the insulin response to arginine was found with increasing levels of chronic hyperglycemia. On the other hand, the ability of a high glucose concentration to inhibit arginine-stimulated glucagon release was preserved in all glucose-infused rats, but the glucagon levels attained in response to the arginine at 2.8 mM glucose were much less in the 50% glucose rats than in all the other groups. These data clearly show that after 48 h of marked hyperglycemia, glucose influence upon insulin secretion in the rat is severely impaired. This model provides a relatively easy and reproducible method to study the effects of long-term hyperglycemia on B cell function. PMID- 3512605 TI - The TM-Sidhi programme, age, and brief tests of perceptual-motor speed and nonverbal intelligence. AB - Three brief tests that assess perceptual-motor speed and two that assess nonverbal intelligence were administered to individuals who were practicing the Transcendental Meditation and TM-Sidhi programme. Multiple regression analyses showed that when motivation (measured on a 5-point self-rating scale), age, sex, education, and duration of practice of the Transcendental Meditation technique were held constant, number of months of practice of the TM-Sidhi programme significantly predicted higher performance on two of the perceptual-motor speed tests and both tests of intelligence. Age predicted lower scores on the same tests. PMID- 3512604 TI - Spontaneous diabetes mellitus in the Bio-Breeding/Worcester rat. Evidence in vitro for natural killer cell lysis of islet cells. AB - We sought direct evidence for anti-islet cellular cytotoxicity in diabetic Bio Breeding/Worcester (BB/W) rats by comparing the effects of splenic lymphoid cells from BB/W diabetic (D), diabetes-prone (DP), and diabetes-resistant (DR) rats on the release of 51Cr from damaged islet cells in vitro. D and DP splenic lymphoid cells were cytotoxic to major histocompatibility complex (MHC)-compatible Wistar Furth (WF) rat islet cells and also to MHC-incompatible Lewis rat islet cells and a rat islet cell line (RIN 5F), whereas WF and Lewis rat spleen cells and a rat pituitary cell line (GH3) were not lysed by lymphoid cells from D or DP rats. The cytotoxic cells were identified as natural killer (NK) cells since NK-sensitive cells (G1-TC and YAC-1 cell lines) were lysed by D and DP spleen cells, YAC-1 cells competed for the lysis of RIN islet cells by D spleen cells, lysis of RIN cells was increased by using D spleen cells from the low density fraction (large lymphocytes/monocytes) of a Percoll density gradient, and incubation of D spleen cells with an antiserum to NK cells (anti-asialo GM1 serum) and complement decreased monoclonal antibody-defined subsets containing NK cells (W3/13+ OX19- and OX8+), and this was accompanied by similar decreases in cytotoxicity to YAC 1, RIN, and WF islet cells. These studies demonstrate that NK cell activity is increased in BB/W diabetic and DP rats, and that islet cells can serve as targets for these NK cells. The findings suggest that NK cells may participate in the islet-directed cellular cytotoxic response leading to beta cell destruction and diabetes. PMID- 3512606 TI - Occurrence of yellow and blue-green fluorescence exhibited by renal tubular cells, red blood cells, and lymphocytes found in urinary sediments of renal allograft recipients immunosuppressed with cyclosporin A. PMID- 3512607 TI - Commercial strip test for reduction of nitrate by bacteria. PMID- 3512608 TI - Does ovarian sex cord tumour with annular tubules produce progesterone? AB - Probable progesterone production was identified by an immunoperoxidase assay in a case of an ovarian sex cord tumour with annular tubules. The tumour was associated with a serous cystadenofibroma in the opposite ovary and with adenoma malignum (adenocarcinoma) of the cervix. PMID- 3512609 TI - Alpha-1-antitrypsin and the liver: a routine immunohistological screen. AB - One hundred and eighty five consecutive liver biopsies were immunostained using anti-alpha-1-antitrypsin to assess the use of routine immunohistochemistry in the diagnosis of alpha-1-antitrypsin (AAT) deficiency. About half the livers showed staining of hepatocytes for alpha-1-antitrypsin, but most of these livers showed a panlobular pattern, possibly indicating increased synthesis of AAT. Only ten contained periportal granules, said to be typical of AAT deficiency. In cases in which serum was also available for quantitation and phenotyping there was no absolute relation between staining pattern, phenotype, and serum concentrations: the immunohistological screening technique, therefore, has limitations in the diagnosis of AAT deficiency in liver biopsy specimens. PMID- 3512610 TI - Immunophenotype analysis of malignant histiocytosis of the intestine. AB - Five cases of malignant histiocytosis of the intestine and one case of true histiocytic lymphoma were studied using immunohistological techniques. In paraffin sections tumour cells in all cases were shown to contain alpha-1 antitrypsin and to express the leucocyte common antigen. Four of the five cases of malignant histiocytosis of the intestine and the case of histiocytic lymphoma expressed the epithelial membrane antigen. Cryostat sections in four cases of malignant histiocytosis of the intestine showed that most tumour cells reacted with anti-T cell monoclonal antibodies. Only a minority expressed a typical monocyte macrophage phenotype. PMID- 3512611 TI - Evaluation of lysis filtration as an adjunct to conventional blood culture. AB - A lysis filtration system was used in conjunction with conventional broth culture for 1112 blood cultures. The system, which entailed collection of 5 ml of blood into bottles containing 50 ml isotonic phosphate buffer, Tween 20, and Rhozyme with subsequent filtration using a 0.45 micron Millipore field monitor, was simple and economical to use. Positive results were obtained earlier than those obtained with conventional broth cultures, and almost twice as many fungi and yeasts were isolated. Some fastidious organisms such as Haemophilus influenzae and Streptococcus pneumoniae however, were not recovered from the lysis system, and contaminants in lysis cultures were three times as common as in conventional culture. The number of positive cultures was also adversely influenced by incubation of the blood lysis mixture overnight before filtration. We conclude that this lysis filtration system is useful as an adjunct to conventional broth culture in selected patients in cases in which filtration can be carried out soon after collection. PMID- 3512612 TI - Cyclosporin and renal graft histology. AB - The histology of renal allografts was compared in a series of 107 biopsies from patients receiving cyclosporin and 126 biopsies from patients receiving azathioprine and prednisolone. Patients receiving cyclosporin were converted to azathioprine and prednisolone 90 days after transplantation. Biopsies were taken routinely at 7, 21, 90, and 365 days, irrespective of clinical graft function and were examined "blind" by two independent observers. Interstitial haemorrhage was more common in patients treated with azathioprine and prednisolone corresponding with their poorer graft survival. Analysis of glomerular, tubular, vascular, and interstitial changes showed no other important differences between the two groups despite clinical evidence of reversible cyclosporin nephrotoxicity. Quantitation of interstitial fibrosis in 90 day biopsies showed it to be equal in prevalence after treatment with azathioprine and prednisolone and cyclosporin. It was preceded by diffuse interstitial cellular infiltration, a common finding in early biopsies. Diffuse cellular infiltrates were generally associated with higher serum creatinine concentrations and, if persistent, a poorer graft prognosis than focal infiltrates, but they were not always associated with renal dysfunction. PMID- 3512614 TI - Detection of group B streptococcal antigen in necropsy specimens using monoclonal antibody and immunoperoxidase staining. AB - A murine monoclonal antibody, which recognises various serotypes of group B Streptococcus in formalin fixed, paraffin embedded tissue, was used to show the organism in necropsy specimens of newborn infant lung by an indirect immunoperoxidase technique. The method seemed to be complementary to that of Gram staining, and may be successfully used to identify group B Streptococcus antigen in histopathological material. PMID- 3512613 TI - Morphological differentiation between rejection and cyclosporin nephrotoxicity in renal allografts. AB - In a prospective study of renal dysfunction in 60 consecutive allograft recipients treated with cyclosporin and prednisolone routine renal biopsies at one week and one month after transplantation, as well as for all episodes of renal dysfunction, were performed. The one year graft survival of this group was 88%. In a retrospective clinical analysis of these patients 35 episodes of dysfunction due to rejection, defined by a response to antirejection treatment alone, and 30 episodes due to cyclosporin nephrotoxicity, defined by a response to reduction in cyclosporin dose alone, were identified. The morphological findings from these biopsies were compared with 20 samples from routine biopsies taken from patients with stable renal function. All patients diagnosed as having rejection had a diffuse, interstitial mononuclear cell infiltrate (32 of 35) or arteritis (19 of 35), or both. In contrast, focal mononuclear cell infiltrates were common in both patients with nephrotoxicity and those with stable function (17 of 30 and 14 of 20, respectively). There were no important differences between biopsies from those with nephrotoxicity and those with stable function, except that arteriolar hyalinosis was considerably more common in the nephrotoxic patients than in those with stable function. Many patients with stable function were, in retrospect, in a state of stable mild nephrotoxicity. In our experience rejection should only be diagnosed when there is at least a diffuse interstitial infiltrate or an arteritis. Focal mononuclear cell infiltrates do not denote rejection. The development of arteriolar lesions in the absence of rejection is indicative of nephrotoxicity. PMID- 3512615 TI - Detection of Chlamydia trachomatis by enzyme immunoassay, immunofluorescence, and cell culture. PMID- 3512616 TI - Comparison of methods for detecting Chlamydia trachomatis. PMID- 3512617 TI - Current concepts in the treatment of rheumatoid arthritis. AB - The treatment of RA is complex and often frustrating. The pathologic process of RA is composed of acute inflammation, chronic immunologic phenomenon, and chronic connective tissue degradation. It is important to understand not only the pathophysiology of RA but also the mechanism of action of our therapeutic drugs so that treatment can be tailored to affect the important aspects of the process leading to end-organ damage. Despite the many drugs available, therapy is still unsatisfactory. Many drugs work in only certain patients. This could be secondary to variability in the disease state or to difference in drug metabolism. A better understanding of both disease and therapeutic agents may lead to better use of our present agents and development of new, more effective treatment modalities. PMID- 3512618 TI - Ibopamine in congestive heart failure refractory to digitalis, diuretics, and captopril. PMID- 3512619 TI - Effects of low-dose aspirin on responses to furosemide. AB - We assessed the effects of low-dose aspirin (0.5 and 15 mg/kg/d) on renal prostaglandin synthesis and action in healthy volunteers using intravenous furosemide as a stimulus. Inhibition of platelet cyclo-oxygenase was assessed by changes in serum thromboxane B2 (TXB2) level. After one week of treatment, ten healthy subjects did not show any change in weight, blood pressure, or diuretic and natriuretic responses to furosemide with either dose of aspirin. Serum TXB2 level was reduced to 3% of control by aspirin 0.5 mg/kg/d and to 0.1% by the higher dose. In contrast, urine excretion of TXB2 was only reduced to 68% and 51% of the placebo value, whereas 6-keto-prostaglandin F1 alpha (6kPGF1 alpha) excretion was not decreased by either dose. Furosemide produced a transient increase in excretion rates of TXB2 and 6kPGF1 alpha that was of lesser duration than the diuretic response. These transient increases were slightly reduced by aspirin. Baseline plasma renin activity was not affected by either dose of aspirin. The brisk increment in plasma renin activity seen ten minutes after furosemide, as well as later values (30 and 240 min) were not changed by aspirin. We conclude that chronic low-dose aspirin can profoundly affect platelet PG production without affecting stimulated renal PGI2 production or plasma renin activity. There is a modest reduction in urine TXB2 excretion that is consistent with a primarily renal source of this metabolite. PMID- 3512620 TI - Enhancement of the antiemetic action of metoclopramide against cisplatin-induced emesis by transdermal electrical nerve stimulation. AB - In a double-blind sequential trial, the influence of transdermal electrical nerve stimulation (TENS) was studied in patients who were treated with total infusions of metoclopramide 3.5 mg/kg to counter the emetic action of cisplatin 60-90 mg/m2. Transdermal electrical nerve stimulation further reduced the emetic episodes in ten of 11 treatment pairs (2 alpha = .10). This effect was blocked by naloxone. More surprisingly, TENS reduced the incidence of extrapyramidal effects of metoclopramide (i.e., akathisia and dystonia). These effects may be explained by the involvement of central nervous and peripheral TENS-induced production of opioid neuromodulators. An alternate hypothesis is the stimulation of serotonergic mechanisms via neuromodulation by opioid peptides, or by involvement of both systems. PMID- 3512621 TI - Ethmozine toxicity: fever of unknown origin. PMID- 3512622 TI - A controlled clinical trial of fluspirilene, a long-acting injectable neuroleptic, in schizophrenic patients with acute exacerbation. AB - A 4-week double-blind controlled clinical trial was carried out in which fluspirilene, an injectable diphenylbutylpiperidine neuroleptic given weekly, was compared to chlorpromazine in the treatment of 40 newly admitted schizophrenic patients with acute exacerbation. Similar therapeutic improvement was obtained with both drugs, but men needed a significantly higher mean dose of fluspirilene (23 mg/week) than women (13 mg/week). Fluspirilene induced more parkinsonism than chlorpromazine, but less drowsiness, dizziness, and dry mouth. The difference between the sexes in the potency of fluspirilene and its greater potential to induce parkinsonism may be related to its lesser presynaptic and D1-dopamine receptor blocking properties. The low incidence of autonomic side effects confirms the relative specificity of fluspirilene for dopamine receptors. PMID- 3512623 TI - The study of childhood language disorders: nineteenth century perspectives. AB - Childhood language disorders have been known and studied at least as far back as the early nineteenth century. The results of the early investigations, however, have essentially been forgotten. The aim of this article is to recall the investigators of the nineteenth century and their findings. Throughout most of that period efforts were directed simply at establishing the existence of mutism without deafness or "idiocy." In the last two decades an "information explosion" took place, authored by a small group of German-speaking physicians. On the basis of their clinical observations they described the disorders, offered theories on their nature and etiology, and devised therapy programs. These findings and theoretical constructions are presented, along with information on the probable sources of the authors' ideas. Although resemblances to modern concepts are often striking, it seems unlikely that the earlier work is the source of the more recent ones. PMID- 3512624 TI - Anatomical studies on the nucleus reticularis tegmenti pontis in the pigmented rat. I. Cytoarchitecture, topography, and cerebral cortical afferents. AB - The nucleus reticularis tegmenti pontis (NRTP) is a precerebellar reticular nucleus that has been found to be related to cerebropontocerebellar pathways and, more recently, to eye movements. The present study investigates the cytoarchitecture, the topography, and the cerebral cortical projections to the NRTP in the pigmented rat. The cytoarchitecture and topography of the NRTP was determined by examination of Nissl-stained material sectioned in the transverse and sagittal planes. Two cytoarchitectonically distinct portions of the NRTP are apparent; a central subdivision (NRTPc) composed of large multipolar, small spherical, and fusiform neurons, and a pericentral subdivision (NRTPp) composed of loosely packed small fusiform and spherical neurons. The NRTPc is located dorsal to the medial lemniscus and pyramidal tracts over the caudal two-thirds of the pons. It extends caudodorsally to the region just rostral and ventral to the abducens nucleus. The NRTPp is adjacent to the lateral margins of the NRTPc, rostrally, and lies ventral to the caudal portions of the NRTPc. Large injections of horseradish peroxidase (HRP) were made into the cerebellum in order to determine the degree to which each subdivision of the NRTP contributes to the cerebellar projection. A high percentage of NRTPc neurons and a lower percentage of NRTPp neurons were labeled. These differences in labeling density and neuronal morphology noted above confirm the appropriateness of subdividing the NRTP into central and pericentral subdivisions. The cerebral cortical afferents to the NRTP were examined by placing small iontophoretic injections of HRP into the NRTPc and NRTPp. A systematic examination of all cortical areas revealed that the HRP labeled neurons are entirely localized within pyramidal layer V of three major cortical areas: the ipsilateral prefrontal cortex (Brodmann areas 8, 8a, 11, and 32); the ipsilateral motor and somatosensory cortices (Brodmann areas 2, 4, 6, and 10), and the bilateral cingular cortex (Brodmann areas 24a, 24b, 29c, and 29d). By far, the heaviest cortical labeling with HRP injections into the medial NRTPc is within the cingular cortex that may, in the rat, be homologous to the frontal eye field of the cat and monkey. In contrast, injections involving the lateral NRTPc or the NRTPp produced labeling within wide regions of the cortex with the greatest number in the somatomotor cortex.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3512625 TI - Anatomical studies on the nucleus reticularis tegmenti pontis in the pigmented rat. II. Subcortical afferents demonstrated by the retrograde transport of horseradish peroxidase. AB - The subcortical nuclear groups projecting to the nucleus reticularis tegmenti pontis (NRTP) were studied in pigmented rats with the aid of the retrograde horseradish peroxidase (HRP) technique. Small iontophoretic injections of HRP were placed in the medial regions of the NRTP, an area that has been shown in several species to be involved in eye movements. Other large injections in the NRTP or small injections placed just outside the nucleus were used to clarify the projections to the NRTP. Results indicate that the NRTP receives afferents from visual relay nuclei, including the nucleus of optic tract, the superior colliculus, and the ventral lateral geniculate nucleus; oculomotor-associated structures including the zona incerta, the H1 and H2 fields of Forel, the nucleus subparafasciculus, the interstitial nucleus of Cajal, the visual tegmental relay zone of the ventral tegmental area of Tsai, the mesencephalic, pontine, and medullary reticular formations, the nucleus of the posterior commissure, and a portion of the periaqueductal gray termed the supra-oculomotor periaqueductal gray; cerebellar and pontomedullary nuclei, including the superior, lateral, and medial vestibular nuclei, the deep cerebellar nuclei, and NRTP interneurons, and nuclei related to limbic functions including the lateral habenula, the mammillary nuclei, the hypothalamic nuclei, the preoptic nuclei, and the nucleus of diagonal band of Broca. A surprisingly large number of afferents to the medial regions of the NRTP arise from visual- or eye-movement-related nuclei. The projection from the nucleus of the optic tract (NOT) confirms previous anatomical and physiological studies on the pathways involved in horizontal optokinetic nystagmus, but the number of NOT afferents is small in relation to other areas potentially related to visuomotor pathways such as the zona incerta, ventral lateral geniculate nucleus, fields of Forel, perirubral area, and subparafasciculus. The NRTP may also relay information related to vertical visuomotor reflexes (e.g., vertical optokinetic nystagmus) given the strong projections from the medial terminal nucleus of the accessory optic system, visual tegmental relay zone, supra-oculomotor periaqueductal gray, interstitial n. of Cajal, and midbrain reticular formation. The presence of significant NRTP projections from the superior colliculus and the mesencephalic and pontine reticular formations suggests that these nuclei may provide the pathways for the noted saccade-related activity of NRTP neurons. In addition, projections from the vestibular nuclei were found that provide the anatomical basis for head velocity signals recorded in NRTP neurons.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3512626 TI - Morphology and physiology of abducens motoneurons and internuclear neurons intracellularly injected with horseradish peroxidase in alert squirrel monkeys. AB - Axons of abducens motoneurons and internuclear neurons were penetrated with HRP filled glass microelectrodes in alert squirrel monkeys. The firing rate of these axons and spontaneous eye movements were recorded and the axons were then injected with HRP for subsequent visualization of the recorded cells. Soma dendritic and axon and axonal terminal morphology were studied for possible correlation with firing frequency. The physiology of squirrel monkey abducens neurons is qualitatively similar to their counterparts in the rhesus monkey and the cat, being primarily correlated with the position and velocity of the eyes. The locations of moto- and internuclear neurons are similar in the squirrel monkey and cat as are the axonal projections and terminals. However, squirrel monkey abducens cells are smaller than their feline counterparts and have dendrites that are confined to the cellular borders of the abducens nucleus. The size of the soma and proximal dendrites of moto- and internuclear neurons are poorly correlated with either their threshold for recruitment or their tonic eye position sensitivity. However, cells with smaller dendritic trees tended to have higher saccadic eye velocity sensitivity than those with larger trees. Three types of internuclear neurons were distinguishable upon the basis of their axon collaterals. All cells terminated within the medial rectus subdivision of the oculomotor nucleus. One class of cells did not give rise to collaterals before projecting to the oculomotor nucleus and the other classes gave rise to collaterals that terminated in the intermediate and/or caudal interstitial nuclei of the median longitudinal fasciculus. Within the IIIrd nucleus internuclear terminations were usually confined to a single subgroup of medial rectus motoneurons. PMID- 3512627 TI - The origin, course, and termination of the hippocampothalamic projections in the macaque. AB - The projections from the hippocampal formation to the thalamus were investigated with both anterograde and retrograde tracers. Horseradish peroxidase was injected into medial and midline thalamic sites in six cases, and tritiated amino acids were injected into the hippocampal formation in nine others, five of which had prior transections of the fornix. Only the subicular and entorhinal cortices were found to project to the thalamus. From the subicular cortex, dense bilateral projections were traced through the fornix to the anterior nuclei, while lighter fornical projections terminated in other rostral midline sites, including the nuclei reuniens, centralis latocellularis, and paraventricularis. These projections arose predominantly from the polymorphic cells which are located in the deepest cellular layers of the subiculum and prosubiculum. In addition, the subicular cortex was found to project to the nucleus lateralis dorsalis. The latter projection, which showed evidence of a crude topographic organization, ran either through the fornix or, unlike the other subicular efferents, through the sublenticular limb of the internal capsule to form part of the temporopulvinar bundle of Arnold. The nonfornical projection to the nucleus lateralis dorsalis passed through the medial pulvinar, where there was some additional termination. Few, if any, projections from the entorhinal cortex to the thalamus travelled in the fornix. Rather, the entorhinal efferents were carried in the inferior thalamic peduncle to the magnocellular portion of the nucleus medialis dorsalis, and in the internal capsule and bundle of Arnold to the medial pulvinar and the nucleus lateralis dorsalis. PMID- 3512628 TI - Mapping of proctolinlike immunoreactivity in the nervous systems of lobster and crayfish. AB - Whole-mount immunocytochemical techniques have been used to map candidate proctolin-containing cells in the central nervous systems of the lobster, Homarus americanus, and the crayfish, Procambarus clarkii. Proctolinlike immunoreactivity was detected in cell bodies and neuropil regions in all central ganglia, and immunoreactive axons were detected in most interganglionic connectives and nerve roots. Cell body staining was confined to fewer than 2% of all cells. Immunoreactive neurons include motoneurons, sensory neurons, neurosecretory cells, and interneurons. Colocalization of the proctolinlike antigen with other neurotransmitters was indicated in a number of cases. Many aspects of the distribution of immunoreactivity were similar in lobster and crayfish; however, staining differences were detected in a number of identified neurons and neural groups, including neurons that innervate the pericardial organs and hindgut motoneurons. Further studies of such neurons might provide interesting clues about the physiological functions of proctolin and the evolution of peptide transmission. PMID- 3512629 TI - Cholinergic and GABAergic afferents to the olfactory bulb in the rat with special emphasis on the projection neurons in the nucleus of the horizontal limb of the diagonal band. AB - We have examined the location of cholinergic and GABAergic neurons that project to the rat main olfactory bulb by combining choline acetyltransferase (ChAT) and glutamic acid decarboxylase (GAD) immunohistochemistry with retrograde fluorescent tracing. Since many of the projection neurons are located in subcortical basal forebrain structures, where the delineation of individual regions is difficult, particular care was taken to localize projection neurons with respect to such landmarks as the ventral pallidum (identified on the basis of GAD immunoreactivity), the diagonal band, and medial forebrain bundle. In addition, sections with fluorescent tracers or immunofluorescence were counterstained for Nissl substance in order to correlate tracer or immunopositive neurons with the cytoarchitecture of the basal forebrain. The majority of the cholinergic bulbopetal neurons are located in the medial half of the nucleus of the horizontal limb of the diagonal band (HDB), whereas only a few are located in its lateral half. A substantial number of cholinergic bulbopetal cells are also found in the sublenticular substantia innominata. A small number of cholinergic bulbopetal neurons, finally, are located in the ventrolateral portion of the nucleus of the vertical limb of the diagonal band. At the level of the crossing of the anterior commissure, approximately 17% of the bulbopetal neurons in the HDB are ChAT-positive. The noncholinergic bulbopetal cells are located mainly in the lateral half of the HDB. GAD-containing bulbopetal neurons are primarily located in the caudal part of the HDB, especially in its lateral part. About 30% of the bulbopetal projection neurons in the HDB are GAD-positive. A few GAD positive bulbopetal cells, furthermore, are located in the ventral pallidum, anterior amygdaloid area, deep olfactory cortex, nucleus of the lateral olfactory tract, lateral hypothalamic area, and tuberomamillary nucleus. The topography of bulbopetal neurons was compared to other projection neurons in the HDB. After multiple injections of fluorescent tracer in the neocortex, retrogradely labeled neurons were concentrated in the most medial part of the HDB, while neurons projecting to the olfactory and entorhinal cortices were located in the ventral part of the HDB. These results show that the cells of the HDB can be divided into subpopulations based upon projection target as well as transmitter content. Furthermore, these subpopulations correspond, at least to a considerable extent, to areas that can be defined on cyto- and fibroarchitectural grounds. PMID- 3512630 TI - A correlated light and electron microscopic immunocytochemical study of cholinergic terminals and neurons in the rat amygdaloid body with special emphasis on the basolateral amygdaloid nucleus. AB - The cholinergic innervation of the rat basolateral amygdaloid nucleus (BL) was determined by the immunocytochemical localization of the acetylcholine biosynthetic enzyme, choline acetyltransferase (ChAT). ChAT-immunoreactive (ChAT IR) elements were observed throughout the BL in the form of fine puncta and varicose fibers. Electron microscopy revealed that the immunoreactive puncta represented small terminals (0.3-1.2 micron), most of which formed synaptic contacts with unlabeled dendritic shafts or spines. Less frequently, ChAT-IR terminals established synaptic contacts with large neuronal cell bodies, which had all the characteristics of projection neurons as defined on the basis of axonal projections to the ventral striatum. ChAT-IR terminals were sometimes seen to form synaptic contacts with small neuronal cell bodies, including those of ChAT-IR neurons. The ChAT-IR boutons contained pleomorphic clear vesicles of varying size, and the large majority of the synapses were of the symmetric type. Small ChAT-IR neurons were observed in all parts of the BL. Although the ChAT-IR cell bodies varied widely in shape from typical fusiform to round, most had a more or less oval shape with a major diameter of 10-14 micron. Most of the ChAT IR neurons seemed to display a radial bipolar dendritic pattern, but multipolar cells were also observed. The ChAT-IR neurons contained an indented nucleus, which was often eccentrically located and surrounded by a thin or moderately thin rim of cytoplasm. The results obtained are discussed in relation to a quasi cortical organization of the BL. PMID- 3512632 TI - Arthur Covel Curtis, B.S., M.D. (1898-1970). PMID- 3512631 TI - Immunocytochemical localization of luteinizing hormone-releasing hormone (LHRH) pathways in the sheep brain during anestrus and the mid-luteal phase of the estrous cycle. AB - The luteinizing hormone-releasing hormone (LHRH) system of the sheep brain was examined by light microscopic immunocytochemistry with thick, unembedded sections. We compared the distribution and morphology of LHRH cells and their fibers in intact and ovariectomized anestrous ewes, and in breeding season ewes during the mid-luteal phase of their estrous cycle. In all animals, a majority of LHRH neurons were found in the medial preoptic area adjacent to the organum vasculosum of the lamina terminalis. These cells formed a continuum rostrally with immunoreactive neurons in the diagonal band of Broca and medial septum and caudally with cells in the ventrolateral anterior hypothalamus and lateral hypothalamus. Relatively few cells (1-2%) were seen in the arcuate nucleus or its vicinity. Preoptic LHRH neurons project to the tubero-infundibular sulcus of the median eminence by at least two routes: a major ventrolateral projection above the optic tract in the anterior and lateral hypothalamus, and a less prominent periventricular pathway along the third ventricle. LHRH fibers were also observed in a number of extrahypothalamic regions, including the medial amygdala and the accessory olfactory bulb. Immunoreactive LHRH neurons in the sheep exhibited a complex light microscopic morphology unlike that seen in LHRH cells of any other species to date. LHRH cells with extensive, branching processes were frequently found in clusters with close somatic appositions between neighboring cells. Multiple thin protuberances emanated from the soma of many immunoreactive neurons. Immunoreactive fibers with beaded varicosities often were intimately associated with both cell bodies and their dendritic processes. Morphometric analyses revealed that preoptic LHRH neurons in three of four mid-luteal phase ewes had a shorter total dendritic length than those neurons in either intact or ovariectomized anestrous ewes, but this difference between breeding season and anestrous ewes was not statistically significant. Evidence for possible seasonal and/or steroid-induced alterations in the morphology of LHRH neurons must be documented by further studies, including immunocytochemical observations at an ultrastructural level. PMID- 3512633 TI - Effects of oral meclofenamate therapy in psoriasis. AB - One hundred three patients entered a study to evaluate the effects of oral meclofenamate sodium therapy on psoriasis. The first 4 weeks of the study were double-blind, with patients receiving either meclofenamate or placebo. Most patients receiving meclofenamate had no change in their psoriasis, in comparison with their pretherapy condition. There was no difference in the response of the psoriasis between the group taking meclofenamate and the group taking placebo. Eighty-nine patients continued in a 4-week open trial of meclofenamate. Approximately one third of the patients showed improvement, but this result appeared to be related to the open trial design. Since oral meclofenamate therapy was not associated with frequent worsening of psoriasis, it is an appropriate treatment for psoriatic arthritis. PMID- 3512634 TI - Oral glucocorticoids and their complications. A review. AB - Glucocorticoid preparations form one of the cornerstones of the modern medical pharmacopeia. This class of medications has been especially useful to dermatologists, who are purported to be among its most prolific users. Oral glucocorticoids, available now for over 30 years, are prescribed to over 7% of hospitalized patients. Of this group, some 17% may experience adverse effects. It behooves any physician who uses these powerful agents to be aware of the potential complications and side effects. In this article we have undertaken to summarize and discuss selective examples of this rapidly growing segment of the literature. PMID- 3512636 TI - Experiences of a black in dermatology. PMID- 3512635 TI - Subepidermal bullous autoimmune disease associated with immune nephritis. Immunomorphologic studies. AB - There are only a few reports of the association of immune-complex glomerulonephritis with bullous pemphigoid. The occurrence of immune-complex nephritis with linear IgA bullous disease has not been previously reported. We report two cases, one a case of bullous pemphigoid and the other a case of linear IgA bullous disease, both of which were associated with immune-complex glomerulonephritis. The clinical and immunomorphologic data are briefly discussed. PMID- 3512637 TI - Signet ring lymphoma of the skin: ultrastructural and immunohistochemical features. AB - Signet ring lymphoma is a recently described morphologic variant of B cell lymphoma. We are reporting the first case of this subtype of follicular lymphoma that was initially confined to the skin and remained so. Light microscopy showed the tumor to be composed of monomorphous plump epithelioid cells with abundant eosinophilic cytoplasm involving the dermis and subcutaneous fat. Cytoplasmic vacuoles were present within some of the tumor cells, suggesting the diagnosis of adenocarcinoma with a signet ring appearance. Some of the vacuoles were positive on periodic acid-Schiff with diastase staining, and no mucin was identified. Immunostaining showed the presence of intracytoplasmic IgG heavy chains and kappa light chains. Characteristic intracytoplasmic inclusions, which were formed by saccules and microvesicular bodies, were seen by electron microscopy. The diagnosis of signet ring lymphoma was made. No systemic involvement was found. Over a period of 7 years, multiple new skin lesions occurred, all of which responded to radiation therapy. This rare variant of follicular center cell lymphoma, which can occur in the skin, should not be confused with metastatic mucinous adenocarcinoma and malignant melanoma. PMID- 3512638 TI - Computed tomography and ultrasonography of carcinoma in duplication cysts. AB - The CT and ultrasound findings of malignancy arising in walls of alimentary tract duplication cysts are previously unreported. We describe two cases where identification of both cyst and tumor nodule and separation of the mass from other visceral organs was achieved. We review the English literature reporting this unusual condition and suggest that CT and ultrasound are of great value in accurate preoperative diagnosis. PMID- 3512639 TI - Focal fatty infiltration of the liver mimicking a tumor: sonographic and CT features. AB - Focal fatty infiltration of the liver detected by ultrasonography (US) in this asymptomatic woman had unusual features. It appeared as a sharply marginated, spherical mass lesion on CT, with soft tissue attenuation values of 30 HU unenhanced and 50 HU with enhancement. This tumor-like zone completely resolved on follow-up US and CT, underscoring the need for follow-up examinations to exclude primary or metastatic tumors. Our review of the literature failed to reveal previous reports of features such as these. PMID- 3512640 TI - Hepatic actinomycosis: CT features. AB - Hepatic actinomycosis is an uncommon entity that forms communicating abscesses and fistulae. A case is presented in which findings on ultrasound, CT, and percutaneous injection of the abscess all reflected the pathologic process. Biopsy by thin-needle aspiration under CT guidance afforded prompt, accurate diagnosis and effective therapy. PMID- 3512641 TI - Multiple cavernous hemangiomas of the spleen: CT findings. AB - Diffuse cavernous hemangiomatosis of the spleen is a rare condition, but it is considered the most common benign tumor to involve the spleen. Computed tomography and ultrasound are useful and effective methods for evaluating the spleen for the presence of multiple hemangiomas, the diagnosis of which is otherwise difficult to establish. This report emphasizes the sonographic and CT findings of the condition and reviews the pathological and clinical features. PMID- 3512642 TI - CT appearance of a surgically retained towel (gossypiboma). AB - A case of a surgically retained towel within the peritoneal space is reported. Computed tomography demonstrated an unusual appearance not unlike that previously described for retained surgical sponges. Computed tomography of the gastrointestinal tract served as a useful adjunct to barium radiography in this case, suggesting the correct diagnosis of foreign body. PMID- 3512643 TI - CT characteristics of cervical mucocele mimicking a cystic adnexal mass. AB - An unusual case of a cervical mucocele (focal hydrometra) was diagnosed only after correlation of ultrasonic, CT, and physical examination findings. PMID- 3512644 TI - CT demonstration of ovarian varices. PMID- 3512645 TI - Annual session, American Association for Dental Research. March 12-15, 1986, Washington, DC. Abstracts of papers. PMID- 3512646 TI - Nasal alar rim reconstruction utilizing the crus of the helix, with several alternatives for donor site closure. AB - The crus of the helix may be the best source for alar rim reconstruction in certain patients. Chances of survival of that composite graft are increased when the nasal mucosal surface can be spared by stringent efforts. A case demonstrating the success of these principles is presented, along with several alternative methods of donor site closure. PMID- 3512647 TI - Treatment of pitted scars: punch transplant technique. AB - This paper describes an operation for treatment of pitted scars of the face. After local anesthesia, the pitted scar is removed by a cutaneous punch. Donor grafts are obtained from the postauricular skin and held in place using a Steri Strip or other method. The graft is placed so that it will be level or slightly elevated. The dressing is removed at 2 days and the graft site is cleaned with hydrogen peroxide. After 3 to 4 weeks, the area is levelled by a dermabrasion or other technique. Expected results and complications are discussed. PMID- 3512648 TI - The development of nursing research as an integral part of professional practice. PMID- 3512649 TI - [The influence of the initial value of a parameter on its changes under external actions]. PMID- 3512650 TI - Application of stochastic analysis to ultrasonic echoes--estimation of attenuation and tissue heterogeneity from peaks of echo envelope. AB - A study of the statistics of ultrasound speckle indicates that the noise-to signal ratio (NSR) of the echo envelope peaks (EEP) in a B scan is monotonically related to the variance of the mean power of the backscattered echoes. If it is assumed that the backscattered echoes all have the same mean power, the NSR of the EEP's in a B scan will be expected to reach a theoretical minimum value NSR0 (0.40 approximately 0.42). In practical situations, the variance of the mean power of the echoes is increased due to the presence of both attenuation (including beam spreading) and the spatial variation in the backscattering cross section (BCS) of the tissue. Accordingly, the measured value of the NSR of the EEP's is expected to be greater than the NSR0. In principle, the effects of beam pattern and the attenuation can be compensated for by system calibration and a depth-related gain function, respectively. The attenuation coefficient of the tissue may then be obtained by adjusting the gain function to minimize the NSR of the EEP's. Due to the random nature of the heterogeneity of diseased tissue, the effect of the variation in the BCS, however, cannot be compensated for by the depth-related gain function. Therefore, the minimum value of the NSR indicates the spatial variation in the BCS and may finally correlate to the disease state of the tissue. PMID- 3512653 TI - Etched metal cingulum rest retainer. AB - The etched metal cingulum rest retainer provides a viable alternative to the use of an incisal rest or a conventional cast restoration incorporating a cingulum rest. It is not intended for use in every case, but may be useful when indicated. PMID- 3512652 TI - High frequency neural modulation in dentistry. PMID- 3512654 TI - Munchausen's syndrome: report of case. AB - A patient with Munchausen's syndrome received treatment from at least 25 dental practitioners in the New York metropolitan area. The patient and the syndrome are described to alert the dental community about this patient who is still presumed to be living in the New York area. PMID- 3512651 TI - A general model for the absorption of ultrasound by biological tissues and experimental verification. AB - In this paper, a closed-form expression is derived for the absorption of ultrasound by biological tissues. In this expression, the viscothermal and viscoelastic theories of relaxation processes are combined. Three relaxation time distribution functions are introduced, and it is assumed that each of these distributions can be described by an identical and simple hyperbolic function. Several simplifying assumptions had to be made to enable the experimental verification of the derived closed-form expression of the absorption coefficient. The simplified expression leaves two degrees of freedom and it was fitted to the experimental data obtained from homogenized beef liver. The model produced a considerably better fit to the data than other, more pragmatic models for the absorption coefficient as a function of frequency that could be found in the literature. Scattering in beef liver was estimated indirectly from the difference between attenuation in in vitro liver tissue as compared to absorption in a homogenate. The frequency dependence of the scattering coefficient could be described by a power law with a power of the order of 2. A comparable figure was found in direct backscattering measurements, performed at our laboratory with the same liver samples [Van den Aarssen et al., J. Acoust. Soc. Am. (to be published)]. A model for scattering recently proposed by Sehgal and Greenleaf [Ultrason. Imag. 6, 60-80 (1984)] was fitted to the scattering data as well. This latter model enabled the estimation of a maximum scatterer distance, which appeared to be of the order of 25 micron. PMID- 3512655 TI - Splinting and replantation after traumatic avulsion. AB - A rational approach can be taken in the dental office to avulsion and replantation. Consideration must be given to: Extraoral time. During this critical time, the prognosis for successful replantation noticeably decreases as the out-of-mouth time increases. Transport. Preferably the tooth will be transported in the socket, but milk or water may be used to keep the tooth moist. The buccal vestibule may be recommended for adults and teenagers but not for young children. Root surface. The root surface must not be handled, scraped, brushed, or have any part removed; it can be rinsed with sterile water, saline, or tap water but not with caustic solutions, disinfectants, or medicaments to clean the surface. Endodontic treatment. A tooth with an open apex should be evaluated bimonthly for revitalization. A tooth with a fully formed apex should have the pulp removed in 7 to 14 days after avulsion. Status of the alveolar process. Alveolar fractures may require a modified splint design to provide additional strength for a longer splinting duration. Obturation materials. Calcium hydroxide paste is used for a minimum of 6 to 24 months before filling permanently with gutta-percha. Selection of a splint. Each case is different and should be treated as such. Special consideration must be given to splint design, which will directly influence the desired result. Although any number of splints may be effective, inherent advantages and disadvantages of each should be understood fully by the clinician. This is where the art, the clinical experience, and the common sense of endodontic therapy dictate the proper splint and appropriate duration of splinting for the patient.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3512656 TI - Dentistry on stamps. PMID- 3512657 TI - The presidents. Clyde Estes Minges 1948-1949. PMID- 3512658 TI - Seven year survival of patients with normal or near normal coronary arteriograms: a CASS registry study. AB - The effect on 7 year survival of having a normal or near normal coronary arteriogram was examined using data from the CASS registry of 21,487 consecutive coronary arteriograms taken in 15 clinical sites. Of these, 4,051 arteriograms were normal or near normal, and the patients had normal left ventricular function as judged by absence of a history of congestive heart failure, no reported segmental wall motion abnormality and an ejection fraction of at least 50%; 3,136 arteriograms were entirely normal and the remaining 915 revealed mild disease with less than 50% stenosis in one or more segments. The 7 year survival rate was 96% for the patients with a normal arteriogram and 92% for those whose study revealed mild disease (p less than 0.0001). Nine risk variables recorded at entry were analyzed for predictive value for survival: age, sex, height, weight, history of smoking, presence of absence of mild disease, electrocardiographic response to exercise, family history of coronary heart disease and a history of hypertension. Of these, age, smoking history, presence or absence of disease and a history of hypertension had predictive value. PMID- 3512659 TI - Bishop lecture. The electrocardiogram 80 years after Einthoven. PMID- 3512660 TI - The coronary sinus: an alternate channel for administration of arterial blood and pharmacologic agents for protection and treatment of acute cardiac ischemia. PMID- 3512661 TI - Phagocytic cell dysfunction. PMID- 3512662 TI - Serum IgG4 concentrations and allergen-specific IgG4 antibodies compared in adults and children with asthma and nonallergic subjects. AB - We describe the development of specific immunoassays for IgG4 protein and for allergen-specific IgG4 antibodies. We also measured the concentrations of IgG4 protein and determined the frequencies of detectable IgG4 antibodies to several common allergens in sera from adults and children with asthma and from nonallergic subjects. Serum concentrations of IgG4 protein increase with age but are not different in children with asthma and nonallergic children, nor does a raised serum concentration predict a severe clinical course in childhood asthma. IgG4 antibodies to milk and egg are common in children and adults and are more common in children with asthma than in nonallergic children less than 3 years of age. The presence of detectable IgG4 antibodies or a raised concentration of IgG4 protein in serum is not useful empirically as a diagnostic indicator of asthma but more likely results from antigen exposure occurring at mucosal surfaces. PMID- 3512663 TI - Comparison study of sustained-release theophylline products: Slo-bid capsules versus Theo-Dur tablets in 20 children and young adults with asthma. AB - Because there are few published studies on capsulized sustained-release theophylline (SRT) products in children, we compared Slo-bid capsules to Theo-Dur tablets in a group of school age children and young adults with asthma in an 8 week randomized crossover study design with patients maintaining daily symptom diary cards and peak expiratory flow rates. Theophylline levels were obtained at 8 hours after the morning dose on day 7, 14, and 28 of each study period. Data were analyzed by one-way analysis of variance, regression equation, and Student's t test. Both products were demonstrated to have grossly similar absorption characteristics and efficacy at 12-hour intervals in the age group studied. Average daily dose requirement was 717 mg/day. Considerable week-to-week intrapatient variation in 8-hour theophylline levels was noted in both products, implying that precise dose adjustments cannot be made from a given level. Our literature review reveals the need for more data to support the current widespread practice of dosing children less than 8 years of age at 12-hour intervals. A retrospective review of ingestion before and after breakfast revealed no variation between the seven patients ingesting SRT before breakfast compared to 13 patients routinely ingesting SRT after a typical childhood breakfast. PMID- 3512664 TI - Influence of slow-release terbutaline on the circadian variation of catecholamines, histamine, and lung function in nonallergic patients with partly reversible airflow obstruction. AB - In order to study the mechanism underlying early morning dyspnea in patients with chronic airflow obstruction, the relation was assessed between the diurnal variation of FEV1, plasma and urinary catecholamines, and urinary histamine (metabolites) in eight nonallergic patients (mean age, 53 years). These parameters were measured both after administration of placebo and slow-release terbutaline tablets during 1 week. The fall in FEV1 at 4 A.M. coincided with a fall in both plasma and urinary epinephrine levels, whereas no correlation between pulmonary function and norepinephrine levels was observed. Histamine and N tau -methylhistamine excretion were found within the normal range without a circadian rhythm, suggesting no important role for histamine in the occurrence of early morning dyspnea in this nonallergic patient group. Administration of slow release terbutaline during 1 week prevented the nocturnal fall in FEV1. Terbutaline treatment suppressed plasma and urinary levels of epinephrine significantly without any effect on norepinephrine. We conclude that epinephrine appears to be an important factor in the regulation of the bronchial smooth muscle tone in patients with early morning dyspnea. PMID- 3512665 TI - The Journal 1975 to 1985: a decade of change. PMID- 3512666 TI - A brief history of child psychoanalysis. Introduction. PMID- 3512667 TI - Nutrient-behavior research with children: methods, considerations, and evaluation. AB - Diet-behavior research with children formerly focused on effects of diet regimens, as with additive-free diets for hyperactivity. However, an important new area of investigation includes studies of the immediate effects of individual nutrients, such as sugar, on the behavior and cognition of children. Studies of this type use methods from a variety of disciplines. Competence in the fields of nutrition, behavior, neurochemistry, and metabolism is required to perform the studies. Important components of nutrient-behavior studies include the study hypothesis and subject description (including recruitment and selection). Aspects of the food challenge to consider are challenge formulation, dosage, carrier, background dietary variables, and challenge administration schedule. Dependent measures that are used frequently in the studies include observations of behavior, rating scales, activity monitoring, biochemical measures, laboratory tests of performance and attention, tests of cognitive function, and measures of mood. Familiarity with each of the components and use of specific evaluation guidelines will enable nutrition professionals to critically evaluate the studies. PMID- 3512668 TI - Food, nutrition, and agriculture: a liaison for world development. AB - In spite of larger worldwide food harvests in recent years, the number of people in underdeveloped countries without enough food to eat is increasing. Those most likely to suffer from undernutrition are the traditionally vulnerable groups, especially the rural poor. In many underdeveloped countries, the average farm size is smaller, the number of landless farm workers is larger, and the number of rural poor families without land on which to grow food or money to buy it for home consumption is greater than ever before. Undernutrition is often viewed as a family health problem only. Thus, education in nutrition is generally directed toward home economists, health workers, and primary school teachers. Since unavailability of food is usually the most limiting factor in improving nutritional status of the poor, all agencies dealing with the food chain from production to consumption should be involved. An educational partnership between health, nutrition, and agriculture may be the most important alliance that could be brought into being to ensure enough food for the nutritional well-being of the world's population. This article presents the rationale for education in nutrition in the preparation of agriculturalists and reviews some of the past efforts and present activities of national and international organizations to meld nutrition into agricultural world development programs. PMID- 3512669 TI - Microwave vs. conventional oven cooking of chicken: relationship of internal temperature to surface contamination by Salmonella typhimurium. PMID- 3512671 TI - Effect of age and environmental factors on glucose tolerance and insulin secretion in a worker population. AB - The effect of age on glucose tolerance, as differentiated from the effects of obesity, work and leisure physical activity, family history of diabetes, and the use of drugs known to adversely affect glucose tolerance and/or insulin secretion, has been analyzed in 732 factory workers aged 22 to 73 years. Glucose tolerance, as evaluated by the plasma glucose response to 75 g of oral glucose deteriorated with age, associated with an increase in plasma insulin levels. However, the age-related decrease in glucose tolerance also correlated significantly with degree of obesity, leisure-time physical activity, and the use of potential diabetogenic drugs. Partial correlation coefficients were calculated to define the effect of age per se on glucose tolerance, controlling for the presence of these other age-related variables. When this was done, the degree of correlation between age and glucose tolerance was reduced, particularly in women, to where it became of marginal statistical significance. The effect of age on insulin response was affected to a greater degree by age-related variables, and was no longer statistically significant when these other factors were taken into consideration. These data suggest that the elevation in plasma glucose and insulin levels associated with age are to a certain extent due to age-related environmental factors, and the deterioration in glucose tolerance with age is relatively modest in magnitude in a generally healthy population. PMID- 3512670 TI - Isolated systolic hypertension in the elderly. A placebo-controlled, dose response evaluation of chlorthalidone. AB - One hundred seventy-one patients, 60 years of age or older with isolated systolic hypertension, were randomly assigned to receive chlorthalidone 12.5, 25.0, or 50.0 mg or placebo once daily for 12 weeks. The majority of the patients receiving chlorthalidone 12.5 mg achieved therapeutic success with no clinically significant biochemical changes or side effects. The 50.0-mg dose level enhanced efficacy only minimally over the 25.0-mg dose level. Drug-related side effects were significantly more prevalent in the chlorthalidone 50.0-mg group than in the placebo group. The data suggest that most elderly patients with isolated systolic hypertension, regardless of the severity, could be treated effectively and safely with chlorthalidone 12.5 mg per day. PMID- 3512672 TI - Oral assessment of the dentulous elderly patient. AB - The percentage of elderly persons retaining natural teeth is increasing. Although many of these individuals cannot be convinced to see a dentist regularly, they are generally seen by a physician or nurse relatively frequently. The physician or nurse can provide a vital service for these patients by performing oral screening examinations. A technique is described for accomplishing this. PMID- 3512673 TI - Role of protein molecular and metabolic aberrations in aging, in the physiologic decline of the aged, and in age-associated diseases. PMID- 3512674 TI - Physician management of the demented patient. PMID- 3512675 TI - Refractive error and the reading process: a literature analysis. AB - The literature analysis of refractive error and reading performance includes only those studies which adhere to the rudaments of scientific investigation. The relative strengths and weaknesses of each study are described and conclusions are drawn where possible. Hyperopia and anisometropia appear to be related to poor reading progress and their correction seems to result in improved performance. Reduced distance visual acuity and myopia are not generally associated with reading difficulties. There is little evidence relating astigmatism and reading, but studies have not been adequately designed to draw conclusions. Implications for school vision screening are discussed. PMID- 3512676 TI - Varix of the vortex vein ampulla. AB - Varix of the vortex vein ampulla is a bulging of the vein and overlying retina into the vitreous. It is of uncertain etiology. The lesion is lightly pigmented and ranges in size from one to three disc diameters. It has a dynamic nature and can be flattened by applying pressure to the globe. Viewing the varix is greatly enhanced with red-free light. Three cases are presented as incidental findings during routine examination, and one as a referral. Varices are a benign condition requiring no treatment. PMID- 3512677 TI - The founding editor-in-chief, Professor Chandler McCuskey Brooks. PMID- 3512678 TI - Pre- and postnatal development of 5-hydroxytryptamine-immunoreactive cells in the superior cervical ganglion of the rat. AB - The pre- and postnatal development of 5-hydroxytryptamine (5-HT)-immunoreactive cells in the superior cervical ganglion of the rat was studied by indirect immunofluorescence method with an antibody to a conjugate of bovine serum albumin and 5-HT. The superior cervical ganglia from 11-day-old embryos to 90-day-old postnatal rats were examined. 5-HT-immunoreactive cells were first detected in the superior cervical ganglion on the 12th day of gestation. At this stage of development the ganglionic cells formed a condensed group, and most of them showed 5-HT-immunoreactivity. During later prenatal development the relative number of the 5-HT-immunoreactive cells in the ganglion decreased and most ganglionic cells appeared as non-reactive. 5-HT-immunoreactive cells showed some variation in size and fluorescence intensity during the whole prenatal development. In the ganglia of newborn rats a wide range of 5-HT-immunoreactive cell sizes was detected. Two types of 5-HT-immunoreactive cells were distinguished in the ganglia of 7- to 35-day-old rats: small (5-15 microns in diameter) cells and large (15-30 microns in diameter) cells, resembling in size small intensely fluorescent (SIF) cells and principal nerve (PN) cells, respectively. The relative number of the large 5-HT-immunoreactive cells gradually decreased after the first postnatal week, and these cells were not detected in the ganglia of 90-day-old rats. Small 5-HT-immunoreactive cells constantly formed clusters in the ganglia of postnatal rats. A marked, statistically significant increase in the density of 5-HT-immunoreactive cells occurred during the 4th postnatal week. The 5-HT-immunoreactive cells appeared in the prenatal superior cervical ganglion of the rat approximately at the same time as the cells showing formaldehyde-induced catecholamine fluorescence. Transient occurrence of the large 5-HT-immunoreactive cells during the first postnatal weeks of development indicates, that in the superior cervical ganglion of the rat, 5-hydroxytryptamine may be expressed in some developing PN cells early postnatally. After the 5th postnatal week, the large 5-HT-immunoreactive neuronal cells cannot be detected, and 5-HT is expressed only in the SIF cells. PMID- 3512679 TI - Autonomic innervation of the pancreas in diabetic and non-diabetic rats. A new view on intramural sympathetic structural organization. AB - Using histochemical and immunocytochemical methods the intramural neural tissue of the pancreas was investigated in non-diabetic and in alloxan-diabetic rats. It was demonstrated that the non-diabetic pancreas contains an average of 2.71 cells/mm3 tissue that react positive for activity of acetylcholinesterase and 2.38 cells/mm3 tissue that show monoamine oxidase activity. Both cholinergic and monoaminergic cells are found as solitary cells and in clusters of various sizes. All these cells are embedded in the exocrine tissue. Both histochemical methods revealed the presence of intra-insular fiber plexuses. Treatment with alloxan resulted in disappearance of intra-insular cholinergic and monoaminergic activity and also in a 68% reduction of the cholinergic cells and 54% of the monoaminergic cells in the diabetic pancreas. Application of immunocytochemical methods employing antibodies against norepinephrine and dopamine demonstrated the noradrenergic character of at least some of the monoaminergic cell groups. It is discussed how the present data and data from previous innervation studies provide evidence for an intramural ganglionic organization of the sympathetic innervation of the rat pancreas. PMID- 3512680 TI - Selective hepatic vagotomy does not prevent compensatory feeding in response to body weight changes. AB - The effects of selective hepatic vagotomy on compensatory adjustments of feeding in response to experimentally induced changes in body weight were investigated in rats. Repeated injections of slow-acting insulin increased food intake and body weight in vagotomized as well as in sham-vagotomized rats. When the treatment was stopped, the rats of both surgical groups displayed a compensatory hypophagia of similar magnitude and body weight returned to preinjection levels. In turn, after 7 days of restricted feeding (5 g/day) with a concomitant loss of body weight, rats became hyperphagic and body weight approached the normal level. Again, the feeding responses or body weight changes did not differ between vagotomized and sham-vagotomized rats. The results demonstrate that selective hepatic vagotomy does not disrupt the putative feedback-loop between body weight and feeding, and raise questions concerning the role of the liver in the lipostatic control of food intake. PMID- 3512681 TI - Tracer diffusion has exaggerated CNS maps of direct preganglionic innervation of pancreas. AB - Small injections of True Blue (TB) into 4 different segments of the pancreas of the rat resulted in characteristic and different numbers and distributions of labeled cells within the dorsal motor nucleus of the vagus (DMN). Composites of these patterns of labeled cells in the DMN closely matched the distributions previously reported for more extensive injections of retrograde tracers into the pancreas. However, the application of a diffusion barrier (formed with a plastic wound spray) on the outer surface of the stomach and intestines adjacent to the pancreas segment which contained the TB injection depot prevented virtually all of the labeling of DMN cells. Similarly, applying a diffusion barrier directly to the injected pancreas segment itself prevented all or most (mean greater than 99%) of the DMN labeling. In contrast to this effect on DMN label, the barrier reduced more modestly the labeling of celiac ganglion somata after pancreas injections. Several additional control experiments also suggest that the absence of DMN label after the barrier application resulted from interference with tracer diffusion from the injected organ and not from neurotoxic effects. These include the following demonstrations in the presence of the barrier: (1) observation of unimpaired vagally stimulated insulin secretion, (2) uncompromised cell labeling of DMN from other organs treated with TB plus the barrier, and (3) normal hematoxylin and eosin stained pancreas tissue which had received TB injections and barrier application. It was concluded that both the number of parasympathetic preganglionic neurons that project monosynaptically to the pancreas and their distribution in the medulla may have been very significantly overestimated in previous tracer studies. PMID- 3512683 TI - Physical and mechanical properties of joints (the pathomechanics of articular cartilage degeneration). AB - A review of the literature was performed to determine current theories regarding the physiology of human articular cartilage. The process of chondrodegeneration in rheumatoid arthritis and osteoarthritis was then discussed. Clinical pedal pathology was used to emphasize important but abstract concepts. PMID- 3512682 TI - Plasma norepinephrine concentration reflects pharmacological alteration of sympathetic activity in the conscious cat. AB - This study provides the first comprehensive set of basal values for hemodynamic variables, plasma norepinephrine (NE) and epinephrine concentrations and plasma renin activity in the conscious cat and demonstrates that changes in plasma NE concentration in the conscious cat accurately reflect the alterations in sympathetic discharge caused by hydralazine, yohimbine, chlorisondamine and clonidine. PMID- 3512684 TI - Periosteal chondroma: a review of the literature and case report. AB - Periosteal chondroma is a benign and relatively rare cartilaginous tumor. The authors discuss a case with some typical and some atypical characteristics. The differential diagnosis is important because of its resemblance to chondrosarcoma. PMID- 3512685 TI - Kaposi's sarcoma: a comprehensive review. AB - Kaposi's sarcoma is a neoplasm that is usually malignant and occurs in the skin and sometimes in the lymph nodes and internal organs. The cause is unknown, but recently it has become epidemic because of its involvement in acquired immune deficiency syndrome (AIDS). Although it is worldwide in distribution, the disease is predominant in eastern Europe, Equitorial Africa, Italy, Russia, and North America. PMID- 3512687 TI - Hepatic beta 2-microglobulin distribution in primary biliary cirrhosis. AB - The distribution of beta 2-microglobulin (beta 2-m) was studied by immunoperoxidase in paraffin sections of 30 liver biopsies from 28 patients with primary biliary cirrhosis (PBC). In 24 of the patients beta 2-m was demonstrable on the membranes of hepatocytes, whereas normal hepatocytes were usually negative. This increased display of beta 2-m probably parallels increased display of class I HLA antigens. The affected hepatocytes may be more susceptible to T cell-mediated immune attack. A greater number of beta 2-m displaying hepatocytes was seen in the later stages of PBC, in keeping with the hypothesis that in this disease hepatocyte involvement is a secondary phenomenon. Bile duct epithelium continued to display beta 2-m at all stages of the disease. PMID- 3512686 TI - Effect of prostacyclin (PGI2) and a prostaglandin analogue BW 245C on galactosamine-induced hepatic necrosis. AB - The reported cytoprotective effects of prostaglandins against noxious stimuli in the liver was the basis for the present investigations of the effects of prostacyclin (PGI2) and a prostaglandin analogue (BW 245C) in an animal model of severe liver failure. Rats were given galactosamine at two dose levels and the prostaglandins were given in repeated doses from 0 to 6 h during the development of the liver damage or in another group from 24 to 30 h at the time of maximal liver injury. For PGI2 significant cytoprotection was found as assessed by a reduction in blood Normotest at 24, 48 and 72 h (P less than 0.05) and the plasma level of aspartate aminotransferase at 24 and 48 h (P less than 0.02) and the lysosomal markers N-acetyl-beta-glucosaminidase at 24, 48 and 72 h (P less than 0.001) and cathepsin D at 48 h (P less than 0.005) as compared to appropriate controls. Early administration of PGI2 reduced the mortality rate from 63% in the control group to 0% (P less than 0.01) in the treated group, but no significant effects were found when either compound was given later in the 24-h to 30-h period. PMID- 3512689 TI - "Advertised by our loving friends": the infant formula industry and the creation of new pharmaceutical markets, 1870-1910. PMID- 3512688 TI - The brief career of "cerebral hyperaemia": William A. Hammond and his insomniac patients, 1854-90. PMID- 3512690 TI - How Hippocrates cured the plague. PMID- 3512691 TI - The doctor and the buccaneer: Sir Hans Sloane's case history of Sir Henry Morgan, Jamaica, 1688. PMID- 3512692 TI - Fluorochrome-coupled lectins reveal distinct cellular domains in human epidermis. AB - The distribution of saccharide moieties in human interfollicular epidermis was studied with fluorochrome-coupled lectins. In frozen sections Concanavalin A (Con A), Lens culinaris agglutinin (LCA), Ricinus communis agglutinin I (RCAI), and wheat germ agglutinin (WGA) stained intensively both dermis and viable epidermal cell layers, whereas peanut agglutinin (PNA) bound only to living epidermal cell layers. Ulex europaeus agglutinin I (UEAI) bound to dermal endothelial cells and upper cell layers of the epidermis but left the basal cell layer unstained. Dolichos biflorus agglutinin (DBA) bound only to basal epidermal cells, whereas both soybean agglutinin (SBA) and Helix pomatia agglutinin (HPA) showed strong binding to the spinous and granular cell layers. On routinely processed paraffin sections, a distinctly different staining pattern was seen with many lectins, and to reveal the binding of some lectins a pretreatment with protease was required. All keratin-positive cells in human epidermal cell suspensions, obtained with the suction blister method, bound PNA, whereas only a fraction of the keratinocytes bound either DBA or UEAI. Such a difference in lectin binding pattern was also seen in epidermal cell cultures both immediately after attachment and in organized cell colonies. This suggests that in addition to basal cells, more differentiated epidermal cells from the spinous cell layer are also able to adhere and spread in culture conditions. Gel electrophoretic analysis of the lectin-binding glycoproteins in detergent extracts of metabolically labeled primary keratinocyte cultures revealed that the lectins recognized both distinct and shared glycoproteins. A much different lectin binding pattern was seen in embryonic human skin: fetal epidermis did not show any binding of DBA, whereas UEAI showed diffuse binding to all cell layers but gave a bright staining of dermal endothelial cells. This was in contrast to staining results obtained with a monoclonal cytokeratin antibody, which showed the presence of a distinct basal cell layer in fetal epidermis also. The results indicate that expression of saccharide moieties in human epidermal keratinocytes is related to the stage of cellular differentiation, different cell layers expressing different terminal saccharide moieties. The results also suggest that the emergence of a mature cell surface glycoconjugate pattern in human epidermis is preceded by the acquisition of cell layer-specific, differential keratin expression. PMID- 3512693 TI - Visualization of binding sites for bovine parathyroid hormone (PTH 1-84) on cultured kidney cells with a biotinyl-b-PTH (1-84) antagonist. AB - Parathyroid hormone (PTH) receptors have been found in a subpopulation of kidney cells. In this report, we investigated the feasibility of techniques that apply a partial antagonist of PTH conjugated to biotin to localize receptors cytochemically on bovine kidney cortical cells in monolayer culture at the light microscopic level. Biotinylated bovine PTH (1-84) (biotinyl-PTH) was bound to the cultured cells for 1-30 min at 37 degrees C in the amounts of 10(-5) -10(-10) M. In a different set of experiments, the cells were also exposed to a solution containing 10(-6) M biotinylated PTH and an excess of unlabeled PTH, insulin, adrenocorticotropin, or calcitonin for 10 and 30 min at 37 degrees C to test the specificity of the binding. The cells were then fixed in 2.5% glutaraldehyde and stained with the avidin-biotin peroxidase complex (ABC) technique. Diffuse labeling was evident on 30% of the cells in 10 min with concentrations of biotinyl-PTH as low as 10(-8) M. The stain was diffuse, but more intense after 1 10 min in higher concentrations (10(-6) M). If a 15-1500-fold excess of unlabeled PTH was added to the biotinyl-PTH, no staining was observed. The other peptides (insulin, ACTH or calcitonin) had no effect on binding. Longer times in biotinyl PTH (10(-6) M for 10-30 min) resulted in intense patches of label on the cells resembling caps (in addition to the pale diffuse label). The percentage of labeled cells in the monolayer (30%) did not change with time. These studies show that a partial antagonist of PTH can be used as a cytochemical probe for specific PTH receptors in a subpopulation of cultured cortical kidney cells. PMID- 3512694 TI - Avidin-biotin-immunoglucose oxidase: use in single and double labeling procedures. AB - We have investigated the use of an avidin-biotin-immunoglucose oxidase (AB-GO) technique for single and double antigen localization in conjunction with the avidin-biotin-immunoperoxidase (AB-P) technique in fixed, embedded specimens, using sequential monoclonal and polyclonal antibodies of the same species. The optimal technique for double labeling requires the first antibody to be applied and localized with the AB-P technique using 3,3'-diaminobenzidine (DAB) as the chromogen, followed by an optional elution step and/or incubation with mild detergent (0.01% Triton). The second antigen is localized with the AB-GO technique with nitro blue tetrazolium (NBT) as a chromogen. Effects of antigen concentration, intermediate elution steps, and the relative efficiency of the two methodologies are described. PMID- 3512695 TI - Degradation of insulin and glucagon in developing rat kidney: immunolocalization of insulin-glucagon-specific protease and quantitative estimation. PMID- 3512696 TI - Localization of L-arginine-glycine amidinotransferase protein in rat tissues by immunofluorescence microscopy. AB - Creatine is a major component of energy metabolism and enzymes involved in its synthesis have therefore been of considerable interest. L-arginine-glycine amidinotransferase, commonly called transamidinase, catalyzes the first reaction in the biosynthesis of creatine. This first reaction is believed to occur in the kidney because of the high concentration of transamidinase in that tissue. Transamidinase activity is also found in many other tissues of the rat, but its role in these tissues is not known. Immunochemical studies with antisera and monoclonal antibodies were used to confirm and refine our understanding of the presence of transamidinase in rat tissues. Immunofluorescence histochemistry was performed to localize transamidinase immunoreactivity within specific tissues including cells in the proximal tubules of the kidney, hepatocytes of the liver, and alpha cells of the pancreatic islet. Immunochemical studies with monoclonal antibodies confirm localization of transamidinase immunoreactivity in the proximal tubules of the kidney. The localization of such immunoreactivity in specialized cells yields insight into possible physiological role(s) of transamidinase in the rat. PMID- 3512697 TI - Filamentous actin in paramecium cells: functional and structural changes correlated with phalloidin affinity labeling in vivo. AB - Rhodaminylated (R)-phalloidin microinjected into Paramecium tetraurelia cells at a final concentration of greater than or equal to 20 micrograms/ml produces considerable functional and structural changes. F-actin bundles (with 20 micrograms/ml phalloidin within 15 min) are formed, which subsequently (greater than 30 min) are sequestered into autophagic vacuoles; simultaneously, the originally intense fluorescence of a narrow cortical layer becomes more and more diminished. When such microinjected cells are processed for electron microscopy, they display concomitant ultrastructural alterations, namely, the formation of transcellular bundles of 5-7 nm-thick filaments, which subsequently appear in autophagosomes, as well as a considerable reduction of filamentous materials in the cortex. This, in turn, entails a considerable restructuring of the cortex, enabling free access of various structural components to the cortex. Higher doses of R-phalloidin abolish cytoplasmic streaming (e.g., 50 micrograms/ml after 20-30 min); although the cells may survive, new secretory organelles (trichocysts) are no longer docked to the cell membrane. In contrast, exocytosis of docked trichocysts (as well as subsequent membrane resealing and retrieval) is not impaired under any conditions. Cortical F-actin may account for the cytoplasmic streaming that may normally guarantee the delivery of new trichocysts to free docking sites at the cell membrane. When docking is inhibited by high R phalloidin doses, excess free trichocysts are sequestered into autophagosomes (crinophagy). One of the most sensitive cell functions is food vacuole formation (assayed by prelabeling with India ink), which correlates with the presence of R phalloidin labeling in the cytostomal region and around food vacuoles. The main conclusions from this work are that filamentous actin may be involved in structuring of the cortex and in cytoplasmic streaming, and may therefore influence the formation, and possibly the transcellular transport (cyclosis), of food vacuoles, as well as the docking of trichocysts, whereas it does not play a role in exocytosis per se or in the steps immediately following. PMID- 3512698 TI - Heterogeneity of basement membranes of the human genitourinary tract revealed by sequential immunofluorescence staining with monoclonal antibodies to laminin. AB - We used monoclonal antibodies specific for human laminin to analyze immunohistochemically the heterogeneity of the basement membranes in various parts of the genitourinary tract. By indirect immunofluorescence microscopy we show that antibody 3H11 reacts with all epithelial basement membranes in the kidneys, testes, epididymis, prostate, uterus, oviduct, and ovary, as well as the smooth muscle cells, blood vessels, and nerves. Antibody 4E10 reacted with most epithelial basement membranes in these organs but was unreactive with the basement membranes of peripheral glomerular capillary loops and the basement membranes of the oviductal mucosa, seminiferous tubules, straight tubules, and rete testis. Hilar seminiferous tubules were reactive with 4E10. In contrast to 3H11, which reacted with all vascular, subendothelial, and muscular basement membranes, 4E10 reacted only with the subendothelial basement membrane of capillaries and veins. The difference in the distribution of epitopes could be demonstrated in tissue sections sequentially reacted with two monoclonal antibodies, but only if the antibody of restricted reactivity (4E10) was used first. These data show that the heterogeneous expression of distinct epitopes of laminin in basement membranes can be demonstrated in the same tissue section by sequential staining. This heterogeneity of basement membranes most likely reflects conformational differences in the expression of epitopes on the laminin molecule in various anatomic structures. PMID- 3512699 TI - Immunoelectronmicroscopy of neural antigens on ultrathin frozen sections. AB - We have utilized immunocryoultramicrotomy to detect synapsin, somatostatin, parvalbumin, and tubulin at the ultrastructural level. Immunocryoultramicrotomy combines informative identification of morphology with accurate immunolabeling. Moreover, since no detergents or organic solvents are used to enable antibody penetration, and since no enzyme marker diffusion occurs, localization of the antigens should be more accurate. Accordingly, it was possible to localize precisely all four antigens within a well-preserved structure. Application of this method has important advantages for high-resolution localization of molecules relevant to neuronal function. PMID- 3512700 TI - Alpha-fodrin in the adrenal gland: localization by immunoelectron microscopy. AB - Localization of fodrin, the brain equivalent of spectrin (a protein constituent of the erythrocyte membrane cytoskeleton), was investigated at the ultrastructural level in rat adrenal gland. By use of an affinity purified antibody directed against the alpha-fodrin subunit, all chromaffin cells, cortical cells, nerve fibers, and their surrounding Schwann cells were found to be labeled close to the cytoplasmic side of their plasma membranes. The labeling appeared more intense for chromaffin cells, and secretory granules and mitochondria were frequently found to be associated with the zone containing alpha-fodrin in these cells. The immunostained zone was estimated to extend 230 +/- 70 nm into the cytoplasm. This localization is discussed in terms of what is known of the properties of spectrin, and possible roles of the molecule in the chromaffin cell are suggested. PMID- 3512701 TI - Immunocytochemical localization of protein antigens in large sections of tissues embedded in water-soluble embedding media. AB - JB4 and Immunobed are water-soluble embedding media used for embedding large blocks of tissue. Immunobed was specifically designed for immunocytochemistry because ethanol extraction of an additive in the monomer of the resin is reported to render tissue sections permeable to immunoglobulins. We have modified the manufacturer's protocol to accomplish localization of two protein antigens in tissues embedded in either JB4 or Immunobed. Luteinizing hormone-beta (LH beta) was localized in sections of rat and bovine pituitary tissues and bovine placental lactogen (bPL) was localized in sections of placentomes from bovine placentas. Sections received one of the following pre-treatments: absolute EtOH; NaHCO3 buffer, pH 6-10; EtOH followed by NaHCO3 buffer; one of several enzymes; EtOH followed by enzyme; NaHCO3 buffer followed by enzyme. Anti-LH beta stained only pituitary gonadotrophs and anti-bPL stained only placental binucleate cells, as assessed by absorption controls. Pre-treatment with enzyme was required for staining of sections, but an alkaline pH change (NaHCO3) had little or no effect. Ethanol pretreatment had little or no effect alone or in conjunction with NaHCO3 or enzyme. Sections were sufficiently thin (1.5 micron) to afford resolution of structure, but suitably large (approximately 2 cm2) to minimize problems of sampling. PMID- 3512702 TI - Application of the avidin-biotin system for post-embedding cytochemical demonstration of a biotin-labeled IgG tracer. AB - The capacity of the avidin-biotin system for post-embedding cytochemical detection of a biotin-labeled proteinaceous tracer was investigated. By testing modifications of the fixatives, the epoxy embedding medium, and various etching solutions, a procedure was developed to localize specifically the biotinylated tracer on 1-micron thick and thin sections. By use of this technique, a systemically administered IgG tracer was demonstrated after 24 hr throughout the endomysium of mouse skeletal muscle. In the adjoining sciatic nerve, the tracer IgG occurred at the perineurium and within endoneurial blood vessels, although the endoneurium itself was spared because of the presence of the blood-nerve barrier. Because of the small size of the biotin ligand and the non-denaturing method of labeling proteins, our mode of application of the avidin-biotin system appears suitable for tracer studies. PMID- 3512703 TI - Tracing Salmonella typhimurium infections. PMID- 3512705 TI - The frequency distribution and consistency of assimilation biotypes of Candida albicans. AB - Two hundred and fifty clinical strains of Candida albicans and six isolates from a cross-infection outbreak were studied for their ability to assimilate 19 carbohydrates in the API-20C system (APILaboratory Products Ltd., Basingstoke, UK). The assimilation profiles were stable on repeat testing; at intervals in the 72 h duration of the test; and when incubated at different temperatures. Although not a complete system of biotyping, the API-20C system shows high typability, and fair reproducibility and discrimination, having a limited role in indicating which isolates should be typed by more elaborate methods. PMID- 3512704 TI - The detection of Chlamydia trachomatis by direct immunofluorescence in conjunctival smears from patients with trachoma and patients with ophthalmia neonatorum using a conjugated monoclonal antibody. AB - Duplicate specimens were taken with cotton-wool swabs from the upper tarsal conjunctiva of 63 patients living in Gambian villages in which trachoma is endemic and from 34 infants with ophthalmia neonatorum (ON) attending an outpatient clinic in The Gambia. The detection of Chlamydia trachomatis by direct immunofluorescence (IF) using a conjugated monoclonal antibody to its principal outer membrane protein was compared with isolation in cycloheximide-treated McCoy cells. For trachoma, the sensitivity and specificity of the immunofluorescent technique were 62% and 100% respectively if ten elementary bodies (EBs) was taken as the minimum requirement for positivity by IF. If all cases with one or more EB were considered positive, the sensitivity was 81% and the specificity 85%. For ON the sensitivity and specificity were 100% and 95% respectively, regardless of which criterion was used. In view of its simplicity and easy applicability to field conditions it seems likely that direct IF using monoclonal antibodies may be a useful technique for the detection of C. trachomatis in the conjunctival epithelium of patients with trachoma. PMID- 3512706 TI - Isolation and partial characterization of an eosinophil chemotactic factor from metacestodes of Taenia taeniaeformis (ECF-Tt). AB - Eosinophil chemotactic activity associated with protein extracts of Taenia taeniaeformis metacestodes was investigated. Chemotactic activity was associated with the nonbound protein after QAE cellulose chromatography of a 3 M KCl extract of homogenized larvae. When this material was precipitated with ammonium sulfate, activity was present in the 40 to 80% precipitate. Upon rechromatography on QAE cellulose equilibrated in a low ionic strength buffer, eosinophil chemotactic activity was retained by the gel and eluted after application of the NaCl gradient. Gel filtration of Sephacryl S-300 yielded an estimated m.w. of 91,000. Chromatofocusing revealed a broad peak of activity with a pI of 4.5 to 5.0. SDS PAGE showed the active fraction migrated as a protein with a m.w. of 10,400. ECF Tt had chemotactic and chemokinetic activity for equine eosinophils and murine eosinophils, but not for equine and murine neutrophils. PMID- 3512707 TI - Independent regulation of granulocyte-macrophage colony-stimulating factor and multi-lineage colony-stimulating factor production in T lymphocyte clones. AB - When murine T lymphocyte clones were cultured with purified recombinant IL 2, a dose-dependent increase in the production of granulocyte-macrophage colony stimulating factor (GM-CSF) was observed. Whereas these clones produced both GM CSF and multi-lineage CSF (multi-CSF) when cultured with concanavalin A, IL 2 induced the production of GM-CSF in the virtual absence of detectable multi-CSF. In addition, IL 2 synergistically enhanced the production of both GM-CSF and multi-CSF by some antigen- or Con-A-stimulated clones. Like Con-A-induced CSF production, GM-CSF production in the presence of IL 2 required protein synthesis but could occur in the absence of proliferation by the clone. Analysis of dose response curves for stimulation of CSF production by Con A in the presence and absence of IL 2 suggested that Con A and IL 2 activated GM-CSF synthesis by different mechanisms. These results indicate that the coordinate production of two factors by a single T cell clone stimulated with Con A can be dissociated when the clone is stimulated with IL 2. PMID- 3512708 TI - The major histocompatibility complex-restricted antigen receptor on T cells. IX. Role of accessory molecules in recognition of antigen plus isolated IA. AB - Antibody inhibition studies were done to determine which molecules on the surface of the T cell hybridomas other than their receptors for antigen plus IAd were involved in interaction with antigen-presenting B cells, with artificial IAd membranes on glass beads, or with anti-receptor antibodies coupled to Sepharose beads. We found that T cell LFA-1 was only involved when B cells were used to present antigen plus IAd, whereas T cell L3T4 was involved in the response of T cells to antigen plus IAd either on cells or in artificial membranes, but not if anti-receptor antibodies were used to stimulate the T cells. From these results we concluded that LFA-1 may be involved in the recognition of a ligand on cells that was not present in artificial membranes, but that L3T4 might interact with a nonpolymorphic portion of class II molecules present in both intact antigen presenting cells and the antigen-presenting artificial membranes. PMID- 3512709 TI - Cloned murine Ia+ BK-BI-2.6.C6 T cells function as accessory cells presenting protein antigens to long-term-cultured antigen-specific T cell lines. AB - A variant clone, BK-BI-2.6.C6, was derived from the murine bovine insulin reactive T cell line BK-BI-2.6 with helper/amplifier phenotype. Variant cells have lost reactivity to insulin, but have acquired constitutive IL 2 receptor expression, growing in IL 2-containing medium without feeder cells. In contrast to their ancestor line, variant cells synthesize and express I-A and I-E region dependent class II molecules as indicated by metabolic radiolabeling, immunoprecipitation with subregion-specific monoclonal antibodies and two dimensional (2D) gel electrophoresis (1D isoelectric focusing, 2D SDS-PAGE). BK BI-2.6.C6 cells can act as accessory cells, presenting the protein antigens bovine insulin and ovalbumin to antigen-dependent long-term cultured T cell lines BK-BI-1.2 and BK-OVA-1 in the context of I-A restriction elements. Antigen recognition on presenting BK-BI-2.6.C6 accessory cells resulted in highly efficient IL 2 production. However, in contrast to splenic antigen-presenting cells, BK-BI-2.6.C6 cells did not initiate antigen-specific [3H]thymidine incorporation by the T cell lines tested. Further study of accessory function of Ia+ T cell clones might provide insight into processes regulating T cell responses to antigen. PMID- 3512710 TI - Plasmodium falciparum antigens synthesized by schizonts and stabilized at the merozoite surface when schizonts mature in the presence of protease inhibitors. AB - Schizonts of Plasmodium falciparum were cultured in medium containing a mixture of 10 micrograms/ml each of leupeptin, chymostatin, pepstatin, and antipain. The protease inhibitors did not inhibit macromolecular synthesis but were associated with decreased reinvasion of red cells and the accumulation of well preserved merozoites clustered around pigment granules (PCM, protease inhibitor clusters of merozoites). The parasite pellet from PCM cultures contained increased amounts of merozoite antigens, particularly at Mr 83, 73, 66, 45, and 17 kDa. The increases of the Mr 83, 73, and 45 kDa surface antigens observed in PCM had been observed also in similar merozoite clusters obtained by culturing schizonts in the presence of inhibitory antibodies. These three antigens are processed products of the abundant Mr 195 kDa schizont surface antigen. Liquid-phase double immunofluorescence of PCM demonstrated a residual red cell membrane through which monoclonal antibodies passed and reacted with the Mr 83, 73, and 45 kDa merozoite surface antigens or their precursors. The processes associated with normal reinvasion apparently involve protease(s), which plays a role(s) in the breakdown of the red cell membrane and the shedding of merozoite surface antigens. Interference with these processes by protease inhibitors is useful in increasing recoveries of merozoite antigens, as well as in elucidating mechanisms of reinvasion. PMID- 3512711 TI - Plasmodium falciparum antigens synthesized by schizonts and stabilized at the merozoite surface by antibodies when schizonts mature in the presence of growth inhibitory immune serum. AB - Some immune sera that inhibit erythrocyte invasion by merozoites also agglutinate the merozoites as they emerge from rupturing schizonts. These immune clusters of merozoites (ICM) possess a surface coat that is cross-linked by antibody and is thicker than the surface coat associated with normal merozoites (NM) obtained from cultures containing preimmune serum. Analysis of metabolically labeled ICM and NM performed by using sodium dodecyl sulfate-polyacrylamide gel electrophoresis showed that washed ICM possessed immune complexes containing antigens representative of schizonts and merozoites. Characteristics of the immune complexes included: a) they were not soluble in pH 8 Triton X-100, b) they were soluble at an acid pH, and c) after pH neutralization they were precipitated by using staphylococcal protein A. Merozoite antigens having Mr of 83, 73, and 45 kDa were associated with immune complexes in ICM. The 83 and 73 kDa antigens were recovered in considerably larger quantities from ICM than from NM. Schizont antigens having Mr of 230, 173 (triplet), 152 (doublet), and 31 kDa were associated with immune complexes in ICM, and a 195 kDa antigen(s) from schizonts and merozoites was also present in the immune complexes. In addition, other antigens of Mr 113, 101, 65, and 51 kDa may have been immune complexed. These 15 antigens accounted for less than 30% of the schizont and merozoite antigens recognized by the immune serum. Immune complexes probably formed between antibodies and a) surface antigens of schizont-infected erythrocytes exposed to antibody before schizont rupture, b) surface antigens of merozoites and schizonts exposed during schizont rupture, and c) soluble antigens normally released during schizont rupture. The antibody components of the immune complexes may have prevented rapid degradation or shedding of some antigens from the merozoite surface. Allowing schizonts to rupture in the presence of inhibitory antibodies (to form ICM) is a useful approach to identifying exposed targets of protective immunity against malaria. PMID- 3512712 TI - Procyclic tsetse fly midgut forms and culture forms of African trypanosomes share stage- and species-specific surface antigens identified by monoclonal antibodies. AB - Procyclic culture form (PCF) trypanosomes were established from a bloodstream form population of cloned Trypanosoma brucei rhodesiense and were used to immunize mice for hybridoma production. Indirect immunofluorescence was used to select 10 hybridomas which secreted antibodies that bound to the surface of homologous living PCF. The antibodies reacted with PCF of several clones of T.b. brucei, T.b. gambiense, and T.b. rhodesiense, but not with PCF of T. congolense or T. vivax, or with promastigotes of several species of Leishmania parasites. The antigens were not detectable in ethanol/acetic acid-fixed bloodstream forms or in lysates of bloodstream forms of any of the T. brucei subspecies, and are thus species-specific and stage-specific markers. Selected monoclonal antibodies bound to procyclic trypanosomes taken directly from the midgut of infected tsetse flies, and to immature epimastigote forms in salivary probes, and may therefore be useful in epidemiologic investigations. PMID- 3512714 TI - Interleukin 1 is a radioprotector. AB - Pretreatment with recombinant interleukin 1 (IL 1) protects mice in a dose dependent manner from lethal effects of ionizing radiation. Two thousand units of IL 1, given i.p. 20 hr before irradiation, protect 88% of C57B1/6 mice from an LD100/17 radiation dose (dose of radiation that kills 100% mice in 17 days), and 1000 U of IL 1 protect 100% of DBA/1 mice from an LD50/30 dose. This finding provides the first evidence that a cytokine, IL 1, which acts as a differentiation- and maturation-inducing agent for a variety of cells, also can serve as a signal that initiates radioprotective events in vivo. Because many of the exogenous immunomodulators that have been shown to be radioprotective also induce endogenous IL 1 production, our observation suggests that IL 1 may mediate their radioprotective effects. PMID- 3512713 TI - Enhancement of selective tumor cell binding by activated murine macrophages in response to phorbol myristate acetate. AB - The fundamental biology of how stable cell-cell bonds develop between activated macrophages and tumor cells, although essential to lysis of the neoplastic targets, remains poorly understood. To investigate whether this phenomenon could be pharmacologically manipulated, we analyzed the effect of phorbol diesters on tumor cell binding by macrophages. Activated murine peritoneal macrophages, treated in vitro with as little as 1 ng/ml of phorbol myristate acetate (PMA), bound significantly more tumor cells than did untreated macrophages. The effect was induced rapidly by PMA (i.e., maximum enhancement was seen within 15 min) and resulted in an average approximately twofold increase in the number of targets bound. The interaction between PMA-treated activated macrophages and tumor cells was completed much more rapidly than by untreated macrophages. The enhanced binding was seen only in macrophages treated with biologically active phorbol esters. Only the selective interaction between activated macrophages and tumor cells was affected (i.e., PMA treatment had no effect on nonselective interactions between activated macrophages and non-neoplastic targets or between nonactivated macrophages and any type of target). Pretreatment of activated macrophages with PMA apparently altered the requirements for microfilaments and microtubules in establishing binding, because cytochalasin B and colchicine, which inhibited control binding, as well as phagocytosis, had no effect on PMA enhanced binding. PMA treatment did not alter energy requirements for binding, however, because low temperature (4 degrees C) or inhibitors of glycolysis and oxidative phosphorylation blocked both control and PMA-enhanced binding. The enhancement of binding apparently was not due to large quantities of secreted oxygen metabolites but did correlate closely with increased spreading and surface area of the macrophages. PMA treatment resulted in enhanced expression of trypsin sensitive tumor-cell binding sites on the macrophage surface. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis of macrophage membrane proteins labeled with 125I by the lactoperoxidase method revealed at least four trypsin sensitive cell surface proteins that were re-expressed after PMA treatment. The data suggest that rearrangement and/or induced expression of surface binding sites may be an important step in the binding of tumor cells and indicate that PMA is a useful pharmacologic probe in dissecting the establishment of such binding into discrete steps. PMID- 3512715 TI - Invariant chain associates with HLA class II antigens via its extracytoplasmic region. AB - Complexes of HLA class II alpha- and beta-chains with invariant chain were proteolytically digested to study domain interactions between these molecules. Detergent extracts of metabolically labeled monensin-treated B lymphoblastoid cells (B-LCL) were digested with proteinase K and immunoprecipitated with anti HLA-DR or anti-invariant chain antibodies. Subsequent two-dimensional polyacrylamide amide gel electrophoresis showed that proteinase K treatment results in the sequential generation of three polypeptides of approximately 21,500, 19,500, and 18,000 daltons respectively. All are proteolytic fragments derived from invariant chain, and all remain associated with class II antigens. Two-dimensional gels of endoglycosidase H-treated immunoprecipitates showed that all three fragments contain two N-linked oligosaccharides. Neuraminidase treatment of immunoprecipitates and Bandeiraea simplicifolia lectin binding of cell extracts showed that the largest fragment, but not the smallest fragment, also contains O-linked oligosaccharides. None of the fragments possess the transmembrane region; fragments were released in soluble form when biosynthetically labeled B-LCL were ruptured by freezing and thawing and intact membranes were separated from aqueous components by ultracentrifugation. Lack of the transmembrane sequence was confirmed on the 18,000 dalton fragment by demonstrating through specific peptide cleavage at tryptophanyl residues that this fragment retains a substantial portion of the C-terminal region of I chain beyond trp162. Retention of the C-terminal region excludes the presence of the transmembrane region when m.w. are considered. Our data, taken in context of the amino acid sequence of the invariant chain predicted by the cDNA clone, demonstrate that invariant chain interacts with class II antigens via its extracytoplasmic region. PMID- 3512716 TI - Induction and regulation by monokines of hepatic synthesis of the mouse serum amyloid P-component (SAP). AB - The in vitro synthesis by mouse hepatocytes of the major acute-phase reactant, serum amyloid P-component (SAP), was induced either by inflammatory macrophages or by the addition of monokine(s), including IL 1. A single cell assay for enumerating SAP-secreting hepatocytes was developed. An increase in the frequency of SAP-synthesizing hepatocytes was found during the acute phase of inflammation. Macrophages elicited with a sterile inflammatory agent, when cultured with hepatocytes, both induced new SAP synthesis by the hepatocytes and increased the number of SAP-producing hepatocytes by sevenfold. Inflammatory macrophage culture supernatants induced new SAP synthesis in hepatocytes; however, the inducing activity did not correlate with the IL 1-dependent thymocyte-proliferating activity. Purified IL 1 alone increased SAP production without increasing the number of hepatocytes secreting SAP. A mixture of purified IL 1 with non-IL 1 monokines both increased the number of SAP synthesizing hepatocytes and the amount of SAP secreted per cell. Two non-IL 1 monokines of 70 to 80 Kd and 30 to 40 Kd were responsible for hepatocyte induction. The inducing activity was not neutralized by anti-mouse IL 1 antibody. IL 1 did contribute to the acute phase response by inducing more SAP synthesis per hepatocyte. The findings suggest that both the induction of nonsynthesizing hepatocytes into new SAP synthesis and the enhancement of the amount of SAP produced per hepatocyte are responsible for the increase in blood levels of SAP during the acute phase of inflammation. PMID- 3512717 TI - Covalent binding properties of the C4A and C4B isotypes of the fourth component of human complement on several C1-bearing cell surfaces. AB - In a previous study we demonstrated that the thioester-mediated transacylation of the human C4B isotype onto sheep erythrocytes (ES) was approximately fourfold more efficient than that of C4A. Moreover, although C4B formed predominantly ester linkages, C4A displayed a preference for amide bond formation. We therefore suggested that the relative functional activity observed for the two isotypes would be a combined reflection of their nucleophilic preference and the surface composition of the C1-bearing target. The present study tests this hypothesis. Chemical modification of amino groups on Es with ethylacetimidate produced a twofold decrease in the C1-dependent binding of C4A isotype, while having a negligible effect on C4B binding. Furthermore, with human erythrocytes and two human leukocyte cell lines, K562 and U937, the C4B to C4A deposition ratio decreased from greater than 4 with ES to between 1.5 and 2. Irrespective of the target, C4A and C4B maintained their preference for forming amide and ester bonds, respectively. Interestingly, SDS-PAGE profiles of radiolabeled C4A and C4B, which had been covalently deposited on the various cells, suggested a further degree of transacylation specificity, as the two isotypic alpha-chains sometimes bound to different membrane components. These differences were not easily accounted for by simple differences in the abundance of the preferred nucleophile for each isotype on a given surface constituent, nor were they due to the preferential binding of one isotype to the sensitizing antibody. We speculate that nascent C4B may contain a substrate binding site that facilitates productive attack on the thioester carbonyl by molecules containing the class of nucleophile preferred by each isotype. PMID- 3512718 TI - Selection and performance of monoclonal and polyclonal antibodies in an IgM antibody capture enzyme immunoassay for rubella. AB - Monoclonal anti-human IgM and anti-rubella antibodies were prepared and tested in an IgM capture enzyme immunoassay (MACEIA) for rubella-specific IgM and compared with polyclonal reagents. Assay sensitivity was increased with monoclonal antibodies resulting in the improved discrimination of adult sera with low levels of specific IgM. Despite high IgM binding, interference by IgM anti-Ig was not a major problem. The use of monoclonal antibodies allowed assay simplification by the simultaneous rather than sequential addition of antigen and conjugate. Although comparable results were obtained with 33 test samples in the sequential and simultaneous MACEIA, the specificity and sensitivity of this modification requires further evaluation. PMID- 3512719 TI - Measurement of human and mouse anti-tetanus antibodies and isotype analysis by ELISA. AB - A rapid and sensitive enzyme immunoassay (ELISA) was developed for the quantitation of anti-tetanus antibodies. This technique was used to measure antibody levels in the plasma of immunized donors, in human anti-tetanus IgG preparations and in human and mouse hybridomas producing monoclonal antibodies to tetanus toxoid. The assay was capable of detecting antibody levels as low as 5 X 10(-4) IU/ml. By inclusion of an extra step involving antibodies to mouse Ig isotypes, a sandwich enzyme immunoassay (SEI) was developed which permitted determination of the Ig isotype of mouse anti-tetanus antibodies including tetanus-specific mouse monoclonal antibodies. SEI confirmed Protein A-Sepharose fractionation of mouse ascites fluid containing anti-tetanus antibody. The tetanus toxoid-coated plates have a shelf life of at least 1 year. PMID- 3512720 TI - Theoretical limitations on immunoassay sensitivity. Current practice and potential advantages of fluorescent Eu3+ chelates as non-radioisotopic tracers. AB - The sensitivity of any immunoassay is a complex function of the underlying physico-chemical basis of the technique and the size and source of 'experimental' errors. Analysis of this relationship emphasizes the distinction between competitive labelled analyte methods, e.g., RIA, and the non-competitive labelled antibody techniques, e.g., IRMA, implying that, in practice, non-competitive methods may display sensitivities which are orders of magnitude greater than similar competitive assays. The achievement of the potential sensitivity of the non-competitive methods depends to a great extent on the application of very highly detectable labels. The long fluorescent lifetime and large Stoke's shift of certain europium (Eu3+) chelates permits such sensitive detection in a commercially available time-resolved fluorimeter. We briefly outline the current application of Eu3+ labels in immunometric assay, compare the application of Eu3+ labels in the immunofluorometric assay of human TSH with conventional RIA and discuss the future potential of this technique. PMID- 3512721 TI - The ELISA-plaque assay for the detection and enumeration of antibody-secreting cells. An overview. AB - A solid-phase immunoenzymatic technique has been developed which allows the ready detection and enumeration of total- and antigen-specific immunoglobulin-secreting cells (ISC). The procedure involves the addition of putative ISC to plastic wells pre-coated with specific antigen or antisera. During incubation, the product of a single cell is immobilized by the solid phase at the point of release providing an immunological 'finger print' of the ISC which is subsequently developed by the application of appropriate enzyme-anti-Ig conjugates and an enzyme substrate which yields an insoluble product after incubation. Blue spots or 'ELISA plaques' are thus produced and can be counted macroscopically. This technique has been employed in rat, mouse and human systems and in each case appears to be of equivalent or greater sensitivity to existing haemolytic plaque techniques. The assay is particularly suited to the enumeration of antigen-specific ISC in which the antigen is difficult to couple to red cells or where a high degree of discriminating power is necessary as is required for example in the enumeration of IgE-ISC. PMID- 3512722 TI - Investigation of IgG4 levels in atopic patients using a competitive inhibition assay employing biotinylated IgG4 myeloma and avidin peroxidase. AB - Modification of a 'sandwich' ELISA assay developed for the determination of serum IgE levels proved to be unsatisfactory for the measurement of IgG4. This was attributed to the limited capacity of the microtitre plate solid phase which required high serum dilutions in order to measure IgG4 levels. To overcome this problem a competitive inhibition assay was developed with monoclonal anti-IgG4 attached to the plate. In this system biotinylated IgG4 myeloma and sample IgG4 compete for the limited antibody binding sites present on the solid phase. The attached biotinylated myeloma is detected by addition of avidin conjugated with peroxidase and following development with substrate, IgG4 levels are calculated by reference to a calibrated inhibition curve. The inhibition ELISA assay has been used clinically to measure IgG4 levels in atopic and normal individuals and the values obtained correlated closely (r = 0.99) with the IgG4 levels determined by radial immunodiffusion. For 43 atopic dermatitis patients investigated the median IgG4 level was 1.1 g/l which was significantly elevated when compared to a median of 0.385 g/l for 60 blood donors (P less than 0.0001, Mann-Whitney U). Among the 47 hay fever patients investigated the median was 0.6 g/l which, although lower than in atopic dermatitis, was again significantly increased (P less than 0.025). Within this latter group, 25 patients were investigated for the effects of desensitization with commercial grass pollen injections. The total IgG4 showed a variable but significant rise between the start and finish of treatment (P less than 0.01 Wilcoxon signed ranks test). PMID- 3512723 TI - Enzyme amplification for immunoassays. Detection limit of one hundredth of an attomole. AB - A method is described for increasing the response of enzyme immunoassays employing alkaline phosphatase as the label initiating 2 sequential catalytic reactions. First, NADP is dephosphorylated to produce NAD, which catalytically activates a specific redox-cycle involving the enzymes alcohol dehydrogenase and diaphorase. During each turn of the cycle 1 molecule of a tetrazolium salt is reduced to an intensely coloured formazan. The method is capable of detecting as little as 0.01 amol alkaline phosphatase, and when applied to an immunoassay for TSH a sensitivity (zero + 2.5 standard deviations) of 0.0013 mIU/l was obtained. PMID- 3512724 TI - A novel enzyme immunoassay for total thyroxine using immobilized antibodies and hydrophobic chromatography purified thyroxine-peroxidase conjugate. AB - A new and simple competitive enzyme immunoassay method for the measurement of total thyroxine in serum is described. Anti-thyroxine antibodies, raised in sheep with a bovine serum albumin-thyroxine conjugate prepared with carbodiimide as coupling initiator, were physically adsorbed onto a large surface area polypropylene support. Competition occurred between thyroxine in the sample and a thyroxine-peroxidase conjugate prepared with a glutaraldehyde spacer and further purified by octyl Sepharose hydrophobic chromatography. The entire assay was performed in 2 h with a useful range of 10-300 micrograms/l. The coefficients of variation ranged from 6.9 to 12% and good agreement (r = 0.93-0.97) was found between this method and 2 radioimmunoassays on 71 serum samples having well distributed thyroxine values. PMID- 3512725 TI - An in situ immunoperoxidase staining procedure for human cell colonies grown in semi-solid agar culture. AB - An adaptation of the immunoperoxidase staining procedure is described which enables the detection of antigens expressed by human hemopoietic cells grown in semi-solid agar culture. Positive staining was achieved using several different monoclonal antibodies recognizing an array of cell surface antigens on developing myeloid cells. PMID- 3512726 TI - Platelet-associated IgG assay using flow cytometric analysis. AB - In this study we describe an immunofluorescent assay system to measure platelet associated immunoglobulin G levels using flow cytometric analysis. This semi quantitative system allows ready distinction of immune from non-immune related thrombocytopenias. It is simple to perform, highly reproducible and has the advantage of requiring a minimum concentration of 5000 platelets/microliter per assay sample. PMID- 3512727 TI - A rapid and sensitive non-competitive avidin-biotin immuno-enzymatic assay for lysozyme. AB - A non-competitive avidin-biotin immuno-enzymatic assay (NABA) for lysozyme is described. The assay was found to be more sensitive than a competitive assay with biotinylated lysozyme. The lower detection limit of NABA was 0.1 ng lysozyme/ml compared to 1 ng/ml for the competitive assay. The intra-assay and inter-assay coefficients of variation for NABA were 5.9 and 9.1%, respectively. The total time for NABA can be decreased (to less than 1 h) without influencing the detection limit or the analytical range. Serum lysozyme levels measured by NABA and the enzymatic assay in 32 samples showed a correlation coefficient of r = 0.97. PMID- 3512728 TI - Re: Demonstration of lymphocyte surface antigens in paraffin-embedded human tissues. PMID- 3512729 TI - Local and systemic antibody responses to naturally acquired enterotoxigenic Escherichia coli diarrhea in an endemic area. AB - Fifteen patients hospitalized with acute, watery diarrhea and with enterotoxigenic Escherichia coli (ETEC) detected from stool samples were studied to evaluate the extent to which natural ETEC diarrhea induces local and systemic antibody responses to E. coli heat-labile toxin (LT), homologous lipopolysaccharide (LPS), and colonization factors (CFA/I and CFA/II). Specific IgA and IgG antibodies to LT, CFA I and II, and each patient's homologous LPS were determined by ELISA in serum, saliva, breastmilk, and intestinal lavage fluid. The majority of patients had greater than a twofold rise in local levels of IgA antibodies in the intestine: 80% of LT+ patients responded to LT, 63% of CFA+ patients responded to CFA, and 78% of all toxin-positive patients responded to the LPS of their infecting strain. Local antibody responses in the intestine were associated with responses in breastmilk and saliva, but relationships were not clear-cut, and the usefulness of these secretions as proxy measures of local intestinal antibody production remains unclear. Antibody responses in serum also occurred in most patients and were significantly more frequent in cases than in controls. This study demonstrates that natural ETEC disease results in local IgA responses to LT, CFA, and LPS in the gut and also in immune responses in breastmilk, saliva, and serum. PMID- 3512730 TI - Gnotobiotic models for study of the microbial ecology of Clostridium difficile and Escherichia coli. AB - Hamster flora introduced into germfree mice reduced the cecum to conventional size, suppressed populations of Escherichia coli and Clostridium difficile to the same degree that mouse flora did, and corrected the hypocellularity that is characteristic of the small bowel of germfree mice. A highly toxigenic strain of C. difficile readily induced cecitis in germfree and antibiotic-treated conventional mice, and histological examination frequently revealed pseudomembranes. Toxins A and B were both detected in ceca of animals with colitis. Gnotobiotic mice provide a model in which to study the role of the indigenous microflora in protecting against antibiotic-associated colitis. PMID- 3512731 TI - Extraintestinal Campylobacter jejuni and Campylobacter coli infections: host factors and strain characteristics. AB - To determine whether extraintestinal isolates of Campylobacter jejuni and Campylobacter coli are the consequence of unusual host or bacterial characteristics, we studied clinical and bacteriologic features of 24 extraintestinal infections. Common serotypes and auxotypes were present among the extraintestinal isolates. Gastrointestinal isolates were more susceptible to normal human serum than were the systemic isolates; however, the ranges overlapped considerably. Predispositions to systemic spread were present in 52% of patients with extraintestinal infections; isolates from these patients were more often (73%) serum sensitive than were isolates from patients without predispositions (9%; P = .002). By sodium dodecyl sulfate-polyacrylamide gel electrophoresis, no specific protein band was associated with serum resistance, and all isolates of C. jejuni and C. coli had rough-type lipopolysaccharide profiles. Serum susceptibility was inversely correlated with carbohydrate or ketodeoxyoctonate (KDO) fraction of cell weight and directly correlated with KDO:carbohydrate ratio. Our results suggest that either host defects or specific bacterial virulence characteristics, such as serum resistance, possibly related to length of lipopolysaccharide side chain, may be responsible for extraintestinal infections due to C. jejuni and C. coli. PMID- 3512732 TI - Quantitation of the phenolic glycolipid of Mycobacterium leprae and relevance to glycolipid antigenemia in leprosy. AB - Chemical and immunologic procedures have been developed for quantitation, in the body fluids of patients with leprosy, of phenolic glycolipid I, the major specific antigen of the leprosy bacillus. Serum samples were extracted with CHCl3/CH3OH and fractionated on columns of silicic acid. Thin-layer chromatography with a sensitivity of about 500 ng allowed detection of the glycolipid in untreated lepromatous and borderline patients, and high-pressure liquid chromatography gave a quantitation of 0.8-3.7 micrograms/ml of serum from four patients. An ELISA-inhibition assay with polyclonal antibodies to glycolipid corroborated these figures. Dot-ELISA on nitrocellulose with polyclonal and monoclonal IgG antibodies allowed for much greater sensitivity (500 pg) and semiquantitative evaluation. Small quantities of glycolipid were present in the urine of patients with lepromatous leprosy. In sera obtained from patients undergoing chemotherapy, the amount of glycolipid declined sooner than did titer of antibody. This experimental approach is applicable to diagnosis of leprosy, bacillary quantification, and standardization of skin-test reagents and vaccines. PMID- 3512733 TI - Emergence of resistance to beta-lactams, aminoglycosides, and quinolones during combination therapy for infection due to Serratia marcescens. PMID- 3512734 TI - Effects of serum lipoproteins on damage to erythrocytes and Candida albicans cells by polyene antibiotics. PMID- 3512735 TI - Serotypes of Cryptococcus neoformans in patients with AIDS. PMID- 3512736 TI - Campylobacter pyloridis and gastritis. PMID- 3512738 TI - John F. Enders, 1897-1985. A tribute. PMID- 3512737 TI - Suppression of immunoglobulin-secreting cells from human peripheral blood by toxic-shock-syndrome toxin-1. AB - Toxic-shock syndrome toxin-1 (TSST-1), a nonspecific T lymphocyte mitogen, was shown to cause the suppression of immunoglobulin-secreting cells (ISCs) generated in pokeweed mitogen (PWM)-stimulated cultures of human peripheral blood mononuclear cells (PBMs). Greater than 90% suppression of the PWM-stimulated ISC response was achieved when 2 X 10(6) PBMs were cultured in the presence of 1 microgram of TSST-1. The nonspecific suppression induced by the toxin was dose related; amounts of TSST-1 as low as 1.0 ng/2 X 10(6) cultured cells caused significant suppression of the ISC response. TSST-1-induced suppression was due to the activation of a population of cells that secreted a soluble factor that mediated the resulting suppression. PBMs were activated by a 24-hr preincubation of 2 X 10(6) cells in the presence of 1 microgram of TSST-1 followed by repeated washing to remove residual toxin. These cells, when co-cultured with unstimulated PBMs and PWM, suppressed the normal ISC response. The supernatant factor, active at volumes of 10 microliters/2 X 10(6) PBMs, was generated by harvesting the supernatant fluid of TSST-1-activated cells. The results of these in vitro experiments confirm that TSST-1 is an immunosuppressing agent that affects human lymphocyte function and, in such a capacity, may play a role in the development of toxic shock syndrome in humans. PMID- 3512739 TI - Historical perspectives and comparisons of TMJ surgery for internal disk derangements and arthropathy. PMID- 3512740 TI - Music therapy in pain management. PMID- 3512741 TI - [Studies on the immunohistochemical localization of coagulation fibrinolysis factors in the placenta, especially of placental plasminogen activator (PPA)]. AB - We succeeded for the first time in extracting and purifying a coagulation fibrinolysis factor in the placenta, that is, a placental plasminogen activator (PPA). Using the enzyme-labeled antibody technique (indirect method), we investigated the localization of PPA, fibrinogen (FBG) and fibronectin (FN) in the placenta. And we tried to elucidate the physiological significance of the above three. The F(ab')2 fragments of their antibodies were produced by pepsin digestion, because there were various Fc receptors in the placenta. The results are summarized as follows: PPA was produced in the trophoblast, and was secreted out of the microvilli. FBG was located in the plasma. But, in the placenta, it was not in the cells and the connective tissue of which chorionic villi was composed. FN was located in the ground substances of connective tissue in the chorionic villi, and was associated with the cell structure. Because PPA, FBG and FN showed the same distribution on the fibrinoid material, it is expected that coagulation fibrinolysis activity proceeds in that fibrinoid material. PMID- 3512742 TI - [Prenatal diagnosis and treatment of nonimmune hydrops fetalis]. PMID- 3512743 TI - [Studies on HLA-class I and class II antigen expression in cultured choriocarcinoma cell lines]. AB - Eight choriocarcinoma cell lines (Two SCH and IMa, were established from non gestational choriocarcinoma and the other six BeWo, JaR, JEG-3, GCH-1, NUC-1, and HCCM-5, were from gestational one) were investigated for HLA-Class I and Class II antigen expression by the immunofluorescence method using rabbit anti HLA-ABC serum, and by a radioimmunoassay inhibition best using monoclonal antibodies (W6/32: anti HLA-ABC, 7B6: anti HLA-Class II, and D1-4-10: anti HLA-DR). With respect to HLA-Class I antigen expression, only non-gestational SCH (gastric origin) showed a clear positive finding. The other non-gestational IMa (ovarian origin) was negative. Cell lines from gestational choriocarcinoma showed a slightly positive finding (negative by immunofluorescence but slightly positive by inhibition test), except for JaR which was negative. All cell lines examined in the present study were negative for HLA-Class II antigen. The present results show that the majority of the gestational choriocarcinoma cell lines may express very slight HLA-Class I antigens. PMID- 3512744 TI - [Sacrospinous ligament fixation of vaginal apex for repair operation of uterine prolapse--operative procedure and postoperative outcome evaluated with score system and X-ray subtraction colpography]. AB - To preserve a snug vagina with complete repair, sacrospinous ligament fixation (SLF) to the vaginal apex was applied in operations for uterine prolapse from the April of 1983 to the April of 1984. SLF was added to 11 vaginal hysterectomies with anterior and posterior (A-P) colporrhaphy, 1 Manchester operation and 1 A-P colporrhaphy. SLF was performed at the stage of posterior colporrhaphy in each operation. The postoperative outcome was evaluated with a score system and an X ray subtraction colpography. The score system describes the grade of vaginal relaxation in each part of the vagina before and after the operation. It showed that the vagina was repaired quite well by the SLF especially in the area of the vaginal apex and posterior wall. The subtraction colpography revealed the side view of the vagina and its movement on straining. It suggested that the SLF was a reasonable procedure for the prevention of recurrence. SLF also proved to have wide application to the repair of uterine prolapse including patients desiring the preservation of childbearing capability and elderly or poor-risk patients. PMID- 3512745 TI - Intravenous administration of prostacyclin in rabbits: elimination kinetics and blood pressure response. AB - Prostacyclin (PGI2) has been used extensively in human clinical trials and animal studies, but because of its instability, knowledge of its pharmacokinetics has progressed slowly. We assayed plasma PGI2 concentrations with a quantitative chromatographic method following bolus intravenous injection and during continuous infusion in rabbits. Blood pressure response was correlated with plasma PGI2 concentrations and compared with the concentrations necessary to inhibit platelet aggregation in vitro. A two-compartment model was used to analyze the elimination kinetics for PGI2 after a single injection. The half-life of the terminal elimination phase was 2.7 minutes. The calculated systemic clearance and whole body volume of distribution were 93 ml/kg/min and 357 ml/kg, respectively. During continuous infusion, steady-state plasma concentrations were reached within 15 minutes and increased linearly with increasing infusion rate from 4.2 to 604 ng/kg/min, which resulted in PGI2 concentrations of 0.06 +/- 0.01 to 7.6 +/- 2.1 ng/ml, respectively. At steady-state plasma concentrations of PGI2 greater than 0.1 ng/ml, the mean arterial blood pressure decreased in a concentration-dependent manner, reaching a decrease of 45 mm Hg when the plasma concentration was 7.6 ng/ml. Prostacyclin caused a concentration-dependent inhibition of adenosine diphosphate-induced platelet aggregation in vitro with 10% inhibition at 0.4 ng/ml. These results indicate that in the rabbit the level of PGI2 at which the onset of hypotension occurs coincides with the inhibition of platelet aggregation. PMID- 3512746 TI - Assay for antibodies to group C and G streptococcal carbohydrate by enzyme-linked immunosorbent assay. AB - An enzyme-linked immunosorbent technique was established for the assay of serum antibodies to the group C and G streptococcal group-specific carbohydrates. The antigens consisted of formamide-extracted purified polysaccharides conjugated to poly-L-lysine. By use of hyperimmune rabbit antisera to the streptococcal group specific polysaccharides A, C, and G, a high degree of specificity was encountered for each of the antigens tested. Antibody titers to these antigens were then measured in sera of 100 normal individuals varying in age from newborn to 20 years. The mean titer of these antibodies increased significantly between the ages of 5 and 15 years and leveled off thereafter. Assay of antibodies to the group A, C, and G carbohydrates on sera of patients with antecedent group A streptococcal infections or rheumatic fever and their matched normal controls revealed significantly elevated titers for the antibody to streptococcal group A carbohydrate only in the sera of these patients. These results support the specificity of these tests and suggest their potential usefulness for providing evidence for infection by the various streptococcal serogroups in humans. PMID- 3512747 TI - Naproxen in otitis media with effusion. AB - The levels of prostaglandin E2 (PGE2) were measured in aspirates of the effusion fluid from children suffering from secretory otitis media. The effects of naproxen 5 mg./kg. twice daily for eight weeks on the condition were studied in a placebo-controlled double-blind trial. Nineteen middle-ear aspirates from 13 children, six of whom had bilateral aspirations were examined. Detectable levels of PGE2 (greater than 1.0 ng. per ml.) were present in seven aspirates from seven children and ranged from PGE2 1.0 to 14.4 ng. per ml. In four of the six patients who had bilateral aspirations, PGE2 was detectable in the aspirate from one ear but not the other. However, the severity of otalgia and hearing loss was almost identical in the ears with detectable levels of PGE2 and those without. In a separate trial of naproxen, 11 patients received active drug and 13 received placebo. Naproxen had no significant effect on otalgia or hearing loss compared to placebo. These findings suggest that it is unlikely that non-steroidal anti inflammatory drugs will be of therapeutic benefit in secretory otitis media. PMID- 3512748 TI - The effect of benzydamine hydrochloride (difflam) spray on post-tonsillectomy symptoms: a double-blind study. PMID- 3512749 TI - Sphenoidal sinusitis secondary to malignant external otitis. PMID- 3512750 TI - Database. PMID- 3512751 TI - Kinetics of macrophage recruitment and turnover in peritoneal inflammatory exudates induced by Salmonella or thioglycollate broth. AB - Kinetics of peritoneal macrophage turnover during infection of mice with Salmonella enteritidis or following injection with thioglycollate broth or other peritoneal stimulants has been studied. Single intravenous injections of tritiated thymidine were given and the cells were examined by autoradiography. Maximum labelling of small adherent peritoneal macrophages occurred when 3H thymidine was given 1 d after Salmonella and the cells were harvested 1 d later. Labelled cells decreased at later times despite maintenance of high numbers of macrophages in the exudates. Results from experiments in which labelled peritoneal cells were reinjected indicated that small, monocyte-enriched, labelled cells were not the major source of the large macrophages. Similar labelling at 2 d was observed using heat-killed Corynebacterium parvum or lipopolysaccharide (LPS) as ip stimulants. Following injection of thioglycollate broth, labelled peritoneal macrophages were only detectable if 3H-thymidine was given before the stimulant. These labelled cells remained longer in the peritoneal cavity. Labelling of and numbers of blood monocytes were consistent with the promotion of monocytopoiesis by Salmonella but not by thioglycollate. The response to thioglycollate but not Salmonella was dependent on the age of the mice. Animals injected with thioglycollate 1 d before Salmonella also had decreased resistance to bacteria and low numbers of labelled peritoneal macrophages. We propose that thioglycollate may recruit from a subset of preformed monocytes and temporarily block monocytopoiesis or macrophage bactericidal activity. PMID- 3512752 TI - The autogenous inner table iliac bone graft. A review of 100 patients. AB - A review of 100 patients in whom an autogenous bone graft from the iliac inner table was used for maxillofacial surgery is presented. The conclusions are that this technique is a relatively simple, quick, safe and reliable procedure for obtaining an iliac bone graft. PMID- 3512753 TI - Irradiation of free vascularized tissue transplants in rats. AB - The aim of this experimental investigation was to show whether immediate irradiation of a free flap or an island flap is dangerous or not. The free epigastric flap of the rat was used as a model for this investigation. The patency of the epigastric vessels of the rat was not influenced by the irradiation and the histological findings showed no early reaction to the irradiation of the vessels of the transplanted tissue. The vessels of this experiment indicate that a free tissue transplantation is possible even if a combined radio-surgical treatment is planned. PMID- 3512754 TI - A Confederate hospital. Surgeon John Patterson and the Clayton during the Atlanta Campaign, 1864. PMID- 3512755 TI - Human pharyngeal and sellar pituitary glands: differences and similarities revealed by an immunocytochemical study. AB - Fifteen pharyngeal and sellar pituitary glands, obtained at autopsy from unselected adult patients, were compared in an attempt to elucidate the functional significance of the pharyngeal pituitary. The study was carried out using light microscopy and an indirect peroxidase technique to detect the presence of prolactin, GH, ACTH, LH, FSH, TSH and lipotrophin (LPH) immunoreactive cells. A quantitative analysis of these cell types in each gland was performed. Neither the pharyngeal nor the sellar pituitaries were abnormal in six cases. In this group the average percentage of immunoreactive cells in the sellar vs the pharyngeal pituitary was 11.3 vs 7.4 for FSH cells, 13.3 vs 4.4 for LH cells, 6.4 vs 5.2 for TSH cells, 14 vs 1.5 for ACTH cells, 13.1 vs 6 for LPH cells, 29.4 vs 5.2 for GH cells and 21.2 vs 8.5 for prolactin cells. A comparative statistical evaluation of the seven hormone-producing cell types indicated that, in most cases, the percentage of immunoreactive cells was significantly higher in the sellar pituitary. Examination of serial sections revealed hyperplasia, with or without microadenomas, in nine sellar pituitaries. In these abnormal cases most of the pharyngeal pituitary glands showed hyperplasia of the same cell type as was found hyperplastic in the sellar adenohypophysis. However, hyperplasia restricted to the sellar pituitary was also seen. There were two cases in which the pharyngeal pituitary was almost lacking in immunoreactive cells; in one of them the sellar pituitary had GH and prolactin cell hyperplasia. The results obtained confirm that under normal conditions the pharyngeal pituitary is not an important source of adenohypophyseal hormones.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3512756 TI - Smear layer removal effects on apical leakage. PMID- 3512757 TI - Fibroblast growth enhancing activity of tumor necrosis factor and its relationship to other polypeptide growth factors. AB - Tumor necrosis factor (TNF) is a monocyte-derived protein cytotoxic or cytostatic for some tumor cell lines. Here we show that highly purified E. coli-derived recombinant human TNF stimulated the growth of human FS-4 diploid fibroblasts. Stimulation of cell growth was demonstrable at a TNF concentration of 10 pg/ml (3 X 10(-13) M). Maximal stimulation was attained at TNF concentrations of 10 ng/ml (3 X 10(-10) M) or higher. Growth-stimulatory activity of TNF was inhibited by an mAb neutralizing the cytotoxic activity of TNF. Growth stimulation was not inhibited by another mAb specific for TNF, lacking neutralizing activity for the cytotoxic activity of TNF. Growth stimulation by TNF was more marked and more sustained in the presence of greater than or equal to 10% FCS than in medium with less than or equal to 5% FCS. Addition of TNF to confluent FS-4 cultures also produced a marked stimulation of cell growth in the presence of fresh FCS, while a much less marked stimulation was seen in the absence of FCS. Stimulation of confluent cultures by TNF in serum-free medium was enhanced by insulin, suggesting that insulin or insulin-like growth factor(s) in the serum can act synergistically with TNF in producing growth stimulation. While the growth stimulatory effects of TNF and insulin were synergistic, the actions of TNF and epidermal growth factor (EGF) were less than additive, suggesting that TNF and EGF may activate identical or similar pathways. We conclude that stimulation of cell growth is probably a physiological function of TNF, and that the cytotoxic and cytostatic actions of TNF may be the result of an anomalous growth signal transduction in neoplastic cells lacking the constraints of normal growth control mechanisms. PMID- 3512758 TI - Lysosomal elastase and cathepsin G in beige mice. Neutrophils of beige (Chediak Higashi) mice selectively lack lysosomal elastase and cathepsin G. AB - A profound decrease in activities of the two lysosomal serine proteinases, elastase, and cathepsin G, was found in neutrophils of four independent beige mutants. Elastase and cathepsin G activities were assayed with the specific synthetic substrates MeO-Suc-Ala-Ala-Pro-Val-MCA and Suc-Ala-Ala-Pro-Phe-pNA, respectively. The defect is intrinsic to cells of beige mice, since transplantation of bone marrow from normal to mutant mice restored normal proteinase activity, and normal mice transplanted with beige marrow produced neutrophils with a deficiency of proteinase activity. The loss of elastase and cathepsin G activity was confirmed by separation of [3H]diisopropylfluorophosphate-labeled proteins on denaturing gels, which also revealed that other serine proteinases are at normal levels in beige neutrophil extracts. The deficiency of lysosomal proteinase activity appears specific, in that four other common neutrophil lysosomal enzymes, plus the spectrum of major neutrophil proteins are not affected by the beige mutation. The deficiency of proteinase activity is likely not the primary genetic alteration of the beige mutation, since more than one proteinase is affected, and heterozygous F1 mice have normal rather than intermediate levels of both proteinases. The lowered proteinase activity may contribute to the high susceptibility of beige mice and Chediak-Higashi patients to infection. PMID- 3512759 TI - Purification and partial characterization of the nephritis strain-associated protein from Streptococcus pyogenes, group A. AB - We report the isolation and purification of the nephritis strain-associated protein (NSAP) first described by Villareal et al. (8). Amino acid analysis, and determination of the first 21 amino-terminal amino acids indicated that this 46 kD protein is a streptokinase. Biochemical analysis confirmed that NSAP could act as a plasminogen activator; immunological investigations indicated that NSAP is antigenically different from streptokinase from group C streptococcus, and possibly represents a unique streptokinase. It is this uniqueness that may contribute to the role of NSAP in the pathogenesis of acute poststreptococcal glomerulonephritis. PMID- 3512760 TI - A recombinant 64 kilodalton protein of Mycobacterium bovis bacillus Calmette Guerin specifically stimulates human T4 clones reactive to mycobacterial antigens. AB - A recombinant 64 kD protein of Mycobacterium bovis bacillus Calmette-Guerin (BCG) (antigen A), which amounted to approximately 2% of an E. coli lysate, was tested for its capacity to stimulate human T4 clones reactive to mycobacterial proteins. Two out of four crossreactive clones, established from a patient with tuberculoid leprosy, which could be stimulated by protein preparations of M. leprae and M. tuberculosis, and by particulate M. bovis BCG were also reactive to antigen A without further enrichment from E. coli lysate. In addition, BCG-reactive T cell clones from two of three healthy PPD+ donors reacted with antigen A. This finding shows that human T cell clones may be useful for probing gene-cloned proteins of potential value for vaccination against diseases where protection is mediated exclusively by T cells. PMID- 3512761 TI - Differentiation of dendritic cells in cultures of rat bone marrow cells. AB - Although dendritic cells (DC) originate from bone marrow, they were not observed in fresh preparations of bone marrow cells (BMC). Likewise, accessory activity was barely measurable in a sensitive assay for this potent function of DC. However, both DC and accessory activity developed when BMC were cultured for 5 d. Based on fractionation before culture, nearly all of the accessory activity could be attributed to only 5% of the total BMC recovered in a low-density (LD) fraction. The LD-DC precursors differed from mature DC in a number of important respects. Removal of Ia+ cells from the LD fraction by panning did not decrease the production of DC when the nonadherent cells were cultured. Thus, the cell from which the DC is derived does not express or minimally expresses Ia antigens, in contrast to the strongly Ia+ DC that is produced in bone marrow cultures. Irradiation of LD cells before culture prevented the development of DC. When irradiation was delayed by daily intervals, progressive increases in the number of DC resulted, up to the fifth day. These findings, together with preliminary autoradiographic data, indicate that cell division has occurred, in contrast to the DC, which does not divide. We conclude that bone marrow-derived DC arise in culture from the division of LD, Ia- precursors. PMID- 3512764 TI - Comparison of throat culture and latex agglutination test for streptococcal pharyngitis. AB - Numerous reports have recently appeared in the clinical microbiology literature that describe agglutination tests for identifying patients with group A streptococcal pharyngitis. These studies have indicated a close correlation between the results of the agglutination tests and traditional throat culturing. This paper describes a comparison study of 100 consecutive throat swab specimens using a commercially available agglutination test and routine throat culturing. The cultures were interpreted by an individual who was blinded to the agglutination test results. All agglutination testing was done by two laboratory members of a family practice office staff. The agglutination procedure was easy to perform and clear to interpret. The test sensitivity and specificity compared well with that reported in the literature from microbiology laboratories. The new agglutination tests are useful in the office laboratory for the identification of group A streptococci. Their primary advantage compared with throat culturing is the rapid availability of test results. PMID- 3512762 TI - Bacterial cell wall-induced hepatic granulomas. An in vivo model of T cell dependent fibrosis. AB - In vitro studies implicate a molecular link between inflammatory mononuclear cells and alterations in fibroblast growth and function. We have extended these observations in an experimental animal model in which we document the T cell dependence of fibrosis that occurs after activation of the cell-mediated immune system by specific antigen. Chronic granulomatous lesions were induced in the livers of susceptible rats by the intraperitoneal injection of group A streptococcal cell walls (SCW). The development of granulomas that are composed primarily of lymphocytes and macrophages was associated with the recruitment and proliferation of connective tissue cells. Furthermore, this expanded population of fibroblasts generated a collagenous structure consisting primarily of types I and III collagen around the granuloma. The progression of these chronic inflammatory lesions leads to the formation of fibrotic nodules throughout the livers of the treated animals. Intact granulomas, as well as mononuclear cells derived from the granulomas, spontaneously elaborated a soluble factor(s) that stimulates fibroblast proliferation. Physicochemical analysis revealed that the primary granuloma-derived peak of fibroblast growth activity corresponded to an apparent Mr of 40,000, which is consistent with a previously described T lymphocyte--derived fibroblast-activating factor (FAF) in guinea pig and human. Furthermore, the fibrosis that occurs in the granuloma is apparently T cell- dependent, since no fibrotic lesions developed in SCW-injected athymic nude rats nor in SCW-injected animals treated with the T cell inhibitor, cyclosporin A (CsA). Mononuclear cells from neither of these functionally T cell--deficient animals could generate FAF activity. These data show a role for T lymphocyte- derived cytokines in the development of hepatic fibrosis in SCW-injected rats. PMID- 3512765 TI - Diagnosis of streptococcal pharyngitis by rapid antigen detection from the throat swab. PMID- 3512766 TI - Health care for the poor: some policy alternatives. AB - Changes in the financing and organization of medical care are most likely to affect adversely the poor who have significant needs for care, but face increasingly stringent eligibility criteria in Medicaid and other public programs. Americans estimated to have neither private nor public health insurance coverage number 33 million persons, and with increased cost pressures, voluntary and proprietary hospitals are less willing to treat such patients. One quarter of hospitals provide 60 percent of all care to the poor, and many of these nonprofit and public hospitals face economic difficulties and an erosion of public commitment. Alternative solutions include publicly subsidized premiums for the poor and near poor and assistance to financially stressed hospitals caring for large numbers of such persons. Mechanisms include all-payer systems, taxes on net hospital revenue or insurance premiums, or contributions from general tax revenues. Financing poses special problems, but it is also necessary to address the special needs of children and the elderly, the appropriate balance between technical and cognitive services, and new ways to maintain health and promote effective functioning. These issues pose challenges and opportunities for family practice. PMID- 3512763 TI - Properties of purified T cell subsets. II. In vivo responses to class I vs. class II H-2 differences. AB - Highly purified populations of C57BL/6 (B6) L3T4+ and Lyt-2+ T cell subsets were compared for their capacity to exert alloreactivity to class I vs. class II H-2 differences in vivo. B6 Lyt-2+ cells responded strongly to the class I different mutant, bm1, as manifested by DNA synthesis in the spleen of irradiated mice followed by entry of blast cells into thoracic duct lymph, induction of splenomegaly in newborn mice, production of lethal GVHD in irradiated mice, and skin allograft rejection. By all of these parameters, B6 Lyt-2+ cells showed almost total unresponsiveness to the class II-different mutant, bm12. Reciprocal results were observed with B6 L3T4+ cells, these cells responding strongly against bm12 but not against bm1. In the case of purified T cell subsets from other strains, CBA/Ca and B10.BR L3T4+ cells both responded well to a full H-2 difference. Responses by Lyt-2+ cells from these strains were weaker, especially for CBA/Ca cells. The implications of these findings are discussed. PMID- 3512767 TI - The distribution of polymerized actin in the rat egg and its sensitivity to cytochalasin B during fertilization. AB - The distribution of polymerized actin in rat eggs fertilized in vitro was determined using NBD-phallacidin (NBD-ph). Unfertilized and fertilized eggs exhibited a 3-5-micron-thick band of fluorescence that encompassed the entire cortical cytoplasm. There was no dramatic increase in the staining of the cortex in association with any component of the fertilizing sperm during its incorporation into the egg. Unfertilized eggs and fertilized eggs obtained at intervals after sperm-egg fusion were treated with cytochalasin B (CB; 5 micrograms/ml) and subsequently stained with NBD-ph. Unfertilized eggs treated with CB exhibited a continuous ring of cortical staining identical to that seen in untreated eggs. Eggs treated with CB 15 min after sperm-egg fusion exhibited small gaps in the cortical staining pattern, whereas those exposed to CB 1 hr after fusion exhibited larger gaps and the staining pattern appeared punctate. This pattern could be seen throughout the remainder of the 7 hr period of sperm incorporation and for at least 13 hr thereafter. CB-treated fertilized eggs that were washed to remove the drug again exhibited uninterrupted cortical staining on treatment with NBD-ph. CB also induced the resorption of surface elevations that are normally seen on the eggs during sperm incorporation, but it did not affect the morphology of unfertilized eggs. The sensitivity to CB during fertilization coincides with the onset of a variety of egg shape changes that occur during the period of sperm incorporation (Battaglia and Gaddum-Rosse, Gamete Res., 10:107 118, 1984a).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3512768 TI - Detection of respiratory syncytial virus in nasopharyngeal secretions by a biotin avidin ELISA more sensitive than the fluorescent antibody technique. AB - The presence of respiratory syncytial virus (RSV) was investigated by immunofluorescent antibody (IF) technique and by a biotin/avidin (BA) ELISA in 156 samples of nasopharyngeal secretions (NPS) obtained from infants and small children with acute respiratory disease. Of 70 RSV-IF-positive NPS, 68 were positive by BA-ELISA. Of 86 RSV-IF-negative NPS, eight were positive by BA-ELISA. BA-ELISA could detect 0.5-1.0 ng RSV-protein. PMID- 3512769 TI - Aortocoronary angioplasty for left main coronary stenosis. PMID- 3512770 TI - Release of endogenous 3,4-dihydroxyphenylethylamine and its metabolites from the isolated neurointermediate lobe of the rat pituitary gland. Effects of electrical stimulation and of inhibition of monoamine oxidase and reuptake. AB - Isolated rat neurointermediate lobes were incubated in vitro. The release of 3,4 dihydroxyphenylethylamine (dopamine, DA), dihydroxyphenylacetic acid (DOPAC), homovanillic acid (HVA), and methoxyphenylethanol (MOPET) was determined by HPLC with electrochemical detection. Under resting conditions, the outflow of metabolites was 35-50 times that of DA. HVA accounted for 50%, DOPAC for 45%, and MOPET for 5% of the metabolites. Although an equivalent of 40-50% of the tissue DA content was released per hour as metabolites, the tissue DA content was not reduced after 110 min of incubation. The spontaneous outflow of DA and its metabolites was not affected by the DA uptake inhibitor GBR 12921 (100 nM). Pargyline (10 microM) caused a time-dependent decrease of all metabolites (up to 90%). In the presence of GBR 12921 and pargyline, the spontaneous outflow of DA increased sevenfold. Removal of the intermediate lobe caused a 78% reduction in tissue DA content and a corresponding reduction of the outflow of metabolites. Electrical stimulation of the pituitary stalk (0.2 ms, 10 V, 15 Hz, three times for 1 min at intervals of 1 min) induced an increase in outflow of DA and all metabolites. DA accounted for 15%, HVA for 41%, DOPAC for 32%, and MOPET for 12% of the evoked release. The electrically evoked release of DA increased fourfold in the presence of GBR 12921 or pargyline and the effects of both drugs were additive. The evoked release of metabolites was not significantly affected by GBR 12921 but completely abolished by pargyline. In conclusion, oxidative deamination and O-methylation are important pathways for the catabolism of DA in the neurointermediate lobe.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3512772 TI - Immunological approach to the detection of taurine and immunocytochemical results. AB - An immunological approach to the detection of taurine resulted in antibodies specific enough to be used for immunocytochemical studies. The experimental conditions were similar to those previously described for raising antibodies against some small-sized neurotransmitter molecules: antisera were obtained from rabbits immunized with taurine conjugated to carrier proteins via glutaraldehyde and purified by adsorption on the glutaraldehyde-treated protein carriers. Antibody affinity and specificity were determined in competition experiments between conjugated taurine and other conjugated amino acids or derivatives by enzyme-linked immunosorbent assay. The resulting cross-reactivity ratios, calculated at half-displacement, showed conjugated taurine to be the best recognized compound. Given the molecular structure of taurine and the method used to prepare the conjugate, it seemed necessary to perform an oxidation step. However, adsorption of antisera on reoxidized or nonreoxidized taurine conjugates suggested that reoxidation did not make a significant difference. Immunocytochemical application of the sera revealed populations of strongly immunopositive nerve cells in the cerebellum, striatum, and septum. The results confirmed that antitaurine antibodies can be used as specific tools for a better understanding of the role of taurine in the central nervous system. PMID- 3512771 TI - Ethanol does not modify opiate-mediated inhibition of striatal adenylate cyclase. AB - Ethanol increases the activity of "basal," guanine nucleotide- and dopamine stimulated adenylate cyclase in mouse striatum. In contrast, ethanol, in vitro, did not modify the inhibition of striatal adenylate cyclase activity by opiates (morphine or [D-Ala2,D-Leu5] enkephalin). Following chronic in vivo ethanol treatment of mice, there was also no change in the character of opiate inhibition of striatal adenylate cyclase activity. Since ethanol, in vitro, does decrease striatal opiate receptor binding, the results suggest that the changes in affinity detected by ligand binding studies are not relevant for receptor-coupled adenylate cyclase activity, or that opiate receptor binding and opiate regulation of adenylate cyclase can be modulated independently. The selective effects of ethanol on systems that modulate adenylate cyclase activity may produce imbalances in neuronal function during in vivo ethanol exposure. PMID- 3512773 TI - Identification of a synaptic vesicle antigen (Mr 86,000) conserved between Torpedo and rat. AB - Antisera were raised in guinea pigs to synaptic vesicles purified from the electric organ of Torpedo marmorata. In cholinergic nerve terminals from Torpedo the major antigens identified had Mr 300,000-150,000, 86,000, and 18,000. The Mr 86,000 antigen was conserved between Torpedo and rat, where it is neuron-specific and concentrated in nerve terminals. When rat brain synaptosomes are subfractionated the antigen is associated with synaptic vesicles. The antigen is not found in the cytoskeleton and in the vesicle-free cytosol. Immunohistochemical localization of the antigen in rat shows it to be associated with synapses in diaphragm, cerebellum, hippocampus, and cerebral cortex. The staining pattern of the antigen indicates that the antigen is not cholinergic specific. The function of the Mr 86,000 antigen remains to be identified. PMID- 3512774 TI - Immunochemical and immunohistochemical localization of parvalbumin in rat nervous tissues. AB - The contents of parvalbumin in various nervous tissues of the rat were measured by radioimmunoassay (RIA) and its cellular distribution was immunohistochemically examined by peroxidase-antiperoxidase methods. The antibody, raised in rabbits using rat skeletal muscle parvalbumin, did not cross-react with other Ca2+ binding proteins such as calmodulin or S-100 proteins. The RIA demonstrated the wide distribution of the antigen, with very high levels in the cerebellum (3,217 +/- 519 ng/mg protein). The immunohistochemical description by Celio and Heizmann [Nature 293, 300-302 (1981)] was confirmed concerning the existence of the antigen in Purkinje cells of the cerebellum; nonpyramidal neurons of the cerebral cortex; and medium-sized cells of the olfactory bulb, hippocampus, and reticular nucleus of the thalamus. In addition to these neurons, we found the parvalbumin like immunoreactivity in the large neurons of the superior vestibular nucleus and the neurons of the medial superior olive nucleus. In the gamma-aminobutyric acid (GABA)-containing nuclei such as substantia nigra, caudatoputamen, and globus pallidus, parvalbumin-positive cells and fibers were rare. In the medial lemniscus of the midbrain which contains no GABA, parvalbumin-immunoreactive fibers were prominent. The possibility was discussed that parvalbumin exists in a specific population of neurons that differ from those containing GABA. PMID- 3512775 TI - Monoclonal antibodies and polyvalent antiserum to chicken choline acetyltransferase. AB - Monoclonal antibodies (mAbs) to chick choline acetyltransferase (ChAT) were obtained from mouse-hybridoma cultures after immunization with partially purified enzyme isolated from optic lobes. Antibodies that bound active enzyme were detected in 11 hybridoma cultures. The mAbs showed cross-reactivity to ChAT from quail and beef but not to ChAT from several other species. An affinity column prepared with one of the mAbs was used to purify ChAT to apparent homogeneity. Polyclonal antiserum to mAb affinity-purified ChAT was produced in a rabbit. This antiserum inhibited chick ChAT activity and quantitatively precipitated ChAT activity from solution. On immunoblots, the antiserum stained ChAT and two other proteins. After preadsorption of the antiserum with effluent from the mAb affinity column, the antiserum became monospecific for ChAT. This antiserum was useful for immunocytochemical localization of ChAT, it selectively stained neuronal cell bodies in chick spinal cord and rat brain at locations known to contain cholinergic neurons. PMID- 3512776 TI - Correlation of hexokinase content and basal energy metabolism in discrete regions of rat brain. AB - Brain hexokinase (ATP:D-hexose 6-phosphotransferase, EC 2.7.1.1) levels in seven regions of rat brain were estimated by photometric measurement of immunofluorescence in cryostat-cut sections. When compared with basal rates of glucose metabolism in these regions, estimated by the 6-[14C]glucose method, a significant correlation was observed. Thus, hexokinase content reflects metabolic energy demands. PMID- 3512777 TI - Effects of polyamines on proline endopeptidase activity in rat brain. AB - The in vitro effects of polyamines on the activity of proline endopeptidase (PEPase) in rat brain cytosol, which contains an endogenous PEPase inhibitor, have been studied. Of the three amines tested (spermine, spermidine, and putrescine), spermine and spermidine markedly enhanced the enzyme activity in brain cytosol. At 6.25 mM spermine or 25 mM spermidine, a 13- or 14-fold enhancement of the enzyme activity was observed. When Mg2+ was used, an approximately fourfold enhancement of the enzyme activity was observed at 50 mM. The enhancement produced by spermine or spermidine was unaffected by Mg2+ up to 50 mM. The activity of purified PEPase was only slightly affected by each polyamine, but it was inhibited 50% by 50 mM Mg2+. On the other hand, 50% inhibition of the enzyme produced by the purified PEPase inhibitor (Mr 7,000: Ki 0.67 mM) was completely restored by addition of 0.7 mM spermine, 3.5 mM spermidine, or 28 mM putrescine. This restoration of inhibition by polyamines was reversed by increasing the inhibitor concentration. These data suggest that polyamines effectively reverse the inhibition of PEPase by its endogenous inhibitor by the reversible formation of a kinetically significant complex. The possible functions of polyamines in the regulation of PEPase in vivo are discussed. PMID- 3512779 TI - Pathology of the spongiform encephalopathy in the Gray tremor mutant mouse. AB - Gray tremor (gt) is an autosomal recessive mutation mapped to chromosome 15 in the mouse. Its phenotypic feature most relevant to human disease is a noninflammatory spongiform encephalopathy which has been transmitted to genetically normal mice in a previously reported, preliminary inoculation experiment. The present study describes the histopathology, topography, developmental sequence, and ultrastructure of the inherited spongiform encephalopathy in the gray tremor homozygote (gt/gt). Vacuolation is present in the first postnatal week in spinal and cerebellar white matter, and spreads rapidly by the second postnatal month to involve gray and white matter throughout almost the entire neuraxis. Adjacent swollen and vacuolated neuronal processes, particularly dendrites, appear to coalesce to form membrane-bound vacuoles in the neuropil. Neuronal abnormalities include focal distension of intracellular membranes and distension, fragmentation, bleb formation, rupture, and disintegration of plasma membranes. White matter vacuoles result from splitting of the myelin sheath at the intraperiod line and from vesicle formation in oligodendroglial inner loop cytoplasm. These ultrastructural abnormalities targeted on subcellular and cellular membranes in neurons and oligodendrocytes implicate a membrane disorder as a fundamental component of the pathogenetic mechanism. A comparison of the pathology of gt to that caused by unconventional agents and neurotropic retroviruses suggests that gt may be valuable in conceptually unifying the whole class of noninflammatory spongiform lesions. PMID- 3512778 TI - Ineffective treatment of essential tremor with an alcohol, methylpentynol. AB - Six patients with essential tremor tested in the therapeutic effectiveness of a 6 carbon alcohol, methylpentynol, 200 mg/day, against placebo in a randomised double-blind clinical cross-over trial. The effect of methylpentynol on postural tremor amplitude was not different from that of placebo. PMID- 3512780 TI - The star-cell of Deiters. PMID- 3512781 TI - Spinal arachnoiditis due to aspergillus meningitis in a previously healthy patient. AB - A 30-year-old, previously healthy, non-addicted man presented with a chronic spinal meningitis complicated by arachnoiditis and spinal cord compression. Biopsy showed a chronic granulomatous leptomeningitis, in which some cells contained branching septate organisms that were immunostained with an antiserum to Aspergillus fumigatus. Precipitins to A. fumigatus were detected in cerebrospinal fluid (CSF), but not in blood, and aspergillus infection was apparently restricted to the leptomeninges. Clinically successful treatment led to the disappearance of CSF precipitins and oligoclonal bands. PMID- 3512782 TI - Sensitization against brain gangliosides after therapeutic swine brain implantation in a multiple sclerosis patient. AB - The case history is presented of a patient with multiple sclerosis who developed acute polyradiculoneuritis 11 days after subcutaneous implantation of a swine brain preparation. By means of lymphocyte transformation tests (LTT), sensitization against brain gangliosides could be demonstrated 16 days after the implantation. A second patient who underwent the same treatment showed neither clinical symptoms nor sensitization against brain gangliosides in the LTT. Patients did not show reactivity when tested with myelin basic protein. The polyradiculoneuritis was caused by the immune response to the implanted swine brain cross-reacting with human nervous system gangliosides. PMID- 3512783 TI - Effect of age on therapeutic outcome in advanced diffuse histiocytic lymphoma: the Southwest Oncology Group experience. AB - To study the influence of chronologic age on treatment outcome in patients with advanced, diffuse large-cell (histiocytic) lymphoma (DHL), we reviewed the results of two recent Southwest Oncology Group (SWOG) clinical trials. From 1974 to 1982, members entered 307 eligible patients treated with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) with or without bleomycin, and CHOP with or without immunotherapy using BCG, levamisole, or both. Complete response (CR) rates declined progressively with advancing age: 65% in those under 40, 60% in the 40 to 54 age group, 55% in the 55 to 64 age group, and 37% in those 65 and older (P = .001). Likewise, survival decreased significantly in older patients: medians were 101 +, 52, 34, and 16 months, respectively (P less than .001). Treatment guidelines included an initial dose reduction of 50% for patients aged 65 or older and for younger patients with bone marrow compromise. Despite protocol specifications, 23 of 81 patients aged 65 or older received initial full-dose therapy. When these patients were compared with younger patients on whom full-dose chemotherapy was started, survival curves, but not CR rates, were still significantly different. There were no significant differences in duration of CR or frequency of treatment complications. These data suggest that older age is associated with a worse prognosis in advanced DHL. Moreover, the initial dose reduction for patients aged 65 or older may have contributed to their inferior outcomes. PMID- 3512784 TI - Reporting the results of randomized trials of empiric antibiotics in febrile neutropenic patients--a critical survey. AB - Twenty-one randomized trials of empiric antibiotic therapy in febrile neutropenic patients were reviewed and scored by methods suggested by Chalmers. In general, the scores were low, indicating that many of these articles failed to meet currently suggested methodologic standards for publication of results of clinical trials. Particularly striking was the lack of attention paid to statistical issues, such as power, exclusions, and repeated analyses. In addition, there appears to be a need for a better-developed system for assessing response in these circumstances. PMID- 3512785 TI - Adjuvant adriamycin and cisplatin in newly diagnosed, nonmetastatic osteosarcoma of the extremity. AB - Twenty-two patients with newly diagnosed nonmetastatic osteosarcoma of the extremity were treated with an adjuvant chemotherapeutic regimen consisting of Adriamycin (Adria Laboratories, Columbus, Ohio) and cisplatin. Fourteen of the 22 patients remain continuously disease free for 65+ to 113+ months, with a median time on study of 70+ months. The 72-month disease-free survival estimate is 64%. Pulmonary metastases occurred in six patients, an isolated stump recurrence was seen in one patient, and one patient had a local recurrence following a limb salvage procedure. For those patients in whom pulmonary metastases developed, the onset was late in three of six, and the number of metastases was three or fewer in all patients. Two patients with pulmonary metastases and one with a stump recurrence have apparently been salvaged, thus resulting in a 77% 72-month survival. Toxicity observed in patients treated with this regimen was in keeping with previous reports. This chemotherapeutic regimen is effective in the adjuvant therapy of nonmetastatic osteosarcoma of the extremity. It should be incorporated into other adjuvant protocols in an effort to continue to improve the outcome in patients with osteosarcoma. PMID- 3512786 TI - Malpositioned hepatic artery catheters. PMID- 3512787 TI - Comparison of CAF versus CMFP in metastatic breast cancer: analysis of prognostic factors. PMID- 3512788 TI - Lateral hypothalamus neuron involvement in integration of natural and artificial rewards and cue signals. AB - Involvement of rat lateral hypothalamus (LHA) neurons in integration of motivation, reward, and learning processes was studied by recording single-neuron activity during cuetone discrimination, learning behavior to obtain glucose, or electrical rewarding intracranial self-stimulation (ICSS) of the posterior LHA. To relate the activity of an LHA neuron to glucose, ICSS, and anticipatory cues, the same licking task was used to obtain both rewards. Each neuron was tested with rewards alone and then with rewards signaled by cuetone stimuli (CTS), CTS1+ = 1,200 Hz for glucose, CTS2+ = 4,300 Hz for ICSS, and CTS- = 2,800 Hz for no reward. The activity of 318 neurons in the LHA was analyzed. Of these, 212 (66.7%) responded to one or both rewarding stimuli (glucose, 115; ICSS, 193). Usually, both rewards affected the same neuron in the same direction. Of 96 neurons that responded to both rewards, the responses of 72 (75%) were similar, i.e., either both excitatory or both inhibitory. When a tone was associated with glucose or ICSS reward, 81 of the 212 neurons that responded to either or both rewards and none of 106 neurons that failed to respond to either reward acquired a response to the respective CTS. Usually, the response to a tone was in the same direction as the reward response. Of 45 neurons that responded to both glucose and CTS1+, 38 (84.4%) were similar, and of 66 that responded to both ICSS and CTS2+, 47 (71.2%) were similar. The neural response to a tone was acquired rapidly after licking behavior was learned and was extinguished equally rapidly before licking stopped in extinction. The latency of the neural response to CTS1+ was 10-150 ms (58.7 +/- 40.9 ms, mean +/- SE, n = 31), and that of the first lick was 100-370 ms (204.8 +/- 59.1 ms, n = 31). The latency of neural responses to CTS2+ was 10-230 ms (68.3 +/- 53.5 ms, n = 33), and that of the first lick was 90 370 ms (212.4 +/- 58.5 ms, n = 33). There was no significant difference between the neural response latencies for the two cue tones nor between the lick latencies for the different rewards. Neurons inhibited by glucose or ICSS reward were distributed widely in the LHA, whereas most excited neurons were in the posterodorsal subarea; fewer were in the anteroventral subarea. Neurons responding to the CTS for glucose or ICSS were found more frequently in the posterior region.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3512789 TI - Effects of eye position on saccades evoked electrically from superior colliculus of alert cats. AB - Electrical stimulation was carried out in the intermediate and deep gray layers of the superior colliculus in alert cats. The heads of the animals were fixed, and their eye movements were recorded with the scleral search coil method. Stimulation in the anterior two-thirds of the colliculus with long-duration pulse trains produced multiple saccades, as in the primate (45, 51), but their directions and amplitudes were influenced significantly by the initial position of the eye. Stimulation in the posterior part of the colliculus evoked saccades that appeared to be "goal-directed," whereas stimulation at the extreme caudal edge of the colliculus yielded centering saccades. These observations confirm previous reports of Roucoux and Crommelinck (48) and Guitton et al. (24). Saccades evoked during bilateral simultaneous stimulation of the superior colliculi were also dependent on the initial position of the eye. At certain relative intensities of stimulation on the two sides, saccades failed to occur when the eye was within a particular part of the oculomotor range. When the eye was outside this region, the same stimuli triggered an eye movement that drove the eye toward the zone of saccade failure. These findings indicate that saccadic commands resulting from focal collicular stimulation in the cat can be modified by information about current eye position. It is not certain where in the brain this occurs or by what neural mechanisms, but a local feedback model of the saccadic control system (46) can account for the main observations. The functional significance of these findings depends in large measure on the degree to which focal collicular stimulation reproduces naturally occurring patterns of neural activity. PMID- 3512790 TI - Glial domains and nerve fiber patterns in the fish retinotectal pathway. AB - Optic nerve fibers run parallel from the retina as far as the optic tract in fish, then suddenly criss-cross into a new pattern matching the tectal map. This change coincides with a unique demarcation between two astroglial territories in the retinotectal pathway, located where the optic chiasm occurs in other vertebrates, which we defined using antibodies directed against intermediate filaments (IF). We found that astroglia in optic nerve territory express an Mr 56,000 IF polypeptide, band 3, which we identify as the fish equivalent of vimentin in mammals. These astrocytic cells lack glial fibrillary acidic protein (GFAP; cf. Dahl and Bignami, 1973). Conversely, glia in brain territory, that is, in the optic tract and elsewhere in the CNS, lack the fish vimentin, but express GFAP. By electron microscopy, we obtained evidence that new retinal axons extend swiftly through the growing optic nerve, where they are tightly shepherded into a narrow track by newly differentiating glial cells, positive for the fish vimentin. In the GFAP-positive glial territory of the optic tract, by contrast, growing axons are slowed down and probably branch. We suggest that this allows them to fasciculate accurately with older fibers and thereby propagate a tectotopic pattern established by pioneer axons in the embryo. PMID- 3512791 TI - Development of ultrastructural specializations during the formation of acetylcholine receptor aggregates on cultured myotubes. AB - The ultrastructure of cultured rat myotubes was examined at stages in the initial assembly of acetylcholine receptor (AChR) aggregates in order to elucidate the role of cell-surface specializations in aggregate formation. Within 4-6 hr, embryonic brain extract (EBX) induces the formation of sites of AChR density elevated 5-9 X above that of surrounding regions, and the appearance of these aggregates is preceded by the formation of clouds of punctate microaggregates (Olek et al., 1983). A video image-intensification system was used to monitor this redistribution of fluorescently labeled AChR, and sites of aggregation were mapped on identified myotubes. After processing the cultures for electron microscopy, thin sections were taken through identified aggregate sites at various stages in assembly. Specializations, including a basal lamina, mound shaped plasma membrane contours with occasional deep infoldings, and a subjacent dense cytoskeletal specialization, which tended to exclude other cytoplasmic organelles, were associated with newly formed aggregates found 4-6 hr after adding EBX to the cultures. Analysis of random thin sections through EBX-treated and untreated myotubes showed that the extent of specializations of the basal lamina and cytoplasm was approximately threefold greater in cells exposed to EBX for 4 hr, suggesting a concurrent, and possibly interdependent, organization of such specializations with AChR aggregate assembly. Examination of sections through clouds of microaggregates, which formed within 90 min, revealed mound shaped plasma membrane contours and underlying cytoplasm depleted of organelles but relatively little basal lamina and submembrane cytoskeletal density. These results suggest that the initial stage of AChR aggregate assembly involves relatively subtle changes in the structure of the cell cortex and that the evolution of microaggregates to aggregates may require the formation of additional cytoskeletal and extracellular matrix structures. PMID- 3512792 TI - Localization of muscarinic receptors on cultured myenteric neurons: a combined autoradiographic and immunocytochemical approach. AB - In order to localize the distribution of muscarinic receptors over the surface of cultured myenteric neurons, an autoradiographic procedure for detecting muscarinic receptors (using [3H]propylbenzilylcholine mustard; [3H]PrBCM) has been combined with an immunofluorescence procedure visualizing neuronal morphology (using an antibody raised against rat brain synaptosomes; anti-CTX). Using this technique, muscarinic receptors were localized over discrete areas of the neuronal cell surface. Receptors were seen to be widely distributed over the somata and neurites of 10-20% of cultured myenteric neurons. The greatest concentration of receptors occurred over the cell somata and proximal neurites. Receptors appeared evenly distributed over labeled cell somata, where their density was estimated to be between 30 and 100 receptors/micron2. Distal regions of neurites were labeled intermittently with some varicosities and intervaricosities being labeled while others were unlabeled. Growth cones and nerve endings of labeled neurites were consistently labeled. The ability to localize muscarinic receptors on a subpopulation of immunocytochemically identified neurons enhances our understanding of muscarinic neurotransmission in myenteric neurons and provides an experimental system for the investigation of regulatory influences on neuronal neurotransmitter receptor expression and distribution. PMID- 3512793 TI - Glutamic acid decarboxylase (GAD) immunocytochemistry of developing rabbit hippocampus. AB - Immunocytochemical techniques were used to examine the synaptic relations of inhibitory interneurons in the developing rabbit hippocampus. Glutamic acid decarboxylase (GAD), the synthesizing enzyme for the inhibitory neurotransmitter GABA, was found in interneurons of immature (8 d old) as well as mature (30 d old) tissue. GAD-immunoreactivity was seen in somata, dendrites, and axon terminals of interneurons at both ages. Electron-microscopic examination revealed that GAD-positive "terminals" in immature tissue were often not associated with the usual synaptic specializations, but were rather in simple apposition to the "postsynaptic" element. In mature tissue, GAD-positive terminals made symmetric contacts primarily with pyramidal cell somata, initial segments, and proximal dendrites. In addition, GAD-positive terminals synapsed onto both GAD-positive and GAD-negative interneuron profiles. PMID- 3512794 TI - Neurite outgrowth patterns in cerebellar microexplant cultures are affected by antibodies to the cell surface glycoprotein L1. AB - To probe for the role of the L1 cell surface glycoprotein during neurite outgrowth and fasciculation in the early postnatal mouse cerebellar cortex, a microexplant culture system was used. Fasciculation of neurites was reduced in the presence of antigen-binding fragments (Fab) of poly- and monoclonal L1 antibodies, as compared to untreated controls. In addition, speed of neurite outgrowth was enhanced in the presence of antibodies. Migration of cell bodies of small neurons was also significantly increased. Very similar effects on these outgrowth parameters were observed with Fab fragments from poly- and monoclonal neural cell adhesion molecule (N-CAM) antibodies. Antibodies from preimmune sera had no effect. These findings suggest that L1 antigen not only plays a role in adhesion of isolated neural cell bodies and migration of granule cell neurons in the early postnatal mouse cerebellar cortex (Lindner et al., 1983; Rathjen and Schachner, 1984), but also in neurite outgrowth and fasciculation. PMID- 3512795 TI - Nizofenone administration in the acute stage following subarachnoid hemorrhage. Results of a multi-center controlled double-blind clinical study. AB - A multi-center controlled double-blind clinical study was carried out to evaluate the effects of nizofenone in patients with subarachnoid hemorrhage who were treated within 2 weeks of the ictus. The test drug was administered as an addition to conventional therapy, which was maintained during the study. Of 208 patients studied, 102 were treated with nizofenone and 106 with placebo. Treatment with nizofenone was significantly more effective (p less than 0.05) than that with placebo based on functional recovery and other clinical findings. Although no significant difference was found in mortality rate between the nizofenone- and placebo-treated groups, a higher percentage of survivors in the former group exhibited a good outcome (p less than 0.05). The effects of nizofenone administration were found to be especially notable in patients with delayed ischemic symptoms, moderately severe preoperative deficits (Hunt and Hess Grade II or III), and diffuse high-density areas in pre- and postoperative computerized tomography scans. No significant side effects were observed. PMID- 3512796 TI - Echocardiographic detection and treatment of intraoperative air embolism. AB - A real-time two-dimensional echocardiogram was used to detect the presence of an air embolism in patients undergoing neurosurgical procedures in the sitting position. The technique could with good sensitivity detect the appearance of a single air bubble intraoperatively, thus allowing early intervention to prevent development of further air emboli. Two types of air embolism could be differentiated; the single-bubble type and the "stormy-bubble" type. The single bubble type was observed during skin and muscle incisions, craniotomy, and brain lesion excision. Further embolism development was prevented by electrocoagulation and application of bone wax. The stormy-bubble type occurred during dura and muscle incisions and was prevented by electrocoagulation, reflection of the dura, or suturing the affected muscle. The routine use of a Swan-Ganz catheter for removal of air embolism by suction proved effective for the treatment of the stormy-bubble type of air embolism. Masking the operative field with saline soaked cotton strips was of moderate benefit in the stabilization of the single bubble type of air influx, but proved to be of little value in controlling the entrance of the stormy-bubble type. PMID- 3512797 TI - Medical imaging of fetal ventriculomegaly. AB - Five cases of fetal ventriculomegaly are described in detail. Following ultrasonography, either computerized tomography or magnetic resonance imaging was used in an attempt to clarify the structural pathology of the ventriculomegaly. In two patients, a precise diagnosis was achieved while a probable diagnosis was established in a third patient. The diverse etiology of fetal ventriculomegaly in these five cases demonstrates that ancillary medical imaging may be necessary to achieve diagnostic precision prior to therapeutic intervention. PMID- 3512798 TI - Interstitial hyperthermia and iridium brachytherapy in treatment of malignant glioma. A phase I clinical trial. AB - An oncolytic effect of hyperthermia in the 42 degrees to 43 degrees C range has been previously demonstrated in cell culture and animal models. To apply this modality clinically, an interstitial microwave antenna array system has been developed for the delivery of controlled hyperthermia to an intracranial tumor volume, and a Phase I clinical trial involving six patients with malignant gliomas was undertaken. The protocol to study technical feasibility and patient tolerance combined interstitial iridium-192 irradiation and interstitial hyperthermia with 60-minute hyperthermia sessions immediately before and after brachytherapy. After-loading catheters suitable for both treatment modalities were implanted using a computerized tomography-assisted technique. Thermometry data confirmed the ability of a microwave antenna system to achieve reliable temperature distributions, and reasonable patient tolerance was documented. PMID- 3512799 TI - Cerebral vasospasm evaluated by transcranial ultrasound correlated with clinical grade and CT-visualized subarachnoid hemorrhage. AB - In 39 patients with a proven subarachnoid hemorrhage (SAH), the clinical status, the amount of subarachnoid blood on a computerized tomography scan obtained within 5 days after SAH, and the flow velocities (FV's) in both middle cerebral arteries (MCA's) measured by transcranial Doppler sonography were recorded daily and correlated. All patients had pathological FV's over 80 cm/sec between Day 4 and Day 10 after SAH. The side of the ruptured aneurysm showed higher FV's than did the unaffected side in cases of laterally localized aneurysms. Increase in FV preceded clinical manifestation of ischemia. A step early increase of FV's portended severe ischemia and impending infarction. Maximum FV's in the range of 120 to 140 cm/sec were not critical and in no case led to brain infarction. Maximum FV's over 200 cm/sec were associated with a tendency for ischemia, but the patients may remain clinically asymptomatic. In cases of no or only a little blood in the basal cisterns, mean FV's in both MCA's increased only moderately whereas, with thick clots of subarachnoid blood, there was a steeper and higher increase of mean FV's. PMID- 3512800 TI - Samuel Lepkovsky (1899-1984) - biographical sketch. PMID- 3512801 TI - Vitamin B-6 requirement and oral contraceptive use--a concern? PMID- 3512802 TI - Interaction between tobacco smoking and occupational exposures in the causation of lung cancer. AB - The nature of the interaction between smoking and occupational exposure is controversial, in part because of lack of agreement on the definition of interaction and in part because of the scarcity of adequate epidemiologic data. Occupational investigators have assessed interaction primarily as a departure from an additive rather than from a multiplicative model of relative risks (or rate ratios). To determine whether smoking modifies the effect of occupational lung carcinogens, the literature was reviewed for the only four established occupational lung carcinogens for which there are data on smoking: radon daughters, asbestos, arsenic, and chloromethyl ethers. Where possible, departure was assessed from both an additive (synergism) and a multiplicative model (effect modification). Only nine studies were considered to have sufficient sample size and to provide sufficient information on tobacco use and occupational exposure to evaluate interaction. The existing data were contradictory for three of the agents studied: asbestos, radon daughters, and arsenic. Inconclusive or contradictory findings may result from small sample size or lack of comparability of the level of occupational or tobacco exposure. It is noteworthy that, for these four agents, whenever smoking did modify the effect of occupational exposure, the lung cancer rate ratio was greater for nonsmokers (compared to nonexposed nonsmokers) than smokers (compared to nonexposed smokers). However, with the exception of chloromethyl ethers, absolute lung cancer rates were higher for smokers than nonsmokers, regardless of occupational exposure. PMID- 3512803 TI - Solvent neurotoxicity: the current evidence. PMID- 3512804 TI - Experimental use of fibrin sealant for skin graft fixation in mandibular vestibuloplasty. AB - A technique for securing skin grafts for vestibuloplasty with the Fibrin Adhesive System is described. This technique proved to be less time-consuming than the standard technique and provided secure, immobile stabilization of the skin grafts without hematoma formation. PMID- 3512805 TI - Subepithelial neuroendocrine cells and carcinoid tumours of the human small intestine and appendix. A comparative immunohistochemical study with regard to serotonin, neuron-specific enolase and S-100 protein reactivity. AB - A comparative immunocytochemical study was performed of subepithelial neuroendocrine cells of the human small intestine and appendix and carcinoid tumours of these sites, using a monoclonal antibody to serotonin and polyclonal antisera against neuron-specific enolase (NSE) and S-100 protein. Subepithelial neuroendocrine cells were easily identified in the lamina propria of the appendix. These cells, which sometimes occurred in aggregates, displayed serotonin and NSE immunoreactivity and were surrounded by S-100 protein immunoreactive cells, presumably of Schwann cell origin. In the appendix scattered cells with corresponding morphological features and immunoreactivity were also observed deep in the submucosa. In addition, subepithelial neuroendocrine cells were sparsely present in the lamina propria of the small intestine, occurring only as single cells in the deeper part of the mucosa below or between the epithelial crypts. Most appendiceal carcinoid tumours (11 of 12 examined cases) were biphasic and consisted of neuroendocrine tumour cells with intermingled S-100 protein immunoreactive cells (Schwann cells) with long cytoplasmic extensions. However, small intestinal (11 cases) and caecal (10 cases) carcinoids lacked S-100 protein immunoreactive cells as an integral component. The results indicate that the appendiceal carcinoids are mostly closely related structurally to the subepithelial neuroendocrine and Schwann cell aggregates of the lamina propria and are thus presumed to be histogenetically related to this cell system, while the histogenesis of small-intestinal and caecal carcinoids remains less clear. PMID- 3512806 TI - Infections in bone marrow transplant recipients. PMID- 3512807 TI - Comparison of a latex agglutination test and four culture methods for identification of group A streptococci in a pediatric office laboratory. AB - A latex agglutination test and four culture methods for the detection of group A hemolytic streptococci were compared in a pediatric office laboratory. The anaerobic (GasPak) and Detekta-Kit methods produced the highest recovery rates, but aerobic incubation of 5% blood agar plates gave very acceptable results (sensitivity 92%, or 98% if the 1+ positive cultures were eliminated; specificity 100%), and had fewer disadvantages. Delaying inoculation of plates for 2 to 6 hours resulted in significantly greater numbers of strongly positive (3+ and 4+) cultures. The group A selective sheep blood agar media as used in this study offered no advantage. The Culturette test had a sensitivity of 72% and specificity of 98%, compared with the GasPak method, and 77% and 97%, respectively, compared with standard aerobic cultures. Thus it appears too insensitive to be used alone, but might complement culture methods in selected patients. PMID- 3512809 TI - The throat culture reconsidered. PMID- 3512808 TI - Renal failure in children with hepatic failure undergoing liver transplantation. AB - Over a 3 1/2 year period, 133 children with hepatic failure underwent orthotopic liver transplantation (OLT) at our center. Renal failure (creatinine clearance less than 20 ml/min/1.73 m2) was present in 19 (14.3%) of these children. In seven of the 19 children, renal failure was present before OLT, and in the other 12 after OLT. The causes of renal failure included hepatorenal syndrome in seven, postischemic acute tubular necrosis in five, severe prerenal azotemia in five, and cyclosporine nephrotoxicity in two. Eight other patients died of renal failure while awaiting emergency transplantation. Of the total of 31 deaths among 133 children who underwent OLT, nine occurred in the 19 patients with renal failure. Thus patients with OLT and renal failure had a significantly higher mortality than other patients with transplants (P less than 0.025). Dialysis was not associated with improved survival. The majority of deaths in patients with renal failure were related to severe hemorrhage, thromboembolic events, and systemic fungal infections. Our experience suggests that renal failure is common in children with hepatic failure and is associated with reduced patient survival after OLT. PMID- 3512810 TI - Enzyme fluorescence procedure for rapid diagnosis of streptococcal pharyngitis. PMID- 3512811 TI - Lymphoma in a patient with severe combined immunodeficiency with adenosine deaminase deficiency, following unsustained engraftment of histoincompatible T cell-depleted bone marrow. PMID- 3512812 TI - Fatty acid balance studies in premature infants fed human milk or formula: effect of calcium supplementation. AB - During the first 4 neonatal weeks, serial total fatty acid and individual fatty acid balance studies were completed in 35 healthy premature infants with appropriate weight for gestational age. Infants weighed less than 1500 gm at birth, were descriptively similar, and were receiving similar volumes of either preterm mothers' milk (PTM) or formula (S-M-A 20). Total fatty acid and major fatty acid contents of the two feeding regimens were similar. Total fecal output and total fatty acid excretion were higher, whereas subsequent total fat absorption and coefficient of absorption were significantly lower, in the group fed S-M-A 20 (P less than 0.001). Administration of oral calcium supplements fed as calcium lactate (1.5 to 2.0 mmol/kg/day) decreased total fatty acid absorption in both the PTM (P less than 0.01) and S-M-A 20 (P less than 0.001) groups. Furthermore, the effect of feeding (P less than 0.0001) and oral calcium (P less than 0.001) independently influenced coefficients of absorption for major fatty acids fed (C12:0, C14:0, C16:0, C18:0, and C18:1). Although the main indices for growth were similar in both feeding groups, infants with inefficient rates of total fatty acid absorption attained slower rates of weight gain and increased skinfold thickness. We conclude that oral calcium supplements significantly alter the efficiency of lipid absorption in enterally fed preterm infants. PMID- 3512813 TI - Pulmonary infections in patients with cystic fibrosis: where to now? PMID- 3512814 TI - Endophthalmitis due to Salmonella typhimurium. AB - A 1-year-old female patient is described who suffered from sepsis and endophthalmitis due to Salmonella typhimurium. This Salmonella species rarely causes septicemic syndrome or focal infection of body organs. As far as we know this is the first case report of endophthalmitis caused by S typhimurium despite its high frequency among Salmonella infections not caused by S typhi. PMID- 3512815 TI - Congenital bile duct dilatation in children. AB - Fifteen children under the age of 15 were identified to have congenital dilatation of the biliary tree. Thirteen of them (87%) had dilatation of both intrahepatic and extrahepatic bile ducts, while two had extrahepatic biliary dilatation only. Visualization of both intrahepatic and extrahepatic biliary tree in small children before operation is possible by ultrasonography, endoscopic retrograde cholangio-pancreatography, or percutaneous transhepatic cholangiography. The advantage and disadvantage of those methods of examinations in children are discussed here. Dilatation of intrahepatic bile ducts is common in children with extrahepatic biliary dilatation. Assessment of both the intrahepatic and extrahepatic bile ducts bears a crucial role in the management of congenital biliary dilatation at operation and during the postoperative follow up. Rouxen-Y hepaticojejunostomy with hepaticocutaneous arm was performed in our patients with satisfactory results. Residual intrahepatic stones could be removed through the hepaticocutaneous arm by choledochoscopy. PMID- 3512816 TI - Infections of congenital cervical neck masses associated with bacteremia. AB - Congenital cervical neck masses are usually benign lesions. However, cystic hygromas and cervical teratomas are associated with a high risk for potentially life-threatening complications, primarily that of respiratory distress secondary to tracheal compression. Children with unoperated teratomas are also at high risk for malignant changes. A third potential complication is that of infection of the lesion. We present two newborns with infections of cervical neck masses associated with bacteremia. One lesion was a teratoma, the other a cystic hygroma. In both infants, surgical excision had been delayed. These cases illustrate the need for prompt, accurate diagnosis and treatment of congenital cervical neck masses. PMID- 3512818 TI - Renal response to pentobarbital anesthesia in rats: effect of interrupting the renin-angiotensin system. AB - The influence of interrupting the renin-angiotensin system on the renal hemodynamic response to barbiturate anesthesia was assessed in conscious, trained, chronically catheterized rats. Anesthesia induced by pentobarbital caused a marked reduction in mean arterial pressure, heart rate, glomerular filtration rate (GFR) and effective renal plasma flow (ERPF). Pretreatment of rats with captopril, an inhibitor of angiotensin I converting enzyme, prevented the impairment of renal hemodynamics by pentobarbital without restoring blood pressure. GFR remained at 100 to 110% of control values in captopril-pretreated rats receiving pentobarbital, but was reduced by pentobarbital (90-120 min after induction) to 75 +/- 5% in rats which did not receive captopril. ERPF showed similar changes. An antagonist of angiotensin II receptors, 1-sarcosine-8 isoleucine-angiotensin II, did not prevent the anesthesia-induced decrements in GFR and ERPF (GFR was reduced to 78 +/- 6% and ERPF to 68 +/- 4% at 90-120 min after pentobarbital). This failure of the antagonist of angiotensin II receptors to protect renal hemodynamics may have been due to its intrinsic agonist activity on the renal vasculature. This is suggested by the fact that, in captopril pretreated rats, which maintained renal hemodynamics in response to pentobarbital, addition of 1-sarcosine-8-isoleucine-angiotensin II caused a reduction in GFR and ERPF and an elevated blood pressure. At 100 min after administration of pentobarbital, plasma renin activity was elevated compared to a conscious control group (3.57 +/- 0.42 vs. 1.94 +/- 0.34 ng angiotensin l/ml X hr, P less than .05). It is concluded that the renin-angiotensin system mediates an impairment of renal hemodynamics during pentobarbital anesthesia.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3512817 TI - Ontogeny of the opioid-mediated control of reproductive endocrinology in the male and female rat. AB - Endogenous opioids (EOP) appear to inhibit the release of luteinizing hormone releasing hormone and, subsequently, luteinizing hormone (LH). These observations have led to the hypothesis that EOP-containing neuronal systems may be involved in the onset of puberty. To examine this possibility, rats were challenged with naloxone and morphine, as probes to decrease or exaggerate, respectively, the effects of EOP on luteinizing hormone releasing hormone/LH release at intervals from birth to adulthood. Morphine had no effect on serum LH up to 15 days of age in males, but thereafter was maximally effective. On the other hand, the onset of adult-appropriate responses to morphine occurred much later in females (30-35 days) and the depressions in LH were consistently less pronounced than in comparably aged males. Naloxone produced large increases in LH in 10- and 25-day old females, but was ineffective at 15 or 20 days. After day 25, the response to naloxone declined gradually, but was still significantly greater than control values in adults. In contrast, naloxone failed to increase serum LH from 10 to 30 days after birth in males. Beginning at 30 to 35 days of age, however, a sudden onset in the sensitivity to naloxone occurred which increased exponentially until 60 days. At this time, serum LH levels were 5 times greater in naloxone-treated males than in controls, and were twice those found in similarly treated females. These age- and sex-related differences in response to the opiates were not related to pharmacokinetic variables and also could not be attributed to gross maturational alternations in the hypothalamic-pituitary-gonadal axis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3512819 TI - SCH23390 effects on apomorphine-induced responses of nigral dopaminergic neurons. AB - SCH23390 is a dopamine antagonist which has a high affinity for D1-like dopaminergic receptors. Receptor binding studies demonstrated significant levels of specific SCH23390 binding within nigral tissue. Therefore, electrophysiological experiments were conducted to determine if this antagonist influenced apomorphine-induced suppressions of unit firing recorded from dopaminergic cells of the substantia nigra zona compacta. Results presented in this report indicate that the autoreceptors located on dendrites and cell bodies of dopamine-containing neurons are not directly acted upon by SCH23390. This conclusion is drawn because: doses of SCH23390 known to block behaviors caused by dopamine agonists were ineffective in blocking rate reductions produced by apomorphine and pretreatment with 0.1 mg/kg of SCH23390 did not change the apomorphine dose-response curve for inhibition of dopaminergic neurons. Consistent with this finding, microinjections of SCH23390 into the zona compacta did not alter apomorphine-induced behaviors which are known to be blocked by haloperidol (a D2-like antagonist) intranigral injections. However, when only the larger apomorphine doses (64 and 128 micrograms/kg i.v.) are considered, SCH23390 pretreatment did attenuate the maximum response to apomorphine in some nigral cells. Because larger apomorphine concentrations alter striatal activity, such results may be reflective of alterations in a subpopulation of nigral neurons which are postsynaptic to neurons containing D1-like receptors and located elsewhere in the brain (e.g., in striatum). Collectively, these results agree with previous studies which suggest that dopamine receptors located on dopamine containing neurons of the substantia nigra zona compacta are likely not of the D1 type. PMID- 3512820 TI - Antibiotic prophylaxis in cesarean section. Comparison of intrauterine lavage and intravenous administration. AB - Intrauterine irrigation with a cefazolin solution at cesarean section was compared with intravenous cefazolin administration for prophylaxis against post cesarean-section endomyometritis in a randomized, controlled, prospective fashion. There were no statistically significant differences in the incidence of infection between the lavage and intravenous groups. The incidence of endomyometritis was 37% in the lavage group and 29% in the intravenous (P = NS). Intrauterine cefazolin lavage is safe, effective, time saving and more cost effective than intravenous cefazolin in preventing post-cesarean-section endomyometritis. PMID- 3512821 TI - Current perspectives on iatrogenic neonatal respiratory distress syndrome. AB - Iatrogenic respiratory distress syndrome (RDS) continues to result in significant morbidity and mortality. In this series of 176 cases of neonatal RDS, 8 (4.6%) resulted from errors in obstetric management: poor documentation of fetal maturity prior to elective delivery (6 cases), elective cesarean section with premature rupture of the membranes at 33 weeks of gestation (1) and failure to attempt tocolysis at 32 weeks of gestation (1). One neonatal death occurred among the eight cases. The authors encourage others to analyze their experiences in order to identify this important health care problem. PMID- 3512822 TI - Intervertebral disc mechanics: a review. PMID- 3512823 TI - Idiopathic obstruction of the inferior vena cava: a review. PMID- 3512824 TI - Why migraine: discussion paper. PMID- 3512825 TI - Development of new drugs in man: a review. PMID- 3512827 TI - Imidazo[2,1-b]benzothiazoles. 2. New immunosuppressive agents. AB - A series of 2-phenylimidazo[2,1-b]benzothiazole derivatives was prepared and tested for immunological activities. Some of the compounds showed significant suppressive activity of delayed type hypersensitivity (DTH) without inhibition of humoral immunity in mice by oral administration. The most active compound was 2 (m-hydroxyphenyl)imidazo[2,1-b]benzothiazole (20). PMID- 3512826 TI - Enol lactone inhibitors of serine proteases. The effect of regiochemistry on the inactivation behavior of phenyl-substituted (halomethylene)tetra- and dihydrofuranones and (halomethylene)tetrahydropyranones toward alpha chymotrypsin: stable acyl enzyme intermediate. AB - We have found that alpha-aryl-substituted halo enol lactones (I and II) are effective mechanism-based inactivators for chymotrypsin. In this study, we have investigated, for comparative purposes, halo enol lactones with aryl functions situated beta and gamma to the lactone carbonyl group. We synthesized 4-phenyl 5(E)-(iodomethylidene)tetrahydro-2-furanone (1), 4-phenyl-5(E) (iodomethylidene)dihydro-2-furanone (2), 4-phenyl-6(E) (iodomethylidene)tetrahydro-2-pyranone (3), and 5-phenyl-6(E) (iodomethylidene)tetrahydro-2-pyranone (4), using a halolactonization reaction to convert the appropriate phenyl-substituted acetylenic acid precursor into the corresponding 5(E)-(halomethylidene)furanone and 6(E)-(halomethylidene)pyranone system. The 4-phenylfuranone (1 and 2) and the 5-phenylpyranone (4) proved to be only reversible, competitive inhibitors. By contrast, the 4 phenyltetrahydropyranone (3) inactivated alpha-chymotrypsin in a time-dependent manner. This inactivation was very rapid but reversible, with regeneration of enzyme activity being spontaneous and hydrazine-accelerated, suggestive of the intermediacy of a stable acyl enzyme. Kinetic comparison of the iodomethylene lactone 3 with the corresponding protio lactone 25 indicates that the iodine accelerates the rate of chymotrypsin acylation but produces an acyl enzyme that is more hydrolytically labile than that formed from lactone 25. From the results of this study, we conclude that a phenyl group situated at C-3 (alpha to the lactone carbonyl group) in both the 5(E)-(iodomethylidene)tetrahydro-2-furanone (I) and 6(E)-(iodomethylidene)tetrahydro-2-pyranone (II) series is essential for their activity as mechanism-based irreversible inactivators of chymotrypsin. The corresponding beta-aryl-substituted lactones, by contrast, are potent acylating agents that lead to acyl enzymes of high stability. PMID- 3512828 TI - Cross-reactive antigens between a tick, Dermacentor variabilis (Acari: Ixodidae), and a mite, Psoroptes cuniculi (Acari: Psoroptidae). PMID- 3512829 TI - Prenatal diagnosis of bullous ichthyosiform erythroderma: detection of tonofilament clumps in fetal epidermal and amniotic fluid cells. AB - The prenatal diagnosis of bullous ichthyosiform erythroderma (BIE) has been achieved at 20 weeks' gestation by electron microscopic identification of a pathognomonic cytoskeletal abnormality within fetal epidermal cells obtained by fetoscopic skin biopsy. The same abnormality was also observed in skin derived amniotic fluid cells. The question whether amniocentesis might be used instead of fetoscopy for future prenatal detection of BIE is discussed. PMID- 3512830 TI - The effect of lincomycin on exoprotein production by Vibrio cholerae. AB - Lincomycin has a differential effect on exoprotein production by Vibrio cholerae. The production of some proteins, such as cholera toxin and deoxyribonuclease, is stimulated by low concentrations of the drug while production of other proteins, such as protease and alkaline phosphatase, is unaffected. Possible mechanisms of the lincomycin effect are discussed. PMID- 3512831 TI - Enterotoxin production by Salmonella typhimurium strains of different virulence. AB - Six strains of Salmonella typhimurium (TML, W118, LT7, SL1027, M206 and Thax-1) of known virulence and ability to induce fluid secretion when inoculated into the rabbit ileum were examined for enterotoxin production. Enterotoxic activity, assayed in the rabbit ileal-loop test, was detected in polymyxin-B extracts from all strains (with the possible exception of Thax-1) cultured for 6 h in casamino acid-yeast extract medium. The extracts were inactive in tissue-culture assays with CHO, Y-1 adrenal and Vero cells, and in the infant mouse assay for enterotoxin. There was no correlation between enterotoxigenicity in vitro and the ability of whole organisms to induce fluid secretion in vivo. The significance of these results in relation to salmonellosis is discussed. PMID- 3512832 TI - Comparative analysis of Haemophilus influenzae type b and Escherichia coli J5 lipopolysaccharides. AB - Haemophilus influenzae type b (HIB) and Escherichia coli J5 (J5) lipopolysaccharides (LPS) were examined to explore the basis of previously observed cross-protection. HIB-LPS and J5-LPS contained ketodeoxyoctonate, glucose, glucoheptose and glucosamine as common carbohydrate moieties, and laurate, myristate, beta-hydroxymyristate and palmitate as common fatty acids, although in different ratios. J5-LPS was five times more lethal than HIB-LPS for chick embryos. Weak serological cross-reactivity was observed by haemagglutination and two-dimensional immunoelectrophoresis. No significant cross reactivity was demonstrated by enzyme-linked immunosorbent or toxicity neutralisation assays. The cross-reactivity observed between HIB-LPS and J5-LPS was probably due to common components in the core glycolipid. PMID- 3512833 TI - Pathogenic synergy between Escherichia coli and Bacteroides fragilis or B. vulgatus in experimental infections: a non-specific phenomenon. AB - The virulence of Bacteroides fragilis and B. vulgatus for mice was compared in a skin-infection model. These strains were also tested for pathogenic synergy in mixed infections with Escherichia coli. Strains of B. fragilis were generally more virulent than strains of B. vulgatus and, with one exception, the effect of Bacteroides strains in mixed infections merely reflected their inherent virulence. PMID- 3512834 TI - Interactions of virulent and avirulent leptospires with primary cultures of renal epithelial cells. AB - A primary culture system for the cells of mouse renal-tubular epithelium was established and used to observe the adhesion of leptospires. Virulent strains of serovars copenhageni and ballum attached themselves to epithelial cells within 3 h of infection whereas an avirulent variant of serovar copenhageni did not adhere to epithelial cells at all within the experimental period of 24 h. The saprophytic Leptospira biflexa serovar patoc became attached non-specifically to inert glass surfaces as well as to the cells. The adhesion of leptospires to epithelial cells was not inhibited by homologous antibody. PMID- 3512835 TI - Surface proteins in the transduction of groups A and G streptococci. AB - Four pairs of M+SOR+ and M-SOR- variants of group-A type-49 streptococci were compared as receptor strains in transduction of a streptomycin-resistance marker. The yield of transductants was 5-9-fold greater with the M-SOR- variants than with the corresponding M+SOR+ variants. Treatment of M+SOR+ variants of type-49 streptococci with trypsin enhanced the rate of transduction by 16-35-fold whereas trypsin treatment of corresponding M-SOR- variants resulted in minimal enhancement (5-fold or less). With trypsin treatment the numbers of transductants were approximately equal in pairs of M+SOR+ and M-SOR- variants. Enhanced transduction (10-26-fold) of streptomycin resistance was obtained by trypsin treatment of another seven M+SOR+ type-49 strains, of diverse phage subtypes and from various geographical locations. A wide range of enhancement (5-46-fold) was found in eight of nine M+ strains of group-A type-6 streptococci. With trypsin treatment, three of 10 transducible group-G strains showed enhanced transduction (10-13-fold) of a plasmid containing a determinant for erythromycin resistance. Transductional enhancement is proteolytic in nature, being enhanced by trypsin, chymotrypsin, papain, pronase and streptococcal proteinase. Although interference with phage adsorption by surface proteins would appear to be the most obvious explanation for these findings, further studies are required to define more clearly the mechanism of trypsin enhancement. PMID- 3512836 TI - Pigment production by Lancefield-group-B streptococci (Streptococcus agalactiae). AB - Cells of group-B streptococci harvested in the late exponential phase of growth and suspended in starch-glucose phosphate-buffered saline extractor solution were observed to form and release pigment into solution. Filtrates of these solutions were analysed spectrophotometrically and two varieties of pigment were detected. Pigment, when freshly produced or in the presence of starch, had four absorption peaks at 520, 485, 455 and 435 nm. If albumin was substituted for starch in the extractor solution or if the starch-pigment complex was disrupted by treatment with amylase or by boiling, the four-peak pigment rapidly and irreversibly degraded to a second type with a single absorption band at 415 nm. The pigments formed by washed cell suspensions had absorption spectra identical to those produced by pigment formed during growth in Todd-Hewitt Broth. The formation and release of soluble pigment appeared to be an active metabolic process; a carrier molecule and an energy source were both required. Pigment yields were increased when the pH of the extractor solution was in the range 7.0-7.4 and when Mg2+, but not other divalent cations, was present. No differences in yield or type of pigment were observed when pigment was formed in anaerobic conditions. These findings support an earlier observation that group-B streptococcal pigment resembles a beta carotenoid. There is some added support for the suggestion that haemolysin and pigment production by these organisms are closely linked characteristics. PMID- 3512837 TI - Adherence of non-fimbriate entero-invasive Escherichia coli O124 to guinea pig intestinal tract in vitro and in vivo. AB - The adherence properties of non-fimbriate entero-invasive Escherichia coli O124 in the guinea pig intestinal tract were studied. Quantitative in-vitro determinations were done by incubating radiolabelled bacteria with suspensions of viable intestinal cells released by treating loops of the guinea pig intestine with solutions containing EDTA, dithiothreitol and citrate. Non-bound bacteria were separated from the intestinal cells on a Percoll gradient. Only cells released from the colon, especially from its transverse and descending regions, avidly adhered to E. coli O124 (68-79 bacteria/cell), whereas the attachment to ileal cells was negligible. The adherence process was Ca++ and temperature dependent, had an optimal pH of 6.2 and was inhibited by fucose, glucose or mannose. Several pretreatment studies of the bacteria or the colonic cells showed that the adherence was mediated by a carbohydrate-binding protein (adhesin or lectin) on the colonic cells and not on the bacterial surface. Results of studies of in-vitro adherence to intestinal loops and to intact intestinal surfaces correlated well with the in-vitro findings. These results indicate that the adherence of entero-invasive E. coli O124 to the gut is similar to the attachment of Shigella flexneri and is quite different from that of enterotoxigenic E. coli. PMID- 3512838 TI - The role of K antigens as virulence factors in Klebsiella. AB - The importance of K antigen of Klebsiella as a virulence factor was studied in nine pairs of K+ and K- strains, each pair isogenic apart from the presence of K antigen. Loss of K antigen by nine K+ strains resulted in the reduced virulence of their K- variants in a mouse-skin model. This reduced virulence of K- strains for mice may be explained in all strains by a higher degree of phagocytosis as measured by chemiluminescence response of human polymorphonuclear leukocytes (PMNL) and in most strains by enhanced killing by either human PMNL or human serum or both. Although the protective role of the K antigen in serum-induced killing and killing by PMNL was generally evident, our results also suggested that other virulence factors were sometimes involved. PMID- 3512839 TI - Rare occurrence of Proteus vulgaris in faeces: a reason for its rare association with urinary tract infections. AB - The faecal carriage rates of different species of Proteeae were assessed in studies with 220 faecal isolates from 219 individuals of whom approximately one third were well and the remainder had gastro-enteritis. As a result of the development of new media that allowed replacement of the phenylalanine deaminase test with the tryptophan deaminase test and made it possible to combine tests for indole and urease production and for hydrogen sulphide and ornithine decarboxylase formation in two single-tube tests, all strains were speciated with speed, economy and accuracy. Most (96%) isolates were either Proteus mirabilis (62%) or Morganella morgani (34%). The significance of these findings in relation to urinary tract infection is discussed. P. vulgaris was found in only one (0.45%) faecal specimen and this rarity of carriage in faeces is believed to be the main reason for its rare association with urinary tract infections. The frequent association of M. morgani, in the absence of other enteropathogenic bacteria, with severe gastroenteritis was noted with interest. PMID- 3512840 TI - A collaborative evaluation of a rapid, semi-automated identification system for gram-negative bacilli: the Quantum II BID. AB - The recently-introduced semi-automated bacterial identification system, the Quantum II BID, is designed to identify fermentative and non-fermentative gram negative bacilli in 4-5 h. The system was evaluated independently by the two participating laboratories. Inter-laboratory reproducibility was determined by testing 181 strains in each laboratory and found to be 97.8%. A further 893 organisms, comprising 417 fresh clinical isolates and 476 stock cultures, were then tested by the system in the two laboratories. Of the fresh clinical isolates, 95.7% yielded the same result as the comparative system used (API 20E) and 93.1% of the stock strains were assigned to their expected, previously established identity. Overall agreement between the two systems for all strains examined was 94.3%. There was no significant statistical difference between the results obtained in the two laboratories. PMID- 3512841 TI - Electronmicroscopy studies on the bactericidal action of inflammatory leukocytes in murine salmonellosis. AB - Inbred female C3H mice were given 2 X 10(7) cfu virulent Salmonella typhimurium by intraperitoneal injection. Peritoneal washings were harvested between 3 h and 72 h after infection and examined by electronmicroscopy. There was evidence of intracellular killing by polymorphs and macrophages. The degeneration of intracellular salmonellae was seen initially as enlarging central electron-lucent areas in the cytoplasm and peripheral condensation of cytoplasmic granules, followed by disruption of the bacterial envelope and disintegration of cellular structure. Alternatively, the initial injury appeared as an irregular and discontinuous bacterial envelope with compression of the bacterium and diffuse condensation of cytoplasmic granules. It was also evident that virulent salmonellae multiplied extracellularly in the peritoneal cavity of the infected mice. PMID- 3512843 TI - Binding of C-reactive protein to Aspergillus fumigatus fractions. AB - Calcium-dependent binding of C-reactive protein (CRP) to Aspergillus fumigatus was determined by enzyme-linked immunosorbent assay. A homogenate of young hyphae was fractionated by hydrophobic interaction chromatography followed by gel filtration. High CRP-binding activity was found in a fraction of mol. wt c. 500,000 which was characterised by strong binding to the hydrophobic column. Three fractions of less conspicuous CRP-binding activity were identified (c. 500 000, 150 000 and 150 000-50 000 mol. wt respectively). In these four fractions, phosphorylcholine was detected by an anti-phosphorylcholine mouse hybridoma antibody. Some CRP-binding activity in fractions with low affinity for the hydrophobic column did not correspond closely with the presence of phosphorylcholine. It is suggested that C-reactive substance in A. fumigatus is heterogeneous. The C-reactive substances did not correspond with fractions containing major antigens (470 000 and 250 000 mol. wt respectively) which elicit a strong immune response in man. PMID- 3512842 TI - Typing of strains of Staphylococcus aureus by Western Blot analysis of culture supernates. AB - Extracellular proteins produced by Staphylococcus aureus strains were examined by Western Blot analysis with blood donor plasma as a source of antibodies. Comparison of epidemiologically related strains showed strong concordance between plot pattern and phage type. PMID- 3512844 TI - Experience with methacholine inhalation challenge in the evaluation of chest symptoms. PMID- 3512845 TI - Opening new windows with corneal transplant. PMID- 3512846 TI - Accuracy of standard urinalysis in predicting culture results. AB - Single and multiple test combinations were studied to determine the accuracy of the standard urinalysis method in predicting sterile or contaminated cultures and cultures with significant bacteriuria from gram negative rods (GNR). The results demonstrated a significant incidence of microscopic bacteriuria and pyuria in GNR culture (P < .001) and an association between large numbers of epithelial cells and culture contamination. A discriminate analysis of multiple test combinations was done to identify the order in which urinalysis tests significantly improved the ability to discriminate between culture groups. Results indicated that multiple test combinations were more predictive than single tests. Based on study results, a cost-effective scheme for ordering urine cultures is proposed. PMID- 3512848 TI - William Osler, MD (1849-1919): myths, images, realities. PMID- 3512847 TI - In search of an ethical equilibrium: a new dilemma in health services. PMID- 3512850 TI - Delayed staple penetration of the heart: transthoracic migration with late tamponade. AB - Most foreign bodies in the chest do their damage at the time of injury. While needle-like objects may migrate (6), delayed intrathoracic injury is rare. Delayed transthoracic penetration of the heart by a staple is reported, and is felt to be unique because acute hemopericardium resulted 30 days after the time of initial injury. The principles of recognition of pericardial tamponade, initial stabilization with periocardiocentesis, and immediate exploration are emphasized. PMID- 3512849 TI - Interactions of a water extract of cotton bract with dog isolated airway smooth muscle. AB - The inhalation of cotton dust by cotton-mill workers causes byssinosis, a disease characterized by chest tightness and other symptoms indicative of bronchoconstriction. In the present study the dog isolated trachealis smooth muscle preparation was employed to examine the ability of a crude, water extract of cotton bracts (CBE) to (1) cause contractile responses mediated by receptors, (2) modify responses of the tissue to a number of excitatory and inhibitory agents, and (3) alter responsiveness of the preparations to electrical field stimulation mediated by intrinsic cholinergic, excitatory nerves and adrenergic, inhibitory nerves. CBE evoked contraction of the tissues by an action that did not involve muscarinic, histamine, or 5-hydroxytryptamine receptors. The maximum tissue responses to exogenous histamine, 5-hydroxytryptamine, and isoproterenol were enhanced significantly in the presence of CBE, while those to KCl and methacholine were unaffected. The sensitivities (EC50 values) of the tissues to these agents were not, however, altered by CBE. Contractions induced by cholinergic nerve stimulation were increased in the presence of CBE, via a mechanism that appears, at present, to result from a prejunctional facilitation of acetycholine release. Relaxations to adrenergic nerve stimulation were not affected by CBE. Results suggest that, in addition to its direct, contractile activity, CBE can alter indirectly the responsiveness of the tissue to a number of endogenous mediator substances. Intrinsic, cholinergic excitatory nerves may be a target for the acute action of CBE as well. PMID- 3512851 TI - Molecular cloning and sequence determination of the genomic regions encoding protease and genome-linked protein of three picornaviruses. AB - To investigate the degree of similarity between picornavirus proteases, we cloned the genomic cDNAs of an enterovirus, echovirus 9 (strain Barty), and two rhinoviruses, serotypes 1A and 14LP, and determined the nucleotide sequence of the region which, by analogy to poliovirus, encodes the protease. The nucleotide sequence of the region encoding the genome-linked protein VPg, immediately adjacent to the protease, was also determined. Comparison of nucleotide and deduced amino acid sequences with other available picornavirus sequences showed remarkable homology in proteases and among VPgs. Three highly conserved peptide regions were identified in the protease; one of these is specific for human picornaviruses and has no obvious counterpart in encephalomyocarditis virus, foot and-mouth disease virus, or cowpea mosaic virus proteases. Within the other two peptide regions two conserved amino acids, Cys 147 and His 161, could be the reactive residues of the active site. We used a statistical method to predict certain features of the secondary structures, such as alpha helices, beta sheets, and turns, and found many of these conformations to be conserved. The hydropathy profiles of the compared proteases were also strikingly similar. Thus, the proteases of human picornaviruses very probably have a similar three-dimensional structure. PMID- 3512852 TI - Neonatal respiratory syncytial virus infection: role of transplacentally and breast milk-acquired antibodies. AB - The effect of transplacentally and breast milk-acquired antibodies on respiratory syncytial virus infection was studied in neonatal and 2-month-old cotton rats. Adult female rats infected intranasally with live virus regularly produced virus specific antibodies in the serum, colostrum, and breast milk. By using foster feeding techniques, we showed that both transplacentally and breast milk-acquired antibodies were effective in reducing the replication of respiratory syncytial virus in the lungs of neonatal animals when they were challenged with live virus via the nasal route at 3 days of age. However, the protection provided by these antibodies was rather brief. There was no difference in the replication of respiratory syncytial virus in the lungs of 2-month-old animals that were delivered and nursed by seropositive (immunized) or seronegative (control) cotton rats. PMID- 3512853 TI - Conservative replication and transcription of Saccharomyces cerevisiae viral double-stranded RNA in vitro. AB - All double-stranded RNA viruses have capsid-associated RNA polymerase activities. In the reoviruses, the transcriptase synthesizes the viral plus strand in a conservative mode and the replicase synthesizes the viral minus strand, again conservatively. In bacteriophage phi 6 and in some fungal viruses, the transcriptase activity is semiconservative, acting by displacement synthesis. In this work we demonstrate Saccharomyces cerevisiae viral RNA replication in vitro for the first time and, using more sensitive techniques than those previously used, show that both the transcriptase and the replicase appear to act conservatively, like those of reovirus. There is therefore clearly no universal life cycle for the double-stranded RNA viruses. PMID- 3512854 TI - Uukuniemi virus glycoproteins accumulate in and cause morphological changes of the Golgi complex in the absence of virus maturation. AB - We have studied the transport of the Uukuniemi virus membrane glycoproteins in baby hamster kidney and chick embryo cells by using a temperature-sensitive mutant (ts12). Uukuniemi virus assembles in the Golgi complex, where both glycoproteins G1 and G2 and nucleocapsid protein N accumulate (E. Kuismanen, B. Bang, M. Hurme, and R. F. Pettersson, J. Virol. 51:137-146, 1984). At the restrictive temperature (39 degrees C), the glycoproteins of ts12 were transported to the Golgi complex as in wild-type, virus-infected cells, whereas the nucleocapsid protein failed to accumulate there. Pulse-chase labeling followed by immunoprecipitation and treatment with endo-beta-N acetylglucosaminidase H showed that G1 synthesized at 39 degrees C in ts12 infected cells had an altered mobility in sodium dodecyl sulfate-polyacrylamide gel electrophoresis, suggesting a lack of terminal glycosylation. The typical Uukuniemi virus-induced vacuolization and expansion of the Golgi complex could be seen also in ts12-infected cells at 39 degrees C, although no virus particles were formed. This suggests that the morphological changes were induced by the Uukuniemi virus glycoproteins. In wild-type virus- or ts12-infected cells, G1 and G2 could not be chased out from the Golgi complex even after 6 h of treatment with cycloheximide. The glycoproteins were thus retained in the Golgi even under conditions when no virus maturation took place and when nucleocapsids did not accumulate in the Golgi region. Accordingly, the glycoproteins of Uukuniemi virus were found to have properties resembling those of Golgi-specific proteins. This virus model system may be useful in studying the synthesis and transport of membrane proteins that are transported to and retained in the Golgi. PMID- 3512856 TI - Measurement of mesenteric blood flow by duplex scanning. AB - Ultrasonic imaging combined with a pulsed Doppler unit (duplex scanning) allows the noninvasive assessment of blood flow of the superior mesenteric artery. The changes in mesenteric blood flow associated with a standardized (1000 kcal) food load were measured and the results were compared with blood flow of the left common carotid artery. Twenty healthy subjects (aged 30.1 +/- 5 years) were studied fasting (12.4 +/- 2.6 hours' duration) and six times with a 15-minute interval after the test meal. The diameters of the superior mesenteric artery (0.60 +/- 0.09 mm) and of the common carotid artery (0.61 +/- 0.05 mm) were measured from the B-mode image. The Doppler frequency spectra were used to determine peak systolic, late systolic, and end-diastolic velocity and to compute the mean velocity. Although the flow parameters of the common carotid artery were virtually unaffected by food intake, a steep increase in mesenteric blood flow velocity and volume flow was observed. At rest, blood flow through the mesenteric artery was 6.3 +/- 2.6 ml/sec and 9.5 +/- 2.1 ml/sec in the carotid artery. After the test meal, mesenteric artery blood flow increased significantly (p less than 0.0001) and reached maximal hyperemia (20.3 +/- 7.4 ml/sec) after 45 minutes. The measurement of mesenteric blood flow before and after a test meal characterizes intestinal hemodynamics and should be suitable to evaluate ischemic disease and other disorders that lead to changes of mesenteric blood flow. PMID- 3512855 TI - In vitro experimental infection of primary duck hepatocyte cultures with duck hepatitis B virus. AB - Duck hepatitis B virus (DHBV) obtained from the serum of congenitally infected ducks was used to infect primary duck hepatocyte cultures 1 to 4 days after plating. Virus replication was demonstrated by the appearance, beginning at 2 days after infection, of intracellular covalently closed-circular and single stranded DHBV DNA replicative intermediates which were not present in the inoculating virus preparation. With increasing time after infection there was further amplification of intracellular relaxed circular, covalently closed circular, and single-stranded DHBV DNA. Cultures of primary duck hepatocytes are competent for infection with DHBV only during the first 4 days of culture. Synthesis of DHBV core antigen and DHBV surface antigen was detected by immunofluorescence in 10% of the hepatocytes in culture. De novo synthesis and release of infectious virus was also demonstrated. Therefore, all stages of viral replication were carried out by these experimentally infected primary hepatocyte cultures. This system makes it possible to study DHBV replication in vitro. PMID- 3512857 TI - The blue toe syndrome: hemodynamics and therapeutic correlates of outcome. AB - We reviewed the limb and digit hemodynamics of 67 extremities of 48 patients evaluated for blue toe syndrome in our vascular laboratory during 7 years. These patients represented 1.4% of the arterial examinations during this period. Abnormal ankle/arm pressure indices (less than 0.9), signifying proximal arterial obstruction, were present in 31 limbs (47%). Toe/ankle indices were abnormal (less than 0.6) in 57 extremities (85%), indicating pedal or digital artery obstruction. Arteriograms were obtained in 40 of 64 extremities (63%) available for follow-up, which revealed atherosclerotic disease in 90% (aortoiliac 20%, femoropopliteotibial 30%, and combined 40%), aneurysm in 7.5%, and no disease in only one extremity (2.5%). Of 64 extremities followed for 1 to 84 months (mean, 26 months), only 28 (44%) manifested an uncomplicated outcome. Tissue loss was noted in 24 (38%), recurrent digital ischemia occurred in nine (14%), and 14 limbs (22%) required amputation of toe(s) (seven), forefeet (three) or legs (four). Nine patients (20%) died in the follow-up period. Outcomes did not correlate with limb or digit hemodynamics or with therapy (surgical in 31, medical in 11, or none in 22) except that tissue necrosis was more common in patients undergoing operation. The blue toe syndrome deserves recognition as an important sign of potential limb-threatening arterial disease, but the optimal therapy remains to be established. PMID- 3512858 TI - The diagnostic interface between noninvasive cerebral vascular testing and digital arteriography. AB - Two hundred forty patients with signs and symptoms of cerebrovascular disease were evaluated by digital and/or standard arteriography. One hundred twenty symptomatic patients had intravenous digital arteriography (IVDSA) done as the initial diagnostic study. Twenty-five percent (30 patients) had inadequate intravenous examinations and required additional intra-arterial studies. Twenty seven of the 30 supplemental arteriograms (90%) demonstrated clinically significant disease. The remaining 120 patients (30 asymptomatic, 90 symptomatic) had preangiographic screening with continuous-wave Doppler and spectral analysis. Forty-eight (40%) patients had hemodynamically severe lesions and 72 (60%) had moderate stenosis or arterial wall disease. IVDSA was performed when critical disease was present and intra-arterial arteriography (80% digital and 20% standard) was done when mild or moderate disease was found. The use of digital techniques on the basis of results of preangiographic noninvasive testing improved the diagnostic accuracy of IVDSA and reduced the incidence of inadequate studies to 6%. Intra-arterial digital angiography (IADSA) was advantageous in reducing costs and patient risks when IVDSA was inappropriate. PMID- 3512859 TI - Diastolic flow as a predictor of arterial stenosis. AB - With a pulsed Doppler imaging system, it is now possible to interrogate sites from the aorta to the popliteal trifurcation. To determine which velocity parameters could be correlated with the degree of disease as determined by angiography, 34 arterial stenoses identified by scanning were also evaluated by contrast arteriography and classified in 10% increments. The angiographic readings were blinded with respect to the scan results. Four hand-measured parameters from velocity waveforms obtained at the site of stenosis were correlated with the angiogram--peak systolic velocity, systolic rise time, diastolic reverse velocity, and diastolic reverse flow time. When diastolic reverse flow was absent, diastolic forward flow was recorded. To describe diastolic flow along a continuum, diastolic reverse velocity was ascribed a positive value and diastolic forward velocity was ascribed a negative value. A systolic velocity gradient (peak velocity/rise time) was also calculated. The relationship between the angiographic categories and the measured parameters was evaluated with the Jonkheere-Terpstra trend test. A trend was determined with diastolic flow (diastolic reverse flow or diastolic flow velocity) that was significant (p less than 0.01). The linear regression was calculated (y = 40.8 + [-5.6X]), and correlation coefficient was obtained (r = 0.76) that was statistically significant (p less than 0.01). The method enables mapping and calculation of arterial stenoses by noninvasive means. This can be expected to obviate the need for diagnostic angiograms in certain and select cases in which angioplasty can be expected to be beneficial. It also affords a convenient quantitative means of following lesions over time. PMID- 3512860 TI - Relative accuracy of the diagnostic components of noninvasive carotid arterial tests: a comparison of pulsed Doppler arteriography and spectrum analysis. AB - Pulsed Doppler ultrasonography (UA), sound spectrum analysis, and subjective interpretation of the audible signal are valuable methods for assessing carotid arterial disease; however, the relative contribution of each in making a diagnosis is disputed. To investigate this issue, 258 noninvasive carotid studies with measured x-ray comparisons were reviewed. Internal carotid spectra, UA images, and images combined with the technician's comments were each interpreted blindly by three independent readers. Percentage of stenosis was categorized into six groups: 0, 1% to 24%, 25% to 49%, 50% to 74%, 75% to 99%, and 100%. Each reader's assessment of the individual noninvasive components and his overall reading of the complete study were compared with x-ray findings and with those of the other two readers. The readings of the three observers were consistent within each diagnostic component (p less than 0.001). For each reader, the technician's comments significantly improved the accuracy of ultrasonic imaging alone (p less than 0.001). Spectrum analysis was as good as the image plus technician's comments and, for two of three readers, was better than the image alone (p less than 0.001). PMID- 3512861 TI - Evaluation of the vertebral arteries with duplex sonography. AB - Using duplex sonography, we have routinely evaluated the vertebral arteries as part of the carotid artery examination in 453 consecutive patients over a 6-month period. Sixty-two of these 906 vessels could not be adequately evaluated, primarily because these vessels lay too deep within the vertebral structures, resulting in a technical failure rate of 6.8%. For the remaining 844 vessels, 74.4% were considered normal by Doppler flowmeter spectral analysis. Angiographic correlation was available for 224 vessels; of 155 judged normal by duplex sonography, 144 (93%) were shown to be normal or have only mild atherosclerotic disease. Eleven vessels were considered either occluded or to have severe disease by duplex sonography, and angiography showed this to be the case in 10 (91%) vessels. Unusually strong vertebral artery flow was associated with hemodynamically significant carotid or contralateral vertebral atherosclerotic disease or subclavian steal 82% of the time. Twelve cases of subclavian steal, only one of which was symptomatic, were identified by duplex sonography; four of these were confirmed by angiography. Angiographic correlation was available for 229 vessels in which duplex evaluation showed vertebral artery flow to be moderately damped. In 11 of these (38%), angiography showed greater than 50% stenosis. Angiography judged the remaining 18 vessels in this group normal; these vessels may represent a small subgroup of patients with normal anatomy or only mild atherosclerotic disease, but with hemodynamic dysfunction that can be identified with the duplex technique. PMID- 3512862 TI - Antibiotic prophylaxis in vascular surgery: pharmacokinetic study of four commonly used cephalosporins. AB - Plasma levels of antibiotics often do not correlate well with their tissue levels. To determine optimal antibiotic coverage for prophylactic effect in vascular surgery, we studied the tissue pharmacokinetics of four cephalosporins in dogs: cefazolin, cefoxitin, cefamandole, and moxalactam for 3 hours after a single (25 mg/kg) intravenous injection. The minimal inhibitory concentration (MIC) of these antibiotics for the three most common pathogens involved in graft infections (Staphylococcus aureus, S. albus, and Escherichia coli) and their tissue concentration (TC) in the plasma, muscle, subcutaneous tissue, and aortic wall were assayed. The data are presented as TC/MIC ratio. Cefoxitin and moxalactam failed to achieve an effective therapeutic TC/MIC ratio (greater than 10) for S. aureus and S. albus in all the tissues studied whereas cefoxitin and cefamandole were above therapeutic levels. All antibiotics achieved an effective therapeutic ratio against E. coli, but cefamandole performed better (p less than 0.05) than cefoxitin; the latter reached effective levels at 3 hours. Cefamandole attained the most effective bioactive aortic tissue levels when the three most common pathogens were considered together and should therefore be considered as an antibiotic agent of choice for prophylaxis in vascular surgery. PMID- 3512863 TI - Effects of prostacyclin injections and infusions on canine femoral hemodynamics. AB - The use of prostacyclin (PGI2) infusions has been recommended in the management of patients with severe distal arteriopathy, who are not candidates for conventional bypass procedures. Further clarification regarding the route of administration and the optimal dose of this potent vasodilator, however, is needed before controlled clinical trials are initiated. We measured bilateral femoral arterial blood flow electromagnetically in seven anesthetized adult mongrel dogs. Systemic arterial pressure and cardiac output were also measured. Central venous and femoral arterial injections of PGI2 were administered in five doses ranging from 10(-4) to 10(0) micrograms X kg-1 to study the dose response. PGI2 was also infused intravenously and intra-arterially for 20 minutes at a dose of 10(-1) micrograms X kg-1 X min-1. Femoral arterial injections of PGI2 in doses from 10(-4) through 10(0) micrograms X kg-1 caused significant (p less than 0.05) and dose-dependent increases in ipsilateral femoral arterial blood flow. Intravenous injections of PGI2 caused no significant changes in the dose range from 10(-4) to 10(-2) micrograms X kg-1 but resulted in a significant (p less than 0.05) reduction in femoral arterial flow and systemic arterial pressure at doses of 10(-1) and 10(0) micrograms X kg-1. The femoral arterial infusion of PGI2 produced a significant and sustained increase in femoral arterial flow that was not observed during the intravenous infusion. Arterial pressure was unchanged with intra-arterial PGI2 but was significantly reduced during the intravenous infusion. The beneficial hemodynamic effects of intra-arterial PGI2 suggest that further clinical trials should employ this route of administration.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3512864 TI - Noninvasive assessment of upper extremity and hand ischemia. AB - The diagnosis and follow-up of patients with ischemic problems of the arm and hand is facilitated by the selective use of simple noninvasive methods readily available in most vascular laboratories. These tests help differentiate between obstruction and vasospasm and document the severity of the circulatory impairment. Although they may not establish etiology, they often clarify the need for further laboratory tests or arteriography. PMID- 3512866 TI - Polio survivors spurred rehabilitation advances. PMID- 3512865 TI - Arterial bypass grafts for upper extremity ischemia. PMID- 3512867 TI - On the physical death of Jesus Christ. AB - Jesus of Nazareth underwent Jewish and Roman trials, was flogged, and was sentenced to death by crucifixion. The scourging produced deep stripelike lacerations and appreciable blood loss, and it probably set the stage for hypovolemic shock, as evidenced by the fact that Jesus was too weakened to carry the crossbar (patibulum) to Golgotha. At the site of crucifixion, his wrists were nailed to the patibulum and, after the patibulum was lifted onto the upright post (stipes), his feet were nailed to the stipes. The major pathophysiologic effect of crucifixion was an interference with normal respirations. Accordingly, death resulted primarily from hypovolemic shock and exhaustion asphyxia. Jesus' death was ensured by the thrust of a soldier's spear into his side. Modern medical interpretation of the historical evidence indicates that Jesus was dead when taken down from the cross. PMID- 3512868 TI - Landmark article May 18, 1929: The use of a new apparatus for the prolonged administration of artificial respiration. I. A fatal case of poliomyelitis. By Philip Drinker and Charles F. McKhann. PMID- 3512869 TI - Landmark perspective: The iron lung. First practical means of respiratory support. PMID- 3512870 TI - Oral acyclovir for treatment and suppression of genital herpes simplex virus infection. A review. PMID- 3512871 TI - Treatment of sexually transmitted chlamydial infections. AB - Tetracycline hydrochloride, 500 mg orally four times a day for seven days, remains the treatment of choice for C trachomatis infections in men and nonpregnant women. Either erythromycin, 500 mg orally four times daily for seven days, or an equivalent dosage of another erythromycin product is an alternative treatment for patients who cannot tolerate tetracycline and for pregnant women. These two treatment regimens can be generalized to include nongonococcal urethritis and mucopurulent cervicitis. However, other treatment regimens that are effective against C trachomatis may not be effective for treating nongonococcal urethritis or mucopurulent cervicitis not caused by C trachomatis. The optimal treatment for pregnant women with C trachomatis infections and women with acute PID has not been established. Additional treatment trials with both groups of patients are needed to determine the effectiveness of antimicrobial agents in addition to those currently used, to establish the appropriate dose of each antimicrobial agent, and to clarify the appropriate duration of treatment. All individuals who are sexual partners of patients with nongonococcal urethritis, mucopurulent cervicitis, and acute PID (within the 30 days prior to onset of their symptoms or time of positive clinical evaluation findings) should be examined for sexually transmitted disease and treated promptly with a regimen effective against uncomplicated gonorrhea and chlamydial infections. Prompt treatment of sexual partners reduces the rate of treatment failure due to reinfection, reduces the transmission of infection, and reduces the frequency of occurrence of adverse sequelae of infection. PMID- 3512873 TI - Primary prevention of sexually transmitted diseases. A primer for clinicians. AB - With the advent of sexually transmitted infections for which curative therapy is not available, primary prevention has assumed greater importance. The spectrum of sexually transmitted diseases (STDs) has broadened, and clinicians need to understand the mechanisms of their transmission and prevention. Modifying selection of sexual partners and avoiding certain sexual practices should theoretically reduce the risk of infection. Clinical and laboratory studies indicate that the use of condoms, diaphragms, and spermicides reduces the risk of acquiring certain infections. At present, hepatitis B is the only STD for which a safe, effective vaccine is available. Use of oral antibiotics cannot be recommended. Postcoital washing or urination have not been shown to have a protective effect against infection. Because of the potential benefits, persons at risk for STDs should be encouraged to modify their sexual behavior and use barrier methods and spermicides to protect themselves against sexually transmitted infections. PMID- 3512872 TI - The treatment of chancroid. AB - Since the treatment of chancroid was reviewed in 1982, the results of subsequent treatment trials have offered the clinician additional therapeutic choices as well as shorter courses of therapy. Erythromycin (500 mg four times a day for seven days) provides consistently effective treatment for cases acquired throughout the world, although erythromycin-resistant strains have been isolated in Singapore. Sulfamethoxazole and trimethoprim (800 mg/160 mg orally twice a day for seven days), ceftriaxone (250 mg intramuscularly one time), and amoxicillin/clavulanic acid (500 mg/125 mg orally three times a day for seven days) are also efficacious. There is, however, significant geographic variability in the susceptibility of Haemophilus ducreyi to sulfamethoxazole and trimethoprim, suggesting this combination may become increasingly less effective, and a lack of in-depth experience in the treatment of chancroid with ceftriaxone and amoxicillin/clavulanic acid. PMID- 3512874 TI - Evaluating vitamin prophylaxis for cancer. PMID- 3512875 TI - Clinically and statistically significant differences. PMID- 3512876 TI - Haemophilus parainfluenzae liver abscess in a recipient of a renal transplant who had polycystic disease. PMID- 3512877 TI - George Washington and variolation; Edward Jenner and vaccination. PMID- 3512878 TI - Donor availability as the primary determinant of the future of heart transplantation. AB - Heart transplantation has now achieved a therapeutic status similar to that of cadaveric renal transplantation. Depending on patient selection criteria, it is estimated that as many as 15,000 people per year could conceivably benefit from a heart transplant, but the actual number of persons who will benefit is severely constrained by donor supply. Availability of heart donors was estimated based on data obtained on 1,955 organ donors in the United States. The results show that because of age and other contraindications, only 400 to 1,100 viable donor hearts may be available each year. Donor supply is the most critical determinant of the future of heart transplantation since it will dictate the number of transplants performed, the survival of transplant recipients, the total program expenditures associated with heart transplantation, the nature of the legal and ethical issues involved, the number of cardiac transplant programs required to make optimal use of the available donor hearts, and the future role of mechanical circulatory support systems. PMID- 3512879 TI - Morning report. Role of the clinical librarian. AB - The educational value of morning report should be enhanced by thorough evaluation of the medical literature. We added a clinical medical librarian (CML) program to our morning report 2 1/2 years ago to provide rapid, complete access to reference material relevant to topics discussed in morning report. MEDLINE searches and references are made available on a same-day basis; cumulative lists of these are provided to the staff and house staff at bimonthly and yearly intervals. All house staff used the CML service to some degree and the majority found it to be of value in making patient care decisions. Since the inception of the CML program, the medical library has noted a more than twofold increase in the number of on-line reference searches and a similar increase in requests for searches by house staff. Patient care decisions have been improved through ready access to current medical literature, and the teaching program has been enhanced by the creation of the CML program as an integral part of morning report. PMID- 3512880 TI - Toward a more ethical emergency nursing practice. PMID- 3512881 TI - Behavioral management of the acutely intoxicated patient in the emergency department. PMID- 3512882 TI - Premedical students as patient and family liaisons in the emergency department: a strategy for patient satisfaction. PMID- 3512883 TI - Personal choice in dress for emergency nurses. PMID- 3512884 TI - When will it end? PMID- 3512885 TI - Design and implementation of a ten-hour work schedule for an ED nursing staff. PMID- 3512886 TI - Assessment of childhood and adolescent depression and suicide potential. PMID- 3512887 TI - Uterine curettage in the emergency department. PMID- 3512888 TI - Polyvalent pneumococcal vaccine: its implications for postsplenectomy patients. PMID- 3512889 TI - Living wills in the emergency department. PMID- 3512890 TI - Seizure and asthma. PMID- 3512891 TI - An adult male patient with unexplained fever. PMID- 3512892 TI - Acute adrenergic reaction after accidental nasal instillation of metaproterenol. PMID- 3512893 TI - Spinal cord compression: an oncologic emergency. PMID- 3512895 TI - Government regulations and health care. PMID- 3512896 TI - [Characteristics of the water-electrolyte metabolism of hypertension patients with stable hypertension and the principles of diuretic therapy]. AB - Different levels of water-salt metabolism control were studied in patients with stable essential hypertension (SEH). The sample was found to be highly heterogeneous in terms of the magnitude of the body's water-filled spaces in relation to plasma renin activity (PRA) and the cooking salt gustatory sensitivity threshold, examined in the presence of various salt diets and diuretic treatments. Three patterns of response to salt loads were identified in SEH patients with respect to sodium and water elimination by the kidneys: the first was identical to that of normal subjects, while the second one featured increased, and the third one, decreased, diuresis and natriuresis. Prostaglandin E2 and kallikrein were shown to be involved in the formation of the second- and third-type renal response to excessive salt. Differential treatment of EH patients with diuretics alone or, where necessary, in combinations with small dose beta-blockers or vasodilators provides effective BP control for some 1.5 to 2 years in 65% of patients. PMID- 3512897 TI - [Biobehavioral aspects of hypertension treatment. Comments on methodology]. PMID- 3512894 TI - Accessory cell activity of murine tumor-associated macrophages. AB - The accessory cell activity of macrophages associated with the murine 3 methylcholanthrene-induced fibrosarcoma FSa was investigated. On the basis of Fc receptor expression and phagocytic activity, 20-25% of cells present within enzymatically disaggregated tumor cell suspensions could be classified as macrophages. These cells were approximately 50% I-Ak positive but did not express the Mac-1 antigen. T-cells played an important role in regulating I-Ak expression, and macrophages obtained from tumors grown in nu/nu mice were I-Ak negative. Tumor-associated macrophages were shown to possess potent accessory cell activity and were fully capable of reconstituting the primary anti-calf red blood cell plaque-forming cell (PFC) response of Sephadex G-10-passed spleen cells. This function required the presence of the I-Ak-positive subpopulation, and macrophages treated with anti-Ia serum and complement or obtained from tumors grown in nu/nu hosts lacked accessory cell activity. Tumor-associated macrophages were also able to provide the essential accessory cell function required for cooperation between tumor-specific TH cells and normal B-cells in the generation of an anti-trinitrophenyl (TNP) PFC response in the presence of TNP-coupled FSa antigen. These results suggest that progressive growth of the FSa tumor in vivo cannot be readily attributed to a defect in the accessory cell function of tumor associated macrophages. PMID- 3512898 TI - [Psychological nondrug treatment of hypertension and the criteria of its effectiveness]. AB - Eighty patients with essential hypertension, stages IIA-IIB, were examined three times: on admission to hospital, and 1 and 12 months later. All patients were subjected to clinical, psychological (brief multifactorial questionnaire for examination of a personality and the interpersonal relationships test) and psychophysiological investigation. The patients were allocated to 3 groups by random selection: 30 patients practicing autogenic training (group 1), 30 patients on relaxation therapy making use of biological feedback (BFB) (group 2), and 20 patients exposed to no psychological influences (group 3, or the controls). In the presence of psychological treatment, the BP decline, the increase in stress tolerance and the improvement of the psychological status were significantly more marked in the former two groups, as compared to the controls. Comparative assessment of the efficiency of autogenic training and BFB showed no basic differences between the two treatment methods. In cases where treatment proved inefficient, the patients exhibited a negative attitude to treatment and markedly demonstrative character. PMID- 3512900 TI - [Methods of improving the results of gastrectomy]. PMID- 3512899 TI - [Psychological factors in hypertension]. AB - We briefly overview behavioral factors of possible relevance to essential hypertension. We examine, in particular, dimensions of individual differences relating to: (a) problems of anger and assertion; and (b) cardiovascular responsivity to behavioral stressors. Hypertensive patients do show larger cardiovascular reactions to common laboratory stressors than normotensive, controls, and similar differences emerge in comparisons of normotensive individuals with and without a family history of hypertension. Concerning the purported dispositional attributes of hypertensives, we also propose re-examining psychodynamic notions regarding the suppression or denial of anger within a more objective, behavioral framework-specifically, as measurable deficits in assertive skill. Preliminary observations point to the presence of lower assertiveness in some hypertensive patients and increased hostility among others. These behavioral characteristics also appear to be associated with different patterns of cardiovascular reactivity, as recorded during interpersonal encounters that call for assertive responding. PMID- 3512901 TI - Endocrine regulation of the immune system. AB - Immunoregulation, the major process of self-defence, appears to be more complex than has been previously thought, involving the central nervous and endocrine systems. This review demonstrates growing evidence for the hypothesis that endocrine factors from the pituitary and hypothalamus directly influence the development and function of the immune system. Both pituitary and hypothalamic hormones interfere with lymphocyte proliferation and function. Proliferation of T lymphocytes as well as production of immunoglobulins by plasma cells seem to be hormone dependent. Clinical observations suggest that hematological, oncological, and immunological disorders known for their immune pathogenesis are associated with alterations of the endocrine homeostasis. Recently, human peripheral mononuclear cells have been shown to possess specific receptors for pituitary hormones. It is hypothesized that proteohormones act directly on lymphocytes via specific membrane receptors. Thus, the endocrine system, closely related to cortical and subcortical centers in the central nervous system, is one of the body's instruments to regulate and modulate its immune response. This hypothesized immunoregulatory pathway via the central nervous system and endocrine glands may well be of importance for the body's defence against infectious and malignant diseases. In addition, a new picture of the complex immunoregulatory mechanisms emerges for a better understanding of the function of the immune system. However, there is no single hormone which has yet been identified as being crucial for development and/or function of the immune system. It appears from the literature that a number of various proteohormones rather than a single hormone acts on immunocompetent cells. PMID- 3512902 TI - Natural killer cell activity against a thymoma cell line Thy 121 in bone marrow transplant recipients. AB - Twenty-one patients with acute and chronic leukemia or severe aplastic anemia were studied for NK activity against a thymoma cell line (Thy 121) before and after allogeneic bone marrow transplantation. The means of the pretransplant and post-transplant levels did not differ from the mean of 134 NK determinations in 67 healthy donors. There was no correlation between pretransplant NK levels and the appearance of graft-versus-host disease. Three weeks following bone marrow transplantation, pretransplant NK levels were observed. The sensitivity of NK cells to interferon was the same as in normal donors both before and after bone marrow transplantation. In contrast to methotrexate, cyclosporin A inhibited NK activity in patients and controls in vitro. In vivo cyclosporin A treatment, however, did not decrease NK levels in bone marrow recipients. PMID- 3512903 TI - The influence of long-term infusion of the calcium antagonist diltiazem on postischemic acute renal failure in conscious dogs. AB - The influence of long-term infusion of the calcium-entry blocker diltiazem on postischemic acute renal failure was investigated in conscious dogs monitored by implanted instruments. In 18 uninephrectomized beagle dogs on a salt-rich diet, an electromagnetic flow probe and an inflatable plastic cuff were placed around the renal artery. Acute renal failure was induced by inflating the cuff for 180 min in the conscious animal. Group A (n = 5, control) received an intraaortic injection of 0.9% NaCl (5 ml/day) from the 3rd day before until the 7th day after ischemia and group B (n = 6, posttreatment) an intra-aortic injection of diltiazem (5 micrograms X min-1 X kg-1) beginning at the end of ischemia until the 7th day. Group C (n = 7, pre- and posttreatment) received diltiazem from the 3rd day before until the 7th day after ischemia. In group A, renal blood flow dropped from 149 +/- 16 (preischemic) to 129 +/- 29 ml X min-1 on the 1st day after ischemia. In contrast, renal blood flow increased on the 1st postischemic day in both treatment groups by 29 +/- 15% (group B, P 0.05) and 14 +/- 13% (group C). In the following days, there was no significant difference in renal blood flow between groups A, B and C. In group B, the reduction of the glomerular filtration rate was similar to that in the control group.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3512905 TI - Determining the viability of faecal bacteria present in germ-free mice. AB - Gram-positive bacilli, originating from the diet, are present in the faeces of germ-free mice in this Unit. Although these organisms have never grown on culture and are assumed to be dead it was considered desirable to test this by non cultural methods because some gut bacteria are difficult or impossible to grow in vitro by present techniques. Germ-free mice were fed a synthetic diet free from live or dead organisms for 10 days during which time the bacilli disappeared from the faeces, re-appearing when the usual diet was re-introduced. This was regarded as confirmation of the non-viability of the bacilli. The use of Wayson's stain for confirmation of non-viability was found to be inappropriate since it produced false-positive reactions with irradiation-killed bacteria. PMID- 3512904 TI - [Prospects for using ultraviolet radiation in protracted space flights]. AB - The data concerning UV-effects on the human body and the environment are reviewed as applied to long-term flights. It is concluded that UV-radiation can be used in long-term space flights in view of its vitamin-forming, desensitizing, bactericidal, and supporting properties to improve the environment and to prevent adverse effects of space flight factors. PMID- 3512906 TI - Isolation of members of the Haemophilus-Pasteurella-Actinobacillus group from feral rodents. AB - 46 feral rodents, including a common vole (Microtus arvalis), house mice (Mus musculus), muskrats (ondatra zibetica), house rats (Rattus rattus) and brown rats (R. norvegicus) were examined for bacteria of the Haemophilus-Pasteurella Actinobacillus group. Haemophilus spp. (only M. musculus examined) were not obtained. All animal species were found contaminated by P. pneumotropica and/or Actinobacillus spp. Almost all M. musculus (96%) and most Rattus spp. (76%) were contaminated by P. pneumotropica and/or Actinobacillus spp. These bacteria were obtained most frequently from the upper respiratory tract, to a lesser extent from the lung and rarely from caecal contents. It is concluded that feral rodents might constitute an important source of contamination of laboratory rodents by members of the HPA-group. PMID- 3512907 TI - Molecular genetics of the X chromosome and X-linked diseases. PMID- 3512908 TI - Kinetics of cellular proliferation after arterial injury. III. Endothelial and smooth muscle growth in chronically denuded vessels. AB - The healing of injured rat carotid chronically denuded of endothelium was studied at late times after balloon injury. One year after injury the endothelial layer was not fully regenerated and had ceased proliferating. The denuded areas of these vessels were covered with luminal smooth muscle cells which strongly resembled endothelium but did not stain with factor VIII.R.Ag antibody. These cells were actively proliferating and formed a surface which was weakly thrombogenic. Indium-111 platelet studies showed that over 24 hours there was a slight but significant adherence of platelets to the denuded surface. Luminal smooth muscle cell proliferation was matched by cell loss and did not produce further intimal thickening or an increase in total cell number. These results demonstrate that damaged conduit arteries can exist in a stable state without endothelium and do not develop thrombosis even after prolonged periods of time. PMID- 3512909 TI - Immunohistological analysis of human mononuclear phagocytes and dendritic cells by using monoclonal antibodies. AB - Mononuclear phagocytes and dendritic cells were analyzed in detail with a panel of monoclonal antibodies by immunoalkaline phosphatase and immunofluorescence techniques. The panel included two antibodies (KB90 and SHCL3) against the two chain membrane constituent, P150,95, an antibody (Mo1) against C3bi receptor, an antibody (To5) against C3b receptor, and two antibodies (Mo2 and UCHM1) against a single chain glycoprotein with a molecular weight of 55 to 60 previously found on monocyte/macrophages. In addition, the panel contained several antibodies including EBM11, LeuM3 and FMC32 whose molecular specificities are not known at present. Frozen sections of spleen, bone marrow, thymus, lymph node, liver, brain, lung, kidney, colon, and skin were examined. Several populations of mononuclear phagocytes and dendritic cells could be distinguished on the basis of their reactivity with the antibody panel. Populations of macrophages resident in parenchymal organs had reaction patterns distinct from those of circulating macrophages. Many of the antibodies in the panel reacted with both macrophages and dendritic cells suggesting a close cytogenic, if not functional, relationship between these cells. There was wide variability in the reactions of macrophages and dendritic cells in different tissue and less variability among cells within individual anatomic locations. PMID- 3512910 TI - The South Carolina Medical Association and the State Board of Medical Examiners: an historical perspective. PMID- 3512911 TI - Health care for the medically indigent: a joint effort. PMID- 3512912 TI - A Compendium of Operative Surgery. PMID- 3512913 TI - Routine monitoring of cyclosporine in whole blood and in kidney tissue using high performance liquid chromatography. AB - A simple isocratic reversed-phase high pressure liquid chromatographic procedure for the specific estimation of cyclosporine in 1 mL of whole blood using cyclosproin D as internal standard is described. The chromatographic conditions chosen afford a high degree of resolution and sensitivity, a prolonged analytical column life (four months), and complete analysis of ether extracts within 8 min. The limit of detection is 10 micrograms/L. Thirty-five patient samples can be analyzed in a single batch with a turnaround time of 7 hr. This method has been in use in the authors' therapeutic drug monitoring laboratory for nearly two years. It can be simply adapted for the analysis of cyclosporine in kidney samples as a possible aid in the diagnosis of therapeutic failure or toxicity in renal allograft recipients. Examples are given to illustrate the usefulness of frequent monitoring of cyclosporine in stabilizing graft function after organ transplantation. PMID- 3512914 TI - Biocompatibility of haemodialysis membranes. AB - Haemodialysis is widely used as a method of treatment for renal failure; it relies on diffusion across a semipermeable membrane. The exposure of blood to the membrane is associated with a rapid transient fall in white cells, activation of the complement system and a fall in arterial oxygenation. The interrelationship between these phenomena, their dependence on the type of membrane used and their clinical implications are reviewed and discussed. PMID- 3512915 TI - On-line control of atracurium induced muscle relaxation. AB - We described recently a microcomputer system capable of controlling muscle relaxation during surgical procedures; the system was tested and evaluated in 42 clinical trials involving the use of the muscle relaxant, d-tubocurarine. The advent of new non-depolarizing neuromuscular blocking drugs with significant clinical advantages makes it essential that any automatic control system for muscle relaxation can also be used with such drugs, and benefit from their improved properties. This paper describes a series of 22 clinical trials in which our controller was used successfully to control muscle relaxation using atracurium. We also investigated an alternative control strategy, taking advantage of the rapid elimination of atracurium from the body. PMID- 3512916 TI - Forty-eight hours hypothermic perfusion storage of pig and baboon hearts. AB - A system has been developed for the continuous hypothermic perfusion of isolated hearts using a clear fluid perfusate. Myocardial viability has been maintained after periods of storage of up to 48 hr. Pig hearts stored in this way showed almost normal hemodynamic performance on subsequent functional testing. Orthotopic allotransplantation or autotransplantation of baboon hearts stored for 48 hr was followed by good immediate and long-term function. Baboons receiving allotransplants survived until rejection. Three of four of those autotransplanted survived until electively sacrificed at 1, 3, and 12 months; all showed normal hemodynamic function on cardiac catheterization and normal myocardial histology. PMID- 3512917 TI - Intrahepatic filling defects. PMID- 3512918 TI - Complications of tracheal reconstruction. Incidence, treatment, and prevention. AB - Between 1962 and 1982, 416 primary tracheal reconstructions and 21 staged reconstructions were performed. Since then 80 additional tracheal reconstructions have been accomplished (to April of 1985). The first 20 years of our experience (1962 to 1982) have been scrutinized to identify complications and describe their management in patients operated on for tumors or postintubation lesions only. Because the series includes all cases, commencing in 1962 when tracheal surgery was not well developed, many complications reflect a learning experience. The first and second halves of the series have therefore been compared. Measures to prevent complications are discussed. PMID- 3512919 TI - A prospective, randomized study of the effects of prostacyclin on platelets and blood loss during coronary bypass operations. AB - A randomized, double-blind study was designed to evaluate the therapeutic effect and safety of prostacyclin (epoprostenol) in patients undergoing cardiopulmonary bypass. One hundred patients having isolated coronary bypass grafting received 300 units/kg of heparin and then either prostacyclin (12.5 ng/kg/min from heparinization until cardiopulmonary bypass, 25 ng/kg/min during bypass) or buffer/diluent in a similar manner. Standardized anesthetic, perfusion, and surgical techniques were used. Drug and placebo groups were similar in demographic data and bypass times, and there were no deaths. Activated coagulation time and platelet count were significantly higher during cardiopulmonary bypass in patients receiving prostacyclin. Platelet count remained significantly higher 24 hours after bypass in the active drug group. Immediately after operation, there was significantly less prolongation of bleeding time (1.3 versus 2.9 minutes; p = 0.009) in the patients receiving prostacyclin. Blood loss was significantly reduced during the first 4 hours postoperatively in the prostacyclin group (261 +/- 159 versus 347 +/- 197 ml; p = 0.02). There was no significant difference between the groups when total blood loss was compared (710 +/- 351 versus 869 +/- 498 ml; p = 0.07). Patients receiving prostacyclin required an average of 257 ml less blood transfused in the intensive care unit (p = 0.02). We conclude that the clinical impact of prostacyclin in patients undergoing coronary artery operations was demonstrable, but small. Prostacyclin may provide clinical benefits in patients undergoing cardiopulmonary bypass when there are contraindications to or other difficulties with blood transfusion. With prostacyclin, reduced heparin dose is possible and therefore reduced protamine requirement would offer a potential benefit of less cardiovascular depression immediately after bypass. However, the advantages offered by prostacyclin are not sufficient to recommend its routine use during cardiopulmonary bypass. PMID- 3512920 TI - Glucose-insulin interactions during cardiopulmonary bypass. Hypothermia versus normothermia. AB - Since hypothermia is commonly used to lower local and general metabolism during cardiopulmonary bypass, we attempted to identify its specific effects on glucose insulin interactions. A group of nondiabetic patients undergoing hypothermic (28 degrees C) cardiopulmonary bypass with ischemic (cold) cardiac arrest was compared to a similar group operated on under normothermic conditions with potassium cardioplegia. In the absence of exogenous dextrose administration, hypothermia blocked insulin secretion for the duration of the operation. It also inhibited insulin secretion in response to an exogenous dextrose load (e.g., the priming fluid of the cardiopulmonary bypass circuit) or a glucagon injection, but this inhibition was lifted by rewarming. Blood glucose levels, which during normothermia were mildly elevated even in the absence of dextrose administration, remained normal during the hypothermic phase of cardiopulmonary bypass. By the end of the rewarming period, however, blood glucose levels had reached the same level as observed under normothermic bypass, a fact suggesting that the cold inhibition of hepatic glucose production had been only temporary. Cold inhibition of hepatic glucose production also explains why glucose clearance after a sudden dextrose load was initially faster at low body temperature than at normal temperature. Glucose-clamp studies indicated that insulin resistance was initiated by anesthesia and surgical trauma, and further accentuated by cardiopulmonary bypass, in association with elevated levels of hormones indicative of surgical stress. Regardless of body temperature changes, the assimilation of glucose by nondiabetic subjects during and immediately after bypass called for the infusion of large doses of insulin. A comparison with diabetic subjects showed that insulin-dependent patients (type I diabetes) required no more insulin during cardiopulmonary bypass than normal subjects, whereas patients with type II diabetes exhibited a marked insulin resistance during the operation and in the immediate postoperative period. PMID- 3512921 TI - Issues concerning the clinical evaluation of new prosthetic valves. PMID- 3512922 TI - Anti-CD2 (T, p50) intact ricin immunotoxins for GVHD-prophylaxis in allogeneic bone marrow transplantation. AB - We evaluated the inhibitory effects of two immunotoxins (IT) synthesized by linking two different anti-CD2 (T, p50) murine monoclonal antibodies (MoAb) to intact ricin (R). Pretreatment with 1000 ng ml-1 35.1-R or OKT 11a-R inhibited PHA-induced T-cell proliferation by 93% and 86%, respectively. At this IT concentration generation of alloreactive cytotoxic T-cells (CTL) was inhibited by more than 99% by either IT. 35.1-R and OKT 11a were minimally toxic to natural killer (NK) effectors or pluripotent bone marrow progenitor cells (CFU-GEMM). Blocking experiments suggested that 35.1-R and OKT 11a-R might recognize different epitopes of the CD2 (T, p50) surface determinant. Our findings show that anti-CD2 IT may be useful for T-cell depletion in allogeneic bone marrow transplantation. We compared TU3, an equimolar mixture of T101 [anti-CD5]-R, UCHT 1 [anti-CD3]-R and 35.1 [anti-CD2]-R with the TUT-cocktail (a mixture of T101-R, UCHT-1-R and TA-1 [anti-CDw18]-R. TUT is currently under evaluation in Phase 1 clinical trials as a T-cell depletion regimen for GVHD prophylaxis. TU3 was as effective as TUT-cocktail in inhibition of PHA response and CTL generation but unlike TUT spared NK effectors. Cocktails of immunotoxins directed against subpopulations of lymphocytes may be useful for more effective anti-GVHD strategies, and to circumvent problems of graft failure/rejection associated with current purgation regimens. PMID- 3512923 TI - In-vitro infection of chronic lymphocytic leukemia cells by Epstein-Barr virus (EBV). AB - We sought to determine the potential of infecting lymphoid cells from patients with chronic leukemia (CLL) with Epstein-Barr virus (EBV) by testing for EBV receptors (EBVR) by flow cytometry, assessing for infectability of these cells by culturing with B95-8-derived virus, and staining for EB nuclear-associated antigens (EBNA) at various times post-infection. EBVR were present on 54-91% of lymphoid cells in seven cases of CLL and on 46% of prolymphocytic leukemia cells. Dynamic changes regarding EBNA positivity, morphology, and viability occurred post-infection with the virus. On day 2 only a few EBNA-positive lymphoblasts were observed. On days 11-21 positivity increased from 2 to 34% of cells. Simultaneously, the viable cell number declined to approximately 1/10th of original number. A significant proportion of the EBNA-positive cells corresponded to the original CLL cells. In 3 of 7 cases of CLL a Pan T-cell phenotype was demonstrated by Leu-1 monoclonal antibody testing. The infected cells did not react with two monoclonal antibodies, EBV-CS 1 and 4, which react with B-cell lymphoblastoid cell lines (B-LCL). Moreover, the B-LCL derived at 1-2 months post infection of CLL cells did not express the Leu-1 antigen, but expressed EBV-CS 1 or 4 defined antigens. In the prolymphocytic leukemia, 64% of the cells showed EBNA positivity on day 7 and giant cells with huge round or multiple nuclei appeared which were EBNA-positive. CLL and prolymphocytic leukemia cells can be infected as demonstrated by EBNA-positivity. This infection does not lead to immediate transformation, but evokes lymphoblast and multinucleated giant cell production prior to the death of cells. PMID- 3512924 TI - The use of monoclonal antibodies for the identification and classification of acute myeloid leukemias. AB - We reviewed a library of monoclonal antibodies (MoAbs) detecting antigens on myelomonocytic cells and analysed their reactivity patterns as reported in the literature. On the basis of the frequency of positivity with the myelocytic variants (FAB M1-3) or monocytic variants (FAB M4/5) of acute myeloid leukemias, the MoAbs were assigned to one of four groups. MoAbs of Group I identified most cases of both the myelocytic and the monocytic cell lineages ('pan myelomonocytic' reactivity) and can be used to identify acute myeloid leukemias regardless of the subtype. Group II comprised MoAbs which reacted with the majority of FAB M1-3 cases, but showed a preference in reactivity with AMMoL/AMoL cases (reactivity: myelocytic partly, monocytic predominantly). MoAbs of Group III stained most cases with monocytic phenotypes, but labelled only a small percentage of non-monocytic cases. These MoAbs are valuable tools for the detection of cases with monocytic features. Group IV MoAbs reacted with a small to intermediate percentage of myelocytic and/or monocytic cases. Besides their diagnostic application MoAbs might be used in new therapeutic approaches such as in-vivo serotherapy with MoAbs and purging of autologous bone marrow for transplantation. None of the described MoAbs appear to be leukemia-specific. Many MoAbs have been produced against non-myelomonocytic cells and were reactive with cells outside the myelomonocytic cell lineages and the hematopoietic system. Other MoAbs with apparent cell lineage-restricted reactivity regarding normal cells stained leukemic cells of other cell lineages. This phenomenon of translineage reactivity of leukemic cells with mutually exclusive markers indicating a biphenotypic marker profile might be the result of abnormal, disregulated gene expression. New classification systems of acute myeloid leukemias based on immunological marker profiles have been proposed. The analysis of reactivity of normal and malignant myelomonocytic cells with MoAbs has led to refined differentiation schemes of the normal hematopoiesis. PMID- 3512925 TI - Liver transplantation at the Mayo Clinic. AB - A liver transplantation program was begun at the Mayo Clinic early in 1985. Between March and November of that year, 19 liver transplantation procedures were done in 17 patients whose ages ranged from 9 to 54 years. The preoperative conditions in these patients were primary biliary cirrhosis in eight, primary sclerosing cholangitis in four, chronic active hepatitis in three, and biliary atresia and bile duct tumor in one each. The most frequent complication of the transplantation procedure was cytomegalovirus infection, which occurred in six patients but caused moderate to severe systemic symptoms in only two of them. Of the 17 patients who underwent liver transplantation, 15 are alive. Hepatologists have determined predictive factors for survival in potential candidates in order to improve the timing of the transplantation procedure. PMID- 3512926 TI - Increasing prescribed office visits. A controlled trial in patients with diabetes mellitus. AB - Patients who fail to show for scheduled visits or who fail to contact their provider when warning symptoms occur pose important problems for the primary care physician. A group of interventions was examined to determine the effectiveness in increasing the number of prescribed office visits in patients with diabetes mellitus. This group of interventions included mailed packets with information on how to use the clinic, providers' names and phone numbers, after-hours phone numbers, a list of early warning signs, and a booklet on managing diabetes mellitus; mailed appointment reminders; and intense follow-up of visit failures for prompt rescheduling. Eight hundred fifty-nine patients on drug therapy for diabetes mellitus were stratified by risk of hospitalization and randomly assigned within strata to control and intervention groups. The intervention group received all interventions. After 1 year, the intervention group averaged 12% more total contacts than the control group (5.8 vs. 5.2, P = 0.01), due largely to an increase in kept scheduled visits (4.1 vs. 3.6, P = 0.006). These effects were greatest in those patients at higher risk of hospitalization. Also, visit failures were reduced only in high-risk patients. The effect of the interventions did not diminish during the year of study. This systematic and repetitive intervention appears effective in increasing prescribed office visits and is especially effective in patients requiring more frequent care. PMID- 3512927 TI - Including health status in Medicare's Adjusted Average Per Capita Cost capitation formula. AB - Actuarial factors currently comprising Medicare's HMO capitation formula, the Adjusted Average Per Capita Cost (AAPCC), are considered by many researchers to be inadequate as predictors of future period health care costs. While it is often suggested that the formula should incorporate beneficiary health status, no measure of health status suitable for this purpose has yet been identified. The authors present initial results from a study of 1,934 randomly selected Medicare beneficiaries in Michigan. Beneficiaries were surveyed to obtain data on several alternative measures of health status. Medicare claims were used to estimate beneficiary health care costs for periods before and after the survey. In regressions on future period Medicare payments, equations including the AAPCC factors plus a health status measure achieved R2 values ranging from 0.013 to 0.072, depending on the health status measure, compared with an R2 value of 0.003 for the equation with AAPCC factors alone. PMID- 3512929 TI - Therapeutic approaches to the treatment of rheumatoid disease. AB - Successful treatment of patients with rheumatoid arthritis demands an understanding of the rationale, clinical use, and side effects of the various antirheumatic modalities. Most patients can be treated effectively with salicylates or other nonsteroidal anti-inflammatory drugs, although some with more serious disease require the addition of a slow-acting agent such as gold, d penicillamine, or methotrexate. PMID- 3512928 TI - Rheumatoid arthritis: clinical features and pathogenetic mechanisms. AB - Rheumatoid arthritis is a disorder characterized by chronic inflammation affecting predominantly articular tissues, leading in some instances to disruption of the normal structure and function of the joint. In some patients extra-articular manifestations are also present. In the joints, the pathologic lesion consists of synovial cell proliferation with infiltration by inflammatory cells. The complex interaction among these cells is likely responsible for the connective tissue abnormalities that characterize the rheumatoid lesion. The factors responsible for inducing the inflammatory process are unknown. PMID- 3512930 TI - Systemic lupus erythematosus. AB - Systemic lupus erythematosus is a multisystem inflammatory disease characterized by autoantibody production. Recent investigations are providing insights into the immunoregulatory disturbances underlying this disease, and are clarifying the approach to diagnosis and treatment. PMID- 3512931 TI - Polymyalgia rheumatica and temporal arteritis. AB - Polymyalgia rheumatica and temporal arteritis are a clinical syndrome and clinicopathologic entity, respectively. Polymyalgia rheumatica occurs more commonly than temporal arteritis, with approximately half of all patients with temporal arteritis having the polymyalgia rheumatica syndrome. Both conditions are found in the population over 50 years of age and are associated with an elevated ESR. The etiology of both is unclear, although genetic, and potentially, environmental factors may play significant roles. Both conditions respond to corticosteroid therapy, but patients with temporal arteritis require significantly higher doses to control symptoms and to prevent blindness. PMID- 3512932 TI - Hyperuricemia and gout. AB - Gout is a clinical syndrome encompassing a group of metabolic diseases that are all characterized by abnormal uric acid metabolism. In its fullest form, gout is defined by: an increase in the serum urate concentration; characteristic, recurrent, acute arthritic attacks, with monosodium urate monohydrate crystals demonstrable in synovial fluid leukocytes; tophi, usually in and around joints of the extremities, composed of monosodium urate monohydrate deposits; renal disease, often accompanied by hypertension with glomerular, tubular, interstitial, and vascular involvement; and uric acid nephrolithiasis. Any combination of these manifestations may occur, although tophi and urate nephropathy rarely antedate gouty arthritis. PMID- 3512933 TI - "Fibrositis" syndrome. AB - There appears to be as yet undefined but significant and possibly multifactorial elements of personality, stress, or depression in the manifestations and possibly the pathogenesis of FS. If these factors, perhaps amplified by the neurophysiologic effects of disturbed sleep, produce a neurochemical disturbance in CNS function, and if this perturbation includes a reduction or impairment of function involving the pain-modulation pathways, then a simple and perhaps compelling explanation for the experience of pain in FS becomes apparent. Reduced midbrain/brainstem inhibition of ascending nociceptive impulses would clearly explain the finding of tender points in normal-appearing areas of the body, as well as the lack of segmental distribution of discomfort in FS. Local anesthetics, injected peripherally into tender points, would be expected, as is the case, to block pain and tenderness in the local area for the duration of action of the agent used. Analgesics with peripheral activity, such as aspirin and NSAIDs, are relatively ineffective in treating FS, and would be predictably so in a disorder involving reduced central pain inhibition as opposed to increased peripheral nociceptive input. It would not be surprising to find that centrally acting agents, particularly those producing enhancement of serotonergic neurons such as amitriptyline, would provide substantial or total pain relief as well as improvement in mood in a significant number of patients. Most importantly, this concept would highlight the real pain experienced by these patients and the obligation of involved physicians to appropriately diagnose and treat this common pain syndrome. Avoiding excessive conjecture, it is then permissible at the present time to conclude that: FS is a characteristic, clinically common pain syndrome in which aspects of the pain itself appear to be of physiologic origin. Although stress or inherent personality traits may play a role in FS, the relative uniformity in symptomatology virtually excludes conversion hysteria as a major factor in this disorder. The lack of evidence for a disturbance in muscle, fascia, and other soft tissues in FS, the lack of adequate response to NSAIDs, and the frequent response to TCAs suggest that specific dysfunction of the CNS may play a major role in the symptomatology of this entity. Impaired function of the pain-modulation system, located anatomically in the midbrain and brainstem, provides a plausible explanation for the pain and finding of tender points in FS, as well as a potentially rational basis for therapy. PMID- 3512934 TI - Carbocyclic nucleosides. PMID- 3512935 TI - Clandestine drug synthesis. PMID- 3512936 TI - Discriminative stimulus properties of amphetamine and structurally related phenalkylamines. PMID- 3512937 TI - [Benzodiazepine dependence and other long-term adverse effects--a review]. PMID- 3512938 TI - [von Bahr screw migrated in the pelvis in 4 patients with medial column fracture]. PMID- 3512939 TI - [Chlamydia commonly present in the teenage girls consulting the family planning clinics]. PMID- 3512940 TI - [Acute hearing loss in the early stage of acquired syphilis. A historical and a new case]. AB - Acute hearing loss in an early stage of syphilis was frequently seen in the 19th century, but is very rare nowadays. One historical and one recent case of untreated syphilis are reported. Based on studies of the diary of the Czech composer Fr. Smetana the history of his disease is presented. Following an angina, which had lasted for several weeks, a profuse exanthema developed about 16 weeks after the primary infection. Two weeks later ear symptoms with hearing disorder, tinnitus and vertigo began, resulting in total bilateral deafness after some weeks. Exitus 10 years later by taboparalysis. The recent case is a 25 year old male subject. Also following a longstanding angina a profuse exanthema appeared about 8 weeks after the primary infection. Ear symptoms, hearing disorder and tinnitus in one ear, developed one week after onset of the exanthema. By immediate specific treatment a fateful cours like that of Smetana's could be prevented. PMID- 3512941 TI - Chronic cough in infants and children. AB - Chronic cough is an important, sometimes frustrating problem, often encountered by the otolaryngologist-head and neck surgeon. Thirty-eight infants and children under age 16 with a normal chest roentgenogram were evaluated for chronic cough persisting for longer than 4 weeks. Specific therapy (rather than symptomatic treatment) of chronic cough lead to a resolution or control of the cough in 33 (87%). Cough-variant asthma was by far the most common cause of chronic cough, followed by sinusitis, aberrant innominate artery, psychogenic cough, and subglottic stenosis. In addition to a detailed history, physical examination, and chest roentgenogram, endoscopy, paranasal sinus roentgenograms, and pulmonary function studies with methacholine challenge testing were particularly effective for establishing a precise diagnosis. Chronic cough is best managed by determining the precise cause of the cough, then specifically treating the underlying disorder. Children with persistent cough and a normal chest roentgenogram should be referred promptly for evaluation by an otolaryngologist when the primary physician's initial efforts at diagnosis and treatment are unsuccessful. Endoscopy is under-utilized in practice and its importance is understated in the literature. It is particularly helpful in establishing a precise diagnosis in infants under 18 months of age. PMID- 3512942 TI - Simple technique for stabilizing depressed zygomatic arch fractures. PMID- 3512943 TI - Directory of Otolaryngologic Societies. PMID- 3512944 TI - Physostigmine effects in Alzheimer's disease: relationship to dementia severity. AB - Eleven demented patients were administered .004, .009, and .013 mg/kg physostigmine intramuscularly, and placebo, double-blind, in Phase 1. The most effective dose, in terms of showing the best memory score as compared to saline, was repeated during Phase 2. Five patients improved their verbal memory scores in both Phases 1 and 2 after the most effective dose of physostigmine; these five "responders" were found to be significantly more demented than the six "nonresponders." Drug-induced increases in memory scores were significantly correlated with illness severity. Intrusions, which were not a factor in selection of the most effective dose, were reduced in the group as a whole, with the responders showing the most improvement and the nonresponders the least. The association between physostigmine effect and degree of dementia suggests to us that the severe cases may have more permeable blood-brain barriers, and that drug availability to the brain is an important factor in evaluating treatment of SDAT with cholinergic substances. PMID- 3512945 TI - The effect of verapamil is reduced in isolated airway smooth muscle preparations lacking the epithelium. AB - The effect of epithelium removal on the reactivity of rabbit airway smooth muscle to bronchoactive agents and on the effect of verapamil was studied in vitro using preparations from several levels within the respiratory tree, i.e., trachea, primary (10) and secondary (20) bronchus. Methacholine contracted tissues from all three levels of airway. Histamine contracted strips from 20 bronchus, had an inconsistent action in strips from 10 bronchus and was without effect in tracheal preparations. K+ contracted tissues from the trachea and 10 bronchus, and had a mixed action in 20 bronchial strips. Removal of the epithelial cell layer variably affected the reactivity of the smooth muscle to the three agents studied. In 20 bronchus, epithelium removal potentiated responses to histamine and methacholine. In 10 bronchus, only responses to methacholine were consistently augmented. In tracheal preparations epithelium removal did not alter the reactivity of the tissue to any agent examined. Verapamil (1 microM) attenuated responses to all agents and increased in its potency from tracheal through 10 to 20 bronchial preparations. Following epithelium removal, verapamil was substantially less effective in 20 bronchi, yet its effects were unchanged in the trachea. The results indicate that the epithelial cell layer modulates airway smooth muscle reactivity; this phenomenon is apparently widespread in mammals, the modulatory effect is more prominent in the smaller airways, and the magnitude of the effect of verapamil on airway smooth muscle is, in part, related to the presence of the epithelium. PMID- 3512947 TI - Magnetic resonance imaging in obstetrics and gynecology. AB - Magnetic resonance imaging of the female pelvis permits visualization of soft tissue structure previously unseen with other radiological techniques. The internal architecture of the corpus uterus, cervix and vagina are directly visualized in any plane. Furthermore, the hormonal environment of the female can be indirectly determined via assessment of the MR appearance of the uterus. Similarly, the complex changes which occur during pregnancy, such as cervical effacement and the relationship of internal os, fetal part and placenta, are easily documented. MR pelvimetry enables fast, safe depiction of the birth canal. Finally, the demonstrated fetal anatomy may prove particularly useful in the evaluation of intrauterine growth retardation and anomalies indeterminate by ultrasound. PMID- 3512946 TI - Applications of magnetic resonance imaging in diseases of the pediatric central nervous system. AB - Magnetic resonance imaging (MRI) is rapidly becoming the initial diagnostic step in the evaluation of gross abnormalities involving the brain or spinal cord in the pediatric patient. Control of patient motion and support of vital functions are critical if future utilization of MRI is to progress beyond its current outpatient diagnostic role. Currently, MRI's noninvasiveness, sensitivity and multiplanar graphic depiction of the disease process are supplanting the more traditional diagnostic modalities of CT, metrizamide CT, and myelography. PMID- 3512949 TI - Cordell's diary. PMID- 3512948 TI - The banking and clinical use of human skin allograft in trauma patients: the banking of allograft skin in Maryland. PMID- 3512950 TI - [Immunologic methods for assessing neurotoxic and neuro-radiation effects in acute human radiation sickness]. AB - A study was made of a possibility to use immunological methods (the leucocyte migration inhibition test, leukergia reaction, the test of the cold fixation of the complement with cerebral antigen) for the assessment of neurotoxic and neuroradiation effects in total therapeutic irradiation of man at a dose of 10 Gy with preceding polychemotherapy. A rapid development of agranulocytosis made cellular reactions impossible. The above effects could be assessed using humoral specific immunological reactions. A possible role of anticerebral antibodies in the pathogenesis of neurological disorders was discussed. PMID- 3512951 TI - [Familial renal polycystic disease]. PMID- 3512952 TI - [Secretory potentialities of beta cells at early stages of diabetes mellitus]. PMID- 3512953 TI - Septic thrombosis of the dural venous sinuses. AB - From 1940 to 1984, 19 cases of septic dural-sinus thrombosis have been diagnosed at the Massachusetts General Hospital, and some 136 cases have been reported from other institutions. Septic thrombosis most frequently involves the cavernous sinuses (96 cases). Facial or sphenoid air sinus infection often precede cavernous-sinus disease. In addition to the classical signs of proptosis, chemosis, and oculomotor paralysis, isolated sixth-nerve palsy and hypo- or hyperesthesia of the fifth nerve may be found. The major pathogens associated with cavernous-sinus infection include Staphylococcus aureus, other gram-positive organisms, and anaerobes. Septic lateral-sinus thrombosis (64 cases) is almost exclusively a complication of otitis media and/or mastoid infection. Organisms causing this infection include Proteus species, Escherichia coli, S. aureus, and anaerobes. Septic thrombosis of the superior sagittal sinus (23 cases) most frequently accompanies bacterial meningitis or air sinus infection. Causative organisms include Streptococcus pneumoniae, S. aureus, other streptococci, and Klebsiella species. Because septic dural-sinus thrombosis is rare, this disease is frequently misdiagnosed. Evaluation should include lumbar puncture, air sinus films, and computed tomographic scan with contrast. Other helpful diagnostic tests may include carotid angiography, and dynamic brain scan. Orbital venography is the most definitive study in cases of chronic cavernous-sinus thrombosis. Therapy should include intravenous antibiotics and early surgical drainage of purulent exudate in the air sinuses or mastoid regions. Retrospective analysis suggests that treatment with heparin may reduce mortality in carefully selected cases of septic cavernous-sinus thrombosis. Anticoagulation is not recommended in other forms of septic dural-sinus thrombosis. Mortality in the antibiotic-era remains high, particularly in patients with septic thrombosis of the cavernous (30%) and superior sagittal (78%) sinuses. PMID- 3512954 TI - Insulin resistance with acanthosis nigricans: the roles of obesity and androgen excess. AB - The roles of hyperandrogenemia and obesity in the syndrome of severe insulin resistance with acanthosis nigricans were evaluated in studies of 11 females with this condition. Our results in these subjects were compared to evaluations of control subjects matched for degree of androgen excess or obesity. Fasting insulin levels were 3-, 5-, and 15-fold higher in the obese (OB), hyperandrogenemic (HO), and acanthosis nigricans (AN) groups, respectively, when compared to normal females. Responsiveness to a standard bolus of exogenous insulin was 78% of normal in the OB group, 40% of normal in the HO group, and 30% of normal in the AN group. Insulin binding to monocytes from both the OB group, and the HO group was modestly diminished primarily due to decreased receptor number. As a group, AN subjects when compared to either normal or weight-matched controls, demonstrated a significant decrease in monocyte insulin binding predominantly due to a decrease in receptor number. However, two patients in the AN group had normal insulin binding suggesting a postreceptor mechanism for the insulin resistance in at least some of these subjects. In vivo glucose utilization insulin dose response curves were determined in 3 acanthotic subjects using the euglycemic clamp technique. All 3 of these subjects had a right shift of the curve and diminished maximal utilization, consistent with combined receptor and postreceptor defects in insulin action. In evaluating the relationship between hyperandrogenemia, insulin resistance, and acanthosis nigricans, significant correlations among basal levels of plasma insulin, and both testosterone and androstenedione were demonstrated.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3512955 TI - Diabetic autonomic neuropathy. AB - The incidence of autonomic dysfunction as a complication of diabetes mellitus is reported to be as high as 20% to 40%. Symptoms of diabetic autonomic neuropathy (DAN) are often vague, and signs difficult to detect on routine physical examination. The early diagnosis of DAN is possible by utilizing several simple noninvasive tests, which may also be helpful in localizing the lesion(s) to specific autonomic pathways. DAN may affect multiple organ systems, to include cardiovascular, gastrointestinal, genitourinary and/or neuroendocrine, and may, in fact, be life-threatening. The same metabolic disturbances of somatic peripheral nerve may also be responsible for DAN. Like somatosensory neuropathy, definitive therapy for DAN is not yet satisfactory, although multiple chemotherapeutic agents have been tried and warrant further investigation. PMID- 3512956 TI - The influence of plasma insulin concentrations on tissue insulin levels in rodents: a study of the diabetic Chinese hamster and the ob/ob mouse. AB - Immunoreactive insulin was measured in acid-ethanol extracts of kidney, brain, liver, and heart from genetically diabetic Chinese hamsters and their nondiabetic controls and from obese (ob/ob) mice and their thin littermates. Selected samples were filtered on Sephadex G-50 columns and the insulin concentration determined. There was a good correlation between the insulin level measured in the acid ethanol extracts of tissues and the insulin level after gel filtration, suggesting that the concentration measured in the whole extract is representative of the true insulin content. The present data demonstrate that different extrapancreatic organs contain characteristic amounts of insulin that are often (sometimes several-fold) higher than the insulin level of plasma. The tissue insulin concentrations also exhibit a wide range of values, with occasional high values. The data also show a direct correlation between plasma and kidney insulins but no relationship between plasma and brain insulins and a mixed correlation among plasma and liver and heart insulins. PMID- 3512957 TI - The effect of chronic ephedrine treatment on substrate utilization, the sympathoadrenal activity, and energy expenditure during glucose-induced thermogenesis in man. AB - Chronic ephedrine treatment of man has recently been found to enhance the thermogenic response to an acute dose of ephedrine. Conceivably, this sensitization to beta-adrenergic stimulation might also affect the facultative component of diet-induced thermogenesis. The glucose-induced thermogenesis (GIT) was studied in five healthy female subjects after 3 months of chronic peroral ephedrine treatment. Similar experiments 3 months after cessation of treatment served as controls. During chronic ephedrine treatment a sustained 10% elevation of the metabolic rate was found compared to that in the control study. Plasma epinephrine levels were increased 87% during treatment. These increases tended to be positively correlated (r = 0.54, P less than 0.07). GIT expressed as a percentage of the ingested energy load was unaltered during chronic ephedrine treatment compared with that in the control study (9.0% v 8.9%). The respiratory quotient (RQ) indicate that relatively more lipid was oxidized during chronic ephedrine treatment than in the control study. This change was observed in the fasting state as well as after glucose administration. Certain effects of ephedrine seems to be appropriate to a thermogenic drug for the treatment of obesity: A single dose of ephedrine stimulates thermogenesis, an effect that is enhanced during chronic treatment; Chronic treatment elevates the metabolic rate; and The substrate utilization is changed in favor of lipid oxidation. PMID- 3512958 TI - Glucose stimulation of insulin secretion in islets of fed and starved rats and its dependence on lipid metabolism. AB - The influence of a physiologic range of palmitate concentrations (0, 0.25, 0.5, and 1.0 mmol/L) on glucose ability to modify insulin secretion, (U-14C) palmitate oxidation, and (U-14C) glucose incorporation into lipids has been studied in islets isolated from either fed or 48-hour starved rats. Palmitate potentiated the insulin response of fed islets to glucose in a particular dose-related manner. Glucose stimulated secretion was accompanied by a decreased palmitate oxidation and an increased (U-14C) glucose incorporation into di-, tri acylglycerols, and predominantly into phospholipids. These metabolic parameters showed also a positive dependence on palmitate concentration. Starvation increased islet capacity to oxidize palmitate, rendered it insensitive to glucose inhibition, and inhibited both (U-14C) glucose incorporation into all lipid fractions and sugar induced insulin release. The stimulation of islet lipid synthesis by glucose seems to be limited by the exogenous supply of fatty acids and their rate of oxidation. As judged from (U-14C) glucose incorporation data, the rate of phospholipid biosynthesis showed a significant and positive correlation with insulin secretion. This metabolic pathway might provide islet cells with some lipid intermediates (diacylglycerol and/or specific phospholipids) that have been considered as possible mediators of the calcium messenger system. PMID- 3512959 TI - Effects of massive obesity on insulin sensitivity and insulin clearance and the metabolic response to insulin as assessed by the euglycemic clamp technique. AB - Insulin sensitivity was studied in nine nondiabetic massively obese patients (one male and eight females ages 39.0 +/- 2.7 years, body mass index 47.1 +/- 1) by the euglycemic clamp technique (40 microU/m2/min) and compared to seven lean control subjects (three males and three females, ages 34.8 +/- 2.5 years, body mass index 23 +/- 1.1). Fasting plasma glucose, immunoreactive insulin, and C peptide concentrations were higher in the massively obese patients than in the controls (P less than 0.025). Following exogenous insulin infusion, immunoreactive glucagon and C-peptide concentrations decreased similarly in the massively obese patients and controls, indicating normal sensitivity of the alpha and beta cell to insulin. Glucose uptake (M) expressed either as mg X min-1 of fat free mass was significantly reduced in the massively obese patients compared to the controls (P less than 0.001). Similarly, the M/I ratio (glucose uptake per unit of insulin) was significantly reduced in the massively obese patients (P less than 0.001). Free fatty acids and glycerol concentrations measured in the fasting state were significantly elevated in the massively obese patients (free fatty acids 678 +/- 51 v 467 +/- 55 mumol/L, P less than 0.05; glycerol 97 +/- 9 v 59 +/- 11 mumol/L, P less than 0.02). The effects of insulin on antilipolysis was assessed by measuring the reductions in free fatty acids and glycerol concentration during the glucose clamp study. Although the absolute levels remained higher in the massively obese patients, inhibition of lipolysis was similar in both groups.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3512960 TI - Purification and properties of protein synthesis initiation and elongation factors from wheat germ. PMID- 3512961 TI - Isolation and characterization of nitrogenase from Klebsiella pneumoniae. PMID- 3512963 TI - Methods for the isolation of bacterial plasmids. PMID- 3512962 TI - Same day identification of gram-negative rods with the Quantum II Microbiology System. AB - The Quantum II Microbiology System was challenged with 479 strains of Enterobacteriaceae and 155 strains of nonfermenters (contained in the data base) and Aeromonas/Plesiomonas. The percentages of strains correctly diagnosed within 5h (i.e., with out additional tests) at greater than or equal to 80% probability were 78% and at greater than or equal to 50% probability, 84.7%. PMID- 3512964 TI - Toxicity of granular activated carbon treated coal gasification water as determined by the Microtox test and Escherichia coli. AB - The Microtox assay and various parameters (growth, ATP concentration and electrochemical detection) of Escherichia coli were used to assess the toxicity of various levels of granular activated carbon treated coal gasification process water. The generation time of E. coli was statistically significantly slower at the level of 50 percent treatment than any other level of treatment. No differences were seen for ATP concentration per cell or in the electrochemical detection methods for any level treatment. There was a very high correlation between total organic carbon removal by GAC treatment and reduction in toxicity as measured by the Microtox system. However, even the treated water which had 91 percent of the TOC removed was still highly toxic. PMID- 3512965 TI - More experience on the microagglutination test in the diagnosis of Legionella pneumophila infection. AB - The sensitivity of the indirect immunofluorescence (IFA) test in Legionella pneumophila infection is said to be maximal when a plyimmunoglobulin conjugate is used. However commercially available non-class-specific fluorescent antisera are not always sensitive enough to detect IgM antibodies as class-specific conjugates do. IFA test's drawback is its inability to detect early stages of infection. We routinely performed the microagglutination (MA) test in order to check the reliability of this test alone in screening diagnostic work for L. pneumophila group 1 infections. The 252 sera tested were from suspected or confirmed legionellosis cases. Five-hundred and thirty sera from healthy-people, 49 sera from patients with serologically confirmed chlamydia, coxiella and mycoplasma pneumonia, and ten sera from patients with Pseudomonas aeruginosa infection were used as controls. There was a good agreement between IFA and MA tests, the MA proving almost as specific as, and in some cases more sensitive than the IFA test. This was particularly evident in early stages of infection. For these reasons, together with its low cost and the ease to perform, it appears that the MA test can be a useful screening test for presumptive cases of legionellosis even on a single serum specimen. PMID- 3512966 TI - Medical student attitudes to computer-assisted learning in anaesthesia. AB - Two methods of data entry for computer-assisted learning (CAL) programs were assessed and the acceptability of two forms of CAL to 100 medical students determined. Sixty-two per cent preferred keyboard entry of data compared with 26% who preferred the light-pen. There was not preference for dynamic simulation programs over patient management programs. The majority of the students preferred using CAL in groups with a supervisor to provide further explanation when required. Ninety-three per cent of students favoured more teaching using this method. PMID- 3512967 TI - [200 years of digitalis. Controversies in the therapy of heart failure]. PMID- 3512968 TI - Imipenem-cilastatin sodium (Primaxin). PMID- 3512969 TI - Aspirin to prevent myocardial infarction and death. PMID- 3512971 TI - Treatment of advanced ovarian cancer: a randomised trial comparing adriamycin or 4'epi-adriamycin in combination with cisplatin and cyclophosphamide. AB - Fifty-one patients with ovarian cancer were entered in a randomised trial comparing treatment with cisplatin + adriamycin + cyclophosphamide (PAC) to cisplatin + 4'epi-adriamycin + cyclophosphamide (PEC). Complete response rates for the two treatment arms were similar (9/27 PAC, 14/24 PEC). Patients with less than 2 cm residual disease had significantly higher rate of complete remission than those with greater than 2 cm residual disease. Cardiotoxicity was significantly less in the PEC-treated group (0/24) as compared with the PAC treated group (6/27, chi2 = 4.09, p less than 0.05). PMID- 3512970 TI - Treatment of metastatic and recurrent cervix cancer with chemotherapy: a randomised trial comparing hydroxyurea with cisdiamminedichloro-platinum plus methotrexate. AB - In a randomised trial comparing single-agent chemotherapy (hydroxyurea) to combination chemotherapy in advanced cervix cancer, response was seen in 57% (including 13% CR) of patients receiving the combination (DDP + MTX) regimen. Responding patients survived significantly longer (11 months) than either those receiving hydroxyurea or those not responding to combination chemotherapy (4 months). Two patients remain in complete remission for 14+ and 17+ months. PMID- 3512972 TI - A case report and literature review of "primary" pulmonary histiocytosis X of childhood. AB - "Primary" pulmonary histiocytosis X, a well-described entity in young adult males in which pulmonary disease is the overriding site of involvement, is exceedingly rare in children younger than 15 years old. We report a new case in a 2-year-old male and review other reported prepubertal cases. The diagnosis of pulmonary histiocytosis X is based on examination of lung tissue. Langerhans cells containing Birbeck granules, seen by electron microscopy, are virtually pathognomonic of histiocytosis X. These Langerhans cells also react with a monoclonal antibody (OKT6) as well as with antibody to S-100 protein. Based on the lack of consensus for the appropriate treatment of pulmonary histiocytosis X and on our patient's favorable response, we recommend initial therapy with corticosteroids alone, reserving more toxic agents for patients who fail to respond to this initial therapy. PMID- 3512973 TI - Evelyn Lundeen: perinatal pioneer. PMID- 3512974 TI - [A model of an enzyme with mixed cooperation: 3 states of aspartate transcarbamylase]. AB - Allosteric enzyme models on the basis of the known properties of aspartate transcarbamylase (ATCase) from Escherichia coli are suggested. In the first model molecules are supposed to equilibrate between two states. In contrast to the classical Monod-Wyman-Changeux model the symmetry of enzyme molecules changes during the conformational transition. It is shown that the number of binding sites of the enzyme defined from the Scatchard plots is sufficiently dependent on values of parameters of enzyme reaction. This fact results from the mixed (both positive and negative) cooperative effects. However the complex kinetic of ATCase is not completely simulated by this model. Therefore the model is complicated by taking into account the inactive third state of the enzyme. Thus the complex kinetic behaviour of ATCase is explained. The models may be also used for other enzymes. PMID- 3512975 TI - [Symmetry of multienzyme complexes]. AB - A model for studying the symmetry of stable states arising from polyenzymic complex conformations is proposed. A formal scheme of submolecular structure self assembly, on which the model is based, enables it not only to limit the class of conformations but in some cases to determine the structure of a complex in an unambigous manner. The model is shown in its application to polyenzymic complexes of dehydrogenases of alpha-keto acids. PMID- 3512976 TI - [Renal tubulopathy in newborn infants following perinatal asphyxia. Detection by determining beta-2-microglobulin in the urine]. AB - An increased urinary excretion of the low molecular weight protein Beta-2 Microglobulin (B-MG) is a sensitive indicator of renal tubular dysfunction. The B MG concentration of the first, spontaneously after birth voided urine was determined by the technique of counterimmunoelectrophoresis (CIE) in 26 asphyxiated newborns (Apgar score less than or equal to 5 after 1 min). In 10 patients (38%) there was a positive reaction, in 45 control children with Apgar scores greater than or equal to 7 after 1 min only one positive reaction occurred. Within the measuring range of CIE, urinary detection of B-MG can be an early indicator of renal tubular dysfunction. PMID- 3512977 TI - [Neonatal blennorrhea caused by Chlamydia trachomatis]. AB - Chlamydial conjunctivitis was diagnosed in a 5-day-old male newborn. Under treatment with erythromycin the clinical picture of intense swelling of the lid and the copious purulent discharge abated during the following 2 days. Chlamydia trachomatis has become worldwide the most prevalent causative agent of neonatal conjunctivitis. PMID- 3512978 TI - [Unilateral pseudotumor of the orbit--an autoimmune disease?]. AB - An eleven-year-old boy with congenital paresis of the left superior rectus eye muscle developed symptoms of acute left orbital expansion: pain, ptosis, redness, extraocular muscle dysfunction. Computer assisted tomography of the orbit showed typical signs of inflammatory orbital pseudotumor and immunological screening cryoglobulinemia. Short-term treatment with prednisone (2 mg/kg bodyweight/day) rapidly improved symptoms. However several relapses occurred following discontinuation of therapy. Therefore a long-term treatment with corticosteroids was instituted. The simultaneous development of inflammatory orbital pseudotumor and cryoglobulinemia support the hypothesis that orbital pseudotumor is an autoimmune disease. The meaning of the congenital superior rectus muscle paresis in this case for the development of the inflammatory process remains uncertain. PMID- 3512979 TI - [Syndrome of acute alcoholic intoxication and its forensic significance]. PMID- 3512980 TI - [Bacterial phagocytosis of the proximal convoluted tubules in experimental pyelonephritis]. PMID- 3512981 TI - [Erno Emil Moravcsik, most prominent teacher, organizer and practitioner of forensic medicine in Hungary at the turn of the century]. PMID- 3512982 TI - HLA class II antigens and the human thyroid cell: a review. PMID- 3512983 TI - Effects of near-ultraviolet light on mutations, intragenic and intergenic recombinations in Saccharomyces cerevisiae. AB - The effects of far (254 nm) and near (290-350 nm) ultraviolet (UV) light on mutations, intragenic and intergenic recombinations were compared in diploid strains of Saccharomyces cerevisiae. At equivalent survival levels there was not much difference in the induction of nonsense and missense mutations between far- and near-UV radiations. However, frameshift mutations were induced more frequently by near-UV than by far-UV radiation. Near-UV radiation induced intragenic recombination (gene conversion) as efficiently as far-UV radiation and the induced levels were similar in both radiations at equitoxic doses. A strikingly higher frequency was observed for the intergenic recombination induced by near-UV radiation than by far-UV radiation when compared at equivalent survival levels. Photoreactivation reduced the frequency only slightly in far-UV induced intergenic recombination and not at all in near-UV induction. These results indicate that near-UV damage involves strand breakage in addition to pyrimidine dimers and other lesions induced, whereas far-UV damage consists largely of photoreactivable lesions, pyrimidine dimers, and near-UV induced damage is more efficient for the induction of crossing-over. PMID- 3512984 TI - Aneuploidy and other genetic effects induced by hydroxyurea in Saccharomyces cerevisiae. AB - Hydroxyurea induces mitotic gene conversion, mitotic crossing-over, reverse mutation, respiration-deficient petite mutants and aneuploidy in growing cultures of Saccharomyces cerevisiae. Evidence is presented indicating that induction rather than selection is responsible for the increase in frequency of the genetic end points measured. Complications concerning the detection of aneuploidy in the presence of other genetic effects are described, and the need for following the complete protocol for confirmation of the aneuploids in any chemical screening program is emphasized. PMID- 3512985 TI - Quantitative and molecular analyses of ethyl methanesulfonate- and ICR 191 induced mutation in AS52 cells. AB - A pSV2gpt-transformed Chinese hamster ovary (CHO) cell line has been used to study mutation at the molecular level. This cell line, designated AS52, was constructed from a hypoxanthine-guanine phosphoribosyl transferase (HPRT) deficient CHO cell line, and has been previously shown to contain a single, functional copy of the E. coli xanthine-guanine phosphoribosyl transferase (XPRT) gene (gpt) stably integrated into the Chinese hamster genome. In this study, conditions for its use in the study of mammalian cell mutagenesis have been stringently defined. The spontaneous mutation rate (2 X 10(-6)/cell division) and phenotypic expression time (7 days) of the gpt locus compare favorably with those of the hprt locus in wild-type CHO-K1-BH4 cells. While both cell lines exhibit similar cytotoxic responses to ethyl methanesulfonate (EMSO and ICR 191, significant differences in mutation induction were observed. Ratios of XPRT to HPRT mutants induced per unit dose of EMS and ICR 191 are 0.70 and 1.6, respectively. Southern blot hybridization analyses revealed that most XPRT mutant cell lines which arose following treatment with EMS (20/22) or ICR 191 (20/24) exhibited no alterations of the gpt locus detectable by this technique. Similar observations were made for the hprt locus in EMS-(21/21) and ICR 191-induced (22/22) HPRT mutants. In contrast, most spontaneous gpt mutants (14/23) contained deletions, while most spontaneous hprt mutants (18/23) exhibited no detectable alterations. Results of this study indicate that the AS52 cell line promises to be useful for future study of mutation in mammalian cells at the DNA sequence level. PMID- 3512986 TI - Mutagenesis and carcinogenesis by nitropyrenes and cancer chemotherapeutics. Meeting report. PMID- 3512987 TI - Activation of mutagens by hepatocytes and liver 9000 X g supernatant from human origin in the Salmonella typhimurium mutagenicity assay. Comparison with rat liver preparations. AB - The mutagenicity of 10 known genotoxic compounds, of several chemical classes, was measured in Salmonella typhimurium mutagenicity assays comprising isolated human hepatocytes or human liver 9000 X g supernatant (S9) from 4 different individuals, as activating system. The mutagenic activity of several compounds as determined with the Salmonella/hepatocyte suspension assay showed obvious differences when compared with the values obtained in the Salmonella/S9 plate assay. For instance, the mutagenic activity of BZ, DMN and DEN appeared to be much higher in the hepatocyte assay than in the S9 assay. However, 2-AF and 2-AAF were activated more effectively into mutagens in the S9 assay than in the hepatocyte assay. 2-AF was slightly more mutagenic than 2-AAF in the hepatocyte assay, whereas it was far more mutagenic than 2-AAF in the S9 assay. DMN was found more mutagenic than DEN in the hepatocyte assay, whereas in the S9 assay DEN appeared to be slightly more mutagenic. Furthermore, great interindividual differences in the metabolic activation of certain compounds, e.g. BZ and DMN, were observed in the hepatocyte suspension assay, whereas these variations were less evident in the S9 plate assay. Comparison of the mutagenicity data obtained with the human liver preparations, with those obtained with rat liver preparations, showed great interspecies differences in the capacity to activate certain chemicals into mutagens. The use of human liver preparations, in particular isolated human hepatocytes, may be of great value in studies on inter- and intraspecies variations in metabolic activation of genotoxic agents. PMID- 3512988 TI - In vitro activation of chemicals by plants: a comparison of techniques. AB - We have studied the ability of two in vitro plant activation techniques to enhance the mutagenicity of 4-nitro-o-phenylenediamine (NOP) and to activate 2 aminofluorene (2AF). Mutagenic activities of NOP and 2AF were both increased by plant S9 in the Salmonella plate-incorporation and preincubation assays. They were also increased during preincubation with intact plant cells. NOP mutagenic activity was enhanced to a similar extent by plant S9 and by intact plant cells in Salmonella assay, whereas 2AF was activated more extensively by the plant cells than by plant S9. NOP was not enhanced by mammalian hepatic S9 in any assay, whereas 2AF was activated by hepatic S9 under all conditions tested. PMID- 3512989 TI - The effects of pretreatment with cytochrome P-450 inducers and preincubation with a cytochrome P-450 effector on the mutagenicity of genotoxic carcinogens mediated by hepatic and renal S9 from two species of marine fish. AB - A series of experiments was designed to characterize the cytochrome P-450 dependent activation of 7 genotoxic carcinogens in the Salmonella preincubation assay by hepatic postmitochondrial fractions (S9) from the oyster toadfish and the Americal eel and by renal S9 from the toadfish. Significant S9-dependent mutagenicity was observed for benzo[a]pyrene (BAP), 2-aminoanthracene (2AA), aflatoxin B1 (AFB1), 7,12-dimethylbenz[a]anthracene (DMBA) and cyclophosphamide (CP) with hepatic S9 from untreated fish (UI S9) of both species and with renal S9 from untreated toadfish, although renal UI S9 was only marginally effective for activating AFB1. Neither UI S9 from toadfish liver or kidney nor that from eel liver consistently affected the direct mutagenicity of ethylene dibromide (EDB) or substantially activated dimethylnitrosamine (DMN). Pretreatment of toadfish with 3-methylcholanthrene (MC) decreased the mutagenicity of 2AA and increased the mutagenicities of BAP, AFB1 and DMBA, whereas, pretreatment of eels with MC increased the mutagenicities of BAP, 2AA and AFB1. Pretreatment of toadfish with Aroclor 1254 (AC) decreased the mutagenicity of AFB1 and increased the mutagenicity of 2AA, whereas, pretreatment of eels with AC increased the mutagenicities of BAP and DMBA. Pretreatment of toadfish with beta-napthoflavone (BNF) effected changes similar to those by pretreatment with MC except that the mutagenicity of AFB1 was not increased. Coincubation with 10(-4) M alpha napthoflavone (ANF) decreased the mutagenicity of BAP mediated by toadfish MC and BNF S9 and eel AC S9 and decreased the mutagenicity of AFB1 mediated by toadfish MC and BNF S9 and by eel MC S9. Coincubation with ANF increased the mutagenicity of AFB1 mediated by toadfish and eel AC S9 and increased the mutagenicity of 2AA mediated by eel AC S9. Pretreatment of toadfish with MC, BNF and AC decreased the mutagenicity of 2AA mediated by renal S9 and ANF decreased the mutagenicity of 2AA mediated by renal UI and BNF S9. MC pretreatment of toadfish and eels and BNF pretreatment of toadfish induced BAP monooxygenase activity in hepatic microsomes. ANF (10(-4) M) inhibited the BAP monooxygenase activity of MC microsomes from toadfish and eels and of BNF microsomes from toadfish. The conjugation effectors diethyl maleate and salicylamide alone or combined had little or no effect on the mutagenicities of BAP and 2AA mediated by toadfish and eel UI and MC S9.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3512990 TI - An ovulation inducing agent containing clomiphene citrate causes DNA-strand breaks without SOS responses in Escherichia coli. AB - Effects of Clomid, an ovulation-inducing drug containing clomiphene citrate, on Escherichia coli were investigated. Radiation-sensitive mutants, uvrA and recA, were more sensitive to Clomid than the parental wild-type strain. DNA synthesis in these two strains was more depressed by Clomid than that in the wild-type strain. Clomid caused DNA-strand breaks, but few SOS responses such as mutation, induction of prophage and expression of the umuC+ gene were induced. PMID- 3512992 TI - Repair in E. coli of transforming plasmid DNA damaged by psoralen plus near ultraviolet irradiation. AB - Treatment of DNA with psoralen plus near-ultraviolet irradiation gives rise to both monoadducts and cross-links. We have examined the repair of plasmid NTP16 DNA treated in this way in vitro and then used to transform E. coli. Monoadducts are found to be potentially lethal, and can be repaired by uvr-dependent and recA dependent pathways. The presence of a related resident plasmid in the transformed cells can enhance the survival of the incoming damaged NTP16 DNA. This effect is not recA-dependent, and a similar effect (designated "resident enhanced repair") has been observed previously with UV-irradiated plasmids of this particular incompatibility group. Removal of unbound psoralen from the plasmid DNA and exposure to further NUV is known to increase the ratio of cross-links to monoadducts, and we demonstrate that such cross-linked plasmid DNA is not readily repaired following transformation. However in the presence of homologous DNA (related resident plasmid) there is evidence for the repair, and hence uptake by the cell, of cross-linked DNA. PMID- 3512991 TI - The influence of repair systems on the presence of sensitive and resistant fractions in the relation of survival of colony-forming ability in Escherichia coli to UV exposure. AB - In the experimentally observed relationship between survival of colony-forming ability and the amount of exposure to ultraviolet light, two characteristics are generally found. First, sensitive and resistant components often show. Second, there is often a shouldered character to the survival. We present evidence that the first is largely due to the presence of active replication forks in the genome, and that the second is related to the operation of the recombinational repair system. We are able to describe our data in terms of a superposition of single and multiple-hit fractions and to show that the latter are greatly increased, in excision-repair-competent strains, by prevention of protein synthesis for 1 h prior to irradiation. Applying this analysis and treatment to a number of mutant strains enables us to make suggestions as to the interaction between recombinational and excision repair. PMID- 3512994 TI - Genotoxicity of cocoa in a series of short-term assays. AB - Cocoa powder was evaluated for genotoxic activity and found to be inactive in the Ames assay, the mouse lymphoma assay, cytogenetic assays measuring chromosome breakage and SCE, and a cell transformation assay using Balb/c-3T3 cells. Although pure theobromine has been shown to be active in some of these test procedures, the levels of this methylxanthine present in cocoa powder were insufficient to elicit responses in this battery of tests. PMID- 3512993 TI - Genotoxicity of theobromine in a series of short-term assays. AB - Theobromine (3,7-dimethylxanthine) was evaluated for genotoxic activity in a series of in vitro assays. Theobromine was not mutagenic in the Ames assay up to a maximum concentration of 5000 micrograms/plate either with or without S9 activation. The compound also failed to induce significant levels of chromosome aberrations in CHO cells (with and without S9 activation) or transformation in Balb/c-3T3 cells. At the maximum tolerated concentration theobromine increased the frequency of TK-/- mutants in mouse lymphoma L5178Y cells. Increased frequencies were observed both with and without S9 activation and they were reproducible in 2 independent experiments. Statistically significant increases in SCEs were obtained in human lymphocytes and in CHO cells under nonactivation test conditions. The spectrum of results in this battery of tests indicate that theobromine treatment results in the expression of genotoxic potential in some assays and the observed activity appears qualitatively and quantitatively similar to that of caffeine, a closely related methylxanthine. PMID- 3512995 TI - Comparison of the mutagenic activity of 5-hydroxymethyldeoxyuridine with 5 substituted 2'-deoxyuridine analogs in the Ames Salmonella/microsome test. AB - 4 antiviral drugs 5-hydroxymethyldeoxyuridine (HMUdR), 5-trifluorothymidine (F3TdR), 5-methoxymethyldeoxyuridine (MMUdR) and 5-ethyldeoxyuridine (EtUdR) have been evaluated for mutagenic activity in the Ames Salmonella/microsome test. The antimetabolites F3TdR and HMUdR were mutagenic in a dose-dependent manner in strain TA100. F3TdR also was mutagenic in strain TA1535. Rat-liver post mitochondrial supernatant (S9) was not required for mutagenicity. PMID- 3512996 TI - Structure-mutagenicity relationships of chalcones and their oxides in the Salmonella assay. AB - 31 p-monosubstituted chalcones (E-1, 3-diphenylpropene-1-one) and the corresponding oxides (E-1-benzoyl-2-phenyloxirane) were tested for mutagenic activity on two strains of Salmonella typhimurium (TA98 and TA100) with and without rat liver microsomal and cytosolic enzymes. Highest mutagenicity (3.0 revertants/nmole in either strain) was seen with the 4-nitrochalcone, especially after S9 activation. Epoxidation, in general, increased the mutagenic activity of the respective chalcone. Benzoyl (4') substituted chalcones and their oxides with an electron-withdrawing substituent (e.g., nitro, fluoro) usually had higher activity than their phenyl (4) substituted counterparts, whereas the converse was the case with electron-donating substituents (e.g., acetamido, methoxy). Further multiple factorial analysis revealed that increasing hydrophilicity as indicated by the Hansch pi parameter, and resonance electronic contributions were more important than other factors including steric terms in explaining the mutagenicity of these compounds. Mutagenic effects of some chalcone oxides, particularly the 4-methoxy derivative, were markedly decreased by S9 treatment. The consequence of the weak-to-moderate mutagenicity of these compounds to dietary intake of hydroxylated and methoxylated chalcones is discussed. PMID- 3512997 TI - Screening complex hazardous wastes for mutagenic activity using a modified version of the TLC/Salmonella assay. AB - 10 complex hazardous wastes were tested for mutagenic activity using a modified version of the TLC/Salmonella assay developed by Bjorseth et al. (1982). This fractionation/bioassay scheme couples thin-layer chromatography (TLC) with the Salmonella/mammalian-microsome (Ames) assay for the detection of mutagenic constituents in complex mixtures. Crude (unadulterated) hazardous wastes and selected hazardous waste extracts were fractionated on commercially available cellulose TLC plates. Mutagenicity testing was performed in situ by applying a single overlay of minimal growth agar, tester strain TA98 or TA100, and the optional metabolic activation system directly onto the developed chromatogram. A mutagenic effect was indicated either by the appearance of localized clusters of revertant colonies or by an increase in total revertant growth vis-a-vis control plates. 7 of 10 hazardous wastes (including tars, emulsions, sludges, and spent acids and caustics) demonstrated mutagenic activity when tested by this method. To assess the sensitivity of the modified TLC/Salmonella assay, 14 Salmonella mutagens from a wide range of chemical classes and polarities were tested. Selected compounds included heterocyclics, aromatic amines, alkylating agents, antitumor agents, a nitrosamine and a nitroaromatic. 11 of the 14 mutagens were positive in this test system. The 3 compounds refractory to analysis included a polycyclic aromatic hydrocarbon and two volatiles. PMID- 3512998 TI - Characterization of bacterial mutagenicity mediated by 13-hydroxy-ent-kaurenoic acid (steviol) and several structurally-related derivatives and evaluation of potential to induce glutathione S-transferase in mice. AB - Stevioside is a sweet-tasting diterpene glycoside that is derived from Stevia rebaudiana (Bertoni) Bertoni (Compositae). It is used commercially in Japan and other parts of the world as a sucrose substitute. Whereas stevioside demonstrates no mutagenic activity in a variety of test systems, the aglycone, steviol (13 hydroxy-ent-kaurenoic acid), is mutagenic toward Salmonella typhimurium strain TM677 in the presence of a metabolic activating system derived from the liver of Aroclor 1254-pretreated rats. The required activating component is localized in the microsomal fraction of rat liver, suggestive of a cytochrome P-450-mediated reaction. Partially purified epoxide hydrolase does not inhibit steviol-induced mutagenicity, indicating that an active metabolite is not an epoxide that serves as a substrate for this enzyme preparation. The 13-hydroxy group of steviol is required for the expression of mutagenicity since ent-kaurenoic acid is nonmutagenic, and acetylation of steviol at this position negates mutagenicity. Similarly, diterpenes bearing a strong structural resemblance to steviol, cafestol and kahweol, were found to demonstrate no mutagenic activity toward Salmonella typhimurium TM677, as were their respective acetates and palmitic acid esters. Conversely, 19-O-beta-D-glucopyranosyl steviol, a potential hydrolysis product of stevioside, is mutagenic and bactericidal in the presence of a metabolic activating system. Additionally, in contrast to the nonmutagenic diterpenes cafestol and kahweol that are effective as inducers of glutathione S transferase activity, evaluation by administration to mice proved steviol, isosteviol and various steviol glycosides to be inactive in this process. Thus, structural differences among these naturally occurring and semi-synthetic diterpenes appear to impart major differences in biological activity that may relate to human health upon dietary ingestion. PMID- 3512999 TI - Structure-activity relationships of nitro and methyl-nitro derivatives of indoline, indole, indazole and benzimidazole in Salmonella typhimurium. AB - The mutagenic activities of eleven nitro derivatives and eleven N-methyl-nitro derivatives of indoline, indole, indazole and benzimidazole were investigated in Salmonella TA98 and TA100. The presence of a nitro group at C4 or C7 resulted in only weakly or nonmutagenic compounds, while a nitro group at C2, C5 or C6 usually resulted in measurable mutagenic activity in the non-N-methylated compounds. Methylation of a ring nitrogen usually reduced the mutagenic activity of these nitroheterocyclics except 2-nitro-benzimidazole, which resulted in a better than 300-fold increase in mutagenic activity. A proposed mechanism for the increased mutagenic activity obtained by methylation of imidazole nitrogens may provide insights into the reasons for the potent mutagenicities observed for several similarly methylated cooked-food mutagens. PMID- 3513000 TI - Promutagen activation as a function of growth curve dynamics in the plant cell/microbe coincubation assay. PMID- 3513002 TI - The pyrogallol related compounds reduce UV-induced mutations in Escherichia coli B/r WP2. AB - Plant components with bio-antimutagenic activity were screened on UVC (254 nm) induced mutagenesis using E. coli B/r WP2. The components with a pyrogallol moiety including gallic acid, (-)-epicatechin gallate (ECG), (-)-epigallocatechin (EGC) and (-)-epigallocatechin gallate (EGCG) reduced the mutation induction, but other components such as caffeic acid, chlorogenic acid and quercetin did not. The above compounds with a pyrogallol moiety were also effective on UVAB (295-400 nm)-induced mutagenesis, while they showed little effect on N-methyl-N'-nitro-N nitrosoguanidine (MNNG)-induced mutagenesis. As this bio-antimutagenic effect was not seen in the DNA excision-repair-deficient strains WP2s and ZA159, the activity by the above plant components might be based on the promotion of the excision-repair system in E. coli B/r WP2. PMID- 3513001 TI - Determination of the activity of 16 hydrazine derivatives in the bioluminescence test for genotoxic agents. AB - The activity of 16 hydrazine derivatives was determined in the bioluminescence test for genotoxic agents (BLT). Hydrazine compounds that were shown to exert mutagenic activity in the Ames test were also active in the BLT. Isoniazid and p tolylhydrazine which reacted as weak mutagens in the Ames test were highly active in the BLT. PMID- 3513004 TI - Mutagenic activity of biliary metabolites of 6-hydroxymethylbenzo[a]pyrene. AB - The biliary excretion of the carcinogen 6-hydroxy-methylbenzo[a]pyrene was investigated in rats after i.p. administration. Mutagenicity of the parent compound and its biliary metabolites was tested in Ames Salmonella/microsome mutagenicity assay. Approximately 40% of the dose administered (0.25-0.5 mg/kg) to the rats was excreted in the bile within 6 h. 6-Hydroxymethylbenzo[a]pyrene was excreted primarily as water-soluble metabolites, including glucuronide and sulfate conjugates. Negligible quantities of unchanged 6 hydroxymethylbenzo[a]pyrene were excreted in the bile. In the presence of Aroclor induced S9, 6-hydroxymethylbenzo[a]pyrene was a potent mutagen. The mutagenicity of bile from rats treated with 6-hydroxymethylbenzo[a]pyrene was variable in the absence of an activation system. However, the same bile samples were mutagenic in the presence of beta-glucuronidase and/or S9. These results indicate that biliary metabolites of 6-hydroxymethylbenzo[a]pyrene can be metabolically activated to mutagenic species. PMID- 3513003 TI - Mutagenicity of the phenacetin metabolites: N-hydroxy-p-phenetidine and nitrosophenetol in S. typhimurium TA100 and derivatives deficient in nitroreductase or O-acetylase: probes for testing intrabacterial metabolic activation. AB - Two mutagenic metabolites of phenacetin, p-nitrosophenetol and N-hydroxy-p phenetidine, were tested in S. typhimurium strains TA100, its nitroreductase deficient derivative TA100NR, and O-acetylase-deficient strains TA100 Tn5-1,8 DNP1011 and -DNP1012 in the presence or absence of an exogenous metabolic activation system. The results indicate that bacterial nitroreductase(s) and O acetylase(s), shown to be involved in the conversion of certain nitroarenes, are not required for the intrabacterial activation of the two phenacetin metabolites to bacterial mutagens. In view of the low reactivity of nitrosoarenes towards nucleophiles at neutrality, the mechanism by which they exert such a high mutagenic effect in S. typhimurium strains remains to be clarified, but is discussed. PMID- 3513005 TI - Fetal myosin immunoreactivity in human dystrophic muscle. AB - We report immunofluorescence observations on normal and dystrophic human muscle using an antibody (anti-bF) raised against bovine fetal myosin and specific for fetal myosin heavy chains. In rat skeletal muscle, anti-bF was previously found to react selectively with myosin isoforms expressed during fetal and early postnatal development and in regenerating muscles. Anti-bF stained most fibers in human fetal and neonatal muscle, whereas only nuclear chain fibers of muscle spindles were labeled in normal adult muscle. In muscle biopsies from patients with Duchenne's muscular dystrophy, numerous extrafusal fibers were stained: some were small regenerating fibers, others were larger fibers presumably resulting from previous regenerative events. Fetal myosin immunoreactivity in Duchenne's dystrophy appears to reflect the reexpression of fetal-specific myosin isoforms and provides a new valuable tool for identifying regenerating fibers and following their destiny in dystrophic muscle. PMID- 3513007 TI - Selective synthesis and degradation of slow skeletal myosin heavy chains in developing muscle fibers. AB - During fetal development of fast skeletal muscles in the rat, three types of cells could be identified using a monoclonal antibody to slow skeletal muscle myosin heavy chain. Presumptive type I cells stained positive for slow forms of skeletal myosin heavy chain and a previously described protein of an apparent molecular weight of 100 KD, whereas presumptive type 2B cells did not stain for either of these peptides. Presumptive type 2A cells, on the other hand, did not stain for slow isoform of 100-K protein, but did stain positive for slow skeletal myosin heavy chain. There was a progressive suppression or degradation of slow skeletal myosin heavy chain in presumptive type 2A cells during subsequent fetal development, so that it was almost undetectable in most animals at birth. Soleus, a slow muscle, however, did not show clear differentiation into presumptive type I and type 2 cells until 4 days after birth. PMID- 3513006 TI - Caveolae preservation in the characterization of human neuromuscular disease. AB - We have examined freeze-fracture replicas and conventional thin-section images of rat myofibers prepared by perfusion and by conventional immersion fixation protocols, and myofibers of normal and dystrophic human myofibers prepared by similar immersion fixation methods. In both rat and human myofibers, the size and distribution of caveolae was found to differ substantially according to the method of glutaraldehyde exposure, the depth of the myofiber from the surface exposed to the fixative, and if surgically bisected, the distance from the cut end of the myofiber. Conventional immersion fixation resulted in unavoidable but predictable alterations in sarcolemmal caveolae. These reproducible artifacts of fixation technique substantially complicate the use of caveolae as reliable markers for the characterization of human neuromuscular disease. PMID- 3513008 TI - Noninvasive measurement of spinal cord conduction: review of presently available methods. AB - The ability to measure spinal cord conduction velocity noninvasively is limited by available methodology. Surface recording of small spinal potentials, although feasible in infants and young children, is problematical in adults, especially when recording over the cervical spine. On the other hand, indirect methods designed to improve the signal-to-noise ratio, which include recording of somatosensory cortical evoked potentials, F-waves, or other muscle responses, are limited by the unproven assumptions necessary in calculating spinal conduction. Additionally, each method has its own particular limitations. The majority of presently available noninvasive methods take a restricted, or no, account of conduction through the motor pathways. Despite these often serious limitations, each of the reviewed methods does play a useful clinical role in the electrophysiologic investigation of cord disease that is not visible radiologically. Knowledge of them allows for sufficient diversity to tackle most relevant problems until an ideal physiologic method is developed. PMID- 3513009 TI - Kidney function during 12 months of strict metabolic control in insulin-dependent diabetic patients with incipient nephropathy. AB - Thirty-six patients with insulin-dependent diabetes mellitus who had Albustix negative urine but elevated urinary albumin excretion (30 to 300 mg per 24 hours) were matched in pairs according to their urinary albumin level, blood glycosylated hemoglobin level, and sex and assigned randomly to either unchanged conventional treatment or continuous insulin infusion. During the next 12 months a significant improvement in glycemic control was observed in the insulin infusion group, with a reduction in the mean glycosylated hemoglobin level from 9.5 to 7.3 percent. There was no change in the control group (9.3 to 9.2 percent). No significant change in albumin excretion was observed in either group. The mean blood pressure increased slightly in both groups (from 98 to 101 mm Hg in the insulin-infusion group and from 98 to 103 mm Hg in the control group). Kidney size was significantly reduced in all patients during insulin infusion, but no consistent change was observed in the control group. No significant change was observed in the glomerular filtration rate. Our data suggest that the pathologic processes causing microalbuminuria in early renal disease are not reversed during 12 months of strict metabolic control. PMID- 3513010 TI - The market structure of residency training. PMID- 3513011 TI - Comparison of omeprazole and ranitidine in the treatment of reflux esophagitis. PMID- 3513013 TI - Atenolol for alcohol withdrawal. PMID- 3513012 TI - Methotrexate and cyclosporine compared with cyclosporine alone for prophylaxis of acute graft versus host disease after marrow transplantation for leukemia. AB - We treated 93 patients who had acute nonlymphoblastic leukemia in the first remission or chronic myelocytic leukemia in the chronic phase (median age, 30 years) with high-dose cyclophosphamide and fractionated total-body irradiation, followed by infusion of marrow from an HLA-identical sibling. To evaluate postgrafting prophylaxis for graft versus host disease, we studied these patients in a sequential, prospective, randomized trial that compared the effect of a combination of methotrexate and cyclosporine (n = 43) with that of cyclosporine alone (n = 50). All patients had evidence of sustained engraftment. A significant reduction in the cumulative incidence of grades II to IV acute graft versus host disease was observed in the patients who received both methotrexate and cyclosporine (33 percent), as compared with those who were given cyclosporine alone (54 percent) (P = 0.014). Seven patients who received cyclosporine alone acquired grade IV acute graft versus host disease, as compared with none who received both methotrexate and cyclosporine. Thirty-five of the 43 patients given both methotrexate and cyclosporine and 31 of the 50 patients given cyclosporine are alive as of this writing, at 4 months to 2 years (median, 15 months); the actuarial survival rates in the two groups at 1.5 years were 80 percent and 55 percent, respectively (P = 0.042). We conclude that the combination of methotrexate and cyclosporine is superior to cyclosporine alone in the prevention of acute graft versus host disease after marrow transplantation for leukemia, and that this therapy may have a beneficial effect on long-term survival. PMID- 3513014 TI - The plague of Athens. PMID- 3513015 TI - The future supply of physicians. PMID- 3513016 TI - New concepts in the biology and biochemistry of ascorbic acid. PMID- 3513017 TI - Kidney transplantation from unrelated living donors. Time to reclaim a discarded opportunity. PMID- 3513018 TI - Home care--who cares? PMID- 3513019 TI - False positive tests for HTLV-III antibodies in alcoholic patients with hepatitis. PMID- 3513020 TI - Biogen revives forgotten project. PMID- 3513021 TI - Activation of meiosis and sporulation by repression of the RME1 product in yeast. AB - The ability of the yeast Saccharomyces cerevisiae to enter meiosis and sporulate is conferred by the a1-alpha 2 regulatory activity of the mating-type locus. We have cloned the RME1 gene and show that: the RME1 transcript is repressed by a1 alpha 2 in a/alpha cells; overexpression of the RME1 product in a/alpha cells blocks sporulation; and inactivation of RME1 by a null mutation constructed in vitro permits cells lacking a1-alpha 2 activity to sporulate. The RME1 product thus inhibits meiosis; the mating-type locus permits entry into meiosis by repression of RME1. PMID- 3513023 TI - [A new year, an old year; observations on the 130th volume of Nederlands Tijdschrift voor Geneeskunde]. PMID- 3513022 TI - Specific interaction between the p53 cellular tumour antigen and major heat shock proteins. AB - The protein p53 is capable of participating in neoplastic transformation and can form specific complexes with the large-T antigen of simian virus 40 (SV40). This interaction probably results in the stabilization of p53 (refs 7,8) and may contribute to SV40-mediated transformation. Several non-SV40-transformed cells also exhibit a stabilized p53 which is present in elevated levels. Recently, this stabilization was shown to coincide with the ability to precipitate a polypeptide (p68) of relative molecular mass (Mr) 68,000-70,000 by anti-p53 monoclonal antibodies. We now report that this co-precipitation indeed represents a specific complex between the two proteins; the complex sediments on a sucrose gradient as a relatively broad peak of 10-14S and can be dissociated in vitro. Furthermore, p68 is the HSP70 heat shock protein cognate, found in elevated levels in a p53 overproducing cell line. On heat-shock treatment of such overproducers, p53 also forms a complex with the related highly inducible HSP68. PMID- 3513024 TI - [The parents' presence at medical procedures and induction of anesthesia]. PMID- 3513025 TI - [Periventricular leukomalacia in premature newborn infants; a frequently occurring cerebral complication and an echographic diagnosis]. PMID- 3513026 TI - [Mesenteric, omental and retroperitoneal cystic lymphangioma]. PMID- 3513027 TI - [Hendrik van Deventer:'father of modern obstetrics']. PMID- 3513028 TI - [Medical history libraries and collections in Dutch institutions]. PMID- 3513029 TI - [Kidney transplantation in patients with diabetic nephropathies]. PMID- 3513030 TI - [Tuberculosis, does it always come out right?]. PMID- 3513031 TI - [Snellen's letter chart]. PMID- 3513032 TI - [he Nobel Prize for Medicine 1985: studies by M.S. Brown and J.L. Goldstein on (the lack of) control of cholesterol metabolism]. PMID- 3513033 TI - [Intermittent cholestasis in echinococcus cysts of the liver]. PMID- 3513034 TI - More on unified membership. PMID- 3513035 TI - Interpretation of a 'bright' liver in ultrasound examination. PMID- 3513036 TI - Recombinant DNA insulins and diabetes mellitus. Short review and perspective. PMID- 3513037 TI - Immunocytochemical changes in serotonin in the forebrain and pituitary of aging fish. AB - The immunocytochemical distribution of immunoreactive serotonin (ir-5HT) was studied in the forebrain of male platyfish ranging in age from 5 to 30 months (mean life span, 30 months). In fish at all ages, ir-5HT is found in the forebrain in the wall of the third ventricle and its lateral and posterior recesses and in the pituitary in PAS-positive cells of the pars intermedia (PI). With increasing age, ir-5HT first appears in perikarya of the nucleus preopticus (18 months) and in gonadotropes of the caudal pars distalis. Between 8 and 12 months of age, some fish display pale 5HT immunoreactivity in pituitary gonadotropes while in all fish of 18 months and older, the gonadotropes as well as the PI cells show intense 5HT immunostaining. It is suggested that these modifications in serotonin localization may be related to reproductive senescence in platyfish and that they may be associated with other age-related changes in neurohormone and neurotransmitter immunoreactivity. These results are compared with similar age-related changes in the metabolism of neurotransmitters which have been found in mammals. PMID- 3513039 TI - [CT-guided stereotaxic implantation of a deep brain electrode for the stimulation of the internal capsule--a case report]. AB - A 47-year-old man was admitted to our clinic because of the pain of left extremities for four years. The patient developed dysesthesia, hyperpathia and spontaneous pain 2 months after the onset of cerebrovascular accident with left hemiparesis. Using Toshiba TCT-20A CT scanner and Leksell's CT-stereotaxic system, stimulation electrode (by Medtronic Co.) was implanted in the posterior limb of the internal capsule which was 25 mm lateral to the posterior commissure. Ventriculography was not necessary because the target point was directly measured from the axial CT and midsagittal reformatted CT based on 18 axial CT images (2 mm thick slices). Anterior commissure, pineal calcification, posterior commissure and Sylvian aqueduct were demonstrated on the midsagittal reformatted CT by this method. The pain was relieved by the ramped square pulse stimulation (2 V, 0.6 msec, 50 Hz) and receivor system was internalized. The patient was free from pain by 30 minutes-long stimulation four to six times a day. Precise electrode placement was possible by CT images alone using high resolution CT and CT stereotaxic system. CT-guided stereotaxic technique seemed to have an advantages especially for the implantation of electrode in the posterior limb of the internal capsule. The reason is as follows: The target is just lateral to the posterior commissure which could be recognized easily on the midsagittal reformatted CT. The internal capsule is advantageously demonstrated on the axial CT. PMID- 3513038 TI - LHRH neurons in the female C57BL/6J mouse brain during reproductive aging: no loss up to middle age. AB - The numbers of neurons containing luteinizing hormone releasing hormone (LHRH) were examined with specific immunocytochemical techniques in C57BL/6J mice at 5-6 months and 15-16 months of age, the latter being the time of transition to the loss of estrous cycles. No changes were found in the organization, morphology, or numbers of LHRH neurons. PMID- 3513040 TI - [Surgery of medulloblastoma]. PMID- 3513041 TI - Androgenic and estrogenic control of the self-priming effect of LHRH in the castrated male rat. AB - Intact pubertal or young adult male rats release more luteinizing hormone in response to luteinizing hormone releasing hormone (LHRH) if pretreated with LHRH than if pretreated with saline. Castrated male rats do not show this self-priming effect of LHRH. In an attempt to determine the testicular factor responsible for the maintenance of the self-priming effect, pubertal male rats were castrated and implanted subcutaneously with various sizes of testosterone-filled Silastic capsules. Control rats were castrated or sham-operated and implanted with empty capsules. Rats were examined for a self-priming effect 4 days later. All sizes of testosterone capsules used maintained the self-priming effect. Three additional experiments were performed to determine the ability of dihydrotestosterone, estradiol and androstenedione to maintain a self-priming effect. The following groups were included in each experiment: castrated plus empty capsule, castrated plus testosterone-filled capsule, castrated plus one of two sizes of capsule filled with the steroid of interest, and sham-operated plus empty capsule. Dihydrotestosterone and estradiol, but not androstenedione were capable of maintaining a self-priming effect. Since it is generally considered that dihydrotestosterone cannot be aromatized to estrogen, this action of estradiol and dihydrotestosterone is probably accomplished by different mechanisms. PMID- 3513042 TI - Luteinizing hormone release in the anaesthetised cat following electrical stimulation of limbic structures. AB - The release of luteinizing hormone (LH) in response to electrical stimulation of limbic centres, namely the medial preoptic region (MPO) medial basal hypothalamus (MBH) and the medial amygdala (AME) has been studied in the anaesthetised gonadectomized cat. Chronically gonadectomized cats were anaesthetised with pentobarbitone or Althesin and paired bipolar stimulating electrodes were aimed at the MPO, AME or MBH. The effect of electrical stimulation of these regions on the secretion of LH was studied by radio-immunoassay of LH in serial blood samples taken before, during and after stimulation. No change in plasma LH in response to electrical stimulation was ever recorded during pentobarbitone anaesthesia. During Althesin anaesthesia stimulation in the MPO more often than not resulted in a peak of LH release during stimulation. A peak release of LH during stimulation was also recorded when electrodes were placed in the arcuate median eminence region of the MBH. The time-course of these peaks in LH secretion was similar to the time-course of the plasma LH responses recorded following a single intravenous injection of gonadotrophin-releasing hormone (GnRH). In contrast, electrodes placed in AME had no effect on plasma LH during electrical stimulation, but immediately after stopping it, a small LH peak was recorded. The time-course of these responses suggests a pulse release of GnRH, the rapid response to MPO and MBH stimulation possibly being the result of a direct action on GnRH neurons while the delayed AME response may be produced by AME projections to the GnRH release system. These responses could be likened to the surge of LH which in the cat occurs post-coitus. PMID- 3513043 TI - Developmental and sex-specific effects of low dose neonatal monosodium glutamate administration on mediobasal hypothalamic chemistry. AB - Neonatal administration of monosodium glutamate (MSG) to rodents results in severe damage to the arcuate nucleus of the hypothalamus (AN). MSG-induced AN damage produces profound alterations in hypothalamic neurotransmitters and anterior pituitary function. Reproductive function is also severely compromised in both male and female MSG-treated rats. The present study investigated the developmental sequelae of MSG-induced alterations in hypothalamic monoamine metabolism as well as other aspects of MSG toxicity. Female rats given 4 mg/g of MSG on postnatal days 2 and 4 did not exhibit any significant alterations in hypothalamic monoamine metabolism on postnatal days 21 or 30, however, postpubertal MSG-treated females had significantly reduced levels of mediobasal hypothalamic (MBH) dopamine and DOPAC. In contrast, male MSG-treated rats had slight reductions in hypothalamic and MBH dopamine levels but these reductions were not statistically significant. Male MSG-treated rats did exhibit significant reductions in hypothalamic DOPAC on postnatal day 30 and MBH homovanillic acid (HVA) levels on day 100. Acetylcholine levels were also measured in the MBH and pituitary of adult male MSG-treated rats and found to be unaltered. The developmental profile of hypothalamic monoamines and their metabolites and MSG induced alterations in dopamine and DOPAC levels in the MBH of female rats are discussed in relation to the neurochemical mechanisms involved in triggering puberty. PMID- 3513044 TI - Effect of insulin on secretion of bombesin-like immunoreactivity and gastrin from the isolated rat stomach in response to acetylcholine, VIP and leucine enkephalin. AB - Bombesin-like immunoreactivity (BLI), a putative peptidergic neurotransmitter of the gastrointestinal intrinsic nervous system is released from the isolated perfused rat stomach in response to the classical neurotransmitter acetylcholine and in response to other putative peptidergic neurotransmitters such as vasoactive intestinal peptide (VIP), peptide histidine isoleucine (PHI) or growth hormone releasing factor (GRF). The secretion of BLI is modulated not only by gastric factors such as the intragastric pH but also by changes of perfusate glucose concentrations indicating that alterations of carbohydrate metabolism might have an effect on gastric neuroendocrine regulation. Since previous studies have shown that insulin, the major regulatory hormone of glucose metabolism, reduces gastric somatostatin and glucagon secretion it was of interest to determine the effect of insulin on gastric BLI and gastrin secretion. The experiments were performed in the isolated perfused rat stomach model. The addition of porcine insulin to the perfusate at concentrations of 50 and 100 microU/ml had no effect on basal BLI and gastrin secretion. The infusion of acetylcholine (2 X 10(-6)M and 4 X 10(-6)M) elicited a stimulation of BLI and gastrin secretion which was not altered by the addition of insulin (100 microU/ml). On the other hand, significant effects of insulin were observed during administration of the two putative peptidergic neurotransmitters VIP and leu-enkephalin. The infusion of VIP at 10(-11)M and 10(-8)M had no effect on BLI and gastrin secretion in the absence of insulin, however, with the addition of insulin (100 microU/ml) the higher dose of VIP (10(-8)M) elicited a significant stimulation of BLI secretion while both doses of VIP (10(-11)M and 10(-8)M) significantly increased gastrin release. Similar to VIP the infusion of leu enkephalin at doses of 10(-9)M and 10(-6)M had no effect on BLI and gastrin secretion in the absence of insulin. When insulin was added to the perfusate both doses of leu-enkephalin elicited a significant stimulation of BLI secretion while gastrin remained unchanged. The addition of the specific opiate receptor antagonist naloxone (10(-5)M) did not block the effect of leu-enkephalin in the presence of insulin. In addition the effect of naloxone was also examined during cholinergic stimulation. The addition of naloxone (10(-5)M) during the infusion of acetylcholine abolished the stimulatory effect on BLI secretion in the absence of insulin, whereas in the presence of insulin naloxone did not alter cholinergically-induced BLI secretion.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3513045 TI - Demonstration of the vasopressin associated glycopeptide in the brain and peripheral tissues of the Brattleboro rat. AB - An antibody that recognizes the C-terminal portion of the vasopressin precursor was used to visualize this peptide (CPP) in the brain and peripheral tissues of the Brattleboro rat. CPP-immunoreactivity was detected in adrenal medullary cells and in Leydig and Sertoli cells of the testis. In addition, CPP positive cells were found in the supraoptic and paraventricular hypothalamic nuclei of colchicine treated and adrenalectomized rats. These results suggest that Brattleboro rats may make a small amount of normal vasopressin precursor. PMID- 3513046 TI - A transcranial Doppler method in the evaluation of cerebrovascular spasm. AB - An ultrasonic Doppler method was used to monitor flow velocities in basal cerebral arteries in 21 patients with spontaneous subarachnoid hemorrhage (SAH). The time course of vasospasm as evaluated by this technique was similar to that reported in angiographic studies. In 82% of the patients an increase in intracranial velocities to 120 cm/s or more was found during the second or third week after hemorrhage. (Normal value 62 cm/s). Arterial narrowing giving rise to velocities above 200 cm/s was classified as severe spasm. This occurred in 42% of the cases, and a significant decrease in flow velocity in the extracranial carotid artery was found in this group. PMID- 3513047 TI - Radiology of the ambient cistern. Part II: Pathology. AB - A combination of computed tomography and angiography permits accurate detailed evaluation of common lesions of the ambient cistern. PMID- 3513048 TI - Neural transplantation: scientific gains and clinical perspectives. AB - Neural transplantation, once deemed impossible, is being studied in many laboratories. Embryonic CNS from a variety of sites can be grafted into an adult host. The foreign cells differentiate and then produce neurotransmitters or neurohormones. Physical connection can be seen between graft and host. Grafting of fetal tissue may be followed by improved function of animals with experimental forms of neurologic disease or physical injury. Grafted segments of peripheral nerve become innervated by central axons that can conduct physiologic impulses. Grafted glial cells can form myelin within the CNS. Therapeutic grafting into the human nervous system may be feasible, but many scientific and ethical questions remain to be addressed. PMID- 3513049 TI - Familial amyloidosis with cranial neuropathy and corneal lattice dystrophy. AB - A 64-year-old woman had bilateral facial weakness, mild peripheral neuropathy, incoordination, and impaired balance. A corneal transplant had been performed for corneal lattice dystrophy. Sural nerve biopsy showed mild axonal neuropathy with deposits of amyloid in the perineurium. Histochemical studies showed amyloid protein AA in the nerve, but not in cornea or muscle. PMID- 3513050 TI - [Peripheral stenosing-occlusive arteriopathies. Doppler echographic and digital angiographic evaluation]. AB - The value of Doppler ultrasound examination and digital intravenous angiography was comparatively evaluated in 207 patients with peripheral vascular disease submitted to both techniques. Owing to the fact that in some patients more than one vascular district was examined, the overall number of evaluations was 232 Doppler ultrasounds and 233 digital angiographies. Doppler ultrasound revealed a normal picture in 18/232 cases, steno-occlusive disease in 186/232 cases and various pathological conditions in the remaining 18 cases. With digital angiography, normal vascularity was observed in 33/233 patients, while steno occlusive disease was present in 164/233 and vascular anatomical abnormalities, like kinking, were found in 20 cases. Doppler/angiographical correlation was fairly good, being complete in 83/207 patients and substantial (i.e.: the same diagnosis but different degree of pathological involvement) in 79 additional cases: the overall diagnostic agreement between Doppler and angiography was 162/207 cases (78%). False negative Doppler results were 29/207, while the false positive Doppler examinations were 16/207. The most common causes of diagnostic errors are evaluated and discussed, both for Doppler ultrasound and for digital angiography. Arterial kinking and vascular abnormalities are recognized as an obvious cause of wrong Doppler diagnoses which can be easily discovered by the angiographic picture. The usefulness of performing both techniques in combination is demonstrated and stressed. PMID- 3513051 TI - [Edematogenic syndrome in diabetics treated with insulin: a little-known complication]. AB - Two cases of insulin oedema similar to that of nephrotic syndrome were described. It appeared in two diabetic patients after the beginning of insulin therapy, when glycemia was normalized, as described by other Authors, with a spontaneous tendency to decrease. Pleural and pericardial effusion were also associated. The possible pathogenesis of insulin oedema in the two cases was discussed. PMID- 3513052 TI - Neonatal treatment with capsaicin influences hormonal regulation of blood pressure in adult, water-deprived Long-Evans but not Brattleboro rats. AB - Conscious, adult, water-deprived Brattleboro rats treated neonatally with capsaicin or vehicle showed similar hypotensive responses to sequential inhibition of the renin-angiotensin system (with captopril) and antagonism of ganglionic transmission (with pentolinium). Following a comparable experimental protocol, Long-Evans rats treated neonatally with capsaicin showed a more marked hypotensive response to captopril administration than did vehicle-injected animals. Furthermore, following administration of captopril and pentolinium, the capsaicin-treated animals showed marked impairment of the vasopressin-dependent recovery of blood pressure. These results indicate that the greater hypotensive response to captopril in water-deprived. Long-Evans rats treated neonatally with capsaicin may be due to less effective compensation for inhibition of the renin angiotensin system when vasopressin release is impaired. PMID- 3513053 TI - Adenosine deaminase and histidine decarboxylase coexist in certain neurons of the rat brain. AB - The enzymes adenosine deaminase (ADA) and histidine decarboxylase (HDC) were immunocytochemically detected in rat brain. The gross distributions of ADA- and HDC-immunoreactive neurons in the basal hypothalamus were very similar. The superficial layers of the superior colliculus showed only ADA-containing neurons. Using adjacent thin-sections of basal hypothalamus, stained alternately for ADA and HDC immunoreactivity, it was possible to show the two labels localized within the same neurons. These observations imply a relationship between two neurochemically distinct putative neurotransmitter/modulator systems, that of histamine and adenosine. PMID- 3513054 TI - In situ degradation of rapidly transported proteins in nerve terminals of retinal ganglion cells. AB - The in situ degradation of rapidly transported proteins in nerve terminals of retinal ganglion cells was studied in pieces of the superior colliculus of the rabbit. Proteolytic degradation was found to be dependent upon extracellular calcium and intact calcium channels. Degradation was inhibited by leupeptin and SH-group blocking agents. PMID- 3513055 TI - Neurofibrillary tangles from Alzheimer's disease brain purified using a cell sorter. AB - We have used a monoclonal antibody to label and purify neurofibrillary tangles using a cell sorter. The method should prove invaluable in future analyses of the biochemical makeup of neurofibrillary tangles, which in turn will greatly assist our comprehension of tangle pathology. PMID- 3513056 TI - Neuropeptide Y (NPY)-like immunoreactivity in the guinea pig pineal organ. AB - Relatively little is known about mammalian pineal neuropeptides. In the present study neuropeptide Y-like immunoreactivity (NPY-LI) was examined in the guinea pig pineal gland. NPY-LI was restricted to few intrapineal nerve fibers of faint fluorescence intensity. They showed no preferential localization with regard to the different pineal portions. As catecholaminergic fibers are abundant in the guinea pig pineal gland, the scarcity of NPY-LI fibers indicates that in the pineal colocalization of noradrenaline and NPY-LI is not a regular feature, in contrast to other organs. The possibility exists that in the pineal NPY-LI fibers are not of peripheral sympathetic but of central origin. PMID- 3513057 TI - Epidermal growth factor is not detectable in developing and adult rodent brain by a sensitive double-site enzyme immunoassay. AB - A highly sensitive double-site enzyme immunoassay for epidermal growth factor (EGF) was used to quantify EGF concentrations in brain and cerebrospinal fluid of early postnatal and adult mice and rats. EGF was not detectable under any condition at sensitivity levels of 0.06 ng/g wet wt. These observations support the notion that EGF receptors on astrocytes are triggered by other growth factors than EGF. PMID- 3513059 TI - Home care agencies and community health services accredited by NLN October 1985. PMID- 3513060 TI - Practical nursing programs accredited by the NLN 1985. PMID- 3513058 TI - Distribution of neuropeptide Y immunoreactivity in the rat basal ganglia: effects of excitotoxin lesions to caudate-putamen. AB - The distribution of neuropeptide Y-like immunoreactivity (NPY-LI) within the rat basal ganglia was studied using microdissection with a sensitive radioimmunoassay, and excitotoxin lesions were made in an attempt to characterise the neurones containing NPY in this brain area. Immunoreactivity was unevenly distributed in the basal ganglia of control rats, with concentrations in the caudate-putamen (CP) and nucleus accumbens being appreciably higher than those found in the globus pallidus and substantia nigra (SN). Within the CP, immunoreactivity was concentrated in caudal and extreme rostral aspects. N-Methyl D-aspartate lesions of the rostral CP significantly reduced immunoreactivity in this area, whilst levels in other regions of the basal ganglia were unaffected. Neurones containing NPY-LI are likely to be intrinsic to the CP and do not appear to project to the globus pallidus or SN. PMID- 3513061 TI - Aztreonam: early clinical studies in New Jersey. PMID- 3513062 TI - Aztreonam: worldwide clinical experience with the first monobactam. PMID- 3513063 TI - Aztreonam: discovery and development of the monobactams. PMID- 3513064 TI - Planning and implementing a hospital information system. PMID- 3513065 TI - Computerization of nursing department and force field theory. PMID- 3513066 TI - Nutrition classics. Nature, Volume 244, August 10, 1973: Vitamin D-like action of Solanum malacoxylon on calcium transport by rat intestine. By J.M. O'Donnell and M.W. Smith. PMID- 3513067 TI - Augmentation mammaplasty. AB - In the early 1900s, the best method for enlarging small breasts was to inject them with paraffin. Within 50 years, researchers turned to the free grafting of autogenous material to achieve breast enlargement. Then came the fast and easy silicone injections of the 1950s and 1960s. For the last 20 years, the surgical implantation of alloplastic materials has been used for augmentation mammaplasty. This article examines the development of augmentation mammaplasty, identifies the current procedures and looks at the possibility for overcoming the greatest complication, capsular contracture. The management of capsular contracture is difficult because it is the natural, enhanced scarring response of tissue that has been subjected to hosting a foreign body, the prosthesis. There is no simple solution to this problem, only the possibility that through manual manipulation of the augmented breast tissue, the intensity of the contracture can be minimized. PMID- 3513068 TI - Dr Widger's war. A photographic history of the 41st Portable Surgical Hospital 1943-1945. PMID- 3513069 TI - The great biologic problem: vitalism, materialism, and the philosophy of organism. PMID- 3513070 TI - Liver lesion with fever and abdominal pain. PMID- 3513071 TI - 65 years: a profession.... An important service in the development of the Quebec health system. PMID- 3513072 TI - Ultrasound guided fine-needle biopsy of abdominal mass lesions. PMID- 3513073 TI - Adverse reactions to antihypertensive drugs in pregnancy. AB - In conclusion from a clinical pharmacological point of view it is stressed that side effects from antihypertensive therapy in part is related to dosage. Increased knowledge should make it possible to reduce the rate of side effects. In the individual case the physician always has to compare a number of factors: general condition of the patient, age, adherence to the prescribed therapy, side effects, and other factors in addition to blood pressure values. With all these limitations in mind there is agreement that the benefit of antihypertensive therapy far out-weigh the negative aspects of such treatment. PMID- 3513074 TI - Pain killing with calcitonin in patients with malignant tumours. AB - The most essential role of Miacalcic (Calcitonin Sandoz), a 32-amino-acids peptide, is the preservation of osseal integrity. Based on this physiological fact it is assumed that this hormone may have a bone-regenerating effect in bone metastasis formation and sometimes in other malignancies. Though no considerable calcium incorporation could be revealed in our 58 patient treated with Miacalcic, a marked relief of pain was observed in 65.5% of the patients. For objectivation of the subjective pain sensation, the decrease in the quantity of other analgetics used daily, duration of pain and changes of its intensity were studied. These figures were 35.4% on the average, from 12.5-6 h and 23.6%, respectively. The pain-killing character of Miacalcic cannot be explained, but the following assumptions are made: (1) it partially inhibits the synthesis of algogenous peptides; (2) with its possibly cytostatic effect it inhibits the cell proliferation in loco and normalizes the internal pressure of the destroyed region, and (3) by conversion into beta-endorphin it exerts its effect centrally. Compared to the pain-killing effect, the simultaneous improvement of the quality of life seems to be even more essential. It has been proved earlier that a hormone physiologically present, when applied in a high dose, has an analgetic effect, i.e. by utilizing the endogenous substance of the organism, relief of pain can be achieved. We should like to point out that Miacalcic is the only analgetic agent capable of ensuring relief of pain with a simultaneous improvement of the quality of life. Accordingly, the application of Miacalcic in patients suffering from malignant tumours is highly recommended. PMID- 3513075 TI - Controlled phase III clinical study of 4-epi-doxorubicin + 5-fluorouracil versus 5-fluorouracil alone in metastatic gastric and rectosigmoid cancer. AB - The combination of 4-epi doxorubicin (4-epi-DX) and 5-fluorouracil (5-FU) versus 5-FU alone was studied in previously untreated patients with metastatic gastric and rectosigmoid cancer. 5-FU alone was administered at the dose of 12 mg/kg/day i.v. on days 1, 2, 3, 4 and 5 every 3-4 weeks. The combination regimen included 4 epi-DX 40 mg/m2/day i.v., on days 1 and 2 (80 mg/m2/cycle) and 5-FU administered as in the single-agent schedule, but at a somewhat lower dose (10 mg/m2/day i.v. on days 1, 2, 3, 4 and 5). Sixty-two patients with gastric cancer were evaluable, 30 in the 5-FU group and 32 in 4-epi-DX + 5-FU group. The results showed 6 partial remissions out of 30 patients treated with 5-FU alone (response rate 20%) with a median remission duration of 4 months. With 4-epi-DX + 5FU the response rate was 41% (13/32) with 1 complete and 12 partial remissions. The median remission duration was 8 months. The difference in treatment results was statistically significant (p less than 0.05). In rectosigmoid cancer the group on 5-FU included 26 patients who showed a response rate of 19% (5/26). 4-epi-DX + 5 FU resulted in 6 responses (2 complete remissions, 4 partial remissions) out of 27 patients treated (22%). Median remission duration in the 5-FU group was 3 months whereas it was 6 months in the 4-epi-DX + 5-FU group. Toxicity was mild and well tolerated in both treatment modalities. The results of the study in gastric cancer showed a clear-cut superiority of 4-epi-DX + 5-FU over 5-FU alone, while no difference in response rate was observed between the two approaches in rectosigmoid cancer. Nevertheless, rectal localization of primary tumors showed a slightly better response to 4-epi-DX + 5-FU (33 vs. 16%). PMID- 3513076 TI - Ophthalmologists' responsibility to participate in clinical trials. PMID- 3513077 TI - Sodium hyaluronate (Healon) in the repair of perforating injuries of the eye. AB - Sodium hyaluronate (Healon) is a valuable adjunct in anterior segment surgery following trauma, including surgical induced trauma. The application of a few principles permits a wide variety of techniques. PMID- 3513078 TI - Distribution of types I, II, III, IV and V collagen in normal and keratoconus corneas. AB - By using type-specific antibodies to types I, II, III, IV and V collagens, distribution of distinct types of collagen in normal human cornea as well as keratoconus cornea were examined by indirect immunofluorescence microscopy. In normal human cornea, immunohistochemical evidence supported the previous biochemical finding that type I collagen was the major type of collagen in human corneal stroma. No reaction was observed to anti-type II collagen antibody in the whole cornea. Anti-type III collagen antibody reacted with the corneal stroma in a similar fashion as that of anti-type I collagen antibody. Type IV collagen was observed in the basement membrane of the corneal epithelium and in Descemet's membrane. Anti-type V collagen antibody also reacted with the corneal stroma diffusely. Bowman's membrane was strongly stained only with he anti-type V collagen antibody. For further details of the distribution of type I, type III and V collagens in human corneal stroma, immunoelectron microscopic study was undertaken. The positive reaction products of anti-type I and anti-type III collagen antibodies were located on the collagen fibrils, while that of anti-type V collagen antibody was either on or close to collagen fibrils. In keratoconus cornea, no difference was observed in terms of the distribution of type I, III and V collagens, while the disruptive and excrescent distribution of type IV collagen was noted in the basement membrane of the corneal epithelium. PMID- 3513079 TI - Comparison of intraocular irrigating solutions in pars plana vitrectomy. AB - A prospective, randomized, masked clinical study was conducted to examine the effects of pars plana vitrectomy on the corneal endothelium comparing Balanced Salt Solution (BSS) to BSS-Plus as an intraocular irrigating solution. Seventy one patients were followed for at least six months. A significant 6.9% decrease in endothelial cell density was observed among all patients at six months postoperatively, compared to preoperative values, using the contralateral eye as a control. However, no significant difference in endothelial cell loss was found between BSS and BSS-Plus eyes. Both aphakic eyes and those undergoing lensectomy (with vitrectomy) showed a significantly greater reduction of endothelial cell density at six months compared to phakic eyes. No significant difference in corneal thickness was observed at six months postoperatively compared to preoperative values. For the one-year duration of our study BSS was as efficacious in preserving the integrity of the corneal endothelium as was BSS Plus. PMID- 3513081 TI - The origin of the ophthalmoscope. PMID- 3513080 TI - Efficacy of cimetidine/pyrilamine eyedrops. A dose response study with histamine challenge. AB - Eighteen healthy volunteers participated in a histamine challenge, dose response study of cimetidine (H2 antagonist)/pyrilamine (H1 antagonist) eyedrops. This was a randomized, double-masked, multiple-crossover trial, consisting of six visits spaced 48 hours apart. At each visit, subjects were pretreated with one of six different doses of test medication in one randomly selected eye and with vehicle in the fellow eye. Five minutes later, one drop of 0.0075% histamine was instilled in both eyes. Conjunctival hyperemia and edema were graded at various time points during a 20-minute interval after the instillation of histamine. Results indicated that the cimetidine/pyrilamine combination was effective in preventing histamine-induced conjunctival hyperemia in normal volunteers; neither cimetidine nor pyrilamine was effective when administered alone. PMID- 3513082 TI - Xenografting of nasopharyngeal carcinoma into athymic mice. AB - Four nasopharyngeal carcinomas (NPC) with positive Epstein-Barr virus serology were successfully grafted into athymic mice. Tumor growth could be maintained up to the 22nd passage. Strong similarity between original NPC biopsies and xenografts is demonstrated in terms of light microscopy and immunohistochemistry. Growth kinetics show an increase of tumor volume doubling time and a decrease of the labeling index after several passages. Xenografting of NPC into nude mice is evaluated as a useful in vivo tumor model for experimental NPC investigation. PMID- 3513083 TI - The value of flunarizine in the treatment of tinnitus. AB - The suppressive effect of flunarizine on tinnitus was assessed in a double-blind trial in 50 patients with tinnitus due to various causes. The duration of the study was 6 weeks. Serum levels of the drug were determined. The patient's subjective assessment of the effect was taken as criterion for the evaluation; objective tests were found to be unsuitable for this purpose. Ten of the patients suffered from dizziness as a secondary complaint. For the group as a whole, there was no difference between flunarizine and the placebo with respect to the effect on tinnitus, but in the 10 patients with dizziness as well there was a significant difference in favor of the drug. Conclusions cannot be drawn as to the reason for this divergence, because the number of patients was too small. PMID- 3513084 TI - [Sandor Ferenczi and the Hungarian Medical Society]. PMID- 3513086 TI - [Fetal resorption during the early stage of twin pregnancy]. PMID- 3513085 TI - [Prenatal diagnosis of Potter syndrome]. PMID- 3513087 TI - [Dr. Janos Denes 1914-1985]. PMID- 3513088 TI - [Public health and population]. PMID- 3513089 TI - [Three prominent physician-musicians (Mihaly Lenhossek, Geza Farkas, Janos Bokay)]. PMID- 3513090 TI - [Performing xenografts in infants]. PMID- 3513091 TI - [Scurvy epidemics in Transylvania and Hungary]. PMID- 3513092 TI - [Pediatric neurology in the works of Veszpremi, Csapo and Rozen Rosenstein]. PMID- 3513093 TI - Biologic and nonbiologic materials in otologic surgery. AB - Review of the materials used in middle ear surgery high-light numerous advantages and disadvantages of specific substances. Nevertheless, the great variety of materials available suggests that the ideal implant has not yet been identified. PMID- 3513094 TI - The evaluation of therapeutic acupuncture: concepts and methods. PMID- 3513095 TI - Bronchopulmonary dysplasia. AB - Bronchopulmonary dysplasia has become the most common pulmonary sequelae in neonates receiving mechanical ventilation. The pathogenesis of BPD is multifactorial, but prematurity, positive pressure ventilation, oxygen toxicity and pulmonary edema are some of the most important factors in its development. By minimizing these factors, it is possible to reduce the incidence and severity of BPD. PMID- 3513096 TI - Anemia of prematurity. Current concepts in the issue of when to transfuse. AB - At no other time of life is the decision to transfuse potentially as difficult as in the newborn period. Superimposed upon complex "physiologic" changes in the ability to deliver and release oxygen are varying requirements among infants in terms of oxygen need. These are compounded by changes brought about as a direct consequence of frequent phlebotomy in the most ill of preterm infants. Despite the confusion overlying many of the changes occurring at this time of life, certain principles can be applied. Unlike that of the adult, an infant's ability to make oxygen available in response to a specific demand is almost as dependent upon the modifiers of oxygen uptake and release by hemoglobin as upon the hemoglobin concentration itself. These modifiers are constantly changing, sometimes in a predictable fashion, sometimes not. As discussed, some attention to the status of a particular infant's capability in providing oxygen relative to need will assist in the decision when to transfuse. If specific parameters of these assessments can not be determined, it may be necessary to proceed with transfusion based on the clinical presentation of an infant. With regard to the above, any infant sufficiently ill to require frequent blood sampling should have such blood losses replaced, certainly before ten percent of blood volume has been exceeded. This is particularly true in infants who are unable to maintain adequate arterial oxygen tensions with or without the use of supplemental inspired oxygen. At several weeks of age, when the clinical status of a preterm infant may have stabilized, transfusion may or may not be needed during the nadir of the anemia of prematurity. Infants who had been previously transfused or who had earlier received frequent simple transfusions should be able to tolerate lower levels of hemoglobin. Infants without compromised cardiopulmonary function and in whom no unusual metabolic needs exist are unlikely to be aided by transfusions when the hemoglobin concentration is greater than 10 to 11 g/dl. At lower levels of hemoglobin, simple calculations of "available oxygen" may be helpful when it is difficult to determine whether clinical signs and symptoms of anemia exist. Such signs and symptoms may include poor feeding, dyspnea, tachycardia, tachypnea, diminished activity, and pallor. Apnea has not unequivocably been shown to improve following transfusion. Clearly, our current concepts regarding indications for transfusion, even when based upon known principles of physiology, still represent an art form that is less than completely scientific.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3513097 TI - Evaluation of renal function and acute renal failure in the neonate. AB - The diagnosis of renal dysfunction in the neonate can be a challenging problem for the practicing pediatrician. Although there are real differences in renal function between term and preterm infants, overall function is quite adequate in both groups when fluid intake and environmental conditions are carefully controlled. When confronted with an infant with a pathologic decrease in urine output, the clinician must provide adequate fluid resuscitation for the infant with prerenal oliguria without inducing fluid overload in the infant with established, intrinsic renal failure. In addition, the infant with obstruction to urine flow must be distinguished. This requires careful assessment of physical findings and a few key laboratory determinations. Once the diagnosis of renal failure is made, frequent clinical monitoring with anticipation of potential complications is critical. Long-term management of renal failure in infancy and intervention for suspected urinary tract malformation in the fetus have emerged as difficult medical and ethical problems as our technology has advanced. PMID- 3513098 TI - Modern fluid and electrolyte management of the critically ill premature infant. AB - In this article, the authors introduce the concept of a transitional physiology which governs fluid and electrolyte balance in the immediate postnatal period. The important impact of the extrauterine environment on fluid balance is also discussed. Finally, the pathophysiology of diuresis in RDS, and fluid shifts in the VLBW infant with therapeutic recommendations are presented. PMID- 3513099 TI - Coagulation disorders in the neonate. AB - A review is presented of those aspects of hemostatic mechanisms that differ between neonates and older children. Practical laboratory tests to evaluate bleeding disorders in the newborn infant are discussed, as are the most frequently encountered primary and secondary conditions that affect hemostasis, both in the otherwise healthy newborn and in the sick low birthweight infant. Pathophysiology and treatment approaches will be briefly reviewed. PMID- 3513100 TI - Principles of neonatal assisted ventilation. AB - Based on the current knowledge of pulmonary mechanics and the results of clinical studies, we have reviewed principles that govern gas exchange during assisted ventilation in infants with RDS. Guidelines for changes in ventilator settings have been presented with respect to their specific effects on CO2 elimination and O2 uptake. In addition, their possible mechanisms of action and potential side effects have been addressed. General strategies have been presented, but they must be employed with caution. All infants will not exhibit the expected response to changes in ventilator setting, and thus their ventilatory management, as well as their general medical care, will need to be individualized. PMID- 3513101 TI - Carbohydrate metabolism in the fetus and neonate and altered neonatal glucoregulation. AB - Altered glucose homeostasis in the neonate often results from antecedent events during fetal life. This article describes the normal and altered development of glucoregulatory capabilities during perinatal life and relates it to problems of hypo- and hyperglycemia in the neonate. PMID- 3513102 TI - Periventricular-intraventricular hemorrhage. AB - This article reviews the pathophysiology of PV-IVH, the clinical aspects, the means of establishing the diagnosis, and the problem of posthemorrhagic ventricular dilation. The most recent advances are emphasized. PMID- 3513103 TI - Neonatal seizures. AB - Neonatal seizures, as distinguished from nonconvulsive abnormal movements, are a significant problem in neonatal intensive care units. Clinical diagnosis without EEG confirmation is difficult. By virtue of brain metabolic and peripheral physiologic effects, seizures may damage the immature brain. The approach to neonatal seizures should be systematic and directed at establishing the primary etiology. On the basis of tradition, phenobarbital is currently the drug of first choice in the treatment of neonatal seizures. A significant number of neonates with seizures have poor outcomes, and both duration of seizure activity and numbers of anticonvulsants required in treatment predict the outcome. PMID- 3513104 TI - Aerosol delivery to the rabbit lung with an infant ventilator. AB - Little is known about delivery of aerosolized medications to infants undergoing assisted positive pressure ventilation. To assess delivery of medications to the lung with an infant ventilator (Bournes LS104), 27 experiments were performed on anesthetized adult rabbits. Lung deposition was determined by using aerosol radiolabeled with 99m technetium sulfur colloid. Initially a traditional nebulizer was studied and very inefficient delivery to the lung was observed (0.19 +/- 0.10 SD% of the initial nebulizer dose). Subsequent experiments using a nebulizer that generates submicronic aerosol particles, at equivalent aerosol output, achieved a highly significant increase in delivery (1.96 +/- 1.19 SD%, P less than 0.001). Our experiments demonstrated that modifications to to traditional nebulizer systems can enhance delivery of aerosolized medication to the lungs of rabbits. PMID- 3513106 TI - Hepatic imaging in stage IV-S neuroblastoma. AB - Stage IV-S neuroblastoma describes a group of infants with tumor spread limited to liver, skin, or bone marrow. Such patients, who constitute about 25% of affected infants with neuroblastoma, may expect spontaneous tumor remission. We report 18 infants with Stage IV-S neuroblastoma, 83% of whom had liver involvement. Imaging investigations included Technetium 99m sulfur colloid scan, ultrasound, and CT. Two patterns of liver metastasis were noted: ill-defined nodules or diffuse tumor throughout the liver. Distinction of normal and abnormal liver with diffuse type metastasis could be quite difficult, particularly with liver scans. We conclude that patients with Stage IV-S neuroblastoma have ultrasound or CT examination as an initial workup, with nuclear medicine scans reserved for followup studies. PMID- 3513107 TI - Fluid-filled structures simulating solid tumors at ultrasonography--a report on five cases. AB - Five cases with echogenic intraabdominal or retroperitoneal cystic structures are described. Some suggestions as to the differentiation of such findings from solid tumors are given. PMID- 3513105 TI - The functional response of infants with persistent wheezing to nebulized beclomethasone dipropionate. AB - Lung function was measured in nine infants, ages 15-36 weeks, who had persistent wheezing, apparently following acute bronchiolitis, before and after 2 weeks of treatment with either inhaled nebulized beclomethasone dipropionate (BDP) or placebo in a randomized, double blind, crossover trial. The effect of nebulized albuterol (Salbutamol) was measured before and after the steroid treatment. Thoracic gas volume (TGV) and specific airway conductance (SGaw) were determined using a whole body plethysmograph, and forced expiratory flow at resting lung volume (VmaxFRC) was determined with a thoracoabdominal compression jacket. All infants had marked airways obstruction before treatment with mean +/- SE VmaxFRC of 24 +/- 4% predicted and SGaw of 37 +/- 5% predicted. Two weeks of placebo treatment had no significant effect on lung function, but after 2 weeks of BDP inhalation there was a significant rise in SGaw to 61 +/- 7% (P less than 0.005). VmaxFRC increased to 42 +/- 13% but the difference did not reach significance. Respiratory rate and clinical score for retractions and wheezing also fell significantly with BDP therapy (P less than 0.01 and P less than 0.001 respectively). Albuterol had no effect on lung function either before or during steroid therapy. Steroids may have a role in the management of persistent wheezing following bronchiolitis. PMID- 3513108 TI - Cranial ultrasonography of neonatal periventricular/intraventricular hemorrhage: who, how, why and when? AB - The sex, age, and cranial ultrasound (US) findings of 742 premature neonates evaluated over a 3-year period were reviewed retrospectively. Examinations were performed with a mechanical-sector real-time unit using a 5 MHz or 7.5 MHz transducer. The caudothalamic groove was carefully imaged with periventricular/intraventricular hemorrhage diagnosed by previously described criteria. Intracranial hemorrhage occurred in 44% of patients with 20% being Grade 1, 10% Grade 2, 7% Grade 3, and 7% Grade 4. All hemorrhages occurred during the first week of life. Computed tomography is superior to US for demonstrating parenchymal changes and extent of hypoxic damage. Based on our 3-year experience and a review of the literature, we propose an algorithm for cranial imaging of the preterm neonate. This ordered, sequential approach to the premature neonate with possible intracranial hemorrhage permits accurate initial diagnosis as well as appropriate follow-up for potential complications of ventricular dilatation, hydrocephalus, porencephaly, and hypoxic encephalomalacia. PMID- 3513109 TI - Pediatric digital subtraction angiography: intraarterial and intracardiac applications. AB - Intraarterial digital subtraction angiography (IA-DSA) was performed in 80 pediatric patients. Forty-four underwent arterial injections with digital filming techniques. Of the 130 injections, DSA imaging was good or excellent in 121, often allowing resolution of vessels 1 mm in size. Thirty-six of the 80 patients underwent cardiac evaluation with intra-cardiac injections. Improved contrast resolution with IA-DSA allowed the use of smaller catheters (3-4F) and smaller amounts of contrast material. Immediate availability of subtracted images (no film processing delay) resulted in shorter total procedure time. Outpatient studies are possible. IA-DSA provides several notable advantages for the pediatric patient. PMID- 3513110 TI - Renal ultrasound in metabolic bone disease. AB - Fifty-one patients aged 1 year to 56 years with metabolic bone disease underwent renal ultrasound. Medullary nephrocalcinosis was found in nine of 24 patients with X-linked hypophosphatemic rickets and is considered to be iatrogenic, related to vitamin D therapy. Another three in this group of 24 with both medullary and cortical increased renal echogenicity had suffered from repeated episodes of vitamin D intoxication and had secondary hyperparathyroidism. Nephrocalcinosis was less frequent in patients with treated vitamin D-dependent rickets or hypophosphatemic bone disease where generally smaller doses of vitamin D are given. Patients with pseudohypoparathyroidism, on small doses of vitamin D, had a normal renal ultrasound. In cystinosis and Fanconi's syndrome, the kidneys are small, echodense (both the cortex and medulla) with a tendency to cyst formation. PMID- 3513111 TI - Ultrasonographic detection of spontaneous perforation of the extrahepatic bile ducts in infancy. AB - Diagnosis of spontaneous perforation of the bile ducts in infancy depends on the awareness of this rare condition. The purpose of this article is to report a new case of extra hepatic bile duct perforation, review the literature, and describe in detail the ultrasonographic findings. PMID- 3513112 TI - Prolapse of an ectopic ureterocele into both urethra and ipsilateral orthotopic ureter. AB - Ectopic ureteroceles frequently prolapse into the urethra. Inversion of ureteroceles into their own ureters has also been described. This patient showed a ureterocele which not only prolapsed into the urethra but also into the ipsilateral orthotopic ureter. We have not seen nor found a description of prolapse of a ureterocele into the ipsilateral orthotopic ureter. PMID- 3513114 TI - Diarrhea associated with adherent enteropathogenic Escherichia coli in an infant and toddler center, Seattle, Washington. AB - During November 1983, the Seattle-King County Department of Public Health investigated an outbreak of diarrhea associated with enteropathogenic Escherichia coli, serogroup 0111:K58, in an infant and toddler day-care center. Of the 25 children in the center, ranging in age from 4 to 30 months (median age 11 months), diarrhea occurred in 14 characterized by watery, greenish stools. The median duration of diarrhea was 12 days. Two of the ill children were hospitalized because of severe dehydration. Stool cultures from the children diagnosed initially did not yield the common bacterial pathogens, parasites, or rotavirus. Stool cultures from 11 of 14 ill children and two of 11 well children (P less than .005), however, yielded an E coli serogroup, 0111:K58, which was not invasive or toxigenic by standard tests. The source of the organism was not identified. Although this organism has been recognized as a cause of diarrhea in newborn nurseries, this is the first published report of a documented outbreak of enteropathogenic E coli-induced diarrhea in a day-care center in the United States. PMID- 3513116 TI - Multicenter trial of cryotherapy for retinopathy of prematurity. PMID- 3513113 TI - Imaging of neuroblastoma: an overview. AB - This review article briefly describes the pathology, clinical features, prognosis, and treatment of neuroblastoma. The emphasis is on applications of newer diagnostic modalities (sonography, nuclear scintigraphy, computed tomography) for imaging and staging. The potential role of magnetic resonance imaging and spectroscopy is discussed. PMID- 3513115 TI - Juvenile chronic myelogenous leukemia: surface antigen phenotyping by monoclonal antibodies and cytogenetic studies. AB - Cells from three children with juvenile chronic myelogenous leukemia were studied using culture in semisolid media, cytogenetic analysis, and surface staining with the monocyte-specific monoclonal antibodies 61D3 and 63D3. The percentage of bone marrow mononuclear cells that were 61D3- and 63D3-positive was markedly increased in all three patients. Bone marrow and peripheral blood mononuclear cells exhibited exceptionally bright immunofluorescence with these antibodies. The presence of monocyte-specific antigens on the surface of juvenile chronic myelogenous leukemia cells suggests that they are derived from a precursor with monocytic characteristics. A specific chromosomal abnormality (47,XY+21) was present in fresh bone marrow cells from one patient; in contrast, 50 metaphases from phytohemagglutinin-stimulated peripheral blood contained a normal karyotype. The chromosomal abnormality was also identified in myeloid colonies grown in vitro from this patient. Granulocytic elements were demonstrated in tissue sections and in cultured myeloid colonies from this child. Our data suggest that malignant transformation in juvenile chronic myelogenous leukemia involves a myeloid progenitor population capable of differentiation in vitro to cells with monocytic or granulocytic characteristics. PMID- 3513117 TI - Joseph Jones: idiosyncratic student of malaria. PMID- 3513118 TI - James Watt Mavor (1883-1963): a forgotten discoverer of radiation effects on heredity. PMID- 3513119 TI - The balance of a bioassayist. PMID- 3513120 TI - The response of adipose tissue blood flow to insulin-induced hypoglycemia in conscious dogs and rats. AB - A comparative study, focusing on the modification of regional blood flow in adipose tissue during insulin-induced hypoglycemia, was performed on dogs and rats at room temperature (22 degrees C) and on rats at thermoneutrality (28-32 degrees C). Insulin dosages of 3 IU/kg in rats and 0.75 IU/kg in dogs were found to cause changes of comparable amplitude and kinetics in plasma glucose and catecholamine levels in both species. At thermoneutrality, hypoglycemia induced an increase in blood supply to adipose tissue in both species: in dogs, blood flow density was markedly increased from the periphery (+75% in subcutaneous region) to the deeper locations (+550% in perirenal region); in rats, the increase of fractional cardiac output was especially pronounced in brown adipose tissue. By contrast, in rats acclimated at room temperature, hypoglycemia induced a decrease of fractional cardiac output to white adipose tissue and even more markedly, to brown adipose tissue (-45%). These results strongly suggest that, in rats at ambient temperature below thermoneutrality, thermoregulatory heat production is shut off during hypoglycemia. PMID- 3513121 TI - The binding of RecA protein to duplex DNA molecules is directional and is promoted by a single stranded region. AB - RecA protein from E. coli binds more strongly to single stranded DNA than to duplex molecules. Using duplex DNA that contains single stranded gaps, we have studied the protection by RecA protein at various concentrations, of restriction sites as a function of their distance from the single stranded region. We show that the binding of RecA protein, initiated in the single stranded region, extends progressively along the adjoining duplex in the 5' to 3' direction with respect to the single stranded region. The strand exchange reaction is known to proceed in the same direction. PMID- 3513122 TI - A sensitive and rapid gel retention assay for nuclear factor I and other DNA binding proteins in crude nuclear extracts. AB - The paper describes a rapid and sensitive assay for DNA binding proteins which interact with specific and defined binding sites. It exploits the observation that complexes of proteins and small synthetic DNA fragments (40 bp) containing the protein/DNA binding site can enter native polyacrylamide gels and remain stably associated during electrophoresis under non-denaturing conditions. The assay was applied to nuclear factor I, to its identification and purification from porcine liver, to an analysis of its binding site on adenovirus type 5 DNA and to an exploration of other potential binding sites for DNA binding proteins within the inverted terminal repetition of adenovirus DNA. The extreme sensitivity of the assay which surpasses that of conventional footprint assays by at least two orders of magnitude permitted the identification of nuclear factor I like activities in Saccharomyces cerevisiae. PMID- 3513123 TI - Promoters of Agrobacterium tumefaciens Ti-plasmid virulence genes. AB - The DNA sequences of the promoter and 5' upstream regions of six Agrobacterium tumefaciens Ti-plasmid encoded virulence (vir) genes were determined. The transcription initiation sites were mapped by the S1 nuclease protection assay. In the -10 region, the vir promoters share a consensus sequence that is homologous to a DNA sequence found in the same region of E. coli promoters. In contrast, the -35 region sequences are variable. Several vir genes contain two common hexanucleotide sequences, 5'CGAGTA3' and 5'GCAATT3'. Translation initiation codons for all vir genes, except virG, are preceded by sequences homologous to the ribosome binding site sequences found in E. coli. PMID- 3513124 TI - The primary structure of chicken B-creatine kinase and evidence for heterogeneity of its mRNA. AB - cDNA clones for chicken B-CK were isolated by immunoscreening from a gizzard cDNA library constructed in the expression vector lambda gtll. The entire coding portion in addition to the complete 3' untranslated region and 42 bp of the 5' noncoding part are represented in the clone H4. On RNA blots H4 insert DNA hybridized to a 1600 bp poly(A)+ RNA from gizzard, brain and heart but not to breast or skeletal muscle RNA. In vitro generated sense strand transcripts of H4 insert DNA were translated in vitro into a protein indistinguishable from isolated, authentic B-CK. The distinct nucleotide sequences of H4 insert DNA and M-CK cDNA were translated into 82% homologous amino acid sequences. Sequence heterogeneity among the B-CK cDNA clones within both the 3' noncoding and even in the coding region indicates the existence of multiple B-CK mRNA species. PMID- 3513125 TI - In vivo events in the generation of pBR322. PMID- 3513126 TI - Effect of salts on abortive and productive elongation catalysed by wheat germ RNA polymerase II. AB - Modification of the ionic conditions in reaction assays containing wheat germ RNA polymerase II and poly(dAT) as template markedly alters the catalytic properties of the transcription complexes. These effects have been studied by measuring the rate of abortive initiation and the extent of productive RNA synthesis. Using combinations of metal ions or various salts, a marked inhibition of abortive initiation was always associated with an increased length of RNA chains. These results are discussed in terms of modulation of the stability of transcription complexes induced by salts or divalent cations. The behavior exhibited by wheat germ RNA polymerase II is also discussed in comparison with previously reported results for procaryotic and eucaryotic RNA polymerases. PMID- 3513128 TI - Papworth's progress. PMID- 3513127 TI - Nucleotide sequence of the gene coding for yeast cytoplasmic aspartyl-tRNA synthetase (APS); mapping of the 5' and 3' termini of AspRS mRNA. AB - A 3.8 Kb DNA fragment, which contains the structural gene of aspartyl-tRNA synthetase (AspRS) and its flanking regions, has been fully sequenced by the combined M13/dideoxy chain terminator method. From the single open reading frame of correct length (1671 bp) we deduced an amino acid sequence consistent with that of several peptides of AspRS. No significant internal sequence repeats were observed in the primary structure of the protein. The AspRS gene (APS) has a codon usage pattern typical of non abundant proteins. S1 nuclease analysis of APS mRNA showed a major start 17 bases downstream from a "TATA box" and stops near an RNA polymerase terminator sequence. PMID- 3513129 TI - Changing factors and changing needs in women's health care. AB - The aforementioned social trends affecting women, including women in poverty, women in the labor force, and elderly women, are all ultimately related to problems of access to health care. In almost every age group, women use more health and medical services. Women are hospitalized more often, although their stays in hospitals tend to be shorter. Women also make more visits to health care providers for preventive health care, such as examinations and dental care. Access to care, however, is tied to ability to pay for the care. Medicaid payments for medical care are related to eligibility criteria in each state. Recent cuts in federal programs targeted eligibility for welfare and Medicaid. In 1982, 725,000 welfare recipients were declared ineligible. Given the earlier discussion of the predominance of women among those labeled poor in this country and the fact that two thirds of Medicaid recipients are women, these cutbacks have serious implications for women's health. Women are less likely to have medical insurance than men. Insurance coverage as a benefit is least likely to be offered in those areas where women work: part-time employment, small businesses, and manufacturing industries. Insurance eligibility is often dependent on a woman's marital status, despite the fact that 41.5 per cent of all American women are not spousal dependents. Insurance companies frequently adjust premiums for sex, age, income, race, and workforce characteristics, a policy which works against women. As the field of women's health expands and receives more emphasis, the data reflecting the experiences of large groups of women will have to be collected and analyzed ever more carefully. Information collected should include physiologic, psychosocial, and economic factors that together affect the health status of women. These data may then be used to guide health policy decision making, as well as provide a basis for health promotion and disease prevention interventions with individual clients. PMID- 3513130 TI - Myths of masculinity. Impact upon men's health. AB - This article focuses on men's stereotyped roles in contemporary American society and the behaviors required to fill these roles. The potential costs incurred by men socialized into these roles are identified and explored in terms of currently available morbidity and mortality data. Conclusions give consideration to nursing practice, education, and research. PMID- 3513131 TI - Developmental concerns and the health of midlife women. AB - Prior to providing anticipatory guidance to a woman approaching or at middle age, the nurse should explore her own and her client's expectations of middle age and work to dispel any existing myths. Menopause is not inevitably a time of increased depression or nervous symptomatology. In addition, women whose children are gone from the home are not at increased risk for depression or low life satisfaction. However, we do know that the majority of women experience vasomotor symptoms including hot flashes and night sweats which are directly attributable to the hormonal changes accompanying menopause. The middle-aged woman may begin to note changes in her physical appearance and level of physical energy. This point in life can also be associated with a variety of transitions, including changes in the parental and marital role, the care and death of aging parents, and the loss of a spouse through death or divorce. As the familial environment changes for a woman, work outside the home may take on a different meaning. This stage of life can be one of growth as the woman seeks new directions or it can be a time of dissatisfaction. No one factor distinguishes those who cope well from those who do not. When identifying those women at risk for midlife developmental crises, the nurse must consider the interaction risk for midlife developmental crises, the nurse must consider the interaction of multiple factors. Preliminary evidence suggests that some women may experience a decreased sense of life satisfaction at the time of menopause.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3513132 TI - Nursing and men's health. Some critical considerations. AB - This article addresses issues concerning the relationships among nursing, a nascent "men's health" movement, and the established "women's health" movement. Suggestions are made in regard to the potential positive contributions of a men's health movement that recognizes masculinity as a social reality while aiding men with health problems from a holistic nursing perspective. PMID- 3513133 TI - Unemployment and health. Health promotion for the jobless male. AB - This article reviews the effects of joblessness on health, with a special emphasis on men. This serves as the basis of a model for health promotion for the unemployed male, bringing together personal, family, and community resources. Health care policy is also considered. PMID- 3513134 TI - Cardiovascular disease. A men's health hazard. AB - This article reviews the literature on cardiovascular disease in men. Factors believed to contribute to the development and progression of atherosclerosis are discussed. Recommendations for nursing practice and research are considered. PMID- 3513135 TI - Women's health. Changing definitions; changing times. AB - The implications of the above observations and questions are far from prescriptive. During this time of rapid social change and economic retrenchment, there is a need for both individual and professional clarification of values. An awareness of one's philosophy of life and philosophy of nursing requires constant re-evaluation and may reflect personal developmental changes, changes within nursing, and changes in social demands. Woods' schema for evaluating health phenomena by considering variables in context and with an awareness of developmental dimensions might well be used as a model for such personal and professional self-evaluation. It is only following such efforts that it will be possible to make knowledgeable decisions about the relationship between philosophy and public policy, personal/private behavior, and public/social consequences. Social change is invariably accompanied by a disquieting ambivalence. Whether one agrees with the philosophies of the women's health movement, one fact is clear. Change has occurred and it is no longer possible to ignore the paternalistic tendencies within the health care field. When lay magazines proclaim that the women's health movement is in the forefront of the consumer movement, it behooves all health care professionals to be aware that consumers will be seeking more information, more power in decision making, and will expect professionals to share responsibility for the development of treatment plans and for the evaluation of such treatments. Consumers and nurses can be expected to continue to demand that their experiences and perspectives be valued and taken into consideration. PMID- 3513136 TI - From patient to consumer; from apprentice to professional practitioner. AB - Women as patients as well as providers within the health care area may yet benefit from the transformations taking place within the medical industry. The evolution from patient to consumer during this past century was fraught with reactions to overzealous paternalism and the misguided notion of separatism as a route to equality. Women's work was confined to her separate sphere and was limited to the privacy of the home or within certain circumscribed work roles "for women only," whereas the work of men involved functioning publicly in the world at large. Historically this situation relates to a key disability of nursing, that is, its dependent relationship to organized medicine which served to limit its advancement. For even though nurses could enter the public male environment of the hospital, they could do so only with the expectation that they were there to serve the physician. All women were limited by the Victorian mentality that prescribed unequal status for them in society. The active optimism which finally resulted in suffrage for women in 1920 offered promise of integration in educational and professional opportunities which remained unfulfilled decades later. In the last half of this century, the resurgence of social reforms dealing with civil rights, consumerism, and born-again feminism has once again stimulated great expectations. The ultimate solution must lie somewhere in the middle ground, where competence determines the provider and an informed compassion meets the needs for health care. PMID- 3513137 TI - Identification and referral to cancer related resources in the United States. PMID- 3513138 TI - Pharmacology and clinical use of mexiletine. AB - Mexiletine is an antiarrhythmic agent with structural and electrophysiologic properties similar to those of lidocaine. Mexiletine decreases ventricular automaticity while shortening both action potential duration and effective refractory period. The drug may be administered orally or intravenously. Hepatic metabolism is the major route of elimination. The elimination half-life is approximately 10 hours, but longer in patients with acute myocardial infarction, chronic congestive heart failure or hepatic insufficiency. Mexiletine suppresses ventricular ectopy in the acute phase of myocardial infarction. The drug is effective for some patients in whom lidocaine has failed. It suppresses chronic ventricular ectopy and is well tolerated in approximately two-thirds of stable outpatients treated with this agent. In that population, mexiletine is comparable in efficacy to quinidine, procainamide and disopyramide. It is effective in 30 50% of patients with ventricular arrhythmias refractory to other antiarrhythmic drugs. In patients with refractory arrhythmias, the efficacy of mexiletine may be enhanced by combination with propranolol, quinidine or amiodarone. Adverse reactions limit use of mexiletine in approximately 20% of patients. Gastrointestinal and central nervous system side effects are the most common. Mexiletine does not depress myocardial function. Aggravation of arrhythmias is uncommonly observed. The usual intravenous dose of mexiletine is 150-250 mg over at least 10 minutes. Long-term oral dosages are usually 200-300 mg 3 or 4 times daily. PMID- 3513140 TI - Infected cephalhematoma and neonatal osteomyelitis of the skull. PMID- 3513139 TI - Rapid latex agglutination compared with the throat culture for the detection of group A streptococcal infection. AB - The Culturette Brand rapid latex agglutination test was compared with the throat culture for accuracy in detecting Group A beta-hemolytic streptococci (GABHS) on paired throat swabs from 1047 children with suspected streptococcal pharyngitis. In this comparison the rapid latex agglutination test had a sensitivity of 78%, a specificity of 88%, a positive predictive value of 52% and a negative predictive value of 96%. In 45 study patients from whom it was possible to obtain paired acute and convalescent sera, the latex agglutination test and the throat culture were compared against each other for detection of infection due to GABHS as evidenced by a 4-fold or greater titer rise of serum antistreptococcal antibodies. The latex agglutination test detected and failed to detect the same number of infections as the throat culture. Thus although a significant number of false positive latex agglutination tests occurred when compared to the throat culture, there is limited evidence in this study that the latex agglutination test is equal to the throat culture in detecting patients who have serologically confirmed infection due to GABHS. PMID- 3513141 TI - Nontyphoidal Salmonella pericarditis: a case report and review of the literature. PMID- 3513142 TI - Bruch's De Morbis Glandulae Prostatae: an early account of prostatic diseases (1835). AB - This Latin dissertation on diseases of the prostate gland was written by the German physician Maximillian J.F. Bruch at the Freiderick Wilhelm University. This English translation permits a rare glimpse into the early medical thinking on prostatic diseases. PMID- 3513143 TI - Etiologic factors in diaper dermatitis: the role of feces. AB - While the etiology of diaper dermatitis in infants is complex, it is generally believed to involve an interaction between skin and irritants in feces and urine. Proteases and lipases were identified as the major irritants in the feces of infants, and bile salts were found to potentiate the damage produced by the action of fecal enzymes on skin. Fecal enzymes also increased the permeability of skin, thereby increasing potential susceptibility to other irritants in the diaper environment. PMID- 3513144 TI - Bart's syndrome: microscopic, ultrastructural, and immunofluorescent mapping features. AB - Bart's syndrome has been clinically described as the association of congenital localized absence of skin (CLAS), epidermolysis bullosa (EB), oral mucosal lesions, and dystrophic nails. Transmission occurs through an autosomal dominant gene with complete penetrance but variable expression. It has been difficult to classify this type of EB because of lack of microscopic and ultrastructural studies on affected family members. This is the first report of microscopic, ultrastructural, and immunofluorescent mapping studies of an affected individual with the complete inherited syndrome initially described by Bart. This study is also the first to document the association of CLAS and dominant dystrophic epidermolysis bullosa by histology, electron microscopy, and immunofluorescent mapping. Our two patients and one other affected family member had diminution or absence of a specific basement membrane antigen as defined by immunofluorescence with a monoclonal antibody (KF-1) in perilesional skin. PMID- 3513145 TI - Cholecystitis occurring without stones. AB - A case of acalculous cholecystitis in a 65-year-old man with underlying diabetes mellitus, hypertension, and peripheral arteriosclerosis is presented here. His case remained diagnostically puzzling for some time until symptoms and signs became more severe and very suggestive of acute cholecystitis. The clinical impression was then supported by an abnormal radioisotope biliary scan. The scan has fairly good sensitivity in detecting this condition but may not be totally dependable. Acalculous cholecystitis is an unusual but serious variant of a common disorder in which treatable gallbladder disease may masquerade as a less treatable liver malady. A common denominator among this disorder's many etiologies may be impairment of the gallbladder microcirculation in the presence of one or more conditions that lower the gallbladder's resistance to bacterial invasion. Prompt detection and treatment are desirable to reduce morbidity and mortality. However, early diagnosis is not always possible, because the clinical picture often is unclear, clear, gallstones are absent, and laboratory test results may be normal or equivocal. As in the case reported here, the vague clinical picture may dictate following a patient until the illness reaches an intensity acute enough to permit identification. The greatest aid to earlier diagnosis for the physician faced with circumstances similar to those described here is to think of cholecystitis and then to give strong weight to that clinical suspicion. At times, a recommendation for cholecystectomy may have to be made mainly on clinical judgment. PMID- 3513146 TI - Unusual mucocutaneous infections in immunosuppressed patients with leukemia- expansion of an earlier study. PMID- 3513147 TI - Hypnotherapy in children. New approach to solving common pediatric problems. AB - Physicians have long used the power of suggestion informally in their practice as a means of motivating patients and boosting compliance. Recent research shows that formal use of hypnosis can be a valuable primary or adjunctive therapy, especially in children. Children are more in touch with innate imagery processes than adults and consequently can learn and use self-hypnosis easily, particularly to control autonomic responses. Hypnotherapy has proven useful in habit and behavior disorders, psychophysiologic disorders, pain control, anxiety control, cellular growth, and chronic conditions. The cases reported here illustrate the effectiveness of this process in children. Before hypnotherapy can be used clinically, the physician should become certified by an association approved by the American Medical Association and know when hypnotherapy is indicated and how long it should be continued. PMID- 3513148 TI - Two aerosol sprays in nipple trauma. PMID- 3513149 TI - Treatment of intermittent claudication with inositol nicotinate. PMID- 3513150 TI - Cadexomer iodine in the management of venous leg ulcers in general practice. PMID- 3513151 TI - Antenatal sonographic diagnosis of arthrogryposis multiplex congenita. AB - Arthrogryposis Multiplex Congenita (AMC) was suspected on ultrasound examination of a fetus at 30.5 weeks of gestation. The criteria for establishing this prenatal diagnosis as well as the importance of establishing the diagnosis at any gestational age are discussed. The diagnosis of AMC was confirmed at birth in this case. PMID- 3513152 TI - Anatomic correlates of ultrasonographic prenatal diagnosis. AB - In utero sonographic diagnoses from forty-five malformed infants were correlated with their autopsy findings. Fifty-two malformations were diagnosed prenatally in 42 of the patients but 90 additional malformations were not. Nine sonographically diagnosed abnormalities were not confirmed at autopsy. Factors compromising sonographic diagnosis included: limited examinations, small fetal size, timing of examination, oligohydramnios, fetal position, nature of the malformation and unfamiliarity of the ultrasonographer with specific malformation syndromes. In utero ultrasonography is an invaluable tool of diagnosing congenital malformations but has limitations. PMID- 3513153 TI - [Autopsy protocol of Emperor Maximilian II. An autopsy report in the German language 1576]. PMID- 3513154 TI - [Isolation and properties of enzyme preparations from the whale pancreas]. AB - A simple and convenient technique was developed for isolation of the proteolytic enzyme complexes from the whale (Balaenoptera) pancreas. The proposed techniques enables the proteolytic complexes to be obtained with the protein yield 2.6 times higher than the classical procedure. The proteolytic activity increased 3.2 times (casein as a substrate), esterase activities, 1.4 times (N-benzoyl-L-tyrosine methyl ester as a substrate) and 1.2 times (N-alpha-benzoyl-L-arginine ethyl ester as a substrate). Soybean and barley trypsin inhibitors and ovomycoid in free and immobilized state inhibit the esterase activities of the proteolytic complexes. An additional purification of the proteolytic complexes was carried out using the affinity sorbent Soybean trypsin inhibitor--Sepharose 4B. The molecular weight of the enzymes determined by means of PAAG electrophoresis was found to be 20 000-20 500. The hydrolysis of some synthetic substrates by the proteolytic enzyme complexes obtained according to the proposed techniques was being studied. PMID- 3513155 TI - [Changes in the glucagon and growth hormone levels in the blood plasma of healthy persons and of patients with disordered glucose tolerance after insulin administration]. AB - In 15 patients with the normal body mass and disturbed glucose tolerance a glycemia level was higher and insulin levels lower than in 10 healthy persons in the first 20 min after i. v. insulin injection (1.2 units per 1 m2 of the body surface). It was suggestive of resistance to insulin in such patients. The level of glucagon in the blood plasma after insulin injection rose in the patients as well as in healthy persons indicating an unchanged response of pancreatic alpha cells to insulin in this type of diabetes mellitus. A growth hormone level in the blood after insulin injection bid not significantly change in both groups. Glucose homeostasis after insulin injection was regulated not by the growth hormone but mainly by glucagon. PMID- 3513156 TI - [Aldosterone content and renin activity in the plasma of hypothyroidism patients before and during treatment with thyroid preparations]. AB - A study was made of aldosterone (A) level and plasma renin activity (PRA) in 47 patients with hypothyrosis of various degree of severity prior to and during therapy with thyroid drugs. A normal basal A level in the blood plasma was noted, in some patients it was raised or lowered. The following tendency was revealed during therapy with thyroid drugs: in patients with lowered A and PRA levels a rise of these levels was noted during treatment, in raised levels a significant drop was noted. Normal A and PRA basal levels (in most of the patients) showed in the process of treatment diverse tendencies: toward a decrease in the A level and a rise of the PRA level within normal range. The results obtained indicated independent effect of thyroid hormones on A and PRA synthesis. In case of low level of endogenous thyroid hormones as well as exposure to exogenous thyroid hormones changes in the A level were not directly controlled by PRA. PMID- 3513157 TI - [Current trends in the therapy of the insulin-dependent form of diabetes mellitus (a lecture)]. PMID- 3513158 TI - [Beta 2-microglobulin in the diagnosis of kidney lesions in diabetes mellitus patients]. AB - The beta2-microglobulin (beta2-MCG) test was done in 115 patients with an insulin dependent type of diabetes mellitus: 30 of them were without renal pathology, 58 had diabetes mellitus with diabetic nephropathy (DN), and 27 had concomitant chronic pyelonephritis. The effect of glucosuria and proteinuria on the beta2-MCG level was revealed. DN development and progress resulted in an increase in the beta2-MCG concentration in the blood that correlated with a decrease in the glomerular filtration. beta2-MCG urinary excretion grew in a clinically manifested DN stage only. Concomitant pyelonephritis in diabetes mellitus patients resulted mostly in a rise of the beta2-MCG level in the urine. Its concentration in the urine during the exacerbation of pyelonephritis exceeded the indices of the control group, on an average, by 467.9%. The beta2-MCG test is a valuable additional criterion in the differential diagnosis of DN in diabetes mellitus patients. PMID- 3513159 TI - [Characteristics of the hormonal regulation of glycemia in rats with varying alcoholic motivation]. AB - Rats preferring ethanol differ from those preferring water in a lowered blood serum IRI level in the presence of the same level of glycemia. Ethanol preferring animals are characterized by raised function of the adrenal cortex revealed in an elevated II-oxycordicosteroid content in these glands and a lowered cholesterol level. The glucose tolerance test (4 g/kg by intragastric administration) shows a faster depletion of beta-cells of langerhans islets in ethanol preferring animals which is suggestive of a prediabetic state. A different sensitivity of the insular apparatus to glucose is noted in the study group, too. As for glycemia, rats preferring ethanol demonstrate greater resistance to 48-hour starvation as compared to rats preferring water. PMID- 3513160 TI - [Role of hormonal disorders in the pathogenesis of abortion]. PMID- 3513161 TI - Magnesium sulfate: rationale for its use in preeclampsia. AB - Preeclampsia is a disorder of pregnancy characterized clinically by hypertension, proteinuria, and edema and characterized pathologically in its late stages by widespread microvascular thrombi. There is evidence from a number of studies that production of prostacyclin (prostaglandin I2, PGI2), a potent vasodilator and inhibitor of platelet aggregation, is deficient in preeclamptic compared to normal pregnancy. Traditional therapy utilizes infusions of large amounts of MgSO4, but the physiologic basis for this is not clear. We studied the effect of MgSO4 on PGI2 release by cultured human umbilical vein endothelial cells (HUVEC) by several methods. By platelet aggregometry, the known antiaggregatory effect of intact HUVEC was enhanced by MgSO4. By radioimmunoassay for 6-keto-PGF1 alpha, the stable metabolite of PGI2, it was shown that MgSO4 amplifies release of PGI2 by HUVEC in a dose-dependent manner, with a peak occurring between 2 and 3 mM. In separate experiments, MgSO4 overcame the enhanced adherence of platelets to HUVEC exhausted by repeated exposure to thrombin. Finally, PGI2 production was 2- to 5 fold greater by HUVEC incubated with plasma obtained from preeclamptic patients undergoing MgSO4 therapy than by HUVEC incubated with pretherapy plasma. We conclude that MgSO4 mediates enhanced production of PGI2 by vascular endothelium, thereby potentially enhancing its thromboresistant properties. PMID- 3513162 TI - Cloning and expression of a cDNA coding for the anticoagulant hirudin from the bloodsucking leech, Hirudo medicinalis. AB - Cloned cDNAs have been isolated that encode a variant of hirudin, a potent thrombin inhibitor that is secreted by the salivary glands of the medicinal leech, Hirudo medicinalis. This variant probably corresponds to a form that has been purified from leech heads but differs in amino acid sequence from the hirudin purified from whole leeches. There are at least three hirudin transcripts detectable in leech RNAs that are different in size, site of synthesis, inducibility by starvation, and relationship to hirudin activity. The new hirudin variant predicted by the cDNA and the heterodisperse transcription products suggest a hirudin protein family. The hirudin cDNA was expressed in Escherichia coli under the control of the bacteriophage lambda PL promoter. The recombinant product is biologically active, inhibiting the cleavage by thrombin of fibrinogen and a synthetic tripeptide substrate. PMID- 3513163 TI - Nerve injury stimulates the secretion of apolipoprotein E by nonneuronal cells. AB - Nerve trauma initiates significant changes in the composition of proteins secreted by nonneuronal cells. The most prominent of these proteins is a 37-kDa protein, whose expression correlates with the time course of nerve development, degeneration, and regeneration. We now report that the 37-kDa protein is apolipoprotein E (apoE). We produced a specific antiserum against the 37-kDa protein isolated from previously crushed nerves. This antiserum recognizes a 36 kDa protein in rat serum that we have purified and identified as apoE. The anti 37-kDa antiserum also recognizes apoE on electrophoretic transfer blots of authentic samples of high and very low density lipoproteins. The nerve 37-kDa protein comigrates with apoE by two-dimensional electrophoresis, shares a similar amino acid composition, and reacts with an antiserum against authentic apoE. The purified apoE specifically blocks the immunoprecipitation of [35S]methionine labeled 37-kDa protein synthesized by nonneuronal cells. Thus, on the basis of its molecular mass, isoelectric point, amino acid composition, and immunological properties, we conclude that the 37-kDa protein is apoE. We also used light microscopic immunohistochemistry to localize apoE following nerve injury. In rats with optic nerve lesions, the 37-kDa antiserum bound specifically to the degenerating optic tracts and to the retino-recipient layers of the lateral geniculate nucleus and the superior colliculus. We propose that apoE is synthesized by phagocytic cells in response to nerve injury for the purpose of mobilizing lipids produced as a consequence of axon degeneration. PMID- 3513164 TI - Evolution in biosynthetic pathways: two enzymes catalyzing consecutive steps in methionine biosynthesis originate from a common ancestor and possess a similar regulatory region. AB - The metC gene of Escherichia coli K-12 was cloned and the nucleotide sequence of the metC gene and its flanking regions was determined. The translation initiation codon was identified by sequencing the NH2-terminal part of beta-cystathionase, the MetC gene product. The metC gene (1185 nucleotides) encodes a protein having 395 amino acid residues. The 5' noncoding region was found to contain a "Met box" homologous to sequences suggestive of operator structures upstream from other methionine genes that are controlled by the product of the pleiotropic regulatory metJ gene. The deduced amino acid sequence of beta-cystathionase showed extensive homology with that of the MetB protein (cystathionine gamma-synthase) that catalyzes the preceding step in methionine biosynthesis. The homology strongly suggests that the structural genes for the MetB and MetC proteins evolved from a common ancestral gene. PMID- 3513165 TI - Isolation of the gene encoding yeast single-stranded nucleic acid binding protein 1. AB - A yeast gene encoding SSB-1, a single-stranded nucleic acid binding protein, has been isolated by screening a lambda gt11 genomic DNA library. The gene is located on a 1.84-kilobase chromosomal Bgl II-BamHI fragment. Yeast strains carrying the high-copy-number vector YEp24 with an SSB1 gene insert overproduce SSB-1 3-fold and SSB-1 mRNA 10-fold. A typical haploid cell contains about 20,000 molecules of SSB-1; thus, the cells can tolerate up to 60,000 copies. Yeast SSB-1 was expressed in Escherichia coli cells by using a phage T7 expression system. Spores containing the gene disrupted at a point within the coding sequence germinate and grow normally; thus, the gene is not essential. Protein blots show that no SSB-1 or novel immunologically related species that might retain SSB-1 activity are present in cells containing the disrupted SSB1 genes. Southern analysis and protein blots suggest the presence in yeast of a second, related, but nonidentical gene and two immunologically related proteins of 55 kDa and 75 kDa. PMID- 3513166 TI - alpha-Transducin immunoreactivity in retinae and sensory pineal organs of adult vertebrates. AB - Antiserum against the alpha subunit of bovine rod-outer-segment transducin was used in an immunocytochemical study that identified the protein in retina (human, baboon, owl monkey, cow, rat, quail, newt, frog, salmon, eel, and lamprey), pineal organ (quail, newt, frog, salmon, eel, and lamprey), and parapineal organ (salmon and lamprey). No reaction was observed in the cow or rat pineal organ or the eel parapineal organ. The immunoreaction was very strong in outer segments but weak in perikarya. Immunoblots of crude tissue extracts of bovine rod-outer segment membranes and frog and fish retina revealed a 39-kDa immunopositive band. The fish retina also contained two additional bands of mass 43 kDa and 25 kDa. Only the 43-kDa band was present in the fish pineal organ, which is photosensitive. This raises the possibility that the 43-kDa alpha transducin immunopositive molecule present in the fish pineal organ and retina may be involved in phototransduction. PMID- 3513167 TI - Anticodon-anticodon interaction induces conformational changes in tRNA: yeast tRNAAsp, a model for tRNA-mRNA recognition. AB - The crystal structure of yeast tRNAAsp enables visualization of an anticodon anticodon interaction at the molecular level. Except for differences in the base stacking and twist, the overall conformation of the anticodon loop is quite similar to that of yeast tRNAPhe. The anticodon nucleotide triplets, GUC, of two symmetrically related molecules form a minihelix of the RNA type 11. The modified base m1G37 stacks on both sides of the triplets and enforces the continuity with the anticodon stems. Anticodon association induces long-range conformational changes in the region of the dihydrouracil and thymine loops. Experimental evidence includes the variation in the distribution of temperature factors between yeast tRNAPhe and tRNAAsp, the difference in the self-splitting patterns of tRNAAsp in crystal and solution, and the differential accessibility of cytidines to dimethyl sulfate in free and duplex tRNAAsp. These observations are linked to the fragility and disruption of the G.C Watson-Crick base pair at the corner of the molecule formed by the dihydrouracil and thymine loops. PMID- 3513168 TI - Mutant ras-encoded proteins with altered nucleotide binding exert dominant biological effects. AB - We report that residues Lys-16 and Asp-119 play critical roles in the guanine nucleotide binding and, consequently, the biological function of the Ha-ras encoded protein (Ha). Substitution of an asparagine residue for Lys-16 reduces the affinity of Ha for GDP and GTP by a factor of 100 but does not alter the specificity of nucleotide binding. The replacement of Asp-119 with an alanine residue reduces the affinity of Ha for GDP and GTP by a factor of 20 and reduces the relative affinity of Ha for GDP over IDP from 200-500 to 10. Based on these observations, a structural model for the GDP/GTP-binding site of Ha is proposed. By microinjecting purified proteins into NIH 3T3 cells, we observed that the ability of [Ala119]Ha to induce changes characteristic of cellular transformation was much greater than that of normal Ha and similar to that of the oncogenic [Val12, Thr59]Ha. In this assay, [Asn16]Ha and [Val12, Asn16, Thr59]Ha were similar in potency to normal Ha. In yeast cells, Ha proteins with reduced nucleotide affinity exert a dominant temperature-dependent lethality that is avoided by the coexpression of the activated yeast ras gene [Ala18, Val19]RAS2. We interpret the biological consequences of reducing the nucleotide affinity of ras proteins in terms of two opposing factors: a growth-promoting effect, resulting from an increase in the GDP-GTP exchange rate, and a growth-limiting effect, resulting from an increase in the nucleotide-free ras protein species. PMID- 3513169 TI - Inhibition of tumor-cell-mediated extracellular matrix destruction by a fibroblast proteinase inhibitor, protease nexin I. AB - Human fibrosarcoma (HT-1080) cells, in contrast to normal fibroblasts, rapidly hydrolyze the glycoprotein, collagen, and elastin extracellular matrix (ECM) synthesized by cultured rat aortic smooth muscle cells. This degradation occurs at a rapid rate in the presence of serum, indicating that the cellular proteases responsible are relatively insensitive to serum proteinase inhibitors. Here it is shown that protease nexin I (PNI), a fibroblast-secreted inhibitor of urokinase, plasmin, and certain other serine proteinases, effectively inhibited the HT-1080 cell-mediated degradation of this ECM. PNI at 2.0 nM significantly inhibited matrix destruction for 1-2 days and at 0.2 microM caused a virtually complete inhibition that persisted for the entire 10-day period of observation. Inhibition of ECM destruction was accompanied by a transient arrest of HT-1080 cell proliferation that took place during the first 3 days after PNI addition. PNI did not inhibit the growth of normal fibroblasts and also did not inhibit the growth of HT-1080 cells that were seeded onto plastic dishes rather than onto ECM. Like many types of malignant cells, HT-1080 cells release large amounts of urokinase. Antibody against this plasminogen activator partially protected ECM from HT-1080 cell-mediated hydrolysis, indicating that it may have been a target of PNI. One potential physiological function of PNI could be to help maintain the integrity of connective tissue matrices, protection that malignant cells could overcome by secreting proteinases in excessive amounts. PMID- 3513170 TI - Proteins of Escherichia coli come in sizes that are multiples of 14 kDa: domain concepts and evolutionary implications. AB - Initial attempts to correlate the distribution of gene density (number of gene loci per unit length on the linkage map) with the distribution of lengths of coding sequences have led to the observation that 46% of approximately 1000 sampled proteins in Escherichia coli have molecular masses of n X 14,000 +/- 2500 daltons (n = 1, 2, ...). This clustering around multiples of 14,000 contrasts with the 36% one would expect in these ranges if the sizes were uniformly distributed. The entire distribution is well fit by a sum of normal or lognormal distributions located at multiples of 14,000, which suggests that the percentage of E. coli proteins governed by the underlying sizing mechanism is much greater than 50%. Clustering of protein molecular sizes around multiples of a unit size also is suggested by the distribution of well-characterized HeLa cell proteins. The distribution of gene lengths for E. coli suggests regular clustering, which implies that the clustering of protein molecular masses is not an artifact of the molecular mass measurement by gel electrophoresis. These observations suggest the existence of a fundamental structural unit. The rather uniform size of this structural unit (without any apparent sequence homology) suggests that a general principle such as geometrical or physical optimization at the DNA or protein level is responsible. This suggestion is discussed in relation to experimental evidence for the domain structure of proteins and to existing hypotheses that attempt to account for these domains. Microevolution would appear to be accommodated by incremental changes within this fundamental unit, whereas macroevolution would appear to involve "quantum" changes to the next stable size of protein. PMID- 3513171 TI - Mutations activating human c-Ha-ras1 protooncogene (HRAS1) induced by chemical carcinogens and depurination. AB - In vitro modification of plasmids containing the human c-Ha-ras1 protooncogene (HRAS1) with the ultimate carcinogens N-acetoxy-2-acetylaminofluorene and r-7, t 8-dihydroxy-t-9, 10-epoxy-7,8,9,10-tetrahydrobenzo[alpha]pyrene (anti-BPDE) generated a transforming oncogene when the modified DNA was transfected into NIH 3T3 cells. The protooncogene was also activated by heating the plasmid at 70 degrees C, pH 4, to generate apurinic/apyrimidinic sites in the DNA. DNA isolated from transformed foci was analyzed by hybridization with 20-mer oligonucleotides designed to detect single point mutations within two regions of the gene commonly found to be mutated in tumor DNA. Of 23 transformants studied, 7 contained a mutation in the region of the 12th codon, whereas the remaining 16 were mutated in the 61st codon. Of the codon-61 mutants, 6 were mutated at the first base position (C X G), 5 at the second (A X T), and 5 at the third (G X C). The point mutations induced by anti-BPDE were predominantly G X C----T X A and A X T----T X A base substitutions, whereas four N-acetoxy-2-acetylaminofluorene-induced mutations were all G X C----T X A, and a single depurination-induced activation that was analyzed contained an A X T----T X A transversion. Together, these methods provide a useful means of determining point mutations produced by DNA damaging agents in mammalian cells. PMID- 3513173 TI - Processing and fatty acid acylation of RAS1 and RAS2 proteins in Saccharomyces cerevisiae. AB - We demonstrate the pathway for the biosynthesis of RAS1 and RAS2 gene products of Saccharomyces cerevisiae leading to their localization in membranes. The primary translation products of these genes are detected in a soluble fraction. Shortly after synthesis, these precursor molecules are converted to forms that migrate slightly faster than the precursor forms on a NaDodSO4/polyacrylamide gel. These processed proteins are further modified by fatty acid acylation, which is detected by [3H]palmitic acid labeling. The acylated derivatives are found exclusively in cell membranes, indicating the translocation of the RAS proteins from cytosol to membranes during maturation process. The attached fatty acids can be released by mild alkaline hydrolysis, suggesting that the linkage between the fatty acid and the protein is an ester bond. The site of the modification by fatty acid is presumably localized to the COOH-terminal portion of the RAS proteins. Fractionation of the membranes by sucrose gradient demonstrates that a majority of the fatty-acylated RAS proteins are localized in plasma membrane. PMID- 3513172 TI - Specific inhibition of mRNA translation by complementary oligonucleotides covalently linked to intercalating agents. AB - Synthetic oligodeoxynucleotides that are covalently linked at their 3' end to an acridine derivative and are complementary to the repeated sequence UUAAAUUAAAUUAAA adjacent to the ribosome binding site of the gene 32-encoded mRNA from phage T4 have been used to regulate the synthesis of gene 32-encoded protein in vitro. These modified, synthetic oligonucleotides specifically block the translation of gene 32-encoded mRNA with a higher efficiency than the homologous unsubstituted oligonucleotides. The inhibition produced by these short "anti messengers" is due to the formation of specific mRNA . oligodeoxynucleotide hybrids that are stabilized by the intercalation of the acridine ring in the RNA . DNA duplex. PMID- 3513174 TI - Identification of yeast mutants with altered telomere structure. AB - The chromosomes of the yeast Saccharomyces cerevisiae terminate in a tract of simple-sequence DNA [poly(C1-3A)] that is several hundred base pairs long. We describe the identification of mutant yeast strains that have telomeric tracts that are shorter than normal. A genetic analysis of these strains indicates that these short telomeres are the result of single nuclear recessive mutations and that these mutations can be classified into two different complementation groups. The full expression of the mutant phenotype shows a very long lag (approximately equal to 150 cell divisions). From our analysis of these mutants as well as other data, we suggest that the duplication of the telomeric poly(C1-3A) tract involves two processes, semiconservative replication and untemplated terminal addition of nucleotides. PMID- 3513175 TI - Mutational and in vivo methylation analysis of F-factor PifC protein binding to the pif operator and the region containing the primary origin of mini-F replication. AB - We have used in vivo methods to identify multiple DNA-binding sites for the negatively autoregulated mini-F replication factor PifC. Sequence analysis of pif operator constitutive mutants, isolated as insensitive to repression by PifC, establishes the structure of pifO. This site contains a 17-base-pair (bp) region of dyad symmetry with 7-bp perfect inverted repeats separated by 3 bp. In vivo DNA methylation studies with dimethyl sulfate show that the reactivity of five of six guanine residues in the pifO region is altered in the presence of PifC protein. In addition, there are several sites of PifC-dependent methylation enhancement and protection upstream of pifO within repeated sequences bearing homology to pifO. The significance of the repeated PifC binding sequences and their relationship to the primary origin of mini-F replication (oriV1) are discussed. PMID- 3513176 TI - Induction of c-myc expression in human B lymphocytes by B-cell growth factor and anti-immunoglobulin. AB - Purified human B lymphocytes were examined for transcriptional expression of c myc in response to mitogenic stimulation by the method of in situ hybridization using 35S-labeled DNA probes. The level of c-myc expression increased 10- to 20 fold within 2 hr after the addition of anti-mu, formalinized Staphylococcus aureus Cowan strain I, or B-cell growth factor, as compared to resting B cells. After 72-96 hr of mitogenic stimulation, c-myc expression remained elevated 5 fold, but expression among individual cells had become more heterogeneous than at early time points. To determine whether c-myc expression in human B lymphocytes is phase specific within the cell cycle, mitogen-stimulated cells were sorted by DNA content into populations of cells in G0/G1, S, and G2/M phases of the cell cycle. Examination of c-myc expression in phase-specific cells revealed that c myc expression was elevated in all phases of the cell cycle, but it appeared to be maximally expressed in S phase. These studies suggest that c-myc expression in normal human B lymphocytes is cell-cycle dependent and remains elevated in all phases of the cycling cell. PMID- 3513177 TI - Isolation of a cDNA clone encoding the amino-terminal region of human apolipoprotein B. AB - A partial cDNA clone for the B-26 region of apolipoprotein B was isolated from an adult human liver DNA library by screening with an oligonucleotide probe derived from amino-terminal protein sequence obtained from purified B-26 peptide. Antisera against a synthetic 17-residue peptide whose amino acid sequence was encoded by the clone cross-reacts with apolipoproteins B-26, B-100, and B-48, but not with B-74. The nucleotide sequence immediately upstream from the amino terminus of B-26 codes for an apparent signal sequence, implying that the B-26 moiety is in an amino-terminal locus in the B-100 protein. That this sequence represents a 5' end region is further supported by primer extension analysis using a fragment of the cDNA clone and by S1 nuclease protection experiments using the corresponding region in a genomic clone. PMID- 3513178 TI - Altered expression of G1-specific genes in human malignant myeloid cells. AB - We have studied the expression of cell-cycle genes specific to the G1 (2A9, 2F1, 4F1, c-myc) and S (histone H3) phases of the cell cycle in normal and malignant human myeloid cycling cells. The levels of expression were determined by measuring the amounts of specific RNA in blot hybridization assays. Levels of expression of the G1 genes were compared to the level of expression of the S phase-specific H3 gene. This method can distinguish whether an increased expression of G1 genes is truly due to deregulation or simply reflects an increase in the fraction of proliferating cells. In a normal asynchronous system provided by the bone marrow cells of three normal donors, the expressions of the four G1-specific genes 2A9, 2F1, 4F1, and c-myc, and of the S-phase-specific gene H3 were in ratios that differed little from one individual to another. In the total RNA of eight patients in the chronic phase of chronic myelogenous leukemia, a high level of expression of G1 cell-cycle genes was paralleled by a high level of expression of the S-phase H3 gene, simply reflecting an increase in the fraction of proliferating cells. In patients with acute myelogenous leukemia (AML), the RNA levels of 2F1 and 4F1 paralleled the expression of H3-i.e., the ratios of expression 2F1/H3 and 4F1/H3 were the same as in normal bone marrow cells. However, in 9 of 10 patients with AML we found that the expression of c myc was elevated with respect to H3 expression. The expression of 2A9 (with respect to H3) was also elevated in some of these AML patients. Two important conclusions can be drawn from these findings: increased levels of a G1-specific RNA in a tumor may not indicate overexpression of that gene but may instead simply reflect the fraction of proliferating cells; and in some patients with AML, however, the expression of certain G1 genes is truly deregulated and might contribute to the impairment of proliferative control that is associated with this phenotype. PMID- 3513179 TI - Bipotential precursors of putative fibrous astrocytes and oligodendrocytes in rat cerebellar cultures express distinct surface features and "neuron-like" gamma aminobutyric acid transport. AB - When postnatal rat cerebellar cells were cultured in a chemically defined, serum free medium, the only type of astrocyte (defined by the expression of the glial fibrillary acidic protein, GFAP) present was unable to accumulate gamma [3H]aminobutyric acid (GABA), did not express surface antigens recognized by two monoclonal antibodies, A2B5 and LB1, and showed minimal proliferation. In these cultures, nonneuronal A2B5+, LB1+ stellate cells exhibiting "neuron-like" [3H]GABA uptake formed cell colonies of increasing size and were GFAP-. After about one week of culturing, the A2B5+, LB1+, GABA-uptake positive cell groups became galactocerebroside (GalCer) positive. Immunocytolysis of the A2B5+ cells at 3 and 4 days in vitro prevented the appearance of the A2B5+, LB1+, GABA-uptake positive cell colonies, and also of the GalCer+ cell groups. If 10% (vol/vol) fetal calf serum was added to 6-day cultures, the A2B5+, LB1+, GABA-uptake positive cell groups expressed GFAP and not GalCer. If the serum was added to the cultures 2 days after lysing the A2B5+ cells, only A2B5-, LB1-, GABA-uptake negative astrocytes proliferated. It is concluded that the putative fibrous astrocytes previously described in serum-containing cultures (which had a stellate shape and were A2B5+, LB1+, GABA-uptake positive) derive from bipotential precursors that differentiate into oligodendrocytes (GalCer+) in serum-free medium or into astrocytes (GFAP+) in the presence of serum, while the epithelioid A2B5-, LB1-, GABA-uptake negative astrocytes originate from a different precursor not yet identified. PMID- 3513180 TI - Melanin-concentrating hormone: unique peptide neuronal system in the rat brain and pituitary gland. AB - A unique neuronal system was detected in the rat central nervous system by immunohistochemistry and radioimmunoassay with antibodies to salmon melanin concentrating hormone (MCH). MCH-like immunoreactive (MCH-LI) cell bodies were confined to the hypothalamus. MCH-LI fibers were found throughout the brain but were most prevalent in hypothalamus, mesencephalon, and pons-medulla regions. High concentrations of MCH-LI were measured in the hypothalamic medial forebrain bundle (MFB), posterior hypothalamic nucleus, and nucleus of the diagonal band. Reversed-phase high-performance liquid chromatography of MFB extracts from rat brain indicate that MCH-like peptide from the rat has a different retention time than that of the salmon MCH. An osmotic stimulus (2% NaCl as drinking water for 120 hr) caused a marked increase in MCH-LI concentrations in the lateral hypothalamus and neurointermediate lobe. The present studies establish the presence of MCH-like peptide in the rat brain. The MCH-LI neuronal system is well situated to coordinate complex functions such as regulation of water intake. PMID- 3513181 TI - Site-saturation studies of beta-lactamase: production and characterization of mutant beta-lactamases with all possible amino acid substitutions at residue 71. AB - A mutagenic technique that "saturates" a particular site in a protein with all possible amino acid substitutions was used to study the role of residue 71 in beta-lactamase (EC 3.5.2.6). Threonine is conserved at residue 71 in all class A beta-lactamases and is adjacent to the active site Ser-70. All 19 mutants of the enzyme were characterized by the penam and cephem antibiotic resistance they provided to Escherichia coli LS1 cells. Surprisingly, cells producing any of 14 of the mutant beta-lactamases displayed appreciable resistance to ampicillin; only cells with mutants having Tyr, Trp, Asp, Lys, or Arg at residue 71 had no observable resistance to ampicillin. However, the mutants are less stable to cellular proteases than wild-type enzyme is. These results suggest that Thr-71 is not essential for binding or catalysis but is important for stability of the beta lactamase protein. An apparent change in specificity indicates that residue 71 influences the region of the protein that accommodates the side chain attached to the beta-lactam ring of the substrate. PMID- 3513183 TI - Enhanced c-Ki-ras expression associated with Friend virus integration in a bone marrow-derived mouse cell line. AB - We have investigated the molecular basis for a 25- to 30-fold overexpression of the c-Ki-ras oncogene in a mouse bone marrow-derived, early myeloid cell line, 416B. Southern blot hybridizations revealed that the 416B cells contain a rearranged c-Ki-ras gene in addition to an apparently normal gene. Molecular cloning and DNA sequence analyses demonstrated that the rearrangement involves the insertion of a 3.5-kilobase-pair segment of Friend virus that includes the envelope gene (env) and 3' long terminal repeat. The Friend provirus is positioned between a 5' nontranslated exon (exon phi) and the first coding exon (exon 1) of the c-Ki-ras gene in the same transcriptional orientation. Results of RNA blot analyses indicate that transcription from the rearranged gene initiates at a promoter that excludes sequences in exon phi. The data support the hypothesis that enhanced c-Ki-ras expression in the 416B cells results from integration of a Friend provirus within this gene. PMID- 3513182 TI - Yeast and mammals utilize similar cytosolic components to drive protein transport through the Golgi complex. AB - Vesicular transport between successive compartments of the mammalian Golgi apparatus has recently been reconstituted in a cell-free system. In addition to ATP, transport requires both membrane-bound and cytosolic proteins. Here we report that the cytosol fraction from yeast will efficiently substitute for mammalian cytosol. Mammalian cytosol contains several distinct transport factors, which we have distinguished on the basis of gel filtration and ion-exchange chromatography. Yeast cytosol appears to contain the same collection of transport factors. Resolved cytosol factors from yeast and mammals complement each other in a synergistic manner. These findings suggest that the molecular mechanisms of intracellular protein transport have been conserved throughout evolution. Moreover, this hybrid cell-free system will enable the application of yeast genetics to the identification and isolation of cytosolic proteins that sustain intracellular protein transport. PMID- 3513184 TI - Expression of a cDNA derived from the yeast killer preprotoxin gene: implications for processing and immunity. AB - The type I killer strains of Saccharomyces cerevisiae secrete a dimeric 19-kDa protein that kills sensitive cells by disrupting cytoplasmic membrane function. This toxin is encoded by the double-stranded RNA plasmid M1-dsRNA, which also determines specific immunity to toxin. A preprotoxin, the 35-kDA in vitro translation product of denatured M1-dsRNA, is presumed to be the primary in vivo gene product. To facilitate studies on preprotoxin structure and maturation, we have inserted a partial cDNA copy of M1-dsRNA into the yeast vector p1A1, bringing it under control of the phosphate-repressible PHO5 promoter. This in frame gene fusion encodes all of the preprotoxin sequence except for its N terminal secretion leader, which is replaced by the leader sequence of PHO5. Transformation of sensitive yeast strains lacking M1-dsRNA with such fusion plasmids converts them to phosphate-repressible, immune killers, demonstrating that both toxin and immunity determinants are contained within the preprotoxin molecule. L-1-Tosylamido-2-phenylethyl chloromethyl ketone retards glycosylation of preprotoxin to toxin, facilitating size comparisons and indicating that processing of the normal precursor involves three glycosylation events but does not involve cotranslational leader peptidase action. In contrast, the PHO5 leader is apparently removed from the fusion preprotoxin. PMID- 3513185 TI - Cytolytic effects of neutrophils: role for a membrane-bound neutral proteinase. AB - A neutral serine proteinase, purified 250-fold from the plasma membrane fraction of human neutrophils, differs in its catalytic and molecular properties from the well-known neutral proteinases present in azurophil (primary) granules. Stimulation of neutrophils with low concentrations of phorbol 12-myristate 13 acetate (PMA) results in the release into the medium of the membrane-bound proteinase and the concomitant production of oxygen radicals. These concentrations of PMA also induce full cytolytic activity measured with 51Cr labeled ox erythrocytes. A role for the neutral serine proteinase in the cytolytic activity of PMA-stimulated neutrophils is supported by the following observations: (i) the lytic activity of the stimulated neutrophils is correlated with the quantity of neutral proteinase present in the membranes; (ii) the extracellular medium from PMA-stimulated neutrophils causes the cytolysis of 51Cr labeled erythrocytes that have been exposed to nonlytic concentrations of H2O2; (iii) cytolysis of H2O2-treated erythrocytes is also observed with the crude proteinase solubilized from neutrophil membranes or with the purified proteinase from the same source; and (iv) in each case the cytolytic activity is proportional to the proteinase activity present and is prevented by the addition of serine proteinase inhibitors. We conclude that cytolysis of target cells by PMA-activated neutrophils can result from the cooperative effects of oxygen radicals and the membrane-bound neutral serine proteinase. The participation of enzymes from specific (secondary) granules is excluded because, with the low concentrations of PMA employed, very little release of secondary granule constituents is observed. PMID- 3513186 TI - Fetal characteristics of small intestinal crypt cells. AB - Nine monoclonal antibodies were prepared against luminal membranes purified from rat intestinal cells at day 19 of gestation, and seven of them were found to define antigens common to adult crypt cells and fetal or embryonic intestinal epithelial cells. The FBB 2/29 antigen was first detected over the entire intestinal epithelial population at days 14-15 of gestation, a period of development characterized by formation of a stratified intestinal epithelium and differentiation of the surrounding mesenchyme. This antigen, identified as a set of high molecular mass proteins, became restricted to the crypt and lower villus cells after birth and was exclusively expressed by the crypt cells in adult intestine. It also was found to be expressed by the epithelial cells of the distal tubuli in the kidney of adult rats and by cultured human tumor colonic cells. The FBB 1/54/1, FBB 3/46, and FBB 3/78/9 antibodies stained only the epithelial cells present at the base of the villi in fetal intestine, starting at days 20-21 of gestation (about 1-2 days before birth), and stained the crypt and lower villus cells in newborn and adult intestine; these antigens may be regarded as specific markers for the developing crypt cells in fetal intestine shortly before birth. The FBB 1/20 and FBB 4/2 antigens were first detected on the fetal intestinal cells at day 18 of gestation; they were located over the entire epithelium in newborn rats and became restricted to the crypts after weaning. The FBB 2/28 antigen was expressed by the entire intestinal epithelium at all stages of development, starting from days 18-19 of gestation in the fetus. Two antibodies, FBB 3/4 and FBB 3/24, were found to be specific for lactase. These results have demonstrated the expression of cell- and tissue-specific components in rat intestine during early embryonic development and revealed a marked similarity in surface membrane antigens between fetal intestinal epithelial cells and adult crypt cells. PMID- 3513187 TI - ATP-dependent formation and motility of aster-like structures with isolated calf brain microtubule proteins. AB - Microtubule proteins isolated from calf brain will undergo gelation-contraction in the presence of ATP. We have now examined this process by video-enhanced contrast microscopy. After ATP addition to steady-state microtubules, slow (1-5 micron/min), linear movements of particles and microtubules toward aggregation centers occur. The resulting structures resemble mitotic spindle asters. During the time when gel contraction occurs, asters move (at 1-5 micron/min) toward other nearby asters. This is accompanied by the apparent shortening of the microtubules running between the asters. This is the first example of isolated microtubules undergoing a process that has similarities to half-spindle shortening during anaphase A. Formation of aster-like structures without preformed microtubule organizing centers raises the possibility that a similar process may contribute to microtubule organization in vivo. PMID- 3513188 TI - Conserved chromosomal positions of dual domains of the ets protooncogene in cats, mice, and humans. AB - The mammalian protooncogene homologue of the avian v-ets sequence from the E26 retrovirus consists of two sequentially distinct domains located on different chromosomes. Using somatic cell hybrid panels, we have mapped the mammalian homologue of the 5' v-ets-domain to chromosome 11 (ETS1) in man, to chromosome 9 (Ets-1) in mouse, and to chromosome D1 (ETS1) in the domestic cat. The mammalian homologue of the 3' v-ets domain was similarly mapped to human chromosome 21 (ETS2), to mouse chromosome 16 (Ets-2), and to feline chromosome C2 (ETS2). Both protooncogenes fell in syntenic groups of homologous linked loci that were conserved among the three species. The occurrence of two distinct functional protooncogenes and their conservation of linkage positions in the three mammalian orders indicate that these two genes have been separate since before the evolutionary divergence of mammals. PMID- 3513189 TI - Heterogeneity of chromosome 22 breakpoint in Philadelphia-positive (Ph+) acute lymphocytic leukemia. AB - In chronic myelogenous leukemias (CML) with the t(9;22)(q34;q11) chromosome translocation the breakpoints on chromosome 22 occur within a 5.8-kilobase segment of DNA referred to as "breakpoint cluster region" (bcr). The same cytogenetically indistinguishable translocation occurs in approximately 10% of patients with acute lymphocytic leukemias (ALL). In this study we have investigated the chromosome breakpoints in several cases of ALL carrying the t(9;22) translocation. In three of five cases of ALL we found that the bcr region was not involved in the chromosome rearrangement and that the 22q11 chromosome breakpoints were proximal (5') to the bcr region at band 22q11. In addition, we observed normal size bcr and c-abl transcripts in an ALL cell line carrying the t(9;22) translocation. We conclude, therefore, that if c-abl is inappropriately expressed in ALL cells without bcr rearrangements, the genetic mechanism of activation must be different from that reported for CML. PMID- 3513190 TI - Structure and expression of the murine N-myc gene. AB - We have demonstrated that the entire murine N-myc gene and the sequences necessary for its expression in human neuroblastoma cells are contained within a 7.4-kilobase murine genomic clone. The complete nucleotide sequence of this gene reveals a number of striking similarities and differences when compared to the related c-myc gene including the following: (i) each gene contains three exons of which the first encodes a long 5'-untranslated leader sequence; (ii) the coding regions of the N- and c-myc genes share regions of substantial nucleic acid homology, the putative N-myc protein shares substantial homology with the c-myc protein; (iii) as with c-myc, extensive nucleotide sequence homology exists between the untranslated regions of the human and murine N-myc gene transcripts; however, the N-myc and c-myc untranslated regions are totally divergent; (iv) the N-myc transcriptional promoter differs from that of c-myc and is more related to the promoter of the simian virus 40. We discuss these findings in the context of previously defined similarities and differences in the potential functional and regulatory aspects of these two myc-family members. PMID- 3513192 TI - Effect of DA1 receptor blockade with SCH 23390 on the renal response to electrical stimulation of the renal nerves. AB - To evaluate the existence of functional renal dopaminergic innervation in the dog, we studied the effects of direct electrical stimulation of the renal nerves (RNS) with and without blockade of the dopamine receptor (DA1) that mediates the vasodilating and natriuretic response to intrarenal infusion of DA. Before infusion of the DA1 receptor antagonist, SCH 23390, RNS at 1 Hz did not change renal blood flow (RBF) but caused decreased urinary sodium excretion (-53 +/- 9%, P less than 0.01) and fractional excretion of sodium (-47 +/- 10%, P less than 0.01). Stimulation at 4 and 12 Hz elicited marked renal vasoconstriction (delta RBF = -37 +/- 12%, P less than 0.05 and -57 +/- 12%, P less than 0.01, respectively). When RNS (1 Hz) was performed during DA1 receptor blockade with SCH 23390, 0.5 microgram . kg-1 . min-1 iv, the responses were not different than those before SCh 23390 infusion (urinary sodium excretion: -54 +/- 7%, P less than 0.01 and fractional excretion of sodium: -46 +/- 5%, P less than 0.01). Renal vasoconstriction was also not influenced by SCH 23390 (delta RBF = -35 +/- 11%, P less than 0.05 during 4 Hz RNS and -58 +/- 12%, P less than 0.01 at 12 Hz RNS). Thus, the present study does not support the concept of functional dopaminergic innervation of the canine kidney. PMID- 3513191 TI - Resistance to human respiratory syncytial virus (RSV) infection induced by immunization of cotton rats with a recombinant vaccinia virus expressing the RSV G glycoprotein. AB - A cDNA copy of the G glycoprotein gene of human respiratory syncytial virus (RSV) was placed under control of a vaccinia virus promoter and inserted into the thymidine kinase locus of the vaccinia virus genome. The recombinant vaccinia virus retained infectivity and expressed a 93-kDa protein that migrated with the authentic RSV G glycoprotein upon polyacrylamide gel electrophoresis. Glycosylation of the expressed protein and transport to the cell surface were demonstrated in the absence of other RSV proteins. Cotton rats that were inoculated intradermally with the infectious recombinant virus produced serum antibody to the G glycoprotein that neutralized RSV in vitro. Furthermore, the vaccinated animals were resistant to lower respiratory tract infection upon intranasal inoculation with RSV and had reduced titers of RSV in the nose. PMID- 3513194 TI - Genetic variation in the recruitment and activation of chicken peritoneal macrophages. AB - Genetic variation in the ability to recruit and activate peritoneal macrophages was examined in seven partially developed 15I5-B congenic White Leghorn chicken lines. While the ability to generate peritoneal exudate cells (PECs) was similar in all lines, major differences were observed in the numbers, composition, and functional activity of harvestable peritoneal adherent cell populations. In response to a general stimulant, Sephadex, lines .7-2 and .6-2 produced the greatest numbers of adherent peritoneal cells while lines .C-12 and .15I-5 were among the poorest responders. Macrophage percentage of adherent PECs varied between lines. 15I5 chickens produced a consistently high percentage of adherent macrophages while .6-2 birds exhibited the lowest macrophage percentage at all ages examined. Phagocytosis was used as one measure of the level of macrophage activation and similar results were obtained using both opsonized and unopsonized sheep erythrocytes; adherent peritoneal cells from lines .6-2, .7-2, and .P-13 exhibited the highest activity and .C-12, .15I-5, and background 15I5(B15) lines produced cells with the lowest phagocytic activity. In a second functional assay, the killing of Salmonella typhimurium, macrophage-rich cells from line .P-13 exhibited the lowest activity which was significantly lower than that obtained with cells from lines .6-2 and .15I-5. Antigen-specific stimulation of peritoneal adherent cells by ferritin also showed that .C-12 was a low responder in contrast with other lines. The results indicate that these genetic lines differ in peritoneal macrophage function and suggest that the chicken major histocompatibility complex may influence certain properties of chicken macrophage function. PMID- 3513193 TI - Conversion to adipocytes of a clonal bone marrow preadipocyte line (H-1/A) and fatty acid composition of the resultant adipocytes. AB - Conversion to adipocytes and fatty acid composition were investigated in a clonal bone marrow preadipocyte line (H-1/A). The growing cells exhibited a fibroblastic appearance. After the cessation of growth, triacylglyceride (TG) synthesis in the cells increased as they incorporated precursor from the growth medium and became adipocytes. Hydrocortisone and insulin accelerated the TG synthesis in H-1/A cells in a dose-dependent manner when they were cultured in the growth medium containing 10% horse serum. The rate of conversion to adipocytes was reduced as the concentration of horse serum was decreased, and this reduction was not influenced by the addition of insulin and/or hydrocortisone. These results suggest that conversion to adipocytes of H-1/A cells is primarily dependent on some component(s) of the serum. Conversion to adipocytes of the cells may involve a process of differentiation since the conversion was completely inhibited when the cells were cultured in the presence of bromodeoxyuridine. Fatty acid composition was significantly different between adipose H-1/A cells and adipocytes derived from other marrow preadipocyte line MC3T3-G2/PA6 cells. Unsaturated fatty acids accounted for 76% of the fatty acid composition of adipose H-1/A cells; in contrast, saturated fatty acids constituted 65% of the fatty acid composition of the adipose MC3T3-G2/PA6 cells. These results suggest that there is a heterogeneity of preadipocytes in bone marrow. These two preadipocyte lines thus provide a useful tool for the study of marrow adipocytes and can also be used to analyze the hematopoietic microenvironment through studies of the effect of these cells on hematopoietic cell proliferation. PMID- 3513195 TI - Thirty-one years of comparative endocrinology, a perspective. PMID- 3513196 TI - Embryonic diapause in a marsupial: roles of the corpus luteum and pituitary in its control. PMID- 3513197 TI - The spectrum of prolactin action in teleosts. PMID- 3513198 TI - Genetic toxicology of browning and caramelizing products. PMID- 3513199 TI - Formation of food mutagens via Maillard reactions. PMID- 3513200 TI - Formation of polycyclic aromatic hydrocarbons during the smoking and grilling of food. PMID- 3513201 TI - Influence of composition of diet on the formation of mutagens. PMID- 3513202 TI - Lipid oxidation and carcinogenesis. PMID- 3513203 TI - Diet and nutrition in the context of cancer epidemiology. PMID- 3513204 TI - Food constituents as a source of mutagens, carcinogens, and anticarcinogens. PMID- 3513205 TI - Genetic toxicology of dietary flavonoids. PMID- 3513206 TI - Mutagens and carcinogens in cooked food. PMID- 3513207 TI - Uptake, transfer and metabolism of prostaglandin E2 in the isolated perfused human placental cotyledon. AB - (3H) PGE2 uptake and transfer in the isolated perfused human placental cotyledon was assessed by a single pass paired isotope dilution technique utilising (14C) sucrose as an extracellular marker. Metabolism of (3H) PGE2 was measured by analysing maternal and fetal effluents from perfused human placental cotyledons after bolus injection of (3H) PGE2 into either the maternal or fetal sides. Maximal uptake of (3H) PGE2 was greater on the maternal (81 +/- 8%) than the fetal sides (42 +/- 12%) and showed saturation with increasing concentrations of PGE2 only on the fetal side with an apparent Km of 12 +/- 4.9 nmol/l and vmax of 1.5 +/- 0.2 pmol/min/g. Total recoveries of (3H) PGE2 were 84.6 +/- 11.8% and 32.6 +/- 6.3% of the injected dose after injection on the fetal and maternal sides respectively. Transfer of (3H) PGE2 was the same in both directions being 6.4 +/- 1.2% of the injected dose in the fetal-maternal direction and 5.8 +/- 2.7% of the injected dose in the maternal-fetal direction. Metabolism was greater on the maternal side (35% of injected (3H) PGE2) than the fetal side (18% of injected (3H) PGE2) and was principally to the 13,14-dihydro-15-keto-PGE2 metabolite. Metabolism of (3H) PGE2 after passage across the placenta was the same in both directions and was of the order of approximately 60%. PMID- 3513208 TI - Selective inhibition of thromboxane synthesis partially protected while inhibition of angiotensin II formation did not protect rats against acute renal failure induced with glycerol. AB - Acute renal failure (ARF) was induced in 35 week-old conscious female Wistar rats, by intramuscular (IM) injection of glycerol. Intraperitoneal (IP) injection of imidazole, an inhibitor of thromboxane (TXA2) synthesis, partially protected the animals against ARF. This protection was accompanied by a significant decrease in renal TXB2 (the stable chemical metabolite of TXA2) and a significant increase in renal 6-keto-PGF1 alpha (the stable chemical metabolite of PGI2) synthesis. Intraperitoneal injection of captopril (SQ 14225) an angiotensin converting-enzyme inhibitor, did not protect the animals against ARF. This lack of protection was accompanied by a significant increase in renal TXB2 and a significant decrease in renal 6-keto-PGF1 alpha synthesis. The results suggest that: (a) the renin-angiotensin (R-A) system does not play a role, or has only a secondary one in the development of ARF; (b) thromboxane A2 (the most potent vasoconstrictor and platelet aggregator agent known) is the preponderant agent responsible for the development of this pathological syndrome. PMID- 3513209 TI - Preinduction cervical priming in high risk pregnancy--experience with a new sustained release PGE2 vaginal film. AB - Experience with a new sustained release PGE2 formulation is presented. 111 high risk primiparae with very poor cervical scores (less than 3) were studied. In 59 patients, labour was induced by forewater amniotomy and I.V. oxytocin. In the remaining 52 patients, film containing 850 ug of PGE2 was inserted into the vagina to ropen the cervix 24 hours prior to induction of labour. Indications for elective delivery and maternal characteristics were similar in both groups. There were significant changes in the cervical state within 12 hours of vaginal insertion. By 24 hours, 19 patients receiving vaginal film (36.5%) had established labour of whom 13 proceeded to vaginal delivery. Significantly fewer patients in the priming group required Caesarean delivery. No untoward maternal or fetal side effects were observed. Safety, ease of administration and efficacy make this new PGE2 formulation a useful agent for priming of the very poor primiparous cervix prior to induction of high risk labour. PMID- 3513210 TI - Amphetamine potentiation of anti-conflict action of chlordiazepoxide. AB - A modified Geller-Seifter paradigm was employed to test in male albino rats the effects of subthreshold doses of amphetamine and chlordiazepoxide (CDP), administered separately or in combination, on shock induced suppression of food reinforced lever-pressing. MK-801, a newly synthesized sympathomimetic with anxiolytic and anticonvulsant properties, was also tested. dl-Amphetamine in doses of 0.1, 0.2, 0.3, and 1.0 mg/kg had no anxiolytic nor anxiogenic effects, but at 1.0 mg/kg it increased non-conflict responding. CDP in doses of 0.1, 0.2, and 0.4 mg/kg had no significant effect on conflict and non-conflict responding. CDP in the dose of 0.8 mg/kg tended to increase conflict responding. Coadministration of amphetamine (0.2 mg/kg) and CDP (0.4 mg/kg) had a significant anti-conflict effect. MK-801 at 50 micrograms/kg and 100 micrograms/kg caused a significant increase in non-conflict responding. MK-801 at 50 micrograms/kg exerted also a significant anti-conflict effect. The disinhibitory effects of amphetamine coadministered with CDP were discussed in terms of a possible enhanced noradrenergic or dopaminergic activity and their interaction with GABA neurotransmission at GABA-benzodiazepine coupled sites. PMID- 3513211 TI - Anson Jones--physician president. PMID- 3513212 TI - Physician writers: Chekhov, Keats, and Maugham. PMID- 3513213 TI - The poet-physician: medicine's impact on the lives and works of John Keats and Robert Bridges. PMID- 3513214 TI - In situ hydrogen peroxide production may account for a portion of NUV (300-400 nm) inactivation of stationary phase Escherichia coli. PMID- 3513215 TI - Voluntary ethanol consumption and obesity in golden hamsters. AB - Adult male golden hamsters with continuous access to Purina chow, water and either 15, 30 or 45% ethanol (v/v) for 14 weeks derived an average of 34, 37 and 22%, respectively, of their total calories from ethanol. Animals in the 15 and 45% ethanol groups derived up to 12.0 and 9.9 kcal/day, respectively, from ethanol, but the Purina chow intakes of these animals were such that their total caloric consumption and their body weights did not significantly exceed those of a control group having access only to Purina chow and water. In contrast, the 30% ethanol group derived up to 16.4 kcal/day from ethanol, and consistently consumed 25% more total calories than the control group, despite eating significantly less Purina chow. Furthermore, hamsters in the 30% ethanol group were 27% heavier and had significantly larger epididymal and retroperitoneal fat pads than controls. Similarities are noted between ethanol-induced obesity in hamsters and the dietary obesity which has been observed in rats having continuous access to Purina chow and a 32% sucrose solution. PMID- 3513216 TI - Effects of manipulations of glucoregulation on feeding in the ground squirrel. AB - Insulin and 2-deoxy-D-glucose (2-DG) stimulate feeding in rats, while glucagon inhibits feeding. We report here their effects on food intake in the 13-lined ground squirrel (Spermophilus tridecumlinectus). These hibernating animals are an interesting model for studying appetite regulation because of the marked seasonal variations in food consumption. Food intake reached a peak of 286 +/- 7 g/kg/day in mid July, decreasing to 16.1 +/- 3 g/kg/day in September. Studies during the hyperphagic period showed that glucagon (0.5 to 1 mg/kg) decreased feeding 30 minutes post injection (p less than 0.01) whereas at 4 hours glucagon produced a 37% increase in feeding (p less than 0.05). During the hypophagic period, glucagon failed to alter food consumption. Insulin (5-100 Units/kg) produced no effect on feeding in hyperphagic animals despite a decrease in glucose from 193 +/- 10 mg/dl to 55 +/- 4 mg/dl after 100 Units/kg. However, insulin (50 and 100 Units/kg) resulted in significant increases in food consumption at 2 and 4 hours (p less than 0.01 and 0.05, respectively) when administered while the animals were hypophagic. 2-DG (250-750 mg/kg) increased food consumption (hyperphagic phase) by 76% at 20 hours (p less than 0.01) with significant increases being present as early as 4 hours, although when 2-DG was given to hypophagic animals it resulted in decreased food intake at 4 hours (p less than 0.05). We conclude that the effects of glucoregulatory manipulations on food consumption are markedly influenced by the circannual rhythm of feeding in the 13-lined ground squirrel. PMID- 3513217 TI - Inhibitory action of insulin on suprachiasmatic nucleus neurons in rat hypothalamic slice preparations. AB - In order to elucidate a role of insulin on neurons in the suprachiasmatic nucleus (SCN) involved in the generation of circadian feeding behavior, we examined the effect of insulin on SCN neuronal activity at in vitro condition. Bath application of insulin (1-100 microU) mainly inhibited the SCN neuronal activity, and this inhibitory effect was still observed in a Ca2+-free Krebs solution. The present result strongly suggests that insulin directly inhibits SCN neurons and may explain an increase in food intake by insulin infusion into the SCN during the light period. PMID- 3513218 TI - Directly repeated, 20-bp sequence of plasmid R1162 DNA is required for replication, expression of incompatibility, and copy-number control. AB - DNA required in cis for the replication of the broad-host-range plasmid R1162 is located on two contiguous HpaII fragments of 210 and 370 bp. The latter of these contains three and one-half, perfectly conserved, 20-bp directly repeated sequences. The significance of these for plasmid replication, incompatibility, and copy-number control was examined by generating deletions into these repeats and testing the properties of the remaining DNA. We conclude from the results that the direct repeats are essential for expression of incompatibility and for the decrease in copy number observed when the directly repeated DNA is cloned into R1162. Little, if any, additional DNA is required from the ori region for these properties. Moreover, deletions of intermediate size result in an intermediate level of incompatibility, indicating the importance of the periodic structure of the direct repeats. The directly repeated DNA is also required for an active origin of replication, as are additional, nonrepeated sequences adjacent to this DNA. The properties of the direct repeats are discussed with respect to their possible role in the replication of R1162 DNA. PMID- 3513219 TI - Dissecting cellulitis of the scalp. AB - Dissecting cellulitis of the scalp or perifolliculitis capitis abscedens et suffodiens is a rare, chronic, progressive, suppurative disease of the scalp of unknown etiology. It is characterized by painful nodules, purulent drainage, burrowing interconnecting abscesses, and cicatricial alopecia. The pathogenesis is unknown, although it is probably related to follicular occlusion, secondary infection, and deep inflammation. Black men in their second to fourth decade are predominantly affected. Treatment varies from systemic antibiotics to incision and drainage, x-ray epilation of the affected areas, systemic steroid administration, and surgical excision. Our experience with four patients with extensive scalp disease is presented. Wide excision of the affected areas and splitthickness skin graft are favored as our treatment of choice. PMID- 3513220 TI - Objective monitoring for safe tissue expansion. AB - The high incidence of complications during tissue expansion may be related to overexpansion with subsequent tissue necrosis and implant extrusion. Subjective parameters such as pain or capillary fill may be poor guidelines for determining the end point of a given session of expansion. In an attempt to rectify this problem, we have shown in a prospective study of eight consecutive patients that noninvasive objective monitoring utilizing transcutaneous measured oxygen levels, local perfusion, and implant pressures allowed us to quickly and safely expand each patient. Although perhaps cumbersome for routine use, this system proved valuable in complicated situations where subjective parameters could not be observed. PMID- 3513222 TI - Metastatic cervical teratoma of infancy. AB - The first case of a documented metastatic cervical teratoma of infancy is presented with a review of diagnostic considerations. Early biopsy of suspicious neonatal head and neck masses is recommended. Complete resection of the teratoma should be considered as soon as clinically possible. PMID- 3513221 TI - Microsurgical hypospadias repair. AB - Successful primary hypospadias repair depends on careful execution of surgical principles, particularly during the urethroplasty portion of the procedure. These principles include careful tissue handling, development of well-vascularized flaps, and avoidance of placing sutures in the uroepithelial surface. Despite meticulous repair, the complication rate requiring secondary surgery is 15 to 30 percent. For the past year, the authors have utilized an operating room microscope, microsurgical instruments, a specially designed microsuture, and a Biooclusive dressing to decrease the postoperative morbidity and subsequent complications requiring secondary surgery (6.5 percent). A comparison of 50 hypospadias patients on whom no microsurgical repair had been used was made with 62 patients on whom microsurgical techniques were employed. The nonmicrosurgical group had 17 complications, 12 of which required reoperation (24 percent). The microsurgical group had 8 complications, 4 of which required reoperation (6.5 percent). PMID- 3513224 TI - History of the American Association of Plastic Surgeons, 1979-1985. PMID- 3513223 TI - A new experimental model for myocutaneous flaps: latissimus dorsi of the rabbit- an anatomic study. AB - A new experimental model, the latissimus dorsi flap of the rabbit, was studied. This was found to be a relatively inexpensive research model. Its use is advocated for composite tissue transfer as transposition, island, or free myocutaneous flaps. PMID- 3513225 TI - Elbow coverage. PMID- 3513226 TI - Mohs' technique for recurrent basal cell cancers of the face. PMID- 3513227 TI - Simultaneous total correction of temporomandibular ankylosis and facial asymmetry. AB - Ankylosis of the temporomandibular joint not only prevents mouth opening and chewing, but also affects the growth and position of the mandible. This produces progressive facial distortion with devastating psychosocial effects compounding the already difficult problem of not being able to open the mouth. Over the past 6 years, 18 patients in Canada and Taiwan were treated by excision of a large block of bone at the ankylosis and repositioning of the jaw, with the addition of osteotomies as necessary to produce a symmetrical face with good occlusion. Bilateral cases were treated at one operation in a similar way. The temporomandibular joint and absent ramus were constructed with a costochondral graft taken from the opposite chest. Some patients were treated with intermaxillary fixation for 8 weeks, while others had no fixation, but there was no difference in the effectiveness of correction of the ankylosis. PMID- 3513229 TI - Fetal surgery: a frontier for plastic surgery. PMID- 3513228 TI - Breast reconstruction using modified tissue expansion. AB - Inadequate chest-wall skin following mastectomy for carcinoma continues to be a problem in many breast reconstructions. To avoid extensive surgery, serial tissue expansion has been advocated. Since 1977, one of the authors has used a simple method of tissue expansion that we have termed "modified tissue expansion", defined as the creation of an adequate breast mound in one or two stages using a permanent prosthesis. Ninety percent of patients undergoing breast reconstruction between 1978 and 1983 were reconstructed using this method. A retrospective analysis of these 208 patients is presented. There were no mortalities, and only a 6.3 percent complication rate. Skin necroses related directly to the prosthesis occurred once, and there were no prosthetic deflations. Eighteen percent had first-step reconstruction only. The initial prosthesis averaged 400 cc in size. Selected Halsted radical mastectomy and postradiotherapy patients were successfully reconstructed. Seventy-eight percent felt their results were excellent at 1 year. Two percent were dissatisfied. Multiple office visits and the potential problems of serial expansion were avoided. Modified tissue expansion is a simple and viable method and should be considered among the options for breast reconstruction following mastectomy. PMID- 3513230 TI - Total reconstruction of aplasia cutis congenita involving scalp, skull, and dura. AB - A case of total reconstruction of skull and scalp in a patient with a large defect from aplasia cutis congenita is reported. Tissue expansion was successfully employed on two occasions: first to construct a well-vascularized space to sustain multiple rib grafts for cranial reconstruction and then to develop adequate quantities of scalp and forehead for total coverage. PMID- 3513231 TI - [History of German psychosomatic medicine--philosophical and historical roots]. PMID- 3513232 TI - Psychiatric disorders in parkinsonism. 1. Functional illnesses and personality. PMID- 3513233 TI - Characterization and quantitation of DNA strand breaks requiring recA-dependent repair in X-irradiated Escherichia coli. AB - The repair of X-ray-induced DNA single-strand breaks was studied after the completion of growth-medium-independent repair in Escherichia coli K-12. A comparison of the sedimentation of DNA from bacteriophages T2 and T7 was used to test the accuracy of our alkaline and neutral sucrose gradient procedures for determining the molecular weight of bacterial DNA. The repair of DNA single strand breaks by cells incubated in buffer occurred by two processes. About 85% of the repairable breaks were resealed rapidly (t1/2 = less than 6 min), while the remainder were resealed slowly (t1/2 = approximately 20 min). After the completion of the repair of DNA single-strand breaks in buffer, about 80% of the single-strand breaks that remained were found to be associated with DNA double strand breaks. The subsequent resuspension of cells in growth medium allowed the repair of both DNA single- and double-strand breaks in wild-type but not in recA cells. Thus the recA-dependent, growth-medium-dependent repair of DNA single strand breaks is essentially the repair of DNA double-strand breaks. PMID- 3513234 TI - The effect of graded doses of fission neutrons or X rays on the lymphoid compartment of the thymus in mice. AB - Young adult CBA/H mice were exposed to graded doses of whole-body irradiation with either fast fission neutrons or 300 kVp X rays at center-line dose rates of 0.1 and 0.3 Gy/min, respectively. Dose-response curves were determined at Days 2 and 5 after irradiation for the total thymic cell survival and for the survival of thymocytes defined by monoclonal anti-Thy-1, -Lyt-1, -Lyt-2, and -T-200 antibodies as measured by flow cytofluorometric analysis. Cell dose-response curves of thymocytes show, 2 days after irradiation, a two-component curve with a radiosensitive part and a part refractory to irradiation. The radiosensitive part of the dose survival curve of the Lyt-2+ cells, i.e., mainly cortical cells, has a D0 value of about 0.26 and 0.60 Gy for neutrons and X rays, respectively, whereas that of the other cell types has corresponding D0 values of about 0.30 and 0.70 Gy. The radiorefractory part of the dose-response curves cannot be detected beyond 5 days after irradiation. At that time, the Lyt-2+ cells are again most radiosensitive with a D0 value of 0.37 and 0.99 Gy for neutrons and X rays, respectively. The other measured cell types have corresponding D0 values of about 0.47 Gy. The fission neutron RBE values for the reduction in the thymocyte populations defined by either monoclonal anti-Thy-1, -Lyt-1, -Lyt-2, or -T-200 antibodies to 1.0% vary from 2.6 to 2.8. Furthermore, the estimated D0 values of the Thy-1-, T-200- intrathymic precursor cells which repopulate the thymus during the bone marrow independent phase of the biphasic thymus regeneration after whole body irradiation are 0.64-0.79 Gy for fission neutrons and 1.32-1.55 Gy for X rays. PMID- 3513235 TI - Polysaccharides induce radioprotection of murine hemopoietic stem cells and increase the LD50/30 days. AB - Intravenous administration of 60 mg/kg of a polysaccharide (MNR, MNZ, GLP/BO4, GLP/BO5) significantly decreases the mortality of mice exposed to a single dose of X rays. The dose reduction factors (DRF) obtained for MNZ, MNR, GLP/BO4, and GLP/BO5 given intraperitoneally 15 min before exposure were 2.16, 1.93, 1.80, and 1.94, respectively. The DRF was not increased when MNZ or GLP/BO4 were combined with injection of AET before X-ray exposure. The LD50 for the CFUs exposed in vivo in mice was 1.13 Gy for the treated mice and 0.75 Gy for the nontreated mice. This corresponds to a DRF of 1.6. The DRF calculated from the slope is 1.27. PMID- 3513237 TI - [Morphological reactions of neural elements in the limbic region of the cerebral cortex to whole body roentgen irradiation]. AB - After whole-body X-irradiation with a dose of 5 Gy, the content of limbic neocortex cells of altered neurocytes markedly increases: many of the disorders in their structure are reversible. In the inner cell complex the neurocytes with "dark type" changes are frequent and, in most cases, irreversible. Different types of gliocytes respond in a different manner to the effect of ionizing radiation. PMID- 3513236 TI - [UMP synthase activity of rat tissue extracts in the bone marrow form of radiation sickness]. AB - Whole-body gamma-irradiation of rats with a dose inducing bone marrow radiation syndrome caused phase organospecific changes in UMP-synthase activity. Disturbances of enzymic activity in the bone marrow and spleen well correlated with the dynamics of interphase and reproductive cell death. In brain extracts, UMP biosynthesis from orotic acid did not undergo essential changes. PMID- 3513238 TI - [Effect of the combined use of chemical radioprotectors and inhibitors of prostaglandin biosynthesis on the postradiation recovery of hemopoiesis in mice]. AB - In experiments on mice it was shown that chemical radioprotective agents and inhibitors of prostaglandins, which were administered in a combination after irradiation to promote the haemopoiesis recovery, exerted a pronounced hemo stimulating effect exceeding that produced by each of the agents applied separately and increasing the survival of mice. PMID- 3513239 TI - [Effect of ionizing radiation on methylation of lysyl tRNA synthetase from rat liver]. AB - X-irradiation of animals with an absolutely lethal dose of 0.21 C/kg increases the incorporation of a methyl group into aminoacyl-tRNA-synthetases the radioactive label being traced in lysine, arginine, and histidine. The isolated protein methyltransferase methylated total preparations of aminoacyl-tRNA synthetases and lysyl-tRNA-synthetase of rat liver in the in vitro experiments with the use of S-adenosylmethionine-14CH3 as a donor of methyl groups: the radioactive label was traced in arginine, lysine, histidine, aspartic and glutamic acids. PMID- 3513240 TI - Real-time ultrasound of hypertrophic pyloric stenosis. PMID- 3513241 TI - [Lung complications in AIDS]. AB - A short description of epidemiologic and clinical facts correlated with the acquired immunodeficiency syndrome (AIDS) is followed by a report on the manifestation of pulmonary infections mostly effected by Pneumocystis carinii. Two examples out of four cases will demonstrate the radiographic appearance of the Pneumocystis carinii pneumonia and clinical data. Only in rare cases does it seem possible to reduce the fatal outcome by early diagnosis. PMID- 3513242 TI - [Long-term observation of a case of intravenous injection of elemental mercury]. AB - Elementary mercury is usually intravenously injected with suicidal intent. It is floated to the heart and lungs but is also deposited in the abdominal organs. Case histories presented in the literature so far have been followed up clinically and roentgenologically for up to three years. We report one patient attempting suicidal mercury injection, whom we were able to follow up for 10 years. It could be demonstrated that quite in contrast to former suggestions elementary mercury is dissolved and oxidised in the body. Chronic poisoning with mercury compounds causes continuing damage, particularly to the kidneys. Apart from that question, the element's pattern of spread within the body, toxicological issues, particular pathologic anatomic changes, their demonstrability on X-ray films and their clinical relevance are all discussed in this paper. PMID- 3513243 TI - Tissue characterization of the testes using ultrasonic CT. Work in progress. AB - Ultrasonic computed tomography (UCT) can aid in characterizing tissue for the detection and diagnosis of leukemic infiltration of the testes. Preliminary studies in 6 healthy adults and 26 patients (3-20 years old) with leukemia or non Hodgkin lymphoma suggest that elevated speed of sound in the testis may be an indicator of leukemic infiltration. UCT may become an important screening method for detecting testicular involvement. In long-term follow-up, UCT can be performed more frequently and easily than biopsy, which is the current screening method. PMID- 3513244 TI - Multicystic dysplastic kidney in utero: changing appearance on US. AB - Serial ultrasound (US) examinations of six cases of fetal multicystic dysplastic kidney were reviewed. In all cases the diagnosis was confirmed by pathologic or neonatal radiologic examination. The in utero appearance on US scans of multicystic dysplastic kidneys sometimes changed dramatically. Furthermore, all of the multicystic dysplastic kidneys changed in size: four enlarged, one shrank, and one initially enlarged and later shrank. Radiologic and laboratory data suggest that multicystic dysplastic kidneys may have the capacity for glomerular filtration. The change in size and appearance of fetal multicystic dysplastic kidneys may result from this residual renal function. PMID- 3513245 TI - Ovarian carcinoma follow-up: US versus laparotomy. AB - Ultrasound (US) was compared with surgical findings in 98 patients with carcinoma of the ovary undergoing follow-up laparotomy after chemotherapy. US had an overall accuracy of 94% in the pelvis, with only small and sheetlike lesions escaping detection. It was more sensitive than clinical examination. Overall accuracy for the liver was 91% with very few false-positive results. For the peritoneal cavity in general, however, accuracy was low, with even large masses escaping detection. Ascites is reliably detected (accuracy of 97%) but is a poor indicator of peritoneal involvement. US is a useful noninvasive complement to laparoscopy in the follow-up of patients with carcinoma of the ovary. PMID- 3513246 TI - Coralline hydroxyapatite bone graft substitutes: preliminary report of radiographic evaluation. AB - A new bone graft substitute made by conversion of the calcium carbonate exoskeleton of reef-building sea coral into hydroxyapatite has recently become clinically available. The normal radiographic appearance of two forms of this material is described. In the immediate postoperative period, the exoskeletal architecture of these implants is readily appreciated. With graft incorporation over the ensuing months, their intrinsic structure is gradually lost in association with poor marginal definition. Evolving radiographic findings reflect the biocompatible nature of these implants, which provides the potential for ingrowth of native bone with preservation of the coralline scaffold, resulting in enhanced biomechanical properties. PMID- 3513248 TI - Specific skeletal dysplasias in utero: sonographic diagnosis. AB - A retrospective study was performed of 13 short-limbed fetuses with lethal skeletal dysplasias that were evaluated with ultrasound (US) from 1981 to 1984. The specific diagnoses were thanatophoric dwarfism, achondrogenesis, osteogenesis imperfecta, and campomelic dwarfism. Death occurred in utero or within 2 weeks after delivery in all cases. US examination showed other associated abnormalities, including polyhydramnios, hydrops, shortened femurs, and CNS abnormalities. Radiographs confirmed these findings and provided more information regarding the shape of the limbs and thorax and the appearance of the spine. The probable diagnosis of lethal short-limbed dwarfism was made antenatally using US in eleven of the fetuses. Spinal appearance, thoracic shape, and associated hydrops and polyhydramnios were most helpful in determining the specific type of dysplasia present. Lethal short-limbed skeletal dysplasia may be diagnosed confidently in utero using US examination; however, obstetric plain film radiography may be required to determine the definitive type of dysplasia. In certain cases, US may be sufficient to make a definitive diagnosis. PMID- 3513247 TI - Ectopic ureter and ureterocele: their varied sonographic manifestations. AB - The sonographic examinations of four patients with simple ectopic ureters and 11 with ectopic ureteroceles were reviewed to determine distinguishing characteristics. Ectopic ureters, in cases of extreme dilatation and tortuosity, sometimes mimic multiseptated, cystic abdominal masses. However, the proximal portions of some severely dilated ureters are surprisingly small. Ectopic ureters sometimes indent the lower vesical wall, simulating a ureterocele. Ectopic ureteroceles are dynamic structures, changing in shape and size according to intravesical pressure. The lower pole of a duplex kidney may be difficult to detect because of displacement by the dilated upper renal pelvis and ureter. The renal parenchyma associated with an ectopic ureter may be equally difficult or impossible to find because of diminutive dysplasia or, less commonly, acquired atrophy. Dysplasia is characterized sonographically by highly echogenic parenchyma, lack of corticomedullary differentiation, and occasionally massive enlargement by cysts. Ectopic ureters and ureteroceles can be identified by fetal sonography. PMID- 3513249 TI - Abnormal facial features and extremities in human trisomy syndromes: prenatal US appearance. AB - Twelve cases of fetal trisomy syndromes are reported in which prenatal sonographic findings were highly suggestive of the chromosomal abnormality. The abnormal appearance on the sonogram led to karyotype studies in ten fetuses and to appropriate obstetrical management. The sonographic abnormalities pertained to the extremities and face of the fetus. PMID- 3513250 TI - Bladder pseudomass following cystography-related bladder trauma. AB - Transient sonographic abnormalities of the urinary bladder in children can be identified immediately after performance of voiding cystourethrography. Both cystic and solid masses may be mimicked by transient hematuria induced by minor, cystography-related trauma. After the bladder has been emptied and refilled, reexamination shows prompt resolution of these pseudo-masses. PMID- 3513251 TI - Breast lesions: differential diagnosis using digital subtraction angiography. AB - To evaluate its potential for differentiating benign from malignant breast lesions, digital subtraction angiography of the breast (DSAB) was performed in 23 women with mammographic evidence of disease, and the results were compared with surgical biopsy findings. The DSAB technique employed breast immobilization with modest compression and bolus injection; following the injection of contrast material, 30-40 sequential subtraction images were obtained over a 5-minute interval. The average technical settings were 50 k Vp and 10 mAs, resulting in an estimated radiation dose to the breast of 0.05 mrad (0.5 mu Gy) per exposure. DSAB consistently demonstrated retention of contrast material and abnormal vasculature in malignant lesions but not in benign lesions. In the 22 breast lesions for which there was histopathologic correlation, DSAB correctly categorized eight of nine malignant and 11 of 13 benign lesions. Although this series is small, the initial results of DSAB suggest its potential for differentiating benign from malignant lesions. PMID- 3513252 TI - Inflammatory aortic aneurysm (periaortic fibrosis): radiologic imaging. AB - Inflammatory aneurysms represent a distinct surgical entity with a reported incidence varying from 5% to 23% of all abdominal aortic aneurysms. Surgical repair of inflammatory aneurysms is associated with a higher morbidity and mortality than is repair of simple aortic aneurysms. Complicated cases require suprarenal aortic control, and the surgeon must be forewarned to maximize the chance for successful aneurysm repair. Preoperative diagnosis of this entity by cross-sectional imaging facilitates improved planning of the operative approach and permits the institution of preoperative steroid treatment to reduce the volume of the periaortic fibrotic mass. Ultrasound demonstrates the inflammatory process as a hypoechoic mass surrounding the intensely echogenic, thickened aortic wall. Computed tomography reveals a thickened, often calcified aortic wall and a mass of periaortic inflammatory tissue. Dynamic scanning reveals rapid intraluminal enhancement, slightly delayed enhancement of the inflammatory mass, and nonenhancement of the thick fibrous adventitia. PMID- 3513253 TI - Normal stomach wall and gastric cancer: evaluation with high-resolution operative US. AB - Operative ultrasound examinations were performed using a 7.5-MHz transducer during nine operations for advanced gastric cancers and during six for early cancers. Normal stomach wall showed five layers that corresponded to histologic structures. Fourteen of 15 tumors, including nonpalpable early cancers, were localized with ultrasonography. In addition, both depth of penetration and lateral wall extension of the gastric cancers were precisely determined with this technique. Our preliminary results indicate that high-resolution operative ultrasonography may become a diagnostic aid during gastric cancer operations. PMID- 3513254 TI - The echogenic focus in prostatic sonograms, with xeroradiographic and histopathologic correlation. AB - The sonograms of 42 patients scanned before and after radical prostatectomy were reviewed, giving specific attention to echogenic foci. All patients had clinical stage A or B adenocarcinoma of the prostate. Comparison of the scans with xeroradiographic and histopathologic studies showed all echogenic foci, with or without acoustic shadowing, to represent prostatic calcifications. Calcifications were located in the central portion of the gland exclusively, either immediately adjacent to the urethra or at the margins of the "internal gland", separate from the peripheral location of small tumors. With carcinomatous spread toward the urethra, calculi were found surrounded by tumor. This was considered a result of secondary involvement rather than dystrophic tumor calcification. Prostatic calcifications seem unrelated to the development of adenocarcinoma but must be recognized to prevent erroneous interpretation. PMID- 3513255 TI - Functional imaging of the heart: methods, limitations, and examples from gated blood pool scintigraphy. PMID- 3513256 TI - Clinical applications of dynamic computed tomography. PMID- 3513257 TI - Veterans Administration cooperative study of medical versus surgical treatment for stable angina--progress report. Sections 12-l5. PMID- 3513258 TI - Dissociation of hyperreninemia and renal prostaglandin synthesis in the adrenalectomized rat. AB - The aim of this study was to determine whether hyperreninemia in the adrenalectomized (ADX) rat is dependent on renal prostaglandin synthesis, as has been suggested for two other hyperreninemic conditions, Bartter's syndrome and chronic liver disease. Plasma renin concentration (PRC) in anesthetized, ADX rats was significantly increased (delta +480%; p less than 0.001) compared to sham operated controls. In vivo, indomethacin (10 mg/kg i.v.) significantly reduced PRC of anesthetized, ADX rats after both 45 min (delta -34%; p less than 0.05) and 90 min (delta -47%; p less than 0.05). In vitro renin release from renal cortical slices of ADX rats was also significantly greater (delta +130%; p less than 0.05) than from sham-operated control cortical slices. Renin release from cortical slices of ADX rats given dexamethasone (10 micrograms/kg/day) for 4 days prior to sacrifice did not differ from sham-operated control values. Prostaglandin E2 (PGE2) release from cortical slices of ADX rats did not differ significantly from controls. However, PGE2 synthesis in glomeruli microdissected from ADX rats was significantly increased (delta +110%; p less than 0.001) compared to controls. PGE2 synthesis in glomeruli of dexamethasone-treated ADX rats remained significantly elevated compared to controls. Ibuprofen (10(-6) M) decreased PGE2 synthesis in cortical slices by 80%. However, prostaglandin synthesis inhibition had no effect on renin release from either ADX or control renal cortical slices. These results suggest that despite increased glomerular synthesis, prostaglandins do not directly influence renin release in the ADX rat. PMID- 3513259 TI - Role of prostacyclin on steroidogenesis by frog interrenal gland in vitro. AB - The role of prostacyclin (PGI2) on amphibian adrenal steroidogenesis was studied in vitro in perifused interrenal fragments from adult male frogs. Exogenous PGI2 (3 X 10(-8) M to 3 X 10(-5) M) and, in a lesser extent, 6-keto-PGF1 alpha increased both corticosterone and aldosterone production in a dose-related manner. Short pulses (20 min) of 0.88 microM PGI2 administered at 90 min intervals within the same experiment did not induce any desensitization phenomenon. A prolonged administration (6 h) of PGI2 gave rise to an important increase in steroid production followed by a decline of corticosteroidogenesis. Indomethacin (IDM, 5 microM) induced a marked reduction of the spontaneous secretion of corticosteroid which confirmed the involvement of endogenous PGs in the process of corticosteroid biosynthesis. The IDM-induced blockade of corticosterone and aldosterone secretion was totally reversed by administration of exogenous PGI2 in our model. Angiotensin II (AII) induced a massive release of 6-keto-PGF1 alpha, the stable metabolite of PGI2. The increase of 6-keto-PGF1 alpha preceded the stimulation of corticosterone and aldosterone secretions. In contrast, the administration of ACTH did not modify the release of 6-keto-PGF1 alpha. These results indicate that PGI2 might be an important mediator of adrenal steroidogenesis in frog. They confirm that the corticosteroidogenic actions of ACTH and AII are mediated by different mechanisms. PMID- 3513260 TI - Pharmacological profile of a novel carbacyclin derivative with high metabolic stability and oral activity in the rat. AB - A novel carbacyclin derivative (16S)-13,14-dehydro-16,20-dimethyl-3-oxa 18,18,19,19-tetradehydro- 6a- carbaprostaglandin-I2 (3-oxa-analogue) has been synthesized in order to find chemically and metabolically stable prostacyclin mimetics with a potency equal or even superior to PGI2. The 3-oxa-analogue was found to be stabilized against beta-oxidation, a main metabolic degradation step also for chemically stable PGI2-analogues. The compound is orally available and displays a long duration of 4.5-48 h of antiaggregatory and hypotensive action. The 3-oxa-analogue inhibits ADP-induced platelet aggregation with an IC50 of 3.0 nM. Following intravenous application the 3-oxa-analogue lowers diastolic blood pressure in a dose dependent manner, the ED20 being 0.1-0.2 micrograms/kg after injection and less than or equal to 0.05 micrograms/kg/min after infusion respectively. In vivo platelet aggregation is inhibited after i.v. infusion of the 3-oxa-analogue with an IC50 of 0.037 micrograms/kg/min. As compared to Iloprost, the 3-oxa-analogue is 5-12 fold more potent with respect to in vivo hypotensive and anti-aggregatory effects. The results of the present studies indicate that the 3-oxa-analogue has a pharmacological profile comparable to prostacyclin (PGI2) and Iloprost. Due to the fact that the 3-oxa-analogue is chemically and metabolically stable, long term oral treatment can be achieved in clinical conditions in which PGI2 and Iloprost have already been shown to be therapeutically useful principles. PMID- 3513261 TI - [The path into the wilderness as the path to the self? Critical reflections on Hans Peter Duerr's ethnology]. PMID- 3513262 TI - Fabricating an indirect dowel-core for a premolar with divergent canals. PMID- 3513263 TI - Immediate, abrade-resistant, fine removable dies. PMID- 3513264 TI - Color coding in RPD design: two clinical cases. PMID- 3513265 TI - Tensile bond strength of veneering resins to opaque systems. PMID- 3513266 TI - Impression technique and laboratory procedures for a processed resilient denture liner. PMID- 3513267 TI - Neuropeptide Y-like immunoreactivity in adrenaline cells of adrenal medulla and in tumors and plasma of pheochromocytoma patients. AB - The occurrence of neuropeptide Y (NPY)-like immunoreactivity (LI) in the adrenal gland of several species as well as in tumor tissue and plasma from pheochromocytoma patients was investigated. NPY-LI was present in chromaffin cells of the adrenaline type in all species investigated except in the pig, as demonstrated by a colocalization of NPY-LI and the adrenaline-synthetizing enzyme phenylethanolamine N-methyltransferase (PNMT). NPY-LI in the adrenaline cells of the cat was clearly separated from the neurotensin-LI in the noradrenaline dopamine-beta-hydroxylase-positive, PNMT-negative cells. NPY-LI seems to co-exist with enkephalin-like material in the chromaffin cells. In addition, NPY-LI was present in nerves both within the adrenal cortex and medulla. The highest levels of NPY-LI were found in mouse and cat, while only a very low amount of NPY-LI was present in the pig adrenal. Characterization of the adrenal NPY-LI by reversed phase high-performance liquid chromatography revealed that the main peak was similar to porcine NPY. In addition, two minor peaks of NPY-LI were present. High levels of NPY-LI were found in plasma and tumors from the pheochromocytoma patients. During manipulation of the tumors upon surgical removal, there was a marked increase in plasma NPY-LI in parallel with the raise in catecholamines and in blood pressure. At least two forms of NPY-LI were present in plasma and tumor extracts from pheochromocytoma patients with the main peak corresponding to porcine NPY. Since NPY exerts vasoconstrictor effects, it may be postulated that NPY contributes to the adrenal cardiovascular response and to the hypertension seen in pheochromocytoma patients. PMID- 3513268 TI - Comparison of lung volume measurements by single breath helium and multiple breath nitrogen equilibration methods in normal subjects and COPD patients. AB - The validity of the single breath helium dilution method for accurate measurement of the total lung capacity (TLC) was investigated. Comparison was made with the multiple breath nitrogen equilibration technique in 22 normal subjects and 37 patients with chronic obstructive pulmonary disease (COPD). The single breath method underestimated the TLC in all the normal individuals and 33 of 37 patients with COPD. Possible explanations for the falsely low lung volumes include uneven distribution of inspired air due to closing volumes and induced bronchoconstriction. PMID- 3513269 TI - Effects of beta-agonists on breathlessness and exercise tolerance in patients with chronic obstructive pulmonary disease. AB - In a single-blind placebo-controlled trial in 12 patients with advanced chronic obstructive pulmonary disease (COPD) we compared the effects of nebulized salbutamol (1 mg), clenbuterol (30 micrograms) and placebo (4 ml of normal saline) on spirometric indices (FVC, FEV1), maximal expiratory flows (Vmax50 and Vmax25), the distance walked in 6 min (6MD), assessment of breathlessness by visual analogue scale (VAS), and estimates by the patients of perceived exertion (RPE). Both clenbuterol and salbutamol produced significant increases in FEV1, FVC, Vmax50 and Vmax25. With both drugs, 6MD increased significantly (p less than 0.01) and breathlessness decreased significantly without an appreciable increase in RPE after exercise despite the extra distance covered. The absolute improvements in FEV1 and 6MD after clenbuterol were correlated (r = 0.763, p less than 0.01), but these indices were not correlated after salbutamol (r = 0.121, p greater than 0.1). The lack of correlation between the changes in 6MD and FEV1 after salbutamol might indicate that relief of airways obstruction is not the only explanation for the effects on distance walked, at least with salbutamol. PMID- 3513270 TI - Cancer cachexia: effects of the disease and its treatment. PMID- 3513271 TI - [Cellular interactions in the inflammatory degradation of cartilage and connective tissues]. PMID- 3513272 TI - [Pathology caused by Legionellaceae. II]. PMID- 3513273 TI - [Pregnancy and traffic accidents]. PMID- 3513274 TI - [Cervical myelopathy--therapeutic criteria]. PMID- 3513275 TI - [Status febrilis, epigastric pain, diarrhea]. PMID- 3513276 TI - [The discovery of the pulmonary circulation]. PMID- 3513277 TI - [Medical deontology in Greek and Roman antiquity: myth and reality]. PMID- 3513278 TI - [Medicine and public health in the 18th century through the correspondence of Albert de Haller and Auguste Tissot]. PMID- 3513279 TI - [Cabanis and the relation between the physical and the moral]. PMID- 3513280 TI - [The dream of electrotherapy]. PMID- 3513281 TI - [Rejuvenation in the Middle Ages. Roger Bacon and the myth of the prolongation of life]. PMID- 3513283 TI - Infective endocarditis complicating mitral valve prolapse: epidemiologic, clinical, and microbiologic aspects. AB - Cases of infective endocarditis superimposed upon prolapsing mitral valves were first described two decades ago. In the intervening years 72 reports in the English-language literature have described 267 such cases. Men predominated numerically in cases occurring after the age of 40 years and in surgical and autopsy series. In cases with auscultatory abnormalities documented before the onset of infective endocarditis, murmurs-and not merely isolated systolic clicks- were usually present. Complications of infective endocarditis were relatively common, and at least 42 patients required valve replacement in the acute phase of illness or during convalescence. Although viridans streptococci were the most frequent etiologic agents (46% of cases), deaths occurred primarily among patients infected with other organisms and among those over 40 years of age. Mitral valve prolapse is increasingly being recognized as a precursor of infective endocarditis because of its high prevalence in the general population and the wider availability of echocardiographic diagnostic techniques. The risk/benefit and cost/benefit ratios for endocarditis prophylaxis in patients with prolapsing mitral valves remain controversial. PMID- 3513282 TI - Skin clues in the diagnosis of life-threatening infections. AB - Skin lesions, an important clue to the cause of septicemia, result from five main processes: (1) disseminated intravascular coagulation and coagulopathy; (2) direct vascular invasion and occlusion by bacteria or fungi; (3) immune vasculitis and immune complex formation; (4) emboli from endocarditis; and (5) vascular effects of toxins. Disseminated intravascular coagulation probably plays only a minor role in pathogenesis. Vascular invasion by bacteria may result in a severe inflammatory reaction, as in meningococcemia, or in a minimal reaction, as in ecthyma gangrenosum. Gram-stained smears of scrapings from the base of skin lesions--a frequently neglected procedure--is an important diagnostic adjunct. Skin biopsies are particularly important in the diagnosis of Rocky Mountain spotted fever and infections caused by Candida. PMID- 3513284 TI - Endophthalmitis following intraocular lens implantation: report of 30 cases and review of the literature. AB - Bacterial endophthalmitis is a postoperative complication of intraocular lens implantation. A review of 30 cases showed that 77% occurred within seven days of initial cataract surgery and that all cases occurred within 32 days. Common presenting symptoms and signs included pain localized to the involved eye, decreased visual acuity, conjunctival injection, anterior chamber inflammation, hypopyon, and absent or poor red reflex. Diagnosis of an infectious etiology was made by aqueous and vitreous sampling for gram stain and culture. The commonest bacterial agents were coagulase-negative staphylococci and Staphylococcus aureus, but a wide variety of gram-negative and -positive organisms were also isolated. On the basis of this series and review of the literature, optimal treatment includes prompt diagnosis by culture and gram stain of vitreous fluid, frequent application of topical antibiotics, and administration of intraocular antibiotics. Intravenous antibiotics and vitrectomy may improve the visual outcome. Removal of the intraocular lens is unnecessary for bacteriologic cure and is not associated with improved visual outcome. PMID- 3513285 TI - Salmonella focal intracranial infections: review of the world literature (1884 1984) and report of an unusual case. AB - Focal intracranial infections are unusual manifestations of salmonellosis. Forty three such infections have been reported in the world literature. The clinical data for 34 well-documented cases are reviewed. Eleven patients had brain abscess, 19 had subdural empyema, three had epidural abscess, and one had both subdural empyema and brain abscess. Brain abscess occurred more often in adults; in contrast, subdural empyema presented more often in children. Fever, signs and symptoms of increased intracranial pressure, change in mental status, seizures, and focal neurologic deficits were the commonest clinical features. Salmonella serotypes typhi, typhimurium, and enteritidis occurred most frequently. The precipitating factors of these infections included meningitis, trauma, and intracranial hematoma. Surgical drainage combined with systemic antibiotic therapy resulted in the recovery of 21 of 25 patients. A case of embryonal carcinoma plus seminoma of the testis with brain metastases complicated by a salmonella brain abscess is also reported. This is the first report in the world literature of a focal salmonella infection in a neoplastic lesion within the central nervous system. PMID- 3513287 TI - Infections with Eikenella corrodens in a general hospital: a report of 33 cases. AB - Of 33 cases of Eikenella corrodens infection occurring in a general hospital during an 18-month period, 18 were related to human bites or fist-fight injuries, and nine of these 18 cases were complicated by septic arthritis and/or osteomyelitis. Because E. corrodens grows slowly, requires an atmosphere containing 5%-10% CO2, and may be overgrown by other organisms, it may be missed on routine culture. The high rate of recovery of the organism in this study was attributable to the use of a selective medium. Because infections due to E. corrodens commonly mimic or occur in association with anaerobic infections, they are sometimes treated inappropriately. E. corrodens should be considered a possible pathogen in infections associated with oral contamination. Empiric antibiotic treatment of these infections with clindamycin or metronidazole alone is inappropriate since E. corrodens is generally resistant to these agents. PMID- 3513286 TI - Corynebacterium JK: a cause of nosocomial device-related infection. AB - Ten cases of serious infection due to antibiotic-resistant Corynebacterium JK are reported. Five infections occurred in patients with hematologic malignancy and granulocytopenia, an association previously reported. Five additional nosocomial infections occurred in patients without underlying disease previously reported to be associated with JK. Nine of the 10 infections were nosocomial in origin and were associated with plastic devices that had been inserted into the patients. JK organisms were isolated from a variety of sources from an additional 40 uninfected patients. Although the majority of clinical isolates of Corynebacterium JK were contaminants, our experience suggests that as many as 20% of isolations are associated with serious nosocomial infections. Isolation of Corynebacterium JK--particularly in blood cultures--from patients with indwelling catheters or other devices is highly suggestive of the presence of a serious nosocomial infection. PMID- 3513288 TI - Adherence of Candida species to host tissues and plastic surfaces. AB - Adherence of Candida species to host tissues and nonbiologic materials has been studied in vivo and in vitro. Attachment of Candida albicans to mucosal cells, fibrin-platelet matrices, vascular endothelial cells, and plastic materials has been examined to elucidate early events in the pathogenesis of mucosal colonization and infection, candidal endocarditis, tissue invasion from the intravascular space, and infection of prosthetic devices. Adherence of C. albicans and Candida tropicalis exceeds that of less virulent Candida species, and germinated C. albicans cells adhere to host tissues more readily than do yeast-phase organisms. The adhesin of Candida that mediates attachment has yet to be characterized at the molecular level; however, on the basis of competitive inhibition by crude and purified cell wall products, blocking by antibody and lectin, and controlled degradation of the cell surface of Candida, it appears that mannans and mannoproteins are important constituents of the adhesin. The methods currently used to assay adherence of Candida all have limitations, and an approach to resolving these limitations is one of several areas that warrant further investigation. PMID- 3513289 TI - Adult polycystic kidney disease. PMID- 3513290 TI - [The model of Florence Nightingale]. PMID- 3513291 TI - [Sonographic diagnosis of an aneurysm of the superior mesenteric artery]. AB - This is a report on a patient with a mycotic aneurysm of the superior mesenteric artery proved by histology. Because of a marked intolerance of contrast media we abstained from angiography. It is shown that real-time sonography gives a definite diagnosis, if the multiple vascular structures of the upper abdomen are precisely identified. PMID- 3513292 TI - [Radiation treatment of benign diseases--indications, results and technic]. AB - Radiotherapy is an effective means to treat several benign diseases; in fact, the therapeutic effects set in quickly and are of a long-term nature. Relapses are rare. Side effects or other undesirable reactions are negligible. The gonads are under risk that should not be underestimated, but this is usually acceptable within reasonable limits. The age of the woman patient and localisation of the disease are decisive factors. Definite dosage reductions can be achieved by suitable radioprotective measures. Nevertheless, indications for any kind of radiotherapy with ionising radiation should be strict as a matter of principle. PMID- 3513293 TI - Acid secretory tests in peptic ulcer disease before and after parietal cell vagotomy. AB - The aim of the present study was to evaluate the role of gastric acid secretory tests in predicting ulcer recurrence in a consecutive series of patients before and up to 5 years after parietal cell vagotomy (PCV). Included in the study are 405 patients with prepyloric or duodenal ulcer disease (57 recurrences). There were no differences in acid secretion in the group of patients with pyloric or prepyloric ulcer disease, with or without recurrences. Thus pre- and post operative acid secretory tests are of no value in predicting the outcome of PCV in this group of patients. In the duodenal ulcer group both postoperative basal acid output and peak acid output after pentagastrin and after insulin were higher in patients with recurrences. The two best discriminatory values were the ratio between the preoperative and the 6-week value of basal acid output and the 6-week value of peak acid output after insulin. The results of the study suggests that the ratio of the basal output before surgery and 6 weeks after surgery is enough for judging the acid reduction after PCV and that only in the case of a recurrence should an acid stimulation test be used. PMID- 3513294 TI - The priming effect of glucose on the gastric inhibitory polypeptide-induced insulin release. AB - Six healthy subjects were given a 15-min intravenous infusion of gastric inhibitory polypeptide (GIP) in a dose of 1.0 microgram X kg-1 X h-1 at a mean blood glucose level of 4.9 mmol/l after a priming infusion with glucose. A significant insulin release was seen during the GIP infusion, an effect that could not be demonstrated without the priming glucose infusion. PMID- 3513295 TI - Influence of bile duct occlusion on plasma insulin responses to glucose in rats. AB - The plasma insulin and glucose responses to intravenous glucose administration were studied in rats after 1, 3, and 6 weeks of bile duct occlusion. One week after the occlusion the first-phase plasma insulin response to glucose was clearly reduced, whereas the late-phase response was increased. Despite a relative hypoglycemia, a clearly increased glucose-induced elevation of plasma insulin was noted after 3 weeks' bile flow obstruction, at which time the median 15-min plasma insulin response to glucose was 38 microU/ml in duct-occluded rats and 7 microU/ml in control rats (p less than 0.001). At the same time an increased glucose elimination rate of 3.59%/min in duct-occluded rats and 3.08%/min in control rats (median values; p less than 0.05) was observed. Available evidence suggests that the effect on the insulin response may be induced by the trypsin-sensitive branch of the 'enteroinsular axis'. PMID- 3513296 TI - The value of routine sonography in clinically suspected acute cholecystitis. AB - Upper abdominal sonography was used as a routine emergency study to diagnose acute cholecystitis in 135 patients clinically suspected of having the disease. Ten radiologists with various experience in sonography performed the studies. Fifty-six patients had acute cholecystitis. Altogether 52 cholecystectomies were performed, mainly within 48 h of admission. Acute cholecystitis was diagnosed correctly in 52 cases (sensitivity, 93%) and excluded correctly in 75 cases (specificity, 95%; overall accuracy, 94%). Of the four patients with a false negative study, calculi without signs of cholecystitis were detected in three, and distention and tenderness without calculi in one case. The final diagnoses in four false-positive studies were chronic cholecystitis in two cases, carcinoma of the gallbladder in one case, and pancreatitis in one case. The results of sonography as a continual emergency service provided by a staff with various experience are equal to those published in other studies performed mainly by an expert staff with long experience. PMID- 3513297 TI - Relationship of plasma lactoferrin content to neutrophil regeneration and bone marrow infusion. AB - Plasma concentrations of lactoferrin were measured in immediately separated EDTA samples from 5 subjects who had received HLA identical bone marrow transplants for leukaemia or aplastic anaemia and from 7 subjects who were leukopenic as a consequence of chemotherapy for a variety of malignant conditions. Plasma lactoferrin concentrations were found to closely parallel the leucocyte count and were not found to either predict or to antedate leucocyte regeneration. Serial measurements of plasma lactoferrin in a subject with no circulating neutrophils who received a bone marrow graft revealed that the clearance of lactoferrin followed an exponential pattern and had an initial half time of 2.2 h. PMID- 3513298 TI - Quantitation of blood lymphocytes secreting antibodies to pneumococcal polysaccharides after in vivo antigenic stimulation. AB - An indirect plaque-forming cell assay detecting B cells secreting IgM, IgG and IgA antibodies against pneumococcal polysaccharides (PPS) is described. The numbers of anti-PPS-secreting cells (SC) and Ig-SC in the blood of normal persons immunized with a polyvalent PPS vaccine were quantitated. Anti-PPS-SC were recorded from the fourth to the twelfth post-vaccination day, and the maximum number was found between days 6 and 9. Quantitatively IgA anti-PPS-SC outnumbered the IgM and IgG anti-PPS-SC. Concomitant with the increase in the numbers of antibody-SC an increase in polyclonally activated IgM-, IgG- and IgA-SC was recorded. The specific anti-PPS-antibody-SC constituted 20-80% of the total numbers of Ig-SC from the sixth to the ninth post-vaccination day. PMID- 3513300 TI - The immune response to pneumococcal polysaccharide type III is followed by increased production of an antibody antifactor. AB - The study shows that serum from pneumococcal polysaccharide type III (SSSIII) immunized and nonimmunized mice that has been absorbed until devoid of anti SSSIII antibodies inhibits anti-SSSIII plaque-forming cells (PFC) but not antisheep red blood PFC in antibody plaque assay. A large fraction of the inhibitions activity can be absorbed by and eluted from anti-SSSIII-Sepharose, but not normal mouse serum-Sepharose. It has low or no affinity for protein A and concanavalin A. The titre of the inhibitor increases with repeated immunizations and inhibits the anti-SSSIII PFC of rats or mice of different allotypes. On the basis of these characteristics, I classify the inhibitor as an anti-idiotypic nonimmunoglobulin factor directed against a common determinant of anti-SSSIII antibodies of mouse and rat, with an immuno-regulatory function. PMID- 3513299 TI - Origin and kinetics of IgA, IgG and IgM milk antibodies in primary and secondary responses of rats. AB - IgA and IgM antibodies were detected in rat milk after immunization with ferritin in Peyer's patches (Pp) 1 day after parturition but not after intramammary gland or intravenous immunization. The antibody levels decreased from day 9 to day 17 of the nursing period and were undetectable during a second lactation period. Despite the absence of milk IgM antibodies after intramammary gland or intravenous immunization, the serum levels of the IgM antibodies were similar after all three immunization methods. IgA antibodies were not found in serum after any of the immunization methods.IgG antibodies appeared in serum and milk after P. intramammary gland, and intravenous immunization. Milk and serum IgG antibodies from all the Pp-immunized animals decreased from day 9 to day 17 of the lactation period. After intramammary gland immunization, however, the IgG antibody levels increased in all the milk samples, but only in four of seven sera. The milk and serum IgG antibody levels were lower but still detectable during a second lactation period. Re-injection of ferritin in the Pp during a third lactation period resulted in higher levels of milk IgA, IgG and IgM antibodies than after the first injection. Rats with serum IgG antibodies against Escherichia coli 08 naturally present in their gut flora had no corresponding milk antibodies of any isotype. The results suggest tht milk antibodies of all three isotypes stem from local production in the mammary gland and that blood IgG and IgM antibodies originate at least partly from stimulation in Pp. PMID- 3513301 TI - Bone marrow transplantation in the rat. II. Quantitation of cellular infiltrates in parenchymal target organs in acute graft-versus-host disease. AB - We have analysed the cytological structure of inflammation in the different parenchymal target organs during acute graft-versus-host disease after bone marrow transplantation in the rat. Inflammation (recovery of increased numbers of white cells) was recorded in the liver, skin, and lungs of the allograft recipient compared with the syngeneic graft recipient from day 5 onwards, accompanied by reduced recovery of inflammatory cells from the gut. The major cytological manifestation of the disorder was an increase in the total number of blast cells, large granular lymphocytes (LGL), and lymphocytes in the liver and skin, and of the number of blast cells and LGL in the lung. At the same time, a depletion of LGL and lymphocytes was recorded in the blood, suggesting migration of these cell components to the site of inflammation. PMID- 3513303 TI - [Ultratard HM, a new human insulin. Advantages as compared to current preparations?]. AB - Ultratard HM, a new human insulin, was studied in 10 patients with type II diabetes mellitus not previously treated with insulin. A control group consisted of 12 patients on Protaphane HM and 22 patients on Monotard MC. All patients tolerated the treatment well. After 6 months of therapy antiinsulin antibodies were detectable in only one patient on Ultratard HM. Therefore, in adult diabetics it is difficult to demonstrate a difference of antigenicity between human and porcine insulin. In another study blood glucose profiles were compared in 7 stable diabetics on Ultratard HM and Monotard HM. In our patients there was no significant difference in the activity profile of these 2 insulins. PMID- 3513302 TI - Interleukin 1 activity produced by human rheumatoid and normal dendritic cells. AB - Dendritic cells (DC) from the synovial inflammatory tissue and peripheral blood of patients with rheumatoid arthritis and from the peripheral blood of normal blood donors were compared with the autologous monocytes for their capacity to produce and release interleukin 1 (IL-1). Synovial DC often spontaneously released higher amounts of IL-1 activity than unstimulated and lipopolysaccharide stimulated peripheral blood DC and monocytes. The IL-1 production by both DC and monocytes increased after stimulation with bacterial lipopolysaccharide. In contrast with synovial DC the peripheral blood DC from both patients with rheumatoid arthritis and normal controls released less IL-1 activity than peripheral blood monocytes did. Inhibition with an antiserum to IL-1 revealed that IL-1 production is important for the accessory activity of the peripheral blood DC. Thus human DC from inflammatory sites and peripheral blood produce IL-1 activity. PMID- 3513304 TI - [The role of ultrasonography in the diagnosis of diffuse liver disease]. AB - 131 patients thought to have diffuse liver disease underwent ultrasonography and percutaneous liver biopsy. The ultrasonographic criteria examined were hepatic echogenicity compared to that of the renal cortex, homogeneity of hepatic parenchyma, and regularity of hepatic outline. On the basis of histologic examination of liver biopsies, several groups of pathologic lesions (not diagnostic entities) were established. Evaluation of ultrasound and histology was double blind. When the lobular architecture of the liver was respected histologically (normal liver, granulomatosis, siderosis, hepatitis), the ultrasound was normal in 86% of cases. The sensitivity of ultrasound was 0.9 for detection of fatty liver and 0.6 for cirrhosis. An abnormal ultrasound predicted structural modifications or a fatty liver in 93% of cases. Ultrasound proved incapable of differentiating between fatty liver and cirrhosis. PMID- 3513305 TI - [Initial experiences with adhesive bridges and splints--a retrospective cross sectional study. 1. Maintenance and prognosis]. PMID- 3513307 TI - [Parapulpal anchoring elements for plastic filling materials--a materials study]. PMID- 3513306 TI - [Fluoride metabolism]. PMID- 3513308 TI - [The beginnings of women's education at both veterinary medicine faculties in Switzerland]. PMID- 3513309 TI - Specific DNA probe for the diagnosis of Plasmodium falciparum malaria. AB - Malaria can be diagnosed either by direct microscopic examination of blood smears, which is time consuming and requires expertise, or by immunological techniques, which are effective but do not distinguish between past and present infections. In this study, a simple procedure was developed for spotting lysed blood from infected patients directly onto nitrocellulose paper and identifying the malaria species on the basis of hybridization of parasite DNA with a species specific probe. A genomic DNA library of Plasmodium falciparum was screened to detect clones containing DNA sequences that are highly repeated within the parasite genome. Several such clones were further analyzed to identify those that hybridize specifically with P. falciparum DNA but not with DNA from humans, P. vivax, or P. cynomolgi. This technique appears to be sensitive enough to detect 10 picograms of purified P. falciparum DNA (equivalent to 100 parasites) and in field studies is able to detect approximately 40 parasites per microliter of blood. PMID- 3513310 TI - Distribution of protein and RNA in the 30S ribosomal subunit. AB - In Escherichia coli, the small ribosomal subunit has a sedimentation coefficient of 30S, and consists of a 16S RNA molecule of 1541 nucleotides complexed with 21 proteins. Over the last few years, a controversy has emerged regarding the spatial distribution of RNA and protein in the 30S subunit. Contrast variation with neutron scattering was used to suggest that the RNA was located in a central core of the subunit and the proteins mainly in the periphery, with virtually no separation between the centers of mass of protein and RNA. However, these findings are incompatible with the results of efforts to locate individual ribosomal proteins by immune electron microscopy and triangulation with interprotein distance measurements. The conflict between these two views is resolved in this report of small-angle neutron scattering measurements on 30S subunits with and without protein S1, and on subunits reconstituted from deuterated 16S RNA and unlabeled proteins. The results show that (i) the proteins and RNA are intermingled, with neither component dominating at the core or the periphery, and (ii) the spatial distribution of protein and RNA is asymmetrical, with a separation between their centers of mass of about 25 angstroms. PMID- 3513311 TI - A receptor-mediated pathway for cholesterol homeostasis. PMID- 3513312 TI - Lectin activation in Giardia lamblia by host protease: a novel host-parasite interaction. AB - A lectin in Giardia lamblia was activated by secretions from the human duodenum, the environment where the parasite lives. Incubation of the secretions with trypsin inhibitors prevented the appearance of lectin activity, implicating proteases as the activating agent. Accordingly, lectin activation was also produced by crystalline trypsin and Pronase; other proteases tested were ineffective. When activated, the lectin agglutinated intestinal cells to which the parasite adheres in vivo. The lectin was most specific to mannose-6-phosphate and apparently was bound to the plasma membrane. Activation of a parasite lectin by a host protease represents a novel mechanism of host-parasite interaction and may contribute to the affinity of Giardia lamblia to the infection site. PMID- 3513314 TI - [Displacement of materials in the cervical spinal canal following clavicular fixation as a late complication]. PMID- 3513313 TI - [Use of digital subtraction angiography in traumatized patients. Experiences with arterial and venous technics]. PMID- 3513316 TI - Therapy of adult malignant brain tumors: what have the clinical trials taught us? PMID- 3513315 TI - Brain tumors in children: current cooperative and institutional chemotherapy trials in newly diagnosed and recurrent disease. PMID- 3513317 TI - Chemotherapy of brain tumors: physiological and pharmacokinetic considerations. PMID- 3513318 TI - Prednimustine in advanced breast cancer: a review. AB - This review summarizes the available data of phase II and phase III single-agent trials with predminustine and one phase II trial of prednimustine in combination with methotrexate, 5-fluorouracil, and tamoxifen in the treatment of advanced breast cancer. The data available so far indicate that the drug is more active than in combined treatment with the two components, chlorambucil and prednisolone. Future trials should be designed to analyze whether this could be ascribed to a sustained release of the components from the parent drug. The data also indicate that prednimustine is as active but less toxic than cyclophosphamide, but this needs to be confirmed in ongoing randomized comparisons. A number of phase II and phase III trials with prednimustine as a part of combinations are in progress. Mature results from these studies are needed to define the future role of prednimustine in the systemic therapy of breast cancer. PMID- 3513319 TI - A randomized comparative study of prednimustine and doxorubicin in patients with metastatic breast cancer. AB - A clinical protocol outline of a study randomizing prednimustine v doxorubicin in patients with metastatic breast cancer is presented. The study has just been initiated, and no results are available at the present time. Unique features of this clinical trial are discussed, including the correlation of objective parameters of tumor response with symptomatic improvement as measured by quality of life, performance status, and pain indices as well as alterations in body weight. PMID- 3513320 TI - Evaluation of hip prostheses by imaging methods. PMID- 3513322 TI - The radiology of total shoulder prostheses. PMID- 3513321 TI - Knee prostheses. PMID- 3513323 TI - Prosthetic replacement of the elbow. PMID- 3513324 TI - Total joint replacement: an overview. PMID- 3513325 TI - Total joint arthroplasty of hands and wrists. PMID- 3513327 TI - Clinical characteristics of hospitalized diabetic patients. AB - In an inpatient diabetes control unit established to fulfill the special needs of hospitalized diabetic patients, 29% of the admissions were for control of diabetes. In 71% the metabolic abnormalities of diabetes were incidental to the cause of admission. Of the first 232 patients, 162 had type II diabetes. The degree of hyperglycemia in the type II patients was virtually identical to that in the type I patients, as measured by hemoglobin A1C levels at admission and by mean blood glucose values in the hospital. The mean hemoglobin A1C level at admission was 9.1% in both groups (normal 3.2 to 6.1). During hospitalization the patients admitted for medical and surgical problems achieved average blood glucose levels similar to levels in those who were admitted strictly for diabetes control. Regardless of the reason for admission, hospitalization of a diabetic patient is an opportunity for improvement in metabolic control and for patient education. PMID- 3513326 TI - Impact of aminoglycoside serum assays on clinical decisions and renal toxicity. AB - To determine whether serum aminoglycoside assays aided clinicians in treating infections and avoiding aminoglycoside nephrotoxicity, we reviewed the charts of patients treated with aminoglycoside antibiotics parenterally. We compared 78 episodes of aminoglycoside-treated infections during which serum assays were done (group B) to 51 episodes without serum assays (group A). The groups of patients were comparable in age, outcome of infection, incidence of aminoglycoside nephrotoxicity, mean total dose of aminoglycosides given, and number of courses. Toxic trough levels of tobramycin (the most frequently used aminoglycoside) were seldom detected before the onset of nephrotoxicity, and peak tobramycin levels were frequently suboptimal. While 71% of decisions to increase or decrease the aminoglycoside dose after serum assays were considered appropriate, only 57% of noninterventions were appropriate. At our hospital, serum aminoglycoside assays did not help improve the outcome of infection or the incidence of nephrotoxicity. Their major clinical contribution was to alert the physician that serum concentrations were low. PMID- 3513328 TI - Plastic and reconstructive surgery: perspectives on recent advances. AB - The challenging and rapidly developing field of plastic and reconstructive surgery warrants a brief introduction. To define the field, we can say that plastic surgery is clinical judgment, surgical techniques, and new frontiers. PMID- 3513329 TI - Effectiveness of foaming antacid in relieving induced heartburn. AB - A double-blind, placebo-controlled, randomized crossover study was made of 60 patients with chronic heartburn to test the efficacy of foaming antacid in promoting symptom relief. Heartburn was induced by a meal consisting of chili, black coffee, and a spicy tomato drink mix. Of the 60 patients, 40 (67%) had relief within 15 minutes after taking foaming antacid tablets as compared to only 17 (28%) after taking a placebo. The difference in response was significant (P less than .05). Foaming antacid appears to be an effective therapy for acute postprandial heartburn. PMID- 3513331 TI - Displacement of mediastinal clips by postoperative mediastinal hemorrhage. AB - We have reported a case in which the separation of radiopaque surgical clips after cardiac operation proved to be a sensitive sign of mediastinal hemorrhage. Echocardiography was done for confirmation. PMID- 3513330 TI - Neuroleptic malignant syndrome. AB - The neuroleptic malignant syndrome (NMS) is a rare but potentially lethal disorder associated with the administration of neuroleptic agents. This syndrome may be underdiagnosed because it is poorly understood and often unrecognized. It affects all age groups and has a 20% mortality. Presenting features include extrapyramidal symptoms, altered mental consciousness, autonomic dysfunction, and hyperthermia. The underlying explanation for these manifestations is a disturbance of the dopaminergic system within the basal ganglia and hypothalamus. Dantrolene (Dantrium), amantadine (Symmetrel), and bromocriptine mesylate (Parlodel) have been efficacious in conjunction with supportive therapy. I report three cases successfully treated with bromocriptine and supportive therapy. PMID- 3513332 TI - Unusual pulmonary lesion of vascular origin: a noninvasive diagnostic approach. AB - Despite the lack of pathologic confirmation, we believe that we are reporting an isolated pulmonary artery branch stenosis with poststenotic dilatation. The differential diagnosis of a solitary pulmonary lesion should include this unusual entity. Digital subtraction angiography offers a safe, minimally invasive way to confirm this anomaly. PMID- 3513333 TI - Pseudallescheria boydii infection of the central nervous system in a cardiac transplant recipient. AB - We have described a cardiac transplant recipient with fatal Pseudallescheria boydii infection of the central nervous system. Unusual features included meningitis without brain abscess and noncommunicating hydrocephalus due to exuberant growth of the organism in the ventricular fluid. Long-term amphotericin B administration may have played a role in the development of this infection. PMID- 3513334 TI - [N.A. Semashko's views on the ethics of a Soviet physician]. PMID- 3513335 TI - [Workers' contribution to public health in Moscow during World War II]. PMID- 3513336 TI - [The physician and Bolshevik N.N. Shtremer]. PMID- 3513337 TI - [Petros Kalantarian--physician, scientist and linguist]. PMID- 3513338 TI - [One of the oldest medical libraries]. PMID- 3513339 TI - [Russian physicians in Egypt]. PMID- 3513340 TI - [Ultrasonographic finding of sludge in the gallbladder--clinical correlations]. PMID- 3513341 TI - [The effect of controlled respiration with positive expiratory pressure (PEEP) on the minute cardiac volume in patients after cardiosurgical procedures]. PMID- 3513342 TI - [Parameters of ovulation in clomiphene citrate treated cycles. The effect of pre ovulatory administration of oestrogen and human chorionic gonadotropin]. AB - This study was undertaken to evaluate the parameters used for monitoring ovulation in patients on clomiphene citrate treatment for the induction of ovulation. The mean serum oestradiol level for every follicle larger than 17 mm on the day before ovulation was 1 885 pmol/l. This value is significantly higher than the value found in spontaneous cycles. The maximum average pre-ovulatory follicle size was 22 mm, also significantly larger than in spontaneous cycles. The maximum pre-ovulatory cervical mucus score is significantly lower than that found in spontaneous cycles. The average midluteal serum progesterone and oestradiol values were significantly higher than in spontaneous cycles. These differences should be taken into consideration in interpreting the results of patients treated with clomiphene citrate for ovulation abnormalities and before in vitro fertilization. Seven patients with a healthy cervix had poor cervical mucus scores in spite of high pre-ovulatory serum oestradiol levels; scores did not improve with administration of exogenous oestrogen, but became optimal with subsequent human menopausal gonadotrophin treatment. Poor cervical mucus despite ovulation and adequate pre-ovulatory serum oestradiol levels in patients on clomiphene treatment should therefore be considered as an indication for gonadotrophin treatment. Pre-ovulatory administration of human chorionic gonadotrophin had no effect in increasing midluteal serum progesterone and oestradiol levels. PMID- 3513343 TI - Maimonides, the physician--1135-1204. A tribute on the occasion of the 850th anniversary of his birth. PMID- 3513345 TI - History of carotid artery surgery. AB - The history of carotid artery surgery is briefly reviewed. The introduction of cerebral angiography, coupled with increasing awareness of the extracranial location of offending lesions responsible for stroke syndromes, has resulted in the use of carotid endarterectomy as an important clinical therapeutic modality. PMID- 3513344 TI - Characterization of the humoral immune response of the rabbit to antigens of Treponema pallidum after experimental infection and therapy. AB - The development of IgM and IgG antibody responses to antigenic molecules of Treponema pallidum was examined in intratesticularly and intradermally infected rabbits by use of immunofluorescence (IF) and Western blotting techniques. IgM antibody was first detectable on day 6 following intratesticular infection and reached maximal IF titers during the period of clinical orchitis (days 10-17). IgG reached peak IF titers in the resolution period following clearance of most organisms from the testes (after day 17). Initial IgM antibody responses on day 6 were directed against the 46-, 43-, and 37-kdalton molecules, with reactivity to the 14- and 12-kdalton molecules appearing on day 10. IgG antibody, which was first apparent in the Western blot on day 6, was directed against the 37-kdalton molecule. IgG antibody to the 46-kdalton molecule was first apparent on day 13, and the full spectrum of 22 molecules was recognized on day 31. Curative therapy of intradermally infected rabbits one week after infection resulted in lower IgG antibody titers but did not abrogate the development of humoral responses to all of the major antigens. PMID- 3513346 TI - Randomized, comparative trial of imipenem/cilastatin and moxalactam in the treatment of serious obstetric and gynecologic infections. AB - Thirty-four patients with pelvic inflammatory disease, postoperative, postabortal and postpartum infections were randomized to intravenous therapy with either 500 milligrams of imipenem and cilastatin sodium every six hours or 2 grams of moxalactam every eight hours for a minimum of four days. One patient in the moxalactam group was nonevaluable because of protocol noncompliance; three more patients had no bacteriologic pathogen isolated (two in the moxalactam group and one patient in the imipenem/cilastatin group). The two groups were similar with respect to age, diagnosis, etiologic agents and duration of therapy. Of the 17 evaluable patients in the imipenem/cilastatin group, all were complete clinical cures. Three patients in the imipenem/cilastatin group had persistence of at least one bacteriologic pathogen despite clinical cure and apparent laboratory evidence of susceptibility. Of the 13 evaluable patients in the moxalactam group, eight were complete clinical cures. Two more patients in that group were clinically improved enough to be discharged on oral antibiotics. There were three clinical failures in the moxalactam group, all of whom had group D streptococcus resistant to moxalactam. An additional three patients in the moxalactam group had other resistant organisms isolated despite clinical cure. Both drugs were well tolerated and no serious complications or side effects occurred in either group. Despite small numbers, our data suggest that imipenem and cilastatin is a more appropriate agent for initial treatment of obstetric and gynecologic infections than moxalactam. PMID- 3513347 TI - Prophylactic oophorectomy in the treatment of carcinoma of the breast. AB - Several prospective clinical trials have been conducted to investigate the efficacy of prophylactic ovarium ablation in the primary treatment of carcinoma of the breast. The results have varied and the follow-up periods have been rather short. A prospective randomized study was done at our institution from 1961 to 1966 to test the value of prophylactic oophorectomy in the treatment of carcinoma of the breast. The patients have now been studied for 17 to 22 years. Patients were randomized into two groups: a control group and a group treated by surgical castration. By December 1983 280 patients were evaluable, 154 in the control group and 126 in the oophorectomy group. One hundred and forty-nine patients died during the observation time. All but 11 patients underwent autopsy. There are no significant differences between the group regarding age, axillary node involvement, menstrual status, perinodal tumor growth and distribution in the different TNM stages. The results of the study did not demonstrate any significant differences in cure rate, survival time, recurrence free intervals or intervals between recurrence of the disease and death. The results were independent of nodal status, TNM classification and menstrual status of the patient. These findings do not support the use of prophylactic oophorectomy in the treatment of operable carcinoma of the breast in TNM Stages I and II, whereas no conclusion can be drawn regarding TNM Stage III as the number of patients in this stage is small. PMID- 3513348 TI - Abdominal approach to the Collis gastroplasty and Nissen fundoplication. AB - A technique to perform the Collis-Nissen operation through an abdominal approach has been described. This method is especially indicated in patients with severe reflux esophagitis and dilatable esophageal strictures, where existing cardiac and pulmonary disease would make a thoracic approach a greater liability to the patient. PMID- 3513349 TI - New technique for repairing large ventral incisional hernias with Marlex mesh. AB - When incisional hernias are irreparable with conventional methods, the foregoing technique of Marlex mesh repair is extremely effective. In the 11 instances that form the basis of this report, the mesh has remained durable and free of hernia and infection while retaining its elasticity and permitting complete freedom of movement. PMID- 3513350 TI - A modified technique for surgical repair of cicatricial stenosis of the bile duct. AB - A modified technique for the treatment of biliary tract strictures is presented. It features the longitudinal incision of the biliary duct above the stricture without any lateral or posterior duct dissection. The duct and the jejunum are brought together and a continuous posterior row of sutures is applied. Separated stitches are used for the anterior suture. No internal splints are used. Four patients have been operated upon with good results during a follow-up period of two years. PMID- 3513351 TI - Harvey Cushing and the evolution of a polymath. AB - The remarkable productivity of the later career of Cushing is well known. Energies and drive undiminished throughout his life, he contributed consistently and prolifically to the field of surgical procedures, history, biography and education at the very least. Consorting with the famous, honored over the world, his shadow is still seen. Early factors which influenced his personality and career have been analyzed herein. Many of these, individually or in concert, affected the extraordinary life of this complex man. PMID- 3513352 TI - Therapeutic endoscopy. AB - The development of flexible endoscopic instruments has altered the surgical approach to many disease processes. Endoscopic treatment of gastrointestinal polyps, common bile duct stones and foreign bodies of the gastrointestinal tract has now become the preferred method of treatment. Endoscopic gastrostomy is replacing surgical gastrostomy for the patient who requires long term enteral nutrition. Sclerosis of esophageal varices has now become the preferred method of managing patients with portal hypertension and bleeding esophageal varices. As newer endoscopic instruments are developed, more and more operative procedures will be carried out by endoscopic methods. PMID- 3513353 TI - A tribute to Paul C. Bucy. PMID- 3513354 TI - Total body irradiation for allogeneic bone marrow transplantation in acute leukemia: a co-operative study from the TBI Subcommittee in Japan. AB - By means of national survey, records of 78 acute leukemia patients who underwent allogeneic bone marrow transplantation (BMT) from September 1975 through September 1983 were collected from 14 participating institutions in Total Body Irradiation (TBI) Subcommittee in Japan. Patients were classified into 37 of acute lymphocytic leukemia (ALL), and 41 of acute non-lymphocytic leukemia (ANLL). One-year survivals were 51% and 33% in ALL and ANLL patients, respectively. Uninfected patients in remission had significantly better survival than infected ones and/or in relapse. Overall incidence of interstitial pneumonia was 43%. Rejection and relapse were encountered in 26% of patients. Concerning cause of death, interstitial pneumonia was the most frequent cause (44%). Uni- and multivariate analyses strongly suggested that favorable prognostic factors were remission, uninfection, preparation of low-dose-rate fractionated TBI and cyclophosphamide, and mild graft-versus-host disease (GVHD) for acute leukemia patient treated with allogeneic BMT. PMID- 3513355 TI - [Creatine content and lipid analysis in radiosensitive organs after whole body x irradiation of mice--a contribution to the further development of biological radiation dosimetry]. AB - The authors intended to test the suitability of creatine level and/or certain criteria of lipid analysis in radiosensitive organs for an individual (i.e. considering biologic variations of radiosensitivity), qualitative and quantitative demonstration of an irradiation damage. It was found that creatine determination and several criteria of lipid peroxidation are not suitable for a biologic radiation dosimetry due to the absence of organ dependent, radiation dose dependent, and time dependent changes. The reasons are discussed. PMID- 3513356 TI - Roman ophthalmology. A glimpse of our distant past. AB - Ophthalmic artifacts from a house destroyed in 275 A.D. and recently excavated in Schwarzenacker, W. Germany, are described and illustrated. The reconstructed house of ophthalmologist, Sextus Ajacius Launus, and its contents provides a fascinating glimpse of ophthalmology as practiced nearly 17 centuries ago in the Roman Empire. PMID- 3513357 TI - Effects of prostaglandin E1 in adult respiratory distress syndrome. AB - Prostaglandin E1 (PGE1, Prostin VR) in doses of 30 ng/kg . min was studied in two series of severely ill surgical patients with adult respiratory distress syndrome (ARDS). First the drug was administered in an initial trial in six patients; then a prospective, randomized, blinded trial was conducted in 10 studies on nine patients. PGE1 markedly decreased pulmonary artery pressure, pulmonary and systemic vascular resistance indexed, and venous pressures, while increasing cardiac output, arterial PO2 (PaO2), oxygen delivery, and oxygen consumption when compared with the baseline preinfusion control values and with the response of the placebo-treated control series. The PGE1 responses were greater in patients whose ARDS was primarily attributed to the postoperative state with or without sepsis and least in patients with cirrhosis. The data are consistent with the concept that the drug reduces vasoconstriction primarily in the pulmonary circulation but also in the systemic circulation; improved PaO2 usually follows the hemodynamic effect. We conclude that PGE1 may be a useful adjunctive therapy for ARDS. PMID- 3513358 TI - Myelolipoma of the adrenal gland: report of two cases with a review of the literature. AB - Myelolipomas are rare, nonfunctioning, benign lesions composed of varying proportions of fat and bone marrow elements. The clinical and pathologic features are described with a brief discussion of the possible etiology and pathogenesis. Forty-seven cases in the world literature are reviewed including two of our patients. Twenty-four patients were seen initially with pain, 19 had hypertension, 15 were obese, and seven had hematuria. These tumors can be diagnosed by their characteristic appearance on ultrasonography, computerized tomography, and angiography and by their lack of hormonal alterations. PMID- 3513359 TI - Distal migration and deformation of the Greenfield vena cava filter. AB - We have presented two patients in whom distal migration of the Greenfield vena cava filter has resulted in complications. In one patient there was marked deformation of the vena cava filter struts for an unknown reason resulting in perforation of the vena cava filter and the small bowel. In a second patient the distal migration resulted in poor alignment of the filter and recurrent pulmonary emboli. We feel that the Greenfield filter represents an excellent choice for caval interruption but that we would like to draw attention to the complication of distal migration. In addition, we would like to point out deformation of the struts of the Greenfield filter for which we have no explanation and which, to our knowledge, has not been reported previously. PMID- 3513360 TI - [Transplantation of kidneys and pancreas in Norway]. PMID- 3513361 TI - [King's Gold Medal of Honor to Ruth Torbjornsen]. PMID- 3513362 TI - Beginnings of medical journalism in Texas. PMID- 3513363 TI - [Possibilities and prospects for the family practitioner with psychosomatic patients]. PMID- 3513364 TI - [Combined analgesics in myalgia of the neck. A double-blind comparison of paracetamol and orphenadrine (Norgesic) and paracetamol and codeine (Paralgin forte) in general practice]. PMID- 3513365 TI - [Cleansing of the colon before coloscopy]. PMID- 3513366 TI - [Automatic suture stapling in low rectal anastomosis. EEA and TA-55]. PMID- 3513367 TI - [Automatic suture stapling in abdominal hysterectomy]. PMID- 3513368 TI - [Presacral rectopexia in rectal prolapse]. PMID- 3513369 TI - [Abdominal abscesses. CT and ultrasound-guided diagnostic puncture and drainage]. PMID- 3513370 TI - [Awarding of the Schornagel Medal and the Schimmel-Viruly Prize]. PMID- 3513371 TI - [More than 10 years of kidney testing in the Netherlands, and now...?]. AB - A historical review of testing for antibacterial residues in slaughtered animals is presented. In recent developments, much attention was paid to microbiological methods. Because of changing views and new possibilities increasing attention is being paid to purely chemical methods of detection. However, so long as chemical multi-purpose methods are not available, there will be a need for microbiological methods. The common misunderstanding that prevention of residues of antibacterial compounds in slaughter animals will contribute to reduction of the problem of bacterial resistance to antibacterial agents, is warned against. PMID- 3513372 TI - [Laboratory animals and animal experiments]. AB - The historical development of the use of laboratory animals runs broadly parallel with the development of western human medicine. From the latter half of the nineteenth century, after the first anaesthetics were discovered, the number of animals used for experiments showed a particularly marked increase. A number of causes of these developments are discussed. From the latter half of the twentieth century, experimental animals themselves have become a subject of investigation. The discipline of laboratory animal science is then developed. Laboratory animal science increases the reproducibility of experimental studies and contributes to the welfare of laboratory animals. An important recent development was started in teaching laboratory animal science when the Laboratory Animal Order promulgated on May 31, 1985, became operative. In this Order, the training requirements are stated, which have to be met by those taking part in animal experiments (investigators, animal technicians, experts in laboratory animal science). A particular training in laboratory animal science is made compulsory on each of these categories. The Department of Laboratory Animal Science in Utrecht has national terms of reference for university education in this field. The contents of this education is briefly discussed. Finally, a number of problems are reviewed, which are associated with testing the ethical aspects of animal experiments. PMID- 3513373 TI - Recognition of polymorphic monocyte antigens. AB - Sera from multiparous women and renal transplant recipients were screened for the presence of anti-monocyte antibodies. Reactions caused by anti-HLA antibodies were excluded by using panel cells that were HLA-compatible with the antibody producers. Six sera with monocyte-specific antibodies were identified, and at least two monocyte-specific (probably allelic) antigens could be recognized. The perspective of the clinical significance of typing for monocyte-specific antigens is discussed. PMID- 3513374 TI - [Rooming-in, a fact in England]. PMID- 3513375 TI - [Continuing education using computers and video]. PMID- 3513376 TI - Metabolism and disposition of propylene glycol monomethyl ether (PGME) beta isomer in male rats. AB - Male Fischer 344 rats were given a single po dose of approximately 1 or 8.7 mmol/kg of radiolabelled propylene glycol monomethyl ether (PGME) beta isomer (2 methoxy-1-propanol). After dosing, expired air, excreta, and tissues were analyzed for 14C activity and metabolites in urine were isolated and identified. Approximately 70 to 80% of the 14C was excreted in urine while about 10 to 20% was eliminated as 14CO2 within 48 hr after dosing. The major urinary metabolite was 2-methoxypropionic acid, which accounted for approximately 93 and 79% of the radioactivity in urine from high- and low-dose animals, respectively. A glucuronide conjugate of the PGME beta isomer was also identified in urine; this metabolite accounted for approximately 3 to 4% of the radioactivity in the urine at both dosages. These results indicate that the PGME beta isomer is metabolized via different routes to different types of metabolites in comparison to the PGME alpha isomer. While the two isomers are biotransformed differently, there is a substantial toxicological data base which clearly shows that the commercial grade PGME mixture (2 to 5% beta isomer) has a low degree of biological activity. PMID- 3513377 TI - Individual and age-dependent variations in the venom of the fer-de-lance Bothrops atrox. AB - Individual and age-dependent variations in the venoms of 23 specimens of Bothrops atrox were studied using SDS-polyacrylamide gel electrophoresis, isoelectric focusing and different enzymic activity measurements. The electrophoretic patterns showed a decrease in total protein band numbers and a shifting from components with higher to those with lower molecular weights with increasing age of the snakes. The venoms of individuals younger than 12 months showed isoelectric focusing patterns within a pH range of 3.5-6.0, whereas those of older specimens extended from pH 3.5 to 7.0. Individual variations were found in fibrinogen-clotting and fibrinolytic activities. Despite the fact that important quantitative differences were also found in amidolytic activities measured on five chromogenic proteinase substrates, all the venoms showed the same activity profile. Specimens of the oldest age group (8 years) showed absence of some enzymatic activities. PMID- 3513378 TI - Geographic and ontogenic variation in venom of the western diamondback rattlesnake (Crotalus atrox). AB - Venom samples from western diamondback rattlesnakes (Crotalus atrox) from 13 localities in the United States were tested for i.v. and s.c. lethality for mice, protease activity, hemorrhagic activity, and the presence of Mojave toxin. Electrophoresis on polyacrylamide gel was used to compare protein composition. The neutralizing effect of two commercial antivenoms was evaluated against selected samples of venom. Venom of young snakes from north Texas was compared with that of adults from the same locality. Venom samples from the southwest portion of the range showed highest lethality, those from the northeast portion lowest. This trend was reversed with respect to protease activity. Hemorrhagic activity showed little geographic variation, but northern samples tended to be slightly higher. Differences in venom protein composition were evident between snakes from the eastern and western portions of the range. Mojave toxin in small to trace amounts was detected in two Arizona venom samples and one from west Texas. Antivenoms were relatively ineffective in neutralizing lethality. Venom of young snakes from north Texas was much more lethal by s.c. injection than that of adult snakes from any part of the range, but very low in protease activity. Hemorrhagic activity was about equal to that of adult snakes from the same region. Fifteen months later, lethality had declined almost five-fold, and protease activity had approached adult levels. There was a distinct change in protein composition. Mojave toxin was not detected in venoms of the young snakes. PMID- 3513379 TI - Formol-saline as a cell conserving medium in the micronucleus test. PMID- 3513380 TI - [Characteristics of the immunological status of patients with generalized and limited periodontal lesions]. PMID- 3513381 TI - [Treatment of patients with Le Fort III-type sagittal fractures of the maxilla]. PMID- 3513382 TI - [Use of an antiseptic sponge with kanamycin in dental polyclinic practice]. PMID- 3513383 TI - [Microanalytical research on the chemical changes in Ni-Cr and Co-Cr alloys for metal ceramics undergoing high-temperature firing]. PMID- 3513384 TI - [Day treatment? An interim evaluation of day treatment in nursing homes]. AB - Day-treatment has developed very rapidly in Dutch nursing homes. This development was due to several unproved positive expectations concerning the therapeutical results, the effects for relatives and caregivers at home and the substitutional effects of day-treatment. In this article these expectations are tested by means of a Dutch literature-review. From a psychosocial point of view, many patients benefit by day-treatment. Somatically, this is probably the case to a lesser extent. For persons in the home-situation, among whom informal and professional caregivers, day-treatment is an important and highly valued provision. To a certain degree there is a substitutional effect for somatic patients, to a considerably lesser degree for psychogeriatric patients. Sometimes, however, day treatment accelerates an admission to a nursing home. Partly, day-treatment has attracted a new category of patients. A plea is made for sound effect-research, for which some recommendations are made. Moreover, there is a demand for well evaluated experiments with day-centers and for the partly maintenance of the daycare function in nursing homes. The substitution of nursing home beds for day treatment capacity is considered as relevant only for a limited part of the population. PMID- 3513385 TI - Report of the Bicentennial Program Planning Committee and New Century Fund. PMID- 3513386 TI - George E. de Schweinitz, M.D., and the de Schweinitz Lecture in Ophthalmology at the College of Physicians of Philadelphia, 1938-1985. PMID- 3513387 TI - Bone marrow transplantation in the rat. B lymphocyte activation in acute graft versus-host disease. AB - We have isolated the white cells from the bone marrow, spleen, and blood of a rat recipient of a bone marrow allograft and the inflammatory leukocytes from the recipient skin, lung, gut, and liver (the parenchymal target organs for acute graft-versus-host disease (aGVHD)) and compared the number of immunoglobulin synthesizing and releasing cells in these cell populations to corresponding compartments of a syngeneic graft recipient. Bone marrow transplantation was associated in the early phase with marked immunoglobulin production in the cells of bone marrow, spleen, and blood of the allograft recipient; as, however, a similar response occurred in the syngeneic graft recipient we conclude that this is related to reconstitution rather than to aGVHD. Later, during aGVHD, the number of immunoglobulin releasing cells decreased significantly in the spleen and bone marrow of the allografted animal. In clear contrast, in the liver--but not in skin, lung, or gut--very few immunoglobulin-releasing cells were observed in the syngeneic graft recipient, whereas in the allograft recipient a very strong and significantly higher immunoglobulin synthesis and release was seen coinciding with the inflammatory episode of aGVHD in the liver. PMID- 3513388 TI - Canine liver transplantation under Nva2-cyclosporine versus cyclosporine. AB - The immunosuppressive qualities and other features of a new cyclosporine (CsA) analogue, Nva2-cyclosporine (Nva2-CsA) were examined using canine orthotopic liver allografts. The mean survival time was 11.8 +/- 9.6 (SD) days in dogs without treatment, 60.8 +/- 4.4 days with Nva2-CsA and 65.1 +/- 33.0 days with CsA. Functional abnormalities indicating toxic side effects were not noted either with Nva2-CsA or with CsA. Using the same oral dose, the rate of blood level rise and the amount of the rise were greater with Nva2-CsA. Histopathologically, Nva2 CsA treatment was associated with the same degree of hydropic vocuolation in the pars recta of the proximal tubules as CsA treatment. Thus, in the dog, Nva2-CsA had identical immunosuppressive properties as CsA, with no functionally detectable toxicity affecting the liver and kidney. PMID- 3513389 TI - Manipulation of graft-versus-host disease for a graft-versus-leukemia effect after allogeneic bone marrow transplantation in AKR mice with spontaneous leukemia/lymphoma. AB - Graft-versus-host (GVH) disease can result in a beneficial graft-versus leukemia (GVL) effect after bone marrow transplantation in patients with malignant disease. In this report, we used bacteria-free AKR (H-2k) mice bearing advanced spontaneous T cell leukemia/lymphoma as a moel to evaluate the GVH and GVL effects of bone marrow transplantation using fully incompatible SJL (H-2s) donors. A therapeutic GVL effect, accompanied by increased leukemia-free survival, was obtained only when 0.5 X 10(6) allogeneic lymphocytes (lymph node cells) were added to the marrow inoculum. Transplantation of allogeneic bone marrow without added lymph node cells (or use of syngeneic cells) resulted in a significant increase in leukemia relapse; increasing the dose of allogeneic lymph node cells to 2.0 X 10(6) resulted in significantly higher GVH-associated mortality. Survival and therapeutic benefits were obtained only when the intensity of the GVH reaction was carefully controlled by manipulation of alloreactive lymphocytes present in the marrow. These results suggest, indirectly, that T cell depletion may abolish any GVL effect of marrow transplantation, even if the donor is mismatched with the host at the major histocompatibility complex. The frequency in the spleen of cytotoxic T lymphocytes (CTL) reactive against host alloantigens was estimated using limiting dilution microcytotoxicity assays at various times after transplantation of allogeneic bone marrow with and without added lymph node cells. The average frequency of CTL was highest in mice that were given marrow plus lymph node cells and tested within the first four weeks after transplantation. The level of CTL activity measured in vitro was dependent on the dose of lymphocytes injected and correlated with both the GVL and GVH effects in vivo. Down-regulation of CTL activity against host, but not third-party, alloantigens in vitro was observed under limiting dilution assay conditions, leading to the suggestion that host specific regulatory cells may be present in these allogeneic bone marrow chimeras. PMID- 3513390 TI - A possible predictive test for graft-versus-host disease in bone marrow graft recipients: the mixed-epidermal cell-lymphocyte reaction. AB - The possible ability of the mixed-epidermal-cell-lymphocyte reaction (MECLR) to detect alloreactivities in HLA-identical MLR negative siblings has been investigated before grafting in 30 donor-recipients pairs and their families. Results indicate that recipients' epidermal cells (EC) can induce proliferative responses of HLA-identical MLR-negative donors' lymphocytes in 55% of the pairs tested. Moreover, further evaluation of 21 patients shows that the positivity of the MECLR before the graft is correlated with later appearance of acute and chronic GVHD, and especially with the severity of cutaneous injury. EC have been shown to be more efficient antigen presenting cells than peripheral blood lymphocytes for in vitro primary proliferative responses, so these reactions could be directed against some minor histocompatibility antigens, thus leading to possible improvement in selecting bone marrow graft donors and to the detection of donor-recipient pairs with a high risk of GVHD. PMID- 3513391 TI - Randomized trials of high-versus-low-dose steroids in renal transplantation. Does the evidence favor a consensus? AB - Published, randomized trials of high-versus-low-dose steroids in renal transplantation, individually and collectively, are too small (median trial size: 72 patients) to reach authoritative conclusions about mortality, graft failure, transplant failure, and the incidence of certain complications. The implications of this review for future therapeutic trials in renal transplantation are that randomization of 400 patients should be seen as minimum Phase III trial size, and that a research strategy is needed to encourage effective multicenter collaboration. One such strategy is described beginning with a single-center randomized Phase II trial to compare times to first rejection episode, thus rendering prior evidence on which the case for multicenter collaboration, effectively in an established trial, can be judged. Analysis by intention to treat and consistent reporting of the number of patients who experience certain classes of complication are two of four ground rules on which we assessed trials when combining evidence from similar studies. The other ground rules are randomization and common treatment theme. The statistical method of formally pooling results is outlined. PMID- 3513392 TI - Plasma ionized calcium monitoring during liver transplantation. AB - Plasma ionized calcium and citrate concentrations were measured in 11 patients undergoing liver transplantation. During the anhepatic phase of the procedure, ionized calcium concentrations fell to as low as 40% of normal, in spite of calcium supplementation. Simultaneously, citrate concentrations rose to between 20 and 100 times preoperative levels. In two patients low plasma ionized calcium concentrations were associated with hypotension that responded to calcium infusion. Intraoperative monitoring of plasma ionized calcium during liver transplantation is helpful in the rational control of the patient's calcium status. PMID- 3513393 TI - Value of urinary sediment in the diagnosis of interstitial rejection in renal transplants. AB - The occurrence of lymphocyturia, or a sharp increase in preexisting lymphocyturia, has been found to correlate with immunological rejection. In most studies time-consuming staining techniques or counting chambers have been used. A new staining technique, with prestained slides, is investigated as a predictor of cellular rejection and to distinguish between cellular rejection and cyclosporine (CsA) toxicity, or other causes of renal function impairment. In 18 consecutive renal transplant recipients, treated with CsA, urinary sediments were analyzed almost daily for two months, and prediction of cellular rejection was related to renal biopsies and retrospective clinical evaluation. In addition 24 transplant biopsies were compared with urinary sediment prediction; in both parts of the study a lymphocyturia of more than 20% and polymorphs less than 55% (of 100 nucleated cells, excluding squamous epithelial cells) were considered to suggest interstitial rejection. Episodes of lymphocyturia (greater than 20%), with simultaneous increase of the number of epithelial cells, resulting in a relative decrease of polymorphs (less than 55%), were found 10 times. Of these, 9 corresponded well with biopsy or clinical evaluation and 1 was false-positive. Correlating urinary sediment analysis with biopsy histology (n = 24), 19 were accurate, 3 equivocal, and 2 false; this corresponds to a sensitivity of 77% and a specificity of 91%. In conclusion, the analysis of urinary sediments with prestained slides is a quick and simple method to diagnose cellular rejection and to distinguish it from toxic of ischemic renal damage. Results are comparable to those of the fine-needle aspiration technique without invasive insult to the patient. PMID- 3513395 TI - Effect of selective T cell depletions in mixed xenogeneic reconstitution on specific hyporeactivity to transplantation across a species barrier. AB - We have recently reported the induction of long-term specific hyporeactivity to transplantation across a species barrier (rat----mouse) through reconstitution of irradiated recipients with a mixture of T-cell-depleted host-type C57BL/10Sn (B10) bone marrow plus T-cell-depleted F344 rat bone marrow (B10+F344----B10) (1). We report here the influence of selective T cell depletions of host-type and/or donor-type bone marrow on induction of such hyporeactivity. Mice that received mixed bone marrow inocula in which the syngeneic marrow had been T-cell depleted, whether or not the xenogeneic donor marrow had been treated, showed specific prolongation of F344 donor-type skin grafts. In contrast, F344 rat skin grafts were promptly rejected by animals that had received mixed bone marrow inocula in which the syngeneic component had not been T-cell-depleted. Serologic reactivity against F344 lymphocyte cell surface antigens also differed among the four groups; animals that had received untreated syngeneic bone marrow demonstrated high levels of reactivity to F344 target cells, while animals reconstituted with mixed inocula in which the syngeneic component had been T-cell depleted exhibited low levels, if any, of serologic reactivity against F344 splenocytes. This model for mixed xenogeneic reconstitution may be helpful to define the conditions required for induction of transplantation tolerance across a species barrier. PMID- 3513394 TI - Identification of Ia-bearing cells in rat, dog, pig, and human islets of Langerhans. AB - Cells expressing Ia-like antigens (Ia) are believed to provide the primary recognition signals for allograft rejection. In order to clarify the localization of Ia within islets of Langerhans in animals most commonly used as transplantation models and in humans, we performed both light microscopic (LM) and electron microscopic (EM) immunocytochemical studies with the following panel of monoclonal antibodies directed against Ia: B1F6 (antidog, antirat, and antihuman Ia) and B2E8 (antidog and antihuman Ia), generated in our laboratory; OX6 (antirat Ia); and L243 (antihuman Ia). By LM, B1F6-labeled or B2E8-labeled dog islets and B1F6-labeled or OX6-labeled rat islets all exhibited Ia-specific localization on 0-15 spheroidal or stellate cells per islet. Ultrastructural identification of these cells by indirect immunoperoxidase labeling of unfixed isolated islets revealed Ia-specific cell surface binding mostly on sparsely distributed cells that exhibited ultrastructural characteristics typical of monocytes or macrophages; no specific correlation between cell shape and cell type was apparent by EM. The presence of a resident population of monocytes and macrophages in these islets was confirmed by cytochemical localization of nonspecific esterase activity. Islet endothelium was Ia-negative, as were endocrine cells. Studies of human islets with B1F6, B2E8, and L243 confirmed our preliminary findings that, although there exists a sparse population of Ia positive leukocytes similar to those present in dog and rat islets, Ia is also expressed extensively and constitutively on the human islet vascular endothelium. This differential localization of Ia in rats and dogs compared with humans could have important implications for the development of successful strategies for the immunomodulation of human islet allografts. We have now shown by immunopurification of 125I-labeled splenocyte plasma membrane antigens, that our MoAbs B1F6 and B2E8 also recognize porcine Ia, and immunocytochemical studies with these MoAbs demonstrated that Ia is also localized on the vascular endothelium in pig islets. Hence, this species may prove to be uniquely suitable as a model in which the immune response functions of Ia-bearing islet endothelium can be explored. PMID- 3513396 TI - Immune reactivity after high-dose irradiation. AB - Immune reactivity after total-body irradiation was investigated in rats using skin graft rejection as the indicator system. After sublethal irradiation with 10.5 Gy (approximately 50% lethality/6 weeks) the rejection of major histocompatibility complex allogeneic skin grafts was delayed significantly compared with nonirradiated control animals (28 versus 6.5 days). In contrast, skin grafts were rejected after 7.5 days in sublethally irradiated animals and 7 days in lethally irradiated animals if additional skin donor type alloantigens- namely, irradiated bone marrow cells--were given i.v. either simultaneously or with a delay of not more than 24 hr after the above conditioning regimen. These reactions were alloantigen-specific. They were observed in six different strain combinations with varying donors and recipients. Starting on day 2 after irradiation, i.v. injection of bone marrow gradually lost its effectivity and skin grafts were no longer rejected with uniform rapidity; skin donor marrow given on days 4 or 8 did not accelerate skin graft rejection at all. These data show that for approximately 1-2 days after high-dose total-body irradiation rats are still capable of starting a vigorous immune reaction against i.v.-injected alloantigens. The phenomenon of impaired rejection of skin grafted immediately after high-dose irradiation appears to result from the poor accessibility of skin graft alloantigens during the early postirradiation phase when vascularization of the grafted skin is insufficient. PMID- 3513397 TI - The course of cyclosporine-pretreated renal allografts in dogs. PMID- 3513398 TI - Hypothermic preservation of the rat liver assessed by orthotopic transplantation. A comparison of flush solutions. PMID- 3513399 TI - Delayed rejection of heart allografts in hypersensitized rats by extracorporeal donor-specific liver hemoperfusion. PMID- 3513400 TI - De novo membranous nephropathy following renal transplantation between conjoint twins. PMID- 3513401 TI - Thrombocyte aggregates in renal allografts. PMID- 3513402 TI - [Development of the molecular genetics of baculoviruses in Ukraine]. AB - Entomopathogenic baculoviruses are of interest from the standpoint of basic science and are of practical importance. The development of molecular biology and molecular genetics of baculoviruses in the Ukraine is considered in a brief review. PMID- 3513403 TI - [Virus-induced mutagenesis and various aspects of genetic engineering in humans]. AB - The author's own data and those available in literature concerning the mutagenic action of viruses and recombinant DNA molecules on mammalian cells permit drawing attention to the possible hazards of genetic engineering which might affect the genome of mammals, including a man. PMID- 3513404 TI - [Karyotype of continuous cell lines. I. The karyotype variability of M-HeLa cells cultured by static and roll-tube methods]. AB - A comparative investigation of three M-HeLa sublines, being of common origin but differing in cultivation technique (roller or static), was undertaken using G- and C-banding. It is shown that the M-HeLa sublines of a non-clonal origin differ in the level of their karyotype variability as compared to most human and animal lines studied earlier. A definite set of normal and marker chromosomes, as well as a typical karyotype, was revealed for either subline tested. The change of the static technique of cultivation into the roller one was accompanied with changes in the modal class, with the increase in polyploid cell number and proliferation index. It is postulated that the change of cultivation technique may result in selection of defined cell types due to the pre-existed karyotype variability. PMID- 3513405 TI - Follicular lymphomas with predominant splenic involvement: report of two cases. AB - The authors describe the results of histological, cytomorphological, cytochemical and immunological studies carried out in two cases of follicular lymphoma characterized at onset by an exceptional degree of splenomegaly. Although several different histological types seem to be capable of giving rise to prominent splenic involvement, the authors, on the basis of the reported findings, suggest the possibility that some cases of follicular lymphoma presenting with conspicuous splenomegaly and which at present are classified in the group of the so-called intermediate lymphocytic lymphoma, might be an expression of proliferation of a cell type normally recognizable in the marginal zone of the splenic follicles. PMID- 3513406 TI - Influence of in vitro culture conditions on tumor cell differentiation. AB - We studied the influence of different in vitro culture conditions on the growth characteristics of certain human and murine tumor cell lines maintained in either conventional medium supplemented with FCS or in serum-free synthetic medium. A lower growth rate was observed for all of the cell lines maintained in serum-free conditions. Three human melanoma cell lines which were Ia-positive and showed an absence of pigmentation in the presence of FCS, without it produced melanin and lost their Ia antigens. In serum-free conditions, a murine hybridoma lost its membrane IgM and two human carcinoma cell lines expressed and secreted an increased amount of several tumor markers identified by monoclonal antibodies. The results of the study are in keeping with the hypothesis that tumor cell lines cultured in serum-free medium acquire differentiation characteristics. PMID- 3513407 TI - Oral contraceptives and cervical neoplasia: pooled information from retrospective and prospective epidemiologic studies. AB - A positive association between the use of oral contraceptives and the risk of cervical neoplasia has been suggested by different sources. This paper examines epidemiologic evidence on this issue through pooled computation of relative risks emerging from 21 studies, subdivided into three main categories: studies based on routine cytologic screening programs, case-control investigations and prospective studies. The pooled estimates of the relative risks for ever vs never use of oral contraceptives were broadly similar and slightly above unity (1.4 from cytologic screening programs, 1.1 from case-control and 1.4 from prospective studies). The risk increased with duration of use and, generally, lower relative risk estimates derived from the older studies, necessarily based on short-term use of oral contraceptives. A particularly limited increase in risk was apparent from case control investigations. Furthermore, when allowance was made for the major covariates (mostly indicators of sexual habits), a noticeable decrease in the excess risk was evident. In conclusion, although statistical significance of moderate differences in risk can be obtained by pooling data from several studies, a risk of the magnitude of that for the association between oral contraceptives and cervical neoplasia may well be due to bias and confounding. In addition, since sexual behavior only indicates the probability of having been exposed to some sexually transmitted agent (most likely human papilloma virus), the greatest additional contribution may come from a case-control study in which adjustment for such exposure is possible. PMID- 3513409 TI - [Ceftazidime, Fortum]. PMID- 3513408 TI - Fine needle percutaneous intratumoral chemotherapy under ultrasound guidance: a feasibility study. AB - To test the feasibility of fine needle (22 gauge) percutaneous intratumoral chemotherapy (PIC) under ultrasound guidance, a trial was conducted on 12 selected neoplastic patients with tumors not responsive to conventional treatments (5 adenocarcinomas of the pancreas, 1 hepatocellular carcinoma, 1 squamous cell carcinoma of the lung, 1 leiomyosarcoma of the hepatic hilum, 1 malignant fibrous histiocytoma of the ischiatic region, 2 liver and 1 peritoneal metastases). The drugs used were 5-fluorouracil, methotrexate and cyclophosphamide, according to the histotype. The doses given never exceeded the routine intravenous doses; 119 sessions of PIC were administered. There have been no significant local complications due to needle injury and drug toxicity or biochemical changes attributable to general toxicity. Partial or total pain control and stable disease or response to 60% was observed. This research has not been described previously to our knowledge. PMID- 3513410 TI - [Doxapram (Dopram). An alternative to respirator treatment in acute episodes of aggravated chronic respiratory insufficiency?]. PMID- 3513411 TI - [Complications of spinal anesthesia]. PMID- 3513412 TI - [Plantar warts. Occurrence and cryosurgical treatment]. PMID- 3513413 TI - [Antibiotics in the treatment of exacerbations in patients with chronic bronchitis]. PMID- 3513414 TI - [Acupuncture for asthma patients]. PMID- 3513415 TI - [Steristrip Tape suturing compared with percutaneous suturing of abdominal incisions. A controlled study of late cosmetic results]. PMID- 3513417 TI - [Ultrasonic follow-up of obese patients operated on by stomach bypass]. PMID- 3513416 TI - [Mechanical suturing of bronchi]. PMID- 3513418 TI - [Auscultatory percussion of the lungs. Prospective comparison of 2 methods of clinical examination of the lungs]. PMID- 3513419 TI - [Insulin shock treated at casualty departments. A retrospective analysis of 120 episodes]. PMID- 3513420 TI - [The effect of salbutamol inhalation on postoperative pulmonary function]. PMID- 3513421 TI - [Surgical treatment of patients with post-traumatic urethral stricture]. PMID- 3513422 TI - [Successful result of the complex treatment of infection in a patient with a functioning renal allotransplant]. PMID- 3513423 TI - [Immunocompetence and immunotherapy of patients with cancer of the kidney and bladder]. PMID- 3513424 TI - Hormonal therapy of prostatic carcinoma: is there a rationale for delayed treatment? PMID- 3513425 TI - Safety and efficacy of intravesical aminocaproic acid for bleeding after transurethral resection of prostate. AB - There appears to be no clinically significant difference in blood loss or transfusion requirements after transurethral resection of the prostate (TURP) when intravesical 0.5% aminocaproic acid is compared with 0.9% sodium chloride irrigation in patients during the first three days after surgery. This is probably because early post-TURP bleeding is due to inadequate hemostasis or perforation of the prostatic capsule, and not excessive local or systemic fibrinolysis. However, we suggest that intravesical aminocaproic acid might be a useful alternative to systemic antifibrinolytic therapy in patients with delayed, recurrent, excessive post-prostatectomy bleeding, which is thought to be due to fibrinolysis. Since aminocaproic acid is not systemically absorbed after bladder instillation, intravesical administration causes few side effects and does not necessitate screening patients for disseminated intravascular coagulation prior to treatment. PMID- 3513426 TI - Endoscopic transurethral suspension of bladder neck and urethra. Experimental trials of new procedure in dogs. AB - An endoscopic, transurethral suspension of the female urethra and bladder neck is achieved by placing sutures through the anterior urethral wall up to the anterior abdominal fascia. The sutures are placed under direct endoscopic vision using a specially designed suture passer. In 8 female dogs a mean increase in urethral length of 1.81 cm (SEM 0.21 cm) was obtained immediately postoperatively. Reevaluation three months postoperatively demonstrated the mean increase to be 1.56 cm (SEM 0.11 cm). Cystoscopy and postmortem dissection demonstrated integrity of the repair in all 8 dogs. A clinical trial in stress incontinent women is suggested. PMID- 3513427 TI - Leiomyosarcoma of penis. PMID- 3513428 TI - Contelle: pelvic floor stimulator for female stress-urge incontinence. A multicenter study. AB - The clinical efficacy of a new device for treatment of female incontinence was studied in a multicenter trial. The device consists of an inflatable electrode carrier and an external stimulator unit. Forty women were treated: 10 had primary or recurrent genuine stress incontinence, 15 had urge incontinence due to idiopathic detrusor instability, not responding to drug treatment, and 15 had stress incontinence combined with detrusor instability. Twenty-five patients were improved by the treatment. Another 8 reported an excellent result of treatment and remained free of symptoms for more than six months after withdrawal of the treatment. The results were more favorable in patients with bladder hyperactivity than in genuine stress incontinence. The patients' general ratings of treatment efficacy correlated well with their recordings of urinary frequency and consumption of incontinence pads. The functional bladder capacity increased in improved patients, but normalization of urodynamic parameters was no prerequisite for clinical improvement. We found intravaginal electrical stimulation to be a valuable alternative to medical and surgical intervention in patients with detrusor instability. PMID- 3513429 TI - [Various aspects of the auditory perception of focused amplitude-modulated ultrasound]. PMID- 3513430 TI - [Insulin treatment of patients with chronic atrophic laryngitis with disorders of carbohydrate metabolism]. PMID- 3513431 TI - [Changes in the external and middle ear in diabetes mellitus]. PMID- 3513432 TI - Staphylococcus hyicus in donkeys. PMID- 3513433 TI - Local and systemic immune response in the cow after intramammary vaccination during lactation. AB - The local and systemic immune response of the lactating cow during the 10 week period after intramammary (IMM) vaccination with killed Mycobacterium bovis (M. bovis) was evaluated. Antigen (tuberculin)-reactive lymphocytes were present in the milk as early as 2 weeks post-vaccination, and in the blood at 6 weeks after vaccination. The milk lymphocytes, compared to the blood lymphocytes were consistently more responsive to tuberculin. Both blood and milk lymphocytes responded in vitro to the lectins, phytohemagglutinin-A (PHA-P) and concanavalin A (Con A), although the milk lymphocytes were consistently less responsive than the blood lymphocytes during the period. Anti-tuberculin antibody was significantly elevated in the milk and blood of the vaccinated animals at 10 weeks post-vaccination. Infusion of tuberculin into the mammary glands of the cows 10 weeks after vaccination resulted in a marked increase in the number of milk leukocytes. The influx of leukocytes initially consisted of polymorphonuclear leukocytes (PMNL), and later, mononuclear leukocytes. Intramammary vaccination also resulted in antigen recognition at sites distant from the mammary gland. PMID- 3513434 TI - Characterization of c-myc proteins from avian bursal lymphoma cell lines. AB - We have used a rabbit antiserum directed against a portion of the MC29 viral myc protein expressed in bacteria to characterize the cellular myc protein from three different avian bursal lymphoma cell lines (1104HI, 1104BI S13, BK25), and from normal chick embryo cells. The phosphorylated myc proteins immunoprecipitated from these cells varied in molecular weight from 58 to 62 kDa and localized to the cell nucleus, as shown by cell fractionation experiments. Pulse-chase experiments established that these proteins had short half-lives ranging from 12 min for the myc proteins from the 1104BI S13 cell line to 25 min for myc proteins from both the 1104HI and the BK25 cell lines. The structural relatedness of the proteins was established by comparing their partial proteolytic digestion products (Cleveland analysis) with the partial proteolytic digestion products of the MH2 viral myc protein. The anti-myc-serum also immunoprecipitated a 48-kDa protein from each of the bursal cell lines. We have identified this protein as a breakdown product of the bursal cell myc proteins. The different size and number of these bursal cell myc proteins may be a direct result of the specific site of integration as well as the orientation of the retrovirus LTR sequence relative to the adjacent cellular myc allele. PMID- 3513436 TI - Viral antigen expression in the pancreas of DHBV-infected embryos and young ducks. AB - The time course of appearance of viral antigen-positive pancreatic cells was examined in both congenitally duck hepatitis B virus (DHBV)-infected duck embryos and experimentally DHBV-infected posthatch ducks. In the embryos, the earliest detectable viral antigen-positive pancreatic cells were localized to islets and identifiable as endocrine on the basis of hormone expression. Non-islet associated, viral antigen-positive cells appeared at a late stage of embryogenesis, following the onset of chymotrypsinogen production by exocrine tissue; a number of these viral antigen-positive cells were directly identifiable as exocrine on the basis of chymotrypsinogen expression. By contrast, in the pancreas of experimentally infected posthatch ducks, the appearance of viral antigen-positive exocrine cells (chymotrypsinogen-positive) predated the appearance of antigen-positive islet cells. These results are consistent with the possibility that viral antigen expression in exocrine tissue is dependent on the state of cell maturation. PMID- 3513435 TI - Nucleotide sequence of the protease-coding region in an infectious DNA of simian retrovirus (STLV) of the HTLV-I family. AB - A provirus clone of simian T-cell leukemia virus isolated from a pigtailed monkey (PT-STLV), which is 90% homologous to HTLV-I, was shown to be biologically active in transfection assay. In transfected cells, gp61env, Pr55gag, and the mature gag proteins p24, p21, and p15 were detected, and type C particles were produced. The virus could be transmitted from the transfectants to recipient cells by cocultivation. In this biologically active provirus clone, a coding frame, possibly for protease, was identified between the gag and pol genes. The corrected sequence of the protease region of HTLV-I was also found to have a single open reading frame overlapping the gag and pol genes, although it has an amber codon in the middle of the frame. Thus, a single coding frame, which is different from those of gag and pol, is common to proteases of the HTLV family including HTLV-I. PMID- 3513437 TI - Dependence of MS2 and T4 phage growth upon host amino acid biosynthesis during infections of Escherichia coli. AB - By manipulating the growth conditions of Escherichia coli both before and after phage MS2 or phage T4 infections, a dependence of phage growth upon postinfection host amino acid biosynthesis can be inferred. Cells grown under repressing conditions for amino acid biosynthesis shifted to amino acid-free medium postinfection (in the absence of further host gene expression) are poor hosts for phage growth, whereas cells grown under derepressing conditions for amino acid biosynthesis are good hosts regardless of postinfection conditions; thus postinfection biosynthesis of amino acids utilizes performed host enzymes which still function to carry out their biosynthetic pathways during phage infections. Phage MS2 also appears to permit the derepression of host amino acid biosynthetic operons during the infection. A functional dependence of MS2 growth upon postinfection host gene function is perhaps the strongest argument that the RNA phage do not shut off host messenger RNA and protein synthesis. PMID- 3513438 TI - [The significance of repeatedly high levels of cytotoxic antibodies in the function of transplanted kidneys]. PMID- 3513439 TI - [Reaction to dinitrochlorobenzene in patients on regular dialysis and after kidney transplantation]. PMID- 3513440 TI - [Fluorescence, fluorochromasia--its use in HLA immunology]. PMID- 3513441 TI - [Ribavirin as an antiviral agent: chemistry, molecular mechanism of action and possibilities of use (review)]. PMID- 3513442 TI - [Solid-phase immunoenzyme method of determining myoglobin in the diagnosis of acute myocardial infarction]. AB - A solid-phase immunoassay was developed for quantitative estimation of myoglobin in human biological fluids. This technique was used for analyses of blood serum and plasma from patients with acute myocardium infarction. The method developed was similar to radioimmunoassay by its diagnostic characteristics but more simple and available. The immunoassay might be used in diagnosis of myocardium infarction as well as in estimation of the disease severity at least in clinics. PMID- 3513443 TI - [Biological role of hyaluronic acid (review)]. AB - The most important studies on hyaluronic acid carried out within the recent 5-7 years are reviewed. Chemical structure, physical parameters and properties of hyaluronic acid are considered. Various functions of hyaluronic acid are discussed on the basis of current information. PMID- 3513444 TI - [Insulin in human gastric juice]. AB - As shown by means of radioimmunoassay high amounts of immunoreactive insulin were first to be found in gastric juice of both healthy persons and the patients with duodenal ulcer. Content of insulin in gastric juice was 3-fold as high as in blood serum. Atropine decreased slightly the insulin content in gastric juice, whereas histamine did not affect its concentration. Estimation of insulin in gastric juice is of importance to elucidate the dependence on its hypersecretion observed in duodenal ulcer as well as to ascertain the insulin role in formation of the gastric juice main components. PMID- 3513445 TI - [Activity of cathepsin B and serine trypsin-like peptide hydrolases in human kidney extracts]. AB - A potentiality to use the available substrates BAPNA and BAME was studied in estimation of activities of cathepsin B and other trypsin-like hydrolases in extracts of human kidney cortex. In these extracts the BAME-hydrolyzing activity of cathepsin B was difficult if impossible to detect due to high level of attendant non-thiol esterases. At the same time, BAPNA might be used for this purpose as a substrate in estimation of cathepsin B- and trypsin-like peptide hydrolase activities in biopsies of human kidney. PMID- 3513446 TI - [Efficacy of contrical in the complex treatment of patients with acute myocardial infarction]. PMID- 3513447 TI - [Disorders of microcirculation in diseases of the digestive system (review of the literature)]. PMID- 3513449 TI - Imaging modalities for lymph nodes. PMID- 3513450 TI - Endoscopic observations of the pharyngeal airway during treatment of obstructive sleep apnea with nasal continuous positive airway pressure--a pneumatic splint. PMID- 3513448 TI - Radiologic imaging modalities, including magnetic resonance, for evaluating lymph nodes. AB - Although lymphography may be more accurate in assessing the extent of abdominal and pelvic Hodgkin's lymphoma, computed tomography (CT) has similar or greater overall accuracy than other imaging modalities in detecting malignant lymph nodes in the neck, chest, abdomen and pelvis. In this early stage of magnetic resonance (MR) imaging, its depiction of nodes is apparently mostly similar to that of CT. In addition, MR imaging shows the capacity to distinguish between enlarged lymph nodes caused by acute inflammation and those caused by malignant processes. PMID- 3513453 TI - Physicians concern under prospective payment. PMID- 3513451 TI - New developments in the treatment of gram-negative bacteremia. AB - Gram-negative bacteremia is an increasingly important nosocomial infectious problem. Endotoxin, endorphins, leukocyte agglutination and deficient opsonization all appear to be major factors in the pathogenesis of Gram-negative septic shock. Outcome has previously correlated best to underlying disease state. With appropriate double antibiotic therapy and hemodynamic support, however, mortality has decreased even for neutropenic patients. Corticosteroids, naloxone, granulocyte transfusions and immunotherapy are experimental adjunctive modes of therapy that offer hope for even better survival in the future. PMID- 3513454 TI - Effects of beta-stimulant aerosol on respiration, circulation and metabolism. Experimental studies of inhalation techniques on canine asthma models. PMID- 3513452 TI - Exercise and coronary artery disease--what should we be recommending to our patients (and ourselves)? PMID- 3513455 TI - [Sonographic studies in the differential diagnosis of thyroid diseases]. AB - In the investigation period from May 1982 to February 1985 1,150 sonographies of the thyroid gland (B-scan) were performed, of which 240 patients underwent a fine needle aspiration. The results of the sonography were compared with the findings of scintigraphy and the results of cytology. With the help of own investigations the indications, the advantages and limits as well as the value of sonography were demarcated under the conditions of our clinic. PMID- 3513456 TI - [Euthanasia in the Third Reich--only a problem of psychiatry? On the development of the euthanasia debate 1933-1941 in Germany]. AB - The devastating consequences of the Fascist dictatorship in Germany for the ethical thinking of the physicians are particularly clearly recognizable by the mass killings of severely damaged children and patients with chronic psychic diseases which were performed at that time. Recent investigations of the developments which began in 1938 show that by way of intensive efforts for a juridicial legalization of the "active euthanasia" an enlargement of this killing practice has been striven after. References to a motive of compassion and the free decision of the affected persons should cover the real intention for reducing welfare services. A bill presented in 1940 for a law "on euthanasia for incurable ill persons" found the unanimous consent of the renowned physicians consulted for this purpose. Though this law finally did not become legal beginning with 1941 the medical practice showed further forms of the repressive and antihumane association with ill persons who were regarded as incurable, which must be valuated as practical consequences of an unadmissible relativation of the life-preserving task of medicine. PMID- 3513457 TI - [Immunohistochemical detection of carcinoembryonic antigen and protein S-100 in sweat gland tumors]. AB - Carcinoembryonic antigen (CEA) and S 100 protein (S 100) have been demonstrated in formalin-fixed paraffin sections of eccrine and apocrine sweat glands, and tumors of the sweat glands, as well as, for comparison, in a variety of tumors deriving from epidermal and follicular structures using the peroxidase antiperoxidase technique. CEA is detectable, as a membrane antigen, in the normal coil of eccrine sweat glands and in the cytoplasm of luminal cells in eccrine and apocrine sweat ducts up to the horny layer. Nearly all tumors of the sweat glands contain variable amounts of CEA. S 100 is localized in the cytoplasm of eccrine coils and secreted with the sweat. Apparently it is only found in tumors derived from the eccrine and apocrine sweat gland coils. Immunohistochemical demonstration of CEA and S 100 thus facilitates the diagnosis of tumors of the sweat glands and their differentiation from epidermal and follicular tumors. PMID- 3513458 TI - [Histologic variation in the width of trichoepitheliomas]. AB - Our histopathological study deals with the evaluation of 232 solitary or multiple trichoepitheliomas, which have been examined by means of hematoxylin-eosin staining. The characteristic features of these benign adnexal tumors have been described with special emphasis on changes of the surrounding stroma. We found a great variation with regard to the size and number of cysts, the maturity of the epithelium and surrounding stroma, as well as the amount of affected stroma. In some cases, a clear separation between trichoepithelioma and keratinizing basal cell epithelioma was not possible. PMID- 3513459 TI - [High-resolution real-time sonography in the evaluation of local lymphatic metastases in malignant melanomas]. AB - 120 patients suffering from malignant melanoma were examined by means of 10-Mcs sonographic scanner for the detection of regional lymphatic metastases. Metastases appeared as circumscribed regions of very low echodensity and could readily be separated from benign alterations. Sonography of the regional lymph nodes, therefore, proved to be a useful technique for the follow-up of melanoma patients. PMID- 3513460 TI - [Familial chronic discoid lupus erythematosus]. AB - We report on two patients (father and son) suffering from familial Lupus erythematosus chronicus discoides which could be proved clinically, histologically, and immunologically. Investigations on HLA revealed A-11, A-24, and B-35 for the father and A-24, B-13, and C-4 for the son. PMID- 3513461 TI - [Intrapacemaker interaction and its role in generating automatic heart rhythm]. PMID- 3513462 TI - [Renal function in changes in the volume and composition of the extracellular fluid]. PMID- 3513463 TI - New aspects on the chemistry of tea and coffee. III. AB - The previous review for 1983/1984 is now continued with references to recent publications (1984/1985) and as before covers the chemistry and technology of tea (leaf, green and black) and coffee (raw, roasted and instant soluble), with particular reference to composition and changes during manufacture, extraction and storage. The effects of composition on the quality of the beverage, with mention of particular physiological properties, are included (210 references). PMID- 3513464 TI - [Prenatal diagnosis of thoracopagus in the 19th week of pregnancy]. AB - A pair of conjoined twins (thoracopagus) was detected in the 19th week of pregnancy, by ultrasound. Serumalphafetoprotein was normal. Since the fetuses had only one heart, the pregnancy was terminated. The embryopathological investigation confirmed the prenatal diagnosis. Authors recommend the ultrasound screening of all pregnant women between the 16-20th week of gestation. This case is a good example of progressive care in the field of prenatal genetics. PMID- 3513465 TI - [Fetal tachycardia--a cause of nonimmunologic hydrops]. AB - A case of nonimmune hydrops fetalis is demonstrated. The cause of this disorder was a severe fetal tachycardia. Prenatal findings, obstetric management, and neonatal outcome are described. Our data have been discussed with reference to the literature. PMID- 3513466 TI - [Significant dates and anniversaries of neuropathology and psychiatry in 1986]. PMID- 3513467 TI - [K. L. Kal'baum i ego kniga "Catatonia or tonic insanity" (1874)]. PMID- 3513468 TI - [Functional test of reactive hyperemia in the diagnosis of the vertebro subclavian steal syndrome using ultrasonic dopplerography]. AB - The authors used ultrasonic dopplerography (UD) and the reactive hyperemia test to diagnose the vertebral-subclavicular stealing syndrome (VSSS) with occlusion of the proximal segment of the subclavicular or innominate arteries. The sonographic and angiographic findings coincided in 92.3% of cases. It is concluded that UD is the method of choice in the evaluation of the efficiency of reconstructive surgery aimed at correcting the VSSS. PMID- 3513469 TI - [Features of the hemodynamics of major extracranial arteries in patients with occlusive lesions of the brachiocephalic vessels]. AB - The article deals with characteristics of the hemodynamics of the extracranial major arteries in patients with different forms of cerebrovascular insufficiency due to occlusive lesions of the brachiocephalic arteries. Clinicoangiographic characteristics of patients with this pathology associated with atherosclerosis and nonspecific aortoarteritis are presented. Angiography showed two variants of occlusive damage to the brachiocephalic arteries: bicarotid and multiple. The authors were the first to use comprehensive examination of patients with the employment of the spectral computerized analysis (SCA) of ultrasonograms (USG) of the common carotid and suprapubic arteries and ultrasonic angiography with the calculation of the circulation rate in the common carotid arteries. Using SCA of USGs criteria of different degrees of stenosis of the common and internal carotid arteries were developed. A correlation analysis of the data obtained by SCA of USGs and of the values of the circulation rate in the common carotid arteries was made. The highest correlation of these parameters was observed in patients with stenosis of 60-90% and occlusion of the internal carotid and common carotid arteries. PMID- 3513470 TI - Venous haemodynamics in the legs after ligation of the inferior vena cava. AB - Doppler ultrasound and strain gauge plethysmography (SGP) were used to study venous insufficiency in 22 patients after ligation of the inferior vena cava (LIVC), 13 control patients with unilateral postthrombotic syndrome (PS) and 20 normal controls. Isotope venography was performed in eight patients. SGP showed low venous capacity in LIVC legs without deep vein thrombosis (DVT), indicating restrictive syndrome. There was no venous obstruction in any of the groups studied. In the LIVC limbs with DVT and in the PS limbs, venous reflux differed significantly from that of normal controls. The popliteal venous reflux examined by Doppler ultrasound was sporadic in LIVC limbs without DVT, occurring in 71% of LIVC limbs with DVT and in 77% of limbs with PS. Isotope venography in eight LIVC patients showed abundant collateral circulation. We conclude that DVT causes venous reflux. LIVC causes a restrictive syndrome without venous obstruction, and alone it did not cause venous reflux. Clinically it indicates that symptoms after uncomplicated LIVC are mild and that late postoperative morbidity is principally arising from DVT and not from LIVC alone. PMID- 3513471 TI - Plasma fibronectin is sequestered into tissue damaged by inflammation and trauma. AB - Mechanical trauma or inflammatory reaction induced in striated muscle tissue of rats was followed by a flux of fibronectin from plasma into the damaged tissue, as determined by measurement of radioactivity, autoradiography and immunofluorescence. When homogenized muscle tissue was incubated with labelled fibronectin prior to separation of its subcellular components by ultracentrifugation, fibronectin bound to all fractions, but with strongest affinity for the microsomal and plasma membrane fraction. When trauma occurs, fibronectin from plasma binds to exposed structures on cell membranes and to components of connective tissue such as collagen and proteoglycans. Because of its ability to mediate cellular adhesion to tissue components, fibronectin probably exerts important functions in normal wound healing. PMID- 3513472 TI - Surgical biopsy of non-palpable mammary lesions. Technique and results. AB - In a randomized controlled trial with mammographic screening for early detection of breast cancer, 314 non-palpable breast lesions were examined by open biopsy between 1978 and 1983. These biopsies were performed after the lesions had been indicated by the hooked wire technique. In 185 cases the findings turned out to be benign while 129 proved to be malignant. Satisfactory initial biopsies were achieved in 95% of the cases. A model for the management of mammary lesions found in such a screening programme is described and some difficulties are discussed. PMID- 3513473 TI - Ultrastructural analysis of major basement membrane types in rhesus monkey Macaca mulatta acellular renal cortex. AB - Increasing interest in animal models of human nephropathies have led to a number of renal studies in nonhuman primates. In the current investigation, sequential detergent extraction of cellular elements was carried out on renal cortical tissue blocks from rhesus monkey in an effort to demonstrate clearly the morphological features of major basement membrane (BM) types and their associated extracellular matrix (ECM). LM and TEM views of acellular tissue blocks demonstrate planar arrangements of ECM components, while SEM studies provide striking three-dimensional images of their surface characteristics. All major BM types maintain their in vivo histoarchitectures despite the absence of cells. We propose that the intrinsic structural rigidity of tubular (TBM), Bowman's capsule (BCBM) and peritubular capillary BM (PTCBM) may be related to to their close external association with collagenous fibrils, while glomerular BM (GBM) may be internally supported by a network of mesangial matrix (MM) plates and trabeculae which extend onto internal surfaces of peripheral GBM loops. Thicknesses of rhesus monkey renal BMs show that they are similar to those seen in the laboratory rat and, in general, BCBM greater than TBM greater than GBM greater than PTCBM. We conclude that rhesus monkey renal BMs closely resemble those described by us in the human [J. Ultrastruct. Res. 82: 96-110, 1983] and that this species offers an attractive model for studies of renal diseases of BM origin-notably diabetes mellitus. PMID- 3513474 TI - [Wilhelm His and 100 years of human embryology]. PMID- 3513475 TI - [Macroscopic and microscopic anatomy of the shoulder joint and the limbus glenoidalis]. AB - Macroscopical and histological examinations were carried out in order to investigate the anatomy of the limbus glenoidalis, with respect to its surrounding structures such as tendons and ligaments. Basically the crosscut limbus glenoidalis has a triangular shape, however, especially in its anterior part, it has a meniscoid or labiate form. Histologically the limbus glenoidalis consists exclusively of connective tissue, rich in cells and fibers. It originates from the fibrocartilaginous rim of the glenoid surface, which merges into the hyalin cartilage. The bundles of fibers have a circular arrangement with radially and reticularly interwoven structures near the tendons of the biceps and triceps muscle. PMID- 3513476 TI - Prostacyclin and vasospasm in subarachnoid hemorrhage from ruptured intracranial aneurysm. A preliminary clinical study. AB - Experimental and clinical observations suggest the importance of arachidonate metabolites in the genesis of symptomatic cerebral vasospasm after subarachnoid hemorrhage. Prostacyclin (PG12) has a well demonstrated vasodilator action. The authors monitored CSF prostacyclin concentration in 12 consecutive cases of subarachnoid hemorrhage with the purpose of correlating the prostacyclin concentration trend with the clinical course and the risk for vasospasm. In three cases patients presented with clinical and radiological signs of vasospasm. CSF prostacyclin concentration showed a typical decreasing trend, which amounted to a minor form of protection from vasospastic agents. The nine cases which did not develop vasospasm demonstrated no significant changes in the prostacyclin CSF concentration trend. The authors also presented four cases in which cisternal CSF samples were available. In one case of developing vasospasm, the cisternal prostacyclin concentration was seven times lower than the highest lumbar CSF concentration. In three cases without evidence of vasospasm cisternal CSF demonstrated a balanced biochemical situation and a minor risk of vasospasm. PMID- 3513477 TI - The influence of prostacyclin on the recovery of bioelectric cerebral activity after complete ischemia. AB - Complete cerebral ischemia (CCI) was evoked by closing the brachiocephalic trunk, the left subclavicular artery and both internal thoracic arteries with simultaneous depression of systemic arterial pressure (SAP) to 70-50 mm Hg. The experiments were performed with three groups of rabbits. The first group consisted of animals with 15 and 20 min CCI, not receiving PGI2. In the second group PGI2 was given for 15 min before and during 15 min CCI. The third group with 15 and 20 min CCI received PGI2 3 min before, during and for 15 min after ischemia. The recovery of ECoG and the activities of the respiratory and vasomotor centres were evaluated as were reflex reactions. In 38 percent of the second group of rabbits improvement of the neurological condition after CCI was noted, as compared with animals of the control groups and a faster recovery of the ECoG. In the third group the neurological state improved in 100 percent of cases with simultaneous significantly quicker recovery of the first symptoms of brain cortex bioelectric activity and continuous activity in ECoG records. Between groups 1 and 2, and group 3 there were differences concerning the time of recovery of ECoG, and the intensity of reflexes. The influence of PGI2 on the brain bioelectric activity of the animals after CCI was found to be favourable. PMID- 3513478 TI - Status at two years in 121 very low birth weight survivors related to neonatal intraventricular haemorrhage and mode of delivery. AB - All 121 infants with birthweight less than or equal to 1500 g (VLBW) discharged from our department through an 18-month period were followed up at two years of age. All but 10 infants were examined by cranial ultrasound scanning in the neonatal period. Six had died after discharge; and of these two had severe brain damage following neonatal intraventricular haemorrhage. Twelve children had definite neuromotor abnormality; of these, the nine children with spastic types of cerebral palsy had all been delivered vaginally. Of the remaining children, one half had at least one neurodevelopmental symptom suggesting perinatal brain damage. Outcome was associated to neonatal intraventricular/subependymal haemorrhage when complicated by ventricular dilatation. Outcome in children with simple haemorrhage was similar to that in children without haemorrhage. The association between outcome and haemorrhage was considerably reduced by simultaneously considering the associations of gestational age at birth and the use of mechanical ventilation in the neonatal period. Head circumference at follow-up was greatest in those children with haemorrhage complicated by ventricular dilatation, when adjusted for actual body weight, birth weight, and gestational age at birth. PMID- 3513479 TI - Daily subcutaneous administration of human growth hormone in growth hormone deficient children. AB - Sixteen children (10 boys, 6 girls) on treatment for some years with i.m. injections twice or thrice weekly of human growth hormone (hGH; Crescormon Kabi Vitrum), participated in a prospective study. The weekly amount of hGH (8, 12, or 16 IU) was kept the same in each child, but divided into daily (7) s.c. injections at bedtime. The growth rate increased in all children during the first year on s.c. daily hGH (5.3 to 7.4 cm/year; 1.95 to 4.27 SDS). This increased growth rate did not persist during the second year on daily s.c. hGH, but an increased growth rate did not persist during the second year on daily s.c. hGH, but an increased predicted final height was found. The plasma profile of hGH was followed: i.m. injected hGH gave mostly a high (200 mU/l) plasma level of some hours (wide intra- and interpatient variation), and s.c. injected hGH a lower max level of longer duration (wide inter patient variation). The daily s.c. regimen of hGH was extremely well accepted by the children and their parents and no GH antibodies or other adverse effects were found. We recommend daily s.c. injection of hGH as an alternative in the treatment of GH-deficient children. PMID- 3513480 TI - Adrenergic innervation and neurogenic response in large and small arteries and veins from the rat. AB - A combined morphological and physiological analysis of the properties of the adrenergic vasoconstrictor innervation was carried out in the splanchnic vasculature in the rat. Three generations of vessels were studied: (1) the abdominal aorta and the caval vein; (2) the superior mesenteric artery and vein; (3) 200 microns branches of the superior mesenteric artery and their parallelling veins. The adrenergic innervation was visualized by the Hillarp-Falck fluorescence technique, and by the immunohistochemical localization of immunoreactivity to tyrosine hydroxylase and dopamine-beta-hydroxylase. Determination of responses to applied noradrenaline, to transmural nerve stimulation and to direct activation of the muscle was made on ring preparations mounted in a myograph. All vessels were found to be innervated at the adventitio medial border by noradrenergic nerves with varying density; the small arteries had the highest nerve density, the abdominal aorta was least innervated. When related to the maximal isometric response to applied noradrenaline, the maximal neurogenic response parallelled the density of the adrenergic innervation. Variations in frequency for half-maximal response among the vessels could not, however, be ascribed to innervation properties only. The constriction under isotonic conditions amounted to 20% of the initial circumference in the aorta, and to 30% in the small arteries and veins. The relation between response to applied noradrenaline and to nerve stimulation was similar for isometric and isotonic responses. In the smaller veins, a beta-receptor-mediated decline in the response to applied noradrenaline was seen. This decline was much less pronounced in neurogenic responses. The results indicate a gradation from proximal to peripheral arteries towards denser innervation and greater neurogenic responses. On the venous side only minor differences were found. PMID- 3513481 TI - Metacarpal bone measurements in renal transplant recipients, in corticosteroid treated patients with polymyalgia rheumatica and in patients with primary hyperparathyroidism. AB - Quantitative radiological measurements on the second left metacarpal bone were carried out in 23 patients with primary hyperparathyroidism, 22 corticosteroid treated patients with polymyalgia rheumatica and 40 renal transplant recipients treated with prednisone and azathioprine. Women with primary hyperparathyroidism and corticosteroid-treated women showed significantly decreased mean values of metacarpal bone compared to normal controls, probably due to a higher bone resorption than formation at the endosteal surface. Bone loss was more pronounced in corticosteroid-treated women than in women with primary hyperparathyroidism, partly due to age difference. In renal transplant recipients, bone loss took place during the initial period after renal transplantation, probably due to increased endosteal bone resorption. During this period a periosteal new bone formation took place in female renal transplant recipients. The quantitative radiological measurements make it possible to determine whether bone loss is due to a higher ratio of bone resorption than of bone formation at the periosteal and/or endosteal surface. PMID- 3513482 TI - Chromosomal abnormalities in leukemia and lymphoma: clinical and biological significance. PMID- 3513484 TI - Molecular genetics of the human major histocompatibility complex. PMID- 3513483 TI - The human argininosuccinate synthetase locus and citrullinemia. PMID- 3513485 TI - An algorithm for comparing two-dimensional electrophoretic gels, with particular reference to the study of mutation. AB - An algorithm dedicated to the detection of presumed mutational events involving the polypeptides displayed with two-dimensional polyacrylamide gel electrophoresis has been described. Because of the large number of gels necessary in most studies of mutation, the algorithm has been designed to minimize operator intervention in its execution. The basic principle involves a comparison of the graph structures of the gels of a father, mother, and one or more children, searching for protein spots in the child not found in either parent. These so called "orphan" spots are considered a probable manifestation of mutation only after other possible causes of such an isolated event have been excluded as rigorously as possible. At present, the analysis of gels prepared from a platelet or erythrocyte lysate yields about 2% "false-positive" findings, i.e., results in the incorrect designation of a unique spot in a child. These errors can be disposed of by technician intervention. In an experiment designed to simulate the occurrence of mutational events, the algorithm operated with 70% accuracy. Most of the "errors" ("false negatives") occurred when the position of the simulated mutant polypeptide coincided in whole or part with that of a preexisting polypeptide, resulting in a class of mutation not detectable by the eye either. With correction for this fact, the accuracy was 84%. Possible improvements in the algorithm which would substantially increase accuracy have been discussed at some length, as have some ideas as to how to manage the large body of data resulting from the operation of the algorithm. A murine experiment designed to validate the approach has been outlined. PMID- 3513486 TI - Trauma of the middle ear. Clinical findings, postmortem observations and results of experimental studies. PMID- 3513487 TI - Cardiovascular haemodynamics and the response of vasopressin, aldosterone, plasma renin activity and plasma catecholamines to head-up tilt in young and old healthy subjects. AB - Increasing age impairs the regulation of blood pressure during posture change. The neuro-humoral and cardiovascular responses to head-up tilt were analysed in carefully-screened young and healthy elderly individuals. Mean blood pressure was significantly higher in the elderly but there were no differences in total peripheral resistance, heart rate, stroke volume and cardiac index. Age-related interactions were observed in the control of mean blood pressure, heart rate and stroke volume. Total peripheral resistance increased and cardiac index decreased but there was no difference in their control in the young and old. Noradrenaline, vasopressin, plasma renin activity and aldosterone all increased in response to the tilt. These observations indicate differences in the neuroendocrine responses and cardiovascular haemodynamics of young and old healthy individuals to head-up tilt and are particularly important because of all observations were made simultaneously in the same subject. It is suggested that a similar approach should be adopted in the investigation of patients with postural hypotension. PMID- 3513488 TI - Computed tomography of gastrointestinal inflammation after bone marrow transplantation. AB - Overwhelming secretory diarrhea can be a major complication after bone marrow transplantation, associated usually with acute graft-versus-host disease (AGVHD). Radiographic evaluation may be hampered by nausea, vomiting, or debilitation. Computed tomography (CT) in seven such patients demonstrated diffuse wall thickening in the small intestine, colon, and/or mesentery. In two cases, prolonged adherence of oral contrast material to the luminal surface resulted in bizarre patterns of coating. In two others, a layer of low attenuation within the thickened wall produced a target appearance consistent with submucosal edema or hemorrhage. Small bowel dilatation and fold enlargement was the only finding in one patient. The role that superinfection of the gastrointestinal tract with opportunistic organisms can play in this immunocompromised group of patients is less well established. In this group of patients, the findings were due to AGVHD in two, AGVHD and viral enteritis in two, and viral enteritis alone in three. CT may be an alternative to routine contrast studies in assessing the extent of gastrointestinal tract involvement after bone marrow transplantation. Neither contrast studies nor CT were able to differentiate between AGVHD and viral enteritis. PMID- 3513489 TI - Fetal renal cystic disease: sonographic-pathologic correlation. AB - Renal cystic disease encompasses a complex group of pathologic and clinical entities, with varied yet distinctive sonographic features. An accurate assessment of the fetal genitourinary tract and the amniotic fluid volume by sonography can lead to a specific prenatal diagnosis in most cases. This article emphasizes the usefulness of sonographic-pathologic correlation in understanding renal cystic disease. The entities discussed are infantile polycystic kidney disease (Osathanondh and Potter type I), multi-cystic renal dysplasia (type II), adult polycystic kidney disease (type III) and renal cystic dysplasia associated with obstructive uropathy (type IV). Sonograms of six correctly diagnosed cases between November 1982 and November 1984 were retrospectively reviewed and correlated with their pathologic findings. The differential diagnosis and possible pitfalls are discussed. In addition, the impact on perinatal management and the role of genetic counselling will be emphasized. PMID- 3513490 TI - Renal sonography in the differentiation of upper from lower urinary tract infection. AB - Increase in renal volume and asymmetry in kidney size determined by sonography proved to be a valuable diagnostic criterion for differentiation between infections of the upper and lower urinary tract in 175 children: acute bacterial interstitial nephritis (79) and lower urinary tract infection (96). Kidney volume in acute pyelonephritis increased to an average of 175% of normal. In 71% of cases, affected kidneys showed an enlargement of at least 2 SD when compared with a group of 325 children without kidney pathology. Most impressive kidney enlargement was seen during the first year of life. In 50% of cases, acute pyelonephritis caused a bilateral increase in renal size and/or distinct volume asymmetry. Kidneys of patients with lower urinary tract infections had a mean volume of 99.68% and a physiologic volume asymmetry comparable to normal kidneys. PMID- 3513491 TI - Time requirements for intraoperative neurosonography. AB - The time requirements needed for radiologists to perform intraoperative neurosonography were analyzed. Eighty-five consecutive intracranial and spinal operative procedures were prospectively monitored, and it was found that the average length of time spent in the operating room by the radiologist was 1 hr in spinal cases and 52 min in intracranial cases; the wide range of time spent in each case depended on the complexities of the operation; only one-fifth of the radiologist's time in the operating room was spent performing the study and interpreting the sonograms; and 24% of cases were either emergencies or were performed after normal working hours. It may be helpful to take these factors into consideration when there are plans to offer the service of intraoperative neurosonography. PMID- 3513492 TI - Limitations of indium-111 leukocyte scanning in febrile renal transplant patients. AB - Indium-111-labeled leukocyte scanning was evaluated as a technique for investigating possible abscess as the cause of fever in 10 renal allograft recipients under therapy for rejection, acute tubular necrosis, or urinary infection. The usefulness of the method in this setting was found to be limited by marked nonspecificity of renal, pulmonary, and other focal leukocyte accumulation. Although wound infections were correctly identified, false-positive scans resulted in multiple nonproductive consultations and radiologic procedures (some invasive) and contributed to the decision to perform one negative exploratory laparotomy. Such generalized nonspecificity in this patient population is in distinct contrast to the experience with this diagnostic test in nontransplant patients, and has not previously been reported. Possible explanations and implications of these findings are discussed. Consequently, great caution is recommended in the use of indium-111 leukocyte scans to diagnose infection in febrile renal transplant patients who present in a similar clinical setting. PMID- 3513493 TI - Digital subtraction angiography: a comparison of 512(2) and 1024(2) imaging. AB - A commercial DSA unit was modified by the manufacturer to permit 1024 X 1024 8 bit imaging. System upgrade includes a high-resolution 1049-line TV camera that operates with variable aperture to minimize x-ray exposure during 1024(2) imaging. To compare the change in resolution and radiation exposure between 512(2) and 1024(2) imaging with this system, a two-phase phantom study was performed using a high-contrast converging lead line phantom and a specially designed high-resolution low-contrast Lucite phantom. The two-phase phantom study tested general system resolution performance and resolution under simulated and actual clinical conditions for each field size (15, 25, and 36 cm). The 512(2) imaging was performed with the aperture reduced to the 512 setting; 1024(2) imaging was performed with the aperture at the 512 and 1024 values. The 1024(2) imaging resulted in only modest improvement in resolution compared to 512(2). While Nyquist limits were approached with 512(2) imaging, this was not the case with 1024(2) imaging. This suggests other factors such as system noise are playing a significant role in 1024(2) image degradation. PMID- 3513494 TI - DSA evaluation of surgically implantable infusaid pump-catheter systems. PMID- 3513495 TI - Crossed-leg technique for digital subtraction angiography. PMID- 3513496 TI - New concepts in acute renal failure. AB - The clinical patterns of acute renal failure have changed in the past 10 to 15 years. Nonoliguric acute tubular necrosis has become more common, as has nephrotoxic acute tubular necrosis. Other syndromes that have increased in incidence are acute tubular necrosis secondary to rhabdomyolysis and acute renal failure secondary to nonsteroidal anti-inflammatory drugs. Calculation of the fractional sodium excretion or the renal failure index helps distinguish between prerenal azotemia and acute tubular necrosis. In a significant number of patients with acute renal failure, a kidney biopsy may be necessary to establish the correct diagnosis and initiate the appropriate therapy. PMID- 3513497 TI - Aspiration pneumonia: a review. AB - The damage caused by aspiration depends on the volume, nature and pH of the aspirate and the type of pathogen involved. Aspirate with a pH below 2.5 is much more likely to be toxic than less acidic material. Anaerobic organisms are common pathogens, but aerobic bacteria frequently appear in the hospital setting. Steroids may be useful if administered within minutes of the aspiration. Lavage with large amounts of alkaline fluid has not proved helpful. PMID- 3513498 TI - The porphyrias. AB - The porphyrias are caused by hereditary defects in the synthesis of heme. Each porphyria is characterized by a unique enzyme defect and measurable elevations of specific heme precursors. While qualitatively normal, these precursors accumulate to cause protean signs and symptoms. Photosensitivity should raise the suspicion of a porphyria, especially in a child or a young adult. The skin, teeth and eyes may provide clues to the diagnosis in some cases. PMID- 3513499 TI - Persistent pulmonary hypertension of the newborn. PMID- 3513500 TI - Acute reversible cardiogenic shock: immune-mediated with mild histologic change. PMID- 3513501 TI - Digitalis: 200 years in perspective. PMID- 3513502 TI - Retraction. PMID- 3513503 TI - Antiarrhythmic efficacy of ethmozine in patients with ventricular tachycardia as determined by programmed electrical stimulation. AB - The antiarrhythmic properties of ethmozine were studied in 27 patients with a history of a cardiac arrest or symptomatic ventricular tachycardia. Programmed electrical stimulation studies were performed in 20 men and seven women with a mean age of 62 years and a mean left ventricular ejection fraction of 43%. All patients had inducible ventricular tachycardia by programmed electrical stimulation while off all antiarrhythmic therapy. Patients were then tested on procainamide if their treatment with this drug orally had not previously failed. Procainamide, 1000 and 1500 mg, was administered intravenously, and ventricular tachycardia could be provoked in 14 of 18 patients. Ethmozine was given in an oral loading regimen starting 24 to 36 hours later. After 500 mg oral ethmozine, patients were given 15 mg/kg ethmozine every 8 hours for seven to nine doses prior to drug testing. Ethmozine did not significantly change the baseline heart rate, blood pressure, and QTc interval from the initial drug-free values. The PR and QRS intervals were significantly prolonged. Seven patients were protected on oral ethmozine; 14 patients still had ventricular tachycardia inducible at programmed electrical stimulation testing, and six patients developed ventricular tachycardia spontaneously on ethmozine and were not tested in the programmed electrical stimulation laboratory. One patient had gastrointestinal complaints and was not discharged on the drug. The five patients who tolerated the oral protocol without side effects and who were protected against programmed stimulation induction of ventricular tachycardia were discharged on oral therapy. One patient on long-term therapy appeared to develop an allergic reaction to the agent with unexplained fevers and was switched to amiodarone therapy.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3513504 TI - Controlled double-blind trial of the clinical effect of nifedipine in the treatment of idiopathic Raynaud's phenomenon. AB - Twenty-six patients with idiopathic Raynaud's phenomenon participated in a double blind, crossover clinical trial comparing the clinical effect of nifedipine with that of placebo. Four patients discontinued the study because of side effects and one patient defaulted at the return visit. Nifedipine significantly reduced frequency and severity of attacks (p less than 0.01). In an overall evaluation of drug effectiveness, 19 of 21 patients preferred nifedipine to placebo (p less than 0.01). Nifedipine proved to be effective in the treatment of idiopathic Raynaud's phenomenon, but side effects should be expected in some 30%. PMID- 3513505 TI - Idiopathic cardiomyopathy in the United States, 1970-1982. PMID- 3513506 TI - Lower incidence of doxorubicin-induced cardiomyopathy by once-a-week low-dose administration. AB - A review of the literature investigating an alternative method of administering doxorubicin on a weekly basis demonstrates a lower incidence of doxorubicin induced cardiomyopathy, as judged by endomyocardial biopsy techniques and by an apparent lower incidence of CHF as compared to older reports in the literature utilizing conventional tri-weekly administration. However, none of these studies has utilized objective methods for verifying cardiac function. The precise reason why weekly administration may induce lesser degrees of damage to the myocardium is not clearly understood. However, it appears that the lower serum concentrations obtained with this dosing regimen result in lower myocardial tissue concentrations of the drug. Though the initial data are encouraging, larger clinical trials are necessary to establish a lower incidence of cardiotoxicity with weekly low-dose doxorubicin administration. Such studies, if specifically designed to evaluate changes in myocardial function, will resolve the questions and hopefully establish the advantages of this encouraging new therapeutic modality. PMID- 3513508 TI - Digital ventriculographic demonstration of ventricular septal defect after myocardial infarction. PMID- 3513507 TI - Ischemia, resuscitation, and reperfusion: mechanisms of tissue injury and prospects for protection. AB - Since its introduction in 1960, CPR has evolved into a complex program involving not only the medical community but also the lay public. Currently, program activities include instruction of the lay public in basic life support techniques, development and deployment of emergency medical systems, recommendations for drug protocols for advanced cardiac life support and, most recently, introduction of new methods for tissue protection following resuscitation. After 25 years of experience, we are beginning to understand the pathophysiology of tissue ischemia during cardiac arrest and the interventions required to improve chances of survival and quality of life of the cardiac arrest victim. Recent data in the literature suggest that modification of certain interventions in the resuscitation program may be needed. The poor neurologic outcomes with prolonged standard CPR show that it is not protective after 4 to 6 minutes of cardiac arrest. Modifications to this technique, including SVC-CPR or IAC-CPR, have not been shown to increase resuscitability or hospital discharge rates. Human studies of open-chest cardiac massage are needed to evaluate this option. Defibrillation is the definitive treatment for ventricular fibrillation. Greater emphasis should be placed on the earliest possible delivery of this treatment modality. Computerized defibrillators may provide greater and earlier access to defibrillation in the homes of patients at high risk of ventricular fibrillation. They may also be applicable by untrained public service personnel (police and firemen), individuals in geographically inaccessible areas (aircraft), or emergency medical technicians in rural areas where skill retention is a significant problem. Calcium has no proved benefit in cardiac resuscitation. There is biochemical evidence that it may be harmful in brain resuscitation. Its use in resuscitation should be discontinued. The dose of epinephrine currently advocated in the ACLS protocols may be inadequate to increase aortic diastolic pressure and coronary and cerebral perfusion pressures and thus aid resuscitation. Animal studies indicate that substantial increases in the current dosage are needed to achieve these effects. Human studies are needed to verify these results. A role for calcium antagonists in the treatment of postarrest encephalopathy has been demonstrated in animals and is currently undergoing clinical trials. Iron-dependent lipid peroxidative cell membrane injury may be important in the pathogenesis of postarrest encephalopathy. Animal studies suggest that the iron chelator deferoxamine may have a significant therapeutic role in the treatment of postarrest encephalopathy. PMID- 3513509 TI - Immunochemical quantitation of an airborne proteolytic enzyme, Esperase, in a consumer products factory. AB - Occupational exposure of dry bleach factory workers to proteolytic enzymes poses a potential health hazard to susceptible workers. A sensitive immunochemical technique has been developed for quantitating exposure of factory workers to Esperase by sampling airborne particles on a fiberglass filter sheet followed by elution and assay for enzyme in a two-site immunoradiometric assay. By this method, 0.05 to 0.1 ng of enzyme (activity 50 KNPU/g) can be quantitated. With this sensitivity, as little as 2 to 4 ng/m3 airborne Esperase could be detected by personal monitors (flow rate of 0.002 m3/min; sampling time of 8 hr) and 0.05 0.1 ng/m3 of airborne Esperase with high volume samplers (flow rate of 1.13 m3/min;sampling time of 8 hr). There were significant day-to-day and site-to-site variations in the airborne Esperase content in the factory. Significant variations were also noted in the quantities of Esperase/m3 in the air inhaled by the workers in the same area on the same day. With this sensitive immunochemical technique and the use of personal monitors, the actual exposure of the worker as he moves about the factory could be measured. PMID- 3513510 TI - Antihypertensive and arterial anticalcinotic effects of calcium antagonists. AB - In vascular smooth muscle (as in myocardial fibers), a transmembrane supply of calcium ions is required for active tension development. In consequence, calcium antagonists possess a wide scope of action against practically all types of vasoconstrictor or spastic responses of arterial smooth muscle cells. Calcium antagonists are the drugs of choice for the treatment of coronary, pulmonary, cerebral or mesenteric artery spasms. Other clinically important targets of calcium antagonists are the systemic resistance vessels that rapidly dilate, which explains why calcium antagonists are increasingly used for the treatment of acute hypertensive crises as well as for antihypertensive long-term therapy. In physiologic experiments, calcium antagonists normalize the blood pressure of spontaneously hypertensive rats, neutralize various vasoconstrictor agents (if they act via promotion of transmembrane calcium influx), and greatly reduce the sensitivity of the systemic arteries and arterioles to mechanical stimuli, which can produce additional vasoconstriction, if a rise in intraluminal pressure stretches the vascular wall (Bayliss effect). Calcium antagonists also prevent noxious arterial calcium overload in animals. In the human arterial walls, at an advanced age, pathogenic degrees of calcium accumulation are reached and probably play an important role in both the development of hypertension and of arteriosclerotic lesions. Hypertensive rats exhibit progressive arterial calcium overload that responds well to the calcium antagonists nifedipine, nimodipine, nisoldipine and nitrendipine, as well as to verapamil. PMID- 3513511 TI - A multicenter study of verapamil in systemic hypertension in Thailand. AB - The antihypertensive effect and possible adverse effects of verapamil were assessed in 30 Thai patients with mild to moderate hypertension. All patients had normal blood chemistry evaluations and electrocardiograms. After a 4-week placebo period, 80 mg of verapamil was given 2 times a day for 8 weeks. Blood pressure and pulse rate were recorded both in supine and standing positions every 2 weeks. Verapamil decreased blood pressure significantly both in supine and standing positions. The pulse rate was not significantly affected. The most common adverse effect was constipation. No vivid dreams or breathlessness were reported. The blood chemistry and electrocardiograms at the end of the study period were not significantly changed. It is concluded that verapamil reduces blood pressure in mild to moderate hypertensive Thai patients. PMID- 3513512 TI - Kinetics and dynamics of calcium entry antagonists in systemic hypertension. AB - The calcium-entry antagonists verapamil, diltiazem and nifedipine (and their analogs) are all eliminated by hepatic metabolism and the rate of disposition is dependent on the rate of liver blood flow. During long-term administration, the profound hemodynamic effects of these agents result in changes in hepatic blood flow in association with decreases in arterial pressure, and either increases or decreases in measured cardiac output. This alters the drug's rate of delivery to the site of elimination, with concomitant changes in systemic clearance and a prolongation in elimination half-life. The pharmacokinetic data determined after initial single doses, therefore, only suggest the kinetic characteristics during long-term administration, because this profile depends on the drugs' sustained effects on liver blood flow. The elimination half-life of all 3 prototypical calcium antagonists is probably significantly prolonged during long-term dosing with clinically effective regimens. Patients with hepatic disorders in which liver blood flow is altered, such as cirrhosis, have profound changes in pharmacokinetics with both short- and long-term administration of verapamil and are likely to have similar changes with other calcium antagonists. During short term administration, the plasma concentrations of verapamil and other calcium antagonists relate closely to the observed hemodynamic (and electrophysiologic) effects. With long-term administration, however, these correlations are much less impressive. When given in tablet form, nifedipine lowers blood pressure roughly in proportion to plasma levels between 20 and 200 ng/ml; verapamil plasma levels between 80 and 800 ng/ml are associated with antihypertensive efficacy. Plasma level measurements, therefore, are not of clinical importance as guides to antihypertensive therapy, except to identify noncompliance or abnormal patterns of drug handling. PMID- 3513513 TI - Calcium-channel blockers for combined angina pectoris and systemic hypertension. AB - Calcium-channel blockers have been successfully used in the treatment of angina of effort and systemic hypertension. Many patients present with concomitant angina pectoris and hypertension. Controlled clinical trials demonstrate that the calcium-channel blockers are safe and effective as monotherapy in the treatment of these patients, and that their use compares favorably with that of propranolol. The effectiveness of these agents in hypertension appears to be primarily due to their ability to induce systemic vasodilation. Calcium-channel blockers have several therapeutic effects in angina pectoris. Beneficial actions on the major determinants of oxygen consumption, i.e. heart rate, blood pressure and contractility, are generally seen. The potent coronary vasodilating actions of these agents allow for increased coronary blood flow. Improvements in ventricular compliance, regression of left ventricular hypertrophy and cardioprotection appear to be additional effects of the calcium-channel blockers; their contribution to the drugs' overall therapeutic efficacy is presently being evaluated. Calcium-channel blockers are a welcome addition to drug regimens available for the management of patients with coexisting angina pectoris and hypertension. PMID- 3513514 TI - Long-term results with verapamil in essential hypertension and its influence on serum lipids. AB - Many studies have confirmed that the treatment of mild and moderate hypertension reduces mortality and morbidity from cardiovascular accidents and cardiac and renal failure; more recent studies suggest that there is some beneficial effect on ischemic heart disease. The harmful metabolic effects of some hypotensive agents on serum potassium, magnesium, uric acid, glucose, renin and lipids might reduce the beneficial effect of controlling raised blood pressure. Also, the adverse effects associated with most antihypertensive drugs have decreased quality of life and, possibly, compliance in many patients. In assessing the value of newer antihypertensive agents, other effects of the drugs must be taken into account. The calcium-channel antagonist verapamil produces a dose-dependent reduction in blood pressure with little postural effect. There is little change in heart rate and the major antihypertensive effect results from a decrease in peripheral vascular resistance, with no accompanying increase in cardiac output. In 75 patients followed for more than 1 year, tolerance to verapamil did not appear to develop, nor were there any significant changes in serum electrolytes or creatinine clearance. Fasting serum lipid levels were measured in 15 patients before and after 3 months of treatment with verapamil (80 to 160 mg, 3 times a day); there was no change in cholesterol, triglycerides or high-density lipoproteins. Verapamil is, therefore, an effective hypotensive agent with a rapid onset of action. Tolerance does not develop with prolonged use, nor does it appear to affect electrolytes or serum lipids adversely. Constipation appears to be its only limiting adverse effect. PMID- 3513515 TI - Comparative study of the antihypertensive effect of verapamil and atenolol. AB - A clinical trial in 24 patients with essential arterial hypertension (14 women and 10 men, mean age 47.5) was conducted on a double-blind basis using a placebo, 240-mg verapamil and 100-mg atenolol daily. The total duration of the trial was 12 weeks: a 2-week washout period on placebo, a 4-week period on one of the trial drugs, a second 2-week weaning period and a further 4-week treatment period on the other trial drug. Stabilization of the hypertension was obtained in 80% of the patients on verapamil and 71% of the patients on atenolol both in the supine and upright positions; there was no significant difference between the 2 drugs. A moderate decrease in heart rate was obtained. Sinus bradycardia was observed in 3 patients on verapamil and 4 patients on atenolol. No instances of atrioventricular block were observed on electrocardiogram. No adverse effects were reported with verapamil and in only 1 patient taking atenolol. Adequate stabilization of hypertension appears possible in most patients with both verapamil and atenolol. PMID- 3513517 TI - Regular formulation and sustained-release verapamil therapy in normotension and in mild to moderate hypertension. AB - Calcium entry blocker drugs have hypotensive effects that are mediated by both cardiac and noncardiac actions. Dihydropyridine calcium blockers, such as nifedipine and nicardipine, are potent vascular smooth muscle relaxants that lower blood pressure by decreasing peripheral arteriolar resistance. Reflex tachycardia, however, may blunt the magnitude of their hypotensive effect, especially in patients with increased baroreflex sensitivity. Nondihydropyridine calcium blocker drugs, such as verapamil and diltiazem, exert their hypotensive action by both cardiac and peripheral circulatory mechanisms. These drugs also act as arteriolar vasodilators. In addition, they slow the heart rate by decreasing the automaticity of sinoatrial pacemaker cells in the heart. The combined negative chronotropic and vasodilatory actions are especially useful in hypertensive patients with baroreflex sensitivity who are prone to fast heart rates, and in hypertensive patients with associated coronary artery disease. Coronary heart disease patients with or without coexisting hypertension usually show reduction in systolic blood pressure (SBP) and heart rate (HR) both at rest and during submaximal exercise on the treadmill or bicycle. A reduced double product (SBP X HR) with submaximal exertion results in a decrease in cardiac work and correlates with enhanced exercise capacity and delay in onset of angina during exercise testing. In some patients with both hypertensive and coronary heart diseases and ventricular dysrhythmias emerging during exercise, verapamil may confer antiarrhythmic as well as antihypertensive and antianginal benefits. At present, calcium blocker drugs, which have an elimination half-life of 3 to 6 hours, must be given 3 times a day for effective antihypertensive control.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3513516 TI - Instant and sustained-release verapamil in the treatment of essential hypertension. AB - In a series of controlled studies for periods of 4 to 6 weeks comprising 103 patients altogether, and in 1 long-term trial for 1 year, various dosages of instant and sustained-release verapamil were administered in the treatment of mild and moderate essential hypertension. One of these trials was a double-blind comparison with nifedipine, in which the 2 calcium antagonists had an equally good effect on blood pressure. A significant blood pressure reduction was achieved with verapamil both at rest and during isometric work in most patients. About 10% of the patients were nonresponders. Pharmacokinetic studies demonstrated great interindividual variations in plasma concentrations of verapamil and its active metabolite norverapamil. Except for 1 study, no significant correlation was found between drug concentration and blood pressure reduction. All formulations of verapamil were well tolerated by the patients, and adverse effects were generally mild and often transient. No negative metabolic effects were observed during long-term treatment; serum lipids, in particular, were unaffected. PQ intervals on the electrocardiogram were significantly but moderately prolonged. QRS and QT intervals were unchanged. No increase in body weight occurred. It is concluded that verapamil is an efficacious, safe drug and a first-line treatment alternative in mild and moderate essential hypertension. The recently developed sustained formulation of the drug renders a simple dosage regimen possible. PMID- 3513518 TI - Combination of verapamil and beta blockers in systemic hypertension. AB - The efficacy and safety of verapamil and propranolol were examined in 14 hypertensive patients (mean age 51.2, range 30 to 65) in a double-blind, randomized, crossover study of verapamil, 360 mg, propranolol, 240 mg, these 2 formulations in combination and placebo, each given for 4 weeks. Supine blood pressure, heart rate, atrioventricular conduction (PR interval) and left ventricular function were measured. All treatments reduced diastolic blood pressure (mean +/- standard deviation) (p less than 0.001): placebo to 106.6 +/- 8.1 mm Hg; propranolol to 93.8 +/- 7.7; verapamil to 89.8 +/- 7.8; the combination to 84.1 +/- 6.1, but the effect of the combination was significantly greater than that of either drug alone (p less than 0.05). Heart rate at rest (placebo, 80.2 +/- 12.2 beats/min) was reduced by propranolol (63.3 +/- 9.4, p less than 0.001), but not by verapamil (79.0 +/- 8.9). However, the addition of verapamil to propranolol led to a further reduction in heart rate (56.9 +/- 8.4, p less than 0.005). PR interval was prolonged significantly by the combination (185.5 +/- 35.3 ms) when compared with placebo (154.0 +/- 22.7); propranolol (159.1 +/- 21.2) and verapamil (165.5 +/- 32.4) (p less than 0.005 for each). The active drugs increased end-diastolic dimension and end-systolic dimension. For each variable, the effect of the combination was statistically significant (p less than 0.01). Fractional shortening was not altered significantly by any of the treatments. Thus verapamil plus propranolol is a very effective antihypertensive combination but heart rate, atrioventricular conduction and left ventricular function may be affected adversely, necessitating careful monitoring of therapy. PMID- 3513519 TI - Twice-daily verapamil for hypertension: a comparison with propranolol. AB - Recent reports have confirmed that some slow calcium channel inhibitors have useful antihypertensive properties because they produce dilatation of the peripheral arterioles without reflex tachycardia. Verapamil is such a drug, but its clinical role in the management of hypertension is not clear. An open crossover trial was performed to compare the 24-hour profiles of blood pressure reduction after long-term therapy with a standard beta-adrenoceptor blocker, propranolol, and verapamil. Nineteen patients were studied by continuous ambulatory intraarterial recording and the order of drug administration was determined by random allocation. The drugs were administered 2 times a day and titrated according to casual clinic pressures (propranolol, 40 to 240 mg 2 times a day; verapamil, 120 to 240 mg 2 times a day). Mean hourly blood pressure and heart rate values were obtained over a 24-hour cycle and the responses to isometric and dynamic exercise were also examined. The drugs produced a uniform and comparable reduction in blood pressure throughout the day, together with a reduction in heart rate, which was greater with propranolol. Comparable effects were also seen on the pressor responses to exercise. Both drugs were equally well tolerated and caused no patient withdrawals. Thus, oral verapamil given 2 times a day shows a degree of efficacy similar to that of propranolol and provides 24 hour blood pressure control. This slow calcium channel inhibitor was well tolerated and may be used as initial therapy for hypertension. PMID- 3513520 TI - Effects of diltiazem hydrochloride on cardiovascular response, platelet aggregation and coagulating activity during exercise testing in systemic hypertension. AB - The effects of diltiazem hydrochloride on exercise-induced changes in cardiovascular response, plasma renin activity, platelet function and blood coagulability were evaluated with multistage treadmill exercise in 20 patients who had systemic hypertension of stage 1 to 2 (World Health Organization classification). Heart rates, blood pressure, and pressure-rate product at rest, at peak exercise and in the recovery period were significantly reduced after 4 weeks of diltiazem administration, 180 mg/day. Plasma renin activity tended to increase after the medication. However, platelet adenosine diphosphate-induced aggregation sensitivity, prothrombin time, activated partial thromboplastin time, plasma fibrinogen concentration and antithrombin III activity did not change significantly. It is concluded that diltiazem could ameliorate the hyperresponsiveness of heart rate and BP to exercise in hypertensive patients without affecting blood coagulability. PMID- 3513521 TI - Role for aldosterone in blood pressure regulation of obese adolescents. AB - To determine the role of aldosterone in the regulation of blood pressure (BP) in obese adolescents, supine and 2-hour upright plasma renin activity (PRA), and aldosterone and cortisol were measured in 10 nonobese and 30 obese adolescents before and after a 20-week weight loss program. The obese adolescents had significantly higher supine and 2-hour upright plasma aldosterone concentrations (17 +/- 8 vs 6 +/- 2 ng/dl [p less than 0.01 supine obese vs nonobese] and 30 +/- 11 vs 14 +/- 8 ng/dl [p less than 0.01 2-hour upright]). Although PRA was not significantly different between the 2 groups of children, a given increment in PRA produced a greater increment in aldosterone in the obese adolescents. In addition, obese subjects had a significantly increased mean BP (93 +/- 12 vs 74 +/- 8, p less than 0.005) and a weak correlation between BP and plasma aldosterone concentration. Compared with an obese control group, weight loss resulted in a significant decrease in plasma aldosterone (p less than 0.01) without an associated decrease in PRA. After weight loss there was also a significant decrease in the slope of the posture-induced relation between PRA and aldosterone. In addition to weight loss being associated with a significant decrease in BP (p less than 0.01), there was a significant correlation between the change in plasma aldosterone and the change in mean BP (r = 0.538; p less than 0.002 change in upright aldosterone vs change in mean BP). Obese adolescents have an increased plasma aldosterone concentration that may be important in the regulation of their BP. PMID- 3513522 TI - Bicyclo-prostaglandin E2 metabolite in congestive heart failure and relation to vasoconstrictor neurohumoral principles. AB - Vasodilator prostaglandins may play a role in maintaining circulatory homeostasis in patients with congestive heart failure (CHF). Plasma levels of bicyclo prostaglandin E2 metabolite (PGEm), a chemically stabilized degradation product of the vasodilator prostaglandin E2, were determined in 45 patients with chronic CHF (New York Heart Association class II, III or IV). Mean circulating levels of bicyclo-PGEm were significantly elevated in patients with functional class III (72 +/- 8 pg/ml) or IV CHF (77 +/- 10 pg/ml) compared with control subjects (49 +/- 3 pg/ml) and patients with functional class II CHF (49 +/- 4 pg/ml). Bicyclo PGEm concentrations correlated with plasma renin activity (r = 0.68, p less than 0.001) and plasma angiotensin II (r = 0.56, p less than 0.001) and plasma noradrenalin levels (r = 0.34, p less than 0.05). An inverse correlation was found between serum sodium concentrations and levels of bicyclo-PGEm (r = 0.46, p less than 0.01) as well as plasma renin activity (r = 0.66, p less than 0.001). Thus, prostaglandin E2 levels in plasma are increased in patients with severe CHF. PMID- 3513523 TI - Effect of atrial fibrillation and mitral regurgitation on calculated mitral valve area in mitral stenosis. AB - Forty-nine patients with mitral stenosis (MS) were studied by Doppler echocardiography and 2-dimensional (2-D) echocardiography to assess the ability of Doppler ultrasound to accurately measure mitral valve orifice area and to assess whether atrial fibrillation (AF) or mitral regurgitation (MR) affected the calculation. Twenty-four patients underwent cardiac catheterization. Mitral valve area by Doppler was determined by the pressure half-time method. Mean mitral valve area of all 49 patients by Doppler and 2-D echocardiography correlated well (r = 0.90). There was good correlation between Doppler and 2-D echocardiography in patients with pure MS in sinus rhythm (r = 0.88), in patients with MR (r = 0.93) and in patients with AF (r = 0.96). In the 7 patients with pure MS in sinus rhythm, there was good correlation between Doppler, 2-D echocardiography and cardiac catheterization (r = 0.95). In patients with either MR or AF, cardiac catheterization appeared to underestimate mitral valve orifice compared with both Doppler and 2-D echocardiography (p less than 0.05). Doppler echocardiography can estimate valve area in patients with MS regardless of the presence of MR or AF. PMID- 3513524 TI - A symposium: Guanfacine--a new choice in centrally acting antihypertensive agents. October 5-6, 1984, Scottsdale, Arizona. PMID- 3513525 TI - Pharmacokinetics of guanfacine in patients with impaired renal function and in some elderly patients. AB - The effects of renal impairment and age on the pharmacokinetics of guanfacine were evaluated. In normal subjects, guanfacine was found to be rapidly and completely absorbed, with an absolute bioavailability close to 100% and therefore no evidence of a noticeable first-pass effect. Its kinetics were best described by a 2-compartment model, with an elimination half-life of the beta phase of 17 hours. The major route of excretion was in the urine, with urinary excretion of 80% of a given dose within 4 days. Linearity of dose and thus predictability of blood levels were observed for single doses and at steady state. Although cumulative urinary excretion and renal clearance of unchanged guanfacine were reduced in patients with renal insufficiency, total clearances, serum levels, elimination rates constants and elimination half-lives differed very slightly, or at most by a factor of 1.5 to 2 between patients with normal and severely impaired renal function. Age-related decreases in urinary excretion and renal clearance of guanfacine were observed in 6 elderly patients and were accompanied by an increased proportion of metabolites to parent drug, confirming the significant nonrenal clearance of the drug. Based on pharmacokinetic studies in these target groups and on the dual renal and nonrenal clearance of guanfacine, the drug may, most probably, be administered to elderly patients and patients with renal insufficiency without dosage adjustment. PMID- 3513526 TI - Hemodynamic and endocrine responses to guanfacine in normotensive volunteers and hypertensive patients. AB - The centrally acting alphamimetic antihypertensive drug, guanfacine, was studied in normotensive volunteers and patients with essential and renal hypertension. After acute (0.02 mg/kg, intravenously) and short-term (mean dose: 6.7 mg/day orally for 4 weeks) administration of guanfacine, systolic, diastolic and mean blood pressures (BPs), heart rate, cardiac output and right atrial pressure were measured by standard techniques. Cardiac index, stroke volume and total peripheral vascular resistance were calculated. After medium-term therapy (mean dose: 6 mg/day orally for 12 weeks), antihypertensive efficacy, as well as plasma renin activity and catecholamine levels, was determined. After intravenous administration, guanfacine lowered systolic, diastolic and mean arterial BPs after a brief and transient increase. Guanfacine exerted its antihypertensive action primarily by its effect on total peripheral resistance. Reflex tachycardia was not observed. Heart rate was reduced. Stroke volume increased and right atrial pressure decreased. These effects were maintained or enhanced during the 4 weeks of oral therapy that followed. In the 12-week study, significant reductions in systolic, diastolic and mean BPs were observed. With a constant dose of 3 mg/day for 1 week, BP decreased from 197/115/149 (systolic/diastolic/mean) to 166/97/126 mm Hg. After 4 weeks at varying doses, BP decreased to 157/91/118, and after 12 weeks, to 147/83/109. In the 12 patients treated for 4 weeks with 3 mg/day, a significant decrease from 192/111/145 to 151/87/114 mm Hg was observed, while in the 6 patients treated for 12 weeks with the 3 mg/day dose, the final readings showed a decrease of 50 mm Hg in systolic pressure, 30 mm Hg in diastolic pressure and 38.4 mm Hg in mean arterial pressure.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3513527 TI - Effects of guanfacine on growth hormone, prolactin, renin, lipoproteins and glucose in essential hypertension. AB - The effect of single-dose, short-term (6 weeks) and long-term (7 years) guanfacine therapy on various endocrine and metabolic parameters was evaluated in patients with moderate essential hypertension (WHO phase I and II). A single oral dose (2 mg) of guanfacine did not affect the secretion of growth hormone but produced a prompt decrease in blood pressure (BP) levels. Short-term treatment decreased BP and heart rate, and also produced a marked (p less than 0.001) fall in urinary excretion of norepinephrine and serum prolactin levels. Short-term therapy did not affect growth hormone or renin levels. A mean daily dose of 2.8 mg of guanfacine maintained normal BP levels in 22 patients during the long-term follow-up study. In addition, treatment produced a progressive decrease in prolactin, renin, total cholesterol and triglyceride levels, but did not change growth hormone values or oral glucose tolerance test results. The cumulative incidence of cardiovascular complications was significantly lower (p less than 0.001) in guanfacine-treated patients than in a matched control group. The most significant difference was the absence of fatal complications in the guanfacine treated patients. The present results support the theory that decreased morbidity and mortality in patients treated with guanfacine may depend not only on its important antihypertensive activity, but also on its beneficial effect on known cardiovascular risk factors. PMID- 3513528 TI - A multicenter, randomized, double-blind dose-response evaluation of step-2 guanfacine versus placebo in mild to moderate hypertension. AB - Guanfacine, an alpha-adrenoceptor agonist, may exhibit distinct dose-related curves for efficacy and adverse effects in the step-2 therapy of essential hypertension. To determine the lowest clinically effective safe dose, 462 newly or previously diagnosed subjects were admitted to a 5-week prerandomization phase at 8 centers. Patients were weaned from any current antihypertensive drugs and placed on 25-mg chlorthalidone, daily, in the morning. At the end of the 5-week weaning period, 362 patients with seated diastolic blood pressures (BPs) between 95 and 114 mm Hg qualified for the 12-week postrandomization phase. Subjects were randomized to receive either an indistinguishable placebo or 0.5, 1, 2 or 3 mg of guanfacine. Chlorthalidone was changed to bedtime administration and taken with the study medications. Guanfacine was started at the lowest dose in all subjects and increased (if scheduled, according to the randomization code) to the next higher dose at biweekly intervals. Of the 362 randomized patients, 278 completed the study. The 1-mg guanfacine dosage produced a 14/13 mm Hg decrease in BP (p less than 0.0125 compared with placebo). Doses of guanfacine at 2 and 3 mg/day were not more effective than the 1 mg/day dose; 0.5 mg/day was not better than placebo. There was an increase in the frequency of side effects possibly or probably associated with 2 and 3 mg/day guanfacine. Only 3.2% of the patients in the 1 mg/day group dropped out of the study because of side effects. We conclude that when added to a diuretic, 1 mg/day guanfacine at bedtime is the lowest safe and therapeutically effective dose. PMID- 3513529 TI - Usefulness of low dose guanfacine, once a day, for 24-hour control of essential hypertension. AB - The 24-hour duration of the antihypertensive effect of guanfacine, a centrally acting alpha 2-adrenoceptor agonist administered once a day, was demonstrated in a 12-week, multicenter, double-blind, placebo-controlled study. Two hundred and forty-nine patients who remained mildly to moderately hypertensive following a 5 week period, during which they had been weaned from previous antihypertensive medications and stabilized on 25-mg chlorthalidone taken once a day, were involved. Of the 249 patients, 126 received guanfacine as a step-2 agent and 123 received placebo. Both groups were further subdivided so that blood pressure (BP) measurements were determined either 12 or 24 hours after dosing. The initial dose of guanfacine was 1 mg/day, which could be raised 1 mg at 2-week intervals to a maximum daily dose of 3 mg/day at the discretion of each investigator. The daily dose could also be lowered by 1 mg at 2-week intervals, depending on patient response. The mean 24-hour reductions with guanfacine in sitting diastolic BP ( 11 mm Hg), systolic BP (-14 mm Hg) and mean arterial pressure (-12 mm Hg) were statistically significant (p less than 0.01) compared with the reductions in BP with placebo. Heart rate also decreased with guanfacine, but no clinically relevant bradycardia (less than 60 beats/min) was observed. Dry mouth (47%), constipation (16%), fatigue (12%) and drowsiness (4%) were the most frequently reported side effects. The highly acceptable side-effects profile of guanfacine was also indicated by the small percentage of patients (7%) who prematurely left the study because of adverse reactions. PMID- 3513530 TI - Comparison of guanfacine versus clonidine for efficacy, safety and occurrence of withdrawal syndrome in step-2 treatment of mild to moderate essential hypertension. AB - Guanfacine, an alpha 2-adrenoceptor agonist, was compared with clonidine as step 2 therapy of mild to moderate essential hypertension in a 24-week, double-blind, randomized, parallel evaluation to determine efficacy, safety and occurrence of withdrawal syndrome. During a 5-week period, patients were weaned from current antihypertensives, if any, and stabilized on step-1 therapy with 25 mg of chlorthalidone once a day. Those with a diastolic blood pressure (BP) from 95 to 114 mm Hg while taking chlorthalidone were randomized to treatment. The 2 agents had equal efficacy; 149 of 270 patients treated with guanfacine (55%) and 164 of 276 treated with clonidine (59%) achieved goal diastolic BP of less than or equal to 90 mm Hg. Terminations because of adverse effects were relatively low. Dry mouth (30% of guanfacine and 37% of clonidine groups) and somnolence (21% of guanfacine and 35% of clonidine groups, p less than 0.05) were reported most frequently. Nonsyncopal dizziness was reported in 11% of guanfacine-treated and 8% of clonidine-treated patients. This difference was not statistically significant. To evaluate the occurrence of a withdrawal syndrome in 316 outpatients and 156 inpatients, vital signs were monitored at least twice a day for up to 7 days after the end of therapy. Segmented 24-hour urine studies were performed on inpatients. Abrupt withdrawal of clonidine produced a rapid increase in diastolic and, especially, systolic BP, whereas guanfacine withdrawal produced more gradual increases. The differences were significant over the first 3 withdrawal days. It is concluded that guanfacine is a safe, effective, second generation alpha 2-adrenoceptor agonist.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3513531 TI - Guanfacine as monotherapy for systemic hypertension. AB - Three clinical studies examined the effects of guanfacine as monotherapy. Study 1 was a double-blind, randomized, parallel trial with a placebo control with 26 patients with mild essential hypertension treated with 1-mg guanfacine or matching placebo daily at bedtime for 8 weeks. Pretreatment and posttreatment determinations of plasma volume, plasma aldosterone and blood pressure (BP) were made in all 26 patients. There were no significant differences between guanfacine and placebo with regard to changes in plasma volume or plasma aldosterone, but a significant decrease (p = 0.001) in both diastolic and mean BPs was seen with the active drug. No side effects were reported. From this study, it was concluded that guanfacine monotherapy is an effective and well-tolerated initial treatment for mild essential hypertension with no effect on either plasma volume or plasma aldosterone. Study 2 was a double-blind, randomized, parallel clinical study with placebo control with 42 patients with mild essential hypertension treated with either guanfacine (1 mg/day) or matching placebo at bedtime for 8 weeks. Pretreatment and posttreatment evaluations of serum cholesterol, triglycerides, low density lipoproteins, very low density lipoproteins and high density lipoproteins revealed no significant differences between the treatment and the placebo groups. A statistically significant (p less than 0.0001) decrease in diastolic BP was seen in the guanfacine group compared with those patients who received placebo. Guanfacine monotherapy was again shown to be an effective initial treatment for mild essential hypertension with no adverse influence on serum lipids.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3513532 TI - Long-term evaluations of therapeutic efficacy and safety of guanfacine. AB - To assess the long-term efficacy and safety of guanfacine, a centrally acting alpha-adrenergic agonist, 580 mild, moderate and severe hypertensive subjects were treated with the drug for 1 year. Mean ages of both the 257 women and 323 men were 52 years. Most had essential hypertension; 55 patients had renal, 22 renovascular and 4 endocrine-related hypertension. When possible, 1- to 3-week washout periods were used before and after treatment. Doses up to 20 mg/day were used in some patients. Diuretics, beta blockers, vasodilators or some combination thereof were used in some patients. After the 1-year study, 169 patients were continued on therapy for another year, and 54 were evaluated for 5 to 7 years. Normalized blood pressures (BPs) were achieved in 54%, 66% and 63% of patients in the first, second, and 5- to 7-year groups, respectively. Guanfacine, alone and in combination, proved safe and effective. Once- and twice-a-day doses were superior to 3-times-a-day dosing. Lower doses were more effective and produced fewer side effects. Large-scale, open-field studies evaluated the effect of low dose therapy in 1,234 Belgian, 3,504 French and 4,627 German patients, with average BPs of 180/103 mm Hg. The average BP reduction during treatment was 16%. Most Belgian (56%) and French (74%) patients received 2 mg/day; 60% of German patients received 1 mg/day throughout the study. BPs normalized in 71% of Belgian, 58% of French and 61% of German patients. PMID- 3513533 TI - Postprandial glucose and insulin responses to various snacks of equivalent carbohydrate content in normal subjects. AB - To evaluate glucose and insulin responses after ingestion of snacks, we gave healthy, nondiabetic male subjects carbohydrate equivalent (25 g) snacks or isocaloric (265 kcal) snack meals in a random crossover design. Individual snacks composed of either a milk chocolate bar, granola bar, chocolate milk, peanut butter cups, yogurt, or potato chips produced similar glucose response curves. Plasma glucose concentrations were lower (p less than or equal to 0.05) at 30 and 60 min postprandially than after a corresponding oral glucose challenge. In contrast, insulin responses to the snacks exhibited a two-fold variation in peak values. Isocaloric snack meals of cereal-milk, cheese sandwich-milk, and peanut butter sandwich-chocolate milk produced glucose and insulin responses similar to individual snacks. Although glucose concentrations at 60 min fell somewhat below baseline values after each snack, clinical hypoglycemia was not evident. These data clearly indicate a similarity in glycemic response among normal individuals consuming a variety of common snacks. PMID- 3513534 TI - Urine C-peptide and creatinine (Jaffe method) excretion in healthy young adults on varied diets: sustained effects of varied carbohydrate, protein, and meat content. AB - We studied effects of isocaloric diets of varied composition (each diet offered for 5 to 7 days) on urine C-peptide and creatinine excretion in eight healthy subjects. C-peptide excretion was higher on the high carbohydrate (60% CHO, 20% PRO) and high protein (45% CHO, 30% PRO) diets than on the low carbohydrate (30% CHO, 20% PRO) and low protein diets (45% CHO, 10% PRO). C-peptide excretion correlated with total kilocalories ingested (r = 0.594, p less than 0.001), and also with CHO (r = 0.469, p = 0.003) and PRO intake (r = 0.453, p = 0.004). Multiple regression analysis is given by the formula: Urine C-peptide (nmol/24 h) = 17.3 + 0.01 (kcal/24 h) + 0.021 (gm CHO/24 h) + 0.049 (gm PRO/24 h) Creatinine excretion was related to body weight (r = 0.959, p less than 0.001) and also to total PRO intake (r = 0.569, p less than 0.001) and meat intake (r = 0.367, p less than 0.05). We conclude that diet composition, especially protein intake, is an important stimulus to sustained insulin production as measured by C-peptide in healthy subjects. Diet composition has a significant impact on creatinine excretion. Urine creatinine cannot be assumed to reflect only lean body weight when it is used as a measure of the adequacy of timed urine collections. PMID- 3513535 TI - Comparison of allogeneic bone marrow transplantation and chemotherapy in adult acute nonlymphocytic leukemia. An Eastern Cooperative Oncology Group Study. AB - To compare the value of ABMT (allogeneic bone marrow transplantation) in first or second remission vs. conventional chemotherapy in adults with acute nonlymphocytic leukemia, we examined retrospectively the outcome of a recently completed chemotherapy trial. We evaluated the survival of patients, with and without histocompatible siblings, who were less than or equal to 45 years old and who had achieved initial complete remission. Of 20 patients who were referred by their physicians for ABMT in first remission, seven relapsed (median duration of remission, 4 months) prior to ABMT, three refused, and 10 underwent ABMT. Nine patients received ABMT in second remission. In comparison to the results of chemotherapy in patients who lacked histocompatible siblings (median duration of survival, 18.5 months), the survival of patients transplanted in first remission was worse (median, 8 months), whereas the survival of patients transplanted in second remission was substantially better (median greater than 22 months). Although ABMT in second remission clearly offers the potential for long-term survival not available by means of conventional chemotherapy, the value of ABMT in first remission remains uncertain. PMID- 3513536 TI - Treatment of early--stages I and II--nodular, poorly differentiated lymphocytic lymphoma. AB - Twenty-nine patients with Stages I and II nodular, poorly differentiated lymphocytic lymphoma were treated with radiation therapy or radiation therapy plus chemotherapy. Twenty-two patients with Stage I received radiation to the involved field, the other seven with Stage II received total lymphoid radiation. Complete remission was achieved in all 29. There were no differences in remission duration or survival according to treatment modality. Five of 29 (17%) patients relapsed. No relapses were observed after 5 years. Ten patients died; one patient died of lymphoma, and nine others died in continuous complete remission of various other causes. Sixty-six percent of the patients were alive at 74-160 months (median 118 months). Involved field radiation with or without chemotherapy was well tolerated, producing acceptable toxicity. Substantially more toxicity was observed after total lymphoid irradiation and although cures were also achieved, less toxic treatment programs should be investigated. The low rate of relapse observed in early stages of this lymphoma in this and in other studies is suggestive that cures might be achieved in nearly one-half of the patients presenting in early stage. PMID- 3513537 TI - Hydroxyurea and 6-mercaptopurine in the treatment of chronic granulocytic leukemia. AB - From 1975 to 1981, 92 patients with newly diagnosed Ph'-positive chronic granulocytic leukemia entered two consecutive studies. The initial trial (Study I, 1975-1978) tested the efficacy of hydroxyurea (HU) as single agent in 45 consecutive patients. In an effort to improve results obtained with HU alone, from 1978 to 1981, 47 new patients entered a second trial (Study II), which consisted of a continuous treatment with a combination of HU and 6-mercaptopurine (6-MP), at doses adjusted so as to maintain the leukocyte counts between 4 and 12 X 10(9)/L. The aim of this second study was to prolong the duration of chronic phase (CP) by the addition of 6-MP to HU and by a stricter continuous control of the size of the total granulocytic mass (TGM). Both regimens were well tolerated. Median duration of CP was 43 months in Study I and 41 months in Study II. Median survival was 51.5 months and 45 months respectively. These data indicate that neither the addition of 6-MP to HU alone, nor the effort to keep a smaller TGM, play a substantial role in postponement of blastic transformation in CGL. PMID- 3513539 TI - Understanding bronchopulmonary dysplasia. PMID- 3513538 TI - Phenotypic analysis in diffuse, large cell lymphoma. Clinical and histologic associations. AB - To investigate the possible relationships between immunologic phenotype, histologic subtype, and clinical features in diffuse, large cell lymphoma (DLCL), a computerized registry has been established for the prospective collection of immunologic, histologic, and clinical data. A combination of immunofluorescence and immunoperoxidase technics on single-cell suspensions, frozen tissues, and B5 fixed, paraffin-embedded specimens was used to study the first 33 biopsies. A definitive phenotype was established in all but two cases. Monoclonal antibody reagents reactive in B5-fixed, paraffin-embedded tissue sections helped assign a B-cell lineage in four cases lacking surface or cytoplasmic immunoglobulin, monoclonal light chains, and T-cell markers. There was no statistically significant association between the immunologic phenotype (whether mature B or not) and any clinical or histologic parameter, including response to therapy and survival. Bone marrow involvement was found to be associated significantly with both vague nodularity and a cleaved cell subtype. Through the use of a multifaceted approach to the immunophenotypic analysis of the DLCLs, a distinct lineage and stage of differentiation could be assigned to most biopsy specimens. That such analysis has significant clinical implications for patients with DLCL could not be demonstrated in this series. PMID- 3513540 TI - Sustained-release theophylline preparations in asthmatic children. A short-term comparison of two products and the relationship of serum theophylline levels and pulmonary function changes. AB - In a four-week study, 20 children with chronic asthma were treated in a randomized, double-blind, crossover manner with two sustained-release theophylline preparations (Theo-Dur and Uniphyl) to compare their drug concentrations and clinical efficacy. In addition, the effects of serum theophylline concentration on results of pulmonary function tests (PFTs) were evaluated. Twelve-hour doses (to achieve serum concentrations between 10 and 20 mg/L) of each drug were given for two weeks. Diaries of asthma symptoms and peak flows were kept daily. After 14 days of each treatment, children returned for measurement of theophylline levels and PFTs over a 12-hour period. The two drugs were equally effective in clinically controlling asthma over the two weeks of treatment. Serum theophylline levels obtained over the 12-hour dosing periods were not significantly different. Uniphyl provided less (but not significantly) deviation between peak and trough levels. Analysis of individual patient data did not reveal a predictable relationship between serum theophylline concentrations and results of PFTs. PMID- 3513541 TI - Large-airway collapse due to acquired tracheobronchomalacia in infancy. AB - Seven infants with wheezing and cyanotic spells were diagnosed as having tracheobronchomalacia by bronchoscopy or fluoroscopy. These studies demonstrated narrowing of the central airways by 75% or more on exhalation. Five patients were premature infants who had been ventilated for hyaline membrane disease. The mean time from onset of symptoms to diagnosis was six months. Determination of the optimal positive end-expiratory pressure (PEEP) during fluoroscopy facilitated subsequent management. Six of the seven patients required PEEP of 8 to 18 cm H2O for at least three months, and five of the seven still require mechanical ventilation. All patients improved, with decreased cyanotic spells and a reduced requirement for ventilatory support. Tracheostomy without PEEP did not appear to be helpful. Tracheobronchomalacia may be more frequent than usually appreciated; the treatment of choice appears to be long-term PEEP. PMID- 3513542 TI - Chronic pancreatitis: clinical features and medical management. PMID- 3513543 TI - Pancreatic abscess: 10-year experience at the University of South Florida. AB - Pancreatic abscess is an uncommon but often catastrophic complication of acute pancreatitis. This study reviews the past 10 yr experience at the University of South Florida Teaching Hospitals involving patients diagnosed to have pancreatic abscess. The etiology, management, complications, and factors affecting mortality are discussed. The results indicate: the presentation of pancreatic abscess is variable; increased positive prognostic signs (by Ranson's criteria) on initial presentation correlate with increased mortality; complications are common (80%) and contribute significantly to morbidity and mortality; CT scan is more accurate than ultrasound in the diagnosis of pancreatic abscess; poorly localized phlegmonous pancreatic slough noted by CT scan, sonography, or exploratory laparotomy, carries a higher mortality than a well-localized purulent collection; negative blood cultures or abscess cultures do not rule out pancreatic abscess; infection of lesser sac fluid collections can occur in the hospital implying that strict attention must be paid to nosocomial infections; the timing of surgical drainage is critical, recurrent abscess requires repeat surgery, and resection is associated with a very high mortality (reflecting greater severity of underlying disease); there has been no change in mortality of pancreatic abscess in the last 10 yr. PMID- 3513544 TI - Herpes simplex esophagitis in a renal transplant patient treated with cyclosporine A: a case report. AB - Herpes simplex esophagitis is a rare disease occurring mostly in immunocompromised and cancer patients. We report the first case of herpes esophagitis in a renal transplant patient treated with Cyclosporine A while on chronic steroid therapy. With the increasing use of Cyclosporine A in transplant patients, the incidence of herpes esophagitis may increase. The disease is suggested endoscopically by its typical appearance. The diagnosis is confirmed by cytology, tissue studies, and viral cultures. Based on the limited knowledge of the natural history of herpetic esophagitis and lack of prospective antiviral trials, symptomatic therapy with viscous Xylocaine appears reasonable. The definitive role of antiviral therapy is yet to be clarified. PMID- 3513546 TI - Eicosanoids and the gastrointestinal tract: promising but no verdict yet. PMID- 3513545 TI - Primary leiomyosarcoma of gallbladder seen on computed tomography and ultrasound. AB - Neoplasms of the gallbladder are relatively rare and their preoperative diagnosis that much rarer; leiomyosarcoma of the gallbladder is one of the most infrequent types. The authors had the opportunity to diagnose such a neoplasm preoperatively (although the histological diagnosis was not made). The ultrasound and computed tomographic appearance has not been published before. Leiomyosarcoma showed a dilated gallbladder with an irregularly thickened wall and a polypoid protrusion into the lumen. PMID- 3513547 TI - Social networks, support, and health: taking the next step forward. PMID- 3513548 TI - The assessment of physical activity by questionnaire. PMID- 3513549 TI - Prevalence of rotavirus antibody among isolated South American Indian communities. AB - Rotavirus antibody was detected by enzyme-linked immunosorbent assay (ELISA) in 711 (54.7%) of 1,299 serum samples collected from Indians belonging to 13 relatively isolated communities in the Amazon region. The Parakanas Novos Indians showed prevalences of immunity of 17.9% and 10.7% by ELISA and the indirect fluorescent antibody technique, respectively. The remaining tribes, with the exception of the Yanomamis, Tucanos, and Xicrins, had percentages of positivity greater than 50% by at least one technique; among both the Kubenkrankreins and the Oyampis, all individuals over 20 years of age possessed antibody. High percentages of rotavirus positivity were observed among the Apalais, ranging from 56.0% (age group 31-40 years) to 74.0% (age group 0-5 years). In the Kubenkrankreins, Maiogongs, and Tucanos, the prevalences of rotavirus antibody regularly increased with age. ELISA and the indirect fluorescent antibody technique agreed in 72.5% of the specimens, but the former test yielded more positives than the latter. PMID- 3513551 TI - Abnormal T cell function in early-stage chronic lymphocytic leukemia (CLL) patients. AB - Significant alterations in T cell subpopulations and function occur in chronic lymphocytic leukemia (CLL) patients. We studied whether abnormalities in peripheral blood T cell parameters were present in 15 untreated early stage CLL patients (ie, Rai stage 0, 1, 2). Seven of the nine patients showed decreased T helper support as compared to control T cells for pokeweed mitogen (PWM)-induced control B cell proliferation (ie, patient 6,063 +/- 1,434 cpm vs control 14,894 +/- 121 cpm). All stage 0 and 1 patients showed a marked impairment of T helper activity for control B cell proliferation (patient T = 7,752 +/- 1,137 cpm vs control T = 14,894 +/- 121 cpm). In a separate assay system, six of nine CLL patients showed T suppressor activity for control B cell proliferation greater than control T cell suppressor activity. Four patients were stage 0 and 1. CLL patients demonstrated markedly impaired T cell support for control B cell immunoglobulin synthesis compared to control T cells (188 +/- 28 vs 869 +/- 56 hemolytic plaque-forming cells (HePFC)/culture, respectively). Control T cells showed increasing support for control B cell immunoglobulin synthesis with increasing T:B cell ratios (869 +/- 56 vs 1,265 +/- 48 HePFC/culture, at 1:1 and 2:1 T:B cell ratios, respectively). In contrast, five of eight CLL patients' T cells showed no improvement in control B cell immunoglobulin synthesis with increasing T:B cell ratios (795 +/- 56 vs 569 +/- 48 HePFC/culture, at 1:1 and 2:1 T:B cell ratios, respectively). There was no direct correlation with CLL T cell-mediated suppression of B cell proliferation and suppression of B cell immunoglobulin synthesis. These studies suggest there is a complex array of abnormal immunoregulatory T cell function in early stage CLL. These include a prominent T helper dysfunction and more variable excessive suppressor activity. The relationship of these findings to the basic disease process remains to be elucidated. PMID- 3513550 TI - Epidemiology of boutonneuse fever in western Sicily. Distribution and prevalence of spotted fever group rickettsial infection in dog ticks (Rhipicephalus sanguineus). AB - The distribution and prevalence of spotted fever group rickettsial infection in the ixodid dog tick Rhipicephalus sanguineus were found to occur at a rate of 19.7% with variation related to geographic and sociooccupational factors. A higher rate of infection was demonstrated in ticks removed from dogs associated with documented cases of boutonneuse fever. The results fit into available clinical and seroepidemiologic data on Rickettsia conorii infection in western Sicily. PMID- 3513552 TI - Hypertension and kidney transplantation. AB - Patients with kidney transplants are often hypertensive. Investigators have described the characteristics of this hypertension in man. Moreover, the hypertension of kidney transplant patients has a higher probability of being responsive to surgical intervention than does hypertension in the general population. Yet the mechanisms of the many varieties of posttransplantation hypertension are not known in detail. Detailed studies that would best be done in animal models are rare. Both medical and surgical management of this transplantation-associated complication needs further study. PMID- 3513554 TI - National survey of hospital pharmacy facilities: introduction. AB - This paper introduces three articles that report results of a national survey of hospital pharmacy facilities conducted in July 1982. A historical perspective of pharmacists' involvement in facilities planning and examples of internal and external factors influencing the optimal design of hospital pharmacies are presented. The survey aimed to identify and describe existing hospital pharmacy facilities, the adequacy of existing facilities, the anticipated need for facilities, and the processes used for planning facilities. These baseline data can be used in the future as a starting point for developing updated model plans for hospital pharmacies and recommending improvements in the planning process. PMID- 3513553 TI - Binding of insulin to a continuous ambulatory peritoneal dialysis system. AB - The binding of insulin in two peritoneal dialysis solutions to polyvinyl chloride dialysate containers and an administration set and the effect of adding antibiotics to the dialysate solutions were studied in a simulated continuous ambulatory peritoneal dialysis (CAPD) system. Using a radiotracer method, binding of insulin to dialysate containers was determined at various times up to 48 hours after addition of 10, 20, 40, and 80 units of insulin each to 2 L of either 1.5% or 4.25% dextrose dialysate solution. The method was repeated in 1-L glass containers. Each of the dialysate solutions was then passed through a CAPD administration set to determine binding to the set's cellulose-ester membrane filter. In another experiment to simulate binding to the set in actual practice, three bags of 1.5% dextrose dialysate were alternately infused with one bag of 4.25% dextrose dialysate through a single CAPD set until eight bags of dialysate containing insulin 40 units were given over 48 hours. The ability of gentamicin sulfate and cephalothin sodium to release bound insulin from the CAPD filter was determined by passing 2 L of each dialysate solution containing either gentamicin 60 mg or cephalothin 500 mg through the set over an 18-minute period. The binding of these antibiotics to the dialysate bags was also studied using high performance liquid chromatography assays. Insulin binding to the bag increased with increasing insulin concentration and length of storage in the bag; binding was not significantly different between the two dialysate solutions except at the 80-unit/2-L concentration. Binding in glass containers was less than that in polyvinyl chloride bags.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3513555 TI - National survey of hospital pharmacy facilities: planning and design experience. AB - Recent major renovation or construction programs of hospital pharmacy facilities and pharmacists' involvement in the planning process for those new facilities are described. A 12-page questionnaire was sent in July 1982 to the chief pharmacists in a random sample of 1846 hospitals in the United States stratified by 10 hospital types. The percentage of hospitals of each type involved in an ongoing or recent (within the preceding 10 years) major renovation or construction project of all or part of the pharmacy was determined. Of those respondents having an ongoing or recent major project, the extent and timing of pharmacists' involvement in the planning process were determined for hospitals of each type. The response rate was 45.6%, and the respondents were representative of the population. Thirty percent of all hospitals had not altered their pharmacy facilities within the preceding 10 years. Nonprofit general medical-surgical hospitals and federal hospitals had the highest percentages of recent projects (78% and 79%, respectively); projects were more likely to involve a new pharmacy facility than remodeling. In 1982, 27% of all respondents had a major pharmacy facilities project under way. Of respondents with an ongoing or recent project, 38% were asked to propose needs for new pharmacy facilities, 45% served on the planning team, and 20% anticipated the need for new facilities; space and location were predetermined without pharmacist involvement in 25% of all cases. Two percent of the respondents had no notice of the deadline for finalizing plans for the new facilities; 22% had one to six months' notice, and 48% had over a year.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3513556 TI - Designing a modern hospital pharmacy. AB - Cooperation between the pharmacy director and the hospital's architects in planning a modern hospital pharmacy is described. The pharmacy director at an 870 bed voluntary nonprofit institution and the hospital's architects planned the design for a new 3250-square foot pharmacy department. They developed a preliminary floor plan based on the following functions that the pharmacy would perform: centralized unit dose drug distribution; compounding; bulk and unit dose prepackaging; preparation of sterile products; controlled substance storage; outpatient and employee prescription dispensing; reserve stock storage; purchasing, receiving, and inventory control; drug information services; and administrative services. A final floor plan was designed that incorporated these functions with structural and utility requirements, such as placement of the computer system and dispensing and lighting fixtures. By integrating modern material management concepts with contemporary hospital pharmacy practice, the pharmacy director and the hospital's architects were able to plan and construct a pharmacy that receives, processes, and dispenses medication efficiently. PMID- 3513557 TI - Limitations of urinary mutagen assays for monitoring occupational exposure to antineoplastic drugs. AB - The sensitivity of the Salmonella reversion test of Ames as a screen for accidental absorption of 17 antineoplastic agents by drug handlers was evaluated. Dilutions of each drug were added to agar inoculated with each of two Salmonella typhimurium strains (TA98 and TA100); control plates contained no test drug. Colonies were counted after incubation at 36 degrees C for 48 hours. The drugs were tested in the presence of a liver preparation to provide metabolic activation of mutagenicity. Urine samples collected from patients after doses of three mutagenic drugs were extracted and tested with the Ames test. For 11 of the 17 drug solutions, no mutagenic activity was seen, but many of these 11 were toxic to the organisms. The most highly mutagenic drugs were doxorubicin and cisplatin, with mechlorethamine, carmustine, dacarbazine, and cyclophosphamide exhibiting less mutagenic activity. Urine from patients treated with doxorubicin or cyclophosphamide showed mutagenicity, but the results suggested that the quantity of these drugs that would have to be absorbed to produce a definite reaction in urine is unlikely to be achieved by drug handlers who use standard precautions. Because of its lack of sensitivity and the potential effects of environmental and dietary factors on the results, this bacterial mutagenicity test should not be used routinely for detection of accidental absorption of antineoplastic drugs. PMID- 3513559 TI - Experience with the use of cefotaxime in the treatment of bacterial meningitis. AB - Information on 62 bacteriologically confirmed cases of bacterial meningitis treated with cefotaxime in this country was obtained retrospectively from infectious disease consultants. This series of cases differed markedly from the world cumulative case data thus far presented. One of the two most common organisms treated was the pneumococcus (allergy to penicillin or misdiagnosis of the Gram stain results were the major reasons given). The other organism was Klebsiella. Unanticipated bacteriologic successes were noted in two cases of staphylococcal meningitis secondary to parameningeal foci. The bacteriologic cure rate and survival rate were about 85 percent. Failure of monotherapy was seen in one case of Pseudomonas meningitis, as well as in three of five cases of Enterobacter meningitis. In addition, two cases of Escherichia coli meningitis in which moxalactam therapy inexplicably failed were cured with cefotaxime. Close analysis of killing kinetics appeared to explain the Enterobacter and E. coli failures. Thus, overall not all gram-negative species and not all isolates of any particular species that cause meningitis can be successfully treated by cephalosporins. Data obtained during the investigative trials do not appear to be entirely predicative of what occurred during the free clinical use of an antibiotic. Post-investigatory follow-up and surveillance of all newly introduced therapeutic agents are needed. PMID- 3513558 TI - Bacteriologic contamination of intravenous infusion delivery systems in an intensive care unit. AB - Seventy intensive care unit patients were admitted to a double-blind prospective study to determine the level of contamination associated with the admixture and administration of intravenous solutions and whether intravenous filtersets prevented bacteremia. Patients were randomly assigned a 0.22 micron filterset (real filter) or a filter cartridge without a 0.22 micron membrane (blank filter) on all possible intravenous lines. Forty-six (14.1 percent) real filtersets and 38 (11.3 percent) blank filtersets were found to be contaminated, and overall 30 patients (42.4 percent) were found to have extrinsically contaminated intravenous administration systems at least once during the study. Bacterial adherence to the plastic cartridge was demonstrated to be responsible for culture-positive blank filtersets. Staphylococcus epidermidis was the organism most frequently isolated from real and blank filtersets. Epidemiologic surveillance identified 10 patients with blank filtersets and three patients with real filtersets with clinically significant hospital-acquired bacteremias during the study period. It is concluded that a significant level of extrinsic contamination of intravenous infusion delivery systems occurred on the intensive care unit; documented clinically significant nosocomial bacteremias occurred less often in those patients who had a 0.22 micron bacterial retention filter on all possible intravenous lines. PMID- 3513560 TI - Effects of aging on the renal glomerulus. AB - The biologic price of aging includes progressive deterioration of renal function and structure. After the age of 30, glomerular filtration and renal blood flow rates decline in a linear fashion, so that values in octagenarians are only half to two thirds those measured in young adults. Renal mass similarly declines, and the incidence of sclerotic glomeruli increases with advancing age. Accordingly, the aging kidney is at high risk of eventual failure when functioning nephron number is further reduced by acquired renal disease. Recent evidence suggests that limitation of dietary protein intake delays the development of age- and disease-related glomerular sclerosis in experimental animals, and that dietary protein restriction may postpone end-stage renal disease in patients with progressive renal insufficiency. PMID- 3513561 TI - Pathogenesis of diabetic microangiopathy. The hemodynamic view. AB - Multiple factors, including altered levels of vasoactive substances, altered vasomotor responsiveness, chronic plasma volume expansion, and tissue hypoxia, contribute to a state of generalized microvascular vasodilatation in early insulin-dependent diabetes mellitus. This vasodilatation, with the consequent elevation in capillary pressures and flows, may be the initiating mechanism leading to both renal and extrarenal diabetic microangiopathy. Sustained hemodynamic actions on the microvasculature, besides directly injuring the capillary wall, promote increased permeability to macromolecules and increased capillary wall proliferation, with consequent thickening of basement membranes and luminal narrowing. These changes eventuate in complete microvascular obstruction and further vasodilatation of less damaged capillaries, thereby ensuring their eventual destruction. The ensuing complications depend on the nature of the surrounding tissue, ranging from reduction of functional reserve, as seen in skeletal muscle, to the devastating functional consequences observed in organs with endarterial circulation such as the kidney and retina. PMID- 3513562 TI - Doxorubicin cardiac toxicity manifesting seven years after treatment. Case report and review. AB - This report describes a patient treated for lymphoma who had development of doxorubicin (Adriamycin) cardiotoxicity proved by endomyocardial biopsy seven years after treatment. Doxorubicin cardiotoxicity is reviewed with emphasis on the implications of the long latency period for anthracycline cardiotoxicity in patients treated with this widely used antineoplastic agent. PMID- 3513563 TI - Nephrotic-range proteinuria and hyperglycemia associated with clonidine therapy. AB - Glycosuria, hyperglycemia, and nephrotic-range proteinuria developed in a 68-year old patient after clonidine was added to a stable antihypertensive regimen, which included metoprolol, of three years' duration. He later became glucose-intolerant with fasting hyperglycemia. Clonidine has been reported to transiently impair glucose tolerance. Persistent diabetes in a previously normoglycemic patient following clonidine has not been reported, and it supports the possibility that clonidine and metoprolol may have additive effects in suppressing endogenous insulin secretion. PMID- 3513564 TI - Bronchodilator and side effects of different modes of administration of metaproterenol: inhaled, oral, and in combination. AB - Twenty subjects with clinically stable asthma were treated in double-blind crossover manner with inhaled and oral metaproterenol, alone and in combination. The combination of inhaled and oral metaproterenol resulted in a greater degree of bronchodilation than either inhaled or oral alone. Inhaled metaproterenol was not associated with any significant side effects. Oral metaproterenol was associated with a small but significant increase in pulse rate and systolic blood pressure, and a small incidence of unpleasant sensations such as tremor and palpitation. Older subjects were more likely to experience the unpleasant sensations, whereas younger subjects were more likely to experience the increase in pulse rate. PMID- 3513565 TI - Cytotoxic intracavitary chemotherapy. AB - The intracavitary administration of chemotherapeutic agents for their cytotoxic properties as therapy for tumors confined to body cavities has significant theoretical appeal. Pharmacokinetic evaluation of several clinically useful antineoplastic drugs has confirmed modeling predictions that suggested a major advantage for cavity exposure to the agents compared with that of the plasma when the drugs are delivered directly into the body cavity. As the direct penetration of the agents into tissue is quite limited, the greatest potential utility of this therapeutic approach would be in patients with microscopic residual disease following debulking surgery or as therapy for patients with a high risk of intraperitoneal recurrence. Major toxicities of this innovative technique include abdominal pain (chemical serositis) and infection. Additional clinical evaluation will be required to define a role for cytotoxic intracavitary chemotherapy in the management of malignant disease. PMID- 3513566 TI - Antinuclear antibody in Henoch-Schonlein purpura. PMID- 3513567 TI - Oral folic acid versus placebo in the treatment of males with the fragile X syndrome. AB - A double-blind, crossover study of a 10 mg folic acid per day (vs. placebo) treatment was carried out in 25 fra(X) males (ages 1-31 years). Each treatment period lasted 6 months. Before, during and after the study, the patients were assessed blindly with psychological, language and behavioral evaluations, and parent or caretaker reports were collected. Standardized testing did not show statistically significant changes in the group as a whole; psychological testing demonstrated a statistically significant improvement on folic acid in the prepubertal males. After uncoding, caretaker or parent reports also demonstrated behavioral improvements in the prepubertal males while being treated with folic acid. PMID- 3513568 TI - High dose folic acid treatment of fragile (X) males. AB - We conducted an experimental trial of high-dose folic acid given to five males, ages 8 to 26 years, with the fra(X) syndrome. In this double blind study, each subject received 250 mg per day of folic acid for 3 months, followed by placebo for 3 months, and folic acid again for an additional three months. Based on IQ tests, behavior ratings, the Autistic Descriptors Checklist, and parental ratings, there was little evidence to suggest any positive effects seen during the administration of high-dose folic acid. Therefore, this study has provided little support for a hypothesis of benefit of high-dose folic acid in the treatment of the fra(X) syndrome. PMID- 3513569 TI - Folic acid treatment in males and females with fragile-(X)-syndrome. AB - Ten males with the fragile X (fra(X] syndrome were treated with folic acid (10 mg/day) for 4 months in a double-blind design study. To eight heterozygotes with mental impairment and fra(X), folic acid was given for 4 months (10 mg/day) in an effort to study possible beneficial effects of folic acid. Psychological and cytogenetic testing were carried out during the trial. There was no improvement in concentration, fine motor co-ordination, or comprehension in the adult male and female patients of the study. One patient showed improvement under a control medications. In the females, improvement was seen only in the youngest patient, a 5-year-old girl. Folate treatment does not seem to be effective in fra(X) adults, but may have some effect in children of both sexes with the disorder. Cytogenetic studies using peripheral lymphocytes showed that the fra(X) frequency decreased significantly (t = 0.00856; 1% level) only in cells cultured in a folic acid-free medium but not in cells cultured in a medium with added antifolate (methotrexate). This shows a "contamination effect" of folate-free culture medium after oral folic acid treatment of these patients. The decrease of fra(X) involves primarily the early-replicating X when culturing with folic acid-free medium. A synergistic suppression effect of "external folate" and BrdU is the most likely explanation of this phenomenon. PMID- 3513570 TI - Fragile X and autism: a multicenter survey. AB - We screened 183 autistic males for the fra(X) and found 24 (13.1%) to be positive. Adding the subjects of this study to those of 11 other surveys, of which 6 were positive and 5 were negative, a total of 614 autistic males have been screened. Overall 47 (7.7%) were positive. Based on this estimate and the prevalence of autism and fra(X), we estimate that 12.3% of fra(X) males are autistic. We have found that 17.3% of our fra(X) males were autistic and overall a 21.2% frequency has been reported, these higher figures are most likely due to biases in age and ascertainment. With an overall 7.7% frequency of fra(X) among autistic males and an estimated 12.3% of autism among fra(X) males, we conclude there is likely to be a significant association of fra(X) with autism. Because fra(X) appears to be the single most common cause of the condition, chromosomal testing is recommended for any autistic person with undiagnosed etiology. PMID- 3513571 TI - Analysis of sister chromatid exchanges in fra (X) individuals. PMID- 3513572 TI - DNA studies of X-linked mental retardation associated with a fragile site at Xq27. AB - X-linked mental retardation associated with expression of a fragile site at Xq27.3 has attracted much interest because transmission can occur through phenotypically normal males. Several theories have been proposed to explain the segregation pattern. Linkage analysis in affected families indicates a high frequency of recombination around this site in some families, although in others the genetic relationships are quite different and closer linkage between bridging markers is suggested. The problems associated with the clinical and cytogenetic analyses of this fascinating disorder await the results of detailed molecular approaches. PMID- 3513573 TI - Bibliography of X-linked mental retardation and related subjects. III. (1986). PMID- 3513574 TI - Maternal effect on intelligence in fragile X males and females. AB - If the mother is the fragile X gene carrier, her daughters (and sons) with the mutation are at high risk of mental retardation. If the father is the (clinically unaffected) carrier, his daughters are normal. This is strong evidence for a maternal effect. The decreased penetrance and variable expressivity in fra(X) offspring of carriers could be related, at least in part, to variabile expression or availability of some maternal factor between pregnancies. We hypothesize a maternal effect in fra(X), with variability in intelligence of heterozygotes and hemizygotes mediated mainly by the maternal uterus or placenta by virtue of different patterns of lyonization in those tissues between pregnancies. If the mother is a carrier, the maternal placenta could develop with a skewed proportion of the normal or the fra(X) genetically active. Each female or male embryo could be exposed to very different environments with respect to genetic activity of the fra(X) chromosome, depending on the site of implantation within the uterus. If the father contributes the fra(X), the intrauterine environment is invariably normal and so are the daughters. Modifiers of the intrauterine effect could include lyonization patterns in tissues of the carrier fetus, and preferential inactivation of the paternal X in extra-embryonic tissues. The ultimate phenotype of the developing heterozygote and hemizygote may be determined by a threshold effect and interaction between the maternal genotype, the placental genotype, and the fetal genotype. The possibility of maternal effect is testable and has implications for treatment. PMID- 3513575 TI - Lethal osteopetrosis with multiple fractures in utero. AB - Severe osteopetrosis was diagnosed in utero in two successive pregnancies resulting from an intermarriage. Hydrocephaly and skeletal hyperdensity were detected at 18 weeks of gestation, and fractures at 24 weeks. We report on extensive ultrasound, radiological, and pathological findings, including those on brain and bone. The markedly reduced number of osteoclasts observed in these sibs and the very early fetal involvement suggest that this form of osteopetrosis might represent a new entity: autosomal recessive lethal osteopetrosis. PMID- 3513576 TI - Camping out in the hospital. PMID- 3513578 TI - Whither CAI? PMID- 3513577 TI - Radiation and pregnancy. Putting the risks in proportion. PMID- 3513579 TI - Residues of pelvic inflammatory disease in intrauterine device users: a result of the intrauterine device or Chlamydia trachomatis infection? AB - It is currently believed that intrauterine devices cause pelvic inflammatory disease and tubal infertility. To investigate this concept further, we evaluated 245 infertile patients for inflammatory residues by laparoscopy or laparotomy; 176 patients had not used an intrauterine device and 69 had used one. Chlamydial antibody titers were performed on all patients. Although users had a higher overall prevalence of inflammatory residues than nonusers, there was no difference in residue prevalence for either group at the same titer level. No specific type of device appeared to be associated with either an increased or decreased residue frequency. "Silent" chlamydial infections occurred with equal frequency in both users and nonusers. We conclude that inflammatory residues and tubal infertility in intrauterine device users are not caused by the intrauterine device but by both overt and silent chlamydial infections. PMID- 3513580 TI - Quantitative assessment of Langerhans' cells in human cervical intraepithelial neoplasia and wart virus infection. AB - Langerhans' cell density was assessed quantitatively in cervical wart virus infection (cervical condyloma), cervical intraepithelial neoplasia, and koilocytic dysplasia with use of an antibody to S100 protein and an indirect immunoperoxidase technique. When compared with normal ectocervix, Langerhans' cell density was significantly decreased in cervical wart virus infection and significantly increased in cervical intraepithelial neoplasia. In koilocytic dysplasia, intermediate Langerhans' cell densities were obtained. In addition to being increased within the lesions of cervical intraepithelial neoplasia, Langerhans' cell density was increased in the adjacent normal ectocervix. Human papillomavirus, by reducing intraepithelial Langerhans' cell density, may decrease local immune surveillance and thus have a promoter effect in the development of cervical cancer. Following the development of cervical intraepithelial neoplasia the increase in intraepithelial Langerhans' cell density suggests a specific immune response directed against neoantigens associated with malignant transformation. If a permissive wart virus infection persists after transformation to cervical intraepithelial neoplasia (koilocytic dysplasia), continued depletion of Langerhans' cells results in intermediate densities. PMID- 3513581 TI - The effects of oral administration of progesterone for premature labor. AB - The potential tocolytic effect of natural progesterone administration on premature labor was investigated in a double-blind study. An oral progesterone formulation was used because its ability to increase both plasma and myometrial concentration of progesterone in pregnant women had been previously demonstrated. Furthermore, no commercial intravenous or intramuscular natural progesterone formulation is currently available in France. Fifty-seven patients in two obstetric clinics, admitted because of the risk of premature delivery, were included in the study, and uterine contractility and fetal cardiac rhythm were monitored in all of them. At random and after 30 minutes' rest, 29 women absorbed four capsules of 100 mg of progesterone each and 28 women absorbed four capsules of a placebo. Plasma progesterone levels were evaluated in all cases after 30 minutes' rest and 1 hour after absorption of the capsules. The results showed that bed rest and placebo administration decrease uterine activity in 42% of the cases and oral progesterone decreases activity in 75% to 88% of cases, depending on the initial severity of the menace of premature delivery. The difference between the effects of progesterone and of placebo is significant. The tocolytic effect of oral progesterone is not as intense or as rapid as the effect of intravenous beta-mimetics but is sufficient in 80% of cases, on the average, to stop the premature labor without any detectable side effects. This tocolytic effect of oral progesterone is related not just to an increase in plasma progesterone levels but probably to an increase in myometrial progesterone concentration. PMID- 3513582 TI - Antenatal diagnosis of renal anomalies with ultrasound. IV. Bilateral multicystic kidney disease. AB - Bilateral multicystic kidney disease is a congenital disorder that is fatal in the newborn period. A series of nine cases of bilateral multicystic kidney disease diagnosed prenatally by ultrasound is presented. Ultrasound criteria necessary for the diagnosis are bilateral multicystic kidneys, loss of renal architecture, nonvisualization of the fetal bladder, and absence of amniotic fluid. Seven of the nine cases had autopsy confirmation of the diagnosis. Three cases had other associated congenital anomalies. Precise prenatal diagnosis may allow patients the option of elective abortion or may prevent unnecessary obstetric intervention. We propose that a reliable diagnosis can be made with prenatal ultrasound. PMID- 3513583 TI - Ultrasound differentiation of the competent from the incompetent cervix: prevention of preterm delivery. AB - To evaluate the feasibility of the use of serial ultrasound measurements of cervical length, membrane protrusion, and dilatation to discriminate between the competent and the incompetent cervix, 107 at-risk patients and 30 control subjects were examined prospectively. Patients were divided into five groups based on treatment and method of diagnosis. Epidemiologic, ultrasound, and outcome data were analyzed. Means and standard deviations for ultrasound measurements were established. Highly significant differences between all prediagnostic and postdiagnostic-pretreatment measurements were found (p less than 0.001). Highly significant differences were also found between all postdiagnostic-pretreatment and postdiagnostic-posttreatment measurements (p less than 0.001). No significant differences between prediagnostic and postdiagnostic posttreatment measurements were noted. The incidence of preterm delivery was significantly higher among untreated diagnosed patients (p less than 0.01). By combined clinical and ultrasound criteria 51 patients (47.7%) were identified as not having cervical incompetency. Fifty-six patients (52.3%) were diagnosed. PMID- 3513584 TI - Gestational diabetes: impact of home glucose monitoring on neonatal birth weight. AB - Two groups of 58 gestational diabetic women matched for age, prepregnancy weight, height, and parity were studied. The home glucose monitoring study group performed fasting and 1-hour postprandial capillary blood glucose testing after every meal. The control group was followed by conventional treatment. The incidence of macrosomia (birth weight of greater than or equal to 4000 gm) and large (greater than or equal to 90%) for gestational age infants was significantly reduced in the home glucose monitoring group. The mean birth weight of the study group was 3231 +/- 561 gm, while that of the control group was 3597 +/- 721 gm (p less than 0.002). Significantly more patients in the home glucose monitoring group were receiving insulin therapy (50% versus 21%). We believe that intensive home glucose monitoring will allow for the early identification of those gestational diabetic patients needing insulin and thus reduce the incidence of macrosomia and large for gestational age infants. PMID- 3513585 TI - Magnetic resonance imaging and placenta previa. AB - Twenty-five women with diagnoses of placenta previa on ultrasound examination underwent magnetic resonance imaging examination. An assessment of placental position and the relationship of the lower placental edge to the internal os was made with both techniques and the results were compared. There was complete correlation of placental localization but significant differences were found in the determination of the degree of placenta previa. This occurred more often with posteriorly situated placentas. Magnetic resonance imaging directly affected management with regard to delivery in seven cases. Magnetic resonance imaging provides a technique capable of accurately assessing placental position and its relationship to the cervix, thereby leading to a reduction in hospitalization and inappropriate operations. PMID- 3513586 TI - A comparison of three techniques for ovarian reconstruction. AB - We compared three methods of ovarian reconstruction in 23 mature female New Zealand White rabbits. Each animal was its own control. The right ovary in each rabbit was incised and repaired by placing three 8-0 nylon sutures through and through the base of the defect (method A). The left ovary was repaired without these through-and-through sutures. In 16, hemostasis was achieved by microbipolar cautery (method B); in seven, hemostasis was achieved with three sutures placed entirely inside the defect (method B1). The cortex of each ovary was repaired identically by continuous 8-0 nylon suture. Outcome was evaluated by laparoscopy 14 days after mating. Through-and-through sutures (right ovary) caused a significant increase in adhesion formation and decrease in nidation index. When these animals were put to death 14 weeks later, the right ovaries were significantly smaller. On the left, there was no difference in any outcome variable between methods B and B1. This study clearly shows the detrimental effect of through-and-through sutures for ovarian reconstruction. PMID- 3513587 TI - A double-blind placebo-controlled trial of progesterone vaginal suppositories in the treatment of premenstrual syndrome. AB - Rigorous criteria were used to select women with severe premenstrual syndrome for inclusion in an 8-month double-blind placebo-controlled clinical trial of progesterone vaginal suppositories. Following a control month without treatment, progesterone (200 mg in polyethylene glycol base) or placebo was self administered twice daily by vaginal suppository for a minimum of 12 days before the onset of menstruation for 3 months. Crossover to the opposite medication for a further 3 months was followed by a final control cycle without treatment in month 8. Physician contact was minimized throughout the study to avoid any possible positive effects of psychological support which may have confounded past investigations. Detailed self-report questionnaires were completed every 3 days for the duration of the study. Although the attrition rate was high, 20 women completed the trial and their records are analyzed here. The results of this trial indicate that the response to vaginal progesterone in these dosages is, at best, marginal and not significantly different from response with placebo use. PMID- 3513588 TI - The effect of antenatal dexamethasone administration on the prevention of respiratory distress syndrome in preterm gestations with premature rupture of membranes. AB - A prospective blinded randomized study was carried out to determine the effect of antepartum administration of dexamethasone on the incidence of respiratory distress syndrome in 250 patients with gestations between 28 and 33 weeks complicated by premature rupture of membranes. The incidence of respiratory distress syndrome was not lowered by the length of rupture of membranes in the 124 untreated patients. The overall incidence of respiratory distress syndrome was reduced from 51% to 25% by the administration of corticosteroids. Further, the dexamethasone-treated group had a statistical significant reduction in the incidence of intraventricular hemorrhage, total time of hospitalization, and average cost per patient. No statistical difference was encountered in the incidence of maternal or neonatal sepsis. PMID- 3513589 TI - Fetal response to vibratory acoustic stimulation in periods of low heart rate reactivity and low activity. AB - The fetal response to vibratory acoustic stimulation during periods of low fetal activity and low fetal heart rate reactivity was studied in 10 healthy pregnant women at term. In each case, two periods of low reactivity were studied. Consecutive cases alternated: The vibratory acoustic stimulus was applied 10 minutes after the first nonreactive period in half of the cases; the remainder were stimulated during the second nonreactive period. The unstimulated period served as a control. After vibratory acoustic stimulation the baseline fetal heart rate, the mean number of fetal heart rate accelerations, and, the number of fetal movements were significantly increased with values in the control nonstimulated periods (p less than 0.0001). This consistent response to vibratory acoustic stimulation may prove to be clinically useful in altering periods of low reactivity observed during nonstress testing of normal fetuses. PMID- 3513590 TI - Intravascular transfusion in utero: the percutaneous approach. AB - A severely Rh-isoimmunized pregnancy is described in which an intrauterine transfusion of blood was given by the intravascular route directly into an umbilical vessel. Fetoscopy was not used, and the procedure was performed percutaneously under direct ultrasound visualization. PMID- 3513591 TI - The prenatal diagnosis of Robin anomalad. AB - The Robin anomalad was diagnosed by the sonographic detection of polyhydramnios and fetal micrognathia in a patient at risk because of a previously affected child. Ultrasound in the second trimester failed to demonstrate any facial anomaly, but mandibular hypoplasia was clearly documented in the third trimester. The antenatal diagnosis allowed immediate neonatal assistance to prevent glossoptosis-induced respiratory failure. PMID- 3513593 TI - Graft rejection and glaucoma. AB - Four patients (three women and one man, 30 to 63 years old) developed increased intraocular pressure during graft rejection reactions. The increased intraocular pressure returned to normal in one case after successful treatment of the immune reaction but a second patient required antiglaucoma medication for a short period. Two patients with previous intraocular inflammation or anterior segment changes developed severe glaucoma and required long-term antiglaucoma medication. One patient was a corticosteroid-responder and eventually required filtering surgery. PMID- 3513592 TI - A 48-year clinical and epidemiologic study of keratoconus. AB - From 1935 through 1982, keratoconus was newly diagnosed in a total of 64 residents (35 males and 29 females) of Olmsted County, Minnesota. There were no significant trends in incidence rates over time; the overall average annual rate was 2.0 per 100,000 population. The age-specific incidence rates were greatest in the younger groups. The incidence rates did not differ significantly by sex. On Dec. 31, 1982, the overall prevalence rate was 54.5 per 100,000 population. At the time of diagnosis, keratoconus was unilateral in 26 patients (41%) and bilateral in 38 patients (59%). Follow-up of the patients showed that survival did not differ significantly from that of the general population. The cumulative probability of survivorship without corneal transplantation for more than 20 years after diagnosis was greater than 80%. PMID- 3513594 TI - Glaucoma treatment with once-daily levobunolol. AB - Although twice-daily instillation of topical beta-blockers is the standard regimen for treatment of increased intraocular pressure, once-daily therapy might improve patient compliance and provide greater safety. In a three-month, double masked clinical trial, 92 patients with open-angle glaucoma or ocular hypertension received levobunolol 0.5% or 1% or timolol 0.5% once daily, in both eyes. Overall mean decreases in intraocular pressure were significantly greater in the groups treated with levobunolol than in the group treated with timolol. Intraocular pressure decreases averaged 7.0 mm Hg with levobunolol 0.5%, 6.5 mm Hg with levobunolol 1%, and 4.5 mm Hg with timolol. The intraocular pressures of 72% (18 of 25 patients) of those treated with levobunolol 0.5%, 79% (22 of 28 patients) of those treated with levobunolol 1%, and 64% (16 of 25 patients) of those treated with timolol were successfully controlled during the study. Heart rate and blood pressure decreases were minimal with both levobunolol and timolol. Study results indicated that once-daily treatment with levobunolol and, to a lesser extent, timolol is sufficient to control intraocular pressure successfully and safely. PMID- 3513595 TI - Crystal growth on the outer enamel surface--an alternative to acid etching. AB - Over the past 2 years an increasing concern has developed about the possible iatrogenic effects of phosphoric acid-etch bonding techniques on the enamel surface. There is an evident need to develop a mechanical or chemical retention system that would not alter (or would minimally alter) the outer enamel surface. An alternative to the conventional phosphoric acid etch technique has been developed. A preliminary clinical trial showed promising performance under normal clinical conditions. These results were achieved with a minimal loss of surface enamel as evidenced by scanning electron microscopy. Debonding and cleanup were greatly facilitated. Creating a micromechanical retentive surface by the formation of a crystalline interface is a potential alternative to phosphoric acid etching. PMID- 3513596 TI - Retention of orthodontic bands with new fluoride-releasing cements. AB - The prevalence of enamel decalcification beneath orthodontic bands has indicated the need for a fluoride-releasing, enamel-adhesive orthodontic luting cement. The purpose of this study was to compare the retentive bond strengths of orthodontic bands cemented with two new fluoride-releasing cements, a zinc polycarboxylate and a glass ionomer, with the retentive bond strength of bands cemented with the standard orthodontic cement zinc phosphate. The site of cement failure was also evaluated. One hundred eighty extracted human molar teeth were embedded in resin blocks and randomly assigned to three cement groups. Adapted bands were cemented by a clinically acceptable technique. The cemented teeth were then assigned to one of three time intervals--24 hours, 7 days, and 60 days--and thermocycled in synthetic saliva. The force required to initially fracture the cement bond was used as a measure of cement retention. By means of the Instron, a tensile load was applied to each cemented band. The maximum retentive strength (cement failure) was interpreted from the stress-strain curve at the point where linearity deviated. The failure site was judged subjectively: between cement and enamel, within the cement, or between cement and the band. Using stress at failure, an analysis of variance showed no significant differences among the retentive strengths of the three cements. The chi-square test revealed a significant difference (P less than 0.01) between failure sites of the zinc phosphate and glass ionomer cements. Significantly more bands cemented with the glass ionomer failed at the cement/band interface, leaving the cement adhered to the tooth.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3513597 TI - Bonding characteristics of impacted versus erupted permanent teeth. AB - Erupted and impacted teeth from young (12 to 24 years of age) and older persons (over 50 years of age) were bonded by a standard technique using etching times of 0, 15, 30, and 60 seconds. Two subgroups of teeth were soaked for 7 days and compared with those in the remainder of the group. Test specimens were loaded in shear to bond failure by means of a testing machine with a 200- kg load cell and a crosshead speed of 5 mm/minute. Results indicated insignificant bond-strength differences between young-impacted and young-erupted teeth for any given etching time. Very small bond-strength differences were found for various etching times (15, 30, and 60 seconds). A significant difference was found between 24-hour soak and 7-day soak for the etching times of 30 and 60 seconds only. PMID- 3513598 TI - Monoclonal antibody reveals heterogeneity in human aortic intima: detection of a ganglioside antigen associated with a subpopulation of intimal cells. AB - The cells of the arterial wall are heterogeneous. To study the functions and peculiarities of various subpopulations of arterial cells the authors have generated an IgM mouse monoclonal antibody, designated 3-Lena, which interacts with human aortic cells (demonstrated by RIA and flow cytofluorometry). The cellular antigens interacting with monoclonal antibody 3-Lena are gangliosides GM3, GD3, GD1a, and GT1b. Presumably, the epitope is represented by the structure -NeuAc alpha 2----3Gal beta 1, a component of the oligosaccharide moiety of the ganglioside molecule. In addition to aortic cells, those dissociated from other large human vessels as well as cells of the myometrium and lung parenchyma interact with 3-Lena. Cells dissociated from the spleen and renal cortex exhibit a substantially weaker interaction, while liver and myocardial cells do not react. Compared with human aortic cells, aortic cells of other mammalian species stain less effectively (dog, swine) or do not stain at all (bovine, ram). Flow cytofluorometric analysis demonstrates that practically all human aorta medial cells interact with antibody 3-Lena, whereas a certain portion of cells in the intimal population do not. In the outer intimal sublayer adjoining the media, the cells reacting with monoclonal antibody 3-Lena make up the bulk of the cell population, and the inner sublayers are characterized by a prevalence of nonreactive cells. After separation of reactive and nonreactive human aortic intimal cells by a cytofluorometer-cell sorter, 3-Lena+ cells were found to have an elongated bipolar shape, whereas most 3-Lena- cells have multiple processes and variable elongated, stellate, or irregular shapes.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3513599 TI - Rapid detection of xenotransplanted human tissues using in situ hybridization. AB - A rapid and sensitive method for the identification of human tissues xenotransplanted in nude mice was developed. An in situ hybridization technique made it possible to distinguish between cells of human origin and cells of murine origin in formalin-fixed paraffin sections. High-molecular-weight DNAs extracted from human or mouse tissues were sonicated, nick-translated with 32P-dCTP, and used as hybridization probes. Dot blot hybridization of 32P-labeled probes revealed clear species-specific signals. Formalin-fixed paraffin-embedded tissue samples from repopulated tracheal transplants, containing either human tracheal epithelial cells or human renal tubular cells, were used. Cells of human and murine origin were distinguishable by in situ hybridization with sonicated DNA probes. This method has several advantages; simple preparation of probes, high sensitivity, and applicability to formalin-fixed paraffin-embedded tissue sections. In situ hybridization with sonicated DNA probes should provide a powerful tool for verifying the human origin of xenotransplanted tissues in nude mice. PMID- 3513600 TI - Immunohistochemical localization of neurofilaments and neuron-specific enolase in 29 cases of neuroblastoma. AB - Twenty-nine neuroblastomas have been examined with the use of rabbit antibodies specific for each of the three neurofilament polypeptides, with a monoclonal antibody specific for the NF-L polypeptide, and with a rabbit antibody specific for neuron-specific enolase. When frozen material was used, all neuroblastomas were positive with the neurofilaments antibodies. When alcohol-fixed paraffin embedded material was used, neurofilament staining was weaker and the fixation procedure appeared to destroy the epitopes recognized by the NF-L antibodies preferentially. Although all neuroblastomas were positive for neurone-specific enolase, so were two rhabdomyosarcomas, suggesting that NSE is not an appropriate marker to distinguish the different small blue cell tumors of children. PMID- 3513602 TI - No aggravation of the course of experimental glomerulonephritis in spontaneously hypertensive rats. AB - Functional and morphologic glomerular alterations induced by antiglomerular basement membrane (anti-GBM) nephritis were investigated in spontaneously hypertensive rats (SHR) and normotensive Wistar Kyoto controls (WKY) for assessment of the role of systemic hypertension in immunologically mediated renal injury. Over a 6-week period serial measurements of systolic blood pressure (BP), serum creatinine (SCreat), creatinine clearance (CCreat), and urinary albumin excretion (UAlbV) were obtained with inulin clearances (CInulin) at the end of the study. Renal tissue was examined by light microscopy (LM), electron microscopy, immunofluorescence, flash 3H-thymidine autoradiography (AR), and staining for nonspecific esterase (NSE). Immunologic humoral response was evaluated by measurement of rat anti-rabbit IgG antibody production. At all time periods studied, SHR and WKY rats with anti-GBM nephritis demonstrated comparable elevations in SCreat and UAlb V as well as diminution of CCreat and CInulin as compared with non-nephritic control rats of each strain. In nephritic WKY rats mild hypertension developed, whereas in nephritic and control SHR rats marked elevations in BP developed. Morphologic injury as assessed by percent glomerular crescents and hypercellularity on LM, numbers of monocyte macrophages by NSE staining, immunofluorescence for IgG, C3, fibrinogen and Ia positivity, and numbers of glomerular 3H-thymidine-labeled cells by AR was notably comparable in both nephritic strains. Humoral antibody responses were also shown to be similar in all rats studied. These results demonstrate that the 5-week course of experimental anti-GBM nephritis is not exacerbated by systemic hypertension. Glomerular autoregulatory capacity may be important in determining the extent of immune-mediated renal injury. PMID- 3513601 TI - Higher susceptibility of mast-cell-deficient W/WV mutant mice to brain thromboembolism and mortality caused by intravenous injection of India ink. AB - (WB X C57BL/6)F1-W/WV mice possess a genetic defect in multipotential hematopoietic stem cells; the mice are anemic and lack mast cells. The authors injected diluted India ink intravenously into W/WV mice and congenic normal +/+ mice and searched for genetically determined differences in the development of complications of the injection. In both W/WV and +/+ mice, intravenous ink resulted in thrombocytopenia and markedly prolonged bleeding times, as well as prolonged partial thromboplastin and prothrombin times and reduced fibrinogen concentrations. These effects were similar in W/WV and +/+ mice, although the reduction in platelet counts was greater in W/WV mice. In addition, the mortality associated with ink injection was significantly higher in W/WV mice than in congenic +/+ mice. Most W/WV mice which died first exhibited paralysis, and examination under the dissection microscope revealed that ink injection resulted in significantly more cerebral thromboemboli in W/WV mice than in +/+ controls. Bone marrow transplantation from +/+ mice corrected both the mast cell deficiency and the anemia of W/WV mice and protected the W/WV recipients from the adverse consequences of ink injection. By contrast, +/+ mice rendered as anemic as W/WV mice by breeding did not exhibit increased morbidity and mortality after ink injection. (WC X C57BL/6)F1-Sl/Sld mice, which are anemic and lack mast cells because of a genetic defect different from that of W/WV mice, also exhibited increased morbidity and mortality after intravenous ink. Finally, mixture of ink with commercial heparin prior to intravenous injection markedly reduced the incidence of cerebral thromboembolism and death in W/WV mice. Taken together, these findings suggest that the increased morbidity and mortality exhibited by W/WV and Sl/Sld mice that received injected ink might be related to their mast cell deficiency rather than to their anemia. But measurement of the histamine content of the blood and various tissues of WBB6F1-+/+ mice injected with ink, and examination of their tissues in 1-mu sections, indicated that intravenous ink did not cause substantial mast cell degranulation. As a result, the possibility that mast cells protect +/+ mice from the adverse effects of intravenous ink by a mechanism other than degranulation and release of heparin, or that the differences in the response of W/WV or Sl/Sld mice and their +/+ littermates are due to defects other than their lack of mast cells, cannot be excluded. PMID- 3513603 TI - Immunohistology of the thymus in bone marrow transplant recipients. AB - The immunohistological findings in the thymus after bone marrow transplantation were studied in autopsy samples from 12 patients who had received allogeneic grafts as treatment for acute leukemia. The findings were compared with those in samples from normal individuals and from conventionally treated leukemic patients. The thymuses were hyperinvoluted in all grafted and nongrafted subjects. The remnants were composed of subcapsular and medullary epithelium which expressed the same phenotype as the normal thymus controls. Most samples also contained small remnants of cortical epithelium which lacked normal expression of HLA-DR antigens. The intraepithelial and stromal thymic lymphocytes were virtually all mature T cells, and no immature cortical thymocytes were seen. With the use of HLA-typing methods in 2 recipients of one-haplotype-matched grafts no donor cells could be identified in any of the thymic components. These findings provide no evidence for a functional role for the thymus in the differentiation of donor-derived precursor T cells, at least in the early period after transplantation. PMID- 3513604 TI - Sodium requirement for insulin release: putative role in regulation of intracellular pH. AB - The effects on insulin release of Na+ removal, alteration of extracellular pH, and inhibition of acid extrusion processes were examined using freshly isolated and 46-h cultured islets of Langerhans. Na+ removal inhibited the secretory response to 16.7 mM glucose specifically in fresh islets but stimulated the low glucose response in cultured islets. These divergent effects of Na+ depletion were perfectly mimicked by amiloride, an inhibitor of Na+-H+ exchange, and could be overcome in a raised HCO-3, pH 8.0 medium. Simply raising extracellular pH at constant HCO-3 had no effect. Na+ removal also inhibited the secretory responses to other nutrient secretagogues such as D-glyceraldehyde and L-leucine but not to agents like 3-isobutyl-1-methylxanthine or 12-O-tetradecanoylphorbol-13-acetate. The results show that Na+ is not itself essential for the secretory process but rather suggest that it plays a permissive role in the regulation of intracellular pH via Na+-H+ exchange. Such a regulation appears important mainly for nutrient stimulated insulin release, which is associated with the generation of acidic metabolites. PMID- 3513605 TI - Angiotensin II stimulates norepinephrine uptake in hypothalamus-brain stem neuronal cultures. AB - In this study we have characterized the uptake of [3H]norepinephrine (NE) into neuronal co-cultures of rat hypothalamus and brain stem and have examined the effects of angiotensin II (ANG II) on this uptake. Neuronal co-cultures prepared from the brains of 1-day-old Sprague-Dawley (SD) or Wistar-Kyoto (WKY) rats exhibited sodium-dependent and sodium-independent portions of the total [3H]NE uptake. The sodium-dependent uptake was abolished by blockers such as maprotiline, desmethylimipramine, and xylamine (0.1-100 microM) and is presumably neuronal uptake. The sodium-independent uptake was unaffected by these drugs and is presumably non-neuronal, since nonneuronal co-cultures from SD rats exhibited no significant sodium-dependent or blocker-sensitive uptake. In SD or WKY neuronal co-cultures, ANG II (0.1 nM-10 microM) caused increased [3H]NE uptake during short-term incubations (1-5 min). This stimulatory effect of ANG II was on neuronal NE uptake. Furthermore, it was inhibited by preincubation with saralasin (1-10 microM). Construction of saturation curves and kinetic analyses revealed that ANG II caused an increase in the maximal velocity of uptake of neuronal [3H]NE, but the affinity of the transporter for NE was not altered. With longer term incubations (15-30 min), ANG II caused a reduction in neuronal [3H]NE uptake. This effect was also blocked by saralasin. However, reliable kinetic analysis was not possible with the longer-term incubations, and it is likely that the inhibitory action of the peptide represents a stimulation of NE release. Therefore, using neuronal co-cultures, we have identified a previously unseen stimulatory action of ANG II on neuronal [3H]NE uptake, which precedes the already documented inhibitory actions. PMID- 3513606 TI - Secretin and its C-terminal hexapeptide potentiates insulin release in mouse islets. AB - Peptides representing the C-terminal end of secretin were synthetized and their effects tested along with secretin on column-perifused isolated mouse pancreatic islets. Insulin release induced by 10 mmol/l D-glucose was potentiated by secretin tested in a concentration range of 0.01-10 micrograms/ml; the maximal effect was obtained with 1 microgram/ml secretin. This effect was mimicked by 50 500 micrograms/ml NH2-Leu-Leu-Gln-Gly-Leu-Val-NH2, [S-(22-27)], which represents an amidated C-terminal sequence of the secretin molecule. The consecutive smaller secretin C-terminal peptides had either no effects [Val-NH2, S-(24-27)] or only marginally [S-(26-27), S-(23-27)] potentiating effects on insulin release in the presence of 10 mmol/l D-glucose. The effects of secretin and S-(22-27) were not influenced by 2 mmol/l glutamine. The intact hormone and the five synthetic peptides as well as Val-NH2 had no stimulatory effect on islet glutamate dehydrogenase activity. In fact, S-(23-27), S-(24-27), and S-(25-27) inhibited the islet glutamate dehydrogenase activity, the activation by which amino acids and amino acid derivatives are known to elicit a potentiation of insulin release. Our results suggest that the C-terminal part is important to the marked potentiation of glucose-induced insulin release in vitro by secretin. PMID- 3513607 TI - Insulin processing by cultured hepatocytes. AB - The chloroquine-sensitive and chloroquine-insensitive steps in insulin degradation by cultured hepatocytes have been explored by employing low temperature to retard processing. Under standard conditions (90 min association and 60 min dissociation) chloroquine inhibited insulin degradation at 15 degrees C but not at 37 degrees C. However, if the association and dissociation periods were short so that only early degradation was examined, marked inhibition of insulin degradation by chloroquine could also be observed at 37 degrees C. This inhibitory effect was observed only during the first 15 min, being masked by increased insulin degradation subsequently. An increase in slowly dissociable insulin, as well as a twofold increase in volume density of multivesicular bodies (MVB), occurred in the presence of chloroquine at both 37 and 15 degrees C. Rapid insulin processing from the slowly dissociable compartment at 37 degrees C masked chloroquine's effect on insulin processing under usual conditions at that temperature. At physiological temperature the chloroquine-sensitive step is not obligatory for insulin degradation by hepatocytes. PMID- 3513608 TI - Beta-adrenergic modulation of insulin binding in skeletal muscle. AB - Both a high physiological concentration (13.1 nM) of epinephrine (E) and acute exercise (AEx) have previously been shown to increase 125I-insulin binding in skeletal muscle. To investigate the site and mechanism of the effect of epinephrine on binding and the possible link between epinephrine- and AEx enhanced insulin binding, we measured insulin binding in three different preparations: 1) crude membranes derived from whole soleus muscle incubated in vitro with 13.1 nM E, 2) crude membranes with E present in the binding assay, and 3) purified plasma membranes with E present. Epinephrine enhanced binding in all three preparations by 169, 144, and 164%, respectively, at low concentrations of insulin but had little effect at high concentrations. Epinephrine, therefore appears to have its effect at the plasma membrane. Propranolol (10 microM), a beta-adrenergic antagonist, blocked E-enhanced insulin binding and when added to crude membranes made from soleus and extensor digitorum longus muscle of AEx rats reversed the increase in binding seen with exercise. This indicates that E enhanced insulin binding is mediated by beta-adrenergic receptors and that AEx enhances insulin binding via beta-adrenergic receptors. Sodium orthovanadate (3 mM), a phosphotyrosyl-protein phosphatase inhibitor, also inhibited the increase in insulin binding due to E, implying that E may increase insulin binding by activating a phosphotyrosyl-protein phosphatase which decreases the phosphorylation of a plasma membrane protein, presumably the insulin receptor. PMID- 3513609 TI - Endotoxin treatment inhibits glucocorticoid induction of hepatic enzymes at a late induction step. AB - Bacterial endotoxin inhibits the glucocorticoid induction of several hepatic enzymes including phosphoenolpyruvate carboxykinase (PEPCK). Experiments were performed to elucidate the mechanism of this inhibition by examination of the early events in the glucocorticoid induction process. At a dose of endotoxin 2-to 10-fold greater than that required to inhibit the induction of PEPCK activity, no effect on the entry of glucocorticoids into hepatocytes or their ability to form complexes with glucocorticoid receptors could be measured. Binding data showed no effect of endotoxin treatment on the association or dissociation kinetics of the steroid-receptor binding reaction. Scatchard analysis revealed no effect on the affinity and number of hepatic glucocorticoid receptor binding sites, indicating that down-regulation of receptors is not responsible for inhibition of induction. Finally, activation of receptor complexes was unaffected as well by endotoxin treatment. We conclude from these data that endotoxin does not act at the early events in the glucocorticoid induction process and must therefore intervene at a subsequent step. PMID- 3513610 TI - Facultative thermogenesis induced by carbohydrate: a skeletal muscle component mediated by epinephrine. AB - In addition to the obligatory thermogenesis due to processing and storage, carbohydrate ingestion is accompanied by a facultative thermogenesis mediated by catecholamines via beta-adrenoceptors. The anatomical origin of facultative thermogenesis has hitherto not been determined. The possible involvement of skeletal muscle was examined in lean, healthy subjects by measuring the response in forearm oxygen consumption to an oral glucose load. The study demonstrates an early component of skeletal muscle thermogenesis coinciding with the local glucose uptake, followed by a late facultative thermogenesis. The arterial epinephrine concentration increased to a maximum of 200% above base-line values 4 h after glucose. This value greatly exceeds the physiological threshold for the thermogenic action of epinephrine. In forearm venous blood the corresponding increase in epinephrine was only approximately 50% due to enhanced peripheral extraction, which accompanies an increase in arterial epinephrine levels. Due to venous sampling previous studies have overlooked the magnitude of the late postglucose increase in arterial epinephrine, and its potential thermogenic effect has been disregarded. The facultative thermogenesis in skeletal muscle may be of importance for the regulation of body weight in humans. PMID- 3513611 TI - LPS-caused secretion of corticosterone is mediated by histamine through histidine decarboxylase. AB - Escherichia coli lipopolysaccharide (LPS) induced strong time- and dose-dependent secretion of corticosterone (CS) in C3H/HeN mice. In contrast, C3H/HeJ mice were very insensitive to LPS; 100,000 times more LPS was required with C3H/HeJ mice for producing a similar degree of CS secretion as that of C3H/HeN mice. However, C3H/HeJ mice could efficiently respond to other types of stressors, immobilization stress or injection of histamine, a possible mediator of LPS induced CS secretion (28), leading to a striking increase in the serum levels of CS. Adoptive transfer of spleen cells from C3H/HeN mice converted x-irradiated C3H/HeJ mice to the donor phenotype. Injection of LPS produced a large increase in the activity of histidine decarboxylase (EC 4.1.1.22) in the spleen, lung, and liver of C3H/HeN mice, whereas C3H/HeJ mice were far less responsive. Transfer of spleen cells from the C3H/HeN mice made C3H/HeJ mice sensitive to LPS, leading to an increase in histidine decarboxylase activity in the spleen. There was a statistically significant relationship between the activity of splenic histidine decarboxylase and the serum levels of CS. These results suggest that the LPS induced secretion of CS is mediated by histamine through induction of histidine decarboxylase in the spleen, lung, and liver. This may be significant in relation to the host-defense mechanism against endotoxemia. PMID- 3513612 TI - Glutamine blocks lipolysis and ketogenesis of fasting. AB - Several in vivo studies have indirectly suggested a relationship between blood glutamine and ketonemia. The present study was designed to characterize the role glutamine plays in regulating lipolysis and ketogenesis during fasting in vivo. Twelve dogs had catheters implanted in the hepatic and portal veins (V) and in the femoral artery (A) 17-21 days before study. The animals were fasted for 4 days. After a 120-min rest and 40-min basal periods, 6 dogs received an infusion of L-glutamine at 6 mumol X kg-1 X min-1 and 6 received saline and acted as controls. Hepatic and splanchnic balances (mumol X kg-1 X min-1) were estimated by A-V differences multiplied by blood flow determined by indocyanine green. Fasting was associated with a compensated (no change in pH) mild metabolic acidosis but no change in plasma insulin and glucagon or blood glutamine. L Glutamine infusion increased blood glutamine by 20% but decreased arterial free fatty acids (FFA, from 1,054 +/- 47 to 850 +/- 43 mumol/l, P less than 0.01), beta-hydroxybutyrate (beta-OHB, from 136 +/- 15 to 66 +/- 8 mumol/l, P less than 0.01), acetoacetate (AcAc, from 168 +/- 26 to 86 +/- 21 mumol/l, P less than 0.01), and glycerol (from 90 +/- 4 to 65 +/- 5 mumol/l, P less than 0.01). It also decreased hepatic uptake of glycerol (from 2.5 +/- 0.5 to 0.8 +/- 0.3 mumol X kg-1 X min-1, P less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3513613 TI - Insulin resistance in acromegaly: defects in both hepatic and extrahepatic insulin action. AB - Short-term growth hormone excess is associated with impaired hepatic and extrahepatic responses to insulin in the absence of a change in insulin binding. To determine whether similar defects occur after chronic growth hormone excess, insulin dose-response curves for stimulation of glucose utilization and suppression of glucose production and monocyte and erythrocyte insulin binding were determined in five acromegalic patients and six healthy volunteers of comparable age, sex, and obesity. During infusion of insulin, glucose infusion rates required to maintain euglycemia were significantly lower (P less than 0.02 all) in the acromegalic patients than in the control subjects. Suppression of glucose production was impaired in the acromegalic subjects at insulin concentrations in the physiological range but not at insulin concentrations in the supraphysiological range. In contrast stimulation of glucose utilization was decreased in the acromegalic subjects at both physiological and supraphysiological insulin concentrations. Neither monocyte nor erythrocyte insulin binding differed significantly in the acromegalic and control subjects. These data indicate that chronic growth hormone excess is associated with a defect in both hepatic and extrahepatic insulin action. The decrease in glucose utilization at supraphysiological insulin concentrations in the acromegalic subjects and the normal monocyte and erythrocyte insulin binding suggest a postbinding alteration in insulin action. PMID- 3513614 TI - Functional changes in luteinizing hormone-secreting cells from pre- and postpartum ewes. AB - Luteinizing hormone (LH)-containing cells from ovine pituitaries obtained during gestation and at various times after parturition were examined to determine whether the ability to store and secrete LH in vitro was correlated with morphological changes. Pituitaries collected on days 50 and 140 of gestation and on days 2, 13, 22, and 35 after parturition were enzymatically dissociated and the resulting cells cultured in media containing estradiol (12 pg/ml), cortisol (12 ng/ml), or no steroid. After 4, 7, or 10 days of culture, cells were washed and basal LH, gonadotropin-releasing hormone (GnRH)-stimulated release of LH, and cellular content of LH were determined. The content of LH (ng/10(6) cells) was lowest on day 140 of gestation (2.7 +/- 0.3) and day 2 postpartum (2.2 +/- 0.6) and then increased (P less than 0.05) on days 13 (36.6 +/- 8.3), 22 (59.9 +/- 14.4), and 35 (54.6 +/- 19.3) postpartum. The percentage of pituitary cells containing immunoreactive LH nearly doubled (P less than 0.05) between days 2 (5.6 +/- 0.2%) and 35 (10.6 +/- 1.1%) postpartum. Moreover, LH-containing cells were smaller, and the percent total cellular volume occupied by secretory granules was less on day 2 than on days 22 and 35 after parturition. Secretion of LH after 4, 7, or 10 days of culture reflected the cellular content of LH and was not influenced by the presence of steroids in the media. These data indicate that decreased synthesis of LH during gestation is associated with hypoplasia of the LH-secreting cells. These cells are reactivated during the postpartum period and their capacity to synthesize LH gradually returns to normal. PMID- 3513615 TI - Triglyceride kinetics: effects of dietary glucose, sucrose, or fructose alone or with hyperinsulinemia. AB - The effects of different dietary sugars, with or without exogenously induced hyperinsulinemia, on rat plasma triglyceride kinetics have been studied. Glucose, sucrose, or fructose were supplied as 10% drinking solutions. The sugar supplemented groups were each divided into subgroups, one receiving 6 U of insulin per day for 2 wk from intraperitoneally implanted minipumps and the other receiving none. The same degree of hyperglycemia and of endogenous hyperinsulinemia was seen in each sugar-supplemented group. Infusing exogenous insulin restored normoglycemia and produced more pronounced but equal hyperinsulinemia in each subgroup. In those rats that received no exogenous insulin, triglyceride production increased 18% in the sucrose-supplemented group and 20% in the fructose supplemented subgroups, but not at all in the glucose supplemented subgroup. This 20% increase in triglyceride production in the fructose-supplemented subgroup was accompanied by a six times greater (120%) increase in triglyceride concentration. This suggested that dietary fructose not only increased triglyceride production, but also impaired triglyceride removal. Exogenously induced hyperinsulinemia further increased triglyceride production in those rats receiving dietary fructose, either as the monosaccharide or as sucrose, but not in those receiving only glucose. Thus, in the presence of fructose, but not glucose, insulin stimulates triglyceride production. As exogenous insulin returned the triglyceride concentrations to normal in the fructose-supplemented rats, it also appeared to overcome any fructose-associated impairment of triglyceride removal. PMID- 3513616 TI - A method for large volume blood sampling and transfusion in rats. AB - A new protocol that makes it feasible to withdraw large volumes of whole blood from an individual rat within 1 h or less is described. This method involves the use of indwelling catheters for withdrawal of blood from the inferior vena cava with concurrent isovolemic replacement of whole blood into the superior vena cava. Simultaneity of the transfusion and withdrawal, strict equality of volumes, and a smooth exchange of blood are assured by the use of separate channels of the same multiple-channel peristaltic pump for withdrawal and replacement. Validation experiments using both anesthetized and unanesthetized rats indicate that several responses remain essentially undisturbed during large volume blood sampling; these parameters include blood pressure, heart rate, hematocrit, plasma hormones including insulin and glucagon, plasma glucose levels, and feeding behavior. Considerations of technical and physiological limitations of the protocol, including choice of catheters and catheter placement, pump, sampling parameters, and obtaining donor blood, are discussed. PMID- 3513617 TI - Interpulse interval sequence of LH in normal men essentially constitutes a renewal process. AB - Luteinizing hormone (LH) is released from the anterior pituitary gland in an episodic pattern driven by pulses of gonadotropin-releasing hormone (GnRH) from the hypothalamus. Autocorrelation analysis of the sequence of interpulse intervals of LH secretion in normal men supports the hypothesis that the underlying mechanism driving LH secretion is a renewal process. That is, whatever "memory" the GnRH pulse generator (i.e., the hypothalamus or its antecedent neural drive) may have, it does not go back in time further than the preceding secretory pulse. Thus the hypothalamic timer starts over again each time there is a GnRH secretory episode. PMID- 3513619 TI - Indirect immunoselection of late distal cell populations from rabbit kidney cortex. AB - This study describes a method for the separation of distal cell populations based on the sequestration of proximal cells on immunoadsorbent columns (CNBr-activated Sepharose 6MB) bound with three brush-border monoclonal antibodies (S6-Mab). A high yield of isolated cell suspension from rabbit kidney cortex was prepared by mechanical dissociation after perfusion and incubation of the kidneys with 10(-3) M EDTA. The sequestration of the proximal cells was achieved in two sequential chromatographic steps. About 92% of the applied cells were first retained on an S6-Mab column after a 60-min stationary stage and the unbound cells were submitted by direct flow to a second S6-Mab column. In such conditions, 8 X 10(6) cells were recovered when starting with 331 X 10(6) cortical cells. The efficiency of the proximal cell depletion process was confirmed by an 80% decrease in brush-border enzymes, a very low phosphoenolpyruvate carboxykinase activity, and absence of cells bearing long microvilli, as ascertained by electron microscopy. This immunodepleted cell population presented the enzymatical characteristics of cells from the more distal segments. As compared with the initial cell suspension, these cells exhibited higher hexokinase (2.3 times), succinate dehydrogenase (1.5 times), and Na+-K+-ATPase (2.6 times) activities. In addition, adenylate cyclase activities remained sensitive to parathormone, arginine vasopressin, and isoproterenol. The functional capacity of these immunodepleted cells was assessed by an almost complete exclusion of eosin dye, a low Na+ and high K+ intracellular content, and a high respiratory rate of oxygen consumption. In conclusion, this immunoselective process makes it possible to obtain subpopulations of renal cortical cells possessing the main characteristics of the distal, connecting, and collecting cells for physiological and metabolic studies. PMID- 3513618 TI - Isolated canine ileal mucosal cells in short-term culture: a model for study of neurotensin release. AB - We have developed a new technique for maintaining isolated enteric mucosal cells containing neurotensinlike immunoreactivity (NTLI) in short-term culture to determine the regulation of NTLI release. Collagenase-dispersed ileal mucosal cells, separated by centrifugal elutriation, were enriched for NTLI-containing cells as determined by immunohistochemistry and radioimmunoassay. Bombesin (BBS) rapidly stimulated NTLI release from freshly isolated cells. However, studies with freshly isolated cells were limited by high, unstable basal release measurements and rapid degradation of added [3H]neurotensin-(1-13). A culture system of elutriator-enriched NTLI cells was therefore developed. After 48 h NTLI cells selectively adhered to the collagen substrate and constituted 40% of the viable cells in culture. The morphology of NTLI cells in culture closely resembled neurotensin cells in intestinal tissue sections, with a secretory granule diameter of 292 +/- 14 nm. Bombesin stimulated a dose-dependent increase in NTLI secretion over 120 min. In these cell cultures, degradation of added [3H] neurotensin-(1-13) was minimal over 120 min. High-pressure liquid chromatographic analysis of culture supernatants characterized neurotensin-(1-13) as the primary molecular form of neurotensin released in response to BBS stimulation. In conclusion, we have established a primary culture of enteric neurotensin cells that provides a model for studying the regulation of peptide release. Bombesin stimulation of NTLI release verified the functional responsiveness of this isolated cell system. PMID- 3513620 TI - Chronic effects of vasopressin on plasma renin activity in sodium-restricted dogs. AB - The effects of chronic (4 days) arginine vasopressin (AVP) infusion were studied in two separate groups of animals: normal Na-restricted dogs with intact renal nerves (n = 8) and renal-denervated Na-restricted dogs (n = 5). Volume expansion during AVP infusion was prevented in these studies with a sensitive servo controlled cage-scale system. With intravenous AVP infusion (0.36 ng X kg-1 X min 1), plasma AVP levels increased from nearly 3 to 15 pg/ml, whereas total body weight remained unchanged from the control level. In renal-innervated dogs, plasma renin activity (PRA) decreased significantly (P less than 0.05) from control levels of 5.50 +/- 0.61 to an average level of 3.45 +/- 0.76 ng angiotensin I (ANG I) X ml-1 X h-1 on days 1 and 2 of AVP infusion. Thereafter, PRA tended to remain decreased on days 3 and 4, averaging 3.82 +/- 1.02 ng ANG I X ml-1 X h-1, but this was not statistically significant. Urinary Na excretion and balance, however, were not significantly altered during the 4-day AVP infusion period. In renal-denervated dogs, the rise of PRA with Na restriction was 50% that seen in normal dogs. In this group, a transient suppression of PRA was observed on day 1 of AVP infusion from 2.84 +/- 0.75 to 1.46 +/- 0.47 ng ANG I X ml-1 X h-1. Urinary Na excretion increased transiently with a small net Na loss of 4.9 +/- 1.3 meq on day 2 of AVP infusion. No significant changes occurred in average 24-h mean arterial pressure (MAP) in response to AVP in either group of dogs. Thus, in contrast to our previous observations in Na-replete dogs, elevations of plasma AVP within the physiological range result in suppression of PRA, but for periods of no longer than 1-2 days in Na-restricted dogs. This decrease of PRA occurred in the absence of measurable changes in MAP, total body weight, or plasma catecholamines. In addition, this transient AVP-induced suppression of PRA was only partially blunted by prior renal denervation. Finally, in the Na-restricted dog, AVP appears to have minimal or no long-term effects on urinary Na excretion. PMID- 3513621 TI - Increased transport of inorganic phosphate in renal brush borders of spontaneously hypertensive rats. AB - Phosphate metabolism was studied in spontaneously hypertensive rats (SHR) and normotensive Wistar-Kyoto rats (WKY) by measuring serum phosphate concentrations and 24-h urinary phosphate excretions in rats placed in metabolic cages from 6 to 23 wk of age. Serum phosphate concentrations in SHR were significantly lower than those in WKY at 6, 12, and 20 wk of age. In addition, 24-h urinary phosphate excretion was lower in SHR relative to WKY from 6 through 23 wk of age. The hypophosphaturia in SHR was accompanied with an increase in the maximal transport rate of Na+-dependent phosphate transport in renal brush border membrane vesicles (BBMV) isolated from kidney cortex at 6, 12, and 20 wk of age. The apparent affinity for phosphate did not differ significantly between WKY and SHR at all ages studied. A direct relationship between maximal Na+-dependent phosphate transport rates in BBMV and serum phosphate concentrations was observed in both strains. In SHR, phosphate homeostasis is disturbed from 6 wk of age on. PMID- 3513622 TI - Prostaglandins may mediate chloride concentration gradient across domes formed by MDCK1 cells. AB - The MDCK1 and LLC-PK1 cell lines have been used to characterize transepithelial transport in isolated culture. Both can be maintained in continuous culture and form domes that represent fluid actively transported from luminal to contraluminal surface. Fluid in domes from LLC-PK1 cells was isotonic with the culture medium and no Cl gradient between domes and medium was present. Fluid from domes formed by MDCK1 cells was also isotonic with respect to Na and K but there was a persistent Cl concentration gradient. To evaluate prostaglandin (PG) production by these cell lines, the culture medium was analyzed for PGE. LLC-PK1 cells released no measurable PGE; MDCK1 cells regularly released PGE both during basal conditions and after augmentation of PG synthesis by a high Ca concentration in the medium. Qualitatively similar results had previously been found with these cell lines when PG synthesis was augmented with addition of arachidonic acid or Ca ionophore A23187, and PGE or 6-keto-prostaglandin F1 alpha was measured in the medium. To evaluate whether PGs might be responsible for the Cl gradient across MDCK1 cells, indomethacin or meclofenamate was added. There was a marked decrease in the Cl gradient with either agent at 5 h. To evaluate the possibility that PGE2 or PGI2 plays a role in maintaining this Cl gradient, further studies were done in which indomethacin was added to the culture medium to block endogenous PG synthesis, and exogenous PGE2 or PGI2 was added. Although addition of PGE2 was without effect, addition of PGI2 to indomethacin-treated cells maintained the Cl gradient for at least 5 h.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3513623 TI - Effects of graded changes in reflex renal nerve activity on renal function. AB - The effects of reflexly produced graded increases in renal nerve activity on excretion of sodium and potassium, urinary flow, glomerular filtration rate (GFR), renal plasma flow (RPF), renin release, and renal venous norepinephrine (NE) overflow were examined in anesthetized dogs. Renal nerve activity was increased by carotid artery occlusion while renal perfusion pressure was held constant. Linear correlation was determined by plotting the percent change from control for each dependent variable vs. the percent change in mean renal nerve activity (MRNA). The percent changes from control for sodium excretion and urinary flow were negatively correlated with percent change from control in MRNA (P less than 0.01), and the percent change from control for renin release was positively correlated with percent change from control in MRNA (P less than 0.05). NE overflow was observed to increase as renal nerve activity increased. These results indicate that physiologically elicited increases in MRNA from 10 to greater than 100% are significantly correlated with changes in sodium excretion, urine flow, and renin release with little or no measurable change in GFR, RPF, or potassium excretion. PMID- 3513624 TI - Differential effect of thyroxine on atrial and ventricular isomyosins in rats. AB - Two myosin heavy chains (MHCs), alpha and beta, which exhibit different levels of ATPase activity related to the different velocities of muscle shortening, are differentially expressed in rat cardiac ventricles, depending on the developmental stage and the thyroid status of the animals. In contrast, no changes have been reported concerning the expression of atrial MHCs in the same physiological and pathological conditions. We have now performed studies with sensitive techniques to test the hypothesis that the expression of alpha- and beta-MHCs can also be modulated in the rat atria, although at a low level. Atrial and ventricular isomyosin patterns of various groups of rats were examined by two dimensional peptide mapping, immunofluorescence with specific anti-alpha- and anti-beta-MHC immunoglobulins, and electrophoresis under nondenaturing conditions. Normal ontogenic development of the atria is characterized by the disappearance of a small amount of beta-MHC, present at 19 days in utero. At 3 wk of age, atria and ventricles both contain only alpha-MHC. Severe hypothyroidism, produced either by methylthiouracil (MTU) treatment of pregnant females and of their litters or by hypophysectomy of adult animals, did not significantly deinduce atrial alpha-MHC but was characterized by a significant although slight accumulation of beta-MHC (less than 5% of total myosin). This latter effect was abolished by L-thyroxine restoration. It is concluded that alpha- and beta-MHC are developmentally and hormonally regulated both in atria and ventricles, although the extent of regulation is very different for the two tissues. PMID- 3513625 TI - Continuous blood densitometry: fluid shifts after graded hemorrhage in animals. AB - To evaluate rapid fluid shifts after graded hemorrhage in splenectomized animals, four pigs and two dogs were bled 15-23 ml/kg body wt in steps of 2.2-6.0 ml/kg. Arterial blood density (BD), mean arterial pressure (MAP), and central venous pressure (CVP) were recorded continuously, and arterial plasma density (PD) and hematocrit (Hct) were determined from blood samples. Erythrocyte density was computed from PD, BD, and Hct. Starting with stable control conditions, MAP, CVP, and BD fell from the beginning of hemorrhage. Each blood withdrawal was followed by an immediate and rapid decrease in BD, even at the lowest (less than 3 ml/kg) initial blood losses. The time course of BD change mirrored that of the volume replacement, with time constants of 3.0-9.6 min and amplitudes depending on the magnitude of the relative volume loss. The PD decrease was significant (P less than 0.01) after 5.4 +/- 0.7 ml/kg hemorrhage. At 15 ml/kg blood loss the mean PD and BD had dropped by 0.99 +/- 0.15 and 2.42 +/- 0.26 g/l, respectively, and Hct had dropped by 2.40 +/- 0.47 units. Calculations suggest that either the inward shifted fluid has a higher density than normal ultrafiltrate and/or there is a rise of the whole-body-to-large vessel Hct (F cell ratio). The rapid fluid replacement ranged from 5.8 +/- 0.8 to 10.6 +/- 2.0% of the initial plasma volume, or one-fifth to one-third of the lost volume with a 20% hemorrhage. Transvascular fluid shifts can be monitored with continuous high-precision blood densitometry. PMID- 3513626 TI - Dural sinus pressure: various aspects in human brain surgery in children and adults. AB - To prevent air embolism and minimize neurosurgical venous hemorrhage, the dural sinus pressure (confluens sinuum pressure, CSP) was examined under various conditions in 47 cases, 11 of whom were children. Either the extracranial (group A) or catheter type (group B) pressure transducer was used. The latter gave approximately 30% higher values than the former. In any surgical position, children showed a tendency toward higher pressure than did adults. This was particularly the case in the sitting position; adults showed negative pressure [ 8.6 +/- 2.3 (SD) mmHg, group A], whereas all eight children less than 9 yr of age (group A, 5 cases; group B, 3 cases) showed positive pressure. The youngest with negative CSP in a sitting position was a 9-yr-old boy. When the upper half of the body was raised, the CSP decreased linearly and became zero at approximately 25 degrees. In anteflexion of the neck, the CSP decreased significantly, and even with inclination of the upper half of the body of only 15-20 degrees or more upward, negative pressure was observed in adults. In children, right and left rotation of the neck showed remarkable increase of the CSP. In both supine and sitting positions, CSP was elevated sufficiently by bilateral jugular compression to prevent air embolism. Positive-pressure respiration did not raise the CSP, contrary to widely accepted knowledge. This study was originally performed in relation to brain surgery, but the results also seemed to be valuable in physiology. PMID- 3513627 TI - Vasopressin and renin response to plasma volume loss in spontaneously hypertensive rats. AB - Abnormalities in the vasopressin (VP) and renin-angiotensin systems have been described in spontaneously hypertensive rats (SHR). Responsiveness of these systems to a decrease in plasma volume was examined in the SHR at 6, 8, and 18 wk of age and compared with responses in age-matched normotensive Wistar and Wistar Kyoto rats (WKY). Trunk blood was collected 3 h after administration of 2 ml/100 g body wt of 0.9% saline, 15 or 30% polyethylene glycol (PEG), and in one group of conscious 8- and 18-wk-old rats, mean arterial pressure was monitored following PEG administration. Hematocrit and serum VP increased significantly in both strains at all ages following PEG. At 6 and 8 wk of age, the VP response to the PEG injection was significantly greater in SHR compared with WKY (P less than 0.005), but at 18 wk the response was comparable in the two strains. Serum renin activity (SRA) also increased in both strains receiving PEG at 6 and 8 wk of age, but the response was suppressed in the SHR relative to the WKY (P less than 0.001). At 18 wk of age, SRA increased in WKY, but the response was totally suppressed in SHR. Renal renin content in a separate group of rats was reduced in 19-wk-old SHR compared with WKY (P less than 0.001) but was not different in 5- and 8-wk-old rats. Thus there appears to be a hyperresponsiveness in the VP system in young SHRs that is not present in the renin-angiotensin system. The divergence in the responsiveness of the renin and VP systems and the attenuation of responsiveness in the VP system in 18-wk SHRs indicate a differential effect of the hypertensive process on the VP and renin systems in the SHR. PMID- 3513628 TI - Endothelial cell uptake of adenosine in canine skeletal muscle. AB - The vascularly isolated muscles in the hindlimbs of five dogs were perfused with an oxygenated physiological salt solution. The extractions of adenosine and of a nontransported analogue of adenosine, 9-beta-D-arabinofuranosyl hypoxanthine (AraH), were determined by the single-pass indicator-dilution technique. A bolus containing [125I]albumin (reference tracer), [14C]adenosine, and [3H]AraH was injected into the artery while samples of venous effluent were collected over the next minute. This injection was repeated with dipyridamole (10(-5) M) in the perfusate. Early extractions of AraH (EAra) and adenosine (EAdo) under control conditions were 48 +/- 4 and 80 +/- 4%, respectively. In the presence of dipyridamole, EAra was unchanged (47 +/- 5) while EAdo decreased to 45 +/- 7%. Since early extraction reflects primarily the barrier posed by endothelial cells, these results demonstrate significant endothelial uptake of adenosine. Analysis of these data using a mathematical model of blood-tissue exchange indicates that, under the conditions of these experiments, at least 78% of the adenosine taken up by skeletal muscle entered endothelial cells. PMID- 3513629 TI - Regulation of hepatic glucose output during exercise by circulating glucose and insulin in humans. AB - We have tested the hypothesis that hepatic glucose output (Ra) during exercise in humans is subject to feedback control by circulating glucose within a control range that is determined by the circulating insulin concentration. Three exercise protocols based on 60-min cycle ergometer exercise at 55% maximal O2 consumption were used: 1) control, 2) insulin infusion with a euglycemic clamp, and 3) insulin infusion with a fixed-rate glucose infusion. Ra was measured using a constant infusion of [3H]glucose. During the glucose clamp there was no Ra response to exercise. There were significant inverse relationships between Ra and plasma glucose during control exercise (r = -0.73, P less than 0.001) and exercise with fixed-rate glucose and insulin infusion (r = -0.96, P less than 0.001). During the fixed-rate glucose and insulin infusion, plasma glucose fell from the commencement of exercise but stabilized at a lower level. These results are interpreted in terms of a simple difference controller where Ra is proportional to the deviation of plasma glucose from a defined set point. Insulin affects Ra and regulates the steady-state glucose level by altering the sensitivity of this control system. PMID- 3513630 TI - The relationship between affective disorder and eating disorders: a review of the literature. AB - The authors review the relationship between affective disorder and anorexia nervosa and bulimia across five lines of inquiry: clinical reports, psychometrics, family history, drug studies, and follow-up investigations. They conclude that affective disorder and eating disorders are related but that the nature of the relationship is unclear. After discussing possible mediating patterns, the authors propose an interactive, multidetermined understanding as the most appropriate model. They recommend that future research in this area attempt to identify subpopulations of patients with affective disorder and eating disorders by means of a longitudinal, multilevel strategy with serial determinations. PMID- 3513631 TI - Treatment of schizophrenia with a vasopressin analogue. AB - Ten patients with chronic schizophrenia completed a 3-month double-blind, placebo controlled trial with a vasopressin analogue. Modest improvement occurred, but several patients also experienced significant fluid and electrolyte imbalance. PMID- 3513632 TI - Psychological and social aspects of the surgical treatment of obesity. AB - New surgical procedures have revolutionized the treatment of morbid obesity (more than 100% overweight), a condition associated with serious medical complications and for which conservative treatment has been largely ineffective. These procedures, which are surprisingly safe, produce large weight losses and marked improvement in hypertension, diabetes, and other disorders influenced by obesity. Striking changes also occur in vocational and psychosocial functioning, including marital and sexual relations, in eating behavior, in food preferences, and in body image. The emotional state of patients during weight loss following surgery is far superior to that during attempts at weight reduction by other methods. The surgical procedures appear to produce a major biological change, perhaps lowering a body weight set point. PMID- 3513633 TI - Psychotherapy of the narcissistic personality disorder patient: two contrasting approaches. AB - The differences in the theoretical and clinical approaches that Kernberg and Kohut have defined are used to discuss the psychodynamics and psychotherapy of the narcissistic personality disorder patient. Their contrasting contributions help clarify the nature of these patients' difficulties, the possibility that there is a spectrum of narcissistic disorders, the effect of existing theory and the personalities of clinicians-theoreticians on the collection of clinical data, and the effects of theoretical formulations on the psychotherapeutic process. PMID- 3513634 TI - Positive effects of carbamazepine on behavioral dyscontrol in borderline personality disorder. AB - In a double-blind crossover trial, carbamazepine, an anticonvulsant with primary effects on subcortical limbic structures, decreased the severity of behavioral dyscontrol in 11 women with borderline personality disorder significantly more than placebo. The authors emphasize the preliminary nature of their findings and discuss alternative hypotheses regarding mechanisms by which carbamazepine might influence behavioral dyscontrol. PMID- 3513635 TI - Diagnosis of adenocarcinoma in transurethral resectates of the prostate gland. AB - The often-posed question of how much prostate tissue should be examined microscopically to detect carcinoma in transurethral prostatectomy specimens was approached by prospective study and probability analysis. Transurethrally resected prostate specimens were weighed, totally embedded, and examined histologically in 151 consecutive cases. Resected fragments and fragments involved by carcinoma were enumerated for each case. Adenocarcinoma was diagnosed in 39 (25.8%) of the cases. Specimens containing carcinoma had a mean of 111 total fragments, with a median of 3 and mean of 7 positive fragments. In two clinically unsuspected cases of poorly differentiated adenocarcinoma, the number of fragments involved by carcinoma was small (2 of 164 and 4 of 190 fragments). Assuming that study of a single microscopic section of a fragment determines whether carcinoma is present, probability formulations are presented expressing the likelihood that at least one fragment containing cancer is found in randomly selected fragments from a specimen. To achieve a 95% probability of detecting carcinoma in TUR specimens, a minimum of 95% of the fragments must be examined if one fragment contains a carcinoma, 63.1% of the fragments if three contain carcinoma and 25.8% of the fragments if 10 contain carcinoma. Literature review indicates many authors recommend examining fewer fragments of transurethrally resected prostate tissue than this study indicates are required to diagnose carcinoma. PMID- 3513636 TI - Incidental carcinoma of the prostate. How much sampling is adequate? AB - A prospective study of 386 consecutive transurethral prostatic resections from 383 patients with clinically benign glands was undertaken to determine the optimal sampling of chips required for the histologic detection of all clinically significant prostatic carcinomas. Cancers were graded according to two systems and staged by counting involved chips as well as estimating volume density. All Stage A2 prostatic carcinomas were detected by histologic examination of 6 g of randomly selected chips. Although additional tumors were detected in direct proportion to the amount of tissue examined, they were small, well differentiated, Stage A1 lesions. Histologic sampling of 12 g of randomly selected prostatic chips detected almost 90% of incidental carcinomas, including all clinically significant neoplasms. PMID- 3513637 TI - Histogenesis of alveolar soft part sarcoma. An immunohistochemical and biochemical study. AB - In order to clarify the histogenesis of alveolar soft part sarcoma (ASPS), an immunohistochemical and biochemical study was performed on three cases. The immunohistochemical study indicated the presence of actin, desmin, vimentin, and Z-protein in all cases. On the other hand, intermediate filaments other than desmin and vimentin were not detected immunohistochemically. The presence of desmin and Z-protein strongly suggests the myogenic character of this tumor. As to whether ASPS shows striated muscle differentiation or smooth muscle differentiation, the immunohistochemical absence of myoglobin in the three cases suggests that the tumor does not differentiate in the direction of striated muscle. However, biochemical assay of subunits of enolase revealed significantly high amounts of beta-enolase, which is known as a marker for striated muscle, in all three cases. The determined values--735, 426, and 584 ng/mg of protein --are indicative of striated muscle differentiation. In addition, the immunohistochemical study of all cases revealed the presence of beta-enolase in tumor cells. These data definitely show the myogenic character and rhabdomyoblastic differentiation of ASPS. PMID- 3513638 TI - Introduction of the President, Paul P. Weinstein. PMID- 3513639 TI - Filariasis: problems and challenges. PMID- 3513640 TI - Field trial in Chiapas, Mexico, of a rapid detection method for malaria in anopheline vectors with low infection rates. AB - A method consisting of filtration of up to 100 macerated mosquitoes in a batch, followed by fixation with glutaraldehyde and concentration of filtrate by centrifugation has been developed to rapidly assess malaria infection in anopheline mosquitoes. Determination of the presence of sporozoites is made by observation of a sample of the final filtrate with a phase microscope. The method is simple and field adaptable, essential factors for the application of any technique to large scale field operations. Application of the technique in El Gancho, Chiapas, Mexico, in February 1984 yielded an infection rate for Anopheles albimanus of 0.9% for intradomicile-collected human bait mosquitoes and 0.1% for peridomicile-collected human bait mosquitoes. PMID- 3513641 TI - The susceptibility of Plasmodium falciparum to sulfadoxine and pyrimethamine: correlation of in vivo and in vitro results. AB - In 1982, 2 of 14 Plasmodium falciparum infections acquired in East Africa and diagnosed in Copenhagen were resistant to treatment with sulfadoxine plus pyrimethamine (Fansidar), while in 1983, 6 of 18 were so. The in vivo tests were supplemented by determinations of drug concentrations in serum, and 4 isolates from in vivo-sensitive cases and 6 from in vivo-resistant cases were selected for in vivo tests. These were performed in ordinary RPMI 1640 medium and in a medium with physiological p-aminobenzoic acid and folic acid concentrations. Pharmacokinetic aberrations were found to be of possible importance in only 2 of the in vivo-resistant cases. In vitro susceptibility to sulfadoxine was found to be uniformly low in all isolates. Testing with a combination of sulfadoxine and pyrimethamine in the medium with physiological concentrations of cofactors probably reflects the in vivo situation most accurately, but in all but 1 of the isolates studied in vitro the in vivo susceptibility to Fansidar would be predicted by in vitro susceptibility to pyrimethamine in either medium. The concentration of p-aminobenzoic acid in serum, quantitated by high performance liquid chromatography, was found to be subject to wide variation, and this may have implications for in vitro testing. PMID- 3513643 TI - Detection of antibodies to Plasmodium vivax by indirect immunofluorescence: influence of the geographic origin of antigens and serum samples. AB - The results of a double-blind serological study of 15 sera sampled in a residual focus of vivax malaria transmission in Algeria, and of 7 sera from patients with slide-proven P. vivax infections acquired in India, are analyzed. The reactivity of each of these serum samples was tested by indirect immunofluorescence using 6 different batches of antigen, including 3 batches of P. vivax antigen prepared with isolates from Zaire (Africa), India and the Solomon Islands, respectively. The geometric mean of reciprocal titers (GMRT) calculated on the 7 sera from proven vivax infections fell from 289.8 using the homologous antigen from the same geographic origin (India) to 48.7 using a homologous (vivax) antigen originating from a different continent (Africa). Among the 15 samples from Algeria, the percentage of seropositives decreased from 100% using the homologous P. vivax antigen originating from the same continent (Africa) to 53.3% using a homologous antigen from India. Two aspects are included in the discussion: in seroepidemiological studies, sensitivity could be improved by the use of a homologous antigen from the same geographic origin; in detection of clinical cases of malaria and species identification based on serology, our results stress the need for caution in interpreting serological titers and for taking into account the geographic origin of the isolates used as antigen. PMID- 3513642 TI - Treatment of falciparum malaria with quinne and tetracycline or combined mefloquine/sulfadoxine/pyrimethamine on the Thai-Kampuchean border. AB - Three different regimens were compared for treatment of falciparum malaria in displaced Kampucheans living in encampments on the Thai-Kampuchean border in 1983: single dose 750 mg mefloquine, 1.5 g sulfadoxine, 75 mg pyrimethamine (MSP); 600 mg quinine 8-hourly for 3 days and 500 mg tetracycline 8-hourly for 7 days (Q3T7); or 600 mg quinine 8-hourly for 7 days and 500 mg tetracycline 8 hourly for 7 days (Q7T7). Radical cure rates were 98% (40/41) for MSP, 76% (32/42) for Q3T7 and 92% (33/36) for Q7T7. The criterion for treatment failure was reappearance of parasites by 35 days after commencement of treatment or no parasite clearance. Treatment failures comprised one case of reduction but no clearance of parasites (RII resistance) for MSP, 10 recrudescences (RI) for Q3T7 and 3 recrudescences (RI) for Q7T7. The radical cure rate for Q3T7 was significantly lower than that for MSP (P less than 0.01), whilst Q7T7 significantly from the other groups. Parasite clearance time was shorter (2.4 days) with MSP than with Q3T7 (3.5 days) and Q7T7 (3.3 days). There was little difference in side effects between the regimens, and tolerance was good. The MSP and Q7T7 regimens are both effective for treatment, but the single dose of MSP is much easier to manage than 7 days of quinine and tetracycline. PMID- 3513644 TI - Effects of chloroquine, amodiaquine and pyrimethamine-sulfadoxine on Plasmodium falciparum gametocytemia. AB - The effects of chloroquine, amodiaquine and pyrimethamine-sulfadoxine (SP) (Fansidar) on the infection rate and density of Plasmodium falciparum gametocytes were studied in 198 patients with falciparum malaria from an area in the Punjab where malaria is endemic but seasonally transmitted. One month following treatment of 100 patients, SP had reduced the gametocyte carrier rate from 37% to 6% and the mean gametocyte density from 80 to 1.4 per mm3 of blood. Chloroquine and amodiaquine were much less effective. Since SP has no gametocytocidal properties and the reduction in gametocytes coincided with clearance of asexual parasitemias, gametocytes were probably reduced subsequent to the cure of the asexual malaria infections. If used during the nontransmission season, SP might be an effective component of an integrated program for reducing malaria transmission in the Punjab and other areas where 4-aminoquinoline-resistant and SP-sensitive falciparum malaria exists. PMID- 3513645 TI - Observations on early and late post-sporozoite tissue stages in primate malaria. IV. Pre-erythrocytic schizonts and/or hypnozoites of Chesson and North Korean strains of Plasmodium vivax in the chimpanzee. AB - In a continuing reexamination of plasmodial tissue stages within the context of the hypnozoite theory of malarial relapse, 2 strains of Plasmodium vivax with distinct and disparate relapse characteristics in humans were studied in chimpanzees. Following intravenous inoculation of massive numbers of salivary gland sporozoites, both the frequently relapsing Chesson strain and a North Korean strain characterized by predominantly delayed relapses exhibited relapse patterns and antimalarial sensitivity in the splenectomized chimpanzee essentially indistinguishable from those seen in humans. Examination of hepatic biopsies obtained at 7 and 10 days after infection revealed both pre-erythrocytic (pre-e) schizonts and hypnozoites in tissue obtained from the animal infected with the Chesson strain, but only rare hypnozoites (no pre-e schizonts) at 7 days in the animal infected with the North Korean strain. These findings, combined with the comparability of relapse behavior--which indicates the suitability of the chimpanzee as a model for the natural (human) host-parasite relationship--are essentially as predicted by the hypnozoite theory, despite the small numbers of tissue forms seen. Pre-erythrocytic schizogony of the Chesson strain in the liver was essentially indistinguishable from that of other strains studied, also underlining the suitability of this model system for tissue stage studies of P. vivax. PMID- 3513646 TI - An oocyst-transmitted outbreak of toxoplasmosis: patterns of immunoglobulin G and M over one year. AB - Sera from 32 patients who became ill after jungle combat training were tested for antibodies to Toxoplasma gondii using the indirect immunofluorescence test. Swift rises of both IgG and IgM antibodies occurred within 2 weeks of infection. Reduction in IgM titers, due to competitive suppression by IgG antibody, occurred in most but not all cases. Suppression of IgM reaction by IgG antibody could be prevented by adsorption of serum with Staphylococcus aureus containing protein A. Antibody of the IgM class could be detected at greater than or equal 1:256 level in many sera at 6-month and 1-year intervals after exposure. In groups with exposures such as were experienced in this study, the presence of IgM antibody titers in single serum specimens cannot be used to indicate recent exposure. Both IgG and IgM antibody may rise together to high levels very rapidly after infection; IgM did not precede IgG antibody in our 32 subjects. PMID- 3513648 TI - Experimental inoculation of Peromyscus spp. with Borrelia burgdorferi: evidence of contact transmission. AB - In order to determine if Peromyscus spp. could become infected with the Lyme disease spirochete (Borrelia burgdorferi) by direct inoculation and to determine the duration of spirochetemia, 4 P. leucopus and 5 P. maniculatus were inoculated by the intramuscular, intraperitoneal, and subcutaneous routes with an isolate of B. burgdorferi obtained from the blood of a trapped wild P. leucopus from Camp McCoy, Wisconsin. All of the mice developed antibodies to B. burgdorferi which reached a peak indirect immunofluorescent (IFA) geometric mean antibody titer of 10 log2 21 days post-inoculation. B burgdorferi was recovered from the blood of 1 P. maniculatus 21 days post-inoculation. One uninfected Peromyscus of each species was housed in the same cage with the infected Peromyscus as a contact control. Both of the contact controls developed IFA B. burgdorferi antibodies by day 14, indicating contact infection. To determine if B. burgdorferi was being transmitted by direct contact, 5 uninfected P. leucopus and 5 uninfected P. maniculatus were caged with 3 B. burgdorferi infected P. leucopus and 3 infected P. maniculatus, respectively. Each of these contact-exposed P. leucopus and P. maniculatus developed antibodies to B. burgdorferi, and B. burgdorferi was isolated from the blood of 1 contact-exposed P. maniculatus 42 days post-initial contact. These findings show that B. burgdorferi can be transmitted by direct contact without an arthropod vector. PMID- 3513647 TI - Mansonella ozzardi in Haiti. IV. Evaluation of antibody reactivity to heterologous antigens. AB - Sera from individuals in an area of Haiti endemic for Mansonella ozzardi were analyzed for reactivity to antigens of Brugia pahangi, Dirofilaria immitis, Mansonella llewellyni or Ascaris lumbricoides using either an enzyme-linked immunosorbent assay or an indirect immunofluorescent antibody test. IgM and IgG reactivity to all antigens was observed with sera from both microfilaremic and amicrofilaremic individuals when compared to reactivity of sera from individuals from nonendemic areas. Antibody reactivity to B. pahangi was greater than that to other antigens. IgG reactivity of sera from endemic patients to filarial antigens was consistently greater than that of IgM. Antibody reactivity was not correlated with age or microfilarial density. PMID- 3513649 TI - Application of indirect hemagglutination test and indirect fluorescent antibody test for IgM antibody for diagnosis of melioidosis in Thailand. AB - In hyperendemic areas such as Thailand, rapid diagnosis of melioidosis depends upon both bacteriological culture and serological methods. However, interpretation of indirect hemagglutination (IHA) for melioidosis which is the only test available, is seriously hampered by increased IHA titers present in one third to one-half of the population. In order to get the best results from the available tests, IHA and indirect fluorescent antibody for IgM (IFA-IgM) were evaluated in controls and patients in Thailand. IHA titers of greater than or equal to 1:40 were considered remote or recent exposure to P. pseudomallei. IHA titers of this level were found in 47.1% of 227 blood donors and 29.5% of 210 sera submitted for other tests, while IFA-IgM was positive in only one donor who had an IHA titer of 1:1,280. IHA was positive in eight out of nine patients with melioidosis with IHA titers of less than 1:20 to 1:2,560. IFA-IgM was positive in six out of seven melioidosis patients whose sera were available for this test including a serum with IHA titer of less than 1:20. Six patients were predisposed by diabetes mellitus. Among sera serologically tested for melioidosis, 33 had IHA titers of 1:80-1:1,280, 10 of which were positive for IFA-IgM. This study demonstrates high background IHA titers among IHA titers among Thai people which greatly limits its use for serodiagnosis of melioidosis. In sharp contrast, serodiagnosis by IFA-IgM was more successful. Positive IFA-IgM among healthy Thais did exist indicating that serologic tests for melioidosis at best are only supplementary to bacteriological culture and clinical awareness. PMID- 3513650 TI - Identification of an antigenic and genetic variant of dengue-4 virus from the Caribbean. AB - Twenty-one dengue (DEN) viruses isolated from the Caribbean (Dominica and Jamaica) during the 1981-1982 epidemic year were distinct serological and genetic variants of DEN-4 virus. These isolates were clearly identified as DEN-4 viruses using type-specific monoclonal antibodies in indirect immunofluorescence assays. However, they either were not neutralized, or were neutralized poorly using hyperimmune mouse ascitic fluids (HMAF) or rhesus monkey serum directed against the H-241 prototype strain of DEN-4 virus isolated in the Philippines in 1956. HMAF prepared against a representative Caribbean isolate, however, neutralized with similar effectiveness the homologous virus, the H-241 prototype strain, and virus strains isolated from the Pacific and Southeast Asian areas from 1973 to 1984. The Caribbean isolate exhibited no more than 30% and 16% oligonucleotide spot homology with the H-241 and Bangkok viruses, respectively, by RNA fingerprint analysis, while demonstrating 82% and 89% homology with the Gilbert and Niue Island isolates, respectively. The isolation of dengue viruses which are serologically and genetically distinct from the prototype virus emphasizes the need for continued dengue virus surveillance. The recognition of unique dengue isolates should allow the selection of reference strains and vaccine candidate strains which will induce antibodies that are equally effective in neutralizing viruses from all geographic areas. PMID- 3513651 TI - Treatment of breast cancer through the ages. AB - Considerable controversy still exists regarding the correct management of cancer of the breast. This short history follows the paths of thought and practice from the Egyptian dynasties to modern times. A description is given of the pathologic reasons for the variance in local treatment and the development of adjuvant therapy. PMID- 3513652 TI - Cholecystectomy: clinical experience with a large series. AB - This large series of 1,035 consecutive operations with a primary diagnosis of inflammatory or calculus disease of the gallbladder included a large number of elderly patients with the greatest incidence in the seventh and eighth decades of life. Operation was performed after initial stabilization when acute illness presented and without prolonged delay of medical treatment. Cholecystectomy was almost always able to be performed successfully at the initial operation. This approach produced low rates of morbidity and mortality when compared with reports from large university centers and with reports advocating delayed operation for acute cholecystitis or planned cholecystostomy in elderly and high risk patients. Operative cholangiograms were rarely performed and rates of residual or retained common duct stones were low. Length of hospital stay was related to age and performance of a common duct exploration. Draining the subhepatic space routinely by way of a separate peritoneal stab incision and removing the drain within 48 hours produced a low rate of wound complications. PMID- 3513653 TI - Low incidence of urologic complications after renal transplantation. AB - The incidence of urologic complications after renal transplantation has been reported to range from less than 1 to 10 percent. They are still a significant source of morbidity and mortality. We report on 111 kidney transplants performed at the San Juan Veterans Administration Hospital in 85 of whom urinary continuity was restored with a Politano-Lead-better ureteroneocystostomy, 23 with the Lich Gregoir operation, and 3 with extravesical urinary, diversions. Important factors included meticulous attention to details during ureter manipulation, the use of prophylactic antibiotics, unabsorbable sutures in the closure of the muscular part of the bladder wall and infrequent use of drains. This resulted in a low rate of complications which included early ureteral obstruction (3.6 percent), late ureteral obstruction (1.8 percent), lithiasis (1.8 percent), urinary extravasation (0.9 percent), and ureteropelvic necrosis. No kidneys or patients were lost to technical complications, and no deep wound infections were observed. Our experience demonstrates the beneficial effects of a low complication rate on patient and graft loss. PMID- 3513654 TI - Chemical and microbiologic characteristics and toxicity of povidone-iodine solutions. AB - The chemical, microbiologic, and toxic characteristics of povidone-iodine solution, a commonly used antiseptic agent, are addressed in a collective review of relevant works published from 1956 to the present. Interactions of this agent with the thyroid gland and the kidneys and its toxicity at the cellular and systemic level are discussed. PMID- 3513655 TI - Antenatal diagnosis of fetal anomalies and the reproductive ultrasound fetal malformation registry. PMID- 3513656 TI - Peer review in a competitive market. PMID- 3513657 TI - Provider and practitioner responsibilities, sanction, and abuse. PMID- 3513658 TI - New developments in spinal surgery. PMID- 3513659 TI - Assisted ventilation and the Servo ventilator in infants. An assessment of three systems used for CPAP/IMV. AB - A laboratory assessment was made of systems used for Continuous Positive Airway Pressure/Intermittent Mandatory Ventilation (CPAP/IMV) with the Servo 900B and 900C ventilators. Pressure-volume loops recorded during sine wave oscillation using an external CPAP/IMV system were similar to those found during normal respiration. Pressure-volume loops using the systems based on the ventilator's inbuilt trigger mechanism were very different, particularly for the 900B. The results were confirmed by measurements in two infants. The implications of these findings with reference to the weaning of infants from mechanical ventilation are discussed. PMID- 3513660 TI - Pulmonary oedema following acute upper airway obstruction. PMID- 3513661 TI - Surgery without pain--Part 1: Background. AB - This paper was commissioned to cover the beginnings of anaesthesia: the transition from surgical operations with pain to those without. It reviews some previous pre-anaesthetic histories (Part I): it focuses upon attitudes to pain; and it seeks evidence from the one hundred years before the discovery of anaesthesia. Finally (Part II) it outlines the introduction of nitrous oxide and of ether anaesthesia. PMID- 3513662 TI - A nitrocellulose filter binding assay for ribonucleotide reductase. AB - Protein B1, one of the two nonidentical subunits of Escherichia coli ribonucleotide reductase, contains two classes of binding sites for nucleoside triphosphates. One class (h-sites), with a high affinity for dATP (KD = 30 nM) regulates the substrate specificity, while the other (l-sites), with a lower affinity for dATP, regulates overall activity. These classes were defined from experiments involving equilibrium dialysis. Here we describe a sensitive alternative method to measure nucleotide binding to ribonucleotide reductases that gave the same results as equilibrium dialysis. The method involves the protein-specific binding of radioactive nucleotides to nitrocellulose filters. We believe that this method will be useful in binding studies with pure reductases from sources other than E. coli, for the characterization of mutants with changed allosteric properties, and as an assay during purification of reductases containing an h-site for dATP. PMID- 3513663 TI - Dynamic features of duct epithelial cells in the mouse pancreas as shown by radioautography following continuous 3H-thymidine infusion. AB - The possibility of turnover of the epithelial duct cells was examined in the adult mouse pancreas by radioautography following continuous administration of 3H thymidine for periods varying from 1 h to 60 days. One hour after an injection of 3H-thymidine, the label observed in small and large ducts was low but increased with the duration of the continuous infusion of 3H-thymidine and reached a level of about 67% cells labeled after 60 days. The rate of duct cell labeling was estimated from the regression line of the labeling index vs. time in four types of ducts classified according to their inner diameter and the presence of the adventitia and was given as 0.60% cells per day in small (adventitia-free) ducts (phi 4-12 micron), 0.89%, 1.02%, and 1.23% cells per day in large (adventitia including) ducts (phi 15-29, 30-49, and 50-160 micron respectively). In contrast, the labeling index of aciner cells after a 60-day infusion indicated an addition of only 0.02-0.07% per day, and that of islet cells 0.14-0.22% per day. It is known that most parenchymal cells belong to either expanding or renewing cell populations. The acinar cells of the pancreas have been shown to constitute an expanding population, a conclusion confirmed by the low addition of cells observed in the present work. However, the relatively high rate of cell addition in the duct epithelia indicates that they may turn over in a period of 2.7 months in the case of large ducts and 5.6 months in the case of small ducts.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3513664 TI - Three-dimensional observation of the intrahepatic lymphatics by scanning electron microscopy of corrosion casts. AB - The three-dimensional arrangement of intrahepatic lymphatics was demonstrated in the rabbit liver by scanning electron microscopy of corrosion casts. These casts were prepared by injecting resin into the common bile duct at a pressure that caused resin to leak from the bile ducts in the small portal tracts and drain into the lymphatics. The lymphatic channels were composed of straight vessels and anastomosing short side branches. The anastomoses were especially rich at the bifurcation of the portal tracts and formed a network. The terminal branches were blind-ended. Constrictions suggesting valves were occasionally observed. PMID- 3513665 TI - Harvey Cushing: his contribution to anesthesia. PMID- 3513666 TI - An appreciation of the coronary circulation. AB - Coronary sinus catheter techniques for evaluation of coronary flow and myocardial metabolism have the drawback that a global sampling method is used to evaluate a regional disease (coronary artery disease). Studies on the coronary circulation are further limited by the fact that interventions acting on the coronary bed may simultaneously modify several of the principal determinants of coronary blood flow. Results are also influenced by differences among species, and whether the coronary vascular bed is normal or pathologically narrowed. Because coronary flow is intimately coupled to myocardial oxygen demand, interpretation of values as abnormal require simultaneous evaluation of some index of myocardial oxygen consumption. Under normal conditions, myocardial flow is predominantly in diastole, and is subject to compromise by factors that abbreviate diastole (e.g., tachyarrhythmias). Autoregulation maintains constant coronary blood flow over a range of perfusion pressures (60-130 mm Hg), and increased flow demands are normally met by coronary vasodilation (coronary flow reserve). In proximal coronary stenosis, this capacity for additional vasodilation may be significantly reduced, and flow to potentially ischemic beds beyond the stenosis may be maintained by collaterals. Pharmacologic coronary vasodilation in this situation can result in coronary steal. When perfusion pressure decreases below the autoregulatory range, or when coronary flow reserve is exhausted early, as in coronary stenosis, flow becomes dependent on mechanical factors including duration of diastole and the perfusion pressure. In these situations, monitoring heart rate and diastolic pressure would allow reasonable assessment of adequacy of coronary flow and myocardial perfusion. PMID- 3513667 TI - Succinylcholine pretreatment with magnesium sulfate. AB - The effect of pretreatment with 60 mg/kg magnesium sulfate on the neuromuscular blockade and consequent potassium release produced by 1.5 mg/kg succinylcholine in ten normal patients was compared with ten saline pretreated control patients. Magnesium had no significant effect on the characteristics of the paralysis. In control patients, serum potassium increased by an average of 0.57 +/- 0.20 (SEM) mmol/L. No patient in the magnesium group had an increase in serum potassium (mean change -0.05 +/- 0.02 mmol/L). The difference between the groups was statistically significant (P less than 0.01). PMID- 3513668 TI - Understanding the blood culture report. AB - There are no hard-and-fast rules for judging whether an organism is a pathogen or contaminant. Experience is critical. In the end, the physician is responsible for determining whether an organism is a contaminant or a pathogen on the basis of laboratory and clinical data, which often include patient history, physical examination, body temperature, peripheral leukocyte count and differential, clinical course, and culture results. When blood culture results are given to a nurse, she or he should communicate this information to the attending physician as soon as possible, with greatest emphasis placed on positive cultures with probable pathogens. The assumption that a blood culture isolate is a pathogen, in the absence of other supporting facts, can lead to inappropriate therapy. On the other hand, assuming a pathogen to be a contaminant can ultimately lead to patient mortality if treatment is delayed. Questions as to how blood cultures are handled should be directed to microbiology personnel, whereas interpretation problems should be discussed with infectious disease specialists. Good communication among the nurses, laboratory personnel, and physicians involved with blood culture studies is invaluable to effective patient care. PMID- 3513669 TI - The use of ketotifen in the prophylaxis of seasonal allergic asthma. AB - This double-blind parallel group study evaluated ketotifen 1 mg bid versus placebo in the treatment of 30 adult seasonally allergic asthmatics during the course of the spring pollen season. Those individuals on placebo had a fall in FEV1 through the pollen season, those on Ketotifen generally did not, and some individuals, in fact, showed improvement. Those patients receiving ketotifen had fewer allergic symptoms, better exercise tolerance, and in general had a better spring. This study demonstrated that ketotifen may have some benefit in the treatment of adult allergic asthma. PMID- 3513670 TI - Oxitropium bromide, a new anticholinergic bronchodilator. AB - Oxitropium bromide (OB) is a quaternary ammonium congener of hyoscine with anticholinergic properties. We studied its bronchodilating properties in 14 patients with chronic obstructive lung disease without features of asthma in whom theophylline and other bronchodilators were withheld. Five doses of OB(20, 40, 100, 200, and 400 micrograms) as well as 150 micrograms of isoproterenol (ISO) and placebo were administered by metered-dose inhaler on separate occasions in a double-blind fashion. Pulmonary function (flow volume loops and airways resistance), blood pressure, and pulse rate were measured at baseline and periodically for eight hours after drug administration. Onset of bronchodilator effect was within five minutes for OB (P less than .025). Duration of action of OB was at least eight hours (P less than .025). The dose response characteristics of OB were examined by correlating the log dose with the areas under the time FEV1 curve (r = .97, P less than .01), the time-forced vital capacity curve (r = .98, P less than .01), and the time-SGAW curve (r = .83, P less than 0.1). For FEV1, doses of 40 to 400 micrograms were significantly better than placebo and 100 to 400 micrograms were better than ISO (P less than .01). For forced vital capacity, all doses of OB were better than placebo (P less than .05). For SGAW, the response to the 100- and 400-micrograms doses were significantly better than placebo and isoproterenol (P less than .05). There were no significant effects of OB on pulse, blood pressure, or electrocardiogram. No side effects were noted from the use of OB.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3513671 TI - Traumatic thoracic aorta-innominate vein fistula: a case report. AB - Traumatic thoracic aorta-innominate vein fistulae are very rare. We present the case of a 20-year-old woman who sustained a stab wound to the left side of the chest. The physical examination was unremarkable. A chest radiograph showed a widened mediastinum, and arteriography demonstrated an arterio-venous fistula involving the thoracic aorta and the innominate vein. Operative repair was accomplished and the patient recovered. PMID- 3513672 TI - Current status of plasmapheresis in toxicology. AB - Although the elimination of specific toxins by the removal of all plasma constituents is a crude approach, further refinements of the technique should permit safer and more selective detoxification in the future. Currently the mainstay of treatment of intoxicated patients remains careful, aggressive, supportive care. Plasmapheresis should be considered as yet an unproven, hazardous form of therapy for the treatment of intoxication. Its main role should be confined to a research setting in which investigators attempt to develop more advanced and potentially useful apheresis techniques. Membrane plasmapheresis with subsequent on-line treatment of the plasma by sorbent may remove specific plasma solutes. The plasma may be perfused back to the patient without the need to use replacement fluids, thus avoiding many of the side effects of conventional exchange. Bile acids have been removed by circulating plasma over charcoal-coated glass beads, and several toxic substances were shown to be absorbed by perfusion over amberlite resin columns. Another productive area for future research includes the use of plasma exchange therapy for the treatment of acute endogenous intoxications. Recent examples include the treatment of severe preeclampsia, extensive rhabdomyolysis, and life-threatening bleeding in a hemophiliac with inhibitors to clotting factors. Although plasmapheresis in the management of intoxications is still an experimental technique, it may open the door to the treatment of previously intractable syndromes, both medical and toxicologic. PMID- 3513673 TI - Insulin and glucose levels. PMID- 3513674 TI - Comparative prevalence of four enterotoxin genes among Escherichia coli isolated from swine. AB - Presence of Escherichia coli enterotoxin genes LT (heat-labile enterotoxin), STaP (heat-stable enterotoxin a, porcine genotype), STaH (heat-stable enterotoxin a, human genotype), and STb (heat-stable enterotoxin b) among 874 swine isolates of E coli was determined, using DNA probes and the DNA colony hybridization technique. Of the 874 isolates evaluated, 45% hybridized with at least one of the enterotoxin gene probes and were designated as enterotoxigenic E coli (ETEC). Eighty-five percent of the ETEC were from pigs with enteric colibacillosis. The remaining 15% were from pigs with edema disease or various other diseases, and from healthy swine. Seventy-four percent of the ETEC hybridized with the STb probe, 52% with STaP, and 31% with LT; ETEC did not hybridize with the STaH probe. Most of the ETEC hybridized with more than one enterotoxin gene probe. Isolates that hybridized with the LT probe also hybridized with STb. The most prevalent gene combination was LT-STb. However, 35% of the ETEC from neonatal (less than or equal to 1 week old) swine with enteric colibacillosis were of the STaP-only genotype, and 33% of the ETEC from older swine with enteric colibacillosis were of the STb-only genotype. PMID- 3513676 TI - Developmental alterations in the regulation of glucagon and insulin secretion in Holstein calves. AB - Twenty-one Holstein bull calves were randomly assigned at birth to 3 groups. Two groups (each of 7 calves) were raised as follows: fed a milk diet alone or fed milk with grain supplementation after 2 weeks of age; studies were done when calves reached 4 weeks of age. The 3rd group was fed on milk with grain supplementation until weaning after which the calves were maintained on grain and pasture. These calves (older calves) were studied at 12 weeks of age. Either propionate (0.28 mmol/kg) or glucose (0.56 mmol/kg) was injected IV in a random order. Samples of blood were obtained from the calves before and immediately after injections were done and at 2, 5, 10, 15, 30, 45, and 60 minutes after secretagogue injection. Plasma was examined for glucose by a glucose oxidase procedure and for immunoreactive insulin (IRI) and glucagon (IRG) by radioimmunoassay. The IRI response to the injection of glucose was greater in older calves (P less than 0.02). Patterns of IRI secretion, as determined by heterogeneity of regression, showed age differences for both secretagogues (P less than 0.05). Base-line IRG was greater in milk/grain-fed calves than in milk fed calves (P less than 0.05). Mean IRG response to propionate injection was higher (P less than 0.05) in milk/grain-fed calves than in milk-fed calves. Plasma glucose concentration increased in older calves, but decreased in milk-fed calves after propionate injection. The data indicate that maturation in the ruminant is accompanied by altered regulation of insulin and glucagon secretion.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3513675 TI - Growth inhibition of environmental mastitis pathogens during physiologic transitions of the bovine mammary gland. AB - Ten dairy cows were infused intramammarily near drying off with concanavalin A (conA) or phytohemagglutinin (PHA). Mammary secretions were collected during physiologic transitions of the udder and were used in an in vitro microbiological assay to determine growth inhibition of mastitis pathogens. As mammary involution progressed, in vitro growth inhibition of Klebsiella pneumoniae, Escherichia coli, and Streptococcus uberis increased. Mammary secretions from conA- and PHA treated glands had significantly increased bacterial growth inhibition. Secretions contained significantly increased concentrations of lactoferrin and a decreased citrate:lactoferrin molar ratio earlier in the dry period than did control mammary secretions. Greatest bacterial growth inhibition was observed in mammary secretions obtained 7 days before parturition. However, differences in secretion composition or bacterial growth inhibition were not found between conA- or PHA-treated and control udder halves during the prepartum period. Bacterial growth inhibition by mammary secretion decreased markedly during early lactation. A highly significant positive correlation was found between bacterial growth inhibition and concentrations of lactoferrin, serum albumin, and immunoglobulin G. A highly significant negative correlation was found in the citrate:lactoferrin molar ratio during early involution and the peripartum period. PMID- 3513677 TI - Adhesion of K99-positive Escherichia coli to intestinal brush borders of pigs. AB - Ileal samples from 242 pigs, collected at 3 Michigan slaughterhouses, were studied to determine the prevalence of intestinal receptors for K99-positive Escherichia coli. A brush border adhesion test was used to identify the receptors. Of the 242 samples examined, receptors were demonstrated in 230 (95%). After storage of brush border preparations at 4 C, bacterial aggregates lacking identifiable brush border fragments were present in samples tested for adhesion, indicating that K99 receptors may be released from brush border membranes. Seemingly, most, if not all, pigs have intestinal receptors for K99 pili, and an inheritance pattern similar to that observed for K88 receptors probably does not exist for K99 receptors. PMID- 3513678 TI - Malignant lymphoma in a Sinclair miniature pig. AB - Malignant lymphoma was diagnosed in a 3-year-old, male Sinclair(S-1) miniature pig with acute anorexia, depression, fever, and markedly enlarged inguinal lymph nodes. Results of an initial hemogram indicated a leukocyte count of 121,489 cells/mm3. Most of the leukocytes were mononuclear cells of various sizes, nuclear chromatin pattern, number of nucleoli, amount of cytoplasm, and amount of staining. Cytochemical staining and flow cytometric evaluation of the leukocytes indicated a large number of hypodiploid lymphoblasts in the peripheral blood. Gross necropsy findings included enlargement of all lymph nodes, a pale liver, and multifocal pale areas scattered throughout the kidneys. Microscopic examination indicated massive infiltration of abnormal lymphoid cells into most major organs and complete loss of normal morphologic features of all lymph nodes. PMID- 3513679 TI - Effects of sodium dichloroacetate in awake, healthy, Yucatan miniature swine. AB - Four healthy, fully conscious, 50- to 80-kg Yucatan miniature swine were fitted with carotid artery and jugular, portal, and hepatic vein catheters and hepatic artery and portal vein flow cuffs to determine transhepatic kinetics and insulin secretion. Three days later, after a 3-hour control period, the pigs were given IV sodium dichloroacetate (30 mg/kg of body weight as a bolus and 30 mg/kg/hr, as an infusion) for 6 hours. Arterial lactate concentrations decreased during the dichloroacetate infusion, but pyruvate concentrations were unaltered. The whole body rate of appearance and disappearance of glucose decreased, but plasma glucose concentrations did not change markedly. Limb skin surface temperatures increased, indicating a peripheral vasodilatory effect. Dichloroacetate had little effect on mean arterial pressure and hepatosplanchnic blood flow. Dichloroacetate may be effective as a hypolactatemic agent for lactic acidosis in pigs. PMID- 3513680 TI - Prospective payment and psychological services. What difference does it make? Psychologists aren't in Medicare anyway! PMID- 3513682 TI - A phase I/II SECSG (Southeastern Cancer Study Group) pilot study of surgical adjuvant immunotherapy with vaccinia melanoma oncolysates (VMO). AB - Forty-eight patients with nonrecurrent high risk Stage I and II malignant melanoma were treated with Vaccinia Melanoma Oncolysates (VMO). Six different dose levels and two different treatment regimens were tested. Thirty-two out of 48 patients completed the 12 months of therapy. Side effects were mild to moderate. Twenty-eight out of 48 patients remain free from disease with a mean survival of 19 months, while 20/48 patients have recurred with a mean time to recurrence of 6 months. PMID- 3513681 TI - Airway responses to aerosolized methacholine and citric acid in ponies with recurrent airway obstruction (heaves). AB - We measured lung function and airway reactivity in response to methacholine and citric acid administered by aerosol in 2 groups of ponies (principal and control). Principal ponies had a history of heaves, a disease characterized by recurrent airway obstruction. Control ponies had no history of respiratory disease. Both principal and control ponies were paired (principal and control), and measurements were made when principal ponies were in clinical remission (Period A), following barn exposure when principal ponies had acute airway obstruction (Period B), and 1 and 2 wk after they were returned to pasture (Periods C and D). Differences between groups were primarily found at Period B. Barn housing (Period B) decreased dynamic compliance (Cdyn) and increased pulmonary resistance (RL) of principal but not of control ponies. When compared with control ponies at Period B, principal ponies demonstrated airway hyperreactivity. The dose of methacholine required to reduce Cdyn to 65% of baseline (ED65Cdyn) was lower, the change in RL induced by an aerosol of 0.1 mg/ml methacholine (delta RL 0.1) was higher, and the percent change in Cdyn in response to an aerosol of 0.1 mg/ml methacholine (delta %Cdyn 0.1) was larger in principal than in control ponies. A 10-min inhalation of 10% citric acid aerosol did not cause changes in Cdyn in either group of ponies. Control ponies did not increase RL in response to citric acid, whereas at Period B, RL of principal ponies increased following citric acid. We conclude that ponies in clinical remission from heaves are not hyperreactive to aerosols of methacholine or citric acid. Hyperreactivity only exists during acute exacerbations of airway obstruction. PMID- 3513683 TI - Increasing accuracy in the diagnosis of acute appendicitis with modern diagnostic techniques. AB - One hundred consecutive patients admitted to the hospital with the prospective diagnosis of appendicitis were evaluated retrospectively to determine the effect of the use of modern diagnostic techniques upon the accuracy of preoperative diagnosis. Appendectomy was performed on 48 patients. In three of these patients, the diagnostic process was assisted by the use of radiologic or ultrasound techniques. Of the 52 patients who did not undergo appendectomy, 13 patients clearly avoided surgery or were steered towards an other appropriate operative procedure due to findings on ultrasound or barium enema. Ultrasound was particularly useful in differentiating the etiology of right lower quadrant pain in the childbearing aged female. This study demonstrates that the traditionally expected 15% normal appendix rate can be narrowed (6.25% in this group of patients) without increasing morbidity, with the use of sophisticated diagnostic techniques in the evaluation of selected patients who present diagnostic dilemmas. PMID- 3513684 TI - Combination chemotherapy compared to tamoxifen as initial therapy for stage IV breast cancer in elderly women. AB - In a randomized crossover study, 181 patients over the age of 65 with recurrent breast cancer received either tamoxifen or cyclophosphamide, methotrexate, and fluorouracil (CMF). After progression on tamoxifen, a hormone withdrawal period was required. Because of altered pharmacokinetics with aging, creatinine clearance was used in calculating the dose of CMF. Response rates were 45% on tamoxifen and 38% on CMF, with median durations of 10.4 and 7.9 months, respectively. Survival rates tended to favor tamoxifen as the initial treatment even in estrogen-receptor-negative patients. Additional disease control with hormone withdrawal occurred in 23% of patients, and this benefit was highly correlated with prior hormone response. We conclude that initiation of hormone therapy rather than CMF chemotherapy is justified in almost all situations in elderly patients, and combination chemotherapy, is safe and useful after hormone failure if modified on the basis of renal dysfunction. PMID- 3513685 TI - The risks of surgery in obese patients. AB - Obesity is commonly considered a surgical risk factor, but the degree of risk has been imprecisely quantified. There is little evidence that excessive body weight in itself should contraindicate general surgery. However, obesity is often associated with abnormal cardiorespiratory function, metabolic function, and hemostasis, which may predispose to morbidity and mortality after surgery. We review pertinent data and offer guidelines to minimize the risks of surgery in obese patients. PMID- 3513686 TI - Computer searching of the medical literature. PMID- 3513687 TI - Efficacy and safety of topical oxymetazoline in treating allergic and environmental conjunctivitis. AB - This randomized, double-masked study evaluated the safety and efficacy of oxymetazoline 0.025% topical ophthalmic solution compared with its vehicle when used to treat allergic or environmental conjunctivitis. Thirty-nine patients with moderate bilateral conjunctival hyperemia instilled one drop of either oxymetazoline 0.025% solution or its vehicle twice daily for one week. At each evaluation the signs and symptoms of conjunctivitis were evaluated, complete eye examinations were performed, and heart rate and blood pressure were measured. An overall assessment of treatment efficacy was made at each follow-up evaluation. The signs and symptoms of conjunctivitis had significantly improved in the oxymetazoline-treated group when compared with those of the vehicle-treated group, and the ocular and systemic safety of each treatment was comparable. PMID- 3513688 TI - Double shifting fluid levels detected ultrasonographically in total retinal detachment. PMID- 3513689 TI - Use of adjustable sutures: a helpful modification. AB - Adjustable suture surgery helps achieve visual axis alignment in special cases. We describe a modification of adjustable suture surgery that provides better patient comfort and easier assessment of the muscle function at the time of adjustment. These beneficial features are achieved by using the cul-de-sac approach and by delaying final adjustment up to one week postoperatively. We review our experience involving 52 cases and discuss the surgical methods and reasoning behind delayed suture adjustment through the cul-de-sac approach. PMID- 3513690 TI - Activation and inhibition of yeast aldehyde dehydrogenase activity by pantethine and its metabolites. AB - D-Pantethine-related metabolites, such as taurine, D-pantetheine, coenzyme A and D-pantothenate, activated yeast aldehyde dehydrogenase in vitro. D-Pantethine and cysteamine hydrochloride, however, strongly inhibited the activity of this enzyme. PMID- 3513691 TI - Diets rich in saturated, monounsaturated and polyunsaturated fatty acids differently affect plasma lipids, platelet and arterial wall eicosanoids in rabbits. AB - New Zealand male rabbits, on a moderate dietary fat intake (10.2% w/w) received, as the major dietary lipid, butter, olive oil and corn oil, respectively, for a period of 8 weeks. At the end of the dietary treatment, plasma total cholesterol was significantly decreased in the corn oil group, compared to butter, whereas the olive-oil-consuming rabbits had an intermediate cholesterolemia; the corn oil and olive oil groups had significantly elevated high-density lipoprotein (HDL) cholesterolemia, compared to the butter group. Maximal platelet aggregability, with collagen and arachidonic acid, did not appear to differ in the three treatment groups. Thromboxane B2 release in the sera of treated rabbits was slightly higher after corn oil administration. The arterial release of prostacyclin (PGI2), tested by perfusing platelet-rich plasma through the aorta of donor rabbits, was lowest in the corn oil group. Corn oil is the most effective dietary fat in reducing cholesterolemia, but it may also reduce PGI2 release from arteries. Butter has the most unfavorable effect on lipidemia and HDL-cholesterol, whereas dietary olive oil shows an intermediate lipid-lowering activity but preserves arterial PGI2 production. PMID- 3513692 TI - Long-term effects on the immune system following local radiation therapy for breast cancer. III. Changes of spontaneous and lectin dependent cellular cytotoxicity. AB - Long-term effects of local radiotherapy (45 Gy) on the spontaneous and PHA mediated cytotoxicity of the peripheral blood lymphocyte population was studied in disease-free breast cancer patients 5-6 and 10-11 years after treatment. The patients were all part of a randomized trial in which pre- or post-operative radiotherapy was evaluated against surgery only. PHA-mediated cytotoxicity for 51Cr-labelled chicken erythrocytes seemed to be somewhat increased in patients who were irradiated 5-6 years earlier (p less than 0.025). This increase was not detectable after a disease-free period of 10-11 years. No significant differences between the various treatment groups were observed for spontaneous cytotoxicity against Chang and K 562 cells. The proportion of Leu 7+ lymphocytes was significantly increased in patients who received radiation therapy 5-6 years earlier (p = 0.029) and there was a significant correlation between PHA-mediated cytotoxicity and proportion of Leu7+ cells. PMID- 3513693 TI - Effect of prolactin on class II HLA antigen expression by MCF7 cell line. AB - Effects of prolactin on Class II HLA Ag expression have been identified for the first time in a human breast cancer cell line maintained in long-term tissue culture (MCF7) and were reported in this work as follows. Quantification methods for assaying Class II HLA Ag expression modulated by prolactin were established. Class II HLA Ags were internally labelled with [35S] methionine, extracted with Nonidet P-40, immunoprecipitated specifically with anti-Class II HLA MoAbs, isolated on protein A-Sepharose and quantified by chromatofocusing. For low doses of prolactin added to a final concentration (0.015 to 0.350 micrograms/ml culture medium), no change in Class II HLA Ags expressed by MCF7 cells was observed, when compared with controls, the percent of Class II HLA Ags assayed by chromatofocusing was then 4.03 +/- 0.57. For high doses of prolactin added to the final concentration (1.50 micrograms to 3.00 micrograms/ml medium), the percent of Class II HLA Ags increased to 6.05 +/- 0.72. When prolactin was added to the culture medium of MCF7 human breast cancer cell line, increased Class II HLA Ag expression by membrane cells was noted. Prolactin induction of Class II HLA Ag expression by human breast cancer cell lines should prove very useful to study the biology of prolactin in the tumorogenesis of the human breast. PMID- 3513694 TI - Long-term cultivation of a human breast cancer cell line, MCF-7, in a chemically defined medium. Effect of estradiol. AB - The human breast cancer cell line, MCF-7, has been adapted to long-term growth in chemically defined medium without loss of estrogen and progesterone receptors or tumorigenicity in athymic mice. An estrogen reversible inhibition of cell proliferation is exerted by newborn calf serum (NCS) 10%, athymic mouse serum (AMS) 2% or tamoxifen 0.1 to 1.0 microM. The mamma-related hormones, hydrocortisone, progesterone, prolactin, and insulin could not mimic this growth inhibitory effect, and estradiol alone or combined with these hormones did not stimulate cell proliferation in chemically defined medium. PMID- 3513695 TI - Ultrastructural localization of carcinoembryonic antigen (CEA) on ultrathin cryosections of human tumours. AB - A new, more direct method for reliable localization of CEA on human tumours has been applied at the ultrastructural level. Freshly prepared biopsy material from breast and gastric tumours, as well as xenografted colon tumours from mice, and a colon tumour cell line (LS 174 T), were briefly fixed in glutaraldehyde and frozen in liquid propane. Ultrathin cryosections were labelled with monospecific CEA antibodies by applying gold-coupled second antibodies. Variations in the labelling patterns were found when comparing breast, colon, and gastric cancers. Apart from breast tumours, all other samples reveal significant extracellular CEA positivity on the cell membrane. Intracellular localization has been found on the endoplasmic reticulum, nuclear membrane, and, in breast tumours, on electron dense bodies. These investigations confirm our previous experimental results using preembedding labelling techniques before Epon inclusion. PMID- 3513696 TI - Pancreatic transplantation. The surgical process. PMID- 3513697 TI - Pancreatic transplantation. Perioperative nursing care. PMID- 3513699 TI - Determination of the intracellular concentration of ethanol in Saccharomyces cerevisiae during fermentation. AB - Considerable controversy exists concerning the intracellular concentration of ethanol in Saccharomyces cerevisiae during fermentation. This controversy results from problems in the measurement of the intracellular concentration of compounds like ethanol, which are being produced rapidly by metabolism and potentially diffuse rapidly from the cell. We used a new method for the determination of intracellular ethanol based on the exclusion of [14C]sorbitol to estimate the aqueous cell volume. This method avoided many of the technical problems in previous reports. Our results indicate that the extracellular concentrations of ethanol in fermenting suspensions of S. cerevisiae are less than or equal to those in the intracellular environment and do not increase to the high levels previously reported even during the most active stages of batch fermentation. PMID- 3513698 TI - Injured coliforms in drinking water. AB - Coliforms were enumerated by using m-Endo agar LES and m-T7 agar in 102 routine samples of drinking water from three New England community water systems to investigate the occurrence and significance of injured coliforms. Samples included water collected immediately after conventional treatment, during the backwash cycle, at various points in the distribution system, and 1 week after the break and subsequent repair of a distribution main. Injured coliforms in these samples averaged greater than 95%. m-T7 agar yielded 8- to 38-fold more coliforms than did m-Endo agar LES. The geometric mean of coliforms recovered by m-Endo agar LES was less than 1 confirmed coliform per 100 ml, although m-T7 agar yielded 5.7 to 67.5 confirmed coliforms per 100 ml. In addition, the majority of these samples giving positive results on m-T7 agar produced no detectable counts on m-Endo agar LES. These findings indicated that coliforms were injured and largely undetected by use of accepted analytical media in the systems examined. PMID- 3513700 TI - Simple method for determination of patulin production by Penicillium griseofulvum Dierckx. AB - Patulin production by Penicillium griseofulvum was monitored with Sep-Pak cartridges and high-pressure liquid chromatography. Determination and quantification of this metabolite proved to be very simple, and our method saved time and a large amount of organic solvents. PMID- 3513701 TI - Simple method to demonstrate radiation-inducible radiation resistance in microbial cells. AB - A simple method for detection of radiation-inducible radiation resistance was developed by irradiating aliquots (0.01 ml) of cell suspension on agar plates. Part of each experimental plate was subjected to an induction treatment, and subsequent radiation resistance was compared with that of untreated cells on the same plate. The UV radiation resistance of a Micrococcus sp. was increased approximately 1.6 times by an induction treatment. This simple procedure of irradiating cells in a "fixed" position on agar avoided washing, centrifugation, and cell enumeration required in traditional methods. PMID- 3513702 TI - Evaluation of carriers used in the test methods of the Association of Official Analytical Chemists. AB - Revision of the official test method for the determination of the tuberculocidal activity of disinfectants is being undertaken. The current procedure lacks precision and accuracy and is not quantitative. Variability associated with carriers and the lack of temperature control were evaluated in this paper. The use of porcelain versus stainless steel carriers was also evaluated. When carriers of either type were contaminated with Mycobacterium bovis BCG, the number of organisms on the carriers varied by as much as 1.0 on the log10 scale. The average number of organisms attached to each porcelain carried was 1.10 x 10(5) CFU (range, 2.7 x 10(4) to 2.7 x 10(5) CFU), whereas the average number of organisms attached to each stainless steel carrier was 1.38 x 10(5) CFU (range, 2.9 x 10(4) to 4.0 x 10(5) CFU). The average number of cells attached to the carrier was directly proportional to the number of cells in the contaminating cell suspension. Variations in drying time did not alter the number of cells attached to the carrier. When porcelain carriers were placed in a test solution, the average number of organisms washed from the carriers was 55% of the total, with a range of 19 to 80%, whereas for stainless steel carriers, the average number was 82% of the total, with a range of 52 to 96%. Data for B. subtilis spores were similar to those for M. bovis BCG, suggesting that there may be similar problems with the Association of Official Analytical Chemists sporicidal test, which uses carriers. It was also found that the lack of an exacting temperature control could influence the outcome of the test. Changes in temperature as little as 1 degree C could influence the rate of killing of M. bovis BCG. PMID- 3513703 TI - Biochemical classification of Clostridium botulinum type C and D strains and their nontoxigenic derivatives. AB - The biochemical properties of 11 toxigenic and 10 nontoxigenic type C and D strains of Clostridium botulinum were studied. All of the strains examined were motile and hemolytic and produced lipase and liquid gelatin. Fermentation of several sugars and the production of lecithinase, indole, and hydrogen sulfide varied with the strain. The strains were classified into four groups based on their sugar fermentation profiles. The resulting classification was identical to the classification which had been proposed from the relationship between toxin production and phages and similar to the grouping based on the nature of toxin antigenic structures. Lecithinase production was negative in the cells belonging to group III, and indole and hydrogen sulfide production was negative in the cells of groups III and IV. Strains belonging to groups III and IV have many characteristics different from those of groups I and II. PMID- 3513704 TI - Existence of a novel enzyme, pyrroloquinoline quinone-dependent polyvinyl alcohol dehydrogenase, in a bacterial symbiont, Pseudomonas sp. strain VM15C. AB - A novel enzyme, pyrroloquinoline quinone (PQQ)-dependent polyvinyl alcohol (PVA) dehydrogenase, was found in and partially purified from the membrane fraction of a PVA-degrading symbiont, Pseudomonas sp. strain VM15C. The enzyme required PQQ for PVA dehydrogenation with phenazine methosulfate, phenazine ethosulfate, and 2,6-dichlorophenolindophenol as electron acceptors and did not show PVA oxidase activity leading to H2O2 formation. The enzyme was active toward low-molecular weight secondary alcohols rather than primary alcohols. A membrane-bound PVA oxidase was also present in cells of VM15C. Although the purified oxidase showed a substrate specificity similar to that of PQQ-dependent PVA dehydrogenase and about threefold-higher PVA-dehydrogenating activity with phenazine methosulfate or phenazine ethosulfate than PVA oxidase activity with H2O2 formation, it was shown that the enzyme does not contain PQQ as the coenzyme, and PQQ did not affect its activity. Incubation of the membrane fraction of cells with PVA caused a reduction in the cytochrome(s) of the fraction. PMID- 3513705 TI - Sensitivity of Moore sewer swabs for isolating Salmonella typhi. AB - Moore swabs (sewer swabs) have been used successfully to culture pathogenic organisms from wastewater. Sensitivity seems to depend on the size of the waterway sampled as well as the number of organisms present. In Santiago, Chile, we placed 24 swabs into the sewers draining the homes of 10 known chronic carriers of typhoid. Swabs were positive for Salmonella typhi in 5 of the 10 households (50%) and 6 of the 24 swabs placed (25%). PMID- 3513706 TI - Isolation of an antigenically unique methanogen from human feces. AB - A methanogenic bacterium with the morphological and physiological properties of the genus Methanobrevibacter was isolated from the feces of a Japanese man who excreted methane in his breath. Indirect immunofluorescence staining revealed that the isolate had an antigenicity unrelated to that of any known members of the genus Methanobrevibacter. PMID- 3513707 TI - Secretagogue-responsive and -unresponsive pools of phosphatidylinositol in pancreatic islets. AB - The effect of glucose on phosphatidylinositol turnover was studied. Phosphatidylinositol of rat pancreatic islets was labeled with myo[2-3H]inositol in the presence of various secretagogues (16.7 mM D-glucose, 22 mM D-mannose, 20 mM D-glyceraldehyde) and nonsecretagogues (3.3 mM D-glucose, 20 mM pyruvate, 16.7 mM D-galactose, 16.7 mM L-glucose). Upon subsequent stimulation with 16.7 mM D glucose, only the islets that were labeled in the presence of secretagogues showed a loss of radioactivity from phosphatidylinositol. No loss of radioactivity from phosphatidylinositol occurred in the presence of 3.3 mM D glucose even after labeling in the presence of secretagogues. A comparison of the subcellular distribution of labeled phosphatidylinositol in islets before and after stimulation with insulinotropic glucose revealed a loss of radioactivity from the plasma membrane fraction as judged by subcellular fractionation with a sucrose gradient. These results support a hypothesis advanced previously that pancreatic islets contain a unique pool of phosphatidylinositol that undergoes rapid turnover only in the presence of insulinotropic concentrations of D-glucose or other secretagogues [R. S. Rana, R. J. Mertz, A. Kowlura, J. F. Dixon, L. E. Hokin, and M. J. MacDonald (1985) J. Biol. Chem. 260, 7861-7867]. On the basis of the subcellular fractionation studies reported here, the secretagogue-responsive phosphatidylinositol pool appears to be located primarily in the plasma membrane of pancreatic islets. PMID- 3513709 TI - Pretibial epidermolysis bullosa. Successful therapy with a skin graft. AB - A patient with pretibial epidermolysis bullosa was successfully treated with a skin graft. Ultrastructural examination revealed a decreased number of and rudimentary anchoring fibrils (AFs) in the pretibial area in contrast to normal AFs in the grafted skin obtained from a nonpredilection site. Our results indicate the importance of AFs in the pathogenesis of pretibial epidermolysis bullosa. PMID- 3513708 TI - Microcystic adnexal carcinoma. Immunohistologic observations suggesting dual (pilar and eccrine) differentiation. AB - Microcystic adnexal carcinoma (MAC) is a locally aggressive neoplasm that has recently been recognized as a clinicopathologic entity. Its histologic appearance includes both pilar and eccrine differentiation. We initially treated two patients with MAC of the cheek and of the nasolabial fold, respectively; by microscopically controlled excision because of the contiguous growth of the tumors. Despite the benign histologic appearance, there was deep and extensive infiltration of the subcutaneous tissue. Both patients responded favorably to initial treatment with microscopically controlled excision. In addition, immunoperoxidase staining for carcinoembryonic antigen supported the dual differentiation of this unusual neoplasm. We speculate that previous radiotherapy may be an important predisposing factor in the pathogenesis of MAC. PMID- 3513710 TI - Proliferating angioendotheliomatosis. Case with long survival and review of literature. AB - A 30-year-old woman developed cutaneous proliferating angioendotheliomatosis without endocarditis. She was treated with local excision and radiotherapy 42 months ago. There is no recurrence eight years after clinical onset of the lesion, making this one of the longest documented cases of survival. A literature review of the disease, including its controversial histiogenesis, treatment, and survival, is presented. In view of the rarity of the disease, only by studying more patients can we better understand the disease. Since more than one disease process may be included under this diagnosis, clearer clinical and histogenetic separation is required, with immunohistochemical techniques potentially helping to provide a more precise diagnosis. PMID- 3513711 TI - Herpes gestationis persisting for 12 years post partum. PMID- 3513712 TI - Histiocytosis X. Flow cytometric DNA-content and immunohistochemical and ultrastructural analysis. AB - A 76-year-old man developed a generalized orange-red nodular eruption associated with constitutional symptoms. A biopsy specimen of a nodule revealed an extensive infiltration of histiocytes with relatively abundant cytoplasm and folded nuclei. Electron microscopy showed Langerhans' cell granules, which confirmed the diagnosis of histiocytosis X. Results of immunohistochemical studies revealed a pattern of antigen expression usually found in histiocytosis X, including Ia, T6, and S100. Analysis of the DNA content of the cells with flow cytometry revealed an aneuploid peak. The patient responded partially to topical mechlorethamine hydrochloride therapy. PMID- 3513713 TI - Anti-endomysial antibodies. A serologic marker of dermatitis herpetiformis. AB - Direct immunofluorescence (IF) studies of skin biopsies are of value in the diagnosis of most, but not all, cases of dermatitis herpetiformis (DH). Similarly, histologic studies are of help but may be questionable or completely nonspecific. Serologic studies for the presence of IgA-class anti-endomysial antibodies are very specific and are found in 70% of patients with DH and in all untreated patients with celiac disease. The titers of these antibodies are directly associated with the degree of gut disease in these patients. Thus, the presence of these antibodies even in the absence of classic direct IF and histologic findings are diagnostically important. We encountered three cases in which both direct IF and histologic studies were equivocal toward confirming the clinical diagnosis of DH. Serologic studies for the presence of IgA-class anti endomysial antibodies provided evidence for the diagnosis of DH, and, in each case, results were confirmed by further direct IF studies. Since these antibodies are disease specific for DH and celiac disease and are found in most active cases of DH, they may be considered an adjunct to the direct IF and histologic studies of the skin. PMID- 3513714 TI - How to use a rotahaler. AB - The bronchodilator response after five different modes of salbutamol inhalation by rotahaler was assessed in 15 asthmatic children in a double blind cross over study. Inspiratory flow rates lower than 50 litres/minute were associated with a significant reduction in response compared with flow rates higher than 60 litres/minute, but tilting the head back during inhalation and holding the breath for 10 seconds had no significant effect on bronchodilation. Peak inspiratory flow rates measured in 150 normal children and 13 asthmatic children with acute wheeze showed that many young children and many children with severe bronchoconstriction were unable to generate a sufficiently high inspiratory flow rate to obtain maximum benefit from rotahaler treatment. Children using a rotahaler should be taught to inhale as quickly as possible and not with a quiet deep breath as recommended in the instruction leaflets. PMID- 3513715 TI - Oral corticosteroids for wheezing attacks under 18 months. AB - In a double blind, partial crossover trial we compared treatment with prednisolone with treatment with placebo (56 treatments) in 38 children aged less than 18 months (mean age 9.8 months, range 3-17 months), 30 of whom had required previous admission to hospital. Placebo or oral prednisolone 2 mg/kg/day in two divided doses for five days was given during acute exacerbations of symptoms on an outpatient basis. Daily symptom scores of cough, wheeze, and breathlessness did not show any significant difference in rate of improvement or overall outcome, either between the two whole groups or within subgroups aged less than 6 months, 6-12 months, and 12-18 months. Parental preference failed to indicate superiority of treatment with prednisolone over treatment with placebo in the 18 crossover patients, and parents were equally as likely to feel that treatment with either placebo or prednisolone had had positive effect in non-crossover patients. Two children required admission to hospital during treatment, one aged 5 1/2 months being treated with prednisolone, and one aged 14 months being treated with placebo. PMID- 3513716 TI - Comparison of desmopressin and enuresis alarm for nocturnal enuresis. AB - Fifty children with primary nocturnal enuresis were randomised for a study comparing desmopressin (DDAVP) and enuresis alarm. Forty six completed the trial, 24 of whom were treated with 20 micrograms intranasal desmopressin nightly and 22 with enuresis alarm for three months. Failures were crossed over and relapses were continued on the same treatment for a further three months. The improvement rate was 70% in the group given desmopressin and 86% in the group treated with alarm; the difference was not significant. During the first week of treatment the group given desmopressin was significantly dryer, and at the end of the study 10 of these patients relapsed compared with one patient in the group given the alarm. No serious side effects were observed. This study confirms the role of conditioning treatment as preferable in long term treatment of nocturnal enuresis. When this fails or when a safe drug with rapid effect is needed, however, desmopressin is a useful alternative. PMID- 3513717 TI - Cause of neonatal convulsions. Towards more precise diagnosis. AB - All infants presenting with neonatal seizures over a two year period were carefully investigated for the cause. In 20% either intracranial haemorrhage or infarction of a major cerebral artery was detected by real time ultrasound. Routine imaging techniques should be performed in all infants with neonatal convulsions. PMID- 3513718 TI - Comparison of ultrasound examination and intravenous urography after a urinary tract infection. AB - The results of ultrasound examination and intravenous urography after a urinary infection were compared in 100 children. Thirty seven had an abnormality on urography, but in 12 this was not seen on ultrasound. One of these had renal scarring, the remainder only minor abnormalities. PMID- 3513719 TI - Two or three insulin injections in adolescence? AB - Morning hyperglycaemia remains a challenge to conventional insulin regimens. Eighteen adolescents participated in a one year crossover study to examine the effect of delaying the evening intermediate acting insulin from before the evening meal to bedtime. This three injection regimen caused slightly higher blood glucose concentrations in the early part of the night, and lower concentrations in the morning, but no overall change in glycosylated haemoglobin concentrations (HbA1c). Seasonal change accounted for substantially more of the variance in HbA1c concentrations than did the regimen change. The three injection regimen did not alter the frequency of hypoglycaemic episodes. Metabolic control on both regimens might have been improved by more intensive monitoring and medical attention. This study suggests that factors beyond medical control, such as seasonal variation, may contribute more to the control of diabetes in adolescents than changes in conventional insulin regimens, particularly when unaccompanied by intensive monitoring. PMID- 3513720 TI - Phenobarbitone prophylaxis of intraventricular haemorrhage. AB - Thirty preterm infants (birthweight under 1500 g) were treated with phenobarbitone to examine its effectiveness in reducing the incidence of intraventricular haemorrhage (IVH), the control group comprising 28 infants. The treated group had 57% incidence of IVH and mortality of 13% compared with 68% and 14%, respectively, in controls. PMID- 3513721 TI - George Frederic Still. PMID- 3513724 TI - Lack of a Doppler signal from a PTFE graft. PMID- 3513723 TI - Treatment of pulmonary infections. PMID- 3513722 TI - What causes center effects in kidney transplantation. AB - Results in 195 renal transplants were compared for two distinct patient populations, those from the out-of-town surrounding rural region and those from the local large metropolitan center. The 1-year cadaver kidney survival was strikingly higher in the group from out-of-town (62% vs. 43%, p less than 0.001). This was partially due to better patient survival in the out-of-town patients. There were more blacks in the local group (7% vs. 48%, p less than 0.001). However, this was not the explanation for the difference, since within the local group the 1-year graft survival for nonblack recipients was no better than for blacks. Other relevant factors were not different between the two groups. This strong dialysis center effect, which exerts a major influence on the subsequent likelihood of success, derives from some factor related to the derivation of the recipient. In addition to its possible implications for patient care, further study of this phenomenon would also be useful with regard to recent interest on the part of government and other third-party payment groups in transplant center results. PMID- 3513725 TI - Current concepts of warfarin therapy. AB - Oral anticoagulants are used extensively, although their risks are not always fully recognized. The prophylaxis of venous thrombosis after hip surgery, the prevention of deep venous thrombosis and pulmonary emboli after an acute episode of these, the prevention of arterial emboli from the heart in patients at risk, and the prophylaxis of thrombosis in patients with congenital deficiency of antithrombin III, protein C, or protein S are some of the indications for oral anticoagulant use. Warfarin sodium is contraindicated in pregnancy, however. The recommended prothrombin time is 1 1/2 to two times control, lower than previously. The major risk of oral anticoagulant therapy, bleeding, is treated with vitamin K or plasma, depending on its severity. Warfarin necrosis and the "purple-toe" syndrome are seen more frequently than realized. PMID- 3513726 TI - Treatment of hypertensive emergencies and urgencies with oral clonidine loading and titration. A review. AB - Oral clonidine hydrochloride rapid titration or loading is a safe, effective method to control severe elevations of blood pressure in hypertensive crisis in many clinical situations. An initial oral dose of 0.1 to 0.2 mg of clonidine hydrochloride followed by hourly doses of 0.05 or 0.1 mg until goal blood pressure is attained that does not reduce perfusion to critical organs, or a total of 0.7 mg is given, will achieve a significant reduction in blood pressure in 93% of patients. A smooth, rapid, predictable reduction in blood pressure, patient comfort, lower overall cost, reduced requirement for close observation, intravenous lines, and hospitalization, and a small incidence of clinically significant side effects make oral clonidine rapid titration an attractive oral antihypertensive agent for patients with hypertensive urgencies and in some carefully selected patients with hypertensive emergencies. Immediate outpatient follow-up within 24 hours is mandatory in all patients who are not hospitalized to adjust the dose of antihypertensive medications. PMID- 3513727 TI - Prophylactic anticoagulation following acute myocardial infarction. AB - Although several large trials have failed to demonstrate unequivocally that anticoagulation decreases mortality following myocardial infarction (MI), anticoagulation has been advocated to prevent embolic cerebrovascular accidents (CVAs). Since CVAs occur during hospitalization in only 1.5% to 3% of MIs, it is not justifiable to anticoagulate all patients after MI because the risk of anticoagulation exceeds the potential benefit. However, a group of patients who are at high risk of developing left ventricular thrombi (LVT) and CVA following MI can be identified. Thirty percent to 40% of patients with transmural anterior MI develop LVT, and early anticoagulation with heparin sodium prevents LVT formation and CVAs in this group. A two-dimensional echocardiogram before hospital discharge allows the identification of patients at risk for later embolization and helps determine the need for anticoagulation with warfarin sodium following hospitalization. PMID- 3513728 TI - Luteinizing hormone-releasing hormone. PMID- 3513729 TI - Mobilization of cloned luciferase genes into Vibrio harveyi luminescence mutants. AB - A recombinant plasmid which carried a 5 kb fragment of Vibrio harveyi DNA containing the luxA and luxB genes was mobilized from Escherichia coli into luminescence-deficient mutants of V. harveyi. The cloned genes complemented a temperature sensitive luciferase mutation, but failed to complement lesions in two different aldehyde deficient mutants. Expression of the cloned genes was not subject to autoinduction in either E. coli or in V. harveyi. PMID- 3513730 TI - Ethanol-sensitive mutants of Saccharomyces cerevisiae. AB - Saccharomyces cerevisiae mutants unable to grow at ethanol concentrations at which the wild type strain S288C does grow, have been isolated. Some of them show additional phenotypic alterations in colony size, temperature sensitivity and viability in ethanol, which cosegregate with the growth sensitivity in ethanol. 21 selected monogenic ethanol-sensitive mutants define 20 complementation groups, denominated ETA1 to ETA20, which indicates that there is a high number of genes involved in the ethanol tolerance/sensitivity mechanism. Out of 21 selected monogenic mutants, 20 are not altered in the glycolytic pathway since, when maintained in glucose-supplemented medium, they can produce as much ethanol as the wild type and at about the same velocity. Nor do any of the mutants seem to be altered in the lipid biosynthetic pathway since, whether grown in the absence or in the presence of ethanol, their concentration of fatty acids and ergosterol is similar to that of the wild type under the same conditions. Therefore growth sensitivity to ethanol does not seem necessarily to be related to carbohydrate or lipid metabolism. PMID- 3513731 TI - Assembly of microfibrils in vivo and in vitro from (1----3)-beta-D-glucan synthesized by protoplasts of Saccharomyces cerevisiae. AB - Polymer chains of (1----3)-beta-D-glucan were dissolved with 1 M NaOH at 4 degrees C from native microfibrillar protoplast nets. The chains associated into microfibrils during NaOH neutralization or dialysis. In contrast to the native microfibrils which are of uniform width individually (10 to 20 nm) and arranged in flat bundles, the microfibrils formed in vitro showed no band formation and consisted of fibrous spindle-shaped subunits of variable width or loose elementary fibrils about 1.7 nm wide. X-ray diagrams of native nets indicated a fairly high crystallinity and were different for wet and dry specimens. They corresponded to those of paramylon. Precipitated glucans produced diagrams different from the former and revealing a lower crystallinity especially with the dry samples. The X-ray pattern, combined with other data, allowed the precipitated microfibrils to be identified as aggregates of molecular strands composed each of three intertwined helical glucan chains. Since these triple helical chains are about 1.7 nm wide the elementary fibrils of this width can represent only single triple-helical strands. These helices have 7 glucose residues per turn and therefore a low symmetry which explains the poor crystallizing properties. The 7 membered helix represents a basic difference with the well crystallized native glucan which is built of highly symmetrical triple helices with 6 glucose residues per turn. Since 6(1) helical conformation is not formed in vitro at normal temperatures its generation in vivo must be due to the action of synthesizing enzymes at the protoplast membrane. The intertwining of these helices and crystallization of the strands are determined by their symmetry and physical properties of the chains.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3513732 TI - Role of relA mutation in the survival of amino acid-starved Escherichia coli. AB - Amino acid-starved cells of Escherichia coli relA+, which contain a large number of glycogen particles, are able to survive in phosphate buffer for a longer time period than their relaxed counterparts. With regard to NH4+ starvation differences in the survival of both strains were not found. NH4+ starved cells of E. coli relA are able to synthesize glycogen but amino acid-starved cells of the relA strain are not. We suggest that the synthesis of glycogen triggered by guanosine tetraphosphate during amino acid starvation is responsible for the prolonged viability of the E. coli relA+ strain. PMID- 3513733 TI - A historical perspective as a compass for future of pathology. AB - A brief historical overview of pathology's role in the evolution of modern medicine is presented by highlighting the contributions of three outstanding figures in the history of pathology. Morgagni developed the concept of clinical pathological correlation as a means of understanding "the seats and causes of diseases". Virchow introduced the microscope to pathology as a means of better understanding disease through the study of cellular (and eventually subcellular) events. Welch applied the then-new approaches of bacteriology to the study of disease and established the laboratory as a central focus for the pathologist. Certain common themes in the lives and works of these three founders are analyzed with respect to their signification for pathologists today and in the future. PMID- 3513734 TI - The Boston Center for Liver Transplantation (BCLT). Initial experience of a new surgical consortium. AB - Improved survival following liver transplantation has led to a rapid increase in the number of centers providing this expensive and demanding therapy. In January 1984, four Boston hospitals launched a cooperative program known as the Boston Center for Liver Transplantation (BCLT). From January 1984 through July 1985, 47 liver transplantations were performed in 41 patients ranging in age from 8 months to 60 years. Donor organs were retrieved from 22 states within a 2,500-mile radius. Thirty-five of the 47 procedures were performed by teams consisting of surgeons from at least two BCLT member hospitals. Twelve-month actuarial survival was 54.1% without significant institutional variability. The BCLT has developed into a unique transplant consortium capable of sharing manpower, equipment, and organs without sacrificing quality of care of disrupting preexisting medical services. PMID- 3513735 TI - Surgical management of necrotizing pancreatitis. AB - Necrotizing pancreatitis has a formidable mortality that may exceed 55% even when treated by surgical drainage. Standard surgical techniques for controlling pancreatic sepsis are often inadequate because the unique chronicity of pancreatitis results in persistent and ongoing inflammation and sloughing of necrotic retroperitoneal tissue that promotes further sepsis. Ten consecutive high-risk patients in whom standard surgical debridement and drainage had failed were treated with open packing of the pancreatic bed. This was followed by daily debridement dressing changes at the bedside in the surgical intensive care unit. Management of the open abdomen in the surgical intensive care unit using standard surgical techniques ensured optimum wound toilet, prevented recurrent intra abdominal sepsis, was logistically acceptable, was well tolerated by critically ill patients, and allowed a higher salvage rate (80%) of high-risk patients than might otherwise be anticipated. PMID- 3513736 TI - Antibodies for autonomous parvoviruses of lower animals detected in human serum. Brief report. AB - Antibodies for autonomous parvoviruses of lower animals were detected in human sera. Serologic and deductive evidence suggested that such antibodies may have been raised to a candidate human parvovirus, namely, B-19 virus. PMID- 3513737 TI - [50th anniversary of the Department of Human Anatomy of the Bashkiria Medical Institute]. PMID- 3513738 TI - [Mercury porometry as a method of studying the structure of osseous tissue]. PMID- 3513739 TI - [Scanning electron microscopy of native preparations of vascular endothelium]. PMID- 3513740 TI - Treatment of acute ischemic stroke. Open trial with continuous intravenous heparinization. AB - To determine safety of early anticoagulation in patients with acute ischemic stroke, 150 consecutive patients were treated with continuous intravenous heparinization for one to 17 days (median, seven days) in an open trial. Fourteen patients had transient ischemic attacks and 136 patients had acute cerebral infarctions (Cls). None of the patients with transient ischemic attacks experienced untoward events. Of those with acute Cl, four patients (3%) suffered a new, or extension of, Cl; six patients (4.4%) suffered hemorrhagic complications, four patients (3%) died during treatment, and six patients (4%) died afterwards. Three of the deaths were related to treatment complications. Only 13 patients (8.6%) experienced fluctuation of deficit. Median hospitalization was 25.5 days. Recovery of function was good to excellent in 81% of the patients with acute Cl; 75% of the survivors were ambulatory, and about 66% of the patients had either a mild or a minimal neurologic deficit at discharge. The incidence of untoward events in patients with acute Cl was high enough (7.4%) for us to conclude that the efficacy of continuous intravenous heparinization in acute ischemic stroke should be established with controlled studies before its routine use can be recommended. PMID- 3513741 TI - Triumph and controversy. Pasteur's preventive treatment of rabies as reported in JAMA. AB - Louis Pasteur's vaccine against rabies, introduced 100 years ago, was greeted by the American medical community with a mixture of praise and skepticism. These sentiments as well as details of Pasteur's landmark discoveries appeared in late 19th-century articles in The Journal of the American Medical Association. PMID- 3513742 TI - Participants in clinical trial in glaucoma needed. PMID- 3513743 TI - Current status of automated perimetry. Is the ideal automated perimeter available? PMID- 3513744 TI - Reduction of pupillary constriction during cataract surgery using suprofen. AB - The efficacy of a new nonsteroidal anti-inflammatory agent, suprofen, for reducing pupillary constriction during cataract surgery was ascertained in a double-masked, multicenter, clinical study. Prior to surgery 1.0% suprofen or a placebo was instilled; the surgeon's normal regimen of mydriatics and cycloplegics was used. Suprofen (209 patients) was far more effective than the placebo (203 patients) in maintaining a dilated pupil prior to intraocular lens (IOL) implantation (or instillation of a miotic). The mean pupillary area prior to IOL implantation was 6.3 sq mm larger (20% larger) in patients treated with suprofen than in patients receiving the placebo. The investigators' subjective evaluations of the adequacy of pupil size for IOL implantation and of the difficulty of IOL implantation favored patients treated with suprofen over those receiving the placebo. PMID- 3513745 TI - Adjunct hyperbaric oxygen therapy in periorbital reconstruction. AB - The abundant blood supply normally found in the periorbital region grants the reconstructive surgeon many options for repair. When this blood supply is altered by such factors as thermal damage or scar formation, classic methods of lid reconstruction may not suffice. In such situations, treatment with hyperbaric oxygen accelerates the process of primary revascularization of full-thickness skin grafts and large composite grafts. Augmentation of capillary budding occurs because hyperbaric oxygen therapy raises the tissue oxygen tension in hypoxic areas to the level needed for extracellular deposition of collagen, which is needed for support of endothelial cells. Hyperbaric oxygen also appears to improve the survival of ischemic skin flaps of the face, although the exact mechanism of this action is unclear. Since 1982, a total of six patients needing periorbital reconstruction has been treated postoperatively with adjunct hyperbaric oxygen. Although the results have been uniformly favorable, a matched series comparing the results with and without hyperbaric oxygen therapy will be required to prove the efficacy of this treatment regimen. PMID- 3513746 TI - Q-switched neodymium-YAG laser iridotomy. A field trial with a portable laser system. AB - The efficacy of a small, portable, battery-operated, Q-switched neodymium-YAG laser with a slit-lamp delivery system was evaluated in a short-term pilot study. Iridotomies were created in 44 Eskimo eyes (23 patients) with occludable angles in Alaska's Kotzebue region. The laser was transported as regular baggage, was used in three villages (utilizing available facilities), and was operational within five minutes. Patent iridotomies were achieved in all eyes and with one pulse in 18 eyes (44%). Complications included transient bleeding from the iridotomy site in 23 eyes (52%), focal corneal opacities in 11 eyes (25%), and a transient immediate postoperative intraocular pressure elevation in nine eyes (20%). This appears to be the first portable laser system that can be used in frontier areas and underdeveloped nations to prophylactically treat pupillary block glaucoma. PMID- 3513747 TI - Q-switched neodymium-YAG laser iridotomy in patients in whom the argon laser fails. AB - We conducted a short-term prospective clinical study to evaluate Q-switched neodymium-YAG laser iridotomy in 33 eyes with pupillary block glaucoma in which the argon laser was unable to create an iridotomy. These eyes had chronic angle closure glaucoma (11 eyes), acute angle closure glaucoma (five eyes), pseudophakic pupillary block (seven eyes), uveitic pupillary block (three eyes), and contralateral eyes (five eyes); also included were both eyes of a patient with a head tremor. In all eyes, a patent iridotomy was created in one treatment session, with a mean of 5 +/- 5 pulses and a mean total energy of 55 +/- 120 millijoules. Complications included iridotomy closure (two eyes with preexisting active uveitis), focal nonprogressive corneal opacities (six eyes), and minimal bleeding from the iridotomy margin (12 eyes). Q-switched neodymium-YAG laser iridotomy appears to be an effective next step in the management of pupillary block glaucoma prior to surgical iridectomy when argon laser iridotomy fails. PMID- 3513748 TI - Correction of a deep superior sulcus with dermis-fat implantation. AB - We describe five patients with deep superior sulcus deformities who had dermis fat grafts implanted into the preaponeurotic space. Three patients had anophthalmic sockets, and two had normal seeing eyes. The grafts were taken from the left lower abdominal quadrant above the iliac crest and the donor site was closed primarily. At the time of surgery, an effort was made to overcorrect the deformity. All five patients were improved, although one of the anophthalmic patients developed a slight postoperative ptosis. A follow-up of at least one year has shown no sign of fat absorption. PMID- 3513749 TI - Body fat distribution and hyperinsulinemia as risk factors for diabetes and cardiovascular disease. AB - Differences in body fat distribution between diabetics and nondiabetics have been recognized for several decades; diabetics have a more centralized or upper body fat pattern than nondiabetics. Recently, attention has focused on fat patterning and also on hyperinsulinemia as possible risk factors for cardiovascular disease, as well. The case for insulin as a cardiovascular risk factor is bolstered by theoretical considerations related to its possibly atherogenic effects on serum and arterial wall lipids. Empirical evidence for fat patterning and hyperinsulinemia as cardiovascular risk factors rests on six prospective epidemiologic studies, three on fat patterning and three on insulin. Although provocative, none of these studies can be regarded as definitive. In none was a dose-response effect demonstrated, and there are various inconsistencies within and across the studies. Moreover, in none of the studies were hyperinsulinemia and fat patterning evaluated simultaneously. This is of particular importance in view of the well-documented interrelationships between these two variables. For example, insulin resistance and hyperinsulinemia have been found to be greater in women with upper body obesity compared to women with lower body obesity of equivalent degree. Considerable progress has been made recently in understanding the mechanisms of the differential metabolic effects of these two types of obesity. The extent to which fat patterning and hyperinsulinemia are genetic or acquired has received relatively little attention. Further research on this question is warranted since elucidation of any environmental influences on these variables might suggest new clinical and public health control measures. PMID- 3513750 TI - The mechanism of fibrin-induced disorganization of cultured human endothelial cell monolayers. AB - Deposition of polymerizing fibrin on the vascular endothelium is the final event in intravascular coagulation. Exposure of fibrin clots to confluent monolayers of cultured human endothelial cells for 4 to 24 hours resulted in the disappearance of their normal cobblestone morphology and in the formation of endothelial cell aggregates. The present study was designed to evaluate the conditions and structural requirements of the fibrin clot for the induction of disorganization. Even after harsh treatment with denaturing agents or loading with large amounts of fibrinogen antibodies, polymerized fibrin always induced disorganization of the monolayers. In contrast, soluble fibrin that was kept in solution by either fibrinogen, fragment D-cate, or the tetrapeptide Gly-Pro-Arg-Pro did not cause any alteration of the monolayers. The fibrinogen degradation product D-cate (Mr 94,000) itself had no microscopically detectable influence on the monolayer structure. In the absence of fibrin, the effect of thrombin on endothelial cells was found to be distinct from that induced by fibrin; however, the exposure of pieces of glass coverslips caused alterations in morphology indistinguishable from the fibrin-induced disorganization of the monolayer. Experiments using protein-coated polyester films indicated that the ability of the endothelial cells to attach to the overlying material, independent of its chemical structure, is the prerequisite for the induction of disorganization, but not a defined component of the fibrin molecule. Disorganization of vascular endothelium in vivo might be important for the organization and revascularization of an occluding thrombus. PMID- 3513751 TI - Development of nonthrombogenicity of injured rabbit aortas despite inhibition of platelet adherence. AB - After removal of the endothelium from normal rabbit aortas or after injury to the neointima, the injured surfaces rapidly become nonreactive to circulating platelets. Experiments were done to determine whether prevention of the initial interaction of platelets with the surfaces would influence the loss of vessel wall reactivity. Inhibition of platelet accumulation on the subendothelium by the infusion of PGI2 (850 ng/kg/min) or the administration of dipyridamole (12.5 mg/kg initially followed by 5 mg/kg/hr) for periods of less than 8 hours inhibited platelet accumulation of platelets on the surfaces when the infusions were stopped. If the animals were treated for 8 hours, platelets did not accumulate on the surface when the drugs were discontinued. Thus, an injured vessel wall can develop a nonthrombogenic surface even when platelet adherence is prevented, although approximately 8 hours are required before the surface loses its ability to interact with platelets. PMID- 3513752 TI - Arousal and stability: the effects of five new sympathomimetic drugs suggest a new principle for the prevention of space motion sickness. AB - Sympathomimetic agents are frequent components in antimotion-sickness drug combinations because of their usefulness in counteracting the sedation caused by stressful motion or resulting from the administration of other antimotion sickness drugs. The noradrenergic neurochemistry of the brain's arousal attentional systems prompted us to evaluate the efficacy of five new sympathomimetic drugs and to further define the role of arousal in susceptibility to motion. Subjects were orally administered methamphetamine (20 mg), phenmetrazine (25 mg), phentermine (37.5 mg), methylphenidate (20 mg), or pemoline (75 mg) 2 h prior to taking a Staircase Profile Test. All of the drugs increased resistance to stressful coriolis stimulation by 80-120%. Methylphenidate and pemoline showed fewer side effects. These findings, interpreted in conjunction with the documented inefficacy of most anticholinergic and antihistaminergic drugs tested to date, suggest that sympathomimetic drugs or a generalized state of arousal can inhibit the development of motion sickness. PMID- 3513753 TI - Chymopapain A. Purification and investigation by covalent chromatography and characterization by two-protonic-state reactivity-probe kinetics, steady-state kinetics and resonance Raman spectroscopy of some dithioacyl derivatives. AB - Chymopapain A was isolated from the dried latex of papaya (Carica papaya) by ion exchange chromatography followed by covalent chromatography by thiol-disulphide interchange. The latter procedure was used to produce fully active enzyme containing one essential thiol group per molecule of protein, to establish that the chymopapain A molecule contains, in addition, one non-essential thiol group per molecule and to recalculate the literature value of epsilon 280 for the enzyme as 36 000 M-1 X cm -1. The Michaelis parameters for the hydrolysis of L benzoylarginine p-nitroanilide and of benzyloxy-carbonyl-lysine nitrophenyl ester at 25 degrees C, and I 0.1 at several pH values catalysed by chymopapain A, papaya proteinase omega, papain (EC 3.4.22.2) and actinidin (EC 3.4.22.14) were determined. Towards these substrates chymopapain A has kcat./km values similar to those of actinidin and of papaya proteinase omega and significantly lower than those of papain or ficin. The environment of the catalytic site of chymopapain A is markedly different from those of other cysteine proteinases studied to date, as evidenced by the pH-dependence of the second-order rate constant (k) for the reaction of the catalytic-site thiol group with 2,2'-dipyridyl disulphide. The striking bell-shaped component that is a characteristic feature of the reactions of S-/ImH+ (thiolate/imidazolium) ion-pair components of many cysteine-proteinase catalytic sites with the 2,2'-dipyridyl disulphide univalent cation is not present in the pH-k profile for the chymopapain A reaction. The result is consistent with the presence of an additional positive charge in, or near, the catalytic site that repels the cationic form of the probe reagent. Resonance Raman spectra were collected at pH values 2.5, 6.0 and 8.0 for each of the following dithioacyl derivatives of chymopapain A: N-benzoylglycine-, N-(Beta phenylpropionl)glycine- and N-methoxycarbonylphenylalanylglycine-. The main conclusion of the spectral study is that in each case the acyl group binds as a single population known as conformer B in which the glycinic N atom is in close contact with the thiol S atom of the catalytic-site cysteine residue, as is the case also for papain and other cysteine proteinases studied. Thus the abnormal catalytic-site environment of chymopapain A detected by the reactivity-probe studies, which may have consequences for the acylation step of the catalytic act, does not perturb the conformation of the bound acyl group at the acyl-enzyme intermediate stage of catalysis. PMID- 3513754 TI - Membrane transport in relation to net uptake of glucose in the perfused rat hindlimb. Stimulatory effect of insulin, hypoxia and contractile activity. AB - The paired-tracer dilution method applied to the perfused rat hindlimb model was used to study glucose transport in relation to net glucose uptake in skeletal muscle tissue. 2-deoxyglucose was used as an analogue for glucose, since this eliminates the problem with release of labelled metabolites. The affinity of 2 deoxyglucose for the glucose carrier was shown to be indistinguishable from that of glucose. An insulin dose-response study showed maximal stimulation of glucose uptake and transport at 0.1 unit/l, and 75% of maximal stimulation at 0.01 unit of insulin/l. Hypoxia and contractile activity stimulated the 2-deoxyglucose transport rate similarly, and the stimuli were not additive, suggesting a common mechanism. The presence of insulin did not increase the effect of hypoxia or contractile activity, indicating no permissive effect of insulin. The 2 deoxyglucose transport rate was closely correlated with and always higher than that of glucose uptake, demonstrating that the transport is never rate-limiting for the net glucose uptake and that both processes are regulated together. Significant correlations between the 2-deoxyglucose transport rate and the intramuscular concentration of phosphocreatine suggest regulation of the glucose utilization by the energy state of the skeletal muscle tissue. PMID- 3513755 TI - Effects of dexamethasone and insulin on the synthesis of triacylglycerols and phosphatidylcholine and the secretion of very-low-density lipoproteins and lysophosphatidylcholine by monolayer cultures of rat hepatocytes. AB - Rat hepatocytes in monolayer culture were preincubated for 19 h with 1 microM dexamethasone, and the incubation was continued for a further 23 h with [14C]oleate, [3H]glycerol and 1 microM-dexamethasone. Dexamethasone increased the secretion of triacylglycerol into the medium in particles that had the properties of very-low-density lipoproteins. The increased secretion was matched by a decrease in the triacylglycerol and phosphatidylcholine that remained in the hepatocytes. Preincubating the hepatocytes for the total 42 h period with 36 nM insulin decreased the amount of triacylglycerol in the medium and in the cells after the final incubation for 23 h with radioactive substrates. However, insulin had no significant effect on the triacylglycerol content of the cell and medium when it was present only in the final 23 h incubation. Insulin antagonized the effects of dexamethasone in stimulating the secretion of triacylglycerol from the hepatocytes, especially when it was present throughout the total 42 h period. The labelling of lysophosphatidylcholine in the medium when hepatocytes were incubated with [14C]oleate and [3H]glycerol was greater than that of phosphatidylcholine. The appearance of this lipid in the medium, unlike that of triacylglycerol and phosphatidylcholine, was not stimulated by dexamethasone, or inhibited by colchicine. However, the presence of lysophosphatidylcholine in the medium was decreased when the hepatocytes were incubated with both dexamethasone and insulin. These findings are discussed in relation to the control of the synthesis of glycerolipids and the secretion of very-low-density lipoproteins and lysophosphatidylcholine by the liver, particularly in relation to the interactions of glucocorticoids and insulin. PMID- 3513756 TI - The mechanism of regulatory light chain dissociation from scallop myosin. AB - The dissociation of the regulatory light chains from scallop myosin subfragments, on addition of EDTA, was investigated by using the fluorophore 8 anilinonaphthalene-1-sulphonate as a probe. The rate of this process (0.014 s-1) was partially limited by the rate of Mg2+ dissociation (0.058 s-1) from the non specific high-affinity site. The dissociation of the regulatory light chain subfragment 1 was less extensive than from heavy meromyosin. Reassociation of the scallop regulatory light chain was induced on addition of Mg2+, but it appeared to be limited by a first-order step. The nature of this step was revealed by the kinetics of Mercenaria regulatory light chain association. Scallop heavy meromyosin, denuded of its regulatory light chains, exists in a refractory state, whose reversal to the nascent state limits the rate of light chain association (0.006 s-1). The formation of the refractory state is the driving force for the net dissociation of regulatory light chains from scallop heavy meromyosin. This mechanism is discussed with reference to existing structural information on light chain-denuded myosin. PMID- 3513757 TI - Comparative binding of bovine, human and rat insulin-like growth factors to membrane receptors and to antibodies against human insulin-like growth factor-1. AB - The immunological properties of human, bovine and rat insulin-like growth factors (IGF) and insulin were compared in competitive binding studies with Tr10 and NPA polyclonal antisera raised in rabbits against human IGF-1. Bovine IGF-1 was 11 19% as effective as human IGF-1 in competing for binding with 125I-labelled human IGF-1, whereas IGF-2 reacted poorly and insulin did not compete. Similar competitive binding curves were obtained with the mouse monoclonal anti-(human IGF-1) antibody 3D1, except that bovine IGF-1 showed a severalfold greater affinity for the monoclonal antibody than for either polyclonal antiserum. Membranes isolated from human placenta, sheep placenta and foetal-human liver were used as sources of cellular receptors. In human placental membranes, most of the binding of IGF-1 tracers could be attributed to a type-1 receptor, because insulin inhibited up to 65% of tracer binding. The other two tissues apparently contain only type-2 receptors, as evidenced by the very low potency of bovine or human IGF-1 in competing for binding with IGF-2 tracers and the absence of any competition by insulin. In competition for binding with labelled bovine or human IGF-1 to human placental membranes, bovine IGF-1 had a similar potency to human IGF-1, whereas bovine IGF-1 was more potent in binding studies with tissues rich in type-2 receptors. Rat IGF-2 was considerably less effective than human IGF-2 in competition for receptors on any of the membrane preparations. PMID- 3513758 TI - Glucose utilization in vivo and insulin-sensitivity of rat brown adipose tissue in various physiological and pathological conditions. AB - Brown-adipose-tissue glucose utilization rate and its insulin-sensitivity were measured in vivo in the anaesthetized rat by a 2-deoxy[1-3H]glucose technique. Glucose utilization can be increased 60-fold by insulin, to reach extremely high rates. Glucose utilization and its insulin-sensitivity are modulated in accordance with physiological or pathological conditions. PMID- 3513760 TI - Discrimination of distinct proteinases at the four structural levels of rat liver mitochondria. AB - Rat liver mitochondrial fractions corresponding to four morphological structures (matrix, inner membrane, intermembrane space and outer membrane) contain proteinases that cleave casein components at different rates. Proteinases of the intermembrane space preferentially cleave kappa-casein, whereas the proteinases of the outer membrane, inner membrane and matrix fractions degrade alpha S1 casein more rapidly. Electrophoretic separation of the degradation products of alpha S1-casein and kappa-casein in polyacrylamide gels shows that different polypeptides are produced when the substrate is degraded by the matrix, by both membranes and by the intermembrane-space fraction. Some of the degradation products resulting from incubation of the caseins with the mitochondrial fractions are probably the result of digestion by contaminating lysosomal proteinase(s). The matrix has a high peptidase activity, since glucagon, a small peptide, is very rapidly degraded by this fraction. These observations strongly suggest that distinct proteinases, with different specificities, are associated respectively with the intermembrane space and with both membrane fractions. PMID- 3513761 TI - Enhancement of glucagon secretion from isolated rat islets of Langerhans by phorbol 12-myristate 13-acetate. AB - The phorbol ester 4 beta-phorbol 12-myristate 13-acetate (PMA), at concentrations of 0.1 microM and above, stimulated secretion of glucagon and of insulin from isolated rat islets of Langerhans incubated in the presence of 5.5 mM-glucose. Stimulation of secretion of both hormones by 1 microM-PMA persisted in the absence of external Ca2+, and could be abolished by incubating the islets at 4 degrees C. These findings suggest a role of protein kinase C in the alpha-cell (and beta-cell) secretory mechanism. PMID- 3513759 TI - Infra-red and Raman spectroscopic studies of enzyme structure and function. PMID- 3513762 TI - Identification and characterization of a calcium-binding protein in the mouse chorioallantoic placenta. AB - Mouse chorioallantoic placenta contains a specific calcium-binding protein (MCaBP). A procedure involving gel filtration and ion-exchange chromatography was developed to purify the MCaBP. The MCaBP activity increased as a function of embryonic gestation and was highly specific for Ca2+. The MCaBP is a monomeric protein of Mr 57000, with pI 4.7. Specific antibodies were prepared against the MCaBP and were used to localize the MCaBP to syncytiotrophoblasts of the chorionic villi of mouse chorioallantoic placenta. These properties suggest that the MCaBP may be involved in transplacental calcium transport. PMID- 3513763 TI - Effects of the beta-adrenoceptor agonist isoprenaline on insulin-sensitivity in soleus muscle of the rat. AB - The interactions between a beta-adrenoceptor agonist (isoprenaline) and insulin on rates of hexose transport, glucose phosphorylation, glycogen synthesis and glycogenolysis were investigated in the incubated stripped soleus-muscle preparation of the rat. In the presence of 1 microM-isoprenaline, insulin was less effective in stimulating glucose phosphorylation and glycogen synthesis. The stimulation of glycogenolysis by isoprenaline was only slightly decreased even at high (10000 microunits/ml) concentrations of insulin. Insulin-stimulated phosphorylation of 2-deoxyglucose was decreased by isoprenaline. It is suggested that this decrease in the rate of glucose phosphorylation is caused by the observed elevated concentration of glucose 6-phosphate, which inhibits hexokinase activity. This conclusion is supported by the fact that isoprenaline had no effect on the stimulation of 3-O-methylglucose transport by insulin. PMID- 3513765 TI - Protein kinase C desensitization by phorbol esters and its impact on growth of human breast cancer cells. AB - Active phorbol esters such as TPA (12-0-tetra-decanoylphorbol-13-acetate) inhibited growth of mammary carcinoma cells (MCF-7 greater than BT-20 greater than MDA-MB-231 greater than = ZR-75-1 greater than HBL-100) with the exception of T-47-D cells presumably by interacting with the phospholipid/Ca2+-dependent protein kinase (PKC). The nonresponsive T-47-D cells exhibited the lowest PKC activity. A rapid (30 min) TPA-dependent translocation of cytosolic PKC to membranes was found in the five TPA-sensitive cell without affecting cell growth. However, TPA-treatment of more than 10 hours inhibited reversibly the growth of TPA-responsive cells. This effect coincided with the complete loss of cellular PKC activity due to the proteolysis of the translocated membrane-bound PKC holoenzyme (75K) into 60K and 50K PKC fragments. Resumption of cell growth after TPA-removal was closely related to the specific reappearance of the PKC holoenzyme activity (75K) in the TPA-responsive human mammary tumor cell lines suggesting an involvement of PKC in growth regulation. PMID- 3513764 TI - Effect of insulin on low-density-lipoprotein metabolism in human lymphocytes in vitro. AB - The metabolism of low-density lipoproteins (LDL) in vitro in the presence of insulin was studied in freshly isolated human peripheral-blood lymphocytes. Insulin appeared to decrease the binding affinity of 125I-LDL to its cell-surface receptor, without any change in apparent Vmax or in the number of LDL receptors. As a consequence, the absolute amounts of 125I-LDL internalized and degraded were lower in the presence of insulin than in its abscence, although the fraction of internalized 125I-LDL degraded in either instance was quite similar. 3-Hydroxy-3 methylglutaryl-CoA reductase activity, and hence cholesterol synthesis, were stimulated by insulin. This effect of insulin was independent of the inhibitory effect of LDL on cholesterol synthesis. At the same time, acid cholesterol esterase and acyl-CoA: cholesterol O-acetyltransferase activities were lower in cells incubated with insulin than in controls. The net effect of these metabolic alterations seems to be that cells accumulate greater quantities of free and esterified cholesterol when treated with insulin. PMID- 3513767 TI - Effects on prostanoid formation and pharmacokinetics of dazmegrel (UK-38,485), a novel thromboxane synthase inhibitor, in man. AB - The pharmacokinetics of dazmegrel (UK-38,485), a novel selective thromboxane synthase inhibitor, and its effects on in vivo prostanoid formation were studied in a 2 weeks, multiple dose, placebo controlled, double blind trial in man. The drug was well tolerated. After dazmegrel 50-200 mg p.o. peak plasma levels of 0.7 3 mu/ml were reached within 1 hr. Elimination was of first order with a half life of 0.88 +/- 0.17 hr. Platelet count and bleeding time were unchanged by all regimes of dazmegrel used (100 and 200 mg b.i.d.; 50, 100 and 200 mg t.i.d.). Serum thromboxane (TXB2) was more than 95% suppressed one hour after all doses studied, but 200 mg t.i.d. were needed suppress circadian serum TXB2 profiles more than 90% at all times. Urinary excretion of 2,3-dinor-TXB2 (TXA2-M) fell by over 90%. An increase in the excretion of 2,3-dinor-6-keto-PGF1 alpha (PGI2-M), the major metabolite of prostacyclin, was largely transient and fell short of significance at all times. The ratio of TXA2-M to PGI2-M was lowered from about 5.0 to 0.2 and sustained throughout treatment. Dazmegrel selectively blocks in vivo and ex vivo TXA2 formation. Redirection of endoperoxides from total body TXA2 formation into prostacyclin formation is only minor under basal conditions. PMID- 3513766 TI - Current concepts of regulation of phosphate transport in renal proximal tubules. AB - The wealth of new information on BBM transport of Pi which has accumulated in recent years gives an indication of the importance and intellectual challenge that the mechanism of this process poses to investigators. In this brief reflection on the field, we have tried to draw attention to some general principles and features which may be helpful as working hypotheses in the development of the field. To date, a disproportionate amount of effort may have been spent on deciphering putative intracellular regulatory mechanisms, without knowing some essential fundamental properties of the Na+-Pi-COT. We suggest that a major effort should be exerted towards elucidating biogenesis of the Na+-Pi COT, the possible existence of a membrane cycling mechanism, and a refined analysis of the Na+-Pi-COT in specific subsegments of proximal tubules. Advances in these areas together with studies of both the rapid and long-term adaptive regulation of Pi transport are needed, given the central role of the kidney in total body Pi homeostasis both in health and disease. PMID- 3513768 TI - Liver regeneration in streptozotocin-diabetic rats. PMID- 3513769 TI - [Ribosomal protein S1 in the complex of E. coli ribosomal subunit 30S with phage MS2 RNA interacts with internal region of the replicase gene]. AB - The MS2 RNA fragments bound to ribosomal protein S1 within the complex of MS2 RNA with 30S ribosomal subunit have been isolated using a specially developed procedure and sequenced by the base-specific enzymatic method. The S1-binding site on MS2 RNA was identified as UUUCUUACAUGACAAAUCCUUGUCAUG and mapped within the replicase gene at positions 2030-2056. This finding suggests that ribosome MS2 RNA interaction involves at least two different regions of the phage RNA--the internal region of the replicase gene (S1-binding site) and ribosome-binding site of the coat protein gene. The possible spatial proximity between these two regions is discussed. PMID- 3513770 TI - Immunofluorescence studies of florid rheumatic Aschoff lesions. AB - We studied cardiac tissues of a patient who died of severe rheumatic myocarditis. Multiple Aschoff lesions were present throughout both ventricles and auricles. Immunofluorescence studies showed large monocytoid cells staining with OKM1 and anti-Leu M-3 as well as anti-Ia. Scattered T cells in areas of focal myocarditis stained with OKT3. Parallel staining for cardiac myosin-heavy chain antigens showed patchy dissolution of cardiac muscle fibers and traces of cardiac myosin within large monocytoid Aschoff cells. PMID- 3513771 TI - Food-induced (allergic) arthritis. Inflammatory arthritis exacerbated by milk. AB - Suggestive, but largely unproven, observations have associated arthritis with environmental antigens, including foods. We studied a patient with inflammatory arthritis in a prospective, "blinded," controlled fashion to determine whether her symptoms were associated with food sensitivities. This 52-year-old white woman with 11 years of class I, stage I, active disease, had symptomatic exacerbations allegedly associated with meat, milk, and beans. We observed an increase in symptoms following an unblinded food challenge and then studied her in our clinical research unit. On her normal diet for 6 days, she averaged 30 minutes of morning stiffness, 9 tender joints, 3 swollen joints, 87% subjective assessment (100% = best possible), and 89% examiner assessment. While she was fasting (3 days) or taking Vivonex (2 days), we noted no morning stiffness, tender joint score of 1, swollen joint score of 0, and assessments of 100% (P less than 0.05 versus normal diet). She was then nourished with Vivonex for 33 days without difficulty and challenged in a blinded fashion at mealtimes with lyophilized foods placed into opaque capsules. Four milk challenges (equivalent to greater than or equal to 8 ounces per meal) produced up to 30 minutes of morning stiffness, 14 tender joints, 4 swollen joints, subjective assessment of 85%, and objective assessment of 80% (P less than 0.05 versus fasting-Vivonex), peaking 24-48 hours postchallenge. Placebo and other foods (lettuce and carrots) were without effect.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3513772 TI - Secretion of higher levels of active proteoglycanases from human osteoarthritic chondrocytes. PMID- 3513773 TI - 2-Acetylpyridine thiosemicarbazones. 12. Derivatives of 3-acetylisoquinoline as potential antimalarial agents. AB - A series of 3-acetylisoquinoline thiosemicarbazones and their related thiosemicarbazides was prepared for evaluation as potential antimalarial agents. The former were synthesized by the reaction of 3-acetylisoquinoline with methyl hydrazinecarbodithioate to give methyl 3-[1-(3 isoquinolinyl)ethylidene]hydrazinecarbodithioate, IV. Displacement of the S methyl group of this intermediate by the requisite amines gave 3 acetylisoquinoline thiosemicarbazones, V. The corresponding thiosemicarbazides, in which the azomethine bond was reduced, were prepared by the reduction of IV with sodium borohydride to give methyl 3-[1-(3 isoquinolinyl)ethyl]hydrazinecarbodithioate, VI. Reaction of this dithioester with amines gave 1-[1-(3-isoquinolinyl)ethyl-3-thiosemicarbazides, VII. The antimalarial properties of series V and VII were evaluated in mice infected with Plasmodium berghei. Significant curative activity could be observed at doses as low as 40 mg/kg for 3 of 10 compounds in series V and at 160 mg/kg for 3 of 11 compounds in series VII. PMID- 3513774 TI - Evaluation of the toxicity of Rh(III) and Pt(II) complexes against Trypanosoma cruzi culture forms. AB - In the present study the activity of 15 complexes of Rh(III) and 19 of Pt(II) against Trypanosoma cruzi epimastigote forms was investigated. The results obtained show that complexes of Rh(III) with the highest antitumoural activity also appear to be more effective against cultured epimastigotes. Thus, complexes [Rh(L)4X2]+X- where L is a derivative of thiazole present high activity against the parasite, and were even more active when Cl- (X) was present in their structure. Complexes cis-Pt(L)m(X)n that present 1,2-diamminecyclohexane (DDH) in their molecule, e.g. cis-Pt(DDH)Cl2 and cis-Pt(DDH)(metafluorobenzoic)2 of high and moderate antitumoural activity, respectively, have shown greater effectiveness than cis-Pt(NH3)2Cl2 (DDP). The effect produced by cis Pt(pentamidine)Cl2 complex, obtained in order to enforce the action of pentamidine, was considerably high. On the other hand, no positive correlation can be established between the antitumour effects of the Pt(II) complexes and its antitrypanosomic activity. PMID- 3513775 TI - In vitro studies of antidermatophytic activity of juliflorine and its screening as carcinogen in Salmonella/microsome test system. AB - Juliflorine, an alkaloid from Prosopis juliflora, was tested for its antifungal activity against the freshly isolated cultures of dermatophytic fungi and its inhibitory effect was compared with that of griseofulvin. The results indicated that the minimum inhibitory concentration (MIC) of juliflorine against Trichophyton rubrum, Trichophyton violaceum, Trichophyton mentagrophytes, Trichophyton tonsurans, Trichophyton megninii, Trichophyton gallinae, Microsporum canis, Microsporum nanum, Microsporum ferrugineum and Epidermophyton floccosum was 1.5 micrograms/ml, whereas that of griseofulvin was 0.1-0.5 microgram/ml. MIC of juliflorine for Candida albicans was 0.05 mg/ml. The alkaloid was also subjected to screening for carcinogenicity in the Ames test (salmonella/microsome test system). The results indicated that the compound in the recommended concentrations did not exhibit positive mutagenic reaction, as compared to a strong positive reaction by ethyl methane sulfonate based on his- ----his+ revertants. PMID- 3513776 TI - Disposition and metabolism of the novel antihypertensive agent alacepril in rats. AB - Disposition and metabolism of 1-[(S)-3-acetylthio-2-methylpropanoyl]-L-prolyl-L phenylalanine (alacepril, DU-1219) in rats were studied and compared to those of 1-[(S)-3-mercapto-2-methylpropanoyl]-L-proline (captopril), using 14C-labeled compounds. Some tissue homogenates and plasma of rats were incubated in vitro with [14C]alacepril or [14C]captopril at the concentration of 50 nmol/ml. For in vivo studies, radioactive agents were orally or intravenously administered to rats in doses of 46 mumol/kg (18.7 and 10 mg/kg for alacepril and captopril, respectively) or 460 mumol/kg. In vitro studies revealed that [14C]alacepril is converted to captopril via desacetyl-alacepril (DU-1227) in the liver, kidney and intestine homogenates, but not in the lung homogenate and plasma where deacetylation alone occurred. DU-1227 and captopril formed were found to be partly bound with endogenous -SH compounds i.e. cysteine, glutathione and probably, protein. 1 h after oral administration of [14C]alacepril, plasma levels of total radioactivity reached a maximum of 8 nmol/ml and disappeared with t1/2 of 2.6 h. [14C]Captopril radioactivity was maximum (13 nmol/ml) at 40 min with the disappearance t1/2 of 1.9 h. Similarly to total radioactivity, levels of radioactivity unbound and bound to plasma protein after [14C]alacepril were lower at maximum and disappeared more slowly than those after [14C]captopril. After oral administration of [14C]alacepril, DU-1227, captopril and mixed disulfides of captopril with cysteine and glutathione were detected in the plasma unbound fraction. The three metabolites except for DU-1227 were commonly detected after [14C]captopril.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3513777 TI - General pharmacology of the novel angiotensin converting enzyme inhibitor alacepril. 1st communication: Effects on cardiovascular, visceral and renal functions and on blood. AB - The effects of 1-[(S)-3-acetylthio-2-methylpropanoyl]-L-prolyl-L-phenylalanine (alacepril, DU-1219) an antihypertensive compound with angiotensin converting enzyme inhibitory activity, and its metabolite, desacetyl-alacepril (DU-1227), on the cardiovascular and autonomic nervous systems and on the blood were compared with those of captopril in the experimental animals. Alacepril and DU-1227 at the i.v. dose of 10 mg/kg gradually lowered the diastolic blood pressure in pentobarbital anesthetized dogs. Captopril showed similar effects. However, the former two compounds showed triphasic effects on the carotid blood flow, i.e., transient increase immediately after the injection, second increase 2 min later, and gradual decrease 20-30 min later. The second increase by DU-1227 was more potent than that by alacepril. Alacepril, DU-1227 and captopril did not affect the pressor responses induced by norepinephrine in anesthetized cats. The contractions of the nictitating membrane in cats induced by electrical stimulation of the cervical sympathetic nerve or epinephrine were depressed with high doses of these three compounds. Captopril potentiated the contractions induced by bradykinin in isolated guinea-pig ileum, while alacepril and DU-1227 were without effect. These three compounds neither affected the resting tension of isolated ileum in guinea-pigs and rabbits nor the contractions induced by acetylcholine, histamine, serotonin and nicotine of isolated guinea-pig ileum. Alacepril at the oral dose of 60 mg/kg decreased the total acidity in pylorus ligated rats, and at higher doses depressed the intestinal charcoal meal passage in mice. Alacepril at comparatively low doses decreased the urine volume with slight reduction of Na+ and K+ excretions in saline-loaded rats.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3513778 TI - General pharmacology of the novel angiotensin converting enzyme inhibitor alacepril. 2nd communication: Effects on central nervous and sensory systems and on the other functions. AB - The effects of 1-[(S)-3-acetylthio-2-methylpropanoyl]-L-prolyl-L-phenylalanine (alacepril, DU-1219), an orally active angiotensin converting enzyme inhibitor, on the central nervous and sensory systems and on several other functions were compared with those of captopril in the experimental animals. Alacepril at the high oral dose of 600 mg/kg prolonged the hexobarbital sleeping time and potentiated the reserpine-induced hypothermia in mice. However, alacepril at the same dose did not affect the general behavior, convulsions induced by maximal electroshock, pentetrazol and strychnine, active avoidance in mice and body temperature in rats. In addition, alacepril (200 mg/kg i.v.) has little effect on general behavior in mice. Captopril at over 107 mg/kg p.o. produced eyelid closure and at 320 mg/kg prolonged the hexobarbital sleeping time. A metabolite of alacepril, desacetylalacepril (DU-1227) (200 mg/kg i.v.), caused salivation in mice. Alacepril and DU-1227 at 60 mg/kg i.v. were without effect on flexor reflex and spontaneous electroencephalogram (EEG) in cats, while captopril at the equimolar dose depressed the flexor reflex and showed a tendency to increase the beta 2-band relative power of the cortical EEG. Alacepril and captopril neither affected the writhing syndrome induced by acetic acid nor that by phenylquinone in mice. Local anesthetic and irritant activities in rabbits and effect on neuromuscular junction in anesthetized rats were not observed with the two compounds. Alacepril at the oral dose of 0.1 mg/kg potentiated the carrageenin induced edema in rats. However, the effect was one third that of captopril. Alacepril and captopril did not affect the increased vascular permeability by acetic acid in mice.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3513779 TI - Effect of the novel orally active angiotensin converting enzyme inhibitor alacepril on cardiovascular system in experimental animals. AB - Effects of 1-[(S)-3-acetylthio-2-methylpropanoyl]-L-prolyl-L-phenylalanine (alacepril, DU-1219) a new orally active angiotensin converting enzyme (ACE) inhibitor, on cardiovascular system in experimental animals were examined. In conscious renal hypertensive dogs, alacepril (3 mg/kg p.o.) caused a marked reduction in systolic and diastolic blood pressure (SBP and DBP) and total peripheral vascular resistance (TPR), but did not change significantly heart rate (HR), cardiac output (CO), stroke volume (SV), cardiac work (CW) and electrocardiogram (ECG). Captopril (3 mg/kg, p.o.) showed similar changes in cardiovascular parameters as alacepril. In anesthetized open-chest normotensive dogs, alacepril (3-100 micrograms/kg/min for 10 min, i.v. infusion) tended to decrease DBP and TPR, but did not change significantly CO, stroke work (SW), left ventricular end diastolic pressure (LVEDP), dp/dt and HR. Captopril also showed similar effects but these changes were greater in extent than those of alacepril. In conscious renal hypertensive rats, alacepril did not affect the regional cerebral blood flow in the frontal cortex and the dorsal hippocampus after single (3 and 10 mg/kg) and successive (3 mg/kg/d for 7 days) oral administration. Captopril (10 mg/kg) significantly decreased blood flow in the frontal cortex after single oral administration. In conscious normotensive dogs, alacepril (3 and 30 mg/kg p.o.) increased renal plasma flow (RPF), urine volume (UV), urinary sodium excretion (UNaV) and urinary Na+/k+ ratio, but did not change glomerular filtration rate (GFR) and urinary potassium excretion (UKV). Captopril (3 and 30 mg/kg p.o.) also showed similar changes as alacepril. These effects of alacepril on cardiovascular system resemble those of captopril and might be considered as a favourable profile for the antihypertensive agent. PMID- 3513781 TI - The historical basis for nursing's troubled self-image. PMID- 3513780 TI - Antihypertensive mechanism of alacepril: effect on norepinephrine-induced vasoconstrictive response in vitro and in vivo. AB - To investigate the antihypertensive mechanism of 1-[(S)-3-acetylthio-2 methylpropanoyl]-L-prolyl-L-phenylalanine (alacepril, DU-1219) a novel orally active angiotensin converting enzyme inhibitor, we studied the inhibitory activity of alacepril and DU-1227 (desacetyl-alacepril, a metabolite of alacepril) on the norepinephrine (noradrenaline, NA)-induced vasoconstrictive and pressor response in vitro and in vivo, and compared with that of captopril. Alacepril and captopril (3 X 10(-4) mol/l) attenuated slightly the NA-induced contractile response in isolated rat thoracic aorta and mesenteric artery, however, DU-1227 (3 X 10(-4) mol/l) inhibited more strongly the response in main artery and peripheral vascular bed. Orally given alacepril (18.7 mg/kg) inhibited the NA-induced pressor response in conscious normotensive rats, and the activity was more potent and long-lasting than that of an equimolar dose of captopril (10 mg/kg). After oral administration in hypertensive rats challenged with NA, alacepril (1.87 to 18.7 mg/kg) showed a dose-related antihypertensive effect which was slower in onset and longer lasting than that of equimolar dose of captopril (1.0 to 10.0 mg/kg). Consequently, the reduced sensitivity of the sympathetic nervous system in peripheral vasculature might contribute partly to the antihypertensive mechanism of alacepril. PMID- 3513782 TI - Indications for ultrasonography in obstetrics. PMID- 3513783 TI - Controlled trials of routine ultrasound in pregnancy. PMID- 3513784 TI - Possible hazards of imaging and Doppler ultrasound in obstetrics. PMID- 3513785 TI - Women's views of ultrasonography in obstetrics. PMID- 3513786 TI - Research strategies for the use of imaging ultrasound as an obstetric screening tool. PMID- 3513787 TI - Royal Society of Medicine Forum on maternity and the newborn: ultrasonography in obstetrics. PMID- 3513788 TI - The history of ultrasonography in obstetrics. PMID- 3513789 TI - Arthroscopic meniscal repair evaluated with repeat arthroscopy. AB - Arthroscopic meniscal repair is a technically feasible approach to the treatment of meniscal tears in young active individuals. To evaluate this premise, we repaired 29 minisci in 27 patients and then arthroscoped their knees 3 months later. Repairs were limited to displaceable longitudinal tears. In 16 patients ligaments were intact. Eleven patients were anterior cruciate ligament deficient, six of whom underwent concomitant ACL reconstructions. In two patients, bicompartmental tears were encountered. Under arthroscopic control, using curved cannulae, horizontal mattress sutures of absorbable monofilament were placed across the tear, out through the capsule, and tied over the fascia, deep to the skin. No arthrotomies were performed, and all portions of the menisci could be reached with this method. Twenty-four of 29 repairs healed completely; 5 healed partially (30 to 50% healing). Four of the five failed repairs occurred in unstable anterior cruciate ligament deficient knees. PMID- 3513790 TI - Arthroscopic meniscus repair: a safe approach to the posterior horns. AB - Seventy arthroscopic meniscus repairs were performed using a technique that places posterior horn sutures through spinal needles from safe posterior corner punctures, thus avoiding injury to the posterior neurovascular structures. Follow up averaged 18 months, with a range from 12 to 28 months. Associated anterior cruciate ligament instability (31%) was either stabilized surgically (13%) or braced postoperatively for pivoting activity (18%). Clinical results were excellent in 98.6% of patients, with only one second tear (1.5%) occurring 2 months postoperatively. Complications (2.8%) included one transient saphenous nerve irritation and one case of pyarthrosis. No major neurovascular complications occurred. PMID- 3513791 TI - Arthroscopy and irrigation control. AB - Saline flow through 2.2, 3.8, and 5.0 mm arthroscopes was studied by varying inflow pressure from 0 to 20 kPa, corresponding to the effect of gravity from 0 to 7 feet. The relation between knee joint distention and intraarticular pressure was studied in 25 patients under general anesthesia, and the secondary effect on gravity flow was calculated. Without distention, flow due to gravity alone was adequate through the larger arthroscopes, but diminished rapidly to low values by distending the joint. Even with a 5.0 mm arthroscope and bags at 7 feet (20 kPa), inflow was low when the joint was distended for arthroscopy. Effective clearing by high flow, combined with distention for hemostasis of capsular vessels, demands the use of a pump. Pump irrigation is most effective and also safe when controlled directly by the surgeon. PMID- 3513792 TI - An iterative region-growing process for cell image segmentation based on local color similarity and global shape criteria. AB - An image segmentation process was derived from an image model that assumed that cell images represent objects having characteristic relationships, limited shape properties and definite local color features. These assumptions allowed the design of a region-growing process in which the color features were used to iteratively aggregate image points in alternation with a test of the convexity of the aggregate obtained. The combination of both local and global criteria allowed the self-adaptation of the algorithm to segmentation difficulties and led to a self-assessment of the adequacy of the final segmentation result. The quality of the segmentation was evaluated by visual control of the match between cell images and the corresponding segmentation masks proposed by the algorithm. A comparison between this region-growing process and the conventional gray-level thresholding is illustrated. A field test involving 700 bone marrow cells, randomly selected from May-Grunwald-Giemsa-stained smears, allowed the evaluation of the efficiency, effectiveness and confidence of the algorithm: 96% of the cells were evaluated as correctly segmented by the algorithm's self-assessment of adequacy, with a 98% confidence. The principles of the other major segmentation algorithms are also reviewed. PMID- 3513793 TI - Morphometry in the diagnosis of Sjogren's syndrome. AB - Sublabial salivary gland biopsies of 20 patients with Sjogren's syndrome and 58 controls were analyzed morphometrically to determine which histologic changes in the tissue are specific enough to justify a diagnosis of Sjogren's syndrome and which changes are due to physiologic aging. The acinar atrophy, fibrosis, ductal hyperplasia and ductal dilatation mentioned in the literature as features of Sjogren's syndrome are also observed in the tissue of aging individuals, and the lymphocytic focus score cited as the most important diagnostic parameter gives rise to about 9% of false-positive diagnoses. When using single quantitative histologic parameters, the volume percentages (Vol%) of lymphocytic foci, diffuse lymphoplasmacytic infiltrate (DLPI), acini and the inner diameter of intralobular ducts (ILD) were able to discern between the patients and the controls at a significant level, regardless of age, although considerable overlap was still present. This overlap could be reduced by consideration of at least two histologic parameters. The inhomogeneity within the tissue constituents was also used in discriminating between the patients and the control subjects. The best bivariate discriminating combination of histologic parameters was Vol% of lymphocytic foci and DLPI. Compared with qualitative subjective evaluation, this morphometric decision rule in the present material gave a 5 X reduction in the number of false-positive diagnoses of Sjogren's syndrome, with only 1 of the 58 control subjects erroneously classified as having the syndrome. We conclude that quantitative investigation of sublabial salivary gland tissue will improve the diagnostic criteria needed for the definition of Sjogren's syndrome. PMID- 3513794 TI - Comparative study of automated morphometric and semiquantitative estimations of alcoholic liver steatosis. AB - Needle biopsy of the liver is of great value in appreciating the intensity, type and topography of the steatosis commonly observed during chronic alcoholic diseases. The usual semiquantitative optical analysis is very inaccurate and depends on the subjectivity and training of the pathologist. We therefore performed an automated analysis of liver steatosis using a QTM 720 image analyzer connected to a PDP 11/34 minicomputer. Visual control of the results of the automated analysis showed it to give good results: 94% of the droplets were detected and only 10% of the patterns automatically selected were not droplets. Eight normal biopsies and 37 biopsies showing alcoholic liver steatosis were analyzed. The automated morphometric analysis calculated the mean density (percentage) of steatosis and the size distribution of the droplets. Statistical comparison of these results with those of the semiquantitative optical analysis performed independently by two pathologists showed a significant correlation between their calculations of the density/degree of steatosis but significant differences for their evaluation of the type of steatosis. The pathologists constantly overestimated the ratio of macrodroplets to microdroplets. PMID- 3513795 TI - Personal computer software for the stereologic evaluation of sympathetic ganglia. AB - Software was developed on a personal computer for a quantitative study of some ultrastructural aspects of sympathetic ganglia (the neuronal cell body, the surrounding satellite cell layer and the nearby capillaries). A low-cost digitizer, originally designed for teaching, semiprofessional graphics applications and games, was utilized to sample areas and distances on electron micrographs. The processing program derives stereologic parameters from the crude data stored in the memory. Further algorithms then assess the mean thickness and the volume densities of the satellite cell layer, endothelial basal lamina and endothelial layer. PMID- 3513796 TI - A BASIC program for computer-assisted point-counting techniques. AB - Description is given of a BASIC program running on inexpensive microcomputers (Commodore CBM 64, SX 64 and Apple II[e]) to facilitate and accelerate substantially the point-counting technique, one of the most widely used methods in the determination of such stereologic parameters as VV, AA, SV, BA, JV, KV and NV. The program aims to alleviate the most laborious manipulations required to obtain estimates of stereologic parameters and their statistical assessments. The program requires the declaration of the coherent grid constants, the desired stereologic parameters and the definition of up to ten keys of the computer keyboard to be used as score counters for the registration of particular grid object events. After the registration of these decision events, the program is used to count points, intersections, transsections, number of profiles and tangents of a coherent test grid system with the objects of interest in a histologic section. The computer then calculates the stereologic parameters as well as the standard deviation and standard error of mean of these parameters, using the contents of the score counters as arguments. The flexibility of the program allows for the construction of investigator-defined parameters that can be expressed as a ratio of particular events as well as the use of standard stereologic parameters. While the program has been successfully utilized by nonprogrammers following basic instruction, knowledge of the elementary principles of stereology is a must in utilizing all of the possibilities of the program. PMID- 3513797 TI - [The abused child syndrome. Spectrum of a problem]. PMID- 3513798 TI - Dietary self-selection in chronically insulin-treated golden hamsters. AB - Adult male golden hamsters were maintained on either Purina Rat Chow (chow group) or a self-selection diet consisting of high-protein chow, pure carbohydrate, and pure fat (choice group). Animals were injected for 12 consecutive days with either long-acting insulin (20 U/kg for 4 days, 60 U/kg for 4 days, and 100 U/kg for 4 days) or physiological saline. Insulin-injected hamsters under both dietary conditions increased their total caloric consumption by up to 33% and gained significantly more weight than saline-injected controls. Choice hamsters increased their fat intake in response to the 60 and 100 U/kg doses of insulin, but carbohydrate and protein consumption increased only in response to the 100 U/kg dose. Choice hamsters derived approximately 65% of the excess calories ingested during insulin administration from fat, but only 20% from carbohydrate and 15% from protein. Results are related to those previously observed in other species. PMID- 3513799 TI - Leu-enkephalin impairs memory of an appetitive maze response in mice. AB - Leu-enkephalin (300 micrograms/kg) impaired memory of a Y-maze response in mice when the animals were trained to obtain food in one arm of the maze. The dose response function was U-shaped, with neither 100 nor 600 micrograms/kg having any effect. Des-Tyr-Leu-enkephalin, a nonopioid peptide, had no effect at doses equimolar to the leu-enkephalin. Finally, the leu-enkephalin (300 micrograms/kg) was without effect if the drug injection was delayed 90 min. The results show that leu-enkephalin affects appetitive conditioning in much the same way as avoidance conditioning, a finding that suggests that leu-enkephalin may generally influence learning and memory. PMID- 3513800 TI - Thyroid cartilage imaging with diagnostic ultrasound. Correlative studies. AB - In 1976, Noyek observed that the thyroid cartilage framework of the larynx could be imaged by diagnostic ultrasound; the image appeared uniquely independent of the presence or absence of calcification. It was suggested that ultrasound, with its simple, nonroentgenographic, noninvasive features, might permit screening detection of thyroid cartilage destruction. It might, therefore, give direction to better computed tomographic (CT) imaging, and, specifically, more effectively identify T4 laryngeal cancer. Since that time, with improving generations of ultrasound transducers, more than 130 clinically correlated laryngeal ultrasound examinations have been recorded. Thirty CT, ultrasound, and pathologically correlated advanced cases of laryngeal carcinoma were critically evaluated by the Departments of Otolaryngology and Radiology at Mount Sinai Hospital, Toronto. Our diagnostic imaging approach has resulted in remarkably improved thyroid cartilage imaging by CT when "directed" by preliminary ultrasound. PMID- 3513801 TI - Prostaglandin inhibitor and radiotherapy in advanced head and neck cancers. AB - Radiotherapy is the usual mode of treatment for unresectable head and neck cancer. To improve cure rates, extend survival, and reduce morbidity, we use accelerated hyperfractionation radiotherapy and an adjuvant drug to inhibit prostaglandin synthesis. In this study, 19 patients received 300 rad/day of radiotherapy in two equally divided doses to a total dose averaging 6,200 rad. Either indomethacin, 25 mg, or placebo was given four times a day in a double blind fashion during therapy. Radiation mucositis was graded as 0 to 4+; pain, nutritional status, and tumor status were monitored daily and recorded biweekly. Evaluation of the data showed delayed mucositis in the experimental group for grades 1 to 3, with a significant difference at grade 3 compared with controls. The significance of a long-term comparison of cure rates would be doubtful considering the heterogeneity of the primary sites and regional disease in this group coupled with the small size of our study. PMID- 3513802 TI - Antibody response in experimental Haemophilus influenzae otitis media. AB - Because Haemophilus influenzae is one of the most common pathogens in otitis media with effusion, we have investigated the antibody response in the serum and middle ear effusion (MEE) in nontypable H influenzae-induced experimental acute otitis media in the chinchilla, using an enzyme-linked immunosorbent assay. During acute otitis media, a reasonable antibody titer was observed: local antibody titers in the MEEs were equal to or greater than those of the serum samples for four of five MEE samples obtained at one week after inoculation. By two weeks, titers in both serum and MEE samples were increased significantly. However, the bacteria persisted in the middle ear cavity, even in the presence of increasing antibody titers, for up to five weeks after infection. The reason for this persistence of the bacteria in the middle ear is unknown. PMID- 3513803 TI - A wonderful journey through skull and brains: the travels of Mr. Gage's tamping iron. AB - Phineas Gage was injured by his tamping iron nearly 140 years ago, and only one similar case has been reported since then. In this paper, the contemporary popular and medical responses to the news of Gage's accident are summarized. An attempt is made to evaluate the contribution of Harlow's treatment of Gage as well as the successive bearings which the case was thought to have on analyses of brain function, aphasia, and frontal lobe function. PMID- 3513804 TI - 'The deformation of cusps by bonded posterior composite restoration'. PMID- 3513805 TI - A practical form of pre-extraction records for construction of complete dentures. PMID- 3513806 TI - An investigation of the efficacy of nystatin for the treatment of chronic atrophic candidosis (denture sore mouth). PMID- 3513807 TI - Diurnal variation of the QT interval--influence of the autonomic nervous system. AB - To assess the influence of diurnal changes in the autonomic nervous system on the QT interval, 24 hour dynamic electrocardiographic monitoring was performed in six pacemaker dependent patients with normally innervated hearts, in six cardiac transplant patients with anatomically denervated hearts (but which respond to circulating catecholamines), and in nine diabetic patients with confirmed autonomic neuropathy. QT and RR intervals from hourly intervals were measured and Bazett's formula was used to correct QT intervals during sinus rhythm. All QT intervals were normalised by dividing by the mean QT for the 24 hours in each patient and were expressed as a percentage. There was pronounced diurnal variation of normalised QT in the patients with normally innervated hearts. QT intervals were longer during sleep than during waking hours (06.00 vs 18.00 h, 102.5% vs 97.8%). Diurnal variation was blunted in the transplant patients (101.3% vs 98.1%) and absent in the diabetic patients (100.0% vs 100.3%). In the normally innervated patients changes were most pronounced at the time of waking (06.00 vs 09.00 h, 102.5% vs 95.4%). There was no change in normalised QT in the transplant and diabetic patients at this time. There was no significant difference between normalised QT for the three groups during sleep, but this variable was shorter in innervated patients during waking hours (for example at 10.00 h, innervated 96.5%, transplant 100.7%, diabetic 100.7%). Diurnal changes of the QT interval may be pronounced in the innervated heart and are dependent on both variations in autonomic tone and concentrations of circulating catecholamines. These changes in repolarisation may be related to the reported diurnal pattern of ventricular arrhythmias. PMID- 3513809 TI - Effect of captopril on bradykinin inactivation by human foetal placental circulation. AB - The inactivation of bradykinin on passage across the human foetal placental circulation was investigated in six full-term human placentas. The placentas were perfused with a modified Krebs-Henseleit solution and placenta perfusion pressure was recorded. Samples collected at the arterial inflow and at the venous effluent were assayed on the isolated guinea-pig ileum as an estimation of bradykinin activity. Bradykinin (100 ng ml-1) was infused through the foetal placental vessels before and during captopril 4 X 10(-7) M. Bradykinin produced a transient increase in placental vascular resistance that was not potentiated by captopril. Bradykinin activity was completely abolished after passage through the foetal placental circulation, and the inactivation was blocked by captopril. These data suggest that angiotensin I converting enzyme (kininase II) might occur in the foetal placental vessels. PMID- 3513808 TI - Vasodilatation with captopril and prazosin in chronic heart failure: double blind study at rest and on exercise. AB - A double blind cross over study was performed to compare the long term hormonal, haemodynamic, and clinical responses to specific inhibition of the renin angiotensin-aldosterone system (captopril) and of the alpha 1 adrenoceptors of the sympathetic system (prazosin) both at rest and during upright exercise in patients with chronic heart failure. Sixteen patients completed one month's treatment with each drug. During conventional diuretic treatment (control) plasma renin activity, aldosterone, and noradrenaline were increased at rest and on exercise. Control left ventricular filling pressures were raised, and correlated significantly with plasma renin activity both at rest and on exercise. Systemic vascular resistance was increased at rest, and its reduction during exercise correlated inversely with the increase in plasma renin activity and plasma noradrenaline. After one month's treatment with captopril there were reductions in plasma aldosterone, weight, left ventricular filling pressure, and systemic vascular resistance at rest and on exercise. Dyspnoea was relieved and exercise capacity increased. The greater fall in systemic vascular resistance on exercise no longer correlated with the increase in plasma renin activity. During treatment with prazosin there were increases in plasma noradrenaline and, transiently, in plasma aldosterone. Fluid retention occurred, and left ventricular filling pressure was unchanged. Compared with control values systemic vascular resistance was reduced at rest but not on exercise. Dyspnoea and exercise capacity did not improve. In chronic heart failure, vasodilatation by inhibition of the alpha adrenergic system with prazosin causes compensatory stimulation of the renin angiotensin-aldosterone system and does not result in clinical benefit. Inhibition of the renin-angiotensin-aldosterone system with captopril causes secondary vasodilatation at rest and on exercise and results in improvement in symptoms and exercise capacity. PMID- 3513810 TI - A comparison of the clinical and bronchodilating effects of plain and slow release tablets of terbutaline at steady state. AB - The clinical efficacy, the bronchodilating effect and the side effects of two oral forms of terbutaline were compared in a double-blind, cross-over study involving ten patients with chronic reversible airways obstruction. The administration of plain-tablets, containing 2.5 mg terbutaline sulphate, three times daily at 6 h intervals was compared to the administration of slow-release (SR) tablets, containing 5 mg terbutaline sulphate, every 12 h. Each course of treatment lasted for 7 days. Treatment with SR-tablets resulted in significantly higher lung function values in the morning (PEFR at home and FEV1 at the lung function laboratory on day 7). There were no significant differences between the two forms with regard to symptom score, extra use of rimiterol aerosol, heart rate or blood pressure. The plasma terbutaline concentration in the morning of the seventh treatment day was significantly higher during SR-tablet treatment. The plasma terbutaline concentration curve showed a smaller peak/trough ratio for the SR-tablets. PMID- 3513811 TI - Bronchodilator activity of a new inhaled beta 2-adrenoceptor agonist, tulobuterol and its protective effect in exercise-induced asthma. AB - In fifteen patients with asthma tulobuterol, a new beta 2-adrenoceptor agonist, given by inhalation in 100 micrograms increments up to a cumulative dose of 600 micrograms produced dose related increases in both the FEV1 and FVC. The bronchodilation was observed within 5 min of the first dose. In a further nine patients tulobuterol 200 micrograms and 400 micrograms aerosol inhibited exercise induced asthma following 6-8 min treadmill exercise and the effect was comparable to 200 micrograms salbutamol aerosol. Minor muscle tremors were observed in two patients with 400 micrograms of tulobuterol but no significant changes in pulse rate or blood pressure were noted. PMID- 3513813 TI - Gastrointestinal cancer-associated antigen CA 19-9 in histological specimens of pancreatic tumours and pancreatitis. AB - The expression of the gastrointestinal cancer associated antigen CA 19-9, defined by the monoclonal antibody 1116 NS 19-9, was studied by immunoperoxidase staining in routine formalin-fixed, paraffin-embedded tissue sections from normal pancreata, pancreata with pancreatitis and from benign and malignant pancreatic neoplasms. The formalin-fixed specimens were treated with pepsin, which enhanced the staining intensity. Eighty-five per cent of well to moderately differentiated adenocarcinomas were positive. The staining was most intense in the apical border of cells lining the lumina of malignant glands, and in mucus inside the lumina, but cytoplasmic staining was also seen. In poorly differentiated adenocarcinomas the number of positive cells was smaller and in anaplastic carcinomas only occasional cells were stained. All mucinous cystadenomas and cystadenocarcinomas stained intensely, whereas serous cystadenomas, and all benign and malignant islet cell tumours were negative. Ducts in chronic pancreatitis and in normal pancreata were positive in 96% and 79%, respectively, but the staining was focal and usually weaker than in carcinomas. In acute pancreatitis (92% positive) the staining was more intense, and the CA 19-9 expression was seen predominantly in small terminal ducts and in centroacinar cells. There was an apparent correlation between the degree of differentiation of the ductal adenocarcinomas and the expression of CA 19-9, whereas the correlation between tissue expression and serum levels of CA 19-9 was poor. PMID- 3513814 TI - Palliative vs direct action stress-reduction procedures as treatments for reading disability. PMID- 3513812 TI - Expression of MHC class II antigens in human B-cell leukaemia and non-Hodgkin's lymphoma. AB - In this review we have summarized our experiences of serological analysis of MHC class II antigen expression in human B cell malignant disease. Cells from a large number of cases of B-cell chronic lymphocytic leukaemia (CLL) and non-Hodgkin's lymphoma (NHL) have been examined for expression of class II antigens. Using a number of monoclonal antibodies which in some cases are specific for class II subregion products (DP, DQ and DR), MHC class II antigens were detected by indirect immunofluorescence and fluorescent activated cell sorter analysis in CLL and by immunohistochemical staining in NHL. At the cell surface in many cases of B cell malignant disease, products of the different class II subregion genes are non-coordinately expressed. The most commonly occurring pattern of non-coordinate expression of class II molecules is of expression of DP and DR antigens in the absence of detectable DQ expression. These findings are in contrast to normal B lymphocytes where DP, DQ and DR antigens are expressed together at the cell surface. There is considerable heterogeneity among cases comprising individual histopathological categories of B cell malignancy, and in many instances heterogeneous class II phenotypes are also found on cells from the same tumour. In chronic lymphocytic leukaemia, class II antigen expression is inducible in vitro by treating the cells with the phorbol ester TPA. CLL cells treated with TPA have much increased levels of class II antigen expression at the cell surface and much increased steady state levels of class II specific mRNA transcripts detectable with complementary DNA probes. Aberrant class II antigen expression may be involved in the pathogenesis of B cell malignant disease. PMID- 3513815 TI - Eczematous reactions in atopic patients caused by epicutaneous testing with inhalant allergens. AB - To determine whether inhalant allergens could induce eczematous lesions we studied 17 patients with atopic eczema (with or without allergic rhinitis), 13 patients with allergic rhinitis without atopic eczema and 10 healthy control subjects. The allergens, birch pollen (Betula verrucosa) and house dust mite (Dermatophagoides pteronyssinus), were applied in aluminium chambers for 48 h on clinically normal skin. In 17 patients with atopic eczema, six epicutaneous test reactions of the delayed type to birch pollen and three to house dust mite were seen at 48 or 72 h. In 13 patients with allergic rhinitis without eczema there was one delayed reaction to birch pollen and none to house dust mite. No delayed type test reactions to either allergen were seen in the controls. Biopsies of the positive test sites revealed an eczematous reaction with epidermal spongiosis and microvesiculation. Immunostaining of cryostat sections showed dermal cell infiltrates consisting of mainly T lymphocytes (ratio of T4:T8, 2-6:I) and to a lesser degree Langerhans and indeterminate T6+ cells. 50-90% of the cells were Ia+. The numbers of basophils and mast cells did not exceed 10-15%. PMID- 3513816 TI - Haemopoietic growth factors now cloned. PMID- 3513817 TI - Natural killer cell activity following T-cell depleted allogeneic bone marrow transplantation. AB - We have examined the recovery of natural killer (NK) cell function in seven recipients of MHC matched T cell depleted bone marrow allografts. NK cell activity against the erythroblastoid line K562 recovers 2-3 weeks after transplantation. Recipients also show a high level of killing of the T cell target HSB2 and of EBV transformed lymphoblastoid cell lines (B-LCL). This activity peaks at 4-6 weeks and declines towards normal by 12-14 weeks after transplantation. Although killing of HSB2 and B-LCL is usually the property of activated NK cells, few of these patients had any obvious 'trigger' of such activation: none had CMV infection, there were no episodes of graft rejection, and only two patients had mild and transient grade I graft versus host disease (GvHD). We conclude that T cell depletion does not affect the reconstitution of NK cell function and that NK cell activation occurs after T depleted bone marrow transplantation even in the absence of clinically detectable GvHD, graft rejection or CMV infection. PMID- 3513818 TI - Successful haploidentical mismatched bone marrow transplantation in severe combined immunodeficiency: T cell removal using CAMPATH-I monoclonal antibody and E-rosetting. AB - Six patients with severe combined immunodeficiency were transplanted with bone marrow from their HLA haploidentical parents. T-lymphocytes were removed by complement mediated lysis with a monoclonal antibody (CAMPATH-I) followed by rosetting with sheep erythrocytes. The patients were pre-conditioned with marrow ablative chemotherapy, using busulphan and cyclophosphamide. There was graft take in five patients, with evidence of transient acute graft-versus-host disease only. Three patients are alive and well greater than 5 months after transplant, and one who is 12 months post graft has full reconstitution of cell mediated and humoral immunity, including specific antibody response to immunization. Transplantation across major histocompatibility barriers can be successfully achieved using this method of treatment of donor marrow. PMID- 3513819 TI - The relation of exposure time and drug concentration in their effect on cloning efficiency after incubation of human bone marrow with cytosine arabinoside. AB - The effect of different cytosine arabinoside (Ara-C) concentrations and exposure times upon clonogenicity of normal bone marrow cells was studied. One hour incubation, even at the pharmacologically high Ara-C concentration of 10(-5) M, was not cytotoxic. Prolonged incubation resulted in a very great increase in Ara C cytotoxicity, provided that inactivation of Ara-C by deamination was limited. The results show that long-term exposure to Ara-C, even at pharmacologically very low concentrations, is deleterious to clonogenic cells and provide an experimental basis for the reported therapeutic efficacy of long-term low dose Ara-C administration in leukaemia and preleukaemic syndromes. PMID- 3513820 TI - The expression of ABH antigens during in vitro megakaryocyte maturation: origin of heterogeneity of antigen density. AB - An indirect immunofluorescence technique with single and double labelling has been used to examine cultured human megakaryocytes for ABH antigens. This technique demonstrated the presence of these antigens on megakaryocytes and a population of small mononuclear cells that probably represent the differentiated precursors of megakaryocytes. In contrast to the intense homogeneous labelling with human anti-PlA1, the labelling with human anti-A, mouse monoclonal anti-A and anti-type 2H is light and heterogeneous, with many cells staining weakly or not at all. This variability in blood group ABH surface antigen expression appears to occur at the level of cell proliferation within colonies. While cells within an individual colony are homogeneous in fluorescence intensity, there is considerable variation between colonies. The progeny of individual megakaryocytes also appear uniform in ABH antigen expression. PMID- 3513821 TI - A prospective study of histocompatibility testing for keratoplasty in high-risk patients. AB - Forty high-risk patients awaiting corneal grafting were randomly selected from a 7-year cumulative list. Twenty were grafted with HLA-A and HLA-B antigen matched material. The other 20 patients were used as controls. Graft survival at two years was 60% (12/20) in the control group and 90% (18/20) in the study group; at five years it was 55% (11/20) in the control group and 85% (17/20) in the study group. PMID- 3513822 TI - Escherichia coli tyrosyl- and methionyl-tRNA synthetases display sequence similarity at the binding site for the 3'-end of tRNA. AB - Covalent modification of Escherichia coli tyrosyl-tRNA synthetase (TyrRS) by the 2',3'-dialdehyde derivative of tRNATyr (tRNAox) resulted in a time-dependent inactivation of both ATP-PPi exchange and tRNA aminoacylation activities of the enzyme. In parallel with the inactivation, covalent incorporation of approximately 1 mol of [14C]tRNATyrox/mol of the dimeric synthetase occurred. Intact tRNATyr protected the enzyme against inactivation by the tRNA dialdehyde. Treatment of the TyrRS-[14C]tRNATyr covalent complex with alpha-chymotrypsin produced two labeled peptides (A and B) that were isolated and identified by sequence analysis. Peptides A and B are adjacent and together span residues 227 244 in the primary structure of the enzyme. The three lysine residues in this sequence (lysines-229, -234, and -237) are labeled in a mutually exclusive fashion, with lysine-234 being the most reactive. By analogy with the known three dimensional structure of the homologous tyrosyl-tRNA synthetase from Bacillus stearothermophilus, these lysines should be part of the C-terminal domain which is presumed to bind the cognate tRNA. Interestingly, the labeled TyrRS structure showed significant similarities to the structure around the lysine residue of E. coli methionyl-tRNA synthetase which is the most reactive toward tRNAMetf(ox) (lysine-335) [Hountondji, C., Blanquet, S., & Lederer, F. (1985) Biochemistry 24, 1175-1180]. PMID- 3513823 TI - Studies of anaerobic and aerobic glycolysis in Saccharomyces cerevisiae. AB - Glucose metabolism was followed in suspensions of Saccharomyces cerevisiae by using 13C NMR and 14C radioactive labeling techniques and by Warburg manometer experiments. These experiments were performed for cells grown with various carbon sources in the growth medium, so as to evaluate the effect of catabolite repression. The rate of glucose utilization was most conveniently determined by the 13C NMR experiments, which measured the concentration of [1-13C]glucose, whereas the distribution of end products was determined from the 13C and the 14C experiments. By combining these measurements the flows into the various pathways that contribute to glucose catabolism were estimated, and the effect of oxygen upon glucose catabolism was evaluated. From these measurements, the Pasteur quotient (PQ) for glucose catabolism was calculated to be 2.95 for acetate-grown cells and 1.89 for cells grown on glucose into saturation. The Warburg experiments provided an independent estimate of glucose catabolism. The PQ estimated from Warburg experiments was 2.9 for acetate-grown cells in excellent agreement with the labeled carbon experiments and 4.6 for cells grown into saturation, which did not agree. Possible explanations of these differences are discussed. From these data an estimate is obtained of the net flow through the Embden-Meyerhof-Parnas pathway. The backward flow through fructose-1,6 bisphosphatase (Fru-1,6-P2-ase) was calculated from the "scrambling" of the 13C label of [1-13C]glucose into the C1 and C6 positions of trehalose. Combining these data allowed us to calculate the net flux through phosphofructokinase (PFK). For acetate-grown cells we found that the relative flow through PFK is a factor of 1.7 faster anaerobically than aerobically.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3513824 TI - 31P and 13C NMR studies of intermediates of aerobic and anaerobic glycolysis in Saccharomyces cerevisiae. AB - The levels of intermediates of aerobic and anaerobic glycolysis were determined in perchloric acid extracts prepared from glycolyzing suspensions of Saccharomyces cerevisiae by 31P and 13C NMR spectroscopy. From 31P NMR measurements a small increase in the level of nucleoside triphosphates was found in derepressed cells upon oxygenation, while the ratio of nucleoside diphosphates to nucleoside triphosphates was a factor of 3 lower aerobically. Combined with the previous observation that the level of intracellular Pi is lower by a factor of 3 aerobically, this leads to the conclusion that the phosphate potential [NTP]/([NDP][Pi]) is lower by an order of magnitude during anaerobic glycolysis than during aerobic glycolysis. There was no correlation between the level of glucose 6-phosphate and the rate of glucose utilization. We used 13C NMR to determine the scrambling of the 13C label from C1 to C6 in fructose 1,6 bisphosphate (Fru-P2). There was more scrambling of the label during aerobic than during anaerobic glycolysis. Since the level of Fru-P2 did not change much upon oxygenation, this suggests that in aerobic glycolysis there is control of at least one enzyme in the lower part of the Embden-Meyerhof-Parnas pathway, below Fru-P2, which gives the 13C level more time to equilibrate between C1 and C6 of Fru-P2. Previous 13C NMR measurements of glucose utilization rates had shown a 2 fold reduction upon oxygenation, reflecting control in the early stages of the pathway. PMID- 3513825 TI - Protonation mechanism and location of rate-determining steps for the Ascaris suum nicotinamide adenine dinucleotide-malic enzyme reaction from isotope effects and pH studies. AB - The pH dependence of the kinetic parameters and the primary deuterium isotope effects with nicotinamide adenine dinucleotide (NAD) and also thionicotinamide adenine dinucleotide (thio-NAD) as the nucleotide substrates were determined in order to obtain information about the chemical mechanism and location of rate determining steps for the Ascaris suum NAD-malic enzyme reaction. The maximum velocity with thio-NAD as the nucleotide is pH-independent from pH 4.2 to 9.6, while with NAD, V decreases below a pK of 4.8. V/K for both nucleotides decreases below a pK of 5.6 and above a pK of 8.9. Both the tartronate pKi and V/Kmalate decrease below a pK of 4.8 and above a pK of 8.9. Oxalate is competitive vs. malate above pH 7 and noncompetitive below pH 7 with NAD as the nucleotide. The oxalate Kis increases from a constant value above a pK of 4.9 to another constant value above a pK of 6.7. The oxalate Kii also increases above a pK of 4.9, and this inhibition is enhanced by NADH. In the presence of thio-NAD the inhibition by oxalate is competitive vs. malate below pH 7. For thio-NAD, both DV and D(V/K) are pH-independent and equal to 1.7. With NAD as the nucleotide, DV decreases to 1.0 below a pK of 4.9, while D(V/KNAD) and D(V/Kmalate) are pH-independent. Above pH 7 the isotope effects on V and the V/K values for NAD and malate are equal to 1.45, the pH-independent value of DV above pH 7. From the above data, the following conclusions can be made concerning the mechanism for this enzyme. Substrates bind to only the correctly protonated form of the enzyme. Two enzyme groups are necessary for binding of substrates and catalysis. Both NAD and malate are released from the Michaelis complex at equal rates which are equal to the rate of NADH release from E-NADH above pH 7. Below pH 7 NADH release becomes more rate-determining as the pH decreases until at pH 4.0 it completely limits the overall rate of the reaction. PMID- 3513826 TI - Kinetic and magnetic resonance studies of effects of genetic substitution of a Ca2+-liganding amino acid in staphylococcal nuclease. AB - The X-ray structure of staphylococcal nuclease suggests octahedral coordination of the essential Ca2+, with Asp-21, Asp-40, and Thr-41 of the enzyme providing three of the six ligands [Cotton, F. A., Hazen, E. E., Jr., & Legg, M. J. (1979) Proc. Natl. Acad. Sci. U.S.A. 76, 2551-2555]. The Asp-40 codon was mutated to Gly 40 on the gene that had been cloned into Escherichia coli, and the mutant (D40G) and wild-type enzymes were both purified from E. coli by a simple procedure. The D40G mutant forms a (5 +/- 2)-fold weaker binary complex with Ca2+ as found by kinetic analysis and by Ca2+ binding studies in competition with Mn2+, a linear competitive inhibitor. Similarly, as found by electron paramagnetic resonance (EPR), Mn2+ binds to the D40G mutant with a 3-fold greater KD than that found with the wild-type enzyme. These differences in KD are increased by saturation of staphylococcal nuclease with the DNA substrate such that KmCa is 10-fold greater and KIMn is 15-fold greater for the mutant than for the wild-type enzyme, although KMDNA is only 1.5-fold greater in the mutant. The six dissociation constants of the ternary enzyme-Mn2+-nucleotide complexes of 3',5'-pdTp and 5' TMP were determined by EPR and by paramagnetic effects on 1/T1 of water protons, and the dissociation constants of the corresponding Ca2+ complexes were determined by competition with Mn2+. Only small differences between the mutant and wild-type enzymes are noted in K3, the dissociation constant of the nucleotides from their respective ternary complexes. 3',5'-pdTp raises the affinities of both wild-type and mutant enzymes for Mn2+ by factors of 47 and 31, respectively, while 5'-TMP raises the affinities of the enzymes for Mn2+ by smaller factors of 6.8 and 4.4, respectively. Conversely, Mn2+ raises the affinities of both wild-type and mutant enzymes for the nucleotides by 1-2 orders of magnitude. Analogous effects are observed in the ternary Ca2+ complexes. Dissociation constants of Ca2+ and Mn2+ from binary and ternary complexes, measured by direct binding studies, show reasonable agreement with those obtained by kinetic analysis. Structural differences in the ternary metal complexes of the D40G mutant are revealed by a 31-fold decrease in Vmax with Ca2+ and by 1.4-3.1 fold decreases in the enhancement of 1/T1 of water protons with Mn2+.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3513827 TI - Glucose-specific permease of the bacterial phosphotransferase system: phosphorylation and oligomeric structure of the glucose-specific IIGlc-IIIGlc complex of Salmonella typhimurium. AB - The glucose-specific membrane permease (IIGlc) of the bacterial phosphoenolpyruvate-dependent phosphotransferase system (PTS) mediates active transport and concomitant phosphorylation of glucose. The purified permease has been phosphorylated in vitro and has been isolated (P-IIGlc). A phosphate to protein stoichiometry of between 0.6 and 0.8 has been measured. Phosphoryl transfer from P-IIGlc to glucose has been demonstrated. This process is, however, slow and accompanied by hydrolysis of the phosphoprotein unless IIIGlc, the cytoplasmic phosphoryl carrier protein specific to the glucose permease (IIGlc) of the PTS, is added. Addition of unphosphorylated IIIGlc resulted in rapid formation of glucose 6-phosphate with almost no hydrolysis of P-IIGlc accompanying the process. A complex of IIGlc and IIIGlc could be precipitated from bacterial cell lysates with monoclonal anti-IIGlc immunoglobulin. The molar ratio of IIGlc:IIIGlc in the immunoprecipitate was approximately 1:2. Analytical equilibrium centrifugation as well as chemical cross-linking showed that purified IIGlc itself is a dimer (106 kDa), consisting of two identical subunits. These results suggest that the functional glucose-specific permease complex comprises a membrane-spanning homodimer of IIGlc to which four molecules of IIIGlc are bound on the cytoplasmic face. PMID- 3513828 TI - Active-site mutants of beta-lactamase: use of an inactive double mutant to study requirements for catalysis. AB - We have studied the catalytic activity and some other properties of mutants of Escherichia coli plasmid-encoded RTEM beta-lactamase (EC 3.5.2.6) with all combinations of serine and threonine residues at the active-site positions 70 and 71. (All natural beta-lactamases have conserved serine-70 and threonine-71.) From the inactive double mutant Ser-70----Thr, Thr-71----Ser [Dalbadie-McFarland, G., Cohen, L. W., Riggs, A. D., Morin, C., Itakura, K., & Richards, J. H. (1982) Proc. Natl. Acad. Sci. U.S.A. 79, 6409-6413], an active revertant, Thr-71----Ser (i.e., residue 70 in the double mutant had changed from threonine to the serine conserved at position 70 in the wild-type enzyme), was isolated by an approach that allows identification of active revertants in the absence of a background of wild-type enzyme. This mutant (Thr-71----Ser) has about 15% of the catalytic activity of wild-type beta-lactamase. The other possible mutant involving serine and threonine residues at positions 70 and 71 (Ser-70----Thr) shows no catalytic activity. The primary nucleophiles of a serine or a cysteine residue [Sigal, I. S., Harwood, B. G., & Arentzen, R. (1982) Proc. Natl. Acad. Sci. U.S.A. 79, 7157 7160] at position 70 thus seem essential for enzymatic activity. Compared to wild type enzyme, all three mutants show significantly reduced resistance to proteolysis; for the active revertant (Thr-71----Ser), we have also observed reduced thermal stability and reduced resistance to denaturation by urea. PMID- 3513829 TI - Methionyl-tRNA synthetase induced 3'-terminal and delocalized conformational transition in tRNAfMet: steady-state fluorescence of tRNA with a single fluorophore. AB - Five species of tRNAfMet labeled with a single fluorophore are prepared to analyze the conformational changes at the 3'-end, at dihydrouridine, and at thiouridine in tRNAfMet upon binding of methionyl-tRNA synthetase. The emission and excitation spectra, anisotropy, and solvent accessibility of the fluorophore in each of the modified tRNAfMet's are determined in the absence and presence of methionyl-tRNA synthetase. The results are consistent with the following. The probes at the 3'-end are in a nonpolar environment, mobile relative to the tRNA molecule, and fully exposed to the solvent. The probes at dihydrouridine are partially stacked over the neighboring bases, nearly immobile, and relatively inaccessible. The S8-C13 cross-linked product is rigid. Upon binding of methionyl tRNA synthetase, the probes at the 3'-terminus become localized in a less polar environment, highly immobilized, and effectively shielded against solvent access, while the probes at dihydrouridine appear to be partially unstacked from the neighboring base and become slightly more accessible for solvent. Singlet-singlet energy transfer between the intrinsic protein fluorescence and the fluorophores in modified tRNA's was observed by sensitized emission for tRNAfMet modified at the 3'-end and for S8-C13 but not for tRNAfMet's modified at dihydrouridine. These results suggest that dihydrouridine in tRNAfMet is oriented away from methionyl-tRNA synthetase in the tRNA-enzyme complex. PMID- 3513830 TI - Backbone dynamics of a model membrane protein: 13C NMR spectroscopy of alanine methyl groups in detergent-solubilized M13 coat protein. AB - The filamentous coliphage M13 possesses multiple copies of a 50-residue coat protein which is inserted into the inner membrane of Escherichia coli during infection. 13C nuclear magnetic resonance (NMR) spectroscopy has been used to probe the structure and dynamics of M13 coat protein solubilized in detergent micelles. A comparison of backbone dynamics within the hydrophobic core region and the hydrophilic terminal domains was obtained by biosynthetic incorporation of [3-13C]alanine. Alanine is distributed throughout the protein and accounts for 10 residues (i.e., 20% of the total). Similar 13C NMR spectra of the protein have been obtained in two anionic detergents, sodium deoxycholate and sodium dodecyl sulfate, although the structures and physical properties of these solubilizing agents are quite different. The N-terminal alanine residues, assigned by pH titration, and the penultimate residue, assigned by carboxypeptidase A digestion, give rise to analogous peaks in both detergent systems. The pKa of Ala-1 (approximately 8.8) and the relaxation parameters of individual carbon atoms (T1, T2, and the nuclear Overhauser enhancement) are also generally similar, suggesting a similarity in the overall protein structure. Relaxation data have been analyzed according to the model-free approach of Lipari and Szabo [Lipari, G., & Szabo, A. (1982) J. Am. Chem. Soc. 104, 4546-4559]. The overall correlation times were obtained by fitting the three experimental relaxation values for a given well-resolved single carbon atom to obtain a unique value for the generalized order parameter, S2, and the effective correlation time, tau e. The former parameter reflects the spatial restriction of motion, and the latter, the rate.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3513831 TI - A specific antibody to a new peptide growth factor from human placenta: immunocytochemical studies on its location and biosynthesis. AB - Recently, we isolated a new peptide growth factor of Mr 34 000 from synctial membranes of human placenta. In its polypeptide molecular weight and receptor binding specificity it is unlike several known growth factors. In this paper we described immunocytochemical studies on its cellular location and biosynthesis. A rabbit antiserum was raised against a homogeneous preparation of the placental peptide. The specificity of the antibody was established by immunoprecipitation and immunoblot analyses. The antibody recognized both the native and denatured 34 kilodalton (kDa) peptide but showed no binding to a variety of other growth factors and hormones tested. The antibody was used to investigate the genesis and location of the 34-kDa membranous mitogen. Immunoperoxidase staining of placental tissue slices revealed a restricted localization of the antigen in the cytoplasmic organelles of cytotrophoblasts and in the brush border membranes of syncytiotrophoblasts. No other placental structures contained the antigen. A developmentally regulated appearance of the mitogen was suggested by the fact that first trimester placenta consistently stained far more strongly than term placenta. These studies show that the 34-kDa mitogenic protein originates in placenta from embryo-derived cellular structures and suggest that in its strategic location it may influence trophoblastic growth in an autocrine manner. In other studies we investigated the presence and biosynthesis of the 34-kDa peptide in the A431 vulval carcinoma cell line, which was shown earlier to contain a membrane-associated 34-kDa growth factor. The studies demonstrate that this cell line, as well as some other human carcinomas of breast and bladder origin, actively expresses this peptide.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3513832 TI - Substrate range of the 40,000-dalton DNA-photoreactivating enzyme from Escherichia coli. AB - We determined the ability of the 40 000-dalton Escherichia coli photoreactivating enzyme to act on a variety of pyrimidine-pyrimidine photoproduct substrates in nucleic acids. The enzyme is at least as active on cis-syn-cyclobutylpyrimidine dimers in supercoiled DNA as in linear DNA, but inactive on dimers in RNA. Both the phosphodiester bond internal to the deoxyriboses of the pyrimidines of the dimer and the N-glycosyl bond joining the pyrimidine to deoxyribose must be intact for enzyme action. The enzyme has no activity toward (6-4) pyrimidine cytosine products in DNA. PMID- 3513833 TI - Effects of guanidine hydrochloride on the refolding kinetics of denatured thioredoxin. AB - The effect of guanidine hydrochloride concentration on the kinetics of the conformational change of Escherichia coli thioredoxin was examined by using fluorescence, absorbance, circular dichroic, and viscosity measurements. Native thioredoxin unfolds in a single kinetic phase whose time constant decreases markedly with increasing denaturant concentration in the denaturation base-line zone. This dependency merges with the time constant of the slowest refolding kinetic phase at the midpoint of the equilibrium transition in 2.5 M denaturant. The time constant of the slowest refolding phase becomes denaturant independent below 1 M denaturant in the native base-line region. The denaturant-independent slowest refolding phase has an activation energy of 16 kcal/mol and is generated in the denatured base-line zone in a denaturant-independent reaction having a time constant of 19 s at 25 degrees C. The fractional amplitude of the slowest refolding phase diminishes in the native base-line zone to a minimum value of 0.25. This decrease is accompanied by an increase in the fractional amplitudes of two faster refolding kinetic phases, an increase describing a sigmoidal transition centered at about 1.6 M denaturant. Manual multimixing measurements indicate that only the slowest refolding kinetic phase generates a product having the stability of the native protein. We suggest that the two faster refolding phases reflect the transient accumulation of folding intermediates which can contain a nonnative isomer of proline peptide 76. PMID- 3513834 TI - Unpaired cysteine-54 interferes with the ability of an engineered disulfide to stabilize T4 lysozyme. AB - We have introduced an intramolecular disulfide bond into T4 lysozyme and have shown this molecule to be significantly more stable than the wild-type molecule to irreversible thermal inactivation [Perry, L.J., & Wetzel, R. (1984) Science (Washington, D.C.) 226, 555-557]. Wild-type T4 lysozyme contains two free cysteines, at positions 54 and 97, and no disulfide bonds. By directed mutagenesis of the cloned T4 lysozyme gene, we replaced Ile-3 with Cys. Oxidation in vitro generated an intramolecular disulfide bond; proteolytic mapping showed this bond to connect Cys-3 to Cys-97. While this molecule exhibited substantially more stability against thermal inactivation than wild type, its stability was further enhanced by additional modification with thiol-specific reagents. This and other evidence suggest that at basic pH and elevated temperatures Cys-54 is involved in intermolecular thiol/disulfide interchange with the engineered disulfide, leading to inactive oligomers. Mutagenic replacement of Cys-54 with Thr or Val in the disulfide-cross-linked variant generated lysozymes exhibiting greatly enhanced stability toward irreversible thermal inactivation. PMID- 3513835 TI - Uncoupler-induced relocation of elongation factor Tu to the outer membrane in an uncoupler-resistant mutant of Escherichia coli. AB - Escherichia coli UV6, a mutant which is resistant to the uncoupler carbonyl cyanide m-chlorophenylhydrazone (CCCP), when grown in the presence of CCCP, but not in its absence, incorporated a new protein (Mr, 42 000) into the cell envelope. This protein was found in both cytoplasmic and outer-membrane fractions. In the outer membrane it was one of three or four most abundant proteins. The protein was tightly bound to the membranes and was not solubilized by several detergents. Solubilization was achieved with sodium lauroylsarcosinate (sarkosyl). The protein was purified close to homogeneity by affinity chromatography on a column of GDP-Sepharose. It was identified as elongation factor Tu (EF-Tu) on the basis of electrophoretic mobility, profiles of peptide fragments produced by proteolysis, and by its ability to bind to GDP-Sepharose. Disruption of cells in the presence of CCCP or incubation of envelopes with EF-Tu did not result in incorporation of EF-Tu into the membranes. It is suggested that this protein is incorporated into the outer membrane as a consequence of an alteration in the normal protein biosynthetic mechanisms of the mutant induced by the presence of CCCP. PMID- 3513836 TI - Reversible loss of affinity induced by glucose in the maltose-H+ symport of Saccharomyces cerevisiae. AB - Glucose represses and inactivates maltose transport in Saccharomyces cerevisiae. The inactivation has been described as an irreversible process involving proteolysis. We have studied the inactivation of the maltose-H+ symport in this yeast and have observed that the mechanism of inactivation depends on the physiological conditions. In resting cells there was a decrease in transport capacity. The rate of decrease was enhanced nonspecifically by the presence of a sugar, glucose being more effective than maltose. In growing cells, glucose induced a decrease in affinity of the H+-symport which could be recovered by starvation, even in the presence of cycloheximide; there was no loss in capacity or, if present, this loss could be explained fully by the dilution due to repression during growth on glucose. We submit that in growing cells inactivation consists in a reversible modification of the permease not involving proteolysis. PMID- 3513837 TI - Evidence for an early degradative event to the insulin molecule following binding to hepatocyte receptors. AB - We have used photoreactive insulin analogues to investigate as related processes, early structural modification of the receptor-bound insulin molecule and internalisation of the insulin-receptor complex. In isolated rat hepatocytes an initial modification of bound insulin leads to the generation of a molecular species unchanged in molecular weight but with reduced receptor and antibody binding affinities and altered electrophoretic mobility. Using photoreactive insulin analogues and density gradient cell fractionation the insulin receptor complex has been shown to undergo internalisation from the plasma membrane to a low density vesicular fraction, the endosome. No labelled material was found in lysosomal fractions after up to 10 min incubation at 37 degrees C. The degree of labelling of the endosome fraction depended on the position of the photoreactive group within the insulin molecule. The data suggest that before or during endocytosis, a small peptide is proteolytically cleaved from the C terminus of the insulin B chain. PMID- 3513838 TI - Demonstration that the insulin receptor undergoes an early structural modification following insulin binding. AB - Processing of the insulin receptor by hepatocytes was studied using a 125I labelled photoreactive insulin derivative which could be covalently attached to the receptor and facilitate the analysis of receptor structure in isolated subcellular fractions by SDS-polyacrylamide gel electrophoresis. Following binding at the cell surface, the label was rapidly internalised and located in a low-density subcellular fraction ('endosomes'). The intact receptor (350 000 molecular weight) and binding (alpha) subunit (135 000), produced by in vitro disulphide reduction of the samples, were found in the plasma membrane fraction but not in endosomes. In endosomes, the label was concentrated in a band at 140 000 (non-reduced) which on reduction generated species of 100 000 and 68 000 predominantly. The insulin receptor therefore undergoes an early structural change during endocytosis. This modification does not involve complete disulphide reduction and may be due to a proteolytic event. PMID- 3513839 TI - Are all mitochondrial translation products synthesized on membrane-bound ribosomes? AB - The Arrhenius kinetics for the synthesis of var1, which is a hydrophilic protein of the mitochondrial ribosomes, have been compared to that of other mitochondrial translation products, which are hydrophobic subunits of the respiratory enzyme complexes. Our results indicate that, in the yeast Saccharomyces cerevisiae, the hydrophilic var1 protein is synthesized on membrane-associated mitochondrial ribosomes which cannot be distinguished from those responsible for the synthesis of the hydrophobic mitochondrial translation products. PMID- 3513840 TI - Formylmethionyl-tRNA binding to 30 S ribosomes programmed with homopolynucleotides and the effect of translational initiation factor 3. AB - Binding of the polynucleotides poly(U), poly(X) and poly(dT) to 30 S ribosomes of Escherichia coli triggers IF2-dependent binding of initiator-tRNA (fMet-tRNA) to these particles. Poly(A) and poly(C) are inactive. A minimum chain-length of approximately 100 residues in poly(U) is required for full activity in fMet-tRNA binding, although much shorter polymers bind tightly to 30 S particles and do stimulate the binding of acPhe-tRNA. The stimulation of fMet-tRNA binding to 30 S ribosomes is strongly reduced under conditions where the polynucleotides adopt secondary structure. Complexes containing fMet-tRNA and the non-cognate codon UUU or XXX are destabilized by IF3, whereas the formation of such a complex containing an AUG codon is slightly enhanced by the factor. Consistent with previous observations, it was found that all model initiation complexes containing acPhe-tRNA are strongly destabilized by IF3, even when the cognate codon (UUU) is present. Our results suggest that IF3 counteracts 'unnatural' initiation events in vitro and suggest a regulatory role for this factor in vivo. PMID- 3513841 TI - A novel yeast histone deacetylase: partial characterization and development of an activity assay. AB - We have characterized a histone deacetylase activity associated with yeast nuclei. An unusual feature of the deacetylase is that it is not inhibited by the short-chain fatty acids n-butyrate and propionate. These short-chain fatty acids are typically potent inhibitors of histone deacetylases in eukaryotic systems. The deacetylase(s) were detected by monitoring the levels of acetylation of yeast histones during incubation of isolated yeast nuclei. The activity was optimal at 37 degrees C and at 0.1 M NaCl. The enzyme did not require divalent cations and was inhibited by Zn2+ and Cu2+. A simple activity assay was developed using as substrate, [3H]acetate-labeled histone in chicken erythrocyte nuclei. This assay was used to demonstrate that the deacetylase(s) can be extracted from yeast nuclei with 0.5 M NaCl. A gel electrophoretic analysis of the deacetylated chicken histones verified that the solubilization of incorporated radiolabel was a result of histone deacetylation, not an artifact of histone degradation by yeast proteinases. PMID- 3513842 TI - Some guidelines for identification of recognition sequences: regulatory sequences frequently contain (T)GTG/CAC(A), TGA/TCA and (T)CTC/GAG(A). AB - Inspection of many proposed recognition signal sequences shows that TGTG/CACA, GAGA/TCTC or their triplet subsets, and TGA/TCA occur frequently. These repeated elements, conserved in recognition sequences from evolutionarily distant organisms, are likely to possess unique structural characteristics. Recurrence of these oligomers may aid in identification of further regulatory sequences in upstream or other regions. Another class of recognition sequences is GC-rich. At present there are only a few examples of this class. It is likely that these sequences function via a different mechanism. PMID- 3513843 TI - A new approach to the measurement of phospholipase A2 in tissue homogenates and its application to human skin. AB - We describe a new approach to the quantification of tissue phospholipase A2 based on the observation that the Vmax is increased by several orders of magnitude in the presence of high concentrations of dimethyl sulphoxide. The enzyme from human skin showed optimal activity at 30% dimethyl sulphoxide and pH 6-7.5, and had an absolute dependence on Ca2+ (apparent Km = 1.4 mmol/l). The relationship between reaction velocity and substrate concentration did not follow Michaelis-Menten kinetics. The enzyme was inhibited by p-bromophenacyl bromide, half-maximal inhibition occurring at 2.4 mumol/l. Surprisingly, assay of specimens of various human tissues indicated that, with the exception of pancreas, skin contained higher levels of phospholipase A2 activity than any other tissue investigated. Equally surprising was that primate skin (in particular human) seems considerably more active than that of other mammals. Speculatively, these findings may be related to the high levels of free fatty acids occurring on the skin surface. PMID- 3513844 TI - Purification and properties of three intracellular proteinases from Candida albicans. AB - Three intracellular proteinases termed A, B and C were purified to homogeneity from the unicellular form of the yeast Candida albicans. Enzyme A is an aspartic proteinase that acts on a variety of proteins. Its optimal pH is around 5 and it is displaced to 6.5 by KSCN. It is not significantly inhibited by PMSF, TLCK (Tos Lys-CHCl2) or soybean trypsin inhibitor but it is inhibited by pepstatin. Its molecular weight is 60 000. Enzyme B is a dipeptidase that acts on esters or on dipeptides without blocks in either the carboxyl or amino ends. Its pH optimum is around 7.5 and the molecular weight is 57 000. It is inhibited by PMSF, TLCK and DANME (N2Ac-Nle-OMe). Proteinase C is an aminopeptidase with an optimum pH around 8. Its molecular weight was 67 000 when determined by SDS gel electrophoresis and 243 000 when determined by gel weight was 67 000 when determined by SDS gel electrophoresis and 243 000 when determined by gel filtration. It is active towards dipeptides in which at least one amino acid is apolar and is not active when the N-terminal amino acid is blocked. It is inhibited by EDTA or o phenanthroline and activated by several divalent cations. PMID- 3513845 TI - Partial purification and characterization of a serine endopeptidase from rat liver plasma membranes. AB - A serine endopeptidase was partially purified from rat liver plasma membranes by using a four-step procedure: solubilization with N-lauroylsarcosine; Ultrogel AcA 34 chromatography; CM Affi-Gel blue chromatography; agarose-soybean trypsin inhibitor chromatography. This enzyme was found to hydrolyze casein and various chromogenic peptide substrates; highest activity occurred with H-D-Val-Leu-Arg-p nitroanilide, reported to be a specific substrate for human glandular kallikreins. The enzyme was heat-sensitive, showed a pH optimum between 8.0 and 9.0 and was inhibited by D-Phe-L-Phe-L-Arg-CH2Cl, aprotinin, diisopropyl fluorophosphate (DFP), soybean trypsin inhibitor, phenylmethylsulphonyl fluoride, leupeptin, antipain and dithiothreitol. This liver plasma membrane proteinase has an apparent molecular weight of about 30 000 as determined by Ultrogel AcA-34 chromatography and by autoradiography of [3H]DFP-labelled protein electrophoresis. PMID- 3513846 TI - Purification and some properties of uracil phosphoribosyltransferase from Escherichia coli K12. AB - Uracil phosphoribosyltransferase from Escherichia coli K12 was purified to homogeneity as determined by polyacrylamide gel electrophoresis. For this purpose a pyrimidine-requiring strain harboring the upp gene on a ColE1 plasmid was used, which showed 15-times higher uracil phosphoribosyltransferase activity in a crude extract. When this strain was grown under conditions of uracil starvation, an additional 10-times elevation of the enzyme activity was obtained. The molecular weight of uracil phosphoribosyltransferase was determined to be 75000; the enzyme consists of three subunits with a molecular weight of 23500. Uracil phosphoribosyltransferase is specific for uracil and some uracil analogues. The apparent Km values for uracil and PRib-PP were 7 microM and 300 microM, respectively. As an effector of enzyme activity, GTP lowered the Km for PRib-PP to 90 microM and increased the Vmax value 2-fold, but had no effect on the Km for uracil. The effect of GTP was found to be pH-dependent. The enzymatic characterization of uracil phosphoribosyltransferase and the observed regulation of its synthesis emphasizes the role of the enzyme in pyrimidine salvage. PMID- 3513847 TI - [Effect of low-intensity monochromatic electromagnetic fields of the millimeter range on biological processes]. AB - A short systematized analysis of Soviet and foreign published materials is presented dealing with biological and physical factors responsible for the effects of monochromatic electromagnetic radiations of low power on the living activity. PMID- 3513848 TI - Linear function neurons: structure and training. AB - Three different representations for a thresholded linear equation are developed. For binary input they are shown to be representationally equivalent though their training characteristics differ. A training algorithm for linear equations is discussed. The similarities between its simplest mathematical representation (perceptron training), a formal model of animal learning (Rescorla-Wagner learning), and one mechanism of neural learning (Aplysia gill withdrawal) are pointed out. For d input features, perceptron training is shown to have a lower bound of 2d and an upper bound of dd adjusts. It is possible that the true upper bound is 4d, though this has not been proved. Average performance is shown to have a lower bound of 1.4d. Learning time is shown to increase linearly with the number of irrelevant or replicated features. The (X of N) function (a subset of linearly separable functions containing OR and AND) is shown to be learnable in d3 time. A method of utilizing conditional probability to accelerate learning is proposed. This reduces the observed growth rate from 4d to the theoretical minimum (for unmodified version) of 2d. A different version reduces the growth rate to about 1.7d. The linear effect of irrelevant features can also be eliminated. Whether such an approach can be made probably convergent is not known. PMID- 3513849 TI - Ultrasonic evaluation of cervical incompetence. AB - Ultrasound can provide important information for the assessment of cervical incompetence (C.I.) and for the follow-up of pregnant women submitted to a cervical cerclage. Attention must be paid to the technical problems involved in the examination and the physiological variations in anatomical configuration must be taken into account. PMID- 3513850 TI - Mycotic vaginitis in pregnancy: a double evaluation of the susceptibility to the main antimycotic drugs of isolated species. AB - The authors examined 160 non-selected patients between the 28th and 40th weeks of gestational age with mycotic vaginitis. The chemosusceptibility of the isolated yeast to the main antimycotic drugs was evaluated through the Kirby-Bauer method as well as the determination of MIC. The antimycotic drugs tested were Nystatin, Miconazole, Ketoconazole, Clotrimazole, Amphotericin B, Econazole and 5 Fluorocytosine. The obtained data indicate a lacking effectiveness of Clotrimazole in contrast with the high percentage of therapeutical success reported in the literature. Better results were found with Econazole and the other antimycotic drugs tested. Nystatin is the most effective drug "in vitro". The authors furthermore highlight the utility of MIC determination, above all in the cases of recurrent vaginitis and when systemic therapy is undertaken. PMID- 3513851 TI - The seventeenth Carl G. Hartman Award. Don Wayne Fawcett. PMID- 3513852 TI - The eighth SSR Research Award. Lutz Birnbaumer. PMID- 3513853 TI - Quantitative determination of the pentose phosphate pathway in preimplantation mouse embryos. AB - A quantitative calculation was made of the pentose phosphate pathway (PPP) activity in preimplantation mouse embryos from the 2-cell through the late blastocyst stage. This activity varied with development and showed repeated high and low values. Peak activities occurred at both the 2-cell (15.8%) and compacted morula (13.6%) stages, with lowest activity at the development of the late blastocyst (3.2%). The metabolic effectors dimitrophenol (DNP) and phenazine ethosulfate (PES) had opposite effects on PPP activity. Dinitrophenol, although stimulating total CO2 production, virtually eliminated PPP activity while PES stimulated the pentose cycle activity 6-fold. These results indicated that the PPP was under metabolic control and that the embryos had a potential for much larger PPP activities. There was no correlation between the C-1/C-6 ratio obtained from the metabolism of [1-14C] and [6-14C] glucose and calculated PPP activities. A metabolic incubation chamber was devised for these experiments that exhibited certain unique features, including continuous collection of 14CO2 and 3H2O. Single embryos were placed in the chamber and sampled momentarily for metabolic activity. Subsequently, such embryos were successfully transferred to pseudopregnant recipients. PMID- 3513854 TI - Gonadotropin-releasing hormone effects on placental hormones during gestation: II. Progesterone, estrone, estradiol and estriol. AB - The release of progesterone (P), estrone (E1), estradiol (E2) and estriol (E3) from human placental tissue in vitro was found to be related to the gestational age of the placenta. The basal release of P, E1 and E2 on Day 1 of culture was highest from placentas of early gestation (9-13 wk). The release of P then declined, reaching a nadir by 15 wk, and continued at that level. The release of E1 and E2, reached a nadir at 17 weeks, and then again increased by term. In contrast, the basal release of E3 increased with increasing gestational age of the placenta. Thus, it appears that differing factors may influence placental P, E1, E2 and E3 production. In addition, the effect of synthetic gonadotropin releasing hormone (GnRH) on these hormonal releases was studied. The stimulation of P by GnRH was greatest in placentas of 16 and 17 wk of gestation after extended culture when the basal release of P had declined. As much as a 240-fold increase was observed on the eighth day of culture. A large stimulation of P (32 fold) was also observed in the term placental cultures. A stimulation of E1 and E2 by GnRH was observed during the initial days of culture and in mid-gestational placental cultures (16-17 wk). A stimulation of E2 only was also observed at 13 15 wk and at term. A stimulation of E3 was observed in certain individual placentas. A correlation of the P and human chorionic gonadotropin (hCG) response to GnRH stimulation was noted, as well as an inverse relation of estrogens and hCG stimulation by GnRH. These data demonstrate that steroidogenic competence of the placenta differs with gestational age and that GnRH can influence steroid release. The degree and pattern of response to GnRH varied with the gestational age of the placenta and its endocrine milieu. PMID- 3513855 TI - Puberty in pine voles, Microtus pinetorum, and the influence of chemosignals on female reproduction. AB - We investigated the reproductive biology of an induced ovulator, the pine vole (Microtus pinetorum). Male puberty, measured as age at first impregnation, was found to occur as early as 44 days of age. Female puberty measured as age at first conception, was found to occur as early as 32 days of age, considerably earlier than previously reported. Females paired with stud males exhibited a doubling of uterine weight within 12 h, and vaginal sperm were present after 48 h. This indicates that although behavioral responses to males--including mating- require prolonged contact, physiological responses to males occur rapidly. Chemosignals from males slightly increased uterine and ovarian weights of females, but chemosignals from other females did not. Young females paired with stud males for 48 h in the presence of soiled bedding from the female's family had significantly smaller increases in ovarian and uterine weights than similar females paired on clean bedding. Suppression of reproduction in female offspring while they remain with the extended family unit is discussed as a life-history tactic and as a possible mechanism for inbreeding avoidance. PMID- 3513856 TI - Alignment and merging of electron microscope images of frozen hydrated crystals of the T4 DNA helix destabilizing protein gp32*I. AB - Low dose cryoelectron microscopy has been used to record images and electron diffraction patterns of frozen hydrated crystals of the single-stranded DNA binding protein gp32*I. Fourier transforms from 13 image areas, corresponding to approximately 40,000 unit cells, were aligned by a minimal phase residual search and merged by vector addition in reciprocal space. Phases from the resulting composite transform were combined with amplitudes from electron diffraction patterns to reconstruct the projected mass density of the gp32*I crystal at 8.4 A resolution. PMID- 3513857 TI - Hydrogen exchange in the hydrophilic regions of detergent-solubilized M13 coat protein detected by 13C nuclear magnetic resonance isotope shifts. PMID- 3513858 TI - Theoretical evaluation of transcriptional pausing effect on the attenuation in trp leader sequence. AB - The effect of transcriptional pausing on attenuation is investigated theoretically on the basis of the attenuation control mechanism presented by Oxender et al. (Oxender, D. L., G. Zurawski, and C. Yanofsky, 1979, Proc. Natl. Acad. Sci. USA. 76:5524-5528). An extended stochastic model including the RNA polymerase pausing in the leader region is developed to calculate the probability of relative position between the RNA polymerase transcribing the trp leader sequence and the ribosome translating the transcript. The present study results in a new rationale that the transcriptional pausing site in the leader sequence makes the attenuation control both more sensitive as an on/off switch and less sensitive to variations in the concentration of cellular metabolites not connected with the need for expressing, or not expressing, the particular operon. It is also proposed that the transcriptional pausing diminishes the dependence of attenuation control characteristics on the number of nucleotides in the leader sequence. This result may be useful for understanding the attenuation control efficiencies of other amino acid leader sequences with different lengths of nucleotides. PMID- 3513859 TI - Repair of near-ultraviolet (365 nm)-induced strand breaks in Escherichia coli DNA. The role of the polA and recA gene products. AB - The action of near-ultraviolet (UV-365 nm) radiation in cellular inactivation (biological measurements) and induction and repair of DNA strand breaks (physical measurements) were studied in a repair-proficient strain and in polA-, recA-, uvrA-, and polA uvrA-deficient strains of Escherichia coli K-12. The induction of breaks in the polA and polA uvrA strains was linear with dose (4.0 and 3.7 X 10( 5) breaks/2.5 X 10(9) daltons/Jm-2, respectively). However, in the recA-, uvrA-, and repair-proficient strains, there was an initial lag in break induction at low doses and then a linear induction of breaks at higher doses with rates of 4.6, 2.8, and 3.2 X 10(-5) breaks/2.5 X 10(9) daltons/Jm-2, respectively. We interpret these strain differences as indicating simultaneous induction and repair of breaks in polymerase 1 (polA)-proficient strains under the 0 degrees C, M9 buffer irradiation conditions that, for maximum efficiency, require both the polA and recA gene products. Strand-break rejoining also occurred at 30 degrees C in complete growth medium. We propose that at least three (and possibly four) distinct types of pathways can act to reduce the levels of 365-nm radiation induced strand breaks. A quantitative comparison of the number of breaks remaining with the number of lethal events remaining after repair in complete medium at 30 degrees C showed that between one and three breaks remain per lethal event in the wild-type and recA strains, whereas in the polA strain one order of magnitude more breaks were induced. PMID- 3513860 TI - Aspects of the clinical pharmacology of nifedipine, a dihydropyridine calcium entry antagonist. AB - Although nifedipine has been characterized in terms of its general vasodilatory effects, this dihydropyridine must still be regarded as investigational with regard to available pharmacokinetic and pharmacodynamic data. Although limited studies are available, it is clear that the pharmacokinetic and pharmacodynamic data reported are quite variable among subjects. Further, it appears that single dose elimination kinetics may be of little predictive value with regard to the kinetic characteristics present during chronic drug administration. It is also possible that the plasma level-effect correlations for the drug may differ with single and sustained dosing regimens. At the present time the lack of definitive data to define the relationships between plasma levels of nifedipine and associated drug effects suggests that measurement of drug levels in plasma serves primarily as a research tool and to identify patient noncompliance or abnormal absorption of the drug. Finally, since the prototype of this class, nifedipine, has been shown to have the potential for non-linear kinetics during chronic dosing, dihydropyridine analogs should be subject to extensive pharmacokinetic and pharmacologic evaluation during both single and chronic dosing studies, prior to widespread clinical use. PMID- 3513861 TI - [Collagen metabolism during immobilization and electropuncture]. AB - The indices of collagen metabolism (free, peptide- and protein bound hydroxyproline) as well as blood plasma proteolytic activity were studied in repeated immobilization (up to 5 days) and skin electropuncture (up to 8 days) in rats. Repeated immobilization (strong stress) steadily increased the contents of free oxyproline and induced undulating changes in the level of other indices under study. Electropuncture (slight stress) produced a short-term increase in free oxyproline blood plasma level. Preliminary and simultaneous electropuncture prevented profound changes in collagen metabolism during immobilization. PMID- 3513862 TI - [Immunohistochemical and ultrastructural characteristics of the bronchial mucosa in chronic inflammation]. AB - The local immunity was studied using 31 biopsy samples obtained during bronchoscopy from patients with various forms of chronic bronchitis. Attenuated IgA synthesis by plasmatic cells of bronchial mucosa lamina propria and increased LgG synthesis were established. Enhanced IgG production and penetration of various agents into bronchial mucosa lamina propria cause local immunocomplex reaction involving microcirculatory bed and resulting in perivascular sclerosis. Repeated damaging and sclerotic processes lead to disconnection of epithelial stromal links and altered cover epithelium differentiation. The role of immunopathologic reactions in the formation of vicious circle underlying morphogenesis of chronic bronchitis is suggested. PMID- 3513864 TI - [Method of treating leukocytes for electron microscopic research]. AB - A technique of pretreatment of leukocytes and other cellular suspensions for the electron microscopic studies in suggested. Cells fixed in a suspension are embedded in a warm gelatine solution. Upon cooling, a gelatinous block that can be cut into small pieces is formed. These pieces are fixed in glutaraldehyde solution and used thereafter as pieces of dense tissues. The technique provides a better preservation of leukocyte structure, considerably facilitating ultratomy. PMID- 3513863 TI - [Morphofunctional changes in the pancreas during restoration of the damaged wall of the cervical pancreas in an experiment]. AB - Morphological and functional changes of the pancreas during experimental restoration of the damaged wall of the cervical part of the esophagus at various periods after the operation were studied. The diabetes-like nature of the sugar curve in this case was due to degenerative changes in beta-cells of the island apparatus and decline in their number, which led to the reduction in endogenous insulin content and the violation of insulin secretion. PMID- 3513865 TI - Modulation of in vitro growth of murine myeloid leukemia by an autologous substance immunochemically cross-reactive with insulin and antiinsulin serum. AB - Murine myeloid leukemia secretes a substance immunochemically cross-reactive with insulin (SICRI) both in vivo and in serum-free media. High SICRI concentrations in peripheral blood of tumorous animals do not affect circulating glucose levels. In culture, DNA synthesis rate per leukemic cell is proportional to cell density and is reduced by antiinsulin serum. Culture medium conditioned by leukemia cells as well as SICRI affinity purified from this medium stimulate DNA synthesis in cultured leukemia cells. It appears that autocrine stimulation of murine myeloid leukemia can be mediated in part by an insulin-related growth factor. PMID- 3513866 TI - Expression of specific granule markers on the cell surface of neutrophil cytoplasts. AB - The widespread assumption that cytoplasts generated from human polymorphonuclear leukocytes (PMNs) are vesicles consisting solely of cytoplasm surrounded by plasma membrane and devoid of granule activity remains to be tested. PMN cytoplasts were prepared by centrifugation of intact cells on a Ficoll step gradient in the presence of cytochalasin B. Two granule membrane markers, Mol, a fluorometrically detectable antigen, and cytochrome b, both of which have been shown to translocate to the plasma membrane during granule release, were compared for their activity in cytoplasts and intact PMNs. We found that the amount of Mol detected on the plasma membrane of intact PMNs, as compared with other membrane markers (such as antigens LFA-1 and beta 2m), increased 1.6-fold upon exposure of PMNs to Ficoll plus cytochalasin B prior to centrifugation. Another twofold increase in Mol expression occurred upon cytoplast preparation. Release of the granule enzymes, vitamin B12-binding protein, and lysozyme were also followed and correlated well (r = .78 and .92) with the amount of Mol antigen present on the cell surface. Cytochrome b was also found to be higher (1.4-fold) on plasma membranes isolated from cytoplasts than on plasma membranes isolated from intact control cells. These results indicate that some fusion of granule membranes and plasma membranes occurred during treatment of PMNs with Ficoll plus cytochalasin b and during cytoplast preparation. PMID- 3513867 TI - Controlled trial of desmopressin in liver cirrhosis and other conditions associated with a prolonged bleeding time. AB - The synthetic vasopressin derivative desmopressin (DDAVP) shortens a prolonged bleeding time (BT) in patients with uremia, congenital platelet dysfunction, and von Willebrand disease. To establish the limits of the clinical usefulness of DDAVP, a controlled randomized study was carried out in 53 patients and ten volunteers with different conditions that have in common a prolonged BT. DDAVP significantly shortened the BT in 21 cirrhotics (P less than .01), in eight patients with unclassified prolonged BT (P less than .05) and in ten volunteers taking the antiplatelet drugs aspirin (P less than .05) and ticlopidine. The BT changes were not statistically significant in 15 patients with severe thrombocytopenia nor in nine with congenital platelet dysfunction, even though a few patients with storage pool deficiency responded with a marked BT shortening. Our findings indicate that DDAVP might be given when biopsies or other surgical procedures must be carried out in patients with prolonged BT. However, the compound is often ineffective in patients with thrombocytopenia or congenital platelet dysfunction. PMID- 3513868 TI - Responses of hemopoietic precursors to 13-cis retinoic acid and 1,25 dihydroxyvitamin D3 in the myelodysplastic syndromes. AB - To determine the effects of the "maturation-inducing" agents 13-cis retinoic acid and 1,25 dihydroxyvitamin D3 on marrow cells from normal individuals and patients with myelodysplastic syndromes (MDS), we assessed marrow hemopoietic clonogenicity and differentiation response patterns to these agents. These vitamins caused increased proliferation in vitro of normal clonogenic marrow myeloid precursor cells (CFU-GM), decreased erythroid precursors (BFU-E), and no change in multipotent stem cells (CFU-GEMM). Marrow hemopoietic colony-forming cell incidence was generally subnormal in the 22 MDS patients evaluated. In vitro exposure to both agents caused various patterns of alteration of MDS hemopoietic colony and cluster formation, with similar but more pronounced effects evoked by retinoic acid. In the vast majority of MDS patients, enhanced marrow clonal granulocyte-monocyte differentiation and decreased BFU-E growth were noted after in vitro exposure to these vitamins. Correlation of biological effects was demonstrated between in vivo changes of peripheral neutrophil counts and in vitro responses of myeloid precursors for ten MDS patients treated with an eight-week therapeutic course of retinoic acid. Cytogenetic analyses indicated persisting aneuploidy or coexisting normal and aneuploid karyotypes in the cultured MDS myeloid cells and (with one exception) in native marrow cells from the treated patients. The varying responses of the MDS cells may monitor differing proportions of normal versus leukemic marrow cells susceptible to proliferative and differentiative expression on exposure to these agents. PMID- 3513869 TI - Hyperacute graft-v-host disease in patients not given immunosuppression after allogeneic marrow transplantation. AB - Sixteen patients with leukemia in relapse or second to third remission, 5 to 27 years old (median, 17), were given cyclophosphamide (60 mg/kg X 2) and total body irradiation (2.25 Gy for each of seven days) followed by unmodified marrow grafts from HLA-identical siblings. Patients did not receive posttransplant immunosuppression and were followed a median of nine months (range, 5-17). Prompt engraftment was sustained in 12 patients with a median time of 16 days (range, 10 to 63) to achieve 500 neutrophils/mm3. One patient failed to engraft, one had delayed engraftment, and two had late poor graft function. All 15 with engraftment developed moderate to life-threatening graft-v-host disease (GVHD, eight grade II and seven grade III-IV). This syndrome was hyperacute (median onset eight days [range, 7 to 29] posttransplant) and manifest by severe skin disease (14 patients at stage 3 and one at stage 4), fever (ten patients), and liver (four patients, stage 3-4) or gut (four patients, stage 3-4) involvement. Serial tissue biopsies confirmed acute GVHD in 13 of 15 patients. Ten were treated with antithymocyte globulin and cyclosporine (four survive), and four with corticosteroids (two survive). Actuarial survival to 17 months was 37%. Causes of death included interstitial pneumonia (four), infection (three), graft failure (one), venocclusive disease (one), and relapse of leukemia (one). Age matched controls receiving standard methotrexate after transplant had comparable relapse-free survival but only a 25% incidence of grade II-IV acute GVHD (P less than .0001). We conclude that deleting posttransplant immunosuppression is associated with frequent and severe hyperacute GVHD, infectious complications, and occasional poor graft function. PMID- 3513870 TI - Chromosomal fragile sites and cancer-specific rearrangements. PMID- 3513871 TI - An explanation for nonimmunologic adsorption of proteins onto red blood cells: Schiff's base reactions. AB - During a phase I evaluation of diglycoaldehyde (INOX), an intravenous chemotherapeutic agent used to treat children with malignancies, all of eight patients tested developed a positive direct antiglobulin test (DAT) in vivo. The DAT became positive within one to seven days after the first administration of the drug and remained positive for up to 12 days following the last dose. The indirect antiglobulin tests were negative. None of the patients showed clinical or laboratory evidence of hemolysis at the time the DAT became positive or during follow-up. Eluates made from the red cells of two of the eight patients were both negative by indirect antihuman globulin testing. In vitro studies with INOX and glutaraldehyde, both dialdehyde compounds, showed nonimmunologic adsorption of protein onto red cells, probably by the condensation of aldehyde groups of these compounds to form Schiff's bases with amino acids of serum proteins and red cell membrane proteins. This reaction provides an explanation for the globulin detected on the red cells of patients treated with INOX. PMID- 3513872 TI - Synchronized cultures of P falciparum in abnormal red cells: the mechanism of the inhibition of growth in HbCC cells. AB - It has been previously demonstrated that HbCC cells fail to support growth of P falciparum in asynchronous Jensen-Trager cultures. To define the mechanism of inhibition we have studied synchronous cultures and found that while intraerythrocytic parasite development appeared normal, the liberation of merozoites and/or invasion was impaired. This effect was detected by a normal growth during the first growth cycle but dramatically reduced number of ring forms following the schizont stage. A specific test for the invasion of CC cells by P falciparum merozoites, nevertheless, was normal. The defect found in infected CC cells was not modified by changes in O2 tension (which altered the ligand saturation of Hb C) nor by the extracellular K+ concentration (excluding a K+ leak-dependent mechanism for the growth inhibition). The osmotic lysis of late staged parasitized red cells revealed that 25% of infected AA cells were lysed when the extracellular medium was 95 mOsm. In contrast, infected CC cells required a decrease to 10 mOsm in the extracellular media to reach 25% lysis. We conclude that CC red cells are unsuitable hosts for the malarial parasite primarily because of their inability to lyse and release merozoites at the appropriate stage of intraerythrocytic development of P falciparum. PMID- 3513873 TI - A simplified functional assay for protein C in plasma samples. AB - The important role of protein C (PC) in the regulation of hemostasis has been appreciated since the description of patients who were deficient in PC and presented with severe thromboembolic events. The potentially fatal complications associated with PC-deficiency require an early and reliable identification of those patients affected with this inherited disorder. The present study introduces a test procedure for the functional assessment of PC in plasma samples. The test utilizes the thrombin/thrombomodulin complex to achieve complete and rapid formation of activated PC whose proteolytic capacity is subsequently determined with a chromogenic substrate. Homogenate obtained from rabbit lung effectively substituted the purified component thrombomodulin in the assay system. This new approach simplifies the test procedure without losing specificity and accuracy. Proteases, such as plasmin, streptokinase and urokinase did not influence the assay and the inhibitory effect of heparin on the PC activation could easily be overcome by the addition of protamine sulphate. The PC activity in a group of unselected patients (n = 50), who did not reveal any abnormalities in global coagulation tests, amounted to 100 +/- 12% (mean +/- SD) with a range from 54 to 143% when analyzed in comparison to a plasma pool constituted from healthy volunteers. Since the synthesis of PC depends on the availability of vitamin K, patients receiving phenprocoumon have also been analyzed. These patients (n = 103) presented 40 +/- 11% residual PC-activity accompanied by a concomitant decrease in PC-antigen levels to 43 +/- 10% (mean +/ SD). The test described is specific, sensitive, less time-consuming and can be performed on a routine basis. PMID- 3513874 TI - In-vivo and in-vitro responsiveness of bronchial smooth muscle. PMID- 3513875 TI - Bronchial mucosal mast cells and their implications in the pathogenesis of asthma. PMID- 3513876 TI - The generation of prostaglandins by human lung and their effects on airway function in man. AB - Human dispersed lung cells containing 5-10% mast cells synthesised and released large quantities of prostaglandin D2 (PGD2) and thromboxane B2 (TXB2), with either IgE-dependent activation or ionophore A23187 challenge. The generation of these prostanoids and the release of histamine was related to the strength of activation stimulus. After activation the release of histamine and PGD2 proceeded in parallel, and the significant correlation between the release of these mediators suggests a common mast cell origin. This hypothesis is supported by cell enrichment experiments using Percoll density gradients. Prostaglandin D2 and histamine release was always associated with those fractions containing mast cells, whereas the generation of TXB2 was mainly associated with cells of the monocyte-macrophage series. The putative 5-lipoxygenase inhibitor 6,9-deepoxy-6, 9-(phenylimino)- 6,8-prostaglandin I1 (U-60,257, Piriprost) had complex inhibitory and potentiating effects on immunoreactive leukotriene C4 generation from ionophore activated human lung cells. The drug also had a surprising potentiating action on PGD2 release, while simultaneously inhibiting the generation of TXB2. The release of prostanoids from human lung cells is discussed in relation to the putative role of prostaglandins in asthma, with particular emphasis on the pharmacological actions of PGD2 on human airway function in vivo. PMID- 3513877 TI - High molecular weight neutrophil chemotactic activity in asthma and related disorders. PMID- 3513878 TI - Reforming the Medicaid program to improve access to health care services. PMID- 3513879 TI - Intravenous digital subtraction angiography. AB - Intravenous digital subtraction angiography (ivDSA) is a method whereby arterial images are produced following a peripheral or central venous injection of contrast medium. It is a safe and relatively simple procedure to undertake and is becoming more widely available. The purpose of this article is to review its clinical applications, its advantages and limitations. PMID- 3513880 TI - Effect of vasoactive peptides on prostacyclin synthesis in man. AB - Bradykinin, angiotensin II, arginine vasopressin (AVP) or des-amino-D-arginine vasopressin (DDAVP) were administered by intravenous infusion to 10 healthy men. The concentration of 6-oxo-prostaglandin F1 alpha (6-oxo-PGF1 alpha), the stable hydrolysis product of prostacyclin (PGI2), was measured in plasma using gas chromatography/negative ion chemical ionisation mass spectrometry. Dose-related increases in plasma concentrations of 6-oxo-PGF1 alpha occurred during administration of bradykinin (100-3200 ng kg-1 min-1). The concentrations of 6 oxo-PGF1 alpha rose from baseline values in the range less than 1.0-4.9 pg ml-1 to 24.9-47.6 pg ml-1 at maximum tolerated infusion rates. There were no changes in the concentrations of 6-oxo-PGF1 alpha during administration of angiotensin II, AVP or DDAVP at infusion rates which caused haemodynamic changes. PMID- 3513881 TI - Comparison of the parasympatholytic activity of ACC-9358 and disopyramide. AB - ACC-9358 (N-[(3,5-di(pyrrolidinylmethyl)-4-hydroxy)benzoyl]aniline) is a newly developed analogue of changrolin, an antiarrhythmic agent used in the Peoples Republic of China. Since changrolin and other antiarrhythmic agents exert parasympatholytic activity which may limit their clinical usefulness, it was of interest to examine the parasympatholytic effects of ACC-9358. For comparative purposes we also studied the parasympatholytic activity of disopyramide. In guinea-pig isolated ileal strips, disopyramide, 3-30 microM, and ACC-9358, 100 300 microM, competitively antagonized carbachol-induced contractions with pA2 values of 5.78 and 4.17, respectively. In guinea-pig isolated right atria, disopyramide 3-30 microM, competitively antagonized methacholine-induced slowing of spontaneous beating with a pA2 value of 5.99 whereas ACC-9358, 3-300 microM, produced no significant muscarinic blockade in this preparation. Disopyramide (1.9-15 mg kg-1, i.v.), but not ACC-9358 (7.5-1.5 mg kg-1, i.v.), significantly increased rat pupil diameter in vivo. Disopyramide and ACC-9358 blocked vagal induced reductions in heart rate in dogs anaesthetized with pentobarbitone. ED50 values were approximately 0.65 and 11.25 mg kg-1, respectively. We conclude that ACC-9358 possesses significantly less parasympatholytic activity than disopyramide. PMID- 3513882 TI - The primary afferent depolarizing action of kainate in the rat. AB - Dorsal roots (L3-L7) isolated from immature (1-9 day old) rats were depolarized selectively by kainate (1-100 microM). L-Glutamate (25-100 microM), but not L aspartate, mimicked the action of kainate. N-methylaspartate had no activity on these preparations and quisqualate was thirty times less active than kainate. Depolarizations evoked by L-glutamate (100-1000 microM) faded rapidly in the presence of L-glutamate. Depolarizations evoked by kainate were depressed during the fade induced by L-glutamate. Certain electrically evoked C-fibre volleys in dorsal roots or leg nerves of rats at any age were selectively depressed or abolished in the presence of kainate. The effect of kainate was more selective than that of gamma-aminobutyric acid or capsaicin. Prolonged treatment of dorsal roots with kainate did not appear to be deleterious to C-fibres. It is suggested that certain primary afferent C-fibres possess kainate receptors which may be activated physiologically by L-glutamate released at their central terminations. PMID- 3513883 TI - Neuroleptic malignant syndrome. AB - The neuroleptic malignant syndrome (NMS) occurs as a hypersensitivity response in certain patients exposed to neuroleptics. It is a relatively rare, but potentially lethal complication, the incidence of which may have been underestimated. Recent interest in NMS has arisen due to the recognition that specific therapy may now be available. This review summarises the clinical features and discusses recent ideas regarding aetiology and treatment. PMID- 3513884 TI - Imipramine and amitriptyline plasma concentrations and clinical response in major depression. AB - Plasma drug concentrations and clinical response were measured in two groups of hospitalised depressed patients, who received amitriptyline or imipramine double blind, in a dosage of 250 mg for four weeks. Virtually no significant linear or curvilinear relationships were found between any plasma measure and any measure of clinical response. Modest but significant direct relationships were found between age and concentration of parent drugs but not demethylated metabolites. Blood drug level measurement therefore appears to be of little value in monitoring drug treatment of depressed in-patients. PMID- 3513885 TI - The secondary dementias of middle and later life. PMID- 3513886 TI - Clinical and neuropsychological assessment of dementia. PMID- 3513887 TI - The transmissibility of dementia. PMID- 3513888 TI - Brain imaging in Alzheimer's disease. PMID- 3513889 TI - Electrophysiology of Alzheimer's disease. PMID- 3513890 TI - The epidemiology of Alzheimer's disease. PMID- 3513891 TI - Recent advances in neuropathology. PMID- 3513892 TI - The association of clinical and neurological findings and its bearing on the classification and aetiology of Alzheimer's disease. PMID- 3513893 TI - Subunit structure of the Alzheimer tangle. PMID- 3513894 TI - Neuroanatomical aspects of neurotransmitters affected in Alzheimer's disease. PMID- 3513895 TI - The cholinergic hypothesis--ten years on. PMID- 3513896 TI - Correlations between neuropathological and neurochemical changes. PMID- 3513897 TI - Management of dementia: a review. PMID- 3513898 TI - A model for clinical-quantitative classification. Generation I: Application to language-disordered preschool children. AB - A model is presented for the integration of clinical-inferential and quantitative approaches to classification. In this, the first application of the proposed model, preschool children with developmental language disorders were classified on the basis of clinical interpretations of performance on psychometric subtests. Five hypothesized subgroups were validated on the basis of (a) consensus among five clinical neuropsychologists, (b) language pathologists' reports, (c) comparisons with subgroups defined by a cluster analytic approach, and (d) comparisons among subgroups on variables not used for classification. Results are discussed in terms of the feasibility of the integrated approach, commonalities with other typologies, and the implications of this work to issues of subtype stability, remediation, predictions of later reading achievement, brain-behavior relationships, and generalizability to other clinical groups. PMID- 3513899 TI - Pupillary responses to syntactic ambiguity of sentences. AB - Pupillary responses have proven to be reliable physiological correlates of cognitive effort in a variety of tasks, including language processing. To investigate the relation between psychological and syntactic complexity 20 syntactically ambiguous sentences, balanced for bias, were presented to 16 subjects, while their pupil size was continuously measured. These sentences could be read as verb oriented (syntactically more complex) or object oriented (syntactically less complex). Principal components analysis of pupillary movements revealed that verb-oriented readings, resulted in greater pupillary dilations than object-oriented readings, indicating that syntactically more complex sentences, as determined via a formal grammar, require greater cognitive effort in processing. This is viewed as further evidence for the notion that syntactic and psychological complexity are related. High- and low-bias sentences did not induce comparable differences in pupillary movements, indicating that the "multiple meaning theory" may have to be modified. PMID- 3513900 TI - Rapid alternating stimulus naming in the developmental dyslexias. AB - A rapid, alternating stimulus (RAS) naming measure was designed to study the developing ability in dyslexic readers to direct attention to contextual patterns while performing a rapid serial naming task. The results from a 3-year longitudinal investigation of 98 children indicate three trends. RAS performances differentiate both average from impaired readers and dyslexic subgroups from each other. The largest, most impaired subgroup can not complete the RAS tasks in kindergarten; the smaller subgroups have little name access speed deficits. Early RAS performances are highly predictive of later reading, particularly at the single-word reading level. Implications for understanding the development of automaticity and the relationship between retrieval speed and reading are discussed. PMID- 3513902 TI - The development of the corticotectal pathway in the albino rat. AB - To study the development of the corticotectal pathway, the enzyme horseradish peroxidase (HRP) was injected electrophoretically into the superior colliculus (SC) of rats ranging in age from newborn to adult. In animals younger than postnatal day 3 (P3), collicular injections did not label any cells in the cortex while in animals injected at P3-P4, only a few cortical cells were retrogradely labeled. In contrast, injections made at P5 or later resulted in the labeling of a substantial proportion of lamina V cells in a number of cortical areas ipsilateral to the injected colliculus. Although at P5-P7 the bulk of labeled cells was located in the visual cortices (both striate and extrastriate), a substantial proportion of the labeled cells was located in the somatosensory, motor and association cortices. On the other hand, in animals injected at P12 (or later), the labeled cells were largely restricted to the visual cortices with relatively few corticotectal cells located in somatosensory area I. At all ages studied, labeled cortical cells were confined to lamina V and had clear-cut apical dendrites (pyramidal cells). The dendritic morphologies and somal sizes of the corticotectal cells indicate that in animals younger than P12 these cells are immature. These observations suggest that the axons of cortical cells do not reach the SC before P3 and that these early corticotectal projections (P3-P12) are established by immature cells. Furthermore, although the corticotectal projection exhibits, from its onset, a high degree of specificity in terms of the laminar distribution of its cells of origin, its areal distribution is 'exuberant'. The 'exuberant' projections originating from non-visual cortical areas disappear by P12-P14, that is at the time when young rats open their eyes for the first time. PMID- 3513901 TI - Non-neuronal cell proliferation in tissue culture: implications for axonal regeneration in the central nervous system. AB - A tissue culture model has been developed to examine the hypothesis that proliferating non-neuronal cells may constitute a physical and/or chemical barrier to regenerating neurons in the central nervous system. Explants from the sensorimotor cortex of 20-day-old fetal rats were cultured in serum medium (control) or serum medium containing 10(-5) M cytosine arabinoside (AraC), a mitotic inhibitor, for varying periods: 2-10, 4-12, 4-10, 4-8 and 4-7 days in vitro (DIV). The center and outgrowth zone of the explants were examined by phase contrast microscopy at varying intervals between 3 and 18 DIV. The extent of central degeneration was greatest in explants treated with AraC from 2 DIV, and was least in the 4-7 day treated group in which only minimal degeneration was evident at 13 and 18 DIV. In the outgrowth zone at 18 DIV non-neuronal cell proliferation was controlled in the 4-10 day treated explants, although this was accompanied by extensive degeneration of neurites. Further examination of neurite viability, using a neurite viability ratio, revealed that degeneration was first evident at 6 DIV in the 2-10 day treated explants, but not until 9 or 13 DIV in any of the explants exposed to AraC from 4 days onwards. There was minimal degeneration in the 4-7 day treated explants. Electron microscopic examination revealed the presence of atypical inclusions in non-neuronal cells of 4-8 day treated explants, suggesting that the cytotoxic effect of AraC may be due to a disturbance in lipid and/or ganglioside metabolism. Quantitative electron microscopic analysis of the outgrowth zone at 18 DIV revealed a significant increase in the summated area of neuronal tissue (from 7 to 18 microns2/100 microns2) and a decline in the summated area of non-neuronal cells (from 83 to 61 microns2/100 microns2) for explants treated with AraC from 4 to 7 DIV compared to control. Diminishing the potential of non-neuronal cells to act as a barrier by controlling their proliferation may, therefore, be of importance in enhancing the regenerative response of central neurons. PMID- 3513903 TI - Axons from restricted regions of the cortex pass through restricted portions of the corpus callosum in adult and neonatal rats. AB - It is known that development of the interhemispheric pathway is accompanied by a dramatic reduction in the number of callosal fibers. By injecting neuroanatomical tracers into the cortex of newborn and adult rats, we examined the distribution of fibers within the corpus callosum both before and after this loss takes place. We found that in both newborn and mature rats, axons from restricted regions of the cortex are grouped into relatively tight bundles within the corpus callosum and that the location of these bundles depends upon the region of cortex from which they originate. These results indicate that callosal fibers that are destined to disappear are not distributed diffusely throughout the corpus callosum of the neonate, but rather that they traverse this commissure through the sector that is appropriate for the area of the cortex from which they originate. This finding suggests that loss of axons does not play a significant role in establishing the overall topographic pattern of the fibers within the callosal commissure. PMID- 3513904 TI - Monoclonal antibodies specific for ganglion cells in the embryonic chicken neural retina. AB - Monoclonal antibodies have been produced which recognize antigens on the surface of embryonic chicken neural retina cells. Two monoclonal antibodies, obtained from separate fusions, have been shown by fluorescence-activated cell-sorter analysis to bind to antigens on a subpopulation of neural retina cells. Immunohistochemical methods demonstrate that both monoclonal antibodies bind to the nerve fiber and inner plexiform layers of the embryonic neural retina. These monoclonal antibodies also bind to cell bodies and neurites of cultured retinal neurons and therefore selectively recognize antigens localized to the surface ganglion cells. One of the monoclonal antibodies binds to a 260 kdalton polypeptide, which has been shown to be developmentally regulated by immunoblotting and immunocytochemistry, as it is not detected in late embryonic neural retina. The second monoclonal antibody appears to bind to different antigens in neural and non-neural tissue. In liver extracts the monoclonal antibody recognizes a trypsin-sensitive antigen, but the antibody reacts with trypsin-resistant molecules in neural tissue. This monoclonal antibody may therefore bind a glycolipid component in the neural retina, although this remains to be determined. These antibodies can be used to obtain cell populations highly enriched in retinal ganglion cells. PMID- 3513905 TI - The twitcher mouse: degeneration of oligodendrocytes in vitro. AB - Oligodendrocytes were isolated from the brain of the twitcher (twi/twi), an authentic murine model of globoid cell leukodystrophy (GLD), carrier (+/twi) and their littermate controls (+/+) and were maintained in vitro for 24 days. By 4 days in vitro (4 DIV) oligodendrocytes developed thorny processes and their morphology were closely similar to each other regardless of their genetic status. After 17 DIV, however, oligodendrocytes in twi/twi progressively degenerated and only 12% of oligodendrocytes counted at 10 DIV survived at 24 DIV in twi/twi, while in +/twi and +/+, mean survival rates were 85 and 83% respectively. Characteristic inclusions of GLD were detected in the perikarya of degenerating twi/twi oligodendrocytes indicating that metabolic defect was expressed even in isolated oligodendrocytes. These results further support the hypothesis that the primary pathogenetic event in murine GLD, twitcher, is degeneration of oligodendrocytes due to progressive accumulation of the toxic metabolite, galactosylsphingosine (psychosine). PMID- 3513906 TI - Ontogeny of adrenomedullary responses to hypoxia and hypoglycemia: role of splanchnic innervation. AB - Adrenals of neonatal rats were denervated at 3 days of age (just before functional neuronal connections are ordinarily made). At 14 days of age, rats with denervated adrenals did not secrete catecholamines in response to a neurogenic reflex stimulus (insulin-induced hypoglycemia), confirming that innervation had failed to develop; sham-operated littermates were fully responsive to insulin. In contrast, hypoxia was still able to cause depletion of adrenal catecholamines in the denervated group, indicating the persistence of a non-neurogenic secretory mechanism well past the age at which it should have disappeared (8 days). Prolonged deprivation of neural input in adult rats also led to the re-emergence of non-neurogenic capabilities. Twenty-one days after surgery in adulthood, adrenal responses to insulin were still not present but those to hypoxia were. Thus, the development of neural stimulation itself is responsible for the ontogenetic loss of the immature type of adrenal catecholamine release mechanism and does so by suppressing the non-neurogenic component; consequently the mechanism can reappear when nerve traffic is interrupted for extended periods. PMID- 3513907 TI - Dopamine dependent behaviours in rats with bilateral ibotenic acid-induced lesions of the globus pallidus. AB - Amphetamine hyperactivity, apomorphine stereotypy and haloperidol catalepsy were studied in rats following selective damage to cell bodies within the globus pallidus (GP). Ibotenic acid-induced bilateral lesions of GP attenuated the spontaneous locomotion of rats, but they did not influence the locomotor response to amphetamine. Apomorphine-induced gnawing and licking but not sniffing were attenuated in rats with GP lesions. The effect of haloperidol on catalepsy was enhanced following the GP lesion. It is concluded that the normal expression of some dopamine-related functions depends to a great degree on the integrity of cells within the GP region. PMID- 3513908 TI - Lordosis-disrupting tectal lesions alter midbrain unit somatosensory responsiveness in hamsters. AB - Previous research has shown that bilateral deep tectal lesions in golden hamsters abolish the lordosis response, whereas unilateral lesions selectively impair lordosis elicitation by contralateral flank stimulation. The present study analyzed the neural basis of these lesion effects by assessing the somatosensory responsiveness of midbrain neurons in three groups of urethane-anesthetized hamsters: animals with lordosis-abolishing bilateral tectal lesions, animals with lordosis-impairing unilateral lesions, and intact animals. Animals with bilateral lesions differed from the other groups in three aspects of unit sensory responsiveness by showing: (1) the highest percentage of neurons responsive to somatic stimulation, (2) the highest incidence of unit responsiveness to flank stimulation, and (3) the greatest proportion of responsive neurons in the ventral tegmentum. Hamsters with unilateral lesions showed basically normal unit responsiveness apart from elevated unit response to face stimulation. The results suggest that bilateral tectal lesions may eliminate lordosis by the combined effects of enhanced ventral tegmental somatosensory responsiveness and tectal destruction. Unilateral lesions appear to impair lordosis without changing the somatosensory excitability of remaining midbrain neurons. PMID- 3513909 TI - Amygdaloid lesions attenuate neurogenic gastric mucosal erosions but do not alter gastric secretory changes induced by intracisternal bombesin. AB - Bilateral lesions of the lateral hypothalamus in rats produce glandular gastric mucosal damage. The results of the first experiment demonstrated that the severity of the neurogenic gastric erosions is attenuated by prior lesions of the centromedial amygdala. In a second experiment it was shown that fasting gastric acidity is significantly reduced following chronic amygdaloid lesions and this may be the mechanism involved in the protective nature of the amygdaloid lesions against gastric mucosal damage. In addition, it was found that gastric secretory changes induced by intracisternal injection of bombesin are unaffected by amygdaloid damage. The present results are consistent with the view that the centromedial amygdaloid region may influence gastric functions by modulating the activity of the preoptic-anterolateral hypothalamic areas or by directly influencing lower brain stem autonomic control areas. PMID- 3513910 TI - alpha-Melanocyte-stimulating hormone infused ICV fails to affect body temperature or endotoxin fever in the cat. AB - Permanent cannulae for intracerebroventricular (ICV) infusion were implanted bilaterally in cats following stereotaxic procedures. After colonic temperature was recorded for a one-hour baseline, a 300 microliter ICV infusion was given of CSF control vehicle, 1:100 dilution of W3110 E. coli endotoxin (10(8) organisms/ml) or alpha-melanocyte-stimulating hormone (alpha-MSH) in one of seven doses ranging from 50.0 ng to 50.0 micrograms. Whereas ICV E. coli always induced an intense and prolonged fever of rapid onset, alpha-MSH infused similarly was essentially without effect on the deep body temperature of the normothermic cat. When each of the doses of alpha-MSH was infused ICV, either during the rising phase of an E. coli fever or after the febrile response had reached its asymptote, the core temperature of the cat was unaffected. Similarly, a mixture of E. coli combined with alpha-MSH given ICV failed to alter the characteristics of the rapidly developing fever produced in the cat by this endotoxin. On the other hand, either excess Ca++ ions (50 mM) given ICV or the antipyretic drug. Dipyrone, administered systematically during the course of an endotoxin fever effectively attenuated the animal's elevated body temperature. These results demonstrate that alpha-MSH is apparently neither involved in the central mechanisms underlying normal thermoregulation, nor does it act as an endogenous antipyretic in the cat as has been postulated in another species. PMID- 3513911 TI - [Characteristics of the hemolytic strains of E.coli]. PMID- 3513912 TI - [Comparisons of the results of toxoplasma IgG and IgM antibodies using ELISA and indirect immunofluorescence]. PMID- 3513913 TI - [The development of ischemic damage to the myocardium and a review of methods which decrease it]. PMID- 3513914 TI - Is BCG and "orphan" drug suffering from chemotherapists' overkill? PMID- 3513915 TI - Annotated bibliography: adolescent perpetrators of sexual molestation of children. PMID- 3513917 TI - It only takes a few seconds to make you think seriously about disability insurance. PMID- 3513916 TI - The practice of dental hygiene in Canada. Description, guidelines and recommendations. Executive summary. Report of the Working Group on the Practice of Dental Hygiene. Part one. PMID- 3513918 TI - A study of the gingival response to polished and unpolished amalgam restorations. PMID- 3513919 TI - The etiology and treatment of intrinsic discolorations. PMID- 3513920 TI - Gardner's syndrome. Diagnosis in a geriatric patient and dental implications. PMID- 3513921 TI - [Full-wing pontics for macroscopic retention]. PMID- 3513922 TI - Interactive video: rationale and practicalities of one experience. PMID- 3513923 TI - Central corneal dermoid: a clinicopathologic correlation and review of the literature. AB - The authors present a clinicopathologic correlation of a central corneal dermoid removed from a one-year-old child. Contrary to the initial clinical impression, the tumour involved the full thickness of the corneal stroma, necessitating a penetrating keratoplasty. After the graft became opaque, a second penetrating keratoplasty was required. In spite of the fact that the eye has remained amblyopic, its cosmetic appearance is excellent. Problems related to the management of central corneal dermoids are discussed. PMID- 3513924 TI - The development of the small intestine. AB - The remarkable degree of coordination between the development of various aspects of gastrointestinal function suggests that the process may be triggered by a single or a few central mechanisms, such as weaning and (or) hormones. Precocious development of enzyme and transport function can be induced by exogenous thyroxine and corticosteroids, while thyroidectomy and adrenalectomy abolish the normal pattern of postnatal development. These hormones may have a primary or a permissive role. Activation of the dormant hormonal mechanism could be controlled by a genetically coded biologic clock, such as chronologic age, or by a biological signal such as body size and oral intake. Generally speaking, shortly after birth, there are increases in the intestinal mucosal surface area, brush border membrane enzymes, and carrier-mediated transport. These adaptive changes occur as a result of the genetic endowment of the animal, but may be modified by environmental factors, particularly nutrient intake. PMID- 3513925 TI - The aging gut. AB - A spectrum of changes occurs in the function of the gastrointestinal tract throughout the life of the animal. With aging, there is a decline towards newborn levels of the villus surface area and brush border membrane markers, but the absorption of some nutrients continues to increase (such as glucose and vitamin), whereas the absorption of some nutrients falls (such as cholesterol) and fatty acids). Clearly there is a distinction between age-related alterations in intestinal form and function, and some of the enzyme- or carrier-mediated changes are substrate specific. With aging, the structure and brush border membrane composition of the intestine tends to regress towards newborn levels. It remains to be clarified whether these changes are a benefit to the animal, whether they represent a degeneration of normal function, and whether these changes are the cause or the effect of various age-related alterations in metabolic and physiological function. PMID- 3513926 TI - Neurologic disorders associated with mitral valve prolapse. AB - Mitral valve prolapse has been reported to be associated with a variety of neurologic disorders, including cerebral ischemia, transient global amnesia, migraine, autonomic dysfunction, and psychiatric disease. The evidence supporting these associations and possible pathogenetic mechanisms are discussed. Some neurologic disorders may be direct complications of mitral valve prolapse, while others may occur as part of an underlying genetic defect or common link. PMID- 3513927 TI - Aneurysmal bone cyst: a review of 26 cases. AB - Twenty-six cases of aneurysmal bone cyst are reviewed to determine the frequency, preferred treatment and prognosis. Some observations are made as to the existence of aneurysmal bone cyst as a primary entity or a secondary manifestation of a more serious underlying condition. The difficulty of differentiating an aneurysmal bone cyst from a giant cell tumor of bone is acknowledged and certain similarities to unicameral bone cyst are noted, with reference to some intriguing hypotheses put forward in the literature. PMID- 3513928 TI - The death of G.B.S. PMID- 3513929 TI - The professional origins of Dr. Joseph Mengele. PMID- 3513930 TI - Percutaneous deflation of a retained Foley catheter balloon with ultrasound guidance. PMID- 3513931 TI - Social problems in relation to medicine. By Richard Monahan. CMAJ 19ll. PMID- 3513932 TI - Iatrogenic disease in late life. AB - Iatrogenic diseases are common in the elderly, particularly in the hospitalized patient. Adverse outcomes may be induced by poor communication with patients, inadequate history and examination, and inappropriate use of diagnostic resources. However, even when resources are used appropriately, adverse outcomes do occur, hence the price paid for sophisticated medical and surgical techniques. Medications offer a great potential for adverse reactions, and careful prescribing and knowledge of the pharmacokinetic changes that occur with aging, particularly impaired renal excretion of drugs, together with the use of the minimum number of drugs and maneuvers to improve compliance, can reduce this risk. Complications of surgery should be anticipated and promptly recognized and managed. PMID- 3513933 TI - Social policy and drug safety. AB - Drug safety policy for the elderly says more by its relative silence and ambiguity than it could by any single affirmative set of rules and principles. The difficulties in developing such social policies embody the interaction of the complexities of each of three dimensions: social policy, which requires consensus on roles, responsibilities, and the sharing of costs; drug safety monitoring, which requires a maturing and evolving body of science, technology, and practice to converge; and geriatric pharmacology, about which the answers are only now beginning to materialize. The social forces of incomplete consensus, incomplete science, and incomplete technology beg for a solid public policy. However in the next breath they beg, yet more urgently, for the first step in such public policy, a step that remains to be taken and is of great urgency. All of those concerned with the goal of minimizing the morbidity and disability, regardless of the state of disease, in the elderly must collaborate to chart the course for each of these three forces to reach the level in which responsible social policy can be made. This will require a good faith collaboration among government, the pharmaceutical industry, the health professions, the university community, and patients or their advocates. Although the recommendations of the Melmon Commission for the creation of a "Center for Drug Safety," jointly funded by government, the industry, and the universities, may never be fulfilled and may not, in fact, be needed in bricks and mortar, certainly the spirit of such a center must be the essential first step. The ground rules--for collaboration, capacity building, nurturance, support, and professional development and technology, particularly linkage-extension--must similarly be discussed broadly in open forum. Otherwise, multiple empires, separate mutually incompatible systems, and epidemiologic squabbling will surely carry the day. Finally, research must be done better to define, understand, and address special problems of the elderly. In the end, it is this special population who must receive the unique attention of drug safety policies and their implementing systems. Just as the processes of health and of ill health need better understanding, so too must the processes of aging and their impacts upon drug risk be better understood. This research must go beyond the high-tech spheres of pharmacology and pharmacokinetics. The addition of epidemiologic analysis of risk factors for therapeutic misadventure (iatrogenic and self-induced) and for health status specific long- and short-term adverse drug experience will contribute substantially to drug safety in the elderly. PMID- 3513934 TI - Biology, primary care, family, and community. A basis for rational geriatric care. AB - The evolution of health-care policy for the elderly must address existing gaps in the current system, the dilemma of increasing costs, and the problems associated with hospitalization and nursing-home use. A major fault of current approaches is their focus on these latter two institutions and the resultant increasing fragmentation of care. An approach based on the five principles of primary care may be more rational. Primary, secondary, and tertiary prevention, based on an understanding of the biology of aging and imbedded in the framework of primary care, must be a major focus of such policy evolution. The principles of primary care must be combined with two based on context, family sensitivity and community orientation, to provide the basis for policy that is truly responsive to the broad needs of the elderly and their families. Policies evolving from such an orientation may begin to address not only current financial concerns, but also the ethical issues frequently encountered in caring for the elderly. PMID- 3513935 TI - Health maintenance of the elderly. AB - Health maintenance of the elderly is an attractive concept in both humanitarian and economic terms. However, knowledge of this subject is in its infancy. Available information suggests that effective maintenance for this age group may be difficult, will require a broader range of strategies than with younger adults, and may not be without risk of significant iatrogenic insult from the measures employed. Therefore, this article discusses the principles by which health maintenance measures should be applied to the elderly population, evaluates the role of screening, outlines two health maintenance packages that appear simple safe and effective to apply, and examines briefly the cost implications of the measures described. PMID- 3513936 TI - Geriatric assessment programs in the United States. Their growing role and impact. AB - Geriatric assessment programs have become a growing component of the health care delivery system for the elderly in the United States. They generally provide interdisciplinary assessment, treatment planning, case management, and often rehabilitation for frail elderly persons and are especially important for persons suspected of needing long-term institutional care. Their development here stems from long experience with geriatric assessment in the United Kingdom and increasing evidence of their effectiveness in North American settings. Among their demonstrated benefits are better diagnostic accuracy and treatment planning, more appropriate placement decisions with less referral to nursing homes, and improved patient functional status, general well-being, and survival. This article provides, in addition to an overview of geriatric assessment programs and their effectiveness, practical guidelines for their establishment in the hospital setting. PMID- 3513937 TI - Cancer detection by nuclear magnetic resonance zeugmatographic imaging. PMID- 3513938 TI - Methotrexate resistance and gene amplification. Mechanisms and implications. PMID- 3513939 TI - Phase II clinical trial using californium 252 fast neutron brachytherapy, external pelvic radiation, and extrafascial hysterectomy in the treatment of bulky, barrel-shaped stage IB cervical cancer. AB - From June 1977 to June 1983, 32 patients with bulky (greater than 4 cm diameter), barrel-shaped Stage IB cervical cancer were treated at the University of Kentucky Medical Center by a combination of outpatient neutron brachytherapy using californium 252 (252Cf) and external pelvic radiation followed by extrafascial hysterectomy. Nineteen patients had cervical tumors 4 to 6 cm in diameter, and 13 patients had lesions in excess of 6 cm in diameter. A dose of 4500 rad external photon therapy was given from a linear accelerator, and one or two 6-hour 252Cf implants were given during or immediately after external radiation. Extrafascial hysterectomy with bilateral salpingo-oophorectomy was performed 6 weeks after completion of radiation therapy. Complications during and after radiation were minimal and included vaginal stenosis (three) and proctitis (two). Tumor clearance in the hysterectomy specimen was complete in 23 patients (72%) and residual cervical tumor was present in 9 patients (28%). Two patients developed tumor recurrence and died of disease 15 and 27 months after therapy, respectively. Thirty patients remain free of disease 26 to 96 months (median, 52 months) after treatment, and none have been lost to follow-up. The actuarial survival of these patients is 97% at 2 years and 94% at 5 years. Intracavitary neutron therapy is well tolerated and is effective when combined with external radiation and hysterectomy in the treatment of bulky, barrel-shaped Stage IB cervical cancer. PMID- 3513940 TI - Value of ultrasonographic examination combined with measurement of serum tumor markers in the diagnosis of pancreatic cancer of less than 3 cm in diameter. AB - Ultrasonographic examinations and measurements of CA 19-9 and elastase 1 were done simultaneously in 14 patients with resectable pancreatic cancer of less than 3.0 cm in longest diameter and 48 patients with pancreatitis. Although a pancreatic mass was detected ultrasonically in only six (42.9%) of the patients with tumors of less than 3.0 cm in diameter, one or more of the abnormal ultrasonic findings (a pancreatic mass and dilatation of the pancreatic and/or bile duct) was significantly more frequent in patients with pancreatic cancer than in those with pancreatitis. An abnormally high level of CA 19-9 and/or elastase 1 also was significantly more frequent in patients with pancreatic cancer than in those with pancreatitis. The rates of detection of pancreatic cancer by ultrasonography only and by measurement of tumor markers only were 92.9% and 100%, respectively, but the specificities and predictive values of positive results by each of these tests alone were low. Thirteen (92.9%) of 14 pancreatic cancers were found in patients giving positive results by both ultrasonography and measurement of tumor markers, whereas no tumors were found in patients giving negative results in both of these examinations. A combination of these two examinations raised the specificity and predictive value of positive results to 87.5% and 68.4%, respectively, but had little or no influence on the sensitivity or predictive value of negative results. Therefore, patients in whom ultrasonographic findings are abnormal and in whom the serum levels of tumor markers also are abnormally high should be examined more extensively. This combination of examinations indicates the possibility of earlier detection of pancreatic cancer. PMID- 3513941 TI - Cardiac complications after bone marrow transplantation. A report on a series of 63 consecutive transplantations. AB - Cardiac complications related to bone marrow grafting were investigated in a group of 63 patients undergoing bone marrow transplantation (57 autologous, 6 allogeneic) in the transplant unit of Hopital Saint-Antoine (Paris, France) between February 1977 and October 1983. The pregraft regimen was cyclophosphamide, 6-thioguanine, cytosine arabinoside, and CCNU (TACC) in 39 cases, cyclophosphamide (CY) associated with whole-body irradiation in 16 cases, and multiple chemotherapeutic agents in 8 cases. The study was retrospective in 49 patients, and prospective in 14. The morbidity was 43% and the mortality 9%. There were 6 fatal cases of cardiomyopathies and/or pericarditis, 14 nonfatal cases of heart failure, 7 nonfatal cases of pure pericarditis, and 32 arythmias including 14 bradycardias, diversely associated on a total of 27 patients. Cyclophosphamide and/or TACC/cyclophosphamide, 6-thioguanine, cytosine arabinoside, and BCNU (BACT) were the factors basically responsible for the cardiac toxicity. The best-defined entity was an acute fatal cardiomyopathy with associated pericarditis of which we report three additional cases. The best predictors of CY toxicity were the daily weight (a gain of more than 2 kg for more than 48 hours) and the electrocardiogram (a decrease of more than 14% in the sum of the QRS complexes in the standard leads on the fourth day of chemotherapy). Routine echocardiography confirmed the high incidence of subclinical cardiac abnormalities and their reversibility. It would seem that radiotherapy and anthracyclines play a secondary role. Currently, we consider that cardiac toxicity is one of the most important limiting factors for bone marrow transplantation. We suggest, therefore, that the transplantation should be done as early as possible and preference should be given whenever possible to whole-body irradiation over high-dose chemotherapy combinations such as TACC. PMID- 3513942 TI - Leiomyosarcoma of the external soft tissues. A clinicopathologic, immunohistochemical, and electron microscopic study. AB - This clinicopathologic study concerns 25 cases of leiomyosarcoma of the external soft tissues, including an immunohistochemical survey of 19 cases and an electron microscopic examination of six. There was a female preponderance in a ratio of 16:9. The most common site of tumors was the thigh (nine cases), followed by the knee (five cases). Three tumors were located in the dermis, 9 were confined down to the subcutis, 2 involved the deep fascia, and 11 involved the skeletal muscle. Superficially located tumors were smaller than deeply located ones. According to the predominant histologic features, the tumors were classified into well (6), moderately (14), and poorly (5) differentiated. In addition to the classical microscopic features, dedifferentiated areas resembling malignant fibrous histiocytoma were noted in three primary tumors and one recurrent tumor. In six tumors, the anatomical location and histologic features were highly suggestive of leiomyosarcoma arising in the venous wall. Many tumor cells immunoreactive for actin were seen in 13 and for desmin in 9 of the 19 cases. Four tumors contained a few tumor giant cells positive for alpha-1-antichymotrypsin. Ultrastructurally, the tumors were characterized by smooth muscle tumor cells showing a spectrum of differentiation of varying degrees. In two cases, histiocyte-like tumor cells were detected. The most reliable prognostic parameter was the depth of the initial tumors; all patients with a leiomyosarcoma confined down to the subcutis are living, most of them more than 5 years after excision, whereas seven of the nine patients with a tumor involving the muscle have died within 5 years after excision. PMID- 3513944 TI - Chronic renal failure: a significant risk factor in the development of acquired renal cysts and renal cell carcinoma. Case reports and review of the literature. AB - Three male patients with end-stage renal disease on chronic hemodialysis presented with gross hematuria and were subsequently found to have acquired renal cyst disease and progressive bilateral renal cell carcinoma. There are now more than 84 similar cases in the literature, but the precise roles that renal failure and hemodialysis play in the development of renal cysts and renal neoplasms remain unclear. The high incidence of acquired renal cyst disease (45%) and the development of renal tumors (9%, with a 5% to 7% metastatic rate) in patients with end-stage renal failure clearly underscores the need for more intense radiologic monitoring. PMID- 3513943 TI - A randomized trial of cyclophosphamide and doxorubicin with or without cisplatin in advanced ovarian carcinoma. A Gynecologic Oncology Group Study. AB - A randomized clinical trial was conducted in women with bulky (suboptimal) Stage III and Stage IV ovarian carcinoma, using doxorubicin (Adriamycin) and cyclophosphamide with or without cisplatin. There were 440 evaluable cases, of which 227 had measurable disease. One hundred twenty of these latter patients were treated with cyclophosphamide and doxorubicin (CA), while 107 received cyclophosphamide, doxorubicin and cisplatin (CAP). The clinical complete response (CR) rate for CA was 26% (31/120) compared with 51% (55/107) for CAP (P = less than 0.0001). Of 23 CRs receiving CA who had a second-look laparotomy, only four were negative; of 39 CRs receiving CAP and a second-look, 13 were negative (not statistically significant). The response duration for patients with measurable disease (median 14.6 versus 8.8 months), progression-free interval for all patients (13.1 versus 7.7 months), and survival for patients with measurable disease (19.7 versus 15.7 months) showed a statistically significant advantage for CAP; however, there was no difference in survival of patients with nonmeasurable disease. Toxicity was more severe with CAP but was tolerable. Thus, the addition of cisplatin improves the chemotherapy of advanced ovarian carcinoma. PMID- 3513945 TI - Chromosome 1 aberrations in cancer. AB - Evidence for chromosome #1 involvement in structural rearrangements in cancer is reviewed. There have been adequate studies of cancer at most of the common sites, and at all of these, nonrandom chromosome #1 involvement has been demonstrated. In general, a variety of changes is encountered, irrespective of the site; most commonly, however, the changes result in the duplication of long arm material. It seems that these nonrandom changes, which tend to occur at a relatively late stage, may contribute to the progression of all forms of cancer. However, a small number of chromosome #1 aberrations are also now known, which may represent specific and possibly initiating changes in particular forms of cancer. These include short arm deletions in neuroblastoma and translocations in leukemias and myelodysplasia. PMID- 3513946 TI - Cytogenetics of Bloom's syndrome. AB - The quantitative aspects of Bloom's syndrome cytogenetics are reviewed. The most characteristic feature is an increased rate of homologous chromatid exchange, both sister chromatid exchange and mitotic crossing-over. Other phenomena are a tendency of somatic cells to fuse, an increased rate of chromosome breaks, often with sister chromatid reunion, formation of nonhomologous quadriradials, and occurrence of allocyclic and triradial chromosomes. Mitotic chiasmata are situated highly nonrandomly, preferably in Q-dark regions. Chromosomes containing chiasma "hot-spots" appear to contain more active genes than similarly sized control chromosomes. They also contain a high proportion of localized oncogenes. Bloom's syndrome homozygotes show a high incidence of cancer (1/4). This may depend on a) the high rate of homozygosity resulting from mitotic crossing-over, which would allow the expression of recessive cancer genes; b) unequal crossing over would amplify these genes; c) chromosome structural changes that might transfer oncogenes to new locations and, thus, activate them; and d) immunodeficiency, which would promote malignant growth. PMID- 3513947 TI - Phase II trial of carboplatin in non-small cell lung cancer. PMID- 3513948 TI - Invertase-catalysed fructosyl transfer in concentrated solutions of sucrose. PMID- 3513949 TI - [Randomized studies evaluating the prognostic significance of myocardial revascularization]. PMID- 3513950 TI - [Spectral analysis of the ECG during ergometric loading after administration of various drugs]. PMID- 3513951 TI - [Nedved's plan--the known and unknown. I]. PMID- 3513952 TI - [Nedved's plan--the known and unknown. II]. PMID- 3513953 TI - [Nifedipine with a long-term effect in older hypertensive patients. A controlled clinical trial]. PMID- 3513954 TI - [Long-term study of patients with low-renin essential hypertension]. PMID- 3513955 TI - [Transplantation of the heart and lungs]. PMID- 3513956 TI - [Bohuslav Boucek (1886-1953). On the 100th anniversary of his birth]. PMID- 3513957 TI - Cell kinetic studies of the effect of a combined therapy with 1-beta D arabinofuranosylcytosine (Ara-C) and X-irradiation on the L1210 ascites tumour. AB - We studied the effect of combined therapy with X-ray and 1-beta-D arabinofuranosylcytosine (Ara-C); firstly the effect of whole-body X-irradiation alone on the proliferation of the L1210 ascites tumour of the mouse was studied by autoradiographic and cytofluorometric (FCM) methods. The effect X-irradiation with 4 Gy was mainly a cytostatic one leading to an altered distribution of the cells throughout the cycle due to radiation induced mitotic delay. The cytocidal effect is negligible. As is known from previous studies (Fietkau, Friede & Maurer Schultze, 1984) the effect of 200 mg/kg Ara-C consists of an inhibition of DNA synthesis and of killing a considerable portion of the L 1210 cells, predominantly of S phase cells. With respect to the importance for potential therapeutic regimens, the influence of the sequence and the time interval between the two therapeutic steps on the survival of tumour-bearing mice was studied. Most combination therapies significantly increase the survival of tumour-bearing mice compared to the single therapeutic steps; however, no significant differences between the various combined therapies were found. Whole-body X irradiation with 4 Gy followed by the application of 200 mg/kg Ara-C 10 hr later resulted in the greatest increase of the mean survival time of tumour-bearing animals, from 13.2 to 17.4 days. It was shown that apart from the cytocidal effect on S-phase cells, Ara-C also kills cells sublethally damaged by a preceding X-irradiation. PMID- 3513959 TI - Immunofluorescent localization of type-V collagen as a fibrillar component of the interstitial connective tissue of human oral mucosa, artery and liver. AB - Polyclonal antibodies against native human type-V collagen were produced in rabbits and goats. Following purification, crossreaction of the antibodies with highly immunogenic peptides of basement membranes or the interstitial matrix was excluded on the basis of sensitive radioimmunoassays. These antibodies, when applied to cryostat sections of human oral mucosa, liver and arterial walls, never stained basement membranes as did antibodies against type-IV collagen or laminin. On the contrary, we observed delicate arborizing fibers in the interstitial compartment with extensions contacting structures such as subepidermal basement membranes. Arterioles contained a unilamellar sheath of longitudinally oriented fibers limited to the intimal layer. Larger arteries exhibited a multilamellar fibrous fluorescence over the whole intima, whereas the media showed a much weaker staining. The data identified type-V collagen as an interstitial fibrillar collagen rather than a basement membrane collagen, with a tissue pattern completely different from that of collagens types I, III, VI or fibronectin. A reinterpretation of the role of type-V collagen in connective tissue function is warranted. PMID- 3513958 TI - Development of myofibrils in the gizzard of chicken embryos. Intracellular distribution of structural proteins and development of contractility. AB - The intracellular distributions of major muscle proteins, myosin, actin, tropomyosin, alpha-actinin, and desmin, in smooth muscle cells of chicken gizzard at various stages of embryogenesis were investigated by immunofluorescence labeling of enzyme-dispersed cells cultured up to three hours. These muscle proteins, except some part of myosin, were organized into fibrous structures as soon as synthesis and accumulation of proteins started. As for myosin, a considerable amount of it was dispersed in soluble cytoplasm as well. On the other hand, Ca++-dependent contractility was detected with detergent-extracted myoblasts and glycerinated tissue from embryos older than 7 days. Although the nascent myofibrils bear a resemblance to "stress fibers," the former could be distinguished from the latter by their high stability in dispersed, spherical cells. The above findings, therefore, show that the synthesis of contractile proteins is followed by immediate assembly of them into functional myofibrils without undergoing any intermediate structure. Based on these findings, the mechanism of myofibril formation in developing smooth muscle cells is discussed. PMID- 3513960 TI - Identification of alpha-1-proteinase inhibitor-containing cells in pancreatic islets. AB - By a regular immunoperoxidase method, alpha-1-proteinase inhibitor (Api) was demonstrated in pancreatic islets in individuals with and without genetic deficiency of Api. Subsequently a double immunoperoxidase method, with two different chromogens (diaminobenzidine-brown and 4-chloro-1-naphthol-blue), was applied on the same tissue section in order to identify cells containing Api and cells secreting polypeptide hormones. Api-positive cells and hormone-secreting cells were found to be mutually exclusive indicating that Api is synthesized by previously unrecognized islet cell. The population of Api cells was significantly higher in persons with genetic deficiency than in other individuals, implying a possible compensatory hyperplasia of those cells triggered by a low level of circulating Api. PMID- 3513961 TI - Immunohistochemical demonstration of histamine N-methyltransferase-like structures in rat kidney. AB - Histamine N-methyltransferase (S-adenosylmethionine: histamine N methyltransferase, E.C. 2.1.1.8) was purified to homogeneity from rat kidney, and antibody was raised against it in guinea pigs. The antibody immunoprecipitated histamine N-methyltransferase. Immunofluorescent histochemical studies with anti histamine N-methyltransferase antibody as the first antibody and goat anti-guinea pig IgG conjugated with fluorescein isothiocyanate as the second, showed the presence of immunoreactive structures in the proximal tubules of rat kidney. The brain showed no immunoreaction with the antibody. PMID- 3513962 TI - Left atrial myxoma: diagnosis by digital subtraction intravenous angiography. AB - Digital subtraction intravenous angiography (DSIVA) represents an important technical advance in angiographic diagnosis. Herein we present three patients with left atrial myxoma assessed by DSIVA. We review the role of DSIVA in evaluation of patients with suspected cardiac tumors and the importance of careful atrial-phase scrutiny in examinations obtained for other purposes (ie, pulmonary angiography and assessment of ventricular function). PMID- 3513963 TI - Coronary artery spasm in a denervated orthotopic transplanted human heart. AB - A case of catheter-induced spasm in a 40-year-old male one year after orthotopic cardiac transplantation is presented. The fact that spasm can occur in this setting of total cardiac denervation demonstrates that other factors can play an important part in modifying the status of coronary artery patency. PMID- 3513964 TI - The value of coronary artery visualization during routine intravenous digital subtraction ventriculography. AB - Right anterior oblique intravenous digital subtraction ventriculograms and selective coronary angiograms were performed on 71 consecutive patients. The intravenous ventriculograms were reviewed by two blinded observers with close examination of the right and left anterior descending coronary arteries. These were considered abnormal if they failed to opacify or if luminal irregularities suggested greater than 50% obstruction. Significant (greater than 50% obstruction) occlusions of the right coronary artery were found in 16 patients according to a blinded reading of the selective angiograms. The observers correctly identified 13 of these on the digital subtraction ventriculograms (sensitivity 81%). Of the 55 nondiseased right coronary arteries, correct identification was made in 47 (specificity 85%). Likewise, 17 patients had angiographically significant obstructions of the left anterior descending coronary artery and 15 were correctly identified by digital subtraction ventriculography (sensitivity 88%). However, only 20 of the 54 nondiseased left anterior descending coronary arteries were correctly identified (specificity 37%). Nonopacification or visualization of a severe obstruction of the right coronary artery is a useful finding and should be sought during examination of routine intravenous digital subtraction ventriculograms. This technique is not adequate at the present time to replace selective coronary arteriography in the assessment of coronary anatomy. PMID- 3513965 TI - Localized conversion at the crossover sequences in the site-specific DNA inversion system of bacteriophage P1. AB - The crossover sites for site-specific C inversion consist of imperfect 12 bp inverted repeats with the dinucleotide TT at the center of symmetry. The phage P1 Cin recombinase acts not only at these cix sites but also less efficiently at cix related sequences called quasi-cix sites, cixQ. When cixQ contains a central dinucleotide TT, crossover occurs in vivo at the 2 bp sequence TT in the normal and the quasi-cix sites. If cixQ carries only one T residue, inversion-associated localized conversion can occur at the mismatched position within the 2 bp sequence. The results indicate that Cin generates 2 bp staggered cuts in vivo and that reciprocal strand exchanges occur at these 2 bp crossover sequences. PMID- 3513966 TI - Mutations in a yeast intron demonstrate the importance of specific conserved nucleotides for the two stages of nuclear mRNA splicing. AB - Mutations were introduced at all positions of the internal conserved sequence (ICS) and at three positions in the 5' junction sequence of a Saccharomyces cerevisiae actin intron contained within an actin-thymidine kinase fusion gene. Stage I of splicing is reduced by changes at all these positions. C or A replacement at the fifth nucleotide of the 5' sequence reduces the fidelity of RNA cleavage at the 5' exon-intron junction and results in an accumulation of aberrant lariat intermediate. Stage II of splicing is affected by changes in the first and second residues of the 5' sequence and in the penultimate position of the ICS. An A to G transition at the branch point of the ICS causes a major accumulation of lariat intermediate. PMID- 3513967 TI - Induction of hepatocytes in the pancreas of copper-depleted rats following copper repletion. AB - Pancreatic hepatocytes are induced in rats maintained on copper-deficient diet containing 0.6% D-penicillamine for 8-10 weeks, followed by copper repletion. These induced hepatocytes are morphologically and functionally very similar to parenchymal cells of the liver. Immunofluorescence stains demonstrated the presence of albumin and catalase in these cells. Stains for pancreatic enzymes and hormones were negative. As expected, the hypolipidemic compound, ciprofibrate, induced peroxisome proliferation in these cells. These results indicate that a simple depletion and repletion of copper can trigger transdifferentiation in the pancreas of adult rats. PMID- 3513968 TI - Immunolocalization of a spectrin-like protein (fodrin) in pancreatic acinar cells. AB - A spectrin-like protein (fodrin) was localized in porcine pancreas using an immunoperoxidase procedure with antibodies raised against erythrocyte spectrin. Fodrin was primarily associated with the cell plasma membrane although some was also detectable in the cytoplasm of the acinar cells. The membrane labelling of the acinar cells was uneven such that the lateral and basal membranes were strongly labelled by anti-spectrin antibodies whereas the apical membranes were poorly labelled. The implications of the results to secretion and to the occurrence of specific membrane domains are discussed. PMID- 3513969 TI - Ribosomal RNA on the surfaces of nonleukemic mouse ascites tumor cells. AB - RNAs on the cell surfaces of two nonleukemic and two leukemic strains of mouse ascites tumor cells were studied by fractionating the RNAs released from the cell surface by gentle pronase treatment after sucrose density gradient centrifugation, by indirect membrane immunofluorescence that used anti-RNA antibody and by cell electrophoresis. RNA was extracted from the cell supernatants of Ehrlich ascites tumor and sarcoma 180 cells (nonleukemic) that had been treated or not treated with pronase (1 microgram/ml, 37 degrees C, 20 min) followed by sucrose density gradient centrifugation. It was clearly demonstrated that the amounts of ribosomal RNA (18S and 28S) released after pronase treatment were approximately 80% greater than that of nonpronase-treated cells. Ehrlich ascites tumor cells that had been treated with actinomycin D (100 micrograms/kg body weight of mouse, 16 h) in vivo released an amount of ribosomal RNA after pronase treatment only 20% greater than the value for untreated cells. Actinomycin D treatment greatly reduced both the cell surface negative charge and the cell surface immunofluorescence when rabbit anti-RNA antibody was used. Under the same experimental conditions with actinomycin D, only ribosomal RNA synthesis showed preferential inhibition, not the syntheses of poly A-containing messenger RNA, 4S or other small-size RNAs. In contrast, L1210 and C1498 cells (leukemic) showed no change in the amounts of ribosomal RNA released after pronase treatment. L1210 cells also showed no change in the surface negative charge after being treated with actinomycin D.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3513971 TI - [Pharmacy and its changes]. PMID- 3513970 TI - Population-dependent requirements of vitamin B12 and metabolically related substances of several mouse cell types in serum-free, albumin-fortified medium. AB - Mouse FM3A cells propagated well in serum-free medium containing 0.5% serum albumin and 1 microgram of insulin/ml. The vitamin B12 (B12) requirement of the cells depended on the population density. This requirement disappeared when a sufficiently large cell population was present. A combination of 1-100 ng of B12/ml and 4 micrograms of hypoxanthine/ml resulted in a synergistic increase in cell growth at low cell densities. A similar growth response was obtained when the B12 plus hypoxanthine was replaced by 4 micrograms of hypoxanthine/ml in combination with 100 ng of thymidine/ml, 1 microgram of folic acid/ml or 1 microgram of folinic acid/ml, even though 1 microgram of folic acid/ml already was present in the medium. Experiments on single cell inoculation showed that colony size and the yield of cells grown in B12-supplemented medium were much larger than those for cells grown in B12-free medium. A more critical population dependent B12 requirement was demonstrated in mouse Ehrlich and L cells and their hybrids. At less than 100 cells there was no propagation in serum-free medium lacking B12, folinic acid and thymidine; whereas, a satisfactory growth response was obtained in medium supplemented with these substances. PMID- 3513972 TI - [The contribution of gynecologists to sexology]. PMID- 3513974 TI - [The hypothalamo-hypophyseal dopaminergic system in rats]. PMID- 3513973 TI - [The endocrine system in old age]. PMID- 3513975 TI - [Functional residual lung capacity (FRC)]. PMID- 3513977 TI - [Delayed inspiratory stridor after a facial injury]. PMID- 3513976 TI - [Changes in the levels of endogenous glucocorticoids in endotoxic uveitis]. PMID- 3513978 TI - [Biologic therapy in psychiatry]. PMID- 3513979 TI - [Virulence plasmids and resistance plasmids in E. coli in infantile dyspepsia during banana diet therapy]. PMID- 3513980 TI - [Tuberculosis caused by Mycobacterium bovis and its current significance in Slovakia]. PMID- 3513981 TI - [Possibilities of diagnosing cholecystolithiasis and cholecystitis using ultrasound]. PMID- 3513982 TI - [Horseshoe kidney]. PMID- 3513983 TI - The concept of preleukemia: clinical and laboratory studies. AB - Thirty-five years ago, a handful of astute clinical hematologists began to notice that some of their patients with acute nonlymphocytic leukemia had a history of a preceding ill-defined hemopathy. This "preleukemic" hemopathy was increasingly reported anecdotally and through careful retrospective analyses. In more recent prospective studies, this syndrome has been relatively well defined. Indeed, it is widely accepted that there exists a hematopoietic abnormality not recognizable as classical, overt, acute nonlymphocytic leukemia, which, nonetheless, can represent an early phase of leukemia. In this manuscript, the author reviews the original case reports, the initial retrospective studies, and the prospective studies which have clarified some of the clinical and laboratory features of the preleukemic syndrome. The notion that the preleukemic syndrome represents an established neoplastic process will be reviewed with special attention to assessment of clonal hematopoiesis, cytogenetic studies, and clonal evolution. Studies on induced leukemia and preleukemia in experimental animals and humans will be reviewed as will be the semantic issues which have complicated our ability to compare interinstitutional studies. A simple classification scheme of the myelodysplastic syndromes will be presented as will be a framework agenda for future studies on the pathophysiology of these syndromes. PMID- 3513984 TI - Current status of treatment of acute leukemia in adults: an overview of the Memorial experience and review of literature. AB - The results of treatment of 629 previously untreated adults with acute leukemia at Memorial Hospital are reviewed. During the past 14 years, 135 adults (greater than 15 years) with acute lymphoblastic leukemia (ALL) have been treated with one of three successive multidrug-intensive treatment protocols (L2, L10/10M, and L17/17M), each calling for 2.5 to 3 years of systemic chemotherapy and prophylactic intrathecal methotrexate without cranial irradiation. The complete remission (CR) rates were L2 (n = 22) = 77%; L10/10M (n = 69) = 86%; L17/17M (n = 44) = 77%. The median durations of survival and remission were, respectively, L2 = 33 and 30 months; L10/10M = 62 months and not reached; and L17/17M = not reached. Almost all relapses occurred within the first 3 years while still continuing treatment, and there were only rate late relapses after stopping treatment. It appears that approximately half of the patients may have been cured with the latest two protocols. During the last 17 years, 494 adults aged 15 to greater than 70 with acute nonlymphoblastic leukemia (ANLL) were treated with one of five successive multiple drug treatment protocols of varying intensity (arabinosylcytosine + 6-thioguanine [n = 36]; L6 [n = 101]; L12 [n = 104]; L14/14M [n = 121]; and L16/16M [n = 132]). Patients with myelodysplastic syndromes generally were not treated until they developed acute leukemia, but were then entered and included in the results. Secondary leukemias following treatment of other neoplastic diseases were not included. The complete remission rates were fairly constant between 47 and 64% and the median durations of remissions were between 9 and 21 months. The intensive treatment L14 and L16 protocols were associated with more early deaths and did not result in a significantly improved remission incidence or duration or survival. With all protocols, the majority of relapses occurred within the first 2 years, but relapses continued to occur at a decreasing rate for 4 years and occasionally even later. Whereas a small fraction (approximately 10 to 15%) of adults with ANLL are now apparently being cured with combination chemotherapy, despite intensive efforts there has been little improvement during the last decade and more selective and effective forms of treatment are urgently needed. PMID- 3513985 TI - Platelet granule disorders. AB - The present review has cataloged the inherited and acquired disorders of platelet granules. Unfortunately, a mere listing of different conditions in which dense bodies, alpha granules, or both are decreased, absent, or fused does little to define their importance in human platelet physiology or as a causative factor in hemorrhagic disease. The inherited disorders serve as the best index of granule involvement in platelet hemostatic function. Our experience with storage pool deficiency in patients with Hermansky-Pudlak syndrome has suggested that in many individuals virtual absence of dense bodies and their contents does not present a serious threat to hemostasis. Placing HPS patients on aspirin did not cause spontaneous hemorrhage, suggesting that secretion of dense body contents and synthesis of endoperoxides and thromboxane A2 are not absolutely essential for platelet function. However, the literature strongly suggests that many patients with HPS and SPD face a serious risk from bleeding, and hemorrhage may cause death. We can only conclude that some patients with HPS have platelet defects or other hemostatic problems that render SPD a far more serious threat than in other patients who appear to have the same disease. Dense bodies of and by themselves do not appear absolutely required for platelet function. Isolated deficiency of alpha granules presents the same enigma. Only a few patients with this rare inherited disease have been reported. They are generally considered to have mild to severe hemorrhagic problems. However, the past medical history of our two patients with GPS has recently been reviewed and platelet function studies repeated. Despite the mild thrombocytopenia, they are free of any significant bleeding episodes and their platelet function appears virtually normal. Our findings do not support the concept that alpha granules are essential for platelet function. The only condition that seems to support a critical role for storage organelles in hemostasis is the combined alpha-granule, dense body deficiency in one patient reported by Weiss. This patient does have bleeding problems. However, it is difficult to draw conclusions based on a single patient, and the discovery of other patients will help to clarify the hemostatic problem of patients with dual storage organelle deficiencies. In the meantime, we have prepared platelets from normal individuals free of storage granules by sedimentation through gradients containing cytochalasin B. The function of the normal agranular platelets is compromised, but they do respond to some aggregating agents.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3513986 TI - The implications of embryonic gene expression in neoplasia. AB - The discovery that human as well as animal tumors generally expressed oncofetal antigens (OFAs) and that these antigens generate a variety of immune responses in the tumor-bearing host is of potential major significance in tumor biology. The concept of the reexpression of embryonic or fetal antigens (EAs) encoded by DNA, which is silent in adults but is essential in metazoan development, may mesh with the exciting concept of cancer causation. While this scenario is still only speculative, it provides an interesting forum for reviewing the current data concerning the role of OFAs in cancer processes. The literature describing OFAs and their embryonic counterparts, the EAs, in modern tumor and fetal immunobiology has become extensive and, unfortunately, is quite scattered. This article seeks to synthesize this complicated data base into a cogent presentation focusing on the immunological role of EAs and OFAs in fetal survival in utero and in tumor progression and regression, respectively. The immunogenicity and characteristics of the immune responses to EAs and OFAs will be presented and placed in perspective to the rapidly unraveling story of protooncogenes and oncogenes in tumor induction. PMID- 3513987 TI - Epidemiological research in asthma: the need for a broad perspective. PMID- 3513988 TI - Bronchial responsiveness to methacholine during airway cooling in normal subjects. AB - In order to investigate the effects of airway cooling on bronchial responsiveness in normal subjects, we measured bronchial responsiveness to inhaled methacholine with and without the inhalation of cold air. Two out of seven subjects showed an increase in baseline respiratory resistance (Rrs) during cooling of the airway but the other five subjects showed little change in their baseline Rrs. All subjects increased bronchial responsiveness to methacholine. Additionally, the threshold dose of methacholine decreased to one-third of the control dose with cooling of the airway. We speculate that airway cooling increased bronchial responsiveness to methacholine in normal subjects presumably due to increased vagal tone, increased alpha-adrenergic activity and/or a release of chemical mediators. PMID- 3513989 TI - Porphyria cutanea tarda, or the uroporphyrinogen decarboxylase deficiency diseases. AB - The term "porphyria cutanea tarda" originally described the dermatological manifestations of various chronic porphyrias. Its usage now is usually restricted to disorders associated with a deficiency of uroporphyrinogen decarboxylase (UROD), for which the term "UROD-deficiency" may be more appropriate. Four etiologic agents have been implicated in this condition: alcohol, oral estrogens, halogenated aromatic hydrocarbons, and iron. An inherited deficiency of UROD is also recognized, with increased susceptibility to these agents. Certain halogenated aromatic hydrocarbons can cause UROD-deficiency in animals and synergism with iron is demonstrable in this model. Neither ethanol nor estrogen has been shown to cause UROD-deficiency in animals. Treatment by venesection to reduce total body iron is safe and effective. The 4-aminoquinoline antimalarial drugs also provide effective treatment, possibly by lysis of affected liver cells. Unlike venesection, they may not reverse the biochemical lesion which causes porphyrins to accumulate. The mechanism of acquired UROD-deficiency is not clear but animal studies suggest a role for the hepatic mixed function oxygenases which initiate iron-dependent inactivation of UROD. Diagnosis is simple, often requiring only appropriate clinical data and testing of a random urine sample. Although not common, the disorder is the most frequently diagnosed disturbance of porphyrin metabolism in many countries, and further insight into its unusual pathogenesis may clarify the hepatotoxic effects of the 4 etiologic agents. PMID- 3513990 TI - Changes in concentrations of C-reactive protein in serum after kidney or heart transplantation. AB - C-reactive protein (CRP) concentrations were serially determined in serum after kidney or heart transplantation. The initial postsurgical CRP response in these patients was compared with that of control patients undergoing related procedures but not subjected to immunosuppressive therapy. Immunosuppression clearly depressed the postsurgical CRP response in transplant recipients. The effect is greatest with the administration of cyclosporine. In addition, we found serial CRP determinations to be a sensitive indicator of renal but not cardiac allograft rejection. The specificity of CRP as such a predictor was affected by non rejection-based inflammation. We conclude that serial determination of CRP, interpreted by the extent by which its concentration increases between sequential samples, may be a useful adjunct to biochemical monitoring of renal transplants, but a similar approach to monitoring heart transplants is not possible. PMID- 3513991 TI - Interaction of cisplatin and carboplatin with sodium thiosulfate: reaction rates and protein binding. AB - Toxicity of cisplatin can be decreased by concomitant administration of sodium thiosulfate, which perhaps chemically inactivates this platinum compound. We studied the disappearance of cisplatin and carboplatin in aqueous solutions of thiosulfate at 37 degrees C by means of liquid chromatography. At initial concentrations that were similar to therapeutic concentrations in plasma, both drugs disappeared, with half-lives of 66 and 537 min for cisplatin and carboplatin, respectively. At higher thiosulfate concentrations, as found in urine, the respective half-lives were 3.7 and 33.8 min. These values suggest that direct chemical interaction in the plasma compartment has limited therapeutic consequences, whereas the anti-toxic effect of thiosulfate might be explained by the rapid inactivation of cisplatin in the kidneys. Reaction products of cisplatin and thiosulfate bound instantaneously and mainly reversibly to plasma proteins. Protein-bound cisplatin was not released by added thiosulfate--which may explain why thiosulfate, to be effective, must be given in advance of and during cisplatin administration. PMID- 3513992 TI - Measurement of alpha-glucosidase activity in serum from patients with cystic fibrosis or pancreatitis. AB - We measured the activity of a non-lysosomal alpha-glucosidase with pH optimum near 6.0 in serum from a wide variety of patients, using the fluorogenic substrate, 4-methylumbelliferyl-alpha-D-glucopyranoside. Acutely ill patients with cystic fibrosis (CF) demonstrated significant increases in alpha-glucosidase compared with CF outpatients. The former group of CF patients experienced far more severe chronic pulmonary disease than did the latter, whereas both groups had similar degrees of gastrointestinal impairment. Patients with pancreatitis associated with trauma or complicated by severe necrosis, hemorrhage, or abscess also displayed greater increases in alpha-glucosidase than did patients with uncomplicated (edematous) pancreatitis. For CF outpatients and patients with either edematous pancreatitis or pancreatic cancer, the alpha-glucosidase activity was similar to that for the general hospital-patient population. Corresponding changes were not observed for other measured serum glycosidases (alpha-fucosidase, alpha-mannosidase, beta-glucuronidase, beta-N acetylglucosaminidase). Measurement of serum alpha-glucosidase may be of value in assessing the clinical course in CF and in differentiating necrotizing from edematous pancreatitis. PMID- 3513993 TI - Rapid, competitive enzymoimmunoassay for albumin in urine. AB - In this solid-phase competitive enzymoimmunoassay for albumin in human urine, antiserum to human serum albumin labeled with horseradish peroxidase (EC 1.11.1.7) is incubated with solid-phase-bound human serum albumin in the presence of sample or standard. Results obtained correlate well (r = 0.96) with those of an established fluoroimmunoassay. The present assay covers the range 0.9 to 200 mg/L and can be performed within 1 h. These characteristics, together with the simplicity of the assay protocol, make it very useful for monitoring low concentrations of albumin in urine. Detection of such minimal albuminuria allows initiation of therapy that may prevent development of clinical proteinuria and associated diabetic nephropathy. PMID- 3513994 TI - Preliminary data on an immunoenzymatic assay of free thyroxin. PMID- 3513995 TI - Relationship of concentrations of cholesterol and triglyceride to cyclosporin A in renal transplant patients. PMID- 3513996 TI - Interference by macro creatine kinase type 1 with an immunoenzymometric method for quantification of CK-MB in serum. PMID- 3513997 TI - Positive diphenhydramine interference in the EMIT-st assay for tricyclic antidepressants in serum. PMID- 3513998 TI - Highly sensitive enzyme immunoassay for human brain aldolase C. AB - A sensitive sandwich-type enzyme immunoassay for brain-type isozyme of human aldolase C4 was developed using purified antibodies specific to the C subunit. The antibodies were raised in rabbits by injecting the purified aldolase C4, and purified by means of immunoaffinity chromatography on a column of aldolase C4 coupled Sepharose. The assay system consisted of polystyrene balls with immobilized antibody F(ab')2 fragments and the same antibody Fab' fragments labelled with beta-D-galactosidase from Escherichia coli. The assay was highly sensitive and the minimum detection limit of aldolase C4 was 3 pg/tube. The assay was specific to the C subunit of aldolase (aldolase C). It cross-reacted about 60% with aldolase AC3, 30% with aldolase A2C2, and 4% with aldolase A3C, but showed no cross-reactivity with aldolase A4, the muscle-type isozyme. Coefficients of variation in within-run and between-run precision studies for serum aldolase C were less than or equal to 11%. Serum aldolase C levels in healthy adults of various ages (16-59 yr old) and both sexes ranged from 8.74 18.9 ng/ml. Immunoreactive aldolase C in the extracts of various human tissues was determined. It was distributed at high concentrations in the central nervous tissue and heart and at significant levels in liver, adrenal glands and testis. The assay of aldolase C in cerebrospinal fluid or serum by employing this sensitive immunoassay might be useful in the diagnosis of neurological disorders or acute myocardial damage. PMID- 3513999 TI - Reexamination of the conditions for processing and storing of blood for plasma renin assay. AB - Reexamination of conditions for processing and storing blood for plasma renin assay confirmed that plasma can be stored at -20 degrees C for at least 4 weeks without significant changes in active renin level. The active renin concentration is increased by storage at 4 degrees C because of conversion from inactive renin. PMID- 3514000 TI - Paracrine mechanisms involved in granulosa cell differentiation. AB - Since the heterogeneous development of individual follicles in a given ovary cannot be accounted for by changes in circulating gonadotropin levels, local modulatory factors play an important role in the paracrine control of follicular development. The important paracrine role of ovarian steroids has been well established. Oestrogen is important in the augmentation of gonadotropin action. High local concentration of oestrogens enhances the gonadotropin stimulation of aromatase activity, resulting in further increases in oestrogen production. The elevated local oestrogens in the follicular fluid are also capable of enhancing the FSH induction of LH receptors. Similar to oestrogens, local high concentrations of progesterone may enhance the gonadotropin stimulation of progesterone biosynthesis in granulosa and luteal cells. This positive autofeedback mechanism is believed to be important for the autonomy of luteal cell steroidogenesis. Ovarian actions of androgens are diverse. In the absence of FSH, androgens exert mainly negative effects at the follicular level by causing atresia and granulosa cell death, whereas in the presence of FSH, androgens augment FSH stimulation of progesterone and oestrogen biosynthesis. Since androgen and oestrogen appear to antagonize each other's actions, the ratio of these two steroids is important in determining the fate of an individual follicle. In contrast to ovarian steroids, the role of ovarian peptides as paracrine signals is less clear. In vitro studies clearly demonstrated that GnRH exerts both stimulatory and inhibitory actions on follicular functions, while IGF I and VIP stimulate ovarian steroidogenesis. The actions of these peptides are presumably mediated through specific granulosa cell receptors that have been tentatively identified. It is presumed that GnRH and IGF-I may be produced by ovarian cells, while VIP may be derived from ovarian nerves. It is anticipated that new methodologies will be developed to study individual follicles as independent units, capable of synthesizing hormones, releasing them, and exerting local paracrine functions. PMID- 3514001 TI - Oocyte maturation inhibitor. AB - The preovulatory surge of gonadotropins induces within the mature Graafian follicle a series of changes culminating in the release of a fertilizable ovum. These include resumption of the meiotic division, a process held in abeyance from a short time after birth, and the progression of the oocyte from the dictyate stage to the metaphase of the second meiotic division. Here the role of a follicular factor, oocyte maturation inhibitor (OMI), in preventing resumption of meiosis by ova of antral follicles prior to the surge of gonadotropins has been reviewed. The suggested involvement of OMI in regulation of meiosis is based on the following observations: (1) fully grown mammalian oocytes explanted from their follicles undergo meiotic maturation spontaneously, whereas follicle enclosed ova remain immature until stimulated; (2) co-culture of oocytes isolated from their follicles with follicular granulosa cells, granulosa cell extract and follicular fluid inhibits the spontaneous maturation; (3) the inhibition of oocyte maturation by OMI is reversible and in several of the models employed can be removed by the addition of the physiological trigger of meiosis, luteinizing hormone (LH). The current state of OMI characterization and purification has been described and the involvement of additional factors, such as cyclic AMP, in the regulation of meiosis discussed. PMID- 3514002 TI - Paracrine regulation of luteal function. AB - The mechanisms controlling luteal function may involve factors that are produced both within the corpus luteum and outside the ovary. The process of luteal control appears to involve a series of molecular species, proteins, peptides, steroids and prostaglandins. Each of these factors may act independently or in concert modifying the actions of one another. The effect of GnRH on luteal function has not been completely examined and thus its significance is unclear. The neurohypophyseal peptides, oxytocin and arginine vasopressin, in combination with LH, prolactin, oestrogens and prostaglandins may play an important regulatory role on the corpus luteum. PMID- 3514003 TI - Paracrine control of the testis. AB - The mammalian testis is under the overall control of pituitary gonadotropins but the utilization of these signals to achieve normal testicular function involves complex local interactions between the Sertoli and germ cells, the Sertoli and peritubular cells, and the Sertoli and Leydig cells as well as local control of the testicular vasculature. These interactions serve two purposes: (1) to coordinate the functions of the three testicular compartments (seminiferous tubules, interstitium and the vasculature); and (2) to control the complex but orderly sequence of events that constitutes the spermatogenic cycle. This process, which involves multiplication, differentiation and translocation of the germ cells is organized into a sequence of stages, each of which is composed of a constant association of germ cells at four or five different stages of development. At each stage of the spermatogenic cycle, different events occur and the function of the Sertoli cells alters, probably in accordance with the changing requirements of the associated germ cells. As yet, our understanding of these many local events is extremely limited, particularly with respect to the identity of the hormones/factors involved in controlling the various processes. Our knowledge of paracrine control mechanisms in the testis is derived mainly from studies of the rat, but as the process of spermatogenesis is essentially the same in most mammals and involves the same sequence of events, then findings in the rat can probably be applied in general, if not in detail, to the human testis; the limited direct information available on the human testis supports this view. As most cases of infertility in men occur despite normal or raised serum gonadotropin levels and are characterized by the production of reduced or normal numbers of sperm, then it seems likely that malfunction of one or more of the intricate paracrine processes within the testis may be involved in the aetiology of idiopathic oligospermia. It is therefore argued that advances in our knowledge of the paracrine control of the testis should have major repercussions on our ability to understand, and eventually treat, idiopathic infertility in men, and also to induce infertility for contraceptive purposes. PMID- 3514004 TI - Paracrine functions of somatomedins. AB - Evidence is growing that the somatomedins act by a paracrine and/or autocrine mechanism. The importance of these mechanisms relative to the traditional endocrine actions is not clear, and it is possible that these growth factors act through all three mechanisms. Supporting the possible paracrine/autocrine mechanisms are reports that production of somatomedins or somatomedin-like peptides is widespread throughout the body. Additionally, the somatomedins have biological actions on remarkably diverse cell types, and these responsive cells are found in close proximity to cells known to produce somatomedin. Finally, factors that alter the growth rate of cultured cells produce parallel changes in somatomedin secretion, suggesting that these phenomena are closely linked. PMID- 3514005 TI - Paracrine regulation of mammary gland growth. AB - The growth and differentiation of the mammary gland is a complex process involving the interactions of various steroid and polypeptide hormones. The mammary growth occurs in a discontinued way during five distinct phases, i.e. fetal, prepubertal, postpubertal, pregnancy, and early lactation periods. The gland expresses its differentiated function by producing milk during the period of lactation. Although the mammary gland has been regarded as one of the well known target tissues for various types of hormones, evidence has been accumulating in recent years indicating the involvement of other factors and substances in the process of mammary growth and differentiation. In this chapter the importance of the mesenchymal component in mammary epithelial cell growth has been documented. This component, including embryonic mesenchyme and adipocytes in adult tissue, play an essential role by not only serving as a structural entity of the gland but also by producing extracellular matrix substances and various factors that promote the growth, morphologic development and differentiation of mammary epithelium in a paracrine fashion. Other possible paracrine peptide factors for mammary cell growth have been isolated from several other sources including mammary tumors and milk. Thus, it is possible that paracrine growth factors play a role in mammary tumorigenesis. Since most of these factors are present in minute amounts, it is difficult to obtain pure forms of these factors in sufficient amounts for detailed physicochemical characterization. Moreover, further studies are needed to assess the physiological importance of these growth factors, their mode of action, and the mechanism of regulation relating to their production. It is conceivable that some mammary paracrine agents interact with each other or with endocrine agents in promoting the normal and neoplastic growth of mammary cells. Furthermore, the possibility exists that the production and release of paracrine factors are under the endocrine control. In view of the rapid progress and great interest in this area, these questions may be answered before long, along with the discovery of some other new growth regulating agents in this system. Clearly such information is important for understanding the complex process of normal and neoplastic growth of the mammary gland. PMID- 3514006 TI - Intestinal motility and its disorders. PMID- 3514007 TI - Abnormalities of the biliary tree. PMID- 3514008 TI - Bacterial diarrhoea. AB - Bacterial infections are important causes of diarrhoea in infants and children, particularly in developing countries and in other settings where standards of personal and community hygiene are low. Knowledge of bacterial diarrhoeas has been significantly expanded in recent years by the finding that many episodes of acute diarrhoea are due to infections with bacteria which produce enterotoxins that interfere with intestinal fluid and electrolyte transport (the 'enterotoxigenic' diarrhoeas). Several 'newer' bacterial agents have also been identified which would not have been detected in earlier studies of the epidemiology of infective diarrhoeas; these include Aeromonas, Campylobacter, Clostridium difficile and Yersinia. Another important advance has been new knowledge about mechanisms by which bacteria cause diarrhoea; this has led to the widespread successful application of oral rehydration therapy in treatment of acute watery diarrhoeas. PMID- 3514009 TI - Food sensitive enteropathies. PMID- 3514010 TI - The effect of gluten on HLA-DR in the small intestinal epithelium of patients with coeliac disease. AB - Frozen sections of control and coeliac jejunal mucosa were examined for HLA-DR staining. In general the staining pattern in the controls and treated coeliac patients was a patchy subapical pattern on villous tips. Untreated coeliac patients gave a different pattern with staining extending to the crypt enterocytes. Gluten challenge in three treated coeliac patients induced an altered staining pattern within 2 h. PMID- 3514011 TI - Effects of suramin on the in vivo antimicrobial resistance against Listeria monocytogenes and Mycobacterium bovis (BCG) in mice. AB - Following one intraperitoneal injection of Suramin (400 mg/kg) in mice, biphasic alterations of the resistance to Listeria monocytogenes were observed, depending on the timing of the drug administration in relation to the intravenous challenge. Treatment with suramin, concomitantly or 1 day before, enhanced markedly the bacterial growth in spleen and liver, detected as early as 3 to 6 h after the challenge, the maximum being observed at 48 h in the liver. In contrast, an increased resistance was observed when suramin was given 8 days before the challenge. This late effect was associated with a stimulation of the mononuclear phagocyte system as measured by the increase of the spleen index and accumulation of histiocytic cells in the lymphoid organs, such as peripheral nodes. Intraperitoneal inoculation of suramin (100 mg/kg), before, during and after an intravenous injection of low dose (2 X 10(4)/mouse) of Mycobacterium bovis (BCG) in C57BL/6 and CH3 mice were followed, in both strains, by a similar increase of the mycobacterial growth in spleen and liver during the first 2 weeks. This indicates that suramin was acting on a different non specific mechanism of resistance than the one being expressed by the Bcg gene controlling the natural resistance as described recently. However, when the same schedule of suramin treatment was given to these two strains, during subcutaneous immunization with 1 X 10(7) viable BCG, a significant decrease of 48 h delayed type hypersensitivity to tuberculin was noted 21 days later only in C57BL/6 but not in C3H mice, in which such a reaction was also of low magnitude in the infected control. The decrease of this cell-mediated immunity parameter in C57BL/6 suramin treated mice was also correlated with a higher number of viable BCG found at the challenge site and in the draining nodes. PMID- 3514013 TI - Emphysematous pyelonephritis in a transplanted kidney. PMID- 3514012 TI - Human monoclonal anti-nuclear antibodies produced by human-mouse heterohybridomas. AB - To obtain human monoclonal anticentromere antibodies, mouse myelomas were fused with unfractionated mononuclear cells from the peripheral blood of a patient diagnosed as having the CREST variant of scleroderma: with only anticentromere antibodies. After a single fusion an heterohybridoma secreting a human antibody specific for nuclear antigens, as detected by indirect immunofluorescence staining, was isolated. The monoclonal antibody secreted by the clone was of the human IgM class. Indirect immunofluorescence staining of the antibody on HEp-2 cells showed multiple nuclear dots or a discrete speckled pattern resembling that of an anticentromere antibody. Immunoblot analysis showed antibody binding to a 33 kD antigen derived from the nuclear protein fraction. Enzyme-immunoassay results clearly showed that the antibody reacted with the chromosomal protein fraction and not calf thymus DNA. PMID- 3514015 TI - The effect of sodium restriction in renovascular hypertension. AB - Six patients with angiographically proven renal artery stenosis were given a low salt diet, consisting of 10 mEq sodium per day for 4-6 days. Five patients showed a remarkable decrease in blood pressure (BP), from 169 +/- 12/107 +/- 4 to 131 +/ 12/84 +/- 5 mmHg, despite a rise in renin level. The decrease in BP was paralleled by a decrease in urinary sodium excretion. Restoration of the regular diet caused immediate elevation of blood pressure. We conclude that severe sodium restriction can reduce blood pressure in patients with renovascular hypertension. PMID- 3514014 TI - Cutaneous angiosarcoma following graft irradiation in a renal transplant patient. PMID- 3514016 TI - De novo focal glomerular sclerosis in preeclampsia. AB - Eleven women were selected on the presence, in postpartum renal biopsies, of focal glomerulosclerosis (FGS) superimposed to glomerular lesions of typical pregnancy-induced nephropathy. Ten out of them presented with severe preeclampsia. The renal specimens were examined by light and/or electron and/or immunofluorescence microscopy. The present study gathered clinical and morphological data suggesting that FGS might develop during preeclampsia. In these renal biopsies with FGS and lesions of pregnancy-induced nephropathy a sparse detachment of podocyte was observed at a distance from the segmental lesions by electron microscopy. The latter has also been observed in experimental models of FGS in which FGS is dependent on glomerular hemodynamic alterations. We think that the mechanism of the development of FGS in these pathological pregnancies may be analogous to these experimental models of FGS with hyperfiltration. PMID- 3514018 TI - Hypoglycemic effect of fenfluramine in insulin-treated diabetics. AB - In addition to its anorectic effect, fenfluramine has been demonstrated to decrease blood glucose levels in diabetics, independently of weight loss or the anorectic action. These studies have usually been performed in insulin independent diabetics. We therefore undertook to investigate 8 non-insulin dependent and 2 insulin-dependent patients receiving insulin, and noted a mean 21.1 +/- 3.8% decrease in blood glucose after 10 days of fenfluramine utilization. This parameter was diminished in all subjects in whom it had been elevated (greater than 120 mg/d1) during the placebo period of our double-blind, randomized study. Thus, fenfluramine apparently has the capacity to lower glucose in patients receiving insulin therapy. PMID- 3514017 TI - Linear glomerular IgG fixation in renal allografts: incidence and significance in Alport's syndrome. AB - Twelve of 767 renal allograft recipients developed linear fixation of IgG along the glomerular basement membrane (GBM) by direct immunofluorescence technique. This was associated with linear fixation along the tubular basement membrane in 7 of them. Circulating anti-GBM antibodies were not detected by indirect immunofluorescence or radioimmunoassay in any patient whereas anti-TBM antibodies were found in 2 of 4 with linear TBM fixation. Among the 12 patients with linear GBM fixation, 5 had Alport's syndrome; the 7 others had various renal diseases, excluding anti-GBM nephritis. Among the 767 patients, 34 had Alport's syndrome or variants (i.e., 4.5%). The incidence of linear GBM fixation is much higher in Alport's syndrome than in other renal diseases. Linear GBM fixation was not clearly related to anti-GBM antibodies and was not accompanied by significant deterioration of graft function. These findings may be relevant, however, to the missing GBM antigen in Alport's syndrome. PMID- 3514019 TI - The contribution of lymphatic drainage to the clearance of inhaled 99mTc-DTPA from the lungs. AB - When inhaled as an aerosol, 99mTc labelled diethylene triamine pentacetate (99mTc DTPA) moves rapidly from the airspace to the vascular space. The rate at which it leaves the lungs is being used to measure the integrity of the pulmonary epithelium. In order to determine what part the lymphatic system plays in the clearance of 99mTc-DTPA from the lungs, we measured the rate of appearance in plasma and lymph of inhaled 99mTc-DTPA and intravenously injected Indium-113m labelled (113mIn-DTPA) in 5 sheep with chronic lung lymph fistalae. Inhaled 99mTc DTPA was detected in the plasma and lymph after 1 minute. This suggests that the inhaled sub-micronic aerosol of 99mTc-DTPA was deposited predominately in a region of the lung with a large vascular surface area, ie. the terminal lung units. The lymph/plasma concentration (1/p) ratio for injected 113mIn-DTPA became greater than 1 by 4 minutes whereas the 1/p ratio for inhaled 99mTc-DTPA did not reach 1 until 25 minutes. This suggests that lymph drainage has very little part to play in the clearance of inhaled 99mTc-DTPA from the lungs. PMID- 3514020 TI - Constitutional delay in growth: comparison of linear growth with serum growth hormone response to provocative tests in 26 children. AB - The peak levels of serum growth hormone (GH) obtained in response to administration of insulin and arginine in 26 children with constitutional delay in growth (CDG) are compared to similar test results in 7 normal children. Heights at the time of testing, and follow-up linear growth, are documented in all subjects. Most patients with constitutional delay in growth could be identified on the basis of history, physical examination, bone age radiograph, and yearly follow-up of growth. Only two patients exhibited growth of less than 4 cm per year; both had normal responses to provocative testing. In response to provocative testing, individual patients with constitutional delay in growth revealed peak levels of serum GH which were within the normal range, but the group mean peak value was less (p less than 0.05) than in normal children. One child with clinical constitutional delay in growth revealed a subnormal response to both provocative tests. The results suggest that children with constitutional delay in growth may have a diminished reserve for secreting growth hormone. PMID- 3514021 TI - Possible limitations of fetal monitoring. PMID- 3514022 TI - Artifacts, blocks, and arrhythmias: confusing nonclassical heart rate tracings. PMID- 3514023 TI - Histologic and microradiographic analysis of a revised porous-coated anatomic (PCA) patellar component. A case report. AB - A retrieved uncemented, porous-coated human patellar component was evaluated histologically and microradiographically. The metal portion of the component and porous coating were made of cobalt--chromium-based alloy. Because of adhesive capsulitis and inadequate knee flexion, the patient had revision surgery 11 months after the original total knee arthroplasty. Clinically, the device was not grossly loose. Contact microradiography of the porous material showed no calcified tissue ingrowth. Undecalcified histologic sections demonstrated only fibrous tissue ingrowth, with obvious bone-resorptive activity as well as numerous multinucleated giant cells adjacent to the porous metal. PMID- 3514025 TI - Diagnostic value of sonography in lesions of the biceps tendon. AB - Lesions of the biceps tendon have been studied with plain radiographs and arthrograms of the intertubercular groove. Sometimes, however, especially when the rotator cuff has a full-thickness tear anteriorly, the sheath of the biceps tendon fails to fill with contrast medium, thus preventing diagnosis of dislocation of the tendon. To solve this problem the authors have tried sonography of the biceps tendon. The suitability of sonography for examining the intertubercular groove and the biceps tendon was assessed in ten volunteers. Thirty patients with chronic shoulder pain were subsequently studied by radiography, arthrography, and sonography. The observations made with these examinations were compared, and in 21 of the patients who were treated by operation with the surgical observations as well. Sonography seemed to provide accurate information about the configuration of the intertubercular groove and the position of the biceps tendon. The technique could be used to show dislocation of the tendon in cases in which the tendon sheath is not visualized in arthrography. Tenderness and the site of this in relation to the anterior upper end of the humerus could also be verified with sonography. PMID- 3514024 TI - Ankle arthrodesis. Problems and pitfalls. AB - Compression ankle arthrodesis remains a widely accepted surgical procedure. However, uniform efficacious results are not always obtainable. Seventeen patients treated by compression ankle arthrodesis showed 11 fusions, or a 65% union rate, with an average immobilization period of five months. The nonunion group of six patients (35%), with an average of ten months of immobilization, included two patients who were treated by below-knee amputations. The failures demonstrated basic violations of surgical, roentgenographic, and biomechanical tenets. In particular, the commonly used external fixation devices afford stability in only one plane and do not give rigid immobilization. A Triangular Compression Device solves these problems and has been used successfully. PMID- 3514026 TI - Giant cell tumor of the distal end of the radius treated by the resection and free vascularized iliac crest graft. AB - Juxtaarticular giant cell tumor involving the distal radius presents a special problem of reconstruction after tumor excision. A tailored block of vascularized iliac crest graft with its feeding artery (i.e., the deep circumflex iliac artery) joined to the ulnar artery was used as a replacement for the resected distal radius, thereby creating a new wrist joint. Excellent graft survivals were observed in all four cases. The wrists, when assessed 24-48 months after surgery, were found to have good ranges of movement, although with mild dorsal subluxation. These results compared well with other means of wrist reconstruction (i.e., the vascularized fibular graft). Although conventional means of arthrodesis give acceptable hand function, the absence of wrist motion is unacceptable to the young and active, who may prefer the method described in this article. PMID- 3514027 TI - The calcar bone graft. AB - A canine model was developed to investigate the use of an autogeneic iliac bone graft to treat the calcar deficiency commonly found at the time of revision surgery for femoral component loosening. Five large male mixed-breed dogs had bilateral total hip arthroplasty staged at three-month intervals, and were sacrificed at six months. Prior to cementing the femoral component, an experimental calcar defect was made, and a bicortical iliac bone graft was fashioned to fill the defect. Serial roentgenograms showed the grafts had united with no resorption. Technetium-99 bone scans showed more uptake at three months than at six months in the graft region. Disulfine blue injection indicated all grafts were perfused at both three and six months. Thin section histology, fluorochromes, and microradiographs confirmed graft viability in all dogs. Semiquantitative grading of the fluorochromes indicated new bone deposition in 20%-50% of each graft at three months and 50%-80% at six months. Although the calcar bone graft was uniformly successful in this canine study, the clinical application of this technique should be evaluated by long-term results in humans. PMID- 3514028 TI - The classic. Injuries of the wrist. A radiological study. By Etienne Destot. 1926. PMID- 3514029 TI - The vascularity of the wrist. Identification of arterial patterns at risk. AB - The intraosseous and extraosseous vascularity of carpal bones was studied in 75 cadaver limbs. Vascular patterns were correlated with the clinical incidence of avascular necrosis, and at-risk patterns of vascularity were identified. The carpal bones were found to fall into three groups. Group 1, which consisted of the scaphoid, the capitate, and eight percent of the lunates, had either vessels entering only one surface or large areas of bone that were dependent on a single vessel. This group was the most vulnerable to posttraumatic avascular necrosis. The bones of Group 2, the hamate and the trapezoid, were characterized by the absence of internal anastomoses. Although these bones are theoretically at risk, they do not undergo avascular necrosis. Group 3 bones, which included the trapezium, the triquetrum, the pisiform, and 92% of the lunates, had rich internal anastomoses and were at least risk of undergoing avascular necrosis. Examination of the arterial anatomy of bones that undergo avascular necrosis in other regions of the body led to a classification based on the types of vascular interruptions that place particular bones at risk. In some, i.e., the scaphoid and the capitate, a pure intraosseous disruption resulted in avascular necrosis; in others, i.e., the femoral head and a small percentage of lunates, an extraosseous disruption was sufficient to produce avascular necrosis. A third class, which included the talus and the majority of lunates, had an adequate intraosseous blood supply and good extraosseous vascularity. This pattern required severe extraosseous or a combination of intraosseous and extraosseous injury to lead to avascular necrosis. PMID- 3514030 TI - Bolt-plate fixation for anterior spinal fusion. AB - A bolt-plate device for fixation of distal thoracic and proximal lumbar vertebral bodies has proved effective in a variety of surgical situations. The instrumentation is designed to obtain the optimum conditions for the healing of cancellous bone, namely, rigid immobilization and, if possible, close apposition of surfaces. The device may also be effectively employed to protect grafts used to replace a vertebral body. PMID- 3514031 TI - The classic. Support for the spondylitic spine by means of buried steel bars, attached to the vertebrae. By Fritz Lange. 1910. PMID- 3514032 TI - Nonunion of the humerus: rigid fixation, bone grafting, and adjunctive bone cement. AB - Five patients with humeral nonunions were treated by open reduction and internal fixation with compression plating and adjunctive methylmethacrylate inserted by use of several techniques to gain secure screw purchase in markedly osteoporotic bone. The rigid fixation was supplemented in each case with cortical-cancellous bone grafting. Postoperative abduction splinting was applied in each case. The average follow-up examination was 24 months, with all five nonunions having healed at an average of five months postoperation. The shoulder arc of motion averaged 120 degrees, and the elbow arc of motion averaged 125 degrees. PMID- 3514033 TI - Adamantinoma of the appendicular skeleton--updated. AB - An updated review of adamantinoma of the appendicular skeleton now provides 195 well-documented cases from the world literature. An additional five new cases are added. Statistically, the tumor remains unusually prevalent in the tibia, but all other major limb bones have been involved, and involvement of several short bones rarely has been reported. The neoplasm is more commonly found in males, but higher earlier age incidence is found in females. The frequent history of preceding trauma may indeed be important in tumor formation. The histogenesis of the tumor is now considered to be epithelial in origin by ultrastructural and immunohistochemical methods. A high incidence of recurrence or metastases is found with inadequate cancer surgery. Known mortalities have indicated severe metastatic disease by aggressive-appearing cells. Previously, early amputation had provided good results, but wide excision or segmental resection with grafting techniques are equally successful. The recent work with allograft replacement of a widely excised segment has shown good early results. PMID- 3514034 TI - Hyperphosphatasemia in an adult. Clinical, roentgenographic, and histomorphometric findings and comparison to classical Paget's disease. AB - A 54-year-old man with short stature, diffuse skeletal abnormalities, and elevated alkaline phosphatase was evaluated by bone biopsy with undecalcified sections and morphometry analysis. Microscopically the bone changes were identical to those of classic Paget's disease. Histomorphometric analysis of bone demonstrated a high remodeling activity with increased mineralization rate similar to Paget's disease. However, the early age at onset and severity suggest that this man suffers from hyperphosphatasemia, a different and distinct condition. PMID- 3514035 TI - The classic. Conservative bone surgery in the treatment of bone tumors. By Dallas Burton Phemister. 1940. PMID- 3514036 TI - Giant cell tumor of bone. AB - Giant cell tumor GCT of bone remains a difficult and challenging management problem because there are no absolute clinical, radiographic, or histologic parameters that accurately predict the tendency of any single lesion to recur or metastasize. Enneking's and Campanacci's radiographic classifications and surgical staging are helpful in planning the initial surgical treatment, because they have observed that a number of the active (Stage 2) lesions and most of the aggressive (Stage 3) lesions have a higher incidence of local recurrence when treated by curettage alone. The bad reputation of curettage and bone grafting is undeserved and arose because of the indiscriminate application of this technique to lesions irrespective of their surgical stage. The ideal aim in the management of GCT is to eradicate the tumor and still save the joint. Curettage, possibly with adjuvant chemical or thermal cauterization, and with bone grafting or polymethyl methacrylate instillation, maintains the structural integrity of the bone and allows for early function. Good results with these techniques when applied to Stage 1 and many Stage 2 lesions may be expected in 70%--80% of the cases. Repetitive freezes with liquid nitrogen, though resulting in a lower recurrence rate, carry with them a not insignificant risk of local complications, require prolonged bracing, and incur the risk of late fracture. When GCTs occur in expendable bones, en bloc resection is the treatment of choice. En bloc resection of major joints requires a facility with reconstruction techniques including the use of allografts, large autogenous grafts and fusion, or custom arthroplasty. These are technically difficult procedures with many early and late complications. Patients have restricted function, and may require prolonged bracing even when uncomplicated. These techniques are therefore reserved for the Stage 3 and selected Stage 2 lesions. Hand lesions have been ineffectively treated by curettage and grafting, and are best treated by early en bloc or ray resection. Multicentric lesions should be handled as individual primary tumors would be in those locations. Radiation therapy has its major role in the treatment of giant cell tumors of the spine and sacrum that are not amenable to complete surgical resection, though long-term sarcomatous change must be looked for. Because of the complex management problem this rare tumor presents, it is recommended that management of giant cell tumor of bone, including the biopsy, the definitive surgery, and the follow-up examination, be carried out by individuals and institutions familiar with this entity. PMID- 3514037 TI - Uremic pleural effusion detected on radionuclide renogram. PMID- 3514038 TI - Hepatic abscess in liver transplantation. Accurate diagnosis and treatment. AB - Serial HIDA scanning was performed on a patient following liver transplantation. During the patient's course he developed biliary obstruction that manifested as a photopenic region in the liver, on the HIDA scan which filled in on the delayed views. The patient subsequently developed a region in the superior portion of the right lobe of the liver that did not fill in with activity on delayed views. The patient was experiencing low-grade fevers and was clinically believed to have either an abscess or an episode of rejection. A gallium scan was performed revealing a photopenic defect in the same region as the HIDA. Because of the clinical suspicion of abscess, a percutaneous transhepatic drainage study was performed, revealing a large abscess cavity in the suspect area within the liver. Following the drainage the patient did well. This case illustrates the usefulness of serial HIDA scanning in patients who have received liver transplants. It also is important to note that the gallium scan was negative in this hepatic abscess. In the authors' opinions, the finding of an intrahepatic fluid collection in a septic patient that does not fill with activity on the HIDA study, should be considered the source of the infection, until proven otherwise, and should be drained regardless of the findings of other studies. PMID- 3514039 TI - Inapparent pulmonary vascular disease in an ex-heroin user. AB - A severe pulmonary vascular derangement, usually reported in drug addicts, was diagnosed in a 28-year-old asymptomatic ex-heroin user by means of fortuitously performed pulmonary perfusion imaging. Neither physical findings nor pulmonary function tests, aroused suspicion of the diagnosis. A search for asymptomatic pulmonary vascular disease probably should be undertaken in drug addicts. PMID- 3514040 TI - Cholescintigraphy in gallbladder carcinoma. AB - Findings on cholescintigraphy in gallbladder carcinoma are described in five patients. Four patients presenting with acute cholecystitis had nonvisualization of the gallbladder with normal hepatoenteric transit time. One of these had a large portal mass and two had liver metastasis as additional findings. The fifth patient was jaundiced, and showed absence of bowel activity compatible with total biliary obstruction. Both the clinical and scintigraphic findings in gallbladder carcinoma are difficult to separate from findings in cholelithiasis and cholecystitis. PMID- 3514041 TI - Renal subcapsular rim sign. Radionuclide pattern. AB - The renal cortical rim sign is a radiological term describing the thin peripheral nephrogram of 2-4 mm thick which is from the peri-renal capsular collateral circulation in an otherwise nonfunctioning kidney. Radionuclides are used frequently in the estimation of renal function. A neonate with renal vein thrombosis demonstrated a rim sign on renal scan with Technetium DTPA. The rim sign on renal scan can be differentiated from severe hydronephrosis or multicystic kidney both of which may have a peripheral thin cortex which functions late on the renal scan. The rim sign in renal vein thrombosis was best visualized during the early blood pool phase when there was a considerable amount of radioactivity in the blood pool. PMID- 3514042 TI - An unusual combination of findings in renal transplantation. PMID- 3514043 TI - Clinical pharmacokinetics of cyclosporin. AB - Cyclosporin (cyclosporin A) is a unique immunosuppressant used to prevent the rejection of transplanted organs and to treat diseases of autoimmune origin. Therapeutic drug monitoring of cyclosporin is essential for several reasons: wide variability in cyclosporin pharmacokinetics has been observed after the oral or intravenous administration of the drug. The variability in the kinetics of cyclosporin is related to a patient's disease state, the type of organ transplant, the age of the patient and therapy with other drugs that interact with cyclosporin; maintaining a blood concentration of cyclosporin required to prevent rejection of the transplanted organ; minimising drug toxicity by maintaining trough concentrations below that which toxicity is most likely to occur; and monitoring for compliance since patient non-compliance with drug regimens is a significant reason for graft loss after 60 days. Clinical monitoring and pharmacokinetic studies of cyclosporin can be performed using different biological fluids (plasma, serum or whole blood) and different analytical techniques (radioimmunoassay or high pressure liquid chromatography). The available analytical methods provide different results when using blood, plasma, or serum. Comparison of therapeutic ranges and pharmacokinetic parameters should be made with careful attention given to the method of cyclosporin analysis. Following oral administration, the absorption of cyclosporin is slow and incomplete. Peak concentrations in blood or plasma are reached in 1 to 8 hours after dosing. The bioavailability of cyclosporin ranges from less than 5% to 89% in transplant patients; poor absorption has frequently been observed in liver and kidney transplant patients and in bone marrow recipients. Factors that affect the oral absorption of cyclosporin include the elapsed time after surgery, the dose administered, gastrointestinal dysfunction, external bile drainage, liver disease, and food. Cyclosporin is widely distributed throughout the body. Following intravenous administration, the drug exhibits multicompartmental behaviour. The volume of distribution (whole blood; HPLC) ranges from 0.9 to 4.8 L/kg. Cyclosporin is highly bound to erythrocytes and plasma proteins and has a blood to plasma ratio of approximately 2. In plasma, approximately 80% of the drug is bound to lipoproteins. The distribution of cyclosporin in blood can be affected by a patient's haematocrit and lipoprotein profile. Cyclosporin is extensively metabolised, primarily by mono- and dihydroxylation as well as N demethylation, and is considered a low-to-intermediate clearance drug.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3514044 TI - Pharmacokinetic determinants of drug abuse and dependence. A conceptual perspective. AB - Drugs that produce physical dependence or have similar pharmacological profiles to highly abused drugs are unlikely to be considered acceptable for marketing. Thus, the prediction of abuse and dependence becomes an important issue in the development of new psychotropic drugs. Both pharmacokinetic and non pharmacokinetic factors play an important role in predicting dependence and abuse liability of drugs. Evidence for the importance of pharmacological factors includes: the demonstration of drug binding to receptors of abused drugs; tolerance; ability to maintain self-administration; and spontaneous or antagonist precipitated withdrawal. The pharmacokinetic properties that presumably contribute to persistent self-administration and abuse include rapid delivery of drug to the central nervous system (CNS), rapid absorption, low protein binding and high free drug clearance. The pharmacokinetic properties of a drug associated with dependence will include long half-life, low free drug clearance and presence of the drug in the body at high enough concentrations and for sufficient time to permit tolerance to develop. These properties have important clinical implications for treatment and research in the area of abuse and dependence liability of psychoactive drugs. PMID- 3514046 TI - Breast-feeding the premature infant. AB - Although some controversy persists regarding the nutritional adequacy of breast milk for the very low birth weight infant, most authorities agree that milk expressed from the infant's biologic mother and fortified with additional minerals and protein is a proper source of nutrition. Proper support of the preterm infant and mother during expression of breast milk and during the transition to nursing requires a broad knowledge base and familiarity with the practical aspects of breast-feeding. PMID- 3514047 TI - Methods for determining the protein requirement of infants. AB - Although there is no clearly preferred method to determine the precise protein requirement of infants, a variety of techniques have been employed to provide a reasonable approximation of this variable. These approaches include anthropometric measurements, the determination of nitrogen balance, the estimation of rate of whole body protein synthesis and catabolism by the administration of amino acids labeled with stable isotopes, and the determination of serum concentrations of certain proteins and amino acids. PMID- 3514045 TI - High-dose morphine and methadone in cancer patients. Clinical pharmacokinetic considerations of oral treatment. AB - Several clinical studies have shown oral morphine and methadone to be effective in the treatment of intractable pain in patients with malignant disease. Recent pharmacokinetic studies have confirmed the rationale for regular administration of oral morphine and methadone but have revealed marked interindividual differences in the kinetics and metabolism which must be considered when titrating the oral dose according to the individual patient's need. Oral absorption of morphine in patients with malignant diseases is rapid, with peak plasma concentrations occurring at 20 to 90 minutes. Predose steady-state concentrations bear a constant relationship to dose, but vary considerably between individuals. The oral bioavailability is approximately 40% with marked patient-to-patient variations as a result of differences in presystemic elimination. The reported values for the volume of distribution range from 1.0 to 4.7 L/kg. Plasma protein binding is about 30%. The elimination half-life varies between 0.7 and 7.8 hours. Plasma clearance is approximately 19 ml/min/kg (5 to 34 ml/min/kg) and mostly accounted for by metabolic clearance. Studies in a few patients with malignant diseases treated regularly with daily doses of oral morphine ranging from 20 to 750mg indicate a linear relationship between the dose and trough concentration of morphine. Long term treatment with 10- to 20-fold increase of the oral dose over a period of 6 to 8 months does not seem to change the kinetics of oral morphine. The plasma concentrations of the main metabolite, morphine-3-glucuronide (M3G), exceed those of the parent drug by approximately 10 fold after intravenous administration and by 20-fold after oral administration. The relationship between the area under the plasma concentration-time curve (AUC) of morphine and the AUC of morphine-3-glucuronide remains constant during the development of tolerance upon long term treatment with increasing doses. Renal disease causes a significant increase in the mean plasma concentrations of morphine for 15 minutes after its administration, while mean values of terminal half-life and total body clearance are within the normal range. However, the glucuronidated polar metabolite morphine-3-glucuronide rises rapidly to high concentrations which persist for several days. Chronic liver disease causes an increase in the bioavailability of oral morphine but no, or only a slight reduction in the intravenous clearance. The elimination half-life and volume of distribution are within the normal range.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3514048 TI - Intravenous administration of lipid emulsions to premature infants. AB - This article describes the mechanisms responsible for hydrolysis and clearance of triglyceride from the circulation and focuses on the factors that affect lipid clearance in the newborn infant. The potential beneficial and adverse effects of IV lipid administration to premature infants are reviewed in detail. Several practical considerations for IV lipid administration are also discussed. PMID- 3514049 TI - Nutritional deficiencies in the neonate. AB - This article reviews common nutritional deficiencies that have been identified in newborn infants, including deficiencies of protein; vitamins A, D, K, C, and E; calcium and phosphorus; folate; zinc; and copper. The etiology, clinical presentation, diagnosis, and treatment of these nutritional deficiencies are discussed. PMID- 3514050 TI - Principles in cellular oxygenation: fetal and neonatal intestines. AB - Complex biochemical consequences are the result of a series of secondary biochemical changes caused by oxygen depletion. Hypoxia in the fetus and neonate results in decreased GI blood flow, especially to the GI mucosa. Although severe O2 deprivation cannot be entirely compensated for, an increase in tissue O2 extraction does occur in cases of moderate hypoxemia. In the neonate increased demands for O2 during feedings result in increased blood flow. The occurrence of hypoxia during feedings causes a decrease in intestinal motility, suggesting a clinical correlate to feeding intolerance and increased vulnerability to necrotizing enterocolitis. PMID- 3514051 TI - Assessment of fetal growth. AB - Normal fetal growth is a logarithmic process, marked by rapid mitosis at its early stages and by cellular hypertrophy and the accumulation of fat, glycogen, and connective tissue later in gestation. Growth-retarding influences can alter cell number, with a symmetric pattern of IUGR resulting if they occur early. Later insults, the result of uteroplacental compromise, affect cell size and may cause an asymmetric growth retardation. Fetuses with asymmetric growth retardation are at particular risk for intrauterine fetal demise and fetal distress in labor. The assessment of fetal growth is complicated by a lack of clear definition for what constitutes normality. Fetal growth curves should be derived from uncomplicated pregnancies. Separate curves should be available on the basis of multiple gestation and sex, maternal parity, and ethnic-racial grouping. Correction factors for maternal height and prepregnancy weight as well as sibling size at birth would be useful. Birth weight-derived data are suspect for preterm gestations; sonographic fetal weight curves may improve accuracy. Without sensitive epidemiologic growth assessment, other modalities (clinical, biochemical, and sonographic) will have limited usefulness. The assessment of fetal growth may include clinical means but care must be taken to garner a meticulous history and to record precisely serial fundal height. Many biochemical methods have been proposed for the detection of IUGR but they have a limited role as screening tests. Ultrasound remains the best method for the diagnosis, characterization, and follow-up of IUGR. Ultrasonography allows for the precise estimation of fetal weight. The calculation of HC:AC ratios allows for characterization of the pattern of IUGR. Evaluation of amniotic fluid volume and placental grading as well as the search for congenital anomalies are helpful exercises. Doppler flow studies of uterine and fetal blood flow may provide an understanding of the cause and severity of the growth-retarding process. Finally, careful antenatal surveillance and judicious timing of delivery are required following the identification of IUGR. Delivery should be planned in concert with the neonatologist. PMID- 3514052 TI - Antipyrine kinetics in liver disease and liver transplantation. AB - Antipyrine kinetics were studied in seven normal subjects, 10 patients with liver disease, and 13 clinically stable patients who received a liver transplant. Five patients were studied both before and after liver transplantation. Antipyrine concentrations in saliva after oral dosing were measured by HPLC. The antipyrine t1/2 was significantly longer (P less than 0.05) in patients with liver disease than in patients undergoing liver transplantation and normal subjects. Antipyrine clearance was not significantly different between patients undergoing liver transplantation and normal subjects, but it was significantly reduced (P less than 0.05) in patients with liver disease. In five patients who were studied before and after liver transplantation, there was a significant (P less than 0.05) increase in the antipyrine clearance and a marked reduction in its t1/2 after liver transplantation. These results indicate that liver transplantation improves the drug metabolizing ability of patients with liver disease and that the oxidative metabolizing capacity of the liver in clinically stable patients after liver transplantation is similar to that of normal subjects. PMID- 3514053 TI - Short-term augmented calcium intake has no effect on sodium homeostasis. AB - To test the hypothesis that the supplementation of dietary calcium intake influences sodium homeostasis, the renin-angiotensin system, and sympathetic nervous system in a manner that might evoke a decrease in arterial blood pressure, we gave 16 participants (eight normal and eight with hypertension) placebo for 8 days, followed by 500 mg elemental calcium as the carbonate salt twice a day for 8 days. The same diet was prepared for each meal for the entire study. Sodium intake was fixed for each participant and averaged 150 mEq/day. All urine was collected every day. Blood was drawn at the end of the placebo and calcium periods for determinations of plasma renin, aldosterone, and norepinephrine values. Calcium supplementation increased urinary calcium excretion significantly in both groups. However, calcium supplementation failed to influence sodium or potassium excretion, serum electrolytes, total serum calcium, renin, aldosterone, or norepinephrine levels, or heart rate. Systolic and diastolic blood pressure were not influenced in normal subjects, but in patients with hypertension the supine systolic blood pressure decreased significantly. We conclude that blood pressure lowering effects of calcium, should they occur, are not likely the result of augmented urinary sodium excretion or of straight-forward influences on the renin-angiotensin system or sympathetic nervous system. PMID- 3514054 TI - Chromium metabolism and its role in disease processes in man. AB - Chromium is an essential element required for normal carbohydrate and lipid metabolism. Insufficient dietary Cr has been linked to maturity-onset diabetes and cardiovascular diseases. The dietary Cr intake of most individuals is considerably less than the suggested safe and adequate intake. Consumption of refined foods, including simple sugars, exacerbates the problem of insufficient dietary Cr since these foods are not only low in dietary Cr but also enhance additional Cr losses. Chromium losses are also increased due to pregnancy, strenuous exercise, infection, physical trauma and other forms of stress. Supplementation of Cr to normal free-living individuals often leads to significant improvements in glucose tolerance, serum lipids including high density lipoprotein cholesterol, insulin and insulin binding. Chromium also tends to normalize blood sugar. Chromium supplementation of subjects with elevated blood sugar following a glucose load leads to a decrease in blood sugar while hypoglycemics respond to supplemental Cr by an increase in hypoglycemic glucose values, increased insulin binding and alleviation of hypoglycemic symptoms. In summary, dietary intake of Cr is suboptimal and this is exacerbated by increased Cr losses due to stress and certain refined foods including simple sugars that enhance Cr losses. Supplemental Cr is associated with improvements of risk factors associated with maturity-onset diabetes and cardiovascular diseases. PMID- 3514055 TI - Iron, infection, and neoplasia. AB - In nearly all forms of life, the number and diversity of enzymes that contain iron or that depend on the presence of this metal for activity are impressive. Not surprisingly, chemical mechanisms have been evolved by many organisms that permit them to solubilize and acquire iron while at the same time depriving their competitors or their pathogens of this element. Proteins such as transferrin and lactoferrin that are employed by vertebrate hosts for iron transport and acquisition can, to some extent, withhold the metal from the siderophores of invading bacteria and fungi. Attempts also are made by animal hosts to withhold iron from protozoa and neoplastic cells. Unfortunately, pathogenic microorganisms have developed a variety of counter measures that are especially dangerous in hosts stressed by iron overload in specific fluids, tissues, or cells. In recent years, however, a number of possible methods and agents for strengthening iron withholding defense have become apparent. Nearly 3,000 papers on various aspects of iron withholding are contained in the 18-year Medline Database and numerous reviews have been published since 1966. The present paper will focus on developments that have been reported within the past 2 1/2 years. PMID- 3514056 TI - Genetic diseases of copper metabolism. AB - There are several known examples of mutations which influence copper homeostasis in humans and animals. Pleiotropic effects are observed when the mutant gene disturbs copper flux. In some cases, the mutation alters the level of a specific copper ligand (enzyme) and the clinical consequences are unique. The two most widely studied genetic maladies in humans are Menkes' and Wilson's diseases. Menkes' disease is an X-linked fatal disorder in which copper accumulates in some organs (intestine and kidney) and is low in others (liver and brain). Wilson's disease is an autosomal recessive disorder in which copper accumulates, if untreated, in liver and subsequently in brain and kidney. Pathophysiological consequences of copper deficiency and toxicity characterize these two disorders. Specific mutations of human cuproenzymes include overproduction of copper-zinc superoxide dismutase in Down's syndrome, absence of tyrosinase in albinism, hereditary mitochondrial myopathy due to reduction in cytochrome c oxidase, and altered lysyl oxidase in X-linked forms of cutis laxa and Ehlers-Danlos syndrome. Mutations altering copper metabolism are also known in animals. Several murine mutants have been studied. The most extensively investigated mutants are the mottled mice, in particular brindled mice, which have a mutation analogous to that of Menkes' disease. Another recently described murine mutation is toxic milk (tx) an autosomal recessive disorder that is characterized by copper accumulation in liver. Two other mutants, crinkled and quaking, were once thought to exhibit abnormal copper metabolism. Recent data has not confirmed this. A mutation in Bedlington terriers has been described which is very similar to Wilson's disease.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3514057 TI - Zinc and its deficiency diseases. AB - The pervasive role of zinc in the metabolic function of the body results from its function as a cofactor of a multitude of enzymes. Zinc is found in every tissue in the body, and because zinc metalloenzymes are found in every known class of enzymes, the metal has a function in every conceivable type of biochemical pathway. Symptoms resulting from zinc deficiency are as diverse as the enzymes with which the metal is associated. If chronic, severe, and untreated, zinc deficiency can be fatal. Less drastic symptoms include infections, hypogonadism, weight loss, emotional disturbance, dermatitis, alopecia, impaired taste acuity, night blindness, poor appetite, delayed wound healing, and elevated blood ammonia levels. Many symptoms of zinc deficiency result from poor diet consumption, but often the most severe symptoms result from other factors including excessive alcohol use, liver diseases, malabsorption syndromes, renal disease, enteral or parenteral alimentation, administration of sulfhydryl-containing drugs, and sickle cell disease. The most severe symptoms of zinc deficiency occur in young children affected with the autosomal-recessive trait, acrodermatitis enteropathica. This disease results in decreased synthesis of picolinic acid which causes an impaired ability to utilize zinc from common food. Because simple laboratory analyses are often not reliable in determining zinc nutriture of a patient, those symptoms caused by suspected zinc deficiency are best verified by the oral administration of zinc dipicolinate. This zinc compound is efficacious and safe and would provide an accurate means of identifying symptoms that do result from zinc deficiency. PMID- 3514058 TI - Trace metals and neoplasia. AB - Numerous trace metals induce cancerous growths in various animal species in vivo and cause mutagenic or chromosomal transformations in cells-cultured cells in vitro. The most potent is probably nickel. The present review indicates that arsenic, cadmium, chromium, nickel and probably beryllium are associated with malignant neoplasms in humans. Inhalation of these metals during processing at refineries has lead to a greater incidence of pulmonary carcinoma as well as other forms of cancer. There is an inverse relationship between the amount of selenium in the environment and the death rate from cancer in humans. Evidence is presented in this review indicating that mutagenic metal ions alter the fidelity of DNA synthesis. This has been demonstrated with purified DNA polymerases using both synthetic and natural DNA templates in vitro, and by mutagenic or carcinogenic effects in vivo. The need for further studies of the molecular effects of metal ions on DNA replication, RNA transcription and translation is indicated by these results. PMID- 3514059 TI - Reconstruction following head and neck burns. AB - Burn reconstruction of the head and neck must first start with special care to this anatomic area in the early acute phase, with appropriate early debridement and coverage with sheet grafts of medium thickness into unit facial orientation. Postoperative garment and mask splinting, will help lessen the hypertrophic scar formation that frequently follows facial burns and skin coverage. Carefully planned reconstruction of these areas is indicated, with priority given first to the neck, then to the periorbital area, and then to perioral areas. Principles of scalp, ear, nasal, and cheek reconstruction following burns of the face are carefully outlined. The unit concept of burn scar resurfacing of the face has been the mainstay of our treatment. We have emphasized skin coverage of the face from similar donor site areas. The emotional and psychological effects of facial scarring secondary to severe burns are crippling to patients. Although numerous reconstructive surgical procedures may lessen the deformity, ultimately burn patients realize that their burn scars are permanent and no surgeon can give them back their original facial appearance. These patients need strong and continued support and reassurance from their physicians and nursing professional staff to maintain their self-identity and confidence. PMID- 3514060 TI - Burns in art. AB - Burn care and burned people are probably the least likely candidates as subjects of fine art. To disprove this notion, three paintings are offered as examples of artistic treatment of an unlikely issue. PMID- 3514061 TI - Management of the burn wound. AB - Thermal injury sets off a chain of pathophysiologic events that evolve into the problems encountered in management of the burn wound. This article reviews those events and presents a method of caring for wounds sustained from thermal injury. PMID- 3514062 TI - Biologic dressings and skin substitutes. AB - Burn wounds require coverage for healing to occur. Many techniques have been utilized to achieve such a closed wound, including biologic dressings, autologous skin, and skin substitutes. These and other methods are discussed. PMID- 3514063 TI - Fluid resuscitation of the thermally injured patient. Current concepts with definition of clinical subsets and their specialized treatment. AB - The key to successful fluid resuscitation of the thermally injured patient is close monitoring of the clinical response. Individualized resuscitation based on the parameters described allows for approximation of this goal. An eclectic approach used by the authors has been described with reference to clinical subsets that may require specialized resuscitative methods. Efforts should be made to use the smallest volume of fluid needed to optimize end organ perfusion. The goals of fluid resuscitation have been summarized and a variety of formulas have been described. We anticipate that our understanding of patient subsets outlined in this paper will undergo further evolution. PMID- 3514064 TI - Burn care in children: special considerations. AB - Burn injuries are common in children. In this article, the epidemiology, initial resuscitation, nutritional management, and wound management of pediatric burn injuries are reviewed with emphasis on the special problems of children. PMID- 3514065 TI - The macro-retentive casting. An alternative to acid-etched retainers. PMID- 3514067 TI - Continuous subcutaneous insulin infusion fails to correct impaired basal glucose metabolism and impaired insulin sensitivity of adipocytes from patients with type 1 (insulin-dependent) diabetes. AB - Studies of the in vivo insulin action in conventionally treated Type 1 diabetic patients have shown insulin resistance, especially in poorly controlled patients. We reported previously on impaired basal and insulin-stimulated glucose utilization in adipocytes from Type 1 diabetic subjects. In this study we have examined whether a near-normalization of glycaemia and plasma levels of metabolites in Type 1 diabetic patients induced by continuous subcutaneous insulin infusion might reverse abnormalities of adipose tissue metabolism. 11 Type 1 diabetic subjects who had been treated conventionally with diet and insulin for 11 yr were studied before and after continuous subcutaneous insulin infusion for 6 months. In Type 1 diabetic patients before insulin pump treatment we found decreased adipocyte insulin binding (p less than 0.01), normal insulin binding to monocytes and erythrocytes, impaired insulin sensitivity of the adipocyte glucose transport (p = 0.02) and reduced basal and maximally insulin stimulated rates of adipocyte glucose oxidation and lipogenesis (all p less than 0.05). After pump therapy for 6 months we found a further reduction of basal and maximal adipocyte glucose oxidation and lipogenesis (all p less than or equal to 0.05), whereas we found no significant changes of insulin receptor binding or insulin sensitivity of adipocyte glucose utilization. We conclude that continuous subcutaneous insulin infusion of Type 1 diabetic patients for 6 months aggravates the defects in basal (non-insulin-stimulated) and maximally insulin-stimulated glucose utilization of isolated adipocytes despite an optimization of glycaemic control and a near-normalization of plasma metabolites. PMID- 3514066 TI - Cyclosporin prophylaxis induces long-term prevention of diabetes, and inhibits lymphocytic infiltration in multiple target tissues in the high-risk BB rat. AB - Spontaneous insulin-dependent diabetes mellitus (IDDM) and other autoimmune manifestations, such as lymphocytic thyroiditis and atrophic gastritis, develop in diabetes-prone (high-risk) lines of Wistar-derived BioBreeding (BB) rats. To examine whether Cyclosporin A (CsA) would abrogate multiple autoimmune manifestations in BB rats, we treated them prophylactically with CsA from 5-6 weeks to 23-25 weeks of age. IDDM developed in 0/58 CsA-treated rats; 47% (29 out of 62) of sex- and age-matched controls treated with vehicle developed IDDM (p less than 0.001). CsA-treated rats had no or minimal lymphocytic infiltration and parenchymal changes in the pancreas, stomach and thyroid at the time of cessation of treatment. IDDM, glycosuria and hyperglycemia developed in 0/22 rats followed up to 370 days of age (up to 210 days following the cessation of CsA therapy); histologic examination of their islets was normal. We conclude that CsA completely abrogates the development of clinical IDDM in the BB rat, and that it inhibits or abolishes lymphocyte infiltration in several organs against which there is autoimmunity. The data also suggest that the protective effect of CsA persists well past the duration of therapy, and that cell-mediated autoimmunity (with or without humoral immunity) may be an important pathogenetic mechanism in the destruction of beta cells in the BB rat. PMID- 3514068 TI - Effects of sera from Cohen, genetically determined diabetic rats, streptozotocin diabetic rats and sucrose fed rats on in vitro development of early somite rat embryos. AB - The effects of sera from genetically determined Cohen diabetic rats, streptozotocin (STZ) diabetic rats and non-diabetic control rats fed a 72% sucrose diet on the in vitro development of 9 1/2 day old rat embryos from control rats have been studied. Hyperglycemic sera from diabetic rats had a high teratogenic effect: abnormalities were seen in 41.5% of embryos cultured in serum from Cohen diabetic animals and in 54% of embryos cultured in serum from STZ diabetic rats. Malformations were seen in 25-27% of embryos cultured in serum from 2 groups of control rats fed a high sucrose diet compared with 10.7% in serum from control rats maintained on regular diet. When embryos from the experimental groups were cultured in serum from control rats on regular diet malformations were seen in 24.7% of embryos from Cohen genetically determined diabetic rats vs 10.9-12.4% in embryos from 2 non-diabetic groups. Only 14% of embryos from STZ-diabetic rats exhibited malformations when cultured in the control serum, but 42% of embryos from the same rats showed abnormalities when grown in serum from STZ-diabetic rats. Normalization of glucose level in the serum of STZ-diabetic rats by prior injection of insulin did not reduce the high incidence of malformations (51%). The high rate of embryonic malformations correlated with the ultrastructural changes of their visceral yolk sac endoderm. We suggest that serum from diabetic rats is teratogenic even at moderate hyperglycemia.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3514069 TI - Specific immunoglobulin M and G antibodies in the rapid diagnosis of human treponemal infections. AB - The serological response to treponemal infections in men before and after specific treatment is analyzed. From the described observations several consequences and possibilities for a specific immunological diagnosis are discussed. In particular, it is shown that early diagnosis of syphilis in need of treatment can be achieved by demonstration of T pallidum-specific IgM antibodies. Finally, new insights into the role of antibody correlations between serum and cerebrospinal fluid are mentioned that have established the detection of asymptomatic neurosyphilis. PMID- 3514070 TI - ELISA detection of specific functional antibodies in human serum to Escherichia coli, tetanus toxoid, and diphtheria-tetanus toxoids: normal values for IgG, IgA, and IgM. AB - An inexpensive, easily performed enzyme-linked immunosorbent assay (ELISA) was developed to measure specific IgG, IgA, and IgM antibodies to the common antigens Escherichia coli, diphtheria-tetanus toxoid, and tetanus toxoid. Normal values were established. Classical antibody deficiency disease states were confirmed and delineated by these assays. Additionally, several instances were discovered when functional antibody levels were abnormal when the serum immunoglobulin levels were normal. The use of ELISA assays for antibodies to common antigens provides a useful technique to measure and monitor isotype responses of the humoral immune system. PMID- 3514071 TI - Immunoglobulin class of anti-Candida antibodies in patients with vaginal candidiasis. AB - Studies of the immunoglobulin class of circulating anti-Candida antibodies in patients with vaginal candidiasis were undertaken with the aim of answering the question of whether these antibodies are predominantly IgA or IgG. Earlier work resulted in conflicting data that we felt would be clarified by the use of a quantitative technique, FIAX fluoroimmunoassay, which could objectively measure the relative amounts of antibody of each class. Results using this assay and the indirect immunofluorescence assay on whole Candida cells demonstrate that the immunoglobulin class distribution of the circulating anti-Candida antibodies of these patients is similar to that seen in other forms of Candida infection, the predominant antibody class being IgG. PMID- 3514072 TI - A low-temperature embedding colloidal gold technique for immunoelectron microscopy. AB - A low-temperature embedding technique using the polar resin Lowicryl K4M with protein A gold as a marker was utilized to localize a variety of antigens at the ultrastructural level. Carcinoembryonic antigen immunoreactivity was noted over the microvilli, secretory vacuoles, and the Golgi apparatus of normal colonic epithelium. Epithelial membrane antigen was localized to the luminal plasma membrane and cytoplasmic vesicles of glandular epithelium. The lymphoid antigens leucocyte common antigen and HLA-DR were both found on the membranes of lymphocytes and histiocytes. In addition, HLA-DR immunoreactivity was noted in the Golgi apparatus of these cells. The method described appears suitable for the localization of both surface and intracellular antigens with excellent preservation of both morphology and antigenicity. PMID- 3514073 TI - Case report: ultrasonographic demonstration of portal vein thrombosis in the acute abdomen. AB - Ultrasonography demonstrated thrombus within the portal venous system in a child who presented with abdominal pain and a fever. This helped lead to a diagnosis of appendicitis complicated by ascending septic thrombophlebitis. Ultrasound of the portal vein may be of value when investigating such children with atyptical abdominal pain. PMID- 3514074 TI - A clinical trial of two conceptually different radical radiotherapy treatments in stage III carcinoma of the cervix. AB - Two hundred and ninety-six consecutive patients under the age of 70 years and having Stage III carcinoma of the cervix were randomised to receive one of two radical radiotherapy techniques. The first was a small-field, wedged, inhomogeneous 3-week X-ray treatment, followed by two radical radium insertions delivering 80% of a radical intracavity dose. The second was a 4-week homogeneous, large-field X-ray technique, supplemented by a single intracavitary insertion giving 50% of a radical intracavitary dose. Mature 5-year survival rates for the two techniques were 38.6% and 40.3% respectively (p = 0.76). Corrected 5-year results were 44.5% and 45% (p = 0.8). The time to pelvic recurrence and the sites of pelvic recurrence were not significantly different. The rate of major morbidity was eight out of 148 in the first group and five out of 148 in the second. This large, prospective, randomised trial failed to identify any significant advantage to two conceptually different techniques which explored different volumes, fractionation and balance between X-ray therapy and intracavitary therapy. The overall results remain very satisfactory when compared with recently published European results. PMID- 3514075 TI - Treatment of basal-cell carcinoma: comparison of radiotherapy and cryotherapy. AB - A prospective randomised trial to compare radiotherapy and cryotherapy in the treatment of basal-cell carcinomas was carried out in 93 patients. Two years after treatment, 4% of tumours treated with radiotherapy and 39% of those treated with cryotherapy had recurred. It is concluded that cryotherapy does not offer a satisfactory alternative to radiotherapy in the treatment of basal-cell carcinomas. PMID- 3514076 TI - Diagnosis of disease in renal allografts: correlation between ultrasound and histology. AB - Ultrasound was compared with histology in 66 cases to assess the accuracy of sonography in demonstrating abnormality in renal allografts. Patients with suspected acute, chronic or acute and chronic rejection, acute tubular necrosis and glomerulonephritis in the transplant kidney were included in the study. It was noted in this trial that ultrasound is less accurate at demonstrating abnormality in the grafted kidney than has been suggested previously in the literature. It was concluded that, where doubt exists, even when ultrasound examination is normal, biopsy should be considered. PMID- 3514077 TI - Typhlitis in acute childhood leukaemia: radiological features. AB - Typhlitis is a necrotising inflammation of the caecum usually found in acute leukaemic patients on chemotherapy. We described the radiological features of two children with this complication. The first was diagnosed by an enema using water soluble contrast medium and the second by ultrasound and computed tomography (CT). A water-soluble contrast medium enema is considered diagnostic in this clinical context and excludes intussusception and, often, appendicitis. Ultrasound showed a rounded mass with dense central echoes and a wider hypoechoic periphery. Computed tomography showed the long segment of thick-walled ascending colon and caecum; if perforation is suspected, ultrasound and CT might be preferable to a contrast enema. PMID- 3514078 TI - Microvascular haemodynamics in diabetes mellitus. PMID- 3514079 TI - Acute pseudoseptic arthritis and palmoplantar pustulosis. AB - The case of a 60-year-old woman who developed acute peripheral arthritis of a pseudoseptic character (high synovial leucocytosis and fever) associated to a palmoplantar pustulosis is reported. PMID- 3514080 TI - Cellular localization of the Ro/SS-A antigen. AB - The cellular localization of the Ro/SS-A antigen was defined using indirect immunofluorescence and eight monospecific anti- Ro/SS-A antisera which were identified by immunoblotting. Several mammalian tissues were used as substrates. The Ro/SS-A antigen was located mainly in the nucleus of dog liver and Hep-2 cells, and anti-Ro sera had produced a speckled staining pattern. Cytoplasmic fluorescence appeared only in one serum. IgG was the predominant immunoglobulin with anti-Ro/SS-A activity; five sera had complement fixing activity. The sera absorption studies with partially purified Ro/SS-A antigen and the negativation of the ANA tests had confirmed the specificity of our findings. PMID- 3514081 TI - Salivary and serum levels of electrolytes and immunomarkers in edentulous healthy subjects and in those with rheumatoid arthritis. AB - Chemical analyses of serum and stimulated parotid saliva of 73 edentulous patients with rheumatoid arthritis (RA) and of 36 edentulous healthy controls were performed. The purpose of the present work was to assess the possible correlations between the concentrations of electrolytes and immunomarkers such as lysozyme, IgA, beta 2-microglobulin (beta 2-m) and rheumatoid factor (RF) in serum and saliva. The results of the chemical analyses of the serum showed elevated values for IgA, IgM, lysozyme and beta 2-m. In addition 45 patients were positive for rheumatoid factor. In saliva, the only significant difference between the groups studied was decreased potassium concentration in the RA patients. Nine salivary specimens were RF positive. There was a highly significant correlation between serum beta 2 and salivary IgA, lysozyme, beta 2 m, urea and amylase in the RA patients. In addition, serum lysozyme and RF were related to salivary beta 2-m and urea. However, no such relations could be observed in the controls. These findings indicate that serum immunomarkers have an effect on the salivary constituents in the patients with an altered immunological state. The importance of simultaneous serum analysis is emphasized when salivary levels are to be interpreted. PMID- 3514082 TI - A double-blind multicentre trial of piroxicam and naproxen in osteoarthritis. AB - A multicentre, double-blind study of unprecedented size was conducted to compare the safety and efficacy of piroxicam and naproxen in the treatment of osteoarthritis. The study comprised 2,035 patients and a treatment period of 12 weeks. The dosage was 20 mg piroxicam and 750 mg naproxen daily with the option to reduce to 10 and 500 mg, respectively, at week 4 or 8. No major difference between the drugs was observed with regard to overall incidence of adverse events. The frequency of serious adverse events was about 1% for both drugs. A statistically significant decline of adverse events with age was found in both sexes. Piroxicam was significantly superior to naproxen for pain at rest and pain on movement at 12 weeks and degree of restriction in daily activity at 4 weeks. A significantly increasing beneficial effect was observed with both drugs between 4 and 12 weeks of treatment. The comparable safety observed for the two drugs is in contrast to perceptions based on spontaneous reports to official monitoring systems. PMID- 3514083 TI - Automatic analysers in clinical biochemistry. PMID- 3514085 TI - Milrinone, a new agent for the treatment of congestive heart failure. AB - The chemistry, pharmacology, pharmacokinetics, dosage, clinical efficacy, and adverse effects of milrinone are reviewed. Milrinone, which is structurally similar to amrinone, is an oral agent under investigation for the treatment of congestive heart failure. The drug produces positive inotropic and vasodilating effects through unknown mechanisms. Milrinone is well absorbed orally and has a duration of action of three to six hours. The major route of elimination is through the kidneys. The usual initial dosage of milrinone is 2.5-5 mg every six hours; patients whose condition is deteriorating may require 50 mg of the drug per day. Although most patients report that early in therapy the drug relieves the symptoms of congestive heart failure, these benefits are not always sustained. Milrinone does not check the natural progression of disease. Complaints of side effects are rare, although diarrhea, hyperthyroidism, aggravation of angina pectoris, worsening of muscle weakness, and increased fluid retention have been reported. There is evidence to suggest that milrinone may cause or aggravate arrhythmias, worsen congestive heart failure, and shorten the length of survival. Experience with milrinone indicates that the drug may be of limited usefulness in the treatment of congestive heart failure. PMID- 3514084 TI - Contemporary recommendations for evaluating and treating hyperlipidemia. AB - The biochemistry, etiology, and evaluation of hyperlipidemia and its management, including dietary and drug therapies, are discussed. Strong evidence supports the role of increased cholesterol concentrations as an independent risk factor for coronary artery disease (CAD); however, evidence that elevated triglyceride concentrations are also an independent risk factor remains questionable. The cornerstone of the laboratory diagnosis of hyperlipidemia involves repeated measurement of serum or plasma cholesterol and triglyceride concentrations. The goals of therapy should be to reduce cholesterol or triglyceride concentrations or both to below the 75th percentile, modify co-existing risk factors, individualize the treatment, and minimize any adverse effects. Specific interventions must be determined on the basis of patient age, gender, etiology of hyperlipidemia, presence of other risk factors, and degree of lipid abnormality. The majority of patients may be managed with dietary therapy alone. The three phase diet developed by the American Heart Association emphasizes a gradual reduction in cholesterol and fats with the substitution of polyunsaturated for saturated fats. Patients at risk for CAD with sustained elevations in plasma cholesterol concentrations above the 95th percentile or a triglyceride concentration above 500 mg/dL after an adequate dietary trial should be considered for drug therapy. The effects of cholestyramine and colestipol hydrochloride, niacin, dextrothyroxine, clofibrate, neomycin sulfate, probucol, gemfibrozil, and mevinolin and compactin on lipids and lipoproteins are reviewed. Hyperlipidemia should be managed systematically using information about the association between increased lipid concentrations and CAD, patient risk factors, and limitations of both diet and drug therapy. PMID- 3514086 TI - Applying decision analysis in therapeutic drug monitoring: using receiver operating characteristic curves in comparative evaluations. AB - In the first of a three-part series, decision-analysis techniques were applied to the evaluation, comparison, and selection of analytic systems for the purpose of improving the information content of serum drug concentration determinations. Receiver-operating characteristic (ROC) curves that graphically compare true positive and false-positive rates at selected drug concentrations were developed and used to evaluate the clinical performance of analytic systems. Decision matrices were constructed using simulated toxicity and serum-concentration data from 150 subjects. These decision matrices were used to construct ROC curves and the curves were compared with prototype curves representing ideal, useful, useless, and hazardous test systems. The ROC curves were used to determine the analytic method (e.g., enzyme-multiplied immunoassay technique versus nephelometric assay) and analyte (e.g., free versus total drug concentration) that conveyed the most information and yielded the fewest errors in classifying patients as toxic or nontoxic. The use of ROC curves to compare new or modified analytic test systems, to monitor use of a given analytic method within an institution over time, and to compare the clinical performance of a given assay method in the therapeutic drug monitoring practices of various institutions is discussed. Decision-analysis techniques can assist practitioners in selecting the optimal analytic test system for reducing analytic variation as well as improving the quality and predictive ability of the serum drug concentration. PMID- 3514087 TI - Effects of high doses of insulin on systemic haemodynamics and regional blood flows in dogs. AB - This study describes the effects of a wide range of plasma concentrations of insulin on systemic haemodynamics and free fatty acids (FFA) and the effect of a high dose of insulin on regional blood flows in the femoral, carotid, mesenteric and renal arteries. Insulin was infused in 10 dogs at rates of 4, 8, 16, 32, 64 and 128 IU/kg/h, and the experiments were concluded with a bolus injection of 300 IU. Plasma glucose concentrations were kept constant during the experiments. A dose-related increase in maximum rate of left ventricular pressure rise, stroke volume and cardiac output, and decrease in total peripheral resistance was found with insulin infusion rates up to 64 IU/kg/h. Heart rate and mean aortic blood pressure were unchanged. The maximum antilipolytic effect was obtained at an infusion rate of 16 IU/kg/h. Insulin was given as a bolus dose of 300 IU in 6 dogs. Blood-flow was increased in all vascular beds, but insulin caused a redistribution of cardiac output. The greatest increases occurred in the femoral and carotid vascular beds, and the least occurred in the renal bed. Mesenteric blood-flow was increased in proportion to cardiac output. The results suggest that insulin exerts combined positive inotropic and vasodilating effects at high dose levels, which result in improved regional perfusion. It may be a potentially useful clinical agent with special benefit under circumstances where enhanced cerebral blood-flow is of importance. PMID- 3514088 TI - The effects of undernutrition on the respiratory muscles. AB - During prolonged undernutrition, the mass of skeletal muscle represents the body's main store of protein and energy. Although it is known that cardiac striated muscle is relatively spared in undernutrition, and that disease-induced reductions in lean body mass do not spare respiratory muscle, the effects of undernutrition per se on the structure and function of the respiratory muscle are largely unstudied in humans. Available data are reviewed. PMID- 3514089 TI - Nutrition and the pulmonary parenchyma. AB - Fasting and starvation affect various aspects of lung structure and function in experimental animals. Short-term food deprivation influences lung metabolism and biochemistry; prolonged partial food restriction affects lung structure and mechanics as well. This article provides a historical review of the topic and summarizes data obtained in humans and animals. PMID- 3514090 TI - Effects of refeeding on respiration and skeletal muscle function. AB - This article discusses refeeding in relation to respiratory skeletal muscle function and the subsequent function of the respiratory system as a whole. The characteristic alterations in malnourished skeletal muscle and the response to refeeding are outlined. Following this, a simple energetic model is used to explore future areas of therapeutic research and practical recommendations. PMID- 3514091 TI - Adaptation of respiratory muscles to acute and chronic stress. Considerations on energy and fuels. AB - Although the majority of patients with acute or chronic pulmonary disease and respiratory failure do not have respiratory muscle disease or dysfunction at the outset of their clinical condition, most if not all do not have a normal respiratory musculature at the time of respiratory failure, especially those who have had a chronic course. Indeed, a large number of alterations in the muscle structure and metabolism occur as a result of a chronic load. Most of these changes are compensatory, but some may be maladaptive and deleterious to function. In addition, the compensatory mechanisms can be limited, and it is now believed that respiratory failure is at least in part exaggerated, or initiated, by the failure of the respiratory musculature. Therefore, the failure of these muscles can lead to hypoventilation, apnea, poor gas exchange, and clinically serious cardiovascular consequences. Although research efforts have increased in the past several years, there is still a great deal to learn about the function of the respiratory musculature under stress. Some of the notable questions are: What is the relation between inspiratory muscles (for example, the diaphragm and the intercostals) and the muscles of the airways during loaded breathing and in the presence of respiratory failure? How does the differential respiratory output to the various motor neuron pools change and evolve during the chronic loaded breathing? What kind of compensatory mechanisms (for example, humoral, biochemical, neural, or mechanical) can the respiratory muscles use to preserve function? What is the relation between the nutritional status of the individual and its effect on the function of these muscles? and What effect(s) do the changes associated with chronic pulmonary disease (for example, hypoxia, hypercapnea) have on respiratory muscle metabolism and function? This is an exciting area of research that has enormous potential for clinical applicability, and we believe that we are just at the very beginning. PMID- 3514093 TI - Advances in immunopathology. PMID- 3514092 TI - Malnutrition and the respiratory muscles. AB - Malnutrition reduces respiratory muscle mass and contractile force through atrophy of Type II fibers and impaired energy metabolism. Nutritional repletion restores respiratory muscle function, but may add to ventilatory work. Nutritional repletion also enhances weaning from mechanical ventilation. PMID- 3514094 TI - Multiple sclerosis: neuroimmunologic puzzle. AB - Multiple sclerosis (MS), a chronic disease with a relapsing and remitting course, is the most common neuroimmunologic condition in the United States. The hallmarks of the disease are focal demyelination and inflammation within the central nervous system (CNS). Because histopathologic changes can be identified only at autopsy, attention has been directed at formulating standardized clinical and laboratory procedures to aid in MS diagnosis. Currently, there are no MS-specific clinical or laboratory tests, but detection of abnormality in cerebrospinal fluid (CSF) IgG is important in supporting clinical evidence of disease. A number of other immunologic abnormalities have been recognized in MS, including the presence of T- and B-lymphocytes within the CNS and alterations in circulating suppressor T-lymphocytes. These findings have been interpreted as indicating disturbed immunoregulation associated with a chronic autoimmune response within the CNS. Evidence implicates viral infection in the pathogenesis of MS but the cause of the disease remains unknown. PMID- 3514096 TI - Oncogenes and human neoplasia. AB - Genes whose products are directly involved in the transformation of a normal to a neoplastic cell are present in most but not all oncogenic RNA viruses (retroviruses) have genes found in oncogenic RNA viruses (retroviruses) have also been found in normal cells, their coding sequences highly conserved in evolution. Such viral genes (v-onc) are expressed at high levels in infected cells. "Activation" of cellular homologues of v-onc genes (c-onc) may occur by a variety of mechanisms leading to an abnormal and/or increased expression of such activated c-onc genes in malignant cells. Although oncogene activation appears to be a critical step in the neoplastic transformation induced by oncogenic viruses, the role of this process in the development of chemical and radiation-induced neoplasia is not yet clear. PMID- 3514095 TI - Clinical laboratory methods for the assessment and management of human allergic diseases. AB - The biologic role and clinical relevance of IgE (reaginic) antibodies in immediate-hypersensitivity (allergic) reactions are reviewed, and methods useful in the laboratory diagnosis and management of human allergic diseases are discussed. Quantitative immunoassays for total and allergen-specific IgE antibodies are examined within the context of their use in diagnosis. The radioallergosorbent test inhibition assay and specific IgG antibody immunoassays are described as useful methods in the planning and monitoring of immunotherapy. PMID- 3514097 TI - Human oncogene-related proteins in urine during pregnancy and neoplasia. AB - The use of site-directed monoclonal antibodies for the detection of oncogene related proteins in human urine samples is described. This approach identifies differential elevations of such proteins in the urine of various cancer and pregnant patients. PMID- 3514098 TI - Immunopathology of renal disease. AB - The reviewed information implicates immune mechanisms in a variety of renal glomerular and tubulointerstitial diseases. Antibodies reactive with intrinsic structural or planted endogenous or exogenous antigens, and with circulating endogenous or exogenous antigens can initiate inflammatory capillary injury by localization in glomerular capillary tufts or along tubular basement membranes. This results in activation of mediator systems, including complement, neutrophils and other leukocytes, amines, peptides, and proteases, which result in vascular and tissue alterations. In some instances, nonimmune activation of complement (for instance, by the properdin system) and other mediators of vascular injury may be involved. A role of cellularly mediated immunologic injury in glomerular disease is not clear and remains the subject of considerable current research. More clearly, there is involvement of lymphocytes in tubulointerstitial and interstitial diseases as well as allograft rejection reactions. A rich armamentarium of in-vitro immunologic tests for specific antibodies, immune complexes, serum complement levels, and renal tissue analysis provides opportunity for enhanced precision of diagnosis and monitoring progress of disease or treatment. Unfortunately, at the present time, there are not many effective therapies specific for most renal glomerular diseases; perhaps in the future better identification of offending environmental or host antigens will result in more effective prevention and treatment. Application of knowledge concerning renal glomerular diseases to the study of hypersensitivity induced tubulointerstitial injury has resulted in increasing understanding of the pathogenesis of interstitial inflammatory disease of the kidney. PMID- 3514099 TI - Cutaneous immunofluorescence. AB - This article provides an update on skin immunofluorescence as a useful laboratory procedure in the evaluation of diseases that have cutaneous manifestations. It also provides insight into some of the problems with submitting and processing specimens as well as the difficulties and variables encountered when interpreting positive results. PMID- 3514100 TI - Immunoenzymatic test for Q-fever. AB - An immunoenzymatic test using as antigen purified suspensions of Coxiella burnetti coated by methylglyoxal on microtiter plates was developed. Multiple testing of the same sera gave similar results: two dilutions of serum (1:400 and 1:1600) were used in routine tests. Good agreement between the immunoenzymatic and the indirect immunofluorescent antibody tests was obtained for 41 of 50 sera examined. Five sera negative by the immunofluorescent antibody test were positive by the immunoenzymatic test; this result may be due to the higher sensitivity of the latter test. On the other hand, three sera with higher titers by the indirect immunofluorescent antibody test showed a rather feeble positivity by the immunoenzymatic test. This is probably due to the different specificity of the reacting antibodies in the two methods. The indirect immunofluorescent antibody test permits better distinction of the very high titers (greater than 1:5120) than the immunoenzymatic test. The immunoenzymatic test seems to be the method of choice for seroepidemiology surveys of Q-fever; however, its use for clinical serodiagnosis needs further confirmation. PMID- 3514101 TI - Blood parasites: problems in diagnosis using automated differential instrumentation. AB - To examine potential problems inherent in using automated differential instruments, we have reviewed herein two cases where blood parasites, Plasmodium vivax and Plasmodium falciparum, were completely missed by use of this method. Diagnosis of these infections was made when blood was sent to the parasitology laboratory after having been missed prior to that time. The first problem involved the laboratory request slip; no indication was made concerning possible suspect organisms. Therefore, peripheral blood examinations were performed using automated equipment. The number of fields scanned by a technologist on these smears is quite low; thus failure to pick up a light parasitemia is almost guaranteed. In both cases, after diagnosis had been made on smears submitted to the parasitology division, all previous smears examined by the automated system were reviewed and found to be positive for parasites. Failure to make the diagnosis resulted in delayed therapy. Although these instruments are not designed to detect intracellular blood parasites, the inability of the automated systems to discriminate between uninfected red blood cells and those infected with parasites may pose serious diagnostic problems. PMID- 3514102 TI - Lack of correlation between streptococcal Fc receptors and symptomatic pharyngitis. AB - To determine whether bacterial Fc(gamma) surface receptors are associated with symptomatic streptococcal pharyngitis, throat cultures were obtained from 264 children (grouped according to symptoms of pharyngeal infection) and from 328 who were asymptomatic. Group A beta-hemolytic streptococci which were recovered were tested for the presence of Fc(gamma) surface receptors. There were no statistically significant differences in the incidence of Fc(gamma) surface receptors on strains from the various patient groups. PMID- 3514103 TI - Branhamella catarrhalis--an emerging human pathogen. PMID- 3514104 TI - Direct antimicrobial susceptibility testing of urines positive in the MS-2 urine screening program. AB - A study was performed using the Abbott MS-2 system, in which positive urine screening specimens were set up directly to an antimicrobial susceptibility test. These results were compared with standard techniques. The overall correlation for urines containing single pathogens was 95.4%. Results were available 5-8 hr after receipt by the laboratory. PMID- 3514105 TI - Management of spina bifida and associated anomalies. AB - Myelomeningocele and its accompanying deformities are among the most complex and frequent of the malformations to which the developing nervous system is subject. a multidisciplinary approach to management of the patient with myelomeningocele is essential, and with aggressive and continuous care, the results may be extremely gratifying. PMID- 3514106 TI - Cross-sectional clinical study of quality of amalgam restorations, oral health and prevalence of recurrent caries. AB - The purpose of the present cross-sectional clinical study was to evaluate the relationship between recurrent caries prevalence, quality of class II amalgam restorations and various oral health parameters. One hundred and forty-four randomly selected 35-yr-old citizens of Oslo were included in the investigation. Caries was scored based on a combined clinical and radiographic examination according to the DMFS index system. Oral hygiene (OHI-S) and periodontal index (PI) were registered, and the quality of class II amalgam restorations was ranked according to a set of occlusal index pictures. A total of 1694 class II amalgam restorations were included and 93 (5.5%) of these were affected by recurrent caries. A statistically significant correlation was found between prevalence of recurrent caries and poor oral hygiene, high PI-scores and prevalence of primary caries. However, a severe deterioration of the quality of amalgam restorations had to be present before a concomitant increase in recurrent caries prevalence could be registered. The present results indicate that measures improving the oral health may be of major importance in preventing recurrent caries and thereby increase the durability of amalgam restorations. PMID- 3514107 TI - Nuclear proteins in spermatogenesis. AB - Mammalian somatic type histone variants are replaced or supplemented in early primary spermatocytes and possibly spermatogonia by testis specific and testis enriched histone variants. The testis complement of histones is replaced entirely by transition basic proteins in mid-spermatids. This transition is accompanied by a dramatic reduction of thermal stability of mid-spermatid chromatin which may be due in part to hyperacetylation of histone H4. The transition basic proteins are replaced by protamines which are arginine-rich and contain cysteine. PMID- 3514108 TI - Purification and properties of a thiol protease from lung fluke adult Paragonimus ohirai. AB - The thiol protease was purified from adult Paragonimus ohirai by alpha 1 antitrypsin-Sepharose, Sephadex G-75 and CM-cellulose, measuring its activities to hydrolyze hemoglobin and tosyl-L-lysine alpha-naphthyl-ester. The purified protease showed a single band on polyacrylamide disc gel isoelectrophoresis as zymogram with Tos-Lys-NE and also by protein staining, and its pI was found to be 6.4. The molecular weight was calculated to be 29,000 by gel filtration and 27,000 by SDS-polyacrylamide gel electrophoresis as a single polypeptide. The protease hydrolyzed hemoglobin and Tos-Lys-NE optimally at pH 4.0 and 5.0, respectively. The both hydrolyzing activities were inhibited by alpha 1-AT and soybean trypsin inhibitor as well as thiol protease inhibitors such as antipain, E-64 and p-hydroxymercuriphenylsulfonate. These results indicate that this enzyme is a new type thiol protease. PMID- 3514109 TI - An endogenous inhibitor of thiol protease from adult lung fluke Paragonimus miyazakii. AB - An endogenous inhibitor of thiol protease from adult Paragonimus miyazakii was found to occur during the gel filtration on Sephacryl S-300. The partially purified inhibitor was specific for thiol proteases such as ficin and papain. The inhibitor also suppressed tosyl-L-lysine alpha-naphthylester hydrolytic activity of Paragonimus thiol protease. The molecular weight of the inhibitor was found to be 430,000 by the gel filtration. This inhibitor was thermostable and resistant to trypsin and glycosidase digestions. PMID- 3514110 TI - Lipid composition of three morphological stages of Trypanosoma cruzi. AB - The neutral and phospholipid content at each of the three morphological stages of the parasite, Trypanosoma cruzi, was analyzed by thin-layer chromatography. Total lipid fatty acid composition at each stage was analyzed by gas-liquid chromatography and the results were compared. Change in lipid composition at each stage was observed. PMID- 3514111 TI - A pocket calculator program for using Pozen's formula. AB - Pozen's formula has been shown to improve diagnostic accuracy in patients with acute chest pain. This paper describes a short program for the HP-41CV calculator which reliably calculates acute ischemic heart disease probabilities using Pozen's formula. PMID- 3514112 TI - Determination of left ventricular volumes with use of DSA density values. AB - A computer program was developed to obtain left ventricular volumes from the density values of DSA. The highest density value along the horizontal pixel line over the left ventricle in 30 degrees RAO was considered to correspond to the greatest width on the same level of 60 degrees LAO. The left ventricular volume was obtained by converting the density values into the width and integrating these values. This method estimated experimental balloon volumes with considerable accuracy. Clinical evaluation revealed good correlation between DSA and conventional cine left ventriculography. PMID- 3514113 TI - Logical empiricism and psychiatric classification. PMID- 3514115 TI - Aretaeus the Cappadocian on mental illness. PMID- 3514114 TI - Psychopathology and violence: a review of literature. PMID- 3514116 TI - An approach to the treatment of advanced periodontal disease: a compromise. PMID- 3514117 TI - Report on a symposium on chemomechanical caries removal: a multicenter study. PMID- 3514118 TI - Why Horace Wells--1985? PMID- 3514119 TI - Cholesterol: what it means in 1986. PMID- 3514120 TI - New developments in oral, injectable and implantable contraceptives, vaginal rings and intrauterine devices. A review. PMID- 3514121 TI - Graphical analysis of multivariate pain data in analgesic trials. AB - In order to compare analgesic treatments effectively one must measure pain over time. In a single-dose clinical analgesic trial one typically obtains repeated pain measurements from each patient during a relatively short period (4-6 hours). Such measurements constitute multivariate data, which are usually reduced by simple addition to a single derived pain measure for analysis of between treatment differences. In this article we consider graphical procedures for the display of multivariate, clinical analgesic data. The first of these are the traditional time-effect curves, with added "standard error bars." We also examine a multivariate display, the biplot, which is based on principal component analysis. This technique provides a representation of the raw pain scores at each time of measurement by a vector originating from the origin of a two-dimensional graph. The multivariate pain scores of individual patients are summarized by points on the graph. Differences in pain scores over time (or between treatment groups) may be examined by relating points (or ellipses representing treatment groups) to different vectors. Using actual data from a postsurgical analgesic trial, we compare the two approaches and show that the multivariate approach is a useful addition to the standard technique for display of such data. PMID- 3514122 TI - Antibodies to DNA. AB - Antibodies that recognize specific conformational variations of DNA structure provide sensitive reagents for testing the extent to which such conformational heterogeneity occurs in nature. A most dramatic recent example has been the development and application of antibodies to left-handed Z-DNA. They provided the first identification of Z-DNA in fixed nuclei and chromosomes, and of DNA sequences that form Z-DNA under the influence of supercoiling. Antibodies have also been induced by chemically modified DNA and by synthetic polydeoxyribonucleotides that differ from the average B-DNA structure. These antibodies recognize only the features that differ from native DNA. In most experiments, native DNA itself is not immunogenic. Antibodies that do react with native DNA occur in sera of patients with autoimmune disease, but even monoclonal anti-DNA autoantibodies usually react with other polynucleotides as well. Anti DNA antibodies, especially those of monoclonal origin, provide a model for the study of protein-nucleic acid recognition. PMID- 3514123 TI - Proteolytic processing and compartmentalization of the primary translation products of mammalian apolipoprotein mRNAs. AB - The steps involved in the initial assembly of apolipoproteins and lipids into supramolecular arrays (nascent lipoprotein particles) are largely unknown. Examination of the proteolytic processing and compartmentalization of the primary translation products of apolipoprotein mRNAs represents one approach to deciphering the molecular details of lipoprotein assembly. The structures of the primary translation products of seven mammalian apolipoprotein mRNAs has been determined in the past several years. The organization of apolipoprotein signal peptides is typical of eukaryotic prepeptides, although an unusual degree of sequence conservation is present among the signal segments of apo AI, AIV, and E. For those apolipoprotein sequences studied in detail, SRP-dependent cotranslational translocation and proteolytic processing appears to be highly efficient and results in sequestration of the processed protein within the lumen of the endoplasmic reticulum (ER). However the mechanism by which these lipid binding proteins avoid arrest during their translocation through the lipid bilayer of the ER membrane remains obscure. The two principal human HDL apolipoproteins undergo novel extracellular post-translational proteolytic processing, which results in removal of nonhomologous propeptides. The proteases responsible for proapo AI and AII processing appear to be different. The processing of these proapolipoproteins provides a potential series of steps for regulating the ordered assembly of HDL constituents. PMID- 3514124 TI - Incidence of microbial colonization in open versus closed delivery systems for thermodilution injectate. AB - The incidence of microbial colonization of injectate was studied in open and closed delivery systems used for thermodilution measurement of cardiac output. Patients with pulmonary artery catheters were prospectively randomized to receive either open two-bottle systems or closed systems. Paired cultures of injectate solution were withdrawn through the stopcock at the time of the initial set-up and every 12 h for 48 h. Injectate from eight (35%) of 23 patients with the open system and one (5%) of 20 patients with the closed system yielded a positive culture (p less than .05). Thirteen (10%) of 129 pairs of cultures were positive from the open system, compared to one (0.9%) of 111 pairs from the closed system (p less than .01). There was no statistically significant difference in the number of cardiac output injections between the two groups, but patients having more than the mean number of injections for cardiac output measurement had a significantly (p less than .05) greater likelihood of positive injectate cultures. PMID- 3514125 TI - A case of total alternans treated with intravenous calcium. PMID- 3514126 TI - Conidiogenesis of fungi pathogenic for man. AB - Despite an apparent stabilizing of nomenclature and concepts involved in fungal conidiogenesis during the past decade, there is now evidence that a much more complex and demanding approach to the descriptive study of processes involved in conidial formation would allow a more phylogenetically realistic classification of anamorphic fungi. The present review attempts to evaluate data on the human pathogenic molds in light of this new approach and to relate conidiogenesis to the known teleomorph connections of the fungi concerned. It is hoped that by treating the species in groups corresponding to their sexual affinities, it may be possible to infer homologous forms of conidiogenesis by comparative morphology and development. PMID- 3514127 TI - Optimization of a vehicle solution for the introduction and removal of glycerol with rabbit kidneys. AB - Previous studies with rabbit kidneys in our laboratories have used a plasma-like solution as the vehicle for the introduction and removal of glycerol. Other workers have usually employed high-potassium solutions. In this study we have assayed the function of rabbit renal cortical slices after incubation in a range of solutions, each of which contained 1 M glycerol, for 4 hr, followed by stepwise removal of the cryoprotectant. The functions measured were endogenous oxygen consumption, p-aminohippurate uptake, and the ability of the slices to accumulate potassium. Exposure to glycerol produced a considerable reduction of slice function, but, in the presence of glycerol, elevation of the potassium concentration was beneficial, whereas high concentrations of magnesium were detrimental. The optimum potassium concentration was 70-100 mM. Replacement of chloride by a range of anions of higher molecular weight was either without benefit (glycerophosphate) or detrimental (sulfate, citrate, and gluconate). Elevation of total osmolality from 300 to 400 mosmolal with glucose, mannitol, glycerophosphate, or Pipes reduced slice function, but when the same osmolality was achieved by raising the concentration of all the components of the solution in the same ratio, there was no significant loss of function. There was a weak optimum pH at ca. 7.0. These experiments led to the formulation of a bicarbonate buffered perfusate containing 80 mM potassium and 17.5 g Haemaccel per liter, having a pH of 7.0 with 5% CO2 at 10 degrees C, and an osmolality of 400 mosmol/kg. This solution was used to preserve rabbit kidneys for 20 hr at 10 degrees C, by continuous perfusion, and was compared with our previous Haemaccel perfusate, HP5, which contained 4 mM K+, 111 mM mannitol, and had a pH of 7.4. The two solutions were equally effective. PMID- 3514128 TI - Capsicum--production, technology, chemistry, and quality--Part II. Processed products, standards, world production and trade. AB - Capsicums, as a spice, have been known since the beginning of civilization and historically associated with the discovery of the New World. The genus Capsicum (Fam. Solanaceae) provides many varieties and adds color, pungency, and aroma to the cuisines of most of the world. From the pungent chilli, of interest also to pharmaceuticals, to the colorful paprika and the bell capsicums with its remarkable aroma, the genus has been of great interest for its chemistry and physiological action. Pungency as a sensory attribute, its evaluation, structure activity relationship, and its increasing acceptance and preference by diverse populations of the world are of great interest to many research disciplines. In a comprehensive review of all aspects in four sequential parts, Part I deals with History, Botany, Cultivation, and Primary Processing (CRC Critical Review, Food Science and Nutrition). The Capsicums among the spices are second only to black pepper in trades both in volume and value. The production of the different forms of this spice as ground, specialty seasonings, and as the concentrated oleoresins through technologically advanced processes, proposed newer products, the standard to control quality of the different products, world production, trade, and prospects are reviewed in detail in this, Part II. PMID- 3514129 TI - Immunohistochemical characterization of extracellular matrix in the developing human cornea. AB - Collagen, fibronectin and laminin are important components of the extracellular matrix of the human cornea. We used the immunofluorescence technique with polyclonal antibodies directed against these proteins and to bullous pemphigoid antigen (BPA), in order to study their distribution in human corneas from 8 weeks of gestation to term and in adult corneas. Immunoreactivity was observed with antibodies to type I collagen in the limbus and the corneal stroma at 8 weeks of gestation. At 11 weeks of gestation it was found in epithelial basement membrane (EBM) and Descemet's membrane (DM) and continued thus throughout fetal and adult life. Type II collagen was not detected in fetal or adult cornea. Type III collagen was detected during 8-20th weeks of gestation in the EBM, DM and stroma. After 27th weeks of gestation, type III collagen could no longer be detected in the central cornea. Type IV collagen was detected in the EBM as early as 8 weeks of gestation and remained positive throughout fetal and adult life. Descemet's membrane was negative for type IV collagen at 8 weeks of gestation and became positive thereafter. Immunostaining for fibronectin in DM was negative at 8 weeks of gestation, followed by patchy staining of corneal stroma and EBM up to the age of 37 weeks of gestation. Staining in the EBM was negative or variable up to 70 years of age, and then became positive again in a 77 year old individual. Staining for LN was positive in the EBM after 8 weeks of gestation. Staining was negative in DM at that age, but became positive after 9 weeks of gestation. Staining for BPA was negative at 8-9 weeks of gestation, then gradually became positive. PMID- 3514131 TI - Neural crest and thymic myoid cells. PMID- 3514130 TI - Surgical stabilization of pathological neoplastic fractures. AB - The most important factor to consider in deciding between treatment options in the management of metastatic bone disease is the level of the patient's dysfunction and pain. Severe dysfunction or pain demands a treatment that predictably leads to a quick resumption of the painless activities of daily living. A treatment that predictably will restore function in months may seem reasonable in patients with a normal remaining life span, but is untenable if those months represent a high percentage of remaining life span, as they do in metastatic disease afflicted patients. The treating physician needs also to understand the basis for the patient's dysfunction. A destroyed joint will not return to painless function even if the metastasis responsible is totally eliminated. A bone that has lost its structural integrity, even though not grossly fractured, will not support weight bearing for months even if the metastasis is eliminated. Control of the metastatic tumor does not always equate with return to function. Treatment options in the management of metastatic bone disease are not mutually exclusive. In many patients treatment options are combined. Surgical stabilization may best return the patient's function while he is being treated postoperatively with radiotherapy or chemotherapy for good neoplasm control. Neoplasm control should not be such an overriding concern that function is not addressed. Function can almost always be returned to the patient, but neoplasm "cure" is rarely achieved in this group of patients. It is a reasonable goal to avoid allowing bone metastasis to progress to pathological fracture. Routine periodic examinations and bone scans should commonly alert the treating physician to the presence of metastatic bone disease well before fracture occurs. Pathological fracture narrows the range of treatment options, mitigates against full functional restoration, demands a rehabilitation hiatus, and acutely frightens the patient who does not have time to participate fully in treatment decisions. An impending pathological fracture can be treated with surgery, radiotherapy, chemotherapy, or hormonal manipulation. The options are basically operative or nonoperative. Lesions that predictably will fracture short term, involve joints, or will cause catastrophic consequences if fracture occurs should be strongly considered for surgical stabilization. Other factors to consider are the location of the metastasis, the primary tumor, and the expected response to nonoperative therapy. The patient becomes a surgical candidate for the above reasons and not because of any estimated life span.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3514132 TI - Dual regulation of expression of exogenous delta-crystallin gene in mammalian cells: a search for molecular background of instability in differentiation. PMID- 3514133 TI - Development of neuronal properties in neural crest cells cultured in vitro. PMID- 3514134 TI - Phenotypic diversification in neural crest-derived cells: the time and stability of commitment during early development. PMID- 3514136 TI - Transitory differentiation of matrix cells and its functional role in the morphogenesis of the developing vertebrate CNS. PMID- 3514135 TI - Instability in cell commitment of vertebrate pigmented epithelial cells and their transdifferentiation into lens cells. PMID- 3514137 TI - Prestalk and prespore differentiation during development of Dictyostelium discoideum. PMID- 3514138 TI - Transdifferentiation occurs continuously in adult hydra. PMID- 3514139 TI - Nematocyte differentiation in hydra. AB - Nematocyte differentiation from interstitial stem cells in hydra occurs in a highly position-dependent manner along the body axis. The results of the studies summarized here have shown that the morphogenetic factors involved in head formation are probably not responsible for this. Whether the morphogenetic factors involved in foot formation are responsible has not been determined. A new factor, presumably unrelated to any of the known morphogens, has been identified which specifically inhibits the developing nematoblasts to differentiate into stenoteles. This factor is present in a gradient along the body column, and appears to be responsible, at least in part, for producing position-dependent nematocyte differentiation. Nematoblasts which normally differentiate into one nematocyte type can be altered to differentiate into another by means of regeneration or treatment with stenotele inhibitor. This alteration occurs near the S/G2 boundary in the terminal cell cycle in the nematocyte differentiation pathway. It appears that either the nematoblasts are not committed to any specific nematocyte pathway until this critical time, or the nematoblasts committed to differentiate into a specific type can transdifferentiate into another type at this step. PMID- 3514140 TI - Differential commitment of hemopoietic stem cells localized in distinct compartments of early Xenopus embryos. PMID- 3514141 TI - Probable dedifferentiation of mast cells in mouse connective tissues. PMID- 3514142 TI - Instability and stabilization in melanoma cell differentiation. PMID- 3514143 TI - Differentiation of embryonal carcinoma cells: commitment, reversibility, and refractoriness. PMID- 3514144 TI - Embryo-derived stem cells: a tool for elucidating the developmental genetics of the mouse. PMID- 3514145 TI - Phenotypic stability and variation in plants. PMID- 3514146 TI - Flexibility and commitment in plant cells during development. PMID- 3514147 TI - Transdifferentiation of skeletal muscle into cartilage: transformation or differentiation? PMID- 3514148 TI - Instability of chromosomes and alkaloid content in cell lines derived from single protoplasts of cultured Coptis japonica cells. PMID- 3514149 TI - Transdifferentiation of amphibian chromatophores. PMID- 3514150 TI - Multipotentiality in differentiation of the pineal as revealed by cell culture. PMID- 3514151 TI - Evaluation of primary hyperparathyroidism and hypercalcemia. PMID- 3514152 TI - Subcorneal pustular dermatosis with polyarthritis. AB - A 19-year-old man experienced the acute onset of subcorneal pustular dermatosis (SPD), fever, and a symmetrical polyarthritis. The association of SPD with acute polyarthritis is rare. PMID- 3514153 TI - Diagnostic criteria for Sweet's syndrome. AB - Five patients with Sweet's syndrome with typical clinical and histologic features were reviewed. Attention is drawn to the possible association of drug use, venipuncture and insect bite, resection of colon, exacerbation of sinusitis, and acute myelocytic leukemia with the onset of the skin eruptions in our patients. The question of whether Sweet's syndrome is just a reactive phenomenon or a specific entity is raised. Our opinion is that Sweet's syndrome is a reaction to many different antigens. However, characteristic clinical and histologic features are present to allow a definite diagnosis of Sweet's syndrome. We propose two major criteria and four minor criteria for the diagnosis of Sweet's syndrome. Findings in patients must fulfill both of the major criteria and at least two of the minor criteria to allow a diagnosis of Sweet's syndrome. PMID- 3514154 TI - A controlled two-center study of lactate 12 percent lotion and a petrolatum-based creme in patients with xerosis. AB - Lactic acid, one of the most widely distributed acids in nature, is present in biological fluids and tissues of humans as an intermediary in carbohydrate metabolism. Alpha-hydroxy acids, including lactic acid, and their salts have been recommended for the treatment of keratinization disorders. This controlled double blind study compares the efficacy of lactate 12 percent lotion and a petrolatum based therapeutic creme (creme B) in patients with moderate to severe xerosis. Lactate 12 percent lotion was significantly more effective than a petrolatum based creme in reducing the severity of xerosis during treatment and post treatment phases. PMID- 3514155 TI - A comparison of clobetasol propionate 0.05 percent ointment and an optimized betamethasone dipropionate 0.05 percent ointment in the treatment of psoriasis. AB - A multicenter, double-blind study compared the effectiveness of two highly potent topical corticosteroids in patients with moderate to severe signs of psoriasis. Left/right paired comparisons of clobetasol propionate ointment 0.05 percent, and an optimized formulation of betamethasone dipropionate ointment 0.05 percent, were made in 130 patients with roughly symmetrical psoriatic lesions. The ointments were applied by the patients twice daily, without occlusion, for two weeks. Both drugs were shown to be highly effective and were well tolerated. Significantly more patients showed greater improvement on the side treated with clobetasol propionate. Follow-up evaluation two weeks after the treatment period showed statistically significant (p less than 0.001) longer remissions resulting from the use of clobetasol propionate. PMID- 3514156 TI - The development of the human thymus microenvironment. PMID- 3514157 TI - Thymic atrophy and immune deficiency in malnutrition. PMID- 3514158 TI - Pathology of the thymus in immunodeficiency states. PMID- 3514159 TI - The thymus in myasthenia gravis. PMID- 3514160 TI - Pathology of thymic epithelial tumors. PMID- 3514161 TI - Changes in the human thymus during aging. PMID- 3514162 TI - Cellular differentiation of lymphoid subpopulations and their microenvironments in the human thymus. PMID- 3514163 TI - Bronchoalveolar lavage of allergic asthmatic patients following allergen bronchoprovocation. AB - In these studies, we describe the use of bronchoalveolar lavage (BAL) to study local changes following aerosol bronchoprovocation (BPC) and environmental exposure to antigen in mildly symptomatic asthmatic patients. The BAL was performed in 12 atopic subjects "out of season," and in five normal subjects at baseline, less than or equal to 4, or 24 hours following BPC. Five asthmatic patients were also lavaged during seasonal exposure to allergen. The BAL cells were examined with light and transmission electron microscopy. Bronchoprovocation, by itself, resulted in an average maximal decrease in FEV1 of 13 percent just prior to BAL. There was no significant decrease in FEV1 as a result of BAL. Within four hours after BPC, the number of neutrophils was significantly greater in BAL compared to baseline (1.5 +/- 0.6 X 10(5) vs 3.4 +/- 1.7 X 10(5) cells; p less than 0.01), and the number of eosinophils was significantly greater within four hours and at 24 hours when compared to baseline values (0.4 +/- 0.3 X 10(5) vs 1.9 +/- 0.7 X 10(5) vs 1.2 +/- 0.4 X 10(5) cells; p less than 0.02). Transmission electron micrographs of BAL from lungs of asthmatic patients revealed degranulation of mast cells and loss of core material from eosinophil granules following challenge with aerosolized allergen or with spontaneous environmental exposure. These studies show that in carefully selected, mildly symptomatic asthmatic subjects, BPC and BAL may be useful to evaluate pathogenetic mechanisms in allergic bronchial asthma. PMID- 3514164 TI - Corticosteroids in COPD. A clinical trial and reassessment of the literature. AB - A placebo-controlled, double-blind cross-over trial was conducted to assess whether 16 men with chronic obstructive pulmonary disease (COPD) would benefit from orally taken corticosteroids. Two weeks of treatment with 40 mg of prednisone daily did not result in improvement of pulmonary symptoms or function in the group as a whole, although one patient had small improvement in airflow. The baseline spirometric data and beta-agonist responsiveness of the patients in the study were then compared to a reference population consisting of 264 men who fulfilled a criteria for chronic obstruction out of 730 men who comprised a systematic sample drawn from all patients referred for spirometry at three hospitals. Our study subjects and those of five similar trials of corticosteroids in COPD had more severe obstruction than this reference group. Furthermore, the proportion of steroid responders found in each study was inversely related to the baseline FEV1 of the patients examined. It appears that previous studies of corticosteroids in COPD may have overestimated the number of COPD patients who might benefit from corticosteroids, due to a bias resulting from the selection of severely obstructed subjects. PMID- 3514165 TI - Fine needle aspiration biopsy of mediastinal and peripheral pulmonary masses guided by real-time sonography. AB - The value of fine needle aspiration biopsy guided by real-time ultrasonography was assessed in 45 patients referred with an intrathoracic mass adjacent to the chest wall. The mass, as determined by chest x-ray examination, was visualized sonographically and subsequently biopsied in 42 patients. Puncture specimen was diagnostic in 34 patients (81 percent), including nine of 12 patients (75 percent) with previous failure of biopsy under fluoroscopic guidance. The success rate was similar in pulmonary and mediastinal masses, 18 of 23 and 16 of 19 patients, respectively. A diagnostic biopsy was obtained in 26 of 31 patients with a malignant mass. No complications were observed except for a minimal pneumothorax in one patient. Thus, real-time sonographic guidance is a safe, easy, and reliable method in biopsy of pulmonary and mediastinal masses adjacent to the chest wall and may also succeed in patients where fluoroscopically guided biopsy has failed. PMID- 3514166 TI - Continuous positive airway pressure and expiratory positive airway pressure increase functional residual capacity equivalently. AB - The effect of continuous positive airway pressure (CPAP) and expiratory positive airway pressure (EPAP) on functional residual capacity (FRC) of ten healthy, spontaneously breathing, lightly anesthetized intubated mongrel dogs was studied. The CPAP and EPAP at 5, 10, 15, and 20 cm H2O were alternately applied to all animals. Total (lung and chest wall) compliance, esophageal pressure, airway pressure, transpulmonary pressure, control FRC, and the change in FRC (delta FRC) were measured before and after each application of CPAP and EPAP. Neither expiratory transpulmonary pressure nor delta FRC with CPAP differed significantly from that with EPAP at all levels (p greater than 0.05). These data suggest that CPAP and EPAP, when applied at the same expiratory pressure, result in an equivalent increase in FRC due to passive mechanical distention of the lungs. PMID- 3514167 TI - Diagnostic imaging of pulmonary arteriovenous malformations. Evaluation with roentgenographic, sonographic, and radionuclide imaging. PMID- 3514168 TI - Mediation of ARDS by leukocytes. Clinical evidence and implications for therapy. PMID- 3514169 TI - Persistent hypoxemia due to patent foramen ovale in a patient with adult respiratory distress syndrome. AB - This report describes a patient in the recovery phase of the adult respiratory distress syndrome in whom the persistence of severe hypoxemia was not corrected by a high fractional concentration of oxygen in the inspired gas and positive end expiratory pressure. A right-to-left interatrial shunt was diagnosed by M-mode and cross-sectional echocardiography with saline injection, and the presence of a patent foramen ovale was confirmed at the time of cardiac surgery. PMID- 3514170 TI - Lung cancer. The past twenty-five years. AB - On the occasion of this Fourth World Conference on Lung Cancer, I am privileged to present the opening keynote address. This presentation has been sponsored by the Ontario Cancer Treatment and Research Foundation. In 1952, the Foundation established an annual lectureship in memory of one of their prominent physicians. Dr. Gordon Earle Richards was one of Canada's pioneer radiologists and radiotherapists who was appointed Director of the Institute of Radiotherapy at Toronto General Hospital at a time when radium and high-voltage x-rays were just coming into common use for the treatment of malignant disease. He established an international reputation for his contributions to clinical radiotherapy, and was subsequently appointed Professor of Radiology at the University of Toronto. He was Managing Director of the Ontario Cancer Treatment and Research Foundation between 1945 and 1949. I wish to thank the Foundation for the privilege of presenting the 33rd Gordon Richards Memorial Lecture. PMID- 3514171 TI - A new international staging system for lung cancer. PMID- 3514172 TI - Endobronchial management of lung cancer. AB - Bronchoscopic phototherapy is available now for 2 distinct categories of tracheobronchial cancer: roentgenographically occult superficial squamous cell carcinoma and advanced malignancy causing significant airway obstruction. Laboratory and clinical experience show that the photodynamic effect of hematoporphyrin derivative phototherapy (HpD-PT) may be useful for treating superficial cancers that penetrate less than 5 mm into bronchial mucosa. The larger, obstructing cancers are better managed by high-power laser sources, such as the YAG laser, which are effective by hyperthermal photocoagulation, thermal necrosis, and tissue vaporization. PMID- 3514173 TI - The role of computed tomography in the diagnosis and management of lung cancer. An overview. AB - Computed tomography (CT) is now established as the principal radiographic adjunct to plain film examination in the diagnosis and management of lung cancer. It should be used in the evaluation of every pulmonary nodule to determine whether the nodule is solitary and whether mediastinal metastases are present and to evaluate the mass by assessing its density. In general, nodules with Hounsfield numbers greater than +175 can be presumed to be calcified and, hence, benign. CT is of great value in determining the extent of lung cancer and at present the best imaging modality for evaluating mediastinal lymph nodes. Spread of tumor to mediastinal nodes is evaluated on the basis of node size. Nodes less than 1.0 cm in diameter are considered normal, 1.0-1.5 cm suspicious for tumor, and greater than 1.5 cm have a high probability of being malignant. Node size, however, is dependent on location in the mediastinum and whether infection is present in the lung. Size criteria alone should not be used to deny surgery. PMID- 3514174 TI - Scintigraphic evaluation of patients with lung carcinoma. PMID- 3514176 TI - Nonsurgical combined modality therapies in non-small cell lung cancer. AB - Nonsurgical combined approaches of non-small cell lung cancer represent a concept that has only been investigated so far with chemotherapy and radiation therapy. Thoracic irradiation of locoregional disease is associated with a high rate of local control and a 5-10% long-term (5-year) survival; however, distant metastases remain the main cause of failure. This observation suggests that the tumor is often microscopically disseminated at the time of diagnosis. Systemic therapy therefore must be associated to radiation therapy to try to control both the undetectable metastases and the local disease. However, the results reported so far have been disappointing, probably because of the modest activity of the available chemotherapy. Further progress with the combined approach requires new developments in the chemotherapy of non-small cell lung cancer, particularly the introduction of new active drugs. PMID- 3514175 TI - Potential value of digital radiography. Preliminary observations on the use of dual-energy subtraction in the evaluation of pulmonary nodules. AB - The radiographic demonstration of calcification in a solitary pulmonary nodule renders the possibility of malignancy extremely unlikely, although rare exceptions have been reported. Conventional roentgenograms and tomograms sometimes provide inconclusive evidence although CT can be highly accurate in both identifying and quantifying calcium content. An alternative method is dual energy subtraction utilizing scanned projection digital radiography. Forty-one patients with solitary (occasionally multiple) pulmonary nodules were examined with the technique, employing second-generation fan-beam equipment: 28 nodules or masses were noncalcified and 13 calcified. Of the former, 20 were pathologically proved, 16 being malignant and 4 benign (2 granulomas, 2 bronchiectasis); in 3 of the remaining 8, a presumptive diagnosis was reasonably certain (1 granuloma, 2 metastases), while in 5 the diagnosis was not made. In 8 of the 13 calcified lesions, the diagnosis can reasonably be regarded as confirmed as granulomas; 5 are being followed up with that presumptive diagnosis. PMID- 3514177 TI - Pathology of lung cancer. PMID- 3514178 TI - Adjuvant therapy for resectable lung cancer. PMID- 3514179 TI - Chemoprevention (lung cancer). PMID- 3514180 TI - [Stabilizing operations of the traumatically-damaged spine]. PMID- 3514181 TI - [Agenesis of the gallbladder]. PMID- 3514182 TI - Reducing the stress of cardiac catheterization by teaching relaxation. PMID- 3514183 TI - Synthesis of bovine prolactin in Escherichia coli. AB - Transformation of Escherichia coli cells with a recombinant plasmid (pESP4) containing a modified bovine prolactin cDNA clone in a pEMBL vector resulted in efficient expression of prolactin. The cDNA was modified by removal of a 5' nontranslated sequence as well as the sequence that specified the signal peptide of preprolactin. To achieve a high level of synthesis, a sequence of 30 nucleotides in the cDNA, which included the ATG initiation codon and the first 7 codons of mature bovine prolactin, was replaced by a chemically synthesized oligonucleotide duplex. The sequence of this duplex was chosen from the consensus sequence around the initiation codon of E. coli genes and by the amino acid sequence of the protein. Prolactin, a single-chain polypeptide of molecular weight 24,000, was identified by Coomassie Blue staining of NaDodSO4 polyacrylamide gels of total protein from transformed E. coli cells, and by reaction with specific antibody. Increased levels of expression of the hormone, corresponding to the form secreted from the pituitary, were observed in the presence of isopropyl-beta-D-thiogalactopyranoside (IPTG). PMID- 3514184 TI - Construction of a systematic set of tRNA mutants by ligation of synthetic oligonucleotides into defined single-stranded gaps. AB - A series of mutant tRNA genes has been constructed by site-directed mutagenesis in pOP203, a colE1 derivative carrying a transcription unit under control of the lacUV5 promoter. These mutant genes include all possible amber suppressing variants of tRNATrp with single nucleotide substitutions at anticodon loop positions 32, 37, and 38 (numbered from the 5' end), and all possible paired base substitutions in the three base pairs nearest the anticodon loop. G at position 38 was not recovered as a single mutation, but rather in conjunction with an undirected mutation to T at position 32. The singly mutated G38 tRNA may not be active, though all the other tRNA derivatives are functional in the translation of amber codons. To construct the mutants, we ligated a synthetic deoxyoligonucleotide into a precisely formed single-stranded gap covering the anticodon arm region DNA, in an otherwise double-stranded fragment containing the tRNATrp gene. The resulting heteroduplex was then ligated into the plasmid and introduced into Escherichia coli. This method of mutagenesis is simple, reproducible, and highly tolerant of varying degrees of heteroduplex in the gap, variations in temperature of ligation, and changes in the oligonucleotide concentration. Mutagenesis does not require a 5'-phosphorylated oligonucleotide. These qualities suit the gap method for intensive study of a region by site directed mutagenesis. PMID- 3514185 TI - Computer analysis of Farnsworth-Munsell 100-hue test. AB - Color vision abnormalities indicated by the Farnsworth-Munsell 100-hue Color Vision Tests (FM-100) were analyzed by computer to better characterize and group congenital and acquired color vision disorders and to help establish statistically significant diagnostic criteria. Standard evaluation of the FM-100 is by axis and error score calculations. A method has been established for computer-averaging many tests from patients with the same color abnormalities determined by history, standard FM-100 and Nagel anomaloscope. The computer calculated an average error score and standard deviation for each of the 85 color caps. Every time a new patient was evaluated for color vision abnormality, his score was compared with averaged tests with common diagnoses, by calculating distance scores. The averaged test with the lowest distance score consistently tended to coincide with the diagnosis. An analysis of 130 FM-100 color tests found technician-calculated error scores to be incorrect, although usually minor, in 40% of the tests. The computer-calculated axes agreed well with the technician's estimates. The distance scores predicted the diagnosis accurately 89% of the time. Many errors were due to the small number of protanopes averaged and inability to distinguish trichromats from dichromats. PMID- 3514187 TI - Diabetes self-care involvement in children, age two to four: case report. PMID- 3514186 TI - Factitious hypoglycemia: case report. PMID- 3514188 TI - CHID: a useful alternative to MEDLINE. PMID- 3514189 TI - [Cross-linking of SH-groups in myosin heads changes the type of conformation changes in F-actin induced by myosin subfragment 1 or heavy meromyosin]. PMID- 3514190 TI - [Ribosomal synthesis of homopolypeptides on the template encoding heteropolypeptides]. PMID- 3514191 TI - [Nucleotide sequence of the Salmonella typhimurium rpoB gene encoding the beta subunit of RNA polymerase]. PMID- 3514192 TI - Calcium channel blockers and treatment of hypertension. AB - Over the past years, research efforts have been focused on the pathophysiologic role of calcium ions, and the implication for the potential role of calcium channel blockers in the management of essential hypertension. Numerous studies have shown that nifedipine and verapamil are effective antihypertensive agents, initial experience with diltiazem is also encouraging. The magnitude of blood pressure reduction with these drugs is related to the pre-treatment blood pressure. In refractory hypertension, combination with other antihypertensive agents provide additive effect. In the elderly population and in patients with ischemic heart disease, supraventricular arrhythmia, bronchospastic disease, peripheral vascular disease or diabetes mellitus, the calcium channel blockers offer potential advantages over other antihypertensive agents. Experimental studies also suggest that these drugs may reverse ventricular hypertrophy. When long-term safety with these drugs is documented from well-controlled clinical trials, the calcium channel blockers may be our first line of therapy for the management of hypertension. PMID- 3514193 TI - [Therapy of pituitary dwarfism with recombinant human growth hormone. A multicenter study]. AB - During the period from 1982 to 1985, biosynthetic growth hormone (methionyl-hGH) was administered to 55 children with pituitary growth deficiency, 49 with idiopathic, six with other forms of the disorder. Preparations with a relatively high content of Escherichia coli polypeptides (ECP) were given to 32 children (group I), those with a markedly reduced ECP content to 12 (group II), while 11 children received almost ECP-free preparations (group III). The treatment achieved an intensive rise of growth acceleration in all three groups. At the same time, somatomedin C, biological somatomedin activity and alkaline phosphatase rose steeply, reaching a maximum after six months and remaining at high concentrations even thereafter. High antibody titres against ECP and hGH (with high binding capacity) were demonstrated in group I children, significantly lower titres with little binding capacity in those of group II, while most of those in group III had no measurable antibodies. Even in high concentrations the antibodies did not have any inhibiting effect on growth. No positive correlation between antibody titre and growth velocity was demonstrable. An exception was a boy with an allergy in group I, who had a maximal antibody titre and, at the same time, a high serum concentration of IgE. He had marked delay in growth which, however, quickly became normal on administration of extractive hGH. PMID- 3514194 TI - [Is the contractility of the respiratory musculature manageable by drugs?]. PMID- 3514195 TI - [Therapy with immunoglobulins]. PMID- 3514196 TI - [Does every 3d patient with essential hypertension have an undiagnosed sleep apnea syndrome?]. PMID- 3514197 TI - [Diagnosis of deep venous thromboses of the legs]. PMID- 3514198 TI - [Immunology of type-1 diabetes. The initial stages in a causal therapy]. PMID- 3514199 TI - [Diagnostic measures and criteria in neurosyphilis]. PMID- 3514200 TI - [Prenatal diagnosis of urinary tract malformations using routine ultrasonic diagnosis]. PMID- 3514201 TI - Brain growth in sick newborn infants: a clinical and real-time ultrasound analysis. AB - This study concerns 152 neonates admitted between June 1981 and December 1983 in a neonatal intensive care unit. It aims to evaluate brain growth and to analyse the influence of intrauterine growth retardation (IUGR), intracranial haemorrhage (ICH) and ventricular dilatation (VD) in pre-term infants. The babies were first analysed at birth. The sample comprised 127 normal infants and 25 IUGR neonates. An ultrasonic index of cerebral growth was devised: the height of the frontal lobes (HFL), measured in a standardised coronal slice of the brain. According to gestational age (GA), HFL and head circumference (HC) gave a similar assessment of brain growth. A regression line of normal intrauterine values of HFL has been produced according to GA and might be added to the other ways of following the intrauterine growth of the brain after 26 weeks. Brain growth was slower in IUGR, when assessed both by HFL and HC. The infants were also assessed during the postnatal period for a mean period of 27.6 days (S.E.M.: 3.5). They were divided into 5 groups: 45 preterm infants without IUGR, ICH or VD; 45 preterm neonates with ICH alone; 12 preterm babies with ICH and VD alone, 10 preterm infants with isolated FGR, and 8 preterm neonates with IUGR and ICH. A calculation of the global anthropometric (body weight, body length, HC and HFL) weekly increment was made for all infants according to their respective group. No statistical difference in any of these parameters between these 5 groups emerged.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3514202 TI - Controlled trial of new formulae for feeding low birth weight infants. AB - Over a 13-month period 85 babies were randomly allocated to one of three groups at birth. Babies in Group A were fed SMA Low Birth Weight, Group B Prematalac and Group C Preaptamil. A fourth group, the control group was fed expressed breast milk (EBM). The babies were studied when they were on full enteral feeds until weight was greater than 2.0 kg. Weight gain was greatest in Group B compared to the other three groups but there was no significant difference in gain of length or occipito-frontal circumference. The babies in Group B had a lower volume of feeds and lower energy intake than the other groups but had a significantly higher sodium intake which was reflected in higher mean sodium levels. This may have accounted for the increased weight gain. There was no significant difference in serum calcium, osmolality, total protein or haematocrit. PMID- 3514203 TI - Treatment of prostate cancer with gonadotropin-releasing hormone agonists. AB - It is now well established that chronic treatment with GnRH agonists offers an advantageous alternative to orchiectomy and estrogens for the treatment of prostate cancer. Castration levels of androgens can thus be easily achieved without side effects other than those related to castration levels of serum androgens. However, man is unique among species in having a high secretion rate of precursor adrenal steroids which are converted into active androgens in the normal prostate and prostatic cancer. All the enzymes required for the transformation of dehydroepiandrosterone sulfate, dehydroepiandrosterone, androstenedione, and androst-5-ene-3 beta, 17 beta-diol are present in prostatic tissue. Moreover, as shown in many systems, castration levels of serum testosterone (T) at 0.2-0.4 ng/ml exert significant androgenic activity in target tissues. In order to inhibit the action of androgens of both testicular and adrenal origin, GnRH agonists have been administered in association with the pure antiandrogen Flutamide in patients having clinical stage D2 (bone metastases) prostate cancer. A positive objective response assessed according to the criteria of the United States National Prostatic Cancer Project (USNPCP) has been observed in 84 of the 88 patients who had received no previous treatment (95.4%). After 2 yr of treatment, the probability of continuing response is 70% compared to 0-10% by previous approaches. In addition, the death rate at 2 yr is at 10.9% as compared to approximately 50% after standard hormonal therapy. When the same treatment was applied to patients who had received previous hormonal therapy (orchiectomy, estrogens or GnRH agonists alone) before showing a relapse, the response rate decreased to 62.9% and the death rate at 2 yr was 52%.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3514205 TI - Evaluation of foot swelling and lower-limb temperatures in relation to leg activity during long-term seated office work. PMID- 3514204 TI - Double-blind, placebo-controlled study of vigabatrin (gamma-vinyl GABA) in drug resistant epilepsy. AB - Vigabatrin (GVG) (3 g/day) and placebo were compared as an add-on to standard therapy in therapy-resistant epileptic patients using a double-blind crossover design with randomized treatment allocation. Twenty-three patients entered the trial, with four dropping out due to either increased seizure frequency following the cross-over from GVG to placebo (n = 1), intolerance to GVG therapy (n = 2), or poor seizure record (n = 1). Of the 19 patients who completed the study, 17 had partial seizures, eight of whom had secondary generalization and two who had primary generalized seizures. Compared with placebo, GVG was associated with a significant reduction in seizure frequency (p less than 0.01), with 11 of 19 patients experiencing greater than 50% reduction in weekly seizure occurrence, two showing a 25-50% reduction, four unchanged, and two showing an increase in seizures. Global efficacy ratings were greater in the GVG period for 15 patients (p less than 0.05) compared with one in whom there was no period difference and two in whom ratings were higher in the placebo period. Fourteen of the 19 patients indicated a preference for the GVG period. Adverse effects observed during GVG treatment were generally mild and consisted of drowsiness, confusion, nausea, irritability, and constipation. No clinically significant alterations in laboratory test results were observed. No treatment-related changes in plasma concentrations of concomitant antiepileptic drugs were noted. These results confirm the antiepileptic efficacy of oral GVG in refractory epileptics. PMID- 3514206 TI - A mutational hot-spot within an intron of the mouse beta 2-microglobulin gene. AB - beta 2-Microglobulin is the smaller, relatively non-polymorphic chain of class I major histocompatibility complex proteins. We have previously described a mutant mouse cell line which had been selected for loss of the class I thymus leukemia (TL) antigen and had concomitantly lost surface expression of H-2k antigens. Expression of class I antigens on the cell surface was restored by fusion to an antigenically distinct mouse lymphoma line, and the defect in the mutant was shown to be the loss of a functional beta 2-microglobulin gene. We now describe three additional mutants with the same phenotype, all selected for loss of TL but after different types of mutagenesis. All of these mutants have genomic rearrangements resulting in the absence of a functional beta 2-microglobulin gene. These data provide strong evidence for the requirement of beta 2 microglobulin for cell surface expression of the heavy chain of class I major histocompatibility complex proteins. We further show that the defects in at least one beta 2-microglobulin gene in each mutant cell line map to the same small DNA segment within the first intron. The breakpoints of these mutations define a hypermutable site within the mouse beta 2-microglobulin gene. PMID- 3514207 TI - Activation of a ribosomal protein S6 protein kinase in Xenopus oocytes by insulin and insulin-receptor kinase. AB - Previous studies in this laboratory have shown that insulin treatment of Xenopus oocytes leads to an increase in phosphorylation of ribosomal protein S6. To investigate the mechanism of this increase, S6 kinase activity was measured in lysates of oocytes exposed to insulin. Insulin caused a rapid 4- to 6-fold increase in S6 kinase activity, which was maximal by 20 min and which could be reversed by removal of insulin prior to homogenization. Dose-response curves showed a detectable increase in specific activity at 1 nM insulin with a maximal effect at 100 nM. Treatment of oocytes with puromycin did not prevent this increase in S6 kinase activity, suggesting activation rather than synthesis of the enzyme. DEAE-Sephacel chromatography of extracts from insulin-treated oocytes revealed two peaks of S6 kinase activity, and the specific activity of the peak eluting at 300 nM NaCl was increased 3-fold in oocytes treated with insulin. The same peak of S6 kinase activity was increased 40% within 10 min in oocytes injected with highly purified insulin-receptor kinase. These results indicate that the insulin-dependent increase in S6 phosphorylation is due, at least in part, to activation of an S6 protein kinase, and this activation may result from the action of the insulin receptor at an intracellular location. PMID- 3514208 TI - Near ultraviolet DNA damage induces the SOS responses in Escherichia coli. AB - The influence of the growth delay induced by near u.v. radiation on the SOS response was monitored by comparing the level of sfiA expression by means of a sfiA::lacZ fusion in both a nuvA+ cell and an isogenic nuvA mutant. The mutant lacks 4-thiouridine in its tRNA and does not exhibit the near u.v.-induced growth delay. Although the two strains exhibit similar sfiA induction levels after 254 nm irradiation, their behaviour is different after illumination with near u.v. light, including solar u.v. Inducibility is 10-20 times higher in the nuvA mutant than in the parent strain. Furthermore, pre-illumination with broad band near u.v. light does not affect the 254 nm-induced sfiA response in the mutant but reduces it by a factor of 3-4 in the parent strain. The kinetics of sfiA induction in near u.v.-illuminated nuvA+ cells, whether treated with 254 nm light or not, is unusual and follows the growth curve: only after 50 min is sfiA derepression observed. It can be concluded that (i) near u.v.-induced DNA lesions are able to trigger the SOS response and (ii) the growth delay effect reduces this response, whether triggered by u.v. or near u.v. light. Hence 4-thiouridine in tRNA acts as a built-in antiphotomutagenic 'device' protecting Escherichia coli cells against mutagenesis and the induction of the SOS response by near u.v. light and sunlight. PMID- 3514210 TI - Thiol-dependent proteases of African trypanosomes. Analysis by electrophoresis in sodium dodecyl sulphate/polyacrylamide gels co-polymerized with fibrinogen. AB - The proteases of several species of African trypanosomes were analysed by electrophoresis in sodium dodecyl sulphate/polyacrylamide gels containing fibrinogen or collagen. After electrophoresis the gels were incubated in the presence of enzyme activators and/or inhibitors and then stained with Coomassie brilliant blue. The areas where the proteolytic activity had degraded the fibrinogen did not stain and so formed clear bands against a blue background. The proteases were found to have pH optima between 5 and 6, and required dithiothreitol or 2-mercaptoethanol for full expression of their activity. They were inhibited by amino acid chloromethanes, iodoacetamide, p chloromercuribenzoate and other inhibitors of the thiol-dependent proteases, as well as by the trypanocidal drugs berenil (4,4'-diamidinodiazoaminobenzene diacetamidoacetate) and pentamidine [1,5-di-(4-amidinophenoxy)pentane-di-(2- hydroxyethanesulphonate)]. Trypanosoma evansi, Trypanosoma brucei brucei and Trypanosoma brucei gambiense each have a protease with a relative molecular mass, Mr, of 28 000. In addition they occasionally exhibit activity at higher Mr values (up to 105000). Trypanosoma congolense has a low-Mr protease (31 000) and may exhibit higher-Mr proteases (up to 150000). The protease profiles of Trypanosoma vivax differ from the other species, T. brucei or T. congolense, and are present in lesser amounts. The proteases of the cultured procyclic forms are present in much smaller amounts than those of the metacyclic or mammalian blood stream forms of these parasites. The catalytic properties and inhibition characteristics of these thiol-dependent enzymes suggest that they resemble the mammalian lysosomal cathepsins B and L. PMID- 3514209 TI - Transit peptides of nuclear-encoded chloroplast proteins share a common amino acid framework. AB - We have identified three major blocks of amino acid homology shared by the transit peptides of two nuclear-encoded chloroplast proteins, the light harvesting chlorophyll a/b-protein (LHCP) II of the thylakoid membrane and the small subunit (SSU) of ribulose 1,5-bisphosphate carboxylase/oxygenase (RuBisCO) of the stroma. These previously unrecognized homology blocks lie at the beginning, middle and end of both transit sequences, and are separated by differing lengths of unshared (interblock) sequence in the two proteins. These interblocks may be dispensible or they might confer a specific property on the individual proteins, such as facilitating proper compartmentalization within the chloroplast. We propose that these three shared sequence elements form a common framework in transit-bearing chloroplast precursors which mediates the common functions performed by each transit peptide. Ferredoxin, the only other such nuclear-encoded protein for which a published transit sequence exists, conforms to the predictions of this hypothesis. These findings stand in contrast to mitochondrial leader sequences and the well-studied signal peptides of secretory and certain integral membrane proteins in which no such framework has been observed. PMID- 3514211 TI - Genes coding for the elongation factor EF-1 alpha in Artemia. AB - The elongation factor EF-1 alpha is one of the most abundant proteins in eukaryotic cells, where it catalyzes the binding of aminoacyl-tRNA to ribosomes. The genes coding for this protein in the brine shrimp Artemia were analyzed by gene cloning, electron microscopy and chromosomal blot hybridization. There are only a few (about four) copies of one type of gene per haploid genome. These genes contain five exons divided over 10(4) base pairs. Local rearrangements give rise to a number of gene variants. Cross-hybridizations of Artemia cDNA probes with yeast and Drosophila DNA revealed two different yeast EF-1 alpha genes and one or two different Drosophila genes, respectively. Nucleotide sequencing revealed signals for synthesis and processing of EF-1 alpha transcripts as well as the exact location of exons. One interruption in the coding sequence corresponds closely to a splice junction in the gene coding for the homologous chloroplast protein EF-Tu from Euglena gracilis, presumably of prokaryotic origin. The first exon in the chloroplast gene codes for the region of EF-Tu that is homologous to regions of the elongation factor EF-G and of the initiation factor IF2, respectively. PMID- 3514212 TI - Magnesium uptake by pancreatic islet cells is modulated by stimulators and inhibitors of the B-cell function. AB - 28Mg2+ uptake by rat islets was measured during incubation with various stimulators or inhibitors of insulin release. D-Glucose induced a dose-dependent increase in 28Mg2+ uptake after 10 min or 120 min. The threshold concentration was around 6 mM and the maximum effect was observed with 15-20 mM glucose. After 120 min 28Mg2+ uptake was also stimulated by the metabolized sugars mannose, N acetylglucosamine or glyceraldehyde, was unaffected by the non-metabolized or poorly metabolized L-glucose, galactose, 3-O-methylglucose, 2-deoxyglucose, fructose or mannoheptulose and was inhibited by glucosamine. The effect of glucose was markedly impaired by mannoheptulose, glucosamine, aminooxyacetate and NH4Cl, but was only partially decreased by D600 or diazoxide, which were ineffective in a glucose-free medium. Tolbutamide or KCl slightly increased 28Mg2+ uptake. Alanine, leucine alone or with glutamine, and ketoisocaproate also stimulated 28Mg2+ uptake, whereas arginine and lysine decreased it. These changes in 28Mg2+ uptake, brought about by various modifiers of the B-cell function, are thus similar but not identical to the changes in Ca2+ uptake, and are not the consequence of insulin release. The stimulatory effect of glucose requires glucose metabolism by islet cells, but is only partially due to depolarization of the B-cell membrane. PMID- 3514213 TI - Pyruvate carboxylase from Saccharomyces cerevisiae. Quaternary structure, effects of allosteric ligands and binding of avidin. AB - The quaternary structure of pyruvate carboxylase purified from Saccharomyces cerevisiae was investigated by electron microscopic examination of negatively stained samples. In the most frequently observed projection form four intensity maxima were arranged at the corners of a rhombus; a cleft along the longitudinal axis of individual protomers could often be discerned. The observation of occasional triangular and dual-intensity projections and the interconversion of all three projection forms in tilting studies indicates that this tetrameric enzyme has a structure very similar to the tetrahedron-like configuration previously proposed for pyruvate carboxylases from vertebrate sources [Mayer, F., Wallace, J. C. and Keech, D. B. (1980) Eur. J. Biochem. 112, 265-272] and Aspergillus nidulans [Osmani, S. A., Mayer, F., Marston, F. A. O., Selmes, I. P. and Scrutton, M. C. (1984) Eur. J. Biochem. 139, 509-518]. An improved structural preservation of the enzyme was observed in the presence of either of the activators acetyl-CoA (250 microM) and palmitoyl-CoA (1-5 microM). At higher than 5 microM palmitoyl-CoA, although activity was further increased, dissociation of enzyme tetramers was evident, presumably because of the detergent effect of the long-chain acyl moiety. Two inhibitors of yeast pyruvate carboxylase, L-aspartate (10 mM) and 2-oxoglutarate (40 mM), added alone or together decreased significantly the proportion of intact tetramers even in the presence of acetyl CoA or palmitoyl-CoA. When yeast pyruvate carboxylase was incubated with avidin, the formation of unbranched linear concatemers occurred at avidin:enzyme ratios between 2:1 and 1:2. Avidin molecules were sometimes bound asymmetrically to the enzyme, appearing to complex only one biotin group on each side of the enzyme. This appeared to permit kinking and circularization of some concatemers. PMID- 3514214 TI - Characterisation of RNA polymerase activity in yeast mitochondria. AB - This paper reports on the optimal incubation conditions for in vitro transcription in isolated yeast mitochondria. The mitochondrial RNA polymerase has an absolute requirement for all four nucleoside triphosphates and Mg2+. The enzyme is inhibited by Mn2+, Ca2+, Cd2+ and KCl while low concentrations of NaCl stimulate activity. Transcription is maximal in Tris/HCl buffer at pH 7.9 and the optimum incubation temperature is 28 degrees C. PMID- 3514215 TI - Formaldehyde dismutase, a novel NAD-binding oxidoreductase from Pseudomonas putida F61. AB - A novel enzyme, formaldehyde dismutase, was purified and crystallized from the cell extract of an isolated bacterium, Pseudomonas putida F61. The enzyme catalyzes the dismutation of aldehydes and alcohol:aldehyde oxidoreduction in the absence of an exogenous electron acceptor. The enzyme is composed of four identical subunits with a Mr of 44 000. Each subunit contains 1 mol NAD(H) and 2 mol zinc/mol. The ratio of NAD+ and NADH in a crystalline preparation of the enzyme was about 7:3. The enzyme-bound coenzyme was completely reduced and oxidized on the addition of a large amount of an alcohol and an aldehyde respectively. Both the oxidized and reduced enzymes catalyzed the dismutation reaction to the same extent. Steady-state kinetics of the enzyme were investigated using an oxidoreduction reaction between an alcohol and p-nitroso-N, N-dimethylaniline. The enzyme obeys a ping-pong mechanism and is competitively inhibited by an alcoholic substrate analogue, pyrazole, but not coenzyme analogues, such as AMP, N-methylnicotinamide. These results indicate that NAD(H) binds firmly (but not covalently) at each active site. The enzyme-bound NAD(H) was reduced and oxidized only by the added second substrates, alcohol and aldehyde respectively, and not by exogenous electron acceptors [including NAD(H)]. PMID- 3514216 TI - Substrate specificities and inhibition of two hemorrhagic zinc proteases Ht-c and Ht-d from Crotalus atrox venom. AB - The proteolytic specificities of two zinc hemorrhagic toxins (Ht-c and Ht-d), isolated from Crotalus atrox venom, were investigated by using the oxidized B chain of bovine insulin and synthetic peptide substrates. The enzymes cleaved the Ala14-Leu15 bond of the insulin B chain most rapidly and the Tyr16-Leu17 slightly more slowly. The His5-Leu6, His10-Leu11, and Gly23-Phe24 bonds were also cleaved but at considerably slower rates. In order to assess the substrate length preferences of the enzymes, peptide analogs of the B chain about the Ala14-Leu15 bond were synthesized ranging in length from four to seven residues. The heptapeptide NH2-Leu-Val-Glu-Ala-Leu-Tyr-Leu-COOH was the best peptide substrate tested with the other peptides having decreasing kcat/Km values with decreasing length. The tetrapeptide NH2-Ala-Leu-Tyr-Leu-COOH was not cleaved by the enzymes. Furthermore, this peptide was shown to serve as a competitive inhibitor of the toxins. The N-acetylated pentapeptides and hexapeptides, synthesized to probe the active site environment of the enzymes, were significantly better substrates than their unacetylated counterparts. The toxins had the highest kcat/Km values for the acetylated peptide Ac-Val-Ala-Leu-Leu-Ala-COOH. The data suggest that the toxins may indeed have extended substrate-binding sites, which may accommodate at least six amino acid residues. The best substrate examined thus far for the toxins is the fluorogenic peptide analog 2-aminobenzoyl-Ala-Gly-Leu-Ala-4 nitrobenzylamide, suggestive of similarities between the toxins and mammalian collagenases as well as thermolysin. Mechanisms for inhibition of the enzymes were investigated using amino acid hydroxamates, chloromethyl esters, phosphoramidon and the peptide NH2-Ala-Leu-Tyr-Leu-COOH. All of these inhibitors had Ki values in the 10(-4) M range. PMID- 3514217 TI - Immunoelectron microscopic localization of alpha-actinin and actin in embryonic hamster heart cells. AB - Myofibrillogenesis in developing cardiac cells of the Syrian hamster from early embryonic stages through newborn was studied by electron microscopy, immunofluorescence microscopy and immunoelectron microscopy. alpha-Actinin and actin were localized at light and electron microscopic levels in embryonic heart cells which had been fixed in a periodate-lysine-paraformaldehyde or a glutaraldehyde-formaldehyde mixture, and embedded in Lowicryl K4M. Indirect staining methods were used for immunofluorescence staining of thick sections and immunoferritin staining of thin sections. The earliest evidence of myofibrillogenesis in embryonic myocardial cells was the presence of many randomly arranged thin (6 nm) filaments and a few scattered thick filaments (15 nm) near the plasma membrane. alpha-Actinin was detected in a semi-continuous, diffuse layer in some portions of the cell just beneath the plasma membrane in association with the filamentous collections. Later in development, alpha-actinin coalesced into Z-plaques at the membrane as the filaments arranged into parallel arrays. Actin was localized in the thin filaments as expected. In later stages of development, alpha-actinin was observed at the Z-lines and intercalated discs of the mature myofibrils while actin was localized at both the I-band and Z-line. Our results suggest that myofibrillogenesis is initiated at the plasma membrane and that Z-plaques are precursors of myofibrillar Z-bands and may serve as organizing centers for myofibrillogenesis in developing cardiomyocytes. PMID- 3514218 TI - Fodrin is part of a filamentous cortical sheath of the detergent resistant cytoskeleton of cultured cells before and after cytochalasin treatment. AB - Cytoskeletons of cultured cells prepared under mild conditions in the presence of "stabilization' buffer contain most of the fodrin present in the cells. The fodrin in these cytoskeletons was localized by immunofluorescence microscopy and found to be present in a cortical sheath of fine filaments. In general, the filamentous distribution showed no correspondence with actin bundles as revealed by double-label fluorescence microscopy. However, in cells with large and abundant stress fibers, some colocalization of fodrin with actin bundles was seen. Treatment of cells with either cytochalasin A or D caused disorganization of the actin bundles whereas fodrin still showed a filamentous distribution in cytoskeletons of the cytochalasin-treated cells. Implications of these results for the organization of the fodrin-containing sheath of cultured cells is discussed. PMID- 3514219 TI - Immunofluorescence analysis of sucrose-induced changes in spindle morphology. AB - Metaphase and anaphase PtK1 cells show spindle elongation without concomitant chromosome motion when treated with culture medium containing 0.5 M sucrose. Electron microscopy has shown sucrose-induced changes in microtubule (MT) organization, changes in trilaminar kinetochore structure, and specific kinetochore-MT associations which may account for these results. In this paper we employ double-label immunofluorescence techniques using antibodies against tubulin and the kinetochore to analyze changes in spindle microtubule and kinetochore distribution produced by sucrose treatment. Cells treated from prometaphase through anaphase with 0.5 M sucrose from 10 min to 2 h showed spindle elongation and a distinct rearrangement of spindle microtubules into bundles, with a pronounced increase in length of interpolar microtubule bundles. In sucrose-treated mitotic cells kinetochores remained as antigenically distinct structures, similar to those found in untreated interphase cells. Kinetochore determinants remained positioned within a diffuse chromatin mass, but the orientation of sister kinetochores to opposite spindle poles was lost. Instead, kinetochore pairs were found in lateral association with microtubule bundles, with several pairs of determinants associated with a single bundle in many instances. Cells released from 0.5 M sucrose treatment showed a return of the spindle to a pretreatment arrangement for both the microtubules and kinetochore determinants. PMID- 3514220 TI - Centrioles are lost as embryonic myoblasts fuse into myotubes in vitro. AB - Embryonic chick myoblasts possess an extensive network of cytoplasmic microtubules which emanate from a single, perinuclear centrosome containing a microtubule-organizing center (MTOC) and the centrioles. However, after myoblasts fuse into myotubes the centrosome is no longer apparent, and instead long parallel arrays of microtubules are seen. From ultrastructural studies on developing muscle tissue, it has been proposed that centrioles are present in myoblasts but are absent from fused muscle fibers. We have examined this hypothesis in vitro in cultures of chick embryonic muscle cells using sera which specifically label centrioles. Almost all (90-97%) mononucleated cells in these cultures, including myoblasts aligned just prior to fusion, contain a pair of centrioles in close proximity to the nucleus. However, in newly fused multinucleated myotubes as well as in older myotubes that had developed myofibrils, centrioles were rarely found (1-10% positive cells). This study thus provides direct evidence for a loss of centrioles from muscle cells soon after they fuse to form myotubes. PMID- 3514221 TI - Vacuolar pH is one factor that regulates hydrolase secretion. AB - Lysosomal hydrolases are continually secreted by Acanthamoeba as a consequence of membrane cycling between the vacuolar compartment and the cell surface. In pinocytosing amoebae acid hydrolases can be separated into two groups on the basis of their secretion kinetics. We have previously shown that in Acanthamoeba acid hydrolases are almost exclusively restricted to a single compartment, digestive vacuoles, and that pH-dependent differential binding of hydrolases to vacuolar membrane can account for the different rates of hydrolase secretion from this compartment. In this report we show that the hydrolase secretion pattern changes and that all of the hydrolases are released with the same kinetics after phagocytosis of yeast or in growth media supplemented with ammonium acetate or chloroquine, but not after phagocytosis of polystyrene beads. The changes in the pattern of hydrolase secretion correlate with changes in vacuolar pH. The vacuolar pH of pinocytosing amoebae and amoebae saturated with beads is about 4.8. This value is increased to 6.8 by accumulation of weak bases and to about 6.1 when digestive vacuoles are saturated with yeast. These results indicate that vacuolar pH modulates hydrolase transport and secretion. PMID- 3514222 TI - Geometric progression in the size of membrane vesicles, nuclei and cells. PMID- 3514223 TI - Evaluation of antiplatelet agents in the prevention of aorto-coronary bypass occlusion. AB - The cumulative occlusion rates of aorto-coronary artery venous bypass grafts average from 16 to 26% per distal anastomosis within 12 months and about 2% per following year. The potential benefit of oral anticoagulants and platelet inhibitor drugs has been tested to prevent graft occlusion and to retard the atherosclerotic process. Oral anticoagulants started on the third postoperative day do not significantly reduce graft occlusion after 6 months. Among the platelet inhibitor drugs, dipyridamole started before surgery, followed by dipyridamole and aspirin soon after surgery, was the drug regimen with the best results. More randomised double-blind clinical trials are highly desirable to confirm these findings and to resolve the question of relative efficacy and safety for the various drugs reported to have shown benefit when used in combination. PMID- 3514224 TI - Randomized placebo-controlled comparative study of nifedipine, verapamil and isosorbide dinitrate in the treatment of angina at rest. AB - Twenty-nine patients with angina at rest took part in a randomized placebo controlled short-term study to assess the relative effectiveness of different dosages of nifedipine (N), verapamil (V) and isosorbide dinitrate (ISDN) versus placebo and to evaluate the antianginal effects of a sustained-release preparation of ISDN (sr), of N retard form (r) and of V retard form (r). The 29 patients were divided into 3 groups: the first group of patients (10 patients, group A) was treated with N 10 mg six times daily, V 80 mg three times daily and ISDN 10 mg six times daily; the second group of patients (9 patients, group B) was treated with N 20 mg six times daily, V 120 mg four times daily and ISDN 20 mg six times daily; the third group of patients (10 patients, group C) was treated with N r 20 mg four times daily, V r 120 mg three times daily and ISDN sr 40 mg four times daily. The daily frequency of ischaemic episodes (IE) was assessed by Holter monitoring. The effect of each drug on the mean frequency of IE was compared with the placebo using a one-way analysis of variance and the Newman-Keuls test. In group A, the mean daily frequency of IE per patient was 8.1 +/- 5.9 with the placebo, 1.4 +/- 1.9 with N (P less than 0.001; -82%), 4 +/- 3.6 with V (P: NS; -50%) and 4.3 +/- 3.6 with ISDN (P: NS; -46%). In group B it was 6.4 +/- 3.4 with the placebo, 0.5 +/- 1.6 with N (P less than 0.01; -91%), 0.3 +/ 0.5 with V (P less than 0.01; -95%) and 1.2 +/- 1 with ISDN (P less than 0.01; 82%). In group C it was 10.3 +/- 8.7 with the placebo, 0.7 +/- 1.6 with N r (P less than 0.01; -93%), 1 +/- 2.5 with V r (P less than 0.01; -90%) and 5.1 +/- 7.7 with ISDN sr (P: NS; -50%). In group A a reduction of 100% in the number of recorded IEs was achieved in 5/10 patients by using N, in none by V, and in 1/10 by ISDN. In group B, in 8/9 patients by N, in 6/9 by V and in 3/9 by ISDN. In group C, in 8/10 patients by both N r and V r in 4/10 patients by ISDN sr.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3514225 TI - 201Tl myocardial imaging in a cardiac rejection episode. AB - Serial myocardial imaging using thallium Tl 201 was performed in the early follow up of two patients with orthotopic cardiac transplantation. In one patient, non homogeneous uptake, small defects and an irregular myocardial edge were observed during a moderately acute rejection crisis revealed by endomyocardial biopsy. The abnormal gammagraphic findings and histological changes were coincident and exhibited a parallel reversal. We emphasize the connection between these two events. The mechanisms which could explain these phenomena are discussed. PMID- 3514226 TI - Normal uterine activity on a 99mTc-glucoheptonate renal scan. AB - Uterine radioactivity uptake has previously been reported for a variety of radionuclide agents in the presence of uterine pathological disorders, such as leiomyomata as well as uterine and cervical neoplasma and infections. Activity within the normal uterus has also been reported in Meckel's scans using 99mTc pertechnetate, but this has not been reported for other radionuclide agents. We report a case exhibiting radioactivity uptake within a normal uterus on a 99mTc glucoheptonate scan of a renal transplant. Awareness of the possibility of radioactivity uptake in a normal uterus is important in order to avoid potential confusion with abnormal pelvic masses or fluid accumulations. PMID- 3514228 TI - Severe hydrops fetalis due to congenital supraventricular tachycardia. AB - Intrauterine supraventricular tachycardia is one of the main causes of non immunological intrauterine hydrops fetalis. Without early diagnosis and treatment it may terminate in fetal death or delivery of a baby with severe hydrops and extreme heart failure. With the improvement in non-invasive imaging techniques in prenatal medicine, this condition can be diagnosed early and treated successfully. A case is described of such a newborn diagnosed in utero and treated before and after delivery, and the different therapeutic approaches to congenital supraventricular tachycardia are discussed. PMID- 3514229 TI - Value of intravesical sonography in tumor classification of bladder carcinoma. AB - The possibility of a T classification for bladder carcinoma by intravesical sonography was investigated in a 3-year field study (1982-1985) at the Urological Clinic, Bonn University. In a total of 571 patients with histologically verified bladder cancer, the sonographic classification was compared with the histological T category. There was an agreement of 70.1%. While the infiltration of superficial tumors (above all of large tumors) was frequently overestimated (28.7%), understaging predominated in invasive carcinomas (20.9%). The overall precision of conventional staging techniques was 67%. Ultrasonography showed a marked superiority, above all in infiltrative papillary tumors of low diameter (precision 76% compared to 12% with the conventional T classification). The sensitivity of the method with regard to the detection of tumor infiltration (90%) was also markedly higher than that of earlier techniques (66%). Particularly helpful in the evaluation of more deeply infiltrating tumors, intravesical sonography constitutes a major extension of the diagnostic spectrum for T classification of bladder carcinoma. PMID- 3514230 TI - Some changing concepts of the natural history of human mammary cancer and their effect on diagnosis and treatment. PMID- 3514227 TI - Peroxisomal disorders: a newly recognised group of genetic diseases. PMID- 3514231 TI - Ultrasonography in the staging of Hodgkin's disease: lymphangiographic correlation. AB - The contribution of ultrasonography (US) to the staging of Hodgkin's disease was studied in 45 patients. US findings were compared with lymphangiograms (LAG) performed in the same period. In 93% of the patients there was good correlation between the two examinations. In 7% (three patients) there was a discrepancy: LAG showed retroperitoneal node involvement while with US this was negative. There were no false-positive US examinations. We therefore suggest that US be used as the primary method in the initial evaluation of Hodgkin's disease and LAG be performed only when US is negative. PMID- 3514232 TI - Intrinsic and reflex actions of verapamil and nifedipine: assessment in normal subjects by noninvasive techniques and autonomic blockade. AB - To determine the intrinsic and reflex activities of calcium antagonists, 8 healthy volunteers were administered single doses of verapamil 10 mg i.v. and nifedipine 20 mg sublingually alone and during autonomic blockade (atropine 0.04 mg/kg and propranolol 0.2 mg/kg). Heart rate, PQ-time, systolic time intervals, blood pressure, and left ventricular echocardiograms were used to measure the pharmacodynamic effects, which were evaluated by multivariate analysis of variance. In general the effects of verapamil were most distinct when the 10-min infusion ended, while nifedipine acted after a latent period of 9 minutes. Both calcium antagonists given alone induced almost identical increases in heart rate and cardiac output and decreases in total peripheral resistance. Nifedipine also reduced systolic wall stress and increased fractional shortening, while verapamil prolonged systolic time intervals and PQ-time and reduced fractional shortening. During autonomic blockade, nifedipine no longer had a significant effect on these parameters. However, after the blockade verapamil led to marked decrease in heart rate, cardiac output, blood pressure and systolic wall stress; total peripheral resistance and fractional shortening were not changed, and the systolic time intervals and PQ-time were prolonged as after verapamil alone. It is concluded that both calcium antagonists stimulate distinct sympathetic reflexes, which may modify or even reverse their intrinsic actions. The effects of nifedipine on the cardiovascular system are considered to result from a reduction in peripheral vascular tone, whereas the effects of verapamil can be attributed to cardiac (negative inotropic, chronotropic and dromotropic) and peripheral vascular actions. PMID- 3514233 TI - Effect of cisapride on human fasting gallbladder volume: a real-time ultrasonographic study. AB - The effect of cisapride, a new non-antidopaminergic agent, on human gallbladder volume has been studied in nine normal subjects. In a double-blind crossover fashion, each subject was given a slow i.v. injection of cisapride and placebo after 12-h fasting. Gallbladder volume was monitored every 15 min for 90 min by real-time ultrasonography. After cisapride, gallbladder volume significantly diminished, with a mean reduction of 22.9 +/- 5%, observed 30 min after injection, whereas no significant changes were noted after placebo. A cholinergic mechanism is proposed to explain the effect of cisapride on gallbladder volume. PMID- 3514234 TI - Self-tolerance to host and donor following HLA-mismatched bone marrow transplantation. AB - The transplantation of T cell-depleted HLA-haploidentical bone marrow can correct the severe combined immunodeficiency disease (SCID) caused by the inherited absence of T lymphocytes. Despite a different environment, no severe graft-vs. host reaction occurred and engrafted T lymphocytes became functional. We have studied tolerance of engrafted T lymphocytes to donor and host HLA antigens in four SCID patients who have been transplanted with bone marrow from one of their HLA-haploidentical parents. Graft-vs.-host reaction was prevented by T cell depletion of infused bone marrow using E rosetting and by in vivo administration of cyclosporine A. Subsequent to bone marrow transplantation (BMT), the engrafted T lymphocytes were shown to be unresponsive in vitro towards host cells collected prior to BMT. Generally, this tolerance could not be explained by a suppressive mechanism. Nevertheless, in one patient suppressive cells were found transiently. In contrast to the early appearance of a tolerance towards host, a reactivity of engrafted donor cells towards donor was always observed within the first 300 days post-grafting. This autoreactivity was mediated by T cells of donor origin and its targets were HLA class II molecules (at least HLA-DR and DQ). The progressive disappearance of this autoreactivity was correlated with the engraftment of Ia positive cells (monocytes plus B lymphocytes) of donor origin and the achievement of complete immunological reconstitution. In the patient showing the strongest autoreactivity, a donor-specific T cell line has been grown which was shown to specifically inhibit the proliferative response of donor lymphocytes. Concomittantly, the immunological reconstitution remains poor in this patient. These data suggest that tolerance to HLA class II molecules is dependent on the presence of the relevant HLA class II molecule-expressing cells allowing the elimination or the suppression of T lymphocytes specifically directed at these molecules. PMID- 3514235 TI - Gut mucosal mast cells in Nippostrongylus-primed rats are the major source of secreted rat mast cell protease II following systemic anaphylaxis. AB - The distribution of the predominant chymotrypsin-like enzyme of mucosal mast cells (rat mast cell protease II: RMCP II) was examined in naive and Nippostrongylus-primed rats both before and after the induction of systemic anaphylaxis. Anaphylactic secretion of RMCP II following i.v. challenge of primed rats with worm antigen was accompanied by significant depletion of this enzyme from the jejunal and gastric mucosae; the concentrations were not altered in the ileum and colon. Despite significant increases in the levels of RMCP II in lung and mesenteric lymph node following infection with N. brasiliensis there was no anaphylactic depletion of this enzyme from these sites. No RMCP II was detected in liver, spleen, kidney or bone marrow either before or after systemic anaphylaxis. Mucosal mast cells were depleted from the jejunal, gastric and colonic mucosae following antigen challenge of primed rats. These data provide further evidence that gastrointestinal mucosal mast cells are the major source of secreted RMCP II following systemic anaphylaxis in the rat. PMID- 3514236 TI - Defective membrane expression of the LFA-1 complex may be secondary to the absence of the beta chain in a child with recurrent bacterial infection. AB - Membrane and intracellular processing of the LFA-1 macromolecular complex, known to be involved in cytolytic function of T lymphocytes, was investigated in a child with recurrent bacterial infections, impaired natural killer activity, T cell-mediated lymphocytolysis and absent adhesion and migration of phagocytic cells. Monoclonal antibodies to the LFA-1 alpha and beta subunits, able to precipitate the LFA-1 alpha, 180-kDa chain, the p151 chain and beta 94-kDa chain (shared by both alpha chains), were used in immunoprecipitation studies of patient and control phytohemagglutinin-blasts. Neither of the alpha chains nor the beta chain were found in precipitates obtained from 125I-surface-labeled patient cells in contrast to controls. However, the precursor of the LFA-1 alpha chain, a 170-kDa polypeptide, was identified in lysates of biosynthetically labeled patients' cells. These results suggest that the defective membrane expression of the LFA-1 complex may be secondary to the absence of the mature beta chain. PMID- 3514237 TI - Recombinant interleukin 2 enhances spontaneous insulin-dependent diabetes in BB rats. AB - Treatment of BB rats with recombinant interleukin 2 (IL2) enhanced the development of spontaneous diabetes in these animals. A dose of 20 micrograms IL 2/kg body weight was administered twice daily for 80 days starting at 42 days of age. The rate of diabetes was doubled after IL 2 administration (53% vs. 23%) and the onset of diabetes was found to be accelerated by a mean of 18 days. Histological analysis showed enhanced inflammation of islets and in addition interstitial pancreatis. It is concluded that IL 2 has a regulatory effect on spontaneous organ-specific autoimmunity. PMID- 3514238 TI - Regulation of thymocyte proliferation and survival by deoxynucleosides. Deoxycytidine produced by thymic accessory cells protects thymocytes from deoxyguanosine toxicity and stimulates their spontaneous proliferation. AB - Deoxyguanosine (dGuo) inhibits thymic blast DNA synthesis and then induces thymocyte cell death. The dGuo inhibitory action, measured with four different assays (spontaneous thymidine incorporation, immunofluorescent detection of 5 bromodeoxyuridine incorporation, dye exclusion, tetrazolium salt cleavage), was suppressed in the presence of supernatants from cultures containing phagocytic cells. In particular, we studied the anti-dGuo activity in supernatants from thymic reticulum cultures (TRS) and in those from phagocytic cells isolated from TR cultures (P-TR). The anti-dGuo substance was identified as deoxycytidine (dCyd) by high performance liquid chromatography and other physicochemical studies. Secretion of dCyd by P-TR is accompanied by thymidine but not by purine nucleoside secretion. A dual mechanism of thymocyte rescue by dCyd was demonstrated by a study of the dose-dependencies of dCyd-mediated prevention and reversal, respectively, of the dGuo inhibition. In addition to this exogenously added anti-dGuo action, dCyd and dCyd-containing TRS induced significant stimulation of spontaneous thymic blast proliferation, and the kinetics of both effects were identical. These findings might suggest that a major role of thymic phagocytic cells is the supply of pyrimidine nucleosides to thymocytes resulting in the maintenance of proliferation and protection of at least some thymic blasts from the toxic effects of dGTP accumulation. The role of this system in the intrathymic selection process is discussed. PMID- 3514239 TI - Influence of carriers on the development and localization of anti-trinitrophenyl antibody-forming cells in the murine spleen. AB - Mice were i.v. immunized with various 2,4,6-trinitrophenyl (TNP)-carrier conjugates, and the development and localization of specific (i.e. anti-TNP) antibody-forming cells (AFC) in the spleen was studied. The nature of the carrier used, thymus dependent (TD) or thymus independent type 1 or type 2 (TI-1, TI-2), had marked effects on the number and time of appearance of AFC. However, no influence of the different carriers on the localization of specific AFC in the spleen was observed. By using a double immunocytochemical technique we could simultaneously determine specificity (anti-TNP) and isotype (class and subclass) of the AFC. The TNP-carrier conjugates evoked (intracellular) immunoglobulins with carrier-characteristic isotype distribution. No carrier-dependent localization pattern, in the lymphoid compartments of the spleen, of these AFC was found. These results show for the first time the actual in situ effects of various TI and TD carriers on the development of specific AFC. Based on the present findings, no direct evidence for a special role of the marginal zone in the immune response against TI-2 antigens could be demonstrated. We suggest that this new method for in vivo investigation, in combination with existing standard enzyme- and immunohistochemical techniques, can provide more insight into the precise role of lymphoid and nonlymphoid cells in TD and TI immune responses. PMID- 3514240 TI - Kinetics of cellular oncogene expression in mouse lymphocytes. I. Expression of c myc and c-ras-Ha in T lymphocytes induced by various mitogens. AB - Murine splenic T lymphocytes display maximal cellular myc gene (c-myc) expression already 3 h after concanavalin A stimulation and subsequent down-regulation before the onset of DNA synthesis. Stimulation by leucoagglutinin in the presence or absence of interleukin 2 leads to only low initial levels of c-myc-specific RNA which, however, increase later on. A similar pattern of c-myc expression is shown by the Lyt-2+ T cell subpopulation stimulated with either concanavalin A or leucoagglutinin in the presence of interleukin 2. Although [3H]thymidine incorporation was identical, the leucoagglutinin-stimulated Lyt-2+ T cells were void of any demonstrable c-myc-specific RNA at 3 h post-stimulation. Thus, the kinetics of c-myc expression in mouse T lymphocytes are not at all uniform, but depend on the mitogen and the subpopulation. In contrast, levels of c-ras-Ha specific RNA were always low at early times, always increased towards the onset of DNA synthesis and down-regulation was not observed. PMID- 3514241 TI - Altered endothelium-mediated relaxation after denervation of growing rabbit ear artery. AB - The relaxation response to methacholine and sodium nitroprusside was examined in ring segments from the posterior auricular artery and its continuation the central ear artery in growing rabbits 2, 4, 6 and 8 weeks following unilateral adrenergic and sensory denervation. The maximal relaxation achieved by methacholine (endothelium-dependent) was significantly depressed in the denervated arteries compared with the contralateral controls. Sodium nitroprusside (endothelium-independent relaxant agent) elicited the maximal relaxation in all tissues. These results demonstrated impaired arterial endothelium-dependent relaxation to methacholine after chronic denervation. PMID- 3514242 TI - DNA-synthesis in mechanically stimulated osteogenic tissue: an autoradiographic study using tritiated thymidine. PMID- 3514243 TI - Benzydamine hydrochloride in the treatment of ulceration associated with recently placed fixed orthodontic appliances. PMID- 3514244 TI - Defective attachment of dermatosparactic fibroblasts to collagens I and IV. AB - Attachment of fibroblasts from dermatosparactic sheep and cattle to collagenous substrates (types I and IV) is defective (30-50%) when compared with fibroblasts from normal or heterozygous animals. The difference was independent of the amount of substrate, incubation time and protein synthesis. No differences were observed in the binding to fibronectin or laminin. Reduced attachment to collagen can be partially restored by adding fibronectin. The polygonal morphology of dermatosparactic cells was, however, not altered by attachment and growth on dishes coated with different collagens or fibronectin. Reduced interaction with collagens could be due to changes in specific receptors and may represent a further pathological change in dermatosparactic animals. PMID- 3514245 TI - Preferential association of acidic actin with nuclei and nuclear matrix from mouse leukemia L5178Y cells. AB - Nuclear matrix prepared from mouse leukemia L5178Y cells contained not only the two common actin isomers, beta and gamma actins, but also two additional acidic species of actin (pI 5.1 and 5.3). An anti-actin antibody recognized these acidic species as well as beta and gamma actins on a nitrocellulose filter following western blotting of two-dimensional electrophoresis. These acidic species were co purified with beta and gamma actins using DNase I-Sepharose affinity chromatography on the nuclear matrix. Limited digestion of the acidic actin with protease V8 or trypsin gave very similar peptide fragments as did digestion of beta and gamma actins. These acidic actins were found to be distributed in the nuclear fraction, but were scarcely detectable in the cytoplasmic fraction. One of the acidic actins (pI 5.3) was found in all subnuclear fractions (DNase extract, high-salt extract and nuclear matrix), while the other species, the most acidic actin (pI 5.1), was localized predominantly in the nuclear matrix. PMID- 3514247 TI - Extraction and preliminary characterization of maturation-promoting factor from starfish oocytes. AB - Cytoplasm of maturing starfish oocytes possesses a factor which induces maturation upon injection into immature oocytes. Such maturation-promoting factor (MPF) was extracted from maturing oocytes of Asterina pectinifera and characterized preliminarily. After 1-methyladenine (1-MeAde) treatment, maturing oocytes were packed in a centrifuge tube to remove jelly and excess medium, and then crushed by centrifugation. The turbid supernatant was homogenized with a buffer containing NaF, Na-beta-glycerophosphate, ATP, EGTA and leupeptin, followed by centrifugation. MPF extracted in the supernatant was purified partially by ammonium sulfate precipitation, hydrophobic chromatography on pentyl agarose and gel filtration on Sephacryl S-300. The final material induced maturation in the recipient starfish oocytes when 0.5 ng of protein was injected in a volume of 400 pl. The maturation response included germinal vesicle breakdown, and formation of polar bodies and egg pronucleus. Such MPF preparation induced maturation in oocytes of Xenopus laevis as well. Further, starfish MPF was found to be a heat-labile protein; its molecular weight (MW) was estimated as 300 X 10(3) D by gel filtration and its sedimentation coefficient value as 5S by centrifugation on sucrose density gradients. PMID- 3514246 TI - Different cellular distribution of thioredoxin and subunit M1 of ribonucleotide reductase in rat tissues. AB - The cellular distribution of thioredoxin and protein M1 of ribonucleotide reductase in adult rat tissues was investigated with immunohistochemical techniques using specific antisera. Tissues with high or low frequency of either mitotic or meiotic cell divisions were compared. Thioredoxin was demonstrated in many cells types that showed no detectable protein M1 of ribonucleotide reductase. A few cell types with protein M1 immunoreactivity also contained immunoreactive thioredoxin. However, in most cells no such co-localization could be demonstrated. This lack of correlation between cells containing subunit M1 of ribonucleotide reductase and the thioredoxin indicates that thioredoxin is not the physiologist hydrogen donor for ribonucleotide reductase in rat tissues and that the expression of two enzymes is differently regulated. PMID- 3514248 TI - Colcemid-resistant mutants of fission yeast have an altered cell cycle. AB - Cell-cycle progression is altered in some colcemid-resistant mutants of fission yeast. The duration of particular stages of the cell cycle is different but total doubling time is unchanged from that of wild type. Cell-plate formation is prolonged relative to wild type but concomitant DNA synthesis is not affected. Separation of daughter cells is inhibited in some strains, giving rise to unusual cell morphologies. Control of cell division is altered in two ways: Critical size for division is increased. The probability of division a function of size is decreased. PMID- 3514249 TI - Distribution of microfilament bundles during rotation of the nucleus in 3T3 cells treated with monensin. AB - Cytoskeletal aspects of monensin-treated 3T3 cells with rotating nuclei were studied by immunofluorescence. The pattern of intermediate filaments and microtubules appeared unchanged when compared with control cells having a stationary nucleus. In contrast, the actin microfilament bundles appeared to have a consistent distribution in cells with rotating nuclei. Typically, we did not find long microfilament bundles that traverse the length of the cytoplasm of cells that were fixed at the time of nuclear rotation. Instead, there was a local distribution of short microfilament bundles situated ventrally to the nucleus and oriented at various angles to one another and to the predominant distribution of microfilament bundles in the cell. The observations suggest that the actin cytoskeleton is reorganized locally before or during rotation of the nucleus. PMID- 3514250 TI - Dynamic expression of the cell adhesion molecule cell-CAM 105 in fetal and regenerating rat liver. AB - Cell-CAM 105 is an integral cell surface glycoprotein that is involved in cell cell adhesion of adult rat hepatocytes in vitro. In the present report we used a radio-immunoassay, a quantitative immunoblotting technique and immunofluorescence microscopy to investigate the expression of cell-CAM 105 in fetal and regenerating rat liver. In the fetal liver cell-CAM 105 did not appear until day 16 of the gestation, when it increased rapidly to reach the level found in adult liver, 3 weeks after birth. In liver regenerating after partial hepatectomy a transient decrease in the amount of cell-CAM 105 was observed in the plasma membranes of the hepatocytes. A significant decrease was observed as early as 12 h after partial hepatectomy, reaching a minimum by 3 days after the operation, corresponding to approx. 35% of the amount of cell-CAM 105 in normal liver. The amount then increased slowly and was back to the normal level by about 15 days after partial hepatectomy. The results indicate that cell-CAM 105 exerts its major function in terminally differentiated cells. An excellent correlation was seen between the kinetics of the expression of cell-CAM 105 and of reported changes of both enzymatic and organizational patterns of hepatocytes in regenerating and fetal liver. This suggests that cell-CAM 105 could be important for the development and maintenance of the cell-cell binding and organizational pattern characteristic of terminally differentiated hepatocytes. PMID- 3514251 TI - Analysis of the internal nuclear matrix. Oligomers of a 38 kD nucleolar polypeptide stabilized by disulfide bonds. AB - When rat liver nuclei are treated with the sulfhydryl cross-linking reagent sodium tetrathionate (NaTT) prior to nuclease treatment and extraction with 1.6 M NaCl, residual nucleoli and an extensive non-chromatin intranuclear network remain associated with the nuclear envelope. Subsequent treatment of this structure with 1 M NaCl containing 20 mM dithiothreitol (DTT) solubilizes the intranuclear material, while the nuclear envelope remains structurally intact. We have isolated and partially characterized a major polypeptide of the disulfide stabilized internal nuclear matrix. The polypeptide, which has an apparent molecular mass 38 kD and isoelectric point 5.3, has been localized to the nucleolus of rat liver nuclei by indirect immunofluorescence using a specific polyclonal chicken antiserum. Based on its molecular mass, isoelectric point, intracellular localization and amino acid composition, the 38 kD polypeptide appears to be analogous to the nucleolar phosphoprotein B23 described by Prestayko et al. (Biochemistry 13 (1974) 1945) [20]. Immunologically related polypeptides have likewise been localized to the nucleoli of both hamster and human tissue culture cell lines as well as the cellular slime mold Physarum polycephalum. By immunoblotting, a single 38 kD polypeptide is recognized by the antiserum in rat, mouse, hamster and human cell lines. The antiserum has been utilized to investigate the oligomeric structure of the 38 kD polypeptide and the nature of its association with the rat liver nuclear matrix. By introducing varying numbers of disulfide bonds, we have found that the 38 kD polypeptide becomes incorporated into the internal nuclear matrix in a two-step process. Soluble disulfide-bonded homodimers of the polypeptide are first formed and then are rendered salt-insoluble by more extensive disulfide cross-linking. PMID- 3514252 TI - Horseradish peroxidase uptake and crinophagy in insulin-secreting cells. AB - Upon exposure of pancreatic B cells to exogenous horseradish peroxidase (HRP), a population of secretory granules becomes HRP-labelled. In isolated islets of Langerhans, we studied the fate of HRP-labelled secretory granules during a pulse chase experiment with HRP in order to assess their relationship with lysosomes containing secretory granule cores. These structures (crinophagic or multigranular bodies) were previously shown to be a site of insulin degradation (Orci et al., J cell biol 98 (1984) 222) [4]. After a 15-min pulse of peroxidase, the number and volume density of HRP-labelled secretory granules decreased over an 85-min chase period, during which the number and volume density of multigranular bodies labelled with HRP was significantly increased. At both time points, the surface density of HRP-labelled Golgi elements was very small compared with that of unlabelled ones. By autoradiography after a 5-min pulse of [3H]leucine and a 55-min chase, followed by a 15-min pulse of HRP and a 85-min chase, we could show that the majority of HRP-containing secretory granules were not radioactively labelled granules. These results suggest that: The low degree of HRP labelling of the Golgi makes it unlikely that secretory granules derive their HRP by budding from HRP-labelled cisternae. HRP-labelled SGs are preferentially transferred to MGBs (which become HRP-labelled) for prospective degradation. HRP labelling does not involve newly-formed mature secretory granules. PMID- 3514253 TI - Do opioid peptides modulate, at the level of the nerve endings, the release of neurohypophysial hormones? AB - Rat neurointermediate lobes and neurohypophyses separated from the pars intermedia were stimulated in vitro in the presence of either D-Ala2, D-Leu5 enkephalin (DADLE), a Leu-enkephalin stable analogue or FK 33-824 a Met enkephalin stable analogue. Secretion of vasopressin (AVP) and oxytocin (OT) was produced by either a Ca2+-ionophore or with electrical stimulation or by K+ induced depolarization. These opioid peptides and their antagonist naloxone did not affect basal nor evoked hormone release. Furthermore, they did not affect the evoked calcium uptake induced with electrical stimulation. These findings were confirmed using a preparation of isolated neurosecretory nerve endings. Further, dopamine had no effect on the K+-induced AVP release although a crude extract of the pars intermedia abolished the electrically-evoked and reduced considerably the potassium-evoked AVP release. It is concluded that in the neurohypophysis neither Leu- and Met-enkephalin nor dopamine affect the secretion-coupling mechanism at the level of the neurosecretory nerve endings. PMID- 3514254 TI - The proportion and size of GABA-immunoreactive neurons in the magnocellular and parvocellular layers of the lateral geniculate nucleus of the rhesus monkey. AB - Neurons containing GABA-immunoreactivity in LGN of the macaque monkey were analyzed quantitatively in semithin (1 micron) sections. The percentage of GABA(+) cells per unit area of the sections was 26% in the magnocellular layers and 19% in the parvocellular layers. However, the percentage of GABA(+) cells in a unit volume of LGN, calculated by a stereological method that takes into account the observed difference in size of labeled and unlabeled somata, was 35% in the magnocellular layers and 25% in the parvocellular layers. GABA(+) somata in the magnocellular layers were significantly larger than those in the parvocellular layers. The possible role of GABAergic cells in inhibitory mechanisms of receptive fields of parvo- and magnocellular neurons are discussed in the light of current knowledge of the physiology and neural circuits of macaque LGN. PMID- 3514255 TI - Trypanosoma cruzi: changes in lipid composition during aging in culture. AB - Changes in lipid composition and fatty acid distribution in lipid fractions from total extracts of Trypanosoma cruzi were studied in culture from Day 2 to Day 14. This comprises the phases of exponential, stationary, and declining growth. Total phospholipid content decreased steadily during the three culture phases due to the marked reduction of phosphatidylcholine. Phosphatidylethanolamine increased during the exponential and declining phases. Thus, the final phosphatidylethanolamine/phosphatidylcholine ratio was higher than that determined on the second day. Sterols and acylglycerides increased as cultures aged. Fatty acid composition of different fractions varied during aging: phosphatidylcholine and phosphatidylethanolamine presented an increase of saturated and reduction of polyunsaturated (linoleic) acids, while for lysophosphatidylcholine and acylglycerides, the opposite change occurred. The modifications described may produce reduction of membrane fluidity and indicate that lipids participate actively in the adaptation of T. cruzi to the environmental changes produced by aging in culture. PMID- 3514256 TI - Schistosoma mansoni: proteinase activity of "hemoglobinase" from the digestive tract of adult worms. AB - A method of collecting samples from the Schistosoma mansoni digestive tract was used to study proteinase activity. Activity against hemoglobin and a low molecular weight synthetic substrate, carbobenzoxy-arginyl-arginyl-7-amino-4 trifluoromethylcoumarin, was demonstrated in the soluble fraction of material regurgitated by S. mansoni adults and was dependent on the addition of a thiol compound, cysteine, to the assays. Using sodium dodecyl sulfate-polyacrylamide gel electrophoresis and gel filtration chromatography (AcA54), two proteins with estimated mol wt of 32,500 and 28,500 were found in the regurgitant and were associated with proteinase activity against both hemoglobin and the synthetic substrate. Homogenates of intact worms showed greater specific activity (synthetic substrate) in the females. Further, in bisected worms proteinase activity paralleled protein content, suggesting that, once secreted into the lumen, proteinase activity was distributed throughout the worm digestive tract. PMID- 3514257 TI - Trypanosoma cruzi and American Leishmania spp: immunocytochemical localization of a laminin-like protein in the plasma membrane. AB - Patients with Chagas' disease or different clinical forms of American cutaneous leishmaniasis have high antilaminin antibody levels. An immunogold technique employing a specific antilaminin antibody was used in the present study to determine the presence, and define the ultrastructural localization, of laminin like molecule(s) in American Leishmania spp. and Trypanosoma cruzi. Laminin was found located specifically in T. cruzi trypomastigotes on the external surface of the plasma membrane, close to the sites where the flagellar veil attaches to the plasma membrane. Laminin immunoreactivity was rapidly lost when trypomastigotes were cultured in liquid medium and no reactivity was found in fresh epimastigotes. Promastigotes and amastigotes of American Leishmania spp. also showed a specific localization of laminin immunoreactivity, this being limited to the lips of the flagellar pocket and to the parasitic side exactly opposite to the flagellar exit. These results confirm the presence of a laminin-like molecule(s) in both trypanosomatids, the specific localization suggesting a presently unknown function for this protein. PMID- 3514258 TI - Trypanosoma lewisi: stage-specific surface antigens and exoantigens recognized by monoclonal antibodies. AB - The stage-specific expression of surface antigens by Trypanosoma lewisi was investigated using monoclonal antibodies directed against this parasite. Hybridomas secreting monoclonal antibodies were produced by the fusion of SP2/0 Ag 14 mouse plasmacytomas with spleen cells from rats infected previously with the Taliaferro strain of T. lewisi. Additivity enzyme-linked immunosorbent assays and indirect immunofluorescent antibody tests indicated the determinant recognized by monoclonal antibody TL40.3 (IgM) was different from those recognized by monoclonal antibodies TL40.1 (IgA), TL40.2 (IgM), and TL40.6 (IgG2 alpha). Monoclonal antibody TL40.3 agglutinated trypanosomes collected 3 days after parasite inoculation while monoclonal antibodies TL40.1, TL40.2, and TL40.6 agglutinated trypanosomes collected 6 days after inoculation. Since agglutinin titers against trypanosomes from irradiated (700 rad from a 60Co source) and nonirradiated rats were similar, expression of the antigens recognized by the monoclonal antibodies appeared to be independent of the immunological state of the host and the morphology of the parasite. The reproduction of T. lewisi in in vitro trypanostatic assays was inhibited only when the monoclonal antibodies were present in concentrations greater than or equal to those needed to agglutinate the trypanosomes. Monoclonal antibodies TL40.1 and TL40.3, but not TL40.2 and TL40.6, agglutinated erythrocytes collected later in the infection from irradiated, infected rats. None of the monoclonal antibodies agglutinated erythrocytes from nonirradiated, infected rats, from irradiated, noninfected rats or from nonirradiated, noninfected rats. This suggests that immunocompetent rats may make blocking antibodies against the exoantigens recognized by monoclonal antibodies TL40.1 and TL40.3. PMID- 3514259 TI - Ontogeny of the olfactory code. PMID- 3514260 TI - Chemical communication in invertebrates. PMID- 3514262 TI - Neural correlates of odor-guided behaviors. PMID- 3514261 TI - Bacterial chemotaxis and vertebrate olfaction. PMID- 3514264 TI - Chemistry of odor stimuli. AB - The present state of the molecular basis of olfaction is shown. With the aid of various examples the regioselectivity of odor sensation is proven. The main part of the experimentation concerns the stereocontrolled process of odor release. PMID- 3514266 TI - Speculations on receptor cells as analyzers and filters. PMID- 3514265 TI - Theory and methods for odor evaluation. PMID- 3514263 TI - Odor-guided behavior in mammals. AB - The odor-guided behaviors selected for presentation in this paper encompass the major areas of animal behavior, and illustrate the important principal that complex relations exist between odor-guided behaviors, hormonal state, and experiential factors. Clearly, experiences with odors at several life stages results in profound influences upon later behaviors, including those related to eating, mating, fighting, and nesting. Interestingly, only brief social encounters are needed in rats to induce such phenomena as ultrasonic calling to conspecific estrous females or their odors, preferences for estrous over non estrous odors, and the short-term modification of feeding behaviors. Although the mechanisms behind these intriguing phenomena are poorly understood, it is noteworthy that rats can learn relatively complex concepts on the basis of odors, rivaling even the ability of our own species to learn analogous tasks by visual cues. Despite the fact that close relationships can be demonstrated between odor guided behaviors and variables such as endocrine state and sexual experience, caution is warranted in assuming that simple causal relations exist between such variables. In normally cycling women, for example, the correlation between olfactory sensitivity and plasma levels of estradiol during the menstrual cycle is relatively high; however, attenuation of the cyclical estradiol fluctuations by oral contraceptives does not eliminate the olfactory fluctuations, suggesting the relation is not causal. In house mice, social experience can override hormonal factors in their odor-guided urine marking and submissive behaviors. Thus, even though androgen titer usually correlates with such measures, a mouse made subordinant in a social encounter will not exhibit scent marking even when its circulating testosterone is maintained at a high level by a silastic implant. Further reason for caution comes from studies that suggest olfactory input influences the endocrine systems of sexually experienced and sexually inexperienced animals in different ways. For example, in sexually experienced male rats, anosmia decreases testosterone and estradiol levels and increases corticosterone levels, whereas in sexually inexperienced ones it has no significant influence on the levels of these steroids. Taken together, such observations suggest that the causal bases of a number of the odor-guided behaviors described in this paper are complex.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3514267 TI - Studies on the modulation of the desensitization of the pituitary gland by luteinizing hormone-releasing hormone in the ovariectomized rat. AB - In ovariectomized rats the desensitization of the LH cells in vivo, which develops during constant rate infusion of LHRH, 1) does not depend on a concomitant depletion of the pituitary LH stores, 2) proceeds normally when the hypothalamo-pituitary connection has been severed and 3) is a process in which LH itself is not involved. PMID- 3514269 TI - Effect of bilateral nephrectomy on the recovery of blood pressure after acute hemorrhage in rats: role of renin-angiotensin system. AB - The effect of bilateral nephrectomy, and administration of an inhibitor of angiotensin converting enzyme, on the recovery of arterial blood pressure after hemorrhage (loss of 1% of b.wt), was studied in male Sprague-Dawley rats. Neither manoeuver significantly affected the recovery of blood pressure within the first 10 min after hemorrhage. Thereafter, the recovery of the blood pressure was markedly suppressed. The study suggests that the initial recovery of blood pressure is unrelated to the kidneys, but the later one requires their presence and depends on the activity of the renin-angiotensin system. PMID- 3514270 TI - Proteases of Antarctic krill--a new system for effective enzymatic debridement of necrotic ulcerations. AB - The Antarctic krill (Euphausia superba) possesses an "over-dimensioned' digestive system, which is of vital importance for the survival of this euphaucean shrimp in the extreme marine environment. The isolated enzymes contain a well-balanced mixture of both endo- and exopeptidases, assuring fast and complete breakdown of proteinaceous material. These unique properties have now been shown to be extremely valuable for the effective removal of necrotic debris, fibrin or blood crusts in vitro. Therefore the krill enzymes should be considered as an important resource in the future management of necrotic wounds. PMID- 3514271 TI - Why mitochondria need a genome. AB - The evolution of the mitochondrial genome towards the compact organization found in the higher eukaryotes is discussed. It is suggested that the machinery for co translational protein export across the endoplasmic reticulum membrane sets strict limits on the kinds of protein-coding genes that can be successfully transferred from the mitochondrial to the nuclear genome. This hypothesis is in perfect agreement with the pattern of mitochondrially vs nuclearly encoded mitochondrial proteins found in species such as man, mouse, and Xenopus. PMID- 3514268 TI - Progress in molecular parasitology. AB - Substantial progress has been made in the last ten years in understanding the structural and functional organization of parasitic protozoa and helminths and the complex physiological relationships that exist between these organisms and their hosts. By employing the new powerful techniques of biochemistry, molecular biology and immunology the genomic organization in parasites, the molecular basis of parasite's variation in surface antigens and the biosynthesis, processing, transport and membrane anchoring of these and other surface proteins were extensively investigated. Significant advances have also been made in our knowledge of the specific and often peculiar strategies of intermediary metabolism, cell compartmentation, the role of oxygen for parasites and the mechanisms of antiparasitic drug action. Further major fields of interest are currently the complex processes which enables parasites to evade the host's immune defense system and other mechanisms which have resulted in the specific adaptations which enabled parasites to survive within their host environments. Various approaches in molecular and biochemical parasitology and in immunoparasitology have been proven to be of high potential for serodiagnosis, immunoprophylaxis and drug design. PMID- 3514272 TI - Characterization of a new cysteine proteinase inhibitor of human saliva, cystatin SN, which is immunologically related to cystatin S. AB - A new cysteine proteinase inhibitor, cystatin SN, was purified from human whole saliva by chromatography with DE32, Sephacryl S200, and CM-Sepharose CL6B. Cystatin SN is immunologically related to cystatin S and both inhibitors have a similar molecular mass of about 13 kDa. The new inhibitor, however, was clearly distinguished from cystatin S by its much higher pI value. These inhibitors showed similar inhibitory activity for ficin, but cystatin SN was a much better inhibitor for papain and dipeptidyl peptidase I. The amino acid sequence of cystatin SN deduced in the light of the known structure of cystatin S indicates that they have 10 different amino acid residues in the sequence comprising in total 113 residues. PMID- 3514273 TI - Null and electrophoretic mobility mutants in the structural gene for L-lactate dehydrogenase of Saccharomyces cerevisiae. AB - A mutant lacking L-lactate dehydrogenase (EC 1.1.2.3) of Saccharomyces cerevisiae was isolated by its inability to grow on minimal medium with L-lactate as a carbon source. A simple activity gel assay for visualization of this enzyme and the two D-lactate dehydrogenases in this organism (EC 1.1.2.4 and 1.1.1.28) was developed. This enabled us to screen spontaneous and ethylmethanesulfonate induced back mutants for electrophoretic mobility. Two mutants with a mobility faster than that of the wild type were isolated, and proved to be allelic to the L-lactate dehydrogenase negative mutant. PMID- 3514274 TI - Bone marrow harvesting for malignant disease. PMID- 3514275 TI - Omental transposition for recurrent breast carcinoma following limited surgical excision and radiation therapy. AB - Failure to control local disease following limited surgical excision and radiotherapy for primary treatment of breast carcinoma often precludes the use of conventional mastectomy techniques. This series reports the use of mastectomy and omental transposition on a gastroepiploic pedicle and delayed skin grafting in 17 such patients. The transposition of omentum permits removal of neoplastic and secondarily infected tissue including sternum, ribs and chest wall muscles if necessary. Fourteen patients underwent hormonal manipulation and 8 patients chemotherapy before surgical referral, which was often as a last resort for ulcerated and secondarily infected masses. Three patients required concomitant chest wall excision. There was no mortality and no long-term morbidity. Local disease was completely eradicated in 9 patients, although 2 now have distant disease; 4 patients had marked symptomatic improvement despite failure to control local disease and 4 patients had poor results. Dermal lymphatic involvement and failure to resect all macroscopic disease accounted for all of the local failures. Omental transposition can provide a safe, effective and occasionally curative surgical means of dealing with these difficult local recurrences in irradiated breasts. PMID- 3514276 TI - Eponyms in oncology. William Ernest Miles (1869-1947). PMID- 3514277 TI - Physiological role of the intrarenal renin-angiotensin system. Introductory comments. PMID- 3514278 TI - Localization of components of the renin-angiotensin system within the kidney. AB - Evidence accumulates that intrarenal angiotensin II (AngII) plays important roles in the regulation of renal functions. To determine the mechanism and site of the intrarenal formation of AngII, we employed histochemical and cell biological methods. Immunohistochemical studies have revealed the coexistence of renin and AngII in juxtaglomerular (JG) cells, and electron microscopic studies and subcellular organelle fractionation have demonstrated the colocalization of renin and angiotensin in renin granules. The mechanism of this AngII accumulation has been investigated. Immunoreactive angiotensin I (AngI) appeared slowly in JG cells after prolonged administration of angiotensin-converting enzyme (ACE) inhibitors. Cloned and cultured renin-containing cells derived from rat kidney were also found to contain renin, ACE, and AngI and AngII. The subcellular fractionation of renin granules from rat kidney homogenate demonstrated AngI and AngII in the renin granule fractions. These findings suggest the formation of both angiotensins in JG cells. To study the release of AngII, we determined the presence of the angiotensins in renal lymph. Renin was found in renal lymph at a high concentration. Both AngI and AngII were also present in renal lymph in moderate concentrations. It is possible that AngII in the interstitial fluid may play a role in the regulation of renal functions. From these results it has been concluded that AngII is formed in JG cells in the kidney and is secreted with renin into interstitial fluid and plasma, and that AngII formed in the kidney cells may participate in various renal functions. PMID- 3514279 TI - Role of the renin-angiotensin system in tubuloglomerular feedback. AB - The link between the renal tubule and glomerular vasculature comprised of the juxtaglomerular apparatus appears to serve two functions: the regulation of filtration rate and of renin secretion. Elevation of macula densa NaCl concentration stimulates a vasoconstrictor response, which results in a fall in filtration rate, a response that has been termed tubuloglomerular feedback (TGF). Simultaneously, renin secretion is suppressed. The two responses appear to be initiated by a furosemide-sensitive transport step probably located in the macula densa. Both show a pattern of anion specificity identical to Na/K/Cl cotransport mechanisms. An increase in intracellular calcium in the effector cells, the vascular smooth muscle, and the renin-containing granular cells is a likely effector mechanism for both reactions. Angiotensin probably does not mediate the vasoconstrictive feedback response, because changes in local (intracellular) angiotensin concentration would have to be opposite from systemic changes. However, acute changes in angiotensin levels appear to be an important modulator of the magnitude of the TGF response. PMID- 3514280 TI - Regulation of glomerular filtration rate and sodium excretion by angiotensin II. AB - In addition to its extrarenal functions, including the control of arterial pressure and aldosterone secretion, the renin-angiotensin system (RAS) also has multiple intrarenal actions in controlling glomerular filtration rate (GFR) and sodium excretion. Angiotensin II (AngII) helps to prevent excessive decreases in GFR in different physiological and pathophysiological conditions by preferentially constricting the efferent arterioles, an action that can be mediated by either intrarenally formed or circulating AngII. Circulating AngII and intrarenally formed AngII do not appear to directly constrict preglomerular vessels, including the afferent arterioles, when the RAS is activated physiologically. The sodium-retaining action of AngII may be due, in part, to constriction of efferent arterioles and to subsequent changes in peritubular capillary physical forces. However, AngII may also directly stimulate sodium reabsorption in proximal and distal tubules, although the exact site at which AngII increases distal tubular transport is still uncertain. Considerable evidence indicates that the direct intrarenal effects of AngII on tubular reabsorption, including those caused by changes in peritubular capillary physical forces or a direct action on tubular transport, are quantitatively more important than those mediated by changes in aldosterone secretion. Thus, the intrarenal effects of AngII provide a mechanism for stabilizing the GFR and excretion of metabolic waste products while causing sodium and water retention, thereby helping to regulate body fluid volumes and arterial pressure. PMID- 3514281 TI - Effects of angiotensin on proximal tubular reabsorption. AB - Effects of angiotensin II on rat, rabbit, and bovine proximal tubular reabsorption have been demonstrated with a variety of techniques, including in vivo microperfusion, free-flow micropuncture of surface and juxtamedullary nephrons, perfusion of isolated tubules in vitro, and cell culture. Blockade of endogenous angiotensin production in vivo with converting-enzyme inhibition, or of receptors with saralasin, consistently inhibits proximal reabsorption of fluid in both superficial and juxtamedullary proximal tubules. Angiotensin effects on the proximal tubule are not neurally mediated, for they persist in denervated kidneys and are seen in nerve-free isolated tubules. Physiological concentrations of angiotensin (10(-11)-10(-9) M) stimulate electroneutral sodium transport from the basolateral membrane, whereas pharmacological doses (10(-7) M and above) inhibit reabsorption. The stimulatory effects appear to be receptor mediated. In addition to these direct effects of angiotensin on the proximal tubule epithelium, endogenous angiotensin may also alter peritubular physical forces to further enhance proximal reabsorption. These effects of angiotensin may represent an important homeostatic mechanism during states of extracellular fluid volume depletion. PMID- 3514282 TI - Arrest of embryo development by ultrasound coupling gels. PMID- 3514283 TI - Extraction and clean-up of contaminants and toxicants from food for mass spectrometric analysis--a literature review. AB - This report presents a review of the literature on the extraction and clean-up procedures used prior to the analysis, by mass spectrometry, of organic contaminants and toxicants in foods and food-related materials. It includes a brief description of the uses of a mass spectrometer and shows how the mode of operation of the machine can influence the amount of clean-up necessary before a sample is presented for analysis. The review covers a variety of contaminants of different compound types in a wide range of foods and not only discusses sample preparation techniques that have been used for contaminant analysis by mass spectrometry but also considers some that could be used. The most commonly used techniques involve solvent extraction followed by a clean-up using liquid-liquid partition or column chromatography or both, although a number of newer methods being evolved are moving towards the ideal of a single-step extraction and clean up process. PMID- 3514284 TI - An outbreak of Shigellosis sonnei in New Castle County, Delaware. PMID- 3514285 TI - Occupations, migration, sex ratios, and nuptiality in nineteenth century English communities: a model of relationships. AB - Two effects of occupational structure on nuptiality levels are examined: a direct functional effect related to the influence of socioeconomic characteristics on the feasibility and desirability of marriage, and an indirect structural effect related to nuptiality levels via sex selective migration patterns and population sex ratios. Our analysis shows that nuptiality levels in nineteenth century English and Welsh districts were responsive to occupational variation and that both direct and indirect effects were significant. Our results suggest that socioeconomic factors, often overlooked in favor of cultural explanation, must be considered in the analysis of nuptiality. PMID- 3514286 TI - Trimming casts. PMID- 3514287 TI - Sealant retention rates in a community children's dental clinic. PMID- 3514288 TI - Titanium plasma spray screw implant system for reconstruction of the edentulous mandible. AB - The most difficult and complicated group of dental patients to restore to function are those with completely edentulous mandibles. The TPS screw implant system is a predictable, cost-effective means by which patients can be restored in an outpatient setting. The TPS screw system has demonstrated a 94 per cent rate of success in 484 patients with 1739 implants from four countries. PMID- 3514289 TI - ITI endosteal hollow cylinder implant systems. AB - The endosteal hollow cylinder implant systems have been in clinical use for over 10 years. These systems incorporate advanced sophisticated biomaterials and bioengineering design concepts such as the titanium plasma spray (TPS) surface coating as well as the cylindric shape. This shape has now introduced the third dimension to dental implantology. In previous systems, such as the blade-vent, only height and width were present. Therefore, these previous systems could not be used as single-tooth replacements; also, they were not able to withstand lateral forces or torquing. In a series of cases reported from Switzerland, Sweden, Germany, and the United States, 580 hollow cylinder implants were placed for up to 10 years with an overall rate of success of 95.3 per cent. PMID- 3514290 TI - Osseointegrated dental implants. AB - Endosseous implants of commercially pure titanium have been demonstrated to give success rates of more than 90 per cent over 10 years of follow-up. This high level of clinical function depends on an implant direct anchorage in bone without any interposed soft tissue layers and on a reaction-free soft tissue surrounding the abutments. Provided a correct protocol is followed, such osseointegrated dental implants may be looked upon as a routine procedure in the treatment of edentulousness. PMID- 3514291 TI - Biomaterial aspects of calcium phosphates. Properties and applications. AB - Biomaterials composed of calcium phosphate ceramics are receiving increasing attention as potential bone graft substitutes. These substances have proved to be the most biocompatible hard-tissue implant materials discovered. The mechanical and biologic properties of the calcium phosphates, as well as their present and future applications, are discussed. PMID- 3514293 TI - Biomaterial aspects of Interpore-200 porous hydroxyapatite. AB - Interpore-200 is the product of over 11 years of continuous research and development. It has been investigated at over 25 research centers in a wide variety of animal and human implant settings, including alveolar ridge augmentation, periodontics, and orthognathic reconstructions. The biomaterial aspects of Interpore-200 show the following: Interpore-200 has a highly interconnected, three-dimensional porosity that is uniform and consistent. The hydroxyapatite manufactured from marine corals is biocompatible and nontoxic. Interpore-200 is essentially pure hydroxyapatite, with the balance consisting of tricalcium phosphate. Interpore-200 is approximately 55 to 65 per cent porous with nominal pore diameters of 200 micron. Unlike nonporous materials, Interpore 200 is osteoconductive and results, when placed next to a viable bone, in an advancing front of bone into the implant. From 50 to 88 per cent of the porosity within the implant is filled with woven and lamellar bone within 3 months. Moreover, the surfaces of Interpore-200 are intimately bonded with the bone tissue. The biomechanical properties of Interpore-200 blocks are similar to those of a cancellous bone graft. Once ingrown with vascularized bone tissue, the defect site is, in effect, restored. Interpore-200 adequately matches the elastic properties of bone so that stresses necessary to maintain healthy bone are transmitted throughout the regenerated region. Extensive animal and clinical studies have shown that nonporous implants or implants without interconnected porosity can result in aberrant mineralization, stress shielding, low fatigue strength, and bulk displacement. Hydroxyapatite with interconnected porosity like Interpore-200 reacts differently than materials with limited or no porosity. In animals, Interpore-200 exhibits 0 to 5 per cent biodegradation per year. Moreover, this minimal biodegradation is compensated by regeneration of bone. These studies have now been extended for 4 years. Interpore-200 and its ingrown bone are remodeled in response to the same chemical and biomechanical forces that remodel normal bone. Therefore, Interpore-200 responds in accordance to Wolff's law. Having achieved an optimal combination of biomaterial (hydroxyapatite) in an ideal porous structure (replamineform), Interpore-200 fulfills the expectation of early researchers in the basic sciences who demonstrated that an interconnected porous material is better tolerated by the body than the same material in solid form.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3514292 TI - Biomaterials, biocompatibility, and peri-implant considerations. AB - There are series of tests recommended for evaluation of dental implants. These materials and instrumentation coupled with the publications reviewed here that deal with animal experimentation and implant experience in humans provide an outline of data that have made tissue response to dental implants more clearly delineated. However, there are several specific aspects of cellular response that remain to be illuminated and correlated with clinical and radiographic signs. The further study of the interface zone with corresponding characterization of materials will produce the final chapter in the development of this most interesting area of dentistry. As stated, no epithelial attachment to any dental implant post has been comprehensively described that utilizes light and electron microscopy or histochemistry. Rather, a concept of a biologic seal has emerged that delineates the external milieu of the mouth with its microbiota and plaque from the internal milieu of bone and connective tissue, where true osseointegration can and does take place. PMID- 3514294 TI - Prosthetic considerations in reconstructive implantology. AB - Diagnosis and treatment planning are essential prior to the placement of any dental implant. An overview of prosthodontic considerations in the restoration of such implants is presented in this article. Concepts for both the edentulous and partially edentulous mouth are discussed. PMID- 3514295 TI - Endosteal blade-vent implants. AB - At this writing, endosteal blade-vent implants have been used in clinical cases for over 17 years. At the last writing in the Dental Clinics of North America, we had just passed the 10-year mark. Many new systems for preprosthetic reconstructive surgery have gained the attention of the existing implantology community; and new systems have stimulated significant new levels of implant activity in the profession in general. Even with long-term research and clinical documentation with such modalities as the Brannemark, Swiss screw, and hollow cylinders, the blade-vent implant remains in the armamentarium of members of the profession active in implantology. Even with advances in design, no implant system can be placed in the extremely narrow or even knife-edge ridges still encountered in a significant percentage of patients, unless the practitioner is knowledgeable and skillful with (the narrow 1.2 mm buccolingual width of) this implant. I predict that the endosteal blade-vent implant will continue to hold a valued place in the implant field. PMID- 3514296 TI - [Quantitative determination of syphilis-specific antibodies with the 19S IgM FTA ABS test]. PMID- 3514297 TI - Dental history on stamps. PMID- 3514298 TI - Distribution of 2,4-dinitrophenyl groups on the epidermal Langerhans cells of guinea pigs following skin painting with 2,4-dinitrochlorobenzene. AB - It has been postulated that epidermal Langerhans cells (LC) are essential for induction and elicitation of contact sensitivity (CS) to simple chemical allergens. Although the precise role of LC in CS has not been determined, recent reports have focused on a function for LC in the presentation of antigen to T lymphocytes. To investigate this possibility, the distribution of allergen on the epidermal LC of inbred strain 13 guinea pigs was observed by the immunofluorescent method using antibodies against Ia antigen and hapten. 2,4 Dinitrophenyl groups were found to be localized on/in Ia-positive epidermal LC of the animals following skin painting with 2,4-dinitrochlorobenzene. This finding is discussed in relation to the role of LC as antigen presenting cells in CS. PMID- 3514299 TI - Bullous pemphigoid--a scanning electron microscopic study. AB - Skin blisters at different stages were taken from 4 patients with bullous pemphigoid and studied mainly by scanning electron microscopy. The under-surface of the roof of the newly formed blisters was composed of columnar or cuboidal epidermal cells. Their intercellular space was dilated. Most of the cells were degenerated and shed off into the blister fluid. The under-surface of the roof of the fully developed blisters was composed of flattened epidermal cells which were polygonal in shape. These findings suggest that the basal cells are degenerated and shed off into the blister fluid, so that the prickle cells become flattened and directly face the blister fluid during blister formation. PMID- 3514300 TI - Hydrops fetalis associated with inferior vena cava thrombosis. AB - A case of hydrops fetalis associated with inferior vena cava thrombosis is described. Although in the literature this association is always listed, this is the first report of a well-documented case. PMID- 3514301 TI - Computer description and evaluation of cardiotocograms: a review. PMID- 3514302 TI - Use of donor-specific T-cell lines for monitoring of human allograft recipients. I. Demonstration of IgG binding to autologous TCL. AB - Donor-specific and highly cytotoxic T-cell lines (TCL) as well as lectin-induced TCL were established from pretransplant lymphocytes of 6 cadaveric renal allograft recipients. These TCL were used in the 125I-staphylococcus protein A assay to detect IgG antibodies in pre- and posttransplant sera of these patients preferentially binding to autologous donor-specific TCL. Such antibodies were detected in pretransplant sera from 4 of these 6 allograft recipients. Antibody levels in these 4 patients and in 1 additional case who became positive after transplantation further increased during acute cellular rejection episodes. They disappeared after successful treatment but remained elevated until transplantectomy for treatment of irreversible rejection in 1 case. IgG antibodies binding to autologous lectin-induced TCL were detected in only 1 patient and exhibited a pattern clearly different from those binding to donor reactive TCL. Although attempts to define the antigenic specificity of the autoantibodies binding to donor-specific TCL by genetical and biochemical means has remained unsuccessful so far, the demonstration of their relationship to in vivo expansion of donor-reactive immune cells deserves further attention. PMID- 3514303 TI - Effect of temperature on the kinetics of the yeast AMP deaminase. AB - The temperature dependence of the kinetics of the yeast AMP deaminase was examined using the purified enzyme and the permeabilized yeast cells. The increase in the enzyme affinity for the substrate AMP was accompanied by the decrease in the maximal velocity with the decreasing temperature in the absence and presence of ATP. The apparent Km for AMP was lowest at 15-20 degrees C, and the affinity was decreased below and above this temperature. The rate of the AMP deaminase reaction remained constant over a wide range of temperature in the presence of physiological AMP concentrations. The temperature dependent change in kinetic properties of AMP deaminase may contribute to the control of the yeast glycolytic flux under the condition of lower temperature environments. PMID- 3514304 TI - The synthesis and use of oligodeoxynucleotides in plasmid DNA sequencing. AB - A convenient procedure for the synthesis and purification of oligonucleotides is described. 16-base long primers synthesised by this method were used to investigate DNA sequencing using plasmid DNA as a template. This allowed the further analysis of the E. coli glt A sequence coding for citrate synthase and enabled determination of the 5'-non-coding regulatory region of the aminoglycoside phosphotransferase gene. PMID- 3514305 TI - How close is the analogy between the reaction centre of Photosystem II and that of purple bacteria? PMID- 3514306 TI - Functional and structural aspects of photosynthetic water oxidation. PMID- 3514307 TI - Mutagenesis and expression of cloned Rubisco (ribulose-bisphosphate carboxylase). PMID- 3514308 TI - Ribulose-bisphosphate carboxylase manipulation in the hydrogen bacterium Alcaligenes eutrophus. PMID- 3514309 TI - Proteins of the photosynthetic oxygen-evolving system. PMID- 3514310 TI - A long-term study of flurbiprofen in rheumatological disorders: I. Rheumatoid arthritis. AB - Eight hundred and forty-two patients undergoing treatment for rheumatoid arthritis in hospital centres in the United Kingdom were evaluated as part of a long-term, variable dose study of the efficacy and safety of flurbiprofen in 1,396 patients with a variety of rheumatological disorders. Highly significant (p less than 0.001) improvements were evident in morning stiffness, grip strength, joint size, articular index and functional capacity at the end of the 18-month observation period reported here, as was a decrease in pain severity in all sub groups, including those patients entering the study because of lack of effect of their previous therapy. Global assessments by doctor and patient showed highly significant improvements over this time period for both young and older patients, in whom objective improvements were less striking. Sixty-four per cent of side effects reported were gastro-intestinal, CNS side-effects (headache, giddiness) accounting for 14%. The incidence varied according to whether or not concomitant therapy was being prescribed. Side-effects in the elderly were similar in nature to those in younger patients. PMID- 3514311 TI - A long-term study of flurbiprofen in rheumatological disorders: III. Other articular conditions. AB - A total of 336 patients with ankylosing spondylitis, psoriatic arthropathy or miscellaneous articular disorders were evaluated over 12 months as part of an open, out-patient, multicentre study in the United Kingdom of the efficacy and safety of the non-steroidal anti-inflammatory drug (NSAID) flurbiprofen (Froben) in a total of 1,396 patients with a variety of rheumatological disorders. Significant improvements in pain were found for patients in all groups from the second week onwards, for up to 6 months in those with ankylosing spondylitis, and for up to 12 months of treatment for those with psoriatic arthropathy or other articular conditions. Global assessments of progress in patients taking flurbiprofen in the therapeutic range of 150-400 mg daily for a minimum of 6 months were recorded by doctor and patient. Improvement of patients in all groups reached statistical significance after 1 month's treatment and remained significant at 12 months. The incidence of side-effect reporting over-all was 17.2%, being higher in men than in women in the group receiving no concomitant therapy and doubling in patients receiving NSAIDs in addition to flurbiprofen. Side-effects were similar in nature to those of other drugs in this group. PMID- 3514312 TI - The use of furoxone: a perspective. AB - Acute infectious diarrhoea is a widespread cause of morbidity and mortality. Some of the major diarrhoeal diseases are cholera, typhoid fever, shigellosis (bacillary dysentery), salmonellosis, "travellers' diarrhoea", and giardiasis These diseases can be avoided with proper education, sanitation, and hygiene. However, the majority of these diseases occur most frequently in areas of the world where political and social upheaval, poverty, overcrowding, and a lack of education prevail. Although vaccines are available for some of the diseases, they are not completely effective. Antimicrobial therapy is effective in decreasing the duration and severity of diarrhoea and in reducing the likelihood of relapses, complications, and death. An antimicrobial drug for the treatment of acute infectious diarrhoeal disease must be relatively specific, effective, and safe, and it should not promote the development of resistant bacteria. Furazolidone (Furoxone) has been used for 30 years for the specific and symptomatic treatment of bacterial or protozoal diarrhoea and enteritis caused by susceptible organisms. Its effectiveness has often been shown to be comparable or superior to that of other drugs. In addition, the toxicity of furazolidone is relatively low, and it minimizes the development of resistant organisms. These characteristics should contribute to the continued use of furazolidone as a rational choice in the treatment of acute infectious diarrhoeal diseases that occur worldwide. PMID- 3514313 TI - Use of ceftazidime in febrile incidents in immunocompromised haematological patients. AB - Ceftazidime was used in twenty-eight febrile episodes recorded in twenty-two neutropenic patients (eleven of each sex, aged between 15 and 73 years) who were immunologically compromised (nineteen acute leukaemias and three malignant lymphomas treated with cytostatics). Seven pathogens were isolated in six patients (four klebsiella, one proteus, one Escherichia coli and one enterobacter). The clinical response was cure in ten cases, improvement in six, failure in four and unassessable in eight. In this study ceftazidime was as effective as the combinations of antibiotics generally used in these cases and free of adverse events. PMID- 3514314 TI - A long-term study of flurbiprofen in rheumatological disorders: II. Osteoarthrosis. AB - Two hundred and twenty-one patients with osteoarthrosis were evaluated over 18 months in the course of an open, multicentre study in the United Kingdom of the efficacy and safety of the non-steroidal anti-inflammatory drug (NSAID) flurbiprofen (Froben), in which a total of 1,396 patients with a variety of rheumatological disorders took part. Highly significant (p less than 0.001) improvements in pain sources were reported during the first 6 months of treatment, remaining significant for the rest of the 18 months of the study, and a global evaluation of progress made by doctor and patient recorded highly significant improvements by both. Improvement was particularly marked in those who had failed to respond to a previously administered drug, and in the elderly. Side-effects occurred in 21% of those not receiving other NSAIDs concomitantly, and were higher in women than in men who took other drugs at the same time. Side effects were similar in nature to those of other drugs in this group and no correlation in their frequency or severity with the dosage of flurbiprofen was found. PMID- 3514315 TI - In vitro studies of the golden hamster sperm acrosome reaction: completion on the zona pellucida and induction by homologous soluble zonae pellucidae. AB - We have studied the occurrence of the golden hamster sperm acrosome reaction (AR) in vitro during interaction with the oocyte investments: the cumulus cell matrix and the zona pellucida. Hamster sperm were capacitated in a defined medium that does not induce the AR. These spermatozoa were allowed to interact with the ovum vestments, the events of which were recorded using high-speed videomicrography. Frame-by-frame analysis revealed that sperm did not complete the AR in the cumulus cell matrix, but did so on the zona pellucida. Furthermore, a higher percentage of sperm completed the AR on the zona pellucida of cumulus-invested than on cumulus-free eggs. We also investigated the effect of solubilized hamster and mouse zonae pellucidae on the hamster sperm AR. Addition of solubilized hamster zonae to capacitated sperm elicited the AR within 15 min. Solubilized mouse zonae were significantly less effective, indicating that the zona-induced AR in hamster sperm may be species specific. These results suggest that the hamster zona pellucida is an inducer of the AR in the intact or soluble form, and that the majority of spermatozoa traverse the cumulus cell matrix without completing the AR in our in vitro system. PMID- 3514316 TI - Microtubule cycles in oocytes of the surf clam, Spisula solidissima: an immunofluorescence study. AB - Oocytes of the surf clam, Spisula solidissima, underwent germinal vesicle breakdown and two meiotic divisions to give off polar bodies when they were fertilized or parthenogenetically activated with KCl. Fertilized eggs further proceeded to mitosis and cleaved, while parthenogenetically activated eggs remained uncleaved. We examined changes in microtubule-containing structures during meiotic divisions and subsequent mitotic processes by immunofluorescence. A monoclonal anti-tubulin antibody was applied to alcohol-fixed eggs from which the vitelline membrane had been removed by protease digestion. Up to the stage of second polar body formation, the pattern of microtubule organization in the first and second meiotic spindles was identical in both fertilized and parthenogenetically activated eggs. However, while fertilized eggs formed a sperm aster and mitotic spindles later, activated eggs formed only monaster- or ring shaped microtubule-containing structures which underwent cycles of alternating formation and breakdown. Lactoorecin staining of parthenogenetically activated eggs revealed that the chromosome cycle could occur in these eggs, in phase with this microtubule cycle. PMID- 3514318 TI - Mouse blastocysts hatch in vitro by using a trypsin-like proteinase associated with cells of mural trophectoderm. AB - The mammalian blastocyst must hatch from its extracellular coat, or zona pellucida, to implant in the uterus and continue development normally. Results of experiments described here strongly suggest that a proteinase (74K Mr), called "strypsin," is directly involved in hatching of isolated mouse blastocysts in vitro. Strypsin is a trypsin-like proteinase, based on its substrate specificity and sensitivity to inhibitors, that is present in mouse blastocysts and exhibits certain properties characteristic of membrane-associated enzymes. Histochemical and autoradiographic evidence suggests that, prior to hatching of blastocysts, strypsin is found with cells of mural trophectoderm; not with polar trophectoderm or inner cell mass. Following hatching, strypsin is also found associated with empty zonae pellucidae, specifically at the opening through which the embryo emerged. These and other observations suggest that hatching of mouse blastocysts in vitro is initiated by limited proteolysis of the region of zona pellucida overlying mural trophectoderm. PMID- 3514317 TI - Expression and development of phenylethanolamine N-methyltransferase (PNMT) in rat brain stem: studies with glucocorticoids. AB - To study the differentiation of adrenergic (epinephrine-synthesizing) neurons in brain, the initial appearance and ontogeny of phenylethanolamine N methyltransferase (PNMT), a specific marker of the adrenergic phenotype, were studied with immunocytochemistry and catalytic assay. The appearance of immunoreactivity to dopamine beta-hydroxylase (DBH-IR), an enzyme common to the noradrenergic and adrenergic phenotypes, was also studied. DBH-IR was initially observed on embryonic Day 13 (E13) in cells located on the ventrolateral floor and wall of the rhombencephalon. A day later (E14), PNMT-IR cells and PNMT catalytic activity were observed in the rhombencephalon suggesting that, as in the adrenal gland, noradrenergic expression precedes adrenergic expression. The PNMT-IR cells were presumed to be precursors of C1 neurons since they were located in the ventrolateral medulla oblongata. Cells located in the wall of the medulla which appeared to be migrating ventrally to the C1 group also contained PNMT-IR. On E15, cells which had PNMT-IR processes coursing through the germinal zone were observed dorsally near the fourth ventricle. Although the location of the C1 cell group was apparent when PNMT was initially expressed, the dorsal C2 and C3 adrenergic cell groups were not evident until late in gestation on E19. Even in the term embryo there appeared to be PNMT-IR cells which had not yet reached their final destination. On E14 and E15, PNMT-IR cells were also observed on the floor of the pons just rostral to the pontine flexure. However, these were not observed in older embryos, suggesting that transient expression of PNMT occurs in brain, as well as in the periphery. To determine whether glucocorticoids regulate brain PNMT, we examined the effects of altered glucocorticoid levels. In contrast to PNMT in the sympathetic nervous system, PNMT activity in medulla oblongata was not affected in neonates or adults by the decrease in glucocorticoids following adrenalectomy or hypophysectomy. Conversely, elevation of glucocorticoids by hormonal treatment did not alter PNMT in neonates. Notably, however, treatment of pregnant rats with dexamethasone on E18-E21, but not earlier, increased PNMT activity in the fetal brain stem. These observations suggest that PNMT expression and development is regulated by different factors in cells derived from neural crest and tube. PNMT is expressed earlier in brain than in adrenal and sympathetic ganglia. Further, the development of PNMT in the periphery, but not in the brain, is dependent on maintenance of physiological levels of glucocorticoids.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3514319 TI - Altered synthesis of myosin light chains is associated with contractility in cultures of differentiating chick embryo breast muscle. AB - Cultured chick embryo skeletal muscle cells normally synthesize only the embryonic isoform of mysoin. We have found that aneural muscle cultures that become or are provoked into an extremely contractile state will begin to synthesize a pattern of myosin light chains typical of maturing muscle. Immunoblots with neonatal and adult specific monoclonal antibodies did not reveal a corresponding isozyme transition in myosin heavy chain. These results demonstrate a correlation between contractility and the regulation of myosin light chain maturation, and also suggest that the transitions of heavy and light chain synthesis during development do not appear to be under close coordinate regulation. PMID- 3514320 TI - Cell specific loss of polarity-inducing ability by later stage mouse preimplantation embryos. AB - The individual blastomeres of the preimplantation mouse embryo become polarized during the 8-cell stage. Microvilli become restricted to the free surface of the embryo and this region of the membrane shows increased labeling with FITC-Con A and trinitrobenzenesulfonate (TNBS). Previous studies have shown that this polarity develops in response to asymmetric cell-cell contact with stage specific induction competent blastomeres. In the present study, the ability of later stage embryos to induce 8-cell polarization has been investigated. Newly-formed, nonpolar 8-cell stage blastomeres (1/8 cells) were isolated, then aggregated with morulae, inner cell clusters (from morulae), blastocysts, or inner cell masses (ICM) and cultured for 8 hr. Aggregates were then assayed for polarity. The results show a hierarchy of inducing ability, with the ICM and IC cluster possessing greater activity than the morula and polar trophectoderm of the early blastocyst, while the mural trophectoderm shows very little inducing activity. Furthermore, the inducing ability of the polar trophectoderm decreases with complete expansion and hatching of the blastocyst. These results indicate that the ability to induce 8-cell blastomere polarization is retained by the embryo beyond the 8-cell stage and that this ability is lost with further differentiation. PMID- 3514321 TI - Hyaluronic acid bonded to cell-culture surfaces stimulates chondrogenesis in stage 24 limb mesenchyme cell cultures. AB - The influence on the differentiation of stage 24 chick limb mesenchymal cells of hyaluronic acid (HA) covalently bonded onto plastic substrates has been examined. Under control conditions, stage 24 cells express phenotypes related to the initial plating density: When plated at high density (5 X 10(6) cells/35-mm culture dish), these cells express a chondrogenic phenotype collectively visualized as a mound or nodule of cartilage. Cartilage nodules are not found in cultures plated at intermediate or low densities, 2 X 10(6) and 1 X 10(6) cells/35-mm dish, respectively. However, when cells are plated onto HA surfaces, expression of the cartilage phenotype occurs at all three plating densities in roughly comparable frequencies. This increase in cartilage nodule formation does not appear to be due to an increased plating efficiency or increased replication rate. The observed effect is dependent on HA concentration; with an increase in bound HA, an increase in the number of cartilage nodules is observed. Digestion of HA substrates with hyaluronidase abolishes the stimulation in chondrogenesis, while no effect is observed if the HA substrates are treated with either trypsin or alkaline borohydride. No other glycosaminoglycan, except for the HA analog, unsulfated chondroitin, exhibits this unique stimulation of chondrogenic expression. While the rate of radiolabeled sulfate incorporation is dramatically increased with cells plated onto HA substrates, the protein biosynthetic rate, as evidenced by radiolabeled proline incorporation, remains unaffected. This dramatic increase in chondrogenic expression is considered in contrast to the previously reported inhibitory effect of HA substrates on myogenesis. These observations suggest that HA may have a regulatory role in the chondrogenic differentiation of chick limb mesenchymal cells. PMID- 3514322 TI - The limitations to and valid use of C-peptide as a marker of the secretion of insulin. AB - The accuracy with which the secretion rate of insulin can be calculated from peripheral concentrations of C-peptide was investigated in conscious mongrel dogs. Biosynthetic human C-peptide and insulin were infused intraportally and their concentrations measured in the femoral artery. During steady-state infusions of C-peptide, the peripheral concentration changed in proportion to the infusion rate and the metabolic clearance rate (5.2 +/- 0.3 ml/kg/min) remained constant over a wide range of plasma concentrations. Application of a two compartment mathematical model, in which the model parameters were estimated from analysis of C-peptide decay curves after intravenous bolus injections, allowed the intraportal infusion rate of C-peptide to be derived from peripheral C peptide concentrations, even under non-steady-state conditions. Estimates of the intraportal infusion rate based on this model were 102.4 +/- 2.6% of the actual infusion rate as it was increasing and 102.3 +/- 5.5% of this rate as it was falling. The peripheral C-peptide: insulin molar ratio was influenced by the rate at which equimolar intraportal infusions of C-peptide and insulin were changed. The baseline C-peptide: insulin molar ratio (4.1 +/- 0.9) increased to peak values of 8.2 +/- 0.6, 10.3 +/- 2.0, and 14.9 +/- 1.3 when the infusion rate was increased and then decreased rapidly. Peak values of only 5.7 +/- 1.2 were found if the intraportal infusion rate was changed slowly.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3514323 TI - Cell type-specific variability of bacitracin's effects on insulin binding and intracellular accumulation. AB - Bacitracin is known to inhibit proteolytic degradation of insulin and several other peptide hormones. Previous work with isolated rat adipocytes showed that bacitracin blocked insulin degradation by the plasma membrane and, even in the absence of detectable insulin degradation, bacitracin increased insulin binding by decreasing the rate of insulin dissociation. The present study examined the effects of bacitracin on insulin binding and degradation and on levels of intracellular insulin in a variety of cell types. Bacitracin inhibited insulin degradation in all cell types. Maximal inhibition varied from 70% (H4IIEC3 hepatoma cells) to 95% (rat adipocytes); concentrations giving half-maximal inhibition varied from 25 microM (3T3-A31 fibroblasts) to 250 microM (H4IIEC3). Dose-response curves showed three distinctive effects on insulin binding: dose dependent stimulation (rat adipocytes), a biphasic curve with slight stimulation at low doses and inhibition at concentrations greater than 50 microM (human fibroblasts, H4IIEC3, and 3T3-L1 adipocytes), or dose-dependent inhibition of binding (3T3-L1 preadipocytes and 3T3-A31 fibroblasts). The intracellular accumulation of insulin rat adipocytes was not affected by bacitracin but was decreased in all other cell types. These data illustrated type-specific variability in the effects of bacitracin on insulin processing resulting from cellular heterogeneity either in processing insulin or in response to bacitracin, or both, and suggest that insulin binding studies performed in the presence of bacitracin can be biased. PMID- 3514324 TI - Tris(hydroxymethyl)aminomethane inhibits the synthesis and processing of proinsulin in isolated rat pancreatic islets without affecting release of insulin stores. AB - Isolated rat islets of Langerhans were pulse-labeled (5 min, [3H]leucine) and then exposed to 10 or 50 mM tris(hydroxymethyl)aminomethane (Tris) at pH 7.4 during an 85-min chase period. There was a dose-related inhibition of the conversion of labeled proinsulin to insulin by Tris. At 50 mM, Tris also inhibited the release of newly synthesized (labeled) proinsulin and insulin. These inhibitory effects of Tris were almost absent if the islets were exposed to 50 mM Tris during only the last 60 min of the 85-min chase period. Both proinsulin and total islet protein synthesis (as indexed by incorporation of [3H]leucine) were inhibited acutely by 50 mM Tris (5-min exposure); after 85 min of exposure to 50 mM Tris, the inhibition of proinsulin biosynthesis was more marked than that of total islet protein. In contrast to its effects on newly synthesized products, 50 mM Tris failed to inhibit the release of immunoreactive insulin during an 85-min incubation. However, when islets were exposed to 50 mM Tris for a longer period, a partial inhibition of immunoreactive insulin release was observed as from 120 min. Insulin released from islets consists of a mixture of older stored material and of newly synthesized products, the latter being released preferentially. These results are consistent with a selective effect of 50 mM Tris on the production of newly synthesized insulin. During the first 120 min of exposure to Tris, islet reserves of newly synthesized products will be depleted thereby leading to a new, reduced, rate of release of immunoreactive material consisting only of older insulin stores.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3514325 TI - Persistence of polymicrobial abscesses in the poorly controlled diabetic host. AB - Polymicrobial infections are frequently found in soft tissue infections of the lower extremities in diabetic patients. The relative susceptibility to and persistence of soft tissue polymicrobial infections of diabetic and nondiabetic mice using bacteria commonly found in clinical foot infections were studied. Subcutaneous abscesses were induced in three groups of diabetic and nondiabetic mice using: (1) E. coli and enterococcus, (2) enterococcus and Bacteroides fragilis (B. fragilis), and (3) E. coli and B. fragilis. Abscesses were removed at 1 and 2 wk for total colony counts. At 1 wk, there was a significantly greater bacterial growth in the abscesses of the diabetic mice compared with the nondiabetic mice only in the group injected with enterococcus and B. fragilis. There were significantly higher colony counts in the diabetic compared with the nondiabetic mice in all three groups at 2 wk after injection of the bacteria. Two weeks after injection of inocula containing B. fragilis, both in combination with E. coli or enterococcus, all nondiabetic mice had eradicated B. fragilis from the abscesses, but significant numbers of B. fragilis persisted in the abscesses of the diabetic mice. In the diabetic mice, the presence of enterococci was more synergistic for growth of B. fragilis than was the presence of E. coli. These studies demonstrate that the bacteria of polymicrobial soft tissue infections persist for a longer period of time in the diabetic compared with the nondiabetic host. In addition, B. fragilis has increased pathogenicity in the diabetic compared with the nondiabetic host, particularly in the presence of enterococci. PMID- 3514326 TI - Alterations in physiologic functions and in brain monoamine content in streptozocin-diabetic rats. AB - In the present study, we used streptozocin (STZ) to induce diabetes in rats and observed alterations in several physiologic functions and in monoamine content of different brain regions. Rats with STZ diabetes displayed a thermoregulatory deficit in the cold. Both the body temperature and metabolic rate of the diabetic animals were reduced at ambient temperatures below 22 degrees C. These diabetic animals had a higher level of the spontaneous pain threshold, but displayed a reduced sensitivity of analgesic responses to morphine injection. In addition, these diabetic animals had a lower level of spontaneous motor activity, but displayed an increased sensitivity of locomotor stimulant responses to amphetamine administration. Biochemical examination revealed that the diabetic animals had a lower serotonin level in both the hypothalamus and the brainstem without changes in the serotonin levels of the corpus striatum. These diabetic animals also had a lower catecholamine level in the hypothalamus, but a higher catecholamine level in the corpus striatum. The alterations in brain monoamine content and in the above-mentioned physiologic parameters were reversed after insulin replacement therapy. The data suggest that alterations in various autonomic, somatosensory, and motor neural functions of untreated STZ-diabetic rats correlated with a reproducible pattern of monoamine content in various brain regions (a pattern that differed from that observed in healthy control rats), and that both the altered neural function and the altered brain monoamine pattern were reversed after insulin therapy. PMID- 3514327 TI - Defect of the first-phase insulin secretion to glucose stimulation in the perfused pancreas of the nonobese diabetic (NOD) mouse. AB - To investigate the development of impaired insulin secretion in type I diabetes mellitus, the pancreata of ICR and NOD mice (10-50 wk of age) were perfused. According to insulin responses to 30 mM glucose and to 19 mM arginine, we classified the NOD mice into four groups: those having normal insulin secretion to glucose and to arginine similar to that of control ICR mice (group 1); those with a defect in the first-phase insulin secretion to glucose stimulation but with almost normal insulin secretion to arginine, total insulin release to glucose being significantly smaller than that of group 1 (group 2); those having only a small insulin response to either stimulus, but a fasting plasma glucose level still within the normal range (group 3); and those being overtly diabetic, showing no insulin response to either stimulus (group 4). The severity of insulitis and insulin concentration of the pancreas in each group of NOD mice was well correlated with the insulin release from the perfused pancreas. These results indicate that the initial sign of B-cell damage in NOD mice is a defect of the first phase of glucose-induced insulin secretion, which is followed by a total loss of ability to respond to glucose or arginine stimulation. PMID- 3514328 TI - Wound collagen accumulation in obese hyperglycemic mice. AB - We used C57-BL ob/ob mice as a model to study wound healing in type II (adult onset) diabetes. Planimetry was used to assess rate of closure in standard open skin wounds. In agreement with previous subcutaneous wound collagen-accumulation studies, closure was slower in the ob/ob mice. Subcutaneous implants were used to evaluate wound collagen accumulation. Weanling mice have collagen accumulation similar to lean littermates (mean 3.43 micrograms/cm vs. 3.46 micrograms/cm), but the same ob/ob animals had decreased wound collagen (mean 2.39 micrograms/cm vs. 3.02 micrograms/cm, P less than 0.04) when mature. Other ob/ob animals fed a restricted diet (and thus not obese) had normal collagen accumulation at the same age. Neither insulin nor diet restriction restored wound collagen accumulation in phenotypically obese mice. Because collagen accumulation is not improved by measures that control hyperglycemia (insulin and diet restriction) and the defect was seen only in phenotypically obese ob/ob mice, the decreased wound collagen accumulation may be due in part to structural changes in adipose tissue. PMID- 3514329 TI - Effect of insulin and oral glutathione on glutathione levels and superoxide dismutase activities in organs of rats with streptozocin-induced diabetes. AB - The effect of insulin or glutathione treatment on glutathione content of liver and jejunal mucosa and on superoxide dismutase (SOD) activity of liver, kidney, and erythrocytes was investigated in pair-fed animals with streptozocin (STZ) induced diabetes. Diabetes lowered hepatic glutathione concentration, but glutathione concentration of the jejunal mucosa was not affected. Insulin, but not oral glutathione, restored hepatic glutathione concentration to normal levels. Diabetes depressed activity of the cytosolic form of SOD in liver, kidney, and erythrocyte. Treatment of diabetic rats with oral glutathione or intramuscular insulin increased cytosolic SOD activity of renal cortex and liver (but not erythrocytes) to control levels. These results suggest a link between glutathione metabolism and cytosolic SOD activity in diabetes. PMID- 3514330 TI - Immunochemical characterization of anti-islet cell surface monoclonal antibody from nonobese diabetic mice. AB - We have produced a monoclonal antibody 3A4 to the surface of islet cells by fusing spleen lymphocytes from nonobese diabetic (NOD) mice. To identify the molecular weight of specific target antigens reacting with 3A4, 125I-surface labeled In-111 insulinoma cells were solubilized and extracts were absorbed with 3A4, and immunoprecipitates were followed by polyacrylamide gel electrophoresis and autoradiography. 3A4 recognized two major polypeptides with apparent molecular weights of radioactive 64K and inactive 28K. In order to evaluate the antibody-mediated cytotoxic mechanisms of 3A4, complement-dependent antibody mediated cytotoxicity (C'-AMC) and antibody-dependent cellular cytotoxicity (ADCC) were tested using a method of specific 51Cr release. In the study for C' AMC, even over wide ranges of concentration of antibody and rabbit complement, purified 3A4 had no apparent cytotoxic effects on In-111 cells. On the other hand, significant ADCC was observed at an antibody concentration of 10 micrograms/ml and a target:effector cell ratio of 1:40 (P less than 0.01). Finally, the effects of 3A4 on glucose-stimulated insulin release were examined in isolated rat islets. At a glucose concentration of 16.7 mM, 3A4 significantly inhibited the insulin release either in the presence or absence of complement (P less than 0.01). In conclusion, 3A4 could not only bind but also be active to the target cells. Therefore, this monoclonal antibody should be a useful tool to permit a detailed analysis of the pathogenesis of type I diabetes mellitus. PMID- 3514331 TI - Basal glucagon replacement in chronic glucagon deficiency increases insulin resistance. AB - To evaluate the role of glucagon in insulin-mediated glucose metabolism, we studied four men and four women, ranging in age from 30-73 yr (mean +/- SEM, 54 +/- 5) who had undergone complete pancreatic resection for cancer or chronic pancreatitis 16-58 mo previously. The patients had undetectable C-peptide levels and established lack of biologically active 3500 mol wt glucagon. Euglycemic insulin clamp studies were performed with a 40 mU X m-2 X min-1 insulin infusion in the basal, post-absorptive, insulin-withdrawn state, before and during the last 3 h of a 72-h glucagon replacement-dose infusion (1.25 ng X kg-1 X min-1). In four patients, hepatic glucose production was determined by a primed-constant infusion of 3-[3H]glucose. Monocyte insulin-binding studies, pre- and postglucagon, were performed in all patients. The 72-h glucagon infusion, resulting in mean plasma glucagon levels of 124 +/- 7 pg/ml, caused a significant rise in the mean plasma glucose level (249 +/- 8 versus 170 +/- 13 mg/dl preglucagon) and a sixfold increase in mean 24-h glucose excretion. Both with and without glucagon, euglycemic hyperinsulinemia achieved identical and complete suppression of hepatic glucose production. The mean glucose utilization rate (4.70 +/- 0.36 mg X kg-1 X min-1 preglucagon) was significantly decreased by glucagon replacement (3.83 +/- 0.31 mg X kg-1 X min-1, P less than 0.02). Mean glucose clearance was also diminished with glucagon (4.49 +/- 0.32 versus 5.73 +/ 0.45 ml X kg-1 X min-1 preglucagon, P less than 0.02).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3514332 TI - An H-2 alloantiserum preserves beta-cell function in mice made diabetic by low dose streptozocin. AB - The pancreatic beta-cell mass and function in C57BL/KsJ mice is markedly reduced the day after the last injection of five daily injections of a subdiabetogenic, 40 mg/kg, dose of streptozocin (STZ). In this study, we prepared an H-2 alloantiserum by injecting C57BL/6J mice (H-2b) with spleen lymphocytes from C57BL/KsJ (H-2d) mice. The alloantiserum given on five consecutive days, 5 h before each injection of STZ, did not prevent the initial beta-cytotoxic effect of STZ detected by perfusion of the pancreas and subsequent morphometric analysis of in situ dithizone-perfused pancreas. However, 12 days after the first injection of STZ, total insulin release in response to D-glucose, total pancreatic insulin, and pancreatic glucagon was greater in the alloantiserum treated mice compared with controls receiving normal mouse serum. It is concluded that an H-2 alloantiserum may protect the function and amounts of beta-cells remaining after the initial five low-dose STZ injections. PMID- 3514333 TI - Effect of sorbinil on blood-retinal barrier in early diabetic retinopathy. AB - To study the effect of sorbinil on the alteration of the blood-retinal barrier, 32 adult-onset, non-insulin-dependent diabetic patients with minimal or no retinopathy were randomly assigned to receive either oral sorbinil (250 mg once a day) or a placebo for 6 mo. All patients underwent fundus photography, fluorescein angiography, and vitreous fluorophotometry before treatment and at 3 and 6 mo after treatment. Vitreous fluorophotometry data showed that the alteration of the blood-retinal barrier increased significantly less in the sorbinil-treated group compared with the placebo group during the 6-mo study period. Side effects were limited to hypersensitivity reactions, with skin rash and fever, in only 2 of the 16 patients who received the drug. These hypersensitivity reactions disappeared with discontinuation of the medication. Aldose-reductase inhibition may play an important role in stabilization of the blood-retinal barrier in early diabetic retinopathy. PMID- 3514334 TI - Exercise adaptation responses for gastric inhibitory polypeptide (GIP) and insulin in obese children. Possible extra-pancreatic effects. AB - Thirteen obese children and matched controls were fed a mixed meal, and responses were evaluated at fixed intervals for glucose, insulin, and gastric inhibitory polypeptide (GIP). The obese children were evaluated before and within 48 h after completion of a 5-mo exercise training program (ETP). The ETP included three aerobic exercise sessions per week and modest diet restrictions. Caloric expenditure was increased by approximately 300 kcal/exercise session. Weight gain was minimal over the 5 mo. An unexpected increase in GIP response and improved insulin tolerance were recorded for the obese children post-ETP. GIP values were higher (P less than 0.05) at 30 and 60 min and led to a highly significant elevation (P less than 0.01) of the integrated GIP response for post-ETP obese versus both pre-ETP and normal-weight controls. Insulin values were lower (P less than 0.05) at 30 and 60 min and led to a lower integrated insulin response (P less than 0.0585) for post-ETP obese children. However, the obese children continued to secrete more insulin (P less than 0.05) than normal-weight controls. Glucose tolerance, similar for pre-ETP obese subjects and controls, did not change in post-ETP children. Exercise-induced improvement in glucose utilization in these obese children was associated with an increase in GIP secretion. This contrasts with reports that calorie restriction will improve glucose utilization with decreased insulin and GIP secretion. The study demonstrates a previously unreported uncoupling of GIP and insulin secretion and suggests shifts in peripheral tissue sensitivity to insulin-induced glucose uptake. These shifts may, in part, be influenced by GIP. PMID- 3514335 TI - Insulin and C-peptide levels after oral and intravenous glucose. Contribution of enteroinsular axis to insulin secretion. AB - Peripheral venous plasma insulin and C-peptide concentrations were measured in 10 healthy volunteers, given either 100 g glucose orally or sufficient intravenous (i.v.) glucose to produce similar glucose concentrations when measured in arterialized blood. The incremental areas under both the insulin and C-peptide curves were significantly increased after oral as compared with i.v. glucose administration by 229% and 138%, respectively. Arteriovenous plasma glucose differences were higher after oral glucose administration and were positively correlated with plasma insulin concentrations. Plasma gastric inhibitory polypeptide (GIP) and insulin concentrations were measured in seven healthy volunteers given oral glucose loads ranging from 25 to 200 g. Both the magnitude and duration of the GIP and insulin responses after oral glucose ingestion were dose dependent. These results suggest that the main cause of the increase in peripheral insulin levels after large oral carbohydrate loads is augmented insulin secretion rather than reduced hepatic extraction, indicating the possibility that an enteroinsular factor does exist, in accordance with the "incretin" concept. They also emphasize the need to document both arterial and venous glucose concentrations for the correct interpretation of experiments investigating glucose homeostasis. PMID- 3514336 TI - Relation between insulin antibody and complement-fixing islet cell antibody at clinical diagnosis of IDDM. AB - To test the hypothesis that insulin-binding antibodies (IBAs) appearing in the circulation before insulin treatment are markers of beta-cell damage, we studied the prevalence of IBAs and both conventional (IF-ICAs)-and complement (CF-ICAs) fixing cytoplasmic islet cell antibodies in 60 newly diagnosed diabetic children with a mean age of 9.5 yr. Seventeen (28.3%) had an insulin binding exceeding the upper range (2.8%) of that observed in 68 age-matched controls. The IBA-positive subjects were characterized by a younger age of onset [6.2 +/- 4.0 (SD) vs. 10.8 +/- 3.2 yr; P less than 0.001], lower glycosylated hemoglobin A1 levels (14.1 +/- 3.1 vs. 16.0 +/- 3.0%; P less than 0.05), lower serum C-peptide concentrations (0.12 +/- 0.07 vs. 0.20 +/- 0.17 nmol/L; P less than 0.05), and an increased frequency of HLA-Dw4 (9/13 vs. 11/37; P less than 0.05). There was no significant relation between IBAs and serum C-peptide concentrations after age adjustment by multiple regression analysis. Forty-three children (75%) were positive for IF-ICA and 38 (63.3%) for CF-ICA. Twelve IBA-positive diabetics (70.6%) had IF-ICA as well as CF-ICA in their serum. No association could be observed between IBA and either IF-ICA or CF-ICA, however. The results suggest that IBAs developing before diagnosis serve as an indicator of clinical and genetic heterogeneity within IDDM rather than as a marker of autoimmune beta-cell destruction. PMID- 3514337 TI - Epidemiology of gallstones in a German industrial town (Essen) from 1940-1975. AB - The prevalence of gallstones was studied in 11,840 consecutive autopsies from 1940 to 1975 in the University hospitals of Essen. The total prevalence was 20.7%: 13.1% for men and 33.7% for women. The male to female sex ratio is 1:2.6. The crude prevalence for three 12-year periods showed a significant increase from 8.2 to 15% in men and from 25.7 to 36.3% in women (p less than 0.001). A detailed analysis showed that this increase occurred only in the age groups over 60 and was the consequence of the fact that a greater proportion of women over 60 came to autopsy. The age- and sex-specific morbidity ratio was calculated to standardize the data. This demonstrated considerable fluctuations in 3-year periods since 1940. It can be concluded that no real increase in the prevalence of gallstones occurred in the last 30 years. PMID- 3514338 TI - Trophic effect of truncal vagotomy on the rat pancreas. AB - The trophic effect of truncal vagotomy was studied in rats. Three months after vagotomy and pyloroplasty pancreatic weight was significantly increased by 40% (p less than 0.001). Gastric stasis and consecutive distension of the stomach was observed in the majority of vagotomized animals despite pyloroplasty; the trophic effect of vagotomy on the pancreas was most pronounced in animals with severe stomach distension. Basal gastrin levels were increased after truncal vagotomy but did not correlate to gastric stasis and to the hypertrophy and hyperplasia of the exocrine pancreas. Basal pancreatic polypeptide hexapeptide levels were not altered after vagotomy. Morphometric studies on the endocrine pancreatic tissue showed that the relative volume density decreased due to the increase in exocrine tissue. However, the total islet cell mass remained constant. It is concluded that chronic truncal vagotomy has a trophic effect on the exocrine but not on the endocrine pancreas; additional factors besides gastrin seem to be responsible for this. PMID- 3514339 TI - Geranylgeranylacetone, a novel anti-ulcer drug, stimulates mucus synthesis and secretion in rat gastric cultured cells. AB - Aim of this study was to investigate the effect of geranylgeranylacetone (GGA) on mucus synthesis and secretion in rat gastric cultured cells, and their relationship to prostaglandin (PG) synthesis. Rate of mucus synthesis was estimated by incorporation of 3H-glucosamine into the cultured cells. Release of 3H-glucosamine from the cells, which were preincubated in the medium containing the radioactive isotope, into the culture media was measured for the evaluation of mucus secretion. PG production by the cultured cells was measured by radioimmunoassay. GGA increased glycoprotein synthesis in a dose-dependent manner (p less than 0.01). Secretion of mucus from cultured cells was also significantly enhanced by GGA. GGA did not significantly increase PG (E2 and I2) production. These results indicate that GGA has the ability to stimulate mucus production by the gastric epithelial cells, and this action may play an important role in protective effect of GGA. It is, however, unlikely that this effect of GGA is mediated by endogenous PGs. PMID- 3514341 TI - Islet cell antibodies and the development of diabetes mellitus in relation to mumps infection and mumps vaccination. AB - Islet cell antibodies were investigated in 127 non-diabetic children after mumps infection and in four out of seven children who developed diabetes mellitus shortly after active mumps vaccination. Twenty-one of the children who had mumps and all four vaccinated children who were tested had islet cell cytoplasmic antibodies. In contrast, islet cell surface antibodies were detected in 43 out of 68 patients with mumps infection and in 32 out of 44 patients with other viral diseases. All but one mumps-infected child and all the other viral infected patients investigated did not develop diabetes mellitus. The mumps-infected ICA positive children did not show those HLA-frequencies associated with Type 1 diabetes. PMID- 3514340 TI - Diabetes in pregnancy 1985. AB - The art of obstetrics is not a subject which is often discussed in the pages of Diabetologia. However, as the care of the diabetic mother and her offspring is rightly an interdisciplinary responsibility between obstetrician, diabetologist and neonatologist, it is important that each has a close understanding of the various problems. Dr. M.I. Drury (Dublin), speaking as an internist, raises a question on the optimum time and method of delivery of the baby; this has more than purely obstetrical implications. Drs. L. Molsted-Pedersen (Copenhagen) and C. Kuhl (Copenhagen and Klampenborg), obstetrician and internist from the longest established joint obstetric/diabetic service in the world, present a Scandinavian view on the management of pregnancy. Both centres have distinguished records in the management of diabetic pregnancy. The different viewpoints in Denmark and in Ireland are clear - in Copenhagen, therapeutic abortion is practiced in a pregnancy at risk of severe congenital malformation; in Dublin it is not. Dr. Drury quotes a perinatal loss of 13 of 285 pregnancies (4.5%) in the past 5 years, but does not include the recognised spontaneous abortions which, on his overall figures, are about 10% of conceptions. Dr. Molsted-Pedersen reports a perinatal loss of 3 of 201 infants (1.5%), excluding 17 spontaneous and 9 induced abortions. If these 9 aborted pregnancies, which were performed due to a risk of severe congenital malformation, were included as fatalities, the Copenhagen figure would be 12 of 210 (5.5%). Of course, we do not know if all those 9 fetuses were affected. The spontaneous abortion rate was 17 of 223 (8.0%).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3514342 TI - Glucose tolerance in siblings of type 1 diabetic patients: relationship to HLA status. AB - In this report, we present an analysis of glucose and insulin responses during oral glucose tolerance tests in 369 siblings of Type 1 diabetic patients. All have been HLA typed at the A, B and C loci. Though most had normal glucose tolerance by National Diabetes Data Group criteria (92% of the males and 95% of the females), siblings who shared both HLA haplotypes with the diabetic patient in the family had higher mean 3-hour glucose areas than those who shared one or neither HLA haplotype (p less than 0.01). This difference was more marked in males and older siblings. Insulin concentrations did not differ significantly between the two groups except that, for those aged less than 16 years, the group sharing both haplotypes had lower fasting insulin concentrations (p = 0.05); for 16-29 year olds, the corresponding group had marginally higher 3-hour insulin areas than the remainder of siblings (p = 0.17). Little association with specific haplotypes (A1B8 or A2B15) was seen. Multivariate analyses, adjusting for age and obesity, eliminated the 3-h glucose difference in females by HLA sharing status (p = 0.37) although in males it remained significant (p less than 0.001). Failure to account for age, sex and obesity may explain some of the conflicts in the reported literature. The glucose tolerance differences seen by HLA haplotype sharing status did not correlate with the presence of anti-islet cell antibodies. These results are consistent with the hypothesis that the HLA identical siblings, particularly males, have different (i.e. worse) glucose tolerance than their haploidentical and non-HLA identical siblings. PMID- 3514343 TI - Reduced incretin effect in type 2 (non-insulin-dependent) diabetes. AB - Integrated incremental immunoreactive insulin and connecting peptide responses to an oral glucose load of 50 g and an "isoglycaemic" intravenous glucose infusion, respectively, were measured in 14 Type 2 (non-insulin-dependent) diabetic patients and 8 age- and weight-matched metabolically healthy control subjects. Differences between responses to oral and intravenous glucose administration are attributed to factors other than glucose itself (incretin effect). Despite higher glucose increases, immunoreactive insulin and connecting peptide responses after oral glucose were delayed in diabetic patients. Integrated responses were not significantly different between both groups. However, during "isoglycaemic" intravenous infusion, insulin and connecting peptide responses were greater in diabetic patients than in control subjects as a consequence of the higher glycaemic stimulus. The contribution of incretin factors to total insulin responses was 72.8 +/- 6.9% (100% = response to oral load) in control subjects and 36.0 +/- 8.8% in diabetic patients (p less than or equal to 0.05). The contribution to connecting peptide responses was 58.4 +/- 7.6% in control subjects and 7.6 +/- 14.5% (p less than or equal to 0.05) in diabetic patients. Ratios of integrated insulin to connecting peptide responses suggest a reduced (hepatic) insulin extraction in control subjects after oral as compared to intravenous glucose. This was not the case in diabetic patients. Immunoreactive gastric inhibitory polypeptide responses were not different between control subjects and diabetic patients.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3514344 TI - Affinity-purified human interleukin I is cytotoxic to isolated islets of Langerhans. AB - Addition of highly purified human Interleukin-1 to the culture medium of isolated rat islets of Langerhans for 6 days led to 88% inhibition of glucose-induced insulin-release, reduction of islet contents of insulin and glucagon to 31% and 8% respectively, and disintegration of the islets. These effects were dose dependent and reproducible when using three different Interleukin-1 preparations. Highly purified human Interleukin-2, Lymphotoxin, Leucocyte Migration Inhibitory Factor and Macrophage Migration Inhibitory Factor were ineffective. These findings suggest that Interleukin-1 may play an important role in the molecular mechanisms underlying autoimmune B-cell destruction leading to Type 1 (insulin dependent) diabetes mellitus. PMID- 3514345 TI - Direct metabolic effects of gastric inhibitory polypeptide (GIP): dissociation at physiological levels of effects on insulin-stimulated fatty acid and glucose incorporation in rat adipose tissue. PMID- 3514346 TI - Review of hay fever. 1. Historical background and mechanisms. AB - This is the first of two review articles about hay fever. The historical background of hay fever, including 'rose fever' in the fifteenth and sixteenth centuries, and the discovery of immunoglobulin E is described. The second section deals with the botanical aspects, aerobiology, climate and topography and geographical differences. Next, the prevalence of hay fever in the community, its natural history and age--sex incidence are considered. The influence of hereditary factors, time of birth and the relationship of hay fever to asthma are also dealt with. The role of the relevant aeroallergen, pollen characteristics and chemistry and allergen exposure lead logically to a description of our current understanding of the type 1 immune reaction. The second article will deal with clinical features, diagnosis and investigation, and treatment. PMID- 3514347 TI - [Pancreatic cystadenoma: diagnostic value of ultrasonics and x-ray computed tomography]. AB - We report six cases of pancreatic cystadenoma (three mucinous cysts, three microcystic adenomas). All patients were women. The mean age at the time of diagnosis was 50 years (with a range from 24 to 70 years). The mean age of patients having mucinous cysts (36.6 years) was lower than that of patients having microcystic adenomas (63.3 years). Abdominal pain was the first symptom in five patients. A palpable abdominal mass was found in three cases. The type of the tumor was demonstrated by ultrasonography and computed tomography and was confirmed by laparotomy in five cases. The tumors involved the body and tail of the pancreas. A distal pancreatectomy was performed in five cases, with a splenectomy in four cases. The post-operative course was uneventful. One patient was not operated. The histological examination of the three mucinous cysts showed benign tumors. This study emphasizes the usefulness of ultrasonography and computed tomography for the diagnosis of pancreatic cystadenomas. Surgical therapy is mandatory for mucinous cysts because of their potential malignancy, but a careful follow-up might be proposed for poor-risk patients having a microcyst adenoma, since this tumor is benign. PMID- 3514348 TI - [Irregular hepatic steatosis. Clinical and imaging study of 6 cases]. AB - Irregular fatty infiltration of the liver is an entity that may be confused with liver metastasis. Since ultrasonography and computed tomography of the liver are frequently performed, it seems to be a relatively commonly encountered lesion. The features of this syndrome are described herein in six patients in whom a liver biopsy confirmed diagnosis. Clinical and biological findings were non specific. In 3 cases ultrasound examination of the liver showed increased echogenic areas. In 3 cases of large lesions, the remaining normal liver was seen as areas of decreased echogenicity and the fatty infiltration was considered falsely normal. The scanographic features of this entity were much more typical than those seen on ultrasonography. With CT, irregular fatty liver usually has a distinctive appearance characterized by a non-spherical shape, absence of mass effect and a density close to water (3 cases). When the fatty lesions are focal (3 cases) and less characteristic on CT, liver biopsy should be performed to confirm the diagnosis. Repeated CT examinations can demonstrate partial or total resolution of the lesions when conditions known to be associated with fatty liver have been treated. PMID- 3514349 TI - [Ultrasonics in the monitoring of portasystemic anastomoses]. AB - Mortality due to recurrent variceal esophageal bleeding secondary to portosystemic shunt thrombosis is high. Early diagnosis of shunt thrombosis is therefore necessary. For these reasons, patients who have undergone a portal diversion must be controlled periodically. To this end, frequent controls, using reliable, riskless and inexpensive methods are needed. In this work, 34 patients who underwent different types of portal systemic shunts were studied by ultrasonography. Diagnosis by ultrasonography (confirmed by radiography showing esophageal varices and sometimes by arteriography) was positive with direct vision of the anastomosis in 65 p. 100 of cases and with indirect signs of patency or thrombosis of the anastomosis in 32 p. 100 of cases. This method failed to conclude in 3 p. 100 of our cases. PMID- 3514350 TI - [Consequences of cholecystectomy (2)]. PMID- 3514351 TI - [Cystic lymphangioma of the lesser omentum: diagnostic value of ultrasonics]. PMID- 3514352 TI - Childhood Menetrier's disease: four new cases and discussion of the literature. AB - Four cases of childhood Menetrier's disease are presented and their clinical and laboratory findings are compared with the other childhood cases reported in the literature. Children with Menetrier's disease usually present with abdominal pain or nausea and vomiting associated with peripheral edema, ascites, or pleural effusion; these symptoms are due to gastrointestinal protein loss and resultant hypoproteinemia. There is no evidence of urinary protein loss. The favorable clinical course as well as distinctive laboratory and roentgenologic findings distinguish this entity from other causes of these symptoms. Supportive therapy is normally all that is required since the symptoms resolve spontaneously in weeks to months. Surgery may be needed in rare cases of active gastrointestinal hemorrhage. PMID- 3514353 TI - Diagnostic value of ultrasound in duodenal stenosis. AB - Radiology and endoscopy are usually used to diagnose stenosis of the duodenum, but the cause of the stenosis may still escape detection. Three pathologic processes--multiple duodenal polyps, duodenal wall cysts, and annular pancreas- are presented to demonstrate how ultrasound, under specific conditions, can provide decisive diagnostic information. The cause of the stenosis may be made accessible to sonographic study through administration of oral fluids and intravenous hyoscin-n-butylbromid (Buscopan). PMID- 3514354 TI - Ultrasound study of adenopathies within the hepatoduodenal ligament: the "rosebud" pattern. AB - In about 10% of lymphopathies with extensive retroperitoneal adenopathies, adenopathies are also encountered within the hepatoduodenal ligament. When large, such adenopathies, which surround the portal vein, hepatic artery, and bile duct, give rise to a particular ultrasound pattern: the "rosebud pattern." PMID- 3514355 TI - "Skip areas" in hepatic steatosis: a sonographic-angiographic study. AB - "Skip areas" in focal steatosis describes a newly proposed "subsegmental type" of focal steatosis, which differs in both extent and topography from the more classic "lobar or segmental type" of focal steatosis. In the subsegmental type of steatosis, fatty infiltration can be considered homogeneous throughout the liver, with the exception of small flattened portions of less affected parenchyma, called "skip areas." These regions are mainly located in the subcapsular areas or along the interlobar fissures or the gallbladder bed. Observations using ultrasound in vivo, as well as on postmortem in vitro angiograms, suggest that both the extent and topography of these skip areas can be explained by local differences in vascular anatomy. PMID- 3514356 TI - Aneurysm of the proper hepatic artery as a rare source of upper gastrointestinal bleeding. AB - The rare case of the penetration of a partially thrombosed aneurysm into the duodenal bulb causing acute upper gastrointestinal bleeding is described. Besides angiography and CT, ultrasound is the method of choice for early detection. In any case of upper gastrointestinal bleeding of unclear origin the existence of an arteriointestinal fistula should be included in the differential diagnosis. PMID- 3514357 TI - Ultrasound detection of choledocholithiasis: prospective comparison with ERCP in the postcholecystectomy patient. AB - The role of ultrasound as a screening test for choledocholithiasis was prospectively assessed by comparing the results of upper abdominal ultrasound with direct cholangiography in 59 unselected symptomatic postcholecystectomy patients. Ultrasound detected duct stones in 13 of 29 patients (sensitivity, 45%) and their absence in 29 of 30 (specificity, 97%). A positive ultrasound diagnosis of choledocholithiasis was correct 13 times out of 14 (predictive value, 93%) whereas a negative diagnosis was correct on only 29 of 45 occasions (predictive value, 64%). No significant learning effect was seen. Intestinal gas obscuring the distal common duct was the most important factor limiting the ability of ultrasound to detect duct stones. Duct stones were present in 25 of 35 patients shown to have a dilated common duct on ultrasound, and in 4 of 24 with nondilated ducts; the predictive value of duct dilatation at ultrasound for duct stones was therefore 71% and that of nondilatation in excluding stones was 83%. Dilated intrahepatic bile ducts were demonstrated at ultrasound in only 17% of patients with choledocholithiasis. We conclude that ultrasound cannot reliably diagnose or exclude bile duct stones and is an inadequate screening test for the symptomatic postcholecystectomy patient. PMID- 3514358 TI - Fine-needle aspiration biopsy of bowel lesions under ultrasound guidance: indications and results. AB - Twenty-four patients with bowel lesions that could be imaged on a sonogram underwent ultrasound-guided fine-needle aspiration biopsy. Indications for biopsy included: poor condition of the patient precluding the use of barium studies and/or endoscopy (9 cases) or hindering technically adequate examinations (3); nonspecific radiographic images (6); inability to obtain an adequate biopsy sample during endoscopy (6). The results of biopsy were correct in the 18 cases proven by surgery or autopsy; in the remaining 6 patients, histologic results were considered conclusive, and were later confirmed by clinical, radiographic, and ultrasound follow-up. Fine-needle aspiration biopsy may be considered a simple, rapid, and accurate diagnostic procedure when an alternative approach to the study of gastrointestinal tract lesions is needed. PMID- 3514359 TI - Western blot analysis of intestinal secretory immunoglobulin A response to Campylobacter jejuni antigens in patients with naturally acquired Campylobacter enteritis. AB - Secretory immunoglobulin A (sIgA) response at the intestinal mucosa is a primary defense against enteric infections. We sought to determine which antigens of Campylobacter jejuni outer membranes elicited sIgA responses in 8 patients with naturally acquired Campylobacter enteritis using Western blot analysis of fecal extracts. Naturally acquired Campylobacter infection elicited an sIgA response in 7 of 8 patients. Of these 7 patients, 5 had Campylobacter-specific sIgA titers of 1:16 and two had titers of 1:64. The C. jejuni antigens eliciting sIgA production varied, but 5 of 8 patients exhibited reactions to a 63-kilodalton flagellar antigen, and 7 of 8 patients had a reaction with a 58- and a 44-kilodalton antigen of C. jejuni and Campylobacter coli. Reaction with a 14.5- and a 97 kilodalton antigen was observed with the only stool that contained gross blood and mucus. Reactions with Campylobacter antigens were not detected in the fecal extracts of 5 healthy individuals. Identification of the antigens of C. jejuni that elicit an sIgA response may help us to better understand the immunology of Campylobacter enteritis and to identify antigens that are important in vaccine development. PMID- 3514360 TI - Regional enteritis: historical perspective (B. Crohn and L. Ginzburg). PMID- 3514361 TI - [Chlamydia trachomatis infection in a patient with condylomata acuminata]. AB - Chlamydia trachomatis cervical infection was observed in a 19-year-old woman with genital condylomata acuminata. To isolate C.trachomatis, cycloheximide-treated McCoy cells and a culture-independent monoclonal antibody were used. In addition, a single-antigen immunofluorescence test was made to determine the chlamydia antibody titer. Condylomata acuminata are induced by human papillomaviruses (HPV), predominantly types 6 and 11. This case shows that simultaneous genital infection of C.trachomatis and HPV requires special attention. PMID- 3514362 TI - [Pelvi-trainer, a training device in operative pelviscopy for teaching endoscopic ligation and suture technics]. AB - Unlike in laparotomy, the art of pelviscopic surgery cannot be learned through assisting. For this reason, a training dummy, called a Pelvi-Trainer, has been developed. With this device, all surgical measures occurring in abdominal surgery can be simulated, such as adhesiolysis, internal ligature, internal sutures, resection, adnexectomy, enucleation of myomas, etc. The Pelvi-Trainer, designed for a three-stage plan, allows one to become gradually acquainted with the field of endoscopic surgery, and to make the transition from binocular vision to perfect three-dimensional control over intra-abdominal surgery under monocular endoscopic vision. PMID- 3514363 TI - [Local metronidazole and PVP-iodine prevention before abdominal and vaginal hysterectomy]. AB - One day before abdominal or vaginal hysterectomy 37 patients received a vaginal suppository of (I) metronidazol (200 mg) (II) PVP-iodine or (III) a placebo. Microbiologic analysis was performed before application and three or four days post surgery. No differences between the three groups were observed regarding bacterial status and postoperative morbidity. Occurrence of postoperative infections did not decrease as a result of the local treatment and dosage as described. PMID- 3514364 TI - [Ultrasonic diagnosis of a fetal lung cyst]. AB - The authors report on prenatal sonographic diagnosis of a large congenital solitary bronchiogenic pulmonary cyst in the 21st week of pregnancy. The cyst became progressively smaller during the further pregnancy course. After delivery on term the bronchial cyst was removed by surgery. The infant has since developed without any abnormal findings. PMID- 3514365 TI - [Prenatal sonographic diagnosis of a cystic coccygeal teratoma with retroperitoneal extension]. AB - The most common teratoma of th newborn is the sacrococcygeal, which contains tissues of all three germinal layers. It is located over and under the sacrum or the coccyx and may extend in front of the sacrum into the retroperitoneal region. The teratoma can lead to compression of the ureters with resultant hydronephrosis or to obstruction of the rectum. The most important complication is the malignant change which usually occurs between the fourth month and the third year. Because of the complications early diagnosis of the teratoma is necessary and extirpation should be carried out as soon as possible. The present paper reports on the sonographic findings in a sacrococcygeal teratoma with retroperitoneal extension at 37 weeks gestation. The aetiology and pathogenesis of this malformation and the clinical findings are discussed. PMID- 3514366 TI - [Labor induction with 3 mg of prostaglandin E2 vaginal tablets. A renaissance of programmed labor? Results of a prospective randomized study]. AB - Vaginal application of tablets containing prostaglandin at term in pregnant women with a favorable cervical score is a very efficacious method of induction of labour. Due to the motility of the women they consider this method of induction as almost natural. We, therefore, aimed at discussing the optimal procedure in low-risk pregnancies at due date, by means of a prospective randomised trial. In 345 women with a favourable cervical score, labour was either induced by means of intravaginal application of tablets containing PGE2 according to a precise plan, or spontaneous onset of labour was awaited while CTG-controls were performed on an outpatient basis every second day until the 42nd week of pregnancy was completed. 80 per cent of the nulliparas and 96.3 per cent of the multiparas of the induction group delivered within 24 hours of the first tablet application. All pertinent delivery intervals were significantly shorter in this group compared to those women where spontaneous onset of labour was awaited. The incidence of prolonged labour was low in both groups and not significantly different. Only 4.2 per cent of the women in the group where spontaneous labour was awaited, reached the completed 42nd week of pregnancy. Only one woman had to be induced because of a suspicious CTG. The rate of operative deliveries was lower in the induction group (1.1% versus 3.8% Caesarean sections). With the exception of one foetal death due to a cord complication three days after the due date the foetal outcome was excellent in both groups. The acceptance of the procedure was tested by means of a questionnaire during the post partum period.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3514367 TI - [Experiences with the Shirodkar-McDonald cerclage in the treatment of cervix insufficiency]. AB - A clinical-statistical study of 1040 pregnancies after cerclage between 1965 and 1982. Over the same period 28,033 births were registered. Frequency of cerclage was 3.7%. Of 1682 pregnancies in the same patients without cerclage, 47.3% of the children survived, while of the 1040 pregnancies with cerclage, 92% of the children survived. The rate of abortion sank from 44% to 5.8%, the frequency of premature birth from 17.6% to 13.1%. The mothers' course of pregnancy, delivery and puerperium were normal. The relative frequency of Caesarean sections and vacuum extractions was slightly lower than that of the whole group. An attempt is made to ascribe the high success rate of 92% to the following facts: that in 75.4% of the cases, these were prophylactic cerclages; that in all cases the bladder was displaced; that, on the day of surgery, nearly all patients received a tocolytic slow drip infusion as prophylaxis; and that the low mortality rate (10.5%) among premature infants is due to excellent collaboration with the intensive care ward for premature infants in the same hospital. As regards indication, surgical techniques, antenatal counselling and management of delivery, the homogeneity of the group observed over this 17-year period is presumably another positive factor. PMID- 3514368 TI - [Multicenter experiences with the intracervical administration of a new PGE2 gel in labor induction]. AB - With the participation of four Swiss obstetric clinics, medically indicated inductions of birth (with living fetuses) were performed using a new, stable PGE2 gel, and documented according to a uniform protocol. The study was conducted to investigate the efficacy of 0.5 mg of PGE2, in 2.5 ml of a vehicle (Triacetin) not yet commercially available, for local cervical maturation (n = 41). Thirty nine patients selected by prospective randomization, in whom birth was induced conventionally, served as a control group. The efficiency of the prostaglandin gel alone or respectively with additional administration of oxytocin was evaluated on the basis of the clear changes in the cervical findings observed within 12 or respectively 24 hours, the spontaneous births, or, in the case of cesarean deliveries, according to the pelvic score. Application of PGE2 alone led to impressive changes of the cervix score and, in 34 of the 41 cases, to regular contractions after an average time of 87 minutes. After 12 hours, prior to administration of oxytocin, 43% of the patients were already delivered. The combination of locally applied PGE2 gel with conventional oxytocin induction significantly increases the number of successful inductions. The percentage of unsuccessfully attempted inductions was reduced to 24% in the PGE2 gel group as compared to 44% in the control group. PMID- 3514369 TI - [Prognostic significance of biochemical and sonographic findings in hemorrhage in early pregnancy]. AB - In order to classify events of bleeding in early pregnancy (7th-16th week of pregnancy), an ultrasonic examination was carried out on 72 pregnant women, as well as tests establishing the HCG-secretion in the early morning urine and the progesterone level in the serum before commencing hormone therapy. The collected medical evidence was compared with standard curves. In order to test its prognostic validity, it was related to the termination of the pregnancy. In cases of miscarriage, the placenta was examined histologically and the progesterone level decrease registered over 48 hours. In 34 women, the pregnancy ended with a birth; in 26 (76.5%) of these cases the progesterone values were with the normal area. The HCG-secretion was normal in 25 (74.3%) patients. The sonographic classification indicated an intact pregnancy in every case. In 38 cases the pregnancy was disturbed. In this group of patients, the progesterone level in 36 cases (94.8%) and the HCG values in 27 patients (71.1%) were below the normal. Signs of life were absent in 37 pregnancies (97.4%) in the ultrasonic examination. By virtue of the statistical evaluation of this data, a high reliability can be attributed to the sonographic evidence with regard to the correct prognosis for bleeding in early pregnancy. PMID- 3514370 TI - Biochemical analyses of the crustacean hyperglycemic hormone of the crayfish Astacus leptodactylus. AB - A biochemical analysis was made of the crustacean hyperglycemic hormone (CHH) of the crayfish Astacus leptodactylus, as present in the CHH-producing perikarya, in the axonal tract and in the sinus gland, respectively. Hyperglycemic material was analyzed by polyacrylamide gel electrophoresis (PAGE and SDS-PAGE) and high pressure liquid chromatography (HPLC) in combination with a dotting immunobinding assay (DIA) and a bioassay for hyperglycemic activity. After electrophoretic analyses, the predominant biologically as well as immunologically detectable product present in all parts of the cell has an apparent molecular radius of approximately 7000 Da. In the perikarya extract, a second factor with lower electrophoretic mobility was found, which may represent the prohormone or precursor of CHH. The analyses by means of HPLC showed two predominant immunopositive peaks with an elution time of 28-29 and 52-54 min, respectively. For both HPLC peaks, electrophoretic analyses indicate a molecular weight of 7000 Da. PMID- 3514371 TI - Multiple forms of gonadotropin-releasing hormone in amphibian brains. AB - Several forms of gonadotropin-releasing hormone (GnRH)-like molecules were found in brains of both anurans (frogs) and urodeles (salamanders). The presence of the mammalian-like GnRH molecule was confirmed by HPLC and cross-reactivity studies. Small amounts of salmonid-like GnRH molecules in the brains of frogs (Rana pipiens, Hyla regilla) and salamanders (Taricha granulosa, Ambystoma gracile) were detected by comparing the HPLC chromatographic pattern and immunological reactivity of the brain extracts with native trout and synthetic salmon GnRH. This nonmammalian form of GnRH in the amphibian brain is similar and perhaps identical, at least by indirect evidence, to a form of GnRH reported earlier to be in sympathetic ganglion, retina, chromaffin tissue, and tadpole brain. If two of the amphibian GnRH molecules prove to be mammalian and salmon GnRH, then it is likely that two separate genes in amphibians code for the distinct primary structures of the molecules. The most parsimonious interpretation of the presence of both mammalian- and salmon-like GnRH in anurans and urodeles is that a common phylogenetic ancestor also possessed the two forms of GnRH. Thus the mammalian form of GnRH may well have been present in labyrinthodont amphibians. Independent of evolutionary origin, the functions of the different GnRH molecules in amphibians are unknown. PMID- 3514372 TI - Frameshift suppression in aminoacyl-tRNA limited cells. AB - Under certain conditions aminoacyl-tRNA limitation can phenotypically suppress frameshift alleles. The observed suppression is due to an increase in abnormal translocation of ribosomes translating codons that have a short supply of aminoacyl-tRNA. The rIIB frameshift alleles of bacteriophage T4 are used here to pinpoint the sites of ribosome frameshifting caused by these hypothetical decoding errors. The data indicate that not all hungry codons are associated with abnormal translocation, only a relatively small subset. Analysis of the hungry codons which are associated with ribosome frameshifting points to the existence of severe context effects determining the shiftiness of these codons. PMID- 3514373 TI - Suppressors of SNF2 mutations restore invertase derepression and cause temperature-sensitive lethality in yeast. AB - Mutations in the SNF2 gene of Saccharomyces cerevisiae prevent derepression of the SUC2 (invertase) gene, and other glucose-repressible genes, in response to glucose deprivation. We have isolated 25 partial phenotypic revertants of a snf2 mutant that are able to derepress secreted invertase. These revertants all carried suppressor mutations at a single locus, designated SSN20 (suppressor of snf2). Alleles with dominant, partially dominant and recessive suppressor phenotypes were recovered, but all were only partial suppressors of snf2, reversing the defect in invertase synthesis but not other defects. All alleles also caused recessive, temperature-sensitive lethality and a recessive defect in galactose utilization, regardless of the SNF2 genotype. No significant effect on SUC2 expression was detected in a wild-type (SNF2) genetic background. The ssn20 mutations also suppressed the defects in invertase derepression caused by snf5 and snf6 mutations, and selection for invertase-producing revertants of snf5 mutants yielded only additional ssn20 alleles. These findings suggest that the roles of the SNF2, SNF5 and SNF6 genes in regulation of SUC2 are functionally related and that SSN20 plays a role in expression of a variety of yeast genes. PMID- 3514374 TI - [The role of natural selection in evolution]. AB - To evaluate properly a role of natural selection, its effect should be considered in relation to different phases of the evolutionary cycle postulated earlier by the author. At the first stage of the cycle natural selection is directed towards organism's persistence to detrimental external factors and leads to an increased fitness (that is viability and fecundity) in every generation. At the next stage of the cycle natural selection occurs under conditions of intraspecific competition and is directed towards a more efficient utilization of food resources. At this stage natural selection leads to formation and divergence of intraspecific races and is carried out by "single" selection actions occurring now and then and consisting of the survival of rare mutants with an altered ecological potential. Such a strict selection for certain mutants occurs again during the periods of acute competition for food, the selected mutants being characterized by a decrease of fitness, the latter to have been restored by means of the "ordinary" selection within the intervals between crises. According to the model suggested, homozygotes for "detrimental" recessive alleles could be selected in diploids, as the mutants mentioned with altered ecological potential. At the end of the cycle, there is a kind of selection for hybrids in which ecological potential of specialized intraspecific races is combined. The genetic drift is considered as an inevitable consequence of the postulated mechanism of natural selection. PMID- 3514375 TI - [Nuclear-mitochondrial interactions in yeasts: mitochondrial mutations compensating the respiration deficiency of sup1 and sup2 mutants]. AB - An approach to the study of nuclear-mitochondrial interactions is reported. A number of spontaneous mutations compensating the respiratory deficiency in nuclear ribosomal suppressor mutants sup1 and sup2 were obtained and analysed. Among mutations analysed, mitochondrial as well as nuclear ones were found. Mitochondrial mutations neutralizing the expression of nuclear mutations were identified using the cytoduction test and their meiotic inheritance. The interaction of these mutations with sup1 and sup2 mutations resulting in restoration of respiratory competence was gene and allele nonspecific. Earlier we proposed that the respiratory deficiency of sup1 and sup2 mutants reflects the participation of sup1 and sup2 proteins not only in cytoplasmic, but also in mitochondrial translation. The interactions revealed open up the possibility of experimental examination of this hypothesis by means of identification of mitochondrial genes bearing compensating mutations. PMID- 3514376 TI - [Induction of mutations in Streptomyces antibioticus]. AB - Mutagenic action of UV-light, nitrosoguanidine and nitrosomethylbiuret was studied in Streptomyces antibioticus VNIIA 1607. Nitrosomethylbiuret appeared to be most effective inducer of auxotrophic mutations (mutation frequency reached 15%). By means of hybridological analysis, it was shown that heterokaryons predominated in the progeny of mixed cultures of multiply marked strains. The test for functional allelism using heterokaryons permitted us to divide 93 independently obtained mutations into 28 complementation groups. PMID- 3514377 TI - [Genetic analysis of the mutant RD-50 in Saccharomyces cerevisiae. The role of nuclear and mitochondrial mutation]. AB - Inheritance of the mutant phenotype of respiratory deficience in RD-50 strain was studied. The deficience can be restored, giving respiratory sufficience, in crosses with rho0 testers. The "restorable" phenotype of the mutant, named RDc+, was shown to be determined by a nuclear pet-like mutation (pet50). The restorable RDc+ phenotype is stabilized in the presence of the pet50 allele, but can remain as such in the presence of the wild-type allele PET50. Restoration also takes place in cytoductants with the nucleus of kar partner. In order to explain the behaviour of the mitochondrial mutation mit50, we suppose it to be a microdeletion, capable of reversion, due to integration of a putative mt episome. Some features of the nuclear mutation pet50, particularly, its segregation in mitotic progeny of some revertants to respiratory competence point to its peculiarity. We suppose the mutation pet50 to be an insertion into the chromosomal PET50 gene. This insertion may be excised, remaining within the cell in the free state for some time, and then either eliminate or reintegrate into the chromosome. PMID- 3514378 TI - Specificities of IncF plasmid conjugation genes. PMID- 3514379 TI - Geriatric hypertension: aggressive therapy and its physiologic rationale. AB - At any given age, the chance of experiencing a cardiovascular event within the next 5 years increases with the levels of systolic and diastolic BP. Carefully administered antihypertensive therapy has the potential for decreasing the morbidity and mortality of large numbers of elderly patients who have diastolic or mixed hypertension. PMID- 3514381 TI - [Epidemiological health service for child and adolescent hygiene in the Ukraine during the period of the elimination of the health consequences of World War II (1946-1950)]. PMID- 3514380 TI - Office techniques to maintain the health of aging patients. AB - The fecal occult blood test is safe and inexpensive; however, diet, medications, desiccation of the sample, and delay in developing the specimen may affect results. If the test is used, six separate samples, two from each of three consecutive bowel movements, should be examined to obtain optimum results. Serum cholesterol need not be assessed routinely in geriatric patients. Dietary restriction of fats is a necessity only in the context of a weight reduction diet. PMID- 3514382 TI - [Fedor Grigor'evich Krotkov (on his 90th birthday)]. PMID- 3514383 TI - [Fedor Grigor'evich Krotkov--the facets of talent (on his 90th birthday)]. PMID- 3514384 TI - [Detection of the causative agents of typhoid and paratyphoid fevers in dairy products by the mobile growth method]. PMID- 3514385 TI - [Deficiencies in the method for the sanitary bacteriological analysis of chlorinated tap water]. PMID- 3514386 TI - [Surgical treatment of resistant forms of ventricular tachycardia]. PMID- 3514387 TI - Human Peyer's patches: an immunohistochemical study. AB - We have used immunoperoxidase techniques to characterise the Peyer's patches in human terminal ileum. The mantle zones of the B cell follicles in human Peyer's patches were surrounded by B cells which did not express surface IgD but which mostly expressed surface immunoglobulin of the IgM and/or IgA1 isotype. Few cells expressing surface IgG or IgA2 were detected. Cells with cytoplasmic immunoglobulin of all isotypes except IgD were present in the dome regions of the Peyer's patches as well as in the lamina propria. There was little evidence of traffic of immunoglobulin synthesising cells across the high endothelial venules. T cells were seen to surround the lymphoid follicles. They were most concentrated on the serosal aspect around the high endothelial venules. Cells with macrophage like morphology were present in both the lamina propria and the dome region of the follicles; those in the lamina propria containing lysozyme and those in the dome region S100 protein. The results are discussed in relation to the generation and dissemination of antibody producing cells in human gut. PMID- 3514389 TI - Analysis of clinical trials in gynecologic cancer--timing and interpretation. AB - When and how often a clinical trial is analyzed is as important as the use of appropriate methodology. Premature analysis may result in inaccurate estimation of tumor response and adverse effects as well as misrepresentation of survival. Moreover, bias may be introduced or the study may be abandoned entirely. Of parallel importance to the timing is the emphasis given to the analyses. If a randomized comparative trial of two regimens is conducted and a significant therapeutic effect is not discerned, the study is generally classified as a negative study. This view is oversimplified; the negative conclusion drawn must have a much more limited scope than is generally appreciated. Lastly, the pitfalls of interpreting time variable curves such as survival are of special note. Quite often the "tails" of the curves totally belie the true implications of the analysis. PMID- 3514388 TI - Effect of clindamycin on the ability of a continuous culture of colonic bacteria to ferment carbohydrate. AB - A continuous culture model of the proximal colon was used to study the effect of clindamycin on the ability of colonic bacteria to ferment carbohydrate. Six steady state anaerobic cultures of human faeces, in a medium simulating ileostomy effluent, were treated with 26 micrograms/ml clindamycin. They were paired with six untreated cultures, run under identical conditions. Clindamycin treatment eliminated the anaerobic bacteria, significantly decreased osmolality and the output of volatile fatty acids, particularly propionic acid and increased the residual carbohydrate concentration. Doubling the amount of carbohydrate in the medium increased osmolality and the production of volatile fatty acid, though the response of clindamycin treated cultures was less than that of untreated cultures. Attempts to introduce Clostridium difficile into three pairs of cultures were successful in only two cultures after administration with clindamycin and when a heavy inoculum (10(6)-10(9) organisms) had been used. PMID- 3514390 TI - Biochemical and immunohistochemical studies on carcinoembryonic antigen of ovarian mucinous and serous tumors. AB - The carcinoembryonic antigen (CEA) in the cyst fluid of ovarian mucinous and serous tumors was investigated. The molecular weight and antigenicity of the CEA from both ovarian tumors were very similar to those of colon cancer CEA as determined by SDS electrophoresis and double immunodiffusion on agar plates. In the cyst fluid of ovarian mucinous tumors, the amount of CEA was generally high and CEA of molecular weight (MW) 200,000 was increased. In contrast, in the cyst fluid of ovarian serous tumors, the CEA amount was low and CEA variants of MW 370,000 and 180,000 were present in addition to the main CEA of MW 200,000. Immunohistochemically, CEA was stained mainly in the intestinal type epithelium of ovarian mucinous tumors, and the CEA revealed a tendency to be stained more frequently and strongly with increasing degree of tumor malignancy. Thus, ovarian mucinous tumors (especially the intestinal type epithelium) produced large amounts of CEA which closely resembled colon cancer CEA, whereas ovarian serous tumors produced small amounts of CEA, including some CEA variants. In the study of ovarian epithelial tumors, CEA may be useful as a marker for the malignant transformation of ovarian mucinous tumors. PMID- 3514391 TI - Ovarian tumor antigens: preliminary histological investigation. AB - The immunoglobulin IgG was isolated from the immune complexes obtained from the ascitic fluids of patients with ovarian serous cystadenocarcinoma. The IgG isolates did not react in immunoperoxidase staining of normal ovarian, fallopian tube, or endocervical tissue. In contrast, the IgG isolates did react in immunoperoxidase staining of autologous and allogeneic ovarian cancer tissue. However, the staining was variable in terms of areas of positivity and was completely absent in some serial sections. This variability was also evident in control sections of an ovarian mucinous cystadenocarcinoma that was positive for the carcinoembryonic antigen. In addition, it appears that serous and mucinous ovarian cancers may share common antigenic determinants. These results demonstrate the antigenic heterogenous nature of ovarian cancer. PMID- 3514392 TI - Cesarean section: a controversial feature of modern obstetric practice. AB - Cesarean section (CS) has been an integral part of modern obstetrics during the last decades. As safety has increased, so too has the range of problems that CS is used to solve, to a degree that it must cause medical concern. There is a great danger in the blind faith that CS is the only way out in every difficult obstetric situation. The problem can always be easily solved by CS in an acute difficult obstetrical situation. However, CS is a major abdominal surgery and it may present any complication that besets major surgery including severe intraoperative and postoperative complications, a much greater risk for maternal death compared to vaginal delivery and also late complications, i.e. secondary involuntary infertility. Therefore, CS should never be undertaken lightly and without serious consideration of the justifications, preparations and all ancillary support. PMID- 3514393 TI - Ultrasound increases the prognostic value of the postcoital test. AB - The prognostic value of the postcoital (PC) test was studied in two groups of women in whom the infertility workup differed only in the way the PC test was timed. Fifty patients were investigated in a traditional way. In this group the PC test failed to have any substantial prognostic value. In a second group consisting of 54 patients, the PC test was timed applying ultrasonographic criteria for ovarian follicular development. This resulted in a highly significant prognostic test. Timing of the PC test by ultrasound enhanced both the reliability and the efficacy of the standard fertility investigation. PMID- 3514394 TI - [Combined insulin and sulfonylurea treatment in diabetes mellitus]. PMID- 3514395 TI - [Kawasaki's disease--a new infectious disease?]. PMID- 3514396 TI - [Pharmacological studies on the pressor response in adrenal-enucleated rats]. AB - Physiological role of the adrenal medulla was evaluated in the rat with special reference to the age. The adrenal medulla of Wistar-Imamichi male and female rats was enucleated (AdMx) or sham-operated at 3 or 12 weeks of age. Blood pressure was determined by the tail-cuff method. Systolic blood pressure in immature- and adult-AdMx rats increased progressively 5 approximately 6 weeks after the operation. Plasma renin activities in the AdMx male and female rats tended to be lower than those in controls. There was no significant difference in the pressor response to 50 micrograms/kg l-adrenaline (s.c.) between control and AdMx groups. Isoproterenol induced a greater decrease in blood pressure in immature AdMx rats. Administration of 200 micrograms/kg tyramine resulted in a marked increase in blood pressure in the immature AdMx males and in a less marked response in adult AdMx and sham-operated rats. In 24 hr-reserpinized immature AdMx male rats, blood pressure was maintained at approximately 110 mmHg, and tyramine induced a slight increase in the blood pressure. In immaure control male rats, blood pressure showed a decrease to 80 mmHg 24 hr after reserpinization, and no response to tyramine was evident. The results indicated that the lack of an adrenal medulla from the prepuberal age, particularly in male rats, develops alterations in the regulatory system of peripheral noradrenaline release. PMID- 3514397 TI - Development of nitrosourea-induced brain tumours--with a special note on changes occurring during latency. AB - Nitrosourea compounds fulfil the requirements of ideal carcinogens, in that they produce a high incidence of tumours selectively and consistently in the nervous system, they induce neoplasms that have morphological and biological similarities to naturally occurring neural tumours in man and animals and they represent an environmental hazard. N-Ethyl-N-nitrosourea (ENU) has a preferential transplacental and neonatal action, a single intravenous or intraperitoneal injection inducing an almost 100% incidence of neural neoplasms. Transplacental carcinogenesis by ENU provides an ideal experimental model in which the sequential development of brain tumours can be studied. Investigations of the early stages of brain carcinogenesis induced by transplacentally administered ENU have shown that: (1) the earliest histologically detectable changes appear in 8 wk-old animals and are composed of stem cells; (2) these early lesions are frequently multiple and become larger with increasing age; (3) they are not distributed at random, but occur in areas in which tumours develop later; (4) the carcinogens endow the cells, even only 2 days after exposure, with a malignant potential which may subsequently become manifest either in vivo or in culture; (5) half-way through latency, malignant cells are present in the brain; (6) the emergence of the malignant phenotype in cultured brain cells is a stepwise process which culminates in the concomitant appearance of tumorigenicity and invasiveness. PMID- 3514398 TI - Brain tumours in man. AB - Brain tumours occur at all ages but they differ in type depending upon the age of the patient. In adults, probably more than 50% of tumours in the brain are metastatic carcinomas or melanomas. The pathological classification of primary brain tumours depends largely upon the cell type involved. Recently, immunocytochemical identification of cell-specific proteins by the use of polyclonal or monoclonal antibodies has greatly enhanced the accuracy of cell identification within tumours. Primary brain tumours in children arise mainly in the brain stem and cerebellum and are astrocytomas, primitive neuroectodermal tumours (medulloblastomas) and ependymomas. Gliomas form the largest group of primary brain tumours in adults, with an annual incidence of 3.94/100,000 in Southern England. In young adults, well differentiated astrocytomas and oligodendrogliomas arise in the cerebral hemispheres. Poorly differentiated, malignant glial tumours include anaplastic astrocytomas and glioblastoma multiforme; these tumours are most common in older adults with a peak annual incidence of 7.3/100,000 in the sixth decade. The major complication of brain tumours is due to their mass effect from tumour growth and from peritumoral oedema. Surgical excision of gliomas is difficult and usually incomplete due to the infiltrative nature of the tumour. As yet these tumours respond poorly to irradiation and chemotherapy. PMID- 3514399 TI - Le Double's study of muscle variations of the human body. Part II: Muscle variations of the foot. PMID- 3514400 TI - The history of child abuse. AB - Though the child abuse syndrome is usually considered to have been first described in the middle of the present century, references to child abuse occur throughout history and in the 19th century, detailed descriptions were published in the French medical literature. PMID- 3514401 TI - Childhood accident prevention strategies. AB - Accidental injuries remain the most common cause of death in young people after 1 year of age, with no changes in overall statistics noted in the past two decades. Automobile accidents are the most frequent cause of serious injury in children and young adults, especially infants under the age of one and people from 15 to 24 years. Various approaches to preventing accidental injuries are now being assessed. The most successful approaches identified to date have been legislative, with slight impact usually found for education endeavors. PMID- 3514402 TI - [Prevention and therapy of sports injuries. Experiences with an escin-containing gel]. PMID- 3514403 TI - [Therapeutic local anesthesia in rheumatic diseases. Open multi-center study of a lidocaine local anesthetic]. PMID- 3514404 TI - [Degeneration theory in psychiatry]. AB - Degeneration (called "degenerescence" in French and "Degenerationslehre" in German terminology) as a theory of human retrogression manifested by degenerative signs in individuals, was a major factor in medicine and especially in psychiatry during the second half to the 19th century and at the beginning of the 20th century. Theories of retrogression seemed to supply conclusive hypothetic explanatory models for a wide variety of deviations from so-called "standard" values of health criteria for neurological diseases, brain disorders and mental diseases. The theory of degeneration, or retrogression, was closely interlinked with the complex ideological pattern that formed the background of philosophy and natural science during the nineteenth century. The theory of degeneration experienced mutual interaction and stimulation by the interplay with various other theories that were "en vogue" at that time, such as the development of positivistic natural science and of the theory of evolution, which in turn gave birth to the theories of social Darwinism, eugenics, genetics and to the development of biological-vitalistic approaches. In contrast with the other fields of medicine, anatomic pathology was unable to uncover any aetiological linkups for the various types of mental diseases. Hence, the theories of degeneration seemed to offer a conclusive concept for the genesis of mental disorders. The concept of degeneration was based on the theory of polymorphism which in turn positioned the wide range of neurological, mental and brain diseases within the descending series of progressing degeneration. PMID- 3514405 TI - To Kate Ireland--in loving celebration of her first 35 years at FNS. PMID- 3514406 TI - Differential distribution of hepatitis B core and E antigens in hepatocytes: analysis by monoclonal antibodies. AB - Current knowledge on the expression of HBeAg in hepatocytes is incomplete because of difficulties in obtaining monospecific antisera devoid of anti-HBc reactivity. In this study, we have examined by immunofluorescence the expression of HBcAg and HBeAg in cryostat liver sections from 25 chronic carriers of HBsAg using monoclonal antibodies. Although virtually all liver biopsies displayed concordance for HBeAg and HBcAg expression, the pattern of fluorescence differed markedly. Thus, monoclonal anti-HBc gave nuclear staining in all 13 reactive biopsies, while cytoplasmic staining was observed in only two of these. In contrast, monoclonal anti-HBe showed cytoplasmic reactivity coexisting with nuclear reactivity in 10 of 13 reactive biopsies. Hepatitis B virus DNA polymerase activity in the serum appeared to correlate better with the presence of HBcAg in hepatocytes rather than HBeAg. These results provide further evidence that HBeAg is expressed both in the nuclei and in the cytoplasm of infected hepatocytes. The observation that the number of cells expressing HBeAg exceeds those expressing HBcAg in carriers with active virus replication would suggest that assembly of core particles occurs in only a proportion of infected hepatocytes expressing HBeAg. PMID- 3514407 TI - Cell types involved in collagen and fibronectin production in normal and fibrotic human liver. AB - Three collagen types (I, III and IV) and fibronectin were localized in normal and alcoholic human liver by light and electron microscopy using the indirect immunoperoxidase technique. In normal liver, most of the bundles of collagen fibers stained for type pro-III collagen while only a few reacted for type I. Basement membranes stained for type IV collagen which formed discontinuous discrete deposits in sinusoids. Only fibronectin appeared as an almost continuous layer in the space of Disse. At the intracellular level, hepatocytes were found to contain little type I collagen and large amounts of fibronectin. Fat-storing cells strongly stained for type IV collagen and expressed low amounts of types I and III collagen and fibronectin. Endothelial cells contained low amounts of all the components. Alcoholic livers were studied at three stages: steatosis, fibrosis and cirrhosis. Qualitative and quantitative differences were observed in extracellular and intracellular distributions of matrix proteins. Increased amounts of all components were usually found in fibrotic and cirrhotic livers compared to normal liver. In two fibrotic livers which contained numerous bundles of collagen in the sinusoids, fat-storing cells stained more intensely for type III collagen. In a cryptogenic fibrotic liver, abundant type IV collagen was observed in hepatocytes. These results suggest that hepatocytes, fat-storing cells and endothelial cells are engaged in production of extracellular matrix components in normal human liver. In fibrosis, hepatocytes which normally did not synthesize types III and IV collagen may produce these collagens. PMID- 3514408 TI - Is the acidity of ascitic fluid a reliable index in making the presumptive diagnosis of spontaneous bacterial peritonitis? AB - Ascitic fluid pH and arterial-ascitic fluid pH gradient were compared to ascitic fluid polymorphonuclear cell count in 84 patients with cirrhotic ascites and in 12 with malignant ascites to assess their role as diagnostic tests for spontaneous bacterial peritonitis and to clarify the relationship between ascitic fluid pH and lactate. Ascitic fluid pH was significantly lower (pH 7.30) in spontaneous bacterial peritonitis (n = 18) and probable spontaneous bacterial peritonitis (n = 12) than in sterile ascites (pH 7.41; n = 54). Since blood pH levels were not different in the presence of infection, arterial-ascitic fluid pH gradient was significantly higher in spontaneous bacterial peritonitis and probable spontaneous bacterial peritonitis than in sterile ascites (0.12 vs. 0.02). The close correlations between arterial-ascitic pH gradient and lactate (r = 0.77, p less than 0.0001), lactate and bicarbonate gradient (r = 0.64, p = 0.003) and arterial-ascitic pH gradient and pCO2 gradient (r = -0.90, p less than 0.0001) suggest that the low ascitic fluid pH may be due to an increase in lactate and CO2. Patients with Escherichia coli-induced spontaneous bacterial peritonitis had significantly lower ascitic fluid pH and higher lactate than those with spontaneous bacterial peritonitis by other organisms. Values of ascitic fluid pH, lactate and arterial-ascitic fluid pH gradient in malignant ascites were similar to those of spontaneous bacterial peritonitis and probable spontaneous bacterial peritonitis. Cutoff points, selected by receiver operating characteristic curves analysis, of 450 per mm3 for polymorphonuclear cells and of 0.07 for arterial-ascitic fluid pH gradient, allow high positive and negative predictive values for spontaneous bacterial peritonitis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3514409 TI - Transmission of hepatitis B from providers to patients: how big is the risk? PMID- 3514410 TI - CAH or SLE? PMID- 3514411 TI - Dendritic reticulum cells in reactive lymph nodes and tonsils: an immunohistological study. AB - There has recently been much interest in the patterns of follicular dendritic reticulum cells (DRC) in pathological lymph nodes, particularly in relation to the phenomenon of DRC break-up (thought to be pathognomonic of AIDS-related lymphadenopathies) and to progressive transformation of germinal centres (as a possible precursor of lymphocyte predominant Hodgkin's disease). In the present study we have immunostained twenty-nine reactive lymph nodes and five tonsils with monoclonal antibody R4/23 (DAKO-DRC) in order to evaluate the frequency of such changes in lymphoid tissue unaffected by AIDS or Hodgkin's disease. Most of the specimens contained typical secondary follicles with clearly defined germinal centres and mantle zones. There were two variants in lymph nodes showing follicular hyperplasia characterized by (i) progressive transformation of germinal centres and (ii) inclusions of nests of small lymphocytes within germinal centres. In each of these types of follicles the compact evenly distributed meshwork of DRCs, as previously described, was seen. However there were considerable variations in DRC meshwork in each category (the pattern could not be predicted from the morphology) with examples in all three of the DRC break up previously considered specific for the AIDS related lymphadenopathy. Since none of the lymph nodes and tonsils studied had any known relationship to either Hodgkin's disease or AIDS it is argued that none of the changes in the DRC meshwork observed are specific for these conditions. PMID- 3514412 TI - Studies of early invasive and intraepithelial squamous cell carcinomas using an antibody to type IV collagen. AB - Using a monoclonal antibody that is specific for type IV collagen we have examined examples of actinically damaged skin, intraepithelial carcinomas and squamous cell carcinomas of varying degrees of differentiation for abnormalities in the basement membrane. In examples of intraepithelial carcinoma and the occasional early invasive carcinoma a residual type IV collagen framework is suggestive of tumour regression. Production of type IV collagen by some tumours supports the view that squamous cell carcinomas do not apparently require to destroy this basement membrane component in order to invade or to metastasize. PMID- 3514414 TI - Gangliorhabdomyosarcoma: a histopathological and immunohistochemical study of three cases. AB - A histopathological and immunoperoxidase study on three cases of genitourinary gangliorhabdomyosarcoma using a spectrum of conventional staining methods and antibodies against myoglobin, neuron-specific enolase and S-100 protein is presented. The results of the study have shown that differentiated myoblasts, ganglion cells and Schwann cells reacted positively with the particular antisera, but the majority of undifferentiated cells were negative. From the immunopathology results it was not possible to determine whether the undifferentiated cells were precursors of neural cells or myoblasts; the histological appearance resembled that of mesenchymal cells commonly seen in rhabdomyosarcomas. Theories concerning the origin of these tumours from neural crest ectomesenchyme or from neural crest and somitic mesenchyme are considered. Further study is needed to establish their histogenesis. PMID- 3514413 TI - Immunocytochemical detection of basement membrane antigens in the histopathological evaluation of laryngeal dysplasia and neoplasia. AB - Immunocytochemical detection of intrinsic components of the basement membrane (type IV collagen and laminin) was performed in biopsies of carcinoma in situ, dysplasia and hyperplasia of the laryngeal mucosa. We found a distinct and continuous basement membrane, containing both laminin and type IV collagen, at the border between epithelial cells and mesenchymal stroma in normal as well as in hyperplastic and dysplastic mucosa. In contrast, irregular discontinuities were found in some cases of carcinoma in situ and in invasive carcinoma. In addition, immunoreactivity for intracytoplasmic basement membrane components was noticed occasionally in neoplastic epithelial cells. In areas of inflammation, infiltration of leucocytes into the epithelium was occasionally accompanied by sharply defined small interruptions of the basement membrane. Our results indicate that immunohistochemical detection of basement membrane components can be of value for the demonstration of microinvasive growth in laryngeal cancer. PMID- 3514415 TI - Sexual dimorphism and gonadal control of ultrasonic vocalizations in adult pine voles, Microtus pinetorum. AB - We investigated the vocalizations produced by adult pine voles during various social interactions by presenting an experimental animal with either an anesthetized or awake (unanesthetized) conspecific. Ultrasonic vocalizations (USVs) occurred frequently during tests in which an awake male was present, but were rarely detected in tests involving only awake females, or when a female was presented with an anesthetized conspecific. Higher rates of USVs were produced when males were tested with a familiar female than when tested with an unfamiliar male or female. Equivalent rates were produced when males were presented with either anesthetized or awake animals, but female-soiled bedding failed to elicit USVs from males. Sonic vocalizations (SVs) were produced by both sexes and were associated with aggressive behavior, but occurred only in tests between awake, unfamiliar animals. Castration greatly reduced and testosterone therapy restored USVs emitted by males in response to anesthetized conspecifics. Our results suggest that (i) USVs are emitted predominantly by males; (ii) familiarity enhances USV response; (iii) SVs are produced during aggressive interactions; and (iv) androgens regulate the production of USVs by males. Possible roles for pine vole vocalizations are discussed. PMID- 3514417 TI - Medicaid caught in deficit-reduction battle. PMID- 3514416 TI - Altered endocrine and behavioral responses with reproductive aging in the male Japanese quail. AB - Experiments were conducted to further characterize the age-related decline in reproductive capability previously described in the male Japanese quail. Behavioral testing of a large number of males in several age groups confirmed earlier results that showed a significant reduction in courtship and mating behavior by 80 weeks of age. Intact males, 78 weeks of age, that showed no reproductive behavior were given Silastic implants containing testosterone. This treatment restored behavior in 80% of the males. Gonadal regression induced by exposure to shortened photoperiod followed by transfer to a stimulatory photoperiod did not successfully restore the endocrine or behavioral components of reproduction. Males of two age groups, 42 and 208 weeks of age, were categorized as behaviorally active or inactive and then castrated. Eight weeks later they were given implants containing testosterone. Older males required longer exposure time to the exogenous steroid and in some cases, an additional implant to restore mating behavior as compared to younger males. The presence or absence of behavioral activity prior to castration did not affect the length of time required for restoration of behavior. Challenge with exogenous luteinizing hormone-releasing hormone revealed that there was reduced release of luteinizing hormone in aged, behaviorally inactive males as compared to young males. Results of these experiments in addition to previous data give evidence that age-related changes occur at the level of the hypothalamus and pituitary as well as at the level of the gonads. PMID- 3514418 TI - Confusion over Medicare waiver. PMID- 3514419 TI - Payment squeezes home health care. PMID- 3514420 TI - Oil states face dramatic losses in tax revenues. PMID- 3514421 TI - Lawsuits may greet new malpractice rule. PMID- 3514423 TI - Children benefit from organ-transplant gains. PMID- 3514422 TI - Will planning/MIS misfit cripple us? PMID- 3514424 TI - Alcohol usage and blood pressure: a review. PMID- 3514425 TI - Relationship of fetal ultrasound measurements to postnatal anthropometric variables and maternal measurements. PMID- 3514426 TI - Inhibition and adaptation of red cell glucose-6-phosphate dehydrogenase (G6PD) in vivo to chronic sublethal dietary cyanide in an animal model. PMID- 3514427 TI - Immunohistochemical detection of laminin in 98 human breast carcinomas: a light and electron microscopic study. AB - The distribution of laminin was studied in 98 breast carcinomas with antilaminin and the avidin-biotin-peroxidase complex method. Laminin was observed within vascular and epithelial basement membranes. Laminin displayed a continuous linear pattern in intraductal carcinomas, and it was heterogeneously distributed, with a discontinuous linear pattern, in invasive carcinomas. No intracellular laminin staining was detected. Electron microscopic study showed laminin immunostaining in the lamina densa of basement membranes in nonneoplastic breast tissue. In tumors, laminin immunostaining frequently revealed multilayered basement membranes and abnormal multilayered basement membranes in blood vessels in the tumor stroma. These data suggest that laminin immunostaining, as a new approach to the heterogeneous basement membrane changes occurring in carcinomas, should permit better understanding of cell diffusion processes and of stroma-tumor cell interactions. The consistent extracellular distribution of laminin in contact with the stroma indicates that the latter plays an important role in the assembly of basement membrane components. PMID- 3514428 TI - Hyperplasia of renin-containing cells in a malignant pheochromocytoma: an immunohistochemical and semiquantitative study. AB - The renin-containing cells in the kidneys of a patient with malignant pheochromocytoma were investigated immunohistochemically. Elevated plasma renin and catecholamine levels were detected during the clinical course. Remarkable hyperplasia of renin-containing cells was observed in the afferent arterioles and interlobular arteries. Semiquantitative assessment was performed to compare this case with cases of renovascular hypertension, with one case of malignant nephrosclerosis, and with six cases without hypertension. The grade of hyperplasia of renin-containing cells in pheochromocytoma was similar to that in renovascular hypertension and was different from that observed in control cases. Histologic examination of the kidneys revealed neither stenosis of the renal arteries nor ischemic changes of glomeruli. Direct stimulation of renin containing cells by catecholamines is suggested as the cause of the hyperplasia. This is the first morphologic demonstration of hyperplasia of renin-containing cells in pheochromocytoma. PMID- 3514429 TI - Improved technique for the study of meiosis in ejaculate: results of the first 50 consecutive cases. AB - An improved technique for the study of meiosis in ejaculate allows one to obtain a diagnosis in 58.1% of cases. We describe the results of the first 50 consecutive infertile or sterile males studied. PMID- 3514430 TI - Efficacies of LICAM(C) and DTPA for the decorporation of inhaled transportable forms of plutonium and americium from the rat. AB - The efficacies of N1, N5, N10, N14-tetrakis (2,3-dihydroxy-4-carboxybenzoyl) tetra-azatetradecane [LICAM(C)] and diethylenetriaminepenta-acetic acid (DTPA) (30 mumol/kg body wt.) have been investigated for plutonium (Pu) decorporation after inhalation as the nitrate or tributyl phosphate (TBP) complexes and the data compared with those obtained after its intravenous injection as the citrate. The efficacy of removal of americium (Am) inhaled as the nitrate has also been examined. The results show that: whereas LICAM(C) and DTPA were similarly effective for removing Pu from the blood, LICAM(C) was considerably inferior to DTPA when transportable forms of Pu were inhaled; LICAM(C) is ineffective for the decorporation of Am; the optimum treatment regimen for both Pu and Am involved the prompt and repeated administration of DTPA. PMID- 3514431 TI - Cadmium metabolism in man. AB - The time course of the fall in blood cadmium concentrations after cessation of exposure has been measured in nine workmen exposed to cadmium. When the initial blood cadmium concentration was below 180 nmol/l (six subjects) it declined smoothly and roughly exponentially, with a mean half-life of 20.4 months and a final asymptote of 70 nmol/l; in the remaining three subjects (initial blood cadmium concentration above 180 nmol/l) the decay was less regular and more prolonged (mean half-life 31.4 months, final asymptote 92 nmol/l). The significance of these results in relation to occupational cadmium exposure is discussed. PMID- 3514432 TI - Monoclonal antibodies against Trichomonas vaginalis. AB - Spleen lymphocytes obtained from mice immunized with Trichomonas vaginalis ATCC 30001 were fused with P3-X63-Ag8-653 mouse myeloma in order to produce hybridoma secreting antibodies against T. vaginalis associated antigens. Six hybridoma cloned cell lines were established; three produced IgG1, two produced IgG2a, and one produced IgM monoclonal antibody. These six monoclonal antibodies showed binding to seven isolated strains of T. vaginalis but did not bind to Giardia lamblia. Three of those monoclonal antibodies did not bind to Tritrichomonas foetus. These anti-trichomonal monoclonal antibodies should prove to be of great value as diagnostic and research reagents. PMID- 3514433 TI - Sensor for catheter-based measurements of electrical conductivity. PMID- 3514434 TI - Carbon tetrachloride induced changes in ultrasonic properties of liver. PMID- 3514435 TI - Entry into professional nursing practice: historical reflections. PMID- 3514436 TI - [A new serologic reaction in patients with polymyalgia rheumatica and/or giant cell arteritis]. AB - Fresh sera from patients with active polymyalgia rheumatica and/or giant cell arteritis are fixing the complement components C4 and C3 to structures of the medulla of rat kidney tissue as demonstrated by the indirect immunofluorescent technique. This PMR-associated reaction is also a useful tool in monitoring disease activity, as it becomes negative under effective treatment with steroids. PMID- 3514437 TI - [Lymphocyte activation by bacterial biostructures: precursor of infection-induced immune phenomena and sequelae? I. lymphocyte reactions to A-streptococci]. AB - The pathogenesis of the nonsuppurative sequelae of bacterial infections, e.g. rheumatic fever (RF) following A-streptococcal infection and seronegative spondarthritis (SS) following enterobacterial infection, is thought to be related to 1. an unusual persistence of infection, and/or 2. direct toxic effects of bacterial toxins, and/or 3. an abnormal immune response to the inital infection. Additionally, modern working hypothesis center around more recent findings concerning the genetic predisposition (for which there are now markers in both diseases) and the various immunologically active biostructures of the bacteria. These structures consist chiefly of a. crossreactive (CR) antigens, i.e. common or similar epitopes in both bacteriae and mammalian tissues, and b. polyclonal cell activators, e.g. the polyclonal B-cell activator (PBA) which induce immunologically many nonspecific resting B-cell clones to mature into Ig secreting cells. In this paper the lymphocyte response to a wide range of bacterial cell preparations is described. Blood lymphocytes from both RF and SS patients respond to the disease-precipitating microorganism more rigorously than the controls. There are several lines of evidence that the heightened response is genetically determined. However, there are no obvious facts which can confirm the idea that the so-called cross-reactive antigen preparations induce a specific cell response to CR antigens. On the contrary, such crude cell membrane preparations are obviously composed of an antigenic mosaic and of polyclonal cell activators: lymphocytes from healthy blood donors and even from newborns respond with lymphokine production, blastogenesis and Ig secretion under certain circumstances.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3514438 TI - [Causative spectrum of bacteremia and sepsis: significance for therapy]. AB - Nowadays, infection with septicemia still can be a life-threatening disease. We evaluated the therapeutic behavior of clinicians basing on our diagnostic experiences during the last years and data from continuous epidemiological analysis. Important statements resulted on therapy without knowledge of the pathogen. Our results allow us to calculate the probabilities of various kinds of pathogens as well as their resistance patterns, dependent on the ward. One third of our isolates were staphylococci, followed by about 15% E. coli. The portions of all the other pathogens, e.g. other gram-negative rods, streptococci or anaerobs, were 2% or less. The application of various classes of antibiotics has been rather constant in the years 1981-1984, the penicillins showing a slight increase while the cephalosporins decreased. However, our data proved the cephalosporins to be of marked better efficacy. This points out the importance of such evaluations, whose results must be given to the physicians. PMID- 3514439 TI - H-Y status of X/X Sxr' male mice: in vivo tests. AB - Sex reversed X/X male mice carrying Sxr or the variant Sxr' were typed for expression of the male specific histocompatibility antigen H-Y, by skin grafting and by in vitro cytotoxic and proliferative tests. The X/XSxr males, like X/Y males, were H-Y positive by in vitro testing, and failed to reject semi-syngeneic male skin grafts. In contrast X/XSxr' males, like X/X females, were H-Y negative and rejected semi-syngeneic, male skin. Spleen cells from X/Y males sensitized C57BL/10 female recipients to reject syngeneic male skin rapidly, whilst immunization with X/X female or X/XSxr' male cells failed to stimulate such second-set responses. These data suggest that the H-Y antigen detected by cytotoxic T cells is the same as that detected by graft rejection responses, that the Sxr' variant is not a tissue-specific regulatory mutation, and that X/XSxr' individuals do not express H-Y antigen but nevertheless develop as phenotypic males. PMID- 3514440 TI - Marginal zone of the spleen and the development and localization of specific antibody-forming cells against thymus-dependent and thymus-independent type-2 antigens. AB - In order to study the precise localization pattern of anti-TNP antibody-forming cells (AFCs) during the early primary immune response against TNP conjugated TD (thymus-dependent) and TI-2 (thymus-independent type-2) antigens, rats received an intravenous injection with either TNP-keyhole limpet haemocyanin (KLH) or with TNP-Ficoll. Anti-TNP AFCs developed in the spleen already at 2 days after injection of the antigens as demonstrated with our immunoenzyme technique for the detection of specific AFCs. In order to obtain information on the relationship between the non-lymphoid cells in the marginal zone (MZ) and the localization of AFCs, simultaneous staining for marginal metallophils and MZ macrophages (MZM) was performed using the monoclonal antibody ED3. AFCs were not found in the marginal zone (MZ), but the bulk of the cells in the white pulp were found in the outer part of the periarteriolar lymphocyte sheaths (PALS) close to the border between PALS and MZ. The precise localization of the anti-TNP AFCs in the outer part of the PALS resembled the localization of marginal metallophils but the latter cells were mainly present in the outer part of the follicles. So, the present results did not indicate a close relationship between marginal zone macrophages or marginal metallophils and anti-TNP AFCs, neither in the immune response to TD antigens nor in that to T1-2 antigens. PMID- 3514441 TI - Anti-TNP-forming cells in bronchus-associated lymphoid tissue (BALT) and paratracheal lymph node (PTLN) of the rat after intratracheal priming and boosting with TNP-KLH. AB - The aim of the present study was to elucidate the role of the paratracheal lymph node (PTLN) and bronchus-associated lymphoid tissue (BALT) in the generation of antigen-specific antibody-forming cells after intratracheal administration of trinitrophenyl-conjugated keyhole limpet haemocyanin (TNP-KLH). Priming as well as boosting resulted in the occurrence of specific antibody-forming cells in the PTLN, in BALT and in the lung. No anti-TNP-forming cells were observed in Peyer's patch, mesenteric lymph node and popliteal lymph node. From the data on the kinetics of anti-TNP-forming cells, it is concluded that intratracheal administration of antigen leads to a locally confined plasmacellular reaction. This suggests that the migrating and/or homing capacities of memory cells generated in the lung environment (PTLN, BALT) differ from those generated in the gut. PMID- 3514442 TI - Cellular aspects of the longer-lasting immunity against mouse typhoid infection afforded by the live-cell and ribosomal vaccines. AB - In order to compare the potential of salmonella vaccines prepared from Salmonella typhimurium to provide the longer-lasting protection from the aspects of cell mediated immunity, groups of mice were immunized with optimal doses of the following preparations: live cells, ribosome-rich extract, acetone-killed cells, and heat-killed cells. At various intervals post-immunization, mouse peritoneal macrophages and splenic T cells were tested for biological activities. The capacity of each vaccine to confer mouse protection against a lethal challenge with S. typhimurium correlated with the degree of macrophage activation engendered by each of them in the early stage of immunization. In the late stage of immunization, the level of mouse protection conferred by each vaccine was found to be based on the capacity of T cells to respond to salmonella antigens, which correlated with the degree of adoptive immunity by T cells. The live-cell and ribosomal vaccines were superior to killed-cell vaccines in inducing the cell mediated protection. Thus, the longer-lasting immunity provided by the live-cell and ribosomal vaccines can be accounted for by the fact that T cells of mice immunized with both vaccines have the persistent reactivity to salmonella antigens. PMID- 3514443 TI - Seasonal variations in the immune response of the tortoise Mauremys caspica. AB - The primary and secondary immune responses to sheep erythrocytes (SRBC) have been characterized in the tortoise Mauremys caspica in terms of circulating antibodies and PFC response in two different seasons: summer and autumn. Primary immunization is followed by the appearance of both 2ME-sensitive antibodies and splenic PFCs in autumn but not in summer. During the secondary response, 2ME resistant antibodies were found in both seasons, but the number of PFCs was significantly reduced during summer. The results are discussed from the perspective of the role played by glucocorticosteroids in the seasonal variations affecting reptilian immunoreactivity. PMID- 3514444 TI - Reduced immunogenicity of long-term, passively enhanced rat renal allografts and passive transfer of graft protection. AB - Enhancing alloantiserum was produced by immunizing male BD IX inbred rats with density gradient separated nylon-wool adherent spleen lymphocytes from male rats of the major histocompatibility complex (MHC) different inbred strain Sprague Dawley (SD). Long-term surviving (BD IX X SD) F1 to BD IX kidney grafts were achieved by treating the recipients with 1 ml alloantiserum at the time of transplantation. After greater than 100 days 7 passively enhanced F1 kidneys were retransplanted into naive BD IX rats. Four out of 7 secondary recipients, producing only low levels of lymphocytotoxic antibodies, survived for greater than 100 days, 3/7 rats died of surgical or infection complications. Twenty-one naive BD IX recipients of normal F1 kidneys were treated with serum (1 ml i.v.) and/or spleen lymphocytes (1 X 10(7) i.v.) obtained from the long-term survivors. An indefinite graft survival was achieved in 13 out of 21 rats. After greater than 150 days 6 out of these 13 passively enhanced F1 kidneys were retransplanted into naive BD IX rats which were challenged at the time of grafting with 4 X 10(7) SD lymphocytes to elicit rejection. Six out of 6 kidneys survived greater than 150 days. Thus, the long-term survival of rat kidney allografts in this model is associated with a strong reduction of graft immunogenicity as well as the development of suppressor cells and enhancing antibodies. PMID- 3514445 TI - Cosegregation of the polymorphic C4 with the MHC in the frog, Xenopus laevis. AB - Employing isoeletric focusing combined with enzyme-linked immunoelectrotransfer blot analysis, the fourth component of complement (C4) was analyzed in the two highly histocompatible, major histocompatibility complex homozygous groups (J and K) of Xenopus laevis. Each group had a characteristic C4 isoelectric focusing pattern, i.e., an isoelectric point range of 8.0-8.5 for J (C4jC4j) and 7.6-8.1 for K (C4kC4k). In (J X K)F1 frogs, C4 proteins were expressed in a codominant fashion (C4jC4k). In the backcrossed progeny B1 [J X (J X K)F1], those with C4jC4j rejected (J X K)F1 skins hyperacutely (less than 17 days), were high responders against (J X K)F1 cells, and nonstimulators to J cells in mixed lymphocyte reaction (MLR), but they did not suffer from the graft-versus-host reaction (GVHR), even after the injection of (J X K)F1 cell-stimulated J splenocytes. On the other hand, the B1 frogs with C4jC4k acutely or chronically (greater than 17 days) rejected (J X K)F1 skins, were low or nonresponders against (J X K)F1 cells and high stimulators to J cells in MLR, and they suffered from GVHR after the injection of prestimulated J splenocytes. These results argue for the notion that the genes equivalent to mammalian class III map to the MHC at the phylogenetic level of the anuran amphibian. PMID- 3514446 TI - An evaluation of self-recorded blood pressure during drug trials. AB - To our knowledge, there have been no published comparisons of different techniques for measuring blood pressure during clinical trials. We undertook a comparison during clinical trials with verapamil and prazosin. During an open trial of verapamil we compared the treatment-induced blood pressure reductions as measured by clinic, intra-arterial, and self-recorded methods. The mean reduction in blood pressure was 38 +/- 13.6/20 +/- 10.1 mm Hg for clinic blood pressure, 24 +/- 17.9/16 +/- 7.3 mm Hg for self-recorded blood pressure, and 23 +/- 12.3/19 +/ 10.1 mm Hg for mean daytime intra-arterial blood pressure. During prazosin treatment the mean reduction in blood pressure was 28 +/- 21.5/18 +/- 8.5 mm Hg for clinic blood pressure, 21 +/- 20.5/6 +/- 13.7 mm Hg for self-recorded blood pressure, and 18 +/- 19.2/5 +/- 9.6 mm Hg for mean daytime intra-arterial blood pressure. There was little agreement between methods within individual patients and for group comparisons of intra-arterial or clinic methods. There was, however, good agreement between intra-arterial and self-recorded methods. This study suggests that self-recorded blood pressure recording is suitable for monitoring efficacy of antihypertensive agents in a group of patients, although caution must be exercised when interpreting the effects of therapy when measured by indirect methods in an individual patient. PMID- 3514447 TI - Diuretic treatment alters clonidine suppression of plasma norepinephrine. AB - The effect of short-term diuretic treatment on the action of clonidine was evaluated in eight subjects with mild, uncomplicated hypertension. A single oral dose of clonidine (0.3 mg) was given before and after 1 week of therapy with hydrochlorothiazide, 50 mg, and amiloride, 5 mg, taken daily. Changes in mean arterial pressure, heart rate, plasma norepinephrine and epinephrine levels, and plasma renin activity were assessed. Diuretic treatment caused a significant weight loss, increased plasma renin activity, and reduced serum potassium concentration but did not significantly alter the absolute reduction in mean arterial pressure caused by clonidine. Absolute clonidine-induced reduction in plasma renin activity after diuretic treatment was three times greater than before treatment, although percent changes were similar. Before diuretic therapy, clonidine significantly reduced the level of norepinephrine (absolute and percent change). After diuretic treatment, clonidine failed to suppress norepinephrine, and the difference from prediuretic changes was significant. The level of epinephrine was not altered significantly either by diuretic treatment or clonidine. These results indicate that diuretic therapy alters the clonidine activated mechanism for reduction of arterial pressure through a shift from overall suppression of sympathetic tone to pathways that are more restricted to renal tone. This shift may be due to changes in fluid or electrolyte balance that alter the action of alpha 2-adrenergic receptor-mediated pathways. Use of the clonidine suppression test for the diagnosis of pheochromocytoma may give false positive results in diuretic-treated patients. PMID- 3514448 TI - Detection of primary aldosteronism by the 6-hour integrated aldosterone/renin ratio. AB - An outpatient diagnostic procedure measuring the 6-hour integrated plasma concentration of aldosterone and plasma renin activity was used to detect primary aldosteronism in 12 patients with low renin hypertension, including six with mild hypertension and normal urinary excretion and spot plasma levels of aldosterone. The ratio of integrated plasma concentration of aldosterone to plasma renin activity in the 12 patients (mean, 339; range, 116-700; p less than 0.0001) did not overlap with that measured in 105 normotensive controls (mean, 27.8; range, 5 97) or in 87 subjects with essential hypertension (mean, 29.2; range, 4-67). Eight patients had surgically proven adenomas (3 of which measured less than 5 mm) with normalization of blood pressure following adrenalectomy. The four remaining patients had bilateral hyperplasia. The 6-hour integrated plasma concentration of aldosterone to plasma renin activity ratio was found to be a useful new outpatient diagnostic tool for evaluation of primary hyperaldosteronism. PMID- 3514449 TI - Are hypertensive effects of aldosterone, angiotensin, vasopressin, and norepinephrine chronically additive? AB - The effects of chronic combined administration of angiotensin II, norepinephrine, aldosterone, and arginine vasopressin were compared with the response to each of these hormones administered alone. The studies were performed in dogs to determine the extent to which moderately inappropriate elevations of these hormones could enhance each other's ability to produce chronic hypertension and influence Na and water homeostasis. Blood pressure sensitivity to Na intake was also evaluated by infusing the hormones for 11 days at normal levels of Na intake followed by 11 days at high Na intake with ad libitum drinking. Combined hormone administration did not enhance each hormone's singular hypertensive actions. With aldosterone infusion alone and normal Na intake, mean arterial pressure rose nearly 15 mm Hg and an additional 3 mm Hg during high Na intake. Combined hormone infusion also resulted in a nearly 15 mm Hg rise during normal Na intake and an additional 3 mm Hg rise in mean arterial pressure during high Na intake. Marked Na retention and hypernatremia were observed with aldosterone infusion, while hyponatremia characterized arginine vasopressin infusion. The combined hormone infusion resulted in a tendency toward hypernatremia, although daily Na balance was not significantly changed. Daily water turnover was substantially increased and urine osmolality fell to hypoosmotic levels, despite elevated arginine vasopressin levels. Even with high Na intake, dogs receiving either angiotensin II, arginine vasopressin, or norepinephrine at the same concentrations showed 4 to 10 mm Hg increases in mean arterial pressure. Thus, humoral summation or synergism of these hormones probably does not play a major role in the development of chronic hypertension. PMID- 3514450 TI - Activation of the complement system by Cryptococcus neoformans leads to binding of iC3b to the yeast. AB - The complement system plays a key role in resistance to cryptococcosis. In the present study, we examined several factors that influence the binding of C3 cleavage fragments to Cryptococcus neoformans. Binding of C3 was determined by using normal human serum supplemented with 125I-labeled C3. Incubation of encapsulated cryptococci in 20% serum led to the binding of approximately 3.2 X 10(6) molecules of C3 to each cell. The binding of C3 was markedly inhibited by heating the serum at 56 degrees C for 30 min or by chelation of the serum with EDTA. Chelation of the serum with EGTA [ethylene glycol-bis(beta-aminoethyl ether)-N,N,N',N'-tetraacetic acid] reduced binding of C3 by 37%. These results indicated that activation of C3 cleavage fragments and their binding to C. neoformans was primarily dependent upon the alternative pathway. Bound C3 could be removed by incubation with 1.0 M hydroxylamine (pH 10) but not by incubation with 3.5 M NaSCN or with phosphate-buffered saline containing 0.1% sodium dodecyl sulfate. These results suggested that C3 fragments were bound to C. neoformans by ester bonds. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis of C3 fragments eluted from the yeast showed the presence of protein bands consistent with the presence of iC3b. C3b was not detected on the yeast after incubation with serum for time intervals as short as 2.5 min, indicating a rapid conversion of cell-bound C3b to iC3b. These results indicate that iC3b is the ligand which most likely interacts with the phagocyte C3 receptors involved in the phagocytosis of C. neoformans. PMID- 3514451 TI - Monoclonal antibody selection and analysis of a recombinant DNA-derived surface immunogen of Treponema pallidum expressed in Escherichia coli. AB - Monoclonal antibodies directed against a 34-kilodalton (kDa) surface immunogen of Treponema pallidum were used to select 12 unique T. pallidum DNA-containing Escherichia coli recombinant clones expressing the recombinant form of the 34-kDa immunogen. The phenotype of the clones was dependent on the presence of recombinant plasmids in the host cell. Restriction enzyme analyses and Southern hybridization of plasmid DNA demonstrated that all recombinant clones contained common DNA sequences of T. pallidum origin. Further hybridization analyses revealed that the cloned T. pallidum DNA sequences were an accurate representation of the T. pallidum genomic DNA arrangement. Purified immunoglobulin G (IgG) from pooled immune rabbit serum reacted with the clones, while IgG from pooled normal rabbit serum did not. Results of immunological experiments and Southern hybridization indicated that a similar 34-kDa immunogen was present in T. pallidum subsp. pertenue, but it was absent from four species of nonpathogenic treponemes tested, as well as from homogenates of normal rabbit testicular tissue. Metabolic labeling of the E. coli clones with [35S]methionine followed by radioimmunoprecipitation with monoclonal antibodies revealed that the 35S-labeled recombinant and 125I-labeled native (T. pallidum) forms of the antigen had identical electrophoretic mobilities. The production of a complete antigen by E. coli was independent of the orientation of the foreign gene sequence with respect to vector DNA. T. pallidum also produced an apparently identical immunoprecipitable 34-kDa antigen after metabolic labeling with [35S]methionine in the presence of cycloheximide. The apparent specificity of the 34-kDa immunogen for pathogenic treponemes and its native cell surface association on T. pallidum justifies a more intense study of this antigen and its corresponding gene. PMID- 3514452 TI - Nucleotide sequence of the type A streptococcal exotoxin (erythrogenic toxin) gene from Streptococcus pyogenes bacteriophage T12. AB - The gene specifying type A streptococcal exotoxin (speA), also known as erythrogenic toxin, was cloned from the Streptococcus pyogenes bacteriophage T12 genome and analyzed by nucleotide sequencing. The speA gene consists of 753 base pairs and codes for a 29,244-molecular-weight protein. The speA gene product contains a putative 30-amino acid signal peptide, resulting in a molecular weight of 25,787 for the secreted protein. A possible promoter and ribosome-binding site are present in the region upstream from the speA gene, and a transcriptional terminator is located 69 bases downstream from the translational termination codon. The amino acid sequence of the carboxy-terminal portion of the type A streptococcal exotoxin exhibits extensive homology with the carboxy terminus of Staphylococcus aureus enterotoxins B and C1. PMID- 3514453 TI - Retained antigen-binding activity of Fab alpha fragments of human monoclonal immunoglobulin A1 (IgA1) cleaved by IgA1 protease. AB - Immunoglobulin A1 (IgA1) proteases may be important virulence factors of certain bacteria involved in the pathogenesis of meningitis, gonorrhea, destructive periodontal diseases, and some other infections affecting mucosal membranes. This study evaluated the antigen-binding activity of free Fab alpha fragments released from human myeloma IgA1 by IgA1 protease from Haemophilus influenzae. Six myeloma proteins with antibody activity against streptolysin O, alpha-staphylolysin, or streptococcal hyaluronidase were used. Complete cleavage of the IgA1 myeloma proteins in the hinge region of the heavy chain did not affect their antigen binding capacity. The titers of neutralizing activity associated with free Fab alpha fragments were not significantly different from those of the intact IgA1 proteins. The retained antigen-binding capacity of cleaved IgA1 is an important factor in the understanding of how IgA1 proteases may interfere with the immune protection of mucosal membranes. PMID- 3514454 TI - Occurrence of chromosome- or plasmid-mediated aerobactin iron transport systems and hemolysin production among clonal groups of human invasive strains of Escherichia coli K1. AB - The incidence of the aerobactin system and the genetic location of aerobactin genes were investigated in Escherichia coli K1 neonatal isolates belonging to different clonal groups. A functional aerobactin system was found in all members of the O7 MP3, O1 MP5, O1 MP9, and O18 MP9 clonal groups examined and also in K1 strains having O6, O16, and O75 lipopolysaccharide types, which are less frequently associated with neonatal infections. In contrast, the aerobactin system was not detected in strains from the O18 MP6 clone. The combined results of plasmid and colony hybridization experiments showed that the aerobactin genes were located on the chromosome in the majority (75%) of the aerobactin-producing K1 isolates, the genetic location of the aerobactin genes was closely correlated with the outer membrane protein profile rather than the O lipopolysaccharide type, the K1 strains harboring a chromosome-mediated aerobactin system did not possess colicin V genes, and five of six K1 isolates possessing a plasmid-borne aerobactin system contained colicin V genes which were located on the same plasmids carrying the aerobactin genes. The comparison of hemolysin production with possession of the aerobactin system in virulent clones of E. coli K1 strains showed that all of the aerobactin-producing strains from the O18 MP9 and O7 MP3 clonal groups did not synthesize hemolysin, whereas 11 of 12 aerobactin nonproducing O18 MP6 isolates were hemolytic. Of the K1 strains examined, 92.5% possessed either the aerobactin system or the ability to produce hemolysin or both. PMID- 3514455 TI - Infant mouse model of adherence and colonization of intestinal tissues by enterotoxigenic strains of Escherichia coli isolated from humans. AB - The ability of enterotoxigenic Escherichia coli H10407, which possesses colonization factor antigen I, to colonize the intestinal mucosa of infant mice was considerably better than that of its colonization factor antigen I-negative derivative H10407-P. The latter strain previously was shown to lack cell adhering ability in vitro and to have a diminished capacity to infect human volunteers as compared with the parent strain. D-Mannose blocked both colonization by an enterotoxigenic E. coli isolate (801) possessing both mannose-resistant and mannose-sensitive adhesins and the in vitro adherence of the strain to intestinal segments of infant mice. A derivative of another enterotoxigenic E. coli strain (lacking both mannose-sensitive and mannose-resistant adhesins obtained by in vivo passage showed a significant increase in colonizing ability in comparison with the parent strain. We conclude that the infant mouse model of infection of intestinal mucosa complemented by in vitro adherence assays with excised intestinal tissue is suitable for the study of the bacterial properties responsible for the various stages of intestinal colonization by human enterotoxigenic E. coli. PMID- 3514456 TI - Role of cell surface receptors in the regulation of intracellular killing of bacteria by murine peritoneal exudate neutrophils. AB - The role of the Fc and third component of complement (C3) receptors on mouse neutrophils in the control of killing of Proteus mirabilis, opsonized in normal mouse serum (NMS) or heated immune mouse serum (HIMS), was studied. The events following incubation of neutrophils with P. mirabilis and the events associated with bacterial killing were assayed. The respiratory burst was quantified by chemiluminescence (CL). Levels of leukocyte-associated bacteria were determined after a 20-min ingestion period as a measure of phagocytosis. Bacterial killing was measured while ingestion was allowed to continue or as a discrete process when extracellular, noningested bacteria had been removed and neutrophils with intracellular bacteria were incubated in the presence of serum. Modification of these responses in the presence of three monoclonal antibodies (MAb), NIMP-R10 and M1/70, which bind to different epitopes of the mouse C3 receptor, and 2.4G2, which binds to the mouse Fc receptor, was investigated. MAb to the C3, but not to the Fc, receptors reduced CL, ingestion, and intracellular killing of NMS opsonized P. mirabilis. MAb to the Fc receptor diminished CL to and reduced the rate of ingestion of HIMS-opsonized bacteria. The two MAb to the C3 receptor each produced a similar inhibition of ingestion and intracellular killing of HIMS opsonized bacteria, but they only partially blocked CL. A range of MAb preparations reactive with other murine antigens did not inhibit these events, either with NMS- or HIMS-opsonized P. mirabilis. The results suggest that C3 receptors on mouse neutrophils played a predominant role in regulation of the killing of P. mirabilis. Similar results were found for Staphylococcus aureus. C3 receptors were necessary for maximal expression of all functions culminating in bacterial kill. That MAb to the C3 receptor inhibited phagocytosis of HIMS opsonized bacteria in similar fashion to the effect of MAb to the Fc receptor and in contrast to the lack of effect of control MAb may reflect steric hindrance of the Fc receptor by MAb binding to the C3 receptor, or it may reflect that the receptors are linked in murine neutrophils as they are in human neutrophils. PMID- 3514457 TI - Properties of proteins MPB64, MPB70, and MPB80 of Mycobacterium bovis BCG. AB - The immunogenic proteins MPB64 and MPB80 of Mycobacterium bovis BCG were purified to homogeneity and compared with MPB70. MPB70 and MPB80 showed a similar distribution in substrains of BCG, both being present in high concentrations in culture fluids of BCG substrain Tokyo, BCG Moreau, BCG Russia, and BCG Sweden and in only very small amounts in BCG Glaxo, BCG Tice, BCG Copenhagen, and BCG Pasteur. In various physicochemical properties MPB70 and MPB80 were closely similar, but MPB80 had a distinctly lower pI value. The N-terminal amino acid sequence was identical for the first 30 residues. In reactions with anti-MPB70 antibodies and delayed-type hypersensitivity skin reactions, MPB70 and MPB80 also had very similar properties. These results show that MPB70 and MPB80 are two closely similar forms of the same gene product, and postsynthetic changes probably explain the observed differences. By contrast, MPB64 had a higher molecular weight. The N-terminal amino acid sequence showed no homology with MPB70, and these two proteins showed no immunologic similarity. MPB64 and MPB70 showed only very restricted cross-reactivity with other species of mycobacteria but cross-reacted with Nocardia asteroides. The similar occurrence in eight different substrains of BCG indicated that the two proteins are influenced by similar control mechanisms, but in contrast to MPB70, MPB64 occurred in sufficient concentration in two strains of Mycobacterium tuberculosis to give a distinct spot in two-dimensional polyacrylamide gel electrophoresis of their culture fluids. PMID- 3514458 TI - Interleukin-1 released by blood-monocyte-derived macrophages from patients with leprosy. AB - In highly purified blood-monocyte-derived macrophages collected from patients with leprosy and from healthy individuals and cultured in vitro with mycobacterial antigens such as Mycobacterium bovis BCG or Mycobacterium leprae, we nonspecifically induced the synthesis of interleukin-1. Normally, all supernatants from cultured macrophages of all subjects tested produced similar amounts of interleukin-1. However, only in patients with lepromatous leprosy, M. leprae, but not BCG, induced high-level synthesis of prostaglandin E2, which acted as a suppressor factor in the mouse thymocyte proliferative assay used to measure the interleukin-1 content of the supernatants. Normal interleukin-1 content of those supernatants was demonstrated by blocking the prostaglandin E2 synthesis by the addition of indomethacin to the medium throughout the experimental procedure. We also tested the efficiency of a combination of BCG and M. leprae in reducing the prostaglandin E2 synthesis, but with the methodology used, we did not observe any beneficial effect of such a combination. These results demonstrate the possible role of M. leprae in the induction of at least one of the suppressive monokines and are additional arguments for the involvement of macrophages in the suppression of the specific cell-mediated immunity to M. leprae observed in lepromatous leprosy. PMID- 3514460 TI - Species specificity and lack of production of STb enterotoxin by Escherichia coli strains isolated from humans with diarrheal illness. AB - Escherichia coli strains produce at least two heat-stable enterotoxins, STa and STb. STa is well known to be important in the pathogenesis of human diarrheal disease; the role of STb has not been defined. Fifty-two E. coli strains recovered from human diarrheal illness in northeast Brazil or Bangladesh were examined in weaned porcine ligated intestinal segments for STb activity. A total of 113 E. coli strains from human diarrheal disease in northeast Brazil and 28 E. coli strains from Bangladesh were examined for DNA hybridization to a STb gene probe. None of these strains produced STb as detected by enterotoxic activity or by the gene probe. We also examined adult human ileal mucosa for responses to STb in the Ussing chamber in vitro. In contrast to piglet jejunum, which consistently responds electrogenically to crude STb, human ileal tissue showed no response to STb but responded electrogenically to theophylline (10 mM). These results suggest that STb-producing E. coli strains are not a major cause of diarrheal illness in humans. PMID- 3514459 TI - Induction of protective immunity to monoclonal-antibody-defined Plasmodium falciparum antigens requires strong adjuvant in Aotus monkeys. AB - Monoclonal antibodies to the major Plasmodium falciparum merozoite surface coat and rhoptry antigens were produced. A combination of the affinity-purified polypeptides with Freund complete adjuvant which was given three times completely protected an Aotus lemurinus azure (karotype VI) monkey against homologous challenge; however, immunization with the same polypeptides with a muramyl dipeptide derivative [MDP-Lys(L18)] did not protect a second Aotus monkey, even though comparable high antibody titers were induced. PMID- 3514461 TI - Localization of a determinant for HEp-2 adherence by enteropathogenic Escherichia coli. AB - pMAR2, a 60-megadalton plasmid encoding localized HEp-2 adherence in enteropathogenic Escherichia coli, was mapped with BamHI, HindIII, and SalI. Deletion and insertion mutants were constructed and used to define a potential DNA probe. Preliminary results indicate that this probe is sensitive and specific for the genes encoding the enteropathogenic E. coli adherence factor. PMID- 3514462 TI - Flow cytometric analysis of the effects exerted by monoclonal antibodies on binding and uptake of Leishmania mexicana subsp. mexicana promastigotes by murine peritoneal macrophages. AB - A flow cytometric assay was developed to quantitate the binding kinetics of Leishmania mexicana subsp. mexicana promastigotes to murine peritoneal macrophages and to determine if selected membrane-specific monoclonal antibodies would exert an effect on the binding process. A total of three monoclonal antibodies, all reactive with a similar 42-kilodalton surface membrane component by Western blot analysis, enhanced parasite-macrophage binding at levels greater than 45%. An additional three monoclonal antibodies that identified low-molecular weight antigens of the promastigote (15 to 20 kilodaltons) had no effect on the binding process. Of these antibodies, however, one did appear to inhibit the internalization of the parasites after it attached to the macrophage membrane. PMID- 3514463 TI - Characterization of murine monoclonal antibodies to Escherichia coli J5. AB - Twenty-eight independently derived monoclonal antibodies (MAb) directed against Escherichia coli J5 endotoxin were produced and characterized. Each MAb exhibited a specific titer by both radioimmunoassay and passive hemagglutination assay. Most of the MAb were of the immunoglobulin G isotype; however, several immunoglobulin M antibodies and one immunoglobulin A antibody were produced. When characterized for their capacity to cross-react with purified endotoxin preparations from several gram-negative bacteria, 22 MAb exhibited no cross reactivity; 6 demonstrated a limited capacity to cross-react with other endotoxin preparations. When characterized for their capacity to react with the intact organism instead of the purified endotoxin the pattern of cross-reactivity was quite different. Most of the MAb were able to react with Salmonella minnesota Re595. Eighteen were able to react with E. coli O111:B4 (the parent strain of E. coli J5), 13 MAb reacted weakly with Pseudomonas aeruginosa, and 3 reacted weakly with Klebsiella pneumonia. The data imply that MAb generated against E. coli J5 endotoxin demonstrate greater cross-reactivity when assayed against the whole bacterium than when assayed against the corresponding purified endotoxin. We were unable to demonstrate that any of the 28 MAb could passively protect mice against lethal endotoxin challenge. PMID- 3514464 TI - Early-phase endotoxin tolerance: induction by a detoxified lipid A derivative, monophosphoryl lipid A. AB - After a sublethal exposure to lipopolysaccharide (LPS) or to lipid A, which is that portion of the LPS molecule associated with endotoxicity, a transient period ensues during which a normally responsive individual is rendered hyporesponsive to LPS-induced toxicity. This period has been defined as early-phase endotoxin tolerance. Recently, a nontoxic derivative of lipid A from Salmonella typhimurium, monophosphoryl lipid A (MPL), was isolated and purified. In this study, we assessed the ability of MPL to induce early endotoxin tolerance. Initial injection of MPL resulted in a dose-dependent stimulation of both serum colony-stimulating factor and serum interferon, indicators of in vivo LPS responsiveness. In contrast, MPL failed to induce the symptoms of endotoxicity which are normally seen after injection of even sublethal amounts of intact endotoxin or lipid A preparations. Injection of MPL on day 0 reduced significantly the amount of LPS-induced serum colony-stimulating factor and interferon produced upon challenge with Escherichia coli LPS 3 days later and also mitigated toxic manifestations, as evidenced by a marked increase in the 50% lethal dose. Like the early tolerance induced by wild-type (toxic) LPS, MPL induced tolerance was characterized by an accompanying elevation in the number of bone marrow-derived macrophage progenitor cells and by an alteration in bone marrow cell sizing profiles. These results indicate that MPL is effective in inducing a state of LPS-hyporesponsiveness without the toxic side effects of endotoxin and that the structural component(s) necessary for induction of early phase endotoxin tolerance is contained within MPL. PMID- 3514465 TI - Escherichia coli hemolysin may damage target cell membranes by generating transmembrane pores. AB - Escherichia coli hemolysin is secreted as a water-soluble polypeptide of Mr 107,000. After binding to target erythrocytes, the membrane-bound toxin resembled an integral membrane protein in that it was refractory towards extraction with salt solutions of low ionic strength. Toxin-induced hemolysis could be totally inhibited by addition of 30 mM dextran 4 (mean Mr, 4,000; molecular diameter approximately 3 nm) to the extracellular medium. Uncharged molecules of smaller size (e.g., sucrose, with a molecular diameter of 0.9 nm, or raffinose, with a molecular diameter of 1.2 to 1.3 nm) did not afford such protection. Treatment of erythrocytes suspended in dextran-containing buffer with the toxin induced rapid efflux of cellular K+ and influx of 45Ca2+, as well as influx of [14C]mannitol and [3H]sucrose. [3H]inulin only slowly permeated into toxin-treated cells, and [3H]dextran uptake was virtually nil. Membranes lysed with high doses of E. coli hemolysin exhibited no recognizable ultrastructural lesions when examined by negative-staining electron microscopy. Sucrose density gradient centrifugation of deoxycholate-solubilized target membranes led to recovery of the toxin exclusively in monomer form. Incubation of toxin-treated cells with trypsin caused limited proteolysis with the generation of membrane-bound, toxin-derived polypeptides of Mr approximately 80,000 without destroying the functional pore. We suggest that E. coli hemolysin may damage cell membranes by partial insertion into the lipid bilayer and generation of a discrete, hydrophilic transmembrane pore with an effective diameter of approximately 3 nm. In contrast to the structured pores generated by cytolysins of gram-positive bacteria such as staphylococcal alpha-toxin and streptolysin O, pore formation by E. coli hemolysin may be caused by the insertion of toxin monomers into the target lipid bilayers. PMID- 3514466 TI - Monoclonal antibody to a major surface glycoprotein immunogen differentiates isolates and subpopulations of Trichomonas vaginalis. AB - To produce monoclonal antibodies (MAbs) to highly immunogenic membrane proteins of Trichomonas vaginalis NYH286, the sera of subcutaneously infected BALB/c mice were first monitored for antibody to trichomonad surface proteins. The sera possessed antibody to one major surface protein by 7 days and antibody to numerous other trichomonad membrane proteins by 4 weeks postinfection. A hybridoma was then generated that synthesized an MAb, designated C20A3, which reacted to a parasite-derived glycoprotein possessing a molecular weight of 267,000 (267K glycoprotein). The immunogen corresponded to the single high molecular-weight immunogenic surface protein recognized by 7-day mouse antisera. The MAb differentiated T. vaginalis isolates by a whole-cell enzyme-linked immunosorbent assay and by indirect immunofluorescence, using either fixed or live organisms. All isolates, however, possessed C20A3-reactive material when tested by enzyme-linked immunosorbent assay, using detergent extracts of the isolates incubated with MAb-coated microtiter well plates. The epitope was accessible to antibody binding on live T. vaginalis organisms expressing the major immunogen, and the 267K glycoprotein was readily removed from the parasite membranes by trypsinizing the intact trichomonads. The antigen incorporated radiolabeled glucose, mannose, and acetate. Also, an unlabeled 267K glycoprotein on nitrocellulose blots was detected by 125I-concanavalin A and 125I-wheat germ agglutinin, confirming the glycoprotein nature of the immunogen. Finally, of seven isolates used in this study, one possessed a cross-reactive 170K, rather than 267K, antigen. The data reinforce the idea that antigenic heterogeneity among T. vaginalis isolates may be a function of the presence or absence of high molecular-weight glycoprotein immunogens from trichomonal membranes. PMID- 3514467 TI - Colonization and persistence of Escherichia coli phenotypes in the intestines of children aged 0 to 18 months. AB - The aim of the present investigation was to study the intestinal colonization of Escherichia coli in newborn children, and to determine which strains become residential within the human intestine. The E. coli flora of 89 newborn children was studied by repeated sampling during their first 11 or 18 months of life. The E. coli isolates from the samples were subdivided into phenotypes by the aid of biochemical fingerprinting, a method which measures the kinetics of 24 selected biochemical tests as a tool for discriminating bacterial strains. It was found that E. coli strains colonizing children soon after birth persisted longer than strains colonizing them later. Especially those phenotypes which were defined as hospital strains persisted longer. Certain phenotypes were commonly found among the children, and these phenotypes were more persistent and more homogeneous than other phenotypes with respect to their pattern of biochemical activities. They might be specially adapted to colonize the human intestine. It was concluded that the generally long persistence of the first E. coli strains colonizing a newborn child indicates that the first case of bacterial colonization in children may be an event too important to be allowed to happen at random. PMID- 3514468 TI - [Summarized results of clinical phase II and III studies with ofloxacin (HOE 280) in Europe]. AB - Ofloxacin is a new quinolone-carboxylic acid derivative with a broad spectrum of activity, excellent bioavailability after oral administration and insignificant metabolisation. The serum elimination half-life is six to eight hours. 879 patients were treated with ofloxacin in therapeutic comparative studies monitored by the Department of Clinical Research, Hoechst AG. Of the original isolates 91 to 100% were susceptible to ofloxacin, 67 to 84% to co-trimoxazole, 73 to 98% to a fixed combination of amoxycilline plus clavulanic acid (AMC), 74% to nalidixic acid, 77% to nitrofurantoin, and 79% to pipemidic acid in previous in vitro tests. In the therapeutic studies which included only patients with pathogens susceptible to the antimicrobial agent used, the following cure rates (clinical and bacteriological) were obtained for uncomplicated infections of the lower urinary tract: ofloxacin (single dose treatment) 78% and 83%, co-trimoxazole 62%, nalidixic acid 72%. A three-day course with ofloxacin compared to a three to four day treatment with co-trimoxazole or seven-day treatment with the other comparative compounds resulted for lower urinary tract infections in the following cure rates: ofloxacin 89%, co-trimoxazole 84%; ofloxacin 71%, AMC 33%; ofloxacin 64%, nitrofurantoin 56%; ofloxacin 56%, pipemidic acid 36%. The unfavourable results after treatment with AMC or pipemidic acid were caused by a high rate of superinfections. The combined cure rate in infections of the upper urinary tract was 73% for ofloxacin and 65% for co-trimoxazole or 81% for ofloxacin and 57% for AMC, respectively.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3514469 TI - Comparative activity of ofloxacin with reference to bacterial strains isolated in in-patients and out-patients. AB - The in vitro activity of ofloxacin, a new quinolone derivative, was compared to that of other agents commonly in use against pathogens isolated in the community and in the hospital. None of the community or hospital strains isolated from urinary tract infection showed resistance to ofloxacin, while variable resistance was demonstrable with all other oral agents. Similar results were obtained with pathogens isolated from infected wounds originating in the community and in the hospital. Among pathogens isolated from the respiratory tract, ofloxacin was most active against Haemophilus influenzae, but less active than the penicillin cephalosporin group against Streptococcus pneumoniae. Ofloxacin was active against all but one (Pseudomonas aeruginosa) blood culture isolates. Of 112 strains isolated from community-acquired infections, only one strain was ofloxacin-resistant while resistance to sulphamethoxazole-trimethoprim, ampicillin and doxycycline was 34%, 42% and 30%, respectively. Among 219 pathogens originating from nosocomial infections, 3.2% were resistant to ofloxacin compared to 56% for cefazolin, to 7.2% for cefotaxime, 15.8% for piperacillin and 22.3% for gentamicin. These results suggest that ofloxacin has great therapeutic potential for the therapy of bacterial infections originating both in the community and in the hospital. PMID- 3514470 TI - [Effect of pH value and magnesium on the antibacterial activity of quinolone preparations]. AB - The activity of ten different 4-quinolone antibacterial agents against Escherichia coli KL16 was investigated at four pH values between 5.6 and 8.3, which is the pH range of urine. It was found that pH affected the minimum inhibitory concentrations of all the drugs, but the nature of the substituent at the C7 position of each 4-quinolone governed how its activity was altered by the hydrogen ion concentration. When a 4-quinolone possessed a piperazine group at its C7 position its activity became progressively less as the pH fell. However, all drugs that lacked a C7 piperazine, irrespective of the nature of their substituent at this position, exhibited a progressive increase in activity as the pH was reduced. In addition it was found that, excepting cinoxacin, a urinary concentration of magnesium generally caused a further antagonism of the activity of the nine other 4-quinolone antibacterials at all pH values tested. PMID- 3514471 TI - [Results of ofloxacin treatment of experimental urinary tract infections]. AB - The antibacterial activity of ofloxacin, a new gyrase inhibitor, was tested in experimental acute occlusive pyelonephritis in rats caused by Escherichia coli O4:H5 and Pseudomonas aeruginosa A 9532. Therapy was performed using increasing concentrations of the substance during three days. Effectiveness of therapy was investigated by determination of the bacterial counts in the tissue of kidneys and in the urine obtained by puncture of the bladder. As little as 3 X 3.75 mg/kg/day of the substance was effective and reduced the E. coli counts. The dosage of 3 X 7.5 mg/kg/day was effective in pseudomonas infections. PMID- 3514472 TI - [Respiratory tract infections--clinical results with ofloxacin]. AB - In an open clinical trial, out-patients with respiratory tract infections were given 200 mg ofloxacin b. i. d. orally. 36 had acute bronchitis and pneumonia was diagnosed in 44. The average duration of therapy was nine days for bronchitis and 12 days for pneumonia. In the sputum of bronchitis patients, Haemophilus influenzae (n = 25), Streptococcus pneumoniae (n = 18), Branhamella catarrhalis (n = 2) and Pasteurella multocida (n = 1) were isolated. 17 H. influenzae and 12 S. pneumoniae were eliminated. All 20 S. pneumoniae strains isolated from patients with pneumonia were eliminated. A cure or improvement of clinical symptoms was seen in 32 of 36 cases of bronchitis and in 33 of 44 cases of pneumonia treated with ofloxacin. PMID- 3514473 TI - [Effectiveness of ofloxacin in the treatment of wound infections]. AB - Ofloxacin (OFX) and doxycycline (D) were compared in an open randomized study in the treatment of wound infections, including soft tissue, traumatic and postoperative wound infections caused by gram-positive as well as gram-negative pathogens. Doses were 2 X 200 mg/day of OFX (n = 21) and 2 X 100 mg/day of D (n = 20). In three cases from the OFX group, the daily dose was successfully increased to 2 X 300 mg. Clinical cure was observed in 20 of 21 patients on OFX and in 12 of 20 patients on D. One patient who failed to respond clinically in the OFX group showed moderately severe gastric pain (possibly drug-related), but by the time this adverse effect became evident, the wound exudate had already cleared bacteriologically. In this study OFX proved to be highly effective in the treatment of wound infections, and it was also well tolerated. Not only did symptoms disappear more frequently under OFX than under D, but they also disappeared more quickly. PMID- 3514474 TI - [Ofloxacin versus pipemidic acid and co-trimoxazole]. AB - In a study comprising 116 patients at a hospital for general care, ofloxacin was tested in various doses and at various time intervals against pipemidic acid (for infections of the lower urinary tract) and co-trimoxazole forte (for infections of the upper urinary tract). Ofloxacin proved superior to the other drugs both clinically and, particularly, bacteriologically. Of 77 patients treated with ofloxacin, only one complained of diarrhoea as a side-effect of the drug. PMID- 3514475 TI - Isolation of a Kentucky Blue grass pollen allergen using a murine monoclonal antibody immunosorbent. AB - We have previously reported the production of murine monoclonal antibodies to the retentate fraction of Kentucky Blue Grass pollen (KBG-R). In the present study, one of these monoclonal antibodies (Mab 27) was used in a combination of methods employing Western and immunoblot analysis to establish its reactivity to various antigenic components present in KBG-R. Thus, Mab 27 reacted predominantly with an antigen having a MW of 30 kD and to a lesser extent with other antigenic components with MW of 35 and 17 kD. Fractions of KBG-R obtained by preparative isoelectrofocusing, revealed on analysis by ELISA, that Mab 27 reacted with several components differing in charge. From these observations it was concluded that KBG-R contained a group of related antigens detectable with Mab 27 and differing in size and charge. A reverse immunosorbent, prepared by coupling Mab 27 to CNBr-activated Sepharose 4B, was used to absorb KBG-R. Bound material was recovered by acid elution and designated as Ag 27. SDS-PAGE analysis revealed that Ag 27 consisted of at least two components with molecular weights of 30 and 17 kD. Analysis by RAST using sera from humans allergic to KBG indicated that Ag 27 was highly allergenic. PMID- 3514476 TI - Comparative studies on tree pollen allergens. XIII. Partial characterization of the alder (Alnus incana) pollen extract by two-dimensional IEF/SDS-PAG electrophoresis combined with electrophoretic transfer and immunoautoradiography. AB - Horizontal isoelectric focusing (IEF) and two-dimensional sodium dodecyl sulfate polyacrylamide gel electrophoresis (2-D SDS-PAGE) combined with electrophoretic transfer (ET) and immunoautoradiography (IAR) were used to characterize the crude alder (Alnus incana) pollen extract (AI crude) and fraction AI 34. IEF resolved AI crude and AI 34 into 34 and 39 distinct protein bands, respectively, when stained with Coomassie brilliant blue. The band patterns were similar and the majority of bands were located in the pH region 4.0-7.0. After ET and IAR, the distribution of antigenic reactivities was similar to that of the protein stain. Allergenic reactivity was detected in the pH region 4.6-5.2 only, where two bands at pH 4.9 demonstrated dominating IgE-binding properties. The 2-D reference maps of AI crude and AI 34 consisted of 40 and 45 protein spots, respectively. The autoradiogram of AI crude demonstrated 35 spots capable of binding rabbit IgG. The main IgE-binding zone was located at pH 4.6-5.2 and 20 kilodaltons with an area of weaker autoradiographic signals at pH 4.6-5.2 and 40 kilodaltons. ET from polyacrylamide gels to nitrocellulose (NC) membranes was quantitative and IAR gave significant radiostaining of spots containing 0.01 and 0.1 microgram of AI crude in the IgG and IgE systems, respectively. For the characterization of the alder pollen extract, horizontal 2-D SDS-PAGE combined with ET and IAR provided a powerful supplement to conventional crossed immuno- and radioimmunoelectrophoretic techniques (CIE/CRIE). PMID- 3514477 TI - Immune response potential of mast cell-deficient W/Wv mice. AB - Immune responses of mast cell-deficient WBB6F1-W/Wv mice and their mast cell sufficient littermates (LM: WBB6F1-W/+, Wv/+ and +/+) were compared. After a single intravenous injection of sheep erythrocytes (SE), polyvinylpyrrolidone or bacterial lipopolysaccharide, the antigen-specific IgM plaque-forming cell (PFC) response of W/Wv mice was similar to or greater than the response of LM mice. When both primary and secondary injections of SE or chicken gamma-globulin were given to mice and antigen-specific IgG PFC responses quantified, the response of W/Wv again was similar to or greater than that of LM mice. Serum titers of antigen-specific IgE were higher in W/Wv than in LM mice after injections of ovalbumin in alum or infections of Nippostrongylus brasiliensis. Ovalbumin sensitized W/Wv and LM mice developed active systemic anaphylaxis after ovalbumin challenge. The ability of W/Wv mice to be sensitized for and elicit contact sensitivity (CS) reactions was studied using picryl chloride or dinitrofluorobenzene as sensitizing and challenge agents and quantifying 24-hour reactions by change in ear thickness. SE or methylated bovine serum albumin was used to sensitize and challenge mice for delayed-type hypersensitivity (DTH) reactions which were quantified at 24 h by change in foot pad or ear thickness. CS and DTH reactions of W/Wv and LM mice were similar. No evidence of immune deficiency of W/Wv mice was found. PMID- 3514478 TI - Diversity of injuries in renal ischemia. PMID- 3514479 TI - The evolution of experimental Trypanosoma cruzi cardiomyopathy in rabbits: further parasitological, morphological and functional studies. AB - Young rabbits (1-2 months of age) inoculated with trypomastigote forms of the Colombia strain of Trypanosoma cruzi have been shown to develop cardiac pathological changes (together with parasitological and immunological alterations) which are very similar to those observed in the acute and chronic phases of Chagas' disease in man. The cardiac alterations in the acute phase are characterized grossly by slight cardiomegaly with dilatation of the right-sided chambers. Microscopically they are characterized by mild focal myocarditis. The chronic phase is characterized by moderate to marked cardiomegaly with hypertrophy and dilatation of both ventricular chambers. There is thinning of the apical region (apical aneurysm), particularly of the left ventricle. Focal myocarditis is seen microscopically with areas of myocytolytic necrosis, atrophic and hypertrophic myofibers, an inflammatory response predominantly composed of mononuclear cells and interstitial fibrosis. Cineventriculography in the left ventricle of rabbits during the chronic phase disclosed regional myocardial dysfunction, with typical apical systolic bulging. The pathogenesis of Chagasic cardiomyopathy is briefly discussed in the light of these findings. Our investigation has further shown that this animal model is particularly suitable for studies on on the mechanisms, pathology and treatment of Chagas' heart disease. PMID- 3514480 TI - The influence of early intervention in acute myocardial infarction on long-term mortality and morbidity as assessed in the Goteborg metoprolol trial. AB - The mortality and morbidity were assessed during a 2-year follow-up in an acute intervention trial in suspected acute myocardial infarction with metoprolol (a selective beta 1-blocker). On admission to the trial, the 1395 participating patients were randomly allocated to metoprolol or placebo for 3 months. Thereafter, if there was no contraindication, patients with infarction and/or angina pectoris were continued on metoprolol for 2 years. A lower mortality was observed after 3 months in patients randomised to metoprolol. The difference remained after 2 years. The difference in 2-year mortality rate was restricted to patients randomised early after onset of pain. Late infarction was observed more often in the placebo group during the first 3 months. When the two groups thereafter were treated similarly, the difference successively declined and did not remain after 2 years. A similar incidence of angina pectoris was observed in the two groups at each check up. During the early recovery period, more patients in the metoprolol group returned to work. No such difference was observed later on. PMID- 3514481 TI - Tributes to Roland Gruentzig. PMID- 3514482 TI - Kawasaki disease--a continuing puzzle. PMID- 3514483 TI - Captopril in a case of severe congestive heart failure and peripheral vascular disease. AB - A case of chronic congestive cardiac failure and peripheral vascular disease due to thromboembolism was treated with captopril. Marked improvement was noted in the cardiac status and peripheral vascular lesion both acutely and in the long term follow-up. PMID- 3514484 TI - Carcinoma of uterine cervix with myocardial metastases associated with chest pain and asystolic arrest. AB - We report a case of secondary deposition of carcinoma of the uterine cervix in the myocardium with development of ischaemic cardiac pain, ST segment elevation and asystolic cardiac arrest. The coronary arteries were free of obstruction. To the best of our knowledge, this is a unique presentation of a rare myocardial metastasis. PMID- 3514485 TI - Clinical effects and kinetic properties of intravenous APSAC--anisoylated plasminogen-streptokinase activator complex (BRL 26921) in acute myocardial infarction. AB - Fifty patients with a first myocardial infarction presenting within 4 hours of the onset of symptoms were treated with intravenous anisoylated plasminogen streptokinase activator complex (APSAC-BRL 26921). Vessel patency with good flow was documented in 88%. The left ventricular ejection fraction declined with the duration of symptoms before treatment (r = -0.53, P less than 0.001). The correlation persisted for the group with anterior infarction (r = -0.46, P less than 0.05) where the mean left ventricular ejection fraction prior to discharge from hospital was 36 +/- 9% compared to 49 +/- 7% for the group with inferior infarction. Reinfarction developed in 12% and mortality at 6 months for the whole group was 6%. A degree of systemic fibrinolysis did occur with a fall in mean plasma fibrinogen from 3.20 g/l to 1.08 g/l. A pharmacokinetic study was performed in six patients demonstrating a clearance half-life of fibrinolytic activity of 87.5 +/- 5.0 min. APSAC is an effective intravenous thrombolytic agent with a relatively long half-life of fibrinolytic activity. PMID- 3514486 TI - The effects of indoprofen vs paracetamol on swelling, pain and other events after surgery. AB - The capability of indoprofen compared to paracetamol in reducing swelling, pain and other events of an acute inflammatory reaction was tested in a double-blind crossover study with bilateral oral surgery. Identical surgical procedures were performed on two separate occasions in 24 patients. After one operation they received tablets of indoprofen, after the other, paracetamol. A double-placebo method was used, as dosage regimens for the two treatments were different. Medication started 3 h after surgery and continued for 3 days. Almost identical swelling was measured after both treatments indicating that indoprofen has the same anti-inflammatory activity as previously found with paracetamol, which reduces swelling with about 30% compared to placebo. The pain and preference assessments were significantly in favor of indoprofen. Subjective bleeding scores were significantly increased with indoprofen. However, bleeding was minimal, and the occurrence of hematoma/ecchymosis was not increased with indoprofen. The results indicate that indoprofen is capable of reducing an acute, post-operative inflammatory reaction. For this purpose, it appears to be more efficient than other non-steroid anti-inflammatory drugs like ibuprofen, oxyphenbutazone, indomethacin and naproxen. PMID- 3514487 TI - Low-dose atenolol-chlorthalidone combination for treatment of mild hypertension. AB - In a randomized, double-blind, within-patient study, 28 out-patients with mild to moderate hypertension were given, at the end of a 3-week placebo wash-out period, four different antihypertensive treatments for 3 weeks each. the treatments were 50 mg atenolol, 100 mg atenolol, 12.5 mg chlorthalidone and a fixed combination of 50 mg atenolol and 12.5 mg chlorthalidone. All treatments were given once daily. Visits were scheduled for the last day of each treatment period, 24-26 hours after the last dose, and there was an intermediary wash-out period between each pair of active treatments. Supine systolic/diastolic blood pressure was 165/102 on placebo, 153/93 mmHg on 50 mg atenolol, 155/91 mmHg on 100 mg atenolol, 148/93 mmHg on 12.5 mg chlorthalidone and 144/89 mmHg on the combination. All the changes in pressure were significant (p less than 0.01) versus placebo. Supine systolic blood pressure was lower on the combination than on 100 mg atenolol alone (p less than 0.05) and upright systolic pressure was lower on the combination than on 100 mg atenolol (p less than 0.05) or 50 mg atenolol (p less than 0.05) alone. The heart rate was lowered by atenolol alone or combined with chlorthalidone but did not fall below 56 bpm in any patient. Serum potassium levels were lower on 12.5 mg chlorthalidone than on placebo (3.88 mEq/l vs 4.09 mEq/l--p less than 0.05) but the difference was trivial; on the combination of atenolol-chlorthalidone there was no significant difference versus placebo (3.97 mEq/l vs 4.09 mEq/l--NS).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3514488 TI - A double-blind controlled trial of ranitidine 300 mg nocte and ranitidine 150 mg b.i.d. in the short-term treatment of gastric ulcer. AB - A multi-center study was carried out to compare the healing rates of ranitidine 300 mg nocte and 150 mg b.i.d. in the short-term treatment of gastric ulcers and to assess the side-effect liability of ranitidine 300 mg given in a single daily dose. Forty-five outpatients suffering from endoscopically and bioptically proven uncomplicated benign gastric ulcer were selected for the study. The patients were treated, for 4 weeks, on the basis of a double-blind randomized design. An endoscopic examination was repeated within 4 days after the end of the treatments. The patients who did not demonstrate complete healing were treated for an additional 4-week period. Clinical controls were performed to evaluate symptoms, antacid consumption, compliance with trial tablet consumption; hematological and biochemical tests were also carried out at the end of the 4 and 8-week periods. No differences were observed between the healing rate induced by 300 mg nocte and 150 mg b.i.d., after 4 weeks of treatment (76% and 79% respectively) and after 8 weeks (100% in both groups). Similar results were obtained as far as symptoms, antacid consumption and compliance are concerned. Neither treatment regimen induced appreciable side-effects. PMID- 3514489 TI - Interplay of various factors in glucose-induced hyperkalemia during captopril treatment. AB - The effect of angiotensin converting enzyme inhibition by captopril (CAP) on serum potassium (SK) changes was studied during a three-hour glucose tolerance test (GTT) in recumbent and upright positions in 16 patients with drug-resistant hypertension. An elevation of SK in the upright posture occurred in the course of GTT during CAP treatment in 50% of the patients (Group I) even without consistent changes in baseline SK. In Group II a qualitatively normal glucose-induced hypokalemic response was obtained. Aldosterone was suppressed by CAP, predominantly in the upright position in Group I due to the significant interaction between the drug and posture. Significant inverse correlations were found in Group I between glucose-induced serum potassium changes and basal glomerular filtration rate. A similar correlation was found also with serum insulin in the whole patient material. It was concluded that the interplay of various factors, CAP, upright posture and impaired renal functions resulting in suppression of aldosterone and insulin played a role in the paradoxical glucose induced serum potassium elevation. PMID- 3514490 TI - Changes in serum phosphorus, calcium and alkaline phosphatase due to sucralfate. AB - We report on the results of the clinical trial, where the effects of sucralfate on the serum phosphorus, calcium and alkaline phosphatase in 30 patients with chronic renal failure on intermittent hemodialysis were examined. After 14 days of treatment with sucralfate (1 gram four times daily), we found a significant reduction in serum phosphorus and alkaline phosphatase and an increase in serum calcium. On the basis of its proven hypophosphatemic and ulcer-healing effects, sucralfate can be recommended in treatment of hyperphosphatemia and secondary hyperparathyroidism in chronic renal failure. Serum phosphorus should be checked routinely in patients treated with sucralfate for the peptic ulcer disease. PMID- 3514491 TI - Prevention of migraine attacks through the use of dihydroergotamine. AB - A strictly controlled clinical trial on a group of 20 patients treated with a time-release preparation of dihydroergotamine compared with 20 on a placebo for the prevention of migraine attacks confirmed that dihydroergotamine was very effective and considered satisfactory by 65% of the patients treated. PMID- 3514492 TI - Analgesizing effect of a methyl donor (S-adenosylmethionine) in migraine: an open clinical trial. AB - The long term administration of a methyl donor (S-adenosylmethionine, SAM) relieves pain in migraine sufferers. The benefit arises gradually and long-term treatment is required for therapeutic effectiveness. Since SAM is an almost ubiquitous methyl donor in many biological systems, an explanation of this peculiar therapeutic effect is only speculative. The activity of SAM on 5 hydroxytryptamine turnover is the most reasonable interpretation of the results. PMID- 3514493 TI - Circadian rhythms in effects of hypnotics and sleep inducers. AB - Chronopharmacology involves the investigation of drug effects as a function of biological time and the investigation of drug effects on rhythm characteristics. Three new concepts must be considered: (a) the chronokinetics of a drug, embracing rhythmic (circadian) changes in drug bioavailability (or pharmacokinetics) and its excretion (urinary among others); (b) the chronaesthesia of a biosystem to a drug, i.e. circadian changes in the susceptibility of any biosystem to a drug (including organ systems, parasites, etc.); skin and bronchial chronaesthesia to various agents have been documented in man; and (c) the chronergy of a drug, taking into consideration its chronokinetics and the chronaesthesia of the involved organismic biosystems. The term chronergy includes rhythmic changes in the overall effects and in the effectiveness of some drugs. Clinical chronopharmacology is useful for solving problems of drug optimization, i.e. enhancing the desired efficiency of a drug and reducing its undesired effects. Circadian rhythms can be demonstrated in various effects of drugs on sleep, anaesthesia and related processes. For example, in the rat the duration of sleep induced by substances such as pentobarbital, hexobarbital, Althesin (alphaxadone and alphadoline in castor oil) is circadian system stage-dependent. Time-dependent changes of liver enzymes (e.g. hexobarbital oxidase) play a role in these circadian rhythms. The clinical chronopharmacokinetics of benzodiazepines have been documented in man. Chronopharmacologic methods can be used to study desired and undesired hypnotic effects of substances. Such is the case of new antihistamines (anti-H1), which do not induce sleepiness, in either acute or chronic administration. Pertinent also is the problem of intolerance to shift-work. Intolerant shift-workers are subject to internal desynchronization between at least two rhythms (e.g. activity-rest cycle and body temperature). Clinically these workers suffer from sleep disturbances, persistent fatigue and are regular users of sleeping pills, which is also a symptom of intolerance. However, over the long-term, these drugs are of no help to intolerant shift-workers. PMID- 3514494 TI - Treatment of claudication with dipyridamole and aspirin. AB - The effects of dipyridamole in association with acetylsalicylic acid were compared with the effects of acetylsalicylic acid alone in patients with peripheral vascular disease. The following parameters were studied in each patient: symptoms-free interval on the treadmill, ankle-arm arterial pressure gradient, oscillographic index, venous occlusion plethysmography and any untoward reactions. Changes were observed in the pain-free interval (p less than 0.005), and in the venous occlusion plethysmography (p less than 0.001) in the patients treated with the two drugs in association. PMID- 3514496 TI - Unethical behavior in an ethical industry? Critical coverage of the pharmaceutical industry, 1983-1984. PMID- 3514495 TI - Clinical evaluation of flurbiprofen alone and plus ampicillin in chronic pharyngitis in acute phase. AB - An open, controlled, completely randomized between-patients study was carried out on 41 patients with chronic pharyngitis in the acute phase. The study was divided in two parts. In the first one the effect of a single flurbiprofen rectal dose was studied in 10 patients: 5 treated with flurbiprofen (120 mg) and 5 with flurbiprofen (100 mg) plus oral ampicillin (500 mg). In the second part 31 patients were treated with flurbiprofen (200 mg/day) for 4 weeks; 18 out of 31 were also treated with ampicillin (1 g/day) for the first week. The mean age was approximately 53 years in the single dose study and 40 days in the long-term one. Flurbiprofen alone allowed an excellent control of pain and of signs of inflammations equivalent to the one obtained in combination with ampicillin but without exposing the patients to the risks of the undesired effects of antibiotics. PMID- 3514497 TI - The hospice movement: institutionalizing innovation. AB - The early leaders of the hospice movement shared a number of attitudes with the founders of the alternative institutions of the 1960s and early 1970s: nostalgia for simple, old fashioned ways, dissatisfaction with bureaucratic and authoritarian institutions, faith in the power of nature, a determination to avoid domination by experts, and a desire to improve the quality of personal relationships. However, as hospices have become better established, they gradually have been incorporated into the dominant health care system and have lost their uniqueness. Some have affiliated with hospitals or home health agencies. Even autonomous organizations are subject to pressures for accommodation because they rely on the established order for resources, personnel, and political acceptance. Organizations receiving payment under the new Medicare benefit must adhere to a set of regulations that may distort the movement. Though creation of this benefit may have been facilitated by increased support for hospice ideals, the government views hospices primarily as a way to save money. Paradoxically, as hospices have grown in popularity, the critical force of the movement has been blunted. PMID- 3514498 TI - Skeletal muscle atrophy during immobilization. PMID- 3514499 TI - A review of methodological issues of the standardized mortality ratio (SMR) in occupational cohort studies. AB - This paper is a review and clarification of methodological issues related to the standardized mortality ratio (SMR), widely used in occupational epidemiology. Although the SMR seems to be a simple statistic, it can be misused and misinterpreted. The paper discusses SMRs in relation to age-specific mortality ratios, relative risk, life expectancy, and statistics derived from direct standardization. Inter-SMR comparisons and the effect of the choice of the comparison population on the SMR are also discussed. Mathematical and empirical review of SMR use has led to the development of a correction procedure which permits direct comparisons of two SMRs by adjusting for the age distributions of the two populations. The paper also proposes a method for testing the trend of age-specific mortality ratios (MRs). If MRs are homogeneous, this method can also be used to compare two SMRs. If MRs are not homogeneous, the relative risk between two sets of age-specific MRs can be tested for significance, but no summary index, including the SMR, can accurately describe the mortality experience over the entire age range. It is suggested that the summary statistics of a cohort mortality experience should include relative risk, attributable risk, and life expectancy. These statistics are complementary and can be derived or approximated from the data that generated the SMR. A valid risk assessment should weigh the evidence from all three summary statistics. PMID- 3514500 TI - The use of the kidney biopsy to predict allograft loss in a pediatric transplant population. AB - Forty-seven biopsy specimens of renal allografts from pediatric transplant recipients were evaluated by light microscopy using a 117 item survey of histopathologic changes. The presence and distribution of immunofluorescent staining were also evaluated. Histopathologic findings associated with irreversible allograft rejection were determined using statistical methods and then correlated with one another. The effect on allograft survival when several of these features were present on the same specimen was assessed. Glomerular, arteriolar and small artery changes were associated with irreversible rejection. When several of these histologic findings occurred on the same biopsy specimen the allograft was always lost. Interstitial and tubular changes generally not predictive of rejection and immunofluorescent staining was not associated with graft loss. PMID- 3514501 TI - Studies of long-term continuous irradiations using daily doses ranging from 0.07 to 0.30 Gy on the B lymphoid system of the rat. AB - The effects of a continuous exposure to cobalt gamma rays administered to rats at a daily dose of 0, 0.07, 0.12, 0.20 or 0.30 Gy for a period of up to 90 or 135 days, have been observed on their B lymphocyte populations and on their immunoglobulin serum levels. The effects increase with the daily dose and the duration of irradiation. At a daily dose of 0.07 Gy, no clear effect was observed. The depletion was almost negligible after 30 days at a daily dose of 0.12 Gy, but visible after all other doses and durations. However, a clear difference in susceptibility was observed between the marginal zone B compartment and the follicular one, the former being much more affected by the radiation than the second. PMID- 3514503 TI - Management of dental phobia: the use of fear-screening questionnaires. PMID- 3514502 TI - Invisible care and invisible women as health care-providers. AB - The author relates how the social and economical value of care provided by women changed completely with the confiscation of women's knowledge of the use of writing, held in men's hands. Furthermore, the rise of Christianity introduced despising and condemnation of the body, considered as the source of evil. While prosecuting as witches those women careproviders who were matrons and sages, the Church instituted consecrated women to provide what she expected from care giving, and had them recognized as the socialized model of care-providers. The development of an ideology of care based upon dedication to the poor and salvation of the soul took the place of a fundamental knowledge of body care practices. This paved the way during the nineteenth century for the increased value of technical cure and consideration of care as menial work, worthless, requiring no ability, no knowledge, and therefore socially and economically unrecognized. PMID- 3514504 TI - More on the outbreak of invasive aspergillosis among allogeneic bone marrow transplants at Roswell Park Memorial Institute. PMID- 3514505 TI - Group B streptococcus. PMID- 3514506 TI - Strategies for preventing neonatal group B streptococcal disease. PMID- 3514507 TI - An outbreak of group A streptococcal bacteremia in an intensive care unit. AB - Admission of a patient with group A streptococcal cellulitis and bacteremia to the intensive care unit of a tertiary care teaching hospital was followed by two subsequent cases of group A streptococcal bacteremia with pneumonia in the unit. All streptococcal isolates were the same M- and T-type. Endotracheal intubation with respiratory ventilation was a risk factor for disease acquisition. The characteristics of onset of the two nosocomially acquired cases suggested that a staff member may have been, at least transiently, a streptococcal carrier, but no such carrier was identified. No further cases occurred subsequent to a period when all patients in the unit received antibiotics effective for group A streptococcal therapy. PMID- 3514508 TI - Cost-effective use of the throat culture in acute pharyngitis. PMID- 3514509 TI - Genetic, biochemical, and molecular approaches to Volvox development and evolution. PMID- 3514510 TI - The ribosomal genes of Plasmodium. PMID- 3514511 TI - Molecular biology of DNA in Acanthamoeba, Amoeba, Entamoeba, and Naegleria. PMID- 3514512 TI - [Drug lists for hospitals--how do they originate and of what use are they?]. PMID- 3514514 TI - [Evaluation of the therapeutic value of drugs--a responsibility of clinical pharmacology]. PMID- 3514513 TI - [Is openness in the drug market possible?]. PMID- 3514515 TI - [New dosage forms for drugs]. PMID- 3514516 TI - [When is determination of drug concentrations in plasma useful or necessary?]. PMID- 3514517 TI - [Informing the patient about drugs]. PMID- 3514518 TI - [131-iodine meta-iodobenzylguanidine scintigraphy and therapy in malignant pheochromocytoma]. PMID- 3514519 TI - [New aspects of classification, diagnosis and therapy of amyloidoses]. PMID- 3514520 TI - [Typing of amyloidoses intra vitam by tissue biopsy using antibodies. Report on 2 patients]. AB - The value of the immunohistochemical classification of amyloid-syndromes has been illustrated in two patients with generalized amyloidosis. Chemical types and exact diagnosis were recognized in biopsies (and later necropsies) using antisera against different purified amyloid fibril proteins and the indirect immunoperoxidase technique. The first case, originally diagnosed as "perireticular" amyloid, was diagnosed as "Ak-amyloidosis with kappa-Bence-Jones proteinuria without apparent B-cell malignoma", the second case as "AA amyloidosis reactive to periodic fever". The diagnosis and possible therapeutic measures are discussed in the light of the new classification of amyloid syndromes. PMID- 3514521 TI - [Pancytopenia and Salmonella infantis infection]. PMID- 3514522 TI - [Pancreatitis as a diagnostic error in masked perforated duodenal ulcer with formation of a retroperitoneal abscess]. PMID- 3514523 TI - [Diagnostic error: non-Hodgkin lymphoma]. PMID- 3514524 TI - [20-year-old patient with hemolytic anemia and leuko- and thrombopenia]. PMID- 3514525 TI - [Dyspnea and upper inflow obstruction in a 43-year-old male]. PMID- 3514526 TI - [Current problems in gene technology and embryo transfer]. PMID- 3514527 TI - [Significance of molecular biology for the development of new concepts in medicine]. PMID- 3514528 TI - [Gene technology: principles and uses]. PMID- 3514530 TI - [The weakness of freedom or the power of responsibility--exemplified by gene research in humans]. PMID- 3514529 TI - [Artificial insemination and embryo transfer. Legal and legal-ethical aspects]. PMID- 3514531 TI - Rapid visualization of three common fungi using fluorescein-conjugated lectins. AB - The feasibility of using fluorescein-conjugated lectins to visualize and differentiate three fungi commonly involved in ophthalmic mycoses was evaluated. Using a panel of fluorescein-conjugated lectins, Candida albicans, Aspergillus fumigatus, and Fusarium solani were rapidly and reproducibly visualized in in vitro culture isolates, as well as in tissue samples and fixed histopathologic specimens taken from experimental mycoses. Additionally, Aspergillus and Fusarium were consistently differentiated from Candida. The binding affinities of the different lectins corresponded well with the individual sugar composition of the fungal cell walls. PMID- 3514532 TI - Human basement membrane components of keratoconus and normal corneas. AB - Using immunofluorescence techniques, we analyzed the distribution of glycoproteins in normal and keratoconus corneas of humans. Laminin, bullous pemphigoid antigen, fibronectin, and fibrin/fibrinogen were all found in the epithelial basement membrane of normal corneas. Keratoconus corneas produced similar results, except that staining for fibrin/fibrinogen was weak. Fibrin/fibrinogen was absent from normal corneal basement membrane in animal models studied previously. Keratoconus may be the result of the lysis of fibrin or may involve impeded elaboration of fibrin. PMID- 3514533 TI - Monoclonal antibodies to human amnion recognize different components of the rabbit eye. AB - The epithelium of the eye originates from embryonic ectoderm, whereas the amnion is an extra-embryonic membrane that bears close relationship with many ectodermal tissues. Shared antigens have been identified between human amnion and cornea using rabbit antisera to human amnion. Three monoclonal antibodies to human amnion, GB4, GB9, and GB11 were studied by immunofluorescence on the anterior segment of the rabbit eye. GB4 recognized the epithelium of the conjunctiva and the subcapsular epithelium of the lens. GB9 reacted only with the central four fifths of the corneal epithelium; the peripheral epithelium near the limbus was not reactive. GB11 detected the pigmented epithelial cells in ciliary processes. PMID- 3514534 TI - Arterial digital angiography in the evaluation of potential renal donors. AB - Twenty-two potential renal donors were examined by both arterial digital and conventional aortography. The digital studies accurately identified all of the renal arteries. Digital subtraction angiography may be a suitable alternative to conventional aortographic evaluation of the renal arterial supply of potential renal donors. PMID- 3514535 TI - Penetration of subarachnoid contrast medium into rabbit spinal cord. Comparison between metrizamide and iohexol. AB - The penetration into rabbit spinal cord of two nonionic contrast media, iohexol and metrizamide, and a reference tracer, technetium DTPA, were compared. The spinal subarachnoid space was perfused for 4 hours with a CSF solution to which technetium DTPA and either iohexol or metrizamide had been added. The contrast media and technetium DTPA concentrations reached a plateau level in CSF outflow within 80 minutes. The contrast media concentrations in CSF were higher than the technetium DTPA (P less than .001). In the cord tissue, technetium DTPA reached higher concentrations than the contrast media (P less than .001), and iohexol reached higher concentrations relative to technetium DTPA than metrizamide (P less than .001). The mean contrast media distribution volumes in the thoracic cord were 13% (iohexol) and 12% (metrizamide). The smaller distribution volume observed for metrizamide could be related to the larger effective size of "associated" metrizamide molecules or an interference with diffusion perhaps related to binding to glucose carriers. PMID- 3514536 TI - Lung cancer. Part II. Staging and therapy. PMID- 3514537 TI - Postoperative parathyroid high-frequency sonography: evaluation of persistent or recurrent hyperparathyroidism. PMID- 3514538 TI - Notice of retraction. PMID- 3514539 TI - Increasing weight and girth after neurosurgery. PMID- 3514540 TI - Contrast media tonicity. Part I. Effects upon IV-DSA time-concentration curve peak and width: experimental studies. AB - Prior to the formation of an intravenous digital subtraction angiography (IV-DSA) image, contrast medium passes through the lesser circulation and is diluted by the blood volume of the heart and lungs. If the contrast medium alone influences central blood volume or cardiac output, the shape of the resultant time concentration curve may be degraded. To the extent that contrast medium tonicity reduces curve peak or increases width, image quality for mask mode IV-DSA will suffer. To quantify the effect of contrast medium tonicity upon curve shape, contrast medium (1) at increasing iodine concentration and increasing osmolality and (2) at constant iodine concentration and increasing osmolality was injected into the right atria of mongrel dogs. In both experiments, increasing osmolality was associated with an increase in central blood volume (CBV) and cardiac output. With an increase in CBV, curve peak fell. With an increase in both CBV and cardiac output, curve width was not influenced by increasing osmolality. The effect of osmolality upon CBV was highly variable; in these experiments CBV was influenced more by subject-to-subject variability. However, on the average, higher tonicity contrast media produced curves with lower peaks. These studies suggest that isotonic contrast medium does not increase CBV and that isotonic contrast medium is preferable to hypertonic contrast medium for IV-DSA image formation. PMID- 3514541 TI - The ultrasonic detection of soft tissue foreign bodies. AB - The ability of B-scan ultrasonography to detect soft tissue foreign bodies of various sizes and composition was investigated in a canine model. Foreign bodies consisting of wooden rods 0.7 mm and larger, lead-free glass rods 2.0 mm and larger, plastic rods 3.9 mm and 5.6 mm, and metal needles 0.5 mm and larger were embedded in fleshy soft tissue. All objects examined were discernible. Wood is best visualized followed by glass, plastic, and metal. Ultrasound may be a valuable noninvasive means of detecting soft tissue foreign bodies; further investigation to delineate its clinical role is warranted. PMID- 3514542 TI - Unsuspected fetal abnormality. Fetal cystic hygroma associated with Turner's syndrome. PMID- 3514543 TI - Bornaprine vs placebo in Parkinson disease: double-blind controlled cross-over trial in 30 patients. AB - The study covers 30 patients with idiopathic Parkinson disease, 13 men and 17 women, aged between 50 and 70, on stabilized L-Dopa and/or bromocriptine, which failed to ensure adequate control of the symptoms, especially tremor. To this regimen was added Bornaprine/placebo in randomized sequence. The patients were tested according to the Webster Rating Scale before, during and after each stage of the treatment. Statistical analysis of the results showed the superiority of Bornaprine over the placebo in reducing tremor (p less than 0.01) and, to a lesser degree, some other parkinsonian symptoms. No noteworthy side effects were found apart from dryness of the mouth, which was more frequent with Bornaprine. PMID- 3514544 TI - Influence on psychological development of early treatment of congenital hypothyroidism detected by neonatal screening: a controlled study. AB - It has been shown that early diagnosis and treatment of congenital hypothyroidism based on neonatal screening will improve outcome. To test this hypothesis, we performed standard psychological tests (Gesell, Stanford-Binet, or Wechsler) in three groups of children with treated hypothyroidism: 14 were discovered by neonatal screening and 24 (15 with thyroid agenesis and 9 with ectopic thyroid) were diagnosed prior to institution of screening. Age (weeks) at initial treatment differed among the three groups (mean values +/- SE: screened 4.6 +/- 0.8, thyroid agenesis 19.3 +/- 4.0, ectopic thyroid 46.4 +/- 8.0). Age at testing averaged 3.3 years in all three groups. The global developmental quotient (DQ) or IQ score was lowest in the thyroid agenesis group (82 +/- 6, range 52 to 142), intermediate in the ectopic thyroid group (93 +/- 10, range 56 to 141) and highest in the screening group (104 +/- 4, range 75 to 127). Neonatal screening for congenital hypothyroidism results in earlier diagnosis than does use of the clinical criteria, and the consequent early treatment results in improved psychomental development. PMID- 3514545 TI - Impact of a protocol for external cephalic version under tocolysis at term. AB - We present our experience with 60 trials of external cephalic version under tocolysis (EVT) performed on 58 women with uncomplicated (low-risk) pregnancies at term (37 to 42 weeks) during a 10-month period. Version was successful in 67.2% of the subjects (70.7% of trials). Fetal well-being was monitored before, during and after the procedure by cardiotocography and real-time ultrasound (RTUS). No analgetic or anesthetic medication was administered. Transient fetal bradycardia was recorded in 18 women. No major complications were noted. Compared with the period preceding the protocol, the breech rate declined during the study period by 1.02% (P less than 0.02) with a parallel decline of 1.12% (P less than 0.001) in the low-risk breech group affected by the protocol. The cesarean section rate for low-risk breeches fell from 1.85 to 0.89% (P less than 0.001), while the overall cesarean section rate decreased from 10.15 to 9.1% (not significant). We conclude from our experience and previous studies that EVT/RTUS is a reasonable alternative in the management of pathological presentations near term, provided that only low-risk pregnancies are included, and analgesia or anesthesia for external version under tocolysis is avoided. PMID- 3514546 TI - Should it be easier or harder to use unapproved drugs and devices? AB - In applying statutory safeguards, the FDA must not regulate investigational new products so stringently that a life-saving therapy is unavailable. But the agency must also protect dying patients from exploitation by unscrupulous or overzealous researchers. The balance between individual choice and public protection has been questioned in cases involving experimental AIDS drugs and an artificial heart. PMID- 3514548 TI - Science, religion, belief and Baby Fae. PMID- 3514547 TI - How technology is reframing the abortion debate. AB - Since the 1973 Supreme Court decision legalizing abortion, medical and scientific developments have focused greater public and professional attention on the status of the fetus. Their cumulative effect may influence legal, social, and moral thought and set the stage for a change in public opinion and a challenge to legalized abortion. There is as yet no inexorable convergence of medical data and legal opinion that would undermine the rational of Roe v. Wade. But the prochoice movement must find room for an open airing of the moral questions if abortion is to remain what it should be--a legally acceptable act. PMID- 3514549 TI - Flunarizine versus pizotifen: a double-blind study in the prophylaxis of migraine. PMID- 3514551 TI - Thomas Willis' two chapters on headache of 1672: a first attempt to apply the "new science" to this topic. PMID- 3514550 TI - Nonpharmacological treatment of menstrual headache: relaxation-biofeedback behavior therapy and person-centered insight therapy. PMID- 3514553 TI - The British Dietetic Association--50 years on. PMID- 3514554 TI - The Rose Simmonds memorial lecture. Translating nutritional science into good diet--the role of the dietitian. PMID- 3514552 TI - Legislation and you. Deficit reduction: its impact on home health care. PMID- 3514555 TI - Extended field (periaortic) irradiation in carcinoma of the prostate--analysis of RTOG 75-06. AB - From 1976 to 1983 the Radiation Therapy Oncology Group conducted a study of extended field (periaortic) irradiation in carcinoma of the prostate. Eligible patients were those with clinical Stage C tumor with or without evidence of pelvic lymph node involvement and also those with Stage A-2 and B with evidence of pelvic lymph node involvement. The stratification criteria included histological grade, clinical stage, absence or presence of hormonal manipulation, and method of lymph node evaluation (lymphangiogram vs. laparotomy vs. no nodal evaluation). The patients were randomized to either receive pelvic irradiation followed by a boost to the prostate or pelvic and periaortic irradiation followed by a boost to the prostate. The prescribed daily dose was 180-200 rad to a total midplane dose to the regional lymphatics to 4000-4500 rad. The prostatic boost target volume was to receive additional 2000-2500 rad bringing the total dose to that area to a minimum of 6500 rad. A total of 523 analyzable patients have been accessioned to the protocol. Four hundred forty-eight of these are known to have received treatment per protocol. Median follow-up is 4 years and 3 months. The analyzable patients were evaluated for the incidence of distant metastases, NED survival and survival as a function of treatment arm. No statistically significant differences between the treatment arms could be documented. Similarly, no significant difference between treatment arms could be documented within a number of subpopulations such as those characterized by a particular grade, hormonal status, stage, age, acid phosphatase level, etc. The results of the study revealed no apparent benefit of elective periaortic irradiation in patients with detectable disease confined to the pelvis. PMID- 3514556 TI - A computer-aided instructional module for radiological physics. AB - A computer program and instructional module have been written to assist the physicist in radiation therapy physics instruction. The program, written in Pascal, presents the student with a screen of instructional material, followed by a multiple choice question pertaining to that material. A correct response allows the student to proceed to the next screen. If the answer is incorrect, another screen is presented which explains to the student why the answer is incorrect. Then the original screen and question are repeated. The program is general and can be used with any instructional module. It also is transportable, with a minimum of machine-dependent instructions. PMID- 3514557 TI - Radiation therapy of inoperable lung cancer. PMID- 3514558 TI - Contraceptive use in the chronically ill adolescent female: Part I. PMID- 3514559 TI - Atypical Histoplasma capsulatum infection in a dog. AB - Disseminated histoplasmosis was diagnosed in a 10-year-old dog suspected of having hepatic carcinoma. Clinical abnormalities included diffuse hepatomegaly, gastrointestinal bleeding, thoracic and abdominal effusion, anemia, leukocytosis, and thrombocytopenia. Histoplasmosis characteristically is a disease of the mononuclear phagocyte system, but in this case was diagnosed by finding Histoplasma capsulatum organisms in neutrophils on the blood smear. PMID- 3514560 TI - Platelet dysplasia associated with megakaryoblastic leukemia in a dog. AB - In a case of megakaryoblastic leukemia in a dog, definitive diagnosis was made through use of specific cytochemical stains of circulating and bone marrow blast cells. Morphologic and functional abnormalities of platelets were revealed through transmission electron microscopy and in vitro aggregation of platelets after addition of adenosine diphosphate. PMID- 3514561 TI - Equine pediatrics: septic arthritis and osteomyelitis. PMID- 3514562 TI - A live Pasteurella haemolytica vaccine efficacy trial. AB - A live Pasteurella haemolytica serotype 1 vaccine was used in an efficacy trial conducted on 100 lightweight feeder calves purchased from a Florida ranch. Forty one calves were inoculated with the vaccine intradermally in the neck. Fifty-nine calves served as nonvaccinated controls. Fourteen days later, the calves were shipped to an order buyer in eastern Tennessee, where the calves were mixed with 60 local calves in a community sale barn for 72 hours. After 3 additional days, the calves were shipped to a research feedlot in Bushland, Tex. They remained in the feedlot for 56 days, and the test was concluded 76 days after vaccination. The P haemolytica vaccine had no significant effect on performance, morbidity, or mortality. There was no significant difference between the vaccinated and nonvaccinated calves in the number of times Pasteurella was isolated. The calves became seropositive to bovine viral diarrhea virus, respiratory syncytial virus, and infectious bovine rhinotracheitis (IBR) virus during the 76-day experiment. All calves initially were seropositive to parainfluenza-3 virus. A virulent outbreak of IBR occurred 30 days after the calves arrived at the feedlot. Before the onset of IBR, the isolation of P haemolytica serotype 1 from nasal turbinates was rare (2 of 500 nasal swabs). After the IBR outbreak, P haemolytica serotype 1 was isolated from 40 of 92 calves. PMID- 3514563 TI - Occurrence of an ascamycin dealanylating enzyme, Xc-aminopeptidase, in mammalian cell membranes and susceptibility to ascamycin. AB - An ascamycin dealanylating enzyme (Xc-aminopeptidase) has been isolated from Xanthomonas citri and characterized as a proline iminopeptidase of molecular weight of 38,000 (H. OSADA & K. ISONO, Biochem. J. 233: 459 approximately 463, 1986). Immunological studies have shown that all the mammalian cells tested possess a closely-related enzyme(s) on their cell membranes. This enzyme is more active in transformed cells than in nontransformed cells. A decreased ratio of ID50 (ascamycin/dealanylascamycin based on [35S]methionine uptake) in transformed cells compared with the nontransformed cell can be explained on the basis of the conversion of ascamycin to dealanylascamycin by the enzyme. It is suggested that ascamycin cannot be transported through mammalian cell membranes but dealanylascamycin can permeate; a similar situation exists in prokaryotic cells. PMID- 3514564 TI - Synergism of cephalosporins at subinhibitory concentrations and polymorphonuclear leukocytes on phagocytic killing of Escherichia coli and its mode of action. AB - The interactions between subinhibitory concentrations of cephalosporins and polymorphonuclear leukocytes in the killing of a strain of Escherichia coli are described and an attempt is made to define the responsible mechanism. Ceftizoxime was the most potent agent tested. Pretreatment of the E. coli strain with subinhibitory concentrations of ceftizoxime increased the susceptibility to both; phagocytic killing activity of the polymorphonuclear leukocytes and bactericidal activities of the oxygen metabolites and the granule extracts. A most interesting result was the increased susceptibility of the ceftizoxime-treated E. coli to killing by beta-glucuronidase which normally is not bactericidal. It is suggested that the augmented killing could be due to bacteriolysis by beta-glucuronidase. PMID- 3514565 TI - Neuron-specific enolase immunoreactivity in the developing mouse cochlea. AB - Onset of neuron-specific enolase reactivity was observed on gestation day 17 in spiral ganglion cells of the basal coil, and 2 days later in cochlear inner (IHC) and outer (OHC) hair cells. IHCs and OHCs were similarly reactive up to postnatal day 7, then the reactivity began to decrease in OHCs. PMID- 3514566 TI - Insulin binding to bovine mammary membranes: comparison of microsomes versus smooth membranes. AB - The study was undertaken to determine if membrane preparations of bovine mammary tissue bound insulin. If binding occurred, it was also the intent to compare binding kinetics between microsomes and smooth membranes. Insulin binding to bovine mammary membranes attained equilibrium, was saturable and was specific for insulin. Additional studies showed binding to be pH sensitive and maximal at 10 mM calcium. Binding affinity of insulin to microsomes and smooth membranes was similar, with the exception that smooth membranes bound 1.8 times more insulin per unit of membrane protein than microsomes. Two different methods were used to generate data for kinetic analysis of the insulin-receptor interaction in microsomes. Competitive binding assays (.6 ng [125I]insulin plus 0 to 100 ng insulin) indicated the presence of two binding sites with dissociation constants (Kd) of .32 and 15.8 nM. Direct titration of microsomes with [125I]insulin (.02 to 10 ng/ml) revealed two binding sites with Kd of .017 and .31 nM. The affinity of the second binding site measured by the competitive binding assay method (Kd of 15.8 nM) is low and therefore may not be of physiological importance for insulin action. Insulin appears to bind to two high-affinity receptor sites in bovine mammary microsomes with Kds of .017 nM and .32 nM. These findings show that bovine mammary tissue contains receptors for insulin. In addition, isolation of smooth membranes from microsomes enriches the number of insulin receptors per unit of membrane protein without altering their binding characteristics. PMID- 3514567 TI - Body weight, total body water and hematocrit in diarrheic piglets. AB - Piglets aged 12 to 72 h in which diarrhea had been induced by enteric Escherichia coli infection or sucrose gavage were studied with respect to body weight, total body water concentration (determined by tritiated-water dilution) and hematocrit. Sucrose-induced diarrhea reduced body weight by 13 to 17%, and E. coli diarrhea, by 8 to 9%. Neither age nor diarrheal treatment affected total body water concentration, although diarrheic piglets tended to have higher hematocrit values at all ages. There was a significant daily cycle in the piglets' hematocrit values, so hematocrit might be a less valid reflector of neonates' whole body hydration status than of adults'. It was concluded that diarrheic neonatal piglets lose body water and dry matter in a ratio similar to that of normal body water and dry matter concentrations, thus their bodies have normal total body water concentrations and normal average specific heat values. PMID- 3514568 TI - Cold resistance and environmental temperature preference in diarrheic piglets. AB - Piglets aged 12 to 72 h in which diarrhea had been induced by enteric Escherichia coli infection or sucrose gavage were studied with respect to cold resistance and thermal-circulation index in a 90-min test in a 6 C environment (Exp. 1) and free choice environmental-temperature preference during a 60-min test in a 24 to 44 C thermocline (Exp. 2). In Exp. 1, diarrhea lowered the piglet's ability to maintain body temperature during the cold test. Also, diarrheic piglets tended to have lower thermal circulation index values at the end of the cold test, indicative of a greater vasoconstrictive response to the cold environment. In Exp. 2, mean preferred environmental temperatures were 35.7, 34.9 and 34.5 C, respectively, for piglets in sham-control, E. coli-infected and sucrose-gavaged groups. For reason(s) still unknown, diarrheic piglets did not choose to locate themselves in a warmer niche than did normal piglets; in fact, they did the opposite. Results of the two experiments indicate that diarrheic neonatal piglets need even more attention and care in terms of the thermal environment than do healthy ones. PMID- 3514569 TI - Stimulation of lipogenesis in bovine adipose tissue by insulin and insulin-like growth factor. AB - The present study was undertaken to determine if insulin and insulin-like growth factor 1 (IGF-1) stimulated lipogenesis in bovine adipose tissue and determine the effects of insulin on lipogenic capacity in adipose tissue cultured for 48 h. In contrast to previous studies, insulin markedly stimulated lipogenesis in short term (2 h) incubations. The stimulation of lipogenesis by insulin was dependent upon the source of bovine serum albumin used in the buffer. Insulin-like growth factor 1 also stimulated lipogenesis; however, the potency was 80- to 100-fold lower than for insulin. Lipogenic capacity was decreased approximately 75% after 48 h of culture in the absence of insulin. When insulin was present in the culture medium, the reduction in lipogenic capacity was attenuated in a dose dependent manner. However, insulin alone did not totally maintain lipogenic capacity after 48 h. In contrast, inclusion of hydrocortisone (HC; 50 ng/ml) and insulin (10 ng/ml) in the medium completely prevented the decline in lipogenic capacity of cultured bovine adipose tissue. In summary, these results indicate that bovine adipocytes are quite sensitive to insulin in short-term in vitro incubations and that insulin plays a predominant role in maintenance of lipogenic capacity of bovine adipose tissue during culture. Furthermore, the marked potentiation of insulin's effects of lipogenesis after 48 h of culture by HC suggests that the glucocorticoid is involved in regulation of insulin receptor number and(or) other cellular proteins (e.g., enzymes) which are important for lipogenesis to occur. PMID- 3514570 TI - Remarkable metabolic availability of oral glucose during long-duration exercise in humans. AB - It was reported previously that glucose ingestion prior to or at the beginning of muscular exercise was a readily available metabolic substrate. The aim of this study was to see what percentage of carbohydrate utilization can be covered by glucose ingested regularly during exercise. Male healthy volunteers exercised for 285 min at approximately 45% of their individual maximal O2 uptake on a 10% uphill treadmill. After 15 min adaptation to exercise they received either 200 g (group G 200) or 400 g (group G 400) glucose (0.25 g X ml H2O-1) orally in eight equal doses repeated every 30 min (G 200 = 8 X 25 g, n = 4; G 400 = 8 X 50 g, n = 4). Indirect calorimetry was used to evaluate carbohydrate and lipid oxidation. Naturally labeled [13C]glucose was used to follow the oxidation of the exogenous glucose. Total carbohydrate oxidation was 341 +/- 22 and 332 +/- 32 g, lipid oxidation was 119 +/- 8 and 105 +/- 5 g, and exogenous glucose oxidation was 137 +/- 4 and 227 +/- 13 g (P less than 0.005) in groups G 200 and G 400, respectively. Endogenous glucose oxidation was about half in G 400 of what it was in G 200: 106 +/- 27 vs. 204 +/- 24 g (P less than 0.02). During the last hour of exercise, exogenous oxidation represented 55.3 and 87.5% of total carbohydrate oxidation for groups G 200 and G 400, respectively.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3514571 TI - Differential recruitment of expiratory muscles during opossum development. AB - Relationships between time-averaged electromyogram (EMG) discharge in abdominal (ABD) and lateralintercostal (IC) muscles (interspaces 1-10) were evaluated when Inactin-anesthetized supine opossums between 20 and 100 days of age were challenged by positive-pressure breathing (PPB) (3, 6, and 8 cmH2O). Expiratory activity upon initiation of PPB was observed in ABD muscles after the 30th postnatal day; recruitment of IC muscles requires further maturation. For example, at a PPB level of 6 cmH2O, animals up to 50-55 days of age recruited IC muscles from the lowest three interspaces on 44% of the occasions where ABD muscles were activated; in older animals the incidence of IC recruitment increased to 87%. Additionally, the occurrence of IC relative to ABD recruitment increased with increasing levels of PPB; IC muscles of highest interspaces (1-3) were activated less often at all pressures. At the onset of PPB, ABD muscles were usually recruited before IC muscles; this effect was more prominent in the younger animals. During the 5th min of PPB, ABD muscles were recruited earlier in expiration than IC muscles in the majority of animals at all ages. Since IC and ABD motor groups are activated from similar levels of the spinal cord, the delayed maturation of IC muscle responses to PPB may reflect developmental processes involving reflexes from the chest or abdomen, and/or may be a function of nonrespiratory utilization (i.e., postural) of ABD and IC muscles. PMID- 3514572 TI - Effect of elevated FFA on carbohydrate and lipid oxidation during prolonged exercise in humans. AB - Increased availability of circulating free fatty acids (FFA) inhibits the rate of glycolysis in heart and resting skeletal muscle (Randle effect). Whether elevated FFA may play a role in decreasing carbohydrate oxidation during prolonged exercise in humans is more controversial. Using respiratory exchange measurements, we measured substrate utilization during 2.5 h of exercise at approximately 44 +/- 1% maximal O2 uptake (VO2 max) in the presence or absence of elevated FFA levels. After 30 min of base-line determinations, 1,000 U heparin was given intravenously and a 3-h constant infusion of Intralipid 10% (150 g/h) and heparin (500 U/h) was started. After an additional 30 min of rest, subjects exercised for 2.5 h (study 1, n = 6). In another five subjects (study 2) 100 g glucose was ingested after 30 min of exercise. The same protocols (studies 1 and 2) were also performed during a 0.9%-saline infusion. During exercise, without glucose ingestion, higher FFA concentrations prevailed during the Intralipid infusion (1,122 +/- 40 vs. 782 +/- 65 mumol/l), but the relative contributions of carbohydrate (49 +/- 4 vs. 50 +/- 4%) or lipid (49 +/- 4 vs. 47 +/- 6%) oxidation to the total energy expenditure were different only during the first 30 min of exercise. Similarly, higher FFA levels (1,032 +/- 62 vs. 568 +/- 46 mumol/l) did not alter the relative contributions of carbohydrate (62 +/- 4 vs. 69 +/- 2%) or lipid (36 +/- 4 vs. 29 +/- 2%) oxidation to the total energy expenditure after glucose feeding.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3514573 TI - Effects of preexercise snack feeding on endurance cycle exercise. AB - We studied the effects of ingesting either a snack food (S) (260 kcal) or placebo (P) 30 min before intermittent cycle exercise at 70% maximal O2 consumption on endurance performance and muscle glycogen depletion in eight healthy human males. Immediately before exercise there were significantly greater increases in plasma glucose (PG) (S +28 +/- 9.7; P +0.1 +/- 0.8 mg/dl) and insulin (S +219 +/- 61.5; P -7 +/- 5.5 pmol/l) (P less than 0.05) following S feeding compared with P. These differences were no longer present by the end of the first exercise period. There were no differences in endurance times (S 52 +/- 6.4; P 48 +/- 5.6 min) or in the extent of muscle glycogen depletion following exercise (S 56 +/- 14.7; P 50 +/- 15.5 micrograms/mg protein) between the two groups. PG was maintained at base-line (prefeeding) concentrations following S, whereas there was a tendency for PG to steadily decrease after P. Total grams of carbohydrate oxidized during exercise did not differ between the two groups (S 120; P 118 g). These results demonstrate that the ingestion of a mixed-macronutrient snack 30 min before exercise does not impair endurance performance nor increase the extent of muscle glycogen depletion during high-intensity cycle exercise in untrained adult male subjects. PMID- 3514574 TI - Formation of a compensatory polyamine by Escherichia coli polyamine-requiring mutants during growth in the absence of polyamines. AB - The amounts of normal and compensatory polyamines of polyamine-requiring Escherichia coli mutants grown in the absence of polyamines were determined. Although aminopropylcadaverine, a compensatory polyamine, was synthesized by MA135 (speB) and DR112 (speA speB), no aminopropylcadaverine or only small amounts of aminopropylcadaverine were synthesized by EWH319 (speA speB speC speD) and MA261 (speB speC), respectively. The average mass doubling times of MA135, DR112, MA261, and EWH319 grown in the absence of polyamines were 113, 105, 260, and 318 min, respectively. The correlation of these values with the sum of spermidine plus aminopropylcadaverine suggested that aminopropylcadaverine is important for cell growth in the presence of limiting amounts of normal polyamines. This hypothesis is supported by the results of aminopropylcadaverine stimulation of the in vitro synthesis of polyphenylalanine and MS2 RNA replicase and of its stimulation of the growth of MA261. For the following reasons, it was concluded that aminopropylcadaverine was synthesized preferentially from cadaverine made by ornithine decarboxylase: aminopropylcadaverine was synthesized in relatively large amounts in cells (MA135 and DR112) which possess ornithine decarboxylase; ornithine decarboxylase catalyzed the decarboxylation of lysine in vitro, and the in vivo formation of aminopropylcadaverine was inhibited by an inhibitor of ornithine decarboxylase. PMID- 3514575 TI - L-asparaginase genes in Escherichia coli: isolation of mutants and characterization of the ansA gene and its protein product. AB - Mutants of Escherichia coli have been isolated which are resistant to beta aspartyl hydroxamate, a lethal substrate of asparaginase II in fungi and a substrate for asparaginase II in E. coli. Among the many phenotypic classes observed, a single mutant (designated GU16) was found with multiple defects affecting asparaginases I and II and aspartase. Other asparaginase II-deficient mutants have also been derived from an asparaginase I-deficient mutant. The mutant strain, GU16, was unable to utilize asparagine and grew poorly on aspartate as the sole source of carbon; transformation of this strain with an E. coli recombinant plasmid library resulted in a large recombinant plasmid which complemented both these defects. Two subclones were isolated, designated pDK1 and pDK2; the former complemented the partial defect in the utilization of aspartate, although its exact function was not established. pDK2 encoded the asparaginase I gene (ansA), the coding region of which was further defined within a 1.7-kilobase fragment. The ansA gene specified a polypeptide, identified in maxicells, with a molecular weight of 43,000. Strains carrying recombinant plasmids encoding the ansA gene overproduced asparaginase I approximately 130-fold, suggesting that the ansA gene might normally be under negative regulation. Extracts from strains overproducing asparaginase I were electrophoresed, blotted, and probed with asparaginase II-specific antisera; no cross-reaction of the antisera with asparaginase I was observed, indicating that asparaginases I and II are not appreciably related immunologically. When a DNA fragment containing the ansA gene was used to probe Southern blots of restriction endonuclease-digested E. coli chromosomal DNA, no homologous sequences were revealed other than the expected ansA-containing fragments. Therefore, the genes encoding asparaginases I and II are highly sequence related. PMID- 3514576 TI - Nucleotide pool in pho regulon mutants and alkaline phosphatase synthesis in Escherichia coli. AB - The intracellular nucleotide pool of Escherichia coli W3110 reproducibly changes from conditions of growth in phosphate excess to phosphate starvation, with at least two nucleotides appearing under starvation conditions and two nucleotides appearing only under excess phosphate conditions. Strains bearing a deletion of the phoA gene show the same pattern, indicating that dephosphorylation by alkaline phosphatase is not responsible for the changes. Strains with mutations in the phoU gene, which result in constitutive expression of the pho regulon, show the nucleotide pattern of phosphate-starved cells even during phosphate excess growth. These changes in nucleotides are therefore due to phoU mutation but not to alkaline phosphatase constitutivity. In fact, a phoR (phoR68) mutant strain has the patterns of the wild type in spite of being constitutive for alkaline phosphatase. That these nucleotides might be specific signals for pho regulon expression was supported by the fact that the two nucleotides appearing under phosphate starvation induced the synthesis of alkaline phosphatase in repressed permeabilized wild-type cells under conditions of phosphate excess. PMID- 3514577 TI - Proline transport and osmotic stress response in Escherichia coli K-12. AB - Proline is accumulated in Escherichia coli via two active transport systems, proline porter I (PPI) and PPII. In our experiments, PPI was insensitive to catabolite repression and was reduced in activity twofold when bacteria were subjected to amino acid-limited growth. PPII, which has a lower affinity for proline than PPI, was induced by tryptophan-limited growth. PPII activity was elevated in bacteria that were subjected to osmotic stress during growth or the transport measurement. Neither PPI nor uptake of serine or glutamine was affected by osmotic stress. Mutation proU205, which was similar in genetic map location and phenotype to other proU mutations isolated in E. coli and Salmonella typhimurium, influenced the sensitivity of the bacteria to the toxic proline analogs azetidine-2-carboxylate and 3,4-dehydroproline, the proline requirements of auxotrophs, and the osmoprotective effect of proline. This mutation did not influence proline uptake via PPI or PPII. A very low uptake activity (6% of the PPII activity) observed in osmotically stressed bacteria lacking PPI and PPII was not observed when the proU205 lesion was introduced. PMID- 3514578 TI - Chromosomal location and nucleotide sequence of the Escherichia coli dapA gene. AB - In Escherichia coli, the first enzyme of the diaminopimelate and lysine pathway is dihydrodipicolinate synthetase, which is feedback-inhibited by lysine and encoded by the dapA gene. The location of the dapA gene on the bacterial chromosome has been determined accurately with respect to the neighboring purC and dapE genes. The complete nucleotide sequence and the transcriptional start of the dapA gene were determined. The results show that dapA consists of a single cistron encoding a 292-amino acid polypeptide of 31,372 daltons. PMID- 3514579 TI - Cloning of a gene encoding choline transport in Saccharomyces cerevisiae. AB - By genetic complementation in a yeast choline transport mutant from a yeast gene library, we isolated plasmids encoding choline transport. The cloned plasmids contained a common 4.0-kilobase DNA fragment and also complemented an ethanolamine transport defect. The cloned sequence present in the yeast genome was possibly unique. PMID- 3514580 TI - Valinomycin-induced cation transport in vesicles does not reflect the activity of K+ transport systems in Escherichia coli. AB - Transport systems for K+ in Escherichia coli are not detectable in membrane vesicles, but vesicles will take up K+ (and Rb+) in the presence of valinomycin. It is generally believed that valinomycin acts as a lipid-soluble cation carrier and that it does not interact with or activate cation transport systems. This view is challenged by Bhattacharyya et al. (Proc. Natl. Acad. Sci. USA 68:1448 1492, 1971), who reported reduced uptake in vesicles from E. coli mutants with K+ transport defects. We reexamined this question with some of the same mutants and were unable to confirm a correlation of valinomycin-induced vesicle transport with transport properties in intact cells. We found great variability in transport activity of vesicles from these E. coli K-12 strains and believe such variability as well as possible contamination with intact cells accounts for the earlier report. Our data do not support the idea that valinomycin-mediated transport in vesicles is related to physiological K+ transport systems. PMID- 3514581 TI - Escherichia coli B/r leuK mutant lacking pseudouridine synthase I activity. AB - Escherichia coli B/r strain EB146 containing mutation leuK16 has elevated levels of enzymes involved in the synthesis of leucine, valine, isoleucine, histidine, and tryptophan (Brown et al., J. Bacteriol. 135:542-550, 1978). We show here that strain EB146 (leuK16) has properties that are similar to those of E. coli and Salmonella typhimurium hisT strains. In tRNA1Leu from both hisT and leuK strains, positions 39 and 41 are uridine residues rather than pseudouridine residues. Furthermore, in tRNA3Leu and tRNA4Leu from a leuK strain, uridine residues at positions 39 and 40, respectively, are unmodified. Pseudouridine synthase I activity is missing in extracts of strain EB146 (leuK16), and extracts of strain EB146 (leuK16) and of a hisT strain do not complement one another in vitro. Four phenotypes of strain EB146 (leuK16), leucine excretion, wrinkled colony morphology, and elevated levels of leu and his enzymes, are complemented by a plasmid having a 1.65-kilobase DNA fragment containing the E. coli K-12 hisT locus. These results indicate that either leuK codes for pseudouridine synthase I (and is thus a hisT locus in reality) or, less likely, it codes for a product that affects the synthesis or activity of pseudouridine synthase I. PMID- 3514582 TI - lep operon proximal gene is not required for growth or secretion by Escherichia coli. AB - Leader peptidase is an essential enzyme of Escherichia coli and is required for protein export. The structural gene for leader peptidase (lep) is separated from its promoter by an upstream gene of unknown function (lepA). The gene lepA was shown by the use of minicell analysis and overproduction to encode a protein of 74,000 daltons. To determine whether this 74,000-dalton protein functions in protein export, a mutant of E. coli H560 was constructed which has a 1.5-kilobase pair deletion in the lepA gene. The lepA deletion mutant had no apparent defect for growth or protein export, indicating that lepA is nonessential and that the two cotranscribed genes lepA and lep probably have unrelated functions. PMID- 3514583 TI - Effective short-term treatment of generalized anxiety disorder with trifluoperazine. AB - The effectiveness of trifluoperazine in daily doses of 2 to 6 mg in the short term treatment of generalized anxiety disorder was evaluated in 415 outpatients in a double-blind, placebo-controlled, multicenter trial. Efficacy and side effects were assessed by a number of psychiatric rating scales for anxiety. All efficacy measurements of anxiety were significantly improved (p less than .001) with trifluoperazine compared to placebo by the end of the study. The side effects profile of trifluoperazine and placebo were similar during the 4-week treatment period. PMID- 3514584 TI - Extended EMIT-DAU phencyclidine screen. AB - In a public hospital emergency room, 580 urines were screened for phencyclidine (PCP) with the routine EMIT-DAU PCP screen, the extended EMIT-DAU PCP screen, and a gas chromatograph/mass spectrometer/computer (GC/MS/COMP) in selected ion mode, which was chosen as the reference method. The extended method produced a 38.5% increase in positives detected over the routine EMIT-DAU PCP screen and allowed 66.4% of the specimens to be signed out as negative without confirmation by GC/MS/COMP. This ability to provide a rapid, relatively inexpensive screen for PCP in urine and, in particular, to eliminate those patients whose specimens are negative, is important in a psychiatric population that contains many acutely psychotic individuals with grossly abnormal behavior. PMID- 3514585 TI - Pharmacologic modification of serotonergic function: drugs for the study and treatment of psychiatric and other disorders. AB - The development of direct serotonin agonists, selective inhibitors of serotonin uptake, serotonin receptor antagonists, and other drugs affecting serotonergic function has aided the study of physiologic functions of brain serotonin neurons in laboratory animals and the recognition and classification of serotonin receptor subtypes. Agents of these types are real or potential drugs for the treatment of psychiatric disorders (e.g., depression) and other disorders such as overeating, alcoholism, myoclonus, and chronic pain. In addition, the agents may permit assessment of the functional state of brain serotonin receptors in humans. PMID- 3514586 TI - Use of serotonergic agents in the clinical assessment of central serotonin function. AB - To assess the status of the brain serotonergic system in relation to ongoing behavior, agents with predominant actions on serotonin synthesis, release, uptake, and receptor mechanisms are being evaluated. Abnormalities in the neuroendocrine responses to tryptophan, 5-hydroxytryptophan, fenfluramine, and m chlorophenylpiperazine are under exploration in depressed patients. These agents are also being used to assess postulated changes in serotonin metabolism and serotonin receptor adaptation during longer term treatment with antidepressant drugs, lithium, and other psychoactive agents. Concurrent studies in rodent and nonhuman primate models are helping to validate these approaches to the exploration of the role of serotonin in psychiatric and neurologic disorders. PMID- 3514587 TI - Investigation into the asymmetric distribution of proteins in human milk-fat globule-membranes. AB - The proteins from human milk-fat-globule-membrane were radioiodinated, solubilized and analyzed by SDS-polyacrylamide gel electrophoresis. The solubilized milk-fat-globule-membrane preparations contained six major size classes of components with apparent molecular weights of 155, 70, 58, 52, 42, and 39 kilodaltons. The membrane proteins were significantly more accessible to lactoperoxidase-125I in isolated membrane compared with that of whole cream. Major proteins of apparent molecular weights of 155, 70, 58, 52, 42, and 39 kilodaltons were labeled in whole cream and were extracted from the fat-globules membrane with magnesium chloride. Residual cream (after being extracted with MgCl2) showed the loss of the above proteins components. Using an indirect immunoperoxidase staining method and the antibodies to MFGM which immunoprecipitated all the six major glycoprotein components of MFGM, demonstrated their presence on the apical plasma membrane of mammary epithelial cells lining the breast duct in tissue sections. The asymmetric arrangements of proteins in the human milk-fat-globule-membranes, after secretion, is discussed. PMID- 3514588 TI - Analysis of debromination of 1,2-dibromoethane by cytochrome P-450-linked hydroxylation systems as observed by bromide electrode. AB - Debromination of 1,2-dibromoethane (DBE) by a rabbit liver microsomal preparation and a reconstituted cytochrome P-450 enzyme system was investigated. The reaction was performed in our newly constructed reaction vessel, in which a bromide electrode was installed. During the reaction, the liberated bromide ion was continuously measured by the bromide electrode, and the amount was recorded. In the microsomal preparation, the DBE-debromination rate per nmol cytochrome P-450 was enhanced by phenobarbital-pretreatment of rabbits compared with the untreated microsomes, whereas it was diminished by 3-methylcholanthrene-pretreatment. The debromination reaction was reconstituted in a purified enzyme system containing phenobarbital-inducible rabbit liver microsomal cytochrome P-450 (P-450PB), NADPH cytochrome P-450 reductase, and NADPH. The optimum conditions required the presence of dilauroylphosphatidylcholine and cytochrome b5. Cytochrome b5 was found not to be an obligatory component for the DBE-debromination in the reconstituted system, but it stimulated the activity about 3.4-fold. Preincubation of the reconstituted mixture with guinea pig anti-cytochrome P 450PB antiserum markedly inhibited the debromination reaction. PMID- 3514589 TI - Distribution of two urinary ribonuclease-like enzymes in human organs and body fluids. AB - In order to determine the distribution of two human urinary RNase (RNase Us and RNase UL)-like enzymes in human tissues and body fluids, enzyme immunoassay systems were established using rabbit anti-RNase sera. The sensitivity of the assay systems was of similar order to that of radioimmunoassay systems previously reported. In the enzyme immunoassay, the cross reactivities of anti-RNase UL serum towards RNase Us, bovine kidney RNase K2, bovine RNase A, and bovine seminal RNase Vs were less than 1%. The cross reactivity of anti-RNase Us-serum towards RNase UL was less than 0.5% and cross reactivities were minimal for RNase A, RNase K2, and RNase Vs. The RNase levels in human organs and body fluids were measured by enzyme immunoassay. In milk, semen and saliva, only RNase UL-like enzyme was found. Both RNase Us- and RNase UL-like enzymes were found in kidney, stomach, and pancreas and the RNase Us/RNase UL ratios were 0.49, 1.35, and 0.34, respectively. In lung, liver, spleen, and leukocytes, most of the RNase activity was accounted for by RNase Us-like enzyme. The activity of RNase Us-like enzyme was especially high in lung, spleen, and leukocytes. The crude extracts of several tissues and body fluids were separated by phosphocellulose column chromatography and the contents of the two urinary RNase-like enzymes were determined by enzyme immunoassay. In stomach, kidney, pancreas, and serum, both enzymes were present in multiple forms. In spleen and lung, both the major RNase (RNase Us) and minor RNase (RNase UL) existed in two forms.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3514591 TI - Difference between subfragment-1 and heavy meromyosin in their interaction with F actin. AB - To elucidate the difference between subfragment-1 and heavy meromyosin in their interaction with F-actin, we used limited tryptic digestion and cross-linking with 1-ethyl-3-[3-(dimethylamino)propyl]carbodiimide. The binding of actin to subfragment-1 lowers the susceptibility of the 50K-20K junction of its heavy chain to tryptic digestion. At a molar ratio of one actin to one subfragment-1, all the sites were gradually cleaved by trypsin whereas the sites were completely protected in the presence of a 2-fold molar excess of actin over subfragment-1. In the case of heavy meromyosin, nearly half of the sites were protected completely by the presence of an equimolar amount of actin to its heads suggesting that the two heads of heavy meromyosin bound actin in a different manner. The rate of the cross-linking reaction between subfragment-1 heavy chain and actin with 1-ethyl-3-[3-(dimethylamino) propyl]carbodiimide also depended on the molar ratio of actin to subfragment-1. The rate was maximum at a molar ratio of about 5 actin to 1 subfragment-1. When heavy meromyosin was cross-linked to actin, the maximum rate was observed at a molar ratio of about 3 actin to 1 heavy meromyosin head, the level being about 60% that for subfragment-1 and actin. It was suggested that the presence of the subfragment-2 portion of heavy meromyosin caused these differences by restricting the motion of the two heads. PMID- 3514590 TI - Separation and proteolytic mapping of the two [3H]cytochalasin B photoaffinity labeled D-glucose-sensitive proteins in the chicken embryo fibroblast plasma membrane. AB - Photoaffinity labeling with [3H]cytochalasin B detects two D-glucose-sensitive proteins in the chicken embryo fibroblast (CEF) plasma membrane, which accumulate under conditions of glucose starvation and are probably involved in the glucose transport system (Pessin, J.E., et al. (1982) Proc. Natl. Acad. Sci. U.S. 79, 2286-2290). The two labeled components, designated as peak I (Mr 45,000) and II (Mr 52,000) components, were separated by preparative gel electrophoresis in the presence of sodium dodecyl sulfate. The fractions were digested with S. aureus V8 or papain, and the radioactive products were analyzed by one-dimensional gel electrophoresis. The peptide maps showed that they have different peptide structures. Peptide maps of authentic actin, a possible contaminant of the peak I fractions, were quite different from those of the peak I component. Rous sarcoma virus-transformed CEF have two components similar as to apparent molecular size and peptide maps to those present in glucose-starved cells. The peak I and II components show minimal affinity to agarose-bound Ricinus communis agglutinin which binds the human erythrocyte glucose transporter quite well. The peak II component was more susceptible to proteolysis than the peak I one or the human erythrocyte glucose transporter. However, the peptide maps of the peak II component were similar to those of the human erythrocyte glucose transporter. PMID- 3514592 TI - Effects of DNA and urea on the specificity for H1 histone of the neutral protease B partially-purified from rat liver chromatin. AB - A neutral protease, named protease B in the previous report (Tsurugi, K. & Ogata, K. (1982) J. Biochem. 92, 1369-1381), was partially purified from rat liver chromatin by gel filtration through Sepharose 6B followed by DE-Sephadex column chromatography. The proteolytic activity on total histones of the partially purified protease B was increased about two fold by addition of DNA and again increased by further addition of 2 M urea. Analysis of the hydrolysed products showed that out of five species of histones, only H1 was degraded in the presence of an amount of DNA equivalent to the amount of histones, whereas core histones were also degraded in the absence or presence of one-tenth amount of DNA. Urea accelerated the selective degradation of H1 histone because H1 histone was preferentially degraded in the presence of even a low amount of DNA. In contrast, core histones became resistant to the protease B in the presence of DNA and/or urea. Heat-denatured DNA stimulated the degradation of H1 histone even in the absence of urea to almost the same extent that native DNA did in the presence of urea. Thus, protease B efficiently degrades H1 histone when its association with DNA is destabilized by either addition of urea or pretreatment of DNA with heat. PMID- 3514593 TI - Amino acid sequence of Trimeresurus flavoviridis phospholipase A2. AB - The amino acid sequence of phospholipase A2 from the venom of Trimeresurus flavoviridis (the Habu snake) was determined. The enzyme subunit has a molecular weight of 13,764 and consists of a single polypeptide chain of 122 amino acids and seven disulfide bonds. The fragmentation was conducted by digesting the reduced and S-carboxymethylated derivative of the protein with Achromobacter protease I, chymotrypsin, and trypsin, respectively. Achromobacter protease I peptides were used for alignment and to establish overlaps over chymotryptic and tryptic peptides. The automated Edman degradation of the S-carboxymethylated protein, which was extended to the N-terminal 30 amino acid residues, supplemented the deletions found with the enzymatic peptides alone. T. flavoviridis phospholipase A2 was found to be highly (65-67%) homologous in sequence to the enzymes from T. okinavensis, Crotalus adamanteus, and Crotalus atrox (viperid family) and less (35-44%) homologous to those from elapid snakes and mammalian pancreas. The T. flavoviridis enzyme appears to be similar in secondary structure composition to the C. atrox enzyme. PMID- 3514594 TI - Differential effect of phosphatidylethanolamine molecular species on glycerophosphate acyltransferase activity of Escherichia coli. AB - The effect of phosphatidylethanolamine (PE) molecular species on the reconstitution of partially purified glycerophosphate acyltransferase of Escherichia coli was investigated. The acyltransferase activity was abolished by 1,2-di-unsaturated (U-U) PE, but not by 1-saturated-2-unsaturated (S-U) PE or 1 saturated-2-cyclopropanoyl PE. Since both the U-U and S-U PE used in the present work are in a fluid state at temperatures above about 30 degrees C, the differential effect cannot be accounted for in terms of the membrane fluidity. Therefore, the inactivation of the reconstituted enzyme was attributed to the large amount of the 1,2-di-cis-vaccenoyl species of PE. PMID- 3514595 TI - Purification and characterization of human kidney renin. AB - By means of a new rapid and small scale purification method, human kidney renin has been purified from a single kidney in a homogeneous state, as judged on SDS PAGE. The kidney which showed unusually high renin activity was from a patient with cardiomyopathy. 8,000-fold purification was attained by means of only pepstatin-aminohexyl-Sepharose chromatography and FPLC on a Mono Q column, and the yield was 34%. The specific activity was 5.63 mg angiotensin I per mg protein per h at 37 degrees C and pH 6.5 with porcine angiotensinogen as the substrate. The molecular weight was estimated to be 37,000 by SDS-PAGE and 38,000 by HPLC on a TSK G-3000 SW column. The preparation showed three bands on isoelectric focusing. The molecular weight and the profile on isoelectric focusing of the purified renin agreed with those found for the extracts of both the patient's kidney and a kidney with the usual low renin activity. PMID- 3514596 TI - The complete amino acid sequence of monkey pepsinogen A. AB - The complete amino acid sequence of pepsinogen A from the Japanese monkey (Macaca fuscata) was determined. After converting the pepsinogen to pepsin by activation, the pepsin moiety was reduced and carboxymethylated, cleaved by cyanogen bromide, and the amino acid sequences of the major fragments determined. These fragments were aligned with the aid of overlapping peptides isolated from a chymotryptic digest of intact pepsin. Since the sequence of the activation segment had been determined previously (Kageyama, T., and Takahashi, K. (1980) J. Biochem. (Tokyo) 88, 9-16), the 373-residue sequence of monkey pepsinogen A was established, consisting of the pepsin moiety of 326 residues and the activation segment of 47 residues. Three disulfide bridges and 1 phosphoserine residue were found to be present in the pepsinogen molecule. The molecular weight was calculated to be 40,027 including the phosphate group. Monkey pepsinogen A showed high homology with human (94% identity) and porcine (86% identity) pepsinogens A. PMID- 3514597 TI - The complete amino acid sequence of monkey progastricsin. AB - The complete amino acid sequence of progastricsin from the Japanese monkey (Macaca fuscata) was determined. Progastricsin is composed of 374 residues, including the gastricsin moiety of 331 residues and the activation segment of 43 residues. Upon activation under acidic conditions, progastricsin was converted to gastricsin via the intermediate protein species. NH2-terminal sequence determination of these protein species enabled us to deduce the NH2-terminal 78 residue sequence of progastricsin, including the 43-residue activation segment. The complete sequence of the gastricsin moiety was determined using peptide fragments obtained by several chemical and enzymatic cleavages. The molecular weight of progastricsin was determined to be 40,785. As compared with pepsinogen A of the same monkey species, deletion of 4 residues and insertion of 5 residues were observed. Although monkey progastricsin and pepsinogen A have highly homologous sequences around the two active site aspartyl residues, the homology between these proteins is rather small (49% identity). This indicates that progastricsin diverged from pepsinogen A in the early phase of the evolution of gastric aspartyl proteinases. PMID- 3514598 TI - Modulation of guanine nucleotide affinity does not affect the first order rate constant of activation of adenylate cyclase in native membranes. AB - A new method was developed to follow the rate of activation of adenylate cyclase in rat brain membranes by rapid freezing and N-ethylmaleimide treatment at 0 degrees C. This method was used to investigate the relationship between the rate of activation of adenylate cyclase by p(NH)ppG and GTP gamma S and their apparent affinities. These studies established the following. 1) The kinetics of activation by p(NH)ppG and GTP gamma S were indistinguishable although the apparent affinity of p(NH)ppG was 20-fold lower than the affinity of GTP gamma S. Activation was first order, kobs varying approximately 1.5-fold (average t 1/2 = 3.5 min, 30 degrees C) between 20-90% occupancy by either guanine nucleotide. 2) Final levels of activity were strictly dependent on the concentration of the nucleotides in a saturable manner. 3) Mg2+ increased the apparent affinity of either guanine nucleotide by 10-20-fold between 0.1 microM and 3 mM free Mg2+ in the presence of 2 mM EDTA but did not enhance the rate or maximal extent of activation. 4) The effects of Mg2+ were expressed through two independent classes of sites with affinities in the nanomolar and micromolar range. 5) A Mg2+ X guanine nucleotide complex was not the substrate for activation. The affinity of Mg2+ for nucleotides was determined as 6.25 mM GTP gamma S, 0.930 mM GTP, 0.156 mM p(NH)ppG. 6) Full activation by p(NH)ppG was completely reversible but activation by GTP gamma S was only partially reversible. These results suggest that: activation of adenylate cyclase in native membranes does not require Mg2+ or irreversible binding of the guanine nucleotide and there are two independent pathways for formation of active adenylate cyclase. A minimal mechanism for activation is discussed in light of current models. PMID- 3514599 TI - Nucleotide sequence of the Saccharomyces cerevisiae ADE3 gene encoding C1 tetrahydrofolate synthase. AB - The sequence of a cloned copy of the yeast ADE3 gene, which encodes the trifunctional enzyme C1-5,6,7,8-tetrahydrofolate (THF) synthase, was determined. Yeast cells transformed with a multicopy yeast plasmid containing this ADE3 gene overexpress C1-THF synthase 20-60-fold relative to wild-type yeast cells. C1-THF synthase from transformed cells is identical with that isolated from wild-type cells by all the criteria tested. The translated DNA sequence and amino-terminal protein sequences are identical and the amino acid composition predicted from the DNA sequence agrees closely with that determined by hydrolysis of C1-THF synthase protein. Correlation of the genetic map of the ADE3 region and of proteolysis experiments with the protein sequence suggests locations for two functional domains within yeast C1-THF synthase. The sequence of C1-THF synthase does not appear to be homologous to any other sequenced protein, including other proteins that use folate substrates. The 5' and 3' untranslated regions of the ADE3 gene suggest initiation and termination signals similar to transcription signals associated with other yeast genes. No special regulatory features have been associated with the ADE3 sequence. An unusual open reading frame that is encoded by a very unbiased set of codons follows the ADE3 gene. PMID- 3514600 TI - Modulation of actin-bundling activity of 55-kDa protein by multiple isoforms of tropomyosin. AB - Cultured rat cells contain five isoforms of tropomyosin (Matsumura, F., Yamashiro Matsumura, S., and Lin, J.J.-C. (1983) J. Biol. Chem. 258, 6636-6644). To explore the roles of the multiple tropomyosin isoforms in the microfilament organization of cultured cells, we have examined effects of tropomyosins on the bundling activity of the 55-kDa protein recently purified from HeLa cells (Yamashiro Matsumura, S., and Matsumura, F. (1985) J. Biol. Chem. 260, 5087-5097). Maximum bundling of F-actin was observed at a molar ratio of 55-kDa protein to actin higher than 1:8. None of the isoforms of cultured rat cell tropomyosin significantly altered the F-actin-bundling activity of 55-kDa protein at this ratio, whereas skeletal muscle tropomyosin inhibited the bundling activity to about 50%. Also, cultured cell tropomyosins did not inhibit binding of 55-kDa protein to actin, whereas skeletal muscle tropomyosin inhibited it by 50%. The effect of 55-kDa protein on the binding of tropomyosin to actin varied with the isoform type of tropomyosin. Most (80%) of the tropomyosins with low Mr values (Mr 32,400 or 32,000) were caused to dissociate from actin by 55-kDa protein, but only 20% of tropomyosins with high Mr values (Mr 40,000 or 36,500) was dissociated from actin in these conditions. Immunofluorescence has shown that, while tropomyosin was localized in stress fibers, 55-kDa protein was found in microspikes as well as stress fibers, both of which are known to contain bundles of microfilaments. Therefore, we suggest that 55-kDa protein together with the multiple tropomyosin isoforms may regulate the formation of two types of actin filament bundles, bundles containing tropomyosin and those without tropomyosin. PMID- 3514601 TI - Crystallization and preliminary characterization of CheY, a chemotaxis control protein from Escherichia coli. AB - Single crystals of the 14.1-kDa cheY gene product from Escherichia coli have been grown from buffered ammonium sulfate solutions using the combined methods of microdialysis and pulsed diffusion. The crystals are of the monoclinic space group P2(l), have cell constants of a = 51.4 A, b = 112 A, c = 51.2 A, and beta = 107.3 degrees, and contain four molecules per asymmetric unit. They are stable to x-ray radiation and diffract beyond 3.0 A resolution. PMID- 3514602 TI - Nucleotide sequence of the luxB gene of Vibrio harveyi and the complete amino acid sequence of the beta subunit of bacterial luciferase. AB - The nucleotide sequence of the 1.30-kilobase EcoRI/BglII fragment from Vibrio harveyi carrying the majority of the luciferase beta subunit coding region (luxB gene) has been determined. The EcoRI/BglII fragment was derived from a 4.0 kilobase HindIII fragment carrying both luxA and luxB which was detected in a genomic clone bank based on the expression of bioluminescence from colonies of Escherichia coli carrying V. harveyi HindIII fragments in plasmid pBR322 (Baldwin, T. O., Berends, T., Bunch, T. A., Holzman, T. F., Rausch, S. K., Shamansky, L., Treat, M. L., and Ziegler, M. M. (1984) Biochemistry 23, 3663 3667). The entire alpha subunit coding sequence (luxA gene) and the amino terminal 13 codons of the beta subunit sequence (luxB gene) were contained on a 1.85-kilobase EcoRI fragment, the sequence of which has been reported (Cohn, D. H., Mileham, A. J., Simon, M. I., Nealson, K. H., Rausch, S. K., Bonam, D., and Baldwin, T. O. (1985) J. Biol. Chem. 260, 6139-6146). The beta subunit coding sequence was found to terminate 972 bases past the start of the luxB coding sequence. The beta subunit had a calculated molecular weight of 36,349 and comprised a total of 324 amino acid residues; the alpha beta dimer had a molecular weight (alpha + beta) of 76,457. There were 27 base pairs separating the stop codon of the beta subunit structural gene and a 340-base open reading frame extending to (and beyond) the distal BglII site. Approximately two-thirds of the beta subunit was sequenced by protein chemical techniques. The amino acid sequence predicted from the DNA sequence, with few exceptions, confirmed the chemically determined sequence, and the measured amino acid composition was in excellent agreement with the composition implied from the DNA sequence. PMID- 3514603 TI - Primary structure of gonadotropin-releasing hormone from lamprey brain. AB - The primary structure of gonadotropin-releasing hormone (GnRH) isolated from whole brains of lamprey is pGlu-His-Tyr-Ser-Leu-Glu-Trp-Lys-Pro-Gly-NH2. This unique decapeptide was isolated and purified from brain extracts by reverse-phase high performance liquid chromatography. The structure of the peptide was established from chymotryptic fragments that were identified by protein sequence analysis and fast atom bombardment mass spectrometry. The peptide reacts with an antiserum raised against mammalian GnRH and is structurally identified as a member of the GnRH family by the amino and carboxyl termini of pGlu1-His2 and Pro9-Gly10NH2, the conservation of Ser4 in the internal segment of the molecule and its length of 10 amino acids. For the first time, amino acid substitutions are found in positions 3 and 6, critical for biological potency and conformation, respectively. Additionally, a second form of GnRH (lamprey II GnRH), representing about 10% of the total GnRH immunoreactive material in the brain, was isolated; its amino acid composition differs by 3 residues from lamprey I GnRH. Synthetic lamprey I GnRH elevates plasma estradiol in adult female lampreys. PMID- 3514604 TI - Contrasting effects of Escherichia coli single-stranded DNA binding protein on synthesis by T7 DNA polymerase and Escherichia coli DNA polymerase I (large fragment). Evidence that binding protein inhibits trans-lesion synthesis by polymerase I. AB - The effect of Escherichia coli single-stranded DNA binding protein (SSB) on DNA synthesis by T7 DNA polymerase and E. coli DNA polymerase I (large fragment) using native or aminofluorene-modified M13 templates was evaluated by in vitro DNA synthesis assays and polyacrylamide gel electrophoresis analysis. The two polymerase enzymes displayed differential responses to the addition of SSB. T7 DNA polymerase, a enzyme required for the replication of the T7 chromosome, was stimulated by the addition of SSB whether native or modified templates were used. On the other hand, E. coli DNA polymerase I was slightly stimulated by the addition of SSB to the native template but substantially inhibited on modified templates. This result suggests that DNA polymerase I may be able to synthesize past an aminofluorene adduct but that the presence of SSB inhibited this trans lesion synthesis. Polyacrylamide gels of the products of DNA synthesis by polymerase I supported this inference since SSB caused a substantial increase in the accumulation of shorter DNA chains induced by blockage at the aminofluorene adduct sites. PMID- 3514605 TI - The reaction of ribosomes with elongation factor Tu.GTP complexes. Aminoacyl-tRNA independent reactions in the elongation cycle determine the accuracy of protein synthesis. AB - The fidelity of protein synthesis depends on the rate constants for the reaction of ribosomes with ternary complexes of elongation factor Tu (EF-Tu), GTP, and aminoacyl (aa)-tRNA. By measuring the rate constants for the reaction of poly(U) programmed ribosomes with a binary complex of elongation factor (EF-Tu) and GTP we have shown that two of the key rate constants in the former reaction are determined exclusively by ribosome-EF-Tu interactions and are not affected by the aa-tRNA. These are the rate constant for GTP hydrolysis, which plays an important role in the fidelity of ternary complex selection by the ribosome, and the rate constant for EF-Tu.GDP dissociation from the ribosome, which plays an equally important role in subsequent proofreading of the aa-tRNA. We conclude that the fidelities of ternary complex selection and proofreading are fundamentally dependent on ribosome-EF-Tu interactions. These interactions determine the absolute value of the rate constants for GTP hydrolysis and EF-Tu.GDP dissociation. The ribosome then uses these rate constants as internal standards to measure, respectively, the rate constants for ternary complex and aa-tRNA dissociation from the ribosome. These rates, in turn, are highly dependent on whether the ternary complex and aa-tRNA are cognate or near-cognate to the codon being translated. PMID- 3514606 TI - Calcium mobilization and catecholamine secretion in adrenal chromaffin cells. A Quin-2 fluorescence study. AB - To better understand the relation between cell calcium and exocytotic secretion, a quantitative dependence of adrenal catecholamine secretion on cytosolic free calcium has been determined for isolated, intact, bovine chromaffin cells, using the fluorescent probe Quin-2. The cells required a threshold of 250-300 nM cytosolic calcium to be reached before detectable secretion occurred and half maximal secretion occurred near 2 microM cytosolic calcium. Nicotinic receptors mediated an increase of cytosolic calcium from resting levels near 100 nM to levels in the 1-10 microM range within seconds followed by a decay back to resting levels over several minutes. Muscarinic receptors mediated a smaller rise in cytosolic free calcium from 100 to about 200 nM, within seconds. The nicotinic response required extracellular calcium, while the muscarinic response was largely independent of extracellular calcium, suggesting the latter mobilizes intracellular calcium. The acetylcholine-evoked rise in cytosolic calcium decayed by at least two kinetically distinct processes with half-time constants: t1 = 0.6 min and t2 = 3.2 min. Extracellular Na+ deprivation caused a more prolonged elevation of the acetylcholine-evoked calcium transient, suggesting a possible role of Na+/Ca2+ exchange and/or other Na+ -dependent processes in lowering cytosolic calcium following stimulation. The possible perturbing effects of Quin 2 on resting and stimulated cytosolic calcium levels and on secretion were examined and a novel use of Quin-2 to measure membrane calcium flux was demonstrated. PMID- 3514607 TI - Characterization of rat and human liver microsomal cytochrome P-450 forms involved in nifedipine oxidation, a prototype for genetic polymorphism in oxidative drug metabolism. AB - The metabolism of the dihydropyridine calcium antagonist and vasodilator nifedipine has been reported to exhibit polymorphism among individual humans (Kleinbloesem, C. H., van Brummelen, P., Faber, H., Danhof, M., Vermeulen, N. P. E., and Breimer, D.D. (1984) Biochem. Pharmacol. 33, 3721-3724). Nifedipine oxidation has been shown to be catalyzed by cytochrome P-450 (P-450) enzymes. Reconstitution, immunoinhibition, and induction studies with rat liver indicated that the forms designated P-450UT-A and P-450PCN-E are the major contributors to microsomal nifedipine oxidation. The P-450 which oxidizes nifedipine (P-450NF) was purified to electrophoretic homogeneity from several human liver samples. Antibodies raised to P-450NF were highly specific as judged by immunoblotting analysis and inhibited greater than 90% of the nifedipine oxidase activity in human liver microsomes. A monoclonal antibody raised to the human P-450 preparation reacted with both human P-450NF and rat P-450PCN-E. Immunoblotting analysis of 39 human liver microsomal samples using anti-P-450NF antibodies revealed the same 52,000-dalton polypeptide, corresponding to P-450NF, with only one of the microsomal samples showing an additional immunoreactive protein. The level of nifedipine oxidase activity was highly correlated with the amount of P 450NF thus detected using either polyclonal (r = 0.78) or monoclonal (r = 0.65) antibodies, suggesting that the amount of the P-450NF polypeptide may be a major factor in influencing the level of catalytic activity in humans as well as rats. Cytochrome b5 enhanced the catalytic activity of reconstituted P-450NF, and anti cytochrome b5 inhibited nifedipine oxidase activity in human liver microsomes. P 450NF also appears to be a major contributor to human liver microsomal aldrin epoxidation, d-benzphetamine N-demethylation, 17 beta-estradiol 2- and 4 hydroxylation, and testosterone 6 beta-hydroxylation, the major pathway for oxidation of this androgen in human liver microsomes. PMID- 3514608 TI - Altered kinetic properties of rat liver 3-hydroxy-3-methylglutaryl coenzyme A reductase following dietary manipulations. AB - The microsomal enzyme 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase catalyzes the rate-limiting step in the cholesterogenic pathway and was proposed to be composed in situ of 2 noncovalently linked subunits (Edwards, P.A., Kempner, E.S., Lan, S.-F., and Erickson, S.K. (1985) J. Biol. Chem. 260, 10278 10282). In the present report, the activities and kinetic properties of HMG-CoA reductase in microsomes isolated from livers of rats fed on diets supplemented with either ground Amberlite XAD-2 ("X"), cholestyramine/mevinolin ("CM"), or unsupplemented, normal rat chow ("N"), were compared. The specific activities of HMG-CoA reductase in X and CM microsomes were, respectively, 5- and 83-fold higher than that of N microsomes. In NADPH-dependent kinetics of HMG-CoA reductase activated with 4.5 mM GSH, the concentration of NADPH required for half maximal velocity (S0.5) was 209 +/- 23, 76 +/- 23, and 40 +/- 4 microM for the N, X, and CM microsomes, respectively. While reductase from X microsomes displays cooperative kinetics toward NADPH (Hill coefficient (nH) = 1.97 +/- 0.07), the enzyme from CM microsomes does not (nH = 1.04 +/- 0.07). Similarly to HMG-CoA reductase from CM microsomes, the freeze-thaw solubilized enzyme ("SOL") displays no cooperativity toward NADPH and its Km for this substrate is 34 microM. At 4.5 mM GSH, HMG-CoA reductase from X, CM, and SOL preparations has a similar Km value for [DL]-HMG-CoA, ranging between 13-16 microM, while reductase from N microsomes had a higher Km value (42 microM) for this substrate. No cooperativity towards HMG-CoA was observed in any of the tested enzyme preparations. Immunoblotting analyses of the different preparations demonstrated that the observed altered kinetics of HMG-CoA reductase in the microsomes is not due to preferential proteolytic cleavage of the native 97-100 kDa subunit of the enzyme to the noncooperative 50-55 kDa species. Moreover, it was found that the ratio enzymatic activity/immunoreactivity of the reductase increased in the order N less than X less than CM approximately equal to SOL, indicating that the activity per reductase molecule increases with the induction of the enzyme. These results are compatible with a model suggesting that dietary induction of hepatic HMG-CoA reductase may change the state of functional aggregation of its subunits. PMID- 3514609 TI - Inhibition of post-translational modification and surface expression of a melanoma-associated chondroitin sulfate proteoglycan by diethylcarbamazine or ammonium chloride. AB - Cultured human melanoma M21 cells were treated with diethylcarbamazine (DEC), an inhibitor of proteoglycan biosynthesis in rat chondrosarcoma cells, to examine the assembly and transport of a chondroitin sulfate proteoglycan to the plasma membrane. Pretreatment of melanoma cells at 37 degrees C for 15 min with increasing doses of DEC followed by a 60-min pulse with [35S]sulfate in the presence of DEC resulted in a dose-related inhibition of incorporation of [35S]sulfate into macromolecules. In cells incubated for 75 min with both 1 mM beta-D-xyloside and 15 mM DEC, synthesis and secretion of beta-D-xyloside-bound 35S-glycosaminoglycans were inhibited by more than 80% as compared to cells treated with beta-D-xyloside alone; this inhibition was reversible. As assessed by [3H]serine incorporation into protein, overall protein synthesis was not substantially inhibited by DEC treatment. Detergent lysates from [35S]methionine labeled melanoma cells were incubated with a monoclonal antibody (9.2.27) that specifically recognizes the peptide core of the melanoma proteoglycan. As assessed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis of the immunoprecipitate, a 240,000 Mr endoglycosidase H (Endo-H)-sensitive intermediate was the only form of the proteoglycan present inside the cells when the cultures were treated for 60-120 min with 10-15 mM DEC. When the melanoma cells were incubated for 10 min with 15 mM DEC and 100 mu Ci/ml of [35S]methionine, washed, and then chased for 15 min to 4 h in radioactive-free medium, the 240,000 Mr Endo H-sensitive intermediate was slowly converted to a 250,000 Endo-H-resistant intermediate but not to a mature proteoglycan molecule that possessed chondroitin sulfate glycosaminoglycans. SDS-PAGE analysis of cell surface immunoprecipitates revealed that only a small amount of the 250,000 Mr intermediate was transported to the plasma membrane within 5 h of incubation in the presence of DEC. Proteoglycan synthesis was also inhibited when the melanoma cells were incubated for 60-120 min with ammonium chloride, but unlike DEC-treated cells the majority of the synthesized peptide core was converted to a 245,000 Mr Endo-H-resistant intermediate that was detected on the cell surface. Light and electron microscopic analysis of DEC-treated melanoma cells revealed large vacuoles and a distended Golgi and endoplasmic reticulum. Ammonium chloride-treated cells contained fewer vacuoles than DEC-treated cells but more vacuoles than normal cells.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3514610 TI - Structures of glycosphingolipids isolated from human embryonal carcinoma cells. The presence of mono- and disialosyl glycolipids with blood group type 1 sequence. AB - Structures of glycolipids present in the human embryonal carcinoma cell PA1, were elucidated by fast atom bombardment-mass spectrometry, methylation analysis, and exo- and endoglycosidase digestion. PA1 cells contain globotriaosylceramide, sialosylgangliotriaosylceramide, sialylated and nonsialylated lacto-N neotetraosylceramide, and the following glycolipids with a blood group type 1 sequence: (formula; see text) The two former glycolipids, lacto-N tetraosylceramide and sialosyllacto-N-tetraosylceramide, reacted with monoclonal antibodies, K21 and K4, respectively. K21 and K4 antigens are present in many of the human embryonal carcinoma cells but not in a variety of other cell lines, suggesting that sialylated but not fucosylated blood group type 1 sequences are characteristic markers for human embryonal carcinoma cells and malignant teratocarcinomas. PMID- 3514611 TI - Characterization of the F plasmid TraJ protein synthesized in F' and Hfr strains of Escherichia coli K-12. AB - Using purified F plasmid TraJ protein (Cuozzo, M., Silverman, P., and Minkley, E. (1984) J. Biol. Chem. 259, 6659-6666), we prepared rabbit anti-TraJ protein antibodies to analyze for the first time the TraJ protein as it is synthesized in normal F' and Hfr conjugal donor strains. Using affinity-purified antibody, we identified the protein on immuno-overlay blots of whole cell proteins separated by sodium dodecyl sulfate/polyacrylamide gel electrophoresis. In contrast to the TraJ protein synthesized in large quantity by heat-induced lambda (traJ) lysogens, the TraJ protein synthesized in normal donor cells was soluble, even after sedimentation at 100,000 X g. The soluble protein was found with the cytoplasmic fraction after separation of cytoplasmic and periplasmic proteins. Velocity sedimentation analysis indicated an S20,w of 3.5 for the single molecular species composed of or including all the TraJ polypeptide in crude extracts. Quantitative analyses showed that conjugal donor strains normally contain 2000-4000 TraJ monomers/cell. However, that level depended on other plasmid and chromosomal genes. PMID- 3514612 TI - Inhibition of acetylcholine receptor assembly by activity in primary cultures of embryonic rat muscle cells. AB - Silencing of contractile activity in muscle is known to increase the level of acetylcholine receptor on the cell surface. Both in vivo and in vitro studies indicate that modulation of receptor-specific mRNA levels plays a role in the activity-related regulation, but other mechanisms have not been explored. In this study, we examine the synthesis and post-translational fate of receptor alpha subunit in actively contracting and tetrodotoxin-inhibited rat muscle cultures. Using metabolic labeling and immunoprecipitation with subunit-specific monoclonal antibodies, we find that the increase of alpha subunit synthesis in tetrodotoxin inactivated cultures is insufficient to account for the increased rate at which new receptors appear on the cell surface. In evaluating stages in the post translational processing of alpha subunit, we find that in active and inactive cultures, newly synthesized subunit acquires the ability to bind alpha bungarotoxin with the same kinetics. However, differences were noted at or preceding the stage where alpha subunit becomes assembled with the other subunits to form the 9 S receptor. In inactivated cultures, newly synthesized alpha subunit transits a 5 S precursor pool more rapidly and is assembled more efficiently than in contracting cultures. The possibility that these differences represent a type of post-translational regulation is discussed. PMID- 3514613 TI - Polysialoglycoproteins of Salmonidae fish eggs. Complete structure of 200-kDa polysialoglycoprotein from the unfertilized eggs of rainbow trout (Salmo gairdneri). AB - Polysialoglycoproteins (PSGP) we first isolated from the unfertilized eggs of rainbow trout (Salmo gairderi) and now found to be a ubiquitous component of Salmonidae fish eggs are a novel type of glycoprotein. PSGP from rainbow trout has a molecular weight of 200 X 10(3), a low protein content (about 15% w/w), and a high sialic acid (N-glycolylneuraminic acid (NeuGc] content (about 60%, w/w). In any evaluation of the biological functions of PSGP, information about the complete structure of this unique macromolecular component is relevant. We have now completed the determination of the overall structural organization of the 200 kDa PSGP, and this is the first report of the complete structural analysis of this novel class of glycoprotein: (Asp)0-2-Ala-Thr*-Ser*-Glu-(Ala-Ala-Thr*-Gly Pro-Ser-Gly-Asp-Asp-Ala-Thr *-Ser*- Glu)n-Ala-Ala-Thr*-Gly-Pro-Ser-Gly where * indicates the amino acid residues to which oligo- and/or polysialylglycan units are attached and n = 25. Thus the most outstanding structural features of PSGP isolated from the unfertilized eggs of rainbow trout are now the occurrence of (a) tandem repeats of a tridecapeptide and (b) an alpha-2----8-linked oligo(poly)sialyl group on each of the core oligosaccharide chains, i.e. GalNAc- beta 1----4(NeuGc alpha 2----3)GalNAc beta 1----3Gal beta 1----4Gal beta 1----3[- --8NeuGc alpha 2)n----6)GalNAc alpha 1----Ser (or Thr), Fuc alpha 1----3GalNAc beta 1----3Gal beta 1----4Gal beta 1----3[----8NeuGc alpha 2)n ----6)GalNAc alpha 1----Ser (or Thr), GalNAc beta 1----3Gal beta 1----4Gal beta 1----3[----8NeuGc alpha 2)n----6)GalNAc alpha 1----Ser (or Thr), Gal beta 1----4Gal beta 1----3[--- 8NeuGc alpha 2)n----6)GalNAc alpha 1----Ser (or Thr), and Gal beta 1----3[--- 8NeuGc alpha 2)n----6) GalNAc alpha 1----Ser (or Thr). PMID- 3514614 TI - Determination of the tissue distributions and relative concentrations of the postsynaptic 43-kDa protein and the acetylcholine receptor in Torpedo. AB - A protein of Mr 43,000 (43-kDa protein) occurs on the postsynaptic membrane in close association with the acetylcholine receptor and comprises a major part of the postsynaptic cytoskeletal apparatus. We have devised an immunological assay for the 43-kDa protein to determine if it is confined to receptor-specific sites or if it, like general cytoskeletal proteins, has a more widespread tissue distribution. The assay utilizes monoclonal antibodies (Mab) to the 43-kDa protein that recognize two spatially separate epitopes. One Mab, attached to the well of a microtiter plate, binds the antigen which is then available to bind the biotin-derivatized second Mab. Bound second antibody is detected with either avidin-alkaline phosphatase or a more elaborate system using avidin, rabbit anti avidin, and anti-rabbit IgG-alkaline phosphatase conjugate. A similar assay was developed for the receptor. The 43-kDa protein and the receptor are found in electric organ and, in 500-fold lower concentrations, in skeletal muscle but are not detectable in heart, liver, pancreas, or brain. In electric organ, the receptor and the 43-kDa protein are present in approximately equimolar concentrations. These results indicate that the 43-kDa protein is not a general membrane-associated cytoskeletal element and that its occurrence, and possibly also its function, is related to the acetylcholine receptor. PMID- 3514615 TI - Polypeptides of the oxygen-evolving photosystem II complex. Immunological detection and biogenesis. AB - Oxygen-evolving photosystem II complex was isolated from spinach chloroplasts. The individual polypeptides of the complex were isolated from sodium dodecyl sulfate (SDS)-polyacrylamide gels and antibodies were raised in rabbits against these polypeptides. After washing of the isolation complex by 0.8 M Tris to release the extrinsic proteins, a distinct diffused protein band was revealed at the position of 33 kDa in SDS gels containing 4 M urea. When this band was electroeluted from the gel and subsequently electrophoresed on SDS gels, three distinct protein bands became apparent. Antibodies raised against each one of these polypeptides cross-reacted with the other two polypeptides to varying degrees but not with the other subunits of the complex. The three polypeptides were denoted as "34," "33," and "32" kDa and the 33 being the herbicide-binding protein. Using the antibodies, the relative amounts of the photosystem II polypeptides were followed during greening of etiolated spinach seedlings. While all three extrinsic polypeptides were present in etiolated leaves at relatively high amounts, the other polypeptides could not be detected prior to an approximate 6-h illumination period. Further illumination induced the appearance of all of the rest of the subunits in a relatively similar rate. The oxygen evolution activity was developed parallel to the increase in the amounts of these polypeptides. Therefore, the assembly of the active photosystem II during greening is a two-step process in contrast with the photosystem I reaction center, which is assembled step by step, and the rest of the chloroplast protein complexes, which are assembled by a concerted mechanism. PMID- 3514616 TI - Purification and characterization of an acid metalloproteinase from human articular cartilage. AB - A metalloprotease that digests cartilage proteoglycan optimally at pH 5.3 has been purified (4400-fold) to homogeneity from 20-g samples of human articular cartilage containing about 100 micrograms of enzyme. This enzyme was cleanly separated from a related neutral metalloprotease with an optimum pH of 7.2. The acid metalloprotease displays 40% of its maximum activity at pH 7.2 and so has significant activity at physiological pH. The protease is calcium-dependent and indirect evidence suggests that it may contain zinc at its active center. It occurs largely in a latent form that can be activated by aminophenylmercuric acetate. The apparent Mr of the latent form is 55,000 and of the active form, 35,000. The isoelectric point is at pH 4.9. The protease activity is inhibited by chelators, Z-phenylalanine, ovostatin, and tissue inhibitor of metalloproteinase from human articular cartilage. It differs from metalloproteinases such as enkephalinase and kidney brush-border protease in its failure to be strongly inhibited by phosphoramidon and Zincov. It cleaves the proteoglycan monomer of bovine nasal cartilage to fragments of approximately 140,000 Da. It cleaves the B chain of insulin at Ala14-Leu15 and Tyr16-Leu17. A survey of 26 cartilage extracts indicates this enzyme is elevated to about 3 times the normal level in human osteoarthritic cartilage and that the tissue inhibitor of metalloproteinase is only slightly diminished. Preliminary evidence points to the presence of a similar acid metalloprotease activity in human polymorphonuclear leukocytes. PMID- 3514618 TI - Nucleotide sequence of Escherichia coli pyrG encoding CTP synthetase. AB - The amino acid sequence of Escherichia coli CTP synthetase was derived from the nucleotide sequence of pyrG. The derived amino acid sequence, confirmed at the N terminus by protein sequencing, predicts a subunit of 544 amino acids having a calculated Mr of 60,300 after removal of the initiator methionine. A glutamine amide transfer domain was identified which extends from approximately amino acid residue 300 to the C terminus of the molecule. The CTP synthetase glutamine amide transfer domain contains three conserved regions similar to those in GMP synthetase, anthranilate synthase, p-aminobenzoate synthase, and carbamoyl-P synthetase. The CTP synthetase structure supports a model for gene fusion of a trpG-related glutamine amide transfer domain to a primitive NH3-dependent CTP synthetase. The major 5' end of pyrG mRNA was localized to a position approximately 48 base pairs upstream of the translation initiation codon. Translation of the gene eno, encoding enolase, is initiated 89 base pairs downstream of pyrG. The pyrG-eno junction is characterized by multiple mRNA species which are ascribed to monocistronic pyrG and/or eno mRNAs and a pyrG eno polycistronic mRNA. PMID- 3514617 TI - Membrane glycophorins in Sta blood group erythrocytes. AB - Structural and immunochemical studies of glycophorins isolated from erythrocytes of an individual homozygous for the M Sta blood group phenotype are described. Reactivities with specific monoclonal antibodies indicated that two major M and N glycophorins were present. The M and N Sta glycophorins were resolved by Lens culinaris lectin affinity chromatography. The N species was not held on the lectin but the M species, like control alpha glycophorins, was retained and could be eluted with alpha-methylmannoside. The two proteins were present in almost equimolar amounts. Studies of the CNBr fragments provided evidence that the structure of M Sta glycophorin is the same as that of the usual M alpha glycophorin but that the N Sta glycophorin is a variant. The amino-terminal octapeptides of the M and N species were similar in amino acid and carbohydrate composition to those isolated, respectively, from M and N alpha glycophorins. The studies focused on CNBr glycopeptide B that, in control alpha glycophorins, extends from amino acid residues 9 to 81. The fragment from the M species exhibited properties identical to those of the corresponding fragment of control alpha glycophorins in terms of size, chromatographic behavior, amino acid and carbohydrate contents and compositions, the presence of O-glycosidically linked saccharides and a single Asn-linked carbohydrate unit. The structures of the O linked units were inferred experimentally to be NeuAc(alpha 2,3)Gal-(beta 1,3)GalNAc and NeuAc(alpha 2,3)Gal(beta 1,3) [NeuAc(alpha 2,6)]GalNAc, present in a ratio similar to that found in controls; and the Asn-linked unit also appeared to be as in the control. The tryptic glycopeptide pattern of the M Sta glycophorin CNBr fragment B was identical to the pattern of the corresponding control fragment, and the composition of the tryptic peptides suggested sequence identity with the control fragment. In contrast, the N Sta glycophorin yielded two CNBr glycopeptides B; both contained fewer amino acid residues and virtually lacked Man and GlcNAc, indicating the absence of the Asn-linked carbohydrate. The much decreased levels of these carbohydrates in the intact N protein, corroborated the latter finding. The O-glycosidic saccharides appeared similar to those found in control alpha glycophorins. However, the tryptic glycopeptide pattern of the variant differed from control M or N alpha glycophorins, suggesting a deletion of a large segment of the molecule near residues 40-61 and/or a substitution of methionine for a residue upstream from residue 40.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3514619 TI - Complete enzymatic replication of plasmids containing the origin of the Escherichia coli chromosome. AB - During enzymatic replication of plasmids containing the origin of the Escherichia coli chromosome, oriC, formation of an active initiation complex consisting of dnaA, dnaB, dnaC, and HU proteins, requires a supercoiled DNA template. Relaxed covalently closed plasmids are active only if supercoiled by gyrase prior to initiation; nicked and linear DNAs are inactive. Semi-conservative replication proceeds via delta structure as intermediates. Daughter molecules include nicked intermediates. Daughter molecules include nicked monomers and catenated pairs. Elongation is rapid, but late replicative intermediates accumulate because the final elongation and termination steps are slow. Production of covalently closed circular daughter DNA molecules requires removal of ribonucleotide residues (primers) by DNA polymerase I, assisted by ribonuclease H, gap filling, and ligation of nascent strands by ligase. Reconstitution of a complete cycle of oriC plasmid replication, beginning and ending with supercoiled molecules, has been achieved with purified proteins. PMID- 3514620 TI - Peptide mapping analysis of the avian progesterone receptor. AB - Progesterone receptor from the chicken oviduct has been shown to exist as two 8 S forms (I and II). Form I contains a protein of Mr = 75,000 and form II contains a protein of Mr = 110,000. In addition to these hormone-binding proteins, both receptor forms contain a protein with Mr = 90,000 that does not bind steroid. To investigate the possibility that these proteins are structurally related, they were isolated by preparative sodium dodecyl sulfate gel electrophoresis and subjected to peptide mapping analyses after digestion with Staphylococcus aureus V-8 protease, papain, or alpha-chymotrypsin. Receptor proteins labeled with [32P]orthophosphate in tissue minces were also subjected to peptide mapping analysis. The electrophoretic patterns of peptide fragments of the 90-kDa protein from receptor forms I and II were identical but were different from the peptide patterns obtained from the 75- and 110-kDa proteins which generated similar peptide patterns, indicating that these are structurally related. However, some differences were evident, indicating that these latter two proteins are not identical substrates for proteases. A one-dimensional comparison of the phosphopeptide patterns from the 75- and 110-kDa proteins also showed them to be similar, but not identical. Two-dimensional maps of phosphopeptides generated from the 75- and 110-kDa protein after complete tryptic digestion revealed multiple sites of phosphorylation which were identical except for one phosphopeptide that was unique to the 110-kDa protein. These results show the two progesterone-binding proteins to be very similar in structure, but to differ considerably from the 90-kDa protein. PMID- 3514621 TI - The quantitative and useful expression of the hardness of agar plate medium for mycoplasmas and bacteria. AB - A method for quantitative expression of the hardness of agar plate medium was studied. As the method for expressing the hardness by using real values of the load which an agar plate medium could sustain for a certain length of time was found to be inaccurate, we proposed a method to express the hardness by utilizing the frequency with which various loads were sustained for a given period of time and the obtained value is referred to as 'gel solidity' (GS). The GS value within a certain range was found to be statistically useful because it linearly reflected the changes in variables in experimental conditions in respect to agar, such as agar concentration, thickness of the agar layer and the temperature of the environment, and especially because it can provide a quantitative as well as reproducible value for the hardness of agar plate medium. On the other hand, GS was little, if at all, affected by variables unrelated to agar. PMID- 3514622 TI - The isolation and characterization of a human diploid cell strain and its use in production of measles vaccine. PMID- 3514623 TI - Evaluation of anti-inflammatory agents using a model of granuloma formation evoked by divinyl copolymer beads in the mouse lung. AB - We have developed and quantitated a reproducible standardized granulomatous inflammatory reaction using divinyl copolymer beads. Approximately 10000 gas sterilized beads (43-53 micron in diameter) are injected into the tail veins of mice and embolize to the lungs where they evoke granuloma formation which is maximal at 48 h. The anti-inflammatory effects of both steroidal and nonsteroidal agents, namely, bacterial levan, hydrocortisone acetate, polyanetholsulfonate, indomethacin, acetylsalicylic acid, ellagic acid, and aminophylline were determined by comparing granuloma size in treated animals with those in untreated controls. Granulomas in paraffin sections were traced on the ground glass screen of a light microscope and the area of each granuloma measured with a digitizer computer programmed to prepare histograms and merge data from replicate experiments. Of the agents tested, the greatest reductions in granuloma size occurred after treatment with bacterial levan (71%), hydrocortisone (70%), polyanetholsulfonate (58%), and indomethacin (55%). PMID- 3514624 TI - S-100 protein in human cartilage lesions. AB - S-100 protein is an acidic calcium-binding protein that was originally isolated from the mammalian central nervous system in 1965. Initially, S-100 protein was thought to be specific to neuroectodermal tissues, but its presence in chondrocytes was recently reported. This study is an analysis of the distribution of S-100 protein in lesions of human cartilage and its possible significance. Several cartilaginous tumors, both benign and malignant, as well as normal epiphyseal growth plates, were examined for S-100 protein by the immunoperoxidase technique. Each cartilaginous lesion that was examined showed immunoreactivity for S-100 protein. The staining product was noted only intracellularly. The highest intensity of staining was seen in the hypertrophic chondrocytes of the zone of provisional calcification in the growth plate and in the large chondrocytes located adjacent to areas of matrix mineralization in cartilaginous tumors. In normal epiphyseal growth plates, the intensity of staining increased in chondrocyte cytoplasm as one moved from the proliferating columnar chondrocytes through the zone of hypertrophic chondrocytes to the hypertrophic, degenerating chondrocytes in the zone of provisional calcification. In cartilaginous tumors, the cells of enchondroma and of the cartilaginous cap of osteochondroma were more immunoreactive than those of chondromyxoid fibroma. In benign chondroblastoma, the chondroblasts were less reactive than the chondrocytes in areas of chondroid matrix production. The latter areas of chondroblastomas showed stronger immunoreactivity in the matrix-enclosed cells adjacent to areas of mineral deposition. Among conventional chondrosarcomas, grade-I tumors showed greater immunoreactivity of the chondrocyte cytoplasm than did those of a higher grade, in which chondroid matrix production was less abundant.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3514625 TI - Conservative or surgical treatment of acromioclavicular dislocation. A prospective, controlled, randomized study. AB - In a prospective, controlled, randomized study of acute acromioclavicular dislocations, we compared conservative and operative treatment (the Phemister procedure) with regard to the clinical results, complications, and social costs. Forty-one patients were operated on and forty-three patients were treated conservatively. Two patients who were operated on and three who were treated conservatively had to have the lateral extremity of the clavicle resected because of pain. The rehabilitation period was significantly shorter with non-operative treatment, and after thirteen months there was no difference in the clinical results. There were no serious postoperative complications, but about half of the patients who were operated on had problems with the metallic device, such as breakage or migration of the pins, or both, and six patients had a superficial infection. For most patients with total acromioclavicular dislocation we recommend conservative treatment with a sling until the patient is free of pain. Operation should be considered in thin patients who have a prominent lateral end of the clavicle, in those who do heavy work, and in patients whose daily work requires that the shoulder often be held in about 90 degrees of abduction and flexion. PMID- 3514626 TI - Management of the hip in cerebral palsy. PMID- 3514627 TI - Craniocervical instability treated by contoured loop fixation. AB - Rigid posterior fixation of the skull to the third, fourth and fifth cervical vertebrae was achieved in three patients who, as a result of operation, had gross instability of the craniocervical junction. An anatomically contoured steel loop was secured to the occiput via small burr holes and to the vertebrae by sublaminar wiring. This technique has the advantage over bone grafting, either alone or with cement, in that it affords rigid stabilisation, allows early mobilisation and may contribute to eventual bony fusion. PMID- 3514628 TI - The fate of fat transplants in operations for partial closure of the growth plate. Clinical examples and an experimental study. AB - The cavities left after resection of bone bridges for partial closure of growth plates in children have commonly been filled with free fat grafts. Such cavities have been seen to elongate and thus enlarge during growth after the operation, but the fate of the grafts has been unknown. Similar cavities, made in the tibiae of growing pigs were filled with autogenous fat and studied by radiography for periods of up to 9 1/2 months. These cavities elongated in a manner similar to those in the clinical cases, and histological section showed them to be filled with living adipose tissue. The volume of this tissue had continuously increased in parallel with the growth in length of the bone. The fate of the grafts used in children may be similar to that seen experimentally. PMID- 3514629 TI - External fixation of the tibia. Basic concepts and prospective evaluation. AB - External fixation of fractures of the leg may give uneven results and a high rate of complications. We postulate that three basic principles can govern the optimal use of these devices. The external fixation frame should avoid damage to vital anatomical structures, it should allow access to the injured area and it should meet the mechanical demands of the patient and the injury. From 1978 to 1981 these principles were evaluated prospectively in 75 consecutive cases of complex tibial injury treated with an external frame. Most were open fractures. The study confirmed that the principles were safe and effective; they have general application and do not depend on the use of a particular frame or device. By following them we have eliminated the majority of complications seen after traditional methods of external fixation. PMID- 3514630 TI - Perioperative antimicrobial prophylaxis in cardiovascular surgery. A prospective randomized trial comparing two day cefuroxime prophylaxis with four day cefazolin prophylaxis. AB - In a randomized prospective study, two different regimens of antibiotic prophylaxis have been tested: four-day cefazolin prophylaxis (Kefzol 0.5 gr every 6 h) compared with two-day cefuroxime administration (Zinacef 1.5 gr every 12 h). A total of 569 patients in the two groups were studied in a 10 month period. Haematological, liver function, serum creatinine and urea measurement were made preoperatively and repeated daily for the first four days and after one week. At least five chest X-rays were taken during the hospitalisation. Body temperature was measured regularly every two hours in the ICU and a least twice a day thereafter. The wounds were examined daily and the patients were carefully observed for other infections. Bacteriological examinations of the tips of all inserted catheters and pacemaker wires were undertaken on removal in the first four months of the trial. Swabs of any tracheal or wound secretion or pus taken for bacteriological examinations as also blood cultures in any suspected septicaemia. Of the 569 patients three had to be withdrawn from the study. Of the assessable ones 285 received cefuroxime and 281 were given cefazolin. Seven patients (1.2%) died postoperatively. The total infection rate was 5.5%: 5.7% in the cefazolin group and 5.3% in the cefuroxime group. The overall wound infection rate was 1.8%: 2.5% in the cefazolin group and 1.1% in the cefuroxime group. Septicaemia occurred in 0.5% of the cases. Pneumonia occurred in 11 (1.9%) patients; 1.5% in the cefazolin and 2.5% in the cefuroxime group. Seven patients (1.2%) developed a urinary tract infection; 1.4% in the cefazolin group and 1.1% in the cefuroxime group.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3514631 TI - Successful repair of post-infarction heart rupture. Case report and review of the literature. AB - Left ventricular rupture secondary to acute myocardial infarction (AMI) if untreated, is invariably fatal. Successful surgical correction reported in the reviewed literature amounts to twenty cases. This is the case presentation of a 53 year old Caucasian woman admitted urgently to our Institution 6 hours after acute chest pain with a presumptive diagnosis of intrapericardial aortic rupture secondary to acute ascending aortic dissection. A cross-sectional echocardiogram demonstrated a posterior left ventricular rupture secondary to myocardial infarction. Emergency repair was carried out with the aid of cardiopulmonary bypass (CPB) and the patient was discharged after an uneventful recovery. However, five months later she was reoperated on for resection of a large pseudoaneurysm presumably secondary to incomplete resection of nonviable myocardium at the first operation. The patient made an uneventful recovery and remains asymptomatic and well. On the basis of this experience and review of the literature the authors propose a more aggressive approach in an attempt to improve the salvage rate of this not so rare complication of AMI. PMID- 3514632 TI - Reconstruction of the left innominate vein in a patient with invasive thymoma undergoing coronary artery bypass surgery. AB - This is a report of a case in which a patient undergoing coronary artery bypass surgery was found to have a thymoma invading the left innominate vein without obstructing it. The tumor was removed, the left innominate vein reconstructed with ringed PTFE graft and the coronary revascularization performed successfully. The surgical treatment adopted the considerations involving this particular patient and the literature of similar cases is reviewed and briefly discussed. PMID- 3514633 TI - Detection of a ventricular-specific myosin heavy chain in adult and developing chicken heart. AB - In the present study, a monoclonal antibody (McAb), ALD19, generated against myosin of slow tonic muscle, was shown to react with the heavy chain of ventricular myosin in the adult chicken heart. With this antibody, it was possible to detect a ventricular-specific myosin during myocardial differentiation and to show that the epitope recognized by ALD19 was present from the earliest stages of ventricular differentiation and maintained throughout development only in the ventricle. A second McAb, specific for atrial myosin heavy chain (MHC) (Gonzalez-Sanchez, A., and D. Bader, 1984, Dev. Biol., 103:151 158), was used as a control to detect an atrial-specific myosin in the caudal portion of the developing heart at Hamburger-Hamilton stage 15. It was found that the appearance of ventricular MHC predated the expression of atrial MHC by approximately 1 d in ovo and that specific MHCs were always differentially distributed. While a common primordial MHC may be present in the early heart, this study showed the tissue-specific expression of a ventricular MHC during the initial stages of heart development and its differential accumulation throughout development. PMID- 3514634 TI - Organization of the cytoskeleton in early Drosophila embryos. AB - The cytoskeleton of early, non-cellularized Drosophila embryos has been examined by indirect immunofluorescence techniques, using whole mounts to visualize the cortical cytoplasm and sections to visualize the interior. Before the completion of outward nuclear migration at nuclear cycle 10, both actin filaments and microtubules are concentrated in a uniform surface layer a few micrometers deep, while a network of microtubules surrounds each of the nuclei in the embryo interior. These two filament-rich regions in the early embryo correspond to special regions of cytoplasm that tend to exclude cytoplasmic particles in light micrographs of histological sections. After the nuclei in the interior migrate to the cell surface and form the syncytial blastoderm, each nucleus is seen to be surrounded by its own domain of filament-rich cytoplasm, into which the cytoskeletal proteins of the original surface layer have presumably been incorporated. At interphase, the microtubules seem to be organized from the centrosome directly above each nucleus, extending to a depth of at least 40 microns throughout the cortical region of cytoplasm (the periplasm). During this stage of the cell cycle, there is also an actin "cap" underlying the plasma membrane immediately above each nucleus. As each nucleus enters mitosis, the centrosome splits and the microtubules are rearranged to form a mitotic spindle. The actin underlying the plasma membrane spreads out, and closely spaced adjacent spindles become separated by transient membrane furrows that are associated with a continuous actin filament-rich layer. Thus, each nucleus in the syncytial blastoderm is surrounded by its own individualized region of the cytoplasm, despite the fact that it shares a single cytoplasmic compartment with thousands of other nuclei. PMID- 3514635 TI - The structure of cytoplasm in directly frozen cultured cells. II. Cytoplasmic domains associated with organelle movements. AB - The relationship between organelle movement and cytoplasmic structure in cultured fibroblasts or epithelial cells was studied using video-enhanced differential interference contrast microscopy and electron microscopy of directly frozen whole mounts. Two functional cytoplasmic domains are characterized by these techniques. A central domain rich in microtubules is associated with directed as well as Brownian movements of organelles, while a surrounding domain rich in f-actin supports directed but often intermittent organelle movements more distally along small but distinct individual microtubule tracks. Differences in the organization of the cytoplasm near microtubules may explain why organelle movements are typically continuous in central regions but usually intermittent along the small tracks through the periphery. The central type of cytoplasm has a looser cytoskeletal meshwork than the peripheral cytoplasm which might, therefore, interfere less frequently with organelles moving along microtubules there. PMID- 3514636 TI - Isolation of a human stromal cell strain secreting hemopoietic growth factors. AB - A diploid fibroblastoid cell strain, termed "ST-1," has been established from a long-term liquid culture of human fetal liver cells. ST-1 cells are nonphagocytic, nonspecific esterase negative and do not possess factor VIII related antigen but stain with antibodies specific for fibronectin and type I collagen. The ST-1 cells produce nondialyzable hemopoietic growth factors capable of stimulating the development of erythroid bursts, mixed granulocyte-macrophage colonies, pure granulocyte colonies, and pure macrophage colonies. These factors are active on both human fetal liver and human adult bone marrow progenitors. When liquid cultures of human fetal liver hemopoietic progenitors are established with a preformed monolayer of ST-1 cells, the yields of nonadherent cells, erythroid progenitors, and myeloid progenitors are greatly increased. These studies demonstrate that the fibroblastoid ST-1 cells support hemopoiesis in vitro and may be a critical element in the stromal microenviroment in vivo. PMID- 3514637 TI - Aluminum ions stimulate mitosis in murine cells in tissue culture. AB - Addition of aluminum to the culture medium of Nakano mouse lens epithelial (NMLE) cells and Swiss 3T3K cells induced both 3H-thymidine incorporation and mitosis. This is in contrast to other metal ions such as vanadium, which, at concentrations high enough to increase 3H-thymidine incorporation, actually inhibits mitosis (Jones and Reid, J Cell Physiol 121:199, 1984). Aluminum concentrations between 20 microM and 50 microM were most effective. The 3T3 cells respond to aluminum with a 7.6-fold increase, and NMLE cells respond with a 21 fold increase in 3H-thymidine incorporation. DNA synthesis in NMLE cells was also found to be synergistically stimulated by aluminum and low concentrations of insulin (4.5 X 10(-8) M). A 3.25-hr incubation with 50 microM aluminum was sufficient to induce 50% of maximum 3H-thymidine incorporation during the 40-hr assay. Aluminum-stimulated 3H-thymidine incorporation is inhibited by hydroxyurea, and aluminum causes an increase in cell number. Also, by sedimentation equilibrium analysis of the product of aluminum-stimulated DNA synthesis it was found that a single copy of DNA was synthesized following addition of aluminum to quiescent cells. These facts indicate that aluminum induces both S-phase DNA synthesis and mitosis. However, only 48% of the NMLE cells found to be labeled with DNA went on to divide. In contrast, although only a small percentage of 3T3 cells were found to be labeled after aluminum treatment, all of these cells appeared to go through mitosis. PMID- 3514638 TI - Fibronectin potentiates actin polymerization in thrombin-activated platelets. AB - The effect of fibronectin on the polymerization state of actin was studied. Triton X-100-insoluble cytoskeleton was prepared from thrombin-activated platelets, and the conversion of G-actin into F-actin was monitored by an assay involving DNase I inhibition by G-actin. It was found that fibronectin bound to membrane receptors decreased the level of platelet G-actin. This observation suggests that in the presence of fibronectin a larger amount of F-actin becomes incorporated into the Triton X-100-insoluble cytoskeleton. At the same molar concentration, fibrinogen only slightly increased actin polymerization, whereas bovine serum albumin at a much higher concentration caused a small inhibition of actin immobilization. Our data show that fibronectin, through interaction with the platelet actomyosin fibrillar system, facilitates actin polymerization into the cytoskeleton. PMID- 3514639 TI - Synthetic potential of Staphylococcus aureus V8-protease: an approach toward semisynthesis of covalent analogs of alpha-chain of hemoglobin S. AB - Enzyme-catalyzed reformation of peptide bonds in the noncovalent fragment systems of proteins has been emerging as a convenient procedure for the semisynthesis of covalent analogs of the respective proteins. Limited proteolysis of the alpha chain of hemoglobin S with Staphylococcus aureus V8-protease converts the chain into a fragment-complementing system by hydrolyzing the peptide bond Glu(30) Arg(31) of the chain. Therefore, it is conceivable that semisynthesis of covalent analogs of alpha-chain could be achieved if conditions for the V8-protease catalyzed formation of peptide bonds could be established. The synthetic potential of V8-protease has been now investigated by incubating V8-protease derived fragments of alpha-chain, namely alpha 1-30 and alpha 31-47 with the enzyme at pH 6.0 in the presence of n-propanol as the organic cosolvent. RP high performance liquid chromatography analysis showed that a new chromatographically distinct component is generated on incubation, and this has been identified as alpha 1-47 by amino acid analysis, redigestion with V8-protease (in the absence of n-propanol), and tryptic peptide mapping. Optimal conditions for the synthesis of alpha 1-47 is at pH 6.0, 4 degrees C, and 24 hr of incubation with 25% n propanol as organic cosolvent. This stereospecific condensation of the fragments proceeded to a high level of about 50% in 24 hr. Further incubation up to 72 hr did not increase the yield of alpha 1-47, suggesting that an equilibration of synthesis and hydrolysis reactions has been attained. The demonstration of the synthetic potential of V8-protease and the fact that alpha 1-30 and alpha 31-141 interact to form a native-like complex, opens up an approach for the semisynthesis of covalent analogs of alpha-chain of hemoglobin S. PMID- 3514640 TI - Antibodies to blood-brain barrier bind selectively to brain capillary endothelial lateral membranes and to a 46K protein. AB - To begin elucidating the biochemical basis of the polarized membrane features of the blood-brain barrier (BBB), a series of immunochemical and immunoperoxidase studies were initiated with bovine brain microvessels that make up the BBB in vivo. A rabbit antiserum was prepared against isolated bovine brain BBB plasma membranes. The bovine microvessel plasma membranes were radioiodinated with chloramine-T, and the antiserum selectively immunoprecipitated a 46K protein. The antibodies directed against the 46K protein were quantitatively absorbed with bovine brain capillaries but not with rat kidney or liver powder. Only the capillaries of brain reacted with the rat kidney-absorbed antiserum in immunoperoxidase studies of ethanol-fixed, 8-micron sections of bovine brain cortex, whereas the capillaries in heart, liver, and kidney did not react. This antiserum also strongly illuminated the lateral membranes of isolated bovine brain capillary endothelial cells grown in primary tissue culture. These studies provide evidence for a polarized distribution of a surface antigen in bovine brain capillary endothelial cells that is not present in capillary endothelia of liver, heart, or kidney. The correlation of the immunoperoxidase and immunoprecipitation techniques suggests that a candidate for the asymmetrically distributed surface antigen in the BBB is the 46K protein. The relationship between the 46K protein and the composition of BBB tight junctions remains to be determined. PMID- 3514641 TI - [Ectopic insertions of single ureters in children. Apropos of 9 cases]. AB - The authors present 9 cases of ectopic implantation of a single ureter in children. Ureteric ectopia is part of a congenital anomaly of the whole of the urinary tract, which explains the incidence of renal ectopia and associated dysplastic lesions of the renal parenchyma. The authors stress the importance of ultrasonography and, more recently, the CT scan for the localisation of the kidney homolateral to the ureteral ectopia. An analysis of the treatment and the results demonstrates the contrast between the unilateral forms which are easily treated and which have a good prognosis and the bilateral forms which are more difficult to treat and have a less favourable prognosis. PMID- 3514642 TI - [Role of chemotherapy in the treatment of soft tissue sarcoma in adults]. AB - Soft tissue sarcomas of adults represent an heterogeneous group of rare malignant tumors, for which clinical and histopathological prognostic factors are now well defined. The GTNM classification recommended by the UICC is effectively predictive for the metastatic potential of these diseases. Although chemotherapy still have limits in advanced sarcomas, the efficacy level reached allows to consider its use with a curative intend, in multidisciplinary therapeutic program. A critical analysis of the studies already published shows that adjuvant chemotherapy can reduce the distant metastases rate in patients presenting an operable primary tumor. Furthermore, the preliminary results of a study indicate that neoadjuvant (induction) chemotherapy may be of value for primarily inoperable patients. All these encouraging results remain to be confirmed by further studies with a long-term follow up of the patients. PMID- 3514643 TI - Childhood precursors of adult schizophrenia. PMID- 3514644 TI - Short term effects of methylphenidate on the cognitive, learning and academic performance of children with attention deficit disorder in the laboratory and the classroom. AB - Sixteen children meeting diagnostic criteria for Attention Deficit Disorder with Hyperactivity (ADD-H) were tested on methylphenidate (0.3 mg/kg) and placebo on cognitive, learning, academic and behavioral measures in a double-blind study. Assessments were carried out in the laboratory and in the children's regular classrooms. Results indicate methylphenidate-induced improvements on a majority of the measures. Drug-induced changes reflected increased output, accuracy and efficiency and improved learning acquisition. There was also evidence of increased effort and self-correcting behaviours. It is argued that reviewers have underestimated the potential of stimulants to improve the performance of ADD-H children on academic, learning and cognitive tasks. PMID- 3514645 TI - Purification of aldehyde reductase 1 from pig liver. PMID- 3514646 TI - Negative-ion chemical-ionization mass spectrometry of eicosanoids and its application to quantitation of prostacyclin synthesis in vascular tissue. PMID- 3514647 TI - Iodination of a long-acting analogue of luteinizing hormone releasing hormone: separation of reaction products by column liquid chromatography and measurement of biological activity. PMID- 3514648 TI - Selection of women at high risk of breast cancer for initial screening. AB - Selective breast cancer screening refers to the intentional restriction of screening to only a high-risk subgroup of the total population of women at risk. Using data from the Canadian National Breast Screening Study, we explored methods of defining such subgroups. Discriminants were based on risk factor information collected prior to screening and were constructed using a training group of 77 cases and 400 controls. They were then tested on a separate group of 38 cases and 200 controls. Both simple risk factor counts and logistic models were utilized and separate analyses were performed for pre- and post-menopausal women. Using a logistic model, we were able to define a high-risk subgroup encompassing less than 40% of the test controls and over 85% of the test cases. Such a selection strategy, if implemented, might reduce initial visit mammography rates by up to 60% with only a small reduction in case detection. Other uses as determining the optimal age for initiation of screening are also discussed. PMID- 3514649 TI - Effect of insulin on glucose uptake and metabolism in the human placenta. AB - The effect of insulin on glucose uptake, transfer, and metabolism was investigated in the human placenta perfused in vitro. Insulin concentrations in maternal perfusion medium were varied from 0-1200 microU/ml, whereas the glucose concentration was kept constant in maternal and fetal perfusion media. Despite significant uptake of insulin by the perfused placenta, neither glucose uptake and transfer nor lactate release were significantly modified during a 1-h insulin perfusion. The MCR of insulin by the placenta was 0.29 +/- 0.03 (+/- SEM) ml/min X g at physiological insulin levels. These data suggest that placental glucose transport and metabolism are insensitive to maternal plasma insulin variations and that the low clearance rate of insulin by the placenta is not a major determinant of maternal insulin adjustments during pregnancy. PMID- 3514650 TI - Luteinizing hormone (LH) and prolactin-releasing pituitary tumor: possible malignant transformation of the LH cell line. AB - A pituitary tumor was diagnosed in a prepubertal 13-yr-old girl, who had elevated plasma LH (58 mIU/ml) and PRL (93 ng/ml) levels; decreased GH, ACTH, and FSH secretion; and diabetes insipidus. After surgery, plasma LH and PRL declined, but not to normal levels. Conventional external radiotherapy to the pituitary was immediately followed by a decrease in LH to prepubertal values (0.7 mIU/ml), while PRL levels became normal only after a long course of bromocriptine therapy. The pituitary tumor was composed of two distinct cell types: small polygonal cells, which were PRL positive by immunohistochemistry, and clusters of pleomorphic large frequently mitotic polynucleated cells, which were LH positive, some of them also being positive for the alpha-subunit or beta LH but not for beta FSH. Four years after surgery and radiotherapy, the patient deteriorated neurologically. Computed tomographic scan showed widespread frontal and periventricular tumor, which had the histological features of a poorly differentiated carcinoma. No PRL, LH, or alpha- or beta-subunits were detectable on immunocytochemistry. While the PRL-positive cells of the pituitary tumor displayed the histological and clinical features of PRL adenomas, the morphological characteristics of LH cells and the sharp decline of plasma LH levels after radiotherapy were suggestive of malignant transformation. In this context, the later brain tumor could have been the result of subependymal spread of the pituitary tumor after it lost its hormone-secreting capacity. PMID- 3514651 TI - Insulin stimulates androgen accumulation in incubations of ovarian stroma obtained from women with hyperandrogenism. AB - The effects of insulin and insulin-like growth factors (IGFs) on ovarian androgen production were examined in ovarian stroma obtained from four women with hyperandrogenism and three women without hyperandrogenism. In incubations of stroma obtained from all four hyperandrogenic patients, insulin alone (500 ng/ml) significantly stimulated androstenedione and testosterone release. LH alone (25 ng/ml) significantly stimulated androstenedione release in incubations of stroma obtained from three of the four hyperandrogenic patients and testosterone release in incubations of stroma obtained from one of the four hyperandrogenic patients. In stromal incubations from three of the four hyperandrogenic patients, insulin alone (500 ng/ml) resulted in a significantly greater release of androstenedione and testosterone than did LH alone (25 ng/ml). Dihydrotestosterone was released in measurable quantities in incubations of stromal tissue obtained from three of the four hyperandrogenic women. In all three instances in which dihydrotestosterone was detectable, insulin alone (500 ng/ml), but not LH alone (25 ng/ml), significantly stimulated dihydrostestosterone release. Incubations of stroma obtained from three nonhyperandrogenic, normally cycling women demonstrated low levels of androstenedione release and negligible testosterone and dihydrotestosterone release. Insulin alone (500 ng/ml) and LH alone (25 ng/ml) produced no significant increase in androstenedione release. Insulin (500 ng/ml) plus LH (25 ng/ml) significantly stimulated androstenedione accumulation in stroma obtained from two of the nonhyperandrogenic women. One insulin dose response experiment was performed using stromal tissue obtained from a hyperandrogenic woman. In this experiment, insulin, at a dose of 50 ng/ml, was as effective as insulin at a dose of 500 ng/ml in stimulating androstenedione and testosterone release. In addition to insulin, IGF-I/somatomedin C (50 ng/ml) stimulated androstenedione and testosterone release. Relaxin (1 microgram/ml) and multiplication-stimulating activity (50 ng/ml) did not stimulate androstenedione and testosterone release. These studies suggest that human ovarian stroma may be a target tissue for insulin and IGF-I, and that hyperinsulinemia may be an important factor contributing to ovarian hyperandrogenism. PMID- 3514652 TI - Glucose storage is a major determinant of in vivo "insulin resistance" in subjects with normal glucose tolerance. AB - In vivo "resistance" to the action of insulin on glucose uptake is commonly found in obesity and is characteristic of noninsulin-dependent diabetes mellitus in obese subjects. To investigate the relationship among glucose uptake, glucose oxidation, and nonoxidative glucose disposal (storage) in subjects with normal glucose tolerance, we studied 25 caucasians and 79 southwestern American Indians, including lean and obese subjects in both groups. The euglycemic clamp technique with simultaneous indirect calorimetry was used to determine rates of glucose uptake and glucose oxidation. These studies were performed at two rates of insulin infusion (40 and 400 mU/m2 X min), with resulting mean plasma insulin concentrations of 113 and 1839 microU/ml, respectively. At the lower insulin infusion rate, there was no glucose storage in subjects with a glucose uptake rate of about 2.2 mg/kg fat free mass X min. In contrast, glucose storage accounted for over 45% of the glucose disposal in subjects with glucose uptake rates over 7.0 mg/kg fat free mass X min studied at similar insulin concentrations. At the high insulin infusion rate, over 70% of the difference in glucose uptake between subjects with a low or high capacity for glucose disposal was due to glucose storage. These studies demonstrated that in normal subjects at both physiological and maximally stimulating plasma insulin concentrations, glucose storage is a major factor in distinguishing between those with low or high rates of insulin-mediated glucose disposal. Since glucose storage may be a specifically activated process, we hypothesize that failure to activate glucose storage is a major defect causing in vivo insulin resistance in subjects with normal glucose tolerance. PMID- 3514653 TI - Failure to detect the "dawn phenomenon" in nondiabetic subjects with markedly different patterns of nocturnal growth hormone secretion. AB - Overnight serum insulin and plasma glucose concentrations were measured every 20 min from midnight to 0900 h in 13 nondiabetic subjects. Seven were normal men, and 6 had isolated GH deficiency. The pre-breakfast increase in serum insulin concentrations ("dawn phenomenon") did not occur in either group of individuals, and a progressive decline in serum insulin concentrations occurred particularly in the dawn hours (0600-0900 h). The GH secretory patterns were strikingly different in the two groups, with normal spontaneous GH peaks mostly between 0100 0200 h in the normal subjects vs. virtually flat GH secretion in the isolated GH deficiency group. The absence of the dawn phenomenon in these nondiabetic subjects regardless of their GH secretory pattern suggests that the dawn phenomenon, as described in insulin-dependent diabetic patients, is not an exaggeration of normal circadian rhythmicity in insulin sensitivity. PMID- 3514655 TI - Tentative interpretive criteria for in vitro antibacterial susceptibility testing with imipenem. AB - Imipenem is a member of a new class of highly potent beta-lactam antibiotics, carbapenems, with a very broad antibacterial spectrum. This study was undertaken to determine tentative interpretive criteria for in vitro susceptibility testing with 10-micrograms imipenem disks. A careful examination of the zone diameters and the corresponding MICs for 489 clinical isolates by regression-line analysis and the error rate-bounded classification scheme suggested the following guidelines: greater than or equal to 16 mm with an MIC correlate of less than or equal to 4 micrograms/ml for susceptible, 14 to 15 mm (8 micrograms/ml) for moderately susceptible, and less than or equal to 13 mm (greater than or equal to 16 micrograms/ml) for resistant. Lack of cross-resistance between imipenem and broad-spectrum cephalosporins such as cefotaxime and ceftazidime argues against their use as class disks to predict in vitro susceptibility of bacterial species to carbapenems. PMID- 3514654 TI - IgA-associated renal diseases: antibodies to environmental antigens in sera and deposition of immunoglobulins and antigens in glomeruli. AB - Levels of IgA1, IgA2, IgM, and IgG antibodies specific for 10 ubiquitous food and bacterial antigens were examined by radioimmunoassay in the sera of 29 patients with IgA-associated renal diseases and 22 normal individuals. No significant differences were observed between patient and normal groups in the levels of IgA1 antibodies, and IgA2 antibodies were detected in only a few individuals in either group. Minor differences in IgM or IgG antibodies were seen against some antigens. Significant positive correlations between IgA1 and IgG and between IgA1 and IgM antibodies to casein were found in the patient group. Analysis of the molecular form of serum IgA1 antibodies revealed that although the pattern of polymeric and monomeric forms varied between individuals and between antibody specificities, there was no preponderance of one form in either patient or normal groups. Examination of kidney biopsies from 50 patients with IgA-associated renal diseases revealed that IgA1 represented the predominant subclass deposited in the glomerular mesangium; glomeruli from three patients contained both IgA1 and IgA2. Seventy-eight percent of the patients also had deposits of IgM, although IgA and IgM deposits did not always coincide. When IgG was present in glomeruli (45% of patients), the IgG1 subclass predominated. J chain was detectable in glomeruli of only four patients. C3 was detected in glomeruli of 95% of the patients, although the distribution of C3 did not always coincide with that of IgA. Indirect immunofluorescence staining with rabbit antisera to various environmental antigens showed that milk protein antigens could be deposited in association with IgA in the glomerular mesangium. PMID- 3514656 TI - Serospecificity of a cloned protease-resistant Treponema pallidum--specific antigen expressed in Escherichia coli. AB - We evaluated the serological reactivity of a protease-resistant antigen designated 4D which was encoded by Treponema pallidum DNA and was expressed in Escherichia coli from recombinant plasmid pAW329. This 19,000-molecular-weight antigen was purified in its native, non-protease-treated form from E. coli sonic extracts by molecular sieving and ion-exchange chromatography. Antibody binding to antigen 4D was detected by a radioimmunoassay. Antigen 4D-specific antibody was detected in 95% of the sera in a Centers for Disease Control syphilis serum panel. It was also detected in 55% of 121 primary syphilis patients, whereas syphilis antibody was detected in 83% of the sera by a fluorescent treponemal antibody absorption test and in 88% of the sera by a T. pallidum microhemagglutination test. In tests of 118 normal sera, less than 3% demonstrated antibody to antigen 4D; these results are similar to microhemagglutination and fluorescent treponemal antibody absorption test results. Rabbit antisera against Treponema phagedenis, Treponema refringens, Treponema denticola, and Treponema vincentii did not react with antigen 4D. PMID- 3514657 TI - Comparison of the standard pour plate procedure and the ATP and Limulus amebocyte lysate procedures for the detection of microbial contamination in intravenous fluids. AB - The intrinsic and extrinsic microbial contamination of large-volume parenterals has been associated with bacteremias in hospitalized patients. When epidemiologic data suggest the association of contaminated intravenous (i.v.) fluids with disease, appropriate laboratory methods must be devised to analyze quickly the suspect fluid. A study was undertaken to compare three laboratory test methods (standard pour plate [SPP] technique, ATP procedure, and Limulus amebocyte lysate [LAL] assay) for detecting the presence of microorganisms in artificially contaminated i.v. fluid. SPP proved the most sensitive of the assay techniques used, but a 24-h period was required for microbial growth. The LAL assay appeared more sensitive in detecting i.v. contamination than the ATP method. These studies suggest that the LAL and ATP methods can be used for the rapid detection of microbial contamination in i.v. fluid. SPP and LAL procedures would have practical laboratory application when the contamination of i.v. fluids is suspected, and they are more sensitive in detecting microbial contamination in these solutions than the ATP method. PMID- 3514658 TI - Rapid detection of respiratory syncytial virus in nasopharyngeal aspirates by a commercial enzyme immunoassay. AB - A commercial enzyme immunoassay (EIA) for the rapid detection of respiratory syncytial virus (RSV) in respiratory secretions was evaluated by comparison with both virus isolation in HEp-2 cells and indirect immunofluorescence (IFA) staining of exfoliated respiratory cells. Initial examination of 80 nasopharyngeal aspirates collected from infants with acute respiratory illness showed that the RSV EIA was positive for 21 of 24 specimens positive by virus isolation or IFA (87.5% sensitivity) and negative for 53 of 56 specimens negative by virus isolation and IFA (95% specificity). The EIA appears to be an acceptable and more rapid test than virus isolation for the detection of RSV, especially for laboratories in which prompt inoculation of specimens is not always possible. IFA staining with commercial bovine anti-RSV serum was found to be the most sensitive and rapid test for the detection of RSV. However, three of four specimens positive by IFA and negative by virus isolation were not cultured under optimal conditions. In addition, the IFA test requires a highly trained technologist to interpret the staining results. PMID- 3514659 TI - Reduction of morbidity and mortality rates for neonatal group B streptococcal disease through early diagnosis and chemoprophylaxis. AB - Pregnant women, part of the term service population at Orlando Regional Medical Center, were screened for group B streptococci (GBS), using Lim Group B Strep Broth (GIBCO Laboratories, Madison, Wis.) and the Phadebact Strep B Test (Pharmacia Diagnostics, Piscataway, N.J.). Of the 803 women screened, 173 were confirmed as colonized with GBS at the time of admission in labor. Eighty of these women were treated with ampicillin at least 6 h prior to delivery. The remaining 93 women received no ampicillin. None of the infants born to the treated women was colonized with GBS at surface culture sites. Forty-three of the infants born to untreated women were colonized. Rapid identification of GBS colonization in women, combined with ampicillin chemoprophylaxis, significantly reduced vertical transmission of GBS. PMID- 3514660 TI - Production of monoclonal antibody against Pneumocystis carinii by using a hybrid of rat spleen and mouse myeloma cells. AB - It has been difficult to obtain pure Pneumocystis carinii antigen either from cultures or from infected lungs for use in producing a specific antibody against P. carinii. This report describes an approach toward producing a monoclonal antibody that bypasses the antigen purification steps. P. carinii infection was developed in Sprague-Dawley rats by the method of immunosuppression with cortisone. The infected lungs were homogenized, and the homogenate was used to immunize Sprague-Dawley rats. Rat spleen cells were then fused with SP2/0 mouse myeloma cells. Hybridoma clones were screened for antibody production against P. carinii by immunoperoxidase staining techniques and by enzyme-linked immunosorbent assay, using as antigens homogenates of normal rat lung, homogenates of P. carinii-infected rat lung, and harvests of P. carinii grown with WI-38 cells. Out of six hybridoma clones obtained that produced antibodies against P. carinii, one was able to produce ascitic fluid. This monoclonal antibody reacted with two P. carinii antigens with masses of about 35,000 and 65,000 daltons in P. carinii-infected lungs and three proteins with masses of about 35,000, 65,000, and 110,000 daltons in P. carinii that was harvested from a WI-38 cell culture. PMID- 3514661 TI - Evaluation of broth disk elution methods for susceptibility testing of anaerobic bacteria with the newer beta-lactam antibiotics. AB - Broth disk elution procedures represent one of the most practical means for clinical laboratories to perform routine antibiotic susceptibility tests on anaerobic bacteria. The accuracy of five disk elution test methods and media (including the one to be proposed by the National Committee for Clinical Laboratory Standards) was evaluated for the testing of newer beta-lactam antibiotics, including cefoperazone, cefotaxime, cefoxitin, ceftazidime, ceftizoxime, moxalactam, and piperacillin. Various numbers of antibiotic disks were used to achieve disk elution test concentrations which approximated the highest MIC termed susceptible by the Food and Drug Administration. A group of 88 anaerobes representing many different species was tested in parallel by the five disk elution methods and the National Committee for Clinical Laboratory Standards reference agar dilution procedure. Overall, full agreement between the reference agar dilution MICs and the disk elution category results was 88.3% for PRAS BHI, 84.5% for Schaedler, 85.7% for thioglycolate, and 87.4% for Wilkins-Chalgren broth. Essential agreement (+/- 1 twofold MIC increment from the disk elution concentration) was achieved with 94.6% of PRAS BHI tests, 94.3% of Schaedler tests, 93.6% of thioglycolate tests, and 95.7% of Wilkins-Chalgren tests. Due to growth failures with a number of isolates and difficulties in interpreting results, the use of Wilkins-West broth was discontinued after approximately one half of the isolates had been tested. The majority of errors with all of the disk elution methods occurred with isolates (most notably members of the Bacteroides fragilis group) having MICs near the single test concentrations used in the disk methods. With the notable exception of tests for the B. fragilis group, the disk elution methods offered acceptable accuracy with the newer beta-lactam antibiotics tested in this study. PMID- 3514662 TI - Two fatal cases of type E adult food-borne botulism with early symptoms and terminal neurologic signs. AB - Type E botulism, one of the least common forms of botulinal intoxication on the East Coast of the United States, is described for two elderly patients with chronic underlying disease. Both patients consumed tainted kapchunka, a salted, ungutted whitefish. Gastrointestinal symptoms and signs were prominent, but neurologic complaints, although noted soon after the consumption of the fish in one patient, did not progress until late in the course of the patient's illness. One patient exhibited both urinary retention, which was reported mainly in one outbreak of type E botulism (M.G. Koenig, A. Spickard, M.A. Cardella, and D.E. Rogers, Medicine [Baltimore] 43:517-545, 1964), and muscular fasciculations, which have been rarely reported. PMID- 3514663 TI - Proteolytic activity of a clinical isolate of Cryptococcus neoformans. AB - A clinical isolate of Cryptococcus neoformans was grown on essential salts medium without (NH4)2SO4 and supplemented with bovine serum albumin as the sole carbon and nitrogen source. Growth on this medium resulted in secretion of proteolytic enzymes by the organism. The secretion of protease enzymes was inhibited by (NH4)2SO4 and glucose. Proteolytic activity may be a factor in virulence and pathogenicity of C. neoformans. PMID- 3514664 TI - Comparison of a new commercially prepared porphyrin test and the conventional satellite test for the identification of Haemophilus species that require the X factor. AB - A test with a commercially developed porphyrin test agar was examined for the identification of Haemophilus spp. The porphyrin test agar method was compared with the conventional paper strip satellite method in tests with 187 isolates and was found to be easier to perform and interpret, giving a sensitivity of 98.7% and specificity of 94.7%. PMID- 3514665 TI - Creatine kinase isoenzymes in spermatozoa. AB - Two isoforms of creatine kinase (CK, E.C. 2.7.3.2), the brain type BB-CK and the mitochondrial-bound MiMi-CK, as well as adenylate kinase (myokinase, E.C. 2.7.4.3) were identified in washed spermatozoa from chicken and man by cellulose polyacetate electrophoresis and immunoblots. BB-CK was localized by indirect immunofluorescence staining within the sperm tail but not in the head portion. MiMi-CK is confined to the midpiece region rich in mitochondria and has been localized directly by immunogold staining within the mitochondria. In contrast to chicken, seminal plasma from man was also found to contain considerable amounts of BB-CK. Total creatine content of spermatozoa (8-15 mM) and seminal plasma (3.8 +/- 0.4 mM) as well as preliminary experiments with metabolic blockers indicate a dependence of sperm motility on CK and phosphoryl creatine (CP). The presence of two CK isoforms located in different 'compartments' of spermatozoa suggests a CP shuttle in sperm similar to that described for cross-striated muscle. PMID- 3514667 TI - Promoting independence in adolescent paraplegics: a 2-week "camping" experience. AB - In the summer of 1982, Texas Scottish Rite Hospital (Dallas, TX, U.S.A.) sponsored a camp for paraplegic adolescents. Six patients, three boys and three girls 14-17 years of age, participated in a 2-week program that was designed to improve their self-esteem, independence, and eventual employability. In their pre and postcamp psychological evaluations, the campers demonstrated improvement in social skills and self-concept testing as compared with the scores of a matched control group, although this improvement did not reach statistical significance. We believe the camp was immensely successful, an opinion that was shared by both the campers and their parents. PMID- 3514666 TI - Myasthenia gravis: immunohistological heterogeneity in microenvironmental organization of hyperplastic and neoplastic thymuses suggesting different mechanisms of tolerance breakdown. AB - Four samples of thymoma obtained from patients affected by myasthenia gravis have been immunohistologically analysed on cryostat sections using a panel of antisera and monoclonal antibodies specific for antigens which define different stages of intrathymic lymphocyte differentiation and antigens specific for different types of thymic epithelial cells (cortical, medullary). When the thymoma samples were compared to age-matched normal thymuses and hyperplastic thymuses obtained from patients with myasthenia gravis some evident microenvironmental differences could be demonstrated using these reagents. In all the thymoma samples in fact the neoplastic lobules appeared as grossly enlarged cortical-type areas, formed by accumulations of T lymphocytes exhibiting the cortical immature phenotype (TdT+, T6+, etc.) within a network of putatively neoplastic epithelial cells characterized by cortical phenotype as defined by reactivity with various monoclonal antibodies (RFD4-, MR3+). These 'cortical' epithelia showed some abnormal features such as lack or irregular distribution of HLA-DR and enhanced keratin expression. Small areas of 'medullary' differentiation could be observed in 3/4 thymoma samples. In thymic hyperplasia, on the other hand, the cortical areas appeared somewhat compressed (but comparable to those observed in normal age-matched samples) by enlarged medullary areas. The expansion of medullary areas was due to the infiltration of 'peripheral' lymphoid tissue intruding through the extraparenchymal zone and forming organized B and T areas. These observations are discussed in the light of the clinical heterogeneity observed in myasthenia gravis. PMID- 3514668 TI - Classic. Translation: Hilgenreiner on congenital hip dislocation. AB - This is an English translation of the original classic paper by Prof. Dr. H. Hilgenreiner in which he reviews the then (1925) current thought on congenital dislocation of the hip (CDH), argues for its early treatment, outlines techniques for early diagnosis, presents a splinting method of treatment for infants, and, especially, describes his method of radiographic evaluation, including the measure of acetabular development that has become known as "the acetabular index." His anticipation of our present understanding of CDH is surprising. PMID- 3514669 TI - Peracute streptococcal pyomyositis: report of two cases and review of the literature. AB - Pyomyositis occurs infrequently in temperate climates. The fulminating peracute form caused by group A Streptococcus is exceedingly rare. We present two children with streptococcal pyomyositis. One child was admitted in septic shock and required intensive supportive care during the acute stage of his illness. Persistent swelling and tenderness of his left thigh presented a diagnostic problem, which was eventually resolved with the aid of computerized tomography. Despite appropriate antibiotic therapy from the onset of illness, surgical debridement of the affected muscle was necessary. The second child presented with pyomyositis of the left paravertebral muscles and signs of incipient shock but did well on antibiotic therapy alone. PMID- 3514670 TI - Somatic gene therapy. Current status and future prospects. PMID- 3514671 TI - Morphologic alterations of the blood-brain barrier with experimental meningitis in the rat. Temporal sequence and role of encapsulation. AB - The cerebral capillary endothelium is unique and functions as an effective blood brain barrier (BBB) owing to its intercellular tight junctions and rare pinocytotic vesicles. To assess how bacterial meningitis alters the BBB, rats were inoculated intracisternally with three encapsulated meningeal pathogens (Escherichia coli K1+, Streptococcus pneumoniae type III, Haemophilus influenzae type b) and an unencapsulated mutant strain (H. influenzae Rd). After defined infection durations, the morphologic alterations of the cerebral capillary endothelium were quantitatively assessed by transmission electron microscopy. Results revealed a significant increase in pinocytotic vesicle formation (P less than 0.001) early after meningitis induction (4 h) that was sustained with longer infection durations (10 h, 18 h) for all encapsulated strains tested. In addition, there was a progressive increase in completely separated intercellular junctions with increasing infection duration, (P less than 0.05). 4 h after induction of meningitis with H. influenzae Rd, cerebrospinal fluid (CSF) bacterial concentrations, cerebral capillary morphologic changes, and functional BBB permeability to circulating 125I-albumin were similar to those observed with H. influenzae type b. However, prolonging the H. influenzae Rd infection to 18 h allowed for CSF clearance of the organism, thereby precluding the significant increase in separated junctions or progression of functional BBB permeability seen with the encapsulated H. influenzae type b. These data suggest a uniform morphologic explanation for altered BBB permeability in meningitis with a reproducible temporal sequence. Encapsulation does not appear essential for BBB injury, but may facilitate its progression by allowing the organism to evade host clearance. PMID- 3514672 TI - Complement-induced glomerular epithelial cell injury. Role of the membrane attack complex in rat membranous nephropathy. AB - In passive Heymann nephritis (PHN) in rats, antibody (anti-Fx1A) reacts in situ with a glomerular epithelial antigen and induces complement (C)-mediated cell independent proteinuria. To assess the role of the membrane attack complex (MAC), we determined the need for C8 in the pathogenesis of proteinuria in an autologous phase model of PHN. Isolated rat kidneys, containing nonnephritogenic, non-C fixing gamma 2 sheep anti-Fx1A (planted antigen), when perfused in vitro with C fixing guinea pig anti-sheep IgG and a source of C (fresh human plasma 50% vol/vol in buffer containing bovine serum albumin), developed marked proteinuria after 20 min (0.58 +/- 0.08 mg/min X g, n = 8) that increased further to 3.20 +/- 0.93 mg/min X g after 80 min. In contrast, identical kidneys perfused with antibody and heat-inactivated or C8-deficient human plasma and normal kidneys perfused with antibody and fresh plasma excreted only 0.27 +/- 0.03 (n = 6), 0.27 +/- 0.04 (n = 5), and 0.40 +/- 0.05 mg/min X g (n = 6) after 20 min, and 0.13 +/- 0.02, 0.22 +/- 0.03, and 0.32 +/- 0.05 mg/min X g after 80 min, respectively. When C8-deficient plasma was reconstituted with sources of C8 (n = 3), proteinuria was restored to the level observed with fresh normal plasma. Differences in protein excretion could not be explained by quantitative differences in glomerular antigen or antibody content. Extensive ultrastructural damage to glomerular visceral epithelial cells was exclusively seen in antigen containing kidneys perfused with antibody and C8-replete plasma. Thus, glomerular injury in this model results from an antigen-specific, antibody-directed, C8 dependent reaction involving assembly of the MAC. The ultrastructural findings argue in favor of MAC-induced cytotoxicity of the glomerular visceral epithelial cells. PMID- 3514674 TI - Isolation of the target antigen of human anti-tubular basement membrane antibody associated interstitial nephritis. AB - Using a monoclonal anti-tubular basement membrane antibody (alpha TBM-Ab) affinity column, we isolated from collagenase-solubilized human renal tissue (HSRTA) a predominantly 48,000-mol-wt moiety (H3M-1) which is selectively recognized by antisera from two patients with alpha TBM-Ab-associated interstitial nephritis (alpha TBM disease). Whereas both antisera had alpha TBM Ab titers of 1:64-1:128 by immunofluorescence on tissue sections, their reactivity with H3M-1 in a solid-phase radioimmunoassay was demonstrable at dilutions up to 1:10,000. While these sera displayed some reactivity with pre column HSRTA, this was markedly less than with H3M-1. HSRTA depleted of H3M-1 by passage over the alpha TBM-Ab affinity column was almost completely depleted of reactivity. Neither pooled normal human sera nor sera from patients with a variety of renal lesions not associated with alpha TBM-Ab (including interstitial nephritis and antiglomerular basement membrane disease) were reactive with H3M-1. Both patient antisera containing alpha TBM-Ab were also highly reactive with R3M 1, the 48,000-mol-wt rabbit glycoprotein antigen of experimental alpha TBM disease. Furthermore, a competitive inhibition radioimmunoassay revealed that alpha TBM-Ab from rodents with experimental alpha TBM disease could inhibit 45 98% of the R3M-1 binding reactivity of patient antisera and 85% of the H3M-1 binding reactivity of patient antisera, thus suggesting paratypic cross reactivity. We conclude, therefore, that tubular basement membrane target epitopes and their paratypic recognition are highly conserved among mammals. PMID- 3514673 TI - Vasopressin reduces cardiac function and augments cardiopulmonary baroreflex resistance increases in man. AB - We examined the effects of physiologic infusions of arginine vasopressin (AVP) on cardiovascular hemodynamics and on reflex responses initiated by decreasing cardiopulmonary baroreceptor stimulation (with lower body negative pressure) in 10 healthy, captopril-pretreated young men (19-27 yr). Their responses were compared with those of four volunteers given isosmotic infusion. Heart rate, stroke volume, blood pressure, and forearm blood flow were measured by electrocardiography, impedance cardiography, radial artery cannulation, and strain gauge plethysmography. Two 55-min infusions of AVP at rates of 0.15 and 0.40 ng/kg per min increased average plasma concentrations from control levels of 5 pg/ml to 18 and 36 pg/ml, respectively. These infusions resulted in progressive reductions of heart rate and cardiac output and increases of forearm and total peripheral resistance. Blood pressure increases were significant only during the larger AVP infusion rate. Lower body negative pressure provoked reflex increases of total peripheral resistance. These increases were enhanced 60% during AVP infusion compared with increases during control (pre-AVP). Baseline measurements and reflex responses were unchanged by isosmotic infusions. These results demonstrate that AVP has profound effects on cardiovascular function and augments cardiopulmonary baroreflex-mediated increases of peripheral resistance in man. PMID- 3514676 TI - Partial factor IX protein in a pedigree with hemophilia B due to a partial gene deletion. AB - A partial gene product was identified in a pedigree with hemophilia B due to a partial deletion of the Factor IX gene (Chen, S.-H.,S. Yoshitake, P.F. Chance, G.L. Bray, A.R. Thompson, C.R. Scott, and K. Kurachi, 1985, J. Clin. Invest., 76:2161-2164). Levels of this mutant protein in plasma of affected family members studied ranged from 24 to 36 ng/ml (0.6-0.9 U/dl or percent of normal) by a solid phase immunoassay which is sensitive and specific for the calcium-dependent conformation of human Factor IX. No Factor IX antigen could be detected in patients' plasmas by a non-calcium-requiring monoclonal anti-Factor IX antibody (less than 2 ng/ml). The unconcentrated urine from the five affected family members and four obligate heterozygotes the five affected family members and four obligate heterozygotes tested contained calcium-dependent Factor IX antigen levels ranging from 64 to 160 ng/ml (1.6-4.0 U/dl) and from 10 to 68 ng/ml (0.25 1.7 U/dl), respectively. Of nine normal volunteers screened, three had detectable calcium-dependent antigen in unconcentrated first morning-voided urines with 9.6 16.8 ng/ml (0.24-0.42 U/dl), while the remaining six had detectable urinary antigen only after a 10-fold concentration. Abnormal and normal urinary Factor IX antigen species were concentrated, immunoaffinity purified, electrophoresed, immunoblotted, and distinguished by autoradiography after incubation with 125I polyclonal calcium-requiring anti-Factor IX. After reducing purified or concentrated samples, a single abnormal 36,000-mol-wt band was identified in the urines from the four affected family members and four obligate heterozygotes tested. Electrophoresis of the reduced urinary Factor IX antigen from the one normal subject tested showed a broad 15,000-20,000-mol-wt band. This normal band was smaller than the species in patients' urines, and was seen as a minor component in the samples from the heterozygotes. No abnormal antigen could be detected in urine from the two other female family members tested. Thus, abnormal urinary Factor IX antigen represents a marker for the presence of the hemophilic Factor IX gene in this family. PMID- 3514675 TI - Laminin promotes rabbit neutrophil motility and attachment. AB - Polymorphonuclear neutrophils (PMN) traverse basement membrane to reach sites of infection. We have studied the role of laminin, a specific basement membrane component, in this process using three assay systems. In the Boyden chamber, laminin was found to stimulate chemotaxis of neutrophils while fibronectin did not. Co-incubation of cells with antibody to laminin blocked this chemotaxis, while antibody to fibronectin was without effect. In the human amnion system, neutrophils were shown to penetrate through the tissue when the peptide chemoattractant f-Met-Leu-Phe was placed on the opposing side. Antibody to laminin, but not to fibronectin, blocked this penetration. In an attachment assay system, laminin, but not fibronectin, was found to increase dispase-treated neutrophil attachment to type IV (basement membrane) collagen-coated plastic and to a plastic substrate itself. Electrophoretic analysis of PMN extract indicated the presence of laminin, and indirect immunofluorescence suggested that laminin is localized on the surface of the neutrophils. These data suggest that PMN can bind laminin on their cell surfaces, use laminin to attach to basement (type IV) membrane collagen, and migrate toward a gradient of laminin. These properties may be important for the passage of neutrophils from the circulation to sites of infection. PMID- 3514677 TI - Insulin action in human adipose tissue in acromegaly. AB - The mechanisms underlying insulin resistance in acromegaly were investigated. Adipose tissue was obtained from nine patients with acromegaly who had in vivo insulin resistance and from 14 matched healthy control subjects. Receptor binding and the antilipolytic effect of insulin were determined in isolated fat cells. Insulin-induced glucose oxidation at a physiological hexose concentration was investigated in fat segments. In fat cells obtained from acromegaly patients after an overnight fast, insulin binding at low hormone concentrations was significantly reduced by 20-30%, insulin-induced antilipolysis was unchanged, but glucose oxidation was unresponsive to insulin. Since it has recently been observed that glucose feeding may rapidly modify insulin action in human adipocytes, fat cells were also obtained 60 min after an 100-g oral glucose load. In this situation, insulin binding at low hormone concentrations was further reduced to one-half of that in the control group, and the sensitivity of insulin induced antilipolysis was markedly decreased in acromegaly. It is concluded that, in the fasting state, the action of insulin on glucose utilization but not on lipolysis is impaired in adipose tissue of acromegalic patients because of a postreceptor defect. After glucose ingestion, the resistance to insulin in acromegaly is further enhanced and antilipolysis is also impaired. Altered coupling between receptor and effector alone or in combination with an additional decrease in receptor binding may explain the enhancement of insulin resistance. These mechanisms may be essential factors in the pathogenesis of insulin resistance in acromegaly. PMID- 3514679 TI - Endothelial cell injury due to copper-catalyzed hydrogen peroxide generation from homocysteine. AB - We have examined whether the toxic effects of homocysteine on cultured endothelial cells could result from the formation and action of hydrogen peroxide. In initial experiments with a cell-free system, micromolar amounts of copper were found to catalyze an oxygen-dependent oxidation of homocysteine. The molar ratio of homocysteine oxidized to oxygen consumed was approximately 4.0, which suggests that oxygen was reduced to water. The addition of catalase, however, decreased oxygen consumption by nearly one-half, which suggests that H2O2 was formed during the reaction. Confirming this hypothesis, H2O2 formation was detected using the horseradish peroxidase-dependent oxidation of fluorescent scopoletin. Ceruloplasmin was also found to catalyze oxidation of homocysteine and generation of H2O2 in molar amounts equivalent to copper sulfate. Finally, homocysteine oxidation was catalyzed by normal human serum in a concentration dependent manner. Using cultured human and bovine endothelial cells, we found that homocysteine plus copper could lyse the cells in a dose-dependent manner, an effect that was completely prevented by catalase. Homocystine plus copper was not toxic to the cells. Specific injury to endothelial cells was seen only after 4 h of incubation with homocysteine plus copper. Confirming the biochemical studies, ceruloplasmin was also found to be equivalent to Cu++ in its ability to cause injury to endothelial cells in the presence of homocysteine. Since elevated levels of homocysteine have been implicated in premature development of atherosclerosis, these findings may be relevant to the mechanism of some types of chronic vascular injury. PMID- 3514678 TI - Evidence that prostacyclin modulates the vascular actions of calcium in man. AB - Increases in extracellular calcium (Ca++) can alter vascular tone, and thus may result in increased blood pressure (Bp) and reduced renal blood flow (RBF). Ca++ can stimulate prostaglandin E2 (PGE2) and/or prostacyclin (PGI2) release in vitro, which may modulate Ca++ vascular effects. However, in man, the effect of Ca++ on PG release is not known. To study this, 14 volunteers received low-dose (2 mg/kg Ca++ gluconate) or high-dose (8 mg/kg) Ca++ infusions. The low-dose Ca++ infusion did not alter systemic or renal hemodynamics, but selectively stimulated PGI2, as reflected by the stable metabolite 6-keto-PGF1 alpha in urine (159 +/- 21-244 +/- 30 ng/g creatinine, P less than 0.02). The same Ca++ infusion given during cyclooxygenase blockade with indomethacin or ibuprofen was not associated with a rise in PGI2 and produced a rise in Bp and fall in RBF. However, sulindac, reported to be a weaker renal PG inhibitor, did not prevent the Ca++ -induced PGI2 stimulation (129 +/- 33-283 +/- 90, P less than 0.02), and RBF was maintained despite similar increases in Bp. The high-dose Ca++ infusion produced an increase in mean Bp without a change in cardiac output, and stimulated urinary 6-keto-PGF1 alpha to values greater than that produced by the 2-mg/kg Ca++ dose (330 +/- 45 vs. 244 +/- 30, P less than 0.05). In contrast, urinary PGE2 levels did not change. A Ca++ blocker, nifedipine, alone had no effect on Bp or urinary 6-keto-PGF1 alpha levels, but completely prevented the Ca++ -induced rise in Bp and 6-keto-PGF1 alpha excretion (158 +/- 30 vs. 182 +/- 38, P greater than 0.2). However, the rise in 6-keto-PGF1 alpha was not altered by the alpha 1 antagonist prazosin (159 +/- 21-258 +/- 23, P less than 0.02), suggesting that calcium entry and not alpha 1 receptor activation mediates Ca++ pressor and PGI2 stimulatory effects. These data indicate a new vascular regulatory system in which PGI2 modulates the systemic and renal vascular actions of calcium in man. PMID- 3514680 TI - Digitalis in the elderly. AB - Since William Withering first described the use of digitalis, over 200 years ago (1), its popularity has waxed and waned. Digitalis preparations are widely prescribed for elderly patients. Surveys of hospital in-patients have shown a high prevalence of the use of digitalis preparations (2, 3), but also of digitalis toxicity; though not all studies have shown the latter to increase with age. A survey of people aged 70, living in Gothenberg, showed that 14% were taking digitalis preparations (4); other studies have shown similar figures. Now that powerful diuretics and vasodilators are available for the treatment of heart failure, and many antiarrhythmics are used for the control of atrial tachyarrhythmias, there is controversy about the value of cardiac glycosides in the treatment of elderly patients. PMID- 3514681 TI - Therapeutic progress--review XVIII. Cystic fibrosis. PMID- 3514682 TI - Digoxin 1785-1985. I. Two hundred years of digitalis. AB - This year we are celebrating the bicentenary of the publication, by William Withering, of An Account of the Foxglove and Some of its Medicinal Uses with Practical Remarks on Dropsy and Other Diseases (1). During these two hundred years digitalis has constantly been to the fore of medical thinking and it is appropriate that we should look back and examine the contributions which studies of this drug have made to medicine as we know it today. Some of the studies have been at the centre of fierce controversy and others have been of seminal importance in the development of new concepts. PMID- 3514683 TI - Pharmaceutical officers and specialist principal pharmacists in the United Kingdom Health Service--Scotland. PMID- 3514684 TI - Use of Leu M1 and antiepithelial membrane antigen monoclonal antibodies for diagnosing Hodgkin's disease. AB - Biopsies of 82 patients diagnosed as having Hodgkin's disease were reviewed. Seventeen were reclassified histologically as non-Hodgkin's lymphoma or reactive lymphoid hyperplasia. A substantial number of cases of Hodgkin's disease were negative when stained with Leu M1. Staining for Leu M1 was not found in the cases of non-Hodgkin's lymphoma or reactive lymphoid hyperplasia. With the exception of the lymphocyte predominant nodular subtype of Hodgkin's disease, epithelial membrane antigen staining was seen in a few cases of Hodgkin's disease and non Hodgkin's lymphomas. This was not a useful discriminating feature. PMID- 3514685 TI - Technique for the culture and direct sensitivity testing or large numbers of urine specimens. AB - A technique was required for batch culturing and direct sensitivity testing of urine specimens to reduce increasing demands on laboratory services. A comparison was made between the filter paper strip method and multipoint inoculator technique using a Denley inoculator (Denley Ltd, Billingshurst, Sussex). The results showed that multipoint inoculation was a rapid, economical, and reliable method for the handling of large numbers of urine samples. PMID- 3514686 TI - Plastic processing of cemented hip joint replacement specimens. PMID- 3514687 TI - Voluntary respiratory effects of butorphanol and fentanyl following barbiturate induction: a double-blind study. AB - Thirty-one healthy women undergoing outpatient gynecologic surgery were given either butorphanol or fentanyl following barbiturate induction, and various respiratory parameters were measured at intervals after administration of the study drugs. Both fentanyl and butorphanol caused comparable decrements in tidal volume and other respiratory parameters. However, seven of the 15 patients receiving fentanyl had significant respiratory depression that required assisted ventilation. One of the butorphanol patients experienced a 45-second self-limited respiratory depression. One of three butorphanol patients experiencing side effects required treatment for these effects, compared with seven of nine fentanyl patients who experienced adverse effects. It is concluded that butorphanol and fentanyl have comparable anesthetic effects, but butorphanol is safer in terms of respiratory and adverse effects. PMID- 3514688 TI - Treatment of depression in chronic cocaine and phencyclidine abuse with desipramine. AB - An open field trial was conducted comparing desipramine and an active placebo in separate populations of chronic cocaine and phencyclidine (PCP) abusers, who discontinued their abuse. Subjects who received desipramine showed a decrease in depressive symptoms after a 20-40 day period regardless of whether they abused PCP or cocaine. PMID- 3514689 TI - A clinical trial comparing intramuscular haloperidol decanoate and oral haloperidol in chronic schizophrenic patients: efficacy, safety, and dosage equivalence. AB - Thirty patients with chronic schizophrenia received oral haloperidol and haloperidol decanoate in a two-phase open study. In the first phase, patients were stabilized on haloperidol tablets for 2 weeks, then maintained on a constant daily dose for 2 more weeks. They were then switched to haloperidol decanoate for the second phase. Patients were first stabilized on a monthly dose of haloperidol decanoate and then received this dose for 5 consecutive months. Haloperidol decanoate, administered in monthly injections at 9.4 to 15 times the daily oral dose, was at least as efficacious as oral haloperidol in controlling the symptoms of schizophrenia. There were no serious adverse reactions to either drug. Blood samples were taken from 22 patients during both the oral and the decanoate phases and analyzed for steady state haloperidol concentrations. These determinations demonstrate that the release of haloperidol with the decanoate form is sustained throughout the 4-week dosing interval. Lower plasma drug concentrations were observed during decanoate treatment than during oral treatment. Despite these lower plasma concentrations, patients remained stable on both drug regimens. This finding suggests that haloperidol decanoate injected every 4 weeks can provide control of psychotic symptoms at least as effectively as daily oral haloperidol. PMID- 3514691 TI - Immunocytochemical demonstration of topographic ordering of Purkinje cell axon terminals in the fastigial nuclei of the rat. AB - We have used a monoclonal antibody, mabQ113, which selectively stains a subset of cerebellar Purkinje cells, to study the topography of the corticonuclear projection of the median vermis to the fastigial nuclei in the rat. The fastigial projection zone contains both mabQ113+ and mabQ113- Purkinje cells grouped into parasagittal bands. The immunoreactivity extends throughout the Purkinje cell including the axon terminals and thus it is possible to investigate the topographic distribution of mabQ113+ terminals. In the fastigial nuclei the target cells receiving mabQ113+ axon terminals are concentrated in the caudal pole. In the rostral pole, cells receive anti-GAD+ terminals but not mabQ113+ terminals. There is no gradient in anti-GAD staining. Double-labelling experiments with mabQ113, anti-GAD, and an antisynaptic antibody mabQ155 suggest that there is little or no mixing of mabQ113+ and mabQ113- Purkinje cell terminals on the same target neuron. PMID- 3514690 TI - Neuropeptide Y innervation of the hippocampal region in the rat and monkey brain. AB - Using antibodies to neuropeptide Y (NPY) in combination with immunohistochemical techniques we have studied the distribution of cell bodies and nerve terminals containing NPY immunoreactivity (-i) in the hippocampal region of rats and monkeys (cynomolgus). In colchicine-pretreated rats a large number of NPY positive cells are present in all areas of the hippocampal region. The NPY-i cells range in size from small (diameter across soma: 10-15 micron) to large (approximately 20 micron). Most of the NPY-i cells are situated in the hilus, in the subgranular zone of the area dentata, and in the stratum oriens of Ammon's horn. A majority of these are polymorphic cells but cells of different morphology are present in these layers as well. These include small spheroid cells and dentate pyramidal basket cells that are distinct from the polymorphic cells in the subgranular zone. The subicular complex (e.g., the subiculum, pre-, and parasubiculum) and the entorhinal area contain fewer NPY-i cells than the rest of the hippocampal region. In the dorsal parts of the pre- and parasubiculum numerous small cells are scattered throughout all layers, while in the entorhinal area the NPY-stained cells are situated primarily in the deep layers (V and VI). In the ventral part of the lateral entorhinal area large multipolar and bitufted cells are found in layers II-VI. In the untreated monkey brain NPY-positive cells are found in the hilus of the area dentata and in the deep (IV through VI) layers of both the medial and lateral entorhinal area. Fewer NPY-stained cells are present in the subicular complex and in the entorhinal area. In the monkey as well as in the rat, NPY-stained cells are present in the angular bundle and in the alveus. A dense network of NPY-i fibers innervates the entire hippocampal region in both the rat and the monkey. The hippocampal NPY-i preterminal processes are present primarily in stratum moleculare of Ammon's horn and in the outer one-third of this layer in the area dentata. The NPY-positive innervation of the dentate molecular layer is far more prominent in the monkey than in the rat brain. Numerous NPY-stained fibers are scattered in other areas as well. In all retrohippocampal structures, and in particular the entorhinal area, the NPY-i fibers form a massive network that innervates all layers to about the same extent, with the exception of the molecular layer, which is more densely innervated than the other layers. PMID- 3514692 TI - The determination of dendrite morphology on lateral rectus motoneurons in cat. AB - Previously developed morphometric analysis of motoneurons (Ulfhake and Kellerth, '81, J. Comp. Neurol. 202: 571-583) was applied to lateral rectus motoneurons (LRMs). Total dendrite size was approximated from a single stem dendrite measurement. Fifteen dendrites from nine LRMs of the principal abducens nucleus intracellularly stained with HRP were morphometrically analyzed. The diameters and lengths along the extent of the dendrite were measured to calculate the surface area, volume, and combined length of the process. Linear correlation of stem dendrite diameter to these size parameters produced r values of .80, .84, and .61, respectively. Although the regression lines could be used to estimate dendrite size from the stem dendrite diameter, two morphologically distinct types were found among the 83 dendrites of the nine cells. Six dendrites differed from the other 77. Therefore, these six and a representative sample of the more common dendrite (nine) were included in the measurements. The rare dendrites consistently branched at about 40 micron from the soma into a rostrally and a caudally directed secondary dendrite. The secondary dendrites branched less and reduced more in diameter by tapering. Also, these dendrites exhibited a higher than expected total dendrite size to stem diameter ratio compared to "regular" dendrites. Statistical correlations of the stem diameter to surface area or volume within each dendrite type showed clear increases in r values from those of all 15. Significant differences were found between the size parameters of the two types. These qualitative and quantitative differences should be considered in accurate motoneuron size determinations in the abducens nucleus. PMID- 3514693 TI - Monoclonal antibodies to the cockroach nervous system. AB - In the cockroach nervous system individual motor neurons may be identified with respect to their position in the thoracic ganglia and to the muscles they innervate. When their axons are cut they have the ability to regrow such that when regeneration is completed they have specifically reinnervated their normal target muscles. This suggests the existence of a specific intercellular recognition process between motor neurons and muscles, and that neurons innervating different muscles are biochemically distinct from one another. The goal of this study was to use hybridoma techniques to obtain monoclonal antibodies that bind to some motor neurons and not others. Mice were injected with whole nerve cord and hybridoma supernatants were screened immunohistochemically on sections of ganglion and leg muscle. The monoclonal antibodies were categorized according to four types of specificity: tissue, regional, cell-type, and neuron-subset specificities. Antibodies expressing neuron-subset specificity were obtained very rarely. The probability of their occurrence could be increased by treating the mice with immunosuppressant drugs after initial administration of immunogen or by fixing the immunogen with paraformaldehyde in a manner similar to that of the tissue sections used in the screening process. Two of the neuron-subset specific monoclonal antibodies (MAbs) are of particular interest with respect to the goals of this study. They bind to axon terminals in the muscles of some neurons and not others. They do not bind to neuronal cell bodies in the ganglion, which makes identification of the neurons difficult. However, from the known innervation pattern of the coxal depressor muscles it appears that one of these MAbs selectively binds to axon terminals from either the inhibitory motor neurons or the dorsal unpaired median cells. Other antibodies of interest bind selectively to the synapse-rich neuropile in the ganglia or to peripheral parts of the nervous system like the nerve roots. PMID- 3514694 TI - Optic tectum of the eastern garter snake, Thamnophis sirtalis. II. Morphology of efferent cells. AB - Tectal efferent neurons were retrogradely filled from extracellular injections of horseradish peroxidase (HRP) into pathways efferent from the tectum. Tectorotundal neurons have cylindrical dendritic trees, 80-100 microns in diameter, that extend vertically across the central and superficial tectal layers. Apical and basal dendrites are laden with complex appendages. The axon gives rise to an intratectal, collateral arbor that extends horizontally into the stratum griseum centrale beyond the cell's dendritic tree. The parent axon exits the tectum laterally in the tectothalamic tract. Tectogeniculate neurons also have narrow, radially oriented, and highly branched apical dendrites, but their basal dendrites are infrequently branched and lack appendages. An intratectal axon collateral forms a small, spherical arbor overlapping the apical dendrites in sublayer c of the stratum fibrosum et griseum superficiale. The parent axon ascends vertically and just below the stratum opticum turns rostrad to follow the optic fibers to the diencephalon. Tectoisthmi neurons have small somata and thin, radial dendrites that arborize below the pial surface in the stratum zonale. An intratectal axon collateral forms a spatially restricted arbor ventral to the soma in register with the dendritic tree. Tectoisthmobulbar neurons have dendrites that arborize extensively in sublayer a of the stratum fibrosum et griseum superficiale. The axon exits the tectum without collateralizing and joins a small-caliber component of the ventral tectobulbar tract. Ipsilateral tectobulbar neurons have stellate dendritic fields, 150-250 microns in diameter, that are restricted to the deep layers of the tectum. Sparsely branched dendrites are appendage-free but bear many short, fine spicules. The axon initially ascends from the soma and recurves into the stratum album centrale without collateralizing before joining a medium-caliber component of the ventral tectobulbar tract. Crossed tectobulbar neurons have large, stellate dendritic trees with diameters ranging from 200 to 500 microns. Like ipsilateral tectobulbar neurons, their dendrites are appendage-free but bear spicules. Their thick-caliber axons exit the tectum without collateralizing and course deep in the stratum album centrale to reach the dorsal tectobulbar tract. PMID- 3514695 TI - A review of pruritus. AB - This article reviews the neurophysiology of pruritus and presents evidence that itch is a separate modality from pain, rather than a submodality of pain. The numerous suggested pruritogens are reviewed, and evidence supporting each one is critically examined. The systemic causes of generalized pruritus are reviewed, with detailed review of the literature on uremic pruritus, cholestatic pruritus, and the pruritus associated with polycythemia vera. The specific treatments used for each of these conditions are reviewed, as well as the use of antihistamines in generalized pruritus. An approach to the workup of a patient with pruritus is suggested. PMID- 3514696 TI - Lupus band test: anatomic regional variations in discoid lupus erythematosus. AB - Seventy-one patients with discoid lupus erythematosus were studied for anatomic regional variations in the lupus band test. The test was positive in 82% of biopsies from the scalp, face, neck, and upper extremity. Only three out of fourteen biopsies (21%) from the trunk were positive. Discoid lupus erythematosus could be confirmed or strongly suspected in the light microscopic sections from all cases. Truncal lesions should not be selected for the lupus band test in discoid lupus erythematosus if there are other choices. PMID- 3514697 TI - Macrophage migration inhibition factor in pemphigus vulgaris. AB - Three cases of pemphigus vulgaris probably induced by ampicillin treatment are described. All of the patients' lymphocytes responded positively toward ampicillin in the migration inhibition factor test. There is a possibility that this test might be significant in recognizing the offending drug in vitro. PMID- 3514698 TI - Bullous pemphigoid and glomerulonephritis. Report of four cases. AB - We report on four patients with bullous pemphigoid and other autoimmune diseases who had or developed glomerulonephritis. The relationship between these two immunologic disorders involving the basement membrane is discussed. Our data suggest a coincidental phenomenon in patients who successively or concurrently have multiple diseases of autoimmunity. PMID- 3514699 TI - Bullous lichen planus: diagnosis by indirect immunofluorescence and treatment with dapsone. AB - Bullous lichen planus may be confused with other subepidermal bullous dermatoses, especially if bullae arise on normal-appearing skin. We present two patients who were originally thought, on the basis of clinical and histopathologic criteria, to have bullous pemphigoid. However, results of standard indirect and direct immunofluorescence assays did not support the diagnosis of bullous pemphigoid. Further investigation using the indirect autologous immunofluorescence assay revealed deposits of immunoglobulins in the stratum granulosum. Moreover, the indirect allogeneic immunofluorescence assay (using papular lichen planus lesional substrates from different patients) was positive for the same pattern, confirming the diagnosis of bullous lichen planus. Bullous lichen planus with bullous pemphigoid-like histologic features can be differentiated from bullous pemphigoid on the basis of the indirect autologous and allogeneic immunofluorescence assays for circulating antigranulosum antibodies. Both patients were treated with systemic corticosteroids. One patient went into remission with this therapy alone; the other patient had a favorable response when dapsone was given with systemic corticosteroids. The suggestion that there is a subset of bullous lichen planus with bullous pemphigoid-like histologic features that responds to dapsone needs to be explored. PMID- 3514700 TI - Who was Donald M. Pillsbury? PMID- 3514701 TI - Antibacterial therapy. PMID- 3514702 TI - A comparison between one and two weeks' treatment with bifonazole in pityriasis versicolor. AB - The mycologic and clinical efficacy and the local tolerance for 1 and 2 weeks of once-daily treatment of sixty cases of pityriasis versicolor with bifonazole 1% cream were studied in a biometrically planned, controlled, double-blind group comparison. The mycologic findings after 2 weeks were negative in all the patients, with the exception of one from the 1-week group. Two weeks later the findings were negative in each case. The evolution of the clinical symptoms was similarly good: after 2 weeks, only two patients in the 2-week group still exhibited scaling. In one case the pruritus, which had disappeared in the course of treatment, reappeared 2 weeks later. The mycosis began to improve within the first week, except in two patients in the 2-week group and one patient in the 1 week group. PMID- 3514703 TI - Cutaneous secondary syphilis: preliminary immunohistopathologic support for a role for immune complexes in lesion pathogenesis. AB - A circulating immune complex-mediated pathogenesis for lesions of secondary syphilis has been postulated. Textbook descriptions of a lymphoplasmacytic histopathologic picture have contradicted a role for circulating immune complexes in lesion pathogenesis. Four patients with early cutaneous lesions of secondary syphilis were studied. All four patients had serum Raji cell and/or Clq binding assay evidence for circulating immune complexes. Three patients showed a neutrophilic vascular reaction on histologic study of early lesions. The patients studied had immunofluorescence microscopic evidence of immunoreactant deposition in dermal blood vessels (4 hours) and/or a neutrophilic vascular reaction (24 hours) after intradermal histamine injection. Dieterle staining of lesional tissue from all patients showed the presence of treponemal organisms in dermal blood vessels. This new preliminary evidence adds some support to a circulating immune complex-mediated pathogenesis of cutaneous lesions in human secondary syphilis. PMID- 3514704 TI - Circulating and in situ lymphocyte subsets and Langerhans cells in patients with compositae oleoresin dermatitis and increased ultraviolet A sensitivity during treatment with azathioprine. AB - Circulating and in situ lymphocyte subsets and Langerhans cells in four patients with compositae oleoresin dermatitis and increased ultraviolet A sensitivity before and during treatment with azathioprine were estimated. It was found that the number of Leu 6+ Langerhans cells decreased during therapy. This decrease was accompanied by a reduction in the number of Leu 2a+, Leu 3a+, Leu 4+, DR+, and Leu M2+ cells in the blood and a reduction in the number of Leu 2a+, Leu 3a+, Leu 4+, and DR+ cells in the skin. Concomitantly with the changes in the number of immunocompetent cells, the eczema cleared. PMID- 3514705 TI - Immunoelectron microscopic observations in a case of linear IgA bullous dermatosis of childhood. AB - A 16-month-old boy exhibited vesicobullous skin lesions on the lower part of his abdomen, in his genital region, and on the buttocks and extremities. The eruptions presented small, tense bullae with or without erythematous changes of the surrounding skin, some of which clustered around the resolving lesions. Histologic examination of the eruptions showed subepidermal, ultrastructurally suprabasal laminar blister formation with infiltration of the polymorphonuclear cells and large mononuclear cells in the blister cavity. Immunoelectron microscopy revealed IgA deposits at the basilar surface of the basal keratinocytes of the lesional skin, as well as the presence of circulating IgA class antibodies reacting to the basilar surface of the hemidesmosomes. The eruptions responded well to a combination therapy of small doses of a corticosteroid agent and a sulfonamide. There were neither clinical nor laboratory findings suggesting dermatitis herpetiformis. This case, diagnosed as linear IgA bullous dermatosis of childhood by immunofluorescence microscopy, ultrastructurally had a pathogenic site close to that observed in bullous pemphigoid. PMID- 3514706 TI - Cutaneous toxoplasmosis. AB - A case of epidermotropic cutaneous toxoplasmosis is reported. The patient, a 53 year-old man with chronic myelogenous leukemia in blast crisis, received a bone marrow allograft but continued to have severe pancytopenia. Numerous diffuse, palpable, purpuric nodules appeared 21 days after the transplant. Organisms were found within the epidermal keratinocytes--both singularly and in cysts. Dermal and neural infiltration was also present. Toxoplasma gondii was identified on the basis of the ultrastructural features of the parasite. Possible sources of infection include reactivation of a previous latent infection, transmission through a bone marrow allograft, or nosocomial acquisition. PMID- 3514707 TI - Erythema multiforme in a patient with T cell chronic lymphocytic leukemia. AB - A patient with T4+ (helper-inducer) T cell chronic lymphocytic leukemia developed an erythema multiforme-like eruption, the diagnosis of which was supported by routine light microscopic findings. Immunopathologic studies using monoclonal antibodies demonstrate that despite an overwhelming majority of leukemic T4+ cells in the peripheral blood and dermal infiltrate, the predominant cells in the epidermal infiltrate are T8+ (cytotoxic-suppressor) cells. These findings are different from those seen in epidermotropic T cell leukemic infiltrates and are similar to those previously reported in erythema multiforme. Thus it is likely that the leukemic T4+ cells are participating in this cutaneous hypersensitivity reaction along with residual, normal T8+ cells. PMID- 3514708 TI - Aplasia cutis congenita: a clinical review and proposal for classification. AB - Aplasia cutis congenita is a condition in which localized or widespread areas of skin are absent at birth. Several distinct clinical subtypes occur, characterized by the location and pattern of skin absence, the presence of associated malformations, and the mode of inheritance. The disorder is seen most frequently on the scalp, often as a solitary lesion without other anomalies. Scalp lesions can be seen in association with limb reduction defects and in association with epidermal and organoid nevi. Lesions may overlie overt or occult embryologic malformations. A form of aplasia cutis congenita occurs in association with placental infarcts or the in utero death of a twin fetus. The condition may be associated with epidermolysis bullosa, specific teratogens or intrauterine infections, or it may occur in the presence of chromosomal abnormalities, ectodermal dysplasias, or other syndromes of malformation. A classification for aplasia cutis congenita is proposed. PMID- 3514709 TI - Iatrogenic false-positive Crithidia luciliae immunofluorescence test. PMID- 3514710 TI - Cicatricial pemphigoid in a patient with rheumatoid arthritis treated with D penicillamine. PMID- 3514711 TI - Adolph Rostenberg, Jr., M.D. PMID- 3514712 TI - Advent of objective measures of the transference concept. PMID- 3514713 TI - Brief psychotherapy methods in clinical research. PMID- 3514714 TI - More on the partial closure. PMID- 3514715 TI - Chemosurgical report: a nongeometric approach to wound closure following Mohs surgery. AB - Scars are best camouflaged by placing incisions precisely within preexistent creases and cosmetic junctions rather than only following the regional favorable scar direction. Since natural rhytids, contours, and junctions are not straight or composed of geometric shapes, this requires an understanding of techniques of creating scars of irregular curvature. Such a method is presented and illustrated with clinical examples. PMID- 3514716 TI - Iatrogenic effects of general anesthesia in children: considerations in treating large congenital nevocytic nevi. AB - Dermatologists are often faced with the decision of when to operate on a child at risk for developing malignant melanoma in a large congenital nevocytic nevus. As a series of operations is usually required, an understanding of the lethal and nonlethal effects of the general anesthesia is necessary. This paper discusses these potential iatrogenic effects on the child's physical and psychological development. Suggestions are given for optimal times to operate, considering both psychological and physical factors, (i.e., 6-9 months or 8-12 years of age) and ways to minimize unwanted side effects. PMID- 3514717 TI - A modified M-plasty. AB - A modified M-plasty, which shortens the length of the excision by the length of the triangular flaps present in the traditional M-plasty, is described. PMID- 3514720 TI - Efficacy of the dentin bonding agents. Part I. Their effectiveness in reducing microleakage. PMID- 3514719 TI - The "dermal tuck" revisited. PMID- 3514718 TI - Nobecutane spray as a temporary dressing of skin graft donor sites. AB - Various methods have been used for managing split-thickness skin graft donor sites. Open and closed techniques have been suggested by various authors with the purpose of achieving smooth and rapid healing of the wound. There is growing evidence to suggest that the site and quality of the healing is improved when the wound is protected from dehydration and further mechanical trauma. A recent method is the spraying of Nobecutane Spray on the donor site. Nobecutane sprayed on a wound forms a plastic film which serves as a dressing material. It contains specially modified acrylic resin in an organic solvent (ethyl acetate) and TMTD (tetramethylthiuram disulphide) which is strongly bactericidal and fungicidal. We employed this method on 50 patients and found it to be effective in achieving rapid and painless healing. The dressing is transparent, permits easy follow-up of healing in the donor site, protects the wound against infection, and does not inconvenience the patient. The treatment is simple, economical, and does not require special skills. The dressing peels off spontaneously after epidermal regeneration of the wound is completed. No complications or allergic reaction were observed with this treatment. PMID- 3514721 TI - Endodontic posts and cores. Part III. Clinical use of the Flexi-post. PMID- 3514722 TI - Fabrication of a crown to fit an existing partial denture. PMID- 3514723 TI - A treasury of dentistry. A gathering of "dental truants". PMID- 3514724 TI - The presidents. Philip Edwin Adams 1949-1950. PMID- 3514725 TI - Orthodontic extrusion and biologic width realignment procedures: methods for reclaiming nonrestorable teeth. AB - A multidisciplinary approach to the management of teeth traditionally classified as nonrestorable is presented. Three case histories are described in which such teeth are extruded orthodontically, the gingiva and biologic width are repositioned apically, and the teeth are restored. PMID- 3514726 TI - The influence of contamination on the bond strength of an etched resin-bonded retainer. AB - This investigation examines the influence of potential sources of contamination on the resin bond strength of a base metal alloy. Sixty specimens were cast in a base metal alloy and etched. Composite resin cylinders were bonded to six groups of ten specimens each and tested for shear bond strength using a testing machine at a strain rate of .5 mm/min. Five of the test groups received a different set of treatments, and one of the test groups was a control group. An analysis of variance disclosed no significant differences in bond strengths among any of the test groups at a level of P less than .05. PMID- 3514727 TI - Preservation of global and regional left ventricular function after early thrombolysis in acute myocardial infarction. AB - The effect of early myocardial reperfusion (within 4 hours after onset of symptoms) on regional left ventricular function in patients with acute myocardial infarction has been quantitated by analysis of segmental wall motion. Of 533 patients randomized either to conventional coronary care unit therapy or to a reperfusion strategy, in 332 high quality angiograms were obtained 2 to 8 weeks after the onset of myocardial infarction. In those assigned to thrombolytic therapy, angiographic data were also available after acute reperfusion. Analysis on an "intention to treat" basis revealed significant preservation of left ventricular function after thrombolytic therapy (ejection fraction 53%) compared with conventional treatment (ejection fraction 47%). In addition, wall motion analysis showed significant improvement of regional function in the infarct zone in both inferior and anterior infarction. In addition, significant changes occurred in regional function of the remote "noninfarct zone" in the acute as well as the chronic stage. It is concluded that improved regional and global left ventricular function can be achieved with early reperfusion and that this is the likely explanation for the reduction of early and late mortality after thrombolysis observed in this study. PMID- 3514728 TI - Contribution of vasopressin to vasoconstriction in patients with congestive heart failure: comparison with the renin-angiotensin system and the sympathetic nervous system. AB - Ten patients with advanced congestive heart failure were treated with an arginine vasopressin V1 antagonist during hemodynamic monitoring to determine the contribution of vasopressin to vasoconstriction in this disorder. The vasopressin antagonist caused a decrease in systemic vascular resistance in the three patients whose plasma vasopressin was greater than 4.0 pg/ml (average for the group was 2.4 +/- 0.6). Plasma vasopressin concentration correlated with the percent decrease of systemic vascular resistance (r = 0.70, p less than 0.025), serum sodium (r = 0.72, p less than 0.02) and serum creatinine (r = 0.85, p less than 0.005). To compare the relative roles of vasopressin, the renin-angiotensin system and the sympathetic nervous system, these patients also received captopril and phentolamine. Captopril decreased systemic vascular resistance by 20% (p less than 0.05), mostly in patients with high plasma renin activity. Levels of plasma renin activity ranged between 1 and 46 ng/ml per h (average 14.7 +/- 5.7) and correlated with serum sodium (r = 0.77, p less than 0.025), serum creatinine (r = 0.73, p less than 0.025) and right atrial pressure (r = 0.67, p less than 0.05). Phentolamine decreased systemic vascular resistance in all patients (average 34%, p less than 0.01), but the decrease did not correlate with the pretreatment norepinephrine concentration. Norepinephrine levels were elevated in all patients (694 +/- 110 pg/ml) and correlated with baseline stroke volume index (r = 0.75, p less than 0.025) and plasma renin activity (r = 0.67, p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3514729 TI - Similarities and differences in the antihypertensive effect of two calcium antagonist drugs, verapamil and nifedipine. AB - The short- and long-term effects of two calcium channel blocking drugs, verapamil and nifedipine, on blood pressure, heart rate, plasma catecholamines, plasma renin activity, plasma volume and cardiac performance (echocardiography) were studied in essential hypertensive patients and in normal subjects. Verapamil, 160 mg orally, reduced blood pressure within 60 minutes in 22 hypertensive patients, but not in 12 normotensive subjects. Nifedipine, 10 mg sublingually, reduced blood pressure within 15 minutes in 19 hypertensive patients, but not in 7 normotensive subjects. Plasma noradrenaline was significantly increased both in normal subjects and in hypertensive patients only after nifedipine was administered. Verapamil (80 mg three times a day) first, and nifedipine (10 mg three times a day) thereafter, or vice versa, were given to 12 hospitalized hypertensive patients on a fixed sodium and potassium intake; the drugs produced similar blood pressure reductions, but heart rate and plasma catecholamines were increased only after nifedipine (p less than 0.05). Neither drug affected plasma volume, aldosterone or plasma renin activity. Long-term ambulatory treatment with verapamil (80 or 160 mg three times a day for 2 to 4 months) or nifedipine (10 mg three times a day for 2 months) produced changes in all variables that were similar to those observed in the hospital (controlled) study. Shortening fraction was significantly increased after nifedipine (p less than 0.05) but no change was observed after verapamil. In conclusion, blood pressure is effectively reduced by both verapamil and nifedipine; an appreciable adrenergic stimulation may be caused by nifedipine, but usually not by verapamil, and fluid retention, renin release or myocardial depression is not observed during verapamil or nifedipine treatment. PMID- 3514730 TI - The eosinophil and the pathophysiology of asthma. AB - Eosinophilia of lung and blood associated with injury to the mucociliary escalator and excessive shedding of bronchial epithelium are hallmarks of both allergic and nonallergic asthma. In vitro, the eosinophil granule major basic protein (MBP) is toxic to helminths and to mammalian cells, including human respiratory epithelium. The MBP-mediated damage to the respiratory epithelium consists of desquamation and frank destruction of ciliated cells. Increased sputum MBP concentration is a good marker for asthma, and patients treated for acute asthma have high levels of MBP in their sputa, which decrease after treatment. Peak sputum MBP levels approximate concentrations toxic to respiratory epithelium in vitro. In the lungs of patients who had died of asthma, MBP has been localized outside of the eosinophil in association with damage to the epithelium. Overall, these and other findings suggest the hypothesis that the eosinophil mediates damage to the respiratory epithelium and is the prime effector cell in the pathophysiology of asthma. PMID- 3514731 TI - Bulimia: clinical characteristics, development, and etiology. AB - Bulimia is characterized by recurrent episodes of binge eating and severe self deprecation, often accompanied by self-induced vomiting and/or laxative abuse. It is most often found among young women in their late teens to mid-30s. Estimates of the disorder's prevalence vary widely, depending on the diagnostic criteria used, but usually range from 5% to 20% of college age women. Binge eating typically begins in late adolescence, frequently after a period of dieting to lose weight. Self-induced vomiting usually follows the onset of binge eating by about a year. To date, theories of the disorder's etiology have included several biological models, a psychosocial model, and a biopsychosocial model. The biological models proposed have viewed bulimia as a form of biological depression, neurological disturbance, or metabolic disturbance. The psychosocial model suggests that society's pressure on young women for extreme thinness leads to excessive dietary restraint, deprivation, and, paradoxically, binge eating. The presence of anxiety or depression exacerbates the process. The biopsychosocial model appears to be the most promising. It proposes that young women with biological predispositions toward overweight, depression, or metabolic disturbance are particularly vulnerable to social pressure for thinness, the binge eating that may result from excessive dieting, and, hence, bulimia. The complex nature of bulimia suggests that a multidisciplinary team approach treatment is appropriate. PMID- 3514732 TI - Robots in food systems: a review and assessment of potential uses. AB - Management personnel in foodservice, food processing, and robot industries were surveyed to evaluate potential job functions for robots in the food industry. The survey instrument listed 64 different food-related job functions that participants were asked to assess as appropriate or not appropriate for robotic implementation. Demographic data were collected from each participant to determine any positive or negative influence on job function responses. The survey responses were statistically evaluated using frequencies and the chi square test of significance. Sixteen of the 64 job functions were identified as appropriate for robot implementation in food industries by both robot manufacturing and food managers. The study indicated, first, that food managers lack knowledge about robots and robot manufacturing managers lack knowledge about food industries. Second, robots are not currently being used to any extent in the food industry. Third, analysis of the demographic data in relation to the 16 identified job functions showed no significant differences in responses. PMID- 3514733 TI - Selenium and vitamins A, E, and C: nutrients with cancer prevention properties. AB - It has been estimated that 35% of all cancer incidence is related to diet. The potential appears great that high intakes of various nutrients can reduce the incidence of some types of cancer. Selenium and vitamins A, C, and E, discussed in this article, have many actions and interactions that are important in relationship to the study of nutrition and cancer. Even though only a few of the necessary human trials of efficacy have been conducted, epidemiological and animal data suggest that vitamins and/or minerals act as anticarcinogens, altering cancer incidence, differentiation, and growth. Thus, they may prove useful adjuncts to conventional therapies or in cancer prevention. However, the nutrients should not be viewed as cure-alls that work alone. Adequate intake ideally should be the result of increased dietary consumption rather than supplements because as yet unidentified components found in food may prove beneficial and protective. More research is needed prior to encouraging members of the general population to increase their intakes of various nutrients, even though there is now some evidence that those nutrients may help prevent some cancers. PMID- 3514734 TI - Renal effects of nonsteroidal antiinflammatory drugs. Heightened risk to the elderly? PMID- 3514735 TI - Aging, gastrointestinal infections, and mucosal immunity. PMID- 3514736 TI - Selected bibliography of recent articles in ethics and geriatrics. AB - The disciplines of bioethics and geriatrics have had parallel development in recent years. From small and relatively esoteric fields 15 or 20 years ago, both have grown enormously. Although the numbers of geriatricians and ethicists in practice or in academic centers have increased substantially, these disciplines represent areas in which better understanding is sorely needed. This bibliography is intended to assist the clinician in locating salient literature concerning bioethical issues in geriatric medicine and research. It is highly selective; it does not attempt to cover all the literature on bioethics. There are several excellent general bioethics bibliographies for clinicians in the recent literature, as well (not limited to clinical journals or clinical topics), some of which are included in section 13 for the reader's further information. The ethical issues that arise in geriatric medicine are similar to those that arise in the care of younger patients, but certain kinds of problems happen with far greater frequency. Dilemmas concerning decisions about care at the end of life are particularly relevant in geriatrics, as persons of extreme old age are often presented with choices about life-sustaining therapy when critical illness occurs. This includes decisions about cardiopulmonary resuscitation and nutritional support. When these clinical decisions arise in the care of patients who cannot decide for themselves, the question arises as to what role the assessment of "quality of life" ought to play in decisions to pursue or to forego life-sustaining therapy. Informed consent to treatment and to participation in research has been an important area of ethical investigation. Dilemmas about consent to treatment are complicated in some elderly populations because of the higher incidence of cognitive impairment and the higher incidence of the clinician's suspicion (or assumption) of cognitive impairment. In consent to research, there are additional issues of voluntariness and equitable selection, especially when subjects are residents of nursing homes. Because of the increasing numbers of elderly persons in our society, and because of the role of social resources (federal, state, and local) in acute and long-term medical major concern in gerontologic bioethics. The topic headings for this bibliography reflect these common issues which arise in the care of the elderly.+2 PMID- 3514737 TI - Increases in blood flow from the adrenal gland following medial hypothalamic stimulation in the cat. AB - Medial hypothalamic sites previously shown to elicit either flight or defense were stimulated in the anesthetized cat. The rate of blood flow from the adrenolumbar (AL) vein ipsilateral to the side of stimulation was measured, as well as the adrenal output of norepinephrine and epinephrine (E). Stimulation at nearly 15% of the hypothalamic sites increased ipsilateral AL venous flow more than 20% over baseline rates. These sites also significantly increased heart rate, mean arterial pressure, and output of E from the ipsilateral adrenal gland. These observations suggest that hypothalamic sites where stimulation increased AL venous flow may overlap with regions that selectively mediate the release of E from the adrenal medulla. PMID- 3514738 TI - The renin-angiotensin system in the perinatal period in rats. AB - Plasma concentrations of renin, angiotensinogen, kininogen, total protein, and renal renin concentration were measured in rats before spontaneous birth, immediately after vaginal delivery, during the subsequent 48 h, as well as at the ages of 10, 20 and 80 days. Preterm rats had a plasma renin concentration about 15 times higher than adults, which increased further in 1 h-old vaginally delivered rats. Thereafter renin fell to very low levels within 2 h, rose again during the first day and remained at 4 times the adults level until day 10. Renal renin content and concentration increased over the whole observation period, except for a slight fall of renin concentration in the first 3 h after birth. In pre- and full-terms rats, angiotensinogen concentration was only 20% that of adults, reaching even lower values immediately after delivery, due to excessive consumption by renin. Thereafter, angiotensinogen increased more than 10 fold within 48 h. Kininogen concentration in plasma was higher than in adults and stable up to the 10th postnatal day. We conclude that vaginal delivery is a strong stimulus for renin release, the resulting high concentration of renin being responsible both for the increased turnover of angiotensinogen and the subsequent inhibition of renin release. The cause and biological significance of the dramatic increase of angiotensinogen during the first 48 h of life remains obscure. PMID- 3514739 TI - Metabolic and hormonal responses to cooling the fetal sheep in utero. AB - The metabolic and hormonal effects of cooling 10 fetal sheep in utero (115-142 days of gestation) for 2h were studied. The fetal core temperature fell by 2.81 +/- 0.14 degrees C while the maternal temperature fell 0.86 +/- 0.15 degrees C. This hypothermia caused a significant rise in the fetal and maternal plasma glucose concentrations (P less than 0.001) and a fall in the fetal insulin concentrations (P less than 0.01). The fetal plasma lactate and cortisol concentrations rose rapidly (P less than 0.01) while the growth hormone fell (P less than 0.01) and remained low until cooling ceased when a rapid rebound occurred. There was no significant change in any of the fetal iodothyronines and no elevation of nonesterified free fatty acid concentrations, in contrast to the rapid rise (P less than 0.01) which occurred when newborn lambs were cooled. These observations demonstrate that appropriate glucose, insulin, lactate and cortisol responses to hypothermia have differentiated by 120 days of gestation. However, neither a thyroid hormone response nor an elevation in free fatty acid levels was observed. Thus not all components of the thermogenic response to hypothermia can be demonstrated in the late gestation fetail sheep in utero. PMID- 3514740 TI - Classical article: Cheiralgia paresthetica (entrapment of the radial nerve). A translation in condensed form of Robert Wartenberg's original article published in 1932. PMID- 3514741 TI - Conservative treatment for a ruptured extensor tendon on the dorsum of the proximal phalanges of the thumb (mallet thumb). AB - Of 35 patients with mallet thumb, 25 received conservative coil-splint immobilization treatment. Those who received treatment were able to extend the interphalangeal joints to at least 0 degrees with the exception of four patients. The number of patients who did not respond to the treatment was greater in those 30 years of age or older compared with those 29 years old or younger, but there was no statistically significant difference. Satisfactory extension was observed in 12 patients who received treatment within 2 weeks after sustaining injuries. Four of 10 patients who received treatment 2 weeks or later after the injuries demonstrated poor results. The preferred treatment for mallet thumb is primary surgical repair. However, conservative treatment should be the first choice if there is no skin wound or the conditions at first consultation are not appropriate for surgery. PMID- 3514742 TI - Polydactyly in the Bible. PMID- 3514743 TI - Liver volume measurement by ultrasonography in normal subjects and alcoholic patients. AB - Computer-assisted ultrasonic planimetry was used to determine hepatic volumes in normal subjects and patients with alcoholic liver disease. Normal subjects showed a diurnal variation in liver volume with a minimum between 12.00 and 14.00 h. Studies indicated that this was related to hydration and liver glycogen content. Using data obtained from nonfasted ambulant subjects correlations were found between liver volume and body weight, height and surface area, with body weight showing the closest correlation. The normal range for adults was 18.1 +/- 0.5 (SE) ml/kg body weight. Patients with alcoholic fatty liver showed increased hepatic volumes correlating with degree of fatty change as judged histologically. Patients who continued to abuse alcohol showed a persistent increase in hepatic volume. Those who moderated, and particularly those who abstained, showed a significant decrease in hepatic volume. Serial measurements of liver volume are useful in assessing hepatic changes in alcohol abusers. PMID- 3514744 TI - Renal handling of angiotensins I and II in patients with renovascular hypertension. AB - Plasma renin (PRC) and angiotensin I (pANG I) and II (pANG II) concentrations were determined at renal vein catheterization in 38 hypertensive patients suspected of renal or renovascular aetiology. Veno-arterial differences in pANG I across the affected kidney in patients with lateralization of the renin secretion indicated release of angiotensin I (ANG I) in considerable amounts. Veno-arterial differences in pANG II of around zero indicated that generation and elimination of angiotensin II (ANG II) were equal in that kidney. Across the contralateral kidney the veno-arterial differences in PRC and pANG II were both close to zero, while negative differences in pANG II indicated the removal of ANG II. In patients without lateralization of the renin secretion the veno-arterial differences in pANG I were close to zero or positive, those of pANG II being close to zero or negative. In 14 of the 38 patients, data were obtained either during maintenance treatment with captopril or after a single dose of this converting enzyme inhibitor. Systemic PRC and pANG I values were extremely high and pANG II values low. The pANG I gradient across the affected kidney was further increased compared with pre-captopril levels, whereas the contralateral kidney still eliminated ANG I. PMID- 3514745 TI - Effect of low doses of angiotensin II perfusion on the hypotensive action of captopril in anaesthetized normotensive and spontaneously hypertensive rats. AB - The effect of intravenous (i.v.) captopril on mean arterial blood pressure (MABP) of anaesthetized normotensive Wistar-Kyoto (WKY) and spontaneously hypertensive (SHR) rats perfused i.v. with two doses of angiotensin II (ANG II; 2.9 and 5.8 pmol/kg per min) was studied to determine the role of the suppression of plasma ANG II in the hypotensive action of captopril. The reduction of MABP by captopril was attenuated in WKY and abolished in SHR by the highest dose of ANG II; it was unchanged in WKY and attenuated in SHR by the lowest dose of ANG II. The suppression of plasma ANG II thus explains a minor part of the acute reduction of MABP by captopril in WKY and a major part of this action in SHR. Plasma ANG II contributes to the maintenance of high blood pressure in SHR. PMID- 3514746 TI - Urinary dopamine excretion in normotensive subjects with or without family history of hypertension. AB - To define the role of the renal dopaminergic system in the pathogenesis of essential hypertension, urinary free dopamine excretion was examined in 23 normotensive subjects who had one or more first-degree relatives with essential hypertension, and also in 36 matched control subjects without any such family history. The group urinary dopamine excretion and urinary sodium excretion were not different. However, a significant urine dopamine-sodium relationship was apparent in the controls but not in the relatives due to relatively high dopamine output in those with lower sodium excretion. The two groups were similar as regards blood pressure (BP), plasma renin activity (PRA), prolactin and catecholamines. These findings demonstrate an alteration in the urine dopamine sodium relationship in some normotensive subjects with genetic risk of hypertension. PMID- 3514747 TI - Potassium supplementation in blacks with mild to moderate essential hypertension. AB - Potassium chloride (KCl) salt (65 mmol) daily reduced BP from 153/104 to 146/101 mmHg in 32 hypertensive black females during a 6-week placebo controlled crossover study. The fall in BP was independent of the order of randomization and was significant for systolic (SBP; P less than 0.01) and diastolic (DBP; P less than 0.05) pressure after 4 weeks. Analysis of the 95% confidence intervals in this and in five other studies, two of which were reported as showing no beneficial effect, suggests that potassium supplementation does lower BP, but that the change is small and within the confidence levels of all six trials. Thus, apparent discrepancies in the literature are not genuine statistically. PMID- 3514748 TI - Is angiotensinogen a renin inhibitor and not the substrate for renin? AB - The cleavage of the angiotensinogen molecule by renin is slow. The rate constant for cleavage of the enzyme-substrate complex, Kcat (turnover number) is lower than usual for enzymes (0.6/s for the homologous human renin reactions and 0.15/s for the homologous mouse renin reaction). Thus each round of catalysis occurs in 1.7 s in the human and 6.7 s in the mouse reaction. The Kcat/Km values (10(4) 10(6) l/mol per s; Km, Michaelis constant) are high and in the range for protein inhibitors. The association constants (Ka) are (10(6)-10(7) l/mol) close to that of inhibitors. The slow rate seems to be favourable since homologous reactions are slower than heterologous. Angiotensinogen is structurally related to alpha1 antitrypsin. We conclude that kinetic as well as structural data indicate that angiotensinogen might be considered a protease inhibitor for renin. PMID- 3514749 TI - Murine IgA binding factors (IgA-BF) suppressing IgA production: characterization and target specificity of IgA-BF. AB - Chemical and functional properties of IgA binding factor(s) (IgA-BF) from both murine Con A-activated spleen cells and Fc gamma R+, Fc alpha R+ T hybridoma cells (T2D4) were studied. IgA-BF produced from the cells after preculture with IgA were purified with IgA-Sepharose. Purified IgA-BF inhibited the binding of IgA to Fc alpha R+ L5178Y T lymphoma cells, and class-specifically suppressed in vitro IgA synthesis of the pokeweed mitogen (PWM)-stimulated murine spleen cells. Both IgA-specific suppressive activity and IgA binding activity of the factor(s) were co-fractionated between BSA and OVA in gel filtration analysis. SDS-PAGE analysis of IgA-BF biosynthetically labeled with [35S]methionine showed a specific band on 56,000. Suppressive activity of IgA-BF was absorbed with lentil lectin-Sepharose and was eluted with 0.2 M alpha-methyl-D-mannoside. The suppressive activity obtained from T2D4 cells (H-2k) and BALB/c Con A blasts (H 2d) was absorbed with the corresponding anti-H-2 and anti-I-A column and recovered in the acid-eluate. The activity was not absorbed with the unrelated anti-H-2 column. Despite the presence of MHC products, IgA-BF from both cell sources equally suppressed IgA-specific responses of BALB/c (H-2d), C3H/He (H 2k), and C57BL/10 (H-2b) spleen cells. They also suppressed IgA production as well as IgA synthesis of PWM-stimulated culture of human peripheral blood lymphocytes without affecting IgM and IgG responses. Suppression of murine and human IgA responses both in mouse and human were mediated by the molecules having the same Ia products, suggesting that there is no MHC, as well as species restriction, for the interaction between IgA-BF and their target cells. IgA specific suppressive activity was absorbed with human B blastoid cells bearing surface IgA (Dakiki) but not with those bearing surface IgG (CESS) or murine and human T cell line cells (BW5147, L5178Y, HPB-ALL, and MOLT4), indicating that IgA BF interact with B cells bearing IgA to suppress their differentiation. PMID- 3514750 TI - Immunologic activity of lipopolysaccharides released from macrophages after the uptake of intact E. coli in vitro. AB - Lipopolysaccharides (LPS) have been isolated from culture supernatants and from cell lysates after the in vitro phagocytosis of E. coli by murine macrophages. By using E. coli radiolabeled specifically in the LPS component with [3H]galactose, our studies have shown that the macrophage-"processed" LPS is enhanced with respect to its immunostimulatory activity in comparison with control phenol-water extracted LPS. As assessed by its ability to induce interleukin 1 production in naive macrophages or proliferation in cultures of murine splenocytes, the macrophage-processed LPS is between 10- and 100-fold greater in specific activity. Evidence is presented for both structural and chemical alterations in the LPS macromolecule. PMID- 3514751 TI - Size and charge heterogeneity of murine IgG-binding factors (IgG-BF). AB - Size and charge of murine IgG-binding factors (IgG-BF) were determined. Four different sources were used to produce the factors: a) cells of a T cell hybrid (T2D4) constitutively secreting IgG-BF upon incubation in serum-free medium, b) T2D4 cells incubated with mouse monoclonal IgG1 antibody in order to induce in vitro the production of isotype-specific IgG1-BF, c) T2D4 cells induced in vivo by passage as ascites in nude mice and incubated in serum-free medium, and d) in vivo alloantigen-activated T cells (ATC) incubated in serum-free medium. IgG-BF were affinity purified on Sepharose beads coated with rabbit or mouse IgG and identified by their biologic activities, i.e., inhibition of in vitro secondary IgG antibody production to SRBC and inhibition of rosette formation between Fc gamma receptor-positive spleen cells and rabbit IgG-sensitized erythrocytes. IgG BF produced by either of these cell sources was found to be heterogeneous in both size and charge. In each case, IgG-BF activities were recovered in three fractions of apparent Mr-74,000 to 78,000, 35,000 to 40,000, and 19,000 to 23,000 and in four fractions of pI-4.7 (or 5.3, depending on experimental conditions), 6.5, 7.7, and 8.4. Moreover, IgG-BF translated in vitro from T2D4 poly A RNA by using rabbit reticulocyte lysate exhibited the same heterogeneity. Thus, IgG-BF contain different proteins exerting similar biologic activities. PMID- 3514752 TI - Gene mapping and somatic cell hybrid analysis of the role of human lymphocyte function-associated antigen-3 (LFA-3) in CTL-target cell interactions. AB - LFA-3 is expressed on a wide variety of human cell lines, including those which have been used as recipients for gene transfer of human class I gene products, whereas a murine counterpart is either absent or significantly different such that the anti-LFA-3 monoclonal antibody (MAb) does not bind. By using a somatic cell genetic approach, we demonstrate that LFA-3 is not a major histocompatibility complex-encoded molecule, and that its gene locus maps to human chromosome 1. When LFA-3 and HLA-A2 are coexpressed on the mouse cell surface, anti-LFA-3 MAb interfered with specific recognition and lysis of these target cells by human CTL capable of lysing HLA-A2-expressing mouse transfectants. A significant contribution of the LFA-3 molecule to CTL reactivity was not observed, however, because the presence of LFA-3 did not restore recognition by CTL clones previously found incapable of lysing HLA-A2-expressing mouse transfectants, nor was it required by those human CTL that could lyse mouse cell transfectants. Thus, we have used genetic techniques to demonstrate that LFA 3 may serve a role in CTL-target cell interactions at the target cell level, but is not a molecule absolutely required for human allospecific CTL recognition of HLA antigens expressed on mouse cells. We suggest that LFA-3 may not participate directly in CTL function under normal circumstances, but delivers a more general inhibitory signal only when provoked by bound MAb. PMID- 3514753 TI - Split tolerance induced by chick embryo thymic epithelium allografted to embryonic recipients. AB - To test the capacity of the epithelial component of the chick embryo thymus to induce tolerance to major histocompatibility complex (MHC) antigens, pre colonized thymic rudiments were grafted into chick embryonic recipients. Semi allogeneic or allogeneic transplantations were done between two lines of chickens histocompatible at the MHC locus. Approximately 10% of these thymic chimeras hatched and were studied 3 mo after hatching. Thymic grafts were not rejected by the allogeneic host. The tolerance of chimeric chickens to thymus donor MHC antigens was tested by using a skin graft rejection test and a graft-vs-host (GvH) assay. Chimeric chickens that received an MHC-incompatible thymic graft during the embryonic life tolerated skin graft with the MHC haplotype of the thymus donor. Nevertheless, the lymphocytes within the thymic graft, the host thymus, and the blood were tolerant to the host MHC antigens but were alloreactive in GvH reaction for the MHC antigens of the thymic graft type. These results suggest that the epithelial component of the thymus when taken before the starting of the colonization by hemopoietic precursors and grafted into an early chick embryonic host can induce a tolerance for the MHC determinants involved in allograft rejection but not in the GvH reaction. PMID- 3514754 TI - Selective phagocytosis of gram-positive bacteria and interleukin 1-like factor production by a subpopulation of large granular lymphocytes. AB - There has been a consensus that a large granular lymphocyte (LGL) population with natural killer (NK) function is nonadherent and nonphagocytic. However, a significant proportion of the nonadherent cells purified by the two-step depletion of adherent cells with a plastic surface and nylon wool columns engulfed Sta. aureus into their cytoplasm. These cells were morphologically identified as LGL in light and electron microscopies. Two-color immunofluorescence tests, furthermore, demonstrated that Leu-11+ LGL, Leu-11+7-, and Leu-11+7+, but not Leu-11-7+, phagocytosed Sta. aureus. Among the particles tested here, only Gram(+) bacteria were preferentially phagocytosed, whereas Gram(-) bacteria, other large-sized microbes (e.g., baker's yeast and Candida albicans), latex, silica, and carbonyl iron were not. LGL exhibited a substantial level of bactericidal activity against Sta. aureus, although the level was one third of that mediated by monocytes. When Gram(+) bacteria were incubated with nonadherent cells for 18 hr, significant amounts of interleukin 1 (IL 1)-like factors (or IL 1 itself) as well as interferon were detected in the supernatants. On the other hand, this incubation did not induce interleukin 2 (IL 2). The IL 1 like factor producer cells were demonstrated to be the low-density lymphocytes on Percoll separation and to have the Leu-11+ phenotype. The phagocytosis was suggested to be an important stimulus in producing IL 1-like factors from LGL. Thus, the treatment of cells with cytochalasin B, a microfilament disrupting agent, completely abrogated both phagocytosis and IL 1-like factor production. Some cell wall components of Gram(+) bacteria might be important to a recognition process of the phagocytosis, since the protoplasts of Sta. aureus, when prepared by the treatment of bacteria with lysostaphin, were no longer phagocytosed by LGL. The present results therefore identify an additional unique characteristic similar to, but not identical with, the myelomonocytic nature of Leu-11+ LGL. PMID- 3514755 TI - Role of the LFA-1 molecule in cellular interactions required for antibody production in humans. AB - The lymphocyte function-associated antigen 1 (LFA-1) has been shown to play a role in various T cell functions in mice and humans including cytotoxicity, and proliferation to allogeneic cells and foreign antigens. These functions have been defined with specific monoclonal antibodies and were additionally confirmed by the investigation of patients with inherited deficiency in membrane LFA-1 expression. In this paper, we report our studies on the potential role of the LFA 1 molecule in T lymphocyte-dependent antibody responses. In a patient with a complete lack of membrane expression of LFA-1, there was no in vivo antibody response to vaccinal antigens such as tetanus, diphtheria toxoids, and polio virus, and no in vivo or in vitro antibody production to influenza virus, whereas serum immunoglobulin levels and antibodies to polysaccharides (isohemagglutinins, antibody to mannan, and a polysaccharide from Candida albicans) were detected in correlation with in vitro production of anti-mannan antibody. The defective antibody response to polypeptides was not secondary to poor antigen-specific T proliferation, because the latter was found to be present. Similarly, in vitro antibody production to influenza virus of normal cells was blocked by several anti LFA-1 monoclonal antibodies specific for the alpha subunit of the molecule, if they were added from the beginning of the culture. The antibody production blockade could be achieved with monoclonal antibody concentrations that partially preserved T cell proliferation. The helper effect of an influenza virus-specific helper T cell clone was also blocked. The targets of the blockade were shown by incubation experiments to be T cells and monocytes. In contrast, anti-LFA-1 monoclonal antibodies had no effect on pokeweed mitogen-induced B cell maturation into immunoglobulin-containing cells and on the anti-mannan antibody production. These combined data demonstrate that the LFA-1 molecule plays a role in T cell dependent antibody production to polypeptidic antigens but not in the antibody response to polysaccharides, although the antibody response to mannan is T cell dependent. It is proposed that the LFA-1 molecule is required to some extent for a antigen-presenting cells-T lymphocyte interaction and for the maintenance of a close association between antigen-specific helper T cells and small resting B lymphocytes. Polysaccharidic antigens that exhibit repetitive antigenic determinants might cross-link membrane immunoglobulins on B lymphocytes, thus allowing B cells to pass through a first step of activation requiring cognate T-B cell interaction. PMID- 3514756 TI - Autoimmunity induced by HgCl2 in Brown-Norway rats. II. Monoclonal antibodies sharing specificities and idiotypes with mouse natural monoclonal antibodies. AB - Spleen cells derived from BN rats receiving HgCl2 were fused with the nonsecreting rat myeloma cell line IR983F. We screened 59 supernatants from immunoglobulin-secreting hybrids for antibody activity against actin, tubulin, autologous and heterologous myosin, myoglobin, dsDNA, peroxidase, and the haptens TNP, NIP, NNP, and NBrP. Six monoclonal antibodies (mAb) were found to react with antigen(s) of the panel. At least three groups of antibody specificities were identified: clones reacting with TNP (1 IgM, 1 IgE); clones reacting with horseradish peroxidase (1 IgM); and clones possessing widespread reactivity for several antigens as found for mouse natural autoantibodies (2 IgM, 1 IgE). We also analyzed the idiotypic (Id) determinants of the 59 mAb by using anti-Id antibodies described elsewhere prepared in rabbits against the BALB/c D23 natural monoclonal autoantibody and recognizing a BALB/c recurrent Id (Id D23) of natural polyspecific autoantibodies. We found that all rat mAb that possessed widespread reactivities bore this Id. We performed similar studies in sera from normal and mercury-stimulated rats. The results indicate a role for HgCl2 in the stimulation of natural antibodies producing cells and the existence of interspecies cross reactive Id among mouse and rat natural antibodies. PMID- 3514757 TI - Mechanism of synergy between T cell signals and C8-substituted guanine nucleosides in humoral immunity: B lymphotropic cytokines induce responsiveness to 8-mercaptoguanosine. AB - B lymphocytes require a source of T cell-like help to produce antibody to T cell dependent antigens. T cell-derived lymphokines and C8-substituted guanine ribonucleosides (such as 8-mercaptoguanosine; 8MGuo) are effective sources of such T cell-like help. Addition of T cell-derived lymphokines to antigen activated B cells together with 8MGuo results in synergistic B cell differentiation, amplifying the sum of the individual responses twofold to four fold. Lymphokine activity is required at initiation of culture for optimal synergy with 8MGuo, whereas the nucleoside can be added up to 48 hr after the lymphokines with full synergy. 8MGuo provides a perceived T cell-like differentiation signal to B cells from immunodeficient xid mice, thereby distinguishing a subset of Lyb-5- nucleoside-responsive B cells from those activated by soluble anti-mu followed by B cell stimulatory factor-1, interleukin 1, and B cell differentiation factors, which are Lyb-5+. Moreover, at least a subset of the B cells recruited by the synergistic interaction of lymphokines and nucleoside is distinct from that responsive to 8MGuo + antigen, insofar as Sephadex G-10 nonadherent xid B cells fail to respond to either 8MGuo or lymphokines alone, but do respond to the combination. A distinct subpopulation can also be demonstrated among normal B cells by limiting dilution analysis in which the precursor frequency of antigen-reactive B cells in the presence of lymphokines or nucleoside alone increases substantially when both agents are present together. In concert with the kinetic data, these observations suggest that synergy derives at least in part from the ability of lymphokines to induce one or more elements the absence of which limits the capacity of a distinct B cell subpopulation to respond to 8MGuo. PMID- 3514758 TI - Complement lysis of U937, a nucleated mammalian cell line in the absence of C9: effect of C9 on C5b-8 mediated cell lysis. AB - Previous studies have demonstrated that in general, nucleated cells are more resistant to killing by serum complement than are erythrocytes. During studies aimed at defining the mechanisms of nucleated cell resistance, we found that the human histiocytic cell line U937 was easily lysed by homologous serum. U937 cells were also killed by serum depleted of C9, but not by serum depleted of C8, implying that the C5b-8 complex was sufficient to cause lysis of these cells. Enumeration of complexes on the cell surface demonstrated that approximately 40 fold more complexes were required to lyse U937 cells in the absence of C9 than in the presence of an excess of C9. Examination of the effects of small amounts of C9 on lysis of U937 cells by the C5b-8 complex demonstrated that at very low doses, C9 inhibited C5b-8 mediated lysis. The use of radiolabeled anti-C8 antibody showed that C5b-8 complexes were eliminated from the surface of U937 cells at 37 degrees C, and C9 at the dose causing inhibition of lysis accelerated the elimination of complexes. These results suggest that the increased lytic potential resulting from binding of small amounts of C9 to C5b-8 complexes is outweighed by enhanced elimination of complexes resulting in decreased cell death. PMID- 3514759 TI - Chemotactic peptides modulate adherence of human polymorphonuclear leukocytes to monolayers of cultured endothelial cells. AB - We have used a new centrifugation assay to examine the effects of highly purified human C5a and C5a des Arg, as well as effects of N-formyl-methionyl-leucyl phenylalanine (FMLP), on both the extent and strength of human polymorphonuclear leukocyte (PMN) adherence to monolayers of cultured human umbilical vein endothelial cells. At concentrations that were chemotactic for PMN, C5a (0.1 nM), C5a des Arg (5.0 nM), and FMLP (1.0 nM) significantly reduced the percentage of PMN that adhered to endothelial monolayers. Adherence also was reduced by C5a des Arg that was generated by incubating (37 degrees C, 30 min) fresh human serum with either zymosan or purified C5a. High concentrations of C5a (greater than 1.0 nM) and FMLP (greater than 50 nM) that diminished PMN chemotaxis significantly enhanced the percentage of PMN that adhered tightly to endothelial cells (adherent cells resisted a dislodgment force of 1200 X G). Tight adherence of PMN to endothelial cells also was increased by high concentrations of C5a that were added to human serum in which carboxypeptidase N activity was destroyed by heating (56 degrees C, 30 min), and by C5a that was generated by incubating (37 degrees C, 30 min) fresh human serum with zymosan in the presence of the carboxypeptidase N inhibitor, epsilon-aminocaproic acid. High concentrations of C5a des Arg (up to 80 nM) neither enhanced adherence of PMN to endothelial cells nor decreased PMN migration. Thus, a reciprocal relation exists between PMN migration and PMN adherence to endothelial cells in response to chemotactic factors. At concentrations that are chemotactic for human PMN, C5-derived peptides and FMLP reduce the adherence of PMN to endothelial monolayers. Only at concentrations that decrease PMN migration do C5a and FMLP augment PMN adherence. PMID- 3514760 TI - Substrate specificity and partial characterization of the PAF-acylhydrolase in human serum that rapidly inactivates platelet-activating factor. AB - The structure of the potent inflammatory mediator, platelet-activating factor, is 1-O-alkyl-2-acetyl-sn-glycero-3-phosphocholine (AGEPC, PAF-acether). Human sera contain an acid labile factor (ALF) that is a Ca+2-independent 2-acylhydrolase specific for AGEPC and AGEPC-like molecules. The enzyme functions by catalytically removing the sn-2 acetyl moiety from AGEPC, producing the biologically inactive sn-2 hydroxy form or 2-lyso-GEPC. Incubation of ALF with sn 2 acyl PAF analogs indicated that the enzyme hydrolyzes the sn-2 fatty acid only if the chain length is five carbons or less, the sn-1 position fatty acid length is greater than 10 carbon units, and at least one methyl group is present on the terminal amine of the choline group. The enzyme was active with either an ether or ester linkage at the sn-1 position. ALF is inactivated by heating to 65 degrees C for 30 min. It is pronase and trypsin sensitive but resistant to papain and papain with dithiothreitol. Further characteristics of human ALF indicated a broad pH range of activity with an optimum of pH 6.2 and an isoelectric point of 6.2 to 6.7. The specificity and Ca+2 independence of human ALF sets it apart from phospholipase A2. It is proposed that human ALF be called human serum PAF acylhydrolase to distinguish it from other hydrolases currently known to exist. PMID- 3514761 TI - An immunoenzymatic staining assay (ISA) for the rapid screening of monoclonal antibodies detecting membrane and cytoplasmic antigens. AB - We report a rapid and very sensitive immunoenzymatic staining assay (ISA) for the determination of the fine specificity of monoclonal antibodies directed against cellular antigens. Reactivity is analysed at the single cell level by light microscopy using alkaline phosphatase-conjugated second and third antibodies on cells bound to Terasaki plates. Reactive cells can be defined by their morphology even in preliminary screening procedures. Only small numbers of cells are necessary for this assay which is comparable to radioimmunoassays in its sensitivity. Plates with fixed cells can be stored at 4 degrees C so that a permanent 'library' of various cell types is always immediately available for use. The test is also suitable for human blood cell phenotyping. Moreover, a simple modification of the procedure by short pretreatment of the cells with the detergent Brij allows the detection of antigens within the cytoplasm. The importance of evaluating the cytoplasmic compartment in order to define antibody specificity and study the distribution of different cytoplasmic and membrane antigens is emphasized. PMID- 3514762 TI - Rat (and mouse) monoclonal antibodies. V. A simple automated technique of antigen purification by immunoaffinity chromatography. AB - A technique to automate the purification of antigens by immunoaffinity chromatography is described. It is operated on a time basis and measurements of the optical density of the immunoaffinity column eluate are made at 280 nm. Immunoaffinity columns of Sepharose 4B coupled mouse or rat monoclonal antibody can be used for 150 or more cycles. From 23 to 120 mg of monoclonal antibody were purified per run. There is a potential application of this system to other forms of affinity chromatography. PMID- 3514763 TI - Human IgG subclass assays using a novel assay method. AB - To facilitate assays for human IgG subclasses, we have adapted a novel assay method (particle concentration fluorescence immunoassay) (Jolley et al., 1984; MacCrindle et al., 1985) using one polyclonal and several monoclonal antibodies for human IgG subclasses. The advantages of this new assay over previously described methods are sensitivity (0.3-3 micrograms/ml), and automated measurement of multiple samples in a short time (2 h). We found that a monkey antibody for IgG2 and monoclonal antibodies for IgG1, IgG4b epitope, and IgG3 can be adapted to this method. We evaluated 7 different antibodies to IgG4 without finding a suitable monoclonal antibody for this assay method. Several of these IgG4 hybridoma antibodies, however, could be used in a competitive radioimmunoassay using polyvinyl microtiter plates. The usefulness of a monoclonal antibody to the IgG4b epitope was evaluated because no suitable monoclonal antibodies for IgG2 are available. Because IgG4 levels are usually much smaller than IgG2 levels, and the IgG4b epitope is expressed on all IgG2 alleles and only some IgG4 alleles (Kunkel et al., 1970), the antibody for IgG4b is potentially useful to screen a large number of samples for IgG2 deficiency. However, when the monoclonal antibody for IgG4b was compared with an IgG2 specific antibody produced in a monkey, the IgG4b antibody could identify only about half of the patients with known IgG2 deficiency. PMID- 3514764 TI - A new simple fluorometric assay for phagocytosis. AB - A highly sensitive, but simple and quantitative, fluorometric assay method for phagocytosis by cells such as macrophages and polymorphonuclear leukocytes was developed by utilizing fluorescent particles. Escherichia coli, Serratia marcescens, yeast, and latex particles were conjugated with fluorescein isothiocyanate and used as fluorescent particles. The assay procedure requires phagocytic cells, appropriate medium, fluorescent particles, sodium dodecyl sulfate, microtiter culture plate (24 wells), clinical centrifuge, and fluorescence spectrophotometer. One hundred assays can be done within 30 min after the incubation period. A time course analysis with this method showed that the phagocytosis of all these particles was dependent on temperature, and that the number of particles ingested by cells increased rapidly during the initial 30 min of incubation at 37 degrees C. Free fluorescent particles can be removed effectively by aspiration from the well. At 0 degree C, very few particles were ingested by cells or adsorbed onto the phagocytic cell surface as confirmed by fluorescence microscopy. An inhibitory effect of cepharanthin and sodium azide on phagocytosis was also confirmed by this method. The differential susceptibility of E. coli B and S. marcescens to phagocytosis also could be determined by this method. PMID- 3514765 TI - A simplified method for purification of human C5a from citrated plasma. AB - A simplified immunoadsorption technique has been developed to purify human C5a. the 11 000 Da glycopeptide produced by C5 convertase cleavage of the fifth component of complement. In this method, human C5 fragments, including C5a, are isolated from zymosan-activated plasma by affinity chromatography, concentrated on CM 52 cellulose, and then purified to homogeneity by gel filtration on Sephadex G-75 in phosphate-buffered saline. Human C5a prepared by this technique demonstrates characteristic immunochemical and biological activity. This method has also been adapted for the purification of 125I-C5a in phosphate-buffered saline. This technique offers a simplified approach to the purification of this important soluble mediator of inflammation. PMID- 3514766 TI - Effects of the blocking agents bovine serum albumin and Tween 20 in different buffers on immunoblotting of brain proteins and marker proteins. AB - The effects of the blocking agents bovine serum albumin and Tween 20 in buffers at pH values 7.2 and 10.2 were compared in immunoblotting with 2 different antisera. The antisera were raised against a purified brain-specific protein fraction from human brain, soluble in perchloric acid, and phosphate-activated glutaminase from pig brain, respectively. The antigens were a crude perchloric acid-soluble brain extract, a crude brain phosphate-activated glutaminase fraction, and proteins commonly used as molecular weight markers. The binding patterns of the 2 antisera to the respective brain antigen preparations changed, depending on the blocking agent and the pH of the blocking buffer. Also, antibody binding to the molecular weight marker proteins was observed with some of the blocking buffers. Immunoblotting with Tris-saline, pH 10.2, containing 3% bovine serum albumin as blocking agent and diluting buffer for the antisera, showed negligible antibody binding to the marker proteins and most specific binding to the brain antigens. PMID- 3514767 TI - Comparison of immunoradiometric and immunofluorometric assays for serum hCG. AB - Earlier studies have demonstrated, that an extremely rapid and sensitive assay for human chorionic gonadotropin (hCG) can be obtained by utilizing time-resolved fluorometry in combination with an immunometric assay. In this assay 2 different monoclonal antibodies are used. One antibody, directed against the beta-subunit of hCG, is immobilized by coating onto a microtitre well whereas the other antibody is labelled with a europium chelate. This assay was compared with a similar assay, which differed only by using 125I instead of europium as a label. The results demonstrate, that the high sensitivity of the immunofluorometric assay was mainly the result of the high antibody concentration used since almost equal sensitivity was obtained using the same amounts of radiolabelled antibody. However, this implied the use of 10-100 times more radioactivity per tube than usually applied in immunoassays. For practical purposes the time-resolved immunofluorometric assay was superior because the measuring time was shorter and the reagents non-radioactive and stable. PMID- 3514768 TI - Re.: The choice of agarose in the under-agarose assay critically affects neutrophil locomotion. PMID- 3514769 TI - Group B streptococcal colonisation and the outcome of pregnancy. AB - Vaginal colonisation of pregnant women with group B streptococci (GBS) was not related to age, parity or blood group. There were marked differences between racial groups, Asians having a low colonisation rate and Negroes a high rate. Vaginal GBS colonisation was associated with intrapartum pyrexia, but not with preterm labour, premature rupture of membranes or other complications in labour. Group B streptococci may be an important cause of bacteriuria in pregnancy and their effect on the outcome of pregnancy as urinary pathogens needs further evaluation. PMID- 3514770 TI - Symptomatic treatment of acute infectious diarrhoea: loperamide versus placebo in a double-blind trial. AB - One hundred and twelve patients with acute infectious diarrhoea were entered in a double-blind randomised study in order to compare loperamide with a placebo. Of 82 evaluable patients, 38 received loperamide and 44 placebo for a maximum of 5 days. There were no significant differences in the number of loose stools during the first day of treatment, in the total number of tablets taken or in the total duration of the period of diarrhoea between the two treatment groups. The loperamide-treated patients had significantly fewer loose stools during the observation period of 5 days than did the placebo treated patients, median five vs. seven, a difference of little clinical importance. Excretion of bacterial pathogens was followed weekly in 13 of the loperamide treated patients (median 35.5 days) and in 18 of the placebo treated patients (median 22.5 days). This difference in the duration of excretion was not significant. PMID- 3514771 TI - Primary hepatic actinomycosis. AB - A case of primary hepatic actinomycosis is reported. Multiple liver abscesses were diagnosed in a febrile 60-year-old-man by means of non-invasive techniques such as ultrasonography, CT and radioisotope scans. The aetiology was confirmed by the unusual finding of Actinomyces israelii in anaerobic blood cultures. Other sites were not involved. Early penicillin therapy enabled surgery to be avoided. PMID- 3514773 TI - [Study on the central action of catecholestrogen: effect of 2-hydroxyestrogens on the preovulatory LH surge]. AB - Administration of 100 micrograms 2-hydroxyestrone (2-OHE1) on the morning of proestrus to 4 day cycling rats resulted in suppression of the preovulatory LH surge. The greatest response was observed when the injection of 2-OHE1 coincided with plasma estradiol levels that were close to but not at their maximal proestrus levels. Injection of 100 micrograms 2-hydroxyestradiol-17 beta (2-OHE2 17 beta) effectively inhibited the LH surge when given at 0800 or 0900h, but not when injected at 1000 or 1200h. Non estrogenic 2-hydroxyestradiol-17 alpha was effective in suppressing the LH surge when given at 0900 or 1000h. Neither 2-OHE1 nor 2-OHE2-17 beta interfered with LH secretion in response to LH-RH administration, indicating that the inhibitory action of the catecholestrogen is exercised at the hypothalamic level. However, 2-OHE1 given five times following the implantation of an estradiol capsule in ovariectomized rats had no effect on the LH surge elicited on the second day. These data indicate that catecholestrogen interferes with the brief neuronal triggering phase necessary for LH-RH release, but not the sensitization phase of positive feedback of estrogen on phasic LH secretion. The evidence also indicates that the action does not involve conventional competition for the estradiol receptor. PMID- 3514772 TI - Analysis of the antibody response developing in an infant with Candida albicans meningitis. AB - A case of meningitis due to Candida albicans in a neonate is described. This is the first report of an immunoblot analysis of both serial samples of serum and cerebrospinal fluid in relation to C. albicans antigens. The western blot technique demonstrated that the mother had IgM antibody against five candidal antigens, including one of molecular weight 47 kDaltons, but only a small amount of IgG antibody against two antigens of molecular weight 104 kDaltons and 60 kDaltons respectively. The baby produced IgM antibody and then IgG antibody against an antigen of 47 kDaltons molecular weight, and this was associated with recovery. PMID- 3514774 TI - Primary flexor tendon repair: the mechanical limitations of the modified Kessler technique. AB - The aim of primary suture of flexor tendons in the hand is to achieve full function as soon as possible with a one stage operation. Much interest has been aroused by this subject and more recently by the possibility of improving results by postoperative active movement of the repaired tendon. We report the results of mechanical testing of the modified Kessler suture which suggests that the peripheral stitch is an important structural component of the suture. It is not merely a 'tucking in' stitch, but is essential to prevent very early gap formation. Steel is the best material for the central or core part of the suture. Cautious active postoperative movements may be possible using the modified Kessler suture, but within a narrow range of safety and with careful supervision. PMID- 3514776 TI - Degradation of cross-linked fibrin by human leukocyte proteases. AB - We have examined the dissolution of plasminogen-free fibrin clots by proteases in a leukocyte lysate using sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) to monitor alterations of cross-linked fibrin structure before solubilization and to characterize the structure of soluble derivatives. Progressive clot lysis was also followed by quantitation of fibrin derivatives that were present as solubilized products, as clot-associated fragments, and as residual degrading clot. An estimate of the total fibrinolytic potential of the plasminogen system relative to that of entrapped leukocytes was based on the specific fibrinolytic activities of plasmin and leukocyte lysate, and this indicated that the capacity of leukocyte-mediated fibrinolysis was only 3% of fibrin-bound plasminogen. Early during leukocyte lysate digestion the predominant soluble products were small peptides of Mr less than 20,000, whereas at later times heterogeneous groups of large fragments were present that were distinct from those produced during plasmic degradation. Electrophoresis in nondissociating conditions showed that a later leukocyte lysate digest of cross linked fibrin contained distinct bands with mobilities indistinguishable from plasmic derivatives DD/E and DY/YD, suggesting a similar assembly in the native state of the leukocyte lysate fragments to those produced by plasmin. During degradation by leukocyte lysate, up to 70% of the degrading, insoluble clot could be solubilized in SDS, indicating that extensive early cleavage of the fibrin matrix failed to release much of the protein into solution. A market difference in the composition of fragments and polypeptide chains in the protein noncovalently bound to clot was seen in comparison with soluble derivatives. This appeared to be caused by the relative resistance to degradation of the C-terminal portions of the gamma-chain of the soluble derivatives, whereas the matrix associated protein could be more easily cleaved in this region. The results demonstrate a distinct difference in the overall pattern of degradation compared with plasmic fibrinolysis. PMID- 3514775 TI - Type-specific antibody prevents platelet aggregation induced by group B streptococci type III. AB - Group B streptococci (GBS) type III organisms readily induced platelet aggregation and serotonin release in human platelet-rich plasma (PRP). In a system using a GBS/platelet ratio of 1.5, aggregation occurred after 2 to 9 minutes (maximum aggregation, 73% +/- 11%). Serotonin release began within the first minute, reaching 40% before aggregation was detected. Maximum release was 65% +/- 9%. The addition of type-specific rabbit antisera inhibited aggregation and release in a dose-dependent fashion, whereas rabbit antisera against GBS type II and a pneumococcus type 14 and 19 had no effect. To test the activity of different isotypes, monoclonal antibodies against the sialic acid determinant of the GBS type III antigens were used. IgG, IgM, and IgA antibodies were all effective in blocking aggregation and serotonin release. Although the significance of this phenomenon is not clear, it may represent a protective function of antibody that is not directly related to opsonization and phagocytosis. PMID- 3514777 TI - Physiological considerations as a guide to the rational use of insulin. PMID- 3514778 TI - Oxidative demethylation of lanosterol in cholesterol biosynthesis: accumulation of sterol intermediates. AB - With [3H-24,25]-dihydrolanosterol as substrate, large-scale metabolic formation of intermediates of lanosterol demethylation was carried out to identify all compounds in the metabolic process. Utilizing knowledge of electron transport of lanosterol demethylation, we interrupted the demethylation reaction allowing accumulation and confirmation of the structure of the oxygenated intermediates lanost-8-en-3 beta,32-diol and 3 beta-hydroxylanost-8-en-32-al, as well as the demethylation product 4,4-dimethyl-cholesta-8,14-dien-3 beta-ol. Further metabolism of the delta 8.14-diene intermediate to a single product 4,4-dimethyl cholest-8-en-3 beta-ol occurs under interruption conditions in the presence of 0.5 mM CN-1. With authentic compounds, each intermediate has been rigorously characterized by high performance liquid chromatography and gas-liquid chromatography plus mass spectral analysis of isolated and derivatized sterols. Intermediates that accumulated in greater abundance were further characterized by ultraviolet, 1H-NMR, and infrared spectroscopy of the isolated sterols. PMID- 3514779 TI - [Thrombophlebitis of the saphenous trunks]. PMID- 3514780 TI - [Vascular exploration of the popliteal fossa by non-invasive methods]. PMID- 3514781 TI - [Photoplethysmography (photoreflexometry) in chronic venous insufficiency]. PMID- 3514782 TI - The historical background of stroke prevention, treatment, and rehabilitation in Georgia. PMID- 3514783 TI - Eikenella corrodens endocarditis: a case report. PMID- 3514784 TI - Low-temperature (70 degrees C) injection Gutta-percha: a scanning electron microscopic investigation. PMID- 3514785 TI - A critical review of adult health maintenance. Part 1: Prevention of atherosclerotic diseases. AB - This is the first paper in a four-part series that presents an updated protocol for selective longitudinal health maintenance of asymptomatic adults. Five conditions related to atherosclerotic diseases are reviewed with reference to six generally accepted screening criteria. A recommendation is made for each condition and is compared, when appropriate, with the recommendations of the Canadian Task Force on the Periodic Health Examination. In the fourth paper, the recommendations will be combined into a practical health maintenance flow sheet for use by primary care physicians. PMID- 3514786 TI - Cardiac transplantation. PMID- 3514787 TI - Changing the rules. PMID- 3514789 TI - Assignment of two new host range types to the P2 family of temperate coliphages. AB - Six non-inducible coliphages which grow on Escherichia coli C but not on K12 (C specific) were shown to be antigenically related to P2. All six were shown to be P4 helpers and some of them could also recombine with P2. PMID- 3514788 TI - Ca2+ compartments in saponin-skinned cultured vascular smooth muscle cells. AB - A method for saponin skinning of primary cultured rat aortic smooth muscle cells was established. The saponin-treated cells could be stained with trypan blue and incorporated more 45Ca2+ than the nontreated cells under the same conditions. At low free Ca2+ concentration, greater than 85% of 45Ca2+ uptake into the skinned cells was dependent on the extracellularly supplied MgATP. In the intact cells, both caffeine and norepinephrine increased 45Ca2+ efflux. In the skinned cells, caffeine increased 45Ca2+ efflux, whereas norepinephrine did not. The caffeine releasable 45Ca2+ uptake fraction in the skinned cells appeared at 3 X 10(-7) M Ca2+, increased gradually with the increase in free Ca2+ concentration, and reached a plateau at 1 X 10(-5) M Ca2+. The 45Ca2+ uptake fraction, which was significantly suppressed by sodium azide, appeared at 1 X 10(-5) M Ca2+ and increased monotonically with increasing free Ca2+ concentration. The results suggest that the caffeine-sensitive Ca2+ store, presumably the sarcoplasmic reticulum, plays a physiological role by releasing Ca2+ in response to norepinephrine or caffeine and by buffering excessive Ca2+. The 45Ca2+ uptake by mitochondria appears too insensitive to be important under physiological conditions. PMID- 3514790 TI - Artificial intelligence and psychiatry. AB - This paper provides a brief historical introduction to the new field of artificial intelligence and describes some applications to psychiatry. It focuses on two successful programs: a model of paranoid processes and an expert system for the pharmacological management of depressive disorders. Finally, it reviews evidence in favor of computerized psychotherapy and offers speculations on the future development of research in this area. PMID- 3514791 TI - Identity between cytoplasmic and membrane-bound S-100 proteins purified from bovine and rat brain. AB - Cytoplasmic and membrane-bound S-100 proteins were purified to homogeneity from bovine and rat brain. Cytoplasmic and membrane-bound S-100 from single species are identical by immunological, electrophoretic, spectrophotometric, and functional criteria. Cytoplasmic and membrane-bound S-100 from bovine brain consists of nearly equal amounts of S-100a and S-100b, whereas cytoplasmic and membrane-bound S-100 from rat brain consists mostly of S-100b. The functional role of membrane-bound S-100 remains to be elucidated. PMID- 3514792 TI - Ethanol administration in the rat decreases prostacyclin production by isolated brain microvessels. AB - The effects of short- and long-term ethanol administration to rats on basal levels and formation of prostacyclin (PGI2) measured as 6-keto-prostaglandin F1 alpha (6-keto-PGF1 alpha), and on lipid class content and fatty acid composition of isolated brain microvessels (BMV) were studied. After acute treatment (2 h, at the peak of plasma ethanol concentration) basal 6-keto-PGF1 alpha levels in BMV and release on incubation were reduced to 50% of control values. After chronic administration (15 days), PGI2 release was reduced to about 40% of control values, without changes in basal levels. Total lipid, phospholipid, and cholesterol levels in BMV, measured after prolonged administration of alcohol, were not modified. Also, only minor changes in the fatty acid composition of individual phospholipid classes were detected. The observed reduction of PGI2 synthesis in BMV thus could not be related to changes of the fatty acid precursor pool in the preparation. Precursor release and/or the biosynthetic pathways may be affected by ethanol administration. PMID- 3514793 TI - Activation of complement by myelin: identification of C1-binding proteins of human myelin from central nervous tissue. AB - Myelin isolated from central nervous tissue activates the classic pathway of complement by directly activating C1. Activation of C1 can proceed to form membrane attack complex, C5b-9, in the myelin. Such an interaction between myelin and complement may be important in diseases involving myelin damage, in view of the role of complement in membrane attack and inflammation. To identify the C1 activating protein, myelin was subjected to sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and Western blot. The blots were incubated with C1 or with whole serum complement, followed by immunostaining for C1 or C3, respectively. A duplicate strip was stained with amido black or anti-myelin antibody to visualize the myelin proteins. The results showed that two major protein bands were capable of activating C1. An approximately 56-58-kilodalton band comigrated with the W2 protein and an approximately 45-47-kilodalton band migrated along with, but slightly behind, the W1 Wolfgram doublet. PMID- 3514794 TI - S100a0 (alpha alpha) protein: distribution in muscle tissues of various animals and purification from human pectoral muscle. AB - When the concentrations of alpha-S100 (alpha subunit of S100 protein) and beta S100 (beta subunit) proteins in various tissues of human and rat were determined by the immunoassay method, immunoreactive beta-S100 was present at high levels in the CNS, adipose tissue, and cartilaginous tissue. In contrast, the alpha-S100 was found in the heart and skeletal muscles at concentrations much higher than in the CNS. The concentration of alpha-S100 protein was also high in the heart and skeletal muscles of bovine, porcine, canine, and mouse. Since beta-S100 protein levels in those tissues were low, it was suggested that S100 protein in the muscle tissues is present mainly as the alpha alpha form (S100a0 protein). To confirm the above findings, immunoreactive alpha-S100 protein was purified from human pectoral muscle by employing column chromatographies with butyl-Sepharose, diethylaminoethyl (DEAE)-Sepharose, Sephadex G-75, and finally with an anion exchange Mono Q column in a HPLC system. The elution profile of alpha-S100 protein from the Mono Q column suggested some heterogeneity of the final preparation. However, each of these fractions traveled with a single band at a position similar to that of bovine S100a0 protein on slab-gel electrophoresis. The amino acid composition of the final preparation was very similar to the composition of bovine S100a0 protein. The purified alpha-S100 protein was eluted from a gel-filtration column (Superose 12) in the same fraction as bovine S100a0 protein.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3514795 TI - Calcium-activated proteolysis of neurofilament proteins in the squid giant neuron. AB - The phosphorylation and proteolysis of squid neurofilament proteins by endogenous kinase and calcium-activated protease activities, respectively, were studied. When axoplasm was incubated in the presence of [gamma-32P]ATP, most of the phosphate was incorporated into two neurofilament proteins: a 220-kilodalton (NF 220) and a high-molecular-weight (HMW) protein. When this phosphorylated axoplasm was subjected to endogenous calcium-activated proteolysis, two significant phosphorylated fragments were generated, i.e., a soluble 110K fragment and a pelletable 100K fragment. Immunochemical and other analyses suggest that the pelletable 100K fragment contains the common helical neurofilament rod region and that the soluble 110K protein is the putative side arm of the NF-220. In contrast, neither the HMW or the NF-220 was detected in the region of the stellate ganglion which contains the cell bodies of the giant axon. However, this region did contain a number of proteins that were sensitive to calcium-activated proteolysis and reacted with a monoclonal intermediate filament antibody. This intermediate filament antibody reacts with most of the axoplasmic proteins that copurify with neurofilaments, i.e., in the order of their intermediate filament antibody staining intensity, a 60K, 65K, 220K, and 74K protein. In the cell body preparation, the intermediate filament antibody labeled, in order of their staining intensity, a 65K, 60K, 74K, and 180K protein. In both the axoplasmic and cell body preparations, endogenous calcium-activated proteolysis generated characteristic fragments that could be labeled with the anti-intermediate filament antibody. PMID- 3514796 TI - Basilar artery ectasia: an unusual cause of trigeminal neuralgia. AB - Basilar artery ectasia may be associated with trigeminal neuralgia as a consequence of trigeminal nerve compression by the aberrant artery. The case histories are presented of four patients, investigation of whom demonstrated the presence of an ectatic basilar artery thought to be the cause of facial pain. The value of intravenous digital subtraction angiography in the investigation of this condition is emphasised. The surgical management is discussed with particular reference to the choice between percutaneous thermocoagulation and posterior fossa microvascular decompression. PMID- 3514798 TI - The biological modification of tumor cells as a means of inducing their regression: an overview. PMID- 3514797 TI - A comparison of primidone, propranolol, and placebo in essential tremor, using quantitative analysis. AB - The effects of placebo, propranolol and primidone were compared in 14 patients with essential tremor in a double blind, randomised, crossover study. Objective measures of tremor were obtained using an accelerometer with subsequent spectral analysis. Both propranolol (p less than 0.01) and primidone (p less than 0.01) gave significant improvement in tremor, but there was no significant difference in improvement between these drugs. Patients with higher dominant frequencies of tremor tended to respond to both drugs, while those with lower frequencies improved on one or other. There was no differential effect between the drugs with the frequency of tremor. PMID- 3514799 TI - Toxicities and side effects associated with intravenous infusions of murine monoclonal antibodies. AB - Toxicity was assessed during and following 186 infusions of various murine monoclonal antibodies (MoAbs) in 82 patients afflicted with 10 different malignancies. Doses ranged from 0.5 to 500 mg per infusion and were administered over 0.25-24 h. Reactions of varying degrees were noted in 27 patients (33%) during or following 57 (31%) infusions. For antibodies that reacted with circulating cells, toxicity was seen in 20/82 of the first infusions compared with 0/55 for patients receiving antibodies that did not react with circulating cells. A 25% decrease in white blood cells (WBC) was associated with side effects in 40/66 courses whereas only 9/81 courses were associated with any sort of toxicity when the WBC decreased by less than 25%. Fevers, rigors, chills, and diaphoresis were observed in 21-23% of patients, but only in association with removal of circulating cells that bound the antibody. Presumed hypersensitivity reactions, including urticaria, pruritus, bronchospasm, and anaphylaxis occurred in 15 patients (18%). The two episodes of bronchospasm and single episode of anaphylaxis occurred in patients treated more than once, at least 2 weeks after a previous treatment. There was no clear relationship between dose or rate of infusion and toxicity for these antibodies. We conclude that murine MoAbs can be given with an acceptable frequency of serious allergic reactions and that the biologic effects of specific antibody-antigen reactions may be a more significant source of toxicity for such antibodies. PMID- 3514800 TI - Comparative evaluation of multiple lymphoid and recombinant human interleukin-2 preparations. AB - Six lymphoid human interleukin-2s (nIL-2s) [four from peripheral blood mononuclear cells (PBMC) and two from JURKAT cells] and six recombinant IL-2s (rIL-2s) were obtained for comparative evaluation. The main issues addressed were possible differences among the preparations in potency in T cell growth assays and other functional assays, and the possible presence of other cytokine activities or contaminants. Each preparation was assigned a standardized IL-2 activity in reference units (RU) by comparing its T cell growth promoting activity against the Biological Response Modifiers Program IL-2 (JURKAT) reference reagent. Relative to the IL-2 unitage indicated by the suppliers, the RU varied from 110-fold less to 38.5-fold more for the various preparations. Two nIL-2s and two rIL-2s contained significant levels of endotoxin. One nIL-2 contained low levels of both alpha and gamma interferon (IFN), and one nIL-2 had a high level of gamma IFN. All other IL-2s were negative for IFN activity. All IL 2 preparations significantly augmented human natural killer (NK) activity, although the amount of RU required varied from 0.1 to 50 RU. Four nIL-2s and three rIL-2s induced human PBMC to produce gamma IFN, whereas two nIL-2s and one rIL2 did not. All nIL-2s had substantial amounts of B cell growth factor activity, whereas none of the rIL-2s consistently displayed this activity. All IL 2s stimulated the tritiated thymidine [3H]TdR incorporation of human PBMC in the absence of other stimuli, in addition to augmenting the response to mitogen or alloantigens. Some nILs and IL-2s had effects on human monocytes such as inhibiting migration, inducing cytotoxic or growth inhibitory activity against tumor cells, and causing changes in cell surface markers. The IL-2s were also tested for activity in vitro and in vivo in mice. Although there was a 12-fold variation in activity among the preparations, all but one of the IL-2s showed augmentation of the mixed lymphocyte reaction activity and all IL-2s tested stimulated macrophage cytotoxicity in vitro. All IL-2s tested enhanced the mixed lymphocyte-allogeneic tumor cell reaction resulting in greater production of cytotoxic T cells. However, significant quantitative differences in potency were evident among the various IL-2 preparations, especially the nIL-2s. Only very high doses of IL-2 (intraperitoneal injection of 100,000 RU/animal) induced in vivo augmentation of splenic or peritoneal NK cells, although all IL-2s tested increased NK activity against tumor target cells in vitro with substantially lower doses (10-100 RU/ml).(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3514801 TI - Guild--name changes! PMID- 3514802 TI - Adjuvant chemoendocrine therapy in breast cancer. PMID- 3514803 TI - High-dose chemotherapy, fractionated total-body irradiation, and allogeneic marrow transplantation for malignant lymphoma. AB - Seventeen patients with malignant lymphoma, including 13 with progressive disease and four in remission following primary chemotherapy, received high-dose chemotherapy, fractionated total-body irradiation (TBI), and allogeneic marrow transplants. Eleven of the 13 (85%) patients in relapse who received transplants achieved remission, and three remain disease free 41, 21, and 17 months later; one patient in second remission who received a transplant is disease free at 11 months. Thirteen patients are dead: four because of progressive lymphoma, seven because of interstitial pneumonitis, and two because of complications of severe acute graft-v-host disease. These results are similar to those noted in marrow transplantation series for advanced acute leukemia; since transplantation during remission has decreased relapse and improved survival in leukemia, earlier transplantation may produce improved results in lymphoma patients as well. However, the effectiveness of conventional therapy regimens for most lymphomas and the high incidence of severe transplant-related complications usually limit allogeneic transplantation to lymphoma patients in situations other than consolidation of first remission. Initial partial remission, early relapse from an initial remission, and perhaps second remission are situations in which conventional therapy is often ineffective, but the adverse features of very advanced lymphoma are not present; marrow transplantation may be considered in eligible patients. Transplant recipients with more advanced disease are anticipated to have poorer survivals. PMID- 3514804 TI - A randomized trial for the treatment of high-grade soft-tissue sarcomas of the extremities: preliminary observations. AB - A new trial for evaluating the effectiveness of adjuvant chemotherapy in high grade soft-tissue sarcomas of the extremities in adult patients is presented. All patients after local treatment were randomized into two arms, one without further therapy and the other to receive adjuvant chemotherapy (Adriamycin [Farmitalia Carlo Erba, Milan, Italy], 450 mg/m2). The preliminary results of the study are reported at a median observation period of 27.6 months. Of the 59 patients who entered the study, 79.1% in the chemotherapy group are without sign of disease, whereas the corresponding figure in the nonadjuvant chemotherapy group is 54.3%. The difference between the two groups is statistically significant (P less than .005, log rank test). These preliminary observations encourage continuation of the study. PMID- 3514805 TI - Therapy for childhood soft-tissue sarcomas other than rhabdomyosarcoma: a review of 62 cases treated at a single institution. AB - The rarity and diverse characteristics of the nonrhabdomyosarcomatous soft-tissue sarcomas (NRSTS) in children have hindered study of their clinical presentations and response to therapy. Here we describe the findings of a retrospective analysis of 62 cases of NRSTS seen in a single institution from 1962 through 1983. The most common histopathologic diagnosis was synovial sarcoma, occurring in 18 patients, followed by malignant schwannoma in 12. The median age at diagnosis was 11 years (range, 2 months to 20 years). Anatomic sites of primary tumors were the trunk (28), extremity (24), and head and neck (10). Of the 31 patients whose tumors were completely resected, 26 (84%) survive with no evidence of disease. Postoperative chemotherapy, administered to nearly one half of this group, did not produce any demonstrable gains in survival. Only one of the 26 patients with local or metastatic gross tumor after resection survives. We conclude that an aggressive surgical approach is imperative in patients with NRSTS and that the contribution of other treatment modalities needs to be defined in a collaborative group trial. PMID- 3514806 TI - Combination chemotherapy (5-fluorouracil, methyl-CCNU, mitomycin C) versus 5 fluorouracil alone for advanced previously untreated colorectal carcinoma. A phase III study of the Piedmont Oncology Association. AB - One-hundred thirty eligible patients with advanced colorectal carcinoma who had received no prior chemotherapy were randomized to either methyl-CCNU, 70 mg/m2 orally every 6 weeks on day 1, mitomycin C, 10 mg/m2 intravenously every 6 weeks on day 1, and 5-fluorouracil (5-FU), 400 mg/m2 intravenously weekly--(MMF)--or 5 FU, 600 mg/m2 intravenously weekly (5-FU). One hundred twenty-six patients are evaluable for response. Of 62 patients treated with MMF, one (2%) achieved complete remission, and three (5%) attained partial remission. Of 64 patients treated with 5-FU, two (3%) achieved complete remission, and eight (13%) attained partial remission. The median survival for patients receiving MMF was 9.5 months compared with 10.3 months for patients receiving 5-FU. The survival distributions for the two regimens were not significantly different, either unadjusted or adjusted for pretreatment characteristics. Performance status and lactic dehydrogenase (LDH) were both significantly associated with survival. Patients with liver metastases only and normal liver function tests had a median survival of 19.8 months and a 40% response rate. This randomized phase III trial did not show any therapeutic advantage for MMF compared to 5-FU therapy alone in advanced colorectal cancer. In addition, hematologic toxicity was significantly greater with the combination (MMF) regimen. PMID- 3514808 TI - Consistent definitions of tumor response. PMID- 3514809 TI - Bone marrow transplantation for Hodgkin's disease. PMID- 3514807 TI - 13-cis retinoic acid treatment for myelodysplastic syndromes. AB - To test the biologic activity of 13-cis retinoic acid (13-CRA) in patients with myelodysplastic states (MDS), we administered 13-CRA orally (2.5 mg/kg/d initially, escalated to 4 mg/kg/d) for 8 weeks to 15 consecutive patients. Eight of 15 patients (53%) experienced an increase in peripheral granulocyte counts of greater than 20% (range, 22% to 700%). In five patients, the absolute increase in peripheral granulocyte count was greater than 500 cells/microL. Two of 15 patients experienced a decrease in the circulating granulocyte count of greater than or equal to 20%. Comparable values for peripheral platelet counts were 27% (4/15 patients) greater than 20% increase and 33% (5/15 patients) greater than 20% decrease. No patient experienced a major change in erythrocyte transfusion requirement while receiving 13-CRA in comparison with pretreatment status. Thirteen patients had morphologic and cytogenetic evaluation of marrow cells before 13-CRA treatment, and with one exception, marrow morphologic and cytogenetic abnormalities persisted following 13-CRA administration. The exception occurred in the patient with the most dramatic response, whose granulocyte count increased from 400 to 2,800 cells/microL along with a normalization of the leukocyte alkaline phosphatase score, a morphologic improvement in granulocyte maturation, and a disappearance of the initial chromosome abnormality. These changes did not persist after cessation of 13-CRA administration, but were reproduced following drug readministration. No patients experienced serious decrements in peripheral blood counts or leukemic transformation while receiving 13-CRA. All patients had mild to marked dermatologic toxicity (cheilosis, skin dryness). No other major toxicity was encountered. We conclude that 13-CRA may be safely administered and may increase peripheral granulocyte counts in a proportion of patients with MDS. PMID- 3514811 TI - Management of patients with ovarian cancer. PMID- 3514810 TI - High-dose melphalan and autologous bone marrow transplant as treatment for refractory Hodgkin's disease. PMID- 3514812 TI - Multiple axon collaterals of single corticospinal axons in the cat spinal cord. AB - To investigate intraspinal branching patterns of single corticospinal neurons (CSNs), we recorded extracellular spike activities from cell bodies of 408 CSNs in the motor cortex in anesthetized cats and mapped the distribution of effective stimulating sites for antidromic activation of their terminal branches in the spinal gray matter. To search for all spinal axon branches belonging to single CSNs in the "forelimb area" of the motor cortex, we microstimulated the gray matter from the dorsal to the ventral border at 100-micron intervals at an intensity of 150-250 microA and systematically mapped effective stimulating penetrations at 1-mm intervals rostrocaudally from C3 to the most caudal level of their axons. From the depth-threshold curves, the comparison of the antidromic latencies of spikes evoked from the gray matter and the lateral funiculus, and the calculated conduction times of the collaterals, we could ascertain that axon collaterals were stimulated in the gray matter rather than stem axons in the corticospinal tract due to current spread. Virtually all CSNs examined in the forelimb area of the motor cortex had three to seven branches at widely separated segments of the cervical and the higher thoracic cord. In addition to terminating at the brachial segments, they had one to three collaterals to the upper cervical cord (C3-C4), where the propriospinal neurons projecting to forelimb motoneurons are located. About three quarters of these CSNs had two to four collaterals in C6 T1. This finding held true for both fast and slow CSNs. About one third of the CSNs in the forelimb area of the motor cortex projected to the thoracic cord below T3. These CSNs also sent axon collaterals to the cervical spinal cord. CSNs in the "hindlimb area" of the motor cortex had three to five axon branches in the lumbosacral cord. These branches were mainly observed at L4 and the lower lumbosacral cord. None of these CSNs had axon collaterals in the cervical cord. CSNs terminating at different segments of the cervical and the thoracic cord were distributed in a wide area of the motor cortex and were intermingled. To determine the detailed trajectory of single axon branches, microstimulation was made at a matrix of points of 100 or 200 micron at the maximum intensity of 30 microA, and their axonal trajectory was reconstructed on the basis of the location of low-threshold foci and the latency of antidromic spikes.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3514813 TI - Long-lasting excitability changes of soleus alpha-motoneuron induced by midpontine stimulation in decerebrate, standing cat. AB - Stimulation of the dorsal portion of the caudal tegmental field (DTF) in the pons resulted in hyperpolarization of extensor alpha-motoneurons (alpha-MNs) that persisted for several minutes after cessation of the stimulation. The resulting inhibition of alpha-MN discharge led to a progressive reduction in the number of active motor units. Renshaw cells, persistently active at high levels of extensor muscle tone, were abruptly silenced by DTF stimulation. Active discharge was renewed at the time of cessation of the stimulation but at a frequency reduced in proportion to the persistently lowered level of extensor muscle tone. Ia primary afferents were tonically active during the high extensor tonus of reflex standing. DTF stimulation was accompanied by a brief, slight increase in Ia discharge frequency followed by a reduction in frequency variably correlated to the magnitude of extensor force reduction. Orthodromically elicited Ia EPSPs in the soleus alpha-MNs were reduced in peak voltage, time to peak, and half width during the hyperpolarization accompanying DTF stimulation. All of these parameters recovered beyond their prestimulus values with the cessation of DTF stimulation in spite of the persisting hyperpolarization. Antidromically initiated invasion of the somatodendritic (SD) segment of the motoneuron membrane was delayed and sometimes blocked during DTF stimulation. At the same time, the peak voltage of the SD action potential was reduced. There was an immediate recovery of these changes on termination of DTF stimulation, although the poststimulus hyperpolarization persisted. Intracellular injection of depolarizing current steps during DTF stimulation revealed a depression of membrane excitability that persisted during the hyperpolarization that followed the termination of the DTF stimulation. Depolarizing and hyperpolarizing steps of intracellular current were used to demonstrate a reduction of cellular input resistance during DTF stimulation. The resistance values rapidly returned to prestimulus levels following the cessation of DTF stimulation. It was demonstrated that the degree of resistance change is greater and that the magnitude of DTF-induced hyperpolarization is smaller for low-resistance cells than for high-resistance cells. Iontophoretically induced increase in intracellular Cl- resulted in a reversal of both Ia IPSPs and the hyperpolarization induced by DTF stimulation. The hyperpolarization enduring after DTF stimulation was not affected by the Cl- injection. PMID- 3514814 TI - Differential effects of low-frequency depression, vibration-induced inhibition, and posttetanic potentiation on H-reflexes and tendon jerks in the human soleus muscle. AB - A comparison was made between the effects of repetition rate, muscle vibration, and tetanic stimulation of the tibial nerve on H-reflexes and tendon (T) jerks elicited in the relaxed soleus muscle of normal human. H- and T-reflexes with electromyographic (EMG) potentials of equivalent amplitude were elicited alternately in the same leg to ensure identical experimental conditions. H- and T reflexes of identical EMG amplitude showed isometric twitch tensions of identical amplitude and time course. H- and T-reflexes were elicited at different repetition rates ranging from once every 6 s to 2/s. H-reflexes showed a significantly stronger low-frequency depression than T-reflexes. Inhibition of H- and T-reflexes was induced by 2-min vibration at 100 Hz of ankle extensors, ankle flexors, or knee flexors. Vibration of ankle extensors and flexors induced a stronger inhibition than vibration of knee flexors. In all three conditions, inhibition of H-reflexes was stronger than inhibition of T-reflexes. The difference was relatively greater during vibration of ankle extensors and flexors than during vibration of knee flexors. When tested together, the effects of low frequency depression and vibration-induced inhibition of H- and T-reflexes were found to be independent if reflex amplitudes were expressed as a percentage of the control reflex amplitude. The cessation of vibration of ankle extensors was followed by a gradual recovery of H-reflexes from inhibition. On the contrary, T reflexes showed a marked potentiation. Such postvibratory effects were generally not observed following vibration of ankle or knee flexors. When postvibratory effects were tested during low-frequency depression, percent postvibratory depression of H-reflexes and percent postvibratory potentiation of T-reflexes were found to be independent of the degree of low-frequency depression. Tetanic stimulation of the tibial nerve for 20 s at 200 Hz resulted in posttetanic potentiation (PTP) of H- and T-reflexes, the former being stronger than the latter. The extent of the changes in H- and T-reflex EMG amplitudes, due to changes in repetition rate, vibration, or tetanic stimulation, was generally inversely related to the intensity of the electrical or mechanical reflex stimuli. The observed discrepancies between the induced changes in H- and T reflex amplitudes are interpreted in terms of the differences in afferent inputs between the two reflexes that were suggested by Burke and his colleagues (9 11).(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3514815 TI - Partitioning of monosynaptic Ia excitatory postsynaptic potentials in the motor nucleus of the cat lateral gastrocnemius muscle. AB - Experiments were conducted to test the hypothesis that a partitioning of Ia monosynaptic excitatory postsynaptic potentials (Ia EPSPs) is present in motor nuclei supplying muscles with regions capable of different mechanical actions. Intracellular recordings of synaptic potentials were made in lateral gastrocnemius (LG) motoneurons in anesthetized low-spinal cats. The effects were tested of stimuli (group I range) to the four primary nerve branches of the LG nerve supplying muscle compartments LGm, LG1, LG2, and LG3 (terminology of English, Ref. 26) and the nerve to a heteronymous muscle, soleus. Stimulation of a given LG nerve branch produced monosynaptic Ia EPSPs of greater amplitude in "own-branch" motoneurons than "other-branch" cells. A significant partitioning of mean Ia EPSPs was found in three (LG1, LG2, LG3) out of the four homonymous pathways studied. An EPSP normalization (7) was performed to eliminate potential differences in cell type that might affect the amplitudes of the EPSPs between these four cell groups (e.g., differences in the number of cells supplying FF, FR, and S muscle units). This normalization confirmed that the partitioning of monosynaptic Ia inputs upon stimulation of LG1, LG2, and LG3 could not be attributed to differences in cell type. In addition, the effects of LGm stimulation were found to be significantly greater in the LGm motoneurons compared with the other cell groups. Heteronymous input (from soleus) to the LG motor nucleus showed some partitioned effects. Motoneurons innervating compartment LG2 received larger EPSPs from soleus than did the cells supplying compartments LG1, LG3, and LGm. The contributions of location specificity and species specificity (terminology of Scott and Mendell, Ref. 55) in the establishment of these Ia-afferent-motoneuronal connections were examined. Cell location sites within the spinal cord were consistent with location specificity making some contribution to the observed pattern of homonymous Ia connections. A more prominent role for species specificity was indicated by species-dependent differences in EPSP amplitude in pairs of LG motoneurons (e.g., LGm vs. LG2) at similar rostrocaudal locations upon stimulation of a given homonymous or heteronymous nerve/branch. PMID- 3514816 TI - Immunocytochemical localization of tubulin and microtubule-associated protein 2 during the development of hippocampal neurons in culture. AB - In dissociated-cell cultures prepared from the embryonic rat hippocampus, neurons establish both axons and dendrites, which differ in geometry, in ultrastructure, and in synaptic polarity. We have used immunocytochemistry with monoclonal antibodies to study the regional distribution of beta-tubulin and micro-tubule associated protein 2 (MAP2) in hippocampal cultures and their localization during early stages of axonal and dendritic development. After development for a week or more in culture, when axons and dendrites were well-differentiated, the distribution of these two proteins was quite different. Beta-tubulin was present throughout the nerve cell, in soma, dendrites, and axon. It was also present in all classes of non-neuronal cells, astrocytes, fibroblasts, and a presumptive glial progenitor cell. In contrast, MAP2 was preferentially localized to nerve cells; within neurons, MAP2 was present in soma and dendrites, but little or no immunostaining was detectable in axons. Both beta-tubulin and MAP2 were present in nerve cells at the time of plating. From the earliest stages of process extension, beta-tubulin was present in all neuronal processes, both axons and dendrites. Surprisingly, MAP2 was also initially present in both axons and dendrites, extending as far as the axonal growth cone. With subsequent development, MAP2 staining was selectively lost from the axon so that after 1 week in vitro little or no axonal staining remained. Taken together with earlier results (Caceres et al., 1984a), these data indicate that the establishment of neuronal polarity, as manifested by the molecular differentiation of the axonal and dendritic cytoskeleton, occurs largely under endogenous control, even under culture conditions in which cell interactions are greatly restricted.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3514817 TI - Variation in content and function of non-neuronal cells in the outgrowth of sympathetic ganglia from embryos of differing age. AB - Studies on cellular interactions in the developing nervous system are greatly facilitated by the availability of tissue culture preparations that contain single or combined populations of neurons and non-neuronal cells (NNCs). Using superior cervical ganglia (SCG) from early E15 rats on air-dried collagen, we were able to prepare cultures containing neurons along with Schwann cells (SCs) as the only NNC type present without the use of antimitotic treatment and cultures containing only neurons, following brief antimitotic treatment. Light microscopic observation of E15 outgrowth showed a uniform population of flattened cells, unlike that of E20 cultures, which contained a mixture of spindle-shaped and flattened cells. Autoradiograms following [3H]thymidine administration to E15 cultures revealed a striking gradient of nuclear labeling: Only a few cells were labeled near the explant and nearly all cells were labeled at the growth front. This was in marked contrast to E20 cultures, in which nuclei were labeled throughout the outgrowth. The conclusion that the labeling gradient is explained by the presence of SCs without other NNC types in E15 cultures was confirmed by immunocytochemical studies. Anti-laminin antibodies stain only those extracellular matrix components related to the SC surface, whereas anti fibronectin antibodies stain fibroblast-related components (Cornbrooks et al., 1983a). Anti-laminin antibodies stained cell surfaces in both E15 and E20 outgrowth. E15 outgrowth did not stain with anti-fibronectin antibodies although marked staining was obtained in E20 cultures. Electron microscopy confirmed the presence of only SCs in E15, and of both SCs and fibroblasts in E20 outgrowth. Thus, it appears that there is a narrow developmental window in which the ganglia contain neurons and SCs but relatively few fibroblast components; cultures prepared from ganglia at this stage form outgrowth containing only neurites and SCs without antimitotic treatment. Surprisingly, neither SC ensheathment nor SC basal lamina formation was normal in E15 and E20 outgrowth. When either E15 or E20 SCG SCs were transplanted onto dorsal root ganglion neurons free of endogenous SCs, however, the sensory neurites were typically ensheathed or myelinated and basal lamina appeared 9 d later, identifying the SCG NNCs as functionally competent SCs.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3514818 TI - Migration of neuroblasts along preexisting axonal tracts during prenatal cerebellar development. AB - During prenatal development of the cerebellum in rats, a secondary stem cell layer, the external granular, or germinal, layer (EGL) develops at the pial surface of the cerebellar anlage. The EGL cells arise in a region at the caudolateral margin of the fourth ventricle, and the cells migrate over the surface of the developing cerebellum. A key question is how this migration is guided. We have investigated the possible role of the extracellular matrix protein, fibronectin, and find none present in the EGL during the migration. Instead, we find that the EGL neuroblasts migrate in close contact with axons that are present prior to the onset of migration. It appears that these axons serve as the substrate for EGL neuroblast migration and that axonal guidance of cell migration may be a third general mechanism to be added to the previously studied guidance by glial processes and extracellular matrix. PMID- 3514819 TI - Dumas and the controversy about the origin of animal fat. PMID- 3514820 TI - Effects of maternal dietary intake on human milk composition. AB - The composition of human milk can be affected by the diet consumed by the lactating woman. The influence of the maternal diet on milk composition varies in magnitude between nutrients; for some nutrients no effect at all has yet been documented. Concentrations of fatty acids, fat-soluble and water-soluble vitamins in milk are, in general, significantly affected by the levels of these nutrients in the diet. Protein concentration may be affected under some conditions, although the magnitude of this change appears relatively limited. Lactose, mineral, trace element and electrolyte concentrations seem comparatively resistant to varying maternal intakes. Although there has been significant progress in this research area in the past decade, many early studies are difficult to interpret due to limitations in the study design and analytical methods. This review demonstrates a distinct need for carefully controlled studies on the effects of both nutrient deficiencies and supplements on milk composition. Interactions among nutrients, homeostatic mechanisms and energy balance (weight loss) are factors that need to be studied further. Information from such research will suggest strategies for nutrition intervention in areas of poor nutrition and provide dietary guidelines for lactating women. PMID- 3514821 TI - The detection of IgA-reticulin antibodies and their incidence in patients with recurrent aphthae. PMID- 3514823 TI - Stabilization of the augmented atrophic mandible with mini-plates. PMID- 3514822 TI - Titanium plasma-sprayed (TPS) screw implants for the reconstruction of the edentulous mandible. AB - The Titanium Plasma-Sprayed Swiss Screw Implant System is described, with a discussion of preoperative patient evaluation, and implantation and prosthetic techniques. The results in 484 patients in whom these implants were placed in four countries are summarized. PMID- 3514824 TI - An investigation into the compatibility of some irreversible hydrocolloid impression materials and dental gypsum products. Part II. A refined discriminatory procedure. AB - Part I of this study considered the ability of alginate and gypsum combinations to reproduce a line on a test block. Part II describes a refined discriminatory procedure in the evaluation of the compatible combinations. Statistical analysis showed this procedure to be consistent, and that it could be expected to be repeatable. On the basis of this analysis, it was found that one alginate was clearly superior to all others, and that it was possible to distinguish a further group of combinations within the group that reproduced the 0.050 mm line. Surface treatment of the alginates by fixing solutions showed that none of the treated materials could be improved to the extent of equating them with the best of the naturally compatible combinations. It is recommended that manufacturers pay more strict adherence to the requirements of the ISO Standard with regard to the availability and recommendation of suitable compatible gypsum products, and also that perhaps the actual Standard should be modified to be more realistic in its demands, and more discriminatory in its evaluation procedure. PMID- 3514825 TI - The application of a duplication technique in post-surgical prosthodontics. AB - In the management of patients with acquired defects of the palate, continuity between immediate and intermediate stages of obturation has always posed a major problem. This is because the intermediate obturator is required as early in the post-surgical phase as possible, consistent with minimum interference to the healing tissues and minimum trauma to the patient. This paper describes a technique which helps to overcome the problem. PMID- 3514826 TI - Occlusal force pattern during chewing and biting in dentitions restored with fixed bridges of cross-arch extension. II. Unilateral posterior two-unit cantilevers. AB - The pattern of axially (perpendicular to the occlusal plane) directed occlusal forces developed during light tooth tapping in habitual occlusion, chewing, swallowing and maximal biting was studied in twelve subjects whose dentitions were periodontally treated and prosthetically restored with cross-arch bridges with unilateral posterior two-unit cantilevers. The measuring devices consisted of four strain-gauge transducers uniformly and bilaterally mounted in pontics of maxillary bridges to represent the posterior (end abutment and distal cantilever respectively) and anterior regions. Thus, the forces could be studied locally in various parts of the dentition simultaneously as well as totally over the entire dentition. The results demonstrated that the distal cantilever unit, on average, was subjected to forces about or less than half of those over the contralateral end abutment unit irrespective of the activity studied. Furthermore, the cantilever forces either equalled or were even significantly smaller than those of the anterior regions. All subjects preferred the end abutment side as the chewing side. When the cantilever side was used as the chewing side, which occurred most infrequently, the bolus was usually located in the anterior region. The mean total chewing force (about 50 N) was only about half of that found in a previous study of subjects supplied with cross-arch bridges with bilateral end abutments (Lundgren & Laurell, 1985). Furthermore, on average only 26% of the voluntary muscular capacity was used during chewing, compared with 37% in the 'bilateral end abutment group' referred to. The reasons for the comparably small forces over the distal cantilever unit and the lower muscular utilization during chewing in cross-bridges with unilateral posterior two-unit cantilevers as well as the implications of the findings for the dimension of such bridge constructions are discussed. PMID- 3514827 TI - Relation of metabolic control to complications in diabetes mellitus. PMID- 3514828 TI - Complexities of intraventricular abnormalities. AB - We identified 59 fetuses and infants with intracranial anomalies over 5 1/2 years. The cases represented heterogeneous diagnostic groups: hydrocephalus with a neural tube defect, hydrocephalus with a specified structural anomaly, hydrocephalus of unspecified or miscellaneous cause, holoprosencephaly, and hydranencephaly. One or more major nonneural tube malformations were present in 19 of 54 cases. Eight of 32 cases had a significant chromosomal abnormality. The rate of survival was poor: 13 of 59 pregnancies were terminated electively before 24 weeks gestation, 10 of 59 infants were stillborn, and 16 of the remaining 38 liveborn infants have died since birth. A prenatal ultrasonographic diagnosis was made in the majority of cases (50 of 59). Diagnostic accuracy of prenatal ultrasound examinations ranged from a high of 90% for hydrocephalus to 33% for holoprosencephaly and hydranencephaly, and a low of 22% for the presence of extracranial malformations. Eleven cases in this series could have been considered potential candidates for in utero treatment of ventriculomegaly; this therapy would have been ineffective or inappropriate in eight of these. We recommend that each case undergo thorough diagnostic evaluation, including ultrasound examination and chromosome studies; that parents be informed of the high frequency of associated anomalies, the poor prognosis regarding survival, and the current limitations of ultrasound diagnostic accuracy; and that in utero treatment of fetal ventriculomegaly seems inadvisable at the present time. PMID- 3514829 TI - Effect of varying inspiratory and expiratory times during high-frequency jet ventilation. AB - Although high-frequency jet ventilation may reduce barotrauma, the optimal ventilator settings at which complications are minimized have not been determined. To develop ventilator strategies applicable to the human infant, we studied six New Zealand rabbits before and after saline lung lavage. Changes in functional residual capacity (delta FRC) and airway pressure gradient (peak inspiratory pressure minus positive end-expiratory pressure) were measured while inspiratory time (TI) and expiratory time (TE) were varied. Frequencies of 120, 240, and 480 cycles per minute and inspiratory to expiratory ratios of 1:1, 1:3, 1:5, and 1:9 resulted in TI that varied from 12 to 250 msec, and TE from 62 to 450 msec. Analysis of variance demonstrated that as TI was shortened, a significantly higher airway pressure gradient was necessary to maintain a constant tidal volume. As TE was shortened, air trapping, as determined from both inadvertent positive end-expiratory pressure and delta FRC, significantly increased. Lung lavage increased the airway pressure gradient at each TI, but decreased air trapping at each TE. At no time did entrainment contribute to the delivered tidal volume. We conclude that a relatively narrow range of TI and TE may be necessary for optimal use of high-frequency jet ventilation to reduce airway pressures and minimize the risk of air trapping. PMID- 3514830 TI - Use of oral vitamin K1 to prevent hemorrhagic disease of the newborn infant. PMID- 3514831 TI - Gastrointestinal enhanced insulin release in response to glucose in newborn infants. AB - The purpose of this investigation was to determine whether or not gastrointestinal (GI) enhanced insulin response occurs in newborn infants soon after birth. Glucose infusion by intravenous or orogastric routes was given to infants during the first 4 days of life, aiming at achieving similar plasma glucose concentrations. Their plasma insulin responses were then compared. Thirty term, newborn infants (10 appropriate for gestational age, 8 small for gestational age, 6 large for gestational age, and 6 infants of diabetic mothers) were studied. With intravenous glucose infusions of 8 mg/kg/min or orogastric infusion of 16 mg/kg/min, the plasma glucose concentrations achieved were similar and approximated 110 mg/dl. Plasma insulin responses were greater in infants receiving glucose via the GI route. The finding was in contrast to our previous data, in which no GI enhancement of insulin response was demonstrated. The present data suggest that in the term newborn infant, GI enhanced insulin release occurs only when a threshold of plasma glucose concentration has been exceeded. It appears that the enteroinsular axis is functional in newborns soon after birth. PMID- 3514832 TI - Pooled pasteurized breast milk and untreated own mother's milk in the feeding of very low birth weight babies: a randomized controlled trial. AB - It has been shown that milk derived from mothers with term infants is not optimal for premature babies. There is also concern about the effect of heat sterilizing breast milk. At Baragwanath Hospital, the majority of mothers remain with and care for their premature babies. Over many years, pooled pasteurized breast milk has been fed to these babies before direct breast feeding is instituted. A study was done to compare feeding pooled pasteurized breast milk and untreated own mother's milk to very low birth weight babies. There was a significantly more rapid weight gain both in terms of regaining birth weight and, from this point, to reaching a weight of 1,800 g when using untreated own mother's milk. This occurred in spite of the fact that there was little difference, especially in terms of energy content, between the two types of breast milk. This was due to the fact that the pooled pasteurized milk was also largely obtained from mothers of premature babies. It is suggested from our data that slower weight gain in the group receiving the pooled pasteurized milk could be due to the pasteurization, which probably destroys heat-labile milk lipase. PMID- 3514833 TI - Mineral homeostasis in very low birth weight infants fed either own mother's milk or pooled pasteurized preterm milk. AB - As part of a randomised controlled study to assess the effect of pasteurization of breast milk on the growth of very-low-birth-weight infants, the longitudinal changes in serum calcium, phosphorus, alkaline phosphatase, 25-hydroxyvitamin D, and bone-gla-protein concentrations were investigated. Infants fed untreated own mother's milk grew more rapidly than those fed pasteurized pooled preterm milk and had higher serum alkaline phosphatase and lower phosphorus values. Serum calcium and 25-hydroxyvitamin D (25-OHD) concentrations were similar in the two groups. Despite the provision of 750 IU vitamin D daily from the 2nd week of life, serum 25-OHD values remained low in a number of infants in both groups, suggesting that either malabsorption of vitamin D or hepatic immaturity might be responsible for the persistently low values. Bone-gla-protein rose significantly after birth and was correlated with alkaline phosphatase values, but not with 25 OHD or phosphorus values. The study supports previous work that indicates that the low phosphorus content of breast milk is probably responsible for biochemical evidence of inadequate bone mineralization and that despite vitamin D supplementation, 25-OHD values do not rise adequately. Thirty-six infants were reexamined between 4 and 11 months after birth. The 25-OHD values had risen significantly in all infants except one who had vitamin D deficiency rickets. PMID- 3514834 TI - Puppet therapy with pediatric bone marrow transplant patients. PMID- 3514835 TI - Fragile-X syndrome: diagnosis and research. PMID- 3514836 TI - The multicenter trial of cryotherapy for retinopathy of prematurity. PMID- 3514837 TI - Serum and crevicular fluid concentrations after a single oral dose of metronidazole. AB - Previous studies have shown that metronidazole is an effective chemotherapeutic agent in the treatment of certain types of periodontal disease. The purpose of this study was to assess, over 18 hours, the concentration of the drug in serum and gingival crevicular fluid after a single oral dose. Six female volunteers with gingivitis created by cessation of brushing for 2 weeks, took 250 mg of metronidazole orally. Micropipettes were used to collect 20 microliters of serum and 4 to 5 microliters of gingival fluid hourly for 8 hours, and at the 12th and 18th hours. Samples were assayed with a high pressure liquid chromatograph. Mean drug levels in serum closely matched those reported by Stephen et al. (Br Dent J 7: 313, 1966) with polography. Mean serum drug levels peaked at 6.09 micrograms/ml at the 2nd hour, and mean gingival crevicular fluid drug levels peaked at 3.62 micrograms/ml at the 2nd and 7th hours. The drug was detectable in both fluids for up to 18 hours. Mean serum concentrations remained greater than mean gingival fluid concentrations at all time intervals, though the differences were not significant (P less than 0.05) as determined by a Hoteling's T2 test. Using reported minimal inhibitory concentration values of metronidazole for various periodontopathogens, it was concluded that a single oral dose of metronidazole will deliver potentially inhibitory levels of the drug to the periodontium in serum and in gingival crevicular fluid. PMID- 3514838 TI - Chemotherapeutic agents and periodontal therapy. Their impact on clinical practice. AB - This paper reviews developments in chemotherapeutic agents relative to their impact on clinical practice. These agents are discussed in terms of their effect on plaque, gingivitis, periodontitis, hypersensitive dentin and re-attachment procedures. The paper also provides a perspective on delivery systems. PMID- 3514839 TI - The impact of research on scaling and root planing. AB - The research expanding our knowledge of the periodontally involved root surface and its treatment is reviewed. To improve communication in the clinic and classroom, definitions are suggested for the terms "scaling" and "root planing." The objective and limitations of root planing procedures are discussed. PMID- 3514840 TI - Healing responses to grafting of combined collagen-decalcified bone in periodontal defects in dogs. AB - The feasibility of a new combined collagen gel-autolysed antigen-extracted allogeneic bone implant was tested. Its effect on gaining new attachment in surgically created defects in four dogs was evaluated over 24 weeks. As controls, sites receiving implants of the bone implant alone, nonimplanted and untreated defects were also evaluated. The collagen gel encouraged ingrowth of regenerative tissue-fibroblasts in the early stages of wound healing while the allogeneic bone induced new bone formation. The graft materials were bicompatible, technically manageable and clinically effective. From the present preliminary study, it was evident that the combined autolysed antigen-extracted allogeneic bone-collagen gel implant may offer advantages over the present implant materials and techniques currently used in the treatment of periodontal intrabony defects. PMID- 3514841 TI - Acute necrotizing ulcerative gingivitis. A review of diagnosis, etiology and treatment. AB - Vincent's original description of the fusiform-spirochete nature of acute necrotizing ulcerative gingivitis (ANUG) still remains true today, although much additional insight has been gained regarding the etiology, pathogenesis and treatment of the disease. In addition to the historic association of fusiform and spirochete microbes with ANUG, recent findings have also implicated Bacteroides and Selenomonas species. Possible abnormalities in immunological function, such as altered PMN and lymphocyte responsiveness, may be present. Stress, which has long been known to be associated with the disease, appears to play a role through induction of increased cortisol and catecholamine levels. These chemical mediators respectively may compromise the host immune responses and the gingival microcirculation. Cortisol may also serve as a nutrient source for Bacteroides bacteria. Other predisposing factors to ANUG may include smoking and poor oral hygiene. Treatment modalities involve eliminating or reducing the levels of bacterial pathogens by mechanical and antibiotic means, along with attempts at controlling significant psychological and physical precipitating factors. PMID- 3514842 TI - Human allografts of iliac bone and marrow in periodontal osseous defects. AB - The purpose of this study was to statistically compare the bone regeneration and/or remodeling that occurred in human periodontal osseous defects treated with frozen allogenic, cancellous, iliac bone and marrow grafts, to defects treated by nongrafted flap curettage using a split-mouth protocol. Six patients were selected to participate in the study. These patients exhibited bilateral intrabony periodontal defects that had been refractory to nonsurgical periodontal therapy. Twenty-three intrabony defects were treated by osseous grafting using allogenic iliac bone and marrow and 32 intrabony defects were treated by open debridement procedures. The bony regeneration in each defect treated was evaluated by probing measurements taken from a fixed reference made at the initial surgery and at reentry 1 year after transplantation. The overall results of this study demonstrated that the percentage of osseous regeneration that occurred in intrabony defects treated by allogenic bone and marrow grafting was statistically greater than that which occurred in defects treated by nongrafted flap curettage procedures. PMID- 3514843 TI - Comparative study of the temperature profiles of growth and death of the pathogenic yeast Cryptococcus neoformans and the non-pathogenic Cryptococcus albidus. AB - The temperature profiles of two species of Cryptococcus were compared. The pathogenic Cr. neoformans had a maximum temperature for growth of 39.8 degrees C and the non-pathogenic Cr. albidus, of 30.2 degrees C. The specific growth rates measured in the former were of an order of magnitude higher than in the latter, whereas the Arrhenius plots of the specific thermal death rates did not show a significant difference. PMID- 3514844 TI - Determination of liothyronine and levothyroxine in thyroid preparations by liquid chromatography. AB - Liothyronine and levothyroxine were quantitatively determined in samples of commercial thyroid tablets and bulk powders. Samples were first hydrolyzed using a bacterial protease and then analyzed by high-performance liquid chromatography. Various hydrolysis conditions were investigated. The liothyronine and levothyroxine contents of commercial tablets and bulk powders were found to be approximately 8-11 micrograms and 25-43 micrograms, respectively, per 65 mg of thyroid. The stability of the iodothyronines in thyroid tablets was also investigated. PMID- 3514845 TI - Management of a posterior capsule rupture in planned extracapsular cataract extraction and posterior chamber lens implantation. AB - Management of zonular dialysis and posterior capsule rupture during extracapsular cataract extraction is described. The Heslin gravity cannula is advocated to maintain the normal structure of the anterior segment in a closed chamber technique. Lens cortical material is stripped away using the manual technique described by Gills and McIntyre to avoid vitreous loss. It is then possible to proceed with posterior chamber lens implantation. If vitreous loss occurs, an adequate anterior vitrectomy with an automated vitreous cutter is recommended. A posterior chamber lens implant is preferred if there is adequate capsule to support the lens. PMID- 3514846 TI - Comparison of drug responses in vivo and in vitro in airways of dogs with and without airway hyperresponsiveness. AB - Basenji-greyhound (BG) dogs demonstrate marked nonspecific airway hyperresponsiveness. To assess the possible contribution of an abnormal sensitivity of airway smooth muscle to this phenomenon, we studied the in vitro contractile responses to methacholine and histamine and the relaxant response to isoproterenol in trachealis muscle from five BG dogs with airway hyperresponsiveness in vivo and from five greyhound dogs that served as a control population. Isoproterenol responses were determined against a half-maximal methacholine contraction. Aerosol methacholine concentrations required to produce a 2-fold increase in pulmonary resistance were 0.07 +/- 0.02 (+/- S.E.) mg/ml in BG dogs and 0.67 +/- 0.26 mg/ml in greyhounds; pD2 values for methacholine induced contraction of cervical trachealis muscle were 7.03 +/- 0.11 in BG dogs and 7.50 +/- 0.11 in greyhounds. A significant (P less than .01) negative correlation was found between methacholine sensitivity in vivo and in vitro. Aerosol concentrations of histamine required to produce a 2-fold increase in pulmonary resistance were 0.19 +/- 0.06 mg/ml in BG dogs and 1.44 +/- 0.43 mg/ml in greyhounds; pD2 values for histamine were identical in BG dogs (4.95 +/- 0.08) and greyhounds (5.05 +/- 0.19). Isoproterenol pD2 values were less in the trachealis muscle (cervical) of BG dogs (6.76 +/- 0.10) than in that of greyhounds (7.93 +/- 0.16), but this is probably a consequence of the higher concentration of methacholine needed to contract BG muscles. We conclude that the airway hyperresponsiveness of BG dogs does not reflect an increased sensitivity of airway smooth muscle per se. PMID- 3514847 TI - Interactions between cyclophosphamide and doxorubicin metabolism in rats. II. Effect of cyclophosphamide on the aldoketoreductase system. AB - Under anaerobic conditions, in comparison to liver microsomes obtained from normal controls, liver microsomes obtained from rats pretreated with cyclophosphamide formed significantly less 7-deoxydoxorubicinol aglycone (P less than or equal to .05), whereas the disappearance of doxorubicin and the formation of 7-deoxydoxorubicin aglycone were unaffected. When directly investigated, the reduction of 7-deoxydoxorubicin aglycone to 7-deoxydoxorubicinol aglycone by microsomes was inhibited by cyclophosphamide pretreatment. Liver cytosols from controls and cyclophosphamide-treated rats reduced daunorubicin to daunorubicinol and 7-deoxydoxorubicin aglycone to 7-deoxydoxorubicinol aglycone at the same rate, which indicates the lack of effect of cyclophosphamide pretreatment on the cytosolic aldoketoreductase. The results suggest the existence of a microsomal carbonyl reduction system for anthracycline antibiotics and indicate that cyclophosphamide does affect the metabolism of doxorubicin; in rats, this interaction results only in an alteration of the relative concentrations of presumably inactive metabolites, the 7-deoxyaglycones. The importance of these findings for the pharmacological interaction between doxorubicin and cyclophosphamide in humans remains to be investigated. PMID- 3514848 TI - Differential effects of methacholine and leukotriene D4 on cyclic nucleotide content and isoproterenol-induced relaxation in the opossum trachea. AB - The effects of leukotriene D4 and methacholine on cyclic nucleotide content and isoproterenol-induced relaxation were examined in the isolated opossum trachea. Although leukotriene D4 (-log EC50 = 6.70) was a more potent contractile agent than methacholine (-log EC50 = 5.78), the maximal response to leukotriene D4 was only 65% of the maximum response to methacholine. Contraction of tracheal strips with leukotriene D4 was accompanied by a 3-fold increase in cyclic GMP accumulation. Methacholine-induced contraction was not associated with an increase in cyclic GMP. Neither agent altered basal cyclic AMP content. Additional experiments were carried out to examine functional inhibitory interactions between bronchoconstricting and bronchodilating pathways. In these studies, cumulative isoproterenol concentration-response curves were constructed in tracheal strips contracted with three different concentrations of methacholine and in tissues contracted with three corresponding equieffective concentrations of leukotriene D4. Although the relaxant response to isoproterenol decreased as tissues were contracted with higher concentrations of either agent, the inhibitory effect of methacholine on isoproterenol-induced relaxation was much greater than the inhibitory effect of leukotriene D4. Previous studies from our laboratory suggested that a potential explanation for the greater inhibitory effect of methacholine on the mechanical response to isoproterenol was that methacholine may inhibit isoproterenol-stimulated cyclic AMP accumulation whereas leukotriene D4 may not. However, neither methacholine nor leukotriene D4 inhibited isoproterenol-stimulated cyclic AMP accumulation in the opossum trachea. The results of this study indicate that the sensitivity of airway smooth muscle to beta adrenoceptor agonists is influenced both by the initial contractile state of the tissue and by the type of agent used to induce tone. PMID- 3514850 TI - Some rehabilitative considerations for future speech-processing hearing aids. AB - Improvements in speech-recognition and speech-processing technology promise eventual ways of assisting the hearing impaired by automatically enhancing the audibility of critical speech segments or distinctive features. Some results of applying enhancement techniques are summarized and procedures are proposed for selecting the speech sounds requiring enhancement, the degree of amplification, and the training that hearing-impaired listeners might need. PMID- 3514849 TI - Bayliss-Starling memorial lecture (1985). Reminiscences of a physiologist, 50 years after. PMID- 3514851 TI - The composite/sealant restoration. Five-year results. PMID- 3514852 TI - Tissue displacement methods in fixed prosthodontics. AB - The various methods to accomplish gingival displacement have been described. The techniques have been noted and their relative advantages and disadvantages summarized. The practicing dentist can use this review to make better informed decisions regarding the method he or she chooses for the treatment of a particular patient. PMID- 3514853 TI - A single-appointment technique for reuse of a crown after tooth fracture. AB - A single-appointment technique for the reuse of an existing crown, the margins of which are intact after tooth fracture, has been presented. Composite resin used in conjunction with a dentin bonding agent serves as a core and cement sealer. Para Posts or TMS pins and undercut areas in tooth structure are used for retention. PMID- 3514854 TI - Resistance to cusp fracture in class II prepared and restored premolars. PMID- 3514855 TI - Effect of metal surface treatment on ceramic bond strength. AB - This study indicates that the unaltered specimens of both alloys produced the lowest bond values; for the gold-palladium alloy, a short degassing period (manufacturer's recommendation) and a 10-minute degassing period resulted in significantly lower bond strengths than those observed with the aluminum oxide and the steam cleaning treatments; and all treatments of the silver-palladium alloy gave comparable bond strengths to that obtained with the manufacturer's recommendation for surface treatment. Because the simplified methods gave equivalent or higher bond strength values than the manufacturer's recommendations, and because of the time saving, we recommend the following procedures for the porcelain-alloy systems tested: After casting and investment removal, use an abrasive to remove casting irregularities and to modify or correct the surface that will receive porcelain. Create a uniform matte finish on the surface that is to receive porcelain by pressure blasting with 50 micron aluminum oxide particles, or steam clean the surface for 30 seconds, or both. Proceed with opaquing. PMID- 3514856 TI - Accuracy of addition silicones as a function of technique. AB - Both addition and condensation silicones produced stone dies that were larger in diameter and shorter in height than the tooth preparation. For both materials, there was little change in the distance between stone die preparations compared with the standard. The most significant difference between types of silicone was that condensation silicones produced significantly shorter dies (-0.24% to 0.37%) than addition silicones (-0.08%). Among addition silicones, Cinch produced more than twice as much vertical change (-0.16%) than the other three products ( 0.06%). Since castings made from a short die will not seat completely on the prepared tooth, these results support the use of three of the four addition silicones tested. The same accuracy of impressions was achieved for all techniques (that is, putty/wash, single mix, and double mix) when addition silicones were used, whereas the putty/wash technique produced the most accurate dies for the condensation silicones. The custom tray produced dies that were much more accurate in vertical dimensions (-0.03%) than the stock trays (-0.15% to 0.21%). Thus the custom tray is the impression tray of choice, even for addition silicones, which produce relatively little polymerization shrinkage and are dimensionally stable. PMID- 3514857 TI - Effect of zinc oxide-eugenol on shear bond strengths of selected core/cement combinations. PMID- 3514858 TI - Comparison of four techniques for the cementation of posts. AB - Four techniques for the cementation of cast post restorations were compared in extracted single-rooted teeth. The techniques used were the lentula spiral, endodontic explorer, paper point, and direct post application. Evaluation was based on the presence of voids in the cement and retention of the post. The lentula spiral technique was performed without voids. The other techniques produced voids in increasing numbers in the following order: the endodontic explorer, direct application, and the paper point. The voids were commonly located along the shaft of the post, but there was no correlation between the number of voids and the retention of the posts. PMID- 3514859 TI - Removal of silver points and fractured posts by ultrasonics. AB - The ultrasonic principle can be used for the removal of intact or fractured cemented silver points and posts. The rationale of removal and a specific technique was presented. PMID- 3514861 TI - Behavior of wrought wire clasps after repeated permanent deformation. PMID- 3514860 TI - Interalar width as a guide in denture tooth selection. AB - This study was undertaken to determine the relationship of the IAW, measured between at the widest dimension of the alae of the nose, and two other measurements of maxillary anterior teeth. The other measurements, both of which are significant in the selection and arrangement of artificial teeth used in complete dentures, were the ICTW and the ARCD measured from the distal surface of the maxillary canine on one side of the arch to the distal surface of the canine on the opposite side of the arch. No distinction was made between either the sex or the age of the subjects. The mean ICTW of 35.35 mm was 3% greater than the mean IAW of 34.28 mm. The mean ARCD of 44.85 mm was 31% greater than the mean IAW of 34.28 mm. This mean ARCD compares favorably (less than 1 mm difference) with a constructed ARCD of 45.8 mm from a tooth dimension study by Shillingburg et al. The ARCD was 44.85 mm. This measurement had not been made in the previous study examining the relationship of interalar distance to ICTW. When the IAW was plotted against the intercanine cusp tip width, a fairly strong correlation coefficient of 0.413 was exhibited. A weaker but definite correlation coefficient of 0.217 was observed when the interalar width plotted against the circumferential arc distance from distal surface to distal surface of the maxillary canines. PMID- 3514862 TI - A fixed prosthodontic technique for mandibular osseointegrated titanium implants. AB - A detailed technique has been presented for the fabrication of a fixed prosthesis supported by osseointegrated titanium implants. The fixed prosthodontic technique is based on the original Swedish procedure. Several new dental products have been added, and some refinements in technique have been made in an effort to consistently produce a fixed prosthesis that fits, functions, and satisfies today's esthetically conscious patient. Branemark's tissue-integrated prosthesis (TIP, Bofors Nobelpharma, Inc.) is the only dental implant system with two decades of high-quality longitudinal clinical experience. A fixed prosthesis supported by osseointegrated implants offers a treatment modality that is predictably successful (Fig. 21). PMID- 3514863 TI - Modified single and short-span restorations supported by osseointegrated fixtures in the partially edentulous jaw. PMID- 3514864 TI - The regenerative potential of the periodontal ligament. AB - The current decline in the incidence of dental caries indicates that patients will retain most of their dentition. Reconstruction or regeneration of the entire attachment apparatus, including the periodontal ligament, cementum, and bone, is an attainable therapeutic goal. Clinical treatments designed to reattach connective tissue to exposed root surfaces commonly result in the formation of a long junctional epithelial attachment. This attachment is probably not an effective barrier to bacterial toxins and may allow recurrent pocket formation. To enhance reattachment of connective tissue, root-conditioning agents have been used but their clinical efficacy is questionable. Restoration of destroyed alveolar supporting bone by means of allogenic and autogenous bone-grafting materials has been recommended, but these procedures do not restore the cementum and PDL. Attempts to promote regeneration of the entire attachment apparatus have included clinical studies that used mechanical means to promote repopulation of affected root surfaces by periodontal ligament fibroblasts and prevent contact of epithelial or gingival connective tissue cells. Results thus far have been encouraging, but the practicality of these techniques may be limited. However, these studies have demonstrated that if only PDL cells contact the root surface during healing, a normal PDL can re-form. Dental follicle tissue is capable of inducing the formation of cementum-like structures and is clearly the cell population responsible for cementum and PDL formation. Recent research has demonstrated that the dental papilla probably shares the same inductive capabilities as the dental follicle.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3514865 TI - Relating denture teeth to the occlusal plane. PMID- 3514867 TI - Dental surveyor preventive maintenance. PMID- 3514866 TI - Temporary replacement of missing maxillary incisors. AB - A technique has been described in which a polycarbonate crown form was used as a temporary replacement for a missing central incisor. As with the other techniques of temporary replacement using acid etching, little chair time is required for the procedure. Additional advantages of this technique are that polycarbonate crown forms are inexpensive and readily available in most dental offices, and filling the crown form with composite resin and opening up the embrasures allows maximum bulk of resin at the connector surface without encountering the staining problems associated with composite resin pontics. PMID- 3514868 TI - Waxing crowns using acrylic resin copings. PMID- 3514869 TI - Relative shear bond strengths of luting media with various core materials. PMID- 3514870 TI - Volumetric shrinkage of a porcelain suspended in wax technique. PMID- 3514871 TI - Accuracy of a hydrophilic irreversible hydrocolloid/silicone impression material. PMID- 3514872 TI - The effect of sintering temperature on the dimensional stability of a new ceramic coping. PMID- 3514873 TI - Effect of die spacer on the seating of complete cast gold crowns with grooves. AB - Fifty crowns were constructed with an indirect technique for a standardized Ivorine tooth preparation to determine whether casting relief would improve the seating of complete cast crowns with zinc phosphate cement. The variables were two grooves in the preparations and die spacer casting relief of approximately 20 to 40 micron. The tooth preparations of two groups had no grooves, but castings were made with internal relief for only one group. Three groups had buccal and lingual grooves in the preparation. One group had no relief, a second group had complete relief, and a third group had relief but not in the grooves. The discrepancies noted before and after cementation of the castings were measured. The average discrepancy for each group and the significance between groups was determined. Results of this study demonstrated the following. Die relief significantly improved the seating of complete cast-gold crowns with or without grooves. Omitting die spacer from grooves did not reduce the benefits of relieving the remainder of the die. Partial internal relief was better than no relief. The grooves did not disrupt seating when die spacer application was complete or specifically omitted from the grooves alone. PMID- 3514874 TI - Comparison of three epoxy die materials. AB - Sixty MOD inlay and 60 complete crown castings were fabricated on three epoxy die materials. The castings were evaluated with a specific criteria for fit, retention, and margin adaptation. Of the three materials tested, the castings fabricated on the Unitek die material had consistently higher ratings on the master die with the exception of unacceptable ratings in retention for the MOD inlay. PMID- 3514875 TI - Spatulation methods and porosities in investments and impression material. PMID- 3514876 TI - Effect of positional loading of three removable partial denture clasp assemblies on movement of abutment teeth. AB - Tests demonstrated that the degree of movement of the abutment tooth for a distal extension base using three different clasp designs was a function of the location of loading. Thus, the null hypothesis, there is no significant difference in the degree of movement of the abutment tooth around the axis of rotation as a function of the position of loading, has been demonstrated to be invalid based on the data obtained in this investigation. PMID- 3514877 TI - The effect of chewing movements on changing mandibular complete dentures to osseointegrated overdentures. PMID- 3514878 TI - Use of magnets for staple mandibular implants. PMID- 3514880 TI - Expediting the fabrication of a nickel-chromium casting. PMID- 3514879 TI - Phosphoric acid concentration: enamel surface loss and bonding strength. PMID- 3514881 TI - Light-activated composite-amalgam copings for overdentures. PMID- 3514882 TI - A method to eliminate trapping air in the palate while making impressions. PMID- 3514883 TI - Scanning electron microscopic evaluation of techniques to extend deficient cast gold margins. PMID- 3514884 TI - Multiple cast post and cores for severely worn anterior teeth. AB - A technique has been presented to simplify the fabrication of multiple direct post and core patterns. When combined with techniques for indirect provisional restorations, this technique merely requires the fabrication of an additional plastic template to form the direct core patterns. PMID- 3514885 TI - In vitro microleakage of a new dental adhesive system. PMID- 3514886 TI - Resisting the curing contraction with adhesive composites. AB - Adhesive dentistry is dependent on new materials, improved cavity form, and technique of application. PMID- 3514887 TI - The effect of using recast metal on the bond between porcelain and a gold palladium alloy. PMID- 3514888 TI - Role of manganese in alloy-porcelain bonding. PMID- 3514889 TI - Surface treatment of nonprecious alloys for adhesion-fixed partial dentures. PMID- 3514890 TI - Measurement of coating agents used for surface protection of stone dies. PMID- 3514891 TI - Magnetizable abutment crowns for distal-extension removable partial dentures. AB - A study of the retention and load-distributing characteristics of bilateral distal-extension dentures with magnetizable abutment crowns revealed the following findings: Comparable retention was obtained with the horizontal and oblique pedestals. Decreased retention was noted when there was space between the magnet and pedestal. The retention values were substantially higher than reported values for the I-bar retainer. For the space and no-space situations, the horizontal pedestal design provided better stress results than the oblique design. Better stress-distributing properties for horizontal and oblique pedestals were obtained with the presence of a space between the magnets and pedestals. Of all the designs tested, the horizontal pedestal with a space demonstrated the best load-transmission characteristics. PMID- 3514892 TI - Pin-modified facial inlay to enhance retentive contours on a removable partial denture abutment. AB - A procedure has been described that will, in many instances, eliminate the necessity for a full veneer crown. The periodontal health of the tooth is not compromised because the accentuated contour is generally remote from the gingival tissues. A single pin will assure sufficient retention and resistance to displacement for the small inlay if the walls of the preparation offer reasonable resistance form. PMID- 3514893 TI - An alternative method for fabrication of a closed hollow obturator. PMID- 3514894 TI - Noninvasive technique for mandibular subperiosteal implant: a preliminary report. PMID- 3514895 TI - Gingival margin finishing on castings: current teaching. PMID- 3514896 TI - Dimensional accuracy of duplicate dentures prepared by different methods. AB - The production of a duplicate denture demands a high degree of perfection to maintain dimensional accuracy of the duplicate denture. Duplicate dentures were made by four methods in order to investigate the dimensional accuracy in relation to a master denture. Replicas made from modeling wax (all-wax replica or acrylic resin base-wax teeth replica) demonstrated better dimensional accuracy compared with the all-acrylic resin replicas. It is well known that modeling wax used alone as a temporary denture base is an unsatisfactory material. The inherent shortcomings of the material may be overcome if dentists and patients make their assessment of the duplicate as quickly as possible in the mouth. The other alternative may be the production of a duplicate denture with an acrylic resin base and modeling wax teeth. PMID- 3514897 TI - The influence of processing variables on dimensional changes of heat-cured poly(methyl methacrylate). PMID- 3514898 TI - The effect of retention grooves in acrylic resin teeth on tooth denture-base bond. AB - A progressive shear compressive load was applied at an angle to the lingual surface of acrylic resin teeth bonded to denture base acrylic resin. No statistically significant advantage was derived by preparing retention grooves of different shapes in the ridge lap surface of the denture teeth. PMID- 3514899 TI - The use of a central bearing device for the dentulous patient. AB - The use of the central bearing device has been described. This method of making accurate centric relation registrations has application in the treatment of dentulous patients with few or no posterior contacts. PMID- 3514900 TI - Cement relief for cast dowel-cores under existing crowns. PMID- 3514902 TI - An improved procedure for the purification of Trypanosoma cruzi (Chagas, 1909) metacyclics from the insect vector. AB - We have developed an improved procedure for isolating and purifying the metacyclic trypomastigote form of Trypanosoma cruzi from infected Triatoma infestans. The procedure was simple, did not require time-consuming removal of the insect gut, and gave a good recovery of metacyclics. Purification involved centrifugal flotation of the parasites in Percoll followed by diethylaminoethyl cellulose column chromatography. The resulting purified metacyclics exhibited no loss of infectivity when assayed in mice as compared to metacyclics taken directly from the insects. PMID- 3514901 TI - Effects of mitochondrial inhibitors on intraerythrocytic Plasmodium falciparum in in vitro cultures. AB - Malarial parasites infecting mammalian hosts are considered to be homolactate fermentors at their asexual intraerythrocytic developmental stage; however, existing ultrastructural and biochemical evidence suggest that their acristate mitochondria could be involved in energy metabolism. In the present study, inhibitors of mitochondrial function including compounds which act on NADH and succinate dehydrogenases, electron transport and mitochondrial ATPase, as well as uncouplers, were found to inhibit the growth and propagation of the human parasite Plasmodium falciparum in in vitro cultures at concentrations that specifically affect mitochondrial functions. Direct measurement of parasite protein and nucleic acid synthesis in synchronized cultures showed that throughout the parasite life cycle both processes were inhibited, the latter process being more sensitive. These results strongly suggest that intraerythrocytic malarial parasites require mitochondrial energy production. PMID- 3514903 TI - In memoriam Erich O. Scholtyseck (1918-1985). PMID- 3514904 TI - An immunofluorescent study of the microtubule organization in Trichomonas vaginalis using antitubulin antibodies. AB - The flagellated protozoon Trichomonas vaginalis, parasite of the human urogenital tract, possesses a well developed microtubule system organized in highly differentiated structures. We have shown by immunoblotting that monospecific anti sheep brain tubulin antibodies are able to react with the microtubular tubulin of T. vaginalis. These antibodies were used to study the microtubular system of T. vaginalis both in interphase and mitosis by indirect immunofluorescence. The interphase microtubular pattern, characterized by an axostyle, a pelta, four anterior flagella, and a recurrent flagellum, displayed remarkable changes at the onset of mitosis: the axostyle disappeared, and two pole bodies connected by a short spindle became evident; chromosomal fibers arose while pole-to-pole fibers elongated. The last phases of mitosis were marked by the disappearance of chromosomal fibers, the appearance of two small axostyles, and the depolymerization of the pole-to-pole bundle. At the end of mitosis, the normal interphase microtubule pattern was observed. PMID- 3514905 TI - Irwin Mandel: public health dentist par excellence! PMID- 3514906 TI - Significance of cone biopsy margins in management of patients with cervical neoplasia. PMID- 3514907 TI - Organizing a search for an academic administrator. AB - The search for new administrators in complex systems is an important activity. The special requirements of academic organizations, particularly those with health centers, present some unique considerations that can confound this important and difficult process. Typically, national searches attract a sizable candidate list composed of persons with diverse backgrounds and experiences, and a committee is empowered to sort through their qualifications. A critical step in the planning of each search is the development of a process that allows participatory decision making while not requiring too much time. Too often the search becomes an unmanageable activity that confuses the searchers and frustrates the administration. A seven-step process has proven successful for use by committees to attract and sort through written candidate applications, to agree upon a preliminary ranking of candidates and to reach a consensus on a final list of recommendations. The process could be applied in almost any organizational setting. PMID- 3514908 TI - Three-day treatment with butoconazole vaginal suppositories for vulvovaginal candidiasis. AB - Butoconazole is a new imidazole, effective as therapy for vulvovaginal candidiasis for women who prefer solid-type vaginal preparations. The efficacy of three-day administration of butoconazole vaginal suppositories, 100 mg/day, was compared to that of clotrimazole vaginal tablets, 200 mg/day. Patients with culture-proven vulvovaginal candidiasis were randomly assigned to either butoconazole (97 patients) or clotrimazole (88 patients). The percentage of patients with fungal cultures negative for Candida albicans was statistically significantly higher for butoconazole than for clotrimazole (92 vs. 74, P = .003) at the eight-day posttreatment examination. At the 30-day posttreatment examination the cure rate was still higher for butoconazole (63%) than for clotrimazole (56%), but the difference was not statistically significant. Complete clinical relief was achieved in 81% of patients in both treatment groups achieved in 81% of patients in both treatment groups at the first follow-up examination, while at the second follow-up examination the clinical cure rate was 77% for butoconazole and 69% for clotrimazole. No systemic side effects were reported. PMID- 3514909 TI - In utero diagnosis of intracranial hemorrhage resulting in fetal hydrocephalus. A case report. AB - An intracranial hemorrhage resulted in fetal hydrocephalus. Antepartum fetal heart rate monitoring instituted for decreased fetal activity led to this intrauterine diagnosis. The infant had no neurologic delay at 16 months of age. PMID- 3514910 TI - Ectopic pregnancy. A review of the etiologic factors. AB - Ectopic pregnancy was experienced by 103 women in our practice, for a total of 123 such pregnancies. These patients' histories were reviewed in an attempt to identify certain risk factors. The ectopic pregnancies were diagnosed prior to rupture in 73% of cases. Patients were followed for subsequent reproductive function. Among the 96 who were not sterilized during or after surgery for ectopic pregnancy, intrauterine pregnancy was achieved by 34, while 15 had at least one additional ectopic gestation. Risk factors were identified. Different surgical approaches to the affected tube influence future reproductive function and repeat ectopic gestation. PMID- 3514911 TI - Development and therapeutic role of synthetic prostaglandins in peptic ulcer disease. PMID- 3514912 TI - Synthesis and inhibition of human acrosin and trypsin and acute toxicity of aryl 4-guanidinobenzoates. AB - The aryl 4-guanidinobenzoate, 4'-nitrophenyl 4-guanidinobenzoate (NPGB), is a potent inhibitor of sperm acrosin, an enzyme with an essential function in the fertilization process. NPGB prevents fertilization in a number of animal species and is a good lead compound for the development of contraceptive agents. In order to assess the efficacy of other aryl 4-guanidinobenzoates as acrosin inhibitors, 24 of these compounds were synthesized. Their inhibitory activity toward human acrosin was determined and compared with their activity toward human pancreatic trypsin in order to assess whether inhibitor sensitivity differed between these similar enzymes. Nine of the inhibitors were synthesized from phenols approved by the FDA for therapeutic use. The acute toxicity of these inhibitors in mice was determined and compared to that of nonoxynol-9, the most commonly used active ingredient in today's vaginal contraceptive preparations. All of the compounds proved to be potent inhibitors of human acrosin although 3 orders of magnitude difference were observed between the most and least effective inhibitors. Little specificity was present in regard to their inhibition of acrosin and trypsin. All the aryl 4-guanidinobenzoates synthesized from FDA-approved phenols were less toxic than nonoxynol-9, and it is concluded that these 4-guanidinobenzoates are of interest for further development and testing as nonhormonal contraceptive agents. PMID- 3514913 TI - Substituted isatoic anhydrides: selective inactivators of trypsin-like serine proteases. AB - Derivatives of isatoic anhydride were prepared and tested as inhibitors of serine proteases. A number of isatoic anhydrides with positively charged substituents irreversibly inactivated several trypsin-like enzymes and preferentially inactivated trypsin over chymotrypsin. Further selectivity was obtained by introduction of an aromatic group on the N-1 position of isatoic anhydride. 7 (Aminomethyl)-1-benzylisatoic anhydride was prepared and was a selective inactivator of thrombin; thus it is possible to prepare derivatives of isatoic anhydride that are highly enzyme selective without attaching peptide recognition structures. PMID- 3514914 TI - Insanity legislation. AB - The McNaughton Rules, which are used when someone pleads insanity at the time of a homicide, are out of date and unsatisfactory. Suggestions have been made about how the insanity defence can be reformulated. The preference of a defence of diminished responsibility means abandoning an ancient and humane principle of not convicting those who are so mentally disordered as not to be responsible for their actions. There is a need for Parliament to consider changes to the law both to prevent the mentally disordered being sent to prison inappropriately, and because the Mental Health Act 1983 has not taken account of rare cases where an offender such as an epileptic might be found legally insane but not mentally disordered. PMID- 3514915 TI - The origins of the Homicide Act 1957. PMID- 3514916 TI - Charges by residents and faculty physicians in a university hospital pediatric practice. AB - The impact of pediatric residents on total patient charges generated in the outpatient pediatric practice of a university hospital was evaluated. Data were collected on 450 consecutive visits covered by two types of third-party category payers, Medicaid and private insurance. Charges were tabulated for visit charges, office-based procedures, and hospital laboratory and radiology tests. Average charges generated for visits to residents were greater than for visits to faculty pediatricians. The difference was attributable to the higher number of hospital laboratory and radiology tests ordered by residents. Patients' age, economic status, and diagnosis did not explain the more frequent use of these tests. These results emphasize that teaching hospitals need to develop specific methods to decrease unnecessary laboratory and radiology tests in pediatrics residency programs. The methodology used in this study provides a means for estimating the economic impact of resident education on the patients they serve. PMID- 3514917 TI - A new immuno quantitative method by latex agglutination--application for the determination of serum C-reactive protein (CRP) and its clinical significance. AB - We developed a new method for the determination of CRP by latex immunoassay which measures the increase in optical density as a result of latex agglutination due to antigen-antibody reaction. This latex agglutination photometric immunoassay can be used for quantitative analysis of various biological substances. We have established the best conditions for CRP determination for the instrument employed here (LA system) which allows rapid and accurate to low concentration measurement. The measurement range of the system is from 0.01-3 mg/l (non-diluted method), which when compared to the lower detection limit of RIA, 3 micrograms/l, it has the same order of magnitude. It is more sensitive than radial immunodiffusion which has the lower detection limit of 2 mg/l and has the similar value to that of radio-electroimmunodiffusion, 10 micrograms/l. Furthermore, the usual method used in the clinical laboratories, the capillary microprecipitation method, has the lower detection limit of approximately 10 mg/l. The method presented here is adequately sensitive to measure the low concentration of CRP among healthy individuals which has not been possible except by using RIA. The normal value derived from 106 healthy individuals by this method is found to be 0.2 +/- 0.2 mg/l (mean +/- 2SD). PMID- 3514918 TI - A new 3-D reconstruction scheme applied to the 50S ribosomal subunit of E. coli. PMID- 3514919 TI - Measurement of the optical thickness of transparent tissue layers. AB - The method of Duc de Chaulnes was employed to determine the mechanical and optical thickness, as well as the refractive index, of transparent tissue layers in living specimens. To this end the reproducible accuracy of the method and its dependence on the adjustment in focusing and on the numerical aperture of the objective was evaluated on test specimens using the procedures of transmitted light, phase-contrast (PC), and differential interference contrast (DIC) microscopy. The best working conditions were then applied to the actual measurements. PMID- 3514920 TI - Adverse drug reaction reporting by Mississippi physicians. PMID- 3514921 TI - Management of ectopic pregnancy. PMID- 3514922 TI - Conformation of the DNA undecamer 5'd(A-A-G-T-G-T-G-A-T-A-T) bound to the single stranded DNA binding protein of Escherichia coli. A time-dependent transferred nuclear Overhauser enhancement study. AB - A time-dependent transferred nuclear Overhauser enhancement study of the conformation of the single-stranded DNA 11mer 5'd(A-A-G-T-G-T-G-A-T-A-T) bound to the single-stranded DNA binding protein of Escherichia coli (SSB) is presented. It is shown that the conformation of the bound 11mer is that of a right-handed B type helix similar to that of the free 11mer. The observation of internucleotide transferred nuclear Overhauser enhancements for every base step excludes the possibility of intercalation by aromatic protein residues. In addition, it is shown that the effective correlation time of the bases (80 ns) corresponds to that of a complex of molecular weight approximately 170,000, containing two SSB tetramers. The sugars, on the other hand, exhibit a shorter effective correlation time (40 ns), indicating the presence of internal motion. This suggests that the bases are anchored to the protein surface, possibly by hydrophobic interactions, whereas the sugar-phosphate groups are directed outwards towards the solvent. PMID- 3514923 TI - Interaction of the Escherichia coli HU protein with DNA. Evidence for formation of nucleosome-like structures with altered DNA helical pitch. AB - Nuclease digestion studies of DNA bound to the histone-like protein HU show that cuts in each strand of the DNA double helix are made with a periodicity of 8.5 base-pairs. By contrast, similar digestions of DNA in eukaryotic nucleosomes show a repeat of 10.4 base-pairs. This and other results (including circular dichroism studies) are consistent with the proposal that the pitch of the DNA double helix in the HU complex is reduced from a repeat length of 10.5 to 8.5 base-pairs per helical turn. Simultaneously, the DNA in the HU-DNA complex containing two dimers of HU per 60 base-pairs has its linking number decreased by 1.0 turn per 290 base pairs. From these changes it is calculated that HU imposes a DNA writhe of 1.0 per three to four monomers of HU. The results suggest a model in which DNA is coiled in left-handed toroidal supercoils on the HU complex, having a stoichiometry resembling that of the half-nucleosome of eukaryotic chromatin. An important distinction is that HU complexes can restrain the same number of DNA superhelical turns as eukaryotic nucleosomes, yet the DNA retains more negative torsional tension, just as is observed in prokaryotic chromosomes in vivo. Another distinction is that HU-DNA complexes are less stable, having a dissociation half-life of 0.6 min in 50 mM-NaCl. This last property may explain prior difficulties in detecting prokaryotic nucleosome-like structures. PMID- 3514924 TI - Energy dependent insulin binding, internalization and degradation in isolated cardiac myocytes from normal and diabetic rats. AB - Insulin binding to isolated cardiac myocytes from normal and streptozotocin induced diabetic rats was investigated. We found that at high affinity sites, the maximum numbers of insulin binding sites per cell are 33 000 and 22 000 for normal and diabetic myocytes, respectively with no discernible difference in receptor affinity. However, since the yield of myocytes from the diabetic heart was only 1/3 of the normal heart, it is suspected that the insulin function in the diabetic heart may be significantly lower than that in the normal heart. Chloroquine was found to markedly decrease insulin degradation with concomitant increase in net insulin uptake by isolated myocytes. This suggests that insulin degradation may take place within lysosomes after insulin is internalized. To determine whether internalization of insulin in myocytes is an energy dependent process, insulin binding and subsequent degradation were assessed in cells depleted of ATP by treatment with various metabolic inhibitors (2,4 dinitrophenol, NaF and iodoacetic acid). Depletion of the cellular ATP level resulted in a decrease in both insulin uptake and degradation. In diabetic myocytes, the general relationship between cellular ATP level and insulin uptake and degradation was similar to that found in normal myocytes. However, in diabetic myocytes, the cellular ATP level and insulin uptake were lower, but insulin degradation was greater than in normal myocytes. Insulin uptake by normal and ATP depleted cells at 4 degrees C (16 h) was lower than at 37 degrees C (1 h), while the ATP level was almost the same at both temperatures. This suggests that the internalization of insulin is a temperature as well as an ATP dependent process. PMID- 3514925 TI - Modification of the effects of muscarinic agonists by reversible and irreversible anticholinesterase compounds in the guinea pig atrium. AB - The cholinergic agonists acetylcholine (ACh), carbamylcholine and methacholine were found to be equieffective in reducing the force of left atrial contraction, but to differ in their ability to shorten the action potential duration. The irreversible cholinesterase inhibitor soman had no effect on the actions of the non-hydrolyzable agonist carbamylcholine, but potentiated the actions of ACh. The reversible inhibitor edrophonium both potentiated and antagonized the effects of ACh. It antagonized the effects of carbamylcholine and after atrial cholinesterase was inhibited with soman it also antagonized the effects of ACh. Its anticholinesterase action and inhibitory action at the muscarinic receptor were confirmed in separate studies. Edrophonium is approximately 12 times more potent as an anticholinesterase than it is in blocking the muscarinic receptor. However, some actions of edrophonium cannot be explained in the context of its anticholinergic and antiesterase actions. Thus it increases the force of atrial contraction and antagonizes the negative inotropy due to soman. An inhibitory effect on an outward K+ current may be involved. The difference in the ability of the three cholinergic agonists to shorten the action potential may also be related to differences in efficacy at this K+ channel. PMID- 3514926 TI - Expression of troponin T in atria and ventricles of avian and mammalian hearts. AB - The expression of troponin T in atria and ventricles of adult chicken, rabbit and beef hearts has been studied by two dimensional electrophoresis of soluble extracts from these tissues. The monoclonal antibody, T1/61, has been used to detect the presence of troponin T in the chicken samples. In the chicken only one form of troponin T has been found which is resolved into two spots that probably are due to phosphorylated and non phosphorylated forms. The gels of chicken atria and ventricles are identical with the same patterns, not only of troponin T but also of tropomyosin and myosin light chains. In rabbit and beef the position of troponin T can be located by comparison with the chicken. In the beef it is possible that two forms are present but in the rabbit there appears to be only one. The gels of atria and ventricles of rabbit and beef hearts show differences only in the myosin light chains whereas the expression of tropomyosin is the same. In beef, beta-tropomyosin is found in both tissues. On the evidence of these gels there are no differences in the expression of troponin T or tropomyosin between the atria and ventricles of any of the hearts studied. PMID- 3514928 TI - An approach to curative effect of large autografts on adipose tissue in special parts with third-degree burns. AB - Burns involving face, hand, dorsum of foot and areas around joints are regarded as burns of special parts. Because of the structural characteristics we emphasize the importance of preserving subeschar adipose tissue and using large sheets of skin graft in these parts of body during the resurfacing procedures. Thirty-one cases with 56 sites of deep burns were observed. The results were good. Followup in three typical cases is reported in detail in this article. Preserving subeschar healthy fatty tissue can ensure high graft take rate, early functional recovery, and immediate as well as long-range curative effect. So one must carefully judge the cutting depth of eschar excision. We prefer grafting debrided facial wounds with sheets of skin according to regional units. The minimal width of circular grafts around ankle and wrist is discussed. For wrist, the recommended minimal width is 4 cm; for ankle, it is 5 cm. PMID- 3514927 TI - Relative permeability of nasal, tracheal, and bronchoalveolar mucosa to macromolecules in rats exposed to ozone. AB - Nasal, tracheal and bronchoalveolar injuries resulting from acute ozone exposure of rats were investigated by permeability changes. 99mTc-labeled diethylenetriaminepentaacetate (DPTA) and 125I-labeled bovine serum albumin (BSA) were selectively instilled into localized airway regions of anesthetized rats exposed to 0.8 ppm 03 or clean air for 2 h. Transmucosal transfer of the radiolabeled tracers was detected by counting the radioactivity in blood samples collected at short postinstillation time intervals. Permeability measurements were made on d 0, 1, and 2 after O3 exposure to analyze the extent and persistence of tissue injury in the nasal, tracheal, and bronchoalveolar regions. Normal mucosal permeability was low in nose, intermediate in bronchoalveolar zone, and high in trachea. The O3-related injury, reflected by elevated permeability, was substantial in the trachea and bronchoalveolar zone but was minimal in the nose immediately after the exposure. Abnormal permeability persisted for less than 24 h in the trachea but for more than 24 h in the bronchoalveolar zone. The results are consistent with the properties of O3 of causing greater injury in the smaller airways and the alveolar zone than in the trachea. PMID- 3514929 TI - Cardiopulmonary effects of severe thoracic subcutaneous emphysema. AB - Isolated subcutaneous emphysema appeared to cause significant pulmonary dysfunction in a traumatized child with no demonstrable intrinsic pulmonary injury or disease. We developed an animal model of severe thoracic subcutaneous emphysema to determine whether it alters pulmonary-thoracic compliance such that ventilation-perfusion relationships or cardiac performance are affected adversely. Twelve anesthetized, mechanically ventilated swine were studied. Baseline measurements and calculations included intrapulmonary shunt fraction (Qsp/Qt), total static pulmonary-thoracic compliance, thermodilution cardiac output, systemic and pulmonary arterial pressures, and mean pulmonary arterial occlusion pressure. Measurements and calculations were repeated after each of three consecutive injections of 400 cc of air into the tissue over the sternum. Comparison of the baseline values with those after the injections showed no increase in Qsp/Qt and no change in any other variable (p less than 0.05). We conclude that, in this model, isolated thoracic subcutaneous emphysema does not adversely affect cardiopulmonary function during positive pressure ventilation. PMID- 3514930 TI - Age related cochlear toxicity from noise and antibiotics--a review. AB - Laboratory experimental evidence indicates that there is an age related susceptibility to cochlear damage from noise exposure and ototoxic antibiotics. In some rodents there is a critical period of auditory development during which there is greater vulnerability to such damage and, in some species, noise induced damage is influenced by genotype. Available data from patients are inconclusive in this regard. Further careful studies are indicated in this area. All available evidence emphasizes that caution should be exercised in the use of ototoxic drugs during pregnancy, in neonates, young children, and older people. PMID- 3514931 TI - Observations on the prevalence of ear disease in the Inuit and Cree Indian school population of Kuujjuaraapik. AB - In the last twenty years it has been recognized that hearing loss as the result of middle ear infection and/or noise exposure is a major problem among Canadian Inuit. In the past ten years in the Eastern Canadian Arctic attempts have been made to alleviate the problem and physicians, audiologists and educators have been involved in treatment, training programs and research with varying degrees of success. In the last few years the Quebec Inuit have become more aware of these problems and have asked for assistance. Whatever evolves, Inuit co operation and advice is essential; their cultural identity must be respected if any project is to be successful. In February, 1984, a program outline working paper entitled "Program for Combatting Hearing Disorders in the Inuit Population of Nouveau Quebec" was circulated by Project Nord-Laval University. The goal of the program was "to ensure the integrity of hearing for the Inuit by preventing hearing loss, identifying hearing loss and minimizing the effects of hearing loss." In October, 1984 a Pilot Project involving the school population at Kuujjuaraapik was carried out involving personnel from the Project Nord-Laval University, the Department of Otolaryngology and the School of Human Communication Disorders-McGill University. PMID- 3514932 TI - Sonographic demonstration of prostatic abscess. PMID- 3514933 TI - Sonographic appearance of pelvic extramedullary hematopoiesis. PMID- 3514934 TI - Antenatal diagnosis of frontal cephalocele in a fetus with atelosteogenesis. PMID- 3514935 TI - Sonographic diagnosis of partial Achilles tendon rupture and healing. PMID- 3514936 TI - Normal fetal adrenal gland location. PMID- 3514937 TI - Varied sonographic manifestations of cystitis. AB - In a retrospective study of 90 cases that had both abdominal ultrasound examinations of the bladder and cystoscopy, four cases of proven cystitis were identified. The sonographic appearance of cystitis is varied, depending on the severity of the process, and several manifestations of involvement detectable by ultrasonography are outlined. PMID- 3514938 TI - High-resolution real-time sonography of the adrenal glands: a routine examination? AB - The feasibility of imaging the adrenal glands during routine upper abdominal examinations was studied for 100 consecutive patients, 47 males and 53 females. The mean patient age was 46 years and the mean weight 63 kg. The suprarenal areas were scanned in a slightly oblique frontal plane through the intercostal spaces with the patient recumbent. The right adrenal gland was detected in 92 per cent of the patients, with a mean examination time of less than one minute. Visualization of the left adrenal gland was more difficult and was successful in only 71 per cent, even where additional views in the right lateral decubitus or erect position were added. The mean examination time on the left was 2 1/2 minutes. Complete visualization of the adrenal gland is impossible in one single plane because of the complex shape of the organ, which necessitates multiple contiguous scan planes. In 13 per cent of the visualized adrenals, cortex and medulla could be differentiated. PMID- 3514939 TI - Sonography of the adrenal glands in chronic disseminated histoplasmosis. AB - In this retrospective study, the findings on abdominal sonograms in six patients newly diagnosed as having chronic disseminated histoplasmosis are reported. Five of six patients showed bilateral adrenal gland enlargement that was similar in degree from side to side. The most characteristic feature was the maintenance of a triangular shape in five glands and a cylindrical shape in two glands. Four glands had a nonspecific round or oval shape. All sonographic findings correlated well with the computed tomographic (CT) findings on each patient except that CT detected the one enlarged right adrenal gland not demonstrated sonographically. Abdominal sonography may provide the initial important clue to the diagnosis of chronic disseminated histoplasmosis. PMID- 3514941 TI - Sonographic diagnosis of clubfoot in utero. AB - The in utero sonographic diagnoses of 13 clubbed feet in eight fetuses are reported, and five representative cases are described in detail. The sonographic findings and clinical features of fetal clubfoot are discussed. The prenatal sonographic detection of clubfoot should alert the sonographer to search for other congenital anomalies associated with syndromes involving clubfoot. PMID- 3514940 TI - Fluid in the female pelvis: cyclic patterns. AB - A total of 254 pelvic sonograms were performed on 40 volunteers in order to determine a cyclic pattern, if any, of free fluid in the pelvis in asymptomatic premenopausal women. Free fluid was observed during all phases of the menstrual cycle. The highest percentage of positive-for-fluid sonograms was observed within 5 days preceding onset of menses in both oral contraceptive users and non-oral contraceptive users. The second highest percentage was observed between days 13 and 21 in non-oral contraceptive users. PMID- 3514942 TI - Sonographic demonstration of malabsorption in neonates. AB - A new sonographic pattern is described that has been found in eight infants having syndromes associated with malabsorption. Five infants had hepatobiliary disease and three infants had transient or permanent cow-milk intolerance. In all cases, upper abdominal sonographic examinations revealed hyperechoic tubular and round masses which, most probably, represent small bowel loops filled with malabsorbed milk. Control examinations, before hepatic failure or under corrected diet, showed absence of the pattern. It is believed by the authors that in some ambiguous cases, the finding of this pattern should direct the pediatrician toward syndromes associated with malabsorption. PMID- 3514943 TI - Deep venous thrombosis: detection by probe compression of veins. AB - The sonographic detection of echogenic, soft-tissue mass within the veins of the lower extremities assures the diagnosis of deep venous thrombosis (DVT). However, the sonographic diagnosis remains inconclusive when fresh thrombus and/or artifacts are present within the lumen of the vein. The present study attempts to augment the clinical utility of real-time sonography in the detection of DVT, based on the premise that total obliteration of the vein lumen by probe compression should not be possible in the presence of venous thrombi. Sonography and contrast venography of the lower extremity were performed in 20 patients with clinical suspicion of DVT. The presence of thrombi was confirmed in 14 patients. Probe compression failed to obliterate the lumen of the veins containing thrombi. The authors conclude that the technique of probe compression is useful for rapid and noninvasive detection of venous thrombi. PMID- 3514944 TI - Sonography of traumatic rupture of the bladder: "bladder within a bladder" appearance of extraperitoneal extravasation. PMID- 3514945 TI - Pyocele of the scrotum: sonographic demonstration of fluid-fluid level and a gas forming component. PMID- 3514946 TI - Sonography of the normal and abnormal stomach (excluding hypertrophic pyloric stenosis in children. AB - Prospective sonographic evaluation after water ingestion in 25 normal children aged 2 days to 15 years (mean 6.3 years) demonstrated that normal gastric wall thickness was less than 3 mm. Gastric walls of 5-15 mm thickness were seen in nine of about 6500 children undergoing abdominal sonographic examinations. These nine patients had a variety of unusual diseases, including varioliform gastritis, gastric ulcer, lymphoid hyperplasia, and gastric hamartoma. Previously unreported sonographic appearances were seen. The sonographic examination was instrumental in the detection of five clinically unsuspected gastric lesions and helpful in follow-up in four others. PMID- 3514947 TI - Predictive value of ultrasonography in the screening of non-ascitic cirrhotic patients with large varices. AB - To evaluate the accuracy of ultrasonography in the screening of cirrhotic patients with large varices, the receiver operator characteristic (ROC) curves of the portal, mesenteric, and splenic veins of 215 consecutive non-ascitic patients were plotted in order to select the most indicative optimal threshold. The contribution of respiratory variations of splenic and mesenteric veins was also evaluated. Taking 13 mm as the limit for the normal diameter of the portal vein, 10 and 9 mm for the upper limits of the mesenteric and splenic veins, respectively, and respiratory variations being absent, the positive rates were 91, 88, and 92 per cent and the false-positive rates were 44, 38, and 42 per cent, respectively. The predictive values of a positive test were 0.34, 0.33, and 0.34, respectively, and the predictive values of a negative test were 0.96 for the portal and mesenteric veins and 0.97 for the splenic vein. Because the portal vein is always visible, the portal diameter may be employed in the screening through the presence of large varices in association with the assessment of respiratory variation in the splenic or mesenteric diameter. A cut-off point of 13 mm and the absence of respiratory variations precludes the need for endoscopy in 47 per cent of patients. PMID- 3514948 TI - Sonographic demonstration of lumbar disc herniation. AB - In a limited series of examinations the capability of ultrasonography in the assessment of intervertebral disc herniation by a transabdominal approach is evaluated. Normal anatomical findings on transabdominal spinal sonography are demonstrated. Two cases of disc herniation proved either by operation or lumbar myelography and spinal computed tomography are reported. The potential capabilities and known limitations of ultrasonography in this field are discussed. PMID- 3514949 TI - Sonographic assessment of the endometrium in patients undergoing in vitro fertilization. AB - Sonography has an important role in the care of infertile patients undergoing in vitro fertilization. Unlike the ovarian follicle, sonographic changes in the endometrium during induction have not been extensively investigated. To determine whether changes in endometrial thickness or changes in endometrial texture would predict subsequent pregnancy, a randomized, double-blind review of 320 studies was performed. None of the endometrial patterns nor any particular change from one pattern to another during induction was predictive of subsequent pregnancy. Although differences in endometrial thickness between non-pregnant and subsequently pregnant patients were noted, on an individual basis, endometrial thickness was not a useful predictor. PMID- 3514950 TI - Sonographic detection of fetal intraperitoneal fluid. AB - The sonograms from 15 patients who underwent 40 intrauterine transfusions at the University of California San Francisco School of Medicine, between December 1981 and December 1984 were retrospectively reviewed. The authors found that 12 to 14 ml of fluid were easily seen in 18- to 20-menstrual-week fetuses and that 30 to 40 ml were seen in fetuses at greater than or equal to 30 menstrual weeks. Since the study was retrospective, the absolute minimum of detectable fetal intraperitoneal fluid was not recorded for each fetus. The above represent amounts that were consistently documented during each intrauterine transfusion. In order to gain information about the minimum detectable fetal intraperitoneal fluid, two fetuses undergoing intraperitoneal transfusions were studied prospectively. The minimum fetal intraperitoneal fluid volumes observed were 10 ml in a 22-week fetus and 15 ml in a 26-week fetus. PMID- 3514951 TI - New observations in the sonographic evaluation of intrauterine contraceptive devices. AB - The in vitro sonographic appearance of the four currently available intrauterine contraceptive devices (IUDs) now used in the United States and Canada were analyzed and compared with in vivo scans. While plastic IUD limbs demonstrated entrance-exit echoes in all scan planes, copper IUDs showed posterior reverberation when optimal gain settings were used. Regardless of the transducer used, posterior acoustic shadowing was only seen when IUD limbs were scanned perpendicular to their long axis and at the junction of long and short limbs. The authors feel that these refined ultrasound characteristics will be helpful in accurately identifying IUDs within the uterus. PMID- 3514952 TI - Hydrometrocolpos, uterus didelphys, and septate vagina: an antenatal sonographic diagnosis. PMID- 3514953 TI - Aneurysmal bone cyst presenting as a pelvic mass on sonographic examination. PMID- 3514954 TI - Sonographic detection of small intestinal subserosal lymphofollicular hyperplasia. PMID- 3514955 TI - Fetal hydrops secondary to a paratracheal hemangiomatous malformation. PMID- 3514956 TI - Artifacts in ultrasound imaging. AB - Ultrasound imaging artifacts of acoustic origin relating to resolution, propagation path, and attenuation are reviewed. Lateral and axial resolution limitations are artifactual in nature since a failure to resolve means a loss of detail and two adjacent structures may be visualized as one. Apparent resolution close to the transducer (speckle) is not directly related to tissue texture but is a result of interference effects from the distribution of scatterers in the tissue. Reverberation produces a set of equally spaced artifactual echoes distal to the real reflectors. The mirror image artifact is the presentation of objects that are present on one side of a strong reflector, appearing on the other side as well. Shadowing and enhancement are useful artifacts for determining the nature of masses. Enhancement results from low attenuation objects in the sound path while shadowing results from strongly reflecting or strongly attenuating objects. Additional artifacts include section thickness, refraction, multipath, side lobe, grating lobe, focal enhancement, comet tail, ring down, speed error, and range ambiguity. PMID- 3514957 TI - Renal transplantation in end stage renal disease patients with existing urinary diversion. AB - From 1971 to 1984 renal transplantation was performed in 20 patients with end stage renal disease who presented with an existing form of urinary diversion. These patients were evaluated with a cystometrogram, voiding cystourethrogram and cystoscopy. In some cases bladder function was studied further by cycling through a suprapubically placed catheter. The bladder was considered unstable in 13 patients and undiversion was done at transplantation. The period of prior diversion ranged from 3 to 20 years (mean 12.7 years). There were no surgical complications postoperatively and normal bladder function returned in all patients. Currently, 8 patients have a functioning renal allograft 16 months to 9 years after transplantation (mean 4.2 years). Seven patients were considered to have a nonusable bladder owing to severe neurogenic disease or refractory contracture. In these patients transplantation was done into a pre-fashioned intestinal conduit (5) or cutaneous ureterostomy (2). Currently, 4 patients have a functioning renal allograft 16 months to 6.2 years after transplantation (mean 3.8 years). Transplantation candidates who present with an existing form of urinary diversion should be evaluated carefully, since many will have a usable bladder. Regardless of whether the bladder is usable, transplantation can be performed safely with no increased surgical or immunological risk. PMID- 3514958 TI - Scrotal ultrasound in the infertile man: detection of subclinical unilateral and bilateral varicoceles. AB - Clinical and laboratory studies have provided convincing evidence that varicoceles are detrimental to spermatogenesis and that this effect is unrelated to their size. Thus, physicians have used diagnostic techniques other than physical examination to find these small but clinically significant varicoceles. Because scrotal sonography has proved to be invaluable to detect many intrascrotal abnormalities, and has the unique ability to visualize the testicle and surrounding structures, we used it to evaluate 50 infertile men. Of our 50 patients 22 had a clinically palpable left varicocele and 3 additional patients had bilateral varicoceles. All clinical varicoceles were confirmed by sonography. However, sonography also demonstrated a left varicocele in an additional 12 patients (34 of 50 or 68 per cent) and a right varicocele in 21 (a total of 24 or 48 per cent). Reflux on the right side always occurred in conjunction with that on the left side. Thus, among our 50 infertile men 24 of 34 (70 per cent) had bilateral varicoceles as detected by sonography, and 12 of 50 (24 per cent) had a subclinical varicocele on the left side. The high percentage of bilateral varicoceles detected by sonography may explain the pathophysiological mechanism by which what formerly was considered a unilateral anatomical abnormality may produce bilateral testicular dysfunction. It also may challenge us to change our present unilateral surgical approach to the patient with a clinically evident left varicocele. PMID- 3514959 TI - Unilateral presentation of adult-type polycystic kidney disease in children. AB - Adult polycystic kidney disease is characterized by autosomal dominant inheritance, diffuse bilateral cystic kidney disease and onset during the young adult years. Relatively few cases of adult-type polycystic kidney disease in children have been reported. We describe a 4-year-old girl who appeared to have multiple, unilateral simple renal cysts by excretory urography and ultrasonography. There was no known familial renal cystic disease. When renal histology was consistent with adult-type polycystic kidney disease, screening nephrosonograms revealed that the mother also had the disease. We review 10 published cases of unilateral presentation of adult-type polycystic kidney disease in children. This report emphasizes the necessity of screening studies in parents of children with diffuse unilateral or bilateral cystic renal disease. Awareness of the unexpected unilateral presentation of adult-type polycystic kidney disease in children may allow a nonoperative diagnosis to be made. PMID- 3514960 TI - Successful hypospadias repair in infants using brief urinary diversion and watertight neourethral closure. AB - Since July 1982, 23 children between 10 and 28 months old underwent correction of hypospadias. After chordee was resected the urethral orifice was in the perineum in 3, at the penoscrotal junction in 5, on the proximal or mid shaft in 10 or at the distal shaft in 5. The neourethra was fashioned from a transverse island pedicle of preputial skin for proximal hypospadias or by using Mustarde's technique for distal hypospadias. A perforated silicone tube was left in the urethra and a feeding tube was passed through the lumen of the urethral stent to drain the bladder. Up to 4 days later the bladder catheter was removed and the children voided per the neourethra. The urethral stent was removed between 6 and 30 days postoperatively. Voiding through a recently constructed urethra was well tolerated. The boys did not experience bladder spasms, urinary extravasation did not occur and cosmetic results were good. Meatal stenosis did not occur. Three children (13 per cent) required closure of a fistula, which was noted 1 to 2 1/2 years later. It appears that briefly diverting bladder urine after hypospadias repair ameliorated postoperative morbidity without compromising the results. This technique was found to be inappropriate in older boys because of significant dysuria. PMID- 3514961 TI - Urological complications associated with a kidney transplant biopsy: report of 3 cases and review of the literature. AB - During the last 12 years 400 renal allograft biopsies have been performed at this institution to facilitate the differential diagnosis of post-transplant renal dysfunction. Of these cases significant urological complications occurred in 3. In 1 patient a caliceal cutaneous fistula developed after an open surgical biopsy, which required nephrostomy drainage for 6 months. The other 2 patients had needle biopsies and, subsequently, anuria occurred from ureteral blood clots. The problem resolved spontaneously after 23 hours in 1 patient and after 30 hours in the other. The complications in these 3 patients are believed to have resulted from a deeper biopsy and consequent damage to the medullary vasculature and the pelviocaliceal collecting system. Because of these and other potential problems, renal transplant biopsies should be performed by experienced staff, after careful consideration of the risk/benefit ratio at each individual setting. PMID- 3514962 TI - Myeloid metaplasia masquerading as a urethral caruncle. AB - A 64-year-old woman presented with a painless bleeding mass of the urethral meatus that was diagnosed as a caruncle and removed surgically. Histological examination revealed a cellular and vascular polypoid lesion that contained megakaryocytes, as well as groups of hematopoietic stem cells, and maturing cells of the erythroid and granulocytic series. The diagnosis of myeloid metaplasia was confirmed by marker studies with immunoperoxidase techniques. The patient had a long history of bleeding and clotting problems owing to a myeloproliferative disorder with thrombocytosis and gradual development of myelofibrosis. No other foci of extramedullary hematopoiesis were apparent. The patient was free of urinary symptoms 22 months postoperatively. PMID- 3514963 TI - Xeroradiography and ultrasonography in the evaluation of a penile injury. AB - A 34-year-old white man presented with severe penile cellulitis following injection of epoxy glue into the shaft of the penis. Preoperative xeroradiography and ultrasonography localized the hardened masses of glue to the left corpus cavernosum and subcutaneous tissues. Under the guidance of intraoperative ultrasonography this foreign material was removed surgically. Postoperatively, the cellulitis resolved promptly and xeroradiography demonstrated no residual fragments. Although various modalities, including computerized tomography and roentgenography, are available to detect foreign bodies in soft tissues, xeroradiography and ultrasonography are ideally suited for use in the male external genitalia. PMID- 3514964 TI - Urinothorax: report of 4 cases and review of the literature. AB - Urinothorax should be considered when pleural effusion occurs in patients with urinary tract obstruction accompanied by retroperitoneal urinoma. This recommendation is based on our experience with 4 cases and a review of the literature. In 2 patients urinary obstruction was owing to retroperitoneal fibrosis secondary to malignancy, including one who had a neuroectodermal undifferentiated small round cell tumor and the other who had a metastatic epithelial neoplasm. In the 2 other patients urinary obstruction resulted from a failed ureteroneocystotomy following renal allograft transplantation. All 4 patients had a urinoma, which may be a predisposing factor to urinothorax. PMID- 3514965 TI - Assessment of renal viability by phosphorus-31 magnetic resonance spectroscopy. AB - To assess the applicability of phosphorus-31 magnetic resonance spectroscopy (31P MRS) in the analysis of renal transplant viability and preservation techniques with respect to pre-transplant ischemia, we studied two rat groups. Twenty-five rat kidneys were subjected to various time increments of warm ischemia (Group A), and 31P-MRS was performed on each kidney at time intervals of up to 72 hours during simple hypothermic storage. We correlated findings of 31P-MRS with simultaneous findings of electron microscopic (EM) ultrastructural viability parameters (in Group A) and subsequent survival and renal function in 30 rats (Group B) subjected to similar amounts of variable ischemia. Intracellular phosphorus metabolite levels were nondestructively monitored by 31P-MRS via spectral peaks of NAD, sugar monophosphates (SP), and inorganic phosphate (Pi). We concluded: SP/Pi and NAD/Pi ratios decay in a time-dependent manner for both warm and cold ischemia, although this process is much slower during cold storage; EM viability parameters correlate with the development of acute tubular necrosis (irreversible damage) versus nonviability (gross cell death) on a qualitative basis only; and 31P-MRS enables a quantitative assessment of renal viability and ischemic renal damage and can predict the degree of acute tubular necrosis and post-ischemic renal function. 31P-MRS is potentially a noninvasive, nondestructive method of assessing viability during simple hypothermic storage of the rat kidney. Preliminary evidence shows that this MRS method can be applied to human kidney viability studies for clinical renal transplantation and urologic research concerning renal preservation. PMID- 3514966 TI - Balanitis caused by group B streptococcus. AB - The Lancefield group B streptococcus is a cause of serious genitourinary tract infections in peripartum women. However, it rarely has been implicated as a pathogen in genital infections of male subjects. We report severe recurrent balanitis owing to group B streptococcus in a sexually active young man. Group B streptococcus was cultured from the vagina of his asymptomatic consort on 1 occasion. It is postulated that penile cellulitis developed by invasion of group B streptococcus through a traumatic abrasion acquired during sexual intercourse. The preferred antibiotic treatment for balanitis caused by group B streptococcus is penicillin or erythromycin. Prevention of additional episodes may be difficult, since therapy of the female carrier state with antibiotics has not provided long-term eradication of group B streptococcus. PMID- 3514967 TI - The natural history of simple renal cysts: a preliminary study. AB - We examined the natural history of simple renal cysts in 59 patients followed periodically with renal ultrasonography. Using the parameters of cyst diameter and number we grouped the patients according to the differing natural history of the cystic lesions. The results indicate that simple cysts tend to progress in number rather than size. Furthermore, 3 patients had independent solid or complex lesions. The only patient explored had an adenocarcinoma of the kidney. Periodic reevaluation of patients with an ultrasonic diagnosis of simple renal cyst warrants serious consideration. PMID- 3514968 TI - Comparison of digital examination and transrectal ultrasonography for the diagnosis of prostatic cancer. AB - The ability to detect prostatic cancer by transrectal ultrasonography was evaluated in a prospective blind study of 216 men. The sensitivity of transrectal ultrasonography was 86 per cent but the specificity was only 41 per cent. Tumors less than 1 cm. in diameter were most difficult to detect by transrectal ultrasonography. The positive and negative predictive values of transrectal ultrasonography were 36 and 89 per cent, respectively. Abnormal scans that strongly suggested carcinoma were present in 10 per cent of the men who had a normal digital examination but no biopsy was performed. Transrectal ultrasound is a sensitive method to detect all but small prostatic tumors and it can detect tumors that are not evident by digital examination. To date, however, transrectal ultrasonography may be difficult to use for routine screening in the United States because of the low positive predictive value. Nevertheless, further investigation of this technique is warranted to define its role in improving the diagnosis of prostatic cancer. PMID- 3514970 TI - Suture technique and para-anastomotic compliance. AB - We previously described a para-anastomotic hypercompliant zone (PHZ), located 3 to 4 mm from end-to-end continuous anastomoses in canine femoral arteries, in which arterial compliance first increases approximately 50% above adjacent reference values before falling to a minimum at the anastomosis. To determine if PHZ is affected by suture technique, 16 interrupted and 21 continuous end-to-end anastomoses were studied. Pulsed ultrasound was used to obtain detailed longitudinal profiles of compliance and diameter vs. distance, at 1 mm intervals within a 2 cm region centered at the anastomoses. Both compliance and diameter at the anastomosis were lower in continuous compared with interrupted anastomoses (p less than 0.003). The PHZ was present in 86% of continuous but in only 50% of interrupted anastomoses (p less than 0.03). The site of peak compliance averaged 3.8 +/- 1.2 mm from the anastomosis and was independent of suture technique. The increase in peak compliance at the PHZ, when normalized to adjacent references values, was the same in continuous and interrupted anastomoses. PHZ augments any preexisting compliance mismatch between artery and graft, which may contribute to the development of para-anastomotic subintimal hyperplasia. Interrupted anastomoses, which create a smaller compliance mismatch than do continuous and have a lower incidence of PHZ, may be preferred in certain settings. PMID- 3514969 TI - Uroradiographic manifestations of Burkitt's lymphoma in children. AB - The radiological studies of 18 children with biopsy proved Burkitt's lymphoma were analyzed retrospectively. Before therapy the genitourinary tract was evaluated in 15 children by excretory urography, sonography, computerized tomography and/or gallium citrate scintigraphy. Genitourinary abnormalities were detected in 9 children. Changes due to tumor included renal or ureteral displacement in 4 children, hydronephrosis in 3 and intraparenchymal masses in 4. Extrinsic compression of the bladder causing no compromise of function was seen in only 2 children. Gonadal involvement occurred in 2 boys and 1 girl. The modality of choice for evaluating the genitourinary tract in patients with Burkitt's lymphoma has been excretory urography. Since ultrasound and computerized tomography provide more direct information about tumor deposits within the kidney and retroperitoneum, either should be performed in this population before initiation of chemotherapy. PMID- 3514971 TI - Primary and adjunctive intra-arterial digital subtraction arteriography of the lower extremities. AB - Standard contrast arteriography (SCA) and intra-arterial digital subtraction arteriography (DSA) were performed during a 26-month period in 459 cases. The DSA group consisted of 22 aortoiliac studies, 66 crural-pedal arch studies, and 227 combinations. In addition, postoperative DSA was performed in 42 patients to evaluate graft patency, morphology, and inflow and runoff circulations. There were no significant differences in the quality of the preoperative aortoiliac studies performed by either SCA or DSA although, in select cases, one or the other of these techniques resulted in a superior study. Distal crural-pedal arch visualization was enhanced with DSA compared with SCA (85% vs. 65%) but when both were compared with their corresponding intraoperative completion arteriograms, the interpretive error rates resulted in comparable accuracies, false positive and negative rates, and predictive values. The likelihood of achieving graft patency in patients who have unsatisfactory preoperative visualization of the distal circulation by DSA is reasonable (11 of 27 patients) but inferior to the number obtained when there is adequate DSA visualization (40 of 53 patients). We conclude that DSA is a valuable adjunct to preoperative SCA but should not be used as the sole criterion for the assessment of operability for limb salvage. Intraoperative prereconstruction arteriography or direct surgical exploration of the crural arteries in patients with inadequate preoperative visualization will result in graft patency in a significant percentage of cases. Intra-arterial DSA for postoperative evaluation of lower limb bypass adds another dimension to analysis of graft structure and status of the host circulatory beds and also provides a method for accurate interpretation of postoperative data. PMID- 3514972 TI - Extracorporeal shock-wave lithotripsy for upper urinary tract calculi. One year's experience at a single center. AB - Four hundred sixty-seven patients with symptomatic upper urinary tract calculi underwent extracorporeal shock-wave lithotripsy (ESWL) at The New York Hospital Cornell Medical Center during the first year. Ninety-five percent of stones were completely treated with one ESWL session. An analysis of 300 treatments revealed that the overall stone-free rate (success) three months after treatment was 75%. The stone-free rate for patients with renal pelvic calculi less than or equal to 20 mm in diameter was 91%. Individual patient stone-free rates depended on stone size (burden), position, composition, and quality of disintegration. Two percent of treatments failed to disintegrate the targeted stone. Complications were minimal. Seven percent of treatments were followed by a secondary endoscopic procedure to facilitate complete stone passage, and 23% of treatments were preceded by cystoscopy with ureteral stent placement of manipulation of stones. Combined therapy utilizing percutaneous surgery or multiple sequential ESWL treatments is necessary for complex stones, and ureteroscopy or basket extraction remains the treatment of choice for distal ureteral calculi. PMID- 3514973 TI - Exercise-induced anaphylactic syndromes. Insights into diagnostic and pathophysiologic features. AB - To differentiate the diagnoses of exercise-induced anaphylaxis and cholinergic urticaria/anaphylaxis, we developed reproducible diagnostic provocative challenges. The data derived from the study of two representative patients, one with cholinergic urticaria and the other with exercise-induced anaphylaxis, suggest approaches to distinguishing these diagnoses. After specific exercise challenges, both patients developed symptoms consistent with anaphylaxis and had associated increases in plasma histamine levels. After passive heat challenges inducing increases in core body temperature more than 0.7 degrees C, only the patient with cholinergic urticaria developed anaphylactic symptoms and had a rise in the plasma histamine level. Neither patient developed symptoms of anaphylaxis when core body temperatures were increased after administration of intravenous endotoxin. Thus, passive heat challenges are extremely valuable in differentiating these two exercise-related syndromes. Although not important in exercise-induced anaphylaxis, specific thermoregulatory mechanisms appear to play an intricate part in the pathophysiology of cholinergic urticaria/anaphylaxis. PMID- 3514974 TI - Frank Netter, MD: 'command performance' in medical art. PMID- 3514975 TI - The retrieval of medical literature. PMID- 3514976 TI - Epidemiology of murine typhus in Texas. 1980 through 1984. AB - From 1980 through 1984, a total of 200 cases of murine typhus were reported in Texas. All cases were confirmed by the indirect fluorescent antibody assay or latex agglutination test. Patients ranged in age from 1 to 90 years (median, 35 years). Fifty-one percent were female. Seventy-four percent of the patients resided in south Texas. Illness occurred in all months of the year, but 40% of the cases had onset in April, May, or June. Annual incidence increased with age and was higher in Hispanics. Murine typhus continues to be an important public health problem in Texas. PMID- 3514977 TI - Landmark perspective: Amniotic fluid embolism. To understand an enigma. PMID- 3514978 TI - Landmark article, Oct. 1941: Maternal pulmonary embolism by amniotic fluid as a cause of obstetric shock and unexpected deaths in obstetrics. By Paul E. Steiner and C. C. Lushbaugh. PMID- 3514979 TI - Brain, spine surgeons say yes to ultrasound. PMID- 3514980 TI - Early use of x-ray machines and electrocardiographs at the Pennsylvania Hospital 1897 through 1927. PMID- 3514981 TI - Arginine: biochemistry, physiology, and therapeutic implications. PMID- 3514982 TI - Disease-specific amino acid infusion (F080) in hepatic encephalopathy: a prospective, randomized, double-blind, controlled trial. PMID- 3514983 TI - [Primary carcinoma of the vermiform appendix]. AB - A 54-year-old Japanese woman with primary adenocarcinoma of the appendix was treated. The diagnosis was established before surgery by means of barium studies and ultrasound examination. Histologically, the tumor was a mucinous cystadenocarcinoma. The patient was treated by ileocecal resection, and a 10 month follow-up has revealed neither evidence of recurrence nor of metastases. The preoperative investigations, pathologic features and surgical management in this case are briefly discussed. PMID- 3514984 TI - [Protein and polypeptide growth factors--parathyroid hormone and calcitonin]. PMID- 3514986 TI - [Steroid substances--regulation of cell proliferation by glucocorticoids]. PMID- 3514985 TI - [Protein and polypeptide growth factors--insulin and gastrointestinal hormones]. PMID- 3514987 TI - [Steroid substances--estrogen, progesterone and cell proliferation]. PMID- 3514988 TI - [Prostaglandin and related substances]. PMID- 3514989 TI - [Transferrin]. PMID- 3514990 TI - [Protein and polypeptide growth factors--nerve growth factor]. PMID- 3514991 TI - [Tumor-derived growth factors--transforming growth factor]. PMID- 3514992 TI - [Tumor-derived growth factors]. PMID- 3514993 TI - [Growth disorders and growth factors in man]. PMID- 3514994 TI - [Corneal would healing and growth factors]. PMID- 3514995 TI - [Determination of urinary epidermal growth factor and its clinical significance]. PMID- 3514996 TI - [Determination of blood insulin-like growth factors and its clinical significance]. PMID- 3514997 TI - [Basic information on culture media without containing sera]. PMID- 3514998 TI - [Protein and polypeptide growth factors--fibroblast growth factor]. PMID- 3514999 TI - [Protein and polypeptide growth factors--vascular endothelial cell growth factor]. PMID- 3515000 TI - [Protein and polypeptide growth factors--colony stimulating factor, thrombopoietin, and erythropoietin]. PMID- 3515001 TI - [Protein and polypeptide growth factors--B lymphocyte growth and differentiation factor]. PMID- 3515002 TI - [Protein and polypeptide growth factors--endothelial cell-derived growth factor]. PMID- 3515003 TI - [Protein and polypeptide growth factors--bone- and cartilage-derived growth factors]. PMID- 3515004 TI - [Clinical aspects of dementia. 12. Various types of dementia. (2) Presenile dementia (Alzheimer's, Pick's, and Creutzfeldt-Jakob diseases)]. PMID- 3515005 TI - Effect of a prostaglandin E1 derivative (OP-1206) and acetylsalicylic acid on electrically induced thrombosis in guinea-pig mesenteric artery and its modification by an inhibitor of prostaglandin I2 synthetase, tranylcypromine. AB - The antithrombotic effect of a prostaglandin E1 derivative, OP-1206 (17S-20 dimethyl-trans-delta 2-PGE1) X alpha-cyclodextrin clathrate (OP-1206 X alpha-CD), was compared with that of acetylsalicylic acid (ASA) in a electrically induced thrombosis model of guinea-pig mesenteric arteries using intact animals and animals subjected to the superfusion of tranylcypromine (TC, 15 mM) over their mesentery. The drug-effect was assessed by the change of the threshold voltage for the thrombus formation. 1) TC (1.5-15 mM) lowered the threshold voltage, and the effect was comparable to its inhibitory effect on PGI2 formation in vitro, suggesting that PGI2 generated in mesenteric arteries acts to prevent thrombus formation. 2) In intact animals, OP-1206 X alpha-CD at doses of 0.01-0.3 mg/kg, p.o. (as OP-1206), significantly and dose-dependently elevated the threshold voltage. ASA (30-1000 mg/kg, p.o.) significantly elevated the threshold voltage, but the effect reached to its maximum at 100 mg/kg and lessened with further increase of ASA. 3) In TC-treated animals, OP-1206 X alpha-CD elevated the threshold voltage dose-dependently, but the elevation of threshold voltage by ASA reached to its plateau level which was significantly lower than that obtained with OP-1206 X alpha-CD at 0.3 mg/kg, indicating that the antithrombotic effect of ASA is incomplete in this model.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3515006 TI - Cystadenoma and cystadenocarcinoma of the liver: localization of carcinoembryonic antigen. AB - Cystadenomas and cystadenocarcinomas of the liver are rare tumors. The distribution of carcinoembryonic antigen (CEA) in two cystadenomas and a cystadenocarcinoma was examined immunohistochemically by the peroxidase-labeled antibody method, at the light microscopic level. In the cystadenomas and areas consisting of benign-appearing cells in the cystadenocarcinoma, CEA was localized to the luminal surfaces of the glandular cells appearing as thin linear stains. In malignant epithelial cells forming nests and daughter cysts of the cystadenocarcinoma, CEA was demonstrated throughout the cytoplasm, in a diffuse pattern. Thus, the immunohistochemical localization of CEA may be helpful in the diagnosis of borderline lesions and in determining the distribution of benign and malignant epithelium in cystadenocarcinomas. The etiology, clinical features, pathology and treatment of these rare tumors are discussed. PMID- 3515007 TI - Immunohistochemical and electron microscopical detection of parafollicular (C) cells in equine parathyroid glands. PMID- 3515008 TI - Pathologic observations of mouse liver infected with Tyzzer's organisms using immunoperoxidase method. PMID- 3515009 TI - Crypt cell antigen expression in human colon tumor cell lines: analysis with a panel of monoclonal antibodies to CaCo-2 luminal membrane components. AB - Twenty BALB/c mouse monoclonal antibodies to surface membrane components of confluent CaCo-2 cells were used to study the expression of small intestine markers in cultured human colon tumor cells. The antigens recognized by 15 of these antibodies were identified as membrane proteins of relatively high molecular weight, one of them corresponding to the single-chain precursor of sucrase-isomaltase. By immunofluorescence, 14 antibodies were found to stain the small intestine epithelial cells, and various distinctive patterns of antigen distribution in human jejunum were observed. Five antibodies stained exclusively the crypt cells, 3 the luminal membranes of the absorptive villus cells, and 4 the entire epithelium. In contrast, only 4 antibodies stained normal human colon tissue. The different antigens defined by this panel of monoclonal antibodies showed great variability in their expression in 14 human intestinal tumor cell lines tested. These results demonstrated a surprising similarity between many colon tumor cell lines and intestinal crypt cells and identified a set of new intestinal cell surface markers that can be used to identify and characterize intestinal tumor cells in vivo and in culture. PMID- 3515010 TI - Reductive effect of aspirin treatment on primary tumor growth and metastasis of implanted fibrosarcoma in rats. AB - For suppression of primary tumor growth and metastatic spread, aspirin and theophylline, either alone or combined, were given daily to inbred female BN rats after sc implantation of a syngeneic nonimmunogenic tumor. Treatment with 200 mg aspirin/kg (body wt) resulted in a statistically significant regression of tumor growth as well as of the number of metastases in the lungs. Aspirin given in a lower dose (20 mg/kg) did not show significant difference from the vehicle group. Theophylline (75 mg/kg) significantly increased primary tumor growth as well as lung metastases. Inhibition of in vitro platelet aggregation, determined in whole blood taken from non-tumor-bearing animals treated with the same therapeutic regimen, was most pronounced in those groups in which tumor growth and spread were significantly retarded. However, this positive correlation between inhibition of tumor spread and platelet aggregation was not associated with a favorable balance of prostacyclin and thromboxane A2 in these animals. PMID- 3515011 TI - Cadaveric bone retrieval/banking techniques. PMID- 3515012 TI - Relationship between energy requirements for Na+ reabsorption and other renal functions. AB - In the mammalian kidney, the use of the ratio, delta net T-Na+/delta Q-O2, provides an overestimate of the energy requirements for unidirectional active Na+ transport. In the proximal tubule, the overestimate of the energy cost for T-Na+ is due to these phenomena: (1) The "leaky" characteristics of the proximal tubule does not permit an accurate estimate to be made of the active fraction of the unidirectional flux of Na+. Thus, the net Na+ or net HCO3- reabsorption rate alone cannot be used to determine the stoichiometry for unidirectional extrusion of Na+ (with HCO3-) by the Na,K-ATPase, since backflux of HCO3- into the lumen occurs. (2) There is a moiety of active Na+ with Cl- along the pars recta. Whether this reabsorptive rate is altered and O2 uptake also changed when GFR or NaHCO3 reabsorption is varied is not yet known. (3) The occurrence of energy requiring synthetic functions (substrate-interconversions) in the proximal tubule, coupled, in part, to the rate of Na+ entry into the proximal tubule cells, results in changes in renal O2 uptake proportional to some (undetermined) fraction of the change in Na+ reabsorption. The utilization of a portion of these reabsorbed substrates in endergonic syntheses must account for a portion of the Na+-stimulated suprabasal O2 uptake rate. Hence, the presence of synthetic functions in the proximal tubule also contributes to the overestimation of the energy value of net Na+ reabsorption when the ratio, delta net TNa-+/delta Q-O2, is used.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3515013 TI - Metabolic fuels along the nephron: pathways and intracellular mechanisms of interaction. PMID- 3515014 TI - Transport and metabolic functions in cultured renal tubule cells. AB - The study tool of cultured tubule epithelia has been applied to new areas in nephron cell biology, such as the evolution of epithelial membrane asymmetry. Studies utilizing monoclonal antibodies against plasma membrane glycoproteins in MDCK revealed that the development of surface cell polarity is a continuous process requiring intact tight junctions and their electrical resistor function [101]. The role of the junctional complex to establish and maintain distinct membrane protein domains had been suggested earlier from work utilizing the apical aminopeptidase [102] and fluorescent membrane probes [103]. Cultured tubule epithelia lend themselves for the evaluation of cell-specific membrane protein synthesis [104] and antigenic determinants [105]. Human renal epithelia, from normal [106, 107] and defined abnormal kidney [108], have been maintained functional in primary and passage culture [106]. Pathophysiological mechanisms may be examined in cultured tubule epithelia, as shown first [109] by studies on the recovery from ischemic failure, where anoxia and substrate deprivation resulted in cell swelling which was prevented in culture by an oncotic agent. This article has not attempted to give an exhaustive account of the studies in which cultured tubule cells have served as a tool. Instead, the investigations quoted herein represent some principal lines of study, as seen from renal physiology, which may disclose details in culture of complex in vivo phenomena. It was Bernard [110] who, in 1865, suggested that "physiological events must be isolated outside the organism . . . to better understand the deepest associations of the phenomena." PMID- 3515015 TI - Glucose metabolism in renal tubular function. AB - Heterogeneity of metabolic activity along the nephron points to a very varied relationship between glucose metabolism and ion transport. Glycolysis is linked closely to free-water clearance and possibly to sodium, potassium, and hydrogen ion transport. Glucose oxidation, while not the major source of renal energy, is crucial in sodium, potassium, and phosphate reabsorption. Gluconeogenesis recovers carbon compounds generated during the process of renal ammoniagenesis. Glucose synthesis and active sodium transport appear to compete for renal ATP, although no regulatory function for this competition has been identified. Glucose formed in the proximal tubule may support free-water clearance in adjacent distal tubule, but is not thought to contribute to any medullary function. The complex network of biosynthetic and catabolic pathways of glucose metabolism may have evolved in the kidney to protect the organism against wide variations in glucose demand which would otherwise be unavoidable during the course of rapidly fluctuating renal electrolyte loads. PMID- 3515016 TI - Regulation of glutamine metabolism in dog kidney in vivo. AB - In summary, we propose: that renal ammoniagenesis is regulated both by factors dependent and independent of the acid-base status, the net effect of the ammoniagenic process on the proton balance being directly related to the rate of urinary ammonium excretion; that the renal metabolism of glutamine should not be examined independently of the metabolism of other substrate physiologically taken up by the kidney; that different pathways for glutamine metabolism will change during acid-base disorders of organic or nonorganic origin; that, among the main glutamine utilizing pathways, only the GLDH pathway is influenced directly by the acid-base status; the ammoniagenic transamination pathways is regulated by substrate availability in the kidney; that the lowest ammoniagenic flux in the kidney coincides with the rate of alanine production since alanine appears to derive directly from glutamine. When this pathway is stimulated without concomitant acidosis, most of the ammonia produced is not excreted in urine but released in the renal venous blood: thus, no significant effect on the acid-base balance is produced; that glutamine is metabolized by proximal kidney tubules of acidotic dogs probably through net oxidation; that the quantitative analysis of the metabolic consequence of this process indicates that the rate of ATP turnover at this site may effectively place an upper limit to the rate of glutamine oxidation, and ammonia production by the kidney, and that this limit is nearly reached in chronically acidotic animals. PMID- 3515017 TI - Metabolic adaptations of the nephron in renal disease. PMID- 3515019 TI - [Experimental and clinical use of a single-row absorbable suture in abdominal surgery]. PMID- 3515018 TI - [The depiction of alcohol-damaged children in the creative art of William Hogarth and Jakob Jordaens--a contribution to the history of alcoholism and alcoholic embryopathy]. PMID- 3515020 TI - [Use of the metabolic products of lactic acid bacteria strain 317/402 in suppurative surgery]. PMID- 3515021 TI - [Wound healing]. PMID- 3515023 TI - [Auxiliary instrument for applying sutures]. PMID- 3515022 TI - [Evaluation of the effectiveness of a method for the active surgical treatment of suppurative-necrotic diseases of the soft tissues]. PMID- 3515024 TI - [Wedge resection of the liver using crisscross pi-form sutures]. PMID- 3515025 TI - [Percutaneous transhepatic cholangiography controlled by ultrasonic scanning]. PMID- 3515026 TI - [Choledochotomy through the stump of the cystic duct]. PMID- 3515027 TI - [Methods of reducing complications of papillosphincteroplasty]. PMID- 3515028 TI - [A method of reconstructive papillosphincteroplasty]. PMID- 3515029 TI - [Benign tumors of the gallbladder and extrahepatic bile ducts (a review of the literature)]. PMID- 3515030 TI - [Antibacterial therapy in surgery of the biliary tract (a review of the literature)]. PMID- 3515031 TI - [Surgical aspects of acalculous cholecystitis (a review of the literature)]. PMID- 3515032 TI - [Morphological changes in the gallbladder and the microflora of the bile in primary acute cholecystitis]. PMID- 3515033 TI - [Keratoconjunctivitis caused by Chlamydia psittaci]. AB - A 25-year-old female patient suffering from acute follicular keratoconjunctivitis with epithelial and subepithelial corneal infiltrates was examined. Antibodies of the IgM class directed against C. psittaci were found. Infection due to C. trachomatis was ruled out by serology (ELISA) and negative isolation attempts. The patient's cat had rhinitis and conjunctivitis and a positive C. psittaci specific IgM antibody titer. Systemic application of tetracycline resulted in fast resolution of symptoms in both the patient and her cat. PMID- 3515034 TI - [Determining the methotrexate concentration in serum with the fluorescence polarization immunoassay (FPIA)--a comparison with the enzyme immunoassay (EMIT)]. AB - The determination of methotrexate in serum was performed by the fluorescence polarization immunoassay (FPIA) and the enzyme immunoassay (EMIT). Both methods showed a good precision and accuracy. The investigation was carried out in 138 sera with a methotrexate concentration up to 1,400 mumol/l. The comparison of the two methods in 100 sera with a methotrexate concentration up to 5 mumol/l showed a good correlation (correlation coefficient r = 0.9798). Close correlation (correlation coefficient r = 0.9845) was also found in 38 sera with a methotrexate concentration between 5 and 1,400 mumol/l. Discussion of the FPIA and EMIT methods. PMID- 3515035 TI - [Haptoglobin and its clinical significance]. PMID- 3515036 TI - [N. I. Pirogov and poets of Pushkin's circle]. PMID- 3515037 TI - [Scientific views of A. P. Chekhov (on the 125th anniversary of his birth)]. PMID- 3515039 TI - [Ultrasonic diagnosis of occlusion of the major arteries of the head in patients with chronic cerebral circulatory insufficiency]. PMID- 3515038 TI - [Concentration of somatotropic hormone, glucagon and insulin in the blood of patients with recurrent rheumocarditis]. PMID- 3515040 TI - [Status of prostacyclin control of the thrombocyte-vessel wall system in patients with cerebral circulatory disorders]. PMID- 3515041 TI - [Transplantation of autologous bone marrow in the treatment of acute leukemia]. PMID- 3515042 TI - [Exhibition "The sick room". The object and nursing care--a meeting of past and present]. PMID- 3515043 TI - [Classic homeopathy (I). The liberation of curing power]. PMID- 3515044 TI - Juxtaglomerular apparatus and the renin-angiotensin system. PMID- 3515045 TI - Experimental IgA nephropathy in mice. AB - Based on a hint from an immunological abnormality found in human IgA nephropathy, we tried to make up an experimental IgA nephropathy in mice by administration of a food antigen for a long term with blockage of the reticuloendothelial system (RES). Mice were divided into three groups: group 1 had oral administration of lactalbumin (Lalb); group 2 was treated with colloidal carbon to block RES in addition to oral administration of lactalbumin; and group 3 was treated only with colloidal carbon for RES blockage. Renal biopsy was performed at 18 weeks after RES blockage and the animals were sacrified at 30 weeks for histopathological observation of renal tissue. The deposits of IgA in the mesangial area were not found in animals of groups 1 and 3 but 17.6% of group 2 at 18 weeks following RES blockage, also in no animal of group 1 but 91.7% of Group 2, and 15.4% of group 3 at 30 weeks. They were highly frequent in group 2 at 30 weeks (p less than 0.001). Observation under electron microscope also revealed a significant increase (p less than 0.001) of mesangial dense deposits in group 2 at 30 weeks, and formation of large dense deposits similar to those seen in human IgA nephropathy. Through observation over a period of time, an increase of mesangial IgA deposition and histopathological aggravation were confirmed. Serologically, serum level of IgA was significantly higher in group 2 (p less than 0.001) and was correlated with the intensity of mesangial IgA deposition. It was concluded that lesions very similar to human IgA nephropathy could be prepared in mice by inducing a dysfunction of RES as continuous oral immunization. PMID- 3515046 TI - Distribution of extracellular matrix glycoproteins during normal development of human kidney. An immunohistochemical study. AB - The distribution of types I, III, and IV collagens, fibronectin, laminin, and heparan sulfate proteoglycan during human fetal kidney development has been studied by indirect immunofluorescence. Fibronectin and interstitial collagens types I and III are present in undifferentiated mesenchyme, whereas the intrinsic basement membrane components, type IV collagen, laminin, and heparan sulfate proteoglycan are not detected. In differentiated cortex, types I and III collagens are detected only as interstitial connective fibers, whereas fibronectin is found in both interstitium and glomeruli where its distribution is dependent on the stage of maturation. It is found in both the mesangium and along capillary walls of immature glomeruli, and principally in the mesangium of mature ones. Basement membrane components delineated the branching ureteric bud. They also outlined the structures of the earliest stage of nephrogenesis (epithelial differentiation). In mature nephrons, they are found along glomerular, capsular, and tubular basement membranes. PMID- 3515047 TI - The hydronephrotic kidney of the mouse as a tool for intravital microscopy and in vitro electrophysiological studies of renin-containing cells. AB - Experimental hydronephrosis in mice has been studied with histological, ultrastructural, immunohistochemical, biochemical, and electrophysiological techniques to establish its value as a preparation for the investigation of glomerular microcirculation as well as the electrophysiological and biochemical properties of the renin-containing juxtaglomerular (JG) and vascular smooth muscle (VSM) cells of the afferent glomerular arteriole. During developing hydronephrosis the kidney parenchyma becomes progressively thinner as a result of tubular atrophy, being, after 12 weeks, a tissue sheet of about 200 micron in thickness. In this preparation, the renal arterial tree, in particular the glomerular arterioles, and also the glomeruli can be easily visualized. This permits intravital microscopic studies or direct visual identification of JG and VSM cells for microelectrode impalement. In spite of complete tubular atrophy, the vascular system is well preserved. Ultrastructurally, JG and VSM cells as well as the axon terminals innervating the vessels are intact. The same holds for the glomeruli except for a certain confluence of the podocyte foot processes and a thickening of the basal lamina. Renin immunostaining and kidney renin content in the hydronephrotic organ correspond to those in control kidneys. In addition, renin release from this preparation can be stimulated in a typical manner by isoproterenol and inhibited by angiotensin II, indicating that the receptors controling renin release and the secretory mechanism itself are still intact. Electrophysiological recordings from JG and VSM cells show a high membrane potential (-75 mv), and spontaneous depolarizing junction potentials, owing to transmitter release from the nerve terminals. Inhibitors of renin secretion, e.g. angiotensin II, depolarize both cell types, whereas stimulators such as isoproterenol do not change the membrane potential. We conclude that the hydronephrotic mouse kidney is a suitable model for in vitro studies of the electrophysiology and biochemistry of the media cells of the afferent arteriole, as well as for in vivo studies of glomerular microcirculation. PMID- 3515048 TI - Is combing the answer to headlice? PMID- 3515050 TI - Communication: the key to better restorations. PMID- 3515049 TI - Dental needs for ambulatory elderly in Tennessee. Is Medicaid the answer? PMID- 3515052 TI - 15th annual UCLA symposium. Abstracts: Proteases in biological control and biotechnology. PMID- 3515051 TI - An analysis of divergent trends in alcohol consumption and economic development. AB - Alcohol consumption has increased significantly since World War II--a trend that is frequently explained by the economic growth during this period. During the second half of the 19th century, the overall trend in alcohol consumption decreased despite strong economic growth. In this study, the reasons for this apparent anomaly are discussed. It is argued that economic factors played an important role in the decrease during the late 19th century as well as in ensuing years, and that the difference in consumption trends is due to factors other than economics. This argument is corroborated by a time-series analysis of Norwegian data 1865-1982, showing that the effects of economic development were at least as strong during the first part of this period as they were during the latter. PMID- 3515053 TI - Repeated endomyocardial biopsy without complication in an infant after heart transplantation. AB - Endomyocardial biopsy is necessary for accurate diagnosis of rejection after heart transplantation. This case illustrates the safe use of repeated endomyocardial biopsies in an infant after heart transplantation. PMID- 3515054 TI - Recognition of a granulocyte-specific membrane protein by monoclonal antibodies. AB - Using membranes isolated from leukemic myeloblasts as immunogen, two granulocyte specific monoclonal antibodies 38D2 and 41D2 were developed. The antibodies are positive in membrane immunofluorescence with granulocytes and bands; they give no reaction with monocytes, platelets, leukemic myeloblasts, lymphoblasts, myeloid cell lines, and immature myeloid cells from bone marrow. Both monoclonal antibodies precipitate the same membrane glycoprotein (MW: 70-78 kd, pI: 6-7), which corresponds to a membrane glycoprotein characteristic for granulocytes, as concluded from two-dimensional polyacrylamide gelelectrophoresis patterns obtained from surface labelled myeloid cells. The monoclonal antibodies did not influence the granulocyte functions tested: phagocytosis of opsonized bacteria, chemiluminiscence after stimulation with various stimuli, and chemotaxis. PMID- 3515056 TI - Computer generation of templates for evaluating the amplitude and latency parameters of two superimposed constituent components of early somatosensory evoked responses. AB - From a study of the range of morphologies of the early somatosensory evoked response (SSER) to median nerve stimulation in a large number of neurosurgical patients, the earliest cortical SSER has been inferred to consist of two superimposed waveform complexes. A description is given of the process of generating templates in the computer so that the relative amplitudes and latencies of these two complexes can be determined by inspection. It is suggested that although the neural substrate of the two complexes is at present unknown, their evaluation in responses will provide additional information which will be useful when using SSERs as aids to the diagnosis of neurological disease. PMID- 3515055 TI - Allogeneic bone marrow transplantation for Philadelphia-chromosome positive acute lymphoblastic leukemia. AB - Allogeneic bone marrow transplantation (BMT) produced remission in three patients with Philadelphia-chromosome (Ph1)-positive acute lymphoblastic leukemia (ALL) in relapse. Two patients had remissions which lasted longer than two years. Since the prognosis of Ph1-positive ALL treated with conventional therapy is poor, BMT is indicated in first remission in this disease. PMID- 3515057 TI - Magnesium content of the food supply in the modern-day world. AB - A large-scale US survey has shown that the dietary magnesium intake tends to be lower than recommended. The suboptimal intake prevalent among US adults is consistent with the pattern observed in other North American and European surveys. Several factors are discussed, including the waterborne magnesium factor, the loss of magnesium during food refining and the magnesium content of vegetarian diets, as well as various metabolic situations, e.g., hypertension, pregnancy, osteoporosis, drug therapy, alcoholism, stress and cardiac trauma. The benefits of magnesium supplementation among those with sub-RDA intakes are illustrated. PMID- 3515058 TI - Magnesium and cell cycle control: an update. AB - Accumulating evidence, from bacteria to human cells, points to a universal role for magnesium in controlling the cell cycle. In microorganisms, the co-ordinate sequence of events which culminate in biomass doubling and cell division may be modulated through expression of differential magnesium effects during the cell cycle. For example, it has been suggested in bacteria that growth and cell division may possess different affinities for magnesium; whilst in yeast, cell cycle-dependent fluxes in intracellular magnesium are postulated to regulate cell proliferation. In mammalian cells, magnesium is important in governing key rate limiting steps in the cell cycle, particularly at the onset of DNA synthesis and at mitosis. Furthermore, it has been demonstrated that cell transformation may cause selective loss of this regulatory role for magnesium, implying that magnesium is important in oncogenesis and perhaps in the expression of malignancy. PMID- 3515060 TI - Using medical records for older patient education in ambulatory practice. AB - The effectiveness of sharing medical records in improving physician-older patient communication was evaluated in 203 ambulatory chronically ill older patients (mean age, 70.1 years) by a randomized controlled trial. Ninety-five experimental group patients received copies of their physicians' progress notes 1 week after their last office visit, and 108 control patients did not. After 1-2 weeks, knowledge of health problems, medication, and nonmedication treatments was assessed by interview. Experimental group patients knew 74.1% of their health problems, compared with 64.1% in the control groups (P less than 0.05). There was no difference in knowledge of medications or adherence to medication regimens. Experimental group patients displayed higher treatment knowledge scores than control group patients (P less than 0.01). Less-educated patients showed greater adherence to nonmedication treatments. Shared medical records can enhance physician-older patient communication about health problems and nonmedication treatments, but they do little to enhance medication knowledge or adherence to medication regimens. PMID- 3515059 TI - Modelling myoelectric interference patterns during movement. PMID- 3515061 TI - Local simulations of alternative policies for financing services to the elderly. AB - Because of demographic, economic, and social pressures, it is likely that public programs benefitting the elderly population will be subject to much public debate and calls for the reform in the next few years. This paper presents an analysis of two prototypical reforms that are based on alternative views of government's role in caring for the elderly. One view focuses on means-testing as a method for restricting the role of government to caring for the poor. The second view focuses on universal standards of care for the poor. The purpose of the analysis is to assess the implications of these two alternative views of the role of government as the basis for altering public support for the elderly. The authors show that either view of government results in a redistribution of public resources so that basic medical care, long-term care, and food and shelter needs of all poor elderly are met. The redistribution, however, involves a large reduction of public support for healthy, non-poor elderly. PMID- 3515062 TI - [Septic risk after splenectomy: indications for prevention]. PMID- 3515063 TI - [Shakespeare and medical writings]. PMID- 3515064 TI - [The renin-aldosterone system in patients with chronic airway obstruction]. PMID- 3515065 TI - [Ethylene glycol poisoning]. PMID- 3515066 TI - [Myoclonic cerebellar dyssynergia (Ramsay Hunt syndrome)]. PMID- 3515067 TI - [Local biphasic reaction as a manifestation of allergy to insulin. Response to human insulin]. PMID- 3515068 TI - Expert systems and diagnostic monitors in psychiatry. PMID- 3515069 TI - Critiquing: a different approach to expert computer advice in medicine. PMID- 3515070 TI - Artificial intelligence and medical informatics. PMID- 3515071 TI - A new expert consultation system in deaf-blind syndromes. PMID- 3515072 TI - Gradualness eases refinement of medical knowledge. PMID- 3515073 TI - Can a patient data base help build a stroke diagnostic expert system? PMID- 3515074 TI - Diagnostic knowledge base construction. PMID- 3515076 TI - [Reconstructive surgery of the mandible within the scope of tumor operations]. PMID- 3515075 TI - [Simultaneous autologous spongioplasty and muscle flap transposition to restore the continuity of the leg with an osteitis defect]. AB - About 12% of compound fractures of the lower leg give rise to posttraumatic osteitis. Loss of bone by sequestration causes many problems particularly if soft tissue quality is poor. Cancellous and corticocancellous bone from the iliac crest is used for bony reconstruction. To obtain bony union, a well vascularised recipient for the graft is essential. Local muscle flaps and distant microvascular flaps and distant microvascular flaps improve vascularity by their separate connection to the vascular system. We treated 54 soft tissue defects by local muscle flaps in 41 and by microvascular flaps in 13 cases. In 21 cases a cancellous or a corticocancellous bone graft was used. Necrosis or partial necrosis of the flap occurred in 12 cases. Skin closure and healing was obtained by secondary procedures. Combined muscle flap and bone grafting was found to allow full weight bearing within reasonable period of time. PMID- 3515077 TI - [Late sequelae of the Caldwell-Luc operation. Comparison between the classic and Feldmann osteoplastic technic]. AB - Complaints and clinical findings with 178 classical Caldwell-Luc operations and 107 osteoplastic operations of maxillary sinus were compared in a follow-up study which took place at least 18 months postoperatively. After this time, the scarring process had reached a steady state. Unpleasant symptoms such as facial neuralgia and discomfort, were reduced to half after osteoplastic reconstruction of the anterior wall of the maxillary sinus. Postoperative closure of the antral nasal window occurred in 32.2% of the patients with the classical and in 17.3% with the osteoplastic procedure. Only 3 out of 34 replanted bone lids showed disturbed healing, as shown by 10 MHz B-Scan ultrasonic examination. PMID- 3515078 TI - [Dog bite injuries of the head and neck]. AB - Dog bite injuries of the head and neck concern mostly children. Early definite surgical treatment provides the best cosmetic results. If necessary, detached tissue must be re-implanted and defects be closed by flap plasties. Antibiotics are given to prevent infections. In most cases, a lack of knowledge or misinterpretation of the animal's behaviour caused the dog bite injury. Only a few animals were really "vicious". Rabies was not found among the animals covered by our study. PMID- 3515079 TI - Myocutaneous fenestration in sleep apnea patients. AB - We present a patient with severe obstructive sleep apnea syndrome (OSAS), including O2 desaturations to 11%, who was successfully managed with myocutaneous fenestration tracheostomy. The myocutaneous fenestration technique employs bilateral horizontal skin-platysma advancement flaps sutured directly to a tracheal fenestra created between rings two to four. It conforms ideally to the unique physical and psychological demands of the sleep apnea patient. Rapid healing time and minimal granulation tissue, combined with a permanently functional, yet reversible and minimally disfigurative stoma, highlight the advantages of the technique over standard tracheostomy. The myocutaneous fenestration tracheostomy is uniquely applicable to the surgical treatment of patients with moderate to severe obstructive sleep apnea. PMID- 3515080 TI - Two modifications of pectoralis major myocutaneous flap (PMMF). AB - Pectoralis major myocutaneous flap is the most commonly used versatile flap in head and neck reconstructive surgery. The use of entirely tubed pectoralis major myocutaneous flap for reconstruction of the hypopharynx following total laryngectomy and total pharyngectomy has a disadvantage of bulkiness of the flap and poor postoperative deglutition. One-stage reconstruction of the entire hypopharynx utilizing a combination of pectoralis major myocutaneous flap and dermal graft minimizes bulkiness, thus achieving satisfactory to excellent functional results. The operation has been performed on four patients with excellent deglutition. The pectoralis major myocutaneous flap is utilized to reconstruct the anterior and lateral walls of the hypopharynx, the dermal graft for the posterior wall as far superior as the vault of the nasopharynx. The operative procedure is described. Pectoralis major myocutaneous flap usually provides enough length to reach the distant site of the surgical defect. On occasion, however, additional length is desirable to avoid tension along the suture line. This becomes apparent when a random portion of elevated pectoralis major myocutaneous flap presents questionable viability which may require further trimming. Resection of the medial half of the clavicle can provide additional length of this flap by 2 cm to 2.5 cm. PMID- 3515081 TI - The low-output carbon dioxide laser for cutaneous wound closure of scalpel incisions: comparative tensile strength studies of the laser to the suture and staple for wound closure. AB - The low-output carbon dioxide (CO2) laser was used for cutaneous wound closure of scalpel incisions. Cutaneous scalpel incisions were placed over the dorsum of three minipigs and were then closed by either the laser, sutures, or staples. At multiple time points after wound closure, up to day 90, the tensile strengths of these wounds were comparatively evaluated. All wounds, including those closed with the laser, clinically appeared to heal similarly with no evidence of wound dehiscence or infection. Tensile strength studies revealed similar sigmoid curves for all wound closure modalities with low initial tensile strengths up to days 14 to 21, which afterwards increased rapidly, with a plateau toward day 90. From our study, it appears that the CO2 laser, in the low-output mode, can be used for cutaneous wound closure and that similar clinical healing and tensile strength measurements are obtained relative to the conventional cutaneous wound closure modalities of the suture or staple. PMID- 3515083 TI - [The Association of Croatian Physicians from its restoration to the present]. PMID- 3515082 TI - [5-Aminosalicylic acid--a new therapeutic possibility in chronic inflammatory bowel disease]. PMID- 3515084 TI - [The importance of the surgical service in the National Liberation War]. PMID- 3515086 TI - [Revolution--the road to freedom]. PMID- 3515085 TI - [The importance of the immunofluorescence Crithidia test for the determination of anti-dsDNA antibodies]. PMID- 3515087 TI - [Medical schools in Croatia and their contribution to the development of the medical profession and medical knowledge]. PMID- 3515088 TI - [Magistrate Kristofor--physician (the 1st physicians' pension in old Dubrovnik, 1399)]. PMID- 3515089 TI - [Paraneoplastic hypoglycemic syndrome--report of a patient with recurrent tumor hypoglycemia]. PMID- 3515090 TI - [Treatment of lymphocele after kidney transplantation by povidone-iodine instillation]. PMID- 3515091 TI - Effect of various enkephalin analogs and dipeptides on the enzymatic activity of enkephalinase B isolated from calf-brain striatum. AB - The inhibitory potency of several enkephalin analogs and dipeptides on the calf brain enkephalinase B activity was established with the aim to characterize its active site. Highest potency was measured for dipeptides with a large side chain on both amino acids. The nature of the distal amino acid is of minor importance, provided it is not a glycine. Free carboxylic function is required for good interaction, whereas the stereochemical configuration of the dipeptide is less so. Enkephalinase B has only little affinity for D-Ala2-Leu-enkephalin. The data are to be used for the design of new enkephalinase B inhibitors. PMID- 3515092 TI - Nomenclature for enkephalin degrading peptidases. AB - The use of trivial names for enkephalin degrading peptidases such as "aminoenkephalinase" and "carboxyenkephalinase" imply a specificity and cellular localization which is not inherent in any of the peptidases implicated in the degradation of endogenous enkephalins. Rather than name these enzymes on the basis of one of their many substrates, it is proposed that they be named according to their general reaction type. Such a nomenclature has already been proposed for the enkephalin degrading endopeptidase 24.11 given the trivial name "enkephalinase". PMID- 3515093 TI - Organophosphorus anticholinesterases do not mediate analgesia through inhibition of enkephalin degradation. AB - The effect on enkephalin degradation of the four highly potent organophosphorus anticholinesterases, soman, sarin, tabun and DFP was studied in synaptosomal fractions of rat brain striata. None of the agents effected any of the enkephalin degrading enzymes, the puromycin sensitive aminopeptidase, the p hydroxymercurybenzoate (p-HMB) sensitive dipeptidyl aminopeptidase or the phosphoramidon sensitive enkephalinase. Furthermore, no peptidase function of acetylcholinesterase was found, when Leu-enkephalin was used as substrate at low concentrations (27 nM). Supporting the in vitro data, no difference was obtained in the striatal levels of Met- and Leu-enkephalin between rats receiving a high single dose of soman and controls. The results show that the analgesic effect of anticholinesterases are more likely due to mechanisms other than inhibition of enkephalin degradation. PMID- 3515095 TI - In remembrance of Henry Kircher. PMID- 3515094 TI - Evidence for facilitated transport in the absorption of sterols by Saccharomyces cerevisiae. AB - Saccharomyces cerevisiae is known to absorb sterols readily in the absence of air. As shown in this paper, yeast cells also will absorb sterols with and without various double bonds or an alkyl group at C-24 in the presence of air at a concentration (ca. 10% of the gas phase) which is growth-limiting due to limited sterol synthesis. However, if the growth conditions are changed to be fully aerobic, sterol is no longer absorbed to any significant extent even when the sterol in the medium (ergosterol) is the same as that present in the cells. This implies that sterol in the medium does not equilibrate passively with sterol in the plasma membrane and that some sort of facilitated transport, which can be turned on and off, is responsible for the entry of sterol when it occurs as a response to an inadequate endogenous supply of sterol. In agreement with facilitated transport mediated by protein binding, yeast cells in an auxotrophic state for sterol exhibit a high degree of stereoselectivity with respect to the orientation of the side chain around the C-17(20)-bond. For instance, E-17(20)- but not Z-17(20)-dehydrocholesterol is absorbed by cells undergoing limited growth with 10% air. PMID- 3515097 TI - An essential fungal growth factor derived from ergosterol: a new end product of sterol biosynthesis in fungi? AB - Concentrations of ergosterol as low as 1.2 mM are effective in satisfying the essential high specificity microrequirement for C5,6 unsaturated sterol in yeast. In a sterol auxotroph supplemented with saturated sterol (cholestanol), aqueous extracts of yeast provide a growth factor that eliminates the ergosterol microrequirement. The factor is easily differentiated from ergosterol by solubility, thermostability, and thin layer and liquid chromatography and is functional at levels equivalent to those of vitamins, hormones and pheromones. PMID- 3515098 TI - Synthesis of the dipalmitoyl species of diacyl glycerophosphocholine by rabbit alveolar macrophages. AB - The distribution of radioactivity among the molecular species of diacyl glycerophosphocholine of rabbit alveolar macrophages was determined after incubation with [3H]glycerol and 1-[14C]palmitoyl-sn-glycero-3-phosphocholine. The highest percentage of radioactivity of [3H]glycerol was found in the dipalmitoyl species (35% of the total) followed by the 1-palmitoyl-2-linoleoyl (23.6%) and 1-stearoyl-2-linoleoyl plus 1-palmitoyl-2-oleoyl species (19.7%) during the first 30 min incubation. The radioactivity of the dipalmitoyl species reached a maximum at 120 min incubation and decreased thereafter, although the radioactivities of other molecular species still increased. In contrast to the [3H]glycerol labeling, only 4% of the total radioactivity in diacyl glycerophosphocholine derived from 1-[14C]palmitoyl glycerophosphocholine was found in the dipalmitoyl species; 80% of the radioactivity was located in the 1 palmitoyl-2-arachidonoyl species at 10 min incubation. The present results indicate that the dipalmitoyl species of diacyl glycerophosphocholine are synthesized predominantly via a de novo pathway and not the deacylation reacylation pathway in rabbit alveolar macrophages. PMID- 3515096 TI - The squalene-2,3-epoxide cyclase as a model for the development of new drugs. AB - The 2,3-oxido squalene (SO) cyclases represent a group of enzymes which convert SO into polycyclic triterpenoids such as lanosterol, cycloartenol, cucurbitadienol and beta-amyrin. Taking into account the postulated model of the enzymatic cyclization of SO, we have investigated the possibility of designing compounds that would be selective and potent inhibitors of SO cyclases. Due to the fundamental role of sterols in animal, higher plant and fungal tissues, these inhibitors might behave as very selective (ipocholesterolemic, antifungal or phytotoxic) drugs. Our first approach was the synthesis and biological evaluation of 2-aza-2,3-dihydrosqualene and its derivatives which, being protonated at physiological pH, would present some similarities to the C-2 carbon ion generated by the opening of the oxirane ring of SO. Microsomes from different sources (germinated pea cotyledons, maize seedlings, rat liver and yeasts) were utilized to determine the inhibition values (I50: concentration of inhibitor producing 50% inhibition at a given substrate concentration). From the results obtained so far we conclude that 2-aza-2-dihydrosqualene and its derivatives strongly inhibited the cyclases, the site of the enzyme responsible for binding to the inhibitor is quite sensitive to the steric hindrance, and the degree of the inhibitory activity is greater in higher plants than in rat liver or fungi. PMID- 3515099 TI - The connections between eugenics, sterilization and mass murder in Germany from 1933 to 1945. PMID- 3515100 TI - The Dalkon Shield in perspective. PMID- 3515101 TI - Nurse practitioners: functions, legal status and legislative control. PMID- 3515102 TI - A blood culture quality control scheme. PMID- 3515103 TI - Rapid presumptive identification of Escherichia coli from urine samples: a simple direct plating method. PMID- 3515105 TI - Single radial haemolysis for demonstrating measles virus antibody. PMID- 3515104 TI - Identification of pathogenic Neisseria by enzyme profiles determined with chromogenic substrates. PMID- 3515106 TI - Analysis of lymphocyte sub-populations in cytocentrifuge preparations. PMID- 3515107 TI - The Legionellaceae. PMID- 3515108 TI - [Importance of the value of the dose fraction and the time factor in radiation therapy]. PMID- 3515109 TI - [Radioimmunologic determination of beta 2-microglobulin and carcinoembryonic antigen in the diagnosis of recurrences of rectal cancer]. AB - The paper is concerned with the results of the determination of beta 2 microglobulin (beta 2-MG) and CEA concentrations in rectal cancer patients to improve diagnosis of recurrences. The CEA content was shown to be the most specific indicator reflecting the course of a recurring tumor process whereas the beta 2-MG test was found inappropriate for the purpose though it might be used in suspected involvement of the urinary organs in a tumor process. PMID- 3515110 TI - [Cyclicity, reversibility and compensation of magnetobiological reactions in isolated cells and tissues]. AB - Cell sensitivity to a constant magnetic field (CMF) of 100 = 200 Oe was studied on a fibroblast culture using time-lapse microfilming. It was expressed in the phasic development of the motility of cells, intracellular structures and inclusions: a short-term latent phase (10-15 min), an excitation phase (1.5-2 h) and a suppression phase (up to the end of exposure). After field removal the return of cells to the initial state with a slight excess (in 1.5-2 h) was noted. The phasic development, reversibility and compensation of magnetobiological reactions were later on confirmed in studies on the inhibition in CMF of 400-600 Oe of the activity of succinate dehydrogenase and peptidase in isolated surviving rat skeletal muscles, liver and kidney as well as on a model of the reaction of a cytopathogenic effect of lymphocytes from patients with rheumatic fever on human embryonic fibroblasts where a noticeable effect of inhibition with the CMF action on the system of lymphocytes-fibroblasts and, on the contrary, of its activation with adding to fibroblasts lymphocytes preexposed in CMF of 400-600 Oe for 1 and 24 h were revealed and interpreted as supercompensation of the inhibited enzymatic activity of immunocompetent cells. The phasic development, reversibility and compensation of magnetobiological reactions should be necessarily taken into account in working out magnetotherapy. PMID- 3515111 TI - [Magnetic resonance--physical bases of the method and technology of obtaining images]. PMID- 3515112 TI - [Chemiluminescence of whole blood in the early stages after experimental whole body irradiation]. PMID- 3515113 TI - [Abu Bakr Razi--great physician of the medieval Orient]. PMID- 3515114 TI - [Relation of the strength of metal-ceramic systems to the surface roughness of the metallic frameworks]. PMID- 3515115 TI - Left ventricular performance of the athletic heart during upright exercise: a heart rate-controlled study. AB - This study compares the left ventricular performance of chronically conditioned pentathletes (N = 10) with less-conditioned subjects (N = 10) during dynamic upright exercise. The pentathletes were found to have a superior treadmill performance [24 +/- 4 vs 17 +/- 2 min (SD), P less than 0.01], reduced resting heart rate (41 +/- 13 vs 62 +/- 6 bpm, P less than 0.01), and increased left ventricular mass (254 +/- 85 vs 179 +/- 35 g, P less than 0.05) compared to the control group. Radionuclide ventriculography and heart rate controlled-bicycle ergometry were employed to examine changes in left ventricular ejection fraction, end-diastolic volume, end-systolic volume, and stroke volume. Heart rate was controlled by adjusting the resistance of the ergometer until stable heart rates of 90, 110, 130, and 150 bpm were achieved. Following heart rate stabilization, 99mTc images were acquired during 3-min stages at each target heart rate level. In the pentathletes, left ventricular ejection fraction, end-diastolic volume, and stroke volume increased (P less than 0.01) during exercise, and end-systolic volume tended to decrease. No difference was noted in left ventricular ejection fraction between groups when heart rates were matched. However, the exercise induced changes in end-diastolic volume and stroke volume were greater (P less than 0.01) in the pentathletes. In conclusion, the athletes studied relied on the same mechanism as the less-conditioned subjects for improving pump performance during exercise stress, but the athletes' ability to mobilize a greater end diastolic volume accounts for their larger stroke output during each stage of heart rate-matched exercise. PMID- 3515116 TI - Implementation of the home and community-based waiver. PMID- 3515117 TI - Reduced hepatic insulin clearance in rats with dietary-induced obesity. AB - Insulin uptake in the in situ perfused liver from rats that were moderately obese after overfeeding was diminished in comparison with controls. The obese rats had higher levels of portal free fatty acids (FFA) and liver triglyceride contents but not of insulin concentration in the portal vein. There were strong negative correlations between hepatic triglyceride and insulin clearance (r approximately 0.8-0.9). The perfusions were performed with lower FFA concentrations than those in vivo in the portal vein. It is suggested that the inhibited insulin uptake in the obese rats was due to exposure of these livers in vivo to elevated FFA concentrations, and that this inhibition remained during the experiment and was associated with the triglyceride contents of the livers. It is also suggested that this mechanism was responsible for the moderate peripheral hyperinsulinemia seen in these rats. A mechanism of regulation of insulin uptake in the liver via FFA and liver triglyceride might be of importance in several conditions with hyperinsulinemia and known elevation of portal FFA, and liver triglyceride contents. PMID- 3515119 TI - Potentiation of glucose-stimulated insulin release by tolazamide and paradoxical absence of glucose facilitation (Staub effect) in non-insulin-dependent diabetes. AB - Acceleration of glucose tolerance after repetitive intravenous glucose loads (Staub-Traugott effect) has not previously been tested in non-insulin-dependent diabetes (NIDDM). Six overt, untreated subjects were administered three hourly IV glucose tolerance tests (GTT). The glucose disappearance rate (K) changed very little between loads, indicating a suppressed Staub effect. However, insulin levels increased with each load. The characteristic loss of early phase insulin release after the first intravenous glucose injection was recovered with the third injection. After four months of tolazamide treatment the fasting plasma glucose fell from 180 +/- 19 to 134 +/- 13 mg/dL. Despite dramatic potentiation of glucose-stimulated insulin release and further improvement of early phase insulin release, K values again failed to progressively rise. This paradox occurred even in three additional subjects tested after two years of tolazamide treatment, suggesting that tolazamide may not ameliorate the postreceptor defects that impede the expression of the Staub effect. The applicability of the glucose facilitatory effect to the treatment of NIDDM might be limited to subjects in whom adjunctive measures have reestablished effective tissue responsiveness to endogenous insulin. PMID- 3515118 TI - Basal and glucose- and arginine-stimulated serum concentrations of insulin, C peptide, and glucagon in hyperthyroid patients. AB - The effect of oral glucose and arginine infusion on plasma glucose, glucagon, serum insulin, and C-peptide concentrations was evaluated in 16 patients with hyperthyroid Graves' disease and in ten euthyroid age- and sex-matched normal subjects. Basal plasma glucose concentrations were significantly higher in the hyperthyroid patients, but the plasma glucose response following glucose and arginine administration was similar in the two groups. The insulin response was similar in the hyperthyroid and normal subjects after glucose administration and significantly lower during arginine infusion in the hyperthyroid patients. The serum C-peptide response to both glucose and arginine administration was markedly blunted in the hyperthyroid patients, and the plasma glucagon response to arginine infusion was decreased. These results suggest that pancreatic beta and alpha cell secretory function is impaired in hyperthyroidism as assessed by C peptide and glucagon secretion following oral glucose administration and arginine infusion. The apparent discrepancy between C-peptide and insulin secretion in the hyperthyroid patients following glucose administration might be due to diminished hepatic extraction of insulin or enhanced metabolism of C-peptide. PMID- 3515120 TI - Intermediary metabolism in diabetic dogs treated with pancreatic autotransplants and insulin pumps. AB - Diurnal metabolite profiles were studied in pancreatectomized dogs who had received grafts of their own pancreas. The results were compared to similarly diabetic animals who received exogenous insulin pumped intravenously either peripherally or portally. All animals were studied at least 52 weeks after pancreatectomy. Nondiabetic animals were similarly studied as normal controls. Interestingly, all of the diabetic animals were in excellent metabolic control but significant differences from normal in one or more of the metabolic variables existed in each group. Thus, none of the methods of insulin replacement entirely restored to normal the metabolic state of the pancreatectomized dogs. For example, in the autotransplanted animals, the profiles of glucose, lactate, pyruvate, and alanine manifested either abnormal levels and/or abnormal postprandial excursions. The grafts delivered insulin into the peripheral rather than portal circulations. In the peripherally infused animals, the profiles of pyruvate, alanine, and free fatty acids were also somewhat abnormal. In the portally infused animals the profiles only of pyruvate and alanine showed minor abnormalities without clear statistical significance in some respects as well. The other differences observed were statistically significant (P less than 0.05 0.01). These results suggest that the portal route of insulin delivery may be the route of choice if intermediary metabolism is to approximate normal most closely whether exogenous intravenous insulin is replaced by implanted pumps or endogenous insulin is replaced by pancreatic transplants and that none of these futuristic methods of insulin replacement entirely restore to normal the metabolic state of pancreatectomized dogs. PMID- 3515121 TI - Applicability of red blood cell sorbitol measurements to monitor the clinical activity of sorbinil. AB - Increased flux of glucose through the polyol pathway with resultant resultant accumulation of tissue sorbitol is implicated in the pathogenesis of the chronic complications of diabetes. Sorbinil is a potent inhibitor of aldose reductase (the first enzyme in the polyol pathway) and has been shown to normalize sorbitol levels in relevant tissues (eg, nerve, kidney, lens) of experimentally-induced diabetic animals. The purpose of this study was to identify a relatively noninvasive method of monitoring the intrinsic (or biochemical) efficacy of sorbinil in diabetic man. Specifically, the objective was to identify a readily accessible tissue that would be reflective of polyol pathway activity and the activity of sorbinil in clinically relevant but less accessible tissues. Based on several previous studies, which demonstrated that sorbitol accumulation in human red blood cells (RBCs) was a function of ambient glucose concentrations, either in vitro or in vivo, our investigations were conducted to determine if RBC sorbitol accumulation would correlate with sorbitol accumulation in lens and nerve tissue of diabetic rats; the effect of sorbinil in reducing sorbitol levels in lens and nerve tissue of diabetic rats would be reflected by changes in RBC sorbitol; and sorbinil would reduce RBC sorbitol in diabetic man. PMID- 3515122 TI - The nuclear matrix: current concepts and unanswered questions. PMID- 3515123 TI - Human antibodies and their use for the study of chromosome organization. PMID- 3515124 TI - Nuclear changes in muscle disorders. PMID- 3515125 TI - Molecular organization of chromatin as revealed by electron microscopy. PMID- 3515126 TI - The isolation and mapping of EF-Tu mutations in Salmonella typhimurium. AB - The first isolation of EF-Tu mutations in Salmonella typhimurium is reported. The mutations were isolated by selecting for resistance to the antibiotic mocimycin (= kirromycin). The mocimycin resistant phenotype is the result of mutations in each of two genes, tufA and tufB. Strains mutant in only one of the two tuf genes are sensitive to mocimycin. The spontaneous mutation rate of each of the two tuf genes to a mocimycin resistant phenotype differs by an order of magnitude. tufA maps at minute 71-72, closely linked to rpsL. tufB maps at minute 88-89, closely linked to rpoB. These map positions correspond to the locations of tufA and tufB in E. coli. PMID- 3515127 TI - An altered ribosomal protein in an edeine-resistant mutant of Saccharomyces cerevisiae. AB - The r-proteins of an edeine-resistant mutant of Saccharomyces cerevisiae were compared to those of the wild-type strain by using two different two-dimensional electrophoretic techniques: (1) the Kaltschmidt-Wittmann method and, (2) the Kaltschmidt-Wittmann system, in the first dimension and the Na Dodecyl-SO4 system in the second. With the first technique, the results indicate that the patterns of basic ribosomal proteins are similar in the two strains. However, the pattern of acidic ribosomal proteins of the mutant revealed an additional protein band with respect to the normal one. Using the other technique, the patterns of basic and acidic ribosomal proteins of the mutant demonstrated a similarity to the corresponding pattern of the wild-type strain. The data disclose that an acidic ribosomal protein of the mutant may have two forms with different electrophoretic mobilities and similar molecular weights. PMID- 3515128 TI - Mutational specificity of a proof-reading defective Escherichia coli dnaQ49 mutator. AB - The dnaQ (mutD) gene product which encodes the epsilon-subunit of the DNA polymerase III holoenzyme has a central role in controlling the fidelity of DNA replication because both mutD5 and dnaQ49 mutations severely decrease the 3'-5' exonucleolytic editing capacity. It is shown in this paper that more than 95% of all dnaQ49-induced base pair substitutions are transversions of the types G:C-T:A and A:T-T:A. Not only is this unusual mutational specificity precisely that observed recently for a number of potent carcinogens such as benzo(a) pyrene diolepoxide (BPDE) and aflatoxin B1 (AFB1), which are dependent on the SOS system to mutagenize bacteria, but it is also seen for the constitutively expressed SOS mutator activity in E. coli tif-1 strains as well as for the SOS mutator activity mediated gap filling of apurinic sites. Because the G:C-T:A and A:T-T:A transversions can either result from the insertion of an adenine across from apurinic sites or arise due to the incorporation of syn-adenine opposite a purine base, we postulate that the DNA polymerase III holoenzyme also has a reduced discrimination ability in a dnaQ49 background. The introduction of a lexA (Ind-) allele, which prevents the expression of SOS functions, led to a significant reduction in the dnaQ49-caused mutator effect. Both, the mutational specificity observed and the partial lexA+ dependence of the mutator effect provoke a reanalysis of the hypothesis that the DNA polymerase III holoenzyme can be converted into the postulated but until now unidentified SOS polymerase. PMID- 3515129 TI - Analysis of mutagenic DNA repair in a thermoconditional mutant of Saccharomyces cerevisiae. III. Dose-response pattern of mutation induction in UV-irradiated rev2ts cells. AB - Recent studies regarding the influence of cycloheximide on the temperature dependent increase in survival and mutation frequencies of a thermoconditional rev2 mutant lead to the suggestion that the REV2-coded mutagenic repair function is UV-inducible. In the present study we show that stationary-phase rev2ts cells are characterized by a biphasic linear-quadratic dose-dependence of mutation induction ("mutation kinetics") of ochre alleles at 23 degrees C (permissive temperature) but linear kinetics at the restrictive temperature of 36 degrees C. Mathematical analysis using a model based on Poisson statistics and a further mathematical procedure, the calculation of "apparent survival", support the assumption that the quadratic component of the reverse mutation kinetics investigated can be attributed to a UV-inducible component of mutagenic DNA repair controlled by the REV2 gene. PMID- 3515130 TI - Base pair substitution and frameshift mutagenesis induced by apurinic sites and two fluorene derivatives in a recA441 lexA (Def) strain. AB - One of the consequences of the induction of the Escherichia coli SOS system is the increased ability of the cells to perform mutagenesis. Induction of the SOS system is the result of derepression of a set of genes through a regulatory mechanism controlled by LexA and RecA. In response to an inducing signal, RecA is activated in a form that facilitates the proteolytic cleavage of LexA repressor. Previous works have shown that activated RecA plays a second role, i.e. it is required for the establishment of base pair substitution mutations promoted by UV irradiation. Using a forward mutational assay and recA441 lexA (Def) host bacteria, we show that the result can be extended not only to other mutagens promoting base pair substitution mutations (Apurinic sites, Ap sites and N hydroxy-N-2-aminofluorene, N-OH-AF) but also mutagens promoting frameshift mutations (N-Acetoxy-N-2-acetylaminofluorene, N-AcO-AAF). In the recA441 lexA (Def) strain all the genes which are part of the lexA regulon, including recA itself, are expressed constitutively. The recA441 mutation allows RecA to acquire its activated form when the bacteria are grown at 42 degrees C. We show that in such strains Ap sites or N-OH-AF induce a high level of mutations only when the bacteria are grown at 42 degrees C. On the other hand, we show that N-AcO-AAF can promote mutations even at 30 degrees C; the number of mutations being increased when the bacteria were grown at 42 degrees C.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3515131 TI - Bertha Van Hoosen, MD was a woman of many "firsts". PMID- 3515133 TI - Protein-mediated elevations in renal hemodynamics: existence of a hepato-renal axis? AB - Unlike the intestinal hyperemia which occurs following ingestion of a mixed meal, postprandial renal hemodynamic responses to food appear to be specific to protein rich meals. Several observations have led to the proposal that following ingestion of protein (meat), a blood-borne factor(s) is released into the systemic circulation which elicits the increases in renal hemodynamics. Glucagon was initially considered as a prime hormonal candidate since the polypeptide is preferentially secreted by the endocrine pancreas in response to protein-rich meals and because glucagon elevates renal hemodynamics by selectively dilating renal afferent arterioles. However, recent data indicate that at postprandial blood levels, glucagon fails to directly mediate protein-induced renal hyperemia and hyperfiltration thus questioning the physiologic importance of glucagon on the renal vasculature. Data have accumulated indicating the importance of the liver and hepatic metabolism during protein-mediated elevations in renal hemodynamics. A hypothesis is advanced suggesting the existence and physiologic importance of a "hepato-renal axis" in mediating the postprandial increases in renal hemodynamics following ingestion of protein-rich meals. The blood-borne factor(s) mediating this response remains to be further clarified and defined. PMID- 3515132 TI - Estrogen-induced proteins: a new class of regulatory substances. AB - The discovery of estrogen-induced growth factors (estromedins) identified a missing link in understanding endocrine regulation. Estromedins are probably not on in vitro mitogens or auto-/paracrine growth regulators but play an important endocrine regulatory role. A review of the literature and our own previous in vivo endocrine experiments with uterus and uterine extracts support this concept. We have also discussed the effects of some other newly discovered endocrine regulators on the synthesis/release and peripheral action of gonadotropins and lactogens. We conclude that our view on endocrine regulation is fundamentally changing. In addition to the classical endocrine axis (hypothalamus-pituitary peripheral tissue) several new factors and conditions have to be taken into consideration to understand the regulation of an endocrine effect on a target organ. PMID- 3515134 TI - Towards safer bone-marrow transplantation. PMID- 3515135 TI - The role of psychological intervention in the management of patients after myocardial infarction. AB - A review of the literature suggests that it is neither appropriate nor cost effective to involve as a routine all patients who have suffered a myocardial infarction in a traditional outpatient rehabilitation programme where physical conditioning is the principal (or only) ingredient. However, there is evidence to show that psychological intervention programmes that provide short-term psychological support, health education and intervention in coronary risk behaviour influence favourably both physical and psychosocial outcome. The case is put forward for intervention, during the first few days of the patient's admission to hospital, with a treatment package that comprises health education and relaxation therapy. The need for further interventions such as counselling, behavioural therapy, and physical conditioning may be assessed, depending on the patient's response to the initial programme. PMID- 3515137 TI - A double-blind trial with clonidine and a placebo to treat hot flushes. AB - A double-blind crossover study that compared clonidine and a placebo, which were administered to 19 postmenopausal women who were suffering from hot flushes, failed to demonstrate any statistical reduction in the number of hot flushes. Therefore, clonidine is not recommended as a treatment drug for this symptom. PMID- 3515136 TI - Metoclopramide--a review. AB - Metoclopramide has wide applications in both clinical and experimental medicine. It is useful in the management of gastro-oesophageal reflux and gastric stasis. It is being used increasingly in the management of nausea and vomiting, and at high doses will significantly relieve the emesis that is induced by cytotoxic agents. Metoclopramide also has an important place in the investigation of the role of dopamine in physiological and pathological processes. PMID- 3515138 TI - Bone-marrow transplantation for thalassaemia. AB - An 18-month-old boy with beta-thalassaemia major underwent bone-marrow transplantation with marrow from his 30-month-old brother. The brother was HLA identical, mixed-lymphocyte culture non-reactive and had thalassaemia minor. The patient was "conditioned" with busulphan and cyclophosphamide before transplantation and received methotrexate to prevent graft-versus-host disease. Immediately after the transplant, complications arose, which included mild graft versus-host disease, gastrointestinal bleeding and fever. The boy is alive 18 months after transplantation, is leading a normal life, is receiving no therapy and has a normally functioning donor marrow with thalassaemia minor. Bone-marrow transplantation may be considered as alternative therapy in patients with beta thalassaemia who are young, and who have no organ dysfunction or iron overload. Chronic transfusion and chelation therapy and its problems must be weighed against the 13% risk of mortality and the 73% chance of a normal life that are associated with transplantation. Older patients, who have received multiple blood transfusions, have iron overload or have organ dysfunction, have a low survival rate after transplantation and this therapy is inappropriate for such patients. PMID- 3515139 TI - Second annual progress report on introduction and use of investigational anticancer agents in Australia, 1984-1985. Anticancer Subcommittee of the Australian Drug Evaluation Committee. AB - Since the publication of its first report, the Anticancer Subcommittee of the Australian Drug Evaluation Committee (ADEC) has provided advice to ADEC and to the Commonwealth Department of Health on investigational anticancer agents in all stages of development. This second report outlines the progress in 1984-1985. PMID- 3515140 TI - The management of diabetes in Aboriginal patients. PMID- 3515141 TI - German measles. PMID- 3515142 TI - [Diabetes mellitus: what's new]. PMID- 3515143 TI - Ribavirin (Virazole). PMID- 3515144 TI - Phenotypic variations among enterotoxigenic O-groups of Escherichia coli from various human populations. AB - ETEC isolates from various sources (children from Ethiopia and some Asian countries, and Swedish tourists suffering from traveller's disease) were analysed with the aid of "biochemical fingerprinting", which is a highly discriminative, computerized method designed to subdivide E. coli isolates into different phenotypes. Isolates belonging to the most common ETEC O-groups and others which had not been typeable with available O-antisera were selected. It was found that certain phenotypes of O-groups 6 and 114 could be found in materials from several continents. Phenotypes of other O-groups were usually more restricted to certain geographic areas. Among children in Addis Abeba, 19 out of 25 isolates carrying O antigen 78 belonged to the same phenotype. Some possible explanations for the fact that certain phenotypes of enterotoxigenic E. coli could be found over the whole world are that they might represent relatively recent developed clones, or they may represent unusually stable clones. Of the isolates that had been nontypeable with available antisera, some had lost their LT-productivity after one year of storage. These isolates proved to belong to a wide variety of phenotypes, whereas nontypeable isolates which were stable LT-producers could be clustered into distinct groups. It is suggested that the non-stable LT-producers are members of the normal E. coli flora of these children, which have occasionally picked up the enterotoxin-producing plasmids, whereas most stable LT producers represent true ETEC clones. PMID- 3515145 TI - Stability of thermolabile (LT) enterotoxin produced from enterotoxigenic Escherichia coli strains maintained in vitro. AB - The stability of thermolabile (LT) enterotoxin in 26 strains of porcine enterotoxigenic Escherichia coli (PETEC) belonging to serogroups 08 and 0149 was assayed by the passive immune hemolysis (PIH) test, over a period of 9 months at 70 degrees C. It was found that the percentage of LT+ colonies (% LT+) and the mean value of hemoglobin release (XHb), could predict a change from LT+ to LT-. PMID- 3515147 TI - Innovative approaches for the study of cultured renal epithelia. AB - Significant advances in renal transport physiology have traditionally depended on the development of novel experimental methods. Increasingly, attention is being given to the application of cell culture technology to renal growth and differentiation, transport, pharmacology and endocrinology. Cell culture not only offers a new technical approach to long-standing problems but, more importantly, provides a tool for expanding renal physiology beyond traditional conceptual boundaries. Renal physiology, placed in the theoretical and technical framework of cell and molecular biology acquires a plethora of novel directions and insights exemplified by the transformation of classical neurophysiology into contemporary molecular neurobiology. For renal cell culture to have this impact, long-term functional cell lines derived from identified nephron segments must be available. Innovative cell culture methods and concepts will be required for these objectives to be achieved. PMID- 3515148 TI - [Epitheliomesenchymal interactions during odontogenesis]. PMID- 3515149 TI - [Pregnancy and local anesthesia in dentistry]. PMID- 3515146 TI - Pathophysiology of Campylobacter enteritis. PMID- 3515150 TI - [Juvenile periodontitis. A review of the literature]. PMID- 3515151 TI - [Distribution of juvenile periodontitis between the sexes. The importance of epidemiologic studies]. PMID- 3515152 TI - [Maxillofacial prostheses. The direct construction of an operculum on a preexisting surgical plate]. PMID- 3515153 TI - [Epidemiological study of the incidence of caries and malocclusion in the deciduous dentition of the children in USL 16 nursery schools (Genoa-Levante)]. PMID- 3515154 TI - [Oral lichen ruber planus in dental practice. A critical review of the literature and notes on clinical diagnosis and therapy]. PMID- 3515155 TI - [Developmental fossula of the salivary gland on the lingual face of the mandible. Description of a case and a review of the literature]. PMID- 3515156 TI - [Epistemology and dental practice in the Renaissance school of Padua]. PMID- 3515157 TI - High frequency jet ventilation: a neonatal nursing perspective. PMID- 3515158 TI - Policies and procedures. High frequency jet ventilation: endotracheal suction procedure. PMID- 3515159 TI - [A clinical report of vascularized segmental pancreatic autotransplantation in chronic pancreatitis]. AB - A vascularized segmental autotransplantation of distal 80% of the pancreas to the right iliopelvic space was successfully performed in a 51-year-old male who had alcoholic chronic pancreatitis. Distal 80% of the gland with severe calcified pancreatitic change was resected and prepared for transplantation by injecting the splenic artery with Ringer's lactate solution containing heparin, albumin and gabexate mecilate cooled to 4 degrees C. The spleen was removed from the specimen. An arteriovenous fistula was constructed at the tail. End-to-side anastomosis of spleno-external iliac veins was carried out after small fusiform resection of the iliac venous wall for the purpose of sufficient venous patency. End-to-end anastomosis of spleno-hypogastric arteries was done. The pancreatic stump was anastomosed to the ileum. Post-operatively, the pain completely resolved. Patency of the graft was demonstrated by angiography. Higher response of the C-peptide immunoreactivity on 75 g OGTT was found in the iliac vein on the transplanted side than in another peripheral vein. The exocrine pancreatic function diagnostant test showed 78.8% post-operatively (vs. 63.2% pre operatively). Vascularized segmental pancreatic autotransplantation offers an excellent method of relieving pain with preservation of endocrine and exocrine functions in selected cases with chronic pancreatitis. PMID- 3515160 TI - Plasminogen activator activity in differentiating rat myoblasts. AB - Primary cultures of skeletal muscle cells secrete plasminogen activator (PA) activity to the conditioning medium and display membrane-bound PA. Growth of these cells in culture in presence of 10(-7) M dexamethasone resulted in a marked reduction of the membranal and secreted PA activity. The hormone also reduced cytosolic creatine phosphokinase (CPK) activity and cytosolic protein content. However, cell viability and their ability to undergo fusion were uneffected. The extent of hormone-induced reduction in PA activity depended on the time and extend of exposure. Maximal suppression was obtained by exposing the cells to dexamethasone during the first 4 days of culture. The medium conditioned with dexamethasone-treated cells did not inhibit plasmin, endogenous PA or exogenous PA. Exposure of the conditioned medium from hormone-treated cells to sodium dodecyl sulphate (SDS) or trypsin restored the activity to values observed in media from cells not exposed to the hormone. Acidification of the medium failed to reactivate the enzyme. The myogenic cell line L-8 also displayed membrane bound PA activity, which was of a comparable magnitude in both fusing and non fusing L-8 cells. However, in contrast to the primary cultures, exposure of L-8 cells to dexamethasone had no effect on their PA activity whether studied under conditions which allowed or prohibited fusion. The present findings imply that PA has no conducive role in the process of fusion associated with maturation of skeletal muscle cells. PMID- 3515162 TI - Psoralen photomutagenic specificity in Salmonella typhimurium. AB - The cytotoxic and mutagenic specificity of two therapeutically employed psoralens was examined in several Ames Salmonella typhimurium strains with near ultraviolet light (UVA, 320-400 nm) activation. Photomutagenic activity of 8-methoxypsoralen (8MOP) and 4,5',8-trimethylpsoralen (TMP) was found to be sequence-specific, and additionally was dependent on the level of DNA-repair proficiency. Base-pair substitution photomutagenesis in hisG46 appeared to require plasmid pKM101 mediated "error-prone" repair. Frameshift photomutagenesis was observed in all hisC3076 strains but not in hisD3052 strains. Frameshift mutagenic activity in hisC3076 was enhanced in the absence of uvrB excision repair and increased further by plasmid pKM101. Phototoxicity was essentially identical in hisC3076, hisD3052 and hisG46 strains; uvrB- excision-repair-deficient bacteria were considerably more susceptible to lethal effects than wild-type parental strains, while the presence of pKM101 had no apparent effect on survival. Finally, the data show that psoralens are potent frameshift photomutagens in Salmonella hisC3076 strains and demonstrate the potential utility of these strains in evaluating photomutagenic and phototoxic activity of new furocoumarin derivatives. PMID- 3515163 TI - Activation and detoxication of promutagens by toadfish (Opsanus tau) hepatic postmitochondrial fractions in the Salmonella assay. AB - Three groups of experiments were conducted to characterize the hepatic postmitochondrial fraction (S9) from the oyster toadfish (Opsanus tau) as an activation system for promutagens in the Salmonella assay and to provide an initial evaluation of the extent to which data from standard in vitro assays with mammalian activation systems are predictive of possible genotoxic effects in this marine fish. In the first group of experiments the effects of increasing the concentration of S9 from untreated and 3-methylcholanthrene (MC)- or Aroclor 1254 (AC)-pretreated toadfish and Sprague-Dawley rats on the mutagenicities of different concentrations of 2-aminoanthracene (2AA) and benzo[a]pyrene (BAP) were examined in Salmonella (TA98) plate assays. The maximum levels of 2AA mutagenicity attained by S9 from untreated (UI S9) toadfish and rats were comparable, but UI S9 from toadfish was more effective than UI S9 from rats in mediating BAP mutagenicity. MC pretreatment decreased maximum levels of 2AA mutagenicity and increased maximum levels of BAP mutagenicity mediated by S9 from both species. MC pretreatment also altered the pattern of dependence of 2AA mutagenicity on the concentration of S9 protein for S9 from both species. A similar alteration in the pattern of dependence of BAP mutagenicity on the concentration of S9 protein was also observed with S9 from MC-pretreated toadfish. Although AC pretreatment of rats effected changes in the mutagenicities of both test chemicals similar to those effected by MC pretreatment, AC pretreatment of toadfish effected little or no change in the mutagenicities of either test chemical. The changes in the pattern of dependence of 2AA and BAP mutagenicities on the concentration of S9 protein effected by MC pretreatment of toadfish were confirmed in a separate group of experiments. A third group of experiments was designed to examine the effects of alpha-naphthoflavone (ANF) on the mutagenicities of 2AA and BAP mediated by UI and MC S9 from toadfish. Although ANF did not affect the 2AA mutagenicity mediated by UI S9, a significant decrease in 2AA mutagenicity and a significant increase in BAP mutagenicity mediated by MC S9 and a significant decrease in BAP mutagenicity mediated by UI S9 were observed. These results indicate that 2AA and BAP are effectively activated by toadfish S9 and that, as in rats, these two test chemicals are activated and/or detoxicated by different cytochrome P-450-dependent pathways. These results also support the contention that cytochrome P-450-dependent detoxication pathways can be an important determinant of the mutagenic potency of some promutagens in vitro. PMID- 3515164 TI - Mutagenicity of chloroolefins in the Salmonella/mammalian microsome test. III. Metabolic activation of the allylic chloropropenes allyl chloride, 1,3 dichloropropene, 2,3-dichloro-1-propene, 1,2,3-trichloropropene, 1,1,2,3 tetrachloro-2-propene and hexachloropropene by S9 mix via two different metabolic pathways. AB - In the presence of S9 mix all allylic chloropropenes tested exert considerable indirect mutagenic activity which is most pronounced for 1,2,3-trichloropropene. Lower as well as higher chlorinated derivatives are clearly less mutagenic. Longer than standard incubation time (120 min instead of 20 min) at 37 degrees C always leads to an increase in mutagenic activity. An increase in concentration of rat-liver homogenate fraction (S9) in the metabolising system (S9 mix) enhances mutagenicity only for 1,3-dichloropropene, 2,3-dichloro-1-propene and for the cis isomer of 1,1,2,3-tetrachloro-2-propene. According to the effects of the enzyme inhibitors SKF525 1,1,1-trichloropropene-2,3-oxide and cyanamide the allylic chloropropenes fall into 3 groups distinguished by their mode of metabolic activation by S9 mix: (a) allyl chloride and 1,3-dichloropropene are hydrolysed to the corresponding allylic alcohols which can be oxidised to the respective acroleins (hydrolytic-oxidative pathway); (b) 2,3-dichloro-1-propene, 1,1,2,3-tetrachloro-2-propene and hexachloropropene are epoxidised in the C=C double bond, giving rise to reactive epoxides (epoxidative pathway); (c) only 1,2,3-trichloropropene is obviously activated by both these alternative metabolic pathways. Structural parameters like chloro-substitution of the central C atom of the C=C-C sequence and substituent-induced polarisation of the C=C double bond as well as cis/trans isomerism might be responsible for different substrate properties for the enzymes involved in allylic chloropropene metabolism, thus determining different degrees of activation by either one or both pathways. PMID- 3515161 TI - Vitamin E and selenium participation in fatty acid desaturation. A proposal for an enzymatic function of these nutrients. AB - A critical review of the literature on the effects of vitamin E and selenium deficiences on unsaturated fatty acid metabolism reveals that some of these effects are inconsistent with the antioxidant hypothesis of these nutrients as their only biological function. On the basis of these data it is proposed that vitamin E and selenium play a role in the desaturation of n-3 and n-6 polyunsaturated fatty acids by participating in the microsomal electron transport chain and in a proposed peroxidase moiety of the desaturase complex, respectively. A re-interpretation of the experimental literature in terms of the proposed hypothesis is provided, with some suggestions to test its main tenets. PMID- 3515165 TI - Ames Salmonella/mammalian-microsome testing of peptides and peptide synthesis reagents. AB - The Ames Salmonella/mammalian-microsome assay was used to evaluate the bacterial mutagenicity of 6 bioactive peptides and of 11 chemical reagents used in peptide synthesis. Samples of 2 reagents, bis(2-oxo-3-oxazolidinyl)phosphinic chloride and fluoren-9-ylmethyl chloroformate, showed mutagenic activity with strains TA100 and TA1535, and with TA1537, respectively. No mutagenic activity was found with the bioactive peptides or with the other 9 peptide synthesis reagents. PMID- 3515166 TI - Mutagenicity of K-region derivatives of 1-nitropyrene; remarkable activity of 1- and 3-nitro-5H-phenanthro[4,5-bcd]pyran-5-one. AB - The mutagenic activities toward S. typhimurium strains TA98 and TA100 of K-region derivatives of 1-nitropyrene and pyrene were determined. The compounds tested were trans-4,5-dihydro-4,5-dihydroxy-1-nitropyrene (Compound 3), trans-4,5 dihydro-4,5-dihydroxypyrene (Compound 4), 1-nitropyrene-4,5-quinone (Compound 5), 1-nitropyrene-9,10-quinone (Compound 6), pyrene-4,5-quinone (Compound 7), and the lactones, 1-nitro-5H-phenanthro[4,5-bcd]pyran-5-one (Compound 8), 3-nitro-5H phenanthro[4,5-bcd]pyran-5-one (Compound 9), and 5H-phenanthro[4,5-bcd]pyran-5 one (Compound 10). Neither pyrene nor any of its K-region derivatives was mutagenic, either in the absence or presence of S9 mix at the doses tested. Of the K-region derivatives of 1-nitropyrene, the lactones (Compounds 8 and 9) were generally the most active; 0.25 microgram/plate induced 900-2200 revertants in TA98 or TA100 without activation. The 4,5-dihydrodiol (Compound 3), an established mammalian metabolite of 1-nitropyrene, was less mutagenic than was 1 nitropyrene in TA98, but was more mutagenic than was 1-nitropyrene in TA100, regardless of the presence of S9 mix. The quinones (Compounds 5 and 6) were less mutagenic than was 1-nitropyrene in the absence of S9 mix in both strains, but their activities were increased in the presence of S9 mix. The mutagenic activities of the lactones (Compounds 8 and 9) were lower in strains TA98NR and TA98/1,8-DNP6 than in TA98, indicating that nitro-reduction and esterification are involved in their activation. The results of this study indicate that K region derivatives of 1-nitropyrene may be important in its metabolic activation. PMID- 3515167 TI - Anti-Candida albicans antibody levels and in vitro lymphoproliferative response to Candida albicans in neonates and their mothers. PMID- 3515168 TI - Purification and characterization of deep candidosis related antigens. PMID- 3515169 TI - A double blind evaluation of fenticonazole cream 2% and clotrimazole cream 1% in dermatomycoses. PMID- 3515170 TI - Treatment of dermatomycoses with topical fenticonazole and econazole. PMID- 3515171 TI - Comparative epidemiology of four deep mycoses--a review. PMID- 3515172 TI - Culture media for the study of the effects of azole derivatives on germ tube formation and hyphal growth of C. albicans. PMID- 3515173 TI - [In vitro studies of the proteolytic and lipolytic activity of yeast-like fungi as well as their virulence in mice]. PMID- 3515174 TI - In vitro inhibition of Plasmodium falciparum by pyrazofurin, an inhibitor of pyrimidine biosynthesis de novo. AB - The effect of pyrazofurin, an inhibitor of UMP synthesis, on Plasmodium falciparum growth in vitro has been studied. ID50 values (concentration of compound causing 50% inhibition of [3H]hypoxanthine incorporation) for the FCQ 27, FCI-1 and K-1 (chloroquine-resistant) isolates were 10 +/- 8.7, 6.4 +/- 5.3 and 6.3 +/- 0.5 microM, respectively. Comparative ID50 values for chloroquine were 13.5 +/- 4.2, 22.8 +/- 7.6 and 343 +/- 114 microM, respectively. Over the 48 h intraerythrocytic cycle of tightly synchronized parasites, pyrazofurin both reduced the parasitemia and retarded the maturation of trophozoites and schizonts. Addition of uracil or uridine to the in vitro culture did not decrease the anti-parasitic activity of pyrazofurin. Chloroquine reduced the parasitemia, but did not retard development of the remaining viable parasites. Pyrazofurin (20 microM) caused a 50% inhibition of parasite orotate phosphoribosyltransferase (E.C. 2.4.2.10) and, in the presence of adenosine kinase and ATP, a 73% inhibition of orotidine-5'-phosphate decarboxylase (E.C. 4.1.1.23). PMID- 3515175 TI - Mitochondrial protein synthesis in Plasmodium falciparum. AB - Protein synthesis in intact Plasmodium falciparum was 333 times more sensitive to cycloheximide than to chloramphenicol. The 50% inhibitory concentration (IC50) of cycloheximide in a 27-h assay in vitro was 6 X 10(-7) M but no constant cycloheximide-insensitive fraction of total protein synthesis was observed at concentrations of this inhibitor between 10(-7) and 10(-2) M. 0.24% of total protein synthesis occurred in the presence of 10(-3) M cycloheximide but the chloramphenicol sensitivity of this fraction was similar to that of overall protein synthesis (IC50 2 X 10(-4) M). The major fraction of protein synthesis by P. falciparum, therefore, is assumed to be cytoplasmic and to occur on 80S ribosomes. Cycloheximide-insensitive, chloramphenicol-sensitive (70S ribosomal) protein synthesis being undetectable by the methods employed, mitochondrial protein synthesis in P. falciparum is presumed to constitute a considerably smaller fraction of the total protein synthetic capacity than observed in other lower eukaryotes. PMID- 3515176 TI - Biochemical properties of larval excretory-secretory glycoproteins of the parasitic nematode Toxocara canis. AB - Toxocara canis larvae, infective to Man, secrete a number of antigenic macromolecules into culture medium over prolonged periods of time. These antigens have been collected and characterised with respect to molecular weight by sodium dodecyl sulphate-polyacrylamide gel electrophoresis following extrinsic and intrinsic radiolabelling, or electrophoresis followed by gel staining or immunoblotting. Panels of enzymes and lectins have been applied to examine protease sensitivity and carbohydrate composition, respectively, and a number of other biochemical data have been noted. Taken together, the excretory-secretory molecules contain more than 40% carbohydrate of which the majority is N acetylgalactosamine and galactose. The individual antigens may readily be separated by gel filtration on a Sepharose 6B column, and it is shown that the major excretory-secretory macromolecules are all glycoproteins which differ in essential characteristics. For example, the 32 kDa antigen (TES-32) binds concanavalin A, is sensitive to a range of proteases and is the band most readily stained by silver and Coomassie blue. Both TES-120 and TES-400 components are resistant to tryptic or peptic cleavage, bind to Helix pomatia lectin and stain with periodic acid-Schiff, yet unlike TES-120, TES-400 does not incorporate radioactive methionine nor can it be stained by silver stain techniques. Finally, one protease, staphylococcal V8, reveals cleavage sites only in the TES-70 and TES-400 molecules. PMID- 3515177 TI - Expression and size heterogeneity of a 63 kilodalton membrane glycoprotein during growth and transformation of Leishmania mexicana amazonensis. AB - Our previous work by immunoprecipitation with a specific monoclonal antibody showed multiple, closely apposed electrophoretic bands of a major surface antigen specific to the promastigote stage of Leishmania mexicana amazonensis. Here, we analyzed the antigen during growth and transformation of this parasite with particular emphasis on the origin of the multiple bands. Immunobinding assays revealed the presence of the antigen throughout all phases of growth of cloned and uncloned promastigotes in various media for different number of generations. More antigen is expressed by promastigotes grown in Medium 199 plus fetal bovine serum than those in serum-supplemented Schneider's medium or a defined medium; however, this is clone-dependent. Purified monoclonal antibody coupled to Affi Gel 10 gave a high capacity of antigen binding, resolving four electrophoretic bands of 60-66 kDa. A 63 kDa membrane protein, representing one of the four bands, became predominant after [35S]methionine label and chase. Pretreatment of promastigotes with 10 micrograms ml-1 tunicamycin reduces the antigen to a single band of 54 kDa. Treatment of the antigen bound to the affinity gel with endoglycosidase-H produces similar, but less complete effect. These results indicate glycosylation of this antigen with asparagine-linked oligosaccharides, which appears to account at least in part for its expression as multiple, closely apposed bands during biosynthesis. Binding of fluorescein isothiocyanate-labeled 6H12 monoclonal IgG or Fab to the promastigotes showed an even distribution of the antigen over the cell surface and its capping upon the addition of rabbit anti-mouse IgG. Additional hybridomas prepared against amastigotes yielded monoclonal antibodies which recognized surface antigens common to both stages of the parasite. PMID- 3515178 TI - Stage-specific surface antigens of metacyclic trypomastigotes of Trypanosoma cruzi identified by monoclonal antibodies. AB - Stage-specific Trypanosoma cruzi surface antigens were characterized by using monoclonal antibodies (MAb) which bind specifically to the metacyclic trypomastigotes derived from either the insect vector or acellular cultures. A protein with an apparent molecular weight of 90,000 was detected by the MAb 5E7 on the surface of cultured metacyclics of four strains of T. cruzi: G, CL, Y and Tulahuen. The MAb 1G7, which binds to an epitope of the 90 kDa antigen distinct from that recognized by the MAb 5E7, reacted with metacyclics of the G and Tulahuen strains but not of the Y or CL strain. A polypeptide of approximately 82 kDa, identified by the MAb 3F6, was found in the metacyclics of all four T. cruzi strains. The MAb 3F6 also detected a 75 kDa antigen in the G strain metacyclics. The stage-specific MAb and the polyclonal antibodies from mice protected against acute T. cruzi infection by immunization with killed G metacyclics identified the same set of major surface proteins of G metacyclic trypomastigotes. PMID- 3515179 TI - Expression of Schistosoma japonicum antigens in Escherichia coli. AB - A cloned library of DNA complementary to the mRNA of adult Schistosoma japonicum has been prepared and expressed as fusion proteins with Escherichia coli beta galactosidase. Colonies expressing the S. japonicum cDNA clones were screened both with antibodies from individuals with a history of schistosomiasis and with antibodies obtained from a rabbit immunized with whole adult worms. In both cases colonies were detected which bound antibody, although the frequency of antigen positive clones was much higher with the rabbit antiserum than with human sera. In both cases the proportion of colonies reacting with antibodies was markedly lower than that published for equivalent screens of Plasmodium falciparum cDNA with sera from individuals with a history of falciparum malaria. Several major S. japonicum antigens were identified by the affinity purification of antibodies using immobilised fusion proteins produced during lytic growth of the recombinant bacteriophage. PMID- 3515180 TI - Characterization of a hemoglobin-degrading, low molecular weight protease from Plasmodium falciparum. AB - A protease from Plasmodium falciparum was purified 150 fold by high performance liquid chromatography on a TSK-G-3000 SW exclusion column. The enzyme is not retained during pressure filtration with an Amicon PM10 membrane but is retained by a YM5 membrane. The molecular weight of the protease is less than 10,000, based upon mobility on a calibrated TSK column. The enzyme catalyzes the hydrolysis both of acid denatured hemoglobin and of albumin. The hydrolysis is optimal at pH4.5, but considerable activity is seen at pH 6.0. Pepstatin strongly inhibits the protease (I50 = 70 nM) while bestatin, antipain and phosphoramidon produce moderate inhibition (I50 = 30, 30 and 3 microM, respectively). The protease is inhibited by ferriprotoporphyrin IX (I50 ca. 5 microM). This inhibition is insensitive to pH between pH 4.5 and 6. Although chloroquine does not strongly inhibit the protease, chloroquine-ferriprotoporphyrin IX complex produces inhibition similar to that of ferriprotoporphyrin IX. It is suggested that the antimalarial effect of chloroquine is due to the formation of ferriprotoporphyrin IX-chloroquine complex which prevents the sequestration of ferriprotoporphyrin IX into malarial pigment, thereby providing both ferriprotoporphyrin IX and its chloroquine complex as inhibitors of one of the proteases required for the degradation of hemoglobin. PMID- 3515181 TI - Potential epidemic of Creutzfeldt-Jakob disease from human growth hormone therapy. PMID- 3515182 TI - Colchicine in the prevention and treatment of the amyloidosis of familial Mediterranean fever. AB - To determine whether colchicine prevents or ameliorates amyloidosis in patients with familial Mediterranean fever, we followed 1070 patients with the latter disease for 4 to 11 years after they were advised to take colchicine to prevent febrile attacks. Overall, at the end of the study, the prevalence of nephropathy was one third of that in a study conducted before colchicine was used to treat familial Mediterranean fever. Among 960 patients who initially had no evidence of amyloidosis, proteinuria appeared in 4 who adhered to the prophylactic schedule and in 16 of 54 who admitted non-compliance. Life-table analysis showed that the cumulative rate of proteinuria was 1.7 percent (90 percent confidence limits, 0.0 and 11.3 percent) after 11 years in the compliant patients and 48.9 percent (18.8 and 79.0 percent) after 9 years in the noncompliant patients (P less than 0.0001). A total of 110 patients had overt nephropathy when they started to take colchicine. Among 86 patients who had proteinuria but not the nephrotic syndrome, proteinuria resolved in 5 and stabilized in 68 (for more than eight years in 40). Renal function deteriorated in 13 of the patients with proteinuria and in all of the 24 patients with the nephrotic syndrome or uremia. We conclude that colchicine prevented amyloidosis in our high-risk population and that it can prevent additional deterioration of renal function in patients with amyloidosis who have proteinuria but not the nephrotic syndrome. PMID- 3515183 TI - Evidence of prostacyclin deficiency in the syndrome of hyporeninemic hypoaldosteronism. AB - Hyporeninemic hypoaldosteronism is an important cause of hyperkalemia and is characterized by low renin secretion. We found that prostacyclin, a potent vasodilator and renin secretagogue, was markedly reduced--as reflected by its stable urinary metabolite 6-keto-prostaglandin F1 alpha--in seven patients with hyporeninemic hypoaldosteronism as compared with seven matched controls with renal insufficiency and as compared with 12 normal volunteers (mean +/- SE, 42 +/ 7 vs. 185 +/- 37 and 164 +/- 20 ng per gram of creatinine, respectively; P less than 0.001). In contrast, renal prostaglandin E2 excretion was similar in all three groups. A low-dose infusion of calcium or norepinephrine (known stimulants of prostacyclin) increased renal prostacyclin release in normal subjects and controls with renal insufficiency. Neither agonist, however, increased the low basal prostacyclin excretion in the patients (49.6 +/- 11 [basal] vs. 62 +/- 20 [norepinephrine] and 47.5 +/- 16 [calcium]; P greater than 0.8). To evaluate the functional importance of the altered prostacyclin production, we studied the responses of renal blood flow and blood pressure to the calcium infusion. The calcium infusion did not alter blood pressure or renal blood flow in the normal subjects or the controls with renal insufficiency. In contrast, the same dose of calcium in the patients with hyporeninemic hypoaldosteronism produced a rise in mean blood pressure (from 91 +/- 6 to 104 +/- 8 mm Hg, P less than 0.05) and a fall in renal blood flow (from 673 +/- 58 to 560 +/- 42 ml per minute per 1.73 m2, P less than 0.05). These results indicate that a deficiency of prostacyclin could explain the low active-renin concentration and altered vasomotor tone seen in hyporeninemic hypoaldosteronism. PMID- 3515185 TI - Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 15-1986. Renal disorder 13 months after renal transplantation for the hemolytic uremic syndrome. PMID- 3515184 TI - The reemergence of smokeless tobacco. AB - Smokeless tobacco (snuff and chewing tobacco) is reemerging as a popular form of tobacco, particularly among male adolescents. In different regions of the United States, from 8 to 36 percent of male high-school students are regular users. The use of smokeless tobacco has been shown to cause oral-pharyngeal cancer. The strongest link is with cancers of the cheek and gum. White mucosal lesions (leukoplakia) are found in 18 to 64 percent of users, often at the site where the tobacco was held. Other associations have been suggested for cancers of the esophagus, larynx, and pancreas. Nitrosamines, found in high concentrations in smokeless tobacco, most likely have a role in its carcinogenicity. Other health problems include periodontal disease, acute elevations of blood pressure, and dependence. In early 1986, after action at the state level, Congress enacted a federal law requiring health-warning labels on packages of smokeless tobacco and a ban on electronic advertising. Other regulatory measures under consideration include raising state and federal excise taxes, tightening controls on advertising, and prohibiting sales to minors. In view of the recent growth of this problem, policy makers are taking the opportunity to intervene with preventive measures to protect a new generation of tobacco users. PMID- 3515186 TI - Hyporeninemic hypoaldosteronism. PMID- 3515187 TI - Six-year follow-up of the Norwegian multicenter study on timolol after myocardial infarction. PMID- 3515188 TI - Psychological stress and metabolic control in patients with type I diabetes mellitus. AB - Acute psychological stress is believed to cause disturbances of metabolic control in patients with Type I diabetes. To examine the validity of this assumption, we subjected nine healthy persons (mean [+/- SEM] blood glucose level, 74 +/- 2 mg per deciliter), nine patients with Type I diabetes who had normoglycemia (130 +/- 10 mg per deciliter), and nine diabetic patients with hyperglycemia (444 +/- 17 mg per deciliter) to two acute psychological stresses: mental arithmetic and public speaking. Subjects in the three groups were matched for age, weight, sex, and socioeconomic status. For all subjects, the mean increase in heart rate was 20 beats per minute while they were doing mental arithmetic and 25 beats per minute while they were speaking publicly (P less than 0.001). In all three groups, systolic and diastolic pressure rose markedly, the plasma epinephrine level increased by 50 to 150 pg per milliliter, and the norepinephrine level by 100 to 200 pg per milliliter under both stress conditions (P less than 0.001). The plasma cortisol level rose significantly after public speaking in all groups. Neither stress induced changes in circulating levels of glucose, ketones, free fatty acids, glucagon, or growth hormone. Thus, sudden, short-lived psychological stimuli causing marked cardiovascular responses and moderate elevations in plasma concentrations of catecholamines and cortisol are unlikely to disturb metabolic control in patients with Type I diabetes. PMID- 3515189 TI - The Association of American Physicians celebrates its centennial. PMID- 3515190 TI - Lidocaine to prevent ventricular fibrillation in early acute myocardial infarction. PMID- 3515191 TI - Acute epiglottitis in adults. An eight-year experience in the state of Rhode Island. AB - We retrospectively reviewed the medical records on all cases of acute epiglottitis in adults from each of the hospitals in Rhode Island and from the state medical examiner's office over an eight-year period (1975-1982). We found 56 cases--an annual incidence of 9.7 cases per million adults. A significant increase occurred in the last two study years. Indirect laryngoscopy proved to be more reliable in making a diagnosis than did x-ray films of the neck; all of 41 indirect examinations were performed without complications. Twenty-three percent (6 of 26) of patients in whom blood cultures had been obtained had bacteremia, all with Hemophilus influenzae. Bacteremia was associated with a high risk of airway obstruction. Four patients died, all from acute airway obstruction, for a mortality rate of 7.1 percent--a rate significantly higher than the current rate among children. Two deaths occurred after admission, while the patients were being observed without an artificial airway. We conclude that the incidence of epiglottitis in adults is higher than previously believed and may be increasing. Fatal airway obstruction can occur without warning, indicating a need for early protection of the airway in adults as well as in children. PMID- 3515192 TI - Unilateral lung transplantation for pulmonary fibrosis. AB - Improvements in immunosuppression and surgical techniques have made unilateral lung transplantation feasible in selected patients with end-stage interstitial lung disease. We report two cases of successful unilateral lung transplantation for end-stage respiratory failure due to pulmonary fibrosis. The patients, both oxygen-dependent, had progressive disease refractory to all treatment, with an anticipated life expectancy of less than one year on the basis of the rate of progression of the disease. Both patients were discharged six weeks after transplantation and returned to normal life. They are alive and well at 26 months and 14 months after the procedure. Pulmonary-function studies have shown substantial improvement in their lung volumes and diffusing capacities. For both patients, arterial oxygen tension is now normal and there is no arterial oxygen desaturation with exercise. This experience shows that unilateral lung transplantation, for selected patients with end-stage interstitial lung disease, provides a good functional result. Moreover, it avoids the necessity for cardiac transplantation, as required by the combined heart-lung procedure, and permits the use of the donor heart for another recipient. PMID- 3515193 TI - Uncompensated care by hospitals or public insurance for the poor. Does it make a difference? AB - Results from two recent surveys of access to medical care, one nationwide and the other in Arizona, were analyzed to determine the consequences of reductions in Medicaid coverage for low-income Americans and the accompanying shift of responsibility for their health care to clinics and hospitals that provide uncompensated or subsidized care. The analysis indicated that in 1982, low-income persons received substantially less care from physicians if they resided in states without Medicaid programs or with only limited programs. In Arizona, the only state at the time without a Medicaid program, poor children saw physicians 40 percent less often, and poor rural residents saw physicians 22 percent less often, than poor residents of states with Medicaid programs; the proportion of poor Arizona residents refused care for financial reasons was almost double that in states with Medicaid programs. In addition, poor residents of states with the highest proportions of their low-income populations covered by Medicaid fared better than those in states with less extensive coverage. Moreover, poor elderly Americans were found to have comparable access to health care, regardless of where they lived, as a result of almost universal coverage under Medicare. Thus, this analysis suggests that the growing reliance on uncompensated care provided by hospitals and clinics may not be an effective substitute for public insurance and may adversely affect the health care received by the poor. PMID- 3515194 TI - Lung transplantation in perspective. PMID- 3515195 TI - Antemortem diagnosis of an apparent case of feline candidiasis. AB - Candidiasis in cats has always been linked with such predisposing factors as parvovirus infections and antibiotic and chemotherapeutic treatments. Moreover these cases were all diagnosed post-mortem. The clinical observations and the diagnostic procedures used in an antemortem case of probable idiopathic intestinal candidiasis in a cat are reported. The therapeutic measures used and the method of evaluating the efficacy of antimycotic treatment are also described. PMID- 3515196 TI - Ultrastructure of acapsular mutant Cryptococcus neoformans cap 67 and monosaccharide composition of cell extracts. AB - Acapsular mutant Cryptococcus neoformans cap 67 was grown in Pine's citrate broth medium for 3 days and the cells then transferred to a nitrogen-free medium for 6 days. The cells were subjected to a four stage extraction with buffered Triton X100, cold dilute alkaline borohydride, hot dilute acetic acid, and a second alkaline extraction. Galactoxylomannan antigens were recovered from the culture supernates of both 3 day-old and 9 day-old yeast cells. The alkaline extracts contained water-soluble galactoxylomannan and a water-insoluble glucan. Dilute acid treatment released a minor amount of carbohydrate from the cells. The second alkaline extraction yielded increased amounts of glucan and galactoxylomannan from the 9 day-old cells. Soluble non-dialyzable cell extracts were antigenically identical in immunodiffusion with the culture supernate antigens. After the extraction sequence, all of the galactose, xylose, and mannose were removed from the cells. The walls retained their shape after extraction but their layers were loosened. Cells resuspended in nitrogen-free medium for six days developed thickened walls with alternating electron-dense and electron-lucent layers. The major constituent of the thickened 9 day-old cell walls was glucose, only 5% glucosamine was detected. PMID- 3515197 TI - Sequence homology of the yeast regulatory protein ADR1 with Xenopus transcription factor TFIIIA. AB - Classical yeast genetics coupled with the cloning of regulatory genes by complementation of function is a powerful means of identifying and isolating trans-acting regulatory elements. One such regulatory gene is ADR1 which encodes a protein required for transcriptional activation of the glucose-repressible alcohol dehydrogenase (ADH2) gene. We now report the nucleotide sequence of ADR1; it encodes a polypeptide chain of 1,323 amino acids, of which the amino-terminal 302 amino acids are sufficient to stimulate ADH2 transcription. This active amino terminal region shows amino-acid sequence homology with the repetitive DNA binding domain of TFIIIA, an RNA polymerase III transcription factor of Xenopus laevis. Similar domains are found in proteins encoded at the Kruppel and Serendipity loci of Drosophila melanogaster. We discuss the implications of this structural homology and suggest that a similar domain may exist in other yeast regulatory proteins such as those encoded by GAL4 (ref. 13) and PPR1 (ref.14). PMID- 3515198 TI - Expression of N-cadherin adhesion molecules associated with early morphogenetic events in chick development. AB - Selective adhesive properties of cells are thought to have a key role in animal morphogenesis, but the molecular bases underlying these properties remain to be determined. Our studies have demonstrated that cell-type-specific adhesiveness resides in a class of cell-cell adhesion molecules, termed cadherins, which were defined as the molecular components of the Ca2+-dependent cell adhesion system (CADS). For example, a cadherin molecule identified in mouse teratocarcinoma cells, termed E-cadherin (this molecule seems to be identical to uvomorulin or cell-CAM 120/80 and equivalent to chicken L-CAM), was detected only in epithelial cells of various organs; it did not cross-react with cadherins on other cell types. We recently described a novel type of cadherin, N-cadherin, which is found in mouse cells and whose tissue distribution is distinct from that of E-cadherin. In the present study, we have identified a molecular component of N-cadherin in the chicken and determined its distribution in the tissues of early embryos. The results suggest that expression of this adhesion molecule is associated with separation and sealing of cell layers in morphogenesis. PMID- 3515199 TI - Crystallographic analysis of mutant human haemoglobins made in Escherichia coli. AB - The expression of beta-globin in Escherichia coli has enabled us to study the functional role of individual amino-acid residues in haemoglobin (Hb) by site directed mutagenesis. In contrast to mammalian Hbs, some teleost fish haemoglobins show a drastic lowering of oxygen affinity and cooperativity at low pH, a phenomenon known as the Root effect. We have produced the two mutant haemoglobins Hb Nympheas [Cys(F9)93 beta----Ser] and Hb Daphne [His(H21)143 beta- --Arg, Cys(F9)93 beta----Ser] to investigate this allosteric property. Although these substitutions were thought to be responsible for the Root effect, Hb Nympheas and Hb Daphne show an increased oxygen affinity and a reduced effect of pH on oxygen affinity. Our X-ray crystallographic studies show that the hydroxyl group of Ser 93 beta forms a hydrogen bond with Asp 94 beta which is in equilibrium with the salt bridge between Asp 94 beta and His 146 beta. The oxygen binding properties of Hbs Nympheas and Daphne are accounted for by the partial disruption of the salt bridge. PMID- 3515200 TI - State strategies for financing indigent care. PMID- 3515201 TI - [Auxiliary partial liver transplantation; recommendations by a Commission of the Public Health Council]. PMID- 3515202 TI - [Hyperbaric medicine]. PMID- 3515203 TI - [Indications and contra-indications for the use of hyperbaric oxygen in jaw surgery]. PMID- 3515204 TI - [Specific vaginal fluor caused by a recently identified bacterium]. PMID- 3515205 TI - [Direct diagnosis of Chlamydia trachomatis using monoclonal antibodies; diagnosis without culture?]. PMID- 3515206 TI - [Intramural hematomas of the small intestine while using oral coagulants]. PMID- 3515207 TI - [Percutaneous removal of kidney stones]. PMID- 3515208 TI - [Antifibrinolytic therapy in subarachnoid hemorrhage]. PMID- 3515209 TI - [The title 'physician' in historical perspective]. PMID- 3515210 TI - [Allogeneic bone marrow transplantation; recommendations of the Public Health Council]. PMID- 3515211 TI - Current trends in hypospadias repair. PMID- 3515213 TI - Ferritin-bearing lymphocytes in Hodgkin's disease. AB - In view of the reported association of Hodgkin's disease (HD) and ferritin, ferritin-bearing lymphocytes were followed during 2-year period in 79 HD patients. Indirect immunofluorescent method was used to evaluate the percentage of ferritin positive cells. In 22 untreated patients a high percentage of ferritin-bearing circulating lymphocytes (mean value 37.3%) was found. In regard to the extent of the disease higher values were found in clinical stage III and IV (mean value 40.6%) as compared to the stage I and II (mean value 26.2%). Similarly, 17 patients in relapse and with disease progression had mean values 41%. These proportions of cells were significantly lower in 44 patients in complete remission with mean value of 8.7% (60 examinations). In 30 healthy controls the mean value was 1.4%. Repeatedly performed examinations of ferritin bearing lymphocytes during the follow-up period in 17 patients showed to be an important prognostic tool. A negative correlation of ferritin-bearing lymphocytes with E-rosette-forming cells was found. Iron content in peripheral blood lymphocytes was confirmed cytochemically after pre-incubation with antiferritin antibody. The results support the presumed role of ferritin in impaired cellular immunity in HD and suggest diagnostic and prognostic value of the examination of ferritin-bearing lymphocytes in HD. PMID- 3515212 TI - Structural changes induced by heparin in Zajdela ascites hepatoma cells. AB - By method of light and electron microscopy the influence of heparin (0.1%) sodium heparinate) on Zajdela ascites hepatoma cells was studied. To provide penetration of heparin into cells, the latter were treated with low-concentration detergent- Triton X-100. Heparin causes increase of cells observable by phase-contrast method, and homogenization of the karyoplasm. When examining stained preparations light-optically, chromatin is distributed evenly and structurelessly over the whole cell. Streaks of DNA-containing material protrude into the cytoplasm. Electronograms show lowering of electron density of cells, transformation of chromatin fibrils into a thin-fibrillar network, vanishing of nucleoli, and appearance of structureless globules about the size of 100 nm. The observed changes are discussed in the light of data on the anti-cancer action of heparin. PMID- 3515214 TI - [Herpes simplex encephalitis (HSE). Immunohistochemical studies]. PMID- 3515215 TI - [Modification of Parkinson tremor by budipine. A comparative study with amantadine]. PMID- 3515216 TI - Hypertension and hypokalaemia due to a renin-secreting kidney tumour. Primary reninism. PMID- 3515217 TI - Present problems of staphylococcal infections in hospital. PMID- 3515218 TI - High plasma ionized calcium with normal PTH and total calcium levels in normal function kidney transplant recipients. AB - Hypercalcemia is a postrenal transplant complication. We found a high frequency of elevated plasma ionized calcium values (65.8%) in 41 normal-function renal graft recipients. In 8 patients increased free calcium was associated with high PTH levels, whereas in 19 PTH was not increased but free calcium was high. In the other 14 patients both free calcium and PTH were in the normal range. The mean transplant duration was different in the three groups: shorter in high PTH patients, longer in normal free calcium patients, intermediate in normal PTH and high free calcium patients. Our findings confirm that a condition of hyperparathyroidism persists in the first post-transplant period, and suggest that this complication evolves towards normalization of the blood chemistry values, passing through a condition of inappropriate PTH secretion with elevated plasma free calcium which in this period is the only marker of parathyroid hyperfunction. PMID- 3515219 TI - Sulindac reduces the urinary excretion of prostaglandins and impairs renal function in cirrhosis with ascites. AB - In 5 patients with cirrhosis and ascites the glomerular filtration rate (GFR), free water clearance (CH2O) and urinary excretion of prostaglandin E2(PGE2) and 6 keto-prostaglandin F1 alpha (6-keto-PGF1 alpha) were measured before and after a 3-day treatment with sulindac (400 mg/day). The administration of sulindac induced a marked fall of urinary excretion of PGE2 (from 24.2 +/- 5.5 to 3.8 +/- 1.1 ng/h; p less than 0.05), 6-keto-PGF1 alpha (from 19.9 +/- 2.9 to 5.6 +/- 1.1 ng/h; p less than 0.02) GFR (from 111 +/- 15 to 67 +/- 10 ml/min; p less than 0.01) and CH2O (from 7 +/- 1.5 to 3.7 +/- 1.3 ml/min; p less than 0.02) in all patients studied. The plasma concentration of the active metabolite sulindac sulfide in cirrhotics was 400% of that found in 6 healthy volunteers (9.6 +/- 1.7 vs. 2.4 +/- 0.6 ng/ml). Our results indicate that sulindac, at a dose of 400 mg/day, inhibits the renal synthesis of prostaglandins and impairs renal function in cirrhotics with ascites. These effects are probably related to the marked alteration of sulindac kinetics that occurs in these patients. PMID- 3515220 TI - Renal transplantation in diabetes mellitus. Influence of preexisting vascular disease on outcome. AB - We reviewed the recommendations and outcomes for all patients with diabetes mellitus and end-stage renal disease referred to the Medical Center Hospital of Vermont from 1971 through December 1983. During this period, we recommended transplantation in 53 of 73 patients evaluated. Thirty-two transplants were performed in 30 patients. Of the 30 patients, 10 had clinical vascular disease prior to transplantation, i.e., claudication, amputation, active angina, myocardial infarction, or stroke. Seven of the 10 had only claudication or amputation. These 10 patients showed a clear excess in graft failure and mortality. One- and 2-year graft survival was 37 and 13%; patient survival was 48 and 24%. By comparison, the 20 patients without evident vascular disease had 1- and 2-year graft survival rates of 83 and 75% and patient survival rates of 85% at both 1 and 2 years. The incidence of cardiovascular death in the group with vascular disease was 45% at 1 year and 63% at 2 years, as compared with none in the group without vascular disease. The high graft loss and mortality in this group after transplantation should be a major consideration when therapeutic alternatives are considered in diabetics with end-stage renal disease. PMID- 3515221 TI - Indomethacin, an antipyretic drug, prevents the endotoxin-induced and potentiates the hemorrhage-induced oxytocin release into the plasma of the male rat. AB - Oxytocin (OXY) is a nonapeptide of hypothalamic origin which has defined roles in the female reproductive functions of lactation and labor. However, OXY may have other physiological functions because of its presence in the male and its release in response to stress. Available evidence suggests prostaglandins may stimulate the release of OXY. These experiments sought to determine if the stressors, endotoxin and hemorrhage, would release OXY in the chronically catheterized, freely behaving male rat and what effect the antipyretic and prostaglandin synthesis inhibiting drug, indomethacin, would have on these responses. Endotoxin caused a marked release of OXY from mean baseline levels of 5 pg/ml to mean peak levels of 168 pg/ml. Indomethacin greatly attenuated this increase. In contrast, OXY release in response to hemorrhage of either 22 or 44% of the blood volume of the rat was enhanced by indomethacin. Indomethacin increased the hemorrhage induced OXY levels about 2-fold over a 2-hour posthemorrhage period. Indomethacin alone had no effect on OXY levels. These data verify that stress is a potent stimulus for OXY release and strengthen the hypothesis that prostaglandins mediate OXY release. The paradoxical effects of indomethacin on OXY release suggest that the prostaglandins may have different effects on OXY release depending upon the evoking stimulus. PMID- 3515222 TI - Hyperprolactinemia alters the frequency and amplitude of pulsatile luteinizing hormone secretion in the ovariectomized rat. AB - Studies were undertaken to examine the effects of hyperprolactinemia on the frequency and amplitude of pulses of LH, and determine if changes in pituitary sensitivity to LHRH were involved in the prolactin-induced suppression of LH secretion. Rats were bilaterally ovariectomized (day 0). Ovine prolactin (4 mg/kg body weight, subcutaneously) or vehicle was administered every 8 h beginning at 09.00 h on day 4 after ovariectomy and continuing until 09.00 h on day 6. On day 6, between 07.00 and 09.00 h all animals received a right atrial cannula, using ether anesthesia. In experiment I blood samples were taken at 10-min intervals beginning at 12.00 h on day 6, for a total of 180 min. To test the effect of hyperprolactinemia on pituitary responsiveness (experiment II) animals received an intravenous injection of LHRH (25 ng/100 g body weight) after the 180-min and again after the 240-min sample. Blood was drawn every 10 min for a total of 300 min. Serum was assayed for LH. Hyperprolactinemia altered the pattern of pulsatile secretion of LH. Treatment with ovine prolactin produced a decrease in both the frequency and amplitude of the LH pulses compared to values found in control animals. However, no differences in pituitary responsiveness between hyperprolactinemic and control animals were found at the dose of LHRH given. Thus, the prolactin-induced suppression of pulsatile secretion of LH was not apparently a result of alterations in the sensitivity of the pituitary to LHRH. From these studies we suggest that hyperprolactinemia directly affects a hypothalamic site which ultimately alters the LHRH pulse generator, thereby changing the secretion of LHRH. PMID- 3515223 TI - Increased periventricular echogenicity (periventricular halos) in neonatal brain: a sonographic study. AB - This study was designed in order to evaluate frequency and natural development of periventricular increased echogenicity (periventricular halos) as a sonographic feature. Sixty healthy term neonates were examined sonographically through the open fontanel within the first twelve hrs of life (phase I). Out of this group, forty-three infants were again studied between the twenty-fourth and forty-eighth hr of life (phase II), forty between third and eighth day of life (phase III), twenty between third and sixth week of life (phase IV) and twelve between third and fifth months of life (phase V). Halos were found in occipital areas in 83% in I, in 86% in II, in 85% in III, in 35% in IV and in 0% in V. They presented as increased echogenicity predominantly occipitally and frontally at the external angles of both lateral ventricles. There was no correlation to the mode of delivery. The differential diagnosis (haemorrhage, hypoxicischaemic injury, oedema) is discussed. Periventricular increased echogenicity represents a common sonographic finding in clinically healthy term infants. When present in the typical form as described here it seems to have no pathological significance. Each clinician examining neonatal heads sonographically should be familiar with his phenomenon and its interpretation. PMID- 3515224 TI - Stereotactic surgery. PMID- 3515225 TI - On the innervation of trigeminal mesencephalic primary afferent neurons by adenosine deaminase-containing projections from the hypothalamus in the rat. AB - The localization and sources of adenosine deaminase-containing structures in the mesencephalic nucleus of the trigeminal nerve of the rat was studied using indirect immunofluorescence or immunoperoxidase immunohistochemical staining techniques for adenosine deaminase in combination with retrograde fluorescent tracing or lesion methods. The majority of large mesencephalic neurons were engulfed by a dense adenosine deaminase-immunoreactive plexus. Immunostaining was often punctate surrounding neuronal profiles or sometimes had the appearance of varicose fibers coursing over the neuronal surface. Occasionally, immunostained axons were found travelling towards and contacting mesencephalic neurons. Mesencephalic neuronal somas surrounded by immunofluorescence staining for adenosine deaminase were simultaneously labelled with fast blue after injections of this dye into the temporalis or masseter muscles of mastication. Injections of fast blue into the mesencephalic nucleus resulted in fast blue labelling of adenosine deaminase-immunoreactive neurons in the tuberal, caudal and postmammillary caudal magnocellular nuclei of the hypothalamus. Ablation of these hypothalamic nuclei caused a near total depletion of adenosine deaminase immunostained fibers in the mesencephalic nucleus including those associated with mesencephalic neurons. It is concluded that adenosine deaminase-containing neurons in the posterior hypothalamus innervate mesencephalic primary sensory neurons, which are known to convey proprioceptive input to trigeminal motor nuclei controlling jaw muscles. The possibility is considered that the hypothalamus, via a direct action on these sensory neurons, may exert automatic control over jaw movements related to aggressive attack, defensive or feeding behavior. In addition, it appears that mesencephalic neurons may provide an ideal model system for electrophysiological investigations of the neurotransmitter(s) utilized by adenosine deaminase-containing hypothalamic projections. PMID- 3515227 TI - Computer-assisted stereotaxis: new approaches for the management of intracranial intra-axial tumors. AB - Modifications of traditional stereotactic procedures have provided new options for the diagnosis and treatment of intracranial intra-axial neoplasms. The development of specific computer software for the incorporation of CT, MRI, and digital angiography data bases into a stereotactically defined computer image matrix for treatment planning and for interactive surgery allows a precision never before possible. These tumors may be stereotactically biopsied and treated by the stereotactic implantation of radionuclide sources or resected using computer-assisted stereotactic laser microsurgical techniques. PMID- 3515226 TI - Neurons reactive to antibodies against serotonin in the stomatogastric nervous system and in the alimentary canal of locust and crickets (Orthoptera, Insecta). AB - Immunoreactive neurons in the stomatogastric nervous system and in the alimentary tract of the locust Schistocerca gregaria and the crickets Gryllus bimaculatus and Acheta domesticus have been examined using antibodies against serotonin (5 hydroxytryptamine; 5-HT). For comparative anatomical analysis cobalt chloride infusion was applied. The innervation of the visceral muscles was studied electron microscopically. In all three species the majority of the 5-HT immunoreactive cell bodies of the stomatogastric nervous system occur in the frontal ganglion in which 30-40% of the total number of cell bodies react with anti-5-HT. In the occipital ganglion only two to four cell bodies (1-2%) are 5-HT immunoreactive. Single immunoreactive cell bodies were observed in the ventricular ganglia in only a few preparations. The 5-HT-immunoreactive neurons in the frontal ganglion are pseudounipolar or multipolar. The main process of the 5-HT-immunoreactive neurons of the frontal ganglion descend along the entire stomatogastric nervous system. Some arborizations of these processes ascend into the brain and others supply the neuropil of all stomatogastric ganglia. Side branches leave the stomatogastric nervous system and form a plexus along the surface of the entire intestinal tract from where 5-HT-immunoreactive fibers supply: all muscle layers of the muscularis; the external dilator muscles of the foregut and probably some somatic muscles, neurohaemal organs and Malpighian tubules (excretory system). Serotonin-immunoreactive fibers further proceed into salivary gland and the retrocerebral complex (corpora cardiaca and corpora allata). The retrocerebral glandular complex and the hindgut receive additional immunoreactive neurons from the central nervous system. Electron microscopic analysis of nerves innervating the muscle layers of the alimentary tract revealed one type of 5-HT-immunoreactive and one or two types of non-5-HT-immunoreactive fibers. All fiber types contact the sarcolemma of muscle fibers without any obvious synaptic membrane specializations. The 5-HT-immunoreactive fibers are in some regions in close contact with the haemolymph. These regions can be regarded as sites of neurohormonal release. The distribution of serotonin-immunoreactive neurons suggests that 5-HT acts as a neurotransmitter and/or modulator on intestinal muscles and some somatic muscles and glandular cells, and as a neurohormone released from neurohaemal sites into the body fluid. PMID- 3515228 TI - [Phlebography in the diagnosis of varices of the legs]. PMID- 3515229 TI - [Echography in general surgery. Potentialities of this new diagnostic technic in abdominal emergencies]. PMID- 3515230 TI - [Surgical treatment of the ascitic patient using LeVeen peritoneojugular shunt. Personal case reports]. PMID- 3515231 TI - [Conservative nonsurgical treatment of splenic rupture in children. Apropos of 2 cases]. PMID- 3515232 TI - [Role of real-time ultrasonic diagnosis in the study of transient ischemic attacks in the carotid area]. PMID- 3515233 TI - Hemodynamic parameters for venous valve incompetence in the lower extremity. AB - Doppler and photoplethysmography studies were compared with invasive venous pressure measurements in ten healthy volunteers and 20 patients with a postthrombotic syndrome to assess the accuracy of noninvasive studies in detecting venous valve incompetence in the lower extremity. Using a refilling time of 20 seconds or less for valve incompetence, photoplethysmography was as accurate as invasive pressure measurements. In the Doppler studies there were two false-positive and three false-negative studies as compared with the invasive method. Photoplethysmography is an accurate and simple method for detecting valve incompetence. The method should be used in patients with suspected chronic venous disease, in evaluation of thrombolytic agents used for acute venous thrombosis, and in evaluation of the results of venous valve reconstruction. PMID- 3515234 TI - [Therapy in utero on a double monster: value of echography]. PMID- 3515235 TI - [Fetal growth based on echographic bone parameters (BPD and LF)]. PMID- 3515237 TI - Physiological properties of visually responsive neurones in the insular cortex of the cat. AB - Extracellularly recorded responses of neurones in the insula and the adjoining rostroventral bank of the anterior ectosylvian sulcus to moving bars of light and to electrical stimulation of the superior colliculus and suprageniculate nucleus were recorded in barbiturate-anaesthetized cats. Insular cortical neurones had extremely large receptive fields, exhibited a high incidence of directional selectivity, responded best to high or medium velocity movements of the stimulus and some displayed fairly powerful end-inhibitions. Orthodromically elicited responses from the superior colliculus and suprageniculate nucleus were obtained at latencies of 5-6.5 ms and 3.0-6.0 ms, respectively. No polysensory responses were obtained from visually sensitive neurones. These data provide evidence that a population of neurones in the dorsal rim of the insula comprise a visual area which may be closely related anatomically and functionally to the recently described anterior ectosylvian visual area. PMID- 3515236 TI - Surface expression of neural cell adhesion molecule in cultured bovine paraneurones: immunogold and immunoperoxidase methods compared. AB - The D2 neural cell adhesion molecule immunolabelling patterns of cultured bovine chromaffin cells are compared at the ultrastructural level, using the indirect immunohistochemical method with the secondary antibody labelled with either 17 or 5 nm gold particles or horseradish peroxidase (HRP). With HRP-conjugated antibody an apparently continuous surface staining was produced, while with 17 nm gold particles relatively large areas of membrane remained unlabelled; 5 nm particles gave a pattern more closely resembling the localization obtained with HRP. These differences are explained by differences in steric hindrance inherent to each method. PMID- 3515238 TI - Effects of substantia nigra and pallidum stimulation on hippocampal interictal activity in the cat. AB - In the present work the role played by substantia nigra pars compacta and globus pallidus pars interna on hippocampal bioelectrical activity is studied. Injections of sodium penicillin (i.v.) produce steady interictal spikes in the hippocampus. Substantia nigra stimulation induces regular theta rhythm and inhibits the spikes. Pallidal stimulation, on the contrary, appears to strongly enhance epileptiform activity, proceeding to generalized seizure activity. The results are discussed in the light of the interrelationships between basal ganglia and hippocampus, hypothesizing a putative feedback loop from striatal to limbic centers. PMID- 3515240 TI - Nutrition classics. American Journal of Diseases of Children, Volume 36 October, 1928: Number 4. Self selection of diet by newly weaned infants: an experimental study. By Clara M. Davis. PMID- 3515239 TI - Anatomical evidence that the pontine lateral tegmental field projects to lamina I of the caudal spinal trigeminal nucleus and spinal cord and to the Edinger Westphal nucleus in the cat. AB - Autoradiographical tracing results in the cat indicate that the lateral pontine tegmental field projects mainly contralaterally to the marginal layer of the spinal trigeminal nucleus, to laminae I and II and the lateral part of laminae V and VI of the spinal cord and the Edinger-Westphal nucleus. It is pointed out that the projections from the lateral pontine tegmentum are very similar to the ones derived from the Edinger-Westphal nucleus and that these two areas are reciprocally connected. It is postulated that both areas may play a role in supraspinal pain control. PMID- 3515241 TI - Interactions of vitamin E and calcium in chemical cytotoxicity. PMID- 3515242 TI - Cataract as an outcome of zinc deficiency in salmon. PMID- 3515243 TI - Sensory-specific satiety. PMID- 3515244 TI - Review of calcium-channel blockers. AB - Calcium-channel blocking drugs were introduced to the United States in 1982. The three approved calcium-channel blockers--nifedipine, verapamil and diltiazem- have offered new treatments for angina. This article presents an overview of these drugs with emphasis on their mechanisms of action, clinical use and guidelines for the nurse practitioner in assessing the need for calcium-channel blockers in the management of angina. PMID- 3515245 TI - Senator Daniel K. Inouye: a champion for nursing in Congress. Interview by Virginia Clark Kent and Denise S. Canton. PMID- 3515246 TI - The management of nursing, Nightingale to Griffiths. PMID- 3515247 TI - Dentist as U.N. diplomat (Dr. Lamuel Stanislaus). PMID- 3515248 TI - The role of orthodontics in comprehensive dental care. PMID- 3515249 TI - Orthognathic surgery: questions and answers for the general practitioner. PMID- 3515250 TI - Overdenture review. PMID- 3515251 TI - Esthetics in complete denture care. PMID- 3515252 TI - Assessing the diagnostic accuracy and efficacy of selected antepartum fetal surveillance techniques. AB - Published studies on the contraction stress test (CST), the nonstress test (NST), and monitoring of fetal movement were reviewed to assess the accuracy and efficacy of these techniques. The false-negativity and false-positivity rates, sensitivity, and specificity of these tests were assessed with use of perinatal mortality and various measures of morbidity as outcomes. Both the CST and the NST generally demonstrated low sensitivity and high rates of false positivity. No randomized controlled trials have been conducted that are of sufficient size to demonstrate whether there is a significant difference in outcome following use of the CST or the NST. A single nonrandomized, controlled trial evaluating fetal movement monitoring suggested clinical benefit. Direct costs of NSTs and CSTs in the United States were estimated to exceed $200 million per year. Yet the CST and the NST have not been demonstrated to be useful diagnostic tests. The CST, the NST, and fetal-movement monitoring are potentially useful screening tests. However, they require critical evaluation, with large randomized, controlled trials, to determine their efficacy and safety before their further diffusion into obstetrical practice. PMID- 3515253 TI - The evaluation of the methods used in the diagnosis of intrauterine growth retardation. AB - Several methods used in the diagnosis of intrauterine growth retardation (IUGR) were evaluated with epidemiologic techniques. The strong effect of IUGR prevalence on the positive predictive and false-positive values of these methods is discussed. If correctly used, the combination of clinical measurements and perinatal risk factors can have a predictive power as high as any of the other more sophisticated techniques. The data reviewed show that at present biparietal diameter measurements, nonstress test/oxytocin challenge test or hormone values do not contribute to a better IUGR prediction than when the above mentioned methods are applied. For IUGR detection, ultrasound evaluation should include ratios of anthropometric measurements and may be complemented with amniotic fluid volume assessment. It is suggested that these procedures be reserved to a selected high risk population. Efforts should be made to evaluate new technologies through randomized controlled trials before they are introduced to the general population, particularly in developing countries. PMID- 3515254 TI - Birth weight in twins: an analysis of discordancy and growth retardation. AB - Sonographic estimation of fetal weight offers the potential of antenatal diagnosis of discordancy and growth retardation in twins. Although standards for intertwin birth weight percent differences in infants over 2500 g are available, similar norms are not available at lower weights. Intertwin birth weight percent differences in live-born twins above 500 g in 500-g increments were analyzed. Intertwin birth weight differences, expressed as a percentage of the weight of the larger twin, were relatively uniform across a wide range of birth weights. Differences above 15% were increasingly more likely to be associated with growth retardation in one of the infants. PMID- 3515255 TI - Glycosylated hemoglobin and protein levels in normal and diabetic pregnancies: relation to birth weight. AB - Glycosylated hemoglobin and protein were measured in maternal and cord blood of 24 normal, 19 class A, and ten insulin-treated diabetics using an affinity chromatographic technique. Maternal (intrapartum) glycohemoglobin and glycoprotein levels in the diabetics were not significantly different from those in normal controls, suggesting "tight" metabolic control in these patients. Compared with controls, cord blood glycohemoglobin and glycoprotein levels were significantly higher in insulin-treated, but not in class A, diabetics. The birth weight ratio correlated significantly only with maternal glycohemoglobin in insulin-treated diabetics. The results suggest that: even in well-controlled insulin-treated diabetics, the fetuses are hyperglycemic; maternal glycohemoglobin correlates with birth weight in insulin-treated diabetics; maternal glycoprotein determinations cannot be used to predict birth weight; hyperglycemia cannot be the sole determinant of fetal overgrowth in diabetic pregnancies; factors influencing fetal overgrowth in class A and insulin-treated diabetics may be different. PMID- 3515256 TI - Sonographic detection of fetal urinary-tract anomalies. AB - The diagnosis of urinary-tract anomalies in the fetus can frequently be made with antenatal ultrasound imaging. This report details 19 cases of fetal urinary-tract malformation diagnosed during a 30-month period. Early onset and more complete urinary-tract obstruction, oligohydramnios, renal dysplasia, and pulmonary hypoplasia occur frequently in cases where urinary-tract anomalies were detected in utero. The frequent association of other major structural anomalies, severe renal damage, and irreversible pulmonary hypoplasia make imperative an intensive evaluation of the fetus before considering invasive surgical procedures. PMID- 3515257 TI - Comparison of fetal weight estimation formulas with and without head measurements. AB - Most published sonographic techniques for estimating fetal weight use measurements of the biparietal diameter (BPD) and abdominal circumference. In many clinical situations, however, accurate head measurements cannot be obtained. One hundred one patients were scanned within 72 hours of delivery. Using multiple stepwise regression analysis, a best-fit formula was developed using abdominal circumference and femur length, or femur length alone. The mean error was 109 g/kg fetal weight for abdominal circumference and femur length that was comparable with BPD and abdominal circumference formulas for estimated fetal weight. The mean error when femur length was used alone was 129 g/kg fetal weight. When these models were tested prospectively on 67 patients and compared with published formulas, they yielded results that were similar in accuracy. Among these additional patients, the model using one parameter (femur length) had an average error of 114 g/kg, whereas the femur length and abdominal circumference showed a mean error of 125 g/kg. PMID- 3515258 TI - Qualitative amniotic fluid volume versus amniocentesis in predicting infection in preterm premature rupture of the membranes. AB - Qualitative amniotic fluid volume assessment and amniocentesis were performed on admission in 54 patients who presented with premature rupture of the membranes and no clinical signs of infection or labor. Comparison of these two methods in predicting infection outcome--as reflected by the development of clinical amnionitis and/or neonatal sepsis--suggests them to have the same efficacy in predicting infection outcome in patients with premature rupture of the membranes. Qualitative amniotic fluid volume was found to have sensitivity 50%, specificity 92.8%, positive predictive value 66.6%, and negative predictive value 86.6%; amniocentesis was found to have sensitivity 58.3%, specificity 88%, positive predictive value 58.3%, and negative predictive value 88%. The use of ultrasonically estimated amniotic fluid volume could replace or be used in addition to amniocentesis in identifying patients with ruptured membranes at particular risk for developing infection. PMID- 3515259 TI - Value of fetal ponderal index in predicting growth retardation. AB - Fetal ponderal indexes were calculated by ultrasound examination and compared with the neonatal ponderal indexes in 113 pregnancies. The relationship between the fetal and neonatal ponderal indexes throughout gestation is described. The fetal ponderal index also was evaluated as a predictor of intrauterine growth retardation (IUGR) and was found to have sensitivity and specificity of 76.9 and 82%, respectively. These data suggest that the fetal ponderal index could be used to rule out the diagnosis of IUGR with reasonable accuracy (negative predictive value 96.4%). PMID- 3515260 TI - Antenatal evaluation and management in nonimmune hydrops fetalis. AB - Thirty-eight cases of nonimmune hydrops fetalis were evaluated by detailed real time ultrasonography and two-dimensional echocardiography. Before ultrasound evaluation, all mothers had a complete blood count, titers for toxoplasmosis, rubella, cytomegalovirus, and herpes (TORCH screen), serum albumin, and a Kleihauer-Betke stain of a peripheral blood smear. Karyotyping of fetal fibroblasts or lymphocytes was performed if these examinations were not diagnostic. A probable etiology was found in 27 (71%) cases. These were chromosome abnormality (nine), pulmonary (three), viral (three), hematologic (two), transient ascites (two), renal (one), skeletal (two), and gastrointestinal (one). Despite extensive antenatal and postmortem examinations, no etiology was found in 11 (28.9%) cases. Although early diagnosis was accomplished in many cases allowing for the option of antenatal therapy, the survival rate was 23.7%, similar to previous reports. PMID- 3515261 TI - Ritodrine in the treatment of preterm labor: second Danish Multicenter Study. AB - In a randomized trial intramuscular ritodrine followed by oral ritodrine treatment and bed rest was compared with placebo and bed rest in the treatment of 99 cases of preterm labor. The ritodrine treatment did not have a statistically significant effect on birth weight, gestational age, or the incidence of low birth weight. However, it did inhibit preterm labor in the initial stage, resulting in a gain of a few days to a few weeks in length of gestation. This gain may be valuable. Where necessary, advantage can be taken of it to transfer the mother before delivery to a more specialized hospital with a neonatal intensive care unit or to administer steroid treatment to promote fetal lung maturation. No serious side effects were recorded. The intramuscular route is recommended because large fluid infusions are avoided and treatment can easily be started before the patient is transported from home to hospital. PMID- 3515262 TI - Monitoring gonadotropin-releasing hormone administration by measurement of urinary steroid conjugates. AB - The use of measuring urinary steroid conjugates in nontimed, randomly collected morning urine samples expressed as a function of creatinine concentration was assessed to monitor ovarian response to pulsatile administration of gonadotropin releasing hormone in ambulatory patients. This method of evaluating ovarian steroid production provided a convenient, inexpensive, and noninvasive means of monitoring responses to gonadotropin-releasing hormone treatments and documents that clomiphene-resistant amenorrheic patients can be induced to ovulate with appropriate gonadotropin-releasing hormone therapy. Different ovarian responses in the same woman to similar doses and frequencies of gonadotropin-releasing hormone indicate that discrete adjustments of individual doses may be required to facilitate consistent ovulatory responses. The strategy presented here allows for subsequent gonadotropin-releasing hormone therapy in the individual patient to be determined by an objective and quantifiable ovarian response to an initial treatment. PMID- 3515263 TI - Maternal upright posture and mobility in labor--a review. AB - There has been a relatively recent interest in alternative birthing techniques, including increased maternal mobility during labor. This literature review was pursued to evaluate the effect of upright maternal posture and ambulation on the first stage of labor. Although previous reviews frequently assume that maternal ambulation speeds labor progress, the data presented in this review are not conclusive as to whether the upright maternal posture or ambulation during the first stage of labor shortens labor length or improves fetal outcome. However, it is clear that ambulation in labor is not harmful either to the mother or fetus. In addition, many investigators have reported that mobility in labor results in greater maternal comfort and ability to tolerate labor and decreased use of anesthesia and analgesia. Thus, acceptance of mobility in labor by patients and staff is generally reported. This information can serve as a guide to clinical management. However, there is a need for further analysis of the effect of maternal ambulation during labor, and specific suggestions for research are presented. PMID- 3515264 TI - Risks after exposure to diagnostic ultrasound in utero. PMID- 3515265 TI - [The stromal colony-forming cell (CFUf) count in the bone marrow of mice and the clonal nature of the fibroblast colonies they form]. AB - The clonal nature of FCFC-derived stromal colonies was tested by chromosomal analysis in mixed cultures of CBA and CBAT6T6 bone marrow cells depleted of macrophages and myeloid cells. Inoculation of the bone marrow cell suspensions in flasks coated with poly-l-lysine has revealed practically no stromal aggregates among the explanted cells. The coincidence of karyotypes within the stromal colonies in the mixed cultures proved that the FCFC-derived colonies were cell clones. It was shown by indirect immunofluorescence with antibodies to type 1 collagen that the mouse bone marrow FCFC-derived colonies consisted of stromal fibroblasts. The cloning efficiency of the bone marrow FCFS depends on the explantation density of cells; a stable colony-forming efficiency could be reached only in the presence of feeder cells (irradiated bone marrow). In the bone marrow cells suspensions obtained by trypsinization the amount of FCFC is markedly higher than in the suspensions of mechanically disaggregated bone marrow cells. PMID- 3515266 TI - [Characteristics of ceruloplasmin synthesis in mammalian embryogenesis. 2. The yolk sac as the site of the primary expression of the ceruloplasmin gene in rats]. AB - It was shown that the omphaloid placenta and, first of all, visceral wall of yolk sac is the site of primary synthesis of ceruloplasmin (CP), whereas the activation of CP synthesis in the liver cells is secondary and is revealed from the 12th day of embryo-genesis. The CP synthesis in the yolk sac cells proved by selective CP localization in the cells of the yolk sac visceral wall and, first of all, in the cells of visceral endoderm on sections stained by the method of indirect immunofluorescence and using the reaction of soluble peroxidase antiperoxidase complex. A specific CP-mRNA has been revealed in the yolk sac cells which is actively translated in the polyribosomes isolated from the yolk sac and in the cell-free translation system from the rabbit reticulocytes. on the 14th day of embryogenesis CP amounts to ca. 4% of all polypeptides secreted by the yolk sac cells. As the embryogenesis proceeds, the relative rate of CP synthesis progressively decreases in the yolk sac and increases in the liver cells. CP synthesized by the yolk sac cells has a molecular mass of ca. 122 kD. Possible causes of differences between the "embryonic" and "adult" rat CPs are discussed. A suggestion has been put forward that the time of activation of CP synthesis coincides with the yolk sac formation (8-9th days of embryogenesis) and the cells of visceral endoderm are the site of primary expression of the CP gene. PMID- 3515268 TI - Diagnosis and management of ocular complications of sickle hemoglobinopathies: Part II. PMID- 3515267 TI - [Histone synthesis in the cells of proliferating and nonproliferating tissues during gametogenesis and early embryogenesis]. AB - A review of available data on the replication-dependent and replication independent histone synthesis in the proliferating and nonproliferating (quiescent) cells during gametogenesis and early embryogenesis. In each of the considered models the replication-dependent and replication-independent histone synthesis play different roles in the chromatin organization and metabolism. The transition from replication-dependent to replication-independent histone synthesis during gametogenesis is a regular process directed to the formation of a highly compacted metabolically inert chromatin (males) and to the formation of histone protein pool in order to provide the chromatin nucleosome structure in the sperm nucleus during fertilization, as well as the nuclear chromatin in zygotes and blastomeres (females). A suggestion is put forward that the coupling of histone and DNA syntheses should arise not simultaneously in all cells of the embryo but have a regional pattern, due, possibly, to the asynchrony of cell cycle in the early embryos. PMID- 3515269 TI - "Deja vu--why gold". A case report. PMID- 3515270 TI - A long-term prospective clinical study of orofacial herpes simplex virus infection in acute leukemia. AB - Orofacial mucocutaneous infections resulting from herpes simplex virus (HSV) were detected in 40% of patients with acute leukemia. Of the 34 separate episodes, oral mucosal sites were involved in 22 cases. Evidence to support dissemination of HSV was found in 3 patients on 4 separate occasions. The relationship of neutrophil levels to the onset and resolution of lesions is examined. The value of acyclovir for treatment of these HSV-induced lesions is reported, and the question of administering this agent for routine prophylaxis against HSV in these patients is addressed. PMID- 3515271 TI - [Prof. N.I. Studenskii (on the centenary of the publication of his "Course in Orthopedics")]. PMID- 3515272 TI - [Work capacity of persons injured in traffic accidents. Temporary disability (a review of the literature)]. PMID- 3515273 TI - [Ultrasonic anatomy of the fetal heart and great vessels]. PMID- 3515274 TI - [The Nobel prize for medicine in 1985]. PMID- 3515275 TI - [Ignac Semmelweis and the journal Orvosi Hetilap]. PMID- 3515276 TI - [The first bacteriological atlas]. PMID- 3515277 TI - [In memory of Peter Dahr]. PMID- 3515278 TI - [The role of sonography in the diagnosis of abdominal aneurysm]. PMID- 3515279 TI - [Metabolic effects of combined low-dose contraceptive tablets]. PMID- 3515280 TI - [Collection of autologous bone transplants]. AB - For the collection of autologous cancellous bone transplants normally the anterior and posterior parts of the Os ilium are used. With proper techniques the conture of the pelvis and the muscle insertions can be conserved. All other collection places should only be used in unexpected situations and need of only small amounts of transplant. Serious complications are fractures and nervous lesions, which can be avoided by a careful procedure. PMID- 3515281 TI - [Bone banks. Equipment, tissue collection, cold preservation, organization, safety]. AB - A well-organized bone bank for cryoconservation is a proven and safe procedure, which is best suitable for emergency surgery. If the indication is correct and donor selection carefully proved, it is an efficient procedure without great problems. For donor selection, the history of the patient, a clinical examination and serological tests are very important, in addition to an aseptic procurement and continuous maintenance of temperature in the freezer. The freezer temperature must be kept below the eutectic point of bone (-28 degrees C). At this temperature all of the individual bone tissue structures are frozen, and bone can be preserved for 1 year in this way. We prefer a cryoconservation at -39/49 degrees C. In the Department of Traumatology of the University in Freiburg, in the last 16 years more than 1000 homologous bone grafts have been performed. Although in the first weeks consolidation is delayed, the rate of complications after bone transplantations is low. The great advantage is the availability of homologous (allogenous) cancellous bone and cortical bone chips at any time, especially for the treatment of polytraumatized patients. PMID- 3515282 TI - [Bone transplantations: principles and clinical use]. PMID- 3515283 TI - [Experimental studies and clinical aspects of cold-preserved allogenic spongiosa]. AB - Different temperatures, freeze techniques, and durations of storage for cryopreservation of allogeneic spongious bone were studied in an experimental model. Low temperatures (-70 degrees C to 196 degrees C) without cryoprotectants proved to be favorable in micromorphological as well as scintigraphic analyses. These transplants seem to be equivalent to fresh autologous transplants - at least in animal experiments. Medium-term durations of storage (3 mo) at low temperatures yield the best osteoinductive capacity. Long term storage (12 months) and radiosterilization reduce the quality of the allogeneic bone. The clinical results in 495 transplantations of cryopreserved allogeneic spongious bone confirm the experimental findings. PMID- 3515284 TI - [Osteoid induction]. AB - Osteoinduction is a biological principle. The implantation of tissue with inductive properties results in the proliferation and differentiation of undifferentiated cells to cartilage and bone. This process, which is similar to a cascade-type mechanism, is controlled by a series of humoral and local growth factors. It was possible to isolate a number of macromolecular substances with osteoinductive, mitogenic, or chemotactic properties specifically from the extracellular bone matrix. A deeper understanding of the regulative mechanisms as well as the greater availability of growth factors may lead to new therapeutic approaches in bone surgery. PMID- 3515285 TI - [Transplantation of bones in aseptic traumatic and post-traumatic conditions]. AB - Autologous and allogeneic bone grafts are indicated under the following traumatic and post-traumatic conditions: bone defects; comminuted areas; avascular fragments; atrophic nonunions; delayed union due to defect or necrosis; wedge or lengthening osteotomies; arthrodeses; vertebral fusions. The contraindications for homogeneous grafting are demonstrated. Modern trends in osteosynthesis, microsurgical techniques, and advanced plastic reconstructive procedures are discussed, and their importance for bone transplantation is stressed. PMID- 3515286 TI - [Transplantation of bones in traumatic and posttraumatic septic conditions]. AB - The treatment of acute and chronic osteitis should be standardized, using the following steps: debridement/sequestrectomy; stabilization; eradication of local infection; revascularization; filling-up defects--bone transplantation. The transplantation of bone is only successful if the defect area is prepared following steps 1-4 mentioned above. If possible, only autologous bone should be transplanted into an infected bone area. For the take of the transplanted bone, good vascularization of the infected area is of great importance. To obtain the best function possible, the Kinesitherapy should be carefully supervised by the surgeon. PMID- 3515287 TI - [Plastic surgery measures in connection with bone transplantation in bone and soft tissue defects]. AB - Free tissue transfer by means of microvascular anastomoses has opened up new dimensions in reconstructive surgery. However, a free microvascular myocutaneous flap should only be used, if a local pedicled flap is impossible. In treatment of complicated soft-tissue and bone defects, there are clear-cut and gradual therapeutic steps: wound debridement; soft tissue repair; bone reconstruction. PMID- 3515288 TI - AIDS references for health care providers. PMID- 3515289 TI - Behavioral remediation of chronic pain: a status report. AB - The literature concerning the behavioral treatment of chronic pain other than headache was reviewed with particular emphasis on those studies being published since the most recent reviews from 1982. In general, the quality of these studies is much better than those included in the previous reviews. Several studies used broad outcome measures and many studies employed control conditions. The critical examination indicates that the operant program is effective in increasing activity levels and in decreasing medication consumption, and probably also in improving reported levels of pain and mood. Relaxation, in the form of biofeedback, showed mixed results. However, progressive relaxation and relaxation used as a coping strategy, proved to be useful especially in controlling pain ratings. No additional studies of pure 'cognitive' methods were found and the multimodal studies continued to be methodologically problematic. It was concluded that there is substantial evidence for the efficacy of some behavioral treatments for chronic pain. The comparative work suggests that relaxation may be a particularly valuable tool in remediating reported pain intensity. One question is which methods are most effective and economical and it remains for future research to find an answer. The data also suggest that treatment gains tend to be maintained and that patients continue to use assigned techniques although at a lower rate than recommended. Finally, it was pointed out that rehabilitation seldom leads to 100% improvement. Consequently, the need for prevention was stressed. PMID- 3515290 TI - MMPI and headache: a special focus on differential diagnosis, prediction of treatment outcome, and patient-treatment matching. AB - The relation between personality characteristics and the psychological functioning of headache patients has long been a topic of interest. Early investigations focused on clinical and anecdotal reports while recent research has moved toward a more objective evaluation of headache groups by using the MMPI. However, the findings from diverse studies have not been integrated, nor has a rationale for the use of these data in the clinical management of headache been formally presented. The focus of this review is to present a concise, integrated analysis of previous group MMPI headache studies and apply these findings to differential diagnosis, prediction of treatment outcome, and client treatment matching. Five selected clinical case studies indicating various degrees of psychopathology in migraine headache patients are presented to highlight treatment issues in support of an idiographic utilization of the MMPI for the clinical treatment of headache patients. PMID- 3515291 TI - D-phenylalanine: a putative enkephalinase inhibitor studied in a primate acute pain model. AB - D-Phenylalanine, along with morphine, acetylsalicylic acid and zomepirac sodium were evaluated for their antinociceptive actions in monkeys (M. fascicularis) trained to autoregulate nociceptive stimulation using a discrete-trials, aversive threshold paradigm. Morphine sulfate produced dose-related increases in aversive threshold which were reversible after administration of naloxone (12.5 or 25 micrograms/kg i.m.). D-Phenylalanine (500 mg/kg p.o.) produced a small increase in aversive threshold which was not statistically significant and not naloxone reversible. Acetylsalicylic acid (200 mg/kg p.o.) but not zomepirac sodium (200 mg/kg p.o.) in combination with D-phenylalanine (500 mg/kg) produced a small statistically significant increase in aversive threshold. Our results argue against the hypothesis that D-phenylalanine is responsible for increasing aversive thresholds via opiate receptor mechanisms involving increased activity of enkephalins at synaptic loci. Previous studies by others in rats and mice showed that D-phenylalanine and acetylsalicylic acid produced increases in nociceptive thresholds which were naloxone reversible. Our failure to find opiate receptor mediated analgesia in a primate model with demonstrated opiate receptor selectivity and sensitivity is discussed in terms of previous basic and clinical research indicating an analgesic role for D-phenylalanine. Possible species difference in drug action is discussed in terms of inhibition by D-phenylalanine of carboxy-peptidase-like enkephalin processing enzymes as well as inhibition of carboxypeptidase-like enkephalin degrading enzymes. PMID- 3515292 TI - A hypothesis on the physiological basis for causalgia and related pains. AB - A hypothesis is presented concerning the neuronal mechanisms which subserve the sympathetically maintained pains such as causalgia and reflex sympathetic dystrophy. The hypothesis rests on two assumptions: that a high rate of firing in spinal wide-dynamic-range (WDR) or multireceptive neurons results in painful sensations; and that nociceptor responses associated with trauma can produce long term sensitization of WDR neurons. The hypothesis states that chronic sympathetically maintained pains are mediated by activity in low-threshold, myelinated mechanoreceptors, that this afferent activity results from sympathetic efferent actions upon the receptors or upon afferent fibers ending in a neuroma and that these afferent fibers evoke sufficient activity in sensitized spinal WDR neurons to produce a painful sensation. This hypothesis is based on known characteristics of these neuronal populations studied in experimental animals and on the observed sensory disturbances reported in patients successfully treated with sympathetic blocks. This hypothesis does not require nerve injury or dystrophic tissue. It explains both the continuous pain and the allodynia that are common to these syndromes and their abolition by sympathetic block. Specific changes are proposed in the diagnosis and treatment of post-traumatic pains. PMID- 3515294 TI - Dr. Zdenek Kunc. PMID- 3515293 TI - Influence of naloxone on relief of acute oro-facial pain by transcutaneous electrical nerve stimulation (TENS) or vibration. AB - Twenty-eight patients suffering acute pain following operative removal of impacted third molars took part in the present study. In 20 patients who reported pain reduction exceeding 25% of the initial pain intensity during vibratory stimulation (100 Hz) or TENS (2 or 100 Hz), only 1 patient (given 2 Hz TENS) reported pain increase after injection of 0.8 mg naloxone (i.v.). In 8 patients, not treated with afferent stimulation, 2 experienced increase in pain intensity after naloxone injection. The results show that pain relief using TENS or vibration is not influenced by naloxone. PMID- 3515295 TI - Isolation and characterization of salivary antigens from Hyalomma anatolicum anatolicum. AB - This study demonstrates the involvement of a large number of salivary proteins in the acquisition of resistance to Hyalomma anatolicum anatolicum. Using immunoblotting, sera from hypersensitized rabbits were shown to react with nine proteins in the saliva and 17 in salivary gland extracts (SGE) from 96 h fed female ticks. The salivary antigens had molecular weights in the range of 14 400 to 130 000. All the antigens identified in the saliva and 12 of the SGE antigens were glycoprotein in nature and a majority of them appeared to be common to different stages of feeding. In addition antigen I (molecular weight 130 000) showed acid phosphatase and antigen III (molecular weight 96 000) showed both non specific esterase and aminopeptidase activity. Three high molecular weight proteins isolated from saliva (antigen I, antigen II--molecular weight 103 000 and antigen III), gave immediate hypersensitivity reactions in intradermal inoculation into rabbits which had previously been exposed to ticks. Antigens II and III also elicited a strong delayed hypersensitivity reaction. These results may help to explain the nature of the immune mechanisms which effect resistance against H. a. anatolicum. PMID- 3515296 TI - Participation of IgG2b antibodies in the initial control of Trypanosoma musculi infection. PMID- 3515298 TI - Blood pressure responses to hypnotic and nonhypnotic suggestions in normotensive subjects. AB - Forty normotensive subjects participated on a voluntary basis in a study designed to compare the effect of suggestions on blood pressure (BP). Two experimental groups received suggestions presumed to be specific in lowering or raising BP after simple relaxation (relaxation group) or hypnotic induction (hypnotic group). A control group was used to record the BP changes over time. The time variable was significant for both systolic (SBP) and diastolic blood pressure (DBP). Induction procedures (hypnosis or relaxation) resulted in significant decreases in DBP in both experimental groups. In the control group there was a significant decrease in SBP. A specific suggestion to increase the BP resulted only in DBP increase in the hypnotic group. This group also gave an increase of both SBP and DBP over the entire experiment, whereas the relaxation group resulted in a significant decrease in SBP. There was no significant group variable, indicating no differences between the groups. Further research is needed to enable firm conclusions of the effect of suggestions on BP. PMID- 3515297 TI - Pavlov and the concept of association. AB - I. P. Pavlov was profoundly influenced during his youth by the writings of D. I. Pisarev and I. M. Sechenov. Sechenov explained the voluntary act in terms of the formation of associations among sensory impressions and motor responses. Apparently under Pisarev's influence, Pavlov studied the physiology of the circulatory and digestive systems. In explaining the formation of the conditional reflex (CR), Pavlov rejected the Wundtian, anthropomorphic conceptualization of CR as suggested by A. T. Snarskii. However, using the objective CR method, the Pavlovians experimentally investigated the formation in the cortex of neural connections, which were equated with associations. PMID- 3515299 TI - Role of the toxicology laboratory in suspected ingestions. AB - The toxicology laboratory can fill an important role in improving patient care. Whether the service provided by the laboratory is specifically in support of a pediatric population or devoted more to the entire hospital population, the considerations involved in its configuration are the same. These considerations involve establishment of an open dialogue between the laboratory and clinical staff, an integrated and comprehensive analytic approach, and provision of reliable laboratory data in a timely fashion. PMID- 3515300 TI - Tricyclic antidepressant overdose. AB - Overdose of a tricyclic antidepressant is a serious and all-too-frequent occurrence. The diagnosis must be considered in known or suspected overdoses, and signs such as a dry axilla, tachycardia, and wide QRS must be specifically sought. Management depends upon support of vital functions and a thorough understanding of the pharmacology of the drug. Emptying the gastrointestinal tract with ipecac or lavage and hastening elimination with activated charcoal and a cathartic are extremely important measures. Cardiac arrhythmias generally respond to sodium bicarbonate, and seizures respond to intravenous diazepam. Neither physostigmine nor dialysis are considered to be treatments of choice. As in other overdoses, counseling to prevent ingestions is more than worth "a pound of the cure." PMID- 3515301 TI - Mothball toxicity. AB - Accidental mothball ingestion is very common in children. Mothballs consist either of naphthalene or paradichlorobenzene, the toxicities of which are very different. This article focuses on the management of mothball ingestion with reference to these major ingredients. PMID- 3515302 TI - Camphor toxicity. AB - Camphor is present in several over-the-counter compounds of questionable use and therefore may be ingested by small children. Because seizures may follow ingestion of certain amounts, appropriate treatment is needed, including the use of anticonvulsants. PMID- 3515303 TI - Management of acute childhood poisonings caused by selected insecticides and herbicides. AB - Most childhood exposures to insecticides and herbicides do not result in poisonings. Decontamination and observation are usually adequate treatments. The most frequent exposures involve carbamate and organophosphate insecticides. These compounds inhibit acetylcholinesterase, resulting in cholinergic signs that are reversible with atropine administration. Recent reports from poison control centers indicate that organophosphates have been associated with most of the serious childhood poisonings. Pralidoxime, a cholinesterase reactivator, must be administered along with atropine to patients with serious organophosphate poisoning, to reverse nicotinic receptor effects--in particular, respiratory paralysis. Although carbamates and organophosphates may cause clinically indistinguishable physical signs, pralidoxime therapy may be contraindicated for carbamate intoxications. In the event of a serious poisoning caused by a combination of organophosphate and carbamate insecticides, or by an unknown cholinergic agent, pralidoxime should not be withheld. Many organochlorine insecticides are restricted or are no longer available in the United States. CNS excitation and seizures, manifestations of organochlorine intoxication, can occur following ingestion or inappropriate application of the 1 per cent topical formulation of lindane used to treat scabies and lice. Treatment of such intoxication consists of decontamination measures and anticonvulsant administration. Pyrethrins are generally nontoxic in doses commonly ingested. Individuals with an allergic history may be at greatest risk for the most common adverse effects, contact dermatitis and hypersensitivity reactions. Of all insecticides or herbicides, paraquat is the most toxic. Any exposure to paraquat must be evaluated, even if several days have passed since the herbicide was ingested. Signs of pulmonary status deterioration usually portend a grave prognosis in paraquat poisoning. Despite in vitro toxicity similar to paraquat, diquat does not cause lung effects in human poisonings, and reported deaths have been from other causes. Poisoned patients who receive appropriate and timely treatment are virtually assured of complete recovery from most insecticide and herbicide poisonings. Deaths and long-term sequelae most often result from respiratory complications, which may occur as complications of the intoxication or from other constituents in the insecticide or herbicide formulation. Good supportive care with meticulous attention to, and anticipation of, respiratory complications is absolutely essential to prevent long-term sequelae or death from hypoxia.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3515304 TI - Neonatal intracranial hemorrhage and phenobarbital. AB - We enrolled 280 intubated babies with birth weights of less than 1,751 g in a double-blind randomized prospective clinical trial to evaluate whether phenobarbital influences the likelihood of developing subependymal intraventricular-intraparenchymal hemorrhage. Phenobarbital was associated with an increased risk of developing any subependymal-intraventricular intraparenchymal hemorrhage and was not associated with a diminished risk of either severe hemorrhage or germinal matrix hemorrhage. This increased risk was apparent even after we considered the influence of phenobarbital levels, timing of phenobarbital administrations, institutional differences, quality of ultrasound scans, gestational age- and birth weight-specific effects, ascertainment bias, and other possible confounders of phenobarbital administration. PMID- 3515305 TI - Twenty years of renal transplantation in children. AB - Two-hundred three children 1 to 16 years of age received kidney transplants during a 20-year period, 100 from living donors and 103 from cadaver donors. The overall survival rate was 79%. Actuarial patient and kidney survival rates at 15 years were 79% and 52%, respectively, for recipients of living donor kidneys and 57% and 19%, respectively, for recipients of cadaver donor kidneys. One of two children who received transplants in 1964 was alive 20 1/2 years later. Twenty nine children had kidneys that had functioned more than 10 years; their mean serum creatinine concentration was 1.7 mg/dL and 24 were fully rehabilitated. Eighteen were more than 2 SD below the mean height of normal children, however. Comparison of survival rates during successive 5-year intervals showed significant improvement in patient survival during the 20-year period and smaller improvements in kidney survival after 1979. Patient survival after living donor transplants during the last 10 years was 100%, and kidney survival during the last 5 years was 92%. Improvement was attributed to the effect of experience, as well as to changes in immunosuppressive therapy in 1972 and the introduction of donor-specific transfusions in 1978. PMID- 3515306 TI - Benzyl alcohol toxicity: impact on mortality and intraventricular hemorrhage among very low birth weight infants. AB - Benzyl alcohol preservative in intravascular flush solutions has been reported to cause neurologic deterioration and death in very low birth weight infants. Following the widespread discontinuation of the use of such solutions in newborns, scattered reports of decreased mortality and decreased incidence of intraventricular hemorrhage among small premature infants appeared in the pediatric literature. To better assess the true impact of benzyl alcohol toxicity in this group of infants, we undertook a detailed review of the medical records of all babies less than 1,250 g birth weight admitted to our neonatal intensive care unit for 13 months before and 13 months after the use of solutions containing benzyl alcohol was stopped. Significant decreases were found in both mortality rate (from 80.7% to 45.7%) and incidence of grade III/IV intraventricular hemorrhage (from 46% to 19%) among infants less than 1,000 g birth weight who did not receive the preservative compared with those who did. No significant changes were found in several other prenatal factors that could have contributed to this improvement in survival. We conclude that benzyl alcohol toxicity contributed significantly to both mortality and the occurrence of major intraventricular hemorrhage among infants weighing less than 1,000 g at birth and that solutions containing benzyl alcohol should never again be used in the care of such infants. PMID- 3515307 TI - High-frequency ventilation and tracheal injuries. AB - Recent reports linking serious tracheal injuries to various forms of high frequency ventilation prompted this study. We compared the tracheal histopathology seen following standard-frequency, conventional mechanical ventilation with that seen following high-frequency, conventional mechanical ventilation, and two different forms of high-frequency jet ventilation. Twenty six adult cats were examined. Each was mechanically ventilated for 16 hours. Seven received standard-frequency, conventional mechanical ventilation at 20 breaths per minute. Seven received high-frequency, conventional mechanical ventilation at 150 breaths per minute. Six received high-frequency jet ventilation at 250 breaths per minute via the Instrument Development Corporation VS600 jet ventilator (IDC). Six received high-frequency jet ventilation at 400 breaths per minute via the Bunnell Life Pulse jet ventilator (BLP). A semiquantitative histopathologic scoring system graded tracheal tissue changes. All forms of high-frequency ventilation produced significant inflammation (erosion, necrosis, and polymorphonuclear leukocyte infiltration) in the trachea in the region of the endotracheal tube tip. Conventional mechanical ventilation produced less histopathology than any form of high-frequency ventilation. Of all of the ventilators examined, the BLP, the ventilator operating at the fastest rate, produced the greatest loss of surface cilia and depletion of intracellular mucus. IDC high-frequency jet ventilation and high-frequency, conventional mechanical ventilation produced nearly identical histologic injuries. In this study, significant tracheal damage occurred with all forms of high-frequency ventilation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3515308 TI - [Contribution of N.P. Gundobin to the creation and development of Russian pediatrics (on the 125th anniversary of his birth)]. PMID- 3515309 TI - [Functional activity of thrombocytes in newborn infants]. PMID- 3515310 TI - [Microelements in human and cow's milk]. PMID- 3515311 TI - Evaluation of meditation and relaxation on physiological response during the performance of fine motor and gross motor tasks. AB - This study investigated the effects of meditation/relaxation on physiological responses during the performance of a fine motor and a gross motor task. A pretest-posttest control group, randomized-blocks design was used to study a group of 16 meditators and a group of 16 nonmeditators, subgroups of each who relaxed prior to performing on a pursuit-rotor tracking device as a fine motor task and to performing the Luft cycle ergometer protocol to a heart rate of 70% of age-adjusted maximum heart rate as a gross motor task. During each of these tasks heart rate, systolic blood pressure, rate-pressure-product, and EMG activity of the frontalis muscle were monitored. No significant difference in the performance of either the fine motor or the gross motor task was noted for persons practicing meditation and persons who were nonmeditators but were given the opportunity to relax prior to a motor task. Likewise, no significant difference was noted in the pattern of response to the imposed fine motor or gross motor task by meditators or relaxed nonmeditators. PMID- 3515312 TI - Fluorinated quinolones. A review of their mode of action, antimicrobial activity, pharmacokinetics and clinical efficacy. AB - Quinolones, chemically related to nalidixic acid, have a strong and rapid bactericidal action against Gram-negative bacteria, including Ps. aeruginosa, some Mycobacteria, Legionella and Staphylococci. Streptococci and anaerobic bacteria are usually less sensitive. The quinolones exert their bactericidal action through inhibition of the enzyme DNA gyrase. Quinolones are absorbed for 50-100% from the gastro-intestinal tract, their volume of distribution is generally high (2 l/kg) and high concentrations are reached in almost all organs. The elimination half-lives range from 4 to 14 h. The efficacy of quinolones in urinary tract infections has been shown in many studies. They also seem to be effective in many serious infections. In animal studies their efficacy was generally equal or superior to aminoglycosides. Until now only mild and infrequent side effects have been reported. PMID- 3515314 TI - Associate degree nursing programs accredited by the NLN 1984-85. PMID- 3515313 TI - Quinolones in the treatment of gonorrhoea and Chlamydia trachomatis infections. AB - 123 Female patients suffering from uncomplicated urogenital gonorrhoea were treated with either 200 mg or 400 mg enoxacin. The cure rate in the 400 mg group was 100%; the cure rate in the 200 mg group was 95.7% 212 Male patients suffering from urethral gonorrhoea were treated with either 250 mg or 500 mg ciprofloxacin (one tablet). Cure rates in both groups were 100%. Post-gonococcal urethritis was observed in 31 out of 85 (36%) patients in the first, and 21 out of 79 (27%) in the second group. In a pilot study 42 male patients suffering from non-gonococcal urethritis were treated during one week with I g ciprofloxacin daily. In 22 patients Chlamydia trachomatis was isolated from the urethra: in 20 of these 22 cases Chlamydia trachomatis could not be cultured after treatment (cure rate 91%), but in 4 of these 20 cases (20%) and in 8 of the 20 Chlamydia trachomatis negative cases (40%) urine-sediment abnormalities were present after treatment. PMID- 3515315 TI - The use of hydroxylamine cleavage to produce a fragment of ribosomal protein S4 which retains the capacity to specifically bind 16S ribosomal RNA. AB - In previous reports we have described the isolation of fragments of 30S ribosomal protein S4 using a number of different enzymatic and chemical cleavage techniques. These experiments were designed to determine the region of the protein responsible for 16S RNA recognition. We report here the isolation of two fragments produced by the hydroxylamine cleavage of the asparaginyl-glycyl peptide bond between positions 124 and 125. The purified fragments were chemically identified and tested for RNA binding capacity. The fragment consisting of residues 1-124 retains RNA binding activity and the fragment 125 203 is totally without RNA binding function. These results and previous results strongly suggest that the domain of protein S4 responsible for 16S RNA specific association is within the region consisting of residues 46-124. PMID- 3515316 TI - The isolation and nucleotide sequence of the complex AROM locus of Aspergillus nidulans. AB - The AROM locus of A. nidulans, which governs five consecutive steps in pre chorismate aromatic amino acid biosynthesis, has been cloned in a bacteriophage vector. The nucleotide sequence of the locus reveals a single, open reading-frame of 4,812 base-pairs, apparently without introns. An internal segment of the A. nidulans AROM sequence has extensive homology with the E. coli aroA gene that encodes the 5-enolpyruvylshikimate 3-phosphate synthase. PMID- 3515317 TI - Nucleotide sequence of the CytR regulatory gene of E. coli K-12. AB - We have determined the nucleotide sequence of the cytR gene, which codes for the Cyt repressor (CytR). The coding region consists of 1023 or 1029 bp. The subunits of CytR are thus predicted to consist of 341 or 343 residues. It is shown that the N-terminal segment of the polypeptide is structurally similar to the DNA binding region of known DNA-binding proteins. In addition, there exists an exceptionally high amino acid sequence homology between CytR and the Gal repressor, indicating a common origin of evolution. PMID- 3515318 TI - Multiple control elements for the uvrC gene unit of Escherichia coli. AB - We have sequenced the control region of the uvrC protein including two open reading frames (ORF) encoding polypeptides of 28 kd and 23 kd molecular weight. The uvrC gene is preceded by five promoters. The P1, P2a and P2b promoter sequences are 5' to the 28 kd and the 23 kd proteins respectively. The P3 and P4 promoters are located within the structural gene for the 23 kd protein. The P3 promoter is required for adequate in vivo expression. There are three putative lexA protein binding sites, detected at the 3' end of the 28 kd protein (lexA1), within the coding sequences for the 23 kd protein (lexA2) and within the P3 promoter (lexA3). Promoter P2 is responsible for transcription of the uvrC gene, producing transcripts of 2.8 and 1.6 kb. The upstream region including the 28 kd protein is required for enhanced expression under non-induced conditions. These results show that the uvrC gene is controlled by multiple promoters and is transcribed as part of a multigene unit. PMID- 3515319 TI - Isolation of human glucose-6-phosphate dehydrogenase (G6PD) cDNA clones: primary structure of the protein and unusual 5' non-coding region. AB - Glucose-6-phosphate dehydrogenase (G6PD) is an ubiquitous enzyme which by determining the NADPH level has a crucial role in NADPH-mediated reductive processes in all cells (1). The structural gene for G6PD, Gd, is X-linked in mammals and on the basis of its expression in many tissues, it can be regarded as a typical "housekeeping" gene (2). Over 300 variants of the protein are known, many of which have deficient enzyme activity. Nearly 100 of these variants are polymorphic in various populations (3). The mammalian enzyme is a homodimer or a homotetramer with a subunit molecular weight of approximately 56000 daltons (4). Here we report the isolation of cDNA clones from HeLa cells, SV40-transformed human fibroblasts, human placenta and human teratocarcinoma cell lines. These clones have enabled us to sequence the entire coding region of Gd. Thus, the entire amino acid sequence of human G6PD is provided for the first time. This work is the first step for structural analysis of G6PD variants and for an understanding of the biological features of this enzyme at the molecular level. PMID- 3515320 TI - Nucleotide sequence and expression of a Pseudomonas savastanoi cytokinin biosynthetic gene: homology with Agrobacterium tumefaciens tmr and tzs loci. AB - The nucleotide sequence of a Pseudomonas trans-zeatin producing gene (ptz) from the pCK1 plasmid of Pseudomonas syringae pv. savastanoi strain 1006 has been determined. This gene confers upon E. coli the ability to synthesize and secrete several cytokinins including trans-zeatin, iso-pentenyladenine and their respective N9-ribosyl derivatives. Sequence analysis indicates an open reading frame encoding a protein of 234 amino acids with a molecular weight of 26,816. Significant sequence homology is found between ptz and both the tzs and tmr genes from Agrobacterium tumefaciens. The results suggest a close relationship between the cytokinin biosynthetic pathways in P. savastanoi and A. tumefaciens. PMID- 3515321 TI - Sequences of the E. coli uvrB gene and protein. AB - The UvrB protein is one of the three subunits of the E. coli ABC excinuclease. We have reported the sequences of the other two subunits, the UvrA and UvrC proteins. In this paper the sequence of the UvrB protein is presented. The protein sequence was determined from the DNA sequence of the uvrB gene and was confirmed by sequencing the NH2-terminus of the UvrB protein and analyzing its overall amino acid composition. The coding region of uvrB is 2019 basepairs, specifying a protein of 672 amino acids and Mr of 76,118. The sequence of the UvrB protein shows a moderate level of homology to that of the UvrC protein and to the ATP binding site of the UvrA protein. During purification of UvrB protein a proteolytic product, UvrB, is produced in high quantities. We find that UvrB results from removal of about 40 amino acids from the COOH-terminus of the UvrB protein. The uvrB gene has complex regulatory features. On the 5' side, the coding region is preceded by 3 promoters, a DnaA box and an SOS box. On the 3' side the gene is followed by an REP (Repetitive Extragenic Palindrome) sequence which has been implicated in gene regulation by an unknown mechanism. PMID- 3515322 TI - Solutions of RNA polymerase plus linear wild type E. coli lac DNA fragments contain a mixture of stable P1 and P2 promoter complexes. AB - The lac promoter is known to have overlapping, mutually exclusive, binding sites for RNA polymerase. A number of techniques have been used to probe solutions of polymerase and linear lac DNA fragments, including gel electrophoresis binding assays, transcription experiments, and exonuclease III digestions. The data indicate that mixing RNA polymerase with the wild type lac promoter leads to formation of more than one kind of complex; a typical solution contains enzyme in heparin resistant, "open" complexes at the P2 site, while other DNA molecules have polymerase bound in a heparin sensitive, "closed" complex at P1. There may be other rather stable complexes as well. The presence of more than one type of complex has obvious implications for in vitro physical studies of this system. The data suggest that using truncated DNA fragments which eliminate the P2 site may allow isolation and study of P1 closed complexes. Quantitative analysis of the fractions of polymerase found at P1 and P2 implies that P2 can have only a limited effect on lac transcription in the cell. PMID- 3515323 TI - Selected list of nursing books and journals. PMID- 3515324 TI - Nursing and the World's Columbian Exposition. PMID- 3515325 TI - Consumer relations. On-screen learning. PMID- 3515326 TI - Systems of life No. 135. Setting up the systems-35. Antenatal examination (continued). PMID- 3515327 TI - The changing face of treatment for diabetes. PMID- 3515328 TI - Family stress and schizophrenia. Theory and practice. AB - The association between clearly defined stress factors and a relapsing course of schizophrenia has gained support from recent research. The role of families in moderating this stress and thereby reducing the morbidity of schizophrenia is detailed in this article. PMID- 3515329 TI - Differential diagnosis and diagnostic systems in schizophrenia. AB - Diagnosis and prognosis are critical issues confronting psychiatry. In order to answer the fundamental questions concerning the origin and development of schizophrenia, we must first be clear about what it is. We must be able to separate the illness of schizophrenia from other disorders (see Fig. 1). We have attempted in this article to examine some of the illnesses that may resemble schizophrenia and make its discrimination difficult. We hope that by discussing these disorders and their similarities to schizophrenia the important issues and dilemmas have become clearer and more readily understood by the clinician. Future studies assessing the validity of diagnostic systems for schizophrenia may have to rely on features other than cross-sectional symptoms and longitudinal course. Such characteristics as pharmacologic responsivity and genetic transmission and the development of biologic markers may be the prospective cornerstones for validating the diagnosis of schizophrenia. PMID- 3515330 TI - Genetic vulnerability to schizophrenia. AB - The genetic contribution to schizophrenia is the most clearly established etiologic factor. This article briefly reviews the evidence for a genetic influence as well as recent challenges to that evidence. It discusses the possible modes of transmission and outlines current efforts to identify more precisely the genetic and environmental factors contributing to schizophrenia and the nature of the gene-environment interaction. PMID- 3515331 TI - Relationship between CT scan findings and neuropsychological performance in chronic schizophrenia. AB - Studies relating CT abnormalities to impairments on neuropsychological tests in schizophrenic patients are critically reviewed. The overall conclusion is that there appears to be an association between CT abnormalities and neuropsychological deficits in at least some schizophrenic patient samples. It is proposed that there may be two classes of CT abnormalities in schizophrenia: "incidental" versus "essential" CT abnormalities and that neuropsychological impairment above the baseline levels found in most schizophrenic patients may be associated only with the former type. Only attempts to replicate these findings in different schizophrenic samples drawn from different settings can reveal whether this association between CT abnormalities and neuropsychological deficits is widely generalizable. PMID- 3515332 TI - Positron emission tomography. AB - PET is a unique tool for the direct in vivo evaluation of physiologic processes within discrete areas of the brain. Thus far, its application to the study of schizophrenia has served to confirm the subtleties of this illness. However, PET does promise to increase our knowledge of the neurochemical anatomy of the normal and abnormal mind with respect to goal-directed behavior. PMID- 3515333 TI - Randomized trial of oral naproxen or local injection of betamethasone in lateral epicondylitis of the humerus. AB - A randomized pilot study, comparing oral naproxen and a single betamethasone injection, was carried out in 21 patients suffering from lateral epicondylitis of the humerus ("tennis elbow"). The naproxen dosage was 250 mg per day for two weeks. Six milligrams of betamethasone in a long-acting form was given as a local injection. To achieve "blindness," the patients receiving naproxen were also given an injection of saline into the area of maximal tenderness at the epicondyle, while the patients getting the betamethasone-injection were given oral placebo tablets. At a clinical control after two weeks, five of the ten patients receiving naproxen and five of the 11 patients receiving betamethasone injection were improved. Thus, no apparent difference in effect could be noted at an evaluation after two weeks' treatment. No significant side effects were noted with any of the treatments. PMID- 3515334 TI - Occult spinal dysraphism. Case report and review of the literature. AB - This case report and review of the literature is presented to create a greater diagnostic awareness of occult spinal dysraphism. Early recognition is based upon an understanding of this congenital anomaly and its variable presentations. These most commonly include abnormal gait, various cutaneous manifestations, particularly subcutaneous lipomata, and less frequently urological complaints. Surgical intervention, to arrest disease progression, is the primary mode of treatment, and functional improvement is variable. Long-term prognosis is dependent upon severity of neurologic deficits prior to surgery and the type of lesion found intraoperatively. Familial occurrence has been reported and genetic counseling may be an important preventive measure. Recent radiologic investigations have been concerned with the use of ultrasonography in screening infants at risk. PMID- 3515335 TI - The migration of a broken pin following fixation of the acromioclavicular joint. A case report and review of the literature. AB - The use of smooth and threaded pins for internal fixation is often complicated by component migration, especially when employed about the acromioclavicular joint. A case report of pin breakage with subsequent migration is presented. This phenomenon occurred despite efforts to stabilize the pin corroborating the potential hazards and unpredictability of these implants. A protocol for the management of these devices, before and after component failure, is presented. PMID- 3515336 TI - Treatment of multiple enchondromatosis (Ollier's disease) of the hand. AB - The clinical treatment and results for three hands in two patients with multiple enchondromatosis (Ollier's disease) are presented. Diaphyseal resection (total or subtotal) in 27 phalanges and metacarpals preceded autogenous fibular bone grafting to the defects. All bone grafts subsequently healed and were well incorporated. Hand function and cosmesis were restored satisfactorily in each case. There were no infections or recurrences. PMID- 3515337 TI - Self-management of diabetes in a Puerto Rican population. PMID- 3515338 TI - [Centenary of the Georg Thieme publishing house, pathfinder and motivating force in German medicine]. PMID- 3515339 TI - [Medical rehabilitation in diseases of the respiratory organs]. PMID- 3515340 TI - [Method for transplanting vascularized periosteum in the surgical treatment of tuberculous spondylitis]. PMID- 3515341 TI - [Effect of root surface demineralization on the formation of new attachment]. PMID- 3515342 TI - Tissue-specific expression of glucokinase: identification of the gene product in liver and pancreatic islets. AB - The tissue distribution of glucokinase (ATP:D-hexose 6-phosphotransferase, EC 2.7.1.1) was examined by protein blotting analysis. Antibodies raised against rat liver glucokinase recognized a single protein subunit with an apparent Mr of 56,500 on nitrocellulose blots of cytosol protein from liver, separated by sodium dodecyl sulfate/polyacrylamide gel electrophoresis. A protein of identical electrophoretic mobility was detected by immunoblotting of cytosol protein from pancreatic islets. Hepatic glucokinase and the immunoreactive islet product bound to and were eluted from DEAE-cellulose at the same ionic strength. Glucokinase was displayed as a set of two spots with apparent pI values of 5.54 and 5.64 by immunoblotting after two-dimensional gel electrophoresis. The two isoforms appeared equally abundant in liver extract, whereas the component with a pI of 5.64 was predominant in islets. By quantitative immunoblotting, glucokinase was estimated to represent 0.1% of total cytosol protein in liver and 1/20th as much in islets. The glucokinase activity of both liver and islet cytosols was suppressed by the antibodies to hepatic glucokinase. Immunoblotting of cytosol protein from intestinal mucosa, exocrine pancreas, epididymal adipose tissue, kidney, brain, and spleen failed to reveal the glucokinase protein. Thus, significant expression of the glucokinase gene appears restricted to the liver and pancreatic islets. PMID- 3515343 TI - Alternative branch points are selected during splicing of a yeast pre-mRNA in mammalian and yeast extracts. AB - Pre-mRNA splicing in yeast and higher eukaryotes proceeds by similar pathways, in which a probable splicing intermediate and the excised intron are in a lariat configuration. To compare the pre-mRNA splicing mechanisms in yeast and higher eukaryotes, we have analyzed the RNA products resulting from in vitro processing of a yeast intron-containing pre-mRNA in HeLa cell and yeast extracts. In yeast, the RNA branch (2'-5' phosphodiester bond) of the RNA lariat forms at the third adenosine of the TACTAAC box in vivo and in vitro. In contrast, in the HeLa cell extract, the yeast pre-mRNA is accurately spliced, but the RNA lariats contain RNA branches located significantly closer to the 3' splice site than the TACTAAC box. In yeast, mutant pre-mRNAs that lack the TACTAAC box are not spliced in vivo or in vitro. However, these same mutant pre-mRNAs are accurately spliced in the HeLa cell extract. Therefore, although pre-mRNA splicing in yeast and higher eukaryotes proceeds by the same basic pathway, there are substantial differences in the specificity of the biochemical components that mediate the formation of the RNA processing products. PMID- 3515344 TI - Elongation factor Tu.guanosine 3'-diphosphate 5'-diphosphate complex increases the fidelity of proofreading in protein biosynthesis: mechanism for reducing translational errors introduced by amino acid starvation. AB - Complexes of elongation factor Tu (EF-Tu) with guanosine 3'-diphosphate 5' diphosphate (ppGpp) bind to ribosomes where they slow the incorporation of aminoacyl-tRNAs into protein by inhibiting both the binding of aminoacyl-tRNA.EF Tu.GTP ternary complexes and the formation of peptide bonds. The latter action increases the time available for aminoacyl-tRNA rejection by the ribosome and, therefore, increases the effectiveness of proofreading. Synthesis of ppGpp and the formation of EF-Tu.ppGpp occur in vivo in response to amino acid starvation. Our finding, therefore, suggests an explanation for the otherwise puzzling observation that amino acid starvation has, at most, a moderate effect on the fidelity of protein synthesis in wild-type Escherichia coli. We suggest that an EF-Tu.ppGpp-induced increase in the effectiveness of proofreading buffers the overall translational fidelity of these cells against amino acid starvation induced errors in initial selection of aminoacyl-tRNA ternary complexes. PMID- 3515345 TI - Visualization of the paranemic joining of homologous DNA molecules catalyzed by the RecA protein of Escherichia coli. AB - In reactions catalyzed by the RecA protein of Escherichia coli, synapsis between two DNA molecules is believed to occur even in the absence of free homologous DNA ends and to involve a metastable interaction termed paranemic joining. We have used electron microscopic methods to visualize synapse formation between supertwisted M13 double-stranded DNA (dsDNA) and linear M13 mp7 single-stranded DNA (ssDNA) with non-M13 sequences at its ends. These non-M13 sequences block strand invasion and make this pairing equivalent to the joining of two fully circular molecules. We observed a high frequency of joining when the ssDNA was initially assembled into presynaptic filaments with RecA protein. Cleavage of the dsDNA in the joined complexes by Hpa I revealed that the joint was at a site of homology. In these joints, the dsDNA entered the presynaptic filament over a length of 360 +/- 80 base pairs, not visibly altering its ultrastructure, and then dissociated from the filament. Although the dsDNA in the complexes appeared topologically relaxed, deproteinization released supertwisted dsDNA, indicating that the dsDNA was unwound by 34 degrees per base pair in the paranemic joint. When supertwisted M13 dsDNA was paired with circular M13 ssDNA, similar joints were observed and both DNA circles appeared topologically relaxed. PMID- 3515346 TI - Biogenesis of the nuclear lamina: in vivo synthesis and processing of nuclear protein precursors. AB - Utilizing antibodies against lamins A, B1, and B2, we have studied the biogenesis of the nuclear lamina in chicken embryo fibroblasts. (Lamins B1 and B2 have been identified recently as structurally distinct "lamin B" proteins.) We demonstrate that, unique among the nuclear proteins studied to date, lamin A is synthesized as a higher molecular mass precursor. A short-lived higher molecular mass variant (t 1/2 approximately equal to 3 min) accompanying the mature-size protein was also detected in the case of lamin B2 biosynthesis, but no precursor was found for lamin B1. By combining pulse-chase experiments with subcellular fractionation, we provide evidence that synthesis of lamin proteins occurs on free polysomes; subsequently, the newly synthesized proteins become rapidly associated with a crude nuclear fraction. The lamin A precursor is processed within the nucleus with a half-time of about 30 min. Concomitantly, lamin proteins acquire a characteristic resistance to detergent extraction, suggesting their insertion into a submembraneous protein network. The described biogenetic pathway involving precursor synthesis and processing is very unusual for nuclear proteins; it may have interesting implications for the mechanisms of transport and assembly of poorly soluble nuclear proteins. PMID- 3515347 TI - Detection of hepatitis B virus X product using an open reading frame Escherichia coli expression vector. AB - The genome of the hepatitis B virus (HBV) contains a sequence, designated X, capable of encoding a protein of 154 amino acids. To determine whether the putative protein synthesized from this region is antigenic, we examined the sera of HBV-infected patients for the ability to react with a hybrid protein that contained 133 amino acids encoded by the X region and portions of the bacterial ompF and beta-galactosidase genes. Some HBV-positive sera tested contained antibodies that specifically recognized the hybrid protein. All sera were from patients diagnosed as suffering from chronic active hepatitis. We conclude that the X region of HBV encodes a protein and that this protein is antigenic in some patients. PMID- 3515348 TI - Changes in insulin and transferrin requirements of pure brain neuronal cultures during embryonic development. AB - A pure neuronal culture grown in a defined serum-free environment has been developed and characterized. Insulin was the only hormone found to enhance the growth of neurons obtained from embryonic chicken brains during the early proliferative stage, a time when many neurons survived without the addition of any growth factors to the culture. With increasing embryonic age, there was an increase in the number of neurons requiring transferrin. By the time neurons reached a postmitotic state in older brains, they were completely dependent on both insulin and transferrin for survival and growth. Because this culture is free of glial cells and serum, it provides an effective basis for investigating molecular mechanisms underlying neuronal development. PMID- 3515349 TI - Effects of gonadotropin-releasing hormone treatment on ovarian steroid production during midpregnancy. AB - During the second half of pregnancy, ovarian testosterone (T) through its conversion to estradiol (E) promotes progesterone (P) synthesis by the ovary which maintains the pregnancy. To determine if the administration of gonadotropin releasing hormone (GnRH) disrupts pregnancy by suppressing ovarian production of T or its conversion to E, rats were treated from Day 11 through Day 18 of pregnancy with 50 or 100 micrograms/day of GnRH or 1, 5, or 10 micrograms/day of a GnRH agonist (GnRH-Ag; WY-40972) using an osmotic minipump. Rats were bled daily from the jugular vein under light ether anesthesia and on Days 14 or 18 of pregnancy both jugular and ovarian blood samples were obtained. While the GnRH-Ag treatment at the dose of 5 or 10 micrograms/day terminated pregnancy within 48 hr as indicated by vaginal bleeding, 1 microgram/day terminated pregnancy more slowly. Neither dose of GnRH was effective in terminating pregnancy through Day 18. By Day 14, peripheral levels of plasma P in rats treated with 0, 1, 5, or 10 micrograms of GnRH-Ag were 97 +/- 9, 24 +/- 1, 13 +/- 3, and 8 +/- 1, respectively. In the same groups, levels in the ovarian vein were 3205 +/- 633, 1317 +/- 273, 360 +/- 113, and 228 +/- 73 ng/ml. By Day 18, serum P levels in the peripheral circulation and in the ovarian vein were declining even more dramatically. Daily administration of P (4 mg) and E (0.5 micrograms) simultaneously with GnRH-Ag at the dose of 5 micrograms/day from Days 11 through 14 reversed the abortifacient effect of GnRH-Ag and maintained pregnancy indicating that the GnRH-Ag effect is not directly on the uterus. Ovarian vein levels of T on Days 14 or 18 of pregnancy were either not different from controls at 1407 +/- 163 or 1476 +/- 122 pg/ml, respectively, or increased dramatically in certain groups. Ovarian vein levels of E were either not different from controls at 292 +/- 13 pg/ml on Day 14 or increased significantly in rats treated at the dose of 1 microgram/day of GnRH-Ag. However by Day 18, treatment with GnRH-Ag at all doses suppressed ovarian secretion of E. These results suggest that while the GnRH-Ag induces abortion in rats by suppressing ovarian production of P, this abortifacient effect is not due to a fall in ovarian T levels nor to its aromatization to E in the ovary. PMID- 3515350 TI - Adenosine release from isolated rat adipocytes: influence of fat cell concentration and cell size. AB - The release of adenosine by isolated rat adipocytes into the incubation medium was studied in relation to fat cell size and concentration. Incubations were carried out for 60 min at 37 degrees C in Krebs-Ringer bicarbonate-albumin medium containing 6 mM glucose. 2'-Deoxycoformycin was added to inhibit endogenous adenosine deaminase activity (maximal suppression was achieved at 0.8 microM concentration of the inhibitor). The data show that (a) the amount of adenosine released into the medium was similar for the first and second 30-min incubation periods; (b) increasing adipocyte concentration markedly inhibited adenosine release; and (c) large fat cells (volume greater than 300 pl) released significantly more adenosine (per fat cell) into the medium than smaller fat cells (volume less than 180 pl) when incubated at concentrations of less than or equal to 350,000 cells/ml. Above this cell concentration, differences between adenosine release and cell size were not noted. Adenosine release by isolated rat adipocytes appears to be a precisely regulated process which is exquisitly sensitive to the number of fat cells in the incubation medium and, to a certain extent, to the adipocyte size. PMID- 3515351 TI - Oxytocin increases extrapancreatic glucagon secretion and glucose production in pancreatectomized dogs. AB - Infusion of oxytocin into normal dogs increases plasma levels of insulin and glucagon and glucose production and uptake. To determine whether infused oxytocin also increases glucagon secretion from extrapancreatic sites, pancreatectomized dogs, off insulin for 18 hr, were infused with oxytocin and plasma glucagon, and glucose production and uptake were measured using the [6-3H]glucose primer infusion technique. The diabetic dogs, in the control period, had elevated plasma glucose and glucagon levels, an increased rate of glucose production, and a relative decrease in glucose uptake (decreased clearance). Infusion of oxytocin (500 microU/kg/min) caused a rise in plasma glucagon and glucose levels, increased glucose production, and further decreased glucose clearance. It is concluded that oxytocin can stimulate secretion of extrapancreatic glucagon, which contributes to the increased glucose production. PMID- 3515352 TI - The occurrence of malignant tumors in immunosuppressed states. PMID- 3515353 TI - Deficiency of cell mediated immunity in leprosy. PMID- 3515354 TI - Lymphadenopathy associated virus: its role in the pathogenesis of AIDS and related diseases. PMID- 3515355 TI - The 52 K protein: an estrogen regulated marker of cell proliferation in human mammary cells. PMID- 3515356 TI - Immunochemical approach to detection and quantitation of DNA adducts resulting from exposure to genotoxic agents. PMID- 3515357 TI - Modification of immunogenicity of transfusion products. AB - The transfusion of foreign blood products (expressing non-self histocompatibility antigens) leads to an immune response in the transfusion recipient. This may result in a memory response to subsequent transfusions, and in patients undergoing marrow transplantation for the treatment of aplastic anemia in an increased risk of marrow graft rejection. We have used the canine model of marrow transplantation as an in vivo indicator system for the occurrence of post transfusion sensitization. Our results show that sensitization can occur in response not only to major histocompatibility complex (DLA) antigens but also to minor (non-DLA) antigens. Our studies suggest that the antigens involved are probably expressed on leukocytes but not on RBC and platelets. Among leukocytes the sensitizing population appears to be contained within mononuclear cells, presumably large Ia positive cells which show accessory cell function in vitro. The responsible antigens are apparently not expressed on T lymphocytes. Our findings are in agreement with the hypothesis that dendritic cells play a central role in transfusion-induced sensitization. Their sensitizing ability can be abrogated by exposure to UV light prior to transfusion. It is conceivable that exposure to UV light alters the function of Ia antigens which in turn results in defective antigen presentation and consequently a lack of sensitization of the recipient. Alternatively non-DLA antigens on donor cells could be modified by exposure to UV light thus escaping recognition by the recipient. The exact mechanism remains to be determined. PMID- 3515358 TI - A tribute to Graham A. Jamieson. PMID- 3515359 TI - Human test tube bone marrow. PMID- 3515360 TI - The blood bank as a source of hematopoietic stem cells. PMID- 3515361 TI - Clinical applications of monoclonal antibodies for patients with leukemia and lymphoma. PMID- 3515362 TI - Removal of neuroblastoma cells from bone marrow with monoclonal antibodies and magnetic immunobeads. PMID- 3515363 TI - Functional studies of in vivo committed lymphocytes propagated from organ transplants. PMID- 3515364 TI - Ex vivo activated monocytes and adoptive immunotherapy trials in colon cancer patients. PMID- 3515365 TI - Prevention of platelet alloimmunization. AB - Based on transfusion studies in patients and animal model systems, there are currently only two established methods of at least delaying platelet alloimmunization. These involve the administration of leukocyte-poor platelets and red cells or reducing a recipient's exposure to incompatible donor antigens by using single-donor pheresis products. The application of these approaches is limited by practical considerations of achieving sufficiently leukocyte-poor blood products to produce the desired effect, and by the availability and costs of pheresis products compared to pooled random donor platelet concentrates. Furthermore, in chronically transfused aplastic patients who are not receiving concurrent immunosuppressive chemotherapy, there is reason to believe that these transfusion programs may be less effective then in leukemic patients. Fortunately, newer insights into the pathways of antigen recognition have suggested other possible ways to prevent recipient recognition of transfused or transplanted donor tissues. Cyclosporin A specifically inhibits T cells that are central to immune recognition of foreign antigens, and thereby is a very effective immunosuppressive agent. Furthermore, a major pathway of immune recognition may involve direct stimulation of the recipient's T cells by APC in donor tissue; methods to eliminate these cells by physical removal, treatment with anti-Ia antisera, or inactivation with U-V light may represent major advances in preventing alloimmunization. In addition, there is evidence that HLA and B antigens may not be intrinsic to the platelet membrane, suggesting it may be possible to remove them before transfusion, thereby eliminating a major source of incompatability. Finally, as platelets do not express Class II MHC antigens on their surface, "pure" platelet transfusions may be not only non-immunogenic, but may actually induce tolerance to subsequent transfusions or transplants. PMID- 3515366 TI - Cardiovascular actions of dietary polyunsaturates and related mechanisms. A state of-the-art-review. AB - A survey of the effects of dietary polyunsaturates on the function of the cardiovascular system is given. In isolated hearts of rats dietary linoleate supply increases both coronary flow and heart muscle function. Hearts of rats fed high amounts of linoleic acid are protected against catecholamine (over) stimulation. Polyunsaturate rich vegetable oils are effective in lowering blood pressure in several murine hypertension models. This effect seems to be closely related to antihypertensive changes in kidney function and in the function of the arterial vessel wall. Dietary polyunsaturates augment the hypotensive effect of antihypertensive drugs. Cardiovascular effects of dietary polyunsaturates are at least partly mediated via changes in the prostanoid metabolism as well as a reduction of the sympathetic activity. Evidence has been accumulated that cardiovascular effects of dietary polyunsaturates in animal and man are comparable. The observed effects are discussed against the background of a reduced risk of cardiovascular disease after a polyunsaturate rich diet in man. PMID- 3515367 TI - Degradation of prostacyclin in the plasma of patients with terminal liver insufficiency. AB - It has been suggested earlier that the increased bleeding tendency observed in patients with hepatic coma is due to prostaglandin I2. Various experimental studies have reported an increased prostaglandin I2-formation, an enhanced plasma factor activity and a prolonged synthesis in-vitro. However, the rate of degradation of prostaglandin I2 in plasma could be another determinant alterating the locally available biologically active substance but this has not been examined so far. Thus, we examined the half-life of synthetic prostaglandin I in vitro in plasma from 25 patients with terminal liver insufficiency in different stages of hepatic coma. In 8 healthy volunteers a 6 months follow up showed no significant change. The half-life of prostaglandin I in controls was 10.21 +/- 2.70 minutes, no different from coma stage I (10.16 +/- 1.36 minutes), coma stage II (10.86 +/- 2.24 minutes), coma stage III (10.95 +/- 3.06 minutes) or coma stage IV (12.07 +/- 2.88 minutes). However, a modest trend towards a prolongation and an increase in standard deviation with the coma stage can be noted. No influence of various drugs commonly used in these patients could be seen. It can thus be concluded that there is no important difference in degradation speed of prostaglandin I2 in the plasma of patients with terminal liver insufficiency, which could account for the increased bleeding tendency. PMID- 3515368 TI - A double-blind comparison of once-daily flupenthixol and mianserin in depressed hospital out-patients. AB - A double-blind, parallel group study was carried out in 51 mild to moderately depressed hospital out-patients to assess the therapeutic efficacy and side effects of once-daily flupenthixol (1 mg) administered in the morning compared with once-daily mianserin (30 mg) administered in the evening. Patients were treated over a period of 6 weeks and assessments were made before and during treatment using the Newcastle Rating Scale, the Clinical Global Impression, the Hamilton Depression Scale, the Leeds Self-Rating Scale for Depression, and a check-list of side-effects. The results showed that 91% of flupenthixol patients and 80% of mianserin patients were assessed as 'normal' on completion of the study period. Depressive symptoms decreased progressively in both groups. Reports of side-effects in both groups showed a progressive reduction in number and severity during the study. The reduction at the end of the first week of treatment with mianserin was not as great as that seen with flupenthixol; reports of drowsiness accounted for most of the difference. PMID- 3515369 TI - Fenoverine: a two-step, double-blind and open clinical assessments of its smooth muscle synchronizing effects. AB - A clinical trial on fenoverine was performed in two parts, one double-blind and one open. In the double-blind segment, 69 patients with chronic gastro-intestinal spasmodic conditions were allocated, according to a pre-set randomization table, to receive orally 3 daily doses of fenoverine (100 mg; 35 patients), trimebutine (150 mg; 14 patients) or placebo (20 patients) during an average of 8 days. In the open assay, 60 similar patients were treated during an average of 10 days with 100 mg fenoverine, orally, 3-times daily. Clinical efficacy was evaluated on the grounds of complete or almost complete remission of all symptoms and signs associated with the spasmodic condition. In the double-blind segment, 66% of patients given fenoverine experienced remission, a significantly higher proportion than those who had placebo (40%). The results with trimebutine (71%) could not be statistically differentiated from those of either fenoverine or placebo. In the open segment, 72% of patients experienced remission with fenoverine, thus showing an overall effectiveness in 70% of the total 95 patients who had such treatment. In neither study could a significant influence of spasm localization be shown on the clinical efficacy of fenoverine. Fenoverine also exerted an unexpected, though clinically interesting, anti-emetic action: of the 14 patients reporting vomiting on entry, 12 (86%) responded positively to fenoverine, whereas none responded out of the 3 who had placebo. Possible side reactions were limited with fenoverine: there were only 17 (18%) complaints, mainly dry mouth, of which 6 were very mild.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3515370 TI - Diphenpyramide: a review of its pharmacology and anti-inflammatory effects. AB - Diphenpyramide is a non-steroidal anti-inflammatory compound which has no free ionizable or particularly reactive groups, in contrast to conventional non steroidal anti-inflammatory agents. In animal tests, diphenpyramide showed anti inflammatory action as powerful as that of indomethacin or phenylbutazone, with major peripheral analgesic, antipyretic and uricosuric properties. The therapeutic index was more favourable than that of the reference compounds. Diphenpyramide inhibits the synthesis of inflammatory prostaglandins and antagonizes the mediators of inflammation, but does not affect platelet aggregation or blood clotting. The major biotransformation products are biphenylacetate (BPA), which is pharmacologically active, p-hydroxy biphenylacetate (p-HBPA) and alpha-aminopyridine (AP). The first is metabolized to p-HBPA which is excreted in the urine. The serum levels of the parent drug and BPA do not result in particularly elevated peaks. Elimination occurs mostly through the faeces. The anti-inflammatory action of diphenpyramide has been extensively proven in clinical trials in which patients with various inflammatory conditions, mainly of a musculoskeletal nature, were treated. The overall therapeutic efficacy was over 80% with a high proportion in osteoarthritis. In double-blind studies, the efficacy of diphenpyramide was significantly better than that of acetylsalicylic acid or indomethacin in osteoarthritis, and comparable with that of naproxen. The preferred dose of diphenpyramide in adults was 1000 mg/day in 2 divided doses for a period of about 30 days. The effective and safe dose in children was 13 to 33 mg/day. Side-effects were seldom reported (2.5%), were mild and transient and mainly of a gastro-intestinal nature. Specific tests on possible drug influence on the gastric mucosa showed diphenpyramide to be 'gastrosafe' both on short-term, high-dose as well as on long-term standard treatments. Biopsy and endoscopy of the mucosa failed to indicate any impairment; occult blood in stools could not be detected. Diphenpyramide seems, therefore, to be an anti-inflammatory drug that combines efficacy and tolerance in the treatment of a wide variety of inflammatory musculoskeletal disorders of primary of secondary nature, as well as the associated pain. Clinical observations also suggest that diphenpyramide could safely be administered to susceptible patients, such as children and infants or elderly, in need of effective anti-inflammatory treatment. PMID- 3515371 TI - A parallel group comparison of tenoxicam and piroxicam in patients with ankylosing spondylitis. AB - Tenoxicam (20 mg/day) and piroxicam (20 mg/day) were compared in a double-blind, parallel group study over 4 weeks in 30 patients with ankylosing spondylitis. Both tenoxicam and piroxicam reduced spinal pain, but the improvement was greater with piroxicam. Tenoxicam and piroxicam were equally effective at improving duration of morning stiffness. Slight improvement was seen with other symptoms with both treatments. Patients were slightly more tolerant of piroxicam than tenoxicam and most patients elected to continue on their particular therapy at the end of the study. PMID- 3515372 TI - [Thrombocyte aggregation inhibitors. A new class of active substances]. PMID- 3515373 TI - Factors determining hygroscopic aerosol deposition in airways. PMID- 3515374 TI - Nutritional and social cues influence the onset of puberty in California voles. AB - Weanling male California voles were housed individually in cages containing either bedding taken from their own mothers, from unrelated mothers, or clean woodshavings. Half of the males in each housing condition received fresh lettuce daily in addition to their standard diets. At 45 days of age males housed in clean bedding had heavier seminal vesicles than males housed in bedding from their own or an unrelated mother. However, males which received lettuce supplementation displayed large-sized seminal vesicles regardless of their housing condition. In a second study 45-47 day old females were housed either with an adult male, alone in the bedding of an adult male, or in clean bedding for 4 days. Again, one half of the females in each housing condition received lettuce daily in addition to their standard diet. Ovarian and uterine weights were heaviest in females that had direct contact with an adult male. Lettuce supplementation increased uterine weights in females housed alone in either clean or male-soiled bedding. Lettuce did not accelerate uterine growth in females co habiting with males, presumably male contact causes maximal development. These data show that the ingestion of green vegetation may facilitate reproductive development in male and female voles, despite inhibitory social conditions. PMID- 3515375 TI - Chronic gonadotropin-releasing hormone agonist treatment suppresses ovulation and sexual behavior in group-living female rhesus monkeys. AB - The sexual behavior of six adult rhesus females was observed with each of four males prior to, during, and following a 90 day treatment with 20 micrograms/day of a gonadotropin releasing-hormone (GnRH) agonist (WY-40972). All females ovulated, approached males and copulated during an untreated cycle. No ovulations occurred during agonist treatment and all females showed reduced sexual interest during the last 25 treatment days. Three females showed elevated estradiol and copulated during the first 10 days of agonist treatment, but never showed similar levels of estradiol or copulation during the rest of treatment. Within 34 days after agonist treatment, all females initiated proximity to males, copulated, and ovulated. All females became pregnant on their second ovulation after agonist treatment. This demonstration that inhibition of ovulation with a GnRH agonist decreased rhesus female sexual initiation, demonstrates the importance of ovarian hormones to female sexual motivation and suggests that the changes in human female sexual interest should be evaluated during the development of agonist based contraceptives. PMID- 3515376 TI - [Classical texts-reread. Cumming,J.,Elaine Cumming. Self and milieu- theory and practice of milieu therapy, 1976; 1962]. PMID- 3515377 TI - Diagnosis and outcome: depression and anxiety in a general population. AB - An assessment of the long-term outcome for depression and anxiety disorders in a general population was made as part of the Stirling County Study. Measuring outcome as a dichotomy between experiencing recurrent episodes or not during a 17 year cohort interval, it was found that 56% of the 'cases' had a poor prognosis. While sex, age and level of severity were not significantly related to outcome, an initial diagnosis of depression was predictive of unfavourable prognosis. Only a few of these 'cases' received psychiatric specialty treatment. Some disorders in the community appear, however, to be as serious as those that come to the attention of psychiatrists. PMID- 3515378 TI - The placebo concept in medicine and psychiatry. AB - The standard technical vocabulary used to define placebo therapies and experimental placebo controls in medicine and psychiatry is both confusing and obscure. To achieve conceptual clarity in the theory of placebogenic phenomena, this paper offers a rigorous articulation of the placebo notion, a lucid new terminology that obviates the defects intrinsic to the traditional locutions employed in the placebo literature, and a substantial revamping of A. K. Shapiro's influential prior definition of 'placebo'. This paper supersedes an earlier version (Grunbaum, 1981). PMID- 3515379 TI - E. coli antibodies in schizophrenia. AB - The present investigation demonstrates relatively high antibody titres against an E. coli O-antigen in sera from somatically healthy male schizophrenic patients. This observation supports the suggestion that abnormal portasystemic collaterals are relevant to the manifestation of schizophrenia. PMID- 3515380 TI - A computerized psychiatric diagnostic system and case nomenclature for elderly subjects: GMS and AGECAT. AB - The Geriatric Mental State and a new computerized diagnostic system, AGECAT, are briefly described. A nomenclature for designating cases for epidemiological work is introduced. Concordance between AGECAT and psychiatrists' diagnoses for these studies, hospital and community based (total of 541 subjects), achieved overall kappa values of 0.84 for a psychiatric hospital sample and 0.74 for a community sample. The values for depression and organic illness specifically in these settings were psychiatric hospital 0.80/0.86, and community 0.80/0.88, respectively. PMID- 3515381 TI - Vocal affect expression: a review and a model for future research. PMID- 3515382 TI - Form of empirical ROCs in discrimination and diagnostic tasks: implications for theory and measurement of performance. PMID- 3515383 TI - Affect and memory: a review. PMID- 3515384 TI - Dietary restraint: a theoretical and empirical review. PMID- 3515385 TI - Contributions to the history of psychology: XL. The Hampstead Wartime Nurseries. PMID- 3515386 TI - [Books on the topic of psycho-oncology (1975-85)]. PMID- 3515387 TI - Man and nature: controversy and philosophy. PMID- 3515388 TI - Microleakage of posterior composite resin materials and an experimental urethane restorative material, tested in vitro above and below the cementoenamel junction. PMID- 3515390 TI - Effect of placement techniques on microleakage of a dentin-bonded composite resin. PMID- 3515389 TI - Increased fracture resistance of teeth: comparison of five bonded composite resin systems. PMID- 3515391 TI - A three-appointment technique for a distal extension removable partial denture. PMID- 3515392 TI - Vocational influences on prosthetic design. PMID- 3515393 TI - A history of copper in amalgam and an overview of setting reaction phases. PMID- 3515394 TI - The treatment of perimolysis using resin bonded etched metal onlays. PMID- 3515395 TI - Analysis of stresses in resin bonded fixed partial dentures. PMID- 3515396 TI - Modification of the chemical composition and structure of the U.S. Reference Standard Endotoxin (RSE) by 60Co radiation. AB - A highly purified bacterial lipopolysaccharide (LPS) preparation was exposed in water to megadoses of ionizing radiation from a 60Co source. As evidenced by electrophoresis, the radiation treatment progressively degraded the lipopolysaccharide molecules by removing first the O-side chain units and then components of the R-core. Chemical analysis of the irradiated (LPS) preparations showed that, in accord with the structural changes, the most profound effects of ionizing radiation occurred in the hydrophilic oligo/polysaccharide moieties (R core and O-side chain). Progressively higher doses of radiation degraded the simple sugars in decreasing order of galactose, galactosamine, glucosamine, glucose, and heptose. The R-core component 2-keto-3-deoxyoctonate was the most "resistant" sugar derivative to ionizing radiation. Due to its central position in the LPS aggregates in water, even at comparatively high doses of radiation the hydrophobic lipid A moiety of endotoxin was less affected than the sugar components. Of the fatty acids of lipid A, however, either partial conversion of beta-hydroxymyristic acid into myristic acid or selective loss of the former occurred. The observed structural and chemical changes of LPS are consistent with the effect of active oxygen radicals of radiolysis. In addition, the extensive physicochemical changes explain the altered biological reactivity of radiation treated endotoxins. PMID- 3515397 TI - Radiation-induced cytogenetic damage in relation to changes in interphase chromosome conformation. AB - The premature chromosome condensation (PCC) technique was used to study several factors that determine the yield of chromosome fragments as observed in interphase cells after irradiation. In addition to absorbed dose and the extent of chromosome condensation at the time of irradiation, changes in chromosome conformation as cells progressed through the cell cycle after irradiation affected dramatically the yield of chromosome fragments observed. As a test of the effect of chromosome decondensation, irradiated metaphase Chinese hamster ovary (CHO) cells were allowed to divide, and the prematurely condensed chromosomes in the daughter cells were analyzed in their G1 phase. The yield of chromosome fragments increased as the daughter cells progressed toward S phase and chromosome decondensation occurred. When early G1 CHO cells were irradiated and analyzed at later times in G1 phase, an increase in chromosome fragmentation again followed the gradual increase in chromosome decondensation. As a test of the effect of chromosome condensation, G0 human lymphocytes were irradiated and analyzed at various times after fusion with mitotic CHO cells, i.e., as condensation proceeded. The yield of fragments observed was directly related to the amount of chromosome condensation allowed to take place after irradiation and inversely related to the extent of chromosome condensation at the time of irradiation. It can be concluded that changes in chromosome conformation interfered with rejoining processes. In contrast, resting chromosomes (as in G0 lymphocytes irradiated before fusion) showed efficient rejoining. These results support the hypothesis that cytogenetic lesions become observable chromosome breaks when chromosome condensation or decondensation occurs during the cell cycle. PMID- 3515398 TI - Radiation damage in patients treated by total-body irradiation, bone marrow grafting, and cyclosporin. AB - The bone marrow (BM) and peripheral blood (PB) from 63 patients were assessed for the presence of chromosomal aberrations after bone marrow transplantation (BMT) following total body irradiation (TBI) for leukemia. Forty-one patients showed no abnormalities in either BM or PB, and 22 had aberrations in either BM or PB or both. Only stable aberrations were found in the BM, but both stable and unstable abnormalities were present in the PB, the majority showing only unstable aberrations. Among the 25 patients who had a leukemic relapse, clonal chromosomal abnormalities were found in the BM of 12 out of the 16 cases for whom marrow was studied at the time of the relapse. A statistically significant negative correlation between leukemic relapse and graft versus host disease (GvHD) was found, but the relationships between chromosome damage and leukemic relapse, GvHD, and the pretransplant radiation dose and between the radiation dose and both leukemic relapse and GvHD were not significant. PMID- 3515399 TI - Spontaneous cell-mediated cytolysis by peripheral blood cells obtained from whole body chronically irradiated beagle dogs. AB - The level of natural killer (NK) activity of continuously gamma-irradiated (whole body) beagle dogs and their nonirradiated controls was studied. For analytical purposes, irradiated dogs were segregated into groups according to their clinical status: clinically normal, hypocellular, or with acute non-lymphocytic leukemia. Since unirradiated control animals exhibited a wide range of NK responses, the data from each irradiated animal were compared to its own age-matched or litter matched unirradiated control. Of the eight clinically normal irradiated dogs (median = 146% activity of control) only one animal had a NK activity lower than that of its control. The hypocellular group (n = 5, median = 21.8% of control) and the leukemic group (n = 4, median = 52.5% of control) each contained one responder with higher activity than its control. The difference between the percentage of control of the clinically normal and clinically abnormal dogs was found to be significant (P less than 0.05). There is a negative correlation between the NK results obtained and the total accumulated dose of radiation at the time of sampling (correlation coefficient = -0.739, P less than 0.01), suggesting a radiation effect upon natural killer activity, which is evidence by enhancement at lower doses and depression at higher doses of irradiation. PMID- 3515400 TI - Hyperthermic sensitivity and growth stage in Escherichia coli. AB - Hyperthermic sensitivities of Escherichia coli B/r and Bs-1 were determined for lag-, midlog-, and stationary-phase cells at 47, 48, and 49 degrees C. In both strains midlog-phase cells were strikingly more heat sensitive (100-fold greater killing after 4 h at 48 degrees C) than stationary-phase cells, with intermediate sensitivity for lag-phase cells. In contrast to the reported difference in the radiation sensitivity between these two strains, very little difference in heat sensitivity was seen. Patterns of fatty acid composition of both strains were very similar at each phase of growth. From midlog to stationary phase, 16:1 and 18:1 unsaturated fatty acids decrease from 16 and 30% to 0.5 and 3%, respectively, while the C17 and C19 cyclopropane fatty acids increase from 7 and 3% to 22 and 25%, respectively. Concomitant with these changes in fatty acid composition, substantially higher membrane microviscosity values were recorded for stationary-phase cells. Total membrane microviscosity was positively associated with the C17 and C19 cyclopropane fatty acid composition and with cell survival following hyperthermia. In contrast to hyperthermic sensitivity, radiation survival differences between B/r and Bs-1 are little affected by growth stage. We propose that these results are consistent with a critical influence of membrane lipids on cellular hyperthermic sensitivity and further that the target sites for radiation and hyperthermia are different in these cells. PMID- 3515401 TI - The image of ourselves: facts and fallacies. PMID- 3515403 TI - Obstetric ultrasonography: college initiative needed. PMID- 3515402 TI - Microcomputer system for record keeping during infertility monitoring by ultrasound. PMID- 3515404 TI - Computer-aided diagnostic strategy selection. AB - Determination of the optimal diagnostic work-up strategy for the patient is becoming a major concern for the practicing physician. Overlap of the indications for various diagnostic procedures, differences in their invasiveness or risk, and high costs have made physicians aware of the need to consider the choice of procedure carefully, as well as its relation to management actions available. In this article, the author discusses research approaches that aim toward development of formal decision analytic methods to allow the physician to determine optimal strategy; clinical algorithms or rules as guides to physician decisions; improved measures for characterizing the performance of diagnostic tests; educational tools for increasing the familiarity of physicians with the concepts underlying these measures and analytic procedures; and computer-based aids for facilitating the employment of these resources in actual clinical practice. PMID- 3515405 TI - Toward automated image analysis: future possibilities in historical perspective. AB - This field is in its infancy. Some people look at artificial intelligence and just call it complex programming, but artificial intelligence is now being applied to image understanding and attempts to utilize knowledge about the domain of the image to analyze it. The practicality of this approach is a long way off, however, and the radiologist of today does not need to fear that computers will change the work habits of image interpretation for some time to come. PMID- 3515406 TI - Teaching with computers. AB - Various methods of using computers in education have been presented. Although the interesting file, interactive video, and bibliographic searches stand on their own, a far better approach is to integrate them, so that the radiologist learning new techniques in interventional procedures, for instance, could search the current literature quickly and easily for new articles using the bibliographic search facility and could review interesting cases from the teaching file that pertained to the lesson at hand. One very important attempt to integrate some of these teaching functions in conjunction with other aspects of medical school administration and research has been the Integrated Academic Information Management Systems (IAIMS) Program of the National Library of Medicine. This program stems from a report created by the Association of American Medical Colleges (AAMC), which was funded originally by the National Library of Medicine. This program has funded several teaching institutions to first plan for an integrated approach to medical information (Fig. 7) and then implement prototype systems. As medical image management systems become available (see the article entitled "Digital Image Management: Networking, Display, and Archiving"), they will be a major component of these information networks and will be most important for teaching purposes. Integrating the teaching components described earlier with the medical image management system will be most important. PMID- 3515407 TI - [Radioimmunologic analysis of the status of the renin-angiotensin-aldosterone system in arterial hypertension]. PMID- 3515408 TI - Obstetrical sonography--focus on the fetus. PMID- 3515409 TI - Adjuvant modalities in lung cancer: an assessment of surgery, radiotherapy, and chemotherapy. PMID- 3515410 TI - [Pancreatic pseudoaneurysm and spurious aneurysm of the splenic artery--diagnosis by angio-CT and ultrasound]. AB - Pseudoaneurysm of the pancreas is a severe complication secondary to pancreatitis. The splenic artery is most often involved, followed by the pancreaticoduodenal vessels and the gastroduodenal artery. Selective arteriography is considered the method of choice in preoperative diagnosis. In a patient with chronic pancreatitis angio-CT and ultrasound allow a definitive diagnosis of pseudoaneurysm of the splenic artery. PMID- 3515411 TI - [Changes in diagnostic imaging of non-Hodgkin's lymphoma in recent years]. AB - The following examinations have been carried out with various methods of diagnostic imaging: 148 CT, 69 US, 56 Ly. Data on the rate of accuracy of the various methods of examination in the individual abdominal regions. CT examinations rose from 1980 to 1985 from 83 percent to 100 percent. US examinations ranged between 50 to 25%. Lymphographies dropped from 54% to 0%. Owing to the early dissemination pattern of the NHL with frequent primary extranodal involvement, lymphography is no longer indicated. In the abdominal region including the pelvis, CT is superior to US accuracy also with those abdominal findings that have been histologically verified. CT cuts show a better reproducibility and more accurate basis for therapeutic controls. The problem of the mere characteristic of the "size of the lymph node" with non-invasive diagnostic imaging will be discussed. The costs of the various methods of examination are compared with each other. The strategy of examination has changed. PMID- 3515412 TI - [Sonographic diagnosis of the gastrointestinal tract]. AB - Ultrasound examination is an established screening procedure for illdefined abdominal complaints and is complementary to the abdominal plain film. The bull's eye phenomenon due to bowel wall thickening is the characteristic feature of bowel pathology. Ultrasound is the method of proof for hypertrophic pyloric stenosis, imperforate anus or ascites. Findings of edematous (intussusception), inflammatory (Crohn disease) and neoplastic stomach or bowel disease require confirmation by radiology or endoscopy. Ultrasound of the gastrointestinal tract allows the selection of further diagnostic procedures and thus accelerates the diagnostic work-up. PMID- 3515413 TI - [Value of intra-arterial digital subtraction angiography]. AB - Among 3000 digital subtraction angiographies which have been performed in our institute, 850 patients have been examined intraarterially. The advantage of i.a. DSA is due to the excellent demonstration of vessels in survey angiograms by small amounts of contrast medium (10-20 ml in the aorta), without risk of selective catheterisation into the neck vessels, the saving of expensive film series, the short duration of vessel examinations and the small complication rate. I.a. DSA can be carried out on outpatients also, using the 4/5 F-catheter, which saves hospital charges. Impressive examples show the advantages of i.a. DSA. PMID- 3515414 TI - Hodgkin disease: practical concepts for the diagnostic radiologist. PMID- 3515415 TI - Intraperitoneal paravesical spaces: CT delineation with US correlation. AB - The urinary bladder, obliterated umbilical arteries, and inferior epigastric vessels located within the extraperitoneal space of the anterior abdominal wall indent the anterior parietal peritoneum, forming intraperitoneal paravesical fossae. These are the supravesical space and the medial and lateral inguinal fossae. More posteriorly, the peritoneum covering the bladder is reflected onto the rectum to form the rectovesical space, which is divided by the uterus into an anterior vesicouterine recess and a posterior rectouterine pouch, or cul-de-sac. The cul-de-sac is continuous with the pararectal and ovarian fossae and is bounded posterolaterally by the rectouterine (sacrogenital) folds. These peritoneal compartments form a large potential space for the accumulation of ascites and are separated from the equally large extraperitoneal paravesical spaces by only a thin layer of peritoneum or peritoneum and umbilicovesical fascia. The computed tomographic scans of 100 patients with ascites were reviewed, with particular attention to the differentiation between intraperitoneal and extraperitoneal paravesical collections. The scans of intraperitoneal collections were found to have certain characteristic appearances, including inferior displacement of the distended urinary bladder, visualization of the umbilical folds, and preservation of the preperitoneal fat. PMID- 3515416 TI - Abdominal lesions: a prospective study of clinical efficacy of percutaneous fine needle biopsy. AB - A prospective study was undertaken to assess the contribution of percutaneous fine-needle biopsy (PFNB) to the diagnostic workup and therapeutic management of 112 abdominal lesions in 106 patients (69 hepatic, 27 pancreatic, and 16 nondetermined). In 75% of the patients, PFNB contributed significantly to the diagnosis, in 22% it was of little help, and in 3% it confused the diagnosis. It confirmed a highly suspected diagnosis in 55% of patients and indicated a specific diagnosis that was not suspected in the remaining 45%. Results of PFNB guided treatment in 32% of cases, increased confidence in a previously planned therapy in 39%, and did not alter therapy in 29%. PFNB was instrumental in avoiding 61 planned invasive investigations and 11 surgical explorations, with a cost savings of about 35%. No significant complication was observed after PFNB. PMID- 3515418 TI - Mediastinal tumors: evaluation with suprasternal sonography. AB - Twelve patients with mediastinal masses evaluated by computed tomography (CT) and histologically verified were evaluated sonographically by means of the suprasternal approach. Eleven of 12 mediastinal tumors could be visualized sonographically, mainly as hypoechoic and perivascularly situated masses, and could be located topographically with a fair degree of certainty. Suprasternal sonography is particularly useful in the detection of small, perivascular lymphomas of the supraaortic branches. In patients with problematic CT findings, particularly children and patients with allergies to contrast media, suprasternal sonography can provide important additional information. Moreover, suprasternal sonography can be used to determine the consistency and to monitor the treatment of mediastinal tumors. Finally, the suprasternal approach is suitable for sonographically guided biopsies of mediastinal tumors. PMID- 3515417 TI - Liver transplant recipients: portable duplex US with correlative angiography. AB - Twenty patients, aged 4 months to 58 years, were evaluated for liver transplantation by duplex sonography, and 15 transplantations were completed; 42 postoperative examinations were performed. Sonographic findings were correlated with seven preoperative and five postoperative angiographic evaluations. Preoperative duplex US findings included tumors, portal vein occlusion, varices, biliary obstruction, and variant vascular anatomy. Postoperative findings included hepatic artery occlusion, portal vein occlusions (one with cavernous transformation), portal vein stenosis, biliary obstruction, intrahepatic and extrahepatic fluid collections, and air in the portal vein due to ischemic bowel. Use of angiography allowed confirmation of the vascular abnormalities and demonstrated evidence of rejection in patients with normal Doppler waveforms. Duplex sonography is a valuable portable technique for evaluating these patients and can be used in triage of patients requiring angiography. PMID- 3515420 TI - Renal allografts: evaluation by MR imaging. AB - The value of magnetic resonance (MR) imaging in assessing renal transplants was prospectively studied in 45 patients with 46 allografts. Four allografts were imaged at two different times, and separate diagnoses were given for both examinations. Therefore, this study was based on 50 proved diagnoses: nine normally functioning allografts, four allografts with acute tubular necrosis (ATN), 29 with acute rejection, one with chronic rejection, five with cyclosporin nephrotoxicity, and two with local inflammation secondary to adjacent abscess. Twenty-seven of the allografts had concomitant fluid collections. Normal renal structures with preservation of corticomedullary contrast (CMC) on T1-weighted images were demonstrated in all the normally functioning allografts. Decreased or absent CMC on T1-weighted images, reflecting a long T1 relaxation time for cortex, was found to be the most consistent sign of acute renal allograft rejection (27/29). No abnormalities on on MR images were observed in allografts compromised by cyclosporin nephrotoxicity. Hydronephrosis of the renal allograft was easily diagnosed with MR. Perirenal abscess (three cases) and perirenal hematomas (five cases), because of their higher MR signal intensity on T1 weighted images (TR = 0.5 sec, TE = 28 msec), could be differentiated from clinically insignificant postoperative fluid seromas (seven cases), lymphoceles (11 cases), and urinoma (one case). PMID- 3515419 TI - Peripheral vascular disease: prospective study of intraarterial digital subtraction angiography using a 9-inch intensifier. AB - A prospective randomized study was undertaken to evaluate the role of intraarterial digital subtraction angiography (IADSA) in the study of peripheral vascular disease. Patients underwent either conventional film-based angiography alone, digital subtraction angiography (DSA) alone, or a combined study. With a 9 inch image intensifier, DSA alone resulted in cost savings of film and contrast material but required a significantly longer examination period than the other groups and an increased iodine dose per examination. When the images were analyzed by a radiologist and a vascular surgeon, the DSA studies provided less detail in the aortoiliac region than the other techniques but had advantages in demonstrating the runoff vessels. IADSA examination should not replace conventional arteriography in patients with peripheral vascular disease but has a useful complementary role. PMID- 3515421 TI - Cyclosporin-A nephrotoxicity and acute cellular rejection in renal transplant recipients: correlation between radionuclide and histologic findings. AB - Serial radionuclide studies using both Tc-99m DTPA (perfusion) and I-131 hippuran (tubular function) were correlated with histologic findings in 25 patients with renal transplants. These cases included 15 cases of cyclosporin-A nephrotoxicity (CsA-NT) and ten cases of acute cellular rejection that were retrospectively selected on the basis of biopsy findings and favorable clinical response to therapy specific for each of these conditions. The serial radionuclide studies enabled the correct diagnosis in 12 of 15 cases of CsA-NT and eight of ten cases of acute rejection. Posttherapy radionuclide studies, furthermore, demonstrated improvement consistent with clinical response. In all cases, the radionuclide results were available at least 24 hours before biopsy findings. These results indicate that serial radionuclide studies evaluating interval changes in both perfusion and tubular function are of significant value in the diagnosis and follow-up of CsA-NT and acute cellular rejection in transplant recipients. This initial experience suggests a sensitivity of 80%. PMID- 3515422 TI - Percutaneous renal ablation in patients with end-stage renal disease: alternative to surgical nephrectomy. AB - Percutaneous transcatheter ablation was performed on 18 kidneys in ten patients with end-stage renal disease (ESRD), who were either on hemodialysis or had undergone renal transplantation, for the following indications: nephrotic syndrome with massive protein loss (seven patients, 13 kidneys), poorly controlled posttransplantation hypertension in the absence of transplant renal artery stenosis (two patients, three kidneys), and diabetic nephropathy with persistent urine leak from ureterocutaneous fistulas following pelvic irradiation (one patient, two kidneys). Desired clinical results were achieved in all cases. Percutaneous renal ablation is an effective alternative to surgery in patients with ESRD who require nephrectomy. PMID- 3515423 TI - Catheter-induced hyperreflexia in spinal cord injury patients: diagnosis by sonographic voiding cystourethrography. AB - In part 1 of this study, 77 consecutive patients with spinal cord injuries and reflex bladders were examined by combined urodynamic studies and sonographic voiding cystourethrography. Of the 15 (19%) who had hyperreflexic bladders (reflex bladders that contracted when containing 125 ml or less), eight (53%) had catheter-induced hyperreflexia (proved by sonographic voiding cystourethrography without catheterization). The significant overdiagnosis influenced patient care because catheter-induced hyperreflexia did not require treatment, whereas primary hyperreflexia caused by lesions above T-5 always required anticholinergic therapy to prevent potentially life-threatening autonomic dysreflexia. In part 2 of this study, 116 additional spinal cord injury patients with reflex bladders were studied, although in these patients the catheter was introduced under sonographic control. Seven (6%) of these patients had hyperreflexia, but in none was the hyperreflexia catheter induced, showing that use of sonography while introducing the catheter can prevent catheter-induced hyperreflexia. PMID- 3515424 TI - Brain gliomas: sonographic characterization. AB - To determine the ability of ultrasound (US) to help characterize brain lesions and determine the best site for biopsy, intraoperative sonographic examination of nine intracerebral gliomas was performed and correlated with the preoperative computed tomographic (CT), gross intraoperative, and histopathologic findings. Real-time US provided a precise and rapid method for intraoperative localization of intracerebral neoplasms in all cases. While the sonographic appearance of gliomas is nonspecific, US added information on tumor characterization to that provided by CT. All gliomas were sonographically echogenic compared with surrounding brain. US permitted good characterization of the cystic components of tumors; portions of the operation therefore involved surgical drainage rather than resection. Autopsy specimens from five anaplastic cerebral gliomas were examined with US and found to be echogenic. The central portions of all five tumors were echogenic and corresponded to areas of tumor necrosis; thus they were poor sites for biopsy. Alternatively, the best site for biopsy was the inner portion of the echogenic margin of the mass, which usually represented areas of active tumor growth. The information obtained from both preoperative CT and intraoperative US is beneficial in characterizing lesions and predicting the best site for biopsy. PMID- 3515425 TI - Epiphyseal ossification centers in the assessment of fetal maturity: sonographic correlation with the amniocentesis lung profile. AB - The epiphyseal ossification centers of the distal femur (DFE) and proximal tibia (PTE) appear and enlarge during the third trimester of pregnancy. Late in the third trimester, the epiphysis of the proximal humerus (PHE) begins to ossify in some fetuses. Using the amniocentesis lung profile to determine the value of sonographic epiphyseal visualization as a predictor of pulmonary maturity, we studied 50 fetuses prospectively and compared the sonographic epiphyseal findings with results from the amniocentesis lung profiles. Nine fetuses with a visible PHE had a mature amniocentesis lung profile (accuracy of positive prediction = 100%), and then fetuses with an immature amniocentesis lung profile had no visible PHE (conegativity = 100%). Fetuses in which the combined DFE and PTE diameters were greater than 11 mm or in which the DFE and the PTE diameters were similar in size (DFE less than or equal to 1 mm larger than PTE) also yielded positive results. Copositivity and accuracy of prediction of an immature amniocentesis lung profile, on the other hand, were low (22%-25%) for the same epiphyseal parameters. These data suggest that antenatal visualization and measurement of the epiphyseal ossification centers of the fetal knee and shoulder may help to identify fetuses that would have a mature amniocentesis lung profile. PMID- 3515426 TI - Absolute flow measurements using pulsed Doppler US. Work in progress. AB - Quantitative flow measurements were assessed in both laboratory and canine models using pulsed Doppler ultrasonography (US). A hydrodynamic model consisting of a Harvard pulsatile pump, a water bath, tubing, and a variable resistance reservoir was used to obtain absolute volumetric flow measurements. Parameters including angle of incidence, size of tubing, stroke volume, stroke rate, sample volume, and transducer frequency were changed independently. The effect of varying these parameters on the determination of absolute flow was analyzed. Absolute flow measurements using duplex US were performed in the canine aorta and femoral artery with reference to the electromagnetic flow probe. These data are presented, along with methods to reduce error in flow measurements that can be directly applied to quantitative estimates of blood flow in humans. PMID- 3515427 TI - Liquid gold: low-osmolality contrast media. AB - The use of low-osmolality versus high-osmolality contrast media is debated. The authors conclude that more studies need to be performed before the high cost of low-osmolality contrast media can justifiably be passed on to the patient population. PMID- 3515428 TI - Identification of the major endogenous leukotriene metabolite in the bile of rats as N-acetyl leukotriene E4. AB - Mercapturic acid formation, an established pathway in the detoxication of xenobiotics, is demonstrated for cysteinyl leukotrienes generated in rats in vivo after endotoxin treatment. The mercapturate N-acetyl-leukotriene E4 (N-acetyl LTE4) represented a major metabolite eliminated into bile after injection of [3H]LTC4 as shown by cochromatography with synthetic N-acetyl-LTE4 in four different HPLC solvent systems. The identity of endogenous N-acetyl-LTE4 elicited by endotoxin in vivo was additionally verified by enzymatic deacetylation followed by chemical N-acetylation. The deacetylation was catalyzed by penicillin amidase. Endogenous cysteinyl leukotrienes were quantified by radioimmunoassay after HPLC separation. A N-acetyl-LTE4 concentration of 80 nmol/l was determined in bile collected between 30 and 60 min after endotoxin injection. Under this condition, other cysteinyl leukotrienes detected in bile by radioimmunoassay amounted to less than 5% of N-acetyl-LTE4. The mercapturic acid pathway, leading from the glutathione conjugate LTC4 to N-acetyl-LTE4, thus plays an important role in the deactivation and elimination of these potent endogenous mediators. PMID- 3515429 TI - Ethanol stimulates formation of leukotriene C4 in rat gastric mucosa. AB - Ethanol-induced gastric mucosal damage is characterized by microcirculatory changes such as stasis and plasma leakage. Sluggish blood flow and stasis have also been observed after administration of exogenous leukotriene (LT) C4. The effect of ethanol on the release of LTC4 from rat gastric mucosa was therefore investigated. It was found that intragastric instillation of ethanol increases gastric mucosal release of LTC4 in a dose- and time-dependent manner parallel to the production of gastric lesions. The lipoxygenase inhibitor nordihydroguaiaretic acid (NDGA) and the anti-ulcer drug carbenoxolone (CX) inhibited mucosal release of LTC4 and simultaneously protected against gastric damage caused by ethanol. It is concluded that increased formation of LTC4 and/or other 5-lipoxygenase-derived products of arachidonate metabolism may be involved in ethanol-induced gastric damage. Furthermore, inhibition of the 5-lipoxygenase pathway may be an important mechanism of action of gastric protective drugs. PMID- 3515430 TI - Possible role of prostaglandin F in blastocyst implantation. AB - The synthesis and release of Prostaglandin F (PGF) by the rabbit blastocyst and endometrium were investigated on Day 6 and Day 7, using radioimmunoassay, autoradiography and conversion experiments. The following results were obtained: The content of PGF in the blastocyst increased significantly (P less than 0.01) from Day 6 to Day 7. The content of PGF in the endometrium was significantly higher (P less than 0.05) on Day 7 implantation sites compared to the other areas. The in vitro synthesis and release of PGF by Day 6 blastocysts sharply increased after one and two hours of culture, respectively. Thereafter both values declined with time. The in vitro synthesis and release of PGF by Day 6 endometria increased continuously with time. 14C-arachidonic acid (14C-AA) was incorporated into Day 6 blastocysts in vitro and converted to PGF2 alpha. These results suggest that both the endometrium and the blastocyst are the sources of the PGs involved in implantation, and that PGF derived from the blastocysts may act as the trigger of implantation. PMID- 3515432 TI - [Freud, Winnicott, Parmenides. Philosophical sources in psychoanalysis]. PMID- 3515431 TI - Ascorbic acid promotes prostanoid release in human lung parenchyma. AB - Ascorbic acid reduces airway reactivity to inhaled bronchoconstrictor agents in man and guinea pigs. The precise mechanism(s) responsible for this effect are unknown, but in both species an acute indomethacin treatment reverses the action of the ascorbic acid. To determine if ascorbic acid promotes prostanoid synthesis and/or inhibits degradation, human lung parenchymal slices (100-200 mg) were incubated for 60 minutes in oxygenated Tyrode's solution alone or with sodium ascorbate (0.001 M-1 M) and/or methacholine (1 microM-100 microM) and/or indomethacin (0.17 microM-17 microM). Aliquots of the incubation medium were assayed by radioimmunoassay for PGE2, PGF2 alpha, thromboxane B2 and 6-keto-PGF1 alpha. Ascorbic acid increased the accumulation of all four prostanoids in the incubation medium, especially thromboxane B2 and 6-keto-PGF1 alpha. This stimulatory effect of ascorbic acid was concentration-dependent and was inhibited by indomethacin. We conclude that ascorbic acid can alter prostanoid generation by human lung tissue and this effect may, in part, explain its antibronchoconstrictor activity in man. PMID- 3515433 TI - [Concepts of anthropologic medicine: Viktor von Weizsacker and Dieter Wyss]. PMID- 3515434 TI - [Death registry in the concentration camp hospital in Kolce]. PMID- 3515435 TI - [Executions by guillotine in the Breslau prison]. PMID- 3515436 TI - [Extermination in the Hadamar Center]. PMID- 3515437 TI - [Experience and emotions during concentration camp roll calls]. PMID- 3515438 TI - [Bio-psycho-social sequelae of long-term stress in persons active in the Home Army and People's Army]. PMID- 3515440 TI - [Physiological problems of every-day-life in the concentration camp]. PMID- 3515439 TI - [Actions of SS personnel in Auschwitz-Birkenau against social and emotional bonds]. PMID- 3515441 TI - [The women's camp at Auschwitz-Birkenau 1943-1945]. PMID- 3515442 TI - [Antipsychotherapy and antipedagogics--examples of totalitarian sociotechnics]. PMID- 3515443 TI - [Dr. Emil Vogl]. PMID- 3515444 TI - [Dr. Antoni Zygmunt Niepokoj]. PMID- 3515445 TI - [War, the Nazi occupation and medicine. International meeting in Cracow, 25-26 April 1985]. PMID- 3515446 TI - [Empirical studies of self concept in former prisoners of Nazi concentration camps]. PMID- 3515447 TI - [Commemoration of the 40th anniversary of the liberation of Auschwitz-Birkenau concentration camp at the Cracow Medical Society]. PMID- 3515448 TI - [From the correspondence on the Auschwitz issues of Przeglad Lekarski (VIII)]. PMID- 3515449 TI - [Medical topics on the Nazi occupation in 1985 Polish publications]. PMID- 3515450 TI - [Contents of preceding issues of "Przeglad Lekarski" (Medical Review) devoted to medical problems of the period of Nazi occupation]. PMID- 3515451 TI - [Attitudes and heroic actions in concentration camps]. PMID- 3515452 TI - [26th issue dedicated to the medical problems during the occupation under Hitler. Introduction]. PMID- 3515453 TI - [The Auschwitz dictionary (E, L, Z). A sample]. PMID- 3515454 TI - [Hospital for prisoners of war in the Jesuit Hospital in Cracow]. PMID- 3515455 TI - [The City Hospital in Kielce (1939-1945)]. PMID- 3515456 TI - [Prisoners of war from Lamsdorf in the Loben Psychiatric Hospital]. PMID- 3515457 TI - [Administrative problems in the Ujazdowski Hospital. Capt. Antoni Wolf]. PMID- 3515458 TI - [Clandestine Medical Department of the University of the Western Territories]. PMID- 3515459 TI - [Efforts in Rome concerning the release of professors imprisoned by the Nazis under the Cracow Special Action]. PMID- 3515460 TI - [Nazi public health policies in Upper Silesia]. PMID- 3515461 TI - Building a crown over a reduced transfer coping. PMID- 3515462 TI - [Sonographic structural and morphological features of the parathyroid glands in patients on dialysis. Observations concerning 75 patients]. AB - The results of US study concerning parathyroid glands performed in 75 uremic patients on regular haemodialysis, examined by echography, are reported. The purpose of this research is the identification of the glands and the analysis of their sonographic features. The results show that parathyroids mostly have round shape and regular outlines, usually hypoechoic structure. The authors stress the use of US as a useful tool for visualization and anatomical definition of parathyroids, providing important information for surgical planning. PMID- 3515463 TI - [Clinical, radiological and ultrasonic correlations in secondary hyperparathyroidism. Observations concerning 75 patients on dialysis]. AB - The results of a US study on parathyroid glands, performed in 75 hemodialysed patients are reported. The correlation between morphological features of the glands, biochemical and radiological pattern of secondary hyperparathyroidism is stressed. The results show a significant link between gland volume and hematic level of PTH: less interesting appears the correlation with radiological pattern of uremic osteodystrophy. PMID- 3515464 TI - [Catheter peridural anesthesia with bupivacaine-HCl and bupivacaine-CO2 during extracorporeal shock-wave lithotripsy]. AB - The effects of 0.5% bupivacaine-CO2 and bupivacaine-HCl were tested in a prospective randomised trial on 16 patients who underwent extracorporal shock wave lithotripsy (ESWL) with epidural analgesia. A shorter time of onset of analgesia (3.75 +/- 0.51 min) and a faster distribution of analgesia were noted with bupivacaine-CO2. Hypoalgesic regions were not registered with bupivacaine CO2 nor with bupivacaine-HCl under shock wave treatment. About thirty minutes after application of either substance a level 1 block according to Bromage was noted, which was not desirable during positioning of the patient on the hydraulic lithotriptor chair. However, toxic blood levels were not reached in either group of patients to any extent. PMID- 3515465 TI - A classification and assessment of composite retained bridges. PMID- 3515466 TI - [Orthotopic transplant of the liver in the pig: peroperative cardiovascular monitoring]. PMID- 3515467 TI - Interaction between laminin, fibronectin and the light chain of the H2 complex. Attachment of glomerular cells to basement membranes by linking the endoskeleton to the exoskeleton by a transmembrane protein. AB - At present the detailed mechanism for transmembrane interactions is not known and a protein linked to the endoskeleton as well as to the exoskeleton has not been described as yet. The H2 complex, a transmembrane protein, consists of heavy and light chains, the latter is named beta-2-microglobulin. In order to look for an association of beta-2-microglobulin with an exoskeleton protein, we examined the extracellular matrix proteins, collagen type I, type IV, fibronectin, amyloid P, the solubilized glomerular basement membrane and laminin in respect to their interaction with the light chain. The heavy chain is known to bind strongly to the endoskeleton protein actin. Only laminin and the glomerular basement membrane bound firmly to the beta-2-microglobulin; 3 M urea was necessary to dissociate the formed complex. Incubation with beta-2-microglobulin antibody prevented binding of beta-2-microglobulin to laminin and the glomerular basement membrane on affinity chromatography columns. Antiserum to the glomerular basement membrane in turn prevented binding of beta-2-microglobulin to the glomerular basement membrane, whereas antibodies against the basement membrane collagen type IV failed to inhibit this binding to the glomerular basement membrane. Beta-2 microglobulin also bound to fibronectin but this complex was dissociated with 1 M urea. In a rosette assay beta-2-microglobulin antibody and antiserum to the glomerular basement membrane reduced attachment of glomerular cells to beads coupled with laminin and solubilized glomerular cells to beads coupled with laminin and solubilized glomerular basement membrane.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3515468 TI - Treatment of lower respiratory tract infections with ceftriaxone and cefotaxime. A comparative study. AB - The microbiological and clinico-therapeutic efficacy and safety of ceftriaxone were compared with those of cefotaxime in an open randomized trial. Fifty-four adult hospitalized patients (37 males and 17 females) suffering from either acute bronchopneumonia (19) or acute exacerbations of chronic bronchopneumonia (35) have been investigated. Four patients were withdrawn from the trial. Underlying diseases were present in 41 patients. Ceftriaxone was administered at a once-a day dose of either 1 or 2 g (in 13 and 14 patients, respectively) and cefotaxime at a 2 g twice daily dosing regimen (27 patients), both antibiotics being given for 7-12 days. In the ceftriaxone group, 15 out of the 27 patients were cured (55%) and 9 had a favourable clinical response for a total satisfactory response rate of 88%. The causative pathogen was eliminated in 18 (66%) patients. The results obtained in the cefotaxime group did not differ significantly, but 2 patients were excluded from the study because of in vitro resistance of the causative pathogen isolated. Both drugs were well tolerated: no relevant laboratory changes were registered. The results indicate that ceftriaxone at a dosage of 2 or 1 g daily is at least as effective as cefotaxime given daily at a dosage of 4 g in the treatment of severe lower respiratory tract infections. PMID- 3515469 TI - [Recommended methods of measurement of lung volumes]. PMID- 3515470 TI - [Comparison of a new standard indocyanine green dye and an old one for cardiac output measurement by the dye dilution method]. PMID- 3515471 TI - Mechanisms of gas loss from normal and hyperinflated excised guinea pig lungs. AB - Increased pulmonary gas trapping was produced by in vivo inhalation exposures of guinea pigs to bronchoconstrictive aerosols. Both normal (filtered air-exposed) and hyperinflated excised lungs lost about 20% of their initial volume by 4 h; gas loss was more rapid during the first 60 min (early period) than the following 180 min (late period). During both periods, absolute rates of gas loss were positively correlated (P less than 0.001) with initial excised lung gas volumes (ELGVs). Tracheal foam movement was observed in most of the hyperinflated lungs, but only during the early period. Occlusion of the trachea reduced gas loss during the early period, but not the late. Gas volumes increased in lungs of animals exposed to SF6:O2 (tracheas tied), and decreased most rapidly in lungs of animals exposed to He:O2 (tracheas tied). Our results suggest that a major part of the early gas loss from excised guinea pig lungs occurs via the trachea and may be influenced by airway foam or menisci formation. After 60 min, airways may be closed and gas loss may occur via transpleural diffusion. PMID- 3515472 TI - Erythropoietin research, 80 years after the initial studies by Carnot and Deflandre. AB - The discovery and present state of knowledge of the specific hormonal mechanism controlling erythropoiesis are briefly reviewed. 80 years ago, Carnot and Deflandre postulated the existence of a humoral erythropoietic factor ('hemopoietine') produced in response to anemia. The general approval of this concept required almost 50 years, when the factor was recognized to be a glycoprotein hormone and termed 'erythropoietin'. Very recently, human erythropoietin has been purified and its amino acid sequence been identified. The hormone is mainly of renal origin. Its production is stimulated by tissue hypoxia of different causes. The mechanism of O2 sensing and the exact site of erythropoietin synthesis in the kidney still remain to be clarified. PMID- 3515473 TI - Airway responses to methacholine and histamine in basenji greyhounds and other purebred dogs. AB - To investigate whether airway hyperresponsiveness is a general characteristic of either the basenji or the greyhound ancestry of the basenji-greyhound (BG) dog and to determine whether airway hyperresponsiveness of the BG dogs in specific for methacholine, we compared pulmonary responsiveness to increasing doses of aerosols of histamine and methacholine in 17 BG dogs, 5 unrelated purebred basenjis and 5 unrelated greyhounds. BG dogs were hyperresponsive to both methacholine and histamine compared to basenjis and greyhounds. There was a significant correlation between histamine compared to basenjis and greyhounds. There was a significant correlation between histamine and methacholine responsiveness (r = 0.70, P less than 0.0001) in the dog population. We conclude that airway hyperresponsiveness characteristic of the BG dog is not a general characteristic of the basenji or greyhound breed and occurs to histamine as well as to methacholine. PMID- 3515474 TI - A new model for ordinal pain data from a pharmaceutical study. AB - For the pain data analysed previously by Cox and Chuang, this paper proposes a new model that assumes monotone scores for ordered response categories. This proposed model possesses several attractive features and allows a stochastic ordering of the drugs under comparison. Such a model also provides insight regarding the ordinal scale used to classify response. Estimation of the parameters in the model is obtained by use of BMDP3R. PMID- 3515475 TI - Assessment of stratum-covariate interactions in Cox's proportional hazards regression model. AB - We assess stratum (e.g. treatment) interactions with covariates and with the baseline hazard function in the proportional hazards (PH) regression model for lifetime data. We consider models incorporating stratum interactions both with and without stratification of the risk sets in the likelihood function, and describe likelihood ratio statistics for tests of the presence of these interactions. We also present step-down methods for building reduced models which include stratum-specific parameters corresponding to covariates which interact with treatment. We apply PH models with such interactions to a clinical trial of DES in the treatment of prostate cancer to determine optimal treatment conditional on each patient's covariates. PMID- 3515476 TI - Operative correction for female urethral incompetence. PMID- 3515477 TI - Surgery for pelvic prolapse. PMID- 3515478 TI - [Alarming dyspnea]. PMID- 3515479 TI - [Arterial catheterization: insertion sites and complications]. PMID- 3515480 TI - [Retinoids in dermatology]. PMID- 3515481 TI - [Amiodarone, a class 3 antiarrhythmic agent: current electrophysiological and therapeutic aspects]. PMID- 3515482 TI - [Microalbuminuria and early detection of diabetic nephropathy]. PMID- 3515483 TI - [Biological bases of drug dependence. I. Alcohol and opiates]. PMID- 3515484 TI - [Guillain-Barre polyradiculoneuritis: an ever current classical entity]. PMID- 3515485 TI - Achilles tendon lesions in sport. AB - Achilles tendon pain is a common cause of disability in sportsmen. The majority of cases are due to overuse injury often exacerbated or precipitated by specific and recognisable factors. A variety of pathologies is demonstrable in Achilles tendon pain which accounts for the considerable variation in the described natural history of the disease. The study of patients with Achilles tendon pain is almost impossible unless an accurate diagnosis is made first. The specific factors of the various conditions demonstrated as causes of Achilles tendon pain are set out and the value of different laboratory and other investigations indicated in the particular pathological conditions. Conservative management of Achilles tendon pain may be unrewarding except in acute crepitating peritendinitis. Various forms of conservative treatment are discussed and the literature reviewed. The role of surgery in management of chronic resistent Achilles tendon pain is discussed in detail with particular reference to the indications and the surgical procedures available. The postoperative management of patients following Achilles tendon surgery is discussed and the outcome indicated. PMID- 3515487 TI - [Balloon tamponade in acute hemorrhage following endoscopic papillotomy]. PMID- 3515488 TI - [Drug therapy of cholelithiasis]. PMID- 3515489 TI - [Present status of and indications for digital subtraction angiography]. PMID- 3515490 TI - [Georg Haas (1886-1971), pioneer in hemodialysis]. PMID- 3515491 TI - [Sophrology]. PMID- 3515486 TI - Exercise and obesity. AB - Obesity, prevalent in industrialised societies, is most usefully categorised by means of the body mass index (BMI-weight/height2). A body mass index of greater than 25 is associated with increasingly poor prognosis. Weight reduction has been shown to be beneficial with respect to both mortality and morbidity. Excess weight results from an imbalance between energy input and expenditure in favour of the former. Weight reduction may be promoted by reducing energy input and/or stimulating expenditure. It is tempting to postulate that inactivity may be a factor in both the development and subsequent continuation of obesity via an effect on energy intake, fat-free mass or energy expenditure. Although available data are by no means conclusive, the majority of evidence suggests that obesity is not associated with either reduced activity or energy expenditure. Likewise, exercise appears not to promote a change in body composition in favour of lean body mass or have a prolonged thermogenic effect beyond the duration of the activity. Exercise alone appears largely ineffective regarding weight loss and almost certainly has to be coupled with calorie reduction. It must be remembered that the exercise tolerance in the severely obese (BMI greater than 40) is very poor. Such individuals must be closely supervised during a specifically graded programme. What is also apparent is the high drop-out rate of individuals recruited into exercise programmes. In those who voluntarily engage in physical activity, the incidence of ischaemic heart disease may be reduced, which may or may not be related to a direct exercise effect on known cardiovascular risk factors. Cigarette smoking is usually less common and general life-style may be more prudent. Whether exercise in obese subjects could have a similar effect remains unknown. Although much of the data on exercise in general and on obesity in particular are negative, it appears unwise to adopt a totally nihilistic approach. Increased physical activity should be encouraged as it is possible that the discipline involved in regularly undertaking such activity may be more conducive to weight loss, a feeling of well-being and fitness and a general change of life-style for the better. Long term it may also afford additional benefit by reducing liability to ischaemic heart disease. PMID- 3515492 TI - [Homage to Dr. Francine Tanner]. PMID- 3515493 TI - [Dr. Francine Tanner and public health]. PMID- 3515494 TI - [Madame Tanner and hospital hygiene in Switzerland]. PMID- 3515495 TI - [Bacteriologist and sociologist: complementarity and dialectics in the work of Dr. Francine Tanner]. PMID- 3515496 TI - [Results of the first 6 months' experience in the monitoring of the sterility of injectable solutions]. PMID- 3515497 TI - [100 years ago. The Review Medicale de la Suisse romande in 1885]. PMID- 3515498 TI - [What does one mean by alternative medicine?]. PMID- 3515499 TI - An annotated bibliography of toxic shock syndrome. PMID- 3515501 TI - [Epistaxis, or bleeding from the nose]. PMID- 3515500 TI - [Diagnostic value of the determination of serum beta human chorionic gonadotropin in extra-uterine pregnancy]. AB - The methods of immunological diagnosis of pregnancy are described, and their reliability is evaluated according to the results of 35 case files of extrauterine pregnancy clinics. In all these case the beta-hCG results were negative, and there was no extrauterine pregnancy. The analysis of positive cases allows it to be stated that on each occasion in which the reaction is positive there is a pregnancy, but the location of this pregnancy is uncertain, and recourse to a complementary technique is justified. PMID- 3515502 TI - [French hospitals in the XIXth century]. PMID- 3515503 TI - Cosmetic laminate dentistry--for better or for worse? Part II: The composite laminates. PMID- 3515504 TI - Cast framework design for fixed prosthodontics supported by Biotes osseointegrated implants. PMID- 3515505 TI - Helping your patient when nausea goes with the treatment. PMID- 3515506 TI - A sense of renewed pride. PMID- 3515507 TI - Immunohistochemical demonstration of myoglobin (Mb) in pathological thyroid tissue. Correlation with thyroglobulin (Tg), thyroxine (T4) and triiodothyronine (T3) distribution. AB - Myoglobin (Mb) was investigated by the immunoperoxidase method (PAP) in 48 cases of thyroid diseases including euthyroid goiter, Graves' disease, folliculo papillary carcinoma, follicular carcinoma, anaplastic carcinoma and medullary carcinoma. Mb was demonstrated in most of the pathological thyroid tissues. In benign lesions, Mb is diffusely disposed throughout the cytoplasm in moderate quantities and only occasionally predominates at the apical border of thyreocytes. Generally, in differentiated carcinomas, the intensity of Mb immunostaining is moderate or weak. In some cases a predominance of Mb at the apical border of the malignant thyreocytes was noticed. In anaplastic and medullary carcinoma no Mb was detected. We compared the pattern of Mb distribution with that of thyroglobulin (Tg), triiodothyronine (T3), and thyroxine (T4) on serial or semiserial sections. The localization of Mb agreed relatively well with that of thyroid hormones. The distribution of Tg, especially in carcinomas did not correspond with that of Mb. Our results could suggest the implication of Mb as a source of oxygen in the thyroid peroxidase system rather than in exocytotic-endocytotic processes. PMID- 3515508 TI - The antimicrobial activities of trimethoprim and sulfonamides. AB - The folate inhibitor trimethoprim (TMP) is active against and potentially cidal to a few higher microorganisms and a wide spectrum of pathogenic bacteria except for Bacteroides, Branhamella, Brucella, Chlamydia, Clostridium, Mycobacterium, Mycoplasma, Nocardia, Neisseria, Pseudomonas and Treponema. These organisms tend to be more sensitive to sulfonamides (SUL) than to TMP, whereas TMP is 10- to 100 fold more active than SUL against most other bacteria. Synergy between TMP and SUL occurs at drug concentrations equal to or less than their respective MICs and is often seen in vitro with isolates that are sensitive or moderately resistant to one or both of the components. Synergy occurs over a wide range of ratios between TMP and SUL, the optimal being that between their respective MICs when acting singly. In vitro synergy is more impaired by bacterial resistance than by suboptimal TMP:SUL ratios. The vast majority of clinical isolates of Haemophilus, staphylococci, streptococci and enteric bacteria are inhibited in vitro by the minimum concentrations of drug attained in plasma during therapy. Exceptions are found among Enterobacter, Citrobacter, Serratia, Proteus and in particular Klebsiella where SUL resistance is common and isolates with TMP MICs of 5 mg/l or more may occur and lead to failure of TMP-SUL therapy in systemic infections. In the urinary tract drug concentrations that are synergistic and therefore inhibitory in vitro against isolates moderately resistant to SUL (MIC less than or equal to 1 g/l) and/or TMP (MIC less than or equal to 0.1 g/l) are present during TMP-SUL therapy. However, whether the synergy and the bactericidal effect of TMP-SUL observed in vitro play a role in vivo is controversial. PMID- 3515510 TI - Congenital malaria in Scandinavia. AB - A case of Plasmodium vivax malaria in a 3-week-old infant, born in Norway of a Pakistanian mother, is reported. The child was admitted with a febrile illness of unknown origin, persistent vomiting, reduced body weight, thrombocytopenia, elevated total level of IgM, and a slightly positive specific IgG antibody titer. The mother had malaria during the puerperium, and febrile episodes 6-8 weeks before parturition. This is the first case of congenital malaria reported from Scandinavia. PMID- 3515511 TI - Lymphocyte immunoglobulin secretion during short-term treatment with cephalosporins in vivo and in vitro: effects on plaque-forming cell response of human peripheral blood lymphocytes. AB - The influence of 4 cephalosporins on the plaque-forming cell (PFC) generation in mitogen-activated cultures of human lymphocytes (PBL) was assessed. In vitro, suprapharmacological concentrations of the drug resulted in a decreased PFC response, while pharmacological concentrations did not influence the generation of PFC. Cells exposed to drugs for 24 h in vivo and propagated in autologous serum in vitro showed a decreased PFC response. PMID- 3515512 TI - A comparison between a commercial coagglutination test and conventional throat culture for the detection of group A streptococci in throat swabs. AB - A co-agglutination test (Phadirect Strep A) for rapid detection of group A streptococci in throat swabs was compared with conventional throat culture in 264 patients with pharyngotonsillitis and fever. The test was easy to perform and proved to have a satisfactory sensitivity and specificity. The predictive value of a positive test will be high also when the prevalence of streptococcal disease is low. PMID- 3515509 TI - Effective treatment of diarrhoeal dehydration with an oral rehydration solution containing citrate. AB - To compare the clinical efficacy of oral rehydration salts (ORS) from effervescent tablets containing citrate with the WHO recommended ORS for the treatment of dehydration due to acute diarrhoea, a randomized clinical trial was carried out in 57 adults and 58 children. These patients had mild or moderate degrees of dehydration and acidosis due to acute watery diarrhoea that was caused by enterotoxigenic Escherichia coli in 43-47% of the cases. Efficacies were compared by measuring oral fluid intake, stool output, gain in body weight, decrease in serum specific gravity and correction of acidosis during treatment. Successful rehydration and maintenance of hydration was achieved in 25 adults and 24 children treated with citrate containing ORS and 25 adults and 24 children treated with WHO ORS. The mean intake of ORS/kg body weight in children receiving WHO ORS was greater (p less than 0.05) and correction of acidosis was faster than the citrate group during the initial 24 h of therapy (p less than 0.05). By 48 h, however, both groups showed satisfactory and comparable intake of ORS and correction of acidosis. Thus ORS from effervescent tablets containing sodium citrate base is effective for management of diarrhoea in both adults and children and is a convenient stable form of ORS for use in the home and for travelers. PMID- 3515513 TI - Results of induction and consolidation treatment with intermediate and high-dose ara-C and m-AMSA containing regimens in patients with primarily failed or relapsed acute leukemia and non-Hodgkin's lymphoma. PMID- 3515514 TI - Prognostic factors in the myelodysplastic syndromes: a review. PMID- 3515515 TI - The myelodysplastic syndromes. Part I. What are they? Part II. Classification. PMID- 3515516 TI - Treatment of patients with myelodysplastic syndromes: a review. PMID- 3515517 TI - Preleukaemic states in children. PMID- 3515518 TI - Ferrokinetic abnormalities and red cell life span in myelodysplastic syndromes: a review. PMID- 3515519 TI - Sideroblasts in myelodysplasia: their nature and clinical significance. PMID- 3515520 TI - Red cell enzymes in myelodysplastic syndromes: a review. PMID- 3515521 TI - Heme synthesis in sideroblastic anaemias. PMID- 3515522 TI - Granulocyte function in myelodysplastic syndromes. PMID- 3515523 TI - Platelet function in the myelodysplastic syndromes. PMID- 3515524 TI - Cytogenetics of the myelodysplastic syndromes. PMID- 3515525 TI - Chromosome abnormalities in secondary myelodysplastic syndromes. PMID- 3515526 TI - Duration of morning stiffness in rheumatic patients after medication with enteric coated and plain naproxen tablets. AB - Twenty-nine adult rheumatic patients who were taking 500 mg naproxen at bedtime and had a certain degree of morning stiffness despite this medication took part in a randomized double-blind cross-over study in which the duration of morning stiffness after evening doses of 500 mg enteric-coated naproxen tablets was compared with that after identical doses of plain naproxen tablets. The duration of morning stiffness was significantly shorter after taking enteric-coated tablets (p less than 0.01), and the mean plasma naproxen morning concentration was 34% higher (p = 0.01). Since the results were unambiguous in such a small group of patients, they are judged to be of considerable clinical value. PMID- 3515527 TI - A double-blind placebo-controlled evaluation of fenflumizole in rheumatoid arthritis. AB - Twenty-eight patients with active classical or definite rheumatoid arthritis were randomly allocated to treatment with fenflumizole 200 mg or 100 mg or placebo daily in a 2-week double-blind placebo-controlled study. Three patients dropped out and 25 patients completed the study. Ten patients received fenflumizole 100 mg daily, 7 patients received fenflumizole 200 mg daily and 8 patients received placebo. Clinical and laboratory assessments before and during the study revealed that in patients treated with fenflumizole, grip strength, morning stiffness and walking time improved significantly. No improvement could be seen in the placebo group. No side effects attributable to fenflumizole were observed during the study. PMID- 3515528 TI - [Radioimmunologic detection of IgE and IgG antibodies against drugs. Conclusions after experience with over 1200 patients]. AB - Based on the radioallergosorbent test (RAST), the authors have developed a series of assays to detect IgE and IgG antibodies against a number of frequently used drugs. In this system drugs bound covalently to cellulose paper are incubated with serum and washed; the hapten-specific IgE and IgG antibodies are then qualified and quantified by means of 125I-labelled anti-human IgE and IgG respectively. Thus far the sera of 1,228 patients have been analyzed following therapy with betalactam antibiotics, co-trimoxazole, salicylates, pyrazolones, flavonoids and tetrahydroisoquinoline. The induction of IgG antibodies is a frequent occurrence and that of IgE rare. Isolated high titers of IgE are associated mainly with anaphylactic reactions; in the presence of simultaneously raised IgG titers such side reactions are often absent. Highest IgG titers were found in patients with immune hemolysis after betalactam antibiotics, flavonoids and tetrahydroisoquinoline. In the other types of side reaction specific IgG titers were not significantly higher than in patients without side reactions. The estimation of circulating antibodies against drugs cannot yet be utilized diagnostically except in the rare cases of anaphylactic side reactions. However, the method described permits specific and sensitive detection of sensitization and is suited for scientific purposes. PMID- 3515529 TI - [Herniated cervical disk, with or without arthrosis--surgical management by simple discectomy or associated with spondylodesis?]. AB - 58 patients underwent surgery by an anterior approach for nerve root or spinal cord compression at one or more levels. The cause was a soft disc herniation, an osteophyte or the two combined. 44 underwent simple discectomy with 70.5% good or very good results. 14 also had interbody fusion by the method of Smith and Robinson, with good and very good results in 57.1%. In most cases the latter group had major cervical spondylosis and myelopathy. The bad results were due to severe neurologic lesions (myelopathy), duration of symptoms and associated illness. The anterior approach with use of the microscope provides good vision and involves few complications. Neither recurrence nor secondary posture disorders were observed. PMID- 3515530 TI - [Tolerability and pharmacokinetics of an intravenous immunoglobulin preparation in immunologically normal subjects and tolerability in patients with hypogammaglobulinemia resulting from chronic lymphatic leukemia]. AB - Tolerance, clinical effects and kinetics of an unmodified immunoglobulin preparation for intravenous use were investigated in 4 patients with advanced chronic lymphocytic leukemia. Previously, good tolerance of the preparation had been found in 49 immunologically normal patients. The four patients with secondary humoral immunodeficiency received doses of 140-360 mg IgG/kg per infusion as outpatients at monthly intervals. With one exception, no acute infections (pneumonitis), as commonly seen before, were observed during the observation time of 24 to 68 weeks, and the pre-existing chronic infections (bronchitis, sinusitis etc.) remained compensated without antibiotics. In all four patients tolerance of the preparation was good. In all cases of hypogammaglobulinemia a dose-dependent increase in the serum IgG concentration was observed immediately after the infusion. However, persistence of the serum IgG increase showed considerable interindividual differences. The half life of the tetanus and HBs antibodies (21.7 to 34.4 and 19.7 to 25.7 days respectively) found in 4 healthy volunteers is within the biological range. This indicates an unmodified structure of the antibodies of the IgG class contained in the preparation used. PMID- 3515531 TI - [SSO (Societe Suisse d'Odonto-stomatologie) 1886-1986]. PMID- 3515532 TI - [Development of dental medicine in Switzerland--reflections perceived through the periodical literature edited by the Societe Suisse d'Odonto-stomatologie from 1891 to 1960]. PMID- 3515533 TI - [The sections of the Societe Suisse d'Odonto-stomatologie--their creation and their development]. PMID- 3515534 TI - [Evolution in Switzerland of scientific knowledge in dental medicine from 1886 to 1986]. PMID- 3515535 TI - [The influence of the Societe Suissse d'Odonto-stomatologie on practice management demonstrated by the history of ergonomics in Switzerland]. PMID- 3515536 TI - [Membership development of the Societe Suisse d'Odonto-stomatologie]. PMID- 3515537 TI - [Wirtschaftliches Bulletin (1923-1952), Bulletin fur Standesfragen (1953-1986)- reflections on the history of the Societe Suisse d'Odonto-stomatologie]. PMID- 3515538 TI - [Table of the chronology of the Societe Suisse d'Odonto-stomatologie]. PMID- 3515539 TI - [Epidemiology of oral diseases in Switzerland--a look back and a look ahead]. PMID- 3515540 TI - [Legislation and dentistry in Switzerland from 1886 to 1986]. PMID- 3515541 TI - [The social medicine commitment of Swiss dentists exemplified by dental care for schoolchildren and adolescents]. PMID- 3515542 TI - [The Societe Suisse d'Odonto-stomatologie: taking stock of a century and a look into the future]. PMID- 3515543 TI - [Sonographic determination of the normal kidney volume in newborn infants and infants]. AB - The kidneys of 211 infants (106 males, 105 females) were measured sonographically. Renal length, width and depth and the calculated kidney volume were correlated to body weight, body length and body surface. It was possible to establish a nomogram, which presented a good correlation between body weight and kidney volume and which can easily be used for routine ultrasound examination. In another prospective study the kidney volumes of 82 young infants were within the normal range of this nomogram. PMID- 3515544 TI - [The significance of nephrosonography for the early recognition of kidney tumors]. AB - In the following presentation the criteria of solid kidney tumours and their differential diagnosis are demonstrated. 175 patients operated upon since 1976 demonstrate the significance of ultrasonography for early detection of kidney tumours. The results show that early detection of kidney tumours is possible by nephrosonography; an early and simple operation can be performed and improves prognosis dramatically. PMID- 3515545 TI - [Contrast sonography of the urinary tract in children]. AB - In 14 healthy children contrast sonography of the bladder was performed with various solutions prior to voiding cystourethrography. The solutions were introduced into the bladder via a bladder catheter. The contrast effects which occurred with iothalamate injections in the urine-filled bladder, with urine injections in the iothalamate-filled bladder, with injections of 0.9% saline solution, and with air injections into the iothalamate-filled bladder were sonographically demonstrated. In echogenicity and duration the intravesical air contrast was superior to all mixture contrasts in the bladder resulting from injections of the respective fluids. PMID- 3515546 TI - [Sonographic imaging of the kidney cavity system using a ultrasonic contrast medium]. AB - The echo contrast solution SH U 454 was injected through an ureteral stent into the upper urinary tract ex vivo in human cadaver kidneys and in vivo in kidneys of pigs. Small amounts of this solution gave excellent echogenic contrast to demonstrate the renal pelvis and calices ultrasonographically in percutaneous examination and ex vivo sonography. This sonographic contrast agent promises to be useful for non-roentgenologic voiding cystograms and antegrade or retrograde pyelography. PMID- 3515547 TI - [Experimental studies in transurethral, intravesicular ultrasonographic research]. AB - The investigations were performed via a 7.5 MHz transurethral rotating ultrasonic probe. The axial and lateral resolution was determined. The experiments for the determination of the thickness of the bladder wall and for the discrimination between the different types of tissue were carried out by means of pig's bladders and biological specimen. A certain and reproducible discrimination of the different tissue layers and an exact determination of the thickness of the bladder wall were not possible due to the missing single echoes of the boundary interfaces and to the dependence of ultrasonic image structures on the selected amplification. Additionally, the speckled structures of the ultrasonic images have a magnitude of millimetres and render the discrimination very difficult between tumour tissue and bladder wall tissue. We would require signal processing by computer to obtain an exact resolution of the signal information. PMID- 3515548 TI - [Sonographically demonstrable changes following percutaneous kidney biopsy]. AB - For diagnosis and therapeutic strategies exact histological diagnosis of certain renal diseases is of great importance. Biopsy, therefore, is an integrated component of patient management. Haemorrhage is the most common complication following percutaneous renal biopsy. Gross haematuria can easily be detected, whereas perirenal bleeding is harder to detect. A high incidence of perirenal haematomas after biopsy can be evaluated with the help of sonography. In a survey of 207 percutaneous renal biopsies performed in 168 patients, we found 64 perirenal haematomas (30.9%). 2 haematomas (0.96%) required surgical intervention. In 4 patients (1.9%) transitory gross haematuria with obstruction of the bladder by blood clots occurred. These were removed by cystoscopy. PMID- 3515549 TI - [Chorionic epithelioma of the testis in the ultrasonic image]. AB - We present the case of a 24-year old man in whose testis echographic criteria of a teratocarcinoma were evident. Histologically the tumour was identified as a chorionic epithelioma. PMID- 3515550 TI - Preoperative localisation of parathyroid adenomas. PMID- 3515552 TI - Leg ulcer infection with an erythromycin-resistant Streptococcus pyogenes. PMID- 3515551 TI - Dermatomyositis-polymyositis in children. AB - Sixteen cases of dermatomyositis-polymyositis in children (dermatomyositis 15; polymyositis 1) have been reviewed. Proximal muscle weakness with a characteristic skin rash was vital for diagnosis in the majority of children. The positive laboratory tests such as creatine phosphokinase (CPK), electromyography (EMG) and muscle biopsy were helpful but results were normal in some cases even in the acute phase of the illness. All but one had been treated initially with high dose corticosteroids followed by a low dose maintenance for a prolonged period. Two in addition had had cytotoxic agents. Thirteen of the sixteen were currently in remission. In the other three cases, one with polymyositis only, the disease remained active and the two with dermatomyositis died. Only three of the patients were incapacitated by residual fixed contractures and extruding calcinosis. On the whole the prognosis of dermatomyositis is good. PMID- 3515553 TI - St Kilda: emigrants and disease. AB - During the nineteenth century the inhabitants of the remote island of St Kilda persisted in their belief that they were susceptible to disease if exposed to infection brought by visitors; these ideas were the source of much ridicule. The emigration of thirty-six islanders to Australia in 1852 resulted in excessive mortality during the voyage compared with other Highland emigrants, and the 1930 evacuation to the mainland of Scotland also revealed their susceptibility to tuberculosis. PMID- 3515554 TI - The Clydesdale experiments: an early attempt at resuscitation. PMID- 3515555 TI - The Royal Samaritan Hospital for Women, 1886-1986. PMID- 3515556 TI - "Computer genome" is full of junk DNA. PMID- 3515557 TI - Effectiveness of anticoagulants. PMID- 3515558 TI - Hemorrhagic complications of anticoagulant therapy. PMID- 3515559 TI - Adult onset polymyositis/dermatomyositis: an analysis of clinical and laboratory features and survival in 76 patients with a review of the literature. PMID- 3515560 TI - Seronegative spondyloarthropathies and IgA glomerulonephritis: a report of four cases and a review of the literature. PMID- 3515561 TI - The neuropsychiatric manifestations of systemic lupus erythematosus: an overview. PMID- 3515563 TI - Clofibrate myopathy: a case report and a review of the literature. PMID- 3515562 TI - The musculoskeletal manifestations of cystic fibrosis. AB - Twenty-seven patients with CF and joint complaints were reviewed. Twelve patients had arthritis, 11 had HPO, and four had symptoms of mechanical neck and back pain. We have confirmed the association of CF with an episodic form of arthritis. For the first time, we have reported that a subgroup of these patients later develop persistent synovitis with progressive asymmetric, erosive disease. The etiology of CF arthritis is unclear, but may relate to chronic infection and immune complex mechanisms. CF arthritis can be contrasted with CF induced HPO, which is associated with worse lung disease, a male predominance, and an older mean age of onset of symptoms. Mechanical neck and back pain may relate to an associated scoliosis or kyphosis in CF. PMID- 3515564 TI - [Primary allo-arthroplasty in acetabulum fractures]. PMID- 3515565 TI - [Diagnosis and therapy of malignant soft tissue tumors]. PMID- 3515566 TI - Health effects of low level radiation: carcinogenesis, teratogenesis, and mutagenesis. AB - The carcinogenic effects of radiation have been demonstrated at high dose levels. At low dose levels, such as those encountered in medical diagnosis, the magnitude of the effect is more difficult to quantify. Three reasons for this difficulty are (1) the effects in human populations are small compared with the natural incidence of cancer in the populations; (2) it is difficult to transfer results obtained in animal studies to the human experience; and (3) the effects of latency period and plateau increase the complexity of population studies. In spite of these difficulties, epidemiologic studies of human populations exposed to low levels of radiation still play a valuable role in the determination of radiation carcinogenecity. They serve to provide upper estimates of risk and to rule out the appearance of new effects that may be masked by the effects of high doses. While there is evidence for mutagenic effects of radiation in experimental animals, no conclusive human data exist at the present. It is not possible to rule out the presence of genetic effects of radiation in humans, however, because many problems exist with regard to the epidemiologic detection of small effects when the natural incidence is relatively large. In animals, subtle effects (eg, a decrease in the probability of survival from egg to adult) may occur with greater frequency than more dramatic disorders in irradiated populations. However, these types of genetic abnormalities are difficult to quantitate. Current risk estimates are based primarily upon data pertaining to dominant mutations in rodents. Some specific locus studies also permit identification of recessive mutation rates. The embryo and fetus are considered to be at greater risk for adverse effects of radiation than is the adult. This sensitivity was predicted in 1906 by the law of Bergonie and Tribondeau and has been demonstrated in human and animal populations. At high dose levels (above 15 rem), the effects of radiation depend upon the gestational stage at which irradiation occurs. Prior to the second week, the predominant effect is preimplantation death, while during the period of major organogenesis (second to sixth week), growth retardation and CNS abnormalities may be produced. These effects have not been demonstrated with a high degree of statistical significance at low dose levels (below 15 rem) and are not considered to present a serious hazard for patients undergoing radiologic exams. PMID- 3515567 TI - Nuclear medicine and the environment: radiation interactions. AB - The effect of radiation interactions on the environment may be considered from the perspective of the purely physical phenomena occurring or from the effects the interactions produce in organized biological systems. The physical processes by which radiation interacts with the environment are quite well defined. Although these processes differ depending upon the nature (either electromagnetic or particulate) of the primary radiation, the ultimate result is the production in the medium of high-speed, secondary charged particles. Some of the energy of these particles is absorbed by the medium, while a portion may be lost as bremsstrahlung. The energy that is absorbed produces excitation and ionization, which can be disruptive to biological systems. The effects produced by ionizing radiations at the biochemical, cellular, and organ level are less well defined. Nevertheless, available data indicate that certain generalizations are possible. For example, given the ubiquitous nature of water in tissues, macromolecules, regardless of their structural types, tend to serve as acceptors of the energy and products of water radiolysis. However, a deeper insight into the consequences of irradiation requires an understanding of the interplay of such parameters as the type and energy of the radiation, and the dose and rate of its application. Furthermore, at the cellular level, the type and age of the irradiated cells, the concentration of oxygen in their environment, and their cell-cycle phase are all important factors in determining the consequences of irradiation. PMID- 3515568 TI - Computed tomography and ultrasonography of the hemophilic pseudotumor and their use in surgical planning. AB - Twenty-one hemophilic pseudotumors in 17 patients were evaluated radiologically to facilitate surgical planning. Plain radiography, angiography, intravenous urography, computerized tomography (CT), and ultrasonography (U/S) were the modalities used. CT proved to be the most efficient method in the detection of bone destruction and soft tissue lesions including additional daughter cysts. The combination of CT, intravenous urography, and angiography were used in pelvic pseudotumors, and that of CT and angiography for extremity pseudotumors, to determine the proper surgical approaches to the lesions. As a non-ionizing technique, U/S was usually preferable in visualizing soft tissue masses and, in sequential studies, to evaluate progress or recurrence of the lesion. PMID- 3515569 TI - Psychiatric cases in community studies: how important an issue? AB - Over the last 15 years the use of standardized clinical-type psychiatric interviews has been extended to the general population and we have a much better understanding of the extent of affective disorder and factors of aetiological importance. The surveys have revealed a worrying amount of affective disorder, of much the same order of severity as those treated in out-patient clinics, particularly among working-class women in inner-city areas. Relatively few are seen at any point by psychiatric services although half the conditions at any one point in time are chronic. Despite the increasing interest in this work relatively few studies have yet been published. The scientific status of the instruments and the generalizability of the current findings and some of their implications are discussed. PMID- 3515570 TI - Sociological concepts in the etiology of chronic disease: the case of ischemic heart disease. AB - This paper first gives a selective and critical review of conventional sociological variables included into epidemiologic and clinical studies of ischemic heart disease (IHD). In a second section, links between social and biological processes are discussed, and a conceptual sociological approach is developed which relates critical experiences of active distress to impaired long term control of social status. This approach is elaborated to some extent in order to illustrate possible avenues of future research which strengthen cross fertilization between medical and social sciences. PMID- 3515571 TI - Health indicators. AB - This paper examines the more general background to health indicators. It deals with the relation between health and social indicators, before examining the health concept. It discusses possible purposes for which health indicators should be developed, and gives some of the important data sources for this exercise. The paper contains some less traditional examples of health indicators as mainly applied in The Netherlands. Finally, it draws conclusions on the possibilities of developing health indicators. PMID- 3515572 TI - Concepts in alternative medicine. AB - After discussing some important alternative approaches, different interpretations are presented of the concepts of health, disease, diagnosis, therapy and patient. These differences are elucidated in three main frames of medical thinking: the pharmaceutical, the integrational and the holistic model. Attention is given to the problem of scientific proof, especially in relation to the effectiveness of alternative therapies. In a concluding paragraph it is attempted to analyse the (social) backgrounds of the controversy between regular and alternative medicine. PMID- 3515573 TI - Lay care in illness. AB - This paper discusses lay care in illness with special reference to research and development in Northern Europe. The discussion concentrates on two components of lay care: individual self-care in illness and self-help groups. Individual self care in illness is shaped in social environments, and in turn is a major determinant of the type and amount of health care services used. Self-help groups of all kinds have increased in recent years. Groups 'next' to the system and groups opposed to the system increased rapidly during the seventies. A form of self-help group that interfaces more directly with services is now being encouraged by physicians. Major issues concerned with these developments are considered. PMID- 3515574 TI - Revolving drug funds: conducting business in the public sector. AB - Pharmaceuticals are essential for preventive and therapeutic health services. Unfortunately, significant demand, limited funds and high prices contribute to frequent shortages of drugs in many public health programs. One method for financing pharmaceutical supplies has been the establishment of revolving drug funds (RDFs) in which, after an initial capital investment, drug supplies are replenished with monies collected from the sale of drugs. All too often however, the funds actually recovered are insufficient to replenish supplies and the fund is soon depleted. In this paper we consider the potential benefits and common pitfalls of revolving drug funds and then focus on the central role of financial planning in establishing drug sales programs. Experiences from a variety of countries suggest several causes for the failure of some RDFs, including: under estimation of capitalization costs, prices set below true replacement cost, frequent failure to collect payment, delays in cash flow which make funds unavailable for replenishment of drug stocks, rapid program expansion for which additional capital funds are not available, losses due to theft and deterioration of drugs, unanticipated price increases due to inflation or changes in parity rates and foreign exchange purchase restrictions. Common to many of these problems is the lack of a businesslike orientation to RDFs and, in particular, lack of careful financial planning and management. Financial planning for an RDF includes four analytical tasks: assessment of the potential market, estimation of the costs of an RDF, establishment of the cost-recovery objectives, definition of the role of subsidies and surcharges.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3515575 TI - [M. I. Kalinin on the problems of public health]. PMID- 3515576 TI - [Medical personnel of the evacuation hospitals of the People's Commissariat of Public Health of the USSR and the organization of their advanced training during World War II]. PMID- 3515577 TI - [Medical community of Bashkiria in the war years]. PMID- 3515578 TI - [The 1st teachers of pediatric diseases at Moscow University]. PMID- 3515579 TI - [Medical questions on the pages of the newspaper Severnaia pchela]. PMID- 3515580 TI - [Medical questions in the works of Kant]. PMID- 3515581 TI - [Asen Khristov Zlatarov--the founder of biochemistry in Bulgaria]. PMID- 3515582 TI - [Ultrasonic and computer tomography in the diagnosis of rectal neoplasm recurrence]. PMID- 3515583 TI - [Evaluation of tumor size in cancer of the breast]. PMID- 3515584 TI - Characterization of a mouse cell line selected for hydroxyurea resistance by a stepwise procedure: drug-dependent overproduction of ribonucleotide reductase activity. AB - Hydroxyurea was used as a selective agent in culture, to isolate by a stepwise procedure, a unique mouse L cell line called LHF which exhibited a stable resistance to high concentrations of drug (5 mM). LHF cells contained an elevation in ribonucleotide reductase activity which depended upon whether cells were previously cultured in the presence or absence of hydroxyurea. M1 immunoprecipitation and M2 titration experiments indicated that both ribonucleotide reductase subunits were elevated in drug-resistant cells. Interestingly, a very large drug-dependent change in the M2 activity (about a 100 fold) was observed. Studies on enzyme activity with cycloheximide and actinomycin D indicated that the hydroxyurea-dependent increase in activity required de novo protein synthesis and transcriptional activity. These results are different from other ribonucleotide reductase overproducing cell lines previously described, and indicate that hydroxyurea modulates enzyme activity by an interesting mechanism. PMID- 3515585 TI - [Complications of amebiasis in the x-ray picture]. PMID- 3515586 TI - Surgical complaints. PMID- 3515587 TI - Penbutolol in black hypertensive patients. AB - A single-blind placebo-controlled study was conducted on black hypertensive patients with a once-daily dose of penbutolol (Betapressin; Hoechst); a non selective beta-blocker. Of 29 patients who participated in a 4-week run-in period, 18 were entered into a 20-week trial of the active medication. Fourteen patients were adequately controlled, 2 did not respond satisfactorily and 2 dropped out of the study. On cessation of therapy all patients became hypertensive again. No significant changes in mean heart rates were observed during active medication as opposed to placebo. Penbutolol can therefore be used as a sole antihypertensive agent in blacks. PMID- 3515588 TI - Inherited disorders in the black population of southern Africa. Part II. Gene disorders. AB - Inherited disorders transmitted by simple genetic mechanisms are documented, with discussion of those notable for their unusually high or low prevalence. PMID- 3515589 TI - Tenoxicam in soft-tissue rheumatism. AB - A randomized double-blind trial with tenoxicam 10 mg/d and 20 mg/d and placebo was carried out for 2 weeks in 90 patients suffering from various extra-articular inflammatory conditions. Statistical analysis revealed significant differences in favour of tenoxicam as regards improvement of all parameters with an intensity which was moderate or severe at baseline, e.g. tenderness, mobility pain, functional limitation. The efficacy of tenoxicam at both dosages was similar (no statistically significant difference). Tenoxicam was well tolerated but some mild adverse reactions were observed in all three treatment groups. PMID- 3515590 TI - Maimonides, nutrition and health. PMID- 3515591 TI - On the sexual intercourse drawings of Leonardo da Vinci. AB - Leonardo da Vinci's marvellous anatomical drawings have been praised by both artists and medical historians over the centuries. Specific reference is made here to Leonardo's drawings of the act of sexual intercourse. It is shown that his illustrations are not based purely on original observation. Rather, they are an attempt to illustrate and clarify anatomy and physiology as presented in the textbooks of the time. PMID- 3515592 TI - Toward understanding the use of dental services by the elderly. PMID- 3515593 TI - [Essential clinical aspects of syphilis]. PMID- 3515594 TI - The role of propranolol in the preoperative preparation of patients with Graves' disease. AB - From March 1980 to August 1982, 108 patients with Graves' disease participated in a prospective study at Yonsei University College of Medicine. Preoperatively, 22 patients were prepared with propranolol alone (group 1) and 86 with propranolol and propylthiouracil (PTU) (group 2). The duration of preparation averaged 11.5 days for group 1 and 10.8 days for group 2. Bilateral subtotal thyroidectomy was performed, leaving 4 to 6 grams at both upper poles. No significant difference was noted in the average weight of the removed gland or the amount of blood loss between both groups. During the operation, the pulse rate of group 1 was significantly faster than that of group 2 but evened out by the day of discharge. The incidence of high fever during and immediately after operation was 27.3 per cent in group 1 which is greater than the 17.4 per cent in group 2. In group 1, the incidence of postoperative transient hypocalcemia was 27.3 per cent, transient or prolonged hypothyroidism was 13.6 per cent and recurrence of thyrotoxicosis was 4.5 per cent. In group 2, the values were 22.1, 18.6 and 4.7 per cent, respectively. High fever developed in one patient from group 1 during operation and this patient died on the third day postoperatively. From the results of our study, it appears to be more beneficial to administer both propranolol and PTU as preoperative medication to patients with Graves' disease prior to undergoing operation. PMID- 3515595 TI - A simplified approach to Shirodkar cerclage procedure. AB - The success of the Shirodkar cerclage procedure described herein lies in the use of the medium curve White tonsil forceps. The use of this curved tonsil clamp allows compression of the vaginal mucosa laterally, thereby making it relatively simple to place the Mersilene band accurately submucosally and avoiding blind advancement of an aneurysm needle. PMID- 3515596 TI - Tube cecostomy with cecal extraperitonealization in the management of obstructing left sided carcinoma of the large intestine. AB - The technique of tube cecostomy has enabled us to manage safely and expeditiously patients with obstruction of the large intestine secondary to left sided carcinoma. Extraperitonealization of the cecum and insertion of a large bore catheter are each critical to the success of this modality. PMID- 3515597 TI - Edmond Halley and the beginnings of medical statistics. PMID- 3515598 TI - Epidural catheter analgesia for the management of postoperative pain. AB - Since its introduction to North America in 1942, the use of epidural catheter analgesia has increased dramatically. Improved equipment, methods and medications have broadened its application to include among others, surgical anesthesia, chronic pain relief and the management of postoperative pain. Numerous techniques for epidural puncture and insertion of the catheter have been described. Although complications have been associated with placement of an epidural catheter, these are rare when performed by an experienced anesthesiologist. Epidural analgesia was first accomplished by blockade with local anesthetics. Bupivacaine has been called the local anesthetic of choice for epidural infusion. Bolus administration of epidural local anesthetics gives effective analgesia; however, its use is limited by brief duration and occasionally severe hypotension. Epidural local anesthetics have been administered by continuous infusion in an attempt to minimize side effects. Nevertheless, hypotension, as well as motor block, numbness, nausea and urinary retention have occurred. Epidural analgesia with local anesthetics is effective in relieving postoperative pain, but its safety and feasibility have been questioned because of the frequent, potentially serious side effects. These problems led to trials of epidural narcotics for postoperative pain management. The exact site of action of epidural narcotic analgesics is debatable; however, the bulk of evidence supports a direct spinal action. Epidural narcotics appear to specifically inhibit nociceptive stimuli. The prolonged and profound analgesia that occurs with epidural narcotics relative to parenteral administration is due to a higher concentration of drug reaching the CSF through the epidural route. Since nervous transmission is not completely blocked this technique cannot provide anesthesia during operation. Morphine has been the most frequently used narcotic for epidural analgesia. Results of several recent, randomized double-blind studies have shown that epidural narcotics give adequate analgesia comparable with that observed with epidural bupivacaine. Epidural morphine provides a greater duration of analgesia and may cause fewer side effects. Improved analgesia has been reported when epidural narcotics are used in combination with local anesthetics. Continuous administration of low dosage epidural narcotics has been shown to have less frequent side effects than bolus administration. Nevertheless, pruritus, urinary retention, hypotension and severe respiratory depression have been reported with both methods.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3515599 TI - The tortuous or kinked carotid artery: pathogenesis and clinical considerations. A historical review. AB - The significance and management of cervical carotid artery tortuosity are controversial. One hundred eighteen cases of angulation of the common carotid artery and over 800 cases of elongation of the internal carotid artery have been reported. The etiology, presentation, diagnosis, and treatment of each entity are reviewed. Angulation of the common carotid artery is often managed conservatively. For clarity, elongations of the internal carotid artery should be classified as either tortuosities or kinks. Some patients with kinks of the internal carotid artery will have episodes of cerebrovascular insufficiency related to the position of their heads. Such patients merit thorough diagnostic evaluation. When other etiologic factors have been eliminated, patients in this group may benefit from a surgical procedure directed at the vascular abnormality. Applicable surgical techniques are discussed. PMID- 3515600 TI - A rare anomaly of the axis: report of a case with shaded three-dimensional computed tomographic display. AB - A rare anomaly of the C-2 vertebra (axis) was found in a 54-year-old man with myelopathy. In addition to spina bifida of C-2 and abnormal articulations between C-2 and C-3, the lamina of the axis was separated from the rest of the posterior arch on each side, and the free dysplastic laminae and spinous process invaginated deeply into the spinal canal. The condition differed from the infrequent but previously described cervical spondylolysis in that the pars interarticularis and the pedicle were not dehiscent. Shaded three-dimensional computed tomographic display proved most useful in demonstrating this complicated osseous anomaly. PMID- 3515601 TI - Postoperative recurrence of meningiomas. PMID- 3515602 TI - Prognostic factors in patients with brain metastases from lung carcinoma. AB - Between September 1980 to December 1983, 70 consecutive patients were entered into two randomly allocated trials in order to investigate the effectiveness of different time-dose radiotherapy schemes (i.e., 30 Gy/ten fractions/two weeks versus 50 Gy/20 fractions/four weeks) and the prognostic factors on the palliation for patients with brain metastases from lung carcinoma. The most important factors for predicting poor prognosis in this series, which were shown by stepwise proportional hazard (Cox) model, were lactate dehydrogenase (LDH) and general performance status. In normal LDH group, the most important factors for predicting poor prognosis were multiplicity of brain metastases (p less than 0.001), treatment methods (p less than 0.0005) and age (p less than 0.0053). In high LDH group any items were not shown for meeting of the 0.05 significant level. PMID- 3515603 TI - The effect of total body irradiation on the occurrence of chemically induced tumors in mice of inbred strains with different activabilities of the AHH system. AB - On four strains of inbred mice (C57B1/6, C57B1/10, C3H and DBA2), which were chosen according to their genetically conditioned activability of the arylhydrocarbonhydroxylase system (AHH) the effect was checked of repeated whole body exposure to 60Co gamma rays on the occurrence and origination of the formation of tumors induced by methylcholanthrene. Mice of the strains C57B1/6, C57B1/10 and C3H have a high activability of the AHH system, those of the strain DBA2 exert a low activability. The experiment was supposed to check, how much is the damage of the immunological reactivity induced by radiation able to affect carcinogenic effects of methylcholanthrene. The repeated whole body irradiation of mice neither increased the rate of occurrence of tumors nor affected the time of origination of growth of tumors induced with methylcholanthrene. These results indicate that in the formation of tumors induced with methylcholanthrene, there is a prevalent role of genetically conditioned metabolism of the precarcinogen and not of an intervention into immunologic processes in the organism resulting from the whole body irradiation. PMID- 3515605 TI - Medicine on Texas plantations. PMID- 3515604 TI - [Asymptomatic myocardial infarct and asymptomatic ischemic heart disease]. PMID- 3515606 TI - Entrepreneur extraordinaire. Interview by John Levis Brown. PMID- 3515607 TI - [Immunologic aspects of kidney transplantation]. PMID- 3515608 TI - [Indications and results in bone marrow transplantation]. PMID- 3515609 TI - [Immunomodulation in the treatment of rheumatoid arthritis]. PMID- 3515610 TI - [Immunology and molecular biology: targetting of a vaccine]. PMID- 3515611 TI - [A new approach to vaccine development: anti-idiotypic vaccines]. PMID- 3515612 TI - [Cellular basis of immunity]. PMID- 3515613 TI - The effect of the degree of diabetic control on thromboxane synthesis in clotted whole blood. PMID- 3515614 TI - The use of sulodexide in the treatment of peripheral vasculopathy accompanying metabolic diseases. Controlled study in hyperlipidemic and diabetic subjects. AB - Thirty vasculopathic subjects with hyperlipoproteinemia (18) and/or diabetes (22) underwent a clinical double-blind study in order to evaluate the effect of sulodexide on lipid and hemorheologic parameters. The experimental design consisted of a first 20-day i.m. therapeutic period with either sulodexide (300 Lipasemic Units twice daily via intramuscular route) or placebo and the following 70 days with the active compound for both groups at the same posology. Results obtained demonstrated that sulodexide yields a hypotriglyceridemic effect on type IV hyperlipoproteinemia and hypofibrinogenic effect, as well. Moreover, this compound exerted a beneficial effect on HDL Cholesterol levels and on the antithrombin III activity by increasing both parameters significantly. Signs and symptoms were alleviated, particularly in the most severe cases of peripheral vascular disease. Insignificant and slight changes were observed at the end of treatments as regards the efficacy of the two administration routes, the i.m. one being more efficacious on lipid parameters and faster acting. No side effects or intolerance were observed during the different periods of the trial. PMID- 3515615 TI - Amidolytic assay of factor V in human plasma. AB - An amidolytic assay was developed for measuring factor V in human plasma. Diluted plasma is incubated at 37 degrees C with lipid, Ca++, Taipan Snake Venom (Oxyuranus Scutellatus Scutellatus) and bovine prothrombin. The reaction is stopped after 4 min with EDTA. The content of factor V in samples is then determined by measuring the amidolytic activity of formed thrombin on synthetic chromogenic peptide substrate S-2238, H-D-Phe-Pip-Arg-pNA. The assay appears to be specific for factor V as: human congenitally deficient FV plasma gives no activity in the system, deficiency of factor II, VII, VIII, IX, X, XI or XII does not affect the determination of FV and no prothrombin is activated if the assay is run without venom. The correlation coefficient r between this amidolytic assay and a clotting assay was 0.91 (n = 20). The intra-assay coefficient of variation was 3.7% for the amidolytic method. PMID- 3515616 TI - Consumptive coagulopathy, fibrinolysis and protease-antiprotease interactions during acute human pancreatitis. AB - Twenty-seven attacks of acute human pancreatitis of different severity were analysed concerning clinical outcome and activation of the coagulation and fibrinolytic systems. Consumptive coagulopathy was suggested by decreased platelet counts, decreased prothrombin values and consumption of fibrinogen during the first days in severe attacks. Factor X was slightly decreased the first 5 days in all attacks. Increased fibrinolysis was suggested by decreased plasminogen values in severe attacks. Fibrinogen degradation products were seen in 40% of the patients in blood and in 100% of the patients in the peritoneal fluid. The four main protease inhibitors of the two systems all showed protease antiprotease complexation and lower functional than quantitative values. Plasma levels of antithrombin III and alpha 2-macroglobulin were low, while the levels of C1-inhibitor and alpha 2-antiplasmin were high. Functional levels of all the four protease inhibitors were almost zero in the peritoneal fluid in severe attacks. It is concluded that severe acute pancreatitis results in both consumptive coagulopathy and in increased fibrinolysis. A local antiprotease deficiency is seen in the peritoneal cavity and high levels of protease antiprotease complexes are also seen in plasma. All these changes are closely correlated to the severity of the disease and may probably determine the clinical outcome of the acute attack. PMID- 3515617 TI - Tissue factor activity in HeLa cells measured with a continuous chromogenic assay and ELISA reader. AB - Tissue factor activity expressed by Hela cells cultured in 96-well plates has been quantitated in situ using a continuous spectrophotometric assay. Following the assay, cells assayed without physical disruption remained as viable as cells not subjected to the assay. Very little (or no) tissue factor was expressed in nondisrupted cells relative to that available in cells disrupted by freeze thawing and sonication. Total tissue factor activity (that available in disrupted cells) decreased not as a simple function of time after subculturing, but was inversely related to cell density. PMID- 3515618 TI - Comparative study of antithrombin III.protease complex metabolism by fibroblasts and vascular endothelial cells. AB - 125I-labeled human antithrombin III (125I-AT III).protease complexes are specifically bound to both cultured human skin fibroblast (HSF) cells and adult bovine aortic endothelial (ABAE) cells; however, there is a significant difference in the rate and degree of metabolism of the complexes by these two cell types. HSF cells appear to internalize the complexes at a rate of about 2.5 pmole/1 X 10(6) cells/h and subsequently degrade them at a rate of 0.6 pmole/1 X 10(6) cells/h. ABAE cells internalize and degrade the complexes at rates approximately 100 and 30 times lower, respectively. Neither cell type interacts with free 125I-AT III but only with its combined form with either thrombin or trypsin. These data indicate the major role of HSF cells in the removal of AT III.protease complexes from extravascular spaces in the body, in contrast to the inert vascular surface with regard to AT III.protease complexes provided by the vascular endothelium. PMID- 3515619 TI - Something to chew on. PMID- 3515620 TI - Dentistry turns the pages--from Josiah Flagg to Justice Hughes. PMID- 3515621 TI - [Appendicitis and appendectomy. A centennial and 50 year anniversary]. PMID- 3515622 TI - [Immunofluorescence test in the diagnosis of AIDS-associated virus infection in Norway]. PMID- 3515623 TI - [Pseudotumor of the gallbladder]. PMID- 3515624 TI - [Ancient legends in modern immunology]. PMID- 3515625 TI - [Anthroposophic medicine]. PMID- 3515627 TI - [Computer-assisted instruction in training and continuing education in veterinary medicine]. AB - The microcomputer is an excellent instrument for stimulation in training in clinical problem-solving. However, the construction of computerprogrammes requires far too much time of teachers. At the Department of Surgery of the University Hospital at Leiden, a software package was developed, called 'CASES' (Computer-Assisted Simulation and Education System). This authoring system enables the clinical teacher to create a new 'case' within a few hours. When this type of computer-assisted instruction is used a student must attempt to solve a problem and in doing so will make a few, or possibly several, mistakes. The author of the programme will comment upon all the mistakes which are made. It is, as if the teacher were personally present and giving private instruction to his student. To create a case the teacher does not need any knowledge of computers nor of programming-languages. Other fields of use could be post-graduate training. By mailing floppy-discs to the doctor's home he could have his interactive training by experts at home in his own study. With little if any modifications, this system may also be used in veterinary medicine. It runs on IBM-PC's (128 K) and all compatible hardware. PMID- 3515626 TI - [Intra-arterial digital subtraction angiography of the carotid arteries]. PMID- 3515628 TI - Phenotypic and karyotypic transitions in the spontaneous transformation of a rat cell line. AB - After 20-50 transfers, a rat myofibroblast line, Hmf-n, 'spontaneously' transforms to an established (immortalized) line of smaller, rapidly cycling fibroblastoid cells (tHmf-f). From these 1 degree transformants, colonies of larger, slower growing anchorage-independent (tHmf-e) cells of epithelioid phenotype emerge. Both transformants grow in low serum and low calcium media, but the tHmf-f cells are highly tumorigenic in nude mice, have diminished substrate adhesivity, and limited anchorage independence, whereas tHmf-e are less tumorigenic, firmly substrate adherent, and markedly anchorage independent. Most tHmf-f are trisomic; most tHmf-e transformants are hypodiploid, a third are tetraploid, and all have chromosomal abnormalities, but no trisomy. Hmf-n cells have polar stress fiber arrays terminating in vinculin adhesion plaques, colinear extracellular fibronectin matrices, and linear non-coincident deposits of fodrin. Microtubules (mt) and vimentin-intermediate filaments (IF) parallel the actin cables. Stress fibers of the tHmf-f are moderately reduced, their vinculin adhesion plaques and fibronectin matrices intact; fodrin is diffuse. Mts and IFs are normal and axial. Most epithelioid tHmf-e have no stress fibers, adhesion plaques, or extracellular fibronectin; instead, dense actin microfilament meshworks are attached to plasma membrane, as is fodrin. Mt and IF are radial. Both transformed phenotypes are stable over greater than 300 continuous passages. The differentiation-inducing agents DMSO, cyclic AMP, 5-azacytidine, and mezerein, were ineffective in normalizing shape or cytoskeleton of transformed Hmf, and butyrate was selectively toxic to 50% of tHmf-e. But hydrocortisone induced striking polarization, and increase in number, and alignment of stress fibers of both tHmf-f and tHmf-e. Growth, anchorage, cytoskeletal arrangements, and tumorigenic potential are not closely correlated in these stable, spontaneously transformed lines of distinct pheno- and karyotype originating from the same normal parental cell, suggesting independent acquisition of properties associated with transformation. PMID- 3515630 TI - [Medical information for nurses. Organ transplantation. II: Kidney, pancreas, liver, heart]. PMID- 3515629 TI - Macromolecular organization of bovine lens capsule. AB - Rabbit antisera to type IV collagen, laminin, entactin, heparan sulfate proteoglycan and fibronectin were used to localize these proteins in cross sections of bovine anterior lens capsule. The antisera were exposed to (a) 10 micron frozen-thawed sections of formaldehyde-fixed tissue for examination in the light microscope by the indirect immunofluorescence method and (b) formaldehyde fixed and L. R. White plastic-embedded thin sections for electron microscopic examination by the protein A-gold technique. The intensity of immunofluorescence was both uniform and strong throughout for type IV collagen, laminin and entactin, but patchy and weak for fibronectin. Electron microscopic immunolabeling with protein A-gold showed that all five components were distributed throughout the full thickness of the membrane, albeit the density of gold particles was not identical for all basement membrane proteins. In general, the number of particles per micron2 was greatest for type IV collagen and entactin, moderate for laminin and heparan sulfate proteoglycan and low for fibronectin. The ultrastructure of the lens capsule as examined by the electron microscope revealed a relatively uniform parallel alignment of filaments, thought to be collagenous. Since the distribution of the filaments corresponds well with the observed immunocytochemical pattern it is concluded that type IV collagen, laminin, entactin, heparan sulfate proteoglycan and fibronectin co-localize throughout the cross-section of the anterior lens capsule. PMID- 3515631 TI - Human pancreatic cancer associated antigen detected by monoclonal antibody. AB - Monoclonal antibody F30 was produced by the fusion of murine myeloma cell line P3 X63-Ag8-653 with spleen cells from a BALB/C mouse immunized with established human pancreatic cancer cell line (PK-1) and the reaction specificity was analyzed. The antigen recognized by monoclonal antibody F30 was different from HLA-associated antigen, beta 2-microglobulin, fetal bovine serum components, ferritin, AFP, or CEA. Monoclonal antibody F30 reacted with all of six pancreatic cancer cell lines established in our laboratory. Cross-reactivity was detected with a colon cancer cell line or an esophagus cancer cell line among various tumor cell lines tested. No reaction was detected with red blood cells, lymphocytes, or lymphoid and myeloid cell lines. By immunoperoxidase staining of frozen sections, the F30-defined antigen was detected not only on pancreatic cancer cell membrane but also on other adenocarcinomas. In addition, the monoclonal antibody F30 had a more wide-spread distribution on normal epithelial cells in the gastrointestinal organs, respiratory system, and urinary system. F30 defined antigen was composed of two protein components with molecular weight of 190 and 160 K. It was indicated that the antigen was an integral protein in the cell membrane since the antigen was not detected in the spent culture medium of antigen-positive cells. PMID- 3515632 TI - Hyperlipidemia and pregnancy associated pancreatitis with reference to plasma exchange as a therapeutic intervention. AB - A 23 year old pregnant woman presented in her third trimester with severe pancreatitis and hyperlipidemia. Initial investigations suggested that her pancreatitis was induced by profound hypertriglyceridemia, which was the result of an underlying Fredrickson's V type hyperlipoproteinemia exacerbated by pregnancy. Concern for the life of the fetus prompted a caesarean operation and then drainage procedure for pancreatitis. Plasma exchange, carried out to lower the levels of lipids and the pancreatic enzymes, improved the signs and symptoms of the patient. Plasma exchange may be of great use in the management of hyperlipidemic pancreatitis. PMID- 3515633 TI - Analysis of lead effects on in vivo antibody-mediated immunity in several mouse strains. AB - The effect of administration of lead acetate (10 mM in the drinking water) for 8 weeks on the in vivo sheep red blood cell (SRBC) specific plaque-forming cell (PFC) responses of inbred A, BALB/c, C57Bl/6, DBA/1, SJL, and NZW/NZB F1 mice and outbred CFW mice was examined to determine if lead was immunomodulatory in a genetically related manner. Lead did not suppress the SRBC-specific PFC/10(6) splenocytes or PFC/spleen response in any mouse strain when compared to the responses of strain-matched control mice. In addition, 10 mM lead-treated BALB/c mice manifested augmented PFC/10(6) splenocytes (17%; p less than .05) but unchanged PFC/spleen responses. Correspondingly, serum concentrations of SRBC specific antibody (measured by radioimmunoassay) and serum immunoglobulin G, M, or A isotypes were also unchanged by lead acetate treatment in all tested mouse strains. There were no observable lead-related histopathological changes or deposition of immune complexes or antibasement membrane antibody in the kidneys of treated mice. Further, splenocytes from lead-treated, SRBC-immunized mice cultured with T-independent antigens (TNP-LPS, TNP-Ficoll) or with a T-dependent antigen (SRBC) exhibited direct and indirect specific PFC responses that were unchanged from those of control mice. The H-2K/D haplotypes of the outbred CFW mice were determined by microcytotoxicity to include r, q, u, and s. These results suggest that lead acetate (10 mM) administered po for 8 weeks does not suppress the primary direct humoral immune response to SRBC in inbred and outbred mice of several H-2 haplotypes (k/d; d; b; q; d,z; s; r; and u). PMID- 3515634 TI - Appearance and reappearance of mutagens in urine from rats after oral administration of direct brown 95, due to coprophagy. AB - Rats treated orally with direct brown 95, a benzidine-based dye, widely used in dyeing of textiles, plastics, paper and other materials, showed 2 peaks of excretion of mutagenic products in urine, one between 6 h and 18 h after administration and one about 30 h later. Prevention of coprophagy by fitting neck collars resulted in the disappearance of the second peak. Oral administration of carminic acid resulted in a biphasic excretion of this dye in the feces, due to coprophagy. The excretion pattern of mutagens in urine after administration of direct brown 95 corresponds with the excretion pattern in the feces of orally administered carminic acid. PMID- 3515635 TI - Hemorrhagic cerebral infarction--a prospective study. AB - In 65 cases of ischemic cerebral infarction, CT scans and quantitative assessments of the neurological disturbances were undertaken at specific intervals during the 4 week period after stroke. Forty-three patients underwent lumbar puncture to determine the serum/CSF albumin ratio. The etiology of the infarction was evaluated on the basis of angiographic, ultrasonic and cardiologic findings. A hemorrhagic transformation of the infarction occurred in 28 patients, eleven within the first week, and 15 within the second. Risks of hemorrhage were correlated with a severe neurological deficit, disturbance of consciousness, large infarction with a mass effect, enhancement of contrast medium in CT (especially if occurring early), involvement of the cortex, and distinct blood/CSF barrier disturbances. Cardiac embolism was a frequent etiology in patients with secondary hemorrhagic infarction, especially when transformation occurred within the first week after stroke. In addition to a heterogeneous pattern of hemorrhage, frank hematoma predominated in those infarcts which underwent early transformation, while those transforming late often showed less hyperdense cortical hemorrhagic changes. Deterioration evident on clinical evaluation was caused by the hemorrhagic transformation in three cases, in each instance within the first week after stroke. PMID- 3515636 TI - [Establishment of the time of formation of blood stains]. PMID- 3515637 TI - Clinical pharmacological evaluation of an assay kit for intoxications with tricyclic antidepressants. AB - The performance of an enzyme immunoassay kit (EMIT) to diagnose intoxications with tricyclic antidepressants was compared with a high performance liquid chromatography (HPLC) technique in vitro and in vivo. The cut-off reference solution contained in the kit of nominally 1,140 nM nortriptyline varied from 1,250 to 1,600 nM. In vitro addition of antidepressants gave positive results (change in absorbance above the cut-off value) of approximately 1,100 nM for amitriptyline, imipramine, and desmethylimipramine and approximately 1,600 nM for clomipramine and desmethylclomipramine. In contrast, high concentrations of the tetracyclic antidepressant maprotiline (7,000 nM) and the bicyclic zimeldine (2,000 nM) gave negative results. False positive results were obtained with high concentrations of thioridazine (4,000 nM), chlorpromazine (300 nM), and alimemazine (trimeprazine) (5,000 nM). Of 51 patient samples, five gave readings above the cut-off value, consistent with a tricyclic antidepressant intoxication, but two of these were false positives as compared with the specific HPLC analysis. However, no false negative results were obtained with the EMIT. In conclusion, the EMIT kit is likely to detect intoxications with tricyclic antidepressants but miss intoxications with nontricyclic antidepressants. For a screening method, this is a serious drawback, since maprotiline and zimeldine together make up approximately 25% of the total of antidepressants used in Sweden. Users of the kit must also be aware that certain phenothiazines in high therapeutic doses or in intoxication cases could interfere with this test and might lead to the false diagnosis of intoxication with tricyclic antidepressants. PMID- 3515638 TI - Evaluation of the powder-formulated enzyme multiplied immunoassay technique quantitative single test for gentamicin. AB - The usefulness of the enzyme multiplied immunoassay quantitative single test (EMIT QST) gentamicin assay was assessed for gentamicin analysis in patient sera. The EMIT QST reagents are in powder form in a single, premeasured vial and are run on a thermoregulated sample processor that controls mixing and timing steps. The results of the clinical evaluation showed that the standard curve was stable throughout a 26-day study period. Within-run precision on 20 replicates at 4.0 micrograms/ml yielded a coefficient of variation (CV) of 5.6%; between-run precision on 66 analyses at 6.0 micrograms/ml over a 152-day period yielded a CV of 4.0%. Mean recovery through the range of the standard curve with 10 spiked patient samples was 102%. Comparative analysis with radioimmunoassay of 95 patient samples showed a correlation of 0.97, with y = 0.93x - 0.03. It was concluded that the EMIT QST gentamicin assay is an appropriate, rapid methodology for patient gentamicin analysis. PMID- 3515639 TI - Comparison of methods for determining unbound theophylline concentrations. AB - In order to determine the suitability of using tears and saliva to estimate theophylline concentrations, simultaneous plasma, tear, and saliva samples were obtained in 22 adult male patients taking theophylline. Unbound theophylline concentrations were determined by equilibrium dialysis for nine of the subjects and compared with the concentrations determined in saliva and tears. The mean tear/unbound and saliva/unbound ratios were 0.94 +/- 0.12, r = 0.88, and 1.25 +/- 0.14, r = 0.91, respectively. Tear/plasma ratios ranged from 0.36 to 0.76 (mean 0.58 +/- 0.11), and tear concentrations correlated well with plasma concentrations (r = 0.94). Saliva/plasma ratios ranged from 0.52 to 1.16 (mean 0.79 +/- 0.19), and there was a positive correlation between plasma and saliva concentrations (r = 0.84). The mean tear/unbound and saliva/unbound ratio predicted the unbound concentration within 1 microgram/ml in 50 and 78% of the cases, respectively. Saliva and tears have limited clinical value in estimating the unbound concentration of theophylline. PMID- 3515640 TI - Basic pharmacokinetics. PMID- 3515641 TI - Practical value of a new serum digitoxin assay. AB - The purpose of this study was to evaluate a new fluorescence polarization immunoassay, TDx, for digitoxin by comparing the results of this assay with those of a radioimmunoassay (RIA). Thirty-three serum samples were obtained from 15 patients during, and for 4 weeks after, a 4-week course of digitoxin therapy. Each sample was separated by centrifugation, coded, and frozen until analysis. At the time of analysis, each sample was divided and analyzed simultaneously by TDx and RIA. Nine samples yielded results less than 2 ng/ml (limit of assay sensitivity) by one or both methods and were excluded from further data analysis. Linear regression analysis of the results of the remaining 24 paired samples (x = TDx, y = RIA) revealed a strong correlation coefficient of r2 = 0.95, slope = 0.95, and a y intercept of -0.99 (y = -0.99 + 0.95x). Additionally, the TDx results were lower than the RIA values in only five of 33 paired samples; and these occurred in four patients who had a significantly lower mean estimated creatinine clearance than that of the other 11 patients (39.0 +/- 9.1 ml/min/1.73 m2 vs. 63.3 +/- 11.8 ml/min/1.73 m2, p less than 0.01). The TDx system is a comparable alternative to the RIA method, but differences in specificity and sensitivity may exist and should be evaluated more thoroughly. PMID- 3515642 TI - Cross-reactivity assessment of oxcarbazepine and its metabolites in the EMIT assay of carbamazepine plasma levels. AB - To study the possible cross-reactivity of trans-10, 11-dihydroxy-10, 11-dihydro carbamazepine (DHCBZ), the diol metabolite of carbamazepine (CBZ), of oxcarbazepine (OCZ), and of its metabolites in the CBZ-enzyme multiplied immunoassay technique (EMIT), this technique was used to analyze sera spiked with CBZ, OCZ, DHCBZ, and 10-hydroxy-10, 11-dihydro-carbamazepine (HCBZ). OCZ and, to a lesser extent, HCBZ cross-reacted with the CBZ-EMIT reagents. However, from a clinical point of view, only HCBZ could significantly interfere in the quantitation of CBZ levels in the plasma of patients taking both CBZ and OCZ. There was no interference by DHCBZ. PMID- 3515643 TI - Serologic methods for the early diagnosis of Pneumocystis carinii infection in renal allograft recipients. AB - Because of the nephrotoxic action of trimethoprimsulfamethoxazole (TMP-SMX) in cyclosporine (CsA)-treated patients, combined with the (CsA)-treated patients, combined with the possibility of selecting resistant gram-negative or Nocardia asteroides organisms, a monitoring tool to detect early Pneumocystis carinii (PC) infection permitting a selective treatment approach is highly desirable. A review of 401 consecutive renal transplants revealed 26 cases (18 suspected and 8 histologically proved) of PC infection in 21 cadaver and 5 living-related renal recipients. The diagnosis was confirmed in 8/18 patients who were invasively studied by open-lung biopsy (1/2), bronchoscopy with transbronchial biopsy (4/9), bronchoscopy with brushing (1/2), bronchoscopy with bronchoalveolar lavage (2/5), and transpleural needle biopsy (0/1)-yielding a confirmed incidence of 2% (8/401). All positive invasive studies had been performed prior to or within 24 hr of the inception of TMP-SMX therapy. Nine of ten negative invasive studies were performed after more than 24 hr of treatment. The mean time from transplantation to the onset of clinical symptoms was 2.5 +/- 1.5 months. The infection rate would be 6.5%, assuming all 18 suspected cases would be PC positive if studied pretreatment. In order to assess the efficacy of a variety of serologic methods of PC detection, qualitative counter-immunoelectrophoresis (CIE) for P carinii antigen (PC-Ag), IgG antibody reactive with PC (enzyme-linked immunosorbent assay [ELISA]), and a latex particle agglutination test (LPA) were performed on 279 sera; 85 sera from the 26 suspected or proved cases, 100 sera from normal age-matched controls, and 94 sera from 78 asymptomatic allograft recipients followed as outpatients. In the eight histologically proven cases, CIE was positive in only 3/8 and turned positive late in the clinical course. LPA was positive in all histologically proved cases; however, it was also positive in 60% of asymptomatic renal recipients. In cases that developed clinical disease, LPA increased in titer weeks to months prior to the onset of symptoms. Additionally, LPA titers decreased or stabilized during successful TMP-SMX therapy, providing an early therapeutic index. Measurement of anti-PC IgG was not useful per se, as it was elevated in both controls and documented PC infection. The combination of very low antibody titer (less than or equal to 1:16) with a positive or increasing LPA PC-Ag titer appeared to be disease-predictive.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3515644 TI - Assessment of plasma neopterin in clinical kidney transplantation. AB - Serial plasma samples of 172 kidney transplant recipients and 42 chronic dialysis patients were evaluated retrospectively in a radioimmunoassay to determine the clinical relevance of plasma neopterin levels. Dialysis patients had a higher neopterin level 196 +/- 82 nmol/L (mean +/- SD) than 70 healthy controls (7 +/- 4 nmol/L). In 45 patients with a completely uneventful postoperative course, elevated pretransplant neopterin levels dropped rapidly within a week to a mean of 30 nmol/L and remained stable thereafter. In 22 outpatients with stable graft function there was a highly significant correlation between 170 paired serum creatinine and plasma neopterin values (r = 0.94). A group of 13 patients had experienced delayed graft function (ATN) without rejection. Their one-week mean neopterin level was 100 nmol/L and continued to drop in parallel with the serum creatinine. Another 15 patients rejected their kidneys irreversibly within 3 weeks-6 of them had extremely high neopterin levels during the rejection process (range 500-1000 nmol/L) that were not seen in other patients. A total of 169 rejection episodes in 43 patients were treated with bolus-dose cortisone. On the day of bolus therapy, both serum creatinine (P less than 0.002) and neopterin (P less than 0.005) were elevated. At 24 hours prior to bolus cortisone therapy, creatinine levels were not significantly elevated, whereas there was a significant rise in plasma neopterin (P less than 0.01). The overall sensitivity of neopterin increase was 86% with a 17% probability of false positives, and the sensitivity was 95% in biopsy-proved rejections. Plasma neopterin appears to be a useful marker for early detection of rejection and for identifying severe rejections that are not responsive to treatment. PMID- 3515645 TI - Demographic factors affecting the pharmacokinetics of cyclosporine estimated by radioimmunoassay. AB - In order to assess the impact of demographic factors on serum levels of cyclosporine (CsA) estimated by radioimmunoassay (RIA) in renal allograft recipients, 493 pharmacokinetic studies were performed in 212 patients. Neither the presence of diabetes mellitus nor the CsA dosing frequency affected the measured pharmacokinetic parameters. Age over 45 years led to slower CsA clearance with resultant increase in maximum serum concentration (Cmax) per administered milligram, and increased volume of distribution. Female patients showed more rapid drug clearance, but greater volume of distribution. Concomitant hepatic impairment reduced drug clearance, increasing the area under the curve (AUC) per administered milligram of drug, and the Cmax. Patients treated with a rapid steroid taper showed a shorter half-life and lower Cmax than those receiving a slow steroid taper. Nephrotoxicity was associated with increased AUC per administered mg, while patients with acute tubular necrosis requiring dialysis showed poorer drug absorption, lower Cmax, and longer time to peak. The only effect of cimetidine administration was a slightly shortened time to peak. Serial analyses posttransplant in 17 patients suggested a tendency toward improved drug absorption with no effect on other parameters. These studies demonstrating the significant impact of demographic factors thus afford a basis on which to predict the trend of anticipated CsA levels as measured by RIA in renal allograft recipients. PMID- 3515646 TI - An assessment of intrarenal hydrostatic pressure measurements in the diagnosis of acute renal allograft rejection. AB - Postoperative intrarenal pressure measurements may be an aid to the diagnosis of acute renal transplant rejection, especially in patients treated with cyclosporine. Serial measurements of intrarenal pressure were made in 38 recipients using a fine-needle technique. Thirty-two intraoperative and 207 postoperative measurements were made, and 39 clinical rejection episodes (23 confirmed by biopsy) monitored. Intraoperative pressures in grafts with immediate function (37.4 +/- 4.0 mmHg, mean +/- SEM) were not significantly different from those with delayed function (30.9 +/- 4.8 mmHg), whereas postoperative pressures were greater (P less than 0.01) in kidneys with acute tubular necrosis (29.4 +/- 1.9 mmHg) than in functioning grafts (20.4 +/- 0.9 mmHg). Pressures recorded during clinical rejection episodes (44.3 +/- 2.3 mmHg) exceeded (P less than 0.001) those during quiescent periods (23.6 +/- 1.0 mmHg). During rejection episodes, higher pressures (P less than 0.01) were recorded from tender or palpably enlarged grafts (52.5 +/- 3.0 mmHg) than in the absence of these signs (36.3 +/- 3.1 mmHg), and patients whose transplants biopsies showed cellular rejection tended to have greater pressures (50.1 +/- 4.1 mmHg) than those with concomitant vasculopathy (36.4 +/- 3.9 mmHg), but the latter did not reach statistical significance. In 7 cases of cyclosporine toxicity the intrarenal pressure was 17.8 +/- 4.2 mmHg. Using a diagnostic cut off point of 40 mmHg, the investigation failed to recognize 26% of acute rejection episodes--and, in the presence of acute tubular necrosis, it wrongly categorized 21% of nonrejectors. While its predictive capacity was limited, the test may occasionally be helpful in the differentiation of cyclosporine toxicity and rejection in functioning kidneys. PMID- 3515647 TI - Failure of platelet transfusion to improve human renal allograft survival. AB - Platelets, expressing only class I antigens on their surface, have been shown to improve renal allograft survival in some experimental models but do not lead to humoral sensitization. In this pilot study, 24 previously untransfused patients were given 3 platelet transfusions at 2-week intervals before renal transplantation. Twelve patients (group 1) received 200 X 10(8) platelets contaminated by 15 X 10(6) leukocytes in each transfusion, and 42% developed cytotoxic antibodies; 12 further patients (group 2) received a purified preparation containing 200 X 10(8) platelets and less than 5 X 10(6) leukocytes, and no cytotoxic antibodies were detected. Using a more sensitive flow cytometry technique, 83% of group 1 but only 17% of group 2 (P less than 0.004) responded to their platelet donors. From each group 9 patients have been transplanted. Four grafts in group 1 and 6 in group 2 have failed, yielding a 1-year graft survival rate of 44%, compared with 69% in blood-transfused patients (P = 0.03). Pure platelet transfusions, using our protocol, do not appear to improve renal allograft survival, and minimal contamination by leukocytes can lead to humoral sensitization. PMID- 3515648 TI - The importance of the Lewis system in cadaver renal transplantation. AB - Previous reports have suggested that Lewis (Le) antigens may exert a significant effect on cadaver renal allograft (CRA) survival, especially in black recipients in whom there is a higher frequency of Le-negative phenotypes. We review our experience with this problem in 70 donor-recipient pairs of CRA who underwent prospective Le typing and received conventional immunosuppression between 1980 and 1983. Recipient typing alone yielded the following graft survival (GS) and patient survival (PS) at 2 years by life table analysis: (a+,b;-) (n = 12) 51% GS, 93% PS; (a-, b+) (n = 44) 57% GS, 88% PS; and (a-,b-) (n = 14) 51% GS, 93% PS(P-ns for GS, PS). Recipient racial characteristics did not effect ultimate graft survival, as whites and blacks had similar two-year GS in all phenotypic groups. When Le matching was considered, no significant differences in one-year graft survivals could be ascertained between Le-matched and Le-mismatched donor recipient pairs, and this effect persisted despite stratification for race and HLA-A,B and DR histoincompatibilities. In light of these results, we do not recommend using Lewis compatibility as a criterion for donor selection in cadaver renal allografting, as this substantially increases the difficulty in finding suitable matches, especially in the (a-,b-) recipient group. PMID- 3515649 TI - Adaptation of adult bone marrow transplant recipient long-term survivors. AB - Although there is a small literature on psychosocial and psychiatric aspects of bone marrow transplants (BMT) in adult recipients during the BMT hospitalization phase, adaptation of long-term adult BMT recipient survivors has received little study. This study surveyed the adaptation of BMT recipient survivors over age 17 who were an average of 42 months posttransplant. Study variables included the recipients' current self-reported health status, mood state, social role function, self esteem, life satisfaction, and relationships with their BMT donors and other family members. A companion study of those who donated BMT to the recipients eligible for this study was also performed. The study participants were preponderantly young adults who currently were in an intimate relationship and vocationally active. About 1/4 of the subjects reported ongoing medical problems. Also, 15-25% reported significant emotional distress, low self-esteem, and less-than-optimal life satisfaction. The subjects' current quality of relationship with their donors was highly correlated with many measures of their psychosocial status. The findings indicate that about 75% of BMT recipient long term survivors are doing well from a psychosocial as well as a medical standpoint, that the recipient-donor relationship may be sensitive to any changes in the recipient's status, and that 15-20% of BMT recipient survivors report a degree of psychological distress that might benefit from specific psychological/psychiatric intervention. PMID- 3515650 TI - Psychological adjustment of adult bone marrow transplant donors whose recipient survives. AB - The psychosocial and psychiatric impact of donating bone marrow (BM) has received little study. This mail questionnaire study of bone marrow donors whose recipient had survived more than one year post-BMT was undertaken to document the psychosocial consequences of donation on "successful" BM donors. Demographic, mood state, self-esteem, current life satisfaction, and donor-recipient relationship characteristics, donor-perceived approval from family members, and donor attitudes about BM donation were studied. A companion study of BM recipients was also performed to provide comparative data on the psychosocial status of donors and recipients. As a group BM donors manifested little emotional distress, high self-esteem, and a high degree of current life satisfaction. Donors reported little change in their relationships with their recipients since the BMT. However the current quality of their relationships with their recipients was highly correlated with several recipient health status and psychosocial variables, suggesting that recipient deterioration might significantly adversely impact donor psychosocial status. From 10% to 20% of donors indicated at least some negative consequences of donating. PMID- 3515651 TI - Detailed analysis and demonstration of differences in the kinetics of induction of class I and class II major histocompatibility complex antigens in rejecting cardiac and kidney allografts in the rat. AB - In this paper, we analyze in detail donor class I and class II major histocompatibility complex (MHC) antigen induction in heart and kidney allografts in the DA-to-PVG rat strain combination. The immunohistological techniques and quantitative absorption analyses utilize monoclonal antibodies and assay systems specific for donor class I and class II MHC antigens, to enable precise interpretation of the results in terms of the MHC antigens of the graft. Quantitative absorption analyses were performed on homogenates comprising 4-6 allografts pooled at each interval examined (days 1-5 for kidneys, days 3-7 for hearts). In the heart allografts, donor class I antigen induction begins at day 3 after transplantation and proceeds rapidly on the 4th and 5th postoperative days. The maximum level (a 10-fold increase in comparison with normal heart) occurs at day 6, and thereafter the level declines. Donor class II antigen induction in the heart allografts follows a similar pattern. In kidney allografts, it was of particular interest that donor class I induction occurred much more rapidly, being already evident on the first postoperative day, and reaching levels 20-fold greater than normal kidney by day 3. Maximum levels (approximately 30-fold that of normal kidney) of donor class I antigens were reached on days 4 and 5. Donor class II induction, by contrast, developed in kidney grafts with kinetics similar to that seen for class II induction in heart grafts (beginning at day 3 and reaching a maximum of 7-fold over normal kidney at day 5). Immunohistological studies were performed at days 1, 3, 5, and 7 after transplantation. These confirmed the early induction of donor class I antigen in the kidney allografts. In kidney, by the fifth postoperative day, all tubules in the cortex and medulla, and the arteriolar vascular endothelium, were strongly positive for class II antigens. However, the glomerulus, including the glomerular capillary endothelium, remained donor-class-II-negative, except for induction of class II antigens on Bowman's capsule. The endothelium of interstitial capillaries also probably remained class-II-negative. These results have potentially important implications for understanding the development of the rejection response. PMID- 3515652 TI - Relative contribution of major histocompatibility complex antigens to the immunogenicity of corneal allografts. AB - The relative contributions made by the major class I (RT1.A) and class II (RT1.B) antigens of the rat major histocompatibility complex (MHC) to the immunogenicity of corneal and skin allografts were investigated using congenic animals. PVG (RT1c) recipients were given skin or heterotopic cornea grafts from congenic PVG.1A (RT1a) or PVG.R1 (RT1r1) donors, which respectively share the entire RT1 complex or only the RT1.A (major class I MHC antigen) region with fully allogeneic ACI (RT1a) rats. Recipient splenocytes were tested at ten days posttransplant for their ability to lyse ACI, PVG.1A, PVG.R1, and PVG target cells in a secondary CML following 6 days in vitro stimulation with irradiated ACI spleen cells. Effector cells from PVG recipients of both RT1.A and B disparate (PVG.1A donor) and RT1.A disparate (PVG.R1) skin or cornea grafts lysed ACI, PVG.1A, and PVG.R1 (but not PVG) targets at levels significantly above controls given syngeneic grafts. However, the level of cytotoxicity against PVG.R1 as well as ACI and PVG.1A allogeneic targets was always significantly higher following PVG.1A grafts than following PVG.R1 grafts, indicating that the addition of a class II MHC antigen difference markedly augmented the immunogenicity of class I MHC antigen disparate cornea and skin grafts. Taken together with other recent evidence confirming the presence of Langerhans cells in the normal rat (and human) cornea, these results suggest that class II MHC bearing cells make an important contribution to the immunogenicity of corneal allografts. PMID- 3515653 TI - Lack of effect of splenectomy on the influence of pretransplant blood transfusions on cardiac allograft survival in histoincompatible rats. PMID- 3515654 TI - The relationship between lymphokine responsiveness and HLA DR antigens as prognostic indicators of renal transplant survival. PMID- 3515655 TI - Cyclosporine for steroid-resistant acute rejection of renal cadaver grafts. PMID- 3515656 TI - Doppler ultrasound as a screen for hepatic artery thrombosis after liver transplantation. PMID- 3515657 TI - Cyclosporine-associated microangiopathy in renal transplantation: a severe but potentially reversible form of early graft injury. PMID- 3515658 TI - Lethal graft-versus-host disease in a recipient of a pancreas-spleen transplant. PMID- 3515659 TI - A randomized prospective trial comparing cyclosporine and methotrexate given for prophylaxis of graft-versus-host disease after bone marrow transplantation. PMID- 3515660 TI - Correlation of recipient-donor HLA matching with renal pathology and OKT4+/OKT8+ (4/8) ratio in renal transplant rejection. PMID- 3515661 TI - Transplantation of cultured human fetal pancreas into insulin-dependent diabetic humans. PMID- 3515662 TI - The association of cytotoxic antidonor HLA antibodies and mismatched marrow graft rejection. PMID- 3515664 TI - Human CFU-Mix assay: its value in assessing engraftment in allogeneic bone marrow transplants. PMID- 3515663 TI - Assessment of fine needle aspiration biopsies from renal transplants using monoclonal antibodies as lymphocyte markers. PMID- 3515665 TI - Modified methotrexate regimen for prevention of graft-versus-host disease. PMID- 3515666 TI - Expression of HLA-DR, -DQ, and -DP antigens on renal tubular cells during rejection episodes. PMID- 3515667 TI - Characteristics of human fetal pancreas cultured in vitro. PMID- 3515668 TI - Correction of enzyme deficiency by allogeneic bone marrow transplantation following total lymphoid irradiation in dogs with lysosomal storage disease (fucosidosis). PMID- 3515669 TI - Insulin and glucagon content of human fetal pancreas transplanted into nude mice. PMID- 3515670 TI - Practical aspects of T cell depletion of bone marrow for clinical marrow allografting. PMID- 3515671 TI - T lymphocyte function following cardiac transplantation. PMID- 3515672 TI - Prolongation of related rabbit skin allografts by preoperative treatment with donor-specific or third-party transfusion and cyclosporine. PMID- 3515673 TI - Drug-induced tolerance to allografts in mice. VII. Optimal protocol and mechanism of cyclophosphamide-induced tolerance in an H-2 haplotype-identical strain combination. PMID- 3515674 TI - Proceedings of a conference on the clinical management of the renal transplant recipient with cyclosporine. November 3-5, 1985, Palm Beach, Florida. PMID- 3515675 TI - Cyclosporine use in early graft dysfunction. PMID- 3515676 TI - Cyclosporine blood level monitoring: the early posttransplant period. PMID- 3515677 TI - Perioperative cyclosporine: interaction with multifactorial variables and effect on allograft function. PMID- 3515678 TI - Low dose cyclosporine strategy for cadaver kidney transplantation. PMID- 3515679 TI - Dallas experience with cyclosporine A (CsA) one to six months posttransplant. PMID- 3515680 TI - The use of low doses of cyclosporine, azathioprine, and prednisone in renal transplantation. PMID- 3515681 TI - Clinical management of immunosuppressive therapy for cyclosporine-treated recipients of cadaver kidney transplants at one to six months. PMID- 3515682 TI - Definition, diagnosis, and management of rejection in the second to sixth months posttransplant--an overview. AB - CsA immunosuppression has resulted in decreased graft loss from rejection. However, rejection episodes do occur and, in fact, rejection remains as the major cause of graft loss in the CsA-treated patient. CsA, itself, has added to the differential diagnosis of renal dysfunction following transplantation. In the majority of circumstances, rejection can be differentiated from CsA nephrotoxicity as well as other causes of renal dysfunction by a combination of clinical presentation, renal scan and sonography, CsA levels, and percutaneous allograft biopsy. In some circumstances, a therapeutic trial of lowering the CsA dose may be indicated before extensive laboratory study. Most acute rejection episodes will respond to increased steroid doses. In patients with low CsA levels, increasing the CsA dose may be advised. Steroid-resistant rejection frequently responds to ALG. Patients with repeated episodes of renal dysfunction may be stabilized by using the combination of prednisone, azathioprine, and CsA. PMID- 3515683 TI - Cyclosporine-associated renal arteriopathy. PMID- 3515684 TI - Usefulness of cyclosporine levels one to six months posttransplant. AB - CsA levels are definitely useful for monitoring patients one to six months post renal transplantation. They help to document that individuals are complying with their medication therapy and taking the medication. They may identify patients who are not absorbing the drug due to associated gastrointestinal problems. There is a correlation, although weak, with both rejection and nephrotoxicity. A variety of other factors may limit the usefulness of this correlation, but serial measurements of the CsA trough level will help when making clinical decisions for these patients. Finally, monitoring of CsA levels will help to identify drug interactions and to determine quantitatively the impact of these interactions. Thus, a more appropriate dosage modification of CsA can be determined because of the availability of specific drug levels. Pharmacokinetic modeling may be useful to assess variability in absorption and metabolism of the drug in individual patients. The practical usefulness of this technique, however, remains less clear due to its expense and inconvenience. PMID- 3515685 TI - Sequential antilymphocyte globulin cyclosporine therapy in cadaver renal transplantation. PMID- 3515686 TI - Long-term effects of short-term cyclosporine. PMID- 3515687 TI - Early and late effects of two immunosuppressive drug protocols on recipients of renal allografts: results of the Minnesota randomized trial comparing cyclosporine versus antilymphocyte globulin-azathioprine. PMID- 3515688 TI - Late rejection in patients receiving cyclosporine. PMID- 3515689 TI - Chronic cyclosporine-associated nephrotoxicity. PMID- 3515690 TI - Development and incidence of cancer following cyclosporine therapy. AB - Eighty-seven organ transplant recipients developed 88 tumors after immunosuppression with CsA. The neoplasms showed important differences from those seen following conventional immunosuppressive therapy (CIT). Malignancies appeared an average of 14 months (range, 1 to 82) after CsA and 59 months (range, 1.0 to 225.5) after CIT. Cancers were particularly common among recipients of extrarenal organs. NHLs were the most common neoplasms comprising 52%, compared with 12% in CIT patients. They appeared an average of 8.5 months after transplantation, compared with an average of 41 months after CIT. Unlike NHLs in CIT patients, they more often involved lymph nodes, were more widespread, more frequently involved the small intestine, rarely involved the brain, were more likely to regress, and had a better prognosis following reduction of immunosuppressive therapy. Skin cancers (13% of cancers) were less common than in CIT patients (40%). Kaposi's sarcomas were more common (10% v 3%). Some tumors commonly seen after CIT, including in situ uterine cervical carcinomas and carcinomas of the vulva/perineum, have not occurred in CsA patients. In this small series, there was a surprising frequency of endocrine-related malignancies (ovarian, testicular, breast, and thyroid) and renal cell carcinomas. Longer follow-up and study of larger numbers of patients will determine whether differences from CIT patients will persist. Only seven (8%) patients were treated only with CsA, the remainder received other immunosuppressive agents, mainly prednisone. The malignancies probably are not specific to CsA therapy but appear to be a complication of immunosuppression per se. PMID- 3515691 TI - The role of blood transfusion in the age of cyclosporine. PMID- 3515692 TI - Kidney preservation and early function in the cyclosporine era: an overview. PMID- 3515693 TI - Long-term results of cyclosporine therapy in recipients of mismatched living related kidneys. PMID- 3515694 TI - Cyclosporine therapy independent of graft diuresis in cadaveric renal transplants. PMID- 3515695 TI - Cyclosporine in the first month posttransplant. PMID- 3515696 TI - Comparison of five cyclosporine-prednisone regimens for induction of immunosuppression in cadaveric kidney recipients: a retrospective analysis of 245 cases. PMID- 3515697 TI - Intravenous cyclosporine and kidney function: the Johns Hopkins experience. PMID- 3515698 TI - Sequential conventional immunotherapy with maintenance cyclosporine following renal transplantation. PMID- 3515699 TI - Cyclosporine therapy and other adjuncts in the perioperative period with cadaveric and living related donor kidney transplantation. PMID- 3515700 TI - Clinical diagnosis and management of the renal transplant recipient with cyclosporine nephrotoxicity. AB - The definition of CsA-induced nephrotoxicity is defined as impairment of renal function after transplantation exclusive of allograft rejection, vascular obstruction, and ureteral obstruction. This imprecise definition is one of exclusion and requires a careful clinical assessment of the patient, using information from the renal biopsy in appropriate circumstances in conjunction with the monitoring of CsA drug levels. The clinical effects of nephrotoxicity can be reported in four categories: delayed allograft function, acute nephrotoxicity, acute vasculopathy, and chronic nephropathy. The best method to avoid delayed allograft function in the cadaveric kidney is to make every effort to obtain a prompt diuresis. This can be accomplished in most patients, recognizing that in most centers 15% to 25% of cadaveric recipients will require one or more dialysis treatments. As renal function improves, the dosage of CsA can be increased. Acute nephrotoxicity must be differentiated from acute rejection, and if a reduction in CsA dosage is not accomplished by a prompt improvement in renal function, acute rejection must be considered with possible confirmation by a renal biopsy. Chronic nephrotoxicity rarely leads to chronic renal failure, but may be associated with a gradual increase in serum creatinine to a point where conversion from CsA to azathioprine should be considered. This conversion should be carried out slowly over a several month period. PMID- 3515701 TI - Insulin secretion during intravenous glucose tolerance tests in non-insulin dependent diabetes in the young. AB - The phasic response of insulin to intravenous glucose was studied in 9 patients with non-insulin-dependent diabetes in the young (NIDDY), with 3-generation transmission of the disease; and 9 age-, weight- and sex-matched reference subjects. Furthermore, 10 non-diabetic siblings of these diabetic patients were submitted to the same test procedure in an attempt to identify a prodrome of impaired glucose tolerance. In comparison to the controls and non-diabetic family members, the diabetics had no first phase insulin release. In addition, the non diabetic siblings had insulin and glucose responses similar to those of the reference subjects. Therefore, it would appear that there is no prodromal phase in this discrete syndrome of NIDDY. PMID- 3515702 TI - Grey scale ultrasonography of the thyroid gland, Nigeria. AB - Thyroid ultrasonography was performed on a combined series of 108 patients over a four-year period. Ultrasonography enabled superb visualisation of the neck, specifically the thyroid, and discriminated solitary from diffuse thyroid abnormalities and segregated these into cystic, solid or 'complex' patterns. Sonographic-pathological correlation was obtained in 38 cases, consisting of 14 follicular adenomas, 11 goitres, 3 Hashimoto thyroiditis, 6 colloid cysts and 4 carcinomata; the clinical course confirmed 11 cases of Graves' disease for a total of 49 confirmed cases. The sonographic patterns lack histological specificity; however, a pattern recognition approach can be developed to better select patients for surgery. Such an approach appears suitable in tropical Africa, where radionuclide imaging may not be available. Diagnostic ultrasound is affordable, versatile and efficacious and without any known biological risks. A plea is made for its increased availability. PMID- 3515703 TI - Prevalence of pathogenic bacteria in patients with sore throat. AB - From 361 females and 452 males (527 primary care out-patients and 286 in patients) a total of 813 throat swabs were examined for bacterial pathogens by conventional bacteriological techniques. Beta-haemolytic streptococci were grouped by the coagglutination method. Throat swabs from 14% of males and 15.6% of females were positive for bacterial pathogens; 75 (64% specimens grew BHS group A. All age groups of both sexes yielded a similar proportion of organisms. All pathogens were sensitive to penicillin, erythromycin and cephradine. PMID- 3515704 TI - Osseous ventegration: a preliminary study. PMID- 3515705 TI - Testicular nodule incidentally found in elderly male. PMID- 3515706 TI - Immunoelectron microscopic investigation of HLA-DR-positive dendritic cells at the dermo-epidermal junction in skin disorders associated with the deposition of immune complexes. AB - HLA-DR-positive dendritic cells present at the dermo-epidermal junction in skin disorders associated with the deposition of immunoglobulins and/or complement factors in the skin biopsy are investigated ultrastructurally. They demonstrate long, slender cytoplasmic processes, an indented nucleus, and strikingly dilated cisternae of the endoplasmic reticulum. HLA-DR antigen is present on the plasma membrane and within some of the dilated cisternae. These findings further support our previously formulated hypothesis that these cells represent a functionally active stage of antigen-presenting cells. PMID- 3515707 TI - Argyria: microanalytic-morphologic correlation using paraffin-embedded tissue. AB - Scanning electron microscopes, which have energy dispersive spectroscopy (x-ray microanalysis) capability, can provide accurate identification of the composition of inorganic deposits in tissue. We report a case of florid argyria in which the same deparaffinized 4-micron sections were sequentially examined by light microscopy, scanning electron microscopy, backscattered electron imaging, and x ray microanalysis to confirm the clinical impression of argyria. We recommend the use of x-ray microanalysis of paraffin-embedded tissue as a simple, rapid and inexpensive means of precise identification of inorganic deposits of heavy elements in tissue sections. PMID- 3515708 TI - A thyroid tumor in a 57-year-old man. PMID- 3515709 TI - [The mediopatellar synovial plica]. PMID- 3515710 TI - [Low-dosage heparin combined with either dihydroergotamine or graduated supportive stockings. Combined prevention of thrombosis in colonic surgery]. PMID- 3515711 TI - [Phantom limb and related phenomena in patients with amputated extremities]. PMID- 3515712 TI - [Urinary tract infection in general practice treated with sulfamethizole in a single dose or for 6 days]. PMID- 3515714 TI - Comparative assessment of ultrasonography and computed tomography in adrenal disorders. AB - Comparative diagnostic assessment by ultrasonography (US) and computed tomography (CT) was performed in each of 17 patients with adrenal disorders. US is better than CT for demonstrating the intratumorous characteristics, the relationship between the tumor and the surrounding organs, and the organ from which large tumors arise, such as pheochromocytoma. On the other hand, CT is better able to detect small adrenal tumors in primary aldosteronism, although US with a sector or linear scanner can also detect small tumors in some cases. Adrenal hyperplasia in both Cushing's disease and congenital adrenogenital syndrome was more easily demonstrated by CT than by US. Of the two US instruments, a sector scanner was more useful in the delineation of the enlarged right nontumorous adrenal by scanning from the right intercostal region, but both scanners were of no use in the delineation of the enlarged nontumorous left adrenal in patients with obesity. PMID- 3515713 TI - [Recurrent intestinal ileus caused by condoms]. PMID- 3515715 TI - Ultrasound '85: challenges and opportunities. PMID- 3515716 TI - A system for rapid analysis of the femoral blood velocity waveform at the bedside. AB - The shape of the arterial blood velocity waveform varies with atherosclerotic disease and several methods of quantifying the shape in order to predict the severity of the disease have been described. These methods include pulsatility index, the Laplace transform method, and principal component analysis. This paper describes the development of a system which allows the operator to acquire, display, and store waveforms from each limb and then to quantify the waveforms at the bedside within a few minutes. The system includes a 10 MHz bi-directional Doppler unit, an instantaneous mean frequency processor, and an Apple II microcomputer fitted with an accelerator card. Both the Laplace transform parameters and the pulsatility index are computed and each result is printed in tabular form together with the averaged results of five waveforms from each limb. The printout is suitable for inclusion in the patient's folder. In initial clinical studies Laplace transform analysis exhibited a good correlation with aorto-iliac stenosis as assessed angiographically (R = 0.73 P less than 0.001 t test). PMID- 3515717 TI - In vitro estimation of acoustic parameters of the liver and correlations with histology. AB - Freshly excised human liver specimens (77) were investigated echographically and histologically. The echography was concerned with the acoustic parameters: speed of sound, impedance, several attenuation parameters, and the texture parameters: reflectivity and the signal to noise ratio. It was found that the speed and impedance, the attenuation parameters, and the texture parameters did not correlate with each other. The major correlation between histologic parameters was found for the focal collagen content to the parenchymal content (r = -0.72). The most important correlations of the acoustic parameters to the histologic ones were: attenuation slope to the focal collagen content (r = +0.63) and the reflectivity to the water content (r = -0.55). The most significantly separating acoustic parameters in the comparison of normal livers from focal tumours were found to be the speed, the attenuation slope, the reflectivity, and the signal to noise ratio. A Fisher discriminant analysis revealed a specificity of 91% and a sensitivity of 83% of the separation of tumours from normals when the speed of sound and two parameters of the frequency dependence of the attenuation were considered. PMID- 3515718 TI - Bibliography of biomedical ultrasound. No. 52. PMID- 3515719 TI - Quantitative contrast measurements in B-mode images comparison between experiment and theory. AB - Quantitative measurements of image contrast were carried out for B-mode images of anechoic spheres (cysts) embedded in a random scattering medium. Four transducer geometries were used: (a) f/5.7 spherical transducer in pulse echo mode, (b) f/2.4 spherical transducer in pulse echo mode, (c) f/2.4, 30 degrees cone (hybrid transducer), (d) f/5.7, 30 degrees cone (hybrid transducer). The image contrast was also calculated via two methods; (i) a three-dimensional computer simulation and (ii) a relatively simple numerical convolution which relates the image of a small point-like scatterer [point spread function (PSF)] to image contrast. Generally, good agreement was found between the experimental measurements and the values calculated via both theoretical methods. The results indicate that image contrast is not determined solely by the full width at half maximum (FWHM) of the PSF. In particular, the results demonstrate the importance of far off-axis contributions of the ultrasound beam to the significant degradation of contrast in images obtained with high resolution (low f-number) axicons. PMID- 3515720 TI - The use of bowel in urologic surgery. An historical perspective. AB - An understanding of the evolution of intestinal usage in urologic surgery should not only be of academic interest but should also serve as an aid to the urologic surgeon in choosing a procedure most appropriate for the disease. In this manner the pitfalls of repeating errors can perhaps be avoided. It is hoped that this introductory review will provide the urologist with some historical insight into the different procedures that have laid the foundation for the variety of operations that will be described in the following articles. PMID- 3515722 TI - Carcinogenesis in ureterosigmoidostomy. AB - Both clinical and experimental observations establish that an adenocarcinoma of the colon is likely to occur at the suture line of ureterosigmoidostomy. The carcinogenesis depends on the initial presence of urine, feces, urothelium, and colonic epithelium in close apposition at a healing suture line. It does not occur in isolated colon loops used for urinary diversion. In our rat model, tumors were completely prevented by interposing ileum between the urothelium and colon. Clinical prevention requires that accurate hospital registries of patients at risk be established and that repeated annual colonoscopy be carried out on all of them. PMID- 3515721 TI - Metabolic complications of urologic intestinal substitutes. AB - Metabolic derangements are a frequent accompaniment of bowel interpositions in urologic surgery. The incidence of metabolic complications secondary to these procedures is a function of the absorptive capacity of the bowel segment used, the surface area of the bowel in contact with the urine, the length of time the urine is in contact with the bowel, and the patient's inherent ability to handle an added electrolyte insult. Each of these factors must be considered when contemplating bowel interposition in the urinary tract. PMID- 3515723 TI - Ileal and jejunal conduit urinary diversion. AB - The indications for urinary diversion have changed in recent years, and it is most often required in association with radical surgery for pelvic malignancies. Many patient with lower urinary tract dysfunction can be managed satisfactorily without diversion by use of intermittent catheterization, administration of specific pharmacologic agents, and, when necessary, implantation of artificial sphincters. For patients who require urinary diversion, the ureteroileal conduit remains the standard by which other methods should be judged. If satisfactory results are to be obtained, it is clear that meticulous attention to indications, operative technique, and careful follow-up are essential. As many of these patients have other disabilities, the management of the urinary tract must be integrated with other aspects of patient care. The introduction of the colonic conduit and recently the continent types of urinary diversion represent a search for the ideal method that has yet to be achieved. PMID- 3515724 TI - Sigmoid conduit urinary diversion. AB - Sigmoid conduit urinary diversion represents a step forward in the evolution of urinary diversion. The rigid test of time, however, is necessary to decide the fate of this form of urinary diversion. Although far from ideal, the nonrefluxing colon conduit represents a useful tool in the urologist's armamentarium for select patients. PMID- 3515725 TI - Stomal construction and reconstruction. AB - Urinary diversion plays an important role in the therapeutic repertoire of urologists. The stoma is often the weak link of any diversionary procedure. Some of the more common stomal problems include peristomal dermatitis, stomal stenosis, parastomal hernias, malposition, prolapse, and retraction. Depending on the nature and severity of the problem, it may be treated by local wound care, urinary appliance adjustment, dilatation, or surgical intervention. Careful site selection and stomal creation will keep stomal problems to a minimum. PMID- 3515726 TI - Ureterosigmoidostomy. AB - With all of the recent attention focused on obtaining an internalized form of urinary diversion, the use of ureterosigmoidostomy is often overlooked. In spite of the many potential complications associated with this procedure, with recent improvements in surgical technique, the availability of antibiotics, and a better understanding of physiology of the colon, these formerly life-threatening complications can now be minimized. We believe the use of ureterosigmoidostomy should not be overlooked in the individual in whom an internalized form of urinary diversion is desirable. In the properly motivated patient with rectal continence, who is free of intrinsic renal disease and does not have ureteral dilation, ureterosigmoidostomy can be expected to be a highly successful form of urinary diversion. PMID- 3515727 TI - Augmentation cystoplasty. AB - Augmentation cystoplasty is a useful adjunct to the surgical management of patients with a small contracted bladder. Although more conservative alternatives should be tried initially, augmentation cystoplasty will increase the volume and capacity of the bladder and may achieve an excellent result. This procedure must be used in properly selected patients with a full understanding of the indications, techniques, and complications. PMID- 3515728 TI - Right colocystoplasty for bladder replacement. AB - Total bladder replacement by an ileoascending colonic segment with adjunctive use of intermittent self-catheterization and secondary insertion of an artificial sphincter has been selectively employed in a group of male patients undergoing cystectomy for localized invasive bladder cancer and disabling interstitial cystitis. This bowel segment offers a capacious reservoir, an effective antireflux barrier, and a consistent tension-free colourethral or coloprostatic anastomosis. Mucous plug catheter obstruction is rarely a problem in this reservoir during the early postoperative course. PMID- 3515729 TI - Bladder substitution in children. AB - In spite of all the difficulties, cystoplasty, particularly with the ileocecal segment, has proved rewarding. Undiversion is easily accomplished in this way. Most patients are outwardly well and happy. Reflux usually does no harm in the near term, especially if infection can be prevented, and bladder pressures are not elevated. However, we believe that we are close to being able to prevent reflux in a reliable manner. If this is the case, the ileocecal segment or hemi Kock pouch may clearly become the optimal choice for bladder substitution in patients with reflux or ureteral obstruction, as well as those with short ureters or very small bladders, or as a standard method of undiversion. We have also employed the intussuscepted ileum as the antireflux mechanism in patients undergoing bladder substitution using a patch of small bowel as in the hemi-Kock. This technique allows one to leave the cecum and ileocecal valve in situ, reducing the risk of chronic postoperative diarrhea. In addition, small bowel is proving to be more compliant on the average than large bowel segments when used in bladder reconstruction. Whether the ileocecal segment or the hemi-Kock cystoplasty has a permanent place in undiversion and in the treatment of chronic or pharmacoresistant noncompliant bladder, neuropathic or otherwise, the techniques learned are making total replacement of the bladder with bowel segments a more attractive and feasible undertaking. The pool of patients susceptible to such maneuvers is a large one. PMID- 3515730 TI - Experimental investigations on intracavity sonography. Part 2: Alteration of imaging by artificial alterations in the wall of isolated porcine urinary bladders. AB - Because the determination of the depth of urinary bladder tumors by means of intracavity sonography depends on several factors (tumor size, reflection behavior of the tumor etc.), we checked the imaging of this diagnostic technique in the isolated porcine urinary bladder under various experimental conditions. Different tissues of defined size were fixed on the inner or outer surface of the bladder wall; both the bladder mucosa and the foreign tissue were damaged thermally or by incision. The importance of a limited depth of sound penetration or of a sound shadow depending on the characteristics of the tissue under investigation was revealed; tissue types could not be distinguished unequivocally by the reflection pattern; above all, a sonographic diagnosis of the tumor was not possible in the presence of histo-pathologically detectable tissue changes due to thermal damage. PMID- 3515731 TI - Synergistic effect of donor pretreatment with 8-methoxypsoralen and ultraviolet irradiation of the graft plus azathioprine and prednisolone therapy in prolonging rat renal allograft survival. AB - Pretreatment of the kidney donor with 8-methoxy-psoralen (8-MOP) and direct longwave ultraviolet (UVA) irradiation of the kidney graft (PUVA therapy) significantly prolonged survival in allogeneic recipients. 40% of the recipients survived more than 100 days with normal transplant function. The addition of standard clinical immunosuppressive agents azathioprine and prednisolone (both at dosages of 15 mg/kg body weight/day for 21 days) to the PUVA therapy further improved graft survival rate, with a recipient survival rate of 62.5%. The two drugs alone were less effective in prolonging graft survival rate (28.5%). A synergistic effect of PUVA therapy and standard immunosuppressive treatment with azathioprine and prednisolone was demonstrated. This suggested a possible clinical application of this type of immunosuppression and immunoregulation. PMID- 3515733 TI - Experimental investigations on intracavity sonography. Part 1: Alteration of imaging by variation of the contents of rigid hollow receptacles or isolated porcine urinary bladders. AB - Multiple artifacts may occur in the diagnostic application of sonography. Occasionally, these may make it difficult to differentiate real tissue structures. In order to investigate the imaging properties of ultrasound in intracavity investigation techniques, we have examined the imaging under different conditions in rigid hollow receptacles as well as in an isolated porcine urinary bladder. A measurable difference of sound conduction depended on the characteristics of the fluid (sound conductor): furthermore, accumulation of air in the hollow space lead to various interfering echos. The importance of a central position of a sound source for obtaining useful sonograms in intracavity ultrasonographic diagnosis was evident. PMID- 3515732 TI - Experimental electrical stimulation of the bladder using a new device. AB - Repeated bladder contractions were evoked during a six month period in three unanaesthetized female minipigs by using unipolar carbon fiber electrodes embedded in the bladder wall adjacent to the ureterovesical junction. In contrast to bipolar and direct bladder muscle stimulation unipolar electrodes at each ureterovesical junction evoked bladder pressure increase similar to those produced in previous investigations in dogs. Sacral nerve stimulation of S2 evoked bladder contraction at a minimal current. Microscopic examination revealed no cellular reactions to the carbon fibers but a subcutaneous reaction to the receivers was seen and was thought to be due to mechanical irritation. The clinical implication of the findings is discussed. PMID- 3515734 TI - [Diagnostic and therapeutic problems in renal oncocytomas]. AB - Renal oncocytomas are a well-defined tumor entity and can be differentiated from renal cell carcinomas both from the histological point of view and the clinical course. An illustration of three case reports and a review of the literature underline the diagnostic and therapeutic dilemma in the management of this tumor type. At present no pre- or intraoperative diagnostic means are available for definite differentiation of pure renal oncocytomas from renal cell carcinomas. Because of this lack of reliable diagnostic means therapeutic management of oncocytomas will continue to be in nephrectomy. In a minority of the reported cases oncocytomas were found in a bilateral or multicentric manifestation thus requiring a more conservative surgical management as recommended for bilateral hypernephromas. PMID- 3515735 TI - Ureteral intussusception catheter for one-incision nephroureterectomy. PMID- 3515736 TI - Renal subcapsular abscess. AB - Renal subcapsular abscess is reported with description of findings by conventional radiography, computerized axial tomography, arteriography, and ultrasonography. The latter was especially helpful in permitting delineation of the lesion, and in facilitating its aspiration and resolution. PMID- 3515737 TI - Treatment of bacterial prostatitis. Comparison of cephalexin and minocycline. AB - The relative safety and efficacy of minocycline and cephalexin were examined in patients with acute or chronic prostatitis. The multicenter study was of single blind, parallel-group design. Forty-two men received minocycline (200-mg initial dose followed by 100 mg twice daily) and 44, cephalexin (500 mg four times daily); each antibiotic was administered orally for four weeks. A follow-up period of patient assessment extended for an additional six weeks. Evaluable data were available for 20 minocycline-treated patients and for 24 cephalexin-treated patients. Clinical cure or improvement without recurrence was seen in 65 per cent of the patients who received minocycline and in 46 per cent of those given cephalexin. Bacteriologic cure without relapse or reinfection occurred in 45 per cent of the minocycline-treated men and in 21 per cent of the cephalexin-treated men. Serious adverse clinical experiences were not encountered in either treatment group. Although several factors, mainly the small number of patients, precluded a statistical analysis of comparative efficacy, it was evident that more patients in the minocycline-treated group had both clinical and bacteriologic cures (35%) than did those in the cephalexin-treated group (21%). PMID- 3515738 TI - [Ocular hemodynamic characteristics of patients with glaucoma combined with myopia]. PMID- 3515739 TI - [Intravitreal use of enzymes in the sequelae of eye injury]. PMID- 3515740 TI - [A talented researcher on the optical system of the eye (on the centenary of the birth of V. K. Verbitskii)]. PMID- 3515741 TI - [Use of the carbon dioxide laser in ophthalmic surgery]. PMID- 3515742 TI - [Effect of precision work on the eye]. PMID- 3515743 TI - An attempt to isolate avian mycoplasmas by inoculating directly on to mycoplasma agar plates. PMID- 3515744 TI - Pipemidic acid, a new treatment for recurrent urinary tract infection in small animals. AB - A new chemotherapeutic agent, pipemidic acid, was used to treat 14 dogs and 2 cats with recurrent urinary tract infection caused by multiresistent strains of Escherichia coli and Proteus spp. Bacterial culture of the urine after treatment revealed disappearance of the microorganisms in all patients. It is concluded that pipemidic acid is a promising chemotherapeutic agent for urinary tract infections caused by multiresistant E. coli and Proteus spp., with the condition that bacterial culture during the course of treatment is obligatory. PMID- 3515745 TI - Delayed swayback in goat kids, a study of 23 cases. AB - The results of a retrospective study of 23 goat kids with delayed swayback are reported. Principal clinical signs were ataxia, loss of postural control, spasticity of the hindlimbs, and muscular weakness, often progressing to permanent recumbency. Denervation of skeletal muscles was demonstrated by electromyography in 2 kids. Three kids slowly recovered during hospitalisation. Histopathological changes were characterized by degeneration of selected neuronal populations with their processes within the central and the peripheral nervous system. Affected systems included upper motor neuron, vestibular, general proprioceptive, and lower motor neuron pathways, with additional involvement of the cerebellar cortex in some animals. Our findings, including limited ultrastructural observations, support the notion that the neuraxon rather than the myelin sheath is the prime target of disease in delayed swayback. The available copper values of affected kids and their unaffected herd mates were significantly lower than those of random control goats, which provides further support for a role of copper deficiency in the aetiology of this disease in the goat. PMID- 3515747 TI - A re-examination of islet cell cytoplasmic antibodies in diabetic dogs. AB - Serum samples were obtained from 48 dogs with recently diagnosed untreated diabetes mellitus. Serums were tested for cytoplasmic autoantibodies to normal canine pancreatic islet antigens by indirect immunofluorescence, peroxidase-anti peroxidase, and avidin-biotin complex, immunohistochemistry. Autoantibodies were not detectable in any of the samples. Serums were also examined from 20 diabetic dogs maintained on exogenous insulin therapy for periods of one month to five years. Positive reactions were seen in 11 dogs. These positive responses were completely absorbed by preincubation of serums with commercial insulin preparations or with purified pork or beef insulin. Newly diagnosed diabetic dogs do not have readily detectable autoantibodies to islet cytoplasmic antigens. Our previous report (Haines and Penhale, 1985) of islet antibody in diabetic dogs with unknown clinical histories was likely demonstrating antibody to insulin in patients treated with exogenous insulin. Antibodies to insulin were detected in approximately half of the insulin treated dogs tested. These antibodies were induced by commercial beef and pork insulin preparations and were found to be broadly cross-reactive recognizing epitopes on canine, bovine and porcine insulins. PMID- 3515746 TI - The loss of opsonic activity of bovine milk whey following depletion of IgA. AB - The role of the IgA antibody to Streptococcus agalactiae found in the whey of milks 12 hours after the first intramammary infection of six Friesian first lactation heifers was assessed using an in vitro bactericidal assay. The mean percentage kill of the streptococci by neutrophils in the presence of these wheys was 36.2% while the equivalent figure for the non-infected quarter whey was 0%. When the IgA antibody was absorbed from the infected quarter wheys using class specific IgA antiserum cross linked with glutaraldehyde the percentage kill of the test system fell to 0%. Elution of the absorbed antibody partially restored the activity to a mean percentage kill of 18.2%. The results indicated that the IgA antibody found in infected quarter whey during the acute stages of intramammary infection with Streptococcus agalactiae was responsible for the opsonic activity which pertained at that time. PMID- 3515748 TI - Presence of viral and inframicrobial germs detected by immunofluorescence reaction in 0-5-year-old children with acute respiratory infections. AB - The presence of viral and/or inframicrobial antigens was investigated by the immunofluorescence (IF) technique in exfoliated pharyngeal cells collected from 85 children aged 0-5 years, with acute infections of the upper or lower respiratory tract. Positive IF reactions were recorded in 83% of the children with bronchopneumonia, 81.8% of those with acute pharyngitis, 77.7% of those with acute upper respiratory tract infections and 66.6% of those with acute bronchitis. In 68.75% of the IF-positive cases 2-5 different antigens were simultaneously visualized. Herpes and parainfluenza virus antigens appeared to be predominant. The proportion of positive IF reactions was much lower (20%) in a control group of 20 apparently healthy children, where a single viral antigen (parainfluenza 1) was detected. PMID- 3515749 TI - Characterization of an enzyme immunoassay by means of specific interaction affinities. AB - Antigen--antibody interactions involved in an enzyme immunoassay are characterized by their specific affinities. The use of a nonlinear least-squares approach of the response versus dose dependence allows the extrapolation of experimental data, as well as qualitative and/or quantitative assumptions about the interactions studied. As a practical test, the present technique has important advantages over common titration methods, by avoiding the fixation of a cut-off limit for positive and negative samples and by determining the affinity of the specific interaction for any dose required. PMID- 3515750 TI - [Glucose tolerance in clinically healthy immediate relatives of diabetics]. PMID- 3515751 TI - [Skin grafting in maxillofacial surgery]. PMID- 3515752 TI - [Epidemiologic significance of urease-positive yersiniae in anthropurgic foci of pseudotuberculosis]. PMID- 3515753 TI - [Clinical significance of antinuclear antibodies in systemic lupus erythematosus]. PMID- 3515754 TI - [Ultrasound. Its use and biological effects]. PMID- 3515755 TI - [Carcinogenic effect of ionizing radiation in combination with chemical and other physical agents]. PMID- 3515756 TI - [Potential ultrasonic study in the early diagnosis of rectal cancer recurrence]. AB - The paper is concerned with the results of ultrasonic tomography carried out in 487 radically-operated cases of rectal cancer. Tumor was detected in 103 out of 136 patients with clinically manifest recurrence (76.9%) (group 1). False negative reports were made in 19 cases of intraintestinal relapse (14.2%). The procedure provided most information in male patients who had undergone extirpation of the rectum; a correct diagnosis was made in 86.2%. In application of ultrasonic tomography, early tumor recurrence was detected in 67 out of 353 surgical cases with unfavorable prognosis who were free of relapse symptoms (18.9%) (group 2). Misinterpretation of data obtained by complex scanning procedures may be avoided thanks to application of "real-time" regimen. PMID- 3515758 TI - [Review of the work of the journal Voprosy Onkologii in 1985]. PMID- 3515757 TI - [Difficulties in the diagnosis of tumors of the small intestine]. PMID- 3515759 TI - [Mutagenic activity of carcinogens and other chemical agents in Salmonella typhimurium tests]. AB - One-hundred and six chemical compounds were tested in Ames test with bacteria Salmonella typhimurium. Eight different strains (mainly, TA98 and TA100) were used. Liver S9 from Aroclor-treated rats was employed for metabolic activation. In group I comprising 51 compounds with sufficient evidence of carcinogenicity for animals, 45 were mutagenic while 6 (urethane, 1,2-dimethylhydrazine, DDT, chlorophorm, 1,4-dioxane and carbon tetrachloride) were not. In group 2 (27 noncarcinogenic compounds), 22 agents failed to exhibit mutagenicity whereas 5 (acrolein, styrene-oxide, acridine orange, I-naphthylamine and dichlormethane) revealed such activity. In groups 1 and 2, the sensitivity was 88.2, specificity- 81.5 and predictive value--90%. In group 3 consisting of 28 agents used in chemical, pharmaceutical and food industries but not yet tested for mutagenicity and for the carcinogenicity of which no conclusive data are available, seven appeared to be mutagens (1-aminoanthraquinone, 2-aminoanthraquinone, 1-amino-4 chloranthraquinone, based blue, dinitrochlorbenzene, nitrosodiphenylamine and 2,3,5-trinitronaphthalene). PMID- 3515760 TI - [Self-examination of the breast]. PMID- 3515762 TI - Fc receptors for IgG1 and IgG3 on human mononuclear cells--an evaluation with known levels of erythrocyte-bound IgG. AB - The Fc receptors on mononuclear cells were investigated by a rosette technique in which human erythrocytes were sensitized with a known number of molecules of anti Rh antibodies (IgG1 or IgG3). The number of IgG molecules was quantitated by a radiometric antiglobulin test. The present quantitative evaluation reveals that (1) there is a logarithmic relationship between the proportion of rosettes and the amount of erythrocyte-bound immunoglobulin for both types of mononuclear cells, and for both subclasses; (2) similar percentage of rosettes can be obtained with fewer IgG3 than IgG1 molecules (about 1:4); (3) for a given number of erythrocyte-bound immunoglobulins a higher percentage of rosettes is observed with monocytes than with lymphocytes (ratios of about 3:1 for IgG1 and 5:1 for IgG3); (4) the minimum number of IgG3 molecules for adherence is 180-460 for monocytes, 520-1,300 for lymphocytes, whilst for IgG1 the numbers are 1,180-4,300 for monocytes and 3,400-14,200 for lymphocytes; (5) the minimum levels of sensitization by alloantibodies for adherence should be detectable by the antiglobulin test. PMID- 3515761 TI - [Effects of diet therapy on protein, lipid and carbohydrate metabolism in patients with alimentary obesity]. AB - Lipid, protein and carbohydrate metabolism was studied in patients with alimentary obesity as was the effect on that metabolism of the diets containing horseflesh and beef. The majority of the obese patients showed an increased content of all lipid fractions (phospholipids, cholesterol, free fatty acids, triglycerides), of very low and low density lipids, and a reduced content of high density lipoproteins. Normolipoproteinemia was only ascertained in 26.6% of the patients. Hyperlipoproteinemia (HLP) Ila was detected in 26.6% of the patients. HLP Ilb in 14.5 and HLP IV in 32,3 of the patients. Disorders of the glucose tolerance test (GTT) were revealed in 24% of the patients. Of these, 10% had low curves of the GTT, 6.5% questionable, and 7.5% of the patients manifested diabetic curves. In addition, all the patients had an increased basal level of immunoreactive insulin. Hyperproteinemia was discovered in 61.7, hypoalbuminemia in 74.9, and dysglobulinemia in 50 to 86% of the patients. Apart from an appreciable reduction of the excess body weight, the dietetic management produced the normalization and improvement of the indicators under study in the overwhelming majority of the patients. It should be noted that a more noticeable effect was attained after the dietetic management with the use of horseflesh. PMID- 3515763 TI - [Diagnostic significance of IgM class-specific antibodies in influenza]. PMID- 3515764 TI - [Development and practical use of new experimental models of the various forms of herpetic infection]. AB - New experimental models of neurological herpes in cotton rats and genital herpes in male guinea pigs have been developed which are more adequate to the corresponding human diseases, and models of ophthalmic herpes in rabbits and guinea pigs have been improved. These models may be used for screening and evaluation of the effectiveness of drugs for herpes. A high activity against herpes of bromovinyldeoxyuridine and acyclovir has been verified, a marked therapeutic effect of Soviet monophosphates ara-A, ara-C, and original silur preparation in some forms of herpes infection has been demonstrated. PMID- 3515765 TI - [Chemotherapy of herpetic infections]. PMID- 3515767 TI - [Imaging diagnosis in echinococcosis of the liver]. AB - Liver echinococcosis, the most frequently occurring form of parasitosis, is caused by the following two types of tapeworm: echinococcus granulosus and echinococcus multilocularis. Both types are to be found in Austria, the latter even being endemic. Imaging techniques such as computed tomography and sonography enable the diagnosis to be made easily, quickly and accurately, although the number of conditions to be considered in the differential diagnosis is considerable. A comparison of the two methods in 32 patients, 25 with echinococcus multilocularis and 7 with echinococcus granulosus demonstrates that ultrasound is slightly inferior to computed tomography. However, ultrasound should be the primary method of investigation and is of great importance in follow-up, whilst computed tomography is necessary pre-operatively to assess the extrahepatic involvement. PMID- 3515766 TI - [Immunoenzyme method in the diagnosis of tick-borne encephalitis]. AB - Data are presented on the use of direct and indirect enzyme-immunoassay (EIA) in the study of tick-borne encephalitis (TBE) virus. EIA has been shown to be considerably more effective than the conventional CFT and HI tests exceeding them in sensitivity by 50-150 times both in studies of the antigenic activity of various preparations and in examinations of human sera. The possibility of testing various antigenic substrates makes EIA a universal method suitable for numerous studies. The high sensitivity of the method is useful for antigenic differentiation of viruses and strains within the TBE complex. The EIA may be used satisfactorily for early diagnosis of TBE and study of seroconversion in vaccines. PMID- 3515768 TI - [Immunohistochemical studies on the occurrence of HBs antigen in alcoholic fatty liver and alcoholic fatty liver hepatitis]. AB - 120 liver biopsies of alcoholic fatty liver, alcoholic hepatitis and cirrhosis were studied immunohistochemically with regard to the occurrence of HBs-antigen. In no instance HBs-antigen was detected. These findings suggest neither a major influence of hepatitis B-virus on the progression of alcoholic liver cell damage nor a defect in immunologic responsiveness to hepatitis B-virus component in the alcoholic. PMID- 3515769 TI - [Was Dr. Carl Koller driven from Vienna in 1885?]. AB - In this article the principal reason for the emigration of Dr. Carl Koller is examined on the basis of the available literature. In fact, antisemitism did not play a crucial role. After his colleague, Dr. Fritz Zinner, called him an impudent Jew in public in the General University Hospital of Vienna, Koller reacted by hitting the man in the face. A duel with heavy sabres was the outcome; Koller was unharmed, whilst his opponent received two deep gashes. Such duels were strictly forbidden at that time already, but were nonetheless still executed. In consequence, Koller's hopes of obtaining a position in the Eye Department, for which he was very well qualified, and of an academic career in Vienna were dashed and he had to emigrate. Koller eventually settled in New York in 1888, where he received many distinctions during his life span. The Medical Association of Vienna also honoured him in 1930. Dr. Koller was proposed several times for the Nobel prize in Physiology and Medicine, since his discovery of cocaine as local anaesthetic in ophthalmology was undoubtedly worthy of this prize, but his discovery had been published too long previously, so that according to the statutes of the Nobel prize this distinction could not be granted. Hence, it can be concluded that although Dr. Koller was forced to leave Vienna in 1885, it was not principally for antisemitic reasons. There were Jewish professors in the Medical Faculty of Vienna University at the time and, indeed, when the author studied medicine in 1931 to 1936, four Jewish professors held chairs in Vienna and one of his predecessors as chief of the First Department of Ophthalmology, Isidor Schnabel, was Jewish. PMID- 3515770 TI - [Nephrology for general practice--sonographic findings]. AB - Ultrasound examination contributes essentially to the assessment of nephrological disorders. This investigation provides accurate information about form, size and mobility of the organ. Circumscript painful areas can be localized in combination with palpation. Pathological changes such as hydronephrosis, cysts, solid tumors or inherited diseases (polycystic diseases, hypoplasia or renal agenesia) can easily be diagnosed. Therefore this harmless method is the investigation of choice in the screening of families for inherited renal diseases. To differentiate between acute and chronic renal failure, this diagnostic technique is preferentially employed. Furthermore, it provides valuable information for the long-term-management of patients on haemodialysis, patients with hydronephrosis or impaired renal function. However, for the diagnosis of minor defects in renal calces, the vasculature and for the detection of small stones, this technique needs still to be improved. PMID- 3515771 TI - [Nuclear medicine diagnosis of kidney diseases]. AB - Some of the methods described here are in use for more than 20 years for renal function studies of patients with nephro-urologic problems as well as patients after renal transplantation. There are in general four groups of renal function studies with radioisotopes: 1) The first group comprises studies of the renal function kinetics based on the renal handling of radio-hippurate (OIH). The comprehensive renal function procedure use 131J-OIH or 123J-OIH and includes renal scintigraphy, determination of effective renal plasma flow (ERPF), fractional radio-hippurate excretion and evaluation of urinary bladder function. The introduction of computer processing for evaluating of these studies has provided a powerful tool for diagnosis of renal diseases. The method studies the renal tubular function by a combination of an in vivo/in vitro technique, since the procedure comprises renal gamma camera functional-scintigraphy and determination of renal ERPF by in vitro techniques. The combination of the results of both methods allows the calculation of the split renal effective plasma flow. The estimation of the global and the split ERPF is of considerable importance in patients with acute renal failure, hypertension or outpatients with various renal diseases. The procedure is save, simple, inexpensive and has less variations and a greater reproducibility than creatinine clearance since urine collection is not required. In addition to the evaluation of tubular function, the degree of obstruction and the bladder function can be assessed for the individual kidney by inspection or computer assisted analysis of the sequential or functional scintigrams.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3515772 TI - [Responsibilities of a nephrology department]. AB - In 1979 a special department for kidney-disease and hypertensives was established in the federal republic of Germany which was completely independent and not part of a University-hospital. It consists of a small ward, an out-patient-department and has close contacts with a central transplantation-team. The figures presented demonstrate the necessity for department with the shown form of organization and prove the advantages for such patients which can be treated close to their homes. PMID- 3515773 TI - [Hepatitis B virus infection: gene technology enriches diagnosis]. PMID- 3515774 TI - [Microbiologic findings in nephrology]. AB - Infections of the urinary tract belong to the most frequently encountered bacterial diseases of man. Up to 20% of urinary tract infections take a chronic course and thus give rise for complications. Culture and identification of microorganisms as well as susceptibility testing are an essential part of the diagnostic procedures and give a basis for specific treatment. Bacteriological reports have an increasing importance also for the physician in private practice, since therapy failures and complications can only be avoided if the resistance patterns of the causative organisms are known. Appropriate collection and transport of specimens are an important prerequisite for clinically relevant reports. In most cases properly collected mid-stream urine is sufficient for microbiology. Catheterization and other collection methods are less frequently applied. The urine sample should reach the laboratory as fast as possible and should be stored refrigerated until processing. As an alternative dip-slide cultures can also be used. Dip-slides, however, yield much less information than urine specimens. Bacterial counts of 10(5)/ml or greater are usually considered as significant bacteriuria. Under certain conditions lower counts can be clinically relevant. The most frequent causes of urinary tract infections are still Escherichia coli and other enterobacteriaceae. Hemodialysis patients and kidney transplant recipients are highly infection-prone. In hemodialysis infections of the vascular shunt are frequently seen. These infections are mainly caused by Staphylococcus aureus. About one third of all complications after kidney transplantation are related infectious conditions. Thus early detection and surveillance of infections to preserve the transplant function are a great concern for clinical microbiology. PMID- 3515775 TI - [Effect of the anti-arrhythmia agent ethmozin on the refractory period of the accessory pathway in Wolff-Parkinson-White syndrome]. AB - Sudden onset of atrial fibrillation can be very dangerous in patients with WPW syndrome, because it may result in high ventricular rate. The ventricular rate depends upon the length of the effective refractory period (ERP) of the accessory pathway. It is appropriate, therefore, to test newer antiarrhythmic agents on their effect on the ERP of the accessory bundle. 13 patients underwent the studies. Ethmozin was given intravenously 1 mg/kg body weight. The ERP increased significantly after Ethmozin (p less than 0.05). The increase was more prominent in those patients who had longer basal values of ERP (greater than 300 ms), as compared with the patients with shorter values (less than 300 ms); the latter revealed at most a slight lengthening of the ERP. Ethmozin exerts a favourable effect on the accessory pathway, however, the effectiveness of this substance is insufficient in patients, who are at risk because of a very short ERP. PMID- 3515776 TI - Gastrointestinal perforations in renal transplant recipients immunosuppressed with cyclosporin. PMID- 3515777 TI - The disposition and metabolism of 14C-oxprenolol.HCl in man. AB - The disposition and metabolism of oxprenolol have been investigated in two healthy male volunteers, following a single 160 mg oral dose of racemic 14C labelled oxprenolol. Absorption was rapid and complete. Peak blood concentrations of total radioactivity were 8.83 and 8.21 nmol X g-1 after 1 and 1.5 h in the two subjects. After 4 days 93.4 and 81.9% of the dose was excreted in urine, and a total of 96.6 and 84.5% found in the excreta. Mean peak blood concentrations of unchanged R(+)- and S(-)- oxprenolol were 0.83 and 0.81 nmol X g-1. Maximal concentrations of the glucuronides of the R(+)- and S(-)- isomers were 1.98 and 3.51 nmol X g-1. The mean half-lives of both oxprenolol enantiomers were 1.8 h, those of their glucuronides were 3.2 h (R(+] and 4.6 h (S(-]. Unchanged oxprenolol and the oxprenolol glucuronides constituted 11.4 and 66.5% of the area under the blood concentration-time curve (AUC, 0-24 h) of total radioactivity. The AUC-ratio of R(+) to S(-) was 1.19 for free oxprenolol and 0.36 for the glucuronides. Free metabolites II-X represented together 4.3% of 14C-AUC, and their glucuronides 15.2%. In urine, 1.8 and 1.0% of the total radioactivity was present as unchanged R(+)- and S(-)- oxprenolol, respectively. The glucuronides of the enantiomers accounted for 24.5 and 26.5%. The percentages of free 4- and 5 hydroxy oxprenolol were 0.7 and 2.4% while those of their glucuronides were 12.3 and 7.5%. Metabolites IV-X constituted together 6.2% in free form and 5.3% in conjugated form. In conclusion, the good mass balances in blood and urine has enabled the comprehensive and quantitative description of the metabolic fate of oxprenolol in man. Oxprenolol is extensively metabolized, direct O glucuronidation being the major metabolic pathway and oxidative reactions minor ones. The disposition of the oxprenolol enantiomers revealed no remarkable stereoselective differences. PMID- 3515779 TI - Bronchiectasis revisited. AB - The writer of this retrospective essay witnessed his first open chest operation during the academic year 1928-29 while an intern in general surgery at Lakeside Hospital, Cleveland, Ohio. The operative procedure was probably the first of its kind to be performed at that teaching hospital, and it involved the excision of a mediastinal tumefaction through a median sternotomy. Now, more than fifty-five years and several thousand thoracic operations later, the author recounts the evolution of pulmonary resection, particularly in relation to the therapy of bronchiectasis. The technical obstacles which delayed too long the achievement of reasonably safe and anatomically complete resections of lung are discussed, and the circuitous route trod by pioneering surgeons in their struggle toward that desired goal is described. In addition, some contributions made along the way by members of the faculty at the Yale University School of Medicine to our present knowledge of bronchiectasis--its pathologic anatomy, pathophysiology, and surgical therapy--are summarized briefly. PMID- 3515778 TI - Enzyme immunoassays for the detection of microbial antigens and prospects for improved assays. AB - The rapid diagnosis of viral infections is an important tool in the management of patients with infectious diseases. Solid-phase enzyme immunoassays have proved to be useful tools for the direct detection of the antigens of some viruses directly in clinical specimens. Such assays have been particularly useful in the diagnosis of viral infections in the gastrointestinal and respiratory tracts. However, standard solid-phase enzyme immunoassays often do not display sufficient sensitivity for the diagnosis of all cases of viral infections. Techniques which might be utilized to increase the sensitivity of solid-phase immunoassays include the use of monoclonal antibodies to maximize the efficiency of the antigen antibody interactions and the use of high-turnover enzymes to increase the amount of signal generated by the ensuing enzyme-substrate reactions. In addition, techniques making use of nucleic acid hybridization have a great deal of potential for the accurate detection of viral nucleic acids in human body fluids. The successful application of these techniques to the diagnosis of viral infections could lead to a marked improvement in the care of patients with suspected infectious diseases as well as to a decrease in the transmission of viral infections to high-risk individuals. PMID- 3515780 TI - [Light microscopy procedure for the identification of asbestos]. PMID- 3515781 TI - [Does the form of duodenal ulcer have a prognostic significance in cimetidine therapy? Report on results of a Swiss multicenter study]. AB - Duodenal ulcer is, with decreasing frequency, round, irregular, linear, and oval. The four forms heal similarly with cimetidine. PMID- 3515783 TI - [Insulin and glucagon secretion of the preserved dog pancreas]. AB - Well defined results can be obtained quickly by in vitro test concerning the preservation effect of the preserved dog's pancreas. Clinical and chemical parameters were received during the hypothermic perfusion respectively during the refrigerant storage. The in vitro function tests were carried out after the preservation by insulin and glucagon stimulation. The results showed that the A and B cells of the dog's pancreas are completely able to function after a preservation of 24 hours. Thereby a strong formation of edemas by releasing high enzyme activities is caused during the mechanical perfusion of the organs. The simple refrigerant storage of the pancreata therefore, is the more suitable preservation form for organ transplantations. PMID- 3515782 TI - [Experimental animal studies on the problem of sealing a woven vascular prosthesis and a textile patch by direct-current activated autologous blood]. AB - The results of our animal experiments showed that the sealing of a woven vascular prosthesis or a textile patch by in vitro electrically activated blood by means of direct current is an alternative for the sealing by fibrin adhesive. The materials sealed in this way are resistant to the endogenic fibrinolysis. This simple and non-expensive method is not useful for heparinised blood and in disturbances of coagulation. PMID- 3515784 TI - [Arterial hemodynamics of kidney transplants after end-to-side and end-to-end anastomosis (experimental study in the dog)]. AB - Arterial hemodynamics of end-to-side versus end-to-end anastomized kidney grafts were studied comparatively in anaesthetized dogs with bilateral autotransplants. Evaluating the data of mean pressure in the renal artery (Pm), amplitude of the pulse-pressure (delta P), maximal steepness of the pulse-pressure (dp/dtmax), maximal speed of the flow-waves (Vimax), planimetric percentage of positive and negative shares of the flow-curves and the resulting "effective" level, mean renal blood flow (Vtotal) and the amount of vascular resistance calculated from the quotient Pm/Vtotal, it was found that delta P, dp/dtmax, Vimax and Vtotal were significant higher immediately after transplantation using end-to-end anastomoses as compared with end-to-side anastomoses. However, controls following 4 months after the transplantation revealed normal hemodynamic findings and no differences in the course of anastomotic pulse curves were observed. The initial disparity in the hemodynamics of both types of anastomoses was refered to different modules of elasticity (E) in consequence of unequal lengths of anastomoses reflecting the pulse waves by increased peripheral resistance. PMID- 3515785 TI - [Normal values for the R peak amplitude in the abdominal fetal ECG at term and their significance for the detection of fetal postmaturity syndrome]. AB - This is a retrospective study on 2 008 abdominal fetal ECGs of 1 005 patients. Standard values of R-peaks in the fetal ECG depending on the weeks of pregnancy are figured out. For the first time these standard values are shown on a percentile table and a percentile curve group. Depending on this standard values the frequency of fetal postmaturity is calculated. If the 90th percentile values for the R-peaks amplitude has been exceeded, then there is a 32% probability of severe fetal postmaturity in the pregnancy time of more than 290 days p.m., and a 20% probability if the pregnancy time is between 270-290 days p.m. Meconium has been observed in 44% of all cases, if pregnancy was prolonged more than 290 days p.m. and if in addition the R-amplitude was higher than the 90. percentile value. The abdominal fetal ECG therefore is a good additional method in cases of prolonged pregnancy to recognize fetal postmaturity. PMID- 3515786 TI - [Ambroxol versus betamethasone for stimulating antepartal lung maturity--a multicenter study]. AB - In a multicenter, randomized double-blind study, the effect of Betamethasone and Ambroxol, both used for prenatal prevention of RDS in premature and newborn infants, is compared in a total of 185 patients with premature labour or an induced termination of pregnancy between the 28 and 36th week of gestation. The Ambroxol group of 93 patients is reduced to 77 due to a break up of therapy in 16 patients. The Betamethasone group is likewise reduced from 92 to 85 due to a break up of therapy in 7 patients. The main reason for breaking up therapy in these patients is the impossibility of stopping labour and delivery within 72 hours after admission to the hospital. Both treatment groups show no significant differences with regard to age, weight, history, rate of premature rupture of membranes, gestational age at beginning of therapy and at time of delivery, mode of delivery, rate of tocolytic therapy and prematurity. RDS morbidity, established by a standardized evaluation of the infants considering X-ray, clinical and blood-gas analyses findings, is 9% (7 out of 79 infants) in the Ambroxol group, and 6% (5 out of 86 infants) in the Betamethasone group. Statistically seen, the difference between the two groups is insignificant. Amniotic fluid analyses carried out in a total of 46 patients of both groups show increased surfactant parameters after therapy as compared to initial values before therapy. A significant difference between the two groups is not manifest. The objections against corticosteroids regarding there indications and side effects are generally known. The results of this study indicate that Ambroxol compared to Betamethasone can be considered as an effective drug for prevention of neonatal respiratory distress syndrome. PMID- 3515787 TI - [Pregnancy and labor in methemoglobinemia (HbM Leipzig II type)]. AB - By means of a casuistic about successful course of pregnancy and labour by a patient with methaemoglobinemia (HbM Leipzig II) is reported. PMID- 3515788 TI - [Significance of the 19-S-IgM-FTA-ABS test in 30 TPHA-positive, clinically undetected syphilis patients in evaluation of the need for therapy. A retrospective study]. PMID- 3515790 TI - Fecundity of Litomosoides carinii (Nematoda, Filarioidea) in vivo and in vitro. AB - Several parameters concerning the reproduction of Litomosoides carinii were assessed using quantitatively infected cotton rats (Sigmodon hispidus). The course of embryogenesis from the fertilization of eggs to the delivery of the first microfilariae was observed by daily autopsies during prepatency. The duration of embryogenesis in vivo could thus be determined as 18 +/- 2 days. The contents of embryos in the uteri of female worms had been examined at various intervals. At the onset of patency 7-8 weeks p.i. the females were 71 +/- 6 mm long and on average contained 308 X 10(3) embryos/female, of which 19% were pathologically altered. In the middle of patency 16-20 weeks p.i. the females had grown up to 100 +/- 11 mm in length and now contained 509 X 10(3) embryos/female, 25% of them were pathologically altered, the others were normally developed. A positive correlation between the body length of a female worm and its number of embryos in utero was evident. Additionally the percentage of pathologically altered embryos was increased with respect to the age of the worms. The calculated fecundity of a female L. carinii in vivo of around 20 X 10(3) microfilariae/female per day had been confirmed with worms maintained in vitro. Three combinations of media and serum supplements were used and their influence on embryogenesis evaluated. PMID- 3515789 TI - Plasmodium falciparum antigens as target molecules for a protective immunization against malaria: an up-to-date review. PMID- 3515792 TI - Immunoenzymatic demonstration of a presumptive prolactin-like substance in Hymenolepis nana. PMID- 3515791 TI - Pathogenesis of lymphatic filariasis in man. PMID- 3515793 TI - Effects of placental malaria on mothers and neonates from Zaire. AB - Of one hundred placentas collected consecutively in the Ubangi district, Zaire, 64 had falciparum malaria. Mothers and infants of the 64 malarious and 36 non malarious placentas were compared. The malarious placentas had no consistent relationship to infant length or head circumference, APGAR score, birthweight, maternal anemia, splenomegaly or hydramnios. The rate of hydramnios, in fact, was higher in the mothers with non-malarious placentas. Mothers with malarious placentas were younger (means 24) than mothers with non-malarious placentas (means 29). Mothers with fewer pregnancies were more likely to have malarious placentas than older multiparous mothers. There were 7 stillbirths, 4 from mothers with malarious placentas. Infants born to mothers with malarious placentas averaged 100 g less than those from mothers with non-malarious placentas. This study shows that mothers with falciparum malaria from the Ubangi district deliver normal and apparently unaffected infants. PMID- 3515794 TI - Collagen immunotyping of the hepatic fibrosis in human alveolar echinococcosis. AB - An extremely dense fibrosis is responsible for the main complications of alveolar echinococcosis (AE), a severe parasitic disease due to the development in the liver of a larval form of the cestode Echinococcus multilocularis. Immunotyping of collagens present in fibrous, granulomatous, and normal areas of the liver was performed in nine patients with AE. Immunofluorescent labelling of collagen types showed that dense fibrosis was entirely composed of thick bundles of type I and type III collagens, surrounding old parasitic vesicles with an autofluorescent laminated layer. In granulomatous areas, collagens were labelled as clusters consisting mainly of type III procollagen and collagen. Concentric bundles of type III collagen surrounded active parasitic vesicles. An enhancement of the normal labelling in portal spaces of the intact liver was present in all the patients. These results suggest that irreversible acellular keloid scar-like fibrosis observed in AE is the ultimate result of cytotoxic and fibrogenetic events related to the immune response of the host which are taking place initially in the granulomatous area surrounding the young parasite larvae. PMID- 3515795 TI - [Fungus-induced spondylitis]. AB - Candida caused osteomyelitis of the spine is a rare entity. In the literature are only 15 cases reported. An own case of Candida-osteomyelitis of the spine is demonstrated and a overview of the literature is given. PMID- 3515796 TI - ELISA detection of influenza haemagglutinin depends on its molecular environment. AB - Two ELISA techniques (indirect and sandwich) were used for detection of influenza HA in three HA-containing specimens: whole influenza virus, HA + NA, isolated HA. Adsorptive and antigenic properties of the HA were found to depend on its physicochemical state and molecular environment. PMID- 3515797 TI - Influenza in the elderly: report of an outbreak and a review of vaccine effectiveness reports. AB - An outbreak of influenza A in nursing home residents is reported and other studies of influenza vaccine effectiveness in elderly populations are reviewed. The outbreak occurred in a Los Angeles nursing home between February and March 1983. Of the 87 residents, 46 (53%) were affected with influenza-like illness. Attack rates were similar between immunized and unimmunized residents (52% versus 58%), and yielded a vaccine effectiveness estimate of 10%. No additional protection could be demonstrated in residents who received vaccine for two consecutive years. Seven persons died (mortality rate of 8.1%); the mortality rate was greater in the unimmunized (15.8%) than in the immunized (6.2%). Because this study and other field studies of influenza vaccine are limited in precision and power, a statistical summary of the various studies was constructed. Summarizing the studies of institutionalized elderly (in hospitals and nursing and retirement homes) yielded an estimate of 74% for the average vaccine effectiveness in mortality reduction, and an estimate of 33% for the average effectiveness in preventing clinical illness. For the non-institutionalized elderly, the corresponding estimates were 47% for mortality, and 5% for clinical illness. Despite the obvious limitations of such summaries, it seems reasonable to conclude that influenza vaccines have on the average been of clear benefit in the institutionalized elderly, while the benefits in the non-institutionalized elderly have been less dramatic and may warrant further investigation. PMID- 3515798 TI - [Cerebrovascular insufficiency: what does early diagnosis contribute to surgical therapy?]. PMID- 3515799 TI - [In vitro prostaglandin I2 synthesis in normal and pathologically-changed human leg veins]. PMID- 3515800 TI - [Ultrasonic dopplerography (USDG) in the diagnosis of diseases of the vessels of the lower extremities]. PMID- 3515801 TI - [A case of generalized herpes zoster in a patient with reticulosarcomatosis]. PMID- 3515803 TI - [Kidney sonography in childhood in chronic recurring pyelonephritis without a urinary transport disorder]. AB - 201 children with healthy kidneys and 61 patients of the paediatric nephrological dispensary with chronically relapsing pyelonephritis without disturbance of the transport of urine were examined sonographically. With the help of an atrophy score was controlled, whether the summation of unspecific parameters is in connection with the length of the kidney. A correlation of the introduced point system with the size of the kidney could be proved. The atrophy score represented shall facilitate the sonographic control of the course of non-obstructive parenchymatous renal diseases. PMID- 3515802 TI - [Antibiotic treatment of perforated appendicitis in childhood--a prospective study]. AB - A prospective randomised study (I) was carried out on 130 children undergoing laparotomy for perforated appendicitis. The present study evaluates the therapeutic effectiveness of different antibiotic regimens in modifying the rate of post-operative complications (intraabdominal abscess, ileus, wound infiltration or abscess). During the first year of this study two treatment groups were used. Group A consisted of 29 children treated with Sulfometrol/Trimethoprim; the rate of postoperative complications was 44.8%. Group B consisted of 36 children treated with mezlocillin, the rate of complications being 13.8%. However, the same treatment with mezlocillin during the second year of the prospective study showed an increase of this rte to 39% (28 children--group C). The final group of 37 children was treated during the second year with mezlocillin and metronidazole (group D). The postoperative rate of complications was 10.8%. A retrospective analysis of further 80 children (study II) with perforated appendicitis treated with mezlocillin and metronidazole showed a consistent low rate of postoperative complications at 10.2%. In 6.8% of children studied, an operative intervention was necessary (four cases of ileus, four wound abscesses). The mean postoperative hospitalisation period decreased from 22.7 days in group A to 15.2 days in group D and finally to 14 days in study II. The present study shows that an effective and persistent attenuation of the rate of postoperative complications after perforated appendicitis in children depends on an early onset of therapy and on the appropriate choice of antibiotic drugs that are effective against aerobic and anaerobic microorganisms. PMID- 3515804 TI - [Bartter syndrome and pseudo-Bartter syndrome--a case report]. AB - One patient with Bartter-syndrome and two patients with pseudo-Bartter-syndrome in abuse of laxatives and diuretics, respectively, were examined clinically and biochemically. The causes of the severe disturbances of the electrolyte metabolism are demonstrated. The differential diagnosis between Bartter- and pseudo-Bartter-syndrome is discussed, exact investigations of electrolyte balance of intake and output are decisive. In consequent therapy with prostaglandin inhibitors (indomethacin), aldosterone antagonists (verospirone) and oral electrolyte supply the prognosis of the Bartter-syndrome is favourable. Little successful is the treatment of the pseudo-Bartter-syndrome. On account of the severe psychic disturbance of the personality a renunciation of laxatives and diuretics, respectively, is frequently not to be achieved. PMID- 3515805 TI - [Status of treatment and results in femur shaft fractures in the adult]. AB - Surgical stabilisation by unambiguous principles of indication is the major purpose of the treatment of femur fractures in adults. An analysis of effectiveness is under discussion regarding various methods of osteosynthesis and their applicability to different types of cases. A comprehensive account is given in this study of methods chosen for and results of femur fracture treatment of more than 4,240 cases in 73 hospitals and wards throughout the GDR. Osteosynthesis accounts for 77 per cent of all approaches. This study, therefore, is confined to evaluation of surgical methods. The need for differentiated approaches is underlined by the results so far achieved. Particular emphasis is laid on the fact that in 85 per cent of all cases good results were obtained by intermedullary nailing. PMID- 3515806 TI - [In memory of the academician Evgenii Mikhailovich Kreps]. PMID- 3515808 TI - [Contribution of the scientists of the 1st institute in the world in advanced training of physicians to the development of trends in preventive medicine in Russia in the prerevolutionary period (on the centenary of the founding of the Leningrad S. M. Kirov State Order of Lenin Institute of Physician Advanced Training)]. PMID- 3515807 TI - [Specificity of the cleavage of peptide regulators from nonspecialized protein precursors]. PMID- 3515809 TI - [A nonuniform sequential procedure for diagnosing Staphylococcus aureus]. AB - The possibility of the sharp differentiation of S. aureus in the nonuniform successive statistical identification procedure with the use of signs ranked by their differential information content. The procedure starting from the signs with greater information content permits the identification of S. aureus in 100% of cases. PMID- 3515810 TI - [Effect of interferon type I on the in vivo persistence of Salmonella typhimurium]. AB - The influence of type I interferon on the persistence of S. typhimurium in the body of mice has been studied. The injection of the preparation of interferon has been shown to be conductive to the survival of the animals and to reduce the time of Salmonella persistence in the body. The injection of interferon enhances the phagocytic activity of macrophages in the peritoneal exudate of mice. PMID- 3515811 TI - [Mechanism of the metabolic death of Escherichia coli B cells following freezing and thawing]. AB - The state of E. coli B genome after low-temperature freezing and subsequent thawing (F--T) has been studied. The study has shown that in the process of F--T the DNA of the cells remains intact. But after thawing the incubation of the cells at 37 degrees C leads to the accumulation of ruptures in their DNA and its low-molecular decomposition products. At the same time the processes of the synthesis of DNA and proteins are suppressed to a considerable extent. Repeated F -T cycles enhance, on one hand, the inhibition of the processes of synthesis and, on the other hand, the activation of DNA metabolic decomposition. Such unbalance of the competitive enzymatic systems governing the synthesis and decomposition of DNA, which appears in the process of the revival of the cell from anabiosis, leads supposedly to the accumulation of ruptures and "gaps" in its DNA and, as a result, to the fragmentation of the genome and the death of the cell. PMID- 3515812 TI - [Basic results of a committee trial of the new vaccine Grippovac SE-AZh]. AB - In the trial of the trivalent subunit influenza vaccine Grippovac CE-AK observations on children aged 3-6 years were made. The preparation showed insignificant reactogenicity and moderate antigenic potency. The trial established that at the period of the epidemic rise of influenza B morbidity the vaccine showed, according to the data of the clinical diagnosis of influenza, insignificant effectiveness, its index of effectiveness (IE) being 1.08; according to the data of the serological diagnosis of influenza, only the A (H1N1) component of the vaccine was found to have IE equal to 1.58. PMID- 3515813 TI - [Heterogeneity and variability of Vibrio cholerae eltor populations and their role in the development of epidemic processes]. PMID- 3515814 TI - [Toxic shock syndrome]. PMID- 3515815 TI - [Determination of the value of spectrum analysis of the Doppler signal in the assessment of the carotid artery bifurcation]. AB - A prospective trial was set up in 100 patients, who underwent arteriography of the cerebropetal and cerebral arteries, to determine the value of the direct examination of the Carotid arteries using a continuous wave bidirectionnal Doppler with spectrum frequency analysis. The results of this non-invasive direct technique are compared with the biplane arteriography and with the indirect noninvasive oculoplethysmography (OPG-Gee). The conclusions of this study are that the direct Doppler examination with spectrum frequency-analysis is a very good tool in detecting lesions in the Carotid arteries, and is superior to the indirect OPG-Gee examination, especially in stenoses of 30-69%. PMID- 3515816 TI - Epithelioid hemangioendothelioma of soft tissue. Fine needle aspiration cytology, histology, electron microscopy and immunohistochemistry of a case. AB - Epithelioid hemangioendothelioma is an unusual vascular tumor with a borderline biologic behavior that usually involves the soft tissue of the extremities of adults. Such a neoplasm studied by fine needle aspiration (FNA) cytology, histology, electron microscopy (EM) and immunohistochemistry in a 45-year-old woman is reported. The needle aspirate readily showed the characteristic epithelioid endothelial cells with eosinophilic cytoplasm, prominent cytoplasmic vacuolization and intranuclear cytoplasmic inclusions seen in the histologic preparations, indicating the possible contribution of FNA cytology to the recognition of this neoplasm. The EM and immunohistochemical studies proved the endothelial nature of the epithelioid-appearing cells comprising the tumor. PMID- 3515817 TI - Short-term effects of oestradiol and 4-hydroxyoestradiol on gonadotrophin releasing hormone induced luteinizing hormone secretion by rat pituitary cells in culture. AB - Dispersed pituitary cells from adult female rats were preincubated for different time periods (0-12 h) in the absence or presence of 10(-9)M oestradiol (E2) or 4 hydroxyoestradiol (4-OHE2). Then the media were changed and the cells incubated for 4 h with either vehicle, or E2, or 4-OHE2 and additionally with different concentrations (10(-11)-10(-7) M) of gonadotrophin-releasing hormone (GnRH). Treatment of pituitary cells with E2 for 4 h (i.e. no preincubation with E2) significantly decreased the LH-response to GnRH at concentrations greater than or equal to 10(-10) M of the decapeptide. During a transition time of approximately 10 h (i.e. in cultures preincubated with E2 or vehicle for 2, 4, 6 or 8 h and then coincubated with E2 or vehicle and GnRH for 4 h) no differences between E2- and vehicle-treated cultures were observed. After 14 and 16 h of E2-treatment (i.e. 10 or 12 h preincubation and 4 h coincubation with GnRH) the LH-responses to GnRH in these cultures were significantly higher than in the respective controls. A nearly identical reaction pattern was observed when 4-OHE2 was used instead of E2. In a second series of experiments dispersed rat pituitary cells were suspended in a carrier gel and continuously perifused with medium, using small chromatography columns. When these cells were exposed for 4 min to 10(-9) M GnRH at 60 or 48 min intervals, they reacted with reproducible pulsatile LH discharges during at least 6 subsequent stimuli with the decapeptide.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3515818 TI - Effects of pregnancy hormones on pancreatic islets in organ culture. AB - Pregnancy is associated with hyperinsulinaemia and decreased glucose tolerance which may lead to gestational diabetes. Sera from pregnant women in the last trimester were found to stimulate insulin secretion of mouse pancreatic islets maintained in organ culture suggesting a direct effect of pregnancy hormones and/or metabolites on the endocrine pancreas. Previous studies have shown that progesterone and human placental lactogen (hPL) had direct effects on isolated islets and in the present study the effects of combined addition of these hormones to the cultured islets were evaluated. hPL, 1 microgram/ml was found to prevent the decrease in the islet insulin content due to progesterone 100 ng/ml, and hPL induced an increase in the DNA-content compared with the progesterone treated islets. The effect of the hormones on the DNA synthesis was evaluated by incorporation of [3H]thymidine into newborn rat islets. Progesterone in a high concentration, 1 microgram/ml, inhibited while 0.1 and 1 microgram/ml hPL stimulated the [3H]thymidine incorporation. These results indicate that progesterone may contribute to the increased glucose-induced insulin release during pregnancy and hPL to the beta-cell hyperplasia. Since progesterone and hPL counteracted each other with regard to both insulin content and DNA-synthesis in the islets, the direct interaction between these two hormones on the beta-cell may be of importance for the changes in glucose metabolism during pregnancy. PMID- 3515819 TI - Early diagnosis of 11 beta-hydroxylase deficiency in two siblings confirmed by analysis of a novel steroid metabolite in newborn urine. AB - Plasma and urinary steroid measurements are reported in 2 normotensive newborn female siblings with virilized external genitalia due to 11 beta-hydroxylase deficiency. Plasma 11-deoxycortisol concentrations were markedly elevated whereas 17OH-progesterone concentrations were not raised. Plasma renin activity was suppressed, but increased to levels characteristic of infancy within 4 weeks of treatment. The enzyme defect was confirmed by measurement of increased urinary excretion of tetrahydro-11-deoxycortisol. A more polar steroid metabolite, 6 alpha-hydroxytetrahydro-11-deoxycortisol was also determined by gas chromatographic and mass spectrometric analysis. Analysis of metabolites in urine is an additional specific marker to plasma 11-deoxycortisol measurement for the diagnosis of 11 beta-hydroxylase deficiency in early infancy. PMID- 3515820 TI - Ovarian multifollicularity, high LH and androgen plasma levels, and anovulation are frequent and strongly linked in adolescent irregular cycles. AB - Ninety-seven adolescents (0.5-6.0 years in gynaecological age) suffering from various kinds of menstrual irregularities were studied and compared with 20 adults by performing ovarian ultrasonography and plasma hormonal determinations. High percentages of multifollicularity (57.7%) and enlarged ovaries (46.3%) were found in the entire group of adolescents. Adolescents with multifollicular ovaries (more than 4 cystic areas) showed higher percentages of luteinizing hormone (LH: 32%), testosterone (T: 34%), and androstenedione (A: 43%) levels exceeding the upper normal adult range than subjects with homogeneous (less than 4 cystic areas) ovaries (LH: 12%, T: 10%, A: 19%, respectively). Ovulation can further discriminate the adolescents: in fact, adolescents with homogeneous ovaries and ovulatory cycles have a hormonal pattern almost identical to that of adults. On the contrary, subjects with multifollicular ovaries and anovulatory cycles show low values of follicle-stimulating hormone (FSH) and high values of LH, T and A, significantly different from those in ovulatory subjects with homogeneous ovaries (P less than 0.005) and from those in adults (P less than 0.005). PMID- 3515821 TI - Ranitidine and prevention of pulmonary aspiration syndrome. AB - Thirty-seven patients undergoing elective abdominal surgery (excluding gastric operations) received either ranitidine 300 mg or placebo orally at 10 p.m. in the evening preceding surgery in a double-blind randomised study. The mean time interval between this oral premedication and induction of anaesthesia was 12 h. When compared to placebo, ranitidine decreased significantly (P less than 0.05) the amount of gastric juice, and none of the ranitidine-treated patients had an increased risk of acid pulmonary aspiration (pH below 2.5 and volume over 25 ml), while four patients in the control group had an increased risk (21%). The mean ranitidine blood level was 237 ng/ml at the time of induction of anaesthesia. It is concluded that in elective abdominal surgery ranitidine included in the premedication is likely to decrease the risk for acid pulmonary aspiration. PMID- 3515822 TI - Estimation of central venous pressure by measurement of proximal axillary venous pressure using a "half-way" catheter. AB - The pressure in the proximal axillary vein (AVP) was compared with central venous pressure (CVP) in eight patients during and after elective abdominal surgery. Both pressures were recorded from soft, elastic, polyurethane catheters inserted in the basilic or cephalic veins ("half-way" catheters), punctured at the fossa cubiti (AVP), and via the right jugular vein (CVP). The AVP and CVP were recorded simultaneously using hydrostatic, conventional disposable venous pressure measurement sets. The measurements were performed during intermittent positive pressure ventilation with positive end-expiratory pressure from 0 to 7.5 cmH2O (0 0.74 kPa), as well as during spontaneous breathing. During both controlled and spontaneous respiration, small mean differences (0.2-1.0 cmH2O) (0.02-0.1 kPa), and a highly significant (P less than 0.001) positive correlation between CVP- and AVP-values were found. An increase of 1 cmH2O (0.10 kPa) in the CVP was associated with an increment of practically identical order (0.99-1.04 cmH2O) (0.10-0.11 kPa) in the AVP. The results suggest that monitoring of the AVP by a basilic "half-way" catheter produces diagnostic information similar to that from the measurement of the CVP from subclavian, external or internal jugular, as well as "long-way" brachial catheter, with no risk of the major mechanical complications which accompany the use of the latter catheters. PMID- 3515823 TI - Effects of dobutamine on renal function in normal man. AB - The effects of graded doses of dobutamine on renal function were studied in eight male volunteers. The infusion rates were 2.5, 5 and 10 micrograms/kg/min. Systolic blood pressure increased by 19% (P less than 0.01), 31% (P less than 0.01), and 44% (P less than 0.01), respectively, while diastolic blood pressure decreased by 17% (P less than 0.02), 17% (P less than 0.02) and 25% (P less than 0.01), respectively. Heart rate increased at the highest dosage by 32% (P less than 0.01). Glomerular filtration rate (GFR) diminished at all three infusion speeds by 10% (P less than 0.02), 9% (P less than 0.05) and 14% (P less than 0.02), respectively, while renal blood flow (RBF) was unchanged. Urine flow rate (UF) decreased by 36% (P less than 0.05) and fractional free water clearance (CH2O/CIn) diminished by 37% (P less than 0.05) at the rate of 10 micrograms/kg/min. Fractional potassium excretion (CK/CIn) decreased by 34% (P less than 0.01) and 44% (P less than 0.01) at the two highest rates. Fractional sodium excretion (CNa/CIn) and fractional chloride excretion (CCl/CIn) were unchanged. Catecholamine levels were unaltered. Plasma renin activity (PRA) rose significantly (P less than 0.05) at the highest infusion rate of dobutamine. It is concluded that dobutamine influences GFR, the clinical significance of which, however, is difficult to evaluate. PMID- 3515824 TI - Peripheral airway pressure during high frequency ventilation. AB - Peripheral airway pressure (Pp) was measured during high frequency ventilation (HFV) (open system) (1-20 Hz) by retrograde catheters in eight excised dog lungs. Central airway pressure (Pc) and pleural pressure (Ppl) were measured simultaneously. We found a significant increase in peripheral end-expiratory pressure at frequencies 5 Hz and higher, when the minute ventilation was increased. Mean Pc and mean Pp remained unchanged during ventilation at different frequencies with constant minute ventilation, although tidal volume decreased. With increasing tidal volume Pc, Pp, and Ppl (mean) increased at all frequencies. The increase in end-expiratory pressure indicates an "auto-PEEP" effect, which may contribute to the better gas exchange described during HFV. PMID- 3515825 TI - Regenerative capacity of transplanted cardiac muscle in the rat. AB - The authors analyzed the regenerative ability of cardiac muscle in the rat. Normal cardiac muscle was minced into mm3 fragments and homotransplanted into a triceps surae complex cavity of a nonsibling rat. Subsequent histological examination of the cardiac regenerate revealed the presence of myofibers. These myofibers typically exhibited centrally located nuclei, a characteristic of normal cardiac muscle. However, the absence of intercalated discs and autonomous contractility prevented indentification of these fibers as cardiac. PMID- 3515826 TI - Do C cells of the thyroid gland of the baboon contain estrogen receptors? AB - The uptake and retention of radiolabelled estradiol was studied in the thyroid gland of the female baboon. Four baboons were injected intravenously with 1 micron/kg body weight of 3H-estradiol. One animal, which served as a control, received an additional injection of 100 micrograms/kg body weight of unlabelled hormone. One hour after the injections, the animals were killed and the thyroid glands removed and processed for either autoradiography or autoradiography in combination with immunocytochemical staining for C cells. Localization of estradiol was observed in the nuclei of interstitial cells, but not in those of the follicular cells. Nuclei of immunostained calcitonin-containing cells in both the walls of the follicles and the interfollicular compartment were not radiolabelled. This study suggests that estrogen does not regulate calcitonin secretion by the C cells of the thyroid via a classical receptor system. PMID- 3515827 TI - Immunoglobulin producing cells in nervous system diseases. PMID- 3515828 TI - S-antigen-like immunoreactivity in a human pineocytoma. AB - A pineocytoma was investigated by means of immunocytochemistry with the use of a polyclonal antibody against bovine retinal S-antigen. Several cells of this tumor displayed strong S-antigen-like immunoreaction in analogy to certain pinealocytes in normal human pineal organs. This study indicates that S-antigen immunocytochemistry may be applied to characterize tumors of the pineal region. PMID- 3515829 TI - Monstrocellular heavily lipidized malignant glioma. AB - A man of 32 years was admitted with a 3-month history of temporal lobe epilepsy. CT-Scan showed a well-circumscribed area of heterogenous contrast enhancement in the right temporal lobe. Gross total resection was performed but the tumor recurred: the patient died 6 months after the onset of symptoms. There was no autopsy. Histology revealed a highly pleomorphic neoplasm with extensive zones of necrosis. Monster cells, up to several hundred micrometers in diameter, with multiple and/or multi-lobed nuclei were numerous and showed emperipolesis for polymorphonuclear, mononuclear, and small tumor cells. Abundant mitoses were observed. Tumor cells of all sizes had ground-glass or vacuolated cytoplasm which obscured their glial nature. GFAP was demonstrated in some neoplastic cells. Reticulin fibers were confined to perivascular areas where mononuclear inflammatory cells were sometimes noted. Vascular proliferation was mild. Electromicroscopic study revealed that the cytoplasms of the tumor cells contained abundant lipid droplets, numerous mitochondria, and glio-filaments. Such a tumor has been reported recently as "malignant glioma with heavily lipidized tumor cells". This rare entity, previously reported as xanthosarcoma of the brain, represents a subgroup of primitive monstrocellular cerebral tumors. PMID- 3515831 TI - Serial ultrastructural study of experimental Creutzfeldt-Jacob disease in guinea pigs. AB - Guinea pigs inoculated with brain homogenate from serially passaged Creutzfeldt Jakob disease (CJD) were killed biweekly starting at week 2 until terminal illness (about 200 days following inoculation). A mild swelling of postsynaptic dendrites and an increase in the number of glial filaments in astrocytic processes was seen at week 4, followed by increased swelling and lucency of axons and dendrites by week 6 post inoculation (p.i.). Severe undulation and focal interruptions of synaptic membranes were also observed both at weeks 4 and 6. By week 8, one could see cystically dilated cellular processes. These sometimes showed continuity with adjacent swollen processes through focally disrupted plasma membranes, and most likely represent a progressive enlargement of vacuoles through fusion and subsequent addition of adjoining processes. The spongiform changes increased mildly between week 8 and week 10 and remained essentially the same in subsequent weeks. After week 24 there was a sharp increase in both the number and size of vacuoles. At week 24 severe structural alterations were present both in the neurons and astrocytes, and numerous intranuclear inclusions were demonstrated in many neuronal nuclei. This study shows that morphological changes in the brain occur considerably earlier than the clinical manifestations of the disease. In the early phase of the disease, there were significant alterations on the dendrites and synapses. PMID- 3515830 TI - Cytoskeletal properties and endogenous degradation of glial fibrillary acidic protein and vimentin in cultured human glioma cells. AB - The cytoskeletal properties and endogenous degradation of intermediate filaments in cultured human glioma cells (U-251MG) were studied using monoclonal antibodies in immunohistochemical and immunochemical methods. Both glial fibrillary acidic protein (GFAP)- and vimentin-antibodies gave a fibrillar cytoplasmic staining of the cells, and double immunofluorescence experiments showed the presence of both types of intermediate filaments in the same cells. GFAP and vimentin could also be located to typical coiling perinuclear bundles after vinblastine treatment of the cultures. In the detergent-resistant, adherent cytoskeletons of the glioma cells, both GFAP and vimentin persisted as fibrillar cytoplasmic arrays. Scanning and transmission electron microscopy showed that only intermediate filaments were left in the cytoplasmic domain. Electrophoretic analysis, combined with the immunoblotting method, revealed that the two major detergent-resistant cytoskeletal polypeptides of the cells, with molecular weights of 51 kD and 58 kD, were GFAP and vimentin, respectively. On the other hand, neither GFAP nor vimentin were detected in the detergent extracts of the glioma cells. Detergent extraction in low ionic strength medium as well as inclusion of Ca2+ into the extraction medium resulted into a rapid degradation of both GFAP and vimentin. These degradation conditions produced different, partially soluble, lower MW immunoreactive polypeptides as detected by the immunoblotting technique. Interestingly, the degradation also produced soluble intact GFAP and vimentin. These results indicate that GFAP and vimentin have closely similar physicochemical properties in the cytoskeletons of human glioma cells including a nearly quantitative localization in filaments, rearrangement upon microtubule disruption, and resistance to extractions by detergents. Proteolytic degradation of both proteins can be induced by a protease activated by both low ionic strength and Ca2+. PMID- 3515832 TI - Immunohistochemical recognition of human neuroepithelial tumors by anti-Leu 7 (HNK-1) monoclonal antibody. AB - The immunoreactivity of the anti-Leu 7 (HNK-1) monoclonal antibody, a marker for natural killer cells, was evaluated with the peroxidase-anti-peroxidase (PAP) method on sections of human paraffin-embedded tissues from 135 tumors of the central nervous system and five esthesioneuroblastomas. As shown independently by others, the antibody was found to react with most types of neoplastic neuroepithelial cells. Our findings indicate that the reaction is most often localized on the cytoplasmic membranes. The immunoreactive cell membranes were generally those of well-differentiated tumor cells and of neoplastic cells found in tumors that usually were not embryonal in nature. Parallel immunostaining either of the same or of successive sections with an anti-glial fibrillary acidic protein serum was of considerable assistance in discriminating between different immunoreactive cells, e.g., between astrocytes and cells presumed to be oligodendrocytes. Despite its cross-recognition of cells of various histogenesis, the anti-Leu 7 monoclonal antibody can, in well-defined circumstances, elucidate specific differential diagnostic problems involving neurogenic neoplasms that cannot be resolved with routine staining techniques. PMID- 3515833 TI - Similarities between the Forssman carotid syndrome and experimental allergic encephalomyelitis. AB - The Forssman carotid syndrome was induced in guinea pigs to study the mechanism of demyelination-like lesions in this animal model and to compare it with experimental allergic encephalomyelitis days after intracarotid injection of rabbit anti-Forssman antibody and chronic lesions at 7-21 days post injection, using routine histological, immunofluorescent, and electron-microscopic techniques. The results were compared to those in a group of guinea pigs with acute or chronic lesions of EAE. The picture was remarkably similar in the two conditions, in regard to localization in the central nervous system (CNS), composition of cellular infiltrates, diameter of lesions produced, myelin loss and axonal degeneration, together with gamma globulin deposition in small vessels in affected areas. The differences were that in the Forssman carotid syndrome, in contrast to EAE, there were no mononuclear cell infiltrates in the acute phase, and no evidence of macrophages invading myelin sheaths was detected. Perivascular lesions consisted of demyelination within infiltrates of mono-nuclear cell in chronic relapsing EAE, but not in the Forssman carotid syndrome. It is suggested that investigation of the CNS may be of benefit in the pathogenetic study of demyelinating disease. PMID- 3515834 TI - Vasoactive intestinal polypeptide-like immunoreactive nerves to the human eye. AB - Using immunohistochemical techniques, vasoactive intestinal polypeptide (VIP) is visualized in nerves distributed to the human eye. Immunoreactive nerve fibers occur about limbal blood vessels and within the trabecular meshwork. In the iris, free-running stromal nerves are the most common, but nerves to both dilator and sphincter muscles are present as well. Immunoreactive nerves are seen within the ciliary muscle and occasionally within a ciliary process. Innervation to choroidal blood vessels constitutes a prominent feature; innervation to more anterior uveal blood vessels is seen only irregularly. Immunoreactive to more anterior uveal blood vessels is seen only irregularly. Immunoreactive nerves are apposed to melanocytes throughout the uvea. The present findings extend prior reports in the human eye, indicating a potential role for VIP in ocular physiology. Additional neuroanatomical, biochemical and physiological studies are necessary to define fully the ocular function of VIP and to determine ultimely whether VIP has clinical and pharmacological implications. PMID- 3515835 TI - Neuron-specific enolase in retinoblastoma. An immunohistochemical study. AB - Forty-six retinoblastoma specimens were studied for the presence of neuron specific enolase (NSE) in the tumour cells and in the remaining morphologically normal retina. The laboratory method was a sensitive immunohistochemical peroxidase staining procedure, and normal ocular nerves were used as positive controls. Neuron-specific enolase was found in perikarya and cell processes in all layers of morphologically normal appearing neuroretina, but not in Muller's cells. All but two of the retinoblastomata studied contained positively staining tumour cells, whereas stromal cells remained constantly negative. Many Flexner Wintersteiner rosettes stained positively as well. The proportion of retinoblastoma cells expressing neuron-specific enolase seemed to be greater in small tumours, in bilateral cases, and in tumours that contained rosettes. The presence of neuron-specific enolase in tumour cells seems to favour a neuronal or neuroectodermal origin for retinoblastoma, but it should be noted that this marker has recently been found in several non-neuronal and non-neuroectodermal malignant neoplasms. PMID- 3515836 TI - Corneal transplantation using long-term cultured donor material. AB - Twenty-seven corneal transplantations with a mean duration of donor incubation of 14.3 days (group 1) and 36 transplantations with a mean duration of incubation of 29.8 days (group 2) were followed for 18 months. No significant difference was found in graft survival between the two groups (81 versus 80%). Almost all graft failures were found among pre-operatively defined high-risk cases, i.e. previously transplanted and/or vascularized recipient cornea. The profile of the corneal thickness curve was almost identical in the two groups, and normal values were reached in both. Visual acuity was 0.5 or better in 23% of the cases in group 1, and 35% in group 2. These figures were highly influenced by co-existing and complicating eye disease i.e. amblyopia, cataract, macular degeneration and glaucoma. The results show that 2 weeks and 4 weeks cultured cornea do not differ with respect to graft survival and thickness. The over all results indicate that long-term cultured donor material is suitable for corneal transplantation and fully comparable to material stored by other methods. PMID- 3515837 TI - Osteogenesis promoted by bone matrix combined with marrow. Titanium implants studied in rats. AB - We evaluated the bone-forming potential of isogeneic bone marrow combined with antigen-extracted, autolyzed allogeneic bone matrix (AAA bone a.m. Urist). The purpose of the experiment was to evaluate bone-inducing materials for application in orthopaedic devices designed for fixation by bone ingrowth into a porous surface. The bone-forming materials were packed into tubes of porous fiber titanium and placed in the back musculature of rats for 12 or 25 days. At 12 days the combination of bone marrow and AAA bone had produced more bone than marrow only. At 25 days, however, there was no difference. The bone-inducing materials produced substantial amounts of new bone, and may become an adjuvant for achieving fixation by bone ingrowth. In particular, a combination of AAA bone and marrow might enhance fixation at a very early postoperative stage. PMID- 3515838 TI - Fibrin sealant in bone transplantation. No effects on blood flow and bone formation in dogs. AB - To study bone formation and regional blood flow following the use of fibrin sealant in autologous cancellous bone transplantation, a dog model was developed. In 18 dogs, a standardized defect in both tibiae was filled with an autologous iliac crest graft. On one side, the bone chips were mixed with fibrin sealant while the other side served as control. After 1, 2 and 3 weeks the blood flow of the transplant was calculated and the new bone formed evaluated histomorphometrically. Generally, the highest blood flow rates and most intensive new bone formation were observed at 2 weeks postoperatively. Fibrin sealant did not alter blood flow or new bone formation, but a tendency to diminished new bone formation was found in some grafts. Our study does not support the application of fibrin sealant in ordinary cancellous bone grafting. PMID- 3515839 TI - Dimensions of the horizontal semicircular duct, ampulla and utricle in rat and guinea pig. AB - The dimensions of the membranous labyrinth partly determine the mechanical operation of the semicircular canal system. This study provides, for the first time, extensive measures in individual specimens of the sizes, cross-sectional shapes and areas of the horizontal semicircular duct, ampulla and utricle in the rat and the guinea pig. The membranous labyrinths were fixed in Karnovsky's fixative, exposed, photographed, sectioned, oriented perpendicular to the line of sight and then measured using a calibrated graticule in the eye piece of an operating microscope. As well as the expected size differences between these species, there are major differences in the shape of the utricle. PMID- 3515840 TI - Malignant histiocytosis (histiocytic sarcoma). A (the?) major cause of the 'midline granuloma syndrome'. AB - Five out of eight consecutive cases with initial symptoms of a 'midline granuloma' were identified as malignant histiocytosis (histiocytic sarcoma) which within 5 months to 4 years led to generalization and death. The three remaining cases also fulfilled the morphological criteria of this type of neoplasia, though these patients are still alive 1/2 to 8 years after diagnosis, possibly as a result of local radiotherapy. The age of the individuals ranged from 18 to 71 years and there was a male preponderance of 7:1. The histiocytic nature of the atypical cells was primarily documented by intense activity of NaF-inhibitable non-specific esterase, of acid phosphatase and of beta-glucuronidase as demonstrated in cryostat sections of formaldehyde-saccharose-fixed fresh biopsy specimens and by the detection of alpha-1-antichymotrypsin, alpha-1-antitrypsin, and lysozyme antigens, in that order of constancy (immunohistochemical examination of formaldehyde-fixed paraffin sections, using the avidin-biotin peroxidase complex method). There was among the reported cases a considerable heterogeneity with regard to these 'markers'. We conclude that malignant histiocytosis is a (the?) major cause of the 'midline granuloma syndrome'. PMID- 3515841 TI - Tumor differentiation and tumor-host interactions as prognostic determinants in squamous cell carcinoma of the lip. AB - A series of 70 patients with the squamous cell carcinoma of the lip and followed up for at least 5 years, was assessed on light microscopy and using histochemical staining for ANAE (acid-naphthyl acetate esterase) to demonstrate the morphological manifestations of tumor-host reactivity. The factors analysed include cancer differentiation (intrinsic malignancy) and stromal reactions (intensity of the immunocompetent cell infiltrate including the mast cells and the subpopulations, i.e. B- or T lymphocytes or mononuclear phagocytes). Differentiation of the lip cancer was shown to be directly (although not statistically significantly) related to the 5-year survival, as was also the intensity of the stromal immunocompetent cell infiltration. Cancer metastases were evidently the most powerful prognostic determinants, their development being influenced both by the intensity of the stromal immunocompetent cell infiltrate and cancer differentiation. B lymphocytes far outnumbered the T and MPS cells in all the infiltrates studied, the percentages of the latter two cell types, however, being inversely related to the intensity of the infiltrate. The cell composition in the infiltrates was seemingly without effect on the frequency of metastases and the 5-year survival, as was the stromal mast cell reaction, too. It was concluded that analysis of tumor-host relationships using a variety of morphological and immunohistochemical techniques may be of benefit in predicting the clinical course of lip cancer. PMID- 3515842 TI - The early postnatal development of the cochlear vasculature in the gerbil. AB - The blood vessels of the cochlea were studied from birth up to adult age in the gerbil. Even at birth the principal vascular arrangement could be identified in the external wall. However, the early circulatory mainstream appeared even more predominantly radial apico-basal over radiating arterioles-arteriovenous anastomoses-collecting venules than at later stages. At birth, only small sections of capillaries could be observed in the stria vascularis. Stria vascularis achieved its adult vascular appearance rapidly between 8-10 days after birth (DAB). The rapid development of stria vascularis immediately preceded the development of cochlear function and may have been related to the development of the ionic composition of endolymph. At birth the vessel of the basilar membrane showed many large vascular connections with the collecting venules in the scala tympani of the external wall but very few supplying and draining ramifications on the medial side of the vessel. This suggests that the vessel of the basilar membrane originates from the external wall vessels, not from the spiral lamina vessels as has previously been supposed. The peripheral vascular connections degenerated rapidly after birth. The vessel, being very large at birth, degenerated completely by 15 to 20 DAB, ultimately disappearing in the basal turn. The degeneration suggests that its major importance may be during embryonic stages, with great probability for the development of the organ of Corti. PMID- 3515843 TI - Mumps IgA antibodies are not absorbed from human milk. AB - We measured mumps virus specific IgA antibodies in the sera of preterm infants after a feeding period on human milk rich in such antibodies. In full-term infants the possibility of absorption was determined from the content of these antibodies in the child's mother's milk, an umbilical cord blood sample and a later serum sample. No absorption of IgA antibodies was found. PMID- 3515844 TI - The functional residual capacity of infants with respiratory distress syndrome. AB - Positive end-expiratory pressure (PEEP) is used in the treatment of infants with respiratory distress syndrome (RDS) to prevent atelectasis, recruit alveolar space and return the functional residual capacity (FRC) toward normal volumes. This study determined the FRC range of 15 prematurely born infants with RDS receiving PEEP. Ventilator settings were controlled clinically using predominantly results of arterial blood-gas analyses. Measurements of arterial blood-gases and FRC (N2 washout) were made during the infants' second day of life. The FRC of the infants on a PEEP of 4.5 +/- 1.3 cmH2O ranged widely from 3 to 33 ml/kg with a mean of 14.5 ml/kg; 17 +/- 2 ml/kg was considered normal. The FRC was within one SD of the mean in only three of the 15 infants (20%) and outside of two SD of normal in seven (47%). A linear regression of calculated alveolar-arterial oxygen gradient (AaDo2) with FRC yielded a correlation coefficient r = 0.825. The AaDo2 values could be used to identify six of the seven infants having FRC outside of 2SD from normal. We conclude that convential methods of PEEP selection for infants with RDS seldom result in a normalization of FRC. Calculated AaDo2 values may be used to identify most RDS infants with FRC widely divergent from normal values. PMID- 3515845 TI - Ultrasound imaging in diffuse thyroid disorders of children. AB - The diagnosis of diffuse thyroid disorders in children is based mainly on hormone and antibody determinations and a cytologic sample taken by aspiration biopsy. The cytologic sample is not always obtainable in small children or when the thyroid gland is not enlarged. Thyroid antibodies lead to diagnosis only in a proportion of cases. Gamma imaging is not recommended in children because of the radiation risk. The aim of this study was to demonstrate that ultrasound imaging can detect diffuse thyroid disorders in children. Ultrasound images were abnormal in 92% of all subjects; they were abnormal in 97% of cases with thyroiditis and in most cases ultrasound was diagnostic. With antibody determinations, only 60% of the cases of thyroiditis could be diagnosed. Ultrasound imaging--a risk-free method--should be included in the diagnostic investigation of thyroid disorders. PMID- 3515846 TI - Mammary carcinoma: DNA analysis in areas showing different histological features in the same tumor. AB - Specimens from 17 invasive primary breast adenocarcinomas that showed distinct areas of different histologic appearance were examined with respects to nuclear DNA content of the tumor cells. DNA in individual tumor cells was measured in sections from the original paraffin-embedded specimens. DNA distribution patterns obtained from the histologically different areas in the same tumor were compared. In 15 cases these patterns were very similar, whereas in two cases the patterns were found to be different. The results suggest that, in spite of histological variations, breast carcinoma often show similar nuclear DNA content throughout the entire tumor. Since nuclear DNA content in breast tumors has been shown to be correlated to prognosis, our observations suggest that the differences in structural pattern occasionally seen in mammary adenocarcinoma do not necessarily reflect a dedifferentiation towards more malignant tumor populations. PMID- 3515847 TI - Immunohistochemical reactivity of monoclonal antibodies to human milk fat globule with breast carcinoma and with other normal and neoplastic tissues. AB - The immunohistochemical reactivity of three monoclonal antibodies, generated against human milk fat globule membranes (HMFG), were studied using peroxidase conjugated secondary antibody or avidin-biotin-peroxidase complex method. Two of the antibodies, III E 8 and III H 2 showed rather broad reactivity, staining all mammary, ovarian, endometrial, cervical and bronchial adenocarcinomas. They also stained all pancreatic adenocarcinomas but only 30% of the carcinomas of the colon. Reaction with prostatic and renal adenocarcinomas varied. No reaction was seen with squamous or transitional cell carcinomas. Antibody III D 5, which previously has been shown to recognize an estrogen receptor activation associated antigen in mammary carcinomas, stained 60% of mammary or gynecological adenocarcinomas. This antibody had a more limited reactivity with other tissues as well, as all intestinal carcinomas were negative. It stained all bronchial adenocarcinomas, however, and 50% of the prostatic carcinomas. The three monoclonal antibodies, although not specific, show a more restricted reactivity than the so far described HMFG antibodies and they may therefore be of value in histopathological diagnosis. PMID- 3515848 TI - Transient supersensitivity in the hypertrophied rat urinary bladder. AB - The presence of a paraffin bolus intravesically for 1 or 4 weeks was accompanied by an approximate three-fold increase in bladder weight. A supersensitivity to methacholine was demonstrated in these hypertrophied bladders at 1 week but not at 4 weeks. At the earlier time of observation, the contractile responses in vitro to nerve stimulation were reduced, while at the later time of observation the responses were the same as those of controls; the atropine-sensitive fraction of the response was entirely responsible for the recovery. The concentration of choline acetyltransferase, indicating cholinergic nerve density and initially reduced by about 50%, rose in course of time. It is suggested that in the beginning of the experimental period, the muscle cells of the hypertrophied bladders in situ are exposed to 'subnormal' transmitter concentration. An extension of the field of innervation of the cholinergic nerves may explain the disappearance of the supersensitivity. PMID- 3515849 TI - Disuse as cause of supersensitivity in the rat urinary bladder. AB - Ureterostomia in situ was performed to reduce the nervous reflex activation of the bladders without concomitant hypertrophy. In muscle strips of these disused and non-hypertrophied bladders, supersensitivity to methacholine was demonstrated, which did not increase between 1 and 3 weeks. The supersensitivity did not increase further by combining urinary diversion with section of the preganglionic bladder nerves (decentralization). From the present results it may be concluded that in decentralized and hypertrophied bladders not only hypertrophy per se, previously studied (Ekstrom et al. 1985), but also loss of nerve impulse traffic (cf. urinary diversion) contribute to the development of supersensitivity. PMID- 3515850 TI - Immunological characterization of plasminogen activators in human mixed saliva. AB - In mixed saliva obtained from six healthy volunteers, the plasminogen activators were characterized immunologically using antibodies specific for human tissue plasminogen activator and urokinase, which were raised in goats immunized with low molecular weight urokinase and tissue-type activator from melanoma cells. The fibrinolytic activity in mixed saliva upon stimulation was assayed on fibrin plates containing plasminogen after preincubation with immunoglobulins with and without specific antibodies. In both centrifuged and uncentrifuged saliva, antibodies against tissue plasminogen activator completely quenched the fibrinolytic activity. By contrast, antibodies against urokinase had no suppressive effect, neither did non-immunized goat serum influence the fibrinolytic activity in mixed saliva. In conclusion, during physiological conditions tissue plasminogen activator appears to regulate fibrinolytic activity in mixed saliva, in which no activity of urokinase-like plasminogen activators could be demonstrated. PMID- 3515851 TI - Psychological etiology in cardiovascular disorders. Basic findings and new trends. AB - Five theories advocate the existence of psychogenic factors in the etiology of cardiovascular diseases. The first of these theories involves a behavioral pattern. Pattern A is predictive of cardiovascular diseases and their risk factors. The second of these theories implies three personality patterns: IRA (Impulsiveness, Repression, Aggressiveness), HHD (Hypochondriasis, Hysteria, Depression) and SAD (Stress, Anxiety, Depression). IRA discriminates significantly people with cardiovascular diseases from healthy subjects. IRA-like patterns account for some 60% of the variance. HHD discriminates to some degree people who show thrombopenia as a reaction to stress. Cardiovascular patients stereotype their defenses and seem to cluster in two subamples: 66% of them repress their aggressiveness and 34% use opposite defense mechanisms. SAD is a reliable predictor; stressful events constitute a risk factor, mainly in anxious or depressed and hostile subjects. PMID- 3515852 TI - Enkephalin analogue in schizophrenia. Double blind cross-over trial. AB - In a double blind, cross-over study 10 chronic schizophrenic patients with productive symptoms in spite of neuroleptic treatment received the methionine enkephalin analogue FK 33-824 2 mg i.m. daily for 7 consecutive days. Ratings performed by the Brief Psychiatric Rating Scale did not show any significant differences between FK 33-824 and the active placebo pentobarbital. The clinical condition of one patient worsened during and after the administration of FK 33 824. It is suggested that this might be due to a dopamine stimulating effect. The discrepancy between the findings of the present and a previous open study is discussed. The present study does not support the hypothesis of dysfunction of the endorphin system in schizophrenia. PMID- 3515853 TI - Low dose urography with a low osmolar contrast medium. AB - In a double blind study of 100 consecutive patients routinely referred for urography, a conventional contrast medium (Isopaque cerebral) was compared at a dose of 180 mg I/kg body weight with a low osmolar contrast medium (Hexabrix 160) at a dose of 90 mg I/kg body weight. In spite of 50 per cent dose reduction, equally good diagnostic effect was achieved with Hexabrix as with the conventional contrast medium. PMID- 3515854 TI - The course of bronchopulmonary dysplasia. A radiographic follow-up. AB - Forty-one low weight premature infants treated with intermittent positive pressure ventilation in infancy were followed clinically and with chest radiography for 4 to 6 years. One child died during the period (sudden infantile death) and 2 others were not available for follow-up examination. The abnormal chest pattern of bronchopulmonary dysplasia (BPD) resolved completely or improved during the period; residual changes were found in 34 per cent of the cases. The main part of the resolution occurred during the first 2 years. Mild BPD was more prone to heal. The persisting parenchymal changes--interstitial fibrosis or areas of hyperinflation or both--were generally slight. The frequency of infection of the lower respiratory tract was increased during the first 2 years of life and was positively correlated to the severity of the pulmonary abnormalities. The frequency of infection dramatically decreased during the subsequent 2 years. PMID- 3515855 TI - Ultrasonic assessment of abdominal venous return. II. Volume blood flow in the inferior vena cava and portal vein. AB - Eighty-five patients subjected to routine heart catheterization, were examined with duplex scanning of the inferior vena cava and portal vein. Volume blood flow in the two veins was estimated and compared with Fick measured cardiac output and duplex measured flow in the lower thoracic aorta. Inferior vena caval and portal vein flow were found to comprise approximately 30 to 40 per cent and 20 per cent, respectively, of cardiac output, but with a large dispersion of individual percentages. A high correlation (r = 0.88) was found between the sum of inferior vena caval and portal vein flow and duplex measured flow in the lower thoracic aorta, the sum of flow in the two veins comprising approximately 90 per cent of lower thoracic aortic flow. It is concluded that duplex scanning seems to be a useful method in estimating volume blood flow in both the inferior vena cava and portal vein. PMID- 3515856 TI - Suprarenal haematoma versus neuroblastoma complicated by haemorrhage. A diagnostic dilemma in the newborn. AB - Concomitant neonatal suprarenal haemorrhage and neuroblastoma is rare. The clinical and radiologic manifestations recorded in 11 patients with this entity are compared with the findings in 32 cases with simple adrenal haemorrhage. Because of the many similarities in presentation the combined lesion must always be considered when a neonate is found to have a retroperitoneal, extra-renal mass. Our present approach to the investigation includes conventional chest and abdominal radiography aimed to demonstrate possible paravertebral widening. Serial ultrasonographies are easy to carry out and indispensable. The low specificity of urography makes us refrain from this modality as a routine. Scintigraphy, in infants and children considered useful in demonstrating extent and spread of neuroblastoma, has hardly been employed in neonates. The true value of the modality in this particular age group remains to be settled. CT scanning does not seem to provide essential information additional to that of sonography and may therefore be excluded from the protocol. Determination of urinary excretion of catecholamine metabolites is of crucial significance and a compulsory part of the investigation. PMID- 3515857 TI - Prospective investigation of radiologic methods in the diagnosis of intra abdominal abscesses. AB - A prospective investigation of conventional abdominal radiography, ultrasonography, computed tomography and 111In-labelled leucocyte scintigraphy was performed in 40 patients suspected of having an intra-abdominal abscess. There were 23 confirmed abscesses in the material. When conventional abdominal radiography indicated an abscess, such a lesion was usually present. The ability of abdominal radiography to exclude an abscess was, however, low. Both ultrasonography and 111In-labelled leucocyte scintigraphy detected 65 to 85 per cent of the confirmed abscesses, but both also revealed many abscess-like areas in patients where no unequivocal abscess was confirmed at follow-up. Computed tomography was, when employed as a single method, the most reliable one both to show and to exclude an abscess, However, the combination of ultrasonography and 111In-labelled leucocyte scintigraphy disclosed all the lesions demonstrated by any one of the four methods used in the investigation. PMID- 3515858 TI - Fallopian tube patency demonstrated at ultrasonography. AB - Fallopian tube patency was assessed in 24 infertile patients by hysterosalpingography (HSG) and ultrasonographic examination of the pouch of Douglas following transcervical injection of a sterile isotonic solution of NaCl. The presence of fluid in the pouch, after the injection, was taken to indicate tubal patency. The results of the HSG and the ultrasonographic diagnosis as to the presence of at least unilateral tubal patency were concordant in 21 patients. Pitfalls consisted of fluid accumulation in periadnexal adhesions, edema in the bowel wall, and spill of the injected saline into a large hydrosalpinx. Ultrasonography is advocated as the initial examination in assessing infertility in young women. If tubal patency is demonstrated, the patient should be recommended a six month trial period, to become pregnant, before invasive procedures are initiated. PMID- 3515859 TI - The validity of radiographic assessment of childhood transient synovitis of the hip. AB - The diagnostic significance of some radiographic signs (abnormal hip 'joint space' and periarticular fat layers) as indicators of hip joint effusion or hip complaints without effusion was studied with ultrasonography and radiography in 47 children (58 examinations), of whom 40 had acute unilateral transient synovitis. It was found that 'joint depth' was not influenced by presence of intra-articular fluid collections; blurring and/or displacement of the periarticular fat pads medial and lateral to the hip joint occurred more frequently when joint effusion was present than in symptom-free hips or in painful hips without effusion. The radiographic signs provided, however, too low diagnostic accuracy to be of practical value. It is suggested that ultrasonography of the hip joint is a valuable means in obtaining a better definition of the diagnosis transient synovitis. PMID- 3515860 TI - Ultrasound examination of skin thickness in patients with progressive systemic sclerosis (scleroderma). AB - A new ultrasound technique for measuring skin thickness in 40 patients with progressive systemic sclerosis (scleroderma) and in 10 healthy control subjects has been evaluated. High frequency (10 MHz) dynamic ultrasound examination was performed at the proximal and middle phalanges of both second fingers. Measurements of the control subjects on two separate occasions demonstrated a good reproducibility of the technique with a standard deviation of 0.06 mm. The skin was thicker in patients with scleroderma 3.3 +/- 0.7 mm (mean +/- SD) compared with control subjects 2.5 +/- 0.2 mm (p less than 0.001). No relation between skin thickness and duration of disease was observed. This method can be used to monitor changes in skin thickness over time. PMID- 3515861 TI - Sound velocity in the middle phalanges of the human hand. AB - Determination of the velocity of ultrasound seems a promising way of monitoring diffuse bone mineral disease. Measurements have been made on 13 healthy adults, 3 healthy children, and 17 patients submitted to haemodialysis. The mean ultrasound velocity in the middle phalanges of the hand was found to be 2403 m/s in the normal adults, 2109 m/s in the children, and 2360 m/s in the haemodialysis group. One person had known halisteresis and had a velocity significantly lower than in the normal group. The method is fast and harmless and might be used in screening procedures or at follow-up examinations in patients at risk. However, a prerequisite for this is further investigation of the normal relationships of velocity to age and to actual bone mineral content. PMID- 3515862 TI - [Study of plasma aldosterone in patients on chronic hemodialysis]. PMID- 3515863 TI - Serotonin-containing nerve fibers in the rat spinal cord: electron microscopic immunohistochemistry. AB - The ultrastructure of the serotonin (5HT) system in the spinal cord of rats was studied by an immunohistochemical peroxidase-antiperoxidase (PAP) method. Under the light microscope, 5HT immunoreactive staining was observed as brown-colored dots in the anterior horn, lateral horn, posterior horn and pericentral canal region. These positively staining dots were probably indicative of 5HT immunoreactive varicosities and nerve terminals. At the ultrastructural level, 5HT immunoreactive nerve fibers appeared as darkly stained varicosities with PAP positive large electron dense vesicles (80-100 nm), as well as small clear vesicles (30-40 nm) finely coated with PAP immunoreactive products. In the anterior horn, some of the 5HT immunoreactive structures were clearly nerve terminals forming asymmetric synaptic contact with soma or dendrites of the anterior horn cells. In the lateral horn, posterior horn and pericentral canal region, however, only 5HT positive varicosities were detected. PMID- 3515864 TI - The effects of acebutolol and metoprolol on walking distances and distal blood pressure in hypertensive patients with intermittent claudication. AB - The effects of acebutolol (with intrinsic sympathomimetic activity (ISA] and metoprolol (without ISA) on arm blood pressure, ankle systolic blood pressure, claudication distances (CD) and maximal walking distances (MWD) were compared in patients with essential hypertension and intermittent claudication. Fourteen patients participated in a long-term, open, randomized cross-over study. After randomization the patients received either acebutolol, 200 mg b.i.d., or metoprolol, 100 mg b.i.d. After eight weeks the drugs were shifted and after another eight weeks they were withdrawn. Arm and ankle blood pressure, CD and MWD were determined before randomization and after 4, 8, 12 and 16 weeks, and again 4 6 weeks after withdrawal of the drugs. The arm blood pressure was reduced by 20/13 mmHg after acebutolol and by 22/21 mmHg after metoprolol. In spite of a significant decrease in arm blood pressure there were no significant changes in ankle blood pressure, CD or MWD after the two drugs. After withdrawal of the drugs and after the arm blood pressure had returned to the control value no significant changes were seen in CD, MWD or ankle blood pressure. It is concluded that beta-blockers have no deleterious effect on CD, MWD or ankle blood pressure in patients with hypertension and intermittent claudication. No effect of ISA was demonstrated. PMID- 3515865 TI - Glipizide does not affect absorption of glucose and xylose in diabetics without residual beta-cell function. AB - We have previously demonstrated that oral glipizide suppresses the absorption of xylose in diabetics treated with diet alone. We suggested that glipizide might influence postprandial glucose levels by interfering with absorptive mechanisms. In the present study we have extended our observations to insulin-dependent diabetics (IDDM). Nine non-obese diabetics without residual beta-cell function and with normal respiratory sinus arrhythmia and Valsalva ratio were studied on two occasions. Their ordinary insulin treatment was discontinued 24 hours before the study and glucose control was maintained by i.v. insulin infusion. The experiments began at 8 a.m. after an overnight fast. Insulin was given as a continuous i.v. infusion of 0.01 U/kg/h at 8-11 a.m. and 0.005 U/kg/h at 11 a.m. 2 p.m. At 8 a.m. the patients ingested 25 g of xylose and 15 g of glucose in 300 ml of water. Glipizide (5 mg) or placebo were given 30 min prior to the glucose xylose load in random order, each patient serving as his own control. Blood samples were taken every 60 min for analysis of glucose, xylose, C-peptide and glipizide. The rise in blood glucose in the control experiment was similar to that previously seen in non-insulin-dependent diabetics (NIDDM) given the same xylose-glucose load. Glipizide did not exert any effects on either blood C peptide, glucose or xylose levels. We conclude that oral glipizide administered in a therapeutic dose does not reduce xylose absorption in IDDM, in contrast to its previously demonstrated effect in NIDDM. PMID- 3515866 TI - Insulin secretion in alcoholics in a withdrawal state. AB - Insulin secretion was studied after stimulation with oral glucose and intravenous glucagon in 23 chronic alcoholics in a withdrawal state. Each subject was studied twice at one week's interval between the examinations. The insulin and C-peptide responses to glucagon were lower in the early withdrawal state. Moreover, the insulin and C-peptide increments were, when related to the magnitude of the glycemic stimulus, lower in the early than in the late withdrawal state. The fasting values of blood glucose, insulin and C-peptide and the blood glucose and C-peptide levels after oral glucose were higher in the early withdrawal state. These findings indicate that glucose metabolism in alcoholics in a withdrawal state can be disturbed by impaired insulin secretion and insulin resistance. PMID- 3515867 TI - Molecular genetics of human B cell neoplasia. PMID- 3515868 TI - Maternally transmitted antigen. PMID- 3515869 TI - Phagocytosis of particulate activators of the alternative complement pathway: effects of fibronectin. PMID- 3515870 TI - In vivo inhibition of plasma protein leakage and Salmonella enteritidis-induced mortality in the rat by a specific paf-acether antagonist: BN 52021. AB - The effects of BN 52021, a new specific paf-acether receptor antagonist and the total Ginkgo Biloba extract (GBE 761) from which this product was isolated, were studied in the rat on paf-acether-induced permeability and cell number changes and on endotoxin-induced lethality. Their activities were compared to those of cyclooxygenase, 5-lipoxygenase and phospholipase A2 inhibitors. BN 52021 given s.c. or orally exerted a dose-related inhibition of paf-acether deleterious effects as well as of endotoxin lethality whereas the other drugs tested were poorly effective. These results strongly suggest paf-acether involvement in endotoxic and septic shock. PMID- 3515871 TI - [Current knowledge on the etiology of plastic induration of the penis (Peyronie's disease). Treatment possibilities]. PMID- 3515872 TI - Diuretic scintigraphy in diagnosis and treatment of urinary tract obstruction. PMID- 3515873 TI - Primary malignant melanoma of female urethra: report of a case and review of the literature. AB - We report herein one case of malignant melanoma with a survival period of more than four years, refer to its recent conception on histopathological and ultrastructural problems and its treatment, and review the literature. PMID- 3515874 TI - [A case of multilocular renal cyst with calcification]. AB - A 55-year-old woman was incidentally found to have a calcified right renal mass on ultrasonography. A plain film of the abdomen revealed a 3.5 X 4.4 cm, curvilinear calcification in the midportion of the right kidney, and an excretory urogram showed no compression or distortion of the pelvocalyceal system. Computed tomography demonstrated a low density renal mass associated with both peripheral and central calcification. Renal arteriogram revealed a hypovascular mass. Right nephrectomy was performed and the multilocular renal cyst with calcification was confirmed histologically. In the Japanese literature, 53 cases of multilocular renal cyst have been reported, but calcification of the multilocular renal cyst seems to be the first as far as we know. PMID- 3515875 TI - Sonography of diffuse benign liver disease: accuracy of pattern recognition and grading. AB - Sonograms of 110 patients were compared to recently performed liver biopsies for evaluation of the accuracy of sonography in predicting the type (pattern) of pathology and its grade of severity (mild, moderate, or severe) in a wide variety of diffuse liver processes. There are two distinct, abnormal sonographic patterns: the fatty-fibrotic pattern seen primarily with cirrhosis, chronic hepatitis, and/or fatty infiltration, and the centrilobular pattern seen primarily with acute hepatitis. Sonography was 88% accurate in assigning the correct pattern to the corresponding pathology (sensitivity 89%, specificity 86%, p less than 0.001). The degree of accuracy was dependent on the grade of pathologic severity, with mild disease offering the greatest difficulty; moderate and severe diseases were accurately detected and placed in the correct pattern in all cases. Sonographic grading of the severity of disease was far less precise (63% overall). This study showed that sonography can distinguish between two abnormal sonographic patterns of diffuse benign liver disease as well as between normal and abnormal patterns. PMID- 3515876 TI - Prepancreatic fat deposition: a possible pitfall in pancreatic sonography. PMID- 3515877 TI - Transrectal pelvic abscess drainage with sonographic guidance. PMID- 3515878 TI - Sonographic characterization of carotid plaque: detection of hemorrhage. AB - By careful evaluation of the sonographic characteristics of carotid plaques, two patterns can be identified: a homogeneous pattern containing uniform echoes corresponding to dense fibrous tissue and a heterogeneous pattern containing mixed echoes and anechoic areas that represent intraplaque hemorrhage pathologically. A prospective study was conducted of 50 patients to determine the accuracy of identifying these different forms of plaque. The patients' carotid arteries were examined by a high-resolution duplex scanner before carotid endarterectomy. The plaques were evaluated carefully by vascular surgeons and pathologists for the presence of intraplaque hemorrhage. In this study, the accuracy of identifying the presence or absence of intraplaque hemorrhage with sonography was 90% (48 of 54); sensitivity, 94% (17 of 18); and specificity, 88% (27 of 31). High-resolution sonography appears to be an accurate means of identifying intraplaque hemorrhage and may ultimately be useful in identifying patients at risk for embolic disease. PMID- 3515879 TI - Peritrigonal echogenic "blush" on cranial sonography: pathologic correlates. AB - Cranial sonography in neonates almost always reveals a hyperechoic "blush" just posterior and superior to the ventricular trigones on parasagittal views. This normal increased echogenicity resembles fine brush strokes. It is probably caused by the interface of numerous parallel fibers that are nearly perpendicular to the longitudinal axis of a sonographic beam passing through the anterior fontanelle. The same echogenicity is not seen on sonograms obtained through the posterior fontanelle because with that angulation the long axis of the sonographic beam and the fiber tracts are nearly parallel. Sonographic-pathologic correlation in 28 autopsy cases showed that abnormal, dense, globular, coarse, peritrigonal echogenicity was due to periventricular leukomalacia with hemorrhage. Cases with nonhemorrhagic periventricular leukomalacia or perinatal telencephalic leukoencephalopathy demonstrated the normal peritrigonal hyperechogenicity. PMID- 3515880 TI - Abdominal case of the day. PMID- 3515881 TI - The gestational sac and HCG levels. PMID- 3515882 TI - Overview of MR of the heart--1986. AB - Experience in the first few years of using MR for evaluation of cardiovascular disease indicates that it can provide information about cardiovascular anatomy, cardiovascular function, myocardial tissue characterization, and myocardial metabolism. Only the first capability is now being used for clinical diagnosis. MR imaging is evolving as a technique for the definitive diagnosis of pericardial disease, paracardiac and intracardiac masses, and thoracic aortic disease. It also shows considerable promise for the evaluation of congenital and ischemic heart disease and cardiomyopathies. The capabilities of MR displayed in animal studies extend beyond anatomic observations. Considerably more research and optimism for early progress are justified in the effort to harness its multiple capabilities for the evaluation of cardiovascular disease. PMID- 3515883 TI - Thoracic aortic rupture: advantages of intraarterial digital subtraction angiography. AB - Sixty-one consecutive patients with blunt thoracic trauma underwent intraarterial digital subtraction angiography (IA-DSA) of the thoracic aorta because of obscuration of the aortic knob or mediastinal widening on chest radiographs. Ten of these patients had aortic ruptures diagnosed by IA-DSA. Digital subtraction aortography proved 100% accurate as indicated by results of surgery, conventional arteriography, serial chest radiography, and clinical follow-up. The method was 50% faster compared with conventional aortography and saved significantly on film costs. The potential for use of smaller caliber catheters and a decrease in contrast requirements also make this method safer than conventional arteriography. We recommend IA-DSA as the procedure of choice when emergency aortography is warranted. PMID- 3515884 TI - Effects of age on respiratory tract immunity in guinea pigs. AB - This study examined cell-mediated immune responses of aged guinea pigs following intranasal sensitization with Bacillus Calmette Guerin (BCG). Young adult and aged guinea pigs, one and three years old, respectively, were inoculated intranasally with BCG. Changes in lung cell profile, production of migration inhibition factor (MIF) by lung derived lymphocytes and development of delayed hypersensitivity-skin (DHS) reaction to purified protein derivative (PPD) were evaluated at various time intervals. Normal lung lavage cell profiles were similar in both groups. Significant increases in total lung lavage cells occurred in both groups at 2 and 6 weeks following sensitization and corresponded with significant increases in the number of macrophages. The young adult group had significant increases in the total number of lymphocytes and rosette forming cells at 6 weeks compared to their preimmunization levels. Production of MIF was significantly greater in magnitude in the young adult group at 2 weeks compared to aged groups. The total number of animals mounting immune responses to BCG (MIF production) was also significantly lower in the aged group over the 6 week study period. DHS reaction to PPD was positive in all young adult animals, while only half of the aged guinea pigs were positive at 6 weeks. Data suggest that age adversely affects lung resistance to infection from intracellular microbial agents of the respiratory tract. PMID- 3515885 TI - An unusual case of hyper-production of IgE, treated by plasmapheresis. AB - A 15-year-old boy with severe inflammatory skin lesions from an early age was found to have extremely elevated serum IgE levels (up to 376.000 IU/ml). His skin showed positive direct immunofluorescence for IgE and he had peripheral and bone marrow eosinophilia. No evidence for atopic disease was found, but he suffered intestinal helminthic infection of moderate intensity. He showed a somewhat depressed cell mediated immune response but a normal polymorphonuclear function. Various treatments that included anti-inflammatory, anti-allergic, anti parasitic, anti-mycotic and PUVA therapy did not significantly improve his condition A therapeutic test using plasmapheresis produced marked, though short lived clinical improvement. We believe that this case might result from the superimposition of the stimulatory effects of intestinal helminthiasis on a background of intrinsic hyper-production of IgE. PMID- 3515886 TI - [Detection of IgE specific for egg yolk by enzyme immunoassay. Description of a case]. AB - Food allergy is a common disease in our country, especially affecting atopic children. Egg-white hypersensitivity is frequently found in these patients. However, egg-yolk hypersensitivity is not usually reported in patients with egg allergy. This article describes a young patient with egg-yolk hypersensitivity, a 12 year old female patient with a medical history of contact urticaria, angioedema and severe acute bronchospasm shortly after the intake of small amounts of egg-yolk. All these episodes required treatment in emergency care units because of the severity of the symptoms. The patient did not describe any other food hypersensitivity and remained symptom-free after the intake of boiled or fried egg-white. She had clinical symptoms of grass pollen hypersensitivity and was therefore on specific immunotherapy at the time of the study. The skin prick-tests were positive to grass pollen and egg-yolk and were negative to mites, moulds, animal dander and to the common food tested (milk, fish, peanut, almond and hazel-nut). Total serum IgE was 1.160 UL/ml. The patient had a positive RAST to egg-white (0.0 PRU/ml) as well as to egg-yolk (8.6 PRU/ml). Furthermore, an indirect enzyme immunoassay as well as a reverse enzyme immunoassay also revealed the presence of specific IgE antibodies. The reverse enzyme immunoassay uses microtiter plates as a solid surface. These plates are coated with a monospecific antihuman IgE antibody. Thereafter, the serum samples are incubated overnight in the wells. After several washings, the presence of specific antibodies is revealed by means of a peroxidase conjugated allergen.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3515887 TI - Carotid surgery in stroke prevention. AB - Extracranial carotid disease accounts for up to 50 percent of strokes. Transient ischemic attacks are associated with a 30 to 35 percent risk of stroke within five years of the initial episode. Carotid endarterectomy is a safe and effective way of reducing the risk of stroke in patients with TIAs. It is also helpful in patients with amaurosis fugax, and may benefit selected patients with acute stroke or those with asymptomatic but hemodynamically significant stenosis. PMID- 3515888 TI - Answers to questions about breast cancer. PMID- 3515889 TI - Pulsed Doppler patterns of left atrial flow in mitral regurgitation. AB - A prospective pulsed Doppler study of 55 patients was undertaken to detect and quantitate mitral regurgitation. Systolic left atrial flow dispersion indicated mitral regurgitation. Doppler study was feasible in nearly 95% of patients. Sensitivity, specificity and predictive accuracy were 89%, 84% and 88%, respectively. Three methods were used to quantitate mitral regurgitation: (1) maximal depth level of systolic left atrial flow, (2) left atrial flow patterns immediately behind the mitral valve closure line (I, protosystolic; II, gradual decrease in intensity of left atrial flow signal throughout systole; and III, broad flow dispersion occupying all systole); and (3) a score system that combined these 2 methods. Results showed that flow patterns behind the mitral valve closure line correlate with angiographic assessment of mitral regurgitation. This provided the simplest and most practical method of determining the severity of mitral regurgitation. PMID- 3515890 TI - Detection and evaluation of tricuspid regurgitation using a real-time, two dimensional, color-coded, Doppler flow imaging system: comparison with contrast two-dimensional echocardiography and right ventriculography. AB - To detect and evaluate regurgitant flow in tricuspid regurgitation (TR) with a newly developed, realtime, 2-dimensional (2-D), color-coded, Doppler flow imaging system (Doppler 2-D echo), 27 patients (18 with suspected TR and 9 normal subjects) were examined and the findings were compared with those obtained using contrast 2-D echocardiography (contrast 2-D echo) and right ventriculography. In 16 of 18 patients with suspected TR, Doppler 2-D echo easily visualized the color coded regurgitant flow in the right atrium and estimated the severity of TR from the distance of the visible TR jet. On the basis of the QRS synchronized appearance of contrast in the inferior vena cava by the subxiphoid approach or of the negative contrast effect above the tricuspid valve just after the contrast entered the right ventricle with its subsequent back-and-forth movements across the tricuspid valve, Doppler 2-D echo was more sensitive and specific in detecting TR (100% and 100%) than contrast 2-D echo (75% and 82% in the subxiphoid view, 56% and 100% in the 4-chamber view) when the fast Fourier transformation frequency analysis was used as the standard of TR, and it was more sensitive in detecting TR (85%) than contrast 2-D echo (69% in the subxiphoid approach, 46% in the 4-chamber view) when right ventriculography was used as the standard of TR. Additionally, the severity of TR as shown by Doppler 2-D echo correlated fairly well with that shown by right ventriculography. Thus, Doppler 2 D echo is clinically useful for detecting and evaluating TR. PMID- 3515892 TI - More on Paul Dudly White, MD. PMID- 3515891 TI - Late thrombolysis: controlled clinical trial overdue. PMID- 3515893 TI - Coronary spasm as viewed by Wilson and Johnston in 1941. PMID- 3515894 TI - Wilhelm His, Sr.'s finding of Johann Sebastian Bach. PMID- 3515895 TI - Does placebo improve indexes of effort-induced myocardial ischemia? An objective study in 150 patients with chronic stable angina pectoris. AB - The effects of placebo were studied in 150 patients (135 men, 15 women) aged 42 to 75 years with stable exertional angina pectoris, using multistage graded exercise testing. Treadmill exercise, using on-line computer analysis of the electrocardiogram, was performed after a basal period, during which time the patients had no treatment for 2 weeks, and after 2 weeks of placebo therapy. Mean exercise time during no treatment was 6.0 +/- 0.2 minutes and during placebo was 6.1 +/- 0.2 minutes (difference not significant). Similarly, time to development of 1 mm of ST-segment depression of 4.0 +/- 0.2 minutes without treatment was 4.1 +/- 0.2 minutes after 2 weeks of placebo therapy (difference not significant). Placebo failed to show any effect on rest or maximal heart rate or on maximal ST segment depression. It also failed to increase exercise tolerance or to improve other objective indexes of effort-induced myocardial ischemia in both single-and double-blind protocols in patients with stable exertional angina pectoris. Therefore, placebo control of antianginal drug trials that use exercise testing for evaluation of effect is unnecessary and can be omitted. PMID- 3515896 TI - Effects of indomethacin on coronary hemodynamics, myocardial metabolism and anginal threshold in coronary artery disease. AB - The effects of orally administered indomethacin or placebo on coronary hemodynamics were studied in 23 patients with coronary artery disease. After indomethacin administration the systemic arterial pressure increased by 12 +/- 4% and the myocardial oxygen consumption by 24 +/- 11%. Coronary sinus flow did not change and coronary vascular resistance increased slightly. Oxygen saturation of the arterial blood did not change, but coronary sinus saturation decreased substantially. Hemodynamic values returned to normal 150 minutes after administration of indomethacin. During rapid atrial pacing, coronary sinus flow increased 79 +/- 14% above the rest value when pacing was done before indomethacin administration; only a 56 +/- 12% increase was seen when pacing was repeated after indomethacin. Peak heart rate achieved during atrial pacing, severity of angina and the degree of ST-segment depression were not altered by indomethacin treatment. Orally administered indomethacin has a mild coronary vasoconstrictive effect that does not interfere substantially with the expected increase in myocardial blood flow during rapid atrial pacing. Anginal threshold is not altered by orally administered indomethacin. PMID- 3515898 TI - Clinical electrophysiology, efficacy and safety of chronic oral cibenzoline therapy in refractory ventricular tachycardia. AB - The electrocardiographic (ECG) and electrophysiologic (EP) effects, clinical efficacy and safety of oral cibenzoline therapy were evaluated using a twice daily dosing regimen in patients with refractory ventricular tachycardia (VT). Twenty patients underwent EP studies in the control (drug-free) state and after cibenzoline therapy using an incremental dose-titration protocol. Oral cibenzoline (2.4 to 5.8 mg/kg/day) was administered in doses of 130, 160 or 190 mg at 12-hour intervals. ECG and EP variables, 24-hour ambulatory ECG monitoring and programmed electrical stimulation studies were obtained in the control state and after 11 +/- 4 days of cibenzoline therapy. Cibenzoline therapy prolonged the mean PR interval (from 179 +/- 29 to 201 +/- 36 ms, p less than 0.001), the mean QRS duration (from 107 +/- 21 to 130 +/- 25 ms, p less than 0.001), and the mean QTc interval (from 422 +/- 25 to 460 +/- 42 ms, p less than 0.001). It increased the mean HV interval (from 50 +/- 17 to 65 +/- 20 ms, p less than 0.01) and mean right ventricular effective refractory period (from 245 +/- 24 to 266 +/- 27 ms, p less than 0.01). After cibenzoline therapy, 5 patients (25%) had suppression of inducible sustained VT during programmed electrical stimulation. High-degree atrioventricular block occurred in 2 patients. Chronic cibenzoline therapy (mean follow-up 24 +/- 3 months) remained effective in long-term suppression of VT in 4 patients. Two patients had to discontinue therapy because of gastrointestinal intolerance. Cibenzoline is effective in suppression of refractory VT in selected patients using a twice-daily dosing schedule. PMID- 3515897 TI - Effectiveness of mevinolin on plasma lipoprotein concentrations in type II hyperlipoproteinemia. AB - Patients with low-density lipoprotein (LDL) concentrations in the top 10th percentile of the population (type II hyperlipoproteinemia [HLP]) are at increased risk for premature cardiovascular disease; however, the incidence of myocardial infarction and death can be decreased by LDL cholesterol reduction. Mevinolin, an inhibitor of endogenous cholesterol synthesis, has been shown to reduce LDL cholesterol concentrations in a subset of type II patients with heterozygous familial hypercholesterolemia (FH). Using a double-blind, randomized, crossover, placebo-controlled trial, the safety and efficacy of mevinolin were compared in 24 patients with type II HLP with heterozygous FH (n = 6) or without FH type II HLP (n = 18). Compared with placebo treatment, both apolipoprotein B and LDL cholesterol levels were reduced (p less than 0.01) in both FH and non-FH patients by 28 to 34% with mevinolin treatment. In addition, high-density lipoprotein cholesterol levels were significantly increased (p less than 0.001) in both patients with FH (16%) and those with non-FH type II HLP (14%). Patients had no serious or clinically significant adverse effects. Thus, mevinolin is a useful drug for treatment of most patients with elevated plasma LDL cholesterol concentrations. PMID- 3515899 TI - Atenolol plus nifedipine for mild to moderate systemic hypertension after fixed doses of either agent alone. AB - Three therapies were used to treat 35 patients with mild to moderate systemic hypertension: (1) the cardioselective beta-adrenoceptor blocker atenolol, (2) the calcium antagonist nifedipine and (3) combination therapy for those who failed to reach the target diastolic blood pressure (BP) of less than 90 mm Hg with monotherapy. After an initial run-in placebo period, when the mean supine diastolic BP was 102 +/- 1 mm Hg (mean +/- standard error of the mean), patients were randomized (double-blind) to atenolol, 100 mg as a single daily dose or nifedipine (slow-release form), 20 mg twice daily, then to a washout dummy placebo period before crossover. Each period lasted 4 weeks. Supine, erect and exercise BP were recorded. Atenolol and nifedipine, in the same fixed doses but in combination, were given to 20 patients in whom either supine or erect diastolic BP exceeded 90 mm Hg after the period of monotherapy. Atenolol monotherapy reduced the erect diastolic BP to less than 90 mm Hg in 14 patients (40%); of the remainder, 1 patient responded only to fixed-dose nifedipine and 11 to combination therapy, yielding a total success rate of 74%. The combination gave enhanced control, as shown by a further decrease in supine and erect BP and by better control of exercise BP; these effects were achieved without an increased incidence of adverse effects. The mean reductions in supine diastolic BP were: atenolol, 9 +/- 2 mm Hg; nifedipine, 6 +/- 2 mm Hg; and combination therapy, 16 +/- 2 mm Hg (p less than 0.05 vs atenolol or nifedipine).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3515900 TI - Intraaortic balloon pumping 1967 through 1982: analysis of complications in 733 patients. AB - Between June 1967 and December 1982, 872 attempts at intraaortic balloon pumping (IABP) were made in 733 patients. Nearly 75% of the patients were men; the proportion of women has increased in recent years. The principal indication for IABP support initially was cardiogenic shock, but over the years, preoperative support, weaning from cardiopulmonary bypass and unstable angina have become the primary indications. Complications of IABP were classified and distributed by severity (minor: I [15%] and II [26%]; major: III [3%] and IV [1%]) and type ([vascular [22%], infectious [22%], and bleeding [7%]). Vascular complication rates were higher in women (32 vs 18%; p = 0.0001), in diabetic patients (32 vs 20%, p = 0.003), and in hypertensive patients (27 vs 20%, p = 0.02). These did not vary with the duration of IABP support (range of duration 0 to 76 days). The rate of infectious complications was related to location where IABP was performed (coronary care unit 26%, operating room 12%). The rate of fever and bacteremia increased significantly with duration of IABP support, but the rate of local wound infection did not. In conclusion, most IABP complications are minor, resolve after balloon removal, are related to vascular status of the patient and, with the exception of bacteremia, are independent of IABP duration. PMID- 3515902 TI - Salvaging the ancient doctrine of cosmology as contribution to modern science. AB - Humours have been interpreted as biochemical processes: Hot = Oxidation, Cold = Reduction, Moist = Hydration, Dry = Dehydration. Germs have to be studied according to their enzymic make up with one, say Oxidases, as the most prominent. Likewise drugs must be classed as hindering or promoting the four detoxicating processes, mentioned above. PMID- 3515901 TI - Fish oil consumption and decreased risk of cardiovascular disease: a comparison of findings from animal and human feeding trials. AB - There is growing evidence that dietary n-3 polyunsaturated fatty acids (n-3 PUFAs), abundant in marine organisms, may reduce the development of cardiovascular disease. Because of this, results of laboratory animal and human volunteer feeding trials (using fatty fish, fish oils, or purified n-3 PUFAs) that have examined similar biochemical and metabolic parameters are compared. The limited data reveal that laboratory animal and human volunteers show many similar responses in certain parameters (ie, serum lipids, lipoproteins, trigacylglycerides, cholesterol, etc), to the consumption of n-3 PUFAs. The biochemical and metabolic changes observed are generally consistent with reduced development of cardiovascular disease. However, comparisons between species are limited because relatively few comparable feeding trials have focused on the effects of fish oils on thromboxane, prostacyclin, platelet aggregation, etc. Limitations of the studies and needed research are discussed. PMID- 3515903 TI - B.C.L. and immune response in mice. AB - The effects of Korean herbal medicine (B.C.L.) on some parameters of immunological response were studied in mice. B.C.L. pretreatment given either intraperitoneally or subcutaneously in a dose of 0.75 mg/mouse did not significantly inhibit lymphocyte transformation induced by concanavalin A. However, B.C.L. pretreatment in a dose of 2.25 mg/mouse was found to reduce significantly both the plaque-forming cells to sheep red blood cells immunisation as well as total spleen cell population. Thus, B.C.L. pretreatment with a higher dose (2.25 mg/mouse) can selectively depress the humoral immune response. It is unclear, however, whether this action is mediated by the parent compound or its metabolites. PMID- 3515904 TI - Escherichia coli empyema in the newborn. PMID- 3515905 TI - Jaundice secondary to hepatic artery aneurysm: radiological appearance and clinical features. AB - Hepatic artery aneurysm comprises only 20% of all visceral aneurysms. The classical triad of abdominal pain, hemobilia, and jaundice is seen in less than one-third of cases. Up to 60% of patients present with an abdominal catastrophe. In our case of hepatic artery aneurysm, the diagnosis was suggested by CT scan and confirmed by angiography. Its appearance is also demonstrated on sonogram and cholangiogram. To our knowledge, this is the first case to be reported where the aneurysm was demonstrated on multiple radiographic images. PMID- 3515906 TI - Growth retardation in children with chronic renal disease: scope of the problem. PMID- 3515907 TI - Renal osteodystrophy in children: the role of vitamin D, phosphorus, and parathyroid hormone. PMID- 3515908 TI - Protein metabolism in renal failure: abnormalities and possible mechanisms. AB - Currently, we have only fragmentary knowledge about alterations of protein metabolism in renal failure, yet several coherent strands appear to be emerging. CRF is, in part, a state of malnutrition, as evidenced by abnormalities of body composition and alterations of both plasma and intracellular amino acid patterns. Superimposed upon this baseline are abnormalities specific to renal disease, changes in the concentration of certain amino acids, and the buildup of nitrogenous wastes and potential metabolic toxins, and the interaction of these toxins with hormones or within metabolic pathways. In acute renal failure, or when intercurrent illness is added to CRF, there is an intensification of the metabolic derangements and an acceleration of the normal catabolic response. Current research is directed at improving protein anabolism by limiting total nitrogen intake, while at the same time, providing supplemental amino or keto acids to restore and maintain nutritional state. Other approaches involve the provision of alternate pathways for nitrogen disposal and by direct stimulation of nitrogen anabolism through the administration of branched-chain amino acids or their keto acid analogues. All would agree that these modifications must be performed on a background of adequate caloric intake and careful patient monitoring. Given the complex nature of the problem, careful prospective controlled studies will be necessary before any hypothesis can be accepted. It is likely that additional improvements will require both a better understanding of the underlying metabolic defects and, probably, the combined application of several of the ideas previously noted. PMID- 3515909 TI - Toxins and inhibitors in chronic renal failure. PMID- 3515910 TI - Nutritional requirements for infants with renal failure. PMID- 3515911 TI - Renal transplant immunity and immunosuppression. PMID- 3515912 TI - Neurologic complications of renal failure. PMID- 3515913 TI - Psychosocial development in children with chronic renal insufficiency. PMID- 3515914 TI - Collaborative studies and controlled clinical trials. PMID- 3515915 TI - Assessment of renal function. PMID- 3515916 TI - Children with renal disease: a commentary. PMID- 3515917 TI - Cotton dust contains proteolytic and elastolytic enzymes not inhibited by alpha-1 proteinase inhibitor. AB - Others have found proteolytic activity in cotton dust and correlated this with the prevalence of acute byssinosis. The present study characterized the proteases in aqueous extracts of cotton dust after controlling for potential artifact from microbial contamination. We tested cotton dust, generated in a model card room operated by the U.S. Department of Agriculture (USDA), for total proteolytic activity (hydrolysis of azocasein) and elastolytic activity (degradation of insoluble 3H-elastin). Both coarse dust and a respirable fraction (aerodynamic diameter less than or equal to 1.7 microgram) yielded proteolytic activity. Proteolysis was inhibited by EDTA (39%), diisopropylfluorophosphate (DFP) (33%) and alpha-1-proteinase inhibitor (alpha 1 PI) (30%), but not by iodoacetic acid or pepstatin. Elastolytic activity was also present, and was inhibited by DFP (80%) and alpha 1 PI (70%), but not by EDTA. We conclude that cotton dust contains preformed metallo- and serine proteases, and serine elastolytic protease(s) which are incompletely inhibited by alpha 1 PI. These findings may be relevant to the development of chronic lung disease in people exposed to cotton dust. PMID- 3515918 TI - Flurbiprofen versus naproxen in the treatment of rheumatoid arthritis. AB - The efficacy and safety of flurbiprofen (Ansaid, Upjohn), 100 mg twice daily, were compared with those of naproxen, 250 mg twice daily, in a six-week, double blind, randomized study involving 133 patients with rheumatoid arthritis. Patients completing the six-week treatment phase were then treated with flurbiprofen, 100 mg twice daily, during a six-week open-label phase. In the double-blind phase, both treatment groups showed improvement from baseline and, in general, the arthritic condition of all patients was significantly less severe while receiving treatment. In the open-label phase, the patients in whom therapy was switched from naproxen to flurbiprofen reported greater improvement compared with baseline than they did at the end of the double-blind phase. Statistically significant differences between medication groups were few. At weeks four and six, grip strength for the naproxen group increased from baseline by a marginal amount compared with the flurbiprofen group. Global evaluations of disease improvement by patients and physicians and proximal interphalangeal joint size showed trends in favor of flurbiprofen. In the double-blind phase, 29.4 percent of flurbiprofen-treated patients (n = 20) and 23.1 percent of naproxen-treated patients (n = 15) experienced side effects, most of which were gastrointestinal in origin. In the open-label phase, 81.0 percent of the patients (n = 87) satisfactorily completed the six weeks of flurbiprofen treatment. Based on this study, 100 mg of flurbiprofen administered twice daily was as effective as 250 mg of naproxen twice daily in the treatment of rheumatoid arthritis. PMID- 3515919 TI - Double-blind comparison of flurbiprofen and sulindac for the treatment of osteoarthritis. AB - In this double-blind, randomized trial involving 143 patients with osteoarthritis of the hip and/or knee, the efficacy and safety of twice-daily dosing with flurbiprofen (Ansaid, Upjohn), which has a half-life of 5.5 hours, were compared with those of sulindac, which has a half-life of 7.8 hours. Patients were treated with flurbiprofen (50 mg orally twice a day) or sulindac (150 mg orally twice a day) for six weeks. Based on evaluations by both patients and physicians, there were no statistically significant differences between the two treatment groups in most of the efficacy parameters studied. In addition, there were no statistically significant differences between the two treatment groups in the incidence or type of side effects, which were primarily gastrointestinal in origin. This study indicates that flurbiprofen, taken as 50 mg twice daily, is equally as effective as 150 mg of sulindac twice a day in the treatment of osteoarthritis. PMID- 3515920 TI - Treatment of acute shoulder syndrome with flurbiprofen. AB - A multi-dose, double-blind, randomized, placebo-controlled, multicenter study was conducted to evaluate 68 patients with acute bursitis or tendinitis following treatment with flurbiprofen (Ansaid, Upjohn) or placebo. Flurbiprofen was administered in a total daily dosage of 200 to 300 mg four times daily. Based on efficacy rating scales, flurbiprofen-treated patients had the greatest proportion of improvement at almost all time periods. They also showed statistically significant improvement compared with placebo-treated patients, according to investigators' overall assessments at all time periods. Most patients showed improvement within three to four days of treatment. Flurbiprofen was both well tolerated and effective for the relief of pain caused by bursitis or tendinitis of the shoulder. PMID- 3515921 TI - Comparison of two dosing schedules of flurbiprofen for patients with rheumatoid arthritis. Twice-daily versus four-times-a-day schedules. AB - A total daily dose of 200 mg of flurbiprofen (Ansaid, Upjohn) was administered either twice daily (100 mg BID) or four times daily (50 mg QID) to 143 patients with rheumatoid arthritis. Results of this 12-week, randomized, double-blind study showed statistically significant reductions in the number of swollen joints, number of affected joints, duration of morning stiffness, and 50-foot walk time in patients receiving either treatment regimen. Using standard statistical tests, no significant differences between regimens were found. Flurbiprofen treatment was rated as "excellent" or "good" by approximately half of the patients and physicians following both BID or QID dosing. PMID- 3515922 TI - Comparison of flurbiprofen and aspirin in the relief of postsurgical pain using the dental pain model. AB - This single-dose, double-blind, randomized, placebo-controlled study evaluated the analgesic efficacy of both 25 and 50 mg of flurbiprofen (Ansaid, Upjohn) compared with 650 mg of aspirin and placebo in 164 patients who had undergone dental impaction surgery. Using the highly sensitive dental pain model, flurbiprofen appears to be an effective, peripherally acting analgesic with a rapid onset of activity. In the current study, it was superior to aspirin in terms of peak effect and duration of action. Although flurbiprofen is much more potent than ibuprofen, its side-effect profile did not differ markedly from that of ibuprofen in this single-dose study. PMID- 3515923 TI - Suppression of dental pain by the preoperative administration of flurbiprofen. AB - In a series of three studies involving dental outpatients undergoing removal of impacted third molars, preoperative and postoperative administration of flurbiprofen (Ansaid, Upjohn) led to superior pain relief when compared with acetaminophen alone or in combination with oxycodone. Patient preference and global evaluations clearly favored flurbiprofen. Side effects were mild and generally more common in patients receiving the opiate/mild analgesic combination. In two additional studies, flurbiprofen and etidocaine, a long acting local anesthetic, also resulted in significantly less postoperative pain than a combination of acetaminophen/oxycodone and lidocaine; 67 percent of patients in the flurbiprofen plus etidocaine group reported no or only slight pain during the entire observation period. The greater analgesic efficacy of flurbiprofen appears to represent a genuine therapeutic advantage, since it is not achieved at the expense of greater side effects. PMID- 3515924 TI - Comparative study of flurbiprofen, zomepirac sodium, acetaminophen plus codeine, and acetaminophen for the relief of postsurgical dental pain. AB - The relative analgesic efficacy and safety of single oral doses of 50 and 100 mg of flurbiprofen (Ansaid, Upjohn) were compared with 100 mg of zomepirac sodium, 650 mg of acetaminophen plus 60 mg of codeine, 650 mg of acetaminophen alone, and placebo in a randomized, double-blind, parallel-group study. A total of 182 patients entered the study with moderate pain from a third molar extraction and were evaluated for six hours. For many efficacy variables, all active treatments were significantly (p less than or equal to 0.05) more effective than placebo. The two doses of flurbiprofen gave approximately similar results, suggesting a plateau effect above 50 mg. With the exception of relief at one hour, there were no significant differences between zomepirac and either dose of flurbiprofen. However, the mean response with zomepirac was greater than with either 50 or 100 mg of flurbiprofen during the first four hours and lower during the last two hours. The analgesic effects of acetaminophen alone were not significantly different from acetaminophen in combination with codeine. At the first hour, acetaminophen plus codeine led to significantly better pain relief than did 100 mg of flurbiprofen. After the first hour, flurbiprofen resulted in greater mean scores than acetaminophen alone or acetaminophen plus codeine, and these differences were significant at the fifth and sixth hours. Five patients had adverse reactions while receiving acetaminophen, acetaminophen plus codeine, or placebo. There were no adverse effects with flurbiprofen or zomepirac. PMID- 3515926 TI - Comparative efficacy of oral flurbiprofen, intramuscular morphine sulfate, and placebo in the treatment of gynecologic postoperative pain. AB - This single-dose, double-blind, randomized, placebo-controlled study compared the efficacy of 50 mg of oral flurbiprofen (Ansaid, Upjohn), 10 mg of intramuscular morphine sulfate, and placebo in 92 patients with moderate to severe postoperative gynecologic pain. According to pain intensity, pain relief, and pain intensity difference scores, the morphine-treated patients experienced significantly more pain reduction than the other patients by the first hour after treatment. The flurbiprofen group obtained the same level of significant pain relief as the morphine group by two hours after dosing, but relief persisted longer than in the morphine-treated patients. Evaluation of other efficacy variables revealed similar levels of significant pain reduction in both the flurbiprofen and morphine groups compared with the placebo group. Flurbiprofen was well tolerated and led to fewer side effects than either morphine or placebo. PMID- 3515925 TI - Comparative study of flurbiprofen and morphine for postsurgical gynecologic pain. AB - This single-dose, double-blind, randomized, placebo-controlled study assessed the efficacy and safety of 50 mg of flurbiprofen (Ansaid, Upjohn) in the relief of postoperative pain following cesarean section, as well as vaginal or abdominal hysterectomies. Results show that both 50 mg of oral flurbiprofen and 10 mg of intramuscular morphine sulfate were significantly superior to placebo in 161 patients with respect to pain intensity after medication, pain relief scores, need for additional analgesia, and overall clinical evaluation of pain relief. By two hours after treatment, there were no significant differences between morphine sulfate and flurbiprofen in terms of pain intensity or degree of pain relief. According to investigators' global evaluations of efficacy, both active treatments were statistically superior to placebo. The only adverse reaction occurred in the morphine treatment group. Flurbiprofen administered orally for the relief of moderate to severe pain following major gynecologic surgery appears to be equal to morphine sulfate and superior to placebo in efficacy and safety. Unlike morphine, flurbiprofen is a nonparenteral, uncontrolled substance, and thus patient acceptance is improved while nursing time is decreased. PMID- 3515927 TI - Flurbiprofen, aspirin, codeine, and placebo for postpartum uterine pain. AB - Flurbiprofen (Ansaid, Upjohn), a substituted phenyl propionic acid, is a new analgesic/anti-inflammatory agent. To evaluate its relative efficacy in noninflammatory pain, 159 hospitalized women with moderate or severe postpartum uterine cramps were given single oral doses of 50 mg of flurbiprofen, 650 mg of aspirin, 60 or 120 mg of codeine sulfate, or placebo in a parallel, stratified, randomized block, placebo-controlled, double-blind trial. Patients rated pain intensity, pain relief, and side effects in uniform interviews for six hours after treatment. All measures of peak and summed analgesia exhibited significant differences among the five treatments. Flurbiprofen and aspirin showed the greatest analgesic response and were significantly superior to placebo. Results of codeine treatment were equivocal with no evidence of a positive dose response. Side effects were unremarkable except for dizziness and drowsiness after the 120 mg codeine dose. These findings suggest that flurbiprofen as an analgesic for patients with postpartum uterine pain is equivalent to aspirin and superior to codeine. PMID- 3515928 TI - Flurbiprofen for the treatment of bone pain in patients with metastatic breast cancer. AB - Two investigators enrolled 26 women with metastatic breast carcinoma in a six week, double-blind, placebo-controlled, crossover study of flurbiprofen (Ansaid, Upjohn) and placebo. The study was designed to determine the efficacy of flurbiprofen in reducing bone pain due to metastatic breast cancer. Pain score, overall performance, and concomitant use of narcotics were evaluated. The overall mean differences in pain scores between flurbiprofen and placebo showed better control of pain during treatment with flurbiprofen. None of these differences approached statistical significance. Evaluation of overall performance status reached statistical significance in one investigator's group. Three out of four patients reported decreased consumption of acetaminophen/aspirin plus codeine combinations while receiving flurbiprofen. PMID- 3515929 TI - Metabolism and disposition of buspirone. AB - The metabolism and disposition of buspirone have been studied in the rat, the monkey, and in more than 150 human subjects. Buspirone is well absorbed, but is subject to first-pass metabolism. The mean systemic availability is approximately 4 percent. Buspirone is eliminated primarily by oxidative metabolism, which produces several hydroxylated metabolites, including 5-hydroxy-buspirone and 1 pyrimidinylpiperazine. The latter metabolite is from 1 to 20 percent as potent as buspirone in a variety of pharmacologic tests; 5-hydroxybuspirone is essentially inactive. In humans, the systemic exposure to buspirone increases linearly in relation to the oral dose. Food increases the bioavailability of buspirone by decreasing first-pass metabolism; absorption is not markedly altered. The pharmacokinetics of buspirone were not significantly different in men and women or in individuals 21 to 40 years old compared with those over 65 years of age. Half-life values observed in healthy volunteers ranged from two to 33 hours. Mean half-life values observed in healthy volunteers in the 14 studies conducted to date ranged from 2 +/- 1 to 11 +/- 3 hours. The half-life in women tended to be slightly longer than in men, but the difference was not significant. Hepatic cirrhosis resulted in a marked decrease in the clearance of buspirone, which correlated with serum alkaline phosphatase activity. Renal disease produced a modest decrease in buspirone clearance, which could not be correlated with an objective clinical measurement reflecting the severity of renal impairment. Buspirone was not removed by hemodialysis. Buspirone is highly protein bound (more than 95 percent), interacting with both albumin and alpha-acid glycoprotein. However, buspirone did not displace dilantin, propranolol, digoxin, or warfarin from plasma proteins. In rats, buspirone neither inhibited nor induced hepatic mixed-function oxidases. Co-administration of buspirone with amitriptyline or diazepam did not alter the disposition of these agents or their demethylated metabolites. PMID- 3515930 TI - Removal of low-density lipoproteins in patients by extracorporeal immunoadsorption. AB - A new technique called LDL-pheresis was used in patients to lower low-density lipoprotein cholesterol levels. This procedure combines continuous extracorporeal plasma separation with immunoadsorption of low-density lipoprotein on columns containing monospecific antibody to human apolipoprotein B. Six patients underwent a total of 164 procedures without significant side effects or nonspecific protein depletion. Acutely, LDL-pheresis lowered plasma cholesterol levels by removing up to 82 percent of the circulating low-density lipoprotein. Weekly LDL-pheresis combined with a portacaval shunt in a patient with homozygous familial hypercholesterolemia resulted in normalization of plasma cholesterol levels and rapid regression of skin xanthomata. Three of four patients with atherosclerotic coronary artery disease have noted improvement in their angina. LDL-pheresis appears to be a promising new technique capable of safely and efficiently lowering plasma low-density lipoprotein cholesterol levels. PMID- 3515931 TI - Objective benefit of nifedipine in the treatment of Raynaud's phenomenon. Double blind controlled study. AB - To compare the effects of the calcium channel antagonist, nifedipine, with that of placebo, a randomized double-blind crossover study was performed in 11 patients with moderate to severe Raynaud's phenomenon. Digital skin temperature recovery time was measured after immersing the patient's hand in ice water for 20 seconds. Patients were randomly assigned to receiving either nifedipine or placebo for one week, followed by the crossover phase. Skin temperature recovery time was also measured in 21 normal volunteers. The mean time to recovery for patients taking nifedipine was 28.5 +/- 20.8 minutes versus 44.9 +/- 18.9 minutes for patients receiving placebo (p less than 0.05 by analysis of variance with repeated measures). The mean time to recovery for the normal volunteers was 11.3 +/- 7.2 minutes versus 40.2 +/- 19.9 minutes for the patients (p less than 0.01 by the Student t test). Nine of the 11 patients noted improvement of symptoms during treatment with nifedipine. It is concluded that nifedipine is an effective, well-tolerated treatment for Raynaud's phenomenon. PMID- 3515932 TI - Complex ventricular arrhythmias associated with the mitral valve prolapse syndrome. Effectiveness of moricizine (Ethmozine) in patients resistant to conventional antiarrhythmics. AB - On the basis of epidemiologic studies, more than 10 million Americans have echocardiographic evidence of mitral valve prolapse. Although ventricular arrhythmias occur frequently (over 50 percent of patients with mitral valve prolapse), they rarely result in sustained ventricular tachycardia or sudden cardiac death. However, a common problem in clinical practice is a patient with mitral valve prolapse and symptomatic complex ventricular arrhythmias refractory or intolerant to both beta blockers and conventional type I antiarrhythmics. These drugs are known to have frequent side effects, toxicity, and proarrhythmic effects. In 17 patients with mitral valve prolapse who presented with symptomatic complex ventricular arrhythmias and who were unresponsive to an average of the three conventional agents, moricizine (Ethmozine) was effective in suppressing 90 percent of ventricular premature depolarizations, 99 percent of nonsustained runs of ventricular tachycardia, as well as all sustained runs of ventricular tachycardia, resulting in abolition of palpitations, dizziness, and syncopal episodes. Its efficacy as well as its low frequency of minor side effects makes it ideal for future consideration in the population with mitral valve prolapse, who are frequently young and may therefore require therapy for many years. PMID- 3515933 TI - The captopril test for identifying renovascular disease in hypertensive patients. AB - To develop a screening test for identifying renovascular hypertension, the blood pressure and plasma renin activity responses to an oral test dose of captopril were studied in 246 quietly seated hypertensive patients. The following criteria were developed that exploit the hyperresponsiveness of renin secretion in renovascular hypertensive patients: a 60-minute post-captopril plasma renin activity of 12 ng/ml per hour or more and an absolute plasma renin activity increase of 10 ng/ml per hour or more, along with a 150 percent increase in plasma renin activity (or a 400 percent increase if the baseline plasma renin activity was below 3 ng/ml per hour). Retrospectively, the test identified, among 200 hypertensive patients without evidence of renal dysfunction, all 56 patients with proved renovascular disease. In this group, false-positive results occurred only in two of 112 patients with essential hypertension and in six with secondary hypertension. Nine untreated patients had blood pressure levels of less than 160/100 mm Hg. The test was neither as sensitive nor specific in the 46 patients with renal insufficiency. This study demonstrates that the renin response to oral captopril is a useful screening test for identifying patients with unilateral or bilateral renovascular disease. Since the test also characterizes the renin dependency of the hypertension, it may have other diagnostic and therapeutic uses. PMID- 3515934 TI - Disseminated intravascular coagulation and purpura fulminans in a patient with Candida sepsis. Biopsy of purpura fulminans as an aid to diagnosis of systemic Candida infection. AB - Disseminated intravascular coagulation and purpura fulminans developed in association with septicemia and meningitis due to Candida tropicalis in an 18 year-old female immunosuppressed renal allograft recipient. Although systemic Candida infection was initially suspected, blood cultures showed no growth of this organism until after its identification in the dermis of a skin biopsy specimen obtained from the site of purpura fulminans. This case illustrates the association between Candida sepsis and purpura fulminans, and demonstrates the usefulness of skin biopsy of purpura fulminans in the early diagnosis of Candida sepsis. PMID- 3515936 TI - Ecthyma gangrenosum in a kidney transplant recipient with Pseudomonas septicemia. AB - This report describes a renal transplant recipient in whom Pseudomonas septicemia and ecthyma gangrenosum developed within days of renal transplantation. Microscopic skin sections showed perivascular bacillary invasion. Pseudomonas organisms were cultured and microscopically visualized in sections from the transplanted kidney. Although cultures from the donor kidney preservation perfusate fluid showed no growth, Pseudomonas aeruginosa was found in the recipient's urine, blood, and peritoneal fluid. The recipient's course was complicated by septic shock, cardiopulmonary arrest, coma, and extensive skin lesions; but his condition improved with appropriate antibiotic therapy, wound debridement, and an aggressive rehabilitative program. He is now a candidate for retransplantation. This is the first known case of ecthyma gangrenosum in a renal transplant recipient. PMID- 3515935 TI - Recurrent sarcoid granulomatous nephritis and reactive tuberculin skin test in a renal transplant recipient. AB - End-stage renal failure developed in a patient with systemic sarcoidosis and granulomatous nephritis. She received a successful cadaveric renal transplant and was doing well for about six years before graft impairment occurred. At that time, her mother was found to have active open pulmonary tuberculosis, and she had a strongly reactive result on tuberculin skin testing. No clinical evidence of tuberculosis or systemic sarcoidosis was noted, but a renal graft biopsy specimen revealed the recurrence of an unusual sarcoid lesion identical to that which had occurred in her native kidney. Her condition responded to high-dose prednisone with improvement in graft function. PMID- 3515937 TI - Serratia marcescens osteomyelitis of the clavicle and sternoclavicular arthritis complicating infected indwelling subclavian vein catheter. AB - Serratia marcescens bacteremia, osteomyelitis of the right clavicle, and septic arthritis of the right sternoclavicular joint developed in a 69-year-old woman after a right subclavian vein catheter was in place for five days. The infections were cured with the combination of gentamicin and ceftizoxime. There have been three previously reported cases of osteomyelitis of the clavicle following indwelling subclavian vein catheterization; two were caused by Staphylococcus aureus and one by Pseudomonas aeruginosa. PMID- 3515938 TI - Neonatal adrenoleukodystrophy: new cases, biochemical studies, and differentiation from Zellweger and related peroxisomal polydystrophy syndromes. AB - Eight new cases of autopsy-confirmed or suspected neonatal adrenoleukodystrophy (NALD) are presented together with new biochemical data on very-long-chain fatty acids (VLCFA) and plasmalogens and a review of all previously published cases. The clinical, biochemical, and histopathologic abnormalities characteristic of this newly recognized form of adrenoleukodystrophy are analyzed in detail and compared to the principal characteristics of the similar disorder, the cerebrohepatorenal syndrome of Zellweger (ZS). Using strict pathologic criteria for the diagnosis of NALD, we find that, despite many clinical resemblances, NALD and the ZS are distinguishable on the basis of histology and peroxisomal biochemistry. Patients with NALD demonstrate adrenal atrophy, systemic infiltration by abnormal lipid-laden macrophages, and elevations of saturated VLCFA. In contrast, patients with ZS have chondrodysplasia, glomerulocystic disease of the kidney, central nervous system dysmyelination, and elevations of unsaturated as well as saturated VLCFA, but they lack adrenal atrophy. We conclude that NALD and the ZS probably represent at least two different genetic defects. PMID- 3515939 TI - Trisomy 14 mosaicism in a liveborn male: clinical report and review of the literature. AB - We present the history and results of chromosome analysis of a liveborn male with mosaic trisomy 14 who was initially evaluated for a congenital heart defect. His chromosome complement was 46,XY/47,XY,+14. The phenotype of the patient is similar in many respects to that of females previously reported with mosaic trisomy 14, whereas the patient's micropenis and cryptorchidism are consistent with findings in males with dup(14q). PMID- 3515940 TI - Diagnosis of chromosome 3 duplication q23----qter, deletion p25----pter in a patient with the C (trigonocephaly) syndrome. AB - The cells of a deceased patient previously reported to have the C (trigonocephaly) syndrome were reinvestigated because his phenotype resembled that of a patient with a duplication-deficiency of chromosome 3. This diagnosis was confirmed using fibroblasts grown from frozen cells, and his mother was shown to carry an inversion of chromosome 3 in her peripheral blood leukocytes. His findings are compared to those of another patient with the C trigonocephaly syndrome with normal chromosomes and to others from the literature. At least one other patient from the literature has a phenotype compatible with "3q duplication syndrome." PMID- 3515941 TI - Delayed hypotensive response to dialysis in hypertensive patients with end-stage renal disease. AB - This study was designed to determine the ambulatory arterial blood pressure profile in hypertensive patients with end-stage renal disease during and following hemodialysis. Blood pressure was noninvasively monitored at 15-min intervals for 24 h using a fully automatic portable recorder, while the 10 patients studied followed their customary activities and were not receiving any antihypertensive medications. Prior to dialysis, the blood pressure was 179 +/- 7.0/101 +/- 3.7 mm Hg. After 4 h of dialysis, the systolic blood pressure did not change, while the diastolic blood pressure fell only slightly (178 +/- 4.2/94 +/- 2.4 mm Hg). After dialysis was completed, a progressive fall in both systolic and diastolic blood pressures was observed reaching the lowest value in the 5th h after dialysis (146 +/- 5.5/75 +/- 3.2 mm Hg). Thereafter, the fall in blood pressure was sustained during sleep (147 +/- 1.7/77 +/- 0.9 mm Hg) and during routine daily activities (147 +/- 2.0/78 +/- 1.0 mm Hg). The delayed fall in blood pressure was observed in patients in whom the plasma renin activity was elevated (8.4 +/- 2.4 ng/ml/h) and in patients in whom the plasma renin activity was low or normal (0.9 +/- 0.2 ng/ml/h). Our data suggest that during dialysis vasopressor mechanisms are activated to sustain blood pressure and that following dialysis such mechanisms are attenuated allowing the blood pressure to fall towards normal levels. The delayed fall in blood pressure documented by this study indicates that in many hypertensive patients with end-stage renal disease antihypertensive drug therapy is not required the day after dialysis. PMID- 3515942 TI - IgA nephropathy in children: significance of glomerular basement membrane deposition of IgA. AB - Seventeen children with IgA nephropathy were grouped according to the absence (group I, n = 10) or presence (group II, n = 7) of glomerular basement membrane (GBM) deposition of IgA to determine whether GBM deposition of IgA correlated with laboratory or pathologic data at diagnosis or clinical status at follow-up. Children in group II had significantly (p less than 0.01) more proteinuria at diagnosis than children in group I. The percentage of glomeruli demonstrating crescent formation was significantly (p less than 0.05) higher in group II biopsies. Chronic changes of fibrous crescents, segmental sclerosis, global obsolescence, tubular atrophy, and interstitial fibrosis were also significantly (p less than 0.001) more common in group II biopsies. After a mean follow-up period of 2 years, all children in group II have persistent proteinuria of more than 1 g/24 h, and 3 of 5 have renal insufficiency (2 require dialysis). In contrast, 2 of 9 group I children have proteinuria exceeding 1 g/24 h, and only 1 has renal insufficiency. We conclude that, as compared to children with IgA localized to the mesangium, children with IgA nephropathy and GBM deposition of IgA have a higher urinary protein excretion at the time of diagnosis, more severe histologic alterations including a greater percentage of glomeruli demonstrating crescent formation, more chronic changes of segmental or global sclerosis, tubular atrophy, and interstitial fibrosis. Such children usually have persistent proteinuria and are more likely to develop progressive renal disease. PMID- 3515943 TI - Eustachio's discovery of the renal tubule. PMID- 3515944 TI - Words, thoughts, and things. PMID- 3515945 TI - Further studies on genital mycoplasmas in intra-amniotic infection: blood cultures and serologic response. AB - Mycoplasma hominis is recovered significantly more often in amniotic fluid of women with intra-amniotic infection than in matched control women, but Ureaplasma urealyticum is found in 50% of amniotic fluid samples of both groups. To gain further understanding, we performed blood cultures for genital mycoplasmas and measured serologic responses by a micro enzyme-linked immunosorbent assay method in women with intra-amniotic infection and in control subjects. In blood cultures of 81 women with intra-amniotic infection, M. hominis was isolated in two (2.5%) and U. urealyticum in 11 (13.6%). In 44 control blood cultures, M. hominis was not isolated, and U. urealyticum was recovered in eight (18.2%). These differences were not significant. Serologic response was determined in 86 patients. Rise in antibody to M. hominis was significantly more common in women with intra-amniotic infection and M. hominis in the amniotic fluid than in either women with intra-amniotic infection or control patients without M. hominis. For U. urealyticum antibody response was significantly more common in the intra amniotic infection group than in control subjects, but there was no association between antibody response and isolation of this organism in amniotic fluid. When M. hominis was found in amniotic fluid or maternal blood, patients were nearly always symptomatic. The high likelihood of serologic response in these cases supports a pathogenic role of M. hominis in intra-amniotic infection. The role of U. urealyticum remains unclear. PMID- 3515946 TI - Uterine artery Doppler velocimetry in pregnant women with hypertension. AB - Uterine and umbilical artery velocimetry was carried out on 71 women with hypertensive disorders in pregnancy. Three categories of hypertensive disease were diagnosed: chronic hypertension, preeclampsia, and chronic hypertension with superimposed preeclampsia. Clinical classifications describe the severity of disease effectively, primarily because the classification is based on the appearance of abnormal physical or laboratory findings. Doppler velocimetry of the uterine arteries shows that normal pregnancy occurs when the systolic/diastolic ratio is less than or equal to 2.6. When the ratio exceeds this level and there is a notch in the waveform, the pregnancy is complicated by stillbirth, premature birth, intrauterine growth retardation, and maternal preeclampsia. The positive and negative predictive value of the examination is 93% and 91%, respectively. It appears that this new technology will be an essential ingredient of optimum pregnancy surveillance. PMID- 3515947 TI - Localization of Chlamydia trachomatis infection by direct immunofluorescence and culture in pelvic inflammatory disease. AB - Fifty-five women with suspected pelvic inflammatory disease underwent diagnostic laparoscopy and endometrial and tubal biopsy, with specimens for isolation of Chlamydia trachomatis and for staining with a species-specific monoclonal fluorescein-conjugated antibody to C. trachomatis were obtained from the urethra, rectum, endocervix, endometrium, tubes, and cul-de-sac. C. trachomatis was isolated from 21 patients (38%), including 10 (18%) who had positive endometrial or tubal cultures. The fluorescein-conjugated antibody stain was positive for 43 (86%) of 50 culture-positive specimens, for 14 (18%) of 78 culture-negative specimens from 21 patients who had positive cultures from other sites, and for one (0.5%) of 192 specimens from 34 patients who had negative cultures at all sites. Thus the sensitivity of direct fluorescein-conjugated antibody for culture positive specimens was 86% and the specificity for specimens from culture negative patients was 99%. Twelve upper genital tract specimens were positive by fluorescein-conjugated antibody only. Fluorescein-conjugated antibody staining of 50 paraffin-embedded endometrial aspirates showed extracellular or intracellular elementary bodies and or cytoplasmic inclusions in all of seven culture-positive specimens, in four of six culture-negative specimens from patients who had positive cultures at other sites, and in none of 34 specimens from patients with negative cultures. Thus fluorescein-conjugated antibody staining is useful for confirming the role of C. trachomatis in endometritis and salpingitis. It is more sensitive than culture for detection of chlamydia in endometrial or tubal specimens and is able to confirm that the organism is actually present in endometrial tissue (rather than simply reflecting contamination from the cervix) in women with clinical evidence of pelvic inflammatory disease. PMID- 3515948 TI - Ultrasound evaluation of amniotic fluid: outcome of pregnancies with severe oligohydramnios. AB - Severe oligohydramnios, defined as a condition in which the largest pocket of amniotic fluid measures less than 1 cm in its vertical axis as determined by an ultrasound method, was observed in 113 patients in a population of 15,431 referred high-risk patients (0.7%). In all cases, intervention took place unless there was a recognized structural anomaly or extreme prematurity. Overall gross perinatal mortality was 132.7/1000, and the incidence of major anomaly was 13.3%. With intervention the corrected perinatal mortality rate was 17.7/1000, a rate not significantly different from that observed in the entire population. All end points of perinatal mortality were significantly increased in patients with severe oligohydramnios, in comparison with randomly selected control subjects with normal amniotic fluid. These findings are interpreted to indicate that severe oligohydramnios in a structurally normal fetus is an indication for delivery. PMID- 3515949 TI - Cefotetan in the treatment of obstetric and gynecologic infections. AB - The efficacy, tolerance, and safety of cefotetan--a new 7-alpha-methoxy cephalosporin--was assessed in controlled and uncontrolled evaluations involving 131 evaluable patients hospitalized with obstetric and gynecologic infections. The 99% satisfactory clinical response rate obtained with this drug was equivalent to that obtained with either moxalactam or cefoxitin, yet the mean amount of cefotetan given was lower than that of the other two drugs. Cefotetan was well tolerated and produced no major adverse reactions. In this era of Diagnosis Related Groups and cost containment, the twice-daily dosage schedule of cefotetan is a decided cost benefit. PMID- 3515950 TI - Comparison of cefotetan and cefoxitin as prophylaxis in cesarean section. AB - A study comparing the efficacy of cefotetan versus cefoxitin for prophylaxis in patients undergoing cesarean section was carried out at the University of Iowa. After institutional review, 36 subjects who met the study criteria and agreed to participate were entered into the study; of these, 29 were evaluable for efficacy. Twenty subjects received a single 2 gm dose of cefotetan, and nine subjects received three 2 gm doses each of cefoxitin. Both antibiotics were administered intravenously at the time the umbilical cord was clamped. The subsequent doses of cefoxitin were given intravenously at four and eight hours after the initial dose. Clinical and bacteriologic responses were evaluated; there were no statistically significant differences between the two groups, and both antibiotics provided effective prophylaxis against infection. It appears that cefotetan is a satisfactory antibiotic choice for cesarean section prophylaxis. Further, in this small study it appears that a single dose of cefotetan is as effective as three doses of cefoxitin. This implies that cefotetan would not only decrease administration time and supplies but would decrease the cost to the patient while maintaining very acceptable infection rates. PMID- 3515951 TI - Single-dose cefotetan versus multidose cefoxitin for prophylaxis in cesarean section in high-risk patients. AB - A prospective, randomized, open trial of a single intravenous dose of a new broad spectrum and long-acting cephalosporin was compared with the effect of three doses of cefoxitin in a group of 70 women undergoing cesarean section who were at high risk for postoperative endomyometritis and wound infection. All patients either had ruptured membranes or were in active labor, or both, without clinically detectable chorioamnionitis at the time of prophylaxis. Forty-six women received a single 2 gm dose of cefotetan and 24 received 2 gm of cefoxitin every 4 hours to complete a three-dose regimen. Outcomes of infectious febrile morbidity due to endomyometritis (15% versus 8%), wound erythema (4% versus 12%), and other parameters were similar for cefotetan and cefoxitin, respectively. Both agents were well tolerated in this high-risk population. Within the limits of this study, single-dose cefotetan chemoprophylaxis appears to be comparable to multidose cefoxitin administration in reducing morbidity in operative site infections after cesarean section. PMID- 3515952 TI - Cefotetan versus cefoxitin as prophylaxis in hysterectomy. AB - Seventy hospitalized women were entered into an open, randomized, parallel study of antimicrobial prophylaxis for abdominal and vaginal hysterectomy with the use of either cefotetan, a new long-acting cephalosporin, or cefoxitin. Ninety-four percent of cefotetan recipients and 83% of cefoxitin recipients did not develop clinical signs or symptoms of infection. The satisfactory bacteriologic response rates were significantly different: 91% satisfactory (43 of 47 patients) for cefotetan and 74% satisfactory (17 of 23 patients) for cefoxitin. The two treatment groups demonstrated no significant differences in postoperative temperature changes, duration of hospitalization, or grading of surgical wounds. Neither drug was associated with significant side effects. PMID- 3515953 TI - Bilateral carcinomas of the eyelid. AB - A 41-year-old man receiving long-term immunosuppressive therapy after renal transplantation developed progressive ulcerative lesions involving both lower eyelids. The lesions began as crusting and exfoliating masses and developed over a one-year period. A biopsy demonstrated that the lesions were invasive squamous cell carcinomas. PMID- 3515954 TI - Bacterial flora of the eye and contact lens. Cases during hydrogel lens wear. AB - Bacteriological comparisons between the tear fluids of soft contact lens wearers and noncontact lens wearers indicate that there is an increase in the bacterial population in contact lens wearers but not a significant change in the varieties present. Differences between groups of contact lens wearers appear to depend on the method of disinfection used. PMID- 3515955 TI - Mandibular growth direction following adenoidectomy. AB - The purpose of this article is to test the hypothesis that the establishment of nasal respiration in children with severe nasopharyngeal obstruction can be eliminated as a factor in determining mandibular growth direction. The article describes the changes in mandibular growth direction (MGD) in a 5-year period after adenoidectomies and the establishment of nasal breathing in a population of Swedish children. Measurements of mandibular growth directions were obtained from serial cephalometric radiographs after adenoidectomies in 38 Swedish children aged 7 to 12 years with previous nasopharyngeal obstructions. These were compared with the growth directions in a control sample of 37 Swedish children with clear airways and matched for age and sex. The adenoidectomy sample initially showed significantly longer lower face heights, steeper mandibular plane angles, and more retrognathic mandibles than the matched controls. Analysis showed that during the 5 years after adenoidectomies, the girls had a more horizontal MGD (P less than 0.02) than did the female controls. A corresponding but not significant trend was found for the boys. The individual growth directions that were obtained following adenoidectomies were more variable than those found in the controls. PMID- 3515956 TI - Monoclonal antibody HISL-19 as an immunocytochemical probe for neuroendocrine differentiation. Its application in diagnostic pathology. AB - The monoclonal islet cell antibody HISL-19 was generated after immunization of BALB/c mice with human islet cell preparations. Besides reactivity with all cells of the human pancreatic islet, MAb HISL-19 also reacted with other cells of the diffuse neuroendocrine system, including anterior pituitary cells, C cells of the thyroid, endocrine cells of the gut and bronchus, the adrenal medulla, and central and peripheral neurons. In this study the authors screened a series of 53 neuroendocrine and 71 nonneuroendocrine tumors for their reactivity with MAb HISL 19 using an indirect immunoperoxidase technique on formalin-fixed and Paraplast embedded sections. MAb HISL-19 reacted strongly with all insulomas (10), carcinoids (8), C-cell carcinomas of the thyroid (8), pituitary adenomas (6), neuroendocrine carcinomas of the skin (4), paragangliomas of the carotid body (3), and pheochromocytomas (2) tested. Neuroblastomas (3), oat-cell carcinomas of the lung (2), and melanomas (4) exhibited only very few immunoreactive cells scattered throughout the tumor or remained unstained with MAb HISL-19. With the exception of one lobular carcinoma of the breast (1/3), one adenocarcinoma of the endometrium (1/4), and one adenocarcinoma of the stomach (1/6), nonneuroendocrine tumors were negative with MAb HISL-19. Biochemical findings obtained by SDS-PAGE, "Western" immunoblotting, immunoaffinity chromatography, and absorption experiments indicate that the MAb HISL-19-defined antigen is not related to neuron specific enolase. Because the epitope recognized by MAb HISL-19 is well preserved in formalin-fixed and routinely processed tissues, this monoclonal antibody finds potential applications in diagnostic pathology as an indicator for neuroendocrine cells and their neoplasms. PMID- 3515957 TI - Ultrastructural pathology of the rectal mucosa in Shigella dysentery. AB - Colonocyte damage in the rectal mucosa in shigellosis is the result of bacterial invasion and leads to ulceration. Additional factors in colonocyte damage may be the Shigella cytotoxin and, especially in colonic crypt cells, bacterial endotoxin. A vascular lesion was present in the lamina propria of the rectal mucosa, which resembled endothelial damage secondary to bacterial endotoxins. In patients with longer duration of symptoms, relative vascular insufficiency, activated lymphocytes, eosinophil and mast cell degranulation, and antibody mediated colonocyte damage may all play a role. PMID- 3515958 TI - Nephropathy induced in a nephritis-resistant inbred mouse strain with the use of a cationized antigen. AB - C3H/HeN mice produce small amounts of antibody when challenged daily with 4 mg horse spleen apoferritin and fail to develop significant renal histologic and immunohistologic lesions. When the same dose of antigen is given in cationized form, glomerular deposits of both antigen and IgG, often accompanied by C3, are uniformly found in all animals. Thus it appears that cationized antigens can induce the formation of potentially damaging immune complexes in low-antibody producing individuals that are not ordinarily susceptible to this kind of immune injury. PMID- 3515959 TI - Diabetes mellitus: current concepts. PMID- 3515960 TI - Meniere's disease: the psychosomatic hypothesis. PMID- 3515961 TI - The "coat" of kidney intercalated cell tubulovesicles does not contain clathrin. AB - Intercalated cells of kidney collecting ducts contain a population of tubulovesicles in their apical cytoplasm, whose limiting membranes are decorated by arrays of dense, club-shaped projections oriented toward the cytoplasm. These tubulovesicles have been implicated in endo-exocytotic events in these cells. To determine a possible relationship between this "coating" material and clathrin, the coat protein associated with endocytotic coated pits and coated vesicles in other cell types, we applied a monospecific, affinity-purified anti-clathrin antibody to thin sections of rat kidney embedded at low temperature in Lowicryl K4M. We found that no specific labeling was associated with the studlike material of intercalated cell tubulovesicles. PMID- 3515963 TI - Aggressive behavior in adult male mice elevates serum nerve growth factor levels. AB - By use of a specific and sensitive beta-nerve growth factor radioimmunoassay (beta NGF-RIA), serum beta NGF concentrations were measured in adult male Swiss Webster mice under various physiological conditions. Animals killed on the day of arrival from the animal supplier showed wide variations (3-15 ng beta NGF/ml) in serum beta NGF levels. These levels significantly decreased if the animals were maintained under individually housed conditions for at least 6 days prior to death. Aggression caused by social contact between previously individually housed animals raised serum beta NGF levels by two orders of magnitude relative to serum beta NGF concentrations in nonaggressive mice. Testosterone propionate treatment (10 mg/animal) 5 days prior to death did not elevate serum beta NGF levels in individually maintained animals. However, the hormone pretreatment markedly augmented serum beta NGF levels in aggressive mice compared with the levels in hormone-treated nonaggressive animals. Removal of the submandibular-sublingual salivary glands 10 days prior to death completely abolished the increase in serum beta NGF due to aggression. The high serum beta NGF levels, as measured by competitive RIA in aggressive mice, were confirmed by a neurite outgrowth PC-12 bioassay system. In conclusion, serum beta NGF in adult male mice is subject to alteration by environmental stress. PMID- 3515962 TI - Correction by insulin of disturbed TG-rich LP metabolism in rats with chronic renal failure. AB - To define the role of insulin in lipid disturbances of chronic renal failure, chronically uremic rats (U+) were supplemented by continuous insulin infusion over a 35-day experimental period and compared with control ad libitum-fed rats (C) and uremic rats without insulin (U). Uremic rats were characterized by hypoinsulinemia, an increase in both circulating very low-density lipoprotein (VLDL) and their cholesterol concentration, a normal hepatic triglyceride secretion rate (TGSR) determined with Triton WR 1339, and a low adipose tissue lipoprotein lipase (LPL) activity. Chronic insulin infusion at low rate (0.5 IU/24 h) to U+ rats normalized serum insulin (from 17.0 +/- 0.6 mU/l in U rats to 23.4 +/- 1.7 mU/l in U+ rats), serum VLDL triglycerides (from 804 +/- 65 to 410 +/- 36 mg/l), and serum VLDL cholesterol (from 43 +/- 8 to 16 +/- 3 mg/l). Hepatic TGSR decreased significantly after insulin treatment (from 0.58 +/- 0.03 to 0.44 +/- 0.03 mumol/min). Moreover, adipose tissue LPL was restored to normal by insulin supplementation (from 460 +/- 60 to 860 +/- 150 mU per total epididymal fat in U and U+ rats, respectively). Correction of the disturbed VLDL metabolism was associated with multiple actions of insulin including 1) a decrease of peripheral lipolysis, 2) a decrease of hepatic TGSR, and 3) an increase of adipose tissue LPL activity. Because cholesterol-rich VLDL are potentially atherogenic, their normalization with insulin treatment in this animal model suggests a viable area of investigation for the prevention of accelerated atherogenesis in chronic renal failure. PMID- 3515964 TI - Glucoregulatory role of cortisol and epinephrine interactions studied in adrenalectomized dogs. AB - The importance of basal cortisol (H) and epinephrine (E) levels on glucoregulation, and the effects of E, given to simulate moderate to severe stress (5 times basal rate of infusion), were examined in seven conscious adrenalectomized dogs. Although plasma glucagon (IRG) increased by 47%, insulin (IRI) decreased by 36%, norepinephrine (NE) increased by 103%, and FFA decreased by 26%, glucose concentration and kinetics remained normal after adrenalectomy. A 4-h infusion of H reestablished basal cortisol levels and returned IRG to its basal preadrenalectomy level with no change in IRI, NE, and FFA levels. Glucose production and metabolic clearance decreased concomitantly by 20%, maintaining euglycemia. A 90-min infusion of basal E caused only a transient increase in IRG. The simultaneous infusion of H with E prevented this increase in IRG and returned IRI to preadrenalectomy levels in the absence of any change in NE or glucose. A subsequent infusion of five times basal E, alone, raised circulating E levels and caused a transient decrease in plasma NE, but no change in IRI. There was a similar hyperglycemic response, as seen previously in normal dogs. The simultaneous infusion of H and E prevented the decrease in NE, but did not change the IRI and FFA responses. There was an 80% greater plasma glucose response than seen during infusion of E alone. In conclusion, what E and H lack after adrenalectomy is compensated for by an increase in IRG and a decrease in IRI, and normal glucose concentrations and kinetics are maintained. It appeared that normoglucagonemia required basal H release, whereas normoinsulinemia required both basal H and E secretion.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3515965 TI - Insulin binding and glucose transport activity in cardiomyocytes of a diabetic rat. AB - We studied insulin binding and glucose transport in isolated adult cardiomyocytes from rats with 2-wk streptozotocin-induced diabetes. At 37 degrees C, cells from diabetic rats bound less 125I-insulin and exhibited lower rates of 3-O methylglucose transport than cells from control rats. In contrast, the amount of 125I-insulin bound to myocytes at 4 degrees C was the same in both groups. Preincubation of cells from both groups with 10-10,000 ng/ml insulin significantly increased their basal rates of glucose transport by approximately 40%. However, the augmented rates in diabetics were still approximately 36% lower than the corresponding insulin-stimulated rates in the controls. When the glucose transport data were expressed as percent maximal insulin effect and plotted as a function of the amount of insulin bound, the curves obtained from both diabetic and nondiabetic controls were superimposable. These data demonstrate that 1) heart cells from diabetic rats bind less insulin than from control rats under conditions in which they exhibit impaired glucose transport rates, 2) there is no apparent difference in total receptor number between the two groups, but internalization of intact insulin appears to be diminished in diabetes, 3) coupling exists between insulin binding and glucose transport in both groups, and 4) these impaired processes are completely reversed by insulin treatment in vivo but not in vitro. PMID- 3515967 TI - Gamma radiation affects active electrolyte transport by rabbit ileum: basal Na and Cl transport. AB - The effect of whole-body gamma radiation (5-12 Gy) on electrolyte transport by rabbit ileum in vitro was assessed for 1-96 h postirradiation using the short circuit technique and radioisotopic fluxes. Although there was no effect of radiation on short-circuit current (Isc), transepithelial potential, or resistance 1 h after exposure, by 24 h the basal parameters of ileal segments isolated from irradiated animals were significantly greater than those of sham irradiated controls. The Isc increased in a dose-dependent fashion and was greatest 24 h postexposure. Isotope flux experiments revealed that the increased Isc following irradiation resulted in part from a stimulation of active serosal to-mucosal net Cl flux. There was no observable change in net Na transport. The results demonstrate that radiation exposure alters cellular transport processes, which may contribute to the fluid and electrolyte imbalance observed following radiation exposure. PMID- 3515966 TI - Genotype dependency of adaptation in adipose tissue metabolism after short-term overfeeding. AB - The present study investigated the interaction of genotype and short-term overfeeding on adipose tissue metabolism of six pairs of male monozygotic twins. The sedentary nonobese twins were submitted to a 22-day overfeeding period in which their normal daily intake was supplemented by an additional 1,000 kcal/day. A fat tissue biopsy was performed in the suprailiac region before and after overfeeding to determine fat cell diameter and basal and maximal stimulated epinephrine, norepinephrine, and isoproterenol lipolysis from collagenase isolated fat cells. Fat cell basal and maximal insulin-stimulated glucose conversion into triglycerides (basal and stimulated lipogenesis) were measured using [14C]glucose. Adipose tissue heparin-releasable lipoprotein lipase activity (LPL) was also determined. A repeated measures analysis of variance revealed overfeeding induced significant elevations in basal lipogenesis (P less than 0.05) and fat cell diameter (P less than 0.05). No significant group changes were noted in basal, epinephrine-, norepinephrine-, and isoproterenol-stimulated lipolysis, insulin-stimulated lipogenesis, and LPL activity due to large individual variation in the response to overfeeding. However, significant intrapair resemblance was noted in the changes of the aforementioned variables, suggesting a coherent within-twin pair response, despite large between-pair variation in response. Less within-pair similarity was noted in changes in basal lipogenesis and fat cell diameter. The results of the present study suggest that overfeeding induced a large range of adipose tissue metabolic responses and that the genotype plays a role in determining the sensitivity of adipose tissue adaptation to caloric affluence. PMID- 3515968 TI - Role of calcium in pathogenesis of acute renal failure. AB - The potential for calcium to play a key role in cell injury has been long suspected. Major sites of calcium action to promote cell injury include the plasma membrane, mitochondria, endoplasmic reticulum, and the cytoskeleton. Major mechanisms of calcium action to promote cell injury include activation of phospholipases, direct and indirect effects on permeability pathways, and effects on contractile and cytoskeletal structure and function. The activation of phospholipases and deterioration of mitochondrial structure and function by calcium appear to be most important in the evolution of cell injury. Tissue calcium levels invariably increase when lethal cell injury develops in a tissue and is due predominantly to mitochondrial accumulation and sequestration. The simultaneous occurrence of cell calcium overload and lethal cell injury, however, only establishes an association between these two events but does not prove causality. Over the past several years, a large amount of data has established that calcium plays a critical modifying role in the pathogenesis of both ischemic and toxic cell injury, but evidence for the thesis that calcium is the "final common pathway" for lethal cell injury is not conclusive. Many studies have emphasized the role of calcium influx from extracellular to intracellular spaces with resulting cellular calcium overload in cell injury. A critical role for intracellular redistribution of calcium pools rather than cellular calcium influx during the important early stages of cell injury may be more important. Modifying alterations in cell calcium redistribution or cellular calcium influx with a variety of agents has been beneficial in ameliorating the degree of cell injury in a number of experimental settings. It is still unclear whether these beneficial effects are due mainly to alterations of calcium-mediated processes that determine the reversibility of injury or are due to alterations in other critical metabolic processes not importantly influenced by calcium. PMID- 3515969 TI - Cardiovascular and renal responses to chronic vasopressin infusion. AB - Arginine vasopressin (AVP) was infused into the renal artery of seven uninephrectomized conscious dogs at successive rates of 0.09, 0.36, and 1.46 ng X kg-1 X min-1 for 18, 9, and 5 days, respectively; subsequently, the nonpressor analogue of AVP, 1-desamino-8-D-arginine vasopressin (DDAVP), was infused intrarenally for 7 additional days. The lowest infusion rate of AVP produced a high concentration of AVP in the renal circulation (maximal antidiuresis) with only a relatively moderate increase in peripheral plasma AVP concentration. For comparison, the effects of a comparable increase in peripheral plasma AVP concentration during intravenous infusion at this same rate were observed in an additional group of dogs. Acutely, when this low dose of AVP was infused either intrarenally or intravenously, there was marked antidiuresis, but there were no significant changes in mean arterial pressure (MAP), renal hemodynamics, or urinary electrolyte excretion. Chronically, in both groups of animals, cumulative water balance was positive, and glomerular filtration rate, effective renal plasma flow, and MAP (16-18 mmHg) all increased; plasma renin activity decreased. Similar changes were observed during DDAVP infusion. When elevated peripheral plasma levels of AVP were achieved during the higher infusion rates of AVP, natriuresis and diuresis occurred, but, otherwise there was little change in the above variables, including MAP. Thus the hydrosmotic effects of AVP appear to account for its moderate hypertensive activity. Further, the failure of AVP to produce prominent hypertension, even when pronounced systemic vasoconstrictor effects are manifested, may be a result of its inability to promote significant renal vasoconstriction and antinatriuresis. PMID- 3515970 TI - Pre- and postabsorptive insulin secretion in chronic decerebrate rats. AB - Basal, taste-stimulated (preabsorptive), and postabsorptive insulin secretion and plasma glucose responses were studied in chronic decerebrate rats and their pair fed neurologically intact controls. In experiment 1, preabsorptive insulin responses (PIR) elicited by oral infusions of glucose solution was measured in chronic decerebrate rats. Oral glucose was ingested and led to a significant short-latency elevation in plasma insulin levels. Plasma glucose levels remained constant during this time. These data show that caudal brain stem mechanisms, in isolation of the forebrain, are sufficient for the neurally mediated PIR elicited by oral glucose stimulation. In experiment 2, effects of decerebration on postabsorptive insulin secretion were measured. During the 3 h immediately after transection there was no effect of decerebration on peripheral plasma insulin or glucose levels. Thereafter, however, basal plasma insulin levels of decerebrate rats were at least twice that of control rats. Plasma glucose levels of both groups remained identical despite the hyperinsulinemia in decerebrate rats. Atropine treatment decreased, and phentolamine administration elicited a greater absolute and percent change increase in insulin levels of decerebrate rats. These data indicate that altered autonomic tone contributes to maintaining the basal hyperinsulinemia in the decerebrate rat. In response to intragastric meals and glucose and intravenous glucose administration, insulin secretion was greater in decerebrate than in control rats. Percent change in insulin levels from base line was similar in both groups after intragastric meals and intravenous glucose. In response to intragastric glucose, however, percent increase in insulin levels was greater in decerebrate rats. Decerebrate rats demonstrated mild glucose intolerance after intragastric and intravenous treatments. These results are contrasted with the known effects of ventromedial hypothalamic lesions on insulin secretion and glucose homeostasis. PMID- 3515971 TI - Effect of adrenalectomy and glucocorticoid replacement on development of obesity. AB - Female obese and lean Zucker rats were adrenalectomized (ADX) or sham-operated at 4 wk of age. ADX animals were given daily injections of 0.01, 0.05, 0.50, 1.0, or 2.0 mg hydrocortisone/100 g body wt for 30 days. ADX rats gained less weight than sham-operated controls. Obese ADX rats at the lowest dose (0.01) had a net positive energy gain but lost body fat. As steroid dose increased, obese rats deposited more fat and less protein. Doses of 0.01 and 0.05 mg produced rats that were less fat than sham-operated controls, whereas doses of 0.50, 1.0, and 2.0 mg produced rats of comparable body fat composition. Obese rats were consistently fatter and had a significantly smaller percentage body protein than lean rats at each dose. Body fat elevation was reflected by heavier parametrial and retroperitoneal fat depots and larger fat cells at all doses except the lowest. Compared with sham-operated controls, lean and obese rats at the two lowest replacement doses (0.01, 0.05) exhibited significantly decreased plasma insulin and triglyceride levels and significantly elevated brown adipose tissue protein content and citrate synthase (CS) activity. Obese rats at these doses had significantly reduced adipose tissue lipoprotein lipase (LPL) activity in the retroperitoneal depot and lower food intake. Furthermore, these obese rats had adipose depot weights, cell sizes, LPL activity, and plasma insulin, glucose, and triglyceride comparable to that of lean sham-operated controls. As steroid dose increased (0.5, 1.0, 2.0), plasma insulin and triglyceride and food intake markedly increased only in obese rats. Adipose tissue LPL activity appeared unaffected by dose. Brown adipose tissue protein content and CS activity significantly decreased as dose increased in both lean and obese rats. At all doses of replacement obese rats were more responsive to steroid than were lean rats. Obese rats receiving 0.01 mg had comparable fat depot weights, cell sizes, and plasma insulin and triglyceride as lean rats receiving 50 times as much steroid per day (0.50 mg). These results suggest glucocorticoids play an important role in the early development of obesity in the Zucker rat and support the hypothesis that obese rats are more responsive to glucocorticoids than are lean rats. PMID- 3515972 TI - Suppression of renin release by antagonism of endogenous opiates in the dog. AB - The influence of blockade of endogenous opioids on the release of renin due to partial renal arterial constriction was determined acutely and chronically in unilaterally nephrectomized dogs. In acute preparations changes in plasma renin activity, arterial blood pressure, and heart rate were determined after 15 min of 60% renal arterial constriction before and after administration of either a saline vehicle, the opiate antagonist naloxone (0.05 mg/kg), or morphine (2 mg/kg). Acute antagonism of endogenous opiates abolished the increase in plasma renin activity and mean arterial pressure associated with renal arterial constriction. Repeated renal arterial constrictions in saline- or morphine treated animals did not alter the humoral or hemodynamic responses. In chronic preparations long-term naloxone infusion attenuated the development of renovascular hypertension and diminished the increase in plasma renin activity. These data suggest that endogenous opioid peptides are modulators in the control of renin release and may be important participants in the pathogenesis of hypertension. PMID- 3515973 TI - Proteolytic enzymes in human eccrine sweat: a screening study. AB - Thermally induced human eccrine sweat was collected both by simple scraping (SS) and by a polyethylene sweat collector that covered the Vaseline-coated skin of the back to minimize epidermal contamination (CS, clean sweat). Using synthetic chromogenic Kabi S-series substrates, we demonstrated a variety of proteases in both SS and CS, the former being higher than the latter to varying extents. The higher enzyme activity in SS is mainly due to epidermal contamination because abundant protease activity was eluted from the nonperspiring stripped and unstripped skin in vivo and from the stripped stratum corneum itself. The electrophoretic separation of sweat protein has shown that CS contains at least 7 and SS 15 gelatinolytic proteinases. Although some CS proteinases could be derived from the sweat duct, the sweat secretory coil itself is responsible for at least two proteinases at 78 and 25 kilodaltons. The identity and function of these enzymes remain to be studied. PMID- 3515974 TI - Insulin-induced hypoglycemia and panic attacks. AB - To investigate whether hypoglycemia might trigger panic attacks, the authors administered intravenous insulin to 10 patients with panic disorder. All subjects developed hypoglycemia but no panic anxiety. They reported symptoms of adrenergic hyperactivity but differentiated them from spontaneous panic attacks. PMID- 3515975 TI - An association between norepinephrine-to-epinephrine ratio and suicidal ideation in depression. PMID- 3515976 TI - Heidegger for psychotherapists. AB - "Philosophical anthropology," and a powerful continental movement in philosophy and psychology have greatly influenced the practice of psychiatry in Europe. Martin Heidegger brought this approach to a position of prominence and wide attention and I describe his views pertinent to modern psychotherapy on (a) human living and (b) the epistemological foundation of psychiatry and psychotherapy. PMID- 3515977 TI - Nurse practitioner and physician assistant practices in three HMOs: implications for future US health manpower needs. AB - This study empirically examines the practices of non-physician providers (NPPs) within three large competitive health maintenance organizations (HMOs), as well as the physicians' and NPPs' views regarding the ideal role of NPPs. These roles are compared with NPP delegation patterns incorporated in the modeling methodology developed by the Graduate Medical Education National Advisory Committee (GMENAC). GMENAC recommended relatively high levels of delegation by physicians to NPPs. One of the HMO sites made use of NPPs at rates even higher than GMENAC's national ideals, while the rates at the other two were lower. The normative ideals for pediatric NPPs developed at each HMO were consistently higher than their actual roles. Concerns with acceptance and the role of NPPs are clearly no longer issues. Instead, the limits on NPP involvement appear to relate to considerations of costs, availability, and the increasing numbers of physicians competing for similar opportunities. PMID- 3515978 TI - The epidemiology of milk-borne scarlet fever: the case of Edwardian Brighton. PMID- 3515979 TI - Failure to identify HLA ABC and Dr antigens on human sperm. AB - An indirect radiolabeled antiglobulin assay (IRAA), adsorption procedures, and an indirect immunofluorescent assay using cytofluorometry (IFAA) failed to identify HLA ABC or D/Dr antigens associated with untreated human sperm or human sperm exposed to capacitating conditions. Two monoclonal clones against HLA ABC and two clones against Dr antigens were utilized. Test results in the IRAA were not different regardless of whether sperm from fertile men or human red blood cells were employed in the IRAA. However, there were highly significant differences in the IRAA between the HLA antigen expression of human sperm and leukocytes. If the antihuman HLA monoclonal antibody was preadsorbed with 25 X 10(6) sperm, there was no diminution in the ability of the adsorbed antibody to identify HLA antigens on leukocytes; however, preadsorption with 2.5 X 10(6) leukocytes reduced the activity of the monoclonal antihuman HLA antibody to levels equivalent to background activity. PMID- 3515980 TI - Fibromuscular dysplasia of the carotid arteries. AB - Fibromuscular disease of the carotid artery was identified in 30 patients, which represented 3.2 percent of all patients who had cerebral angiography at Brooke Army Medical Center in the 6 year period from 1978 to 1984. Focal neurologic events were the presenting symptoms in 63 percent of the patients. The majority of the patients were treated with antiplatelet therapy, and eight patients had a total of 10 carotid artery dilatations. The only patients with recurrent symptoms were those who received either no treatment or antiplatelet therapy. There were no recurrent symptoms in the operated patients. This study suggests that surgical treatment for the symptomatic patient may prevent recurrent symptoms with an acceptably low morbidity and mortality. There was, however, no indication that prophylactic dilation of the fibromuscular disease in the asymptomatic patient was beneficial. Fibromuscular dysplasia of the carotid arteries is often associated with intracranial aneurysms, and surgical therapy rather than antiplatelet therapy may be advisable in patients who have intracranial aneurysms. Patients with concomitant atherosclerosis of the carotid artery bifurcation should be treated like any patient with atherosclerotic disease and an endarterectomy should be performed with carotid dilatation when indicated. Fibromuscular disease of the carotid artery is an infrequent angiographic finding that is associated with focal and global neurologic symptoms. Most patients can be effectively treated with antiplatelet drugs with no recurrent symptoms, however, for persistent or progressive symptoms, some patients will require surgical dilatation of the carotid artery. Fibromuscular disease of the carotid artery may lead to catastrophic symptoms of stroke or intracranial hemorrhage if left undiagnosed or untreated. PMID- 3515981 TI - Endotoxemia after relief of biliary obstruction by internal and external drainage in rats. AB - Systemic and portal endotoxemia were studied in rats with biliary obstruction and after relief of the obstruction by internal and external drainage. Endotoxemia was increased after bile duct ligation (p less than 0.001) compared with control values. The incidence of systemic and portal endotoxemia was significantly reduced after internal drainage (p less than 0.001). A significantly higher incidence of portal (86 percent) and systemic (57 percent) endotoxemia, however, was found after external drainage. The persistence of endotoxemia after external drainage, when serum bilirubin levels returned to normal units, indicates that bile flow is important in controlling endotoxemia during preoperative biliary drainage. These results suggest that the systemic endotoxemia observed after relief of obstruction by external drainage may contribute to the increased mortality, as found in previous rat studies. This observation may contribute to an understanding of why patients with preoperative external drainage of biliary obstruction have a higher incidence of septic complications. PMID- 3515982 TI - Advances in calcium blocker therapy. AB - Calcium blockers are drugs that interfere with the entry of calcium ions into cells of a variety of tissues. Three calcium blockers, verapamil, nifedipine, and diltiazem, are currently approved for clinical use in the United States and many others are undergoing clinical trials. All calcium blockers share the effect of dilating blood vessels, although some agents are selective dilators of certain vascular beds, such as the coronary or cerebral circulation. There exist major differences among these drugs in their ability to depress myocardial contraction and inhibit cardiac impulse conduction, as well as other properties. The therapeutic actions of the agents in use, as well as the actions of the investigational calcium blockers, have been reviewed. Although calcium blockers are generally well tolerated and have fewer side effects than many alternative drugs, serious adverse effects are possible in certain clinical settings. The clinical indications for these drugs continue to expand and will likely find many uses in surgical patients, especially in the areas of cardiac surgery, neurosurgery, vascular surgery, and general surgery. PMID- 3515983 TI - Middle ear sound transmission: a field of early interest to Merle Lawrence. AB - Merle Lawrence, together with his teacher, E.G. Wever, made early contributions to the problem of middle ear sound transmission. Experiments were mostly done in cats and studied the effects of stepwise destruction of the middle ear on cochlear input and the effects of changes in middle ear air pressure on sound transmission. Their experiments provided the first physiologic evidence that the origin of auditory distortion lies in the inner ear, not in the middle ear. Lawrence also demonstrated a dual innervation of the tensor tympani muscle. With the aid of newer instrumentation, the authors studied the effects of alterations of the middle ear cavity configuration, stepwise removal of the middle ear structures, restriction of ossicular mobility, and ossicular mass loading. Our experiments caused partial decoupling of the tympanic membrane and distortion of the axis ligaments, the apparent weak elements of the middle ear system in cats. The placement of the prosthesis along the mallear handle did not affect sound transmission, as long as the connection between malleus and prosthesis was made inflexible. PMID- 3515984 TI - Animal models of inner ear vascular disturbances. AB - Animal models of vascular disorders are identified or developed for the evaluation of functional deficits and morphologic alterations. This information will serve a useful purpose for a better understanding of sudden deafness, Meniere's disease, and presbycusis. The study of microcirculation of the inner ear vessels reveals that their responses to various stimuli, such as anoxia, sympathetic nerve stimulation, hypothermia, and drugs, are different from those of the middle ear vessels. In sudden occlusion of the major vascular supply to the inner ear, the cochlea is found to be more vulnerable than the vestibular labyrinth; outer and inner hair cells and stria vascularis are most often affected. Animal models for Meniere's disease are also described, and the importance of vascularity at the endolymphatic duct and sac is discussed from an etiologic viewpoint. In presbycusis, animal models show sensory cell and spiral ganglion cell atrophies in different locations than in human cochleas, and the relationship between these atrophies and vascular impairments is not clear at the present time. PMID- 3515985 TI - Effects of noise and ototoxic drugs at the cellular level in the cochlea: a review. AB - Currently available information concerning the cellular mechanisms involved in acoustic trauma and aminoglycoside ototoxicity is reviewed to shed some new light on the cellular events that may be related to functional impairment of the auditory organ. Based on the available data, the following postulations can be made concerning the cellular mechanisms involved. 1) The macromolecular disruption of the stereocilia and cuticular plates is the initial cellular event in acoustic trauma. This disruption would affect the micromechanics of the transduction process, leading to temporary threshold shift. Further cellular impairment would involve basic cellular functions such as the protein, lipid, and glucose synthesis needed for cell repair and survival, and such impairment would result in permanent cell injury or cell death, leading to permanent threshold shift. 2) It can be postulated that the cellular mechanisms involved in aminoglycoside ototoxicity include two events. The early event is the reversible blockage of the transduction channels from the endolymph side of the hair cells. The later event is the interference in such cellular functions as protein and/or phospholipid synthesis because of binding of aminoglycoside to the phospholipids and/or protein, leading to cell death. The latter event may be facilitated by penetration or membrane-mediated internalization of the aminoglycoside from the perilymph side of the hair cell. PMID- 3515986 TI - The challenge for investigators and research funding for the 1990's: thoughts of the 1985 recipient of the RSA's annual award for research excellence. PMID- 3515987 TI - Clonal response to ethanol of proliferating rat hepatoma cells in vitro. AB - We have grown HTC cells (ascites variant of Morris hepatoma 7288c) in spinner cultures in the presence of various concentrations of ethanol, both in short-term incubations and in chronically exposed cultures. In short-term exposures cell proliferation is decreased in a dose-related fashion, falling to approximately 25% of control values at 35 mM ethanol. In refed cultures maintained at ethanol concentrations gradually increased to 17 mM, there is an initial decrease in proliferation followed by stabilization. Comparison of the growth patterns of cells chronically exposed to ethanol with the growth patterns of uncloned naive cells suggests the presence of both ethanol-sensitive and -resistant HTC cell clones. Preliminary cloning experiments have been successful in demonstrating that HTC clones do exist which have widely varying responses to ethanol. Clones have been isolated which are growth-inhibited by low concentrations of ethanol whereas others are resistant or even stimulated in the same concentration range. The critical differences between ethanol-sensitive and -resistant HTC cells are currently unknown, but the general phenomenon of clonal selection during chronic ethanol exposure is of interest in the pathogenesis of alcohol-related diseases. PMID- 3515988 TI - Cerebral metabolic alterations in rats following prenatal alcohol exposure: a deoxyglucose study. AB - Numerous reports dealing with the gross morphological, microanatomical, and behavioral changes occurring with prenatal alcohol exposure in rats have appeared. In order to define the cerebral metabolic correlates of prenatal alcohol exposure, in vivo glucose utilization rates in brain were assayed using an autoradiographic [14C]deoxyglucose technique. Pregnant Long-Evans rats were fed liquid diets containing either 35% or 0% ethanol-derived calories during day 6 through day 20 of gestation. These liquid diets were isocaloric and a pair feeding procedure was employed. The offspring were tested on shuttle avoidance techniques at 90 days of age; at 105 days of age all animals were subjected to the deoxyglucose procedures. Prenatal alcohol exposure resulted in a deficit in shuttle avoidance and yielded chronic effects on brain metabolism. Significant decreases in glucose utilization were seen in many structures within sensory, motor, and limbic systems. Significant increases in glucose consumption were found in the hypothalamic-neurohypophysial axis. In summary long-term behavioral and brain metabolic alterations were seen in rats exposed prenatally to alcohol. PMID- 3515989 TI - Alcoholism, drug abuse, and gambling. AB - Patients in an alcoholism and drug dependency treatment facility were questioned about their gambling behavior in order to find out what percentage of them were abusing alcohol and/or drugs and gambling. In order to do this, a pathological gambling signs index was constructed according to a modification of DSM III criteria and validated using independent procedures. Out of 458 patients interviewed, 40 (9%) were diagnosed as pathological gamblers and an additional 47 (10%) showed signs of problematic gambling. These patients showed clear signs of emotional, financial, family and occupational disruption, and illegal behavior in connection with their gambling which compound the disruption induced by alcohol and/or drugs. Five per cent of the patients abusing only alcohol, 12% of those with alcohol and another drug in combination, and 18% of those with other drug abuse problems without an alcohol component showed clear signs of pathological gambling; 11 1/2% of males and 2% of females were classified as pathological gamblers. The index was also significantly associated with parental gambling (38% of the children of pathological gamblers were pathological gamblers themselves). Gambling by siblings, alcoholism in the father (but not in the mother), gambling prior to age 20, greater amounts of gambling for more money, and "chasing losses in order to get even" were also positively correlated with the index. The implications for study and treatment of these individuals are discussed in terms of the study of addictions. PMID- 3515990 TI - Alcohol-metabolizing enzymes in placenta and fetal liver: effect of chronic ethanol intake. AB - Alcohol dehydrogenase and different subcellular distribution of aldehyde dehydrogenase (ALDH) in fetal liver and placenta at 15 and 21 days of gestation were studied in three different groups of pregnant rats: alcoholic, pair-fed, and rat solid chow diet animals. Chronic ethanol intake during pregnancy produced a decrease in fetal body and liver weight but an increase of placenta weight. No alcohol dehydrogenase was detected in placenta at any stage of gestation, nor in fetal liver at 15 days although a low activity was found at 21 days. No significant difference was observed from fetuses of alcoholic and nonalcoholic mothers. Subcellular aldehyde dehydrogenase distribution in placenta was similar to that in adult liver. Although no cytosolic ALDH was detected in fetal liver at any period of gestation, low activities were found in placenta and fetal liver at 15 days of pregnancy in other subcellular fractions. However, at 21 days the placental activity decreased while that of fetal liver increased markedly. The increase of the fetal liver ALDH was especially noticeable in the mitochondrial fraction in which the activity was approximately 10-fold higher than in the placenta mitochondrial fraction. A small decrease in placenta and fetal liver ALDH was observed in alcoholic rats. The role of the placenta ALDH in the acetaldehyde placental transfer is discussed. PMID- 3515991 TI - Disulfiram-ethanol reaction in the rat. 1. Blood alcohol, acetaldehyde, and liver aldehyde dehydrogenase relationships. AB - Studies were carried out to determine whether the disulfiram-ethanol reaction (DER) in the rat could be correlated with blood acetaldehyde, ethanol, and liver aldehyde dehydrogenase (ALDH) inhibition. Both hypothermia and hypotension were used as indices of the DER. Female Sprague-Dawley rats were given disulfiram (DSF) (100 mg/kg, i.p.) and low and high liver ALDH determined. No effect on high Km ALDH was found. Inhibition of low Km ALDH was dependent on DSF pretreatment time, with significant inhibition observed at 6, 8, and 12 hr following DSF. In rats receiving ethanol only, maximal blood ethanol was reached within 120 min. Blood acetaldehyde was almost undetectable. No change in rat core temperature was observed. In rats pretreated with DSF (100 mg/kg, i.p.) 8 hr before ethanol challenge (1 g/kg, i.p.), a marked increase in blood acetaldehyde was found and remained elevated throughout the temperature and blood pressure monitoring period. Blood ethanol reached a maximum within 90 min and then declined. Maximal hypothermia and hypotension occurred 120 min after ethanol. The administration of the dopamine receptor blocker pimozide (0.5 mg/kg, i.p.) 60 min before ethanol challenge, attenuated the hypothermia and hypotension. Pimozide was effective when given either 60 min before ethanol or 30 min after ethanol. The onset and duration of hypothermia and hypotension during the DER appears to follow the rise and fall of blood ethanol but not blood acetaldehyde.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3515992 TI - The effects of physostigmine on open-field behavior in rats exposed to alcohol prenatally. AB - The present study examined the effects of physostigmine, a cholinesterase inhibitor, on activity in young rats whose mothers consumed isocaloric liquid diets containing 35% or 0% ethanol-derived calories on days 6-20 of pregnancy. A pair-feeding procedure was utilized and an ad libitum lab chow group was included. Physostigmine was administered to 18-day-old offspring on 3 consecutive days with activity measures recorded for 30 min each day. Injections of physostigmine produced significant reductions in activity in alcohol-exposed offspring relative to control groups. These results provide support for a functional cholinergic deficit in offspring exposed to alcohol in utero and may have relevant clinical implications in the treatment of attentional deficit disorder which can occur following prenatal alcohol exposure. PMID- 3515993 TI - Dexamethasone suppression test testing of depressed alcoholics. AB - In order to determine the sensitivity of the dexamethasone suppression test (DST) for major depression in alcoholics, we administered this test to 27 alcoholics with major depression. Sixteen of 27 had abnormal DST results, yielding a 59% sensitivity for depression in alcoholics. When combined with previously reported specificity findings of 100%, the DST significantly (p less than 0.001) distinguished depressed from nondepressed alcoholics. PMID- 3515994 TI - Carbohydrate composition of serum transferrin in alcoholic patients. AB - Previous studies have shown that sialic acid-deficient isotransferrins appear in serum during chronic alcohol abuse. In this investigation whole serum transferrin from alcoholic patients and healthy controls was isolated by antitransferrin affinity chromatography and the total levels of sialic acid, galactose, N acetylglucosamine, and mannose were analyzed. The results showed that the concentrations of sialic acid and galactose as well as N-acetylglucosamine were reduced in all of the alcoholics studied. These findings indicate that chronic ethanol misuse exerts a more complex effect on the glycans of transferrin than previously realized. PMID- 3515995 TI - Alcohol use patterns of first-year medical students: II. Psychosocial characteristics associated with drinking level. AB - Psychosocial characteristics that identified first-year medical students who drank more or less alcohol than their peers were examined. Subjects were 116 freshman medical students (96% of one class) who completed questionnaires about alcohol use, mood, personality, social relationships, and parental alcohol abuse on the first day of school, and 106 (88% of the class) who responded to the same questionnaires in April of the first year. Heavier drinking students (i.e., the upper 25% of the sample) were more likely to be male and single, to have drunk heavily prior to medical school, to come from larger social networks which include fewer relatives, and to demonstrate a lower interpersonal orientation. Mood, academic performance, and parental alcohol abuse were not associated with drinking level. The heaviest drinkers in this sample appear to be precisely those individuals who are most impervious to peer or other social influences. PMID- 3515996 TI - Cellular distribution and properties of human blood aldehyde dehydrogenase. AB - The activity of aldehyde dehydrogenase (ALDH, EC 1.2.1.3) was measured in different fractions of human blood. Of the recovered activity 99% was detected in the intracellular fraction of the erythrocytes. The results also indicated the presence of ALDH activity in the leukocytes, since an increased activity was obtained after cultivation of the cells in the presence of a mitogen. No activity was detected in platelets, plasma, or erythrocyte membranes. Nonlinear Lineweaver Burk plots were obtained with acetaldehyde, 3,4-dihydroxyphenylacetaldehyde, and indole-3-acetaldehyde as the substrates. The apparent Km values, calculated from the low and high substrate concentration ranges of the curves, were much lower for 3,4-dihydroxyphenylacetaldehyde and indole-3-acetaldehyde than for acetaldehyde. Disulfiram caused almost complete inhibition of the blood ALDH activity in assays with acetaldehyde as the substrate, whereas 15-30% of the activity remained unaffected in assays with 3,4-dihydroxyphenylacetaldehyde and indole-3-acetaldehyde. Kinetic experiments using the mixed substrate method and isoelectric focusing of a partially purified sample of blood did not reveal the presence of more than one isozyme. PMID- 3515997 TI - Improved methods for the measurement of acetaldehyde concentrations in plasma and red blood cells. AB - Research on the toxic effects of acetaldehyde (Ach) is hampered by analytical difficulties which have been overcome by two new methods suitable for the measurement of Ach in plasma and red blood cells. The first procedure involves rapid separation of plasma, deproteinization, and Ach derivatization with 2,4 dinitrophenylhydrazine (DNP). After extraction with isooctane, the Ach-DNP complex is separated by reverse-phase high performance liquid chromatography. Red blood cell Ach is measured by a modification of the semicarbazide method. The red blood cell hemolysate is mixed with the semicarbazide solution and the extract is injected into the head-space gas chromatograph. The procedure minimizes the artifactual Ach formation which interferes with the direct hemolysis method when human blood is used. After 0.3 g/kg of ethanol, Ach values of 1.5 +/- 0.2 and 9.9 +/- 2.3 microM were detected in plasma and red blood cells of healthy volunteers. These data indicate that an important fraction of Ach circulates in the red blood cells and can be missed or underestimated when only plasma Ach is measured. PMID- 3515998 TI - Carpal pedal spasms in abstinent alcoholics. PMID- 3515999 TI - Thrombocyte involvement in immune inflammatory reactions. PMID- 3516001 TI - [Hemodynamic side effects of high-frequency jet ventilation as a function of lung volume. Impedance spirometric studies]. AB - In five patients with acute respiratory insufficiency the changes in tracheal pressure (P), lung volume (V) and transthoracic electric impedance TEI (Z) were measured during delayed expiration all over the inspiratory capacity (IC) from TLC to FRC. The quasi-static V/Z- and Z/P-curves were two-dimensionally displayed, and the Z/P-curve was volume-calibrated on the Y-axis (Z) using the linear V/Z-relationship. During high-frequency jet ventilation (HFJV, 200/min), the Z- and P-excursions were displayed on the "frozen" Z/P-curve as flat discs. By well-aimed increase in driving pressure and I/E-ratio the unknown FRC was enhanced in 4 stages (I-IV) by 0.33 IC, 0.5 IC, 0.66 IC and 0.75 IC, to measure haemodynamic reactions 10 minutes later (Swan-Ganz catheter). The pulmonary vascular resistance remained unchanged between stage I and II. It changed moderately in stage III (+14%) and was found to be markedly increased in stage IV (+45%). The increase in PVR was well parabolically correlated (r = 0.88) to the fraction of IC by which FRC was expanded. In a previous study a very similar function could be documented by us for the end-inspiratory lung volume during conventional PEEP ventilation. Concomitant to the increase in PVR the CI fell linearilly (r = 0.95). We conclude from our results: 1. TEI may be of value in monitoring HFJV. It offers the possibility to measure the increase in lung volume ("PEEP effect") and to titrate it deliberately within the usable volume range IC. 2.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3516000 TI - Meptazinol versus pethidine for postoperative pain relief in children. AB - A double-blind, randomised, clinical trial was undertaken comparing intramuscular meptazinol (1 mg/kg) with intramuscular pethidine (1 mg/kg) for the relief of post-tonsillectomy pain, in 100 children under 15 years of age. Pethidine provided better analgesia in those patients who were awake after 30 minutes, but thereafter no statistically significant differences between the degree of pain relief could be detected. Meptazinol caused less sedation than pethidine, in that significantly more patients were awake after 40 minutes in the meptazinol group. The incidence of nausea and vomiting was similar in patients of both groups. PMID- 3516002 TI - [Comparative studies of CPAP systems using a respiration simulator. I. Evaluation criteria]. AB - Assessment of the performance of modern ventilators that combine spontaneous breathing and mechanical ventilation is orientated not only towards the assessment of the inspiratory and expiratory resistance within the system, but also towards the functional criteria for the inspiratory and expiratory valves. This conclusion is particularly valid for CPAP procedures, as in this case patients must perform the entire work of breathing by themselves. As it has proved to be extremely problematic to carry out comparative testing of ventilators on patients in the intensive care unit, a breathing simulator has been developed, the use of which has enabled us to have a "patient" at our disposal who can tolerate the procedures for measuring the performance of ventilators with IMV and with CPAP without injury. The pressure-flow characteristics and the work of breathing can thus be measured under constant conditions and with various ventilation systems. Exact analysis of the pressure curve pattern under standardized conditions proved to be of value for assessing the suitability of CPAP in the case of both demand-valve systems and continuous flow systems. Appropriate assessment criteria have been worked out; the course of the test and the results for two ventilators are discussed as an example, using these criteria. PMID- 3516003 TI - A new rapid procedure for the preparation of plasmid DNA. AB - This report describes a simple and efficient procedure for the isolation of plasmid DNA free from chromosomal DNA, cellular RNA, and protein. The technique comprises a modified cleared lysate procedure of D.B. Clewell and D.R. Helinski (1969, Proc. Natl. Acad. Sci. USA, 62, 1159-1166) followed by high-performance liquid chromatography on a Dupont Bioseries GF250 surface stable diol-coated silica gel permeation column (Zorbax) for the final purification of the plasmid DNA. The use of HPLC facilitates rapid and high-resolution separations within 3-4 h. Plasmid DNA produced in this manner retains its biological activity and exhibits yields equal to those obtained by the conventional cesium chloride ethidium bromide density centrifugation method. PMID- 3516004 TI - A new assay for N-hydroxyarylamine O-acetyltransferase: reduction of N hydroxyarylamines through N-acetoxyarylamines. AB - A simple fluorometric assay for N-hydroxyarylamine O-acetyltransferase is described and compared with a nucleic acid-binding assay. The assay method is based on the finding that the highly mutagenic 2-hydroxyamino-6 methyldipyrido[1,2-a:3',2'-d]imidazole (N-OH-Glu-P-1) was reduced to the corresponding amine, 2-amino-6-methyldipyrido[1,2-a:3',2'-d]imidazole (Glu-P-1), through N-acetoxy-Glu-P-1 as the reactive intermediate in the presence of N hydroxyarylamine O-acetyltransferase, acetyl-CoA, and a sulfhydryl compound. The formation of Glu-P-1 was determined by its characteristic fluorescence intensity at 445 nm with excitation wavelength at 376 nm. The reductive reaction was inhibited by the addition of tRNA, DNA, and poly(G), to which the enzymatic product, N-acetoxy Glu-P-1, bound effectively due to its electrophilic nature. Since the fluorometric assay for the O-acetyltransferase is rapid, simple, and sensitive as compared with the nucleic acid-binding method using radioisotope labeled N-hydroxyarylamine, this method is applicable to the general assay for the formation of reactive N-acetoxy-Glu-P-1. PMID- 3516005 TI - Dideoxy sequencing method using denatured plasmid templates. AB - The dideoxy sequencing method in which denatured plasmid DNA is used as a template was improved. The method is simple and rapid: the recombinant plasmid DNA is extracted and purified by rapid alkaline lysis followed by ribonuclease treatment. The plasmid DNA is then immediately denatured with alkali and subjected to a sequencing reaction utilizing synthetic oligonucleotide primers. It takes only several hours from the start of the plasmid extraction to the end of the sequencing reaction. We examined each step of the procedure, and several points were found to be crucial for making the method reproducible and powerful: (i) the plasmid DNA should be free from RNA and open circular (or linear) DNA; (ii) a heptadecamer rather than a pentadecamer is recommended as a primer; and (iii) the sequencing reaction should be done at 37 degrees C or higher rather than at room temperature. The method enabled us to determine the sequence of more than a thousand nucleotides from a single template DNA. PMID- 3516006 TI - Enzymoblotting: a method for localizing proteinases and their zymogens using para nitroanilide substrates after agarose gel electrophoresis and transfer to nitrocellulose. AB - A method--enzymoblotting--was developed for localizing various enzymes after electrophoretic separation, transfer to nitrocellulose, and incubation with specific substrates. As an application, the proteinases porcine trypsin (EC 3.4.21.4), bovine chymotrypsin (EC 3.4.21.1), porcine elastase (EC 3.4.22.11), and their zymogen forms from porcine pancreas homogenate were analyzed utilizing specific p-nitroanilide substrates. After agarose gel electrophoresis, transfer of the separated proteinases to a nitrocellulose membrane was performed by capillary diffusion for 30 min. After air-drying of the nitrocellulose membrane, it was incubated in the appropriate substrate solution for 60 min. N-alpha Benzoyl-DL-arginine-para-nitroanilide HCl was used as a substrate for trypsin, N benzoyl-L-tyrosine-para-nitroanilide and succinyl-L-phenylalanine-para nitroanilide for chymotrypsin, and N-succinyl-L-alanyl-L-alanyl-L-alanine-para nitroanilide for elastase. p-Nitroaniline, the product thus obtained, was diazotized with N-(1-naphthyl)ethylenediamine to a red azo dye, visible at the site of the proteinases on the nitrocellulose membrane. The results could be preserved at -18 degrees C. Zymogen forms of the pancreas proteinases were detected in a similar manner. They were converted to active proteinases in situ on the nitrocellulose membrane after preincubating the nitrocellulose membrane in the activation enzymes enteropeptidase or trypsin. PMID- 3516007 TI - High-performance liquid chromatography followed by peroxyoxalate chemiluminescence detection of acetylcholine and choline utilizing immobilized enzymes. AB - A sensitive and selective method for the simultaneous determination of acetylcholine (ACh) and choline (Ch) is reported. ACh and Ch were separated on a reversed-phase column, passed through an immobilized enzymes (acetylcholine esterase and choline oxidase) column, and converted to hydrogen peroxide. The generated hydrogen peroxide was detected by the peroxyoxalate chemiluminescence reaction. The linear determination ranges were from 10 pmol to 10 nmol. The detection limit for both cholines was 1 pmol. PMID- 3516008 TI - Two-dimensional electrophoresis of yeast histones on cellogel strips and polyacrylamide gels. AB - For a quick analytical identification of histones a two-dimensional electrophoretic system has been developed. First the proteins are separated on cellulose acetate strips in alkaline buffer. Then they are reelectrophoresed in a second dimension on polyacrylamide gels either with sodium dodecyl sulfate or in the presence of urea at pH 2.7. The technique is demonstrated with yeast and calf thymus histones. PMID- 3516009 TI - Lead poisoning in children. PMID- 3516010 TI - Quantitation of nucleic acids at the picogram level using high-performance liquid chromatography with electrochemical detection. PMID- 3516011 TI - Cardiodilatin-immunoreactivity in specific atrial granules of human heart revealed by the immunogold stain. AB - The immunogold technique was applied to detect cardiodilatin-immunoreactivity (CDD-IR) in human heart. Using antibodies directed against C-terminal regions of CDD, we could identify colloidal gold label in specific atrial granules of human heart. The granules in all areas of the myoendocrine cells were homogeneously labelled and all right atrial biopsy specimen of patients with different heart diseases reacted positively and had the same distribution of label. The Golgi apparatus and ergastoplasma exhibited and extremely weak CDD-IR. The results indicate a predominant storage of CDD in specific granules. PMID- 3516012 TI - Is motilin a cerebellar peptide in the rat? A radioimmunological, chromatographic and immunohistochemical study. AB - Motilin was demonstrated by the immunoperoxidase technique in endocrine cells of the gastrointestinal tract using several specific antisera. Motilin-like immunoreactivity could only be demonstrated with one of these antisera and was observed in Purkinje cells and dendrites of the cerebellum, in pyramidal cells and dendrites of the cerebral cortex and in dendrites of the CA 3 field of the hippocampus of the rat. Very low motilin-like immunoreactivity was found in cerebellum as well as in cerebral cortex using radioimmunoassay. However, using reverse phase liquid chromatography combined with UV-detection and radioimmunoassay, no peak of a peptide corresponding to synthetic motilin was detectable in rat cerebellar extracts, in contrast to findings in rat duodenum. The results do not suggest that motilin is an intrinsic neuroactive substance of the cerebellum. PMID- 3516014 TI - Neuropeptide tyrosine (NPY)-like immunoreactivity in adrenal chromaffin cells and intraadrenal nerve fibers of rats. AB - The present peroxidase-antiperoxidase immunohistochemical study demonstrated that approximately 50% of the total chromaffin cells of the rat adrenal medulla exhibited NPY-like immunoreactivity. The immunoreactive material was localized in the core of the chromaffin granules as well as diffusely in the cytoplasm. By combination of immunohistochemistry with noradrenaline-fluorescence microscopy, all NPY-immunoreactive chromaffin cells are nonfluorescent, indicating that all NPY-chromaffin cells co-store adrenaline. A comparison of two consecutive sections, each of which was processed for the immunostaining with anti-NPY and anti-Met-Enk-Arg-Gly-Leu antisera, respectively, indicated that NPY and preproenkephalin A and its derivatives coexist in approximately one-fifth of the total NPY-immunoreactive cells. In addition to the NPY-immunoreactive cells, a plexus of NPY-immunoreactive nerve fibers with varicosities was found in the subcapsular regions of the adrenal gland. The nerve fibers were often associated with small blood vessels and extended into the zona glomerulosa. Single NPY immunoreactive fibers were sparsely distributed in the deeper regions of the cortex and in the medulla. Ganglion cells in the adrenal gland were not seen exhibiting intensely positive NPY-like immunoreactivity. The NPY-immunoreactive nerve fibers contained abundant small clear vesicles mixed with a few small and large granular vesicles. The immunoreactive material appeared on the granular cores as well as in the axoplasm. The NPY fibers were closely apposed to smooth muscle cells and pericytes of small blood vessels in the cortex.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3516013 TI - Immunofluorescence antigen localization on boar sperm plasma membranes: monoclonal antibodies reveal apparent new domains and apparent redistribution of surface antigens during sperm maturation and at ejaculation. AB - Purified boar sperm plasma membranes (PM) and PM proteins were used as antigens to produce 58 monoclonal antibodies against surface antigens. Fluorescence labelling (biotin-avidin-FITC) was used to determine the distribution of antigens in caput and cauda epididymal and in ejaculated spermatozoa with hybridoma supernatants and/or 1:100 diluted ascites fluid after subcloning. Sixteen areas (subdomains) of apparent restricted antigen mobility were identified and significant differences in the localization of most antigens in caput, cauda, and ejaculated PM were recognized. While localization patterns were highly reproducible with a given protocol for sample preparation and immunolabelling, localization patterns were markedly affected by changes in protocols. Fluorescence patterns were affected by the manner in which sperm were labelled (live sperm or sperm labelled at various steps), by washing, and by temperature or by addition of seminal plasma. These results indicate that the dynamic properties of the sperm PM or the surrounding fluids can easily mask or unmask or reconfigure binding sites for highly site-specific monoclonal antibodies and that antigen distribution is probably under-estimated when these labelling techniques are used. Such changes in the accessibility of antigenic sites to monoclonal antibodies limited determining the extent of distribution of a given antigen on epididymal sperm. However, the reproducibility of patterns when a given protocol is used and the large number of antibodies (39/42) displaying marked differences in localization on caput, cauda, and ejaculated PM suggest that changes in the organization of the PM constituents, whether by addition or subtraction of antigen or through configurational changes in proteins, are a major consequence of sperm maturation in the epididymis. PMID- 3516015 TI - Computer-assisted morphometry using video-mixed microscopic images and computer graphics. AB - A microcomputer system has been developed for collection and analysis of morphometric data from video images of histological sections. Microscopic fields of view are visualized on a video monitor and are overlaid with computer generated graphics by means of a video mixer. Planimetric data are entered by drawing on a digitizing tablet while observing the drawn image superimposed on the tissue. Programs are available to calculate various geometric parameters, count objects in a field, perform descriptive statistics, and measure volume and surface area of a solid from a series of cross sections. A program for point counting stereology presents single points for scoring within a user-defined reference area. The potential applications of interactive graphics in morphometry are discussed. PMID- 3516016 TI - Evaluation of lidocaine as an adjunct to fentanyl anesthesia for coronary artery bypass graft surgery. AB - A double-blind, randomized, prospective trial was conducted to evaluate intravenous lidocaine, 3 mg/kg, followed by an infusion of 0.05 mg X kg-1 X min 1, as an adjunct to fentanyl in 20 patients undergoing coronary artery bypass graft surgery. Lidocaine prevented hemodynamic abnormalities during tracheal intubation and after skin incision, but was ineffective in preventing hypertension following sternotomy. Intravenous lidocaine, 3 mg/kg, produced a decrease in mean arterial pressure after fentanyl, 30 micrograms/kg, that was unacceptable in some patients. Total fentanyl requirements for the duration of surgery were similar in the control group and in patients given lidocaine. We conclude that lidocaine, when administered as an adjunct to fentanyl in the dosage used in this study, can cause cardiovascular depression, and is of minimal benefit in preventing hemodynamic abnormalities after sternotomy during coronary artery bypass graft surgery. PMID- 3516017 TI - Effects of intraoperative glucose on protein catabolism and plasma glucose levels in patients with supratentorial tumors. AB - Animal studies suggest that hyperglycemia (glucose concentrations greater than 225 mg/dl) occurring prior to periods of brain ischemia exacerbates neurologic damage. Neurosurgical patients, a group at risk for intraoperative brain ischemia, often receive glucose. Therefore, the effects of intraoperative glucose administration (IGA) on these patients were studied. Sixteen patients undergoing supratentorial craniotomy were randomly assigned to receive either 5% glucose in 0.9% sodium chloride solution (G) or 0.9% sodium chloride solution (S) infusion (both at a rate of 3-4 ml X kg-1 X h-1) during the first 4 h of surgery. All patients received glucose infusions postoperatively. Plasma glucose, insulin, free fatty acids, alanine, ketones, base excess, pH, triglycerides, and lactate were measured during the infusion period and 24 h postoperatively. Urinary nitrogen was measured, commencing with the infusion and continuing for 24 h. Neurologic testing included preoperative and postoperative neurologic and psychomotor exams, time to extubation (min), and degree of alertness at the completion of anesthesia. The G group had significantly greater intraoperative plasma glucose concentrations at all time periods studied during the infusion (P less than 0.05). Glucose levels ranged from 200-242 mg/dl compared with 120-160 mg/dl in G and S groups, respectively. G group hyperglycemia was within the range associated with exacerbation of ischemic brain damage in animal studies. Free fatty acids and ketones were significantly greater (P less than 0.05) intraoperatively in the S group. Lactate and insulin were significantly greater in the G group at 4 h.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3516018 TI - From the history of anesthesia in military surgery. PMID- 3516019 TI - [Paravertebral analgesia after intra-thoracic surgery]. PMID- 3516020 TI - Sulfite sensitivity. PMID- 3516021 TI - Detection of the cholestatic factor in the liver tissue of patients with acute intrahepatic cholestasis. AB - A novel lymphokine, which we have designated as the cholestatic factor (CF). was produced from peripheral blood lymphocytes of patients with drug-induced allergic intrahepatic cholestasis by stimulation with a causative drug in the presence of the liver soluble fraction containing liver-specific lipoprotein (LSP). Marked reductions in bile flow and bile acid excretion were induced in rats by injecting CF through a mesenteric vein. In order to confirm the presence of CF in the liver tissue of patients, we attempted to detect this lymphokine by using the immunofluorescence technique. As a result, CF was found in the liver tissue of six out of 30 patients with acute intrahepatic cholestasis including one with hepatitis A type, one with hepatitis B type, one with hepatitis non-A non-B type and three with drug-induced allergic hepatitis. In contrast, CF was undetectable in the liver tissue of patients without intrahepatic cholestasis. These results may additionally support our assumption that CF plays an important role in the induction of intrahepatic cholestasis in various liver diseases. PMID- 3516022 TI - Sexually related trauma: a review. AB - Every type of sexual trauma is overlaid with the sexual mores and taboos of society and the individual psychosexual values of the patient. Informed and appropriate treatment should give good results for the patient physically as well as psychologically. Fortunately for the human species, wounds from Cupid's bow are much more common than any injury discussed by us. For those unfortunates who sustain such injuries in the pursuit of happiness, however, these guidelines for diagnosis and treatment are submitted for your review and their benefit. PMID- 3516023 TI - Effectiveness of oxfendazole against early and later 4th-stage Strongylus vulgaris in ponies. AB - Twenty pony foals (reared worm free), 6.5 to 10 weeks of age, were inoculated with Strongylus vulgaris and allocated to 5 groups, each with 4 foals. One week after inoculation, 1 group of 4 foals was given oxfendazole (OFZ) at a dosage rate of 10 mg/kg of body weight, another group was given 2 such treatments 48 hours apart, and a 3rd group was given a placebo. All treatments were administered by stomach tube. Three weeks later, foals were euthanatized and necropsied in a test for efficacy against early 4th-stage larvae. Oxfendazole was 80% and 94.9% effective against early 4th-stage S vulgaris with 1 and 2 doses, respectively. A 4th group of 4 foals was given 2 treatments of OFZ, 48 hours apart, about 8 weeks after inoculation, and a 5th group was given a placebo. These foals were euthanatized and necropsied 5 weeks after treatment in a test for efficacy against later 4th-stage larvae. Two doses of OFZ were 96.6% effective against later 4th-stage larvae. PMID- 3516024 TI - Evaluation of three formulations of fenbendazole (10% suspension, 0.5% pellets, and 20% premix) against nematode infections in cattle. AB - Anthelmintic efficacies of 3 formulations of fenbendazole were evaluated in cattle naturally parasitized with nematodes: a 10% oral suspension, 0.5% pellets as a top dressing on feed, and a 20% premix. All formulations of fenbendazole were greater than 99% effective in removing adults of Haemonchus contortus, Ostertagia spp, Cooperia spp, and Oesophagostomum radiatum. Fenbendazole was greater than 96% effective in removing adults of Strongyloides papillosus and greater than 85% effective in the removal of Trichuris sp. Fenbendazole was greater than 96% effective against immature nematodes, which were thought to be primarily Cooperia spp. Adverse reactions were not observed in calves treated with the 3 formulations of fenbendazole. PMID- 3516025 TI - Endotoxemia in horses: protection provided by antiserum to core lipopolysaccharide. AB - An equine antiserum to core lipopolysaccharide was produced by inoculation of 6 horses with a boiled cell bacterin made from the J-5 mutant of Escherichia coli O111:B4. The antiserum immunoglobulin G titer to J-5 mutant E coli, as determined by enzyme-linked immunosorbent assay, was 1:15,006. Pooled serum prepared before inoculation (preimmune serum) had a J-5 immunoglobulin G titer of 1:350. The J-5 antiserum was tested for its protective efficacy in sublethal endotoxemia in 14 horses. Four horses served as nontreated controls and were given nothing before endotoxin challenge exposure (10 micrograms/kg of body weight, IV). Pooled preimmune serum (3 ml/kg, IV) was administered to 5 horses and J-5 antiserum (3 ml/kg, IV) was administered to 5 other horses 2 to 15 hours before endotoxin challenge exposure. During the 24 hours postendotoxin challenge exposure, endotoxemia was accompanied by significant (P less than 0.05) time-related changes in temperature, heart rate, pulse character, respiratory rate and character, capillary refill time, mucous membrane color, fecal composition, attitude, PCV, total plasma protein, WBC count, platelet count, plasma fibrinogen, prothrombin time, activated partial thromboplastin time, fibrinolytic degradation products, plasma glucose, and plasma lactate in all horses. There were no apparent treatment vs time interactions (P greater than 0.05). Two horses (1 control and 1 given J-5 antiserum) died suddenly from unknown causes immediately after endotoxin challenge exposure. Seemingly, equine antiserum to core lipopolysaccharide did not provide protection from the adverse effects of experimental endotoxemia produced by bolus IV infusion of 10 micrograms of endotoxin/kg. PMID- 3516026 TI - Equine intravenous glucose tolerance test: glucose and insulin responses of healthy horses fed grain or hay and of horses with pituitary adenoma. AB - Intravenous glucose tolerance testing (0.5 g/kg of body weight) was done on 2 groups of healthy horses maintained with hay (group 1, n = 5) and with hay plus grain supplementation (group 2, n = 5) and on a group of horses with clinically diagnosed pituitary adenoma (group 3, n = 10). Healthy horses showed an immediate increase of plasma glucose concentration after the IV glucose injection, with return of values to base line in 1 hour. Group 3 horses showed resting hyperglycemia and a delayed return of glucose values to base line (3 hours). Group 3 horses showed resting hyperinsulinemia and a feeble (nonsignificant) response to the glycemic stimulus, with gradual decrease of insulin values to base line. In addition to the apparently reduced tissue sensitivity to insulin in group 3 horses, as evidenced by hyperglycemia, hyperinsulinemia, and protracted glucose and insulin curves, the initial decrease in the insulin/glucose ratio indicates that there was secretory deficiency in response to acute IV glucose loading. PMID- 3516027 TI - Changes in QRS complex in dogs with normal and exaggerated tidal volumes. AB - The influence of normal and exaggerated ventilation on the QRS was studied in 10 dogs. Peak-to-peak amplitudes of QRS in 4 circumferential unipolar and 2 limb lead ECG were obtained during eupnea and during hyperinflation produced by intermittent positive pressure ventilation or negative extrathoracic pressure. Marked changes were not observed in any lead during eupnea. During hyperinflation to a transpulmonary pressure of 10 mm of Hg (whether by intermittent positive pressure ventilation or negative extrathoracic pressure), voltages decreased in leads I, V10, rV3, and aVF and were variable in leads V3 and V5. Radiography revealed that during the hyperinflation the heart was displaced to the nondependent side of the thorax further from the dependent electrodes and that the heart became generally smaller. Changes in voltage could be attributed to alterations in relationships between the heart and electrodes on the torso surface or to changes in volume conductor properties of the heart and torso. PMID- 3516028 TI - Microscopic alterations in jejunal epithelium of 3-week-old pigs induced by pig specific, mouse-negative, heat-stable Escherichia coli enterotoxin. AB - The objective of this study was to determine whether exposure of swine jejunum to crude culture filtrates containing Escherichia coli pig-specific, mouse-negative, heat-stable enterotoxin (STb) induces structural alterations in the jejunal mucosa of pigs. Two ligated intestinal loops in each of twelve 3-week-old pigs were exposed for 2 hours to sterile E coli culture filtrates from each of the following strains: 431 (STa-producing), 1261 (STa and STb-producing), and 1790 (STb-producing); recombinant strain HB101-pRAS-1 (STb-producing); the nontoxigenic K-12 variant HB101; or trypticase soy broth. Formalin-fixed sections from these loops were examined for sloughed cells around villi, and a lesion score was determined, indicating a change in villous epithelium from columnar to cuboidal or squamous cell types or to discontinuous epithelium. Villous lengths and crypt depths also were determined. For loops exposed to culture filtrates containing STa and STb or containing only STb, lesion scores and numbers of sloughed cells were greater (P less than 0.05) and villous length was shorter (P less than 0.01) than in loops not exposed to toxin. For loops exposed to culture filtrates containing STa, lesion scores, villus lengths, and numbers of sloughed cells were not different from those of loops not exposed to toxin. Therefore, exposure of swine jejunum to STb induced structural alterations in intestinal mucosa (ie, loss of villous absorptive cells and partial atrophy of villi) that were consistent with those causing compromised absorptive capacity. PMID- 3516029 TI - Effect of induced prostatic infection on semen quality in the dog. AB - Chronic Escherichia coli prostatitis was induced in 6 dogs, with 5 sham-operated dogs serving as controls. Semen volume and sperm motility, concentration, and appearance were measured 3 times (every other day) before surgery and 3 times during the 3rd and 5th week after surgery. When values for these collections were compared, using a 2-factor analysis of variance, no significant differences (P greater than 0.05) were found. However, the percentage of normal sperm decreased markedly (from 92% to 61% to 64%) in 2 infected dogs because of an increase in primary (from 6% to 32%) or secondary (from 2% to 28%) sperm abnormalities. Testes from both of these dogs were histologically normal. PMID- 3516030 TI - Experimentally induced rabies in four cats inoculated with a rabies virus isolated from a bat. AB - Four cats were inoculated IM with rabies virus isolated from the salivary gland of a naturally infected big brown bat (Eptesicus fuscus). The 4 cats developed clinical signs of rabies after a median incubation period of 42 days. The median duration of clinical illness was 5 days. Results of fluorescent antibody evaluation, mouse inoculation, and tissue culture isolation indicated large differences in virus concentrations in various areas of the CNS of individual cats. These differences also were observed between cats. Rabies virus was isolated from the salivary glands and saliva of 2 cats; urinary bladder was the only other nonneural tissue found infected. Our observations indicated that cat rabies can be caused by bat rabies virus; that cats thus infected have infectious saliva during aggressive behavior and can therefore transmit the disease; and that adequate specimens of hippocampus, cerebellum, and brain stem are essential for reliable determination of rabies infection. The findings support recommendations for regular rabies vaccination of cats, even in areas of rabies free terrestrial mammals. PMID- 3516031 TI - Fate of [14C]xanthotoxin (8-methoxypsoralen) in a goat and in bovine ruminal fluid. AB - A lactating Nubian goat was treated with [14C]xanthotoxin, a photosensitizing psoralen that occurs naturally in some phototoxic range plants, as a single oral dose equivalent to 10.0 mg of xanthotoxin/kg of body weight. The radiochemical was rapidly absorbed, metabolized, and excreted. Although expired air was not monitored for the presence of volatile radiocarbon, the data indicated that greater than 50% of the administered [14C]xanthotoxin was metabolized by cleavage of the O-[14C]methyl moiety, with subsequent loss of the label as, presumably, [14C]CO2. Studies with bovine ruminal fluid in vitro indicated that cleavage of the O-methyl moiety of xanthotoxin could occur rapidly in the rumen. In the goat, nonmetabolized xanthotoxin was not excreted in urine, and of several metabolites in urine extracts, 3 were identified as resulting from opening of the furan or lactone ring. Only about 2% of the dose was recovered in the feces, and this consisted mainly of unmetabolized xanthotoxin. Although appreciable amounts of radiocarbon were secreted into milk, this radiocarbon was not in the form of xanthotoxin or any identifiable metabolites. The radiocarbon in milk likely resulted from the biosynthetic incorporation of [14C]CO2 into normal milk components. PMID- 3516033 TI - Infectious bovine keratoconjunctivitis: evidence for genetic modulation of resistance in purebred Hereford cattle. AB - A vaccination study was conducted in a herd of purebred Hereford cattle representing 4 selection (genetic) lines. For each of 2 years, half of the cattle were vaccinated with a pilus-enriched Moraxella bovis bacterin. Cows were vaccinated before parturition, and calves were vaccinated at 2 to 3 months of age. None of the cattle was vaccinated for 1 year preceding and 1 year after the 2 years in which cattle were vaccinated. There was a significantly (P less than 0.05) lower percentage of infectious bovine keratoconjunctivitis (IBK) in calves during years cattle were vaccinated than during years cattle were not vaccinated. During years cattle were vaccinated, there were lower percentages of IBK in vaccinated calves when compared with the percentages of IBK in nonvaccinated calves. When calves were compared on the basis of selection lines, regardless of the vaccination group, there were consistent differences in the percentages that developed IBK. Although calves with pigmented and nonpigmented eyes (representing all 4 genetic lines) developed IBK, the genetic line of calves with the most pigmented eyes had the lowest (P less than 0.05) percentage of IBK. Also, across all genetic lines, there was less IBK in pigmented eyes than in nonpigmented eyes. Seemingly, vaccination of dams, before parturition, and young calves reduced the occurrence of severe IBK in a herd situation under natural exposure conditions. The resistance or susceptibility in cattle under good management may be influenced by genetic factors. PMID- 3516032 TI - Decreased complement and bacteriostatic activities in the sera of cattle given single or multiple doses of aflatoxin. AB - Five steers given 1 dose of partially purified aflatoxin at concentrations sufficient to provide 0.2 mg to 0.8 mg of aflatoxin B1 equivalents/kg of body weight were compared with 4 steers given 14 daily doses of 0.25 mg of aflatoxin B1 equivalents/kg of body weight for complement activity and bacteriostasis. Complement activity was measured by hemolysis in gel, and bacteriostatic activity, by growth inhibition of Escherichia coli in liquid medium. In the single-dose group, complement activity and bacteriostatic activities decreased by 57 hours after dosing, and both returned to near base line by 168 hours. In the daily dose group, only bacteriostatic activity decreased, and the decrease persisted 2 weeks after the last dose of aflatoxin was given. Apparently, aflatoxin affects both complement-dependent and independent serum bacteriostatic activity. PMID- 3516034 TI - Histopathologic and antibody responses of rabbits exposed to aerosols containing spores of Aspergillus fumigatus: comparison of single and multiple exposures. AB - Resistance to pulmonary aspergillosis was studied in groups of rabbits exposed to aerosolized spores of Aspergillus fumigatus for 15 minutes on successive days for a total of 10, 7, or 4 exposures or a single exposure. The results of the study demonstrated that exposure of rabbits to spores for 15 minutes on 10 successive days did not result in an accumulation of viable spores in excess of those present in the lungs of rabbits exposed a single time. The tissue response in the lungs of the rabbits exposed at multiple times was more intense than that in the rabbits exposed once, but resolution of the lesions occurred similarly in terms of time and completeness of resolution. The duration of the antibody response as determined by a passive hemagglutination test and by enzyme-linked immunosorbent assay correlated with the number of exposures to spores, in that rabbits exposed 10 or 7 times to aerosolized spores remained positive longer than did those exposed fewer times. The results of the precipitin tests in agar gel were negative in all the rabbits but one. PMID- 3516036 TI - The dose-effect relationship in psychotherapy. PMID- 3516035 TI - Ethical issues in psychotherapy research. Problems in a collaborative clinical trials study. PMID- 3516037 TI - Dose-response effects of methacholine in normal and in asthmatic subjects. Relationship between the site of airway response and overall airway hyperresponsiveness. AB - We examined the dose-response curves to methacholine in 6 normal subjects and 13 asthmatics by simultaneous assessment of respiratory resistance (Rrs) and anatomic dead space (VDan). Methacholine was continuously inhaled in stepwise incremented concentrations during tidal breathing until a nearly twofold increase in respiratory resistance (Rrs) was observed. Large airway response was determined by VDan, and overall airway response was determined by Rrs. Small airways response was inferred from Rrs when the decrease in VDan was slight. Respiratory resistance was measured with the 5-Hz oscillation technique, and the VDan was measured by Langley's method (14) with CO2 as the test gas, and both were recorded simultaneously breath by breath. In the normal subject, VDan decreased by 28 +/- 7% (mean +/- SD) and Rrs increased simultaneously by 100%, suggesting a large airways responder. Five asthmatics were large airway responders in a manner similar to that of the normal subjects, but in 8 asthmatics, VDan decreased by 10% or less, whereas Rrs increased by 100%, suggesting that the increase in Rrs was due to an increase in small airways resistance (small airways responder). In the asthmatic subjects, small airways responders showed more hypersensitivity than did large airways responders (p less than 0.01). These results suggest that the site of airway response is one of the determining factors in bronchial hypersensitivity. PMID- 3516038 TI - Modification of the methacholine inhalation test and its epidemiologic use in polyurethane workers. AB - The dosimeter method of administering doubling cumulative doses of methacholine to measure bronchial responsiveness was standardized to control for the effects of a number of potential influencing variables. The aerodynamic mass median diameter of the challenge aerosol produced from a DeVilbiss 646 nebulizer proved to be 1.2 mu, and the mean output per inhalation 8.9 microliters. Each challenge dose comprised 5 inhalations. Cumulative doses ranged from 0.3 methacholine inhalation units (1 unit = 1 inhalation of aerosol from a 1-mg/ml solution of methacholine, i.e., 8.9 micrograms methacholine) to a possible 640 units, the maximum that was considered reasonable to avoid the risk of unacceptable systemic effects. Responsiveness was expressed as the dose provoking a 20% decline (PD20) in FEV1. Modifications in this full protocol were introduced to facilitate epidemiologic investigations. Physician assessments coupled with baseline measurements of ventilatory function allowed starting at higher dosages for persons with low probability of hyperresponsiveness, thereby shortening the time required for testing to an average of 38 min. In a validation study of 20 persons using both the full and modified protocols, no significant differences were detected between measured PD20 values (geometric means Full versus Modified, 14.83 versus 14.88; r = 0.99). The modified protocol was used to measure bronchial responsiveness in 254 workers exposed to toluene diisocyanate. It proved to be safe and acceptable. Sixty-four workers (25.2%) were found to be reactors. The frequency distribution of the PD20 values exhibited a steadily increasing trend, consistent with a unimodal distribution. PMID- 3516039 TI - Ascorbate modulates antibacterial mechanisms in experimental pneumococcal pneumonia. AB - To evaluate the influence of vitamin C on pulmonary antibacterial mechanisms, normal CD-1 mice were administered sodium ascorbate (200 mg/kg/24 h) and challenged intratracheally with type 3 Streptococcus pneumoniae. Survival rates were similar in ascorbate-treated and control animals. When infected with a high inoculum (1 X 10(6) cfu), animals given vitamin C demonstrated a significant enhancement in their capacity to clear viable pneumococci from the lungs at 24 h after challenge; the augmented pulmonary clearance was associated with an increased influx of granulocytes at 6 and 24 h. After infection with a lower inoculum (1 X 10(5) cfu), animals treated with the vitamin exhibited a significant advantage in pulmonary clearance and granulocyte recruitment but at 6 h only. After a very low inoculum challenge (1 X 10(4) cfu), the clearance of viable pneumococci was retarded in ascorbate-treated mice. In vitro, the pneumococcidal capacity of resident alveolar macrophages from animals given vitamin C was significantly reduced, but the ability of these cells to generate leukocyte chemoattractant activity after stimulation with the calcium ionophore A23187 remained unaltered. We conclude that in the mouse, large doses of vitamin C alter pulmonary defense mechanisms against S. pneumoniae; however, these changes do not appear to convey a substantial advantage to the host. PMID- 3516040 TI - Occupational asthma. PMID- 3516041 TI - [Acute lymphoblastic leukemia in children. Long survivals obtained with protocols C2-72 and D-74 (1972-1977)]. AB - Between 1972-1977, 92 patients with acute lymphoblastic leukemia, between 0 and 14 years of age, were treated with C2-72 and D-74 protocols. Induction treatment consisted of prednisolone (PRED)-vincristine (VCR) with the addition of daunorubicin (prot. C2-72) or asparaginase (prot. D-74). In both protocols, preventive therapy on the CNS consisted of cranial irradiation (24 Gy) and 5 doses of methotrexate i.t. (MTX). For the maintenance phase in protocol C2-72, three combinations: mercaptopurine (MP)-MTX, MP-Ara.C and MTX-cyclophosphamide, were sequentially administered for 3 years, with reinductions of PRED-VCR every three months. In protocol D-74, only MP-MTX was used for 3 years; the random half of the patients also received "reinductions". In protocol C2-72, BCG was administered by scarifications for 2 years to patients in remission after 36 months; in D-74, the random-half patients received BCG and irradiated allogeneic blasts for one year. The other half of the patients received no other treatment. The overall disease-free survival rate is 45.6% with a duration of between 84 and 156 months. Only one death occurred after 7 years. In protocol C2-72, 9 of 26 initial patients (34.6%) and in protocol D-74, 33 of 66 initial patients (50%) are still alive, off treatment and with no sign of disease. Ten patients (10.8%) died in continuous remission of infection (8) or toxic encephalopathy (2); five deaths were caused by "Pn. carinii". The incidence of meningeal relapse was 11% and isolated testicular relapse in males 15.7%; moreover, in 6 of the 22 boys in remission, programmed testicular biopsy showed interstitial leukemic infiltrates. Analysis of initial risk factors permitted the establishment of a risk index (r.i.): in cases with a r.i. below 3 (76% of cases) the survival rate was 53%; in the group with a higher r.i. (24%), it was 22%. Further conclusions of this study were: the lack of effectivity of "reinductions" and immunotherapy and proof of a higher rate of relapses in males mainly owing to isolated testicular relapse. PMID- 3516042 TI - Infectious complications in adults with bone marrow transplantation and T-cell depletion of donor marrow. Increased susceptibility to fungal infections. AB - The infectious complications of bone marrow transplantation were reviewed in 43 adults, 22 of whom received transplants from HLA-matched donors without T-cell depletion and 21 of whom received donor marrow pretreated with the murine anti-T cell monoclonal antibody CT-2 and complement. Recipients of HLA-mismatched, T cell-depleted transplants had a higher rate of bacteremia (1.33 compared with 0.64 per patient, p = 0.05) and especially systemic fungal infections (0.92 compared with 0.14 per patient, p less than 0.001) than recipients of transplants from HLA-identical donors without T-cell depletion; two thirds of these infections occurred during the granulocytopenic period early after transplantation. Recipients of HLA-identical but T-cell-depleted transplants also had significantly more systemic fungal infections (0.77 per patient, p less than 0.001). T-cell depletion was associated with delayed engraftment, more prolonged granulocytopenia, and more severe lymphopenia and was shown by stepwise multivariate regression analysis to be the most powerful predictor of systemic fungal infection (r = 0.512, p less than 0.0001). Whereas ex-vivo T-cell depletion may reduce the risk of severe graft-versus-host disease, it may predispose the patient to infection, especially with fungi. PMID- 3516043 TI - The utility of routine chest radiographs. AB - Although admission and preoperative chest radiography has been done for many years in various settings, existing data do not support its utility in enhancing patient care. Calculations based on estimates of the accuracy of chest radiographs and the likelihood of disease suggest that routine chest radiography may result in many more misleading than helpful results. Patients in whom chest radiographs are likely to improve outcome are best identified by a careful history and physical examination. We recommend that the practice of doing routine chest radiographs on admission and preoperatively be stopped and that the procedure be reserved for patients with clinical evidence of chest disease and patients having intrathoracic surgery. PMID- 3516045 TI - Computer searching of the medical literature. PMID- 3516044 TI - Intracardiac thrombi and systemic embolization. AB - Recent progress has been made in diagnosing and tracing the natural history of intracardiac thrombi by echocardiography. Left ventricular thrombi occur and cause emboli in three clinical conditions: acute myocardial infarction, left ventricular aneurysm as a sequel to infarction, and idiopathic dilated cardiomyopathy. Echocardiographic studies have shown that one third of patients with acute anterior myocardial infarction have left ventricular thrombi; only a small percentage of these patients have emboli. Administration of anticoagulants decreases the prevalence of left ventricular thrombi and the frequency of embolization in this group. Thrombi that are protruding and mobile are most likely to embolize. Anticoagulation treatment decreases the prevalence of embolization in idiopathic dilated cardiomyopathy and should be instituted regardless of whether atrial or ventricular thrombi are detected by two dimensional echocardiography. In patients with chronic left ventricular aneurysm, thrombi occur commonly, but emboli, infrequently. Therefore, data are insufficient to suggest that anticoagulation treatment is indicated, even if left ventricular thrombi are detected by two-dimensional echocardiography. PMID- 3516046 TI - Enzyme immunoassay screening for hepatitis B immunization. PMID- 3516047 TI - Chronic exudative ischemic superior temporal-branch retinal-vein obstruction simulating Coat's disease. AB - A 62-year-old white man presenting with retinal telangiectasia, subretinal exudates, and a circumscribed nonrhegmatogenous retinal detachment secondary to an ischemic superotemporal-branch retinal-vein obstruction is described. Sectorial-scatter argon laser photocoagulation resulted in complete flattening of the retina and a return of visual acuity to 6/12 (20/40). Although lipid exudates and retinal detachment secondary to retinal venous occlusion have previously been reported, our case had the additional finding of marked retinal telangiectasia suggesting adult Coat's disease. This case indicates that a retinal venous occlusion can produce a capillary response simulating the characteristic features of Coat's disease. PMID- 3516048 TI - Judgment of voice improvement after recurrent laryngeal nerve section for spastic dysphonia: clinicians versus patients. AB - Four or more years after recurrent laryngeal nerve section for adductor spastic dysphonia, 25 patients assessed their voice quality and phonatory effort in relation to presurgical status, using categorical ratings (gradations of better or worse, and of easier and harder) and also numerical ratings. Quality was judged better by 88%, and effort easier by 84%; but many thought the improvement was only moderate or slight. Three speech pathologists, assessing presurgical and current recordings of the patient's voices numerically, rated the majority of the better and easier voices much closer to their presurgical status than to normal. Clinicians were highly consistent and reliable in their assessments. Patients were often in disagreement with clinician ratings and generally rated their dysphonia as less severe than the clinicians did. These discrepancies are discussed within the context of contradictory opinions regarding the efficacy of recurrent laryngeal nerve section for the treatment of adductor spastic dysphonia. PMID- 3516049 TI - [Acute laryngitis causing dyspnea in children. Recent findings]. PMID- 3516050 TI - [Is ultrasonic diagnosis indispensable in thyroid pathology, in '85? Apropos of 201 cases]. PMID- 3516051 TI - [Heterogeneous fatty liver: ultrasonic variant or anatomic entity?]. PMID- 3516052 TI - [Aneurysms of the interauricular septum. Review of the literature apropos of 8 cases]. AB - The authors present 8 cases of aneurysms of the interauricular septum (AIAS). The diagnosis was established in all cases by two-dimensional echocardiography (E2D) which was requested, three times following a cerebral vascular accident (CVA). The AIAS manifest themselves as localised "hernias" of the inter-auricular septum, mobile during the cardiac cycle. Their topography was strictly right inter-auricular in 6 cases, whereas in the other 2 patients the AIAS passed into the left atrium at protosystole and returned to the right atrium at telesystole. Catheterization with angiography was carried out 5 times: the inter-auricular septum was crossed 4 times without gasometric reasons for an associated shunt; the AIAS was opacified in all cases. An anti-coagulant treatment was prescribed for 3 patients who had suffered a CVA, and for a fourth presenting numerous supraventricular extrasystoles which were sometimes grouped. A review of the literature of the last fifty years enabled a compilation of 93 cases of AIAS to be made, 49 of which had been examined by E2D, 35 had had a hemodynamic and angiographic exploration and 47 an anatomical and/or surgical confirmation. The main results obtained are described and commented on. The diagnostic, etiopathological and prognostic problems raised by the "updating" of this pathology are discussed. PMID- 3516053 TI - [Value of the combination of trimetazidine and a calcium inhibitor in the treatment of chronic coronary insufficiency. Double-blind controlled study versus placebo]. PMID- 3516054 TI - The endomyocardial biopsy. AB - Endomyocardial biopsy (EMB) provides a safe, simple method of gathering unique information. Although the role of EMB continues to evolve rapidly, present consensus includes the following indications, based on the ability of EMB to provide diagnoses unobtainable by other means: assessment of early rejection following cardiac transplantation; determination of myocarditis as etiology of clinically obscure cardiac dysfunction; quantification of chemotherapeutic (especially anthracycline) cardiotoxicity; and distinction between constrictive and restrictive heart disease. Each of these indications carries major therapeutic as well as prognostic implications. Methods of processing EMB are presented, complications listed, artifacts described, findings and uses illustrated, and suggestions for future development addressed briefly. PMID- 3516055 TI - Streptococcal antibody tests in rheumatic fever. AB - Although the incidence of rheumatic fever has declined significantly over the last decade, testing for antibodies to streptococcal extracellular enzymes maintains an important role in differentiating this disease from others with similar characteristics. Detection of antibodies to streptolysin O and DNase-B remain the more popular single antibody tests while the streptozyme test, which detects antibodies to five distinct streptococcal extracellular products, has been increasingly used in recent years as a screening test. Several new procedures detecting antibodies to different somatic antigens have been developed, the most promising of which seem to be anti-Group A carbohydrate tests. Because antibodies to the group A carbohydrate remain for several years in patients with persistent rheumatic valvular disease, this test should aid in the differentiation of rheumatic from non-rheumatic heart disease. PMID- 3516056 TI - [Treatment of an abdominal form of Castleman's disease by chemotherapy]. AB - In this report, we present a case of abdominal Castleman's disease determining lymphatic blockade and chylous ascites. On laparotomy, the tumour was considered as unremovable. Management of this unusual case included total parenteral nutrition, corticoids, cyclophosphamide and antituberculous therapy. This treatment was followed by a dramatic improvement and disappearance of the ascitic effusion. Shrinkage of the tumour was demonstrated by repeated ultrasonography. PMID- 3516057 TI - [Digestive manifestations in disseminated lupus erythematosus]. PMID- 3516058 TI - Patterns and correlates of genetic variation in South Amerindians. AB - Gene frequency data from six polymorphic blood group systems in 70 South American Indian populations are used to derive synthetic gene frequency maps that document the geographical pattern of genetic variation. Additional analyses are directed toward the elucidation of mechanisms that give rise to or maintain the observed distributions. Variables of local ecology do not appear to explain gene frequency distributions in South America. Instead, local isolation and the action of stochastic forces appears to be the most parsimonious explanation of the observed geographical patterns. This is distinctly different from the geographical patterns of genetic variation seen in other continents. PMID- 3516059 TI - Patterns of children's growth in east-central Europe in the eighteenth century. AB - Records in Vienna of the heights of (a) Military Academy youths born between 1730 and 1760, (b) orphanage children born between 1760 and 1780 and (c) military boarding-school children born between 1775 and 1815 have been retrieved and analysed. This constitutes the earliest extant set of measurements of the heights of a group of individuals. Stature was increasing in the late 1740s and decreasing after the 1770s. This evidence indicates a rise and subsequent fall in nutritional status and is consistent with the known pattern of European agricultural conditions in the eighteenth century. Shifts in the age of maximum increment support the notion of the secular changes in the nutritional status of these boys. The stature of the Habsburg boys was greater than the poorest boys of contemporary London but compared unfavourably with the height of the English gentry and American cadets of the nineteenth century and, of course, with the height of today's populations. PMID- 3516060 TI - [Gluconeogenesis, ketogenesis, and ureogenesis in isolated hepatocytes from diabetic rats: effects of insulin]. AB - The intermediary metabolism in hepatocytes isolated from diabetic rats has been studied. The incubation medium is a Krebs-Henseleit buffer containing albumin bound oleate (1 mmol/l). The high rates of gluconeogenesis, ureogenesis and ketogenesis were consistent with the diabetic state of the rats. Insulin (8 X 10( 7) mol/l) decreased glucose and urea productions from alanine (10 mmol/l) by 30%; beta-hydroxybutyrate production, oleate utilization and malate efflux (calculated) from mitochondria were also decreased. No effect of insulin was found with lactate (10 mmol/l) as gluconeogenic substrate. The glycogen content of cells was constant during the time of incubation (4h). These data suggest that the oxidation-reduction state of mitochondria and the cytoplasmic oxaloacetate concentration could be important factors in the action of insulin. PMID- 3516061 TI - Characterization of monoclonal antibodies against bovine insulin. AB - Six different monoclonal antibodies (IgG1 and IgG2a) were obtained after fusions of X63-Ag8-6.5.3 myeloma cells with spleen cells from BALB/c mice immunized with bovine insulin. Definition of binding determinants was attempted by competitive binding studies with insulins, proinsulins and modified insulins from various species. The monoclonal antibodies OXI-001 and OXI-004 were inferred to react with a region including residue A10, OXI-002 with an antigenic determinant in the B26-30 region, OXI-005 with a region including B30 and OXI-006 with a tertiary structure near the N-terminus of the B chain, possibly including B3 and A10. The equilibrium binding constants for these antibodies were calculated by three different methods (Scatchard, Langmuir and non-linear regression) and were found to be in the range of 2 X 10(7)-8 X 10(9), with good agreement between the different methods of calculation. As expected for a given monoclonal antibody, the heterogeneity index was close to 1.0, as calculated from Sip's logarithmic transformation of the binding equation. These parameters were compared to those of a mixture of the six different monoclonal antibodies and those of a conventional hyperimmune anti-insulin serum (guinea-pig). The half-dissociation times (t1/2) of complexes of antibody and bovine insulin ranged from 35 min to 38 h. PMID- 3516063 TI - A new syndrome of anosmia, ichthyosis, hypogonadism, and various neurological manifestations with deficiency of steroid sulfatase and arylsulfatase C. AB - We describe a family consisting of 3 affected men with congenital ichthyosis, anosmia, hypogonadism, nystagmus with decreased visual acuity, strabismus, hypopigmentation of the iris, and mirror movements of the hands and feet. Two of them had limitation of ocular movement and unilateral renal agenesis or hypoplasia. The condition appears to be inherited as an X-linked recessive trait. Clinical, pathological, and biochemical evaluations were compatible with a diagnosis of X-linked ichthyosis. Steroid sulfatase and arylsulfatase C activities in leukocytes and fibroblasts were markedly diminished in the affected patients. Their hypogonadism was due to decreased luteinizing hormone-releasing hormone secretion (hypogonadotropic). Hyposecretion of antidiuretic hormone was also recognized. Chromosome analysis of leukocytes and skin fibroblasts revealed a normal 46,XY male karyotype in all of the patients. PMID- 3516062 TI - [Application of the vapor test for the detection and immunologic determination of Escherichia coli heat labile enterotoxin]. AB - The principle of this thin-layer immunoassay (vapour condensation technique or TVAP) is based on the ability of antibodies to absorb firmly to polystyrene surfaces and to retain their reactivity. A condensation pattern consisting of large confluent water drops is noticable when an antibody-antigen reaction takes place. We used this technique to detect and assay the Escherichia coli heat labile enterotoxin (ETEC LT+) and compared the results of 53 strains (40 positives and 13 negatives) with single radial immune haemolysis, Gm1-ELISA and Vero cell culture tests. With the reagents used, this reaction was specific for a toxin dilution up to 1/14. As little as 0.025 micrograms/ml of cholera toxin could be detected. The TVAP-test is simple, rapid and cost-effective. It is thus quite suitable for use in diarrhoeal endemic areas. PMID- 3516064 TI - Does improved control of glycemia prevent or ameliorate diabetic polyneuropathy? Committee on Health Care Issues, American Neurological Association. PMID- 3516065 TI - [Is the postmenopausal-age-at-death variable a fitness-maximizing reproductive strategy?]. AB - On the basis of the complete 18th century vital statistics available for 811 women from Ostfriesland (Germany), an attempt is made to examine the relationship between the postmenopausal age at death and the reproductive behaviour (reproductive effort and reproductive management). Although reproductive activities appeared to have a basically life-shortening effect in the population under study, this was independent of the amount of reproductive effort. The positive correlation reported in the literature to exist between the number of (surviving) children and the age at death was confirmed in our analysis; and it can partly be explained by the interference of another relationship, i.e. between the age at the last parturition and longevity. This correlation is interpreted as an expression of fitness-maximizing reproductive management. To this belongs the idea that the existence of unmarried children, i.e. the sub-optimal social position of one's descendants, had a life-lengthening effect on the women investigated. Whereas the effects found are largely statistically significant, they are on the whole very minor, so that we may surmise that only a small part of the total variance of the postmenopausal age at death can be interpreted as an expression of an adaptive reproductive strategy. PMID- 3516067 TI - [Enzymatic synthesis of peptides]. AB - The present status of the synthesis of biologically active peptides with the use of proteolytic enzymes such as trypsin, chemotrypsin, papain and others as the catalysts is discussed. The processes of the synthesis of enkefalin, angiotensin, cholecystokinin and endorfin described in the literature prior to 1985 are indicated. The advantages and disadvantages of the enzymatic synthesis in comparison to those of the chemical one are presented. PMID- 3516066 TI - [Efferent treatment methods]. AB - The methods of treatment based on removal of toxic compounds from the host by dialysis, electrochemical oxidation and sorption are named efferent. The process of extracorporeal purification of blood with the use of specific and nonspecific sorbents is described. The action of the specific sorbents is based on the principle of using the catalytic properties of immobilized ligands or affinity sorption of the substances subject to the removal. Immunosorbents and enterosorbents are presented. PMID- 3516068 TI - Establishing a bone bank. Experience at a community hospital. PMID- 3516069 TI - A review of treatment research for aggressive and disruptive behavior in the mentally retarded. AB - This study reviews current treatment research on aggression of mentally retarded persons. Twenty-seven studies meet methodological criteria from an initial pool of 47. All the studies reviewed were empirical and had been published in national and internationally recognized journals. Treatments were behavioral and level of mental retardation and ages of the persons studied varied widely. Age and level of mental retardation proved to be significant factors in predicting treatment outcome. Also, it was found that some types of behaviors were treated more frequently than others, with inappropriate verbal responses being the most common, followed by aggression toward others and noncompliance. The implications of these findings are discussed. PMID- 3516070 TI - Excystation and culturing of human and animal Giardia spp. by using gerbils and TYI-S-33 medium. AB - Mongolian gerbils were used as an animal model to excyst and host Giardia spp. isolated from meadow voles, dogs, beavers, and humans. Both cysts and trophozoites were used to establish infections. Gerbils were infected with Giardia duodenalis from beaver, dog, and human sources, and the trophozoites were extracted and cultured in Diamond TYI-S-33 medium. The use of gentamicin and ampicillin in the medium, coupled with treatment of gerbils with gentamicin before they were sacrificed, permitted the elimination of trophozoite purification techniques before culturing. An extract of whole bovine calf blood, CLEX, was substituted for fetal bovine serum in TYI-S-33 medium and was found to be both adequate and less expensive. PMID- 3516071 TI - Studies on thylakoid phosphorylation and noncyclic electron transport. AB - The effect of thylakoid phosphorylation on noncyclic electron transport in spinach chloroplasts was investigated by measuring both the reduction of nicotinamide adenine dinucleotide phosphate (NADP) and the steady-state redox level of the primary electron acceptor quinone of photosystem II (Q) during electron flow to NADP. These data are compared with the theoretical predictions for an electron transport model which relates both the redox levels of Q and the photosystem II optical cross section to the overall velocity of noncyclic electron flow. It is demonstrated that transfer of 15-20% of the photosystem II antenna to photosystem I may stimulate electron flow to NADP only if Q is less than 60-70% oxidized (this condition exists with our thylakoids, even at extremely low absorption fluxes, when the illumination is not specifically enriched in photosystem I absorbed wavelengths); in phosphorylated thylakoids the steady-state redox level Q is substantially shifted to a more oxidized one (measurements of this parameter using light of different wavelengths quantitatively support the idea that thylakoid phosphorylation leads to increased photosystem I and decreased photosystem II cross sections); thylakoid phosphorylation leads to stimulated noncyclic electron flow to NADP only when the increased photosystem I antenna is able to bring about large increases in the steady-state level of oxidized Q. PMID- 3516072 TI - Isolation of rat liver microsomal short-chain beta-ketoacyl-coenzyme A reductase and trans-2-enoyl-coenzyme A hydratase: evidence for more than one hydratase. AB - An enzyme preparation (IIIB) isolated from liver microsomes of untreated male rats was found to contain two activities--short-chain trans-2-enoyl-CoA hydratase and beta-ketoacyl-CoA reductase. The hydratase was purified more than 1000-fold, while the reductase activity was purified over 600-fold. Employing sodium dodecyl sulfate (SDS)-polyacrylamide gel electrophoresis, a single band with a molecular weight of 76,000 was observed. Although attempts to separate these two activities have failed, it remains to be established whether the final preparation contains a single enzyme with two activities or two separate enzymes. The hydratase was most active toward crotonyl-CoA, followed by trans-2-hexenoyl-CoA (6:1) and octenoyl-CoA (8:1); the enzyme was essentially inactive toward substrates containing more than eight carbon atoms. The Vmax for crotonyl-CoA was 2117 mumol/min/mg protein, while the Km was 59 microM. Using acetoacetyl-CoA as substrate, the Vmax for the beta-ketoacyl-CoA reductase was over 60 mumol/min/mg protein and the Km was 37 microM; the Vmax for beta-ketopalmitoyl-CoA was only 15% of that observed with acetoacetyl-CoA, although the Km was 6 microM. During the course of purification, a second short-chain hydratase was discovered (fraction IVA); unlike IIIB, this fraction catalyzed the hydration of 4:1, 6:1, and 8:1 at similar rates. The partially purified preparation yielded maximal activity with 8:1 CoA (apparent Vmax 35 mumol/min/mg), followed by 6:1 CoA, 4:1 CoA, and 10:1 CoA; longer chain CoA's were relatively poor substrates, with trans 2-hexadecenoyl CoA about 0.1 as active as 8:1 CoA. On SDS-gels, fraction IVA contained four bands, all of which were below 60,000 Mr. Proteases, such as trypsin, chymotrypsin, and subtilisin, were found to completely inactivate both enzyme fractions. PMID- 3516073 TI - Effect on gluconeogenesis of mutants blocking two mitochondrial transport systems in the yeast Saccharomyces cerevisiae. AB - Two mutants of Saccharomyces cerevisiae, ccr1 and tpy1, have been found to interfere with the transport of small molecules across the inner mitochondrial membrane. Both also have the effect of interfering with the synthesis of a number of cytoplasmically located enzymes involved in gluconeogenesis, even when the cells are released from glucose repression. The ccr1 mutant, defective in the transport of dicarboxylic acids across the inner membrane, represses the synthesis of gluconeogenic enzymes almost totally, but synthesis can be induced on complete medium without a carbon source. This mutant has low levels of intracellular malate under all growth conditions tested. The tpy1 mutant, defective in the transport of pyruvate across the inner membrane, shows repression of gluconeogenesis enzymes under some growth conditions, particularly high levels of ethanol in the medium. These conditions also lead to low levels of malate in the cells. Intracellular levels of malate in these mutants, and in the wild type, are correlated with the levels of gluconeogenic enzymes present. The ability of isolated mutant mitochondria to phosphorylate ADP is shown to be consistent with the interpretation that they are defective in inner membrane transport, although as yet no evidence is available that these defects are the primary lesions in the two mutants. The data are consistent with two general models. In one, the exhaustion of an extramitochondrial corepressor or introduction of a coinducer by mitochondrial activity triggers the induction of gluconeogenic enzyme synthesis. In the second, the mitochondria themselves trigger this induction, but only when the tricarboxylic acid cycle is able to operate at a high level. PMID- 3516074 TI - [Enzyme-immuno-histo in situ hybridization]. AB - In order to understand the physiological functions of normal as well as neoplastic cells, it is best to investigate at the level of individual cell. We have been involved for the past several years with the development of a method for the localization of mRNA in individual cells using hapten labeled cDNA. Specifically, cDNA are labeled with dinitrophenyl (DNP) and the labeled cDNA are hybridized with mRNA in cells. Then the hybridized DNP-cDNA are then localized immunohistochemically using peroxidase-labeled antibodies. In this investigation, we concentrated on establishing the best condition for the removal of proteins in order to expose mRNA and for the removal of non-specific back ground staining. It was found that some proteins treatment was necessary for the exposure of mRNA for well fixed tissues and that high concentration of formamide and low concentration of salt removed effectively the nonspecific staining. Using the backscattered electron imaging for by scanning electron microscope, specific mRNA was localized in cells and tissues at the ultrastructural level. PMID- 3516075 TI - [Distribution of BCG antigens in mouse-tumor cells]. PMID- 3516076 TI - [Bone marrow transplantation with preparation involving total body irradiation of leukemia and malignant lymphoma]. AB - The records of 225 patients with leukemia and 25 patients with malignant lymphoma who underwent bone marrow transplantation (BMT) from 1975 through June 1985 were collected by national survey in Japan. For acute leukemia patients, one-year survivals by year of BMT were 8%, 46% and 56% for groups I (-1980), II (-June, 1983) and III (-June, 1985), respectively. The corresponding one-year probabilities of developing interstitial pneumonia were 93%, 45% and 27%, respectively. Survivals after BMT in the first remission in ALL and ANL patients as well as in the chronic phase in CML were better than in the remaining conditions. On the basis of the high relapse rate in syngeneic BMT for acute leukemia, it was indicated that a more aggressive treatment schedule would be necessary before and after transplantation. Despite extensive disease in cases of malignant lymphoma (all clinical stages III and IV), 5-year survival was 36%. The present analysis indicated that changes in the selection of patients, e.g., those in the first remission without infection at the time of BMT, as well as low dose rate fractionated TBI and selection of platelet donors with negative CMV titer, had resulted in a significant improvement of survival and a decreased incidence of interstitial pneumonia after BMT for leukemia in Japan. PMID- 3516077 TI - Early administration of indomethacin to preterm infants. AB - Indomethacin (0.2 mg/kg) or saline was given intravenously during the first 24 hours to 50 preterm infants in a double blind controlled trial. Eight of the control group later required treatment with indomethacin for clinical signs of left to right shunt, but only one in the treatment group (p = 0.03). Treatment with indomethacin prolonged bleeding time, raised serum creatinine concentrations, and was associated with gastrointestinal haemorrhage in seven infants. Five of these had a serum indomethacin concentration greater than 1.0 microgram/ml. There was a significant reduction of the stable metabolite of prostacyclin, 6-ketoprostaglandin F1 alpha, commencing six hours after treatment and lasting for four days. There was no significant difference in the incidence of intraventricular haemorrhage, days of treatment with oxygen or ventilation, or mortality between the two groups. PMID- 3516078 TI - Nebulised beclomethasone dipropionate in preschool asthma. AB - Twenty nine young children with severe recurrent asthma were given nebulised beclomethasone dipropionate or normal saline in a double blind manner over a six month period. Progress was monitored using diary score cards. Those receiving beclomethasone had lower symptom scores, had more symptom free days, and required less additional treatment with bronchodilator agents. The code needed to be broken more frequently if normal saline was used. Over the study period height and weight increases in the two groups were similar, and no serious side effects were noted. PMID- 3516080 TI - Ventilator settings and active expiration. PMID- 3516079 TI - Late onset cystic leucomalacia. AB - The ultrasound findings of eight premature infants who developed extensive cystic leucomalacia after the first two weeks of life are reported. Ultrasound examinations should be considered after any clinical deterioration in preterm infants up to 40 weeks' postmenstrual age to avoid missing cases of extensive cystic leucomalacia. PMID- 3516081 TI - Exposure to electromagnetic fields and the risk of leukemia. AB - Evidence from animal experiments and human studies suggests that electromagnetic fields may be human leukemogens. Epidemiological studies of leukemia in occupational groups and in the general populations are reviewed. The results are inconsistent. In the few studies showing an association between exposure to electromagnetic fields and the risk of leukemia, the temporal relationship between exposure and effect was not established, the observed associations were weak, the dose-response relationships were based on qualitative levels of exposure without regard to the duration of exposure or secondary sources of exposure, and the risk ratios were probably biased due to the population selection procedures used and misclassification of exposure. The proportionate mortality or cancer incidence ratios are unreliable estimates of relative risk. Further epidemiological research is needed to establish an association between exposure to electromagnetic fields and the risk of leukemia. PMID- 3516083 TI - Using cyclosporine: results of planned conversion to azathioprine after transplantation. PMID- 3516082 TI - Effects of estradiol and some antiestrogens (clomiphene, tamoxifen, and hydroxytamoxifen) on luteinizing hormone secretion by rat pituitary cells in culture. AB - Primary pituitary cell cultures from adult female rats were incubated for 4 or 24 h with various concentrations of estradiol (E2) or the antiestrogens (AE) tamoxifen (TMX), 4-hydroxytamoxifen (OH-TMX), and clomiphene citrate (CC). The luteinizing hormone (LH)-response of these cultures to gonadotrophin releasing hormone (GnRH) was monitored. Treatment for 4 or 24 h with high concentrations (10(-5) M) of the AE significantly decreased the GnRH-induced LH-release by the gonadotrophs. The negative E2-effect, which is observed in this model after 4 h was enhanced and the positive E2-effect, which occurs after 24 h, was completely reversed into a negative effect by these high AE-concentrations. Treatment of pituitary cells with increasing concentrations of E2 (10(-13)-10(-6) M) or AE (10(-12)-10(-5) M) for 24 h led first to a dose dependent increase of the LH response to 5 X 10(-10) M GnRH. At higher E2- or AE-concentrations this positive effect was lost, resulting in bell shaped dose-response curves. The following maximal effective concentrations (EDmax) were found: E2 = 10(-10) M, OH-TMX = 10( 9) M, CC = 10(-7) M, TMX = 10(-6) M. Incubation of pituitary cells for 24 h with concentrations of AE near their EDmax and stimulation with increasing concentrations (10(-11)-10(-7) M) of GnRH resulted in significant increases of LH secretion over a wide range of GnRH-concentrations. It is concluded that AE possess marked intrinsic activities on pituitary LH-secretion: at extremely high concentrations they suppress the GnRH-induced release of the gonadotrophin. At lower concentrations they increase the pituitary LH-response to GnRH in a manner which is qualitatively indistinguishable from that of E2. PMID- 3516084 TI - Biochemical (functional) adaptation of "arterialized" vein grafts. AB - Canine venous autografts and allografts were interposed in the femoral and carotid arterial positions in 29 dogs; grafts were harvested at three postoperative intervals (1-2 weeks, 4-6 weeks, and 8-10 weeks) for light and scanning electron (SEM) microscopy and lumenal surface prostacyclin (PGI2) production. Normal veins and arteries were used as controls. Radioimmunoassay for tritiated 6-k-PGF1 alpha, the stable metabolite of PGI2, was performed using a flow surface template incubation chamber during basal and arachidonic acid stimulated conditions. Using SEM, the autografts revealed normal endothelial cell (EC) surfaces at all time intervals; conversely, allografts exhibited extensive EC loss at 1-2 weeks with gradual reparation by 10-12 weeks (such that the EC surface was virtually indistinguishable from that of control veins or autografts). PGI2 production was significantly greater in control arteries than veins (p = 0.0001). At 1-2 weeks and 4-6 weeks, lumenal production of PGI2 in both the autografts and allografts was not significantly different from control vein; however, PGI2 production after 10-12 weeks was identical to normal arterial levels (and significantly [p less than 0.0044] higher than venous levels) in both basal and stimulated conditions. Although the mechanisms responsible for this functional (biochemical) "arterialization" process remain conjectural, increased biosynthesis and/or release of PGI2 by endothelial cells, acute phase inflammatory cells (allografts) mediated by interleukin-1 or myointimal cells seems most likely. Further elucidation of these sources of PGI2 is necessary, but these data demonstrate for the first time that venous grafts placed in the arterial circulation undergo complete functional adaptation (in addition to the well known morphological changes). PMID- 3516085 TI - Prostaglandin E1 and survival in patients with the adult respiratory distress syndrome. A prospective trial. AB - A 7-day infusion of prostaglandin E1 (PGE1), an immunomodulator, was evaluated in a prospective, randomized, placebo-controlled, double-blinded trial in surgical patients with the adult respiratory distress syndrome (ARDS). The drug seemed to improve pulmonary function--only two PGE1 patients died with severe pulmonary failure compared with nine placebo patients (p = 0.01). Survival at 30 days after the end of the infusion--the predetermined end point of the study--was significantly better in the patients given PGE1 (p = 0.03), with 15 of 21 PGE1 patients (71%) alive at this time compared with seven of 20 placebo patients (35%). Improvement in overall survival in the PGE1 patients did not reach statistical significance (p = 0.08). Overall survival in patients initially free of severe organ failure, however, was significantly better in the PGE1 patients (p = 0.03). Of the six PGE1 patients free of severe organ failure at time of entry, all survived to leave the hospital; of the 10 placebo patients initially free of severe organ failure, four survived. The drug had no serious side effects and did not potentiate susceptibility to infection. PGE1 is a promising agent for the treatment of ARDS. PMID- 3516087 TI - The cardiac donor: a six-year experience. AB - From March 1, 1979, to March 1, 1985, the University of Arizona received 223 cardiac donor referrals. Sixty-two were accepted: 15 local, 23 regional (less than 370 km or 200 nautical miles), and 24 distant (370 to 1556 km or 200 to 840 nautical miles). Thirty-eight donor deaths were due to motor vehicle accidents, 10 to gunshot wounds, 6 to cerebral disease, and 8 to other closed-head lesions. The mean time from injury to brain death was 65 +/- 5 hours (+/- standard error of the mean [SEM]) and from brain death to organ donation, 12 +/- 3 hours. The mean ischemic time for the donor hearts ranged from 30 to 233 minutes (mean +/- SEM, 128 +/- 7 minutes). Fifty patients, otherwise acceptable, were refused as cardiac donors because an ABO-compatible recipient was not available. Two regionally procured hearts failed at operation, 1 because of unrecognized donor sepsis and 1 from a patient on large-dose inotropic support. Although there was no difference in myocardial function, median survival with follow-up through June 30, 1985, of patients receiving locally, regionally, and distantly procured organs was 59 months, 18 months, and 21 months, respectively. Cumulative proportion 1-year survival was 93%, 56%, and 61%, respectively. The 2-year survival was 85% for patients given locally procured hearts, 43% for those with regionally procured hearts, and 38% for those with a heart from a distant donor. Survival curves showed significantly longer survival for locally procured organs than regionally or distantly procured organs (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3516086 TI - Fibrin in peritonitis. V. Fibrin inhibits phagocytic killing of Escherichia coli by human polymorphonuclear leukocytes. AB - Fibrin deposition initiated by peritonitis is thought to be an important local defense mechanism because it sequesters and walls off bacterial spillage. However, fibrin has been shown to predispose to residual abscess formation in rat peritonitis model. To examine the potential mechanisms of this effect, fibrin was tested in vitro for its inhibitory effect on neutrophil function. At all concentrations tested (50-1000 mg/dl), fibrin significantly impaired the ability of neutrophils to kill Escherichia coli. This inhibition occurred in a dose dependent fashion with almost complete prevention of killing at the highest concentration tested. Further studies showed that pre-exposure to fibrin did not reduce the neutrophil's ability to degranulate, undergo a respiratory burst, or kill E. coli, indicating that fibrin did not cause irreversible damage to the normal microbicidal functions of the neutrophil. However, fibrin, at physiologic concentrations, significantly impaired phagocytosis of radiolabeled E. coli. The data support the concept that phagocytosis of bacteria is impaired by neutrophils enmeshed in fibrin. Thus, contaminated fibrin could act as a nidus for residual abscesses formation following peritonitis even if an adequate number of normal leukocytes were present. PMID- 3516088 TI - Toward a better understanding of the etiology of left ventricular dysfunction after mitral valve replacement: an experimental study with possible clinical implications. AB - The relatively high morbidity and mortality of mitral valve replacement (MVR) appears to be related to an impairment in left ventricular (LV) function. This two-part investigation was designed to assess the effect of MVR on global LV function in an isolated heart preparation and to evaluate whether a mitral prosthesis with a flexible annulus would be of benefit. In Part I (14 pigs), the effects of each step in MVR were studied. Division of the chordae tendineae caused a severe deterioration in LV function (systolic pressure, 180 +/- 13 versus 120 +/- 10 mm Hg; p less than 0.05; developed pressure, 167 +/- 13 versus 108 +/- 11 mm Hg; p less than 0.05; first derivative of LV pressure [dP/dt], 2,630 +/- 300 versus 1,610 +/- 180 mm Hg/sec; p less than 0.05; balloon volume, 30 ml). Fixation of the mitral annulus prior to division of the chordae tendineae resulted in a small decrease (not significant) in LV function but had no effect after the chordae tendineae were divided. In Part II (10 pigs), two mitral annular prostheses were studied: a standard rigid prosthesis and a prosthesis of identical size but with a flexible annulus. LV function was better with the flexible than the rigid prosthesis (systolic pressure, 118 +/- 10 versus 89 +/- 5% control, p less than 0.02; developed pressure, 120 +/- 11 versus 87 +/- 5% control; p less than 0.02; dP/dt, 119 +/- 10 versus 85 +/- 4% control; p less than 0.02; balloon volume, 30 ml).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3516089 TI - Airborne contamination during cardiopulmonary bypass: the role of cardiotomy suction. AB - Airborne contamination of the wound area and the cardiopulmonary bypass circuit during sham open-heart operations on dogs was studied. The air of the operating room (OR) was contaminated with two typeable bacterial strains. It was found that the number of wounds, blood specimens, oxygenators, and cardiotomy reservoirs contaminated with Staphylococcus aureus was related to the number of S. aureus present in the air of the OR, but that contamination with Serratia marcescens was related to the type of suction used. This form of contamination was considerably higher when air was aspirated together with blood into the suction line (p less than 0.05). The oxygenator and cardiotomy reservoir were contaminated mainly by aspirating wound fluid from the airborne-contaminated wound area. The low number of sample sites positive for S. marcescens may be due to a better preserved host defense mechanism if only wound fluid is sucked. A rather high incidence of postoperative infections occurred even in dogs operated on in an OR with a low level of airborne contamination. PMID- 3516090 TI - Bronchial artery aneurysm. AB - Two patients with bronchial artery aneurysm were surgically treated. One patient had a saccular aneurysm in the root of the left bronchial artery, and the other had a mediastinal as well as an intrapulmonary aneurysm, rupture of the latter of which had resulted in massive hemoptysis. Twelve reports of bronchial artery aneurysm have appeared in the literature to date. Those of mediastinal location frequently have symptoms mimicking dissecting aortic aneurysm, whereas their intrapulmonary counterparts usually are manifested by hemoptysis. Although its etiological process remains to be elucidated, this rare entity should be recognized in the clinical practice. PMID- 3516091 TI - Pedunculated left ventricular rhabdomyoma. AB - A patient with an unusual left ventricular outflow tract obstruction caused by a solitary pedunculated left ventricular rhabdomyoma is described. Diagnosis was based on two-dimensional echocardiographic findings alone. The obstructive portion of the tumor was successfully removed from the interventricular septum by an aortic root approach. PMID- 3516092 TI - Chronic treatment with tibalosine in essential hypertension. AB - After a run-in period on placebo, 26 patients with essential hypertension were prescribed single-blind tibalosine, 150 mg daily. On tibalosine their blood pressure decreased from 157/101 to 147/93 mm Hg (p less than 0.001) and their heart rate from 74 to 68 beats per minute (p less than 0.01), while plasma renin activity tended to fall from 0.81 to 0.65 ng/ml/hr (p = 0.06). Twelve patients, maintained on monotherapy with tibalosine for an average of 3.8 months, kept a diastolic pressure below 90 mm Hg. Ten patients, whose diastolic pressure on tibalosine alone remained equal to or higher than 90 mm Hg were continued on this drug for 6.6 months, but were additionally given in a double-blind and randomized way either placebo, or atenolol 100 mg, or chlorthalidone, 50 mg, daily. As compared to tibalosine plus placebo, blood pressure and heart rate decreased further on tibalosine plus atenolol from 148/97 to 140/90 mm Hg (p less than 0.05) and from 70 to 60 beats per minute (p less than 0.05), respectively. The additional blood pressure lowering effect of tibalosine plus chlorthalidone to a level of 143/96 mm Hg was not statistically significant. Eight of 10 patients' blood pressure responded better to tibalosine combined with atenolol than with chlorthalidone. Because of adverse reactions tibalosine was discontinued in 8 of the 26 patients (31%), namely in 4 who prematurely dropped out from the study and in another 4 patients, who remained adherent to the protocol. Somnolence, weary legs and dry mouth were reported more frequently (p less than 0.05) on tibalosine than on placebo. IN CONCLUSION: tibalosine is an effective anti-hypertensive drug, but side effects preclude its clinical use at a daily dose of 150 mg; the combination with a beta-adrenoceptor blocking drug seems therapeutically more effective than with a thiazide. PMID- 3516093 TI - Effect of captopril on blood pressure responses to enkephalins in chloralose anaesthetized rats. AB - Captopril lowered blood pressure in chloralose-anaesthetized rats and enhanced the depressor responses to metenkephalin and D-Ala-metenkephalinamide to the same extent. Since metenkephalin is a much better substrate than D-Ala metenkephalinamide for dipeptidylcarboxypeptidase, some mechanism other than inhibition of this enzyme appears to be responsible for the enhancement by captopril of the responses to opioids. When the blood pressure had been lowered by haemorrhage, naloxone was no more effective than saline control in restoring blood pressure. However, when captopril was given after haemorrhage, the blood pressure was further lowered, and then naloxone produced a significant restoration. Hydralazine given after haemorrhage also caused a further lowering of blood pressure, then naloxone produced a lesser restoration of blood pressure than in haemorrhage plus captopril experiments. The results suggest that release of endogenous opioids may contribute to the fall in blood pressure upon bleeding. PMID- 3516094 TI - Anti-inflammatory actions of clonidine, guanfacine and B-HT 920 against various inflammagen-induced acute paw oedema in rats. AB - Clonidine (0.1-1.0 mg/kg, i.p.) exhibited anti-inflammatory activity in carrageenan-, formalin-, 5-HT- and histamine-induced paw oedema in rats. Similarly, other two alpha 2-adrenoceptor agonists, guanfacine and B-HT 920, also displayed an anti-inflammatory action in these models. The anti-inflammatory effect of all the three alpha 2-adrenoceptor agonists was reversed by yohimbine. However, prazosin failed to block the anti-inflammatory effect of clonidine. Intracerebroventricularly administered clonidine had a delayed onset of anti inflammatory action, starting only from 60 min post carrageenan administration. This was in contrast to the systemically administered clonidine which was effective against both phases of carrageenan-induced oedema. On the other hand, irrespective of the route of administration, i.e. peripheral or central, guanfacine and B-HT 920 were effective against the early as well as against the delayed phases of the inflammatory reaction. The studies suggest that it is not the imidazoline moiety but the activation of alpha 2-adrenoceptors which is essential for the anti-inflammatory action of these agents. PMID- 3516095 TI - Maimonides and psychosomatic medicine. PMID- 3516096 TI - Insulin and a sulfonylurea agent in non-insulin-dependent diabetes mellitus. AB - Using a double-blind crossover design, we studied the effect of tolazamide, an orally administered sulfonylurea, in 11 patients with non-insulin-dependent diabetes mellitus, poorly controlled on 40 units/day or more of insulin; all had previously failed to respond adequately to oral hypoglycemic agents and diet. In addition, six nondiabetic sex-, age-, and weight-matched controls were studied. Tolazamide significantly lowered fasting plasma glucose level from 272 +/- 21 to 222 +/- 31 mg/dL, increased fasting C peptide concentration from 0.09 +/- 0.03 to 0.28 +/- 0.10 pmole/mL (controls, 0.23 +/- 0.2 pmole/mL), and increased integrated C peptide concentration during a test meal (area under the curve) from 42 +/- 18 to 95 +/- 22 pmole/mL X min (controls, 94 +/- 8 pmole/mL X min). These data show that addition of tolazamide markedly increased fasting and meal stimulated insulin secretion and modestly lowered fasting plasma glucose concentrations. We conclude that some patients who cannot achieve satisfactory control with oral hypoglycemic agents and diet may benefit from combined therapy with oral sulfonylurea agents plus insulin. PMID- 3516097 TI - Bile acid levels in diagnosing mild liver disease. Fasting and postcholecystokinetic values. AB - In ten healthy controls and in ten patients with biopsy-proved mild liver disease, we studied fasting and postcholecystokinetic bile acid levels to assess their diagnostic value compared with standard liver tests. Cholecystokinetic bile acid elevation was standardized by evacuating the gallbladder with intramuscular ceruletide diethylamine (cholecystokinin decapeptide) in a double-blind, randomized, placebo-controlled crossover design. Radioimmunoassay of primary conjugated bile acids was adequately sensitive to separate controls from patients even on the basis of fasting serum bile acid levels. In both controls and patients, the 180-minute postcholecystokinetic bile acid time curve was significantly higher after ceruletide than after placebo. Nevertheless, neither this response nor any of the 30-minute postcholecystokinetic interval bile acid levels separated controls from patients better than the fasting bile acid values, which discriminated better than standard liver tests or the indocyanine green clearance at 20 minutes. Alanine aminotransferase separated the two groups with a sensitivity equal to fasting bile acid levels. PMID- 3516098 TI - Gonadotropin-releasing hormone in practice. PMID- 3516099 TI - Transient elevation of serum growth hormone level during pituitary apoplexy in acromegaly. AB - We report a case of acromegaly followed by pituitary apoplexy in which hormonal changes during the course of an acute episode were investigated. Serum growth hormone level increased markedly during the acute phase, and, subsequently, decreased rapidly. Finally, serum growth hormone level remained low and did not respond to stimulation. In contrast, the serum cortisol level remarkably decreased during the most serious stage and returned to the previous level after pituitary apoplexy. The low level of cortisol during the acute phase is compatible with the patient's manifestation of adrenal insufficiency, and hydrocortisone sodium succinate administration improved the critical state of the patient dramatically. PMID- 3516101 TI - Cough and captopril. PMID- 3516100 TI - Combined tubular dysfunction in medullary cystic disease. AB - A patient with medullary cystic disease presented with a combined tubular dysfunction, including severe salt wasting, renal tubular acidosis types I and IV, and marked aldosterone resistance. High-dose mineralocorticoid treatment partially corrected the defect in potassium excretion and did not affect natriuresis. Plasma aldosterone level was more than 30 times the upper normal level and was decreased but not normalized by captopril administration and volume expansion. The severe hemodynamic and metabolic consequences of these defects were corrected by renal transplantation. PMID- 3516102 TI - Bacteriology of hospital-acquired pneumonia. AB - Hospital-acquired pneumonia was studied prospectively for 3 1/2 years in a 549 bed facility with acute medical-surgical care wards, convalescent wards, and a chronic care unit. Bacteriological studies were limited to transtracheal aspirates, pleural fluid, and blood cultures. The predominant isolates in 159 patients were gram-negative bacilli (47%), anaerobic bacteria (35%), Staphylococcus aureus (31%), and Streptococcus pneumoniae (26%). Nearly half of all specimens yielded a polymicrobial flora with more than one potential pathogen. Distribution of pathogens was similar with analysis of all patients, including patients with a monomicrobial infection and patients with bacteremic pneumonia. The prevalence of cases and distribution of bacteria were similar for patients located on acute medical-surgical wards and those in the nursing home care unit. Nosocomial pneumonia was judged directly responsible for lethal outcome in 19% of patients and a contributing factor to death in another 13%. PMID- 3516103 TI - Allergic bronchopulmonary aspergillosis. Natural history and classification of early disease by serologic and roentgenographic studies. AB - Eighty-four patients with allergic bronchopulmonary aspergillosis (ABPA) were evaluated for a total of 294 patient-years with a mean observation period of 3.7 years and classified by the stage of ABPA. The largest percentage of patients were in the stage IV (corticosteroid-dependent asthma stage) group. The next largest percentage were in the stage V (fibrotic, end-stage lung disease) group. Of the latter 24 patients, eight had died. In addition, we describe 13 patients with all serologic characteristics of ABPA but without central bronchiectasis. We propose that these patients have seropositive ABPA and represent the earliest cases of it that can be diagnosed in contrast with ABPA with central bronchiectasis in which lung damage is already present. PMID- 3516104 TI - Low- vs high-dose aspirin. Effects on platelet function in hyperlipoproteinemic and normal subjects. AB - Low-dose aspirin may be inadequate for inhibition of platelet function in hyperlipoproteinemics due to increased platelet reactivity. Platelet function was studied in 18 type II hyperlipoproteinemic and 12 normal subjects after at least ten days of treatment with placebo and with low-dose (0.45 mg/kg/day) and high dose (900 mg/day) aspirin. In the normal and hyperlipoproteinemic subjects, low dose aspirin produced near maximal (90%) inhibition of platelet thromboxane generation, significant prolongation of the bleeding time, and significant inhibition of platelet aggregation, similar in degree to the inhibition produced by high-dose aspirin. There was no significant difference between hyperlipoproteinemic and normal subjects in any of the platelet function measures before and after aspirin treatment. Thus, a daily 0.45-mg/kg aspirin dose (20 to 45 mg) effectively inhibited platelet function in type II hyperlipoproteinemics, who do not appear to have an increased dose requirement for aspirin. PMID- 3516105 TI - Life-threatening complications of infective endocarditis and their management. AB - Life-threatening complications of acute infective endocarditis are still a problem despite the availability of effective antimicrobial agents. These complications, divided into two main categories, cardiac and extracardiac, and a review of the literature are presented. PMID- 3516106 TI - Diagnosis of pulmonary embolism. AB - An accurate diagnosis of pulmonary embolism is essential to prevent excessive morbidity and mortality from lack of therapy or inappropriate anticoagulation. Clinical signs and symptoms are reported to be nonspecific, although published studies do not allow calculation of true specificity. Since certain clinical characteristics or groups of findings may be sensitive enough for pulmonary embolism, the diagnosis is unlikely in their absence. Ventilation-perfusion lung scanning has high sensitivity but variable specificity for pulmonary embolism. Patients with scans showing multiple segmental or lobar perfusion defects with normal ventilation have a high probability of pulmonary embolism. Scans with less extensive perfusion abnormalities or matching ventilation defects do not reliably exclude pulmonary embolism. Pulmonary angiography is the most definitive procedure for diagnosing pulmonary embolism. Digital subtraction pulmonary angiography and radiolabeled platelet scanning are promising but require more extensive validation before routine use. PMID- 3516107 TI - Expanded role of charcoal therapy in the poisoned and overdosed patient. AB - Activated charcoal is widely used as an adsorbent for the management of patients with drug overdoses and poisonings. Activated charcoal can be used orally to prevent drug and poison absorption in cases of overdose and poisoning. Multiple oral doses of charcoal increase the elimination of several, but not all, drugs and poisons. The effectiveness of multiple oral doses of charcoal in accelerating drug clearance is dependent primarily on the endogenous clearance of the drug or poison and its volume of distribution. Multiple doses of charcoal are used to shorten the period of supportive care in certain patients or to more rapidly remove drugs or poisons that may cause tissue damage, eg, theophylline. Charcoal is a safe, effective, and inexpensive alternative to more invasive treatments for some cases of drug overdose and poisoning. PMID- 3516108 TI - Physiology of venous return. An unappreciated boost to the heart. AB - Adequate cardiovascular function depends on the control of venous tone as well as cardiac contractility, heart rate, vascular resistances, and an adequate blood volume. Venous tone is a major determinant of cardiac preload, a clinically important factor influencing cardiac function, especially during cardiac failure. In this review, vascular capacitance, venous tone, and venous return are discussed, and the concepts relating them to cardiovascular function are summarized. Active venoconstriction or dilation provides a rapid compensation, equivalent to a change in blood volume, for cardiovascular homeostasis. PMID- 3516109 TI - Expression and regulation of the Escherichia coli glutamate dehydrogenase gene (gdh) in Rhizobium japonicum. AB - The glutamate dehydrogenase (gdh) gene of Escherichia coli was transferred into an ammonium assimilation deficient mutant (Asm-) of Rhizobium japonicum (CJ9) using plasmid pRP301, a broad host range derivative of RP4. Exconjugants capable of growth on ammonia as sole N-source occurred at a frequency of 6.8 X 10(-6). Assimilatory GDH (NADP+) activity was detected in the strain carrying the E. coli gdh gene and the pattern of ammonia assimilation via GDH was similar to that of the Asm+ wild type strain. However, GDH mediated ammonia assimilation was not subject to regulation by L-glutamate. Nitrogenase activity was expressed ex planta in R. japonicum CJ9 harbouring the gdh gene, however, the presence of the gdh gene did not restore symbiotic effectiveness to the CJ9 Asm- strain in nodules. The gdh plasmid was maintained in approximately 90% of the isolates recovered from soybean nodules. PMID- 3516110 TI - Combined psychotherapy and pharmacotherapy for depression. A systematic analysis of the evidence. AB - To determine whether combined psychotherapy and pharmacotherapy is superior to alternative therapies for unipolar depression, we reviewed all controlled studies of outpatients treated for unipolar depression reported between 1974 and 1984. To accomplish this, we developed a new statistical approach that is specific in its method of evaluating the quality of each study and specific about the weights given to each outcome. The combined active treatments (drugs plus psychotherapy) were appreciably more effective than the placebo conditions but only slightly superior to psychotherapy alone, pharmacotherapy alone, or either of these combined with a placebo. PMID- 3516111 TI - [Ultrasound-guided fine needle biopsy in tumor diagnosis]. AB - Ultrasound guided fine needle biopsy led in 92 of 100 patients with suspected tumours to correct diagnostic results which determined the diagnostic and therapeutic management. Ultrasound-tomography may thus in connection with fine needle biopsy enlarge and simplify tumour diagnosis. PMID- 3516112 TI - Perspectives in metal carcinogenesis. I. Selenium. AB - This review has focused primarily on the sources of exposure to selenium and its role as an antioxidant as well as its anticarcinogenic and antimutagenic properties. Selenium is an essential trace element and a constituent of glutathione peroxidase in human erythrocytes. Numerous studies with animals have demonstrated that it is a potent inhibitor of virally- and chemically-induced tumorigenesis when administered continuously in a variety of tumor systems (predominantly in the skin, liver, colon, and mammary gland). The mechanisms by which selenium inhibits tumorigenesis is not definitely known. Several epidemiological studies have demonstrated statistically significant inverse associations between human cancer mortalities in different populations. In these studies, the regional availabilities of selenium were measured via a variety of means, including blood selenium levels, the concentration of selenium in grains and forage crops or from calculated apparent selenium intake estimated from food consumption and consumption data. These animal and human studies demonstrating inverse associations between tumorigenesis and selenium levels have led to suggestions that selenium be considered a prophylactic agent in the chemoprevention of tumorigenesis. It would appear prudent to avoid the unnecessary supplementation of normal diets with selenium. PMID- 3516113 TI - The President's cancer, the Dukes classification, and confusion. PMID- 3516114 TI - A universal staging system for cancer of the colon and rectum. Let there be light. PMID- 3516115 TI - Tumors of the heart. AB - Two thirds of primary tumors of the heart are benign, and half of the benign tumors are myxomas. Metastatic tumors of the heart are 20 to 40 times more common than primary tumors. Metastatic tumors originate mainly in melanomas, leukemias/lymphomas, and carcinomas, especially of the lung or breast. The parts of the heart affected, in decreasing order of frequency, are the pericardium, myocardium, and endocardium. The clinical diagnosis is suggested by a patient with cancer and a normal heart who develops any kind of heart disease that is progressive and unresponsive to the usual methods of treatment. Irradiation, percardiocentesis, and injection with chemotherapeutic agents are effective in ameliorating symptoms from lymphomas/leukemias of the heart and in pericardial effusions due to malignant disease. PMID- 3516116 TI - Acute cellular rejection and cyclosporine nephrotoxicity monitored by biopsy in a renal allograft recipient. The differentiation of drug nephrotoxicity from rejection by phenotyping of cellular infiltrates. AB - Serial allograft biopsies were performed on a renal transplant patient who experienced recurrent episodes of acute cellular rejection as well as cyclosporine nephrotoxicity. Five biopsies were performed after acute elevations of the serum creatinine level (15, 46, 155, 244, and 324 days after transplant). Each specimen was evaluated by routine histologic techniques as well as by immunofluorescence analysis and by monoclonal antibody labeling for determination of the cell phenotype of the mononuclear cell infiltrates within each specimen. The first and third specimens disclosed significant T-cell infiltrates with an equal number of T-cytotoxic-suppressor (Leu 2a) and T-helper-inducer (Leu 3a) cells in a diffuse cortical pattern, while the second biopsy showed a slightly milder infiltrate with a marked elevation (7:1) in the Leu 3a:Leu 2a ratio in the cortical-diffuse pattern. Clinically, the patient responded dramatically to cyclosporine dosage reduction following the second biopsy, and bolus steroid antirejection therapy following the first and third biopsies. These findings suggest that phenotypic cell marker analysis within the context of histologic pattern is a useful adjunct to the routine histologic evaluation of renal allograft biopsy specimens and may provide a means of differentiating rejection from cyclosporine nephrotoxicity. PMID- 3516117 TI - Prenatal ultrasonographic diagnosis of congenital adenomatoid malformation of the lung. Correlation with pathology and implications for pregnancy management. AB - Congenital cystic adenomatoid malformation of the lung is an uncommon malformation. The solid type III variety is the rarest and carries the poorest prognosis. This report describes the prenatal diagnosis of a case of congenital cystic adenomatoid malformation type III at 24 weeks' gestation. The pathologic features of the malformation and the etiology and prognostic significance of hydramnios and anasarca are discussed. This case indicates that the malformation can be diagnosed early enough to allow for therapeutic intervention. PMID- 3516118 TI - Utility of Leu M1 monoclonal antibody in the differential diagnosis of Hodgkin's disease. AB - We conducted a retrospective study of the utility of Leu M1 monoclonal antibody staining of paraffin-embedded tissue in the differential diagnosis of Hodgkin's disease (HD). Forty-two cases of HD of various histologic types and 33 cases of non-HD lymphomas and hyperplasias were stained with Leu M1 using the avidin biotin-peroxidase complex technique. Varying numbers, but not all Reed-Sternberg (RS) and Hodgkin's cells in all 42 cases of HD, were Leu M1 positive. These cases included seven examples of interfollicular HD and nine cases of lymphocyte predominance HD, eight of which were nodular. Four of five cases of immunologically proved T-cell lymphoma contained Leu M1-positive RS-like cells, and Leu M1-positive RS-like cells were noted in two of five cases of non-HD lymphoma that were not phenotyped but were morphologically consistent with T-cell lymphoma. We concluded that Leu M1 staining is an aid in the diagnosis of HD, but it cannot be used to differentiate HD from T-cell lymphoma containing RS-like cells. PMID- 3516119 TI - Physical fitness effect on bone mass in postmenopausal women. AB - This study was conducted to determine if bone mineral mass is influenced by the level of physical fitness in active, healthy, postmenopausal women from 50 through 59 years of age. In vivo neutron activation analysis (NAA) was used to measure calcium or bone mineral in the trunk and proximal femurs. The NAA measurement is expressed as calcium bone index (CaBI), which relates the subject's Ca value to the estimated mean value for normal subjects of the same size based on height and arm span. The normal CaBI is 1.00 +/- 0.12 (ISD). The level of physical fitness was determined by calculating the maximum oxygen uptake (VO2max), attained by a graded exercise test on the treadmill, and evaluating the muscle strength in performing one repetition maximum in the bench press and leg press. The "above-average fit" group (VO2max greater than 29 ml/kg/min) when compared to the "average fit" group (VO2max 21-29 ml/kg/min) had significantly higher CaBI (p less than 0.001) and leg press (p less than 0.01). There was significant correlation between VO2max and CaBI (p less than 0.01). The findings suggest that level of physical activity may modify the amount of bone loss in postmenopausal women. PMID- 3516120 TI - Felix A. Theilhaber--pioneer sexologist. AB - Felix A. Theilhaber, a physician, was born in Germany in 1884 and died in Israel in 1956. He was a pioneer sexologist, demographer, and sportsman and an early Zionist. Theilhaber was an original thinker and a prolific writer. He fought courageously against the pervasive reactionary and antisocial attitudes in the Germany of his time and campaigned actively, in his public addresses, books, pamphlets, and papers, for sexual reform, especially for liberalization of abortion and legalization of contraception. He founded the Society for Sexual Reform (Gesex) in 1913 and was cofounder and sexologic adviser of one of the first birth control and sex advisory clinics in Berlin (1930), operating under the patronage of the Gesex. In 1925, he founded the Coalition for Reform of the (Germany) Criminal Law, and in 1928, the periodical Sexual Hygiene. Among 20 books authored by Theilhaber are The Decline of the German Jews (1911), Das Sterile Berlin (1913), and Goethe, Sexus and Eros (1929). After his emigration to Israel in 1935, he continued his writings and later founded a Health Insurance Company in Tel Aviv, acting as its medical director. He has left a great legacy for sexology. PMID- 3516121 TI - [Immunomorphological study of fibronectin and collagen types I, III, IV and V in the myocardium in cardiosclerosis]. AB - Fibronectin and collagen, types I, III, IV and V, in the granulation tissue replacing the myocardial infarction, in the focal and diffuse cardiosclerosis were studied by means of the immunofluorescent method. The extracellular matrix in the granulation tissue contained fibronectin and collagen of the above types. Intracellular fibronectin was also found in the necrotized cardiomyocytes. Fibronectin and collagen of type IV were not detected in the postinfarction scars. The extracellular matrix consisted mainly of collagen, types III and V. Fibronectin and collagen, types I, III and V, are observed in the connective tissue in diffuse cardiosclerosis in the presence of the coronary arteries stenosis. No prevalence of the collagen of any type was found. PMID- 3516122 TI - [Structure of the thymus, immune status and the pathological process]. AB - Morphological changes in the immune system organs are described which allow the pathologist to diagnose primary syndromes of immunodeficiency. The criterion for the evaluation of the infant immune status is a thymic structure at various stages of ontogenesis as compared to the structure of a normal thymus after an antigenic stimulation. PMID- 3516123 TI - [Importance of modern methods of morphological research for the differential diagnosis of kidney diseases]. AB - It is shown on the basis of the authors' and literature data that the combination of light, immunofluorescent and electron microscopy is optimal for the diagnosis of glomerulonephritis and tubulo-interstitial nephritis. This complex of modern morphological methods made it possible to search for etiological markers of nephrological diseases, the determination of their morpho- and pathogenesis, performance of detailed differential diagnosis of certain morphological types of glomerulonephritis, elucidation of their nosological entity. PMID- 3516124 TI - [Hormonal regulation of bone tissue and skeletal tumors]. AB - Data on the importance of hormones in the regulation of bone tissue are presented. The results of studies on the direct and mediated action of growth hormones, prolactin, somatomedins, insulin-like growth factors, parathormone as well as thyroid and steroid hormones on bone tissue are summarized. Information on the modifying effect of hormones on the development of induced osteosarcomas in animals and analysis of clinical data on the role of hormones in the pathogenesis of human osteosarcomas are given. PMID- 3516125 TI - An introduction to biocompatibility. PMID- 3516126 TI - Hughlings Jackson. The man and his time. AB - This article is a brief account of the personality of Hughlings Jackson, his mode of life, and his intimate friends. He grew up when worldwide developments were taking place in biological thinking. The philosopher Herbert Spencer impressed him with his exciting concept of evolution, a principle which Jackson realized was applicable to the functions and disorders of the nervous system. Jackson and Spencer corresponded over a period of at least 37 years but they were not friends, their personal qualities being very different. Revered by his colleagues, even though they may not have fully understood what he was trying to say, Jackson became a legend in his own lifetime and an inspiration to neurologists who succeeded him. PMID- 3516128 TI - The significance of the variety of mechanisms of allograft tolerance. AB - The influence of variations in protocol on the induction and early stages of maintenance of allograft tolerance in neonatal rats was studied. Allogeneic bone marrow cells, the anti-recipient activity of which was specifically reduced because of their origin from immunologically tolerant donors, possessed diminished tolerogenic capacity. This was commonly manifested by development of an unreactive state in only one of the two parameters of reactivity--allograft rejection and graft-versus-host reactivity--that were monitored. A similar deviation from the occurrence of unreactivity in both forms that characterizes tolerant rats was observed in animals which had been inoculated with syngeneic thymus cells at the time of induction of tolerance. Attempts to demonstrate a requirement for an extended period of exposure of young rats to semi-allogeneic bone marrow cells before specific unreactivity on the part of host cells became irreversible were unsuccessful. PMID- 3516127 TI - Who was 'the father of bromide treatment of epilepsy'? AB - The introduction of bromide for the treatment of epilepsy was an important episode in the history of neurology, and the individual responsible for it is therefore deserving of special recognition. This accolade is almost unanimously given to Sir Charles Locock. However, such a conclusion needs to be seriously questioned. Both C. Bland Radcliffe and Sir Samuel Wilks are at least as deserving of the honor. PMID- 3516129 TI - Lymphoid aggregates in the guinea pig large bowel: development of quantitation techniques for number, volume and distribution. AB - A technique for assessing the number, distribution and volume of the lymphoid aggregates (LA) in the guinea pig large bowel is described. Aggregates could be visualised macroscopically after immersion of the bowel in 10% acetic acid and their number and distribution recorded by tracing on plastic sheets. Serial sections through a sample of 13 LA showed that they were ellipsoidal and this was confirmed by mathematical comparison with hypothetical ellipsoids. In practice, only the length and width of each LA could be measured but, using the sample of 13 LA, it was established that regression analysis enabled the volumes of all except the smallest LA to be predicted accurately from the knowledge of length and width alone. PMID- 3516130 TI - Immunosuppression in murine malaria: role of activated macrophages. AB - The role of macrophages in immunosuppression which develops during Plasmodium berghei infection in mice has been studied. The transfer of activated macrophages (or their extracts) from the infected mice with low parasitaemia (less than 10%) to uninfected mice enhanced their humoral response to sheep red blood cells (SRBC) as indicated by the number of splenic IgM and IgG plaque-forming cells (PFC). In contrast, when macrophages obtained during higher parasitaemia (16%) were used, significant inhibition was observed. These findings indicate that during Plasmodium berghei infection in mice macrophages may play a dual role. PMID- 3516131 TI - Use of enzyme immunoassay in a serological survey of leptospirosis in sheep. AB - A total of 731 serums, all from Merino rams from 20 farms, were tested for antibodies against Leptospira interrogans serovars hardjo, pomona and tarassovi using the microscopic agglutination test (MAT). The enzyme immunoassay (EIA) technique was used to test all serums for IgM and IgG antibodies to serovar hardjo. In the MAT, reactions to serovar hardjo were most common with 236 rams (32.3%) reacting at 1/100 or greater. Only 1.9% of serums reacted against serovar tarassovi and 1.1% against serovar pomona. The percentage of sheep with positive MAT reactions to serovar hardjo ranged from 0 0 to 94.9 between farms. When using EIA, 46 (6.2%) of the serums were positive for IgM antibody and 246 (33.6%) were positive for IgG antibody. Correlation of the EIA for detection of IgG antibody with the MAT was good. The EIA detection of IgG antibody was considered to be a good alternative test to the MAT for epidemiological studies in sheep. PMID- 3516132 TI - Osteomyelitis and arthritis associated with Aspergillus fumigatus in a dog. PMID- 3516133 TI - A review of the psychological aspects of space flight. AB - Instances of overt, serious functional impairment of space crews caused by adverse psychologic responses have not been scientifically documented. However, transient disorientation, spatial illusions, and visual disturbances as well as anomalous myopias, sleep disturbances, and instances of substandard performance have been described. Moreover, anecdotal information describes significant psychologic aberrations in space flight. Adequate scientific data are lacking for optimal psychological and psychophysiological methods for crew selection, training, and performance evaluation, for identifying key psychosocial factors for crew compatibility, cohesiveness, and productivity, and for determining the effects of space flight on perceptual, intellectual, and motor skills. The ad hoc Working Group, convened to review psychological aspects of space flight, favored establishment of a comprehensive research and development program to address the deficiencies identified in the study. PMID- 3516134 TI - Stimulation of brain muscarinic acetylcholine receptors acutely reverses radiogenic hypodipsia. AB - A sufficiently large dose of ionizing radiation produces changes in water consumption. However, the direction, durations, and physiological substrates of these alterations remain in question. Here we report a 5-d hypodipsia in rats exposed to 600 rads 60Co but a more transient, albeit larger, reduction in drinking after 1000 60Co. Brain cholinergic neurons have been implicated as mediators of thirst. Therefore, we explored the role of hypothalamic muscarinic receptors in the production of radiation-induced hypodipsia. This was accomplished through the intrahypothalamic injection of carbachol (a muscarinic agonist) or atropine (a muscarinic antagonist) in irradiated rats. Intracranial carbachol produced acute reversal of radiogenic hypodipsia while atropine potentiated the hypodipsia. These post-irradiation drug-induced behaviors were similar to those observed after the same drug treatments before irradiation. Since cholinergic neuronal functions persist and are labile (can be pharmacologically stimulated and blocked) after irradiation, this suggests that other neuronal systems and/or neurochemicals may be more prominently involved in radiogenic hypodipsia. PMID- 3516135 TI - [Isolated severance of the deep flexor tendon of the finger]. PMID- 3516136 TI - [Horse leukosis. 4. Bibliography]. PMID- 3516137 TI - Energy supply of the central nervous system. PMID- 3516138 TI - Pain and vitamin B1 therapy. PMID- 3516139 TI - Vitamin C status in schizophrenia. PMID- 3516140 TI - Behavioral changes caused by nutrients. PMID- 3516141 TI - Detection of a serum class I molecule in rat with anti-rat liver beta-2 microglobulin. AB - Rat serum was fractionated on a column of Sephacryl-300 and tested with a rabbit anti-rat beta-2-microglobulin (B2m) antiserum. This antiserum was directed against B2m purified from rat liver, and its specificity was confirmed by immunoprecipitation procedures. The antiserum recognized three peaks in the fractionated rat serum: a 200- to 300-kd (kilodalton) fraction, a 40- to 70-kd component, and the free 12-kd B2m. Indirect immunoprecipitation from the 200- to 300-kd fraction led to the identification of a 43-kd polypeptide associated with B2m. A xenoantiserum against RT1 class I antigen also precipitated a similar polypeptide from the same fraction, but this molecule differed in size and antigenic specificity from the one precipitated by anti-rat B2m. PMID- 3516142 TI - The nonclassical insulin binding of insulin receptors from rat liver is due to the presence of two interacting alpha-subunits in the receptor complex. AB - The binding characteristics of the insulin receptor tetramer (alpha 2 beta 2) and dimer (alpha beta) were examined. Unlabelled insulin enhanced the dilution induced dissociation only of the receptor tetramer-bound 125I-insulin. Furthermore, when both the receptor forms had been preincubated with anti receptor-antibodies (B9-antiserum), insulin binding only to the receptor tetramer but not to the dimer was inhibited. However, both oligomers are not immunologically distinct since more than 80% of the two forms were immunoprecipitated by the antiserum. These results suggest that both insulin and anti-receptor-antibodies induce cooperative interactions between the two linked alpha-subunits of the receptor tetramer leading to a decrease in insulin binding of this receptor form. PMID- 3516143 TI - Bradykinin induces a rapid release of inositol trisphosphate from a neuroblastoma hybrid cell line NCB-20 that is not antagonized by enkephalin. AB - In mouse neuroblastoma x Chinese hamster brain clonal cell line NCB-20, bradykinin (BK) receptor stimulation causes phosphoinositide hydrolysis and release of inositol phosphates. Maximum stimulation (4-fold) of [2-3H]inositol trisphosphate (IP3) release in the absence of Li+ from NCB-20's prelabelled for 20-24 hours with [2-3H]myo-inositol (15 microCi/confluent 60mm dish) occurred after 5-10 seconds of bradykinin exposure, with an EC50 of approximately 100nM. Inositol bisphosphate (IP2) and inositol monophosphate (IP1) also showed increases (2.9-fold and 1.5 fold, respectively), with peaks at 15-20 seconds and 50 seconds, respectively. Under these same conditions, D-Ala2-D-Leu5 enkephalin (DADLE) (10 microM), an opiate agonist with 2nM affinity, gave no stimulation of IP3 release. Furthermore, it did not block BK-initiated release, both when applied simultaneously with BK and when cells were preincubated with DADLE for 100 minutes to lower cyclic AMP levels. These results show that pain-inducing BK has a major acute stimulatory effect on receptor-phospholipase C-coupled IP3 release, the opioid peptide DADLE has no such effect and, DADLE does not block the IP3 release induced by BK. PMID- 3516144 TI - Expression and secretion of hepatitis B viral surface antigen in E. coli. AB - Hepatitis B viral surface antigen (HBsAg) gene was subcloned into the BglII site of Bacillus licheniformis penicillinase (penP) gene of secretory vector pJP104. Expression and secretion of HBsAg protein was achieved by the E. coli CS412 carrying the plasmid pJPS2 in which the penP:HBsAg hybrid gene was under the control of two promoters, lipoprotein (lpp) and penP, spaced 450 bases apart. The secreted form of HBsAg encoded by the hybrid penP: HBsAg gene of plasmid pJPS2 was purified by immunoaffinity chromatography and found to be a 25 kilodalton protein. PMID- 3516145 TI - Phorbol esters, but not insulin, promote depletion of cytosolic protein kinase C in rat adipocytes. AB - The tumor-promoting phorbol esters have insulinomimetic effects in several tissues. Employing two different assay systems, we have compared the effects of phorbol ester and insulin on the activity and intracellular distribution of the Ca++ and phospholipid dependent protein kinase (protein kinase C) in isolated rat adipocytes. Phorbol ester leads to a prompt depletion of kinase activity from the cytosolic fraction and appearance of activity in membrane extracts; neither of these effects is mimicked by insulin. These results, taken together with other data, emphasize important divergences between the actions of these agonists and suggest that changes in protein kinase C activity or intracellular distribution are not a necessary concomitant of the cascade of insulin action. PMID- 3516146 TI - Immunocytochemical evidence for phorbol ester-induced protein kinase C translocation in HL60 cells. AB - The ability of tumor promoting 12-O-tetradecanoylphorbol-13-acetate (TPA) to redistribute protein kinase C in human promyelocytic leukemic HL60 cells was investigated. It was found that TPA caused a rapid translocation (within 10 min) of protein kinase C from the cytosolic (soluble) fraction to the particulate (membrane) fraction, as determined indirectly by assaying for the enzyme activity or by immunoblotting of the enzyme protein in the isolated subcellular fractions. Immunocytochemical localization of the enzyme demonstrated directly that the TPA caused an enzyme translocation t the plasma membrane. These findings suggest that translocation to the plasma membrane of the enzyme may represent initial events related to the TPA effect on terminal differentiation of HL60 cells to monocytes/macrophages. PMID- 3516147 TI - Isopycnography of intact cells. VI: Effect of temperature on steady state Escherichia coli. AB - Steady state cultures of Escherichia coli W3110 possess constant cellular concentrations of ribosomes while above 22 C as measured isopycnographically. Below 22 C, ribosome levels are significantly diminished, equivalent to those found in dormant cells. Concommitantly, the energy of activation of steady state population growth in E. coli remains at a constant 18.6 kcal between 22 C and 37 C. This suggests that the thermal stability of the protein synthesis apparatus may play an important role in pathogenesis as well as in other areas of ecological niche acquisition and dominance. PMID- 3516148 TI - Reflective densitometry of Western blots to quantitate the developmentally regulated accumulation of myosin light chain 3. AB - We have employed a monoclonal antibody to fast myosin alkali light chains to study the accumulation of myosin light chain 3 (MLC3f) in the breast and limb musculature of developing quail embryos using quantitative densitometry of Western blots. Our analyses reveal that MLC3f is first detected in the breast muscle of 11 day embryos and accumulates at a constant rate until hatching at day 16. This data suggests, by extrapolation, that MLC3f accumulation is initiated at day 10 in embryonic breast muscle. MLC3f is also first detected in the limb muscle of 11 day embryos, but does not accumulate rapidly until after day 13. These results demonstrate the effective use of reflective densitometry in the study of developmental problems and in the quantitation of Western blots in general. PMID- 3516149 TI - Rat liver microsomal 3 alpha-hydroxysteroid dehydrogenase and dihydrodiol dehydrogenase: solubilization, separation and partial purification. AB - Rat liver microsomes contain 3 alpha-hydroxysteroid dehydrogenase (HSD) (EC 1.1.1.50) and dihydrodiol dehydrogenase (DHD) (EC 1.3.1.20) activities. The two enzyme activities were solubilized by 10% Triton X-100 or 0.4% sodium deoxycholate. Unlike the cytosolic enzyme (Penning & Talalay (1983) Proc. Natl. Acad. Sci. U.S.A., 80, 4505), the microsomal HSD and DHD activities were not inhibited by indomethacin. Chromatography of the microsomal Triton X-100 extract on Affigel Blue and then on Phenyl-Sepharose gave an HSD preparation containing no detectable (less than 3 - 5%) DHD activity, whereas chromatography of the deoxycholate extract on Phenyl-Sepharose provided a DHD preparation that lacked measurable HSD activity. These results are in sharp contrast to the cytosolic enzyme where both HSD and DHD activities could be copurified to homogeneity (Penning et al. (1984) Biochem. J. 222, 601). PMID- 3516150 TI - Role of excess lipoyl dehydrogenase in reconstituted alpha-ketoglutarate dehydrogenase complex of Escherichia coli. AB - The alpha-ketoglutarate dehydrogenase complex of Escherichia coli can bind up to 12 dimers of dihydrolipoyl dehydrogenase (E3) besides those already present. Maximal activity does not increase, however, when surplus E3 is present. This observation was previously interpreted to mean that the excess enzyme is inactive. We have now determined that if the reactions catalyzed by E3 are made rate-limiting, the excess E3 functions equivalently to that in the native complex. PMID- 3516151 TI - The inactivation of Bacillus thuringiensis subsp. israelensis toxin by mosquito larvae proteases liberated into the medium. AB - Crystal serine-proteases of B. thuringiensis subsp. israelensis were able to process the 28,000-dalton protein during crystal solubilization. On the other hand, solubilized crystal proteins were degraded during the larvicidal bioassay by the action of serine-proteases liberated by mosquito larvae into the medium, with loss of toxicity. However, proteins in intact crystals were protected from the action of these proteases. This resistance to degradation of crystals partly explains the observation that they are more toxic than solubilized crystal proteins. PMID- 3516152 TI - Rapid electrocatalytic procedure for hydrogenase kinetic determination in the H2 evolution direction. AB - The linear sweep voltammetric method is used as a new approach for kinetic determination with enzymes accepting reversible redox couples as cosubstrate. A monolayer of hydrogenase molecules is grafted onto a glassy carbon electrode which is both the support of the enzyme and the detector of the activity. Reduced viologen concentration in the enzyme microenvironment is controlled by the electrode potential. The catalytic current produced by the enzyme allows an easy kinetic constant determination without the classical constraints found in hydrogenase kinetic measurements. PMID- 3516153 TI - Purification and characterization of bacteriophage 9NA lysozyme. AB - Bacteriophage 9NA is a virulent phage of Salmonella typhimurium which induces a lysozyme in host cells toward the later stages of its multiplication. 9NA lysozyme has been purified about 1000 fold starting from the lysate of 9NA infected cells. The enzyme has an optimum pH between 7 and 8 and its activity is dependent on the ionic strength of the assay medium. Salts like NaCl and KCl are inhibitory to the lysozyme. Gram-negative cells act as better substrate for the lysozyme than do Gram-positive cells. The enzyme has a molecular weight of about 2.1 X 10(4) and rapidly loses its activity at temperatures higher than 45 degrees C. The properties of 9NA lysozyme have been compared with those of T4, lambda and P22 lysozymes. PMID- 3516154 TI - Comparative studies of total cross-linking, cell survival and cell cycle perturbations in Chinese hamster cells treated with alkylating agents in vitro. AB - The toxicities of 4-hydroperoxycyclophosphamide (4-OOH CY), phosphoramide mustard (PM), melphalan (MEL) and busulphan (BU) have been compared in Chinese hamster cells, V-79-753B. The initial total amount of cross-linking was a determining factor for the clonogenic survival of cells treated with MEL or PM. Although 4 OOH CY generated cross-links in this cell line, this damage did not account for the toxicity of the compound. There was no evidence for cross-link formation in cells treated with BU, even at a dose of the drug (1000 micrograms/ml) that was too toxic to measure clonogenic survival. Comparison for the four compounds at equitoxic doses showed that both PM and MEL caused the arrest of the cell cycle at G2 which persisted after drug removal. This was accompanied by a decline in the population growth rate and a decrease in total cell count. In contrast, both BU and 4-OOH CY caused a temporary arrest of the cell cycle G2, 24 hr after drug removal. However, the cell cycle distribution returned the control values within 3-4 days after treatment. Both BU and 4-OOH CY showed little effect on the initial growth rate of the cells. It is concluded that the initial amount of cross-links contributes to the toxicity of PM and MEL. However, it is unlikely that the generation of cross-links is of major importance for the toxicity of either 4-OOH CY or BU. PMID- 3516155 TI - Mercapturic acid formation is an activation and intermediary step in the metabolism of hexachlorobutadiene. AB - 14C-hexachlorobutadiene (HCBD), a mutagenic and nephrocarcinogenic pollutant, was administered by oral gavage of 100 mg/kg to female rats, and the radioactivity in 24 hr urine pooled. The average amount of radioactivity recovered in urine was 5.4% of the total 14C-activity ingested. Solvent extraction, high performance liquid chromatography (HPLC), radio gas chromatography and gas chromatography/mass spectrometry were used for separation and identification of metabolites. After solvent extraction and HPLC four fractions were separated containing 1%, 5%, 15% and 80% of radioactivity. In the 80% fraction one metabolite was identified after derivatization and comparison with the authentic compound as the mercapturic acid of HCBD (N-acetyl-S-1,1,2,3,4 pentachlorobutadienyl)-L-cysteine). The mercapturic acid accounts for 10% of the urinary 14C-activity. In a first attempt the mutagenic potential of the mercapturic acid was determined on Salmonella typhimurium TA 100 with and without metabolic activating S9 mix. In the presence of S9 mix the mercapturic acid exerts a strong mutagenic effect which proved to be about 80 times higher than that of HCBD. The results identify the formation of the mercapturic acid via direct glutathione conjugation as an activating and intermediary step in the metabolism of hexachlorobutadiene. PMID- 3516157 TI - Synovial amyloidosis and beta 2-microglobulin in patients undergoing long-term hemodialysis. PMID- 3516156 TI - Complement-dependent stimulation of prostacyclin biosynthesis: inhibition by rosmarinic acid. PMID- 3516158 TI - Suppression of myocardial protein degradation by the protease inhibitor bis[ethyl(2R,3R)-3-[(S)-methyl-1-[4-(2,3,4-tri-methoxy-phenyl-methyl) piperazine 1-ylcarbonyl]butyl-carbonyl]oxiran-2-carboxylat e]sulfate under hypoxia. AB - The synthetic protease inhibitor bis[ethyl(2R,3R)-3-[(S)-methyl-1-[4-(2,3,4-tri methoxyphenyl-methyl) piperazine-1-ylcarbonyl]butyl-carbonyl]oxiran-2 carboxylate] sulfate (NCO-700) suppressed both activities of calcium-activated neutral protease and cathepsin B isolated from cardiac muscle, showing 50% inhibition at 46 and 0.8 mumol/l, respectively. A kinetics study using 14C labelled NCO-700 suggested its incorporation into cultured myocardial cells, demonstrating the half-maximal saturation time at 17 min. Under both aerobic and hypoxic conditions, the reagent inhibited the peptide release from cultured myocardial cells dose-dependently. The amino acid release from heart slices of adult rabbit was also blocked by the drug under hypoxic and glucose-depleted condition. These data and the myocardial infarction size reducing action of NCO 700 might support the view that NCO-700 sensitive protease(s) - possibly, calcium activated neutral protease and/or cathepsin B - is (are) working to induce an irreversible proteolysis in the process of myocardial cell degradation. PMID- 3516159 TI - Non-competitive inhibition of the alcohol dehydrogenase activity in rat liver by latamoxef, cefamandole or cefoperazone. AB - High concentrations of 1 or 10 mmol/l latamoxef (LMOX), cefamandole (CMD) or cefoperazone (CPZ) in vitro non-competitively inhibit to a small extent the alcohol dehydrogenase isolated from rat liver in the presence of ethanol as a substrate, as is shown by enzyme-kinetic data evaluated in a Lineweaver-Burk diagram. This observation may serve as an approach to partially explain a possible delay of ethanol elimination from the blood after pretreatment with these beta-lactam antibiotics. PMID- 3516160 TI - [Omega-aminoacyl compounds against malaria]. AB - Investigations on diphenylthioether derivatives led to compounds with a high antimalarial (P. berghei) activity. 58 new compounds were synthetisized in order to study structure-efficacy relationships. General formula: Efficacy was optimal in compounds with R1 = NO2. Some of such compounds were at least half as effective as chloroquine and fully effective against drug resistant strains of P. berghei. But also other radicals proved to be suitable as long as S was not replaced by O. But two diphenylthioether derivatives (R1 = NO2 resp. CN) were found to be mutagenic in Salmonella/Microsome Ames test. Replacement of S by O caused a loss of mutagenicity but also a markedly drop of antimalarial activity. PMID- 3516161 TI - 3,5,3'-Triiodothyronine regulates insulin level in the circulation following glucose ingestion in humans. AB - To clarify the relationship between the 3,5,3'-triiodothyronine (T3) response and the insulin response after glucose ingestion in humans, serum T3, immunoreactive insulin (IRI), C-peptide immunoreactivity (CPR), nonesterified fatty acid (NEFA) and plasma glucose levels were measured in 11 nonobese inpatients with normal glucose tolerance after oral 75 g glucose tolerance test. Ingestion of the glucose solution significantly increased serum T3 levels from 120.1 +/- 4.1 ng/dl to 132.5 +/- 4.4 ng/dl (P less than 0.01) at 60 min after glucose ingestion and it continued to increase after 3 h. Serum IRI and CPR levels peaked at 60 min (P less than 0.01, respectively) after glucose ingestion and they also continued to increase after 3 h. Plasma glucose levels peaked at 30 min (P less than 0.01) after glucose ingestion and then decreased to basal level after 3 h. Negative correlation was found between sigma T3 level and sigma IRI level (r = -0.75), and between sigma T3 level and sigma IRI/sigma glucose ratio (r = -0.88). Negative correlation was also found between basal T3 level and sigma IRI level (r = 0.82). No correlation was found between sigma T3 level and sigma CPR level. Positive correlation was found between sigma glucose level and sigma dT3 level (r = 0.74), and between sigma dglucose level and sigma dT3 level (r = 0.81). The findings suggest that T3 regulates insulin level in the circulation after glucose ingestion and the increase in serum T3 levels after glucose ingestion is necessary for the glucose removal from the circulation in humans. PMID- 3516162 TI - Business, marketing, ethics, and professionalism. An annotated bibliography. PMID- 3516163 TI - Influence on lipoprotein metabolism of the platelet inhibitory drug ticlopidine. AB - The influence of the platelet inhibitory drug Ticlopidine (T) (500 mg daily) on lipoprotein metabolism was investigated in a double-blind placebo-controlled study of 38 middle-aged men with incapacitating stable angina pectoris. The concentrations of cholesterol (C), phospholipid (PL) and triglyceride (TG) in plasma, and very low density (VLDL), low density (LDL) and high density lipoprotein (HDL) fractions were measured before and after 4 and 8 weeks of treatment. After 8 weeks of T treatment the levels of C, PL and TG were increased by 14%, 15% and 30%, respectively. These elevations were confined to the atherogenic VLDL and LDL fractions. The LDL level showed a continuous increase during the study. There were no changes in the HDL fraction. The present findings emphasize the necessity to investigate several risk factors in all attempts of prevention of atherosclerotic disease. Before and during long-term treatment with T monitoring of plasma lipoprotein levels are recommended. PMID- 3516164 TI - Time-course of changes in plasma lipids in diabetic rats fed diets high in fish or safflower oils. AB - Adult male rats were maintained for 10 days on a standard chow diet or that diet supplemented with either safflower or marine fish oils, and then rendered diabetic with streptozotocin (40 mg/kg of body weight) and circulating metabolites determined over the next 3 days. Pre-diabetic concentrations of glucose and insulin did not differ between groups, and the severity of hyperglycaemia and lowering of insulin in streptozotocin-treated animals were also similar. Pre-diabetic concentrations of plasma free fatty acids and triacylglycerols were lower, and blood ketone bodies were higher in non-diabetic rats fed fish oil than in both other groups. However, following streptozotocin treatment, plasma free fatty acids rose significantly more in both groups of oil fed animals than in chow-fed ones. Plasma triacylglycerols were unaltered from pre-treatment levels in rats fed chow, but rose considerably in both groups fed oil-supplemented diets. In a subsequent experiment it was shown that the increase in triacylglycerols persisted for up to 11 days after streptozotocin and the hypertriglyceridaemia was greatest in the fish oil group. The rise would seem to result from defective clearance of lipoproteins of dietary origin. It appears that fish oil-supplemented diets should be avoided in diabetics until the possibility of increased hypertriglyceridaemia has been excluded by controlled studies. PMID- 3516165 TI - Open-chest cardiopulmonary resuscitation. PMID- 3516166 TI - Analysis of fetal activity and maternal and fetal heart rate using a laboratory minicomputer. AB - Using a PDP-11 minicomputer, a system was developed for real-time acquisition of fetal breathing, body movement, and heart rate data. Analogue event pulses were input electronically to a DR-11 16 channel A/D, D/A interface and the event times were measured using an AR-11 real-time clock. Event times were stored for comprehensive off-line analysis and useful data summaries were also provided on line. The on-line printouts enabled investigators to examine the quality of the data at the time of the study. The system has resulted in faster data acquisition and analysis and greater accuracy of measurement. PMID- 3516167 TI - Neonatal alloimmune thrombocytopenic purpura. AB - We reviewed 58 literature reports of neonatal alloimmune thrombocytopenic purpura (NAITP). The mortality rate was 9%. The total incidence of suspected intracranial hemorrhage was 28%. We reviewed 17 sibship cases for the relation of birth order to treatment and outcome. Among firstborn affected infants (n = 17) the mortality rate and incidence of central nervous system sequelae were 24 and 47%, respectively, compared to rates of 5 and 15%, respectively, in their younger affected siblings (n = 20). The improved outcome in the latter group appeared to be related to more frequent cesarean section delivery and more frequent and earlier use of corticosteroids and maternal platelet transfusions in the neonate. Sensitive assays of maternal platelet alloantibody are now available, but they lack specificity for NAITP affecting the current gestation. There are two reports in which sensitive assays revealed rising titers of maternal platelet alloantibody during advancing gestation. We propose further study to determine if this is specific for the antepartum diagnosis of NAITP. PMID- 3516168 TI - Computer-aided instruction in perinatal education. AB - Medicine is a field that requires very extensive education to reach and maintain an acceptable level of functional competence. Often it is necessary for busy people to teach other busy people. Medical lectures may become tedious and repetitive for those who give them as well as an intrusion into their patient care and research time. Students may find it difficult to be in the right place at the right time to take advantage of important lecture material due to their own complex schedules. To work well, education requires a careful match of the student and the educational process. Computer-aided instruction offers some solutions to these and other problems of medical education. PMID- 3516169 TI - Decision analysis computer program for use in the labor room. AB - A decision analytic model (a decision tree) was constructed for use in the labor room. Probabilities and (dis)utilities were estimated by obstetricians and computerized. A sensitivity analysis on six branches of the decision tree uses estimates of four obstetricians and proves that the decisions resulting from the model are stable and insensitive to differences in probability estimates within reasonable limits. Therefore it is concluded that we can construct a decision tree that is a practical, valuable, and stable tool for consistent decision making. PMID- 3516170 TI - Femur length versus biparietal diameter for estimating gestational age in the third trimester. AB - It is well established that ultrasound measurement of femur length and biparietal diameter are comparably accurate estimators of gestational age when obtained in the first half of pregnancy. Both estimators, however, become less accurate later in pregnancy. The present study compares the relative accuracy of these estimators when obtained in the third trimester. It is concluded from linear regression analysis that the correlation between gestational age estimated from femur length and the actual gestational age is stronger than that between gestational age estimated from biparietal diameter and actual gestational age. Furthermore, gestational age calculated from femur length is significantly more likely to be within 2 weeks (P less than or equal to .01) and 3 weeks (P less than or equal to .05) of actual gestational age than is gestational age calculated from biparietal diameter. Estimating gestational age from the mean of the gestational age based on biparietal diameter and that based on femur length is less accurate than estimating gestational age from femur length alone. PMID- 3516171 TI - Midtrimester diagnosis of severe deforming osteogenesis imperfecta with autosomal dominant inheritance. AB - Sonographic examination of a fetus whose father had severe deforming osteogenesis imperfecta (OI) was performed. The father had multiple congenital rib and extremity fractures. Subsequent fracture and deformity had suggested an autosomal recessive OI syndrome. However, fetal sonography at 18 weeks gestational age showed foreshortening of long bones in both legs and a reduced thoracic circumference, recapitulating, in part, the father's phenotype. This third reported case of early fetal diagnosis of autosomal dominant OI suggests that the fetal sonographic phenotype reflects that of the affected parent. Implications of this case for the application of fetal sonography in dominant OI syndromes are discussed. PMID- 3516173 TI - [High frequency ventilation (HFV)--a review]. PMID- 3516172 TI - Amino acid concentrations in maternal plasma and amniotic fluid in relation to fetal insulin secretion during the last trimester of pregnancy in gestational and type I diabetic women and women with small-for-gestational-age infants. AB - Free amino acid concentrations were determined in maternal plasma and amniotic fluid (AF) under standardized and unstressed conditions in four groups of women comprising 6 gestational and 13 type I diabetics, 10 women with small-for gestational-age (SGA) infants, and 18 healthy control women between 36 and 39 weeks of gestation. Plasma values for branched chain amino acids (the sum of leucine, isoleucine and valine) did not differ significantly between the four groups. The corresponding values in AF were significantly higher (P less than 0.05) in the type I diabetic group and significantly lower (P less than 0.05) in the gestational diabetic group as compared to the control group. The mean AF C peptide concentration was elevated but not significantly so in gestational (0.69 nmol/l) or type I diabetic (0.54 nmol/l) pregnancies and significantly lower (P less than 0.05) in women with SGA infants (0.28 nmol/l) as compared to the control group (0.38 nmol/l). There was a significant correlation between C peptide in AF and branched chain amino acids in maternal plasma (r = 0.63; P less than 0.05) as well as to maternal blood glucose (r = 0.79; P less than 0.01) in the type I diabetic group, which merely suggests a greater beta cell reactivity to insulin secretagogues in offspring of diabetic mothers. The correlation between AF C-peptide and branched chain amino acids in maternal plasma was significantly inverse in women with SGA infants (r = -0.75; P less than 0.05). Both individual, branched chain, or total amino acid concentration in AF were unrelated to AF C-peptide. PMID- 3516174 TI - [Current concepts on the formulation of oral rehydration solutions for children with acute diarrhea]. PMID- 3516175 TI - [Bronchial hyperreactivity and viral respiratory infection]. PMID- 3516176 TI - Biological activity in vivo of insulin analogues modified in the N-terminal region of the B-chain. AB - [AlaB5]Insulin as well as a hybrid analogue of insulin and "insulin-like growth factor" (IGF-I), in which the N-terminal amino-acid sequence H-Phe-Val-Asn-Gln- of the B-chain has been replaced by the tripeptide H-Gly-Pro-Glu-of IGF-I, have been prepared by the partial-synthetic route. Their biological activity in vivo has been compared with that of other analogues in rabbits, mice and rats as far as data are available. These rodents respond differently, rats being less sensitive to modifications than rabbits and mice. The results explain unexpected discrepancies discussed in previous papers. PMID- 3516178 TI - The management of extranodal head and neck lymphomas. AB - The results from 156 patients with extranodal head and neck lymphomas treated at Stanford (Calif) University School of Medicine are combined with the experience of other investigators to recommend the management of these lymphomas. The tonsil and sinuses were the most common sites of presentation, and the most common histology was diffuse histiocytic lymphoma. The histologic classification systems are described as well as the use of immunohistochemistry in diagnosis. The appropriate staging procedures and the Ann Arbor staging system are discussed. Following the staging of 948 patients, 66% were found to have stage I or stage II disease and 34% had more widespread disease. Treatment with radiotherapy is discussed. Patterns of relapse following local radiotherapy for 360 relapsing patients with stage I and II disease showed a 73% distal relapse rate. Various treatment programs are recommended based on site, stage, and histology. PMID- 3516177 TI - The effect of antibiotic therapy on recovery after tonsillectomy in children. A controlled study. AB - Tonsillectomy continues to be a commonly performed operation in the pediatric age group. The postoperative period is often protracted and characterized by throat and ear pain, intermittent fever, foul odor from the oral cavity, and poor oral intake. Consequently, antibiotics are frequently prescribed in an effort to minimize these symptoms and/or avoid complications such as dehydration or secondary infection of the operative site. However, to our knowledge, no study to date has been performed to demonstrate the efficacy of antibiotic therapy in this setting. At the Children's Hospital of Philadelphia, a prospective, randomized, double-blind study was undertaken in which ampicillin (or placebo) was administered intravenously at the time of surgery and for 12 to 24 hours postoperatively. The children then continued to receive oral amoxicillin therapy (or placebo) for an additional seven days. The patients were then evaluated for the incidence and severity of postoperative symptoms and complications. Intraoperative cultures of the oropharynx and tonsillar tissue, as well as cultures of the tonsillar fossa, were obtained following completion of one week of therapy. Our results indicate that ampicillin sodium/amoxicillin trihydrate therapy is well tolerated and safe in the nonallergic child and is effective in minimizing fever and other troublesome postoperative symptoms, such as pain, lassitude, mouth odor, and poor oral intake after tonsillectomy. PMID- 3516179 TI - Effect of lipid structural modifications on their intermolecular hydrogen bonding interactions and membrane functions. AB - The large number of different membrane lipids with various structural modifications and properties and the characteristic lipid composition of different types of membranes suggest that different lipids have specific functions in the membrane. Many of the varying properties of lipids with different polar head groups and in different ionization states can be attributed to the presence of interactive or repulsive forces between the head groups in the bilayer. The interactive forces are hydrogen bonds between hydrogen bond donating groups such as --P--OH,--OH, and--NH3+ and hydrogen bond accepting groups such as --P--O- and --COO-. These interactions increase the lipid phase transition temperature and can account for the tendency of certain lipids to go into the hexagonal phase and the dependence of this tendency on the pH and ionization state of the lipid. The presence or absence of these interactions can also affect the penetration of hydrophobic substances into the bilayer, including hydrophobic residues of membrane proteins. Evidence for this suggestion has been gathered from studies of the myelin basic protein, a water-soluble protein with a number of hydrophobic residues. In this way the lipid composition can affect the conformation and activity of membrane proteins. Since hydrogen-bonding interactions depend on the ionization state of the lipid, they can be altered by changes in the environment which affect the pK of the ionizable groups. The formation of the hexagonal phase or inverted micelles, the conformation and activity of membrane proteins, and other functions mediated by lipids could thus be regulated in this way. PMID- 3516180 TI - [Trends in apraxia research]. PMID- 3516181 TI - [Recent advances in split-brain research]. PMID- 3516182 TI - [Progressive muscular dystrophy]. PMID- 3516183 TI - [Long-term follow-up study of spasmodic torticollis]. AB - Since 1958, 61 patients with spasmodic torticollis, 46 of whom did not develop other kinds of involuntary movements, have been experienced in our neurosurgical clinic. The course of these 46 patients was followed for more than one year. The retrospective analysis revealed 25 patients were treated conservatively, and 21 patients were treated surgically. Surgical treatment consisted of stereotactic ventrolateral thalamotomy in 19 patients, and Olivecrona's operation in the other 2. The long-term outcome of conservative therapy was compared to that of surgical therapy. One patient with severe retrocollis with horizontal components was treated successfully but transiently by implantation of stimulating electrodes in the cervical epidural spinal cord. The peak incidence of the onset of the disease was in the fourth decade; however, the time of onset ranged from 7 to 55 years of age. The period from disease onset to the final evaluation in the follow-up was 9.3 years (mean) in the conservative group, and 8.5 years in the surgically treated group (no significant difference). There were no significant differences between the groups in the interval from the time of disease onset to the initial evaluation in our clinic, stage determined at evaluation, and follow-up period after the initial evaluation. Of the 25 conservatively treated patients, symptoms and signs remained unchanged in 8, deteriorated in one, but improved significantly in most of the remaining patients. Many of the surgically treated patients showed improvement one week after surgery, but the long-term outcome was not significantly better than that of the conservatively treated patients.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3516184 TI - The development of fetal mice long bones in vitro: an assay of bone modeling. AB - This study was carried out to develop an in vitro system for the analysis of bone modeling (coincidentally occurring bone growth, formation, mineralization, and resorption) as is seen during bone development. The fetuses of pregnant mice previously labeled with 45Ca were removed on Days 15, 16, and 17 of gestation. The radii and ulnae were dissected free and cultured for up to 6 days in a chemically defined medium (BGJ) supplemented with fetal calf serum or human serum albumin and 150 micrograms/ml vitamin C. The change in bone length over the culture period was measured as were the changes in calcium and phosphorus content, the hydroxyproline: protein ratio, and the percent 45Ca released into the medium. The effect of insulin and parathyroid extract on the system was also examined. The results indicate that cultures of 16-day-old fetal bones provided the most suitable model. During culture there was a continuous increase in bone length as well as calcium and phosphorus content in the ratio of 2:1, a significant increase in the hydroxyproline content, and a continuous release of 45Ca into the medium. Parathyroid extract caused a dose-dependent inhibition of both growth in diaphyseal length and calcium and phosphorus uptake with an increase in 45Ca release into the medium. Insulin at 10(-9) M and 10(-10) M resulted in a significant increase in diaphyseal length and calcium and phosphorus uptake without affecting 45Ca release. These results indicate that the assay described is suitable for the study of bone modeling, providing a means to measure bone growth, formation, calcification, and resorption. The direct effect of various factors on bone modeling can also be measured. PMID- 3516185 TI - Inadequate trays. PMID- 3516186 TI - A controlled clinical trial of prophylactic tinidazole for chemoprophylaxis in third molar surgery. PMID- 3516187 TI - Afterload reduction: a comparison of captopril and nifedipine in dilated cardiomyopathy. AB - Nifedipine and captopril are potent vasodilators and may be expected to help left ventricular failure by reducing afterload. Nifedipine (20 mg three times a day) and captopril (50 mg three times a day) were added to an optimal regimen of digitalis and diuretics in a double blind crossover trial in 18 cases of dilated cardiomyopathy. New York Heart Association functional class rating symptoms and exercise tolerance times improved on captopril but not on nifedipine. The reduction in pulmonary capillary wedge pressure and the increase of cardiac output on captopril indicated that the augmented functional capacity may have resulted in part from an improved performance of the left ventricle. Although there were comparable decreases in systemic vascular resistance and presumably in impedence to ejection by the left ventricle on both drugs, the dimensions of the ventricular cavity were found to be reduced by captopril and augmented by nifedipine, and only captopril reduced the afterload (wall stress). In addition, the force-length relation (between left ventricular end systolic stress and end systolic diameter) was shifted to the left of baseline by captopril and to the right by nifedipine, suggesting that muscle contractility was reduced by nifedipine and not by captopril. These results suggest that nifedipine and captopril have different effects on afterload and contractility and these may account for the different effects of these drugs on the performance of the heart and clinical responses. PMID- 3516188 TI - Myocardial infarction after blunt chest trauma incurred during rugby football that later required cardiac transplantation. AB - A 28 year old man sustained an extensive anterolateral myocardial infarction five minutes after a blow on the chest while playing rugby football. The resulting persistent cardiac failure necessitated orthotopic cardiac transplantation. PMID- 3516189 TI - Prevention of histamine-induced cardiovascular reactions during the induction of anaesthesia following premedication with H1- + H2-antagonists i.m. AB - In a prospective controlled double-blind study, 60 elective surgical patients were randomly assigned to three premedication groups. Twenty patients received promethazine 0.5 mg kg-1 i.m. 45 min before induction of anaesthesia; a further 20 patients received an additional i.m. injection of cimetidine 400 mg 120 min before induction. The third group (n = 20) served as the control group. Following vecuronium 0.02 mg kg-1, anaesthesia was induced with fentanyl, and etomidate. All patients then received suxamethonium 1.5 mg kg-1 i.v. The combined administration of H1- + H2-antagonists as premedication led to a significant reduction in the increase in heart rate when compared with the effects in the other groups. PMID- 3516190 TI - Could nicotine antagonists be used in smoking cessation? PMID- 3516191 TI - The expression of ABH and Y blood group antigens in benign and malignant breast tissue: the preservation of the H and Y antigens in malignant epithelium. AB - The ABO(H) and Y antigen status of epithelial cells from 45 breast carcinomas, 14 benign breast lesions and 7 normal breasts have been assessed using an indirect immunoperoxidase histochemical assay and a series of blood group specific monoclonal antibodies. All 20 A, AB and B group tumours had lost the A and B isoantigens, 13 of these tumours were however found to express H and Y antigens. Of 25 group O tumours 17 expressed the expected H and Y antigens. These findings were not dependent on the histological nature or the invasive characteristics of the tumour. Similar results were obtained when 28 metastases from breast carcinomas were examined, the H and Y antigens being identified in the tumour elements in 24 lymph nodes while we failed to identify either the A or B antigens. The development of breast malignancy appeared therefore to correlate best with the deletion of A and B glycosyl transferases. Normal breast tissue consistently expressed the expected blood group isoantigens. Areas of benign breast disease showed a more varied pattern of antigen expression. Seven of 14 lesions lacked ABH antigens, the loss of blood group structures could not however be correlated with any specific histological features and was not limited to the loss of A and B substances. PMID- 3516192 TI - Small intestinal mucosal toxicity of cis-platinum--comparison of toxicity with platinum analogues and dexamethasone. AB - Cis-platinum causes profound gastrointestinal symptoms in patients and these may persist for many days after drug administration. Gut mucosal toxicity may be a factor in the pathogenesis of such prolonged nausea, vomiting and anorexia. The effects of cis-platinum on mouse ileal mucosal architecture, villus epithelial cell influx and disaccharidase activity are described in comparison with dhe effects of two platinum analogues, CBDCA and CHIP. In addition the effect of dexamethasone, a useful drug in the palliation of cis-platinum-induced emesis, in combination with cis-platinum is described. Cis-platinum, CBDCA and CHIP cause profound reduction in crypt cell production rate (CCPR) and thus villus epithelial cell influx within hours of administration leading to villus stunting and diminished function. CBDCA showed the least profound effect with early rebound in CCPR by day 3. Cis-platinum and CHIP were roughly equitoxic to ileal crypts with rebound in CCPR being delayed until day 7. Similarly, CBDCA caused least reduction in disaccharidase activity with cis-platinum and CHIP being equitoxic. The addition of dexamethasone had no protective effect on the effects of cis-platinum on murine ileal mucosa and mice given the combination chronically had no weight gain over 18 weeks, their weight paralleling those receiving cis platinum alone. The platinate compounds have differing degrees of intestinal mucosal toxicity but no direct inference can be drawn in respect to the clinical situation where CBDCA causes less gastrointestinal symptomatology than CHIP but where both cause less than cis-platinum. Dexamethasone does not act by mucosal protection to provide its useful effects in prolonged cis-platinum-induced gastrointestinal symptoms. PMID- 3516193 TI - Histochemical detection of oestrogen receptors in breast carcinoma: a successful technique. PMID- 3516194 TI - Antitumour activity of platinum analogues against human yolk sac tumours heterotransplanted in nude mice. PMID- 3516195 TI - Hyperlipidaemia due to isotretinoin and etretinate: possible mechanisms and consequences. PMID- 3516197 TI - Future directions in clinical bone marrow transplantation: interests converge on the bone marrow microenvironment. PMID- 3516196 TI - Immunohistochemical staining of normal sweat glands. AB - Sweat glands from normal skin obtained at autopsy or as routine biopsies were examined using a panel of immunoperoxidase-linked antibodies. The results indicate that such a panel of antibodies defines all known functional regions of the eccrine sweat gland and provides a reliable distinction from all other skin elements. PMID- 3516198 TI - A monoclonal antibody reactive with a subset of human plasma cells. AB - A mouse monoclonal antibody (R1-3) raised against a human plasmacytoma xenograft and reactive with human plasma cells is described. The antibody reacts with a subset of plasma cells and lymphocytes, but is nonreactive with granulocytes, normoblasts, thymus, spleen or T lymphocytes. Flow cytometer double labelling experiments showed that approximately 50% of R1-3 positive bone marrow cells expressed surface immunoglobulin, but no R1-3 positive cells also expressed B1 or Leu 4. In a myeloma patient the R1-3 reactive cells were found to have a higher rate of DNA proliferation and were aneuploid as determined by flow cytometry. The R1-3 antigen is expressed on late B lymphocytes and early plasma cells. PMID- 3516199 TI - Human granulocytes lack red cell Kx antigen. AB - We have investigated the presence or absence of the red cell Kx antigen on human granulocytes by measuring specific uptake of anti-Kx using three techniques: direct measurement by 125I-staphylococcal protein A (125I-SPA) and avidin-biotin complex (ABC) immunoperoxidase staining and also, an indirect measurement using granulocyte adsorption of anti-Kx. Our results with all three methods indicate that the Kx antigen is not present on normal human granulocytes. Prior to adsorption of the anti-Kx serum with purified, pooled, normal human granulocytes, 11 of 21 (53%) of normal granulocytes were non-reactive by 125I-SPA and 16 of 20 (80%) by ABC. This pattern of reactivity was shown to be due to contamination of our anti-Kx serum with an antibody to a granulocyte-specific antigen unrelated to the Kx antigen. After adsorption, there was no diminution in the reactivity of the adsorbed anti-Kx compared to the unadsorbed antiserum against red cells which express strong Kx antigen, i.e. Ko and DTT-modified normal human red cells, by either serologic or 125I-SPA techniques. Likewise, reactivity with McLeod red cells, which have weak expression of the Kx antigen, was not changed using either the unadsorbed or adsorbed anti-Kx. The adsorbed anti-Kx was nonreactive with all 12 normal donors' granulocytes tested by 125I-SPA and with 10 normal donors' granulocytes tested by ABC. Furthermore, granulocytes from a Ko individual were nonreactive using either unadsorbed or adsorbed anti-Kx. These studies indicate that Kx antigen is not present on normal human granulocytes. Further, additional adsorption studies using granulocytes from a boy with X-linked chronic granulomatous disease (CGD) indicated that these granulocytes also do not possess the Kx antigen. In contrast to previous reports, these data suggest that Kx antigen is most probably a red cell-specific antigen and that the red cell Kx antigen has no direct relationship to the biochemical defect in CGD. PMID- 3516200 TI - Personality and control of diabetes mellitus. AB - The importance of psychological factors in the management of diabetes mellitus (DM) is increasingly recognized. One factor is the personality of the individual diabetic. The present study compared the personality structure of diabetics in good and those in poor control. The Arrow-Dot Test (ADT) was employed in 45 diabetic subjects. Subjects in poor diabetic control had significantly higher id scores than well-controlled subjects. Subjects that were well controlled had significantly higher ego strength scores than those in poor control. Thus the ADT appears to have a potential use in the stricter control of DM; this is generally accepted to be desirable to reduce or slow down complications of the disease. PMID- 3516201 TI - Diagnosis of intrauterine infection by demonstration of antibody-coated bacteria in the amniotic fluid. AB - Immunofluorescence examination of amniotic fluid for the occurrence of antibody coated bacteria was carried out in 72 consecutive women with premature rupture of the fetal membranes to assess this method in the diagnosis of intrauterine infection. Antibody-coated bacteria were demonstrated in 11 women with clinical signs of intrauterine infection, histological amnionitis and heavy growth of one bacterial species. The presence of intrauterine infection was considered possible in another 14 women. One patient had no clinical signs of infection, but positive histological and bacteriological evidence; antibody-coated bacteria were demonstrated in this patient, but not in the remaining 13 women. In 47 women clinical, histological and bacteriological signs of intrauterine infection were absent, and examinations for antibody-coated bacteria were negative in all of them. It is concluded that the demonstration of antibody-coated bacteria in amniotic fluid indicates the presence of intrauterine infection, and the examination may in some cases be positive before the appearance of clinical signs of infection. PMID- 3516202 TI - Comparative study of meptazinol and pethidine for the relief of pain in labour. AB - A double-blind comparison of pethidine and meptazinol in the relief of pain during labour was undertaken in 205 healthy women. The protocol allowed 100 mg of the test drug to be repeated at intervals of 2 h to a maximum of three doses. It was noteworthy that only 29 mothers were given a second dose of narcotic. Every woman receiving one injection of meptazinol complained of moderate to severe pain after 2 h; 97% of those receiving one injection of pethidine were complaining of moderate to severe pain after 2 h. There was no difference between the two drugs with regard to pain relief or in side-effects both in mother and baby. PMID- 3516203 TI - Ibuprofen prevents IUCD-induced increases in menstrual blood loss. AB - To study the effects of a copper-releasing intrauterine contraceptive device (IUCD) and a prostaglandin (PG) synthesis inhibitor, ibuprofen, on menstrual blood loss, 28 healthy women received either a Fincoid 350 or a ML Cu375 device and were then treated in a double-blind randomized manner with ibuprofen (1200 mg daily) or a placebo during their next three menstruations. The preinsertion menstrual blood loss (2 cycles) was normal for healthy women (median 38 ml) with no difference between women who subsequently received either Fincoid 350 or ML Cu375 and ibuprofen or placebo treatment. The median increase in menstrual blood loss after the insertion of an IUCD was 74% (P less than 0.01) in women receiving placebo treatment, and this rise was not dependent on the type of IUCD. Ibuprofen treatment prevented the increase in blood loss following IUCD insertion, but it failed to shorten the duration of menstruation. Four women reported side-effects (tiredness, irritability, sweating, dyspepsia) during ibuprofen treatment, and two women did so during placebo treatment. It is concluded that IUCDs with a large copper surface also increase menstrual blood loss, but that this increase can be prevented with ibuprofen treatment. PMID- 3516204 TI - The routine use of ultrasound. PMID- 3516205 TI - Examining the fetal heart. PMID- 3516206 TI - A new method for the measurement of pre-ejection period in the human fetus. AB - The pre-ejection period (PEP) of the cardiac cycle was measured in the human fetus using pulse Doppler in association with transabdominal ECG. The technique permitted the exact localization of the aortic valve, a good recording of its opening and the exact measurement of PEP. Between 32 and 42 weeks of pregnancy there is a strong correlation between PEP and gestational age. This new method seems to be an easy and reliable tool for measuring the PEP during intrauterine life. PMID- 3516207 TI - Biparietal diameter in the Australian aboriginal fetus. AB - Fetal biparietal diameters (BPD) were measured by real time scanning on 657 occasions in 206 Aboriginal women attending for antenatal care in Arnhemland in the Northern Territory of Australia. Gestational age was estimated at birth for 202 of their infants and correlated with BPD measurements. Birthweights and BPD are compared with those for Aboriginal infants born in Queensland and for a Melbourne hospital population. PMID- 3516208 TI - Eosinophils in corneas removed by penetrating keratoplasty. AB - One hundred consecutively submitted corneas removed by penetrating keratoplasty were studied histologically to determine the frequency in which eosinophils are found. In 20 corneas eosinophils occurred in densities ranging from 0.2 to more than 50 per high power field (HPF), and accounted for 1.5% to 100% of the total leucocytes counted. More than half of the corneal specimens containing eosinophils, including six of seven corneas having the highest eosinophil concentrations, were failed grafts. Because the concentration of eosinophils was in many cases beyond that attributable to non-specific vascular permeability, the existence of eosinophil chemotaxic substances in the cornea is postulated. PMID- 3516209 TI - Keratomalacia on a 'healthy diet'. AB - The case is described of a 39-year-old man with previously undiagnosed chronic schizophrenia and with bilateral keratomalacia secondary to his bizarre diet. He presented with a perforation of the right cornea which required an emergency penetrating keratoplasty. The difficulties of clinical management of a patient with an overt psychosis and the use of serum retinol levels to monitor treatment are described. Causes of vitamin A deficiency seen in Great Britain are discussed. PMID- 3516210 TI - Production and characterization of monoclonal antibodies against the two subunits proteins B1 and B2 of Escherichia coli ribonucleotide reductase. AB - Ribonucleotide reductase from Escherichia coli consists of two nonidentical subunits, named protein B1 (170 000) and protein B2 (87 000). We purified and characterized five monoclonal antibodies against B1 and three against B2 from hybridomas obtained by fusion of spleen cells from immunized mice and the myeloma cell line P3-X63Ag8. All are of the IgG1 class with a high affinity for the antigen with dissociation constants in the nanomolar range. Four of the anti-B1 monoclonals and all three anti-B2 monoclonals neutralize reductase activity while one anti-B1 monoclonal binds tightly to B1 without affecting its activity. Fab fragments prepared from three anti-B1 monoclonals had similar dissociation constants. The anti-B1 monoclonals interacted with separate epitopes while two of the anti-B2 monoclonals appeared to react with the same epitope. In the case of B1, various allosteric states of the protein induced by binding of effectors had no apparent effect on the interaction with monoclonals, nor did their binding prevent subsequent binding of effectors. With B2, binding of monoclonals did not affect the typical electron paramagnetic resonance spectrum of the protein and thus did not involve either the tyrosyl free radical or the iron center of B2. All neutralizing antibodies interfered with the interaction between the two subunits, explaining their effect on enzyme activity, since active ribonucleotide reductase consists of a B1-B2 complex. PMID- 3516211 TI - Affinity chromatography on anti-B1 monoclonal gels for purification and characterization of protein B1 from Escherichia coli ribonucleotide reductase. AB - Affinity gels were prepared from four monoclonal antibodies against the B1 protein of ribonucleotide reductase of Escherichia coli. The gels were used to purify protein B1 and also to study some of its properties. Gels from the nonneutralizing monoclonal anti-B1-k bound as much as 2 mg of B1/mL and were employed to prepare essentially pure B1 protein in a single step from extracts of wild-type E. coli and strains overproducing the subunit. However, B1 prepared from wild-type extracts had a lowered specific activity, suggesting some denaturation during elution of the protein from the column. Addition of the allosteric effector dATP during affinity chromatography changed the chromatographic pattern. Some protein B2, the second subunit of the reductase, remained in all cases bound to the gels together with B1. The gel prepared from anti-B1-c retained two additional proteins. In other experiments involving binding of proteolytic fragments of B1 to various antibodies, we also found a striking effect of dATP, suggesting that dATP made protein B1 less accessible to proteolysis. In these experiments fragments around 15K still had the ability to bind monoclonals, making possible more detailed investigations of the structural contacts between B1 and the monoclonals. PMID- 3516212 TI - Substrate and inhibitor activities of the screw sense isomers of metal-nucleotide complexes in the formyltetrahydrofolate synthetase reaction. AB - Phosphorothioate analogues of ATP and isomers of CrATP and CrADP were used to examine the nucleotide stereoselectivity of formyltetrahydrofolate synthetase from procaryotic and eucaryotic sources. Substrate activity of the thio-ATP analogues increased as the site of sulfur substitution was changed from the gamma to the alpha position. Thus, adenine nucleotide analogues substituted with sulfur at an alpha nonbridging position (ATP alpha S isomers) were the most active, and ATP gamma S was inactive. When Mg2+ was used as the divalent cation, both enzymes showed a clear preference (higher V/Km value) for the Sp isomer of ATP beta S although the magnitude of the preference was greater with the bacterial enzyme. With Cd2+ as the divalent cation the Rp isomer was preferred, but the difference was greater with the yeast enzyme. Both (Sp)-MgATP beta S and (Rp)-CdATP beta S have the delta or right-hand screw sense configuration of the metal chelate ring. The reversal of stereoselectivity when the cation was changed indicates that the metal ion is coordinated to the beta-phosphate group. No stereoselectivity was observed when ATP alpha S isomers were used in the presence of Mg2+ or Cd2+, suggesting that the metals are not coordinated to the alpha-phosphate. ATP beta S was also found to be a competitive inhibitor of MgATP and CdATP, and the lowest Ki values were obtained with the lambda screw sense isomers. The screw sense isomers of bidentate CrATP exhibited no detectable substrate activity but were competitive inhibitors of MgATP.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3516213 TI - N2O as a substrate and as a competitive inhibitor of nitrogenase. AB - We have investigated the inhibitory effect of N2O on NH3 formation by purified component proteins from Klebsiella pneumoniae and have confirmed that the inhibition is competitive with respect to N2 and that N2O is reduced to N2, which in turn is further reduced to NH3. In addition, we have shown that N2O is unable to support HD formation from D2 and H2O. N2-supported HD formation from D2 and H2O was found to be inhibited by N2O. In contrast to N2, N2O was found to suppress nitrogenase-mediated H2 evolution completely at infinitely high pN2O. H2 was found to inhibit N2O-supported NH3 production but not N2O-supported N2 production. The steady-state kinetics of N2O reduction showed a good fit to Michaelis-Menten kinetics with a Km for N2O of 5 mM at 30 degrees C, corresponding to 24 kPa of N2O. A model is proposed that fits the observed results. PMID- 3516214 TI - Complement-mediated killing of Escherichia coli: dissipation of membrane potential by a C9-derived peptide. AB - The molecular mechanism of complement-mediated killing of Gram-negative bacteria has yet to be resolved, but it is generally accepted that assembly of the membrane attack complex (MAC) of complement on the outer bacterial membrane is a required step. We have now investigated the effect of the MAC and its precursor complex, C5b-8, on the membrane potential (delta Em) across the inner bacterial membrane. Delta Em of whole cells was measured directly by using a lipophilic cation (tetraphenylphosphonium) that equilibrates with the potential or indirectly by measuring transport of solutes (proline and galactoside), which is dependent on delta Em. Our results indicate that the C5b-8 complex caused a transient collapse of delta Em in the absence of cell killing. Addition of C9 to allow formation of the MAC dissipated delta Em irreversibly, and the cells were killed. Since delta Em is generated across the inner membrane in Gram-negative bacteria, inner membrane vesicles were prepared and membrane potentials were generated either by adding D-lactate to energize the electron-transport chain or by creating a K+ diffusion potential with valinomycin. C9 added in the absence of earlier acting complement proteins had no effect on delta Em of isolated, actively respiring vesicles or on K+ diffusion potentials. In contrast, its C terminal thrombin fragment (C9b), which has been shown earlier to contain the membrane-active domain of C9, efficiently collapsed delta Em in such vesicles. C9b did not require a specific receptor since it was effective on "right-side out" and "inside-out" vesicles. These results are interpreted to indicate that a C9-derived fragment deenergizes cells and may be the causative agent for cell death. PMID- 3516215 TI - Tryptophanyl adenylate formation by tryptophanyl-tRNA synthetase from Escherichia coli. AB - By gel filtration and titration on DEAE-cellulose filters we show that Escherichia coli tryptophanyl-tRNA synthetase forms tryptophanyl adenylate as an initial reaction product when the enzyme is mixed with ATP-Mg and tryptophan. This reaction precedes the synthesis of the tryptophanyl-ATP ester known to be formed by this enzyme. The stoichiometry of tryptophanyl adenylate synthesis is 2 mol per mole of dimeric enzyme. When this reaction is studied either by the stopped-flow method, by the fluorescence changes of the enzyme, or by radioactive ATP depletion, three successive chemical processes are identified. The first two processes correspond to the synthesis of the two adenylates, at very different rates. The rate constants of tryptophanyl adenylate synthesis are respectively 146 +/- 17 s-1 and 3.3 +/- 0.9 s-1. The third process is the synthesis of tryptophanyl-ATP, the rate constant of which is 0.025 s-1. The Michaelis constants for ATP and for tryptophan in the activation reaction are respectively 179 +/- 35 microM and 23.9 +/- 7.9 microM, for the fast site, and 116 +/- 45 microM and 3.7 +/- 2.2 microM, for the slow site. No synergy between ATP and tryptophan can be evidenced. The data are interpreted as showing positive cooperativity between the subunits associated with conformational changes evidenced by fluorometric methods. The pyrophosphorolysis of tryptophanyl adenylate presents a Michaelian behavior for both sites, and the rate constant of the reverse reaction is 360 +/- 10 s-1 with a binding constant of 196 +/- 12 microM for inorganic pyrophosphate (PPi).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3516216 TI - O4-Methyl-, O4-ethyl-, and O4-isopropylthymidine 5'-triphosphates as analogues of thymidine 5'-triphosphate: kinetics of incorporation by Escherichia coli DNA polymerase I. AB - O4-Methyl-, O4-ethyl-, and O4-isopropylthymidine 5'-triphosphates, which can be formed by N-nitroso carcinogens, were tested for their ability to substitute for thymidine 5'-triphosphate (dTTP) in synthesis catalyzed by Escherichia coli DNA polymerase I (Pol I) by using activated DNA or synthetic polymers as templates. All could substitute for dTTP for short periods, the rate and extent decreasing with the size of the alkyl group. Because the structure of O4-alkylthymidine does not permit normal hydrogen bond formation with deoxyadenosine, it was inferred that eventual formation of a poor or frayed primer end was responsible for termination of synthesis. Synthesis of polymers at temperatures ranging from 0 to 40 degrees C showed that the extent of incorporation using the O4-alkyl-dTTPs was favored, relative to dTTP, when the terminal helical structure was stabilized by low temperatures. Kmapp values were determined for each O4-alkyldeoxynucleoside 5'-triphosphate. These values were 0.7 microM for dTTP, 5 microM for methyl-dTTP, 11 microM for ethyl-dTTP, and 33 microM for isopropyl-dTTP. O4-Alkyl-dTTPs were tested for their ability to inhibit or compete with dTTP incorporation and found to have a minimal effect, even when present at high concentration. These experiments indicated that Pol I can incorporate deoxynucleotides with O4-alkyl substituents into an ordered DNA structure. A postulated base-pairing scheme with deoxyadenosine is described. PMID- 3516217 TI - alpha-Aminoboronic acid derivatives: effective inhibitors of aminopeptidases. AB - alpha-Aminoboronic acids and their derivatives have been synthesized as stable white solids. These compounds are effective inhibitors of human enkephalin degrading aminopeptidase, microsomal leucine aminopeptidase (EC 3.4.11.2), and cytosolic leucine aminopeptidase (EC 3.4.11.1) at micro- to nanomolar concentrations. The inhibition of cytosolic leucine aminopeptidase has been studied in some detail. Kinetic data correspond to the mechanism for biphasic slow-binding inhibition: E + I in equilibrium E.I in equilibrium E.I*, in which a rapid initial binding is followed by a slow transformation to a stable enzyme inhibitor complex. The initial and final binding constants are dependent on the nature of the side chain at the alpha-carbon atom but are independent of the protecting group on the boronic acid moiety and follow the trend for the hydrolysis of the corresponding amino acid amides. The first-order rate constant for the transformation of E.I to E.I* is similar for all four compounds studied. These data suggest that the slow-binding step represents the formation of tetrahedral boronate species from trigonal boronic acid. PMID- 3516218 TI - Substrate and inhibitor studies of thermolysin-like neutral metalloendopeptidase from kidney membrane fractions. Comparison with bacterial thermolysin. AB - The inhibitory constants of a series of synthetic N-carboxymethyl peptide inhibitors and the kinetic parameters (Km, kcat, and kcat/Km) of a series of model synthetic substrates were determined for the membrane-bound kidney metalloendopeptidase isolated from rabbit kidney and compared with those of bacterial thermolysin. The two enzymes show striking similarities with respect to structural requirements for substrate binding to the hydrophobic pocket at the S1' subsite of the active site. Both enzymes showed the highest reaction rates with substrates having leucine residues in this position while phenylalanine residues gave the lowest Km. The two enzymes were also inhibited by the same N carboxymethyl peptide inhibitors. Although the mammalian enzyme was more susceptible to inhibition than its bacterial counterpart, structural variations in the inhibitor molecules affected the inhibitory constants for both enzymes in a similar manner. The two enzymes differed significantly, however, with respect to the effect of structural changes in the P1 and P2' positions of the substrate on the kinetic parameters of the reaction. The mammalian enzyme showed the highest reaction rates and specificity constants with substrates having the sequence -Phe-Gly-Phe- or -Phe-Ala-Phe- in positions P2, P1, and P1', respectively, while the sequence -Ala-Phe-Phe- was the most favored by the bacterial enzyme. The sequence -Gly-Gly-Phe- as found in enkephalins was not favored by either of the enzymes. Of the substrates having an aminobenzoate group in the P2' position, the mammalian enzyme favored those with the carboxyl group in the meta position while the bacterial enzyme favored those with the carboxyl group in the para position.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3516219 TI - Kinetic studies of L-aspartase from Escherichia coli: substrate activation. AB - The enzyme L-aspartase from Escherichia coli was observed to have a time lag during the production of aspartic acid from fumarate and ammonia. This time lag is pH dependent, with little lag observed below pH 7.0 and a very extensive lag observed above pH 8.0. This time lag was also found to be dependent on both substrate and divalent metal ion concentrations and on the degree of proteolysis of L-aspartase. The observed lag, in the reaction examined in the amination direction, has been found to be correlated with the nonlinear kinetics seen at higher pH in the deamination direction. Both phenomena are consistent with a model in which there is a separate activator site for the substrate, L-aspartic acid, that is distinct from the enzyme active site. Occupation of this site by the substrate, or by various substrate analogues, eliminates both the nonlinearity and the time lag. The D isomer of aspartic acid, which does not bind at the active site, can bind at this newly identified activator site. PMID- 3516220 TI - Menaquinone (vitamin K2) biosynthesis in Escherichia coli: synthesis of o succinylbenzoate does not require the decarboxylase activity of the ketoglutarate dehydrogenase complex. AB - The committed step in menaquinone biosynthesis is the formation of o succinylbenzoate (OSB). It is presumed to require the reaction of a seven-carbon intermediate of the shikimate pathway with a succinic semialdehyde-thiamin pyrophosphate (TPP) anion, derived by decarboxylation of 2-ketoglutarate. The following evidence indicates that the decarboxylation is not a function of the ketoglutarate dehydrogenase complex but is carried out by a separate activity. (A) Cell-free extracts of Escherichia coli K12 without added TPP lose OSB synthase activity but retain all of the ketoglutarate dehydrogenase complex activities. (B) OSB synthase activity is inhibited by addition of tetrahydro-TPP (th-TPP) to the incubations. The ketoglutarate dehydrogenase complex activities are only inhibited by this analogue after an initial preincubation period. (C) The high molecular weight ketoglutarate dehydrogenase complex can be separated from OSB synthase activity by gel-permeation chromatography on Sepharose CL-6B. Experiment series A and B also provide supporting evidence that TPP does play an important role in menaquinone biosynthesis. PMID- 3516221 TI - Evidence for the existence of a channel in the glucose-specific carrier EIIGlc of the Salmonella typhimurium phosphoenolpyruvate-dependent phosphotransferase system. AB - The effect of membrane-impermeable sulfhydryl reagents on glucose-specific enzyme II (EIIGlc) activity has been studied in Salmonella typhimurium whole cells and in properly sealed inverted cytoplasmic membrane vesicles. Glutathione N hexylmaleimide and N-polymethylenecarboxymaleimides inactivate methyl alpha-D glucopyranoside (alpha-MeGlc) transport and phosphorylation in whole cell preparations at a dithiol that can be protected by oxidizing reagents, trivalent arsenicals, or phosphorylation of EIIGlc. Accessibility to this activity-linked site is restricted to small apolar reagents or to polar reagents with a hydrophobic spacer between the polar group and the reactive maleimide moiety. These same reagents inactivate alpha-MeGlc phosphorylation in inverted cytoplasmic membrane vesicles. Inhibition results from reaction at a dithiol that can be protected by nonpermeant mercurials, oxidants, and arsenicals as well as by phosphorylation of EII. The characteristics of this site are virtually identical with those of the activity-linked dithiol elucidated in intact cells. No evidence could be found for a second activity-linked site on the other side of the membrane when the permeable reagent N-ethylmaleimide was used. Since only one activity-linked dithiol can be detected with sealed inverted membrane vesicles or intact cells and it is accessible to membrane-impermeable sulfhydryl reagents from both sides of the cytoplasmic membrane, we suggest that it is located in a channel constructured by the carrier and that the channel spans the membrane. A second dithiol, not essential for activity, is located near the outer surface of the cytoplasmic membrane. PMID- 3516222 TI - Isolation of a manganese-containing protein complex from photosystem II preparations of spinach. AB - Purified 125I-labeled 33-kDa protein binds to calcium-washed photosystem II preparations at high-affinity and low-affinity binding sites. Filling 70% of the high-affinity site with 33-kDa protein induces 63% of the maximum achievable reconstitution of O2-evolving activity. When N-succinimidyl [(4 azidophenyl)dithio]propionate modified 33-kDa protein was reconstituted into Ca(II)-washed membranes under conditions that primarily filled the high-affinity site and then cross-linked to adjacent proteins by illumination of the photoaffinity label, a cross-linked protein complex was formed that could be solubilized from the membranes with sodium dodecyl sulfate. The protein complex consisted of 22-, 24-, 26-, 28-, 29-, and 31-kDa proteins cross-linked to the 33 kDa protein and contained about 3-4 mol of Mn/mol of protein. PMID- 3516223 TI - Regulation of insulin receptor activity of human erythrocyte membrane by prostaglandin E1. AB - Incubation of human erythrocyte membrane with low concentration of prostaglandin E1 or prostacyclin increased the binding of 125I-labeled insulin to the membrane. The binding of the radioiodinated hormone was maximally stimulated at 3 nM prostaglandin E1 and the use of higher concentrations (above 8 nM) of the autacoid tended to reverse its own effect at lower concentrations. While prostaglandins A1, A2, B1, B2, D2, F1 alpha, F2 alpha or 6-keto-prostaglandin F1 alpha had no effect on the binding of insulin to the erythrocyte membrane, prostaglandin E2 at similar concentrations decreased the binding of the hormone. The effect of prostaglandin E1 on the increased binding of the insulin was found to be reversible and depended on the occupancy of the autacoid molecules on the membrane and showed positive cooperativity. Scatchard analysis of the binding of 125I-labeled insulin to the erythrocyte ghosts indicated that in the presence of the autacoid, the binding capacity of the insulin receptor increased 2-fold (from 207 to 424 fmol/mg protein) without any change in the ghosts affinity for the ligand (Kd 2.4 X 10(-9) versus 2.49 X 10(-9) M). As a consequence of increased binding of insulin to the erythrocyte membrane in the presence of prostaglandin E1 (3.0 nM), the optimal concentration of the peptide hormone for the maximal reduction of the membrane microviscosity decreased from approx. 1.6 to approx. 0.4 nM. Addition of prostaglandin E1 alone at the above concentration to the assay mixture had no effect on the membrane microviscosity. PMID- 3516225 TI - Quantitation and characterization of tau factor in porcine tissues. AB - Using a monospecific antibody against brain tau factor purified by affinity chromatography, we have studied the distribution of tau factor or related polypeptides in different cells. The presence of tau in all cell types tested was demonstrated by a radioimmunoassay. Tau factor-related proteins were found in liver, spleen, pancreas, kidney and lung, although at much lower levels than that found in neural cells. In all cases, they copolymerized with tubulin and were heat-resistant. When the distribution of tau factor-related proteins was studied by Western blotting, tau factor antiserum reacted against peptides with an electrophoretic mobility that was similar to those of brain tau factor peptides. Immunofluorescence studies have also been performed with the same antibody to determine the distribution of tau factor-related peptides in PK15 cells. Our results indicated that these peptides were associated to the microtubule network. PMID- 3516224 TI - How proteins get into microbodies (peroxisomes, glyoxysomes, glycosomes). AB - All microbody proteins studies, including one microbody membrane protein, are made on free polysomes and imported post-translationally. This holds for animal tissues, plants, and fungi. The majority of microbody protein sub-units are synthesized in a form not detectably different from mature sub-units. In five cases a larger precursor protein has been found. The position of the extra piece in this precursor is not known. In two of the five cases, processing of the precursor is not coupled to import; in the other three this remains to be determined. It is not even known whether information in the prepiece contributes to topogenesis, or serves other purposes. Microbody preparations from Neurospora, plant tissue and rat liver can take up some newly synthesized microbody proteins in vitro. In most cases uptake is inefficient. No special requirements for uptake have been established and whether a receptor is involved is not yet known. Several examples have been reported of peroxisomal enzymes with a counterpart in another cell compartment. With the exception of catalase, no direct evidence is available in any of these cases for two isoenzymes specified by the same gene. In the Zellweger syndrome, a lethal hereditary disease of man, characterized by a lack of peroxisomes, the levels of several enzymes of lipid metabolism are strongly decreased. In contrast, D-amino-acid oxidase, L-alpha-hydroxyacid oxidase and catalase levels are normal. The catalase resides in the cytosol. Since there is no separate gene for cytosolic catalase, the normal catalase levels in Zellweger cells show that some peroxisomal enzymes can mature and survive stably in the cytosol. It is possible that maturation of the peroxisomal enzyme in the cytoplasm can account for the finding of cytosolic catalase in some normal mammalian cells. The glycosomes of trypanosomes are microbodies that contain a glycolytic system. Comparison of the glycosomal phosphoglycerate kinase with its cytosolic counterpart has shown that these isoenzymes are 93% homologous in amino-acid sequence, but less than 50% homologous to the corresponding enzymes of yeast and mammals. This implies that few alterations are required to direct a protein into microbodies. This interpretation is supported by the evidence for homology between some microbody and mitochondrial isoenzymes in other organisms mentioned under point 4. The major changes of the glycosomal phosphoglycerate kinase relative to the cytosolic enzyme are a large increase in positive charge and a C-terminal extension of 20 amino acids.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3516226 TI - The reversible receptor binding of insulin in isolated rat adipocytes measured at 37 degrees C. The binding is not rate limiting for cellular uptake. AB - The bimolecular binding reaction between mono[TyrA14-125I]iodoinsulin and the insulin receptor was investigated at 37 degrees C in intact isolated rat adipocytes in which membrane traffic was inhibited by 1 mM KCN. This treatment decreased the fraction of cell-associated radioactivity resistant to treatment at pH 3 (usually regarded as internalized ligand) from 70% to 17%. The total amount of tracer being cell-associated at steady state was reduced to about half of the control value partly because of a decreased apparent binding affinity. The t1/2 for the forward reaction was reduced from 414 s in the control cell to 26 s in the KCN treated cell. Likewise, the t1/2 for the dissociation was reduced from 461 s to 67 s. Both rate constants were pH sensitive, the association rate constant being 7-8-fold more than the dissociation rate constant. Since both rate constants for the bimolecular reaction were one order of magnitude greater than those for the uptake and the release of label in the untreated cell, other processes than binding constitute the rate-limiting step(s) in the cellular reaction with insulin. PMID- 3516228 TI - [Detection of the neurospecific protein Sy-1 in the human brain and its regional localization in nerve tissue]. AB - Using affinity chromatography, a neurospecific protein was isolated from human and rat brain. Both proteins were shown to possess identical physico-chemical properties. However, antisera raised against these proteins exhibited no cross reactions with the corresponding proteins, thus suggesting their species specificity. Immunochemical analysis revealed that the neurospecific protein from rat brain is identical to protein Sy-1 specific for rat brain. Since the human brain protein is analogous to its rat brain counterpart, it may also be considered as protein Sy-1. The uneven distribution of the protein in various structures of human brain was demonstrated by the immunoenzymatic method. Protein Sy-1 is found at relatively low concentrations in the cortex, caudate nucleus and claustrum (2.5-5 micrograms/mg of water-soluble protein), but is predominant in the brain stem (20 micrograms/mg). PMID- 3516227 TI - [Microcalorimetric study of the oncogene EJ and proto-oncogene EC in the plasmid pBR 322]. AB - Thermodynamic parameters were obtained of melting of the linear form of plasmids pBR 322 and plasmids pBR 322 with incorporated oncogene EC. The melting temperature of the main stage of heat absorption of the oncogene EJ was shown to be 1.6 degrees C lower than in the norm (EC). It is suggested that the thermostability change observed is related not only with point mutations of high melting GC-pairs of bases for more low melting AT-pairs, but evidently with the structural changes in the DNA double helix as well. PMID- 3516229 TI - [Insulin-like substance and insulin-degrading complex in hemolysates of human erythrocytes]. AB - Human erythrocyte lysate was fractionated on various gel filtration media and immunoreactive insulin, insulinase and the influence of individual fractions of the insulin-degrading activity were determined. The hemolysate was shown to contain a complex of substances including an insulin-like substance, insulinase, protease inhibitor and insulinase activator. The insulin-like substance eluted from a Sephadex G-50 column in the same manner as native insulin, and its concentration exceeded the plasma level. Insulinase (Mr 100,000) degraded insulin to the trichloroacetic acid soluble fragments but did not degrade protein or glycoprotein hormones from human pituitaries. Insulinase was inhibited by low temperature, aprotinin and by a newly discovered protease inhibitor from erythrocytes which also inhibits serine proteases--trypsin and chymotrypsin. Another newly discovered substance eluted from a Sephadex G-100 column in the region of low molecular weight substances and showed an insulinase activating activity. The elution patterns of the protease inhibitor and insulinase activator suggest the possibility of the presence of more than one inhibiting and activating factor. The experimental results suggest that the insulin-degrading complex plays a role of a regulator of plasma insulin level. The nonpancreatic origin of the insulin-like substance is also possible. PMID- 3516230 TI - [Enzymological bases of the physiological action of regulatory peptides]. AB - The examination of enzymes involved in the neuropeptides metabolism shows that the same substance can be hydrolysed by different peptidases. At the same time each of these enzymes can take part in destruction of different in their structure and functional significance peptides. The analysis of the conditions ensuring selective, regulating action of the definite neuropeptidases in the process of peptides formation and destruction is necessary for the understanding of the regulatory peptides physiological role. Substrate specificity of the enzyme, its localisation in some tissues and organs in brain and periphery, the organisation of enzyme or enzymatic complexes in a cell, the specific inhibitors influence are considered as such conditions. These conditions are examined for a number of peptidases involved in enkephalin metabolism, angiotensin I and II, bradykinin, substance P and others. The significance of such enzymologic approach in the investigation of regulatory peptides function is illustrated by concrete examples. PMID- 3516231 TI - Metabolic effects of endotoxin in newborn rabbits. AB - The metabolic and hormonal effects of Escherichia coli endotoxin injected intraperitoneally (IP) or into the cerebral ventricles (ICV) and that of passive hyperthermia were studied in rabbits aged 6-10 days. Irrespective of the route of administration, endotoxin caused a transient rise in blood glucose with a simultaneous rise in plasma insulin. In contrast, only in the IP, but not in the ICV group, the endotoxin resulted in a rise of the free fatty acid and a fall in the ketone body concentrations by the second hour. The blood level of pyruvate, lactate, alanine and glycerol was not altered by endotoxin. No parameter was affected by the injection of saline or passive hyperthermia. PMID- 3516232 TI - Physiologically elevated concentration of serum trypsin-like immunoreactivity in newborns. Comparison with lipase. AB - Comparative measurements on the levels of immunoreactive trypsin(ogen)-1 and lipase have been performed on newborn and adult sera. Values observed for immunoreactive trypsin(ogen)-1 with newborn sera are more dispersed and significantly higher (mean +/- SD, 31.9 +/- 12.9 micrograms/l) than the values obtained with adult sera (20.2 +/- 7.3 micrograms/l). The molecular size distribution of the immunoreactive trypsin-like material in newborns was studied by gel filtration. This material was eluted with a molecular weight of 25,000 which eliminates the possibility of an increased intestinal permeability of active trypsin which would be bound to serum protease inhibitors. In contrast to trypsin values, the mean serum lipase value at birth was significantly lower (7.0 +/- 3.2 micrograms/l) than the value observed for adults (26.9 +/- 8.2 micrograms/l). The possibility of an adaptation process in newborns is evoked. PMID- 3516233 TI - Circulatory changes in fetuses with imminent asphyxia. AB - Blood flow was measured in 11 term fetuses who were later delivered by means of emergency caesarean section because of cardiotocographic changes indicating imminent asphyxia. Blood flow was recorded in the fetal descending aorta and in the intraabdominal part of the umbilical vein by combined real-time and 2-MHz pulsed Doppler ultrasound method. In all 11 fetuses, the waveform of the maximum aortic blood velocity was changed in a typical way with elimination of the diastolic flow (zero flow). In 4 of the fetuses, a short-lasting reversal of the diastolic flow occurred. In 5 fetuses, the pulsatility index of the aortic flow was increased, and the aortic volume flow was pathologically low in 3 fetuses. In the umbilical vein, the volume flow was within normal limits in all cases. The umbilical flow, which normally is continuous and nonpulsatile, showed heart synchronous pulsations in 3 of the fetuses. The typical changes in the aortic diastolic flow occurred 1-3 days before the onset of the cardiotocographic changes. This suggests that the changes in the fetal aortic blood velocity might be a clinically useful early sign of imminent asphyxia. PMID- 3516234 TI - Immunocytochemical localization of neurophysin and oxytocin in ovine corpora lutea. AB - The cellular distribution of neurophysin and oxytocin within ovine corpora lutea obtained on Days 4, 10 and 16 of the estrous cycle was examined immunocytochemically. Serial sections (8-10 micron-thick) prepared from corpora lutea that had been fixed in Bouin's solution and embedded in paraffin were immunostained for neurophysin or oxytocin using the peroxidase-antiperoxidase (PAP) procedure. Irrespective of the day of the cycle examined, immunoreactivity was restricted to large luteal cells. However, on Days 4 and 10 of the cycle, the intensity of staining in large luteal cells was highly variable; and, within the same section some cells were heavily stained, others were only lightly stained, and still others were not stained at all. In contrast, on Day 16 of the cycle, the intensity of staining was uniform and essentially all of the large luteal cells were immunoreactive. Based on the results obtained, it is evident that immunoreactive neurophysin and oxytocin can be detected as early as Day 4 of the cycle, persists through Day 15, and is restricted to large luteal cells. PMID- 3516235 TI - Changes in the dynamics of luteinizing hormone-releasing hormone-stimulated secretion of luteinizing hormone during sexual maturation of female rats. AB - Our aim was to identify age-related changes in the dynamics of luteinizing hormone (LH) release that may contribute to the decline in pituitary sensitivity to luteinizing hormone-releasing hormone (LHRH) during sexual maturation of female rats. We studied LHRH-stimulated LH secretion curves of superfused pituitaries from rats ranging in age from 10 days to the first estrous cycle. Pituitary fragments were exposed for 10 min to medium alone or to medium plus LHRH; incubation continued in medium alone for 130 min and effluent was collected for LH analysis. Secretion curves were compared on the basis of total secretion (area under the curve), maximal change in LH secretion rate, and rates of rise and decay of the curves. The data show that total LH secretion in response to LHRH is greatest in 15-, 20-day-old and first-proestrus animals. Also, the maximal change in LH secretion rate was greater, and the increase in LH secretion rate faster in younger animals than in 30-day-old animals. Analysis of secretory granules in LH-containing gonadotropes of 15- and 30-day-old animals revealed changes in he granule population with age. We conclude that younger animals respond faster with a greater LH secretion response to LHRH than do 30-day-old or first-estrus animals, and that these age-related changes in the dynamics of LH secretion may be due in part to maturation of the LH secretory granules. PMID- 3516237 TI - Bone marrow transplantation for treatment of lysosomal storage diseases. Proceedings of a colloquium. May 7, 1985, Washington, D.C. PMID- 3516236 TI - Efficient degradation in vitro of all intermediate filament subunit proteins by the Ca2+-activated neutral thiol proteinase from Ehrlich ascites tumor cells and porcine kidney. AB - Vimentin, desmin, glial fibrillary acidic protein, neurofilament triplet proteins, and a mixture of cytokeratins were digested with Ca2+-activated neutral thiol proteinase isolated from Ehrlich ascites tumor (EAT) cells and porcine kidney. All intermediate filament proteins were degraded by the proteinase, although with different rates and Ca2+ optima. These results are in part at variance with our previous statement that the Ca2+-activated proteinase from EAT cells is specific for vimentin and desmin. PMID- 3516238 TI - Bone marrow transplantation in Gaucher disease. PMID- 3516239 TI - Bone marrow transplantation in Lesch-Nyhan disease. PMID- 3516240 TI - Bone marrow transplantation in type IIa glycogen storage disease. PMID- 3516241 TI - Survey of preparative regimens and complications of bone marrow transplantation in patients with lysosomal storage diseases. PMID- 3516242 TI - Brain catalase activity following syngeneic bone marrow transplantation in acatalasemic mice. PMID- 3516243 TI - Biochemical findings after bone marrow transplantation for metachromatic leukodystrophy: a preliminary report. PMID- 3516244 TI - Allogeneic bone marrow transplantation in adrenoleukodystrophy: clinical, pathologic, and biochemical studies. PMID- 3516245 TI - [Immunohistochemical identification of endogenous sources of cardiac glycoside biosynthesis]. AB - Using immunohistochemical technique, digoxin-containing cells were detected in some brain areas, liver, pancreas and heart. The possible existence of endogenous sources of cardiac glycoside biosynthesis is suggested. The substances under study are termed "endocorsides". PMID- 3516246 TI - [Proteolysis of blood plasma proteins in the stomach in early ontogeny]. AB - Proteolysis of milk substitutes containing fibrinogen, casecid and bovine serum albumin as protein components was studied. Artificial feeding of newborn rats has shown high casecid and fibrinogen utilization. Casecid and fibrinogen contained in milk substitutes delayed protein evacuation from the stomach, while bovine serum albumin intensified protein evacuation. Adaptive changes in enzyme-forming gastric function depend on the protein quality. PMID- 3516247 TI - [Hemodynamic aspects of the hypotensive action of captopril]. AB - Captopril was tested in acute experiments on anesthetized cats subject to cardiopulmonary bypass. The drug was shown to reduce total peripheral vascular resistance and to increase vascular bed capacity. PMID- 3516248 TI - [Characteristics of the implantation of venous patches into the common bile duct of dogs]. AB - Seven free grafts of an anterior wall of common bile duct with autovenous patches were realized using microsurgical technique in 7 dogs. Carcass and cavity drainage were not used. It was shown that one month after the operation the interior surface of the patch was covered with normal duct mucosa and the duct was not dilated. No inflammatory and macrophage reactions were observed in the patch or surrounding tissue. PMID- 3516249 TI - The structural and functional properties of thrombospondin. PMID- 3516250 TI - The proportion of mitoses in different cell lineages changes during short-term culture of normal human bone marrow. AB - To determine the hematopoietic cell lineage of mitotic cells in human bone marrow on direct examination and after 24-hour culture, marrow mitoses from four healthy individuals were studied, using a new technique that allows analysis of karyotypes in cells whose cell membrane and cytoplasm have been preserved. Mitoses were identified as being of erythroid lineage by immunofluorescent staining for surface glycophorin A and as being of granulocytic lineage by cytoplasmic staining for Sudan black B. On direct marrow examination without prior culture, the great majority of mitoses (74% to 90%) were of erythroid lineage; only a few (0% to 10%) were granulocytic. After 24-hour culture, the percentage of erythroid mitoses (15% to 40%) decreased, while the percentage of granulocytic mitoses (58% to 87%) increased strikingly. These data indicate that mitotic cells of different hematopoietic cell lineages predominate in marrow at different culture times and offer a plausible explanation for the high frequency of normal karyotypes in acute myeloid leukemia after direct marrow cytogenetic evaluation. PMID- 3516251 TI - A soluble adenosine triphosphate-dependent proteolytic system in human peripheral red blood cells. AB - A soluble adenosine triphosphate (ATP)-dependent proteolytic system has been detected in human peripheral blood erythroid cells. Hemolysates prepared from reticulocyte-rich blood of subjects with autoimmune hemolytic anemia, treated pernicious anemia, and iron deficiency anemia or from pools of red blood cells enriched for reticulocytes by density gradient centrifugation were tested against a radioactive casein standard. Up to 57% of the casein was rendered trichloroacetic acid (TCA) soluble after incubation with such hemolysates for 60 minutes in the presence of 1.0 mmol/L ATP. In the absence of ATP or in hemolysates prepared from reticulocyte-poor blood as little as 6% to 10% of the casein was hydrolyzed. The proteolytic activity was found in the 100,000-g supernatant of active hemolysates and was blocked by hemin, N-ethylmaleimide, and sodium vanadate and thus resembles a previously described activity in rabbit reticulocytes. In the presence of ATP, similar lysates prepared from rabbit reticulocytes preferentially hydrolyzed the abnormal human hemoglobins Leiden and Gun Hill compared with hemoglobin A. These results suggest that there is an active ATP-dependent proteolytic system in young human erythroid cells that can degrade certain abnormal globin chains; the enzymatic activity is lost in the transition from reticulocyte to erythrocyte. PMID- 3516252 TI - High-dose melphalan with autologous bone marrow transplantation for multiple myeloma. AB - A large dose of melphalan was given to 23 patients with advanced multiple myeloma that was refractory to multiple prior treatments. Sixteen patients received a dose of 80 to 100 mg/m2, and seven were given 140 mg/m2 followed by autologous bone marrow infusion. Tumor mass was reduced by more than 75% in 14 patients, including four who died of bone marrow aplasia. Serious infections were prevented in six of seven patients who received autologous bone marrow. The marked cytoreduction in patients with previously refractory disease indicated the apparent drug resistance could be overcome by dose escalation. However, short remission times in most responding patients were consistent with rapid regrowth of primordial tumor cells with high proliferative activity. Although high-dose melphalan was of limited benefit to patients with refractory myeloma, further studies are necessary to clarify its role during earlier phases of disease. PMID- 3516253 TI - Depletion of donor lymphocytes by counterflow centrifugation successfully prevents acute graft-versus-host disease in matched allogeneic marrow transplantation. AB - Bone marrow from 22 histocompatible siblings was depleted of 98% of the lymphocytes using a combination of density flotation centrifugation followed by counterflow elutriation. Even with the marrow suppressive influence of methotrexate (MTX), the viability of the hematopoietic stem cells was not affected, as indicated by the normal repopulation after grafting in the evaluable patients. One patient (UPN 9) showed a primary graft failure, possibly resulting from persisting septicemia and long-term antibiotic therapy. Two patients have persistent host lymphocytes, one of whom was examined during relapse; the other remains in remission. Two patients did not receive immunosuppression after bone marrow transplantation (BMT), and acute graft-v-host disease (GVHD) developed in both. Nine patients received MTX as immunosuppression following BMT. GVHD did not develop in any of them, but fatal infections in the immediate posttransplant period developed in five patients. Eleven patients received cyclosporine (CsA) after transplantation. Beginning in week 5 after BMT, CsA was gradually replaced by MTX. Acute GVHD, substantial chronic GVHD, or fatal infections did not develop in any of these patients. Removal of 98% of the lymphocytes by counterflow centrifugation prevents development of acute GVHD, provided that immunosuppression is administered after BMT. Graft rejection was not observed, but the number of evaluable patients is limited at present. PMID- 3516254 TI - Autologous bone marrow transplantation using marrow incubated with Asta Z 7557 in adult acute leukemia. AB - The sensitivity of human myeloblastic leukemic (CFU-L) and normal hemopoietic stem cells (CFU-GM and BFU-e) to Asta Z 7557 (INN Mafosfamide) was studied with regard to autologous bone marrow transplantation (ABMT) with cleansed marrow for consolidation therapy in adult patients with acute leukemia (AL) in remission. Establishment of the dose-response curves for CFU-GM (n = 37), BFUe (n = 11), and myeloblastic CFU-L (n = 9) demonstrated a wide range of sensitivity from patient to patient for all three progenitors. Whereas CFU-L, CFU-GM, and BFU-e grown in semisolid cultures disclosed similar sensitivities to Asta Z 7557, long-term culture (LTC) studies (n = 41) indicated a higher resistance of early progenitors. In an effort to achieve a maximum tumor cell kill and yet spare a sufficient amount of normal stem cells to ensure consistent engraftment, we defined the optimal dose for marrow cleansing as the dose sparing 5% CFU-GM (LD95). This dose was established from a preincubation test (PIT) realized on a 10-mL marrow aspirate taken 15 days before marrow collection in each individual patient. Twenty-four adult patients while in remission of AL (20 in complete remission, four in partial remission) were consolidated by cyclophosphamide 60 mg/kg X 2 and total body irradiation at 10 Gy followed by ABMT with marrow cleansed by Asta Z 7557 according to the specification described above. Patients were divided in two groups: group 1, unfavorable prognosis (11 patients); group 2, standard prognosis [13 patients in first complete remission (CR)]. All patients engrafted on leukocytes (median day for recovery to 10(9)/L: day 30), patients with ALL recovered faster than patients with ANL (median day 19 v 34). Similarly, recovery of platelets to 50.10(9)/L occurred sooner in patients with ALL (median day 67, range day 23 through 90) whereas three patients with acute nonlymphoblastic leukemia (ANLL) in group 2 had to be supported with platelet transfusions for more than one year. In group 1, six patients had recurrent tumor within six months; three patients died from toxicity with no evidence of tumor. Two patients are still disease-free with a short follow-up (nine and ten months). In group 2, two patients died from toxicity with no evidence of leukemia three and 16 months post-ABMT. One patient with a M5 ANLL and one patient with ALL relapsed at six and 15 months, respectively. Nine patients have remained in CR or are disease-free with a median follow-up of 22 months.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3516255 TI - Activation of human neutrophils by monoclonal antibody PMN7C3: cell movement and adhesion can be triggered independently from the respiratory burst. AB - Anti-neutrophil monoclonal antibody PMN7C3 (IgG3) recognizes glycoproteins bearing the oligosaccharide lacto-N-fucopentaose III, including the C3bi receptor, LFA-1, and p150,95 on the plasma membrane and a group of granule associated glycoproteins. We have previously shown that binding of this antibody to polymorphonuclear leukocytes (PMNs) stimulates a transient rise in cytosolic free calcium concentration but does not trigger the neutrophil respiratory burst. We now demonstrate that binding of PMN7C3 (and five other monoclonal antibodies recognizing the same antigen) to human neutrophils activates several other cellular responses. Addition of PMN7C3 to monolayers of neutrophils induces a rapid change in cell shape followed by pseudopod formation and increased migration. With incubation at 37 degrees C, the neutrophils aggregate in clusters (leukoagglutination). Quantitation of cell movement in a multiwell chemotaxis assembly or by migration of PMNs under agarose revealed that PMN7C3 is both chemotactic and chemokinetic. Pretreatment with the antibody inhibits subsequent chemotactic response to other stimuli. Monoclonal antibodies binding to other neutrophil antigens do not mimic these effects. These data suggest that cell movement and adhesion can be triggered independently from the respiratory burst. PMN7C3 may be a useful probe with which to study the events that link receptor ligand binding to cellular response. PMID- 3516256 TI - Stromal cell-associated erythropoiesis. AB - A novel cover slip-transfer culture system was designed to study the functional roles of stromal cells in hemopoiesis, particularly erythropoiesis. Human bone marrow stromal cell colonies were allowed to develop on small glass cover slips in liquid medium. The cover slips, along with the stromal cell colonies and progenitors attached to them were then transferred to a new tissue culture dish and overlaid with methylcellulose culture medium. No exogenous colony-stimulating factors except erythropoietin were supplied. Large erythroid bursts, comprising multiple subcolonies, developed on the stromal cells. In order to determine if stromal fibroblasts together with erythropoietin and serum proteins could support erythroid development, human bone marrow cells depleted of monocytes, macrophages, and T lymphocytes were allowed to adhere to monolayers of a homogeneous fibroblastoid human stromal cell strain ST-1 grown on cover slips. The cover slips were then washed to remove nonadherent cells, transferred to a new culture dish, and overlaid with methylcellulose culture medium containing fetal calf serum and erythropoietin. In this modified system as well, primitive erythroid progenitors migrated extensively on and within the stroma to form huge colonies of hemoglobinized erythroblasts that proceeded to enucleate. Our results indicate that (1) ST-1 cells together with serum proteins and erythropoietin can support the development of large erythroid bursts; (2) erythroid progenitors and precursors adhere to and migrate on and within the extracellular matrix elaborated by ST-1 cells; (3) erythroid progenitors are more adherent to the ST-1 cells or the extracellular matrix than are the more mature cells and possibly the myeloid progenitors. PMID- 3516257 TI - A collaborative, double-blind randomized study of cetiedil citrate in sickle cell crisis. AB - We have recently completed a double-blind, placebo-controlled, noncrossover study, the goal of which was to determine whether cetiedil citrate (cetiedil) could affect the course of vaso-occlusive crises in sickle cell disease. Patients, who presented to the emergency room at least 4 but no more than 24 hours after the onset of a painful vasoocclusive crisis severe enough to require hospitalization, were considered candidates for the study. Each patient received either placebo or cetiedil at one of the following three dosages: 0.2, 0.3, or 0.4 mg/kg body weight. The assigned drug dosage was given as a 30 minute intravenous infusion every 8 hours for 4 consecutive days. A total of 67 patients was enrolled in the study. Cetiedil, at its highest dosage (0.4 mg/kg body weight), was found to be significantly superior to placebo both in reducing the number of painful sites present on all 4 treatment days and in shortening the total time in crisis. No serious adverse reactions were observed during the course of the study. We conclude that cetiedil, given at a dosage of 0.4 mg/kg body weight, is therapeutically advantageous for sickle cell crisis. PMID- 3516259 TI - Invasion of erythrocytes by Plasmodium falciparum malaria parasites: evidence for receptor heterogeneity and two receptors. AB - Plasmodium falciparum malaria parasites with different capabilities of invading sialic acid-deficient erythrocytes were identified. Thai-2 parasites cultured in Tn erythrocytes invaded neuraminidase-treated and Tn erythrocytes twice as efficiently as Thai-2 parasites cultured in normal erythrocytes and seven to ten times more efficiently than a cloned line of Camp parasites cultured in normal erythrocytes. All three parasite lines required sialic acid for optimal invasion, but Thai-2 parasites cultured in Tn erythrocytes invaded neuraminidase-treated erythrocytes with 45% efficiency whereas Camp parasites invaded neuraminidase treated erythrocytes with less than 10% efficiency. P falciparum malaria parasites probably possess two receptors: one that binds to a sialic acid dependent ligand and another that binds to a sialic acid-independent ligand. Parasites may differ in the quantity or affinity of their receptors for the sialic acid-independent ligand. PMID- 3516258 TI - Increased red blood cell deformability due to isoxsuprine administration decreases platelet adherence in a perfusion chamber: a double-blind cross-over study in patients with intermittent claudication. AB - Platelet transport towards the vessel wall is influenced by the hematocrit, red blood cell (RBC) size, and shape. Recent in vitro studies have indicated that RBC deformability may also influence platelet transport. The observation that isoxsuprine, a known vasodilating drug, caused increased RBC deformability in vitro and decreased platelet transport in vitro prompted us to study the effects of this drug in vivo. The study was performed in a double-blind cross-over study of isoxsuprine v placebo in ten patients with peripheral arterial insufficiency. RBC deformability was estimated from viscosity measurements using the blood viscosity equation of Dintenfass and expressed as T value. Platelet transport was studied in an annular perfusion chamber according to Baumgartner. Human umbilical arteries were used as blood vessels. Perfusion studies were performed with whole blood or with RBCs of the patients mixed with normal platelets and plasma at a standardized hematocrit and platelet count. An increase in RBC deformability concomitant with a decrease in platelet adherence was observed in patients on isoxsuprine with a drop in T value of approximately 0.06 (from 0.91 toward 0.86), and a concomitant decrease in platelet adherence of 20% to 40%. These observations differed significantly from the results in the placebo group and showed a significant group-period interaction at the cross-over of medication (analysis of variance). The effects on platelet adherence were observed at high vessel wall shear rate (1,800 s-1) with perfusates consisting of patients' RBCs and donor plasma and platelets at standardized hematocrit and platelet count. No differences were observed under these conditions at a shear rate of 300 s-1. When whole blood of patients was used, nonsignificant effect was observed at shear rates of 300 s-1 and 1,800 s-1. This was probably caused by the added noise due to variations in hematocrit and platelet number. These data demonstrate that isoxsuprine increases RBC deformability, and they suggest the possibility of decreasing platelet-vessel wall interaction in vivo by manipulation of RBC deformability. PMID- 3516260 TI - Critical review of cobalamin-folate interrelations. PMID- 3516261 TI - Combined prophylactic suppression of graft-versus-host and host-versus-graft reactions following treatment of prospective bone marrow recipients with rat IgG 2b anti-mouse T cell antibodies. AB - A new approach to avoid typical complications from bone marrow transplantation into MHC different mice was studied. Rat monoclonal anti-Thy-1 antibodies of the IgG 2b isotype were identified, which inhibit T lymphocytes in vivo so that transplanted donor T cells as well as residual T cells of the conditioned marrow recipient were suppressed. A single injection of these antibodies after irradiation and before marrow transplantation did not only prevent graft-versus host mortality but suppressed also host-versus-graft reactivity so that the radiation dose necessary for engraftment of donor cells differing in H-2, IA (both haplotypes) major histocompatibility antigens could be reduced to 6.0 Gy. In addition an anti-T leukemic cell effect from the injected monoclonal T cell antibodies was observed. PMID- 3516263 TI - Reduced recurrence-free survival after reduced doses of adjuvant chemotherapy in breast cancer: are groups selected after randomization comparable? PMID- 3516262 TI - Long-term survival following relapse after 5-FU but not CMF adjuvant breast cancer therapy. AB - Beginning in 1974, patients with greater than or equal to 4 nodes positive following mastectomy were randomized to receive either 5-FU i.v. weekly or CMF i.v. every 2 weeks, both given for 12 months. Median follow-up now exceeds 112 months with nine year results below: (table; see text) Early results based on relapse-free survival favored CMF, but more patients currently are alive on the 5 FU arm. As the survival curves cross at 40 months, the 20% survival advantage for 5-FU did not achieve statistical significance. For 34% of patients failing adjuvant 5-FU, use of combination chemotherapy after relapse (commonly with CMFVP or CMF) resulted in long term survival. In contrast, long-term survival for patients failing adjuvant CMF was unusual. Relapse was detected while under weekly observation in a greater proportion of patients on 5-FU (36%) compared to CMF (6%) adjuvant treatment (p less than 0.05), potentially influencing tumor burden at recurrence. Hormonal therapy or radiation therapy as initial therapy after relapse was ineffective, with no long term survivors resulting on either arm. Weight increase on adjuvant chemotherapy was commonly seen, with weight increase greater than 10 kg associated with a poor prognosis. We conclude that initial improvement in relapse-free survival may not predict long term survival in adjuvant breast cancer trials since both the specific adjuvant therapy given pre-relapse as well as the type of salvage therapy given post-relapse may influence ultimate patient outcome. PMID- 3516264 TI - Biological therapy of cancer. AB - Interferons and monoclonal antibodies are among the most promising biological approaches to cancer treatment which have so far been investigated. Both natural and recombinant interferon-alpha preparations have shown activity in a number of trials in hematologic malignancies, even in previously treated patients; activity in solid tumors, however, has been limited. Unconjugated monoclonal antibodies have been safely administered in several small trials and have had therapeutic value on occasion. In spite of a number of remaining problems and questions, monoclonal antibodies and their conjugates seem likely to find a number of distinct roles in cancer treatment; elimination of micrometastases and purging of bone marrow for grafting may be among these roles. PMID- 3516265 TI - The impact of parental homosexuality in child custody cases: a review of the literature. AB - As a result of the relatively high rate of divorce in this country and the increasing awareness that many parents (an estimated 1.5 million) are homosexual, the courts, as well as divorce mediators, have become actively involved in child custody placement decisions involving homosexual parents. While custody decisions have tended to reflect stereotyped beliefs or fears concerning the detrimental effects of homosexual parenting practices on child development, a review of the research consistently fails to document any evidence substantiating these fears. A number of specific custody issues are discussed as well as social factors relevant to lesbian motherhood. In conclusion, several authors call for increased awareness of the facts of homosexual parenting by lawyers, judges, and other professionals involved in homosexual parent-child custody cases. PMID- 3516266 TI - House dust allergens. PMID- 3516267 TI - The pathogenesis of emphysema. AB - Emphysema is an increase in size of the air spaces distal to the terminal bronchioles, and can thus only be diagnosed pathologically, but new quantitative CT methods hold promise, diagnosing, quantitating and locating the lesions in man, in life, non-invasively. The protease/antiprotease theory of the pathogenesis of emphysema proposes that cigarette smoke attracts alveolar macrophages to distal terminal bronchioles, these in turn releasing neutrophil chemotactic factors which attract circulating polymorphonuclear leucocytes, to release potent proteolytic enzymes (serine protease) in addition to the alveolar macrophage protease. These enzymes, which can cleave all the macromolecules of the lung interstitium, are antagonized (at least the serine elastase) in health by alpha 1-antitrypsin, a normal constituent of lung lining fluid. However, this can be oxidized by oxidants in cigarette smoke, and oxidants released by polymorphonuclear leucocytes in microbial killing. The role of these actions, and of antioxidants (both natural and therapeutic) and antielastases are reviewed, as well as the activities of lung defence cells in this process. Despite this explosion of recent knowledge, we are still unable to answer the all important question "Why don't all smokers develop emphysema?", and further research is needed into variability in these multiple factors involved in this important new theory of the pathogenesis of this, possibly the commonest of all respiratory disorders of a chronic disabling nature. PMID- 3516268 TI - Clearance of inhaled 99mTc DTPA from regions of the lung recently affected by pulmonary embolus. AB - Pulmonary emboli lead to regional limitation of pulmonary artery perfusion, often without affecting distribution of ventilation. We have studied the effect of this regional reduction of pulmonary artery perfusion on the integrity of epithelium of alveoli (and possibly bronchioli). Integrity of alveolar epithelium was assessed by measuring regional rates of clearance from lung to blood of an inhaled aerosol of a small molecular weight solute, 99mTc DTPA (technetium-99m diethylene-triamine-pentaacetate). Ten patients with pulmonary emboli were studied, where the diagnosis was made from 'mismatching' seen on ventilation (V) and perfusion (Q) lung scintigraphy. Rates of clearance of DTPA in regions with normal V/Q ratios were compared with embolized regions with high V/Q ratios. Clearance rates were increased in embolized regions (V/Q ratio greater than 1): 2.59 +/- (SD) 0.89% X min-1, compared with normal regions (V/Q ratio less than 1): mean 1.39 +/- 0.60% X min-1 (p less than 0.01). In repeat studies in nine patients (one died), after intervals between 2 and 12 weeks, the V/Q ratio of previously embolized regions decreased towards unity in all nine patients, suggesting resolution. The differences in clearance rates for DTPA between normal and embolized regions decreased in association with this return towards normal of V/Q ratios. We surmise that reduction in pulmonary artery perfusion which occurs in pulmonary embolic disease alters the integrity of the alveolar (and possibly bronchiolar) epithelium. This effect is largely reversible, recovering with return of pulmonary artery perfusion. PMID- 3516269 TI - Measurement and mechanisms of breathlessness. PMID- 3516270 TI - A history of local anesthesia armamentarium. PMID- 3516271 TI - Historic insights on dental radiography. PMID- 3516272 TI - Hans Sachs: pioneer periodontologist and dental historian. PMID- 3516273 TI - President Harry S. Truman's dental health. PMID- 3516274 TI - The coming of age of dental biological research and those who led the way. PMID- 3516275 TI - Oddments in dental history: Charles Land and his ingenious maxillofacial prosthetic appliance. PMID- 3516277 TI - The care of the teeth as dealt with in "ladies' books". PMID- 3516276 TI - Charles H. Land and the science of porcelain in dentistry. PMID- 3516278 TI - Dentistry in folk art XXII: Cavadenti. PMID- 3516279 TI - William Osler Medal essay. The education, naval service, and early career of William Smellie. PMID- 3516280 TI - Imagining the body. "Corps et chirurgie a l'apogee du Moyen-Age". By Marie Christine Pouchelle. An essay review. PMID- 3516281 TI - The Fielding H. Garrison lecture. Patterns of scientific creativity. PMID- 3516282 TI - American psychiatry and the cause of suicide, 1844-1917. PMID- 3516283 TI - The limits of progress: the professional lives of women doctors, 1881-1926. PMID- 3516284 TI - Orthodoxy vs. homeopathy: ironic developments following the Flexner Report at the Ohio State University. PMID- 3516286 TI - Thomas Hodgkin (1798-1866): morbid anatomist and social activist. PMID- 3516285 TI - Newer radiographic modalities in diagnosis of disorders of the spine. PMID- 3516287 TI - Complications of radial forearm flap donor sites. AB - The complications of radial forearm flap donor sites in 15 patients from two centres have been reviewed. The complications included skin graft failure, swelling of the hand, stiffness of joints, reduced strength and sensation, cold induced symptoms and fractures of the radius. Methods to reduce the incidence of such complications are discussed. PMID- 3516288 TI - A split Chinese forearm flap for simultaneous oral lining and skin cover. AB - The use of the Chinese or radial forearm flap to provide simultaneous oral lining, mandibular reconstruction and skin cover is reported in three patients, and suggestions are made about flap design. PMID- 3516289 TI - Blindness following cosmetic blepharoplasty--a review. AB - A case of unilateral blindness following cosmetic blepharoplasty is reported. A review of some 60 previously recorded cases is made with a more detailed analysis of 22 cases. An attempt has been made to highlight the opinions on causes and treatment held in common by those authors who have previously reported and discussed their cases. A degree of retrobulbar haemorrhage was a feature common to most cases and the final event leading to permanent visual impairment was usually ischaemia of retinal or optic nerve tissue. The relationship between these findings remains uncertain although intra-orbital compression was thought to be a frequent common pathway. Recommendations to reduce the chance of this rare but serious complication are made. The importance of simple pre-operative eye records and the early involvement of an ophthalmic surgeon when retrobulbar haemorrhage arises are stressed. PMID- 3516290 TI - Conversion without hysteria: a case report and review of the literature. AB - The term 'conversion' implies a correlation between conversion symptoms, hysteria, and hysterical personality. A clinical case of conversion related to chronic post-traumatic disorder, with paranoid features, was successfully treated by anti-psychotic drugs; it illustrates the non-specific nature of conversion symptoms. Mechanic's concept of 'illness behaviour' is a frame-work that meets the need for a broader understanding of conversion symptoms. PMID- 3516291 TI - Effects of intravenous and subcutaneous administration of apomorphine on the clinical symptoms of chronic schizophrenics. AB - The effects of apomorphine, a stimulant of dopamine autoreceptors, were studied in 12 chronic schizophrenics on neuroleptic treatment; both subcutaneous and intravenous administration were used. Apomorphine has been reported to have therapeutic effects in previous studies but, we were not able to confirm any significant and specific differences in psychotic symptoms or tardive dyskinesia scores with apomorphine administration, compared with placebo. These results do not support the importance of dopamine autoreceptors in the regulation of schizophrenic and dyskinetic symptoms in chronic neuroleptic-treated patients. PMID- 3516292 TI - Intravenous digital subtraction angiography in patients with suspected bypass graft occlusion following surgery for peripheral vascular disease. AB - Intravenous digital subtraction angiography has been used to investigate 40 patients with suspected bypass graft occlusion. Its accuracy and clinical impact have been assessed. PMID- 3516293 TI - The results of a randomised trial of mixed-schedule (neutron/photon) irradiation in the treatment of supratentorial Grade III and Grade IV astrocytoma. AB - A randomised trial is reported of mixed-schedule (neutron/photon) irradiation compared with photon therapy for patients with Grade III or Grade IV astrocytoma. Thirty-one patients were allocated to be treated by the neutron/photon regime and 30 patients by photons. The median survival was 4 months in the mixed-schedule group and 8 months in the photon group. The survival rates were not significantly different. All patients who died had evidence of residual brain tumour. None had signs of radiation-related morbidity. PMID- 3516294 TI - Priapism: a three-phase concept of management according to aetiology and prognosis. AB - Priapism is a persistent, painful erection of the penis unassociated with sexual stimulation or desire, and detumescence does not occur following ejaculation. Prolonged pathological erections may occur and it is only when they are painful that the term priapism should be used. The erection is limited to the corpora cavernosa. Although the syndrome was named after Priapos, the mythical Greek god of fertility, impotence persists in one half of patients treated for priapism. The disease is rare; the literature consists mainly of case reports and comprehensive reviews are seldom found. Permanent sequelae cause a psychological and physical handicap and justify the present review, which is based upon recent literature as well as personal clinical experience of 15 patients. We have reviewed 170 reports describing 1400 cases of priapism and have based the analysis upon the 230 single case reports found in the literature. PMID- 3516295 TI - Dose titration in clinical trials. An example using emepronium carrageenate in detrusor instability. AB - Seventy-two women with proven detrusor instability completed a novel clinical trial of the new anticholinergic emepronium carrageenate (Cetiprin novum), which allowed for dose titration. The tolerated dose has been shown to correlate with the severity of symptoms. Statistically significant improvement was achieved in symptomatic and urodynamic parameters without serious side effects. PMID- 3516296 TI - Terodiline in the treatment of women with urgency and motor urge incontinence. A clinical and urodynamic double-blind cross-over study. AB - In a consecutive double-blind cross-over study, 18 females with detrusor instability were treated with an anticholinergic and calcium antagonistic agent terodiline 25 mg bid or placebo for 3 weeks; cross-over took place after a wash out period of 1 week. The efficacy of the drug was investigated at the end of each treatment period by means of drug preference, micturition charts, pad usage, bladder and urethral mucosal perception threshold and bulbocavernosus reflex latency measurement. Serum levels of terodiline were estimated at the end of each treatment period and all side effects were reported. The preference for the drug was statistically significant (P less than 0.01): 14 patients preferred the drug, one preferred the placebo and three had no preference. A small but statistically significant reduction was found in 24-h micturition frequency (P less than 0.05). Cystometry showed an increase in volume at first sensation, an increase in volume at detrusor contraction and a tendency towards an increase in bladder capacity, whereas detrusor contraction pressure was unchanged. Median serum levels of the drug were 559 ng/ml (range 203-1117). No serious side effects were reported. It was concluded that terodiline should be considered as an alternative drug in the treatment of motor urge incontinence. PMID- 3516297 TI - The use of split-skin mesh graft in the management of urethral strictures. AB - In the last 3 years 268 patients with urethral strictures have attended this unit. We treat most strictures by urethrotomy and consider an open operation only after two recurrences or in patients whose strictures are considered unsuitable for urethrotomy. Open operations have been performed on 42 patients. Although several types of operation have been used, most comprised an end-to-end anastomosis or Blandy's scrotal flaps. In the last few years a split-skin mesh graft has been used to replace the posterior urethra and the advantage of this technique is that the new urethra is soft and hairless. We present our experience with this method and our overall results. PMID- 3516298 TI - Indications for ultrasound in the evaluation of the pathological scrotum. AB - Scrotal ultrasound scans carried out on 156 patients were reviewed in a retrospective study and the sonographic findings and indications evaluated. Ultrasound was able accurately to distinguish the normal from the pathological scrotum. Extratesticular lesions were readily differentiated from testicular lesions. Abnormal testicular echo patterns were usually associated with tumours, but orchitis, granulomas and haematomas were found to have a similar appearance. Occult testicular tumours could readily be identified. Ultrasound was also useful in excluding underlying pathology in hydroceles, in the diagnosis and follow-up of epididymitis and other epididymal lesions and in the assessment of underlying testicular damage in traumatic haematoceles. Ultrasound may also be useful in post-orchiectomy follow-up examinations to exclude tumour in the contralateral testis. PMID- 3516299 TI - Negative effect of Metoclopramide in postoperative adynamic ileus. A prospective, randomized, double blind study. AB - In a double blind controlled study including 60 patients it was found that Metoclopramide has a negative effect upon the resolution of postoperative adynamic ileus. Metoclopramide causes a delay in the time from operation to the first passage of flatus. PMID- 3516300 TI - Metabolic changes in the non-insulin-dependent diabetic undergoing minor surgery: effect of glucose-insulin-potassium infusion. AB - We have compared the metabolic response to minor surgery in the non-insulin dependent diabetic patient with that in the non-diabetic, using transurethral surgery under general anaesthesia as a model. Preoperative blood glucose and 3 hydroxybutyrate concentrations were higher in the diabetic patients, but the response to surgery did not differ. The postoperative cortisol response was lower in the diabetic patients. Glucose insulin potassium infusion (GIK) resulted in lower plasma nonesterified fatty acid, and blood 3-hydroxybutyrate and glycerol concentrations, with markedly higher serum insulin levels compared to patients managed with a 'no insulin' regimen. Blood glucose however was not significantly different except at 2 h postoperatively. Blood metabolite and serum insulin concentrations in the diabetic patients were closer to those in non-diabetic patients in the group not given insulin, than in those given GIK. Rather than rendering the diabetic patient the same as the non-diabetic, GIK produces a further abnormal state which is probably of little benefit. We conclude that there is no indication for the use of insulin in the well or moderately well controlled non-insulin dependent diabetic patient undergoing minor surgery, provided that glucose containing fluids are not given. PMID- 3516301 TI - Central impairment of renal nerve response to stimulation of medullary pressor area in rabbit endotoxic hypotension. AB - The present study was designed to determine if there is a central abnormality in the sympathetic efferent outflow through the brainstem in endotoxic hypotension. Mean blood pressure (MBP), heart rate (HR) and renal nerve activity (NA) were recorded simultaneously following intravenous injection of endotoxin (1 mg/kg). MBP fell significantly so that 30 min and 60 min after the injection, MBP were 76 +/- 11 mm Hg and 56 +/- 10 mm Hg respectively. Simultaneously with decreases in MBP, NA and HR also decreased significantly. Peak responses in MBP and NA to repetitive stimulation of medullary pressor area (MPA) were attenuated significantly after endotoxin. Onset and peak latencies of renal nerve discharges (RNDe) evoked by the electrical stimulation of the MPA at 5 min after endotoxin were significantly shorter than that before endotoxin, followed by a recovery to the pre-endotoxin level. Peak and total activities of RNDe were reduced significantly so that 30 min after endotoxin activities were 53 +/- 9% and 53 +/- 11% of pre-endotoxin levels respectively. However, responses in MBP, NA and RNDe to the stimulation of the thoracic sympathetic chain did not differ significantly between before and after injection of endotoxin. These data confirm the presence of a central neural abnormality in central sympathetic outflow in the hypotension induced by E. coli endotoxin. PMID- 3516302 TI - Localization and identification of alpha-melanocyte-stimulating hormone (alpha MSH) in the frog brain. AB - The distribution of alpha-melanocyte-stimulating hormone (alpha-MSH) in the central nervous system of the frog Rana ridibunda was determined by immunofluorescence using a highly specific antiserum. alpha-MSH-like containing perikarya were localized in the infundibular region, mainly in the ventral hypothalamic nucleus. A rich plexus of immunoreactive fibers directed towards the ventral telencephalic region was detected. Reverse-phase high-performance liquid chromatography and radioimmunoassay were used to characterize alpha-MSH-like peptides in the frog brain. Chromatographic separation revealed that immunoreactive alpha-MSH coeluted with synthetic des-N alpha-acetyl alpha-MSH, authentic alpha-MSH and their sulfoxide derivatives. The heterogeneity of alpha MSH-like material in the frog brain was in marked contrast with the figure observed in the intermediate lobe of the pituitary gland where only des-N alpha acetyl alpha-MSH is present. These findings support the existence of discrete alpha-MSH immunoreactive neurons in the frog brain containing both desacetyl and authentic alpha-MSH. PMID- 3516303 TI - Vasoactive intestinal polypeptide neurons in fetal cortical homografts to adult rat spinal cord. AB - Transplants of central nervous system to adult spinal cords are considered as potential aids in regeneration of the spinal cord and/or recovery of function after injury. The organization and development of the implant are important issues in seeking the potential for a transplant and host to become functionally integrated. This study uses embryonic cerebral cortex transplanted into the spinal cord of adult rats (T6) and examined the development and organization of the transplant with an antibody to vasoactive intestinal polypeptide (VIP). The cell bodies of VIP neurons are in the implants at 30 days postimplantation, but few of the somata have processes. By 45 days postimplantation, VIP neurons in the implant have dendrites and axons and are clearly recognizable as cortical bipolar cells which are not normally present in the thoracic spinal cord. These data show that neurons in embryonic cerebral cortical implants into the spinal cord elaborate the appropriate biochemical and morphological constituents in spite of the ectopic location. However, the cell processes develop at a slower than normal pace. Morphological interaction between the host spinal cord and the implant can be demonstrated possibly as early as 45 days postimplantation and clearly at 6 months following the implant. Thus, further examination of cerebral cortical implants as a potential aid in alleviation of paraplegia subsequent to spinal cord injury is warranted. PMID- 3516304 TI - Three-dimensional representation and cortical projection topography of the nucleus basalis (Ch4) in the macaque: concurrent demonstration of choline acetyltransferase and retrograde transport with a stabilized tetramethylbenzidine method for horseradish peroxidase. AB - Ninety-six percent of the nucleus basalis neurons that project to the neocortex contain choline acetyltransferase. These projections from the cholinergic component of the nucleus basalis (Ch4) are topographically organized so that each cortical area receives most of its cholinergic input from a different Ch4 sector. The three-dimensional reconstruction of these sectors reveals the presence of a complex structure. A stabilization procedure that was used in these experiments maintains all the advantages of the tetramethylbenzidine method for horseradish peroxidase while eliminating the vulnerability of the reaction-product to high pH and dehydrating agents. PMID- 3516305 TI - Biochemical and radioautographic analysis of estrogen-inducible progestin receptors in female ferret brain and pituitary: correlations with effects of progesterone on sexual behavior and gonadotropin-releasing hormone-stimulated secretion of luteinizing hormone. AB - Cytosolic binding molecules for the synthetic progestin [3H]R5020, were isolated in vitro from several brain regions including preoptic area/anterior hypothalamus, mediobasal hypothalamus, medial amygdala and parietal cortex as well as the pituitary gland of ovohysterectomized female ferrets. Binding of [3H]R5020 to cortical cytosols was saturable, of high affinity (apparent dissociation constant of 2.0 nM), and was steroid specific. Pretreatment of ferrets with a Silastic capsule containing estradiol caused significant increments in the concentration of cytosolic R5020 binding sites in hypothalamus and pituitary gland, but not in the other brain regions studied. Brains of additional ovohysterectomized ferrets, which had been primed with estradiol prior to receiving an i.v. injection of [3H]R5020, were processed radioautographically. Intense labeling of cells was seen in the medial and lateral preoptic area, in the lateral hypothalamus, and in the ventromedial and arcuate nuclei of the hypothalamus. Radioautograms from the brains of additional ovohysterectomized ferrets given an i.v. injection of [3H]estradiol revealed labeled cells in all of the above regions, in addition to the basolateral portion of the septum, the bed nucleus of the stria terminalis, and in the anterior amygdaloid area as well as the medial and cortical nuclei of the amygdala. This distribution of neural progestin and estrogen binding sites resembles those previously reported for these steroids in the rat, guinea pig, hamster and macaque. Functional studies showed that acute s.c. implantation of a Silastic capsule containing progesterone to ovohysterectomized ferrets, which had been primed with a low dosage of estradiol, failed to augment their sexual receptivity in limited tests with stimulus males given 4 and 8 h after progesterone treatment. This result contrasts with the well-established facilitatory effect of progesterone on sexual receptivity in rat and guinea pig. Chronic exposure to a progesterone capsule caused significant reductions in sexual receptivity in ovohysterectomized ferrets which were implanted concurrently with a second Silastic capsule containing a high dosage of estradiol. Similar effects of progesterone have been reported in rat and guinea pig, but not in the rhesus monkey. Thus species differences in the ability of progesterone to facilitate or inhibit sexual receptivity are not readily explained by species differences in the neural distribution of estrogen induced progestin receptors.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3516306 TI - Muscarinic cholinergic receptors mediate the cerebrovasodilation elicited by stimulation of the cerebellar fastigial nucleus in rat. AB - We have investigated the effects of systemic administration of atropine sulfate on the global cerebrovascular vasodilation elicited by electrical stimulation of the cerebellar fastigial nucleus (FN) in chloralose-anesthetized rat. Atropine (0.3 mg/kg, i.v.) abolished the cerebrovasodilation elicited from FN but did not affect the concomitant elevation in arterial pressure and the EEG changes. We conclude that the cerebrovascular effect of FN stimulation, but not the peripheral cardiovascular or EEG changes, are mediated by cholinergic muscarinic receptors associated with cerebral vessels and/or intrinsic neural pathways. PMID- 3516307 TI - Direct projections from the parvocellular part of the posteromedial ventral nucleus of the thalamus to the infralimbic cortex in the cat. AB - It was shown in the cat by the anterograde and retrograde WGA-HRP method that the medial portion of the parvocellular part of the posteromedial ventral nucleus of the thalamus sent fibers ipsilaterally to the caudoventral part of the infralimbic cortex on the medial surface of the frontal lobe, as well as the orbital cortical regions and the rostrodorsal part of the lateral amygdaloid nucleus. PMID- 3516308 TI - Histaminergic projections from the premammillary and posterior hypothalamic region to the caudate-putamen complex in the rat. AB - Immunofluorescence, using antibodies to histamine and to histidine decarboxylase, was combined with retrograde axonal tracing by injecting Granular Blue into the caudate-putamen complex. Evidence is presented for the existence of histaminergic as well as non-histaminergic projections from the posterior hypothalamus and the premammillary region to the caudate-putamen complex. The majority of the histaminergic neurons projecting to this brain region are localized in the nuclei caudalis magnocellularis and caudalis magnocellularis postmammillaris. Roughly 20 25% of the histaminergic neurons in these cell groups innervate the caudate putamen complex. PMID- 3516309 TI - Formation of cholinergic synapses by intrahippocampal septal grafts as revealed by choline acetyltransferase immunocytochemistry. AB - The ultrastructural features of the contacts established by intrahippocampal grafts of foetal septal/diagonal band neurones in the dentate gyrus and the CA1 region of the previously denervated host hippocampus have been analysed with electron microscopic immunocytochemistry using a monoclonal antibody to choline acetyltransferase (ChAT). The results show that the grafted ChAT-positive neurones are capable of forming extensive synaptic contacts with neuronal targets in areas of the dentate gyrus and CA1 which normally receive such innervation. While all types of contacts normally found in association with the granule and pyramidal cell layers were also present in the graft-reinnervated specimens, the quantitative relationship between somatic and dendritic synapses was abnormal. Thus, the ChAT-immunoreactive synapses on cell bodies, which amounted to only a few percent in the normal animal, constituted over 60% in the grafted animals. Conversely, synapses on dendrites which constituted over 90% in the normal dentate were reduced to less than 40% in the grafted animals. The postsynaptic targets of the graft-derived cholinergic synapses included dendrites and cell bodies of dentate granule cells and CA1 pyramidal cells. This supports previous electrophysiological studies and indicates that the septal grafts may be able to modulate host hippocampal function via direct efferent connections onto the granule and pyramidal neurons in the host hippocampal formation. PMID- 3516310 TI - Immunocytochemical localization of serotonin in the rat dentate gyrus following raphe transplants. AB - The ultrastructural features of the serotoninergic innervation of the rat dentate gyrus in normal adults and in animals receiving raphe nuclear area transplants was investigated using an antibody to serotonin (5-HT). Neonatal rats received a lesion of the fimbria-fornix and entorhinal cortex. Three days later, a portion of embryonic (E-16-18) raphe nuclear area was transplanted to the entorhinal cavity and the animals were allowed to survive for 60 days. Animals were processed for the immunocytochemical localization of 5-HT using the peroxidase antiperoxidase method. Light microscopic observation showed that 5-HT-containing fibers from transplanted raphe neurons densely innervated the hilar and molecular zones of the dentate gyrus. Electron microscopic analysis showed that 5-HT immunoreactivity was contained only in axons and axon varicosities. There were no differences in the ultrastructural characteristics of axons and axon terminals between normal animals and those which had received raphe transplants. A mixture of both conventional synaptic junctions and non-synaptic axonal swellings were found in both groups. PMID- 3516311 TI - N-methylaspartate: an effective tool for lesioning basal forebrain cholinergic neurons of the rat. AB - The ability of the excitotoxin, N-methyl-D,L-aspartic acid (NMA), to destroy basal forebrain cholinergic (BFC) neurons was evaluated. NMA (100 nmol) was directly injected into the peripallidum, a region containing a proportionately large number of cortically-projecting BFC neurons. Cholineacetyltransferase (ChAT) activity 10 days later was markedly and significantly reduced (up to 62%) in the cortex ipsilateral to the lesion. NMA induced a focal lesion affecting BFC neurons without damaging axons of passage or causing lesions distant from the site of injection. ChAT immunohistochemistry (IHC) was used to directly demonstrate loss of ChAT-positive neurons from the lesion site. This loss persisted at all survival times examined, from 2 days to 7.5 months post injection. PMID- 3516312 TI - Effects of monosodium L-glutamate administration on neuropeptide Y-containing neurons in the rat hypothalamus. AB - Immunocytochemical localization of neuropeptide Y (NPY) was performed in the hypothalamus of rats of which the arcuate nucleus had been destroyed with monosodium L-glutamate in the neonatal period. The treatment produced a disappearance of most of the NPY cell bodies normally found in the arcuate nucleus. The concentration of fibers was decreased in the paraventricular nucleus, but not in the other hypothalamic nuclei. The treatment also induced the appearance of a large number of immunoreactive cell bodies in the paraventricular nucleus. These results strongly suggest that arcuate NPY neurons are projecting to the paraventricular nucleus and that the arcuate nucleus probably exerts some inhibitory tonic influence on NPY paraventricular neurons. PMID- 3516313 TI - Non-phosphorylated and phosphorylated neurofilaments in the cerebellum of the rat: an immunocytochemical study using monoclonal antibodies. Development in normal and thyroid-deficient animals. AB - The immunocytochemical staining patterns of two monoclonal antibodies specifically directed against non-phosphorylated and phosphorylated neurofilaments were studied during development of cerebellum in normal and thyroid-deficient rats. In normal animals, non-phosphorylated neurofilaments first appeared in Purkinje cell cytoplasm, then in dendritic tree and axon. They were also observed in basket cell axons running in the lower parts of the molecular layer and thereafter around the initial segment of Purkinje cell axons. Thyroid deficiency markedly retarded the appearance of these non-phosphorylated neurofilaments in Purkinje cells. More strikingly, the labelling in basket cell axons never appeared. In normal animals, phosphorylated neurofilaments were localized only in axons. They were first restricted to Purkinje cell axons and then appeared in basket cell axons. In thyroid-deficient rats, a transient weak labelling was observed in the cytoplasm of the Purkinje cells. Moreover, the characteristic arrangement of basket cell axons around the Purkinje cell body and proximal axon was never observed. Hypothyroidism thus retards the appearance of neurofilaments in Purkinje and basket cells and transiently disturbs their phosphorylation state. It also disorganized the basket cell morphogenesis and consequently the major inhibitory pathway of the cerebellar cortex. This last effect is only poorly corrected when the animals are allowed to return to an euthyroid state after one month of postnatal antithyroid treatment. PMID- 3516314 TI - Influence of thyroid hormones on rat cerebellar cell aggregation and survival in culture. AB - In order to study the effect of thyroid hormones on rat cerebellar granule cells, cerebellar perikarya isolated from 5-7-day-old rats were cultured in the presence of normal fetal calf serum, fetal calf serum treated with Dowex-2 ion exchange resin to remove thyroid hormones, or ion exchange-treated serum resupplemented with physiological concentrations of T4 and T3. Granule cells grown under hypothyroid conditions showed abnormal cellular aggregation, neurite fasciculation and cell survival. Cell aggregation, which may be an in vitro correlate of cerebellar granule cell migration to the internal granule layer, was reduced by over 50% under hypothyroid conditions. The rate of protein synthesis in hypothyroid cultures was stimulated by as much as 3-fold compared to thyroid hormone-containing cultures consistent with a proposal that the normal developmental pattern of diminishing protein synthesis specific activity is delayed or prevented under hypothyroid conditions. In addition ultrastructural studies revealed abnormalities in the density of cold-stable microtubules in thyroid hormone-deficient cultures. These results demonstrate that thyroid hormones can influence granule neuron behavior in the absence of Purkinje cells. Furthermore, the observed defects bear numerous similarities to documented abnormalities within the hypothyroid cerebellum, suggesting that this in vitro culture system may serve as a useful model for studying the mechanism of action of thyroid hormones on the cells of the cerebellum. PMID- 3516315 TI - Cerebral perivascular serotonergic fibres have a peripheral origin in the gerbil. AB - The origin of serotonergic nerves supplying the large cerebral vessels of the gerbil has been investigated after bilateral superior cervical ganglionectomy. Immunohistochemical techniques were applied to whole-mount stretch preparations of the cerebral vessels. Removal of both ganglia resulted in the complete loss of immunoreactive fibres in the vessels supplied by the internal carotid artery and in a marked reduction of fibres innervating vessels of the vertebro-basilar system, indicating that most of the cerebrovascular serotonergic nerves have a peripheral sympathetic origin in the gerbil. The contrast with the central origin of serotonergic perivascular nerves claimed in the rat is discussed. PMID- 3516317 TI - Developing socio-dental indicators--the social impact of dental disease. PMID- 3516316 TI - Dental needs of the elderly: a comparison between some European and North American surveys. PMID- 3516318 TI - Diagnostic ultrasound. PMID- 3516319 TI - Diseases of the liver. AB - The ability to image the liver in horses can add valuable diagnostic information or aid in guided biopsy procedures. Anytime the size, shape, position, and texture of the liver can be determined, additional information about the horse's condition is gained. Conditions such as cholelithiasis, neoplasia, fibrosis can be detected ultrasonographically. PMID- 3516320 TI - Ultrasound-guided renal and hepatic biopsy techniques. AB - Diagnostic ultrasound is an easy, accurate method of locating both kidneys and liver in the horse. Good contact between the transducer and body wall is essential for clear, precise images. The greatest limitation to ultrasonic organ localization and biopsy guidance is the inability of ultrasound to transmit through gas-filled structures and bone. These structures act as barriers to sound beam penetration and prevent visualization of soft-tissue structures deep to them. Organ parenchyma can be evaluated with ultrasonography. Focal and/or diffuse lesions can alter the normal parenchymal pattern and result in an increased or decreased echogenicity of the diseased area. Under ultrasound guidance, the biopsy instrument can be directed into these areas to insure that the sample is representative of the disease process within that organ. Biopsy associated complications can be identified early and monitored until resolution. Equine renal and hepatic biopsies are not innocuous procedures, but ultrasonographic guidance has helped to reduce the risks involved with the biopsy techniques. PMID- 3516321 TI - Ultrasonographic appearance and correlative anatomy of the soft tissues of the distal extremities in the horse. AB - The diagnostician should be familiar with the normal ultrasound appearance (size, shape, position, and textural quality) of each structure examined. With these factors as reference points, one can describe lesions in the structure involved, the precise location and extent of the lesions, and the degree of structural compromise that is manifested. Documentation of lesions of tendons and ligaments enables one to make an accurate diagnosis and a more precise prognosis. Serial examination during the healing phases allows for a more accurate prediction as to when the structure in question can withstand athletic challenge. PMID- 3516322 TI - Diagnostic ultrasonography of equine limbs. AB - In our 3 years of clinical experience, we have found that diagnostic ultrasound provides the veterinarian with a valuable diagnostic tool. It allows the clinician to quantify morphologic change that has occurred as a result of soft tissue injuries, even when the clinical findings are ambiguous or insufficient. In cases in which aggressive postinjury therapy has been instituted prior to presentation, diagnostic ultrasound is often the only noninvasive method that can ascertain the extent of the horse's injury. Diagnostic ultrasound provides the technology to detect injuries before they become permanently debilitating, because lesions as small as 1 mm in diameter can be detected. Prior to diagnostic ultrasound, the severity of many injuries was underestimated. In such cases, if the horse responded favorably to symptomatic therapy, the client would resume training. The result was often debilitation. Diagnostic ultrasound also enables the clinician to demonstrate visually to the client the location, size, and extent of lesions in the limb. One of the more gratifying effects of a sonographic study is the client's acceptance of the presence and extent of the injury after visualizing it. We have found that the old adage "a picture is worth a thousand words" is generally the rule in obtaining the proper course of therapy for the horse. The ability to make hard copies of sonograms enables the clinician to morphologically evaluate the rate of healing. He can accurately determine the effectiveness of a therapeutic regimen and ascertain when optimal healing has occurred. Diagnostic ultrasound can provide the researcher with an invaluable tool to document and quantify soft-tissue disease. We anticipate that, in the future, the sonographic appearance of recovered tissues will be correlated with new data on the healing process and the effectiveness of various therapies. The material presented above has covered the value of diagnostic ultrasound in major clinical situations related to equine lameness. Other applications, the discussion of which is beyond the scope of this article, include evaluation of the pastern for injuries to the SDF, DDF, and oblique sesamoidean ligament, and evaluation of the navicular bursae. Examination of muscles for hematomas, abscessations, and tears has also been accomplished ultrasonographically. Diagnostic ultrasound has facilitated study of the trochanteric and bicipital bursae, blood flow through arteries, and structures above the carpus and hock. Obviously, the clinical potential of diagnostic ultrasound is limitless.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3516323 TI - Diagnostic ultrasound in equine reproduction. AB - This article reviews the type of equipment available, the examination techniques, and the interpretation of information derived from ultrasound in broodmare practice. The application of diagnostic ultrasound has found immediate acceptability and clinical usefulness in the genital evaluations of the broodmare. PMID- 3516324 TI - Uses of ultrasound in equine internal medicine. AB - Ultrasound examination allows the diagnostician to examine peripheral soft tissues and many internal organs in a noninvasive manner. In most instances, ultrasound can be utilized to complement other diagnostic aids, but its increased use has revealed the unique advantages of this technique over more established diagnostic tools. The ease with which ultrasound interpretation can be learned and the increased availability of instruments make this approach to diagnosis a valuable asset in the diagnosis of many equine medical diseases. PMID- 3516325 TI - General considerations for ultrasound examinations. AB - Patient preparation and restraint, instrumentation, and methods of retaining records of ultrasound images are discussed. PMID- 3516326 TI - Ultrasound science for the veterinarian. AB - In order to successfully sort out the information, both real and bogus, in an ultrasonic image, one must have a fundamental understanding of the physical and electronic events that produced the image. We have looked at the basic science, signal processing, some case examples of ultrasound science in practice, and some popular illusions. It is a good starting place for the newcomer to ultrasonic imaging. PMID- 3516327 TI - Diseases of the heart. AB - Diagnostic ultrasound has allowed significant findings to be made in the investigation of cardiac disease in the horse. Because of the limited value of thoracic radiography in the adult horse with cardiac disease, ultrasound is the method of choice to document chamber enlargement, pericardial effusion, valvular abnormalities, and decreased contractility of the myocardium. The apparent changes in the flow characteristics and suspicion of abnormality in the right heart of racehorses need further investigation to fully document the etiopathogenesis of spontaneous contrast. PMID- 3516329 TI - Diseases of the abdomen. AB - Because the abdomen of the adult horse is too thick to obtain good-quality radiographs, diagnostic ultrasound is a particularly valuable imaging modality in the diagnosis of abdominal disease. The size, shape, position, and texture of the liver, spleen, kidneys, urinary bladder, gravid uterus, and gut wall can be determined by scanning the abdominal surface. The presence or absence of abdominal fluid can be determined efficiently. Gut motility as well as ileus secondary to peritonitis or obstruction can be assessed. Suspected adhesions of the bowel can often be documented, and primary or secondary neoplastic processes can be identified and biopsied. PMID- 3516328 TI - Diseases of the thorax. AB - Diagnostic ultrasound is an important adjunct to existing methods in the diagnosis of thoracic disease in the horse. This article discusses scanning techniques, anatomy of the thoracic cavity, and how diagnosis of pleural effusion, pulmonary abscessation, pneumothorax, and vegetative endocarditis may be facilitated by ultrasound. PMID- 3516330 TI - Diseases of the kidneys. AB - Ultrasound examination offers important diagnostic and prognostic information in renal disease of the horse. Differentiation between acute nephrosis and chronic renal disease can usually be made because of the advanced degree of morphologic change usually prevalent in chronic conditions. Dilatations of the recesses and pelvis (hydronephrosis) as well as the relative thickness of the renal cortex and medulla are readily determined. Mineral densities (calculi) are recognizable by their characteristic acoustic shadowing. PMID- 3516331 TI - Absolute edentulous impressions. PMID- 3516332 TI - Provisional ADA acceptance puts Occlusin on the road to success. PMID- 3516333 TI - AIDS and the safety and adequacy of the Canadian blood supply. PMID- 3516334 TI - Does PEEP reduce the incidence of aspiration around endotracheal tubes? AB - Despite improved endotracheal tube designs, aspiration remains a cause of pulmonary complications. This in vitro study evaluates the efficacy of positive end-expiratory pressure (PEEP) in reducing the incidence of seepage around endotracheal tubes during mechanical (MV) and spontaneous ventilation (SV). Two transparent plastic "tracheas" with cuffed and uncuffed endotracheal tubes simulated adult and paediatric airways respectively. Ten trials without PEEP and ten with PEEP at each of two different levels were completed for each model using both SV and MV. Simulated SV in both models was associated with seepage nearly 100 per cent of the time, regardless of PEEP level. During MV without PEEP, seepage occurred in 55 per cent of the adult trials and 100 per cent of the paediatric trials. In contrast, MV with 5 cmH2O PEEP produced seepage rates of 15 per cent in the adult model and 0 per cent in the paediatric model. Compared to trials without PEEP, seepage occurred less frequently, was reduced in amount and delayed in onset. MV with PEEP significantly (p less than 0.05) decreased the incidence of seepage around endotracheal tubes. PMID- 3516337 TI - Posts in molars. Must we? PMID- 3516338 TI - Tupilaks, scrimshaw and netsukes. PMID- 3516339 TI - International trends in oral health. PMID- 3516336 TI - Update on obstetrical anaesthesia. PMID- 3516335 TI - Intraocular pressure--physiology and implications for anaesthetic management. AB - The major factors controlling intraocular pressure during surgery are the dynamic balance between aqueous humour production in the ciliary body and its elimination via the canal of Schlemm; the auto-regulation and chemical control of choridal blood volume; the extraocular muscle tone and vitreous humour volume. Prior to surgical incision of the anterior chamber in open intraocular procedures, a low normal intraocular pressure is mandatory to avoid the hazards of iris or lens prolapse and vitreous loss associated with sudden decompression. In general, the central nervous system depressant drugs, hypnotics, narcotics, major tranquillizers, volatile anaesthetic agents are associated with a reduction in intraocular pressure, with the exception of ketamine and possibly trichloroethylene. The mechanism of action of anaesthetic agents in reducing intraocular pressure may involve a direct effect on central diencephalic control centres, reduction of aqueous production, facilitation of aqueous drainage or relaxation of extraocular muscle tone. Succinylcholine administration is associated with a significant rise in intraocular pressure, with a peak increase between two to four minutes following administration and a return to base line values after six minutes. The intraocular hypertensive effect may be due to a tonic contraction of the extraocular muscles, choroidal vascular dilatation or relaxation of orbital smooth muscle. Despite many claims to the contrary, no reported method to date has been shown to consistently prevent the intraocular hypertensive response to intravenous succinylcholine administration. Because the non-depolarizing relaxants are associated with a reduced intraocular pressure, a barbiturate-non-depolarizing relaxant technique utilizing preoxygenation and cricoid pressure has evolved as the most commonly employed induction technique for the emergency repair of a penetrating eye injury. The alternative non depolarizing relaxant pretreatment-barbiturate-succinylcholine technique may offer the advantages of more rapid onset of relaxation with only minor increases in intraocular pressure and in a carefully controlled rapid sequence induction technique may be the most acceptable method of handling emergency penetrating eye injuries. PMID- 3516340 TI - Medical licensure. An historical and theoretical perspective. PMID- 3516341 TI - The legal profession. An historical view of the developments. Re: Licensure. PMID- 3516342 TI - The dental profession. A historical review of developments. Re: Licensure and review of current arrangements for testing and licensure. PMID- 3516343 TI - Prelicensure. Its impact on research. PMID- 3516344 TI - Effects of prelicensure on students and their teaching. PMID- 3516345 TI - The decline of dental caries in Ontario school children. PMID- 3516346 TI - Quality control mechanisms in dental insurance schemes in Ontario. PMID- 3516347 TI - Effects of strontium on calcium-dependent hexose transport in muscle. AB - Hexose transport in isolated perifused rat and guinea pig left atria and in isolated intact rat hemidiaphragms was followed by measuring the tissue/medium distribution of the nonmetabolized glucose analog, 3-O-methyl-D-glucose. Stimulation of 3-methylglucose transport by insulin, hyperosmolar medium, K+-free medium, and ouabain was depressed or absent in Ca2+-free medium. Addition of 2 mM Sr2+ to Ca2+-free media restored the response of transport to the stimulatory factors. Sr2+ also increased basal hexose transport. The Ca2+ dependence and the effect of Sr2 was greatest in guinea pig atria and least in rat hemidiaphragms. It is concluded that Sr2+ plays a Ca2+-like role in the regulation of hexose transport. PMID- 3516348 TI - Effects of insulin perfusion and altered glucose concentrations on heart function in 3-day and 6-week diabetic rats. AB - Diabetes is known to result in depression of myocardial function, whereas hearts from insulin-treated diabetic rats exhibit functional characteristics similar to controls. In the present study, we have studied the effect of insulin perfusion on cardiac performance of 3-day and 6-week streptozotocin (STZ) diabetic rats. Three days of diabetes did not result in depressed cardiac performance when the hearts were isolated and perfused in the working heart mode. Increasing the concentration of glucose from 5 to 10 mM in the perfusion fluid did not alter the function in either control or in diabetic rat hearts. However, when regular insulin or glucagon-free insulin (Humulin) (5 mU/mL) was included in the perfusion medium, the ventricular function of hearts from control rats was significantly enhanced, while diabetic myocardial function remained unaffected. When the study was repeated on hearts from 6-week diabetic animals, cardiac function of diabetic rats was significantly depressed as compared with controls. As in the 3-day study, contractility was not affected in either group by increasing glucose concentration in the perfusion medium. Again, inclusion of insulin in the medium enhanced cardiac contractility only in control hearts. These results suggest that diabetes results in a loss of myocardial sensitivity to insulin which seems to occur as early as 3 days after induction of diabetes with STZ. The study also demonstrates that the beneficial effects of in vivo insulin treatment on myocardial alterations induced by diabetes are not due to its direct myocardial effects. PMID- 3516350 TI - Site specificity of metallic ion binding in Escherichia coli K-12 lipopolysaccharide. AB - The site specificity of metallic ion binding in Escherichia coli K-12 lipopolysaccharide was assessed by collecting high-resolution phosphorus nuclear magnetic resonance spectra in the presence of manganese, a paramagnetic divalent cation. This technique revealed high-affinity interactions between the cation and all of the lipopolysaccharide phosphoryl groups. To ascertain whether the carboxyl groups of 2-keto-3-deoxyoctonate contributed to the metal cation binding, lipopolysaccharide was chemically modified using a glycine ethyl ester - carbodiimide reaction. Of the three available carboxyl groups, only one was neutralized by the exogenously added ligand; the others appeared to be cross linked within the molecule. By analogy, only one carboxyl group should be freely available for binding metallic ions, while the others are probably neutralized by the close proximity of endogenous amino substituents. Although high-resolution phosphorus nuclear magnetic resonance showed that an intermolecular conformational change had occurred after the carboxyl groups were neutralized, titration with manganese revealed no differences in the apparent strength of the interactions between the cation and the phosphoryl groups. Together, these data suggest that the high affinity of lipopolysaccharide for divalent metallic ions can be attributed primarily to the phosphoryl substituents and not free carboxyl groups. PMID- 3516349 TI - Increased phenylalanine incorporation in regenerating skeletal muscle grafts. AB - Skeletal muscle regenerates following grafting, but little is known about protein synthesis and its regulation during regeneration. We determined the sequence of changes in protein synthesis in rat extensor digitorum longus (EDL) muscle by the measurement of phenylalanine (Phe) incorporation into muscle protein at various times after grafting. Compared with control EDL, Phe incorporation in grafts doubled in 1 day, was four- to eight-fold greater from days 2 to 10 after grafting, and then subsided. Tissue mass (wet weight) increased rapidly from days 7 to 20 in EDL grafts. The maximal increase in protein synthesis occurred 7-10 days after grafting, whether or not the nerve was left intact. Autoradiography indicated that incorporated radioactivity was associated with regenerating muscle fibers on day 10. Deficiencies of insulin, pituitary or testicular hormones, or chronic in vivo administration of insulin, growth hormone, testosterone, or tri iodothyronine did not substantially alter the elevation in incorporation of the Phe into muscle protein 10 days after grafting. The breakdown of EDL protein, measured in vitro simultaneously with protein synthesis, was increased five-fold, and overall protein degradation was elevated six-fold 10 days after grafting. These findings indicate that Phe incorporation is rapidly elevated following grafting of the EDL, and that by days 7-10 reflects synthesis in regenerating muscle fibers. The increase in protein synthesis associated with muscle regeneration at this time appears to be independent of innervation and anabolic hormones. PMID- 3516351 TI - [Transfer of the cecal flora of the hamster to the germfree C3H mouse: use of this model to study the flora of the anti-Clostridium difficile barrier]. AB - The purpose of this work was the research and development of an experimental model to study anti-Clostridium difficile caecal microflora in the hamster. First the existence of this "barrier" was verified in conventional hamsters. Then, the caecal flora from these animals was orally transferred to C3H germfree mice. The barrier effect was maintained in the axenic mice. The comparative bacteriological analysis of hamster and mouse feces did not reveal important variations in the dominant anaerobic flora (P less than 0.01). After treatment with erythromycin, the barrier effect was maintained and while the disappearance of Escherichia coli was observed, the dominant anaerobic flora persisted. After dilution (10(-2] and subsequent heating (70 degrees C, 10 min) of caecal contents, the inhibitory activity against C. difficile was maintained although the number of aerobic and aerotolerant bacteria was reduced. The isolation from caecal microflora of anaerobic strains implicated in the resistance to colonization is presently underway in Freter anaerobic chambers. PMID- 3516352 TI - Stabilization and purification of the secondary metabolism specific enzyme, m hydroxybenzylalcohol dehydrogenase. AB - m-Hydroxybenzylalcohol dehydrogenase (EC 1.1.1.97), a secondary metabolism associated protein from stationary phase cultures of Penicillium urticae, was stabilized in crude extracts prior to purification. Stabilization studies resulted in the formulation of an optimal cell breakage and purification buffer. This buffer increased the enzyme's in vitro half-life at 30 degrees C from 14 to over 800 min which greatly aided purification and enhanced yields. Purification was achieved by salt fractionation, size-exclusion chromatography, affinity chromatography, and ion-exchange chromatography. The 1200-fold purified protein gave only one major band by sodium dodecyl sulphate - polyacrylamide gel electrophoresis. PMID- 3516353 TI - The fatty acid composition of the conidia and mycelia of the fungus Aspergillus nidulans. AB - The total fatty acids were characterized from conidia, exponential phase, and stationary phase Aspergillus nidulans. Several quantitative and qualitative variations were observed. Most notable was the approximately 15-fold increase in linolenate observed during the 1st day of incubation and its subsequent total disappearance by day 4. PMID- 3516354 TI - J. Douglas Galbraith fights TB among Indians and Inuit. PMID- 3516355 TI - Metabolic syndromes with dermatologic manifestations. PMID- 3516356 TI - The role of "allergy" in atopic dermatitis. AB - Atopic dermatitis is a disorder that affects up to 4.3% of the pediatric population. Its etiology is unknown, but is probably multifactorial. Evidence has been presented to implicate a role for "allergy" in the pathogenesis of AD. Disregarding the myriad of clinical reports, there is sufficient data in the literature to suggest an etiologic role for inhalants (pollen, mold, and dust mite) and foods in some patients with AD. Definitive studies have demonstrated that both inhalant and food antigens can be absorbed rapidly and transported to the skin, where sensitized mast cells can be activated. Controlled challenges have demonstrated skin reactions following exposure to inhalant and food antigens in sensitive subjects. Activiation of mast cells and/or basophils has been shown following oral food challenges in sensitized children with AD. Although sufficient evidence is now available to implicate "allergy" as an etiologic factor in atopic dermatitis, the link between mast cell activation and the development of eczematous skin changes remains to be clearly defined. PMID- 3516357 TI - Natural history and clinical manifestations of atopic dermatitis. PMID- 3516358 TI - Drug allergy: an overview. PMID- 3516359 TI - Penicillin allergy. PMID- 3516360 TI - Chymopapain induced allergic reactions. PMID- 3516361 TI - Anaphylactic and anaphylactoid reactions due to anesthetic agents. PMID- 3516362 TI - The aging lung. AB - Structural changes occur in the respiratory system with advancing age. Lung elasticity decreases, stiffness of the chest wall increases, and respiratory muscle strength declines. These alterations contribute to gradual, but progressive, reductions in forced vital capacity, expiratory flow rates, diffusing capacity, gas exchange, ventilatory drive, and respiratory sensation. Cigarette smoking accelerates the age-related decline in flow rates. Understanding the effects of aging on the lung is important in order to distinguish pathologic changes from changes that are part of the normal aging process. PMID- 3516363 TI - Ventilatory control during sleep in the elderly. AB - This review has briefly discussed the normal control of respiration during sleep with aging. Although we still do not have a complete understanding of ventilatory control during sleep in the elderly, it is clear that disorders of ventilation during sleep are clinically important in older overweight individuals. The identification of risk factors in this group will lead to an increased awareness and diagnosis of these disorders and therefore result in the development of rational approaches to the management of these individuals. PMID- 3516364 TI - Pneumonia in the elderly. AB - Pneumonia from bacterial and viral agents is the fourth leading cause of death in persons over age 65, accounting for 169.7 deaths per 100,000 persons per year. This high incidence of infection is the result of aging itself as well as age related coexisting illnesses and their therapies. These factors combine to affect upper and lower respiratory tract host defenses adversely against invading pathogens. Gram-negative colonization of the oropharynx, followed by the spread of bacteria to the tracheobronchial tree, commonly precedes the development of pneumonia. Bacterial adherence is one important and modifiable pathogenetic factor that leads to colonization at both of these sites. Diagnosis of pneumonia in the elderly is often thwarted by difficulties in recognizing infection, as signs and symptoms differ from those observed in younger patients. Therapy is confounded by the frequent inability to obtain adequate culture material to establish a likely pathogen and by altered drug metabolism. In this instance epidemiologic data may be helpful in guiding therapy. Streptococcus pneumoniae is the most common pathogen in community patients, followed by Legionella pneumophila and enteric gram-negative bacilli. Hospitalized and institutionalized individuals are commonly infected with Klebsiella pneumoniae and other enteric gram-negative bacilli, and Legionella pneumophila and Streptococcus pneumoniae are also found. Because recognition of pneumonia may be difficult and therapy is fraught with problems, mortality is high in the elderly. Accordingly, serious attention must be paid to prevention. Prophylaxis includes the use of pneumococcal and influenza vaccines as well as careful attention to the patient's host defense status. Disease states leading to impairment of the immune system should be sought, and efforts should be made to improve host factors that assist the individual in removing invading pathogens. PMID- 3516365 TI - Wheezing in the elderly. Asthma and other causes. AB - The evaluation and treatment of patients who complain of wheezing take on special significance in the elderly. Although asthma may begin late in life, it is distinctly uncommon. When it does, it is clinically undistinguishable from asthma present at an earlier age. If severe, the disease may require treatment with corticosteroids as well as bronchodilators. Any side effects are particularly troublesome in the elderly, and careful patient monitoring is essential. Wheezing in the elderly may also signal the onset of other diseases such as chronic obstructive pulmonary disease, congestive heart failure, pulmonary aspiration, pulmonary embolism, and bronchogenic carcinoma. Consideration of these causes of wheezing will lead to appropriate diagnostic studies and specific therapy. PMID- 3516366 TI - Chronic obstructive pulmonary disease. AB - Morbidity and mortality associated with chronic airway disease are expected to continue to rise over the coming years. Accordingly, increased attention will need to be directed toward the diagnosis and treatment of COPD in the elderly population. Cessation of cigarette smoking should be pursued in all patients regardless of age. The goals of bronchodilator therapy are to reduce respiratory symptoms and to improve functional capacity without causing adverse effects. In addition, supplemental oxygen, phlebotomy for polycythemia, general exercise training, and specific respiratory muscle training may further augment exercise tolerance. Complications of COPD, such as upper respiratory infections and right heart failure, should be recognized early and treated appropriately. Implementation of a pulmonary rehabilitation program, as discussed in the next article, should complement medical therapy in the treatment of elderly patients with COPD. PMID- 3516367 TI - Pulmonary rehabilitation for the elderly. AB - The elements of a pulmonary rehabilitation program require a variety of different skills. However, the number of people involved in a rehabilitation program will vary with the clinical setting and the number of patients served. In a large program, a physician, respiratory nurse, physical and occupational therapist, psychologist, social worker, respiratory therapist, and dietitian might all be involved on a full- or part-time basis. In other settings, two or three individuals, mostly working part-time, may be the entire team. Pulmonary rehabilitation may be performed on an outpatient basis, in a group practice setting, or in an inpatient hospital unit. Whatever its size, a system must be developed that allows for thorough initial evaluation of patients, formation of rational goals with the patient, adequate time for patient education and training, ongoing re-enforcement to consolidate and maintain gains, and an appropriate means of intervention when the patient experiences an exacerbation of his disease. It should also be recognized that in many areas of the country, there are too few patients and scarce medical resources to mount an intensive pulmonary rehabilitation program. In such instances, referral can be made to larger medical centers. More importantly, the individual practitioner can successfully incorporate many of the elements of pulmonary rehabilitation into his practice by taking the time and effort necessary to ascertain how illness affects the daily lives of the patient with COPD and then addressing patient concerns in an ongoing, comprehensive manner. PMID- 3516368 TI - Cigarette smoking. Health effects and cessation strategies. AB - During the last 15 years substantial advances in the fields of analytical chemistry, behavioral pharmacology, neurologic sciences, and the behavioral sciences have produced new understanding and insight into why people smoke and how they can stop. These fundamental research efforts have now produced treatment strategies that have objectively documented success rates and that the physician can now implement in his office. Impressive as current results can be, when the physician is willing to spend appropriate and necessary time, effort, and energy, current research indicates that our basic neurochemical understanding of cigarette smoking should improve substantially and lead to even more effective treatment interventions in the next 10 years. PMID- 3516369 TI - Lung cancer in the elderly. AB - Lung cancer is the most common malignancy in the elderly population and was responsible for greater than 125,000 deaths in 1985. Although advances have been made in the areas of diagnosis and staging, the long-term outlook for the disease remains poor, primarily because of dissemination of disease prior to diagnosis. Despite this, several studies suggest that lung cancer in the elderly is a more indolent disease process, which should be treated in the same manner as it is in the young population. PMID- 3516370 TI - Interstitial lung diseases in the elderly patient. AB - In this article we have attempted to review basic aspects of the respiratory immune system and some of what is known about the effects of aging on immunity. We have discussed the more common forms of interstitial lung disease as they relate to the elderly patient and have outlined a general method of approaching interstitial disease in this population. This topic is the focus of considerable ongoing research, and a wealth of information is available for the clinician who desires to delve more deeply into the subject. It is our hope that this article will serve as a background to facilitate further study by those with a particular interest in this area. PMID- 3516371 TI - Pulmonary edema. AB - The lungs are marvelously designed to handle fluid. The mechanical properties of the lungs and the lymphatics act simply and efficiently to drain fluid out of the pulmonary interstitium. Despite the enormous blood flow through the pulmonary and bronchial circulation, a dynamic equilibrium is maintained between fluid fluxing out of the vasculature into the pulmonary interstitium and fluid being drained out of the lungs by the lymphatics. This is obviously important because maintaining "dry" air spaces is essential for normal pulmonary function. Fluid accumulates in the lung when flux across the vascular endothelium exceeds lymphatic drainage. Two different types of abnormalities will result in accumulation of fluid, an increase in pulmonary microvascular pressure and an increase in the pulmonary vascular endothelial permeability to protein. Regardless of the type of abnormality causing pulmonary edema, fluid tends to accumulate in the lungs in a predictable pattern based on the same mechanical properties that normally keep the lung dry. Only by understanding the normal process of fluid handling will the clinician truly appreciate the consequences of pulmonary edema. PMID- 3516372 TI - Aging and exercise performance. AB - Diverse physiologic changes occur in the oxygen transport system during the aging process. Physical performance and VO2max decline with age, but the changes may be attenuated by exercise training. Increased ventilation is required during exercise in order to compensate for reduced efficiency of gas exchange. Cardiovascular alterations include prolonged duration of myocardial contraction, a slightly reduced left ventricular ejection fraction during exercise, decreased heart rate during both submaximal and maximal exercise, and attenuation of myocardial response to beta-adrenergic stimulation. Cardiac output during exercise can be maintained in the elderly owing to a greater dependence on ventricular filling. Appropriate exercise training leads to enhanced efficiency of the lungs, heart, and skeletal muscles. These physiologic benefits contribute to an increase in functional capacity and an enhanced sense of well-being. Exercise testing is recommended for individuals who have cardiorespiratory symptoms and for those at risk for the development of coronary artery disease. Reasonable goals for an aerobic training program are continuous activity for 30 minutes at a moderate intensity of exertion at least 3 days per week. The intensity of exercise should be based on a prescribed training heart rate. The exercise prescription should be individualized and should incorporate one or more activities for optimal enjoyment and compliance. Opportunities and facilities for indoor exercise are important during inclement weather. Regular physical exercise is important at any age! PMID- 3516373 TI - On transference: developmental and clinical considerations. AB - Following a short historical overview of the evolution of the concept of transference, the factors involved in this process are examined. The developmental or dynamic aspects of transference, that is, its illusory character defined by the "potential space" within which transference develops, and the importance of the holding environment at the early stages of therapy for an optimal development of transference are discussed. To understand resistances, Merton Gill's distinction of resistances to the awareness of the transference, and resistances to the resolution of the transference are particularly relevant. Finally, the concept of transference neurosis is focused upon. Detailed clinical vignettes are given to illustrate the points made. Although the clinical material is taken from sessions of patients in analysis the theoretical implications pertaining to the transference are equally applicable to the practice of psychoanalytic psychotherapy. It is in this spirit that throughout the paper the terms "therapeutic" and "analytic" are used interchangeably. PMID- 3516374 TI - Family therapy and schizophrenia: recent developments. AB - A review of recent studies of family interaction as a causal factor in the development of schizophrenia suggests a paucity of evidence supporting this point of view. However, research has suggested family variables may influence the course and outcome of schizophrenia. The impact of schizophrenia on the family has recently received more attention. Some research has identified differences between families of schizophrenics and the families of other diagnostic groups and controls. Whether these studies are beginning to influence the theory and practice of family therapy is discussed. Recent studies suggest the combination of long-acting medication and 'psychosocial' interventions may reduce the relapse rate of schizophrenia in the short term. This research suggests that family therapists must re-evaluate their role in the management of schizophrenia. PMID- 3516375 TI - Immunohistologic identification of phenotypic antigens associated with Hodgkin and Reed-Sternberg cells. A paraffin section study. AB - A combination of two monoclonal antibodies, designated LN-1 and LN-2, were used in an attempt to identify the corresponding antigens in Hodgkin and Reed Sternberg cells. The LN-1 antibody has been shown in previous studies in our laboratories to identify follicular center cells, whereas LN-2 marks certain B cell subpopulations as well as interfollicular histiocytes. Utilizing the peroxidase-antiperoxidase (PAP) technique, paraffin-embedded sections were examined representing 39 cases of various histologic subgroups of Hodgkin's lymphoma following immunostaining with LN-1, LN-2, and the antibody to S-100. Of these 39 cases, the LN-2 antibody was found to consistently mark the majority of Hodgkin and Reed-Sternberg cells. LN-1 was found to identify Hodgkin and Reed Sternberg cells in a smaller number of cases. In no instance were Hodgkin or Reed Sternberg cells found to mark for the S-100 protein. The use of LN-1 and LN-2 antibodies facilitated the identification of Hodgkin and Reed-Sternberg cells and produced additional information regarding the phenotypic nature of these cells. PMID- 3516376 TI - Peripheral T-cell lymphoma. A case report demonstrating morphologic heterogeneity and progression, and atypical immune reactions. AB - Peripheral T-cell lymphomas (PTCL) comprise a morphologically heterogeneous group of non-Hodgkin's lymphomas. The authors report on PTCL occurring in a 13-year-old girl, in whom they were able to evaluate histologic material from 11 biopsy specimens obtained during her 8-month clinical course. These biopsy specimens demonstrated morphologic progression from atypical immune reactions and diffuse mixed cell lymphoma observed at different anatomic sites during early stages of the disease to pleomorphic large cell lymphoma with erythrophagocytic tumor cells at the time of her death. Morphologic variability of PTCL that may occur during the course of a patient's illness was demonstrated, and discordant histologic findings in biopsy specimens obtained simultaneously from different anatomic sites was noted. The morphologic evolution of PTCL was expressed, in sequential biopsy specimens, by a progressive cellular pleomorphism with the appearance of large, often bizarre lymphoid cells. This was associated with the gradual diminution and disappearance of the B-cell areas and epithelioid histiocytic reactions which were present initially in the biopsy specimens. The findings suggest that some of the various morphologic descriptions of PTCL given in the literature may represent transient histologic expressions of the lymphoma at various stages in its natural history. PMID- 3516377 TI - Transplantation of the B16-F10 melanoma to the anterior chamber of the eye uniquely fails to elicit elevation in plasma proteinase activity. AB - Transplantation of B16-F10 melanoma cells to C57BL/6 mice led to increased levels of plasma proteinase activity in tumor-bearing mice if the tumor was transplanted to a subcutaneous site or intraperitoneally. However, transplantation of the tumor cells to the anterior chamber of the eye did not induce elevations in plasma proteinase activity. This latter result was observed when the tumor cells were transplanted to intact or splenectomized animals. These results indicate that tumors in the anterior chamber of the eye are perceived in a unique fashion by the host and that host systems, rather than the tumor, are responsible for the altered plasma proteinase activity observed in animals bearing the tumor at other sites. The failure of animals bearing intraocular tumors to develop elevated proteinase activation appeared to be a result of a failure of such tumors to impinge on specific host systems rather than the induction of a deviated host response. PMID- 3516378 TI - Conditions for transformation of human fibroblast cells: an overview. AB - Low passage (low population doubling) human diploid fibroblasts respond to carcinogen and mutagen treatment, with higher passage level human cells remaining refractory to the insult. A cell cycle dependency for an optimize response to the carcinogen of competent responsive low passage cells is associated with early S phase. The process of fixation of the damage in dividing young cells could be more efficient due to intrinsic sensitivity of young cells towards carcinogens. However, specific DNA-carcinogen adduct analysis does not reveal any qualitative or quantitative difference. These low passage carcinogen initiated human cells progress towards the expression of a malignant phenotype. There is little evidence to suggest that these abnormal phenotypes exhibit an infinite lifespan using the selection pressures for isolation of the transformed phenotypes. However, the lifespan of these treated cells is extended beyond those of the untreated cells. In conclusion, criteria can be established to measure the expression of progression of these carcinogen initiated cells towards a malignant phenotype. PMID- 3516380 TI - Mechanisms of tumor progression. PMID- 3516379 TI - Mechanism of inhibition of N-methyl-N'-nitro-N-nitrosoguanidine-induced mutagenesis by phenolic compounds. AB - At non-toxic concentrations, 2 naturally occurring phenolic compounds, caffeic acid and chlorogenic acid, suppressed the mutagenic activity of the carcinogen N methyl-N'-nitro-N-nitrosoguanidine (MNNG) in Salmonella typhimurium strain TA1535. The inhibitory effect was observed only when the phenolic compound and the mutagen were administered concurrently. The interaction between phenolic compounds and MNNG was also studied in a cell-free system using a colorimetric method. The results are consistent with the assumption that phenolic compounds scavenge reactive electrophilic MNNG degradation products, thereby preventing their action on critical cellular targets. PMID- 3516381 TI - Autocrine tumor growth regulation and tumor-associated hypoglycemia in murine melanoma B16 in vivo. AB - A substance immunochemically cross-reactive with insulin (SICRI) appears in melanoma B16 growing in diabetic and nondiabetic C57BL/6 mice. Progression of tumor size is paralleled by the increase of SICRI levels in the serum of both diabetic and nondiabetic animals; this increase correlates with a decreased concentration of circulating glucose and an elevated concentration of growth hormone in blood. Melanoma B16 grown under serum-free culture conditions secretes SICRI into the medium. Affinity-purified SICRI stimulates glucose uptake by rat epididymal adipocytes and competes with radiolabeled insulin for binding to these cells. Low concentrations of SICRI enhance growth of cultured melanoma B16 cells, whereas high concentrations of this substance have inhibitory growth effects on these cells. Porcine insulin, human insulin-like growth factors I and II, human growth hormone, platelet-derived growth factor, epidermal growth factor, and fibroblast growth factor have negligible influence on growth of melanoma B16. PMID- 3516382 TI - Simultaneous nuclear antigen and DNA content quantitation using paraffin-embedded colonic tissue and multiparameter flow cytometry. AB - The simultaneous quantitation of nuclear antigens and DNA content is presented using monoclonal antibodies and flow cytometric analysis, with paraffin-embedded human colonic pathology specimens utilized as source material. The monoclonal antibodies evaluated were shown by immunogold electron microscopy to recognize nuclear proteins preferentially associated with interchromatin (p105) and heterochromatin (p34) regions. Indirect immunofluorescence analysis of p105 revealed two distinct G1-G0 cell subpopulations in cells from normal colonic epithelium and colonic adenocarcinomas. In addition, enhanced levels of both p105 and p34 were observed in aneuploid DNA content stemlines, relative to diploid cells. Cell-sorting experiments performed on cells sorted on the basis of p105 and DNA contents reveal the capability of this method for identifying morphologically heterogeneous cell subpopulations. Other data suggest that p105 is differentially expressed in well-differentiated versus poorly differentiated tumor regions. The potential utility of this approach for the retrospective study of proliferation-associated antigens and protooncogene protein products is discussed. PMID- 3516383 TI - Lewisx- and sialylated Lewisx-related antigen expression in human malignant and nonmalignant colonic tissues. AB - Biochemical studies have revealed that some normal cells express the LeX trisaccharide Gal beta 1----4(Fuc alpha 1----3)GlcNAc either on short-chain fucolipids or as a single immunodeterminant on glycolipid oligosaccharide side chains. Cancer cells, including those from colonic adenocarcinomas, express this antigen on longer type 2 blood group side chains as difucosylated or trifucosylated fucolipids. Moreover, sialylated forms of difucosylated LeX also accumulate in colon cancer but not in normal colonic mucosa. In the present study, six monoclonal antibodies which selectively recognize the various LeX related antigens were used for immunohistochemical examination of these antigens in serial sections of human colonic tissue. All of these antigens were oncodevelopmental in human colon. Monoclonal antibodies anti-SSEA-1 and AH8-183, directed against short-chain, monofucosylated LeX, were unable to discriminate well between normal and malignant colonic tissue. However, the other four antibodies were much better at distinguishing cancer from normal tissue. FH6 was the most specific in that no normal tissues bound this antibody. However, FH6 failed to stain poorly differentiated cancers and some colloid-type carcinomas. FH4, which was also highly specific, stained almost all cancers, regardless of the degree of differentiation. FH4 primarily stained cancer cell cytoplasm, whereas the sialylated antigen defined by FH6 predominantly stained cell membranes. Differences were noted between the expression of LeX-related antigens in autopsied normal mucosa compared to mucosa of benign colonic diseases. Monoclonal antibodies recognizing long-chain polyfucosylated and sialylated LeX related antigens appear to be useful tools for detection of colon cancer. PMID- 3516384 TI - Differential expression of difucosyl type 2 chain (LeY) defined by monoclonal antibody AH6 in different locations of colonic epithelia, various histological types of colonic polyps, and adenocarcinomas. AB - The expression of LeY (Fuc alpha 1----2Gal beta 1----4 [Fuc alpha 1----3]GlcNAc beta 1----R) (in which Fuc is fucose, Gal is galactose, and GlcNAc is N acetylglucosamine) defined by monoclonal antibody AH6 in various locations of human colonic epithelia, colonic polyps, and adenocarcinomas has been studied. In normal colonic mucosa, strong staining by AH6 was observed in the proximal regions such as the terminal ileum and cecum. The staining was, however, greatly reduced in the epithelia of the ascending colon and became very weak in the epithelia of transverse, descending, and sigmoidal colon as well as the rectum. Of 481 crypts in 40 biopsy samples of the epithelia of normal sigmoidal colon, 421 crypts did not show any staining, and only a weak staining of the lowest crypt area was observed in 60 crypts (12%); of 474 crypts in 40 biopsy samples of normal rectal epithelia, 110 crypts (26%) showed a weak staining. At the fetal stage, the LeY staining was much more intense in all locations of the colon than in corresponding locations of adult epithelia, and staining was observed in the epithelia of the sigmoidal colon and rectum. A strong staining was observed in 24 of 25 cases of colorectal adenocarcinomas, irrespective of their original location. The expression of LeY in polyps was correlated with histological type as well as the degree of dysplasia of the polyps. Of various adenomas examined, tubular adenomas, many of which showed mild or moderate dysplasia and less malignant potentials, displayed the least LeY expression. Tubulovillous and villous adenomas, which have higher malignant potential and showed a higher incidence of severe dysplasia, showed a greater area and intensity of LeY expression. No LeY was detectable in juvenile polyps, and only a very weak staining was observed in the dysplastic area of hyperplastic polyps. The extent and intensity of staining in various adenocarcinomas and adenomas could not be correlated with blood group ABO status of the hosts nor with location of the tumors. These results suggest that LeY in colonic adenocarcinomas and polyps at the distal region of the colon and rectum is a typical oncofetal antigen and is a useful marker for diagnosis of colonic cancer. Its expression in colonic polyps can be correlated with the degree of dysplasia and may indicate the degree of malignant potential of the polyp. Thus, LeY expression in polyps may have prognostic value. PMID- 3516385 TI - Immunomodulation by polyaromatic hydrocarbons in mice and murine cells. AB - Several functionally defined in vitro antibody generating systems were used to assess the immunomodulating mechanisms of the benzopyrenes. When benzo(a)pyrene (BaP) or benzo(e)pyrene (BeP) was incorporated into a T-dependent antibody (TDAb) producing spleen cell culture system, dose- and time-dependent inhibition of plaque-forming cell responses was observed. Addition of BaP at concentrations as low as 0.002 microgram/ml (7.93 nM) resulted in suppression of the TDAb plaque forming cell response. BeP-induced suppression was seen at the 2-microgram level (7.93 microM). Time course evaluations demonstrated an early requirement for either chemical in culture in order to induce significant suppression. In vitro incorporation of BaP and BeP into polyclonal antibody-generating cultures also resulted in a dose-related inhibition. Inhibition of these antibody responses was also noted following in vivo exposure of mice to BaP or BeP. Fourteen-day exposure of mice to BaP (40 mg/kg) resulted in 98% suppression of the TDAb response. Polyclonal antibody responses were reduced 50 to 66% following 7 days of chemical exposure. BeP caused 51% suppression of the TDAb response following 14-day exposure of animals. These studies indicate that the suppressive effects of the benzopyrenes are multicellular in origin, occur apart from the carcinogenic effects of the chemicals, and cannot be attributed merely to cellular toxicity. PMID- 3516386 TI - Bacterial and mammalian cell mutagenicity of four optically active bay-region 3,4 diol-1,2-epoxides and other derivatives of the nitrogen heterocycle dibenz[c,h]acridine. AB - The mutagenic activities of the enantiomers of the diastereomeric pair of bay region 3,4-diol-1,2-epoxides of the nitrogen heterocycle, dibenz[c,h]acridine, have been evaluated in histidine-dependent strains of Salmonella typhimurium and in an 8-azaguanine-sensitive line of Chinese hamster cells. In strains TA 98 and TA 100 of S. typhimurium the pair of enantiomers with [1R,2S,3S,4R] and [1S,2R,3R,4S] absolute configuration and the benzylic hydroxyl group trans to the epoxide oxygen are 2 to 4 times more mutagenic than the [1S,2R,3S,4R] and [1R,2S,3R,4S] isomers in which the benzylic hydroxyl and epoxide oxygen are cis. In both strains of bacteria there is very little difference in mutagenic activity between the enantiomers of each diastereomer. In contrast to these results in bacteria, the bay-region 3,4-diol-1,2-epoxide isomer with [1R,2S,3S,4R] absolute configuration is 5 to 7 times more mutagenic to Chinese hamster V79 cells than are the other 3 isomers. The enantiomeric pair of bay-region tetrahydro-1,2 epoxides of dibenz[c,h]acridine are at least 7 times more mutagenic than the diol epoxides in the Salmonella assay, and no difference in mutagenic activity is observed between enantiomers. In the Chinese hamster V79 cell system, however, the tetrahydro-1,2-epoxide with [1R,2S] absolute configuration is 2- to 3-fold more mutagenic than its enantiomer with [1S,2R] absolute configuration. Homogeneous rat liver epoxide hydrolase does not catalyze the hydration of the diol-epoxide isomers to nonmutagenic products, although the tetrahydroepoxides, especially the tetrahydro-3,4-epoxide, are metabolized by the enzyme. Results of metabolic activation experiments with the bacterial mutagenesis system and microsomes from Aroclor 1254-treated rats are consistent with the mutagenicity data described above and support the concept that dibenz[c,h]acridine is metabolically activated to a bay-region diol-epoxide. Notably: (a) 3,4 dihydrodibenz[c,h]acridine, the expected precursor of a bay-region tetrahydroepoxide, is metabolized to a potent mutagen; (b) racemic dibenz[c,h]acridine 3,4-dihydrodiol is metabolized to products which are several fold more mutagenic than are products of the metabolism of dibenz[c,h]acridine or its 1,2- or 5,6-dihydrodiols; and (c) the tetrahydro-3,4-diol, which lacks the isolated bay-region double bond, is not metabolically activated to a bacterial mutagen. PMID- 3516387 TI - Development and characterization of a mouse monoclonal antibody, MoAb HMSA-1, against a melanosomal fraction of human malignant melanoma. AB - To characterize the biological property unique to melanocytes and to utilize this property to establish laboratory diagnostic tools for malignant melanoma, monoclonal antibody (MoAb) human melanosome-associated antigen-1 (HMSA-1), a mouse monoclonal antibody, was developed against purified melanosomal fractions of human melanoma. MoAb HMSA-1 belongs to an IgG1 (kappa) subclass. Fractionation of cell organelles combined with enzyme linked immunosorbent assay analysis indicated that the antigen(s) reactive with MoAb HMSA-1 is localized in melanosome and endoplasmic reticulum fractions and that it is related to melanosomal protein and its precursor forms. The localization of the antigen in the melanosome and endoplasmic reticulum was also confirmed by immunoelectron microscopy. Characteristically, MoAb HMSA-1 reacted with formalin-fixed and paraffin-processed tissues of melanocytic nevi and malignant melanoma, including amelanotic lesions. It did not react with normal melanocytes, normal tissues and organs from fetuses and adults, or most non-melanocytic tumors. Thus MoAb HMSA-1 identifies the differentiation antigen for the melanosome-associated property in neoplastic melanocytes and is a useful adjunct for immunohistological diagnosis of melanocytic lesions on routine paraffin sections. PMID- 3516388 TI - Highly selective recognition of human neuroblastoma cells by mouse monoclonal antibody to a cytoplasmic antigen. AB - Immunization of a BALB/c mouse with cells from the human neuroblastoma line LAN-1 and fusion of the spleen cells with mouse myeloma cells, NS-1, led to the production of a monoclonal antibody (Mab) with a rather unique reactivity for neuroblastoma. This Mab, named 5 A7, detects an antigen of an apparent molecular weight of 65,000-67,000, localized mainly in the cytoplasm and released into culture medium, as revealed by immunoprecipitation and immunoblotting experiments. By immunoperoxidase staining using a biotin-avidin technique, Mab 5 A7 demonstrates a restrictive staining for neuroblastoma cell lines. Following extensive testing on freshly frozen specimens of neuroblastoma and other tumors, Mab 5 A7 shows a highly selective reactivity for neuroblastomas (13 of 14) and some cells of one primitive neuroectodermal tumor (ependymoblastoma). No reactivity could be detected with Mab 5 A7 on the 57 other tumor tissues tested. Among the normal fetal or adult tissue specimens tested, positive staining is found only on adult brain, colonic crypts, some renal tubules, and fetal medulla of the adrenal gland. Among bone marrow specimens tested, only those infiltrated by neuroblastoma cells gave a positive staining. Normal or malignant hematopoietic cells showed no reactivity with Mab 5 A7. Our results with Mab 5 A7 suggest that this reagent not only provides a valuable probe for the immunohistological diagnosis of neuroblastoma on fresh tumor specimens but also allows the detection of bone marrow infiltration by neuroblastoma cells. PMID- 3516389 TI - Detection of antigens recognized by a novel monoclonal antibody in tissue and serum from patients with breast cancer. AB - Monoclonal antibodies were produced in mice immunized with proteins released into tissue culture fluid of human breast cancer cells maintained in vitro. One monoclonal antibody (SP-2) identified a Mr 90,000 antigen which appears to be a proteolipid. In immunoperoxidase assays, SP-2 reacted with 81 of 90 specimens of human breast cancer. It also reacted with 12 of 23 cancers of nonbreast origin but was unreactive with all normal tissues tested. The Mr 90,000 antigen, purified by immunoaffinity chromatography using SP-2, was used in an indirect binding inhibition assay for the detection of antigen in human serum. With this assay, 35 of 69 patients with breast cancer and 11 of 37 patients with benign breast lesions showed serum antigen levels above 6 units/ml. Patients with nonbreast cancers also demonstrated elevated levels of antigen in 32% of cases. The SP-2 defined Mr 90,000 antigen appeared to be distinct from carcinoembryonic antigen and other monoclonal antibody-defined breast cancer antigens of similar molecular weight. SP-2 may prove useful as a serum and/or tissue marker in breast pathology. PMID- 3516390 TI - Influence of glucose concentration on growth and formation of necrosis in spheroids derived from a human bladder cancer cell line. AB - Spheroids derived from the human bladder cancer cell line MGH-U1 were initiated in spinner culture and then transferred to multiwell plates which contained medium with varying concentrations of glucose and pyruvate. Growth of individual spheroids was monitored, and at different times after transfer spheroids were sectioned and the diameter of the necrotic center and the thickness of the viable rim were determined. In normal medium containing glucose (1 g/liter; 5.5 mM), spheroid diameter increased linearly with time, growing from approximately 400 micron to approximately 1200 micron in 8 days, and most spheroids did not develop central necrosis. Increase in glucose concentration up to 5 g/liter had no effect on spheroid growth. Lower glucose concentration decreased the rate of spheroid growth, but large effects were observed only at glucose concentration lower than 100 mg/liter. Spheroids developed central necrosis at 2-4 days after transfer to glucose-deficient medium, and the diameter of the necrotic center increased more rapidly than the diameter of the spheroid. There was an approximately linear relationship between thickness of the viable rim in 5-6-day spheroids and glucose concentration in the range of zero (rim thickness, approximately 150 micron) to 500 mg/liter (rim thickness, approximately 400 micron). The presence or absence of pyruvate (110 mg/liter) in the medium had no effect on spheroid growth or formation of necrosis. These results suggest that limited penetration of glucose may be one of the factors that contribute to cell death in solid tumors. PMID- 3516391 TI - Sequential protooncogene expression during rat liver regeneration. AB - When growth is stimulated in the normally quiescent adult rat liver by partial hepatectomy, steady state levels of messenger RNAs (mRNAs) for c-fos, c-myc, and p53 increase sequentially during the prereplicative phase which precedes DNA synthesis. Levels of c-fos mRNA are elevated at least 4-fold within 15 min after partial hepatectomy and decrease rapidly by 2 h; c-myc mRNA reaches maximal levels (5-fold over normal) between 30 min and 2 h after the operation. A second, transient phase of expression for both c-fos and c-myc occurs around 8 h after partial hepatectomy. p53 mRNA levels increase between 8 and 12 h after the operation (5-fold over normal) and are reflected in an elevation of steady state levels of p53 protein between 12 and 15 h after partial hepatectomy. The levels of ras p21 protein increase much later at a time of active DNA replication and cell division. Actinomycin D injected at the time of partial hepatectomy blocks the increase in c-myc at 2 h but has no effect on c-fos mRNA levels. Actinomycin D injected at 6 h only partially blocks the increase in c-myc and p53 mRNA at 8 h but does not affect c-fos mRNA. Our results suggest that the transient and sequential expression of protooncogenes during the prereplicative stage of liver regeneration is likely to reflect events associated with entry and progression of hepatocytes into the cell cycle and can serve as markers for identifying specific humoral factors involved in liver regeneration. PMID- 3516392 TI - Distribution of oncofetal antigen tumor-associated glycoprotein-72 defined by monoclonal antibody B72.3. AB - Murine monoclonal antibody B72.3, prepared against a membrane-enriched extract of human metastatic carcinoma, was reacted with a spectrum of adult and fetal human tissues using avidin-biotin-complex immunohistochemical techniques to evaluate the expression of the reactive tumor associated glycoprotein (TAG)-72 antigen. TAG-72 was shown to be expressed in several epithelial-derived cancers including 94% of colonic adenocarcinomas, 84% of invasive ductal carcinomas of the breast, 96% of non-small cell lung carcinomas, 100% of common epithelial ovarian carcinomas, as well as the majority of pancreatic, gastric, and esophageal cancers evaluated. TAG-72 expression was not observed, however, in tumors of neural, hematopoietic, or sarcomatous derivation, suggesting that the TAG-72 antigen is "pancarcinoma" in nature. Appreciable monoclonal antibody B72.3 reactivity was generally not observed in adult normal tissues, with limited reactivity noted in a few benign lesions of the breast and colon. TAG-72 antigen expression was detected, however, in fetal colon, stomach, and esophagus, thus defining TAG-72 as an oncofetal antigen. TAG-72 has previously been shown to be distinct from carcinoembryonic antigen and other tumor associated antigens. The pancarcinoma distribution and lack of significant reactivity with normal adult tissues of monoclonal antibody B72.3 suggest its potential diagnostic and therapeutic utility for human carcinomas. PMID- 3516393 TI - Limitations of radiolabeled monoclonal antibodies for localization of human neoplasms. AB - Tumor-associated monoclonal antibodies were radiolabeled with 125I and 131I and given i.v. in pairs to 19 patients 1-26 days prior to surgical excision of primary and metastatic breast, ovarian, and gastrointestinal tumors. For individual patients each monoclonal antibody was designated as specific or nonspecific according to prior immunoperoxidase staining results on the appropriate target neoplastic tissues. Quantitation of antibody uptake was performed on resected normal and neoplastic tissues. Although good tumor:non tumor ratios were obtained with the specific antibodies (maximal tumor:blood ratio, 35.8:1 at 12 days postadministration), the absolute amount of radiolabel detected in tumors was small (mean value of 0.015% of total injected amount per g of tumor occurring 1 day postadministration). Furthermore, both specific and nonspecific antibodies accumulated in normal lymph nodes to a significant extent (mean value of 0.0026% of total injected amount per g of tissue occurring 1 day postadministration). Knowledge of such data is essential prior to considering therapeutic uses of radiolabeled monoclonal antibodies. PMID- 3516394 TI - High-dose melphalan with or without marrow transplantation: a study of dose effect in patients with refractory and/or relapsed acute leukemias. AB - Dose-effect relationships of high-dose melphalan were evaluated in 37 patients with measurable relapsed or refractory acute leukemias. Thirteen patients (Group 1) received 70-100 mg/m2 of melphalan without marrow rescue and 24 patients (Group 2) received 140-180 mg/m2 of melphalan followed by marrow transplantation. Patients in both groups were comparable with respect to age, sex, diagnosis, and status of the leukemia. The complete remission rate was 23% in Group 1 versus 75% in Group 2 (P less than 0.01). Hematological recovery of remission patients was not statistically different in either group. Nonhematological toxicity was comparable in the two dose ranges examined. These results demonstrate the existence of a dose-response effect of high-dose melphalan regimens in relapsed acute leukemias, without marked increases in nonhematological toxicity with these doses. PMID- 3516395 TI - Randomized trial of high-dose cytarabine versus amsacrine in acute myelogenous leukemia in relapse: a Leukemia Intergroup Study. AB - Patients with acute myelogenous leukemia in relapse who were ineligible for further anthracycline therapy either because they were judged to be anthracycline resistant or had received the maximum doses were randomized to receive high-dose cytarabine (3 g/m2 every 12 hours for 6 days) or amsacrine (75 mg/m2 daily for 7 days). The response rates in both groups were similar: three of 25 patients given high-dose cytarabine and three of 23 given amsacrine obtained complete remissions. PMID- 3516396 TI - Phase III study of 5-FU and carmustine versus 5-FU, carmustine, and doxorubicin in advanced gastric cancer. AB - Seventy-seven patients with advanced gastric carcinoma were prospectively randomized to receive 5-FU and carmustine (FB) with or without doxorubicin (FAB). Thirty-five patients were evaluable for response. Neither the response rates (partial remission, 11% for FB and 24% for FAB) nor survival times (median, 4.0 months for FB and 5.5 months for FAB) were statistically different. The median survival of patients with partial remission (7.8 months) and those with no change (7.4 months) was significantly prolonged compared to patients with progressive disease (4.5 months). The side effects of both regimens after the first treatment cycle (except alopecia in FAB) were low. After the second cycle more pronounced myelosuppression in the FAB arm was observed. PMID- 3516397 TI - Randomized comparison of 5-FU alone or combined with carmustine, doxorubicin, and mitomycin (BAFMi) in the treatment of advanced gastric cancer: a phase III trial of the Italian Clinical Research Oncology Group (GOIRC). AB - Eighty-two evaluable patients with advanced gastric carcinoma were randomized to receive either 5-FU alone or the combination of carmustine, doxorubicin, 5-FU, and mitomycin (BAFMi). Objective remissions were seen in 15% of the patients who received 5-FU alone and in 22% of the patients on the BAFMi regimen. The difference was not statistically significant. The median duration of objective remission (31 vs 40 weeks) was longer using BAFMi combination, and the median duration of survival, calculated in the 85 randomized patients, was slightly longer using 5-FU (28 vs 24 weeks). The differences were not statistically significant. It is concluded that there is no therapeutic advantage in using the BAFMi combination over 5-FU alone. PMID- 3516398 TI - Albendazole, a broad-spectrum anthelmintic, in the treatment of intestinal nematode and cestode infection: a multicenter study in 480 patients. AB - The anthelmintic activity of and patient tolerance to albendazole, a broad spectrum anthelmintic, were studied in a multicenter trial involving 480 patients ranging in age from 2 to 60 years. The patients had single or mixed infections caused by pinworms, roundworms, hookworms, whipworms, threadworms, or tapeworms. The stools were examined by the direct method, and ova were counted by means of the Kato-Katz technique. A Graham-Scotch test was also done in patients infected with Enterobius vermicularis. Most patients received a single 400-mg dose of albendazole; adults were given two tablets, and children were given a 2% suspension. All patients with Hymenolepis nana and about half of those with Taenia infections were treated for three successive days. Patients were carefully evaluated before and after treatment to assess the efficacy and safety of the drug. After a single dose of albendazole, the cure rate was 95.3% in ascariasis, 92.2% in ancylostomiasis, 90.5% in trichuriasis, 64.9% in taeniasis, and 100% in enterobiasis. Among patients receiving 400 mg of albendazole for three days, the cure rate was 63.4% in hymenolepiasis and 86.1% in taeniasis. The drug was well tolerated, and no significant side effects were reported. PMID- 3516399 TI - Type-I collagen production by human odontoblast-like cells in explants cultured on cyanoacrylate films. Electron-immunolocalization of fibronectin at cell/film interface. AB - Odontoblast-like cells derived from human tooth pulps were maintained in explant culture and grown either on glass coverslips only (used as control) or on glass coverslips coated with cyanoacrylate films. Ultrastructural and cyto-morphometric evidence showed that cells exposed to cyanoacrylate, in contrast to controls, display a significant decrease of rough endoplasmic reticulum and mitochondria. In addition, immunofluorescent staining and radioimmunoassays for type-I collagen suggested disturbances in production for the exposed cells. The use of anti fibronectin antibodies with electron-microscopic immunoperoxidase-labelling demonstrated that the adherence of cells to cyanoacrylate can involve both adhesion plaques and fibronectin. These results therefore suggest that there were no apparent differences in the adhesion interaction of cells between glass and cyanoacrylate substrates. PMID- 3516400 TI - Distribution of subgroups of noradrenaline neurons in the coeliac ganglion of the guinea-pig. AB - The distributions within the coeliac ganglion of different chemically coded subgroups of noradrenaline neurons, and the relationships between these neurons and nerve fibres projecting to the ganglion from the intestine, have been assessed quantitatively by use of an immunohistochemical double-staining method. Noradrenaline (NA) neurons made up 99% of all cell bodies. Of these, 21% were also reactive for somatostatin (NA/SOM neurons), 53% were also reactive for NPY (NA/NPY neurons), and 26% were not reactive for either peptide. NA neurons without reactivity for any of the peptides whose localization was tested have been designated NA/-. A small percentage, about 1%, of neurons were reactive for both NPY and SOM. The three major types of NA neurons were arranged in clumps or ribbons throughout the ganglia, with a tendency for NA/SOM neurons to be medial and NA/NPY neurons to be lateral in the ganglia. A small group of neurons (less than 1%) encoded with dynorphin, NPY and vasoactive intestinal peptide (VIP) was encountered. VIP-immunoreactive nerve terminals, projecting to the ganglion from cell bodies in the intestine, ended around NA/SOM and NA/- neurons but not around NA/NPY neurons. Thus, the VIP axons from the intestine end selectively around neurons that modify intestinal function (NA/SOM and NA/- neurons) but not around neurons, the terminals of which supply blood vessels (NA/NPY neurons). PMID- 3516401 TI - Septal afferents to the area dentata terminate on vasoactive intestinal polypeptide (VIP)-like immunoreactive, non-pyramidal neurons. An electron microscopic immunocytochemical degeneration study in the rat. AB - Thermic lesions in the medial septum of adult rats result in dark degeneration of terminal boutons in the stratum moleculare and hilus of the area dentata. While most of the degenerating terminals are in synaptic contact with non-reactive cells, part of them end on dendrites of VIP-like immunoreactive neurons. PMID- 3516402 TI - Cell shape and motility of oligodendrocytes cultured without neurons. AB - Oligodendrocytes, the myelin-forming cells of the central nervous system (CNS), were cultured from newborn rat brain and optic nerve to study how they differentiate in vitro in the absence of neurons. By use of galactocerebroside (GC) as a reference marker, the development of the cell phenotype was studied with video-enhanced differential interference contrast microscopy, immunofluorescence and electron microscopy. After a few days in culture, oligodendrocytes extend 5 to 10 main processes that are very rich in microtubules, but they did not stain with a monoclonal antibody reacting with all known classes of intermediate filaments. The number of processes can vary with the substrate on which the cells are grown; fewer processes form on laminin than on polylysine coated glass. Oligodendrocytes, in a fashion similar to that of neurons appear to keep their body immobile while the long processes grow. However, while neurons display motile activities mostly at the end of the cell processes called growth cones, the oligodendrocytes display motile, actin rich filopodia and lamellipodia along the entire length of all processes. The outgrowth of motile processes from oligodendrocytes sometimes occurs preferentially towards neighboring astrocytes. Oligodendrocyte processes display intense bidirectional movement of cytoplasmic organelles. Movement of surface components also occurs since GC molecules cross-linked by antibodies move from the processes towards the cell body. Thus, oligodendrocytes cultured without neurons develop on schedule a complex phenotype similar to their in vivo counterpart. In addition, their processes are capable of specific motile activities which may function in vivo to find the target axon and to transport myelin membrane components at the site of myelin assembly. PMID- 3516403 TI - Distribution and characterization of the opioid octapeptide met5-enkephalin-arg6 gly7-leu8 in the gastrointestinal tract of the rat. AB - The distribution and characterization of the opioid octapeptide met5-enkephalin arg6-gly7-leu8 (met5-enk-arg6-gly7-leu8) within the gastrointestinal tract of the rat has been determined by immunohistochemistry and radioimmunoassay by use of a newly developed antibody to met5-enk-arg6-gly7-leu8. With both techniques, met5 enk-arg6-gly7-leu8-immunoreactivity (met5-enk-arg6-gly7-leu8-IR) was detected in all regions of the gastrointestinal (GI) tract except the esophagus. The highest concentration of immunoreactive met5-enk-arg6-gly7-leu8 was observed in the colon, while intermediate concentrations were found in the stomach, duodenum, jejunum, and ileum. Immunostained somata were observed chiefly in the myenteric plexus; immunostained processes were present primarily in the myenteric plexus and the circular muscle layer. This distribution pattern is similar to that previously observed with antiserum to met5-enkephalin-arg6-phe7 (met5-enk-arg6 phe7). Chromatographic analysis of met5-enk-arg6-gly7-leu8-immunoreactive peptides extracted from the GI tract revealed the presence of an immunoreactive peptide of high molecular weight which accounted for approximately three-quarters of met5-enk-arg6-gly7-leu8-IR in both stomach and colon. These findings suggest a role for peptides related to the octapeptide met5-enk-arg6-gly7-leu8 in the regulation of GI function. PMID- 3516404 TI - Characterization of intermediate filaments and their structural organization during epithelium formation in pigmented epithelial cells of the retina in vitro. AB - Retinal pigmented epithelial cells of chicken have circumferential microfilament bundles (CMBs) at the zonula adherens region. Isolated CMBs are polygons filled with a meshwork composed primarily of intermediate filaments; they show three major components of 200 000, 55 000, and 42 000 daltons in SDS-gel electrophoresis. Here we have characterized the 55 000-dalton protein immunochemically and ultrastructurally. Immunoblotting and immunofluorescence microscopy have shown that the 55 000-dalton protein is an intermediate filament protein, vimentin. Vimentin filaments changed their distribution during differentiation of pigmented epithelial cells in culture. The protein in the elongated cells showed a fibroblast-type pattern of intermediate filaments. During epithelium formation, the filaments were uniformly distributed and formed a finer meshwork at the apical level. In pigmented epithelial cells that differentiated and matured in culture, vimentin and actin exhibited their characteristic behavior after treatment with colcemid. In the central to basal region of the cell, intermediate filaments formed thick perinuclear bundles. In the apical region, however, intermediate filaments changed in organization from a nonpolarized meshwork to a polarized bundle-like structure. Simultaneously, new actin bundles were formed, running parallel to the intermediate filaments. This suggests that there is some interaction between microfilaments and intermediate filaments in the apical region of these cells. PMID- 3516406 TI - Flunarizine-pizotifen single-dose double-blind cross-over trial in migraine prophylaxis. AB - The results of a double-blind cross-over clinical trial involving 27 patients with classical or common migraine are described to compare the prophylactic effect of the calcium entry blocker flunarizine with that of pizotifen. Duration of the treatment was two months, with an evening single-dose administration of both drugs. For most parameters, there was no definite difference between flunarizine and pizotifen in migraine prophylaxis. It has been demonstrated previously that pizotifen is an effective drug in migraine prophylaxis, and these results suggest that flunarizine is effective, too. Weight gain as a side effect was less frequent and less severe with flunarizine than with pizotifen; other side effects showed the same incidence with both drugs. PMID- 3516405 TI - Lipolysis of serum-activated triacylglycerol at the surface of J774.1 macrophages. A biochemical--electron-microscopic study. AB - Cultured mouse (J774.1) macrophages accumulated triacylglycerol, but no cholesteryl ester or cholesterol, when incubated in albumin-poor medium with serum-activated lipid particles containing 84 mol% trioleoylglycerol and 9 mol% cholesteryl oleate. Accumulation of triacylglycerol by cells was associated with hydrolysis of particulate triacylglycerol to fatty acid and glycerol. Both acyl and glyceryl moieties of particulate triacylglycerol were recovered in cellular triacylglycerol with a molar ratio of 3.6. The cells also accumulated fatty acid and monoacylglycerol. Whether acylglycerol was taken up as a single molecular species, such as monoacylglycerol, or as several species can not be determined by the present findings. Macrophages incubated with lipid particles for 24 h had many lipid particles attached to cell surfaces and numerous intracellular lipid droplets. The surface film of attached particles was continuous with the outer leaflet of plasma membrane of the cells. Particles partially depleted of core triacylglycerol and collapsed surface films were found attached to surfaces of macrophages. There was no morphological evidence that lipid particles were taken up intact by cells, through endocytosis or phagocytosis. Macrophages incubated with lipid particles also contained intracellular lamellar structures. They varied in size and shape, and were located in the periphery of cells, sometimes near lipid droplets and endoplasmic reticulum. Only 3% of the lamellar structures were associated with lysosomes, indicating they probably were not of lysosomal origin. Lipid particles attached to cells decreased in size and number, and lamellar structures developed at the surface of particles, or replaced the particles, when glutaraldehyde-fixed specimens were incubated at 25 degrees C, demonstrating lipolytic activity at the surface of macrophages. Our findings suggest that particulate triacylglycerol was hydrolyzed by lipoprotein lipase at the surface of macrophages, and that fatty acid and monoacylglycerol formed by lipolysis were transported directly into the cells to be reesterified. When lipolytic products were taken up faster than they could be utilized, they accumulated as lamellar structures in the cells. PMID- 3516408 TI - Dihydroergotamine nasal spray in the treatment of attacks of cluster headache. A double-blind trial versus placebo. AB - A double-blind trial of dihydroergotamine (DHE) nasal spray compared with placebo was carried out in patients with cluster headache. Twenty-five patients were included in the trial. In three patients, all receiving DHE, the pain attacks ceased after five attacks. In the other 22 patients, 133 attacks were treated with placebo and 137 attacks with DHE nasal spray (dosage, 1 mg of DHE). The trial showed that the treatment given has no effect on the attack frequency or the duration of the single attack. However, the treatment had a significant effect on the intensity of the single attacks. It can be concluded that the trial should be repeated, using a larger dosage of DHE. This should be ethically justifiable, since none of the patients had any adverse reactions locally in the mucous membrane of the nose or systemically. PMID- 3516407 TI - A new formulation of aspirin: bioavailability and analgesic efficacy in migraine attacks. AB - Plasma aspirin and salicylate concentrations were followed after 600 mg of a new palatable glycinated preparation of aspirin was given to six healthy male volunteers in an attempt to investigate whether pre-gastric absorption of aspirin could occur. In each subject the drug was administered by three different routes, viz. (i) swallowed with water, (ii) dissolved sublingually and retained in the mouth, and (iii) allowed to disperse on the tongue, and then swallowed without water intake. Using the latter route of administration and the same aspirin formulation, plasma aspirin and salicylate concentrations were also followed in 10 patients during acute migraine attacks. These results were compared with those from another 10 migraineurs given 600 mg of soluble aspirin swallowed with water during attacks. Aspirin and salicylate pharmacokinetic parameters (Cmax, tmax, t1/2, Kabs and AUC) in the normal volunteers were not significantly different (p greater than 0.05) whether glycinated aspirin was swallowed with water or swallowed without water after dispersion in the mouth. However, negligible aspirin was absorbed when the glycinated preparation was retained in the mouth. In migraine patients, there was no significant difference (p greater than 0.05) between the bioavailabilities of soluble aspirin swallowed with water (AUC = 5.7 +/- 2.3 mg h/l) and glycinated aspirin swallowed without water (AUC = 4.4 +/- 1.6 mg h/l). There also was no significant difference (p greater than 0.05) when the time courses of pain relief were compared, both treatments being associated with a significant (p less than 0.01) analgesic effect. The glycinated aspirin was thus bioequivalent to swallowed aspirin but has no advantages for migraineurs over soluble aspirin if water is readily available for self-administration. PMID- 3516409 TI - A placebo-controlled, double-blind, cross-over trial of flunarizine in common migraine. AB - After four weeks of medication-free baseline observation, 29 patients with common migraine randomly received flunarizine (10 mg daily) or placebo for a 16-week period. After four weeks wash-out they crossed treatments for another 16 weeks; 27 patients completed the trial. Compared with placebo, flunarizine significantly reduced the frequency of migraine attacks and the derived headache indices, but the duration and severity of single attacks remained unchanged (Mann-Whitney U test). The effect of flunarizine increased during the 16-week treatment period and during the last four weeks the number of migraine attacks reduced to 50% compared to the wash-out period. The only side-effect of flunarizine was mild daytime sedation in three patients. It is concluded that flunarizine is a valuable new prophylactic agent for common migraine. PMID- 3516410 TI - Translational control of transcription in eukaryotes. PMID- 3516411 TI - Multiple upstream AUG codons mediate translational control of GCN4. AB - GCN4 encodes a transcriptional activator of amino acid biosynthetic genes in yeast that is regulated at the translational level. The 5' leader of GCN4 mRNA contains four small open-reading-frames. By constructing point mutations in the initiation codons of these sequences, we show that they are essential for translational repression of GCN4. Each upstream AUG codon can repress translation; however, the two 3' proximal AUG codons are much more inhibitory than the 5' proximal AUG codons. Unexpectedly, the first AUG codon is required for efficient GCN4 expression under starvation conditions. This positive function appears to involve antagonism of the inhibitory effect of the 3' proximal AUG codons since it is dispensable in the absence of these sequences. The interaction between the upstream AUG codons is modulated by the trans-acting factors GCN2 and GCD1 in response to amino acid availability. PMID- 3516412 TI - The cell cycle control gene cdc2+ of fission yeast encodes a protein kinase potentially regulated by phosphorylation. AB - The cdc2+ gene function has an important role in controlling the commitment of the fission yeast cell to the mitotic cycle and the timing of mitosis. We have raised antibodies against the cdc2+ protein using synthetic peptides and have demonstrated that it is a 34 kd phosphoprotein with protein kinase activity. The protein level and phosphorylation state remain unchanged during the mitotic cycle of rapidly growing cells. When cells cease to proliferate and arrest in G1 the protein becomes dephosphorylated and loses protein kinase activity. Exit from the mitotic cycle and entry into stationary phase may be controlled in part by modulation of the cdc2 protein kinase activity by changes in its phosphorylation state. PMID- 3516413 TI - Beyond self-assembly: from microtubules to morphogenesis. PMID- 3516414 TI - Yeast histone H2A and H2B amino termini have interchangeable functions. AB - The N-terminal ends of histones H2B and H2A have very different sequences and rates of evolution. However, they both extend from the nucleosome core and are positively charged. Short sequences at the C termini of both proteins also differ from each other and appear to be hydrophilic. Deletions at the N and C termini of yeast histones H2B2 and H2A1 do not obviously affect the cell's viability under normal growth conditions. However, deletions at the N termini of both H2B and H2A in the same cell are lethal or result in greatly reduced viability. Even switching portions of the N termini between H2B and H2A to create two chimeric histone proteins within the same cell has no obvious effect on viability. This supports the argument that the N-terminal end of one protein complements the function of the other. PMID- 3516415 TI - The E. coli dnaY gene encodes an arginine transfer RNA. AB - The E. coli dnaY gene product is an arginine tRNA. Its 77 nucleotide sequence can be folded into a typical cloverleaf structure with a UCU anticodon corresponding to the rare arginine codon AGA. A dnaY+ plasmid confers overproduction of at least one arginine-accepting minor species of tRNAArg. The dnaY promoter was identified by run-off transcription studies, and the initiating nucleotide was identified by sequencing the 5' end of the in vitro transcript. The primary products in vitro are RNAs of 180 and 190 nucleotides, which presumably are processed in vivo to generate the mature form. Transcription is terminated in vitro, and presumably in vivo, by a rho-dependent process. PMID- 3516416 TI - Diagnosis and treatment planning for the denture cripple. PMID- 3516417 TI - Phased treatment of the neglected dentition. PMID- 3516418 TI - [The history of ophthalmology in Bratislava--II. The Ophthalmology Clinic of Comenius University Medical School in Bratislava in the 30s]. PMID- 3516419 TI - Effect of cysteine on chromate resistance in the yeast Saccharomyces cerevisiae. PMID- 3516420 TI - Studies on chemical carcinogens and mutagens. XXXIII. Mutation frequencies induced by combinations of methylating and/or ethylating mutagens. PMID- 3516421 TI - Purification and characterization of proline endopeptidase from rat liver. PMID- 3516422 TI - Specificity of a membrane-bound neutral endopeptidase from rat kidney. PMID- 3516423 TI - [Impact of building a dam on the transmission of malaria. Malaria survey conducted in southeast Mauritania]. AB - In March during the dry season an investigation was conducted on the site of Foum Gleita dam in the Islamic Republic of Mauritania in order to study, one year after the filling of the dam, the epidemiological situation of local malaria at a clinico-parasitological, immunological and entomological level. No malarial transmission was observed in the 5th month of the dry season. So far, the damming of water has not led to the spread of anophelines which would have brought about malarial transmission not within the rainy season. PMID- 3516424 TI - [A fatal case of chloroquine-resistant neuromalaria in a traveller to Cameroon]. AB - A death from chloroquinoresistant falciparum malaria contracted by a traveller under chloroquine chemoprophylaxis during a stay in the Cameroon provides the authors with an opportunity to analyze the extension of chloroquinoresistance in Africa. Having appeared there about 10 years ago, it remained for a long time localized in East Africa. In recent years, it has moved West. Today, 17 countries located from the North to the South between Sudan and Mozambique, and from East to West between Kenya and the Cameroon are affected, as are the Malagasy Republic, the Comores and Zanzibar. The strains resistant to chloroquine are still sensitive to amodiaquine. In certain regions which are widespread in the continent, resistance to pyrimethamine has become evident in the last 30 years; resistance to pyrimethamine-sulfadoxine and pyrimethamine-dapsone has appeared in the last 3 years in East Africa. In the light of the complexity of the problem of malaria chemoprophylaxis, the authors emphasize the necessity of resensitizing the public at large with respect to personal protection against biting anopheline mosquitos, especially during the hours of darkness. The medical profession should equally be made aware of these new problems. Three types of chemoprophylaxis in relation to the areas visited are proposed: the first for West Africa; the second for Central Africa, neighbouring regions and the Malagasy Republic and the Comores; the third for the 3 East Africa countries the most affected, which are Kenya, Burundi and Tanzania. PMID- 3516425 TI - [ELISA test in sero-epidemiologic studies of human malaria. Evaluation of an antigen prepared from erythrocytes of Saimiri sciureus experimentally infected with Plasmodium falciparum]. AB - A soluble antigen was prepared from squirrel monkeys (Saimiri sciureus) infected with blood-passaged Plasmodium falciparum, and evaluated in an enzyme-linked immunosorbent assay (ELISA) as a potent antigen for malaria diagnostic. The specificity, reproducibility and sensibility of the test showed the suitability of our antigenic preparation in detecting antibodies, IgG and IgM, in patients with P. falciparum infections. Thus, the Saimiri monkey represents an interesting alternative to the classicals sources of parasites from which P. falciparum antigens are commonly extracted (continuous culture and natural infections). PMID- 3516426 TI - [Amphizoic stage of free amoebae, myth or reality (could oxygen be the limiting factor?)]. AB - We did not succeed to show of true free living amoebic parasites in stools of 207 micromammals from Finistere area, while on the other side 17 stool cultures were positive. To explain this failure, we exposed A. culbertsoni to oxygen: the trophozoit stage offers astonishing resistance during 1 to 6 hours and under 1 to 36 ATA pressures. Thus the lack of intestinal amphizoic free living amoebae could be explained by their very high affinity for oxygen and their lack of growth in a medium without this gas. PMID- 3516427 TI - [Bancroftian filariasis in French Polynesia. Epidemiologic status and perspectives after a 35-year preventive campaign]. AB - The authors assess of three decades of struggle against Bancroftian filariasis in French Polynesia. Wuchereria bancrofti var. pacifica, aperiodic filaria, and Aedes polynesiensis, mosquito with high parasitologic output, set up a cycle very well adapted to the Polynesian environment; after numerous tests, the chemoprophylaxis with diethylcarbamazine (3 mg/kg/half-year) of all the exposed population has been decided, in association with methods of vector-control (use of predatory crustaceans). However, the achievement of this strategy is impeded by economical contingencies and the endemic comes up again particularly in areas close to eradication. Entomological clues show a high transmission over the greater part of French Polynesia. PMID- 3516428 TI - Lyme disease: a review. AB - Lyme disease has protean manifestations. The causative agent is Borrelia burgdorferi, a recently discovered spirochete. The disease has been found on three continents. The initial major clinical feature is a characteristic skin eruption known as erythema chronicum migrans. Subsequent main clinical manifestations are meningopolyneuritis and arthritis. However, clinical expressions of the disease vary widely. Some patients have very mild disease and others develop severe and prolonged illness. Specific laboratory tests for the detection of antibody to the organism are now available. The sensitivity of these tests approaches 100% when the sera are collected from patients having the later clinical manifestations. Penicillin and tetracycline are the therapeutic drugs of choice. PMID- 3516429 TI - High-performance liquid chromatographic procedures for the analysis of carboplatin in human plasma and urine. AB - Specific, sensitive and reproducible high-performance liquid chromatographic procedures were developed for the quantitative analysis of carboplatin in human plasma and urine. Plasma and urine were ultrafiltered with an Amicon Centrifree micropartition system, and samples were injected onto a LiChrosorb diol column. The mobile phase was CH3CN/H2O (92:8, v/v) for plasma and CH3CN/0.015% H3PO4 (89:11, v/v) for urine. The effluents were monitored at 229 nm. Carboplatin eluted by 10 min. The detector response was linear from 0.5 (plasma) or 5 (urine) to 500 micrograms/ml. The lower limit of quantification was 1.0 micrograms/ml plasma and 5.0 micrograms/ml urine. Constituents in plasma and urine, and possible degradation products (cyclobutane mono- and dicarboxylic acids) did not interfere. Within-day precision was less than 4% for plasma and 9% and 4% for urine concentrations of 40 and 401 micrograms/ml, respectively. Within-day accuracy was 96% or greater for both matrices. Carboplatin was not bound to the Centrifree membrane and recovery was 94% for plasma and 96% for urine. The storage stability of carboplatin in water, plasma, plasma ultrafiltrate, and urine and the extent of binding to human plasma proteins were evaluated. The percentage of carboplatin reversibly bound to plasma proteins was minimal (less than or equal to 10%) over a range of 1-50 micrograms/ml. In human plasma at 37 degrees C the drug was stable for about 2 h, but then degraded with a half-life of 32 h. Carboplatin had limited stability in water, plasma, and urine stored at 25 degrees C. Biological samples, therefore, should be stored frozen and analyzed within a week of collection to obtain valid results. PMID- 3516430 TI - Pharmacokinetics of high-dose intravenous melphalan in children and adults with forced diuresis. Report in 26 cases. AB - The pharmacokinetic parameters of the alkylating agent melphalan were determined in 15 children and 11 adults with advanced malignant solid tumors. High IV bolus doses of 140 mg/m2 were given under standard hyperhydration conditions and followed by autologous bone marrow grafting. In all cases the time-concentration curves could be best fitted to a biexponential pattern. A high scattering of drug concentrations was observed in our patients, the disposition half-lives ranging in the whole group from 17.8 to 71.2 min. The areas under the curves also showed a wide variation, ranging from 175 to 682 mg 1(-1) min-1. In all patients, melphalan levels in plasma were unmeasurable at 8 h or earlier, indicating that bone marrow can be safely reinfused at that time. No difference was apparent between children and adults regarding the drug pharmacokinetics. In each of 11 cerebrospinal fluid samples drawn 45-150 min after melphalan administration, drug levels were unmeasurable. PMID- 3516432 TI - Comparative mutagenicity of 4-(carbethoxynitrosamino)-4-(3-pyridyl)butanal and 4 (carbethoxynitrosamino)-1-(3-pyridyl)-1-butanone, model compounds for alpha hydroxylation of N'-nitrosonornicotine. AB - 4-(Carbethoxynitrosamino)-1-(3-pyridyl)butanal, a stable precursor to the putative diazohydroxide formed by 5'-hydroxylation of the tobacco-specific nitrosamine, N'-nitrosonornicotine, was synthesized in six steps from nicotinaldehyde. Its mutagenicity toward S. typhimurium was compared to that of 4 (carbethoxynitrosamino)-1-(3-pyridyl)-1-butanone, a precursor to the diazohydroxide formed by 2'-hydroxylation of N'-nitrosonornicotine. At equimolar doses, 4-(carbethoxynitrosamino)-1-(3-pyridyl)-1-butanone was a potent mutagen, but 4-(carbethoxynitrosamino)-1-(3-pyridyl)butanal was inactive toward strains TA 100 and TA 1535. The results of this study indicate that the putative diazohydroxide formed by 2'-hydroxylation of N'-nitrosonornicotine has higher inherent mutagenicity toward S. typhimurium than does the corresponding diazohydroxide formed by 5'-hydroxylation. PMID- 3516431 TI - A randomized trial of two regimens of cyclophosphamide, methotrexate, 5 fluorouracil, and prednisone in advanced breast cancer. AB - One-hundred evaluable patients with progressive advanced breast carcinoma untreated by cytotoxic chemotherapy but resistant to hormone therapy and irradiation were randomly allocated to receive either a combination of cyclophosphamide (600 mg/m2), methotrexate (40 mg/m2), 5-fluorouracil (600 mg/m2) IV every 3 weeks and prednisone 20 mg/m2 PO daily, with diminishing doses (intermittent group), or a combination of cyclophosphamide (100 mg/m2 PO on days 1-15, alternating with a 15-day rest period), methotrexate 20 mg/m2 IV, 5 fluorouracil 500 mg/m2 IV weekly for 20 weeks and prednisone 20 mg/m2 PO daily, with diminishing doses in the remission induction period, followed by a maintenance regimen of cyclophosphamide 100 mg/m2 PO on days 1-15, methotrexate 20 mg/m2 IV on days 1, 8 and 15, 5-fluorouracil 500 mg/m2 IV on days 1, 8, and 15, and prednisone 20 mg/m2 PO on days 1-15, with a 3-week rest period between the courses (intensive group). Entry was from 1 December 1982 to 30 November 1983. Objective responses were seen in 20/49 (41%) patients in the intermittent group and 34/51 (67%) in the intensive group (chi 2 = 6.72; P less than 0.01). The estimated median duration of response was 11 months in the intermittent group and 14 months in the intensive group. The estimated median survival was greater in the intensive group, but the difference was not statistically significant, although this parameter can be influenced with alternative additional chemotherapy. Toxicity was similar in both groups. These data suggest there are no therapeutic and survival advantages to the 3-weekly IV protocol compared with our previous regimen CMFP. PMID- 3516433 TI - Immunocytochemical localization of RasHa p21 in normal and neoplastic cells in fixed tissue sections from Harvey sarcoma virus-infected mice. AB - An affinity purified sheep IgG antibody to a 20 amino acid peptide from the carboxyterminal end of RasHa p21 was used to localize RasHa p21 on fixed tissue sections of Harvey sarcoma (HaSV) virus-infected mice by the avidin-biotin peroxidase immunocytochemical technique. Control sera included immune sheep sera absorbed with the peptide, preimmune sheep sera and a goat polyclonal antibody to Rauscher leukemia virus p30. Neonatal BALB/c mice were injected with HaSV/Moloney leukemia virus (MoLV), MoLV alone or buffer. Short-term fixation in Bouin's fixative was found to be the most effective method for demonstrating p21 in fixed tissue sections. RasHa p21 was found in 5-80% of the induced sarcoma cells, depending on the tissue fixative and antibody dilution. The antigen was localized to the cell membrane and in the cytoplasm. Tumors induced by NIH 3T3 cells transformed with cellular Ha-ras oncogenes had less than 1% immunoreactive tumor cells. Splenic erythroblasts in HaSV-induced erythroblastosis contained membrane antigen as did some reticular cells in lymph nodes draining the sarcomas. Normal tissues of virus-inoculated mice, uninoculated controls or fetuses and selected naturally occurring or induced liver tumors of mice, chemically induced skin tumors of mice, N-nitrosomethylurea-induced mammary tumors of rats, and naturally occurring tumors of F344/NCr rats did not contain immunoreactive p21. Thus, with the use of affinity purified IgG sheep polyclonal antibody to a peptide in RasHa p21, we were able to demonstrate RasHa p21 in tumors and other cells. The degree of immunoreactivity was related to the expected level of p21 expression. PMID- 3516434 TI - Effects of secondary biliary acids on the mutagenicity of N-methyl-N'-nitro-N nitrosoguanidine, 2-acetylaminofluorene and 2-nitrofluorene towards Salmonella typhimurium strains. AB - The two secondary biliary acids (lithocholic and deoxycholic acids) were co mutagenic when they were each co-incubated with dimethylhydrazine in the presence of Salmonella typhimurium TA 100. These observations were extended to other toxic chemicals, acting as direct (N-methyl-N'nitro-N-nitrosoguanidine and 2 nitrofluorene) or indirect (2-acetylaminofluorene) mutagens. Lithocholic and deoxycholic acids show a similar behavior towards genotoxic molecules. Nevertheless two differences must be noted. Lithocholic acid was the stronger co mutagen. When lithocholic acid inhibited mutagenic activity of 2-nitrofluorene, deoxycholic acid did not modify it. Interactions between the two secondary bile acids occurred so that the co-mutagenic activity of the mixture of these two bile acids depended on the ratio of their concentrations. Besides their cancer promoting effect, biliary acids also could have co-initiating effect that could depend upon the ratio of their concentration in the intestine. Calculating the ratio of fecal concentrations of deoxycholic/lithocholic acids thus could be a more sensitive index for cancer risk than simply measuring the fecal concentration of the two biliary acids taken separately. PMID- 3516435 TI - Ascorbate enhances u.v.-mutagenesis in E. coli but inhibits it in Chinese hamster cells. AB - Ascorbic acid (vitamin C) causes an increase in the mutation frequency of u.v. irradiated Escherichia coli WP2. The enhancement occurs at all u.v. fluences, and is dependent upon the ascorbate concentration in the medium. A maximum effect (approximately 8- to 13-fold) is seen at 100-150 micrograms/ml, although some enhancement can be seen even at 10 micrograms/ml. The comutagenic effect of ascorbate with u.v. in E. coli is dependent upon peptone, a constituent of nutrient broth. The enhancement of u.v.-mutagenesis by ascorbate is absent in strains WP2s (uvrA) and WP6 (polA), suggesting that ascorbate affects the repair of pyrimidine dimers. The opposite results are observed for u.v.-mutagenesis in Chinese hamster V79 cells. The presence of ascorbate (50 micrograms/ml) during u.v. irradiation does not enhance the u.v. effect, but rather decreases it approximately 30%. These results are discussed with regard to differences in the mechanism of u.v.-mutagenesis and DNA repair in bacterial and mammalian cells. PMID- 3516436 TI - Effect on cardiopulmonary changes of gram-negative endotoxemia in sheep after type-specific, cross-reactive, and nonspecific immune stimulation. AB - The purpose of this study was to examine the effects of prior nonspecific immune stimulation (BCG), cross-reactive immunization (E coli J5 0111 whole cells [J5 WC], and core glycolipid [J5 CGL]), and type-specific immunization (Serratia marcescens core glycolipid [SM CGL]) on the cardiopulmonary variables and white blood cell counts of awake, monitored sheep following IV Serratia marcescens endotoxin. Comparison of cardiac output, pulmonary artery pressure, pulmonary capillary wedge pressure, pulmonary vascular resistance, alveolar-arterial oxygen gradients, and total white blood cells lead us to conclude that type-specific immunization (SM CGL) most effectively ameliorates the changes of gram-negative endotoxemia contrasted to nonimmunization. Core glycolipid cross-reactive (J5 CGL) immunization was somewhat more effective than whole-cell cross-reactive (J5 WC) immunization in this regard. Nonspecific immune stimulation (BCG) was able only to significantly decrease the changes in pulmonary vascular resistance compared to nonimmunization. PMID- 3516437 TI - Effects of methylprednisolone upon vascular permeability changes in endotoxic shock. AB - This study was designed to examine glucocorticoid effects on increases in vascular permeability caused by endotoxic shock in dogs anesthetized with pentobarbital sodium (30 mg/kg). Methylprednisolone sodium succinate was administered IV in two doses (30 mg/kg each) before Escherichia coli endotoxin was administered (0.5 mg/kg). Samples of serum and lymph from the left thoracic duct were collected for measurement of total protein and separation by polyacrylamide gel electrophoresis. The same four protein electrophoretic fractions with molecular weights (M.W.) ranging from 60,000 to 1,000,000 were consistently chosen for analysis. Methylprednisolone treatment given prior to endotoxin administration resulted in an attenuation of the early increase in total protein flux and lymph to plasma protein (L/P) ratio and prevented significant increases in the permeability surface area product observed in the group given endotoxin alone. Endotoxin administration alone resulted in significant increases in the permeability-surface area product and L/P ratio for all four electrophoretic fractions. Pretreatment with glucocorticoid partially attenuated the increase in the L/P ratio for only those fractions of 100,000 M.W. or less. These results suggest MP provides partial but not complete protection from increases in vascular permeability during endotoxic shock. PMID- 3516438 TI - Histamine level changes in the plasma and tissues in hemorrhagic shock. AB - Histamine (H) levels have been reported during various types of shock, but there is a paucity of such data during hemorrhagic shock. The present study demonstrates a rapid, severalfold increase of radioenzymatically measured plasma H in conscious and anesthetized dogs subjected to experimental hemorrhagic shock. Shock was elicited by bleeding to a mean arterial blood pressure of 5.3 kPa, and maintained until 20% of the maximal bleeding volume (MBV) was taken back by the animal. The corresponding figures in the anesthetized group were 4 kPa and 30% uptake. The increased H level persisted in both groups during hypovolemia and remained above the control value following reinfusion. Survival was examined in the conscious group. At MBV, survivors had significantly higher H levels and H/norepinephrine and H/renin activity ratios in the plasma than nonsurvivors. The H level increased in the liver, lungs, spleen, left atrium and ventricle, and blood vessel walls (superior mesenteric artery, small jejunal arteries and veins, femoral artery and vein). The H/norepinephrine ratio increased in the left ventricle and blood vessel walls. The increase of H in the blood plasma and blood vessels during hemorrhagic shock may exemplify a counterregulation against excessive vasoconstriction and could be a positive factor in survival. PMID- 3516439 TI - Salutary effects of ATP-MgCl2 are not dependent on the presence of vanadium or the source of ATP. PMID- 3516440 TI - Regional blood flow during continuous low-dose endotoxin infusion. AB - Escherichia coli endotoxin (ET) was administered to adult rats by continuous IV infusion from a subcutaneously implanted osmotic pump (Alzet). Cardiac output and regional blood flow were determined by the radiolabeled microsphere method after 6 and 30 hr of ET or saline infusion. Cardiac output (CO) of ET rats was not different from time-matched controls, whereas arterial pressure was 13% lower after 30 hr of infusion. After both 6 and 30 hr of ET, pancreatic blood flow and percentage of cardiac output were lower than in controls. Estimated portal venous flow was decreased at each time point, and an increased hepatic arterial flow (significant after 30 hr) resulted in an unchanged total hepatic blood flow. Blood flow to most other tissues, including epididymal fat, muscle, kidneys, adrenals, and gastrointestinal tract, was similar between treatments. Maintenance of blood flow to metabolically important tissues indicates that the previously reported alterations in in vitro cellular metabolism are not due to tissue hypoperfusion. Earlier observations of in vitro myocardial dysfunction, coexistent with the significant impairment in pancreatic flow, raise the possibility that release of a myocardial depressant factor occurs not only in profound shock but also under less severe conditions of sepsis and endotoxemia. PMID- 3516441 TI - Metabolic effects of glucagon in endotoxemic minipigs. AB - A treatment group of four 50-80-kg Yucatan minipigs was fitted with jugular, portal, hepatic vein, and carotid artery catheters, and hepatic artery and portal vein flow cuffs to quantitate transhepatic kinetics of glucose, lactate, and insulin. Three days later, they were placed in slings, and a primed-continuous intravenous infusion of 3-tritiated glucose was initiated to monitor whole body glucose kinetics. Following a 3-hour control period, an intravenous infusion of E. coli endotoxin was administered at 15 micrograms/kg/hr for 6 hours. After 1 hour of endotoxin infusion, glucagon was administered as a primed (50 micrograms/kg)-continuous (50 micrograms/kg/hr) intravenous infusion for 5 hours. These results were compared statistically to a control group of eight minipigs given endotoxin only. Glucagon caused a transient (less than 1 hour) peak elevation of arterial glucose levels due to increased hepatic glycogenolysis immediately following initiation of the glucagon infusion. Despite enhanced extrahepatic (renal) gluconeogenesis, plasma glucose concentrations decreased to the hypoglycemic levels of the control group, as glucagon was unable to overcome the relative endotoxic inhibition of hepatic gluconeogenesis. Pancreatic output of insulin increased sixfold resulting in threefold increments in transhepatic uptake and arterial serum insulin levels. Arterial lactate and pyruvate concentrations were elevated due to increased peripheral production and hepatic output. Survivability in the treatment group (75%) improved over the control group (33%). PMID- 3516442 TI - Directory. The Shock Society. PMID- 3516443 TI - Replication of smooth muscle cells in vascular disease. AB - Smooth muscle proliferation has been recognized as central to the pathology of both major forms of vascular disease: atherosclerosis and hypertension. Recent advances in our knowledge of mechanisms of control of proliferation suggest that events occurring in adult animals may recapitulate portions of the developmental biology of the smooth muscle cell. This review attempts to consider the current state of knowledge of the mechanisms controlling smooth muscle proliferation in these two diseases, to put that knowledge into the context of what is known about smooth muscle biology, and to offer two hypotheses on the possible roles of smooth muscle developmental biology in manifestations of atherosclerosis and hypertension in adult humans. PMID- 3516444 TI - Endothelial cells express a spectrin-like cytoskeletal protein. AB - Vascular endothelium was investigated by indirect immunofluorescence and immunoautoradiography for the possible presence of spectrin-like molecules. Antibodies were raised against electrophoretically purified rat, rabbit, and bovine red blood cell spectrin and against rabbit brain fodrin. Antibody specificity was assessed by immunoblotting and double-diffusion technique. Homogenates of endothelial cells freshly isolated from heart microvasculature or aorta, as well as cultured aortic endothelial cells, were analyzed by gel electrophoresis. Immunoautoradiograms of gels incubated with spectrin specific antibody, followed by radio-labeled protein A, revealed two bands of electrophoretic mobility similar to that of the alpha- and beta-subunits of spectrin. Indirect immunofluorescence of endothelial cells, both in situ and in vitro, showed the existence of a protein which cross-reacted with the antibodies against spectrin and fodrin. Controls, in which endothelial cells were exposed to spectrin antibody absorbed with pure spectrin or preimmune serum, were negative. These findings indicate that endothelial cells express a protein antigenically related to the spectrin family; both spectrin- and fodrin-like molecules, in various proportions, may coexist. In the endothelial cell, these proteins may play an important role in modulation of the cytoskeleton in response to various stimuli, and in maintaining the biochemically differentiated microdomains of plasmalemma. PMID- 3516445 TI - H. Newell Martin and the isolated heart preparation: the link between the frog and open heart surgery. PMID- 3516446 TI - Pacing in perspective: concepts and controversies. PMID- 3516447 TI - A prospective evaluation of the Bjork-Shiley, Hancock, and Carpentier-Edwards heart valve prostheses. AB - From 1975 to 1979, 540 patients undergoing valve replacement were entered into a randomized trial and received either a Bjork-Shiley (273 patients) or a porcine heterograft prosthesis (initially a Hancock valve [107 patients] and later a Carpentier-Edwards prosthesis [160 patients]). Two hundred and sixty-two patients required mitral valve replacement, 210 required aortic valve replacement, 60 required mitral and aortic valve replacement, and eight also required associated tricuspid valve replacement (six mitral valve replacement; two mitral plus aortic valve replacement). Analysis of 34 preoperative and operative variables showed the treatment groups to be well randomized. In-hospital mortality was not significantly different among patients receiving the three prostheses for aortic valve replacement (7.6% overall) and mitral plus aortic valve replacement (10% overall), but there was a higher in-hospital mortality for patients undergoing mitral valve replacement with the Carpentier-Edwards prosthesis (15.5% compared with 8.8% overall; p = .03). This difference could not be explained on the basis of any preoperative or operative variable. Median follow-up was 5.6 (range 2.8 to 8.3) years. Actuarial survival after mitral valve replacement was 56.7 +/- 7.0% at 7 years, that after aortic valve replacement was 69.6 +/- 9.6% at 7 years, and that after mitral plus aortic valve replacement was 62.5 +/- 20.0% at 7 years. There was no significant difference in actuarial survival of patients receiving the three prostheses within the mitral, aortic, and mitral plus aortic valve replacement groups, nor was there a difference when these groups were amalgamated. Thirty-seven patients required reoperation for valve failure (15 with Bjork-Shiley, 12 with Hancock, and 10 with Carpentier-Edwards valves; p = NS) and 11 died at reoperation (four with Bjork-Shiley, four with Hancock, and three with Carpentier-Edwards valves; overall operative mortality 29.7%). Up to 7 years after surgery, there was no significant difference in the incidence of thromboembolism in patients with different prostheses undergoing mitral or aortic valve replacement. There were too few patients undergoing mitral plus aortic valve replacement for meaningful comparison. There was no significant beneficial effect of anticoagulants in patients undergoing mitral or aortic valve replacement with porcine prostheses, but patients were not randomly allocated to anticoagulant treatment. All patients with Bjork-Shiley prostheses received anticoagulants.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3516448 TI - A sensitive radioimmunoassay for human proinsulin, with sequential use of antisera to C-peptide and insulin. AB - In this assay for immunoreactive human proinsulin (IRPI), it first is separated from plasma by use of an antiserum to human C-peptide. An immunoprecipitate is then formed by using a precipitating antiserum and polyethylene glycol, after which IRPI is dissociated from the antiserum by incubation in warm HCl, pH 2.0. The resulting mixture is assayed for insulin immunoreactivity by a double antibody tracer-competition method involving incubation for four days with a high affinity anti-insulin antiserum. Human proinsulin of recombinant-DNA origin is used as the standard. Added C-peptide at supraphysiological concentrations did not interfere with or react in the assay. Human insulin cross reacted by 1.5%. The detection limit for IRPI (2 SD from zero-dose binding) is 3 pmol/L. Proinsulin conversion intermediates are measured nearly as well as intact proinsulin. IRPI concentrations in 10 nondiabetic human subjects averaged 12.0 (SEM 1.6) pmol/L. The ratio of proinsulin to immunoreactive insulin averaged 14.3 (SEM 2.2)%. After intravenous arginine, the increase in proinsulin was less than that of insulin, and it declined more slowly. PMID- 3516449 TI - Direct solid-phase chemiluminescence immunoassay for salivary progesterone. AB - A simple, direct chemiluminescence immunoassay for progesterone in mixed, unstimulated saliva is described. We use purified polyclonal anti-progesterone antibodies covalently coupled to polyacrylamide beads and progesterone-11 alpha hemisuccinyl-aminobutylethyl isoluminol as the chemiluminescent ligand marker. Bound and free ligand are separated by simple centrifugation. The detection limit of the assay is 1.5 pg per tube (38 pmol/L). Intra- and interassay coefficients of variation for low, medium, and high progesterone concentrations are 7.9, 6.8, 8.8% and 9.3, 6.9, 8.5%, respectively. Analytical recovery of added progesterone is 99.6%. Mean +/- SD progesterone concentrations (pmol/L) in saliva are 178 +/- 46 in the follicular phase, 313 +/- 90 in the periovulatory phase, and 658 +/- 166 in the luteal phase of the menstrual cycle. Correlation between progesterone concentrations in serum (assayed by RIA after extraction) and in saliva is good (r = 0.88, p less than 0.001, n = 96). The assay is simple, fast (4 h, including 1.5 h of incubation time), and reliable. PMID- 3516450 TI - Quantitative homogeneous enzyme immunoassays for amitriptyline, nortriptyline, imipramine, and desipramine. AB - We describe specific EMIT homogeneous enzyme immunoassays for amitriptyline, nortriptyline, imipramine, and desipramine in patients' serum samples. Before analysis, an easily performed extraction step involving the use of 500 microL of sample and a 1-mL disposable column eliminates cross-reacting polar metabolites. The range of the standard curve for the first three drugs is 25 to 250 micrograms/L, and for desipramine is 50 to 500 micrograms/L. Within-run and between-run CVs are less than 10% throughout the range of the assays. Results for patients' samples obtained by this method and by "high-performance" liquid chromatography compare well, showing a slope range of 0.94-1.04 and correlation coefficients ranging from 0.93 to 0.96, depending on the assay. PMID- 3516451 TI - Error in laboratory reference limits as shown in a collaborative quality assurance program. AB - Laboratories participate in collaborative quality-assurance programs to maintain and improve the quality of their diagnostic assays, but little attention has been paid to diagnostic quality in these programs. We used a national quality assurance program to assess the quality of laboratory reference intervals as exemplified by triiodothyronine, thyroxin, and thyrotropin immunoassays. The limits of the reference intervals used by laboratories bear virtually no relationship to laboratory bias, i.e., whether assays read "high" or "low." Further, correcting assay results from different laboratories for the reference limits used increases rather than decreases interlaboratory scatter. We conclude that the analytical quality of immunoassays now exceeds the quality of the reference limits supplied to clinicians to assist diagnosis, and that nationally or internationally defined reference limits would therefore provide more information at less cost than do individual laboratory reference limits. PMID- 3516452 TI - Various methods for determining urinary choriogonadotropin evaluated for the early diagnosis of ectopic pregnancy. AB - We evaluated the accuracy, sensitivity, specificity, and performance characteristics of seven methods for determining urinary choriogonadotropin in the early diagnosis of ectopic pregnancy in 46 patients with gynecological emergencies. The kits examined included immunoenzymometric assays (Tandem Icon hCG, Model Plus, Diapreg-25, Pregnastick, Nimbus) and reverse hemagglutination inhibition assays (NeoPregnosticon 75 Duoclon, Pregtest). We found immunoenzymometric assays to be the most sensitive procedures (lowest detection limits) for qualitatively detecting hCG secreted by ectopic pregnancy. We concluded that the Tandem Icon best meets our criteria and we advocate its use in the emergency room or ward as the first-line investigation of ectopic pregnancy. In addition, the use of Diapreg-25 has many theoretical advantages as an extremely sensitive index of choriogonadotropin status because of its ability to detect very low concentrations of beta subunit. PMID- 3516453 TI - Erythrocyte binding of theophylline, determined by the EMIT system. PMID- 3516454 TI - Comparison of Tonar II, pressure-flow, and listener judgments of hypernasality in the assessment of velopharyngeal function. AB - The purpose of the present investigation was to study the interrelationships among Tonar II, pressure-flow, and listener judgments of hypernasality in a consecutive series of patients. The subjects employed were 124 children and adults seen for evaluation at the University of North Carolina Oral-Facial and Communicative Disorders Program. The results indicated that nasalance scores and clinical ratings of hypernasality change systematically among patients as a function of their pressure-flow categorization. A discussion is presented concerning the impact that differential use of information from these assessment techniques can have upon patient management. PMID- 3516455 TI - Repair of alveolar cleft defects with autogenous bone grafting: periodontal evaluation. AB - Twenty-six patients with cleft lip and palate (18 with unilateral and eight with bilateral clefts) with 34 canines that had erupted through grafted alveolar cleft defects were studied to evaluate their periodontal status. The results were compared with 58 canines erupted through a normal alveolus in 29 noncleft control patients. The overall periodontal status revealed a higher plaque index in the patients with cleft compared to the orthodontic control patients, but parameters of gingival index, probing depth, and attachment loss had no significant differences between these groups. The cleft-associated canines had more than 90 percent of their possible clinical attachment levels intact at the examination. This indicated that grafting of these alveolar cleft defects resulted in a clinically satisfactory periodontium to support these canines as they erupted through the osseous grafts for periods of at least 2 to 8 years following surgery. PMID- 3516456 TI - Measurement of beta-2-microglobulin in serum and plasma by an enzyme-linked immunosorbent assay (ELISA). AB - A simple technique for the measurement of beta-2-microglobulin (beta 2M) in serum was developed. The method was designed as a sandwich technique using rabbit anti human antibodies, employing commercially available reagents in an enzyme linked immunosorbent assay (ELISA). The assay was of high specificity, sensitivity, accuracy and reproducibility. beta 2M in serum was strongly correlated with age (p less than 0.005), but independent of sex. Values in heparin and citrate plasma were significantly lower than in serum (p less than 0.001), whereas values in serum and EDTA plasma were similar. Release of beta 2M from normal blood cells was not observed in vitro before the test procedure. An excellent correlation between the results obtained in the ELISA and a RIA was demonstrated (rS = 0.99, p less than 0.0001). PMID- 3516457 TI - Patients with coeliac disease have a characteristic gliadin antibody pattern. AB - By use of an immunoblotting technique we have investigated the specificity of circulating IgG antibodies with respect to reactions with the alpha-, beta-, gamma- and omega-fractions of gliadin in patients with coeliac disease and in patients with diarrhoea of other causes. Untreated coeliac patients show a characteristic reactivity against polypeptides in the gamma-fraction, with an Mr of 35 and 45 kilodaltons, but only minor reactivity against the other fractions. One coeliac patient exclusively had antibodies to a 80 kilodalton component. Such a reaction pattern was not observed in other groups of patients with diarrhoea, as they had only weak reactions against the gamma-fraction but a stronger reaction against the other fractions. This might indicate that enterocytes of coeliac patients specifically take up distinct polypeptides of gamma-gliadin and by transcellular transport present them to immunocompetent cells. The results also suggest that there are distinct components of gliadin that provoke symptoms in different coeliac patients, indicating a heterogenecity of the disease. The study might lead to new diagnostic methods and to elucidation of the pathogenetic mechanisms behind coeliac disease. PMID- 3516458 TI - A turbidimetric immunochemical method for determination of serum beta 2 microglobulin using a centrifugal analyzer. AB - A turbidimetric immunochemical method has been developed for quantitation of serum-beta 2-microglobulin. The serum samples are pre-treated with polyethyleneglycol to decrease the background turbidity and a centrifugal analyzer is used for the absorbance measurements. The within-assay coefficient of variation was 4.6% when 58 serum samples with a mean value of 2.0 mg/l were analyzed in duplicate. The sensitivity of the method is below 0.5 mg/l. When serum samples were analyzed by both the turbidimetric method and a radioimmunoassay a correlation coefficient of 0.989 was obtained. The turbidimetric method is simple, cheap and has a high capacity which makes it suitable for routine determinations of serum beta 2-microglobulin in a clinical laboratory. PMID- 3516459 TI - Pulsatile pattern of thyrotropin-release in normal men. AB - To evaluate the existence of a pulsatile secretion pattern of thyrotropin (TSH) the 24 h release profile of the hormone was investigated in 7 healthy male subjects by taking blood via an indwelling venous catheter at 10-min intervals. Thyrotropin levels were analysed with high precision by a recently developed immunoradiometric assay (IRMA) able to distinguish euthroid and hyperthyroid TSH levels. Visual analysis (n = 10.4 peaks/24 h) and the computer assisted evaluation by the Santenprogramme (n = 9.9 peaks/24 h) as well as the Pulsar programme (n = 7.7 peaks/24 h) revealed an episodic release pattern with a low amplitude of pulses. These preliminary results are highly suggestive of a pulsatile TSH secretion similar to other pituitary hormones. PMID- 3516460 TI - Oncogenes. PMID- 3516461 TI - Development of a sensitive enzyme immunoassay for human epidermal growth factor (urogastrone). AB - A sensitive two-site enzyme immunoassay (EIA) for human epidermal growth factor (hEGF) was developed, based on the sandwiching of an antigen between anti-hEGF IgG-coated polystyrene beads and anti-hEGF Fab'-linked peroxidase complex (horseradish peroxidase, EC. 1.11.1.7). This method has four advantages: the anti hEGF Fab'-linked peroxidase complex is more stable than 125I-labelled antibody; the procedure is simple and rapid compared to bioassay; its discriminatory sensitivity is as low as 0.1 pg/assay tube; and serial dilution curves of unextracted human serum and urine samples all paralleled that of standard hEGF. The validity of the measurement of hEGF-like immunoreactivity in human serum and plasma is discussed. PMID- 3516462 TI - The design of phase III palliative chemotherapy trials in head and neck cancer. AB - This paper describes a series of 2447 patients with squamous carcinoma of the head and neck treated personally over 22 years; 276 patients with advanced untreatable disease and 498 with recurrent untreatable disease are analysed. The median survival for the first group was 13 weeks and for the second 11 weeks. The data fitted an exponential curve. Prognostic factors included general condition and N status for the first group, and site of the primary tumour, site of the recurrence and length of time to recurrence for the second group. However, these factors only explained 5% of the variance; the remaining 95% was unexplained, emphasizing the futility of stratification for prognostic factors, and the necessity for large trials. Using the above facts the number of patients required for a trial, and the length of the trial, can be worked out, and tables of these are given. PMID- 3516463 TI - Nasolabial cyst. AB - The nasolabial cyst is a rare lesion. Eight cases seen at the Birmingham and Midland ENT Hospital over 10 years were studied. Little diagnostic difficulty was encountered and all were successfully treated by surgical excision. A brief review of the literature is included. PMID- 3516465 TI - Precursor frequency of donor-specific lymphocytes recovered from canine lung transplants. AB - Dogs receiving left unilateral allo- or auto-grafts were treated with Cyclosporin A (Cy A) for 4 days. Thereafter allografted transplant recipients showed pulmonary pathology consistent with rejection. Blood and bronchoalveolar lavage (BAL)-derived lymphocytes were isolated from the recipient animals before and at various times after operation and the frequency of allospecific precursor cytolytic lymphocytes (pCTL) determined by limiting dilution analysis (LDA). Samples from the autografted control animal did not show any post-operative frequency changes; however, both blood and BAL-derived lymphocytes from allografted recipients showed a significant post-operative increase in the proportion of donor-specific pCTL. This increase was consistently greater in samples from the transplanted than the autochthonous lung. The frequency of pCTL determined using targets from an unrelated dog showed no post-operative increase. It is likely that the increase in frequency of donor-specific pCTL recorded during graft-rejection is a specific consequence of an interaction between the graft and recipient's immune system. PMID- 3516464 TI - Down-regulation of immune responses in the lower respiratory tract: the role of alveolar macrophages. PMID- 3516466 TI - Characterization of the humoral immune response in Plasmodium falciparum malaria. III. Factors influencing the coexpression of antibody isotypes (IgM and IgG-1 to 4). AB - Isotypes (IgM and IgG-1 to 4) of anti-P. falciparum antibodies were investigated in sera of malarial patients or immune donors by enzyme linked immunosorbent assay (ELISA) and two indirect immunofluorescence assays (IFAs), one staining intra-erythrocytic parasites of all stages and the other a restricted number of parasite antigens deposited in the membrane of infected erythrocytes by invading merozoites (Perlmann & Wahlgren, 1983; Perlmann et al., 1984, Wahlgren et al., 1985a). There was no correlation in overall antibody titres between the two IFAs. Antibodies of both IgM and all four IgG isotypes were detected in both assays. With the IFA for intracellular parasites a brilliant fluorescence was obtained with antibodies of all isotypes. However IgG-2 antibodies often gave staining restricted to the surface of schizonts. The incidence and reactivity in individual sera of antibodies of the different isotypes did not relate to the immune status of the donors (acute infection or clinically immune) but related well to the degree of malarial exposure as reflected by the overall antibody titres. This, in all three assays, high titred sera frequently contained antibodies of all isotypes while low titred sera usually only contained antibodies of IgM, IgG-1 and IgG-3 isotype. On average, the overall expression of antibodies of different isotypes in individual sera appears to reflect a sequential downstream (5' to 3') activation of the corresponding Igh-C genes in P. falciparum specific B-cell clones. PMID- 3516467 TI - IgA mesangial deposits in C3H/HeJ mice after oral immunization with ferritin or bovine serum albumin. AB - In order to study an experimental model of IgA nephropathy, C3H/HeJ mice which are high IgA responders were strongly immunized orally with ferritin and compared to syngeneic C3H/eB. C3H/HeJ exhibited a significant increase of total IgA level in the serum and of IgA deposits in the mesangium. However the low level of IgA antibody to ferritin detected in the serum and the unsuccessful search for ferritin and antibody to ferritin in the glomeruli suggest that strong oral immunization of C3H/HeJ mice leads to high level of non specific IgA in the serum and deposition of IgA in the kidney. PMID- 3516469 TI - Patterns of autoreactivity to collagen type II in autoimmune MRL/l mice. AB - The kinetics and mechanisms for secretion of antibodies against native and denatured collagen type II have been studied in spontaneously arthritic MRL/l mice. Circulating antibodies were quantified by an ELISA assay and frequencies of specific antibody secreting spleen cells by an ELISPOT assay. The degree of humoral immunity to collagen type II increased at late stages of the disease (6 months of age) whereas severe synovitis was seen earlier (5 months of age). Both the appearance of anti-collagen II producing cells and development of synovitis was preceded by and not correlated with a general state of polyclonal B cell activation. In MRL/l mice, collagen II specific antibodies appeared spontaneously and titres were largely unaffected by collagen II immunization. The levels of circulating anti-collagen II antibodies in MRL/l mice were lower, and the antibodies displayed lower avidities and different specificities as compared with the antibodies generated in collagen II high responder DBA/l mice after immunization with collagen II. It is suggested that the antibody response in MRL/l mice against collagen type II does not need MHC-restricted T cell help and that induction of antibody production to collagen II in MRL/l mice is triggered by joint cartilage destruction and subsequent collagen II release. PMID- 3516468 TI - Nuclear antigens recognized by antibodies present in liver disease sera. AB - Nuclear and nuclear matrix proteins of HeLa cells were separated by sodium dodecyl sulfate polyacrylamide gel electrophoresis, and subsequently transferred onto nitrocellulose. Antibodies present in sera of patients with primary biliary cirrhosis and autoimmune chronic active hepatitis reacted with some of the blotted proteins. The antibodies were mainly directed against chromatin associated proteins and protein constituents of discrete RNP particles. In addition, antibodies found in autoimmune liver disease sera detected a hitherto undescribed nuclear protein of 54 kD, and a nuclear matrix protein of approximately 150 kD. Antibodies recognizing a nuclear 25 kD doublet apparently constituted a marker antibody for autoimmune liver disease. Those directed at the 17 kD centromere protein were associated with the primary biliary cirrhosis related CREST syndrome, while those recognizing La antigen were related to cases of sicca syndrome associated with autoimmune liver diseases. PMID- 3516470 TI - Human monocyte modulation of endothelial cells and fibroblast growth: possible mechanism for fibrosis. AB - Several human diseases are characterized by vascular pathology, fibroblast activation, and excessive fibrosis (e.g., scleroderma, chronic graft versus host disease, pulmonary fibrosis). An intense inflammatory exudate of mononuclear cells which are derived from the peripheral blood precedes the vascular and fibrotic changes. We examined, in vitro, the effects of human peripheral blood mononuclear cell culture supernatants (PBM-SN) on the growth and survival of human endothelial cells (EC) and of human dermal fibroblasts (FB). The same PBM SN consistently induced inhibition of EC and stimulation of FB proliferation. PBM SN derived from 42 patients with scleroderma induced 32 +/- 5% (mean +/- SE) more inhibition of EC and 42 +/- 18% more stimulation of FB compared with PBM-SN derived from 30 healthy subjects. Depletion of phagocytic cells or adherent cells from PBM resulted in SN with no demonstrable activity on either EC or FB. Partial purification of PBM-SN on ion exchange and gel filtration chromatography revealed the presence of two fractions that stimulated and one fraction that inhibited FB proliferation, and two fractions that inhibited and one that stimulated EC proliferation. These data suggest that monocytes are capable of releasing mediators that stimulate or suppress EC or FB. However, when activated by surface adherence, resulting SN inhibit EC and stimulate FB proliferation. Serum is required for the expression of FB proliferation. PMID- 3516471 TI - Leu-M2 (Mac-120) is a platelet antigen and is not constitutively expressed by macrophages. AB - Leu-M2 (Mac-120) is a mouse anti-human monoclonal antibody that reacts with an antigen on the surface of most peripheral blood monocytes. The presence of Leu-M2 positivity has been associated with the capacity of monocytes to present antigen to T cells. We found that anti-Leu-M2 does not react with an intrinsic monocyte antigen but instead binds to platelets present on the surface of monocytes. Leu M2 staining is lost from monocytes after they are treated with calcium chelating agents which remove platelets bound to the monocyte surface. Staining for Leu-M2 can be reintroduced by incubating monocytes with autologous platelets. Human alveolar, peritoneal, and tissue macrophages and the U937 cell failed to stain for Leu-M2 antigen. Leu-M2 does not appear to represent either platelet glycoprotein IIb/IIIa or thrombospondin. Our study underscores the importance of carefully screening antimonocyte antibodies for their reactivity with platelets. PMID- 3516472 TI - Differential localization of ferritin and ferritin immune complexes in the spleen: influence of the charge of ferritin. AB - Prior studies have demonstrated that following administration to animals most antigens (Ag) localize within the red pulp whereas immune complexes (IC) are found in the white pulp. Using ferritin and ferritin IC, we describe a striking different localization of the Ag alone compared with the same AG complexed with its antibody. In addition, cationization of native ferritin (pI 4.5) to cationized ferritin (pI 7) decreases significantly the splenic uptake of the Ag but has no effect on the uptake of the respective ferritin IC by the white pulp. PMID- 3516473 TI - A reinforced composite resin fixed partial denture. PMID- 3516474 TI - Recurrent aphthous stomatitis. PMID- 3516475 TI - Reduction of urinary protein and prostaglandin E2 excretion in the nephrotic syndrome by non-steroidal anti-inflammatory drugs. AB - Seven salt depleted patients with the idiopathic nephrotic syndrome were treated with various non-steroidal anti-inflammatory drugs. Indomethacin, diclofenac sodium and flurbiprofen decreased proteinuria, glomerular filtration rate, plasma renin activity and renal prostaglandin E2 excretion by 59%, 19%, 55% and 68% respectively. Sulindac induced no major changes in proteinuria, glomerular filtration rate, plasma renin activity and renal prostaglandin E2 excretion. The relative change in proteinuria and glomerular filtration rate during non steroidal anti-inflammatory drug treatment correlated strongly with that of the renal prostaglandin E2 excretion (r = 0.89 and r = 0.70, respectively p less than 0.05). It is likely that the anti-proteinuric effect of non-steroidal anti inflammatory drugs is dependent on their potency to inhibit renal prostaglandin synthesis and it is suggested that this effect is mediated by lowering transcapillary glomerular hydraulic pressure. PMID- 3516476 TI - Uremic encephalopathy: an updating. AB - Uremic encephalopathy (UE) is a clinical syndrome, closely linked to the progression of renal failure. Many approaches can be utilized to diagnose it: EEG changes, somatosensory evoked potentials, choice reaction time test, cerebrospinal fluid (CSF) studies, brain computerized tomography, plasma and CSF amino acid concentration. On the basis of the data available at present, it is possible to postulate that UE could be caused by amino acid derangements (mainly glutamine, glycine, aromatic and branched-chain amino acids) and by the subsequent imbalance of neurotransmitters (mainly GABA, dopamine, serotonin). Disturbances of mental, neurologic, motor and hormonal functions could derive. PMID- 3516477 TI - Pantethine improves the lipid abnormalities of chronic hemodialysis patients: results of a multicenter clinical trial. AB - In the course of a post-marketing surveillance program on the effectiveness and tolerability of pantethine in the treatment of hyperlipidemia, the effects of the drug were explored in 31 patients with dyslipidemia undergoing chronic hemodialysis. The mean duration of treatment was 9 months (min. 7 months, max. 24 months), with oral doses of 600 to 1200 mg of pantethine daily (mean daily dosage 970 mg). Improvement was noted in terms of total blood cholesterol in the 7 patients with basal hypercholesterolemia (p less than 0.01) and highly significant reduction of serum triglycerides. No variations of HDL-cholesterol or total Apo-A were detected. None of the patients experienced any adverse effects from the treatment. In the light of extensive experience with the drug, plus the results of this study, the authors conclude by stressing the importance of an effective and readily tolerated product, such as pantethine, for the treatment of dyslipidemia in patients on chronic hemodialysis. PMID- 3516478 TI - No tissue level abnormality of vitamin A concentration despite elevated serum vitamin A of uremic patients. AB - In 57 patients with chronic renal failure (CRF) [44 patients on regular dialysis treatment (RDT), 33 renal transplant patients (RT) and 26 normal patients (NP)] and in a further 11 patients with CRF (8 patients on RDT and 17 patients without any renal disease in the post mortem) the vitamin A content of the serum obtained from the tissue of the liver, the stomach, the subcutaneous adipose tissue and the bone were analyzed. The vitamin A content of the serum was increased significantly for all groups of patients in comparison with the control group, but hypervitaminotic ranges were not reached in any case. The vitamin A content decreased depending on the time of dialysis treatment and the period after kidney transplantation. The retinol-binding protein accumulated even more than vitamin A in CRF and RDT. This statement is not in conformity with that of a hypervitaminosis A, of which normal respectively decreased RBP levels are characteristic. The serum prealbumin concentration was near the upper limit of the normal range in all groups of patients. The serum content of beta-carotene in patients with CRF and RDT was raised in comparison with NP and RT patients. As to the vitamin A content of the organs, a distinctive decrease appeared in the liver, so that a marginal supply must be assumed. In the stomach and the subcutaneous adipose tissue no changes, in comparison with the control patients, resulted. Due to renal insufficiency the results indicated an unphysiological situation in the vitamin A metabolism. Connections with disturbances of the fat household could not be set up.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3516479 TI - Glomerulonephritis in ankylosing spondylitis. AB - There have been a few reports suggesting the association between glomerulonephritis (GN) and ankylosing spondylitis (AS). The reported glomerulonephritides include IgA nephropathy, mesangial proliferative GN and membranous nephropathy. From January 1983, through December 1984, we observed 5 cases of GN among 116 cases of definite AS. Three of them were IgA nephropathy. The other two were mesangial proliferative GN, with IgM deposit in one case and isolated C3 deposit in another. Microscopic hematuria was observed in all of them. The renal function and 24-hour urine protein excretion were all within normal limits. Serum IgA level increased in all but the case of mesangial proliferative GN with IgM deposit. All except one had the antigen of HLA-B27. Serum IgA level was determined in 78 cases (86 estimations) of AS. The mean value was 399.6 +/- 15.0 mg/dl (mean +/- SE) (normal range: 100-350 mg/dl). Fifty-four of them (63%) had a value higher than 350 mg/dl. The interrelationship of AS and IgA nephropathy was discussed. PMID- 3516480 TI - Autonomic function in uremic patients treated by hemodialysis or CAPD and in transplant patients. AB - Tests of autonomic nerve function have been performed in patients receiving dialysis and following transplantation. These tests, consisting of blood pressure and heart rate response to standard stimuli were carried out in four groups of subjects: 10 patients were receiving continuous ambulatory peritoneal dialysis (CAPD), 12 hemodialysis, 11 had functioning transplants and there were 12 healthy subjects. The heart rate responses to the Valsalva maneuver, deep breathing and standing were equally reduced in the hemodialysis and CAPD patients while the responses in the transplant patients were not significantly different from those in the control subjects. Peroneal nerve conduction velocity was used to measure the degree of peripheral neuropathy and while in most patients there was a positive relationship with the autonomic studies, in five patients the results were clearly dissociated. Plasma parathyroid hormone (PTH) levels were elevated in both the dialysis groups but not in the transplanted patients and there was no correlation between the PTH levels and any of the neurological tests. This study has confirmed the presence of autonomic neuropathy in dialysed uremic patients and has demonstrated almost complete resolution of this following transplantation but has failed to show any benefit of CAPD over hemodialysis in protecting against neuropathy. PMID- 3516481 TI - The usefulness of micro- and macrochromatographic determinations of glycohemoglobin in diabetic patients with nephropathy. AB - Determination of glycohemoglobin in blood (HbA1) represents an established measure of glycemic control in diabetic patients. In patients with uremia, however, the determination can be subject to pitfalls which may limit its reliability. In order to evaluate the clinical usefulness of HbA1 determinations in diabetic patients with nephropathy, concentrations of HbA1 and its subfractions HbA1c and HbA1a+b were measured by micro- and macrocolumn chromatography in 58 diabetic and 80 non-diabetic patients with impaired renal function. Fifteen diabetic patients without nephropathy and 15 healthy subjects served as controls. The concentrations of HbA1 and its subfractions were significantly higher in non-diabetic patients with nephropathy than in healthy controls. A positive correlation was seen between HbA1 and plasma glucose concentrations in all subjects, and between HbA1 and serum urea and creatinine concentrations in the non-diabetic subjects. When measured repeatedly in the same patient there was a positive correlation between HbA1 and plasma glucose concentrations in diabetic patients with azotemia. There was no change in HbA1 concentrations measured immediately before and after hemo- or peritoneal dialysis. The increase of chromatographically determined HbA1 concentrations in azotemic patients is most likely due to the joint action of carbamylation of hemoglobin with urea derived cyanate and deterioration of glycemic control induced by azotemia. Despite these problems, chromatographically determined HbA1 is still a clinically useful measure of glycemic control in diabetic patients with nephropathy. This presumes repeated measurements in the same patient and the use of appropriate reference levels which consider the degree of renal impairment. PMID- 3516483 TI - Persistant hypokalemia due to bilateral fibromuscular dysplasia of the renal arteries. AB - Bilateral fibromuscular dysplasia of the renal arteries was the underlying pathology in a 51-year-old woman with severe hypokalemia and borderline hypertension. Very high renin levels were found in both renal veins. The secondary hyperaldosteronism was most probably responsible for the persistant hypokalemia in this patient. PMID- 3516482 TI - Disturbances of prostacyclin metabolism in children with hemolytic-uremic syndrome and in first degree relatives. AB - Plasma from 24 children with hemolytic uremic syndrome (HUS) (10 in acute, 14 in remission phase), 42 first degree relatives and 24 controls were studied for PGI2 supporting activity (PSA) from human umbilical arterial rings and the concentration of PGI2 metabolite (PGI2m). HUS patients in acute phase showed very low or absent level of plasma PSA, which remained depressed 3 months following presentation. Plasma from 2 out of 5 acute HUS patients showed inhibition against PGI2-like activity, and depressed preservation of PGI2 effect. The mean value of PGI2m in acute phase of HUS patients was elevated initially, but fell below control range by the day 14 and remained decreased at the end of 3rd month. Patients on long term remission showed a significantly lower concentration of plasma PGI2m. Eight of 14 HUS patients in remission and 18 of 42 family members had lower PSA levels than the controls. These studies confirmed a decreased PSA in HUS and suggest that persistently low PSA levels may reflect an inherited predisposition. PMID- 3516485 TI - Autologous bone marrow transplantation. PMID- 3516484 TI - Overview of the clinical relevance of autologous bone marrow transplantation. PMID- 3516486 TI - Clinical studies of ABMT in non-Hodgkin's lymphoma. PMID- 3516487 TI - Clinical studies of autologous bone marrow transplantation in Hodgkin's disease. AB - Approximately half of conventional-chemotherapy-resistant, far-advanced Hodgkin's disease patients can be placed into remission with existing intensive therapy regimens and ABMT; these results are similar to those noted in less-heavily pretreated non-Hodgkin's lymphoma patients. While a few of these end-stage patients have prolonged remissions, failure frequently occurs in a pattern that suggests the inadequacy of the intensive regimens rather than reinoculation of malignant cells in the marrow autograft. The use of additional local radiotherapy may be helpful in selected patients, and more effective regimens may be developed in the future. However, treatment of less advanced disease is primarily indicated. Due to previous treatment features, patients with advanced Hodgkin's disease may have more morbidity and mortality than a similar group of non Hodgkin's lymphoma patients. This problem can be minimized by better patient selection, earlier marrow storage and the avoidance of TBI-containing regimens in patients at high risk of interstitial pneumonitis. Routine marrow purging is unlikely to be required for Hodgkin's disease patients given ABMT. The use of intensive therapy and ABMT for the treatment of Hodgkin's disease is currently indicated most clearly for treatment of a patient in initial partial remission, early relapse from an initial chemotherapy-induced remission, or consolidation of a second remission reinduced by conventional therapy. PMID- 3516488 TI - Clinical studies of ABMT in acute myeloid leukaemia. PMID- 3516489 TI - Autologous bone marrow transplantation in paediatric solid tumours. AB - Massive therapy with ABMT is now an established treatment modality in paediatric oncology. The technical aspects and most treatment-related complications have been clarified and many phase II studies have shown encouraging results. In advanced neuroblastoma the poor outlook with conventional chemotherapy has stimulated extensive investigation of forms of massive therapy. Current results from several centres indicate that although the median survival is increased, long-term survival in an unselected group of stage IV patients is unlikely to exceed 30% with current regimens. In the future, management of this disease may involve the use of more intensive induction regimens to improve the quality of remission at the time of ABMT, which remains the single most important prognostic factor. Improved purging procedures involve the possible use of double massive therapy regimens and a combination of immunological and chemical treatments. In other paediatric tumours, the relative rarity and limited indications for ABMT make the evaluation of its role more difficult. Preliminary results in advanced rhabdomyosarcoma and Ewing's sarcoma are none the less encouraging and justify further investigation. The value of purging procedures remains controversial and their assessment has been hampered by the lack of sensitive clonogenic assays to detect residual tumour cells. However, neuroblastoma has provided a useful model for the investigation of physical, immunological and chemical procedures. Massive therapy is expensive, time consuming, and carries a high cost in patient morbidity and stress to the families involved. As with any new treatment, it must be adequately assessed in phase III, randomized studies. The ENSG and SIOP trials are a beginning and the future of massive therapy in the paediatric patient will, we hope, be based on a rigorous and scientific comparison with other treatment modalities. PMID- 3516491 TI - Autografting in chronic granulocytic leukaemia. PMID- 3516490 TI - The role of massive therapy with autologous bone marrow transplantation in Burkitt's lymphoma. AB - Burkitt's lymphoma has proved to be a very useful model for the evaluation of both massive therapy regimens and purging techniques. Results from several centres now confirm a number of general principles in relation to the use of ABMT procedures in this tumour. Patients in whom conventional chemotherapy has failed can be cured by massive therapy but this should be limited to those who have responded to salvage regimens or have only achieved first PR. Chemoresistant relapse is unlikely to be cured and the high probability of a transient response does not justify the procedure in such cases. Important ongoing clinical studies include the use of ABMT in first CR for CNS disease or B-cell ALL. Results in allogeneic grafts suggest that current massive therapy regimens are curative in only 20-50% of patients (Appelbaum and Thomas, 1983) and new combinations are, therefore, still required. Phase I and II studies in patients with 'resistant relapse' are investigating the use of sequential high-dose alkylating agents and role of TBI. It is of particular importance to develop effective conventional 'salvage' regimens. Recent experience indicates that the combination of high-dose cisplatin and VP 16 is useful; other possibilities include high-dose interferon and high-dose cytarabine. Purging techniques in BL are now at an advanced stage and the combination of immunological and chemical treatments, once of proven efficacy in individual patients at a laboratory level, should be the subject of randomized studies. PMID- 3516492 TI - The use of monoclonal antibodies for purging autologous bone marrow in the lymphoid malignancies. PMID- 3516493 TI - Current status of syngeneic marrow transplantation and its relevance to autografting. PMID- 3516494 TI - Cytotoxic activity of enriched large granular lymphocyte populations in rheumatoid arthritis. AB - Enriched large granular lymphocyte (LGL) populations and mononuclear cell populations from peripheral blood of rheumatoid arthritis (RA) patients and control individuals were compared for natural killer (NK) cell activity. The NK activity of the two study groups was very similar when mean values for both cell populations were analyzed. When comparing the difference between the NK activity of the mononuclear cell and LGL populations, 44% of the RA patients demonstrated less of an increase than all of the control individuals although the percentages of LGL, Leu 11+, and Leu 7+ cells were equivalent. PMID- 3516495 TI - Antianemic and potential anti-inflammatory activity of desferrioxamine: possible usefulness in rheumatoid arthritis. AB - In order to study the role of excessive synovial iron sequestration in the production of anemia in rheumatoid arthritis (RA), the antianemic efficacy and anti-inflammatory effect of desferrioxamine administered in a short-term treatment (14 days), were evaluated in 10 patients suffering from classic or definite RA and hyposideremic anemia. Treatment with desferrioxamine showed an elevated urinary iron excretion, a significant increase of serum iron, UIBC and hemoglobin, and a marked progressive decrease of serum ferritin. A moderate improvement of the pain intensity, morning stiffness and Ritchie's index was also observed. The results obtained suggest that excessive reticuloendothelial iron deposits occur in RA and that the iron uptake can be an important factor in the production of anemia. Desferrioxamine seems to be useful in the treatment of patients suffering from RA and anemia, in order to release iron from synovial tissue, reduce the inflammatory process and improve anemia, changing an anemia which is typically resistant to the martial therapy into an iron-sensitive anemia. PMID- 3516496 TI - Tiopronin-nephropathy: clinical, pathological, immunological and immunogenetic characteristics. AB - Nine patients who developed proteinuria while on Tiopronin (a D-Penicillamine like drug) have been studied. Nephrotic syndrome was observed in six cases. Immunologic analysis revealed a high frequency of ANA positivity and RF seronegativity by the time nephropathy appeared. Six patients were biopsied. Immunofluorescence, electron and light microscopy studies showed: glomerulonephritis with segmental deposits in the mesangium and along the capillary walls in one patient, mesangioprolipherative glomerulonephritis in one case and stage 1 membranous glomerulonephritis in four cases. Immunogenetic typing disclosed a strong association with B35-Cw4 class I antigens. PMID- 3516497 TI - Frequency of administration of short half-life nonsteroidal anti-inflammatory analgesics (NSAID's): studies with ibuprofen. PMID- 3516498 TI - Bone grafting of tibial defects in primary and revision total knee arthroplasty. AB - Bone grafting of tibial defects in primary and revision total knee arthroplasty is performed by at least two different methods, preferably with local autogeneic bone. Incorporation of the graft occurs between four and eight months. No restriction in weight-bearing is recommended, except with repair of large defects. Bone grafting is a viable alternative to using custom tibial prostheses or excess cement, even for very large defects. PMID- 3516499 TI - Bone graft for tibial defects in total knee arthroplasty. AB - Twenty-four knees with bone grafts for tibial defects at the time of either primary or revision total knee arthroplasty were followed for three to six years. With 22 of 24 bone grafts, union and revascularization were seen and no clinical collapse was present. In two, nonunion occurred, accompanied by collapse in one. Failure was attributed to varus alignment of the leg in one (a medial condylar graft) and to insufficient preparation of the bony bed in the second (bleeding bone was not exposed). Evidence for incorporation of the grafts was obtained by tomogram, bone scan, and bone biopsy. Incorporation was present by six months, but the time to complete remodeling was not determined. A bone graft is recommended for tibial defect involving 50% or more of the bony support of either tibial plateau. A bone graft is indicated whenever a cement column under the prosthesis would measure more than 5 mm in height. PMID- 3516500 TI - Gentamicin-PMMA beads. Pharmacokinetic and nephrotoxicological study. AB - Five patients treated with gentamicin-polymethylmethacrylate (PMMA) beads were monitored during the treatment of nine to 14 days. Kinetic data of the gentamicin delivery were gathered constantly by multiple samples of blood and urine. The treatment with 48-360 beads caused a gentamicin serum concentration of 0.03-0.4 micrograms/ml and a renal excretion rate of 3-40 micrograms/min. The total amount of gentamicin excreted after the whole treatment was 20%-70%, with an in vivo half-life of 5.7-10 days. The gentamicin appeared to be released constantly during the entire treatment (nine to 14 days); the beads are kinetically slow release carriers. Despite precise measurement of tubular and glomerular renal function, no nephrotoxicity could be demonstrated. This local antibiotic gentamicin therapy may use the blood bone barrier effectively as a protection of the body against a very high local gentamicin concentration. PMID- 3516501 TI - Quantitative comparisons of healing in cranial fresh autografts, frozen autografts and processed autografts, and allografts in canine skull defects. AB - Adult dog skull defects larger than 17 mm do not spontaneously heal. A quest for a potentially viable, cosmetically, mechanically, and technically acceptable template for human cranial reconstruction prompted a comparison of processed autogeneic and allogeneic bone implants with a fresh autograft control in the dog. Quantitative reproducible observations demonstrated that fresh calvarial bone autografts were superior to the nonviable implants in volume percent defect filled, mm2 new cortical bone, mm2 new and old cortical bone, and cortical bone porosity. Frozen autografts achieved 75%, antigen-extracted, autolyzed, partially demineralized auto- and allografts, 50% of the overall efficiency of fresh autografts. Fresh cancellous bone added to allografts did not improve long-term repair. Remodeling of all grafts appeared consistent with osteoconductive invasion by peripheral host endosteal and diploic elements; host external periosteum and dura contributed less. Central osteoinductive recruitment of mesenchymal cells from muscle or dura seemed not to occur in the adult dog. Partially demineralized dog calvarial grafts were resorbed without acting as a template for new bone formation. Surface demineralization, antigen extraction, and autolytic digestion of autografts and allografts, with or without fresh iliac bone, did not improve calvarial bone regeneration in adult dogs. PMID- 3516502 TI - The classic. Polycentric knee arthroplasty. Prosthetic simulation of normal knee movement. By Frank Gunston. 1971. PMID- 3516503 TI - Technical considerations in total knee arthroplasty. AB - Results with total knee arthroplasty as published in this issue show few mechanical failures in knees correctly aligned. If the principles of technique are respected, the narrow limits for margin of error can be met. To provide optimal results, the following measures are recommended. The tibia should be cut no more than 5 mm from the medial subchondral bone, if the posterior cruciate ligament is sacrificed, and between 5 mm and 8 mm, if the posterior cruciate is saved. Fill a defect as necessary with bone graft. The tibia should be cut 90 degrees to its axis in the medial-lateral plane and with 5 degrees posterior tilt. Maintain the anterior-posterior height of the femur to ensure flexion stability. Use the distal femur as the "adjustment cut" even if the joint line is elevated. If the posterior cruciate ligament tension is tight, lengthen the ligament or convert to a sacrificing design. Deformity should be corrected with soft tissue release and not angular bone cuts. The patella cut should be performed so that the result is a symmetrical patella that is not increased from its anatomic height. If these principles are followed, the instrumentation use and order of osteotomy of the distal femur or tibia do not matter. PMID- 3516504 TI - [A case of van Buchem's disease with multiple cranial neuropathy]. PMID- 3516505 TI - Prominent confluence of the straight and transverse sinuses. A potential pitfall in the interpretation of tomographic brain scans. PMID- 3516506 TI - The efficacy of computer-assisted instruction (CAI) in an outpatient pediatrics clinic. AB - This prospective study was done to measure the effectiveness of a CAI program in teaching outpatient pediatrics to third-year medical students, as measured by their scores on the mandatory pediatrics examination taken at the end of their pediatrics rotation. A significant difference was found between the number of students receiving Honors vs. Satisfactory scores on their examinations between those who worked at our hospital before vs. after the CAI program became available; there was also a statistically significant difference between the number of students who received Honors on their pediatrics examinations when comparing the Harborview-after-computer group to the Other-locations-after computer group. Such a CAI program appears to be an effective learning aid for medical students doing their outpatient pediatrics rotations. It affords information about costs to the patient, is omnipresent and is an effective alternative to either lecture or reading as a method of learning. PMID- 3516507 TI - Salivary gland disease in children: a review. Part 1: Acquired non-neoplastic disease. AB - The early recognition of salivary gland disease depends upon a high index of suspicion by the clinician. A systematic approach to salivary gland disease in children is presented by a group of algorithms, which is supplemented by a discussion of the historical, physical, and diagnostic test findings characteristic of salivary gland pathology. Therapeutic alternatives are discussed for both neoplastic and non-neoplastic disorders. PMID- 3516508 TI - Salmonella enteritidis. A rare cause of pyelonephritis in children. AB - A previously healthy 2.5-year-old boy developed symptoms of acute pyelonephritis following an acute gastroenteritis. The patient received parenteral ampicillin and gentamicin for 72 hours and then ampicillin for an additional 11 days when the original urine and stool cultures grew Salmonella enteritidis, sensitive to ampicillin. The patient responded very well to treatment, but B-mode renal ultrasonogram revealed a left hydronephrosis and megaureter suggestive of longstanding obstruction of the ureterovesicular junction, later confirmed by other diagnostic studies and by surgical exploration and repair. Salmonella infection has been rarely documented to cause pyelonephritis in children. Obstructive uropathy appears to be a predisposing factor for this unusual complication of Salmonella enteritis. PMID- 3516509 TI - Phenylpropanolamine OROS (Acutrim) vs. placebo in combination with caloric restriction and physician-managed behavior modification. AB - We added phenylpropanolamine OROS (Acutrim; Ciba-Geigy Corp.) or placebo to a physician-managed behavior modification, mild caloric restriction, and exercise weight control program. One hundred six healthy, overweight (115% to 130% ideal body weight) women participated in this 14-week double-blind clinical trial. On average, the participants who took Acutrim lost significantly more weight (X +/- SE; 6.1 +/- 0.6 kg; 8.0% +/- 0.8%) than did those taking placebo (4.3 +/- 0.7 kg; 5.5% +/- 0.8%; P less than 0.05). Those taking Actrim continued to lose weight over the Christmas holiday, while the placebo group gained weight. Fifteen participants taking placebo withdrew, three because of adverse drug reactions (ADRs). Thirteen of 53 participants in the Acutrim group left the study, two because of ADRs. Dry mouth was the most frequent complaint from participants taking Acutrim. No serious cardiovascular effects occurred. Both complaints and the number of participants reporting ADRs decreased with continued dosing. We conclude that Acutrim is a safe, modestly effective adjunct to a physician managed, integrated weight control program. PMID- 3516510 TI - Diphenhydramine and the calcium carbimide-ethanol reaction: a placebo-controlled clinical study. AB - The effect of diphenhydramine on the cyanamide-ethanol reaction was evaluated in a double-blind, controlled clinical study. Seven healthy subjects ingested 50 mg calcium carbimide at 4 hours and 100 mg diphenhydramine or placebo at 2 hours before a 0.2 gm/kg iv infusion of ethanol. Blood acetaldehyde and blood ethanol analyses were performed together with recordings of blood pressure, pulse rate, and flushing intensity during the hour after ethanol infusion. Diphenhydramine increased the mean ethanol AUC but did not influence blood acetaldehyde levels. Antihistamine reduced the flushing response by 40% and decreased the pulse rate from 40 minutes onward after ethanol infusion subsequent to calcium carbamide dosing. Blood pressure was not significantly influenced by ethanol at the calcium carbimide dose we used. PMID- 3516511 TI - Comparison of the effects of muzolimine and a fixed combination of diuretics in essential hypertension. AB - The efficacy and tolerance of the loop diuretic muzolimine were compared with those of a fixed combination of hydrochlorothiazide and amiloride in patients with mild to moderate hypertension. After a placebo lead-in period, patients whose supine diastolic blood pressure was between 90 and 115 mm Hg were randomly allocated either to muzolimine, 20 mg/day, or to hydrochlorothiazide, 50 mg/day, and amiloride, 5 mg/day. The mean duration of follow-up was 4.7 months in both groups. Both muzolimine and the combination significantly decreased the mean blood pressure. The two treatments were similar in efficacy. The incidence of side effects during the trial was similar with both treatments, and no serious adverse reactions occurred. Eleven subjects in the muzolimine group were entered into an open long-term study. In all these subjects the blood pressure remained adequately controlled throughout the 4 to 6 months of additional follow-up and no side effects were reported. Muzolimine appears to be an effective and safe antihypertensive agent. PMID- 3516512 TI - Single and repeated dosing of the converting enzyme inhibitor perindopril to normal subjects. AB - The new orally active angiotensin converting enzyme (ACE) inhibitor perindopril (S9490-3) was evaluated in 18 normotensive men. In three subjects the pressor response to exogenous angiotensin I was tested. A 8 mg oral dose reduced the pressor response by greater than 80%. Single oral perindopril doses of 2, 4, 8, and 16 mg were given to groups of five subjects each. Eight and 16 mg decreased plasma ACE activity within 4 hours to less than 10% of control; 72 hours later, plasma ACE activity was still reduced by at least 40%. Doses of 4 and 8 mg po once a day were then given for 8 days to two groups of six subjects. Four hours after the first and the last morning doses, plasma angiotensin II, aldosterone, and plasma ACE activity fell significantly, whereas blood angiotensin I and plasma renin activity rose. There was no evidence of drug accumulation. No significant change in blood pressure or heart rate was observed. Thus in normotensive subjects, perindopril seems an effective, orally active, long lasting ACE inhibitor. PMID- 3516513 TI - Use of the automatic interaction detector method to identify patient characteristics related to methotrexate clearance. AB - Systemic methotrexate (MTX) clearance was determined in 108 children who received 15 courses of MTX, 1000 mg/m2 iv over 24 hours, as a component of therapy for acute lymphocytic leukemia. The median MTX clearance was used as the representative value for each patient, and these values ranged from 44.7 to 132.1 ml/min/m2 (X = 78.4 ml/min/m2). The automatic interaction detector approach was used to determine the patient characteristics that correlated with MTX clearance. Characteristics examined were sex, age, estimated creatinine clearance, SGPT, and body surface area. The initial splits were based on creatinine clearance, and mean MTX clearances in three subgroups (50 to 100, 100 to 150, and greater than 150 ml/min/m2) were 73.1, 78.3, and 90.5 ml/min/m2, respectively. For patients with the slowest creatinine clearance, abnormal SGPT concentrations (greater than 35 IU/L) were associated with slower MTX clearance (77.6 vs. 67.8 ml/min/m2). In the latter subgroup, boys had faster clearance than girls (77.4 vs. 60.9 ml/min/m2). These results demonstrate that for children with normal serum creatinine concentrations, interpatient variability in MTX clearance can partly be explained by measures of renal and hepatic function, which indicates that the observed variability in MTX clearance is not totally random. PMID- 3516514 TI - Comparison of biochemical markers between benign and malignant ovarian cysts. AB - To investigate the presumption that earlier diagnosis of ovarian tumors might lead to an improved outcome, we compared several substances in the fluid of benign and malignant ovarian cysts. Our results showed the following: (1) benign cysts were readily separated from malignant cysts on the basis of total lactate dehydrogenase (LD) activity and except for mucinous cysts, by their isoenzyme patterns. (2) Preoperative serum total LD activity and LD isoenzymes were of no diagnostic help in predicting the malignant tumors. (3) Carcinoembryonic antigen (CEA) levels usually differed greatly between benign and malignant cysts, although the benign mucinous cysts had CEA levels indistinguishable from malignant cysts. (4) Prominent quantitative differences between Roche and Abbott CEA activity were present in both benign and malignant cysts. (5) Preoperative serum CEA levels were not helpful in differentiating the benign from the malignant cysts. PMID- 3516515 TI - Skin and soft-tissue coverage--retrospective. AB - The transfer of autogenous tissues in man has its origins in antiquity. Movement of composite tissues using pedicle techniques, which assured that such tissues were never deprived of vital blood supply, preceded free grafting. The ultimate refinement of carrying pedicles was reached in the vascularized island pedicle flap, which carried composite tissues solely on an intact vascular leash. An enormous increase in the versatility of composite transfers occurred when microvascular surgery made transfer with immediate vascularization a reliable procedure. This opened the door to free functioning muscle and musculocutaneous transfers with motor reinnervation at the recipient site--the supreme tissue transfers. PMID- 3516516 TI - Flexor tendon surgery--today and looking ahead. AB - The biology, management, and results of primary repair and secondary reconstruction are reviewed. Repair of the tendon sheath and controlled mobilization appear to improve the results of both groups. PMID- 3516517 TI - Peripheral nerve surgery--retrospective and contemporary techniques. AB - The best technique for repairing peripheral nerves is the one that yields the best results with the greatest consistency. Because each repair has different anatomic and physical circumstances associated with it, the best approach is probably the one that best fulfills the needs of a given situation and this must be individualized from one situation to the next. PMID- 3516518 TI - Bone and joint surgery--looking ahead. AB - Looking ahead, one envisions an era of remarkable progress in the study of the healing of bone and cartilage. The physical, biochemical, and biomechanical factors governing bone and cartilage healing will be defined and manipulated to accelerate the healing process. Joint stiffness, the undesirable sequela of many simple fractures of the hand as a result of prolonged immobilization, will be obviated. For cases of limited joint damage, techniques for joint reconstruction will be refined. For non-salvageable bone and joint destruction, microvascular allogenic transplantation of skeletal units will become a reality. Silastic implants in the wrist will become historical oddities. PMID- 3516519 TI - Hand rehabilitation--retrospective. AB - From the exercise principles of Galen through the compassionate practices of Canute and the leadership of Tissot, Dunton, Bunnell, Brand, and Hunter, hand rehabilitation has grown. Surgeons, nurses, physical therapists, and occupational therapists now work together for a common goal--to restore the patient with the injured hand to the greatest possible productivity in the shortest period of time. PMID- 3516520 TI - Microsurgery--retrospective. AB - The author recalls his early experiences in the experimental development of microsurgical replantation and transplantation. The operating microscope and an unlimited supply of microsutures have made possible the development of clinical microsurgery. PMID- 3516521 TI - A comparison of the uptake of human and porcine insulins given intraperitoneally to patients with diabetes mellitus on continuous ambulatory peritoneal dialysis. AB - Intraperitoneal absorption of human insulin (crb) and porcine insulin was examined in 9 diabetic patients with renal failure, and on Continuous Ambulatory Peritoneal Dialysis (CAPD). Serial blood sampling was performed to determine the characteristics of insulin absorption and glycaemic control. Four patients received successive equal doses of human and porcine insulins, 2 received different doses and 3 received human insulin only. Glycaemic control was similar after both insulins. Mean insulin levels were consistently higher after human insulin with significant differences at 90, 300 and 360 min. It is concluded that, if required, patients may be transferred from i.p. purified porcine to i.p. human insulin without a change in insulin dose. PMID- 3516522 TI - Fasting plasma insulin. A risk factor for abnormal electrocardiogram in Maltese residents of Australia. AB - Analysis of atherogenic risk factors in 493 Maltese-born residents of Melbourne showed that after adjustment for the effects of age, fasting plasma insulin was the only factor with a highly significant (p = less than 0.001) association with electrocardiogram abnormalities suggestive of atherosclerotic coronary artery disease. Absence of peripheral arterial pulses was not correlated with abnormal electrocardiogram but was significantly associated with both age and smoking. Elevation of plasma insulin appears to be a significant risk factor for atherosclerotic heart disease. PMID- 3516523 TI - [Problems in fatal incidents using contrast media after computed tomography]. AB - Referring to literature and our own cases (140.048 CT investigations--37% of them after intravenous application of contrast media) the possibility of decrease in consequence of contrast application is discussed. PMID- 3516524 TI - [Abdominal abscess--diagnostic progress via sonography and computed tomography]. AB - Remarkable progress in the detection of abdominal abscesses has been achieved in the course of the last few years by sonography and by computed tomography. Successful detection of abscesses depends to a major extent on sufficient knowledge about their formation and spread, especially under postoperative conditions. These problems are, therefore, dealt with first, Typical examples of sonographic and CT findings are then described and discussed. PMID- 3516525 TI - [Sonography of 2 unusual extramedullary plasmacytomas]. AB - The author describes two unusual extramedullary plasmacytomas. In the first patient, a 48-year old man, a mass was found sonographically in a retroperitoneal space. A discontinuity of the left iliac bone bordering on the tumour was prominent. Two years earlier, an epidural plasmacytoma had been removed. Subsequently, multiple osteolysis also developed in the left iliac bone. It was concluded that after destruction of the compact bone the plasmacytoma had infiltrated directly into the retroperitoneal space. An excretion of light chains of the kappa type was found in the urine. Six months after the tumour in the left iliac fossa had been confirmed, a second mass was seen in the abdomen. The patient died a few days later. Autopsy revealed plasmocytic infiltration of the retroperitoneal lymph nodes. In the second case, a man of 29 years of age, multiple tumours developed in the skin after removal of a meningeal plasmacytoma. Two months later, a recurrent intracranial tumour and a tumour in the left sinus maxillaris were found. Sonography of the "skin tumours" revealed intramuscular location and a cyst-like aspect; their consistency, however, was considerably increased. Histologically, plasmacytoma was present. Paraproteinaemia IgA of the kappa type was found. No lesions of the bone were seen. 11 months after the diagnosis of an intracranial tumour the patient died from local recurrence of the disease. PMID- 3516526 TI - [Arterial digital subtraction angiography in the diagnosis of venous sinus thrombosis]. AB - The transarterial digital subtraction angiography (DSA) examination of 4 patients studied for cerebral sinus venous thrombosis of the intracranial venous structures was reviewed to determine the reliability and adequacy of visualization of the venous drainage of the brain. In addition, 4 patients were specifically evaluated with DSA for venous sinus thrombosis of the intracranial veins and sinuses. Conditions studies included: Compression, or occlusion of the venous structures. Transarterial DSA is usually sufficient to replace conventional angiography in the evaluation of the cerebral sinus venous thrombosis (SVT). PMID- 3516527 TI - Computed tomographic and ultrasound appearances of a solitary intrahepatic choledochal cyst. AB - A pregnant patient presenting with acute abdominal pain was found to have an intrahepatic mass, the features of which, on computed tomography and ultrasound examination, suggested a solid lesion. At surgery this proved to be a solitary intrahepatic choledochal cyst (Todani Type 5) with areas of malignant degeneration. PMID- 3516528 TI - Influence of exogenous vasopressin on baroreflex mechanisms. PMID- 3516529 TI - Glucose homoeostasis in chronic liver disease. PMID- 3516530 TI - Chemiluminescence immunoassay: an overview. PMID- 3516531 TI - A comparison of the relative effectiveness of three transplant preservation fluids upon the integrity and function of rabbit proximal convoluted tubules perfused in vitro. AB - Rabbits were anaesthetized and kidneys removed directly with no flush (group NF), or alternatively kidneys were flushed (group F) with sodium phosphate buffered 140 mmol/l sucrose (PBsuc 140), Collins C2 (C2) or Euro-Collins (EC) transplant preservation solutions and stored at 4 degrees C for 0-4, 24 or 48 h. Mid cortical proximal convoluted tubule (PCT) segments were dissected from all groups and set up for microperfusion in vitro. Observations were made of tubule morphology, fluid reabsorption rate (Jv), bath leak of the glomerular marker iothalamate and transmural potential difference (p.d.), both at 37 degrees C and at 15-20 degrees C, in order to compare the relative effectiveness of the solutions in the preservation of tubule integrity and immediate function. Tubules from kidneys flushed with EC and C2 contained luminal debris and frequently had high bath leaks of iothalamate, both indicative of poor preservation of tubule integrity. In contrast, tubules from NF kidneys and PBsuc 140-flushed kidneys were free of luminal debris with a lower incidence of high iothalamate leaks. Tubules from PBsuc 140-flushed and EC-flushed kidneys after 0-4 and 24 h storage had Jv that were similar to those of NF kidneys. Tubules from all groups of flushed kidneys after 48 h cold storage and all tubules from C2-flushed kidneys showed reduced Jv values. In all cases Jv was reduced to approximately zero when the temperature was lowered to 15-20 degrees C. Transmural p.d. was similar in all groups except for particularly low p.d. values observed in tubules from C2 flushed kidneys after 48 h storage. These observations suggest that PBsuc 140 is more effective in the preservation of tubule function during prolonged cold storage than the glucose-based Collins solutions. The marked difference in the effectiveness of C2 and EC contraindicates the inclusion of magnesium (present in C2) for preservation of kidneys, as judged by experiments on the rabbit. PMID- 3516532 TI - Effects of verapamil alone and with captopril on blood pressure and bilateral renal function in Goldblatt hypertensive rats. AB - The effects of verapamil infusion alone and superimposed with captopril on arterial pressure and bilateral renal function were evaluated in 21 two-kidney, one-clip Goldblatt hypertensive rats and in 13 control rats. Verapamil significantly decreased arterial pressure of both hypertensive and control rats. Addition of captopril further reduced arterial pressure in hypertensive rats only. There were significant increases in glomerular filtration rate (GFR), urine flow and absolute and fractional excretory rates of sodium and potassium in the non-clipped kidney. In contrast, these renal indices decreased in the clipped kidney. Superimposed captopril during verapamil infusion did not significantly change function of the non-clipped kidney but further depressed function of the clipped kidney. In control rats, no significant change in GFR occurred in response to drugs. Renal excretion of water and sodium, but not potassium, increased after verapamil. However, the diuresis and natriuresis were less pronounced than those seen in the non-clipped kidney of hypertensive rats. There was a proportionate increase in osmolar clearance and free water reabsorption rate in the non-clipped kidney and the normal kidney. The linear relationship did not change after verapamil infusion. The results suggest that verapamil enhances the excretory function of the non-clipped kidney of Goldblatt hypertensive rats via increased GFR and decreased tubular reabsorption in the proximal and/or distal tubules despite its hypotensive action. PMID- 3516533 TI - Renal prostaglandins in cirrhosis of the liver. AB - Urinary prostaglandin excretion was studied in 42 patients with liver cirrhosis and in nine control subjects on restricted sodium intake and on bed rest. Creatinine clearance (CCr), sodium excretion (UNaV), plasma renin activity (PRA) and plasma aldosterone were also evaluated. Patients without ascites and ascitic patients without renal failure showed increased urinary excretion of immunoreactive 6-ketoprostaglandin F1 alpha (i6-keto-PGF1 alpha), prostaglandin E2 (iPGE2) and thromboxane B2 (iTXB2) when compared with controls, while immunoreactive PGF2a (iPGF2 alpha) levels did not differ from those in the control group. Patients with functional renal failure (FRF) presented a significant reduction of vasodilator prostaglandins but urinary excretion of iTXB2 was higher than in controls. On the whole, cirrhotic patients with higher urinary excretion of prostaglandins had normal or nearly normal PRA and aldosterone levels. i6-keto-PGF1 alpha and iPGE2 inversely correlated with PRA and aldosterone. The relationship between i6-ketoPGF alpha alpha and CCr was found to be highly significant in cirrhotic patients but not in the control group. On the other hand, iPGE2 significantly correlated with UNaV and with the fractional excretion of sodium (FENa). We concluded that: (a) enhanced renal prostaglandin synthesis in cirrhosis, inversely related to PRA and aldosterone, may be dependent on volume status; and (b) preserved renal function in these patients is associated with the ability to synthesize prostacyclin and PGE2. PMID- 3516534 TI - Effects of sulindac on renal function and prostaglandin synthesis in patients with moderate chronic renal insufficiency. AB - The renal effects of therapeutic doses of sulindac were studied in nine patients with stable renal insufficiency, mean creatinine clearance 37.0 +/- 2.2 ml min-1 1.73 m-2 (range 24.7-54.6 ml min-1 1.73 m-2). Nine days' treatment with sulindac produced a small, but significant, reduction in the mean creatinine clearance (37.0 +/- 2.2 to 34.7 +/- 2.2 ml min-1 1.73 m-2; P less than 0.02) and 99mTc diethylenetriaminepenta-acetate (DTPA) clearance (35.5 +/- 3.4 to 31.4 +/- 3.6 ml min-1 1.73 m-2; P less than 0.02) without altering body weight, effective renal plasma flow [131I]hippuran clearance), plasma renin activity (PRA), 24 h urinary volume or electrolyte excretion. After discontinuation of sulindac, creatinine clearance returned to pretreatment values. In five female patients, pretreatment urinary excretion of the 6-ketoprostaglandin F1 alpha (6-keto-PGF1 alpha), a stable breakdown product of prostacyclin (PGI2), was significantly reduced (P less than 0.02) when compared with four healthy controls, whereas prostaglandin E2 (PGE2) was unchanged. Administration of sulindac did not significantly alter the excretion rate of PGE2 or 6-ketoPGF1 alpha in this group of patients. In chronic renal disease with moderate renal impairment, reduced renal prostacyclin synthesis may be an important predisposing factor to the renal toxicity associated with the use of non-steroidal anti-inflammatory drugs (NSAID). Short term use of sulindac in therapeutic doses does not appear to influence the excretion of prostaglandins and produces only a minor reversible change in renal function; used cautiously it may have advantages over other NSAID in these patients. PMID- 3516535 TI - Dopamine blockade and natriuresis during water immersion in normal man. AB - Natriuresis was studied during water immersion in eight normal subjects either in the absence or in the presence of dopamine blockade by domperidone. Creatinine clearance showed no significant changes; urine flow remained significantly above control values during water immersion, implying persistent suppression of antidiuretic hormone. The marked natriuresis seen during water immersion alone was significantly blunted (P less than 0.05) but not abolished during water immersion plus domperidone. Suppression of the renin-aldosterone system by water immersion alone was not significantly different from that obtained during water immersion plus dopamine blockade. On the contrary, plasma prolactin levels, previously suppressed during water immersion alone, were significantly stimulated during water immersion plus domperidone, thus indirectly suggesting a role of dopamine in mediating the blunted natriuresis seen during water immersion. PMID- 3516536 TI - Colorado Medical Society. Physician's directory 1985-1986. PMID- 3516537 TI - [Drugs active on mucus in the primary treatment of chronic bronchitis. Controlled study of the activity of letosteine]. PMID- 3516538 TI - [Unwanted collateral effects of diuretics]. PMID- 3516539 TI - [The physician and language disorders]. PMID- 3516540 TI - [Response to exertion after treatment with captopril in hypertensive patients with cardiac insufficiency of a mild degree]. PMID- 3516541 TI - [The control of bronchial secretions in chronic hypersecretory bronchopneumopathies: the role of letosteine]. PMID- 3516542 TI - [Controlled clinical trial of flunitrazepam versus nitrazepam]. PMID- 3516543 TI - [Role of lipemia-lowering agents in the secondary prevention of myocardial infarct]. PMID- 3516544 TI - [Clinical and hemodynamic effects of captopril in patients with arterial hypertension and obliterative arteriopathy of the legs]. PMID- 3516545 TI - Effect of Medicare/Medicaid reimbursement policies on diagnostic methodology in the physician's office. AB - The Deficit Reduction Act of 1984 has mandated the most significant change in Medicare payment for clinical laboratory testing services since the program's inception in 1965. The reasonable charge methodology previously used for determining payment for laboratory services under Medicare Part B has been replaced with a fee schedule applicable to laboratory services provided in physician's offices, independent laboratories, and hospital outpatient laboratories. Physicians are now prohibited from billing Medicare or Medicare patients for outside laboratory tests, including professional interpretation of these outside laboratory results. The new regulations appear to provide strong incentives for office-based laboratory testing, and the development of more sophisticated laboratory technology has allowed office labs to perform accurate and reliable analyses at realistic costs that are the equivalent of the services of independent laboratories. The exemption of physicians' office laboratories from licensure requirements has generated controversy among pathologists' groups and laboratory administrators. PMID- 3516546 TI - Clinical considerations in the diagnosis of viral respiratory infections. AB - Recent advances are allowing the transfer of sensitive and precise rapid viral antigen detection technology from sophisticated research laboratories to standardly equipped clinical diagnostic facilities. It is now possible to identify many viral respiratory pathogens directly from clinical specimens in less than 1 hr. Rapid antigen detection promises to be of the most value in the identification of respiratory viruses 1) for which antiviral therapy is available, 2) which can be prevented by employing isolation precautions, chemoprophylaxis, and/or immunization, 3) whose presence usually is associated with acute respiratory disease, not just asymptomatic colonization, and 4) which ordinarily are not associated with concomitant bacterial infection, and thus, whose early detection may allow withholding or withdrawing antibiotics. Based on these considerations, the relative usefulness of rapid viral antigen detection of commonly encountered respiratory pathogens will be discussed. In addition, the role of rapid viral detection in diagnosis of respiratory infections in high risk versus otherwise healthy individuals will be explored. PMID- 3516547 TI - Diagnosis of group A beta-hemolytic streptococcal pharyngitis. Use of antigen detection tests. AB - Early diagnosis and prompt initiation of antibiotic therapy for group A beta hemolytic streptococcal pharyngitis can shorten the duration of the clinical illness and reduce the period of infectivity. This in turn may expedite a patient's return to school or day care, as well as a parent's return to work. Antigen detection tests are available that can provide a rapid diagnosis of group A beta-hemolytic streptococcal pharyngitis and can facilitate the prompt initiation of antibiotic therapy. In addition, these antigen detection tests can provide a rapid exclusion of group A beta-hemolytic streptococcal pharyngitis and thereby prevent the initiation of unnecessary antibiotics in patients with nonstreptococcal pharyngitis. However, before throat cultures on blood agar plates are totally abandoned and completely replaced by antigen detection tests, a number of additional studies are needed. The consequences of false-negative and false-positive antigen detection tests need to be determined. The accuracy of the antigen detection test as performed in physicians' offices needs to be compared with traditional culture methods performed in physicians' offices and not with an "idealized" standard. Finally, investigations need to be initiated to determine the impact of different antigen detection tests on the revenues and work flow in various practice settings, as well as their direct impact on patient care. PMID- 3516548 TI - Considerations in the laboratory diagnosis of antibiotic-associated gastroenteritis. AB - Clostridium difficile has been shown to be the major cause of antibiotic associated gastroenteritis in both humans and experimental animals. During the past few years an increasing number of laboratories have attempted to detect, isolate, and identify this organism and its toxin from clinical samples. Direct visualization of C. difficile in patient specimens using immunofluorescent microscopy has been proposed. The major disadvantage of this method was its lack of specificity due to crossreaction with other clostridial species. Attempts to absorb the antisera with crossreacting strains also failed. Laboratory diagnosis of C. difficile in clinical specimens has relied on either culture using one or more selective media or on the detection of specific cytotoxin in stool filtrates. Until recently the cytotoxicity assay was the only procedure available for the routine detection of cytotoxin and, as a result, has limited this test to laboratories with access to tissue culture facilities. As a result, there has been much interest in the development of immunochemical methods for the detection of C. difficile toxins. We originally reported on the detection of C. difficile toxin in stool filtrates using counterimmunoelectrophoresis. We examined 140 fecal specimens submitted for C. difficile toxin assay by counterimmunoelectrophoresis, using both unabsorbed and absorbed antitoxin, tissue culture, and bacterial culture. Using tissue culture assay as the reference method, the sensitivity of counterimmunoelectrophoresis and counterimmunoelectrophoresis-absorbed was 100% and the specificity 63.0% and 77.5%, respectively. Enzyme immunosorbent assays for the detection of toxin A from C. difficile have also been reported, however, at the present time they do not appear to be as sensitive as the cytotoxicity assay for toxin B (cytotoxin).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3516549 TI - Identification of enteric pathogens in the small and large intestine of children with diarrhea. AB - Enteric pathogens were identified in children with diarrhea from duodenal specimens obtained with a string capsule and from fecal specimens. Rotavirus was identified in stools of 43 of 100 children, and was recovered from the small intestine from nine (21%) children who were excreting this virus. Shigella was isolated from stools from 22, Salmonella from 17, enterotoxigenic Escherichia coli from eight, and Aeromonas hydrophila from one of 100 children with diarrhea. In contrast to rotavirus, Salmonella, Shigella, enterotoxigenic Escherichia coli, and A. hydrophila were not isolated from the small intestine. Nonenterotoxigenic Aeromonas species were recovered from the small intestine, but not the stool of five children. These children were also infected with Shigella or with rotavirus; this suggests that Aeromonas was not the cause of their diarrhea. None of 51 Escherichia coli isolated with the string capsules, or 67 isolated from stool that agglutinated in commercial enteropathogenic Escherichia coli antisera were of classical enteropathogenic Escherichia coli serotypes. One hundred and five of these 118 Escherichia coli did not hybridize with a deoxyribonucleic acid probe for plasmid mediated factors conferring adherence to HeLa cells. Examination of specimens collected with a string capsule from children with diarrhea did not identify any more enteric pathogens than examining stools. Furthermore testing Escherichia coli for agglutination in commercial enteropathogenic Escherichia coli antisera did not identify Escherichia coli of enteropathogenic serotypes. PMID- 3516550 TI - Adaptation of a commercially available indirect fluorescent antibody slide test for measuring measles-specific immunoglobulins. AB - A commercially available indirect fluorescent antibody (IFA) test was evaluated for the determination of measles-specific immunoglobulins G and M (MIgG, MIgM). The IFA test detected fourfold rises of MIgG in 34 of 35 (97%) cases of measles confirmed by complement fixation or hemagglutination inhibition. In determining immune status, MIgG-IFA correlated with hemagglutination inhibition in 22 of 23 (96%) cases. The IFA test detected MIgM in only 11 of 34 acute-phase sera collected within 5 days of the reported onset of rash and in the convalescent specimens of another 13 of the 35 specimens. The IFA test is an effective method for the conventional diagnosis of measles and for determining immune status. This IFA test has a limited role as a rapid diagnostic test for measles when used to detect measles-specific MIgM in acute-phase sera obtained from patients with suspected measles. PMID- 3516551 TI - Penicillin tolerant group A streptococci. AB - A penicillin (PCN) tolerant [minimal inhibitory concentration (MIC) less than or equal to 0.02, minimal bactericidal concentration (MBC) = 3.10 micrograms/ml] group A streptococcus (GAS) was recovered from the bone aspirate of a child with osteomyelitis. The penicillin therapy with 200,000 micron/kg X day, and subsequently ampicillin 360 mg/kg X day, resulting in a serum ampicillin concentration of 74 micrograms/ml, failed to achieve a serum bactericidal effect greater than 1:2. Ninety-nine additional isolates of GAS obtained from 99 infants and children with pharyngitis were randomly selected for study. Organisms were screened for tolerance by macrobroth dilution determination at 0.05 and 1.0 microgram/ml of penicillin. Twenty-two of 100 organisms had MICs = 0.05 microgram/ml and MBCs = 1.0 microgram/ml; further tests were performed on these organisms. Twenty of the 22 strains (20% of all GAS) grown in Mueller-Hinton broth with 2% sheep blood were tolerant to penicillin at 24 hr, with MICs less than or equal to 0.02 and MBCs = 0.39 microgram/ml. When retested at 48 hr the MBCs of the 20 tolerant strains had decreased: three strains by twofold, three strains by fourfold, four strains by eightfold, one strain by 16-fold, and nine strains by 40-fold or greater. Seven strains were not tolerant after 48 hr of incubation. The detection of tolerance was media dependent; only nine strains were tolerant when grown in Todd-Hewitt broth. Tolerance to GAS was more frequent than generally suspected. The phenomenon of tolerance, and potentially delayed killing may alter prophylaxis and therapy of GAS disease and merits further investigation. PMID- 3516552 TI - Practical modification of conventional blood culture systems for recovery of mycobacteria. AB - Supplementation of tryptic soy broth and Columbia broth with OADC Enrichment improved the growth rate of Mycobacterium avium-intracellulare. This simple procedure could permit laboratories to isolate mycobacteria from blood specimens without the use of special culturing techniques. PMID- 3516553 TI - Tetanus. AB - Tetanus is produced by the action of the potent neurotoxin, tetanospasmin, which is elaborated during the growth of Clostridium tetani. The objectives of management of tetanus are to provide supportive care until the tetanospasmin that is fixed in tissue has been metabolized, to neutralize circulating toxin, and to remove the source of tetanospasmin. This disease, which is frequently fatal, is prevented by immunization. PMID- 3516554 TI - Reporting radiographic methods in dental epidemiologic and experimental studies. AB - A number of technical and methodologic factors govern the quality of the radiographic image. The purpose of the present paper is to analyze the attention paid to these factors in epidemiologic studies and clinical trials. The description of radiographic methods in a sample of scientific reports was reviewed. It is concluded that the descriptions are generally sparse. They seem to be of an erratic character, and the data described are not selected according to their significance. Factors governing object coverage, image density and contrast, image geometry, and readability are discussed in relation to the descriptions analyzed. Recommendations for relevant and informative descriptions enabling the reader to evaluate and control the results of an investigation are presented. PMID- 3516555 TI - Medical officers of health and health services. PMID- 3516556 TI - From first aid to paramedical: ambulance officers in the health division of labour. PMID- 3516557 TI - Evaluation of a new classification system for anemias using Consult Learning System. AB - Since the advent of electronic particle counting, anemias have customarily been classified by evaluating cell size (MCV) and hemoglobin content (MCH). Recently a new parameter estimating red cell size heterogeneity (the 'red cell distribution width' or 'RDW') has been introduced. We have evaluated a proposed classification of anemias based upon this new parameter in a large group of hospitalized patients utilizing an expert system based upon statistical pattern recognition and compared our results to other studies. The potential advantages of using such a system over currently existing uni-dimensional classification systems to evaluate clinical problems are discussed. PMID- 3516558 TI - Critiquing the process of radiologic differential diagnosis. AB - ICON is a developmental expert system designed to critique the process of radiologic differential diagnosis. To use ICON, a physician outlines (1) findings observed in a chest radiograph, (2) a small amount of clinical information describing the patient, and (3) a proposed diagnosis. ICON critiques the appropriateness of that diagnosis in detail, analyzing why and how well the findings serve to confirm it, or to rule it out. ICON may also suggest further information to look for. ICON explores the design issues involved in critiquing the process of differential diagnosis, and is currently implemented in a limited domain: the radiographic diagnosis of a lung mass in a patient with Hodgkin's disease. PMID- 3516559 TI - A program for training and feedback about probability estimation for physicians. AB - Medical decisions are rarely made under conditions of complete certainty. In the past decade there has been a rapid growth of interest in formal methods for optimizing medical decisions under uncertainty. Application of decision-analytic methods requires physicians to make probability estimates about clinical events for which extensive data are not available. This paper describes a computer program to train physicians to be better probability estimators: to make probability estimates that are numerically meaningful for use in formal decision analyses. It is designed to be a stand-alone application requiring about 2 hours of physician time. Use requires an IBM-PC or compatible microcomputer with graphics adaptor and monitor, and 8087 coprocessor. PMID- 3516560 TI - The evaluation of artificial intelligence systems in medicine. AB - This paper discusses the underlying issues in the evaluation of computer systems which apply artificial intelligence in medicine. Three different levels of evaluation are described: the subjective evaluation of the research contribution of a developmental prototype, the validation of a system's knowledge and performance, and the evaluation of the clinical efficacy of an operational system. The paper outlines a number of evaluation issues at each level, and discusses how previous artificial intelligence in medicine evaluations fit into this framework. PMID- 3516561 TI - Interactive instruction in the radiographic anatomy of the chest. AB - An instructional program has been developed which is designed to instruct medical students in a systematic approach to the reading of the chest radiograph. A videodisc player is used to display a radiograph on a video monitor and computer graphics are superimposed over this image. Another feature is the use of a mouse pointer as an input device to identify structures on the radiograph. The instructional approach is based upon the drill and practice method. All questions and responses are created by the computer through the program's database manipulation. PMID- 3516562 TI - Development of electrocardiographic teaching materials using an MC68000-based, interactive graphics microcomputer. AB - Interactive computer-graphics methods of computer-aided design (CAD) have been applied to problems in physical science and industry for several years; however, at the present time CAD methods have not been widely used to solve similar problems in medical education. Electrocardiogram waveform fabrication for the production of teaching materials seemed to be a well-defined area for CAD application. The availability of inexpensive, 16/32 bit word, MC68000-based microcomputers (e.g. Apple, Macintosh) and interactive graphics software (e.g. MacPaint and MacDraw) seemed to provide the necessary tools to make this application. This paper describes the authors' initial experience (from June 1984 to March 1985) in developing and employing an interactive computer graphics routine to produce ECG teaching materials. PMID- 3516563 TI - Pulmonary diseases in the neonate: a computer-assisted instruction. AB - This project consists of an interactive audiovisual learning program in respiratory disease in premature and term infants. It is directed towards the primary care physicians to help increase their knowledge base of neonatal pulmonary diseases. This program will teach common respiratory diseases seen in the sick newborn infant by way of interactive computer-assisted programs interfaced to a video display terminal showing such things as x-rays, laboratory findings and physical signs. The need for this type of program is shown by the increased population of infants born at high risk for respiratory diseases, as well as the centralization of high risk newborn care at the tertiary center, leaving many physicians without the experience or skill to stabilize and manage premature and term infants with respiratory problems. It is hypothesized that this method of instruction will be effective because of its accessibility and practicability. PMID- 3516564 TI - ["Anonymous thought" by Nightingale]. PMID- 3516565 TI - Restoration of severe tooth wear and an uneven occlusal plane using removable partial dentures. PMID- 3516566 TI - Hardening of the hearteries. PMID- 3516567 TI - Syncope and other vasovagal reactions at interval insertion of Lippes Loop D--who is most vulnerable? AB - Syncope and other vasovagal reactions occasionally occur at or immediately after IUD insertion. This analysis, using an international data set comprised of interval insertions of Lippes Loop D, found that women who are primiparous (as compared to those who are multiparous), and/or those who want more children are at higher risk for vasovagal reactions and deserve more careful counseling and gentler cervical manipulation. Moderate to severe pelvic pain at insertion is closely associated with the development of vasovagal reaction. Measures to alleviate or prevent pain at insertion could reduce the incidence of vasovagal reactions. PMID- 3516568 TI - Peter Olafson 1897-1985. PMID- 3516569 TI - Definition of diabetes mellitus. AB - The nomenclature of human diabetes mellitus (DM) has been revised, and this classification has been accepted throughout the medical world and literature. The major categories of diabetes are: insulin-dependent DM, type I or IDDM; noninsulin-dependent DM, type II or NIDDM; secondary DM or type S; impaired glucose tolerance, IGT; gestational diabetes; and previous abnormality of glucose tolerance, PrevAGT. A review of the literature has shown that over half of the documented diabetic dogs, with a single medical diagnosis, appear to be type I, IDDM, with a substantial proportion being type S, and the remainder being type II, NIDDM. Obesity is frequently associated with IGT and NIDDM. Diabetic cats most commonly have pancreatic islet destruction associated with pancreatic amyloidosis; they are insulin deficient, IDDM. The commonest causes of secondary diabetes in dogs are pancreatic damage, hyperadrenocorticism and hypersomatotropism secondary to persistent progesterone influence. Progestogen therapy is the most frequently reported cause of secondary diabetes in cats. Diabetes in horses is type S, usually secondary to a functional pituitary tumor but occasionally following chronic pancreatitis. The blood glucose ranges for normal, IGT and diabetic animals, and the normal serum insulin values of various species is tabulated. PMID- 3516570 TI - Molecular biology of parathyroid hormone. AB - The entire biosynthetic pathway of PTH has been elucidated from the determination of the chromosomal location to the eventual secretion of the hormone from the cell. The human gene is present on the short arm of chromosome 11, and restriction site polymorphisms near the gene have been detected. The PTH genes and cDNAs have been isolated and characterized in the bovine, human, and rat species. The gene contains two introns, which are in the same position in each species, and dissect the gene into 3 exons that code, respectively, for the 5' untranslated region, the signal peptide, and PTH plus the 3' untranslated region. The mRNAs are about twice as long as necessary to code for preProPTH and contain a 7-methylquanosine cap at the 5' terminus and polyadenylic acid at the 3' terminus. The 5' termini of the bovine and human mRNAs are heterogeneous at the 5' terminus, the basis of which is two TATA sequences in the 5' flanking regions of the gene. In contrast, the rat gene contains a single TATA sequence and the mRNA has a single 5' terminus. The initial translational product of the mRNA is preProPTH, and the pre-peptide of 25 amino acids is equivalent to signal peptides of other secreted and membrane proteins. The genes of the three species are very homologous in the region that codes for preProPTH. Substantial homology is also retained in the gene flanking regions, introns, and mRNA untranslated regions. Silent sites are also conserved more than would be expected, particularly between the human and bovine sequences. The bovine and human sequences are more closely related than the rat is to either the human or bovine. These studies of the basic molecular biology of PTH will provide the framework for future analysis of significant biological and medical questions. In vitro mutagenesis techniques should soon provide information about the elements of the gene involved in regulating transcription and about functional elements of the signal peptide. Eventually, signals involved in directing the ProPTH molecule to secretory granules as well as the biologically active regions of PTH, itself, will be examined by these methods. The molecular biological studies, combined with the development of dispersed cell cultures, provide the opportunity to study the effects of chronic changes in calcium on gene transcription and mRNA metabolism. The restriction site polymorphisms associated with the human PTH gene will allow a search for correlations between PTH gene structure and parathyroid disease.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3516571 TI - Mechanics of lung fluid balance. AB - Recent research in pulmonary physiology, anatomy, and mechanics have clarified our general understanding of liquid and solute transport through the lung. Fluid crosses the microvascular endothelial membrane at a rate that depends on gradients in the transmembrane hydrostatic and osmotic pressures and the conductance of the permeable membrane. Under normal conditions, the filtered fluid is removed by an efficient lymphatic pump. Edema accumulates in the lung when an increased flux due to an elevated vascular pressure or to a more permeable membrane is not matched by an adequate lymph clearance rate. Initially a favorable hydrostatic pressure gradient drives the excess fluid into interstitial spaces surrounding large blood vessels and airways away from filtration sites near capillaries and thereby ensures efficient gas exchange. Further edema formation reduces the pressure gradient, eventually leading to the flooding of alveolar air spaces and impaired gas exchange. I will focus on the role of the above forces in the regulation of extravascular lung water. It will become clear that many details of the general scheme are not known, and our conceptual understanding of the relevant mechanisms involved is often rudimentary and incomplete. Some of the more important questions pertain to the interstitial pressure around capillaries, the resistance and compliance of the interstitial matrix, and the role of the lymphatics in regulating interstitial fluid volume and interstitial pressure. PMID- 3516572 TI - Safety considerations in clinical engineering. AB - Clinical engineering is a professional specialty which emerged in the 1960s primarily in response to concern about the hazard of electrocution in hospitals. It has already developed to encompass a much broader range of topics affecting the safe and effective use of technology in health care. However, safety remains as one major focus of clinical engineering. In this paper, issues arising in relation to electrical safety and treated in considerable detail. The next major safety area of concern involves medical gases. This area is newer and, consequently, the issues are less well resolved and therefore it is treated in less detail. Other safety issues, which are numerous, await review at some time in the future. PMID- 3516573 TI - Theory and cardiac applications of electrical impedance measurements. AB - The methodology of the two-electrode, four-electrode, and guard-ring techniques is presented following a brief history of impedance plethysmography. The theoretical basis for predicting the sampling fields for conductivity and volume changes is presented. Theoretical and experimental studies of the sampling field associated with various electrode arrays are reviewed. With this background, the use of impedance plethysmography for cardiac monitoring and diagnosis is reviewed. The basic methodology is presented and models used to interpret the signal are reviewed. Theoretical and experimental studies of what is sampled are summarized. The accuracy of impedance stroke volume estimates is evaluated by surveying the results of human studies and examining critical animal studies. The usefulness of impedance cardiography for ventricular performance evaluation is also reviewed. Additional uses for cardiopulmonary diagnosis are briefly presented. PMID- 3516574 TI - Respiratory failure in patients with acquired immunodeficiency syndrome and Pneumocystis carinii pneumonia. AB - Seven patients with acquired immunodeficiency syndrome (AIDS) and Pneumocystis carinii pneumonia were studied to define the pathophysiology of their respiratory failure. The patients had fever, cough, dyspnea, hypoxemia, and diffuse infiltrates on chest x-ray. Biopsies revealed a spectrum of alveolar filling, interstitial edema and infiltration, and fibrosis. The patients were studied on mechanical ventilation to assess the effect of positive end-expiratory pressure (PEEP) and supplemental oxygen on shunt fraction. Mean anatomic shunt (measured on 100% oxygen) was 34 +/- 8%, which increased significantly (p less than .001) to 43 +/- 9% when the FIO2 was decreased to 40% to 60% (physiologic shunt), indicating ventilation/perfusion (V/Q) imbalance or impaired diffusion. Increasing PEEP by 9 +/- 2 cm H2O reduced the anatomic shunt to 30 +/- 7% (p less than .01) and the physiologic shunt to 37 +/- 7% (p less than .02). There was a similar decrease in anatomic and physiologic shunts in five studies, a greater decrease in physiologic shunt in four, and a greater decrease in anatomic shunt in two. Evidence of alveolar recruitment with PEEP, measured by an increase in static thoracic compliance, was found in only one study. There was no correlation between the effect of PEEP on compliance and its effect on shunt. The data suggest that in patients with AIDS and P. carinii pneumonia, PEEP can decrease shunt by reducing the anatomic shunt, improving V/Q imbalance, and converting areas of anatomic shunt to areas of low V/Q. P. carinii pneumonia in patients with AIDS can produce a clinical and pathophysiologic pattern similar to that described in the adult respiratory distress syndrome. PMID- 3516576 TI - Radiologic demonstration of Caroli's disease: a case report. AB - Since the first report by Caroli et al., there have been several reports dealing with Caroli's disease or multiple communicating cysts of the biliary tree. Recently, the usefulness of computed tomography, endoscopic retrograde cholangiopancreatography, ultrasonography, and radionuclide scintigraphy have been emphasized for evaluation of this condition. This report describes a case of Caroli's disease and emphasizes the value of ultrasonography in the evaluation of this condition. PMID- 3516575 TI - A comparison of intermittent mandatory ventilation systems. AB - Many recent ventilators used in the ICU have a demand valve for intermittent gas flow. While demand systems conserve gas flow, they do not appear to be as well tolerated by patients as are continuous flow systems. Using a mechanical model to simulate a patient's spontaneous breathing efforts, we tested nine common ventilators in the intermittent mode. Their sensitivity varied from -2.0 to -0.2 cm H2O and the total delay time from 19 to 92 msec. The initial inspiratory resistance varied between 0.03 and 0.10 cm H2O/L X min and initial flow was between 2.5 and 12.3 L/min. These values were often not supplied or not the same as those in the manufacturer's specifications. PMID- 3516577 TI - Nursing care of the patient with dilated cardiomyopathy. PMID- 3516578 TI - Heart transplantation: postoperative care during the acute period (continuing education credit). PMID- 3516579 TI - The safety of bromocriptine in long-term use: a review of the literature. AB - This paper reviews the safety data on bromocriptine administration for 1 to 10 years at daily doses of 1.25 to 80 mg in over 1100 patients with pituitary hormone overproduction (mainly from prolactinomas and growth-hormone producing adenomas), at daily doses of 3.75 to 170 mg in over 700 patients with Parkinson's disease, and at daily doses of 2.5 to 20 mg in 28 patients with various other conditions. In addition, information is provided on the safety for mother and child of bromocriptine administered at daily doses of 2.5 to 35 mg throughout gestation (54 pregnancies) or during its later stages (39 pregnancies). The side effects of long-term bromocriptine treatment are usually no different from those seen during short-term treatment; most of them are relatively benign, and they have been shown in virtually all patients to be reversible. Bromocriptine appears to have no harmful effect on hepatic, renal, haematologic, or cardiac functions. It is considered that a hitherto unknown, severe though rare side-effect of bromocriptine is unlikely to be reported after such long experience. PMID- 3516580 TI - Fenoverine: smooth muscle synchronizer for the management of gastro-intestinal conditions. II. A trimebutine-controlled, double-blind, crossover clinical evaluation. AB - A double-blind, crossover trial was carried out in 40 in-patients with gastro intestinal spasmodic syndromes to compare the effectiveness and tolerance of fenoverine and trimebutine. Patients were allocated at random to receive either 100 mg fenoverine or 150 mg trimebutine 3-times daily for 20 days and were then crossed over, without a wash-out period, to the alternative medication for a further 20 days. After the first dose, pain severity was monitored over 4 hours and changes in intensity compared between groups. During the two 20-day periods, the proportion of patients in complete or almost complete remission was monitored at 10-day intervals, and the pooled data similarly compared. At the end of the 40 day trial period, patients stated their preference for one or other treatment, and the relevant data were processed by sequential analysis. Subjective signs of adverse effects were monitored by questioning every 10 days, and haematology and haematochemistry before and after each phase of the study. The results showed that fenoverine produced significantly greater pain relief after a single dose in comparison with trimebutine over the 4 hours of observation. Similarly, it gave significantly more favourable clinical results after both the 10th and 20th day of treatment. Finally, according to the patients' preference, fenoverine was significantly preferred (p less than 0.05) in comparison with trimebutine. Neither treatment was associated with the onset of signs of possible adverse reactions, either subjective or objective. PMID- 3516581 TI - Development of services for mental patients in the USSR. PMID- 3516582 TI - The influence of preservation techniques on prostacyclin biosynthesis in venous autografts. PMID- 3516583 TI - The osteoinductive potential of intramedullary canal bone reamings. PMID- 3516584 TI - Comparison of three cross-match techniques to select platelet donors. Lymphocytotoxicity, platelet suspension immunofluorescence test, and enzyme linked immunosorbent assay. PMID- 3516585 TI - Severe alloimmune neonatal thrombocytopenia due to specific HLA antibodies. PMID- 3516586 TI - Hypercapnia in the obstructive sleep apnea syndrome. A reevaluation of the "Pickwickian syndrome". AB - The mechanisms of hypercapnia in eight patients with the "Pickwickian" syndrome and obstructive sleep apnea (OSAS) were evaluated pretherapy and posttherapy (tracheostomy in seven patients and chronic nocturnal use of nasal CPAP in one). Four patients (correctors) became eucapnic within two weeks of therapy. Four others (noncorrectors) remained hypercapnic. Neither residual apneas, changes in pulmonary function, change in anatomic dead space, nor changes in ventilatory chemoresponsiveness differentiated the two groups, nor did the last three factors account for return to eucapnia in the correctors. The results indicated two separate mechanisms exist for chronic hypercapnia in OSAS: a critical balance between the ventilation during the time spent awake and hypoventilation due to apneas, a mechanism removed by treatment for obstructive apnea; and sustained hypoventilation independent of the apnea phenomenon and therefore not correctible. The subset of patients with the second mechanism appears to represent the true "Pickwickian" syndrome and can be identified before therapy by measuring a low level of ventilation in the sustained awake state. PMID- 3516588 TI - Diagnostic approaches for deep vein thrombosis. AB - This article briefly reviews the advantages and limitations of currently available methods for the diagnosis of deep vein thrombosis (DVT). Clinical evaluation alone is inadequate but still useful in assessing the need for further testing. The medical history, especially the detection of risk factors for DVT, is as important as the physical examination. Confirmation by objective diagnostic tests is essential. Venography has been the traditional standard for determining the optimal management of DVT, but has significant limitations which are not widely appreciated. Noninvasive diagnostic methods for DVT are essential for effective management, but the optimal method for a particular hospital depends on the personnel and resources available. PMID- 3516587 TI - A meta-analysis of the studies of dihydroergotamine plus heparin in the prophylaxis of deep vein thrombosis. PMID- 3516589 TI - Role of surgery in iliofemoral venous thrombosis. AB - Thrombectomy has a limited but definite role in the clinical management of patients with iliofemoral venous thrombosis. It is best applied selectively to achieve specific goals in two different groups of patients at either end of the disease spectrum. In relatively active healthy young patients with phlegmasia alba dolens operated on relatively soon after thrombosis, better protection against the late postthrombotic sequelae can be achieved. Patients with malignancy, underlying coagulopathy, or those who are inactive or have a limited life expectancy due to age or concurrent disease should not be operated on for bland thrombosis. At the other extreme, when phlegmasia cerulea dolens causes painful tense swelling, increases compartmental or decreases ankle pressures, and threatens limb viability in spite of heparinization and leg elevation, thrombectomy should be performed. PMID- 3516590 TI - Influence of human serum on bactericidal activity of ceftizoxime sodium. AB - The influence of normal human serum on bactericidal activity of ceftizoxime sodium (CZX) was studied in vitro against Escherichia coli and Staphylococcus aureus. Subminimal inhibitory concentrations of CZX inhibited the growth of bacteria. Normal human serum as a source of complement and low doses of CZX, such as 1/20 or 1/10 the minimal inhibitory concentration, had a strong synergic action on the gram-negative bacteria E. coli, but not on the gram-positive bacteria S. aureus. However, the combination of CZX and fresh human serum had a stronger inhibitory effect on the growth of S. aureus than CZX alone. It is concluded that subminimal inhibitory concentrations of CZX inhibited the growth of bacteria in vitro in the presence of human serum, indicating that smaller dosages of CZX may act to eliminate the invading bacteria in vivo together with serum complement. PMID- 3516591 TI - Comparative antibacterial effects of amoxycillin, amoxycillin/clavulanic acid and cefotaxime against Enterobacteriaceae as determined by turbidimetry, morphology and viable count. AB - Cefotaxime has extremely low MIC values in comparison with amoxycillin against Enterobacteriaceae, but studies of antibacterial activity using turbidimetric and viable count methods show no advantage for cefotaxime. Superior rates of killing have been demonstrated for amoxycillin and amoxycillin/clavulanic acid using both constant antibiotic concentrations and changing concentrations to simulate conditions in vivo. Slow bactericidal activity was seen with cefotaxime even at levels greatly in excess of the MIC and could be correlated with filament formation by this compound over a wide range of concentrations. PMID- 3516592 TI - In vitro activity of cefpimizole sodium (U-63196E) and other antimicrobial agents against Haemophilus isolates from pediatric patients. AB - In vitro activity of cefpimizole, an experimental third generation cephalosporin, and 10 other antimicrobials (ampicillin, azlocillin, cefamandole, cefoperazone, cefotaxime, mezlocillin, moxalactam, piperacillin, rifampin and sulfamethoxazole/trimethoprim) were determined for 181 isolates of Haemophilus obtained from pediatric patients. For 156 beta-lactamase-negative isolates, MIC50 values of cefoperazone, cefpimizole, and cefamandole were 4, 8, and 16 times greater than those of moxalactam and cefotaxime (0.06 micrograms/ml). 25 beta lactamase-producing isolates were resistant to ampicillin, azlocillin, mezlocillin, and piperacillin, however, MIC50 of all third generation cephalosporin were similar to those obtained for beta-lactamase-negative organisms. Rifampin and SMX/TMP demonstrated low MIC50 values for all isolates. PMID- 3516593 TI - Antibacterial antagonism of beta-lactam antibiotics in experimental infections. AB - In vitro, 5 micrograms/ml of cefoxitin induced the highest beta-lactamase activity in Serratia marcescens TMS22, and the drug at this optimal dose required 2 h to increase the enzyme activity. The increasing enzyme activity was found to decline rapidly after the enzyme inducer effect was lost. When antagonism of cefoxitin against another beta-lactam, cefotaxime, was examined in infected granuloma pouch of rats, cefoxitin antagonized the antibacterial activity of cefotaxime administered at 4 and 6 h after cefoxitin (cefoxitin levels in pouch exudate were around 5 micrograms/ml). The antagonism of an enzyme inducer and another antibiotic may be prevented by administering the non-enzyme inducer before the enzyme inducer exerts its inducer effect or after the enzyme inducer level decreases to an ineffective one. PMID- 3516594 TI - Comparative penetration of ceftazidime into cardiac and skeletal muscle in rabbits. AB - The concentrations of ceftazidime attained in cardiac and leg muscles of rabbits were compared after a single intramuscular injection of 100 mg/kg. Simultaneous measurements of muscle and muscle fluid over an 8-hour period showed that ceftazidime penetrated heart muscle more rapidly and to a greater extent than leg muscle. Although the half-lives did not vary, the areas under the time/concentration curves for heart muscle and heart muscle fluid were significantly greater than those for leg muscle and leg muscle fluid. It is suggested that an increased fluid content and vascularity of cardiac muscle may explain these results. This study also confirms previous reports that whole muscle tissue levels of beta-lactam antibiotics substantially underestimate the actual concentrations present in the extracellular fluid. PMID- 3516595 TI - [Planning of soft tissue coverage in the resection of superficial, deforming tumors]. PMID- 3516596 TI - [Suture materials]. PMID- 3516597 TI - [Inflammatory stenoses of the rectal anastomosis: a complication of nonresorbable suture material]. AB - Inflammatory anastomotic stenosis requiring reoperation developed in 8 patients within 9 months to 12 years after rectal resection. The clinical course in combination with the macroscopic and histologic findings allowed to identify nonabsorbable suture material leading to stenosis trough acute and chronic proliferative foreign body reactions in all cases. The danger of stenosis arises generally in infectious tissue in which synthetic absorbable are superior to all nonabsorbable materials. PMID- 3516598 TI - [Surgical therapy of pronounced gynecomastia]. AB - Surgery for gynecomastia is primarily aimed at the complete removal of the breast tissue and the reconstruction of the normal breast and chest contour while leaving minimal telltale signs of the surgery. Dufourmentel and Webster described a technique that placed the incision along the border of the nipple-areola complex. The aesthetic results are good by smaller and moderate cases of gynecomastia. The surgical correction of the larger cases requires the correction of both glandular tissue and skin. The concentric circle operation - described by Schrudde - permits the complete removal of breast tissue and corrects the skin redundancy. The periareolar operative scar is relatively inconspicuous. Our technique and the results are described. PMID- 3516599 TI - [Segmental arteriosclerotic occlusion of the infrarenal aorta]. AB - Atherosclerosis involving the terminal aorta usually is a diffuse process that commonly includes the iliac and femoral arteries. Less frequently, the lesions are limited to the infrarenal aortic segment with normal distal vessels. Patients with isolated occlusion or stenosis of the infrarenal aorta tend to be younger, more often female and have slower progression of atherosclerotic lesions. There is a causative relationship of this well-localized form of atherosclerosis to the use of oral contraceptives and heavy smoking. In 90% of the cases, surgery of these lesions is limited to endarterectomy. End results are satisfactory in a majority of the patients. Percutaneous transluminal angioplasty produces satisfactory early results for concentric stenosis, although long-term results have not yet been established. PMID- 3516600 TI - Bacteremia in anal dilatation. AB - One hundred patients underwent anal dilatation for acute or chronic anal fissure during the period 1983-1984; white blood count, serum, muscle enzymes, and blood cultures were done. Positive blood cultures were found following the procedure in eight patients. A correlation based on serum enzymes, bacteremia, and trauma can be made. Prophylactic broad-spectrum antibiotics are recommended for patients at risk. PMID- 3516601 TI - A comparison of stapled and handsewn anastomoses in patients undergoing resection for Dukes' B and C colorectal cancer. An analysis of disease-free survival and survival from the NSABP prospective clinical trials. AB - This study was to assess the effect of stapled colorectal anastomoses on local recurrence, disease-free survival, and survival following curative resection for Dukes' B and C adenocarcinoma. Data were derived from two randomized prospective trials of the National Surgical Adjuvant Breast and Bowel Project designed to evaluate the efficacy of adjuvant therapy in colorectal cancer. Of 1111 patients with colonic anastomoses, 255 were stapled mechanically. There were no significant differences in disease-free survival, survival, or local tumor recurrence among patients subjected to stapled or handsewn anastomoses. Of the 181 patients undergoing anterior resection for rectal cancer, 82 anastomoses were fashioned with staples. No significant disadvantage in disease-free survival, survival, or local recurrence could be attributed to use of the mechanical stapling devices. Twelve percent of patients undergoing stapled rectal anastomoses developed a local recurrence as a first sign of treatment failure compared with 19 percent for the handsewn group. No significant differences in the length of distal margins were detectable. The average time on study was 41 months. The use of stapled anastomoses for carcinoma of the colon or rectum is not associated with an adverse effect on long-term outcome. PMID- 3516603 TI - Classic articles in colonic and rectal surgery. Francois Rabelais, 1494 (?)-1553. Chapter XIII. How Gargantua's wonderful understanding became known to his father Grangousier, by the invention of a torch-cul or wipe-breech. PMID- 3516602 TI - Pneumatosis cystoides intestinalis. A review of the literature. AB - Pneumatosis cystoides intestinalis is a condition in which submucosal or subserosal gas cysts are found in the wall of the small or large bowel. Both fulminant and benign forms exist. Fulminant pneumatosis cystoides intestinalis is associated with an acute bacterial process, sepsis, and necrosis of the bowel, while benign pneumatosis cystoides intestinalis can be totally asymptomatic and observed as an incidental finding at laparotomy. Many different causes of pneumatosis cystoides intestinalis have been proposed, including mechanical and bacterial causes. A review of the literature is presented with emphasis on the etiology of pneumatosis cystoides intestinalis, which probably can be attributed to bacterial and mechanical factors. Diagnosis and different forms of therapy and their efficacy are also discussed. PMID- 3516604 TI - Hemorrhoids. PMID- 3516605 TI - Metabolic consequence of two-week fructose feeding in diabetic subjects. AB - We studied the metabolic effects of 2-wk fructose feeding as the sweetener in the diet of seven non-insulin-dependent diabetic individuals. The data demonstrated reduced postprandial hyperglycemia to an oral glucose challenge after 14 days without a significant difference in insulin response. There was no change in the markedly blunted glucose response to a fructose challenge but a significantly lower insulin response (area under the 3-h curve) was observed after 14 days of fructose feeding. There was reduced postprandial hyperglycemia after 14 days of fructose feeding with test meals as compared with baseline, without significant differences in insulin response. We also found no significant difference in free fatty acids, cholesterol, high-density lipoprotein (HDL) cholesterol, pyruvate, lactate, or uric acid after fructose feedings. There was a 13% increase in triglyceride levels after 14 days in 5 subjects with initial fasting hypertriglyceridemia (greater than 150 mg/dl). Insulin receptor binding to isolated adipocytes did not change after 14 days of fructose feeding. PMID- 3516606 TI - Glycemic control with closed-loop intraperitoneal insulin in type I diabetes. AB - Blood glucose levels were compared in eight type I diabetic subjects who were given closed-loop infusions of insulin by intraperitoneal (i.p.) and intravenous (i.v.) routes, in a cross-over randomized study. After a test meal, plasma glucose peaks were significantly higher with i.p. than with i.v. infusion (174 +/ 22 versus 129 +/- 29 mg/dl) and marked hypoglycemia occurred after 180 min in five of eight subjects. These observations appear to be the consequence of a 60 min lag in insulin rise with i.p. administration. Because of this difference in plasma glucose rise, twice as much insulin was administered i.p. than with i.v. Plasma insulin rose to similar values in both cases. Therefore, with present closed-loop systems, i.p. insulin infusion does not lead to better control of glucose levels than i.v. infusion and does not prevent hyperinsulinism. Adjustments of the artificial B-cell algorithms and the injection of a bolus dose must be tested so that the potential advantages of the i.p. route may be achieved. PMID- 3516607 TI - Secondary failure to treatment with oral antidiabetic agents in non-insulin dependent diabetes. AB - To study the etiopathogenesis of secondary drug failure to treatment with oral antidiabetic agents in patients with non-insulin-dependent diabetes (NIDD) we compared 60 "nonresponders" with 60 "responders" to treatment with oral drugs. Secondary drug failure was defined as mean diurnal blood glucose greater than 12 mmol/L after an initial good response of greater than or equal to 2 yr. The nonresponders were characterized by 50% lower C-peptide concentrations than the responders (P less than 0.001). We could not, however, define a critical C peptide level to discriminate between patients requiring and not requiring insulin therapy. There was a wide overlap of individual C-peptide values between responders and nonresponders that attenuates the clinical value of single C peptide measurements in predicting therapy. Only by serial measurements over a period of time was it possible to achieve information about changes in beta cell function. The nonresponders showed increased frequency of islet cell (P less than 0.01), thyroid antimicrosomal (P less than 0.01), and gastric parietal cell antibodies (P less than 0.02). In nonresponders, HLA-antigen B8 was increased (P less than 0.05) and HLA-B7 decreased (P less than 0.01) compared with frequencies of responders. In conclusion, impaired beta cell function is a characteristic feature of many, but not all, NIDD patients who fail on treatment with oral antidiabetic drugs. The presence of islet cell and thyrogastric antibodies can unmask a distinct group of NIDD patients with a high risk of secondary drug failure and subsequent insulin dependency. HLA typing may further help to predict secondary failure in NIDD. PMID- 3516608 TI - Veterans Administration Cooperative Study on antiplatelet agents in diabetic patients after amputation for gangrene: II. Effects of aspirin and dipyridamole on atherosclerotic vascular disease rates. AB - We report the results of a randomized multicenter clinical trial on the effects of aspirin plus dipyridamole versus placebo on major vascular end points in 231 non-insulin-dependent diabetic men with either a recent amputation for gangrene or active gangrene. Primary end points were death from atherosclerotic vascular disease plus amputation of the opposite extremity for gangrene. There were 24 atherosclerotic deaths in the drug treatment group (21.8%) and 23 in the placebo group (19.0%). There were 22 patients in the drug treatment group (20.0%) and 29 patients in the placebo group (24.0%) with opposite-side amputations. Survival curve analyses revealed little difference between these groups for major vascular end points, total mortality, all amputations, or myocardial infarctions. The most noteworthy group difference was observed for cerebrovascular end points (strokes and transient ischemic attacks), with an incidence of 8.2% (9 patients) in the drug treatment group and 19.0% (23 patients) in the placebo group. We conclude from this study that antiplatelet agents have no effect on the primary vascular end points, vascular deaths and/or amputation of the opposite extremity, in this population. Similarly, no effects were seen on secondary vascular end points, except for a suggestion of protection versus strokes and transient ischemic attacks. However, this finding must be interpreted with caution, since it is a secondary end point and was found only after multiple analyses of the data. PMID- 3516609 TI - The person and diabetes in psychosocial context. AB - This review spans life with diabetes from the first year through the succeeding period of relatively good health, into the phase when the patient needs to accommodate for more symptoms and impaired functioning. Focusing on autonomy, vulnerability to fears, and vocational choices, this article compares effects of diabetes on children and youths with effects on those with onset in later life. A concept of biopsychosocial homeostasis helps to explain: (1) why patients turn to a physician when they do; (2) how the physician may often save the patient time and money by helping that patient to change psychological and social components of well-being and functioning--and highlights the importance of these; (3) how to treat depressive disorder; (4) how to discuss worst fears and encourage patients to play with their unpleasant imaginings; and (5) how to reduce hypoglycemia. Repeated hypoglycemic episodes have the cumulative deleterious effect of undercutting the patient's and others' sense that the patient is dependable, with impaired performance and even serious occupational and marital repercussions. Educational tactics are suggested for the patient with IDDM who finds it harder to identify early levels of hypoglycemia; that patient must learn to respond to specific clues of mild hypoglycemia, stemming from defective thinking and emotional and sexual functioning. There is no substitute for a full history and an empathic understanding of the patient's imaginings, relationships, and circumstances. PMID- 3516610 TI - Futility of self-monitoring of blood glucose without algorithms for adjusting insulin doses. PMID- 3516611 TI - New developments in infectious diarrhea. AB - The past decade has produced exciting advances in our knowledge of infectious diarrhea. The list of potential enteric pathogens continues to grow with both the identification of new organisms, e.g., E. coli serotype O157:H7, and the recognition that previously characterized microorganisms, e.g., M. avium intracellulare, can also cause gastrointestinal disease in immunosuppressed patients. Multiple investigations have led to a greater understanding of the epidemiology and clinical features of these illnesses. Application of modern biological techniques has yielded a number of diagnostic assays that are just now becoming clinically relevant. New drugs and treatment modalities for enteric infections have been developed and are now being evaluated in clinical trials. Despite these advancements, however, many questions still remain unanswered. For example, the etiology of the debilitating diarrhea in AIDS patients in whom no known intestinal pathogen can be identified remains unknown. The mechanism of diarrhea due to Cryptosporidium, Isospora, and Giardia remains elusive. And last, will new intestinal vaccines be effective in preventing diarrheal disease? Certainly, the next decade of research in enteric diseases should prove to be even more interesting than the last. PMID- 3516612 TI - Behavioral responses to perceived hypoglycemic symptoms. PMID- 3516614 TI - [Kinetics of the immunologic agglutination reaction and express determination of bacteria using an automated laser photon-correlation spectrometer]. PMID- 3516613 TI - [Myelopeptides--regulatory mediators produced by bone marrow cells]. PMID- 3516615 TI - Norfloxacin: a quinoline antibiotic. AB - Norfloxacin is a quinoline (quinolinecarboxylic acid) that should prove successful in treating infections that currently require hospitalization and intravenous antibiotics. Although a nalidixic acid derivative, it possesses greater antibacterial activity against gram-positive and gram-negative bacteria. Compared with other antimicrobial agents, norfloxacin is more potent than the aminoglycosides, first-, second-, and third-generation cephalosporins, tetracycline, trimethoprim-sulfamethoxazole, carbenicillin, piperacillin, nalidixic acid, oxolinic acid, cinoxacin, and enoxacin. In the clinical studies to date, the side effects of norfloxacin have been minimal, but include nausea, vomiting, anorexia, dizziness, headache, drowsiness, depression, and a bitter taste in the mouth. In studies with more than 4000 patients, the incidence of side effects ranged from 3.9 to 4.7 percent, with most appearing by the second day of therapy. PMID- 3516616 TI - Behavioral side effects of triazolam in psychiatric inpatients: report of five cases. AB - Triazolam was administered to five psychiatric inpatients for a two-week period. This period was preceded by a one-week placebo baseline and followed by another week of placebo administration. All conditions were double blind. By the second week of active drug administration, psychopathology greatly intensified across all of the patients with the emergence of anxiety, memory impairment, confusion, paranoid ideation, and hallucinations. The drug-induced behavioral changes persisted during the initial withdrawal period, but then gradually subsided. Also following drug withdrawal, four patients showed a marked worsening of their sleeplessness for several nights. PMID- 3516618 TI - Cimetidine and non-ulcer dyspepsia. PMID- 3516617 TI - Inhaled corticosteroids: are higher doses better? PMID- 3516619 TI - [immunosuppression following kidney transplantation using antilymphocyte globulin followed by treatment with cyclosporin. A prospective study]. AB - In a prospective study three different immunosuppressive schemata after renal transplantation were compared. In group A (47 patients) conventional treatment with azathioprin and steroids was administered; in group B (47 patients) antilymphocyte globulin (ALG) was additionally given for three weeks. In group C (47 patients) ALG-azathioprin-steroid administration lasted for a mean of nine days after the transplantation, followed by ciclosporin. One-year transplant survival rate was 59.6% in group A, 70.2% in group B and 89.4% in group C; one year patients survival rate 95.7%, 89.4% and 100%, respectively. Thus conventional immunosuppression with ALG followed by ciclosporin was statistically significantly superior to the other two treatment schedules, both with respect to patient and transplant survival. This was also true of postoperative dialysis rate, which was lowest in group C, at 17%, compared with group A (85.1%) and group B (42.6%). Under the chosen study conditions there was no evidence of a negative effect of ciclosporin on long-term renal function. PMID- 3516620 TI - [Status of testing cytostatic drugs in the therapy of malignant tumors]. PMID- 3516621 TI - [alpha 2-interferon: preliminary treatment results in chronic myeloid leukemia]. AB - Interferon (IFN-alpha 2 B) was administered to 21 patients with chronic myeloid leukaemia (CML), at an initial dose of 4 X 10(6) IU/m2 daily subcutaneously, adapted to changes in leukocyte count in the course of treatment. Of 16 patients that could be fully evaluated (12 males, 4 females; aged 21-64 years), 15 were in the chronic phase, one had a blast crisis. "Haematological remission" was achieved in nine of the 16 patients, while in the remainder, with one exception, transitory reduction in leukocyte count was obtained. With pretreatment counts of 18-151 X 10(9)/l, normalization to 2.7-6.9 X 10(9)/l was achieved in 13 patients after 3-40 weeks. In parallel to these effects there was a decrease in platelet count (before treatment 86-1550 X 10(9)/l to 30-279 X 10(9)/l after an average of six weeks) and in lactate dehydrogenase (initially 220-958 U/l to 87-232 U/l after 3-33 weeks). A reduction in Philadelphia chromosome-positive metaphases by as much as 50% was observed in four of eight patients. Administration of IFN alpha 2 B achieved a relatively rapid cell reduction in the chronic phase of CML. The long-term effect on the course of the disease and the place of IFN in the overall concept of CML treatment remains unanswered. PMID- 3516623 TI - [Endoscopic ultrasonography of the upper gastrointestinal tract]. PMID- 3516622 TI - [Effect of fructose and sorbitol on insulin-induced hypoglycemia]. AB - Twelve metabolically normal subjects were given 0.325 g/kg fructose or glucose dissolved in water 30 minutes after intravenous infusion of insulin, 0.05 U/kg. Blood glucose concentration was then measured for up to 60 minutes or until the onset of hypoglycaemia (study I). In study II two bread units (BU) were given to six subjects in the form of dark bread, as well as 12 g of butter and water. In two other groups, of six subjects each, 1 BU was substituted either by fructose or sorbitol. Seven subjects who had been given insulin but only water to drink afterwards served as the control group. In study I, both glucose and fructose achieved a clear slowing in the blood-sugar drop compared with the control group. But with glucose there was initially a slight rerise and the final hypoglycaemic level was somewhat delayed. This minor difference between glucose and fructose was not demonstrable in study II with the addition of fat and carbohydrate substitution. Each carbohydrate combination similarly influenced the course of blood sugar concentration. The results indicate that diabetics should continue to be given glucose rather than fructose or sorbitol if hypoglycaemia occurs. On the other hand, both fructose and sorbitol, although acutely less effective in raising blood glucose concentration, do counteract as carbohydrates the development of insulin-induced hypoglycaemia. PMID- 3516624 TI - [The psyche, central nervous system and gastrointestinal tract. 1. Physiology]. PMID- 3516625 TI - [Unexpected findings during abdominal sonography. Their incidence and clinical significance]. AB - 19% of 1490 abdominal sonograms from 1192 patients led to findings which were not related to the original purpose of the sonogram or to the actual disease, and of which neither the treating physician nor the patient were aware. The most frequent findings were those in liver, kidneys and gallbladder. The majority of ultrasonographically detected lesions were benign; tumour diseases were suspected only in 26 cases. The incidence of such findings increased with the patients' age. The positive, predictive value of the findings was around 90%. In 20% of the patients with unexpected findings, further diagnostic measures were taken; therapeutic consequences were recorded in only twelve cases. Further measures were recommended in 20% of the patients, a majority of which had pancreatic and vascular abnormalities. Because such findings may considerably facilitate the diagnosis of subsequent complaints, all accessible organs should be examined during abdominal ultrasonography. PMID- 3516626 TI - [Candida abscesses in the liver and spleen. The sonographic and computed tomographic morphology]. AB - In three patients with acute leukemia candidal abscesses occurred. In spite of ready response to induction chemotherapy, septic fever as well as hepatic and splenic enlargement were observed. Broad-spectrum antibiotics did not improve the patients' condition either. Ultrasonography of liver and spleen revealed multiple, small echolucent foci and target lesions. Computed tomography detected multiple, hypodense foci 1-2 cm in diameter; after contrast medium application there was no enhancement. Candidal septicaemia was demonstrated in all three patients. PMID- 3516627 TI - [The psyche, central nervous system and gastrointestinal tract. 2. Pathophysiology]. PMID- 3516628 TI - [Effect of increasing the pectin content in feed on the metabolism of laying hens]. PMID- 3516629 TI - [Isolation and preliminary characterization of a paramyxovirus isolate of serotype 1 from budgerigars]. PMID- 3516630 TI - [Detection and significance of tetracycline residues in eggs]. PMID- 3516631 TI - [Conclusions drawn from the course of paramyxovirus disease in pigeons to date]. PMID- 3516632 TI - [Inactivation of the fungus Aspergillus fumigatus]. PMID- 3516633 TI - [Feather loss syndrome in cockatoos]. PMID- 3516634 TI - [Occurrence of yersinia in birds]. PMID- 3516635 TI - [Effectiveness of various dosage concentrations and administration times of Baycox medication in experimental chicken coccidiosis in caged conditions]. PMID- 3516636 TI - [Pharmacokinetics and pharmacotherapy in ornamental and zoo birds]. PMID- 3516637 TI - [Simple and sensitive method for the detection of Salmonella in eggs]. PMID- 3516638 TI - [Tolerance of halofuginone (Stenorol) by geese (Anser anser f. dom.), flight ducks (Cairina moschata f. dom.) and Peking ducks (Anas platyrhynchos f. dom.)]. PMID- 3516639 TI - [The specialty of poultry diseases--status determination and future perspectives]. PMID- 3516640 TI - [Alternatives to the identification of parrots]. PMID- 3516641 TI - [Immunological laboratory studies in neurological diagnosis]. PMID- 3516642 TI - [Methodological approaches to the study of tumor and body tissue metabolism in vitro and in vivo]. AB - The idea is put forward that in vitro measurements of the potential activity even of the key enzymes are not sufficient for correct evaluation of the rate of complex enzymic processes in vivo. The rate of the in vivo formation of final (not intermediate) products from the corresponding precursors is thought to be the most adequate criterion for it. The idea is substantiated by our studies on the glycolysis enzymes and RNA pyrimidine nucleotide synthesis. Such an approach permits gaining in particular, exact information on both features of the RNA synthesis in experimental tumours and mechanisms underlying a successful competition of the tumour and host tissues for RNA precursors. The latter phenomenon is one of manifestations of the tumour capacity to act as a trap for nitrogen. PMID- 3516643 TI - [Use of lyophilized bone marrow in the cytopenic syndrome in dogs]. AB - Intramuscular (subcutaneous) introduction of the allogenic bone marrow lyophilizate suspension to irradiated animals has a positive therapeutic effect. It is manifested in a less grave course of the disease, accelerated recovery of the disturbed hemopoiesis, reduced mortality and a longer life time of irradiated dogs. PMID- 3516644 TI - Diffusion of thyroglobulin in the follicular colloid. (Minireview). AB - Methods used for estimating in vivo diffusion velocity of thyroglobulin (Tgb), the factors affecting hydrodynamic properties of thyroidal colloid and the effects of changing diffusion properties on follicular function are briefly reviewed. The principal methods, besides pure in vitro techniques, are autoradiography of thyroid sections after in vivo labelling of Tgb and freezing autoradiography for examining colloidal diffusion of ions or other small molecules. The main factors known to affect diffusion of Tgb in the colloid space are concentration and actual physico-chemical properties of the Tgb molecule itself, the latter parameter depending on several factors such as sugar content, iodination degree, etc. Additional factors are thyrotropin which speeds up and drugs such as pentobarbital or verapamil which slow down the velocity of Tgb diffusion. High iodine supply has a retarding effect on Tgb diffusion in the colloid of mice thyroids. Any change of Tgb diffusion in the colloid may have a striking effect on follicular function. The hydrodynamic properties of the colloid components are increasingly recognized as a potentially important factor in regulating kinetics of hormone synthesis. PMID- 3516645 TI - Blood urea nitrogen and creatinine. AB - The determination of serum creatinine and serum urea nitrogen levels is of great value in helping to ascertain the renal function in the clinical setting. These two serum determinations are best viewed in concert, observing their absolute levels as well as their relation to one another. The serum creatinine level is less influenced by extra-renal factors than is the serum urea nitrogen level, and is the more accurate test. Reproducibility of measurement is within 2 per cent. When the test results return, there are a number of questions to be asked: What is the normal range for the laboratory which analyzed the serum? Are the levels real; i.e., could the elevated levels be factitious? Are there extrarenal etiologies for the abnormal levels? What is the BUN to creatinine ratio? If the abnormal findings are secondary to intrinsic renal disease, what other tests will help to determine the etiology of the renal disease? The laboratory assessments of BUN levels and blood creatinine levels are "standard fare" in the assessment of renal function. They are relatively low-cost tests, are available in any standard hospital laboratory, and are relatively easy to run. They are essential in the assessment of renal function in the Emergency Department. PMID- 3516646 TI - Urinalysis. AB - When properly performed and interpreted, urinalysis is one of the most useful tests available to the emergency physician. This article reviews procedures for urine collection and analysis, emphasizing inexpensive and noninvasive chemical, macroscopic, and microscopic techniques. PMID- 3516647 TI - Cerebral spinal fluid. AB - The advent of very sensitive and rapid agglutination tests has been a major advance in facilitating the rapid diagnosis of bacterial meningitis (Table 3). Future investigations will focus on the use of monoclonal antibodies that have been found to be more sensitive and specific than polyclonal antiserums. Modifications of enzyme immunoassays of bacterial antigens to improve speed and technical reliability are in progress. The day may come with the present advances in technology that within 1 hour of receiving a CSF specimen, both the identity and antimicrobial sensitivity of the invading pathogen will be known to the physician. In addition, through quantitation of bacterial antigen, a reliable prognosis as to the outcome of the treated meningitis will also be possible. Finally, the continued refinement of reliable antiserums to group B Neisseria meningitidis, as well as other bacteria responsible for meningitis, particularly in the immunocompromised host will occur. PMID- 3516648 TI - Selected serology: pregnancy testing, hepatitis A and B, and infectious mononucleosis. AB - The basic principles of serologic testing are discussed in this article. Specific emphasis is placed on pregnancy tests, hepatitis serology, and infectious mononucleosis testing. Indications for emergency department use are elucidated. PMID- 3516649 TI - Other enzymes. Creatinine phosphokinase, lactate dehydrogenase, serum glutamic oxaloacetic transaminase, serum glutamic pyruvic transaminase, and alkaline phosphatase. AB - Enzyme assays remain an important laboratory tool for the Emergency physician. This chapter has reviewed the biochemistry of the enzymes routinely assayed and the pathophysiology of the organs that liberate those enzymes with respect to particular disease states. Information on costs and turnaround time is listed in Table 8. The most important tool that a clinician has available is clinical judgment. A laboratory test should confirm a diagnosis already entertained, not make one by surprise. PMID- 3516650 TI - Microbiologic studies. AB - Although useful to emergency physicians in determining and following up treatment, the microbiology department can be a source of frustration and erroneous results due to improper or inconsistent methodology, ordering, and interpretation. This article will review the principles of microbiologic specimen collection, handling, and processing as well as noting specific techniques for selected clinical settings. PMID- 3516651 TI - Selected laboratory in pediatric emergency care. AB - The superiority of either a complete blood count, erythrocyte sedimentation rate, or C-reactive protein as a generic, global screening test for bacterial infection in infants or children has not been clearly demonstrated. The few claims of superiority for one determination over another relate more to the clinical setting than marginal differences in sensitivity or specificity. Neither the complete blood count, erythrocyte sedimentation rate, or C-reactive protein has proved sensitive enough of predicting invasive bacterial infection that it can be used as an isolated measure upon which major management decisions can safely be based. Several investigators have therefore addressed whether these tests can complement each other. Unfortunately, acquisition of multiple nonspecific laboratory tests in a given clinical situation may yield widely divergent results. The C-reactive protein, complete blood count, erythrocyte sedimentation rate, and zeta sedimentation ratio are all comparably priced in the $15.00 to $30.00 range. However, if multiple tests are obtained, the cost of this approach may become unacceptably high. Current practice advocates a careful evaluation of an ill pediatric patient in an Emergency setting. The initial clinical impression of an experienced clinician based on history and physical examination frequently provides dependable information with which to direct subsequent evaluation. If bacterial infection ranks high on the differential list, relevant laboratory studies should be considered. Observation of quantitative and qualitative changes of the hematologic profile or rate of erythrocyte sedimentation are adequate tools in specific circumstances. With the resurgence of interest in the use of C reactive protein, it too may join the ranks of convention in selected settings. PMID- 3516652 TI - Insulin stimulation of glucose metabolism in rat adipocytes: possible implication of protein kinase C. AB - The hypothesis that insulin stimulation of glucose and lipid metabolism in rat adipocytes may involve the activation of protein kinase C was evaluated. 4 beta Phorbol 12 beta-myristate, 13 alpha-acetate (PMA, 0.1-1000 ng/ml), a potent tumor promoter acting as a substitute for diacylglycerol to activate protein kinase C, stimulated 2-deoxyglucose transport in a time- and dose-dependent manner, without affecting passive glucose diffusion. PMA (0.1-1000 ng/ml) also elicited a dose dependent activation of lipogenesis from [3-3H] glucose. Maximal PMA effects (100 ng/ml) on both processes were 60% of insulin maximal effects. In contrast, PMA (1 1000 ng/ml) failed to mimic the ability of insulin to stimulate lipogenesis from [3H]acetate. 4 beta-Phorbol 12,13 dibutyrate, mezerein, 1-oleyl-2-acetyl glycerol, 1,2 diolein, known as protein kinase C activators, also markedly stimulated glucose metabolism whereas 4 alpha-phorbol 12,13 didecanoate and 4 beta-phorbol 13-monoacetate, shown not to activate protein kinase C, were ineffective. Mellitin, a cytotoxin-inhibiting protein kinase C, markedly decreased both PMA and insulin stimulation of glucose metabolism. PMA decreased insulin submaximal effects on 2-deoxyglucose transport without inhibiting insulin binding. Maximal PMA and insulin effects on 2-deoxyglucose transport and lipogenesis from [3-3H]glucose were not additive. Both PMA and insulin activated each metabolic process in a calcium-dependent manner. PMA, like insulin, no longer stimulated 2-deoxyglucose transport in fat cells treated with 2,4 dinitrophenol. These data show that PMA exhibited specific insulin-like properties on glucose metabolism in fat cells, without any effect on lipid synthesis from acetate. They indicate that PMA and insulin bioeffects may share a common step implicating a calcium- and energy-dependent process, distal to the initial insulin binding event. Our results suggest that protein kinase C may play a role in insulin regulation of glucose metabolism. PMID- 3516653 TI - Secretory endometrium synthesizes placental protein 14. AB - Saline extracts of human nonpregnant endometrium were found to contain placental protein 14 (PP14). The tissue PP14 content was highest in the late secretory phase (median, 7.7 mg/g protein; n = 14), whereas proliferative endometrium (n = 8) was either PP14 negative or showed a low PP14 content (median, 0.15 mg/g protein). By immunoperoxidase staining, PP14 was localized in the glandular epithelial cells of endometrium. In tissue culture, secretory endometrium released more PP14 than proliferative endometrium, and cycloheximide markedly decreased this release. Synthesis of PP14 by secretory endometrium was demonstrated by incorporation of [35S]methionine into immunoprecipitable PP14. These results show that PP14 is synthesized and secreted by the nonpregnant endometrium. PMID- 3516654 TI - 17 beta-estradiol 2- and 4-hydroxylation catalyzed by rat hepatic cytochrome P 450: roles of individual forms, inductive effects, developmental patterns, and alterations by gonadectomy and hormone replacement. AB - The participation of rat hepatic P-450 in the conversion of 17 beta-estradiol to catechol estrogens was examined by means of enzyme reconstitution and immunoinhibition studies. It was thus demonstrated that three rat liver microsomal cytochrome P-450 forms, designated P-450UT-A, P-450PCN-E, and P-450ISF G, each contribute to the 2- and 4-hydroxylation of 17 beta-estradiol catalyzed by hepatic microsomal preparations. Two of these enzymes, P-450UT-A and P-450PCN E, are expressed constitutively, are male-specific, and are regulated by testosterone as well as influenced by the administration of various chemicals. Consistent with these observations, 17 beta-estradiol 2- and 4-hydroxylation activities both increased rapidly during puberty in male rats and were induced by treatment of rats with phenobarbital or pregnenolone 16 alpha-carbonitrile. Castration of male rats at birth or at 5 weeks of age suppressed the levels of 17 beta-estradiol 2- and 4-hydroxylase activities measured at 10 weeks of age. This suppression of activity was reversed upon administration of testosterone during the neonatal period (days 1 and 3 of life) or by capsule implantation at 5 weeks of age. These patterns of 17 beta-estradiol 2- and 4-hydroxylation are discussed in terms of the previously characterized response of the multiple rat hepatic P 450 forms to ontogenic, hormonal, and xenobiotic factors. PMID- 3516655 TI - Effect of 1,25-dihydroxyvitamin D3 on insulin secretion: direct or mediated? AB - In order to clarify the role of vitamin D (D) in regulating insulin secretion, we studied the effect of long term (10 days) and short term (3 days) supplementation with D and/or calcium (Ca) on insulin secretion from the isolated, perfused pancreas of D- and Ca-deficient rats. The influence of the nutritional state induced by D deficiency was also evaluated. The long term supplementation of either D, Ca, or both restored the body weight and improved insulin secretion induced by high glucose concentration to the same extent; thus, no significant difference in insulin secretion was found between the D-only-supplemented group and the Ca-only-supplemented group. When the insulin secretion was compared in D deplete vs. D-replete rats given the same amount of Ca, insulin secretion was significantly higher in D-replete animals, although plasma Ca levels were also higher. In short term experiments, insulin release was significantly augmented to a similar extent in D- or Ca-replete rats as compared with D- and Ca-deficient rats, despite no significant change in body weight. In a separate experiment, the pancreas from D-deficient rats was perfused with or without 1,25-dihydroxyvitamin D3 [1,25-OH)2D3] to observe its acute effect on insulin release. The perfusion with 1,25-(OH)2D3 did not affect insulin release. This result suggests that impaired insulin secretion in D-deficient rats is caused by a decrease in Ca in the body fluid and possibly by the lack of D effect on the pancreas. PMID- 3516656 TI - Degradation of insulin by insulin-degrading enzyme and biological characteristics of its fragments. AB - We have previously reported on the purification, characterization, and biological significance of insulin-degrading enzyme (IDE) from pig and rat skeletal muscle. In the present study, we have investigated the detection and the HPLC separation of degradation products of native insulin from the reaction of monocomponent porcine insulin with affinity-purified pig IDE. Insulin was degraded by IDE in a time- and dose-dependent manner. Eight peaks (peaks I through VIII) appeared after 1 h of incubation, and peak V was identified as insulin. Among seven peaks representing degradation products, peak VI appeared most rapidly at 30 sec of incubation, increased until 10 min, and then decreased after 15 min of incubation; and six degradation products other than peak VI were not detected within 15 min of incubation, suggesting that peak VI was an initial degradation product of insulin produced by IDE and converted into relatively low molecular weight products as incubation time increased. The generation of peak VI may be due to cleavage at a peptide bond between the interchain disulfide bonds of the A or B chain. Subsequently, the split insulin derivative (peak VI) was evidently further degraded to relatively low molecular weight intermediates, such as peaks III and IV, peaks II and VIII, or peaks I and VII, because these pairs of peaks appeared and were degraded concomitantly. The peptide products designated as peaks IV, VI, VII, and VIII had both immunoprecipitability by antiinsulin antibodies and binding capacity to IM-9 lymphocytes, whereas the less hydrophobic intermediates (peaks I, II, and III) did not have these activities. Since some of these peptides have insulin-like properties, amino acid analysis of these products may enable us to identify not only the splitting position of insulin by IDE but also the site of the hormone for receptor binding. PMID- 3516657 TI - Insulin regulates low density lipoprotein metabolism by swine granulosa cells. AB - Insulin synergistically amplified the stimulatory effect of low density lipoprotein (LDL) on progesterone biosynthesis by primary cultures of swine granulosa cells. The mechanisms subserving this facilitative interaction included the following: 1) insulin's synergism with LDL was profoundly attenuated by covalent modification of arginine residues in LDL by 1,2-cyclohexanedione treatment; 2) insulin increased by 2- to 6-fold the number of specific high affinity LDL receptors on granulosa cells, with no change in apparent binding affinity; 3) insulin augmented rates of [125I]iodo-LDL internalization and degradation without enhancing nonspecific bulk fluid-phase pinocytosis (assessed with [125I]iodo-polyvinylpyrollidone); 4) insulin increased by 2.5- to 3-fold granulosa cell content of free and esterified cholesterol (measured by fluorometry) in response to treatment with unlabeled LDL; 5) insulin stimulated the intracellular accumulation of free [3H]cholesterol and [3H]cholesteryl ester, and amplified [3H]progesterone secretion by granulosa cells exposed to [3H]cholesteryl linoleate-labeled LDL; and 6) insulin action was specific in that it was not mimicked by desoctapeptide insulin, epidermal growth factor, fibroblast growth factor, or relaxin. We conclude that insulin and LDL synergistically enhance progesterone biosynthesis by swine granulosa cells via specific mechanisms that depend upon 1,2,-cyclohexanedione-sensitive residues within LDL apoprotein. Insulin action results in significantly augmented binding, internalization, and degradation of LDL, which is accompanied by increased effectual delivery of cholesterol substrate into cellular sterol pools that participate in enhanced steroidogenesis. PMID- 3516658 TI - Functional characteristics of the luteinizing hormone-releasing hormone pulse generator in conscious unrestrained female rabbits: activation by norepinephrine. AB - We probed the activity of the neural LHRH apparatus by means of push-pull cannulae implanted in the hypothalamus of conscious intact anestrous unrestrained New Zealand White female rabbits raised under natural light. The data revealed that the neuropeptide LHRH is released in a pulsatile manner (one pulse per 46.4 +/- 3.9 min; amplitude, 1.63 +/- 0.39 pg; n = 7) from a rather extensive area within the basal hypothalamus of the rabbit covering the rostral, medial, and posterior regions in a rostro-caudal direction and about 1 mm lateral. A remarkable change in mean LHRH output was observed during the year, and two distinct types of LHRH output were detected: low (0.72 +/- 0.07 pg/10 min; n = 7) when these reflex ovulators were perfused during late spring to early summer and high (2.92 +/- 0.29 pg/10 min; n = 5) when perfused during late summer, early fall to spring months. This 4-fold annual change in LHRH output was mainly due to changes in the amplitude of the LHRH signal and was not correlated with the position of the push-pull cannula within a restricted area in the hypothalamus. These changes may be related to the state of the ovaries, since rabbits with high LHRH output showed larger ovaries with well developed follicles than rabbits with low LHRH output. Norepinephrine, a hypothalamic neurotransmitter known to be involved in the mounting-evoked ovulation reflex in this induced ovulator, elicited a 2-fold greater mean LHRH release (P less than 0.05) when infused in doses of 10(-7) - 10(-6) M directly into the hypothalamic perfusion area. The data indicate that the activity of the LHRH pulse generator in this species presents remarkable annual variations in its mean LHRH output mainly due to a greater amplitude of the LHRH signal and that norepinephrine is a potent stimulator of LHRH release in conscious unrestrained female rabbits. PMID- 3516659 TI - Baseline and luteinizing hormone-releasing hormone-perturbed patterns of estrogen receptor distribution in anterior pituitary cell nuclei. AB - We have previously demonstrated that LHRH elicits a direct and dramatic elevation of nuclear estradiol receptor (ERn) levels in the anterior pituitary of young adult female rats. We now describe the effect of LHRH on subpopulations of ERn in the anterior pituitary. Intact purified pituitary nuclei were prepared from adult ovariectomized rats primed with estradiol (E2) and incubated with or without (control) 100 pmol LHRH/pituitary equivalent for 30 min at 37 C. The nuclei were subjected to salt extraction, and the number of occupied and unoccupied specific E2-binding sites in the salt-soluble and salt-resistant fractions of nuclei were measured. In the control pituitary nuclei, 70% of ERn were in the salt-soluble fraction, of which the great majority were occupied by endogenous steroid. The remaining ERn in the salt-resistant fraction consisted of an almost equal distribution of free and occupied sites. On preincubation of the nuclei in the absence of LHRH at 37 C for 30 min, a 40% decrease in the total number of ERn was observed, which reflected primarily a significant decrease in the number of salt soluble ERn. Incubation of the nuclei in the presence of LHRH led to the expected increase in total ERn levels, and this was traced to a dramatic and significant increase in the salt-resistant forms of ERn, while number of salt-soluble ERn was not significantly changed from the control level. Triton X-100 treatment of nonextracted nuclei had no effect on control or LHRH-induced levels of ERn. Salt resistant ERn were subjected to DNase and RNase treatment, and the majority of the specific binding sites (70%) remained resistant to the digestion. The enzyme resistant forms increased significantly in the presence of LHRH, while the enzyme soluble forms did not change significantly. It is clear from these studies that LHRH affects a specific subpopulation of ERn, which appears to be an integral part of the protein matrix of the nuclei. These observations pose new questions about the mechanism of peptide hormone action and advance our understanding of the molecular basis for LHRH-E2 interactions in regulation of reproductive functions. PMID- 3516660 TI - Effects of epinephrine, norepinephrine, and dopamine on gonadotropin-releasing hormone-induced secretion of luteinizing hormone in vitro. AB - Recent evidence indicates that catecholamines may directly alter anterior pituitary function. In the present study, an in vitro perifusion system was used to investigate whether catecholamines affect the gonadotrope. Pituitary tissue from castrated ram lambs was incubated in the presence of epinephrine (EPI), norepinephrine (NE), or dopamine (DA). During a 2-h treatment period, neither DA (10(-8) M), NE (10(-7) M), nor EPI (10(-7) - 10(-9) M) significantly affected basal LH secretion. In contrast, the LH response to a subsequent 10(-10) M GnRH challenge was significantly potentiated by NE and EPI. NE increased the amount of LH secreted in response to GnRH 14 +/- 1.1% (P less than 0.01). Likewise, 10(-7), 10(-8), and 10(-9) M EPI resulted in 22 +/- 1.4% (P less than 0.001), 13 +/- 1.2% (P less than 0.001), and 6 +/- 1.3% (P less than 0.03) increases, respectively. The stimulatory effect of 10(-7) M EPI was blocked by pretreatment with propranolol (a beta-adrenergic blocker), but not with phentolamine (an alpha adrenergic blocker). The beta-adrenergic agonist isoproterenol enhanced GnRH induced LH secretion 46 +/- 1.5% (P less than 0.001), but had no effect on basal LH release. DA had no effect on LH secretion; however, it inhibited PRL release 24 +/- 0.9% (P less than 0.001). Neither NE, EPI, nor isoproterenol had any effect on PRL secretion. These results suggest that EPI, acting by a beta 2 adrenergic receptor, modulates the pituitary gonadotrope's response to GnRH. PMID- 3516661 TI - Occurrence of spectrin-like protein in Y-1 adrenal tumor cells. AB - With the aid of two monospecific antibodies raised in rabbits (antimouse erythrocyte spectrin and antimouse brain spectrin), the presence of a spectrin like protein was demonstrated in mouse adrenal tumor (Y-1) cells. Y-1 cells contain two large polypeptides, with mol wt characteristic of nonerythroid spectrin alpha- and beta-subunits (240,000 and 235,000). When proteins from plasma membranes of Y-1 cells were electrophoretically transferred to a nitrocellulose membrane, two polypeptides with mol wt of 240,000 and 225,000 were specifically stained with antimouse erythrocyte (rbc) spectrin immunoglobulin G (IgG). The rbc spectrin antibody was used to immunoprecipitate Y-1 spectrin from a neutral detergent (physiological ionic strength) cell extract. The 240,000 (alpha)- and 235,000 (beta)-dalton polypeptides were immunoprecipitated in a 1:1 molar ratio, despite the fact that the antibody recognizes only the alpha subunit. Two-dimensional chymotryptic peptide-mapping analysis indicated that the 240,000- and 235,000-dalton subunits of Y-1 adrenal tumor spectrin are structurally unique and share limited homology with mouse rbc spectrin alpha- and beta-subunits, but are nearly identical to the mouse brain spectrin 240,000 dalton alpha-subunit and 235,000-dalton beta-subunit. Indirect immunofluorescence with anti-rbc or antibrain spectrin IgG and goat antirabbit IgG conjugated with rhodamine demonstrated intense staining at the plasma membrane and throughout the cytoplasm of Y-1 cells, with little staining within the nucleus. PMID- 3516663 TI - Food-restricted, prepubertal, female rats: rapid recovery of luteinizing hormone pulsing with excess food, and full recovery of pubertal development with gonadotropin-releasing hormone. AB - Prepubertal female rats were maintained continuously at 45% of their expected 50 day body weight by restricting their food intake. Uteri and ovaries declined in weight under these conditions. No evidence of pulsatile LH release was seen when these animals were examined at 50 days of age. Allowing unlimited access to food at this time caused rapid pubertal development. LH pulsing began in some females within 12 h; strong LH pulsing was seen in most females within 24 h, and all ovulated after only 2 1/2 or 3 1/2 days of ad libitum feeding. These were fertile ovulations, accompanied by mating and resulting in pregnancy. Administering GnRH in a pulsatile manner to 50-day-old, food-restricted animals also yielded full pubertal development. Uteri and ovaries gradually increased in weight, and ovulation occurred in 3 1/2 to 5 1/2 days. These findings support a contention that the major reproductive deficit resulting from food restriction relates to the control of GnRH secretion. In toto they also suggest a close metabolic coupling between some dimension of nutrient and/or energy processing and the GnRH pulse generator in the normally growing female. PMID- 3516662 TI - Renin in the rat pituitary coexists with angiotensin II and depends on testosterone. AB - In the rat pituitary gland, immunoreactive angiotensin II (ANG II), renin, and LH, but not PRL, were found within the same cells of the anterior pituitary gland by staining with the avidin-biotin complex method in adjacent sections. No renin positive staining was observed in the pituitary of the rats after 10 days of castration, but positive staining reappeared after 8 weeks. This effect of castration on renin immunoreactivity was abolished by the simultaneous administration of testosterone. In contrast, ANG II immunoreactivity was unaffected by castration. The intensity of renin immunoreactivity in the pituitary was less prominent in the female than in the male rat. These results suggest that there exists a pituitary renin-angiotensin system localized in the gonadotrophs and that the pituitary renin is under androgenic control. PMID- 3516664 TI - Coordinate roles of insulin and glucose on the growth of hepatoma cells in culture. PMID- 3516665 TI - Antagonism of insulin action in cultured pig adipose tissue by pituitary and recombinant porcine growth hormone: potentiation by hydrocortisone. AB - The effects of physiological levels of pituitary porcine GH (ppGH) and recombinant pGH (rpGH) on lipogenesis in pig adipose tissue incubated with insulin and hydrocortisone (HC) were measured in short term (2-h) incubations and after long term culture (50 h). HC (50 ng/ml) had no effect on lipogenesis in 2-h incubations; however, HC and insulin (10 ng/ml) maintained the lipogenic capacity of cultured tissue at rates comparable to those in fresh adipose tissue. Neither ppGH nor rpGH (1 and 10 ng/ml, respectively) had any effect in short term incubations. After 50 h of culture, ppGH and rpGH both directly antagonized the ability of insulin to maintain lipogenesis; however, this antagonism was markedly enhanced by HC. The present study is the first to demonstrate a direct antagonism of insulin action by ppGH and rpGH in pig adipose tissue, and a marked potentiation of this antagonism by HC. This intrinsic property of pGH may account, in part, for the decrease in adipose tissue growth rates in pigs treated chronically with pGH. PMID- 3516666 TI - Tooth avulsion and replantation--a review. PMID- 3516667 TI - Regional deposition of particles in human lung after induced bronchoconstriction. AB - The percentage 24-hr lung retention (Ret24), a measure of penetration to the aveoli, of 4 micron monodispersed Teflon particles, aerodynamic diameter 6 micron, was studied in 8 healthy nonsmokers. The particles were inhaled at 0.2 1/sec with maximally deep breaths. Bronchoconstriction was induced by inhalation of a methacholinebromide aerosol for one exposure before and for one exposure after inhalation of the Teflon particles. Airway resistance (Raw) was measured using a whole body pletysmograph before and after the induction of bronchoconstriction and increased on an average by a factor 2-3. Ret24 was significantly lower when the Teflon particles were inhaled during bronchoconstriction than when bronchoconstriction was induced after inhalation of the Teflon particles, 26 +/- 12% and 48 +/- 6% (mean +/- SD), respectively. These experimental data agree fairly well with data on deposition due to impaction and sedimentation using a lung model where the diameters of the airways were varied so that an increase in airway resistance occurs similar to that produced in our experimental subjects. However, the experimental data tended to be lower than the theoretical ones when the particles were inhaled during the induced bronchoconstriction. In this study, where the mucociliary transport system was stimulated by methacholinebromide, the percentage 3-hr retention (Ret3) was highly correlated with Ret24, r = 0.97, i.e., Ret3 can be used instead of the Ret24. This implies that radionuclides with shorter half-lives which give lower radiation doses, can be used, and that subjects can be studied within shorter periods of time. PMID- 3516668 TI - Cognitive-behavior therapy with adult patients with epilepsy: a controlled outcome study. AB - The present study evaluated the efficacy of group cognitive-behavior therapy for the alleviation of psychosocial problems and reduction of seizures with adult epileptic patients. Twenty-seven outpatients were randomly assigned to one of three groups: Cognitive-Behavior Therapy, Supportive Counseling (attention placebo control), and Waiting list (no treatment control). The major outcome measures used were: patient's, neurologist's, and therapist's global ratings of psychological adjustment, patient's target complaints and weekly seizure frequency, patient's and neurologist's ratings of seizure control, the Minnesota Multiphasic Personality Inventory, the Washington Psychosocial Seizure Inventory, and the Beck Depression Inventory. No significant differences were found among the three groups on these measures except for therapist's global ratings of psychological adjustment, on which both the Cognitive-Behavior Therapy and Supportive Counseling groups improved significantly after therapy, but the Waiting List control group did not. Overall, little support was found for the efficacy of group cognitive behavior therapy (eight 2-h weekly sessions) for the reduction of psychosocial difficulties or seizures. Implications of the present findings are discussed, with the need for further controlled outcome research stressed. PMID- 3516670 TI - Interhemispheric propagation time of human hippocampal seizures. I. Relationship to surgical outcome. AB - This study evaluated ictal stereotaxic electroencephalogram (SEEG) records in 75 patients with complex partial seizures who later received anterior temporal lobectomy and were evaluated for long-term seizure relief. The time required for seizures to propagate from the putatively epileptogenic hippocampal formation to the contralateral hippocampal formation was measured from 615 ictal SEEG records. These interhemispheric propagation times were then compared with the degree of post-lobectomy seizure relief. Poor postsurgical seizure relief was associated with seizure propagation times of less than or equal to 5 s. Relief or reduction of seizures after surgery was associated with seizure propagation times greater than 50 s. These relationships were also found to occur in a subset of 56 patients who did not exhibit interhemispheric propagation times of less than 0.5 s, thus indicating that interhemispheric propagation times in the range of 0.5-5 s is a negative prognostic sign even in the absence of "bilaterally synchronous" ictal SEEG onsets. The finding of longer interhemispheric propagation times in patients who were improved by surgery may be accounted for by the greatly reduced size, or absence, of the hippocampal commissure in humans and suggests that the corpus callosum is a major, albeit indirect, route by which hippocampal foci may propagate seizure activity contralaterally. The finding of shorter interhemispheric propagation times in patients who did poorly after surgery may be accounted for by the existence of foci outside the region of excision with more direct access to callosal pathways or, alternatively, by the presence of damage in a more seizure-prone contralateral hippocampus. PMID- 3516669 TI - Double-blind study of milacemide in hospitalized therapy-resistant patients with epilepsy. AB - Milacemide, 2-N-pentylaminoacetamide, a glycine prodrug, which readily crosses the blood-brain barrier, has been tested for antiepileptic efficacy and tolerability in 30 patients compared in a double-blind design with 30 patients treated with placebo. All patients continued to receive, without alteration, their previous partly effective medication. All patients presented an average of at least 10 seizures a month during the 6 months preceding the trial with no more than 50% fluctuation. The ratio of seizure frequency in the trial period over the seizure frequency in the baseline period (RSF) was calculated. In the milacemide group, 9 of 29 patients had an RSF less than 0.7 as opposed to 2 of 29 in the placebo group. Although no firm proof of therapeutic efficacy, this and the dramatic improvement of a patient with myoclonus epilepsy indicates that further studies are warranted. This opinion is strengthened if one considers the subgroup of patients aged less than or equal to 25 years in which a statistically significant reduction in seizure frequency was observed with milacemide treatment. The drug was well tolerated. PMID- 3516671 TI - Interhemispheric propagation time of human hippocampal seizures: II. Relationship to pathology and cell density. AB - The time required for hippocampal seizure activity to propagate to the contralateral hippocampal formation was evaluated in 57 patients with complex partial seizures and related to histological findings following temporal lobectomy. Interhemispheric propagation times were found to be significantly longer (greater than 20 s) in those patients diagnosed as having hippocampal sclerosis than in those patients without hippocampal sclerosis. Quantitative analysis of cell densities was made in 28 patients. Dentate fascia granule densities and hippocampal pyramidal cell densities were found to be lower in those patients with longer interhemispheric propagation times. However, this relationship was not observed when only patients with hippocampal sclerosis were considered. Thus, a tendency for hippocampal seizures to exhibit interhemispheric propagation times greater than 20 s is suggestive of underlying hippocampal sclerosis. However, information about interhemispheric propagation time does not appear useful for estimating the actual degree of cell loss within the sclerotic hippocampus. The association of longer interhemispheric propagation times with hippocampal sclerosis supports the hypothesis that direct commissural connections between the hippocampal formations in humans are either unimportant or missing. PMID- 3516672 TI - Mutagenicity studies in Salmonella: residues of ozonated and/or chlorinated water fulvic acids. AB - Aqueous residues of ozonated, chlorinated, and ozonated/chlorinated water fulvic acids (WFA) were tested for induction of His+ reversion in Salmonella typhimurium strain TA100 in fluctuation tests for mutagenicity. The data suggest that ozonation of natural organics present in sources of drinking water can prevent subsequent formation of by-products of chlorination that are mutagenic in bacteria. Ozonation of the WFA at different pH and at varying dose levels produced residues that were not or were only weakly mutagenic. Chlorination of WFA or of previously ozonated WFA led to residues that were highly mutagenic. However, mutagen formation in the ozonated/chlorinated residues could be prevented, depending upon the pH of the WFA solutions during ozonation mutagenicity decreased as pH increased. This decrease in mutagenicity is associated with previous observations of enhanced ozone decomposition into its highly reactive oxidant species at higher pH. Since ozonation seems to be more effective at alkaline pH, alkaline raw water sources seem to be the best candidates for water treatment that involves ozonation. PMID- 3516673 TI - The genetic toxicology of metal compounds: II. Enhancement of ultraviolet light induced mutagenesis in Escherichia coli WP2. AB - Salts of metals which are carcinogenic, noncarcinogenic, or of unknown carcinogenicity were assayed for their abilities to modulate ultraviolet (UV) induced mutagenesis in Escherichia coli WP2. In addition to the previously reported comutagenic effect of arsenite, salts of three other compounds were found to enhance UV mutagenesis. CuCl2, MnCl2 (and a small effect by KMnO4), and NaMoO4 acted as comutagens in E coli WP2, which has wild-type DNA repair capability, but were much less comutagenic in the repair deficient strain WP2s (uvrA). The survival of irradiated or unirradiated cells was not affected by these compounds. No effects on UV mutagenesis were seen for 16 other metal compounds. We suggest that the comutagenic effects might occur either via metal induced decreases in the fidelity of repair replication or (in the case of CuCl2) via metal-induced depurination. PMID- 3516674 TI - Structure-activity relationships (SARs) among mutagens and carcinogens: a review. AB - This review is an introduction to methods for evaluating structure-activity relationships (SARs), and, in particular, to those methods that have been applied to study mutagenicity and carcinogenicity. A brief history and some background material on the earliest attempts to correlate molecular structure and biological activity are included. Most of the discussion focuses on modern methods utilizing extrathermodynamic and physical property variables such as the Hansch method and SIMCA, and approaches based on molecular connectivity such as the ADAPT, CASE, and Enslein methods. In general, the latter class is potentially the most useful in the study of the large and structurally diverse databases so often encountered in the study of mutagenicity and carcinogenicity. They also are not very sensitive to lab-to-lab variances in reported activities and outright misclassifications in activities of some compounds. This is chiefly because the statistical treatments used in these methods tend to dilute the importance of outliers. The methods using physicochemical and extrathermodynamic variables are especially important in relatively small, congeneric databases and can help fine tune the role of physicochemical properties in mechanistic hypotheses. All of the above methods have been used to look at mutagenicity and carcinogenicity and some of the results reported in the literature are reviewed here. As far as specific methods go, ADAPT, CASE, SIMCA and the Enslein approach all seem to have similar classification powers (in the range of 75-95%), depending very much on the database studied. The emphasis in this review is on showing that the use of these computer-aided storage, retrieval and analysis techniques is a timely approach to predicting and even understanding the toxicity of environmental substances. However, each of the methods discussed is still under development, and their potential usefulness for predictive purposes is still being explored. PMID- 3516675 TI - Salmonella mutagenicity tests: II. Results from the testing of 270 chemicals. AB - This publication includes data of Salmonella mutagenicity results on 270 coded chemicals, encompassing 329 tests performed by three laboratories under contract to the National Toxicology Program (NTP). The preincubation modification of the Salmonella/mammalian microsome assay was used to test chemicals in up to five Salmonella strains in the presence and absence of rat and hamster liver S-9. With a few exceptions, inter- and intralaboratory reproducibility was good. PMID- 3516676 TI - Non-insulin dependent diabetes mellitus in a horse. PMID- 3516678 TI - Some lessons from a tomb. PMID- 3516677 TI - Glucose tolerance and insulin sensitivity in ponies and Standardbred horses. AB - The existence of an innate insulin insensitivity in ponies was investigated and compared with the situation in larger breeds of horse. Ponies that were fat or had previously suffered laminitis were found to be far more intolerant to oral glucose loading (1 g/kg bodyweight [bwt]) than normal ponies or Standardbreds. These ponies also exhibited a far greater response in plasma insulin levels after glucose loading. Insulin response tests (0.4 iu/kg bwt insulin intravenously) showed only a minimal and very protracted response in both the fat and laminitic groups. The relevance of these findings in regulation of carbohydrate and lipid metabolism, and their role in the pathogenesis of hyperlipaemia, are discussed. PMID- 3516679 TI - Plasma vasopressin, neurophysin, renin and aldosterone during a 4-day head-down bed rest with and without exercise. AB - The purpose of this study was to investigate the main renal and hormonal responses to head-down bed rest, which is currently considered a reliable experimental model for the simulation of weightlessness. Urinary output and electrolytes, plasma renin activity (PRA), aldosterone (PA), antidiuretic hormone (ADH) and immunoreactive neurophysin-I (Np) were measured in eight adult volunteers submitted to a 4-day head-down bed rest (-6 degrees) after a 24-h control period in the horizontal position (day 0). Four of the eight subjects were submitted to two 1-h periods of controlled muscular exercise (50% VO2max) from day 1 to day 4. Throughout the head-down bed rest period, urinary output remained stable, although lower than in the control period (day 0), but the urinary Na/K ratio decreased. Plasma electrolytes and osmolality, and creatinine clearance remained unchanged. There was no significant difference between exercising and non-exercising subjects. At the hormonal level, PRA and PA increased during the head-down bed rest. This increase was more pronounced in the group with exercise. At the end of the tilt period, PRA and PA were about 3 times higher than on day 1. No significant changes could be observed for ADH and Np. It is concluded that a 4-day head-down bed rest results in no apparent changes in neurohypophyseal secretory activity, and in a progressive secondary hyperaldosteronism. PMID- 3516681 TI - Serum fungistatic and fungicidal activity in volunteers receiving antifungal agents. AB - The serum levels of two imidazoles, ketoconazole and Bayer n7133, when administered alone or in combination with rifampin, were measured in volunteers and the serum antifungal activity was determined against various fungal strains. Serum levels were measured by high pressure liquid chromatography and correlated with serum fungistatic activity as determined in microtiter plates. Ketoconazole showed a wide range of serum levels, suggesting individual variations. The addition of two doses of rifampin significantly decreased serum levels of both imidazoles and no synergism was observed. Serum fungicidal activity could only occasionally be demonstrated against one strain of Candida albicans and Candida stellatoidea. Serum fungistatic activity significantly correlated with the serum levels of both imidazoles. This approach should be investigated in patients to establish its potential clinical relevance for managing invasive fungal infections. PMID- 3516680 TI - Vascular fluid shifts and endocrine responses to exercise in the heat. Effect of rehydration. AB - This study examines the relationships between vascular changes and endocrine responses to prolonged exercise in the heat, associated with dehydration and rehydration by fluids of different osmolarity. Five subjects were exposed, in a 34 degrees C environment for 4 h of intermittent exercise on a cycle ergometer at 85 +/- 12 Watts (SD). Fluid regulatory hormones and cortisol were analysed in 3 experimental sessions: one without any fluid supplement (NO FLUID), and two with progressive rehydration, either by spring water (WATER) or isotonic solution (ISO), given after 70 min of exercise. Results were expressed in terms of differences between the mean values observed at the end of the exercise and the first hour values taken as references. Dehydration (NO FLUID) elicited a 4.0 +/- 0.8% (SE) decrease in plasma volume (PV) and an increase in osmolarity (8.4 +/- 3.1 mosmol X l-1). Concomitantly, plasma aldosterone (PA), renin activity (PRA), arginin vasopressin (AVP) and cortisol (PC) levels increased greatly in response to exercise in the heat (PA: 37.2 +/- 10.8 ng. 100 ml-1; PRA: 13.4 +/- 2.5 ng X ml-1 X h-1; AVP: 3.8 +/- 1.3 pg X ml-1; PC: 12.2 +/- 2.7 micrograms X 100 ml-1). Rehydration with water led to decreased osmolarity (-8.2 +/- 2.1 mosmol X l-1) with no significant changes in PV. With ISO, PV increased by 6.0 +/- 1.3% and the decrease in osmolarity was-5.8 +/- 1.8 mosmol X l-1. With both modes of rehydration, the increases in PRA, AVP and cortisol were blunted; only ISO prevented the rise in PA.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3516682 TI - Commercial kit for preliminary identification of Staphylococcus saprophyticus in urine. PMID- 3516683 TI - Clinical isolates of Cryptococcus neoformans from Zaire. PMID- 3516684 TI - Gardnerella vaginalis in urinary tract infections of renal allograft patients. PMID- 3516685 TI - Measurement of bactericidal activity in body fluids as a clinical research procedure. PMID- 3516686 TI - Standardization of the serum bactericidal test and its relationship to levels of antimicrobial agents. PMID- 3516687 TI - Value of the serum bactericidal test in management of patients with bacterial endocarditis. AB - A review is given of the available clinical data on the prognostic value of the serum bactericidal test in the treatment of patients with bacterial endocarditis. It is concluded that the test, even when performed in a standardized manner, does not provide useful information for the majority of patients with bacterial endocarditis. Until further clinical data are available, routine performance of the test in patients with bacterial endocarditis is not recommended. PMID- 3516689 TI - Purification and properties of membrane-bound hydrogenase isoenzyme 1 from anaerobically grown Escherichia coli K12. AB - Hydrogenase isoenzyme 1 from the membrane fraction of anaerobically grown Escherichia coli has been purified to near homogeneity. The preparation involved dispersion of the membrane fraction with deoxycholate followed by ammonium sulphate precipitation, ion-exchange, hydroxyapatite and gel filtration chromatography steps. The enzyme was assayed by quantification of the H2:benzyl viologen oxidoreductase activity immunoprecipitated by a non-inhibitory antiserum specific for the enzyme. The enzyme constituted about 8% of the hydrogenase activity found in the detergent-dispersed membranes, the remainder being attributable to hydrogenase isoenzyme 2. Isoenzyme 1 was purified 130-fold and the specific activity of the final preparation was 10.6 mumol benzyl viologen reduced min-1 (mg protein)-1 (H2:benzyl viologen oxidoreductase). The final preparation contained polypeptides of apparent Mr 64,000, 31,000 and 29,000. Antibodies were raised both to the final preparation and to immunoprecipitation arcs containing hydrogenase isoenzyme 1, excised from crossed immunoelectrophoresis plates. The former cross-reacted with all three polypeptides in the enzyme preparation but the latter recognised only the Mr 64,000 polypeptide. Immunological analysis revealed that the polypeptides of apparent Mr 31,000 and 29,000 are fragments of a single polypeptide of Mr 35,000 which is present in the detergent-dispersed membranes. The fragmentation of the Mr-35,000 polypeptide during the preparation correlates with a change in the electrophoretic mobility of the enzyme. A similar electrophoretic mobility change was observed, accompanied by cleavage of the Mr-35,000 polypeptide to one of 32,000 when the enzyme was analysed after exposure of detergent-dispersed membranes to trypsin. The enzyme in the detergent-dispersed membranes consists minimally of two subunits of Mr 64,000 and two subunits of Mr 35,000. It contained 12.2 mol Fe and 9.1 mol acid-labile S2-/200,000 g enzyme. The enzyme, purified from bacteria grown in the presence of 63Ni, was found to contain 0.64 (+/- 0.20) mol Ni/200,000 g enzyme. A constant ratio of 63Ni immunoprecipitated to hydrogenase isoenzyme 1 activity immunoprecipitated by antiserum specific for the enzyme was observed during the preparation, consistent with Ni being part of the enzyme. The enzyme has a low Km for H2 (2.0 microM) in the H2:benzyl viologen oxidoreductase assay. It catalyses H2 evolution employing reduced methyl viologen as electron donor. It is inhibited reversibly by CO and irreversibly by N bromosuccinimide. PMID- 3516688 TI - Technical aspects and clinical correlations of the serum bactericidal test. AB - A review of the studies using 50% human serum as a diluent for the serum bactericidal test has shown correlations with patient outcome. Human serum used as diluent of the patient's serum appears to be essential because of high protein binding of some antibiotics. An inoculum of 10(5)-10(6) bacteria/ml and a bactericidal criteria of 99.9% killing are technical aspects that have gained popularity. Careful timing of serum collection for the assay is important. Neither the macrotube nor microtiter techniques are entirely satisfactory. The latter method, however, has the advantage of being more reproducible than the macrotube method, less cumbersome and requiring less serum. Preliminary guidelines for performing and interpreting the test are provided. Future research should be directed toward making the microtiter technique more sensitive for identifying antibiotic tolerance, developing effective methods to eliminate the need for human serum as a diluent and obtaining more clinical correlations. PMID- 3516690 TI - Isolation and characterisation of a soluble active fragment of hydrogenase isoenzyme 2 from the membranes of anaerobically grown Escherichia coli. AB - An active tryptic fragment of membrane-bound hydrogenase isoenzyme 2 from anaerobically grown Escherichia coli has been purified. The soluble enzyme derivative was released from the membrane fraction by trypsin cleavage. The purification procedure involved ion-exchange, hydroxyapatite and gel permeation chromatography. The enzyme derivative was purified 100-fold from the membrane fraction and the specific activity of the final preparation was 320 mumol benzyl viologen reduced min-1 mg protein-1 (H2:benzyl viologen oxidoreductase). The native enzyme derivative had an Mr of 180,000 and was composed of equimolar amounts of polypeptides of Mr 61,000 and 30,000. It possessed 12.5 mol Fe, 12.8 mol acid-labile S2- and 3.1 mol Ni/180,000 g enzyme. Antibodies were raised to the purified preparation which cross-reacted with hydrogenase isoenzyme 2 but not with isoenzyme 1 in detergent-dispersed preparations. Western immunoblot analysis revealed that isoenzyme 2 which had not been exposed to trypsin contained cross reacting polypeptides of Mr 61,000 and 35,000. Trypsin treatment of the membrane bound enzyme to form the soluble derivative of isoenzyme 2, therefore, cleaves a polypeptide of Mr 35,000 to produce the 30,000-Mr fragment. Trypsin treatment of the detergent-dispersed isoenzyme 2 produces the same fragmentation of the enzyme. Neither of the subunits of the enzyme revealed any immunological identity with those of hydrogenase isoenzyme 1. PMID- 3516691 TI - Nucleotide sequence of the bacteriophage T5 DNA fragment which contains the gene for tRNAAsp. AB - The nucleotide sequence of bacteriophage T5 tRNAAsp has been determined by conventional methods using thin-layer chromatography on cellulose for oligonucleotide fractionation. It exhibits several unusual features, such as (a) the displacement of the constant residues U-8, A-14 and R-15; (b) the presence of three G X U out of four base pairs in the D-stem. The gene for T5 tRNAAsp has been cloned in pBR 322 and sequenced. The analysis of the flanking regions shows the presence of two open reading frames on both sides of this gene. It has also been shown that the cloned gene is expressed in Escherichia coli, and RNase P is involved in the T5 tRNAAsp processing. PMID- 3516692 TI - Inhibition of yeast cytosine deaminase by 5-bromo-2-pyrimidinone and its covalent hydrate. AB - Yeast cytosine deaminase (EC 3.5.4.1) is inhibited by 5-bromo-2-pyrimidinone. In aqueous solution at neutral pH three forms of this compound (the anion, the parent, and the covalent hydrate) are in equilibrium. Experiments were undertaken in order to determine the relative contributions of these three forms to the observed inhibition. The anion makes little or no contribution. Both the parent and the covalent hydrate inhibit the enzyme, with the Ki for the hydrate being 0.2-0.02 times that of the parent. In the presence of stoichiometric concentrations of the enzyme, the equilibrium between parent and hydrate is displaced towards the hydrate; however, the hydration is not catalyzed by cytosine deaminase. PMID- 3516693 TI - Localization of L11 on the Escherichia coli ribosome by singlet-singlet energy transfer. AB - Isolated Escherichia coli ribosomal protein L11 was labeled with maleimidyl derivatives of coumarin or fluorescein at the thiol group of its single cysteine, then reconstituted singly or in pairs with other fluorescently labeled ribosomal components. The characteristics of fluorescence from the labeled protein were studied and its distance to other components was determined by non-radiative energy transfer. The distance between probes on L11 and cysteine residues on other proteins or the 3' end of the ribosomal RNAs were found to be: S1, 7.4-8.3 nm; S21, 7.6 nm; 23S RNA, 6.9 nm; 5S RNA, 7.6 nm; 16S RNA, greater than 8.5 nm. Considered together with previously published results these distances indicate that the location of L11 in the 50S subunit is below the lateral protuberance characterized by L7/L12. PMID- 3516694 TI - The nucleotide sequence of the HEM1 gene and evidence for a precursor form of the mitochondrial 5-aminolevulinate synthase in Saccharomyces cerevisiae. AB - The biosynthesis of yeast 5-aminolevulinate (ALA) synthase, a mitochondrial protein encoded by the nuclear HEM1 gene, has been studied in vitro in a cell free translation system and in vivo in whole cells. In vitro translation of mRNA hybrid-selected by the cloned HEM1 gene, or of total RNA followed by immunoprecipitation with anti-(ALA synthase) antibody yielded a single polypeptide of higher molecular mass than the purified ALA synthase. This larger form, also seen in pulse-labeled cells, can be post-translationally processed by isolated mitochondria. These results show that the cytoplasmically made ALA synthase is synthesized with a cleavable extension which was estimated to be about 3.5 kDa by sodium dodecyl sulfate polyacrylamide gel electrophoresis. The complete nucleotide sequence of the HEM1 gene and its flanking regions was determined. The 5' ends of the HEM1 mRNAs map from -76 to -63 nucleotides upstream of the translation initiation codon. The open reading frame of 1644 base pairs encodes a protein of 548 amino acids with a calculated Mr of 59,275. The predicted amino-terminal sequence of the protein is strongly basic (five basic and no acidic amino acids within the first 35 residues), rich in serine and threonine and must represent the transient presequence that targets this protein to the mitochondria. Comparison of deduced amino acid sequences indicates a clear homology between the mature yeast and chick embryo liver ALA synthases. PMID- 3516695 TI - Purification and properties of coproporphyrinogen oxidase from the yeast Saccharomyces cerevisiae. AB - Coproporphyrinogen oxidase has been located in the cytosol of yeast cells. The enzyme was purified to homogeneity from a heme mutant strain exhibiting a high specific activity (15-20 enzyme units/mg soluble protein compared to 1-2 enzyme units/mg soluble protein of by the wild-type strain). The final preparation was homogeneous as judged by sodium dodecyl sulfate/polyacrylamide gel electrophoresis (Mr = 35,000) and isoelectrofocusing (pI = 6.2). Gel filtration on AcA 44 gave a relative molecular mass of 70,000. N-terminal amino-acid sequence analysis revealed a single polypeptide chain. Thus the enzyme appears to be a dimer with identical subunits. Two iron atoms/molecule of native protein were detected; they could not be removed by exhaustive dialysis or gel filtration on Sephadex G-25. However the involvement of the iron atoms in the oxidative catalytic activity of the enzyme was not demonstrated. The Km value for coproporphyrinogen was 0.05 microM. The enzyme was active only when molecular oxygen was used as electron acceptor; no anaerobic activity could be detected. Thiol-directed reagents partially inhibited the enzyme, indicating that an SH group is required for activity. Yeast coproporphyrinogen oxidase was activated by phospholipids or neutral detergents as described for the bovine liver enzyme. PMID- 3516696 TI - Isolation and localization of filamin in heart muscle. AB - High-molecular-mass protein was isolated from chicken heart muscle. The apparent molecular mass of a single polypeptide chain is similar to that of chicken gizzard filamin: 250-270 kDa. The protein interacts with antibodies against chicken gizzard filamin and induces F-actin gelation in a concentration-dependent manner. Immunofluorescent staining of cardiomyocytes and chicken heart sections with antifilamin antibody demonstrates two types of filamin localization: filamin was located on the sarcomere border in the periphery of the Z-disk; filamin was found in intercalated disks between cardiomyocytes. PMID- 3516697 TI - Deuterium incorporation into Escherichia coli proteins. A neutron-scattering study of DNA-dependent RNA polymerase. AB - Neutron small-angle scattering studies of single protein subunits in a protein DNA complex require the adjustment of the neutron scattering-length densities of protein and DNA, which is attainable by specific deuteration of the protein. The neutron scattering densities of unlabelled DNA and DNA-dependent RNA polymerase of Escherichia coli match when RNA polymerase is isolated from cells grown in a medium containing 46% D2O and unlabelled glucose as carbon source. Their contrasts vanish simultaneously in a dialysis buffer containing 65% D2O. An expression was evaluated which allows the calculation of the degree of deuteration and match point of any E. coli protein from the D2O content of the growth medium, taking the 2H incorporation into RNA polymerase amino acids to be representative for all amino acids in E. coli proteins. The small-angle scattering results, on which the calculation of the degree of deuteration is based, were confirmed by mass spectrometric measurements. PMID- 3516698 TI - Primary structures of mutationally altered ribosomal protein L7/L12 and their effects on cellular growth and translational accuracy. AB - The amino acid sequences of mutationally altered ribosomal protein L7/L12 from four different rplL mutants of Escherichia coli were determined and correlated with some features of the mutant ribosomes. Two of the rplL mutations are deletions around position 40, which give rise to a shortened hinge region between the two domains of L7/L12. The other two mutants harbor point mutations at position 74 (Gly----Asp) or at position 82 (Glu----Lys), which are in or close to an evolutionarily conserved sequence in the C-terminal domain. The two latter mutations are associated with decreased rates of growth and translational elongation. All four mutants show increased nonsense codon read-through in vivo. Ribosomes from one of the deletion mutants show clearly increased missense error rates in vitro. PMID- 3516699 TI - Anomalous intrapulmonal vein drainage and pulmonary vein connection in DSA. AB - Anomalous pulmonary venous drainage can be detected and evaluated by angiographic studies. Now that intravenous DSA is available, this method can be used to demonstrate pulmonary venous return. This study presents the results of DSA examination in three patients having anomalous pulmonary vein connection with the left innominate vein and the superior vena cava respectively. In a fourth patient, intra-pulmonary atypical venous return could be demonstrated by DSA without anomalous connection. This minimal invasive procedure is diagnostically useful in anomalies of pulmonary veins when recommended post-processing techniques are evaluated, particularly in patients with additional cardiac septal defects. PMID- 3516700 TI - Cardiac gating in intravenous DSA. AB - ECG-gating of a pulsed radiation exposure during end-diastole using digital subtraction angiography shows significantly better results in the examination of the aortic arch vessels and pulmonary arteries and may be expected to decrease the rate of false positive diagnosis of stenosis when examining renal arteries. Different types of misregistration artifacts due to a smear effect by integrating several television frames using non-gated DSA are described and schematically explained. Furthermore, a short description of the difficulties which may be encountered with ecg-gated DSA--mainly rapid changes of heart frequency--is given. PMID- 3516701 TI - Impact of technology and technique on the performance of the intravenous D.S.A. of the carotid arteries. AB - Intravenous Digital Subtraction Angiography (i.v. D.S.A.) was performed at the carotid bifurcation level in 259 patients with clinical or physical findings of a Cerebrovascular Insufficiency (C.V.I.). The angiographic examinations have been performed during two different periods, basically differing for the technology of the digital equipment and for the technique used. The personal experience showed how these two factors are important in determining the quality of the image and therefore the accuracy of the i.v. studies. Images of good quality of the common and internal carotid arteries have been obtained in 73% and 54% of the cases of the first period and in 93% and 82% of the cases of the second period. The role of the i.v. D.S.A. in the management of the C.V.I. depends not only upon the quality of the images, but also upon the surgical policy and from the availability of ultrasounds. PMID- 3516702 TI - Computer processed fluoroscopic images for digital intravenous renal angiography. AB - We investigated intravenous digital angiography using computer processed fluoroscopic images. Computer processed fluoroscopy (CPF) was compared to conventional digital subtraction angiography (DSA) in 39 patients referred for renal vessel evaluation. For assessment of CPF the anterior-posterior images were compared with the corresponding digital subtraction angiograms. 79% percent of DSA and 71% of CPF studies were diagnostic. Peripheral injection of contrast medium caused deterioration of CPF images. Skin dose measurements were obtained in 24 patients. The median dose for DSA was 8.2 rad, compared to 1.1 rad for CPF. It is concluded that sophisticated algorithms should be investigated for digital angiography, so that high image quality can be achieved with a reduced radiation exposure. PMID- 3516704 TI - A randomized double blind cross-over trial of nifedipine in the treatment of primary Raynaud's phenomenon. AB - During three winter months, 23 women participated in a double blind placebo controlled cross-over clinical trial of nifedipine in the treatment of Raynaud's phenomenon. Nifedipine and placebo were given in random order for two consecutive four-week periods. The dose of nifedipine was increased from 5 mg three times daily (tds) to 15 mg tds. During the final two weeks, the median number of attacks of Raynaud's phenomenon on nifedipine was 2.3 per week compared to 5.0 on placebo (P less than 0.01). Fifteen patients gave nifedipine a higher drug evaluation score than placebo (P less than 0.01). Side-effects were experienced by 14 patients (61%) on nifedipine and by two on placebo (P = 0.005). Finger systolic pressure after digit cooling did not differ significantly at the end of each treatment period. Nifedipine is effective in primary Raynaud's phenomenon in most patients but side effects are common. PMID- 3516703 TI - Acute haemodynamic effects of the antiarrhythmic agent pirmenol in cardiac patients: a comparison with lidocaine. AB - The acute haemodynamic effects of pirmenol, a new Class 1 antiarrhythmic agent, were investigated in a double-blind comparison with lidocaine and placebo. Three groups of 10 patients each received either pirmenol as a 50 mg intravenous injection followed by a 2.5 mg min-1 infusion, or lidocaine as a 75 mg injection followed by a 3 mg min-1 infusion, or placebo. Mean plasma pirmenol concentrations during the 30 min infusion period were 2.3-2.5 mg l-1, and were considered to be therapeutically effective. Compared to measurements taken during a baseline phase of 15 min duration, pirmenol increased heart rate by 10 beats min-1 (P less than 0.001) and mean arterial pressure (MAP) by 5 mmHg (P less than 0.001). It also increased systemic vascular (P less than 0.05) and pulmonary arterial resistances (P less than 0.01). Left ventricular end-diastolic pressure (LVEDP) was not increased significantly. Cardiac index and left ventricular work index remained unchanged. Lidocaine induced a comparable increase in MAP (6 mmHg; P less than 0.001) and elevated LVEDP (2.8 mmHg; P less than 0.05) and did not affect left ventricular work index. Echocardiographic left ventricular ejection fraction was reduced more by pirmenol (-0.05; P less than 0.001) than by lidocaine (-0.03; P less than 0.05), but the greater reduction may partly be explained by the increase in heart rate. Primenol did not induce excessive circulatory responses or side-effects in any patient. Intravenous administration of pirmenol results in increased heart rate and afterload but has little effect on preload. The myocardial depressant effect is relatively slight, and comparable to that of lidocaine. PMID- 3516705 TI - Long-term lymphocytapheresis therapy in multiple sclerosis. Preliminary observations. AB - Long-term lymphocytapheresis (LPH) therapy was applied in 9 patients with a relapsing-remitting course of multiple sclerosis (MS) and a high frequency of bouts. The therapeutic scheme included series of 4 LPH within 8 days, which were repeated every 6-8 weeks during 1 year or longer, until the myelin-reactive T cell test--which was used for immunological control--became normal. Altogether, the therapy was well tolerated, but severe problems with the veins occurred in 2 of the 9 patients. No bouts during LPH therapy were seen in 7 of the 9 patients. The 3 patients with the shortest duration of the disease showed an improvement of the Kurtzke scale. No relapses or a reduced relapse rate--compared to the time before LPH therapy--was observed in 6 of the 9 patients during the follow-up period of up to 23 months. Conclusively, long-term LPH therapy seems to be recommended as an alternative to the continuous administration of immunosuppressive drugs, especially for active cases of MS with a short duration of the disease. PMID- 3516706 TI - Sequential MTX and 5-FU: advance or myth? PMID- 3516707 TI - Sinus histiocytes in axillary lymph nodes from patients with breast cancer: macrophage characteristics and activation level. AB - Cell suspensions from 16 tumour-free axillary lymph nodes from breast cancer patients were prepared, using collagenase digestion to free the sinus histiocytes from the fibrous stroma of the nodes. The histiocytic cells so obtained were then characterized using four surface markers: Fc(IgG) receptors, C3 receptors, DR antigen and a macrophage-associated antigen (defined by the monoclonal antibody VEP-7). In addition phagocytosis was assessed using IgG-coated red cells, and both lysozyme and alpha-1-antitrypsin were localized by means of immunoperoxidase staining. The results demonstrated that the majority of sinus histiocytes carried surface macrophage markers, but that a minority displayed phagocytosis and the presence of lysozyme or alpha-1-antitrypsin. PMID- 3516709 TI - NK-9, a distinct sialylated antigen of the T200 family. AB - The nature and properties of antigens detected by a novel monoclonal antibody, NK 9, were studied. The NK-9 antigens had apparent molecular masses of 190, 200 and 220 kDa and were sensitive to neuraminidase and sodium metaperiodate treatments, which destroy the sialic acid residues of the cell surface glycoproteins. Trypsin treatment also removed the NK-9 reactivity, but the antigens were restored within a few hours thereafter. Tunicamycin, which inhibits the N-linked glycosylation after neuraminidase treatment, had no effect on the reappearance of the NK-9 positivity. Neither did endoglycosidase F, which removes the N-linked sugars, abolish the NK-9 antigenicity. Monensin, which blocks the cellular secretion, inhibited the restoration of the antigens, and monensin block also without preceding treatment with neuraminidase led to the disappearance of NK-9 reactivity, suggesting possible recycling molecules as carriers of the NK-9 detected epitopes. The NK-9 antigens appear to belong to the T200 antigen family, but are distinct from the antigens reactive with the available anti-T200 antibodies anti-LC, T29/33 and HLe-1, based on their different cell type distribution and absence of cross-reactivity in sequential immunoprecipitations. PMID- 3516708 TI - Ultrasonically guided fine needle aspiration biopsy (UG-FNAB): a useful technique for the diagnosis of abdominal malignancies. PMID- 3516710 TI - Human leukocyte function-associated antigens on lympho-hemopoietic precursor cells. AB - The expression of human leukocyte function-associated antigens (HLFA, equivalents of murine LFA-1) was studied on early lympho-hemopoietic cells in infant thymus and normal bone marrow by double immunofluorescence methods, cell sorting and colony-forming assays. Monoclonal antibodies MHM-24 recognizing the alpha chain (180 kDa) and 60.3 and 60.1 identifying the beta chain (95 kDa) were used. The vast majority of thymocytes including large terminal deoxynucleotidyl transferase (TdT)-positive blast cells are HLFA positive. On the other hand, most B cell precursors in the bone marrow, identified by the expression of nuclear TdT, do not show surface HLFA which appears at the pre-B cell stage (cytoplasmic mu positive, surface Ig negative). Cell sorting experiments revealed an enrichment of early myeloid cells (myeloblasts and colony-forming unit cells) in the HLFA negative fraction. Erythroid cells appeared to be completely negative from the burst-forming unit erythrocyte stage onwards. Anti-HLFA-antibodies, capable of blocking T cell and natural killer function, may have therapeutic potential without interfering with precursor cell development in man. PMID- 3516711 TI - Presentation of alloantigens by host cells. AB - Presentation of alloantigens by host cells has been examined in vivo by means of a murine cell transfer system. Primary (1 degree) hosts were activated by the i.p. administration of allogeneic spleen cells and their spleen or peritoneal cells were transferred into syngeneic secondary (2 degrees) hosts 3 days later. Sensitization of 2 degrees hosts was assessed by their ability to reject donor strain skin grafts prematurely. The transferred cells were routinely depleted of T lymphocytes. We show that (a) 5 X 10(7) spleen and 3 X 10(6) peritoneal cells consistently caused marked accelerated graft rejection; (b) this effect was antigen specific and observable in all strain combinations studied; (c) it was caused by the active sensitization of 2 degrees hosts, but not by contaminating donor strain cells; (d) the cells involved were plastic adherent and viability was not a requirement; and (e) both class I and II, but not minor, histocompatibility antigens played a role in this model. We conclude that presentation of alloantigens by host antigen-presenting cells can be a potent route of allosensitization. PMID- 3516712 TI - Collagens of the retinal microvascular basement membrane and of retinal microvascular cells in vitro. AB - We have analysed the collagens present in vascular basement membranes isolated from bovine retinal and cerebral microvessels and bovine renal glomeruli, and from the non-vascular basement membrane of bovine lens capsule. These are compared with the collagens produced by cultured bovine retinal microvascular pericytes and lens epithelial cells, and by canine retinal microvascular endothelial cells, in vitro. Biochemical and immunocytochemical analyses indicate that all of the vascular basement membrane preparations have an identical collagenous composition, consisting of the same polypeptides present in lens capsule (primarily type IV collagen), together with other polypeptides that are identified as type I, and a small amount of type III collagen. Identification of the latter is based on two-dimensional gel electrophoresis in the presence and absence of a reducing agent. Immunocytochemical studies, however, demonstrate type I, type IV and some type V collagen in the basement membranes of the isolated microvessels. The cultured microvascular cells produce predominantly type I collagen molecules, but they also produce other collagen peptides that appear to be type IV, and, at least in some experiments, small amounts of type III collagen. The biochemical identification of collagens type I and IV is confirmed by immunocytochemistry. However, results with anti-type I collagen and procollagen antibodies in cultured pericytes vary with antibodies from different sources. The quantities of the type IV peptides produced by the cultured cells also vary in different experiments. PMID- 3516713 TI - Progenitor cell defect correctable by bone marrow transplantation in five independent mouse models of platelet storage pool deficiency. AB - Two human platelet storage pool deficiencies (SPD), Hermansky-Pudlak syndrome and Chediak-Higashi syndrome, are recessively inherited and characterized by hypopigmentation, prolonged bleeding, and normal platelet numbers accompanied by a reduction of platelet dense granules. Seven independent and unique mouse pigment mutations regulated by separate genes have been proposed as animal models for SPD. Mice homozygous for the recessive mutations have diluted pigmentation, prolonged bleeding times, normal platelet concentrations, and reduced numbers of platelet dense granules. Reciprocal bone marrow transplantations were carried out between normal C57Bl/6J mice and five of these mutants, pearl, light ear, pale ear, ruby-eye, and maroon, to test whether the platelet defects are due to platelet progenitor cells or to humoral regulatory factors. Recipient mice were transplanted with marrow after 950-rad whole body irradiation. The prolonged bleeding time and low serotonin concentrations of the five mutants were converted to normal values after transplantation with normal marrow. Normal mice displayed characteristics of platelet SPD when transplanted with mutant marrow. This study demonstrates that in each of five independent mouse models the thrombopathy of SPD is due to a platelet progenitor cell defect correctable by bone marrow transplantation. These findings suggest that in severe cases human SPD may be amenable to treatment by bone marrow transplantation. PMID- 3516714 TI - Studies of hemopoietic stromal fibroblastic colonies in patients undergoing bone marrow transplantation. AB - We report here the results of serial bone marrow fibroblast cultures from recipients of histocompatible allogeneic bone marrow transplants (37 patients with acute leukemia, and seven with severe aplastic anemia). The mean value of marrow CFU-F growth for recipients at day 21 after transplant was significantly lower than that for normals and for patients before transplant. There were no obvious differences in the morphologic, ultrastructural, and cytochemical characteristics of the CFU-F between the normals and the patients who received transplants. The number of stromal CFU-F cells in S phase was increased during the early period after transplantation, as demonstrated by a significant reduction of CFU-F growth after short exposure to hydroxyurea. However, the return to normal was rapid, within six weeks. The presence of graft-vs-host disease (greater than or equal to grade II) and the choice of immunosuppressive drug, i.e., methotrexate or cyclosporine, did not affect the CFU-F recovery. The findings in the present study show that the marrow stromal compartment is compromised after marrow transplantation, but its regeneration is rapid. No in vitro CFU-F growth was obtained from peripheral blood of donors and patients, either before or after bone marrow transplant. PMID- 3516715 TI - Transplantation of HLA-haploidentical T-cell-depleted marrow for leukemia: autologous marrow recovery with specific immune sensitization to donor antigens. AB - Autologous marrow recovery without engraftment of donor marrow was observed after bone marrow transplantation (BMT) for two patients with acute lymphoblastic leukemia. Each had received marrow from a haploidentical mixed lymphocyte culture (MLC) reactive donor after pretransplant conditioning with total body irradiation and high-dose cyclophosphamide. To minimize graft-vs-host disease, the marrow was depleted of T cells in vitro by treatment with a monoclonal anti-T-cell antibody and complement. Two weeks after each transplant, reactive lymphocytes were noted transiently in the blood of each patient. Analysis of karyotype, HLA type, and in vitro MLC responsiveness proved the lymphocytes to be of host, not donor, origin. MLC studies showed rapid proliferative responses specifically to stimulating cells from the BMT donor, indicating in vivo sensitization to donor antigens. Return of hematopoietic function was markedly delayed, but it eventually normalized after several months, without evidence of chimerism. These studies confirm that some immune and hematopoietic stem cells of host origin survive the high-dose chemoradiotherapy used as transplant conditioning. Because these immune cells are specifically reactive to donor alloantigens, more potent suppression of host immunity may be needed to prevent nonengraftment of T-cell-depleted, HLA mismatched bone marrow. PMID- 3516716 TI - Stromal cells in long-term murine bone marrow culture: FACS studies and origin of stromal cells in radiation chimeras. AB - Adherent layers from hematopoietically active long-term bone marrow cultures (LTBMC), incubated with fluorescent beads, were analyzed for autofluorescence and phagocytic ability, using a fluorescence-activated cell sorter (FACS). Four groups of cells were separated from the adherent layers, including a group of large polygonal fibroblastoid stromal cells. Long-term chimeras were made by lethal irradiation of CBA/Ca (CBA) and C57Bl6/J (B6) mice and repopulation with phosphoglycerate kinase (PGK-1) alloenzyme-congenic bone marrow cells. Hematopoietically active LTBMC were established from such chimeras, and donor and host contributions of FACS-sorted adherent-layer cells were measured. While macrophages and other hematopoietic cells were of donor origin, the fibroblastoid stromal cells were mainly or entirely host derived. PMID- 3516717 TI - Controversies in the pathogenesis of exercise-induced asthma. AB - Exercise-induced asthma is considered in terms of the stimulus, the intermediary pathway and the response. Various controversies about each of these components are discussed. The stimulus may be cooling of the airways, loss of water or neither of these, and there is evidence for and against the identity of exercise- and hyperventilation-induced asthma. The intermediary pathway seems certain to involve the release of chemical mediators, although other neurogenic mechanisms have been proposed. Since the response is far from uniform, it may well be that different pathways are involved in different subjects. The effector mechanism appears to be bronchospasm, but recent evidence has suggested that an inflammatory response may be involved in a late reaction to exercise. The variability of exercise-induced asthma may well be due to variations in intrinsic bronchial reactivity resulting from allergenic stimulation. PMID- 3516718 TI - Association of defective monocyte chemotaxis with recurrent acute exacerbations in chronic obstructive lung disease. AB - Since mononuclear phagocytes are crucial in resisting microbial challenge in the lung, selected functions of blood monocytes were studied in 27 patients with chronic bronchitis (19 with hypersecretory symptoms and many acute infectious exacerbations and eight with obstructive symptoms without recurrent infections), and compared with 82 healthy controls. While monocytes from patients with solely obstructive symptoms had a normal migratory function, both spontaneous and chemotactic migration were depressed in the patients with hypersecretory symptoms. Phagocytic activity of the blood monocytes was equally depressed in both subgroups. Intracellular killing of Candida albicans was normal in all patients when compared with smoking control subjects. Chemotactic responsiveness was thus decreased only in patients with hypersecretory symptoms, suggesting that a defect in monocyte migration in these patients might contribute to the high incidence of acute bronchial exacerbations. PMID- 3516719 TI - Detection of DNA damage in human cells and tissue using sequencing techniques. AB - Methods have been developed that permit both identification and location of sites of alterations is defined DNA sequences. These methods can be extended to human tissues using the alphoid segment, which comprises 1% of the human genome. This segment can be isolated in ample quantities from human cells and tissues. Once purified and end labeled, this defined segment can be used to detect sites of altered DNA moieties by combining Maxam-Gilbert sequencing protocols with appropriate enzymatic probes and chemical techniques. These studies can be performed in cultured cells or in tissues obtained by surgical excision or autopsy. PMID- 3516720 TI - [Monoclonal antibodies: problems and applications]. PMID- 3516721 TI - Preclinical increase in activity of muscle microsomal trypsin-like protease in murine muscular dystrophy, C57BL/10-mdx. AB - Preclinical alterations of protease activities in skeletal muscles from 10-day old dystrophic mouse, C57BL/10-mdx, were examined by using 10 fluorogenic peptide substrates. Among the activities tested, only Boc-Val-Pro-Arg-MCA-hydrolyzing enzyme of the muscle microsomes showed an about 6-fold higher level of activity in mdx mouse. The increase in activity was not observed in tissues other than skeletal muscle. The enzyme had a pH optimum between 8.5 and 11.0, and was inhibited with DFP and variety of trypsin inhibitors. The enzymatic activity transiently increased at 1-2 weeks of age, the preclinical or very early stage of the disease. These results imply that the increased level of a trypsin-like protease possibly present in muscle microsomes may be closely related to the manifestation of muscular dystrophy. PMID- 3516722 TI - The occurrence and distribution of alpha-hydroxy-acid dehydrogenase in some members of the order Kinetoplastida. AB - LDH-X is the isoenzyme of lactate dehydrogenase found in mammalian spermatozoa, occurring in cytosolic and mitochondrial locations. Gossypol strongly inhibits it, and the spermicidal action of this compound is attributed to the disruption of a reducing shuttle. The flagellated protozoan, Trypanosoma cruzi, contains an enzyme activity similar to LDH-X, called alpha-hydroxy-acid dehydrogenase, which is here shown to possess cytosolic and glycosomal components. The glycosome is a microbody-like organelle containing the early glycolytic enzymes. We postulate that the inhibition of replication of T. cruzi by gossypol derives from interference with glycosomal reducing shuttles. T. lewisi resembles T. cruzi in this respect. PMID- 3516723 TI - The processing of peptide precursors. 'Proline-directed arginyl cleavage' and other monobasic processing mechanisms. AB - The classical conversion site in precursors of regulatory peptides is a sequence of two basic amino acids. During recent years, however, a group of monobasic cleavage sites has emerged. In certain cell systems it has been shown that the monobasic cleavage mechanism is both a specific mechanism which only attacks a particular basic residue, and a distinct mechanism which can be separated from the dibasic cleaving mechanism within the same cell. The vast majority of monobasic cleavages occur at single arginines although cleavage after a lysine residue has also been demonstrated. There is no 'consensus sequence' of amino acids surrounding the single basic residue which is the apparent signal for proteolytic processing. However, in approximately one third of the cases, a proline residue is found either just before or just after the basic residue. On the basis of this 'proline-directed arginyl cleavage' it is discussed how the conformation of the peptide backbone might be important for this type of cleavage. Finally, it is suggested that tissue-specific expression of different processing enzymes, e.g. dibasic and monobasic specific forms, might explain the tissue-specific processing of precursors like the pro-opiomelanocortin and the CKK and somatostatin precursor. PMID- 3516724 TI - Altered heat-shock response in polyamine-depleted bacteria. AB - A polyamine-auxotrophic mutant of E. coli was cultivated in the presence or absence of putrescine and submitted to heat shock over 3 different ranges of temperature. In all cases, protein synthetic capacity measured in comparison to that of cultures at the preshift temperature was much higher in polyamine depleted bacteria under thermic stress. Addition of putrescine only before the shift-up was able to restore gradually normal control of the relative protein synthetic capacity. PMID- 3516725 TI - Lipogenesis in isolated human sebaceous glands. AB - Lipogenesis in isolated human sebaceous glands from [U-14C]glucose, [U 14C]leucine, [U-14C]isoleucine, and [U-14C]valine has been determined by thin layer chromatography. Total lipogenesis from 2 mmol/l [U-14C]glucose was 114.8 +/ 22.3 pmol/gland per h (mean +/- SE), with 53.8% being incorporated into triglycerides, 20.2% into squalene, 12.8% into phospholipids, 2.1% into cholesterol and 7.1% into wax monoester and cholesterol ester and 5% into di- and monoglycerides and free fatty acids. Total lipogenesis from 2 mmol/l [U 14C]leucine, 2 mmol/l [U-14C]isoleucine, and 2 mmol/l [U-14C]valine in the presence of 2 mmol/l glucose was 26, 29 and 9%, respectively, of that seen with 2 mmol/l glucose alone. The pattern of 14C distribution in the various lipid classes from the three U-14C-labelled branched-chain amino acids was not significantly different from that seen with [U-14C]glucose. PMID- 3516727 TI - [Activities of the Pirogov Russian Public Readingroom in Heidelberg (1862-1920)]. PMID- 3516726 TI - A tobacco chloroplast DNA sequence possibly coding for a polypeptide similar to E. coli RNA polymerase beta-subunit. AB - DNA sequencing has revealed a long open reading frame (ORF) in the large single copy region of tobacco chloroplast DNA. This ORF consists of 1070 codons and its deduced amino acid sequence shows about 39% homology to that of the beta-subunit of E. coli RNA polymerase. This finding raises a possibility that some of the chloroplast RNA polymerase subunits are coded for by the chloroplast genome. PMID- 3516728 TI - [International exploits of Vladimir Aronovich Khavkin]. PMID- 3516729 TI - [Vladimir Petrovich Filatov]. PMID- 3516730 TI - [At the summons of the motherland]. PMID- 3516731 TI - Transvaginal sector scan sonography for needle guided transvaginal follicle aspiration and other applications in gynecologic routine and research. AB - A transvaginal sector scanner probe has been developed for precise needle-guided transvaginal follicle aspiration under sonographic control. The first results of transvaginal needle-guided follicle aspiration are presented. A high recovery rate was obtained (86% /follicle). The pregnancy rate after in vitro fertilization and embryo replacement was remarkably high (21.3%/cycle). Because exceptionally high-quality images of the organs in the pelvis are obtained, there are numerous other potential applications for the trans-vaginal sector scanner. PMID- 3516732 TI - GnRH ovulation induction. PMID- 3516733 TI - [Academician of the Ukrainian SSR Georgii Vladimirovich Fol'bort (on the centenary of his birth)]. PMID- 3516734 TI - [Determination of thyroid volume using computerized ultrasonography and its clinical application]. AB - A new method for determining thyroid gland volume was developed by means of computerized ultrasonography. A maximum area of the thyroid (S) was obtained from coronal sections and a maximum thickness (C) was obtained from sagittal sections. The thyroid volume was then calculated by SXC. The volume of phantoms and pig thyroids obtained by this method was identical with the actual volume. The thyroid volume in this method correlated well with the estimated volume in patients with Graves' disease undergoing thyroidectomy (r = 0.954). The measurement was then performed in 56 healthy subjects (male 28, female 28, age 15 68 y.o.) and 126 patients with thyroid diseases. The thyroid volume in healthy men was significantly larger than that in women (18.4 +/- 6.1 ml vs 13.9 +/- 4.9 ml, Mean +/- SD, p less than 0.01). The thyroid volume in normal subjects correlated with body height, body weight or body surface area (p less than 0.01), which may explain the sex differences. An attempt was made to calculate the prospective thyroid volume (Y ml) from body height as follows; Y = 0.425 X - 52.8, X; body height (cm). Four out of thirty patients with untreated Graves' disease had a gland volume of the normal range, but in all patients the thyroid volume was larger than the prospective volume. The thyroid volume and the rate of volume increase (determined thyroid volume/calculated prospective volume) were correlated with the serum levels of T3, T4 concentration in the untreated stage. The volume and the rate of volume increase did not correlate with serum TSH receptor antibody activity. The thyroid volume in patients with Graves' disease who had been in remission (33.0 +/- 13.5 ml) was significantly smaller than that in untreated patients (51.8 +/- 24.4 ml, p less than 0.02). These findings indicate that the present method is reliable and clinically useful for the investigation of thyroid diseases. PMID- 3516735 TI - Reconstructive implant surgery and implant prosthodontics II. PMID- 3516736 TI - The mandibular staple bone plate. Its use and advantages in reconstructive surgery. AB - The mandibular staple bone plate is a reconstructive device that will attach to the inferior border of the mandible and will orthopedically provide for prosthetic and jaw stabilization in the edentulous mandible and the deformed mandible. It can be useful in a variety of clinical settings and is adaptable to a number of prosthetic needs. It is cost-effective and has demonstrated osteointegration in over 91 per cent of cases. The cumulative rate of success for 5 to 6 years is 94.6 per cent. PMID- 3516737 TI - Prosthodontic reconstruction with the mandibular staple bone plate. AB - The atrophic edentulous mandible is treated successfully with a mandibular staple bone plate. The lower denture must be tissue-borne with retention and stability provided by the implant. An attachment with stress-breaking capability is necessary for the success of the reconstruction. PMID- 3516738 TI - Maxillary and sinus implant reconstructions. AB - The root and sinus series of the Omnii system have been used extensively since 1981. They are very versatile in their ability to be used within edentulous areas of the maxilla. Their design attempts to maximize the use of the available bone, and placement techniques allow the manipulation of bone to form sockets in otherwise deficient areas of bone. The root implants can be used as free-standing implants or as multiple abutments. The sinus implant is always used as an abutment. It may be used in conjunction with other implants or with natural abutments. Maxillary implants are not loaded until a 6-month healing time has elapsed following placement. An understanding of the different qualities of bone found in the maxilla is important to achieving the successful loading of these implants. Different times are required to allow physiologic loading in different qualities of maxillary bone. Restorative treatment is normally done with fixed bridge work, and the use of any type of stress breaker attachments is not recommended. PMID- 3516739 TI - Ramus frame implant reconstruction. PMID- 3516740 TI - Evaluation in reconstructive implantology. AB - Acceptance of implants by dentist, readiness for use, and general indications are described. Individual evaluation for implants is detailed and success of implants defined. Indications for removal are cited and appropriate statistic methodology presented. PMID- 3516741 TI - [Recollections of Heinrich Auspitz on his 150th birthday]. PMID- 3516742 TI - [The staircase advancement flap in the reconstruction of the lower lip following resection of prickle cell carcinoma]. PMID- 3516743 TI - [Late complications following ear piercing--therapeutic possibilities]. PMID- 3516744 TI - Replacement of a partial denture: a conservative approach. PMID- 3516745 TI - Partial denture design: modern concepts. 1. Patient motivation, personality and successful dentures. PMID- 3516746 TI - A chromium release assay for the assessment of spontaneous and immune hemolysis of heterologous erythrocytes by sera of rainbow trout. AB - This report describes the development of a microtiter system for measuring spontaneous hemolytic activity and immune hemolysins in rainbow trout serum. The chromium release assay, utilizing complement-mediated lysis of heterologous erythrocytes allows rapid, efficient quantitation of hemolytic activity in small serum samples from numerous fish. PMID- 3516747 TI - Ontogenetic development of lipopolysaccharide-reactive B cells against bromelain treated mouse erythrocytes in mouse lymphoid tissues. AB - In lymphoid tissues of mice, there exist LPS-reactive B cells which can differentiate to IgM-secreting plaque-forming cells (IgM-PFC) and PFC secreting antibodies against bromelain-treated mouse erythrocytes (BrMRBC) by LPS activation. In this study, four groups of LPS-reactive B cells in spleen, peritoneal cavity and mesenteric lymph nodes from 2- and 10-week-old mice were compared and enumerated as precursors of IgM-PFC and anti-BrMRBC PFC on days 1 and 2 after LPS activation in quantitative culture conditions. The induction of each of four PFC responses in peritoneal cells was sensitive to LPS and anti mouse IgM antibodies as much as the induction of the respective PFC response in spleen cells. The ratios of four groups of PFC to each other were different among three tissues and between two ages. These findings support the view that the four groups of LPS-reactive B cells in each tissue are mostly in distinct subpopulations of B cells from each other, and the respective groups of different lymphoid tissues at different ages belong to the same subpopulation. PMID- 3516748 TI - The impact of treatment on insulin release and relative peripheral resistance during the oral glucose tolerance test. A study of noninsulin-dependent diabetes mellitus and glucose intolerance. AB - Using 75 g oral glucose tolerance tests (OGTTs), insulin release and relative peripheral resistance were studied in two groups of subjects before and after treatment; ten mostly obese subjects with glucose intolerance (GI), who had improved glucose tolerance after six months of diet and exercise with weight reduction; nine nonobese patients with noninsulin-dependent diabetes mellitus (NIDDM), who received a daily dose of 5 mg glipizide for three months. Total insulin release was measured as the total area under the insulin curve during the OGTT. The insulin response to glucose was expressed as the ratio of the incremental area under the insulin curve to that of the glucose curve above fasting levels (delta AUCI/delta AUCG), during the first 30 minutes and the latter part of the test. The glucose uptake rate (M) was measured as the difference between the glucose load and the increase of glucose in the glucose space after compared to before the OGTT. The relative peripheral resistance (rel R) against glucose-uptake-promoting factors was expressed as 1/M. The main effects of therapy in the GI-group appeared to be a decrease of the mean rel-R value and a decrease of the mean total insulin release. This implies a mainly peripheral action of therapy at receptor and/or postreceptor levels. The mean [delta AUCI/delta AUCG]0-30 value was unchanged and the mean [delta AUCI/delta AUCG]30-120 value was only slightly increased at follow-up.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3516749 TI - [Hospital care of insulin-treated diabetes in African immigrants, in France]. AB - Eighty insulin treated diabetics from North or West Africa were interviewed and compared to 80 French controls matched for sex, age and duration of insulin therapy. Modalities and access to medical care in a specialized clinic were studied. African people were predominantly blue collar workers (49%) and French people employees (70%). The percentage of unemployed people was similar. Africans performed blood glucose self testing less frequently (35.5% vs 60.5%). Only 40% (vs 75%) participated in specific educational activities because 40% of the migrants did not read French. Despite insulin treatment being similar, metabolic control was worse among migrants (HbA1: 10.5 +/- 2.4 vs 9.3% +/- 1.9; p less than 0.01). In migrants, there was an increased prevalence of degenerative complications which did not reach statistical significance. Three parameters may explain these differences: less strict follow-up, poorer knowledge, lower socioeconomic status. PMID- 3516750 TI - Regulation of peripheral plasma somatostatin like immunoreactivity in type I diabetes: role of the degree of metabolic control. AB - We have determined peripheral venous somatostatin like immunoreactivity (SLI) levels in 11 normal subjects (blood glucose--BG--: 4.4 +/- 0.1 mM; ketone bodies- KB--: 90 +/- 12 microM; plasma free fatty acids--FFA --: 340 +/- 42 microM), 4 Biostator controlled insulin dependent diabetics (BG: 5.4 +/- 0.2 mM; FFA: 418 +/ 38 microM; KB: 226 +/- 41 microM) and 7 poorly controlled ketotic diabetics (BG: 10.8 +/- 1.3 mM; FFA: 915 +/- 19 microM; KB: 2490 +/- 576 microM). SLI was determined again after 48 to 96 hours of intravenous insulin infusion for the 7 ketotic diabetics and after transient interruption of insulin infusion for the Biostator controlled diabetics. Relative to normal subjects ketotic diabetics had elevated SLI levels (29.7 +/- 5.9 vs 13.5 +/- 1.8 ng/L, p less than 0.01) whereas biostator-controlled patient had near to normal values (20.4 +/- 6.4 ng/L, p greater than 0.30). Transient arrest of insulin infusion in the Biostator controlled diabetics resulted only in a mild metabolic deterioration (BG: 12.8 +/ 2.1 mM; FFA: 640 +/- 146 microM; KB: 950 +/- 163 microM) without a significant rise of SLI. Intravenous insulin infusion in the initially ketotic patients decreased BG and KB in each subject (p less than 0.01) but decreased FFA (1097 +/ 170 to 453 +/- 74 microM, p less than 0.05) and SLI (34.0 +/- 12.0 to 9.8 +/- 2.4 ng/L, p less than 0.05) only in 4 patients whereas both FFA (737 +/- 107 to 725 +/- 25 microM) and SLI (27.6 +/- 4.7 to 20.3 +/- 4.7 ng/L) levels remained stable in the other 3. These results suggest that SLI levels in type I diabetics are dependent the degree of metabolic control and could be related to the variations of FFA concentrations. PMID- 3516751 TI - Update on ibuprofen: review article. AB - Non-steroidal anti-inflammatory drugs (NSAIDs) have become the principal mode of therapy for rheumatic diseases and their use has continued to increase despite concern expressed recently regarding potential hazards (Figure 1). Prior to 1969, a limited number of NSAID drugs were available. Aspirin and indomethacin became the mainstay of treatment but tolerability, particularly gastric irritation, at doses necessary to control rheumatic symptoms limited the usefulness of these valuable agents. The pyrazolone, phenylbutazone, showed slightly better gastro intestinal (GIT) tolerability but has since been associated with an increased risk of blood dyscrasiae and is now only available for restricted use in most countries. Ibuprofen was the first of a new breed of NSAIDs originally introduced into the United Kingdom in 1969. Chemically quite distinct from its forerunners it was the first of the propionic acid derivatives to be used in rheumatic practice. The propionics have since become the largest, single and most important group of NSAIDs accounting for 50% of NSAID prescriptions in the United Kingdom. It is estimated that over 100 million patients worldwide have received ibuprofen which is now available in over 100 countries throughout the world including all the major markets. Ibuprofen was developed directly as a result of the problems associated with the use of corticosteroids in the treatment of rheumatoid arthritis and also because of the gastro-intestinal irritation and general intolerability of the established NSAIDs, at that time. Ibuprofen was readily accepted because, unlike the previous drugs, its therapeutic efficacy was easily seen to outweigh the severity of its side-effects. Ibuprofen was the first new drug with the potency of aspirin but without its major disadvantages. PMID- 3516752 TI - A randomized double-blind placebo-controlled study of dipyrone and aspirin in post-operative orthopaedic patients. AB - Two hundred and fifty-four patients with post-operative pain following closed reduction of fractured long bones completed a double-blind study of dipyrone and aspirin. Compared with placebo both active treatments produced significant relief of pain, which was apparent 30 minutes after ingestion and was maintained for the 6-hour duration of the study. Dipyrone 500 mg produced significantly greater pain relief than aspirin 500 mg. Both drugs were generally well tolerated. PMID- 3516753 TI - A comparison of the incidence of peptic ulceration for fenbufen, indomethacin and aspirin treated patients compared with the general population. AB - Survival analysis techniques were used to compare the long-term incidence of peptic ulceration occurring in fenbufen, indomethacin and aspirin treated patients with a "background" incidence for the whole population. The results of this analysis indicate that the incidence of peptic ulceration occurring in patients receiving long-term therapy with fenbufen is comparable to the background incidence for the whole population. PMID- 3516754 TI - Hydrocortisone 17-butyrate (Locoid) 0.1% fatty cream versus desonide (Apolar) 0.1% ointment in the treatment of patients suffering from atopic dermatitis. AB - A randomized, double-blind, left-right study to compare the therapeutic efficacy and the cosmetic acceptability of the new hydrocortisone 17-butyrate (Locoid) 0.1% fatty cream application form with desonide (Apolar) 0.1% ointment was performed in thirty patients suffering from moderate to severe atopic dermatitis. The medications were applied to symmetrical, bilateral skin lesions twice daily for 4 weeks. Both treatments effected highly significant reductions of the score values for the severity of all clinical skin parameters assessed. Score reductions were, however, more pronounced on Locoid-treated sides than on Apolar treated sides both after 2 and 4 weeks of therapy. It appeared further that clinical efficacy of treatment at completion of the study was also in favour of Locoid-treated sides, indicating that Locoid fatty cream is more effective than Apolar ointment. No serious side-effects were reported during the study. The expressed patient preferences with respect to cosmetic acceptability of treatments were significantly in favour of Locoid fatty cream, indicating that patients preferred the use of this new galenic formulation over an ointment formulation. It is concluded that the new application form of Locoid, a fatty cream, is a useful and beneficial addition to topical corticosteroid therapy, which will promote patient compliance in a wide range of corticosteroid responsive skin diseases. PMID- 3516755 TI - Diclofenac sodium versus acetylsalicylic acid: a randomized study in febrile patients. AB - One hundred and twenty adult patients with high temperatures (greater than or equal to 38 degrees C) brought about by influenza viruses or other conditions were randomly treated with two different antipyretics: a) a 25 mg sodium diclofenac tablet (Novapirina) every 12 hours for 2 consecutive days; b) a 500 mg tablet of acetylsalicylic acid (Aspirin) every 8 hours for 2 consecutive days. Antipyretic action (assessed at 6 hours following the first administration) was found to be equally rapid and consistent in both cases but significantly longer lasting in the Novapirina-treated group than the Aspirin-treated group (p less than 0.01). Mean temperature changes over the 48 hours of observation and the over-all judgement on the antipyretic effect expressed at the end of each day of treatment were similar for both groups and good in all cases. The antiphlogistic painkilling properties of both drugs were found to be effective in improving the symptomatology accompanying the high temperature during the course of the bout of influenza. The effectiveness/tolerability ratio was found to be satisfactory for both groups: only one case of gastric intolerance to Novapirina was recorded and five cases of gastric intolerance to Aspirin. PMID- 3516756 TI - Epithelioid cells: membrane potential changes induced by substances influencing renin secretion. AB - Microelectrode recordings were performed in renin-containing epithelioid (JG) and vascular smooth muscle (VSM) cells of the afferent arteriole in the isolated hydronephrotic mouse kidney. Both cell types had a membrane potential of about 75 mV and exhibited small, spontaneous depolarizing transients, probably resulting from random transmitter release by sympathetic axon terminals. Substances depressing renin secretion, such as angiotensin II, arginine vasopressin, and alpha 1-adrenergic agents reversibly depolarized both JG and VSM cells. On a molar basis, the action of angiotensin II was strongest. Stimulators of renin release, e.g. isoproterenol, histamine, and prostaglandin E2 did not influence the membrane potential of both cell types. VIP and NPY, possible co transmitters of norepinephrine, as well as AP II, were also without effect. It is proposed that suppression of renin secretion from JG cells is mediated by depolarization and Ca2+ influx, whereas stimulation is triggered independently from membrane potential changes, e.g. by adenylate cyclase activation. PMID- 3516757 TI - Adrenal dopamine beta-hydroxylase induction in the young rat: influence of thyroid hormones. AB - The adrenals of 14-day-old control and hypothyroid rats have been stimulated by insulin-induced hypoglycaemia, and the subsequent induction in dopamine beta hydroxylase (DBH) has been studied. In control rats, DBH induction was maximum 48 h after insulin administration. Hypothyroidism completely suppressed DBH induction. PMID- 3516758 TI - Proliferation of muscle satellite cells on intact myofibers in culture. AB - Muscle satellite cells are quiescent myogenic stem cells situated between the basal lamina and plasmalemma of mature skeletal muscle fibers. Injury to the fiber triggers the activation and proliferation of satellite cells whose progeny subsequently fuse to form new myotubes during regeneration. In this paper we report the proliferation of satellite cells on single muscle fibers isolated from adult rats and placed in culture. Viable fibers were liberated from muscle with collagenase and purified from non-muscle cells. The fibers were covered with a basal lamina and retained normal morphological characteristics. Each fiber contained two to three satellite cells per 100 myonuclei. Satellite cells showed little proliferative activity in medium with 10% serum but could be induced to enter the cell cycle by chick embryo extract or fibroblast growth factor. Other polypeptide mitogens such as epidermal growth factor, multiplication stimulating activity, and platelet-derived growth factor were ineffective. Mitogen-stimulated satellite cells fused to form new myotubes after 4-5 days in culture. These results imply that satellite cells are under positive growth control since they proliferate in contact with viable mature fibers when stimulated with mitogen. The mature fibers remained viable in culture but did not give rise to mononucleated cells. After several days, however, the fibers began to extend sarcoplasmic sprouts and underwent dedifferentiative changes that led to the formation of multinucleated cells resembling myotubes. These cells reexpressed embryonic isozymes of creatine kinase not made by the mature fibers. PMID- 3516759 TI - Morphogenesis of an identified leech neuron: segmental specification of axonal outgrowth. AB - We have investigated the development of segmental diversity in an identified leech neuron, the Retzius cell. Retzius cells in the genital segments differ from those in other segments in lacking central axons and contacting different peripheral targets: the genitalia. These differences are not apparent during initial axon outgrowth, when all Retzius cells follow the same morphogenetic pattern. Rather, they first appear about the time the peripheral axons of the genital segment Retzius cells contact the genital primordia. This suggests that the pattern of central and peripheral axonal outgrowth may be modified by an interaction with peripheral targets. PMID- 3516761 TI - Filaggrin breakdown to water binding compounds during development of the rat stratum corneum is controlled by the water activity of the environment. AB - Filaggrin is a specific epidermal protein which is the precursor of the free amino acids, urocanic acid and pyrrolidone carboxylic acid which are largely responsible for the ability of the stratum corneum of the skin to remain hydrated at low environmental humidity. The distribution of filaggrin shown by immunofluorescence in the stratum corneum of the rat changed dramatically during the first hours of postnatal life. During late foetal development, filaggrin accumulated through the entire thickness of the stratum corneum, indicating that there was a block on the subsequent processing of the protein which normally would convert it to free amino acids. Immediately after birth this block was lifted and normal proteolysis of the filaggrin took place in the outer part of the stratum corneum, leaving the normal adult pattern of a thin zone of cells containing filaggrin at the bottom of the stratum corneum. This activation of filaggrin proteolysis was dependent on the drop in external water activity caused by the transition from an aqueous environment in utero to a dryer environment after birth and it could be blocked by maintaining a 100% humidity atmosphere around the newborn rat after birth. In isolated stratum corneum in vitro, filaggrin proteolysis took place only between 80 and 95% relative humidity, both higher and lower relative humidity blocked the proteolysis. Application of occlusive patches to adult rats prevented the normal proteolysis of filaggrin, indicating that this mechanism controls not only the massive filaggrin proteolysis occurring after birth but also the proteolysis occurring during normal stratum corneum maturation. The stratum corneum therefore has the ability to respond to changes in external humidity by altering the level of the stratum corneum where it converts its reserves of filaggrin into water binding amino acids, such that under humid conditions water binding components will be produced in only the most superficial stratum corneum, or even not produced at all. PMID- 3516760 TI - Analysis of the early stages of trunk neural crest migration in avian embryos using monoclonal antibody HNK-1. AB - The monoclonal antibody HNK-1 was used to identify neural crest cells in serial sections of avian embryos to provide a detailed description of the distribution of trunk neural crest cells. The results indicate the presence of three migratory routes in the trunk: (1) a ventral pathway through the anterior sclerotome; (2) a ventral pathway between the neural tube and the posterior sclerotome; and (3) a dorsolateral pathway between the somites and ectoderm. Neural crest cells were first seen entering the anterior half of the sclerotome at about the time the somite begins to dissociate to form the dermomyotome and sclerotome, approximately 5-10 somites rostral to the most recently formed somite. In contrast, neural crest cells were never observed in the posterior sclerotome or in the perinotochordal space. The distribution of neural crest cells was compared with that of injected latex beads which were previously found to translocate along the ventral trunk neural crest pathway (Bronner-Fraser, Dev. Biol. 91, 130, 1982). During the early stages of neural crest migration, injected latex beads were found to extensively colocalize with cells stained by the HNK-1 antibody. Injected latex beads (78%) were found immediately adjacent to HNK-1 positive cells and another 11% were within one cell diameter. The results suggest that latex beads injected into the trunk somites are deposited onto a normal pathway of neural crest migration. PMID- 3516762 TI - Bibliography of developmental medicine and child neurology: selected books and articles received in 1985. PMID- 3516763 TI - Microcomputers: software directory and selected bibliography. PMID- 3516764 TI - The effects of carbohydrate-enriched meals on glucose turnover and metabolic clearance rates of glucose in type 2 diabetic patients. AB - The addition of fructose to natural meals elicits lower serum glucose and immunoreactive insulin responses when compared with that of sucrose and starch meals. Differences in rates of splanchnic glucose appearance and peripheral glucose disposal may be partly responsible. To evaluate the role of both parameters after different carbohydrate-enriched meals, we measured the arterialized venous blood glucose, immunoreactive insulin and gastric inhibitory polypeptide concentrations in seven Type 2 diabetic patients after ingestion of isocaloric test meals. Measurements were made in a random manner on three separate occasions. Fructose, sucrose, and bread supplementation constituted 68% of the total carbohydrate content of each meal. Rates of total glucose appearance, glucose utilization and metabolic clearance rates of glucose were determined by the D3-H-3 glucose prime-continuous infusion technique. The mean fasting glucose levels were similar in the three groups. Mean peak glucose concentrations and integrated incremental areas were significantly lower (p less than 0.02) after the fructose-enriched meals compared with that of either sucrose or bread. The basal arterialized venous blood glucose levels were similar in all three groups. The mean incremental integrated arterialized venous blood glucose area was significantly lower in the fructose group when compared with the sucrose (p less than 0.05) and bread (p less than 0.02) groups. The mean fasting gastric inhibitory polypeptide levels were similar in the three groups. However, the mean incremental integrated gastric inhibitory polypeptide areas were significantly lower in the fructose group compared with the sucrose and bread groups (p less than 0.01 and p less than 0.05 respectively). Basal hepatic glucose outputs were not significantly different in the three groups.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3516765 TI - Insulin-dependent inhibition of hepatic glycogenolysis by gastric inhibitory polypeptide (GIP) in perfused rat liver. AB - The effect of porcine gastric inhibitory polypeptide on hepatic glycogen metabolism was investigated in the isolated in situ perfused rat liver. Glycogenolysis was stimulated by infusion of glucagon into the portal vein (half maximal effective portal vein concentration approximately 30 pmol/l). When glucagon was infused at a final portal vein concentration of 0.5 nmol/l, simultaneous addition of insulin inhibited the glucagon-dependent glycogenolysis in a dose-dependent way (half maximal effective concentration for insulin about 2 nmol/l). Gastric inhibitory polypeptide alone at a concentration of 1 nmol/l reduced glucagon-dependent glycogenolysis only slightly. However, when infused simultaneously at low insulin concentrations (0.1 nmol/l), gastric inhibitory polypeptide suppressed hepatic glucose production dose-dependently up to 70%. The data suggest that gastric inhibitory polypeptide exerts direct metabolic effects on hepatic glycogen metabolism predominantly in a situation where insulin is simultaneously present, e.g. following ingestion of glucose. PMID- 3516766 TI - A two-colour immunofluorescence test with a monoclonal human proinsulin antibody improves the assay for islet cell antibodies. AB - The conventional indirect immunofluorescence assay for islet cell antibodies was compared with a two-colour immunofluorescent assay to detect both islet cell antibodies with fluorescein isothiocyanate-labeled rabbit anti-human IgG and pancreatic B cells with a monoclonal human proinsulin antibody and Texas red labeled sheep anti-mouse IgG. Determinations of end-point titres showed a correlation between the new two-colour immunofluorescent assay and the conventional indirect immunofluorescent assay in 1) selected sera positive for islet cell antibodies and insulin autoantibodies rs = 0.93 (p less than 0.01) or for islet cell antibodies alone rs = 0.99 (p less than 0.005) and 2) sera from children or young adults with newly diagnosed Type 1 (insulin-dependent) diabetes rs = 0.95 (p less than 0.0001). No interference between the monoclonal human proinsulin antibodies and islet cell antibodies with or without insulin autoantibodies or between the two second fluorescent antibodies was detected. It is concluded that the two-colour immunofluorescence assay is advantageous since it is possible to mix the reagents to avoid a more time-consuming and technically complicated assay, the presence of B cells can be confirmed in each section to permit detection of B cell cytoplasmic antibodies and microscopic evaluation is easier and more accurate, particularly in islet cell antibody negative samples. PMID- 3516767 TI - Effect of adrenal steroids on insulin release from cultured rat islets of Langerhans. AB - The effect of additions to the culture medium of some natural or synthetic corticosteroid hormones was studied in cultured rat islets of Langerhans. The steroids decreased glucose-induced insulin release. The extent of inhibition by dexamethasone was 18-55%, prednisolone 23%, hydrocortisone 21% and aldosterone 18%. None of them affected the basal secretion of insulin or had any effect on diameter or insulin content of the islet. The inhibitory action of dexamethasone on insulin release was observed in the range 63 nmol/l to 6.3 mumol/l. At 6.3 mumol/l during two h, dexamethasone (a) inhibited insulin response to glucose concentrations above 5 mmol/l (b) caused a delay in the first phase and markedly reduced the second phase of insulin release of perifused islets, and (c) decreased the incorporation of [H3]-leucine into total islet proteins without affecting [H3]-leucine-incorporation into insulin plus proinsulin. It is suggested that steroids, by directly acting on the islets of Langerhans, may modulate the insulin-release response to secretagogues. PMID- 3516768 TI - The effect of insulin and catecholamines on the activities of 3-hydroxy-3-methyl glutaryl coenzyme A reductase and acyl-coenzyme A: cholesterol-o-acyltransferase in isolated rat hepatocytes. AB - This study was concerned with the effect of insulin and catecholamines on the rate limiting enzymes of cholesterol metabolism in rat hepatocytes. Insulin was found to increase the activity of 3-hydroxy-3-methyl glutaryl coenzyme A reductase and to have no effect on the activity of acyl-coenzyme A: cholesterol-o acyltransferase. Noradrenaline and isoprenaline increased the activities of both 3-hydroxy-3-methyl glutaryl coenzyme A reductase and acyl-coenzyme A: cholesterol o-acyltransferase. The effect of noradrenaline or isoprenaline in the presence of insulin was that of a lower stimulatory response on 3-hydroxy-3-methyl glutaryl coenzyme A reductase but comparable to that found with either catecholamine alone. The combination of either catecholamine with insulin had no effect on the activity of acyl-coenzyme A: cholesterol-o-acyltransferase. These observations suggest that the activities of 3-hydroxy-3-methyl glutaryl coenzyme A reductase and acyl-coenzyme A: cholesterol-o-acyl-transferase are regulated independently by insulin in the presence or absence of catecholamines. By contrast, catecholamines appear to regulate both enzyme activities in a similar fashion. PMID- 3516769 TI - Insulin resistance in man. PMID- 3516770 TI - Effect of past and concurrent body mass index on prevalence of glucose intolerance and type 2 (non-insulin-dependent) diabetes and on insulin response. The Israel study of glucose intolerance, obesity and hypertension. AB - A representative sample (n = 2140) of the Israeli Jewish population aged 40-70 (excluding known diabetic patients), whose body mass index had been measured 10 years earlier, underwent an oral glucose tolerance test and redetermination of body mass index. Irrespective of weight changes, high concurrent and high past body mass index values (greater than or equal to 27) were associated with similarly increased rates of glucose intolerance as compared with body mass index values less than 27 at both time-points (rate ratio 1.76, 90% confidence limits 1.56-1.99). Glucose intolerance here includes borderline and impaired tolerance as well as Type 2 diabetes. The rate of Type 2 diabetes increased only with increasing past body mass index, while concurrent body mass index had no effect [rate ratios: 2.36 (1.48-3.75) and 1.99 (1.48-2.68) respectively for the medium (23-26.9) versus-low (less than 23) and high- (greater than or equal to 27) versus-medium past body-mass-index categories]. Weight reduction was associated with only slightly reduced rate of glucose intolerance and had no effect on the rate of diabetes. Mean sum insulin (summed 1 and 2 h levels, mU/l) increased significantly with increasing concurrent body mass index (123, 150 and 190 in the low, medium and high categories) with no effect of past body mass index. It also increased significantly (p less than 0.001) in all concurrent body mass index categories from normal tolerance through borderline to impaired tolerance, and decreased significantly (p less than 0.001) in diabetes relative to impaired tolerance, although it remained above normal.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3516771 TI - Effects of vitamin D deficiency and repletion on insulin and glucagon secretion in man. AB - We have studied the effects of vitamin D deficiency on pancreatic A- and B-cell function. Four subjects with vitamin D deficiency and 10 healthy subjects were studied. Pancreatic B-cell function was assessed by the insulin response to an oral glucose tolerance test. An insulin tolerance test was used to evaluate pancreatic A-cell function. The patients were then treated with 2000 U/day of vitamin D3 for 6 months, after which the clinical, metabolic, biochemical and radiological features of vitamin D deficiency resolved, and pancreatic A-and B cell function was repeated. In the vitamin D-deficient subjects pre-treatment and post-treatment serum calcium levels (mean +/- SEM) were 2.22 +/- 0.01 mmol/l and 2.24 +/- 0.01 mmol/l respectively, and 2.27 +/- 0.02 mmol/l in healthy subjects (NS). The pre-treatment level of 1,25-dihydroxy vitamin D (1,25-(OH)2D) of 29.7 +/- 3.3 pg/ml in the vitamin D deficient subjects rose to 70.3 +/- 10.3 pg/ml after treatment (p less than 0.05). The 1,25-(OH)2D level in the healthy subjects was 50.0 +/- 13.7 pg/ml (p less than 0.05 versus pre- and post-treatment values in the patients). Insulin secretion, calculated by the area under the insulin curve, was significantly lower before vitamin D3 treatment in the patients (9.09 +/- 0.7 mU X min, p less than 0.05) compared with the healthy subjects (11.9 +/- 0.5 mU X min) and post-treatment values of the patients with vitamin D deficiency (13.7 +/- 0.5 mU X min). Similar changes were seen in the insulogenic indices (delta I/delta G).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3516772 TI - Erythrocyte adhesion to cultured endothelium and glycaemic control in type 1 (insulin-dependent) diabetic patients. AB - The relation between blood glucose control and erythrocyte adhesion to cultured human vascular endothelial cells was studied in 12 Type 1 (insulin-dependent) diabetic patients. Erythrocyte adhesion was measured before, 8 days and 6 weeks after continuous subcutaneous insulin infusion (CSII). Compared to controls, erythrocyte adhesion expressed as an adhesion ratio was increased in 10 diabetic patients at the first examination (adhesion ratio greater than 1.52). After 8 days, adhesion ratio was normalized in 5 patients. After 6 weeks, adhesion ratio was normal in 7 patients and significantly lower in the group of 12 patients (p less than 0.01). The adhesion ratio was significantly correlated with glycosylated haemoglobin values (p less than 0.001). Insulin did not directly affect erythrocyte adhesion. Adequate insulin treatment modifies erythrocyte adhesion through a metabolic effect which needs longer than 1 week to be effective. PMID- 3516773 TI - Renal kallikrein in diabetic patients with hypertension accompanied by nephropathy. AB - We measured the 24-h excretion of urinary kallikrein in 27 patients with Type 2 (non-insulin-dependent) diabetes and in 10 normal control subjects. Mean (+/- SD) kallikrein excretion in diabetic patients with nephropathy (6.2 +/- 2.4 naphthyl units (NU)/day, n = 13) was significantly lower than in control subjects (12.8 +/ 3.4 NU/day, p less than 0.01) and in diabetic patients without nephropathy (9.4 +/- 3.4 NU/day, n = 14, p less than 0.05). Kallikrein excretion in hypertensive diabetic patients with nephropathy (5.1 +/- 1.6 NU/day, n = 8) was significantly lower (p less than 0.05) than in normotensive patients with nephropathy (8.3 +/- 2.1 NU/day, n = 5). There were no significant differences in kallikrein excretion rate (24-h excretion of urinary kallikrein/24-h creatinine clearance) among control subjects (9.9 +/- 4.3 NU/ml), diabetic patients with (9.0 +/- 3.2 NU/ml) and without (9.3 +/- 3.5 NU/ml) nephropathy. However, kallikrein excretion rate in hypertensive diabetic patients with nephropathy (7.7 +/- 3.3 NU/ml) was significantly lower (p less than 0.05) than in normotensive diabetic patients with nephropathy (11.8 +/- 2.0 NU/ml, n = 10). Respective basal and post stimulated (with intravenous furosemide 40 mg plus 60 min ambulation) plasma aldosterone concentrations measured in control subjects and in hypertensive diabetic patients with nephropathy were similar and increased to the same extent in the 2 groups (5.5 +/- 3.2 versus 5.3 +/- 3.2 and 9.3 +/- 2.6 versus 10.5 +/- 3.4 ng/ml), although the respective plasma renin activity tended to be lower in diabetic patients than in control subjects (0.7 +/- 0.6 versus 1.3 +/- 0.9 and 1.8 +/- 1.8 versus 3.0 +/- 2.6 ng-1 . ml-1 . h-1).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3516774 TI - Vitreous fluorescein accumulation determined by in vivo fluorophotometry and by vitreous extraction in normal and diabetic rats. AB - Vitreous fluorophotometry was performed on pigmented male rats (Piebald strain) 2 weeks after induction of diabetes by streptozotocin. In vivo fluorophotometry data were compared with measurements obtained by direct extraction of the vitreous 60 min after an intravenous injection of sodium fluorescein. In addition, the rate of fluorescein disappearance from blood plasma, plasma protein binding of fluorescein and the effect of insulin treatment of diabetic animals were investigated. Age-matched nondiabetic animals served as controls. In vivo fluorophotometric measurements showed a good correlation with fluorescein determinations after direct extraction of the vitreous. Vitreous fluorescein concentrations were similar in diabetic and normal rats and were strongly related to the dye plasma levels within each group of animals. In the diabetic rats, however, the elimination of plasma fluorescein was accelerated and the percentage of free fluorescein, as determined by ultrafiltration and equilibrium dialysis, was consistently higher (130-150% of controls). The ratios of vitreous to total or free plasma fluorescein levels were elevated in diabetic rats. Experimental data indicate that plasma concentration of free fluorescein is crucial for vitreous dye accumulation. Insulin treatment of diabetic rats markedly improved their metabolic state and normalized the plasma fluorescein elimination and the vitreous to plasma fluorescein concentration ratios. It is concluded that vitreous fluorophotometry can be adequately applied to pigmented rats, provided that plasma fluorescein elimination rate and protein binding are considered in the interpretation of the results, since both influence the vitreous fluorescein accumulation and both may be altered by disease and drug treatment. PMID- 3516775 TI - In vivo insulin resistance in individual peripheral tissues of the high fat fed rat: assessment by euglycaemic clamp plus deoxyglucose administration. AB - We have examined peripheral insulin action in conscious rats chronically fed high fat (60% calories as fat) or high carbohydrate (lab chow) diets using the euglycaemic clamp plus 3H-2-deoxyglucose technique. A response parameter of individual tissue glucose metabolic rate (the glucose metabolic index, based on tissue deoxyglucose phosphorylation) was used to assess diet effects in eight skeletal muscle types, heart, lung and white and brown adipose tissue. Comparing high fat with high carbohydrate fed rats, basal glucose metabolism was only mildly reduced in skeletal muscle (only diaphragm was significant, p less than 0.05), but was more substantially reduced in other tissues (e.g. white adipose tissue 61% and heart 33%). No evidence of basal hyperinsulinaemia was found. In contrast, widespread insulin resistance was found during the hyperinsulinaemic clamp (150 mU/l) in high fat fed animals; mean whole body net glucose utilization was 34% lower (p less than 0.01), and the glucose metabolic index was lower in skeletal muscle (14 to 56%, p less than 0.05 in 6 out of 8 muscles), white adipose (27%, p less than 0.05) and brown adipose tissue (76%, p less than 0.01). The glucose metabolic index was also lower at maximal insulin levels in muscle and fat, suggesting the major effect of a high fat diet was a loss of insulin responsiveness. White adipose tissue differed from muscle in that incremental responses (maximal insulin minus basal) were not reduced by high fat feeding. The heart showed an effect opposite to other tissues, with an increase in insulin stimulated glucose metabolism in high fat versus chow fed rats.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3516776 TI - Genetics of type 1 (insulin-dependent) diabetes. PMID- 3516777 TI - Development of avascularity during cartilage differentiation in the embryonic limb. An exclusion model. AB - The differentiation of cartilage and muscle in limb-bud mesenchyme has been interpreted by some investigators in terms of a vascular pre-pattern model. It has been argued that a pre-pattern of the early limb vasculature compartmentalises the mesenchyme into specific microenvironmental areas in which, depending on the oxygen tension and nutrient supply, cartilage or muscle will differentiate. However, recent analyses of the development and differentiation of blood vessels in limbs have shown that regional variations in vascularization develop co-incidentally with the earliest indication of cartilage formation or mesenchymal condensation. The simple model described in the present study suggests that the mechanical compression/tension forces generated by the condensing mesenchyme are sufficient to constrict and eventually close off the thin-walled undifferentiated vessels caught in the condensation foci, thus leading to the avascularity of cartilage rudiments. This view suggests that the vasculature has no major function in governing the pattern of cartilage differentiation. PMID- 3516778 TI - Differential distribution of receptors for two fucose-binding lectins in embryos and adult tissues of the mouse. AB - Ulex europaeus agglutinin-I (UEA-I) recognizes the Fuc alpha 1----2 Gal linkage. Receptors for UEA-I were not detected in mouse embryos until the 13th day of embryo-genesis, except for their temporary expression in early trophectoderm cells. In adult mice, UEA-I receptors were detected at various sites, including cells of the digestive tracts, the bronchial epithelium, Hassall's corpuscle of the thymus, and the skin. The fucose-binding protein of Lotus tetragonolobus (FBP) is another lectin that recognizes fucosyl residues. The distribution of FBP receptors was significantly different from that of UEA-I receptors. FBP receptors were first detected in late 8-cell embryos and were expressed in the embryonic ectoderm, visceral endoderm, and trophoblastic giant cells in egg-cylinders. At later stages, the distribution of FBP receptors became restricted to certain parts of the embryo. In the adult, the distribution of FBP receptors was more restricted than that of UEA-I receptors. Particularly in embryos before the 11th day of gestation, the distribution of FBP receptors resembled that of SSEA-1, which is defined by the Gal beta 1----4(Fuc alpha 1----3) GlcNAc linkage. From the specificity of FBP, we inferred that the disappearance of SSEA-1 and FBP receptors during embryogenesis is not the result of alpha 1----2 fucosylation of the terminal galactosyl residue in the determinant. The fact that the expression of two fucose-related cell-surface markers, i.e., UEA-I receptors and SSEA-1 (or FBP receptors), is developmentally regulated in an entirely different fashion is an excellent example illustrating the precise control of differentiation dependent alterations in cell-surface carbohydrates. PMID- 3516779 TI - The necessary minimal duration of final long-term toxicologic tests of drugs. AB - The optimal, and thus mandatory duration of final, long-term toxicologic tests of drugs in animals prior to marketing for use in human beings remains controversial. Some regulatory authorities contend that exposure for 6 or 12 months is adequate. However, the Bureau of Human Prescription Drugs of the Health Protection Branch of Health and Welfare Canada has evaluated a number of confidential reports from manufacturers in which significant, non-neoplastic, pathologic changes occurred only after exposure of animals for more than 1 year. Fifteen examples from these files and the literature are described. These studies support the current Canadian guidelines' requirement for the duration of final long-term toxicologic tests of drugs to be at least 18 months. PMID- 3516780 TI - A solution for the problematic atrophic mandible: the titanium plasma spray (TPS) screw implant system. PMID- 3516781 TI - [Models of autoimmune diseases of the retina]. PMID- 3516783 TI - [Hepatic intra-arterial chemotherapy of isolated metastases of colo-rectal adenocarcinoma]. PMID- 3516782 TI - C3-mediated phagocytosis induced in murine Kupffer cells by "in vitro" activation with endotoxin. AB - Binding and phagocytosis of red blood cells by Kupffer cells, mediated by C3 receptors, have been studied by incubating sheep red blood cells opsonized with C3, and Kupffer cells isolated from rat and mouse livers. Sheep red blood cell binding was followed by internalization and phagocytosis only after preincubation of Kupffer cells with bacterial endotoxin. In both species of cells there was a direct relationship between the value of the phagocytic index and the amount of endotoxin needed to stimulate the cells. Increased phagocytosis was related to an increase in the number of phagocytosing cells; it did not depend on an increase in the number of red blood cells internalized per Kupffer cell. C3-mediated phagocytosis, together with the intrinsic and extrinsic antiviral activities, and the synthesis of interferon which take place in activated cells may play an important role in non-specific immunity. PMID- 3516784 TI - [Extrinsic nervous control of the colon and the internal anal sphincter]. PMID- 3516785 TI - Effects of cholecystokinin-octapeptide on the human gallbladder both in vivo and in vitro. AB - To determine the sites and mechanisms of action of cholecystokinin-octapeptide (CCK-OP) on the human gallbladder, effects of atropine sulfate on CCK-OP-evoked contractions were studied in both in vivo and in vitro experiments. In vivo studies performed by means of real time ultrasonography in six healthy volunteers showed remarkable contractions of the gallbladder after intramuscular injection of CCK-OP (0.07 microgram/kg), which was nearly abolished by premedication of atropine sulfate (0.015 mg/kg). Atropine sulfate (10(-6) M) slightly but significantly reduced CCK-OP (10(-11) M-3 X 10(-7) M) induced contractions and the dose-response curve for CCK-OP was shifted to the right of the muscle strips of the human gallbladders. It is suggested that CCK-OP acts mainly on cholinergic neurons in vivo. On the contrary, the most sensitive sites of action of CCK-OP might be smooth muscles rather than cholinergic neurons in vitro. PMID- 3516786 TI - Development profile of neuron-specific enolase in human gut and its implications in Hirschsprung's disease. AB - The most widely held view on the pathogenesis of Hirschsprung's disease as an arrest of neuroblast migration in the gut was based on the hypothesis of a single craniocaudal gradient of development of enteric neurons. Recent experimental studies in animals, however, have revived a contradictory hypothesis of a dual gradient of neuronal development; such data are not available in humans. To test these hypotheses in humans, we studied the pylorus, ileum, and colon of 28 fetuses with gestational ages of 9-21 wk, using immunohistochemical localization of neuron-specific enolase, a specific neuronal marker indicative of differentiation. Development of the enteric nervous system was shown to be most advanced in the pylorus, less so in the colon, and least so in the ileum. The findings support the hypothesis of a dual gradient of neuronal development proceeding from both ends to the middle of the gut in midtrimester human fetuses and suggest that the pathogenesis of Hirschsprung's disease needs to be reconsidered. PMID- 3516787 TI - Fulminant Wilson's disease treated with postdilution hemofiltration and orthotopic liver transplantation. AB - A 22-yr-old woman presented with fulminant Wilson's disease. The diagnosis was suspected clinically and was later confirmed with chemical and pathologic studies. She presented with acute hepatic failure, hemolysis, and acute anuric renal failure. Postdilution hemofiltration and continuous arteriovenous hemofiltration with oral D-penicillamine allowed removal of a total of 95,700 micrograms of copper; 78,665 micrograms of the total were removed via postdilution hemofiltration alone. On the 57th day, the patient received successful liver and renal transplants. We found that the determination of serum copper was instrumental in the diagnosis of fulminant Wilson's disease, that postdilution hemofiltration allowed a rapid removal of copper in the presence of renal failure, and that, finally, orthotopic liver transplantation should be performed early in the clinical course of these patients. This patient is the longest survivor of this serious condition. PMID- 3516788 TI - Hepatobiliary system in sickle cell disease. AB - This paper reviews the literature reports concerning sickle cell disease and the hepatobiliary system. Sickle cell disease can cause progressive injury to the liver with significant fibrosis, often cirrhosis, and decreased liver function by adulthood. Asymptomatic patients commonly have hepatomegaly and elevated liver enzyme levels. The presence of sickle cell disease obscures features otherwise useful in differential diagnosis. Acute episodes of the disease selectively affect the liver in 10% of patients, causing hepatic crisis with abdominal pain, nausea, fever, jaundice, and transaminase elevation. Viral hepatitis is often clinically indistinguishable from hepatic crisis, but in viral hepatitis the abdominal pain is usually less, the jaundice tends to be more severe, and the transaminase elevation more prolonged. The two can be distinguished by serology and liver biopsy. Furthermore, acute cholecystitis or choledocholithiasis may have clinical and laboratory features similar to sickle cell hepatic crisis or viral hepatitis. By adulthood, 50%-70% of sickle cell patients have gallstones. Elective cholecystectomy is indicated for those who are symptomatic, but, because of operative mortality, there is disagreement concerning surgery for asymptomatic patients. The literature contains nine well-documented cases of acute hepatic failure related to sickle cell disease. The mechanism is unclear; however, as the necrosis is often not severe, a metabolic problem is suggested. PMID- 3516789 TI - [Sonographic evaluation of the amount of amniotic fluid. I. Polyhydramnios- significance for the course of pregnancy and labor]. AB - In this study, 3,274 pregnant patients were sonographically examined. Special attention was paid to the classification of the quantity of amniotic fluid according to sonographic criteria. An increase in amniotic fluid was observed in 6% of the patients examined. Cases in which the largest sonographically demonstrable amniotic fluid was significantly larger than the transverse thoracoabdominal diameter were classified as polyhydramnios. An amniotic fluid depot that was either as large as or up to 10% larger than the transverse thoracoabdominal diameter of the fetus was regarded as the upper normal range for the amount of amniotic fluid. These cases were compared with a randomly chosen control group with normal quantities of amniotic fluid with regard to the occurrence of complications during pregnancy and birth and to the incidence of fetal malformation. Patients with increased quantities of amniotic fluid more frequently had symptoms of toxemia (p less than 0.01). In patients with manifest diabetes mellitus the quantity of amniotic fluid was frequently in the upper normal range (p less than 0.01), while women with gestation diabetes frequently suffered from polyhydramnios (p less than 0.001). Fifteen percent of women with quantities of amniotic fluid in the upper normal range beared macrosomatic children (p less than 0.001). Twenty-seven percent of cases with polyhydramnios (p less than 0.001) and 8% of cases with a quantity of amniotic fluid in the upper normal range (p less than 0.01) were associated with serious fetal malformation. PMID- 3516790 TI - [Successful pregnancy after kidney transplantation and cyclosporin A]. AB - A 21-year-old patient is described who, with a kidney transplant and immunosuppressive treatment with Cyclosporin A, successfully concluded pregnancy. Effective immunosuppression is especially important during pregnancy with its increased risk of transplant rejection. Aside from conventional substances such as azathioprine and steroids, Cyclosporin A (Sandimmun) seems to be the most effective substance available in transplantation medicine today. There is, however, still insufficient knowledge of the effects of Cyclosporin A during pregnancy, so that an endangered pregnancy must be expected during this type of therapy. Because of persistent premature labor in spite of tocolytic treatment, a cesarean section was performed in the 36th week of pregnancy after establishing pulmonary maturity. A review of the literature points out the presently known problems connected with Cyclosporin A intake during pregnancy. PMID- 3516791 TI - Possible relationship between the syntheses of endothelium-derived relaxing factor (EDRF) and PAF-acether. PMID- 3516792 TI - Effects of ephedrine and atenolol on the development of obesity and diabetes in ob/ob mice. AB - To investigate the involvement of adrenergic mechanisms in the development of obesity, hyperglycaemia and hyperinsulinaemia in Aston ob/ob mice, the sympathomimetic agent ephedrine (12 mg/kg/day) and the predominantly beta 1 adrenergic antagonist atenolol (12 mg/kg/day) were administered alone and in combination to weanling ob/ob mice for 40 days. Excessive weight gain in ob/ob mice was reduced (15-20%) by ephedrine, exacerbated (8-10%) by atenolol, but not significantly altered by a combination of these agents. The effects of ephedrine and atenolol were lost rapidly (within 5 days) when these agents were withdrawn. Ephedrine slightly reduced the hyperphagia in ob/ob mice, and food intake was transiently increased above that of untreated ob/ob mice when this agent was withdrawn. The development of basal hyperglycaemia and hyperinsulinaemia was not significantly altered by any of the treatments studied. None of the treatments significantly altered body weight, food intake, plasma glucose or plasma insulin concentrations in lean (+/+) mice. The results indicate that a defective adrenergic mechanism involving beta 1-adrenergic receptors contributes to the development of obesity in ob/ob mice. PMID- 3516793 TI - Gene transfer into intact plant cells by electroinjection through cell walls and membranes. AB - Tobacco mosaic virus (TMV) RNA was introduced directly into mesophyll cells of Nicotiana tabacum var. Samsun using electric-field pulses (electroinjection). The injected gene was successfully expressed in the recipient cells as judged by the assay for the virus coat protein using immunofluorescence and by the virus infectivity assay of the homogenate of the electroinjected cells for local lesions on tobacco leaves. As much as 50% of the cells that survived 24 days after electroinjection showed immunofluorescent specks. PMID- 3516794 TI - Mutations that reduce expression from the P2 promoter of the Escherichia coli galactose operon. AB - We describe the isolation and characterisation of twelve different mutations that reduce gene expression from the galP2 promoter, starting with a gal regulatory region with a mutation that inactivated galP1, the cAMP-CRP-dependent promoter. Seven of the new mutations reduce the initiation of transcription at P2 whereas the others reduce translation initiation of the first gal operon gene, galE. Two of the mutations affecting translation fall in the galE initiation codon and the Shine-Dalgarno sequence. Mutations that allow the formation of a stem-loop structure in the messenger including this sequence also reduce translation. A deletion of 11 bp, upstream of the Shine-Dalgarno sequence, almost totally prevents translation. Although none of the point mutations that reduced transcription initiation at P2 fall in the -35 region, we repeatedly isolated insertions in this zone. The point mutations all fell around the -10 region: the strongest effects were found with mutations that altered the sequence away from the consensus that has been established for Escherichia coli promoters. The effects of the two strongest P2 mutations were investigated in the absence of the P1 mutation used for their isolation. One mutation, a T:A to C:G transition at 12, inactivates both P2 and P1. In contrast the other, a T:A to G:C transversion at -19, specifically inactivates P2, but leaves P1 partially active even in the absence of cAMP-CRP. The implications of this are discussed in the context of how cAMP-CRP controls the balance between transcription from P2 and P1 at the gal operon regulatory region. PMID- 3516795 TI - Primary structure of the maltase gene of the MAL6 locus of Saccharomyces carlsbergensis. AB - We have determined the complete nucleotide (nt) sequence of a 2937-bp DNA fragment containing the yeast maltase (EC 3.2.1.20) gene (MAL6S) as well as part of the contiguous maltose permease gene (MAL6T) from the MAL6 locus of Saccharomyces carlsbergensis. The MAL6S gene encodes an alpha-glucosidase that is required for the utilization of maltose as a carbon source by yeast. The 5' transcription initiation sites for both MAL6S and MAL6T were determined by primer extension experiments using reverse transcriptase. The sequence data show one major open reading frame (ORF) of 584 amino acids (aa) for maltase with a calculated Mr of 68 107, somewhat larger than the value of 63 000 previously determined by sodium dodecyl sulfate (SDS)-polyacrylamide gel electrophoresis (PAGE) analysis. The nucleotide sequences upstream of both the MAL6S and MAL6T genes, which are divergently transcribed, show common structural features for the transcription initiation of yeast genes as well as signals required for their translation. The codon bias index shows that the MAL6S gene is moderately expressed. The possible significance of two 17-bp dyad symmetric sequences, found in the intergenic region of MAL6S and MAL6T, for the control of expression of these genes is also discussed. PMID- 3516796 TI - Segmental homology between the promoter region of the human renin gene and the mouse ren1 and ren2 promoter regions. AB - We have isolated and determined the nucleotide (nt) sequence of the 5' region of the human renin gene (h-ren). Two TATA boxes and a CAAT box were found. Start point determination has shown that only the proximal TATA box was used as the transcription initiation signal, both in the kidney and in a renin-secreting tumor. Comparison of the sequence of the 500-bp region upstream from the transcription start point with the corresponding regions of the ren1 and ren2 genes of the Swiss mouse revealed no overall homology between the human and mouse renin sequences. Only very short sequences of high homology ranging in size from 10 to 18 nt were found in the sequenced regions. By hybridization experiments, we have detected a region upstream from each mouse renin gene related to the h-ren; analysis of the nt sequence of this region reveals that they belong to the Alu family of repetitive DNA. PMID- 3516797 TI - [Occupational hygiene and health protection of medical personnel working with lasers (review of the literature)]. PMID- 3516798 TI - Focus on Dr. Thomas R. Abbott. PMID- 3516800 TI - [Technical aspects of using left ventricular bypass in acute left ventricular failure]. PMID- 3516799 TI - [Diagnosis of latent right ventricular insufficiency in a functioning heart transplant]. PMID- 3516801 TI - [Current status of the problem of diagnosing mediastinal tumors and cysts]. PMID- 3516802 TI - Dietary essential fatty acids and the decline in peptic ulcer disease--a hypothesis. PMID- 3516803 TI - Opposite effects of bombesin on insulin and gastrin response to food in humans. AB - The effect of bombesin on insulin and gastrin response to a standard labelled meal was studied in eight healthy male volunteers. The gastric emptying of solids was simultaneously evaluated. During intravenous infusion of the peptide (5 ng/kg/min) the insulin release after eating was greatly reduced whereas food stimulated gastrin release was significantly enhanced. Both effects of bombesin are likely to be connected with the marked inhibition of gastric emptying induced by the peptide. PMID- 3516805 TI - Stiffer federal regulation of nursing homes proposed by Institute of Medicine. PMID- 3516804 TI - Quantitative distribution of immunoglobulin-producing cells in gastric mucosa: relation to chronic gastritis and glandular atrophy. AB - Immunoglobulin (Ig)-producing immunocytes were quantified by paired immunofluorescence staining in specimens of gastric antral (n = 52) and body (n = 117) mucosa obtained from 45 patients with various gastrointestinal disorders. Enumerations were carried out in a 500 micron wide zone from the muscularis mucosae to the lumen ('tissue unit'). The specimens were divided into three categories according to the degree of inflammation, and each specimen received a grade for atrophy (0-2). The total number of IgA-, IgM- and IgG-producing cells per tissue unit increased strikingly with increasing degree of inflammation, both in antral and body mucosa. IgA immunocytes predominated (61-91%) in all specimens, but the IgG isotype showed the largest relative increase (four to 17 fold), particularly in the basal part of the mucosa. In this layer of the gastric body the proportion of IgG cells was also significantly raised in association with atrophy, irrespective of degree of inflammation. Locally produced IgG may be of protective significance in terms of internal (or 'second line') defence but may at the same time maintain immunopathological mechanisms contributing to the chronicity of gastritis. PMID- 3516806 TI - Evidence that the elevated levels of proteinase activity in the plasma of melanoma-bearing mice may be of host origin. AB - C57B1/6 mice bearing the B16-F1 melanoma, an invasive variant (BL6) or a highly 'metastatic' variant (B16-F10) were found to develop elevated levels (200-300% of control) of neutral proteinase activity in their plasma during the progression of the disease. The magnitude of the level of proteinase activity detected was not dependent on tumor burden. Similar elevations in activity were detected with all 3 variants when they were transplanted either subcutaneously or intraperitoneally. However, transplantation of the B16-F10 line to the anterior chamber of the eye did not induce elevated plasma proteinase activity. Animals bearing intraocular tumors developed splenomegaly and lived the same length of time as animals bearing intraperitoneal or subcutaneous tumors. The development of increased levels of activity appeared to occur equally in male and female mice and was not dependent on the presence of a spleen, which undergoes enlargement during the disease process. These various lines of evidence support the hypothesis that the elevated level of plasma proteinase activity observed in melanoma-bearing mice is regulated by the host. PMID- 3516807 TI - [Primary treatment of severely injured noses]. AB - Five cases of severe open nasal injuries are presented. A description is given of the early treatment and the results. In the first two cases a major part of the nose and upper lip were avulsed and remained attached by a lateral pedicle. Lining, support and skin were carefully repaired and defects of the nasal mucosa replaced by buccal mucosa. Both cases were treated in co-operation with the ophthalmologist and neurosurgeon. In the third case, a large defect of the nasal skin was replaced by an island flap of midline frontal skin. In the fourth case, a perforating wound of the nose, the nasal floor, and orbit was treated by a complete reconstruction of all the involved structures. The fifth case was an avulsion of the nose with a cranial pedicle in the region of the glabella. There was also a craniofacial injury with fractures into the frontal and ethmoidal sinuses and the medial wall of the orbits. With neurosurgical assistance the nose was reconstructed. The early results were favourable in all five cases. PMID- 3516808 TI - [Reconstruction of the index finger metacarpophalangeal joint by implantation of a homologous cartilagenous corticospongioid graft]. AB - Intraarticular fractures with marked comminution or irreparable defects lead to deformity and painful restriction of movement. Repair by means of arthrodesis or arthroplasty results in loss of motion and strength in the injured fingers. In a few cases only implantation of a prosthesis is indicated. Reconstruction of the joint by implantation of a cortico-cancellous homograft is proposed as an alternative to arthroplasty. PMID- 3516809 TI - [Late results of flexor tendon sutures in a "no man's land" of the hand]. AB - The authors studied the late functional results of primary and secondary Kleinert Kessler flexor tendon sutures in "no man's land" in their five-year clinical material. They compared the data of preoperative prognosis and postoperative results and found good correlation. Best results were achieved after primary tendon suture. Therefore, they--like others--advise operation if the conditions for primary tendon suture exist. In secondary tendon repairs mainly the preoperative state of the injured hand determined the postoperative results. In the part of their cases with the worst prognosis, late results were unfavourable because of peritendinous adhesions. In these cases new methods to improve the end results are necessary. PMID- 3516810 TI - [Esthetic surgery of the lower third of the face]. AB - Various techniques for the correction of the aging perioral region are discussed. The authors emphasize the fact that one of the reasons of presenile lipwrinkling is soft tissue loss. As a remedy dermis grafting is recommended and is described in detail. The procedure can be combined with the standard techniques of perioral aesthetic surgery. PMID- 3516811 TI - [Pregnancy in women with chronic renal disease]. PMID- 3516812 TI - [New frontiers in cancer chemotherapy: cis-platinum]. PMID- 3516813 TI - Compliance and control: issues in group training for diabetics. AB - When patients in treatment do not comply with medical directives, the most competent health care may go for naught and patients' well-being may be jeopardized. By focusing on the links between assertiveness and coping skills and compliant behavior, the group program described here increased compliance as well as self-confidence in diabetic group members. PMID- 3516814 TI - Serodiagnosis of Toxoplasma gondii in habitually aborting women and other adults from North Jordan. AB - The prevalence of anti-Toxoplasma gondii antibodies in serum samples of 55 habitually aborting women, 46 women with normal pregnancies, 92 outpatient adults, and 150 University students from North Jordan was studied using the enzyme linked immunosorbent assay (ELISA). Sera from the habitually aborting group were also tested by the indirect immunofluorescent (IIF) test. No significant difference was found between the overall prevalence rates in University students, outpatient adults and women with normal pregnancies (25.3%, 22.8% and 26.1% respectively). The prevalence in habitually aborting women exceeded two times that in women with normal pregnancies or in outpatient females (58.2%, 26.1% and 25.0% respectively), and was approximately three times that in female University students (18.3%). The greatest difference in the prevalence rate between habitually aborting women and those with normal pregnancies or outpatient females was found in groups having the highest antibody level (greater than or equal to 100% of standard positive controls). A positive correlation between the results of the ELISA and those of the IIF test occurred at titres of greater than or equal to 1:40 of the latter test in habitually aborting women. PMID- 3516815 TI - [Treatment of epilepsy in the Middle Ages and by Paracelsus. On hagiotherapy and pharmacology in the "falling disease"]. PMID- 3516816 TI - [Indapamide in the treatment of hypertension. A multicenter study of 3301 hypertensive patients]. PMID- 3516817 TI - [Iohexol in excretory urography. Results of drug monitoring]. PMID- 3516818 TI - [Primary degenerative dementia: therapy with Ginkgo biloba extract. Placebo controlled double-blind and comparative study]. PMID- 3516819 TI - [How the academic physician replaced the hangman and the stone cutter. Medicine and the lower classes in the 19th century: professional interests--missions of civilization--social politics]. PMID- 3516820 TI - [Studies on the interaction between cells infected with measles virus and anti measles antibody. II. Production and application of monoclonal antibodies against measles virus]. AB - Somatic cell hybrids which produced antibodies against measles virus were established by fusing the spleen cells of BALB/c mice immunizing with purified measles virus and the myeloma cell line P3.653 using polyethylene glycol 1,000. Mouse ascites were obtained by inoculating several hybridoma clones, and 2 ascites showed to have high HI titer antibodies. Location of the measles virus antigens on the cells infected with measles virus could be analysed by indirect immunofluorescence technique using these monoclonal antibodies. Reversed passive hemagglutination-inhibition (R-PHI) titers checked by chicken blood cells coated with 2 monoclonal antibodies were parallel with the HI tiers by African green monkey blood cells. These antibodies will be valuable for many virological investigation, for instance, for the detailed antigenic analysis of measles virus and for searching the location of measles virus antigens in the infected cells or tissues. PMID- 3516821 TI - Hormonal regulation of the synthesis of casein and alpha-lactalbumin in a primary mammary cell culture system. AB - The addition of 5 micrograms/ml of both insulin and prolactin, 3 microM cortisol and 5% fetal bovine serum stimulated casein synthesis during a 5 day culture of mammary epithelium from lactating mice using a floating collagen gel as a culture substratum. Omission of any of the three hormones or serum decreased casein synthesis substantially. The use of 10% serum or the attached gel culture system also decreased casein synthesis. Cells cultured with the combination of the three hormones and 5% serum contained a low level of casein mRNA on day 2, but it increased to much higher levels on day 4 and 5, amounting to over 30% of total mRNA on day 5. In contrast to casein synthesis, the maximal increase in alpha lactalbumin synthesis required the presence of 0.03 microM cortisol. The combination of insulin, prolactin and 3 microM cortisol or insulin and prolactin elicited smaller increases. The translatable mRNA for alpha-lactalbumin in cells cultured with insulin, cortisol and prolactin for 5 days was detected, but not in cells with insulin and cortisol. Both a high and low concentration of cortisol in combination with insulin increased prolactin binding capacity of cultured cells to the same extent, whereas cells cultured with insulin alone contained much lower levels of prolactin binding. The difference in the capacity of prolactin binding between cells cultured with insulin alone and those cultured with insulin and cortisol correlated well with their ability to synthesize casein in response to prolactin. PMID- 3516822 TI - Islet cell antibodies and other autoantibodies in South African blacks and indians with insulin dependent diabetes mellitus (IDDM). AB - The presence or absence of islet cell antibodies and other autoantibodies was determined in 47 African and 34 Indian patients with IDDM and 37 controls. Islet cell antibodies (ICA-IgG) were found in over a third of the patients and in only 2 controls. Complement fixing antibodies (ICA-Cf) were found in 10% of patients, but in none of the controls. Persistence of ICA beyond 3 years was more frequent in Black compared to Indian patients. Parietal cell antibodies were found more often in patients (20%) than controls (5%) as were thyroid microsomal antibodies (11% vs. 0%). None of the patients or controls had adrenal antibodies. PMID- 3516823 TI - Metabolic effects of low-dose incremental insulin infusion in diabetic man. AB - An incremental insulin infusion technique to assess insulin action at physiological circulating levels in diabetic man is described. Insulin was infused during sequential one hour periods at rates of 0.01, 0.05 and 0.10 u/kg/h. Serum free insulin concentrations had reached a plateau by the second 30 minutes of each infusion period. Blood glucose concentrations fell at a similar rate during the two lower rates of insulin infusion, but the fall was significantly greater with the highest insulin infusion. Glucose production and utilisation were measured isotopically using a 3-3H glucose infusion technique. Glucose production was inhibited with the lowest insulin infusion rate and a marked increase in glucose metabolic clearance rate occurred with the highest insulin infusion. Key intermediary metabolites were measured and blood glycerol, total ketone bodies, and plasma non-esterified fatty acids fell with the lowest insulin infusion rate. It is concluded that this technique allows identification of the effect of insulin upon different metabolic processes. PMID- 3516824 TI - Effect of exogenous insulin on intra-insular degradation of insulin. PMID- 3516825 TI - Oestradiol inhibits the insulin secretion on the first day of treatment in the ovariectomized rat. AB - Long term oestradiol treatments stimulate the B cell of the endocrine pancreas. The first effects of oestradiol-17-beta were studied in ovariectomized rats, 16 hours after a subcutaneous injection of various concentrations of this hormone (0, 2.5, 25, 50 micrograms). Plasma oestradiol concentrations, food intake and insulin secretion from islets of Langerhans were measured. Oestradiol always decreased food intake and insulin secretion. However, this inhibiting effect of oestradiol on the B cell was also found in fasted rats. This negative action did not appear on basal insulin secretion but on glucose-induced insulin response. It was characterized by a decrease in the B cell capacity of response to glucose. Short and long term opposite actions of oestradiol on the B cell of the endocrine pancreas could be compared to similar effects shown with glucocorticoids. PMID- 3516826 TI - Intensive exercise training does not improve intravenous glucose tolerance in severely diabetic rats. AB - Several studies have recently demonstrated that exercise training improves glucose tolerance in mildly diabetic rats. To test whether some minimal levels of circulating insulin are required to observe the beneficial effects of exercise training, severe diabetes was induced by injecting female Wistar rats with streptozotocin. Half of diabetic and control rats were submitted to a strenuous program of swimming exercise. After 4 wks of training, intravenous glucose tolerance tests (IVGTT) were performed in precannulated, unrestrained and unanesthetized animals. In non-diabetic rats, exercise training significantly reduced both basal and glucose-stimulated levels of insulin (P less than 0.01) without altering glucose tolerance. On the other hand, the same training program applied to severely diabetic animals (basal plasma insulin levels less than 8 microU/ml) failed to reduce the marked hyperglycemia in the resting state (400 mg% range) as well as during the entire IVGTT (400-500 mg%). The results indicate that exercise training effectively increased the sensitivity of peripheral tissues to insulin in non-diabetic but not in diabetic animals. The data also suggest that a minimal amount of circulating insulin is required in order to observe the beneficial effects of exercise training. PMID- 3516827 TI - Effect of insulin on lipolysis in adipose tissue of rats of different ages. AB - Several authors have not been able to find any antilipolytic effect of insulin in adipose tissue "in vitro". We investigated the possible role of cell size and/or age of donors on this phenomenon. The lipolytic rates (glycerol release per cell) were lower in the small cells of the 4-6 weeks old rats than in the larger cells of the 25-30 weeks old animals; however, the difference disappeared when the data were expressed per unit of cell surface area. Insulin (0.5-50 ng/ml) failed to inhibit both maximally and submaximally noradrenaline stimulated lipolysis in the adipocytes of the young rats, but its antilipolytic action was fully restored by using glucose-free medium. Therefore, at our experimental conditions, a glucose dependent factor, possibly involving the preferential hydrolysis of newly synthetized triglycerides, seems to blunt or to mask the insulin induced inhibition of glycerol release. Relatively higher rates of glucose metabolism and a lower lipolysis in small fat cells might explain the difference in the action of insulin on glycerol release in the adipose tissue of young rats as compared to the older ones. PMID- 3516828 TI - Study on the effect of a high fat diet on diaphragm and liver glycogen and glycerides in the rat. AB - The present work was undertaken to study the effect of nutritional obesity induced by a high fat diet on the consumption of glycogen and glycerides in rat liver and diaphragm. Groups of rats were fed for five weeks from weaning either a fat-rich-carbohydrate (CHO)-poor diet, or a CHO-rich-fat-poor diet. Basal plasma glucose and free fatty acids (FFA) were significantly increased in the animals adapted to the fat-rich diet. Half of the rats were submitted to a 48-h fast. After fast, basal plasma glucose and immunoreactive insulin (IRI) fell significantly, whereas plasma FFA levels were higher than in the group fed the CHO-rich-fat-poor diet. In the liver, glycogen concentration fell in both groups after fast, with a glycogen breakdown of 1930 +/- 244 mumole glycogen glucose/liver in the fat-fed group vs 4636 +/- 216 mumole/liver in the CHO-fed group. Glycerides fell by 750 +/- 68 mumole glyceride glycerol/liver in the fat fed rats while remaining unchanged (increased by 82 +/- 57 mumole/liver) in the CHO-fed group. In the diaphragm glycogen concentration also fell in both groups, with a glycogen breakdown of 6.0 +/- 0.3 mumole glycogen glucose/g wet tissue in the fat-fed rats vs 15.2 +/- 1.4 mumole/g wet tissue in the CHO-fed animals. Glycerides fell by 23.1 +/- 4.0 mumole/g wet diaphragm in the CHO-fed animals. The lower breakdown of glycogen in both liver and diaphragm of fat-fed rats demonstrates a decreased utilization of glycogen during fast, with energy consumption originating in larger part from triglycerides.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3516829 TI - Glucocorticoid-induced insulin resistance in vitro: inhibition of insulin stimulated methylaminoisobutyric acid uptake. AB - We have previously developed an in vitro model for the induction of insulin resistance by glucocorticoids using 3T3-L1 fat cells (Grunfeld, Baird, Van Obberghen and Kahn 1981). In this model, glucocorticoid treatment was shown to decrease insulin binding and inhibit the acute stimulation of deoxyglucose uptake by insulin. We now extend the findings in this model to examine insulin stimulated methylaminoisobutyric acid (MAIB) uptake, an event whose expression requires m-RNA and protein synthesis and takes many hours. As previously seen with insulin stimulation of deoxyglucose uptake, one day of exposure to dexamethasone had little effect on insulin stimulation of MAIB uptake. Significant inhibition of insulin-stimulated MAIB uptake was seen after 2 days of exposure, and 3 days were required for the maximum effect of the glucocorticoid. The half-maximal concentration of dexamethasone required for inhibition was 1.6 nM. Exposure to dexamethasone produced a 57% decrease in the maximal response to insulin and a small but consistant shift in the sensitivity to insulin. As seen with the acute effects of insulin, the major locus of glucocorticoid action in inhibiting insulin stimulated MAIB uptake is also after the binding of insulin to its receptor. These data indicate that the inhibitory effects of glucocorticoids on insulin action in fat cells extend to those effects of insulin which require gene expression and are not merely limited to short-term metabolic actions of insulin. PMID- 3516830 TI - Possible role of pancreatic insulin and glucagon in the hyperlipidemia and obesity of obese strain of chicken. AB - Circulating levels of insulin, glucagon, thyroid hormones as well as lipid levels were determined in an obese strain of chicken and their lean controls. Hepatic and muscle glycogen and lipids were also measured. Obese birds had higher plasma lipids accompanied by significantly higher insulin and lower glucagon levels compared to lean controls. Hepatic and muscle triglycerides were also higher in obese birds. Plasma T4 level was significantly higher in obese but T3 was not different in the two groups. Results suggest that genetically obese birds have significantly increased insulin/glucagon ratios as previously reported in the PTU induced hypothyroid-obese chicks (Horm. Metab. Res. 12: 51, 1980) and this could have causal relationship to hyperlipidemia and obesity observed in these birds. PMID- 3516831 TI - Insulin internalization and intracellular protein degradation: a quantitative correlation. AB - We have recently demonstrated that internalization of insulin is essential for insulin's action upon intracellular proteolysis (Draznin and Trowbridge 1982). In this study we have investigated the quantitative relationship between the rate of insulin internalization and its ability to inhibit intracellular proteolysis. We have used the acidification technique to separate surface bound 125I-insulin (sur) from internalized ligand (In). The In/Sur ratio plotted as a function of time permits the calculation of the rate of insulin internalization (K-e) (Draznin, Trowbridge and Ferguson 1984). Insulin in a dose dependent manner increased the rate of C14-glucose incorporation into glycogen and inhibited the rate of degradation of intracellular proteins prelabelled in vivo with C14 valine. When insulin internalization was blocked by phenylarsine oxide (10(-5) M), the amount of surface bound ligand and its effect on glucose incorporation into glycogen were unaffected whereas insulin's effect on intracellular proteolysis was markedly diminished. There was a direct and significant correlation between K-e and insulin induced inhibition of intracellular proteolysis (r = .72, P less than .05). The correlation between the amount of internalized insulin and intracellular proteolysis was also significant (r = .84, P less than .01). PMID- 3516832 TI - The effects of porcine GIP on insulin secretion and glucose clearance in the pig. AB - The present study was undertaken with the aims of studying the pharmacological effects and the pharmacokinetics of porcine GIP in pigs in vivo. Infusion of GIP and glucose resulted in a significant increase in the insulin release compared to the insulin release after glucose infusion in the control group. A significant increase in glucose clearance was also seen during GIP infusions. A two compartment open model with first order kinetics was used for the description of the pharmacokinetics of the infused GIP. The plasma half-life for GIP was found to be between 34-35 minutes. PMID- 3516833 TI - Effect of GIP on insulin release to intravenous glucose infusion in hyperthyroid rats. AB - Triiodothyronine induced hyperthyroidism caused significantly elevated basal and stimulated glucose and insulin levels in rats. The release of Gastric Inhibitory Polypeptide (GIP) following an oral glucose load was not significantly different between euthyroid and hyperthyroid rats. The insulin response, however, was significantly higher in hyperthyroid rats. Following intravenous glucose hyperthyroid rats showed a diminished insulin response when compared with euthyroid rats but intravenous infusion of glucose together with GIP caused a significantly higher insulin response in hyperthyroid rats. It is hypothesized that in hyperthyroidism there is an increased sensitivity to the insulinotropic action of GIP and that this mechanism could emphasize the importance of the enteroinsular axis in pathophysiological states. PMID- 3516834 TI - Failure of hyperketonemia to alter basal and insulin-mediated glucose metabolism in man. AB - The effect of physiologic elevations of plasma hydroxybutyrate induced by the infusion of sodium D,L-beta-hydroxybutyrate (15 mumol X kg-1 X min-1) on carbohydrate metabolism was examined with the euglycemic insulin clamp technique in nine healthy volunteers. Plasma insulin concentration was acutely raised and maintained at 126 +/- 6 microU/ml and plasma glucose was held constant at the fasting level by a variable glucose infusion. Glucose uptake of 6.53 +/- 0.80 mg X kg-1 X min-1 was unchanged by hyperketonemia when compared with an intraindividual control study using saline instead of beta-OH-butyrate infusion (6.26 +/- 0.59 mg X kg-1 X min-1). In studies, in which the degree of metabolic alkalosis accompanying butyrate infusion was mimicked by the continuous administration of bicarbonate, glucose uptake was also unaffected (6.25 +/- 0.45 mg X kg-1 X min-1). Furthermore, hyperketonemia had no effect on basal glucose production or the suppression of hepatic glucose production following hyperinsulinemia. It is concluded that moderate elevations in plasma beta-hydroxy butyrate do not alter hepatic or peripheral glucose metabolism. PMID- 3516835 TI - The effects of oral agent or insulin treatments on the plasma lipoproteins and the plasma lipoprotein lipase activator in diabetic patients. AB - The structure and the metabolism of plasma lipoproteins are altered in diabetes mellitus. Insulin or oral agent treatments affect the lipoprotein metabolism in addition to improving hyperglycemia. However, it is not clear whether the alterations seen in lipoproteins during treatment are related to the degree of diabetic control or to the mode of diabetic treatment. The effects of insulin or oral agent treatments on the plasma lipoproteins and lipoprotein lipase activator were compared in a strictly defined non-obese, non-insulin dependent diabetic patient. Both treatment groups had similar plasma triglyceride, total cholesterol, low and high density lipoprotein cholesterol, and lipoprotein lipase activator levels. Lipoprotein lipase activator contents of the very low density lipoproteins correlated positively with their triglyceride (r = 0.803 in insulin, r = 0.828 in oral agent treated patients) and protein (r = 0.713 in insulin, r = 0.862 in oral agent treated patients) contents. The findings of this study indicated that plasma lipid levels, very low density lipoprotein compositions, and lipoprotein lipase activator contents were not significantly different in non obese, non-insulin dependent diabetic patients treated with either oral hypoglycemic agents or insulin. PMID- 3516836 TI - Effect of fasting upon the potentiating effect of tolbutamide on the occurrence of alloxan diabetes. PMID- 3516837 TI - Obesity, hyperinsulinaemia and hyperplasia of the pancreatic islets in ageing (C3H/HeJ x C57Bl/6J) F1 hybrid mice. PMID- 3516838 TI - Morphological and immunohistochemical characteristics of T-cell malignant lymphomas in the west of Scotland. AB - Sixteen cases of T-cell malignant lymphoma are described. They represent the experience of a single pathology department in recent years and serve to illustrate several of the reasons why recognition of T-cell differentiation is important in the classification of lymphomas. PMID- 3516839 TI - Peripheral T-cell lymphomas: a clinicopathological and immunological study of 10 cases. AB - Diagnosis and classification of T-cell lymphomas is notoriously difficult. Existing classification schemes are insufficient. Some clinicopathologically well defined T-cell lymphomas exist (mycosis fungoides, Sezary's syndrome, and T lymphoblastic lymphomas) but the remaining tumours, frequently called peripheral T-cell lymphomas, are a heterogeneous group, clinically, morphologically and immunologically. The data on 10 peripheral T-cell lymphomas are presented and compared to data from the literature. Patients were elderly, had a high frequency of extranodal localizations (notably the skin 75%) and had a poor prognosis: five of 10 patients have died, median survival 22 months. Morphologically and immunophenotypically the group is very heterogeneous. The variety of blast cell morphology is emphasized. No correlations were found between immunophenotype and prognosis, or immunophenotype and morphology. PMID- 3516840 TI - Immunohistology of the human spleen: an inventory of the localization of lymphocyte subpopulations. AB - The immunohistochemistry of the cell population of the human spleen was studied. As controls, a strictly defined group of five specimens were used. This study stresses the need for the utmost care in this selection procedure. Using enzyme- and immuno-histochemistry the lymphocyte subpopulations were studied as to their localization in the several specific compartments in the red and white pulp. The findings were compared to those in idiopathic thrombocytopenic purpura, autoimmune haemolytic anaemia and Hodgkin's disease. In the controls a consistent pattern was found. There were specific changes in each of the disease groups consisting mainly of shifts between the compartments. PMID- 3516841 TI - Basement membrane proteins in the spleen: immunohistochemical demonstration and relation to reticulin. AB - In the present study immunohistochemical staining has shown that the ring fibres of the human spleen contain the major basement membrane components, type IV collagen and laminin. The superiority of immunohistochemical methods in demonstrating basement membrane material in the spleen is emphasized. The results are compared with the demonstration of reticular fibres by Gomori's reticulin stain. The findings provide further information about the relationship between basement membrane material and reticular fibres in human spleen. The nature of splenic ring fibres is discussed in the light of the scientific literature. PMID- 3516842 TI - T-cell lymphomas. PMID- 3516844 TI - Medicare and Alzheimer's. PMID- 3516843 TI - Confidentiality: winning for a change. PMID- 3516845 TI - The policies and practices of American psychiatry are oppressive. AB - The author argues that psychiatry is not a medical specialty but an instrument for the social control of people whose ideas, actions, values, and life-styles threaten or disrupt established power relationships within families, communities, or society. Psychiatry's instruments for social control are involuntary incarceration and so-called treatment in facilities in which inmates are brutalized, harassed, neglected, and humiliated. The major somatic psychiatric treatments--drugs, electroconvulsive therapy (ECT), and lobotomy--have produced an epidemic of neurological and brain dysfunction, such as tardive dyskinesia, associated with neuroleptic drugs, and memory impairment, associated with ECT. The author condemns the freezing experiments conducted on psychiatric inmates in the United States and on concentration-camp inmates in Germany during the 1940s. PMID- 3516846 TI - Illinois gets tough with health costs. PMID- 3516847 TI - It's illegal to tax Medicare for state indigent care pool. PMID- 3516848 TI - Home care: cutting health care's safety net. PMID- 3516849 TI - William Cleverley: finance could be his middle name. PMID- 3516850 TI - Inspector general lauds quality of care under PPS. Interview by Pamela Taulbee. PMID- 3516851 TI - The complicated evolution of strategic planning. PMID- 3516852 TI - Medicare stance may backfire on HHS: attorneys. PMID- 3516853 TI - Providers fight for Medicaid money. PMID- 3516854 TI - Different answers for hospitals with same complaints. PMID- 3516855 TI - Conditions of participation resurface. PMID- 3516856 TI - Meet health care's leaders for the 21st century. PMID- 3516857 TI - Fifty years of U.S. health care policy. PMID- 3516858 TI - Prospects for telepathology. PMID- 3516859 TI - Flow cytometric analysis of paraffin-embedded tumors: implications for diagnostic pathology. PMID- 3516860 TI - T-cell subsets in sarcoidosis: an immunocytochemical investigation of blood, bronchoalveolar lavage fluid, and prescalenic lymph nodes from eight patients. AB - T-lymphocyte subsets in peripheral blood, bronchoalveolar lavage fluid, and prescalenic lymph nodes from eight patients with sarcoidosis were evaluated with monoclonal antibodies. Both in lung and lymph nodes significant increases in helper T cells were demonstrated, except in patients with stage III pulmonary disease or with unaffected lymph nodes. A good statistical correlation was observed between the activity of the disease (expressed by an increased ratio of helper to suppressor/cytotoxic T cells) in bronchoalveolar fluid and in lymph node cell suspensions from each patient. A three-step immunoperoxidase staining reaction, performed on lymph node frozen sections, showed a prevalence of helper T cells both inside and around the granulomas. These findings confirm that sarcoidosis is characterized by increased activity of cell-mediated immunity in its different localizations. PMID- 3516861 TI - Splenic angiosarcoma following chemotherapy for follicular lymphoma. AB - A case of splenic angiosarcoma in a patient who had been treated for a follicular lymphoma with chemotherapy over a period of about nine years is reported. The etiologic agents for angiosarcomas at various sites, and their associations with other tumors, are reviewed. The most important of these associations are radiotherapy and lymphedema with tumors of the skin and soft tissues; and vinyl chloride, arsenic, and thorium dioxide with hepatic tumors. For splenic angiosarcomas, only isolated associations with breast carcinoma and thorium dioxide exposure have been reported. In the present case long-term combination chemotherapy seems to be the most likely etiologic association. PMID- 3516863 TI - Genetic markers in schizophrenia. AB - A genetic contribution to schizophrenia is the best established aetiological clue for this common and serious condition. Purely statistical attempts to establish the mode of inheritance have yielded inconclusive results although SML models where a major gene is the sole cause of concordance between relatives can be effectively excluded. The question of genetic heterogeneity is also unresolved. Genetic marker studies offer potentially productive strategies for detecting major genes for schizophrenia or schizophrenia subtypes, but also offer the possibility of detecting contributory (minor) susceptibility loci. The most consistent genetic marker finding, to date, of an association between HLA A9 and paranoid schizophrenia may fall into the latter category. This and other possible associations discovered by recent population studies (e.g. with complement factors) merit further investigation. On the other hand, the findings of linkage studies, including those with HLA, have been predominantly negative. Recent advances in recombinant DNA technology, and the potential availability of many more polymorphisms, make genetic marker studies an increasingly attractive prospect in schizophrenia. However, as in other disorders with complex and non Mendelian patterns of inheritance, there remain formidable problems in the statistical analysis of the results. PMID- 3516862 TI - Ethnic variation in vitamin D-binding protein (GC): a review of isoelectric focusing studies in human populations. AB - Since the discovery in 1977 that the GC1 gene could be resolved into two common subcomponents on an isoelectric focusing (IEF) gel, a large number of ethnic groups have been screened to analyze the extent of genetic variation in human populations. Using the IEF technique, approximately 50,000 individuals from 160 different populations have been tested for the GC polymorphism. A marked variation in common GC suballele frequencies in different geographic areas seems to correlate with skin pigmentation and intensity of sun light. Pigmented (black) and keratinized (yellowish) skin type populations have a relatively high frequency of the GC*IF allele as compared to white skin populations. By comparison non-pigmented and non-keratinized white skin populations are generally characterized by having the maximum values of the GC*IS allele. The anthropologic significance of the GC locus has been enhanced further by detecting additional unique GC variants which provide useful information about evolutionary links between different populations. However, the presence of some electrophoretically identical unique variants in genetically and geographically distinct populations demand further investigation of these allelic variants to shed more light on their origins. PMID- 3516864 TI - Heterogeneity in disease associations. AB - Associations between polymorphisms and disease are usually detected by comparing phenotype frequencies in affected individuals and controls, usually by the method of Woolf, which also allows assessment of heterogeneity between studies. The risk of reporting a chance spurious association could be reduced if family studies, such as sib comparisons, were carried out at the same time as the original survey, rather than after many surveys have been conducted. PMID- 3516865 TI - Idiotypic manipulation of the immune response to transplantation antigens. PMID- 3516867 TI - Stimulation & leakage of phospholipase A of Escherichia coli K12 by bile salts & chemical surfactants. PMID- 3516866 TI - [The presence of yeasts in the oral cavity]. PMID- 3516868 TI - Role of Plasmodium vivax in oxidation of haemoglobin in red cells of the host. PMID- 3516869 TI - Counterimmunoelectrophoresis in urinary candidiasis. PMID- 3516870 TI - Selective vasodilation produced by renal denervation in adult spontaneously hypertensive rats. AB - The kidneys of adult male spontaneously hypertensive rats (SHR) were denervated, and systemic and regional blood flows were measured 3 to 5 hours or 5 days after denervation. Arterial pressure was reduced 20 to 27% in denervated SHR during both periods compared with that in sham-operated SHR (iliolumbar blood vessels painted with phenol). This hypotensive response was produced by a 32 to 35% reduction in total peripheral resistance. At 3 to 5 hours and at 5 days, a major decrease in total peripheral resistance was produced by vasodilation in the kidneys and splanchnic organs. Acute urine output, sodium excretion, and plasma renin activity in response to a saline load were not different between sham operated and denervated SHR. The decreased total peripheral resistance in denervated SHR may have been secondary to a decreased central sympathetic nerve activity revealed by a decreased maximum response to ganglionic blockade. The results suggest that a pathophysiological link may exist between the kidneys and splanchnic organs in genetic hypertension and that specific efferent antiadrenergic or antiafferent nerve therapy, or both, in the kidney may lead to substantial specific decreases not only in renal vascular resistance but also in splanchnic vascular resistance and total peripheral resistance. PMID- 3516871 TI - Spectrum of deranged sodium homeostasis in essential hypertension. AB - Essential hypertension is thought to produce a uniform exaggerated natriuresis and diuresis. Because validation of this formulation in humans is incomplete, the natriuretic and diuretic responses to acute volume expansion were characterized by using water immersion to the neck. This method provides a volume stimulus identical to that induced by 2 L of saline without plasma compositional change. Twenty-seven subjects with essential hypertension were studied on three occasions in the seated posture while in balance on a 10 mEq Na, 100 mEq K diet: during the seated control study, during 4 hours of head-out immersion, and during saline infusion (2 L/2 hours). Four subjects had exaggerated urinary Na excretion in response to neck immersion (Group 3), and 16 had a normal response (Group 2) indistinguishable from that of 15 previously studied normal subjects. The remaining seven subjects (Group 1) had blunted or absent natriuretic responses compared with that in normal subjects (p less than 0.005). Similar results were obtained with saline administration; cumulative Na excretion in Group 1 was markedly less than that in Group 2 and the normal subjects. The heterogeneity in Na excretion indicates that an exaggerated natriuresis is not a uniform concomitant of essential hypertension. The significant inverse correlation between basal plasma aldosterone level and peak urinary as well as cumulative Na excretion suggests that plasma aldosterone constitutes a determinant of the differing natriuretic responses. In contrast to findings with urinary Na excretion, the diuretic responses of Groups 1 and 2 were identical. The striking dissociation between renal Na and water handling underscores the specificity of the derangement in renal Na handling. PMID- 3516872 TI - Comparison of in vivo degradation of 125I-labeled peptidoglycan-polysaccharide fragments from group A and group D streptococci. AB - The in vivo degradation and persistence of 125I-labeled peptidoglycan polysaccharide (PG-PS) fragments from the cell walls of group A and D streptococci were compared by group after intraperitoneal injection into rats. The quantity of PG-PS in the livers and spleens of group D PG-PS-injected rats was less than the quantity in rats injected with group A PG-PS throughout the course of the experiment. Gel filtration analyses of liver and spleen homogenates indicated that group A PG-PS was relatively resistant to degradation, whereas group D PG-PS was extensively degraded to yield a heterogeneous mixture of fragments of lower molecular weight. There was no significant difference in the content of group A PG-PS versus that of group D in joints or blood samples. Analysis of fragment sizes in these tissues also indicated more extensive degradation of group D PG-PS. However, the majority of group A PG-PS in blood samples and joints was a lower molecular weight than that found in the livers or spleens. We conclude that group A PG-PS undergoes a significant but low level of degradation and that group D PG-PS is much less persistent and more extensively degraded than group A PG-PS is in vivo. These differences in PG-PS catabolism may account, in part, for the capacity of group A PG-PS to induce chronic, recurrent arthritis of longer duration than that induced by group D PG-PS. PMID- 3516873 TI - In vivo degradation of bacterial cell wall by the muralytic enzyme mutanolysin. AB - The muralytic enzyme mutanolysin can act in vivo to eliminate chronic erosive arthritis induced in rats by polymers of peptidoglycan-polysaccharide isolated from group A streptococci (PG-APS). The amounts of PG-APS in the livers and spleens of rats treated with mutanolysin were significantly reduced compared with the amounts in control rats treated with phosphate-buffered saline. However, the amounts of PG-APS in the limbs of mutanolysin- and phosphate-buffered saline treated rats were comparable. PG-APS polymers extracted from the livers, spleens, and limbs of mutanolysin-treated rats were extensively degraded, whereas PG-APS extracted from phosphate-buffered saline-treated rats had a high molecular weight. We propose that mutanolysin abrogates arthritis in rats by degrading PG APS polymers to a size which is no longer able to induce chronic erosive arthritis, even though the polymers are still present in the limbs. PMID- 3516875 TI - Delayed-type hypersensitivity and immunity to Salmonella typhimurium. AB - Studies were carried out to correlate immunity and expression of delayed-type hypersensitivity (DTH) in mice of the C3H lineage immunized with an avirulent strain of Salmonella typhimurium (strain SL3235). This strain belongs to a class of aroA- organisms which are being considered as vaccine strains for humans and veterinary use. In a systematic study, the relationship between the mouse strain and the immunizing dose of strain SL3235 on the development of protective immunity and DTH was examined. It was found that in hypersusceptible C3H/HeJ and C3HeB/FeJ mice, several doses of strain SL3235 afforded protection against intravenous challenge doses as high as 1,300 50% lethal doses. Despite these significant levels of immunity to challenge, mice of these two strains never mounted significant DTH responses following immunization with the doses of strain SL3235 tested, which spanned 3 orders of magnitude. Nonresponsiveness was not due to antigen overload, as all of the mouse strains were comparably colonized with strain SL3235 at the time of DTH elicitation. Further, it was found that the ability of responsive C3H/HeNCrlBR mice to display DTH was dependent on the immunizing dose of strain SL3235 and that a dosage could be found that resulted in increased resistance to challenge in these mice without a concomitant display of DTH. Thus, while both induction of protective immunity and DTH were vaccine dosage dependent in the responsive mouse strain (C3H/HeNCrlBR), DTH was a less sensitive measure of protective immunity than survival. Vaccine dosages ranging over three orders of magnitude failed to yield positive footpads to the Salmonella elicitin in the nonresponsive mice. The data suggest that caution should be observed in interpreting Salmonella DTH tests that are used as screens of immune status to typhoid fever in humans, as the extent of discordance between immunity and DTH in humans is unknown. PMID- 3516874 TI - Identification of a nonfimbrial adhesive factor of an enterotoxigenic Escherichia coli strain. AB - An enterotoxigenic Escherichia coli strain (strain 2230), isolated from a patient with acute infantile diarrhea, was found to adhere only to the brush border of human intestinal epithelial cells. This strain does not hemagglutinate human, bovine, chicken, or guinea pig erythrocytes. The adhesion of E. coli 2230 appears to be mediated by a nonfimbrial bacterial surface protein of 16,000 daltons which can be extracted by heating the bacteria at 60 degrees C for 20 min. This surface protein is implicated as an adhesive factor because pretreatment of enterocytes with this protein extract completely inhibits the adhesion of E. coli 2230. This adhesive factor is serologically distinct from other adhesive factors found in enterotoxigenic E. coli strains. A plasmid DNA of 66 megadaltons is involved in the synthesis of this nonfimbrial adhesive factor. PMID- 3516877 TI - Lack of biological significance of in vitro Brugia malayi microfilarial cytotoxicity mediated by Propionibacterium acnes ("Corynebacterium parvum")-and Mycobacterium bovis BCG-activated macrophages. AB - The effect of nonspecific activation of host macrophages by Propionibacterium acnes ("Corynebacterium parvum") or Mycobacterium bovis BCG on Brugia malayi microfilariae was determined by in vitro and in vivo studies. Intraperitoneal injection of C. parvum or BCG stimulated peritoneal exudate cells, which were toxic to microfilariae. Microfilariae were equally susceptible to damage by C57BL/6J or BALB/cJ peritoneal exudate cells. Furthermore, inhibitors of oxidative metabolism and arginine supplementation did not prevent this toxicity, suggesting that the mechanism of microfilarial damage differs from that seen with another multicellular helminth, Schistosoma mansoni. In vivo studies with both BCG and C parvum, however, did not confirm the importance of nonspecific immunity in resistance to B. malayi microfilaremia. Despite the lack of biologic relevance of this phenomenon, in vitro studies may yield important knowledge about the mechanisms of microfilarial damage. PMID- 3516876 TI - Quantitative and qualitative analyses of serum antibodies elicited in adults by Haemophilus influenzae type b and pneumococcus type 6A capsular polysaccharide tetanus toxoid conjugates. AB - Covalent binding to immunogenic proteins increases the immunogenicity of the capsular polysaccharides of Haemophilus influenzae type b (Hib) and pneumococcus type 6A (Pn6A). Conjugates composed of Hib, Pn6A, or the cross-reacting Escherichia coli K100 covalently bound to tetanus toxoid (TT) were injected into young adult volunteers. Local reactions were common and were probably due to Arthus reactivity mediated by the preexisting antibodies reacting with the TT component of the conjugates. Fever occurred in about 10% of the volunteers after the first injection; no volunteers had fever after the second injection. Similar levels of Hib or Pn6A antibodies were elicited by either 50- or 100-micrograms doses or by concurrent injection of two different conjugates (Hib-TT and Pn6A-TT or Hib-TT and K100-TT). The Hib-TT elicited about a 180-fold increase in Hib antibodies, and the Pn6A-TT conjugate elicited about an 8-fold increase in Pn6A antibodies after one injection. Booster reactions were not elicited in adults; similar levels of antibodies in the five experimental groups suggested that the responses elicited by the conjugates were maximal. A one-way cross-reaction was noted as Pn6A conjugates elicited rises of Hib antibodies in 13 of 20 volunteers; only 4 of 59 volunteers immunized with Hib-TT had increases in Pn6A antibodies. The preimmunization Hib antibodies were composed of immunoglobulin M (IgM), IgA, and IgG. The postimmunization sera showed an increase in all three isotypes; the elevation of the IgG was the highest of the three isotypes. Conjugate-induced antibodies to both the polysaccharide and TT exerted biological activities that have been correlated with immunity. Adsorption of the Hib-TT onto aluminium hydroxide resulted in higher levels and an earlier Hib antibody response in infant rhesus. These results encourage the evaluation of Hib and Pn6A conjugates in human children and infants. PMID- 3516878 TI - A Borrelia-specific monoclonal antibody binds to a flagellar epitope. AB - In immunofluorescence assays monoclonal antibody H9724 recognized eight species of the spirochetal genus Borrelia but not representatives of the genera Treponema, Leptospira, and Spirochaeta. We examined the reactivity of H9724 against subcellular components of Borrelia hermsii, an agent of relapsing fever, and B. burgdorferi, the cause of Lyme disease. H9724 bound to isolated periplasmic flagella of the two borreliae. In Western blots the antibody reacted with the predominant protein in flagellar preparations from B. hermsii and B. burgdorferi; the apparent molecular weights of these flagellins were 39,000 and 41,000, respectively. PMID- 3516879 TI - Antibody response to Giardia muris trophozoites in mouse intestine. AB - The protozoan parasite Giardia muris colonizes the mouse small intestinal lumen. This parasite is cleared immunologically from the intestine of normal mice. In contrast, T-lymphocyte-deficient (nude) mice have an impaired immunological response to G. muris and become chronically infected. In the present study, trophozoites were harvested from the intestinal lumen of immunocompetent BALB/c mice and nude mice and examined for surface-bound mouse immunoglobulins by immunofluorescence microscopy. Immunoglobulin A (IgA) and IgG, but not IgM, were detected on trophozoites obtained from BALB/c mice, from day 10 of the infection onwards. Trophozoites from nude mice showed very little evidence of surface-bound mouse immunoglobulin at any time during the 5-week period immediately following infection of these animals with G. muris cysts. Intestinal G. muris infection was cleared by the BALB/c mice but not by the nude animals. The data suggest that parasite-specific IgA and IgG bind to G. muris trophozoites in the intestinal lumen of immunocompetent BALB/c mice. Intestinal antibodies that bind to trophozoite surfaces are likely to play an important part in the clearance of G. muris infection by immunocompetent mice. The inability of nude mice to clear this infection at a normal rate is likely to be due to impairment of Giardia-specific intestinal antibody production. PMID- 3516881 TI - Homologous regions within M protein genes in group A streptococci of different serotypes. AB - DNA hybridization with probes from the structural gene for the M6 protein shows that the carboxy-terminal region (proximal to the cell surface) is conserved among strains of different M serotypes. The amino-terminal region, which is more available to immunological surveillance, exhibits greater variation. PMID- 3516880 TI - Native surface association of a recombinant 38-kilodalton Treponema pallidum antigen isolated from the Escherichia coli outer membrane. AB - A recombinant plasmid designated pAW305, containing a 6-kilobase insert of Treponema pallidum DNA, directed the expression of a 38-kilodalton (kDa) treponemal antigen in Escherichia coli. The 38-kDa antigen copurified with the outer membrane fraction of the E. coli cell envelope after treatment with nonionic detergents or sucrose density gradient centrifugation. Rabbits immunized with the recombinant 38-kDa antigen developed antibodies which reacted specifically with a 38-kDa T. pallidum antigen on immunoblots, and 38-kDa antisera specifically immobilized T. pallidum in a complement-dependent manner in the T. pallidum immobilization test. Antisera to the 38-kDa recombinant antigen were also used to demonstrate its native surface association on T. pallidum by immunoelectron microscopy. PMID- 3516882 TI - Evidence for lipid peroxidation in endotoxin-poisoned mice. AB - Ethane has been identified and quantitated in air exhaled by mice following intraperitoneal injection of 20, 40, or 200 mg of Escherichia coli O111:B4 lipopolysaccharide (LPS) per kg. Significant increases in ethane concentration occurred within 1 to 5 h after LPS administration. In addition, increased concentrations of malondialdehyde were found in crude homogenates of livers obtained from mice 16 h after administration of 20 mg of LPS per kg. These results suggest that lipid peroxidation may be an important mechanism responsible for LPS toxicity. PMID- 3516883 TI - Monoclonal antibodies reactive with K1-encapsulated Escherichia coli lipopolysaccharide are opsonic and protect mice against lethal challenge. AB - Seven murine monoclonal antibodies (MAbs) directed against O-side-chain determinants of the K1-encapsulated Bortolussi strain of Escherichia coli (O18:K1:H7) were evaluated for their in vitro and in vivo activities. All the MAbs reacted well in Western blots against E. coli O18 lipopolysaccharide antigens. Two MAbs of the immunoglobulin G (IgG) class promoted in vitro opsonophagocytosis and protected mice lethally challenged with bacteria. Two IgM MAbs showed partial protection, although they had no in vitro opsonic activity, and the remaining three IgM MAbs showed no apparent functional activities. Monoclonal IgG antibodies against bacterial lipopolysaccharide can be opsonic and protective in spite of the presence of the K1 capsule on the bacterium. PMID- 3516884 TI - Lack of immunoglobulin A1 protease production by Branhamella catarrhalis. AB - Clinical isolates of Branhamella catarrhalis from the sputum of 20 patients with acute bronchopulmonary infection were examined for synthesis of immunoglobulin A1 protease by immunoelectrophoresis. Ten strains produced beta-lactamase, and 10 were beta-lactamase negative. None of the strains demonstrated immunoglobulin A1 protease activity despite the fact that three different culture media were used. PMID- 3516886 TI - The role of the prosthodontist in the treatment of periodontal disease. AB - The inter-relationships between the periodontal situation of a patient and a prosthetic appliance should be regarded in particular from the aspect of oral hygiene. Creating or maintaining a high standard of oral hygiene is thus the joint objective characterizing cooperation between the periodontist and the prosthodontist. The tasks falling to the prosthodontist during initial therapy are: removal and temporary replacement of restorations that are not conducive to good oral hygiene, temporary replacement of teeth with hopeless prognoses, and temporary prosthetic planning in conjunction with the periodontist. In the phase of surgical periodontal treatment, the creation of new attachments should be accompanied by morphologic corrections; these are essential to the oral hygiene of patients with prosthetic appliances. The prosthodontist has therefore to advise the periodontist on what corrections are desirable and where. This applies firstly to gingival corrections at abutment teeth and secondly to mucosal corrections on the edentulous alveolar ridge. On conclusion of the periodontal treatment, the prosthodontist will have to come to terms with three problems: the indication for prosthetic treatment, the decision between fixed bridges and removable partial dentures, and the periodontal problem zones occurring with crowns and bridgework. The indications for prosthetic treatment can now be more restricted, following recent findings on oral function with shortened dental arches. When deciding between fixed bridges and removable partial dentures, it is the oral hygiene aspect that is decisive. In existing or threatened free-end situations preference should be given to bridgework. This can be implemented with: cantilever bridges, bridges abutted at each end by the distal movement of a premolar, and bridges abutted at each end by hemisectioning of a periodontally damaged molar. With crowns and bridges, prospects for oral hygiene are determined by the following: the position of the crown margin, the contour of the crown in the marginal area, and the contour of the under-surface of the pontic. If optimum prospects for oral hygiene have been created by good coordination between the periodontist and the prosthodontist, the prognosis in the maintenance phase is considerably improved. PMID- 3516885 TI - T-lymphocyte involvement in abscess formation in nonimmune mice. AB - Athymic mice formed significantly smaller abscesses than euthymic mice in response to the intraperitoneal inoculation of an abscess-inducing mixture of Escherichia coli, Bacteroides fragilis, and autoclaved colonic contents, an abscess-potentiating agent. Adoptive transfer of nonimmune, Thy-1-positive spleen cells to athymic mice restored their ability to make abscesses of sizes similar to those in controls, indicating that T lymphocytes contribute to abscess formation in normal mice. PMID- 3516887 TI - A scanning electron microscope study of the effect of etching time and mechanical pre-treatment on the pattern of acid etching on the enamel of primary teeth. AB - Eighty-five deciduous teeth, divided into five groups, were examined using a scanning electron microscope. The first two groups were etched for 60 and 120 sec respectively; the third and fourth groups were lightly milled and then etched for 60 and 120 sec respectively. In the first two groups, etching produced very few histological modifications. In the milled groups removal of the prismless enamel exposed the prisms to dissolution by the phosphoric acid. It was found that pretreatment and an etching time of 120 sec produced a constant and regularly distributed loss of inter- and intraprismatic substances. PMID- 3516888 TI - The role of the specialist periodontist. AB - The major portion of periodontal care of the population belongs in the hands of the general dentist. This is because of the overwhelming number of patients with periodontal disease and the intimate relationship between the periodontal condition and restorative dentistry. The probable increase, in the near future, in the number of patients with periodontal problems will necessitate a greater understanding and an increased level of expertise for their solution on the part of the general practitioner of dentistry. However, there will always be a need for specialists to treat particularly difficult cases, patients with systemic health problems and situations in which complex prosthetic construction requires absolute assurance of reliable results. PMID- 3516889 TI - Pharmacokinetics of estulic [corrected] in humans. AB - Estulic [corrected] given orally without food after overnight fast produces a blood concentration curve with a pronounced second peak that does not appear when the drug is taken with food. A two-compartment open model involving two different time lags is used to study the pharmacokinetics of estulic [corrected] in humans after oral administration. The drug accumulates in a tissue or organ that is well perfused in the first pass transfer. The accumulation appears to occur by a competitive process. The second peak apparently is the result of a rapid release of drug and bioreversible drug compounds from the hepatic-biliary system with subsequent reabsorption. This release may occur spontaneously, but appears to be triggered by food intake. We use an optimization method to characterize the pharmacokinetic profiles of drug for this model. This technique which provides the global minimum of the deviation delta, from the given observations, leads to the optimization of a single variable function. The results are compared with those obtained from the generalized least squares method. PMID- 3516890 TI - Immunohistologic expression of blood-group antigens in normal human gastrointestinal tract and colonic carcinoma. AB - A panel of 7 mouse monoclonal antibodies and the lectin from Ulex europeus, detecting blood-group-related antigens of the ABH and Lewis systems, have been used to define the distribution of these antigenic structures within the human gastrointestinal tract, and to characterize their expression and modulation in colorectal carcinomas. The reagents employed detect the following blood-group specificities: A (all variants), B, H (type 2), Lewisa, Lewisb, X (Lewisx), Y (Lewisy) and type 1 precursor chain. Immunohistochemical studies demonstrate that these antigens are differentially expressed in various cell types and developmental stages of the human gastrointestinal tract. ABH expression undergoes developmental modulation in the human colorectal tract from positive to negative during embryogenesis, and is lost in adult cells. Colorectal tumors exhibit neosynthesis of ABH specificities that appear in tumor cells, and accumulation of the precursor antigens. They also show increased expression of Lewis antigens, especially Y determinant, which has a restricted pattern of distribution in normal tissues and is not found in normal colonic mucosa. Enhancement of the Lewis antigens is observed in all colorectal tumors analyzed, regardless of blood-group type and secretory status of the individuals studied. Tumor modulation of these antigens may be related to activation of suppressed genes and enhancement of fucosyltransferases. PMID- 3516891 TI - The effects of relaxation and imagery inductions on responses to suggestions. PMID- 3516892 TI - Ceftazidime in patients with severe Pseudomonas infections. AB - Forty patients suffering from severe Pseudomonas infections (13 urinary tract infections, 8 of which complicated, 16 cases of pneumonia, 3 cases of sepsis, 1 case of sepsis with osteomyelitis, 2 cases of osteomyelitis, 1 case of ophthalmitis, and 4 cases of peritonitis) were treated with ceftazidime (1-6 g/die). Most cases presented with severe underlying conditions associated with, or predisposing to, infection (surgical intervention, neoplasia, immunodepression, etc.). Both microbiological results (38 out of 43 strains eradicated) and clinical outcome (28 infections cured, 10 improved, and only 2 unchanged) proved highly satisfactory. The authors advocate the empirical use of ceftazidime as first-line single-drug therapy in severe hospital acquired infections in high-risk patients. PMID- 3516893 TI - Eugenics and prenatal testing. AB - Prejudices against people with disabilities, poor people, and immigrants during the nineteenth century generated a science of "race improvement" called eugenics. In the United States, a number of eugenic measures were enacted early in this century, but it was in Nazi Germany that eugenics flourished under the name of racial hygiene (Rassenhygiene). In the guise of furthering the health of the German people, German scientists and physicians initially designed programs of sterilization. Next came euthanasia and finally mass extermination of "lives not worth living." Remembering this history, many German women oppose the new technical developments in prenatal diagnosis because they see them as yet another way to specify what kinds of people are and are not fit to inhabit the world. This paper tries to place the new technologies in the context of eugenics and to point out some of the ways in which the new, supposedly liberating, choices in fact limit women's control over our lives. PMID- 3516894 TI - Subcorneal pustular dermatosis treated with phototherapy. AB - A 12-year-old boy had a 5-year history of recurrent generalized dermatoses with scales, crusts, and pustules. Histologic findings showed subcorneal blisters filled with polymorphonuclear leukocytes typical of subcorneal pustular dermatosis. Dapsone and prednisolone with a topical fluocinolone acetonide did not produce improvement. The skin lesions cleared completely after 11 exposures of UV-B three times a week. After 8 months of follow-up, there has been no recurrence. PMID- 3516895 TI - Historical aspects of herpes simplex infections. Part 2. PMID- 3516896 TI - The role of arachidonic acid metabolites in mononuclear phagocytic cell interactions. AB - Numerous investigations support the theory that arachidonic acid metabolites play a critical role in dictating the progression of chronic immune reactions. With regard to macrophage-mediated inflammatory responses, enzymatic oxygenation of arachidonic acid via the lipoxygenase or cyclooxygenase pathway can result in the production of compounds that may potentiate or suppress the inflammatory lesion. We recently have presented data demonstrating that lipoxygenase derived leukotriene B4 and C4 can induce the release of IL-1 by macrophages, while PGE2 and PGI2 can suppress the production of IL-1. Macrophages are central to the induction of immune responses and the progression of chronic inflammatory reactions. Therefore, an understanding of the role that macrophage-derived arachidonic acid metabolites play in the initiation, maintenance, and resolution of chronic immune responses is essential. As shown in Figure 3, there are a number of chemical signals that occur between macrophages and lymphocytes that are critical for immune cell communication. The investigations described above have demonstrated that the macrophage may regulate the production and expression of any or all of these signals, such that the inflammatory response is potentiated, sustained, suppressed, or resolved. A better comprehension of the activity of these potent arachidonate derivates will undoubtedly aid in the therapeutic manipulation of inflammatory disease. PMID- 3516897 TI - Cicatricial pemphigoid. PMID- 3516899 TI - Sporotrichosis. A historical approach. PMID- 3516898 TI - Granulomas induced by living agents. PMID- 3516900 TI - Inhibition of mammalian cell DNA synthesis by ionizing radiation. AB - A semi-log plot of the inhibitory effect of ionizing radiation on the rate of DNA synthesis in normal mammalian cells yields a two-component curve. The steep component, at low doses, has a D0 of about 5 Gy and is the result of blocks to initiation of DNA replicons. The shallow component, at high doses, has a D0 of greater than or equal to 100 Gy and is the result of blocks to DNA chain elongation. The target size for the inhibition of DNA replicon initiation is about 1000 kb, and the target size for inhibition of DNA chain elongation is about 50 kb. There is evidence that the target for both components is DNA alone. Therefore, the target size for inhibition of DNA chain elongation is consistent with the idea that an effective radiation-induced lesion in front of the DNA growing point somehow blocks its advance. The target size for inhibition of DNA replicon initiation is so large that it must include many replicons, which is consistent with the concept that a single lesion anywhere within a large group (cluster) of replicons is sufficient to block the initiation of replication of all replicons within that cluster. Studies with radiosensitive human cell mutants suggest that there is an intermediary factor whose normal function is necessary for radiation-induced lesions to cause the inhibition of replicon initiation in clusters and to block chain elongation; this factor is not related to poly(ADP ribose) synthesis. Studies with radiosensitive Chinese hamster cell mutants suggest that double-strand breaks and their repair are important in regulating the duration of radiation-induced inhibition of replicon initiation but have little to do with effects on chain elongation. There is no simple correlation between inhibition of DNA synthesis and cell killing by ionizing radiation. PMID- 3516901 TI - In vitro growth potential of fibroblasts isolated from pigs with radiation induced fibrosis. AB - Degenerative processes were studied in pig muscles irradiated with single doses of 30 or 40 Gy. Damaged muscle was gradually replaced by an invasive fibrotic tissue. As a control, surgical muscle exeresis was performed of the same size as the radiation-induced lesions at the same anatomical site. Primary cultures were set up comprising cells freshly extracted from normal dermis, or from tissue exhibiting either normal wound fibrosis or radiation-induced fibrosis. The growth potential of cells taken from the latter region far exceeded that of the two other types; attachment efficiency was higher, and fibronectin was detected early by immunofluorescence. These in vivo and in vitro observations imply that a pathological repair process occurs after localized irradiation. PMID- 3516902 TI - Participation in the transcendental meditation program and frontal EEG coherence during concept learning. AB - This study assesses variation in frontal bilateral EEG coherence among normal subjects during trials of a concept learning task; the task used a concept reversal paradigm found from prior research to distinguish frontal lobe patients from normal adults. Subjects were either participants in the Transcendental Meditation (TM) program or controls matched for age, sex, and intellectual ability, and additional experimental factors were whether or not the subject gained information on a given trial and whether or not the trial occurred before, during, or after the shift of concept. It was hypothesized that: (1) higher frontal EEG coherence (alpha and beta frequencies) would be associated with trials on which information was gained; (2) higher coherence in the same frequencies would be found in the two concept-solution periods in contrast to the concept-reversal period that divided them; and (3) these patterns would be more clearly expressed among TM program participants. Each hypothesis received partial support. The first hypothesis was true only for TM program participants for alpha coherence, and only during the first concept-solution period for beta coherence. The second hypothesis was true for alpha coherence only, and the third hypothesis received support for alpha coherence. Results were not attributable to muscle or eye artifacts. However, a different response style was found to the change in concept among the two groups; control subjects displayed greater arousal (muscle artifact) during the concept-reversal period, while TM program participants displayed less arousal. PMID- 3516903 TI - Electroacupuncture: an alternative to antidepressants for treating affective diseases? AB - The monoamine hypothesis for affective disorders indicates a functional impairment of the monoamine systems in CNS as the causative factor for the development of depression. Pharmacological manipulations of the monoaminergic neuronal system using tricyclics and monoamine oxidase inhibitors produced promising therapeutic effects as well as certain unwanted side effects, which urged the search of a physiological means to activate the central monoamine systems. In the present paper, evidence from animal experiments is presented to show that acupuncture or electroacupuncture (EA) is capable of accelerating the synthesis and release of serotonin (5-HT) and norepinephrine (NE) in the CNS. Clinical data indicate that EA is effective in treating depressive patients, and at least as effective and with a higher therapeutic index than tricyclic amitriptyline. PMID- 3516905 TI - Prosthetic and periodontal considerations of free-end removable partial dentures. PMID- 3516904 TI - Water irrigating devices for the orthodontic patient. PMID- 3516906 TI - Microcirculatory changes during skin allograft rejection and prolongation of survival time by antiplatelet agents. AB - The process of rejection of skin first-set-allograft transplantation was pursued by observing the microcirculation of living mice, in comparison with that of the isograft transplantation (BALB/C vs. BALB/C). The vascular connection of the skin allograft between the host (BALB/C) and graft (R III) was established on day 8, in just the same pattern as in isograft skin, but the blood flow slowed down on day 9, and the formation of microthrombi was observed in the arterioles and later in the venules and capillaries at the sites slightly inside the graft from the margin on day 10. Thereafter each small vessel of the host formed a loop and the blood flow from the host did not enter the graft. The thrombus formation was confirmed by light and electron microscopy. The importance of the thrombus formation in the rejection process was further strengthened by prolongation of the cessation of the blood flow at the boundary from day 10 to days 14-15, after daily administration from days 2 to 9 of OKY-1581 (0.4 mg/g i.p.), a selective thromboxane synthetase inhibitor, or ticlopidine (0.3 mg/10 g p.o.), an inhibitor of platelet aggregation, in combination with a subthreshold dose (0.4 mg/10 g i.p.) of azathioprine. None of these drugs alone significantly prolonged the survival time. PMID- 3516907 TI - Portable thermogram technique for topically applied benzydamine cream in acute soft-tissue injuries. AB - A double-blind, parallel trial was undertaken with 3% benzydamine cream compared with a matching placebo, on patients suffering acute soft-tissue injuries. 21 patients received active material and 22 received placebo material. Patients applied the cream lightly 6 times a day for 6 days. Assessments were made (by the same physician) on days 0, 2, 4 and 6, and signs and symptoms were graded as "absent", "slight", "moderate" or "severe". Thermograms were taken on day 0 and day 6. The results showed significant relief of spontaneous pain, significant reduction in tenderness on pressure and in swelling on days 2, 4 and 6 of the trial, and a significant reduction in functional impairment on days 4 and 6, in the patients who had received the 3% benzydamine cream. PMID- 3516908 TI - "Dermodress", a new temporary skin substitute: pilot study on donor sites. AB - "Dermodress" is a new temporary biological dressing (heterograft) composed of a pure neonatal bovine collagen I. The authors present their first trial with this skin substitute. Ten consecutive patients who required skin grafts were included in the pilot test group. The "Dermodress" was tested on their donor sites and compared with "Furacin" gauze. It was found that "Dermodress" provided a covering that adhered excellently to debrided surfaces, without disturbing the healing processes underneath, for up to three weeks after application. The results point to the potential value of the "Dermodress" for open wounds. PMID- 3516909 TI - Peripheral airways inflammation. PMID- 3516910 TI - Differentiation antigens of melanoma and melanocytes. PMID- 3516912 TI - Immunological regulation and control of experimental leishmaniasis. PMID- 3516911 TI - The immunobiology of leprosy. AB - Leprosy, a chronic infectious disease of man, is caused by the obligate intracellular bacterium M. leprae. Infection with M. leprae affects the peripheral nerves and the dermis, causing an accumulation of macrophages and other immune cells at the infected sites. Host resistance to the bacterium determines the extent of local inflammatory reactions and its resulting damage to the affected tissues. In lepromatous disease little if any cellular immunity develops. Bacterial multiplication is uncontrolled and M. leprae disseminate throughout most of the dermis. In tuberculoid disease, marked cellular immunity is observed and bacterial growth and dissemination are controlled. The depression of cellular immunity in lepromatous patients is not fully understood. Since M. leprae cannot be grown in vitro, and a suitable animal model has not yet been developed, the study of host immunity to the pathogen is limited primarily to investigations of the cutaneous lesions of patients and to in vitro responses of the peripheral blood leukocytes to M. leprae. While the blood monocytes of leprosy patients appear to be activated normally by lymphokines, T cell proliferation and production of lymphokines in response to M. leprae are impaired in lepromatous patients. Attempts to restore responsiveness in cells from these patients have been unsuccessful in our hands. The addition of exogenous IL-2 to leukocyte cultures does not appear to restore responsiveness to M. leprae in cells from nonresponsive patients. Rather, some enhancement, often not antigen specific, is observed in cells from patients with a preexisting response. Similarly, depletion of monocytes does not restore responsiveness to M. leprae in nonresponder patients, but a nonspecific enhancement of proliferation is observed in monocyte-free cultures from patients that do respond to M. leprae. Thus, the defect in lepromatous nonresponder patients does not result from a simple lack of IL-2 production or suppression by monocytes and/or their products. Possibly, there is a low level or lack of M. leprae-responsive T cells in the circulation of these patients. Attempts to overcome the defect in immunity of patients with lepromatous leprosy by immunoprophylaxis and immunotherapy are being investigated. This approach has become of major importance since the development of widespread drug resistance to Dapsone as well as to the other chemotherapeutic agents used to control leprosy. PMID- 3516913 TI - Intestinal cell membranes. PMID- 3516914 TI - Biochemical aspects of cytokinesis. PMID- 3516915 TI - Ontogeny of steroid receptors in the reproductive system. PMID- 3516916 TI - Fertilization in amphibians: the ancestry of the block to polyspermy. PMID- 3516917 TI - In vitro maintenance of a pure-cone retina. AB - The retina of the lizard, Sceloporus occidentalis, appears to have only cone photoreceptors. Eyecups from this animal were incubated in media containing Earle's Balanced Salts, supplemented with amino acids and vitamins, and gassed with 5% CO2/95% O2. Under these conditions, good morphology, protein synthesis, and normal cyclic AMP and cyclic GMP levels were maintained for 1-2 days. This in vitro preparation is likely to be useful for pharmacological studies of cone photoreceptors. PMID- 3516919 TI - Breast imaging. State-of-the-art. AB - The underlying goal of all breast imaging procedures is the detection of cancer. X-ray mammography places greatest emphasis on the disclosure of early, nonpalpable, curable cancer. Diagnostic ultrasonography stresses the differentiation of benign cysts from diagnostically indeterminate solid masses that require biopsy. Evolving experimental procedures such as transillumination light-scanning and magnetic resonance imaging currently are undergoing preliminary evaluation. An older procedure, thermography, seems to operate at a high level of effectiveness only for advanced cancer. Since x-ray mammography is the technique that has proven most successful in detecting early breast cancer, it is the standard to which all imaging alternatives must be compared. PMID- 3516918 TI - Idarubicin (4-demethoxydaunorubicin). A preliminary overview of preclinical and clinical studies. AB - 4-Demethoxydaunorubicin (4-DMDR, IMI 30, Idarubicin, NSC 256439) is a new analog of daunorubicin (DNR) with antileukemic activity in experimental systems that is superior to that of daunorubicin (DNR) or doxorubicin (DX). The drug is more potent than DNR and DX and is active by both the intravenous and the oral routes of administration. After i.v. and oral administration in humans, Idarubicin is rapidly metabolized to its 13-dihydroderivative (Idarubicinol) and the plasma levels of this metabolite are consistently higher than those of the unchanged drug. Idarubicinol has been shown to be an active metabolite in experimental models, being as potent and as active as the parent compound. Phase II clinical trials of Idarubicin have indicated that: By I.V. route Idarubicin is a potent antileukemic agent active in relapsed or refractory, ANLL, ALL (adult and pediatric) either as single agent or in combination with Ara-C at doses of 8-12 mg/m2 by i.v. day 1, 2 and 3 or 7-8 mg/m2 i.v. daily X 5 days (adults). There is evidence of lack of cross-resistance with parent drugs and other antileukemic agents. Phase III studies in previously untreated acute leukemias have been initiated. By oral route Idarubicin has antitumor activity in breast cancer at the doses of 35-45 mg/m2 q 3-4 weeks or 15 mg/m2 daily X 3 days q 3-4 weeks. Idarubicin has activity as a single agent in adult leukemias at the doses of 20 30 mg/m2/day X 3 days. The safety of administration (no risk of extravasation), the good tolerability and the reduced potential for cardiac toxicity, make oral Idarubicin particular attractive for further clinical development. Whether Idarubicin proves to be more effective and/or less cardiotoxic in clinical therapy than DNR or DX remains to be seen through prospective randomized studies which have been already initiated both in leukemias and solid tumors. PMID- 3516920 TI - High resolution sonography of the menisci of the knee. AB - High-resolution real-time ultrasonography (5, 7.5, and 10 MHz) was used to examine the menisci of the knee in ten normal volunteers and in ten patients with knee injuries. The posterior horns of the medial and lateral menisci were easily demonstrated. Normal anatomy and pathologic changes could be imaged in the menisci, capsular ligaments, and articular cartilage. While the menisci were seen in all subjects, the weight-bearing portion of the femoral articular cartilage could not be seen in several of the symptomatic patients who could not flex their knees. Ultrasound promises to be a useful, noninvasive adjunct to conventional techniques in evaluating the injured knee--especially in assessing the posterior horns of the menisci, an area difficult to assess with arthroscopy. PMID- 3516921 TI - Contrast media tonicity. Part II. Isotonic ioxaglate vs. standard renografin for IV-DSA evaluation of the carotid bifurcation, a double-blind prospective clinical trial. AB - Laboratory research has suggested that isotonic contrast media may be optimal for intravenous digital subtraction angiography (IV-DSA) by generating taller, narrower time-concentration curves. Clinical investigation of low osmolality contrast media has suggested that less patient discomfort is encountered with low osmolality contrast media than with standard, high-osmolality agents. In order to directly compare isotonic contrast media with a standard hypertonic contrast media, isotonic ioxaglate (Hexabrix-20) was compared with Renografin-76 in a double-blind prospective clinical trial for IV-DSA examination of the carotid artery bifurcation. Isotonic ioxaglate produced superior contrast medium time opacification curves and produced superior images across four scales of image quality: anatomic "openness" of the carotid bifurcation, contrast level within the carotid vessels, bone misregistration artifact over the bifurcation, and air (soft tissue) misregistration. The bilateral overall score for isotonic ioxaglate was 1.68 vs. 1.37 for Renografin-76, a 23% superiority. The bulk of the superiority occurred in the contralateral carotid artery. Over the four scales, isotonic ioxaglate was 37% better in image quality of the contralateral carotid artery bifurcation. Since the contralateral carotid artery is very often difficult to visualize during IV-DSA, isotonic ioxaglate represents a significant improvement for this imaging modality. PMID- 3516922 TI - Bilateral abdominal masses in an asymptomatic infant. PMID- 3516923 TI - The menopause. AB - Symptoms due to estrogen deficiency begin in the perimenopausal years and progress as serum levels of this hormone decrease Vasomotor instability, manifested by hot flushes or night sweats, may persist for several months to a few years. Psychologic symptoms include anxiety, tension, depression, insomnia, palpitations, and headaches. Atrophy of the genital epithelium may result in senile vaginitis with symptoms of irritation, burning, pruritus, dyspareunia, and even vaginal bleeding. Even the lower urinary tract mucosa is dependent upon estrogen. Postmenopausal osteoporosis affects 25 to 50% of older women and increases the risk for vertebral, hip, and other fractures. Estrogen therapy for menopausal complaints has received adverse publicity because several reports have indicated that unopposed estrogens increase the risk of endometrial cancer. Added progestogen not only negates this risk but reduces the incidence of endometrial adenocarcinoma in estrogen-progestogen users to less than that observed in untreated women. Estrogen replacement therapy does not increase the risk of breast cancer; the incidence of this malignancy, however, was also less in the estrogen-progestogen users when compared with either the untreated women or from that expected from the national cancer surveys. In evaluating postmenopausal women for hormone replacement, the benefits of estrogen-progestogen therapy must be weighed against possible risks. PMID- 3516924 TI - Taxonomic classification of human hepatitis B virus. AB - Sufficient data have accumulated to permit the ICTV Study Group on the Nomenclature of Hepatitis Viruses to recognize human hepatitis B virus as a member of a unique group of viruses and to classify it, together with a number of related animal viruses, into a new family called the Hepadnaviridae. Over the past decade, the International Committee on Taxonomy of Viruses (ICTV) has been active in the development of a classification system for viruses. The majority of viruses infecting vertebrate hosts have been classified into families and genera on the recommendations of the Vertebrate Virus Subcommittee (VVSC). In June 1980, the VVSC authorized the formation of an ad hoc Study Group on the Nomenclature of Hepatitis Viruses under the Chairmanship of Dr. Ian D. Gust. This paper represents the first report of the Study Group on the Taxonomic Classification of Human Hepatitis B Virus. PMID- 3516925 TI - Real-time carotid ultrasonography and wave-speed oculoplethysmography: a useful combination in the screening for carotid occlusive disease in ocular embolism. PMID- 3516926 TI - Pregnancy following renal transplantation. PMID- 3516927 TI - Biographical sketches--62. Kendall. PMID- 3516928 TI - [Normalization of uremic skin changes following kidney transplantation]. AB - A clinical dermatological examination was performed on 49 patients (30 males, 19 females; 24-64 years of age) 3.1 years after successful kidney transplantation. Some patients underwent skin biopsy procedures for examination by light and electron microscopy, as well as immunohistological methods. Six patients had already been examined using these methods prior to the transplantation. When sufficient renal function was restored after successful kidney transplantation, the uremic skin alterations disappeared. The increase in sweat secretion, a common symptom in uremic patients was not observed after renal transplantation. The ichthyosiform feature of uremic skin and the increased vulnerability of the skin was observed in only a minority of the transplanted patients examined. In addition, the generalized pruritus and Raynaud phenomenon that are seen so frequently among uremic patients disappeared completely. However, the uremic induced alterations of the connective tissue, like severe actinic elastosis and Dupuytren's contractures, persisted after renal transplantation. Histological examinations revealed renormalization of the uremic altered skin; in particular, the severe microangiopathy of skin vessels in long-term hemodialysis patients vanished. PMID- 3516930 TI - [Chronic monocytic leukemia]. AB - A case of chronic monocytic leukemia with specific dermal lesions is presented. The patient developed an adenocarcinoma of the cecum. PMID- 3516929 TI - [Sterile eosinophilic pustulosis]. AB - Sterile eosinophilic pustulosis (SEP) first described by Ofuji et al. in 1970 as "eosinophilic pustular folliculitis," is obviously a new entity. The majority of patients are Japanese. So far only four European cases have been reported. However, we have recently observed a 46-year-old Greek male (the fifth case in Europe) with the typical clinical features of SEP: repeated eruptions of aggregated pruritic (follicular) papulopustules (1-2 mm in diameter). The eruptions developed in slightly elevated erythematous patches localized on the extremities, face, and trunk. Histologic examination revealed intraepidermal pustules containing eosinophils and moderate dermal infiltrates with mononuclear cells and eosinophils around follicles, sebaceous glands, and vessels. In addition to the characteristic clinical and histological features, our patient showed all the typical laboratory findings previously described: negative bacterial cultures from the pustules, blood eosinophilia, increased total IgE, negative reactions to intradermal tests of recall agents. Furthermore, the rate of suppressor/cytotoxic T-cells (OKT 8-cells) in peripheral blood was significantly diminished, and mitogenic stimulation of lymphocytes in vitro was negative (decreased LTT). These laboratory data resemble the immunopathological findings in atopic diseases. On the other hand, seborrheic skin with sterile eosinophilic pustules predominantly occurring in skin areas rich in sebaceous glands seems to be another remarkable sign of SEP. The question of whether the co incidence of atopylike immunological constellation and seborrheic skin observed in SEP has pathogenetic importance, however remains open. Apart from corticosteroids and sulfones, a favorable therapeutic effect may be obtained by inhibitors of cyclooxygenase. In our case indomethacin caused a quick and lasting therapeutical benefit. PMID- 3516931 TI - Bacterial pneumonias--an overview with emphasis on pathogenesis, diagnosis, and treatment. PMID- 3516932 TI - Cardiovascular monitoring of patients with pulmonary disease. AB - Assessing cardiac function in patients with pulmonary disease requires knowledge of cardiac loading conditions, which can be obtained if the practitioner is aware of physiologic and technical factors that can affect observed pressures and flows. Only with proper care in measuring and interpreting these parameters can therapeutic decisions be made confidently for these patients. PMID- 3516933 TI - Adult respiratory distress syndrome: diagnosis and management. AB - ARDS yearly afflicts more than 150,000 people, many of whom are young and otherwise healthy and yet the mortality rate remains in excess of 60% to 70%. This high mortality has not yielded to the significant gains made in intensive care patient management and rapid advances in technology. Acute lung injury research in the past 15 to 20 years has greatly enhanced our understanding of the pathophysiologic mechanisms underlying this complicated disorder. Therapeutic goals should be aimed at total patient surveillance and support, including the psychosocial aspects of patient care. Fortunately, basic research has recently yielded promising results with pharmacologic interventions designed to limit lung injury or prompt lung repair. Clinical trials underway and proposed will determine which, if any, of these approaches is effective. Until success is achieved, supportive intensive care with diligent attention to infection control, fluid therapy, nutrition, and ventilator management will remain the focal point of therapy for ARDS. PMID- 3516934 TI - The use of cough cardiopulmonary resuscitation in clinical practice. AB - In summary, the cough CPR technique uses physiologic principles similar to those that maintain circulation during chest compression with a number of significant advantages over the latter. At the onset of lethal arrhythmias such as asystole, profound bradycardia, VT, and VF, coughing may assist in maintaining consciousness and an optimum systolic blood pressure. It may also generate the mechanism required to convert the arrhythmia. The simplicity and effectiveness of this technique warrants its consideration for greater clinical use by hospital staff in all monitored settings. It has been noted, however, that clinical research is indicated to more closely examine the proposed cause and effect relationship between cough and arrhythmia conversion and to compare the clinical efficacy between the cough CPR technique and chest blow or other clinical practice measures. PMID- 3516935 TI - Integrating the findings of critical care nursing research: the case for meta analysis. PMID- 3516936 TI - Nutritional support of the brain injured patient: five years of clinical study in perspective. PMID- 3516937 TI - High-frequency ventilation: current status. PMID- 3516938 TI - Complotypes, extended haplotypes, male segregation distortion, and disease markers. AB - From our studies in Caucasian families of HLA, complement, and glyoxalase alleles have developed the concepts of the complotype and the extended haplotype. complotypes are clusters of the four genes for complement proteins encoded within the MHC designated (in arbitrary order) by their BF, C2, C4A, and C4B alleles. They are inherited in families and occur in populations as functionally single genetic units and exhibit linkage disequilibrium with HLA-B and HLA-DR alleles which are complotype, rather than complement gene allele, specific. In Caucasians, there are 10-12 common sets of HLA-B, DR, complotype sets that show significant linkage disequilibrium. These haplotypes constitute 25-30% of all MHC haplotypes in Caucasians. Because there is evidence for relative fixity of alleles on these chromosomes to an unknown extent beyond the HLA-B-DR interval, they have been called extended MHC haplotypes. It appears likely that it is these extended haplotypes that provide most of the known linkage disequilibrium pairs previously reported for MHC alleles as well as many of the known MHC allele disease associations. The most common extended haplotype [HLA-B8, DR3, SC01], when it carries GLO2, is increased in type I diabetes mellitus and probably a number of other diseases, including gluten-sensitive enteropathy and membranoproliferative glomerulonephritis. In the families with these disorders studied by us, this haplotype exhibits male segregation distortion, a feature displayed by t-mutants found in wild mouse populations. This feature constitutes an important selective advantage for the chromosome and may contribute to the accumulation of susceptibility mutations for a variety of diseases.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3516939 TI - Genetic analysis of the T/t complex. AB - The T/t-complex has held considerable interest for immunologists, primarily because of its close genetic linkage to the major histocompatibility complex (MHC) on mouse chromosome 17. This interest has been heightened recently with the discovery that the MHC is fully contained within the t-complex and that two regions of the MHC, Qa and K, contain t-lethal genes. For a long time, T/t has been an enigmatic system, mainly because classical genetic analysis was not possible. Here the system is defined, recent information is presented, and our understanding of the mouse data to available information about the human MHC is correlated. PMID- 3516940 TI - Neural dynamics of speech and language coding: developmental programs, perceptual grouping, and competition for short-term memory. AB - A computational theory of how an observer parses a speech stream into context sensitive language representations is described. It is shown how temporal lists of events can be chunked into unitized representations, how perceptual groupings of past item sublists can be reorganized due to information carried by newly occurring items, and how item information and temporal order information are bound together into context-sensitive codes. These language units are emergent properties due to intercellular interactions among large numbers of nerve cells. The controlling neural networks can arise through simple rules of neuronal development: random growth of connections along spatial gradients, activity dependent self-similar cell growth, and competition for conserved synaptic sites. Within these networks, a spatial frequency analysis of temporally evolving activity patterns leads to competitive masking of inappropriate list encodings in short term memory. The neurons obey membrane equations undergoing shunting recurrent on-center off-surround interactions. Several design principles are embodied by the networks, such as the sequence masking principle, the long-term memory invariance principle, and the principle of self-similar growth. PMID- 3516941 TI - Models for sensation and perception: a selective history. AB - This paper is a historical survey, for nonspecialists, of models used to account for sensation and perception. Emphasis is placed on several crucial ideas that have given rise to major changes in explanatory models: namely, geometrical optics, receptive fields and systems or computational approaches. The nature of sensory coding and neural representation is briefly considered against this background. PMID- 3516942 TI - On functional concepts for the explanation of visual pattern recognition. AB - An overview is given covering approximately 30 years of research in the field of functional concepts for the explanation of visual pattern recognition processes. Due to its important role, the Perceptron approach is briefly sketched. This concept, representing to a great extent the present opinion about pattern recognition in the field of visual sciences, is investigated with respect to its invariance properties and its structure. Fundamental facts about the nature of human perception (Gestalt-aspect) and about the processing structure of the visual system are used as qualification criteria. Alternatively, a recent concept that explains the high degree of invariance in visual perception by the evaluation of inner pattern relations is introduced and investigated with respect to its biological plausibility. It is also compared with the Perceptron concept. PMID- 3516943 TI - Nonspecificity in the ultrasonographic appearance of angiomyolipoma. PMID- 3516944 TI - Sepsis in the early postsplenectomy period. PMID- 3516945 TI - Milton Friedman, M.D.--an appreciation. PMID- 3516946 TI - Third Rome International Symposium: The challenge of local tumor control and its impact on survival. May 12-16, 1985. Dedicated to Milton Friedman. PMID- 3516947 TI - Milton Friedman, M.D. PMID- 3516948 TI - Impact of improved local control on survival. AB - Estimates of the gain in survival, if all local failures were eliminated, indicate that many more patients could be cured provided the efficacy of treatment of the primary and regional disease were substantially improved. The expected gain in survival is assumed to be the gain in local control, less the loss due to distant metastases and intercurrent disease among the new local control subjects. The observed incidence of DM among local failure patients may be higher than among local control patients; this excess in incidence of DM is assumed to result from metastases established secondary to the persistent or recurring tumor. A powerful argument that higher local control rates would result in more cured patients is the high incidence of long-term survivors after salvage surgery for local failures. Examples of higher survival associated with more effective local therapy are presented from the literature for medulloblastoma, ependymoma, carcinoma of the oral cavity-oropharynx, carcinoma of the urinary bladder, carcinoma of the prostate and carcinoma of the rectum. For Stage I-II cancer of the breast, the reduction of an already low local failure rate by combining surgery and radiation has a very small impact. For tumors, such as, early stage breast cancer, where the possible decrease in local failure is small and the loss due to DM is high, a demonstrable gain in survival is not likely. The potential increase in number of survivors among the U.S. cancer population, if the primary-regional disease were regularly treated successfully, indicates large gains for patients with cancer of the uterine cervix, oral cavity oropharynx, ovary, colo-rectum, non-oat cell cancer of lung, prostate cancer, and bladder cancer. These provide powerful bases for aggressive investigation of new approaches to improvement of local-regional therapies. PMID- 3516949 TI - Potential methods for predicting tumor radiocurability. AB - Several predictors of tumor radiocurability are already integrated into clinical practice, for example, tumor size, gross morphology (that is, infiltrative or exophytic), histologic type and grade. These are nonspecific and relatively imprecise. The aim of research into predictive assays is not only to refine the discrimination of existing predictors, but also to suggest specific experimental approaches for overcoming tumor radioresistance in individual patients. Two broad categories of predictive assays can be defined: direct and indirect measurement of tumor cell survival and/or repair capability following irradiation, and measurement of cellular and extracellular parameters affecting radiosensitivity. The ongoing research at The University of Texas M. D. Anderson Hospital is overviewed to illustrate potential methods for predicting radiocurability. PMID- 3516950 TI - Prognostic factors in non-Hodgkin's lymphoma. AB - The results obtained with the various types of treatment in non-Hodgkin's lymphoma are reviewed and the data from the recent EORTC trials are summarized. In patients with Stage I follicular histology, regional radiotherapy (RT) alone gives excellent results. The long-term relapse-free survival (RFS) is high and relapsing patients can be rescued by aggressive combination chemotherapy; initial chemotherapy with CVP improves RFS but not total survival (TS). In patients with Stage I diffuse histology, the long-term survival is less satisfactory. CVP chemotherapy does not improve either RFS or TS; therefore if adjuvant chemotherapy is justified, it should be more aggressive than CVP. In patients with Stage II follicular type, regional radiotherapy alone gives good results. The addition of abdominal bath irradiation to regional RT increases RFS but not TS. After relapse, patients can be rescued by combination chemotherapy. In patients with Stage II diffuse histology, extended RT followed by CVP gives poor results and RT should be combined with more aggressive combination CT; the preliminary results of an integrated alternating regimen being excellent. In patients with Stage III and IV follicular type, the 8 year TS of patients treated with combination CT regimen (CHVP) followed by localized irradiation is approximately 55%, however the indications for the various types of treatment are still unclear. In patients with diffuse Stage III and IV, the results obtained with a combination CT regimen (CHVP) are still unsatisfactory, but are better in patients treated by a more aggressive CT regimen (CHVP-Bleo-VCR). Therefore aggressive CT associated with localized irradiation appears to be the best treatment. Further research should aim to identify the optimal combination CT regimen. In patients with high grade lymphomas who have relapsed the use of bone marrow autografts will be investigated. The present data show that besides histological type and age, the main prognostic factor is total tumor body burden as assessed by clinical stage, number of involved lymph node areas, and bulk of the disease. The study of the biological characteristics of the disease may provide more powerful prognostic indicators. PMID- 3516951 TI - Radiation therapy in operable breast cancer: results from the Stockholm trial on adjuvant radiotherapy. AB - In a randomized trial, 960 women with Stage 1-3 operable breast cancer were treated by a modified radical mastectomy alone, or by the same procedure, preceded or followed by radiotherapy (4500 rad to the breast/chest wall, and internal mammary, axillary and supraclavicular lymph nodes). Up to ten years after treatment, there is an increasing gap between the recurrence-free survival of the irradiated patients and the surgical controls. Between the two types of radiotherapy, there was no difference. There were significantly fewer distant metastases and a tendency for improved survival in node positive patients treated with postoperative radiotherapy, compared to the surgical controls, this difference was, however, statistically not significant. PMID- 3516952 TI - Prognostic factors for loco/regional control and metastasis and the impact on survival. AB - For the identification of predictive factors for local (head and neck) control and metastases and impact on survival in squamous cell cancer of the head and neck, we have used data from over 2000 patients from the Patterns of Care Study (PCS) and the Radiation Therapy Oncology Group (RTOG) studies. Complete local response (C.R.) is significantly related to T stage, N stage, general performance status (Karnofsky), and site of primary tumor. There is a strong association between T and N stage. T1N0 tumors showed a C.R. of 99%, whereas, T1N3 had a C.R. of 57%. T4N0 showed a C.R. of 75%, but this went down to 31% in the T4N3 lesions. Glottic tumors showed a C.R. of 96% versus the other sites, which ranged from 81% for the nasopharynx to 59% for the hypopharynx. Patients with a performance status (KPS) of less than 90% showed a C.R. of 60% versus 88% for AKPS 90% or higher. Absence of local recurrence after C.R. is significantly related to T stage, N stage, and the site of primary tumor (glottis versus the rest). The appearance of distant metastases is significantly related only to N stage and primary site. This relationship persists in control of loco/regional tumors. In Stages III & IV in non-glottic head and neck cancer, metastases as the cause of death play an increasingly important role. This can be as high as 30%. The appearance of new malignant tumors and death unrelated to cancer, that is, death related to lifestyle, assumes an important role in patients with advanced head and neck cancer. The number of advanced glottic larynx was too small to examine this question. The use of a surgical procedure in carcinomas of the anterior tongue and floor of the mouth was associated with a smaller percentage of infield recurrences at 2 years, than when radiation therapy alone was used (27% versus 88% p less than .01). The same observation was noted at 3 years in the glottic and supraglottic Stage III & IV tumors (p less than .01). PMID- 3516953 TI - Early results of the EORTC randomized clinical trial on multiple fractions per day (MFD) and misonidazole in advanced head and neck cancer. AB - From Feb. 1981 to Oct. 1984, a randomized clinical trial was carried out in the EORTC Radiotherapy Group, comparing classical radiotherapy 70 Gy/7 weeks to MFD (3 X 1.6 Gy/day for 10 days, 3 weeks rest, followed by a boost to 67.2 or 72 Gy), with or without Misonidazole (1 g/m2 every irradiation day, total 12 to 14 g/m2) in advanced head and neck cancer (all T3 and T4, all N2, N3 and N1 greater than 3 cm). A total of 523 patients were entered in the study. At the time of analysis (4/85), the median follow-up time was 64 weeks. No significant differences in survival or locoregional control could be demonstrated between the three treatment arms at this time. Whereas early mucosal reactions were heavier in the MFD-arms, no differences in late effects (fibrosis, edema, xerostomy) were found between the three treatment arms. Five patients (all MFD + Misonidazole) died with local complications (edema, necrosis). All five had cancer of the laryngopharynx and 3 of them died from a hemorrhage. Factors affecting prognosis were tumor site, tumor stage, nodal status, and histological differentiation. PMID- 3516954 TI - Response of cells of human origin, normal and malignant, to acute and low dose rate irradiation. AB - Dose response curves were obtained for normal human fibroblasts and for several cell lines derived from human tumors, including melanomas and an osteosarcoma. Most of the tumor lines are similar in radiosensitivity to the normal fibroblasts, except for the melanoma lines, which are significantly more resistant. The two melanoma lines differ, one being much more radioresistant than the other. Potentially lethal damage repair (PLDR) has been studied in these cell lines as well. The extent of PLDR does not appear to correlate with radioresistance; for example, the most resistant melanoma line shows very little repair of PLD. In addition, the normal fibroblasts repair PLD at least as well as any of the tumor derived lines, which casts doubts on the wisdom of introducing into clinical practice inhibitors of PLD until a clear differential between normal tissues and tumors has been demonstrated in vivo. Low dose-rate studies with normal human fibroblasts indicate a smaller dose-rate effect than for most established cell lines of rodent origin. Indeed, in the human cells studied, the effect of sublethal damage repair is quantitatively similar to the repair of potentially lethal damage. Dose response curves for acute and protracted exposures have been obtained for cells derived from patients with cancer-prone syndromes including ataxia telangiectasia (AT) and Bloom's syndrome. Both cell lines are much more radiosensitive than normal human fibroblasts; the AT cells show a dose-rate effect, while Bloom's syndrome cells do not. PMID- 3516955 TI - Adjuvant irradiation of gastrointestinal malignancies: impact on local control and tumor cure. AB - Radiation therapy has recently been used more frequently in the adjuvant treatment of gastrointestinal malignancies. A number of studies have shown a high local failure in patients with Stages B2 and C rectal carcinomas and in Stages B3, C2 and C3 colon carcinomas. In rectal cancer, both randomized and non randomized studies have demonstrated improved local control and survival with the use of adjuvant radiation. Randomized studies have not been performed in colon cancer, but preliminary data from MGH indicate improved local control and survival in some patient subsets with the use of local irradiation after resection. Both gastric and pancreatic cancer have a greater propensity to distant metastases. A review of failure patterns after resection has, nonetheless, shown a high incidence of local recurrence and small prospective randomized studies have recently demonstrated a survival advantage with the use of adjuvant irradiation. PMID- 3516956 TI - The effect of definitive irradiation on local control and disease free survival in breast cancer. AB - The prognostic factors important in determining local regional control or failures can be divided into two groups. The first, the intrinsic factors, relate to the initial inherent condition of the tumor, that is, the tumor labeling index, progesterone receptors, the degree of involvement of the lymph nodes in he area, the size of the tumor, etc. The second, extrinsic factors, relate to type and adequacy of treatment. The presentation demonstrates that the most critical factors in determining failure and patterns of failure are the intrinsic factors, that is, histologic grade tumor labeling index, number of nodes involved, progesterone receptors and size, and that the adequacy of treatment affects failure and patterns of failure in patients treated. This paper shows that adequate radiation reduces local recurrence and, consequently, increases the survival rate; it also demonstrates that inadequate radiation will lead to increased local recurrence and decreased survival. The factors involved in determining the adequacy of irradiation are discussed. PMID- 3516957 TI - Echocardiographic diagnosis of pulmonic valve vegetative endocarditis in a cow. AB - A 5-year-old cow developed signs of bacterial endocarditis subsequent to parturition and mastitis. Massive vegetative lesions on the pulmonic valve were imaged with 2-dimensional echocardiography. PMID- 3516958 TI - The chemistry, mechanism of action and biological properties of CC-1065, a potent antitumor antibiotic. PMID- 3516959 TI - Steroid hormone pathways in the pig, with special emphasis on boar odor: a review. AB - Although castration of male pigs grown for meat production has long been a commercial practice in order to eliminate an undesirable odor emanating from the meat upon heating, intact males (boars) grow faster, utilize feed more efficiently and produce leaner carcasses. This review outlines the biochemical pathways of steroid hormone formation in the pig, placing special emphasis on the C19-delta 16-steroids, which have been shown to produce the "urine- or perspiration-like" odor of boar meat. Analytical methods currently available for quantitation of the C19-delta 16-steroids are also reviewed, including gas chromatography-mass spectrometry, radioimmunoassays and enzyme-linked-immuno absorbent-assays (ELISA). Finally, methods for preventing boar odor are discussed, such as environmental methods of rearing boars, genetic selection against boar odor and autoimmunization against C19-delta 16-steroids. Autoimmunization techniques appear to offer the most promise for inhibiting production of the compounds responsible for boar odor in male pigs raised for meat production, while still maintaining the advantages of improved efficiency and greater leanness. PMID- 3516960 TI - Effects of obesity on insulin and glucose metabolism in cyclic heifers. AB - Effects of degree of obesity on basal concentrations of insulin, glucose, thyroxine (T4), triiodothyronine (T3), estradiol-17 beta (E) and progesterone (P) were measured in serum from 50 estrous and 73 diestrous Holstein heifers and the insulin response to glucose infusion was assessed in diestrous obese (n = 7) and lean (n = 7) heifers. Basal concentrations of glucose, T4, T3, E and P were not correlated with degree of obesity, although concentrations of glucose, T4 and T3 were higher (P less than .05) at estrus than diestrus. Basal concentrations of insulin at estrus and diestrus were positively correlated (r = .6; P less than .001) with degree of obesity but this relationship was different (P less than .001) between estrus and diestrus. Furthermore, there was interaction (P less than .001) between body condition and stage of the estrous cycle only for basal concentrations (mean +/- SE) of insulin, with the difference in insulin levels (microU/ml) between 12 obese and 12 lean heifers at diestrus (11.7 +/- 1.3 vs 6.7 +/- .6; P less than .05) increasing during estrus (21.9 +/- 2.4 vs 10.8 +/- 1.3; P less than .001). Insulin response to glucose infusion was greater in obese than in lean heifers, whether determined as actual concentration (P less than .01) or as insulin response areas (P less than .05) above base-line concentrations. Obese heifers were less responsive to insulin since hyperinsulinemia and euglycemia coexisted, and because glucose fractional removal rates were similar in both groups after glucose infusion in spite of greater concentrations of insulin in obese heifers. Thus, obesity in heifers was associated with insulin resistance, basal hyperinsulinemia and greater glucose-induced secretion of insulin. PMID- 3516961 TI - A note on survival of salmonellas during anaerobic digestion of cattle dung. AB - Anaerobic digestion of night soil with cattle dung slurry in biogas plants is advocated in Indian villages as a means of disposal of human excreta in the absence of conventional sanitary systems. Although intestinal pathogens are likely to be eliminated during anaerobic digestion, there is no conclusive evidence that this is so. Large numbers of saprophytic organisms in the fermenting mass make it impossible to detect the residual pathogens. Use of an antibiotic-resistant strain of Salmonella typhimurium as a test organism to study its survival during anaerobic digestion showed that the organism is totally eliminated in nine days. PMID- 3516962 TI - Behaviour of TEM-1 beta-lactamase as a resistance mechanism to ampicillin, mezlocillin and azlocillin in Escherichia coli. AB - Escherichia coli isolates which synthesised the extremely common 'TEM-1' plasmid mediated beta-lactamase were more resistant to the alpha-aminopenicillins, ampicillin, mezlocillin and azlocillin, than were strains which lacked this enzyme. However, many TEM-1+ isolates remained sensitive to therapeutic concentrations of mezlocillin (less than 64 mg/l), whereas virtually none was susceptible to such levels of ampicillin or azlocillin. Transconjugants of E. coli K12 into which we introduced various TEM-1 coding plasmids similarly acquired lower levels of resistance to mezlocillin than to ampicillin and azlocillin. Those which expressed relatively small amounts of enzyme remained sensitive to 64 mg/l of mezlocillin, whereas they were substantially resistant (MIC greater than 64 mg/l) to the other alpha-aminopenicillins. These data suggested that the enzyme afforded weaker protection against mezlocillin than against azlocillin and ampicillin and we attempted to relate this finding to its hydrolytic activity. Extracted TEM-1 beta-lactamase hydrolysed high concentrations of mezlocillin more rapidly than ampicillin and azlocillin; however, mezlocillin was calculated to be the weakest substrate at the low concentrations which are likely to be obtainable in the bacterial cell. These data may partly account for the residual activity of mezlocillin against enzyme producers, but target and permeability factors probably also contribute. PMID- 3516963 TI - Kinetics and bactericidal effect of gentamicin and latamoxef (moxalactam) in experimental Escherichia coli endocarditis. AB - The pharmacokinetics of gentamicin and latamoxef (moxalactam) were examined in serum, normal heart valves, sterile cardiac vegetations and vegetations infected with Escherichia coli. Penetration of antibiotics into heart valves and vegetations was rapid; the maximum concentration was achieved in both sites at the end of a 20 min iv infusion. However, both antibiotics penetrated better into vegetations than into normal heart valves. In rabbits with left-sided endocarditis, similar antibiotic levels were found in infected vegetations after one or 22 im injections. After 11 im injections (one every 8 h) of latamoxef (15 mg/kg) the bacterial titre (cfu/g) was significantly reduced, but not nil, despite concentrations about 40 times the MBC for this antibiotic in the vegetations. Afer 22 im injections, vegetations in rabbits receiving latamoxef were sterile and were significantly reduced in those receiving gentamicin (1.5 mg/kg/im), concentrations of which in the vegetations were inferior to the MBC. Our results suggest that the in-vivo antibacterial effect depends on local antibiotic levels, kinetics of killing and duration of contact between antibiotic and bacteria. PMID- 3516965 TI - Gram-negative bacillary meningitis in neonates: a glimmer of therapeutic success. AB - A combination of gentamicin and ceftazidime was used to treat four neonates with Gram-negative bacillary meningitis. The causative organisms were Escherichia coli (3 cases) and Enterobacter agglomerans (1 case). The laboratory findings, including cerebrospinal fluid (CSF) ceftazidime levels and bactericidal activity demonstrated that penetration of the cephalosporin into the cerebrospinal fluid was adequate. The antibiotics caused no side effects and all the patients responded well. On follow up none of the patients exhibited neurological deficits. PMID- 3516964 TI - Efficacy of cefmenoxime in experimental group B streptococcal bacteraemia and meningitis. AB - Cefmenoxime, a new semisynthetic cephalosporin, was evaluated in vitro and in vivo in comparison with penicillin G against a type III group B streptococcal strain. In vitro, the minimal inhibitory and minimal bactericidal concentrations of the two drugs were very close (less than or equal to 2 dilutions). In-vivo studies using experimental bacteraemia and meningitis in newborn rats revealed that despite similar drug levels, cefmenoxime had significantly greater bactericidal titres in blood at 6-7 h after administration and bacterial clearance from blood was significantly faster with cefmenoxime than with penicillin G at the end of one day of treatment. In addition, all animals with cefmenoxime therapy had bactericidal titres in cerebrospinal fluid greater than or equal to 1:8 at 1-2 h after administration, whereas most (67%) animals receiving penicillin G had titres less than 1:8. However, overall efficacy of cefmenoxime was similar to that of penicillin G. These findings suggest that cefmenoxime may be an effective alternative against group B streptococcal infection. PMID- 3516966 TI - A comparison of the homogeneous enzyme immunoassay (EMIT) autocarousel and quantitative single test (QST) systems with the radioenzymatic assay. AB - A comparison was made of three methods for gentamicin assay; a modification of the radioenzymatic transferase technique, which was used as the reference method; EMIT autocarousel; and EMIT quantitative single test (QST). Correlation of both EMIT systems with the radioenzymatic method and with each other gave acceptable correlation coefficients, 0.955-0.975, for the range of concentrations tested. The coefficients of variation for within assay studies were between 3.3 and 4.9 for all three methods. Both EMIT systems provided rapid results, within minutes, albeit at a higher cost than the radioenzymatic assay. The radioenzymatic technique although cheaper with regard to the cost of materials involves considerably more technical time and effort and might not be considered suitable for samples received out-of-hours. However the combination of both EMIT systems provides facilities for batch and one-off sample tests and the ease of operation and rapid results are suited to out-of-hours operation. PMID- 3516967 TI - Suggested mechanisms for the antimycotic activity of the polyene antibiotics and the N-substituted imidazoles. AB - The polyene antibiotics and the N-substituted imidazoles (azoles) are two groups of clinically important antifungal drugs. Both are hydrophobic and both interact with the plasma membrane of susceptible fungi but the mode of action of the two groups is not fully resolved. In this paper their biological properties are reviewed in the context of recent work so that common features may be identified and further areas of research indicated. PMID- 3516968 TI - Lack of synergy between phagocytes and antimicrobials against Nocardia asteroides. AB - Previous observations suggested that synergy between antimicrobials and phagocytes may occur during Nocardia asteroides infection. We incubated N. asteroides with seven antimicrobials, and then exposed the nocardiae to phagocytes. Neutrophils and monocytes killed about half the nocardiae whether or not the nocardiae had been preincubated with antimicrobials. We also determined whether exposure to neutrophils led to increased susceptibility of nocardiae to antimicrobials, and it did not. We found no evidence for synergy between antimicrobials and phagocytes in host defence against this bacterium. PMID- 3516969 TI - Contractility of isolated single submucosal gland from trachea. AB - We isolated single submucosal glands from canine and feline trachea. Examination by light and electron microscope showed that these isolated glands consist mainly of glandular tissue, and no smooth muscle. Cell components in the glandular tissue were ultrastructurally normal, and myoepithelial cells surrounded acini and secretory tubules. In response to methacholine, the mucus was squeezed from the tip of the collecting ducts in coincidence with the contraction of the glands. The contractile properties of isolated single glands were examined with a force transducer. Cholinergic agents (methacholine and acetylcholine) as well as 40-150 mM K+ showed a dose-response relationship and induced tension up to 12 mg. The length-tension relationship was also observed. The removal of Ca2+ from the medium eliminated contractile response. Caffeine induced approximately 30% of the response to methacholine, and phenylephrine, a tension less than 30% of that with methacholine. These findings suggest that squeezing of mucus due to the contraction of myoepithelial cells has an important effect on secretory response of airway submucosal glands. PMID- 3516970 TI - Relationship between CO and transit times for dye and thermal indicators in central circulation. AB - We investigated two factors that may influence the estimation of lung water by the thermal-dye double-indicator-dilution method: 1) changes in cardiac output (CO), and 2) thermal equilibration with cardiac tissue. In theory, the difference between mean transit times of thermal and dye indicators (delta MTT) is proportional to the extravascular volume of distribution of the thermal indicator (VODev) and inversely related to CO. The delta MTT also includes a time element DT due to the difference in response times of the measuring instruments such that delta MTT = VODev/CO + DT. In nine anesthetized dogs we recorded 286 aortic thermal and dye curves following left atrial (LA) and right atrial (RA) injections as CO was increased from 2.35 to 6.65 ml X s-1 X kg-1 by isoproterenol infusion, and a regression of delta MTT on CO-1 was performed. DT was measured in vitro for comparison with the y-intercept. In six of nine dogs the slope of the regression for LA injections was not different from zero, indicating that there is no measurable volume of distribution for thermal indicator in cardiac tissue. For RA injections the relationship between delta MTT and CO-1 was linear in all experiments, with an average correlation coefficient of 0.97 +/- 0.01 (SE), indicating that the VODev was constant over a threefold increase in CO. Although the in vitro measurement of DT agreed closely with the average of the y intercepts of the regressions, small between-subject differences in DT can lead to apparent flow-related changes in extravascular thermal volume computed in the conventional fashion using the in vitro estimate of DT. PMID- 3516971 TI - Reaggregation of fetal rat brain cells in a stationary culture system. I: Methodology and cell identification. AB - A stationary tissue culture system for reaggregation cultures of rat brain cells is described. Aggregates were formed by placing cells at high concentration in liquid overlay cultures on a nonadherent nutrient agar surface. No physical stress in the form of rotation or shaking was applied to the aggregating cell population. Transmission electron microscopy and immunohistochemistry showed that the cells developed from homogeneously dispersed, immature cells in Day 4 aggregates, to mature astrocytes, oligodendrocytes, and neurons in Day 20 aggregates. Twenty days older aggregates had a tightly packed neuropil which was most prominent in a cell-sparse outer layer of the aggregates. When the aggregates were allowed to adhere to a substrate, both glial fibrillary acidic protein (GFAP) positive and negative cells were observed migrating out from the aggregates. Cells giving a positive reaction for neuron specific enolase (NSE) were also present. This reaggregation procedure, with transfer of selected brain cell aggregates into agar-coated multiwells is an alternative three-dimensional culture system which can be potentially useful in the study of morphogenesis and cell interactions in the nervous system. PMID- 3516973 TI - In vitro effect of the Escherichia coli heat shock regulatory protein on expression of heat shock genes. AB - In Escherichia coli, the ability to elicit a heat shock response depends on the htpR gene product. Previous work has shown that the HtpR protein serves as a sigma factor (sigma 32) for RNA polymerase that specifically recognizes heat shock promoters (A.D. Grossman, J.W. Erickson, and C.A. Gross Cell 38:383-390, 1984). In the present study we showed that sigma 32 synthesized in vitro could stimulate the expression of heat shock genes. The in vitro-synthesized sigma 32 was found to be associated with RNA polymerase. In vivo-synthesized sigma 32 was also associated with RNA polymerase, and this polymerase (E sigma 32) could be isolated free of the standard polymerase (E sigma 70). E sigma 32 was more active than E sigma 70 with heat shock genes; however, non-heat-shock genes were not transcribed by E sigma 32. The in vitro expression of the htpR gene required E sigma 70 but did not require E sigma 32. PMID- 3516972 TI - RAS genes and growth control in Saccharomyces cerevisiae. PMID- 3516974 TI - Molecular cloning and expression of hipA, a gene of Escherichia coli K-12 that affects frequency of persistence after inhibition of murein synthesis. AB - The hipA gene at 33.8 min on the Escherichia coli chromosome controls the frequency of persistence upon inhibition of murein synthesis; for strains bearing hipA+ the frequency is 10(-6), and for hipA- strains the frequency is 10(-2). hip+ has been cloned by selection for a kanamycin resistance determinant at 33.9 min. hipA+ is dominant over hipA- in both recA+ and recA- backgrounds. The smallest DNA insert which contains hipA+, as determined by the ability of the plasmids to complement hipA- strains, is 1,885 base pairs. Both orientations of hipA+ are obtained when the cloning site of vector is remote from strong promoters; both orientations complement hipA-, and both encode a unique peptide of 50,000 Mr. The probable direction of transcription has been deduced from the pattern of peptides encoded by plasmids from which either end of the insert and adjacent vector sequences have been deleted. This information and the recovery of only one orientation of hipA+ when the cloning site is close to a strong promoter suggest that a high level of expression of the gene is not tolerated by E. coli. PMID- 3516975 TI - Bimodal pattern of killing of DNA-repair-defective or anoxically grown Escherichia coli by hydrogen peroxide. AB - Two modes of killing of Escherichia coli K-12 by hydrogen peroxide can be distinguished. Mode-one killing was maximal with hydrogen peroxide at a concentration of 1 to 2 mM. At higher concentrations the killing rate was approximately half maximal and was independent of H2O2 concentration but first order with respect to exposure time. Mode-one killing required active metabolism during the H2O2 challenge, and it resulted in sfiA-independent filamentation of both cells which survived and those which were killed by the challenge. This mode of killing was enhanced in xth, polA, recA, and recB strains and was accelerated in all strains by an unidentified, anoxia-induced cell function. A strain carrying both xth and recA mutations appeared to undergo spontaneous mode-one killing only under aerobic conditions. Mode-one killing appeared to result from DNA damage which normally occurs at a low, nonlethal level during aerobic growth. Mode-two killing occurred at higher doses of H2O2 and exhibited a multihit dependence on both H2O2 concentration and exposure time. Mode-two killing did not require active metabolism, and killed cells did not filament, although survivors demonstrated a dose-dependent growth lag. Strains with DNA-repair defects were not especially susceptible to mode-two killing. PMID- 3516977 TI - Early placebo response in anxious and depressed patients. AB - Specific subgroups of anxiety disorder patients (N = 130) and depression patients (N = 105), defined according to DSM-III criteria, were given 1 week of placebo treatment as part of ongoing clinical drug trials. Placebo responses and dropout rates were assessed at the end of the placebo trial period. The results indicate a comparable dropout rate between depression and anxiety disorder groups due to positive placebo response, negative placebo response, and "nonsymptomatic" reasons. In addition, male anxiety disorder patients dropped out at a significantly higher rate than male depression patients. PMID- 3516976 TI - Monoamine oxidase inhibitors and tricyclic antidepressants: comparison of their cardiovascular effects. AB - The cardiovascular effects of monoamine oxidase inhibitors (MAOIs) are contrasted with those of the tricyclic antidepressants (TCAs). At therapeutic doses, MAOIs lower supine blood pressure and increase the postural fall in blood pressure, whereas TCAs have only the latter effect. MAOIs have little effect on heart rate and do not prolong cardiac conduction; TCAs increase heart rate and prolong cardiac conduction. Neither class of drugs appears to impair cardiac mechanical functioning. For patients with certain cardiac problems, MAOIs may have an advantage over TCAs. PMID- 3516978 TI - Treating delusional depressives with amitriptyline. AB - Thirty-five delusional depressed patients were treated for either 28 or 35 days with amitriptyline. The 12 responders could not be differentiated from the nonresponders on a variety of demographic and clinical characteristics. Patients with amitriptyline+nortriptyline plasma levels above 250 ng/ml were significantly more likely to be responders than were patients with levels below that value (p less than .05). A review of the relevant literature revealed that, although some delusional depressives do respond to treatment with tricyclic antidepressants, the presence of delusions is a predictor of poor response to tricyclic antidepressants. PMID- 3516979 TI - The effect of serial therapeutic plasmapheresis on platelet count, coagulation factors, plasma immunoglobulin, and complement levels. AB - One hundred therapeutic plasmaphereses were carried out at biweekly intervals in seven patients, without morbidity or mortality, using the IBM 2997 blood fraction separator. In standardised procedures, 1.5 times the calculated plasma volume was replaced with an electrolyte solution containing 4% salt-free human albumin. Anticoagulation was achieved using a whole venous blood to acid-citrate dextrose ratio of 11 to 1. Median flow rates, plasma collection, and procedure times were respectively 40 ml/minute, 20 ml/minute, and 3 hours. Haemoglobin and total white cell counts were not significantly affected by the procedures. In contrast, platelet count, fibrinogen, immunoglobulin levels, total haemolytic complement, as well as C3 and C4 fractions fell, and the prothrombin and partial thromboplastin times were lengthened by the exchanges. All these measurements had returned to normal within 24 hours, apart from the fibrinogen, which took between 48 and 72 hours, and the immunoglobulin level, which required 35 days to return to baseline. In a further patient, more detailed studies (n = 13) were carried out to characterise the behaviour of antithrombin III and factor VIII. Both levels were markedly reduced immediately following the procedure and, like fibrinogen, had returned to normal within 48 hours. These data indicate that in an isovolemic plasmapheresis there was a transient but rapidly reversible effect on all the factors studied, with fibrinogen level, antithrombin III, and factor VIII returning more slowly to normal than the others, and immunoglobulin levels responding the slowest. None of these changes was associated with clinically significant haemostatic abnormalities.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3516980 TI - Improved method for automated red cell exchange in sickle cell disease. AB - An improved method for intermittent-flow erythrocytapheresis in patients with sickle cell disease is reported. The method, a modification of the standard red cell exchange procedure for the Haemonetics 30S unit, dilutes with physiologic saline the patient's blood as it flows from the draw line and before it reaches the centrifugation bowl. The blood dilution (approximately 1.6 parts saline to 1 part blood) is used only during the first two passes, when the proportion of sickle erythrocytes in the patient's blood is still high. Only that amount of bowl supernatant (saline-diluted plasma) necessary to maintain extracorporeal volume below 500 ml is returned to the patient. The method described largely prevents the clumping of sickle erythrocytes in the centrifugation bowl, a complication frequently encountered with the Haemonetics 30S unit. Thus, changing the bowl between passes is avoided. Furthermore, the sickle red cells can be collected with the first pass and cryopreserved for possible future uses including the option of autotransfusion. PMID- 3516981 TI - Instability of an arginine-overproducing mutant of Serratia marcescens and its stabilization. AB - Arginine productivity of an arginine-producing mutant of Serratia marcescens decreased during successive batch culturing. The mutant grew more slowly than the parent strains in a minimal medium, and spontaneously produced derivatives that grew more rapidly than the mutant. A large majority of the derivatives required N acetylglutamate or arginine for growth, due to lack of N-acetylglutamate synthase, the argA gene product. The argA1 allele carried by the mutant was found to be relatively unstable. While the mutation rate in a stable argA mutant allele was less than 1 X 10(-8) per cell per generation, that in the argA1 allele was 9 X 10(-7). The instability of the arginine productivity, therefore, was owing to both a disadvantage of the mutant in growth and a high mutability in the argA1 allele. In addition to the auxotrophs, the unstable arginine-producing mutant spontaneously produced at low frequency stable arginine-producing derivatives; among them, AT428 formed N-acetylglutamate synthase with a reduced affinity for glutamic acid. The derivative showed restored capability for propagation, and stably produced a large amount of arginine in the presence of glutamic acid or fumaric acid. By transductional analysis, the derivative was found to have acquired in the argA allele an additional mutation leading to the reduced affinity independently of the original one leading to the feedback-resistant enzyme. PMID- 3516982 TI - Acetyl-CoA-dependent chain elongation of fatty acids in Escherichia coli K-12. AB - Crude extract of Escherichia coli was found to elongate medium chain acyl-CoA primers. The reaction products were fatty acids one or two C2 units longer than the primer. Acetyl-CoA acted as the condensing unit in this reaction, while malonyl-CoA did not. The optimal pH for the reaction was 5.0 in 0.1 M citrate phosphate buffer. NADH was the predominant electron donor for the incorporation of acetyl-CoA into fatty acids, and NADPH was one-third as effective as NADH at pH 5.0. Acyl carrier protein and cerulenin had no effect on the acetyl-CoA incorporation into the chain elongation products. Acyl-CoA compounds with medium carbon chain lengths proved to be the best as primers, and the maximum incorporation was observed with octanoyl-CoA. N-Ethylmaleimide and p hydroxymercuribenzoate blocked the chain elongation reaction by inhibiting either condensation or 3-ketoacyl reduction. PMID- 3516983 TI - Purification and characterization of a collagenolytic serine proteinase from the catfish pancreas. AB - A collagenolytic enzyme was purified to homogeneity from the activated pancreatic extract of the catfish Parasilurus asotus by chromatography on DEAE-cellulose, hydroxylapatite, and Cellulofine columns. The molecular weight of the enzyme was estimated to be 29,500 by SDS-polyacrylamide gel electrophoresis. The enzyme is capable of degrading native, reconstituted calf skin collagen fibrils at pH 7.5 and 37 degrees C, and also of reducing the viscosity of native calf skin collagen at pH 7.5 and 20 degrees C. The SDS-polyacrylamide gel electrophoresis of thermally denatured enzyme-collagen reaction mixtures showed that the enzyme can cleave peptide bonds in the non-helical and triple-helical regions of the collagen. The enzyme was inhibited by DFP, PMSF, soybean trypsin inhibitor, and chicken ovoinhibitor, but not by metal-chelating reagents EDTA, EGTA, o phenanthroline, or L-cysteine. These results indicate that the enzyme is a unique collagenolytic proteinase belonging to the group of serine proteinases and is a new member of the class of pancreatic enzymes. PMID- 3516984 TI - Isolation and characterization of proteinases from the sarcocarp of snake-gourd fruit. AB - Seven proteinases were isolated from the fruit of snake-gourd, Trichosanthes cucumeroides Maxim. Their isozymes are all serine proteinases, and homologous in their respective molecular weights, amino acid compositions, and enzymatic properties. Their molecular weight was estimated to be about 50,000. Using casein as a substrate, the maximum activity was found in the alkaline pH region. The optimum temperature using casein was 70 degrees C at pH 7.3. The enzymes were strongly inhibited by diisopropyl fluorophosphate and not inhibited by inhibitors of sulfhydryl or metalloproteases. The reduced and S-carboxymethylated insulin B chain was used as a substrate in an investigation of the specificity. The enzyme was found to have a wide specificity for this substrate but preferentially hydrolyzed the peptide bonds involving the carboxyl groups of charged amino acid such as S-cm-cysteine, glutamic acid, histidine, arginine, and lysine. Experimental evidence indicated that the snake-gourd proteinases are similar in their properties to cucumisin, which is isolated from the sarcocarp of melon fruit. PMID- 3516985 TI - Primary structures of the ColE2-P9 and ColE3-CA38 lysis genes. AB - The lysis genes of plasmids ColE2-P9 and ColE3-CA38 were identified by DNA sequencing and electrophoretic analysis of the products of both wild type and artificially introduced ochre mutant genes. The E2 and E3 lysis genes had identical primary structures and were shown to encode 47 amino acids with a calculated molecular weight of 4,861, which is much smaller than that proposed previously for the ColE3-CA38 lysis protein. They are homologous with ColDF13 gene H, except in their 3'-portions. The nine C-terminal amino acids of the E2 and E3 lysis proteins proved to be non-essential for the lysis phenotype. PMID- 3516987 TI - A single base change in the intron of a serine tRNA affects the rate of RNase P cleavage in vitro and suppressor activity in vivo in Saccharomyces cerevisiae. AB - Differences in the processing of dimeric tRNASer-tRNAMet precursors derived from the Schizosaccharomyces pombe sup9 wild-type and opal suppressor genes can be attributed to conformational alterations in the tRNASer anticodon/intron domain. A comparison of the patterns obtained upon transcription of the sup9+ (wild-type) and sup9-e (opal suppressor) genes in a coupled transcription/processing extract from Saccharomyces cerevisiae reveals that the latter exhibits a greatly reduced efficiency of 5'-end maturation and is susceptible to specific endonucleolytic cleavage(s) within the intron. Free energy calculations indicate that these effects coincide with a destabilization of the wild-type anticodon/intron stem and suggest that the predominant sup9-e conformer lacks secondary structure in this region. Evidence in support of this hypothesis was obtained by analyzing the processing of sup9+ and sup9-e precursors carrying the intron base substitution, G37:10, which destroys and restores, respectively, the base-pairing potential of the proposed secondary structure and comparing the strength and temperature sensitivity of sup9-e and sup9-e G37:10 suppression in vivo in S. cerevisiae. The data indicate that the anticodon/intron structure of tRNA precursors can influence the rate of RNase P cleavage in vitro and affect tRNA expression in vivo. PMID- 3516986 TI - [Physiology of Langerhans cells and their potential role in oral pathology]. AB - Langerhans cells represent a minor epidermal cell population in mammals. They are also observed in squamous epithelia of the oesophagus, vagina and cervix, as well as in oral epithelia. They occur in higher density in the non keratinized epithelium. These cells are characterized by a dendritic pattern, a clear cytoplasm and ultrastructurally by the presence of Birbeck granules. They are usually located in a suprabasal position. Their bone marrow origin is now well established. Surface markers and functional properties identify them as belonging to the macrophage/monocyte lineage. Langerhans cells can be identified in tissue sections by immunofluorescence or immunoperoxidase techniques using monoclonal antibodies directed against surface antigens such as class II histocompatibility antigens, T6 marker, or possibly T4 marker. There is also a cytoplasmic marker, the S-100 protein. A renewed interest in Langerhans cells comes from evidence of their role in the cutaneous immune response. At present these cells are considered as dendritic cells expressing a high density of class II histocompatibility antigens and behave as very potent antigen presenting cells that activate mainly helper T lymphocytes. However, experimental data on antigen processing and interleukin 1 secretion are still lacking. This review also examines the oral pathology literature with respect to modifications in the number or localization of Langerhans cells and their proximity to T lymphocytes, for example in lichen planus, Behcet's syndrome, erythema multiforme, gingivitis and oral carcinoma. Histiocytosis X represents a particular case in which the Langerhans cell itself is affected. PMID- 3516988 TI - Denaturation of covalently closed circular DNA. Kinetics, comparison of several DNAs, mechanism and ionic effects. AB - The rates of the alkaline denaturation of the covalently closed, circular DNAs (form I) of the replicative forms (RF) of phages G4, phi X174, and fd, and of plasmid pBR322 and phage PM2 have been measured at 0 degrees C and some at higher temperatures. These rates are orders of magnitude slower than the denaturation of linear DNA because of the increased stability of the helix to deprotonation that results from the accumulating positive superhelicity during denaturation. Denaturation reactions were initiated by rapid, infrasonic mixing (Camien, M.N., and Warner, R.C. (1984) Anal. Biochem. 138, 329-334), and their progress was measured by analytical ultracentrifugal analysis for the amounts of form I and denatured (Id) DNA after neutralization of the alkaline reaction. The comparative rates of the five DNAs varied over a wide range; the fastest, G4-RF, denatured at 500-fold the rate of the slowest, fd-RF. The differences are accounted for by the interaction of positive superhelicity with the sequence-dependent regions of relative helix stability in the various DNAs. Renaturation rates of Id DNAs varied similarly for Ids prepared at 0 degrees C, but only a few-fold for Ids prepared at 50 degrees C. The rate of denaturation of G4-RF was determined over a wide range of NaOH and NaCl concentrations at 0 degrees C, and the pHm was determined as a function of ionic strength and temperature. The effects of ionic strength have been analyzed in an application of the Manning ion condensation screening theory (Manning, G.S. (1978) Q. Rev. Biophys. 11, 179-246) which is shown to account for the large destablizing effect of salts on the helix. The pH region of transition at 50 degrees C from renaturation to denaturation was examined, and it was found that the maximum rate of renaturation occurred at a pH about 0.05 units below the pHm. PMID- 3516989 TI - Production of pea lectin in Escherichia coli. AB - In order to explore the molecular basis for the glycopeptide specificity of legume lectins, we have developed an experimental system in which specific amino acid alterations can be introduced into the carbohydrate binding site of pea lectin. This system is based on the production of pea lectin in Escherichia coli. The plasmid coding for the lectin was constructed from two lectin cDNA sequences isolated from Pisum sativum seeds (Higgins, T. J. V., Chandler, P. M., Zurawski, G., Button, S. C., and Spencer, D. (1983) J. Biol. Chem. 258, 9544-9549) and an expression vector based on the gene for the outer membrane lipoprotein of E. coli (Nakamura, K., and Inouye, M. (1982) EMBO J. 1, 771-775). The lectin is produced as a single polypeptide chain and forms insoluble aggregates in E. coli cells (2 5 mg/liter). Functional lectin is recovered by solubilization of the aggregates in guanidinium hydrochloride, renaturation in the presence of MnCl2 and CaCl2, and affinity purification on Sephadex. This procedure yields a homogeneous 28,000 dalton protein. Comparison of the recombinant lectin with natural pea lectin in an inhibition of hemagglutination assay demonstrated that there is no detectable difference in the carbohydrate binding properties of the two lectins. PMID- 3516990 TI - Ligand binding-promoted conformational changes in yeast ornithine transcarbamoylase. AB - It has been proposed that regulatory multienzyme complex formation between yeast ornithine transcarbamoylase (OTCase) and arginase is triggered by a conformational change promoted by the binding of ornithine to a regulatory site in OTCase (Wiame, J.-M. (1971) Curr. Top. Cell. Regul. 4, 1-38). To isolate the binding of ornithine to the proposed regulatory site, the active site was blocked with the high affinity (Ki = 13 +/- 1.4 nM) bisubstrate analogue, delta-N phosphonacetyl-L-ornithine (PALO). The binding of PALO to the active site produces large changes in the absorption (delta A290-296 = 0.010/mg of enzyme) and in the fluorescence (25% quenching) of the protein. These changes both saturate at one PALO/polypeptide chain. The binding of PALO also changes the rate constant for diffusional acrylamide quenching by 43% and increases the midpoint for the thermal denaturation of the enzyme by 13 degrees C. Finally, PALO binding results in a +2.8% change in the sedimentation coefficient demonstrating that these spectral and energetic changes are associated with a gross structural change in the enzyme. In an effort to detect ligand binding to the proposed effector site on OTCase, ornithine was added to the enzyme saturated with PALO, and consequent conformational changes were tested for using methodologies identical to those which demonstrated active site ligand binding-promoted conformational changes. In no instance were any additional differences observed. Hence, strong support for isosteric effector binding-promoted conformational changes cannot be presented. We conclude that active site ligand binding events themselves are responsible for conformational changes which promote enzyme-enzyme association of OTCase with arginase. PMID- 3516991 TI - Pressure dependence of equilibria and kinetics of Escherichia coli ribosomal subunit association. AB - Equilibria and rates were observed over the ranges 1-1600 atm, 3-10 mM Mg2+, at 60 mM NH4Cl, pH 7.5, 20 degrees C, by light scattering. The main reaction is accurately represented at all conditions by the following phenomenological equations. 30 S + 50 S = 70 S, KA70 = ka/kd = [70 S]/[30 S][50 S] The equilibrium constants obey simple rules: the volume of association, delta VA0, has the constant value 242 +/- 9 ml/mol, independent of pressure, at all Mg2+ concentrations; the derived values of log KA70 at 1 atm increase linearly with log [Mg2+] at a slope of 7.5. In contrast, the rate constants show a clear break at 6 mM Mg2+: below 6 mM, log ka decreases with pressure with a delta Va of 105 +/- 9 ml/mol and increases with log [Mg2+] at a slope of 4.9; above 6 mM, these values are halved; a split can actually be seen at 6 mM Mg2+, near 500 atm. The usual two-step mechanism for second order reactions in solution, which would insert a 70 S' species, either an encounter complex or a true low concentration steady state intermediate, into the above equation can accommodate these results: as [Mg2+] increases, the rate of transformation of 70 S' into 70 S finally predominates over the rate of dissociation of 70 S' into subunits. The bulk of the pressure effects and all of the [Mg2+] dependence arise from the progressive increase in delta GA0 (electrostatic) that occurs when 30, 50, and 70 S particles all lose equivalent fractions of their internal Mg2+ in response to increases in pressure or decreases in [Mg2+]. PMID- 3516992 TI - Different phosphorylated forms of myosin in contracting tracheal smooth muscle. AB - Calmodulin-dependent myosin light chain kinase phosphorylates two light chain subunits on each myosin molecule. We have developed a method for measuring nonphosphorylated, monophosphorylated, and diphosphorylated forms of myosin in smooth muscle. Four protein bands were separated in tissue extracts by nondenaturing polyacrylamide gel electrophoresis in the presence of pyrophosphate. Immunoblots demonstrated that three forms (designated M, MP, and MP2) reacted with rabbit antisera prepared against the purified phosphorylatable light chain (P-light chain) from bovine tracheal smooth muscle. Evidence was obtained that M, MP, and MP2 represented nonphosphorylated, monophosphorylated, and diphosphorylated myosin, respectively, and that the other protein band was probably filamin. The formation of different phosphorylated forms of myosin was measured in bovine trachealis strips neurally stimulated from 1.0 to 3.5 s and quick-frozen. There was no detectable MP or MP2 in unstimulated muscles; the extent of P-light chain phosphorylation measured directly was 0.02 +/- 0.01 mol of phosphate/mol of P-light chain. After 2.5-s stimulation, maximal values of 0.63 +/- 0.06 mol of phosphate/mol of P-light chain and 0.40 +/- 0.06 MP2/myosintotal were obtained. During continuous neural stimulation from 1.0 to 3.5 s, the relationship between the extent of P-light chain phosphorylation (measured directly or calculated) and the relative amount of MP2 is consistent with a random phosphorylation process. PMID- 3516993 TI - In vivo glucose metabolism in individual tissues of the rat. Interaction between epinephrine and insulin. AB - The interaction between epinephrine and insulin in modulating in vivo glucose metabolism within individual tissues of the body has not previously been examined. This was investigated using the euglycemic hyperinsulinemic (120 milliunits/liter) clamp combined with administration of [3H]2-deoxyglucose and D [U-14C]glucose. Epinephrine produced whole body insulin resistance due to increased hepatic glucose output and reduced peripheral glucose disposal. Despite elevated insulin levels liver glycogen content was reduced by 50% during epinephrine infusion (5 nM). However, this effect was transient, occurring predominantly during the initial 60 min of study. These effects were prevented during beta-adrenergic blockade with propranolol and potentiated during alpha 1 adrenergic blockade with prazosin. The most significant effect of epinephrine in peripheral tissues was increased glycogenolysis in both oxidative and glycolytic skeletal muscle. A significant reduction in insulin-mediated [3H]2-deoxyglucose uptake (30%) was evident in 5 of 9 muscles tested during epinephrine infusion. This effect was most pronounced in the more insulin-sensitive oxidative muscles. The latter effect was probably indirectly mediated via increased glycogenolysis- increased accumulation of metabolites--inhibition of hexokinase. In addition, it is evident that insulin-mediated glycogen synthesis occurred during epinephrine infusion. All effects of epinephrine on muscle glucose metabolism were prevented by propranolol but not prazosin. Similar effects to that observed in muscle were not evident in adipose tissue. It is concluded that epinephrine may override many of the actions of insulin in vivo, and most of these effects are mediated via the beta-adrenergic receptor. In the intact rat there may be a complex interaction between alpha- and beta-adrenergic effects in regulating hepatic glucose output. PMID- 3516994 TI - Comparison of the subsite specificity of the mammalian neutral endopeptidase 24.11 (enkephalinase) to the bacterial neutral endopeptidase thermolysin. AB - A comparison has been made of the specificity of the mammalian neutral metalloendopeptidase, endopeptidase 24.11, with that of the bacterial neutral metalloendopeptidase thermolysin. A series of synthetic oligopeptides which have previously been studied as substrates for thermolysin and used in computer modeling were examined as substrates for the mammalian enzyme. It was found that P1, P2, and P'3 subsite interactions in the mammalian enzyme, although similar to those found in thermolysin, are less restrictive spatially and are considerably less dependent on hydrophobic interactions. This difference was maximally expressed with the synthetic substrate dansyl-D alanylglycylnitrophenylalanylglycine which is a substrate for the mammalian enzyme, but not for the bacterial enzyme. A comparison of substrates in the free acid form with their corresponding amides showed that binding to the mammalian enzyme is dependent in part on an ionic interaction between the substrate carboxylate group and the enzyme. Such an ionic interaction was not observed with the bacterial enzyme. PMID- 3516995 TI - High-level overexpression, rapid purification, and properties of Escherichia coli tRNA nucleotidyltransferase. AB - The cloned Escherichia coli cca gene, described in the accompanying paper (Cudny, H., Lupski, J. R., Godson, G. N., and Deutscher, M. P. (1986) J. Biol. Chem. 261, 6444-6449), has been used to construct strains that overproduce tRNA nucleotidyltransferase, the enzyme that synthesizes the CCA terminus of tRNA. Strain UT481 (pEC4), which contains a 1.9-kilobase cca gene insert in plasmid pUC8, overproduces the enzyme by about 100-150-fold, probably under the control of the cca gene promoter. A second strain, containing a plasmid with a 1.5 kilobase insert, overproduces tRNA nucleotidyltransferase by about 650-fold, to a level of about 3-4% of the soluble cell protein. In this case, overexpression was dependent on the lac promoter of the plasmid. A rapid, two-step procedure was developed to purify large amounts of the enzyme from strain UT481 (pEC4) that was about 40% pure, free of ribonucleases, and suitable for use as a reagent for modification of tRNA molecules. Preparation of milligram quantities of homogeneous tRNA nucleotidyltransferase was accomplished by two further chromatographic steps. The structural and catalytic properties of this purified enzyme were similar to those from partially purified preparations previously described. The availability of large amounts of pure tRNA nucleotidyltransferase will not permit a variety of structural and functional studies of the enzyme that previously were not possible. PMID- 3516996 TI - In vivo formation and stability of engineered disulfide bonds in subtilisin. AB - Computer modeling suggested that a disulfide bond could be built into Bacillus amyloliquefaciens subtilisin between positions 22 (wild-type, Thr) and 87 (Ser) or between positions 24 (Ser) and 87 (Ser). Single cysteines were introduced into this cysteine-free protease at positions 22, 24, or 87 by site-directed mutagenesis of the cloned subtilisin gene. The corresponding double-cysteine mutants were constructed, and recombinant plasmids were expressed in Bacillus subtilis. Double-cysteine mutant enzymes were secreted as efficiently as wild type, and disulfide bonds were formed quantitatively in vivo. These disulfide bonds were introduced approximately 24 A away from the catalytic site and had no detectable effect on either the specific activities or the pH optima of the mutant enzymes. The equilibrium constants for the reduction of the mutant disulfide bonds by dithiothreitol were determined to be 82 +/- 22 and 20 +/- 5 for Cys22/Cys87 and Cys24/Cys87, respectively. Studies of autoproteolytic inactivation of wild-type subtilisin support a relationship between autolytic stability and conformational stability of the protein. The stabilities of Cys24/Cys87 and wild-type enzymes to autolysis were essentially the same; however, Cys22/Cys87 was actually less stable to autolysis. Reduction of the disulfide cross-bridge lowered the autolytic stability of both double-cysteine mutants relative to their disulfide forms. This correlates with a lowered autolytic stability for the Cys22 and Cys87 single-cysteine mutants, and the fact that an intramolecular hydrogen bond between the hydroxyl groups of Thr22 and Ser87 is likely to be disrupted in the Cys22 and Cys87 single-cysteine mutant proteins. PMID- 3516997 TI - Fluorescence studies on a streptomycin-induced conformational change in ribosomes which correlates with misreading. AB - The fluorescent reagent N-(iodoacetylaminoethyl)-5-naphthylamine-1-sulfonic acid (I-AEDANS) was employed to detect and study the previously reported conformational change in the Escherichia coli ribosome induced by streptomycin. Labeling of ribosomes with this probe, which results in the derivatization of proteins S18 and L31', described earlier, inhibits neither their ribosomal protein synthesizing nor misreading ability. To calculate the amount of streptomycin bound to the ribosome, we determined the K'D for streptomycin, which is 0.24 micron, indicating that under our conditions, bound streptomycin/ribosome molar ratios are low, not in excess of 1. Under these conditions, streptomycin addition induces fluorescence quenching by 15% but does not affect streptomycin resistant ribosomes. Maximal misreading occurs at these same ratios. Removal of AEDANS-L31' from the ribosomes drastically reduces streptomycin-induced quenching indicating the involvement of the environment of this protein in streptomycin action. The finding that streptomycin decreases AEDANS-L31' affinity for the ribosome supports this view. Streptomycin has been shown to bind to the 30 S subunit protein S4 while the 50 S protein L31' has been shown to be localized at the subunit interface. Thus, the observation that streptomycin influences this 50 S subunit protein L31', combined with the tight correlation between the effects of streptomycin on quenching and on misreading, strongly suggests that this antibiotic induces a conformational change at the subunit interface of the ribosome, and that this results in misreading. Polyuridylic acid also induces a conformational change in the ribosome but the polynucleotide and streptomycin seem to act independently. Streptomycin-resistant ribosomes, which undergo neither streptomycin-induced fluorescence nor streptomycin-induced misreading, are resistant to misreading induced by high Mg2+ as well. PMID- 3516998 TI - The effects of human low and high density lipoproteins on the binding of rat intermediate density lipoproteins to rat liver membranes. AB - Upon incubation with rat liver membranes, radioiodinated rat intermediate density lipoproteins (IDL) interacted with at least two binding sites having a low and a high affinity as demonstrated by the curvilinear Scatchard plots obtained from the specific binding data. The purpose of our work was to identify the nature of these binding sites. Human low density lipoproteins (LDL), contain apolipoprotein B only, and human high density lipoproteins (HDL3), containing neither apolipoprotein B nor E, were both capable of decreasing the specific binding of rat 125I-IDL. The Scatchard analysis clearly revealed that only the low affinity component was affected by the addition of these human lipoproteins. In fact, the low affinity binding component gradually decreased as the amount of human LDL or HDL3 increased in the binding assay. At a 200-fold excess of human LDL or HDL3, the low affinity binding was totally masked, and the Scatchard plot of the specific 125I-IDL binding became linear. Only the high affinity binding component was left, enabling a precise measurement of its binding parameters. In a series of competitive displacement experiments in which the binding assay contained a 200-fold excess of human LDL or HDL3, only unlabeled rat IDL effectively displaced the binding of rat 125I-IDL. We conclude that the low affinity binding of rat IDL to rat liver membranes is due to weak interactions with unspecified lipoprotein binding sites. The camouflage of these sites by human lipoproteins makes possible the study of IDL binding to the high affinity component which likely represents the combined effect of IDL binding to both the remnant and the LDL receptors. PMID- 3516999 TI - Sugar binding properties of the melibiose permease in Escherichia coli membrane vesicles. Effects of Na+ and H+ concentrations. AB - The substrate binding reaction of the melibiose carrier was analyzed by studying [3H]p-nitrophenyl-alpha-D-galactopyranoside (Np alpha Gal) binding to de energized membrane vesicles from Escherichia coli RA11 as a function of H+ and Na+ (or Li+) concentrations. The data indicate first that Na+ (or Li+) activates Np alpha Gal binding at all pH values tested between 5.5 and 7.5 and second that H+ inhibits the Na+ (or Li+)-dependent activating effect on Np alpha Gal binding. Similar conclusions were drawn for melibiose and methyl-1-thio-beta-D-galactoside binding activities. Unexpectedly, Np alpha Gal, melibiose, and methyl-1-thio-beta D-galactoside binding activities are insensitive to a variety of SH reagents which completely block transport activity. Quantitative analysis of the effects of H+ and Na+ ions on the parameters of Np alpha Gal binding show that 1) the maximal number of binding sites is constant irrespective of the concentration of Na+ or Li+ in the range of pH between 6 and 7.5 and 2) the apparent dissociation constant for Np alpha Gal binding varies with both Na+ and H+ according to a relation described by a linear combination of the concentration of H+ and the reciprocal of Na+ concentration. These results can be accounted for by a model which assumes sequential binding of the cation and substrate in this order and competition between Na+ and H+ for a common cationic binding site on the porter. Predictions of the proposed binding model for a carrier mechanism catalyzing sugar transport according to a Na+ symport mode or a H+ symport mode are discussed. PMID- 3517000 TI - Quantitative analysis of the early changes of hepatocyte nuclei after treating Syrian golden hamsters with di(2-ethylhexyl)phthalate. AB - Although the biological action of phthalates has been widely discussed there is little information on early cellular changes indicative for toxic or carcinogenic effects. To study subtle alterations in the cell morphology, we have by means of image processing evaluated the nuclei of hamster hepatocytes after treatment with di(2-ethylhexyl)phthalate given in single i.p. doses of 30, 300, and 3000 mg/kg. The results indicate that by using specially developed methods for analysis of images of cell nuclei and chromatin structure, it is possible to recognize changes eluding detection with usual light microscopy. PMID- 3517001 TI - Secretory protein translocation in a yeast cell-free system can occur posttranslationally and requires ATP hydrolysis. AB - We describe an in vitro system with all components derived from the yeast Saccharomyces cerevisiae that can translocate a yeast secretory protein across microsomal membranes. In vitro transcribed prepro-alpha-factor mRNA served to program a membrane-depleted yeast translation system. Translocation and core glycosylation of prepro-alpha-factor were observed when yeast microsomal membranes were added during or after translation. A membrane potential is not required for translocation. However, ATP is required for translocation and nonhydrolyzable analogues of ATP cannot serve as a substitute. These findings suggest that ATP hydrolysis may supply the energy required for translocation of proteins across the endoplasmic reticulum. PMID- 3517002 TI - Gene dosage-dependent secretion of yeast vacuolar carboxypeptidase Y. AB - The structural gene for yeast vacuolar carboxypeptidase Y (PRC1) has been cloned by complementation of the prc1-1 mutation. As much as an eightfold elevation in the level of carboxypeptidase Y (CPY) results when a multiple-copy plasmid containing the PRC1 gene is introduced into yeast. Unlike the situation with a single copy of PRC1 in which newly synthesized CPY is efficiently localized to the vacuole, plasmid-directed overproduction results in secretion of greater than 50% of the protein as the precursor form. Secretion is blocked in a mutant that is defective at a late stage in the transport of periplasmic proteins. Unlike normal cell surface glycoproteins, secreted CPY precursor acquires no additional oligosaccharide modifications beyond those that accompany normal transport to the vacuole. In the periplasm, the CPY precursor is proteolytically activated to an enzymatically active form by an enzyme that is unrelated to the vacuolar processing enzyme. These findings suggest that proper sorting and transport of CPY is saturable. This may reflect limiting amounts of a CPY-sorting receptor, or of CPY-modifying machinery that is essential for recognition by such a receptor. PMID- 3517003 TI - Unusual forms of low density lipoprotein receptors in hamster cell mutants with defects in the receptor structural gene. AB - The structure and processing of low density lipoprotein (LDL) receptors in wild type and LDL receptor-deficient mutant Chinese hamster ovary cells was examined using polyclonal anti-receptor antibodies. As previously reported for human LDL receptors, the LDL receptors in wild-type Chinese hamster ovary cells were synthesized as precursors which were extensively processed by glycosylation to a mature form. In the course of normal receptor turnover, an apparently unglycosylated portion of the cysteine-rich N-terminal LDL binding domain of the receptor is proteolytically removed. The LDL receptor-deficient mutants fall into four complementation groups, ldlA, ldlB, ldlC, and ldlD; results of the analysis of ldlB, ldlC, and ldlD mutants are described in the accompanying paper (Kingsley, D. M., K. F. Kozarsky, M. Segal, and M. Krieger, 1986, J. Cell. Biol, 102:1576-1585). Analysis of ldlA cells has identified three classes of mutant alleles at the ldlA locus: null alleles, alleles that code for normally processed receptors that cannot bind LDL, and alleles that code for abnormally processed receptors. The abnormally processed receptors were continually converted to novel unstable intracellular intermediates. We also identified a compound-heterozygous mutant and a heterozygous revertant which indicate that the ldlA locus is diploid. In conjunction with other genetic and biochemical data, the finding of multiple mutant forms of the LDL receptor in ldlA mutants, some of which appeared together in the same cell, confirm that the ldlA locus is the structural gene for the LDL receptor. PMID- 3517005 TI - Identification by monoclonal antibodies and characterization of human platelet caldesmon. AB - Actin-based gels were prepared from clarified high-salt extracts of human platelets by dialysis against physiological salt buffers. The gel was partially solubilized with 0.3 M KCl. Mice were immunized with the 0.3 M KCl extract of the actin gel, and hybridomas were produced by fusion of spleen cells with myeloma cells. Three hybridomas were generated that secrete antibodies against an 80-kD protein. These monoclonal antibodies stained stress fibers in cultured cells and cross-reacted with proteins in several tissue types, including smooth muscle. The cross-reacting protein in chicken gizzard smooth muscle had an apparent molecular weight of 140,000 and was demonstrated to be caldesmon, a calmodulin and actin binding protein (Sobue, K., Y. Muramoto, M. Fujita, and S. Kakiuchi, Proc. Natl. Acad. Sci. USA, 78:5652-5655). No proteins of molecular weight greater than 80 kD were detectable in platelets by immunoblotting using the monoclonal antibodies. The 80-kD protein is heat stable and was purified using modifications of the procedure reported by Bretscher for the rapid purification of smooth muscle caldesmon (Bretscher, A., 1985, J. Biol. Chem., 259:12873-12880). The 80-kD protein bound to calmodulin-Sepharose in a Ca++-dependent manner and sedimented with actin filaments, but did not greatly increase the viscosity of F-actin solutions. The actin-binding activity was inhibited by calmodulin in the presence of calcium. Except for the molecular weight difference, the 80-kD platelet protein appears functionally similar to 140-kD smooth muscle caldesmon. We propose that the 80-kD protein is platelet caldesmon. PMID- 3517004 TI - The distribution of cytoplasmic microtubules throughout the cell cycle of the centric diatom Stephanopyxis turris: their role in nuclear migration and positioning the mitotic spindle during cytokinesis. AB - The cell cycle of the marine centric diatom Stephanopyxis turris consists of a series of spatially and temporally well-ordered events. We have used immunofluorescence microscopy to examine the role of cytoplasmic microtubules in these events. At interphase, microtubules radiate out from the microtubule organizing center, forming a network around the nucleus and extending much of the length and breadth of the cell. As the cell enters mitosis, this network breaks down and a highly ordered mitotic spindle is formed. Peripheral microtubule bundles radiate out from each spindle pole and swing out and away from the central spindle during anaphase. Treatment of synchronized cells with 2.5 X 10( 8) M Nocodazole reversibly inhibited nuclear migration concurrent with the disappearance of the extensive cytoplasmic microtubule arrays associated with migrating nuclei. Microtubule arrays and mitotic spindles that reformed after the drug was washed out appeared normal. In contrast, cells treated with 5.0 X 10(-8) M Nocodazole were not able to complete nuclear migration after the drug was washed out and the mitotic spindles that formed were multipolar. Normal and multipolar spindles that were displaced toward one end of the cell by the drug treatment had no effect on the plane of division during cytokinesis. The cleavage furrow always bisected the cell regardless of the position of the mitotic spindle, resulting in binucleate/anucleate daughter cells. This suggests that in S. turris, unlike animal cells, the location of the plane of division is cortically determined before mitosis. PMID- 3517006 TI - Myosin types and fiber types in cardiac muscle. III. Nodal conduction tissue. AB - The sinoatrial (SA) and atrioventricular (AV) nodes are specialized centers of the heart conduction system and are composed of muscle cells with distinctive morphological and electrophysiological properties. We report here results of immunofluorescence and immunoperoxidase studies on the bovine heart showing that a large number of SA and AV nodal cells share a distinct type of myosin heavy chain (MHC) which is not found in other myocardial cells and can thus be used as a cell-type-specific marker. The antibody used in this study was raised against fetal skeletal myosin and reacted with fetal skeletal but not with adult skeletal MHCs. Both atrial and ventricular fibers, as well as fibers of the ventricular conduction tissue were unlabeled by this antibody. Specific reactivity was exclusively seen in most cells in the central portions of the SA and AV nodes and rare cells in perinodal areas. However, a number of nodal cells, particularly those located in the peripheral nodal regions, were unreactive with this antibody. The myosin composition of nodal tissues was also explored using two antibodies reacting specifically with alpha-MHC, the predominant atrial isoform, and beta-MHC, the predominant ventricular isoform. Most nodal cells were reactive for alpha-MHC and a number of them also for beta-MHC. Variation in reactivity with the two antibodies was also observed in perinodal areas: at these sites a population of large fibers reacted exclusively for beta-MHC. These findings point to the existence of muscle cell heterogeneity with respect to myosin composition both in nodal and perinodal tissues. PMID- 3517007 TI - Membrane and cytoplasmic proteins are transported in the same organelle complex during nematode spermatogenesis. AB - During the development of pseudopodial spermatozoa of the nematode, Caenorhabditis elegans, protein synthesis stops before differentiation is completed. Colloidal gold conjugates of monoclonal antibody SP56, which binds to the surface of spermatozoa, and TR20, which recognizes the major sperm cytoplasmic protein (MSP), were used to label thin sections of testes embedded in Lowicryl K4M in order to follow polypeptides from their synthesis early in spermatogenesis to their segregation to specific compartments of the mature cell. Both antigens are synthesized in primary spermatocytes and are assembled into a unique double organelle, the fibrous body-membranous organelle (FB-MO) complex. However, the antigens are localized in different regions of this FB-MO complex. As described in detail, the assembly of proteins into the FB-MO complex allows both membrane and cytoplasmic components to be concentrated in the spermatids after meiosis. Then, the stepwise disassembly of this transient structure ensures delivery of each component to its final destination in the mature spermatozoan: MSP filaments in the fibrous body depolymerize, releasing MSP into the cytoplasm and the membranous organelles fuse with the plasma membrane, delivering SP56 antigen to the surface. PMID- 3517008 TI - Purification and characterization of two plasma membrane domains from ejaculated bull spermatozoa. AB - Plasma membranes were detached from ejaculated bull spermatozoa by a brief sonication in a moderately hypotonic medium, and the released plasma membranes were partially purified by differential centrifugation. The resulting fraction was enriched 8- and 15-fold in alkaline phosphatase and 5' nucleotidase activities, respectively, compared with the starting sonicated spermatozoa. This total plasma membrane fraction was separated into two distinct fractions by equilibrium density centrifugation on a continuous linear sucrose gradient. Two peaks of light scattering material were formed at densities of 1.117 and 1.148 g/ml. The denser peak contained most of the protein of the plasma membrane fraction, whereas nearly all the concanavalin A binding activity was found in the lighter peak. The two bands had distinctly different polypeptide compositions when analyzed by SDS PAGE. Polyclonal antibodies were raised in rabbits against a major integral membrane glycoprotein of each fraction (Mr of 92,000 in the light peak and 98,000 in the dense peak). The two antigens were detected on the surface of intact spermatozoa by indirect immunofluorescence microscopy. The 92-kD protein (present in the lighter band) was detected only on the plasma membrane of the acrosomal and anterior postacrosomal regions of the head. The 98-kD antigen, present in the heavier band, was localized to the surface of the postacrosomal region of the head, to the principal piece of the tail, and to the connecting piece between the head and tail. The exclusive localization of the 92-kD polypeptide to the surface of the anterior portion of the head was confirmed by immunoelectron microscopy. These data show that the two fractions isolated on the sucrose gradient originate from different regions of the sperm cell plasma membrane. PMID- 3517009 TI - The organic matrix of the skeletal spicule of sea urchin embryos. AB - The micromeres that arise at the fourth cell division in developing sea urchin embryos give rise to primary mesenchyme, which in turn differentiates and produces calcareous endoskeletal spicules. These spicules have been isolated and purified from pluteus larvae by washing in combinations of ionic and nonionic detergents followed by brief exposure to sodium hypochlorite. The spicules may be demineralized and the integral matrix dissolves. The matrix is composed of a limited number of glycoproteins rich in aspx, glux, gly, ser, and ala, a composition not unlike that found in matrix proteins of biomineralized tissues of molluscs, sponges, and arthropods. There is no evidence for collagen as a component of the matrix. The matrix contains N-linked glycoproteins of the complex type. The matrix arises primarily from proteins synthesized from late gastrulation onward, during the time that spicule deposition occurs. The mixture of proteins binds calcium and is an effective immunogen. Electrophoresis of the glycoproteins on SDS-containing acrylamide gels, followed by blotting and immunocytochemical detection, reveals major components of approximately 47, 50, 57, and 64 kD, and several minor components. These same components may be detected with silver staining or fluorography of amino acid-labeled proteins. In addition to providing convenient molecular marker for the study of the development of the micromere lineage, the spicule matrix glycoproteins provide an interesting system for investigations in biomineralization. PMID- 3517010 TI - The identification of extracellular matrix (ECM) binding sites on the basal surface of embryonic corneal epithelium and the effect of ECM binding on epithelial collagen production. AB - Previously, we have shown that embryonic corneal epithelia can interact with, and respond to, soluble extracellular matrices (ECM) (laminin, collagen, and fibronectin). The basal surface of epithelia isolated free of the underlying ECM can be seen to be disrupted by numerous blebs that sprout from this formerly smooth surface. Laminin, collagen, or fibronectin added to the culture medium cause the epithelium to reorganize its cytoskeleton and flatten its basal surface. We show here that ECM molecules at concentrations that reorganize epithelial cytoskeletal morphology also increase the amount of collagen produced by the epithelial cells. However, molecules that do not reorganize basal epithelial morphology (concanavalin A, heparin, bovine serum albumin) have no effect on collagen production. We also report that fluorescently labeled laminin, collagen, and fibronectin, when added to the medium surrounding isolated corneal epithelia, bind to and flatten the basal epithelial cell surface. The binding site on the basal surface is protease sensitive and is specific for each ECM molecule. These results are compatible with the idea that the basal epithelial plasmalemma possesses a diverse population of binding sites for ECM that link cell surface matrix to the cytoskeleton, causing a dramatic cytoskeletal reorganization which in turn results in enhanced production of collagen by the cells. PMID- 3517011 TI - On the role of type IX collagen in the extracellular matrix of cartilage: type IX collagen is localized to intersections of collagen fibrils. AB - The tissue distribution of type II and type IX collagen in 17-d-old chicken embryo was studied by immunofluorescence using polyclonal antibodies against type II collagen and a peptic fragment of type IX collagen (HMW), respectively. Both proteins were found only in cartilage where they were co-distributed. They occurred uniformly throughout the extracellular matrix, i.e., without distinction between pericellular, territorial, and interterritorial matrices. Tissues that undergo endochondral bone formation contained type IX collagen, whereas periosteal and membranous bones were negative. The thin collagenous fibrils in cartilage consisted of type II collagen as determined by immunoelectron microscopy. Type IX collagen was associated with the fibrils but essentially was restricted to intersections of the fibrils. These observations suggested that type IX collagen contributes to the stabilization of the network of thin fibers of the extracellular matrix of cartilage by interactions of its triple helical domains with several fibrils at or close to their intersections. PMID- 3517012 TI - Glucose metabolism in human spermatozoa: lack of insulin effects and dissociation from alloxan handling. AB - The role of glucose metabolism in sperm cell motility was examined in purified human spermatozoa from the perspective of elucidating its possible significance in spontaneous and experimental diabetes. After a 4-h incubation in the absence of D-glucose, the mean progressive velocity of human spermatozoa was 40% lower than that of control cells kept in the presence of D-glucose. The decline was rapidly overcome by the addition of D-glucose or D-fructose, the amplitude of this stimulatory effect being independent of the ambient hexose concentration. Between 1.4 and 16.7 mM glucose, spermatozoal glucose oxidation also proceeded independently of the extracellular glucose levels, whereas both insulin (100nM) and glucagon (100nM) failed to significantly affect the rate of glucose metabolism or cellular motility. It is speculated from these results that an alteration in seminal hexose concentrations or pancreatic hormone levels may be an unlikely cause for the reduced sperm motility that is characteristically observed in diabetic patients. Human spermatozoa rapidly incorporated D-glucose and 3-O-methyl-D-glucose but excluded the glucose-analogue alloxan, which may explain their resistance against the toxic effects of this diabetogenic drug, in spite of their intrinsic sensitivity to organic peroxides such as tert-butyl hydroperoxide. PMID- 3517013 TI - Transient stimulation of glucose metabolism by insulin in the 1-day chick embryo. AB - Effects of insulin upon glucose metabolism were investigated in chick embryos explanted in vitro during the first 30 h of incubation. Insulin stimulated the glucose consumption of the chick gastrula (18 h) and neurula (24 h), but had no effect on the late blastula (0 h:laying) and on the stage of six to eight somites (30 h). The increase in glucose consumption concerned both the embryonic area pellucida (AP) and extraembryonic area opaca (AO). AP responded to a greater extent (50%) and at a lower range of concentrations (0.1-1.0 ng/ml) than AO (30%; 1-100 ng/ml). Insulin had no effect on the oxygen consumption of blastoderms, whereas it stimulated the aerobic lactate production (approximately 70% of the additional glucose consumption was converted to lactate). The nanomolar range of stimulating concentrations suggests that insulin has a specific effect in the chick embryo, and that it could modulate glucose metabolism in ovo as well. The transient sensitivity of the embryo to insulin is discussed in relation to behavior of mesodermal cells. PMID- 3517014 TI - Complications following surgery on the basal joint of the thumb. AB - Basal joint arthritis of the thumb is common and can be disabling. Effective surgical treatment is realistic, and most patients will obtain predictably gratifying results. With attention to detail, most problems can be prevented. Occasionally, however, in spite of excellent care, complications do occur. Fortunately, such complications will usually respond to prompt recognition and treatment. PMID- 3517015 TI - Silicone synovitis following silicone implant arthroplasty. AB - Silicone synovitis is a late complication of silicone implant arthroplasty. The problem is usually heralded by pain and limitation of motion caused by synovitis and bone destruction. Once silicone synovitis develops, secondary procedures include removal of the implant, synovectomy, and reconstructive surgery individualized to the patient's pathology. PMID- 3517016 TI - Complications following small joint injuries. AB - Injuries to the small joints in the hand can lead to stiffness, pain, instability, and arthrosis. Careful evaluation and an understanding of possible complications may prevent serious difficulties from occurring. PMID- 3517017 TI - Complications of free flap transfers. AB - Review of 72 cases of free flap transfer showed that flap failure was associated with thrombocytosis and open wounds and that complications were associated with open wounds. Specific biologic variables, therefore, may underlie flap failure and complications, and investigation of these variables could lead to reduced morbidity. PMID- 3517018 TI - Complications of skin grafts and pedicle flaps. AB - Skin coverage complications of hand wounds can be divided into two categories: those associated with problems of the wound bed itself and those associated with failure of the skin graft or flap coverage. Wound problems generally are the result of inadequate preparation, infection, or excess scarring due to a long interval between injury and time of coverage. If the wound is adequately debrided, removing all devitalized tissue or tissue colonized with bacteria, coverage can usually be undertaken no later than 3 days after injury. Injuries that result in loss of skin only are best treated with skin grafts. If the bed is well vascularized, complications generally are only mechanical ones, either establishment of a barrier such as hematoma between the bed and the graft, or shearing forces tearing the graft from the bed. Skin flaps carry their own blood supply so they are not generally subject to those kinds of complications; but they are dependent upon continuation of adequate circulation until vascularization takes place. Because they are much thicker than grafts, this is a slower process, and the flap is vulnerable to problems of kinking or tension of the base. Careful attention must be paid to prevention of these problems, especially in the first few days. Axial flaps are preferable to random ones, but any flap must be carefully planned in order to assure adequate vascular perfusion and minimal tension. PMID- 3517019 TI - Problems and complications in the management of upper limb anomalies. AB - Nonsurgical problems and complications of orthotist-prosthetist techniques are not addressed in this article. There are a number of complications, such as decubiti, joint contracture or damage, tendon injury, wound healing, etc., which are not discussed because they are similar in cause, identification, and treatment to the same adult problems. Though it is possible to list the more common complications seen for each congenital anomaly, the tedious repetitiveness of such an approach dissuaded the author. General principles can always be specifically applied when the occasion requires. It is also possible to detail painstakingly the techniques of coping with each complication, but such would require book rather than chapter exegesis, and those who need these details are referred to the bibliography. The theme of this article is that there is no longer much distinction in the mind of the consumer clientele between the problem of the congenital anomaly, the results of treatment, and the complications of those treatments. The provider must therefore be wary, extensively informed, and exceedingly communicative, to the point of suggesting secondary consultation as warranted or desired. Despite this almost adversarial approach, the rewards are still great, for more can be accomplished than ever before, the child will seldom show motivational problems in using what is provided, and gratitude is not lost coinage. PMID- 3517020 TI - Complications of the management of carpal tunnel syndrome. AB - The recognition and frequency of treatment of carpal tunnel syndrome has increased over the past several years. As a result, more complications of treatment are being seen. These can be minimized by accurate diagnosis, proper selection of treatment, and careful technical application of the treatment chosen. PMID- 3517021 TI - Prevention of complications in hand therapy. AB - Basic principles stress that the injury or surgery is not to be extended through complications resulting from a failure to control edema, poor wound care, improper splinting, or forceful exercise. Prevention of these problems in hand therapy is discussed. Close rapport between surgeon, patient, and therapist is most important to support and motivate the patient. If that motivation is demolished or even impaired, the entire course of surgery and therapy may be complicated or impaired. PMID- 3517022 TI - Role of nonenzymatic glycosylation in atherogenesis. AB - This review summarizes progress in nonenzymatic glycosylation research of potential relevance to atherosclerosis using a hypothetical model based on current concepts of atherogenesis. Recently, new information has been presented showing that the initial Amadori product undergoes a series of further reactions and rearrangements to form adducts, called advanced glycosylation end products (AGE). These products are irreversible and accumulate indefinitely on long-lived molecules. These AGE covalently trap soluble plasma proteins, act as signals for macrophage recognition and uptake, and induce mutations in double-stranded plasmid DNA. Covalent trapping of low-density lipoprotein (LDL) by AGE on collagen or elastin could promote lipid accumulation in the arterial wall, whereas AGE trapping of von Willebrand factor would increase platelet adhesion and aggregation leading to intimal smooth muscle cell proliferation. Recognition and uptake of AGE-proteins by scavenging macrophages could further contribute to the process of atherogenesis by stimulating release of macrophage secretory products such as macrophage-derived growth factor. Accumulation of AGE on smooth muscle cell DNA might also enhance arterial smooth muscle cell proliferation by increasing the rate of mutations affecting growth controls. This model should provide the basis for future experiments. PMID- 3517023 TI - Interactions between endothelial cells and leukocytes. AB - We present evidence that specific receptors are utilized by neutrophils to control their interaction with endothelial cells at sites of acute inflammation and that these receptors are related if not identical to lymphocyte "homing receptors" for lymphoid tissue high endothelium. We speculate that such receptors play a fundamental but not exclusive role in controlling the extravasation and tissue localization of all bone marrow-derived nucleated cells. In addition, we emphasize the active role of endothelial cells in the process of lymphocyte migration and leukocyte extravasation. By the expression of as yet unidentified organ-specific determinants for lymphocyte recognition, endothelial cells control the exit of particular lymphocyte subsets into mucosal versus nonmucosal sites, thus helping to determine the unique features of mucosal versus nonmucosal immune responses. Furthermore, we argue that endothelial cells are exquisitely responsive to local immune reactivity and present evidence that specific lymphokines, including gamma-interferon, play an important role in inducing postcapillary venules to express differentiated features required for the support of lymphocyte traffic into lymphoid organs and into sites of chronic inflammation. Leukocytes, endothelial cells, and probably other tissue cell classes appear to interact at multiple levels by a variety of mechanisms to regulate the local extravasation of immune effector cells. PMID- 3517024 TI - The present status of erythrocyte spectrin structure: the 106-residue repetitive structure is a basic feature of an entire class of proteins. AB - Spectrin, the major component of the erythroid membrane skeleton, is a long, asymmetrical rodlike protein that interacts with several other proteins to form a two-dimensional membrane skeleton. Progress in several laboratories over the past few years including substantial partial peptide and nucleotide sequence determination has greatly enhanced our knowledge of the structural properties of this large molecule (heterodimer = 465,000 daltons). The alpha and beta subunits are homologous with approximately 30% identity. They are aligned in an antiparallel side-to-side orientation with the amino- and carboxy-termini near opposite physical ends of the molecule. The predominant structural feature elucidated from sequencing this large molecule is the nearly universal occurrence in both subunits of a single type of repetitive structure. The periodicity of this homologous structure is exactly 106 amino acid residues. As many as 36 homologous, but nonidentical, repeats exist and comprise more than 90% of the mass of the heterodimer. Each of these repetitive units is folded into a triple stranded structure that is highly helical. Peptide maps, antibody crossreactivity, peptide sequence analysis, and more recently nucleic acid sequences have defined several major properties of the erythroid molecule and related proteins in other tissues. Tissue-specific spectrins have the same 106 residue repetitive structure and show sequence homology to erythroid spectrin. PMID- 3517025 TI - [Endoscopic sclerosis of esophageal varices]. AB - The increasing popularity of treatment of esophageal varices by endoscopic sclerosis is the result of two factors. First, the principle underlying the procedure, which tends towards selective occlusion of the submucous venous network at the esophagogastric junction, where the risk of rupture is maximal, while respecting other periesophageal bypass pathways of portal blood. Second, the improvement of the apparatus used, thus simplifying the operation and reducing risks, and the improved definition of the limitations of medicosurgical treatment of portal hypertension. Results may be altered by several variables: protocol of injections, particularly intra- or paravascular site of injection, nature of sclerosing agent, type of endoscopy performed, size of varices, etiology of portal hypertension and severity of hepatic lesion and especially the relation between time of operation and the hemorrhagic episode. Hemostasis of a ruptured esophageal varix was obtained in 75 to 100% of cases. Adequate follow up and repeat injections are essential for varicose recurrences (long-term relapse rate = 50%) to avoid hemorrhagic complications. PMID- 3517027 TI - Assay of polyamines by thin-layer chromatography and a combination of double isotope dilution and scintillation methods. PMID- 3517026 TI - [Technic for orthotopic hepatic transplantation in rats using cuffs for 3 vascular anastomoses]. AB - A technique for orthotopic hepatic transplantation in the rat uses polyethylene cuffs to re-establish vascular and biliary continuity. Introduction of the suprahepatic cuff into the intrahepatic vena cava of the receiver rat, after partial hepatectomy, reduces the duration of vascular clamping and improves survival of grafted rats (long-term survival: 70%). This technique is simple to reproduce after several weeks of training and can allow research teams to study immunologic mechanisms of tolerance or rejection of liver allografts in the pure strain rat. PMID- 3517028 TI - Effect of differences in glucose tolerance on insulin's ability to regulate carbohydrate and free fatty acid metabolism in obese individuals. AB - The effect of variations in glucose tolerance on insulin's ability to regulate glucose uptake and plasma glucose and FFA concentrations was assessed in 22 obese individuals [8 with normal glucose tolerance, 7 with impaired glucose tolerance (IGT), and 7 with noninsulin-dependent diabetes mellitus (NIDDM)]. Patients with IGT had ambient insulin levels that were higher than normal, associated with elevated postprandial glucose levels and a marked reduction in insulin-stimulated glucose uptake. On the other hand, plasma FFA levels were relatively normal in IGT, possibly because of the hyperinsulinemia. Patients with NIDDM were also hyperinsulinemic, with insulin levels throughout the day that were approximately twice normal. Hyperinsulinemia in patients with NIDDM was associated with a significant decline in insulin-stimulated glucose uptake as well as with significant increases in both ambient plasma glucose and FFA concentrations. Thus, and in contrast to patients with IGT, plasma FFA metabolism in NIDDM was grossly abnormal, despite the concomitant hyperinsulinemia. These data indicate that insulin resistance in obese individuals varies as a function of degree of glucose tolerance, and insulin resistance in patients with NIDDM involves defects in the regulation of both plasma glucose and FFA metabolism. PMID- 3517029 TI - Type I diabetes is characterized by insulin resistance not only with regard to glucose, but also to lipid and amino acid metabolism. AB - Resistance to the metabolic effects of insulin has been reported with regard to glucose disposal in type I diabetic patients (IDDM) even when they were euglycemic. Our aim was to study glucose, lipid, and amino acid metabolism during glucose clamping at multiple levels of insulin in 10 normal (N) and 6 IDDM patients. Blood glucose was maintained constant (4.7 mmol/liter) at three insulin plateaus (160 min each) [42 +/- 6 (SD) 89 +/- 11, and 1255 +/- 185 microU/ml in N and 36 +/- 4, 80 +/- 13, and 1249 +/- 107 microU/liter in IDDM]. Mean glucose disposal was 34 +/- 11, 69 +/- 10, and 84 +/- 22 mumol kg-1 min-1 in N and 16 +/- 5, 40 +/- 18, and 65 +/- 27 in IDDM, respectively. Baseline concentrations of blood lactate, pyruvate, alanine, and branched chain amino acids were 560 +/- 130, 36 +/- 9, 212 +/- 44, and 451 +/- 19 mumol/liter, in N and 793 +/- 179 (P less than 0.05), 45 +/- 14, 195 +/- 50, and 439 +/- 33 in IDDM, respectively. The maximum percent change of lactate during the euglycemic clamp was +147 +/- 23% in N and +75 +/- 15% (P less than 0.05) in IDDM; that of branched chain amino acids was -61 +/- 5% in N and -48 +/- 7% (P less than 0.01) in IDDM. Baseline concentrations of glycerol, FFA, and adipate were 44 +/- 15, 449 +/- 152, and 8 - 8 mumol/liter in N and 39 +/- 14, 473 +/- 44, and 41 +/- 14 (P less than 0.01) in IDDM. The maximum percent change of glycerol during the euglycemic clamp was -50 +/- 8% in N and -16 +/- 8% (P less than 0.01) in IDDM, that of FFA -98 +/- 3% in N and -70 +/- 4% in IDDM (P less than 0.05). No significant differences were found between N and IDDM with regard to blood concentrations of ketone bodies, citrate, ketoglutarate, and hydroxymethylglutaryl coenzyme A both before and during the euglycemic clamp. The lactate percent increase was significantly correlated to glucose disposal rate (P less than 0.001). The lactate turnover rate increased during the euglycemic clamp and was lower in IDDM than in N. We conclude that during euglycemic-multiple insulin clamp studies the greater lactate increase suggests that the flux of glycolysis is higher in N than in IDDM, tricarboxylic acid concentrations are comparable in N and IDDM, and FFA, glycerol, and branched chain amino acid decreases were less in IDDM than in N, suggesting that IDDM patients are resistant to insulin with regard to lipid and protein metabolism. The higher adipate basal values demonstrate enhanced omega oxidation in IDDM. PMID- 3517030 TI - Oral glucose tolerance during the menstrual cycle in normal women and women with alleged premenstrual "hypoglycemic" attacks: effects of naloxone. AB - To resolve existing controversies about the impact of the menstrual cycle on oral glucose tolerance, we examined the glucose, insulin, and glucagon responses to an oral glucose challenge at different phases of the menstrual cycle in five normal women (NW) and six women with premenstrual syndrome and alleged premenstrual hypoglycemic attacks (PMHA). Responses to oral glucose did not differ significantly between follicular and luteal phase studies in either group, nor were significant differences found between the responses of NW and women reporting PMHA. In parallel studies, the possible glucoregulatory effects of endogenous opiates were assessed. Concomitant infusion of naloxone altered neither the basal concentrations of glucose, insulin, and glucagon nor the responses of these measures to the glucose challenge. We conclude that NW and women with premenstrual syndrome and alleged PMHA have no menstrual cycle-related changes in glucose, insulin, or glucagon responses to an oral glucose load. The fact that four of six PMHA subjects had symptoms typical of hypoglycemia at glucose nadirs above 50 mg/dl suggests that an explanation other than hypoglycemia must be sought for such symptomatic episodes. Endogenous opiate peptides appear to exert no glucoregulatory effects at naloxone-sensitive receptor sites. PMID- 3517032 TI - Evidence for an association of high blood pressure and hyperinsulinemia in obese man. AB - An association between hyperinsulinemia and hypertension has been suggested by epidemiological surveys. To assess whether this association is independent of the presence of other hyperinsulinemic states, such as obesity and glucose intolerance, we measured the insulin response to oral glucose in a group of middle-aged moderately obese [144 +/- 4% overweight (mean +/- SEM)] patients (n = 18) with essential hypertension (174 +/- 5/104 +/- 2 mm Hg) and normal glucose tolerance. Normotensive subjects (n = 17) with normal glucose tolerance, matched for age and degree of overweight, served as the control group. The mean insulin response to glucose was twice as high in the hypertensive patients (25.8 +/- 0.2 mU/ml X 2 h) as in the normotensive subjects (11.3 +/- 0.2; P less than 0.001), yet the glucose incremental area was 3-fold higher in the former (10.9 +/- 1.0 g/dl X 2 h) than in the latter (3.5 +/- 0.7; P less than 0.001), thus indicating more severe insulin resistance. In the hypertensive group, systolic blood pressure levels were directly correlated with the 2-h plasma insulin values (r = 0.75; P less than 0.001). Furthermore, the 2-h plasma insulin value and the degree of overweight accounted for 65% of the variation in the systolic blood pressure in a multiple regression model (r = 0.81; P less than 0.001). We conclude that in obesity, the occurrence of hypertension marks the presence of additional hyperinsulinemia and insulin resistance, independent of any impairment of glucose tolerance. PMID- 3517031 TI - Role of endogenous opiates in pubertal maturation: opposing actions of naltrexone in prepubertal and late pubertal boys. AB - Despite the acute enhancement of gonadotropin output that occurs in the presence of opiate blockade in sexually immature rats and adult men, studies thus far have not demonstrated a role for endogenous opioid peptides during pubertal development in the human. We studied 15 normal boys, 5 sexually developed (Tanner stages IV-V) and 10 sexually infantile, before and after chronic (1-month) administration of a selective micromicron-opiate-receptor antagonist (naltrexone). Gonadotropin secretion was assessed by repetitive venous sampling for 24 h to appraise the pulsatile features of LH release as well as by graded serum LH responses to GnRH. Using an objective pulse detection method, we found that 1) in response to naltrexone, pubertal boys had significantly higher LH pulse frequency (P = 0.044), mean LH concentration (P = 0.0325), and area under the LH vs. time curve (P = 0.0325) compared to those in the basal state; and 2) in sexually immature individuals, naltrexone significantly decreased LH pulse frequency (P = 0.014), mean LH concentration (P = 0.049), and absolute LH peak concentration (P = 0.039) compared to those in the basal state. We suggest that the paradoxical inhibitory response to naltrexone in prepubertal boys represents an agonist-like effect of chronic naltrexone administration. This consideration implies that opiate neural pathways are responsive if not highly sensitive to the agonist effect of opiate substances in the prepubertal male. Accordingly, physiological pubertal progression may be accompanied by decreased sensitivity of the hypothalamic gonadostat to the inhibitory effects of opioid peptides. PMID- 3517033 TI - Immunohistochemical localization of prostaglandins E and F2 alpha in the developing murine palate. AB - Prostaglandins E2 and F2 alpha (PGE2 and PGF2 alpha) have been shown to cause changes in adenosine 3',5'-cyclic monophosphate (cAMP) levels in a wide variety of tissues. In particular, murine palatal mesenchyme responds to PGE2 stimulation with dose-dependent increases in intracellular cAMP levels. These same mesenchymal cells also synthesize PGE2 and PGF2 alpha. The purpose of this study is to localize PGE and PGF2 alpha in the developing murine palate by using immunohistochemical techniques. Fresh frozen cryostat sections of murine C57BL/6J embryo palates (days 12-14 of gestation) were incubated with anti-PGE or PGF2 alpha monoclonal antibodies. On day 12 of gestation, PGE and PGF2 alpha, identified as 3',3-diaminobenzidine (DAB) reaction products, were localized throughout palatal mesenchyme and epithelium; on day 13 of gestation, reaction product indicative of both PGE and PGF2 alpha was detectable primarily in mesenchyme subjacent to palatal epithelium. Extracellular spaces of the adjacent mesenchyme in the central region of the day 13 palate exhibited less reaction product. Palatal epithelium, particularly the medial edge epithelium, exhibited a diminished amount of reaction product for both prostaglandins on day 13 as compared to the underlying mesenchyme. After formation of a midline epithelial seam between homologous palatal processes on day 14 of gestation, medial edge, oral, and nasal epithelium exhibited light staining for PGE or PGF2 alpha. Palate mesenchymal cells subjacent to the midline seam exhibited a diminished amount of reaction product for both PGE and PGF2 alpha as compared to day 13 of gestation. Overall, the results show local and temporal changes in the distribution of prostaglandins in the developing murine palate. PMID- 3517034 TI - Comparison of the Quantum II Bacterial Identification System and the AutoMicrobic System for the identification of gram-negative bacilli. AB - The Quantum II Bacterial Identification System (BID; Abbott Laboratories) is a microprocessor-based spectrophotometric system for identification within 4 to 5 h of both enteric and nonenteric gram-negative bacilli. We compared the BID with the AutoMicrobic System (AMS; Vitek Systems, Inc.), using the most recent gram negative identification card and software (AMS-GNI), for the identification of 501 clinical isolates of gram-negative bacilli, including 382 belonging to the Enterobacteriaceae and 119 nonenteric organisms. The API 20E (Analytab Products) was used as the reference system. The BID correctly identified 375 (98.2%) of the Enterobacteriaceae isolates and 111 (93.2%) of the nonenteric isolates; the AMS GNI correctly identified 374 (97.9%) and 115 (96.6%) isolates, respectively. The BID identified all isolates within 5 h, whereas the AMS-GNI identified only 35% within this time period. The BID performed comparably to the AMS-GNI for the identification of most gram-negative bacilli. Simplicity, speed, and relatively low reagent cost make the BID a competitive system for many clinical laboratories. PMID- 3517035 TI - Comparison of monoclonal antibody staining and culture in diagnosing cervical chlamydial infection. AB - We compared a fluorescein-conjugated monoclonal antibody (FA) direct specimen test (MicroTrak; Syva Co., Palo Alto, Calif.) with culture (TC) in McCoy cells (vials, with blind passage and iodine staining of inclusions) for diagnosis of Chlamydia trachomatis infection in the cervix. Duplicate specimens were collected from 1,230 women, but for 262 of these subjects, both results were unavailable (150 FA smears were inadequate, indicating a need for clinical training in specimen collection), leaving 968 comparisons. Prevalence of chlamydiae by culture was 13% (126/968). Compared with TC results, the sensitivity of FA was 70% (88/126) and the specificity was 94% (795/842). There was a 91% agreement (883/968). The predictive value of a positive FA test was 65% (88/135), and that of a negative FA was 95% (795/833). We reexamined 38 smears for which paired results were discrepant, and the reread would have changed the result in only 5 of these. TC is less than 100% sensitive and some FA-positive, TC-negative specimens represent positive specimens not detected by TC. Unfortunately, it is not possible to identify which results in this group are truly false-positive. Clearly, the FA procedure has a performance profile which would make it a useful tool in screening high-risk populations (particularly when TC is not available) but it is less suited to screening low-risk populations, for which false-positive results are more important. The greater utility of the FA procedure in a venereal disease clinic was confirmed by testing 172 evaluable specimen pairs, of which 34 (20%) were Chlamydia isolate positive. The FA sensitivity was 76% (26/34) and specificity was 96% (133/138), giving a predictive value of 84% (26/31) for a positive test. PMID- 3517036 TI - Two-dimensional thin-layer chromatography for the specific detection of hippurate hydrolysis by microorganisms. AB - Glycine, one of the end products of hippurate hydrolysis by microorganisms, was detected by a rapid, specific technique utilizing two-dimensional thin-layer chromatography. A loopful of growth of each organism from its suitable agar medium was washed, suspended, and incubated with 0.1% sodium hippurate for 30 min at 37 degrees C. The supernatant of the incubated suspension from each organism was then dansylated, and the dansyl derivatives were separated by two-dimensional thin-layer chromatography on polyamide sheets. Glycine, a product of hippurate hydrolysis, was detected under UV light. This technique does not require prolonged incubation and was found to be more specific and reliable than the standard ninhydrin reaction. In addition, it is inexpensive and can be easily conducted in a clinical microbiological reference laboratory. By this method, 100% (22/22) of Campylobacter jejuni and 0% (0/9) of Campylobacter coli reference strains were positive. In addition, 100% (13/13) of group B streptococci, 100% (24/24) of group D streptococci, and 90% (18/20) of Gardenerella vaginalis clinical isolates were positive for hippurate hydrolysis. This method is useful for the identification to the species level of Campylobacter organisms and the biotyping of Gardnerella organisms and for the detection of hippurate hydrolysis by unknown microorganisms. PMID- 3517037 TI - Comparison of the MicroScan system with the API Staph-Ident system for species identification of coagulase-negative staphylococci. AB - To evaluate the accuracy of the MicroScan System (American Hospital Supply Corp., Sacramento, Calif.) for identification of coagulase-negative staphylococci, we tested 175 clinical isolates of coagulase-negative staphylococci. The results obtained by the MicroScan system were compared with those of the API Staph-Ident system (Analytab Products, Plainview, N.Y.). Forty-three discrepancies between the two systems were resolved by the conventional method of Kloos and Schleifer (W.E. Kloos and K.H. Schleifer, J. Clin. Microbiol. 1:82-88, 1975). The MicroScan and the Staph-Ident systems correctly identified 146 (86.4%) and 154 (88%) of 175 strains, respectively. The API system failed to identify phosphatase-negative Staphylococcus epidermidis. The MicroScan system demonstrated the greatest accuracy in the identification of S. epidermidis and S. saprophyticus, whereas lesser accuracy was achieved with S. hominis, S. warneri, and S. sciuri. PMID- 3517038 TI - Peromyscus leucopus and Microtus pennsylvanicus simultaneously infected with Borrelia burgdorferi and Babesia microti. AB - Borrelia burgdorferi, the etiologic agent of Lyme disease, and Babesia microti, the causative agent of human babesiosis, were isolated from 71 and 57%, respectively, of 14 specimens of Peromyscus leucopus and Microtus pennsylvanicus collected from Prudence and Patience Islands, R.I. Both pathogens were isolated from five individual rodents. The presence of these two infectious organisms in the same mammal suggests that individual larval Ixodes dammini may ingest both pathogens and subsequently transmit them in the nymphal stage. PMID- 3517039 TI - Inability of the Chemstrip LN compared with quantitative urine culture to predict significant bacteriuria. AB - The Chemstrip LN (Boehringer Mannheim Biochemicals, Indianapolis, Ind.), designed to detect pyuria and bacteriuria, was compared with culture of 1,020 unselected, consecutive midstream urine specimens and evaluated on its ability to predict colony counts at three levels. At the level of greater than or equal to 10(5) CFU/ml, the combined test (detection of leukocyte esterase and nitrite) had sensitivity of 82.3%, specificity of 67.9%, positive predictive value of 41.3%, and negative predictive value of 93.3% at prevalence rate of 21.6%. The test would have rejected 9.4% of the specimens with significant bacteriuria if the Chemstrip alone had been used. PMID- 3517040 TI - Hemadsorption immunosorbent technique for the detection of dengue immunoglobulin M antibody. AB - We developed a highly specific, sensitive, and economical hemadsorption immunosorbent technique for the detection of dengue-specific immunoglobulin M (IgM) antibody. The technique is based on the reaction of human sera with anti human IgM immobilized onto a solid phase followed by the detection of dengue specific IgM by the addition of a known quantity of dengue virus hemagglutinin and goose erythrocytes. Dengue-specific IgM-positive sera showed hemadsorption. IgM antibody specific for dengue virus was detected in 22 of 39 (56%) convalescent-phase sera from primary dengue infections and 8 of 10 (80%) convalescent-phase sera from secondary dengue infections. Additionally, 32 of 76 single sera from patients were positive for dengue IgM; these sera were previously uninterpretable by the hemagglutination inhibition test, as only a single serum specimen was available. No false-positive results were obtained with sera that were negative by the hemagglutination inhibition test for dengue virus. Crude dengue virus hemagglutinin preparations could be used without purification. Dengue-specific IgG did not interfere with the results, nor was there any cross reactivity between dengue hemagglutinins and IgM specific for other viruses. Some cross-reactivity of the dengue-specific IgM was observed with Japanese encephalitis virus hemagglutinins, but this did not present any problems in the interpretation of results. This test is specific, inexpensive, highly reproducible, and simple to perform. PMID- 3517041 TI - Blood-borne pulmonary infection with Nocardia asteroides in a heroin addict. AB - Nocardia asteroides frequently causes primary lung infection with possible hematogenous dissemination to various organs, especially in patients with altered immune responses. The preponderance of pulmonary infections suggests an airborne route of contamination. We report a case of pulmonary nocardiosis in a previously healthy intravenous heroin abuser. The clinical and epidemiologic data strongly suggest a paraphernalia blood-borne infection in this patient, a mode of contamination which has not been previously reported. PMID- 3517042 TI - Isolation of highly encapsulated Cryptococcus neoformans serotype B from a patient in New York City. AB - For the first time, Cryptococcus neoformans serotype B was isolated from a patient in New York City, not a region endemic for B/C serotypes. The isolate was morphologically unusual, with cells several times larger in infected tissue than those characteristic of the yeastlike pathogen. This anomaly may be a problem in the identification of similar isolates. Two serotype differentiation media and a slide agglutination test were used for definitive serotype identification. PMID- 3517043 TI - Characterization of an organism that produces type E botulinal toxin but which resembles Clostridium butyricum from the feces of an infant with type E botulism. AB - The apparent causative organism from the only reported case of type E infant botulism was isolated and characterized. Except for its ability to produce type E botulinal toxin, this organism (strain 5262) would be unquestionably identified as Clostridium butyricum. This is the second time an organism resembling a defined Clostridium species other than a member of the C. botulinum group has been implicated in infant botulism. PMID- 3517044 TI - Fluorescent anti-immunoglobulin G assay of circulating immune complexes extracted with polyethylene glycol. AB - After a polyethylene glycol extraction which removes monomeric immunoglobulin G (IgG), circulating immune complexes were assayed by the FIAX fluorescence assay (Whittaker M. A. Bioproducts, Walkersville, Md.). The extraction portion of the procedure can be completed within a few hours after an overnight precipitation step, and the fluorescence assay takes about 0.5 h. The fluorescence assay is similar to the routine FIAX method for measuring IgG in cerebrospinal fluid except that a 10-microliter sample from sera is substituted for a 50-microliter sample. Good parallelism between endogenous immune complexes, monomeric IgG, and aggregated human globulin, along with good between-run precision (coefficients of variation, less than 10%), indicates that monomeric IgG calibrators from the kit could be used to standardize the assay. This standardization eliminates the need for aggregated human globulin, which is unstable and difficult to prepare. A reference range of 9 to 63 mg/liter followed a gaussian distribution. Correlation data indicate that the test provides information similar to the C1q-binding test (rho = 0.87; n = 30) but has better diagnostic sensitivity and better discrimination in the high range. Because of its simplicity, good reproducibility, and accessibility to equipment available in many laboratories, the method described here may be a preferred technique for measuring circulating immune complexes. PMID- 3517045 TI - An enzyme immunoassay for immunoglobulin M antibodies to Toxoplasma gondii which is not affected by rheumatoid factor or immunoglobulin G antibodies. AB - An enzyme-linked immunosorbent assay (ELISA) for total antibodies to Toxoplasma gondii was modified to measure specific immunoglobulin M (IgM) antibodies. The assay requires three incubation periods totaling 2 h and enzyme-labeled-heavy chain-specific antibodies to human IgM. The objective read-out in absorbance was normalized to percent of a standardized positive control for interpretations. No difference was observed between the assay results with or without previous absorption of the samples by Staphylococcus aureus protein A to remove most of the IgG antibodies. Addition of serum containing very high levels of IgG antibodies to another containing both IgG and IgM antibodies did not change the IgM assay values for the latter. None of the 22 sera containing high levels of IgM rheumatoid factor (RF) gave positive ELISA IgM results, even though 8 of them also had high levels of IgG toxoplasma antibodies. Mixtures of sera containing high concentrations of RF with sera having high levels of IgG toxoplasma antibodies also failed to show any false-positive reactions in the IgM toxoplasma assay. Thus, this ELISA for T. gondii IgM antibodies was not affected by IgG toxoplasma antibodies and RF. PMID- 3517046 TI - Immunologic response of patients with legionellosis against major protein containing antigens of Legionella pneumophila serogroup 1 as shown by immunoblot analysis. AB - Major protein-containing antigens of Legionella pneumophila serogroup 1 were were identified by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and immunoblot analysis with rabbit antisera to 14 different Legionella species or serogroups. Fourteen bands were observed in immunoelectropherograms of whole cell, sonicated cell, and heated cell preparations, seven of which appeared in the supernatant fluid from the heated cells and three of which were shown in an outer membrane fraction. Immunoblots of whole-cell antigen preparations of 14 Legionella species or serogroups revealed seven major Legionella proteins: antigens with molecular weights of 58,000, 79,000, and 154,000 were present in all Legionella sp. strains, antigens with molecular weights of 44,000 and 97,000 occurred in multiple species, and antigens with molecular weights of 14,000 and 25,000 were present only in L. pneumophila strains. All sera from 15 patients with culture-confirmed L. pneumophila serogroup 1 disease and 14 of 18 (78%) sera from serologically diagnosed patients reacted with the 58-kilodalton (kDa) common antigen. In contrast, less than one-half of the sera reacted with the L. pneumophila-specific proteins (14 and 25 kDa). Absorption of sera with Escherichia coli cells had no effect on their reactivity with the 58-kDa antigen, whereas absorption with L. pneumophila serogroup 1 cells removed reactivity. These data suggest that the 58-kDa antigen may prove useful in serodiagnostic tests for legionellosis. PMID- 3517047 TI - Controlled evaluation of the agar-slide and radiometric blood culture systems for the detection of bacteremia and fungemia. AB - A commercially available agar-slide blood culture bottle (Septi-Chek; Roche Diagnostics, Div. Hoffman-La Roche, Inc., Nutley, N.J.) was compared with the radiometric blood culture system (BACTEC; Johnston Laboratories, Inc., Towson, Md.) in 8,544 paired blood cultures from adult patients. The systems were inoculated with equal volumes (10 ml) of blood. Overall, there was no statistically significant difference between the two systems in the recovery of clinically important microorganisms, but significantly more members of the family Enterobacteriaceae other than Escherichia coli were detected by the agar-slide system (P less than 0.005). The agar-slide system detected more fungi, and the BACTEC detected more anaerobic bacteria; however, small numbers of recovered organisms precluded statistical significance. When microorganisms grew in both systems, their presence was detected one or more days earlier in the BACTEC (P less than 0.001). More contaminants grew in the agar-slide system (P less than 0.001). Both systems performed well, and either system should provide high yield and prompt detection of positive blood cultures in patients with bacteremia and fungemia if used in an optimal way as recommended by the respective manufacturers. PMID- 3517048 TI - Analysis of epidemiologic markers of nosocomial Serratia marcescens isolates with special reference to the Grimont biotyping system. AB - Seventy-one strains of Serratia marcescens obtained from hospitalized patients of the Instituto Nacional de la Nutricion in Mexico City and two Virginia hospitals (University of Virginia Medical Center and Norfolk General Hospital) were analyzed to find markers useful for the epidemiologic investigation of outbreaks with this organism. Biotyping with commercial microwell systems (API 20# system [Analytab Products, Plainview, N.Y.] and DMS Rapid NFT [DMS Laboratories, Inc., Flemington, N.J.]) was not useful. Biotyping with the system designed by Grimont (assimilation tests, pigment production, and the ability to reduce tetrathionate broth) was helpful to characterize all strains. Of the 37 Mexican strains, 36 belonged to biogroup A 5/8 and 32 were biotype A8b. The 34 strains from the Virginia hospitals were distributed among six different biogroups and 12 biotypes. Significant differences in antimicrobial susceptibility (50% MIC, microgram/ml) between Mexican and Virginia strains were seen with carbenicillin (256 versus 8), piperacillin (64 versus 4), amikacin (16 versus 2), gentamicin (2 versus 0.5), and tobramycin (16 versus 2). Some Mexican strains showed variability in the susceptibility to amikacin because they were low producers of 6'-N-acetyltransferase type I. The Mexican strains seemed to come from a hospital with cross-infection problems because most were isolated from urine, were multiresistant, and more nonpigmented; in contrast, the strains isolated at University of Virginia Medical Center represent the experience of a hospital with scattered S. marcescens infections. The Grimont biotyping scheme is a useful epidemiologic tool for the clinical microbiologist. PMID- 3517049 TI - Characterization and evaluation of monoclonal antibodies developed for typing influenza A and influenza B viruses. AB - Monoclonal antibodies that are broadly reactive with influenza A or influenza B viruses were produced as stable reagents for typing influenza viruses. Monoclonal antibodies to influenza A were specific for either matrix protein or nucleoprotein. The antibodies to influenza B were specific for nucleoprotein or hemagglutinin protein. In an enzyme immunoassay procedure, influenza A antibodies detected H1N1, H2N2, and H3N2 influenza A virus strains collected between 1934 and 1984. Each of the influenza B antibodies detected influenza B reference viruses collected between 1940 and 1984. Pools of either influenza A or influenza B monoclonal antibodies were used to detect influenza viruses reisolated from clinical specimens in tissue culture. At 48 h after inoculation, the influenza A monoclonal antibodies detected 64% of H1N1 and 94% of H3N2 influenza A specimens, and the influenza B monoclonal antibodies detected 79% of the influenza B specimens. The results of this study suggest that the monoclonal antibodies described should provide useful diagnostic reagents for workers in virology laboratories who wish to isolate and identify influenza virus but have been unable to obtain consistent supplies of animal sera specific for influenza A or B viruses. PMID- 3517050 TI - Critical evaluation of the AutoMicrobic system gram-negative identification card for identification of glucose-nonfermenting gram-negative rods. AB - During a 6-month study we critically evaluated the accuracy of the AutoMicrobic system Gram-Negative Identification Card (Vitek Systems, Inc., Hazelwood, Mo.) in identifying glucose-nonfermenting gram-negative bacilli by testing 419 selected isolates in parallel with a conventional reference method. Of 356 isolates included in the AutoMicrobic system profile, a total of 307 (86.2%) were correctly identified, 36 (10.1%) were not identified, and 13 (3.7%) were misidentified. Fifty-eight of 63 (92%) isolates not included in the profile were correctly reported as "unidentified organisms." Overall, if the first-choice identification was always accepted, only 18 (4.3%) isolates would have been incorrectly reported. When first-choice identifications appended with the special message "questionable biopattern" were rejected, and organisms were screened for characteristic odor and antimicrobial susceptibility before final acceptance of the AutoMicrobic system report, the number of misidentifications was reduced to 5 (1.2%). The average time to identification with the AutoMicrobic system Gram Negative Identification Card was 15 h. This compares favorably with the 65 h required by the reference method. PMID- 3517052 TI - Evaluation of chlamydiazyme for the detection of genital infections caused by Chlamydia trachomatis. AB - Chlamydiazyme is a 4-h enzyme-linked immunoassay that detects an antigen of Chlamydia trachomatis directly in clinical specimens. This immunoassay was compared with cell culture for the diagnosis of chlamydial infections of the genital tract. The assay was evaluated at five clinics with a total of 1,277 cervical specimens of which 239 were culture positive. At three of these clinics where urethral samples were taken from males, 99 of 363 samples were culture positive. The sensitivity of the assay averaged 89.5% for detecting cervical infections and 78.8% for detecting male urethral infections. Specificity was 97.0% when samples from either males or females were tested. Some patients who were culture negative were infected with chlamydiae according to both Chlamydiazyme and a monoclonal antibody test that detected a chlamydial antigen distinct from the antigen detected by Chlamydiazyme. If the 15 females and 2 males who were positive by both immunoassays but culture negative were considered positive for chlamydial infection, the specificity of the assay was 98.4% in females and 97.7% in males. Chlamydiazyme is a simple and relatively rapid immunoassay that has sufficient sensitivity and specificity to supplant culture in the detection of genital chlamydial infections. PMID- 3517051 TI - Results of a survey of antifungal susceptibility tests in the United States and interlaboratory comparison of broth dilution testing of flucytosine and amphotericin B. AB - In a survey of 350 laboratories, 41 of 210 respondents indicated that they performed antifungal susceptibility tests. Two-thirds performed 20 or fewer tests per year, and most used a broth dilution method to test amphotericin B and flucytosine activity against Candida albicans. The broth dilution procedure of S. Shadomy and A. Espinel-Ingroff (p. 647-653, in E.H. Lennette, ed., Manual of Clinical Microbiology, 3rd ed., 1980) was the method most frequently cited, and therefore this method was used to test the susceptibility of five isolates of C. albicans and one of Saccharomyces cerevisiae to amphotericin B and flucytosine in seven research laboratories. Agreement among replicates performed on the same day by each laboratory was excellent for both drugs, all values being within 1 twofold drug dilution. Precision from week to week for each laboratory was also good, with 95 and 92% of values being within 1 drug dilution for amphotericin B and flucytosine, respectively. Interlaboratory precision, however, was poor. For amphotericin B, values varied 8- to 32-fold, and for flucytosine, they varied 32- to greater than 512-fold. We conclude that antifungal susceptibility testing is currently being performed in small volumes by numerous laboratories in the United States and that results from one laboratory may not agree with results from another. Improved standardization of fungal susceptibility tests is necessary before their results can be generally applied to clinical situations. PMID- 3517053 TI - Addi-Chek filtration, BACTEC, and 10-ml culture methods for recovery of microorganisms from dialysis effluent during episodes of peritonitis. AB - The Addi-Chek (filtration; Millipore Corp., Bedford, Mass.) and BACTEC (radiometric detection of growth in culture media; Johnston Laboratories, Inc., Towson, Md.) systems were compared with the 10-ml culture (centrifugation) method for the recovery of microorganisms from peritoneal dialysate collected from patients with clinical evidence of peritonitis and containing greater than or equal to 200 leukocytes per mm3. Both alternate methods were comparable, and results were not significantly different from those of the conventional 10-ml culture method. All systems were adversely affected in their capacity to recover organisms when dialysates had been collected during periods of antimicrobial therapy. PMID- 3517054 TI - Plasmid profile analysis in epidemiological studies of animal Salmonella typhimurium infection in Japan. AB - Plasmid profiles were investigated in 65 isolates of Salmonella typhimurium derived from animal outbreaks during the period of 1978 through 1983 in Japan. Incidence of plasmids, drug-resistance, and conjugative R plasmids were extraordinarily high in these isolates. This high incidence reflects the prophylactic and therapeutic use of antibiotics. Most isolates from diseased animals, cohabiting animals, and each farm showed the same or similar plasmid patterns. However, there was a difference in plasmid patterns within strains isolated from each of several animals. It may be that one or two plasmids were introduced or deleted in these strains, leading to the difference discerned in strains isolated from the same animal. It was also shown that during one epidemic, two strains of S. typhimurium were involved that could be distinguished by plasmid profile analysis. Our conclusion is that when S. typhimurium strains isolated from animals reared in limited areas exhibit identical or similar plasmid patterns, they are derived from the same source and that when strains isolated in a limited area exhibit quite a different plasmid pattern, these strains are derived from independent sources. PMID- 3517055 TI - Comparison of Gram stain and Nomarski optics for screening sputum specimens before culture. AB - Although the Gram stain is usually used to screen sputum specimens prior to culture, wet mount observation with Nomarski optics has been suggested as a useful alternative. We compared the two methods and found that more specimens were rejected by the Gram stain technique without eliminating any that yielded important clinical information. PMID- 3517056 TI - Immunoblot analysis of the serological response in invasive Trichosporon beigelii and Blastoschizomyces capitatus infections. AB - The serological response to Trichosporon sp. was examined by the immunoblot technique. Antibodies to a range of antigens (200 to 16 kilodaltons) were detectable in three patients with invasive Trichosporon beigelii or Blastoschizomyces capitatus infections and 10 uninfected controls. High levels of preexisting antibodies may contribute to the rarity of systemic infections. PMID- 3517057 TI - Occurrence and pathogenic role of Morganella-Proteus-Providencia group bacteria in human feces. AB - A total of 2,693 fecal specimens, with 1,422 from healthy persons and 1,271 from patients suffering from enteric diseases, was investigated to isolate species of the Morganella-Proteus-Providencia group and to evaluate the role of these bacteria in intestinal disorders. Most strains were isolated from two media, i.e., blood agar and tryptophan agar. Two of the species were more frequently found in diarrheal cases than in healthy controls. These species were Morganella morganii and Proteus mirabilis. Two new species of Enterobacteriaceae, i.e., Proteus penneri and Providencia rustigianii, were found in 33 and 5 people, respectively. However, these two species were not found more frequently in the diarrheal cases. PMID- 3517058 TI - Seroepidemiology of Klebsiella bacteremic isolates and implications for vaccine development. AB - The frequencies of capsular serotypes among 703 Klebsiella strains isolated from the blood of hospitalized patients were determined. More than 90% of the isolates were typeable, with 69 of the 77 known serotypes being identified. Serotypes 2, 21, and 55, representing 8.9, 7.8, and 4.8% of all the isolates, respectively, were observed at a frequency significantly higher (P less than 0.05) than that for other capsular serotypes. Approximately 43% of the serotypes appeared at a frequency of less than 0.5%. Differences were found when the seroepidemiology of North American and European isolates was compared. The current findings indicate that a capsular polysaccharide-based vaccine against Klebsiella organisms is feasible and should be multivalent, eliciting antibodies directed against the 25 serotypes which make up approximately 70% of all the bacteremic isolates. PMID- 3517059 TI - In vitro and in vivo study of stone formation by Corynebacterium group D2 (Corynebacterium urealyticum). AB - Corynebacterium group D2 inoculated into normal human urine formed struvite crystals and an increase in pH and ammonium concentration after 24 h of incubation. Zinc disks dipped into a broth culture of this microorganism and inserted into the bladders of rats produced stones with a mean weight of 12.5 mg (ranging from 1 to 57.7 mg) after 12 days. Analysis of the infrared spectrum determined the stones to be composed of struvite. From these results its seems that stone formation by Corynebacterium group D2 may be possible both in vitro and in vivo, which may confirm a previous report involving these bacteria in human clinical encrusted cystitis. PMID- 3517060 TI - Performance characteristics of a commercially prepared biphasic blood culture bottle. AB - A biphasic blood culture bottle (BiPB: GIBCO Laboratories, North Andover, Mass.) with an architectural design that physically separates the agar slant from the broth was compared with a conventional vented monophasic bottle (MPB-A) for use in the routine culture of blood. Both bottles contained tryptic soy broth. Tryptic soy agar was used for the BiPB slant. A third unvented bottle (MPB-N) with Columbia broth was included as part of the blood culture set. Of 3,537 sets collected, 444 were positive; 57 of these 444 sets were positive by virtue of an exclusively positive anaerobic bottle. Both BiPB and MPB-A were positive in 235 of the remaining 387 positive sets. A total of 521 isolates was recovered during the study. Of these isolates, 252 were recovered in both the BiPB and the MPB-A from the same set; 105 isolates grew in the BIPB but not in MPB-A, 95 isolates grew only in the MPB-A but not in BiPB, and 69 grew exclusively in the MPB-N. The BiPB allowed more rapid recovery of Candida spp., J-K diphtheroids, Pseudomonas spp. Making BiPB subcultures was easy enough to permit both early and daily subculture, which provided isolated colonies sooner than could be done by using the MPB-A. Isolated colonies and, therefore, identification and susceptibility results were available at least 1 day earlier for the BiPB isolates in approximately 50% of instances when both the BiPB and the MPB-A were positive. Staphylococcus epidermidis and streptococci were recovered more frequently in the BiPB, while gram-positive anaerobes were detected at a significantly (P less than 0.025) more frequent rate in the MPB-A than in the BiPB. Either bottle, however, should be used in conjunction with an anaerobic bottle for optimal recovery of anaerobic bacteria. PMID- 3517061 TI - Feasibility of same-day identification of members of the family Vibrionaceae by the API 20E system. AB - Sixty isolates, comprising nine species of the family Vibrionaceae, were tested with the API 20E 5-h same-day procedure (Analytab Products, Plainview, N.Y.). Included were 27 Aeromonas hydrophila isolates, 10 Aeromonas sobria isolates, 7 Aeromonas caviae isolates, 3 Plesiomonas shigelloides isolates, 3 Vibrio alginolyticus isolates, 3 Vibrio cholerae isolates, 1 Vibrio fluvialis isolate, 5 Vibrio parahaemolyticus isolates, and 1 Vibrio vulnificus isolate. The 5-h profile numbers were specific for the five Vibrio species and the Plesiomonas isolates. The three Aeromonas species shared seven 5-h profile numbers. Of the 63 5-h profile numbers generated by testing each isolate twice, 22 were identical to those found in the overnight analytical profile index. Of these, 20 were correct identifications, and two were incorrect. The remaining 41 5-h profile numbers were not found in the overnight analytical profile index. Because the 5-h analytical profile index does not contain any oxidase-positive organisms, the oxidase value was subtracted from the 63 5-h profile numbers to determine whether misidentifications could occur if the oxidase test was either not performed or not performed correctly. Only five of these factored profile numbers resulted in a possible misidentification. It is feasible, within limitations, to use the 5-h API 20E same-day procedure to identify the more commonly occurring members of the Vibrionaceae. The manufacturer should develop a data base for this purpose. PMID- 3517062 TI - Evaluation of an enzyme immunoassay for the diagnosis of chlamydial infections in urogenital specimens. AB - A total of 194 male urethral and 402 cervical specimens were obtained from patients at the venereal disease outpatient clinic of University Hospital, Rotterdam, The Netherlands, to evaluate the IDEIA test (Boots Celltech) for the detection of chlamydial infections. The prevalences of culture-positive males and females were 17.5 and 8.2%, respectively. The respective overall sensitivities and specificities found were 67.6 and 93.7% for the males and 63.6 and 93.8% for the females. The highest sensitivity (83.3%) was found in male patients with more than 20 leukocytes per field in the sediment of the first-voided urine (magnification, X250) and in women with more than 10 leukocytes per field in a cervical Gram stain (magnification, X800). However, in men without urethritis and in women with fewer than 10 leukocytes per field in the Gram stain, sensitivities of 44.4 and 40%, respectively, were found. Culture-positive, IDEIA-negative results were predominantly observed in samples with few inclusions in the culture. PMID- 3517063 TI - Effect of inoculum size on ampicillin and amoxycillin susceptibility determined by gas-liquid chromatography for members of the family Enterobacteriaceae. AB - Inoculum size had only a small effect on the results for ampicillin and amoxycillin susceptibility testing of Escherichia coli. In contrast, a difference in inoculum size from 10(6) to 10(8) CFU/ml profoundly affected the results for ampicillin and amoxycillin susceptibility testing of Proteus mirabilis, causing a change from susceptibility to complete resistance. These different effects of inoculum size were observed both when susceptibility was determined by the suppression of a characteristic metabolic product analyzed by head-space gas liquid chromatography (HS-GLC) and when it was determined by MIC testing in broth. Inoculum size affected the results for ampicillin susceptibility of P. mirabilis determined concurrently with the rapid HS-GLC urine test, because 10(8) CFU/ml may occur in urine specimens. In the rapid test, significant numbers of Escherichia, Klebsiella, Citrobacter, Proteus, Morganella, and Providencia spp. in urine specimens are detected within 4 h by HS-GLC analysis for characteristic metabolic products in cultures. Most P. mirabilis in urine specimens appeared to be ampicillin resistant in the rapid HS-GLC test but were reported to be ampicillin susceptible in hospital laboratory agar dilution tests 2 days later. However, ampicillin susceptibility results for Escherichia, Klebsiella, and Citrobacter spp. agreed with hospital laboratory reports. It was concluded that reports of ampicillin susceptibility or resistance for the commonest cause of urinary tract infections, E. coli, within 4 h of receipt of the specimen would be clinically valuable and that a provisional report of ampicillin resistance for P. mirabilis would not lead to ineffective therapy. PMID- 3517064 TI - Development of a standardized subgrouping scheme for Legionella pneumophila serogroup 1 using monoclonal antibodies. AB - A panel of monoclonal antibodies to Legionella pneumophila serogroup 1 and a subclassification scheme were developed in a collaborative project among three laboratories. The seven most useful monoclonal antibodies were selected from three previously developed panels on the basis of indirect fluorescent antibody patterns with 83 strains of L. pneumophila serogroup 1 that were obtained from widely distributed geographic locations. The isolates were divided into 10 major subgroups on the basis of reactivity patterns that can be readily reproduced in any laboratory and are not subject to major inconsistencies of interpretation of staining intensity. A standard protocol for the indirect fluorescent antibody procedure was also developed. PMID- 3517065 TI - Differences in antibody responses with rapid agglutination tests for the detection of rubella antibodies. AB - Rapid agglutination tests (Rubaquick, Rubascan, and Rubacell) were used to screen sera (374 from immune and 124 from susceptible patients) for rubella immunity. Compared with enzyme immunoassay (Rubazyme) the erythrocyte agglutination assays (Rubaquick and Rubacell) were greater than 98% sensitive and 92 to 96% specific. The latex test (Rubascan) was sensitive (97.8%) and specific (96.8%) on undiluted serum but only 68.7% sensitive on serum diluted 1:10. Although the three rapid assays detected a substantial number of positive sera within 3 months of rubella immunization, a large number of variable responses were seen after infection with rubella. Analysis of discordant results suggests that these tests may be effectively used for immunity screening. The different individual assay results observed on low-titered sera or blood collected shortly after infection or immunization may not be comparable, because each assay has a different antigenic component on the agglutinin. PMID- 3517066 TI - Sodium and water balance in chronic congestive heart failure. AB - As the characteristics of sodium and water balance in heart failure remain undefined, we evaluated the hemodynamic, metabolic, and hormonal effects of balanced sodium intake in 10 patients with chronic congestive heart failure. We discontinued diuretics to avoid their confounding influence, and all patients received 1 wk of 10 meq and 100 meq balanced sodium intake and controlled free water. Comparing sodium intake of 10 with 100 meq, the following observations were made. There was weight gain (2.0 kg) and increased sodium excretion (11 +/- 3 to 63 +/- 15 meq/24 h), unaccompanied by increase of blood volume. Both renin angiotensin system and sympathetic nervous system activity were greater during the 10 meq diet, and suppressed with the 100 meq sodium diet. For both diets, plasma renin and urinary aldosterone excretion were correlated with urinary sodium excretion (r = -0.768, r = -0.726, respectively; P less than 0.005). Systemic hemodynamics were minimally changed with increased sodium intake. However, reversal of vasoconstriction by captopril during the 10 meq diet, and its ineffectiveness during the 100 meq diet, indicated a renin-dependent mechanism in the former, and a renin-independent mechanism in the latter diet. There were two subgroups of response to the 100 meq diet: one group (n = 5) achieved neutral balance, while the second (n = 5) avidly retained sodium and water. Renin-angiotensin system activity was significantly higher in the latter group, and the mechanism for differences in sodium excretion for the subgroups could not be identified by blood volume or hemodynamic parameters. Orthostatic hypotension during tilt was greater during the 10 meq sodium diet, and in all cases, related to ineffective hemodynamic and hormonal compensatory responses. PMID- 3517067 TI - Postprandial hyperglycemia in patients with noninsulin-dependent diabetes mellitus. Role of hepatic and extrahepatic tissues. AB - Patients with noninsulin-dependent diabetes mellitus (NIDDM) have both preprandial and postprandial hyperglycemia. To determine the mechanism responsible for the postprandial hyperglycemia, insulin secretion, insulin action, and the pattern of carbohydrate metabolism after glucose ingestion were assessed in patients with NIDDM and in matched nondiabetic subjects using the dual isotope and forearm catheterization techniques. Prior to meal ingestion, hepatic glucose release was increased (P less than 0.001) in the diabetic patients measured using [2-3H] or [3-3H] glucose. After meal ingestion, patients with NIDDM had excessive rates of systemic glucose entry (1,316 +/- 56 vs. 1,018 +/- 65 mg/kg X 7 h, P less than 0.01), primarily owing to a failure to suppress adequately endogenous glucose release (680 +/- 50 vs. 470 +/- 32 mg/kg X 7 h, P less than 0.01) from its high preprandial level. Despite impaired suppression of endogenous glucose production during a hyperinsulinemic glucose clamp (P less than 0.001) and decreased postprandial C-peptide response (P less than 0.05) in NIDDM, percent suppression of hepatic glucose release after oral glucose was comparable in the diabetic and nondiabetic subjects (45 +/- 3 vs. 39 +/- 2%). Although new glucose formation from meal-derived three-carbon precursors (53 +/- 3 vs. 40 +/- 7 mg/kg X 7 h, P less than 0.05) was greater in the diabetic patients, it accounted for only a minor part of this excessive postprandial hepatic glucose release. Postprandial hyperglycemia was exacerbated by the lack of an appropriate increase in glucose uptake whether measured isotopically or by forearm glucose uptake. Thus as has been proposed for fasting hyperglycemia, excessive hepatic glucose release and impaired glucose uptake are involved in the pathogenesis of postprandial hyperglycemia in patients with NIDDM. PMID- 3517068 TI - Studies of the human liver insulin receptor in noninsulin-dependent diabetes mellitus. AB - The insulin binding characteristics and the structural components of the insulin receptor were studied in the purified liver plasma membranes from seven patients with noninsulin-dependent diabetes (NIDDM) and seven control subjects. In comparison to the controls, diabetic subjects had a 65% reduction in plasma insulin levels in response to an oral glucose load. Specific insulin binding by liver membranes from diabetic patients was, however, twofold greater than the binding activity by membranes from control subjects. This alteration resulted largely from an increase in the number of insulin receptors and a modest increase in receptor binding affinity. Holo (nonreduced) receptor species of similar molecular weights were detected by an affinity labeling technique in the two membrane preparations and sulfhydryl reduction demonstrated an insulin binding subunit of 125,000 mol wt. Overall, these results show that the hepatic insulin resistance of NIDDM cannot be explained by a deficiency in insulin binding. PMID- 3517069 TI - Reflections on caring for Indochinese children and youths. PMID- 3517071 TI - Strongyloides stercoralis hyperinfestation syndrome with Escherichia coli meningitis: report of two cases. AB - Two cases of Strongyloides stercoralis hyperinfestation syndrome accompanied by Gram negative bacteraemia and meningitis were studied. Both occurred in non immunosuppressed West Indian women. PMID- 3517072 TI - Interactions between polymorphonuclear leucocytes, Bacteroides sp, and Escherichia coli: their role in the pathogenesis of mixed infection. AB - Five Bacteroides fragilis strains and five Bacteroides vulgatus strains were compared with regard to their ability to consume complement and to fix C3, their killing by polymorphonuclear leucocytes, and their ability to inhibit the bactericidal effect of serum and polymorphs on Escherichia coli strains. Complement consumption was positively related to C3 fixation, but no relation was observed between these variables and the killing of the anaerobes. Greatest inhibition of the killing of E coli by serum and polymorphs was achieved with the bacteroides strains that fixed most complement. The greater virulence of B fragilis in mixed infections with E coli was not reflected either by a greater ability to inhibit the killing of E coli or a greater resistance of the anaerobes themselves to the bactericidal effect of serum and polymorphs. PMID- 3517070 TI - Campylobacter pyloridis, gastritis, and peptic ulceration. AB - Campylobacter pyloridis is a spiral bacterium which was seen by histopathologists several years before it was cultured in 1982 in Perth, Western Australia. It has unique cellular fatty acids, predominantly tetradecanoic acid and cis-11, 12 methylene octadecanoic acid. It also has a unique ultrastructure which is different from that of other campylobacters. C pyloridis possesses a powerful urease enzyme and produces large amounts of extracellular catalase. Both these features may be important virulence factors, allowing it to occupy a protected niche in the stomach below the mucus layer but above the gastric mucosa. Specific lesions are found in the gastric mucosa, and ultrastructural studies show the presence of adherence pedestals identical with those found with enteropathogenic Escherichia coli of the intestine. Histological examination of gastric biopsy tissue has shown that C pyloridis is strongly associated with active chronic gastritis, when polymorphonuclear leucocytes are present, and is not found on normal mucosa except when a biopsy specimen from elsewhere in the stomach shows active chronic gastritis. When patients with symptoms caused by gastritis are identified dual antibacterial treatment, combining the action of bismuth in the stomach with a systemic antibiotic, can eradicate C pyloridis, with remission of symptoms and restoration of normal epithelial morphology. Most peptic ulcers relapse after modern acid reducing treatment, and antibacterial treatment may be beneficial in preventing relapse. PMID- 3517073 TI - Scaling and root planing with and without periodontal flap surgery. AB - Complete removal of calculus is a primary part of achieving a "biologically acceptable" tooth surface in the treatment of periodontitis. Rabbani et al. reported that a single episode of scaling did not completely remove subgingival calculus and that the deeper the periodontal pocket, the less complete the calculus removal. The purpose of the present study was to evaluate the effectiveness of scaling relative to calculus removal following reflection of a periodontal flap. Each of 21 patients who required multiple extractions had 2 teeth scaled, 2 teeth scaled following the reflection of a periodontal flap, and 2 teeth serve as controls. Local anesthesia was used. Following extraction, the % of subgingival tooth surfaces free of calculus was determined using the method described by Rabbani with a stereomicroscope. Results showed that while scaling only (SO) and scaling with a flap (SF) increased the % of root surface without calculus, scaling following the reflection of a flap aided calculus removal in pockets 4mm and deeper. Comparison of SO versus SF at various pocket depths for % of tooth surfaces completely free of calculus showed 1 to 3 mm pockets to be 86% versus 86%, 4 to 6 mm pockets to be 43% versus 76% and greater than 6 mm pockets to be 32% versus 50%. The extent of residual calculus was directly related to pocket depth, was greater following scaling only, and was greatest at the CEJ or in association with grooves, fossae or furcations. No differences were noted between anterior and posterior teeth or between different tooth surfaces. PMID- 3517074 TI - In vitro effectiveness of dental floss in plaque removal. AB - This study was designed to determine whether there was any measurable difference in the effectiveness of bacterial plaque removal between 4 commercially available dental flosses. By means of a highly standardized and controlled in vitro experimental model technique utilizing 50 freshly extracted third molars, the possibility of intra- and inter-individual variability was eliminated. Each tooth was individually mounted in a formatray block and the surface was finished to either a "planed" or "unplaned" surface configuration. The "planed" root surface (dentin) was achieved by using 600 grit wet-sandpaper for tooth surface reduction while the "unplaned" root surface was achieved by using 600 gift wet-sandpaper. The teeth were then individually processed to effect the growth of bacterial plaque (S. mutans) on the prepared surfaces. Each tooth was subsequently disclosed, flossed and photographed without interruption. The flossing was carried out on a flossing machine utilizing a controlled force of 50 g. A controlled direction of the stroke perpendicular to the long axis of the tooth, and a controlled frequency of flossing (2 strokes per trial) was used. The results of the clinical trials were evaluated utilizing Ektachrome slides of the previously flossed and disclosed tooth surfaces. The photographs were projected, measured, and statistically analyzed (Student t-test and paired t-test) for the effectiveness of plaque removal of the 4 dental flosses and the effect of root surface roughness on the ability of the flosses to remove bacterial plaque. It was found that on smooth, "planed" root surfaces, there were no measurable difference among the 4 flosses.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3517075 TI - The effects of a simplified oral hygiene regime plus supragingival irrigation with chlorhexidine or metronidazole on chronic inflammatory periodontal disease. AB - This study compared a simplified oral hygiene regime (scaling, root planing and Bass brushing) with this same regime plus 0.02% chlorhexidine (CH), 0.05% metronidazole (MD) and inactive control (PL) solutions delivered supragingivally by a pulsating water jet irrigator. 22 patients were distributed randomly into 3 groups, 0.02% chlorhexidine (CH), 0.05% metronidazole (MD), and inactive control (PL). Approximal surfaces with associated pockets greater than or equal to 4 mm were monitored at day 0, for plaque index (PII), gingival index (GI), sulcus bleeding index (SBI), baseline measurement for gingival shrinkage and probable pocket depth. All monitored surfaces were then immediately scaled and root planed. All patients received identical oral hygiene instruction (Bass brushing), with a sodium fluoride toothpaste and a multituft toothbrush, and were shown how to use the oral irrigator. Proficiency in use of the oral irrigator was checked again at day 7. No interdental cleaning was taught. The active treatment period was 28 days. Patients were seen at days 7, 28, 56 and 84, and all parameters were recorded at each visit, but no further oral hygiene instruction was given. Within procedure comparisons of the findings at days 28 (end of active treatment) 56 and 84 with those at day 0, showed statistically highly significant improvements in all parameters for all groups. Regarding between procedure comparisons, CH was better in reducing PII at all times except at day 84, and on several occasions in reducing GI and SBI. Irrigated groups were always better than nonirrigated groups. Although the differences were statistically highly significant, clinically the differences between groups were relatively small, except for CH effect on PII.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3517076 TI - The influence of pindolol and hydrochlorothiazide on blood pressure, and plasma renin and plasma lipid levels. AB - After three weeks' administration of placebo, three groups of eight patients with moderate hypertension were randomly assigned to single daily dose, double-blind treatment with either pindolol 15 mg, hydrochlorothiazide 50 mg, or a combination of both for eight weeks. All determinations were made 24 hours after ingestion of a dose. Reductions in supine, sitting, and standing systolic and diastolic blood pressure were greater in patients receiving hydrochlorothiazide than in those administered pindolol; however, the greatest reductions were registered in individuals receiving combination therapy. Mean basal plasma renin activity rose significantly from 0.45 +/- 0.44 to 1.42 +/- 1.31 ng/mL/hr and from 0.67 +/- 0.46 to 1.27 +/- 0.83 ng/mL/hr in patients receiving hydrochlorothiazide and combination therapy, respectively, but there was no change in those administered pindolol. Hydrochlorothiazide and combination therapy increased mean total cholesterol levels from 247 +/- 25 to 263 +/- 37 mg/dL and 198 +/- 36 to 211 +/- 33 mg/dL, respectively, at eight weeks, and both increased mean triglyceride concentrations at two weeks. Pindolol did not show any tendency to alter lipid levels. Pindolol should be given twice daily. At 15 mg daily, it has little or no effect on basal plasma renin activity or plasma lipid levels. PMID- 3517077 TI - Pharmacokinetics of captopril in elderly healthy male volunteers. AB - The pharmacokinetics of captopril were studied in 12 healthy male volunteers aged 65 to 76 years, who each received a single 100-mg oral dose. Blood and urine samples were collected over a 24-hour period, and assayed for unchanged captopril (CAP), S-methylcaptopril (Me-CAP, plasma concentrations from 2 subjects only), and total captopril levels (TOT, a mixture of CAP and its dimer and mixed disulfides with endogenous thiol-containing compounds such as glutathione and cysteine). Mean values for the maximum concentration (Cmax) were 803 and 66.3 ng/mL for CAP and Me-CAP, respectively. Mean time to maximum concentration (tmax) was determined as 1.0, 1.4, and 1.0 for CAP, TOT, and Me-CAP, respectively. Mean areas under the plasma concentration-time curve (AUC) were 1,394 hr-ng/mL (CAP, 0 8 hr) and 17,316 hr-ng/mL (TOT, 0-24 hr). The mean estimated half-life (t 1/2) for CAP was 1.4 hr, and its renal clearance was 187 mL/hr/kg. Mean urinary excretion over 24 hr was 20.8 and 53.1 for CAP and TOT, respectively. Cmax, and AUC for CAP were 9% less and 13% greater, respectively, than in a historical control group of 18-35-year-old men, treated in the same clinic, by the same personnel, using the same analytic procedures, whereas the 24-hour urinary excretion was 25% lower and eight-hour renal clearance 36% lower in the older population. Since the values for Cmax, AUC, and t 1/2 were similar in the two populations, it does not appear that the pharmacokinetics of CAP are altered markedly with age alone. PMID- 3517078 TI - Cyclosporine concentration determinations for monitoring and pharmacokinetic studies. AB - The availability of the immunosuppressant cyclosporin has led to significant improvements in the recent success of clinical organ transplantation. Problems associated with cyclosporine therapy include serious adverse reactions, such as nephrotoxicity, wide variability in the drug's pharmacokinetics, and several complex drug interactions. Monitoring of drug concentrations is accepted as a part of the routine care of patients receiving cyclosporine. However, cyclosporine concentrations can be determined in different biologic fluids by either radioimmunoassay or high-performance liquid chromatographic techniques. Controversy exists regarding the optimal analytic technique to be used for cyclosporine monitoring and pharmacokinetic studies. This commentary addresses factors including: why the monitoring of cyclosporine concentrations is important, the differences between the biologic fluids and analytic techniques, when monitoring and special pharmacokinetic studies are indicated, what some major transplant centers have established as a "therapeutic range" for cyclosporine concentrations, and provides guidelines for the optimal clinical monitoring of cyclosporine concentrations. PMID- 3517079 TI - Cyclosporine blood concentrations determined by specific versus nonspecific assay methods. AB - Cyclosporine blood concentrations were simultaneously determined by radioimmunoassay (RIA) and high-performance liquid chromatography (HPLC) at multiple points in time in two patients receiving cyclosporine for immunosuppression following liver transplantation. Radioimmunoassay levels always exceed those determined by HPLC; however, the divergence between the two methods increased as serum bilirubin concentration increased, with HPLC:RIA ratios generally less than 0.3 when serum bilirubin concentrations exceeded 10.0 mg/dL. These preliminary results suggest that retention of immunoactive cyclosporine metabolites due to imparied liver function may account for RIA-determined cyclosporine concentrations that greatly exceed those measured by HPLC. PMID- 3517081 TI - Pharmacokinetic and pharmacodynamic interactions between caffeine and diazepam. AB - The pharmacokinetic and dynamic interactions of caffeine and diazepam after single doses were investigated in six young healthy adults. Subjects received 6 mg/kg of caffeine, 0.3 mg/kg of diazepam, and their combination at 2-week intervals according to a Latin square design and a double-blind procedure. Subjects had blood samples withdrawn at 0, 5, 10, 20, 30, 45, 60 minutes and every 30 minutes thereafter until 210 minutes after treatment. A battery of behavioral tests were administered before treatment and after each blood sampling, starting with the 20-minute period. The coadministration of caffeine with diazepam resulted in a 22% reduction in diazepam plasma levels. Caffeine produced hand tremors and diazepam produced sedation and impaired memory and cognition. The two drugs did not antagonize the effects of each other except in the symbol cancellation task. There were significant correlations between the caffeine and diazepam plasma levels and performance on several tasks and evidence for the development of acute tolerance to both drugs. PMID- 3517080 TI - Pharmacologic induction of cholinergic system up-regulation and supersensitivity in affective disorders research. AB - Phenomenological, physiological, biochemical, and receptor binding measures are useful as dependent variables in affective disorders research. Abnormalities of these measures can result from up-regulation and supersensitivity of cholinergic systems and disturbances of cholinergic-monoaminergic interaction. These deviations are safely and inexpensively produced by pharmacologic induction of up regulation and supersensitivity of central muscarinic cholinergic systems. Techniques for inducing these changes in cholinergic systems are reviewed, and principles governing their application to specific problems are illustrated. PMID- 3517082 TI - Psychiatric indications for clonidine: the neuropharmacologic and clinical basis. AB - Clonidine's actions and efficacy in mental disorders are reviewed and examined. Its efficacy in suppressing acute opiate withdrawal symptoms and its role in preparing the opiate-dependent patient for transition from opiate agonist to naltrexone therapy are well documented. Studies also indicate clonidine's value in alcohol and tobacco withdrawal syndromes. Of special interest is evidence which suggests that clonidine can reduce the duration and cost of the withdrawal process. Also discussed is clonidine's utility for mania, anxiety and panic disorders, schizophrenia, and the symptoms of tardive dyskinesia. Although further documentation of its efficacy for these disorders is required, clonidine's efficacy as an antimanic agent and treatment for tardive dyskinesia is particularly exciting and worthy of further study. PMID- 3517083 TI - An open clinical trial of fluoxetine in the treatment of obsessive-compulsive disorder. AB - In a 9-week open label study, seven outpatients with obsessive-compulsive disorder were treated with fluoxetine, a selective inhibitor of neuronal reuptake of serotonin. After a 7-day placebo washout period, patients were given a dose of 40 mg/day, which was gradually increased to a maximum of 80 mg/day. A significant improvement was found in the symptomatology of patients as measured on the obsessive-compulsive subscale of the Comprehensive Psychopathological Rating Scale (p less than 0.001) and the Clinical Global Impression of severity of illness (p less than 0.01). These findings support the hypothesis that serotonergic antidepressants may be useful in the treatment of obsessive compulsive disorder and underline the need to carry out double-blind clinical trials to confirm these results. PMID- 3517084 TI - G. V. Black come to Colorado. PMID- 3517085 TI - Organisation of lateral line and auditory areas in the midbrain of Xenopus laevis. AB - Lateral line areas in the midbrain of Xenopus laevis were identified by recording evoked potentials and neural activity elicited by stimulating anterior and posterior lateral line nerves. Spike activity was found in the lateral half of the optic tectum, ventrolateral tectum, and torus semicircularis. Contra- and ipsilateral lateral line pathways to these regions were identified. Spike discharge was associated with an evoked potential (EP) consisting of a large negative-positive wave sometimes preceded by a small positive-negative deflection. EP depth profiles varied according to electrode position within the lateral line midbrain projection field. In the middle of the field a dramatic increase in EP growth occurred as the electrode passed through the torus semicircularis, with peak amplitudes being achieved 900-1,100 micron from the surface within nucleus principalis and magnocellularis. Tracks at the lateral edge of the field showed a steady growth of EP, with peak amplitudes around 600 micron as the electrode passed through ventrolateral tectum. Auditory responses to tone pips were found in the nucleus laminaris and principalis in caudomedial regions of the torus semicircularis, in areas lying medial to the main centers of lateral line evoked activity; this is a similar organisation to that found in teleost fish. The results indicate the torus semicircularis and deep layers of the lateral tectum to be involved in lateral line processing Some topographic separation of the representation of anterior and posterior lateral line systems is indicated. The possible involvement of these areas in lateral line stimulus localisation is discussed. PMID- 3517086 TI - The organization of neural inputs to the medial preoptic nucleus of the rat. AB - There is general agreement that the medial preoptic nucleus (MPN) receives projections from widespread regions of the brain, although there are significant discrepancies in the literature with regard to certain specific inputs. Therefore, we have reexamined the inputs to this nucleus with both retrograde and anterograde axonal transport techniques. First, injections of the retrograde tracers true blue, SITS, or wheat germ agglutinin were made into the region of the MPN and the distribution of retrogradely labeled cells was charted. Then, autoradiographic material was used to confirm the results of the retrograde studies, to identify the route taken by fibers projecting to the MPN, and to describe the distribution of projections with respect to the three cytoarchitectonic subdivisions of the nucleus. The results indicate that the MPN receives inputs from widely distributed areas in both the forebrain and brainstem, and that these inputs appear to be distributed topographically within the three cytoarchitectonic subdivisions of the nucleus. Direct inputs to the MPN arise from all major areas of the hypothalamus (except for the median and magnocellular preoptic nuclei, the supraoptic and suprachiasmatic nuclei, and the medial and lateral mammillary nuclei). Projections from nuclei within the periventricular zone of the hypothalamus end primarily in the medial part of the MPN, while inputs from the lateral zone are mainly confined to the lateral part of the nucleus, as are projections from the nuclei within the medial zone, except for those from the anterior and ventromedial nuclei, which appear to be more widespread. The MPN receives major inputs from limbic regions including the amygdala, ventral subiculum, and ventral lateral septal nucleus, all of which end preferentially in the lateral part of the MPN. In contrast, the projection from the encapsulated part of the bed nucleus of the stria terminalis appears to end preferentially in the central part of the MPN and in immediately adjacent regions of the medial subdivision. In addition, the MPN may receive relatively sparse inputs from infralimbic and insular cortical areas, the nucleus accumbens, and the substantia innominata. Finally, ascending serotoninergic projections from the raphe nuclei appear to terminate principally in the lateral part of the MPN, whereas inputs from regions containing noradrenergic cell groups are chiefly distributed to the central and medial parts of the nucleus. Other brainstem regions that appear to provide modest inputs include the ventral tegmental area, central tegmental field, periaqueductal gray, pedunculopontine nucleus, and the peripeduncular nucleus.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3517087 TI - Ambiguities in MR imaging of tumoral cysts in the spinal cord. AB - We describe two cases in which the magnetic resonance (MR) imaging characteristics of tumors of the spinal cord were ambiguous. Both cases were primary low-grade astrocytomas that had had previous surgery. In the first case the findings were indeterminate as to whether the lesion was solid, cystic with proteinaceous fluid, or mixed. Intraoperative ultrasound demonstrated large cystic areas with an associated solid mass. In the second case MR was reported as cystic with a solid nodule. Ultrasonography demonstrated an almost entirely solid mass with a localized cyst corresponding to the presumed solid area. In both of these cases, but especially the latter, the localization of cysts within the lesions was of vital importance to therapy. PMID- 3517089 TI - Effect of season and stage of lactation on plasma insulin and glucose following glucose injection in Holstein cattle. AB - Changes in plasma glucose and insulin concentrations following glucose injection in dairy cows (six per stage of lactation per season) were characterized during early, middle, and late lactation in winter, spring, and summer. Blood samples were collected 60, 45, 30, 20, 15, 10, 5, and 0 min (period 1) before glucose injection (.1 g/kg body weight) and at 5, 10, 15, 20, 30, 45, and 60 min (period 2) after injection. Plasma insulin concentrations were affected by season, period, season by period interaction, and time within period. Plasma glucose was affected by period, time within period, and stage of lactation by period interaction. Insulin was lowest in summer. Magnitude of insulin response to glucose was highest in spring. Both plasma glucose and insulin increased significantly 5 min following glucose injection. Peak glucose concentrations increased with advancing lactation. Results indicate alterations in glucose metabolism as well as changes in insulin sensitivity to glucose in various seasons and stages of lactation. PMID- 3517088 TI - Extrusion of bone graft after lumbar fusion: CT appearance. AB - Two cases of bone graft plug extrusion following posterior lumbar interbody fusion are presented. The surgical procedure is described and the utility of CT in postoperative evaluation is discussed. PMID- 3517090 TI - Efficacy of dodecylaminoalkyl glycine teat dip against Staphylococcus aureus and Streptococcus agalactiae mastitis. AB - Dodecylaminoalkyl glycine teat dip, diluted to 1.5% active ingredients, was evaluated in a controlled experimental challenge study to determine efficacy for preventing new intramammary infections with Staphylococcus aureus (Newbould 305) and Streptococcus agalactiae (McDonald 44). The dip reduced the incidence of intramammary infection with Staphylococcus aureus by 81.2%. Reduction of Streptococcus agalactiae intramammary infection was 67.5%. PMID- 3517091 TI - Characterization of metabolic changes during a protocol for inducing lactation ketosis in dairy cows. AB - During the 5 wk immediately after parturition, five high producing cows that were overfed prepartum completed a protocol for inducement of ketosis. By 12 d postpartum, hepatic glycogen decreased by 75% and hepatic triglyceride, beta hydroxybutyrate, and acetoacetate increased by 6, 4, and 2.5 times. The protocol, initiated at 2 wk postpartum, consisted of a 15 to 20% decrease from ad libitum feed intake plus dietary supplementation with 1,3-butanediol, a ketogenic substrate. Severity of the ketotic state increased gradually, and four cows developed clinical signs of ketosis at an average of 36 d postpartum. Glycogen was 90% depleted, and triglycerides, beta-hydroxybutyrate, and acetoacetate concentrations in liver were increased to 10, 10, and 15 times above average prepartum concentrations. In plasma, beta-hydroxybutyrate increased and glucose decreased. Plasma insulin exhibited an initial postpartal decrease (40%) but then was stable at that concentration through 36 d. After treatment for ketosis, glucose and insulin concentrations of plasma were greater than prepartal concentrations. Results indicate that a relatively simple protocol of prolonged energy deficit combined with an influx of ketone body precursors can induce experimental lactation ketosis in overfed cows. The protocol should be a valuable tool for ketosis research. PMID- 3517092 TI - Reproductive performance of dairy cows with cystic ovaries following administration of Procystin. AB - Eighty-five postpartum Holstein cows were randomly assigned to receive 0, 50, 100, or 250 micrograms of the gonadotropin-releasing hormone product, Procystin when follicular cysts were diagnosed by palpation per rectum. Accurate reproductive records were maintained, and milk samples were collected at the time of diagnoses for assay for progesterone. An additional 101 cows were injected with only the 100 micrograms dose of Procystin when cysts were identified. Data showed that days from treatment to first observed estrus decreased with increasing doses of Procystin with no advantage of 250 micrograms over 100 micrograms. Days open and conception rates were similar among the treatment groups. Cows with less than 1 ng/ml progesterone in their milk at the time of treatment returned to estrus sooner than cows with progesterone concentrations greater than 1 ng/ml. In addition, gonadotropin-releasing hormone administered to those cows with low progesterone at the time of treatment led to significantly increased progesterone concentrations by 7 and 14 d posttreatment. We conclude that although Procystin administration hastened estrus of cows with ovarian cysts, breeding practices on the farms did not lead to an improvement in reproductive efficiency of the cows that possessed cysts. PMID- 3517093 TI - Regulation of calcium and phosphorus homeostasis in the dairy cow. AB - This paper describes the mechanism of calcium and phosphorus homeostasis in dairy cows in an effort to provide a clearer understanding of the rationale behind current management and supplementation practices. Specifically addressed is the need to keep prepartum dietary calcium intake at less than or equal to 50 g/d to minimize the incidence of milk fever. Also discussed is the need to increase National Research Council recommendations for postpartum dietary calcium from 2.7 to 3.4 g/kg milk. This is particularly important during the first 1 to 2 mo of lactation to maintain calcium balance. PMID- 3517094 TI - Home relaxation practice in hypertension treatment: objective assessment and compliance induction. PMID- 3517095 TI - Relaxation and cognitive treatments of anger. PMID- 3517096 TI - Effect of antimicrobial agents on root surface caries, alveolar bone loss, and microflora in rice rats. AB - Two antimicrobial agents, 9-aminoacridine (0.2%) and minocycline (0.2%), were evaluated for their efficacy in inhibiting root surface caries, bone loss, and microflora in rice rats. A solution of 5000 ppm fluoride was used as a positive control for the inhibition of root surface caries, and double-distilled water was used as a negative control group. Each rat was treated by having its molar teeth swabbed 2 X per day with the prescribed agent in its group for nine weeks. Root caries reduction in the minocycline and fluoride groups was not significantly different, but the reduction was significantly greater than in the 9 aminoacridine group, with the caries score in all three groups being significantly less than that in the water control. Bone loss reduction for the minocycline group was significantly greater than that for any other group. PMID- 3517097 TI - Relation between the presence of supragingival calculus and protease activity in dental plaque. AB - Protease activity was measured in dental plaque collected from patients with or without supragingival calculus. Plaque specimens from the calculus group showed significantly greater protease activity in the presence of 0.05% sodium thioglycollate than did those from the non-calculus group. No significant difference between the two groups was observed in the protease activity without sodium thioglycollate. There was no significant correlation between the age of the patients and the protease activity. PMID- 3517098 TI - Acute renal failure in the intensive care unit today. PMID- 3517099 TI - Portal blood flow in man during graded positive end-expiratory pressure ventilation. AB - The cardiovascular response to graded PEEP ventilation (5-10 cm H20) was studied peroperatively in patients undergoing cholecystectomy (n = 8) or hepatic tumour surgery (n = 3). Portal blood flow was measured by the continuous thermodilution technique and cardiac output, in a sub-group of the patients, by impedance cardiography. A parallel reduction in cardiac output and portal blood flow was demonstrated in patients undergoing cholecystectomy as the result of the application of PEEP. Thus, ventilation with 5 cm H2O of PEEP elicited a 17% decrease in cardiac output and a 26% decrease in portal blood flow. During 10 cm H2O of PEEP cardiac output decreased by 22% and portal blood flow by 32%. However, there were no significant changes in preportal tissue perfusion pressure by the application of PEEP and preportal vascular resistance increased by 22% and 30%, respectively. This indicates that a vasoconstrictor response, elicited by PEEP, in the preportal tissue is the predominating mechanism for the observed decrease in portal blood flow. Systemic oxygen transport decreased by 214 ml/min during PEEP ventilation, but preportal tissue oxygen utilization was not significantly changed due to a concurrent increase (2.9%; p less than 0.05) in oxygen extraction. PMID- 3517100 TI - An index to predict outcome in adult respiratory distress syndrome. AB - Thirty patients with adult respiratory distress syndrome required intermittent positive pressure ventilation; 15 survived. In 25 the syndrome followed bacterial infection or multiple injuries. From the peak upper airway pressure, the oxygen gradient and the age of the patient, an index was obtained which discriminated between the survivors and those who died from the pulmonary lesion of the syndrome. PMID- 3517101 TI - Clinical applications of independent lung ventilation with unilateral high frequency jet ventilation (ILV-UHFJV). AB - Six patients with unilateral acute lung injury (ALI) were treated with a new form of ventilatory support: independent lung ventilation with unilateral high frequency jet ventilation (ILV-UHFJV). The first three patients suffered from unilateral ALI complicated by a bronchopleural fistula (BPF); they were at first ventilated with HFJV, but remained unresponsive to treatment, showing a progressive impairment of the ventilation/perfusion ratio with a deterioration in clinical condition. After selective bronchial intubation, ILV-UHFJV was started, ventilating the healthy lung with CPPV and the contralateral with HFJV. ILV-UHFJV caused a significant improvement in alveolar gas exchange leading to a rapid fall in Qs/Qt; it was also associated with a stable haemodynamic condition throughout the duration of the treatment. Subsequently, three more patients were treated; their respiratory failure was due to a unilateral ALI without BPF, unresponsive to either HFJV or CPPV. Once again, ILV-UHFJV was followed by a dramatic improvement in respiratory function; the haemodynamics remained unchanged and it was also possible to demonstrate a rapid improvement in individual and overall lung function. PMID- 3517102 TI - Wave equations in linear viscoelastic materials. AB - Conditions for writing wave equations in linear viscoelastic materials are investigated. The study is restricted to the infinitesimal theory and an application is suggested in modeling ultrasound propagation in soft biological tissues. First, a general wave equation is obtained for the displacement field in an inhomogeneous medium. Second, the propagation of "the mean principal stress" (i.e., minus the arithmetical mean of the principal stresses) is examined. That quantity is particularly relevant when the force per unit area is detected at the surface of a nondissipative coupling medium. If the material is homogeneous, a wave equation is always obtained for the mean principal stress. Otherwise, supplementary conditions have to be assumed on the material and possibly on the motion. Results are illustrated by examples which present linearly elastic perfect fluids and linearly elastic Newtonian viscous fluids as particular viscoelastic materials. PMID- 3517103 TI - Critical review of toxic air pollutants--revisited. PMID- 3517104 TI - Overcoming dental anxiety. PMID- 3517105 TI - Esthetic dentistry. PMID- 3517106 TI - Special people ... special care. PMID- 3517107 TI - The Presidents. Harold Whinery Oppice 1950-1951. PMID- 3517108 TI - Removal of acid-etched fixed partial dentures with modified ultrasonic scaler tips. PMID- 3517109 TI - Hemisection and root amputation. AB - The disciplines of endodontics and periodontics fuse when molars that have bifurcation or trifurcation involvements are treated with hemisection and root amputation. Attempts to save parts of teeth go back 100 years or more, but it is the increased predictability of success of endodontic therapy and the increased sophistication of periodontal treatment that have given us the means to save molars with furcation problems that, otherwise, would be lost. Even when less invasive modes of therapy have failed (scaling, root planing, occlusal adjustment, and flap surgery perhaps with osseous recontouring and synthetic or natural bone grafting material where indicated), it is no longer necessary to lose a molar with complete furcation problems. When restorative dentistry has already been finished, and the retention of part of the tooth will extend the life of a crown or fixed partial denture, the patient certainly deserves the option of hemisection or root amputation rather than extraction. PMID- 3517110 TI - Guidelines for acceptance of chemotherapeutic products for the control of supragingival dental plaque and gingivitis. Council on Dental Therapeutics. PMID- 3517111 TI - Carbohydrate tolerance and serum lipid responses to type of dietary carbohydrate and oral contraceptive use in young women. AB - The responses of serum glucose, insulin, and lipids to a glucose load were compared in two groups of college-age women fed two different carbohydrate diets. One group of women took oral contraceptives (OC) and the other group had never taken OC. Two experimental diets supplied approximately 13% of the calories from protein, 36% from fat, and 51% from carbohydrate. Of the carbohydrate, 84% was either sucrose or wheat starch. Each diet was fed for 4 weeks in a cross-over design. The subjects were given a glucose load dose, 1 g/kg of body weight, before and after each dietary period. Serum glucose, insulin, and lipids were measured before and 30, 60, 120, and 180 minutes after the load dose. Serum insulin was significantly affected by the type of carbohydrate in the diet (p less than .01). The sucrose diet generally gave lower insulin levels in response to the glucose load. Serum triglyceride levels were significantly higher (p less than .01) in users than nonusers of OC. Serum free fatty acids and total lipids were not significantly affected by OC use. There was no effect of different carbohydrates on any of the serum lipid parameters. Significant responses from fasting levels were observed for serum glucose, insulin, and triglyceride levels (p less than .01). PMID- 3517113 TI - Food allergies: immunological reactions to food. AB - Allergic reactions to food are mediated by the immune system, can be consistently reproduced, and cause a change in the target organ. An estimated 0.3% to 20% of infants are affected. The incidence decreases with age to about 1% to 3% in adults. Development of food allergies depends on heredity, intestinal permeability, immune responsiveness, and exposure to food. Common symptoms include gastrointestinal, skin, or respiratory disturbances that occur from seconds to several hours after food ingestion. Although the skin-prick test is the most reliable diagnostic test, positive results must be followed by a trial elimination diet and food challenge to determine whether symptoms appear after food ingestion. Food allergies are treated by the elimination of the offending foods from the diet. Breast feeding is usually recommended to reduce the incidence of allergic disease in infants. The dietitian's expertise is particularly valuable in assessing the nutritional status of the allergic person, assuring nutritional adequacy during treatment and maintenance, and participating in research to address the many unresolved issues surrounding food allergies. PMID- 3517112 TI - Plasma fructose, uric acid, and inorganic phosphorus responses of hyperinsulinemic men fed fructose. AB - We fed 12 men with abnormally high insulin responses to a sucrose load and 12 controls normal diets containing 0, 7.5, or 15% of the calories as pure fructose for 5 weeks each in a crossover design. Purified wheat starch replaced the fructose in the 0 and 7.5% diets. The two groups were matched for age, height, and weight. At the beginning of the study and at the end of each of the three 5 week periods, plasma responses to a sucrose load (2 gm/kg body weight) were measured. Initially there were no significant differences in the plasma fructose, uric acid, or inorganic phosphorus responses of the two groups. Plasma fructose responses to a sucrose load were significantly higher after the men consumed the 7.5 and 15% fructose diets than after the 0% diet. Uric acid responses tended to be greater in the hyperinsulinemic men than in controls and increased as the levels of fructose in the diet increased. The inorganic phosphorus levels after a sucrose load were higher in the hyperinsulinemic men than in controls when they consumed the 7.5 and 15% fructose diets. These results indicate that moderate levels of dietary fructose can affect plasma fructose, uric acid, and inorganic phosphorus levels, especially in hyperinsulinemic men. PMID- 3517115 TI - Transient hypoglycemic hemiparesis in an elderly patient. PMID- 3517114 TI - Biological basis of the sex differential in longevity. PMID- 3517116 TI - Alterations in prostacyclin and thromboxane formation by chronic cigarette smoke exposure: temporal relationships and whole smoke vs. gas phase. AB - Chronic cigarette smoke exposure in vivo causes decreased conversion of [14C]arachidonic acid (AA) to prostacyclin (PGI2) by isolated aortic tissue and increased conversion to thromboxane (TXA2) by isolated platelets from rats. Alterations in the PGI2/TXA2 balance may be part of the mechanism through which smoking increases the risk of cardiovascular disease. To study the influence of smoke exposure duration on this response, male rats were exposed daily to 10 puffs of freshly generated cigarette smoke. Animals were killed after 1, 4, 14, 28 and 57 days of smoke exposure and 3, 7, 14 and 28 days after cessation of the 57-day of smoke-exposure regimen. Elevated carboxyhemoglobin levels during the smoke-exposure sessions verified smoke (gas phase) inhalation. Statistically significant alterations in prostacyclin synthesis preceded those of thromboxane. A decrease of 20-25% (P less than 0.05) in PGI2 production from [14C]AA in isolated aortic tissue was found beginning 28 days after smoke was initiated and quickly rebounded when smoke exposure was terminated. Increased production of TXA2 from [14C]AA by isolated platelets became statistically significant (P less than 0.05) on the 57th day and returned to normal 7-14 days after cessation of smoke exposure. To determine the effect of gas phase constituents on the PGI2/TXA2 balance a second series of experiments divided male and female Sprague Dawley rats into sham, whole smoke and gas phase groups. Gas phase was produced by passing whole smoke through a Cambridge filter to remove particulate matter. Per cent COHb averaged 1.4 for sham, 7.8 for whole smoke and 9.4 for gas phase groups.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3517117 TI - Comparative sensitivity of survival-adjusted chi-square and normal statistics for the mutagenesis fluctuation assay. AB - Three statistics for analysis of microtitre plate mutagenesis fluctuation tests were studied by simulation, and in enzyme-activated assays of dimethylnitrosamine and diethylnitramine. A survival-adjusted chi 2 statistic ('Gsq') was compared with Katz's normally distributed statistic ('Phi'), and with the survival independent statistic ('Zsq') of Gilbert. When toxicity was either very low or high, the Phi statistic either could not be evaluated over the whole range of possible background mutant frequencies, or sometimes it indicated unusually high levels of statistical significance, even when the other tests were negative. The survival-adjusted Gsq closely followed the Zsq statistic throughout the experimentally useful range of toxicities and mutant background values, with some improvement in sensitivity. Within the range 80 +/- 10% survival approximately, Katz's statistic 'Phi' was the most sensitive. The choice of statistical test could affect the estimate of the minimal effective mutagenic concentration by a factor of 10-100. For screening unknowns, both types of test (Phi and Gsq (or Zsq] may help in detecting suspect pro-mutagens and in designing a confirmatory assay. Bacterial population statistics are needed to assess the value of statistically positive results. PMID- 3517118 TI - Indices of sympathetic vascular innervation in sympathectomized patients. AB - We measured arterial and venous plasma catecholamines and used laser-Doppler flowmetry to measure cutaneous microcirculatory flow in the sympathectomized and in the intact limbs of 3 patients who had undergone regional sympathectomies. Venous concentrations of norepinephrine, the sympathetic neurotransmitter, exceeded arterial concentrations in the intact limbs--a normal finding--but invariably were less than arterial in the sympathectomized limbs of the same patients, both during baseline conditions and during sympathetic stimulation using tilt, standing and the cold pressor test (mean arteriovenous decrement about 40%). Arterial epinephrine levels exceeded venous levels with or without sympathectomy. Skin microvascular flow rapidly decreased during the cold pressor test and the Valsalva maneuver in the intact but not in the sympathectomized limbs, and spontaneous flow oscillations occurred in the sympathectomized limbs. The results suggest that an arteriovenous increment in plasma norepinephrine reflects local release of norepinephrine from sympathetic nerve endings, whereas removal of circulating catecholamines can occur with or without sympathetic neural impulses. Laser-Doppler flowmetry can measure reflexive sympathetically mediated responses of skin microvascular flow and so can detect sympathetic denervation. Spontaneous oscillations in this flow may not depend exclusively on oscillations in the activity of the sympathetic microvascular innervation. PMID- 3517119 TI - How the founder of photography came to be painted by George Stubbs. PMID- 3517120 TI - Embedding in plastic of early embryonic stages of the chicken for teaching purposes. PMID- 3517121 TI - Muscarinic cholinergic modulation of insulin response to an intravenous glucose tolerance test in normal man. AB - The effect of pirenzepine, a specific muscarinic cholinergic receptor antagonist, on insulin and glucagon responses to an intravenous injection of glucose was investigated in eight normal adult subjects. These volunteers received two iv glucose tolerance tests (0.33 g/kg) before and after the oral administration of 125 mg of pirenzepine (three doses of 25 mg during the day before the experiment and a fourth dose of 50 mg 2 h before glucose injection). Treatment with pirenzepine neither altered basal blood glucose levels nor affected glucose tolerance after the injection of the glucose load. In addition, it did not modify basal plasma insulin and glucagon levels and the decrement of glucagon in response to glucose injection. In contrast, pirenzepine significantly decreased insulin release induced by glucose administration. In man, during the present experimental conditions, the muscarinic cholinergic system modulates insulin, but not glucagon response to an iv glucose injection. PMID- 3517122 TI - Selective complement fixation by pancreatic B-cells after binding to islet cell surface antibodies. AB - A two wavelength immunofluorescence system was used to demonstrate islet cell surface antibodies (ICSA) from juvenile diabetics and complement on the same viable rat islet cell. When incubated with rat islet cells at 4 C and at 37 C, ICSA specific for B-cells proved capable of binding complement. In contrast, ICSA specific for both B and non-B cells were able to fix complement on all cell types at 4 C but only on B-cells at 37 C. This study provides further evidence for the B-cell specific cytotoxic effect of ICSA in the presence of complement at physiological temperature. In addition, the ultrastructural events leading to B cell destruction after ICSA and complement binding were studied by transmission electron microscopy (TEM). PMID- 3517123 TI - [Etiology of cancer of the cervix uteri. An account of 150 years' research]. AB - One hundred and fifty years ago, a descriptive study showed that marriage was a risk factor in cervical carcinoma. More recent analytical epidemiological studies have shown that this carcinoma was a sexually transmitted disease. Great strides in molecular biology have made it possible to assign to some human papillomavirus form a strong aetiological role in the disease. PMID- 3517124 TI - [Echographic evaluation of non-immunologic feto-placental anasarca. A series of 24 cases]. AB - 24 cases of non-immune feto-placental hydrops which were diagnosed by ultrasonography are presented. The precise etiology was possible in 21 of the cases using chromosome analyses, radiological assessments and carefully conducted post mortem examinations. The cause was maternal in 3 cases and due to fetal pathology in 18 cases, of which 5 were due to chromosome abnormalities. Three recessive autosomal syndrome, 9 malformations and in particular cardiac malformations and one twin pregnancy with transfusion from one fetus to the other were diagnosed. These features, which can be compared with those already in the literature, show that most of these cases of hydrops are due to genetic fetal defects and demonstrate how important it is to carry out chromosome analyses and systematic anatomo-pathological investigations. The results of these tests will indicate the way the doctors should look after the mother during pregnancy and how to deliver these mothers in subsequent pregnancies. PMID- 3517125 TI - [Ectopia cordis: early echographic diagnosis in utero]. AB - Having had a case of ectopia cordis which was diagnosed early in utero, the authors have analysed the information they have obtained and they have suggested what steps to take according to the features revealed by the ultrasound pictures and taking into account the different anatomical forms. They have also considered the lesions that are associated with this condition and the principal prognostic features. PMID- 3517126 TI - The competitive impact of health maintenance organizations on hospital finances: an exploratory study. AB - In this study we explore whether HMO-induced competition has contained expenditures in Minneapolis/St. Paul hospitals. Specifically, we assessed the impact of HMOs on revenue, cost, and net income per admission in Twin Cities hospitals from 1979 to 1981. Some HMOs have obtained negotiated discounts from hospitals. We found that hospitals which gave larger discounts did not have lower costs per admission. This finding suggest that discounts do not force hospitals to operate more efficiently. In addition, hospitals with a large share of patients from HMOs or government Medicare and Medicaid programs did not have lower costs per admission than other hospitals during the years from 1979 to 1981. This finding casts doubt on the claim that discounts are justified by lower costs for HMO or government patients. Finally, neither HMO market share nor discounts had an adverse effect on hospital profits. During the three years studied, hospital profits in the Twin Cities showed an upward trend. This study concludes that if competition is to succeed it must encompass more than HMOs. HMOs may be important, but they are only one agent in the market. Thus, public policy created to induce competition must go beyond the simple stimulus of HMO growth. PMID- 3517128 TI - Percutaneous endoscopic gastrostomy (PEG). A new procedure comes of age. AB - Our cumulative literature review suggests PEG is a simple, relatively safe, and cost-effective means of establishing enteral access for patients who qualify for long-term nutritional support. Tube placement can be achieved in 98% of patients, usually within 15 to 30 minutes without general anesthesia. The gastrostomy catheter can be easily removed when treatment is ended and conveniently replaced if accidentally dislodged. Complications occur in approximately 17% of patients, but only 3.0% are regarded as serious. No procedure-related deaths have been reported. PEG as the initial choice for feeding tube placement followed by surgical gastrostomy in patients in whom PEG is unsuccessful is a reasonable approach to nutritional management in appropriate patients. PEG for purposes of chronic gastrointestinal decompression and internalization of biliary drainage holds promise but requires further evaluation. PMID- 3517127 TI - The alcoholic in the lifeboat. Should drinkers be candidates for liver transplantation? PMID- 3517129 TI - The echogenic echinococcal cyst. A diagnostic trap. AB - Two patients with echogenic solid echinococcal cysts of the liver are reported. The literature of this unusual form of echinococcal liver disease is reviewed. PMID- 3517130 TI - Barrett's mucosa with multiple carcinomas of the esophagus and oral cavity. AB - A 62-year-old man with carcinoma of the tongue had two separate asymptomatic carcinomas of the esophagus, one squamous and the other adenocarcinoma arising from Barrett's mucosa. We review the multicentric origin and synchronous occurrence of tumors in the oropharyngoesophageal area with and without Barrett's mucosa to emphasize the importance of complete evaluation of the esophagus in patients with oropharyngeal malignancy. PMID- 3517131 TI - Hepatic transplantation. The role of the pathologist. PMID- 3517132 TI - The syndrome of type A chronic atrophic gastritis, pernicious anemia, and multiple gastric carcinoids. AB - Gastric carcinoid tumors comprise approximately 1.0 to 2.7% of all carcinoid tumors. There appears to be an association between gastric carcinoids and pernicious anemia on the basis of underlying type A chronic atrophic gastritis. We review the relevant literature and describe a 63-year-old woman who had pernicious anemia and multiple polypoid gastric carcinoid tumors. The association of these disorders, proposed mechanisms of such association, and the need for an aggressive diagnostic approach are discussed. PMID- 3517133 TI - Spontaneous pancreatic duct-colon fistula. AB - A fistula between the pancreatic duct and the colon is quite rare and usually associated with such manifestations as bleeding and sepsis. We have seen a patient with such a fistula detected almost incidentally at ERCP. We report the course of this fistula and review the literature to suggest a place for conservative surgical management. PMID- 3517134 TI - A clinical view of recent advances in ascites. AB - We discuss current perspectives in ascites, focusing on newer developments of interest to clinicians and stressing the value and limitations of therapeutic paracentesis. Because there is considerable evidence to support both the "underfilled" and "overflow" hypotheses for the development of ascites, current concepts concentrate on integration of these two theories. In the management of ascites the rate of ascites mobilization is more important than the method by which excess peritoneal fluid is removed; thus salt restriction may not have to be rigid if diuretics are used judiciously. An approach to intractable ascites emphasizes the difference between unresponsive and refractory ascites, but in both situations a conservative philosophy is recommended. Nonhepatic causes of ascites are briefly reviewed since their management may require principles different from those used in cirrhosis. PMID- 3517136 TI - Aortic surgery: a short synopsis. PMID- 3517135 TI - Demonstration of carboxyl and thiol protease activities in adult Schistosoma mansoni, Dirofilaria immitis, Angiostrongylus cantonensis and Ascaris suum. AB - Evidence has been presented showing two kinds of acidic protease activities in adult Schistosoma mansoni, Dirofilaria immitis, Angiostrongylus cantonensis and Ascaris suum. A haemoglobinolytic activity without adding any SH-containing compounds was maximal at pH 3.5, 2.5, 3.0 and 3.5 in S. mansoni, D. immitis, Angiostrongylus cantonensis and Ascaris suum respectively. The inhibitor studies demonstrated that this activity is ascribable to carboxyl protease(s). In the presence of dithiothreitol, activity on Azocoll (azo-dye coupled hide powder) was maximal at pH 4.6, 4.6, 3.5 and 5.6 in S. mansoni, D. immitis, Angiostrongylus cantonensis and Ascaris suum respectively. The effects of inhibitors demonstrated that this activity belongs to the thiol protease class. The intraspecific distribution of the protease activities was studied in some of the nematodes from which the organs could be anatomically separated. The distribution patterns of the haemoglobinolytic and azocollytic activities were quite different in An. cantonensis and much the same in As. suum. Based on the present results, acidic haemoglobinolytic activities reported in adult S. mansoni by other authors are thought to be due to carboxyl and thiol protease(s) respectively. PMID- 3517137 TI - An Indiana study: an original clinical approach to a fatal metabolic problem. PMID- 3517138 TI - Herder and ethnography. AB - The source and nature of the ethnography of the important eighteenth century thinker Johann Gottfried Herder can in large part be understood through his relationship to his own society and especially through his part in the German cultural nationalist movement of the day. Herder's long involvement with the literature of travel led him to an understanding of many ideas now associated with cultural anthropology; he often recounts ethnographic information in a plain and impartial way. He also gives frequent moral judgements of native cultures. These judgements, often favorable and occasionally negative, may be traced to his announced political sympathies. PMID- 3517139 TI - An eighteenth-century battle for priority: Jacques Daviel (1693-1762) and the extraction of cataracts. PMID- 3517140 TI - Harper's Weekly on health in America, 1876. PMID- 3517141 TI - Deadly parents: child homicide in eighteenth- and nineteenth-century England. PMID- 3517142 TI - The G.R.B. Horner papers: a source for the study of nineteenth century medicine. PMID- 3517143 TI - Polypeptides of the chloroplast envelope membranes as visualized by immunochemical techniques. AB - The polypeptides of relative molecular masses (Mr) 22,000, 29,000, and 36,000 represent three major constituents of the chloroplast envelope of spinach (Spinacia oleracea L.) leaves. The Mr 22,000 polypeptide has been localized in the outer membrane, whereas the two other peptides have been attributed to the inner envelope membrane (Joyard et al., 1983). The Mr 29,000 polypeptide has been identified as the "phosphate translocator" (Flugge and Heldt, 1979). In this investigation, we studied the three envelope polypeptides by means of immunocytochemistry. Using indirect immunofluorescence, all three polypeptides were visualized in cryostat sections of formaldehyde-fixed leaf tissue. They were found in both palisade and spongy parenchyma cells and in guard cells, as indicated by a strong fluorescence in the chloroplast periphery. In contrast, fluorescein isothiocyanate or protein A-gold labeling of isolated fixed chloroplasts resulted only in visualization of the Mr 22,000 polypeptide, a constituent of the outer membrane. We further studied the morphological distribution and frequency of this peptide by electron microscopic evaluation of platinum-carbon replicas after freeze-etching or label-fracture and of ultra-thin sections. By use of these three methods, the polypeptide was found to be randomly distributed in the outer envelope membrane and easily accessible to the immunomarker. Average marker density, as obtained by freeze-etching and label fracture, was approximately 130 gold particles per square micron. PMID- 3517144 TI - The unlabeled antibody method: comparison of peroxidase-antiperoxidase with avidin-biotin complex by a new method of quantification. AB - Upon plotting of areas against optical densities in immunocytochemically stained tissue sections, hyperbolic curves were obtained which could be reduced to two straight lines, one representing variations in stained structures, and the other variations in background. The slopes of the stained structure lines reflected staining intensity independently of total area of stained structure in a section. The ratio of slopes of the stained structure and background lines reflected immunocytochemical sensitivity. A comparison of the peroxidase-antiperoxidase (PAP) method with the avidin-biotin complex (ABC) method showed that at usual antibody dilutions the PAP method was much more sensitive than the ABC method, while at impractically high antibody dilutions it was moderately more sensitive. Once sufficient dilutions of antibodies were reached, staining intensities dropped sharply with the PAP method. On the other hand, the dilution curves were flat with the ABC method. The ABC method consequently appeared unsuitable for estimating variations in concentration of antigen or for distinguishing high or low concentrations of antigen. The ABC method provided a stain for myelin even in the absence of any antibodies. PMID- 3517145 TI - Immuno-ultrastructural localization of B-cell-specific monoclonal antibodies B1 and B2. AB - Monoclonal antibodies B1 and B2 are thought to recognize B-lineage restricted antigens, and have been used to define stages of B-cell maturation and characterize B-cell lymphomas. Immunostaining on cryostat sections has revealed a puzzling dendritic or extracellular pattern of staining for B2 within germinal centers and neoplastic follicles. In this study B1 and B2 are localized precisely on hyperplastic and neoplastic lymphoid tissues using immuno-ultrastructural techniques on cryostat sections, cell suspensions, and cell monolayers. B1 and B2 were localized to cell surfaces, including microvillous surface projections, on small and large transformed normal and neoplastic B lymphocytes. B2, in addition to staining in lymphoid cells, was localized to anastomosing cytoplasmic processes of dendritic histiocytes. These findings explain the apparently extracellular localization of B2 in cryostat sections and indicate that patterns of staining for B2 may represent a combination of staining on lymphoid cells and dendritic histiocytes. PMID- 3517146 TI - Immunocytochemical localization of insulin- and glucagonlike peptides in rat salivary glands. AB - An avidin-biotin immunocytochemical technique was used to localize cells containing an insulin- or glucagon-like peptide in the major salivary glands of Sprague-Dawley rats. Cells with insulin-like staining were observed in the intercalated ducts of both the parotid and submandibular glands, but none were found in the sublingual gland. A discrete population of cells with intense glucagon-like immunostaining was associated with the acini of all three major salivary glands. This immunostaining only followed use of a glucagon antiserum with N-terminal specificity and not after incubation of tissues with an anti glucagon serum having C-terminal specificity. These results suggest that rat salivary glands may contain peptides potentially capable of influencing substrate metabolism. In addition, the present findings indicate that the glucagon-like peptide found in salivary glands has a greater immunocytochemical similarity to glicentin (gut-type glucagon) and/or glucagon precursors than to the 3500 molecular weight pancreatic glucagon. PMID- 3517147 TI - The development of the resident pattern of endogenous peroxidatic activity in mouse peritoneal macrophages coincides with the expression of the differentiation antigen F4/80. A combined method for immunoperoxidase labeling and endogenous peroxidase cytochemistry. AB - In the mouse the maturation of mononuclear phagocytes was followed by comparing the ultrastructural pattern of endogenous peroxidatic activity (PA) at different time points during an acute peritonitis induced with newborn calf serum (NCS). Exudate macrophages demonstrate PA only in lysosomes, whereas resident macrophages have reaction product in the nuclear envelope (NE) and rough endoplasmic reticulum (RER). Transitional cells called "exudate-resident" macrophages have PA in the NE, RER, and some virginal lysosomes. In addition, peroxidase-negative macrophages were also present. A monoclonal antibody, F4/80, that specifically recognizes a mouse macrophage differentiation antigen (Austyn and Gordon, 1981) was used in this study. To compare the indirect immunoperoxidase labeling of this antigen and the endogenous peroxidase cytochemistry on the cellular level, a combined method was developed. Finally, the method was applied to the peritoneal cells at different time points after intraperitoneal injection of NCS in mice. The relative numbers of cells demonstrating the different patterns of endogenous PA and the proportions of each subpopulation expressing F4/80 antigen were estimated. It appeared that the expression of the antigen F4/80 coincides with the development of the resident pattern of PA. It is therefore concluded that the macrophages with the resident pattern of endogenous peroxidase are derived from monocyte-like exudate macrophages. In addition, the results indicate that both exudate-resident macrophages and at least a part of the peroxidase-negative macrophages are transitional forms. PMID- 3517148 TI - Immunohistochemical identification of proliferating cells in organ culture using bromodeoxyuridine and a monoclonal antibody. AB - The ability to measure cell proliferation is important in the study of cancer biology. The usual technique for quantitating proliferating cells in tissue explant and organ culture by detection of [3H]-thymidine incorporation into DNA by autoradiography is tedious and time-consuming. We have developed a technique for identification and quantitation of bromodeoxyuridine (an analogue of thymidine) in cultured tissue explants. Fetal mouse colon explants were exposed in vitro to bromodeoxyuridine (BUdR) or [3H]-thymidine for 3 to 72 hr and then for various periods to unlabeled thymidine. The tissues were stained with a monoclonal anti-bromodeoxyuridine antibody and in parallel [3H]-thymidine incorporation was detected by autoradiography. Incorporation of BUdR was measured by quantitating the amount of pigment deposited over nuclei after immunohistochemical staining, using an optical data digitizer. It was found that both techniques identified proliferating cells. Dividing cells were present both in crypts and in the surrounding stroma in Day 14 fetal mouse colon cultures. The immunohistochemical technique was more rapid and less cumbersome than autoradiography. PMID- 3517149 TI - Ultrastructural localization of serotonin and polypeptide YY (PYY) in endocrine cells of the human rectum. AB - This study was performed with the aim of ultrastructurally localizing serotonin and polypeptide YY (PYY) in the endocrine cells of the human rectum. Existing basic methods for immunolocalization of antigenic sites in ultrathin sections were tested and modified to allow reproducible results with distinct localization of marker (colloidal gold probes coupled either to IgG or protein A). Probes signifying presence of serotonin were distinctly localized over all heteromorphous granules in argentaffin cells and, in addition, over some of the more monomorphous, rounded granules in a second cell type whose granules all were covered by probes showing localization of the PYY antigen. The results suggest that serotonin in endocrine cells of the gut is not confined to the enterochromaffin type but may also be present in trace amounts in non enterochromaffin endocrine cells storing peptide hormones. Since probes marking sites of PYY were deposited over some heteromorphous granules in enterochromaffin cells, the evidence obtained also suggests that PYY may occur in low concentration in these cells. The distribution of probes in the sections indicated that antigenic sites were confined to granules in the cells. PMID- 3517150 TI - Quantitative immunoferritin localization of leucine aminopeptidase on canine hepatocyte cell surface. AB - Rabbit monospecific antibody against canine kidney leucine aminopeptidase (LAP) (EC.3.4.11.2) specifically immunoprecipitated kidney and also liver LAP activity from corresponding plasma membrane preparations previously solubilized with Triton X-100. Immunological specificity of the antibody was also shown by immunoblotting of LAP from canine and rat liver plasma membranes and by electrophoretic analyses of the precursor forms in MDCK cells. Canine liver was pre-fixed by perfusion with 0.6% glutaraldehyde and the dissociated liver cells were prepared without losing their polarized structure (22). They were incubated with ferritin antibody conjugates against canine kidney LAP at the saturation level, and the distribution of ferritin particles on the three surface domains of the hepatocytes was investigated quantitatively by counting ferritin particles on the cross-sectional profiles of these surfaces. Our analysis clearly indicated that LAP exists only on the bile canalicular surface, and no significant number of ferritin particles was detected either on the sinusoidal front or on the lateral surface. Ferritin particles were distributed homogeneously both on the microvillar and intermicrovillar regions. All the bile canalicular surface domains of all the hepatocytes were heavily labeled with ferritin particles, without exception. PMID- 3517151 TI - Immunolocalization of band 3 protein in normal and cystic fibrosis skin. AB - Current evidence indicates that the defect in cystic fibrosis (CF) involves chloride transport in various epithelial cells. The sweat gland, one site of altered chloride transport in CF, was examined immunocytochemically for localization of a chloride-channel membrane protein, designated band 3 protein. Immunoreactivity was observed in sweat duct cell membranes of both normal and CF samples, whereas secretory coil regions were entirely unreactive. No difference was observed in the pattern or intensity of immunoreactivity between the two groups at the light microscopic (LM) level of resolution. PMID- 3517152 TI - Ia antigens in plastic-embedded tissues: a post-embedding immunohistochemical study. AB - The aim of the present study was to establish a plastic embedding technique that makes possible the immunohistochemical demonstration of class II major histocompatibility complex (MHC) antigens (Ia antigens) in undecalcified joint tissues. Therefore a series of fixatives and dehydrating agents was tested for saving Ia immunoreactivity by post-embedding immunostaining of thin sections (2 microns) of rat tissues that had been embedded in glycol methacrylate (GMA), and by comparing with cryostat sections. An indirect immunoperoxidase and the avidin biotin complex (ABC) technique were used. Combined with fixation by 4% formaldehyde, dehydration with GMA was found to give the best preservation of Ia antigenicity, followed by dehydration with ethylene glycol. The thinness of tissue sections facilitated the association of Ia antigens with different subcellular compartments in distinct cell populations. These various patterns are described. PMID- 3517153 TI - Inhibition of colonization of the chicken caecum with Salmonella typhimurium by pre-treatment with strains of Escherichia coli. AB - Simultaneous oral administration of broth cultures of three strains of Escherichia coli isolated from sewage and an abattoir strongly inhibited the colonization of a subsequently administered strain of Salmonella typhimurium. The three strains were protective against the S. typhimurium strain under a variety of conditions: in different breeds and in chickens fed different diets. The strains were not equally effective against other salmonella strains. Oral administration of the strains produced a statistically significant reduction in the excretion of the S. typhimurium strain over a period of 7 weeks. PMID- 3517155 TI - The adverse effect of dilution on the infectivity of Fusobacterium necrophorum culture. AB - Dilution had an adverse effect on the infectivity of 24 h cultures of a strain of Fusobacterium necrophorum, which became apparent at or near the minimum lethal dose. Thus in mice inoculated subcutaneously the mortality produced by 0.01 ml of undiluted culture was almost invariably greater than that produced by 0.1 ml of a 1 in 10 dilution. The explanation appeared to lie in the increased physical separation of bacterial cells that was the inevitable consequence of dilution. PMID- 3517154 TI - Self-disinfecting plastics for intravenous catheters and prosthetic inserts. AB - A disinfectant (2,4,4'-trichloro-2'-hydroxydiphenyl ether: Irgasan, Ciba-Geigy) was incorporated into plastic washers fabricated from ethylvinyl acetate (EVA), polyethylene, polypropylene or TPX. Plastics containing 0.2 and 2% Irgasan gave zones of inhibition on nutrient and blood agar plates seeded with micro-organisms (Staphylococcus aureus, Staph. epidermidis, Escherichia coli, Proteus mirabilis or Candida albicans) even after thorough washing. Exceptionally, C. albicans was inhibited only by 2% Irgasan, and EVA gave good inhibition only against the staphylococci. Similar washers of each plastic were implanted subcutaneously into the flanks of rabbits; before insertion each was washed, had thread woven into it and was surrounded by a plasma clot containing 2 X 10(8) Staph. aureus. All the plastics without Irgasan gave rise to abscesses, none of the plastics impregnated with 2% Irgasan did, though from 2 out of 12 sites small numbers of Staph. aureus were isolated at post mortem. Using either clinical or bacteriological criteria, the results were highly significant (P less than 0.00001 and P less than 0.001 respectively), demonstrating the effectiveness of this technique in preventing plastic-associated infection. PMID- 3517156 TI - Studies on microbial quality of filtered water in households of a university community in Nigeria. AB - Water samples from home filters in nine residential areas of a Nigerian university community were studied. The membrane filter technique was used to determine the total coliform and faecal coliform counts/100 ml of water. Most of the 100 samples studied were grossly contaminated with total coliform counts/100 ml ranging from 0-442, faecal coliform counts/100 ml, 0-216 and the total aerobic plate count per millilitre ranged from 3.0 X 10(3) to 1.9 X 10(9) c.f.u. The source (dams) of water, fitness of filter candles, frequency of cleaning candles and pH of water did not significantly (P greater than 0.05; chi2) affect the microbial quality of either filtered boiled or unboiled tap water. Escherichia coli type I was isolated from 17.9% of the faecal coliforms tested but from only 2.3% of total coliforms. Enterobacter aerogenes was most predominant (38.5%) amongst faecal coliforms isolated while Enterobacter cloacae was the most frequent (37.2%) of the total coliform isolates. The gross contamination of filtered water from all households sampled calls for an enlightenment of residents on the proper use of home water filters. PMID- 3517157 TI - The method of transmission of epidemic influenza: further evidence from archival mortality data. AB - Evidence for influenza-associated excess mortality in the three centuries before the 20th has been sought from parish burial registers in Cumbria, Devon, Dyfed, East Anglia, Gloucestershire and Northumbria, compared with inter-epidemic years. Most of the registers showed excess of burials concordant with eight historic influenza epidemics. Comparison of the dates of these epidemics, deduced from the burials data in different areas, showed a rate of spread difficult to reconcile with direct person-to-person spread of influenza from the sick. An alternative explanation based on development of latency of the virus in the sick person and subsequent seasonal reactivation is discussed. PMID- 3517158 TI - Activation analysis of human hair as a tool for environmental pollution monitoring. AB - Recent development and uses of neutron activation techniques for human hair analyses are reviewed. The method of neutron activation analysis (NAA) appears to have the potential to be used as a tool for environmental pollution monitoring. Principally, two types of NAA procedure are in use nowadays for multielement analyses of human scalp hair. The more common of these is the method of instrumental neutron activation analysis (INAA), consisting of a single short term (3-10 hours) exposure of hair to a beam of neutrons in a nuclear reactor, followed by two measurements of gamma-ray spectra at 2-3 days and 3-4 weeks after the end of irradiation. The following microelements can be commonly determined by this type of activation procedure: As, Au, Br, Cu, K, La, Na, Sb, Sm, Co, Cr, Cs, Fe, Hg, Rb, Sc, Se and Zn. The other of the two procedures involves the use of radiochemical separation techniques and is employed for quantitative determinations of elements that are not easily determined by INAA (Mo, Cd, Ni, etc.), or in cases where there is a need to achieve the lowest possible limits of analytical determination. The accuracy of NAA techniques is strongly dependent on the hair sampling and hair sample processing methods used. The analytical error of this method may vary within the range of 5-15%. Its applicability as a tool for monitoring the environmental pollution level is here demonstrated on an example of groups of individuals living in the areas differing by the degree of environmental pollution. The use of other biopsy materials, such as e.g. mammalian hair, for the purpose of environmental exposure monitoring is also considered in this review. PMID- 3517159 TI - The hair of the common hare (Lepus europaeus Pall.) and of the common vole (Microtus arvalis Pall.) as indicator of the environmental pollution. AB - We made the INAA of hair of the common hare (Lepus europaeus Pall.) and of the common vole (Microtus arvalis Pall.) living in the emission zones. Both the hare and the vole are almost exclusively herbivores; they consume relatively large amounts of contaminated food and mirror reliably the contamination degree of the respective ecosystem. The use of free-living animals for the control of the environmental quality may complete effectively the information obtained by examination of habitants. Though the free-living animals lead a rather different way of existence it has been found that the analyses of their hair correlate very well with the analyses of human hair. It may be expected that the changes of concentrations of heavy metals will manifest themselves earlier in animals than in men, because the animals are strictly tied to the local food sources. The hair samples of hares contained increased concentrations of Sm, La, Au, As, Se, Cr, Sc, Fe, Ce, Th and Co. The hair of voles showed increased concentrations of Sm, La, Zn, As, Se, Cr, Sc, Fe, Sb, Ce, Cs and Co. A conspicuous trend towards the cumulation in hair was observed in the following elements: As, Se, Sc and Fe. The increase of their concentrations in the hair of animals from the emission regions amounted as such as to 10(3)%. PMID- 3517160 TI - Different subclass distribution of IgA-producing cells in human lymphoid organs and various secretory tissues. AB - A highly reproducible paired immunofluorescence staining method was used to map the relative distribution of IgA1- and IgA2-producing cells in peripheral lymphoid organs and various secretory tissues. Spleen, peripheral lymph nodes, and tonsils all contained a marked predominance (91 to 95%) of IgA1 immunocytes. However, striking variations were demonstrated among the secretory tissues with regard to the median proportion of IgA1-producing cells: nasal mucosa, 96%; lacrimal glands, 81%; major salivary glands, 66%; mammary glands, 63%; gastric and proximal small intestinal mucosa, 84 to 77%; ileum, 55%; and large bowel, 41%. Thus, IgA2 production is relatively enhanced mainly in the distal gut and in mammary and salivary glands, in that order. PMID- 3517161 TI - Plasma membrane and intracellular expression of globotetraosylceramide (globoside) in mouse bone marrow-derived mast cells. AB - The cellular localization of globotetraosylceramide (globoside), one of the predominant neutral glycosphingolipids of mouse interleukin 3-dependent, bone marrow culture-derived mast cells (BMMC), has been determined by immunologic and chemical methods. Although less than 10% of BMMC expressed globoside on their surface, as assessed by cytofluorographic analysis of the binding of a mouse monoclonal IgM anti-globoside antibody, treatment of BMMC with nonactivating doses of pronase, trypsin, or neuraminidase increased the percentage of BMMC binding anti-globoside antibody by an average of six, three, or sixfold respectively. That most BMMC had globoside on their plasma membrane was confirmed by the surface radiolabeling of globoside with galactose oxidase and sodium borotritide, as detected by autoradiography of thin layer chromatograms of the extracted neutral glycosphingolipids. Thus, BMMC expressed globoside on their plasma membrane, but accessibility of a large probe such as IgM antibody to the glycosphingolipid was impeded by surrounding surface molecules. All BMMC bound anti-globoside antibody intracellularly, as assessed by indirect immunofluorescence staining and fluorescence microscopy on acetone-permeabilized cells, and the pattern of staining suggested that globoside was associated with the secretory granules of BMMC. Immunologic activation of BMMC resulted in a fivefold increase in the surface expression of globoside, as detected by cytofluorographic analysis of the binding of monoclonal anti-globoside antibody. The findings suggest that activation of BMMC causes a reorganization of the plasma membrane such that globoside is more exposed or that activation is accompanied by movement of globoside from internal membranes to the plasma membrane. The increased expression of globoside is a novel marker of the activated mouse BMMC. PMID- 3517162 TI - Induction of bone marrow allograft rejection and hybrid resistance in nonresponder recipients by antibody: is there evidence for a dual receptor interaction in acute marrow graft rejection? AB - Acute marrow graft rejection in allogeneic or semiallogeneic donor-recipient mouse combinations has been suggested to be caused by natural killer (NK) cells. The unique in vitro specificity of NK cells for tumor cells, however, does not explain the specific rejection of bone marrow grafts by NK cells. Recent experiments have implicated antibody in marrow graft recipients as the specificity-inducing component that guides NK cells in an antibody-dependent cytotoxic (ADCC) reaction to attack the marrow graft. On the basis of this hypothesis, one would postulate that nonresponder marrow graft recipients can be converted into responders by injection with antibody of appropriate specificity. Results presented in this report show that this is indeed possible. Specific monoclonal or polyclonal antibody of IgG isotype induces marrow graft rejection in nonresponder recipients. This can be demonstrated in allogeneic as well as in semi-allogeneic (hybrid resistance) donor-recipient strain combinations. Antibody induced marrow graft rejection is independent of complement and dependent on the presence of NK cells. Surprisingly, graft rejection induced by antibody is quite efficient in allogeneic and semiallogeneic marrow donor-recipient combinations, whereas it is generally poor in syngeneic combinations. This result is not understood if NK cells lyse bone marrow cells solely in an ADCC-type reaction. Because NK cells can lyse targets in an antibody-dependent as well as independent reaction, it is proposed that the binding of NK cells to targets via their receptors plays an additional role in the rejection of bone marrow in vivo. Preliminary evidence for this possibility is that NK cells in the apparent absence of antibody may have a detectable suppressive effect on the growth of marrow grafts in F1 hybrid mice transplanted with parental marrow grafts. PMID- 3517163 TI - Suppressive effects of insulin and insulin-like growth factor-1 (IGF1) on immune responses. AB - This paper describes conditions wherein the serum peptides insulin and IGF1, which are typically associated with growth-promoting functions, can suppress in vitro immune responses. IL 2-induced proliferation of lymphocytes as well as in vitro antibody-producing cultures are suppressed by physiologic concentrations of IGF1 or by superphysiologic concentrations of insulin. Suppression of IL 2 induced proliferation is not overcome by increasing the IL 2 concentration and is mediated only during the first 24 to 48 hr of the 110-hr incubation period required to measure the proliferative response to IL 2. By analogy to other biologic systems, these effects of insulin and of IGF1 are probably mediated by occupancy of the IGF1-receptor, which is cross-occupied by insulin at superphysiologic concentrations. These data support the possibility of a novel function for these endocrine and endocrine-like peptides and also expands their range of biologic activities to within the immune system. PMID- 3517164 TI - Reversal by lymphokines of the effect of cyclosporin A on contact sensitivity and antibody production in mice. AB - Cyclosporin A (CsA) treatment of mice during the first 4 days of the sensitization phase prevents induction of contact sensitivity to trinitrochlorobenzene (TNCB). Administration of CsA on the day of ear challenge with TNCB also inhibits the effector phase of this response. Simultaneous treatment of the mice with IL 2-containing murine lymphokine preparations or with recombinant human IL 2 reverses the effect of CsA on the induction of contact sensitivity. Recombinant IL 2 also reverses the inhibition by CsA of the effector phase. Neither phase of the response is restored by murine IFN-gamma. Anti-body production to trinitrophenylated (TNP) Ficoll or TNP-hemocyanin is also strongly inhibited (greater than 75%) by CsA injected on the day of antigen injection. Although lymphokines or endotoxin may strongly enhance these responses, no reversal of the effect of CsA can be obtained. We conclude that inhibition of IL 2 production is of paramount importance for the inhibitory effect of CsA on contact sensitivity, but that additional effects are involved in the inhibition of antibody production to both T-dependent and T-independent antigens. PMID- 3517165 TI - Surface-bound capsular polysaccharide of type Ia group B Streptococcus mediates C1 binding and activation of the classic complement pathway. AB - The role of surface-bound type Ia group B Streptococcus (GBS) capsular polysaccharide in antibody-independent binding of C1 and activation of the classic complement pathway was investigated. In a radiolabeled bacterial polymorphonuclear leukocyte (PMN) association assay, a measure of bacterial opsonization, preincubation of 3H-type Ia GBS with purified F(ab')2 to the organism blocked the association of the bacteria with PMN', and the inhibitory effect was dose dependent. The specificity of F(ab')2 blocking was shown after adsorption of F(ab')2 with type Ia polysaccharide-sensitized erythrocytes. Polysaccharide-adsorbed F(ab')2 had a 70% decrease in ability to block the association of bacteria with PMN. Evidence for the requirement of the capsular polysaccharide in classic complement pathway activation came from a C1 transfer assay with the use of neuraminidase-digested type Ia GBS. Neuraminidase digestion removed 80% of the terminal sialic acid residues from the native polysaccharide. These neuraminidase-digested organisms had a 72% decrease in binding and transfer of purified C1 compared with non-enzyme-treated organisms. Type Ia capsular polysaccharide bound to sheep erythrocytes promoted classic complement pathway mediated hemolysis of the cells. The role of C1 inhibitor (INH) in modulation of C1 activation by the organisms was investigated. The possibility existed that the C1 INH could be bound by the bacteria, allowing C1 activation to occur in the fluid phase. The inhibitor was purified from human serum, and its activity was measured before and after incubation with type Ia GBS. The organisms had no effect on C1 INH activity. Thus surface-bound capsular polysaccharide of type Ia GBS mediates C1 binding and classic pathway activation, and this does not involve the C1 INH. PMID- 3517166 TI - Purification and characterization of the lymphocyte function-associated-2 (LFA-2) molecule. AB - The lymphocyte function-associated-2 (LFA-2) molecule, equivalent to CD2 and the E rosette receptor, was purified by MAb affinity chromatography from the Jurkat T lymphoma cell line. Jurkat was selected for its high level of expression of 1.0 X 10(5) sites/cell. A two-site radioimmunometric assay was developed to monitor purification. From 50 g of packed cells, 230 micrograms of LFA-2 was obtained with 65% yield of antigenic activity with a purification factor of 13,000. A major component of 58,000 and 54,000 was obtained that corresponded to LFA-2 antigenic activity as shown by immunoblotting and immunoprecipitation. The doublet was resolved by 2D IEF-SDS-PAGE into components of pI = 5.5 and 5.6. Smaller amounts of lower Mr components were also seen. All these components appeared related by processing or proteolytic breakdown, as shown by Cleveland peptide mapping. The LFA-2 deoxycholate complex had an apparent Mr of 68,000 by gel filtration, suggesting it was monomeric. Purified LFA-2 inhibited rosetting of T lymphocytes with sheep E, and addition to preformed rosettes caused their disruption. Inhibitory activity was absorbed by sheep E. This is the first evidence that the CD2/LFA-2 molecule can directly bind to sheep E. Purified LFA-2 should be useful for the further biochemical and functional characterization of this molecule. PMID- 3517167 TI - Both species of chlamydia and two biovars of Chlamydia trachomatis stimulate mouse B lymphocytes. AB - We have investigated the ability of both species of chlamydiae (C. trachomatis and C. psittaci), two major biovars of C. trachomatis (lymphogranuloma venereum and trachoma), and the two developmental forms of chlamydia (reticulate and elementary bodies) to stimulate murine spleen lymphocytes. All of these forms of the bacteria induce potent proliferation and differentiation to plaque-forming cells by B lymphocytes in vitro. Chlamydiae induce a broad antibody response, suggesting that stimulation is polyclonal in nature. Although all chlamydiae possess a lipopolysaccharide (LPS) genus-specific molecule similar to LPS found on Re mutant enterobacteria, polyclonal B cell stimulation is likely caused by molecules other than LPS, since i) polymyxin B failed to inhibit chlamydia induced immunostimulation and ii) C3H/HeJ mice (LPS nonresponders) produced normal numbers of PFC after culture with chlamydia (but not LPS). Thus, a cross species moiety that is not LPS is responsible for polyclonal stimulation by chlamydia. Because these bacteria can exist in latent forms in an animal, and all forms are immunostimulatory, the question of whether these bacteria can alter immune responses if released during other infections or immunizations has been raised. PMID- 3517168 TI - Complement effects on the infectivity of Plasmodium gallinaceum to Aedes aegypti mosquitoes. I. Resistance of zygotes to the alternative pathway of complement. AB - Gametocytes are the intraerythrocytic stages of malaria parasites that infect mosquitoes. When gametocytes of the chicken malaria parasite Plasmodium gallinaceum are ingested by a mosquito they become extracellular in the mosquito midgut, form gametes, and fertilize within 10 to 15 min after the insect has taken a blood meal. Gametocytes of P. gallinaceum were infectious when fed to Aedes aegypti mosquitoes in blood meals containing native serum from chickens or from the non-host species, man or sheep. Gametocytes stimulated to undergo gametogenesis and to fertilize in vitro were also infectious when fed to mosquitoes in native chicken serum. However, native serum from most non-host species, including sheep and man, suppressed the infectivity of newly fertilized zygotes to mosquitoes and lysed the zygotes in vitro. These effects were shown to be due to the activity of the alternative pathway of complement (APC) in the serum of the non-host species. After mild trypsin treatment, the zygotes of P. gallinaceum no longer infected mosquitoes in the presence of native chicken serum, although in heat-inactivated chicken serum their infectivity was normal. We conclude that trypsin-sensitive components on the zygotes surface protect them from destruction by the APC of their native host. The ability of gametocytes of P. gallinaceum to infect mosquitoes in the presence of native human serum is probably due to proteases that inactivate the APC of human serum before the gametes and zygotes emerge as extracellular parasites in the blood meal. PMID- 3517169 TI - Evaluation of alternative methodologies for the generation of murine monoclonal anti-idiotypic antibodies to human B cell leukemias and lymphomas. AB - The standard immunization procedure for the development of monoclonal antibodies to human malignant B cell idiotype immunoglobulin in our laboratory consists of intraperitoneal immunization with 50-100 micrograms of purified immunoglobulin followed 7 days later by intravenous immunization with an equal quantity of protein. In order to shorten the process and decrease the amount of idiotypic immunoglobulin necessary for successful immunization, we have evaluated 2 alternative immunization procedures. When immunized by the standard method, the percentage of hybridomas demonstrating anti-idiotype activity was 0.3-1.0%. In order to increase the proportion of anti-idiotype hybrids tolerance to the constant regions of human IgM was established by intraperitoneal administration of disaggregated human gamma globulin 14 days prior to immunization of both male and female mice. The percentage of wells with anti-idiotype activity rose to 16 52% in tolerant male mice. The percentage of anti-idiotype hybrids generated was significantly lower in tolerant female mice. To accelerate the process of anti idiotype development, a single intrasplenic immunization with soluble idiotype IgM was also evaluated. No anti-idiotype or anti-IgM secreting heterohybrids were formed out of nearly 1400 wells seeded in 3 separate fusions using soluble IgM. When the idiotype IgM was immobilized onto protein A-Sepharose, and then injected intrasplenically, approximately 1% of the wells seeded showed anti-idiotype activity. Thus, a single intrasplenic immunization with immobilized immunoglobulin resulted in significant time saving, while prior tolerization may greatly increase the percentage of anti-idiotype hybrids. PMID- 3517170 TI - An improved semi-quantitative enzyme immunostaining procedure for glycosphingolipid antigens on high performance thin layer chromatograms. AB - An immunoassay is described which allows the detection of glycosphingolipid (GSL) antigens on high performance thin layer chromatograms (HPTLC). The method involves: (1) the separation of GSL on HPTLCs; (2) incubation with specific antibodies against carbohydrate structures of GSL, and (3) the detection of specifically bound antibodies with alkaline phosphatase-conjugated second antibodies and 5-bromo-4-chloro-3-indolyl-phosphate (BCIP) as substrate. Using a monoclonal rat IgG2c antibody against Forssman GSL, a BALB/c monoclonal antibody against asialo GM2, and polyclonal rabbit antibodies against asialo GM1, it was shown that as little as 3 ng GSL antigen could be detected in a procedure taking detected in a procedure taking only 4 h to perform. The assay should be useful for screening mono- and polyclonal antibodies with potential specificity for GSL antigens, for the detection and quantification of GSL-antigens in tissue extracts, and for defining the specificity of anti-GSL antibodies. PMID- 3517171 TI - Description and comparison of three in vitro methods for the detection of guinea pig MHC antigens. AB - Two methods (an immunoenzymatic and a cell dot immunobinding assay) are described and compared with a reference protein A rosetting assay, for the detection of guinea pig class I and class II histocompatibility antigens. The main requirement of these three assays for obtaining good results is the use of whole fresh target cells since all tested experimental conditions for fixing cellular antigens (glutaraldehyde, formaldehyde, paraformaldehyde), as well as for obtaining cell monolayers (adherence, desiccation, poly-L-lysine) presented several drawbacks and were unsuccessful in our hands. The comparison between the three methods shows that the immunoenzymatic assay gives good results but that it is less reproducible than the other two. The cell dot immunobinding is highly sensitive, reproducible and economical. It can be used for genetic typing and alloantigen analysis of guinea-pig lines, instead of the rosetting method, which is highly reliable but time consuming. PMID- 3517172 TI - A protein A-binding, polyethylene glycol precipitation-based immunoradiometric assay. Application to the detection of immune complexes and C3 in human sera and of private antigens in cross-reacting parasite extracts. AB - An immunoradiometric assay, based on the precipitation of antigen-antibody complexes by polyethylene glycol (PEG) and on the subsequent binding of PEG soluble radiolabelled staphylococcal protein A to the PEG-insoluble complexes, is described. The assay can be applied to the detection of naturally occurring, circulating immune complexes, and of complexes artificially created by mixing antigen and antibody solutions, which makes it of potential use for the detection of either antigen or antibody in several situations. Pre-treatment of the antibody-containing sera with 3% PEG greatly reduced the background values and increased the sensitivity of the assay. The assay was also applied to the detection and isolation of Leishmania donovani antigens that did not cross-react with antigens of the related parasite Trypanosoma cruzi (private antigens) and private antigens of insect-derived metacyclic trypomastigotes of T. cruzi in relation to culture-derived metacyclic trypomastigotes of T. cruzi. A simple and extremely effective procedure for washing precipitates with just one centrifugation is also described. PMID- 3517173 TI - A new micromethod for the evaluation of Fc receptor expression on polymorphonuclear neutrophils. AB - A simple method for the evaluation of rosetting polymorphonuclear neutrophils is described. It uses small (200 microliter) quantities of heparinized whole blood and is simpler than the micromethod proposed by Buescher and Gallin. The high concentration of neutrophils and paucity of lymphocytes considerably simplify the evaluation of specimens and make the technique particularly useful in granulopenic states. There was a close correlation between results obtained using this technique and those from a standard method requiring the isolation of polymorphonuclear neutrophils. PMID- 3517174 TI - A quantitative dot immunobinding assay for human HLA class II antigens using nitrocellulose membrane filters. AB - A quantitative method for the evaluation of human HLA-DR antigen expression has been developed. Cell membrane proteins were solubilized in Nonidet P-40 or deoxycholic acid detergent and diluted in a Triton X-100 containing sample buffer. The samples were subsequently spotted on a nitrocellulose membrane filter and fixed by immersion in isopropyl alcohol-acetic acid solution. The membrane was saturated in a 5% BSA blocking buffer and sequentially incubated with specific monoclonal anti-HLA-DR antibody, and 125I-labelled protein A. Each spot was then assayed for radioactivity in a gamma scintillation counter. Immunoadsorbant purified HLA-DR antigen was used to standardize the method and a reference dosage curve was established with serial dilutions of the purified HLA DR antigen. The method permitted the detection of HLA-DR antigens with reproducibility in the ng range, in cellular extracts, physiological and pathological fluids, and in fractions eluted from affinity columns. PMID- 3517175 TI - Cytoplasmic immunofluorescence and light scatter analysis of lamina propria plasma cells by flow cytometry. AB - Cytoplasmic immunoglobulin of lamina propria plasma cells was analyzed by immunofluorescence on the flow cytometer. Lymphoid cells were made permeable to immunofluorescent reagents by treatment with Triton X-100. These cells were then reacted with FITC (green) anti-light chain and with phycoerythrin (red) anti heavy chain antibodies. Flow cytometric analysis of these cells revealed that plasma cells expressing cytoplasmic immunoglobulin light and heavy chains were specifically stained by the immunofluorescent reagents. These plasma cells were also shown to have membrane Ig as detected by cell surface immunofluorescence. Light scatter analysis indicated that these plasma cells could be distinguished from lymphocytes by 90 degrees light scatter. These studies provide a method by which several parameters of gut plasma cells can be analyzed by flow cytometry. PMID- 3517176 TI - Detection of circulating Yersinia-immunoglobulin complexes by enzyme immunoassay (EIA). AB - An enzyme immunoassay (EIA) was developed for the detection of Yersinia immunoglobulin complexes of known Ig class. Immune complexes (ICs) were attached to polystyrene microtiter plates by rabbit anti-human immunoglobulins, and the existence of Yersinia enterocolitica O:3 antigens was demonstrated using Fab fragments of alkaline phosphatase (AP)-conjugated antibody against the same serotype. Simultaneous binding of Yersinia antigens and immunoglobulins was a prerequisite for the detection of ICs. The method will be valuable for research into the immunopathogenetic mechanisms leading to reactive arthritis after Yersinia infection. PMID- 3517177 TI - Plaque antibody selection: rapid immunological analysis of a large number of recombinant phage clones positive to sera raised against Plasmodium falciparum antigens. AB - A library of Plasmodium falciparum genomic DNA on the lambda gt11 phage vector was screened for clones positive to a rabbit serum raised against a purified fraction of P. falciparum proteins and a pool of sera from malaria patients. The positive clones were characterized with antibodies purified by the plaque antibody selection technique. This technique consist of purifying specific antibodies on a nitrocellulose filter blotted directly on a lawn of plaques of an antigen-producing phage clone. The purified antibodies are then used as a probe in a Western blot of parasite protein extract, for preliminary characterization of the clones. Using this method, two different clones coding for P. falciparum antigens were identified with the rabbit serum and about 20 with the human sera. This method can be of general use, i.e. it is not limited to parasite systems, and facilitates the immunological analysis and identification of a large number of clones. PMID- 3517178 TI - Use of particulate antigen to enhance primary in vitro antibody responses to trinitrophenyl-keyhole limpet hemocyanin. AB - Methods are described for the efficient induction of primary anti-hapten antibody responses to trinitrophenyl-keyhole limpet hemocyanin (TNP-KLH) in vitro. Mouse leukocytes stimulated in vitro with particulate (bentonite-adsorbed) TNP-KLH demonstrated 10-fold more IgM-secreting, plaque-forming cells (PFC) as measured by a hemolytic plaque assay than did leukocytes stimulated with soluble TNP-KLH. The T dependency of the enhanced antibody response was confirmed using highly enriched B and T lymphocyte populations. These methods should greatly facilitate studies regarding primary in vitro antibody responsiveness to T-dependent antigens. PMID- 3517179 TI - A standard microcytotoxicity technique for quantitative analysis of lymphocyte subsets. A comparison with indirect immunofluorescence, evaluated by microscopy or flow cytometry. AB - A standard complement-dependent microcytotoxicity (CDC) technique was used for quantitative analysis of T-lymphocyte subsets in human peripheral blood and the results compared to those obtained by indirect immunofluorescence microscopy and flow cytometry. The monoclonal antibodies OKT3, OKT4 and OKT8 were used in the CDC method for detection of total-T cells, T-helper and T-suppressor cells respectively. The CDC technique provided reproducible results (CV, 3-7%) correlating well with both immunofluorescence techniques. This observation was valid both for healthy persons (n = 21) and for patients (n = 10) with immunological disorders. The correct antibody dilution, correction for background and the use of eosin staining are considered critical for the usefulness of this technique. The method has several advantages: it is widely used for histocompatibility testing, only simple equipment is necessary, and the amount of monoclonal antibody required per test is small. PMID- 3517180 TI - An acceptable approach to R.P.D. in present socio-economic set-up. PMID- 3517181 TI - Control of bancroftian filariasis by salt medicated with diethylcarbamazine citrate. PMID- 3517182 TI - Asymptomatic ileal perforation by copper-T. PMID- 3517183 TI - Use of dot-immunobinding and immunofluorescence assays to investigate clinically suspected cases of chancroid. AB - In 1984 and 1985, outbreaks of genital ulcers occurred in Florida and New York. Initial investigations for syphilis, herpes simplex, Chlamydia trachomatis, and Haemophilus ducreyi did not implicate any of these organisms as etiologic agents. From the results of dot-immunobinding assays, we found that sera from the patients had higher levels of IgM (30 [47.6%] of 63 patients) and IgG (22 [34.9%] of 63 patients) reactivities with an outer-membrane preparation from H. ducreyi strain CIP542 than with outer-membrane preparations from Haemophilus influenzae ATCC 10211 or Haemophilus parainfluenzae ATCC 7901. In contrast, sera from 35 patients in the control group did not react with any of the outer-membrane preparations (P less than .01 for both IgM and and IgG reactivity), nor did sera from eight individuals with disease caused by H. influenzae (P = .051 for IgM reactivity, P = .02 for IgG reactivity). Indirect immunofluorescence assay using a monoclonal antibody reactive with outer-membrane preparations from H. ducreyi strain CIP542 stained organisms in smears of lesion material from genital ulcers from three of six patients. These results suggested that the cause of both outbreaks of genital ulcers was H. ducreyi which was subsequently isolated in both geographic areas. PMID- 3517184 TI - Effect of immune serum and its immunoglobulin fractions on hamsters challenged with Treponema pallidum ssp. pertenue. AB - Passive transfer of frambesial immune serum is capable of conferring complete protection on hamsters against challenge with Treponema pallidum ssp. pertenue. Treponemicidal activity in the pooled immune serum is relatively high. Immune serum and its immunoglobulin fractions, especially IgG2, also killed T. pallidum ssp. pertenue in vitro. Treponemicidal activity was present only when immune serum was administered to hamsters within a short time (three days) of frambesial challenge. By contrast, administration of pooled immune serum to hamsters infected for more than one week failed to reduce the number and size of lesions and the weight and number of treponemes in the lymph nodes. These results suggest that hamsters can develop the humoral components necessary to protect them against frambesial challenge, but these components are unable to destroy treponemes at the primary foci of infection. PMID- 3517185 TI - Role of circulating immune complexes in human secondary syphilis. AB - Studies in animal models and in the glomerulonephritis of human secondary syphilis and results from in vitro assays have suggested a role for circulating immune complexes (CICs) in human secondary syphilis. Nine adult subjects with early secondary syphilis were studied. All patients tested had CICs on C1q binding or Raji cell assays. Proteins previously described as Treponema pallidum specific antigens were detected by radioimmunoblot techniques in CICs from all five subjects tested. Biopsy of early cutaneous lesions revealed immunoreactants (IgG, C3, and/or C1q) in three of nine subjects and treponemal antigen in six of eight subjects tested. Histamine was injected intradermally as a trap for CICs, and biopsy of these injection sites revealed immunoreactants in four of nine subjects and treponemal antigen in five of eight subjects tested. A neutrophilic vascular reaction consistent with CIC-mediated vessel damage was seen in three of nine lesions and six of nine histamine injection sites. Normal controls did not show these changes. PMID- 3517186 TI - Serodiagnosis of syphilis by enzyme-linked immunosorbent assay with purified recombinant Treponema pallidum antigen 4D. AB - An enzyme-linked immunosorbent assay (ELISA) for syphilis has been developed that detects IgG antibody to purified recombinant Treponema pallidum surface antigen 4D. The 4D ELISA was capable of detecting 25 ng of 4D antigen-specific antibody. Neither 172 nonsyphilitic sera nor 20 false-positive sera in the Venereal Disease Research Laboratory test reacted in the 4D ELISA. The sensitivity of the 4D ELISA was comparable to that of the adsorbed fluorescent treponemal antibody test in primary, secondary, and latent disease. Most sera from patients with yaws or pinta were also reactive, a result indicating that a 4D antigen-like molecule also exists in the closely related pathogenic treponemes Treponema pertenue and Treponema carateum. PMID- 3517188 TI - The colonization of Peyer's patches by a strain of Salmonella typhimurium cured of the cryptic plasmid. AB - We cured a strain of Salmonella typhimurium of its cryptic plasmid and confirmed that orally administered cured strains lost virulence for mice. Loss of the cryptic plasmid rendered the S. typhimurium strain sensitive to the bactericidal action of normal human serum. However, loss of the plasmid did not change the ability of the strain to associate with HeLa cells in tissue culture. Furthermore, when administered orally to mice, both the plasmid-containing and plasmid-free strains invaded the Peyer's patches of the small intestine to the same extent, and both were capable of inducing resistance to oral challenge with virulent S. typhimurium. When injected intraperitoneally, the cured strain was eliminated rapidly, whereas the parental strain persisted. We also showed that the cured strain did not contain a plasmid copy in the chromosome. We propose that although the plasmid-cured strain of S. typhimurium is able to colonize Peyer's patches, it cannot survive when administered intraperitoneally because it is susceptible to elimination by macrophages. PMID- 3517187 TI - Functional activities of various preparations of human intravenous immunoglobulin against type III group B Streptococcus. AB - Two preparations of human immunoglobulin modified for intravenous use (iv immunoglobulin) by different methods (reduction-and-alkylation, or pH 4 treatment) were evaluated for in vitro and in vivo activity against a strain of type III group B Streptococcus (GBS). Both preparations contained similar amounts of total IgG and specific IgG antibody against the type-specific polysaccharide. In vitro, opsonophagocytic studies revealed that pH 4-treated iv immunoglobulin was significantly more effective than reduced-and-alkylated iv immunoglobulin in supporting neutrophil-mediated killing of the type III GBS strain. In vivo, both preparations resulted in similar levels of serum antibody in newborn rats, but pH 4-treated iv immunoglobulin was significantly more protective against the type III GBS strain. This was demonstrated by the lower magnitude of bacteremia, improved survival, and lower protective dose (PD50) in recipients of pH 4-treated iv immunoglobulin. Thus, reduced-and-alkylated iv immunoglobulin was less effective in vitro and in vivo against the strain of type III GBS than was pH 4 treated iv immunoglobulin. Further studies are needed to elucidate the mechanisms for this apparent discrepancy in functional activities of iv immunoglobulin. PMID- 3517189 TI - The role of Shigella spp., enteroinvasive Escherichia coli, and other enteropathogens as causes of childhood dysentery in Thailand. AB - Shigella spp. were isolated from 44%, Pleisomonas shigelloides from 22%, Campylobacter spp. from 16%, and Salmonella spp. from 10% of 200 Thai children with mucoid or bloody diarrhea. Enteroinvasive Escherichia coli (EIEC) was identified by examining isolates of E. coli for plasmids larger than 120 megadaltons (MDa), by identifying E. coli with a virulence marker antigen in an ELISA, and by performing DNA hybridization with a 17-kilobase (kb) EcoRI digestion fragment of plasmid pWR100 (a 140-MDa plasmid of Shigella flexneri 5). Sixty-four isolates of EIEC from 10 (5%) of the children were identified by these methods and confirmed by the Sereny test. All isolates of EIEC fermented lactose, and isolates of EIEC from seven children belonged to recognized serotypes of EIEC (O28ac:H- and O29:H-), whereas isolates of EIEC from three children were untypable. Examination of DNA from the total fecal growth with the 17-kb probe identified 9 of 10 children from whom EIEC were isolated and 2 of 102 children from whom EIEC or Shigella spp. were not isolated. Detection of EIEC by ELISA and DNA hybridization are important advances in defining the etiology of dysentery. PMID- 3517190 TI - Type-specific monoclonal antibody enhances the local phagocytic response to group B streptococcal infection. PMID- 3517191 TI - Stool survey for Escherichia coli O157:H7. PMID- 3517192 TI - Hemopoietic progenitor cell function after HLA-identical sibling bone marrow transplantation: influence of chronic graft-versus-host disease. AB - We examined hemopoietic reconstitution during the first 12 months post-transplant in 31 patients given high-dose cyclophosphamide, total body irradiation and an HLA-identical sibling marrow transplant for hematological malignancy. Unexpectedly, we found marrow CFU-gm and marrow CFU-e cells to be denser than normal throughout the first year post-transplant. While functionally adequate neutrophil and platelet counts were achieved in the first six weeks post transplant, there were defects in hemopoietic progenitor cell function during the first year post-transplant. Although we could detect no influence from acute graft-versus-host disease (GVHD), chronic GVHD adversely affected the growth of both myeloid and erythroid blood progenitor cells. PMID- 3517193 TI - [Lipid transfer proteins]. PMID- 3517194 TI - [Structure and function of the heat shock regulatory gene]. PMID- 3517195 TI - [Regulation of glucose transport system in animal cells (mechanisms of adaptive regulation)]. PMID- 3517196 TI - [Experimental induction and cytogenetic study of yolk sac tumors in Chinese hamsters]. AB - The development of teratomas and yolk sac tumors from displaced yolk sac is well documented in rats and mice. However, the precise mechanisms of induction and pathogeneses of these tumors still remain unknown. The present study was undertaken in order 1) to elucidate whether this phenomenon is common to all rodents, 2) to identify the origin of these tumors and 3) to explore specific chromosomal changes in yolk sac tumors. Ten benign teratomas and two malignant tumors with teratomatous elements were obtained from 33 Chinese hamsters after fetectomy, followed by displacement of yolk sac. The histological characteristics and the presence of laminin in the stroma suggested that the malignant tumors belonged to the category of yolk sac tumors. Similarities in electromicroscopic features observed in the tumor cells and the yolk sac of normal 12-day conceptuses suggested that the tumor originated from yolk sac cells. Chromosomal analyses of in vitro cell lines established from one of the yolk sac tumors disclosed that the tumors was composed of clones with an XX and XY sex chromosome constitution. The 1p + marker was identified as a consistent abnormality, which seemed to play an important role in the development of yolk sac tumors in Chinese hamsters. PMID- 3517197 TI - [Ultrasonogram and ultrasonic histogram of intrauterine clot at late pregnancy]. PMID- 3517198 TI - [Studies on individual fetal weight estimation by ultrasonography in multiple pregnancies]. AB - Fetal weight estimation was tried in each fetus in 16 cases of twins and 2 cases of triplets using the formula derived from the regression analysis of fetal biometric data and actual neonatal weights in 26 cases of singleton pregnancies. The fetal biometric data used were biparietal diameter (BPD), abdominal antero posterior diameter (APD), abdominal transverse diameter (TD), abdominal circumference (AC) and fetal femur length (FFL). The correlation between the estimated and actual weight was significant (r = 0.926) and the estimation error in neonates smaller than 2,500 g was less than 10% of the birth weight. Estimated weight differences in 16 pairs of twin pregnancies correlated well with the actual weight differences (r = 0.678). A sensitivity of 70% and specificity of 100% were revealed in the diagnosis of IUGR using the estimation formula and the intrauterine fetal growth curve. These results showed how the estimation formula derived from ultrasonically measured fetal biometric parameters, can be applied clinically but two kinds of formula with or without BPD are necessary for fetal weight estimation in multiple pregnancies as only 53% of BPD were available for fetal weight estimation. PMID- 3517199 TI - [Treatment of follicular lymphoma: 16 years' experience]. PMID- 3517200 TI - [A case of primary aldosteronism with polycystic kidney disease]. PMID- 3517201 TI - [A case of type I diabetes mellitus associated with chronic thyroiditis and thyroid cancer]. PMID- 3517202 TI - Binding of human fibronectin to antigen-antibody complexes. AB - We examined the capacity of human fibronectin (FN) to bind to antigen-antibody (IgG) complexes (IC) in the absence of complement components. Binding of FN to IC was not significantly different at 37 degrees C and 4 degrees C and reached equilibrium after 60 minutes of incubation. The binding was markedly enhanced by decreasing the ionic strength and lowering the pH of the incubation media. The effect of ionic strength on binding was caused at least in part by an increase in the percent of the total FN able to bind to IC. Binding of radiolabeled FN to IC was saturable and was inhibited by the addition of an excess of unlabeled FN. In addition, soluble IC prepared in antigen excess but not antigen or antibody alone inhibited the binding of FN to precipitable IC. FN binding to precipitable IC increased with increasing antibody concentrations in the IC. Heparin and gelatin, which bind to specific locations in the FN molecule, did not inhibit the binding of FN to IC. In conclusion, human FN binds to IC in the absence of C1q, and the binding is enhanced under conditions of antibody excess. PMID- 3517203 TI - Effect of vitamin E deficiency and selenium deficiency on insulin secretory reserve and free radical scavenging systems in islets: decrease of islet manganosuperoxide dismutase. AB - There is increasing evidence that islet beta cells may be susceptible to redox insult, and that this susceptibility may contribute to the pathogenesis of experimental models of diabetes mellitus. We investigated the effect of vitamin E deficiency, selenium deficiency, and combined deficiency on islet function and free radical scavenging systems. The tissue levels of glutathione peroxidase, catalase, and immunoreactive superoxide dismutases were measured in four groups of rats (i.e., controls and those with vitamin E, selenium, and combined deficiency). Glucose tolerance tests were performed for each animal before sacrifice. Superoxide dismutase concentrations in liver, heart, and skeletal muscle were within 20% of the control levels in all groups. However, the manganosuperoxide dismutase concentrations in islets were significantly lower than control levels in response to vitamin E, selenium, and combined deficiency. Combined deficiency appeared to have an additive effect. In contrast, cuprozinc superoxide dismutase concentration in islets was higher in the deficient groups than in controls. Insulin secretory reserve was decreased in each of the three deficient groups. This decrease was reflected as glucose intolerance only in the group with combined deficiency. Glutathione peroxidase activity was markedly decreased in selenium-deficient animals in all tissues studied. Catalase activity did not change significantly among groups in any tissue studied. Islets had the lowest glutathione peroxidase and cuprozinc and total superoxide dismutase levels among tissues studied. PMID- 3517204 TI - Role of exercise in management of diabetes. PMID- 3517205 TI - Postpartum sepsis. PMID- 3517206 TI - Hepatosplenomegaly in infectious mononucleosis, assessed by ultrasonic scanning. AB - The present study aims at an assessment of hepato-splenomegaly in infectious mononucleosis (IM). In 29 patients admitted to the ENT department with IM, based on the typical clinical and laboratory findings, including a positive mononucleosis test in most cases, the size of the liver and spleen was estimated by ultrasonic scanning on days 1, 3, 5, 10, 20, 30, 90 and 120 after admission. A control group of eight patients with peritonsillar abscess was included for comparison. The results showed that all patients had an enlarged spleen (mean enlargement: 50-60 per cent) but only a few were palpable. Half of the patients had enlargement of the liver (5-20 per cent), which was palpable in only 8 per cent. There was no correlation between the size of the spleen and that of the liver, not between the changes in the size of these organs. There was no enlargement of the liver or spleen in the control group. No correlation was found between the size, or changes in the size, of the organs and blood values such as lactatdehydrogenase and aspartatamino-transferase. There is, however, a striking parallelism between the curves for these parameters, which might indicate that the organs as well as the blood tests return to normal within 28 days. If this holds true, our warning to abstain from physical exercise and alcoholic intake may be limited to a period of about 1 month. PMID- 3517207 TI - The in vitro mitogenic response to intact bacteria by murine B cells does not predict in vivo susceptibility to Salmonella typhimurium. AB - We are interested in developing in vitro culture systems that will permit immune responses to intact Salmonella typhimurium, since these systems would have certain advantages over in vivo infection models for the characterization of the host's responding cell types. In this report, the in vitro proliferative response of nonimmune murine spleen cells to four different killed preparations of S. typhimurium, strain TML (TML), are examined. These studies show that UV-killed TML, heat-killed TML, glutaraldehyde-killed TML, and acetone-killed and dried TML, all elicit a nonspecific mitogenic spleen cell response in vitro, as does a live, avirulent, temperature-sensitive mutant of TML, TS27. This response reaches a maximum on day 2 after initiation of culture, which is similar to the time course of a conventional lipopolysaccharide (LPS) response. Unlike the LPS response, little 3H-thymidine incorporation is observed in low-density cultures (2 X 10(5) cells/well), which suggests a critical role for accessory cells. The responding cell types include, but are not necessarily limited to, the B-cell population. The response cannot be readily inhibited by polymyxin B, which binds specifically to the lipid A portion of LPS. Thus, the bacterial components required for mitogenicity are not yet definitively identified. A survey of the mitogenic responses of lymphocytes from various inbred mouse strains, including the C3H/HeJ LPS hyporesponsive strain, indicates that all B cells tested are capable of proliferating vigorously in response to intact TML, regardless of the in vivo susceptibility to virulent infection. These results also emphasize the importance of assessing the nonspecific components of the immune response when studying the specific immune response to intact S. typhimurium. PMID- 3517208 TI - The role of extracellular matrix proteins in the control of phagocytosis. AB - The phagocytic function of human-peripheral-blood-derived mononuclear and polymorphonuclear leukocytes can be regulated by external stimuli. In particular, the extracellular matrix (ECM) proteins fibronectin and laminin and serum amyloid P component can increase the phagocytic activity of these cells. Phagocytosis enhancement by the ECM requires two distinct signals to the ingesting cell. First, a ligand for interaction of the target particle with phagocytic cells is required. Generally this occurs because of opsonins such as antibody or complement on the phagocytic target and is independent of the ECM proteins. The phagocytosis-enhancing effect of the connective tissue proteins also requires direct interaction of these proteins with phagocytic cells and occurs through cell surface receptors for these molecules. In the case of neutrophils, sensitivity to the phagocytosis-enhancing effects of connective tissue proteins requires prior stimulation with the chemotactic peptides C5a or f-met-leu-phe. The present state or knowledge of the mechanism of phagocytosis enhancement by ECM proteins and the implications of the phenomenon for host defense are discussed. PMID- 3517209 TI - Immunohistochemical detection of 6-oxo-PGF1 alpha and PGE2 in radicular cysts. AB - Prostaglandin synthesis in the wall of radicular cysts was determined by immunohistochemistry and radiothinlayer chromatography. PGE2 is predominantly produced by plasma cells and histiocytic elements, whereas much less is synthesized by fibroblasts and endothelial cells as estimated using immunohistochemistry. 6-oxo-PGF1 alpha, however, was primarily found to be generated by endothelial cells and fibroblasts; only small amounts seem to be derived from histiocytic elements and plasma cells. The response of the cystic epithelium to anti-PGE2 and anti-6-oxo-PGF1 alpha antibodies was negative or showed only minimal staining. It can thus be concluded that the granulation tissue and its cellular components modulating the inflammatory process are the main source of prostaglandin synthesis in the wall of radicular cysts and may therefore be responsible for the resultant osteolytic activity. PMID- 3517210 TI - The versatility of pectoralis major and latissimus dorsi myocutaneous flaps in the reconstruction of cancrum oris defects of children and adolescents. AB - The application of the recently described myocutaneous flaps in 7 cases of cancrum oris defects is shown and the consistency of the blood supply in children is stressed. The surgical anatomy is mentioned and the use of the flaps in the reconstruction of defects of the cheek, angle of mouth, lips and chin is illustrated. The excellence of the muscle island flap in preventing reankylosis if interposed into new joints in the body of the mandible is emphasised, together with the advantages over the forehead and delto-pectoral flaps when used for the same purpose. PMID- 3517211 TI - The management of hypertensive disease: a review of spinal manipulation and the efficacy of conservative therapeusis. AB - When considering the ailments that plague mankind, certainly one of the enigmatic conditions is hypertensive disease. This perplexing disorder is recognized insidiously in the clinical setting. It is believed to occur because of the complex interactions of a variety of factors which act on the components of the blood vasculature. Although afflicted individuals may appear relatively asymptomatic, the additive influences of such factors eventually culminate in deleterious sequelae. Overall, hypertension appears to be related to stress, diet and lifestyle. The autonomic nervous system, particularly its sympathetic component, appears to mediate such accumulated factors, affecting the overall clinical scenario of hypertension. Although generally aligned with the aging process, this condition also may affect younger individuals. Hypertension, therefore, may be regarded as a prime condition warranting specialized care that includes proper education during the formative years, modification of dietary habits in conjunction with daily exercise regimens, and regular spinal maintenance, all of which are covered by modern chiropractic clinical practice. PMID- 3517212 TI - Aldosterone regulates salivary sodium secretion in cattle. AB - Intravenous infusion of aldosterone (10 microgram/kg body wt per h for 5 h) in four 2-month-old calves decreased salivary and urinary sodium (Na+) concentration and increased salivary potassium (K+) concentration without modifying salivary flow or urinary K+ concentration. Intravenous angiotensin II infusion (0.3 microgram/kg body wt per min for 1 h) in four Na+-replete 16-month-old bulls decreased salivary Na+ concentration and increased that of K+. It also increased plasma cortisol and plasma aldosterone concentrations, and decreased plasma renin activity (PRA). In four 16-month-old bulls Na+ deficiency (induced by chronic cannulation of the right parotid duct and loss of saliva for 5 days) had similar effects to those observed following aldosterone infusion in calves: a decrease in salivary Na+/K+ ratio. This decrease was associated with an increase in PRA and an increase in plasma aldosterone concentration. In these animals a close positive relationship was observed between PRA and plasma aldosterone concentration (r = 0.91; n = 20; P less than 0.01). Thus in cattle, during Na+ deficiency, the effect of aldosterone on parotid glands participates in the regulation of Na+ metabolism. PMID- 3517213 TI - Raised levels of calcium-binding protein in plasma following insulin-induced hypoglycaemia in the pig. AB - Insulin-induced hypoglycaemia in the pig elicited sharp increases in the plasma concentrations of vitamin D-dependent calcium-binding protein (CaBP) and cortisol and a decrease in plasma inorganic phosphate. Glucose infusion following insulin administration abolished the increases in plasma CaBP and cortisol in response to insulin and reduced the hypophosphataemia. The percentage increases in plasma CaBP and cortisol in response to insulin-induced hypoglycaemia were reduced when the pigs were fed a low-calcium diet, but the hypophosphataemic response was similar. We conclude that insulin-induced hypoglycaemia leads to increased plasma CaBP in pigs fed a normal calcium diet, which is associated with the hypoglycaemia rather than being a direct effect of insulin. We therefore suggest that plasma CaBP may represent more than a mere uncontrolled leak from its sites of storage. PMID- 3517214 TI - Stimulation of steroid production in isolated rat Leydig cells by unknown factors in testicular fluid differs from the effects of LH or LH-releasing hormone. AB - After the addition of charcoal-treated testicular fluid to Leydig cells isolated from 22-day-old rats, pregnenolone production could be increased to a maximum of tenfold within 30 min in a dose-dependent manner. Testicular fluid, but not serum, further increased pregnenolone formation threefold when pregnenolone production by Leydig cells was stimulated by the addition of LH-releasing hormone (fourfold), LH (25-fold) and 22R-hydroxycholesterol (300-fold). The effect of testicular fluid on steroid production in the presence of 22R-hydroxycholesterol was not inhibited by cycloheximide whereas cycloheximide completely inhibited the effect of LH. It appears unlikely that steroids, lipoproteins or other plasma components constitute the stimulatory agents in testicular fluid. The biologically active principles may be locally produced factors with a molecular weight greater than 25,000. Similar biological activities could be shown in testicular lymph from boars but not in systemic lymph from boars nor in charcoal treated bovine follicular fluid. The presumably locally produced factor(s) may amplify the effect of LH and can thus act as a local modulator(s). PMID- 3517215 TI - Changes in the granule population of gonadotrophs of hypogonadal (hpg) and normal female mice associated with the priming effect of LH-releasing hormone in vitro. AB - Changes in the size and position of secretory granules in pituitary gonadotrophs have been studied in relationship to LH release and self-priming induced by LH releasing hormone (LHRH) in pituitary glands from normal and hypogonadal (hpg) female mice. Hemipituitary glands were preincubated and then incubated for either 1 or 2 h in the absence or presence of LHRH (8.5 nmol/l). The glands were either processed for ultrastructural morphometry or homogenized for the determination of pituitary LH content. Morphometry was carried out on gonadotrophs identified by immunocytochemistry for LH beta using the thin/semi-thin section method. Pituitary LH content and the amount of LH released were determined by radioimmunoassay. The amount of LH released in response to the first and second hours of incubation with LHRH were similar in hpg and normal mice with a clear priming effect (three- to fourfold increase in pituitary responsiveness to LHRH) occurring in both strains. Despite a substantially reduced total number of granules (and amount of LH) in unstimulated hpg gonadotrophs, the number of granules in the outer 500 nm marginal zone of the cells was similar to that in normal mice. This could explain the similar amount of LH released from normal and hpg glands by the first LHRH challenge. The initial exposure to LHRH was also associated with a marked translocation of secretory granules from the central to the outer marginal region of cytoplasm subjacent to the gonadotroph plasmalemma, such that in 'primed' glands 60% of granules were found in this marginal zone compared with 40% (hpg) or 33% (normal) in unstimulated glands. The mean diameter of granules in the marginal zone was significantly less than that of granules in the central zone of the gonadotrophs of unstimulated glands from both normal and hpg animals. Exposure to LHRH for 1 h was associated with an increase in the number of small granules in the marginal zone and a significant decrease in the mean diameter of the gonadotroph granule population as a whole. After the primed release of LH, increased proportions of granules were still located in the marginal zone of gonadotrophs, indicating that granule migration continued during the second hour of exposure to LHRH in which primed release occurred. The primed release was associated with a detectable reduction in both the LH and granule content of gonadotrophs in normal, but not hpg glands.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3517216 TI - Evaluation of the apical seal produced by injected thermoplasticized Gutta-percha in the absence of smear layer and root canal sealer. PMID- 3517217 TI - Sealing ability of four retrofilling techniques. PMID- 3517218 TI - The requirement for lymphocyte function-associated antigen 1 in homotypic leukocyte adhesion stimulated by phorbol ester. AB - Lymphocytes become adherent and aggregate after stimulation with phorbol esters such as PMA. Time-lapse video showed that aggregating cells were motile and exhibited vigorous pseudopodial movements. Adhesion sites were initiated between pseudopodia of neighboring cells, and then moved to the uropod. PMA-stimulated aggregation by EBV-transformed B cell lines, SKW-3 (a T cell line), differentiated U937 (a monocytic line), and blood lymphocytes was inhibited by mAbs to LFA-1. A number of different mAb to the LFA-1 alpha and beta subunits and F(ab')2 and Fab' fragments inhibited aggregation. Furthermore, lymphoblasts from normal individuals, but not from LFA-1-deficient patients, aggregated in response to PMA. These findings suggest LFA-1 is critically involved in stimulated lymphocyte adhesion. LFA-1 expression was not increased by PMA stimulation, showing that other mechanisms regulate LFA-1-dependent adherence. LFA-1-deficient patient cells were able to coaggregate with LFA-1+ cells, showing that aggregation is not mediated by like-like interactions between LFA-1 molecules on opposite cells. Aggregation was Mg+2-dependent, inhibited by cytochalasin B, and was reversed when LFA-1 mAb was added to preformed aggregates. Previous findings suggesting that LFA-1 is important in a wide variety of leukocyte functions are elucidated by this work, which shows that LFA-1 is a general leukocyte cell adhesion molecule, the activity of which is regulated by cell activation. PMID- 3517219 TI - Immunocytochemical detection of interleukin 1 within stimulated human monocytes. AB - We have used synthetic peptides coupled to KLH to raise high titer antisera to human IL-1 beta, and in the present report show the usefulness of these sera for immunocytochemical analyses of IL-1 production. Using indirect immunofluorescence, we have been able to specifically identify IL-1 within human monocytes and to monitor its accumulation with time. After indirect immunofluorescent staining of LPS- and PHA-stimulated mononuclear cell cultures, intense cytoplasmic fluorescence was observed in 93% of the monocytes, but not in lymphocytes or platelets present in the same preparation. Unstimulated monocytes did not contain immunocytochemically detectable IL-1. When put into culture, however, some of the otherwise unstimulated monocytes subsequently showed a transient accumulation of intracellular IL-1. Monocytes cultured in the presence of LPS and PHA exhibited detectable fluorescence after 2.5 h, and the fluorescent intensity of these cells continued to increase over the course of 21 h. Fluorescent staining was abolished by preincubation of the sera with relevant but not irrelevant peptide, and while preimmune or anti-KLH serum produced no staining, antisera against either the amino terminus or an internal region of IL 1 beta produced identical staining patterns. Immunoblot analyses of lysates from stimulated monocytes showed that the antisera against IL-1 recognize a single intracellular species with an apparent molecular weight (33 kD) similar to that predicted for IL-1 precursor from the nucleotide sequence of IL-1 cDNA. The ability to specifically identify and immunocytochemically localize IL-1 within producing cells should prove extremely useful for studying the in situ production of IL-1 in immune-based and inflammatory diseases. PMID- 3517220 TI - Kinetic of adjustment of enzyme catalytic concentrations in the extracellular space of the man, the dog and the rat. Approach to a quantitative diagnostic enzymology, V. Communication. AB - The high degree of constancy of enzyme catalytic activity in the plasma of a given individual is regulated by a complex system of flux equilibria consisting of eight basic processes. Some of these processes are of primarily theoretic importance. Enzymes from all tissues of the body, including the liver, are released via a continuous physiological process into the interstitial space and get into the intravascular space by way of lymphatic transport. The release of enzymes from tissues directly into the intravascular space is of secondary importance as is the exchange of enzyme molecules across capillary membranes from the intravascular to the interstitial space and vice versa. In contrast, enzymes from circulating blood cells are transported directly into the intravascular space. Enzymes are removed from the intravascular space at rates which vary greatly between both enzymes and species. In a review of the literature, half lives of diagnostically important enzymes in plasma of man, dogs and rats were given and the striking differences in the results for a given enzyme are discussed from a methodological point of view. In a mathematical analysis, data for lymphatic transport of enzymes from dogs and rats (Lindena et al. (1986) this J. 24, 19-33) and of enzyme efflux from in vivo ageing erythrocytes (Lindena et al. (1986) this J. 24, 49-59) into the plasma are related to the elimination rate constants of enzymes from the plasma. The contribution of lymphatically transported enzymes to the basal catalytic activity in plasma (Lindena & Trautschold (1986) this J. 24, 11-18) amounts to 55-80% for lactate dehydrogenase and malate dehydrogenase, 80-90% for adenylate kinase and phosphohexose isomerase, 90-95% for aspartate aminotransferase and aldolase and 99% for creatine kinase. A model of Ca2+ -mediated vesicular transport of enzymes out of ageing erythrocytes is proposed. The importance of lymphatically transported enzymes to total plasma catalytic activity in dogs and rats argues for a similar contribution of lymph transport in man. PMID- 3517221 TI - Evaluation of a commercial immunoenzymometric assay kit for creatine kinase MB isoenzyme determination using monoclonal antibodies. AB - A simultaneous two-site immunoenzymometric assay for creatine kinase MB determination (Hybritech Tandem-E CK-MB) using monoclonal antibodies was evaluated and compared with cellulose acetate electrophoresis using fluorometric scanning densitometry. The assay has satisfactory precision (between-day analysis gives a coefficient of variation between 2.1 and 9.4%) and is not susceptible to interference by concentrations of creatine kinase MM up to 5000 micrograms/l (3400 U/l) and creatine kinase BB up to 1000 micrograms/l (1085 U/l). The upper limit of MB isoenzyme concentration in 250 apparently healthy people was 5.5 micrograms/l. Comparison between the immunoenzymometric assay (y) and electrophoresis (x) yielded the following linear regression equation: y = 0.37x + 1.9, with a correlation coefficient of 0.828. The characteristics of the temporal kinetics of MB isoenzyme, calculated by two methods, in 49 patients with acute myocardial infarction, were nearly identical in terms of the rate of creatine kinase MB release and the time at which the peak value is obtained, but not in terms of the rate of elimination of the isoenzyme. The fractional disappearance rate of MB isoenzyme from the circulation was significantly higher if calculated with Tandem-E results rather than with electrophoresis results (-0.035 vs -0.028, p less than 0.001). Whereas in the first day after infarction immunoenzymometric assay and electrophoresis had the same clinical sensitivity for identifying patients with acute myocardial infarction, in specimens collected more than 24 hours after the onset of the chest pain, the clinical sensitivity of the immunoenzymometric method was lower. Our results show that it is still premature to draw definitive clinical conclusions from the immunoassay results. PMID- 3517222 TI - Monitoring of urinary proteins by SDS electrophoresis in kidney transplant patients. AB - Sodium dodecyl sulphate (SDS) electrophoresis of urinary proteins was used routinely for monitoring more than 80 kidney transplant recipients as out patients during one year. Special attention was paid to the question of whether this method can help the clinician to differentiate between a graft rejection reaction and Cyclosporin A-induced nephrotoxic damage. Two cases are presented showing the time course of proteinuric patterns together with serum creatinine, total urinary protein and, in one case, the blood level of Cyclosporin A. Changes of proteinuric patterns signalled the start of rejection and/or nephrotoxicity. A homogeneous collective of 33 kidney recipients (first transplantation) with chronic glomerulonephritis as a basic disease was specially selected. In this collective, the distribution of proteinuric patterns among patients and its dependence on immunosuppressive therapy was investigated. During the observation period of 7 months, two proteinuric patterns, "tubular" and "mixed weak", were found exclusively in Cyclosporin A-treated patients. We ascribe this finding to nephrotoxic effect of Cyclosporin A. We found the SDS electrophoresis of urinary proteins to be a useful, non-invasive method for monitoring Cyclosporin A-treated kidney transplant patients. PMID- 3517223 TI - Two groups of capsule-specific coliphages coding for RNA polymerases with new promoter specificities. AB - Four bacteriophages (A16, CK235, phi 1.2 and K31) which specifically attack different encapsulated strains of Escherichia coli have been shown to be related to bacteriophage T7 (which is unable to grow on encapsulated hosts). The conclusion that phages A16 and CK235 are related to T7 is based on similarities in the pattern of expression of intracellular phage proteins, early appearance, in infected host cells, of a phage DNA-specific RNA polymerase and hybridization (albeit to a low extent) of A16 DNA and of CK235 DNA to T7 DNA. The first two criteria also apply to phages phi 1.2 and K31 but hybridization of their DNAs with T7 DNA could not be detected. The RNA polymerases of CK235 and A16 have similar template specificities and the same applies to the RNA polymerases of phi 1.2 and K31. None of the new RNA polymerases can use T7 DNA as template. PMID- 3517224 TI - Antigenic variation between human respiratory syncytial virus isolates. AB - Three hybridoma antibodies, prepared against the RSN-2 strain of human respiratory syncytial (RS) virus, have been used to identify antigenic variation between 41 isolates of RS virus collected from widely separated geographical regions over a period of 29 years. One antibody was directed against an antigenic site on the virus fusion protein, VP70. This site was shared by 21 virus isolates tested and its recognition by the antibody was sensitive to the presence of 2 mercaptoethanol. The remaining two antibodies used react against the virus phosphoprotein, VPP32. Two independent sites were recognized on VPP32 by these antibodies. One antibody reacted with all of the virus isolates screened while the second reacted with only 21 out of the 41 virus isolates. On the basis of the variable epitope, two antigenic types of human RS virus were identified. The distribution of each antigenic group among 28 RS virus isolates from the Grampian Region, north-east Scotland, collected between 1982 and 1984 was determined. The reactivity of these antibodies was examined using immunofluorescence staining and by immunoblotting; the latter technique also revealed that the electrophoretic mobility of VPP32 varied in parallel with the variable antigenic site. PMID- 3517225 TI - Interaction of frog virus 3 with the cytomatrix. IV. Phosphorylation of vimentin precedes the reorganization of intermediate filaments around the virus assembly sites. AB - Frog virus 3 (FV3) assembles in morphologically distinct assembly sites in the cytoplasm of infected cells. As the assembly sites form, the intermediate filaments (IF) aggregate, delimit the assembly sites, and remain so throughout infection. To determine the molecular basis of reorganization of IF, we analysed the vimentin of uninfected and FV3-infected cells by two-dimensional gel electrophoresis. The results showed that (i) the vimentin was more acidic in FV3 infected cells than in uninfected cells, (ii) the acidification of vimentin in FV3-infected cells was possibly due to a fourfold increase in phosphorylation, and (iii) the phosphorylation of vimentin preceded the reorganization of IF around virus assembly sites. A temperature-sensitive mutant of FV3 (ts9467), which at the non-permissive temperature neither reorganized IF nor formed assembly sites, failed to increase the phosphorylation of vimentin. Together, the above results suggest that changes in phosphorylation may modulate IF organization and that changes in IF organization are required for FV3 assembly site formation. PMID- 3517226 TI - Evaluation of clinical specimens for the presence of respiratory syncytial virus antigens using an enzyme immunoassay. AB - An enzyme-linked immunoassay (EIA) was developed for the detection of respiratory syncytial virus (RSV) antigen in nasopharyngeal secretions. This assay, which employs goat and rabbit anti-RSV as the capture and detector antibodies respectively, was used in a retrospective evaluation of frozen clinical specimens from children. The EIA results were compared with those of virus isolation in cell culture and direct fluorescent antibody staining performed at the time of specimen collection. The sensitivity of the RSV EIA compared to cell culture was 91.3% (63/69) with a specificity of 96.8% (93/96). The predictive value of a positive EIA result was 95.4% and for a negative EIA result, 93.9%. The sensitivity of the RSV-EIA compared to direct FA was 91.5% (43/47) with a specificity of 96.5% (83/86). These data represent the preclinical evaluation of the Abbott RSV-EIA. This assay could prove to be a useful alternative to virus isolation or direct FA for the diagnosis of RSV infection. PMID- 3517228 TI - Propranolol treatment of assaultive patients with organic brain disease. A double blind crossover, placebo-controlled study. AB - A double-blind, placebo-controlled crossover study was conducted to examine the effects of long-acting propranolol in the treatment of violent behavior associated with organic brain disease in 10 patients whose symptoms had proved refractory to various conventional medications. Long-acting propranolol treatment was associated with reductions of assaultive behavior without apparent sedative effects. Cautions are noted regarding potential undesirable side effects which may necessitate careful patient monitoring during treatment. PMID- 3517227 TI - Homology between HBV-DNA and a sequence regulating the interferon-induced antiviral system: possible mechanism of persistent infection. AB - Treatment of hepatitis B virus (HBV)-infected hepatocytes with lymphoblastoid alpha-interferon (IFN) leads to an increased expression of the core antigen (HBcAg) and reduced expression of surface antigen (HBsAg). We have identified the presence of a nucleotide sequence at the start of the HBc gene in the hepatitis B virus genome similar to a consensus sequence known to occur upstream from genes induced by IFN in mammalian cells. It is possible that interferon influences the expression of the viral genes because of the presence of this homologous sequence. This sequence in the viral genome may determine the site of integration of the virus and could influence the ability of the cell containing the integrated viral sequence to respond to interferon. This "neutralisation" of the interferon system by viral integration might not only facilitate persistent infection but might also adversely affect response to alpha-interferon therapy. PMID- 3517229 TI - A neurotrophic factor derived from goldfish brain: characterization and purification. AB - Previous studies carried out in our laboratory have demonstrated that goldfish brain contains substances that promote neurite extension from regenerating retinae in culture. Fractionation of the brain extract by molecular sieving chromatography revealed the presence of several molecular species, including two peaks that have neurotrophic activity, representing low-molecular-weight substances. One peak was eluted (P-a) with an apparent molecular weight of about 13 kDa and was designated substratum neurite extension factor (SNEF) because it retained its neurotrophic activity when adsorbed onto the substratum. This recovered Sephadex fraction (P-a) when applied in vivo intraocularly caused an earlier capacity of the corresponding retinae to sprout in vitro. Thus, at 3 and 5 days after injury the neuritic growth indices from the factor-treated retinae were of 0.9 +/- 0.2 and 2.8 +/- 0.5, respectively, as compared with indices of 0.3 +/- 0.1 and 0.9 +/- 0.2, respectively, in retinae of injured but nontreated nerves. The factor was further purified by two steps of HPLC (ion exchange followed by reversed phase). The results showed that it is an acidic glycoprotein with an apparent molecular weight of 10 kDa. PMID- 3517230 TI - Transport of prostaglandins and other eicosanoids by the choroid plexus: its characterization and physiological significance. AB - Choroid plexi from the lateral ventricles of rabbits, cats, and dogfish (Mustelus canis) were used to characterize the prostaglandin (PG) uptake process and to establish its kinetic parameters and substrate specificity. The apparent Kt for PGF2 alpha transport by the rabbit choroid plexus was 20 microM; the Jmax was 27 nmol g-1 min-1. The Ki of inhibition of PGF2 alpha transport by PGE2 was 20 microM; the Jmax of PGF2 alpha transport was unaltered by PGE2. A concentration of p-aminohippuric acid of up to 1 mM did not appreciably affect the Kt or the Jmax of PGF2 alpha transport. The rate of PGF2 alpha accumulation by rabbit choroid plexus was reduced by incubation at 4 degrees C, under anaerobic conditions, in the absence of sodium or in the presence of ouabain, probenecid, or bromcresol green. The choroid plexi of all three species also accumulated thromboxane B2, PGI2, and 6-keto-PGF1 alpha, suggesting that most, if not all, eicosanoids are substrates for this transport system. It is concluded that the choroid plexus transport system satisfies all the criteria of an active, energy dependent transport system and that this system functions effectively at concentrations of eicosanoids present in the ventricular system under normal or pathological conditions. Hence, this transport system must make an important contribution to the pharmacokinetics of eicosanoids within the brain. PMID- 3517231 TI - Adrenal medullary tropomyosins: purification and biochemical characterization. AB - Tropomyosins have been isolated from bovine adrenal medulla. Purified from a heat stable extract, the adrenal medullary tropomyosins show the same chromatographic patterns as platelet tropomyosin components purified under very similar conditions on ion-exchange (DEAE-Sephacel) and hydroxylapatite columns. When analyzed by polyacrylamide gel electrophoresis, the purified fraction, reduced and denatured, yielded three polypeptides with apparent molecular weights of 38,000, 35,500, and 32,000. The molar ratio of the two major polypeptides (38 kd and 32 kd) was 2:1. The predominant form of 38 kd is different from other nonmuscle tropomyosins previously isolated and with which an apparent molecular weight of 30,000 is normally associated. The three adrenal medullary tropomyosins have similar isoelectric points of about 4.7. When adrenal tropomyosins were subjected to sodium dodecyl sulfate-polyacrylamide gel electrophoresis in the presence of 8 M urea, each form showed a shift to a higher molecular weight, which is a characteristic of muscle tropomyosin. The 38,000 adrenal medullary tropomyosin exhibits a stronger affinity for F-actin than the other forms. Peptide profiles obtained after limited proteolytic digestion show some similarity between the two predominant tropomyosins of the bovine adrenal medulla and also between these and the alpha and beta forms of bovine skeletal muscle tropomyosin. PMID- 3517232 TI - Highly sensitive immunoassay for rat brain-type creatine kinase: determination in isolated Purkinje cells. AB - Ultrasensitive enzyme immunoassay method for the measurement of rat brain-type creatine kinase BB (CK-BB) was developed by use of purified antibodies specific to the B subunit of creatine kinase. The antibody immunoglobulin G was purified with immunoaffinity chromatography of the antiserum raised in rabbits by injecting the purified rat CK-BB. The assay system consisted of polystyrene balls with immobilized antibody F(ab')2 fragments and the same antibody Fab' fragments labeled with beta-D-galactosidase from Escherichia coli. The assay was specific to the B subunit of CK (CK-B), showing about 10% cross-reactivity with CK-MB, but it did not cross-react with CK-MM and neuron-specific gamma gamma enolase. The minimum detection limit of the assay was 0.1 pg or 1 amol CK-BB, being sufficiently sensitive for the measurement of CK-B contents in the isolated Purkinje cell bodies at the level of single cells. The average content of CK-B in a single Purkinje cell was 1.64 pg. The CK-B concentration in rat cerebellum (about 22 micrograms/mg protein) was about twofold higher than that (about 13 micrograms/mg protein) in the cerebrum. High levels (greater than 5 micrograms/mg protein) of CK-B were also found in the peripheral tissues such as gastrointestinal tract and urinary bladder, all of which are composed of smooth muscle. Immunohistochemical localization of CK-B antigens in the CNS revealed that the antigens is distributed not only in the neurons but also in the glial cells. PMID- 3517233 TI - Isolation of low-molecular-weight proteins from amyloid plaque fibers in Alzheimer's disease. AB - During aging of the human brain, and particularly in Alzheimer's disease, progressive neuronal loss is accompanied by the formation of highly stable intra- and extraneuronal protein fibers. Using fluorescence-activated particle sorting, a method has been developed for purifying essentially to homogeneity the extracellular amyloid fibers that form the cores of senile plaques. The purified plaque cores each contain 60-130 pg of protein. Their amino acid composition shows abundant glycine, trace proline, and approximately 50% hydrophobic residues; it resembles that of enriched fractions of the paired helical filaments (PHF) that accumulate intraneuronally in Alzheimer's disease. Senile plaque amyloid fibers share with PHF insolubility in numerous protein denaturants and resistance to proteinases. However, treatment of either fiber preparation with concentrated (88%) formic acid or saturated (6.8 M) guanidine thiocyanate followed by sodium dodecyl sulfate causes disappearance of the fibers and releases proteins migrating at 5-7,000 and 11-15,000 Mr which appear to be dimerically related. Following their separation by size-exclusion HPLC, the proteins solubilized from plaque amyloid and PHF-enriched fractions have highly similar compositions and, on dialysis, readily aggregate into higher Mr polymers. Antibodies raised to the major low-Mr protein selectively label both plaque cores and vascular amyloid deposits in Alzheimer brain but do not stain neurofibrillary tangles, senile plaque neurites, or any other neuronal structure. Thus, extraneuronal amyloid plaque filaments in Alzheimer's disease are composed of hydrophobic low-Mr protein(s) which are also present in vascular amyloid deposits. Current evidence suggests that such protein(s) found in PHF-enriched fractions may derive from copurifying amyloid filaments rather than from PHF. PMID- 3517234 TI - Regional cerebral glucose utilization during insulin-induced hypoglycemia in unanesthetized rats. AB - Regional cerebral glucose utilization (rCMRgl) was studied during insulin-induced hypoglycemia in unanesthetized rats. Rats were surgically prepared using halothane and nitrous oxide anesthesia and allowed 5 h to recover from the anesthesia before rCMRgl was measured. The rCMRgl was measured using [6 14C]glucose in a normoglycemic control group and two hypoglycemic groups, A (30 min after insulin injection) and B (2 h after insulin injection). The mean plasma glucose level was 7.03 mumol/ml in the normoglycemic group, 1.96 mumol/ml in hypoglycemic group A, and 1.40 mumol/ml in hypoglycemic group B. The rCMRgl in hypoglycemic group A decreased 8-18% in 17 brain regions measured; five changes were statistically significant. The rCMRgl in hypoglycemic group B decreased significantly in all but one of the brain regions measured; the decrease ranged from 15% in the pyramidal tract to 36% in the motor and auditory cortices. The rCMRgl in every brain region decreased when the plasma glucose level fell below 1.5-2.5 mumol/ml. No brain region could maintain rCMRgl at plasma glucose concentrations lower than predicted by regional glucose influx described in previous studies. Glucose utilization in all brain regions appears to be limited by the influx of glucose. PMID- 3517235 TI - Mesulergine in early Parkinson's disease: a double blind controlled trial. AB - The efficacy and tolerance of treatment with an 8-alpha-amino-ergoline derivative CU32-o85, Mesulergine, were compared with levodopa/benserazide (Madopar) in a 3 month double-blind controlled trial in 31 patients with Parkinson's disease, not previously treated with levodopa. The two treatments were equally well tolerated, and neither dyskinesias nor dose-related fluctuations developed. In 90% of the patients treated with Mesulergine, Parkinsonian symptoms improved, and at the dose given the overall therapeutical response was two-thirds that of levodopa. During further 9 months of open study the beneficial effect was maintained equally well in both groups. Compared with other dopamine agonists Mesulergine has a considerable antiparkinsonian effect. Unfortunately, further clinical evaluation of the compound recently has been stopped owing to sex and species specific histological alterations in rats. It is suggested that Mesulergine derivatives might well be of value in future treatment of early Parkinson's disease and of late incompensated stages. PMID- 3517236 TI - Cerebrospinal fluid lysozyme and beta 2-microglobulin in neurosarcoidosis. AB - The levels of lysozyme (LZM) and beta 2-microglobulin (beta 2m) were measured in the cerebrospinal fluid (CSF) and serum of 32 patients with sarcoidosis, 20 of whom had neurosarcoidosis. LZM was analyzed by a new radioimmunoassay (RIA) modification. CSF LZM was elevated in 15 of 20 patients with neurosarcoidosis but in only 4 of 12 patients with extraneural sarcoidosis. CSF beta 2m values were elevated in 13 of 19 and in one of 11 patients, respectively. In neurosarcoidosis, both CSF LZM and beta 2m correlated to CSF leucocytes but not significantly to CSF albumin thus suggesting that LZM and beta 2m were secreted from cells within the central nervous system (CNS). In patients with sarcoidosis, elevations of CSF LZM and beta 2m revealed disease activity in the CNS. Both analyses were also useful in the follow-up of neurosarcoidosis. PMID- 3517237 TI - Virus-induced subacute spongiform encephalopathy (Creutzfeldt-Jakob disease). A report of two Chinese cases with clinico-pathologic studies. AB - Two Chinese cases of Creutzfeldt-Jakob disease (CJD) are described which show the typical clinical, EEG and neuropathological changes of a subacute spongiform encephalopathy. One case was sporadic and the other was probably familial. This is the first formal report of CJD occurring in China. PMID- 3517238 TI - Samuel Auguste Tissot (1728-1797). His research on migraine. AB - The famous Swiss physician of the eighteenth century, Samuel Auguste Andre David Tissot, devoted an 83-page chapter to migraine in his Traite des nerfs et de leurs maladies (Treatise on the nerves and nervous disorders). From his own personal observations and an exhaustive critical review of the medical literature, he described in clear terms the signs and symptoms and the clinical course of the disease, made known his findings to contemporary physicians and created a basis for research for future generations of doctors. In so doing, he fully deserves his high reputation as the classical authority on migraine. PMID- 3517239 TI - Is more better? PMID- 3517240 TI - High-dose combination alkylating agents with autologous bone marrow support: a Phase 1 trial. AB - Twenty-nine patients were treated with 31 courses of high-dose combination cyclophosphamide, cisplatin, and carmustine (BCNU) with and without melphalan with autologous bone marrow support. Toxicity was dose related. The maximum tolerated dose for cyclophosphamide, cisplatin, and BCNU in this combination in mg/m2 was 5,625, 165, and 600, respectively. Further dose escalation was precluded by the development of multiple organ toxicity, including venoocclusive disease, refractory thrombocytopenia, and hypertension. Melphalan added to the three-drug combination produced excessive renal and gastrointestinal toxicity. Objective tumor regression occurred in 21 of 25 evaluable cases. The results suggest that selected alkylating agents can be combined in full or nearly full doses before nonmyelosuppressive dose-limiting toxicity precludes further escalation. PMID- 3517241 TI - A comparison of mitoxantrone and doxorubicin in breast cancer. AB - Ninety patients with breast cancer refractory to cyclophosphamide/fluorouracil/methotrexate (CMF) have been randomized in their treatment, receiving either doxorubicin or mitoxantrone. Seventy-nine have received two full courses of therapy. Twelve of the 40 (30%) who initially received doxorubicin responded, whereas eight of the 47 (17%) who received mitoxantrone responded. These rates are not statistically different. The degree of myelosuppression was equivalent. Patients who received mitoxantrone had less nausea, vomiting, alopecia, and fatigue. Controllable clinical congestive heart failure developed in seven patients, and four others had a deterioration of noninvasive measures of cardiac function without clinical failure. One patient with clinical heart failure developing received only doxorubicin and one, only mitoxantrone, whereas the others received both agents. The duration of remission and time lapsed before disease progression were almost identical for the two regimens. This study included a crossover design. Two of 22 (10%) patients receiving doxorubicin and five of 24 (21%) receiving mitoxantrone as secondary therapy responded. This suggests that there is not absolute cross-resistance between these agents. We conclude that the efficacy of these two drugs is comparable in patients refractory to CMF, though the nonhematologic side effects of mitoxantrone are less. PMID- 3517242 TI - Treatment of advanced colorectal and gastric adenocarcinomas with 5-fluorouracil and high-dose folinic acid. AB - We report the results of an expanded trial of 5-fluorouracil (5-FU) combined with high-dose folinic acid for treatment of patients with advanced colorectal or advanced gastric adenocarcinoma. In each treatment course, the patients received both 5-FU (340 to 400 mg/m2/d by intravenous (IV) infusion for a period of 15 minutes) and folinic acid (200 mg/m2/d by IV bolus) for 5 consecutive days, with a 21-day interval between courses. Eighty-six patients with colorectal carcinoma were evaluated. The combined complete and partial response rates were 39% for 54 patients who did not receive prior chemotherapy and 22% for 32 patients who had previously received chemotherapy. Four patients who were previously resistant to 5-FU attained objective responses. The median time to disease progression for the 28 responders was 10 months. The median survival time of responders was 19.5 months, and the probability of their being alive at 2 years was 40%. Of 27 patients with gastric adenocarcinoma, 13 (48%) responded to therapy. Their median time to disease progression was 5.5 months. The median survival time of responders was 11 months, and their probability of being alive at 15 months was 30%. Toxicity was within acceptable limits. Toxic effects included stomatitis, diarrhea, conjunctivitis, skin rash, and mild myeloid hypoplasia. In a separate study, plasma concentrations of L-folates greater than 10(-5) mol/L were achieved after a rapid single IV injection of 200 mg/m2 of folinic acid. Comparisons of our results with those reported in previous studies on 5-FU administered as a single agent suggest that, in advanced colorectal and gastric adenocarcinoma, folinic acid administered in high doses enhances the effectiveness of 5-FU administered concomitantly. Furthermore, some colorectal tumors that were previously resistant to 5-FU become sensitive to this drug. The survival of the patients who responded to therapy was markedly improved over that observed in reported series of untreated patients with advanced colorectal and gastric adenocarcinomas. PMID- 3517243 TI - A prospective randomized trial comparing high-dose cisplatin with low-dose cisplatin and chlorambucil in advanced ovarian carcinoma. AB - Sixty-one patients with FIGO stage III ovarian carcinoma and 30 patients with stage IV ovarian carcinoma were randomized to receive either high-dose cisplatin (100 mg/m2) or low-dose cisplatin (20 mg/m2) and chlorambucil. Overall response rates were similar in both arms, with 68% and 49% of stage III patients and 61% and 72% of stage IV patients responding to high-dose cisplatin and the combination, respectively. There was a strong trend for better survival in stage III (P less than .05) but not in stage IV patients treated with cisplatin alone. The toxicity suffered by patients treated with high-dose cisplatin was severe, and in 15 patients cisplatin therapy was stopped because of unacceptable toxicity. PMID- 3517244 TI - Improved disease-free survival of children with acute lymphoblastic leukemia at high risk for early relapse with the New York regimen--a new intensive therapy protocol: a report from the Childrens Cancer Study Group. AB - An intensive multimodal therapy was developed for the treatment of a subpopulation of children with acute lymphoblastic leukemia (ALL) who had a predicted event-free survival of less than 40% on previously reported therapeutic regimens (at high risk for early relapse). Induction with multiagent chemotherapy and radiotherapy to bulky disease-bearing areas (peripheral lymph nodes and mediastinum) was followed by consolidation, CNS prophylaxis, and cyclical remission maintenance therapy. Ninety-six (96%) of 100 previously untreated patients, 1 to 17 years of age, attained a complete remission. Seven patients received other maintenance therapy or a bone marrow transplant in remission. Sixty-six of the remaining 89 (74%) are in continuous complete remission at 22+ to 72+ months (median, 44+ months). Marrow relapse occurred in 15 (17%), CNS relapse in 5 (6%), and testicular relapse in one. Sixty-six of the 93 evaluable patients (71%) (including the induction failures) are event-free survivors. Two patients died of infection during the induction phase. No patient died during consolidation or maintenance without recurrent disease. The patients spent a median of 19, 0, and 0 days hospitalized during induction, consolidation, and maintenance, respectively. The most common complications were bacteremia and mucositis during induction and mucositis and fever during periods of neutropenia in consolidation. Maintenance was well tolerated. We conclude that the treatment protocol is intensive, but the inherent toxicities are manageable with adequate supportive care. The life table--projected event-free survival of 69% +/- 5% 48 months from diagnosis is encouraging. PMID- 3517245 TI - Pharmacokinetics of dibromodulcitol in humans: a phase I study. AB - A combined clinical and pharmacokinetic phase I study of the substituted hexitol dibromodulcitol (DBD), administered as a single oral monthly dose, has been performed. Twenty-three patients with advanced neoplasms received DBD doses ranging from 600 to 1,800 mg/m2 body surface area (BSA). The dose-limiting toxicity was myelosuppression, with both significant granulocytopenia and thrombocytopenia occurring at dose levels of 1,500 to 1,800 mg/m2. The average pharmacokinetic parameters for DBD, calculated on the basis of a one-compartment model with first-order absorption and elimination, include the elimination constant, .005 +/- .002/min; absorption constant, .012 +/- .009/min; and an apparent volume of distribution, 1.03 +/- .4 L/kg. The area under the drug concentration curve (AUC) and the peak drug level (Cmax) were linearly related to the dose administered (P less than .001). The mean AUC was 18.7 +/- 6.1 mmol/L min, and the mean Cmax was 47.1 +/- 16.8 mumol/L when normalized to a DBD dose of 1 gm/m2. The elimination constant was significantly reduced in patients with abnormal hepatic function (P less than .01). The elimination constant was not correlated with renal function. The half-life of DBD in plasma (158 minutes) was considerably shorter than the four-to eight-hour half-life of total radioactivity in plasma measured by previous investigators following the administration of radiolabeled DBD. PMID- 3517246 TI - Localization of central rhythm generator involved in cortically induced rhythmical masticatory jaw-opening movement in the guinea pig. AB - The location of the central rhythm generator involved in the cortically induced rhythmical masticatory jaw-opening movement was studied in the ketamine anesthetized guinea pig. These studies show that a population of neurons is activated by a nonrhythmical input from the cortical masticatory area (CMA) and produces a rhythmical output to the trigeminal motoneurons innervating the jaw opening muscles. Repetitive stimulation (30 Hz) of the pyramidal tract (PT) rostral to the middle level of the medulla oblongata, in the animal with a precollicular transection as well as with an intact neuraxis, induced a rhythmical reciprocal EMG activity in the anterior digastric and masseter muscles. The rhythmical activity could be monitored by a rhythmical burst in the efferent discharge in the mylohyoid nerve innervating the anterior digastric muscle. Essentially the same pattern was observed when stimulating the PT as that induced by repetitive stimulation of the CMA. The rhythmical efferent burst in the mylohyoid nerve could still be induced after paralyzing the animal. Repetitive PT stimulation in the isolated brain stem after precollicular and bulbospinal transections induced a rhythmical pattern in the anterior digastric EMG and an efferent activity in the mylohyoid nerve. The rhythmical mylohyoid nerve burst could be induced after paralyzing the animal. After section of the medial part of the brain stem at the pontobulbar junction, including the PT, repetitive PT stimulation at the pontine level did not induce any masticatory activity either in the digastric EMG or in the efferent discharge in the mylohyoid nerve, while stimulation at the rostral bulbar level still induced a rhythmicity that was essentially the same pattern as before the section. By testing the effects of total and partial transections of the brain stem in coronal and sagittal planes at various locations, we found that the medial bulbar reticular formation, the lateral pons including the trigeminal motor nucleus and nerve, and the reticulotrigeminal motoneuronal pathways composed the minimum structures that must be left intact to induce a rhythmicity in the anterior digastric EMG and the efferent discharge in the mylohyoid nerve by repetitively stimulating the PT. Repetitive PT stimulation induced a field potential in the medial bulbar reticular formation, which periodically fluctuated in the masticatory rhythm coincident with the rhythmical activity in the digastric EMG. This fluctuation persisted in the same rhythm after paralysis of the animal.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3517247 TI - Role of corticobulbar projection neurons in cortically induced rhythmical masticatory jaw-opening movement in the guinea pig. AB - The role of the pyramidal tract (PT) in the induction of the rhythmical masticatory activity (RMA) of the anterior digastric motoneurons by repetitive stimulation of the cortical masticatory area (CMA) was studied in the ketamine anesthetized guinea pig. The coronal section of the medial brain stem at the pontine level did not show any effect on the cortically induced RMA in the digastric EMG, as long as the majority of the PT fibers was spared of the section. In contrast, unilateral section of the PT at the pontine level abolished the RMA in the digastric EMG induced by repetitive stimulation of the ipsilateral CMA, while that induced by the contralateral CMA stimulation was not affected by the PT section. The threshold of repetitive PT stimulation for induction of the RMA of the digastric EMG was much higher at the levels caudal to the facial nucleus than that at more rostral levels, and no RMA was induced by the PT stimulation at the caudal bulbar levels even at the supramaximal intensities for RMA induction of the PT stimulation at more rostral levels. Single shocks applied to the PT at the caudal bulbar levels did not evoke any antidromic field potential in the CMA. Single shocks applied to the CMA evoked a negative field potential in the medial bulbar reticular formation (MBRF) mainly on the contralateral side after a monosynaptic latency, which was largest in amplitude in the region including the most dorsal portion of the nucleus reticularis paragigantocellularis and the area dorsally adjacent to it (dPGC). Stimulation of the oral portion of the nucleus reticularis gigantocellularis (GC) evoked an antidromic negative field potential in the ipsilateral dPGC. Intracellular recording from neurons in the dPGC demonstrated that neurons were located in the dPGC that responded with EPSPs after a monosynaptic latency to single shocks applied to the contralateral CMA and with antidromic spike potentials to stimulation of the oral portion of the ipsilateral GC (GCo). Single shocks applied to the dPGC evoked antidromic field potential in the area in the contralateral cerebral cortex corresponding with the CMA. Injection of horseradish peroxidase (HRP) into the dPGC on one side retrogradely labeled the pyramidal cells with HRP bilaterally in the cerebral cortical area corresponding with the CMA. The number and density of the labeled cells on the contralateral side far exceeded those on the ipsilateral side.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3517248 TI - The right hemisphere: neuropsychological functions. AB - In the past two to three decades, clinicians and neuroscientists have been studying the functions of the right hemisphere. Neither hemisphere seems to be dominant in the absolute sense. Each appears to be specialized and is dominant for different functions. However, most functions require the cooperation of both hemispheres. When one is damaged, the other can often compensate for the damaged one. Lesions of the left hemisphere are associated with language (speech, reading, and writing) and praxic disorders, and lesions of the right hemisphere can result in visuospatial, attentional, and emotional disorders. The authors review some of the major behavior disorders associated with right hemisphere dysfunction and concentrate on three major types of disorders--visuospatial, attentional, and emotional. Although not all the behavioral defects associated with right hemisphere damage can be subgrouped under these three types, they are the ones most often associated with right hemisphere lesions. PMID- 3517249 TI - W. W. Keen and the dawn of American neurosurgery. AB - Before the turn of the century, W. W. Keen was the most celebrated neurosurgeon in the United States. During the Civil War he served as a surgeon in the Union Army. He collaborated with Mitchell and Morehouse in clinical studies that culminated in their publishing Gunshot Wounds and Other Injuries of Nerves. In 1887, he was the first surgeon in the Americas to remove a benign brain tumor. He perfected a technique for ventricular puncture, devised operations for spasmodic torticollis, microcephalus, and tic douloureaux, and introduced many European neurosurgical techniques to the United States. An astute clinician and excellent teacher, Keen had no research interests other than anatomical and pathological dissections. He published over 50 papers on neurosurgical topics, in addition to articles on numerous other subjects. Although recognized as a pioneer in neurosurgery, he is not usually considered a founder of neurosurgery in the United States because of his failure to develop the specialty further than his contemporaries in the remainder of the neurosurgical world. This failure related not to his abilities, but probably to the fact that he was elderly before it became technically possible to perform safe and effective intracranial procedures. PMID- 3517251 TI - Intraoperative angiography using a portable digital subtraction unit. Technical note. AB - A portable digital subtraction unit has been used in the operating room as an important improvement in obtaining high-quality intraoperative angiograms. This digital subtraction system offers several advantages over previously described techniques for intraoperative studies. Not only are the images of good quality, but also the dose of contrast medium is reduced and a real-time imaging capability allows the surgeon to visualize the passage of contrast agent dynamically. Arterial injections may be performed by selective femoral cerebral catheterization, puncture of the cervical carotid artery, retrograde catheterization via the superficial temporal artery, or puncture of an intracranial vessel at the time of surgery. PMID- 3517250 TI - Interleukin-2 and autologous lymphokine-activated killer cells in the treatment of malignant glioma. Preliminary report. AB - Nine patients with malignant glioma were treated with the lymphokine interleukin 2 (IL-2) or with lymphokine-activated killer (LAK) cells, and one patient received combination therapy with both LAK cells and IL-2. The LAK cells were generated by culturing recombinant IL-2 with peripheral blood lymphocytes obtained from brain-tumor patients. Escalating doses of LAK cells (10(8) to 10(10] or IL-2 (10(4) to 10(6) U) were administered intraoperatively by direct injection into the brain tissue surrounding the cavity left by debulking the tumor. There were no signs of systemic or neural toxicity following treatment. The selective killing of the tumor by LAK cells used for these treatments was demonstrated by a chromium release microcytotoxicity assay which showed in vitro the ability of the LAK cells to lyse glioma cells but not normal cells. PMID- 3517252 TI - Small intestinal mucosal hyperplasia caused by an enterokinase inhibitor from red kidney bean in rats. AB - A specific enterokinase inhibitor (EKI) was purified from red kidney bean (RKB). Male weanling rats fed a diet containing this purified EKI (0.06%) for 6 d showed increases in mucosal weights, protein, DNA and lactic dehydrogenase contents in their small intestines compared to age-matched control rats fed a standard diet. Total mucosal EK and disaccharidase activities were, however, decreased in EKI fed rats. Thus, oral consumption of EKI from RKB led to small intestinal mucosal hyperplasia in rats. The mucosal hyperplasia observed in EKI-fed rats is not likely due to decreased turnover of mucosal proteins as a result of reduced luminal proteases since luminal contents of trypsin, chymotrypsin and elastase in EKI-fed rats were similar to those of control rats. Enterokinase inhibitor may have a direct hyperplastic effect on the small intestine of rats. PMID- 3517253 TI - Trypsin inhibitors: concern for human nutrition or not? PMID- 3517254 TI - The history and practice of occupational medicine in the Federal Republic of Germany. PMID- 3517255 TI - Relationship between weight change and diaphragm size change. AB - To evaluate the necessity of refitting the vaginal contraceptive diaphragm after weight loss or gain, an ex post facto/correlational study examined the relationship between body weight change and diaphragm size change. The hypothesis that no relationship exists between weight change and diaphragm size change was tested by selecting 125 clients from two family planning agencies. Weight change and diaphragm size change were compared statistically via chi-square tests, two tailed t-tests, and regression analysis, revealing overwhelming support of the hypothesis. No significant relationship between weight change and diaphragm size change was found, which suggests that refitting the vaginal diaphragm after weight loss or gain is unnecessary. PMID- 3517256 TI - Teaching mothers about their preterm infants. AB - The effects of a structured teaching program on 30 mothers' perceptions of and interaction with their premature (between 28 and 35 weeks' gestational age) infants was evaluated. Mothers who agreed to participate in the study were randomly assigned to one of three study groups: control, instruction, and attention. Mothers in the control group received routine care and support from the intensive care nursery staff. Mothers in the instruction group, in addition to the usual intensive care nursery procedures, received instruction about the unique physical and behavioral characteristics of premature infants. Mothers in the attention group were provided with the opportunity to discuss nonmedical concerns about their infants or their situations with the nurse researcher. Measures of maternal perceptions and behaviors were obtained by unbiased observers during home visits two, four, and eight weeks after the infants were discharged from the hospital. No significant differences were found among the groups on maternal perceptions or interaction behaviors. PMID- 3517257 TI - Historical introduction: the Italian contribution to the discovery of 5 hydroxytryptamine (enteramine, serotonin). AB - In 1949-1951 two independent lines of research led to the discovery and elucidation of the structure of serotonin and enteramine, and their identification with 5-hydroxytryptamine. This is briefly described, with emphasis on the Italian contribution to the solution of the problem. PMID- 3517258 TI - The use of real-time ultrasound in a child with spinal dysraphism. PMID- 3517259 TI - What's new in endodontics. PMID- 3517260 TI - Viability of the retained bone core in the core-vent dental implant. AB - The survival of dental implants has been correlated with the formation of a bone implant interface. This study was done to determine whether the recently developed Core-Vent dental implant forms a bone-implant interface without intervening fibrous tissue. Core-Vent implants were placed in four dogs, and healing was evaluated histologically 15, 30, 60, and 120 days after insertion. Bone grew through the implant vents to join with the inner bone plug, and the implants approximated the bone without an intervening fibrous tissue layer. PMID- 3517262 TI - Homologous cancellous bone grafts for large jaw defects caused by bone cysts. AB - For more than 10 years homologous bone stored at -20 degrees C has been used to fill large bone cavities after cystectomy. This article outlines the principles of collecting, storing, and preserving the homograft, presents special aspects of the surgical technique, and reports long-term results. PMID- 3517261 TI - Aspiration pneumonitis: predisposing conditions and prevention. AB - Aspiration pneumonitis is a common complication of general anesthesia. The lower the pH of gastric fluid and/or the larger the volume, the greater is the potential danger. In spite of preoperative fasting, an alarmingly high percentage of patients who undergo surgery may be at risk. This review discusses conditions that predispose to aspiration pneumonitis and examines current strategies for its prevention. PMID- 3517264 TI - Dental pioneer honored for 56 years of service (Dr. John C. Bartels). PMID- 3517263 TI - Development of exostoses following skin graft vestibuloplasty: report of a case. PMID- 3517265 TI - Creating the denture posterior palatal seal. PMID- 3517266 TI - Adenomatoid tumours: an immunohistochemical and ultrastructural appraisal of their histogenesis. AB - The histogenesis of adenomatoid tumour has continued to provoke debate since Golden and Ash suggested the term in 1945 for a characteristic benign neoplasm typically found in the uterus, fallopian tube or epididymis. Endothelial, epithelial, mesonephric, mullerian and mesothelial histogenesis have been suggested. The balance of evidence suggests mesothelial derivation, but two recent studies point to endothelial origin for at least some of these tumours. Twenty-two histologically typical adenomatoid tumours were studied by electron microscopy, mucin histochemistry and immunohistochemistry. Ultrastructurally, all cases showed vacuolated cells bearing long bushy microvilli and the features were not those of endothelial cells. Glandular spaces contained acid mucopolysaccharide consistent with hyaluronic acid. Immunohistochemical double labelling techniques showed the cells lining such spaces to contain cytokeratin in the absence of factor VIII related antigen and receptors for Ulex europaeus I lectin which were expressed in the endothelium of tumour blood vessels. The evidence points to mesothelial histogenesis in all cases examined. PMID- 3517267 TI - Puromycin aminonucleoside nephropathy: ultrastructure, glomerular polyanion, and cell surface markers. AB - Puromycin aminonucleoside nephropathy with heavy proteinuria and oedema was induced in rats by 10 consecutive daily subcutaneous injections of aminonucleoside (1.67 mg/100 g of body weight). The main ultrastructural lesions were vacuolation of podocytes and total fusion of foot processes with loss of colloidal iron-reactive polyanion layer on the epithelial surface adjacent to the basement membrane. On the other hand the outer surface of podocytes and intravacuolar granular substance stained with colloidal iron. In scanning electron microscopy of freeze-fractured tissue the swollen podocytes and the urinary spaces displayed granular and filamentous precipitates. Seven cell surface antigens were examined by indirect enzyme immunohistochemistry with a series of MRC OX monoclonal antibodies. Glomeruli of control rats exhibited rare isolated Ia- positive endocapillary cells, possibly monocytes; these elements were significantly reduced in puromycin aminonucleoside nephropathy but there was an increase in Ia- positive cells in the cortical interstitium. Control kidneys harboured scanty interstitial T lymphocytes. These latter, especially the T8- positive cytotoxic/suppressor subpopulation, were markedly augmented in puromycin aminonucleoside nephropathy. The expression of class I histocompatibility antigens and of differentiation antigens (Thy 1) was not altered by aminonucleoside. PMID- 3517268 TI - Antigen detection test for streptococcal pharyngitis: evaluation of sensitivity with respect to true infections. AB - The clinical significance of false-negative results on antigen detection tests for group A beta-hemolytic streptococcal (GABHS) pharyngitis (negative test results and positive culture) has yet to be determined. We recently compared the Culturette Brand Ten-Minute Group A Strep ID Kit with blood agar cultures in 313 patients with pharyngitis, 257 (82%) of whom had positive throat cultures for GABHS. The Culturette Brand test had a sensitivity of 88%, specificity of 96%, a positive predictive value of 99%, and negative predictive value of 64%. More than half of the false-negative Culturette Brand test results occurred in children with less than 10 GABHS colonies on throat culture (1+ culture). When these 1+ cultures were not considered positive, the sensitivity of the Culturette Brand test was 93%. The sensitivity of the Culturette Brand test increased with an increased degree of positivity of the corresponding throat culture. Of the 31 children with false-negative Culturette Brand test results, 14 (45%) had a significant streptococcal antibody response; of the 224 children with true positive Culturette Brand test results (positive test results and positive culture) from whom serologic data were available, 114 (51%) had a significant streptococcal antibody response. This difference is not statistically significant. These findings suggest that almost half of patients with false negative results on antigen detection tests for GABHS pharyngitis have true infections (positive culture and antibody rise) and are not merely streptococcal carriers. PMID- 3517269 TI - Outbreak of primary cutaneous aspergillosis related to intravenous arm boards. PMID- 3517270 TI - Evaluation of fluorescein-conjugated monoclonal antibody test to detect Chlamydia trachomatis endocervical infections in adolescent girls. AB - We evaluated the fluorescein-conjugated monoclonal antibody (FA) test for screening for Chlamydia trachomatis endocervical infection in a general adolescent clinic. Three hundred sixty-three consecutive adolescent girls, ages 13 to 20 years (mean 17.3 years) were examined. Forty-five (12%) FA smears had insufficient cells. Reason for visit included non-lower genital tract-related disorders in 241 (76%) girls, and lower genital tract-related disorders in 77 (24%). C. trachomatis was isolated by tissue culture in 46 (14%) patients, and Neisseria gonorrhoeae by culture in 22 (7%), and Trichomonas vaginalis was identified by wet mount in 13 (5%). Compared with our tissue culture technique, the performance of the FA test was as follows: sensitivity 61% (28 of 46), specificity 97% (264 of 272), positive predictive value 78% (28 of 36), and negative predictive value 94% (264 of 282). There was no significant difference in test performance by race, although the sensitivity rate (64%) of the test in blacks was twice that (30%) in nonblacks. This apparent difference in test performance by race may actually represent variations in group characteristics, including exposure rate, susceptibility, and number of inclusion forming units available for tissue culture of Chlamydia in blacks compared with nonblacks. In our adolescent clinic, the tissue culture is superior to FA in detecting Chlamydia. We recommend that the FA test be used where tissue culture isolation for Chlamydia is not readily available, where known or predicted chlamydial infection rates are high, and where known or predicted numbers of inclusion forming units of Chlamydia in tissue culture are high. PMID- 3517271 TI - Pseudomonas cepacia: biology, mechanisms of virulence, epidemiology. AB - Pseudomonas cepacia, originally described as a plant pathogen, has emerged as an important cause of infection in altered hosts, particularly in the hospital setting. This organism's ability to survive and proliferate in a variety of solutions, medications, and even disinfectants and antiseptics has resulted in numerous clusters of common-source nosocomial infections. Many patients exposed to P. cepacia are merely colonized, but serious infections, including surgical and burn wound infections, bacteremia, meningitis, pneumonia, peritonitis, and urinary tract infections, are not rare. The virulence properties of this pathogen remain poorly characterized. Recently, P. cepacia has been reported in some cystic fibrosis centers as an increasingly frequent pulmonary pathogen. This trend has caused considerable concern because of reports of occasional cases of fulminant necrotizing pneumonia and bacteremia. Conversely, many patients with CF who become colonized with this organism have no ill effects. The epidemiology of P. cepacia in the CF population is unclear, but some patients probably acquire the organism from colonized siblings with CF. Circumstantial evidence suggests that the organism may also be acquired in the hospital. Treatment of infections is exceedingly difficult, particularly in patients with CF, because P. cepacia is resistant to a broad range of antibiotics. PMID- 3517272 TI - Introduction to pharmacokinetics: aminoglycosides in cystic fibrosis as a prototype. AB - Pharmacokinetics is the study of the time course of drug absorption, distribution, metabolism, and excretion, allowing examination of the potential relationships between drug disposition and pharmacologic or toxicologic effects. The pharmacokinetics of the aminoglycosides and certain other drugs are different in patients with cystic fibrosis (CF), but this topic is controversial. Differences in disease severity between study subjects and in the methods used might explain the disparities. Understanding the fundamental principles of pharmacokinetics is necessary for the clinician to evaluate drug disposition data in patients with CF. To determine whether observed pharmacokinetic differences are attributable to CF, the investigator must consider a number of factors in the design and conduct of pharmacokinetic studies: analytical methods, study population selection, techniques for drug administration, method used to collect biologic specimens, evaluation of parallel rates and routes of drug excretion, and selection of pharmacokinetic and statistical techniques. Pharmacokinetic investigation in patients with CF should permit evaluation of the complete disposition profile for a drug, allow comparison between the experimental data and factors that characterize the disease state, and be rigorous enough to provide explanations for any observed variability in pharmacokinetics. PMID- 3517273 TI - Cephalosporin therapeutics in cystic fibrosis. AB - Cephalosporins modified at the C-3 and C-7 positions of the cephem-nucleus have high antimicrobial activity and are safe. With evolution through first, second, and third generations, they have gained increasing gram-negative activity, but often at the expense of potency against gram-positive organisms. All third generation cephalosporins have some intrinsic anti-Pseudomonas activity, indicating their potential benefit in the treatment of acute pulmonary exacerbations in patients with cystic fibrosis. Rational therapy in this clinical setting requires recognition of the pharmacodynamic and pharmacokinetic idiosyncrasies intrinsic to this patient population. When these priorities are recognized, only two of the available agents, cefsulodin and ceftazidime, appear to be of any therapeutic value. Both agents have been evaluated extensively in the treatment of acute pulmonary exacerbation in cystic fibrosis, and both have been found to be safe and effective. PMID- 3517274 TI - Inhaled antibiotics in cystic fibrosis: is there a therapeutic effect? AB - Antibiotics are administered to patients with cystic fibrosis to eliminate or suppress sputum bacteria. Aerosol administration is attractive because it delivers antibiotic directly to the site of infection. Effective aerosol administration is compromised by the inefficiency of nebulizers to generate small particle aerosols, adverse airway reaction to the drug, potential emergence of resistant bacteria, and cost. Studies evaluating aerosol treatment have not always controlled for confounding factors and have used a variety of outcome indicators. Results of controlled studies are contradictory with regard to the beneficial effect of aerosol therapy on pulmonary function, sputum bacterial density, and frequency of hospitalization. Therefore, until additional well controlled trials are completed, routine aerosol administration of antibiotics in cystic fibrosis is not warranted because of cost, potential side effects, and the propensity to select resistant organisms. PMID- 3517275 TI - Antibiotic therapy in cystic fibrosis: evaluation of clinical trials. AB - Evaluation of antibiotic efficacy for infections in previously well individuals is based on eradication of the bacterium and resolution of the signs and symptoms of inflammation. In patients with cystic fibrosis, these criteria are less applicable: systemic signs of inflammation (fever, leukocytosis, and increased erythrocyte sedimentation rate) are variably present, and bacteria are present in the lower respiratory tract after clinical improvement. Administration of a variety of antibiotics produces resolution of subjective signs and symptoms and improvement in pulmonary function tests. Because of the cost of therapy, the need to evaluate new and potentially toxic antibiotics, and the desire to provide optimum care, the evaluation of therapy needs to be objective. Controlled studies evaluating efficacy in a blinded fashion and assessing lung function and resolution of local pulmonary inflammation may provide reliable data on antibiotic effectiveness in CF. PMID- 3517276 TI - Parenteral emulsions as drug carrier systems. PMID- 3517277 TI - Thermal death potentiation by amphotericin B in Cryptococcus neoformans and its dependence on pre-incubation temperature. AB - Thermal death of Cryptococcus neoformans in the presence of amphotericin B was strongly dependent upon the temperature of pre-incubation. The entropy coefficient, that is, the increase in entropy of activation of thermal death per square unit concentration of the drug in the medium, was 35 times higher after pre-incubation at 25 degrees C than at 39 degrees C. This means that C. neoformans cells grown at lower temperatures were much more sensitive to the temperature-dependent fungicidal effect of amphotericin B. PMID- 3517278 TI - Pathogenicity of Candida albicans with particular reference to the vagina. PMID- 3517279 TI - Inhibition of cellular immunity by products of Aspergillus fumigatus. AB - A fraction, FB, from extracts of Aspergillus fumigatus which previously was found to display a high degree of cellular hypersensitivity in skin tests in sensitized guinea-pigs but a low ability to affect transformation of lymphocytes in vitro, was studied. This fraction was found to be capable of inhibiting lymphocyte transformation induced in vitro by tuberculin and by T and B cell mitogens. The inhibitory properties of FB on lymphocyte activation were heat labile, destroyed by proteolysis, and could be reversed by washing 24 h after addition. Antibody to FB did not reduce inhibition of lymphocyte transformation. Fluorescence labeling studies showed a uniform and non-capping distribution of FB on lymphocyte surfaces which resulted in exclusion of attachment of fluorescein-labeled Concanavalin A to the cell surface. PMID- 3517280 TI - Biotypes of oral Candida albicans and Candida tropicalis isolates. AB - 213 oral isolates of Candida albicans and 62 isolates of C. tropicalis were tested for their hydrolytic enzyme profiles with the API ZYM system. One major biotype accounted for more than 50% of the isolates and a number of minor biotypes was recognized in both Candida species. The enzyme profiles of the major biotypes were identical and one quarter of the C. tropicalis isolates possessed a beta-glucosidase which has not been previously described. PMID- 3517281 TI - Chester Wilson Emmons. PMID- 3517282 TI - Absence of the enteric nervous system in the newborn: presentation of three patients and review of the literature. AB - Three patients suffering from an absence of the enteric nervous system are reported. Two sisters presented with severe vomiting shortly after birth and dilatation of the intestine proximal to a stenosis. There was an absence of the enteric nervous system throughout the entire length of the intestine distal to the duodenum. A boy presenting an ileus was found to suffer from an aganglionosis of the entire colon. There was also an absence of neuronal bodies and nerve fibers in the small intestine. The final diagnosis was made by histochemical and immunocytochemical stains for acetylcholinesterase, lactate hydrogenase, neuron specific enolase, protein S-100, and substance P. In the literature, 13 other patients have been reported. On the basis of differences of symptoms, incidence, sex ratio, genetics, and, presumably, pathogenesis between absence of the enteric nervous system and aganglionosis, it is assumed that the two diseases are separate entities. PMID- 3517283 TI - Antenatal ultrasonography: the experience in a high risk perinatal center. AB - During a 52-month span, 14,324 ultrasonographic examinations were performed on 9,453 pregnant patients. One-hundred and fifty-one anatomical malformations were found in 122 fetuses (1.29%). Our analysis of patients referred to the perinatal center for ultrasonography indicates that the number of high risk patients has increased, and a parallel increase of neonatal surgical anomalies has resulted. An analysis of fetuses concluded that anomalies of the: gastrointestinal tract had improved care, deaths occurred due to associated anomalies or severe prematurity; genitourinary system received earlier diagnosis and treatment; central nervous system/musculoskeletal system/hydrops--no difference in management, treatment or outcome was noted; teratoma/cystic hygroma--did not effect treatment; cardiovascular system--inutero medical treatment by digitalization of the mother was possible. Paradoxically, an increase in the mortality of diaphragmatic hernia patients was noted and concluded to be secondary to the extremely early detection of this anomaly. PMID- 3517284 TI - Effects of postoperative cholestyramine and phenobarbital administration on bile flow restoration in infants with extrahepatic biliary atresia. AB - Surgical restoration of bile flow in patients with extrahepatic biliary atresia (EHBA) results in the disappearance of clinical cholestasis in about 30% of cases. It is suggested that early postoperative administration of phenobarbital (PB) or cholestyramine (Ch) may improve this percentage. Eighty patients were randomly divided into three subgroups comprising 27 who were treated with Ch (4 g/d), 27 who were given PB (7.5 to 10 mg/kg/d) during the first 3 postoperative months and 26 untreated patients, who served as controls. Cholestasis was observed to disappear in 38 (group I) patients and to persist in 42 (group II) patients, as judged from their total blood bilirubin levels, the conjugated/total bilirubin ratio, measurements of cholesterol, bile acids and alkaline phosphatase, and of Rose Bengal fecal excretion. Neither Ch nor PB significantly improved the degree or duration of cholestasis in either group. PMID- 3517285 TI - Percutaneous drainage of hepatic abscesses in children. AB - Ultrasound guided percutaneous drainage of seven hepatic abscesses in five pediatric patients was performed. Abscesses were pyogenic in four of the patients and amebic in one. All patients recovered completely without surgical intervention. Methodology necessary in the pediatric patient is stressed. PMID- 3517286 TI - Maternal hyperventilation and the fetus. PMID- 3517287 TI - Gingival and bacterial plaque response to instrumentation, oral hygiene instruction and nutritional therapy. PMID- 3517288 TI - Sudden infant death: nursing care for the survivors. PMID- 3517289 TI - Impression formation: the role of expressive behavior. AB - This research examined the effects of personality/social skills and individual differences in expressive style on impression formation. Particular attention was given to the role of nonverbal behaviors in the formation of initial impressions. Sixty-two subjects were measured on self-report personality and communication skill scales, on posed emotional sending ability, and on physical attractiveness. Subjects were then videotaped while giving a spontaneous "explanation." Trained coders measured five separate nonverbal cue factors displayed by the subjects in the videotapes. Groups of untrained judges viewed the tapes and rated their impressions of the subjects on scales of likability, speaking effectiveness, and expressivity-confidence. Male subjects who were nonverbally skilled and extraverted tended to display more outwardly focused and fluid expressive behaviors, and made more favorable impressions on judges, than did males who scored low on the measures of nonverbal skills and extraversion. Females who were nonverbally skilled displayed more facial expressiveness, which led to more favorable initial impressions. Sex differences may reflect basic differences in the acquisition and use of expressive nonverbal cues by males and females. PMID- 3517290 TI - When patient care & Medicare conflict. PMID- 3517291 TI - When patient care & Medicare conflict. A home health nurse responds: no ethical conflict. PMID- 3517292 TI - When patient care & Medicare conflict. An ethicist responds: responsibility is the issue. PMID- 3517293 TI - [Improved analysis of serrapeptase by high performance steric exclusion chromatography (SEC). I]. PMID- 3517294 TI - Pharmacokinetics of methylprednisolone, methylprednisolone sodium succinate, and methylprednisolone acetate in dogs. AB - The absolute bioavailability and pharmacokinetic parameters of two methylprednisolone formulations (methylprednisolone sodium succinate and methylprednisolone acetate) were determined in five dogs. Plasma concentrations of methylprednisolone, methylprednisolone sodium succinate, and methylprednisolone acetate were measured by sensitive and specific high performance liquid chromatographic methods. After intravenous methylprednisolone sodium succinate administration, methylprednisolone was released rapidly but the extent of availability was rather low (43.6%). This has been tentatively explained in terms of its subsequent single-pass metabolism in the liver, i.e., hepatic hydrolysis of methylprednisolone sodium succinate followed by immediate hepatic elimination of the released methylprednisolone. After intramuscular administration of methylprednisolone acetate, its absorption was slow (half-time of absorption, 69.04 h) and the availability of the released methylprednisolone was low (42.7%). Therapeutic implications of these results are discussed, especially those which are relevant to shock therapy. PMID- 3517296 TI - Rotational autograft, reconstruction of the anterior segment, and intraocular lens implantation. AB - Six patients were affected by extensive central corneal scars and disruption of the anterior segment. Reconstruction of the anterior segment, synechialysis, membranectomy, and vitrectomy were performed as first-step procedures. Rotational autografts combined with either anterior or posterior chamber intraocular lens implantation were then performed. The results in this series of severely traumatized eyes were satisfactory with a follow-up of three years. PMID- 3517295 TI - Peptide-carrier interaction: induction of liposome fusion and aggregation by insulin. AB - As the roles of peptidic agents in therapy expand, the need for gaining the knowledge for formulating peptides and/or polypeptides becomes increasingly urgent. In an attempt to study various approaches to formulating peptidic agents for therapeutic applications, we investigated the interactions between drug carriers and peptides, using liposomes and insulin as a model. The fusion and aggregation properties of dipalmitoylphosphatidylcholine (DPPC) small, unilamellar liposomes, on the binding of insulin was studied by the techniques of resonance energy transfer of fluorescent labeled lipids, electron microscopy, and right-angle scattering. Within 1 h of adding insulin to DPPC liposomes at 25 degrees C, the average size of the liposomes increased from 239 to 361 A in diameter. There was no further increase in the size of the liposomes after the fused liposomes reached this size. However, the aggregation of the fused liposomes continued to increase for several hours after the insulin-induced fusion stopped. Our results suggest that insulin induces the aggregation of newly fused liposomes, when the temperature is below the gel----liquid crystalline phase-transition temperature (Tc) of the liposomes. The aggregation of fused liposomes is markedly affected by not only the zinc content of insulin but also the pH and ionic strength of the solution. The results of the present study demonstrate that an amphyphilic molecule, such as insulin, could induce the fusion of liposomes via hydrophobic interaction and facilitate liposome aggregation via hydrophilic interaction. Thus, when entrapping insulin by small, unilamellar liposomes, care should be taken to avoid fusion and aggregation. PMID- 3517298 TI - Temporal incision for astigmatic control in secondary implantation. AB - A small group of aphakic patients having secondary lens implantation had keratometry performed before and at four months after surgery. A temporally oriented scleral pocket incision and closure technique was used to place the incision in fresh tissue and in the steepest corneal meridian. The results demonstrated an overall reduction of corneal cylinder from modest flattening of the surgical axis. Placement of the scleral pocket incision in fresh temporal tissue for secondary lens implantation affords a watertight stable wound with astigmatic control. PMID- 3517297 TI - Review of the clinical literature on the use of the Nd:YAG laser for posterior capsulotomy. AB - An overview of the safety and effectiveness of the Nd:YAG laser for posterior capsulotomy as discussed in the current scientific literature is presented. The results of three clinical investigations in Europe and ten clinical reports in the United States are briefly summarized. PMID- 3517299 TI - [Central and peripheral factors affecting sweating activity]. PMID- 3517300 TI - On the road to recovery: a retrospective. PMID- 3517301 TI - Innovation: the nurse-manager's critical skill. Part I: The planning process. PMID- 3517302 TI - Multiple sclerosis: psychiatric and psychometric abnormalities. PMID- 3517304 TI - [Opacification of the aorta in arteritis of the legs. Dilemma or false problem?]. AB - Recent advances in therapy: angioluminal dilatation, fibrinolysis, microsurgery, require precise arterial visualization, to include the aorta, to prevent lack of recognition of an embolus of aortic origin. The new techniques for vascular visualization have modified the algorithm of exploration of an arteritis of lower limbs. Ultrasound and CT scan imaging are effective but do not exclude the use of angiography before deciding therapy. Digital subtraction venous angiography is insufficiently precise for aortic exploration but is a good method for diagnosis of peripheral artery lesions. Digital subtraction arterial angiography is perhaps the method for the future but it requires multiple injections. A place still exists for traditional aortoarteriography for exploration of lower limb arteritis, at least for patients under 65 years of age and in good general condition. PMID- 3517303 TI - Predicting treatment completion in a behavioral therapy program for chronic temporomandibular pain. AB - The aim of this study was to identify factors useful in predicting whether chronic temporomandibular pain patients would complete a behavioral treatment program. Detailed clinical examination and interviews regarding demographic and social factors were given to 78 patients on week prior to treatment. They also completed a number of personality measures (depression, anxiety, locus of control) at that time and kept a pain diary during the following week to establish baseline levels. Motivation was also assessed. Patients were classified as completing (54%) or failing to complete (46%) the program. Social factors (family and generalized others' attitudes towards the patient's pain) were the only significant predictors of treatment completion. In a multiple regression analysis, these factors accounted for 43% of the variance. These results suggest the usefulness of including social-environmental factors when considering patient compliance. Implications for the conceptualization of social support are discussed. PMID- 3517305 TI - [X-ray computed tomography in pheochromocytoma. Apropos of 20 cases]. AB - Study of 20 pheochromocytomas in 19 patients confirmed the remarkable sensitivity of computed tomography (100%) for the detection of their adrenal and juxtarenal localizations. However, ultrasonography was as effective as the CT scan in these same patients, and even detected latent tumors in several cases. Certain pheochromocytomas in this series presented unusual appearances, particularly two large tumors which were manifest as abdominal masses and a malignant form which provoked a total infarct of the homolateral kidney. PMID- 3517306 TI - [Peroperative spinal cord ultrasonography in neurosurgery]. AB - Intraoperative spinal sonography is a new method of investigation. We are reporting 14 observations. The results of these explorations permit to describe the normal spinal sonography and a spinal ultrasonic semeiology. We underline the advantage of this technic in the neurospinal surgery particularly to locate the tumors and to facilitate the removal. PMID- 3517307 TI - [Digitalized angiography of the thorax in children]. AB - Technical aspects and indications for the use of digital subtraction angiography of thorax in 109 children are discussed, and the interest of this exploratory method emphasized in chronic respiratory disease in children. Results obtained are compared with other investigations for screening of bronchopulmonary dysplasia. Although generally reliable for exploration of thoracic aorta anomalies (coarctation and abnormal vascular arch) it is considered to be incompletely effective for investigation of congenital heart disease. PMID- 3517308 TI - [Congenital cystic dilatation of the common bile duct in adults. Apropos of a case diagnosed ultrasonically]. AB - The authors report the observation of a thirty years old woman presenting a choledochal cyst demonstrated by echography. This rare condition is characterized by a segmentary dilatation of the distal portion of the commun bile duct needing surgical treatment. The described case is distinguishable from usual forms by a few own particularities. PMID- 3517309 TI - [Technic for digitalized angiography of the legs by unilateral femoral artery puncture and programmed displacement of the examination table. Apropos of 56 cases]. AB - The authors describe a technique for digital subtraction angiography of vessels of the legs, performed in 56 patients for suspicion or control of peripheral vascular disease. Owing to an unilateral femoral arterial puncture and a programmed moving of the table top, a subtraction arterial mapping of the two legs is obtained with only two injections of contrast medium. On the side of the puncture the arterial opacification is always very satisfactory. On the other side opacified by reflux the popliteotibial region is visualized in 95% of cases. We had no complication with iodine or arterial puncture. Our technique is then characterized by its simplicity and a small trauma owing to the unilateral puncture and the reduction of contrast medium injections. PMID- 3517310 TI - Bacteriologic and nonbacteriologic criteria for identifying individuals at high risk of developing dental caries: a review. AB - A review of the literature on bacteriologic and nonbacteriologic criteria for identifying individuals at high risk to dental caries is presented. The studies have been evaluated on the basis of 1) their ability to predict future caries activity of individuals and 2) their practical use. Single measurements of past caries experience in the primary and permanent dentitions, filled tooth surfaces, and S. mutans in dental plaque and saliva were found to have limited value in identifying individuals that later would develop carious lesions, as judged from the low values of sensitivity and specificity. Lactobacilli counts in saliva indicated some evidence of high reliability as a basis for selecting patients susceptible to dental decay. The results of these studies, however, were not comparable because of variations in methods, critical value of the screening criteria, and age and size of the samples. A combination of two or more predictors showed promising results, as the predictive value was increased. More research is needed on appropriate screening methods to provide higher reliability and validity of the predictors. PMID- 3517311 TI - Introduction of Donald J. Galagan, recipient of the John W. Knutson Award in dental public health. PMID- 3517312 TI - Mitchiner Memorial Lecture. Military surgery, our debt to our patients and predecessors. PMID- 3517313 TI - The first recorded aeromedical evacuation in the British Army--the true story. PMID- 3517314 TI - Polyresistant malaria in Gurkha soldiers returning from Papua New Guinea: treatment and prevention. AB - Two company strength exercises to Papua New Guinea produced 21 malaria casualties of whom 16 had potentially fatal falciparum infections. The chemotherapy and prevention of polyresistant malaria from Papua New Guinea and the threat posed to the Hong Kong environment regarding malaria re-introduction are discussed. PMID- 3517315 TI - Reflections of forty years ago--Belsen 1945. PMID- 3517316 TI - Delayed puberty caused by hyperthyroidism in ram lambs is not a result of suppression in body growth. AB - Over a period of 8 weeks ram lambs (16 weeks old) were made hyperthyroidal (serum thyroxine approximately equal to 150 ng/ml, compared with control approximately equal to 48 ng/ml) by daily subcutaneous injections of thyroxine or maintained at a constant body weight by restriction of the feed intake. Hyperthyroidal and restricted-intake lambs remained at a constant body weight during the period of treatment whilst control rams gained body weight. Testicular growth was normal in restricted-intake lambs but was suppressed in hyperthyroidal animals. Hyperthyroidism, but not feed restriction, was also associated with decrease in LH pulse frequency (1.3 +/- 0.3/12 h compared with controls 4.8 +/- 0.9/12 h. Hyperthyroidal lambs showed normal LH responses to exogenous LHRH. After cessation of treatment testicular growth continued to be suppressed for up to 16 weeks in previously hyperthyroidic rams; thereafter testes began to increase in size but at 30 weeks after treatment were still smaller than those of control rams. It is concluded that elevated thyroxine concentrations directly influence sexual maturation in ram lambs through actions at hypothalamic and/or higher brain centres which control LH secretion. Transient hyperthyroidism during sexual maturation may cause permanent impairment of sexual development. PMID- 3517317 TI - The embryo-maternal dialogue during early pregnancy in primates. PMID- 3517319 TI - Maternal and embryonic factors associated with prenatal loss in mammals. PMID- 3517318 TI - Role of conceptus secretory products in establishment of pregnancy. AB - Conceptuses produce steroids, prostaglandins, proteins and possibly other unidentified agents which may play a role in the establishment and maintenance of pregnancy. A key event in this process is protection of the corpus luteum (CL) from the luteolytic activity of prostaglandin (PG) F-2 alpha of uterine origin. Oestrogens produced by the pig conceptuses between Days 11 and 16 appear to exert an antiluteolytic effect resulting in the sequestering of PGF-2 alpha within the uterine lumen. Failure of the pregnant uterus to release PGF-2 alpha in an endocrine fashion, therefore, allows for maintenance of CL function. Conceptuses of sheep and cattle produce proteins which, when introduced into the uterine lumen of nonpregnant ewes and cows, suppress the ability of oestradiol and oxytocin to stimulate uterine production of PGF-2 alpha. These conceptus secretory proteins appear to exert an antiluteolytic effect by inhibiting uterine production of luteolytic amounts of PGF-2 alpha. The horse conceptus produces both oestrogens and proteins during early pregnancy when uterine production of PGF-2 alpha is suppressed. Co-culture of horse endometrium and conceptus inhibits endometrial production of PGF-2 alpha. Conceptuses of pigs, sheep and cattle undergo elongation to achieve apposition between trophectoderm and endometrium but the horse embryo migrates rapidly and consistently throughout the uterus to achieve endometrial contact. PMID- 3517320 TI - Recurrent nonimmune hydrops fetalis, A case report. AB - Nonimmune hydrops fetalis occurred in two pregnancies in one woman. The first fetus had the Wolff-Parkinson-White syndrome. In both pregnancies the mother had a skin rash and subfebrile temperature when the fetal anomaly was detected. No viral, bacterial or autoimmune cause was found. PMID- 3517321 TI - Azathioprine versus placebo in patients with juvenile rheumatoid arthritis: a single center double blind comparative study. AB - Thirty-two patients with juvenile rheumatoid arthritis (JRA) entered a comparative, double blind, parallel 16-week clinical trial of azathioprine versus placebo. After 8 weeks of therapy the changes in disease activity measurements indicated an improvement in the azathioprine group compared to the placebo group. At the end of the study, most of the disease activity measurements were changed in favour of the azathioprine group compared to the placebo group, but statistically significant differences between the groups were found for only 2 disease activity measurements. Therapy was stopped for 2 patients in the azathioprine group because of reversible leukopenia. Our results and the risk for severe adverse reactions indicate that azathioprine remains a third line drug for patients with JRA. PMID- 3517322 TI - Rheumatoid iliopsoas bursitis presenting as unilateral leg edema. AB - A 66-year-old woman with rheumatoid arthritis presented with unilateral leg edema attributable to an enlarged iliopsoas bursa with presumed impedance of lymphatic drainage. The adjacent hip joint was not severely involved by arthritis. Ultrasonography and computed tomography were used to delineate the bursal mass and demonstrate communication with the joint space. PMID- 3517323 TI - Human articular cartilage secretes characteristic metal dependent proteinases upon stimulation by mononuclear cell factor. AB - Human articular cartilage stimulated during organ culture by the addition of human blood mononuclear cell factor concomitantly released latent proteinases and proteoglycan. Gel chromatography at pH 7.4 separated 2 distinct latent enzymes: a general proteinase which could degrade proteoglycan, casein and gelatin, and a collagenolytic activity of smaller molecular size. The general proteinase was calcium dependent and could be activated by either trypsin or 4 aminophenylmercuric acetate; the former procedure invariably generating greatest activity. The enzyme exhibited a broad bimodal pH profile against proteoglycan, with optimum activity at pH 5.5. PMID- 3517324 TI - Neurofilament antibodies in systemic lupus erythematosus. AB - Autoantibodies against neuronal antigens occur in sera of patients with systemic lupus erythematosus (SLE). These antibodies may have significance in the pathogenesis of neurological complications of SLE. However, the neuronal structures containing the corresponding autoantigens are poorly known. In our study we assayed circulating antibodies against defined neuronal components- neurofilaments--by an enzyme-linked immunosorbent assay (ELISA) using purified neurofilament polypeptides as targets. Circulating neurofilament antibodies (anti NF) of IgG class were detected in 21% of 28 patients with SLE and in 6% of 17 patients with rheumatoid arthritis and in none of the 14 patients with primary sicca syndrome and 40 blood donors. The presence of anti-NF could also be confirmed by the indirect immunofluorescence technique using frozen sections of rat spinal cord. In one serum, anti-NF cross reacted with vimentin type of intermediate filaments. The antibodies bound both to the 70 kilodalton and the 200 kilodalton polypeptides of neurofilaments as judged by the immunoblotting technique. Two of 6 anti-NF positive patients had neurological complications. PMID- 3517325 TI - Anti-beta 2-microglobulin antibodies in systemic lupus erythematosus and ankylosing spondylitis: effects on in vitro lymphocyte function. AB - Antibodies to beta 2-microglobulin (anti-beta 2-mu) were isolated from sera of 6 patients with systemic lupus erythematosus (SLE) and 6 patients with ankylosing spondylitis (AS) by affinity chromatography on beta 2-mu-Sepharose. Specificity of the purified anti-beta 2-mu antibodies was demonstrated by immunofluorescent reactivity with cell surface beta 2-mu and by reactivity with purified beta 2-mu in ELISA. Anti-beta 2-mu from both SLE and AS patients inhibited Concanavalin A and phyto hemagglutinin induced proliferation of normal human peripheral blood lymphocytes (PBL) in a concentration dependent manner. High concentrations of anti-beta 2-mu inhibited pokeweed mitogen (PWM) induced PBL proliferation whereas lower concentrations enhanced the PWM response. Anti-beta 2-mu also inhibited E rosette formation. The inhibition and enhancement of mitogen induced PBL proliferation and the inhibition of E-rosette formation were reversed when the antibodies were preincubated with purified beta 2-mu. PMID- 3517326 TI - Cognitive processes in anxiety and depression: discussion paper. PMID- 3517328 TI - Psychological treatment for anxiety disorders: a review. PMID- 3517327 TI - Infections caused by opportunist mycobacteria: a review. PMID- 3517329 TI - Joan of Arc, creative psychopath: is there another explanation? PMID- 3517330 TI - Conformational energy calculations and electrostatic potentials of dihydrofolate reductase ligands: relevance to mode of binding and species specificity. AB - Classical potential energy calculations are reported for a series of 11 structurally diverse substrates, products, and inhibitors of dihydrofolate reductase. In almost every case, the calculations reveal a range of potential biologically active conformations accessible to the molecule, and geometry optimization with molecular mechanics and molecular orbital calculations further expands the range of accessible conformations. The energy calculations are supplemented with electrostatic potential energy surfaces for the heterocyclic components of each molecule. These data are used in conjunction with the energy calculations and the crystallographically determined enzyme structures to compare two alternative proposed binding modes of folates known to bind with their pteridine rings inverted relative to that of methotrexate. It is shown that the conformational flexibility of the connecting chain between the benzoyl glutamate and pteridine moieties in the folates actually allows the pteridine ring to shift between these alternative binding modes, a combination of which may offer the best explanation for the observed activity. The electrostatic potentials and conformational energy data are also used in an attempt to account for the species specificity of inhibitors of mammalian, bacterial, and protozoal dihydrofolate reductases. The results show that while these techniques can be used to explain many of the observed results, others require recourse to the observed crystal structures to provide a satisfactory explanation. PMID- 3517331 TI - 1H NMR configurational correlation for retro-inverso dipeptides: application to the determination of the absolute configuration of "enkephalinase" inhibitors. Relationships between stereochemistry and enzyme recognition. AB - A stereospecific synthesis of thiorphan [N-[2(RS)-(mercaptomethyl)-1-oxo-3 phenylpropyl]glycine] and retro-thiorphan [3-[[1(RS)-(mercaptomethyl)-2 phenylethyl]amino]-3-oxopropanoic acid], two highly potent inhibitors of enkephalinase, a neutral endopeptidase involved in enkephalin metabolism, is reported. Due to a rapid isomerization process, derivatives of retro-thiorphan, which contains a 2-substituted malonyl moiety, cannot be separated by classical methods. However, a separation of the diastereoisomeric mixtures of these retro thiorphan derivatives was achieved by HPLC. The absolute configuration of each isomer was determined by using an NMR configurational correlation. The inhibitory potency of the various inhibitors indicates that, in the thiorphan series, the affinity for enkephalinase is independent of the stereochemistry of the 2 (mercaptomethyl)-1-oxo-3-phenylpropyl moiety. In contrast, in the retro-thiorphan series a 100-fold difference in the inhibitory activity of the two enantiomers is observed. This indicates that there are large differences in the conformational behavior of the two series of inhibitors at the active site of the enzyme. PMID- 3517332 TI - Thromboxane synthetase inhibitors and antihypertensive agents. 2. N-[(1H-imidazol 1-yl)alkyl]-1H-isoindole-1,3(2H)-diones and N-[(1H-1,2,4-triazol-1-yl)alkyl]-1H isoindole-1,3(2H)-diones as unique antihypertensive agents. AB - A series of N-[(1H-heteroaryl)alkyl]-1H-isoindole-1,3(2H)-diones were prepared as part of a continuing investigation into the biological properties of compounds that were both thromboxane synthetase inhibitors and potential antihypertensive agents. The most active thromboxane synthetase inhibition was found for the title imidazole derivatives wherein a hexyl or octyl chain separated the heterocyclic ends of the molecule (5,6) or with substitution on the isoindole portion of the molecule (18, 19, 21, 22, 25, 26). Compounds with shorter alkyl chain separations had good antihypertensive effects (1-5, 8-10, 19-22, 27-30). Butyl derivative 3 was chosen for further evaluation as a potential antihypertensive agent with thromboxane synthetase inhibitory properties. PMID- 3517333 TI - The prevalence of allergic sensitization to Triatoma protracta (Heteroptera: Reduviidae) in a Southern California, USA, community. PMID- 3517335 TI - A survey of computer literacy among medical students. PMID- 3517334 TI - Isolation and identification of two antibacterial agents produced by a strain of Proteus mirabilis isolated from larvae of the screwworm (Cochliomyia hominivorax) (Diptera: Calliphoridae). PMID- 3517336 TI - Differentiation of Streptococcus sanguis and S. mitior by whole-cell rhamnose content and possession of arginine dihydrolase. AB - Whole-cell rhamnose concentrations were measured in 48 strains of streptococci resembling Streptococcus sanguis and S. mitior. Physiological characteristics were tested by the API-20/Strep system, and it was found that "typical" S. sanguis (arginine positive, aesculin positive) contained significant amounts of rhamnose, while "typical" S. mitior (arginine negative, aesculin negative) contained very low or undetectable amounts of rhamnose. Both groups contained dextran-positive and dextran-negative strains. Organisms that were more difficult to speciate (those giving positive results in the arginine or the aesculin test, but not in both) could also be divided into a rhamnose-positive and a rhamnose negative group; with one exception, all of the rhamnose-positive strains gave a positive result with arginine in the API-20/Strep test. There were several discrepancies between the results of conventional tests for arginine and aesculin hydrolysis and those of the corresponding API test. The results of conventional tests for arginine hydrolysis did not correlate closely with rhamnose content, and conventional tests for aesculin hydrolysis were less sensitive than API tests. With the API-20/Strep system, S. sanguis can almost always be distinguished from S. mitior by its ability to hydrolyse arginine. PMID- 3517337 TI - Effect of saliva and serum on the adherence of Candida species to chlorhexidine treated denture acrylic. AB - The effect of saliva and serum on the adherence of five strains of Candida albicans and one each of C. tropicalis and C. glabrata to chlorhexidine pretreated acrylic was measured in vitro. A four-fold dilution of saliva or serum significantly inactivated the fungicidal effect of chlorhexidine gluconate. Pretreatment of the acrylic with unstimulated mixed saliva for 30 min led to a reduced adherence for all the Candida strains tested, whilst a similar pretreatment with serum slightly increased adhesion. Moreover treatment of saliva or serum-coated acrylic with chlorhexidine gluconate 2% reduced adherence by between 19% and 86%. The inhibition of yeast adherence by chlorhexidine persisted for up to 19 days after the exposure of the acrylic strips to the disinfectant. PMID- 3517338 TI - Rapid identification of gram-negative bacilli from blood cultures. AB - Blood-culture broths showing macroscopic or radiometric evidence of growth of gram-negative bacilli were examined by a rapid automated bacterial identification system. A differential centrifugation technique was developed to prepare suitable inocula. The identification results obtained were confirmed by the API 20E method, with single colonies of the strains isolated 24 h later. Of 90 organisms tested, seven did not give the same identification by the two systems. With the rapid automated technique a presumptive identification of gram-negative bacilli can be made 24 h earlier than by more conventional methods. PMID- 3517339 TI - Adherence of multiresistant strains of Klebsiella pneumoniae to cerebrospinal fluid shunts: correlation with plasmid content. AB - A nosocomial multiresistant Klebsiella pneumoniae strain (KMD01) isolated from a patient with an infected ventriculoperitoneal (V-P) shunt was found to contain three plasmids of mol. wts (10(6)) c. 85, 50 and 2.4. A derivative isogenic strain (KMD11) carrying only the plasmids of mol. wts (10(6)) 50 and 2.4 was obtained spontaneously by plating the parent strain. The absence of the plasmid of mol. wt 85 X 10(6) in strain KMD11 correlated with an increased adherence to V P catheters and glass surfaces, as well as autoagglutination in minimal medium. Bacterial cells containing the whole set of plasmids (strain KMD01) also showed the incorporation into the outer membrane of a new polypeptide (mol. wt, c. 41 X 10(3)), when grown in minimal medium. The presence of this polypeptide correlated with absence of autoagglutination, as shown by strain KMD01 under these cultural conditions. These data suggest that the cell-surface characteristics in K. pneumoniae may be affected by the plasmid content of the strain. Since nosocomial strains of K. pneumoniae usually contain one or more plasmids, and strains easily exchange these extrachromosomal elements, it seems reasonable to speculate that new variants with higher V-P shunt colonisation effectiveness, like the one described in this work, may also evolve in nature. PMID- 3517340 TI - Bacteroides fragilis is a silent pathogen in acute appendicitis. AB - The role of Bacteroides fragilis in the pathogenesis of acute appendicitis was studied in 135 patients in four patient groups: normal (17); phlegmonous appendicitis (17); gangrenous appendicitis (75); and septic complications of appendicitis (26). Aerobic and anaerobic bacteria were isolated from all groups and members of the 'B. fragilis group' were the most common anaerobic isolates. The rate of isolation of B. fragilis was similar from normal and inflamed appendices but was significantly higher from those with septic complications (p less than 0.01). Antibodies against B. fragilis were demonstrated in patients of all groups and occurred with similar frequencies in patients with normal and inflamed appendices but at a significantly higher rate in those with septic complications (p less than 0.01). Whereas patients in this latter group showed IgM-antibody responses to B. fragilis only, those with acute appendicitis had IgM antibodies against a wide range of organisms of the 'B. fragilis group' which suggests that B. fragilis does not play a significant role in acute appendicitis but may be a major cause of its septic complications. PMID- 3517341 TI - A new enzyme-linked fluorescence assay (ELFA) for use with peroxidase-antibody conjugates: a comparison with ELISA for the quantitation of IgM antibodies to hepatitis B core antigen. AB - A new enzyme-linked fluorescence assay (ELFA) suitable for use with peroxidase antibody conjugates is described. The substrate for the assay is p hydroxyphenylacetic acid, the fluorescent product of which is stable and unaffected by light. The assay compared favourably with a standard ELISA for the quantitation of IgM antibodies to hepatitis B core antigen. PMID- 3517342 TI - Erythema multiforme: a possible pathogenetic role of increased reactive oxygen species. AB - Recently, it has been suggested that reactive oxygen species (ROS) produced by activated polymorphonuclear leukocytes (PMNs) exert auto-oxidative tissue damage at the site of inflammation. In the present study, a possible role of ROS in the pathogenesis of erythema multiforme (EM) was investigated by determining the capacity of the sera from patients for generating ROS from PMNs. Significantly increased hydroxyl radical production was observed, which is one of the most potent ROS capable of causing tissue damage. This change was not observed when PMNs were incubated with sera from patients with bullous pemphigoid (BP) or inflammatory acne, indicating that this finding was not a common feature of immunologically mediated and/or inflammatory cutaneous disorders. Elevated C1q activities and depositions of immunoreactants in the blood vessels were also noticed in some patients. These findings suggest that ROS generated by PMNs are involved in the formation of cutaneous lesions of EM and that immune complexes (ICs) may provide an important mechanism in PMN activation. PMID- 3517343 TI - Regeneration of T lymphocytes from human bone marrow cells after depletion with methylprednisolone. AB - This study evaluates the propagation of T lymphocytes in bone marrow cells after in vitro methylprednisolone treatment. Previous studies from this laboratory showed that immunocompetent T lymphocytes could be eliminated from the bone marrow cells by incubation with 15 mg/ml (0.04 M) of methylprednisolone for 1 hr. The effectiveness of the chemoseparation was assessed by E-rosette forming cell assay, mitogen-induced lymphoblastogenic responses, and lymphocyte surface markers. In this study, bone marrow cells treated with different concentrations of methylprednisolone were cultured in the presence of PHA and Interleukin-2. The mitogen-induced lymphoblastogenesis was restored in the 15 mg/ml MP-treated bone marrow cells by the 8th day of culture in the presence of Interleukin-2. The cells in the culture were analyzed by E-rosette forming cell assay. It was shown that the predominant cells in the cultures were E-rosette forming cells. This study demonstrates that immunocompetent T lymphocytes can be regenerated in the presence of mitogen and Interleukin-2 from bone marrow cells treated with 15 mg/ml of methylprednisolone. PMID- 3517344 TI - Monocyte regulation of lymphokine production in cancer patients. AB - The effect of monocytes from patients with gastric cancer on lymphokine production was investigated. Patients' monocytes both augmented and reduced production of T-cell migration inhibitory factor (TIF) by normal and patients' T lymphocytes stimulated with PHA, while normal monocytes did not change or decreased the TIF production. This regulatory effect of cancer patients' monocytes on lymphokine production was independent of the initial potential of T cells to produce TIF. These observations suggest that the regulation of lymphokine production by monocytes is altered in some cancer patients. PMID- 3517345 TI - Citric acid and its use in regenerative surgical periodontal therapy. PMID- 3517346 TI - Restoring the endodontically treated bi-rooted premolar--the effect of endodontic and post preparation on width of root dentin. PMID- 3517347 TI - Low temperature light microscopy and its application to study freezing in aqueous solutions and biological cell suspensions. AB - The freezing of biological cell suspensions can be understood in terms of ice formation in the external suspension medium and the cellular reactions to the changing environment. Cryomicroscopy allows a quantitative analysis of both categories of phenomena. Besides freezing stages of appropriate thermal design, the components used for that purpose include a microcomputer (PSI 80) based control system, an image analysis system (Intellect 100) and a spectrophotometer (MPV compact). The investigation of extracellular ice formation is focused on the following effects: The redistribution of solutes in the residual liquid and the resulting concentration profiles are determined photometrically or densitometrically. The transitions between various morphologies of the ice-liquid phase boundary (planar-cellular-dendritic) can be related to interface instability theories. With respect to solute segregation, the studies also involve the formation of bubbles from supersaturated gaseous solutes and freezing potentials resulting from the differential incorporation of cations and anions into the solid phase. The interaction between particles or cells and the advancing ice front is determined from critical interface velocities marking the transition between repulsion and entrapment. The effects of freezing on biological cells are studied mainly with blood cells, especially lymphocytes. The water efflux due to osmotical gradients across the membrane yields volume shrinkage curves which are recorded and analysed from video images for various cooling rates. Beyond a certain threshold cooling rate, intracellular ice starts to form, and different crystallization morphologies can be detected. The intracellular crystallization temperatures depend on cooling and warming rates as well as on the presence of penetrating cryoadditives. A fluorescence viability is used to determine the percentage of damaged cells immediately after thawing. PMID- 3517348 TI - A procedure for obtaining complementary replicas of ultra-rapidly frozen sandwiched samples. AB - Complementary replicas of samples prepared for electron microscopy by the freeze fracture/etch technique are extremely valuable in the interpretation of the exposed surfaces, the nature and location of the membrane fracture plane, and as an aid in the recognition of the potential artefacts of this technique. This paper describes a procedure for the preparation of complementary replicas of thin samples sandwiched between copper foil strips and frozen ultra-rapidly in the absence of chemical pretreatments. In this procedure, the copper foil support bearing the replica is floated on the surface of a chromic acid solution, resulting in the controlled dissolution of the copper metal. The replica which remains at the surface of the chromic acid is then stabilized against fragmentation during subsequent cleaning and rinsing steps by placing a 50 mesh gold grid on top of the replica. To minimize agitation of the replica/grid, all cleaning steps are performed in a single depression plate well. The clean replica/grid is picked up from below on a thin Formvar film, dried, and then separated from the extra film. Careful placement of the gold grid on the replicas and low magnification electron micrograph montages of the complementary grids facilitate the location of complementary regions and simplify examination of complementary specimen areas at higher magnification. PMID- 3517349 TI - Effect of specimen preparation and section transfer techniques on the preservation of ultrastructure, lipids and elements in cryosections. AB - Cryofixation, cryoultramicrotomy, and proper transfer of the cryosections into the electron microscope are important for the preservation of good ultrastructure and the measurement of subcellular elemental distributions. These techniques are applicable to tissue systems which can be rapidly frozen so that minimal to no ice damage occurs during the cryofixation step. For the transfer step we have compared the cryotransfer of hydrated sections and subsequent freeze-drying in the electron microscope with the transfer of sections into an external freeze dryer, followed by exposure to room temperature and humidity before introduction into the electron microscope. The use of a cryotransfer stage for section transfer from the cryoultramicrotome to the electron microscope and low temperature observation of the thin sections avoids the potential problem of rehydration damage to freeze-dried sections as well as provides protection from the possibility of melting of the lipids in the sections. Both of these problems may lead to loss of in situ elemental distribution and morphology. In this report, observations are presented which show the damaging effects of temperatures above 273 K on ultrastructure due to lipid melting in tissues with high lipid content and the redistribution of elements which can be encountered when thin sections become inadvertantly rehydrated. PMID- 3517350 TI - Properties of frozen sections relevant to quantitative microanalysis. AB - Difficulties in the quantitative X-ray microanalysis of frozen sections may conceivably arise from ice-crystal damage and from electron-beam damage. X-ray peak-to-continuum ratios are commonly taken as a quantitative index of elemental concentrations. But recent reports suggest that in dehydrated frozen sections such ratios vary greatly with the scale of ice-crystal formation existing prior to sublimation. The experiments in these reports are re-interpreted here; it is argued that peak intensities may be affected by ice-crystal scale but that ratios of peak to continuum should not be affected after corrections for exogenous continuum. The accuracy of the peak-to-continuum method is affected by beam induced loss of mass from microvolumes during analysis. Mass loss can be reduced or slowed by a cold-stage. For example, the radiation sensitivity for loss of chlorine from PVC is reduced by a factor of 1000 or more with reduction of temperature from 300 to 100 K. For sections of soft tissue the effectiveness of cooling is not nearly so striking but at 100 K, analyses of 1 micron frozen hydrated sections by the continuum method, with spatial resolution of the order of 1 micron, can be completed before substantial mass loss occurs. However, analysis of frozen-hydrated sections by the continuum method at much higher resolution, say 100 nm resolution in 100 nm sections, is precluded by mass loss. Measurements of local mass can be achieved with much lower dose by observation and calibration of the electron transmission or backscattering. But even with these methods, several problems remain in achieving quantitative X-ray analysis at very high resolution. PMID- 3517351 TI - Microtubule structure studied by quick freezing: cryo-electron microscopy and freeze fracture. AB - Microtubules have been quickly frozen and examined by electron microscopy using several techniques: (1) freezing of a thin layer of solution by plunging into cryogen, followed by cryoelectron microscopy of the unstained vitrified samples; (2) freezing by the propane-jet method, followed by freeze fracturing and metal replication. The unstained frozen-hydrated microtubules show a structure in agreement with X-ray diffraction data; they differ from negatively stained particles mainly by the better preservation of cylindrical shape. Secondly, they reveal a supertwist of the profilaments that is not detected reliably by other methods. This allows a determination of the number of protofilaments and the polarity. The structural resolution of unstained microtubules is similar to that of stained ones (about 2-3 nm); it is limited by low contrast and lack of crystalline order. Propane-jet or cryo-block freezing followed by freeze fracturing reveals the structures of the inner and outer surfaces of the microtubule wall at a resolution of 4 nm or better. The outside is dominated by the longitudinal protofilaments whereas on the inside one observes tilted cross striations. Although the freezing temperatures of the two methods are different (liquid nitrogen or helium) they yield similar results for the case of thin layers of protein solution. PMID- 3517353 TI - Phosphorylation of an Escherichia coli protein at tyrosine. AB - The analysis of protein phosphorylation in the bacterium Escherichia coli showed that, while most phosphoproteins are modified at serine and/or threonine residues, one of them is modified exclusively at tyrosine. This particular protein which has a molecular weight of 54,500 and a pHi value of 5.6 is found associated with the membrane/ribosome fraction of the cell. PMID- 3517352 TI - Barriers to regimen adherence among persons with insulin-dependent diabetes. AB - The present study was designed to assess the frequency of different barriers to adherence among persons with insulin-dependent diabetes mellitus (IDDM) and to determine the relationship between such barriers and adherence to insulin injection, glucose testing, and dietary and exercise components of the regimen. The behavior analytic model was used to develop a Barriers to Adherence Scale for adults and adolescents with IDDM. Sixty-five outpatient subjects were then interviewed in their home and reassessed 6 months later. Subjects reported the greatest number of barriers to dietary and exercise adherence and the fewest barriers to insulin injections. Females reported more barriers than males, but age was not associated with barriers scores. Self-report measures of adherence revealed consistent relationships between barriers and all areas of regimen adherence assessed. Adherence indices based on self-monitoring and dietary recall data correlated less consistently with barriers scores. We conclude that the behavior analytic model has great potential for use in the development of psychosocial assessment procedures for diabetes. PMID- 3517354 TI - Kinetic and equilibrium characterization of the Tet repressor-tetracycline complex by fluorescence measurements. Evidence for divalent metal ion requirement and energy transfer. AB - The interaction of Tet repressor protein with the inducer tetracycline was studied by fluorescence measurements, equilibrium dialysis and nitrocellulose filter binding. The repressor-tetracycline complex was formed from two molecules of tetracycline and one Tet repressor dimer. Formation of the complex requires divalent cations, and results in drastic effects upon the fluorescence spectra of both compounds. The fluorescence of Tet repressor was quenched about 70%, while that of tetracycline was increased between three- and eightfold, depending upon pH. In addition, the emission maximum of the protein was shifted from 330 to 340 nm, and the excitation maximum of tetracycline dropped from 380 to 370 nm. The latter shift is accompanied by a similar change in the absorption spectra. An analogous effect was observed upon changing the environment of the drug by the addition of sodium dodecyl sulphate. These results suggest that tetracycline binds to a hydrophobic region of the protein. A new excitation band in the fluorescence spectrum of the complex is observed. This presumably arises from energy transfer from a tryptophan to the drug. The association rate constant for formation of the complex is 3.3(+/- 0.3) X 10(5) M-1 s-1, and the equilibrium association constant is 2.8(+/- 0.5) X 10(9) M-1. These results are discussed with respect to the biological function of the Tet repressor. PMID- 3517355 TI - Comparative mutagenicity studies of azo dyes and their reduction products in Salmonella typhimurium. AB - The arabinose-resistant and Ames assay systems of Salmonella typhimurium were used to evaluate the mutagenic potential of azo dyes and their aromatic amine reduction products. Azo dyes, namely direct black 38, direct blue 15, and direct red 2, were mutagenic in the arabinose-resistant and Ames assays with both hamster and rat liver S9 activation. Both assays gave relatively higher mutagenic responses with hamster S9. Reduction products of these dyes, namely benzidine, o dianisidine, and o-tolidine, were mutagenic in the Ames assay. Benzidine was weakly mutagenic and o-dianisidine and o-tolidine were nonmutagenic in the arabinose-resistant assay. These results indicate that both arabinose-resistant tester SV50 and Ames tester TA98 were sensitive in detecting mutagenicity of azo dyes. The use of the standard plate protocol with Ames tester TA98 is more efficient than the modified azo dye protocol in detecting mutagenicity of aromatic amine reduction products. Additional modifications in either the standard plate or modified azo dye protocols may improve detection of mutagenicity of these compounds in the arabinose-resistant assay system. PMID- 3517356 TI - Cartilage delivery and open rhinoplasty as two preferred approaches to the nasal tip. AB - There seems to be a great difference of opinion among rhinoplastic surgeons concerning incisions to gain access to the nasal tip. Some state that the method of exposure is of secondary importance. This author firmly believes that many unsatisfactory results could be avoided if adequate surgical exposure were used for nasal tip surgery. Alar cartilage delivery and external approach rhinoplasty are recommended as the only methods for all cases. These methods are described in detail, and in accordance with the author's conviction that all pre- and postoperative photographs should be published to allow proper assessment, these are provided in selected cases. PMID- 3517357 TI - Fetal lateral ventricular ratio determination during the second trimester. AB - Ventriculomegaly may be diagnosed sonographically by identifying abnormal ventricular size. The lateral ventricular ratio (LVR) is a useful index in differentiating normal-sized ventricles from ventriculomegaly. The purpose of this study was to validate previously reported data establishing the normal range for LVR during the second trimester. Prior to 24 weeks, the diagnosis of ventriculomegaly may be difficult since the LVR normal range is quite large. The LVRs for 122 normal fetal ultrasound examinations were calculated based on measurements obtained by three observers. Data were obtained for fetuses during each week of gestation from 15 to 25 weeks. Lateral ventricular ratios varied from 56 +/- 18 per cent (mean +/- 2 standard deviations) at 15 weeks to 33 +/- 4 per cent at 25 weeks. The lateral ventricular width (LVW) range for normal fetuses was 0.7 to 1.1 cm as compared with a LVW range of 1.1 to 2.7 cm for 16 fetuses with hydrocephalus diagnosed during the second trimester. In conclusion, the LVR is extremely useful in differentiating ventriculomegaly from normal ventricular size. Serial ultrasound examinations are often mandatory in the second trimester in order to definitely identify ventriculomegaly. In addition, normal ventricular size may be verified with a LVW of less than 1.1 cm. PMID- 3517358 TI - Ultrasonography of Turner's syndrome. AB - Pelvic sonographic studies were performed on 15 phenotypic females with Turner's syndrome and varying X chromosome abnormalities. In those individuals with the 45XO karyotype, the ovaries were not visible, consistent with the classic description of absent or fibrous streak ovaries. The patients who were chromosomal mosaics showed a range of findings from absent to infantile to normal adult-size ovaries. Turner's syndrome should be suggested in individuals with delayed onset of puberty, primary amenorrhea, and short stature in whom pelvic ultrasonography fails to reveal ovaries. On the other hand, the detection of ovarian tissue by pelvic ultrasonography does not exclude the diagnosis of Turner's syndrome but does suggest that an X chromosomal abnormality other than 45XO is probably present. PMID- 3517359 TI - Chronic maternal cigarette smoking and fetal abdominal aortic blood flow in humans. AB - The abdominal aortic blood flow was measured in 19 fetuses of nonsmoking mothers (NS) and five fetuses of smoking mothers (S) who consumed over 10 cigarettes per day throughout gestation. Serial blood flow measurements beginning in the mid second trimester to term were made noninvasively with an ultrasonic duplex scanner. Biparietal and transverse abdominal diameters were used to estimate gestational age and fetal weight. Blood velocity spectral waveforms and lumen diameters were used to calculate blood flow (Q, ml/min) and weight normalized blood flow (Q/kg, ml/kg/min). Both Q and Q/kg for the two groups were significantly different by analysis of variance throughout the periods of observation. Third trimester Q and Q/kg (+/- SD) in the S group (738 +/- 20 ml/min and 278 +/- 36 ml/kg/min) were significantly higher (P less than 0.01) than values in the NS group (522 +/- 60 ml/min and 180 +/- 24 ml/kg/min). A redistribution of blood flow to the placenta resulting from an increase in fetal systemic vascular resistance is postulated. PMID- 3517360 TI - In utero analysis of heterozygous achondroplasia: variable time of onset as detected by femur length measurements. AB - Seven cases of heterozygous achondroplasia were examined in utero. Although the head shape and growth were normal, the initially normal femur length showed a decrease in growth and fell below the lower 99 per cent confidence limit in all cases. The time of presentation of achondroplasia varied between 21 and 27 gestational weeks. This study suggests that the diagnosis of achondroplasia can be reasonably made when the femur is abnormally short. When the femoral length is appropriate prior to 30 weeks, more caution should be taken in interpretation. Because of the variability in presentation, the fetus could be normal or still could be affected. PMID- 3517361 TI - Femur length/abdominal circumference ratio. Poor predictor of macrosomic fetuses in diabetic mothers. AB - Antenatal diagnosis of fetal macrosomia can affect the management of diabetic mothers. Because the sonographically determined femur length/abdominal circumference (FL/AC) ratio has been shown to differ in macrosomic and non macrosomic fetuses (in a population containing few diabetics), its value in establishing the diagnosis of macrosomia was examined. The results indicate that the FL/AC ratio differs in non-macrosomic (20.4 +/- 1.6) and macrosomic (19.5 +/- 1.4) fetuses of diabetic mothers, but there is considerable overlap. For no cutoff value is there a high sensitivity and high specificity. The positive predictive value is 36-43 per cent (depending on the cutoff), only slightly greater than the prevalence (26 per cent in the study population). The authors conclude that the FL/AC ratio is not useful in predicting macrosomia among diabetic mothers. PMID- 3517363 TI - Cortical sulcal development seen on sonography: relationship to gestational parameters. AB - Cranial sonograms are now routine for the evaluation of neonates for intracranial hemorrhage and other pathology. In this study, normal gyral development of the neonatal brain is reviewed and gyral pattern is correlated to gestational parameters. The value of this information for the sonographer is discussed. PMID- 3517362 TI - Comparison of biparietal diameter and femur length in the third trimester: effects of gestational age and variation in fetal growth. AB - A multiple regression-based statistical model capable of quantitatively comparing two or more sonographic parameters for the effects of gestational age, variation in fetal growth and error in sonographic measurement is presented and then used to compare the biparietal diameter and femur length as estimators of gestational age in late pregnancy. A total of 311 patients were studied between 24 and 42 weeks' gestation. Variation in fetal growth was expressed as the birth weight percentile for gestational age. Biparietal diameter and femur length correlated equally well with gestational age. However, the biparietal diameter was more than twice as sensitive as the femur length to variation in fetal growth. Femur length had a larger error associated with its measurement. These results suggest that the biparietal diameter and femur length in late pregnancy are equal estimators of gestational age; that the femur length is a more stable estimator of gestational age when fetal growth deviates from normal; and that the femur length is technically more difficult to obtain. PMID- 3517364 TI - Focal areas of decreased echogenicity in the liver at the porta hepatis. AB - Twelve patients are described in whom solitary focal hypoechoic areas in the liver were observed adjacent to the gallbladder and portal vein. These areas were all homogeneously hypoechoic relative to adjacent liver, had variable shapes but well-defined borders, and were less than 4 cm in diameter. These apparent pseudolesions were incidental findings in patients who had no evidence of significant liver disease, metastatic malignancy, or subsequent evidence of developing liver masses. In one patient, a second sonogram done 21 months after one such area was identified showed no change. In another patient, a computed tomogram done to clarify the finding was normal. Solitary hypoechoic areas in the liver at the porta hepatis fitting the above criteria should be interpreted cautiously. When there is no clinical suspicion of focal liver disease, these areas may be dismissed as insignificant or may be followed. If focal liver disease is suspected, the liver should be assessed by an additional method of examination. PMID- 3517365 TI - Sonographic features of bile plug syndrome. PMID- 3517366 TI - The varied sonographic appearance of cystic hygromas in utero. PMID- 3517367 TI - The spectrum of sonographic findings in pancreatic carcinoma. AB - The ultrasound studies of 59 patients with cancer of the pancreas were reviewed and the findings grouped into two categories: intrapancreatic, which included the appearance of the primary tumor and the pancreatic duct; and extrapancreatic, which included biliary obstruction, hepatic metastases, regional lymph node involvement, ascites, spleen enlargement and invasion, and alteration of the upper abdominal veins. Pancreatic duct dilatation was more evident with smaller tumors of the pancreatic head, while inferior vena cava compression was found not to be a constant finding even with large tumors of the head of the pancreas. Tumor extension to regional lymph nodes was difficult to detect and consequently underestimated. Nonvisualization, occlusion with or without collaterals, and displacement or deformity of the major branches of the portal venous system were detectable sonographically. The liver metastases of pancreatic carcinoma tended to be small and hypoechoic. This is a different pattern from that typically described for other gastrointestinal adenocarcinomas and, in particular, markedly different and distinguishable from the metastatic pattern seen with malignant pancreatic islet cell tumors. The significance of the intra- and extrapancreatic changes seen sonographically in cancer of the pancreas by ultrasound is discussed in relationship to clinical staging and prognosis. PMID- 3517368 TI - Antepartum obstetrical ultrasound examination guidelines. PMID- 3517369 TI - Fetal femur length/abdominal circumference ratio in preterm labor patients with and without successful tocolytic therapy. AB - A correlation has been suggested between impaired fetal growth and preterm delivery. To further investigate this possibility, the femur length/abdominal circumference ratio (FL/AC) was used as a gestational-age independent index of fetal growth in 82 patients admitted because of preterm labor. Of these patients, 43 delivered at term; tocolysis was unsuccessful in 39 patients who delivered preterm. The FL/AC was significant larger in the group with unsuccessful tocolytic therapy compared with the successfully treated group, 23.6 +/- 2.6 vs. 21.3 +/- 1.3 (mean + SD), respectively (P less than 0.001). These results indicate that preterm delivery may be associated with suboptimal fetal growth. PMID- 3517370 TI - The echo-Doppler (duplex) system for the detection of vertebral artery occlusive disease: comparison with angiography. AB - The reliability of the echo-Doppler (duplex) system for the visualization of the vertebral arteries was evaluated in 304 patients, in which 588 vertebral arteries had been investigated. Of these, 545 (92.69 per cent) arteries, either normal or diseased, were successfully visualized. However, the origin of the vertebral artery from the subclavian artery was localized in only 354 vessels (60 per cent of those visualized). Angiography was available for comparison in 33 arteries. The overall accuracy and the sensitivity of the duplex were 63.64 per cent and 38.46 per cent, respectively; they attained 86.67 per cent and 83.33 per cent in the vertebral arteries visualized from their origin, (a site early and most commonly involved by the atherosclerotic process). As the vertebral arteries can be visualized with a 92 per cent success rate, their examination should become a routine part of the duplex cerebrovascular study. In order to accurately detect diseased vertebral arteries, their origin from the subclavian artery should be localized. PMID- 3517371 TI - Sonographic evaluation of cerebral cortical mantle thickness in the fetus and neonate with hydrocephalus. AB - Sonographic measurement of the occipital, parietal, and frontal cerebral cortical mantle in ten neonates and ten fetuses with moderate to marked hydrocephalus was performed. In 11 of 14 (78.5 per cent) of the neonatal scans and in 10 of 12 (83 per cent) of the fetal scans, the occipital cortical mantle was less than that of the frontal cortical mantle. This difference varied from 1 to 16 mm. While prognostic data regarding compression of the cerebral mantle from ventricular dilatation exist, they are based upon measurements of the frontal-parietal and not the occipital mantle. Because of the difference observed, if these data are to be used in management, the comparable cerebral cortical mantle should be measured. PMID- 3517372 TI - Prenatal sonographic diagnosis of congenital hemivertebra. AB - The prenatal sonographic diagnosis of spinal abnormalities associated with neural tube element malformations has been well described; however, the diagnosis of fetal skeletal anomalies of the vertebral bodies with a neurologically intact spine has received little attention. Three cases of congenital hemivertebra should alert the sonographer to search for other congenital defects and for orthopedic complications of vertebral body malformations in childhood. Prior knowledge of the presence of an abnormal vertebral body can alert the pediatrician to watch for early signs of problems such as scoliosis or kyphoscoliosis, and to plan surgery if necessary. PMID- 3517373 TI - Adrenal hypertrophy: possible pitfall in the sonographic diagnosis of renal agenesis. AB - Six cases are presented in which the sonographic appearance of adrenal enlargement in the fetus or neonate mimics that of renal tissue. When normal renal tissue is not present, the adrenal preserves its characteristic echogenic medulla and anechoic cortex but enlarges, loses its characteristic "V" or "Y" shape, and appears more elliptical on ultrasound scans. The average length of the adrenal was 3.4 cm on the right and 2.9 cm on the left in these cases, with adrenal thickness increased to an average of 5 mm. Care must be taken not to mistake the enlarged adrenal for renal tissue. Conversely, an elongated adrenal gland without adjacent renal tissue does not necessarily imply renal agenesis, but may occur with renal ectopia. PMID- 3517374 TI - The sonographic appearance of duodenal lesions. AB - The sonographic findings in 17 patients with duodenal tumors and in one patient with a benign ulcer and stricture of the duodenum were reviewed. An abdominal mass was detected sonographically in all patients; in 15 of 18 cases, such lesions presented high-level central echoes and hypoechoic periphery. Identification of the duodenal origin of the disease was possible by sonography in only 16 of 18 patients: by evaluation of the relationship of the mass with abdominal vessels in eight patients; by demonstrating that the lesion was continuous with a normal duodenum in seven patients; or by demonstrating the mass within the duodenum itself in one patient. Signs and symptoms of duodenal tumors are usually nonspecific, and sonography can be used as the first imaging method in these cases. A careful analysis of the relationship of the tumor to surrounding structures may allow correct identification of its origin. PMID- 3517375 TI - The antenatal sonographic visualization of cloacal dysgenesis. AB - Hydronephrosis associated with a septated cystic structure in the fetal pelvis in the absence of an otherwise identifiable fetal bladder should alert the sonographer to the possibility of a persistent cloaca. Problems associated with compromised urinary tract drainage and the associated oligohydramnios occurring early in gestation as well as frequent association of anomalies with other organ systems must be addressed. Squamous epithelia in fetal bladder aspirate is further supportive evidence for the diagnosis. PMID- 3517376 TI - Prenatal sonographic diagnosis of triploidy. PMID- 3517377 TI - Sonographic detection of fetal extrathoracic pulmonary sequestration. PMID- 3517378 TI - The Mayer-Rokitansky-Kuster-Hauser syndrome: sonographic aid to diagnosis. PMID- 3517380 TI - Standard deviation vs. standard error. PMID- 3517379 TI - Prenatal sonographic diagnosis of bladder extrophy. PMID- 3517381 TI - An easily made ultrasound biopsy phantom. PMID- 3517382 TI - Phenylbutazone in the horse: a review. AB - Phenylbutazone is an acidic, lipophilic, non-steroidal anti-inflammatory drug (NSAID). It is extensively metabolized in the horse. The metabolites so far identified, oxyphenbutazone, gamma-hydroxyoxyphenbutazone, account for some 25 30% of administered dose over 24 h. The plasma half-life of phenylbutazone and termination of its pharmacological action are determined primarily by its rate of hepatic metabolism. Phenylbutazone acts by inhibiting the cyclooxygenase enzyme system, which is responsible for synthesis of prostanoids such as PGE2. It appears to act on prostaglandin-H synthase and prostacyclin synthase, after conversion by prostaglandin-H synthase to reactive intermediates. It markedly reduces prostanoid-dependent swelling, edema, erythema, and hypersensitivity to pain in inflamed tissues. Its principal use in the horse is for treatment of soft tissue inflammation. Phenylbutazone is highly bound (greater than 98%) to plasma protein. After i.v. injection, blood levels decline with an elimination half-life of 3-10 h. The plasma kinetics of phenylbutazone may be dose dependent, with the plasma half-life increasing as the drug dosage level increases. Plasma residues of the drug at 24 h after a single i.v. dose of 2 g/450 kg average about 0.9 microgram/ml, but considerable variation occurs. If dosing is repeated, the plasma residue accumulates to give mean residual blood levels of approximately 4.5 microgram/ml on Day 5 after 4 days of dosing. Approximately similar blood levels are found after a combination of oral and i.v. dosing. Experiments on large numbers of horses in training have been undertaken to ascertain the population distributions of residual blood levels after such dosing schedules. Absorption of phenylbutazone from the gastrointestinal tract is influenced by the dose administered and the relationship of dosing to feeding. Access to hay can delay the time of peak plasma concentration to 18 h or longer. Under optimal conditions, the bioavailability of oral phenylbutazone is probably in the region of 70%. Paste preparations may be more slowly absorbed than other preparations and yield higher residual plasma levels at 24 h after dosing, but further controlled studies are required. Phenylbutazone is easily detected in the plasma and urine of horses but concentrations in saliva are low. It is quantitated for forensic purposes by HPLC. The variability of this method between laboratories is about +/- 25%. Increasing urinary pH increases the urinary concentration of phenylbutazone and its metabolites up to 200-fold.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3517383 TI - Localization of structural proteins in African swine fever virus particles by immunoelectron microscopy. AB - Seven African swine fever virus structural proteins were localized in the virion by immunoelectron microscopy. African swine fever virus-infected cells were incubated, before or after embedding and thin sectioning, with monoclonal antibodies specific for different structural proteins, and after labeling with protein A-gold complexes, the samples were examined in the electron microscope. Proteins p14 and p24 were found in the external region of the virion, proteins p12, p72, p17, and p37 were found in the intermediate layers, and protein p150 was found in the nucleoid and in one vertex. A monoclonal antibody that recognized protein p150 as well as p220, a virus-induced, nonstructural protein, could also bind to a component present in the nucleus of both uninfected and virus-infected cells. PMID- 3517384 TI - Conserved regions in defective interfering viral double-stranded RNAs from a yeast virus. AB - We have completely sequenced a defective interfering viral double-stranded RNA (dsRNA) from the Saccharomyces cerevisiae virus. This RNA (S14) is a simple internal deletion of its parental dsRNA, M1, of 1.9 kilobases. The 5' 964 bases of the M1 plus strand encode the type 1 killer toxin of the yeast. S14 is 793 base pairs (bp) long, with 253 bp from the 5' region of its parental plus strand and 540 bp from the 3' region. All three defective interfering RNAs derived from M1 that have been characterized so far preserve a large 3' region, which includes five repeats of a rotationally symmetrical 11-bp consensus sequence. This 11-bp sequence is not present in the 5' 1 kilobase of the parental RNA or in any of the sequenced regions of unrelated yeast viral dsRNAs, but it is present in the 3' region of the plus strand of another yeast viral dsRNA, M2, that encodes the type 2 killer toxin. The 3' region of 550 bases of the M1 plus strand, previously only partially sequenced, reveals no large open reading frames. Hence only about half of M1 appears to have a coding function. PMID- 3517386 TI - The vascular surgeon: not a tradesman. PMID- 3517385 TI - Intracellular assembly and packaging of hepatitis B surface antigen particles occur in the endoplasmic reticulum. AB - Hepatitis B surface antigen (HBsAg) particles are secreted by Chinese hamster ovary cells that are stably transfected with the S gene of hepatitis B virus. The assembly of HBsAg into cylindrical and spherical particles occurred intracellularly within the endoplasmic reticulum. HBsAg particles accumulated within large dilated areas of the endoplasmic reticulum and remained within these structures for most of the time prior to secretion from the cells. Once the particles were formed, the HBsAg polypeptides did not appear to become associated with subsequent intracellular organelle membranes or the plasma membrane. HBsAg within the dilated structures did not bind wheat germ agglutinin, indicating that its oligosaccharide chains had not yet been processed to the complex form (containing terminal sialic acid-N-acetylglucosamine residues). The oligosaccharide chains of HBsAg are processed to the complex form and can be detected on the HBsAg after secretion, but this event was not detected within cells. In addition, HBsAg was not observed on the cell surface by indirect immunofluorescence or immunoprecipitation, although immunoelectron microscopy revealed some staining at or near the cell surface. These results suggested that HBsAg was either secreted from cells without being incorporated into the plasma membrane, or that the levels of HBsAg in the plasma membrane were below the limits of detection. PMID- 3517387 TI - Infected femoral artery false aneurysms in drug addicts: evolution of selective vascular reconstruction. AB - Fifty-four infected femoral artery false aneurysms resulting from chronic drug addiction were managed surgically with an 11% amputation rate and no mortality. Angiography localized the arterial segment involved, which in turn influenced the type of operation performed. Twenty-six aneurysms of anatomically isolated femoral artery segments were ligated and excised without resultant amputation. However, of the 28 aneurysms involving the common femoral bifurcation, 18 required triple ligation and excision that led to six amputations. Six of the 28 aneurysms were reconstructed with autogenous saphenous vein grafts, three by prosthetic grafts, and one by primary anastomosis. No amputations followed vascular reconstruction. However, all synthetic grafts eventually developed septic complications that required graft removal. On the basis of this experience we recommend ligation and excision for single artery segment aneurysms and immediate autogenous reconstruction for selected common femoral bifurcation lesions. This approach has proved safe and has reduced our amputation and graft complication rates. Extensive uncontrollable wound sepsis may contraindicate revascularization. Under these circumstances we estimate a 33% risk of amputation when the common femoral bifurcation is excised. PMID- 3517388 TI - Reducing the risk of urgent revascularization for unstable angina: a randomized clinical trial. AB - A prospective, randomized trial was instituted to determine whether blood cardioplegia (BC) could reduce the morbidity and mortality for patients undergoing urgent coronary bypass for unstable angina. One hundred forty patients who came to the hospital with prolonged angina at rest and who required urgent revascularization because their symptoms were resistant to medical therapy were randomized to receive BC (n = 70) or crystalloid cardioplegia (CC) (n = 70). The operative mortality rate was 2.8%, the incidence of myocardial infarction was 8.6%, the incidence of low output syndrome was 18% and morbidity (myocardial infraction or low output syndrome) was 23%. Patients who received BC had a significantly lower mortality rate (BC, 0%; CC, 5%; p less than 0.05) and incidence of myocardial infarction (BC, 4%; CC, 13.5%; p less than 0.05) or low output syndrome (BC, 10%; CC, 19%; p less than 0.05). The highest postoperative CK-MB level was less after BC (BC, 31 +/- 17 U/L; CC, 56 +/- 13 U/L; p less than 0.05). Preoperative predictors of postoperative morbidity in addition to the type of cardioplegia included the response to medical therapy, persistent ischemic electrocardiographic changes, left ventricular ejection fraction, and age. A multivariate analysis identified the type of cardioplegic protection (p = 0.008) and age (p = 0.05) as significant independent predictors of postoperative morbidity. BC reduced the risk of urgent revascularization for unstable angina. PMID- 3517390 TI - Leads from the MMWR. Reported contamination of heparin sodium with Pseudomonas putida. PMID- 3517389 TI - Preoperative noninvasive assessment of arm veins to be used as bypass grafts in the lower extremities. AB - Preoperative noninvasive imaging of the veins of the upper extremities has been included in the protocol to select an autogenous vein for a distal bypass in the lower extremity. Arm veins are sought as bypass grafts when the saphenous vein is absent or not usable. Duplex ultrasound provided images of the cephalic and basilic veins in 10 patients in whom visual inspection failed to reveal usable grafts. All arm veins implanted were at least 2 mm (range 2 to 6 mm) in internal diameter determined by ultrasound and were, on the average, 2 mm larger when unroofed. This noninvasive technique has decreased the number of fruitless surgical explorations to obtain a suitable arm vein and has increased the use of arm veins by revealing veins previously not anticipated by physical examination, which virtually eliminated the use of nonautogenous conduits in our practice. PMID- 3517391 TI - Yet more, yet older snakes. PMID- 3517392 TI - More snakes, definitively. PMID- 3517393 TI - Medical and public health aspects of boxing. AB - In recent years, an extensive medical literature has accumulated regarding the health hazards associated with boxing. As the evidence that boxing produces irreversible brain damage in boxers has become more compelling, physicians have begun to consider the larger issue of whether the sport is acceptable in its present form. This has resulted in a number of proclamations concerning boxing by various representatives of the medical community, which have both added information to and fueled the public debate over boxing. This article seeks to review the relevant medical literature concerning the health effects of boxing; to look at the contributions made in the last few years by the medical community to the public debate over boxing; and to suggest ways in which the objectives of the medical professional concerning boxing can best be achieved. PMID- 3517394 TI - Staging of President's cancer continues to stimulate discussion. PMID- 3517395 TI - Passive transfer of antibodies to human T-cell lymphotropic virus type III in patients receiving high-dose intravenous immunoglobulin. PMID- 3517396 TI - A randomized, controlled clinical trial of a geriatric consultation team. Compliance with recommendations. AB - As part of a prospective, randomized, controlled study of the effectiveness of a geriatric consultation team, we examined compliance by the house staff with recommendations made by the team. Recommendations were formulated for 185 patients, aged 75 years or older, who were randomized into intervention (n = 92) and control (n = 93) groups. In the control group, only 27.1% of the actions that would have been recommended by the team were implemented independently by the house staff. Problems commonly neglected included polypharmacy, sensory impairment, confusion, and depression. In the intervention group, overall compliance was 71.7%. Highest compliance occurred for recommendations addressing instability and falls (95.0%) and discharge planning (94.3%). We conclude that a geriatric consultation team contributes substantial additional input into the care of older patients. Furthermore, relatively high compliance can be achieved with recommendations made by a geriatric consultation team, thereby overcoming the first barrier to the establishment of such a service. PMID- 3517397 TI - Detection of group A streptococci in the laboratory or physician's office. Culture vs antibody methods. AB - Much controversy has existed concerning the clinical significance of small numbers of group A streptococci (eg, one to ten or even 50 colonies) recovered in culture. The relative quantity of streptococci recovered is, in part, technique dependent. This review documents the need for sensitive throat culture technology, addresses technical problems associated with the culture procedure, and, in light of these problems, explores the need for very carefully performed studies on streptococcal antigen detection kits before their implementation as a routine test either in physicians' offices or in microbiology laboratories. PMID- 3517398 TI - The Agnew Clinic, 1889, American. Oil on canvas. PMID- 3517400 TI - On the physical death of Jesus Christ. PMID- 3517399 TI - POW-turned-physician pilots revised course. PMID- 3517402 TI - Shigella bacteremia in adults. PMID- 3517401 TI - A question of conscience. Physicians in defense of human rights. PMID- 3517404 TI - [Effect of nifedipine pretreatment on SNP doses and overshoot hypertension after discontinuation of SNP in SNP-induced hypotension anesthesia]. PMID- 3517405 TI - [In vivo antibacterial activity of cefbuperazone. Synergy of cefbuperazone for bactericidal effect with human polymorphonuclear leukocytes]. AB - Studies were done utilizing E. coli No. 59 which are resistant against human and mouse serum, and the following results were obtained. The therapeutic effect of cefbuperazone (CPBZ) against systemic infections of mice was much higher than that of cefmetazole (CMZ), cefotetan (CTT), latamoxef (LMOX) and cefoperazone (CPZ). Synergistic bactericidal effect with human polymorphonuclear leukocytes was more marked for CBPZ than CMZ. PMID- 3517403 TI - Concepts in spinal anesthesia. PMID- 3517406 TI - [Efficacy evaluation of aztreonam for suppurative otitis media]. AB - Preclinical and clinical studies were performed to evaluate usefulness and safety of aztreonam (AZT) in the treatment of acute otitis media, acute exacerbation of chronic otitis media and chronic otitis media and the following results were obtained. MICs for P. aeruginosa, P. mirabilis and P. inconstans isolated from the patients with suppurative otitis media were 1.56 micrograms/ml, less than or equal to 0.025 micrograms/ml and less than or equal to 0.025 micrograms/ml respectively in their peaks. In the intravenous injection of 1 g, AZT concentration in the mastoid cell mucosa was 7.52 micrograms/g on average and serum concentration 51.6 micrograms/ml sufficiently suggesting clinical efficacy of AZT. In the clinical trial by administering AZT 1-2 g/day for the patients with suppurative otitis media, effective rates were 2/3 (66.7%) for acute otitis media, 16/22 (72.7%) for acute exacerbation of chronic otitis media, 21/34 (61.8%) for chronic otitis media and 6/7 (85.7%) for cholesteatoma of the middle ear. Elimination rate of single Gram-negative pathogens was 82.1% in the bacteriological studies of AZT. As for abnormal laboratory findings, 7 cases showed GOT, GPT elevations. However, they were in minor degree and transient. Side effect was not noted except 1 case of flushing with itching. It was considered from the above results that AZT is a highly useful antibiotic for suppurative otitis media. PMID- 3517408 TI - [Carcinogens and their mechanism of action]. PMID- 3517407 TI - [Well-controlled comparative study on aztreonam and cefoperazone in the treatment of complicated urinary tract infections]. AB - A well-controlled comparative study was conducted in order to evaluate the efficacy, safety and usefulness of the monobactam antibiotic aztreonam (AZT) in complicated urinary tract infections (UTI) using cefoperazone (CPZ) as the control drug. Patients with complicated UTI due to Gram-negative bacteria were examined. However, in polymicrobial infections, the cases caused by Gram-negative and Gram-positive bacteria were also examined. Both drugs were administered 1 g, twice a day by intravenous drip infusion for 5 days. Overall clinical efficacy was evaluated by the criteria proposed by the UTI committee in Japan. Of the total 394 cases, the clinical efficacy was evaluated for 152 cases in the AZT group and 143 cases in the CPZ group excluding 99 cases of exclusion or dropout. There was no statistically significant difference in the back ground characteristics between the 2 groups. The overall clinical efficacy rate was 55.3% for AZT and 55.2% for CPZ with difference not significant. As for clinical efficacy, in the monomicrobial infection after postprostatectomy (G-2), AZT was superior to CPZ (P less than 0.05), whereas in the polymicrobial infection without indwelling catheter (G-6), CPZ was superior to AZT (P less than 0.1). The overall bacteriological eradication rate was 77.2% for AZT and 74.5% for CPZ. For Gram-negative bacteria only the eradication rate for AZT (83.2%) was superior to that for CPZ (74.6%). This was probably due to the stability of AZT to beta lactamase. Side effects were observed in 3 cases out of 201 in the AZT group and 5 cases out of 189 in the CPZ group. No severe abnormal laboratory finding was observed in any group; there was no significant difference between the 2 groups. Consequently, AZT was judged to be an antibiotic with clinical usefulness equal to, or even superior to that of CPZ. PMID- 3517409 TI - [Breakdown of immunological surveillance]. PMID- 3517411 TI - [Composition of the membrane of cancer cells]. PMID- 3517410 TI - [Cancer development and animal models]. PMID- 3517412 TI - [Cytoskeleton of cancer cells]. PMID- 3517413 TI - [Extra-cellular skeleton of cancer cells]. PMID- 3517414 TI - [Abnormal metabolism of lipids and proteins in neoplastic cell division]. PMID- 3517415 TI - [Abnormal control of cell division and neoplastic transformation]. PMID- 3517416 TI - [Mechanism of neoplastic metastasis]. PMID- 3517417 TI - [Cell differentiation induction therapy in leukemia]. PMID- 3517418 TI - [Antineoplastic mechanism of immunotherapy in neoplastic cells]. PMID- 3517419 TI - [Stem cell assay of neoplastic cells]. PMID- 3517420 TI - [Clinical pharmacology and administration schedule of antineoplastic agents]. PMID- 3517421 TI - [Tumor necrosis factor (TNF)]. PMID- 3517422 TI - [Biophysics of the neoplastic process]. PMID- 3517423 TI - [Bacterial infections and protective mechanisms of the host]. PMID- 3517424 TI - [Lymphocytes and defense mechanism of infection--on the interaction between NK cells and microbials]. PMID- 3517425 TI - [Abdominal ultrasonography]. PMID- 3517426 TI - [Measurement of thyroid microsomal antibody in serum by enzyme immunoassay]. PMID- 3517427 TI - [A study of the localization of estradiol by the immunoperoxidase method]. PMID- 3517428 TI - [Evaluation of the assay for fibrin derivatives using monoclonal antibodies to D dimer]. PMID- 3517429 TI - [Detection of antibody to Epstein-Barr virus associated nuclear antigen by enzyme linked immunosorbent assay]. PMID- 3517430 TI - [Peripheral arteriography by the IVDSA technic under treatment with hot compress]. PMID- 3517431 TI - [Renal ultrasound. II]. PMID- 3517432 TI - [The significance of immunoglobulin deposits in amyloids of skin-limited amyloidoses]. PMID- 3517433 TI - [Bullous pemphigoid antigen protein extracted from Pam cells and cultured human epidermal cells]. PMID- 3517434 TI - [Prostaglandins in rat gastric mucosa. (11th report)--effect of hypoxia]. PMID- 3517435 TI - [Endoscopic ultrasonography of the gallbladder compared with pathological findings]. PMID- 3517436 TI - [A case of eosinophilic gastroenteritis and review of the Japanese literature]. PMID- 3517437 TI - [Experimental evaluation of a new prostacyclin analog (OP 41483) for myocardial protection]. PMID- 3517438 TI - [Intraaortic balloon pumping--current status of IABP and artificial heart in Japan]. PMID- 3517439 TI - Relationship between serum total cholesterol levels on the day of hormonal treatment and the subsequent ovarian response in ovarian cystic cows. PMID- 3517441 TI - Pulmonary edema and conscious patient with overdose. PMID- 3517440 TI - A new nematode, Yatinema japonicum gen. et sp. n. (Heligmonellidae: Nematoda), from voles, Eothenomys smithi Thomas and E. niigatae (Anderson). PMID- 3517442 TI - An "America heroine" in emergency nursing (Cindy Young). PMID- 3517443 TI - Choosing leadership. PMID- 3517444 TI - An eight-year-old boy with a stab wound to the heart. PMID- 3517445 TI - Careful assessment of abdominal pain. PMID- 3517446 TI - Search and seizure in the emergency department. PMID- 3517447 TI - Use of naloxone in septic shock. PMID- 3517448 TI - Emergency admissions and lunar cycles. PMID- 3517449 TI - The trauma patient who is pregnant. PMID- 3517450 TI - Seat belt legislation: buckle up! PMID- 3517451 TI - Concealed illegal drugs. PMID- 3517452 TI - Monoclonal antibody against human ovarian tumor-associated antigens. AB - Mouse monoclonal antibodies (OV-TL 3) were raised against human ovarian tumor associated antigens for diagnostic purposes. A cloned hybridoma cell line was obtained by fusion of murine myeloma cells with spleen lymphocytes from BALB/c mice immunized with a tumor cell suspension prepared from an ovarian endometrioid carcinoma. The antibodies were initially screened for their ability to bind on frozen sections of human ovarian carcinoma tissue and a negative reaction on gastric carcinoma tissue by indirect immunofluorescence. The reactivity of the selected OV-TL 3 clone (IgG1 subclass) was studied on normal and neoplastic tissues as well as on a cell line derived from the original tumor cell suspension used for immunization. OV-TL 3 antibodies stained frozen sections of human ovarian carcinomas of the following histological types: serous, mucinous, endometrioid, and clear cell. No reaction was found with breast cancers or other nongynecological tumors. No differences in staining pattern were observed between primary and metastatic ovarian carcinomas. OV-TL 3 antibodies brightly stained ovarian carcinoma cell clusters in ascitic fluids and left unstained mesothelial cells and peripheral blood cells. The OV-TL 3-defined antigen also remained strongly expressed on a cell line derived from the endometrioid ovarian carcinoma originally used for generation of OV-TL 3 clone. Reactivity was weak and irregular in a few ovarian cysts, while traces of fluorescence were sometimes detected in epithelial cells lining the female genital tract. In only 3 specimens of 15 endometrium carcinomas was weak focal reactivity with OV-TL 3 antibodies observed. The results of the immunofluorescence study were confirmed by the more sensitive avidin-biotin method and by 125I-labeled OV-TL 3 antibodies. Thus OV-TL 3 recognizes a common antigen for most ovarian carcinomas and may be a useful tool for rapid diagnosis of ovarian carcinomas. PMID- 3517453 TI - Autologous antibodies eluted from membrane fragments in human ovarian epithelial neoplastic effusions. II. Tissue specificity and reactivity. AB - Cyst and ascitic fluids from patients with ovarian epithelial neoplasms were studied to determine whether they contained immunoglobulins with antitumor activity. The results demonstrated the presence of autologous antibodies bound to the cellular membrane fragments obtained from human ovarian neoplastic effusions. Membrane fragments were prepared from more than 60 samples of human ovarian effusions, and the amounts of membrane-bound IgG and IgA were determined. Six fluids obtained from patients with malignant ovarian neoplasms were selected for large-scale preparation of IgG, on the basis of the quantity of fluid available (greater than 200 ml) and amount of membrane-bound IgG (greater than 400 ng/ml) determined by enzyme-linked immunoassay. The antibodies were strongly reactive with cell-surface antigens on 4 different human ovarian cell lines, 4 surgical specimens of human ovarian adenocarcinoma, and 2 human ovarian tumors grown in athymic BALB/c mice, as demonstrated by indirect immunofluorescence. The antibodies did not react, or reacted only weakly, with tissue preparations from 4 normal human ovaries, other nonovarian normal or neoplastic tissues, and nonovarian human cell lines. These studies indicate that patients with ovarian cancer have the capability to recognize and form antibodies against autologous ovarian tumor-associated antigens. PMID- 3517455 TI - [A. Huchard and the functional trend in cardiology]. PMID- 3517454 TI - Dose-response relationship of radiation-induced harderian gland tumors and myeloid leukemia of the CBA/Cne mouse. AB - Transplantation of harderian gland cells from CBA/-Cne mice into the fat pad of isogenic recipients was used for a quantitative in vivo study of cell survival and risk of transformation after x-ray irradiation (1-7 Gy). A survival curve for gland cells was generated in vivo with a D0 of 1.83 Gy and an extrapolation number of 7.23. Subsequently, the dose-response curve for lesions observed in nodules after cell transplantation was compared with that for lesions observed in glands irradiated in situ. A high incidence of epithelial hyperplasias with severe dysplasia was observed in transplantation nodules after x-irradiation. Gland tumors were significantly induced in whole-body irradiated animals; the tumors reached a maximum incidence after doses of 3 Gy. The risk of transformation per surviving cell was estimated both for dysplastic lesions and for tumors. These results approximated a dose-squared relationship in both cases, suggesting a common induction mechanism at the cellular level. Myeloid leukemia was observed at all doses in whole-body irradiated mice, and the maximum tumor incidence was reached at doses around 3 Gy. PMID- 3517456 TI - [The place of cardiomyopathy in modern cardiology]. PMID- 3517457 TI - Potential role of platelet-activating factor in renal pathophysiology. PMID- 3517458 TI - Antibody, antigen, and glomerular capillary wall charge interactions: influence of antigen location on in situ immune complex formation. AB - These studies examined the charge interactions between the glomerular capillary wall, antibody and antigen at different sites in the glomerulus. Sheep IgG was separated into differently charged subclasses and immunologically placed in one of two glomerular locations (subepithelial or subendothelial) to serve as planted antigen. Single kidneys with planted antigen were transplanted into uninephrectomized recipients that received affinity-purified, cationic and anionic rat anti-sheep IgG labelled with 125I and 131I, respectively. Glomerular bound antibody was determined and corrected for antibody delivery. Specificity of antibody binding was confirmed by comparison of kidneys with or without planted antigen. The results indicate that the influence of charge on glomerular antibody binding depends on the site of the antigen. When antigen was planted in the subepithelial space, significantly more (15 to 25%) cationic than anionic antibody bound despite the fact that the antigen was cationic. Conversely, when the antigen was planted subendothelially, significantly more anionic (13 to 22%) antibody bound when the antigen was cationic, and significantly more cationic (7 to 16%) antibody bound when the antigen was anionic. Thus, the negatively-charged glomerular filtration barrier retards the permeation of anionic antibodies that complex with antigens located in the subepithelial space, but antigen-antibody charge interactions appear to predominate when the antigen is more proximally located. PMID- 3517459 TI - Pathological specimens of the kidney examined by Richard Bright. PMID- 3517460 TI - Analytical methods for aluminum measurement. PMID- 3517461 TI - Experimental aluminum-induced bone disease: studies in vivo. AB - The administration of aluminum to experimental animals can induce osteomalacia in previously normal bone. Aluminum exposure impairs the synthesis of new bone matrix which reduces bone formation. A specific action of aluminum to inhibit the mineralization of bone in vivo has not yet been demonstrated. The role of parathyroid hormone in the pathogenesis of the osteomalacia that develops after aluminum loading also remains uncertain. However, the occurrence of both osteomalacia and impaired bone formation in experimental animals following aluminum administration has been documented in the absence of reductions in the serum levels of PTH. The results of the animal studies completed to date are consistent with a direct adverse effect of aluminum to suppress new bone formation. This response of bone may be mediated through a toxic effect of aluminum on the osteoblast. Whether aluminum also disrupts the mineralization of bone by a mechanism separate from its effect on the osteoblast requires additional study. PMID- 3517462 TI - [Classification and etiopathogenesis of diabetes mellitus]. PMID- 3517463 TI - [Response to the article by B.N. Esterov et al]. PMID- 3517464 TI - [Resection of the rectum with creation of a delayed colostomy]. PMID- 3517465 TI - [Evaluation of various types of ileorectal anastomosis after colectomy]. PMID- 3517466 TI - [Precision operative technics in various proctological diseases]. PMID- 3517467 TI - [Immunobiological reactivity in patients with peptic ulcer (review of the literature)]. PMID- 3517468 TI - [Restoration of the continuity of the large intestine after the Hartmann operation]. PMID- 3517469 TI - [The Hartmann operation in diseases of the large intestine]. PMID- 3517470 TI - [Experience using an immunosuppressive agent sandimmun (cyclosporin A) in kidney transplantation in the clinic]. PMID- 3517471 TI - [Reconstructive operations in severe post-burn hand deformities]. PMID- 3517472 TI - [Prevention of incompetence of sutures of the duodenal stump]. PMID- 3517473 TI - Theophylline relieves headache following lumbar puncture. Placebo-controlled, double-blind pilot study. AB - In a study of 11 patients with typical headache following diagnostic lumbar puncture the effect of peroral treatment with theophylline (Euphyllin retard) was compared with that of placebo. When the headache was provoked by orthostatic strain, the six patients in the verum group showed significantly less pain (mean pain score: 16 +/- 3.91) than the five patients in the placebo group (mean pain score: 28 +/- 4.73). This beneficial effect of theophylline on post-puncture headache was subsequently confirmed by open observations of ten additional patients. In view of the small sample size our results should be considered preliminary. Nevertheless, they suggest that additional trials on the benefit of methylxanthines in the treatment of post-puncture headache are called for. PMID- 3517474 TI - [Immunohistochemical studies of the determination of the hormone receptor status of breast cancer]. AB - Immunohistochemical examinations of 89 breast cancer specimens were performed using two different monoclonal antibodies. One marked the nuclear estrogen receptor (ER) protein (anti-ER, Abbott), whereas the other marked an ER-related cytoplasmic protein (ER-D5 Amersham). Comparison of the results of the biochemical assay with those of the immunohistochemical markers revealed the following correlations: 75% anti ER and 71% ER-D5. Clinical follow-up studies are necessary to specify the relevance of these new immunohistochemical techniques in the anti-hormonal therapeutic management of breast cancer patients. PMID- 3517475 TI - The effect of new alpha-glucosidase inhibitors (BAY m 1099 and BAY o 1248) on meal-stimulated increases in glucose and insulin levels in man. AB - To confirm findings obtained from animal experiments demonstrating the metabolic effect of two new glucosidase inhibitors, 7 single blind cross-over studies with 42 healthy male volunteers were performed. In each group 6 subjects received 25, 50, 100 and 200 mg BAY m 1099 and 10, 20, and 40 mg BAY o 1248 or placebo with a standardized breakfast. Blood glucose and serum insulin were measured in venous blood before and 30, 60, 90, 120 and 180 min after each of 3 meals. ECG, blood pressure, body weight, monitor ECG and haematological and clinico-chemical parameters were also examined. The postprandial increase in blood glucose and serum insulin after breakfast were significantly and dose-dependently reduced by BAY m 1099. 10 and 20 mg BAY o 1248 not only reduced the increases in blood glucose and serum insulin after breakfast, but also after lunch (10 mg). 40 mg BAY o 1248 prevented the postprandial increase in both metabolic parameters after breakfast (p less than 0.05), an effect which was sustained after lunch. Intestinal problems occurred (flatulence, meteorism, diarrhoea) in 25 of 42 volunteers. Objective tolerability was good. The results of these first clinical pharmacological studies with two new glucosidase inhibitors justify studies on patients with diabetes mellitus. PMID- 3517476 TI - [Thyroid echography in various thyroid diseases]. PMID- 3517477 TI - [Current problems in burns]. PMID- 3517478 TI - [High-count eosinophilias in the clinical picture of internal diseases]. PMID- 3517479 TI - [Hereditary disorders of local protection in the development of chronic nonspecific lung diseases]. PMID- 3517480 TI - [Drug interaction in modern gastroenterology]. PMID- 3517481 TI - [Genetics of atherosclerosis and its clinical manifestations]. PMID- 3517482 TI - [Effect of hydrocortisone on the osteogenetic function of the bone marrow of the mouse]. AB - Bone marrow cells were implanted into the capsule of the kidney of mice which were then given intraperitoneal injections of hydrocortisone in the dose of 5 mg per animal. The drug influenced different stages of bone histogenesis in a different manner. The stage of the onset of bone formation proved to be most sensitive, whereas the earlier and later stages were less sensitive to hydrocortisone. It is concluded that the target cells for hydrocortisone are osteoblasts at the stage of active synthesis of bone proteins rather than cells precursors of osteogenesis. PMID- 3517483 TI - [Concerning the collaboration between nurses and parents. "For the nurses that must be the hardest ..."]. PMID- 3517484 TI - A simple and economic technique for long-term continuous intravenous infusion in the unrestrained rat. AB - A reliable, inexpensive and ethically acceptable method for long-term intravenous infusion in unrestrained rats is described. This system absorbs rotational forces produced by the animal turning without kinking of the tube. PMID- 3517486 TI - Mechanism of Theiler's virus-induced demyelination in nude mice. AB - In its natural murine host, infection with Theiler's murine encephalomyelitis virus (TMEV) produces a chronic, progressive demyelinating disease. To help elucidate the role of host immune mechanisms involved in demyelination, we studied TMEV infection in Nude mice. These animals demonstrated rising titers of infectious virus within the central nervous system and failed to produce anti TMEV antibody. Neurologic signs including the development of severe hind limb paralysis were evident approximately 2 weeks postinfection with most animals succumbing within the first month. Immunoperoxidase studies demonstrated viral antigen in the cytoplasm of neurons and glial cells for the entire period of observation. Plaques of demyelination associated with scanty inflammatory infiltrates were present in the spinal cord by 14 days postinfection. Electron microscopic studies of the involved white matter revealed numerous degenerating glial cells, many of which contained paracrystalline arrays of picornavirus within their cytoplasm. Some of the infected glial cells were identified as oligodendrocytes by demonstrating their myelin-plasma membrane connections. The studies indicate that in Nude mice TMEV causes a lytic infection of oligodendrocytes producing demyelination independent of the T lymphocyte immune system. PMID- 3517485 TI - Mechanisms and consequences of proteinuria. AB - The glomerulus is a complex structure containing a remarkable capillary bed which is freely permeable to water and solutes up to the size of inulin. Many small proteins are filtered, reabsorbed, and catabolized by the kidney; but most large proteins, such as albumin or immunoglobulins, are almost entirely excluded from the glomerular ultrafiltrate due to the charge-size permselectivity of the glomerular capillary basement membrane. These large proteins appear in the urine when diseases reduce the charge selectivity or result in the development of large pores in this membrane. The reabsorptive capacity of the renal tubules for these proteins is overwhelmed. Hypoalbuminemia results when increased synthetic and decreased catabolic rates of albumin fail to compensate for the urinary loss of the protein. The resulting decrease in serum oncotic pressure increases the flux of fluid out of systemic capillaries into the interstitial space, a process that increases lymphatic flow and returns the relatively protein-poor ultrafiltrate to the plasma compartment. Interstitial proteins are swept into the plasma by the increased lymphatic flow, leading to a depletion of the extravascular pool of albumin even more severe than the depletion of albumin in the plasma compartment. The rate of albumin synthesis is increased but not sufficiently to replace losses and restore the serum concentration to normal. The rate of albumin catabolism is decreased. This decrease from the normal catabolic rate is as important as the increased rate of albumin synthesis in maintenance of albumin homeostasis in nephrosis. Whereas the reduced serum oncotic pressure certainly contributes to edema formation, sodium retention may result from processes intrinsic to the kidney itself; and plasma volume may actually be expanded despite hypoalbuminemia. The hyperlipemia that occurs in nephrosis is due to a combined defect in lipoprotein metabolism: increased hepatic synthesis of VLDL and decreased removal of TG and highly atherogenic remnants of incompletely metabolized CMs. The defects in lipoprotein metabolism may in part be the end result of the urinary loss of highly negative-charged macromolecules of the mucopolysaccharide called orosomucoid, which carries with it heparan sulfate, and important cofactor for LPL. PMID- 3517488 TI - South Carolina's first woman doctor. PMID- 3517487 TI - Nephritogenic potential of sheep antibodies against glomerular basement membrane laminin in the rat. AB - Antilaminin antibodies have been shown to bind to laminin within the glomerular basement membrane (GBM) and mesangium of experimental animals but have induced little or no glomerular injury. We used a sheep antiserum to murine Englebreth Holm-Swarm sarcoma laminin (sheep antilaminin) to further study the potential of antilaminin antibodies to cause glomerular injury. Intravenous injections of sheep antilaminin into rats produced intense linear GBM deposits of sheep IgG but consistently failed to induce heterologous phase proteinuria as previously shown. In addition, no autologous phase injury appeared even after preimmunization with sheep IgG (N = 4) or passive administration of rat anti-sheep IgG (N = 3) (mean urine protein less than 4 mg/24 hours up to 16 days). GBM deposits of rat C3 in vivo were absent despite the ability of both sheep antilaminin and rat anti-sheep IgG to fix human and rat C3 in vitro as determined by an indirect immunofluorescent assay. In contrast, when kidneys containing sheep antilaminin were transplanted into naive recipients that were passively immunized with rat anti-sheep IgG, severe proteinuria occurred (range 7 to 109 mg/24 hours on day 2; 49 to 350 mg/24 hours on day 5 posttransplantation) in association with glomerular deposition of C3. Histological evaluation at day 5 showed a severe proliferative glomerulonephritis with infiltrating polymorphonuclear and mononuclear leukocytes. Electron microscopy showed endothelial and epithelial cell detachment from the GBM and inflammatory cell adherence to denuded GBM. Epithelial foot process effacement and cytoplasmic absorption droplets were also noted. Identical kidneys transplanted into nonimmunized recipients or immunized recipients depleted of complement had significantly less (p less than 0.05) proteinuria (nonimmunized: 5 to 18 mg/24 hours on day 2, 4 to 9 mg/24 hours on day 5; complement-depleted: 6 to 13 mg/24 hours on day 2, 4 to 27 mg/24 hours on day 5) and no glomerular complement fixation was seen in these animals. Thus, severe glomerular injury can be induced by a focused, amplified, complement dependent immune attack on glomerular laminin. In contrast, the widespread distribution of laminin and antilaminin probably dilutes the total glomerular immune reaction and precludes effective complement fixation and glomerular injury during the autologous phase in nontransplanted kidneys. A similar explanation might account for the lack of glomerular injury in previous studies that utilized antisera to known GBM constituents. PMID- 3517489 TI - One hundred EMIT positive cannabinoid urine samples confirmed by BPA/TLC, RIA, and GC/MS. PMID- 3517490 TI - Occupational medicine in international industry. PMID- 3517492 TI - Fibrin seal--an alternative to suture repair in experimental pulmonary surgery. AB - Fibrin seal (FS) a biological tissue adhesive was evaluated as a sealant of lung parenchyma. New Zealand White (NZW) rabbits underwent a right upper lobe wedge resection. The defect was repaired with FS, suture (S), or a combination of S and FS (SFS). Five rabbits from each treatment group were sacrificed on postoperative Days 1, 3, and 14. The ventilatory pressure required to produce air leak was measured and the wet weight of normal vs hemorrhagic lung tissue determined. Although leak pressure was lowest in FS on Day 1 (P less than 0.05), leak pressure was equal to S and SFS of Day 3 and highest on Day 14 (P less than 0.01). FS-treated lungs had less hemorrhagic tissue than S and SFS (P less than 0.0001). Microscopically S and SFS repairs had large areas of hemorrhagic necrosis while FS showed minimal changes. We conclude that FS is an effective sealant of lung parenchyma. PMID- 3517491 TI - Graft irradiation abrogates graft-versus-host disease in combined pancreas-spleen transplantation. AB - A model of combined pancreas-spleen transplantation (PST) was studied in LBN F1 recipients of Lewis grafts in order to evaluate the efficacy of pretransplant graft irradiation in preventing lethal graft-versus-host disease (GVHD). Recipients of unmodified PST uniformly developed severe GVHD and died (MST = 16.7 +/- 3.8 days). Whole body donor irradiation with either 500 or 250 rad prevented lethal GVHD. Similarly, ex vivo graft irradiation with either 1000 or 500 rad also resulted in normal weight gain, graft function, and host survival for the 6 week study period. Conversely, delay of graft irradiation until 3 days after transplantation failed to prevent this complication (MST = 15.8 +/- 3.7 days). Recipients of irradiated grafts displayed glucose tolerance tests that were identical to those in the control group indicating that the doses of radiation employed in these experiments were not deleterious to islet function. Irradiated spleen grafts appeared histologically normal at 6 weeks after transplantation. Cells derived from these grafts failed to stimulate lymph node enlargement in a popliteal lymph node assay for GVHD, suggesting that these spleens may have become repopulated with host cells. These experiments confirm that PST has the potential to cause lethal GVHD and suggest that pretransplant graft irradiation may be used to prevent its occurrence. PMID- 3517493 TI - Nuclide imaging of vascular graft-platelet interactions: comparison of indium excess and technetium subtraction techniques. AB - Indium-111-labeled platelet adherence to ePTFE thoracoabdominal vascular prostheses in a canine model (n = 10) was quantitated by (1) an indium-111 excess technique, contrasting graft radioactivity to that in a reference region, and (2) a technetium-99m subtraction technique, with radioactivity of circulating platelets eliminated by discounting background blood activity. Variation in graft thrombogenicity was provided by seeding six prostheses with enzymatically derived autologous endothelial cells, and implanting four prostheses without seeding. Grafts were imaged at 1, 4, and 6 weeks postimplantation, with platelet labeling using indium-111-oxine and red blood cell labeling using technetium-99m. At 7 weeks grafts were excised and gamma activity was measured in proximal, middle, and distal segments. Luminal generation of TxB2 and 6-keto-PGF1 alpha from midportions of grafts was assayed. Indium-111 excess ratios at 6 weeks correlated with actual gamma activity of excised grafts (proximal r = 0.80, P less than 0.01; middle r = 0.73, P less than 0.05; distal r = 0.48, ns) but such a correlation did not exist for the technetium-99m subtraction technique (r = 0.05, -0.25, and 0.16, in the three segments, respectively, all ns). The ratio of graft to aortic TxB2 production revealed a positive correlation with graft gamma activity (r = 0.87, P less than 0.01), and the ratio of graft 6-keto-PGF1 alpha to TxB2 production also correlated with gamma counts (r = -0.64, P = 0.05). In this experimental setting technetium-99m subtraction analysis was an imprecise method of detecting graft platelet accumulation, whereas indium-111 excess ratios proved to be a more accurate method of quantitating vascular prosthetic thrombogenicity. PMID- 3517494 TI - Insulin stimulates branched chain amino acid uptake and diminishes nitrogen flux from skeletal muscle of injured patients. AB - Resistance to insulin-mediated glucose disposal occurs in uninjured skeletal muscle of trauma patients but the effect of insulin on the accelerated proteolysis of trauma is unknown. We examined the influence of insulin on forearm amino acid and substrate exchange in five normals and four trauma patients using the hyperinsulinemic glucose clamp technique. Forearm substrate and amino acid flux (Q, nM/100 ml tissue/min), the product of blood flow and arterial deep venous concentration difference, was calculated before and during insulin infusion. Total nitrogen release (NQ, nM/100 ml tissue/min) was calculated as the algebraic sum of all nitrogen groups contained in the amino acids released. Among normal subjects, total nitrogen release from the forearm did not change (581 +/- 197 nM/100 ml tissue/min to 1167 +/- 455) during insulin infusion nor did total branched chain amino acid flux (0 +/- 30 nM/100 ml/min to 106 +/- 36). Under conditions of hyperinsulinemia, neither glutamine nor alanine changed in control subjects. In trauma patients, total nitrogen release (3843 +/- 1383 nM/100 ml/min) was inhibited during insulin administration (819 +/- 314, P less than 0.05). Total branched chain amino acid flux went from a net release of 460 +/- 134 nM/100 ml/min to a net uptake of 10 +/- 82 (P less than 0.05). In patients, statistically significant (P less than 0.05) differences were seen in individual amino acids as well. Forearm nitrogen flux was directly related to total branched chain amino acid flux in patients (r2 = 0.89). Additional studies in normals (n = 4) at higher insulin infusion rates confirmed that these effects were unique to injured subjects and not an effect of the insulin dose. Insulin attenuates the accelerated release of skeletal muscle amino acid in trauma patients. This effect may be mediated in part by facilitated branched chain amino acid uptake. The manipulation of both insulin and branched chain amino acid concentrations may provide a method to reduce post-traumatic protein catabolism. PMID- 3517495 TI - Chronic lymphocytic leukemia following treatment of status asthmaticus with systemic steroids. PMID- 3517496 TI - Management of the severely burned hand. PMID- 3517497 TI - Structure and dynamics of the estrogen receptor. AB - To evaluate the structure and function of estrogen receptor (ER) in various mammalian systems, the cytosolic forms of receptor from calf uterus and from MCF 7 human breast cancer cells have been purified to virtual homogeneity by sequential selective adsorption to estradiol-Sepharose and heparin-Sepharose. In both cases, the purified steroid-receptor complex appears to exist as an activated 5S homo- or heterodimer of mol. wt 65,000 (4S) steroid-binding subunits. Purified ER has high affinity for DNA and serves as a substrate for phosphorylation by a purified rat brain kinase. Several monoclonal antibodies prepared against affinity-purified MCF-7 cytosol ER have been used to localize receptor by an indirect immunoperoxidase technique in fixed, frozen sections of human breast tumors, human uterus, rabbit uterus and in other mammalian reproductive tissues and cancers, as well as in fixed MCF-7 cell cultures and in paraffin-embedded sections of breast tumors and human endometrium. In all cases, we have observed only nuclear localization of immunoreactive receptor in tissues and whole cells, even under conditions in which virtually all of the receptor is found in a low-salt extract (cytosol) of the target cells. Treatment of cells or tissues in vivo or in vitro with estradiol alters the intensity but not the distribution of specific staining for ER. By immunoelectron microscopy, receptor was localized in the euchromatin, but not in the marginated heterochromatin or nucleoli of MCF-7 nuclei and epithelial and stromal nuclei of postmenopausal human endometrium. These observations suggest that the majority of the unoccupied receptor may actually reside in the nucleus, rather than in the cytoplasm as previously thought. Thus, hormone action may involve binding of the steroid directly to receptor loosely associated with nuclear components, followed by conversion of the steroid-receptor complex to an activated form which becomes more tightly associated with chromatin. PMID- 3517498 TI - Immunological probes for oestradiol receptors in human breast tumours. AB - Monoclonal antibodies have been prepared against a soluble oestradiol receptor (REC) preparation partially purified from human myometrium by oestradiol affinity chromatography. The antibodies were detected by their ability to immunoprecipitate receptor bound [125I] oestradiol. One of the antibodies (D5) has been studied in detail. It will only precipitate REC after activation by salt, heat, low pH or KCNS and will not react with nuclear RE. It will not react with androgen, progesterone or glucocorticoid receptors nor with sex hormone binding globulin; it will only combine with REC from human sources. D5 recognizes a cytoplasmic 29 kdalton protein (p29) that can be separated from both type I and II soluble oestradiol binding proteins. p29 can react with activated REC and is qualitatively and quantitatively related to REC. IRMA and histochemical methods have been developed for quantitating p29 and relating its amount to receptors in human breast tumours. With both methods, highly significant (P less than 0.001) correlations with REC but not RP have been obtained. Both methods indicate that many REC-RP+ tumours contain p29. The histochemical method detects marked cellular heterogeneity in some tumours. The function of p29 is not known. It is an REC-related antigen that may be a previously undetected component of the oestradiol receptor machinery. PMID- 3517499 TI - The molybdate-stabilized glucocorticoid binding complex of L-cells contains a 98 100 kdalton steroid binding phosphoprotein and a 90 kdalton nonsteroid-binding phosphoprotein that is part of the murine heat-shock complex. AB - This paper summarizes our work performed with glucocorticoid-binding complexes in molybdate-stabilized cytosol prepared from 32P-labeled L-cells. In our early work, we showed that cytosol prepared from 32P-labeled L-cells contains two phosphoproteins (a 90 and a 98-100 kdalton protein) that elute from an affinity resin of deoxycorticosterone agarose in a manner consistent with the predicted behavior of the glucocorticoid receptor. Both phosphoproteins are immunoadsorbed onto protein-A-Sepharose from molybdate-stabilized cytosol incubated with a monoclonal antibody against the receptor. The 98-100 kdalton phosphoprotein binds steroid and the 90 kdalton phosphoprotein is a structurally different, nonsteroid binding protein that is bound to the untransformed, molybdate-stabilized glucocorticoid receptor. The 90 kdalton protein reacts on Western blots with a monoclonal antibody raised against a 90 kdalton protein from the water mold Achlya ambisexualis. This antibody recognizes an epitope that is conserved in 90 kdalton phosphoproteins from rodent and human cells, and it reacts with the 90 kdalton phosphoprotein that copurifies with the molybdate-stabilized, untransformed chick oviduct progesterone receptor. The 90 kdalton nonsteroid binding phosphoprotein is an abundant cytosolic protein that dissociates from the glucocorticoid receptor when it is transformed, and unlike the steroid-binding protein, it does not bind to DNA. The 90 kdalton phosphoprotein determines the acidic behavior of the untransformed glucocorticoid receptor on DEAE-cellulose. This abundant cytosolic 90 kdalton phosphoprotein reacts with rabbit antiserum raised against the gel purified 89 kdalton chicken heat-shock protein (hsp89). This antiserum recognizes 90 kdalton heat-shock proteins in human, rodent, frog and Drosophila cells. Immunoadsorption of molybdate-stabilized cytosol with antibody directed against the 98-100 kdalton steroid receptor results in the immune-specific adsorption of a 90 kdalton phosphoprotein that reacts with anti hsp89 antibody on Western blots. These observations suggest that, like the transforming proteins from several avian sarcoma viruses, the untransformed glucocorticoid receptor exists in a complex with the 90 kdalton heat-shock protein. PMID- 3517500 TI - In vitro metabolism of adrenocortical hormones by mammary glands of lactating rats. A comparative study. AB - A comparative study was made of the metabolism of tritium-labeled corticosterone, cortisol and aldosterone on incubation with minced mammary glands of lactating rats. The yield of total nonpolar (acylated) radiometabolites was highest for [3H]corticosterone, lowest for [3H]cortisol and intermediate for [3H]aldosterone. Unlike [3H]corticosterone, [3H]aldosterone yielded two 21-acyl derivatives (Metabolites I and II) in comparable amounts. Metabolite I (39%) was identified as [3H]aldosterone 21-oleate by isotope dilution analysis. Metabolite II (54%) could not be identified: it is intermediate in polarity between corticosterone 21 oleate and the less polar, corticosterone 21-stearate, and is distinctly less polar than the 21-palmityl, linoleoyl (and presumably also less polar than the arachidonyl) derivatives of aldosterone. The [3H]cortisol metabolites were not further investigated. PMID- 3517501 TI - Sex-differentiated enzyme levels and oestrogen uptake in adult rats treated neonatally with tamoxifen or CI-628. AB - Serum cholinesterase, hepatic histidase and monoamine oxidase activity levels are higher in adult female rats than in adult male rats. Exposure of neonatal rats to antioestrogen (tamoxifen or CI-628) resulted in increased serum cholinesterase in adult females only and no effect on hepatic histidase and monoamine oxidase in both sexes. Neonatal tamoxifen or CI-628 treatment resulted in reduced body weights in adult male rats and reduced uterine wet weights in adult female rats. Circulating oestrogen levels measured in adult female rats treated neonatally with tamoxifen were not significantly different from controls. Specific oestrogen uptake in the brain of adult male and female rats was found to be higher in the pituitary than in the preoptic-anterior hypothalamic area and the median eminence basal hypothalamus than in the cerebral cortex. There was higher uptake of [3H]oestradiol-17 beta in male pituitaries than in female pituitaries. No other sex-difference was observed. Neonatal tamoxifen treatment did not alter the capacity of these brain tissues to take up oestrogen. It is suggested that neonatal antioestrogen exposure has altered the endocrine expression of serum cholinesterase in adult female rats by interfering with normal imprinting mechanisms. PMID- 3517502 TI - Correlation between LH and estrogen receptor turnover in pituitary and hypothalamus of castrate rats following estrogen agonists and antagonists. AB - A series of studies was undertaken to correlate the short-term dynamics of LH secretion and depletion-replenishment patterns of estrogen receptors (ER) in hypothalamic and pituitary cytosols of ovariectomized rats. Animals castrated for 2 weeks were administered various test compounds and analyzed at 1, 3, 5, 10 and 15 h post-treatment. A single injection of 10 micrograms 17 beta-estradiol (E2) to ovariectomized rats elicited a rapid depletion of ER in both pituitary and hypothalamus and a dramatic, though delayed, fall in serum LH. ER replenishment occurred in both tissues through 15 h and LH recovered in a similar manner. When cycloheximide was administered along with E2, ER replenishment was completely inhibited in both tissues; serum LH fell and failed to recover. Actinomycin D injected with E2 blocked replenishment in pituitary but not hypothalamus; serum LH recovered in parallel with the hypothalamic ER pattern. 17 alpha-E2 elicited only slight changes in ER and LH was suppressed 10-20% through 15 h. CI-628 caused a near total depletion of pituitary ER with no subsequent replenishment, whereas hypothalamic ER content was virtually unaltered; serum LH was suppressed and later recovered. Orchidectomized rats given 5 micrograms E2 demonstrated a less complete ER depletion in hypothalamus, and an earlier replenishment than that seen in pituitary or hypothalamus of similarly treated ovariectomized females. Serum LH rebounded to 157% of control levels at 15 h. The results indicate that the acute feedback suppression of LH by exposure to estrogens correlates with binding to ER and nuclear translocation. Replenishment and/or retention of cytoplasmic ER in hypothalamus appears to be required for full resumption of LH secretion, following acute suppression. PMID- 3517504 TI - 15th annual UCLA symposia. March 30-April 26, 1986. Abstracts. PMID- 3517503 TI - Ovarian metabolic pathways of steroid biosynthesis in the European eel (Anguilla anguilla L.) at the silver stage. AB - Ovarian slices of the European eel at the silver stage were incubated with 4 tritiated precursors (pregnenolone, progesterone, androstenedione, testosterone) in the presence or not of an inhibitor of 11 beta-hydroxylase activity, metopirone. Ether extracts were submitted to a gradient elution chromatography on celite columns. Isolated peaks were identified by isopolarity on TLC, microchemical reactions and recrystallization to constant specific activity. Interpretation of the results shows that the ovary of the European eel contains the following enzymes: a 3 beta-hydroxysteroid dehydrogenase, 5----4-ene isomerase complex, a 17 alpha-hydroxylase, a C21-C19 desmolase, a 17 beta hydroxysteroid oxidoreductase, a 5 alpha-reductase, a 3 beta-hydroxysteroid oxidoreductase and an aromatase complex. Metopirone effect indicates the presence of an 11 beta-hydroxylase activity. At this stage, 5 beta-reductase, 20 beta reductase and 21-hydroxylase activities are not detected in the ovary. Water soluble steroids were formed from all the precursors used. It appears that the ovarian biosynthesis is orientated towards the production of 5 alpha-reduced compounds and that this might limit the production of 17 beta-estradiol by lowering the amount of disposable endogenous precursors. PMID- 3517505 TI - 15th annual UCLA symposium. Abstracts: Recent advances in bone marrow transplantation. PMID- 3517506 TI - Diltiazem cardioplegia. A balance of risk and benefit. AB - Calcium channel blockers may prevent myocardial injury during cardioplegia and reperfusion. A prospective, randomized trial was instituted to evaluate the hemodynamic and myocardial metabolic recovery in 40 patients undergoing elective aorta-coronary bypass with either diltiazem in crystalloid potassium cardioplegia (n = 20) or crystalloid potassium cardioplegia (n = 20). In a preliminary trial, doses between 150 and 250 micrograms/kg reduced the period of heart block after cross-clamp removal (90 +/- 110 minutes) from that found with higher doses and improved myocardial metabolism. In the randomized trial, diltiazem cardioplegia (150 micrograms/kg) produced coronary vasodilatation during cardioplegia and produced less reactive hyperemia during reperfusion. Myocardial oxygen extraction was lower and myocardial lactate production was less after diltiazem cardioplegia during reperfusion. Tissue adenosine triphosphate and creatine phosphate concentrations were preserved better after diltiazem cardioplegia. The postoperative creatine kinase MB levels were less (p less than 0.05) after diltiazem cardioplegia, which indicated less myocardial injury. Postoperative volume loading demonstrated that systolic function (the relation between systolic blood pressure and end-systolic volume index) was depressed after diltiazem cardioplegia compared to crystalloid cardioplegia, but cardiac index was higher because afterload (mean arterial pressure) was lower and preload (end-diastolic volume index) was higher. Diltiazem cardioplegia preserved high-energy phosphates, improved postoperative myocardial metabolism, and reduced ischemic injury after elective coronary bypass. However, diltiazem was a potent negative inotrope and produced prolonged periods of electromechanical arrest. Diltiazem cardioplegia may be of value in patients with severe ischemia but should be used with caution in patients with ventricular dysfunction, and a dose-response relation must be established at each institution before clinical use. PMID- 3517507 TI - Will the real CASS stand up? A review and perspective on the Coronary Artery Surgery Study. PMID- 3517509 TI - [Management of furcation involvement]. PMID- 3517508 TI - Nifedipine as an adjunct to St. Thomas' Hospital cardioplegia. A double-blind, placebo-controlled, randomized clinical trial. AB - The cardioprotective effect of the addition of the slow calcium-channel blocker nifedipine to cardioplegic solution was tested in two double-blind placebo controlled randomized studies. The first study included 24 patients undergoing aortic-coronary bypass grafting, and the second included 24 patients undergoing aortic valve replacement. Nifedipine at a dose of 200 micrograms/L or placebo was added to St. Thomas' Hospital cardioplegic solution. The following markers of ischemia were used: adenosine triphosphate and its catabolites, creatine phosphate and inorganic phosphate, determined in transmural left ventricular biopsy specimens taken before, at the end of, and after aortic cross-clamping; hemodynamic recovery 15 minutes after cessation of cardiopulmonary bypass; clinical outcome in terms of the incidence of arrhythmias, low cardiac output, positive inotropic support immediately after operation, and follow-up at 15 months. The main difference between the two studies was that myocardial temperature during cross-clamping remained constant at 14 degrees C in coronary bypass grafting but increased to 25 degrees C in valve operations despite the application of the same amounts of cardioplegic solutions. This lower temperature resulted in better preservation of high-energy phosphates in coronary bypass operations as compared to the placebo group having valve replacement operations. According to analysis of variance, a drug effect could be demonstrated only in the aortic valve replacement study: Accumulation of breakdown products of the adenine nucleotide pool was less in the nifedipine group than in the placebo group (p less than 0.05). Adenosine triphosphate decreased only to 84% in the nifedipine group and to 72% in the placebo group. Despite this adenosine triphosphate-sparing effect, weaning from cardiopulmonary bypass was more difficult in the nifedipine group. Left ventricular stroke work index 15 minutes after bypass was decreased to 72% of the prebypass value in the nifedipine group (t test, p less than 0.01) and only to 86% in the placebo group (p = NS). In contrast, after the patients were admitted to the intensive care unit, the incidence of low cardiac output tended to be lower in the nifedipine group than in the placebo group: 33% versus 58% (p = NS). In conclusion, ischemia-induced degradation of nucleotides as it occurs when myocardial cooling is inadequate can be prevented by the addition of nifedipine to the St. Thomas' Hospital cardioplegic solution. This effect, however, is not associated with an improved clinical outcome. PMID- 3517510 TI - Biosynthesis of macrophage activation factor. AB - Splenic lymphocytes from BCG-immunized mice were cultured with PPD for 72 hrs. The proteins secreted by these cells activate peritoneal macrophages to kill TU-5 mouse kidney cells. The fraction whose molecular weight falls between 67K and 50K exhibits most of the macrophage stimulating activity. However, lymphokine protein isolated from cultures of splenic lymphocytes harvested from iron-deficient mice showed decreased macrophage stimulating activity. These results further demonstrate the requirement for iron in lymphokine-dependent macrophage cytotoxic activity. Evidence is presented to suggest that the lymphokine fraction which induces tumoricidal activity binds first to a specific site on the surface of the macrophage membrane and then induces protein synthesis. In addition, the lymphokine proteins isolated from iron deficient or unstimulated spleen cultures neither bind to nor induce tumoricidal activity in macrophages. The binding of lymphokine to macrophages seems to be specific since no significant binding occurred to several other cell lines. The binding is saturable and reversible since the bound protein can be displaced by unlabelled lymphokines or xylose at concentration of 0.1M. The SDS gel analysis of macrophage membrane proteins newly synthesized in response to lymphokine showed several proteins with the different mol. wt. but major protein peaks approximately at 55K. The significance of induction of protein synthesis in macrophages by lymphokine is discussed. PMID- 3517511 TI - Stimulation of endothelial cell prostacyclin formation by interleukin-2. AB - The production of prostacyclin (PGI2) by the luminal surface of bovine aorta was significantly increased when incubated with 1 unit of interleukin-2 (IL-2). In separate experiments, confluent cultured bovine aortic endothelial cells were also shown to be stimulated to produce increased levels of PGI2 in a concentration-dependent manner by purified IL-2. This increase in prostacyclin biosynthesis was inhibited by cycloheximide. Since the recovery of prostacyclin production in aspirin treated cells was stimulated by interleukin-2, our results suggest that the stimulatory effect of interleukin-2 on prostacyclin synthesis is at least partially mediated by the de novo synthesis of cyclooxygenase. PMID- 3517512 TI - Electrical discoveries open new horizons in medicine. PMID- 3517513 TI - Hospital utilization by health maintenance organizations. Separating apples from oranges. AB - The hospitalization rate of HMOs is reported to be 444 bed days per 1,000 enrollees per year. It is often forgotten that there is also out-of-plan utilization. A review of previous studies and a survey of reporting practices by three HMOs illustrate many problems with HMO utilization data. HMO rates, like those of other insurers, reflect only the hospital admissions that the plans know about and pay for, not the total hospital experience of their enrollees. While only a thorough tracking of subscriber utilization of all insurers and institutions will provide estimates of the magnitude of unreported admissions and their impact on utilization rates, this report enumerates the ways in which patients may receive inpatient care without the HMO having a record of the admissions and/or having to pay for them. It was found that admissions can be unreported when another insurer or institution pays (e.g., Medicare, No Fault, Workmen's Compensation, duplicate coverage, school health and liability insurance or VA, military, municipal, and state hospitals); when the HMO does not cover benefits (e.g., cosmetic and oral surgery, experimental procedures, long-term psychiatric, chronic, or rehabilitation stays); and when HMO coverage is denied for procedural reasons (e.g., catastrophic stays covered by reinsurance, newborns, voluntary "leakage," or improper following of HMO procedures). True HMO rates are unknown but are estimated by some authors to be 7-37% higher than the reported figure, depending on which types of unreported use are estimated. There is a need for future analyses to quantify true hospitalization rates of enrollees of HMOs and other insurers. PMID- 3517514 TI - [Avascular necrosis of the femoral head and corticoid treatment]. PMID- 3517515 TI - [Sleep apnea syndrome]. PMID- 3517516 TI - [Asthma, aspirin, prostaglandins and leukotrienes]. PMID- 3517517 TI - [Spongiform encephalopathy]. PMID- 3517518 TI - [Food poisoning due to enteroinvasive Escherichia coli serotype O124]. PMID- 3517519 TI - [Renal transplant]. PMID- 3517520 TI - Clinical trials with C 1740, an immunomodulator compound proposed for prevention of acute infectious exacerbations in chronic bronchitis. AB - C 1740 is an immunmodulating agent of biological origin proposed for the prevention of infectious exacerbations in chronic bronchopathy. The first placebo controlled double-blind randomized clinical trials have led to opposite conclusions regarding the utility of C 1740. The rate of infectious exacerbations in the placebo group and a large Type II error could explain the "negative clinical trials". However, two out of four "positive clinical trials" were associated with high risk of falsely positive results. The activity of C 1740 is discussed here. PMID- 3517521 TI - A transformation in training: the formation of University medical faculties in Manchester, Leeds, and Liverpool, 1870-84. PMID- 3517522 TI - Samuel Johnson's gout. PMID- 3517523 TI - The Board of Supervision and the Scottish parochial medical service, 1845-95. PMID- 3517524 TI - George Owen Rees, MD, FRS (1813-89): pioneer of medical chemistry. PMID- 3517525 TI - Thomas Wakley and the medical coronership--occupational death and the judicial process. PMID- 3517526 TI - George Baker: translator of Aparicio de Zubia's pamphlet on the "Oleum Magistrale". PMID- 3517527 TI - Illustrations from the Wellcome Institute Library. The archive of the Lister Institute of Preventive Medicine. PMID- 3517528 TI - "The birth of the hospital in the Byzantine Empire". By Timothy S. Miller. Essay review. PMID- 3517530 TI - [The Uppsala model limits the need of ultrasound in late pregnancy to 25 per cent of the population]. PMID- 3517529 TI - [Coronary artery spasm--a review. Etiological causes are still unknown]. PMID- 3517531 TI - [Swallowed drug-dosage cup causing perforation of the small intestine]. PMID- 3517532 TI - [Cognitive therapy in the treatment of psychotic and postpsychotic states--an overview]. PMID- 3517533 TI - The use of Gore-Tex E-PTFE bonded to silicone rubber as an alloplastic implant material. AB - The purpose of this paper is to evaluate the use of an alloplastic material, Gore Tex Soft Tissue Patch, which when bonded to silicone rubber (Silastic) may represent a more "ideal" implant material. It's use in the rabbit model is compared to Silastic alone, Supramid Mesh, and cartilage control. Grafts were harvested at 3 weeks and 3 months, and the histologic findings were reviewed. Our results demonstrate that the implant is quite inert (minimal tissue reaction), allows for tissue ingrowth with reduced capsule formation, and protects the silicone rubber infrastructure from encapsulation. These findings suggest that Gore-Tex Soft Tissue Patch bonded to silicone rubber is a superior implant material and is worthy of consideration for clinical applications. PMID- 3517534 TI - Ventilation tube surgery and middle ear irrigation. AB - Tympanostomy and insertion of ventilation tubes has become one of the most commonly performed operations in the United States. Most authors reporting complications of this procedure describe a postoperative rate of otorrhea in the range of 10%-20% with some reports much higher. This rate of presumed suppuration would generally be considered high by surgeons operating in other areas of the body. It is a commonly accepted surgical practice to follow incision and drainage of a relatively closed space effusion with irrigation of that space. This is true in the surgery for the paranasal sinuses, deep space infections of the neck, joint spaces, and abscesses in general. However, this practice is not routinely performed when incising and draining the middle ear. We have completed a prospective controlled double blind study on post-tympanostomy tube otorrhea utilizing irrigation of the middle ear. In 220 consecutive cases, the use of middle ear irrigation reduced postoperative infections in the first 6 months from 16% to 4%. Irrigation was also found to be useful in removing very thick effusions from the middle ear by displacement, including those effusions localized in the hypo or epitympanum which were not initially identified at the time of incision and suction. A soft plastic, angled irrigation catheter with radial ports was developed for this purpose. PMID- 3517535 TI - The number of Mycobacterium leprae in the pretreatment biopsy-specimen does not determine the rate of response of patients with lepromatous leprosy to chemotherapy with acedapsone. PMID- 3517536 TI - Secondary dapsone-resistant leprosy in Brazil: a preliminary report. PMID- 3517537 TI - Treatment of plantar ulcers in leprosy patients in the community with adhesive zinc tape. PMID- 3517538 TI - Effect of anaesthetics on intracellular calcium ions in muscle. PMID- 3517539 TI - An improved radioenzymatic assay for plasma norepinephrine using purified phenylethanolamine N-methyltransferase. AB - Radioenzymatic assays have been developed for norepinephrine (NE) using either catechol O-methyltransferase (COMT) or phenylethanolamine N-methyltransferase (PNMT). Assays using PNMT are specific for NE but have been considered less sensitive than the more complex assay procedures employing COMT. An improved purification procedure for bovine PNMT has permitted development of a NE assay with substantially improved sensitivity (less than 0.5 pg), reproducibility, and decreased manipulative effort. PNMT was purified by sequential pH 5.0 treatment and dialysis and by column chromatographic procedures using DEAE-Sephacel, Sephacryl S-200 and Phenyl Boronate-agarose. Recovery of PNMT activity through the purification scheme was 50% while blank recovery was less than 0.001%. Norepinephrine can be directly quantified in 25 microliters of human plasma and a seventy-tube assay can be routinely completed within 4 h. The capillary to venous plasma NE gradient was examined in eight normotensive male subjects. Capillary plasma NE (211 +/- 21.7 pg/ml) was significantly lower than venous plasma NE (367 +/- 32.7 pg/ml) in all subjects (p less than 0.005). This difference suggests the concentration of NE in capillary blood may be a unique indicator of sympathetic nervous system activity in vivo. PMID- 3517540 TI - The dependence of airway smooth muscle on extracellular Ca2+ for contraction is influenced by the presence of cartilage. AB - Isolated guinea-pig and rabbit airway smooth muscle preparations lacking cartilage are less able to contract, in response to methacholine, histamine and K+, in the absence of extracellular Ca2+ than cartilage-containing preparations removed from the same animal. Cartilage apparently provides utilizable Ca2+ for contraction of airway smooth muscle. The presence of cartilage, therefore, affects the apparent dependence of the isolated smooth muscle on extracellular Ca2+ for contraction. PMID- 3517541 TI - Cell agglutination by a novel cell surface sialoglycopeptide inhibitor and the relationship between its protease and biological activities. AB - A bovine sialoglycopeptide, purified to homogeneity and capable of inhibiting cellular protein synthesis and proliferation, was shown to agglutinate a wide variety of nontransformed and transformed cells. The cell agglutination activity was shown to be independent of the biological inhibitory action and most likely related to a protease activity that could not be physically separated during purification of the sialoglycopeptide. Samples that were completely biologically inactivated retained full protease activity and their ability to agglutinate target cells. Balb/c 3T3 cells were not agglutinated by the sialoglycopeptide and they elicited a protein that interfered with the agglutination reaction and even redispursed cells that already had been aggregated by the inhibitor. PMID- 3517543 TI - [Training of nurses in World War II]. PMID- 3517544 TI - [Woman with the lamp (Florence Nightingale)]. PMID- 3517542 TI - Effects of dietary triolein and sunflower oil on insulin release and lipid metabolism in Zucker rats. AB - Obese and lean male Zucker rats were fed ad libitum on diets containing either 50 (L) or 200 (H) g/kg diet of either triolein (T) or sunflowerseed oil (S). The specific activity of the hepatic microsomal delta 9 desaturase enzyme was depressed in both lean and obese rats fed the HS diet compared with the other three diets. The fatty acid composition of liver and subcutaneous white adipose tissue lipids were consistent with a lower delta 9 desaturation activity in rats fed the H diets, particularly for the HS diet. In both genotypes, microsomal delta 9 desaturase activity and the ratio of 16:1/(16:0 + 16:1) fatty acids in liver lipids were inversely related to the proportion of 18:2 in liver lipid. Plasma insulin concentrations and rates of glucose-stimulated insulin release in vivo were higher in obese rats compared with lean rats, and plasma insulin levels were higher in rats fed S compared with T. There was no relationship between delta 9 desaturase activity and either plasma insulin concentration or rates of insulin release in vitro. These findings suggest that hepatic delta 9 desaturase activity of Zucker rats is responsive to changes in the proportion of 18:2 in liver lipids but is not affected by changes in insulin secretion. PMID- 3517545 TI - [Clinical evaluation of the RKA 3-01 radiocardioanalyzer]. AB - Detection of cardiovascular diseases can be improved through the use of the radiocardioanalyser RKA 3-01. It measures automatically the volume of circulating blood, records radiocardiograms, performs their analysis, and computes circulation indices. PMID- 3517546 TI - [Experience in the use of flexible echo-probes in the ultrasonic diagnosis of tumors of the oral cavity]. AB - The use of a flexible echo-probe with a special handle-holder makes it possible to examine every site in the oral cavity. As analysis of echograms recorded in 20 healthy persons and 33 patients with tumours in the oral cavity has shown the intraoral echography supplies objective information on conditions of oral cavity sites inaccessible for examinations with routine transcutaneous echography. PMID- 3517547 TI - J.B. Wolffe memorial lecture. Is the lung built for exercise? AB - In summary, we have shown that the design of the pulmonary system from the architectural capacities of the lung parenchyma and respiratory muscles to the remarkable, multi-level neural integration of breathing pattern and respiratory muscle recruitment is clearly intended for the exercising state. Furthermore, the system shows remarkable capability for true adaptation, both phylogenetically and even within only a few generations within a species, when preservation of the organism's ability to survive and function is at stake. At the same time there are limits to the system's homeostatic capabilities, and these appear in instances other than the "usual" ones, where the capabilities for gas transport and utilization beyond the lung (i.e., by the cardiovascular and musculo-skeletal systems) surpass those of the lung and chest wall, such as during exercise in certain pulmonary disease states or in alien environments or in the highly trained. Exercise-induced hypoxemia in the thoroughbred horse is a different type of dominance of the superior locomotor control system, because their extraordinary capability to produce and sustain a very high limb velocity dictates requirements for airway flow rates which may surpass the mechanical capabilities of the lung and perhaps even the chest wall. So this hypothesis does indeed suggest that the healthy pulmonary system may become a so-called "limiting" factor to oxygen transport and utilization and to CO2 transport and elimination, at least during short-term maximum exercise in the highly trained. On the one hand, the idea is especially appealing in a philosophical sense because of its conceptual tidiness and its confirmation of the premise that no organ system has limitless functional capacity; on the other hand, given the long list of our still untested speculations, we could use a bit more data. PMID- 3517548 TI - Blood biochemical status of miniature swine during submaximal and exhaustive exercise. AB - Simultaneous arterial (left atrial) and mixed venous (right atrial) blood samples were anaerobically drawn from 14 miniature swine (mean weight = 25.0 +/- 1.7 [SE] kg) in order to examine the adequacy of these animals as a model for the exercising human. Samples were drawn: 1) at rest; 2) during exercise that elicited 80.4 +/- 1.2% of the animals' measured maximal heart rates; 3) at exhaustion; and 4) during the 4th min of a standing, resting recovery period. At rest, the animals were mildly alkalotic (pHa = 7.497 +/- 0.016) and hypocapnic (pCO2a = 29.6 +/- 1.2 torr), with low hematological values (arterial hemoglobin = 6.66 +/- 0.18 mmol X 1-1; arterial hematocrit = 32.0 +/- 0.9%) and slightly elevated catecholamine concentrations. During the submaximal exercise, there were no statistically significant changes in the arterial blood pH or in plasma sodium (Na+) and chloride (Cl-) concentrations, with significant decreases observed in Hcta, pCO2a, and increases in arterial plasma norepinephrine, total protein, and potassium (K+) concentrations. At exhaustion, pHa and pCO2a decreased further, with increases noted in the arterial plasma concentrations of K+, epinephrine, total protein, and the Hct but not in Na+ or Cl-. During recovery, arterial lactate averaged 20.54 +/- 0.71 mmol X 1-1. Venous changes were similar to those observed in arterial blood, with a mean pHv of 7.168 +/- 0.043 and arterial lactate = 21.08 +/- 0.90 mmol X 1-1 during recovery. Exercise-induced hemoconcentration was similar for both arterial and venous sample sites during both the submaximal and exhaustive exercise.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3517549 TI - [Indirect immunofluorescence in onchocerciasis in Mali: comparison of O. volvulus antigen and D. viteae antigen for detecting circulating antibodies]. AB - In Mali, a comparative study of O. volvulus and D. viteae filariasis antigens was made on 52 onchocerciasis sera with immunofluorescence immunoassay. At a dilution greater than 1/40, 34 sera are positive with homologous Ag against 24 with heterologous Ag. PMID- 3517551 TI - Pulmonary sporotrichosis: review of treatment and outcome. AB - Four culture-documented cases of pulmonary sporotrichosis, three primary infections and one with multisystem involvement, are presented. Two of these patients are the first reported cases of primary lung disease treated with ketoconazole. This antifungal agent appears to be ineffective in eradicating this infection. The four cases, as well as a review of the literature, illustrate several important aspects of this rare disease. Pulmonary sporotrichosis is most commonly found in males with a history of alcohol abuse who are between the ages of 30 and 60. The infection is usually confined to the parenchyma of the lung but can involve hilar and mediastinal lymph nodes, pleura, skin, subcutaneous tissue, and joints. All but two cases have been reported in the United States, and the majority reside within states bordering the Missouri or Mississippi rivers. Direct occupational or environmental exposure appears to be an important predisposing risk factor. The onset of the disease is insidious, presenting in a manner similar to many other granulomatous or neoplastic diseases. Tuberculosis is the most common suspected diagnosis before confirmation of sporotrichosis. The chest radiograph most commonly demonstrates upperlobe cavitary disease with surrounding parenchymal infiltrates. The diagnosis can be suspected with high serologic titers or skin-test positivity, but needs to be confirmed by culture. The organism can usually be grown from sputum, as well as routine bronchoscopic procedures, open-lung biopsy specimens or pleural fluid. Histologic examination shows granulomas of both the caseating and noncaseating varieties. Frequently, organisms can be seen in necrotic areas of the lung tissue by diastase-modified GMS or PAS staining. Staining by direct fluorescent antibody technique can also be done and appears to be highly specific. Treatment is controversial, but total surgical resection of diseased lung as well as a perioperative regimen of SSKI or amphotericin B appears to be the most efficacious therapy. Medical therapy alone with SSKI or amphotericin B may be useful in selected cases but has been disappointing in the majority of reports. The imidazoles are usually ineffective, and the search for more effective medical therapy continues. PMID- 3517550 TI - [Artificial lenses at the Institute of Tropical Ophthalmology of Africa]. AB - The authors present a report on the first set of twenty-three intra-ocular lenses fitting on subjects from Mali, performed at the "Tropical African Ophthalmology Institute" (I.O.T.A.) from december 1983 up to december 1984. This report deals mainly about the implants of the inner aqueous chamber of the eye after the intracapsular extraction. The mechanical complications and inflammatory corneal and retinal consequences which occurred after the surgical operation are being tested. None of these complications has questioned the visual and functional prognosis. So, the results seem quite good. Nevertheless, the mass-surgery concerning the cataract with the fixing of an intra-ocular lens will be able to be considered when the cost of the implants is materially reduced. PMID- 3517552 TI - Treatment-related leukoencephalopathy. A study of three cases and literature review. AB - The etiology and pathogenesis of treatment-related leukoencephalopathy remain obscure. The evidence is substantial, however, that radiation therapy in combination with higher cerebral concentrations of certain chemotherapeutic agents such as MTX increases the likelihood of permanent damage. There is no therapy of apparent benefit for treatment-related leukoencephalopathy, but reasonable alternatives include 1) withholding chemotherapy and/or radiation, 2) administering calcium leucovorin in high doses intravenously in methotrexate induced leukoencephalopathy (26), or 3) perfusing the subarachnoid space (2) from above through an Ommaya reservoir and out from below through a lumbar puncture needle or lumbar subarachnoid catheter. Because CT scan abnormalities and subtle mental or intellectual changes are often noted before the full-blown clinical presentation, a prospective study involving periodic CT scanning as well as formal neuropsychologic testing appears worthwhile in all patients who are to receive cranial irradiation and/or chemotherapy in the prophylaxis or active treatment of CNS disease in order to detect and perhaps even to prevent this adverse side effect of cancer therapy. PMID- 3517553 TI - Pathogenetic mechanisms of the endogenous hypertriglyceridemia in a nonobese rat model. AB - Male Sprague-Dawley IVA-SIV rats were compared to male Sprague-Dawley Charles River rats of the same age, body weight, and daily food intake. The IVA-SIV rats demonstrated hypertriglyceridemia (182 +/- 9.4 v 131 +/- 9.4 mg/dL, P less than 0.001), associated with increased fasting plasma glucose (115 +/- 3 v 84 +/- 2 mg/dL, P less than 0.001), and plasma insulin (35 +/- 5 v 19 +/- 2 microU/mL, P less than 0.001) levels. Furthermore, IVA-SIV rats responded to an oral glucose load with higher plasma glucose and insulin levels. Very-low-density lipoprotein (VLDL)-triglyceride (TG) turnover studies were performed, documenting a higher TG production rate, which correlated with the plasma TG concentrations, (r = 0.58, P less than 0.01) in the IVA-SIV rats. Since lipoprotein lipase activity in both adipose tissue and muscle was not significantly different in the two groups of rats, it appears that the hypertriglyceridemia in IVA-SIV rats is due to increased VLDL-TG secretion, associated with hyperglycemia, hyperinsulinemia, and increased plasma FFA levels. The IVA-SIV rats provide a model of endogenous hypertriglyceridemia, independent of obesity. PMID- 3517554 TI - Acute cortisol excess results in unimpaired insulin action on lipolysis and branched chain amino acids, but not on glucose kinetics and C-peptide concentrations in man. AB - To assess whether acute cortisol excess impairs insulin action on lipolysis, plasma amino acids, endogenous insulin secretion, and glucose kinetics, nine normal subjects were studied after acute cortisol excess (80 mg hydrocortisone by mouth) and after placebo. Insulin sensitivity was assessed 6 hours after hydrocortisone using the glucose clamp technique (insulin infusion of 20 mU/m2 X minute for 120 minutes, plasma insulin levels of approximately equal to 50 mU/L). Hyperinsulinemia suppressed plasma free fatty acids (FFA) similarly by 75 and 76%, respectively. Most plasma amino acid concentrations were increased after hydrocortisone; however, the insulin-induced decrease of branched chain amino acids, serine, threonine, and tyrosine was unimpaired after hydrocortisone. Plasma C-peptide concentrations were less suppressed during hyperinsulinemia after hydrocortisone than after placebo (by 0.15 +/- 0.03 v 0.25 +/- 0.02 nmol/L, P less than 0.01), suggesting diminished insulin-induced suppression of insulin secretion. The glucose infusion rates required to maintain euglycemia were 35% lower (P less than 0.01) after hydrocortisone due to decreased insulin effects on metabolic clearance rate of glucose and diminished suppression of hepatic glucose production (0.4 +/- 0.1 v -0.1 +/- 0.1 mg/kg X minute, p less than 0.05, 3-3H glucose infusion method). The data demonstrate that acute elevation of plasma cortisol to levels near those observed in severe stress results in insulin resistance of peripheral and hepatic glucose metabolism but in unimpaired insulin effects on plasma FFA and branched chain amino acids, suggesting that cortisol's lipolytic and proteolytic effects are antagonized by elevated plasma insulin levels. PMID- 3517555 TI - Stimulation of cholesterol and lipid synthesis by insulin in familial hypercholesterolemic fibroblasts. AB - Cultured skin fibroblasts from two patients with homozygous familial hypercholesterolemia and three normal subjects were preincubated for 24 hours in medium containing 10% delipidated serum with insulin concentrations of 0.4, 4, or 40 ng/mL. [14C]acetate incorporation into total lipids, cholesterol, and phospholipids was significantly increased in familial hypercholesterolemic cells at insulin concentrations of 0.4 and 4 ng/mL, which had no effect in normal cells. When the data were normalized as percent stimulation over control for individual experiments, [14C]acetate incorporation into cholesterol was comparable at 40 ng/mL in both cell types. Similar results were obtained in cells preincubated in serum free artificial medium. Coordinate increases in the activity of 3-hydroxy-3-methylglutaryl CoA reductase in response to insulin were not found. These studies show that familial hypercholesterolemic cells have an altered lipogenic response to low concentrations of insulin. PMID- 3517556 TI - Magnitude and duration of excess postexercise oxygen consumption in healthy young subjects. AB - Postexercise oxygen consumption was investigated in eight healthy subjects. The subjects exercised for about 80 minutes at 70% of their maximum VO2. Following the exercise the subjects rested in bed for 24 hours. Oxygen uptake was measured continuously during the first hour after exercise, then hourly for the next 11 hours, and finally at 24 hours after exercise. Heart rate and rectal temperature were recorded continuously during the first 12 hours and then at 24 hours after exercise. Blood was sampled hourly after exercise. The results were compared with those of an identical control experiment in which the subjects rested instead of exercising. Oxygen uptake of each time point in each subject was greater after exercise compared with the control experiment. Mean total oxygen consumption after exercise was 211 +/- 16 L/12 h as compared to 185 +/- 13 L/12 h in the control experiment (P less than 0.001). Also, the heart rate was higher during the first 12 hours following exercise than in the control study. No significant differences were observed in rectal temperature in the two experiments after the initial 30 minutes following exercise. The first meal taken after the cessation of exercise increased markedly the rate of oxygen consumption in comparison to the increase observed following the same meal in the control experiment. The respiratory exchange ratios were lower following exercise than in the control study. In conclusion, we have demonstrated that the excess postexercise oxygen consumption (EPOC), may persist for at least 12 hours, and possibly for 24 hours. Also, exercise caused enhancement of the stimulation in oxygen uptake seen after a meal.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3517557 TI - Adipocyte insulin binding and insulin action in chronic renal failure before and during continuous ambulatory peritoneal dialysis. AB - In order to investigate the cellular mechanisms of the insulin resistance displayed by subjects with chronic renal failure, adipocyte insulin receptor status and in vitro insulin sensitivity were studied. Adipocytes from uremic subjects displayed normal maximum specific insulin binding (2.55 +/- 0.23 v 2.57 +/- 0.09% per 10 cm2 cell membrane, although half-maximum binding was observed at 91 +/- 8 (uremic) and 139 +/- 11 (control) pmol/L (P less than 0.005). In six subjects restudied after three months of continuous ambulatory peritoneal dialysis, maximum specific insulin binding fell as a consequence of changes in both receptor affinity and number (2.87 +/- 0.20 v 2.05 +/- 0.17% per 10 cm2 cell membrane, P less than 0.01). Basal and maximal rates of lipogenesis were similar in the uremic and control groups, and half-maximal stimulation occurred at 13.5 +/- 4.4 and 21.4 +/- 3.0 pmol/L, respectively (NS). During continuous ambulatory peritoneal dialysis, adipocyte insulin sensitivity did not change significantly as assessed by stimulation of lipogenesis or glucose uptake (half-maximal stimulation at 12.0 +/- 4.0 v 26.4 +/- 11.0 and 23.1 +/- 7.1 v 29.0 +/- 7.5 pmol/L, before and during dialysis, respectively). These data suggest either that adipose tissue and muscle display differential insulin sensitivities in chronic renal failure or that other factors such as circulating inhibitors of insulin action are not detected by in vitro assays. PMID- 3517558 TI - Fasting plasma glucose and insulin levels and their relationship to cardiovascular risk factors in children: Bogalusa Heart Study. AB - Plasma glucose and insulin levels were determined in a total biracial community of 3313 children, ages 5-17 years. Black children have significantly higher insulin and lower glucose levels than white children of comparable age and sex. Children of diabetic parents have elevated levels of age- and weight-adjusted fasting cholesterol. Moderate tracking (r = 0.31) of glucose levels over a 3-year period was seen. Insulin levels, however, track well (r = 0.36) only in older children (ages 9-14 years at initial examination). Fasting insulin levels are positively related to measures of obesity, systolic and diastolic blood pressure, triglyceride, beta-lipoprotein cholesterol and pre-beta-lipoprotein cholesterol levels. In addition, insulin levels are negatively related to alpha-lipoprotein cholesterol levels. Fasting glucose levels are positively related to systolic and diastolic blood pressure, triglycerides, pre-beta-lipoprotein cholesterol, and obesity levels. The relationship of plasma glucose and insulin levels to the traditional cardiovascular risk factors in children emphasizes the importance of subtle abnormalities in carbohydrate metabolism in the early natural history of cardiovascular disease. PMID- 3517559 TI - Influence of serum lipoproteins and carbohydrate metabolism on erythrocyte membrane composition in children: Bogalusa Heart Study. AB - The influence of serum lipoprotein profile and measures of carbohydrate metabolism on erythrocyte membrane composition were examined in four groups of children (n = 356, ages 6 to 18 years) from a total biracial population whose earlier very low density (VLDL-C) or low density lipoprotein cholesterol (LDL-C) levels (or both) were in the extreme quintiles or quartiles. Erythrocyte membranes of white children contained significantly increased levels of protein (+2.0%) and phospholipid (+2.7%) and decreased levels of neutral sugars (-4.6%) when compared to black children. Membrane neutral sugars were markedly higher (+4.7%) in girls than in boys. Membrane protein was lowest in children characterized by high LDL-C and low VLDL-C. The phospholipid/protein ratio was consistently higher (+1.9%) in the low VLDL-C strata. The relationships between membrane constituents and plasma/serum variables were explored after controlling for race, sex, and age effects and after combining the four selection groups. Less membrane cholesterol was present in the lowest (v highest) quintile of serum LDL-C/high density lipoprotein cholesterol (HDL-C) ratio (P less than 0.01). Membrane phospholipid levels were lower in the highest (v lowest) quintiles of the apoB/apoA-I ratio (P less than 0.01). With respect to measures of carbohydrate tolerance, membrane hexosamine showed low values in the highest (v lowest) quintile of hemoglobin A1c, while the trend was opposite for plasma insulin response (P less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3517561 TI - Pyruvoyl-dependent histidine decarboxylase from Lactobacillus 30a: purification and properties. PMID- 3517560 TI - Effect of alpha-glycohydrolase inhibitors (Bay m1099 and Bay o1248) on sucrose metabolism in normal men. AB - The inhibitory effect of N- beta-(4-ethoxycarbonylphenoxy-ethyl-1 desoxynojirimycin (BAY o1248) and of N-hydroxyethyl-1-desoxynojirimycin (BAY o1099) was studied in normal men. Nine healthy volunteers (weight range of 82% to 117% of their ideal body weight) ingested a 50 g sucrose load together with placebo, 50 mg BAY m1099, or 10 mg BAY of o1248. Their substrate oxidation rate was measured by continuous indirect calorimetry during four hours. The plasma glucose and plasma insulin peaks were both significantly blunted and the late fall of glycemia reduced. Mean plasma glucose, fructose, and insulin were reduced by both drugs during the first two hours following the sucrose load and led to a decrease of the suprabasal glucose oxidation (oxidation above baseline) during the first two hours of the test. However, the total suprabasal glucose oxidation during the four hours of the test was not significantly different from that of the control. Breath hydrogen, as an index of malabsorption, was shown to increase with both 50 mg BAY m1099 and 10 mg BAY o1248, starting from the third hour. These findings are consistent with a significant delay of sucrose absorption induced by these new alpha-glycohydrolase inhibitors. PMID- 3517562 TI - Competitive binding assays for riboflavin and riboflavin-binding protein. PMID- 3517563 TI - Purification of rat liver folate-binding protein: cytosol I. PMID- 3517564 TI - Preparation of (6S)-5-formyltetrahydrofolate labeled at high specific activity with 14C and 3H. PMID- 3517566 TI - Radioenzymatic assay for dihydrofolate reductase using [3H]dihydrofolate. PMID- 3517565 TI - Tissue folate polyglutamate chain length determination by electrophoresis as thymidylate synthase-fluorodeoxyuridylate ternary complexes. PMID- 3517567 TI - Enzymatic hydrolysis of pantetheine. PMID- 3517568 TI - Dihydrofolate reductase: a coupled radiometric assay. PMID- 3517569 TI - Enzymatic assay of 5-methyl-L-tetrahydrofolate. PMID- 3517570 TI - Purification and properties of 5,10-methylenetetrahydrofolate reductase from Clostridium formicoaceticum. PMID- 3517572 TI - Preparation of radioactive acyl coenzyme A. PMID- 3517571 TI - Micromethod for the measurement of acetyl phosphate and acetyl coenzyme A. PMID- 3517573 TI - Purification of plant acetyl-CoA:acyl carrier protein transacylase. PMID- 3517574 TI - Solid-phase assay for d-biotin and avidin on cellulose disks. PMID- 3517575 TI - Enzyme-linked immunoabsorption assay for vitamin D-induced calcium-binding protein. PMID- 3517576 TI - Determination of cobalamins in biological material. PMID- 3517577 TI - Solid-phase immunoassay for human transcobalamin II and detection of the secretory protein in cultured human cells. PMID- 3517578 TI - Synthesis of [14C]coproporphyrin III by yeast cell-free extracts. PMID- 3517579 TI - Making decisions based on "fuzzy" medical data--can expert systems help? PMID- 3517580 TI - ELSA--a method for medical knowledge acquisition and processing to aid medical reasoning. PMID- 3517581 TI - The protein synthetic machinery: ribosomes and cell-free systems. PMID- 3517582 TI - Isolation of embryonic cilia and sperm flagella. PMID- 3517583 TI - Components of the actin-based cytoskeleton. PMID- 3517584 TI - Induced fusion of echinoderm oocytes and eggs. PMID- 3517585 TI - Microinjection and cytoplasmic transfer in starfish oocytes. PMID- 3517586 TI - Rapid repetitive microinjection. AB - This article describes methods to inject large numbers of echinoid eggs and zygotes with globin mRNA and label them with tritiated amino acids. The products can be quantitatively analyzed to determine the amounts of peptide synthesis. The injections can be performed quickly and require relatively simple and inexpensive equipment. Although I designed my methods to inject large numbers of echinoid eggs and zygotes, these methods should also be useful for injecting many different molecules and ions into smaller numbers of cells as well as into a variety of cell types. PMID- 3517587 TI - Sperm motility. PMID- 3517588 TI - The compression method for determining the surface force. PMID- 3517589 TI - Gonad-stimulating and maturation-inducing substance. PMID- 3517590 TI - Techniques for observing living gametes and embryos. PMID- 3517591 TI - Isolation of nuclear encoded plastid ribosomal protein cDNAs. AB - A pea leaf cDNA library was constructed in the expression vector lambda gt11 and screened with antisera raised against proteins extracted from 30S and 50S ribosomal subunits and 70S ribosomes prepared from isolated pea chloroplasts. Six recombinant phage were identified that encoded fusion proteins containing plastid ribosomal protein antigenic determinants. Phage-induced cell lysate proteins, containing the fusion proteins, were bound to nitrocellulose membranes and used as affinity matrices to prepare monospecific antibodies. These antibodies were then used to identify by Western blotting which plastid ribosomal protein shared antigenic determinants with the fusion proteins. cDNA inserts from the antigen producing phage were used to hybrid-select complementary mRNAs. The cell-free translation products of these mRNAs were added to a pea chloroplast in vitro transport system and imported proteins analyzed by two-dimensional gel electrophoresis. The imported proteins comigrated with the plastid ribosomal proteins that were identified as being antigenically related to the fusion proteins produced by the corresponding recombinant phage. The imported proteins were 3,500-5,500 daltons smaller than their precursors. PMID- 3517592 TI - How do combinations of rpsL- and miaA- generate streptomycin dependence? AB - Petrullo et al. (1983) have studied the consequences of combining a mutation (rpsL-) that normally generates streptomycin resistant (Smr) ribosomes with a mutation (miaA-) that leads to loss of a tRNA hypermodification. They found surprisingly that such doubly mutant bacteria become streptomycin dependent (Smd). Here, we show in vitro that ribosomes purified from an Smr mutant behave very like Smd ribosomes when they are combined with tRNA from an miaA- mutant. Our analysis suggests that proofreading becomes excessively intense when the mutant components are combined, and that this reduces the efficiency of translation to the very low levels characteristic of Smd ribosomes. We show that Sm increases the efficiency of translation in vitro by suppressing the proofreading flows. We suggest that this will explain the growth stimulatory effect of Sm on the rpsL-, miaA- double mutants. PMID- 3517593 TI - Pleiotropic mutations in appR reduce pH 2.5 acid phosphatase expression and restore succinate utilisation in CRP-deficient strains of Escherichia coli. AB - Several strains of Escherichia coli K12 were compared for activity of the periplasmic "pH 2.5 acid phosphatase", an enzyme whose expression is regulated negatively by cyclic AMP. Two distinct enzyme levels differing by about four-fold were observed. This strain-dependent difference does not involve modifications in the structure of the enzyme, but results from a difference in its expression. We show that strains with a high- or a low level of enzyme differ in the gene locus appR located in the 59 min region of the chromosome, a site remote from the structural gene appA; the appR+ versus appR enzyme ratio is 3-4 in wild-type strains, adenylate cyclase-deficient strains (cya) or cyclic AMP receptor protein deficient strains (crp) grown in rich medium or in glucose minimal medium, but is close to 1 in cya strains in the presence of 0.1 mM cyclic AMP and in wild-type strains grown with succinate as carbon source; in a crp genetic background, appR strains, contrary to appR+ strains, are able to grow on minimal medium with succinate as the sole carbon source. The selection, from an appR+ crp strain, of clones growing on succinate-minimal medium, yielded mutations in the same region of the chromosome and showing the same phenotype as "naturally-occurring" appR strains. All appR strains analysed so far showed other similar deficiencies. The possibility that mutated appR gene products might function as weak substitutes for a functional cAMP-CRP complex is discussed. PMID- 3517594 TI - Effect of acrylonitrile on the transcription of specific genes in Saccharomyces cerevisiae. AB - We have studied the effect of acrylonitrile on the transcription of specific genes of Saccharomyces cerevisiae. The results presented demonstrate that ACN disturbs the coordinated response of ribosomal protein genes and causes a dramatic induction of the LEU2 gene, which might be due to metabolites of ACN. PMID- 3517595 TI - Post-menopausal hormone replacement therapy: effects of progestogens on serum lipids and lipoproteins. A review. PMID- 3517596 TI - The Microcirculatory Society Eugene M. Landis Award lecture. The microrheology of human blood. PMID- 3517597 TI - Response of the rabbit cutaneous microcirculation to prostanoid modifiers as determined by laser Doppler flowmetry. AB - The cutaneous microvascular flow of the rabbit epigastric island flap under the influence of various prostanoid modifiers has been determined semiquantitatively with a Laser Doppler flowmeter. Infused prostacyclin, diluted with arterial blood to an estimated concentration of 2.5 ng/ml in the microvasculature, increased the microvascular blood flow to approximately 130% of the buffer control. The three thromboxane synthetase inhibitors tested--dazoxiben hydrochloride, UK-38,485, and 7-(1-imidazolyl) heptanoic acid--at concentrations up to 3 X 10(-5) M in the microvasculature, failed to induce any change in blood flow compared to a control neutral-buffered saline infusion. Preliminary results also found that the lipoxygenase inhibitor Bay g6575 did not alter microvascular flow up to 7 X 10( 6) M, but the prostacyclin analog carbacyclin at 30 ng/ml in the microvasculature induced a similar response to 2.5 ng/ml prostacyclin. While such responses are well known for the major vessels, this is one of the few reports with semiquantitative data on the influence of prostanoid synthesis modifiers on blood flow for the microcirculation. PMID- 3517598 TI - When your patients ask about relaxation techniques. PMID- 3517599 TI - [Selection of Escherichia coli and Pseudomonas putida cultures with an enhanced resistance to immobilization on polyacrylamide gel]. AB - Clones of Escherichia coli (A4, A70, G60) and Pseudomonas putida (A70, G30) with an elevated resistance to the process of immobilization in polyacrylamide gel and to the action of monomeric acrylamide were selected from the parent E. coli IBPM B115 and P. putida. The isolated cultures remained resistant to the above actions for a long time. The frequency at which cells with the elevated resistance appeared was comparable with the frequency of bacterial mutations. The plasmid analysis did not reveal the presence of plasmid DNA in the cells of the isolated cultures. The decrease in the viability index of bacterial populations caused by their immobilization in polyacrylamide gel and by the action of monomeric acrylamide did depend on the growth phase. The cells were more resistant to these actions in the stationary phase. The isolated cultures were more resistant as compared to the parent cultures irrespective of the growth phase. PMID- 3517600 TI - [Lipid inclusions in cells and their changes during the desiccation and reactivation of yeast organisms]. AB - The formation of lipid granules in Saccharomyces cerevisiae cells was shown to begin in the exponential phase of the culture growth and to be associated with the activity of the endoplasmic reticulum. Lipid granules can be formed (1) when the endoplasmic reticulum cisterns extend and (2) when the endoplasmic reticulum membranes separate relatively small regions of the cell cytoplasm. Yeast cells contain spherosomes which differ in their structure. Lipid granules merge together upon dehydration of yeast cells. The authors discuss possible participation of these granules in the reparation of damages of the intracellular membranes. PMID- 3517601 TI - [Streptomyces spheroides mutant deprepressed for exoprotease biosynthesis]. AB - The effect of carbon, nitrogen and sulfur sources on the biosynthesis of exoproteases was studied with the parent Streptomyces spheroides strain 35 and its mutant M8-2. Addition of a carbon, nitrogen and sulfur source to the medium deficient in one of these elements did not repress the synthesis of exoproteases by the washed mycelium of the mutant as compared to the parent strain. Protein as a sole source of carbon, nitrogen and sulfur had no effect on the biosynthesis of exoproteases by the mutant. In contrast to the parent strain, the biosynthesis of exoproteases in the mutant was not controlled by metabolite repression. PMID- 3517603 TI - A control system for high-frequency jet ventilation. AB - The design of a system for high-frequency jet ventilation is described. Jets of 10-40 psig humidified air were introduced into the trachea through an 8-gauge needle inserted through the cricothyroid membrane. Gas flow to the needle was interrupted by a solenoid valve operated by a controller circuit. The controller allowed the independent setting of duty cycle (ratio of inspiratory time to total cycle time) from 10-50% and respiratory frequency from 10-350/min. When the electrical control signal was set equal to the desired duty cycle, the actual mechanical duty cycle erred from the desired value by as much as 109%. These errors were caused by unequal time delays for solenoid opening and closing. Tests of a commercially available jet-ventilator also demonstrated frequency-dependent errors caused by unequal time delays and changes in wave shape. The controller described here compensates for differences in opening and closing delays and delivers volumes within 3.4% of those calculated from continuous flows. PMID- 3517602 TI - Is aging inevitable? The intracellular zinc deficiency hypothesis of aging. AB - A review of the literature suggests that an intracellular zinc deficiency may be the primary cause of the aging process. Zinc-metalloenzymes play an important role in many aspects of cellular metabolism including DNA replication, repair and transcription. The main enzymes affected by zinc deficiency may be specific for each cell type. Depending on which zinc enzymes are "overvulnerable", zinc deficiency may result in accumulation of useless (or toxic) materials, malproduction of essential proteins, a neoplastic change or cell death, thus explaining the variability in aging patterns in different cell types. There is no simple and reliable index of zinc status in humans and a therapeutic trial may be needed to establish zinc deficiency. Finding a zinc-compound which can enter the cell and avoid the development of intracellular zinc deficiency may retard the aging process and postpone age-related diseases. PMID- 3517604 TI - Abel and onward: some early history of hemodialysis. PMID- 3517605 TI - Australian doctors and the visual arts. Part 2. Doctors as collectors, donors, gallery supporters and writers in New South Wales. AB - The contribution of doctors to the visual arts if being discussed in a series of six articles. The first article dealt with doctor-artists in new South Wales. In this, the second, doctors are discussed as collectors, donors, gallery supporters and writers in this State. PMID- 3517606 TI - Rapid diagnosis of granuloma inguinale. PMID- 3517607 TI - Long-term health effects of industrial solvents--a critical review of the epidemiological research. PMID- 3517608 TI - Considerations in the choice of expected numbers for appropriate comparisons in occupational cohort studies. PMID- 3517609 TI - Methods of treatment of exposure data in occupational epidemiology. PMID- 3517610 TI - Suprofen. PMID- 3517611 TI - Buprenorphine. PMID- 3517612 TI - Investigation of basic imaging properties in digital radiography. 7. Noise Wiener spectra of II-TV digital imaging systems. AB - We used Wiener spectral analysis in order to investigate the different noise sources and the effects of various parameters such as pixel size, image intensifier (II) field size, and exposure level on the noise in an II-TV digital system. The digital Wiener spectra in terms of relative x-ray intensity were determined directly from the digital noise data in terms of pixel values, by use of the characteristic curve of the imaging system. From averaged, subtracted, and/or combination images, the amount of structure mottle relative to the amount of quantum mottle was estimated. We found that a substantial amount of structure mottle was included in our II-TV digital subtraction angiography system, whereas the electronic noise of the TV system was quite small relative to the quantum and structure mottle. The effects of time jitter on the noise in single-frame images (consisting of multiple video frames) and in subtracted and averaged images were also investigated. PMID- 3517613 TI - The iron lung: halfway technology or necessary step? AB - The iron lung is often used to epitomize the costly halfway technologies of modern-day medicine that fail to cure and only prolong a seriously compromised existence. Historical evidence indicates that the iron lung was not a costly instrument of last resort; instead, it was a lifesaving device that played a critical role in the evolution of modern respirators and respiratory care. Contrary to the prevailing views of the biomedical research community, the creation of new devices and instruments is often as important a source of technical change in medicine as are advances in the biological sciences. PMID- 3517616 TI - [Radioisotopic study of the cerebrospinal fluid in young children with 99mTc DTPA]. PMID- 3517615 TI - [Demonstration of biliary lithiasis in sickle-cell anemia and thalassemia major using ultrasonics]. PMID- 3517617 TI - Subgingival irrigation in periodontal therapy. PMID- 3517618 TI - Identification of a human liver cytochrome P-450 homologous to the major isosafrole-inducible cytochrome P-450 in the rat. AB - The rat 3-methylcholanthrene-inducible family of liver cytochromes P-450 contains two proteins (P-450c and P-450d) that are immunochemically related, possess 68% total sequence homology, and are induced by a number of toxic or carcinogenic compounds. To determine whether equivalent isozymes of hepatic cytochrome P-450 are expressed in humans, as they are in several mammalian species, we performed immunoblot analyses on microsomes prepared from 14 human liver specimens and found that each one contained a 52.5-kDa protein (termed HLd) that reacted with antibodies specific for rat P-450d. In addition, one specimen contained a 54-kDa protein (termed HLc) that reacted with antibodies specific for rat P-450c. HLd was purified through the use of immunoaffinity chromatography and was found to be 56% homologous to rat P-450d and 61% homologous to the equivalent isozyme in the rabbit (P-450 LM4) through their first 18 NH2-terminal amino acids. Finally, levels of immunoreactive HLd varied more than 10-fold among these patients but were unrelated to the patients' drug treatments, smoking habits, or amount of immunoreactive HLp, a human liver cytochrome P-450 related to the glucocorticoid inducible family of rat cytochromes P-450. We conclude that, in man, there is a cytochrome P-450 family composed of two isozymes (HLc and HLd) that are immunochemically and structurally related to the 3-methylcholanthrene-inducible family observed in several other species. PMID- 3517619 TI - [Diversity and unity of methods of replication of viral DNA]. AB - A systematization of the modes of viral DNA genomes replication was attempted. The key problem of replication, the complete copying of the genome, has several fundamentally different ("strategic") solutions, which utilize different mechanisms of initiation of a round of replication. Noticeable diversity may exist also within a given strategy, since consecutive replication steps may be accomplished by several (but not many) distinct means. There appears to exist a significant similarity between the viral and cellular replication systems. The approach used permits an assessment of the actual diversity in DNA replication systems. PMID- 3517620 TI - [Bacteriophages T3 and T7: transcription-dependent mechanism of phage DNA transport into the cell during infection]. AB - The mechanism by which bacteriophage T3 DNA is transported into the E. coli cell during infection was studied. The data obtained testify that bacteriophage T3, similarly to what we have earlier found for bacteriophage T7, introduces its DNA into the infected cell is a transcription-dependent way. A detailed discussion is presented on the occurrence of the transcription-coupled transport of viral DNA into the infected cell and on a number of general issues concerning the transport functions of template-directed enzymes. PMID- 3517621 TI - Cytoplasmic membrane potential of mouse lymphocytes is decreased by cyclosporins. AB - Membrane potential of mouse lymphocytes was investigated in the presence and absence of cyclosporin A (CsA) and cyclosporin G (CsG) by flow cytometry and fluorescence spectroscopy. A carbocyanine dye, dihexyloxacarbocyanine iodide [DIOC6(3)], was applied as a membrane potential probe. A dose-dependent decrease in the membrane potential of T and B lymphocytes was observed in the presence of CsA and CsG. However, pretreatment of lymphocytes with insulin reduced the effect of the cyclosporins. Mobile ionophores, such as valinomycin, ionomycin and A23187 were less effective in changing the membrane potential of lymphocytes in the presence of CsA. The channel forming ionophore, gramicidin or high extra-cellular potassium concentration (160 mM) strongly reduced the membrane potential regardless of the absence or presence the CsA. These observations suggest incorporation of CsA into the cytoplasmic membrane causing changes in ion fluxes. Other reported biochemical effects of CsA may be secondary to the observed membrane potential changes. The membrane potential change induced by CsA may have selective biological consequences in a certain subpopulation of lymphocytes. PMID- 3517622 TI - Specificity of the monoclonal anti-I antibody (Hy). AB - In previous work we found that a monoclonal cold hemagglutinin from patient Hy strongly bound antigens contained in stage IV breast cancer sera. To infer the chemical structure of the antigens expressed in the cancer sera, we studied the specificity of the antibody (Hy). The antibody (Hy) had I specificity, based on agglutination scores with adult and cord red blood cells. The binding of the antibody to synthetic and milk oligosaccharides was determined using a solid phase enzyme immunoassay (EIA). The anti-I antibody (Hy) strongly bound LacNAc0 Me, LacNAc1----6Gal, LacNAc1----6 (LacNAc1----3)Gal, LacNAc-1----6 alpha GalNAc, LacNAc1----3LacNAc, and LacNAc, 0.05, 0.06, 0.09, 0.22, 0.35 and 0.75 mM giving 50% inhibition, respectively. The anti-I antibody (Hy), similar to the anti-I antibody (Ma), strongly bound LacNAc1----6Gal, but it differed from the anti-I antibody (Ma) in its cross-reactivity with the i sequence. The anti-I antibody (Hy) showed similar reactivities as the hybridoma monoclonal antibodies M18 and M39 with LacNAc1----6Gal and with the i-active sequence. The EIA procedure is a useful alternative to either radioimmunoassay or immunoprecipitation method in the study of anti-I,i specificities. PMID- 3517623 TI - [Diagnosis and therapy of occlusion caused by thromboembolism in a premature infant using digital subtraction angiography]. AB - A neonate born after 35 weeks' gestation developed thrombosis of the right external iliac artery after removal of an umbilical artery catheter. Digital subtraction angiography was utilized to demonstrate the site of obstruction and the effect of fibrinolytic therapy with streptokinase. PMID- 3517624 TI - [Results of intensive education and self control in diabetic children and adolescents based on Hb A1c]. AB - Ninety-six measurements of glycosylated hemoglobin (Hb A1c) were performed over a 2 1/4 year period in 40 children and young adults with Type I diabetes mellitus. Sixty-five per cent of the patients were found to be under ideal or good control and 17.5% under satisfactory control. Urgent readjustment of therapy was indicated in 17.5%. Our experience suggests the importance of quarterly Hb A1c determinations as a therapeutic guide-line and as a prognostic and quality control parameter. PMID- 3517625 TI - [Diagnosis of pleural effusion using sector sonography in childhood]. AB - Sectorsonographic examination was performed in 17 patients with pleural effusion after heart surgery (n = 15) and during bacterial pneumonia (n = 2). When pleural effusion could be diagnosed by chest roentgenogram, it was identified by ultrasound in every patient. On the other hand, it was possible to recognize pleural effusion by ultrasound in 6 patients in whom chest roentgenogram was equivocal or failed the diagnosis. Neither chest roentgenogram nor ultrasound allowed the differentiation between transsudate, exsudate, chylus, and blood in the pleural space. However, localization and mobility of the diaphragm as well as concomitant pericardial effusion and/or ascites can be identified by ultrasound. Sonographic examination, an easily repeatable harmless method without radiation exposure should be performed in pediatric patients whenever pleural effusion is suspected. PMID- 3517626 TI - [Transitory diabetes mellitus in the newborn infant]. AB - A female newborn of 1,870 g with low Apgar scores, after septicemia, shock and blood exchange transfusion, developed a transient diabetes mellitus on the seventh day after birth. The disease was kept well under control by insulin, given at first intravenously and later subcutaneously. The amount of insulin required decreased continuously. Even when the blood glucose level was high, there was no coma or ketoacidosis. PMID- 3517627 TI - Peripheral blood granulocytes as effectors of regulation for the human natural killer cell system. A review. PMID- 3517628 TI - A case of meconium peritonitis with ileal stenosis: prenatal sonographic findings with radiologic correlation. PMID- 3517629 TI - Chlamydia trachomatis infections in infants. PMID- 3517630 TI - Mutagenic and comutagenic action of 5'-deoxy-5'-(methylthio)adenosine. AB - 5'-Deoxy-5'-(methylthio)adenosine (MTA) alone and in combination with methionine was found to increase frequencies of background HGPRT mutation and SCE in V79 Chinese hamster cells. The same agents exert a comutagenic action on these effects as well as upon mutation induction in Escherichia coli stain AB1157 (but not in its non-adaptable derivative ada-6) following treatment with N-methyl-N nitrosourea (MNU). MTA plus methionine also enhanced the lethal action of MNU on hamster cells. The effects observed may tentatively be ascribed to hypomethylation due to inhibition of DNA methylase by MTA. PMID- 3517631 TI - Mutagenic sterol hydroperoxides. AB - Sterol hydroperoxides 3 beta-hydroxy-5 alpha-cholest-6-ene-5-hydroperoxide and 3 beta-hydroxycholest-5-ene-7 alpha-hydroperoxide show weak dose-response direct mutagenicity towards Salmonella typhimurium strain TA 1537 in a liquid medium incubation bioassay. Responses were compromised by metabolism of the sterol hydroperoxides and by phase separation during the incubation period. Mutagenicity responses were increased by added superoxide dismutase but diminished by added rat liver S9 enzymes and abolished by added catalase. Catalase also abolished the stimulatory effect of superoxide dismutase. These results indicate that superoxide and peroxide be implicated in the mutagenicity responses. PMID- 3517632 TI - A yeast screening system for simultaneously monitoring multiple genetic endpoints. AB - Mutation, recombination, and mitochondrial deficiencies have been proposed to have roles in the carcinogenic process. We describe a diploid strain of the yeast Saccharomyces cerevisiae capable of detecting this wide spectrum of genetic changes. Strain XD83 can detect forward mutation, back nuclear frameshift and base-pair substitution mutation, nuclear intragenic and intergenic recombination, and mitochondrial forward point mutations and deletions. The markers used for monitoring these events have been especially well characterized genetically. Ultraviolet light was chosen as a model carcinogenic agent to test this system. In addition to highly significant (P less than 0.01) increases in the frequencies of each genetic change, increases in the absolute numbers (yields) of each change indicated induction and not selective survival. The relative amounts of each type of genetic change varied with dose and should be considered a part of the spectrum of change induced by ultraviolet light. The wide spectrum of endpoints monitored in the XD83 yeast system may allow the detection of certain carcinogens and other genetically toxic agents which have escaped detection in more limited systems. Since only one strain is required to simultaneously monitor these genetic changes, this assay system should facilitate comparisons of the induced changes and be more efficient than using multiple strains to monitor the same endpoints. PMID- 3517633 TI - The relative cytotoxicity and mutagenicity of cyclobutane pyrimidine dimers and (6-4) photoproducts in Escherichia coli cells. AB - In order to calculate the relative cytotoxicity and mutagenicity of (5-6) cyclobutane pyrimidine dimers and (6-4) photoproducts, we have measured survival and mutation induction in UV-irradiated excision-deficient E. coli uvrA cells, with or without complete photoreactivation of the (5-6) dimers. Radioimmunoassays with specificity for (5-6) dimers or (6-4) photoproducts have shown that maximum photoreactivation eliminates all of the (5-6) dimers produced up to 10 Jm-2 254 nm light, while it has no effect on (6-4) photoproducts. These results were confirmed by measuring the frequency of T4 endonuclease V-sensitive sites. Based on the best fit equations for survival and mutation induction, we have found that the calculated cytotoxicity of (6-4) photoproducts is similar to that of (5-6) dimers; however, the former is much more mutagenic than the latter. PMID- 3517635 TI - Transient correction of excision repair defects in fibroblasts of 9 xeroderma pigmentosum complementation groups by microinjection of crude human cell extracts. AB - Crude extracts from human cells were microinjected into the cytoplasm of cultured fibroblasts from 9 excision-deficient xeroderma pigmentosum (XP) complementation groups. The level of UV-induced unscheduled DNA synthesis (UDS) was measured to determine the effect of the extract on the repair capacity of the injected cells. With a sensitive UDS assay procedure a (transient) increase in UV-induced UDS level was found in fibroblasts from all complementation groups after injection of extracts from repair-proficient (HeLa) or complementing XP cells (except in the case of XP-G), but not after introduction of extracts from cells belonging to the same complementation group. This indicates that the phenotypic correction is exerted by complementation-group-specific factors in the extract, a conclusion that is in agreement with the observation that different levels of correction are found for different complementation groups. The XP-G-correcting factor was shown to be sensitive to proteolytic degradation, suggesting that it is a protein like the XP-A factor. PMID- 3517634 TI - The isolation and characterization of an alkylating-agent-sensitive yeast mutant, ngs1. AB - We have isolated and characterized a mutant of baker's yeast, Saccharomyces cerevisiae, carrying the new mutation, ngs1, which is sensitive to the toxic effects of monofunctional alkylating agents, but normal with respect to 254-nm ultraviolet light sensitivity. ngs1 mutants exhibited more or less normal reversion frequencies for his1-7 and ilv1-92 induced by each of these mutagens. The various sensitivities associated with ngs1 cosegregated and have been shown to be the result of a lesion in a single nuclear gene. Extracts of ngs1 and NGS1+ strains contained approximately equal levels of an activity that removes 3 methyladenine (3MA) and 7-methylguanine (7MG) from DNA in vitro. The mutation also depressed sporulation. PMID- 3517636 TI - Antimutagenicity of extracts from crude drugs in Chinese medicines. AB - The antimutagenicity of extracts from crude drugs was studied by the Ames bioassay system. The crude drugs chosen were medical plants used very frequently as Chinese medicines. Each crude drug was extracted with hot water similar to the method of Chinese medical treatment. Antimutagenicity of the extract was found with 4 kinds of crude drugs, Paeoniae radix, Bupleuri radix, Hoelen and Glycyrrhizae radix. Each extract of the crude drug showed a different type of antimutagenic action from the others. PMID- 3517637 TI - Aneuploidy-inducing chemicals in yeast evaluated by the micronucleus test. AB - Chinese hamsters were exposed to acetone, methyl ethyl ketone, ethyl acetate and 2-methoxy ethyl acetate, known to be strong inducers of aneuploidy in the yeast Saccharomyces cerevisiae. All solvents yielded negative results in the micronucleus test, whereas the vinca alkaloid vindesine--used as a positive control substance--proved to act as a spindle poison in mammals in vivo. PMID- 3517638 TI - Tissue culture studies of muscle disorders: Part 1. Techniques, cell growth, morphology, cell surface. AB - Tissue culture has been used extensively in studies of human inherited disorders, and its application in the field of the neuromuscular disorders has increased rapidly in recent years. This review, covering the period 1977 to 1984, deals with tissue culture studies of both human and animal muscle disorders, although Duchenne muscular dystrophy (DMD) figures prominently because of the overwhelming interest in that disorder. The review is in two parts. In the first part, I discuss technical innovations in the field, the morphology and growth of cells, and a variety of studies related to the cell surface. Important findings in relation to DMD include reports of abnormal growth rates and reduced lifespan of DMD cells, hypersensitivity to DNA-damaging agents, abnormal cell-to-cell and cell-to-substratum adhesion, and a more "fluid" cell membrane. However, these findings are controversial or have so far been reported only by single laboratories. PMID- 3517639 TI - Insulin binding in denervated muscle. AB - Insulin binding was measured in rat muscle following denervation. There was a 40% reduction in the number of high-affinity insulin receptors, with no change in the insulin binding Kd. Selected muscles showed a 40%-60% reduction in weight during this period. The down-regulation in the number of insulin receptors may contribute to the mechanism of muscle atrophy following denervation. PMID- 3517640 TI - Cellular mediators of anti-histoplasma immunity: II. Protective immunity and delayed hypersensitivity in mice immunized by sublethal infection with yeast cells of histoplasma capsulatum. PMID- 3517641 TI - Screening for lymphadenopathy/AIDS virus in bone marrow-transplant recipients. PMID- 3517642 TI - Termination of Medi-Cal benefits. A follow-up study one year later. PMID- 3517643 TI - Penicillamine and hydroxychloroquine in the treatment of severe juvenile rheumatoid arthritis. Results of the U.S.A.-U.S.S.R. double-blind placebo controlled trial. AB - One hundred sixty-two children with severe juvenile rheumatoid arthritis were entered in a randomized, double-blind, placebo-controlled 12-month clinical trial designed to establish the efficacy and safety of two slower-acting antirheumatic drugs, penicillamine and hydroxychloroquine. The study was a cooperative effort of the United States and the Soviet Union. One group of subjects received 10 mg of penicillamine per kilogram of body weight per day, another group received 6 mg of hydroxychloroquine per kilogram daily, and a third group received placebo. All three groups were allowed a single concurrent nonsteroidal antiinflammatory drug, but no other antirheumatic medications, including corticosteroids. All three groups had dramatic improvement in many of the clinical and laboratory outcome variables after one year of study. There were no significant differences in efficacy between the penicillamine and placebo groups. Pain on movement was the only index of articular disease that was alleviated more by hydroxychloroquine than by placebo. Serious adverse drug reactions attributable to the active agents were rare. We were unable to demonstrate that, in the presence of a nonsteroidal antiinflammatory drug, either penicillamine or hydroxychloroquine is superior to placebo in the treatment of children with juvenile rheumatoid arthritis. PMID- 3517644 TI - Effects of tolazamide and exogenous insulin on insulin action in patients with non-insulin-dependent diabetes mellitus. AB - To determine whether sulfonylureas and exogenous insulin have different effects on insulin action, we studied eight patients with non-insulin-dependent diabetes mellitus before and after three months of treatment with tolazamide and exogenous semisynthetic human insulin, using a randomized crossover design. Therapy with tolazamide and therapy with insulin resulted in similar improvement of glycemic control, as measured by a decrease in mean glycosylated hemoglobin (+/- SEM) from 9.4 +/- 0.7 percent to 7.7 +/- 0.5 percent with tolazamide and to 7.1 +/- 0.2 percent with exogenous insulin (P less than 0.01 for both comparisons). Therapy with either tolazamide or exogenous insulin resulted in a similar lowering (P less than 0.05) of postabsorptive glucose-production rates (from 2.3 +/- 0.1 to 2.0 +/- 0.2 and 1.8 +/- 0.1 mg per kilogram of body weight per minute, respectively) but not to normal (1.5 +/- 0.1 mg per kilogram per minute). Both tolazamide and exogenous insulin increased (P less than 0.05) glucose utilization at supraphysiologic insulin concentrations (from 6.2 +/- 0.7 to 7.7 +/- 0.6 mg per kilogram per minute with tolazamide and to 7.8 +/- 0.6 mg per kilogram per minute with exogenous insulin) to nondiabetic rates (7.9 +/- 0.5 mg per kilogram per minute). Neither agent altered erythrocyte insulin binding at physiologic insulin concentrations. We conclude that treatment with sulfonylureas or exogenous insulin results in equivalent improvement in insulin action in patients with non-insulin-dependent diabetes mellitus. Therefore, the choice between these agents should be based on considerations other than their ability to ameliorate insulin resistance. PMID- 3517645 TI - Treatment of children with juvenile rheumatoid arthritis. PMID- 3517646 TI - Type II diabetes: insulin versus oral agents. PMID- 3517647 TI - Prevalence of insulin-gene mutations in non-insulin-dependent diabetes mellitus. PMID- 3517648 TI - Type I diabetes mellitus. A chronic autoimmune disease. PMID- 3517649 TI - Surgery for hepatic neoplasms. PMID- 3517650 TI - Treatment with desmopressin acetate to reduce blood loss after cardiac surgery. A double-blind randomized trial. AB - Bleeding after cardiopulmonary bypass remains a cause for concern, requiring reexploration of the chest in approximately 3 percent of patients who have had operations on the heart. We examined the possibility that this problem might be alleviated by desmopressin acetate (DDAVP), which increases the plasma level of von Willebrand factor and improves hemostasis in mild hemophilia and other conditions associated with defective platelet function. In a double-blind, prospective, randomized trial, we studied the effect of intraoperative desmopressin acetate in 70 patients undergoing various cardiac operations requiring cardiopulmonary bypass. Patients undergoing uncomplicated primary coronary-artery bypass grafting were not included. The drug significantly reduced mean operative and early postoperative blood loss (1317 +/- 486 ml in the treated group vs. 2210 +/- 1415 ml in the placebo group); of the 14 patients whose 24 hour blood loss exceeded 2000 ml, 11 had received the placebo. Plasma levels of von Willebrand factor were higher after desmopressin acetate than after placebo. Patients with the most bleeding had relatively low levels of von Willebrand factor before operation, suggesting a role for this factor in the hemorrhagic tendency induced by extracorporeal circulation. There were no untoward side effects of desmopressin acetate. We conclude that the administration of desmopressin acetate can be recommended to reduce blood loss in patients undergoing complex cardiac operations. The beneficial effect of the drug on hemostasis after cardiopulmonary bypass may be related to its effect on von Willebrand factor. PMID- 3517652 TI - Osteosarcoma. PMID- 3517651 TI - Clinical implications of tumor-cell heterogeneity. PMID- 3517653 TI - Clinical evaluation of reversed dermis graft for reconstruction of oral mucosa. PMID- 3517654 TI - Incidence of sleep apnea syndromes in general patients at a hospital for internal medicine. PMID- 3517655 TI - Enkephalins. A new approach to pain relief? PMID- 3517656 TI - Homoeo-domain homology in yeast MAT alpha 2 is essential for repressor activity. AB - The MAT alpha locus of the yeast Saccharomyces cerevisiae encodes two regulatory proteins, alpha 1 and alpha 2, which are responsible for determining the alpha cell type. MAT alpha 1 is a positive regulator of alpha-cell-type-specific genes, and MAT alpha 2 is a negative regulator of a-cell-type-specific genes. MAT alpha 2 also determines the a/alpha diploid cell type, in conjunction with the MATa product, a1, by repressing haploid cell-type-specific genes. The MAT alpha 2 encoded protein binds specifically in vitro to a DNA sequence found upstream of several a-specific genes and is thus thought to exert its control directly at the transcriptional level of target genes. In an initial attempt to understand the molecular basis of the interaction of alpha 2 with DNA, we have saturated with missense mutations the segment of alpha 2 that is weakly homologous to a conserved prokaryote DNA-binding structure and to a portion of the higher eukaryote homoeo domain to ascertain the possible functional significance of this homology in alpha 2. We report here that most of the amino-acid residues in alpha 2 which correspond to conserved amino acids in the prokaryote DNA-binding proteins and in the homoeo domain are essential for the two repressor activities of alpha 2, that is, the repression of a-specific genes and of haploid-specific genes. Mutations in a subset of these amino-acid residues more severely affect the ability to repress a-specific genes than haploid-specific genes. PMID- 3517657 TI - Further studies of the mechanism of counter irritation by turpentine. AB - The influence of counter irritation by turpentine (0.2 ml) on zymosan- and carrageenan-oedemas was investigated in the rat. Zymosan-oedema was inhibited by mepyramine and methysergide and by leucopenia. It was not modified by captopril and developed normally in kininogendeficient Brown Norway rats. Leucocytes and mast cell amines but not kinins are thus involved in zymosan-oedema. The last phase of this reaction was inhibited by counter irritation alone, but the odema was largely depressed by counter irritation in rats pretreated with mepyramine and methysergide. Carrageenan-oedema was increased by kininase inhibitors and inhibited by leucopenia in normal rats. This inflammatory reaction had a small developement and was not increased by kininase inhibitors in kininogen-deficient BN rats. Leucocytes and kinins participate in the developement of this inflammatory reaction in normal rats while kinins are lacking in deficient rats. Counter irritation depressed carrageenan-oedema in deficient Brown Norway rats and suppressed the potentiating effect of kininase inhibitors in normal rats. Carrageenan oedema was nearly abolished in turpentine-treated leucopenic rats. These results suggest that the anti-inflammatory effect of counter irritation by turpentine could depend on a reduction of leucocyte accumulation into zymosan oedema and on a reduction of both kinin formation and of leucocyte accumulation into carrageenan-oedema. The significance of T-kininogen as acute phase reactant is discussed. PMID- 3517658 TI - [Hyperparathyroidism: an 'obsolete' problem?]. PMID- 3517659 TI - [The slow start of smallpox prevention]. PMID- 3517660 TI - [Intramural hematomas of the small intestines during the use of oral anticoagulants]. PMID- 3517661 TI - [Impotence: organic causes]. PMID- 3517662 TI - Clinical features of patients with solitary kidneys. AB - A clinical study was performed in 2 groups of patients with solitary kidneys, followed for 11-146 months. Group 1 had 9 patients (7 males and 2 females, aged between 23 and 68 years) with unilateral renal agenesis. Group 2 had 13 patients (9 females and 4 males, aged between 27 and 70 years) who underwent unilateral nephrectomy for the following reasons: hydronephrosis secondary to ureteropelvic junction stenosis, 7 patients; renal trauma, 4 patients; benign neoplasia, 2 patients. During the follow up, urinary protein excretion of more than 300 mg/day was observed in 9 patients, 3 in group 1 and 6 in group 2. Eleven patients, 8 in group 1 and 3 in group 2, were hypertensive (diastolic blood pressure higher than 95 mm Hg). Hyperuricemia was observed in 14 patients, 10 in group 1 and 4 in group 2. Seven patients, 4 in group 1 and 3 in group 2, had a significant deterioration of renal function. Neither proteinuria nor renal failure were observed before at least 10 years had elapsed since the anatomic condition of solitary kidney had been established. A surgical renal biopsy was performed in 1 patient with unilateral renal agenesis and showed focal glomerular sclerosis. This study adds support to the view that the reduction of 50% of the renal tissue may be a risky situation in humans as well as in animals. PMID- 3517663 TI - Sclerotic lesions in the glomeruli of Buffalo/Mna rats. AB - Spontaneously developing focal and segmental glomerulosclerosis (FGS) in Buffalo/Mna rats was studied. There were no differences in the occurrence of the disease between male and female rats. Plasma macromolecules were detected in the urine samples of 2-month-old rats using sodium dodecyl sulphate polyacrylamide gel electrophoresis. All 4-month-old animals had proteinuria in excess of 30 mg/24 h. At the age of 4 months, sclerotic glomeruli were rarely observed. At the age of 6 months, all animals had a few sclerotic glomeruli in every kidney section examined. Animals which were 22 months old had sclerotic lesions in 37.8 52.1% of the glomeruli. Ultrastructural examination revealed that alterations in epithelial cells, such as effacement of foot processes, vacuolization, and a podocytic membrane-like structure, were found at the age of 2 months. The animals examined were neither uremic nor hypertensive. Our present study showed that female as well as male Buffalo/Mna rats had an earlier onset of the disease than the other strains of rats and that alterations in glomerular epithelial cells were first detected in the early stage of the disease. PMID- 3517664 TI - [Vascular spasm and cerebral ischemia after meningeal hemorrhage caused by rupture of an aneurysm]. AB - The author discusses the epidemiology, the diagnosis, the clinical and morphological aspects of cerebral vasospasm from his personal experience and a study of the literature. Prediction and diagnosis of vasospasm is possible by evaluation of the amount of blood on CT scan, measuring fibrin breakdown products in the CSF and the findings of early EEG and Transcranial Doppler Sonography. CBF measurement is helpful in following the process of ischemia and deciding the right moment for operation. Early surgery on cerebral aneurysms is advocated in order to prevent rebleeding and for early removal of blood clot from the basal cisterns. If vasospasm and ischemia do develop, energetic treatment with hypervolemia and induced hypertension can be started without fear of rebleeding. Prophylactic intravenous administration of Nimodipine is thought to be of real value. Since the introduction of early surgery by the author 80 patients have been operated within 3 days after S.A.H. The mortality was 11% and the morbidity 7.5%. Management mortality and morbidity for the total group of 209 patients with S.A.H. treated either medically or surgically were 23.5% and 6% respectively. If one excludes the 18 patients that died within 24 hours the mortality was 15.6%. PMID- 3517666 TI - [Stereotactic evacuation of hypertensive thalamic hematomas using plasminogen activator (urokinase)]. AB - In the past five years, the authors have performed stereotactic evacuation of hypertensive thalamic hematoma using Komai's CT-stereotactic apparatus in 44 cases. Liquefied hematoma was aspirated through a stereotactic cannula, and solid hematoma difficult to aspirate was dissolved by a plasminogen activator (Urokinase) and drained out through a silastic catheter. The mean ratio of the total volume of evacuated hematoma to the estimated volume by CT image was 83.8%. The recovery from motor paresis and consciousness disturbance was observed during the early postoperative days in most patients. Functional outcome (ADL) at 3 months after operation was as follows: 24 cases (54.5%) recovered to a full or partial (self-cared) social life, 15 (34.1%) required partial care at home and 2 (4.5%) remained bedridden. Although 3 patients died within 1 month after operation, the cause of death in these patients was admitted to have no direct relation to operative procedure or to rebleeding due to the Urokinase injection. Postoperative functional prognosis was not affected by the timing of the operation. The important factors affecting ADL were preoperative neurological grade and CT classification. This stereotactic method apparently exceeded the conventional craniotomy method in the functional outcome. PMID- 3517665 TI - [CT-stereotaxy]. PMID- 3517667 TI - [Direct carotid angiography using a subcutaneous needle and injection of minimal dosage of contrast media--a special use of DSA]. AB - A new simplified cerebral digital subtraction angiography (DSA) has been performed using a fine subcutaneous needle (21G-23G) and minimal volume (1.5 2 ml) contrast medium in 33 cases. Representative angiograms have been presented in 3 cases (one of occlusive cerebrovascular disease, cerebral aneurysm, and superior sagittal sinus thrombosis respectively). Advantages of this method are simple procedure, easy puncture with little carotid injury and almost none of patient's complaints accompanied by dye-injection. Therefore, this technique is very useful in emergency cases, as a screening test in an outpatient clinic, and also in senile cases. Periarterial injection of contrast media was experienced in 5 cases which would be overcome by using a little larger needle like 21G in the future. PMID- 3517668 TI - In vitro LHRH release from superfused hypothalamus as a function of the rat estrous cycle: effect of progesterone. AB - The present study examines the effect of progesterone (P) on in vitro LHRH release from hypothalamic fragments from intact adult rats throughout the estrous cycle. Estrous cyclicity was monitored by daily vaginal smears, and animals which exhibited at least two consecutive 4-day estrous cycles were used. Animals were sacrificed between 10.00 and 13.00 h and the mediobasal hypothalamic-preoptic area-suprachiasmatic nucleus units were removed and transferred into superfusion chambers (one unit/chamber). Following a 2-hour control period, in which the spontaneous LHRH release was established, P (10 ng/ml) was infused in an intermittent mode (10 min-on, 20 min-off). Effluents were collected at 10-min intervals and LHRH concentrations were determined by RIA. The spontaneous LHRH release from control preparations was episodic throughout all stages of the estrous cycle with a significant low release rate and low LHRH amplitude only during estrus. Interestingly, intermittent infusion of P significantly stimulated LHRH release solely in hypothalamic fragments derived from proestrous rats. The P stimulated LHRH release during the 1st-hour period after P infusion was significantly higher (p less than 0.05) than that observed in the control preparations during the same time period as well as from its own basal pre-P values (1-hour post-P: 4.26 +/- 0.96 vs. 1-hour control and pre-P: 2.34 +/- 0.38 and 2.32 +/- 0.57 pg/10 min, respectively). P administration did not stimulate in vitro LHRH release during the other stages of the estrous cycle.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3517669 TI - Removal of the vomeronasal organ impairs lordosis in female hamsters: effect is reversed by luteinising hormone-releasing hormone. AB - In female golden hamsters, vomeronasal organ removal disrupts the elicitation of lordosis by lumbosacral tactile stimulation. A similar disruption occurs if the nasopalatine ducts are closed, without removing the vomeronasal organ. Injection of luteinising hormone-releasing hormone reverses the effect of vomeronasal organ removal. These findings suggest that chemosensory signals from the male hamster act via the accessory olfactory system, to facilitate the triggering of lordosis by somatic stimulation. PMID- 3517670 TI - Effect of estrogen on prolactin mRNA in the rat pituitary. Analysis by in situ hybridization and immunohistochemistry. AB - The effect of estrogen on prolactin (PRL) synthesis at a single-cell level was studied by in situ hybridization and immunohistochemistry. Long-term estrogen treatment increased PRL-containing cells from 10-20% of total cell population to 80-90%, as revealed by immunohistochemistry. PRL mRNA containing cells also increased in a similar fashion. Moreover, cytoplasmic PRL mRNA expressed as the number of silver grains per cell increased 4- to 5-fold by estrogen. These results suggest that long-term estrogen treatment causes not only PRL cell proliferation but also an increase in PRL mRNA in a single cell. PMID- 3517671 TI - Evaluation of the direct actions of drugs with a serotonergic link in spinal analgesia on the release of [3H]serotonin from spinal cord synaptosomes. AB - Morphine, ketamine, ethylketocyclazocine and quipazine, drugs with an apparent local spinal serotonergic action, which contributes to their analgesic effects, were tested for their ability to alter the release of [3H]serotonin ([3H]5-HT) from a synaptosomal preparation from the spinal cord of the rat. Related compounds including [D-Ala2, D-Leu5]enkephalin (DADLE), n-allylnormetazocine and phencyclidine were also examined. None of the drugs was found to be capable of inducing a direct release of [3H]5-HT or of facilitating potassium-induced release of 5-HT. However, quipazine inhibited the depressant action of exogenous 5-HT on overflow of 3H (mediated through the 5-HT autoreceptor), an action that should facilitate serotonergic neurotransmission. In contrast to the other drugs, DADLE was found to depress K+ stimulated release of 5-HT. The results suggests that the serotonergic mechanism involved in the antinociceptive action of some of these drugs (i.e. ketamine, morphine and ethyl-ketocyclazocine) is not related to direct presynaptic interactions to promote release of 5-HT. On the other hand, a small population of serotonergic nerves critical for analgesia may be involved and are not detected using tissue from the whole spinal cord, However, it seems equally plausible that these drugs may produce their antinociceptive action through interactions with other neurotransmitter systems that in turn interface with the serotonergic nerves, perhaps through interneurons or collateral connections. PMID- 3517672 TI - Comparative study of rat sciatic nerve microepineurial anastomoses made with carbon dioxide laser and suture techniques: Part 2. A morphometric analysis of myelinated nerve fibers. AB - Sciatic nerves of rats were severed with steel scalpel blades and subsequently anastomosed with epineurial sutures and laser-aided techniques. Morphometric analysis of myelinated nerve fibers proximal and distal to the anastomosed region revealed that the laser had no deleterious effects on the degree of retrograde axonal degeneration or regeneration potential as compared to the traditional suture technique. Although no significant difference in myelinated nerve fiber population was evident between the two methods, future experimentation with various laser parameters might lead to more effective use of lasers in nerve repair. PMID- 3517673 TI - Aneurysm formation after low power carbon dioxide laser-assisted vascular anastomosis. AB - A series of 125 adult rats was operated upon to perform end-to-end anastomosis of the femoral artery using either a carbon dioxide laser or conventional suture technique. Vessels were inspected at varying time intervals grossly and microscopically. Overall, the rate of aneurysm formation for the laser group was 18.6% (21/113). Late aneurysm formation (1 week or longer after operation) was seen in 29.8% (20/67) of the laser group. No aneurysms were noted in the suture group either early or late. Histological examination of the laser-joined vessels revealed widespread necrosis and loss of elastic elements in the media. In time, abnormal spindle-shaped cells appeared in this damaged layer. Histologically, the aneurysms were indistinguishable from those reported in human cerebral aneurysm cases. This technique provides an experimental aneurysm model and lends support to the acquired/degenerative theory of human cerebral aneurysm formation. PMID- 3517674 TI - Orbitocraniobasal approach for anterior communicating artery aneurysms. AB - We describe an orbitofrontotemporobasal craniotomy technique that allows excellent access to anterior communicating artery aneurysms. This orbitocraniobasal approach is particularly useful for the surgical treatment of ruptured aneurysms in the acute stage of subarachnoid hemorrhage, when retraction of the brain needs to be kept to a minimum. With this approach, retraction of the orbital contents decreases the amount of retraction of the brain to such an extent that a brain spatula is not necessary for access to the anterior communicating artery complex. The procedure is described, as is a modification of the approach for removal of large tumors on the skull base. PMID- 3517675 TI - Ventriculoatrial shunt infection due to Cryptococcus neoformans: an ultrastructural and quantitative microbiological study. AB - A 28-year-old man presented with hydrocephalus due to an infection by Cryptococcus neoformans involving his ventriculoatrial shunt. Ultrastructural studies of the ventriculoatrial shunt demonstrated yeastlike organisms consistent with C. neoformans within a biofilm on the appliance. Quantitative microbiological studies of segments of the shunt demonstrated C. neoformans in a concentration gradient from 9 X 10(6) colony-forming units (CFU)/0.5-cm section involving the ventricular portion of the catheter to 1 X 10(2) CFU/0.5-cm section at the vascular tip. The clinical, microbiological, and ultrastructural data suggest that this cryptococcal infection started as a ventriculitis or encephalitis with extension to the meningeal surface. Future application of these methods may further elucidate the pathogenesis of ventriculoatrial shunt infections. PMID- 3517676 TI - Experience with external pneumatic calf compression in neurology and neurosurgery. AB - This report reviews our experience with external pneumatic compression (EPC) therapy in preventing clinically evident deep venous thrombosis (DVT) and pulmonary emboli (PE) in neurological and neurosurgical patients. A total of 523 patients admitted to the Departments of Neurology and Neurosurgery at the Massachusetts General Hospital from December 1980 through January 1984 are included. The incidence of DVT despite EPC use was 2.3%. The incidence of PE diagnosed by lung scan and usually confirmed by angiography was 1.8%. In conjunction with previously published reports of the incidence of DVT and PE, these data suggest that EPC may be efficacious in decreasing the incidence of DVT but may not prevent PE in neurological and neurosurgical patients. PMID- 3517677 TI - Management of asymptomatic carotid atherosclerosis. AB - The detection, evaluation, and treatment of patients with asymptomatic carotid artery disease are controversial issues. In this review, these issues are addressed and the appropriate application of medical and surgical therapies is discussed. There seem to be two subgroups of asymptomatic patients with angiographically defined lesions (marked stenosis or large, deep, and compound ulcers) who have a significant risk of subsequent cerebral infarction. These patients should be considered for carotid endarterectomy at a surgical center with an established low incidence of perioperative complications. PMID- 3517678 TI - Chronometric analysis in neuropsychology. PMID- 3517679 TI - Learning and memory disorders and their assessment. AB - Brain lesions cause memory to break down in several distinct ways in people. First, cortical lesions cause disturbances in short-term memory. Second, other cortical lesions disturb the retrieval of previously well-established semantic and episodic memories. Third, frontal cortex dysfunction seems to be related to a memory syndrome caused by a breakdown in the ability to plan and carry out elaborative processing. Fourth, and most explored, is the amnesic syndrome(s), caused by limbic system or diencephalic lesions. Other less-studied forms of memory breakdown almost certainly exist and some memory syndromes are compounded from these more basic deficits. Appropriate assessment of memory disorders must take this heterogeneity and complexity into account, and is important not only for clinical purposes but also to gain further insight into the precise nature of the different kinds of breakdown. The major theoretical and clinical requirements that such assessment procedures must meet are outlined. PMID- 3517680 TI - Mechanisms of visuomotor coordination: a study in normal and brain-damaged subjects. AB - This paper reviews the role of vision in controlling pointing and reaching movements in man. Studies of visuomotor behaviour in normal subjects allow the identification of several levels for describing organization of visuomotor control. The relative contribution of central (programming) and peripheral (feedback) mechanisms; the role of the eye-head coordinated position as a reference for controlling accuracy and direction of movements; and the relative independence of input-output channels in controlling proximal and distal segments of the musculature. These levels represent a useful framework for understanding pathological disruption of visuomotor control produced by cortical lesions. PMID- 3517681 TI - Dichotic and dichhaptic techniques. AB - Auditory and tactual asymmetries frequently demonstrate right side advantages for verbal stimuli and the opposite effects for nonverbal stimuli. Such asymmetries may, however, reflect the perceived position of events in space, rather than the role of anatomical afferent pathways with suppression of ipsilateral by contralateral routes. Consequently, despite popular tradition, simultaneous competitive stimulation (dichotic or dichhaptic) may be unnecessary. We review the reliability and the relatively low validity of such techniques for predicting hemispheric specialization in various clinical and normal populations. We discuss the role of stimulus factors, the various indices and measures, the effect of order and mode of report, division of attention, task difficulty and memory factors. PMID- 3517682 TI - Afferent and efferent models of visual perceptual asymmetries: theoretical and empirical implications. AB - Visual laterality studies are reviewed in the framework of an afferent hierarchical information-processing model. According to this model, the hemispheres are viewed as separate information-processing systems, each with its own components and resources, as well as a common pool of resources. Information is shared across interhemispheric pathways. The magnitude and direction of visual field differences are determined by two factors: the processing efficiency of the components in one hemisphere relative to the other and interhemispheric transmission to components that are functionally localized to only one hemisphere. Rules are derived for weighing the relative contribution of these to visual field differences. As designed, the model can accommodate dynamic features characteristic of competing efferent (attentional) models without sacrificing its basic structure. The model's adequacy and usefulness for interpreting and guiding research on normal and brain-damaged people is discussed. PMID- 3517683 TI - A method of stereotaxic localization adopted for conventional and digital radiography. AB - A method for the determination of stereotaxic coordinates in radiography, e.g. angiography, pneumoencephalography or digital vascular radiography, is described. A special localization frame containing radiopaque structures and scales defines a diagnostic coordinate system. This frame is fixed to the X-ray-table prior to the radiographic procedure and two projections are obtained at arbitrary angles to each other. The focus-film distances do not how to be fixed. The target coordinates are then determined either by a simple graphical procedure or with the use of a digitizing x-y-table, by a computer. With the computer method the films are placed on the digitizing table and the target and a few reference points are marked using a cursor. From the relative positions the computer calculates the coordinates. With the special head fixation system, coordinates of structures visualized in radiographic examinations can be transferred to various therapeutic or diagnostic stereotaxic devices. PMID- 3517684 TI - Stereoscopic DSA of the central nervous system. AB - Stereoscopic DSA is performed with alternate exposures from a twin focal X-ray tube (6,5 cm focal separation). Excellent intravenous and intra-arterial DSA images of the cerebral vessels are obtained with separation of overlapping parts of the normal and abnormal vasculature. The clinical value of DSA has been enhanced by use of stereoscopic DSA. PMID- 3517685 TI - A fully-automated computer-assisted method of CT brain scan analysis for the measurement of cerebrospinal fluid spaces and brain absorption density. AB - Computer-assisted methods of CT brain scan analysis offer considerable advantages over visual inspection, particularly in research; and several semi-automated methods are currently available. A new computer-assisted program is presented which provides fully automated processing of CT brain scans, depending on "anatomical knowledge" of where cerebrospinal fluid (CSF)-containing spaces are likely to lie. After identifying these regions of interest quantitative estimates are then provided of CSF content in each slice in cisterns, ventricles, Sylvian fissure and interhemispheric fissure. Separate measures are also provided of mean brain density in each slice. These estimates can be summated to provide total ventricular and total brain volumes. The program shows a high correlation with measures derived from mechanical planimetry and visual grading procedures, also when tested against a phantom brain of known ventricular volume. The advantages and limitations of the present program are discussed. PMID- 3517686 TI - Radionuclide cisternography and computed tomography in 30 healthy volunteers. AB - Radiological assessments of patients with symptoms of impaired cerebrospinal fluid (CSF) circulation are usually based on observations of anatomical and functional alterations using computed tomography (CT) and radionuclide cisternography (RC). In order to define criteria of normality for these two techniques, 30 healthy volunteers have been studied. In the studies of CSF flow the radiopharmaceutical 99mTc-DTPA was used and single photon emission computed tomography (SPECT) was performed as a complement to planar scintigraphy. In 16 of the 30 volunteers the pattern of CSF flow was normal according to conventional criteria. In these subjects the radioactivity was symmetrically located over the parietal cortex 24 h after the injection and no intraventricular activity could be recorded. In 11 (41%) of the subjects, radioactivity could be observed in the lateral ventricles 6 h after injection. One of these subjects had a reflux of radioactivity into the lateral ventricles. The intraventricular radioactivity persisted for at least 24 h. This subject also had signs of obstruction of CSF flow over the convexities. Asymmetric distribution of radioactivity within the CSF spaces was observed in the images obtained after 6 but not 24 h in two cases. One of those also demonstrated transient intraventricular radioactivity. The results of the computed tomography were interpreted to be normal in 19 (63%) of the 30 volunteers. One subject had an asymmetric ventricular system. The CT scans of six subjects (20%) differed considerably from the others as they displayed wide cortical or vermian sulci at the borderline of normal variations. The case with the pathological RC belonged to the group of subjects who had wide sulci.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3517687 TI - Immunocytochemical localization of proenkephalin-derived peptides in the central nervous system of the rat. AB - Most of the early studies on the immunohistochemical distribution of enkephalin pentapeptide-like immunoreactivity used antisera that stained both proenkephalin- and prodynorphin-containing neurons. The present study used the peroxidase antiperoxidase method, thick Vibratome sections and antisera specific for the carboxyl termini of [Met]enkephalin, [Met]enkephalyl-Arg6-Phe7, [Met]enkephalyl Arg6-Gly7-Leu8, and metorphamide and for BAM 22P in order to obtain a detailed description of the distribution of authentic proenkephalin-containing perikarya and nerve processes. The peroxidase-antiperoxidase reaction product was intensified by the selective deposition of silver crystals in order to display the morphology of proenkephalin-containing neurons with great fidelity. The results indicate that the magnocellular perikarya in the supraoptic and paraventricular nuclei contain prodynorphin rather than proenkephalin as had been suggested by earlier investigators. The coarse fibers in the internal zone of the median eminence and the granule cell-mossy fiber pathway in the hippocampus also contain prodynorphin rather than proenkephalin. The number of proenkephalin containing perikarya and/or the density of proenkephalin-containing nerve terminals in several other areas of the brain, e.g. the substantia nigra, the central amygdaloid nucleus, the periaqueductal gray and the parabrachial nuclei, were overestimated by earlier investigators. The distribution of authentic proenkephalin-containing perikarya and nerve processes is, despite these errors, similar to the distribution of enkephalin pentapeptide-like immunoreactivity described by earlier investigators. Proenkephalin-containing perikarya were identified for the first time in the medial and lateral habenular nuclei of the adult rat. Antisera specific for [Met]enkephalin, [Met]enkephalyl-Arg6-Phe7, [Met]enkephalyl-Arg6-Gly7-Leu8 and BAM 22P stain perikarya and nerve terminals with a similar distribution. The metorphamide antiserum also stains the same perikarya and nerve terminals; however, it also stains magnocellular perikarya in the zona incerta and the lateral hypothalamus that are not stained by any of the other proenkephalin-specific antisera. PMID- 3517688 TI - Electrophysiological study of the effects of D1 and D2 dopamine antagonists on the interaction of converging inputs from the sensory-motor cortex and substantia nigra neurons in the rat. AB - The interaction of stimulation of the cerebral cortex and of the substantia nigra on the activity of neostriatal neurons was investigated in urethane-anesthetized rats. Neurons of the dorsal striatum were activated by single pulse stimulation of the sensory-motor cortex. The effects of nigral conditioning stimulation on this excitatory response of striatal neurons to cortical stimulation were studied in a series of parametric experiments in which the length of the train of pulses and the intensity of the nigral stimulation were varied. One and five pulses of nigral conditioning stimulation had little or no effect. Ten pulses of nigral conditioning stimulation reduced the excitatory response, the magnitude of the reduction being greater with higher current intensities. In another series of experiments, the effects of dopaminergic receptor antagonists on the interaction of cortical and nigral inputs to striatal neurons were studied. Sulpiride, a D2 antagonist, reversed the attenuating effects of nigral conditioning stimulation on the excitatory response of striatal neurons to cortical stimulation, whereas SCH 23390 a D1 antagonist, had no effect. The present findings support the hypothesis that the nigrostriatal dopaminergic pathway modulates the excitatory response of striatal neurons to cortical stimulation by means of dopamine D2 receptors. PMID- 3517689 TI - Microtubule-associated protein 2 and tubulin are differently distributed in the dendrites of developing neurons. AB - We have followed the appearance of two microtubule proteins, tubulin and microtubule-associated protein 2, in rat hippocampal neurons differentiating in cell culture. Double-label immunofluorescence staining showed that from day 1 in vitro onward tubulin appeared as filaments but that microtubule-associated protein 2 remained distributed throughout the cytoplasm. This difference persisted throughout development and was also detectable in cells that had reached morphological maturity. When cells were treated with the microtubule depolymerizing agent nocodazole, the depolymerized tubulin became spread throughout the cytoplasm so that its distribution was then identical to microtubule associated protein 2. At the same time, multiple side branches began to emerge along the dendrites. When cells which had been exposed to nocodazole were allowed to recover before staining, the tubulin was again present as filaments but the microtubule-associated protein 2 remained distributed throughout the dendritic cytoplasm. Under these conditions the previously extended proximal side branches were resorbed into the main process. These results suggest that cellular microtubule-associated protein 2 is not necessarily exclusively associated with microtubules. Neuronal dendrites in particular appear to contain this protein at levels in excess of the capacity of microtubular microtubule-associated protein 2 binding sites. In view of the known effectiveness of microtubule-associated protein 2 as a promoter of tubulin polymerization, its abundance in dendrites suggests that it acts to ensure total polymerization of dendritic microtubules. In this way it would contribute both to the support of the growing process and the suppression of adventitious sidebranching. PMID- 3517690 TI - Distribution of GABAergic and cholinergic neurons in the rat diagonal band. AB - GABAergic neurons are coextensive with cholinergic neurons in the medial septum diagonal band complex. Serial sectioning, sequential staining and double immunofluorescence techniques employing antibodies to glutamate decarboxylase and choline acetyltransferase revealed the distribution of these transmitter-specific neurons in the rat. Morphologically, the two types of neurons appear similar, in that they are predominantly large multipolar cells, but they are characterized by different, overlapping distributions in the diagonal band. Glutamate decarboxylase-positive cells are scattered throughout the nucleus of the vertical limb of the diagonal band, while choline acetyltransferase-positive neurons are more numerous medially and are distributed in groups corresponding to the dorsal and ventral aspects of the nucleus. In the rostral parts of the nucleus of the horizontal limb of the diagonal band, the choline acetyltransferase-positive cells tend to be located medially, whereas caudally they spread dorsal to the nucleus to become continuous with other large cholinergic neurons in the ventral pallidum and sublenticular substantia innominata. The large majority of glutamate decarboxylase-positive neurons remain in a more ventral and lateral position within the nucleus of the horizontal limb and are particularly numerous just lateral to the diagonal band fibers as they join the medial forebrain bundle. Cholinergic neurons were estimated to be about two times more numerous than GABAergic neurons. Approximately 1% of the choline acetyltransferase-positive neurons were also glutamate decarboxylase-positive in double immunofluorescence studies, but not in sequentially stained or serial sections. PMID- 3517691 TI - Actions of phencyclidine on rat locus coeruleus neurones in vitro. AB - Intracellular recordings were made from neurones in the rat locus coeruleus in a brain slice maintained in vitro. Phencyclidine and related psychotomimetic drugs, applied in known concentrations in the fluid bathing the slice, depressed responses to N-methyl-D-aspartic acid noradrenaline (in the presence of the uptake inhibitor desmethylimipramine) and [D-Ala2,MePhe4,Gly-ol5]enkephalin and also prolonged the action potential. The sensitivities of these responses to depression by phencyclidine was N-methyl-D-aspartic acid (IC50 0.4 microM) greater than noradrenaline (IC50 3.9 microM) greater than [D-Ala2,MePhe4,Gly ol5]enkephalin (IC50 8.5 microM) greater than prolongation of the action potential (41% increase by 30 microM). Stereoselectivity was observed only in the depression of responses to N-methyl-D-aspartic acid where (+)-1-(1 phenylcyclohexyl)-3-methyl piperidine was 3.3-fold more potent in suppressing N methyl-D-aspartic acid depolarizations than its (-) isomer. The responses to N methyl-D-aspartic acid were also depressed by the structurally unrelated psychotomimetic (+/-)-N-allyl-N-normetazocine (IC50 0.9 microM). All of the effects of the psychotomimetic drugs examined were slow in onset and difficult to reverse following washout. No effect of phencyclidine (0.03-100 microM) or related drugs was observed on membrane potential, input resistance or spontaneous action potential firing rate of locus coeruleus neurones. The depression of responses to N-methyl-D-aspartic acid by phencyclidine was the most potent and the only stereoselective effect of those studied. The importance of this effect and of those not showing stereoselectivity in relation to the phencyclidine behavioural syndrome is discussed. PMID- 3517692 TI - Extent of survival and vascularization of adult superior cervical sympathetic or nodose ganglia transplanted into the septal nuclei or choroid fissure of adult rats. AB - Adult superior cervical sympathetic ganglia were auto-transplanted, and adult nodose ganglia were homografted into the septal nuclei or the choroid fissure of adult Wistar rats. At times from 4 h to 9 weeks after operation, the distribution of surviving transplanted neurons was compared with the development of the transplant vascularization, as visualized by transcardial Indian ink filling of the host vascular system. Within 24 h, the ganglionic neurons and Schwann cells of the interior of the transplants in both sites were necrotic. The surviving neurons and Schwann cells formed a shell, occupying those areas of the transplant periphery which were in direct contact with the host circulation. Occasional ink filled vessels were evident at this time in transplants in the choroid fissure, but there were none in the septal nuclei, where vessels did not appear until the next day. Blood vessels reached the centre of the ganglia by 3-4 days in the choroid fissure and one week in the septal nuclei, the finest diameter capillaries forming last. At longer survivals there was a slow loss of neurons, notable between 1 and 2 months, and leading progressively (especially in the septal transplantation site) to the disappearance of all but a very small number of ganglionic neurons. The general findings were similar for both types of ganglion, and in both sites, but the initial cell loss was much greater for both types of ganglia in the septum (over 90%) as compared with about a 50% loss in the choroid fissure. The initial rapid cell loss was probably a result of ischaemia. The subsequent, slow progressive loss may be associated with failure to make or receive neuronal connections, or the absence of appropriate growth factors. PMID- 3517693 TI - Noninvasive transcranial Doppler ultrasound in intracranial angiomas. AB - Transcranial Doppler ultrasound is a noninvasive method to evaluate flow velocities in the basal cerebral arteries. It can provide hemodynamic data like velocity distributions, intracranial steal phenomena, and functional stenoses in angiomas as illustrated in four patients. This information may supplement conventional neuroradiologic procedures for therapeutic decisions and follow-up. PMID- 3517694 TI - Controlled trial of aspirin in cerebral ischemia: an addendum. AB - Patients (303) who had had carotid territory transient ischemic attacks were randomly assigned to aspirin or placebo treatments. Patients with amaurosis fugax responded as well to aspirin as those with hemisphere events. Patients with lesions of the appropriate carotid artery responded better to aspirin therapy than patients with no lesion or an occlusion. The aspirin effect was the same across all risk-factor groups. Smoking had no effect on clinical outcome. PMID- 3517695 TI - Vulpian's sign: conjugate eye deviation in acute cerebral hemisphere lesions. PMID- 3517696 TI - Sporadic Creutzfeldt-Jakob disease in two coworkers. AB - We report the coincidence of pathologically confirmed sporadic CJD in two unrelated schoolteachers who shared a school wing for 9 months. The first developed ataxia, tremulousness, and dementia 5 months after his last contact with his colleague. Diagnosis of CJD was made 2 months later by brain biopsy. Eight months later, the second teacher developed similar symptoms and died after 9 months. Whether this unique coincidence reflects mere chance or some form of direct viral transmission is unknown. Continued epidemiologic surveillance for any future "coincidence" is warranted. PMID- 3517697 TI - [Evaluation of CEA in the serum. Comparison of 2 methods of determination and a statistical contribution]. PMID- 3517698 TI - [Clinical experiment with glypressin in hemorrhage due to esophageal varices]. PMID- 3517699 TI - [Acarbose in the treatment of type 2 diabetes]. PMID- 3517700 TI - [Is it still useful to integrate cholecystography with direct radiography in the cholecystokinetic test?]. AB - There are discordant opinions in literature on the techniques of execution of the cholecystography. The authors have examined 104 consecutive patients with the clinical suspicion of gallstones in order to verify the usefulness of the plain radiogram and of the cholecystokinetic test. All the patients have been studied systematically with the plain radiogram of the hepatic region, with cholecystography completed by cholecystokinetic test and with ultrasound. In two cases of radiopaque gallstones (7.1%) the plain radiogram was indispensable for the diagnosis while the cholecystokinetic test has permitted to visualize, in one patient (3.5%), a small radiopaque gallstone previously hidden by the gallbladder opacity. In one subject (50%) the cholecystokinetic test has permitted the identification of a small adenomyoma later confirmed by ultrasound. As a conclusion, the diagnostic accuracy of the cholecystography is inferior to that of ultrasound (in the diagnosis of gallbladder stones and adenomyoma) if the first one is not integrated both with the plain radiogram and with the cholecystokinetic test; the Authors consider on the other side, that this last procedures can be substituted if cholecystography is systematically associated to ultrasound examination. PMID- 3517701 TI - [Double-blind cross-over comparison of flurbiprofen and indomethacin in osteoarthritis of the knee and hip]. AB - A randomised double blind cross-over study was conducted in order to compare the therapeutic efficacy and tolerability of flurbiprofen and indomethacin in 16 patients with osteoarthrosis of the knee or hip. 300 mg per diem flurbiprofen and 150 mg per diem indomethacin were given for 14 days. Both treatment were very effective against pain whether spontaneous, under pressure or in movement and against functional limitations, joint mobility and on ESR. Undesirable side effects were noted in 4 flurbiprofen and 5 indomethacin cases. PMID- 3517702 TI - [Ultrasonographic study of the gastric emptying time using a liquid meal in the diagnostic protocol of reflux esophagitis. Preliminary data with normal subjects for standardization of the method]. PMID- 3517703 TI - [Echo-guided percutaneous treatment of pancreatic pseudocysts]. PMID- 3517704 TI - [The hand, an amulet that protects and heals. A study over time]. PMID- 3517705 TI - [Clinico-statistical study on hydropinic and balneothermal therapy of psoriatic patients using the low mineral-content waters of the Comano springs]. AB - The authors report the results obtained treating 39 subjects affected from psoriasis with hydropinic therapy and thermal balneo-therapy, using the thermal water of Comano. At the end of the treatment the results were rather bad with an inclusive reduction of 8.5% of the lesions as regards the initial data, but after 3-6 months an average per cent reduction of the lesions about 50% and in some cases quite a total regression of the psoriasis has been noted. No kind of collateral effects has been noted. PMID- 3517706 TI - [Echographic picture of a case of prune belly syndrome]. PMID- 3517707 TI - [Colpopexy by fashioning prosthetic ligaments in the treatment of prolapse of the vaginal dome after total hysterectomy]. PMID- 3517708 TI - Randomized clinical trial of transparent polyurethane i.v. dressings. PMID- 3517709 TI - Sights set on quality care for the elderly. PMID- 3517710 TI - Heroin and medical reasoning: the power of analogy. PMID- 3517711 TI - Dementia, myoclonus, and EEG findings typical of Jakob-Creutzfeldt disease in a patient with Alzheimer's disease. PMID- 3517712 TI - Danazol therapy in haemophilia. AB - Three patients with severe haemophilia A and one patient with moderately severe Christmas disease were given danazol and placebo in a double blind cross over trial to study the effects on haemostatic variables and bleeding tendency. In each case there was a shortening of the activated partial thromboplastin time (APTT) and euglobulin clot lysis time (ECLT) during danazol therapy but factor VIII and IX levels did not show any consistent change and there was no improvement in the bleeding tendency. PMID- 3517713 TI - The early diagnosis of breast cancer. PMID- 3517714 TI - Multiple dose insulin regimen using the NovoPen: initial experience and approximate dose requirements. AB - We present our initial experience with a multiple dose per day insulin regimen using the newly developed multidose NovoPen insulin injector. Fourteen insulin dependent diabetic patients were studied, 6 with excellent control and 8 with poor control on twice a day conventional insulin injection regimens. Total insulin dosage per day remained the same on the new compared to the old regimen; 0.71 (SD) 0.22 versus 0.73 (0.23) units/kg per day. Mean blood glucose control as evidenced by HbA1% values did not alter significantly in the well controlled group, but improved significantly in the poorly controlled group. Frequency of hypoglycaemia appeared to be reduced on the multiple dose regimen in particular in two of the subjects with excellent blood glucose control. The NovoPen proved to be reliable and convenient and was well accepted by all but one subject. PMID- 3517715 TI - Cardiac arrest and heart attack: an evaluation of lay knowledge. AB - Random samples of Dunedin residents were interviewed before and after the publication in the telephone directory of an information sheet on cardiac arrest and heart attack. Most subjects had heard of both cardiac arrest and heart attack but almost half of the samples were either wrong in identifying which was the more serious or they did not know. One-third of the post-publication sample had looked at the information sheet. Results indicate limited awareness of all but the most elementary medical facts and the existence of a variety of confusions and misconceptions in the two samples. Problems of comprehension and remembering are discussed in the context of the communication of medical information by doctors and health educators. PMID- 3517716 TI - Infections with Eikenella corrodens. PMID- 3517717 TI - Antibacterial agents and periodontal therapy. PMID- 3517718 TI - Bone grafts in periodontal therapy. PMID- 3517719 TI - Genital rhabdomyosarcoma: current management and review of the literature. AB - Rhabdomyosarcoma is the most common soft tissue sarcoma in childhood and 20 per cent of these cancers involve the pelvis or genitourinary system. Radical pelvic surgery, such as exenteration, was considered at one time to be the standard treatment for this cancer which carried a very poor prognosis. Over the past 15 years, a combined modality approach to treating rhabdomyosarcoma, using chemotherapy, radiotherapy, and less radical surgery, has evolved and survival rates have improved. This paper presents a case of rhabdomyosarcoma involving the perineum which was treated by combination chemotherapy of Vincristine, Actinomycin-D, and Cytoxan, followed by wide local excision, interstitial and external beam radiotherapy, and postoperative chemotherapy. The literature on pelvic rhabdomyosarcoma is reviewed and the current approach to treating this cancer using multimodal therapy is discussed. PMID- 3517720 TI - Pregnancy in renal transplant recipients: a review. AB - Although pregnancy in renal transplant patients was looked upon with skepticism in the past, it is no longer an insurmountable barrier to successful pregnancy. Gestation in these patients, once quite rare, is increasing markedly and obstetricians expect to encounter problems such as immunologic, genetic, teratogenic, and infectious disease during the course of pregnancy in these patients. The purpose of this paper is to review various maternal and fetal aspects of pregnancy in renal transplant recipients. PMID- 3517721 TI - Myotonic dystrophy and pregnancy: a review. AB - The previous reports of 20 women with myotonic dystrophy and pregnancy are reviewed, and a new case report added. Myotonic dystrophy is often unrecognized in early life due to vague symptoms, and is often first diagnosed during pregnancy which is known to worsen the main features of muscular weakness and myotonia. Complications of pregnancy and delivery are frequent and serious and should be known to all those dealing with pregnant women. A history of fetal wastage or a child suffering from symptoms of congenital myotonic dystrophy may be a clue to the diagnosis and these patients should be closely followed until safe delivery. The neonatologist should be involved as feeding and respiratory problems in the neonate may indicate that the infant is affected. PMID- 3517722 TI - Recurrent vulvovaginal candidiasis: vaginal epithelial cell susceptibility to Candida albicans adherence. AB - The pathogenesis of recurrent and chronic vulvovaginal candidiasis remains obscure. The majority of such patients lack recognized predisposing factors. In an attempt to further clarify host factors that enhance susceptibility to vaginal colonization and infection by candida, the in vitro adherence of Candida albicans to exfoliated vaginal epithelial cells was measured. Comparison of in vitro adherence to vaginal cells obtained from young, healthy volunteers failed to reveal any significant difference in attachment avidity (P greater than .5). Enhanced susceptibility to adherence does not appear to be a factor responsible for recurrent candidal infection. PMID- 3517723 TI - Fetal breathing as a predictor of infection in premature rupture of the membranes. AB - The value of the presence or absence of fetal breathing in predicting infection was determined by a retrospective analysis of 130 patients with premature rupture of the membranes and no clinical signs of infection or labor. The last ultrasound examination performed within 48 hours of delivery was used for comparison to infection outcome, as reflected by the development of clinical amnionitis, possible neonatal sepsis, and neonatal sepsis. The sensitivity and specificity of fetal breathing in predicting infection in patients with premature rupture of the membranes were 91.6 and 64.8%, respectively. These data suggest that the presence of fetal breathing is a good predictor of noninfection outcome (negative predictive value 95.3%), whereas its absence does not necessarily indicate impending infection (positive predictive value 50%). PMID- 3517724 TI - Fetal biophysical profile and the effect of premature rupture of the membranes. AB - A retrospective study of 1151 fetal biophysical profiles and scores associated with good pregnancy outcome was conducted over a three-year period in the author's institution. Normal fetal biophysical activities and scores were determined throughout gestation from 25 to 44 weeks in patients with intact membranes, and compared with profiles and scores of a group of patients with premature rupture of the membranes and good pregnancy outcome. These data suggest that although the biophysical scoring of the healthy fetus with intact membranes does not change significantly throughout gestation, some of the fetal biophysical variables (nonstress test, fetal breathing movements, amniotic fluid volume, and placental grading) do. The rupture of membranes was found to be associated with higher incidence of reactive nonstress testing, absence of fetal breathing, and reduced amniotic fluid volume in most gestational ages; however, the overall biophysical scoring of the healthy fetus was not altered throughout gestation by the presence of ruptured membranes. PMID- 3517725 TI - Fetal biophysical profile in twin gestations. AB - The fetal biophysical profile (nonstress test, fetal breathing movements, fetal movements, fetal tone, amniotic fluid volume, placental grading) was assessed in 49 consecutive referred high-risk patients with twin gestations. The relationship between the last fetal biophysical profile score before delivery was compared with the pregnancy outcome--as reflected by the presence of fetal distress and perinatal death. These data suggest that the fetal biophysical profile is a useful tool for observing fetal status in patients with twin gestations, and could be reliably used as a means of follow-up of nonreactive nonstress testing in these patients. PMID- 3517726 TI - Diabetic macrosomia: accuracy of third trimester ultrasound. AB - Sonar biparietal diameter, head circumference, and abdominal circumference percentile values obtained late in the third trimester were compared with birth weight percentile (relative to dates) in 147 diabetic mothers and 40 control fetuses of nondiabetics. Estimates of fetal weight by the method of Shepard et al were also calculated from these sonar data and compared with birth weight percentile. Abdominal circumference values greater than the 90th percentile correctly predicted macrosomia (defined as birth weight greater than 90th percentile) in 78% of cases. Biparietal diameter and head circumference percentiles were significantly less predictive of macrosomia. When analyzed in a similar manner, estimated fetal weights greater than the 90th percentile correctly predicted macrosomia at birth in 74% of cases. However, when both the abdominal circumference and the estimated fetal weight exceeded the 90th percentile, macrosomia was correctly diagnosed in 88.8% of pregnant women with diabetes mellitus. PMID- 3517727 TI - Ultrasonic fetal abdominal circumference: comparison of direct versus calculated measurement. AB - The ultrasonically derived fetal abdominal circumference is one of the essential parameters used to predict birth weight, assess fetal growth, and follow the evolution of fetal ascites. Growth curves relating abdominal circumference to gestational age have been reported for directly measured abdominal circumferences. However, none have been reported for abdominal circumferences calculated from measurements of fetal abdominal diameters. In this report, 197 normal fetuses ranging from 18 to 41 weeks' gestation are studied. The validity of 468 abdominal circumferences calculated from fetal abdominal diameters is tested by comparing the data with a similar number of direct abdominal circumference measurements obtained by a digitizer. From 18 to 41 weeks' gestation, directly measured fetal abdominal circumferences are significantly larger than fetal abdominal circumferences calculated from abdominal diameters (P less than .0001). The authors conclude that clinical management decisions based on abdominal circumference data are predicated on the use of appropriate abdominal circumference and/or abdominal diameter growth curves. PMID- 3517729 TI - Blood velocity waveforms of the fetal aorta in normal and hypertensive pregnancies. AB - Blood velocity waveforms were studied using a combination of real-time and Doppler ultrasonic equipment, a spectral analyzer, and on-line computer in the thoracic descending aorta of the human fetus. In 43 normal pregnancies (weeks 30 to 42) the median of mean velocity was 26.5 (24.1 to 27.9) cm/sec, that of the end-diastolic velocity 10.9 (7.9 to 13.4) cm/sec, the velocity acceleration 718.9 (620.3 to 844.1) cm/sec2, the resistance index 0.84 (0.80 to 0.89), and the pulsatility index was 2.49 (1.94 to 3.10). No differences in these values were observed in the fetuses of noncomplicated hypertensive pregnancies (N = 32), whereas the resistance index increased and the mean velocity and end-diastolic velocity decreased if fetal growth retardation was associated with maternal hypertension (N = 14). In the subgroup of fetal distress (N = 6), all of these parameters except velocity acceleration differed from the normal values, reflecting increased peripheral vascular resistance. This method may be of value in the follow-up of fetal well-being in risk pregnancies by giving an early sign of hemodynamic changes in developing hypoxia. PMID- 3517728 TI - Blood flow velocity waveforms in the descending fetal aorta: comparison between normal and growth-retarded pregnancies. AB - A linear array real-time transducer was combined with a pulsed Doppler transducer to study and compare the mean blood flow velocity waveform in 77 normal pregnancies and 12 cases of intrauterine growth retardation. All pregnancies were in the third trimester. In normal pregnancies the peak velocity, end diastolic velocity, and pulsatile index remained unchanged with increasing gestational age. End diastolic velocity was lowered or at zero level (high pass filter level), and the pulsatile index was elevated in most cases of severe intrauterine growth retardation. Peak velocity related closely with the quality of the heart rate patterns and the condition of the infant at birth. PMID- 3517730 TI - Looking after the men of slate. PMID- 3517731 TI - A 'holiday' with a difference! PMID- 3517732 TI - [Ultrastructural changes in the cell wall during germ tube and bud formation in the dimorphic fungus Candida albicans]. PMID- 3517733 TI - Gorbachev's brain. PMID- 3517734 TI - [Models of artificial crystalline lenses]. PMID- 3517735 TI - Dental health status and treatment needs of institutionalized seniors. PMID- 3517736 TI - [The origin of hematopoietic stem cells in the ontogenesis of vertebrates]. AB - A review of the origin of stem blood cells in ontogeny of vertebrates is presented. The comparative analysis of the data on laying, determination and migration of the hemopoietic precursor cells during embryogenesis in various taxonomic groups (teleosteans, urodeleans, anurans, avians and mammals) is performed. The change of the hemopoietic site and erythroid cells populations has been described. The data on sources of blood cell precursors and the origin of hemopoietic cells in the primordiums of hemopoietic organs were classified. A conclusion has been reached that in the course of evolution the hemopoietic anlage is gradually divided into two parts: one part migrates to the extraembryonic (ventral) mesoderm and another one remains intraembryonically and gives rice to the predecessors of definitive hemopoietic stem cells. PMID- 3517737 TI - [Polyploidization of cardiac myocytes as a programmed event of ontogenesis]. AB - The pieces of ventricles of newborn rats, which consist of diploid myocytes in more than 95%, were transplanted under the renal capsule of a syngeneic adult rat. Within 35 days the transplants contained 40 to 60% of the cells with the double or even greater DNA content in the mononuclear and binuclear classes. The composition of the classes was similar unlike the number of the cells of a certain class in the transplant and in the heart of a 35 day old rat. A conclusion has been drawn that the polyploidization is programmed and the realization of this programme depends on the growth, work, and other factors but is expressed even at their minimal action in the transplant. The growth of the transplanted myocytes was weaker than in the heart. It is supposed that, unlike the polyploidization, the growth of the myocytes outside the cycle is, predominantly, functional-dependent. PMID- 3517738 TI - Small choroidal melanoma with diffuse orbital involvement detected and differentiated with standardized echography--with special reference to the reliability of sonography in predicting scleral tumoral infiltration. AB - Report on a 73-year-old man with a proptosis of the left eye. Standardized A- and B-scan sonography revealed a large orbital tumor with low reflectivity and regular internal structure. Furthermore, a small choroidal melanoma with a typical excavation at its base was detected by echography. It could be demonstrated by reduction of the sound energy that the sclera adjacent to this tumor was intact, suggesting a melanoma migration along small scleral vessel channels into the orbit. All these findings were proved by histology. The echographical criteria of choroidal melanomas without and with scleral infiltration will be presented and their reliability will be discussed. PMID- 3517739 TI - Comparison of ultrasonic corneal thickness measurements before and during surgery in the prospective evaluation of Radial Keratotomy (PERK) Study. AB - Central corneal thickness, determined by an ultrasonic pachymeter, was studied in one eye each of 395 patients enrolled in the Prospective Evaluation of Radial Keratotomy (PERK) Study, to determine the changes in central corneal thickness between preoperative and intraoperative measurements. There was no statistical difference between the preoperative and the intraoperative measurement. However, 9.4% of the corneas were 0.03 to 0.08 mm thinner intraoperatively and 3.3% were 0.03 to 0.06 mm thicker intraoperatively, indicating that clinically meaningful changes in corneal thickness occurred between the preoperative and intraoperative measurements in some eyes. We conclude that the most reliable way to use ultrasonic pachymetry readings to set the length of the knife blade for radial keratotomy surgery is to measure the corneal thickness intraoperatively. PMID- 3517741 TI - Five year follow-up of epikeratophakia in children. AB - Epikeratophakia alters the anterior curvature of the cornea by the addition of a machine-carved donor lenticule. Since March 1980, 88 patients under eight years of age have had epikeratophakia, with at least six months of follow-up. Eighty percent of the original surgeries were successful; some failed grafts were replaced successfully, so that in all, 89% of the patients had successful grafts. The average increase in curvature of the cornea was 14.7 diopters, and the average spectacle overcorrection was +0.56 diopters. In these growing eyes, we documented a myopic shift of 1.5 diopters per year. Visual acuity results varied with the timing of refractive surgery, density of the amblyopia, and the parents' ability to maintain the patching schedule. The largest group of children were those who had unilateral traumatic cataracts. In this group, 7 of 15 patients who had surgery under 4 years of age had final verbal acuities of 20/40 or better. Long-term follow-up has demonstrated that epikeratophakia safely and successfully corrects refractive errors in aphakic children either as a primary procedure, or as a secondary procedure after cataract extraction. PMID- 3517740 TI - Dermal-fat graft as a primary enucleation technique. PMID- 3517742 TI - The use of PhEA 34c in trabeculectomy. AB - PhEA 34c, a 1.9% solution of sodium hyaluronate (Healon = 1.0%) was injected intracamerally and between the scleral and conjunctival flaps after trabeculectomy in 15 eyes, while randomized controls received balanced salt solution (BSS). Anterior chamber depths in both groups in the early postoperative period were significantly different from baseline measurements, but were not different between the two groups at any interval. PhEA 34c did not prevent postoperative flat or shallow anterior chambers. There was no significant difference in the rate of success between the two groups for the duration of the study, but five patients in the PhEA 34c group developed loculated blebs. PMID- 3517743 TI - Oral mucous membrane pemphigoid. A study of sixty-five patients. AB - Sixty-five patients with oral mucous membrane pemphigoid were examined, treated, and followed for a mean of 3.5 years. Seventy-two percent were women, and the mean age was 59 years. In most patients multiple oral sites were involved and the gingiva was affected in 94% of the patients. Seven patients had ocular lesions (symblepharon), and seven others had nasal, vaginal, or pharyngeal involvement. Persons with skin lesions (bullous form) were not included in this series. Topical and systemic anti-inflammatory/immunosuppressive medications were successful in controlling signs and symptoms. There were no spontaneous remissions. Candidiasis, tobacco, other diseases, and drugs did not appear to be related to the pemphigoid. PMID- 3517744 TI - Pilocarpine for the treatment of xerostomia associated with salivary gland dysfunction. AB - A double-blind placebo-controlled study was conducted to evaluate the efficacy of orally administered pilocarpine in treating oral dryness caused by salivary gland hypofunction. At low dosages, pilocarpine increased the production of saliva by parotid and submandibular and/or sublingual glands and relieved the sensation of oral dryness. The quantity and composition of pilocarpine-stimulated secretions were similar to saliva produced in response to gustatory stimulation with citrate. In appropriate patients, pilocarpine is a safe, easily administered, effective therapy to relieve xerostomia by increasing natural salivary function. PMID- 3517745 TI - Scanning electron microscope study of the predentin-pulpal border zone in human dentin. AB - Fragments of sound human molars were prepared for the scanning electron microscope (SEM) using modified fixative procedures and the carbon dioxide critical-point method to study the predentin-pulpal border zone. This technique minimizes the usual artifacts related to SEM procedures. The elongated odontoblast bodies are closely related to each other at the predentin level. For the first time in SEM procedures, the cell processes almost completely fill the predentinal tubules. Fibers measuring 0.3 to 0.5 micron in diameter are visible between the odontoblasts and fan out into the predentin. They correspond to the so-called Korff's fibers. Others, measuring less than 0.2 micron in diameter, are visible on the predentinal surface and follow the cell processes into the predentinal tubules. They correspond to nerve fibers. This study demonstrates that the proper use of improved SEM fixative techniques and the carbon dioxide critical-point method provides data on the relation between the different components of the predentin-pulpal border zone, which are in agreement with transmission electron microscope data. PMID- 3517746 TI - Alfonso Corti (1822-1876)--discoverer of the sensory end organ of hearing in Wurzburg. AB - Alfonso Corti was born at Gambarana in Lombardy. As a medical student he enrolled first at the University of Pavia, later at the University of Vienna. There he received his degree in medicine. In the years 1850/51, in the laboratory of Albert von Kolliker at the University of Wurzburg, he described for the first time the sensory epithelium, the spiral ganglion, the tectorial membrane, and the stria vascularis of the inner ear. PMID- 3517747 TI - Intermediate filaments in the newborn inner ear of the mouse. AB - The presence of intermediate filaments in the inner ear of the newborn mouse was analyzed with immunofluorescence techniques using antibodies against the five classes of intermediate filaments: cytokeratins, vimentin, desmin, neurofilaments and glial fibrillary acid protein (GFA). Neurofilaments were found in all nerve fibers from the ganglion cell to the hair cell. In the vestibular ganglion two subpopulations of ganglion cells were identified: a minor part staining intensively with neurofilament and the major part of cells lacking this immunofluorescence. Vimentin occurred in a number of supporting structures in the membranous labyrinth, but not in vestibular or cochlear ganglion cells. Cytokeratins, desmin or GFA were not identified in the inner ear. PMID- 3517748 TI - [Ujpest in the service of the Hungarian Settlement movement]. PMID- 3517749 TI - [Janos Daniel Perliczy (1705-1778), physician of Nograd]. PMID- 3517750 TI - [Dr. Stanislaw Kadyi (1900-1982) from the Polish branch of the Zrinyi family]. PMID- 3517751 TI - [On the 40th anniversary of the liberation of Hungary]. PMID- 3517753 TI - [Twin pregnancies with the death of one of the fetuses; diagnostic and therapeutic tasks]. PMID- 3517752 TI - [Electrolyte shifts in erythrocytes of patients with juvenile diabetes mellitus]. PMID- 3517754 TI - [Progressive hyperkalemia during chronic captopril therapy (pharmacological hypoaldosteronism)]. PMID- 3517755 TI - [Functional renal scintigraphy under captopril medication in screening for renovascular hypertension]. PMID- 3517756 TI - [Pseudogestational sac in ectopic pregnancy]. PMID- 3517757 TI - [The textbook "Diagnostics" by Arkovy was published 100 years ago]. PMID- 3517758 TI - [Medical congresses at the beginning of the 19th century]. PMID- 3517759 TI - [Janos Kabay (1896-1936)]. PMID- 3517760 TI - [Subclinical varicocele diagnosed by Doppler sound]. PMID- 3517761 TI - [Public health in Esztergom during the Turkish occupation]. PMID- 3517762 TI - Philosophy and financing of organ transplants. PMID- 3517763 TI - A double blind trial between metronidazole and secnidazole in acute amebic dysentery in children (preliminary report). PMID- 3517764 TI - IgE antibody against surface antigens of Leishmania promastigotes in American cutaneous leishmaniasis. AB - As IgE-mediated immune mechanisms participate in the host defence against some types of parasites, we evaluated sera from American cutaneous leishmaniasis (ACL) patients for the presence of this antibody against Leishmania. Using monoclonal antibodies against human IgE and an immunoperoxidase staining technique, 48% of the patients sera tested were found to contain IgE antibody that bound strongly to Leishmania promastigotes. A much lower proportion of sera from non-symptomatic subjects from either endemic or non-endemic areas of the disease contained significant levels of anti-Leishmania IgE antibody (6.5% and 0% respectively). The results indicated that the IgE antibody bound predominantly to surface components of the promastigotes, and reactivity against the intracellular amastigote form of the parasite was rarely detected. Somewhat unexpectedly, in a small proportion of the sera, the IgE antibody showed apparent specificity for L. mexicana or L. braziliensis. This study demonstrates that ACL patients can develop anti-Leishmania IgE antibody responses, that seem to be directed preferentially against surface antigens of promastigotes, and that can be strain specific. This raises the question as to the possible contribution of this antibody to the immune defence mechanisms against the parasite. PMID- 3517765 TI - M. leprae phagocytosis and its association with membrane changes in macrophages from leprosy patients. AB - Abnormal phagocytosis of Mycobacterium leprae by macrophages of lepromatous patients was demonstrated under various conditions. The largest proportion of macrophages with an excessive bacterial load belonged to the lepromatous group of patients. Lepromatous macrophages treated with Cytochalasin B, an inhibitor of phagocytosis, exhibited a significantly lower degree of ingestion of heat-killed organisms whereas uptake of 'viable' organisms was not affected to the same extent. Regulation of phagocytosis was studied by noting the rate of phagocytosis of M. leprae after the ingestion of a primary particle viz carbonyl iron. Solely in lepromatous macrophages, phagocytosis of carbonyl iron did not result in a decreased uptake of M. leprae implying aberrant phagocytic activity. Lastly, excessive phagocytosis was always noted in macrophages of familial contacts of leprosy patients who displayed decreased Fc receptor expression after M. leprae ingestion. This is of interest since phagocytosis, like Fc receptor expression, is a membrane dependent event and other membrane associated defects have been recognized by us earlier in lepromatous macrophages. PMID- 3517766 TI - Detection of specific circulating antigen, immune complexes and antibodies in human hydatidosis from Turkana (Kenya) and Great Britain, by enzyme-immunoassay. AB - Circulating antigen, specific immune complexes (IgG and IgM) and specific antibodies (IgG, IgM, IgE and IgA) were detected by enzyme-linked immunosorbent assay (ELISA) in the sera of hydatid (Echinococcus granulosus) patients from Turkana (Kenya) and the UK. Specific IgG and IgM antibodies predominated in current UK hydatid infections, while all classes of specific antibodies were lower in the Turkana patients. Circulating antigen, detected in 3% polyethylene glycol (PEG) precipitated complexes, using peroxidase conjugated hyperimmune human hydatid IgG (Fab) was more specific in ELISA than either antibody or immune complex assays where peroxidase conjugated anti-human IgG was used. Anti-human immunoglobulin ('rheumatoid' factor) was not detected in hydatid sera. Serum antigen, specific IgM immune complexes and specific IgM antibodies were associated with UK cases of current hydatid infection in contrast to patients with previous histories of hydatidosis. In 3 hydatid patients (from UK) levels of circulating antigen and specific IgM immune complexes rapidly declined within 1-4 months after surgical cyst removal. The detection of specific IgG and antigen in PEG precipitated immune complexes from false-negative/low responder Turkana hydatid sera, suggests that antibody 'mopping' by specific antigen may be occurring. After SDS-PAGE/immunoblotting analysis, antigen of mol. wt 67 000, present in hydatid cyst fluid and protoscoleces, was identified as putative circulating antigen in 3% PEG precipitates of sera from albendazole treated hydatid patients. PMID- 3517767 TI - Interstitial collagens in fibrous atherosclerotic lesions of human aorta. AB - The present study was undertaken to clarify the existing controversy on the collagenous content and composition of human fibrous atherosclerotic versus normal aortic tissues. Several analytic procedures (slab gel electrophoresis; cyanogen bromide peptide mapping; high performance liquid chromatography; ion exchange chromatography) revealed that the amount of the interstitial collagens, i.e. types I and III, was similar in fibrous atherosclerotic lesions and control tissues (70% and 30% respectively). Moreover, when fibrous lesions were analyzed as serial fractions there was a uniform distribution of type I and type III throughout the lesion. Small increases in type III were observed only beneath the lesion where it interfaced with the normal media. The results suggest that contrary to some previous studies no major shifts in the ratio of the interstitial collagens are evident in atherosclerotic lesions as compared to normal intima-media preparations. PMID- 3517768 TI - [Histomorphometric profile of bone fluorosis induced by prolonged ingestion of Vichy Saint-Yorre water. Comparison with bone fluorine levels]. AB - Nine transiliac bone biopsies from 7 patients with skeletal fluorosis due to prolonged ingestion of often high quantities of Vichy Saint-Yorre water were analyzed. Four of these patients also suffered from a chronic renal failure. A histomorphometric study was possible in 8 out of the 9 biopsies. The measurement of bone fluoride content, and a microradiographic examination, were performed on all bone samples. The radiologically evident osteosclerosis observed in each patient was confirmed by the significant increase of trabecular bone volume. Furthermore, the osteoid surfaces were very extended but the thickness of osteoid seams was normal in 6 out of 8 cases. Two biopsies demonstrated a morphological evidence of osteomalacia with abnormally thick osteoid seams. Calcification rate, measured in one of these 2 cases after tetracycline double labeling, was extremely low (less than 0.20 micron/d). The bone fluoride content was significantly high in each specimen (greater than 0.40 bone ash%) and correlated with relative osteoid volume (r' = 0.91) and thickness index of osteoid seams (r' = 0.83). Histologically, bone tissue showed modifications classically reported in the various types of skeletal fluorosis (formation defects, mottled bone with mottled periosteocytic lacunae). In conclusion, the prolonged administration of Vichy Saint-Yorre water containing 8.5 mg of fluoride ion per liter, provokes a skeletal fluorosis. This intoxication appeared very quickly if the patient suffered from an even mild renal failure. Once again, it is shown that a disturbed renal function predisposes to an excessive retention of fluoride. PMID- 3517769 TI - [Hepatotoxicity of (chloro-2-ethyl)-1-cyclohexyl-3-nitroso-1-urea (CCNU) in the rat]. AB - Few cases of liver involvement have been reported in patients receiving treatment with CCNU. CCNU is an anti-tumoral agent used in the treatment of leukemia, Hodgkin's disease and bronchial or cerebral tumors. A single daily dose of 20 or 50 mg/kg CCNU in female Wistar rats induces an important increase of transaminases, reaching 10 times initial level between day 2 and day 6, followed by a second and moderate increase between day 21 and day 28. Three-fold increased alkaline phosphatases and conjugated hyperbilirubinemia were noted for the two doses, and was greater for the higher dose. Histological and ultrastructural studies showed two types of lesions: during the first phase of transaminase elevation, edema and inflammatory infiltration of the portal spaces; during the second phase of transaminases elevation, numerous bundles of pericanalicular microfilaments and severe dilation of the biliary tract. Hepatic cells had few alterations although some necrotic foci were observed, particularly at the higher dose. So CCNU induced an intrahepatic cholestasis with pericholangitis in the rat. PMID- 3517771 TI - [Bacterial flora in gastric juice taken at endoscopy in 93 normal subjects]. AB - Bacteriologic examination of gastric juice samples taken during endoscopy in ninety-three subjects free of endoscopically-detectable disease was performed. Mucosal pH was determined using bromocresol green dye. Among the 17 subjects with a mucosal pH exceeding 4, 11 (64%) had more than 10(5) organisms/ml. In contrast, similar counts were found in only 10 of the 76 subjects with a normal mucosal pH. The pathogens recovered were normal hosts of the upper digestive tract and a few nitrate reductase + Enterobacteriaceae. Questions still to be resolved are whether these pathogens can induce disease and whether bacterial colonization correlates with the increased gastric nitrosamine levels and microscopic mucosal lesions previously described in patients with a gastric pH above 4. PMID- 3517770 TI - [Determination of micro-quantities of serum lithium by atomic absorption spectrophotometry. Significance and applications]. AB - The dilution of serum and the ionic components having an usual effect upon the lithium assay is examined about their influences in the determination of lithium microquantities. These are discussed according to the technique selected as well as the normal ionic variations that may be come across in serums. The method was applied to determination of serum lithium rate in a group of old subjects. The got lithium distribution is unsymmetrical at lower rates and no influence of age or sex was obvious. PMID- 3517772 TI - [Low molecular weight heparins]. AB - Heparin is a heterogeneous component consisting of anionic polysaccharides chains of variable molecular weight ranging from 3 000 to 40 000 daltons. It is by potentiating antithrombin III (AT III) a natural inhibitor of coagulation, that heparin exerts its anticoagulant effect. Actually, it has been demonstrated that only 30% of the molecule in commercial heparin preparations are capable of binding to AT III: moreover, several procedures were used to prepare low molecular weight heparin fractions or fragments. These preparations were lacking in ability to prolong the clotting time (APTT) and to inhibit thrombin, but were capable of potentiating the inhibition of factor Xa. The hypothesis that low molecular weight heparins may exhibit antithrombotic effect by inhibition the coagulation cascade system at the initial stages is very attractive. Moreover, on animal models, heparin fractions with molecular weight less than 3 000 had limited ability to prevent experimental thrombosis despite good anti-Xa activity. Thus, the anti-Xa activity did not alone reflect the antithrombotic effect. Experimental studies have shown less bleeding with low molecular weight heparins compared to standard heparin. Some data have suggested other properties of low molecular weight heparins such as enhancement of fibrinolysis and a slighter effect on platelets. The risk of thrombocytopenia induced heparin could be reduced by the use of low molecular weight heparins. The pharmacokinetics of low molecular weight heparins have been studied in human subjects. A higher bioavailability and a longer duration of action were reported compared to heparin. Preliminary clinical trials have shown that one daily injection is sufficient to protect against post-operative thrombosis. PMID- 3517773 TI - Analysis of the intermediate and basement membrane collagens in fibrous atherosclerotic lesions of human aorta. AB - The collagens of fibrous atherosclerotic lesions of human aortae obtained at post mortem examination were compared with those of normal intima-media preparations. Assessed quantitatively, pepsin-solubilized types IV, V and VI collagens decreased in relation to types I and III in preparations from lesions as compared to values for controls. The type V collagen in both tissues were composed of alpha 1 (V) and alpha 2 (V) chains in a 2:1 ratio. A novel ("V") collagen polypeptide identical in size to the alpha 1 (V) chain was identified in association with the interstitial collagen fraction in both tissue types. This chain had unique solubility characteristics and cyanogen bromide peptide composition. The exact relation of this polypeptide to the other collagens is not known, but it is possible that it accounts for the reported fluctuations in type V chains in aortic tissues. PMID- 3517774 TI - [Prostanoids of the peritoneal fluid and sterility with or without pelvic lesions (endometriosis, postinfectious adhesions)]. AB - Peritoneal fluid levels of 6-keto-PGF1 alpha, TxB2, PGE2 and PGF2 alpha were measured in 62 infertile women undergoing coelioscopy. In 10 patients with mild endometriosis, the levels of all prostanoids were significantly enhanced as compared to control group (15 infertile patients without pelvic lesion). In 5 patients with moderate endometriosis, only PGF2 alpha exhibited a significant enhancement. The results confirmed the prostanoid component alteration of peritoneal fluid in infertile women with mild or moderate endometriosis, which however not has been found by all authors. In 6 patients with chronic salpingitis, no difference was found in prostanoid levels as compared to control group. The 26 patients with pelvic adhesions were distributed in 3 groups on the criterion of easy lysed or not adhesions. In group I (not lysed adhesions, 7 patients), no difference was found in prostanoid levels as compared to control group. In group II (mixed adhesions, 13 patients), the levels of all prostanoids, particularly 6-keto-PGF1 alpha, were significantly higher than that found in control group. In group III (easy lysed adhesions, 6 patients), the levels of 6 keto-PGF1 alpha, TxB2 and particularly PGF2 alpha were significantly enhanced as compared to control group. The results of this study suggest that prostanoids are implicated in physiopathology of endometriosis and pelvic adhesions and perhaps in mechanism of the associated infertility. PMID- 3517776 TI - [Diffusion of amikacin in the lungs]. AB - The authors report their findings on amikacin concentrations in serum and in the lungs, its diffusion in the parenchyma of the lungs--evaluated from the ratio tissue/serum concentrations, and they also compare their results with those registered during a study on dibekacin, tobramycin and netilmicin, designed according to the same protocol. Ten patients with bronchial carcinoma who had to undergo chirurgical excision, received 5 IM injections at 12-hourly intervals. The dose administrated at each injection was 7.5 mg/kg. The assay of amikacin was realized by HPLC. Serum concentrations at the presumed peak (17 micrograms/ml) and 12 hours after that were somewhat lower than those reported by other authors. The mean tissue concentrations 2 h 20 min. after the last injection were 14,95 +/ 4,52 micrograms/g in the normal parenchyma, and 16,18 +/- 3,67 micrograms/g in the pathological parenchyma. The ratio concentrations in the tissues and in serum were comparable for both the normal and pathological parenchyma. Compared to dibekacin, tobramycin and netilmicin, this study confirms the large distribution of the aminoglycosides in the lung parenchyma. The behaviour of dibekacin and tobramycin with regard to the pathological parenchyma is rather comparable; netilmicin better penetrates into the normal parenchyma, and the diffusion of amikacin is parallel for both the normal and pathological tissues. PMID- 3517775 TI - [High-density lipoproteins, total cholesterol, triglycerides and serum trypsin activity. Study in chronic alcoholic and withdrawn subjects]. AB - Apolipoprotein is controlled by proteolytic processus and serum trypsin-like activity (STA) may be elevated in some chronic alcoholic subjects. STA, apoA lipoprotein, HDL-cholesterol, total cholesterol and triglycerides were tested in 44 men dealt in 4 groups (subjects with normal or elevated STA, alcoholic or withdrawn). Significantly lower apoA lipoprotein (p less than 0,02) and HDL cholesterol (p less than 0,001) levels as well as significantly higher triglyceride levels (p less than 0,01) were evidenced in the group with elevated STA compared to the group with normal STA. In another way, a negative correlation between HDL-cholesterol and STA (p less than 0,01) and a positive correlation between triglycerides and STA (p less than 0,001) were noted. The different factors known to modify these lipidic parameters cannot account for such disturbances. The role of elevated STA is evoked. PMID- 3517777 TI - [Lincosamides]. AB - The two main antibiotics that make up the group of lincosamides are lincomycin and its more recent derivative clindamycin; the latter, more active drug is gaining preference over the former. These antibiotics are active primarily against Gram positive cocci (i.e. staphylococci, pneumococci and group A and unclassifiable streptococci) and against most anaerobes (including Bacteroides fragilis). This action originates in binding to the 50S ribosomal fraction. Lincosamides may be given per os, intramuscularly or intravenously. After an oral dose of clindamycin, 90% of the drug is absorbed, and the peak serum level is reached within the first hour. Drug absorption is not modified by meals. Regardless of the route of administration, the serum half life of clindamycin is 2 to 3.8 hours in healthy individuals. Longer half lives are observed in patients with severe renal or hepatic failure, requiring that lower dosages be given by widening the intervals between doses. Diffusion of lincosamides into tissues is of clinical significance except for the central nervous system, especially the cerebrospinal fluid. On the whole, lincosamides are well tolerated. Pseudomembranous colitis is a potential hazard. The main indications of clindamycin are infections due to anaerobes, especially intestinal and vaginal infections. As clindamycin has virtually no effect against Gram negative aerobic pathogens, in most instances another antibiotic, usually an aminoglycoside, is given simultaneously. Other less common indications are some instances of aspiration pneumonia, septicemias due to B. fragilis, and actinomycoses. Because of the risk of pseudomembranous colitis, prophylactic use of clindamycin to prevent postoperative infections following colorectal surgery seems unadvisable. PMID- 3517778 TI - [Tissue and blood ferritins and isoferritins]. AB - Ferritins which can store excess iron are localised principally in tissue. Ferritins have on apoprotein shell which is composed of 24 sub-units, from 2 types of sub-units: "H" (molecular weight about 21 000) and "L" (molecular weight about 19 000) that assemble in different proportions and give multiple forms. Protein pattern depends on tissue nature. Since 1972, radio-immunology assays have shown very low serum ferritin levels. There is a good correlation between these levels and the amount of storage iron in the body. However it was demonstrated that elevation of serum ferritin could also occur without iron metabolism trouble by various mechanisms. PMID- 3517779 TI - [Use of monoclonal antibodies for the immunoenzyme determination of creatine kinase-isoenzyme MB]. AB - An enzyme immunoassay using monoclonal antibodies for creatine kinase-MB in human serum is described. The specificity and the linearity have been studied. The coefficient of within assay ranges from 6% to 22.5% according to the concentrations. The coefficient of between-assay ranges from 8% to 16.6%. Compared to electrophoresis, the results obtained with the enzyme immunoassay are a better sign of the physical state of the patients. PMID- 3517780 TI - [Veno-occlusive disease of the liver: present and future]. PMID- 3517781 TI - Ultrastructural appearances of subcultured aortic smooth muscle cells migrating into Millipore filters. AB - The ultrastructures of vascular smooth muscle cells migrating in Millipore filters were examined using a modified Boyden chamber. The cells (seventh and eighth subculture) were obtained from explants of rat aorta. Very small numbers of bipolar-shaped cells migrated deeply into the filter toward a platelet suspension added to the lower compartment. The migrating cells were richer in intermediate filaments and microtubules than the cells on the filter. The cytoskeleton was oriented along the elongated cell body, and the cortical microfilamentous mat was disorganized along the entire cell periphery. These data are discussed. PMID- 3517782 TI - [Contribution of electron microscopy of cultures of fibroblasts in the diagnosis of hereditary metabolic diseases]. AB - This work is an electron microscopic study of fibroblast culture of patients with metabolic diseases. In all cases, except for Niemann-Pick disease, primary lysosomes or secondary lysosomes containing lamellar, rectilinear or curvilinear material are accumulated in cytoplasm of fibroblasts. Though clinical consequences of metabolic diseases are diverse, cellular injuries are relatively uniform. Then electron microscopic study would'nt allow the diagnostic of a metabolic disease but it can provide an orientation. In one case, the enzymatic defect is not determined with biochemical analyses though clinical observation is characteristic of a metabolic disease; only the electron microscopic study shows a lysosomal accumulation. PMID- 3517783 TI - The therapy of acute myelogenous leukemia, a major challenge of onco-hematology. PMID- 3517784 TI - [Expression of class II HLA antigens (HLA-DR, DQW1, DQW3) in normal skin and cutaneous pathology]. AB - We report the cutaneous expression of class II HLA antigens disclosed by immunohistochemical staining of normal and lesional skin with monoclonal antibodies (MoAbs) reacting with HLA-DR, DQW1 and DQW3 antigens. Briefly, we disclosed: on normal human skin: 1) The Langerhans cells (LC) HLA-DR+, DQW1+; 2) the acrosyringium HLA-DR+, DQW1+, DQW3+; 3) the dermal vessel endothelial cells HLA-DR+. On lesional skin: 1) The LC were found HLA-DQW3+ in the lesional skin of some cutaneous diseases; this expression was never shown on LC of normal human skin; 2) the epidermal keratinocytes disclosed an uniform membrane expression of HLA-DR antigens in some cutaneous diseases; this kind of expression was not found by immunostaining with MoAbs directed against HLA-DQ antigens; 3) in psoriatic lesions some keratinocytes disclosed an heterogeneous expression of HLA-DR, DQW1 and DQW3 antigens; 4) tumoral cells from cutaneous malignant melanomas were shown to be HLA-DR+, DQW1+, DQW3+. The HLA-DQW3 expression on the LC of lesional skin is in favour with a modulation of HLA-DQW3 expression by unknown factors present in pathological skin. The HLA-DR expression on epidermal keratinocytes suggests a functional collaboration of keratinocytes with LC in the genetic restriction of cutaneous immune reactions. PMID- 3517785 TI - [Anti-fibronectin autoantibodies in systemic lupus erythematosus, rheumatoid polyarthritis, and various viral or bacterial infectious diseases]. AB - A micro-enzyme linked immunosorbent assay (ELISA) aimed at detecting anti fibronectin (anti-Fn) antibodies has been developed and standardized. Fifty sera from systemic lupus erythematosus (SLE), 50 from rheumatoid arthritis (RA) patients, as well as 200 sera from patients with bacterial or viral infections were assayed for the presence of anti-Fn autoantibodies. The IgG fractions of three representative positive sera (1 SLE, 1 RA and 1 streptococcal endocarditis) were digested with pepsin and the resulting F(ab')2 fragment assayed in the test. The presence of the anti-Fn activity in these fragments as well as lack of correlation in individual sera between the level of anti-Fn (as determined by ELISA) and that of Ig or immune complexes, suggest that our anti-Fn autoantibodies are indeed detected in our assay. The meaning of these antibodies, which were also found with bacterial and viral infections is discussed within the frame of the fibronectin biological properties. PMID- 3517786 TI - [A new agglutination reaction for the diagnosis of the developmental stage of acquired toxoplasmosis]. AB - Agglutination of acetone treated toxoplasma (AC) is different from that one of formalin fixed parasites (HS). Sera from patients with a recently acquired ("acute") infection agglutinate both HS and AC parasites suspensions as well; contrary to sera from patients with past infection ("chronic stage") in which high titers of HS agglutination are often present, while the titres of AC agglutination are lower even negative. This is markedly observed in patients with local lesions (relapsing chorioretinitis, patients with AIDS and brain abscesses). The reason might be that different membrane toxoplasma antigens may induce the synthesis of agglutinating IgG. For example, antigens 35 KD and 27 KD described by E. Handman et al. The antibody specific for 27 KD is apparently present mainly during acute infection, contrary to the antibody specific for 35 KD which might be responsible of the high HS agglutination titre in sera from patients with chronic infection. Even if these hypotheses were not confirmed in the future, comparison of the titre in the HS and AC agglutination test might actually be helpful for practical diagnosis of the stage of toxoplasma infection. PMID- 3517787 TI - [Male infertility in Gabon. Comparison of spermatic parameters between fertile and infertile groups]. AB - Aetiology of infertility in Central Africa remains largely controversial. The male factor has been less studied than the female factor. We present data obtained on spermatic parameters in comparison between fertile and infertile groups. Values obtained in fertile men are similar to those observed in European or American countries. Very low values of spermatozoa concentration, percentage of motile and morphologically normal forms were found in infertile male. PMID- 3517788 TI - [Results of bacteriological technics and demonstration of pneumococcal antigens by counterimmunoelectrophoresis in 40 cases of Streptococcus pneumoniae pneumonia]. AB - This study is conducted on 45 patients with Streptococcus pneumoniae pneumonias. Counter-immunoelectrophoresis (CIE) (detection of pneumococcal polysaccharides antigens in serum and/or urine and/or pleural fluid) and conventional bacteriological technics (blood culture and/or thoracentesis and/or transtracheal function) have been performed in all cases. Streptococcus pneumoniae has been identified with conventional bacteriological technics in 27 patients. Pneumococcal antigens have been identified in 28 patients. Both technics have been positive in 10 patients. The detection of antigens has been positive in 7 on 8 pleural fluids. The CIE is very useful in patients who has been treated by antibiotics before bacteriological examination of samples (6 CIE + and 1 bacteriological technic +). The association of the two technics is very useful. The percentage of cases with CIE / and bacteriology - is 40% (18 cases). The percentage of cases with bacteriology + and CIE - is 37.7% (17 cases). PMID- 3517789 TI - [Quantitative changes of plasma fibronectin in Plasmodium knowlesi malaria]. AB - In order to study the variation of plasma fibronectin (FN) during malaria infection, two male monkeys (Macaca fascicularis) were splenectomized and infected with Plasmodium knowlesi. As parasitaemia increased FN concentration decreased gradually from 260 to 140 microgram/ml and 300 to 85 micrograms/ml for monkeys 1 and 2 respectively. The significance of this finding is discussed. PMID- 3517790 TI - [Automation for the evaluation of blood basophilia]. AB - We report here the first results of our experience in evaluating the blood basophils count through the "H 6000" automatic counter. An artefact is described through which this count may falsely be increased. The value of basophil cells rates in some diseases is being discussed. PMID- 3517791 TI - [Analgesic effect of myelopeptides]. PMID- 3517792 TI - [Effect of prostacyclin on the lipid metabolic indices and on the lipid peroxidation level in the plasma and erythrocyte membranes]. PMID- 3517793 TI - Antenatal diagnosis of pulmonary tumours: report of two cases. AB - We report two cases of antenatal diagnosis of pulmonary tumours. In one case a bronchogenic cyst was connected with the bronchopulmonary tree and grew rapidly after birth. Thanks to the antenatal diagnosis, it was resected before any complication appeared. In the second case, congenital cystic adenomatoid malformation of the lung was associated with fetal anasarca. Initially cyst aspiration was carried out; then long-term drainage was attempted. These cases illustrate the impact of antenatal diagnosis on perinatal management. PMID- 3517795 TI - Real-time ultrasonographic surveillance in the detection of CNS involvement in systemic Candida infection. AB - Systemic candidiasis is becoming more common in the neonatal unit as the survival of extremely premature infants increases. Central nervous system (CNS) involvement occurs in 64% of infants with systemic infection. Real-time ultrasonography is useful in the diagnosis of CNS involvement and its sequelae as well as in monitoring the efficacy of therapeutic interventions. A patient with extensive CNS involvement is presented. Ultrasonographic findings are described and correlated with neuropathological examination of the brain. PMID- 3517794 TI - The improved ultrasound diagnosis of hypertrophic pyloric stenosis. AB - A prospective study of ultrasound in the diagnosis of idiopathic hypertrophic pyloric stenosis (IHPS) in 200 consecutive infants with persistent vomiting is reported. The criteria evaluated include measurements of the pyloric diameter, muscle thickness and canal length, and observing the function of the pylorus and gastric peristalsis in real-time. Using these ultrasonic criteria, the infants studied were assessed as 112 with IHPS and 88 normals. All the infants were followed up, and the method was 100% accurate, with no false positive or negative results. The statistics of the static measurements are included and show that the canal length is the only precise discriminator between a normal and an hypertrophied pylorus. The method is accurate, rapid and safe, allowing earlier diagnosis of IHPS. It should replace the barium meal in the evaluation of IHPS where the clinical diagnosis is in doubt. PMID- 3517796 TI - Ultrasonographic and computed tomographic diagnosis of benign masseteric hypertrophy. AB - Benign masseteric hypertrophy in a young child is presented. Diagnosis was confirmed by sonography and computed tomography. Recognition of this disorder obviates the need for further invasive investigations. PMID- 3517797 TI - Erythrocyte insulin binding in preterm newborn infants. AB - To characterize the erythrocyte insulin receptor in newborn infants we studied the binding of 125I-insulin to the erythrocytes from 42 preterm infants (14 at birth, 14 aged 2-7 days, and 14 aged 8-16 days) with a mean gestational age of 34.1 wk, and from 32 term infants (16 at birth and 16 aged 2-7 days). The insulin binding to cord blood erythrocytes from preterm infants was significantly higher than that of cord blood cells from term infants and to postnatal cells from preterm as well as term infants. The erythrocytes from preterm infants aged 2-7 days bound more insulin than cells from preterm infants aged 8-16 days. The maximum insulin binding (specific insulin binding at tracer concentration of insulin) correlated negatively with the gestational age both at birth and over the 1st postnatal wk. In the preterm infants there was a strong negative correlation between the maximum insulin binding and postnatal age. The enhanced insulin binding to cord blood erythrocytes from preterm infants was due to both an increased receptor concentration and a high affinity for insulin. The increased affinity persisted over the 1st wk of life. In preterm infants older than 1 wk the insulin binding characteristics were basically similar to those in term newborn infants. In all infants studied the receptor concentration seemed to be postnatal age dependent while the receptor affinity was gestational age dependent. No correlation was found between the insulin binding data and the plasma concentrations of immunoreactive insulin or C-peptide.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3517798 TI - Measurement of cardiopulmonary function in ventilated neonates with respiratory distress syndrome using rebreathing methodology. AB - The feasibility of using a multiple gas rebreathing technique to evaluate cardiopulmonary function in the ventilated neonate was assessed by measuring functional residual capacity, diffusing capacity of lung for carbon monoxide, and effective pulmonary capillary blood flow in 10 neonates with respiratory distress syndrome. Measurements were first made on the level of positive end expiratory pressure (PEEP) selected by the clinicians caring for the infants ("clinical" PEEP, mean of 4.4 +/- 0.3 cm H2O). To evaluate the effect of PEEP on cardiopulmonary function, PEEP was then changed above (mean of 6.7 +/- 0.4 cm H2O) and below (mean of 1.9 +/- 0.3 cm H2O) this level and measurements were repeated. Mean functional residual capacity on clinical PEEP (10.8 +/- 1.6 ml/kg) was far below the predicted normal and varied directly with changes in PEEP (mean change of 1.2 ml/kg/cm H2O). Diffusing capacity of the lung for carbon monoxide on clinical PEEP was 0.04 +/- 0.01 ml/min/mm Hg/kg and did not change significantly with changes in PEEP. Mean effective pulmonary capillary blood flow was highest (70 ml/min/kg) at the lowest level of PEEP. However, the effect of increasing PEEP on effective pulmonary capillary blood flow in individual infants varied. Increasing PEEP increased arterial oxygen tension but did not cause changes in systemic arterial pressure or heart rate. We conclude that infants with respiratory distress syndrome have severe lung injury with decreased functional residual capacity and diffusing capacity of the lung for carbon monoxide, and that lung volume improves with the use of PEEP.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3517799 TI - Increased carrying reduces infant crying: a randomized controlled trial. AB - The crying pattern of normal infants in industrialized societies is characterized by an overall increase until 6 weeks of age followed by a decline until 4 months of age with a preponderance of evening crying. We hypothesized that this "normal" crying could be reduced by supplemental carrying, that is, increased carrying throughout the day in addition to that which occurs during feeding and in response to crying. In a randomized controlled trial, 99 mother-infant pairs were assigned to an increased carrying or control group. At the time of peak crying (6 weeks of age), infants who received supplemental carrying cried and fussed 43% less (1.23 v 2.16 h/d) overall, and 51% less (0.63 v 1.28 hours) during the evening hours (4 PM to midnight). Similar but smaller decreases occurred at 4, 8, and 12 weeks of age. Decreased crying and fussing were associated with increased contentment and feeding frequency but no change in feeding duration or sleep. We conclude that supplemental carrying modifies "normal" crying by reducing the duration and altering the typical pattern of crying and fussing in the first 3 months of life. The relative lack of carrying in our society may predispose to crying and colic in normal infants. PMID- 3517800 TI - Lectures on the diseases of children by Eli Ives, MD, of Yale and New Haven: America's first academic pediatrician. PMID- 3517801 TI - American Academy of Pediatrics. Medicaid policy statement. Committee on Child Health Financing. PMID- 3517802 TI - Halifax and the precipitate birth of pediatric surgery. PMID- 3517803 TI - Nonketotic hyperosmolal diabetic coma in a child: management with low-dose insulin infusion and intracranial pressure monitoring. AB - Nonketotic hyperosmolal diabetic coma, which is rare in children, is associated with a high mortality in both children and adults. We report a case of nonketotic hyperosmolal diabetic coma in a 3 1/2-year-old child, who was successfully managed with low-dose insulin infusion and invasive intracranial pressure monitoring and recovered without sequelae. Despite severely elevated serum glucose (2,660 mg/dL) and osmolality (435 mosm/kg) levels, there was no elevation of intracranial pressure during her treatment. This case illustrates that insulin should be used cautiously and at low dose in this disease, and that intracranial pressure monitoring is of use in the management of such patients. The pathogenesis and clinical features of nonketotic hyperosmolal diabetic coma are briefly reviewed. PMID- 3517804 TI - Gelatin sign: ultrasonographic evidence of cerebral necrosis in infants. PMID- 3517805 TI - [Sonographic evaluation of mammary carcinoma by using the 7.5 MHz polymer transducer]. PMID- 3517806 TI - [Increase of hepatic metallothionein content induced by whole body irradiation]. PMID- 3517808 TI - Practical nursing programs accredited by the NLN 1985. PMID- 3517807 TI - [Image signals of digital subtraction angiography in a videodensitometric method]. PMID- 3517811 TI - Eating problems. An unhealthy obsession. PMID- 3517810 TI - Persistence of DNA synthesis arrest sites in the presence of T4 DNA polymerase and T4 gene 32, 44, 45 and 62 DNA polymerase accessory proteins. AB - DNA synthesis by phage T4 DNA polymerase is arrested at specific sequences in single-stranded DNA templates. To determine whether or not T4 DNA polymerase accessory proteins 32, 44, 45 and 62 eliminated recognition of these arrest sites, unique primer-templates were constructed in which DNA synthesis began at a DNA primer located at different distances from palindromic and nonpalindromic arrest sites. Nucleotide positions that caused polymerase to pause or leave the template were identified by sequence analysis of 5'-end labeled nascent DNA chains. Stable hairpin structures at palindromic sequences were confirmed by acetylation of single-stranded sequences with bromoacetaldehyde. Our results confirmed that these T4 DNA polymerase accessory proteins stimulated T4 DNA polymerase activity and processivity on natural as well as homopolymer primer templates. However, they did not alter recognition of DNA synthesis arrest sites by T4 DNA polymerase. Extensive DNA synthesis resulted from an increased rate of translocation and/or processivity to the same extent over all DNA sequences. PMID- 3517809 TI - Variation in the gene encoding a major merozoite surface antigen of the human malaria parasite Plasmodium falciparum. AB - Plasmodium falciparum merozoites have a variable surface protein of about 195,000 molecular weight which may be involved in strain-specific immunity. We have cloned and sequenced a major portion of the gene encoding this antigen from the CAMP strain and have located sites of preferred mung bean nuclease cleavage around the gene. These sites depend on reaction conditions, but at 40% formamide and 2 units of mung bean nuclease per microgram DNA, the intact gene was excised from the chromosome. Comparison of the CAMP strain gene with the same gene from other strains of P. falciparum by matching available DNA sequences and by DNA hybridization revealed five regions of homology separated by divergent segments. Two of the variable regions encoded three amino acid repeats, predominantly Ser Gly-Thr and Thr-Glu-Glu. Implications of these findings on the function of the antigen, and possible mechanisms for generation of variants are discussed. PMID- 3517812 TI - Computers in nursing. Gaining command of language. PMID- 3517813 TI - Pathophysiology related to peripheral vascular disease. AB - The problems of peripheral vascular diseases are varied and sometimes complex. The major and most common disease is arteriosclerosis obliterans. This problem will continue as the life expectancy increases. The severity of the disease compromises the quality of life. An understanding of the pathophysiologic process is necessary to enhance the quality of life and prevent the terrible and disfiguring complications which can arise as a result of insufficient knowledge. PMID- 3517814 TI - Diagnostic testing for peripheral vascular disease. AB - Regardless of the type of test that a client undergoes for diagnosis of PVD, the following information should be provided: purpose of the test; level of participation required of the client during the test; length of the procedure; special preparation needed before the test; restrictions imposed after the test and for how long; and the potential risks and benefits of the test. This information should be given to the client and his significant others in oral as well as written form. Clients who undergo diagnostic testing are often anxious and do not remember verbal instructions. In conclusion, the nurse must use her clinical judgment as to the amount of technical information the client needs and desires. PMID- 3517815 TI - Nursing assessment and nursing diagnosis in patients with peripheral vascular disease. AB - Effective nursing interventions are determined by the nursing diagnoses and associated etiologies. The diagnoses are derived from a complete data base that results from a thorough assessment. As the nurse proceeds through the process of differentiating among diagnoses, the focused cue search is essential. For the client with PVD, lifestyle changes, symptomatology, chronicity of the disease, and frequent contact with the health care system are the major influences on the diagnoses. These clients are likely to have potential for injury, potential for infection, impaired skin integrity, activity intolerance, alteration in tissue perfusion, alteration in comfort, and knowledge deficit. Other diagnoses are probable but are determined by the unique characteristics of each client. PMID- 3517816 TI - Nursing intervention in patients with peripheral vascular disease. AB - Peripheral vascular disease is a chronic progressive disease. Nursing intervention will be aimed at primary prevention through risk factor modification. Quality patient care will be facilitated through the development of an individualized plan of care. An essential element to consider in promoting successful nursing intervention is collaboration of the nurse and patient when developing the plan of care. Overall goals of care for a patient with PVD include promotion of circulation, relief of pain, and prevention of tissue damage or infection. PMID- 3517817 TI - Psychosocial considerations in peripheral vascular disease. Cause or effect? AB - Psychosocial factors play an important role in the development of peripheral vascular disease. The disease can also have profound effects on a client's psychosocial systems. This article emphasizes the importance of obtaining specific information about these systems and suggests methods of psychosocial evaluation to use during the nursing assessment of clients with peripheral vascular disease. PMID- 3517818 TI - Cerebrovascular disease. Pathophysiology and diagnosis. AB - Cerebrovascular disease is a heterogeneous group of disorders which are set apart from one another by their unique pathophysiologic mechanisms and clinical manifestations. When classified in this manner, stroke is divided into two major categories: hemorrhagic stroke--which results from rupture of a cerebral blood vessel into the subarachnoid space (subarachnoid hemorrhage) or brain parenchyma (intraparenchymal hemorrhage); and ischemic stroke--which results from occlusion of a cerebral artery due to degenerative vessel wall disease (atherosclerosis or lipohyalinosis) or emboli. Early recognition of the specific stroke types promises to lead to more effective diagnosis and treatment of cerebrovascular disease. PMID- 3517819 TI - Nursing diagnoses and interventions with the acute stroke patient. AB - The multiple and complex needs of the stroke patient may best be managed by thorough nursing assessment, precise interpretation of clinical signs and symptoms, and identification of individualized nursing diagnoses, etiologic factors, desired outcomes, and nursing interventions. A strong knowledge base of neuroanatomy and cerebral blood flow, together with skillful use of the nursing process, will help the nurse meet the challenge of caring for these complex patients in the acute phase. PMID- 3517820 TI - Alterations in communication. Biopsychosocial aspects of aphasia, dysarthria, and right hemisphere syndromes in the stroke patient. AB - Aphasia, dysarthria, and right hemisphere syndromes will be discussed from several vantage points which are important in facilitating the nurse's role in the work of the speech pathologist. General guidelines for determining whether a patient exhibits a communicative disorder and is in need of further diagnosis and treatment will be delineated. Communication suggestions for family and staff and a checklist of deficit areas will be offered. Additionally, a description of possible psychological reactions to the disorder and their effect on the patient and his social network will be provided. PMID- 3517821 TI - Nursing diagnoses and interventions for the rehabilitation of the stroke patient. AB - The nurse has many opportunities and interventions with which to facilitate rehabilitation for the patient with a stroke. The most effective interventions are those related to helping the patient become as independent as possible and to increasing feelings of self-worth and dignity, which in turn has a positive impact on the resocialization of the patient in the family and community. PMID- 3517822 TI - The use of myocutaneous flaps in reconstructive surgery for head and neck cancer: guidelines for nursing care. PMID- 3517823 TI - Nursing care and management of venous access ports. PMID- 3517825 TI - Systemic drug photosensitivity. AB - Photosensitivity as a side effect in treatment with systemic drugs occurs both as a phototoxic, non-immunologic phenomenon and as a photoallergic, immune-dependent reaction. The former principle is the more common one, and is seen with a number of non-related, widely used drug groups such as the tetracyclines, the phenothiazines, nonsteroidal antiinflammatory drugs, nalidixic acid, amiodarone and griseofulvin. For some of these drugs, for quinidine/quinine, and for the sulfonamides and related drugs, the reactions are probably also photoallergic. The majority of photosensitizing drugs have an action spectrum within UVA. Experimental studies have revealed that photoproducts and metabolites in some instances make important contributions to the biological photoreaction. For several of these drug groups, progress is presently underway in elucidating their mechanisms of action, as well as the relationship between chemical structure and in vivo photoactivity. PMID- 3517826 TI - Phototherapy and photochemotherapy ultraviolet irradiation equipment. AB - An appreciation of the salient physical properties of phototherapy and photochemotherapy treatment equipment should benefit any center constructing its own unit, or may influence the choice of a commercial system. These properties are discussed and different commercial units are listed. Fluorescent lamp arrays are the most commonly used source of ultraviolet radiation. The spectra of fluorescent lamps for PUVA are very similar, but there are clinically important variations between the emission spectra of different types of UVB lamp. The spatial uniformity and magnitude of irradiance will be affected by the number and distribution of tubes in a unit, and by the use of aluminium reflectors. It is usual to find such reflectors located behind an array of lamps, but horizontal reflectors positioned above and below enclosed vertical cabinets are often omitted. The measured irradiance in a unit depends on many factors, and specified irradiances must be compared with caution. Treatment should be prescribed by dose rather than time, and on-line integration of the irradiance to control the exposure should lead to more reproducible treatment. The ability of a unit to be fitted with both UVA and UVB lamps is a factor to be considered by clinical centers offering both PUVA and phototherapy treatment. PMID- 3517824 TI - Scimitar syndrome in neonates: report of four cases and review of the literature. AB - Four neonates with scimitar syndrome are presented. Three of the cases had congenital cardiovascular abnormalities not usually regarded as part of the scimitar syndrome, namely, ventricular septal defect, abnormalities of the aortic arch, and abnormal relationship of the pulmonary arteries and bronchi. Review of the literature indicates that among subjects of all ages the incidence of additional congenital heart disease is 24%; in patients within the pediatric age group the incidence is about 36% and is highest (75%) among those subjects having diagnostic studies while neonates. PMID- 3517827 TI - Health behavior change at the worksite: cardiovascular risk reduction. PMID- 3517829 TI - Innovations in behavioral medicine. AB - The chapter begins with a brief history of the behavioral medicine movement along with an overview of contemporary activities in the field. Three subsequent sections review technical innovations in major areas of clinical behavioral medicine: treatment, health care delivery, and preventive health care. The final section describes the methodological characteristics of research in behavioral medicine, discusses the field in light of the psychosomatic medicine and behavior modification movements, and calls for a conceptual integration that is authentically behavioristic. Already the quality of research in behavioral medicine appears comparable to that of research in behavior therapy. Even so, when viewed in terms of contemporary methodological desiderata, most of the work is fairly unimpressive. Possibly needed are "hybrid" experimental approaches in which the inferential power of intrasubject phase manipulations and between subject outcome comparisons are combined. There is good reason to believe that behavioral medicine will follow the historical course of behavior therapy/modification, not the course of psychosomatic medicine. Behaviorally knowledgeable psychologists can become major service providers in liaison with well-informed medical practitioners. Some potentially deleterious influences on the behavioral medicine movement are (inevitable) mentalistic and dualistic thinking and a retreat toward psychosomatic medicine. Field behaviorism as an organizing schema can, in principle, serve as a safeguard against such untoward influences. PMID- 3517828 TI - The role of behavioral change procedures in multifactorial coronary heart disease prevention programs. AB - Coronary risk factor screening and health education programs have constituted the mainstay of intervention in the large-scale community and clinic-based multifactorial CHD intervention trials which have been conducted in recent years. Community-based trials involving intervention along these lines have generally reported significant improvements in self-reported smoking patterns, slight improvements in blood pressure and serum lipid levels, and negligible changes in weight and physical fitness. The findings of controlled clinic-based trials involving nonbehavioral intervention have generally been only slightly more encouraging. Of note are the impressive findings of the Oslo Study (52), in which intervention involving brief personalized counseling and coronary risk factor assessment at 6-monthly intervals resulted in markedly greater improvements in mean serum cholesterol levels (13%) and the prevalence of smoking (15%) than was a case for the "no treatment" control group. The greater improvements in cigarette smoking were validated using serum thiocianate levels. The findings of both the North Karelia project and the MRFIT suggest behavioral intervention to be superior to traditional "exhortative" (i.e., screening; health education; medical counseling) procedures in achieving lasting improvements in the primary coronary risk factors (i.e., blood pressure, serum cholesterol, and cigarette smoking), but to be similarly ineffectual in changing the secondary risk factors (i.e., body weight, physical fitness). The issues of cost effectiveness, and the role of particular behavioral techniques in achieving lasting improvements in target coronary risk-related behaviors remain to be researched. PMID- 3517830 TI - [Sarcoidosis and the heart--personal observations]. PMID- 3517831 TI - [Effect of urinary tract infections on the effectiveness of the litholytic action of Debelysin]. PMID- 3517832 TI - [Hemodynamic and hormonal aspects of water immersion]. PMID- 3517833 TI - [Effect of digoxin on plasma renin activity in healthy persons]. PMID- 3517834 TI - [Campylobacteriosis--a disease one should know about]. PMID- 3517835 TI - [Jan Stanislaw Olbrycht (1886-1968)]. PMID- 3517836 TI - "Brunneroma": hamartoma or tumor? AB - Clinically relevant "tumors" of duodenal glands (Brunner's glands) are uncommon. We present a patient suffering from an exceptionally large tumor of the pars descendens of the duodenum. The tumor remained undetected at endoscopy and is of interest because of its localization, size and its presumable production of urogastrone (human epidermal growth factor). "Brunneromas" are probably hamartomas rather than true neoplasias. PMID- 3517837 TI - S-100 protein in amelanotic melanoma. A convenient immunocytochemical approach compared to electron microscopy. AB - 16 amelanotic melanomas were investigated immunocytochemically using two different antibodies against S-100 protein. In six cases electron microscopy was carried out. All 16 tumors showed a positive reaction for both antisera in epithelioid as well as in spindle-shaped tumor cells. Ultrastructurally the six investigated tumors contained stage II to IV melanosomes. Immunocytochemical and electron microscopical results are compared and discussed with regard to their significance in routine surgical pathology. PMID- 3517838 TI - Ultrastructural, lectin histochemical and immunohistological observations on Merkel cell tumors. AB - The clinicopathological and ultrastructural findings of 10 cases of Merkel cell tumor (MCT) are presented. Three patients died rapidly due to tumor dissemination. The tumor cells in eight out of the 10 cases were positive for neuron-specific enolase, however, all were negative for the ten polypeptide hormones examined, as well as for the argentaffin and argyrophil reactions. One of the patients had suffered from chronic lymphocytic leukaemia. Particularly in this case, but also in the others, the differentiation of MCT from a malignant lymphoma necessitated immuno-histological, lectin histochemical and ultrastructural studies. The focal peanut agglutinin positivity of the tumor cells in 6 out of the 10 MCTs seems to be a characteristic feature of these cells. PMID- 3517839 TI - Relationship between the early arterial reaction to hypertension and the development of intimal proliferation. AB - Malignant renal hypertension was induced in male Wistar rats. In the early phase of the disease, ie. the 1st week, a transient and generalized activation of arterial cellular functions was observed, while later, on day 21 widespread intimal proliferations developed in the arteries. This early activation included an increase in transmural permeability, DNA-, protein, collagen, elastin and ground substance synthesis, a rise in mural PGI2 content and an increase in number of Weibel-Palade bodies. An activation of platelets and monocytes could also be detected during the 1st week. In a group of rats the development of malignant hypertension was interrupted following the early activation of arteries and the incidence of intimal proliferations was compared with that of rats with maintained hypertension. No intimal proliferation was observed on day 21 in the rats with interrupted hypertension. It is concluded that the early activation of the artery does not furnish enough stimulus for triggering intimal proliferations and intimal plaques are not direct sequelae of the early arterial reaction. Furthermore the entrance of plasma materials during transmural permeability increase can not induce smooth muscle proliferation if the hypertension is interrupted. PMID- 3517840 TI - The microvasculature of the human pancreas and its relation to Langerhans islets and lobules. AB - The 3-D relation between the lobules, terminal blood vessels and Langerhans islets of human pancreas was established by graphic reconstruction from serial histologic sections. The material included three pancreases obtained at autopsy. It was found that the lobule is an assembly of sublobular parenchymal units which have a terminal arteriole at the center. These, being considered to be an elemental structure of microcirculation, were named the "primary lobule" of the pancreas. The concept was also supported by the 3-D analysis of a pancreas "pseudolobulated" due to chronic venous congestion, in which "primary lobules" were clearly demarcated by atrophic zones distributed along the periphery of circulation. Four types of terminal arterioles were discriminated: 1) those terminating at an islet, 2) those having no relation with islet, 3) those with islets dispersed near the ending and 4) those coming directly from an interlobular artery. More than half the endings were found to belong to either Type 2 or 3, which was quite different from the traditional assumption of complete arterio-insular correlation. Consequently, islets could also be classified according to whether or not having an afferent arteriole, namely, into "arterial" and "non-arterial" islets. The "arterial" islets amounted to 75% in the total islet volume, although in islet number, the "non-arterial" ones accounted for as much as 72.5%. Thus, at least in man, functional correlation between islets and exocrine gland is not so tight as claimed by the insulo-acinar axis theory. PMID- 3517841 TI - Immunizing the world's children. PMID- 3517842 TI - Diagnosis of deep venous thrombosis and pulmonary embolism. The tests and their limitations. AB - Pulmonary embolism and venous thrombosis are ubiquitous diseases with significant morbidity and mortality and for which successful although risky treatments are available. Accurate diagnosis is therefore necessary and requires testing beyond the physical examination and history. The number of tests proposed over the years compared with the number in current use attests to the problems with the methods. The more definitive tests are also more invasive, riskier, and more expensive. Individual experience in performance and interpretation of the available tests is of great importance in achieving accurate results, and thus the best scheme for investigation of the patient varies from institution to institution. The most accepted and practiced scheme would involve contrast venography as the initial and final test for suspected venous thrombosis, and pulmonary perfusion imaging (with use of chest radiography in all instances and ventilation imaging in most instances) as the screening test for pulmonary embolism, followed by pulmonary angiography when the scan is not definitive or the clinical picture is divergent from the scan results. PMID- 3517843 TI - Prenatal treatment of fetal hydrops associated with the hypertelorism-dysphagia syndrome (Opitz-G syndrome). AB - Non-immunological fetal hydrops diagnosed prenatally presents a difficult diagnostic and therapeutic problem. In the case presented, fetal hydrops was recognized at 19 weeks gestation and no specific cause was found prenatally in spite of extensive investigations. The fetal hydrops was treated in utero by thoracocentesis and an intravenous infusion of albumin carried out at fetoscopy. After birth the infant was recognized to have the hypertelorism-dysphagia syndrome (or Opitz-G syndrome, McK no. 30710). This autosomal dominant syndrome consists of hypertelorism, laryngeal abnormalities, swallowing difficulties, hyprospadias and an imperforate anus. Fetal hydrops has been reported on one previous occasion in this syndrome. The intrauterine treatment given in this case may have been successful in reducing the neonatal complications of the Opitz-G syndrome. PMID- 3517844 TI - Prenatal measurement of the fetal cerebellum and cisterna cerebellomedullaris by ultrasound. AB - The fetal cerebellum can be visualized with ultrasound throughout the second trimester. We describe a technique for measuring the transverse and anteroposterior cerebellar diameters and the measurement of the cisterna magna in the same plane between 14 and 32 weeks gestation. Nomograms for these measurements against gestational age showed good correlation, and narrow confidence limits for the transverse cerebellar diameter. The transverse cerebellar diameter was also measured directly in 79 fetuses after midtrimester abortion and the measurements obtained were compared with the ultrasound TCD nomogram. Good correlation, was obtained between the post mortem measurements and the ultrasound TCD nomogram. Routine use of these measurements and nomograms should prove valuable in the diagnosis of congenital abnormality of the posterior fossa and may also be of use in assessing the effect of severe intrauterine growth retardation and other insults on cerebellar growth and development. The narrow confidence limits obtained with the TCD nomogram should enable it to be used with confidence in clinical practice. PMID- 3517846 TI - [An autopsy protocol written in Friedrich Schiller's hand]. PMID- 3517845 TI - Prenatal diagnosis of dyssegmental dwarfism. AB - Fetal ultrasound evaluations at 18 weeks gestation on two consecutive pregnancies of a woman who previously gave birth to a stillborn female affected with dyssegmental dwarfism, resulted in accurate diagnoses of unaffected and affected fetuses. Marked disorganization of vertebral bodies and associated encephalocele found in two affected cases in this family are consistent with the original observation of this new syndrome as two major aspects which differentiate it from other forms of lethal dwarfism. PMID- 3517847 TI - [Physicians in the Yalta period and in the last period of Chekhov's life]. PMID- 3517848 TI - Adoption studies: historical and methodological critique. AB - The history of adoption studies and their use in separating heredity from environmental influences is reviewed. The adoptee separation paradigm became possible through changing social practices which formalized adoption procedures. In the earlier past of this century, the technique was used principally to investigate the relative importance of heredity and environment in the determination of IQ. It was not until the sixties that the technique was used to study the role of heredity in psychopathology. Genetic factors in alcoholism, criminality, personality disorders, antisocial personality, somatization disorder, affective disorder, hyperactivity and schizophrenia were assessed. The review analyses the potential interactions of confounding variables in such studies and how these can be controlled, and discusses the major methodological criticisms which have been raised. Although the predominant interest has been in the use of the technique to define genetic etiological factors in psychopathology, the paradigm is equally able to delineate precisely the role of environmental factors while controlling for heredity. With about 1 per cent of populations being adopted in Western countries, the further scope for such studies continues to hold promise. PMID- 3517849 TI - A mutation that prevents glucosylation of the lipid-linked oligosaccharide precursor leads to underglycosylation of secreted yeast invertase. AB - A mutant of Saccharomyces cerevisiae with the genotype mnn1 mnn2 mnn9 gls1 synthesizes mannoproteins with oligosaccharides having the composition Glc3Man10Glc-NAc2- owing to the mnn9 defect, which prevents synthesis of the outer chain, the mnn1 defect, which prevents branching of the core, and the gls1 mutation, which prevents deglucosylation of the resultant glycoprotein as a consequence of a defective glucosidase-I [Tsai, P.-K., Ballou, L., Esmon, B., Schekman, R. & Ballou, C. E. (1984) Proc. Natl. Acad. Sci. USA 81, 6340-6343]. (The mnn2 defect is not expressed in presence of the mnn9 mutation.) This strain spontaneously forms new colonies in which gls1 is suppressed owing to a defect in synthesis of dolichol phosphoglucose, the glucosylation substrate. The new mutant, designated mnn1 mnn2 mnn9 gls1 dpg1, synthesizes and secretes invertase (EC 3.2.1.26) that has a higher mobility on native gel electrophoresis than that made by the parent strain, the consequence of a reduction in both the size and the number of carbohydrate chains. The mannoprotein chains have the mnn1 mnn9 structure (Man10Glc-NAc2-), and the invertase is resolved by gel electrophoresis in sodium dodecyl sulfate into two major and two minor bands that represent homologs with about 4-7 carbohydrate units, in contrast to about 8-11 chains in the parent strain. Thus, the inability to glucosylate the lipid-linked precursor reduces the efficiency of glycosylation of the protein chains. The genetic defect is in synthesis of the glucose donor dolichol phosphoglucose, but the mutation is nonallelic with the reported alg5-1 mutation, which has a similar phenotype [Runge, K. W., Huffaker, T. C. & Robbins, P. W. (1984) J. Biol. Chem. 259, 412 417]. PMID- 3517850 TI - Secretion and autoproteolytic maturation of subtilisin. AB - The sequence of the cloned Bacillus amyloliquefaciens subtilisin gene suggested that this secreted serine protease is produced as a larger precursor, designated preprosubtilisin [Wells, J. A., Ferrari, E., Henner, D. J., Estell, D. A. & Chen, E. Y. (1983) Nucleic Acids Res. 11, 7911-7925]. Biochemical evidence presented here shows that a subtilisin precursor is produced in Bacillus subtilis hosts. The precursor is first localized in the cell membrane, reaching a steady-state level of approximately equal to 1000 sites per cell. Mutations in the subtilisin gene that alter a catalytically critical residue (i.e., aspartate +32--- asparagine), or delete the carboxyl-terminal portion of the enzyme that contains catalytically critical residues, block the maturation of this precursor. This block occurs when these mutant genes are expressed in B. subtilis hosts where the chromosomal subtilisin gene has been deleted. When the mutant B. amyloliquefaciens subtilisins are expressed in B. subtilis hosts that contain an intact chromosomal subtilisin gene, the mutant precursors are processed to a mature form and released to the medium. Such processing, in trans, of the precursor is also demonstrated in vitro by addition of active subtilisin. Thus, the release of subtilisin from the cell membrane is dependent on an autoproteolytic process that appears to be novel among secreted proteins. PMID- 3517851 TI - Unique type of plasmid maintenance function: postsegregational killing of plasmid free cells. AB - The stability locus parB+ of plasmid R1 has been found to specify a unique type of plasmid maintenance function. Two genes, hok (host killing) and sok (suppressor of killing), are required for the stabilizing activity. The hok gene encodes a highly toxic gene product, whose overexpression causes a rapid killing and a concomitant dramatic change in morphology of the host cell. The other gene, sok, was found to encode a product that counteracts the hok gene-mediated killing. The parB+ region was inserted in a plasmid with a temperature-sensitive replication system. At nonpermissive temperature, the parB+ plasmid was maintained in the population for a significantly longer period than the corresponding parB- plasmid. Coupled to this extended maintenance, a large fraction of the population was shown to be nonviable plasmid-free cells with the characteristic hok-induced change in morphology. Based on these findings, we propose that the parB+ locus mediates plasmid stability by killing cells that have lost the parB+ plasmid during the preceding cell division, thereby ensuring that a growing bacterial culture predominantly consists of plasmid-containing cells. PMID- 3517852 TI - Homology between RNA polymerases of poxviruses, prokaryotes, and eukaryotes: nucleotide sequence and transcriptional analysis of vaccinia virus genes encoding 147-kDa and 22-kDa subunits. AB - We have determined the nucleotide sequence of a region of the vaccinia virus genome encoding RNA polymerase subunits of 22 and 147 kDa and have mapped the 5' and 3' ends of the two mRNAs. The predicted amino acid sequence of the vaccinia 147-kDa subunit shows extensive homology with the largest subunit of Escherichia coli RNA polymerase, yeast RNA polymerases II and III, and Drosophila RNA polymerase II. The regions of homology between the five RNA polymerases are subdivided into five separate domains that span most of the length of each. A sixth domain shared by the vaccinia and the eukaryotic polymerases is absent from the E. coli sequence. In all specified regions, the vaccinia large subunit has greater homology with eukaryotic RNA polymerases II and III than with the E. coli polymerase. Vaccinia virus and eukaryotic RNA polymerases may therefore have evolved from a common ancestral gene after the latter diverged from prokaryotes. PMID- 3517853 TI - Regulation of rat insulin 1 gene expression: evidence for negative regulation in nonpancreatic cells. AB - Two cis-acting elements, the enhancer and the promoter, independently contribute to the cell-specific expression of the rat insulin 1 gene. The activities of these elements are presumably mediated by trans-acting factors. We have performed intracellular competition experiments that suggest the presence of a negative factor(s) that represses the enhancer activity in cells that do not express the insulin gene. In these experiments fibroblast cells (COS-7) were transfected with two plasmids: a test plasmid containing the gene for chloramphenicol acetyltransferase under the control of the thymidine kinase promoter and the insulin enhancer; and a competitor plasmid containing insulin enhancer sequences and the simian virus 40 origin of replication to permit its replication in the recipient cells. The presence of the competitor plasmid led to a 5- to 6-fold increase in chloramphenicol acetyltransferase activity as compared with the activity detected when insulin enhancer was absent from either the competitor or the test plasmid. A 5-fold increase in chloramphenicol acetyltransferase activity was also seen when the rat amylase enhancer was present on the competitor plasmid; in contrast the simian virus 40 enhancer exerted no effect. Efficient derepression required additional sequences downstream from those essential for enhancer activity. We propose that the activity of the rat insulin 1 enhancer is modulated by a negative trans-acting factor(s) that is active in cells not expressing insulin but is overridden by the dominant positive trans-acting factor(s) present in insulin-producing cells. PMID- 3517854 TI - Cloning, sequence, and expression of bovine interleukin 2. AB - Interleukin 2 (IL-2) cDNA clones have been isolated from both human and murine sources. We report here the isolation of a cDNA clone encoding bovine IL-2. This was accomplished by screening a cDNA library constructed from lectin-stimulated bovine lymph node cells, using a human IL-2 probe. Bovine IL-2 is composed of 155 amino acids and has a predicted molecular weight of 19,555. Alignment of the amino acid sequence with human IL-2 indicates that mature bovine IL-2 is composed of 135 amino acids and has a predicted molecular weight of 15,452. It has an amino acid homology of 65% with human IL-2 and 50% with murine IL-2. Bovine IL-2 is unique among IL-2 homologs in that it has a single N-linked glycosylation site. Biologically active bovine IL-2 was synthesized in an Escherichia coli expression system. PMID- 3517855 TI - Overproduction-induced mislocalization of a yeast vacuolar protein allows isolation of its structural gene. AB - Using an immunological screening procedure that allows the detection of yeast cells aberrantly secreting vacuolar proteins, we have isolated a cloned DNA fragment containing the structural gene for the vacuolar enzyme proteinase A (PrA; EC 3.4.23.6). A large portion of PrA is misdirected to the cell surface in cells harboring the PrA structural gene on a multicopy plasmid. This mislocalized PrA traverses the late stages of the secretory pathway and differs slightly in apparent molecular weight from the vacuolar form. A deletion in the genomic copy of the PrA structural gene eliminates immunoreactive PrA as well as the enzymatic activities of at least three other vacuolar hydrolases. In the case of the vacuolar enzyme carboxypeptidase Y (EC 3.4.16.1), the lack of activity is due to the absence of proteolytic activation of the zymogen. Thus, PrA may be required for in vivo processing of a number of yeast vacuolar hydrolases. PMID- 3517856 TI - Platelets contain a peptide inhibitor of endothelial cell replication and growth. AB - Platelets release specific growth factors that stimulate division of aortic endothelial cells. Acidification or heating to 56 degrees C of platelet extracts is required to detect these factors. Nonheated platelet extracts inhibit endothelial growth. To determine if this inhibitory effect is due to a discrete chemical substance, a crude extract obtained by freezing and thawing human platelets was incubated with an endothelial cell mitogen and found to inhibit the endothelial cell incorporation of [3H]thymidine by greater than 95%. The inhibitor was partially purified by ion-exchange and gel-filtration chromatography. The partially purified material inhibited endothelial cell division as well as DNA synthesis. Inhibition caused by the partially purified material was concentration dependent, reversible, and not due to cytotoxicity. Further purification by heparin-Sepharose chromatography resulted in removal of greater than 95% of the contaminating substances without a loss of inhibitory activity. Physical characterization revealed that heparin-Sepharose-purified factor was heat labile, had a molecular size estimated at 35-40 kDa, and was stable between pH 4.5 and 9.0. Treatment with proteolytic enzymes destroyed all biologic activity, suggesting a peptide composition. These data support the conclusion that platelets contain a potent inhibitor of endothelial replication and growth. Since platelet deposition and release occur after endothelial denudation, release of this platelet-derived growth inhibitor may be an important regulator of reendothelialization that occurs after vessel injury. PMID- 3517857 TI - Cell specificity and an effect of ras on human metallothionein gene expression. AB - The expression of three human metallothionein (hMT) genes has been compared in various established cell lines and primary liver. The single gene for hMT isoform II is ubiquitously expressed in all cell types in response to cadmium. In contrast, two genes encoding hMT-I isoforms are expressed in a highly specific, reciprocal fashion that correlates with the embryonic germ layer origin of the cells. In one cell line that failed to express detectable amounts of hMT-IE, treatment with the demethylating agent 5-azacytidine led to cadmium-inducible expression of this subtype. The genes for both MT-I isoforms are coordinately inducible by heavy metals but differ in their response to glucocorticoids. Surprisingly, cells transformed with the Ha-ras oncogene contain elevated basal levels of both MT-I and MT-II RNA. The implications of these results for growth related and developmental functions of MT are discussed. PMID- 3517858 TI - Yeast RPO41 gene product is required for transcription and maintenance of the mitochondrial genome. AB - A 4-kilobase DNA fragment carried by a recombinant lambda gt11 bacteriophage appears to contain most of the coding information for the 145-kDa subunit of the Saccharomyces cerevisiae mitochondrial RNA polymerase. The RPO41 gene is located on chromosome VI, as determined by hybridization to electrophoretically separated yeast chromosomes. Hybridization and gene disruption/replacement experiments show that the RPO41 gene exists in a single copy and that its product is required for transcription and maintenance of the mitochondrial genome. PMID- 3517859 TI - Monoclonal antibodies to HLA-DP-transfected mouse L cells. AB - Mouse L cells transfected with human HLA-DP (DPw4) alpha and beta genes were used to make monoclonal antibodies in C3H mice. A polymorphic antibody, DP11.1, was obtained, as well as several monomorphic antibodies. In ELISAs, DP11.1 bound to DPw4 cells and, more weakly, to DPw2, but not DPw1, -3, -5, or -6, using HLA homozygous cells. It also bound to L-cell transfectants expressing either DPw2 or DPw4 products. From B lymphoblastoid cell lysates labeled with [35S]methionine, the antibody immunoprecipitated alpha and beta chains of a similar size to those precipitated by a well-characterized DP monoclonal antibody, B7/21.2. Immunoblotting indicated that the DP11.1 antibody was directed against the alpha chain. This result confirms partial sequence data that showed that the DP alpha chain, as well as DP beta, is polymorphic, and that DPw2 and -4 alpha chains are very similar, if not identical. PMID- 3517860 TI - Gene encoding the alpha chain of the T-cell receptor is moved immediately downstream of c-myc in a chromosomal 8;14 translocation in a cell line from a human T-cell leukemia. AB - The SKW-3 cell line, which was established from the malignant cells of a patient with T-cell chronic lymphocytic leukemia, is characterized by a translocation involving chromosome 8 (band q24) and chromosome 14 (band q11) [t(8;14)(q24;q11)]. To determine the position of the gene encoding the alpha chain of the T-cell receptor and of the human protooncogene myc (c-myc) in relation to the breakpoint junctions and to evaluate their possible role in the pathogenesis of T-cell neoplasia, we applied the techniques of in situ chromosomal hybridization and Southern blot analysis to SKW-3 cells. Our results indicate that the breakpoint on chromosome 14 at band q11 occurs close to a joining sequence of the gene encoding the alpha chain of the T-cell receptor. Additional rearrangements within the alpha-chain locus appear to split the variable region cluster. As a result of the rearrangements, the constant region of this gene, as well as some variable region segments, are translocated to chromosome 8, to the 3' side of the c-myc-coding exons. The identification of a breakpoint to the 3' side of c-myc suggests that this translocation is analogous to the variant (2;8) and t(8;22) translocations observed in the B-cell malignancies. PMID- 3517861 TI - Human seminal alpha-inhibins: detection in human pituitary, hypothalamus, and serum by immunoreactivity. AB - An antiserum generated in rabbits against human seminal alpha-inhibin-52 has been used to develop a sensitive radioimmunoassay for the detection of alpha-inhibins. The alpha-inhibin-52 antiserum reacts with alpha-inhibin-92 and alpha-inhibin-31 with equal avidity. These peptides were found to be present in human pituitary, hypothalamus, and serum. In exclusion chromatography on Sephadex G-100, the immunoreactive material eluted in a large molecular size region. Immunoblot analysis of column-derived fractions of these extracts revealed the presence of alpha-inhibin-92. The mean concentrations of immunoreactive alpha-inhibin were found to be 7.2 ng/ml in normal adult male serum, 70.3 ng/g (wet weight) of pituitary, and 12.9 ng/g (wet weight) of hypothalamus. This communication reports on the evidence for the existence of gonadal peptides in the brain. PMID- 3517862 TI - Protease-induced immunoregulatory activity of platelet factor 4. AB - Intravenous injection of human or mouse serum or platelet material secreted from appropriately stimulated platelets ("releasate") together with antigen alleviates the immunosuppression in SJL/J mice induced by injection of irradiated lymphoma cells or in (CB6)F1 mice induced by injection of concanavalin A. We now report that injection of releasate from 10(6) human platelets restores plaque-forming cells to the unsuppressed number; greater amounts increase responses further. Immunoregulatory activity is released from platelets exposed to thrombin in parallel with other alpha-granule components. Heparin-agarose absorbs activity. Purified platelet factor 4 (PF4) has activity; beta-thromboglobulin and platelet derived growth factor have little or none. Activity in serum is neutralized by goat anti-human PF4. An enzymatic step is necessary for production of immunoregulatory activity. Releasates boiled immediately after platelet aggregation with 250 nM A23187 or those produced by adding A23187 in the presence of 100 microM serine protease inhibitor (p-amidinophenyl)methanesulfonyl fluoride (APMSF) are ineffective, whereas releasates boiled or mixed with APMSF after incubation for 60 min are active. Activity is generated by incubating a mixture of heparin-absorbed releasate (as enzyme source) and heparin-agarose eluate of releasate made in the presence of APMSF (as substrate source). The enzymatic step does not alter the heparin-neutralizing activity of PF4. Apparently a secreted platelet protease converts PF4 to a form with immunoregulatory activity. PMID- 3517863 TI - Growth-associated protein, GAP-43, a polypeptide that is induced when neurons extend axons, is a component of growth cones and corresponds to pp46, a major polypeptide of a subcellular fraction enriched in growth cones. AB - Growth-associated protein, GAP-43, is a polypeptide that is induced in neurons when they grow axons. We show by means of subcellular fractionation and immunohistochemical localization that GAP-43 is a component of neuronal growth cones as well as growing neurites; it is similar to a major phosphoprotein, pp46, of a growth cone-enriched subcellular fraction. These conclusions are consistent with the possibility that the induction of GAP-43/pp46 is an important event in the establishment of a productive growth state in which a neuron is competent to extend an axon. PMID- 3517864 TI - Identification of the DNA sequences controlling the expression of the MAT alpha locus of yeast. AB - We have excised a 28-base-pair DNA fragment from the MAT alpha intergenic region and tested its ability to direct diploid-specific transcriptional repression. This fragment (1643-1671, 5'-GCTTCCCAATGTAGAAAAGTACA-TCATA-3') lies within a region required for the normal diploid-specific repression of the MAT alpha transcripts. First, the fragment was inserted into a 53-base-pair MAT alpha deletion that expresses alpha 1 and alpha 2 constitutively. Insertion of the fragment restores proper diploid regulation to the MAT alpha transcripts: alpha 1 mRNA is strongly repressed and alpha 2 mRNA is reduced by a factor of approximately equal to 10 from its haploid level. The fragment works equally well in either orientation, and two copies of the fragment do not lead to stronger repression than a single copy. We also inserted the fragment at three sites upstream of the CYC1-lacZ fusion gene. Insertions placing the regulatory fragment between the CYC1 upstream activator sequence (UAS) and the coding region make beta-galactosidase efficiently in alpha haploids but produce 1/40th the enzyme in a/alpha diploids. This diploid-specific repression requires functional MATa-1 gene product. Insertion of the MAT fragment on the opposite side of the UAS (37 base pairs upstream of the UAS) also caused diploid repression of the fusion gene, but only by a factor of 7. When the regulatory fragment is inserted at a large distance on the far side of the UAS (375 base pairs), it has little if any effect on beta-galactosidase expression. We postulate that this sequence is the operator recognized by the diploid-specific repressor. PMID- 3517866 TI - Superoxide dismutase participates in the enzymatic formation of the tyrosine radical of ribonucleotide reductase from Escherichia coli. AB - One of the two nonidentical subunits of Escherichia coli ribonucleotide reductase, protein B2, contains in its active form two antiferromagnetically coupled Fe(III) ions and an organic free radical that arises by the one-electron oxidation of tyrosine-122 of the polypeptide chain. Protein B2 lacking the tyrosine radical but with the iron center intact (called protein B2/HU because it is produced by treatment with hydroxyurea) is enzymatically inactive. Previously, it was found that a crude extract from E. coli transforms B2/HU into B2 in the presence of dithiothreitol, Mg2+, and oxygen. On purification of the enzyme system, we now find that radical introduction requires three separate proteins as well as NADPH and FMN. One of the proteins is superoxide dismutase. We hypothesize that the overall reaction involves a reduction of the iron center followed by the oxidation of iron and tyrosine-122. Superoxide dismutase may then be involved in the second step to protect an oxidation-sensitive intermediate. Alternatively, the enzyme might be directly involved in the oxidation step. PMID- 3517865 TI - Harvey ras genes transform without mutant codons, apparently activated by truncation of a 5' exon (exon -1). AB - The hypothesis is tested that the ras gene of Harvey sarcoma virus (Ha-SV) and the proto-ras DNAs from certain tumor cells derive transforming function from specific codons in which they differ from normal proto-ras genes. Molecularly cloned Harvey proviral vectors carrying viral ras, normal rat proto-ras, and recombinant ras genes in which the virus-specific ras codons 12 and 59 were replaced by proto-ras equivalents each transformed aneuploid mouse 3T3 cells after latent periods that ranged from 4 to 10 days. Viruses with or without virus specific ras codons all transformed diploid rat cells in 3-5 days equally well. However, in the absence of virus replication, mutant codons were beneficial for transforming function. Deletion of non-ras regions of Ha-SV did not affect transforming function. We conclude that specific ras codons are not necessary for transforming function. Comparisons of the ras sequences of Ha-SV, BALB SV, and Rasheed SV with sequences of proto-ras genes from rat and man revealed an upstream proto-ras exon, termed exon -1. The 3' end of this exon is present in all three viruses and in a ras pseudogene of the rat. Since ras genes transform without mutation and since exon -1 is truncated in viral ras genes and all transforming proto-ras DNAs of the Harvey and the Kirsten ras family, we propose that ras genes are activated by truncation of exon -1 either via viral transduction or artificially via cloning and transfection. The proposal implies that untruncated proto-ras genes with point mutations may not be cellular cancer genes. PMID- 3517867 TI - Sporulation of the yeast Saccharomyces cerevisiae is accompanied by synthesis of adenosine 5'-tetraphosphate and adenosine 5'-pentaphosphate. AB - Two-dimensional TLC analysis of 32P-labeled nucleotides extracted from the yeast Saccharomyces cerevisiae reveals that two highly phosphorylated nucleotides are synthesized during sporulation. These nucleotides have been identified as adenosine 5'-tetraphosphate (ppppA) and adenosine 5'-pentaphosphate (pppppA). The synthesis of ppppA and pppppA commences late in sporulation and follows formation of ascospores. The maximum concentration of ppppA and pppppA in sporulating yeast cultures was 2% and 1.5%, respectively, that of ATP. Adenosine 5'-tetraphosphate and 5'-pentaphosphate are unique to this stage of yeast development and are absent in vegetative yeast cells. Since these nucleotides are also absent in asporogenous a/a and alpha/alpha cells, it is reasonable to propose that they are signal nucleotides marking one of the stages of yeast development--i.e., ascospore formation. PMID- 3517868 TI - Fractionation and characterization of a yeast mRNA splicing extract. AB - We have fractionated a yeast whole cell extract that can accurately splice synthetic actin and CYH2 pre-mRNAs. Three fractions, designated I, II, and III, have been separated by use of ammonium sulfate fractionation and chromatography on heparin agarose. Each fraction alone has no splicing activity. Fractions I and II allow the first step of the splicing reaction to proceed, giving rise to the splicing intermediates, free exon 1, and intron-exon 2. Addition of fraction III completes the reaction. Micrococcal nuclease treatment of the whole cell extract or of either fraction I or II abolished splicing activity, indicating that fractions I and II have RNA moieties that are required in the splicing reaction. The nature of the RNAs was examined using antibodies directed against the trimethylated cap structure unique to small nuclear RNAs. Preincubation of the whole cell extract with protein A-Sepharose coupled to trimethylated cap antibody abolished splicing activity. This indicates that at least one essential RNA component contains a trimethyl cap. Thus, in yeast as in mammalian systems, small nuclear RNAs are involved in mRNA splicing. PMID- 3517869 TI - Structure and sequence of the human c-sis/platelet-derived growth factor 2 (SIS/PDGF2) transcriptional unit. AB - The structure of the normal human c-sis/platelet-derived growth factor 2 (SIS/PDGF2) transcript was determined by a combination of cDNA cloning, nuclease S1 mapping, and primer extension. Nucleotide sequence analysis revealed that the 3373-nucleotide SIS/PDGF2 mRNA contained only a 723-base-pair (bp) coding sequence for the PDGF2 precursor polypeptide. The coding sequence was flanked by long 5' (1022 bp) and 3' (1625 bp) untranslated regions. The 5' noncoding region, as well as upstream flanking genomic sequences, contained clusters of specific short repeat sequences. A consensus transcriptional promoter sequence, TATAAA, was identified 24 bp upstream of the mRNA start site and an enhancer-like "TG element" was detected about 180 bp downstream from the site of polyadenylylation. These findings identify putative regulatory elements of the SIS/PDGF2 gene. PMID- 3517870 TI - Components of microtubular structures in Saccharomyces cerevisiae. AB - Most studies of cytoskeletal organelles have concentrated on molecular analyses of abundant and biochemically accessible structures. In many of the classical cases, however, the nature of the system chosen has precluded a concurrent genetic analysis. The mitotic spindle of the yeast Saccharomyces cerevisiae is one example of an organelle that can be studied by both classical and molecular genetics. We show here that this microtubule structure also can be examined biochemically. The spindle can be isolated by selective extractions of yeast cells by using adaptations of methods successfully applied to animal cells. In this way, microtubule-associated proteins of the yeast spindle are identified. PMID- 3517871 TI - Pancreatic expression of human insulin gene in transgenic mice. AB - We have investigated the possibility of obtaining integration and expression of a native human gene in transgenic mice. An 11-kilobase (kb) human chromosomal DNA fragment including the insulin gene (1430 base pairs) was microinjected into fertilized mouse eggs. This fragment was present in the genomic DNA of several developing animals. One transgenic mouse and its progeny were analyzed for expression of the foreign gene. Synthesis and release of human insulin was revealed by detection of the human C-peptide in the plasma and urine. Human insulin mRNA was found in pancreas but not in other tissues. These findings indicate that the 11-kb human DNA fragment carries the sequences necessary for tissue-specific expression of the insulin gene and the human regulatory sequences react to homologous signals in the mouse. PMID- 3517872 TI - Sequences upstream of the STE6 gene required for its expression and regulation by the mating type locus in Saccharomyces cerevisiae. AB - The STE6 gene of Saccharomyces cerevisiae is an a-specific gene; it is repressed in alpha cells by the alpha 2 product of the mating type locus. To study the role of sequences upstream of STE6 in its regulation and expression, we have determined the DNA sequence of the promoter region, identified the start sites for the STE6 transcript, and identified sequences governing its transcription. Deletions that remove DNA upstream of the STE6 gene were produced and assayed for effects on regulation and expression. The deletions defined two intervals upstream of the STE6 transcription initiation sites. One contains all or part of a negative element; the other contains all or part of a positive element. The negative element is required for repression of STE6 by alpha 2: deletions lacking this element express STE6 constitutively. Such deletions remove a 31-base-pair site, located 135 base pairs upstream of the first transcript start site, that is highly homologous to sites present in the upstream regions of four other genes repressed by alpha 2. These sites are presumably responsible for repression of the a-specific genes by alpha 2. The positive element (a putative upstream activation site) is required for expression of STE6. The deletions define the left boundary of the proposed upstream activation site. Sequence homologies between STE6 and other a-specific genes are found in this region and may mediate activation of this set of genes. PMID- 3517873 TI - Human erythrocyte glucose transporter: normal asymmetric orientation and function in liposomes. AB - The transport function and orientation of the reconstituted human erythrocyte glucose transporter was studied with liposomes made with bovine brain lipid or Escherichia coli lipid. Reconstitution was achieved by a simple octyl glucoside dilution method. The reconstituted transporters with either lipid showed identical counterflow transport activity, the same response to various inhibitors, and characteristic cytochalasin B (CB) labeling. Functional location and purification of the glucose transporter was performed by using gel-permeation high-performance liquid chromatography with octyl glucoside-containing buffer. The reconstituted transport activity was associated only with band 4.5 protein (preactin) and not with band 3 protein. Both CB binding and transport function of the reconstituted transporters were resistant to trypsin but susceptible to chymotrypsin digestion. However, both trypsin and chymotrypsin treatment of unsealed ghosts completely eliminated the CB labeling and transport function of the glucose transporter. In our reconstitution system the glucose transporters maintained a normal asymmetrical (right-side-out) orientation and good transport function. A specific monoclonal antibody against the glucose transporter inhibited CB labeling of the transporters on unsealed ghosts. This was not found with the reconstituted system; however, after freeze-thawing there was a significant inhibition of CB binding by the antibody. These findings suggest that the CB-binding site of the reconstituted transporter is on the inner side of the proteoliposomes. PMID- 3517874 TI - Mouse antisera specific for desmosomal adhesion molecules of suprabasal skin cells, meninges, and meningioma. AB - Mouse polyclonal antisera were raised to the Mr 130,000 and Mr 115,000 cell surface glycoproteins, desmocollins, of desmosomes from bovine nasal epithelium. Immunoblotting confirmed that the antisera were specific for the desmocollins. An immunofluorescence study showed that the antisera distinguished between the basal and suprabasal layers of bovine and human epidermis. The antibodies reacted with cultured keratinocytes only after calcium-induced stratification. In epidermis, therefore, there appears to be a difference between the desmocollins of basal and suprabasal cells that may be important in relation to epidermal differentiation. Previous work has shown that polyclonal antisera raised in other animals (guinea pigs and rabbits) against desmocollins, as well as against other desmosomal components, react with all desmosome-containing epithelia. In contrast, an immunofluorescence survey of bovine, rat, and human tissues showed that the present mouse antisera stained only suprabasal skin cells and the arachnoid layer of the meninges, demonstrating that these have common determinants that distinguished their desmocollins from those of all other tissues. The antibodies also stained 11 of 12 meningiomas and, therefore, may be useful as a marker not only for the diagnosis of these tumors but also for investigation of their histogenesis. PMID- 3517875 TI - A Plasmodium falciparum antigen containing clusters of asparagine residues. AB - A genomic DNA fragment that encodes a Plasmodium falciparum antigen has been isolated by using human antibodies eluted from the membrane of infected erythrocytes. The antigen has a very unusual primary structure; it is exceptionally rich in asparagine residues, many of which are distributed in clusters (2-15 residues) along the polypeptide chain. Unlike many P. falciparum antigens, this protein lacks tandemly repeated sequences. The antigen is distinct from Pf 155, a merozoite-derived antigen deposited in the membrane of infected erythrocytes, but contains epitopes that crossreact with anti-Pf 155 antibodies. Antisera prepared in mice against the asparagine-rich protein react with late stage parasites in indirect immunofluorescence. In an in vitro merozoite reinvasion assay, the IgG fraction of a mouse polyclonal antiserum, as well as a mouse monoclonal antibody, gave significant inhibition. Three polypeptides (Mr 36,000, 30,000, and 15,000) were recognized by these antibodies on immunoblots of P. falciparum extracts. PMID- 3517876 TI - The role of lipoproteins and receptor-mediated endocytosis in the transport of bacterial lipopolysaccharide. AB - The addition of bacterial lipopolysaccharide (LPS) from Escherichia coli 0111:B4 to human monocyte-macrophages cultured in serum results in suppression of scavenger receptor activity. The present studies were performed to examine if the effect on scavenger receptor activity was mediated by LPS alone or by LPS in association with lipoproteins. Radioiodinated LPS (125I-LPS) was added to human plasma in vitro and to normal and hyperlipidemic rabbit plasma in vitro and in vivo to determine the distribution of 125I-LPS among the lipoprotein classes. It was found that all lipoprotein classes bound LPS in direct proportion to their plasma cholesterol concentration. LPS alone was compared to LPS bound to low density lipoprotein (LDL), high density lipoprotein, or reductively-methylated LDL for their abilities to suppress scavenger receptor activity in monocyte macrophages in lipoprotein-free serum. Only LPS bound to LDL (LPS-LDL) demonstrated an effect similar to that observed when LPS was added to cells in serum. Either unlabeled LDL or unlabeled LPS-LDL complexes competed with the uptake of 125I-LPS-LDL complexes, which appeared to proceed by receptor-mediated endocytosis. In contrast to the uptake of 125I-LDL, the uptake of 125I-LPS-LDL by cultured monocyte-macrophages was not followed by its hydrolysis and the release of its radioactive degradation products into the medium. The association of LPS with lipoproteins was very stable and appeared to be mediated by a lipid-lipid interaction. We hypothesize that LPS bound to lipoproteins may be transported into the artery wall and may initiate the atherosclerotic reaction. PMID- 3517877 TI - Protein fatty acid acylation: enzymatic synthesis of an N-myristoylglycyl peptide. AB - Incubation of Saccharomyces cerevisiae strain JR153 with either [3H]myristate or [3H]palmitate demonstrates the synthesis of proteins that contain covalently bound fatty acids. A unique set of proteins is labeled by each fatty acid. Detailed analysis of a 20-kDa protein labeled with myristic acid demonstrates that myristate is linked to the amino-terminal glycine. We describe an enzymatic activity in yeast that will transfer myristic acid to the amino terminus of the octapeptide Gly-Asn-Ala-Ala-Ala-Ala-Arg-Arg, whose sequence was derived from a known N-myristoylated acyl protein, the catalytic subunit of cAMP-dependent protein kinase of bovine cardiac muscle. The acylation reaction is dependent on ATP and CoA, is enriched in a crude membrane fraction, and will use myristate but not palmitate as the acyl donor. Specificity of the glycyl peptide substrate is demonstrated by the observation that other glycyl peptides do not competitively inhibit myristoylation of Gly-Asn-Ala-Ala-Ala-Ala-Arg-Arg. PMID- 3517878 TI - Identification, nucleotide sequence, and control of developmentally regulated promoters in the hook operon region of Caulobacter crescentus. AB - The major flagellar proteins, including the flagellins and the hook protein, are synthesized periodically in the Caulobacter crescentus cell cycle at the time of flagellum assembly. Although fla genes are regulated at the transcriptional level [Ohta, N., Chen, L.-S., Swanson, E. & Newton, A. (1985) J. Mol. Biol. 186, 107 115], the 5' regulatory regions of C. crescentus genes have not been identified. We describe here the results of nuclease S1 protection assays that map the 5' ends of mRNAs synthesized in vivo from transcription units II (hook operon) and II.1 of the hook gene cluster and locate the corresponding promoter regions PII and PII.1. The two promoters are regulated with different periodicities in the cell cycle and have different genetic requirements for expression. The failure to detect transcripts from either PI or PII in Escherichia coli suggests that developmentally regulated promoters of C. crescentus have different recognition sequences from those of E. coli. There is little nucleotide sequence homology between PII and PII.1. There are, however, three regions of homology between PII and the nucleotide sequence 5' to the 29-kDa-flagellin-related gene, and two of these are in regions of dyad symmetry. We discuss the possibility that DNA protein interactions at homologous nucleotide sequences like those identified in PII are part of a regulatory gene cascade that participates in timing fla gene expression in the C. crescentus cell cycle. PMID- 3517879 TI - A translocated human c-myc oncogene is altered in a conserved coding sequence. AB - We have cloned and characterized a c-myc (now designated MYC) oncogene that had been translocated into the mu switch region of the immunoglobulin heavy chain locus in a Burkitt lymphoma cell line. The breakpoint of the translocation occurs within the first intron of the c-myc gene, thereby separating the untranslocated first exon from the two coding exons. Transcription from the translocated gene arises from a cryptic promoter within the first intron, which produces a 438 nucleotide untranslated 5' region. The amino acid sequence of the protein encoded by the c-myc gene has been substantially altered. In particular, a compensating set of frameshift mutations alters a string of 24 amino acids in a region of the protein tightly conserved in human, mouse, and chicken c-myc genes as well as in the human N-myc and L-myc oncogenes. Despite this, the mutated gene retains a reduced transforming ability in a rat embryo fibroblast focus-formation assay. PMID- 3517880 TI - Amyloid fibrils in hereditary cerebral hemorrhage with amyloidosis of Icelandic type is a variant of gamma-trace basic protein (cystatin C). AB - A gamma-trace variant protein is the major constituent of the amyloid fibrils in patients from Iceland with hereditary cerebral hemorrhage with amyloidosis. The protein consists of 110 residues and is similar to human urinary gamma-trace basic protein (or cystatin C) beginning at its 11th amino-terminal residue. It has an amino acid substitution (glutamine for leucine) at position 58 (position 68 in gamma-trace numbering), which is near the proposed active site of related proteins--namely, cysteine protease inhibitors and kininogens. It is postulated that a point mutation has occurred, leading to the production of an unusual protein that is abnormally degraded, bound, and/or precipitated. Alternatively, gamma-trace basic protein may be genetically polymorphic, and the variant described here may represent an as-yet-undiscovered isotype or an allelic form that is linked to, but not responsible for, the deposition disease. Our data on the structure of a gamma-trace variant protein suggests that its gene expresses a polyprotein precursor in which active peptides are flanked by basic amino acid residues that permit cleavage to liberate small internal peptides. It is likely that the nucleotide sequence coding for Arg-Xaa and Lys-Xaa repeated several times in the molecule may function as alternative splicing sites for mRNA processing. PMID- 3517881 TI - Feeding-induced regulation of cholesterol metabolism: a unified proposal. PMID- 3517882 TI - Changes of renin isoelectric heterogeneity after acute and chronic stimulation of renin secretion. AB - Changes in the multiple forms of renin secreted or stored in vitro by renal cortical slices were studied in rats made hypertensive with deoxycorticosterone, adrenalectomized rats, and rats fed a high or low salt diet. Renal slices from normal rats were also incubated with angiotensin II, vasopressin, and verapamil. Aliquots of incubation media were subjected to isoelectric focusing, and the six forms of renin were quantified and expressed as a percentage of the total renin activity recovered from the gel. The results showed that chronic and acute stimulation of renin secretion produced a similar modification of the isoelectric focusing profile, consisting of an increased proportion of renin forms with the more acidic isoelectric points. The change in the proportions of the more acidic renin forms was greater with chronic stimulation than that after stimulation with verapamil. However, chronic and acute inhibition or reductions of the rate of renin secretion did not modify the renin profile. We suggest that the progression in the shift of secreted renin forms to those with the more acidic isoelectric points correlates with the intensity or duration of stimulation of renin secretion. These data support the hypothesis that different pools of renin exist and are altered differently by chronic and acute stimulation of renin secretion. PMID- 3517883 TI - Pharmacological evaluation of 5-(Z,E)-13,14-didehydro-20-methyl-carboprostacyclin (FCE 22509). AB - FCE 22509, 5-(Z,E)-13,14-didehydro-20-methyl-carboprostacyclin, a chemically stable prostacyclin (PGI2) derivative, was 3.5 times more potent than PGI2 in relaxing bovine coronary artery in vitro; unlike PGI2, it did not contract bovine coronary vein and it antagonized PGI2-induced contractions of the coronary vein. In vitro smooth muscle (guinea pig ileum and trachea and rat stomach strip) was contracted to a lesser extent than with PGI2. FCE 22509 was about five times less potent than PGI2 in deaggregating platelet clumps formed on rabbit Achilles tendon bathed with heparinized cat blood (ED50 = 7.6 and 1.6 mcg/kg i.v. respectively). In the conscious normotensive and spontaneously hypertensive rat FCE 22509 lowered mean systemic arterial pressure (MSAP) (ED25 = 11.5 and 4.8 mcg/kg i.v.) to a lesser extent than PGI2 (ED25 = 2.1 and 2.34 mcg/kg i.v.) and increased heart rate but not dose-dependently. Orally administered, FCE 22509 likewise reduced MSAP though at high dosages (ED30 = 1.33 and 1.02 mg/kg in normotensive and hypertensive rats). Heart rate (HR) was raised after i.v. and oral treatment but not dose-dependently. In the open-chest anaesthetized dog, FCE 22509, compared with PGI2 at the same three doses, 0.2, 0.4 and 0.8 mcg/kg i.v., lowered MSAP but its hypotensive effect was less pronounced than that of PGI2. Like PGI2, FCE 22509 did not modify HR (though PGI2 showed a tendency to a decrease and FCE 22509 seemed to increase this cardiovascular function) and mean pulmonary arterial pressure (MPAP) and likewise significantly reduced myocardial contractile force. After infusion of PGI2 and FCE 22509 0.2 mcg/kg i.v. for 15 min in the open chest anaesthetized cat, the ex-vivo ADP-induced inhibition of platelet aggregation was the same for both compounds. Unlike PGI2, which reduced MSAP and MPAP, FCE 22509 had no significant lowering effect on MSAP and MPAP. PMID- 3517884 TI - Regulation of prostaglandin E2 and plasminogen activator by various immunomodulators in human monocytes. AB - Mononuclear phagocyte populations and monocytes are able to produce, among numerous substances, a neutral protease, i.e. plasminogen activator (PA) and prostaglandins. Since it has been shown that prostaglandins (PGs) and particularly PGE2 could exert an inhibitory effect on PA production by macrophages, we have measured the in vitro production of PA and PGE2 by monocytes isolated from healthy donors. These monocytes were cultured either in the absence or the presence of various immunomodulators: lipopolysaccharide from E. coli, concanavalin A and RU 41740 or Biostim a broad spectrum immunostimulating agent isolated from Klebsiella pneumoniae (Cassenne Laboratories, France). The production of PGE2 was proportional to the number of monocytes per incubation, and at a given cell concentration varied greatly from one subject to another. When considering PGE2 productions, the type of the response to the different immunomodulators varied from subject to subject and ranged from stimulation to no effect, or even inhibition. Moreover, a statistically significant, inverse relationship exists between the spontaneous production of PGE2 and the effect of each immunomodulator. For a given subject, all agents always acted in the same way and there was an inverse relationship between the effects of the immunomodulators on plasminogen activator and PGE2 production. PMID- 3517885 TI - Pressor and depressor actions of prostanoids in the intact human fetoplacental vascular bed. AB - Effects of the prostanoids PGE2, PGF2 alpha, PGI2, PGE1, 6-keto-PGE1 and the PGH2 analogue U46619, on fetoplacental perfusion pressure were measured in human term placental cotyledons in which both fetal and maternal circuits were perfused at constant flow. Fetal arterial injections of bolus doses of PGE2, PGF2 alpha and U46619 caused reversible increases in fetal perfusion pressure. Pressor responses to PGF2 alpha and U46619 were dose-related, with threshold doses of less than or equal to 2 nmoles and 14 pmoles, respectively. Reversible dose-related decreases in fetoplacental perfusion pressure were elicited by fetal arterial injection of PGI2, 6-keto-PGE1 and PGE1; threshold concentrations were: PGI2 less than or equal to 10 pmoles, PGE1 less than or equal to 141 pmoles and 6-keto-PGE1 less than or equal to 270 pmoles. The potent depressor effect of PGI2 and the potent pressor effect of U46619, a TxA2 mimetic, in the intact human fetoplacental vascular bed suggest that endogenous PGI2 and TxA2 could play a role in modulating fetoplacental blood flow in the term placenta. PMID- 3517886 TI - Pharmacological evidence of catecholaminergic involvement in the behavioral effects of luteinizing hormone releasing hormone in rats. AB - The influence of L-DOPA on the behavioral effects of LHRH was studied in male rats. Subcutaneous administration of LHRH (100 micrograms/kg) caused a significant disruption in the acquisition of a conditioned avoidance response (CAR) and a significant increase in head shaking behavior (HSB). Pretreatment with this hormone antagonized the stimulatory action of amphetamine (1 mg/kg, IP) in acquisition of CARs, spontaneous motor activity (SMA) and rearing behavior (RB). L-DOPA (100 mg/kg, IP), administered after LHRH, stimulated SMA, RB and HSB. In addition L-DOPA antagonized the effect of LHRH on acquisition of CARs and counteracted the antagonism between LHRH and amphetamine in acquisition of CARs and SMA. These findings indicate that LHRH could exert its behavioral effects through an inhibitory action upon brain catecholamine synthesis. The suppression of CARs may be the response to DA antagonism and the interaction with amphetamine could be mediated by an inhibition of both DA and NE activities. The possibility of an interaction between LHRH and central serotonin mechanisms is also discussed. PMID- 3517887 TI - Dr. John Gorrie: from malaria to the ice machine. PMID- 3517888 TI - The heritage bank. PMID- 3517889 TI - The other Flexner report: how Abraham Flexner was diverted from medical schools to brothels. PMID- 3517890 TI - Contribution to the search for vigilance-indicative EEG variables. Results of a controlled, double-blind study with pyritinol in elderly patients with symptoms of mental dysfunction. AB - We used a clinical pharmacological model to test pyritinol versus placebo in patients with mental deficiency and a clinical diagnosis of beginning chronic brain syndrome. Following a two weeks' washout phase, 50 patients were randomly allocated to two treatment groups of 25 patients each, receiving either 200 mg pyritinol three times daily, or placebo under double-blind conditions. The treatment period lasted 8 weeks. To be included in the study, patients had to have at least 50% subvigil phases in the 15-min EEG resting recording. We define such behaviour as a neurophysiological disturbance of vigilance. Scores in the Benton test were to be 2 points below the expected value, and/or the NAF score was to be above a standard value attained in an old peoples' home (greater than or equal to 14). We used this clinical pharmacological model for an internal validation of our Vigilance Index (VI). According to our definition, the Vigilance Index should express vigilance in the sense of an optimalization of the neuronal system to enable this system to perform better. The delta F power and the alpha slow-wave index have been considered as vigilance-indicative variables in the EEG. We believe that vigilance can be better expressed by a multidimensional approach, which takes into account all EEG elements that express vigilance, such as the replacement of the occipital basic rhythm (e.g. alpha or beta rhythm) into slow waves, the lowering of the dominant occipital frequency (be it an alpha or beta frequency), the anteriorization of the basic rhythm in the occipital field to the frontal region.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3517891 TI - Yesterday's journals lead to new horizons. PMID- 3517892 TI - [Phlebology consultation services open to physicians]. PMID- 3517893 TI - [Phlebitis in a child due to a femoral exostosis. Apropos of 1 case]. AB - The author describes the case of a child aged 11 spontaneously presenting a right surral phlebitis. The positive diagnosis was made immediately, with the aid of Functional vascular Investigation, that is venous Doppler and venous occlusion rheoplethysmography. A standard X-ray showed the existence of a right posterior femoral exostosis which looked as though it had been a causal factor in this phlebitis. However, the aetiological proof of this could not be given until seven months later, using phlebography. A survey of the existing literature does not reveal a comparable spontaneous case, without associated causal traumatism. For one thing, femoral osteogenic exostoses do not, despite their frequent occurrence, provoke more than a minimum of vascular complications, affecting the femoral or popliteal veins in particular. For another, spontaneous phlebitis in children are extremely rare and when they do occur it is as a result of haemopathies or collagenoses. Functional Vascular Investigation, now common practice in adults, made it possible to follow very precisely the development of the phlebitis in this child, and to check up on its sequelae. The great correlation between these functional investigations and clinical explorations and phlebography confirms their merit. They could be applied more systematically in infantile pathology. PMID- 3517895 TI - Metabolism of tRNAs in growing cells of Escherichia coli illuminated with near ultraviolet light. PMID- 3517894 TI - [Echographic aspects of blood clots]. AB - The ultrasonic imaging of blood clots depends on the degree of compactness of the red cells which it contains. When the clot is densely compact, the number of targets struck by the ultrasound beam is large, and major diffusion occurs, providing a visible image. When the clot is less dense, there are insufficient targets and it is not possible to pick-up a reflected signal able to create a visible image. The former situation arises in the case of a recently-formed clot, whereas the latter occurs in ageing clots. PMID- 3517896 TI - Photobiological activities of 5-alkoxypsoralens with respect to the action on Escherichia coli. PMID- 3517897 TI - Kainate and electrolytic lesions of the lateral habenula: effect on avoidance responses. AB - Male Sprague Dawley rats (n = 24), which received either bilateral electrolytic lesions, kainic acid lesions or sham treatments in the lateral habenula, were tested for acquisition of a one-way, conditioned avoidance response. Animals with electrolytic lesions failed to learn the avoidance task within 15 trials. In contrast, rats with kainic acid lesions performed as well as the control group. The results indicate that the disruption of the septal-medial habenula interpenduncular nucleus pathway may be responsible for the observed avoidance deficit in electrolytically lesioned animals. PMID- 3517898 TI - Cephalic phase insulin secretion in relation to food presentation in normal and overweight subjects. AB - The existence of a preabsorptive insulin reflex is well known in animals but remains controversial in humans. Glycemia and insulin variations following olfactive and visual presentation of a standard meal were studied in 25 subjects, 10 of them (5 men and 5 women) of normal weight and 15 overweight (7 men and 8 women), after a 15 hour fast. Blood samples were collected continuously, every minute for 16 minutes after the meal was presented. The presentation produced an early blood insulin increment, variable in magnitude and time course and occurring between the 3rd and 9th minute, in both normal and overweight subjects. Glycemia variations were not significant. Our study demonstrated a positive correlation between the reflex insulin release, body weight and a conscious effort to maintain current body weight. However, the differences between overweight and normal subjects remained small. The physiological and psychological determinants of the cephalic phase of insulin secretion are discussed. PMID- 3517899 TI - Medial preoptic-anterior hypothalamic lesions in prepubertal male cats: effects on juvenile and adult sociosexual behaviors. AB - Bilateral lesions of the medial preoptic-anterior hypothalamic (MP-AH) area were made in prepubertal male cats at 6-8 weeks of age. All subjects were subsequently reared in groups containing male and female peers, until the last phase of the juvenile period when an adult estrous female was inserted in these social groups. In spite of such optimal conditions for the practice of sociosexual behaviors during development, no sparing of adult male copulatory behavior was observed in these MP-AH animals during testing in adulthood. This finding, while consistent with earlier work on dogs, contrasts with the results obtained in prepubertally lesioned rats. Urine spraying, another sexually dimorphic behavior which is eliminated by MP-AH lesions in adult cats, was spared by prepubertal lesion placement. Heterotypical sexual behavior was not enhanced by prepubertal MP-AH lesion placement, as it is with postpubertal placement. In the present study, therefore, different behavioral systems influenced by the MP-AH area showed varying degrees of plasticity. As found in dogs, prepubertal MP-AH lesions enhanced and accelerated testosterone secretion in cats. PMID- 3517900 TI - Medial hypothalamic lesions in Syrian hamsters: characterization of hyperphagia and weight gain. AB - Syrian golden hamsters (Mesocricetus auratus) received bilateral lesions aimed at the ventromedial hypothalamus (VMH) or a sham lesion. In the first study, some of the animals in each surgical group were housed in standard sedentary conditions while others had free access to running wheels. The lesions produced a 30% increase in the daily intake of chow, and this was accomplished exclusively by increased meal sizes. As a result, lesioned hamsters gained body weight relative to controls both on the chow diet and in a subsequent high fat diet phase. The effects were comparable in both sedentary and exercising groups. The lesions produced increases in body length and fat content. In the second study, lesions were made in the VMH or in adjacent nuclei and, after an initial period on chow, the hamsters were then given a choice between chow and high fat diet. The lesioned hamsters showed no unusual preference for the high fat diet but, as before, those with damage to the VMH or paraventricular nucleus (PVN) showed exaggerated body weight gain. Hamsters with these lesions were hyperinsulinemic in both fed and fasted conditions at the end of the study. PMID- 3517901 TI - Perinatal androgen manipulations do not affect feminine behavioral potentials in voles. AB - Adult voles show sexual differences in their behavioral responses to estrogen. To determine whether this sexual dimorphism is related to early androgen exposure as it is in other rodents, female voles were treated neonatally with testosterone. In addition, males were castrated neonatally or treated perinatally with either the antiandrogen, flutamide or with the antiaromatase, ATD. When androgenized females were treated with estrogen in adulthood, they exhibited normal sexual behaviors. Males deprived of androgen or treated with ATD during development did not display feminine behaviors when injected with estrogen in adulthood. These results suggest that the organizational hypothesis of sexual differentiation cannot explain the development of feminine behavior potentials in the vole. It is possible that the development of feminine behaviors in voles requires exposure to ovarian hormones during prepubertal development. PMID- 3517902 TI - Ovarian hormone effects on activity, glucoregulation and thyroid hormones in the rat. AB - Ovarian hormonal influences on the range of physiological and behavioral variables which combine to affect overall energy balance are poorly delineated. In the present study 4 groups of virgin, female rats (intact, ovariectomized, ovariectomized with estrogen replacement and ovariectomized with estrogen plus progesterone) were allowed access to running wheels and activity; food intake and weight gain were measured initially under food restricted, then under ad lib conditions. Serum insulin, glucose, thyroxine (T4) and triiodothyronine (T3) were determined on trunk blood samples obtained at the end of the experiment. Ovariectomy resulted in an increased rate of weight gain through reduced activity and T3 but food intake was unchanged. Insulin levels were greatly reduced. Estrogen replacement restored activity to the intact group's level and normalized weight gain. Insulin and T3 were also raised to control levels but T4 was reduced as was serum glucose. Estrogen plus progesterone replacement reduced weight gain markedly and increased T3 with normal T4. Despite the lower body weight this group was hyperglycemic and hyperinsulinemic suggesting insulin resistance. The results have important implications for the glucoregulatory and energy balance perturbations of ovarian hormone fluctuations and focus particularly on progesterone. PMID- 3517903 TI - Characterization of transferable plasmids from Shigella flexneri 2a that confer resistance to trimethoprim, streptomycin, and sulfonamides. AB - A set of plasmids conferring resistance to several antibiotics, including the combination of trimethoprim and sulfamethoxazole, has been isolated from Escherichia coli following conjugative cotransfer from a clinical isolate of Shigella flexneri 2a. One of the plasmids, pCN1, was shown by subcloning and DNA sequencing to carry a gene encoding a trimethoprim-insensitive dihydrofolate reductase identical to that found in E. coli transposon 7. This plasmid was also shown to confer resistance to both streptomycin and spectinomycin by production of an adenylyltransferase that inactivated the drugs and the gene encoding this enzyme has also been sequenced. A second plasmid from the set, pCN2, was shown to inactivate streptomycin by a phosphotransferase mechanism and also to confer resistance to sulfonamides. The third plasmid from the set could not be correlated with a drug-resistance phenotype, but does appear to play a crucial role in plasmid mobilization. PMID- 3517904 TI - M13-oriC cloning vehicles: use for amplification of high copy lethal (HCL) genetic elements. AB - M13 cloning vehicles have been constructed which contain the Escherichia coli origin for DNA replication (oriC), with and without selectable antibiotic resistance genes. Since the M13 viral strand origin requires a functional rep gene product, using oriC these vehicles propagate as low-copy-number plasmids in E. coli rep mutants. This property is exploited to amplify cloned "high copy lethal" (HCL) DNA fragments, those containing genetic elements which kill the E. coli host when present at multiple copies in the cell. Following cloning of such fragments in these vehicles and initial selection in E. coli rep cells, the M13 oriC chimeric plasmid DNA is used to transfect appropriate E. coli rep+ cells. The chimeric DNA propagates as M13 viral DNA, yielding double-stranded and single stranded DNA products and phage particles prior to killing of the host via expression of the HCL element; these events mimic a lytic phage infection. Such amplification will greatly facilitate both DNA "library" constructions (HCL elements are absent a priori from libraries using high-copy-number cloning vehicles) and studies of HCL elements including restriction mapping, DNA sequencing, and physiological studies. PMID- 3517905 TI - Primary repair of the bilateral cleft lip nose: a 10-year review. PMID- 3517907 TI - Excision of burns of the face. AB - Sequential excision of burns is now a common technique. Nevertheless, standard texts, when describing the treatment of facial burns, recommend allowing spontaneous separation of the eschar and then grafting on granulation tissue if healing does not occur. This method yielded disappointing results for us and the reconstructive procedures required were of great magnitude. Therefore, in January of 1979, we began primary excision and grafting of those face burns not essentially healed at 10 days. We have now treated 16 consecutive patients (approximately 5 percent of all face burns) in this manner who are at least 12 months postinjury. Three were lost to follow-up, leaving 13 for evaluation. This method yields better appearance and function than that obtained by allowing spontaneous healing over more than 3 weeks or grafting on granulation tissue and decreases the magnitude of subsequent reconstruction. PMID- 3517906 TI - The use of Champy miniplates for osteosynthesis in craniofacial deformities and trauma. AB - Champy miniplates have been used in the treatment of craniofacial fractures and in osteotomies for correction of posttraumatic deformities, congenital craniofacial deformities, and secondary bony deformities due to pathologies such as hemangioma and neurofibroma. An additional use has been to stabilize free and vascularized bone grafts. The total number of cases reviewed were 50 (25 acute trauma, 4 vascularized mandible reconstruction, and 21 osteotomies of varied types). There were three infections, two in mandibular fractures that were comminuted and compound into the mouth and one in a compound comminuted fracture of the frontal and maxillary area that was judged to be infected when the plate was placed in position. Two plates have been obvious under the skin. No patient has requested plate removal. The advantages of plating in selected cases are decreased operating time, rigid fixation at surgery, good fixation of bone grafts, and the ability to remove intermaxillary fixation in children at the end of the procedure or within the first few postoperative days. PMID- 3517908 TI - A review of scalp split-thickness skin grafts and potential complications. AB - A review of 113 patients who underwent 178 scalp split-thickness skin graft procedures is presented. Although our study confirms some of the work of previous authors, we found that the scalp donor site has potential complications which should be considered. These complications are minor in the adult population. In the pediatric population, however, excessive blood loss due to the relatively large surface area of the scalp limits the use of the scalp as a preferred donor site. PMID- 3517909 TI - Free iliac skin flap transplantation by anastomosing the fourth lumbar blood vessel. PMID- 3517910 TI - Cleft lip surgery in Anglo-Saxon Britain: the Leech Book (circa A.D. 920). AB - The Leech Book, the oldest known Anglo-Saxon herbarium, probably written in Winchester, circa A.D. 920, by Cyril Bald or at his special request, contains a short chapter on the surgical treatment of the cleft lip; this chapter apparently represents the first record in a medical manuscript of this treatment. The original Anglo-Saxon text is presented together with transcriptions into more modern English. The general value of the Leech Book is briefly studied. PMID- 3517911 TI - Analysis of a dream of a 5 1/2-year-old boy by Hermine Hug-Hellmuth, Ph.D. PMID- 3517913 TI - Forensic psychiatry and literature Part I: Simenon's syndrome or De Clerambault's syndrome? (A psycho-literary postscript to erotomania). PMID- 3517912 TI - The woman psychiatrist in residency and practice. PMID- 3517914 TI - Psychotherapy in Nigerian psychiatric practice. An overview. PMID- 3517916 TI - Neuroleptic malignant syndrome: fatalities associated with neuroleptic use and schizophrenia. PMID- 3517915 TI - Escalating imipramine dosage requirements. PMID- 3517917 TI - A particular type of perverse marital relationship. PMID- 3517918 TI - Fatal metabolic disease and family breakdown. PMID- 3517919 TI - The young adult chronic inpatient: comparative analyses. PMID- 3517920 TI - Fifty years at the Washington School of Psychiatry. AB - The Washington School of Psychiatry, the distinguished institution that publishes Psychiatry, is in 1986 celebrating the fiftieth anniversary of its founding by Harry Stack Sullivan and his colleagues. Like most institutions that reach the half-century mark, the School is reflecting on its accomplishments--its contributions to the development of psychiatric thought and to the training of mental health professionals during that period. In presenting this brief history of the School's first five decades, I hope not only to review what the School has been in the past but also to emphasize the elements in the School's history that can and should serve as a solid foundation for the School's continued progress in the years ahead. PMID- 3517921 TI - Rationale exposure and compliance to relaxation training. PMID- 3517922 TI - Somatostatin-like immunoreactivity and acetylcholinesterase activities in cerebrospinal fluid of patients with Alzheimer disease and senile dementia of the Alzheimer type. AB - Somatostatin-like immunoreactivity (SLI) and acetylcholinesterase (AchE) activities were measured in the cerebrospinal fluid of 25 patients with senile dementia of the Alzheimer type (SDAT). Both SLI levels and AchE activities were reduced in the CSF of SDAT patients. The SLI levels and AchE activities were not correlated with the duration and the dementia score. However, in two patients the CSF SLI concentration was in agreement with the SLI levels in the frontal cortex obtained by biopsy. Our findings suggest that CSF SLI may be a good index of cortical SLI activities. PMID- 3517923 TI - Norepinephrine alterations under stress conditions following the regular practice of meditation. AB - The present study reexamined an investigation that found enhanced plasma norepinephrine (NE) levels during isometric handgrip after 30 days of meditation practice. Since hemodynamic activity did not show corresponding increases, it was suggested that meditation had down regulated the cardiovascular response to sympathetic stimulation. The present study assessed response to venipuncture as well as isometric stress. At posttest, meditators showed a trend towards higher plasma NE levels than controls during isometric handgrip. However, in contrast to previous speculation, this did not appear to represent cardiovascular down regulation. At the same time, meditators produced the greater NE levels during venipuncture, accompanied by marginally lower heart rate. The results support the association between regular meditation and noradrenergic hyperactivation, but suggest the need for further investigation of underlying mechanisms. PMID- 3517924 TI - [Use of imagination in suggestive therapy and the catathymic picture perception]. PMID- 3517925 TI - The extracranial-intracranial bypass study. PMID- 3517926 TI - The effect of increasing fibrinolysis in patients with rheumatoid arthritis: a double blind study of stanozolol. AB - Fibrin deposition in rheumatoid arthritis may be responsible for some of the clinical manifestations of the disease. It has been shown that in severe rheumatoid arthritis fibrinolysis is decreased but can be stimulated using the fibrinolytic enhancing agent stanozolol. A prolonged increase in fibrinolysis may decrease joint fibrin deposition and lead to clinical improvement and we have therefore investigated stanozolol as a therapeutic agent. Forty patients were enrolled. Twenty patients received stanozolol 5 mg twice daily for six months and 20 received a matching placebo. Assessment of disease activity was made in the conventional way. Results show that the two groups were comparable. After six months nine of the control patients had withdrawn because of drug ineffectiveness compared with two stanozolol patients, and five control patients felt they had improved compared with 15 stanozolol patients. Disease activity had significantly decreased by the end of the study in the treated group, and detailed analysis showed improvement in ESR, articular index, duration of morning stiffness and visual analogue pain scale. We suggest that stanozolol may be of value in rheumatoid arthritis although this pilot study has looked at only small numbers of patients over a short period. PMID- 3517927 TI - Breathing disorders during sleep. PMID- 3517928 TI - A clinical trial of a visible light-cured posterior composite resin restorative: two-year results. PMID- 3517929 TI - The combination acid etched retained and fixed partial denture. PMID- 3517930 TI - The spectrum of function--a classification system for attachments in removable prosthodontic therapy. PMID- 3517931 TI - Evaluation of a custom porcelain-fused-to-metal shade guide. PMID- 3517932 TI - Dowel-inlay repair of a loose crown of an endodontically involved tooth. PMID- 3517933 TI - Escherichia coli radC is deficient in the recA-dependent repair of X-ray-induced DNA strand breaks. AB - Escherichia coli K-12 cells incubated in buffer can repair most of their X-ray induced DNA single-strand breaks, but additional single-strand breaks are repaired when the cells are incubated in growth medium. While the radC102 mutant was proficient at repairing DNA single-strand breaks in buffer (polA-dependent repair), it was partially deficient in repairing the additional single-strand breaks (or alkali-labile lesions) that the wild-type strain can repair in growth medium (recA-dependent repair), and this repair deficiency correlated with the X ray survival deficiency of the radC strain. In studies using neutral sucrose gradients, the radC strain consistently showed a small deficiency in rejoining X ray-induced DNA double-strand breaks, and it was deficient in restoring the normal sedimentation characteristics of the repaired DNA. PMID- 3517934 TI - The effects of ionizing radiation on the pulmonary endothelial cell uptake of alpha-aminoisobutyric acid and synthesis of prostacyclin. AB - The effects of gamma irradiation (150-3000 rad) on prostacyclin synthesis (PGI2) and Na+-dependent amino acid uptake (alpha-aminoisobutyric acid, AIB) were assessed in vitro in bovine pulmonary artery endothelial cells grown in plastic culture dishes. A dose-dependent increase in both PGI2 synthesis and AIB was found 24 h after irradiation at exposure levels greater than 600 rad. The increase in PGI2 synthesis [297% of sham-irradiated values at 3000 rad, P less than 0.01] was due to an increase in release of arachidonic acid from plasma membrane stores as well as stimulation of cyclooxygenase and/or prostacyclin synthetase enzymes. The increase in AIB uptake (75% increase at 3000 rad compared to sham-exposure values) correlated with the increased synthesis of PGI2 (r = 0.94). There was also a dose-dependent increase in the number of cells that became detached from the culture dishes during the 24-h period after irradiation. The changes in PGI2 synthesis and AIB uptake induced by gamma irradiation differed if the endothelial cells were grown on cover slips, indicating that the endothelial response to irradiation may be dependent on the interaction between the endothelial cell and its extracellular basement membrane matrix. PMID- 3517935 TI - [Molecular-cellular mechanism of the oxygen effect]. AB - A new scheme of the oxygen effect is proposed for the radiation-induced reproductive cell death. According to this scheme, the oxygen effect manifests itself by the increased yield of lesions, and the thiol effect, by elimination of these lesions. The relationship between the oxygen effect and the enzyme repair can be explained by a change in the share of the oxygen-dependent and oxygen independent lesions in the lethal effect. The proposed scheme is in agreement with the experimental data which could not be explained earlier. The authors give the molecular description of the phenomenologic scheme symbols. PMID- 3517936 TI - [Modification of the radiosensitivity of E. coli cells by factors affecting the yield of photoreactivated damage]. AB - A study was made of the influence of irradiation conditions on the yield of the photoreactivable damages in radiosensitive mutants of E. coli cells (E. coli WP2). Pyrimidine dimers were shown to occur in exrA- and recA- mutants irradiated under anoxic conditions, the survival of these mutants being modified depending on cell genotype. The processes of direct excitation of the molecules were involved in the formation of the damages observed. It can be assumed that the lesser oxygen effect observed in exrA- and partially in recA- mutants of E. coli WP2 cells is associated with a contribution of the photoreactivable damages to a lethal effect of ionizing radiation. PMID- 3517937 TI - [Synthesis of lipids in the thymocytes of irradiated rats]. AB - During the first two hours following whole-body gamma-irradiation of rats with a dose of 7.5 Gy, the content of free cholesterol, phosphatidylcholine and phosphatidylethanolamine in the thymus decreases. Incorporation of 2-14C-acetate into cholesterol and fatty acids of thymus phospholipids in vitro is inhibited. At a dose of 4 Gy, incorporation of 2-14C-acetate into cholesterol and total lipids of thymocytes is activated. PMID- 3517938 TI - [Hematopoietic effectiveness of prostaglandin synthesis inhibitors during fractionated irradiation]. AB - In experiments on mice, a pronounced haemostimulating effect of prostaglandin biosynthesis inhibitors was registered in conditions of fractionated irradiation. The use of the preparations like these may be promising in solving the problem of protection of the haemopoietic tissue exposed during the radiotherapy course. PMID- 3517939 TI - [The effect of the frequency of periodic irradiation on the rate of inactivation of E. coli cells]. AB - It was shown that the periodic radiation source frequency influences the rate of E. coli cell inactivation. The impulse duration from 2 microseconds to 40 ns does not influence the survival of E. coli. The analysis of the survival curves obtained permitted to assess the contribution of the direct and indirect effects of radiation to microorganism inactivation. PMID- 3517940 TI - [Relation between the radiation sensitivity of the rat thymus and the subpopulation composition of its lymphocytes]. AB - The administration to rats of Freund adjuvant and conditions of their keeping in the autumn time reduce the mass and cellularity of the thymus and inhibit cell proliferation therein, the content of lymphocytes with high buoyant density being relatively increased. The indicated changes are accompanied by a two-fold increase in the death rate of thymus cells both after irradiation of rats and following four-hour incubation. PMID- 3517941 TI - [Anaerobic shift of energy metabolism in the mouse brain during the recovery period in acute radiation sickness]. AB - Three months after whole-body irradiation of mice with a sublethal dose of 5 Gy a study was made of some indices of energy metabolism like tissue respiration, oxidative phosphorylation, and formation of lactic acid in the survived brain homogenate. Revealed were the diminution of coupling of tissue respiration of oxidative phosphorylation, the rate of oxygen consumption and the level of cyano resistant respiration being constant, the increase in the rate of glycolysis in anaerobic and particularly, in aerobic conditions, and reduction of the Pasteur and Crabtree effects. The above mentioned changes in the brain energy metabolism seem to be a manifestation of the process of the reduced metabolism formation in the nervous tissue at the remote times after irradiation. PMID- 3517942 TI - [Modification of the radiation injury of hematopoiesis in rats using the gaseous hypoxic mixture GHM-10]. AB - In experiments on Wistar rats it was shown that gas hypoxic mixture containing O2 (10%) and N2 (90%) had a radioprotective action with regard to the survival rate for 30 days and to the haemopoietic system status. The application of gas hypoxic mixture reduced the postirradiation cytopenia in the blood and lowered the degree of the bone marrow depletion by the 3d day following irradiation; DMF was 1.25 as determined by total bone marrow cellularity. PMID- 3517943 TI - [The effect of post-radiation hypoxia on potential cell injury]. AB - The effect is described of increasing the reproductive death of pro- and eucaryotes by the action of a short-term (approximately 60 min) acute hypoxia after a single irradiation thereof in normal culture medium at the logarithmic phase of growth. The effect observed is probably associated with the fact that potential damages are poorly repaired and are fixed under hypoxic conditions. PMID- 3517944 TI - [Early changes in the lymphocyte surface membrane of rats after whole-body irradiation with neutrons and gamma rays]. AB - Biochemical changes in lymphocyte plasma membranes were studied 3 and 18 h after whole-body exposure of rats to neutrons and gamma-rays at doses from 2 to 6 Gy. It was shown that fast neutrons, with an average energy of 1.5-2.0 MeV, increased the rate of lipid peroxidation more markedly than gamma-rays did. In addition, there was an increase in the number of free aminogroups on the thymocyte surface. Dose- and time-dependent parameters of changes in the aminogroup content on the cellular surface were quantitatively different after the effect of radiation with different LET. PMID- 3517945 TI - [The effect of ionizing radiation on the functional properties of hemoglobin from fractionated cells of dog bone marrow]. AB - Cell populations of dog bone marrow enriched by erythroid cells were obtained by fractionation in a sucrose density gradient. Functional properties of the haemoglobin isolated from nucleate erythrocyte precursors were studied during the radiation injury development. The haemoglobin of later nucleate forms of the erythroid series of irradiated dog bone marrow exhibited an increase in its affinity to oxygen. PMID- 3517946 TI - [The effect of irradiation on dopamine level and metabolism in the rat brain]. AB - In experiments on rats it was shown that after 20 Gy irradiation dopamine and homovanilic acid content increases in the caudate nucleus and limbic structures of the forebrain: dopamine disappears more readily when its biosynthesis is blocked. The rate of the mediator degradation in the brain increases by 1.5-2 times, and the rate of the synthesis, by 3-5 times at early times after irradiation. PMID- 3517947 TI - [Impairment of antibody formation in the spleen of irradiated animals subjected to additional thermal injury]. AB - It was shown that the 3d degree thermal burn of 10% of CBA mouse body aggravates disturbances of antibodygenesis in the spleen of irradiated (4 Gy) animals. The aggravating effects of the thermal trauma manifests itself at the time of complete recovery of the postirradiation immunoreactivity and is not associated with the dynamics of injury and repopulation of T- and B-lymphocytes. PMID- 3517948 TI - [Nuclear medicine--brief scientific reports. 22d symposium of the Society for Nuclear Medicine of East Germany. Reinhardsbrunn, April 1985]. PMID- 3517949 TI - Schizencephaly: diagnosis and progression in utero. AB - Schizencephaly is an unusual condition of obscure etiology. Most theories of pathogenesis postulate an in utero insult leading to maldevelopment rather than destruction of brain. The cause has most often been described as vascular or idiopathic dysgenesis. The authors report a case in which two in utero ultrasound (US) examinations performed at 31 and 36 menstrual weeks demonstrated progressive deterioration of the relatively narrow, symmetrical clefts connecting the lateral ventricles with the subarachnoid space into broad defects that corresponded to the entire distribution of the middle cerebral arteries. The findings in this case document progressive destruction of brain tissue in utero and are consistent with a vascular cause rather than a failure of formation of portions of the cerebral mantle. PMID- 3517950 TI - Left coronary arterial blood flow: noninvasive detection by Doppler US. AB - Continuous wave (CW) and pulsed Doppler ultrasound studies with spectral analysis were used to detect the left coronary arterial blood flow in patients who were undergoing routine echocardiography. The pulmonary artery is a stable ultrasonic landmark from which detection of the blood flow can be effected. The left coronary artery can be distinguished by its blood flow toward the cardiac apex and by specific, functional flow features. Flow patterns vary among the left main, circumflex, and anterior descending arteries; patterns also vary with respiration cycles. In the present study, coronary arterial blood flow was detected in 58 of 70 patients (83%). Findings were validated by selectively injecting an agitated saline contrast medium into the left coronary artery and, in another study, by comparing human Doppler phasic flow waveforms with electromagnetic flowmeter recordings obtained in dogs. PMID- 3517951 TI - Obstruction of the superior vena cava or subclavian veins: sonographic diagnosis. AB - The normal subclavian vein shows a respiratory rhythmicity on sonograms and responds to a sudden sniff maneuver by collapsing in a rapid, transient manner secondary to the sudden decrease in intrathoracic pressure. Of 11 patients studied using ultrasound (US) for possible superior vena cava (SVC) obstruction, five patients with proved SVC obstruction had no response of the enlarged subclavian veins to respiratory maneuvers. One patient with a partial obstruction had a minimal response on one side. Two patients with isolated subclavian vein obstructions had no response on the affected side and a normal response on the contralateral side. Three patients proved not to have SVC obstruction had normal responses. Sonography of the subclavian veins may be an effective, indirect screening technique for the presence of SVC obstruction and can also be used to evaluate the patency of the subclavian vein, although the sensitivity and specificity of the method remain to be determined from a larger, prospective study. PMID- 3517952 TI - Automated breast sonography using a 7.5-MHz PVDF transducer: preliminary clinical evaluation. Work in progress. AB - Breast ultrasound imaging performed with an automated machine was carried out in 89 patients, and images obtained with a conventional ceramic single-focus 4-MHz transducer and a 7.5-MHz polyvinylidene fluoride (PVDF) transducer were compared. The 7.5-MHz PVDF transducer improved overall image quality in 77% of patients and had equal penetration in 83%. It yielded greatly increased diagnostic information in 43% of 81 masses and improved visualization of calcification in 57% of 14 lesions in which calcium was visible on mammograms. PMID- 3517953 TI - Aneurysmal portahepatic venous fistula: report of two cases. AB - Two cases are reported of congenital intrahepatic portacaval shunts in middle aged women who had encephalopathy or hypoglycemia. Real-time ultrasound (US) investigations revealed vascular communication between the left portal and hepatic veins in one patient and communication between the right portal and hepatic veins in the other. These findings were confirmed using angiography with pressure measurement. One patient underwent surgery; the other received dietetic treatment. The findings in these two cases are compared with those of three previously reported cases. PMID- 3517954 TI - Extrapancreatic spread of acute pancreatitis: new observations with real-time US. AB - Real-time ultrasonography (US) was compared with abdominal computed tomography (CT) in 40 patients with moderate to severe acute pancreatitis. Emphasis was placed on the ability of US to disclose peripancreatic involvement of the anterior pararenal spaces, lesser sac, and transverse mesocolon. When a realtime US scanning technique emphasizing semierect patient positioning and coronal views was used, 20 of 26 lesions in the anterior pararenal space (77%) and 14 of 14 abnormalities in the lesser sac (100%) were visualized. Abnormalities in the transverse mesocolon, however, were poorly detected on US scans. Ten patients (25%) in the study had extrapancreatic abnormalities missed by US. CT remains the imaging method of choice in patients with clinically moderate to severe pancreatitis. In patients with mild pancreatitis, the real-time US technique we describe improved extra-pancreatic visualization compared with previous studies using static scanners. A new US observation of perivascular spread of acute pancreatitis around the splenic and portal veins is described. PMID- 3517955 TI - The left-sided pancreas. AB - Ultrasonography (US) performed in nine patients (two with pancreatic carcinoma, one with hepatomegaly, six with no relevant abdominal disease) showed the pancreas to lie wholly to the left of the aorta. This not uncommon location may give rise to difficulty in demonstrating the pancreas on real-time US scans. The superior mesenteric vessels and splenic vein remain useful landmarks for locating the head of the pancreas in this position. PMID- 3517956 TI - Pelvic masses in pregnant patients: MR and US imaging. AB - Sixteen pregnant patients with pelvic masses detected with ultrasound (US) were studied with magnetic resonance (MR) imaging at 0.35 T. Two patients were in their first trimester, eight in the second, and six in the last. On MR images, 34 masses were seen, including 19 uterine leiomyomas. With US, 20 masses were detected. All masses not seen with US were leiomyomas. Only 20 masses (in 11 patients) were removed for histologic study. In nine cases, MR imaging and US provided similar information on the origin, extent, and type of mass. In seven patients, MR imaging contributed additional information. MR imaging depicted more leiomyomas than US in three patients. In another case, MR images showed that a mass depicted with US was actually a loop of bowel. MR images allowed differentiation between a solid soft-tissue mass and a hemorrhagic fluid containing mass, correctly depicted the presence of an abdominal pregnancy, and allowed evaluation of the parametrium for spread of cervical carcinoma. PMID- 3517957 TI - Ovary volume in young and premenopausal adults: US determination. Work in progress. AB - Normal adult ovary volume determined by ultrasonography (US) is often stated to be less than 6 cm3. This is based on data from teenagers and young adults aged 12 20 years. Recently, the mean normal volume determined by US was reported to be considerably higher. We measured the volumes of 28 ovaries from 15 healthy young adults and found them to range as high as 13.84 cm3, with an average of 6.48 cm3. PMID- 3517958 TI - Unsuspected pheochromocytoma: risk of blood-pressure alterations during percutaneous adrenal biopsy. AB - Four unsuspected pheochromocytomas were discovered during percutaneous fine needle biopsy of the adrenal gland under ultrasound (n = 1) and computed tomographic (n = 3) guidance. One patient suffered an acute episode of alternating hypertension and hypotension during the procedure. A second patient had no alterations in vital signs during the procedure but had a severe hypertensive crisis during induction of anesthesia at surgery. Neither biopsy nor surgery affected the vital signs in the other two patients. During biopsy study of adrenal lesions, the possibility of unsuspected pheochromocytoma should be considered, and the interventional radiologist must be familiar with the emergency treatment of hypotensive or hypertensive crises that may occur. PMID- 3517959 TI - Achilles tendon: US examination. AB - Real-time ultrasonography (US) using linear-array probes and a stand-off pad as a "waterpath" was performed to evaluate the Achilles tendon in 67 patients (including 24 athletes) believed to have acute or chronic traumatic or inflammatory pathologic conditions. Tendons in 23 patients appeared normal on US scans. The 44 abnormal tendons comprised five complete and four partial ruptures, seven instances of postoperative change, and 28 cases of tendinitis. US depiction of the inner structure of the tendon resulted in the diagnosis of focal abnormalities, including partial ruptures, nodules, and calcifications. Tendinitis was characterized by enlargement and decreased echogenicity of the tendon. The normal US appearance of the Achilles tendon is described. PMID- 3517960 TI - Achilles tendon: US diagnosis of pathologic conditions. Work in progress. AB - Twenty-three patients were prospectively examined with ultrasound (US) for acute or recurrent Achilles tendon symptoms. Three types of pathologic conditions of the Achilles tendon were found: tendinitis/tenosynovitis, acute tendon trauma, and postoperative changes. US appears to enable differentiation of these conditions and to contribute to the diagnosis of a broad range of Achilles tendon disorders. PMID- 3517961 TI - Quantitative computer techniques for analyzing coronary arteriograms. PMID- 3517962 TI - New radionuclides for cardiac imaging. PMID- 3517963 TI - Use of conventional and newer radiographic contrast agents in cardiac angiography. PMID- 3517964 TI - Exercise testing early after myocardial infarction: historic perspective and current uses. AB - Exercise testing performed earlier than six weeks post-MI is accepted as "standard" medical practice. Although both heart rate-limited and symptom-limited exercise protocols are used with nearly equal frequency, the latter appears more valuable because the prognostic yield is greater without sacrificing patient safety. Treadmill or cycle ergometers are the preferred modes of testing because of higher exercise work loads imposed and increased sensitivity and specificity of results. The physiologic exercise responses to graded work loads among these acute MI survivors include a mean maximal heart rate range of 118 to 136 beats/min, a peak systolic blood pressure between 137 and 170 mmHg, a mean peak double product from 16,000 to 22,400, and a mean maximal work load between 4.8 and 7.0 METS. Exercise findings which are most clinically useful are greater than 1 mm ST segment depression from rest level, presence of angina pectoris during exercise, decrease in systolic blood pressure with increasing work, presence of complex or frequent VEBs, and exercise tolerance less than 4 METS. These exercise findings identify, in recent post-MI survivors, groups of patients that have significantly different estimated future cardiac morbidity and mortality rates. The most consistent indices of multi-vessel coronary heart disease are ST segment depression, angina pectoris, and poor exercise tolerance. The most important role of stress testing in this period post-MI is identification of individuals who urgently need evaluation for coronary bypass surgery. In addition to risk stratification, exercise testing provides valuable information regarding exercise prescription for cardiac rehabilitation, direct psychologic benefit for resuming an active lifestyle, and motivation for exercise participation. Although safety of the early post-MI stress test has not been systematically studied, reports from individual studies indicated low morbidity and mortality. Attesting to this is the frequency with which it is performed as a routine office procedure. Finally, there has been a growing use of this procedure not only among cardiologists but also among internists and family practice physicians. PMID- 3517965 TI - Quantum calculations on proteins: the incorporation of environmental effects in quantum chemistry. PMID- 3517966 TI - The modelling of neural circuitry. PMID- 3517967 TI - Memantine in the treatment of senile dementia of the Alzheimer type. AB - The efficacy of the dopaminergic substance Memantine was studied in severe cases of senile dementia of the Alzheimer type using a randomized single blind trial. Following 20 days of a basis therapy, consisting mainly of the proper therapy of medical disorders, 10 patients received 20-30mg Memantine pro die intravenously, 10 other patients were given placebo infusions. Patients were evaluated using the Syndrom Kurztest, the Funktionspsychose-Skala, the Plutchik Geriatric Rating Scale as well as the Sandoz Clinical Assessment Geriatric 5 times following the baseline period. Statistical evaluation showed no significant differences between the two groups. Mild amelioration of sleep-wakefulness cycles and impulse and drive functions could be observed clinically in both groups. Side effects (deterioration of psychopathology in two patients of the Memantine group) disappeared after withdrawal of the substance. PMID- 3517968 TI - [Separation and removal of proteins from biological samples]. PMID- 3517969 TI - [Immobilized enzyme reactors--their use in chemiluminescence detection]. PMID- 3517970 TI - Monoclonal antibodies in cancer treatment: where do we stand after 10 years? AB - Monoclonal antibodies (MoAbs) with specificity to tumour-associated antigens have become increasingly available during the past years. Presently, they are being applied in various in vitro diagnostic assays. They have contributed to the knowledge of cancer biology to a large extent. The understanding of cell surface characteristics and antigenic phenotype of tumours has in particular influenced the approach in the treatment of leukemias and lymphomas. From successful tumour localization in patients by gamma-emitting radio-labelled MoAbs it became clear, that these proteins offer a unique possibility to target therapeutic agents to tumour sites. The mere administration of MoAbs did not result in sufficient clinical benefit, but with proper precautions high doses of murine antibody were well tolerated. In order to use MoAbs as a carrier system, various toxins, cytostatic drugs, or radionuclides have been conjugated to these proteins. Thus far, specific problems were encountered not only associated with the immunoconjugate itself, but also to its fate in the patient. With regard to the substantial knowledge on the use of MoAbs in vivo obtained from animal tumour models, immunoscintigraphy in patients, and phase I serotherapy trials, we will undoubtedly determine the optimal conditions required for a conjugated anti tumour agent to achieve enhanced cytotoxicity without increased side-effects. Preliminary results with high doses of 131I-labelled MoAbs in patients having tumour lesions expressing relevant antigens encourage further studies with immunoconjugates in cancer treatment. While much work needs to be done to further define the role of MoAbs as a new treatment modality in malignancies, this area of immunotherapy deserves great emphasis for the development of effective conjugates for future patients. PMID- 3517971 TI - The treatment of soft tissue sarcomas with focus on chemotherapy: a review. AB - Radical surgery remains the most effective treatment of soft tissue sarcomas. The postoperative addition of radiotherapy appears to reduce local recurrence in extremity lesions. To date, there are still only two drugs with major activity as a single agent in the treatment of soft tissue sarcomas: doxorubicin (DX) and ifosfamide (IFX). Doxorubicin should be administered preferably as 3-weekly bolus injections at doses higher than 60 mg/m2 because of its dose-response relationship. In combination chemotherapy ADIC and CYVADIC are probably the best choice. Although there are no definite data on increased activity with the addition of cyclophosphamide (CTX) and vincristine (VCR) to ADIC, we prefer CYVADIC because of the higher reported complete response rate. A limited number of patients with soft tissue sarcomas achieving a complete response with chemotherapy, will probably be cured, and for this reason it is important to aim at achieving a complete response. Preoperative intraarterial chemotherapy in locally advanced soft tissue sarcomas may further improve survival results, but before definite conclusions can be drawn, this technique should be investigated in randomized studies. Postoperative adjuvant chemotherapy should still be considered investigational, as no advantage has been observed in head, neck and trunk lesions, while data on extremity lesions are still conflicting. PMID- 3517972 TI - Tumour growth delay as a clinical endpoint for the measurement of radiation response. AB - Tumour growth delay has been investigated as an endpoint of radiation effect in selected patients with superficial metastases measured by calipers and ultrasound. Of 42 patients referred for study with two or more nodules, 17 were suitable for entry into protocols evaluating single or multifraction treatment. The reproducibility of tumour growth delay to the same dose schedule was evaluable in four patients and the sensitivity to 10-20% differences in total dose was evaluable in three patients. No significant size dependency was detected in the response of nodules to radiotherapy and the findings suggest that the growth delay endpoint is sensitive to 20% differences in radiation dose. Evaluable patients with multiple measurable nodules are uncommon but constitute a valuable resource for the testing of biological response modifiers, including radiosensitizers. PMID- 3517973 TI - Multiple fractions per day in retrospect; the L-Q model and the tolerance profile. AB - Multifractionation was about half a century ago used in radiation therapy. This becomes clear from a review of the literature. One case, reported to have been treated by Coutard with multifractionation is discussed in detail. In order to compare the various treatment modalities the authors have plotted the Extrapolated Tolerance Dose (ETD) against the alpha/beta dose (parameters featuring in the linear-quadratic model, L-Q model), and derived the idea of a "tolerance profile". The case treated by Coutard remains closely within the limits of the present day tolerance profile. It remains unclear why multifractionation has disappeared as a treatment modality for 50 years before returning recently. PMID- 3517974 TI - Genetically-engineered microorganisms: I. Identification, classification, and strain history. AB - We have argued that accurate identification of the microorganism will form a cornerstone of the assessment of potential hazard. Appropriate methodology for identification exists, and is continually under development and refinement. Organizations such as the American Type Culture Collection will perform certified identifications for relatively low cost. Thus there appears to be little reason that an organism should not be identified insofar as current microbiology allows prior to submission for PMN review. We suggest that a complete microbiological characterization be considered an essential element of an acceptable PMN. To accomplish this, however, current institutional arrangements for the protection of trade secret information needed in the process of identification may need to be improved. An accurate identification of the strain will often provide access to important information with which to evaluate its ecology, pathogenicity, biochemistry, and genetics. Specialized texts, the scientific literature, and professional consultation are ready sources of such information. However, a major effort should be made to establish a data base that can specifically address the needs of biohazard evaluation. This could be done, in part, by collecting information about the construction, and about the behavior in the environment of genetically-engineered microorganisms that are now under development and will soon be tested or used. Identification information may also eventually be useful for the formulation of hypotheses about possible modes of harm or about relative safety, based on phylogenetic relationships. This is a very difficult undertaking at present, however. Microbial taxonomy is currently in a process of radical reevaluation as new macromolecular sequence information reveals previously unsuspected phylogenetic relationships, and disturbs categorizations based on older types of traits such as morphology, etc. This means that both inferences about relative safety and about possible modes of harm from taxonomic relationships must be highly tentative based on current information. Regulatory authorities may wish to consider requesting confirmatory DNA hybridization data or other macromolecular sequence comparisons in cases where strong arguments related to safety must be made from taxonomic information in relatively poorly studied groups of organisms. Detailed strain histories would provide valuable information for safety evaluations.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3517975 TI - [Equipments and instruments for use in radiological protection (IV). Characteristics and use of area monitors and water monitors]. PMID- 3517976 TI - [Echographic diagnosis of acute rejection of the transplanted kidney]. AB - After a general review of the US findings in acute renal allograft rejection, the results are discussed of a retrospective sonographic-histologic study in 17 patients affected by acute rejection. The high sensitivity of sonography in detecting acute rejection is confirmed, but echographic studies were unable to differentiate between vascular and cellular sub-types of rejection and to provide a prognostic evaluation. PMID- 3517977 TI - [Mammary echography. Comparison with mammography]. AB - The analysis of 249 cases of mammary pathologic conditions, confirmed by cytologic and/or histological examinations, comparatively studied by echography and mammography, shows a better diagnostic accuracy of US compared with mammography in benign pathology. The authors emphasize that US, although displaying lower diagnostic accuracy than mammography in malignancies, allow to correct some diagnostic mistakes of mammography, showing complementarity of both techniques, at least in women aged 30 to 50 years; in women under 30, US may be the first choice examination, while showing considerable limits in the fatty breasts of old women. PMID- 3517978 TI - ["Umbilicate" aspect of some lateral cervical adenomegalies. A possible sign of benign characterization?]. AB - Fifty-one patients were examined by sonography for suspicious cervical adenopathies. In 11 the adenopathies, histologically benign, showed typical "umbilicate" aspect. We present this aspect as a possible benign sign and we advance a pathological interpretation. PMID- 3517979 TI - [Use of diagnostic imaging in an atypical case of echinococcosis of the iliopsoas muscle]. PMID- 3517980 TI - [Echographic evaluation of a case of "erysipelas of the scrotum"]. PMID- 3517981 TI - Classification and forms of inebriety. Historical antecedents of alcoholic typologies. AB - This chapter reviews 39 typological classifications of alcoholics published in the world alcohol literature between 1850 and 1941. After a brief discussion of the concept of typology within the Western intellectual tradition, the typologies are described in terms of classification criteria, cultural context, and historical trends. Four countries (France, Germany, England, and the United States) accounted for all but one of the typologies. Within countries, typological theories tended to be concentrated during specific historical periods, often reflecting prevailing trends in medicine, psychiatry, and clinical practice. Despite a number of common themes, there was little indication of the progressive development of typology theory in a predictable direction. Like their counterparts in contemporary times, these typologies failed to gain widespread acceptance as the basis for theoretical explanations or clinical practice. Rather, their function was more likely to serve as justifications for the disciplinary or policy orientations held by the typologists. It is concluded that unless typologies are formulated on the basis of careful research, sound theory, and clinical relevance, they are likely to be relegated to a similar status as historical artifacts. PMID- 3517982 TI - [Erythema nodosum associated with Salmonella enteritidis gastroenteritis]. PMID- 3517984 TI - [Liver preservation: fundamentals, current situation and prospects]. PMID- 3517983 TI - [Percutaneous puncture cholecystography under echographic control. Presentation of 2 cases]. PMID- 3517985 TI - [Interaction among anaerobic microbe species in the rumen]. AB - The rumen is a strictly anaerobic ecosystem colonized by an extremely dense microflora and microfauna. These populations are composed of a grand variety of bacterial and protozoal species. Their cohabitation allows observation of most of the known stages of communal life. The different hydrolytic, fermentative and methanogenic activities of these populations ensure the efficient degradation of cell wall constituent in forages (cellulose, hemicellulose, pectin) ingested by ruminants. PMID- 3517986 TI - [Influence of dietary factors on microbial protein synthesis in the rumen]. AB - The effect of dietary factors (usually controlled in practice) on microbial protein synthesis is reviewed using in vivo experiments. Attention is drawn on the necessity to clearly distinguish variations in microbial growth efficiency from those of intestinal flow of microbial protein and to consider simultaneously variations in feed protein degradation. In practice, the relationship between microbial protein synthesis and energy intake depends mainly on diet composition and the nature of the forage. Microbial protein flow to the intestine, relative to energy intake, is lower with high concentrate diets (when given in restricted amounts), with silages and with antibiotic supplements. This flow is increased by some forage processing (such as dehydration and alkali treatments), by natural or induced defaunation, and occasionally by increased feeding frequency (when intake is restricted) and buffer and vitamin supplements. However, with some factors such as feeding frequency and antibiotics supplementation, these variations are partly counterbalanced by reverse effects on feed protein degradation. PMID- 3517987 TI - [Liver metabolism of carbohydrates and lipids in ruminants: principal interaction during gestation and lactation]. PMID- 3517988 TI - Effects of D-glucose during preincubation of pancreatic islets with 45Ca upon the subsequent stimulation of 45Ca outflow by hypoglycemic sulfonylureas and K+. AB - Nonnutrient secretagogues, such as gliclazide or a high extracellular concentration of K+, are known to stimulate 45Ca outflow from prelabelled pancreatic islets. The present study aimed at characterizing the dose-related effect of D-glucose during preincubation of the islets with 45Ca upon the magnitude of the subsequent increment in 45Ca efflux evoked by these nonnutrient secretagogues in the prelabelled islets. Such an increment was much greater in islets first incubated with D-glucose than in islets prelabelled in the absence of exogenous nutrient. The effect of D-glucose was already evident at a concentration of 5.6 mM but a further increase in 45Ca outflow was seen in islets preincubated at higher glucose concentrations. The effect of D-glucose was not attributable to a higher net uptake of Ca2+ in response to stimulation by a given nonnutrient secretagogue. Instead, the present data suggest that glucose, in addition to stimulating Ca2+ inflow into the islet cells, favours the sequestration of the cation by intracellular organelles. PMID- 3517989 TI - Nicotine enzyme immunoassay. AB - In the present study of the use of racemic aminonicotine as a functionalized hapten, nicotine antibodies suitable for use in nicotine determinations have been produced from antigens in which both 'flexible' and 'semi-rigid' chains serve to couple racemic 6-aminonicotine to bovine serum albumin. Nicotine enzyme immunoassay has been developed for the first time using antibodies produced against 6-epsilon-aminocapramido -DL-nicotine and beta-galactosidase nicotine enzyme. The assay is a double antibody method which requires 60 and 15 min incubation respectively. The correlation of nicotine pooled plasma was found to be 0.994 with very good precision and accuracy. The sensitivity, defined as the concentration of nicotine measured at delta F/delta Fo = 90%, was found to be 10 micrograms/1. Samples of human smokers (N = 9) after 1 cigarette at 3 min were 50 100 micrograms/1, and at 15 min were 30-60 micrograms/1. PMID- 3517990 TI - Epidemiological study of swine influenza virus as a component of the respiratory disease complex of feeder calves. AB - A survey of 177 paired calf sera collected during the years 1978-1981 showed that 3.4% of the calves had prior experience with swine influenza virus. Six calves positive by the single radial hemolysis test (SRH) were also positive by the virus neutralization test (VN) in chicken embryos, and one calf reacted with all three tests (hemagglutination-inhibition (HI), SRH, and VN). The SRH and HI tests available cannot adequately provide the information necessary in a survey of this sort. The HI test is subject to too many variations to enable the data to be used with any degree of confidence. The SRH test lacks accepted standarization for performing the test with cattle sera. Therefore, the VN test is necessary for confirmatory results. PMID- 3517991 TI - Emigration of polymorphonuclear leucocytes into the intestinal lumen of the neonatal piglet in response to challenge with K88-positive Escherichia coli. AB - The emigration of neutrophils from the blood of neonatal piglets into the intestinal lumen in response to a K88-positive strain of Escherichia coli was investigated. The pig herd used was of known genetic susceptibility to K88 positive E coli and had recently experienced an outbreak of neonatal diarrhoea. Neutrophil emigration depended on certain factors. Neutrophils emigrated into ligated loops in susceptible piglets sucking immune colostrum from susceptible dams but not into loops in colostrum deprived resistant piglets or piglets sucking non-immune colostrum from resistant dams. In susceptible, colostrum deprived piglets neutrophils in intestinal contents were only associated with severe lesions. Large numbers of neutrophils which appeared at several foci on the villi were observed in three of six resistant piglets that sucked immune colostrum from susceptible dams. It was concluded that neutrophil emigration into the intestinal lumen of piglets could occur in response to K88-positive E coli and resulted not from the presence or absence of the intestinal K88-receptor but from the ingestion of immune colostrum. PMID- 3517993 TI - Changes in immunoglobulin levels in whey during experimental Streptococcus agalactiae mastitis. AB - Total protein and immunoglobulin levels in the wheys of eight first lactation heifers, four vaccinated and four unvaccinated, were measured during three consecutive experimental intramammary infections with Streptococcus agalactiae. There were no significant differences between infections 1, 2 and 3 in the protein or immunoglobulin content of the uninfected quarters. Peak whey total protein of the infected quarters came earlier with each infection, until by the third they were seen after eight hours. During this acute phase a reversal of the normal milk IgG1/IgG2 ratio in all infected quarters was measured. Increases in whey IgA and IgM in the infected quarters of the vaccinates were also noted. A similar response only occurred following the third infection of the unvaccinated animals. All whey immunoglobulin levels returned to normal by 48 hours after infection, after which only IgG1 levels increased in infected quarters. PMID- 3517992 TI - Effects of flunixin meglumine, phenylbutazone and a selective thromboxane synthetase inhibitor (UK-38,485) on thromboxane and prostacyclin production in healthy horses. AB - The efficacy of three agents which alter the metabolism of arachidonic acid was investigated in normal, conscious horses. A dose response evaluation was made of flunixin meglumine and phenylbutazone, two cyclo-oxygenase inhibitors, and of a selective thromboxane synthetase inhibitor, UK-38,485. Radioimmunoassay of thromboxane B2 (TxB2) and 6-keto prostaglandin F1 alpha (PGF1 alpha) was used to assess the concentrations of thromboxane A2 (TxA2) and prostacyclin (PGI2) respectively, in serum. Flunixin was the most potent inhibitor of serum TxB2 and 6-keto PGF1 alpha production. UK-38,485 also decreased serum TxB2 generation while significantly increasing serum 6-keto PGF1 alpha levels, thus confirming its selectivity as a thromboxane synthetase inhibitor. PMID- 3517994 TI - Theileria orientalis occurs in Central Africa. AB - An outbreak of bovine theileriosis in Burundi was investigated and the occurrence of Theileria orientalis in Central Africa was confirmed for the first time. Its identity was established on morphological and serological grounds. The parasite was associated with clinical signs and further complicates the disease picture of bovine theileriosis in Africa. Amblyomma variegatum is suspected as being the local vector. PMID- 3517995 TI - Embedding of skeletal tissue in plastic for vascular and histological study to demonstrate delayed endochondral ossification in Leghorn type fowl. AB - A method is described which enables visualisation of the blood supply in developing avian long bones, followed by the preparation of undecalcified histological sections from the same material. The circulatory system was perfused with a solution of fixative, dye and barium sulphate. The skeletal tissue was cleared in plastic resin before embedding and tissue blocks were cut into 1 mm slabs. The vascular canals were then examined with a dissecting microscope. Slabs were re-embedded in resin and 5 microns sections cut for routine undecalcified histological staining. Focal areas of delayed endochondral ossification were demonstrated in slabs prepared from the proximal ends of femora of White Leghorns. These lesions are considered a less severe form of the dyschondroplastic condition occurring in broilers. PMID- 3517996 TI - The toxicology of methyl ethyl ketone. PMID- 3517997 TI - 1,3-Dichloropropene. PMID- 3517998 TI - Scleral buckling methods for rhegmatogenous retinal detachment. AB - Scleral buckling techniques are effective in treating most eyes with rhegmatogenous retinal detachment, and usually the final visual result is limited only by possible preexisting macular damage due to the detachment. Still, a variety of techniques are used, including exoplant or implant methods for the scleral buckle; cryotherapy, diathermy, or photocoagulation to cause the chorioretinal adhesion; and drainage or nondrainage of subretinal fluid. Also, recent development of alternative surgical techniques such as vitreous surgery and/or intraocular gas injection have raised questions about the current role of scleral buckling methods. This article reviews the principles and techniques of scleral buckling for retinal detachment and describes the methods we have found most useful. PMID- 3517999 TI - [Non-invasive measurement of arterial oxygen saturation]. PMID- 3518000 TI - [Electrophysiologic examination of the heart]. PMID- 3518001 TI - [Experimental evaluation of calcium channel blockers for preventing coronary atherosclerosis in the heterotopic rat allograft]. PMID- 3518002 TI - [Effects of OP-41483.alpha-CD, a prostacyclin analog, in the treatment of congestive refractory heart failure--efficacy as a vasodilator]. PMID- 3518003 TI - Alterations in pulmonary fluid balance induced by positive end-expiratory pressure. AB - We examined the consequences of positive end-expiratory pressure ventilation (PEEP) on pulmonary lymph flow in normal lungs and in lungs with alloxan-induced vascular injury. Studies were made in anesthetized sheep prepared with a lung lymph fistula. Prior to lung injury, the sheep were subjected to a protocol consisting of ventilation with zero end-expiratory pressure (ZEEP) for 1 h followed by ventilation with 20 cm H2O PEEP for 1 h. Subsequently, each animal received an infusion of alloxan (0.75 mg/kg i.v.) during ZEEP ventilation to induce lung vascular injury. ZEEP ventilation was maintained for 1 h and was followed by 1 h of PEEP ventilation. Alloxan infusion more than doubled lymph flow and lymph protein flux from baseline. PEEP ventilation did not affect lymph flow and lymph protein flux of normal lungs. However, in the alloxan-injured lung, PEEP ventilation caused significant decreases in lymph flow and lymph protein flux. Although PEEP ventilation redistributed regional pulmonary blood flow, as determined by radiolabelled microspheres, changes were identical in the normal and the alloxan-injured lung. The results indicate that PEEP ventilation does not alter fluid balance in the normal lung. However, PEEP ventilation depresses lymphatic flow in the injured lung, which may increase extravascular lung water content. PMID- 3518004 TI - [Malaise and loss of consciousness in the elderly patient: prospective evaluation of methods of investigation]. AB - 60 consecutive patients (mean age: 80,7 yrs; s.d.: 6,1 yrs; range 70-94 yrs) referred to a geriatric medicine department with syncope or dizziness were proposectively compared with 40 age and sex matched controls. A battery of non invasive investigations including tilt-test, glycemia, 12 lead ecg., eeg, 24 hour ambulatory ecg recording,. M--mode echocardiogram and cervical Doppler velocimetry was applied blindly to patients and controls. The proportion of abnormalities was similar in both groups having sick sinus syndrom or complete atrio-ventricular block versus no control (p less than 0.05). By contrast history case was of great predictive value: 6 of 13 patients reporting abrupt syncope had a 24 ecg recording showing sick sinus syndrom or complete atrio ventricular block, versus 2 of 47 other patients (p less than 0,01); 11 of 14 patients reporting orhostatic dizziness or syncope had a tilt-test consistent with orthostactic hypotension versus 6 of 46 other patients (p less than 0,01). PMID- 3518005 TI - [Treatment of chronic renal insufficiency by continuous ambulatory peritoneal dialysis]. PMID- 3518006 TI - Evolution of attitudes toward occupational health in the U. S. A. AB - Attitudes toward ill-health associated with workplace are inevitably closely linked to attitudes toward disease occurring generally, and these have evolved remarkably slowly since the Middle Ages. By the nineteenth century in western countries, at least, people considered disease as a retribution for sins against God, or as a result of bad luck. Certainly this attitude was a factor in why the advent of the germ theory was followed only very slowly by measures aimed at preventing infections brought about from water, food, or airborne sources, even when methods for doing so were well understood. Today, attention is directed toward chronic degenerative diseases and cancer, with their long periods of development, and preventive approaches to these diseases are similarly slow to be applied. In part because the U. S. A. is a relatively young country, with a rapid influx of immigrant labor in this century, the contribution of occupations to injury, ill health and disease has been too seldom recognized. Doctors or nurses working in industries have usually focussed their attention on traditional health care techniques. In the U. S. A. there has recently been, however, a change, at least by ordinary citizens, toward recognizing the importance of prevention of disease. In the context of work-related illness, this recognition has been accelerated by recent legislation which makes employers legally responsible for detecting adverse effects on health of workers and the general public arising from their operations. Paradoxically the Occupational Safety and Health Act of 1970 has been less effective in bringing about a change of awareness of occupational disease than has the Toxic Substances Control Act of 1977.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3518007 TI - Ultrasonic tissue characterization of malignant lymphoma. AB - The echographic characteristics and ultrasonic tissue characterization of malignant lymphoma are reported. The patient was a 72-year-old man with stage IV malignant lymphoma of medium cell type and had lymphomatous involvements in the liver, the spleen, and peripancreatic, para-aortic, hepatic and splenic hilar lymph nodes. The echo-characteristics were hypoechoic in nature in all these involved lesions and the histologic specimen at the border between the lymphoma lesion and the liver was examined as well as the peripancreatic lymph node from the viewpoint of the ultrasonic tissue characterization. It was concluded that the rich cellularity in the homogeneous nature when compared with the surrounding structure, can produce hypoechoic lesion in routine clinical echograms. PMID- 3518008 TI - [Cutaneous manifestations of AIDS]. PMID- 3518010 TI - [The pharmacology of antimalarials]. PMID- 3518009 TI - [Genetic toxicology and occupational medicine: prospects of its use]. PMID- 3518011 TI - [Malaria despite chemoprophylaxis: problems for diagnosis and therapy]. PMID- 3518012 TI - [Current recommendations for malaria prevention]. PMID- 3518013 TI - [Practical experience with mefloquine as an antimalarial]. PMID- 3518014 TI - [The future of life support measures in terminal renal failure]. PMID- 3518015 TI - [Plague control at Gotthard. The 1585 Milan-Swiss agreement in the light of modern research]. PMID- 3518016 TI - [Myoclonia. From the myoclonia of Papio papio to various human myoclonias]. AB - The baboon Papio papio is naturally predisposed to present several types of myoclonus, the study of which can help in understanding the various human myoclonic symptomatologies. The three types of myoclonus which are studied have been called A, B and C. Myoclonus A, which is induced by intermittent photic stimulation in photosensitive animals, is of epileptic nature: It is always preceded by spikes-waves predominating in the fronto-rolandic cortex (areas 4 and 6) and can be followed by secondarily generalized tonic-clonic seizures. Myoclonus B, which occurs when the animal is agitated, is facilitated by somatic stimulations. Since it is never preceded or accompanied by spikes-waves and since it is never associated with epileptic seizures, myoclonus B is considered as non epileptic. Myoclonus C occurs during wave-sleep. They are associated with spikes waves during the slow but not during paradoxical sleep. Myoclonus A, B and C can co-exist in the same animal when it is photosensitive. Myoclonus B and C can co exist in the same animal when it is non-photosensitive. Clinically, the three types of myoclonus have different symptomatologies. Myoclonus A is bilateral and synchronous. It always involves initially the eyelids and face. It can secondarily become generalized to the whole body. Myoclonus B, which is also bilateral and synchronous, is limited to the truncular musculature and to the proximal part of limbs. It never involves the eyelids and face. It never becomes generalized. Myoclonus C has a variable symptomatology and can be parcellar. The nervous structures originating the three types of myoclonus in the baboon are not identical. Myoclonus A is originated in the fronto-rolandic cortex, where a neuronal generator is triggered by visual inputs induced by photic stimulation. It appears mainly due to a dysfunction of the GABA system, because it is suppressed by GABA agonists and by benzodiazepines. On the contrary, it is facilitated by GABA antagonists. Myoclonus B has probably its origin in the lower brain stem (ponto-bulbar reticular formation) and is favored by cerebellar lesions. It appears mainly due to a dysfunction of the cholinergic system and is considerably facilitated by atropine. Myoclonus C can also have its origin in the lower brain stem but, contrary to myoclonus B, it can involve the cortex and thus can be accompanied by spikes-waves. The 3 types of myoclonus which are distinguished in the baboon have different relationships with epilepsy.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3518017 TI - [French Neurology Society. List of members (1986)]. PMID- 3518018 TI - Increased frequency of non-insulin-dependent diabetes mellitus among narcoleptic patients. AB - Forty-eight narcoleptic patients were randomly selected from a group of 197 narcoleptic outpatients, and a 50-g oral glucose tolerance test (OGTT) was performed. Blood glucose levels were determined by oximetry before and 30, 60, and 120 min after the glucose administration. Serum insulin concentrations (IRI) were determined by enzyme immunoassay, and an insulinogenic index (II) was calculated. (II = the ratio of IRI increment to blood glucose increment in 30 min following glucose load). From the results of the OGTT, six patients with definite diabetes mellitus (DM) were identified (12.5%, 4 men and 2 women) according to World Health Organization criteria (1980). The II of the DM patients was significantly low, with an average of 0.13 +/- 0.03. From recent data in the literature on the prevalence of DM in the general Japanese adult population (1.75 5.5%), it was concluded that the frequency of DM among our randomly selected narcoleptic patients was significantly increased. The positive results for diabetes in our six narcoleptic patients could not be attributed to obesity, because there was no difference between the obesity indices of DM and nonDM narcoleptic patients, nor was there a difference between the frequency of DM in obese and nonobese patients. PMID- 3518019 TI - Treatment of narcolepsy with codeine. AB - The effectiveness of codeine as a treatment for the excessive daytime sleepiness of narcolepsy was studied in two experimental trials. In an open trial of codeine in five narcoleptic subjects, dramatic clinical improvement was reported. However, all-night polysomnography and maintenance of wakefulness tests before and after codeine showed no significant differences. A double-blind placebo codeine trial was conducted in which eight narcoleptic subjects received codeine for 1 week and placebo for 1 week in a random order. During the week they kept a diary, and on the sixth evening and for 10 h following awakening on the seventh day they were monitored by radiotelemetry in the sleep laboratory for electroencephalogram, electro-oculogram, and electromyogram. The results were analyzed for sleep stages as well as four levels of wakefulness. The results showed no significant differences in any of the objective sleep or wakefulness parameters. However, the diaries showed significantly fewer naps during the week on codeine as compared with the placebo week. Eighteen of 27 narcoleptic patients treated with codeine report clinical improvement. Codeine consistently results in subjective clinical improvement. However, this is not reflected in the objective measures generally used to assess daytime sleepiness. PMID- 3518020 TI - Group B streptococcal endocarditis: report of seven cases and review of the literature, 1962-1985. AB - Infective endocarditis is an uncommon manifestation of group B streptococcal disease. Seven cases of group B streptococcal endocarditis are reported herein. Another fifty-five cases published in the literature since 1962 are reviewed: the male to female ratio was 1.4:1. The average age was 53.8 years, and 45% of patients were 60 years of age or older. Two cases of nonsocomial endocarditis and two cases of polymicrobial endocarditis were identified. There were five cases of prosthetic valve endocarditis. Mitral and aortic valvular involvement were present in 48% and 29% of cases, respectively. Underlying heart disease was found in more than half of the cases. Rheumatic heart disease was the commonest underlying cardiac condition. Noncardiac underlying conditions included diabetes mellitus, alcoholism, pregnancy, intravenous drug abuse, and genitourinary disease. Onset was varied as was initial presentation of the disease. Large arterial thrombi were common. Overall mortality was 43.5%. Penicillin is the treatment of choice for group B streptococcal endocarditis. However, based on in vitro and in vivo studies as well as case reports, some authors feel that the combination of penicillin and an aminoglycoside is a superior regimen. Cephalothin or vancomycin are alternatives for patients who are allergic to penicillin. PMID- 3518021 TI - Problems in salmonellosis: rationale for clinical trials with newer beta-lactam agents and quinolones. AB - Disease syndromes caused by Salmonella species continue to be important, as evidenced by a major outbreak of infection due to multiresistant Salmonella typhimurium in 1985; this outbreak involved more than 12,000 people in five north central states of the United States. Salmonella species have become progressively more resistant in recent years to the clinically useful antibiotics (trimethoprim sulfamethoxazole, ampicillin, and chloramphenicol). The clinical experience accumulated thus far indicates that two new classes of antimicrobial agents, the third-generation cephalosporins and the quinolones, offer significant potential for the treatment of specific problems in salmonellosis: bacteremia and enteric fever, meningitis, osteomyelitis, and the chronic carrier state. PMID- 3518022 TI - Microbial ribosomal vaccines. AB - Ribosomal vaccines have been prepared from several different bacterial, fungal, and protozoan microorganisms. Most of these preparations offer a higher degree of protection than do vaccines made from the homologous whole cells, but the mode of protection is controversial. All of the reported ribosomal vaccines are contaminated with cell surface determinants. Antisera raised to ribosomal preparations are directed to innate ribosomal components as well as to surface antigens. Several hypotheses exist for the reported protection from disease: the cell surface contaminants serve as the protective moieties; ribosomes act as potent adjuvants for contaminating cell surface determinants; ribosomes innately contain antigenic determinants that cross-react with cell surface antigens; recently translated cell surface polypeptides are still attached to the ribosomal RNA in the ribosomes; ribosomes migrate from the cytoplasm of the microbe to the periphery of the cell, and ribosomal antigens are exposed on the cell surface; or ribosomes contain messenger RNA and produce microbial cell surface polypeptides in immunized individuals. A short description of the biochemical, biophysical, and structural characteristics of prokaryotic and eukaryotic ribosomes is presented, followed by a discussion of the ability of various ribosomal vaccines to protect against infectious agents. PMID- 3518023 TI - [Influence of echography on the psychological course of pregnancy]. AB - In an attempt to define the psychological impact of obstetrical ultrasonography, we have had semi-directive talks with 86 pregnant women coming from 3 different institutions. We asked them about the image that they had of that examination: its function and the type of information it could provide. The experience of the ultrasonographic examination was then analysed: what reactions did the ultrasonographic image provoke? In the case of the father as well as the mother how do the women perceive what the physician has to say to them? Ought the ultrasonographist to tell them of possible malformations of the child and its sex? The confrontation between the child imagined by every expectant mother and the image of the actual foetus which is presented to her does not always pass without problems and appears to be clearly linked to the kind of relationship which has been established between the physician and his patient. PMID- 3518024 TI - [Renal transplantation and pregnancy. Apropos of a case]. AB - A cystic disease of the medulla is found in a young women at the 5th month of her first pregnancy and entails the death of the foetus in utero. The chronic renal insufficiency rapidly worsens and necessitates periodic hemodialysis. Renal transplantation is carried out from a brother with identical HLA. Two years later the graft is functioning well enough to permit another pregnancy. It proceeds without accompanying nephropathy. A caesarean operation carried out 36 weeks after amenorrhea gives birth to a girl who presents normal psychomotor development at two years of age. The authors consider the influence of pregnancy on the functioning of the kidney graft and the criteria permitting pregnancy after a renal transplant. They discuss the consequences of a renal transplant on the progress of the pregnancy and delivery. Finally, they study the effects of immunosuppressive treatment on the child in the short and long term. PMID- 3518025 TI - Cosmetic laminate dentistry--for better or for worse. Part III--The porcelain laminates. PMID- 3518026 TI - Development of the immune system in children. PMID- 3518027 TI - Autoantibodies in Burkitt's lymphoma patients from the Ugandan prospective study. AB - Pre- and post syndrome sera from five Burkitt's lymphoma patients who partook in the Ugandan prospective study (A. Geser et al., Int. J. Cancer 29 (1982) 397-400) were investigated with respect to autoantibodies. Neighbours and siblings of these patients served as controls and all of these groups were compared with sera from 50 Caucasian normal controls (CNC). Antibody levels significantly higher than those in CNC were found in all African groups for actin, desmin, vimentin, tubulin, keratin, laminin, and collagen type I. Polyclonal B-cell activation, as measured by antibodies to DNP, and high levels of antibodies to P. falciparum were also found. Anti-DNP and antibodies to malaria were also present in sera from our earlier study on Burkitt's lymphoma (E. Vainio et al., Clin. exp. Immunol. 54 (1983) 387-396). Whereas EBV infected B cells do produce autoantibodies, there is a potentiation of autoantibody formation as a result of infection with malaria, which seems to provide an independent trigger of polyclonal B cell activation. This latter event might be one of the factors which results in a correlation of Burkitt's lymphoma with malaria endemic regions. PMID- 3518028 TI - Prognostic significance of tissue carcinoembryonic antigen in mild dysplasia of the uterine cervix. AB - Two murine monoclonal antibodies to carcinoembryonic antigen (CEA) were used to detect CEA by the immunoperoxidase staining method in mild dysplasia of the uterine cervix in order to evaluate the prognostic significance of the expression of this antigen. The high affinity antibodies (Ha) detected CEA determinants in 53% of the 47 lesions studied while 40% of the epithelial changes were positive with the low affinity antibodies (La). Ha antibodies stained ten out of the 16 progressive lesions (62%), while La antibodies detected CEA determinants in 38% of these. Forty-eight per cent of the 23 regressive lesions were CEA positive with Ha and 39% with La antibodies respectively. The eight persistent lesions expressed CEA equally frequently (50%) with both antibodies. The results indicate that tissue CEA in patients with mild cervical dysplasia does not reflect malignant potential. PMID- 3518029 TI - [Hormonal mechanisms of puberty]. PMID- 3518030 TI - Fibronectin in plasma and synovial fluid of patients with rheumatic diseases. AB - Fibronectin is a high molecular weight glycoprotein from plasma and other body fluids, connective tissue matrix and basement membranes. No significant differences in the mean values of plasma fibronectin were found in patients with rheumatic diseases compared to control subjects. The fibronectin in synovial fluids in these patients presented higher levels than in plasma. No other protein from the synovial fluid presented such a peculiar behaviour. The synovial fluid fibronectin/plasma fibronectin ratio is 2.49 in patients with rheumatoid arthritis, 1.56 in those with inflammatory nonrheumatoid arthritides and 1.60 in those with osteoarthritis. Statistically significant higher values of synovial fibronectin were found in patients with rheumatoid arthritis compared to those with osteoarthritis. No significant statistical correlations were found between the synovial fibronectin concentrations and the other clinical or biological parameters of the rheumatoid arthritis patients, but for synovial fluid C3. Immunohistochemical localization of fibronectin in the rheumatoid synovium showed more intense and extended specific deposits than in the control patients. These results suggest a local synthesis of fibronectin related to the chronic inflammatory process. PMID- 3518031 TI - [Penicillamine in 1985]. AB - After reviewing the history of the discovery of the action of D-penicillamine in rheumatoid arthritis, the authors define the practical modalities for the management of treatment based on their own experience and on the data from the literature. The therapeutic score remains relatively low because of the frequency of side effects and therapeutic escapes, even when an encouraging result has been obtained during the first years of treatment. PMID- 3518032 TI - [ Chronic juvenile arthritis. Double-blind study of efficacy and tolerance of D penicillamine]. PMID- 3518033 TI - [Study of a painful total hip prosthesis]. AB - The authors propose a simple routine survey to be performed in the case of a painful total hip prosthesis which is generally able to define the diagnosis and the prognosis. X-ray films are more valuable by their repetition than by their simple analysis. Certain minor signs can help predict or detect loosening of the prosthesis or other complications, but in the great majority of cases, radiology alone is not sufficient to make the diagnosis, as the films are only able to show clear spaces around the prosthesis, without being able to definitely confirm the aetiopathogenic significance of this sign. In these cases, when the decision has not been taken to re-operate, more sophisticated investigations are required (scintigraphy, dynamic tests, arthrography), although they must be used with caution as very often the clinical findings will have the last word. PMID- 3518034 TI - Non-restraining factors affecting setting expansion of phosphate-bonded investments. AB - Only a few studies on the setting expansion of phosphate-bonded investments have been published. In the present work the effect on the non-restrained setting expansion of mixing time, mixing liquid, mixing device, and volume mixed was investigated for selected brands of this type of investment. It was found that all variables studied may greatly affect the setting expansion, and that the use of the special liquid delivered by the manufacturers in most cases causes an unacceptably high expansion. A modification of the brands studied appears necessary before they can be employed in a precision-requiring technique. PMID- 3518035 TI - Gingival and alveolar bone reaction to marginal fit of subgingival crown margins. AB - Interproximal subgingival marginal discrepancies of full coverage restorations were compared with adjacent crevicular fluid flow and percentage radiographic periodontal bone loss. A total of 88 patients with 116 premolar crowns were evaluated. Patients were selected at random from student treatment records, Institute of Dental Prosthetics, Royal Dental College, Copenhagen, Denmark. Crevicular fluid collected on filter paper strips from the interproximal area was stained with 0.2% ninhydrin solution and the length of the area measured. Marginal fit was determined by measuring the marginal excess or deficit recorded in a polyether impression. The amount of bone around each crowned tooth was measured on five times magnified prints of radiographs. Percentage bone loss was calculated by dividing the distance from the alveolar crest to the most coronal level at which the periodontal space retained its normal width by the distance from the alveolar crest to the root apex. Correlating marginal fit with crevicular fluid within gingival index scores showed r = 0.32 (G.I.1) and r = 0.42 (G.I.2). Fit vs percentage bone loss showed r = 0.68 and r = 0.59, respectively (P less than or equal to 0.001). Differentiation was further made within the 0.0-0.2 mm range discrepancy by categorizing the data in four groups. Comparing fit relative to crevicular fluid and bone loss, most of these groups were significantly different when analyzed statistically using the Mann-Whitney U Test. Small defects less than or equal to 0.050 mm were associated with significantly less fluid flow and bone loss than defects exceeding this value. PMID- 3518036 TI - Salivary IgA, lysozyme and beta 2-microglobulin in periodontal disease. AB - The concentrations of IgA, lysozyme and beta 2-microglobulin (beta 2-m) were quantitated in wax-stimulated mixed saliva from 28 patients with severe periodontitis and from 28 healthy controls. The mutual correlations between IgA, lysozyme and beta 2-m were determined. In patients with periodontitis decreased lysozyme concentrations were detected when compared with controls (P less than 0.05). The correlation between IgA and beta 2-m concentrations was highly significant in both groups studied (P less than 0.0001, and P less than 0.002), whereas beta 2-m and lysozyme concentrations were positively correlated in patients but not in controls. In addition, a significant correlation between IgA and lysozyme was found only in periodontal patients (P less than 0.001). PMID- 3518037 TI - Surgical and prosthetic treatment of the atrophic mandible. AB - Two vestibuloplasty methods and a muscle-formed method for improving the retention and stability of complete mandibular dentures were compared in 19 edentulous patients with advanced mandibular bone resorption. The resorptive changes in the alveolar crest and any relapse in the extended vestibule after surgery were monitored for 2 yr. Simultaneous production of the first new complete dentures, to which the labial plate is added during the surgical procedure, and firm circummandibular fixation during primary healing will guarantee the best surgical and prosthetic results. This order of treatment also eliminates unnecessary surgical procedures. A muscle-formed method for extending the baseplate of a complete mandibular denture was found to be a useful alternative for patients with highly advanced mandibular bone resorption. PMID- 3518038 TI - Restraining factors affecting setting expansion of phosphate-bonded investments. AB - The effects of several factors on the setting expansion of a phosphate-bonded investment used in a steel casting ring were studied. The results show that the setting expansion under the conditions analyzed can be characterized only as a most unreliable means to partly compensate for the solid thermal contraction of casting alloys in a precision-requiring technique. PMID- 3518039 TI - A new phosphate bonded investment. AB - A new type of phosphate bonded investment has been studied. The setting expansion was found to be 0.03-0.05%, the thermal expansion was 1.54-1.85% depending upon the mixing liquid used: water or aqueous glycerol solutions, 5, 10, or 20%. Trial castings of alloys with a thermal expansion room to solidus temperature ranging from 1.60 to 1.91% showed either a very high accuracy or the possibility of improving the accuracy actually found by modifying the glycerol content of the mixing liquid used. To prevent cracking, heating of the investment mould in the temperature range 200-300 degrees C must be slow, probably not faster than 2-3 degrees per min. PMID- 3518040 TI - Possible pathogenetic significance of specific chromosome abnormalities and activated proto-oncogenes in malignant diseases of man. PMID- 3518041 TI - Bone marrow transplantation in multiple myeloma. AB - We report 3 cases of allogeneic bone marrow transplantation in multiple myeloma that we have recently performed. Following conditioning treatment with i.v. cyclophosphamide (60 mg/kg/d, for 2 d), oral melphalan (1.0 mg/kg/d, for 5 d), i.v. BCNU (5.5 mg/kg, in a single dose) and total body irradiation (10 Gy in a single fraction) we observed in all 3 cases the disappearance both of serum M component and of monoclonal bone marrow plasma cells. 1 patient died of acute GVH disease, grade IV, at 2 months, while the other 2 patients are in good health and in unmaintained complete remission at 4 and 20 months, respectively. The usefulness of allogeneic bone marrow transplantation in the management of multiple myeloma is emphasized. PMID- 3518042 TI - Enhancement of in vitro erythropoiesis by peripheral blood mononuclear cells from allogeneic marrow recipients in the early post-transplant period. AB - The effect of peripheral blood mononuclear cells (PBMCs) from bone marrow recipients on in vitro growth of erythroid burst-forming units (BFU-E) was studied. PBMCs were obtained from 5 allogeneic, 1 syngeneic and 1 autologous bone marrow recipient(s) at different intervals after transplantation. The number of BFU-E was significantly increased when donor bone marrow cells were co-cultured with PBMCs obtained from allogeneic marrow recipients in the early post transplant period. No effect was observed using PBMCs obtained in the later post transplant period, PBMCs from a syngeneic marrow recipient, or PBMCs from an autologous marrow recipient. The BFU-E enhancing activity was present among T cells and was abolished by treating them with OKT3 or OKT4 antibody and complement. These observations suggest that chimeric T lymphocytes, probably of the helper/inducer subset, from allogeneic marrow recipients in the early post transplant period have a potent enhancing effect on in vitro erythropoiesis. PMID- 3518043 TI - Monoclonal antibodies against pancreatic islet-cell-surface antigens selected by flow cytofluorometry. AB - BALB/c mice were immunized with human islets of Langerhans, and spleen cells from two mice, found to develop cell-surface antibodies against insulin-producing rat islet tumour RIN-5F cells, were fused with mouse myeloma cells. Antibody producing hybrids were cloned on the basis of their production of surface antibodies reactive with paraformaldehyde-fixed RIN-5F cells by indirect immunofluorescence analysis in the fluorescence-activated cell sorter. Among 236 primary clones, eight stable cell lines producing islet-cell-surface antibodies were eventually cloned. Antibody 2G3 (IgM) reacted with viable normal rat islet cells and high insulin-producing rat islet tumour RIN5-A2 cells, while 3G3 (IgM) only reacted with RIN5-A2 cells. Antibody beta B1 (IgG1) reacted with all islet cells tested and detected an Mr21k component in immunoblotting experiments with RIN-5AH cell plasma membrane proteins electrophoretically transferred to nitrocellulose filters. Antibody 7F6 (IgM) reacted with all islet and non-islet cells tested and detected bands of Mr 66k and 27k by immunoblotting. Antibodies gamma B3, gamma B6, gamma C2, and 6B1 (all IgM) showed varying degrees of binding to different islet cells, but reacted only weakly with non-islet human cells. It is concluded that monoclonal antibodies against pancreatic islet cells may define specific endocrine islet-cell-surface determinants. PMID- 3518044 TI - Hepatic uptake of autologous immune complexes in the rat. AB - The hepatic uptake of autologous immune complexes (ICx) was studied in Wistar rats immunized with bovine serum albumin (BSA). After attaining a suitable serum titre of rat anti-BSA Ig (RatABSA) they were injected intravenously with 2 mg BSA. The antibody levels were measured with an ELISA and the rate of disappearance of BSA from the circulation was studied by labelling the antigen with FITC. At various times after injection of BSA the uptake of ICx in the different types of liver cells was studied with the immunoperoxidase technique at the light microscope and ultrastructural levels. Within 5 min of injection with BSA ICx appeared to be bound and internalized by Kupffer cells, endothelial cells, and hepatocytes. After 2 h hepatocytes showed many large vacuoles containing ICx, whereas most microvilli had disappeared from the sinusoidal plasma membrane of these cells. In rats with a high antibody titre BSA had disappeared almost completely (92%) from the blood within 2 h. Rats with low antibody titre showed a lower disappearance rate of BSA, whereas a considerable amount of antibody was still present in the blood after 2 h. We conclude that autologous ICx are bound and endocytosed by Kupffer cells, endothelial cells and hepatocytes of the liver. The affinity for the antigen from the circulation. Uptake of autologous ICx by hepatocytes occurs only in the presence of large amounts of circulating ICx. PMID- 3518045 TI - Human serum albumin and the enigma of chronic hepatitis type B. PMID- 3518046 TI - Immunocytochemical localization of a medullary thymic epithelial glycoprotein. AB - The thymic microenvironment is known to play a key role in T-cell differentiation, but the exact nature of the interactions between epithelial and lymphoid cells has not been fully elucidated. With a monoclonal antibody to a thymic epithelial glycoprotein, we report the localization of an antigen specific for medullary epithelial cells of the mouse thymus. This antigen is found in the Golgi apparatus of epithelial cells, and on their borders with adjoining lymphocytes. This location is compatible with the previously reported observation that differentiation signals transmitted to thymic lymphocytes by thymic epithelial cells require actual contact between these two cell types. PMID- 3518047 TI - Dependency of B cells on the presence of adherent cells, or factors derived from them, for the production of autoantibodies in vitro in the absence of cell division. AB - Peritoneal cells from untreated mice secrete autoantibodies after 3-4 days of in vitro culture, although the cells do not divide. Here, peritoneal cells enriched for B cells to contain 95% surface Ig-bearing cells, did not secrete autoantibodies after 3 days of in vitro culture unless plastic-adherent cells derived from the peritoneal cavity were cultured with the B cells. Cell-free media, taken from peritoneal adherent cells that had been cultured for 3 days in vitro, when added a final concentration of 50% in fresh culture medium to purified B cells, substituted for the presence of accessory cells. In contrast to cultures of unfractionated peritoneal cells, little increase in precursor frequency was detected when enriched B cells were cultured in the presence of LPS/DXS. However, the addition of adherent cells, supernatants derived from adherent cells, or cytokines produced by a T-cell hybrid EL4, resulted in an increased precursor frequency when LPS/DXS was added to the culture medium. Three macrophage cell lines, P388-D1, J774, and PU-5-IR, when added to purified B cells. augmented the autoantibody precursor frequency detected in vitro. This is strong evidence that potentially autoreactive B cells require one or more types of accessory cells in order to differentiate into autoantibody secretors during culture in vitro. Further, the results provide indirect evidence that interleukin 1 may be a crucial molecule in the differentiation of B cells. PMID- 3518048 TI - Immediate and prolonged clinical efficacy of ceftazidime versus ceftazidime plus tobramycin in chronic Pseudomonas aeruginosa infection in cystic fibrosis. AB - 20 patients with cystic fibrosis and chronic bronchopulmonary infection due to Pseudomonas aeruginosa entered a randomized cross-over study comparing ceftazidime (150 mg/kg body weight/24 h) plus tobramycin (10 mg/kg body weight/24 h) to ceftazidime alone (150 mg/kg body weight/24 h), both given intravenously for 2 weeks. 17 patients completed the study; both treatment regimens improved lung function and decreased the WBC count. No difference in clinical efficacy was found between the treatments. Pulmonary function returned to pre-treatment levels 3 months later with no difference between the treatments. No changes were seen in minimal inhibitory concentrations during treatment. None of the patients developed hypersensitivity or experienced serious adverse reactions to the drugs. PMID- 3518049 TI - Comparative toxicity of gentamicin and cefotetan. AB - In a prospective, randomized, comparative study, the renal, hepatic and gastrointestinal toxicity and effects on the vitamin K dependent coagulation factors of gentamicin and cefotetan were compared. Gentamicin, which in all but one patient was combined with a penicillin, was found to cause a significant decrease of glomerular filtration rate (GFR) after 1 week of treatment. In 6/14 patients a further decrease of GFR was found during the week following the last treatment day. The renal proximal tubular cells were affected by gentamicin, as evident from significant increases in urinary activity of 2 tubular enzymes, alanine aminopeptidase (AAP) and N-acetyl-beta-D-glucosaminidase (NAG), as well as rises of urinary beta 2-microglobulin. Changes in GFR and tubular function were reversible. No statistically significant changes of these variables were seen with cefotetan. One cefotetan treated patient developed diarrhoea of moderate severity and 2 patients in the same group developed minor increases of liver transaminases. A small but statistically significant decrease of the activity of the vitamin K dependent coagulation factors occurred during cefotetan treatment. No gastrointestinal or hepatic adverse reactions were observed in the gentamicin treated patients. PMID- 3518050 TI - Susceptibility of Plasmodium falciparum to chloroquine in Liberia, West Africa: in vitro tests for 24 and 48 hours. AB - In vitro tests of Plasmodium falciparum susceptibility to chloroquine were performed in May 1982 in Yekepa area, northern Liberia where several previous in vivo investigations had shown full susceptibility. The isolates from 19 subjects were studied. 18 Rieckmann 24-h micro tests were successful. Effective chloroquine concentrations by probit analysis were 0.3 microM for 50% inhibition (EC50) and 1.2 microM for 99% inhibition (EC99). 18 of the 48-h tests were successful. 10 isolates were inhibited by 0.75 microM chloroquine and another 8 by 2.5 microM. PMID- 3518051 TI - Significance of the sulfonamide component for the clinical efficacy of trimethoprim-sulfonamide combinations. AB - The reasons for combining trimethoprim (TMP) with sulfonamides (SUL) are still mainly theoretical but are supported by results from experimental infections and treatment of specific pathogens in humans, such as Branhamella catarrhalis, Neisseria gonorrhoeae, Brucella, Nocardia asteroides and perhaps Bordetella pertussis and Chlamydia trachomatis. Addition of SUL to TMP confers a therapeutic advantage also in patients with complicated urinary tract infection but probably not in young women with acute cystitis. Conditions that may enable TMP-SUL synergy in vivo can be expected to occur only in occasional cases of infection due to staphylococci, streptococci, Haemophilus or enteric bacteria. This fact together with ethical problems and availability of alternative therapies make further evaluations of the clinical significance of the SUL component of TMP-SUL very difficult. Although the use of TMP alone has shown promise in exacerbations of chronic bronchitis the role of the SUL component in TMP-SUL treatment of infections outside the urinary tract remains to be defined in comparative clinical trials. PMID- 3518052 TI - [The endocrine impact of sports]. AB - Physical exercise triggers neurons within the central nervous system which are responsible for complex alterations of the hypothalamo-pituitary axis as well as an increase in sympathoadrenal activity. Although mechanisms controlling the release of pituitary hormones have not yet been fully understood, there is evidence that endogenous opioid peptides and catechol oestrogens probably play an important neuromodulatory role. From the clinical point of view female reproductive function is exquisitely sensitive to physical training. However, cycle disturbances disappear spontaneously when training is drastically reduced. After cessation of sports activities, fertility and pregnancy do not seem to be affected. Growth delay is observed in some types of sport. It is similar to constitutional short stature and therefore probably not related to growth hormone secretion. PMID- 3518053 TI - [Prognostic value of the renin-angiotensin system in response to salt restriction and prognosis of alcoholic ascitic cirrhosis]. AB - Prognostic factors in alcoholic cirrhosis with ascites were analyzed in a prospective study of 37 patients (25 men, 12 women), 26 of whom presented with clinically diagnosed ascites. A good therapeutic response following salt restriction was obtained in 50%; this response correlated well with an initially small ascites volume, male sex, daily urinary sodium excretion of greater than 10 mmol, plasma renin activity of less than 5 ng/ml/hr and a normal plasma aldosterone level. On the other hand, age, number of episodes and duration of ascites, hepatic functional parameters, plasma creatinine concentration and portal venous pressure had no predictive value as to therapeutic response. Patients' survival was inversely related to plasma renin activity and positively to sodium excretion. The one-year mortality rate reached 88% in patients with renin of greater than 5 ng/ml/hr or daily urinary sodium excretion of less than 10 mmol, while 70% of patients with renin of less than 5 ng/ml/hr or daily sodium excretion of greater than 10 mmol survived more than two years. No prognostic index of survival could be derived from age, sex, number of episodes, duration and volume of ascites, portal venous pressure or hepatic biochemical parameters. Thus, in cirrhotic alcoholic patients with ascites the determination of daily urinary sodium excretion, which is inversely related to the activity of the renin angiotensin system, provides a useful prognostic index for the response to salt restriction and longterm survival. PMID- 3518054 TI - [Propedeutic periodontology--a new practical model course of instruction]. PMID- 3518055 TI - [Comparative in vitro study of the antimicrobial effectiveness of Novugen]. PMID- 3518056 TI - Lead: petrol lead in the environment and its contribution to human blood lead levels. PMID- 3518057 TI - Unexpected size pattern in bacterial proteins. PMID- 3518059 TI - Innervation of periosteum and bone by sympathetic vasoactive intestinal peptide containing nerve fibers. AB - Neural control of bone metabolism and growth has been suggested, although the identity of participating neurons and neurotransmitters effecting this control has not been established. Immunohistochemical studies demonstrated a system of vasoactive intestinal peptide (VIP)-immunoreactive nerve fibers that innervate periosteum and bone in several mammalian species. Thoracic sympathetic chain ganglionectomy resulted in an ipsilateral loss of VIP-immunoreactive fibers in the periosteum of ribs, whereas dorsal root ganglionectomy had no effect. Injection of fast blue into rib periosteum labeled a population of VIP immunoreactive sympathetic postganglionic neurons. Thus, postganglionic sympathetic neurons may provide an important means by which VIP regulates bone mineralization. PMID- 3518058 TI - Novel serine proteases encoded by two cytotoxic T lymphocyte-specific genes. AB - Genes that are expressed exclusively in cytotoxic T cells should encode proteins that are essential for target cell lysis in cell-mediated immune responses. The sequences of two cytotoxic T lymphocyte-specific complementary DNA's (cDNA's) suggest that the two genes encode serine proteases. A full-length cDNA corresponding to one of the genes was isolated and sequenced. The predicted protein resembles serine proteases in that it includes all the residues that form the catalytic triad of the active site of serine proteases. Moreover, it has sequence characteristics thought to occur only in rat mast cell protease type II. These results are in accord with the view that a protease cascade plays a key role in cytotoxic T-cell activation. PMID- 3518060 TI - Two-dimensional nuclear magnetic resonance spectroscopy. AB - Great spectral simplification can be obtained by spreading the conventional one dimensional nuclear magnetic resonance (NMR) spectrum in two independent frequency dimensions. This so-called two-dimensional NMR spectroscopy removes spectral overlap, facilitates spectral assignment, and provides a wealth of additional information. For example, conformational information related to interproton distances is available from resonance intensities in certain types of two-dimensional experiments. Another method generates 1H NMR spectra of a preselected fragment of the molecule, suppressing resonances from other regions and greatly simplifying spectral appearance. Two-dimensional NMR spectroscopy can also be applied to the study of 13C and 15N, not only providing valuable connectivity information but also improving sensitivity of 13C and 15N detection by up to two orders of magnitude. PMID- 3518062 TI - [Spina bifida anterior atlantis--misinterpretation of a congenital abnormality as a dens fracture]. PMID- 3518061 TI - Brain glutamate decarboxylase cloned in lambda gt-11: fusion protein produces gamma-aminobutyric acid. AB - Glutamate decarboxylase (GAD; E.C. 4.1.1.15) converts glutamate to gamma aminobutyric acid (GABA), the major inhibitory neurotransmitter in the vertebrate central nervous system. This report describes the isolation of a GAD complementary DNA clone by immunological screening of a lambda gt-11 brain complementary DNA expression library. The fusion protein produced by this clone catalyzes the conversion of glutamate to GABA and carbon dioxide, confirming its identity as GAD. Antibodies to beta-galactosidase remove GAD enzymatic activity from solution, showing that this activity is associated with the fusion protein. In immunoblotting experiments all three available antisera to GAD reacted with the fusion polypeptide and with two major polypeptides (molecular size, 60,000 and 66,000 daltons) in brain extracts. PMID- 3518063 TI - Other organs and other amyloids. PMID- 3518065 TI - Work in pregnancy: its evolving relationship with perinatal outcome (a review). PMID- 3518064 TI - Unemployment, health and health services in German-speaking countries. AB - The links between unemployment and health are manifold: Employment may lead to illness: health problems (that may lead to unemployment) often result from unfavourable working conditions of the (previous) employment. Another factor is job insecurity: fear of job loss increases the incidence of disease, and this applies not only to people who are emotionally unstable. Illness may lead to unemployment: in many cases, unemployment is caused by previous health impairments, which, to a considerable extent, also explain the duration of unemployment. Unemployment may lead to illness: there is evidence that unemployment not only reinforces existing physical disease but also acts as a risk factor for new ones. This seems particularly true for problem groups such as the unemployed elderly as well as for infants and children of unemployed people. The relations between unemployment and mental health are strong, mainly in terms of depression and alcoholism. Unemployment may lead to health: short-time work and short-term unemployment may improve health by reducing previous stress, caused by employment or by an overload with social roles. Even in the case of long-term unemployment there are some positive health effects as long as a minimum of social security and alternative social roles are available and useful activities--minor agricultural jobs, illicit work--can be carried out. The links between unemployment, work and society can considerably be loosened by a number of social factors and personal characteristics of the people affected. Existing health services are not in a position to deal with disease stemming from employment or unemployment except through symptomatical and curative therapies. In addition to general medical care, which is guaranteed by the German health insurance system for the unemployed, too, therapeutical measures are especially important in cases of depression and alcoholism. As a rule, the medical profession has no knowledge of the links between health, work and unemployment; such knowledge, however, would facilitate prevention. Individual prevention and rehabilitation measures are of great importance to problem groups suffering from cumulative or indirect unemployment, i.e. to unemployed elderly as well as to children of unemployed parents. Since the unemployed tend to isolate themselves, extramural services are useful. Specific services for the unemployed only are certainly not as helpful as multi-functional social services, such as those being already rendered by some self-help organizations, churches and trade unions.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3518066 TI - An interview study of pregnant women's attitudes to ultrasound scanning. AB - 404 pregnant women were interviewed, in the ante-natal clinics of two hospitals, concerning their attitudes to ultrasound scanning, which is routine at one of these hospitals, selective at the other. It was found at the hospital where scanning is selective, that women who had not been examined by ultrasound were less likely to regard a scan as an additional source of reassurance, and to approve of routine scanning, than were those who had yet to be scanned at the other hospital, or any of those who had experienced the procedure. A majority of the women interviewed were enthusiastic about the method, but an important source of dissatisfaction was failure of the operator to reveal and/or explain the foetal image. PMID- 3518067 TI - [Dionysus, deity of mania and depression. A model of socio-mythologic organization of the struggle against anxiety]. PMID- 3518068 TI - Genitourinary fungal infections. AB - Genitourinary fungal infections have become increasingly common in clinical practice. We review the literature on such infections, emphasizing recognition of fungal disease, predisposing factors, pathogenesis, and approaches to therapy. PMID- 3518069 TI - Decline of bloodletting: a study in 19th-century ratiocinations. PMID- 3518070 TI - Fate of retained foreign bodies in the peritoneal cavity. AB - Two patients with retained laparotomy pads after laparotomy had pain, abscess formation, and bleeding, with erosion of the pad into the small bowel and colon. PMID- 3518071 TI - Disseminated Fusarium moniliforme infection after allogeneic marrow transplantation. AB - We have described the first case of systemic Fusarium moniliforme infection complicating marrow transplantation. The infection was fulminant despite aggressive therapy. Review of previously reported cases of human Fusarium infection suggests that the skin is a common portal of infection. PMID- 3518072 TI - Postoperative pain relief: a double-blind comparison of dezocine, butorphanol, and placebo. AB - The safety and efficacy of single intramuscular doses of dezocine (10 or 15 mg) were compared with butorphanol (2 mg) and placebo in 157 patients with moderate to severe postoperative pain. A verbal pain intensity scale, an analog pain intensity scale, and a verbal pain relief scale were used to record the patients' subjective assessments. The results of this study indicate that a single 10 or 15 mg intramuscular injection of dezocine is safe and more effective than placebo for four to six hours, respectively, in the treatment of moderate to severe postoperative pain (P less than .05). During the first hour of treatment the pain relief afforded by 2 mg of butorphanol was significantly greater than that afforded by 10 mg of dezocine (P less than .05), but both doses of dezocine provided long-lasting relief. The scores on all three efficacy scales were highest with the 15 mg dose of dezocine after the first hour, while the 10 mg dose of dezocine and butorphanol were compared during this period. Nausea and vomiting were the most commonly reported side effects; injection site reactions were reported more frequently in the butorphanol group. PMID- 3518073 TI - Pseudo-occlusion of the internal carotid artery: how not to miss it. AB - Although pseudo-occlusion of the internal carotid artery has been previously reported, it is not widely appreciated. The purpose of this report is to demonstrate methods of making the diagnosis. We present two cases illustrating the angiographic findings in pseudo-occlusion of the internal carotid artery. Its recognition is important to the vascular surgeon in making recommendations for surgery. PMID- 3518074 TI - Pseudoseizures: an overview. AB - Pseudoseizures, formerly called hysterical seizures, have become an acknowledged clinical entity in their own right. Diagnosis of pseudoseizures is a complex process, depending primarily on clinical neurologic observation of the spell pattern and negative response to anticonvulsant therapy. Diagnosis is aided by psychiatric evidence of psychopathology, and in difficult cases, by video/EEG observation of actual spells, either spontaneous or induced by saline infusion or hypnosis. Exposure to some model of spell behavior is considered important in the development of most cases of pseudoseizures. Pseudoseizures are difficult to treat successfully, and exploratory attempts at treatment have included hypnosis and behavior therapy. Pseudoseizures may represent either conversion disorder or dissociative disorder. PMID- 3518075 TI - [Preservation of the pylorus in the surgical treatment of peptic ulcer]. PMID- 3518076 TI - [Ultrasonic diagnosis of hypercorticism]. PMID- 3518077 TI - [Ferritins--history of their study and clinical significance]. PMID- 3518078 TI - [Use of adrenergic blockaders in hypertension]. PMID- 3518079 TI - [Treatment of duodenal ulcer with trental]. PMID- 3518080 TI - The reliability of measurements of the lumbar spine using ultrasound B-scan. AB - Diagnostic ultrasound is used in research and clinical settings to determine the size of the lumbar spinal canal. When the technique was first introduced, measurements were obtained directly from an A-scan while concurrently viewing a B scan. However, measurements obtained directly from a B-scan are now commonly used despite the undetermined reliability of the technique. To determine the reliability, 50 randomly selected ultrasound B-scan examinations were read on two separate occasions by three investigators. For each spinal level, the mean intraobserver error (same investigator), from the first to the second reading was determined, as was the interobserver error (between investigators) and the error due to variability in obtaining the ultrasound images. The resultant errors were approximately double those reported previously for the technique using A-scan. Interobserver variations were the major source of measurement error. PMID- 3518081 TI - [40 years of Czechoslovak surgery]. PMID- 3518082 TI - [The effect of extracorporeal blood circulation on the myocardium of the autotransplanted dog heart]. PMID- 3518083 TI - Apgar scores and asphyxia. Results of a study and proposal for a clinical grading system. AB - The Apgar score (AS) was devised in 1953 as a simple system for classifying neonatal condition at 1 minute and was later modified to include status at 5 minutes. However, studies have documented pitfalls, e.g. a poor correlation between AS and acid-base status. We studied 35 infants born at term. ASs were assigned by two nurses not involved in the delivery, and antepartum and postpartum events were noted. We confirmed the following: (i) labour ward staff tend to overestimate ASs; (ii) there is a poor correlation between the AS and acid-base status; and (iii) the labour ward staff's decision to resuscitate with intermittent positive-pressure respiration (IPPR) correlates with the AS but not with blood gas status. Infants with initially low ASs and/or a brief requirement for IPPR may be recorded by medical or nursing staff as being asphyxiated at birth. Our results show that low ASs may be associated with normal acid-base status and vice versa. In order further to define asphyxia, we therefore propose that a grading system which incorporates clinical data and the AS be used. Use of such a system would facilitate inter-area comparisons of grades of asphyxia encountered, efficacy of intervention programmes and developmental outcome of asphyxiated neonates. PMID- 3518084 TI - Antenatal ultrasonographic findings in tuberous sclerosis. Report of 2 cases. AB - Tuberous sclerosis is an autosomal dominant disease with variable expression. The initial manifestations have been reported at varying stages postnatally, but little is known about the fetal age at which the disease may be detected. The antenatal ultrasonographic features in 2 affected fetuses, at 40 and 26 weeks respectively, are reported. The second case appears unique because of the early fetal involvement and the abnormally large brain tumour. PMID- 3518085 TI - Ultrasonographic demonstration of a gas-containing pancreatic abscess. A case report. AB - A 24-year-old man presented with acute pancreatitis. Serial ultrasonographic examination showed the development of bright echoes within the pancreatic parenchyma compatible with gas formation. This was confirmed on subsequent computed tomography and at laparotomy. The value of serial ultrasonographic examinations in pancreatitis is emphasized. PMID- 3518086 TI - The effect of age and dentition status on masticatory function in older adults. PMID- 3518088 TI - [Diabetes in children: case report]. PMID- 3518087 TI - Effect of a new form of adhesive on retention and stability of complete maxillary dentures. PMID- 3518089 TI - [Etiology of insulin-dependent diabetes]. PMID- 3518090 TI - Inflammatory abdominal aortic aneurysm. AB - Between January 1976 and December 1982, 181 patients with abdominal aortic aneurysms were treated surgically, and in 13 patients the aneurysms were found to be inflammatory. Inflammatory aneurysms of the abdominal aorta (IAAA) share important characteristics with typical atherosclerotic abdominal aortic aneurysms. Diagnosis and surgical management of IAAA are distinctive which suggests that IAAA should be considered separately, as a varient of typical abdominal aortic aneurysms. IAAA occur predominantly in males. The presenting symptoms are often idiosyncratic and include severe abdominal or back pain, or both, and ureteral obstruction; the diagnosis of IAAA should be considered when these symptoms are present. Although grossly and microscopically, the perianeurysmal fibrosis resembles idiopathic retroperitoneal fibrosis, the two conditions can be differentiated. At the present time, ultrasonography and computed tomography appear to offer reliable means for diagnosing IAAA. The presence of IAAA, whether established preoperatively or discovered unexpectedly at operation, necessitate certain modifications in the surgical approach, in order to avoid injuring the duodenum and the venous structures. Most patients can be successfully treated by resection and graft replacement. Rupture of the aneurysm in IAAA appears to be less frequent than in typical atherosclerotic abdominal aortic aneurysm. PMID- 3518091 TI - Branch patch for arterialization of hepatic grafts. AB - Arterial revascularization is essential for graft survival in transplantation of the liver. The "branch-patch" technique described herein simplifies this small anastomoses. Fifty-two pig and human transplants have been performed resulting in 100 per cent patency. This approach may also be suitable for other small arterial anastomoses. PMID- 3518092 TI - Halsted's final resting place. PMID- 3518093 TI - Accidental severe hypothermia. AB - Accidental hypothermia is a health problem with a scope which has been underestimated by the medical community. Limited awareness and limited diagnostic equipment, along with hospital coding inaccuracies, make calculation of the true number of instances of accidental hypothermia nearly impossible. Severe hypothermia occurs when body temperature falls below 28 degrees C. The patient may be unconscious, with such severely depressed vital signs that he appears to be dead. All such patients, regardless of extremis upon presentation, should undergo vigorous cardiopulmonary resuscitation in addition to rewarming, because a reliable determination of death is nearly impossible without the restoration of body temperature. Rewarming must follow the implementation of adequate cardiovascular support, maintaining serum acid base balance, arterial oxygenation and intravascular volume levels within the appropriate physiologic ranges; otherwise, the reawakening of metabolic needs will outpace the recovery of cardiac function, and the patient will die of multiple organ infarction. In addition, standard mechanical or manual CPR can furnish adequate cardiovascular support for the severely failing myocardium. When cardiovascular resuscitation is performed first, followed by rewarming with a continual maintenance of optimum cardiovascular function, then all standard methods of rewarming (external rewarming with a fluid-circulated blanket, peritoneal lavage or partial cardiac bypass) should give equally good results. The preceding guidelines are extrapolated from a retrospective review of available clinical material as well as controlled prospective animal studies. Prospective clinical studies should be performed to confirm the acceptability of these guidelines; an inter institutional study may be the best way to glean such data and should be considered by researchers interested in this problem. PMID- 3518094 TI - Problems of total body irradiation. Proceedings of a seminar and workshop on physical problems of TBI. Essen, Germany, September 19th and 20th, 1985. PMID- 3518095 TI - Physical aspects and problems of total body irradiation. PMID- 3518096 TI - Bone marrow transplantation in severe aplastic anemia and acute or chronic leukemia. AB - In Essen 121 bone marrow transplantations were carried out. The indications were severe aplastic anemia (n = 18), acute leukemia in relapse (n = 20), acute leukemia in remission (n = 46) or chronic myeloid leukemia (n = 37). 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 hyperimmunoglobulin and CMV-negative blood products have been applied routinely since two years. MTX was used as prophylaxis against GVH-disease. In case of severe aplastic anemia 13 patients (72%) are still alive with a median observation time of 24 months. In the prognostically unfavourable group of acute leukemia in relapse only one patient showed long term survival. In this patient leukemic relapse occurred six years after transplantation. The survival rate of AML patients grafted during the first remission is 55% (15/27) with a median observation time of 40 months. For patients grafted in first or consecutive remission of ALL the survival rate is 42% (5/12) with a maximal observation time of 29 months. Out of 37 patients grafted because of CML, eight were in an advanced stage of the disease. 13 patients are still alive, the maximal observation time is 37 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- 3518097 TI - The incidence of interstitial pneumonitis: comparison of total body irradiation schedules for allogenic bone marrow transplantation. AB - Interstitial pneumonitis (IP) is one of the major causes of death following bone marrow transplantation (BMT). This report deals with a comparison between data compiled from six centers concerning the essential factors responsible for the development of IP. Special concern has been paid to the idiopathic form of disease where TBI is thought to be the most important factor in its pathogenesis. Our own experience using different TBI modalities shows that the instantaneous dose rate seems to be an important factor in the development of IIP. Comparing the data from various centers it is not possible at the present time to recommend one optimal modality. PMID- 3518098 TI - Some radiobiological aspects of total body irradiation (TBI). AB - Data from the literature on total body irradiation are reported. The biological concept of fractionation of TBI is reviewed. The therapeutic gain of fractionated single dose as compared single dose to irradiation is explained. However, other data from Song et al. show that repair capacity of hemopoietic or leukemic cells may be underestimated. More data with fractionation experiments are needed. The significance of repopulation between fractionation doses is unknown. The interaction of TBI and preceding chemotherapy should be studied in more detail. PMID- 3518099 TI - Total body irradiation: the lung as critical organ. AB - The pathogenesis of interstitial pneumonitis (IP) after chemoradiotherapy and subsequent bone marrow transplantation is not completely understood. Total body irradiation (TBI) with a dose of about 10 Gy significantly contributes to this very serious complication. The radiation induced morphological alterations especially of the crucial targets, namely the pneumocytes type II and capillaries are described. Investigations in animals and in humans reveal that pneumonitis occurs over a very short range of doses. In humans a single dose of 9.3 Gy given at a high dose rate leads to an incidence of 50%. Reduction of the dose by shielding the lungs, fractionation of irradiation and decreasing the dose rate are considered to be the main possibilities which diminish the risk of pneumonitis after TBI. The role of further factors involved in the development of IP such as cytomegalovirus, age, reduced lung volume, immunological mechanisms and others is discussed. Especially chemotherapeutic agents may increase lung morbidity by interacting with TBI. PMID- 3518100 TI - Physical problems of total body irradiation. AB - In the concept of combined treatment of acute leukemias the whole body has to be irradiated as precisely and homogeneously as reasonably achieveable. In fulfillment of these radiobiological requirements, total body irradiation (TBI) means a very special challenge to medical physicists. Very large, uniform high energy photon beams have to be realized and applied. The dose at any relevant reference point has to be determined, regarding all influences of the TBI treatment situation. The dose distribution has to be modified - if necessary - verified and recorded. The lungs - the vital organs at risk in TBI - have to be shielded to tolerable doses. Optimization of TBI demands to understand all physical limitations and to utilize all technical possibilities. These physical problems encountered with TBI dosimetry, treatment planning and treatment performance are discussed. PMID- 3518101 TI - Physical aspects of total body irradiation in Basel. AB - Total body irradiations have been performed on 112 patients at the University Hospital in Basel since 1979. Total body irradiations are effected in order to prepare patients with leukemia for bone marrow transplantation. The irradiation technique with 4 MV X-rays is described. The patients are treated without lung shieldings. The dose-measurements show an acceptable homogeneity. The applied technique is very easy in comparison with other centers. A main point is making the patient's position as comfortable as possible. The accuracy of dose application and dose-distribution is considered clinically acceptable. PMID- 3518102 TI - The TBI method preceding BMT at Innsbruck University Clinic for radiation therapy. AB - Thirteen TBIs have been performed prior to allogenic or autologous bone-marrow transplants in Innsbruck since August 1983 using a Linac (SL 75/20). Irradiation takes place from two lateral opposing fields with the patient lying in a dorsal position on a special couch on the wall (FSD = 350 cm). The mean dose of 10 Gy is administered during a single session. The patient's upper arms partially shield the lungs. The Linac's PRF is set to prevent the maximum dose rate in the lung from exceeding 0.10 Gy/min. Distribution of the dose in the patient is measured by means of TLD and semiconductor detectors. PMID- 3518103 TI - A suggestion to change the TBI protocol of the IBMTR. PMID- 3518104 TI - Problems of dose modification in total body irradiation. AB - Physical treatment planning of total body irradiation (TBI) has the goal to optimize the spatial distribution of dose, taking radiobiological requirements and technical possibilities into account. In order to improve the dose homogeneity in the target volume or to reduce dose and dose rate in organs at risk dose modifications are needed to raise or to lower the local dose. Treatment optimization demands to know possible techniques, the methods of individual planning and calculation as well as the limitations of beam modifying aids. PMID- 3518105 TI - Physical treatment planning of total body irradiation. AB - The treatment planning of total body irradiations shows partially other problems than conventional treatments. The data refer to long source-skin-distance and large fields, which are even larger than the patient. In most centres, it is aspired to a homogeneous dose distribution. But its importance is not known, at present. The radiobiology has to yield further answers to a lot of questions. This and the clinical results must help to decide, which technique is the best to eliminate leukemic cells and to avoid side effects as interstitial pneumonia. PMID- 3518106 TI - The management of juxtahepatic venous injuries without an atriocaval shunt: preliminary clinical observations. AB - Juxtahepatic venous injuries are usually fatal. The optimal method of dealing with these injuries remains controversial, but most experience has been with the insertion of an atriocaval shunt. However, the mortality rate with atriocaval shunting remains prohibitively high (60% to 100%). The experience at the Bellevue Hospital Trauma and Shock Unit during a 9-year period revealed a 50% mortality rate in four consecutive patients who underwent atriocaval shunting. As such, a different approach was used in the following five patients, all of whom survived. One additional patient died in the operating room before any definitive repair could be undertaken. Four steps are considered essential to the successful management of these patients: (1) compression of the injury site until adequate resuscitation has been achieved; (2) early recognition that a juxtahepatic venous injury exists, as indicated by failure of the Pringle maneuver to adequately arrest hemorrhage; (3) prolonged portal triad occlusion with hepatocyte protection by means of large doses of steroids and topical hypothermia (portal triad occlusion time in the nonshunted group ranged from 20 to 64 minutes with a mean occlusion time of 46 minutes; although a transient rise in liver function test results seemed to correlate with the length of ischemia time, neither hepatic dysfunction nor hepatic necrosis occurred; and (4) extensive finger fracture of the liver to the site of vascular injury for primary repair or ligation; the extent of the finger fracture varied from 15 to 30 cm in length and from 5 to 15 cm in depth. The successful results achieved in five consecutive patients who sustained juxtahepatic venous injuries treated without a shunt serve as a basis for recommending this operative approach. PMID- 3518107 TI - Methylxanthine, alcohol-free diet and fibrocystic breast disease: a factorial clinical trial. AB - A controlled clinical trial was conducted in Milan, Italy to analyze the effects of methylxanthine (MTX) and alcohol abstention on signs and symptoms of fibrocystic breast disease. A total of 192 women with a clinical and thermographic diagnosis of fibrocystic breast disease were randomly assigned to four groups on the basis of two-by-two factorial design: (1) abstention from MTX containing beverages, (2) abstention from alcohol, (3) abstention from MTX and alcohol, and (4) no dietary advice. Of these, 162 (84.4%) were followed up at approximately 6 months. No statistically or clinically significant effect of a MTX- or alcohol-free diet was observed on signs and symptoms of fibrocystic breast disease. On the basis of the results of the present and previous randomized controlled studies, it thus appears possible to exclude that abstention from coffee and other MTX-containing beverages can substantially reduce signs and symptoms of fibrocystic breast disease within a few months. PMID- 3518108 TI - William Cowper. AB - William Cowper, now virtually forgotten, was the first of the surgeon-scientists of Great Britain. He was the first to bring the power of the experimental method to bear on practical surgical problems and to urge that the principles of surgery be drawn from an understanding of the "animal oeconomy." In these areas he anticipated the celebrated Hunterian school of surgery by more than half a century and by his example he actually set the foundation on which that school was built. Cowper was a scientist of a high order. He was the first to prove the existence of capillaries in higher mammals, to describe naturally occurring arteriovenous shunts in the lungs and spleen, to define the essential physiology of aortic valvular disease, and to recognize the nature and consequences of arteriosclerotic vascular disease. He was the author of two important anatomy books and the first English language treatise on general physiology available to surgeons. He was one of the first two surgeons ever honored by election to the prestigious Royal Society of London. An analysis of the works and doctrines of William Cowper appears to cast serious doubt on the common teaching that the idea of "scientific surgery" was the sole creation of John Hunter. PMID- 3518109 TI - Duplex scanning of the portal vein and portasystemic shunts. AB - This article describes the preliminary findings of a Duplex ultrasound technique that enables the patency of the portal circulation and portosystemic shunt patency to be determined. In addition, the equipment allows the noninvasive measurement of quantitative rates of blood flow in these vessels. Portal vein flow was 952 +/- 273 ml/min in 10 normal subjects after an overnight fast and increased by 50% at 30 minutes in response to a standard 660-calorie liquid meal. Thirteen portosystemic shunts were scanned, and hemodynamic information was obtained from 10. Three of the four patients who had a Warren shunt performed 3 to 4 years earlier had portal vein occlusion. There is evidence of an increase in flow through the Warren shunt on feeding, suggesting a hemodynamic connection to the mesenteric side of the circulation. The apparatus, technique of examination, and the characteristics and difficulties with particular types of shunts are described. PMID- 3518110 TI - The association of antivascular endothelial cell antibody with hyperacute rejection: a case report. AB - Early graft loss almost always occurs when recipients of a renal allograft develop antibody directed against antigens specific for donor vascular endothelial cells (VECs) and peripheral blood monocytes. In studies involving recipients of human leukocyte antigen identical, living-related grafts exhibiting preformed antibody to the VEC antigens of their donors, the median onset of rejection was 3 days after transplantation. Although preformed antibody to VEC antigens has been related in numerous articles to early graft loss, there has never been a published report of anti-VEC antibody leading to hyperacute rejection. We report a patient who hyperacutely rejected a renal allograft after undergoing a donor-specific transfusion protocol with her mother in which the kidney was removed in less than 24 hours. Nine months later the patient had a retransplantation with an allograft from a cadaveric donor. The cadaveric graft was again hyperacutely rejected, and this kidney was removed immediately. Anti VEC/monocyte antibody directed against both donors was detected in the patient's pretransplant sera. With the exception of a positive B-lymphocyte crossmatch with her mother, all the standard crossmatches were negative. PMID- 3518111 TI - Geza de Takats--1892-1985. PMID- 3518112 TI - Clinical judgement and patients' evaluation of complete dentures five years after treatment. A follow-up study. AB - An investigation of 39 complete denture wearers five year after receiving new dentures showed that the great majority of the patients were satisfied with their dentures. In the examiner's opinion, 60 per cent of the dentures were in need of corrections or replacement. A positive, but not statistically significant, correlation between the subjective and objective evaluation of the dentures was found. Although the patients were strongly advised not to wear their dentures at night, in order to preserve the denture-bearing tissue, most patients preferred to wear the dentures also at night. The patients had also been told to contact the clinic at least every two years for a clinical check-up, but more than half of the patients had not been in contact with a dentist during the five-year period. Those who had been to a dentist had, in all cases, done so because of acute problems. It is concluded that the agreement between patients' and examiners' opinions about the function of complete dentures is poor, and that denture acceptance is related to many variables. No single variable has a decisive effect on denture acceptance but the subjective opinion of the fit of the upper denture seemed to be the most important one. It is also stressed that a regular recall system is important for complete denture wearers. It is likely that if these patients had been seen regularly, minor corrections to the dentures could have been made, thus preventing or delaying the deterioration of the dentures. PMID- 3518113 TI - Rotational panoramic radiography in epidemiological studies of dental health. Comparison between panoramic radiographs and intraoral full mouth surveys. AB - In conjunction with an epidemiological study of oral health in women the capacity of the panoramic radiograph to yield information on oral conditions was compared to that of the intraoral full mouth survey including posterior bitewing radiographs. Full mouth surveys and panoramic radiographs of 75 women were compared for gross characteristics such as distribution of teeth, missing teeth, restorations, and endodontic treatment as well as for osteolytic lesions at the root, marginal bone loss and carious lesions. A nearly 100% agreement was found for gross characteristics but also for osteolytic lesions associated with teeth and for marginal bone loss the agreement was good; osteolytic lesions at single rooted teeth 76%, multirooted teeth 90% and a coefficient of correlation of .96 for individual mean marginal bone scores. Poor agreement was found for carious lesions as only 36% of those extending well into the dentine were found both in the intraoral radiographs and in the panoramic radiographs. It may be included that, except for carious lesions, the panoramic radiographs can be considered a useful tool in epidemiological studies of oral health. PMID- 3518115 TI - [Resin-bonded bridges. 1: Method]. PMID- 3518114 TI - [Diet as an etiologic factor in caries: a literature review]. PMID- 3518116 TI - [Secretion of somatotropic hormone in patients with pancreatitis]. AB - The concentration of somatotropic hormone (STH) was measured by radioimmunoassay in 108 patients with acute and chronic pancreatitis and in 15 healthy persons. In addition, to study the reserve capacity of the somatotropic function of the pituitary, insulin hypoglycemia was employed. It was established that during exacerbation, the pancreatitis patients manifested an increase in the hormone content. In the patients suffering from acute pancreatitis, the STH level returned to normal following treatment. In chronic pancreatitis, the hormone concentration remained elevated after treatment. No correlation was discovered between alterations in the STH level and the activity of pancreatic enzymes. The data obtained point to a definite role of STH in the pathogenesis of chronic pancreatitis. PMID- 3518117 TI - [Echographic diagnosis of diseases of the pancreas]. PMID- 3518118 TI - [Spot percutaneous biopsy of the pancreas monitored by computer tomography and ultrasonic examination]. AB - The authors analyse the results of the use of modern methods of morphological verification of a diagnosis in 23 patients with different diseases of the pancreas. The patients were subjected to 26 spot transcutaneous biopsies verified by computer-aided tomography or ultrasonic exploration. The morphological diagnosis was verified in 20 out of the 23 examinees (87%). Three patients with pseudocysts received curative manipulations under the control of computer-aided tomography and ultrasonic exploration, sanitation and sclerosing of the pathological cavities. PMID- 3518119 TI - [Gastrin cells and the basal level of serum gastrin in patients with insulin dependent diabetes mellitus]. AB - In 40 patients with insulin-dependent diabetes mellitus, the number of gastrin cells in the mucous membrane of the antrum of the stomach was measured by immunohistochemistry according to the method of L. Sternberger. The number of the cells depended on the gravity of antral gastritis, namely their number decreased as the lesion was aggravated. The basal level of serum gastrin was determined by radioimmunoassay in 144 patients with insulin-dependent diabetes mellitus. The high basal level of gastrin was recorded in patients with achlorhydria. However, no correlation was established between the gravity of antral gastritis and the basal level of serum gastrin. If the basal gastrin level is too high, the possibility of asymptomatic paresis of the stomach should be taken into account together with the other factors. PMID- 3518120 TI - [Changes in the cardiovascular system in acute pancreatitis]. PMID- 3518121 TI - [Experience with the treatment of duodenal ulcer using H2-histamine receptor blockers]. AB - The authors compared the efficacy of the blockers of H2-histamine receptors with the conventional multimodality treatment in patients with peptic ulcer of the duodenum and explored the effect of cimetidine on the secretory and motor functions of the stomach and on the endocrine status of the patients. It was established that cimetidine made the healing of duodenal ulcers more rapid as compared with the use of the multimodality therapy. It was also found that the drug efficacy was mainly related to the suppression of hydrochloric acid secretion in the stomach and to the recovery of motor activity of the stomach and duodenum. It is demonstrated that cimetidine has a broad-range action on the endocrine system, which should be taken into consideration in administering cimetidine. PMID- 3518122 TI - [Diagnostic possibilities of ultrasonic studies of the liver]. PMID- 3518123 TI - [Ultrasonic diagnosis of biliary tract dyskinesia]. AB - Ultrasonic sectoral scanning was used to determine the type of biliary tract dyskinesias in the course of digestion. 89 patients with different gastroenterological diseases were examined. 21 healthy subjects made up the control group. The process of gallbladder contraction was conventionally divided into 3 phases. In practically healthy subjects, the first phase was marked by gallbladder contraction from the neck down to the bottom while the gallbladder assumed an optimally suitable form for prolonged contraction. The second phase involved rapid contraction (during 15 min the gallbladder size reduced by 28.8%). The third phase involved slow contraction (during 30 min the gallbladder decreased in size by another 29%). 5 types of dyskinetic disorders were distinguished. This permitted diagnosing the focus of pathology within the system of the biliary tract together with administering the differentiated treatment. PMID- 3518124 TI - [Clinical significance of echography in the diagnosis of portal circulatory disorders]. AB - Forty-one patients with the endoscopically diagnosed varicose veins of the esophagus and stomach were examined. The echograms of 32 patients with liver cirrhosis showed the impoverishment of the vascular pattern of the liver parenchyma, dilatation of the portal, superior mesenterial and splenic veins, enlargement of the coronary vein of the stomach, uncovered gastroesophageal and splenorenal collaterals, the umbilical vein, and increase in the size and echogenicity of the spleen. In 5 patients with neoplastic and in 4 patients with inflammatory occlusion of the main veins of the portal system, the normal or high contrast vascular pattern of the liver parenchyma, no signs of the recanalization of the umbilical vein attested to the absence of any correlation between portal hypertension and liver diseases. PMID- 3518125 TI - Green Vardiman Black (1836-1915). PMID- 3518126 TI - Old Red: a legacy lives on. PMID- 3518127 TI - Byssinosis: a disease or a symptom? PMID- 3518128 TI - In vitro and in vivo effect of verapamil on human airway responsiveness to leukotriene D4. AB - The mechanism by which leukotriene D4 (LTD4) induces airway narrowing in man is unclear. We have investigated this by examining the effect of the calcium channel blocker verapamil on the sensitivity of in vitro preparations of human bronchi to LTD4 and methacholine, and on the bronchoconstriction induced in normal subjects by these agonists in vivo. In vitro smooth muscle sensitivity was assessed by the concentration of LTD4 and methacholine causing a 50% of maximum contraction (EC50) and as the maximum tension generated. Verapamil did not alter baseline tension or the response to LTD4 but did inhibit contractile responses to methacholine. In vivo studies were performed in six normal subjects; they inhaled increasing concentrations of LTD4 (0.4-50 micrograms/ml) or methacholine (2-64 mg/ml). Airway responsiveness in vivo was expressed as the provocation concentration (PC) of agonist producing a 35% fall in specific airways conductance (PC35sGaw) and a 30% fall in flow at 30% of vital capacity (PC30 V30(p)). Verapamil did not alter baseline sGaw or V30(p). One subject did not respond to LTD4 on either day. In contrast to the in vitro results, verapamil produced a greater than 10 fold reduction in LTD4 induced bronchoconstriction, but had no effect on methacholine induced bronchoconstriction. These results suggest that in normal subjects bronchoconstriction induced by inhaled LTD4 is due to a combination of direct and indirect mechanisms. PMID- 3518129 TI - Prednisolone in the treatment of airflow obstruction in adults with cystic fibrosis. AB - The effect of oral prednisolone on the lung function of 20 adult patients with cystic fibrosis who had severe stable airflow obstruction was assessed in a placebo controlled study, blind to the patients. Placebo tablets were followed by prednisolone given in a median dose of 0.48 mg/kg body weight/day (20 mg/day in 11 patients, 30 mg/day in nine patients), each for three weeks. No significant improvement was seen in lung function in the group after receiving prednisolone, and none of the individual patients had clinically useful improvements in lung function. Atopic subjects showed an improvement in evening recordings of peak expiratory flow rate (PEF) while taking prednisolone (p less than 0.05). Significant deterioration in forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) was seen after withdrawal of prednisolone. Two patients developed pneumothoraces while taking prednisolone. PMID- 3518130 TI - Effects of pholcodine and salbutamol on citric acid induced cough in normal subjects. PMID- 3518131 TI - Observations on the pathogenesis of chronic airflow obstruction in smokers: implications for the detection of "early" lung disease. PMID- 3518132 TI - Heparin cofactor II: purification and antibody production. AB - Heparin cofactor II (HCII) was purified from plasma to homogeneity. The procedure includes adsorption with (A1)OH3, fractionation with polyethylene glycol 6000, chromatography on QAE-Sephadex A-50, on heparin-Sepharose 4B and on Sephadex G 150. QAE-Sephadex A-50 chromatography provides a good separation of HCII from antithrombin III (AT) and most contaminants having a heparin affinity similar to that of HCII. HCII is eluted at 0.28 M NaCl from the heparin-Sepharose column. After gel filtration on G-150, contaminating AT was removed by immunoadsorption. Purified HCII shows an apparent Mr of 66,500 daltons as analyzed on SDS polyacrylamide gel and 62,100 daltons by ultracentrifugation. Antibodies to HCII were raised in rabbits. Former antisera mostly directed to a contaminating protein were used to remove it from the HCII preparation. Antibodies to HCII were made monospecific by immunoadsorption on HCII-free plasma linked to Sepharose 4B. Since many functional AT assays have neglected the presence of HCII in plasma, antibodies to HCII using as immunoadsorbent will provide a more specific test for AT. PMID- 3518133 TI - Tissue thromboplastin induced reversible DIC and heparin-enhanced inhibitors in dogs. AB - Reversible acute disseminated intravascular coagulation (DIC) has been induced in dogs by intravenous injection of homologous tissue thromboplastin. There was no measurable consumption of antithrombin III and heparin cofactor II even if fibrinogen was reduced during DIC by more than 80% of its baseline. The prothrombin level remained practically constant. These data correspond to the generation of a few nanomoles of thrombin in vivo with subsequent pseudo-first order inactivation by the major thrombin inhibitors. An ex vivo measure of the pseudo-first order rate constant (dynamic thrombin inhibitory capacity, DTIC) was a sensitive probe of circulating heparin. There was no change of DTIC during DIC in the absence of exogenous heparin suggesting that heparin-like endogenous glycosaminoglycans were not released in substantial amounts. Pretreatment with heparin efficiently inhibited the development of tissue thromboplastin induced DIC. This animal model may serve as a tool for the study of glycosaminoglycan anticoagulants in vivo. PMID- 3518134 TI - Heparin-induced thrombocytopenia platelet aggregation studies in the presence of heparin fractions or semi-synthetic analogues of various molecular weights and anticoagulant activities. AB - One case of heparin-induced thrombocytopenia is reported. Aggregation was observed in the platelet-rich plasma of this patient in the presence of two commercial standard heparin preparations (from a final concentration of 0.025 IU/ml upwards), of two semi-synthetic heparin analogues (0.1 APTT U/ml) and of three low-molecular weight heparin (LMWH) fractions (0.1 anti-Xa U/ml) but not in the presence of five other LMWH fractions. The patient's isolated platelets no longer aggregated in the The patient's isolated platelets no longer aggregated in the presence of heparin but the phenomenon recurred after addition of the patient's platelet poor plasma (PPP). Furthermore, addition of patient's PPP to control platelets led to heparin-induced aggregation. The phenomenon was associated with thromboxane generation and could be blocked by in vitro addition of aspirin, PGI2, and PGD2 whereas the lag phase was dose-dependently prolonged by adenosine. It is concluded that platelet aggregation may be induced in some patients by standard heparin and by certain LMWH fractions or semi-synthetic analogues, independently of their molecular weight and anticoagulant activity. PMID- 3518135 TI - Triton X-114 phase separation of platelet membrane glycoproteins from normal subjects and a patient with type I thrombasthenia. AB - Surface-labelled normal and thrombasthenic platelets have been subjected to phase separation in Triton X-114. Triton-rich and Triton-poor fractions have been analysed by SDS-PAGE and IEF-SDS-PAGE. Partitioning characteristics of the major glycoproteins have been defined. The Triton-rich fraction contained GPIIb, III, IV, VI, VII, VIII, GP38 and the IIb beta subunit. In contrast, the Triton-poor fraction contained the HMWGP, GPIa, Ib, IIb, III, V and GPIX. Analysis of the platelet membrane glycoproteins of a patient with Type 1 thrombasthenia has been carried out using Triton X-114. The value of the method in diagnosis of this condition and differences between our findings and those published previously are discussed. PMID- 3518136 TI - Chromogenic assay of endotoxin in platelet poor or rich plasma. AB - In order to determine which sample preparation, platelet rich plasma (PRP) or platelet poor plasma (PPP), is more suitable for clinical endotoxin assay, we investigated the binding of endotoxins to platelets by comparing the amount of endotoxin in PRP with that in PPP, using a newly developed colorimetric assay with chromogenic substrate (Boc-Leu-Gly-Arg-pNA). When purified endotoxins were added to human whole blood, the amount of endotoxin recovered in PPP was significantly lower than that in PRP for all endotoxins tested except that from E. coli 0111:B4 and their ability to bind to platelets was varied depending on the species of bacteria from which they were purified. However, the amount of endotoxin in PRP obtained from surgical patients (n = 50) was almost same as that in PPP with a correlation coefficient r = 0.95, indicating that natural endotoxins circulating in human blood may not bind to platelets and that PPP can be used for endotoxin assay as well as PRP. PMID- 3518137 TI - [Heart transplantation. Pathologico-anatomical aspects]. PMID- 3518138 TI - [Enuresis nocturna in school children in Bodo. A therapeutic trial with a vasopressin analog: desmopressin and imipramine]. PMID- 3518139 TI - [Twin pregnancy. The importance of early diagnosis and bedrest]. PMID- 3518140 TI - [Endomyocardial biopsy in heart transplanted patients]. PMID- 3518141 TI - [Aggressive and malignant bone tumors. Radical sparing surgery]. PMID- 3518142 TI - [Clinical trial of an ear oximeter]. PMID- 3518143 TI - [Trichinella spiralis as a teacher or the parasite-host relationship between a threadworm and an institute]. AB - The present paper provides a review of activities of the National Institute of Public Health in the field of studies on Trichinella spiralis in man and animals. The development of a system of (immune) surveillance of infections due to Trichinella in pigs has been central since the early sixties. Both the fluorescent antibody technique introduced in 1967 and the enzyme-linked immunosorbent assay (ELISA) published in 1974 are examples of these efforts. The method was standardised and, specifically, the ELISA method was mechanized. Comparative studies were done as part of the activities of the EEC working party concerned with trichinosis. The two methods were officially accepted by the EEC. Studies in the slaughter-house as well as in the piggeries (so-called 'in process control') are possible on the basis of the ELISA technique, in which method interest is also being taken in the United States today. Conceivably, industry in Europe will also become interested in the principles of good manufacturing practice, in which certification of slaughtered animals, based on negative results of ELISA studies (without any further inspection in the slaughter-house) will be possible in theory. In addition to the object directly aimed at, i.e. improvement of the method of detection in pigs, designed to prevent human trichinosis, studies on the parasite Trichinella spiralis centered, among other things, on closer examination of the immune response and effector mechanisms in regard to this nematode infection, in which particularly studies on the role of so-called intestinal mast cells produced interesting new views on the subject of (immunological) regulation. PMID- 3518144 TI - [Epidemiologic studies using computerized data bases. III. Various examples of epidemiological studies using computerized data bases]. AB - Three epidemiological observational studies, utilising data from the computerized data base at the Royal (Dick) School of Veterinary Studies, Edinburgh, are presented: the association between tail injuries and docking in dogs; a study of breed and sex in relation to canine degenerative heart valve disease, the association between urinary incontinence and spaying in bitches. PMID- 3518145 TI - [African swine fever in the Netherlands]. AB - African swine fever (ASF) was diagnosed for the first time in the Netherlands on a farm near The Hague, illegally feeding swill from hospitals, hotels and restaurants. Laboratory diagnosis was based initially on the indirect immunofluorescence test (IFT) and the immunoperoxidase monolayer assay (IPMA) for antibodies in tissue extracts and later on confirmed by the direct-IFT on cryostat sections, animal inoculation and haemadsorption. Clinical signs and post mortem lesions were consistent with the subacute form of ASF. Mortality amounted to 19% over a period of three weeks. Forty-three sera collected from animals in stables with active disease were all found positive by the IPMA. PMID- 3518146 TI - [Chronic benign neutropenia possibly caused by a plasma factor]. AB - In this article two patients are reported with recurrent upper airways and ENT infections. Laboratory investigation showed a persistent neutropenia. The bone marrow aspirations showed a normal cellularity of the erythroid series and the megakaryocytes. The myeloid series were normal with a decreased number of mature segmented neutrophils. In these patients the serum levels of immunoglobulins were within normal range and antibodies against the white cells could not be demonstrated. By the age of 2-3 years the recurrence of infections had decreased and infections of importance have not been reported since. By that age the peripheral white count was not abnormal. This combination of signs and symptoms is known as 'chronic benign neutropenia'. The etiology is obscure. Our investigation in one case (by that time recovered) showed a diminished growth of the myeloid series of donor bone marrow in the presence of patient's serum. This suggests a plasma-factor responsible for the maturation of the myeloid series. This finding has not yet been reported in the literature. PMID- 3518147 TI - Expression of blood group antigens including HLA markers in human adult liver. AB - The localisation of the principal blood group antigens has been studied in human liver. These blood group antigens included the erythrocyte antigens and the antigen of the major histocompatibility complex. This study was performed by the indirect immunofluorescence technique using polyclonal antibodies of human or animal origin and monoclonal antibodies from hybridomas. This study has shown that the normal hepatocyte is lacking in blood group antigens. On the contrary, the biliary cell was rich in antigenic markers: the main antigens expressed were Lewis, Pr, HLA-A and B antigens. In Kupffer cells, only i and HLA-DR antigens were clearly expressed. The endothelial cells of blood vessels mainly show A, B, H, HLA-A and B antigens; HLA-DR and Pr are slightly expressed. HLA-DR antigens were more strongly expressed on veins than on arteries. Dendritic cells have been identified in the portal space of human liver. They bore i and HLA-DR antigens. PMID- 3518148 TI - Canine MHC-class II antigens on B and T lymphocytes. AB - MHC-class II antigens on canine lymphoid cells were detected with monoclonal antibodies (Mabs). On the basis of reactivity with resting or activated T lymphocytes two groups of Mabs were reported earlier. Non-activated T lymphocytes expressed MHC-class II antigens recognized by the first group whereas the second group recognized only MHC-class II antigens on activated T lymphocytes. In this study we analysed the reactivity pattern of both groups of Mabs with purified canine B lymphocytes. One- and two-colour immunoflowcytometric analysis, immunoprecipitation, immunohistology and MLC inhibition were performed. The Mabs which only reacted with activated T lymphocytes appeared to stain also purified sIg+ lymph node cells. Two-colour fluorescence and immunohistology confirmed the reactivity of these Mabs with B lymphocytes. Immunoprecipitation showed the bimolecular structure of these antigens. It was concluded that two subsets of MHC class II antigens can be detected on canine lymphoid cells. One subset showed an aberrant distribution being expressed on both nonactivated and activated T and on B lymphocytes. The second subset of MHC-class II antigens could only be detected on B lymphocytes and activated T lymphocytes, a distribution pattern similar to that found in most other species, for instance man. PMID- 3518149 TI - [Sleepless nights and the psychologist]. PMID- 3518150 TI - A method for measurement of total circulating blood volume using indocyanine green. AB - A method of measuring total circulating blood volume (TBV) using indocyanine green (ICG) dye was investigated in 7 dogs and 16 patients. Since concentration of injected ICG decreases exponentially from the circulating system after recirculation, concentration of the dye at the time of appearance (Cta) can be extrapolated by extending the slope of the dye dilution curve transcribed to a semi-logarithmic graph. TBV was calculated using the following formula: TBV = I/Cta, where I is the amount (mg) of ICG injected. Repeat measurements of TBV using ICG demonstrated good reproducibility (average coefficient of variation, 2.0%) and when compared to measurements made with Evans blue dye resulted in a correlation coefficient of 0.98 or more. We conclude that assessment of TBV using ICG is reliable and experimentally and clinically feasible. PMID- 3518151 TI - A cytotoxic substance (CTS-51) produced by human buffy coat cultures stimulated by staphylococcal enterotoxin B: further characterizations and combined action with interferon. AB - A recently recognized unique cytotoxic substance, CTS-51, was tested for the hear or acid stability, trypsin digestion and dialysis. Moreover, influences of elevated incubation temperatures or serum concentrations of medium on the cytotoxic activity of CTS-51, and the combination effects of CTS-51 and human leucocyte interferon (HuIFN-alpha (Le)) were investigated. The cytotoxic activity of CTS-51, which is promoted by a small molecule easily passable the dialysis membrane, was found to be very stable to heat (even at 100 degrees C for 30 min) or acid (pH 2.0 for 24 hr at 4 degrees C) treatments. The treatment with 0.75% trypsin for 1 hr did not diminish the CTS-51 activity. The susceptibility of Daudi lymphoma cells to the antiproliferative action of HuIFN-alpha (Le) was further potentiated by treating the cells with CTS-51 for 16 hr. On the other hand, the CTS-51 activity which was revealed to be prescribed by its concentration in the medium, was not potentiated at 39 degrees C when compared to that at 37 degrees C in contrast to HuIFN-alpha (Le) action, and was reduced according to the increase of the fetal calf serum concentration in the medium. PMID- 3518152 TI - Liver transplantation in dogs after 30 minutes of warm ischemia. AB - In order to investigate the applicability of liver transplantation after warm ischemia, a partial auxiliary auto-transplantation of the liver after 30 min of warm ischemia was carried out in 9 mongrel dogs. Among them, 6 dogs survived longer than 7 days. Liver functions, blood coagulability and histological changes were investigated before and after the transplantation. Serum GOT, LDH, and GPT levels were elevated immediately after transplantation, and returned to normal within a few days. Hemostatic tests also showed significant abnormalities after transplantation. Although PT and thrombotest became normal within a week, PTT and antithrombin III remained slightly abnormal for longer periods. Microscopically, vacuolization and degeneration of hepatocytes were observed after transplantation but they recovered completely within 4 weeks. Based on these results, it could be said that the livers subjected to warm ischemia for 30 min ischemia were still acceptable for auxiliary transplantation. PMID- 3518153 TI - cis-Diamminedichloroplatinum (CDDP)-fosfomycin (FOM) combination in lung cancer patients with respect to the peripheral T lymphocyte subsets. AB - An antibiotic FOM was found to be preventive of the side effect of an antineoplastic drug CDDP on the peripheral T lymphocytes in lung cancer patients. Whereas finding a significant decrease in T3+ cells (p less than 0.01) and T4+ subset (p less than 0.05) with CDDP alone, the initial levels of these cell populations were kept unchanged in combination with FOM. T8+ subset showed no substantial change. A protective effect of FOM on T4+ subset was suggested to be an additional aspect of its action at least in combination with CDDP. PMID- 3518154 TI - Effect of T-2 toxin on regional blood flow and vascular resistance in the conscious rat. AB - The acute effect of T-2 toxemia on local blood flow and vascular resistance in hindquarter, mesenteric, and renal vascular beds was continuously measured by the directional pulsed Doppler technique in conscious, male Sprague-Dawley rats. Intravenous injection of T-2 toxin (1 mg/kg) in the conscious rat reduced blood flow and increased vascular resistance in all blood vessels studied but had no significant effect on mean arterial pressure or heart rate. The blood flow in hindquarters gradually decreased to a minimum of -77 +/- 9% (mean +/- SE) 6 hr after the toxin injection. The hindquarter vascular resistance concomitantly increased to a maximum value of +323 +/- 69% above the resistance before toxin administration. Mesenteric and renal blood flow initially increased (slightly) and then gradually decreased. The maximum drop of blood flow, -90 +/- 13% and -76 +/- 13% for the mesenteric and renal vascular beds, respectively, was achieved 4 hr after T-2 toxin injection and the blood flow values remained low for up to 6 hr. Simultaneously with the impairment of blood flow the mesenteric and renal vascular resistance increased to reach the maximal values of +404 +/- 99% and +556 +/- 15%, respectively. In addition, plasma renin activity was markedly elevated (+653 +/- 160%) at the time of reduced renal blood flow. Intravenous injection of the same value of vehicle (10% ethanol in saline) had no significant effect on any of the cardiovascular variables studied. Two of five rats in the T 2 toxin-treated group died within 5 hr after the T-2 toxin injection and only one animal survived 24 hr while all the control animals survived over 24 hr. The results suggest that strong vasoconstriction in skeletal muscle, mesenteric, and renal vascular beds leads to impairment of local blood flow. The ischemia in vital organs together with the earlier reported decrease in cardiac output by T-2 toxin might then be the cause of rapid death in acute T-2 toxemia. PMID- 3518155 TI - Decrease of hepatic mitochondrial glutathione and mitochondrial injury induced by 1,2-dibromoethane in the rat in vivo: effect of diethylmaleate pretreatment. AB - Diethylmaleate (DEM) potentiated the 1,2-dibromoethane (DBE)-induced hepatic morphological lesion in fasted male Wistar rats, as revealed by light and electron microscopy examination. The subcellular structures involved in such lesions were the mitochondria. The potentiating effect of DEM appeared to be due to enhancement of the depletion of hepatic mitochondrial glutathione (GSH) caused by DBE. DEM, however, failed to potentiate the DBE-induced release in the plasma of hepatic enzymes. The relationship between loss of mitochondrial GSH, mitochondrial injury, and the importance of the mitochondrial lesion in DBE induced hepatotoxicity is discussed. PMID- 3518156 TI - Ethyl acrylate-induced gastric toxicity. III. Development and recovery of lesions. AB - Rats receiving 14 daily gavage doses of 100 or 200 mg/kg ethyl acrylate (EtAc) and killed at varying times following the end of dosing exhibited dose-dependent lesions and recovery from lesions in the forestomach. The glandular stomach which was previously shown to be affected by acute exposure to EtAc appeared to have adapted to resist EtAc toxicity with repeat exposure and appeared normal in all animals. Adaptation of the forestomach was characterized by increased papillomatous thickening with dose. Lesions observed in acute exposure to EtAc were still present with repeat dosing and were more pronounced at the high dose. Forestomachs of rats which received 100 mg/kg EtAc for 14 days were recovered to normal within 2 weeks following the last dose. Forestomachs of rats receiving 200 mg/kg EtAc still exhibited numerous lesions 2 weeks following the last dose, and mucosal hyperplasia was present in the forestomachs at 4 weeks postexposure. Two lesions, submucosal fibrosis and foreign body reaction, became more prevalent in high-dose animals with time. Foreign body reaction, which was present in all animals 4 weeks postexposure, appeared to have resulted from entrapment of hair and/or feed particles in forestomach lesions in the course of healing. It is speculated that the increased cell proliferation and the induced foreign body reactions may contribute to the previously demonstrated carcinogenic effect of EtAc on the rat forestomach. PMID- 3518157 TI - Effects of deoxynivalenol (vomitoxin) on the humoral and cellular immunity of mice. AB - Sublethal doses (0.00, 0.25, 0.50 and 1.00 mg/kg b.w./day) of vomitoxin (deoxynivalenol; DON) were studied for their effects on humoral and cellular immunity and serum proteins of inbred, male Swiss Webster mice in a series of 4 separate experiments. Vomitoxin was added to basal diet (less than the detection limit, i.e., less than 0.05 micrograms of vomitoxin per g of feed) and administered to mice for 5 weeks beginning at 21 days of age. Mice in experiment 2 were fed the basal diet for 40 days in addition to the 5-week treatment with vomitoxin. The 1.00 mg/kg dose of vomitoxin resulted in a statistically significant reduction in the serum levels of alpha 1 and alpha 2-globulins, an increase in total serum albumin, and a reduction in feed consumption and body weight gain compared to the control group. The 0.50 mg/kg dose of vomitoxin resulted in significantly reduced serum levels of alpha 2- and beta-globulins while a significant reduction of feed consumption was evident only during Week 4. Similarly, body weight gain in this group of mice was significantly reduced during Week 2 but increased to normal levels during Week 3 and remained parallel to the control for Week 4 and 5. Both levels (0.50 and 1.00 mg/kg) of vomitoxin resulted in a reduced, dose-related, time-to-death interval following a challenge with L. monocytogenes and increased proliferative capacity of splenic lymphocyte cultures stimulated with the phytohemagglutinin P (PHA-P) mitogen compared to the control group of mice. The 0.25 mg/kg dose of vomitoxin did not have any significant effects on the parameters studied. A reasonable estimation of a 'no effect' level for immunologic effects in mice based on these and previous immunological studies would seem to be between 0.25 and 0.50 mg/kg b.w./day. PMID- 3518158 TI - Comparative induction of hepatic zinc-thionein and increase in tissue calcium by bacterial endotoxin in endotoxin-sensitive (C3H/HeN) and endotoxin-resistant (C3H/HeJ) mice. AB - Induction of zinc-thionein (Zn-Th) by endotoxin was studied in mice using an endotoxin-sensitive C3H/HeN strain and an endotoxin-resistant C3H/HeJ strain to find a relation between the sensitivity of these strains to endotoxin and the inducibility of hepatic Zn-Th by the endotoxin. Both strains of female mice were injected with endotoxin at two doses and the increase in hepatic Zn-Th levels was examined after 24 h. At the lower dose (0.25 mg/kg body weight), C3H/HeJ mice induced Zn-Th at a markedly lower level than C3H/HeN mice. However, both strains exhibited a comparable amount of Zn-Th when a higher dose (10 mg/kg body weight) of endotoxin was used. A parallel increase in hepatic calcium concentration was observed with the induction of hepatic Zn-Th in both strains. The injection of a spleen supernatant fraction from C3H/HeJ mice into C3H/HeN mice did not reduce the Zn-Th induction by endotoxin in C3H/HeN mice. PMID- 3518159 TI - Metabolism of 2-aminofluorene by rat small-intestine fractions: differential effect of intragastric versus intraperitoneal administration of 3 methylcholanthrene. AB - The influence of 3-methylcholanthrene (3-MC) induction on small intestinal enzymes was studied by measuring the enzymatic characteristics of 2-aminofluorene N-hydroxylase and the activation of this aromatic amine into mutagen(s) towards Salmonella typhimurium. When injected intraperitoneally to rats, 3-MC modified neither the N-hydroxylation nor the mutagenic properties of 2-aminofluorene (2 AF) in the presence of postmitochondrial and microsomal fractions from small intestine. On the other hand, the intragastric administration of the inducer slightly increased affinity and significantly induced maximum velocity of N hydroxylase. Moreover, the ability of the small intestinal fractions to activate 2-AF into mutagenic intermediate(s) was enhanced after intragastric application. The mode of administration seems to be crucial in the induction of small intestinal enzymes required for metabolic and mutagenic activation of carcinogenic aromatic amines such as 2-AF. PMID- 3518160 TI - CDC guideline for handwashing and hospital environmental control, 1985. PMID- 3518161 TI - Immune anti-A1 in A2 recipients of kidneys from group O donors. AB - Antibodies specific for recipient red cell antigens have been demonstrated in patients who receive organs from ABO unmatched donors. In some cases, severe but self-limited hemolysis has been associated with the development of posttransplantation antibodies. We report a case in which an A2 recipient of a kidney from a group O donor formed anti-A1 antibody which reacted with homologous red cells. The patient developed a delayed hemolytic transfusion reaction. A radiochromium survival study revealed decreased survival of A1 red cells. A broader specificity of the antibody was not shown during follow-up. The anti-A1 was not detected in a sample tested 6 months after the initial study. It is probable that the anti-A1 noted in this case was formed by passenger lymphocytes. A2 patients who develop anti-A1 after renal transplantation should be transfused with red cells negative for A1. PMID- 3518162 TI - Lifelong reversal of the metabolic abnormalities of advanced diabetes in rats by whole-pancreas transplantation. AB - Evidence suggests that metabolic abnormalities are responsible for the widespread microvascular complications of insulin-dependent diabetes mellitus (IDDM). Interest in endocrine pancreas replacement therapy, including pancreas transplantation, is based on the hope that such treatment will reverse the complications of IDDM by providing more precise metabolic control than conventional therapy. To determine if whole pancreas transplantation is capable of reversing well-established metabolic abnormalities of diabetes mellitus (DM) and maintaining strict metabolic control for life, we performed monthly metabolic studies for 2 years in 141 nondiabetic control rats, 273 diabetic control rats with alloxan-induced DM, and 267 diabetic rats that received syngeneic whole pancreaticoduodenal transplants 6, 9, 12, 15, 18, and 21 months after induction of DM with alloxan. Whole-pancreas transplantation in rats with long-standing DM permanently reversed the metabolic disorders. Elevated plasma glucose concentrations were permanently reduced to normal, depressed plasma insulin levels were permanently increased to normal, elevations of BUN and serum creatinine were permanently normalized, and there was a striking gain in body weight. Hyperglycemia during glucose tolerance tests was of lesser magnitude and shorter duration than normal, as a result of greater-than-normal plasma insulin levels. The only abnormality that persisted was hyperglucagonemia, but it did not interfere with control of hyperglycemia and is of unknown significance. These results indicate that whole-pancreas transplantation produces the most complete and sustained correction of the metabolic abnormalities of experimental DM of any available therapeutic modality. PMID- 3518163 TI - ALG treatment of steroid-resistant rejection in patients receiving cyclosporine. AB - Thirty-one episodes of biopsy-proved acute rejection (R) in 28 patients maintained on cyclosporine did not respond to high-dose steroids and were treated with antilymphocyte globulin (ALG). Cyclosporine was discontinued in all but three during ALG administration. (A) Twenty-four patients received 26 courses of ALG within 90 days of transplant (11 1st R, 15 2nd or 3rd). Seven treatment courses were cut short due to infection (4), ongoing R (2) and a combination of infection and rejection (1). Only 1 of 7 has a functioning graft. Of the remaining 19 full ALG courses (17 patients) (8 1st R, 11 2nd or 3rd), 13 (11 patients) responded (7 1st R, 6 greater than 1st). The remaining 6 patients lost their grafts to ongoing acute rejection. (B) Five patients were treated after 6 months posttransplant; two responded but no grafts currently function. (C) Overall 7 patients developed systemic infection (7 viruses, 1 Candida) with 1 death, and 2 additional patients developed severe thrombocytopenia and leukopenia. Patients responding to their ALG course were restarted on cyclosporine. We conclude that ALG is not as effective in reversing steroid resistant rejection in patients maintained on cyclosporine as it has been in patients maintained on azathioprine. However, more than 50% of steroid-resistant rejection episodes are reversed. PMID- 3518164 TI - Severe aplastic anemia associated with chronic mucocutaneous candidiasis. Immunologic and hematologic reconstitution after allogeneic bone marrow transplantation. AB - Chronic mucocutaneous candidiasis (CMC) is typically associated with the inability of T lymphocytes to proliferate and produce lymphokines in response to Candida antigen. A 7-year-old girl with CMC developed severe aplastic anemia and, after conditioning with cyclophosphamide, 200 mg/kg, underwent bone marrow transplantation from her HLA-identical sister. Engraftment was prompt and complete. The patient is surviving more than 3 years after transplantation with normal donor-derived hemopoiesis and immune function. Manifestations of CMC have resolved completely and she has not received antifungal therapy for more than 2 years. PMID- 3518165 TI - A critical look at survival of diabetics with end-stage renal disease. Transplantation versus dialysis therapy. AB - The survival of 100 consecutive patients with diabetic nephropathy after treatment with hemodialysis, peritoneal dialysis, or renal transplantation was reviewed at our institution from 1976 to 1982. Standard actuarial survival analysis revealed an overall survival of 83% and 61% at one and two years, respectively. Coronary angiography was used as a screening procedure for renal transplantation. In the dialysis group, 27 patients were considered acceptable transplant candidates on the basis of the coronary angiography but were not transplanted for other reasons. When the survival analysis was limited to those "transplant candidates" the survival rates were 78%, 51%, and 8% at 1, 2, and 5 years, respectively. In comparison, survival after transplantation was 81%, 67%, and 45%, at 1, 2, and 5 years, respectively. In order to eliminate bias, survival comparisons were subsequently made using the Cox Proportional Hazard Model to take into account the time the transplant patients spent on dialysis prior to renal transplantation. When this analysis was performed, there was no significant difference in survival between transplantation and dialysis for the first two years, but overall survival after five years was significantly better after renal transplantation even when the comparison was limited to acceptable transplant candidates who remained on dialysis (P = .04). Survival for patients with significant coronary disease (greater than 70% stenosis of a coronary vessel or moderate to severe left ventricular dysfunction) was analyzed according to therapeutic modality. Although overall prognosis was poor in this group as a whole (1, 2, and 5 year survivals were 76%, 45%, and 19%, respectively), the cardiac patients had a trend to better survival after renal transplantation than when maintained on dialysis (P = .22). In addition to other factors such as quality of life, rehabilitation, and progression of other diabetic complications, the benefit of renal transplantation on patient survival must be considered when deciding between renal transplantation and maintenance dialysis therapy for diabetic patients with renal failure. PMID- 3518166 TI - Autonomic system dysfunction and polyneuropathy in nondiabetic uremia. A one-year follow-up study after renal transplantation. AB - Polyneuropathy and autonomic dysfunction were studied in 15 patients with nondiabetic terminal uremia before renal transplantation and again at 6 and 12 months after the transplantation. Beat-to-beat variation of the electrocardiogram (ECG) relative to mean beat interval was used as an observation of the function of the parasympathetic vagal reflex arc. Marked autonomic dysfunction--i.e., reduced beat-to-beat variation and a mild diffuse polyneuropathy--was found. The neuropathy was mainly of axonal type, but a slowing of conduction velocities was also found. The latter was markedly improved after transplantation and is suggested to be caused by a toxic metabolic factor, possibly causing nodal dysfunction. Action potential amplitudes and autonomic function did not improve during the study. This implies a structural damage that is not repaired in 12 months. Neurological examination should be included in the care of patients with uremia, and the results should be one of the factors considered when transplantation is discussed. PMID- 3518167 TI - Transfusion of donor class I MHC antigen prior to kidney transplantation in dogs. PMID- 3518168 TI - Optimization by timing of oral cyclosporine to prevent acute kidney allograft rejection in dogs. PMID- 3518169 TI - Hematuria and hypercalciuria following renal transplantation. PMID- 3518170 TI - Proceedings of the Second International Congress on Organ Procurement. October 3 5, 1985, Detroit, Michigan. PMID- 3518171 TI - [Immunocytochemical and autoradiographic research on the growth of serotoninergic fibers to the cerebral ventricles in the perinatal period in rats]. AB - Anatomical relationships between serotoninergic (5-HT) fibers and cerebral ventricles were studied in rats from the 16th fetal day until the 9th postnatal day with immunocytochemistry and radioautography. In the latter case, 5-HT neuronal elements were detected according to their specific uptake of intraventricularly injected 3H-5-HT. On the 16th fetal day, occasional 5-HT fibers first spread from the main place of their origin in the raphe nuclei to the dorsocaudal portion of the 3rd ventricle and aqueduct. Two days later, a more extensive network of 5-HT fibers appeared around the dorsal portion of the 3rd ventricle, whereas fibers only rarely penetrated fibers became noticeable in the lateral and 3rd ventricles. The functional significance of hypothalamic and ventricular 5-HT is discussed from the standpoint of its being either a modulator of growth and differentiation of the developing brain, or a factor involved in some specific neuroendocrine functions. PMID- 3518172 TI - [Simple method of calculating the average duration of mitosis by using a radiation method]. AB - On the mitotic index curve of the cellular population following radiation there is a linear part. The time interval between the initial decrease of the mitotic index and the extrapolation of the straight part of the curve to X-axes is the mean duration of mitosis. The values of this parameter for the culture of fibroblasts obtained by this method are practically identical with those obtained by a method based on determination of the mitotic index and the doubling time of the cell count. PMID- 3518173 TI - [Stability and absorption of liposomes with incorporated insulin in the small intestine]. AB - Lecithin-cholesterol liposomes with the incorporated insulin were studied in vitro for their stability to the action of some factors of gastrointestinal tract -hydrochloric acid, gastric juice, pepsin, trypsin, bile. A considerable destructive action of bile on liposomes is established. Modification of the lipid composition of liposomes makes it possible to increase their stability to the bile action. Suction of liposomes from the isolated sites of rat small intestine is studied. Insulin from liposomes is established to be sucked most intensive from the initial parts of small intestine. In this case it penetrates into the blood bed not in a free state but in the composition of liposomes. PMID- 3518174 TI - [Serine proteinases of lower vertebrates]. AB - Recent data on the effect of serine proteinases of lower vertebrates are generalized. Hydrolysis specificity and kinetics of different synthetic substrates, dependence of the activity of enzymes on pH, their irreversible inhibition by chloromethyl ketones of amino acids and peptides as well as high molecular proteinase inhibitors are considered in detail. The data testify to the fact that chymotrypsins and trypsins of higher vertebrates and serine proteinases of lower vertebrates act as an acid-base catalysis. Enzymes in the pyloric cacca of fishes are in the state of proenzymes and are transformed into an active form with the aid of their own proteolytic factors. The esterase and proteolytic activity of fish proteinases is concentrated in the same active site and reaches the highest values at pH 7,8. New data are presented on particularities of the lower vertebrate proteinases, on the similarity and differences in their specificity. A distinct difference is shown in the nature of the binding site of the active centre in a number of serine proteinases of fishes as compared to chymotrypsin and trypsin of higher vertebrates. PMID- 3518175 TI - [Local proteolytic treatment of infected leg ulcers]. PMID- 3518176 TI - [Pain reaction in patients with venous leg ulcers during treatment with Trypure]. PMID- 3518177 TI - [Ultrasonic scanning of IUD wearers with a string missing in the external orifice]. PMID- 3518178 TI - [Insulin receptors and the effect of insulin. Possible pathogenetic significance of abnormalities of insulin receptors and post-receptor function in diabetes mellitus and other insulin-resistant conditions]. PMID- 3518180 TI - [Relaxation technics and anxiety]. PMID- 3518181 TI - [Psychiatric manifestations of multiple sclerosis: critical review of the literature]. PMID- 3518179 TI - [Plasmodium falciparum malaria resistant to chloroquine in 2 Canadian travelers]. PMID- 3518182 TI - Radiation nephritis. Clinical manifestations and pathophysiologic mechanisms. AB - Radiation nephritis is both volume and dose related. Clinical experience would indicate that a minimum of one third of the renal volume needs to be excluded from nephrotoxic doses which appears to have a threshold of 2,000 cGy. The site of damage leading to renal failure appears to be the microvasculature ultimately expressed as glomerulosclerosis. How much direct damage to the tubular system contributes to this process is unclear, but undoubtedly the resultant systemic physiologic effects potentiate the expression of damage in the irradiated kidney. The acute syndrome, with all the potential manifestations of renal failure, rarely presents sooner than six months and appears to have no clear prodrome, although it would seem reasonable that a subclinical syndrome consisting of abnormalities detectable by urinalysis may occur. Treatment of radiation-induced nephritis or hypertension is no different from treatment for nephritis from any other cause and should be aggressive with lifelong follow-up. Carcinogenesis is a rare late expression of radiation-induced kidney damage. PMID- 3518184 TI - [Hyperbaric oxygenation in the intensive treatment of otorhinolaryngological patients]. PMID- 3518183 TI - Prophylactic antibiotics in transurethral resection of bladder tumors: are they necessary? AB - In a double-blind study, 30 patients having transurethral surgery for bladder tumors were randomly assigned to receive prophylactic carbenicillin indanyl sodium or a placebo perioperatively. Only one patient in the carbenicillin group had a postoperative urinary infection due to carbenicillin-resistant Klebsiella oxytoca organisms. Thus, no advantage from the prophylactic use of antibiotics was evident in this uninfected group of patients. PMID- 3518185 TI - [Mastoido- and tympanomastoidoplasty using brephocartilaginous and corneal xenotransplants]. PMID- 3518186 TI - [Measurement and evaluation of nasal respiratory function (rhinopneumometry) (review of the literature)]. PMID- 3518187 TI - [Use of anti-inflammatory x-ray therapy in surgical practice (review of the literature)]. PMID- 3518188 TI - [Directed percutaneous punctures of pathological liver foci controlled by computed tomography and ultrasound]. AB - In 42 patients with various diseases of the liver 45 aimed percutaneous biopsies were performed. The morphological diagnosis of the disease was verified in 38 of the 42 examined patients (90.5%). After the diagnostic punctures 19 patients with cysts and abscesses of the liver were given different curative manipulations. PMID- 3518189 TI - [Operative treatment of osseous and osteoarticular paronychia by applying a closed suture to the wound and by prolonged intra-osseous administration of antibiotics]. AB - Continuous intraosseous injections of antibiotics were used in 104 patients in the operative treatment of bony and osteo-articular panaritium with putting primary sutures on the wound. Healing by first intention was noted in most cases. PMID- 3518190 TI - [Treatment of compression fractures of the spine]. PMID- 3518191 TI - [Hemodynamics in controlled normovolemic hemodilution in patients with obliterative vascular diseases]. AB - The influence of acute controlled normovolemic hemodilution on the parameters of central hemodynamics was studied in 40 patients with obliterating diseases of lower extremities with eukinetic, hyperkinetic and hypokinetic types of blood circulation. Cardiac output was found to increase and general peripheral resistance to decrease after hemodilution. The greatest changes were noted in patients with the initial hypodynamic type of blood circulation. It was found that 24% increase of the oxygen transport function of the blood circulation was reached without an increase of the intensity of cardiac activity and hypoxia of the myocardium. PMID- 3518192 TI - [Pigmented gallstones]. PMID- 3518193 TI - [Multiple polyps and cancer of the large intestine]. PMID- 3518194 TI - [Rare forms of ureteral pathology in surgical practice]. AB - Clinical observations of two patients are described. Direct vesicopelvic anastomosis was fulfilled in both of them: in one patient--in autotransplantation of the left kidney, in the other--in pelvic dystopia of the hydronephrotically altered right kidney. Clinical recovery and perfect restoration of working capacity of the patients was obtained. None of them had vesicopelvic refluxes. PMID- 3518195 TI - [Causes for the recurrence of an epithelial coccygeal cyst]. PMID- 3518196 TI - [The danger zone in heart wounds]. AB - On the basis of statistical analysis of chest wounds in 349 patients the authors have determined the "risk zone". Wounds in this zone have the greatest probability to injure the heart. The zone is restricted by the II-VIII ribs on the left and III-VIII ribs on the right, left medioaxillary and right parasternal lines. PMID- 3518197 TI - [Use of demineralized bone matrix in children]. AB - Eighty five clinical observations of the authors have shown autotransplants demineralized in the solution of hydrochloric acid to possess pronounced osteoinductive properties. Their ability to induce osteogenesis was mostly pronounced in simultaneous plasty with a demineralized and frozen bone. Reconstructive processes are perfectly completed within 18-24 months after operation. PMID- 3518198 TI - [Salmonella osteomyelitis in an infant]. PMID- 3518199 TI - Etiopathogenesis, clinical manifestations, and management of canine calcium oxalate urolithiasis. AB - Calcium oxalate uroliths are commonly called metabolic uroliths because they are sequelae of a variety of metabolic abnormalities that alter the composition of body fluids and urine. Factors incriminated in the etiopathogenesis of calcium oxalate urolithiasis include hypercalciuria, hyperoxaluria, and hyperuricosuria. The predominant type of calcium oxalate urolith encountered in dogs is the monohydrate form; however, the dihydrate form may also occur. Male dogs have been more frequently affected than female dogs. Medical therapy should be formulated with the goal of reducing urine concentration of calculogenic substances. PMID- 3518200 TI - Canine calcium phosphate uroliths. AB - Uroliths composed primarily of calcium phosphate are identified in approximately 3 per cent of canine stone patients. Predisposing factors to the formation of calcium phosphate uroliths include elevated urine pH, hypercalciuria, and the presence of crystallization inhibitors and promoters. Medical therapy of patients forming calcium phosphate uroliths should initially be directed at removing factors contributing to urine supersaturation with calcium phosphate. PMID- 3518201 TI - Initiation and growth of uroliths. AB - The urinary concentrating capacity of terrestrial animals often results in a high degree of urinary supersaturation. Supersaturation provides a driving force for rapid precipitation of solids. For some minerals in urine, the balance between supersaturation and presence of inhibitors determines whether crystal growth will occur. If crystals are delayed in their transit through the urinary tract, they may grow to such a size that they cannot readily pass through the ureters or urethra. PMID- 3518202 TI - Etiopathogenesis of canine struvite urolithiasis. AB - Urine must be oversaturated with magnesium ammonium phosphate for struvite uroliths to form. Oversaturation of urine with magnesium ammonium phosphate may be associated with several factors, including urinary tract infections with urease-producing microbes, alkaline urine, diet, and genetic predisposition. Of the urease-producing microbes, staphylococci are most struvitogenic in dogs. The precise mechanisms resulting in formation of sterile struvite uroliths in dogs have not been determined. PMID- 3518203 TI - Etiopathogenesis of uric acid and ammonium urate uroliths in non-Dalmatian dogs. AB - The etiopathogenesis of uric acid, sodium acid urate, and ammonium acid urate uroliths in non-Dalmatian dogs appears to be a complex phenomenon. It may involve one or more pathologic and/or physiologic processes acting independently or in concert to increase urinary concentration of lithogenic substances that result in initiation, growth, and retention of urate uroliths. Increased urine uric acid concentration and/or urinary excretion of uric acid appear to be primary predisposing factors in urate lithogenesis. Specific disorders resulting in hyperuricuria may involve abnormalities of increased synthesis, diminished biodegradation, and/or enhance excretion of uric acid. In addition, ammonium ion, hydrogen ion, and other organic and inorganic urine constituents appear to have major influences on urate urolith formation. Unfortunately, many specific disorders of uric acid metabolism and other factors promoting or inhibiting urate urolith formation remain poorly characterized in the majority of non-Dalmatian dogs with urate urolithiasis. Growing awareness of the significance of urate uroliths in non-Dalmatian dogs should encourage further investigation into the identification, characterization, and quantitation of parameters influencing urate lithogenesis. Results of such studies are required for development of practical and effective strategies for treatment and prevention of canine urate urolithiasis. PMID- 3518204 TI - Etiopathogenesis of uncommon canine uroliths. Xanthine, carbonate, drugs, and drug metabolites. AB - Metabolic disorders, medication, and diagnostic agents may be associated with urolithiasis in dogs. Examples of uroliths that have been uncommonly encountered in dogs include xanthine, dolomite, tetracycline, and sulfonamides. Detection of these and other apparently uncommon uroliths requires a high index of suspicion and proper methods of analysis. PMID- 3518205 TI - Canine primary hyperparathyroidism and its association with urolithiasis. AB - Primary hyperparathyroidism results from autonomous secretion of parathyroid hormone by a single or multiple parathyroid glands. Clinical signs result from various combinations of hypercalcemia, hypercalcemic nephropathy, urolithiasis, or mobilization of calcium and phosphorus from bone. Following parathyroidectomy, the prognosis for dogs with primary hyperparathyroidism is good if the disorder is diagnosed before renal disease is advanced. PMID- 3518206 TI - Radiographic and ultrasonographic features of uroliths and other urinary tract filling defects. AB - Radiopaque uroliths and nonradiopaque (water density) uroliths are filling defects encountered in the urinary tracts of dogs and cats. Other free luminal and attached soft tissue density filling defects encountered during uroradiographic special procedures include blood clots, air bubbles, hematomas, granulomas, abscesses, inflammatory and neoplastic polyps. Nonradiopaque uroliths cannot be identified on survey radiographs from other soft tissue dense structures. Gray scale ultrasonography can be used to differentiate nonradiopaque (water dense) uroliths from other soft tissue attached or free luminal filling defects of the excretory pathway. The differential radiographic features of filling defects encountered during cystography and urethrography are described and illustrated. PMID- 3518207 TI - Bacterial culture of uroliths. Techniques and interpretation of results. AB - This article discusses techniques of bacterial culture of uroliths, interpretation of results of culture, and antimicrobial therapy of bacteria associated with uroliths. PMID- 3518208 TI - Hyena disease in cattle: a review. AB - Hyena disease was first reported in France in 1975 and since then has been recognized in many countries. It is currently regarded as a disorder of skeletal development, mainly localised in the pelvic limbs of young cattle. Some investigators consider that it is a metabolic disease but the authors believe that it may be caused by a virus. Their hypothesis, according to which bovine virus diarrhoea-mucosal disease virus is involved, is based on epidemiological, histopathological and immunological evidence. PMID- 3518209 TI - Immunofluorescence and cell culture techniques in the diagnosis of viral infection of aborted bovine fetuses. PMID- 3518210 TI - A review of toxoplasmosis in pigs. AB - Toxoplasma gondii infection is highly prevalent in pigs in most countries, but little is known of its epizootiology. Transplacental infection appears to be less common than post-natal infection. Most pigs acquire subclinical infection. Clinical toxoplasmosis occurs mostly in young pigs. The frequency of oocyst- vs tissue cyst-acquired infections is unknown. Why clinical toxoplasmosis is more prevalent in Japan than in other countries is puzzling and needs investigation. In experimentally infected pigs, tissue cysts persist in edible organs for several months. They persist longer in the brain, heart and tongue than in other tissues. PMID- 3518211 TI - A review of toxoplasmosis of animals in the U.S.S.R. AB - Information on the serologic and parasitologic prevalence of Toxoplasma gondii infection in domestic and wild animals of the U.S.S.R. is reviewed. Although complement-fixing antibodies to T. gondii were widely prevalent in animals, little information is available on the presence of viable T. gondii in tissues of animals. Reports of epizootics in which T. gondii was suspected to be the causative agent of toxoplasmosis are summarized. Also, the strict economic impact of toxoplasmosis on agriculture in the U.S.S.R. needs evaluation. PMID- 3518212 TI - A review of eosinophil chemotaxis and function in Taenia taeniaeformis infections in the laboratory rat. AB - The eosinophil has long been associated with diseases of acute hypersensitivity and with parasite infections, but its exact role in the pathogenesis of these conditions remains uncertain. Characterization of factors associated with migration of eosinophils into tissues has helped to elucidate eosinophil function. Eosinophil chemotactic factors associated with acute hypersensitivity reactions include the eosinophil chemotactic factors of anaphylaxis, histamine, and arachidonic acid metabolites, all of which are released from mast cells, and the lymphokine eosinophil stimulation promoter (ESP). Eosinophilotaxins associated with parasitic diseases include the lymphokine ESP and the low molecular weight factor ECF-G, both associated with schistosome infection in mice. In addition, in several parasite infections parasite-derived protein eosinophil chemotactic factors have been identified and characterized. The proteins associated with Ascaris, Anisakis, and Schistosoma infections appear to be distinct from one another. We have recently partially characterized a protein from Taenia taeniaeformis larvae which has marked chemotactic activity for eosinophils. In addition we have demonstrated eosinophil chemotactic activity associated with metabolism of arachidonic acid by T. taeniaeformis metacestodes. The results of studies in taeniasis and other parasite infections, therefore, indicate that parasite-derived factors may directly influence migration of eosinophils. PMID- 3518213 TI - An overview of serological tests currently available for laboratory diagnosis of parasitic infections. AB - Current methods and commercial test systems for the diagnosis of parasitic infections in both animals and humans are reviewed. Lists of test kits and their manufacturers are provided along with ordering information: the only commercially available test kits are for the diagnosis of toxoplasmosis in humans or animals and dirofilariasis (heartworm) in dogs. A partial list of diagnostic laboratories and the parasite tests they perform is also provided. Complete lists of diagnostic tests that could be obtained in the private sector are not available but would be useful. Two microfluorometric solid-phase assay systems are reviewed, and adaptations to custom assays for several kinds of parasites are briefly described. User problems in performing tests and interpreting results are stressed with emphasis placed on diagnosis of dirofilariasis in dogs. False positive serology in dogs without heartworms and negative antibody responses in micro-filariae-positive animals are discussed with respect to proper interpretation of results. PMID- 3518215 TI - Determination of IgM and IgG antibodies to Toxoplasma using the IFA test, ELISA, and Dot-ELISA procedures. AB - The dot enzyme-linked immunosorbent assay (Dot-ELISA) and the enzyme-linked immunosorbent assay (ELISA) were compared with the immunofluorescent antibody test (IFA) for detection of IgM- and IgG-specific antibodies to human toxoplasmosis. Reciprocal titers were determined in all three assays using sera from 56 patients with suspected toxoplasmosis or with symptoms and diseases requiring exclusion of toxoplasmosis and control sera from 56 healthy persons. Using the Dot-ELISA, six patient sera (10.7%) were positive at titers of greater than equal to 1024 for IgM antibodies (titer range 1024-16 384) and 47 sera (84%) were positive for IgG antibodies (titer range 16-262 144) at a titer of greater than or equal to 16. One control serum was reactive for IgM (titer 1024) and 10 control sera (18%) were positive for IgG in the Dot-ELISA. In the ELISA, at titers of greater than or equal to 128, five sera (9%) were reactive for IgM (titer range 128-512) and 52 sera (92.8%) were reactive for IgG (titer range 32 8192) at a titer of greater than or equal to 32; no control sera gave positive reactions for IgM while 10 sera (18%) were positive for IgG in the ELISA. Using the IFA test at reciprocal titers of greater than or equal to 16, four sera (7.1%) were positive for IgM (titer range 32-512), and 51 sera (91%) were positive for IgG (titer range 16-8192). None was reactive for IgM, and eight sera (14%) were positive for IgG (titer range 32-128) in the IFA test. The Dot-ELISA correlated well with the IFA test (correlation coefficient = 0.895) and the ELISA correlated slightly higher with the IFA test (correlation coefficient = 0.910) for detection of IgG antibodies to Toxoplasma gondii. PMID- 3518214 TI - Unique characteristics of local responses in host resistance to mucosal parasitic infections. AB - Because of the tremendous impact that parasitic infections have on the health and productivity of humans and domestic animals, considerable research effort has been focused upon understanding the mechanisms of host-parasite coexistence, host resistance and immunopathology. Studies have employed a range of approaches including: kinetic analysis of parasite establishment, development, fecundity and survival in naive and previously-infected hosts; correlation between parasite survival and histopathologic responses at the site of infection; vaccination with attenuated parasites or their products; cellular and serum transfer of immunity to naive or immunocompromised hosts; pharmacologic manipulation of potential mediators of host defense using agonistic and antagonistic drugs. However, it is becoming increasingly clear that to understand the mechanisms associated with host resistance and parasite survival, one must define the characteristics of the local microenvironment at the host-parasite interface. One of the approaches by which such studies can be made involves the isolation and characterization of cells derived from the local infection site. This manuscript reviews some of these studies on local aspects of mucosal immune responses in parasitic infections. Examples that will be discussed include IgA antibody, intraepithelial leukocytes from the intestine, intestinal mast cell populations, macrophages derived from bronchoalveolar lavage, and local immunoregulatory responses during respiratory and intestinal parasitic infection. These studies have established unequivocally that local responses to mucosal parasitic infection can only be appropriately investigated using cells derived from the specific microenvironment. This conclusion should encourage others to further study these local responses and to be innovative in investigating unexplored aspects of the host-parasite interface. PMID- 3518216 TI - Species-specific serodiagnosis of equine piroplasma infections by means of complement fixation test (CFT), immunofluorescence (IIF), and enzyme-linked immunosorbent assay (ELISA). AB - The increasing horse trade requires a reliable immunodiagnosis of equine piroplasma infections due to import restrictions imposed by various countries, including the United States of America. It was the aim of our investigations to establish the suitability of serological tests for the detection of parasite carriers and, eventually, to differentiate between Babesia caballi and B. equi infections. The investigations were carried out on 11 ponies with experimentally induced B. caballi and/or B. equi infection. The infections were confirmed by the demonstration of parasites in blood smears 2-13 days post infection (PI). The complement fixation test (CFT), the indirect immunofluorescence (IIF) and the enzyme-linked immunosorbent assay (ELISA) were employed for the demonstration of antibodies, and different antigen preparations were tested for their suitability. Antibodies could be demonstrated by all three tests. Complement-fixing antibodies disappear after 2-3 months PI in B. caballi-infected horses, while the IIF and ELISA gave positive results during latent infection. A reliable serodiagnosis thus requires the use of the CFT and IIF, since parasite carriers may appear seronegative by the CFT. Serological differentiation between B. caballi and B. equi was possible by CFT and, to a certain extent, by IIF during early infection, but not by ELISA. The successful treatment of B. caballi infections with Berenil could only be confirmed serologically by IIF. PMID- 3518218 TI - Resistance to fascioliasis--a review. AB - Attempts to actively stimulate or passively transfer resistance to Fasciola hepatica or F. gigantica in various laboratory and farm animals including mice, rats, rabbits, sheep, goats and cattle have been reviewed. These attempts comprised sensitization by primary homologous or heterologous normal or irradiated infections per os, sensitization by subcutaneous, intramuscular or intraperitoneal implantation with the various fluke stages, sensitization by somatic extracts or metabolic products of mature or immature flukes and passive transfer of resistance by immune serum or sensitized lymphocytes. PMID- 3518217 TI - Serodiagnosis of experimental and natural Babesia equi and B. caballi infections. AB - The sensitivity and specificity of the complement fixation (CF) test for the diagnosis of Babesia infections in equines was assessed, using the indirect fluorescent antibody (IFA) test as a reference. Antibodies were first detected between 11 and 20 days post infection (dpi) in the CF test and between 7 and 14 dpi in the IFA test in ponies infected experimentally with B. equi (USDA strain). The CF test became negative in four of five ponies 63-174 dpi although B. equi was demonstrated microscopically in two of these four ponies up to 364 and 455 dpi. The IFA test remained positive up to 476 dpi (end of the examination period). Ponies infected experimentally with B. caballi (USDA strain) showed positive reactions in the CF test at first between 13 and 15 dpi and in the IFA test 10 or 11 dpi. The CF test became negative in two of three ponies 80 and 140 dpi, whereas the IFA test remained positive up to 190 dpi (end of the examination period). Cross-reactions of sera with heterologous antigens occurred at dilutions of 1/5 in the CF test and up to 1/20 in the IFA test. A total of 3944 CF tests was performed on 3765 horses from various European countries during 1980-1984. Sera that gave positive or trace CF reactions were retested in the IFA test. All 123 CF-positive sera were also IFA-positive and 26 of 31 sera (B. equi) and 11 of 32 sera (B. caballi) showing CF trace reactions were positive in the IFA test. Sera of two CF-negative horses were positive in the IFA test (B. equi); one of these horses was also positive upon microscopic examination. In seven of 21 horses repeatedly examined over longer periods the IFA titers (B. equi) persisted for up to 454 days longer than the CF titers. Sera of horses from highly endemic areas gave the following reactions: Sudan, 62 of 91 sera CF- and 86 of 91 IFA positive; Zaire, 58 of 75 sera CF- and 72 of 75 IFA-positive; Columbia, 51 of 56 sera CF- and 56 of 56 IFA-positive; Brazil, 17 of 25 sera CF- and 21 of 25 IFA positive. Only B. equi infections were demonstrated in Zaire. The combined use of the CF and IFA tests is recommended for safe identification of equine Babesia infections. PMID- 3518219 TI - Bovine bonkers: new terminology for an old problem a review of toxicity problems associated with ammoniated feeds. PMID- 3518220 TI - Plant poisoning in canines and felines. PMID- 3518221 TI - Fate of synthetic organic chemicals in soil-groundwater systems. AB - Land disposal of municipal, industrial and agricultural wastes often leads to soil and groundwater contamination with synthetic organic chemicals. In this review, the fate of such organics in soils and the subsurface environment is discussed. In particular, the biodegradation of organic compounds in soils and the subsurface region, as well as the sorption of these compounds to soils is emphasized. Due to the disastrous impact of groundwater contamination on a community and the great cost of restoring a contaminated aquifer, a case is made for concentrating future efforts on isolating potential sources of groundwater contamination and instituting appropriate control measures. PMID- 3518223 TI - Factors affecting the yield of viable cells of Corynebacterium pseudotuberculosis in a liquid medium. AB - Growth of Corynebacterium pseudotuberculosis in an undefined liquid medium was studied with the aim of obtaining uniform, single-cell suspensions of the organism suitable for experimental infection. Adequate yields of viable cells were shown to be dependent on a fermentable substrate and a buffering system in a medium containing Tween 80. The development of Nutrient Tween 80 Broth for the culture of C. pseudotuberculosis is considered to be a significant advance particularly for studies involving animal inoculation. PMID- 3518222 TI - Bacteriostasis of Escherichia coli by bovine lactoferrin, transferrin and immunoglobulins (IgG1, IgG2, IgM) acting alone or in combination. AB - The effect on Escherichia coli strain B117 of bovine lactoferrin (LF), transferrin (Tr) and immunoglobulins (Ig), acting alone or in combination, was investigated in vitro. IgG1 and IgM, which, in contrast to IgG2 possessed a marked antibody activity, as assessed by enzyme-linked immunosorbent assay, induced the appearance of microcolonies in suspension, a phenomenon which could lead to misleading interpretations in the absence of sonic treatment, but none of these three isotypes influenced bacterial growth. Both LF and Tr promoted a strong inhibition of bacteria without requirement for antibodies. After a short period of growth, the multiplication of bacteria was almost completely prevented by the iron-binding proteins acting alone. A significant (p less than 0.02) but moderate (0.5 less than log10) further growth reduction was obtained when Ig of either class was added to Tr, while addition of Ig to LF revealed no significant cooperative effect. All of 11 strains of E. coli isolated from bovine mastitis were sensitive to LF action in the absence of Ig. It therefore appeared that antibodies were not required for iron-binding proteins to exert a potent bacteriostatic effect on mastitis isolates of E. coli. PMID- 3518224 TI - Screening of pig intestines for K88 non-adhesive phenotype by enzyme immunoassay. AB - An adhesion test for binding of porcine brush border membranes to Escherichia coli cells that possess the K88 antigen (K88+) has been developed using enzyme immunoassay procedures. K88 pilus protein or K88+ E. coli cells were immobilized in the wells of polystyrene microtitre plates. These plates were incubated in the presence of material obtained by scraping the villous surface of pig small intestines. Adhesion of membrane material to immobilized K88 was detected by adding rabbit anti-brush border IgG followed by urease-labelled sheep anti-rabbit IgG conjugate. Action of bound enzyme on urea/bromo-cresol purple substrate solution (pH 4.8) produced an intense colour change from yellow to purple, enabling the test to be read visually. This test enables simple, rapid testing of large numbers of intestial samples and gives results that agree well with the more cumbersome microscopic adhesion test for adhesion of K88+ E. coli to purified brush border membranes. PMID- 3518225 TI - Resistance of Berne virus to physical and chemical treatment. AB - Thermal inactivation of Berne virus proceeded at a linear rate between 31 degrees and 43 degrees C. Storage at temperatures lower than -20 degrees C preserved the infectivity, while at 4 degrees C appreciable loss occurred between 92 and 185 days. Freeze-drying or desiccation at 22 degrees C caused only insignificant loss of infectivity. Virus preparations were not affected by pH values between 2.5 and 10.3. Inactivation by UV occurred more rapidly than with herpes, toga and rhabdoviruses. Berne virus infectivity was sensitive to pronase and B. subtilis proteinase. It was not inactivated by trypsin and chymotrypsin treatment, which resulted in enhancement of infectivity; low concentrations of pronase (less than 10 micrograms ml-1) had a similar effect on Berne virus. Neither phospholipase C or RNase, alone or in combination, nor sodium deoxycholate (0.1%) inactivated the virus; in contrast, Triton X-100 (0.1%; 1.0%) caused rapid inactivation with a constant level of residual infectivity. PMID- 3518226 TI - Identification of Mycoplasmatales in pneumonic calf lungs. AB - Lungs from 153 calves with clinical signs of pneumonia were examined post-mortem (PM) for the presence of mycoplasmas and ureaplasmas during a 38-month period. Sixty-two percent of the cases were submitted during the months when wide fluctuations in climatic conditions occur. Using indirect fluorescent antibody tests (IFAT) and culture, mycoplasmas and/or ureaplasmas were detected in 63% of the lungs examined. Mycoplasma dispar was detected in 39%, M. bovis in 36%, Ureaplasma spp. in 22% and M. bovirhinis in 8.5% of the lungs. Thirty percent of the lungs were infected with more than one species; the most frequent combination was M. bovis, M. dispar and Ureaplasma spp. (10.5%). M. arginini, M. bovigenitalium and acholeplasmas were not cultured. M. dispar was shown to remain viable for up to 15 days PM in apical and cardiac lobes held at 4 degrees C and also was detected by IFAT in the same tissues for 49 days. PMID- 3518227 TI - [Iodamide-300 and 380: evaluation of the results of clinical trials in angiography and urography]. PMID- 3518228 TI - Changes in the nucleoprotein complexes of a baculovirus DNA during infection. AB - The nature of the DNA-protein complexes assumed by Autographa californica nuclear polyhedrosis virus (AcNPV) DNA during infection of Spodoptera frugiperda cells was investigated by micrococcal nuclease digestion of infected nuclei. Both parental viral DNA and progeny viral DNA assumed a chromatin-like structure early in infection. By late times (24 hr) p.i., the viral DNA acquired a unique nucleoprotein structure. In addition to fragments of mononucleosome size (185 bp), two subnucleosomal bands of 120 and 90 bp were observed. The subnucleosomal bands contained exclusively viral DNA. No alteration in the nature of the host chromatin structure following AcNPV infection was observed. An examination of the basic chromatin-associated proteins revealed two major viral-induced proteins having molecular weights of 15K and 39K. The induction of the basic 15K protein between 10 and 24 hr p.i. coincided with the appearance of the altered nucleoprotein structure observed by 24 hr p.i. and the cessation of histone synthesis. PMID- 3518229 TI - [More attention with regard to the activities of military medicine museums]. PMID- 3518230 TI - [Emergency procedures after perforation of the maxillary sinus during tooth extraction]. PMID- 3518231 TI - [Use of local raw material resources in Western Siberia for the treatment of the wounded and sick]. PMID- 3518232 TI - [New method of treating patients with rheumatoid arthritis using electrophoresis of the immunosuppressive preparation dopan from a dimexide solution]. PMID- 3518233 TI - [Biochemical defects in hereditary diseases of the connective tissue (review)]. PMID- 3518234 TI - [Characteristics of cysteine peptidohydrolases from the human kidney cortex]. AB - Spectrum of cysteine peptide hydrolases was studied in human kidney cortex using a variety of protein and synthetic substrates after the preparation was fractionated on Sephadex G-100 following the precipitation with ammonium sulfate 40-70%. Activities of dipeptidyl aminopeptidase I, lysosomal carboxypeptidases A and B, cathepsins B and H, as well as the activity of Ca+2-dependent neutral proteinase were detected. A thiol-dependent proteolytic activity, which was apparently stimulated by cathepsin T- and -M like enzymes, was also observed. Besides, the proteinase with molecular mass of 50-60 KDa and high hemoglobin and casein splitting activity was found. This activity cannot be attributed to any of the proteinases so far known. Isoelectrofocusing technique showed that two forms of cathepsin B occurred in human kidney with isoelectric points at pH 5.32 and pH 5.65; two forms of cathepsin H were also detected exhibiting isoelectric points at pH 6.03 and pH 6.7. PMID- 3518235 TI - [Comparative evaluation of bovine serum albumin and ovalbumin proteolysis in the small intestine of rat pups on artificial feeding]. AB - Relationship between the type of protein digestion in gastrointestinal tract and coefficient of protein efficiency (CPE) was studied after artificial feeding of 15-21 days-old rats using milk substitutes. Distinctly low level of CPE was observed after rapid transfer of blood serum albumin (BSA) along the gastrointestinal tract accompanied by the protein intensive proteolysis. On the other hand, a considerable retardation of ovalbumin in intestine and the low rate of its proteolysis resulted in high efficiency of the protein consumption. Thus, a long-term transfer of protein in gastrointestinal tract is of paramount importance for its effective consumption at the early neonatal period. Therefore ovalbumin may be a better component in the protein complex of the milk substitutes as compared with BSA. Caseins, which are coagulated in stomach simultaneously with formation of peptides, affecting actively the functions of gastrointestinal tract, appear to maintain the most suitable for neonates rate of digestion and absorption of proteins, responsible for highly effective consumption of a protein mixture including casein. The most intensive digestion and absorption of the milk protein substitutes occurred in the middle and distal sections of small intestine. Cavital digestion of proteins was shown to be incomplete in spite of its relatively high efficiency. PMID- 3518237 TI - [Short-term tests in the system of assessment of human carcinogens]. PMID- 3518236 TI - [T gamma-lymphocytosis: a lymphoproliferative disease or reactive state]. PMID- 3518238 TI - [Possibility of evaluating the degree of dissemination of malignant tumors of the bladder using ultrasonic tomography]. AB - The paper discusses the results of an analysis of degree of bladder cancer expansion with the aid of ultrasonic tomography. The results of tomography were compared with surgical and pathohistologic findings. The study group included 94 patients with bladder cancer. Stages A, B, and C were distinguished on the basis of tomographic features, which correspond to T1, T2, T3 and T4 according to TNM system. Application of ultrasonic tomography in conjunction with other diagnostic procedures offers more advantage in selecting an adequate stage-oriented treatment. The tomographic examination findings were confirmed in 80.7% for stage A (T1), 81.9%--stage B (T2) and 93.4% for stage T (T3 and T4). PMID- 3518239 TI - [Josef Ducuing (on the 100th anniversary of his birth)]. PMID- 3518240 TI - [Food products--sources of radionuclide uptake into the human body]. PMID- 3518241 TI - [Use of prodigiozan in the combined therapy of infectious diseases (a review of the literature)]. PMID- 3518242 TI - [Functional changes in the digestive organs in chronic circulatory failure (a review of the literature)]. PMID- 3518243 TI - [Parasites of domestic animals in "De re rustica" by L.I. Columella. I. Internal parasites]. PMID- 3518244 TI - [Use of electrophoretic/enzyme studies in the taxonomy of Protozoa]. PMID- 3518245 TI - [Vasodilating effect of leukotriene C4 and D4 by stimulation of prostacyclin synthesis]. AB - Since the original discovery and structural characterization of leukotrienes, these substances have attracted considerable interest due to their numerous biological activities. It is known that these substances exert a short lasting vasoconstrictory and a longer lasting vasodilatory response. However, the cause of this biphasic response is not clear as yet. Human coronary artery segments synthesize about 50 pg PGI2/cm2/min in vitro under pressure perfusion. At concentrations ranging from 1 to 100 ng leukotrienes C4 and D4 cause a dose dependent increase in PGI2 generation. Inhibition by acetylsalicylic acid and 15 hydroxyperoxyarachidonic acid indicates the mechanism to be mediated via the cyclooxygenase. It is, therefore, concluded that the capacity of leukotrienes C4 and D4 to stimulate PGI2 formation might play a key role during acute inflammation at the site of white blood cell accumulation. PMID- 3518246 TI - Hydrogen peroxide induced pulmonary vasoconstriction in isolated rat lungs is attenuated by U60,257, a leucotriene synthesis blocker. AB - Reactive oxygen metabolites cause pulmonary vasoconstriction and activate arachidonic acid metabolism. We proposed that hydrogen peroxide, generated enzymatically in an insolated rat lung model, would cause vasoconstriction which was independent of circulating cells, but dependent on activation of the arachidonic acid cascade. Although hydrogen peroxide caused an increase in lung effluent thromboxane B2 concentration, indomethacin did not inhibit hydrogen peroxide induced vasoconstriction. In order to test the hypothesis that hydrogen peroxide activates the 5-lipoxygenase pathway, lung effluents were analyzed for 5 hydroxy-eicosatetranoic acid (5-HETE) using a sensitive, highly specific mass spectrometer technique. Glucose oxidase increased the 5-HEFE effluent concentrations and this was prevented by U60,257. We therefore conclude that hydrogen peroxide stimulates the 5-lipoxygenase pathway and that substances derived from this pathway are at least in part responsible for the hydrogen peroxide induced vasoconstriction in isolated rat lungs. PMID- 3518247 TI - [Bladder cancer as an incidental finding]. AB - Transitional cell carcinoma of the urinary bladder was found in 54 patients as an incidental finding. These patients are compared with 618 patients with symptomatic tumours as regards tumour type, grade and stage. The mean age is lower, there are more women and less tumours of high malignancy in the asymptomatic group than in the symptomatic. The main clinical sign in the symptomatic patient is gross haematuria. With increasing tumour stage and grade there are significantly more patients with dysuria and pollacisuria. Comprehensive urological examination of patients with dysuria or microhaematuria is a necessity. Sonography should be used as a valuable tool in the early detection of bladder tumours. PMID- 3518248 TI - Ultrastructural findings on platelet depositions in initial atherogenesis. AB - Morphological methods, especially scanning electron microscopy, were used in mini pigs to prove that locally and systemically acting angiopathic stimuli caused an initial adhesion of platelets with altered shape to apparently intact arterial endothelium in a highly reproducible manner. These angiopathy models imitate the risk factors for human arteriosclerosis. Transmission electron microscopic studies, on the other hand, showed very early changes in endothelial and media cells subjected to suitable stimuli. The effective stimuli for angiopathy were local contact of the arteries with ice or epinephrine, the inhalation of cigarette smoke or carbon monoxide, a high-cholesterol diet, renovascular hypertension, and insulin-dependent diabetes. On acting over a longer period these stimuli caused intimal thickening, formation of microparietal thrombi consisting of platelets and fibrin on the endothelium. Within half a year the stimuli led to the formation of lipid-containing plaques of the intima. Several of these stimuli led to increased platelet aggregation. According to these findings we see the decisive mechanism for the pathogenesis of all stenosing, obliterative arteriopathies in a disturbed interaction between vessel wall and arterially circulating blood. Adherence of platelets to the arterial endothelium appears to play a key role in the initial phase of atherogenesis. This concept is supported and augmented by a multitude of partly very recent findings cited in the literature. PMID- 3518249 TI - Topographic aspects of prostacyclin-like and fibrinolytic activity and of biogenic amines in the arterial system of the mini-pig. AB - Although arteriosclerosis is a systemic disease, it nevertheless exhibits noticeable topographical preference and particularities. The reason for this could be lie with certain biochemical features of the arterial wall. We therefore examined prostacyclin-like and fibrinolytic activity in mini-pigs, as well as the concentration of various biogenic amines in the thoracic and abdominal aorta, in coronary arteries and in the carotid and femoral artery. There was a similar behaviour between PG I2-like release and biogenic amines in the different arteries, whereas fibrinolytic activity behaved differently in some cases. In the femoral artery particularly low fibrinolytic activity was confronted by a particularly high level of PG I2-like activity and biogenic amines, while the reverse was the case in the abdominal aorta. In older animals PG I2-like activity considerably decreased. PMID- 3518251 TI - An approach to repair of radiation necrosis of chest wall and mammary gland. PMID- 3518252 TI - Pelvic complications after interstitial and external beam irradiation of urologic and gynecologic malignancy. PMID- 3518254 TI - Liver transplantation at the University of Wisconsin-Madison. PMID- 3518253 TI - Endotoxin inactivation in plasma from septic patients: an in vitro study. PMID- 3518250 TI - Complications of radiation therapy and factors in their prevention. PMID- 3518255 TI - The chromatographic analysis of enantiomers in drug metabolism studies. PMID- 3518256 TI - [Public health evaluation of highly eutrophic bathing water]. PMID- 3518257 TI - [The Berlin medical faculty and its contribution to the new foundation of medical and scientific societies after 1945]. PMID- 3518258 TI - [Significance of eicosanoids for arteriosclerosis and the effect of lipoproteins on prostanoid formation]. AB - In a review the possible relevance of the eicosanoid system for arteriosclerosis is outlined. Particularly the interdependence between prostacyclin and thromboxane regarding the development of arteriosclerosis is discussed. Own findings show the influence of lipoproteins on the synthesis of prostacyclin or thromboxane in different biological material. On the one hand, HDL stimulates the synthesis of prostacyclin, whereas LDL inhibits it; both of them were sampled from human volunteers. On the other hand, the synthesis of thromboxane is inhibited by HDL and stimulated by LDL. The results indicate the close relationship between the lipoprotein and the eicosanoid hypotheses of arteriosclerosis. PMID- 3518259 TI - [Progress in research on ulcer therapy?]. PMID- 3518260 TI - [Historical development of the cardiac pacemaker]. AB - The history of electric cardiac stimulation is long and fascinating. It is not only the anatomy of the heart, but also the analysis of the peripheral pulse that plays an important role in the history of cardiac pacing. The Romans, the Greeks and even before them the Chinese attempted to explain the origin and variations of the pulse as the basis of further investigations. - The growing clinical importance has been recognized and renewed as Zoll in 1952 described a successful resuscitation in cardiac standstill by external stimulation. Meanwhile more than 3 million patients with disorders of cardiac rhythm have been treated all over the world in the last 25 years. Recently the technical refinements of intracardiac stimulation and defibrillation improved our knowledge of cardiac physiology and diseases, and arrhythmias in particular. The pertinent interest in these dramatic developments and the intention to learn more about the basic fundamentals are reasons to look at the history of cardiac pacing. The advances in the field of therapeutic and diagnostic application of cardiac pacing will continue as rapidly as before in order to give us further significant aid in taking care of the patient. PMID- 3518261 TI - [Clinical value of digital subtraction angiography in cardiology--current status and future prospects]. AB - Advances in digital technology have made the digital processing of X-ray images possible. The principles of processing, which can be traced back to the early origin of radiology, are characterized by the aims "image enhancement" and "functional imaging". These principles have been routinely applied in digital subtraction angiography (DSA) for visualization of non-moving vessels. DSA is used with caution in cardiology mainly because methodical problems caused by the motion of the background structures. In order to assess the clinical relevance of DSA to cardiology the following questions will be answered: Which structures can be visualized? How large is the error of the parameters determined by DSA? What is the clinical relevance of these parameters? What are the advantages of DSA with regard to the examination procedure? Using DSA the left ventricle can be visualized at rest and during exercise by intravenous injection of contrast medium. The examination procedure can easily be combined with measurements of pulmonary arterial pressure. The errors of left ventricular parameters amount to: ventricular volumes: +/- 12- +/- 18 ml; ejection fraction: +/- 8%; ventricular diameters: +/- 7- +/- 13%; wall volume: +/- 48 ml; wall thickness: +/- 1.6 mm. The image quality of aorto-coronary bypass grafts visualized by intravenously injected contrast medium is sufficient to decide whether the grafts are patent or occluded. The visualization of the proximal segments of coronary arteries by intravenous injection of contrast medium is reported in rare cases.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3518262 TI - [Abstracts of the 52d annual meeting of the German Society for Cardiovascular Research. 4-6 April 1986, Mannheim]. PMID- 3518263 TI - [In vitro activation of plasma proteases by endotoxin]. PMID- 3518264 TI - [Use of the antibody chimera technic for the detection of IgM antibodies against rubella virus]. PMID- 3518265 TI - [Enzyme immunologic detection of pregnancy-specific beta 1-glycoprotein (SP1) with antibody chimeras]. PMID- 3518266 TI - Effects of red blood cell potassium and hypertonicity on the growth of Plasmodium falciparum in culture. AB - Malarial parasites reproduce asexually inside the erythrocytes of their vertebrate host. Relatively little is known about the interaction between host cell and parasite metabolism. In the present study the effect of host cell cation composition and osmotic shrinkage on in vitro growth and propagation of Plasmodium falciparum in human erythrocytes was investigated. It is shown that throughout the parasite cell cycle, infected cells lose potassium and gain sodium. Compartment analysis of infected cells revealed that host cell cytosol is poor in potassium and rich in sodium while in the parasite this relationship is reversed, indicating that the parasite is able to regulate its ionic composition independently. Parasites proceeded normally through their cell cycle in the presence of the sodium-pump inhibitor ouabain, although host cells lost up to 75 80% of their normal potassium content. Potassium-depleted erythrocytes harboring trophozoites and schizonts also display normal rates of protein synthesis as measured by isoleucine incorporation. Parasite growth was inhibited when infected cells were osmotically shrunken in hypertonic media, but this was not due to parasite dehydration. It is suggested that increased viscosity of host cell cytosol and/or hemoglobin gelation, are responsible for the effect, probably through interference with parasite feeding. The relevance of these results to understanding of the cellular mechanism involved in the inhibiton of parasite growth in deoxygenated sickle-trait erythrocytes is discussed. PMID- 3518268 TI - Three cartoons that shook medical ethics. PMID- 3518267 TI - The ability of microfilariae to evade in vitro cell-mediated cytotoxicity. AB - When microfilariae (Mf) of Dirofilaria immitis, both uterine and systemic, were incubated in an in vitro cytotoxicity assay with neutrophils and sera from dogs with occult infections, some Mf remained free of adherent cells and consequently evaded cytotoxicity. The ability to evade cytotoxicity could not be related to the age of the Mf, and host albumin was not detected on any Mf, either uterine or systemic. However, it was shown that some Mf failed to bind IgM, IgG and C3 when incubated with occult sera. It is suggested that the ability of some Mf to evade serum-dependent, neutrophil-mediated cytotoxicity in vitro was related to differences in their antigenicity. PMID- 3518269 TI - Cryptogenic splenic abscess. PMID- 3518270 TI - [Further study of the prevention of streptococcal infections in experiments on monkeys]. PMID- 3518271 TI - [Trial of the protective activity of ribosomal Sonne vaccine in monkeys]. PMID- 3518272 TI - [Use of hyperbaric oxygenation in dermatology]. PMID- 3518273 TI - [History of the creation and chief stages in the activity of the A. M. Pospelov Moscow Scientific Society of Dermatologists and Venereologists (on the occasion of the 800th plenary session)]. PMID- 3518274 TI - [Non-Hodgkin's lymphoma. Cytology and cytochemistry]. AB - Imprints of lymph nodes and tumor specimens from 442 patients with non-Hodgkin's lymphoma (NHL) were evaluated cytologically and cytochemically. With the exception of hairy cell leukemia, special forms of peripheral pleomorphic T-cell lymphoma, and lymph node plasmacytoma, all types of NHL of the Kiel classification were included in this study. The investigations were performed on slides stained with Pappenheim (May-Grunwald-Giemsa) or conventional cytochemical techniques for substrate and enzyme demonstration, such as periodic acid Schiff (PAS), neutral and acid non-specific alphanaphthyl acetate esterase, and acid and alkaline phosphatase. In certain cases further techniques for substrate and enzyme demonstration, including myeloperoxidase and naphthol AS-D chloroacetate esterase, were used. We combined the cytologic and cytochemical evaluation with an attempt to diagnose the type of lymphoma on imprints without prior knowledge of the histologic findings or clinical data, in other words, blind. At the same time, we attempted to distinguish the NHL from reactive lymph node lesions, nonlymphoid malignant tumors, and systemic diseases. For this purpose, 75 cases of lymphadenitis and 33 cases of nonlymphoid neoplasia were mixed with the NHL for a blind test. In the following we will summarize the results pertaining to the NHL only. Chronic lymphocytic leukemia of B type (B-CLL; n = 75) was cytologically characterized by the presence of so-called prolymphocytes and paraimmunoblasts and a predominance of lymphocytes. In our opinion, there are four main variants of B-CLL: small-cell ("mature") CLL, a type in which prolymphocytes are plentiful ("immature" CLL), LP immunocytoma-like ("basophilic") CLL, and a type of CLL with centrocyte-like lymphocytes ("B2 CLL"). B-CLL had no cytochemical profile of its own. The reproducibility of the diagnosis on imprints was 80%. In prolymphocytic leukemia of B type (B-PLL; n = 1) prolymphocytes and blast cells were plentiful. In the case studied, acid phosphatase activity was moderately strong (evident as granules distributed in a semicircular fashion and focally accumulated). In the blind test we diagnosed it only descriptively as an "acid phosphatase-rich lymphoma of low-grade malignancy with a high prolymphocyte and blast cell content". Chronic lymphocytic leukemia of T type (T-CLL) and prolymphocytic leukemia of T type (T-PLL) could not be distinguished with certainty in sections or imprints. There was also no strict delineation between T-CLL and T-PLL in blood smears. The T-CLL and T-PLL cases we evaluated (n = 4) belonged to the so-called helper cell type.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3518275 TI - Inhibition of the assembly of Newcastle disease virus by monensin. AB - Monensin inhibits the intracellular transport of the glycoproteins of Newcastle disease virus between cis and trans Golgi stacks of infected BHK cells, as evidenced by its effect upon their post-translational modifications such as fatty acid acylation, glycosylation and proteolytic cleavage. Thus the drug has markedly altered the subcellular distribution of the glycoproteins so that they accumulate in the internal smooth membranes but are virtually absent in the plasma membrane. These glycoproteins that accumulated in intracellular membranes have a cytoplasmic domain susceptible to protease digestion and thus are transmembranous. Under such conditions, the behavior of M protein, which plays a crucial role in virus assembly (Y. Nagai et al., 1976, Virology 69, 523-538), has been analyzed. It has been found that the M protein can neither associate with the internal membranes nor bind to the plasma membrane. Thus no virus budding has been observed, either at the plasma membranes or at internal membranes. These results substantiate the view that the interaction between M and glycoproteins is of great importance for virus assembly and suggest further that this interaction is possibly only when the glycoproteins have been incorporated into the plasma membrane. PMID- 3518276 TI - [The amplitude principle of the structural-functional classification of cortical neurons]. AB - Some literature and author's experimental data are presented on functional and morphological characteristics of nerve cells by their electrophysiological parameters. The proposition is substantiated that in multineuron discharges reflecting the activity of microgroups of neighbouring cells, the absolute size of impulses indicates the distance of cortical neurones from the tip of the electrode, while amplitudes correlation may characterize the size of the cell and some of its functional properties. Arguments for this proposition are: latencies of impulse responses to afferent and antidromic stimulations and amplitude changes of multineuronal activity during movement of the electrode through the cortex thickness in acute experiments. As the electrode (with the tip diameter of 50 mcm) approaches a microgroup of neurons, the amplitude of the recorded impulse discharges increases, while the relation of big spikes to small ones remains almost the same. PMID- 3518277 TI - [Status of arthrosonography in rheumatologic diagnosis: examination technic, findings and their interpretation. I. The elbow joint]. AB - Between July 1984 and October 1985 the elbow joints of 135 patients were examined by arthrosonography. Of these 97 patients suffered from rheumatoid arthritis, 4 from psoriatic arthritis, 2 from suspected ankylosing spondylitis, 1 from gout, and 27 patients were found to be normal. The equipment used was a Kretz sector scanner Combison 320 and a Siemens Sonoline SL linear scanner. The examination was divided into three parts: longitudinal and transversal scans of the fossa olecrani, the fossa coronoidea and fossa radii. We found, that inflammation of the elbow joint has to be evaluated separately for each part of the joint. The more intense the inflammation, the more certain diagnosis becomes. Bursitis and rheumatoid nodules could be separated sonographically. Also synovialitic complications such as of the bone and the development of synovial cysts could easily be recognized. These arthrosonographical findings are a valuable help in the diagnostics of rheumatic diseases. Their interpretation, however, requires the input of all clinical data. PMID- 3518278 TI - [Saralasin test in the differential diagnosis of essential and renal hypertension]. AB - In a multicentric prospective study should be tested clinically the effectiveness and the tolerance of an angiotensin-II-antagonist (Saralasin-IWF) developed by the Institut fur Wirkstofforschung der Akademie der Wissenschaften, its position in the differential-diagnostic step programme of the arterial hypertension should be analysed and with it should be performed pathogenetic investigations for hypertension after kidney transplantation. Taking into consideration international studies our results confirm that the Saralasin test, taking into account strongly standardized methodical prerequisites, is suited to objectify a participation of the RAAS in the hypertension pathogenesis, without, however, thus making an absolutely reliable evidence concerning the etiology of hypertension. The Saralasin test may represent an important diagnostic criterion for an optimization of the therapy of "volume-resistant" hypertension under the conditions of haemodialysis and in connection with selective renin determinations it possesses a high value in the screening diagnostics of the arterial stenosis after allogenic kidney transplantation. PMID- 3518279 TI - [Immunologic diagnosis of glomerulonephritis by basement membrane antibodies]. AB - In the immunological diagnostics of glomerulonephritis by basement membrane antibodies highly sensitive demonstration methods for circulating antibodies increasingly gain significance for judgements of courses. The results which were achieved by a new non-competitive ELISA using chimaera antibodies in comparison to the indirect immunofluorescence confirm the advantages of the enzyme immunoassay with regard to its higher sensitiveness. PMID- 3518280 TI - [Dielectric behavior of isolated dog kidneys following storage preservation and subsequent autotransplantation]. AB - A measurement of the vitality of kidney transplants before the implantation is not yet possible, however, criteria for the proof of anoxic and hypothermic lesions on isolate kidneys are known. With the investigation means of the passive electric behaviour over the determination of the DK-course and the dispersion of epsilon' an original evaluation of the vitality is possible. With the help of the measurement of epsilon' in frequencies between 0.5 MHz and 3 MHz we establish the proportion of intact cell membranes and mitochondria. The modul M3 explains the distribution of relaxing structures. Our hitherto performed experiments have shown that by means of the observation of the two sizes a judgment of the vitality seems to be possible. Examinations on bastard dogs of either sex were performed. For the supplementation of the dielectric measurements in certain time intervals tissue samples of the preserved kidneys were investigated electron microscopically. PMID- 3518281 TI - [Growth of transplanted kidneys]. AB - Two or more years after a kidney transplantation were determined the GFR as 51Cr EDTA-clearance and the effective renal plasma flow as 125J-hippuran clearance. In 14 children the results of the clearance with the HLA-identity (HLA-I), the quantity of the transfusion units (TU) received before the transplantation and the duration of the cold ischaemia time (CIT) were correlated. While with HLA-I and TU no connections could be proved, the results of the clearance seemed to be reversedly proportional to the CIT (r = -0.53 and -0.64 for GFR and ERPF) for a longer time after transplantation. Different age between donor and recipient shows worse results of clearance in the group of the adults who received a kidney of a child, in contrast to the other three possible combinations of the kidney transplantation. PMID- 3518282 TI - [Simultaneous determination of C-reactive protein in the urine and serum of patients following kidney transplantation]. AB - In 75 patients after kidney transplantation during the whole stay in hospital after operation the serum concentration of C-reactive protein (CRP) was determined serially and quantitatively as well as all the urines were investigated with regard to the appearance of a CRP-uria. We succeeded in proving CRP in the urine in a high percentage (67%) in transplants which never functioned and in a smaller extent (25%) during the postoperative renal failure. For the diagnostic ascertainment of the rejection crises as well as for the estimation of the effectiveness of the antirejection therapy with high doses of prednisolone the daily CRP serum control is a valuable contrivance. The judgement of the CRP values should always be performed together with the other data received by laboratory investigations as well as also with the clinical data. PMID- 3518283 TI - [Experimental studies of the pathogenesis of hypertension immediately following kidney transplantation]. AB - To investigate pathomechanisms of the hypertension originating immediately after kidney transplantation, acute model studies were performed on binephrectomised hypertensive dogs receiving a cold-stored autograft. Comparative determinations of freely circulating renin-angiotensin und catecholamines were made after transplantation of canine and human kidneys, showing a corresponding post anastomotic increase in plasma levels. For estimation of the vascular contractile response to the high plasma transmitter concentrations, antagonists having different pharmacological characteristics were infused in the dogs. It was found that immediately after transplantation the kidney's vasopressor system had only a moderate impact on increase in systemic and renal resistance. Using inhibitors of central sympathetic activities, also a moderate decline in blood pressure was observed, but it unfortunately led to a decrease in renal blood flow and filtration. The direct vasodilatatoric stimulation of vascular smooth muscle had no hemodynamic effects. However, the peripheral alpha-adrenergic blockade induced a marked decrease in blood pressure as well as an almost complete normalization of the elevated arteriolar tone of the graft associated with an increase in glomerular filtration. The suppression of vascular alpha-adrenergic stimulation was likewise attainable by inhibition of the neuro-muscular transmission due to calcium channel blockade. The results suggest that sympathetic vasoconstriction plays the major role in producing this type of posttransplant hypertension. PMID- 3518284 TI - [Occurrence of gentamicin-resistant coliforms in river water samples]. AB - In river water samples 0.006...0.3% of total coliforms were detected as gentamicin resistant. Among gentamicin resistant coliforms most strains (86.5%) could be identified as Klebsiella. Most frequently a Gm-plasmid of about 150 Md was isolated harboring in Klebsiella oxytoca, K. pneumoniae and E. coli strains. All gentamicin resistant wild strains transferred the resistance to E. coli K-12. Most Klebsiella strains harbored several plasmids, R-plasmids and others. There were not any differences in plasmid profiles between sensitive and resistant strains. PMID- 3518285 TI - [Phytoeffective metabolites of Alternaria]. AB - A review of literature of phytoeffective metabolites of Alternaria is presented. 38 chemically known metabolites with derivates were named. Further there are 4 phytotoxic systems of Alternaria strains of these chemical characteristic are unknown. Dates of literature were collected and listed about Alternaria metabolite-producer, metabolite sensitive organisms with disease symptoms, conditions of culture for biosynthesis and methodic fundamentals of isolation and detection in biotest and chemical nature of Alternaria metabolites. PMID- 3518286 TI - [Should the injured spleen be preserved?]. AB - Splenectomy is primarily followed by reduced defence against infection due to encapsulated bacteria, such as pneumococci. Organ preservation, therefore, has been emphasised in the treatment of traumatic rupture of the spleen, especially when it comes to patients in childhood. There are several practicable approaches to orthotopic preservation of the spleen, including conservative treatment of patients for smallest ruptures under stringent clinical control and, even more, fibrin sealing. Growth in accurate knowledge of the segmental structure of the spleen have enabled partial removal of the organ along the poorly vascularised intersegmental regions. Autologous transplantation of splenic pulp into the major omentum should be considered an alternative to splenectomy alone in strictly selected cases of massive splenic rupture. PMID- 3518287 TI - [Quality assurance in general surgery by prospective patient documentation. A comparison over 5 years]. AB - All patients who had undergone general surgery in three different periods of time were prospectively recorded. Results were found to have been improving with significance owing to peri-operative antibiotic prophylaxis, mechanical suturing (for gastro-intestinal anastomoses), and introduction of a system of regular documentation. Rates of postoperative complications were also affected by the individual surgeon's efficiency and techniques. PMID- 3518288 TI - [Aggressive fibromatoses. Treatment concept and results with special reference to ultrasound diagnosis]. AB - Therapeutic tactics and control regime for aggressive fibromatosis are described in this paper, with reference being made to the authors' own patients. Locally delimited, wide excision without supporting radiotherapy is recommended also for recurrent cases. Anti-oestrogenic treatment has now been adopted to cope with locally delimited inoperability. The polytopic, usually congenital form of aggressive fibromatosis must be interpreted as a particularly unfavourable course with potential malignancy. Sonography so far has proved to be a suitable approach to pre-operative and postoperative screening. PMID- 3518289 TI - [Possibilities for use of monoclonal antibodies in gynecology and obstetrics]. AB - It is demonstrated the theory of hybridoma technology and the production of monoclonal antibodies. Hybridomas can be obtained by fusion of spleen cells from Balb/c mice immunized with certain antigens and of myeloma cells, which produced monoclonal antibodies after cloning, culturing and recloning. The attraction of monoclonal antibodies is against polyclonal antibodies that all antibodies from one cell clon are equal with regard to primary structure, specificity and affinity to certain antigen. The application of monoclonal antibodies leads to an improvement of immunologic diagnostical methods. Special proceedings may expected in the fields of immunology of tumors, research of infertility and immunology of fetomaternal relationship. PMID- 3518290 TI - [Ambroxol in comparison with betamethasone for the stimulation of antepartal lung maturity. A clinical double-blind study]. AB - Stimulation of the surfactant production in fetal cells by ambroxol (metabolite VIII of bromhexine) has been investigated in human and animal experiments. There are no contraindications for the prenatal use of ambroxol, which is also well tolerated in high dose. Therefore the 1st Department of Obstetrics and Gynecology in Vienna took part in a multicentric clinical trial, where the allocation between cortisone and ambroxol was randomised in a double blind fashion. The 1st Department included 34 women between 30 and 36 weeks of pregnancy with premature labour or indicated premature induction. Amniotic fluid samples were taken by amniocentesis before therapy to prove lung immaturity by measurement of the L/S ratio and the dynamic surface tension. Following doses were used for this clinical trial group A: 1,000 mg ambroxol in 500 ml 5% glucose infusion i.v. daily from day 1 to day 5 and 2 ml placebo-injection i.m. on day 1 and day 2, group B: 8 mg Betamethasone i.m. on day 1 and day 2 and 500 ml 5% glucose infusion with a placebo daily from day 1 to day 5. The patients were treated at least 3 days; in all cases amniotic fluid samples were taken after therapy, to examine the L/S ratio and the dynamic surface tension. 29 women of the 34 fulfilled the above criteria, 15 in group A and 14 in group B (1 twin pregnancy). With the pretreatment parameters of lung maturity being similar in both groups ambroxol was found to lead to a marked but not significant improvement of the L/S ratio and the surface tension.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3518291 TI - [Puerperal infection]. AB - Puerperal infections are of great importance also under the conditions of modern obstetrics. There is a close connection with the problematic nature of hospitalism. The prospective study from 1,409 patients shows a puerperal fever at a percentage of 32.1%. Only 19.0% of the patients meet the criteria of a "standard puerperal morbidity". Within the complications occurring during the childbed period subinvolutio uteri holds the first place with 16.3%. The incidence of puerperal infections is influenced by predisposing factors dominated by the mode of accouchement. Ampicillin and chloramphenicol are the most used antibiotics. The preventive and therapeutic application of antibiotics is discussed. In the experimental part of the study the settlement of the vagina, the cervix, and the amniotic fluid is analysed. The evidence of causative organism for oxybiontic pathogenes partly also for anoxybiontic pathogenes and fungi is made. The fight against puerperal infections is particularly based on preventive measures. There must be mentioned a strict consideration of the antisepsis and asepsis as well as the restriction of predisposing factors. Under this precondition the wellaimed and indicated application of a therapy based on antibiotics will be successful. PMID- 3518292 TI - [Detection and significance of serum zona pellucida antibodies in sterile females]. AB - Sera of 100 infertile women and of 100 patients with early pregnancy as control group were investigated for antibodies to zona pellucida by the indirect immunofluorescence. Zonae of oocytes from pigs were used for the procedure. A positive control serum with a high titer was produced by immunization of rabbits with an antigen from pig zonae. The frequency of antibodies to zona pellucida was 29% for infertile patients and 18% in the control group. The titers of these autoantibodies were higher in infertile than in fertile women. There was no increase of these antibodies if the age increased and no relation to the menarche and the ovulation. Antibodies to zona pellucida were demonstrated frequently in patients with disturbances of cycle, free Fallopian tubes, secondary infertility, and ovarian and unknown origin of infertility. PMID- 3518293 TI - Detection of Clostridium difficile Toxin A by immunoblotting. AB - A clinical isolate of Clostridium difficile has been tested for its toxin production. Both toxins, toxin A and toxin B, could be detected by tissue culture and in animal models as well. Antibodies against a crude toxin A preparation have been prepared. These antibodies are able to neutralize the toxin both in the mouse lethality test and tissue culture test systems. The specificity of this antiserum has been analysed by electroimmunoprecipitation methods. Using immunoblotting, it could be demonstrated that the antigenicity of toxin A after SDS polyacrylamide gel electrophoresis under denaturing and reducing conditions was still preserved. The molecular weight of toxin A has been estimated to be 250000. Immunoblotting offers a simple and reliable procedure for toxin A detection from culture supernatants of C. difficile. PMID- 3518294 TI - Biological activities of leptospiral lipopolysaccharide. AB - Lipopolysaccharide extracted with phenol-water from Leptospira interrogans serovar copenhageni strain Shibaura (L-LPS) showed various biological activities. In lethality for mice, L-LPS was active (LD 50, 3.4 mg/mouse) but about 12 times less potent than Escherichia coli LPS (E-LPS) per weight basis. L-LPS had pyrogenicity for rabbits, and the fever curves showed no evidence of the classical biphasic fever produced by E-LPS. In the bone marrow of mice, L-LPS caused hemorrhages and necrosis but less severe than those caused by E-LPS. Histopathologically, fresh hemorrhages were found in the intestine, spleen, lung and the other organs at 24 h after inoculation of L-LPS. Necrosis was also found in these organs and was particularly severe in mice inoculated with more than 2 mgL-LPS. Liver necrosis was found at 7th day after inoculation of L-LPS but not after inoculation of E-LPS. L-LPS had adjuvant activity just like E-LPS. L-LPS enhanced non-specific resistance to Salmonella infection and activated mouse peritoneal macrophages to kill these organisms. L-LPS was positive in limulus test just like E-LPS. These results demonstrated similarities of L-LPS and E-LPS. Some toxic effects of L-LPS were less than those of E-LPS, but some effects of L LPS were more than those of E-LPS. L-LPS was antigenically active and the specificity was serogroup-associated. L-LPS was composed of carbohydrate (54%), lipid (12%), protein (5%). Arabinose, xylose and rhamnose were major sugars as detected by gas chromatography. 2-keto-deoxyoctanate (KDO) was not detectable. PMID- 3518295 TI - [Isolation and characterization of erythrogenic toxins. VIII. Purification of a biologically active protein of the molecular weight 10,000 (LMP-10k) from filtrates of Streptococcus pyogenes, strain NY-5. Relationship to erythrogenic toxin type A]. AB - The "classical" method for purification of erythrogenic toxin type A results in two products: erythrogenic toxin type A and a low molecular weight protein, m.w. 10,000 (LMP-10k) with mitogenic activities. LMP-10k was purified from culture supernatants of S. pyogenes (group A) by CM-Sepharose CL-6B chromatography and Sephacryl S-200 and Sephadex G75 gel filtration to a high degree of purity with minimal amounts of residual erythrogenic toxin A. The isoelectric point of LMP 10k is the same as for erythrogenic toxin A: 5.2. The immunogenic activity is low, only one of two rabbits produced anti-LMP-10k-antibodies after a prolonged course of immunization. On the other hand it is possible to induce antierythrogenic toxin A-antibodies by immunization with LMP-10k preparations contaminated with small amounts of erythrogenic toxin A. Possibly the data given by some authors for the m.w. of erythrogenic toxin type A as 8 000 D are the results of a mix-up with co-purified LMP-10k. PMID- 3518296 TI - Intraphagocytic bactericidal activity of ofloxacin compared with that of aztreonam and ceftriaxone against Serratia marcescens. AB - Addition of phenylbutazone (2 mg/ml) to 55 vol % of fresh defibrinated human blood permitted leukocytic ingestion of serum-resistant Serratia marcescens bacteria, but blocked phagocytic killing activity. The group A (phage tail) bacteriocin bA+ 16 served to kill extraphagocytic test bacteria. At greater than or equal to 2 X MBC, the DNA gyrase inhibitor ofloxacin revealed potent intraphagocytic bactericidal activity against S. marcescens test bacteria (99% kill; 3 h observation period) which corresponded to that of the control drug rifampin (97% kill). The monobactam aztreonam (11% kill) and the third generation cephalosporin ceftriaxone (14% kill) corresponded to cefotaxime (26% kill) in terms of suboptimal intraphagocytic activity. Ofloxacin and aztreonam yielded additive effects following combination of supra-(2 X MIC) and inhibitory (MIC), but not sub-inhibitory (0.5 X MIC) concentrations with 55 vol % of defibrinated human blood against S. marcescens and Escherichia coli control strain ATCC 25922; sub- and inhibitory concentrations of ceftriaxone yielded indifferent effects. PMID- 3518297 TI - [The occurrence of Mycoplasma bovis and other Mycoplasma species in cattle in the northern part of Germany]. PMID- 3518298 TI - [Head-space gas chromatographic analysis in the rapid diagnosis of anaerobic infections]. AB - The comparison of the results obtained by the gas-chromatographic vapor-phase analysis and by the bacteriological analysis of exudate samples, taken from patients with intraperitoneal and intrapleural infections, has demonstrated high reliability of the chromatographic method. Despite the presence of some discrepancies between the results of the vapor-phase analysis and the bacteriological analysis due to the difficulties of the microbiological isolation of anaerobes and the specific features of their metabolism, the diagnostic value of the gas-chromatographic method has been confirmed. PMID- 3518299 TI - [Population migrations and the epidemic process of Flexner and Sonne dysentery]. AB - Analysis of the materials from the Khabarovsk Territory for the representative period of 25 years (1956-1980) revealed the influence of the migration of the population on the level and dynamics of morbidity in different kinds of dysentery, Flexner's dysentery shown to occur more frequently than Sonne dysentery. Intensive migrations increase the proportion of susceptible persons among the population, thus facilitating the formation and circulation of Shigella strains with pronounced virulence. PMID- 3518300 TI - [Rapid diagnosis of exacerbations of chronic bronchitis of pneumococcal etiology in children]. AB - The diagnostic possibilities of the microscopic examination of bronchial secretion smears, stained by Gram's method, from 56 children with chronic bronchitis at different stages of exacerbation have been studied. The following criteria have been proposed for confirming the etiological role of pneumococci in cases of endobronchitis in children: the number of paired diplococci in the visual field must exceed 10 with polynuclears covering the whole field. In 84% of cases the use of this method makes it possible to determine the pneumococcal etiology of the disease within two hours from the arrival of the pathological material to a bacteriological laboratory; this method can also be used for evaluating the effectiveness of antibacterial therapy at its different stages. PMID- 3518301 TI - [Ecological and epidemiological aspects of the random parasitism of pathogenic bacteria]. PMID- 3518302 TI - [The chemiluminescent method in immunology]. PMID- 3518303 TI - [Kingellae]. PMID- 3518304 TI - [Development of the classification of bacteria in the genus Shigella]. PMID- 3518305 TI - [Pathogenetic significance of the psychrophilia of Yersinia pseudotuberculosis]. AB - The work presents the data indicating that the temperature of Y. pseudotuberculosis cultivation is very important in regulating the activity of pathogenicity factors, necessary for the initiation of the pathogenic process in the cells of the macroorganism. Low temperature (8-10 degrees C), necessary for the growth of Y. pseudotuberculosis, facilitates the activation of invasive and toxic pathogenicity factors. At a growth temperature of 37 degrees C the inhibition of such necessary attributes of virulence as adhesion and invasion into epithelial cells occurs in Y. pseudotuberculosis, which decreases the capacity of these bacteria for inducing the infectious process. The virulence of Y. pseudotuberculosis population, lost as the result of its cultivation in synthetic culture media at a temperature of 37 degrees C, has been found to be restored at low temperature. PMID- 3518306 TI - [Evaluation of the possibility of using genetic and microbiological research methods for resolving current problems in the epidemiology of salmonellosis]. AB - S. typhimurium strains isolated in 14 regions of the USSR have, parallel with considerable similarity in their biological characteristics, a number of essential differences. These differences become manifest in the determination of the plasmid spectra of the above organisms. The transfer of R-plasmid PLE518 F1 me fin+ with a molecular weight of 96 Md to strains, sensitive to the action of typing bacteriophages, renders these strains resistant to the lytic action of a number of phages, which leads to the conversion of their phage type. In some cases it may deteriorate the validity of the method of phage typing, used for epidemiological purposes. PMID- 3518307 TI - [Elimination of Klebsiella pneumoniae and humoral immunity in immunization with the IS-4 immunostimulating mixture]. AB - The present investigation has revealed that in mice, immunized with preparation HC-4 (an immunostimulating agent consisting of water-soluble antigenic complexes obtained from 4 opportunistic microorganisms: Klebsiella pneumoniae, staphylococcus, Proteus and Escherichia coli K-100 having a common antigen with Haemophilus influenzae) and challenged with K. pneumoniae culture on day 7 after immunization, the complete elimination of K. pneumoniae from the blood occurs within 24 hours. The subcutaneous immunization of rabbits with the above preparation leads to a significant increase in antibody titers, determined in the passive hemagglutination test with Klebsiella diagnosticum. The test of the passive protection of mice from Klebsiella sepsis has revealed a rise in the preventive activity of the sera of rabbits immunized with this preparation. PMID- 3518308 TI - [Bactericidal and immunocorrective properties of plant extracts]. AB - Extract from oak cork, St. John's wort leaves and flowers and pine buds possess more pronounced bactericidal properties with respect to staphylococci, shigellae, Escherichia coli than decoctions from these medicinal plants. Such extracts may be included into complexes for the treatment of otorhinolaryngological diseases, enterocolitis in children and bacterial eczema. As a medicinal form, extract prepared from medicinal plants are more convenient for storage and permit more exact dosage. PMID- 3518309 TI - [Characteristics of the immune response of inoculated and intact animals to the administration of toxigenic and nontoxigenic strains of Clostridium tetani]. AB - In experiments on guinea pigs the immune reactions of the animals immunized and not immunized against tetanus in response to the injection of C. tetani spores were studied. In the immunized animals an increase in the production of tetanus antitoxin, the development of delayed hypersensitivity and the activation of the mechanisms of cell-mediated immunity were observed. The nonimmunized animals showed specific changes in the T-system of immunity without the appearance of the clinical symptoms of tetanus, which is, probably, one of the mechanisms of natural immunity. PMID- 3518310 TI - [Effect of human immunoglobulins on microflora of the large intestine in nonspecific ulcerative colitis]. AB - The use of commercial preparations of human immunoglobulin for the treatment of ulcerous colitis produces a positive effect on the microflora of the large intestine, contributing to the disappearance of Proteus, the lactose-negative forms of enterobacteria and the hemolytic variants of staphylococci, as well as to the increase of the amount of useful indigenous microflora (bifidobacteria and lactobacteria). The quantitative and qualitative improvement of the microflora leads, possibly, to the decrease of the intoxication of the body, improvement in the activity of the intestine and increased vitamin formation, thus giving a pronounced clinical effect and improvement in the endoscopic picture of the mucous membrane of the large intestine, peculiar for this disease. PMID- 3518311 TI - [Determination of a factor inhibiting migration of leukocytes to brain antigens, its concentration in serum and spontaneous leukocyte migration in multiple sclerosis]. AB - The authors examined 58 patients with multiple sclerosis and 56 healthy donors. The patients presented elevated production of the migration inhibition factor (MIF) by lymphoid cells to cerebral tissue antigens, most expressed in the acute period of the disease. The blood serum of patients with multiple sclerosis showed inhibitory activity, lymphocytes spontaneously produced the MIF in vitro. Hyperproduction of lymphokins may serve as one of the pathogenetic factors of generalization of the inflammatory process in the central nervous system in patients with multiple sclerosis and indicates impaired regulation of immunity. PMID- 3518312 TI - [Corticosteroid therapy of multiple sclerosis with attention to biorhythms]. AB - The corticosteroid therapy of multiple sclerosis was modified in relation to the biorhythms of the hypothalamic-pituitary-adrenal axis (HPAA). Prednisolone was prescribed per os in a dose of 1.5 mg/kg bw daily to be taken only in the morning once every three days for 30-45 days. In the control group, prednisolone was administered daily in a dose of 30-60 mg. In the test group, remissions were attained even in hormone-resistant forms of the disease and HPAA function was not seriously affected. Unlike control patients, no severe and persistent complications were observed in that group. The authors believe that the emergence of such complications following the corticosteroid treatment is partially related to the iatrogenic desynchronism of the regulatory biorhythmical processes in the HPAA with the suppression and perversion of adrenal function of steroidogenesis. PMID- 3518314 TI - [50th anniversary of the Department of Nervous Diseases of the Donetsk Medical Institute]. PMID- 3518313 TI - [History of the establishment of hospitals for alcoholics]. PMID- 3518315 TI - [50th anniversary of the Department of Psychiatry of the Donetsk Medical Institute]. PMID- 3518316 TI - [Borderline states and slowly progressive schizophrenia: clinico-genetic aspects (review)]. PMID- 3518317 TI - [Mechanisms of compensatory reinnervation in axon injuries of peripheral nerves (review)]. PMID- 3518318 TI - [Jackson's theory and the modern psychopathology of psychogenic disorders (on the 150th anniversary of the birth of J. H. Jackson and the 100th anniversary of the publication of his article "Evolution and dissolution of the nervous system"]. PMID- 3518319 TI - [Role of neurotrophic control in the pathogenesis of muscular dystrophy (a review)]. PMID- 3518321 TI - Infections and iron overload. PMID- 3518320 TI - [Carpal tunnel syndrome in pregnancy and the climacteric]. PMID- 3518322 TI - Sexually transmitted indigenous amoebic liver abscess. PMID- 3518324 TI - No association between retinopathy and insulin resistance in type 1 diabetes. AB - Intact endothelial cell function has been suggested to be important for insulin action. An association between retinopathy and insulin resistance has been found in type 2 diabetes. To evaluate, whether insulin resistance is related to retinopathy in insulin dependent diabetes, we examined 36 type 1 diabetic patients with various degrees of retinopathy: 7 patients had proliferative, 15 had background and 14 patients had no retinopathy. The three groups were matched for age, sex, body weight and insulin dose. Compared with patients with no retinopathy, those with proliferative retinopathy had a longer (P less than 0.05) duration of diabetes (13 +/- 3 vs 22 +/- 3 years for no vs proliferative retinopathy), and higher (P less than 0.05) serum creatinine (74 +/- 4 vs 97 +/- 8 mumol/l), triglyceride (0.69 +/- 0.04 vs 1.02 +/- 0.17 mmol/l) and diastolic blood pressure (77 +/- 3 vs 90 +/- 10 mmHg) levels. The rate of insulin-mediated glucose metabolism (1 mU euglycaemic insulin clamp) was virtually identical in each diabetic group (4.80 +/- 0.42, 4.90 +/- 0.36 and 4.98 +/- 0.74 mg/kg/min) and 40% below that in 8 matched normal subjects (7.53 +/- 0.53 mg/kg/min, P less than 0.001). In conclusion, proliferative retinopathy is related to long duration of diabetes, incipient nephropathy and hypertension. Insulin resistance characterizes the majority of patients with type 1 diabetes but is unrelated to retinopathy. PMID- 3518325 TI - Influence of pretransplant clinical conditions on the prognosis of patients treated with allogeneic bone marrow transplantation during leukemia relapse. PMID- 3518323 TI - Counterregulation of insulin-induced hypoglycaemia in primary hypothyroidism. AB - Hypothyroidism has been alleged to modulate insulin action and influence the secretion of growth hormone and catecholamines. We recently investigated the influence of hypothyroidism on glucose counter-regulatory capacity and the hormonal responses to insulin-induced hypoglycaemia in 6 patients with primary hypothyroidism (age 32-52 years, TSH-values 66-200 mU/l). Hypoglycaemia was induced in the hypothyroid state and again when the subjects were euthyroid. After an overnight fast a constant rate infusion of insulin (2.4 U/h) was given for 4 h. Glucose was measured every 15 min and insulin. C-peptide, glucagon, epinephrine, norepinephrine, growth hormone and cortisol every 30 min for 5 h. During insulin infusion somewhat higher concentrations of the hormone were obtained in the hypothyroid state and simultaneously glucose levels were 0.5 mmol/l lower. As expected, basal norepinephrine levels were higher in hypothyroidism. However, no increase in circulating norepinephrine during hypoglycaemia was registered in the two experiments. The responses of counterregulatory hormones showed an enhanced response of cortisol, similar responses of growth hormone and epinephrine while the glucagon response was paradoxically impaired. Our findings suggest that hypothyroidism alters insulin metabolism, and that the glucagon response to hypoglycaemia is impaired in this condition. PMID- 3518326 TI - Medicare amendments of 1986 and 1987. PMID- 3518327 TI - The effect of prostacyclin on the morphological and enzymatic properties of CNS cultures exposed to anoxia. AB - Organotypic cultures of rat cerebella were exposed to anoxia for 30 min. Prostacyclin (0.5 micrograms/ml medium) or 0.05 M Tris buffer pH 7.5 were added to the cultures immediately before exposure to anoxia. Cultures for histological, histoenzymatic and electron microscopic examination were taken immediately, 30 min and one, three, 24 and 72 h following anoxia. Cultures pretreated with prostacyclin showed a marked decrease in lactate dehydrogenase activity. Electron microscopic examination revealed that severe swelling and degenerative changes of neurons and glia induced by anoxia were much less pronounced in cultures treated with PGI2. Prostacyclin pretreatment also resulted in the appearance of morphological features of activation in glial cells. The results indicate that prostacyclin exerts a cytoprotective effect on the nerve tissue in vitro, predominantly reducing cell swelling and acidosis. This direct protection, besides vascular action of prostacyclin, may provide a basis for its beneficial clinical effect in ischemic stroke. PMID- 3518328 TI - The distribution of immunoglobulins and albumin in the central nervous system in acute experimental allergic encephalomyelitis. AB - Experimental allergic encephalomyelitis (EAE) was induced in young male Lewis rats. Immunohistochemical visualisation of albumin and IgG in the nervous tissue was performed at intervals after induction. The results were correlated to the histological appearance of the tissue. Albumin appeared in the tissue about day 10, 1-2 days before IgG. Within one day both proteins spread from sharply defined perivascular subpial locations to diffuse distribution throughout the tissue. Cellular inflammation was not seen until 3-4 days after extravasation of proteins. The cells also spread from perivascular locations to a diffuse infiltration of the tissue. PMID- 3518329 TI - Double-blind randomized controlled study of phosphatidylserine in senile demented patients. AB - A double-blind randomized controlled study was conducted in 42 hospitalized demented patients to evaluate the therapeutical effect of phosphatidylserine (BS PS). Half of the patients received 3 X 100 mg of this product, and the other half a placebo of the same appearance. After a wash-out period, prescription lasted for six weeks. To evaluate the patients, two distinct rating scales were used: the Crichton Scale and an original one (Peri Scale) designed in our geriatric unit (see Appendix). A circle crossing test was added. Out of the 35 patients who completed the trial, 18 had received placebo and 17 BC-PS. The results indicated a trend toward improvement in the BC-PS treated patients and an analysis of covariance showed a significant (p less than 0.05) treatment effect on the Peri Scale. The results at the end of the treatment period were compared with those obtained three weeks later. Here again there was a statistically significant difference in the Peri Scale results, indicating that modifications are drug related. The behavioral improvement shown in this study is in agreement with experimental studies on aged animals. PMID- 3518330 TI - Socket loosening after hip arthroplasty. Radiographic observations in 241 cases up to 15 years. AB - Serial radiographs of 241 consecutive, noninfected low friction arthroplasties performed between 1968 and 1972 were evaluated with respect to socket migration and the presence of radiolucencies, progressive or not. The number of intact sockets in 207 cases of arthrosis decreased slowly and, depending on their classification, approached 95-88 per cent about 10 years postoperatively. Contrary to previous reports, we could not observe any increase in the rate of loosening with time; half of the hips were observed for more than 10 years, and only a few cases of socket loosening were found beyond this point. In rheumatoid arthritis the number of intact sockets was significantly fewer--23 of 34--after about 10 years of service. PMID- 3518331 TI - Transient synovitis of the hip in the child. PMID- 3518332 TI - Morphometric comparison of endolymphatic and perilymphatic spaces in human temporal bones. AB - To measure the endolymphatic and perilymphatic spaces, we used human temporal bones (horizontal serial sections) under two selection criteria: absence of otological pathology, and absence of artifact in the membranous labyrinth (boundary between endolymphatic and perilymphatic spaces) maintaining an intact structural integrity. Under magnified projection, the area of scala tympani, scala vestibuli, scala media, vestibular endolymphatic space, and vestibular perilymphatic space were measured separately, using a microcomputer digitizing tablet. Three repeated measurements were obtained and averaged. The mean total labyrinthine fluid space was 204.5 mm3; the mean total endolymphatic space was 38.1 mm3 and mean total perilymphatic space 166.4 mm3. The mean total vestibular fluid space was 120.9 mm3 and mean total cochlear fluid space 83.6 mm3. In the vestibule, the perilymphatic space occupied 74.8%, and the endolymphatic space, 25.2%, whereas 90.8% of the cochlear fluid space was occupied by perilymph. PMID- 3518333 TI - The effect of lignocaine on nasal resistance and nasal sensation of airflow. AB - The effect of lignocaine on nasal sensation of airflow and nasal resistance was assessed in twenty-five subjects. A randomised crossover trial was conducted with lignocaine as the active drug and saline as the placebo. Both substances were delivered to the nasal mucosa as a nasal spray. Lignocaine caused a sensation of increased nasal patency in twenty-two of the twenty-five subjects studied. Saline had no such effect. The difference between this subjective effect of the two substances was highly significant (p less than 0.001). Neither spray had any significant effect on nasal resistance to airflow assessed objectively by rhinomanometry. PMID- 3518334 TI - Invasive lobular carcinoma of the breast. An analysis of 29 cases. AB - Twenty-nine cases of invasive lobular carcinoma were analyzed, based on three aspects of the histology: 1) cellular features such as a monotonous proliferation of uniform small cells, 2) a single file or targetoid arrangement, and 3) loss of cell cohesion or dissociation of tumor cells. Twenty-four tumors which fulfilled these three criteria were appraised as cases of conventional lobular carcinoma, in a classic sense, while five others were a variant of this tumor. Individual tumor cells of lobular carcinoma were estimated to be well differentiated, both morphologically and functionally, revealing well developed intracytoplasmic organelles and a high percentage of alpha-lactalbumin content in the cytoplasm. Nevertheless, the tumor itself was characterized by a lack of any particular structural differentiation in the arrangement of cells. Based on the observation of the histologic features, invasive lobular carcinoma was subclassified into three groups, in situ predominant, intermediate, and diffuse infiltrating and with a definite correlation to the age of the patient and to the prognosis. Validity of this classification indicates that lobular carcinoma progresses gradually, even in the invasive phase, and can be categorized as a slowly growing subset of mammary carcinoma. PMID- 3518335 TI - Immunopathological study related to myoglobin in myasthenic and non-myasthenic thymuses. AB - Twelve biopsied thymuses taken from 4 cases with myasthenia gravis (MG group) and 8 cases without myasthenia gravis (control group) including 2 thymoma cases in each group were immunopathologically investigated in relation to myoglobin (Mb). Mb positive cells of various degrees were detected in all thymuses of both groups, and immunoelectron microscopical examination disclosed that Mb positive cells corresponded to interdigitating reticulum cells and myoid cells in non neoplastic thymuses, and neoplastic epithelial reticular cells in thymomas. Anti Mb antibody staining by direct immunoperoxidase technique revealed positive localization to the lymphoid cells in the thymuses of 2 cases of MG group with thymoma. In addition, indirect immunofluorescent study with the serum of each case which was applied to the normal human skeletal muscle, showed positive staining of the sarcoplasm in 3 cases of MG group, including 2 thymoma cases, and using peroxidase labeled serum IgG F (ab')2 of the same patients this anti-muscle antibodies were proved to be against both postsynaptic cytosol and sarcoplasm of the extraocular muscle of the guinea pig. From these results, it was suggested that Mb may conduct itself as a homologous antigen between the thymus and the skeletal muscle in the myasthenic patient with thymoma, and in the thymus the interdigitating reticulum cell, the myoid cell, or the neoplastic epithelial reticular cell may retain or produce Mb as an antigen-presenting cell. PMID- 3518336 TI - Glomerulonephritis in patients with rheumatoid arthritis (RA). Report of five cases and review of the literature. AB - We reported five cases of glomerulonephritis developed in the course of rheumatoid arthritis (RA), which had no apparent relation with therapeutic agents. Systemic angiitis was observed in patient 1 and overlapping of systemic lupus erythematosus (SLE) with RA was implied in patient 2, while the other three patients did not show these changes. Renal biopsies were performed in all of the cases and glomerular deposition of immune complexes was suggested by both the immunofluorescent and electron microscopic findings, though the amount was variable. Furthermore, cases of glomerulonephritis in patients with RA were reviewed in the literature and classified into three groups: occurring in association with angiitis, overlapping with SLE or other collagen diseases, and developing without the above two factors. Group 3 was further divided into two subgroups according to immunologic abnormalities. All cases included in the three groups can be regarded as glomerulonephritis of RA. The cases of group 2, however, can more preferentially be considered to be caused by SLE or some other collagen disease that has overlapped with RA. Deposition of immune complexes was suggested in most of the cases examined with immunofluorescence. Various changes were seen in the glomerulonephritis of RA presented here (patients 1, 3, 4, and 5) and reviewed in the literature (groups 1 and 3). Immune complexes might be involved in the pathogenesis of glomerulitis. PMID- 3518337 TI - Actin filament alterations in glomerular epithelial cells of adriamycin-induced nephrotic rats. AB - The alterations of actin filaments in the glomerular epithelial cells of adriamycin-induced nephrotic rats were studied by electron microscopy and immunohistochemistry using both of the peroxidase-antiperoxidase and avidin biotin methods. After the administration of adriamycin, the glomerular epithelial cells showed cell swelling, deformation of cell shape, vacuole formations, retraction or fusion of foot processes, detachment of the plasma membrane from the glomerular besement membrane (GBM), and an increase of cellular organelles. In parallel with these alterations, abnormal distribution of intracytoplasmic microfilaments of 5-6 nm in diameter was observed, which formed clusters, particularly gathering densely along the plasma membrane of the fused foot processes that abutted the GBM. Immnohistochemically, actin was demonstrated on the site of the above described filaments. The above results suggest that actin filaments may closely relate to the morphological maintenance of the glomerular epithelial cells and to their function as well. PMID- 3518338 TI - Effects of six cholecystokinin (CCK) fragments on insulin secretion in the mouse. AB - In a recent study it was demonstrated that the C-terminal octapeptide of cholecystokinin (CCK-26-33; often abbreviated CCK-8) and CCK-39 (= CCK--6-33) potently and with the same efficacy stimulated basal insulin secretion when injected intravenously to mice. In the present study, the effects of four other CCK fragments, CCK-30-33 (= CCK-4), CCK-1-33 (= CCK-33), CCK-1-21 (= CCK-21) and CCK-10-20, on basal and glucose-induced insulin secretion were studied. It was found that CCK-33 stimulated insulin secretion. At a dose level of 4.25 nmol/kg, plasma insulin concentrations were elevated by 58 +/- 7 microU/ml (P less than 0.001). On the contrary, neither CCK-4, nor CCK-21, nor CCK-10-20 displayed any effect on basal insulin secretion, not even at high dose levels. When injecting CCK-8, CCK-33 or CCK-39 at dose levels substimulatory on basal insulin secretion (0.53 nmol/kg), together with glucose, CCK-39 potentiated glucose-induced insulin secretion whereas CCK-8 and CCK-33 were without effects. In contrast, at the higher dose level of 5.3 nmol/kg, CCK-8, CCK-33, and CCK-39 all potentiated glucose-induced insulin secretion. The three other fragments, CCK-4, CCK-21, and CCK-10-20, were all without effects on glucose-induced insulin secretion. In conclusion, the potent stimulatory action on basal insulin secretion in the mouse exerted by various CCK fragments is confined to the C-terminal octapeptide (= CCK 8 or CCK-26-33).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3518339 TI - Localization of IGF-I in adult rats. Immunohistochemical studies. PMID- 3518340 TI - The role of psychiatric factors in symptoms of hiatus hernia or gastric reflux. AB - The study comprised 26 patients with somatic symptoms indicating a hernia-reflux syndrome referred to a university hospital ear, nose and throat department. The aim was to throw light on the hypothesis that this syndrome is largely a psychosomatic problem. The patients were divided into two groups: subjects with and without laboratory findings of physical pathology of hernia and/or reflux. Intergroup comparisons were made of symptoms, a psychological test and psychiatric ratings. Those who had no laboratory findings of physical pathology often reported "phobia" and "feeling of lump in the throat", which were interpreted as signs of hysterical or somatizing mechanisms. Most of these patients showed a high level of anxiety in the psychological test. "Agitation", "depression" and "frustration" were characteristics of patients with laboratory findings of reflux. "Depression" was interpreted as a reaction to the somatic illness. The group with reflux contained more old male patients and that without more younger female patients. PMID- 3518341 TI - Reduction of the pyrexial response to acute myocardial infarction by beta adrenoceptor blockade. AB - We have studied the effect of beta-adrenoceptor blockade on the pyrexial response to acute myocardial infarction (AMI). Temperatures of 22 patients treated with timolol, 20 mg daily, in the acute phase of AMI were compared to temperatures of 22 patients not receiving timolol treatment. Fever response after AMI was significantly reduced in the timolol-treated patients, maximal and mean temperature in the febrile period being lower and the febrile period being shorter. Reduction of fever in AMI may be of importance as a higher body temperature increases the risk of developing heart failure and arrhythmias. The study lends support to the use of beta-adrenoceptor blockade in AMI. It also substantiates a possible role of beta-adrenergic receptors in the regulation of body temperature during fever. PMID- 3518342 TI - Prognostic influence of early diagnostic splenectomy in Hodgkin's disease. A long term follow-up. AB - The influence of early laparotomy with splenectomy on prognosis in patients with Hodgkin's disease who were regarded as having uncertain prognostic indices (all patients except those with lymphocytic predominance and nodular sclerosis stages IA and IIA with right-sided presentation, stage IV disease, splenomegaly or age greater than 65 years) was evaluated in a randomized trial initiated in Jan. 1973. The patients were treated with total nodal irradiation (excluding the splenic and hepatic areas) and 33 of 69 patients were randomized to laparotomy with splenectomy. No significant difference in relapse-free or overall survival was found between the two groups after a median observation time of 85 months. Progressive or recurrent disease was as common in splenectomized as in non splenectomized patients. Splenectomized patients with splenic tumour involvement fared worse than those without. It is concluded that diagnostic laparotomy with splenectomy is of no benefit in this clinical setting. PMID- 3518343 TI - Scalp marking of intracranial lesions using computed tomography (CT) images. A technical note. AB - A technique for scalp marking using computed tomography (CT) images is described. A reference marker is placed on the scalp and a plain lateral skull film is obtained. Using the CT scan image and the CT scout film, the target is marked on the plain skull film. The distance and angle of the target from the reference point on the plain film are measured and marked on the scalp to indicate the location of the target. PMID- 3518344 TI - HPLC of glycosphingolipids and phospholipids. PMID- 3518345 TI - Inherited convulsive disorders in mice. AB - In this chapter, we review the major inherited convulsive disorders found in mice and discuss their possible relationship to specific clinical seizure disorders in humans. These disorders in mice include audiogenic seizures, the epilepsy (El) mouse, various spontaneous seizures, the tottering/leaner syndrome, seizures associated with cerebellar abnormalities, seizures associated with myelin disorders, and alcohol withdrawal seizures. We find that for most major types of epilepsy in humans, there exists a similar counterpart in the mouse. Because human and rodent nervous systems respond similarly to seizure-provoking stimuli, it is possible that biochemical and physiological mechanisms of naturally occurring convulsive disorders are also similar in these species. The use of recombinant inbred (RI) and congenic mouse strains for genetic and biochemical studies of audiogenic seizures is presented. Using these strains, we have identified a major gene, Ias, that inhibits the spread of seizure activity. This gene was found through its close linkage with the Ah locus on chromosome 17. We also found that juvenile-onset and adult-onset audiogenic seizures are controlled by different genetic systems. The problem of juvenile-onset audiogenic seizure susceptibility is especially interesting because these seizures are genetically associated with an ecto-Ca2+-ATPase deficiency among the RI strains. This deficiency is the first neurochemical trait found to be inherited together with an idiopathic convulsive disorder, and may represent a potentially important basic mechanism of epilepsy. Because the brains of human epileptics are generally inaccessible for neurochemical research, the epileptic mouse mutants offer a convenient means of pursuing this type of research. The well-known genetic constitution of the mouse, together with the availability of numerous physiologically distinct convulsive disorders, makes the mouse ideally suited for molecular, genetic, and biochemical studies of convulsive behavior. PMID- 3518346 TI - Control theory applied to neural networks illuminates synaptic basis of interictal epileptiform activity. AB - A brief historical account is presented of the formulation of two hypotheses that have been proposed to explain the mechanisms underlying the paroxysmal depolarizing shift (PDS) in experimental epilepsy. The two hypotheses are called the giant EPSP hypothesis and the endogenous burst hypothesis. The giant EPSP hypothesis states that the PDS (the intracellular correlate of the interictal discharge) is comprised of a larger-than-normal-strength excitatory synaptic input, whereas the endogenous burst hypothesis states that the PDS is an endogenous burst triggered by an excitatory postsynaptic potential of normal strength. Two sets of four experimentally testable predictions, which were derived from these two hypotheses for the PDS, are presented. These predictions describe the expected behavior of the PDS in response to changes in membrane potential and under conditions of voltage clamping. With the advent of single electrode current- and voltage-clamp techniques and improved intracellular recording conditions, the testing of these predictions has become possible. Experiments are described in which each of the predictions from the two hypotheses were tested. The results strongly support the giant EPSP hypothesis and are not easily reconciled with the endogenous burst hypothesis. Because the PDS is a network-driven event, it is important to understand the properties of the neuronal network responsible for the genesis of the PDS. Others have proposed that there are three necessary conditions for epileptiform activity in any neuronal network: endogenous bursting, disinhibition, and recurrent excitatory synapses. Using control theory as a frame of reference, we argue that it is premature to raise these three phenomena to the level of general theoretical requirements for interictal activity. Insufficient quantitative information exists about the properties of neurons, synapses, and connectivity patterns in any cortical neuronal network to conclude that the three preposed requirements are necessary and sufficient general conditions for epileptiform activity. Because all of the key predictions of the giant EPSP hypothesis have now been experimentally verified, we conclude that the PDS is a large, network-driven EPSP. The current challenge to neurophysiologists is to describe is detail the properties of neurons and synapses in a cortical neuronal network and then to evaluate the relative contributions of network and individual neuronal properties to the expression of interictal epileptiform activity. PMID- 3518347 TI - Mechanisms of interictal epileptogenesis. AB - The interictal discharge is a brief epileptiform event that provides the simplest experimental system available for investigating some of the basic mechanisms of epilepsy. Interictal discharges are characterized by two major abnormal properties: each involved neuron exhibits a transient large amplitude depolarization (the "depolarization shift") associated with repetitive spike generation, and this excitation arises with virtual synchrony in the majority of cells in a local population. Recent studies have attempted to define the cellular properties that predispose a cortical circuit to this pathological behavior. There appear to be three general factors that interactively determine cortical susceptibility to epilepsy: Intrinsic membrane properties of neurons. The intrinsic excitability of individual cells may vary greatly within a cortical area; the initiation of a synchronous discharge usually occurs in the subpopulation of cells that has the endogenous ability to generate bursts of action potentials. Efficacy of local inhibitory synaptic mechanisms. Normal integrative functions of the cortex require robust inhibition; depression of inhibition is one of the most reliable ways to trigger a seizure. Effectiveness of excitatory synaptic connections and other synchronizing mechanisms. Highly synchronized discharge among a large number of neurons requires widely divergent excitatory interactions. Differences in these factors for different cortical areas can confer relative susceptibility or resistance to development of epileptiform discharge. Pharmacologic, pathologic, developmental, and genetic processes can presumably mitigate or aggravate focal cortical epileptogenesis by affecting any of these three general factors. PMID- 3518348 TI - Genetic heterogeneity in the epilepsies. AB - There is ample evidence for genetic and other heterogeneity in the mechanisms leading to epilepsy. Animal models of epilepsy show that genetic factors can influence the hypersensitivity of neurons. In the human, there are over 140 Mendelian traits (including disorders of amino acids, enzymes, hormones, and vasculature) that increase the risk of seizures. Furthermore, systems with an intermediate optimum (such as blood clotting and blood glucose) involve a number of mechanisms under independent genetic control, and it is reasonable to assume that the same principle applies to neuronal excitability. Finally, genetic variation can be expected in any of the factors that are altered in the origin of seizures: neuronal inhibition, inactivation of excitatory neurotransmitters, feedback control, and seizure generalization. One goal of future research is to define etiological subtypes on the basis of biochemical data or other factors. Meanwhile, it is possible to analyze currently available indicators of phenotypic variability (age at onset of seizures, family history of seizures, seizure type, EEG pattern, and history of antecedent factors such as fever or trauma) to address the following questions: Do any phenotypic groups have different sibling risks for seizures? How much phenotypic variability is seen among affected siblings of each defined group of probands (index cases)? Do any groups of probands show significant biochemical differences? Within a specific group, do isolated and familial cases show the same phenotype? Within a presumed single entity, will linkage marker studies show further heterogeneity? With such data in hand, certain strategies can be recommended. Complex segregation analysis of family data will permit a test of alternative models for genetic transmission. Linkage studies of selected large families (using recombinant DNA probes) will establish the genetic map location of any single-locus major factor. Selected samples of multiplex families (with several affected siblings) will concentrate the likelihood of genetic factors and will permit the detection of biochemical factors that might be significant in only a few families. Biochemical and other hypotheses can be tested in a panel of twin pairs concordant or discordant for epilepsy. The search for genetic heterogeneity clearly has implications for diagnosis, prognosis, therapy, and genetic counseling, as well as for other research studies on the basic mechanisms of the epilepsies.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3518349 TI - Ionic changes and alterations in the size of the extracellular space during epileptic activity. AB - Experiments with ion-selective microelectrodes revealed that a considerable activity of K ions appears temporarily in the extracellular space (ES) during enhanced neuronal activity and is removed from the ES by diffusion, active uptake, and entry into glial cells. The glial uptake results from the preferential glial K permeability and spatial glial K buffering. The glia responds to the local extracellular accumulation by a depolarization of the exposed part of its membrane. This depolarization will spread along the glial syncytium or extended glial cells. At sites where the extracellular K concentration has not yet increased, the membrane potential will thus be depolarized with respect to the K diffusion potential. Here K will move from the intra- into the extracellular space, in order to restore the electrochemical equilibrium. This induces a current that carries K into glial cells at sites of maximal K accumulation and that transports K out of glial cells at remote areas. In this way K is spatially redistributed. The corresponding current loop in the ES is predominantly carried by Na and Cl, the majority ions. Thus, Na and Ca are transported to the site of K accumulation while Cl moves away. The Cl and K ions are only partially replaced by Na. Hence, a decrease of extracellular osmolarity results, which leads to a water flux from the ES into the cells, inducing a shrinkage of the ES at sites of maximal K accumulation. At remote sites, the opposite effect is expected due to K flow out of glia and Cl transport to these sites. Thus, remote from the area of maximal neuronal activity, an increase of the ES is expected. This mechanism can explain the measured depth profile of the changes in the ES. At sites of maximal neuronal activity, the extracellular space undergoes a reduction by more than 30%. The ionic changes are accompanied by slow negative potential shifts. An increase in intracellular osmolarity due to enhanced metabolic activity and possibly KCl uptake mechanisms contributes to the changes in volume and ionic concentration. Model calculations of the after effects of the loss of positive charges from the extracellular space and the K specific glial buffering could predict size and time course of these changes. Experimental tests of this view include observations during epileptiform activity in gliotic scar foci as well as in hippocampal slices with depressed synaptic transmission. The extra- and intracellular ionic changes influence the generation, spread, and termination of seizure activity.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3518350 TI - Extracellular calcium and potassium concentration changes in chronic epileptic brain tissue. AB - Repetitive electrical stimulation and application of excitatory amino acids lead to decreases in extracellular Ca2+ concentration and to rises in extracellular K+ concentration [( Ca2+]o, [K+]o) with a typical laminar distribution in a given neo- or allocortical structure. These ionic changes result from transmembrane ion fluxes along their respective electrochemical gradients. Epileptogenic drugs that impair repolarizing K+ conductances or inhibitory synaptic transmission enhance such extracellular ionic changes, but they do not alter the laminar distribution of [K+]o and [Ca2+]o changes. Enhanced [Ca2+]o concentration changes are also observed in chronic epilepsies such as the chronic alumina cream and cobalt focus, the kindling epilepsy, and during photically induced seizures in the baboon Papio papio. In chronic epilepsies, the sites of maximal [Ca2+]o changes shift to other layers, suggesting changes in the distribution of ion channels over the surface of nerve cells that may be involved in epileptogenesis in chronic epilepsies. The K+ and Ca2+ concentration changes associated with seizure contribute to the generation and spread of epileptic activity. This is demonstrated by the fact that lowering of extracellular free calcium concentration can induce spreading epileptiform activity in the absence of chemical synaptic transmission, with [K+]o rises preceding epileptiform activity. PMID- 3518351 TI - Interstitial ion concentrations and paroxysmal discharges in hippocampal formation and spinal cord. AB - This chapter contains a summary of previous work, as well as some new data concerning the roles of potassium and calcium in electrically and chemically induced seizures. During tonic-clonic seizure discharges, the extracellular concentration of potassium, [K+]o, increases from its resting level of 3.0 to 3.5 mM to between 8.0 and 12.0 mM. The time course of the [K+]o increase is such that it cannot play a part in causing either the onset or termination of paroxysmal firing, but its magnitude is in the range where K+ ions have a profound influence on the functions of excitable membranes and synapses. During nonparoxysmal activation of central nervous system (CNS) tissue, [Ca2+]o may decrease, increase, or remain unchanged. When the same stimulus train is repeated every few seconds, in time the [Ca2+]o response may change polarity even if the experimental conditions have not deliberately been altered. Changes in cerebral pH can cause small changes in the level of free Ca2+ ions in the CNS interstitium, possibly contributing to the variability of its response. At the site of origin of seizure discharges, however, [Ca2+]o does decrease in most or all cases. Paroxysmal firing provoked in hippocampal formation by repetitive stimulation of an afferent pathway and recorded with extracellular microelectrodes in a cell-body layer consists of "giant" population spikes riding on a sustained negative shift of the baseline potential. The paroxysmal sustained potential (SP) shift appears to be generated by intense and sustained depolarization of the cell bodies of dentate granule cells, and of hippocampal pyramidal cells. This is different from spinal cord and cerebral neocortex, where paroxysmal SP shifts are generated mainly by depolarization of neuroglial cells. The giant population spikes are probably the result of lockstep firing of granule cells and of pyramidal cells. PMID- 3518352 TI - Identification of seizure-mediating brain structures with the deoxyglucose method: studies of human epilepsy with positron emission tomography, and animal seizure models with contact autoradiography. AB - This chapter describes tomographic and autoradiographic studies of human and animal seizure syndromes employing Sokoloff's deoxyglucose method. The method's rationale rests on two principal facts: that adult brains normally utilize glucose almost exclusively as their exogenous energy source, and that deoxyglucose, a glucose analog, accumulates in brain cells in proportion to their activity level. Thus, computed tomography or contact autoradiography allows visualization and indirect measurement of changes in the activity of different brain structures under specified conditions, such as between, during, or immediately following seizures. In humans, partial seizures have been the most extensively studied, with 18F-fluorodeoxyglucose and positron emission tomography. Interictally, the brains of patients with partial seizures are characterized by hypometabolism that is particularly severe in the vicinity of seizure foci. In many cases, these focal hypometabolic zones become hypermetabolic ictally. Other brain areas may also become hypermetabolic ictally, or they may instead become hypometabolic. Often the physical extent of interictal hypometabolic zones is substantially greater than the extent of overt pathology. This indicates that hypometabolism can result from subtle, presently undescribed, structural or functional derangements, as well as from frank neuronal loss. A variety of animal seizure "models" have also been studied, with 14C-2 deoxyglucose and contact autoradiography. Each model has produced a unique deoxyglucose and contact autoradiography. Each model has produced a unique deoxyglucose utilization pattern, but thus far none that closely resembles any of the human seizure patterns. This probably reflects true differences between the mechanisms mediating different types of animal seizures and those mediating human seizures. Although in widespread use for only a few years, the Sokoloff method has already demonstrated its ability to distinguish among a variety of seizure types in both humans and animals, and to correctly identify those structures most involved in focal seizures. Thus, the method can be of great aid in narrowing the search for seizure-mediating mechanisms. PMID- 3518353 TI - Psychiatric aspects of cardiac surgery. PMID- 3518354 TI - Renal transplantation and the new medical era. PMID- 3518355 TI - Psychological intervention with surgical patients: evaluation outcome. PMID- 3518357 TI - [In memory of Marie-Elise Kayser]. PMID- 3518356 TI - Voluntary systems of adverse reaction reporting--Part II. PMID- 3518358 TI - Changes of endogenous prostacyclin-level in different experimental gastroduodenal ulcer models of rat. AB - It seems that the gastric antral mucosa either in normal, physiological circumstances, or in IND or STR induced gastric ulcer models, contains significantly more endogenous PG-I2 than that of gastric fundic mucosa, while the duodenal mucosa contains significantly lower endogenous PG-I2-level compared to the gastric antral or fundic level. Either in gastric or in duodenal ulceration the endogenous PG-I2 level basically decreased proportionally to the degree of ulceration - therefore it is tempting to speculate that the endogenous PG-I2 is most probably one of the natural protective substances in the gastrointestinal mucosa. PMID- 3518359 TI - Interaction of a new low molecular weight heparin (OP/LMWH) with human platelets. AB - In vitro platelet proaggregating effect of unfractionated heparin (H) and OP/LMWH were studied with human platelets. OP/LMWH produced a significant less potentiation of ADP and PAF induced aggregation and slightly counteracted the antiaggregating effect of PGI2, in comparison with H. The proaggregating effect of both heparins was neutralized by equal contemporaneous amount of protamine sulfate. PMID- 3518360 TI - [Image processing of the ocular region in ultrasonic diagnosis and its clinical significance. 17. Three-dimensional display and volume measurements of intraocular mass based on spiral scanning]. PMID- 3518361 TI - [Chemotactic factor to polymorphonuclear leukocytes in the human crystallin lens. 5. Chemotactic factor in gamma-crystallin]. PMID- 3518362 TI - [Study on ultrasonic tissue characterization of intraocular membranous structures]. PMID- 3518363 TI - [Total imaging diagnosis in ophthalmology: new experiments and clinical applications]. PMID- 3518364 TI - [Histopathological and histochemical study of tissue response after the fadenoperation and related surgery. Report 1. Histopathological changes after the fadenoperation and related surgery]. PMID- 3518365 TI - High-contrast mammography with a moving grid: assessment of clinical utility. AB - Mammography techniques using moving grids produce superior breast images in many patients but result in increased radiation dose. This prospective controlled study of 1000 unselected screen-film mammography patients identifies a subset of women who are most likely to benefit from higher-dose grid-assisted techniques. In approximately 60% of the patients, the increased contrast of grid films produced a noticeable improvement in overall image quality. In only 20% of cases did this translate into clinically useful information, however, usually resulting in an increased level of confidence in interpretation. In virtually all the cases in which grid images aided mammographic diagnosis, the patients were women having more than 50% dense fibroglandular tissue or compressed breast thickness greater than 6 cm (only 37% of the study population). We suggest that the use of grid techniques be restricted to patients with such dense or thick breasts, because only in these women can the increase in radiation dose be justified. PMID- 3518366 TI - Atypical radiographic findings in hepatic cavernous hemangioma: correlation with histologic features. AB - Three cases of cavernous hemangioma of the liver having atypical imaging features are described. In the first case, an 11 x 10 cm hypervascular mass with a central hypovascular area supplied by many large tortuous vessels was demonstrated on angiography, CT, and sonography. The mass had a central cavity that contained fluid. In the second case there was a 2-cm isoechoic mass with a peripheral halo, despite the presence of typical features of hemangioma on angiography. The halo was shown histologically to be fibrous tissue surrounding the tumor. In the third case, a 6.5 x 4.3 cm mass exhibited slight peripheral enhancement on CT but was not detectable by angiography. Histologically, the tumor was hyalinized with only scattered small foci of hemangioma within it. PMID- 3518367 TI - MRI of hemorrhagic renal cysts in polycystic kidney disease. AB - Nine patients with polycystic kidney disease were examined by MRI, CT, and sonography. MRI distinguished among simple cysts, cysts complicated by prior hemorrhage, and coexistent renal cell carcinoma. On T1-weighted spin-echo images, simple renal cysts appeared as round, homogeneous, low-signal regions with smooth outer margins and a distinct interface with remaining normal renal parenchyma or adjacent cysts. Hemorrhagic cysts were seen as homogeneous medium- to high-signal intensity regions, and about half of them correlated with hyperdense cysts by CT. In five cases, fluid-iron levels were evident by dependent high-intensity layering within the cysts. Renal cell carcinomas occasionally show high intensity because of hemorrhage, but intratumoral fluid-iron levels have not yet been described. These results suggest that MRI is useful in differentiating between simple cysts, hemorrhagic cysts, and neoplasms when CT and sonography are indeterminate. PMID- 3518368 TI - Hemorrhagic focal bacterial nephritis: findings on gray-scale sonography and CT. AB - Five patients with acute focal bacterial nephritis and hematuria had sonographic and CT findings atypical for renal infection. Sonographically, each presented with an echogenic focus in the renal parenchyma. Noncontrast CT images showed an area of increased density in the corresponding segment of the kidney in three patients, mixed high and low density in one patient, and low density alone in the remaining patient. It is proposed that these appearances result from the presence of hemorrhage at different stages, associated with focal infection. Venous compromise is suggested as the etiology. PMID- 3518369 TI - Quantitative analysis of intracranial circulation using rapid-sequence DSA. AB - By using a high-frame-rate technique, intravenous digital subtraction angiography (IVDSA) of the intracranial circulation was performed in patients with transient ischemic attacks and asymptomatic bruits. Twenty patients with normal carotid arteries or mild stenosis of no hemodynamic significance were selected as a control group to evaluate the effect of carotid stenosis on the difference between hemispheres in the peak arrival time (delta TMAX) of the contrast bolus. Data were obtained for the anterior (ACA), middle (MCA), and posterior (PCA) cerebral artery distributions. Raw data of the time-density curve in a region of interest were analyzed by polynomial curve-fitting techniques to obtain the peak arrival time (TMAX). The delta TMAXs for normal middle, anterior, and posterior distributions were 0.140 +/- 0.119 sec, 0.152 +/- 0.146 sec, and 0.189 +/- 0.187 sec, respectively. Eleven patients with tight carotid stenosis or occlusion whose delta TMAX fell outside the normal range as established from the 20 control patients were analyzed with regard to ischemic symptoms. The delta TMAXs of the MCA, ACA distributions in the asymptomatic patients with tight carotid stenosis or occlusion were 0.653 +/- 0.379 sec and 0.118 +/- 0.159 sec, respectively; p less than 0.001 in the MCA when compared with controls. The delta TMAXs of the MCA, ACA distribution in the symptomatic patients with tight carotid stenosis or occlusion were 1.31 +/- 0.13 sec and 0.525 +/- 0.079 sec, respectively; p less than 0.001 in the MCA and ACA distributions when compared with controls. Quantitative analysis of this type of physiologic data may enable the detection of patients with carotid stenosis who are well compensated by collateral flow from those who are poorly compensated and at risk for possible infarction on a hemodynamic basis. Serial followup DSA studies in patients with asymptomatic bruits may help to correlate the progression of extracranial carotid stenosis and the status of intracranial collateral reserves. PMID- 3518370 TI - Renal calcium deposition in children: sonographic demonstration of the Anderson Carr progression. AB - The Anderson-Carr theory of renal-stone formation, based on cadaver studies, postulates the aggregation of calcium at the tips and margins of the renal pyramid. Progressive calcium deposition is followed by the formation of calcium plaques, which may perforate the calyx and form a nidus for further stone growth. This theory has not been demonstrated in vivo. We studied 50 children with conditions leading to nephrocalcinosis with renal sonography. Seven of these had high-resolution CT. Twenty-four positive sonographic examinations were used to study patterns of calcium deposition in the kidney. Nephrocalcinosis was confined to the medulla and was found at the margins of the pyramid, at the fornix, or throughout the entire pyramid. Five children showed calcium plaques in or near the calyx. The sonographic pattern identified appears to provide an in vivo demonstration of the Anderson-Carr progression of renal-stone formation. PMID- 3518371 TI - Neonatal aortoiliac compression caused by a distended bladder. AB - Neonatal aortoiliac insufficiency caused by a distended urinary bladder is an unusual occurrence that can be difficult to distinguish from aortoiliac thrombosis. Real-time sonography can permit recognition of the abnormality, demonstration of the related pathophysiology, and exclusion of other causes of aortoiliac occlusion. PMID- 3518373 TI - Pseudoomphalocele: pitfall in fetal sonography. AB - Compression of the fetal abdomen between the walls of the uterus or placenta can result in an appearance that mimics that of omphalocele on sonography. This may be caused by oligohydramnios or by a transient compression of the fetal abdomen with a normal amount of amniotic fluid. Four cases of pseudoomphalocele and one case of true omphalocele are presented. PMID- 3518372 TI - The sonographic evaluation of fetal anomalies in oligohydramnios between 16 and 30 weeks gestation. AB - The sonograms of all patients with oligohydramnios between 16 and 30 weeks gestation seen over a 4-year period were reviewed to determine (1) whether sonographically detectable fetal anomalies were present, and (2) when these anomalies were present, how this information was used in maternal fetal management. Cases of ruptured membranes and fetal demise were excluded from the study. Sixteen patients with severe oligohydramnios were identified. On postmortem examination, nine had urinary tract anomalies, one had evidence of a chronic intrauterine infection, and four had no anomalies. There were only two neonatal survivors: one had no anomalies while the other had posterior urethral valves. These findings confirm that second trimester oligohydramnios has a poor prognosis and is often associated with anomalies of the urinary tract. Sonography aids in the clinical management of such patients. PMID- 3518374 TI - Primary biliary cirrhosis. AB - Primary biliary cirrhosis often presents insidiously but progresses relentlessly in its later stages. Asymptomatic patients, however, may have a relatively benign course. Clinical, laboratory and histologic characteristics support an autoimmune pathogenesis. The complications of primary biliary cirrhosis are secondary to severe cholestasis, portal hypertension and progressive hepatocellular dysfunction. Currently, treatment is only supportive; no drug regimen has been shown to alter the disease course. PMID- 3518375 TI - Steroid pulse therapy. PMID- 3518376 TI - Two cases of sudden death documented by Holter monitor during Secondary Prevention Reinfarction Nifedipine Trial (SPRINT). PMID- 3518377 TI - Are the CASS statisticians answering a question no clinician is asking? PMID- 3518378 TI - Major anomalies of coronary arterial origin seen in adulthood. PMID- 3518379 TI - Treatment of hypertensive urgencies and emergencies with nifedipine. AB - The calcium channel blocker, nifedipine, is an effective antihypertensive agent for the treatment of hypertensive urgencies and emergencies. It produces a prompt, safe, predictable, and consistent reduction in systemic arterial pressure with minimal adverse effects. The reduction in blood pressure 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. The overall efficacy in reaching goal blood pressure approaches 98% with a 10 to 20 mg dose of nifedipine. Hemodynamic changes are favorable, and there is rarely any associated morbidity (severe hypotension) or mortality. The role of nifedipine in the treatment of hypertensive emergencies is promising, but further studies are needed to compare it to other approved emergency antihypertensive regimens. PMID- 3518380 TI - Pharmaceutical services for patients with diabetes. Module 3. Current concepts in diabetes therapy. PMID- 3518381 TI - Effects of nifedipine on left ventricular performance in unstable angina pectoris during a follow-up of 48 hours. AB - In 1981, a large, double-blind, randomized, multicenter trial was started in The Netherlands to evaluate the therapeutic effects of nifedipine or metoprolol in patients with unstable angina. This study, called the Holland Interuniversity Nifedipine Trial (HINT), included several hundred patients to establish potential therapeutic effects. From December 1982 until January 1984 the effects of nifedipine on left ventricular (LV) performance in a subgroup of 37 HINT patients were studied using radionuclide techniques. All patients (18 treated with nifedipine, 19 with placebo) underwent radionuclide angiography and 33 underwent thallium-201 scintigraphy just before and 48 hours after the start of treatment with the experimental medication. Radionuclide angiographic studies were also performed 1 hour (29 patients) and 4 hours (31 patients) after the start of treatment. The thallium-201 images showed defects in 24 (73%) of the baseline images and in 21 (64%) of the 48-hour images. No significant differences were seen between patients receiving nifedipine or placebo in the incidence of new defects or in the disappearance of defects at 48 hours. Changes in thallium-201 images were not related to recurrence of myocardial ischemia or the development of acute myocardial infarction. Nineteen of the 37 patients (51%) with baseline blood pool images had a reduced LV ejection fraction (EF) (38 +/- 10%) and 18 patients (49%) had a normal LVEF of 56 +/- 5%. LVEF improved after 48 hours in 8 patients receiving nifedipine and in only 1 patient receiving placebo (p less than 0.02). This effect was not present at 1 and 4 hours after treatment.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3518382 TI - Impaired left ventricular function in acute myocardial infarction assessed by Doppler measurement of ascending aortic blood velocity and maximum acceleration. AB - The Doppler-derived ejection variables systolic velocity integral, maximum acceleration and heart rate were recorded in 92 patients with acute myocardial infarction (AMI) and 73 age-matched normal subjects. Systolic velocity integral was validated as an index of stroke volume against a thermodilution technique in acutely ill patients. Patients with AMI were separated into clinically defined Forrester subsets and into survivors and nonsurvivors of the acute infarction period. Systolic velocity integral correlates significantly with stroke volume determined by thermodilution (r = 0.07) in patients with aortic root areas within the normal range. Patients had a 37% lower maximum acceleration (p less than or equal to 0.001), a 48% lower systolic velocity integral (p less than or equal to 0.001) and a 13% higher heart rate than the age-matched normal subjects (p less than or equal to 0.01). Systolic velocity integral and maximum acceleration both showed a systematic significant decrease through the Forrester subsets (p less than or equal to 0.01, p less than or equal to 0.001, respectively), and were also significantly different between the survivor and nonsurvivor groups (p less than or equal to 0.05, p less than or equal to 0.01, respectively.) Thus, noninvasive measurement of ascending aortic blood velocity and acceleration allows rapid assessment of left ventricular function and provides indexes closely related to the patients' clinical status and subsequent risk of mortality, indicating the potential of the Doppler technique in the prognosis and subsequent management of patients with myocardial infarction. PMID- 3518383 TI - Acute and chronic effects of sotalol and propranolol on ventricular repolarization using constant-rate pacing. AB - Sotalol and propranolol were administered both intravenously and orally in conventional equipotent beta-blocking doses to 8 patients with permanent programmable ventricular pacemakers to study their effects on ventricular repolarization. Sotalol prolonged the QT interval by 6.5% (430 to 455 ms) after intravenous administration (p less than 0.01) and by up to 11.5% (430 to 483 ms) after 4 weeks of oral treatment (p less than 0.001). This was entirely due to prolongation of the JT interval, since there was no effect on QRS duration. The magnitude of QT and JT prolongation related to the serum level but the correlation was not statistically significant. QT prolongation was exaggerated after chronic treatment despite lower serum levels of sotalol (2.0 micrograms/ml) compared with levels after acute administration (3.5 micrograms/ml). After propranolol was given, there was no consistent change in QT or JT intervals, and although there was a tendency to slight prolongation of QT interval, by 2.5% after chronic oral administration, this was not statistically significant. This suggests that the prolongation of ventricular repolarization by sotalol is not caused by beta-blockade, but by its class III activity, and that chronic treatment increases the effect. There was no significant effect on chronic ventricular pacing threshold after intravenous or oral administration of either drug. PMID- 3518384 TI - Effects of six-month afterload reduction therapy with hydralazine in chronic aortic regurgitation. AB - Seventeen patients with chronic asymptomatic aortic regurgitation (AR) were studied to determine whether 6 months of hydralazine therapy can reduce the severity of AR or reverse left ventricular (LV) enlargement and hypertrophy. Echocardiography, radionuclide angiography at rest and during exercise, and maximal treadmill exercise with respiratory gas analysis were performed at intake and after a 6-month double-blind treatment period. After dose titration with hydralazine, patients were randomized to their maximal tolerated hydralazine dose or to placebo. At intake, hydralazine and placebo groups were similar. Six patients taking hydralazine and 8 taking placebo completed the study protocol. One patient taking placebo died and 2 patients taking hydralazine withdrew with drug-related adverse effects. The mean titrated dose of hydralazine was 96 +/- 9 mg, but the mean treatment dose was 63 +/- 21 mg administered 3 times daily because of drug intolerance. After 6 months, mean systolic blood pressure with hydralazine therapy decreased from 136 to 125 mm Hg (p less than 0.02), and end systolic posterior wall thickness increased from 1.58 to 1.70 cm (p less than 0.05), resulting in a significant reduction in M-mode meridional end-systolic stress (from 104 to 80 kdynes/cm2) (p less than 0.05). M-mode fractional shortening increased from 0.28 to 0.31 (p less than 0.05) with hydralazine, but mean LV echocardiographic dimensions were unchanged. LV mass increased from 383 to 434 g (p less than 0.05) with hydralazine primarily because of an increase in end-diastolic wall thickness. In the placebo group, there was no change in any of the hemodynamic or echocardiographic parameters at 6 months.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3518385 TI - Need and design of a prospective study to assess the value of different strategic approaches for management of ventricular tachycardia or fibrillation. PMID- 3518386 TI - Education of the patient with cardiac disease in the twenty-first century: an overview. AB - The current status of education, behavioral change, and use of technology identifies a need for professionals who can develop interactive educational programs and apply existing techniques in a cost-effective manner. The general public, including patients with cardiac disease, are sophisticated consumers of information technology and demand quality production. The challenge is to train specialists to produce educational programs, to instruct health professionals in use of these programs, to deliver appropriate messages, to teach needed skills to patients with cardiac disease, and to evaluate the outcomes. Unless incentives to restore cardiac patients to an optimal functional status with few recurrences and complications are as tangible as are incentives for treating acute cardiac illnesses, the appropriate use of technology to educate patients with heart disease is unlikely to develop. However, the trend to increased ambulatory care under prospective payment systems makes it likely that technology will be applied to improve the efficiency in maintaining health and preventing acute illness. The potential benefits to the nation are substantial. PMID- 3518387 TI - Immunocytochemical methods. PMID- 3518388 TI - A glossary of immunocytochemical terms. PMID- 3518389 TI - Use of pre-embedding ultrastructural immunocytochemistry in the localization of a secretory product and membrane proteins in cultured prolactin cells. AB - A pre-embedding immunoperoxidase procedure performed directly on cultured cells in situ was used to localize several intracellular antigens at the electron microscope level. With this procedure, we compared the effect of various fixatives, with or without saponin permeabilization, on the immunoreactivity of a secretory product (prolactin) and membrane proteins in cultured prolactin cells. Prolactin was detected within all compartments of its intracellular secretory pathway. Membrane antigens of the rough endoplasmic reticulum, the Golgi apparatus, and lysosomes were localized in distinct intracellular compartments. These immunocytochemical results are discussed in relationship to others in the literature that describe the localization of similar types of antigens. The technique, here described, which preserves ultrastructural detail and antigenicity, should be applicable for the localization of other intracellular antigens in cultured cells. PMID- 3518390 TI - Combined light and electron microscope immunocytochemical localization of scattered peptidergic neurons in the central nervous system. AB - A pre-embedding immunocytochemical technique is described for combined light and electron microscope study of peptidergic neurons in the central nervous system. The protocol is especially designed to overcome the sampling problems inherent in electron microscope study of structures, such as luteinizing hormone-releasing hormone (LHRH) neurons, that are scattered individually across large brain regions. The fixation methods outlined for several mammalian species include immersion and vascular perfusion with acrolein. Fine-structural preservation and LHRH immunoreactivity obtained with this fixative are compared to results with more conventional fixatives. Vibratome sectioning and a "pretreatment" regime, which prepare the tissues for immunocytochemistry, are described. Immunocytochemical labeling is done with free-floating sections and the peroxidase-antiperoxidase unlabeled antibody enzyme technique. Techniques are also described for the subsequent processing of immunoreacted sections for electron microscopy. These methods ensure that the processed sections are readily scanned by light microscopy, so that regions containing immunoreactive structures can be specifically chosen for electron microscope analysis. Sample electron micrographs are shown that illustrate some fine structural features of LHRH neurons in rats, bats, ferrets, and monkeys, as revealed with the techniques described. PMID- 3518391 TI - Ultrastructural characteristics of peptidergic neurons using pre-embedding immunocytochemical methods. AB - The immunocytochemical staining technique represents a valuable method for electron microscopic analysis with which to elucidate the ultrastructural characteristics, synaptology, and potential interactions of selectively labeled neuronal systems. The unlabeled antibody peroxidase-antiperoxidase (PAP) technique is one of the most widely used immunocytochemical methods and has been applied to both pre-embedding and postembedding EM procedures. This review provides a detailed protocol for the former method and discusses advantages and disadvantages associated with the use of both approaches. A descriptive fine structural analysis of peptidergic neurons localized in the hypothalamus of brain illustrates the applicability and specificity of utilizing this method for the localization of cellular antigens of other systems. PMID- 3518392 TI - An excursion through the ultrastructural world of quick-frozen pancreatic islets. AB - In this article we have presented a philosophical and historical perspective on quick freezing, freeze-drying, freeze-substitution, and immunocytochemical localization of pancreatic islet hormones. A compilation of our findings indicates that quick-freezing does not produce any gross distortion of islet tissue; the amount of usable islet tissue for ultrastructural analysis is approximately 13 micron deep from the frozen edge; three different cell types can be identified in quick-frozen tissue based on general morphological characteristics; freeze-substitution with tetrahydrofuran produces a unique ultrastructural appearance in which ribosomes are particularly striking; with the use of protein A-gold, insulin and glucagon can be localized immunocytochemically on silver-gray (50-nm-thick) sections treated with 1% ovalbumin at room temperature overnight; secretory granules of quick-frozen alpha and beta cells may exist in either a swollen or condensed state; swollen beta cell secretory granules contain a filamentous material that demonstrates immunogold labeling for insulin; insulin and glucagon can be localized within the cisternae of endoplasmic reticulum; our methods provide not only discrete immunocytochemical localization of hormone, but also well-preserved cellular compartments; energy electron loss spectroscopy (EELS) has shown that quantifiable nitrogen maps can be used as an index of hormone packaging in secretory granules; and the sectioning properties of secretory granules at the ultramicrotome change when islet tissue is unosmicated and sectioned on glycerol. PMID- 3518393 TI - Pitfalls in immunocytochemistry with special reference to the specificity problems in the localization of neuropeptides. AB - In this review, the different types of specificity in immunocytochemistry (ICC) are discussed. Some examples of misinterpretations on the basis of ICC results are given. A strategy is proposed to assess the specificity of antisera and to test them again after purification. PMID- 3518394 TI - Leucine kinetics at graded leucine intakes in young men. AB - A study was carried out with 12 young men to examine the relationships between the intake of leucine and indices of leucine kinetics, using L-[1-13C]leucine as a tracer. Six subjects received L-amino acid diets during 7-day periods supplying leucine in the range of 79 to 20 mg.kg-1.day-1 (Group I) and another six subjects (Group II) received leucine intakes ranging from 20 to 4 mg.kg-1.day-1. Estimations were made of leucine kinetics, at the end of each diet period, when subjects were receiving small isonitrogenous, isocaloric meals during the isotope infusion period. Leucine flux declined with reduced leucine intake and leucine oxidation tended not to change at intakes below 20 mg.kg-1.day-1 (slope not statistically different than zero). Plasma valine increased markedly with further restriction in leucine intake below this level. The daily mass balance of leucine, estimated from the difference between intake and oxidation, became negative at an intake of about 20 mg.kg-1.day-1. These findings are discussed in relation to the published mean and upper range of requirement for leucine in healthy adults, currently taken to be 11 mg.kg-1.day-1 and 14 mg.kg-1.day-1, respectively. PMID- 3518395 TI - Folacin, cobalamin, and hematological status during pregnancy in rural Kenya: the influence of parity, gestation, and Plasmodium falciparum malaria. AB - To investigate folacin concentrations in malaria during pregnancy, women attending a rural antenatal clinic in Kenya were studied. Low serum folacin values had poor specificity for low red blood cell (RBC) folacin concentrations. Multigravidae had lower mean serum folacin (p less than 0.03) and RBC folacin (p less than 0.001) values than primigravidae. Primigravidae had higher mean RBC folacin values than nulliparae (p less than 0.05). Although anemia was frequent, no evidence of neutrophil hypersegmentation was seen in blood smears of individuals with low RBC folacin or indeterminate cobalamin values. The unexpectedly high RBC folacin concentrations are probably related to P falciparum infection: during followup a significant decrease in both RBC and serum folacin activity occurred after chloroquine was administered. This decrease may be unrelated to a gestational effect (RBC folacin p less than 0.01; serum folacin p less than 0.025). The pathogenesis of high RBC folacin activity is discussed in relation to reticulocytosis as well as to a biochemical mechanism within the RBC. PMID- 3518396 TI - Sensitivity and specificity of immunostaining in the diagnosis of mantle zone lymphoma. AB - The diagnosis of mantle zone lymphoma is sometimes difficult to make solely on the basis of morphology because the mantle zone pattern may be present in other disorders such as benign mantle zone hyperplasia, follicular center cell (FCC) lymphomas, and Castleman disease. To distinguish mantle zone lymphoma from the other disorders mentioned previously, the authors performed immunoperoxidase studies on B-5-fixed, paraffin-embedded sections or cryostat sections of lymph nodes from nine patients with a diagnosis of mantle zone lymphoma. The results then were compared with the immunostaining pattern seen in FCC lymphomas and various benign lymphoid hyperplasias. A monoclonal proliferation of mantle zone cells, as shown by staining for immunoglobulin light chains, was noted in the mantle zones and interfollicular areas in all six cases from which cryostat sections were available. The cells in the residual follicular centers uniformly had a polyclonal light chain marking pattern. Two novel monoclonal antibodies (LN 1 and LN-2) that identify FCCs and B-cells in B-5-fixed, paraffin-embedded tissues also were used in this study. Of the six cases in which the monoclonal antibodies could be used, the cells in the residual follicles were uniformly LN-1 positive, LN-2 positive, while the mantle zone and interfollicular cells were almost completely LN-1 negative, LN-2 positive. The data suggest that mantle zone lymphomas are a distinctive neoplasm of monoclonal B-cells of non-FCC origin. The authors conclude that immunostaining is a sensitive technic for identifying a malignant neoplasm of B-cells in the mantle zone and interfollicular areas. In addition, the method is relatively specific and useful for distinguishing mantle zone lymphoma from similar-appearing disorders such as benign mantle zone hyperplasias and certain FCC lymphomas. PMID- 3518397 TI - Monoclonal antibody study of Philadelphia chromosome-positive blastic leukemias using the alkaline phosphatase anti-alkaline phosphatase (APAAP) technic. AB - The leukemic cells from 15 cases of Philadelphia chromosome-positive blastic leukemia were immunophenotyped by the alkaline phosphatase anti-alkaline phosphatase (APAAP) immunocytochemical technic using nine monoclonal antibodies (MoAb) reactive with various myeloid or lymphoid antigens. On the basis of morphology, cytochemistry, terminal deoxynucleotidyl transferase (TdT) reactivity, and electron microscopy, five of the cases had been classified as lymphoid; eight, myeloid; one, mixed myeloid-lymphoid; and one, undifferentiated. The blasts from all five lymphoid cases were reactive with lymphocyte differentiation antigen MoAb, and four of five reacted with MoAb to anti-common acute lymphoblastic leukemia-associated antigen (CALLA) (BA3). The blasts from all eight myeloid cases were reactive with MY7, a marker of myelomonocytic differentiation. Some of the blasts from three of the eight myeloid cases reacted with HP1-1D and AP3, markers of megakaryocytic differentiation; megakaryocyte differentiation was confirmed by electron microscopy. In the case classified as mixed myeloid-lymphoid, the blasts showed morphologic and immunophenotypic heterogeneity; ultrastructural studies demonstrated lymphoid, basophil, and erythroid differentiation. The blasts from the case classified as undifferentiated were immunophenotypically heterogeneous. In all cases in which the leukemic cells were also immunophenotyped by flow cytometry, the results correlated well with those obtained by the APAAP technic. The APAAP technic is a reliable method for immunophenotyping leukemias. Advantages of this method include its applicability to routinely prepared blood and bone marrow smears and cytocentrifuge preparations, lack of endogenous peroxidase background staining, and a permanent record. PMID- 3518398 TI - Characterization and comparison of immune-depleted and hereditary factor-VII deficient plasmas as substrate plasmas for factor VII assays. AB - The functional activity of coagulation factors usually is determined using bioassays dependent on substrate plasmas deficient in the factor being measured. These are obtained most often from patients with hereditary deficiency and are frequently poorly characterized. The authors characterized seven commercially available hereditary Factor-VII-deficient substrate plasmas in terms of Factor VII activity and antigen level, and then compared them with a Factor-VII deficient plasma prepared by immunoadsorption. All of the hereditary Factor-VII deficient plasmas contained significant quantities of Factor VII antigen (120-217 ng/mL; normal, 250-600 ng/mL). One of the commercial substrate plasmas showed significant factor VII coagulant activity with a human thromboplastin. The sensitivity of the Factor VII assay system was dependent on both the source of Factor-VII-deficient plasma and the origin of the thromboplastins; human thromboplastin was more sensitive than rabbit thromboplastin, and immune-depleted plasma gave the most sensitive assay with each thromboplastin. These results indicate that immunoadsorbed plasma may be a superior reagent for coagulation factor assays. PMID- 3518399 TI - Immunohistochemical localization of CA 125 antigen in formalin-fixed paraffin sections of ovarian tumors with the use of Pronase. AB - The OC 125 monoclonal antibody was used to localize CA 125 antigen in routine paraffin sections of ovarian tumors with the use of a modified avidin-biotin peroxidase complex (ABC) technic. Pretreatment of the paraffin sections with Pronase allowed subsequent detection of CA 125 antigen. OC 125 stained 4 (80%) of 5 benign and borderline serous ovarian tumors, 12 (86%) of 14 serous adenocarcinomas, and 3 (23%) of 13 benign and malignant mucinous ovarian tumors. The pattern of distribution of CA 125 antigen was mostly at the intraluminal and peripheral cell surfaces, while intracytoplasmic staining also was seen. Overall, CA 125 antigen detectability rate in paraffin sections was found to be compatible with those reported in frozen sections. The method allows retrospective immunohistochemical examination of a large number of cases with ovarian tumors. PMID- 3518400 TI - Clinical trial of a new disposable bleeding-time device. AB - A new disposable bleeding time device (Hemalet) was tested in 20 normal individuals and 11 patients with various bleeding disorders. The results were compared with those of Simplate II. The mean bleeding time for normal individuals was 5.4 +/- 1.5 (mean +/- 1 SD) minutes by Hemalet and 5.8 +/- 1.4 (mean +/- 1 SD) minutes by Simplate II, with good correlation between the results by the two devices (r = 0.81). The bleeding time in patients with various bleeding disorders were also comparably prolonged between the two devices. The new disposable bleeding time device with a disposable blade has quick release (penetration) into skin and retraction, and offers an alternative means of a bleeding time test. PMID- 3518401 TI - Comparison of visual and photometric Bac-T-Screen results. AB - The Bac-T-Screen (Marion Laboratories, Kansas City, MO) was used to screen 826 urine specimens. Of these, 85 either pigmented or clogged the Bac-T-Screen filter and could not be evaluated. Results for the remaining 741 specimens were examined both visually and photometrically by a newly developed photometric card reader. The results were then compared. Screening results for all urines containing greater than or equal to 10(5) pathogens/mL were equivalent for both methods, with sensitivity and predictive negative values of greater than 98% and greater than 99%, respectively. The predictive values of positive tests were also equivalent at 57.5% for visual and 59.6% by photometry. The overall agreement varied with the card reader value used because the photometric card-reader procedure allows the user to select desired sensitivity and specificity levels. PMID- 3518402 TI - Cardiac amyloid deposits in endomyocardial biopsies. Light microscopic, ultrastructural, and immunohistochemical studies. AB - In four patients with unexplained, abnormal thickening of the interventricular septum as demonstrated by echocardiography, right ventricular endomyocardial biopsy revealed unexpected cardiac amyloid deposits that resulted in increased myocardial thickness and rapidly progressive heart failure. Light microscopically, amyloid was observed in the subendocardial layer, interstitium, and walls of the intramural arterioles. Electron-microscopically, the amyloid fibrils were adjacent to the basement membranes of the heart muscle cells and the vascular smooth muscle cells. Immunohistochemical typing with specific antibodies against different amyloid fibril proteins on glutaraldehyde-fixed paraffin sections revealed different amyloid types. In two patients with generalized idiopathic amyloidosis and in two others with amyloidosis in multiple myeloma, the A-lambda form was diagnosed. In a fifth patient, AA-amyloidosis was found in familial Mediterranean fever with cardiac manifestation without thickening of the interventricular septum. The amyloid deposits were located almost exclusively within the walls of the myocardial arterioles. The amount of amyloid as observed in the myocardial biopsies correlates with the rapidly progressive cardiac failure. It is suggested that in patients with abnormal thickening of the interventricular septum of unknown origin the diagnosis should be clarified by endomyocardial biopsy. PMID- 3518403 TI - Islet-cell hyperplasia in genetic deficiency of alpha-1-proteinase inhibitor. AB - By light microscopy and immunoperoxidase methods, morphology and distribution of alpha-1-proteinase inhibitor (Api) cells in the pancreatic islets were studied in seven patients with and in 17 patients without periodic acid-Schiff-positive, diastase-resistant globules in the liver. Five of the seven patients with liver globules had cirrhosis and emphysema, suggesting genetic deficiency of Api, which was confirmed in four by pi phenotyping (blood from one patient was not available). The two remaining patients had only a mild degree of liver fibrosis and mild emphysema and showed a normal MM phenotype. Islet cell hyperplasia and an increased population of Api cells were observed in all five patients with genetic deficiency, compared with the 17 patients without Api deficiency. These morphologic changes were more pronounced in the one homozygous patient than in the heterozygous patients. Nesidioblastosis, ductular proliferation, and atypia of insular cells were seen only in patients with an abnormal phenotype. The increased amount of Api in the islets in the genetic deficiency state may be due to hyperplasia and hypertrophy of Api cells or due to storage of abnormal Api in the preexisting Api cells. The exact stimulus for islet cell hyperplasia and proliferation of Api cells is still unknown. PMID- 3518404 TI - Herpes simplex hepatitis in apparently immunocompetent adults. AB - A study of eight cases of herpes simplex hepatitis in apparently immunocompetent adults is presented. The clinical features were nonspecific and were usually those of a severe systemic infection, mimicking septic shock. However, the histologic features were distinctive, with randomly distributed patchy areas of coagulative necrosis surrounded by hepatocytes containing viral inclusions. Viral particles could be identified by electron microscopy and Herpes simplex antigens by immunohistochemistry, but these were not necessary for diagnosis. The light microscopic morphologic features are so distinctive that if these are recognized in a biopsy, the diagnosis of herpetic hepatitis can be made and anti-viral therapy may be instituted. PMID- 3518405 TI - Comparison of Minitek Anaerobe II, API An-Ident, and RapID ANA systems for identification of Clostridium difficile. AB - Three commercial anaerobic systems, Minitek (BBL Microbiology Systems, Cockeysville, MD), API An-Ident (Analytab Products, Plainview, NY), and RapID ANA (Innovative Diagnostic Systems, Decatur, GA) were evaluated for ability to identify 45 Clostridium difficile isolates accurately. Minitek correctly identified 66% of C. difficile isolates to species, 27% were incompletely identified, and 7% were misidentified. Most of the discrepancies with Minitek were due to false negative biochemical results. API An-Ident correctly identified 9% C. difficile isolates to species, 89% were incompletely identified, and 2% were misidentified. Most of the API An-Ident discrepancies were due to the data base, which distinguished poorly between C. difficile, Clostridium hastiforme, and Clostridium sporogenes. RapID ANA correctly identified 100% of C. difficile isolates. PMID- 3518406 TI - A case of TdT-positive B-cell acute lymphoblastic leukemia. AB - The phenotypic marker profile of a patient with B-cell acute lymphoblastic leukemia (B-ALL) is described. The blast cells showed typical FAB L3 morphology, had the characteristic t(8;14) chromosomal abnormality, and were monoclonal in the expression of surface immunoglobulins. The clinical course of this patient is consistent with the poor prognosis described for B-ALL cases. Surface marker analysis identified cells positive for surface immunoglobulins, Ia-like antigen, common ALL-antigen, and terminal deoxynucleotidyl transferase. This marker profile shows immunologic characteristics of the two B-cell leukemia subtypes, pre-B-ALL and B-ALL. This "intermediate" immunologic phenotype might either be the result of an uncoupling of the sequential immunologic maturation processes or of an arrest of the cells at an intermediate stage between the two otherwise clearly defined leukemia subtypes, but closer to the typical B-ALL stage. This latter observation is supported by isoenzyme marker analysis, as the cells were negative for the hexosaminidase I isoenzyme, which is positive in pre-B-ALL but negative in B-ALL. PMID- 3518407 TI - Chronic oral treatment with cisapride decreases high bile salt reflux rates. AB - The effect of cisapride, a new gastrokinetic drug, on gastric emptying and duodenogastric reflux of bile salts was tested in healthy volunteers in a placebo controlled double-blind randomized cross-over trial. Twenty subjects were treated with either 10 mg of cisapride, tid orally or with matching placebo tablets for 1 wk. On test days, the subjects were studied using a marker technique with gastric intubation in the fasting state and after feeding a mixed liquid meal. Cisapride did not affect gastric secretion and gastric emptying. There was a tendency to lower reflux rates after cisapride treatment both fasting (0.63 +/- 0.14 versus 0.38 mumol/min +/- 0.05 SEM) and after feeding (2.60 +/- 0.61 versus 1.88 mumol/min +/- 0.33 SEM). This was due to a decrease of high placebo reflux rates: the reduction of reflux rate achieved by cisapride was significantly correlated to the height of the placebo reflux rate (p less than 0.001). A similar relationship was found for gastric bile salt concentration (p less than 0.001). It is concluded that cisapride reduces high bile salt reflux. Therapeutic trials with this drug in diseases where high bile reflux is believed to play a pathogenic role are of interest. PMID- 3518408 TI - 5-Aminosalicylic acid enemas in refractory distal ulcerative colitis: a randomized, controlled trial. AB - 5-Aminosalicylic acid (5-ASA), the presumed active moiety of sulfasalazine, has shown clinical efficacy when administered per rectum as initial therapy to patients with distal ulcerative colitis. We report the results of a randomized double-blind trial comparing nightly retention of a 4-g 5-ASA enema with continued administration of hydrocortisone enemas in 18 patients with persistent active distal ulcerative colitis after at least a 3-wk course of treatment with 100-mg hydrocortisone enemas with or without oral sulfasalazine. Continuation of hydrocortisone enemas rather than placebo was used in the control group to reflect the realistic alternative therapy likely to be employed in current practice. Response to therapy was assessed after 3 wk by comparing pretreatment and posttreatment point scores of clinical, sigmoidoscopic, and histological severity. Improvement in clinical score was achieved in seven of nine 5-ASA enema treated patients versus one of nine hydrocortisone enema-treated patients (p less than 0.05). Sigmoidoscopic and histological improvement generally paralleled clinical improvement. We conclude that in patients with distal ulcerative colitis unresponsive to standard therapy, treatment with 5-ASA enemas results in significant short-term clinical and sigmoidoscopic improvement in a majority of cases. Moreover, a significantly greater number of refractory patients improve when switched to 5-ASA enemas than when continued on standard therapy. PMID- 3518409 TI - Clinical and portal hemodynamic features in cirrhotic patients having a large spontaneous splenorenal and/or gastrorenal shunt. AB - Clinical and portal hemodynamic features in 28 cirrhotic subjects with a large spontaneous spleno- and/or gastrorenal shunt were studied in comparison with 30 control cirrhotic cases without such collaterals. Forty-six percent of the former had chronic hepatic encephalopathy, but none of the latter was encephalopathic. These patients with large renal shunts were divided into those with and those without encephalopathy. Large esophageal varices were significantly less common in patients with a large shunt and encephalopathy compared with those who had a large shunt but no encephalopathy, and the control. But there was no significant difference of past variceal bleeding among these three groups. In all those with encephalopathy, part of superior mesenteric venous blood was shunting through these collaterals into the left renal vein or inferior vena cava, but the same was not demonstrable in patients with a large shunt and no encephalopathy and control cirrhotics. In the chronic encephalopathic, portal venous flow was estimated to be less than one-half of that in control cirrhotics, and the portion of superior mesenteric venous blood that was flowing hepatofugally through a large shunt into the left renal vein seemed about the same or greater than the portal venous flow. Thus, a large spontaneous spleno- and/or gastrorenal shunt might prevent development of large esophageal varices but not variceal hemorrhage and it increased a risk of chronic hepatic encephalopathy. PMID- 3518410 TI - Enteric intussusception presenting as a rapidly enlarging mass. AB - Enteric intussusception is unusual in adults and frequently presents in a confusing manner. A case of jejunojejunal intussusception is presented in which a 15-cm abdominal mass developed in 24 h. The plain film, barium, and ultrasound findings in enteric intussusception are stressed. PMID- 3518411 TI - Summary of the 30th meeting of the Food and Drug Administration Gastrointestinal Drugs Advisory Committee January 16-17, 1986. PMID- 3518412 TI - The impact of new imaging techniques on the study of portal hypertension. PMID- 3518414 TI - On the logic of causal inference. PMID- 3518413 TI - Type A behavior pattern and coronary disease risk. Update and critical evaluation. PMID- 3518415 TI - Successful renal transplantation for Epstein syndrome. AB - Successful cadaveric renal transplantation was accomplished in a patient with Epstein syndrome, a triad of macrothrombocytopenia, partial high-frequency hearing loss, and nephritis, which often progresses to complete renal failure. The success of the transplant demonstrates that the macrothrombocytopenia which occurs in this syndrome is not a contraindication to aggressive management of end stage renal disease. PMID- 3518416 TI - The distribution of lysozyme, alpha-1-antitrypsin, and alpha-1-antichymotrypsin in normal hematopoietic cells and in myeloid leukemias: an immunoperoxidase study on cytocentrifuge preparations, smears, and paraffin sections. AB - Blood and bone marrow samples from 20 individuals with reactive conditions and 26 cases of acute and chronic myeloid leukemias were tested for the presence of lysozyme, alpha-1-antitrypsin (alpha-1-AT), and alpha-1-antichymotrypsin (alpha-1 ACT). We compared the reactivity of samples in smears, cytocentrifuge preparations, and paraffin sections. Lysozyme, alpha-1-antitrypsin, and alpha-1 antichymotrypsin were found only in polymorphonuclear leukocytes and monocytes and their precursors. Lymphocytes, E-rosetting cells, Con A-activated lymphocytes, natural killer (NK) cells, red blood cells, erythroblasts, and megakaryocytes were consistently negative. Leukemic myeloblasts showed definite reactivity for both alpha-1-antitrypsin and alpha-1-ACT, but not for lysozyme. By contrast, lysozyme was present in poorly differentiated leukemic monoblasts, while alpha-1-antitrypsin and alpha-1-antichymotrypsin showed only weak reactivity. More mature myeloid and moncytic cells showed positive staining for all three antigens tested with differences in staining distribution and intensity. In four cases of chronic myeloid leukemia (CML), circulating mature polymorphonuclear leukocytes were deficient in both lysozymne and alpha-1 antitrypsin. The use of lysozyme, alpha-1-antitrypsin, and alpha-1 antichymotrypsin identifies normal and leukemic cells of the myeloid-monocytic series at all stages of maturation and is applicable to a variety of sample preparations. PMID- 3518417 TI - Terminal deoxynucleotidyl transferase activity in acute leukemia: a study of 100 cases comparing an immunoperoxidase (PAP) vs immunofluorescent method. AB - A comparison between the immunofluorescent (IF) method for terminal deoxynucleotidyl transferase (TdT) activity and the immunoperoxidase (IP) method by peroxidase-anti-peroxidase (PAP) technique was done for 100 cases of acute leukemia. For the acute lymphoblastic leukemias (ALL) there was agreement in 93% of the cases. However, the IP method detected 51/55 (93%) TdT+ cases versus 47/55 (85%) by the IF method. For the acute nonlymphocytic leukemias (ANLL), there was an agreement in 89% of the cases. The IP method detected 8/36 (22%) TdT-positive cases while IF detected 4/36 (11%) positive cases. If a figure of 10% TdT+ cells is considered significant in the marrow of the ANLLs, then the IP method would detect eight additional cases for a total of 16/36 (44%) TdT+ cases. This latter figure questions the ability of the IP TdT assay as a single test adequately to determine the lineage of a cell line. It may be rather that TdT is a marker that is expressed in a stem cell. PMID- 3518418 TI - Philadelphia-positive metaphases in the marrow after bone marrow transplantation for chronic granulocytic leukemia. AB - A 28-year-old man with Ph-positive chronic granulocytic leukemia (CGL) was treated by high-dose chemoradiotherapy and transplantation of marrow cells harvested from his HLA-identical brother. One year after bone marrow transplantation (BMT) examination of his marrow showed a minority population of Ph-positive cells; their proportion subsequently fell such that 2 years after transplant analysis of marrow cells showed only cytogenetically normal cells. The patient remains clinically normal with a persisting mild lymphocytosis but without hematological evidence of leukemia. We cannot in this patient distinguish between persisting leukemia that later could no longer be recognized and relapse of leukemia that is now suppressed, perhaps only temporarily. This case emphasizes the need for caution in interpreting chromosomal finding after BMT for CGL. PMID- 3518419 TI - Hemopoietic marrow function in chronic neutropenia of blacks: cure of aplastic anemia by allogeneic marrow transplantation from a neutropenic sibling donor. AB - A black patient with severe aplastic anemia is described who underwent successful bone marrow transplantation from a sibling with chronic neutropenia. During an evaluation to identify a suitable donor, it was found that the majority of family members tested had neutropenia, with no familial history of significant infections or related hospitalizations. In vitro hemopoietic culture studies of marrow from the patient's HLA-MLC-matched siblings showed normal numbers of pluripotential and committed hemopoietic progenitors; in vitro hemopoietic colony formation from the patient was markedly subnormal, consistent with the clinical picture of severe aplastic anemia. Following appropriate conditioning therapy, marrow transplanted from one of these neutropenic sibs produced full hematopoietic reconstitution. Posttransplant marrow culture studies of the patient showed restoration of a normal pattern of in vitro hemopoiesis. The in vitro culture studies and clinical experience in this patient support the concept that chronic neutropenia of blacks is not primarily a marrow progenitor cell disorder but, more likely, a manifestation of a genetically determined alteration in granulocyte kinetics. PMID- 3518420 TI - Trench nephritis: a retrospective perception. AB - An epidemic of nephritis occurred among soldiers in World War I, predominantly those in the trenches. Characterized by the sudden onset of albuminuria, hypertension, edema, and dyspnea, atypical features such as bronchitis, an evanescent course, low early mortality, and frequent relapses distinguished it from poststreptococcal glomerulonephritis. Pathologic features included glomerular ischemia, capillary thrombi, endocapillary proliferation, and frequently epithelial crescents, suggesting an underlying vasculitis. The cause was not established, but a postinfectious, possibly postviral, etiology seems most plausible. Trench nephritis was the major nephrologic problem of World War I, accounting for 5% of medical admissions and more than 10% of military hospital bed occupancy at that time. PMID- 3518421 TI - Exercise in end-stage renal disease. AB - Available studies indicate that exercise tolerance in renal patients is low. Although significant improvements in maximal oxygen consumption have been reported following exercise training in these patients, there may be physiologic limitations to the attainable levels of aerobic capacity due to the multisystemic nature of the disease. Long-term exercise training may result in other medical benefits. Compliance to regular exercise in hemodialysis patients remains a problem, however, exercise training during the dialysis treatment may prove beneficial in terms of compliance and supervision. PMID- 3518422 TI - The role of glucose in hemodialysis: the effects of glucose-free dialysate. AB - Glucose-free dialysate has been traditionally used in patients on chronic hemodialysis, reportedly without any side effects. Although hypoglycemia is not produced, several other metabolic changes must occur to maintain the euglycemic state. We studied ten patients on chronic hemodialysis using both a glucose-free bath and a glucose bath. Without glucose, a drop in osmolality of 20 mosm/kg H2O occurred, whereas a change of only 10 mosm/kg H2O was observed using a glucose bath. Abnormal EEG changes were observed after dialysis without glucose that were not present or were minimal with a glucose bath. PMID- 3518423 TI - Subclavian hemodialysis catheter infections. AB - One hundred sixteen subclavian hemodialysis catheter placements in 88 patients were prospectively evaluated for catheter-related infections. Semiquantitative culture techniques and a rigid infection control protocol were used. The overall catheter colonization rate was 21.6% and catheter-associated bacteremia occurred in 9.4%. Catheters removed from febrile patients had much higher colonization (48.3%) and bacteremia (34.5%) rates. In a randomized study comparing infection rates in catheters tunneled subcutaneously or not tunneled, there was no significant difference in the incidence of infection. Catheters inserted over a guidewire to replace clotted or malfunctioning catheters were not associated with higher infection rates. PMID- 3518424 TI - Penetration of trimethoprim and sulfamethoxazole into cysts in a patient with autosomal-dominant polycystic kidney disease. AB - This study examines the causes for the therapeutic failure of trimethoprim sulfamethoxazole in a patient with infected cysts caused by a sensitive strain of Escherichia coli. We determined the concentration of trimethoprim and sulfamethoxazole in eight cysts (four proximal, four distal) following therapeutic nephrectomy in a patient treated eight days with trimethoprim sulfamethoxazole in appropriate doses. In four proximal cysts, mean trimethoprim level was 16.1 +/- 0.8 micrograms/mL with mean sulfamethoxazole level of 94.7 +/- 13.0 micrograms/mL. In distal cysts, mean trimethoprim level was 227.8 +/- 16.8 micrograms/mL with mean sulfamethoxazole level of 9.7 +/- 3.6 micrograms/mL. Serum peak and trough trimethoprim concentrations were 9.8 micrograms/mL and 5.4 micrograms/mL with peak and trough sulfamethoxazole concentrations of 136.0 micrograms/mL and 65.0 micrograms/mL. Significant WBC counts were present in seven cysts, three proximal and four distal. All three proximal cysts were sterile; in contrast, the four distal cysts grew the same strain of E coli isolated from the blood and urine of this patient. The infection resolved following nephrectomy. We conclude that the failure of trimethoprim sulfamethoxazole to eradicate the infection was caused by the inability of sulfamethoxazole to enter distal cysts in sufficient concentration for the synergistic effect commonly seen with trimethoprim and sulfamethoxazole in combination. Treatment of cyst infections with trimethoprim-sulfamethoxazole should probably be avoided in instances when the organism is resistant to trimethoprim alone. PMID- 3518426 TI - Acute effects of routine firefighting on lung function. AB - We undertook a study to determine the acute effects of routine firefighting on lung function and the relationship between these acute effects and nonspecific airway responsiveness. For 29 firefighters from a single fire station, we calculated the concentration of methacholine aerosol that caused a 100% increase in specific airway resistance (Pc100). Over an 8-week period we than measured FEV1 and FVC in each firefighter before and after each 24-hr workshift and after every fire. From 199 individual workshifts without fires, we calculated the mean +/- 2 SD across-workshift change in FEV1 and FVC for each firefighter. Eighteen of 76 measurements obtained within 2 hr after a fire (24%) showed a greater than 2 SD fall in FEV1 and/or FVC compared to two of 199 obtained after routine workshifts without fires (1%; p less than .001). On 13 of 18 occasions when spirometry decreased significantly, we obtained repeat spirometry (postshift) 3 18.5 hr after fires, and on four of these occasions FEV1 and/or FVC were still more than 2 SD below baseline. Decrements in spirometry occurred as often in firefighters with high Pc100s as in those with low Pc100s. In two firefighters in whom FEV1 and FVC fell by more than 10% after fires, we repeated measurements of methacholine sensitivity, and it was increased over the prestudy baseline. These findings suggest that routine firefighting is associated with a high incidence of acute decrements in lung function.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3518425 TI - Computer prediction of peptide maps: assignment of polypeptides to human and mouse mitochondrial DNA genes by analysis of two-dimensional-proteolytic digest gels. AB - We have prepared a computer program that predicts complete and partial peptide maps from amino acid sequences. The program fragments amino acid sequences at designated cleavage sites and calculates the molecular weight and relative labeling of each peptide. These data are graphed as log molecular weight of the original protein (X-axis) vs. log molecular weight of the component peptides (Y axis). The program is interactive, permitting adjustment of a number of graphic parameters and alteration of the position of proteins in the first dimension to accommodate aberrations in protein mobility. The program has been used to predict the V8 protease peptide maps of the 13 open reading frames (ORFs) identified in the human and the mouse mitochondrial DNA (mtDNA) sequences. The results were compared to the V8 protease peptide maps obtained for mouse and human mitochondrially synthesized proteins by two-dimensional proteolytic digest gels. A high correlation was observed between the predicted and observed peptide maps. These results suggest the assignment of several proteins to mtDNA genes. PMID- 3518428 TI - Gramm-Rudman-Hollings. PMID- 3518427 TI - Respiratory disease in a photographer. AB - Reversible airways obstruction occurred in a photographer after long-term exposure (over many years) to sulfuric and acetic acid fixers. Air-exchange recommendations for darkrooms by the Building Officials Code Administration [1981] differ markedly from those recommended by the American Society of Heating, Refrigerating, and Airconditioning Engineers [1977] and the fixer manufacturer (Eastman Kodak). Use of fume hoods or rates of air-exchange higher than are required by law may be necessary to prevent symptoms and disease in certain workers. PMID- 3518429 TI - Bacterial endotoxin retention by inline intravenous filters. AB - Filters used in i.v. administration sets were tested for their ability to retain bacterial endotoxins for up to 96 hours of continuous infusion. Inline filters composed of cellulose ester, polyacrylate, polypropylene, polyethylene, or Posidyne Nylon 66 were used during continuous infusion of 5% dextrose injection at 83 mL/hr. One milliliter of inoculum containing 10(8) Escherichia coli was injected through a port upstream from the filter. A bacterial filter was used to monitor the sterility of effluent from the inline filters. The effluent was tested with limulus amebocyte lysate (LAL) that could detect endotoxin concentrations greater than 50 pg/mL. A control solution was monitored for viability of the bacteria throughout the course of the study, and positive endotoxin controls were used to confirm the sensitivity of the LAL. Samples of effluent were tested at 0, 4, 19, 24, 48, 72, and 96 hours. Effluent from all filters was sterile throughout the study. LAL assay indicated that only the effluent from filters containing Posidyne Nylon 66 was free of endotoxins for 96 hours. Effluent from the other filters contained endotoxins immediately after injection of the E. coli. Of the inline filters tested, only the one composed of Posidyne Nylon 66 was able to retain E. coli endotoxin for 96 hours. Further study is needed with E. coli and other microorganisms that are likely contaminants of i.v. infusions. PMID- 3518430 TI - The PACT study: post-marketing surveillance in 47,465 patients treated with Maxzide (triamterene/hydrochlorothiazide). An interim report. PMID- 3518431 TI - International experience with diclofenac in rheumatoid arthritis. AB - Rheumatoid arthritis, although not the most common of the rheumatic diseases, is potentially the most disabling. For this reason, it is considered the principal disorder for determining the therapeutic effectiveness of any new antirheumatic agent. Diclofenac sodium, a nonsteroidal anti-inflammatory drug, has been studied extensively in international clinical trials since the early 1970s. It has proved to be at least equal in efficacy to other nonsteroidal anti-inflammatory drugs. In addition, its superior safety profile suggests that diclofenac will be a valuable agent in the treatment of rheumatoid arthritis, for which long-term drug therapy is usually required. PMID- 3518432 TI - Efficacy and safety of diclofenac sodium in rheumatoid arthritis. Experience in the United States. AB - Diclofenac sodium is a nonsteroidal, anti-inflammatory drug that has been studied in the United States for the treatment of rheumatoid arthritis in 681 patients, 468 of whom were enrolled in five multicenter, double-blind parallel controlled investigations. Results of these trials indicate that 150 mg daily of diclofenac is more effective than placebo and as effective as 2.4 g daily of ibuprofen or 3.6 g daily of aspirin. Moreover, the safety profile of diclofenac proved to be better than that of aspirin and similar to that of ibuprofen. PMID- 3518433 TI - International experiences with diclofenac in osteoarthritis. AB - Despite a wide range of study designs, a multiplicity of international trials of diclofenac in osteoarthritis have disclosed similar results. These include double blind comparisons with indomethacin, aspirin, naproxen, ibuprofen, sulindac, and diflunisal, as well as open trials from European field studies. The results of this review document that diclofenac is as effective as other nonsteroidal anti inflammatory drugs in the treatment of osteoarthritis. PMID- 3518434 TI - Efficacy of diclofenac in osteoarthritis. Experience in the United States. AB - The role of diclofenac sodium in patients with symptomatic osteoarthritis of the hip or knee has been evaluated in five prospective, randomized, double-blind, controlled trials with placebo, aspirin, and naproxen conducted in the United States. The objectives were to evaluate efficacy, tolerability, and safety. In these trials, diclofenac, 100 or 150 mg daily, was more effective than aspirin, 2.4 or 3.6 g daily, and as effective as naproxen, 500 mg daily. In individual trials, there were no statistically significant differences in the incidence of adverse effects between treatment groups. For all trials combined, the dropout rate due to adverse effects was similar for each treatment group. The dropout rate because of an unsatisfactory response was lowest for patients treated with diclofenac. PMID- 3518435 TI - Efficacy of diclofenac in ankylosing spondylitis. AB - Ankylosing spondylitis is a systemic rheumatic disorder characterized by inflammation of the spine, sacroiliac, and large peripheral joints. Effective management demands both immediate and long-term objectives. The physician must first relieve joint inflammation and discomfort with nonsteroidal anti inflammatory drugs, then begin long-range planning with daily exercise and other supportive measures to prevent, delay, or correct deformity. Diclofenac sodium, a nonsteroidal anti-inflammatory drug that is used worldwide in ankylosing spondylitis, has not yet been marketed in the United States. This article highlights two American studies with diclofenac: (1) a short-term, double-blind comparison with indomethacin, and (2) a 38-week extension with diclofenac for long-term efficacy and safety data. The results of these trials demonstrate diclofenac to be effective and safe for both short- and long-term treatment. When compared with indomethacin, a standard reference drug in trials of ankylosing spondylitis, diclofenac was comparable in efficacy but had a more favorable side effect profile. PMID- 3518436 TI - Worldwide safety experience with diclofenac. AB - Worldwide use of diclofenac sodium since 1974 has yielded an extensive body of data on the safety of this drug. Documentation is derived from clinical trials, post-marketing surveillance, special studies, and spontaneous reports of adverse drug reactions from foreign countries. Comprehensive safety data from foreign studies show that diclofenac is safer and better tolerated than aspirin and is comparable in safety to ibuprofen and naproxen. Safety data from clinical trials in the United States, in which most patients received 150 mg daily of diclofenac, show that patients receiving diclofenac had lower rates of adverse reactions than patients receiving any of the comparative nonsteroidal anti-inflammatory drugs, except for naproxen at 500 mg daily. Special safety studies performed outside the United States address organ systems and patient groups of particular concern with nonsteroidal anti-inflammatory drugs, i.e., effects of diclofenac on gastrointestinal, renal, hepatic, and hemostatic systems; use in children and the elderly; and interactions with concomitant medications. PMID- 3518437 TI - Blood pressure, insulin, and glycemia in nondiabetic subjects. AB - The relation of blood pressure to fasting (basal) insulin and glycosylated hemoglobin (hemoglobin A1) was examined in 248 nondiabetic subjects (137 women and 111 men). None of the subjects was taking antihypertensive medication. There were statistically significant associations of systolic and diastolic blood pressure with insulin levels (r = 0.24, p less than 0.01; r = 0.30, p less than 0.01) and hemoglobin A1 levels (r = 0.28, p less than 0.001; r = 0.22, p less than 0.05) in women. These blood pressure indexes were also related to insulin levels in men (r = 0.23, p less than 0.05; r = 0.02, p less than 0.05). In a multiple regression analysis, the association between blood pressure and insulin level was diminished with an allowance for adiposity; however, it remained statistically significant. These data indicate that blood pressure is related to insulin levels in nondiabetic subjects and suggest that insulin may be a physiologic determinant of blood pressure. PMID- 3518438 TI - Impotence. PMID- 3518439 TI - Harvey, Pasteur, and the truth. PMID- 3518441 TI - Temporal arteritis without an elevated erythrocyte sedimentation rate. Case report and review of the literature. AB - An elevated erythrocyte sedimentation rate is regarded as a hallmark of temporal arteritis. Thirty-five cases of biopsy-proved temporal arteritis without an elevated erythrocyte sedimentation rate are identified, and a 36th case is described. All patients had age-adjusted normal Westergren sedimentation rates, 16 with sedimentation rates of 20 mm per hour or less and 20 with sedimentation rates of 21 to 40 mm per hour. Twenty-two patients had sufficient clinical information for analysis and comparison with reported series of patients with biopsy-proved temporal arteritis with an elevated Westergren sedimentation rate. Headache (41 percent), temporal artery abnormalities (41 percent), and visual symptoms (36 percent) were the most common manifestations in patients without an elevated sedimentation rate. Headache (41 percent versus 75 percent, p less than 0.05) and jaw claudication (9 percent versus 43 percent, p less than 0.025) were found less often in the patients without an elevated sedimentation rate. History and physical examination are essential in the diagnosis of temporal arteritis with a normal Westergren sedimentation rate. PMID- 3518440 TI - Is atherosclerosis a complication of long-term corticosteroid treatment? AB - In clinical practice, arteriosclerotic heart disease has not been recognized as a complication of long-term corticosteroid treatment. Yet, an increasing body of evidence suggests that prolonged corticosteroid therapy accelerates the development of atherosclerosis. An important element in this process may be the fact that corticosteroids induce or exacerbate several known coronary risk factors, including hypertension, hypercholesterolemia, hypertriglyceridemia, and impairment of glucose tolerance. One group of patients that is often exposed to long-term corticosteroid treatment is that with rheumatoid arthritis. These patients have an increased mortality, with cardiovascular disease appearing to be a major contributor to this decreased survival. The weight of evidence relates the development of atherosclerosis to corticosteroid use. However, no long-term epidemiologic or morphologic studies have been performed to elucidate this issue. Until these are accomplished, prolonged therapy with this medication, particularly in younger persons, should be avoided whenever possible. PMID- 3518442 TI - Bacterial peritonitis secondary to a perinephric abscess. Case report and differentiation from spontaneous bacterial peritonitis. AB - A cirrhotic patient is described who presented with Escherichia coli septic arthritis as the first manifestation of a perinephric abscess. Results of baseline abdominal paracentesis were unremarkable. After 10 days of antibiotics, abdominal paracentesis was repeated because of recurrence of fever; E. coli peritonitis was confirmed. Subsequent autopsy revealed a perinephric abscess. Development of bacterial peritonitis during antibiotic treatment is distinctly unusual in the "spontaneous" form of peritonitis and should raise suspicion of secondary bacterial peritonitis. PMID- 3518443 TI - Diabetes in the elderly: diagnosis, pathogenesis, and therapy. AB - The prevalence of diabetes mellitus increases with age; it occurs in approximately 10 percent of Americans 60 years of age and in 16 to 20 percent of those 80 years old. Type II diabetes mellitus is primarily found in the elderly, and it is estimated that an additional 20 percent of the elderly population has age-associated hyperglycemia, which may be part of a spectrum between normality and type II diabetes. The diabetic group is at risk for both microvascular and macrovascular complications of diabetes, whereas the group with the hyperglycemia of aging may be at risk for macrovascular-type complications. Thus, 40 percent of our senior population has abnormal carbohydrate tolerance and is at risk for diabetic-type chronic complications. The basis for both the diabetic state as well as for the hyperglycemia of aging is probably multifactorial--involving both altered insulin secretion and altered insulin action. Unique problems arise in treating older diabetic patients. Physiologic changes occurring during normal aging, age-associated pathologic processes, the increased prevalence of other chronic diseases, and polypharmacy must all be considered in selecting appropriate therapy for these patients. A rational approach for the maintenance of glucose homeostasis is presented for older patients with diabetes. PMID- 3518444 TI - Pharmacokinetic changes in aging. AB - A multitude of factors influence the prescribing, dosing, and clinical monitoring of long-term drug therapy in elderly patients. These include life-style and environment, possible multiple disease states and concomitant medications, compliance, and continuous changes in physiology, all of which can--with advancing age--gradually alter the pharmacodynamics and pharmacokinetics of drugs. The physiologic changes associated with aging that can affect the absorption, distribution, excretion, and metabolism of drugs are reviewed and related to the clinical use of several drugs that are widely used in elderly patients. Important clinical factors may also magnify or counteract the physiologic changes that occur with respect to altered drug response. Finally, the pharmacokinetic properties of the available oral hypoglycemic agents are described as they relate to selection of an optimal drug in elderly diabetic patients. PMID- 3518445 TI - Effects of extracellular volume expansion on plasma renin concentration in rats with diabetes insipidus. AB - The effect of acute and chronic expansion of the extracellular fluid volume on plasma renin concentration (PRC) was studied in normal Long-Evans rats (LE rats) and in rats with hereditary hypothalamic diabetes insipidus (DI rats). Chronic deoxycorticosterone acetate (DOCA) treatment, combined with a high sodium intake, significantly reduced PRC of both DI and LE rats. PRC of DI rats, however, remained higher than that of LE rats. Acute volume expansion, either alone or with DOCA treatment, also significantly diminished PRC of both DI and LE rats. PRC of untreated and DOCA-treated DI rats again remained significantly higher than that of LE rats after acute volume expansion. These findings suggest that the elevated PRC normally observed in DI rats is not due solely to diminished volume of extracellular fluid. Instead, the absence of ADH per se may directly alter renin secretion or the sensitivity of the granular cell to other stimuli. PMID- 3518446 TI - The influence of glucocorticoid dose on protein catabolism after renal transplantation. AB - Protein catabolic rate (PCR) and protein balance were measured daily by computerized mass balance studies in 20 subjects during hospitalization after renal transplantation. All hospital courses were uncomplicated. Ten subjects received approximately 1 mg/kg/day prednisone, and ten subjects received 3-5 mg/kg/day prednisone on day 1 with a tapering dose to approximately 1 mg/kg/day by discharge. In both groups, PCR rose during the first 3-4 postoperative days then stabilized at an accelerated level. PCR was significantly greater in the higher prednisone group. Despite encouragement most subjects ate less protein than prescribed, and most were in negative protein balance. Mean daily and net protein deficits were more severe in the higher prednisone group. Higher protein intakes improved protein balance. The protein catabolic effects of the two regimens have been defined and a dose dependency demonstrated. In any therapeutic situation the use of the minimum effective dose of steroids seem advised, and high protein intake should be encouraged to improve protein balance. Some steroid morbidity might thus be avoided. PMID- 3518447 TI - Elevated growth hormone levels and insulin resistance in patients with cirrhosis of the liver. AB - Carbohydrate intolerance is frequently seen in patients with hepatic cirrhosis. To study the role of the counter regulatory hormones, glucagon, cortisol and growth hormone in this disease, these hormones were measured in 11 patients with hepatic cirrhosis and six controls during a 4-hour oral glucose tolerance test (OGTT) and in five normal and cirrhotic subjects during steady-state plasma insulin and glucose concentrations (SSPGI) achieved with the euglycemic clamp technique. Fasting plasma glucose was 103 +/- 4.3 mg/dl in cirrhotics and 88 +/- 3.3 mg/dl in controls (p less than 0.001). Immunoreactive insulin (IRI) was 24.3 microU/ml in cirrhotics and 12.7 +/- 2.2 microU/ml in controls (p less than 0.001); immunoreactive glucagon (IRG) was 263 +/- 30 pg/ml in cirrhotics and 122 +/- 17.5 pg/ml in controls (p less than 0.001); serum growth hormone (GH) was 4.4 +/- 0.9 ng/ml in cirrhotics and 0.5 +/- 0.1 ng/ml in controls (p less than 0.001). During OGTT, the 2-hour glucose concentration was 201 +/- 9.7 mg/dl in cirrhotic subjects and 147 +/- 10.0 mg/dl in controls (p less than 0.001). IRG levels were suppressed by 20% of basal values in patients with cirrhosis, while controls showed 10% suppression after an oral glucose load. At 60 minutes, the serum GH was 14.7 +/- 3.9 ng/ml in cirrhotics and 0.3 +/- 0.1 ng/ml in controls (p less than 0.001). The normal suppressive effect of hyperglycemia on GH secretion in controls was sharply contrasted by a paradoxical elevation of serum GH in the cirrhotic group.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3518448 TI - Review: Renal osteodystrophy--pathogenesis and treatment. AB - Histologic bone changes of osteitis fibrosa and osteomalacia are commonly present in patients with end-stage renal disease. Although many patients are not symptomatic from these bone changes, some patients are severely disabled. Altered metabolism of vitamin D, calcium, phosphorus, and parathyroid hormone occurs in renal failure and contributes to the development of uremic bone disease. This article reviews the current theories of pathogenesis and treatment of renal osteodystrophy. In addition, the clinical presentation, pathogenesis, and treatment of the various aluminum-associated osteomalacic syndromes in uremia are discussed. PMID- 3518449 TI - Hepatic transplantation. PMID- 3518450 TI - Hormonal effects of smoking--I: Effects on plasma renin activity. AB - It is generally recognized that smoking is associated with an increased risk for the development of coronary artery disease. Since it has been suggested that increased plasma renin activity (PRA) may be a risk factor for cardiovascular disease, PRA was measured in a group of smokers and nonsmokers. PRA was measured under basal conditions, following intravenous (IV) furosemide administration and after a short burst of smoking. In addition, the effect of nicotine on renin secretion was evaluated in vitro. Smoking was associated with a significant increase in pulse rate and systolic blood pressure, but no significant change in diastolic blood pressure in both groups. Basal PRA was similar among smokers and was not significantly influenced by smoking in either group. PRA increased significantly following IV administration of furosemide, but there was no significant difference between the two groups. Incubation of rat kidney slices with nicotine also did not result in increased renin secretion. These findings confirm that smoking affects the cardiovascular system, but no significant effect of smoking on PRA was observed both in vivo and in vitro experiments. These findings suggest that the increased risk for the development of coronary artery disease associated with smoking is not mediated by increased PRA. PMID- 3518451 TI - Topical minoxidil for male pattern baldness. AB - Significant hair growth occurred in 53% of the 81 patients completing a 1 year trial of topical minoxidil. The average reduction in the diameter of the balding crown was 3.48 cm for all patients. There were no minoxidil related changes in laboratory tests during the study period. Psychosocial studies of our patients indicate that 95% assessed the effectiveness of topical minoxidil as moderate or excellent. The majority of those participating in the study thought that their personal presentation of self was of equal or greater importance than their work performance. It was concluded that topical minoxidil has the potential to improve male pattern baldness significantly without apparent risk and to be a means by which individual presentation of self may be improved. PMID- 3518452 TI - Nonsecretory multiple myeloma with osteoporosis: immunocytologic and bone resorptive studies. AB - Two patients, ultimately found to have advanced nonsecretory multiple myeloma, presented with skeletal pain, diffuse skeletal demineralization, and fractures. The correct diagnosis was initially obscured by the absence of typical hematologic findings and discrete lytic bone lesions. Bone marrow examination was diagnostic. Intracytoplasmic IgA or IgD kappa was demonstrated in the myeloma cells of each case. Decreased quantitative polyclonal serum immunoglobulins and hypercalcemia were important clinical clues. The demonstration of increased osteoclast activating factor (OAF) derived from the cultured myeloma cells from each case suggests that the secretion of OAF and immunoglobulin are unrelated. PMID- 3518453 TI - Nosocomial pneumonia. PMID- 3518454 TI - Prenatal diagnosis of the Beckwith-Wiedemann syndrome. AB - We report on the prenatal diagnosis of Beckwith-Wiedemann syndrome (BWS) in a pregnancy monitored because of a previously affected child. The proposita had classical stigmata of BWS including macroglossia, omphalocele, and typical ear creases. Chromosomes were 46,XX. Both parents and the extended maternal family were clinically normal. In a subsequent pregnancy by another father, the mother had serial ultrasound monitoring at 13.5, 18, and 19 weeks gestation which showed an enlarged abdominal circumference and a 2-cm omphalocele. At termination the female fetus weighed more than two times the expected weight, had striking hypertrophy of skeletal muscles, a protuberant abdomen, and a 2-cm omphalocele and characteristic facial appearance. Autopsy confirmed generalized organomegaly. This is the first report of the prenatal diagnosis of BWS prior to 20 weeks in an at-risk family. The recurrence in this family emphasizes the difficulty in providing accurate genetic recurrence risks in BWS and suggests that ultrasonographic prenatal diagnosis should be offered to families even when the case appears to be "sporadic." PMID- 3518455 TI - Are there "innocent" amniotic bands? PMID- 3518456 TI - Steroid-sensitive nephrotic syndrome with mesangial IgA deposits: a separate entity? Observation of two cases. AB - In minimal-change steroid-sensitive nephrotic syndrome with selective proteinuria, mesangial IgA deposition at immunofluorescence is a very rare finding which has been previously considered a pure coincidence. Two patients, aged 6 and 14 years, respectively, with a steroid-sensitive but frequently relapsing nephrotic syndrome and highly selective proteinuria, exhibited minor glomerular alterations at light microscopy and an immunofluorescence deposition of predominant and diffuse mesangial IgA, confirmed by electron microscopy as dense deposits. The observed syndrome, that is surprisingly identical to sporadic literature reports, can be considered a separate entity or subgroup belonging either to IgA nephropathy or to lipoid nephrosis. In the latter case mesangial IgA could be the marker of an easy relapsing course. PMID- 3518457 TI - Diabetes mellitus in renal transplant recipients. PMID- 3518458 TI - Effects of complement activation by hemodialysis membranes. PMID- 3518460 TI - Ultrasound evaluation of polyhydramnios and twin pregnancy. AB - We analyzed the ultrasound examinations and medical records of 75 pairs of twins who were delivered between January, 1983, and December, 1984, to study the relationship between increased amniotic fluid volume, fetal abnormalities, and preterm labor. Ten of these 75 twin pregnancies demonstrated elevated amniotic fluid volume that persisted throughout pregnancy. Total intrauterine volumes were elevated in these cases, and nine of the ten pregnancies were abnormal. In addition, it was noted that elevation of the amniotic fluid volume alone did not explain the high rate of preterm labor and delivery in twin gestations. PMID- 3518459 TI - Are preoperative antibiotics helpful in abdominal hysterectomy? AB - An open, randomized study to compare the effectiveness of triple-dose cefoxitin with the effectiveness of cephradine-tinidazole and with the result of nontreatment in patients undergoing abdominal hysterectomy was conducted from July 1983 to July 1984. One hundred ninety-nine patients were enrolled: 66 untreated control patients, 69 patients in the cephradine-tinidazole--treated group, and 64 patients in the cefoxitin-treated group. No significant differences were present in relation to age, pathologic condition, length of operation, blood loss, or length of hospital stay. That patients in both treatment groups had a lower incidence of postoperative febrile morbidity was not statistically significant. PMID- 3518461 TI - Human fallopian tube contains placental protein 14. AB - Radioimmunoassay and immunoperoxidase staining were used to study the tissue content and localization of an endometrial protein, placental protein 14, in the human fallopian tube. Placental protein 14 immunoreactivity was found in saline extracts from all fallopian tubes tested (n = 14). In the fimbrial part the placental protein 14 content was higher in the secretory than in the proliferative phase (p less than 0.01). No difference was found in the placental protein 14 content between the isthmic, ampullar, and fimbrial parts of the tube. Immunoperoxidase staining localized placental protein 14 to the ciliated and secretory epithelial cells of the mucosa in all parts of the tube regardless of the phase of menstrual cycle. The occurrence of the same protein in the endometrium and fallopian tube is compatible with the common embryonic origin from the mullerian duct of these tissues. PMID- 3518462 TI - Failure of nonstress test and Doppler-assessed umbilical arterial blood flow to detect imminent intrauterine death. AB - An unexplained intrauterine death occurred within 12 hours of a normal reactive nonstress test. Furthermore the umbilical arterial impedance measured by pulsed Doppler ultrasound was also normal. PMID- 3518463 TI - The in vivo effect of amniotic fluid on endocervical microflora. AB - To test the in vivo effect of amniotic fluid on endocervical microflora, we performed endocervical cultures before and after rupture of the membranes in 20 patients in term labor. There were no significant qualitative or quantitative differences in aerobic or anaerobic isolates for up to 4 hours after membrane rupture. Group B streptococci, isolated in two patients (10%), persisted after rupture of the membranes. These data suggest that endocervical cultures are minimally influenced by rupture of the chorioamnion for at least 4 hours. PMID- 3518464 TI - A double-masked comparison of betaxolol vs timolol in the treatment of open-angle glaucoma. AB - We conducted a six-month prospective, double-masked randomized trial comparing betaxolol with timolol at 0.25% and 0.5% concentrations in the treatment of primary open-angle glaucoma in 38 patients. To qualify, patients had to demonstrate an average intraocular pressure in at least one eye of greater than or equal to 26 mm Hg without treatment. The median intraocular pressure was consistently lower in the timolol group than in the betaxolol group (after four weeks of therapy, it was 20.2 mm Hg for timolol vs 22.5 mm Hg for betaxolol; P less than .04). Adjunctive therapy was required in eight patients in the betaxolol group compared to one in the timolol group (P less than .05). Betaxolol appears to be a clinically effective and safe agent in the treatment of open angle glaucoma. However, the magnitude of the decrease in intraocular pressure with it may not be as great as that with timolol and there may be a greater need for adjunctive therapy with it than with timolol. PMID- 3518465 TI - Retinal damage after argon laser iridotomy. AB - We conducted a prospective clinical study to evaluate potential retinal damage after argon laser iridotomy in 25 eyes of 22 patients with primary chronic angle closure glaucoma. Kinetic perimetry and ophthalmoscopy showed no detectable damage. Iridotomy required a mean of 11.4 +/- 10 joules to achieve a patent coloboma of 200 micron after one to three sessions. Dark-prone and mydriasis tests were performed one month after surgery. Pilocarpine was discontinued in all cases. Both static perimetry and fluorescein angiography of the midperiphery corresponding to the meridian of laser coloboma done six months after surgery showed focal damage. There was no damage in control tests of the same eyes in an opposite area of the retina. PMID- 3518467 TI - A marking suture for use in adjustable strabismus surgery. PMID- 3518466 TI - Expression of HLA-DR antigen on retinal pigment epithelial cells in retinitis pigmentosa. AB - Class II (HLA-DR) antigens are cell surface molecules that play a major role in the initiation and perpetuation of immune responses. Although most cells do not constitutively express class II antigens, selected cells can be stimulated to do so in some immunologically mediated disorders. When retinal pigment epithelial cells were evaluated by either immunoperoxidase or immunofluorescent staining of frozen eye sections from normal individuals, HLA-DR antigens were not detected. In contrast, retinal pigment epithelial cells from two patients with retinitis pigmentosa did express HLA-DR antigens. These findings demonstrated that at some time during the course of retinitis pigmentosa, the retinal pigment epithelial cell is activated to express HLA-DR. PMID- 3518468 TI - Oxygen flux into the aberrant cornea. AB - Polarographic oxygen sensors placed on the postsurgical human cornea indicate subnormal oxygen uptake rates. Given the nature of the method of measurement (due to Hill and Fatt), this implies that epithelial oxygen consumption rate is reduced post-surgically. However, other studies using the Rasson-Fatt method report no difference in corneal oxygen uptake through a thick soft contact lens after unilateral surgery. Application of a recently described three-layer computer model of corneal oxygen distribution suggests that the difference between normal and postsurgical corneal oxygen flux is greater at high precorneal oxygen tensions (the measurement area of the Hill-Fatt method). In contrast, the difference is small at low precorneal oxygen tensions, which would tend to confound efforts to detect a difference in postsurgical corneal oxygen uptake using the Rasson-Fatt method. This probably explains the null results reported previously. PMID- 3518469 TI - Second molar extractions: a review. AB - In this exhaustive review, a number of parameters related to maxillary and mandibular second molar extractions are discussed. The parameters reviewed include the timing of extractions and the effect of extractions on third molar eruption, posterior interdigitation, and incisor imbrication. The advantages and limitations of this procedure are outlined. The available information strongly suggests that the extraction of second molars relieves crowding in the posterior part of the arch, causes faster eruption of third molars, and diminishes the number of unerupted and/or impacted third molars. Consideration of the decrease in the number of impacted third molars after second molar extraction should be balanced with the fact that the extracted teeth are usually sound and are unimpacted. In addition, the third molars that do erupt frequently are poorly angulated and/or in poor contact with the first molars. This will necessitate an additional "late" period of fixed-appliance therapy to bring these teeth into good occlusion. PMID- 3518470 TI - The International Journal of Orthodontia, Volume I--reprise. PMID- 3518471 TI - Early days, major problems, and gradual acceptance of the American Board of Orthodontics. PMID- 3518472 TI - The soft underbelly or RME revisited. PMID- 3518473 TI - Monoclonal antibodies specific for melanocytic tumors distinguish subpopulations of melanocytes. AB - The authors have generated monoclonal antibodies to an extract of melanoma. When tested on a variety of fixed, embedded sections of malignant tumors, one antibody (HMB-45) reacted with 60 of 62 melanomas and none of 168 nonmelanomas (carcinomas, lymphomas, and sarcomas). The antibody reacts with junctional nevus cells but not intradermal nevi, and recognizes fetal and neonatal melanocytes but not normal adult melanocytes. This antibody thus demonstrates absolute specificity for melanocytic tumors and thus has great utility for the surgical pathologist in distinguishing among poorly differentiated tumors of uncertain origin. It also identifies differences among populations of melanocytes which may be useful in understanding the biology of and interrelationships between these cells. PMID- 3518474 TI - Mononuclear cell pulmonary vasculitis in NZB/W mice. II. Immunohistochemical characterization of the infiltrating cells. AB - NZB/W mice spontaneously develop pulmonary lymphoid hyperplasia and vasculitis in an age-related fashion. The cellular infiltrates and pattern of involvement bear similarity to various forms of pulmonary vasculitis in humans. In this study the authors used monoclonal antibodies and the avidin-biotin immunoperoxidase technique to analyze the pulmonary mononuclear cell infiltrates of female NZB/W mice at various ages and levels of disease activity. T cells, T-cell subsets, B cells, and Ia-bearing cells were localized with this technique. Most cells within the infiltrates were T cells that expressed the Lyt-1 phenotype, whereas cells expressing Lyt-2 were rarely observed. Cells reacting with a monoclonal antibody which recognizes cells of the B-lineage and cells expressing Ia antigens were also observed. Before the development of vasculitis, B and T cells were randomly distributed throughout the lesion. In older animals with vasculitis, T cells expressing Lyt-1 were associated with vessel lumen and were primarily responsible for the vascular infiltration, to the apparent exclusion of other lymphoid cell types. The B cells and Ia+ cells were localized at the periphery of the lesions. PMID- 3518475 TI - Participation of neutrophils and delayed hypersensitivity in the clearance of experimental cutaneous candidiasis in mice. AB - Involvement of neutrophils and delayed hypersensitivity in the clearance of Candida albicans infections was investigated with the use of a model of the disease in inbred mice. Experimental infections were produced by rubbing C albicans onto the shaved skin of the flank without the use of occlusive dressings. After a single infection, delayed hypersensitivity to Candida developed in C57BL/6 mice, and the infection cleared more rapidly than in C3H/He mice, in which delayed hypersensitivity did not develop. In both strains, the organisms were associated with neutrophilic microabscesses in the upper epidermis within 1 day of inoculation; by 3 days, the organisms and microabscesses had become relocated to a site just above the skin surface. At this time, the epidermis was intact under the microabscesses and significantly thickened, which indicated that epidermal proliferation had occurred. Delayed hypersensitivity reactions accelerated clearance of the infection, apparently by increasing the rate of removal of the microabscesses and associated organisms from the skin surface. However, delayed hypersensitivity was not an absolute requirement for clearance, because in animals of the C3H/He strain, in which delayed hypersensitivity did not develop during the first infection, the infection was eventually cleared. It is postulated that in these infections an important defense mechanism may be the enhancement, perhaps by the neutrophilic infiltrate, of epidermal proliferation early in the infection such that the infecting organisms are moved to a location above the skin surface from which they can be more easily removed by other processes, including delayed hypersensitivity reactions. PMID- 3518476 TI - Development of allergic sialadenitis in mice immunized with mumps virus-infected submandibular salivary gland. AB - This article reports that sialadenitis developed in female, rather than male, of CRJ:CD-1 mice thymectomized 3 days after birth and later immunized with murine submandibular salivary gland cells which were infected with mumps virus (MV) in vitro. Significant inflammatory changes did not develop in various control groups, including animals not thymectomized but immunized, animals thymectomized on the day of birth and immunized, animals thymectomized at Day 3 and immunized with the uninfected cells, and animals thymectomized at Day 3 and immunized with MV alone. The presence of antisalivary duct antibody was found in sera from mice with sialadenitis. MV antigen in the lesions as well as viremia was not detected. The lesions observed in mice with sialadenitis were mostly composed of small and medium-sized lymphocytes stained by anti-Thy 1.2 and Lyt 2 antibodies and in later stages by immunoglobulin-containing cells in the periphery of inflammatory lesions. Moreover, mild inflammatory lesions were observed in parotid salivary gland or pancreas in some mice that developed sialadenitis. PMID- 3518477 TI - Problems in transition following bone marrow transplantation: psychosocial aspects. AB - The number of patients achieving long-term survival following bone marrow transplantation is increasing. Psychosocial issues that may arise for the pediatric patient and for the family following discharge from the hospital are described. Implications for other situations in which there is a lengthy hospitalization for an organ transplant or life-threatening condition are highlighted. PMID- 3518478 TI - Outcome in psychoeducational day school programs: a review. AB - Psychoeducational day schools provide clinical and special education services to children with severe behavior disorders. Outcome studies indicate that treated children tend to improve in behavioral, academic, and family functioning but warrant continued intervention. Family therapy, development of academic skills, and coordination of aftercare services appear critical to long-term program success. PMID- 3518479 TI - Cutmarks on the Engis 2 calvaria? AB - An examination of the surface morphology of the juvenile Neandertal calvaria, Engis 2, has resulted in the discovery of several series of incised striations. The purpose of this paper is to describe and discuss these striations. A preliminary interpretation of at least some of the striations as cutmarks, made at or near the time of the child's death, is offered. PMID- 3518480 TI - Dental pathology of prehistoric residents of Oregon. AB - Dentitions of 208 prehistoric skeletal specimens from five geographic regions of Oregon were studied to describe their dental status. Comparisons were made of the incidence of specific pathologies among regions and between jaws. Maxillary premortem tooth losses were significantly higher than mandibular tooth loss. A relatively high caries incidence occurs in samples from the Willamette Valley and Klamath Basin, where plant foods were used aboriginally to a significant extent. A high frequency of abscesses was recorded in the Klamath Basin and the Lower Columbia River sample, which also showed the highest levels of attrition. Each of the five subsamples shows patterns of dental pathology consistent with former use of natural resources. PMID- 3518481 TI - Porotic hyperostosis in a marine-dependent California Indian population. AB - A maize-based iron- and protein-deficient diet is commonly cited as the most important cause of porotic hyperostosis among American Indian agriculturalists. An alternative to this maize dependence hypothesis is suggested by the analysis of 432 crania from the nonagricultural, fish-dependent population of the Channel Island area of southern California. Cribra orbitalia, a form of porotic hyperostosis associated with iron deficiency anemia, is just as common among these fisherpeople, whose diet was rich in iron and essential amino acids, as it is among maize-dependent agriculturalists. Northern Channel Island crania have much more cribra orbitalia than those from the California mainland. The highest incidence is on San Miguel, a small geographically isolated island with a shortage of fresh water and terrestrial resources. The Indians who lived on Santa Cruz, the largest of the northern Channel Islands with the greatest diversity of terrestrial plants and animals, have less cribra orbitalia than those who lived on Santa Rosa or San Miguel Island. This geographical distribution appears to be explained by island-mainland and interisland differences in water contamination, exposure to fish-borne parasites, and nutritional adequacy of the diet. The prevalence of porotic hyperostosis in a population with a heavy dietary dependence on marine resources shows that among prehistoric American Indians, this condition is not always associated with an iron- and protein-deficient diet of cultigens. It seems likely that high nutrient losses associated with diarrheal disease are often more significant in the etiology of porotic hyperostosis than a low dietary intake of essential nutrients. PMID- 3518482 TI - Density-dependent migration and human population structure in historical Massachusetts. AB - Studies of population structure often focus on the effects of population size and migration rates on genetic variation. Few studies, however, have investigated the relationship between these two factors. The purpose of this paper is to determine the extent to which migration (and gene flow) is density-dependent (that is, affected by population size) for populations in historical Massachusetts. Data from 4,859 marriage records were analyzed from four populations in north-central Massachusetts during the time period 1741 to 1849. These data were placed into 29 samples defined in terms of population and time cohort. Within each cohort the overall exogamy rate was computed along with three estimates of gene flow based on marital migration: local migration (k), long-distance migration (m), and effective migration rate (me). Three samples show unusually low rates that reflect the history of settlement. Regression analyses were used with the remaining samples, and they show nonlinear density-dependent migration that is unrelated to temporal trends. Migration is highest in samples with small population sizes (less than 800) and large population sizes (greater than 1,600). Migration is lowest in medium-sized populations. Two processes are suggested to explain this curvilinear relationship of migration and population size. In small populations, the lack of suitable potential mates and/or availability of settled land leads to an increase in migration into the population. As population size increases, this migration decreases. After populations reach a certain size, migration increases again, most likely reflecting the economic pull of larger populations. These patterns could act to enhance, or counter, genetic drift, depending on the direction of density dependence. PMID- 3518483 TI - Biphasic concentration dependency of stimulation of myoblast differentiation by somatomedins. AB - It is widely believed that mitogens inhibit in vitro differentiation of myoblasts to form postmitotic myotubes, but we and others have shown that the mitogenic hormones insulin and the insulin-like growth factors (IGFs) stimulate myoblast differentiation. We now report the results of concentration-dependency studies that resolve this disagreement. We found that the IGFs give a biphasic dose response curve; at low concentrations, there is progressive stimulation of L6 myoblast differentiation; at higher concentrations, there is a progressive decrease. Similar results were obtained with IGF-II and insulin. When differentiation was maximally stimulated (by 1,280 ng/ml insulin), adding rat IGF II gave decreases in differentiation similar to those reported for other mitogens. Two trivial explanations have been eliminated: stimulation of differentiation (at low concentrations) is not due to enhanced survival or growth of the cells, and inhibition (at higher concentrations) is not a toxic effect. In L6 cells, epidermal growth factor and fibroblast growth factor had no effect on proliferation or differentiation. We conclude that the effects of medium components on myoblast differentiation cannot be generalized to indicate inhibition by all mitogens; depending on the cell lines and concentrations used, certain mitogens may either stimulate or inhibit differentiation. PMID- 3518484 TI - Response of ketone body metabolism to exercise during transition from postabsorptive to fasted state. AB - This study examines the effects of a 2-h exercise of moderate intensity (50% of VO2 max) on the tracer-determined turnover rate of ketone bodies (KB) in 21 normal subjects fasted for 16 h, 5 days, whose basal ketonemia ranged between 0.09 and 6.16 mM. The KB response observed at the end of exercise is a function of the initial degree of ketosis. When basal ketonemia is below 0.6 mM, exercise enhances ketogenesis (Ra), the amplitude of this process being positively correlated with KB level. There is a concomitant acceleration of the metabolic clearance rate (MCR) of KB attaining 40-50%. When ketonemia exceeds 2.5 mM, the stimulatory effects of exercise on Ra and on MCR become less marked as basal ketonemia rises and are completely abolished or even reversed when initial KB level is higher than 3-4 mM. The pattern of changes in the concentration and in the overall disposal rate of KB were similar to that of Ra. It is suggested that the parallel inhibition of the stimulatory effect of work on hepatic ketogenesis and on muscular extraction of ketones associated with increasing degrees of fasting hyperketonemia has two physiological implications: it maintains the preferential utilization of KB by nonmuscular tissues (presumably the brain) and prevents the development of uncontrolled hyperketonemia, despite the intense catabolic situation created by the combination of exercise and starvation. PMID- 3518485 TI - Metabolic effects of chronic infusions of epinephrine and norepinephrine in rats. AB - Chronic infusions of epinephrine, norepinephrine, or vehicle were performed in adult male rats by means of subcutaneous implanted osmotic minipumps (ALZET). The calculated dose was 180 ng/min during 7-8 days. Daily food intake and body weight were measured during this period and also 7 days before and 5 days after it. During the period of infusion, norepinephrine stopped body weight gain while epinephrine-infused rats gained weight at the same rate as controls. Once the infusion period was finished, epinephrine-infused rats gained more weight than controls, while norepinephrine-infused rats just returned to the slope of weight gain of the controls. In no group did food intake change. In a second experiment, similar infusions were carried out in other rats on the same schedule; body temperature, glycemia, and serum insulin and triiodothyronine were measured. Epinephrine infusion significantly elevated glycemia and triiodothyronine, whereas norepinephrine infusion increased temperature and serum insulin. The results obtained by chronic administration of the catecholamines support the concept of a disassociation of adrenomedullary and sympathetic nervous system metabolic effects. PMID- 3518487 TI - Rapid effects of insulin on in vitro translational activity of specific mRNA in diabetic rat heart. AB - We studied the time course of response of specific cardiac mRNA after administration of insulin to diabetic rats. The primary aim was to identify specific cardiac mRNA, which show a rapid response to insulin administration. Diabetic rats were injected with 2 U of regular insulin intravenously, and total cardiac RNA was prepared 0.5, 1.5, 3, 5, 12, and 24 h later. RNA was translated in vitro in the presence of [35S]methionine and the translational products separated by two-dimensional electrophoresis and quantitated by digital matrix photometry. A rapid change in the translational activity of five specific mRNA species was observed within 0.5 h after administration of insulin to the diabetic animal. One translational product exhibits a more delayed response at 1.5 h. The predominance of three of these products was increased, while that of three was decreased. Two specific mRNA coding for translation products designated as spots 97 and 106 show the most significant change, with a dramatic decrease of 15-fold and 6.5-fold, respectively, within 0.5 h after insulin administration. The change in levels of these specific mRNA species could result from effects of insulin at various sites of mRNA synthesis or degradation. However, the rapidity of the response is compatible with a direct effect of insulin on gene expression. The very quick response of these specific mRNA species to insulin could thus serve as a useful model system to examine the molecular mechanisms of insulin action in the heart. PMID- 3518486 TI - Different production and decay rates of six renin forms isolated from rat plasma. AB - Rat kidney contains six forms of renin, which are in different proportion from those found in plasma. We tested the hypothesis that differential removal and production of the forms might explain the differences between stored and circulating renins. In one group of rats, the six forms of renin were measured in plasma, 10 min after hemorrhage, or after aortic constriction. Plasma was run on an isoelectric focusing gel, and the six peaks of renin activity were expressed either as angiotensin I per hour per milliliter or as a percentage of the total plasma renin concentration. After hemorrhage or aortic constriction, the concentration of each form was significantly increased; the profile of circulating renin was significantly modified, showing an increase in proportion of form 2 and a decrease of forms 4, 5, and 6. In a second group, the disappearance of each form was measured 0 to 100 min after nephrectomy and fitted a two-exponential decay curve. Interpreted as a two-pool system with degradation from pool 1, the degradation rate decreased progressively, going from form 1 to 6. In a third group, arterial and renal venous blood were collected. The profile of secreted renin was calculated from the arterial venous difference. This profile fitted the prediction of the two-compartment model. Our data support the hypothesis that the proportion of each circulating renin form is the result of a balance between the rate of production of renin of constant composition and the degradation of the six forms at different rates. PMID- 3518488 TI - Effect of training on insulin binding to rat skeletal muscle sarcolemmal vesicles. AB - We examined the hypothesis that the exercise training-induced increase in skeletal muscle insulin sensitivity is mediated by adaptations in insulin binding to sarcolemmal (SL) insulin receptors. Insulin binding studies were performed on rat skeletal muscle SL isolated from control and trained rats. No significant differences were noted between groups in body weight or fat. An intravenous glucose tolerance test showed an increase in whole-body insulin sensitivity with training, and specific D-glucose transport studies on isolated SL vesicles indicated that this was due in part to adaptations in skeletal muscle. Enzyme marker analyses revealed no differences in yield, purity, or contamination of SL membranes between the two groups. Scatchard analyses indicated no significant differences in the number of insulin binding sites per milligram SL protein on the high-affinity (15.0 +/- 4.1 vs. 18.1 +/- 6.4 X 10(9)) or on the low-affinity portions (925 +/- 80 vs. 884 +/- 106 X 10(9)) of the curves. The association constants of the high-affinity (0.764 +/- 0.154 vs. 0.685 +/- 0.264 X 10(9) M-1) and of the low affinity sites (0.0096 +/- 0.0012 vs. 0.0102 +/- 0.0012 X 10(9) M 1) also were similar. These results do not support the hypothesis that the increased sensitivity to insulin after exercise training is due to changes in SL insulin receptor binding. PMID- 3518489 TI - Oscillations enhance the efficiency and stability of glucose disposal. AB - Oscillations in plasma concentrations of glucose and insulin as well as the rates of glucose disposal by liver and periphery have been observed in dogs during states of net glucose anabolism. To examine whether the existence of oscillations is important for efficient disposal of nutrients, we compared constant glucose infusion (with plasma glucose and insulin oscillations) to experiments in which glucose oscillations were suppressed using the glucose clamp. Mean glucose levels attained were the same for the two protocols (142 +/- 2 for constant glucose infusion at 10.8 +/- 0.4 mg X kg-1 X min-1, 144 +/- 1 mg/dl for clamps, P = 0.35). Despite matched mean glucose, integrated plasma insulin was 36.3 +/- 3.2 mU X ml-1 X 600 min in controls but higher in clamps (53.8 +/- 9.1 mU X ml-1 X 600 min, P = 0.017). Despite 48% higher insulin, total glucose disposed during the 10-h clamps was not greater than during constant glucose infusion (clamps, 162.1 +/- 10.7 g/600 min; infusions, 154.4 +/- 7.5 g/600 min; P = 0.19). These studies demonstrate that the presence of coordinated oscillations in glucose and insulin, during glucose infusion, are associated with more efficient disposal of glucose than when oscillations are suppressed. The results suggest that oscillations may play an important role in the efficient disposal of administered nutrient and may be an important component of normal glucose tolerance. PMID- 3518490 TI - Estimation of insulin sensitivity and glucose clearance from minimal model: new insights from labeled IVGTT. AB - The "minimal model" of glucose disappearance provides noninvasive estimates of insulin sensitivity and glucose effectiveness from an intravenous glucose tolerance test (IVGTT). However, this model does not allow the separation of glucose production from utilization. To overcome this limitation, labeled glucose was injected along with cold glucose in six normal dogs, and both cold and labeled glucose time courses were monitored along with insulin concentration. A revised minimal model was fitted to tracer data to obtain new measures of insulin sensitivity (SI* = 6.41 +/- 0.91 10(-4) min-1 X microU-1 X ml-1) and fractional glucose clearance (SG* = 0.0092 +/- 0.0009 min-1). SG* was compared with a direct measure obtained by a hepatic arterial-venous difference technique, which yielded a value of 0.0097 +/- 0.0002, virtually identical to SG*, thereby validating the model estimate. When the original minimal model was identified from cold data, we obtained S1 = 4.52 +/- 1.39 and SG = 0.042 +/- 0.009. SI* and SG* were different from SI and SG, respectively. In particular SG overestimates fractional glucose clearance by approximately five times. The revised minimal model yields glucose disposal parameters SI* and SG* that are not affected by the confounding effect of insulin and glucose inhibition of glucose production. Limitations inherent in cold IVGTT and original minimal model are overcome by labeled IVGTT and the revised minimal model, while test simplicity remains. PMID- 3518491 TI - Electrophysiological properties of cultured adult rat ventricular cardiac muscle cells. AB - Action and resting potential characteristics of isolated adult rat myocardial cells maintained in culture for 10-28 days are described. Resting potentials averaged -76.3 +/- 2 mV in 5 mM extracellular [K+] ([K+]o). Resting potentials changed by 54.3 mV/decade change in [K+]o for concentrations greater than 5 mM. The average maximum rate of rise of action potential (Vmax) was 117.7 +/- 10 V/s with overshoots of 34.6 +/- 2.5 mV. Action potential durations (APD) to 0 and -40 mV and full repolarization were 21.8 +/- 3.9, 36.3 +/- 6.0, and 206 +/- 16.9 ms respectively. Action potential configurations were qualitatively similar to those previously reported by others for rat myocardial tissue or freshly dissociated cells. Tetrodotoxin (4 micrograms/ml) decreased Vmax to less than 24 V/s and decreased overshoot and APD. Isoproterenol (10(-8) M) decreased APD with slight elevation of the overshoot. Verapamil (10(-5) to 10(-4) M) depressed overshoot and plateau while slowing the final phase of repolarization. Verapamil (10(-4) M) depressed upstroke velocity and blocked excitability. While APDs recorded from these cultured cells are apparently longer than those reported by others for rat myocardial APDs, the values of all other electrophysiological parameters recorded are within the limits previously reported for normal rat myocardial tissue. These data indicate that adult rat myocardial cells maintained in tissue culture for 10 28 days possess electrophysiological properties and responses to pharmacological agents similar to adult rat myocardial tissue or undamaged freshly isolated cells. PMID- 3518492 TI - Effect of endorphins on heart rate and blood pressure in adult dogs. AB - To investigate the role of opioids in regulating cardiovascular function, we administered delta-opioid receptor agonists D-Ala-D-Leu enkephalin (DADLE) and D Ala-Met enkephalinamide (DAME), and mu-opioid receptor agonist, a morphiceptin analogue (MA), intracisternally in 13 unanesthetized, chronically instrumented adult dogs in 2 doses (25 and 125 micrograms/kg). After an initial transient drop, the R-R interval increased (peak approximately 25-60 min) postadministration of opioids. The time course and the magnitude of the change in R-R interval depended on the agonist: delta-agonists induced a more prolonged and marked change in R-R interval than mu-agonists at both doses. Mean arterial blood pressure (MAP) increased initially but dropped toward or even below base line 30 min after opioids administration. Atropine, given intravenously or intra arterially at peak action of agonist in relatively low doses (0.02 mg/kg), induced an AV block followed by a marked decrease in R-R interval. There was also an increase in MAP after atropine. Naloxone, given intracisternally, reversed both delta- and mu-opioid effects but did not induce changes in the R-R interval without prior administration of opioids. We conclude that in unanesthetized adult dogs 1) both mu- and delta-receptor opioid agonists prolong the R-R interval, and this depends on the type of receptor stimulated; 2) opioids induce slowing in heart rate, possibly by increasing parasympathetic activity to the heart; 3) enkephalin and morphiceptin analogues induce a biphasic response in MAP; and 4) endorphins do not modulate cardiovascular function tonically; we speculate that they can alter the R-R interval and MAP in the presence of stimuli. PMID- 3518493 TI - Secretory NaCl and volume flow in renal tubules. AB - This review attempts to give a retrospective survey of the available evidence concerning the secretion of NaCl and fluid in renal tubules of the vertebrate kidney. In the absence of glomerular filtration, epithelial secretory mechanisms, which to this date have not been elucidated, are responsible for the renal excretion of NaCl and water in aglomerular fish. However, proximal tubules isolated from glomerular fish kidneys of the flounder, killifish, and the shark also have the capacity to secrete NaCl and fluid. In shark proximal tubules, fluid secretion appears to be driven via secondary active transport of Cl. In another marine vertebrate, the sea snake, secretion of Na (presumably NaCl) and fluid is observed in freshwater-adapted and water-loaded animals. Proximal tubules of mammals can be made to secrete NaCl in vitro together with secretion of aryl acids. An epithelial cell line derived from dog kidney exhibits secondary active secretion of Cl when stimulated with catecholamines. Tubular secretion of NaCl and fluid may serve a variety of renal functions, all of which are considered here. The occurrence of NaCl and fluid secretion in glomerular proximal tubules of teleosts, elasmobranchs, and reptiles and in mammalian renal tissue cultures suggests that the genetic potential for NaCl secretion is present in every vertebrate kidney. PMID- 3518494 TI - Effects of exercise training on regional adipose tissue metabolism in pregnant rats. AB - To investigate the effects of intense exercise training on maternal adiposity and fetal development, normal lean Zucker (Fa/Fa) rats were divided into three groups: control nonpregnant (CNP), control pregnant (CP), and exercise-trained pregnant (TRP). Trained rats swam three continuous hours per day, 6 days/wk, throughout pregnancy. Food efficiency increased with pregnancy, the highest values being observed during the last trimester of the gestation period. On day 21, pup number, weight, and body composition were similar for CP and TRP. By day 21 of gestation, in both TRP and CP rats, inguinal adipose tissue weight, cell size, and lipoprotein lipase (LPL) activity increased; although TRP values were smaller (P less than 0.05). In CP rats, parametrial and retroperitoneal adipose tissue weights, cell size, and LPL activities increased throughout pregnancy, whereas TRP values were similar to CNP (P less than 0.05). Parametrial fat cell lipolysis showed, however, no effect of training. These results indicate that the extensive energy expenditure occurring during endurance training selectively reduced the dams' adiposity in a regionally specific fashion without any apparent alteration in pup development. The increased substrate utilization required by training during pregnancy did not, however, modify fat cell lipolysis but rather prevented lipid filling through suppression of LPL activity of some depots. PMID- 3518495 TI - Effect of fasting interval on CCK-8 suppression of food intake in the baboon. AB - Baboons were infused intravenously for 5 min with the octapeptide of cholecystokinin (CCK-8) after either a 16.5- or 3.5-h fast. After a 3.5-h fast, food intake was significantly suppressed over the ensuing 30 min by 2 micrograms/kg of CCK-8 (-156 +/- 34 kcal compared with control days, P less than 0.02) and by 4 micrograms/kg of CCK-8 (-257 +/- 31 kcal, P less than 0.01). In contrast, CCK-8 had no reliable effect on food intake after the same baboons had been fasted for 16.5 h (2 micrograms/kg: -93 +/- 40 kcal, P greater than 0.05; 4 micrograms/kg: -30 +/- 82 kcal, P greater than 0.05). There was no reliable effect of 1 microgram/kg of CCK-8 on food intake at either deprivation interval. CCK-8 infusions resulted in a small increase of fasting plasma immunoreactive insulin (IRI); this effect was not related to either dose or deprivation length. Postprandial IRI and glucose concentrations were significantly suppressed by CCK 8 independently of its effect on food intake. Thus, after a 16.5-h fast, 4 micrograms/kg of CCK-8 decreased postprandial IRI from 145 +/- 65 to 29 +/- 4 microU/ml (P less than 0.01) and glucose from 101 +/- 5 to 80 +/- 3 mg/dl (P less than 0.02), despite no concomitant effect on food intake. Similar suppression of plasma IRI and glucose were observed after infusions of 1 and 2 micrograms/kg in 16.5-h-fasted animals. All doses of CCK-8 (1, 2, and 4 micrograms/kg) suppressed postprandial IRI and glucose after a 3.5-h fast.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3518496 TI - Intracisternal insulin alters sensitivity to CCK-induced meal suppression in baboons. AB - We have previously reported that intravenous administration of the octapeptide of cholecystokinin (CCK-8) is more effective in reducing single meal size in baboons at noontime than in the morning. We have also reported that immunoreactive insulin levels in the cerebrospinal fluid (CSF) are elevated after animals have recently eaten. To test whether elevated CSF insulin levels can alter the efficacy of intravenous CCK to reduce meal size we administered subthreshold doses of CCK-8 to baboons infused with either synthetic CSF or CSF and insulin (100 microU X kg-1 X day-1) via the cisterna magna. Intravenous CCK-8 alone reduced 30-min meal size from 504 +/- 121 to 378 +/- 113 kcal (n = 7, P = NS). Chronic intracisternal insulin infusion enhanced CCK-8's suppressive effects such that 30-min meal size was reduced from 544 +/- 74 to 240 +/- 108 kcal (n = 7, P less than 0.005). Intracisternal insulin infusion had no significant effect on total food intake, basal plasma insulin and glucose levels, or postprandial plasma insulin and glucose levels. These findings suggest that central insulin may contribute to food intake regulation by modulating the ability of brain-gut peptides to alter single meal size. PMID- 3518497 TI - Plasma renin and angiotensin in dehydrated and rehydrated rats. AB - The role of the renin-angiotensin system in the stimulation and termination of dehydration-induced drinking was examined in the rat. Rats dehydrated for 48 h had significantly elevated renin, angiotensin II, plasma Na+ concentration, osmolality, and hematocrit when compared with replete controls. Although plasma Na+ concentration, osmolality, and hematocrit of dehydrated rats had returned to control replete levels by 2-4 h after the return of water, the plasma renin and angiotensin II levels exhibited a further increase on rehydration and remained significantly above dehydration levels for 2-4 h after the return of water. The levels of renin and angiotensin II in rehydrated rats were maintained at levels in excess of the dipsogenic threshold for circulating angiotensin II during the 8 h period after rehydration, indicating that termination of the drinking is not dependent on a reduction of circulating angiotensin II. Finally, rehydrated rats did not drink significantly more than replete controls in the 1- to 8-h postrehydration period despite plasma angiotensin II levels in excess of that of the dipsogenic threshold for angiotensin II, indicating that mechanisms exist which override the dipsogenic action of circulating angiotensin II. PMID- 3518498 TI - Control of day care shigellosis: a trial of convalescent day care in isolation. AB - Simultaneous outbreaks of S. sonnei infections occurred in September 1983 at two day care centers in Seattle, Washington. At both centers, there were high rates of diarrheal illness in the children (22/80 and 11/23, respectively), in staff members, and in family members of the ill children. The smaller center was temporarily closed, but the larger one remained open. Convalescent children and staff whose diarrhea had resolved and who were receiving appropriate antimicrobials were allowed to return to the larger center before negative cultures were obtained and were separated in an isolation room. No culture-proven cases of shigellosis occurred at either center in the following two months. Plasmid profile determinations suggested the Shigella were not transmitted from the center that remained open to the community. Estimated need for alternate child care requirements at the closed center were 100-fold greater than at the center with the isolation room. Caring for convalescent children in isolation at day care centers while they receive antimicrobial therapy may be a useful strategy for controlling day care shigellosis. PMID- 3518499 TI - Maternal marijuana use and neonatal outcome: uncertainty posed by self-reports. AB - To assess the validity of self-reported marijuana use during pregnancy, this study randomly allocated pregnant women into a group who were told their urine would be tested for marijuana, alcohol, and other drugs and another group not so tested. Women told they would be tested reported more marijuana use during pregnancy than did untested women. Moreover, urine assays identified more women who used marijuana during pregnancy than were willing to admit it in the interview even after being told their urine would be tested. No differences in reported drinking or cigarette smoking during pregnancy were found between tested and untested women. PMID- 3518500 TI - Immunocytochemistry of rhabdomyosarcoma. The use of four different markers. AB - Fast myosin and slow myosin are specific markers of skeletal muscle, in addition to myoglobin. This study of 15 specimens of rhabdomyosarcomas from 13 patients using specific antisera for the three markers as well as for desmin led to positive findings in all cases with at least one antiserum. Desmin was present in all cases; fast myosin and myoglobin were present in 10 cases each. Slow myosin was present in six cases. It appears that the combination of several markers is helpful in differentiating rhabdomyosarcomas from other tumors. The markers considered were generally more abundant in neoplastic elements with large amounts of cytoplasm. This finding suggests that the larger cells of rhabdomyosarcomas are more differentiated than smaller rhabdomyoblasts, which were often negative with some of the antisera used. PMID- 3518501 TI - Monitoring of chloroquine sensitivity of Plasmodium falciparum in Haiti, 1981 1983. AB - Between 1981 and 1983, in vivo and in vitro studies were conducted in Haiti to assess the responsiveness of Plasmodium falciparum to chloroquine. The standard tests successfully performed included 92 WHO standardized in vivo field tests and 160 in vitro tests (64 macrotests, 33 microtests, and 63 48-hr tests). No clearcut evidence of chloroquine resistance was detected. In 3 in vivo and 5 in vitro tests, a decreased susceptibility to the drug was suggested, but these isolated findings failed to be corroborated by parallel alternate tests. In addition, during the initial trial of an alternate monitoring system, 339 simplified 7-day in vivo tests were successfully performed, with no suggestion of resistance detected. This simplified 7-day in vivo test potentially represents an efficient low cost method for monitoring drug resistance in many developing countries. PMID- 3518502 TI - In vivo efficacy of chloroquine treatment for Plasmodium falciparum in Malawian children under five years of age. AB - In 1984 the government of Malawi instituted a program to reduce malaria mortality and morbidity in children less than 5 years of age as a part of the Combatting Childhood Communicable Diseases (CCCD) program. To define the appropriate malaria therapy regimen, investigators used a quality assurance design in a simplified 7 day in vivo drug response study with follow-up observations on day 2 (D2), D3, and D7 after the initial day of the study (D0). The efficacy of oral chloroquine was assessed in 224 children who were enrolled at 6 sites, 2 in each of the 3 administrative regions of Malawi. Parasitological failure, defined as failure of parasitemia to decrease by 75% of the value by D3 or presence of any detectable parasitemia on D7, ranged from 41%-65% following administration of chloroquine 25 mg (base)/kg. However, only 8% of children who were parasitemic on D7 were febrile or judged to be ill. Considering these therapeutic results and the higher cost and limited availability of alternative therapies, chloroquine 25 mg/kg therapy was adopted as the primary therapy for malaria. PMID- 3518503 TI - Adaptation of the Indochina I/CDC strain of Plasmodium falciparum to the squirrel monkey (Saimiri sciureus). AB - The Indochina I/CDC strain of Plasmodium falciparum was linearly passaged in squirrel monkeys (Saimiri sciureus) of 3 phenotypes. Splenectomized monkeys of Guyanan and Peruvian type developed high density parasitemias, but considerably lower than the mean peak parasitemia (greater than 10(6)/mm3) in Bolivian phenotype squirrel monkeys. Spleen-intact Bolivian and Peruvian squirrel monkeys all developed potentially lethal infections after linear passage of parasites from Saimiri and Aotus. For the evaluation of induced immunity to P. falciparum, the Indochina I/CDC strain in Saimiri will be a valuable model system. PMID- 3518504 TI - Growth of Plasmodium falciparum in sodium-enriched human erythrocytes. AB - Transport of nutrients into animal cells is driven by transmembrane gradient of Na+ across the plasma membrane. The protozoan malaria parasite, Plasmodium falciparum, however, grows within the host human erythrocytes, in which the cytoplasmic concentration of Na+ is maintained low by the membrane Na+, K+ ATPase. Our experiments show that human erythrocytes enriched with Na+ by treatment with ouabain (an inhibitor of the ATPase) will support the growth of P. falciparum in culture. PMID- 3518505 TI - Rhodnius neivai: a new experimental vector of Trypanosoma rangeli. AB - Rhodnius neivai was as efficient as Rhodnius prolixus and Rhodnius robustus in transmitting by bite a Colombian strain of Trypanosoma rangeli following its inoculation into the hemocoel. Under conditions of the study the strain of T. rangeli had a high and constant infectivity to the salivary glands of R. prolixus, its natural vector in Colombia. Six species of Triatoma and Dipetalogaster maximus likewise inoculated did not develop metatrypomastigotes in the salivary glands. Of the 12 known species of Rhodnius, R. neivai is the eight to be demonstrated as an anterior station vector of T. rangeli. PMID- 3518506 TI - Ultrastructural localization of the circulating anodic antigen in the digestive tract of Schistosoma mansoni using monoclonal antibodies in an immunogold labeling procedure. AB - The purpose of this study was to determine the ultrastructural localization of a major schistosome circulating antigen-the circulating anodic antigen (CAA)-in the digestive tract of various life cycle stages of Schistosoma mansoni. The presence of CAA was determined by an indirect gold-labeling procedure using CAA-specific monoclonal antibodies. In cercariae, gold label was found in the cytoplasm and in the surface coat of the gut epithelium. A minimal amount of gold particles was also observed in the esophagus epithelium, but this was limited to the luminal surface coat and located proximally to the gut. In 3 1/2-week-old worms and in adult male and female worms CAA was demonstrable in the Golgi apparatus, in cytoplasmic vesicles, and in the luminal surface coat of the gut epithelium. As determined in the adult worms, CAA-positive lysosome-like bodies were only encountered in the most caudal quarter of the gut. In the gut lumen CAA was associated with host white blood cells and with a thick layer of finely granular, moderately electron-dense material covering the gut epithelium. The esophagus of these worms did not show CAA reactivity. These results definitely prove that CAA is a gut-specific antigen produced by various life cycle stages of S. mansoni, from the cercarial stage on. PMID- 3518507 TI - Identification of Brugia malayi in vectors with a species-specific DNA probe. AB - We evaluated the potential value of a cloned sequence of genomic DNA of Brugia malayi as a species-specific probe. Clone pBm 15 reacted with all stages of 8 different geographic isolates of B. malayi and cross-hybridized with microfilariae of B. timori. It did not hybridize with Wuchereria bancrofti or with B. pahangi, W. kalimantani, Dirofilaria repens, Breinlia booliati or Cardiofilaria species, animal filariids that can be sympatric with B. malayi. P32 labeled clone pBm 15 correctly identified mosquitoes infected even with 1 infective larva of B. malayi. This specific DNA probe should be an invaluable tool to monitor control programs of Brugian filariasis. PMID- 3518508 TI - Detection of circulating parasite antigen in bancroftian filariasis by counterimmunoelectrophoresis. AB - We used counterimmunoelectrophoresis (CIEP) with rabbit antibodies to Dirofilaria immitis and Brugia malayi to detect soluble filarial antigen in sera collected in a Wuchereria bancrofti-endemic area in South India. Filarial antigen was detected in 38 of 38 sera from microfilaremic patients, 3 of 48 sera from amicrofilaremic patients with lymphatic pathology, and 3 of 5 sera from former microfilaria carriers with negative blood examinations 6 months or more after diethylcarbamazine therapy. One of 32 endemic control sera, 0 of 35 nonendemic sera, and 0 of 20 B. malayi sera were positive. Antigenemia was equally detectable in sera collected at night or during the day (when microfilariae are absent from the blood). Parasite antigen was also detected in the urine of patients with positive serum tests. Antibodies to circulating filarial antigen (also detected by CIEP) were absent in all but 2 antigen-positive sera but present in 22 of 45 antigen-negative sera from clinical filariasis patients and in 9 of 31 antigen-negative sera from endemic controls. Parasite antigen detection by CIEP appears to be a sensitive, specific, and practical diagnostic test for active W. bancrofti infection. PMID- 3518509 TI - Evaluation of the origin of Mycobacterium leprae infections in the wild armadillo, Dasypus novemcinctus. AB - An enzyme-linked immunosorbent assay (ELISA) using the phenolic glycolipid-1 (PGL 1) antigen of Mycobacterium leprae and cross-reactive antisera specific for human IgM was developed to detect IgM antibodies to M. leprae in the nine-banded armadillo (Dasypus novemcinctus). Statistical definitions for positive and negative interpretations in the ELISA were developed by screening animals recently captured and experimentally inoculated with M. leprae. The ELISA was shown to have high sensitivity and specificity. Modern day armadillos of central Louisiana were observed to have a PGL-1 antibody prevalence rate as high as 20%, and a clinical disease rate as high as 5%. A retrospective serological survey of 182 armadillos taken in the years 1960-1964 and predating the use of armadillos in leprosy research was used to evaluate the 1968 environmental contamination hypothesis for the origin of M. leprae infections in the wild armadillo. Antibodies to the apparently species-specific PGL-1 antigen were detected in 17 of the samples taken in 1960-1964. Absorption with whole M. leprae, M. intracellulare, M. terrae, M. rhodesiae, M. scrofulaceum, M. diernhoferi, M. kansasii, M. phlei, M. avium, BCG, and 2 new armadillo-derived mycobacterial species showed these antibody reactions to be specific for PGL-1. Apparently, M. leprae was enzootic in armadillos as early as 1961, and original infection of these animals could not have occurred in 1968. PMID- 3518510 TI - Dengue in Greece in 1927 and 1928 and the pathogenesis of dengue hemorrhagic fever: new data and a different conclusion. AB - A massive outbreak of dengue, with a high incidence of hemorrhagic manifestations and a high death rate, occurred in Athens and neighboring areas of Greece in 1927 and 1928. For many years it was believed that the episode had been caused by dengue type 1 virus. Recently, it was claimed that dengue type 2 virus also was present in Athens in 1928, and this report is cited in support of the hypotheses that dengue hemorrhagic fever is almost always the result of sequential infection with different dengue serotypes and that infection with dengue type 2 following dengue type 1 is particularly pathogenic. In the present study of 258 Greek residents born from 1914 to 1938, it was also found that dengue type 2 had occurred in Greece--but after 1928. No evidence was found that that virus had occurred in the country during, or within 13 years before, the 1927-1928 epidemic. PMID- 3518511 TI - Surgical management of multiple intestinal atresias. AB - The unusual problem of multiple intestinal atresias associated with jejunal atresia has been reviewed and seven cases have been summarized. Maintaining maximal bowel length without jeopardizing the patient is of utmost importance. The shish kebob technique has been illustrated in a patient with 15 obstructions. The other cases include one patient with the apple peel deformity and two with atresias associated with gastroschisis. Although these children are small in general, they are bright and otherwise healthy. The 90 percent mortality reported previously has been reversed by a combination of techniques and lessons learned from the leaders in pediatric surgery. PMID- 3518512 TI - Improved survival rates of patients with acral lentiginous melanoma treated with hyperthermic isolation perfusion, wide excision, and regional lymphadenectomy. AB - Twenty-three patients with extremity malignant melanoma who fit the clinical and pathologic criteria for acral lentiginous melanoma were treated in a prospective, nonrandomized trial of wide local excision, regional lymphadenectomy, and hyperthermic isolation perfusion. There were 17 patients (73.9 percent) pathologically judged to be in stage I and 6 (26.1 percent) in stage II. Three patients entered the study with regional recurrence. Delay in diagnosis of the lesions averaged almost 3 1/2 years. Increasing awareness about the occurrence of acral lentiginous melanoma may result in earlier diagnosis, increased survival rates, and cure. Life table survival analysis revealed 5 and 10 year survival rates of 75 percent and 58 percent, respectively. This supports the findings of Krementz et al and suggests not only that a marked improvement in survival can be achieved through the use of hyperthermic isolation perfusion, but that the survival of patients with acral lentiginous melanoma is comparable with that of patients with other extremity malignant melanomas treated with aggressive multimodality therapy. PMID- 3518513 TI - Carotid endarterectomy after Doppler ultrasonographic examination without angiography. AB - We prospectively reviewed our experience with 32 carotid endarterectomies in 30 patients performed without angiography in a 7 year period. Although this represents 6.7 percent of our total experience with carotid endarterectomy in this period, carotid endarterectomy without angiography is increasing and comprises 17 percent of the last 2 years' total. We have adhered to strict criteria for patient selection that identifies circumstances for a safe operative experience in seven broad categories. Evidence is also presented to reduce an overriding concern for intracranial aneurysms and siphon stenosis if either one exists unrecognized. We are hopeful that in the future, the latter will be identified by intracranial Doppler studies currently being performed. Our experience in this small series has been favorable, with intraoperatively measured lesions equal to the preoperative noninvasive predictions. We suggest that Doppler ultrasonography in its current form can be effectively used in place of conventional angiography or digital subtraction angiography in selected patients. PMID- 3518514 TI - Extraperitoneal approach for aortoiliac reconstruction of the abdominal aorta. AB - The extraperitoneal approach is not usually used for reconstruction of the abdominal aorta; however, herein we have made an attempt to influence vascular surgeons to modify this practice. The results in 200 patients approached extraperitoneally have been compared with those of 70 patients explored by the traditional transperitoneal route. The expeditious technique of extraperitoneal exploration described results in significantly less postoperative morbidity due to the pulmonary complications of atelectasis and pneumonia. Intestinal ileus is uniformly brief, and rarely requires nasogastric suction. Patients explored extraperitoneally have demonstrably less pain and were discharged from the hospital sooner. Furthermore, prosthetic graft patency and mortality were comparable in both groups. Thus, the retroperitoneal approach should be the preferred method of aortoiliac reconstruction since the postoperative convalescence period is smoother and shorter. PMID- 3518515 TI - John Hunter, Esq, FRCS (1728-1793). PMID- 3518516 TI - Ultrasound of the breast. What are the indications? PMID- 3518517 TI - Medicine show tonight. PMID- 3518518 TI - The "Spanish Lady" in Alabama. PMID- 3518519 TI - Medical discovery. The problem of uniqueness. PMID- 3518521 TI - Immunoperoxidase techniques. I. Facts and artifacts. PMID- 3518520 TI - Cranial ultrasound in the detection of postmeningitic complications in the neonates. AB - Serial cranial ultrasound examinations were performed through the anterior fontanel to detect and follow the complications of bacterial meningitis in 16 neonates. The final results included normal findings in 9 patients, and abnormal in the other 7 cases. Among the latter, 5 patients with hydrocephalus were sequentially found after the second week of the disease and the earlier the onset, the larger the ventricular dilation. One ventriculitis showed polycystic loculi with abnormal septa in the advanced stage. Cystic low attenuation lesion with mass effect at a later stage of meningitis specified one patient with brain abscess. Progressive dilatation of ventricular systems without associated growth of head girth disclosed a process of brain atrophy. They had neither obvious neurological signs nor specific CSF findings clinically, but their sonograms showed the abnormal changes which were finally proved by CT scans. The potential value of cranial ultrasound in the detection of post-meningitic complication besides CT scan is stressed. PMID- 3518522 TI - Expression of a cell-cycle-associated nuclear antigen (Ki-67) in cutaneous lymphoid infiltrates. AB - Cryostat sections of skin biopsies from 83 patients with benign or malignant cutaneous lymphoid infiltrates were examined immunohistologically for reactivity with Ki-67 (a monoclonal antibody recognizing a nuclear antigen expressed by cycling cells) using the APAAP immunoalkaline phosphatase labeling method and a double immunoperoxidase/alkaline phosphatase staining technique. Ki-67-positive neoplastic lymphocytes were plentiful in all large-cell lymphoma cases and in one third of the small-cell lymphomas. Some benign disorders (patch test biopsies, cutaneous lymphocytoma, lichen planus) also contained many Ki-67-positive lymphocytes. These data indicate the value of using Ki-67 to assess the proliferative capacities of the lymphoid cells in cutaneous infiltrates. Use of this technique in the future may have important prognostic and therapeutic implications in the management of cutaneous lymphoid malignancies. PMID- 3518523 TI - Papillary eccrine adenoma. A tubulopapillary hidradenoma with eccrine differentiation. AB - A slow-growing tumor on the dorsum of the right foot of a 25-year-old female had features that corresponded to papillary eccrine adenoma. The grouping of this entity under the term "tubular apocrine adenoma" in a recent edition of a textbook led to further study of this case in the form of enzyme histochemistry and electron microscopy. The tumor was positive for amylophosphorylase and negative for acid phosphatase, and on electron microscopy showed complex intercellular membrane interdigitation and a possible intercellular canaliculus. No features of apocrine differentiation were found, and we feel that this tumor is distinctly eccrine in its differentiation. The similarity of these two ostensibly separate entities, and the opinion of some authors that intermediate differentiation may be possible in adnexal tumors, would favor them being grouped under the single term of "tubulopapillary hidradenoma," with apocrine or eccrine differentiation as the case may be. PMID- 3518524 TI - The man behind the eponym. Jean Louis Brocq (1856-1928). PMID- 3518525 TI - The man behind the eponym. Remembering Heinrich Auspitz. PMID- 3518526 TI - A double-blind, multicenter immunotherapy trial in children, using a purified and standardized Cladosporium herbarum preparation. I. Clinical results. AB - A double-blind histamine placebo controlled immunotherapy trial was performed to investigate the clinical effect of a purified and standardized Cladosporium herbarum allergen preparation. Thirty children with a clinical history suggesting mould-induced asthma and/or rhinoconjunctivitis were included. The diagnosis was confirmed by positive skin prick test and Phadebas RAST as well as positive bronchial and/or conjunctival provocation test to Cladosporium herbarum. Immunotherapy was given for 10 months in a double-blind manner to randomized groups with either Pharmalgen/Cladosporium herbarum preparation or histamine placebo. Allergic side effects to injections were common, especially during the peak of the mould season (July-September in Scandinavia). In the active group, 13/16 patients experienced general reactions during the first 10 months of treatment. After 6 months of treatment, eye, nose and bronchial symptom scores and peak expiratory flow rates were similar for the groups, maybe because most of the children were also sensitive to many other allergens, including Alternaria alternata. However, medication scores were significantly lower in the treated group (P less than 0.01). Bronchial (P less than 0.01) and conjunctival sensitivity (P = 0.01) were significantly reduced in the Cladosporium-treated group but not in the placebo group after 10 months of treatment. This is the first double-blind clinical trial showing the clinical efficacy of immunotherapy in children with mould-induced asthma. PMID- 3518527 TI - A double-blind, multicenter immunotherapy trial in children, using a purified and standardized Cladosporium herbarum preparation. II. In vitro results. AB - This double-blind immunotherapy trial in children, using a purified and standardized Cladosporium herbarum allergen preparation, has shown that children with mould asthma and/or rhinoconjunctivitis, responded to immunotherapy with a decrease in specific IgE and a significant increase in specific IgG. There was a marked increase in the ratio specific IgG/specific IgE as a result of active treatment. IgE-CRIE radiostaining patterns showed no pronounced changes after 10 months' active treatment and no "new sensitivities" could be detected in the studied patients. IgG-CRIE radiostaining, primarily directed towards the important allergens, was significantly increased in the active group and particularly towards Ag-12 (partially identical to a previously described major allergen in Cladosporium herbarum, Ag-54). Children treated with histamine placebo showed no change in antibody patterns during 10 months of treatment. PMID- 3518528 TI - Comparison of enprofylline and theophylline for intravenous treatment of acute asthma. AB - Thirty-nine patients with asthma requiring acute treatment were included in a randomized, double-blind, parallel study which compared the effect of enprofylline (1.0 mg/kg) and theophylline (3.0 mg/kg). The drugs were given intravenously over a period of 10 min. Peak flow (PEF), heart rate and plasma concentrations of the drugs were determined before and after the injection. Both enprofylline and theophylline significantly increased the PEF 30 min after the injection, the mean increases over the baseline values being 21% and 23%, respectively. The clinical effects assessed by the patient and the physician and the significant decreases in heart rate were similar for the two drugs. Side effects were rare. Thus, 1.0 mg/kg of enprofylline was comparable to 3.0 mg/kg of theophylline in the treatment of patients with acute asthma. PMID- 3518529 TI - Immunotherapy with yellow jacket venom. A comparative study including three different extracts, one adsorbed to aluminium hydroxide and two unmodified. AB - Thirty-two patients with previous systemic allergic reaction to yellow jacket stings were randomly allocated to three groups receiving immunotherapy with different preparations of yellow jacket venom: 1) extract adsorbed to aluminium hydroxide (Alutard-SQ), 2) Pharmalgen extract or 3) non-adsorbed extract from Allergologisk Laboratorium (ALK aq.). Regular examinations showed a decrease in skin prick test size in nearly all patients. Specific IgE-antibody (RAST and CRIE scores) showed a similar, but not significant tendency to decrease in all three groups. Specific IgG-antibody increased considerably in the Alutard group only; after 2 years, however, no difference could be detected between the three groups. During dose increase, patients treated with ALK aq. generally had smaller local reactions to injections than those treated with Pharmalgen. Few systemic reactions occurred in all three groups. Nineteen patients treated for 2 1/2-3 1/2 years were challenged in-hospital with stings from yellow jackets. No systemic and only minor local reactions occurred. Consequently, with the dose regimens applied all three extracts seem effective even though no common changes in either specific IgE or IgG could be demonstrated. PMID- 3518530 TI - [Microscopic innervation of the respiratory nasal mucosa]. PMID- 3518531 TI - [Complication and survival in reconstructive surgery of the head and neck]. PMID- 3518532 TI - Atracurium infusions in patients with renal failure on an ITU. AB - An infusion of atracurium was used (after an initial bolus dose) in five patients with renal and respiratory failure, who were being subjected to intermittent positive pressure ventilation before renal dialysis. Neuromuscular function was monitored by the train-of-four pattern of stimulation. In three patients, atracurium 0.6-0.7 mg/kg/hour completely abolished the twitch response; in the other two (both of whom were markedly oedematous) this did not occur, even with a dose of 1.0 mg/kg/hour, although satisfactory clinical control was obtained. In all patients, there was rapid spontaneous recovery when the infusion was stopped. One patient convulsed, but plasma laudanosine levels taken at this time were below the toxic range. Atracurium infusions appear to provide easily controllable neuromuscular blockade in the intensive therapy unit, although these preliminary results suggest that larger doses may be required in the oedematous patient. PMID- 3518533 TI - Multiple complications after internal jugular vein catheterisation. AB - We report a case of a young female who developed multiple life threatening complications after a single internal jugular vein catheterisation. They consisted of pleural misplacement of the catheter, massive haemorrhage with cardiovascular collapse following catheter removal, and development of arteriovenous fistula, diagnosed 18 months later. PMID- 3518534 TI - Purification of heparin-binding growth factors. PMID- 3518535 TI - Bioluminescent immunosorbent for rapid immunoassays. AB - We describe a bioluminescent immunoassay procedure which does not require a separation step to remove excess free label. A luminescent immunosorbent constituted of bacterial luciferase, FMN oxidoreductase, and an antibody coimmobilized on Sepharose is used to determine specifically the label enzyme (glucose-6-phosphate dehydrogenase, coupled to an antigen) bound by a specific antibody. The immunosorbent confines the bioluminescent reaction in a small volume, and the bound label produces NADH, which is directly used by the nearby luciferase FMN oxidoreductase enzyme system. On the contrary NADH produced by dehydrogenases in solution is directly oxidized without emitting light. Dehydrogenases contained in the biological sample do not interfere with the assay, which can be performed directly on 25 microliter of serum. In this paper we describe the general procedure and we analyze the different parameters that must be optimized. PMID- 3518536 TI - Bioluminescent immunoassays of progesterone: a comparative study of three different procedures. AB - Three bioluminescent immunoassay procedures for the determination of serum progesterone are compared. The sensitivity of the three procedures is similar to the sensitivity of radioimmunoassay (10 pg per tube). The use of a bioluminescent immunosorbent is particularly attractive since it has the simpler protocol. No separation step is required to remove the excess of free label (glucose-6 phosphate dehydrogenase coupled to progesterone). The free enzyme activity is not determined since the bioluminescent reaction occurs in the immunosorbent. The intensity of the signal is greater than with other procedures, and biological components contained in ethyl ether extract do not affect the quality of the assay. A good correlation with a radioimmunoassay using tritiated progesterone is obtained (r2 = 0.96) and coefficients of variation of bioluminescent assays are similar (4 to 12%) to those obtained with commercial radioimmunoassays. PMID- 3518537 TI - [Schummer's plastoid corrosion procedure in scanning electron microscopy of blood vessel systems]. AB - In 1951 Plastoid was introduced into the anatomical reconstruction technique of vascular system by Schummer. Now the present study shows Plastoid as a casting material even for scanning electron microscope-technique superior to other resins used for this purpose. Its special benefit is well-founded in intensive temperature stability, variable polymerization time, changeable viscosity and last not least in his low priced application-mode. Plastoid corrosion-casting models exhibit endothel nuclear impressions and cell borders, smooth muscle layers ("Plastic-Strips") (Castenholz et al. 1982) and inner elastic elements of blood vessels in scanning electron microscopy. PMID- 3518539 TI - Cryopreservation of human fetal organs. AB - The effects of low temperature preservation on morphology, viability and differentiation capacity of different human fetal organs were studied using transmission (TEM) and scanning (SEM) electron microscopy, in vitro cultivation as well as xenogeneic transplantation. For this purpose fragments of lung, kidney, small intestine, thyroid, brain, liver and spleen from 10 human fetuses (aged 9 to 14 weeks of gestation) were frozen by a three step cooling procedure. After 3 to 12 months the specimens were thawed rapidly and processed for TEM and/or in vitro cultivation and/or transplantation into nude mice. TEM studies on frozen lung, kidney and intestine revealed generally a well preserved ultrastructure whereas liver and spleen fragments appeared highly necrotic. From three fetuses, frozen intestine and lung specimens were used for the establishment of monolayer cultures. Following trypsinization, both epithelial and mesenchymal cells formed a continuous layer on the bottom of plastic bottles. During further subpassages the number of epithelial cells decreased resulting in the formation of pure fibroblast cultures. Frozen brain tissue from one fetus was also successfully cultivated forming cell clusters and fiber bundles of variable size at the surface of glass cover slips. Following subcutaneous implantation into nude mice, the vast majority of fragments from lung, kidney, intestine and thyroid was found to grow in the recipients. The growth of xenografts was accompanied by persistence (kidney, intestine) or even increase (lung, thyroid) in cellular differentiation studied by TEM or autoradiography. Transplanted liver and spleen fragments, however, regularly regressed forming solid scars in the subcutaneous tissue of nude mice.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3518540 TI - Cell shape and cytoskeletal organization of the endothelial cells of the semilunar heart valves in the developing chick. AB - The composition and arrangement of the cytoskeletal elements of the endothelium of the semilunar valves have been studied in the embryonic chick heart during the stages 30 to 38. Microtubules, vimentin intermediate filaments and actin microfilaments were constant components of the valvular endothelial cells in the studied stages. Scanning electron microscopy after Triton-X-100 extraction revealed significant differences in the tridimensional arrangement of the cytoskeleton in the course of valve development. In the ventricular face of the cusps the cytoskeletal elements displayed a progressive longitudinal alignment, while in the arterial face of the cusps the cytoskeleton maintained the appearance of a network. Transmission electron microscopy revealed that these differences were especially prominent for vimentin intermediate filaments, although a similar tendency was also observed for microtubules. Microfilaments were scarce in the endothelial cells of both faces of the cusps, and the stress fibers typical of the endothelial cells of the adult valves were not observed in the embryonic material. The significance of these results in valve morphogenesis and histogenesis and a possible linkage with differences in the local characteristics of the blood flow are discussed. PMID- 3518541 TI - An ultrastructural study of the papillary layer and its vascular bed in the kitten enamel organ. AB - Ultrastructure and three-dimensional architecture of the papillary layer and associated capillaries in the enamel organ of 2-3-month-old kittens were examined by means of routine thin sections, freeze-fracture, and scanning electron microscopy of the tissues digested by HCl-collagenase and of vascular corrosion casts. Outwardly, the papillary layer formed gently sloping upheavals, but did not show prominent papillary ridges. The papillary cells were characterized by a high concentration of intramembranous particles on the plasma membrane P-face, by numerous hemi-annular gap junctions between the cell process of one papillary cell and the cell body of another host cell, and by annular gap junctional vesicles in the subsurface cytoplasm. Some annular gap junctions appeared partially degenerated. These findings led us to speculate that these annular gap junctions are produced by the endocytosis of gap junctional membranes from the cell surface into the subsurface cytoplasm. Capillaries were distributed on the enamel organ within shallow furrows between the papillary upheavals. A part of these capillaries penetrated deeply into the enamel organ but did not contact the ameloblasts. The endothelial walls of the capillaries were pierced with many endothelial fenestrations, especially when facing the papillary layer. The endothelial cell also contained numerous micropinocytotic vesicles throughout its entire cytoplasm. These findings suggest that the papillary cells and associated capillaries are highly specialized for transport of solutes and molecules between the vascular region and the enamel organ during the phase of enamel maturation. PMID- 3518542 TI - Peritubular myoid cells of human and rat testis are smooth muscle cells that contain desmin-type intermediate filaments. AB - We studied the cytoskeletal composition of human and rat testicular myoid cells by using immunofluorescence microscopy with polyclonal and monoclonal antibodies. In adult human and rat testis, the peritubular myoid cell layer was brightly positive for desmin, the muscle type of intermediate filament protein, and a faint reaction was also seen with antibodies to vimentin, the intermediate filament protein of fibroblasts and diverse other mesenchymal cells. The desmin positive myoid cell layer could already be identified in newborn rat testis but was more compact in appearance 23 days after birth. Both squash preparations and cultured cells from adult rat seminiferous tubules revealed distinct cell populations positive for desmin. The adult myoid cells of both species also showed a strong reaction with antibodies to myosin and p230, a nonerythroid avian alpha-spectrin analogue. The immunostaining results could be confirmed by the western blotting technique: Experiments with isolated seminiferous tubules showed a specific reaction with a 55,000-dalton and a 58,000-dalton polypeptide when desmin and vimentin antibodies were used, respectively. The present results show that the peritubular myoid cells are genuine smooth muscle cells with desmin-type intermediate filament cytoskeleton and suggest that these cells can be identified by this feature before their ultrastructural maturation. PMID- 3518538 TI - The primitive streak. AB - The emphasis of this review is on the primitive streak of the chick embryo, collated with such information as is available on the mouse embryo. Little modern work has been published on any reptile primitive streak. The following topics are considered: evolutionary significance; formation of the primitive streak; ingression and de-epithelialisation; the basal lamina; migration from the primitive streak of the endoderm and mesoderm; the role of the extracellular matrix; changes in cell adhesiveness; regression of the primitive streak and its role in body patterning; the primitive streak and induction. PMID- 3518543 TI - Light and electron microscope demonstration of VIP- and enkephalin-immunoreactive nerves in the human male genitourinary tract. AB - Vasoactive intestinal polypeptide (VIP) and enkephalins were demonstrated in the nerves of the human male urogenital tract by light and electron microscope immunohistochemical techniques. Nerves containing immunoreactivity to VIP were more numerous than enkephalin-immunoreactive nerves. Both VIP- and enkephalin immunoreactive nerves were detected in the vas deferens, prostate, seminal vesicles, and urinary bladder. In the kidney, testis, and epididymis no immunoreactive nerves could be demonstrated. By electron microscope both types of immunoreactivities were localized to the large granular vesicles of nerve terminals. VIP-immunoreactive nerves were mostly found subepithelially, whereas enkephalin-immunoreactive nerves were mainly related to smooth muscle cells. The possible functions of these peptide-containing nerves are discussed. PMID- 3518544 TI - The effect of high frequency positive pressure ventilation on right and left ventricular function. PMID- 3518545 TI - [Evaluation of tobacco-related main artery vasoconstriction by a new index of the Doppler wave]. PMID- 3518546 TI - Transcutaneous flow measurements in in-situ bypasses: an assessment of duplex scanning. AB - Measurement of laminar flow using an ultrasound scanner was shown to have a high degree of correlation with quantified timed flows (r = 0.98, p less than or equal to .001). Sixty-one in-situ bypasses had flow assessed both proximally and distally. Mean fistula flow (proximal-distal flows) for time periods 1-8 weeks, 3 to 8, and 9+ months were 108, 85, and 16mls respectively. Distal bypass flow remained constant despite a significant decrease in fistula flow between the later time periods (p less than or equal to .001) (unpaired t-test). There was no evidence from the study that proximal flow through fistulas of varying resistances adversely affected the distal bypass flow. PMID- 3518547 TI - Naftidrofuryl in chronic arterial disease. Results of a six month controlled multicenter study using Naftidrofuryl tablets 200 mg. AB - The study was carried out on patients with intermittent claudication (Fontaine's stage II). The arterial and atheromatous origin of the disease was confirmed and localized by angiography or Doppler velocimetry examination. One hundred eighty six patients were selected initially. Their pain-free walking distance on a treadmill (at a speed of 3 km/hour and an inclination of 10%) had to be 150-300 m. During the first month all patients received 3 placebo tablets daily. At the end of this run-in period (D-30; D 0) and after checking walking distance stability (allowed variation: +/- 20% between the two measurements) the patients were included in the study. One hundred fifty-four patients were selected and 118 remained during the whole study. The study was designed as a double-blind, using two parallel randomly selected groups. Sixty-four patients received for six months Naftidrofuryl (3 X 200 mg tablets daily with meals); 54 patients received placebo under the same conditions. During this period, clinical and paraclinical examinations were carried out every quarter (D 90 and D 180). After checking the initial homogeneity of the Naftidrofuryl and placebo-groups, the comparison between groups indicates a significant improvement in Naftidrofuryl group after 3 and 6 months of treatment. At the end of the study the observed differences in walking distance with Naftidrofuryl are approximately twice the difference in the reference group (D 90: p less than 0.05; D 180: p less than 0.02). The results of this study indicate that Naftidrofuryl is an efficient pharmacological tool for treatment of patients with chronic arterial disease (Fontaine's stage II). PMID- 3518548 TI - Platelet hyperaggregability, blood prostacyclin and dipyridamole. AB - This study demonstrates the presence of PGI2 in blood and its influence on platelet retention tests, possibly by the intermediate of a releasing system in the columns, which is followed by a proximate recuperation on the erythrocyte sites after the passage. The presence of prostacyclin on the erythrocyte sites seems to depend upon the red cell deformability in relation to the good condition of their erythrocyte ATP reserve. The load of the erythrocyte sites increases with the daily dose of dipyridamole. The maximum load of the sites appears to be reached with a daily dose of dipyridamole 450 mg. Approximately 10% of the atherosclerosis patients who have been treated by dipyridamole keep their platelet hyperaggregability and their abnormally lowered prostacyclin level. PMID- 3518549 TI - Lichenoid eruption due to hydrochlorothiazide. Diagnostic aid of macrophage migration inhibition factor (MIF) test. AB - The case of a lichenoid photosensitive eruption induced by hydrochlorothiazide is described. The macrophage migration inhibition factor test identified hydrochlorothiazide as the offending drug out of the several suspected drugs taken by the patient. It is suggested that an allergic reaction towards hydrochlorothiazide was involved in the development of the photosensitive lichenoid eruption in this case. PMID- 3518550 TI - [Rational posology and drug dosage]. AB - Serum level monitoring of drugs allows an optimal drug therapy, because it can take into account individual pharmacokinetic (and metabolic) variations. Some special conditions in drugs and in patients are highly suggestive of drug monitoring. These include mainly physiological but also pharmacological situations and apply to drugs with low therapeutic indices. However, for some drugs, highly bound to proteins or to blood cells, another more specific measurements will take in the future the place of serum level monitoring. PMID- 3518551 TI - [Effect of androgens on erythroid stem cells in culture]. PMID- 3518552 TI - [Epidural anesthesia during labor: comparison of 3 combinations of fentanyl bupivacaine and bupivacaine alone]. AB - The association of bupivacaine and fentanyl appeared as the best method of inducing satisfactory obstetrical analgesia. But the various techniques of drug administration had to be detailed; this justified the present work, a single blind controlled trial performed on 159 primipara women at term (except one of them), randomized in four groups, after informed consent. In each group, the number of patients, the age and the degree of uterine dilatation at the beginning of the epidural anaesthesia were comparable. Epidural anaesthesia aimed to improve the maternal comfort during labour. After a first epidural injection of 10 ml, several other injections of 6 ml were carried out according to four different protocols (I, II, III, IV), with different concentrations of fentanyl (respectively 0, 0.05, 0.1 and 0.15 mg). The mean total dosages of fentanyl were statistically higher in the protocols III and IV. The foetal cardiac rhythm and uterine contractions were monitored continuously as well as maternal blood pressure and heart beats during labour. The following parameters were assessed: contraction pain intensity (five point scale), the onset of analgesia, the duration of analgesia, the length of labour, the interval between the first drug injection and subsequent injections, the type of delivery. In the newborn, Apgar score was assessed at 1, 5 and 10 min after delivery. The degree of analgesia was statistically improved in the groups receiving fentanyl, without any differences between them. On the other hand, the length of labour was shorter with protocol II (lowest concentration of fentanyl).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3518553 TI - [Anesthesia and immune defenses]. PMID- 3518554 TI - Annotated bibliography of trauma care systems categorization and regionalization. PMID- 3518555 TI - Child sexual abuse: the emergency department response. AB - Each child who presents with a suspicion of sexual abuse must have immediate access to a complete medical evaluation performed by a competent and knowledgeable examiner. This evaluation should include, at a minimum, a history, a complete physical examination with a detailed genital examination, treatment of identified medical problems, and collection of evidence. It is not appropriate to perform a cursory examination simply because there was a time delay between the abuse and the examination or because the history is suspect. Each sexual abuse workup must be medically and forensically complete. In addition, each child presenting with suggestive complaints should have sexual abuse strongly considered in the differential diagnosis. A report to the appropriate social and legal agencies is indicated even if the suspicion cannot be confirmed. If sexually abused children are to be examined in hospital emergency departments, a protocol should be developed to ensure rapid, thorough, uniform, and caring evaluation. With planning, preparation, and education, most current inadequacies in the emergency medical assessment of sexually abused children can be resolved so that child victims receive sensitive and comprehensive medical care. PMID- 3518556 TI - Effects of the calcium channel blocker, verapamil, on asthmatic airway responses to muscarinic, histaminergic, and allergenic stimuli. AB - The effect of calcium channel blocking agents on bronchomotor tone and airway responsiveness to inhaled provocative stimuli remains controversial. In this study we examined the effects of verapamil (a papaverine derivative) on baseline airway function as well as the response to methacholine, histamine, and ragweed allergen. Verapamil was chosen because of its aqueous solubility and hence suitability for aerosol administration in higher doses than previously given. The effects of 5 mg and 12.5 mg aerosolized verapamil doses were compared with placebo as separate parts of the same study in subjects with ragweed-allergic asthma. Neither dose of verapamil was found to produce bronchodilatation within 30 min after aerosol administration. At the 12.5 mg dose, however, we observed mild to moderate bronchospasm occurring within 5 min of administration, with a return toward baseline within 30 to 40 min. This bronchoconstrictor effect was unrelated to the low osmolarity of the drug solution (33 mosmol/L). Responses to methacholine, histamine, and ragweed allergen were unaltered by drug pretreatment at the 5-mg dose. At the 12.5-mg dose, however, we found significant inhibition of methacholine responsiveness but no effect on histamine or allergen responses. From these studies we conclude that verapamil can influence airway function by modulating agonist-induced bronchoconstriction. The selectivity of this inhibitory effect on muscarinic responses alone, however, leaves questionable the importance of this activity with regard to its clinical implications. PMID- 3518557 TI - Factors that contribute to inhibition of methacholine-induced bronchoconstriction. AB - To evaluate the factors that contribute to inhibition of airways reactivity, we compared the effect of inhaled isoproterenol, 125 micrograms, on the response to methacholine-induced bronchoconstriction in 10 normal and 10 asthmatic subjects. We measured in each subject baseline lung function, response to inhaled bronchodilator, dose of bronchodilator causing 50% maximal response, and degree of airways reactivity to inhalation of methacholine before and after isoproterenol. In asthmatics, but not normal subjects, inhalation of isoproterenol led to significant inhibition of methacholine-induced bronchospasm. In asthmatics, the greater the airways reactivity to methacholine the greater the inhibition by isoproterenol (p less than 0.05). In both groups, there was significant correlation between baseline lung function and level of airways reactivity. In neither normal subjects nor asthmatics did the maximal bronchodilator response to isoproterenol inhalation correlate with inhibition of airways reactivity. Studies evaluating inhibition of airways reactivity should take into account the population tested, baseline lung function, and baseline level of airways reactivity. PMID- 3518559 TI - Anatomic abnormalities of cadaver kidneys procured for purposes of transplantation. AB - Over a 7-year period the authors studied the vascular and ureteric anomalies of kidneys procured from brain dead, heart-beating cadavers for the purposes of transplantation. Four hundred donors had a bilateral nephroureterectomy performed using an en-bloc technique, followed by fine anatomical dissection in cold saline slush solution. Thus, 800 kidneys were available for study. Single renal arteries were found in 72 per cent of the kidneys, with multiple arteries occurring in 28 per cent. The renal veins showed a more uniform anatomical pattern and were single in 92 per cent of instances. There were nine ureteral anomalies, all duplications, being just 1 per cent of the total number studied. Sex, race, and blood group of the donor did not significantly influence the number of anomalies seen. In sum, anatomical variants were noted in 197 (49.3%) donors, 69 (17.3%) with bilateral anomalies and 128 (32.0%) with unilateral anomalies. A knowledge of these anatomical variants will allow surgeons responsible for organ procurement to proceed with caution and so prevent wastage of cadaver kidneys due to technical misadventures. PMID- 3518558 TI - Tracing the leukocyte marker protein in lung fluids and lung-draining lymph nodes during endotoxemia in sheep. AB - Infusion of Escherichia coli endotoxin into sheep produces a form of acute lung injury that resembles the adult respiratory distress syndrome (ARDS). A large portion of the physiologic derangements produced by E. coli endotoxin in this model is thought to be granulocyte-dependent. We measured the level of L1, a granulocyte and monocyte marker protein, in various tissues and fluids after infusion of E. coli endotoxin into sheep. In an acute study, sheep received saline or 1.25 microgram/kg E. coli endotoxin dissolved in saline, or endotoxin after hydroxyurea-induced granulocytopenia. L1 was measured by radioimmunoassay in efferent lymph from the caudal mediastinal lymph node collected between 5 and 6 h after infusion. In addition, L1 was visualized in both lung-draining and extrapulmonary lymph nodes by indirect immunofluorescence. In a chronic study, sheep were prepared with lung lymph fistulas, and L1 was measured in draining pulmonary lymph, plasma, and bronchoalveolar lavage (BAL) fluid, serially, over a 24-h period after infusion. Mean L1 level in pulmonary lymph in the acute study was 6 times higher by absolute concentration, and 19 times higher when lymph flow rates were taken into account, in the sheep that received endotoxin than in saline-infused sheep or endotoxin-infused, granulocytopenic sheep. Fluorescence was greater in the outer cortical region adjacent to subcapsular, afferent sinuses of lung draining-lymph nodes of endotoxin-treated sheep than in the comparable nodes of saline-infused sheep and endotoxin-infused granulocytopenic sheep. In endotoxin-treated sheep, extrapulmonary lymph nodes were less reactive than lung-draining nodes.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3518560 TI - [Botulism in the infant. Presentation of a case]. AB - First case reported in our country with infant botulism is described in a 5 month old infant. Clinical and electrodiagnostic abnormalities are the only relatively specific findings in infant botulism, which were seen in this infant, but it requires isolation of "C. botulinum" for diagnosis confirmation. "C. botulinum" type B spores were identified in stool samples from this infant. It has been described frequently isolation of "C. botulinum" from honey specimens that had been fed to infants who subsequently developed infant botulism. They are now studying honey samples with appropriate methods (MDL-10), obtained from alimentation of this infant. PMID- 3518561 TI - Factors predicting survival in adults with stage I and II large-cell lymphoma treated with primary radiation therapy. AB - The records of 148 consecutive patients with Ann Arbor stage I and II large-cell lymphoma treated with primary radiation therapy with or without adjuvant chemotherapy were analyzed retrospectively for pretreatment prognostic variables and results of treatment. For patients treated with radiation to fields on one side of the diaphragm, the 5 year freedom-from-relapse rate was 25% and the survival rate was 35%, but for those given additional transdiaphragmatic radiation or for those given radiation plus adjuvant chemotherapy, the rates were both approximately 67%. In a multivariate analysis, the only significant pretreatment prognostic variables were the number of sites of involvement and bulk of disease, with relapse as the endpoint. For patients treated with radiation to both sides of the diaphragm or with radiation plus adjuvant chemotherapy, the 5-year freedom-from-relapse rate was 82% for the group with a favorable prognosis (with less than three sites of involvement and a mass size of less than 10 cm) and 55% for those with an unfavorable prognosis. PMID- 3518562 TI - Borrelia burgdorferi in joint fluid in chronic Lyme arthritis. AB - Although indirect evidence suggests that chronic Lyme arthritis is caused by persistent infection with Borrelia burgdorferi, direct visualization has been lacking. We report the demonstration of B. burgdorferi from synovial fluid aspirated from the right knee of a 31-year-old man with Lyme arthritis for more than 1 year. After 6 days, culture medium inoculated with synovial fluid showed one motile and several nonmotile spirochetes. Direct immunofluorescence staining showed reactivity with anti-B. burgdorferi serum. Spirochetes were not seen in subcultured material. The patient's arthritis improved with high-dose intravenous penicillin. Identification of B. burgdorferi from the joint fluid of a patient with long-standing arthritis supports the concept that the arthritis is due to persistent infection. PMID- 3518563 TI - Prevalence of human T-lymphotropic virus type III antibodies among patients in dialysis programs at a university hospital. PMID- 3518566 TI - Searching the medical literature. PMID- 3518565 TI - The spinal tap: a new look at an old test. AB - The spinal tap, or lumbar puncture, has indisputable value; opinions differ, however, on the amount of that value. The procedure has variable utility depending on the clinical indications and the results of tests on the cerebrospinal fluid. Its greatest value is in the evaluation of infectious or malignant meningitis; for most other diseases, it provides additional, but not essential, information. Because of the potential risk of the spinal tap, decisions about when to do the procedure must be made carefully. A probability analysis is provided to elucidate the usefulness of data from cerebrospinal fluid tests. PMID- 3518564 TI - Drug-induced hepatotoxicity. AB - Drug-induced injury to the liver can mimic any form of acute or chronic liver disease. Acute injury to the liver frequently is due to the action of cytochrome P450, which breaks down drugs into electrophiles or free radicals; these reactive metabolites can covalently bind to protein and unsaturated fatty acids or induce lipid peroxidation, respectively. These events may impair vital functions of the cell, such as maintenance of calcium homeostasis, leading to death; or hypothetically they may elicit a hypersensitivity reaction directed mainly at the liver. Glutathione and tocopherol play critical roles in cellular defense. Cholestatic disease caused by drugs results from a selective disturbance in bile secretion. Agents such as estrogens, chlorpromazine, and monohydroxy bile acids alter the chemical and physical properties of membranes, leading to impaired activity of carriers and pumps for bile acids and electrolytes. Certain drugs produce chronic liver disease that is pathologically identical to chronic active hepatitis, biliary cirrhosis, or alcoholic liver disease. PMID- 3518567 TI - [Clinical aspects and treatment of Pneumocystis carinii infections]. PMID- 3518568 TI - [Hypersensitivity vasculitis of drug origin]. PMID- 3518570 TI - Cerebral blood flow and metabolic rate during seizures. Relationship to epileptic brain damage. AB - After long periods of status epilepticus, selective neuronal necrosis is incurred in the neocortex (layer III-IV), in the hippocampus (CA1 and CA4), and in the thalamus (VPL-VPM). In these areas the cerebral metabolic rate for glucose is increased to between 200-300% of control, indicating a correlation between neuronal damage and enhanced neuronal activity. Measurements of local cerebral blood flow indicate that the damage is not due to insufficient supply of oxygen. In most rats with status epilepticus lasting longer than 30 minutes, an infarction develops in the substantia nigra pars reticulata. In this region the metabolic rate is first increased but later during the seizure activity falls to very low values indicating cell necrosis. CONCLUSION: prolonged neuronal hyperactivity with a concomitant increase in the metabolic rate for glucose is a prerequisite for the development of neuronal damage. However, the necrosis of the SNPR demonstrates that other factors determine the vulnerability of neurons to hyperexcitation, e.g., the type of agonist acting on the neuron. PMID- 3518571 TI - Neuropsychological and behavioral sequelae of spontaneous seizures. PMID- 3518572 TI - Neuroendocrine predictors of electroconvulsive therapy outcome. Dexamethasone suppression test and prolactin. PMID- 3518573 TI - Electroconvulsive therapy and lateralized affective systems. AB - The neurophysiological systems subtending generalized seizures (activated by ECT) and temporal-limbic seizures are described as well as the interactions existing between the two seizure systems. There are correlations between schizophrenia and the limbic seizure system on the one hand and the manic-depressive or bipolar syndromes and the generalized seizure system on the other which are theoretically related to the different (although overlapping) neural substrates underlying the two major syndromes of psychosis. Evidence is reviewed that indicates that in ECT responsive depression (with both bilateral and unilateral nondominant ECT) the modus operandi hinges on right-hemispheric neural events. Neurophysiological, neurological, and acoustic threshold evidence is discussed: all of which emphasizes the importance of the nondominant hemisphere in the genesis of endogenous depressions and in their treatment with convulsive therapies. In addition, studies showing that psychotropic agents with specific antidepressant effects produce asymmetric activation of the right hemisphere (EEG) are related to the above issues. PMID- 3518574 TI - Is unilateral electroconvulsive therapy really the treatment of choice in endogenous depression? PMID- 3518575 TI - Electroconvulsive therapy and animal models of depression. PMID- 3518576 TI - [Primary malignant melanoma of the parotid gland: anatomico-clinical study. Apropos of a case and review of the medical literature]. AB - A 62 yo man presented with an enlargement of the parotid gland that had accentuated over the past ten months. Results of a needle aspiration cytology were interpreted as consistent with an adenocarcinoma. A surgical investigation was decided. Frozen and paraffin sections of superficial parotidectomy specimen disclosed a malignant melanoma. This specimen also contained an intraparotid lymph node which was free of tumor. Cervical lymph node dissection yielded 4 metastatic adenopathies among 15 lymph nodes. A retrospective search for an anterior melanocytic lesion was negative. The final diagnosis was primary malignant melanoma of the parotid gland. Cervical radiotherapy was applied. 7 months later, the patient died of diffuse metastatic involvement in the skin, brain, lungs and liver. No local recurrence occurred. Review of the medical literature revealed the rarity of malignant melanomas of the parotid gland (0.68%). No significant differences concerning clinical data and pathological aspects were noted in so called primary malignant melanoma and secondary malignant melanoma of the parotid gland. Nevertheless, primary malignant melanoma of the parotid gland is a controversial entity. Pathogenesis is discussed on the light of modern concepts of diffuse neuro-endocrine system. Prognosis remains poor, due to a late diagnosis and to an inherent aggressiveness of this type of tumor. PMID- 3518577 TI - [Bullae and urticaria-like lesions of allergic vasculitis with immunomarkers of the bullous pemphigoid type during treatment with D-penicillamine]. PMID- 3518579 TI - [Urinary tract malformations diagnosed prenatally: exploratory strategy during the neonatal period]. PMID- 3518578 TI - [Current concepts of high blood pressure in children]. PMID- 3518580 TI - [Hyperechogenicity of the renal medulla in the newborn]. PMID- 3518581 TI - [New antibiotics in urinary infections in children]. PMID- 3518582 TI - [Growth of children with renal insufficiency. The Montpellier experience]. PMID- 3518583 TI - Artificial intelligence and the brain: computational studies of the visual system. PMID- 3518584 TI - Chemo-electrical transduction in insect olfactory receptors. PMID- 3518585 TI - On reaching. PMID- 3518586 TI - Hybridization approaches to the study of neuropeptides. AB - During the course of evolution, species have increased in complexity, and their nervous systems have evolved correspondingly with an increase in the diversity of their capabilities to respond. Part of that diversity has resulted from an increase in cell types and numbers and their interconnections. In addition, much of it comes from the panoply of neurotransmitters available, of which the neuropeptides represent a major portion. The application of the techniques of molecular biology to the nervous system has led to an appreciation of some of the genetic means by which such diversity can be generated. The cloning and sequencing of peptide precursor genes has shown the existence of gene families, genes with duplications of internal sequences, and genes evolutionarily related to one another, suggesting that one response to the increasing complexity of the organism has been a genetic diversification of the precursor population for peptides. As the precursor genes evolved and thereby provided increasing numbers of peptides, the receptor genes may have evolved simultaneously to provide diversification in the responses to these peptides (for example, the opioid peptide precursors) (Comb et al 1983). The precursor sequences obtained have led not only to the predictions of new peptides but also to the discovery of alternative methods of generating diversity from a single gene. At one extreme, the gene is translated into a polyprotein containing several peptides, which are produced in and released from the same cell. At the other extreme, the nuclear transcript of the gene is differentially spliced such that one peptide is expressed in one tissue and another in a different tissue (Calcitonin-CGRP), or one peptide may be expressed with or without a second peptide in different cells (substance P-substance K). The net result is either one neuron producing a multiplicity of responses to several co-released peptides derived from a polyprotein (POMC or PE) or a tissue- or cell-specificity in terms of which peptide is produced and released. Numerous applications have been made utilizing the cDNA probes generated from the cloning of neuropeptide precursors. Hybridization analyses, including in vitro transcription run-off, have demonstrated that the transcription of neuropeptide genes is regulated by transsynaptic activation of transmitter receptors located in the neuronal membrane, or by hormones, or by as yet unveiled mechanisms. Hybridization techniques have allowed assessment of the dynamic state of neuropeptides functioning as neuromodulators.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3518587 TI - Linkage between axonal ensheathment and basal lamina production by Schwann cells. AB - The availability of several methods for the preparation of SCs free of other cell types has allowed recent experimentation providing new insights into the capacity of SCs to synthesize, release, and organize extracellular matrix materials, particularly those of the basal lamina. When these SC populations are combined in tissue culture with pure populations of neurons capable of directing SC function (without fibroblasts), new aspects of interrelationships between these cell types have come to light. In this brief chapter we review the results from this experimental approach during the last decade, and suggest the implications these observations have for interpreting known differences in SC functional expression in various body regions as well as for understanding certain disease processes. Of particular note is the discovery of an apparently essential linkage between the function of the SCs in organizing and relating to basal lamina and their ability to ensheathe and myelinate axons. It now appears that SC functional expression requires an alliance not only with the nerve fiber but also with the ECM through the production and organization of a basal lamina. PMID- 3518588 TI - New perspectives on Alzheimer's disease. AB - Significant progress has been made in refining diagnostic criteria for AD and in developing imaging approaches to exclude treatable disease and to assess some of the metabolic processes occurring in vivo in the brains of individuals with AD. However, as yet, no reliable diagnostic test is available. Although risk factors have been identified, the etiology of AD remains an enigma. The roles of familial, chromosomal, and genetic factors, toxins, and transmissible agents in the pathogenesis of this disease deserve intensive study. A variety of neurotransmitter systems are affected in the disease, and it seems likely that new approaches may identify additional systems at risk. Of particular importance will be studies on surviving neurons, since these cells will be targets for treatment. Neurons in certain parts of the brainstem, basal forebrain, amygdala, hippocampus, and neocortex show several types of cytoskeletal abnormalities, but mechanisms of cytoskeletal disorganization are not well understood, e.g. we do not have a clear idea of the sequence of cytoskeletal pathology, the time course of dysfunction of individual neurons, and consequences of these processes on cell function. In situ hybridization with radiolabeled nucleic acid probes and immunocytochemical approaches should provide information about levels of gene expression, protein compositions, and posttranslational modifications of normal and abnormal proteins in these cells. The relationships and sources of some of the abnormal proteins (e.g. those associated with PHF, 15-nm straight filaments, plaque amyloid, and vascular amyloid) can be clarified by new approaches of protein chemistry (purification and sequencing) and molecular biology (recombinant DNA techniques). Finally, investigations of animal models that recapitulate certain features of AD should provide new insights into the nature, mechanisms, and consequences of cellular pathology of specific systems. These models may be useful for imaging studies similar to those used in human patients and for developing and testing new therapeutic approaches that eventually may be useful for treating this all-too-common disorder of the central nervous system. PMID- 3518589 TI - [Effects of physical training on the denervated human heart after orthotopic cardiac transplantation]. AB - Three patients who had undergone an orthotopic cardiac transplantation followed a course of supervised intermittent physical training (60 to 80 per cent of the maximum load) involving three weekly sessions of thirty minutes, for a period of 150 +/- 80 days. During maximal effort, we observed increases of 50 per cent in the load in watts (0.05 less than p less than 0.1), 40 per cent in oxygen consumption (0.1 less than p less than 0.2), 10 per cent in heart rate (p = 0.5) and 21 per cent in systolic blood pressure (0.7 less than p less than 0.8). The respiratory equivalent for oxygen decreased by 21 per cent (0.025 less than p less than 0.05) and the respiratory quotient by 5 per cent (0.4 less than p less than 0.05). For a given submaximal effort (30 watts) the following decreases were observed: 9 per cent in oxygen consumption (V'O2) (0.1 less than p less than 0.2), 32 per cent in the minute ventilation (V'E) (0.05 less than p less than 0.1), 22 per cent in the respiratory equivalent for oxygen (REO2) (0.025 less than p less than 0.05), 8 per cent in the respiratory quotient (RQ) (0.2 less than p less than 0.3) and 11 per cent in the heart rate (HR) (0.1 less than p less than 0.2). The systolic blood pressure (SBP) increased by 6 per cent (0.2 less than p less than 0.3). No changes were observed in these parameters in the postoperative follow-ups (10 to 24 months) of two patients who did not undergo physical training. Physical training is, therefore, necessary in the process of physical readaptation of patients after orthotopic cardiac grafts. PMID- 3518590 TI - Primary tumours of the small intestine--the diagnostic problem. AB - The records of 43 patients with 32 malignant and 11 benign neoplasms of the small intestine were reviewed in order to improve early diagnosis. The malignant tumours comprised of 14 carcinoids, 10 carcinomas and 8 sarcomas. The benign tumours constituted 7 different histological types. An increasing frequency of malignant tumours through the bowel was found. Thirty-three per cent of all patients had a sudden onset of symptoms leading to acute explorative laparotomy, whereas the remaining 67 per cent were characterized by a long history. The predominant symptoms were abdominal pain, nausea and vomiting, weight loss and a palpable abdominal mass. An exact preoperative diagnosis was made in 41 per cent of the cases. Upper gastrointestinal X-ray contrast examination with small bowel follow through and ultrasonography gave the greatest sensitivity. A diagnostic strategy was difficult to recommend considering the rarity of these tumours and the low sensitivity of the employed diagnostic modalities. Recently developed Japanese enteroscopes capable of exploring the entire small bowel seem to offer the most promising diagnostic method for the future. PMID- 3518591 TI - Sclerotherapy for hydroceles and epididymal cysts with ethanolamine oleate. AB - Seventeen patients with hydroceles or epididymal cysts were treated by tapping and injection with ethanolamine oleate. All 11 patients with hydroceles were cured. Three of six patients with epididymal cysts were cured. There were no cases of haematoma or infection. Sclerotherapy is recommended as primary treatment for all men over 50 years with hydroceles and for selected cases with epididymal cysts. PMID- 3518592 TI - Isolation of Chlamydia trachomatis in Singapore. AB - With the introduction of the culture method for isolating Chlamydia trachomatis in Singapore, several studies have been carried out to define its prevalence in different patient populations. The organism was isolated from a variety of clinical conditions. In certain clinical settings it appears to be even more prevalent than the gonococcus. Over 10% of the prostitutes are carriers, and they are probably the major transmitters. A control programme is needed to reduce the infective reservoir. PMID- 3518593 TI - Osteosarcoma in a 14 month old female child. AB - A case of osteosarcoma in a 14 month old girl is reported. The child presented with a history of difficulty in standing for 2 months and x-rays revealed an osteolytic lesion in the upper third of the femur associated with widening of bone and periosteal reaction. Osteosarcoma was diagnosed by biopsy. Treatment was refused and the child died 13 weeks later. Only one other case of osteosarcoma in a child as young as 14 months has been reported. A review of literature showed 22 cases of osteosarcoma in children aged 5 years or younger. PMID- 3518594 TI - The distribution of subcutaneous and internal fat in man. AB - Total body fat mass was estimated in 25 women and 21 men from densitometry. All subjects were apparently healthy. Subcutaneous fat mass was calculated by measuring subcutaneous fat thickness at 12 sites using A-mode ultrasound. The proportion of fat situated subcutaneously (PFSS) was found to vary considerably between individuals (range 0.50-0.97 in the women, 0.40-0.97 in the men). Moreover, there was no relationship between subcutaneous and internal fat masses. More information is required on the variability of the PFSS, and the technique described may have a role to play in this field. PMID- 3518595 TI - Immunohistochemical analysis of estrogen receptors in cells obtained by fine needle aspiration from human mammary carcinomas. AB - An immunocytochemical assay for the estrogen receptor has been used to analyze the receptor content in tumor cells obtained by fine needle aspiration from human breast carcinomas. The results were compared with receptor determinations on cryostat sections of freshly frozen tumors and by biochemical technique based on radiolabelled ligand binding. The staining intensity and fraction of positive cells were comparable in cryostat sections and tumor cell specimens obtained by fine needle aspiration. Moreover, there was a good correlation between the semiquantitative receptor level estimated by the immunoperoxidase technique and the biochemical assay. These results show that tumor cell specimens obtained by fine needle aspirates can be used for estrogen receptor analysis by the immunocytochemical technique. PMID- 3518596 TI - Hormone stimulation and chemotherapy in advanced prostate cancer: interim analysis of an ongoing randomized trial. AB - We report here in the interim analysis of an ongoing randomized clinical trial designed to test whether androgen priming enhances tumor chemosensitivity in men with stage D prostate cancer refractory to orchiectomy. All patients are continuously treated with aminoglutethimide and hydrocortisone, to lower adrenal androgen secretion, and are given cyclic chemotherapy. Patients in the stimulation arm receive also the synthetic androgen, fluoxymesterone, for 3 days before and on the day of chemotherapy. Of 57 patients entered to date, 41 have received adequate treatment to be evaluable. Response to therapy (objective remissions + stabilizations of disease) occurred in 17 of 18 evaluable patients (94%) randomized to the stimulation arm, and in 16 of 23 evaluable patients (70%) in the control group (p less than 0.025). Duration of response was not significantly different in the two groups (median: 9 months in the stimulation and 12 months in the control arm). With 30% of the total of 57 patients still alive, survival is not significantly different in the stimulation (median: 13 months) and control arm (median: 16 months). As expected, patients who responded to treatment lived significantly longer than those who failed to benefit. Two episodes of reversible spinal cord compression occurred during androgen administration. (The risk of this serious side effect may be reduced by performing a screening myelogram to rule out subclinical spinal metastasis). Our preliminary data suggest that androgen priming may enhance the tumoricidal effect of cytotoxic drugs in advanced prostate cancer. The lack of improvement in duration of response and survival may be explained by the large fraction of hormone-independent cells probably present in patients with tumors refractory to orchiectomy. PMID- 3518597 TI - Sensitization of P388 murine leukemia cells to hydroxyurea cytotoxicity by hydrophobic iron-chelating agents. AB - The potentiation in the cytotoxic effect of antineoplastic agent hydroxyurea (HU) from the non-toxic concentration on P388 murine lymphocytic leukemia cells is observed with the hydrophobic iron-chelating agents, 2,2-bipyridine (bipyridyl) and 1,10-phenanthroline in a concentration and time dependent manner. However EDTA, EGTA, 2,3-dihydroxybenzoic acid (2,3-DBA), Rhodotorulic acid, 8 hydroxyquinoline (8-Hq), catechin and Desferal, and other chelators failed to show sensitization of these tumor cells towards HU. The potentiation in the cytotoxic activity of HU in combination with the bipyridyl was found to be reversible but was maintained when the drug exposed cells were washed and retreated with the non-toxic concentrations of HU or bipyridyl. The presence of Fe++ blocked completely the cytotoxic action of HU alone and a combination with iron-chelator, and partially reversed the inhibition induced by HU and bipyridyl. These findings suggest that the hydrophobic iron-chelators affect the membrane mediated transfer, localisation and transient intracellular chelatable iron pools. As a consequence of this, the regulatory role mediated by iron on the overall activity of ribonucleotide reductase enzyme is disturbed leading to a conclusive imbalance in DNA biosynthesis. PMID- 3518598 TI - [Perirenal prosthesis in traumatic ruptures. Apropos of a case]. AB - A polyglactin mesh wrapping was used to unite the four fragments of a severely ruptured kidney. The operation was performed on the twelfth day after the trauma. One year postoperatively, the clinical biological and urographic results are excellent. PMID- 3518599 TI - [Strangulated ureterocele and prolapsed urethral mucosa in a little girl. Diagnostic difficulties]. AB - The author reports a case of a 2 year-old girl, with prolapse of the urethra treated since birth, twice by electro-coagulations. The persistence of the symptoms required further urological examinations (Urography, Ultrasonography), which revealed an ureterocele, prolapsed into the urethra with total duplication of the urinary tract. The operation consisted of a nephro-ureterectomy of the upper tract, with resection and suture of the exteriorized part of the ureterocele in the urethra. PMID- 3518600 TI - Electrophysiologic studies in patients with ventricular tachycardia. AB - Invasive electrophysiologic studies are used to guide drug and non-pharmacologic therapy, including surgery, in patients with ventricular tachycardia. We discuss the indications, methods, and results of electrophysiologic studies in these patients. Both catheter and intraoperative studies are described. This approach to patients with ventricular tachycardia is contrasted to the approach using noninvasive electrocardiographic monitoring. PMID- 3518601 TI - Acute gastric mucosal injury: pathogenesis and therapy. AB - Our knowledge concerning the pathogenesis and treatment of acute gastric mucosal injury is rapidly expanding. The gastric mucosa maintains its integrity despite exposure to hydrochloric acid, pepsin, bile, and potentially damaging ingested substances. The balance between gastric mucosal injury and repair is a dynamic process involving multiple complex mechanisms. Clinically, when this process breaks down, acute gastric musocal injury results. Therapy of this disorder has included the use of antisecretory drugs and antacids, while more recent research efforts are exploring the use of cytoprotective agents. PMID- 3518603 TI - Role of arginine vasopressin in regulation of systemic arterial pressure. AB - Arginine vasopressin (AVP) not only influences renal water metabolism but also has profound cardiovascular effects. Physiologic levels of the hormone produce a pressor response in the basal state when vasoregulatory reflex mechanisms are interrupted. During hypovolemia, vasopressin affects systemic blood pressure independent of the renin-angiotensin system and efferent sympathetic pathways. Many studies implicate AVP in the pathogenesis of hypertension, but the actual mechanism and relative importance of vasopressin's role remain a matter of intense investigation. PMID- 3518602 TI - Prospects for immunotoxin therapy in cancer. AB - Immunotoxins are formed by chemically linking antibodies to "toxic" polypeptides that inactivate protein synthesis. These hybrid protein molecules are guided to tumor cells by the antibody moiety, and once bound to the tumor cells, the toxic polypeptide moiety penetrates the cell membrane and enzymatically inactivates protein synthesis. A stepwise approach to identifying the potential clinical uses of immunotoxins in cancer therapy is examined in this chapter. PMID- 3518604 TI - Interleukins. AB - Interleukins are polypeptides that act on leukocytes and other tissue targets. Interleukin-1, produced by macrophages and other cells, activates lymphocytes and also induces several components of the host's acute-phase response to infection and injury. Interleukin-2, produced by T lymphocytes, is a growth factor for helper, suppressor, and cytotoxic T lymphocytes. By several criteria, interleukins can be considered the hormones that regulate immune and inflammatory responses. PMID- 3518605 TI - Behavioral disturbances associated with endocrine disorders. AB - Patients with major endocrine disorders frequently experience significant changes in mood and mentation. Similarly, many individuals presenting as psychiatric patients have pathologic alterations in neuroendocrine function. Although pathognomic behavioral changes are rare, increased recognition of characteristic symptom complexes may lead to earlier diagnosis and improved treatment planning. PMID- 3518606 TI - Clinical pharmacology of nicotine. AB - Nicotine is the primary reason why people consume tobacco products and it may contribute to causation of tobacco-related diseases. This chapter reviews the human pharmacology of nicotine, the evidence for a role of nicotine in human disease, and the use of nicotine (gum) as a therapeutic agent in smoking cessation therapy. PMID- 3518607 TI - In vivo diagnostic and therapeutic uses of monoclonal antibodies in cardiology. AB - Antibodies, long used as discriminating tools in immunoassay, are now being used in vivo, both in diagnosis and therapy. In cardiovascular medicine, applications that have reached the stage of clinical trial include the reversal of digitalis intoxication by digoxin-specific antibodies and the imaging of cardiac necrosis with monoclonal myosin-specific antibodies. An exciting future prospect, still in an early experimental stage, is the application of fibrin-specific monoclonal antibodies to both the visualization of thrombi and emboli and the targeting of fibrinolytic agents. PMID- 3518608 TI - The relationship of psychiatric disorder to gastrointestinal illness. AB - The definition of psychiatric illness by specific criteria has provided a new method for examining the relationship of certain gastrointestinal (GI) diseases to psychiatric disorder. Using this technique, researchers have found that rates of psychiatric diagnosis in patients with certain functional GI syndromes and Crohn's disease exceed those found in the general population and in comparably ill control groups. Timing of onset of both sets of symptoms (GI and psychiatric) suggests that the functional syndromes generally follow or coincide with the onset of psychiatric symptoms, whereas the onset of Crohn's disease is more independent. A relationship of psychiatric illness to other GI disease is suspected based on results of psychometric testing or on less structured attempts at psychiatric diagnosis employed in earlier studies. Psychiatric diagnosis by criteria definition may play an important role in more clearly understanding any relationship of psychiatric disorder to somatic GI disease as the applications of this scientific technique are expanded. PMID- 3518609 TI - The clinical spectrum of renal tubular acidosis. AB - Renal tubular acidosis (RTA) is associated with a large group of disorders that interfere with normal tubular hydrogen-ion handling by any of several mechanisms. This review presents an approach to the pathophysiology, diagnosis, and therapy of RTA by defining three major subgroups: proximal RTA, distal RTA presenting with normal or decreased serum potassium (hypokalemic distal RTA), and distal RTA presenting with increased serum potassium (hyperkalemic distal RTA). PMID- 3518610 TI - Natural killer cells. AB - Natural killer (NK) cells are a subpopulation of lymphocytes, with azurophilic granules in their cytoplasm, that have spontaneous cytotoxicity against a variety of tumor cells, virus-infected cells, and some normal cells in the bone marrow and thymus. When lymphocytes are cultured in the presence of interleukin 2 (IL 2), strong cytotoxic reactivity develops and it has been difficult to determine clearly the relationship of these effector cells to NK cells. Much recent insight has been gained regarding the mechanism of lysis by NK cells; a central role is played by a cytolytic protein contained within their cytoplasmic granules. NK cells have been shown to be involved in host resistance against the development of tumor metastases and against certain virus infections, which provides a rationale for therapeutic strategies involving augmentation of NK activity. PMID- 3518611 TI - Treatment of hypercholesterolemia. PMID- 3518613 TI - The making of a comparative physiologist. PMID- 3518612 TI - The role of the spleen in resistance to infection. AB - The spleen serves two major critical functions in protecting against bloodstream bacterial infections--it is a phagocytic filter that removes bacteria from the bloodstream and it is an antibody-producing organ. Although the liver appears to remove the majority of well-opsonized bacteria from the bloodstream, the spleen plays an important role through its ability to sequester bacteria that are not as well opsonized and, thus, is of critical importance in the nonimmune host. The spleen may also be critical in the production of opsonizing antibodies, which are important for the rapid and efficient removal of bacteria from the bloodstream. PMID- 3518614 TI - The role of osmotic forces in exocytosis from adrenal chromaffin cells. PMID- 3518615 TI - Mimicry and mechanism in phospholipid models of membrane fusion. AB - In spite of heroic efforts, phospholipid bilayer models of fusion do not mimic the cellular process closely enough to be confident that the cellular mechanism is being probed. Probably the experimental factors that are most difficult to control are the uniformity of the vesicles and the constraints that determine their behavior. In most conditions where fusion is triggered, the probability of bilayer mechanical rupture and leakage is increased. Confining that rupture to the contact area remains the most elusive characteristic of cell fusion to mimic. It may depend on fusogenic proteins. Some membrane characteristics, such as lipid asymmetry, may be crucial and may be determined biochemically, but they are difficult to duplicate in model systems. The contact-induced formation of nonbilayer lipid structures triggered by phosphatidylinositol turnover may offer some guidance in how the biochemical and required physical changes may be coupled. PMID- 3518616 TI - Endothelial cell influences on vascular smooth muscle phenotype. PMID- 3518617 TI - Indicator dilution estimation of capillary endothelial transport. AB - Mechanisms of transport of substrates and small solutes across the endothelial lining of the capillaries include passive diffusion (through clefts between cells or across the plasmalemma) and transporter-mediated flux across the plasmalemma. Because the transport rates are typically high, the multiple indicator dilution technique is usually the method of choice, as it provides the high temporal resolution required. In the simplest version of this technique, a test solute is injected into the inflow simultaneously with reference solutes that are restricted to intravascular and extracellular space. Interpretation of the resulting data requires models; the most precise approach is to fit the model solutions to the data. When appropriate combinations of indicators and sufficiently complex models (those that account for flow heterogeneity, arteriovenous gradients, passive and saturable transport, reaction, and diffusion in multicomponent systems) are used the transporters can be characterized. Features such as the rapidity of intracellular reaction can also be revealed by this technique. PMID- 3518619 TI - Cell adhesion molecules in neural histogenesis. PMID- 3518618 TI - Renal metabolism during normoxia, hypoxia, and ischemic injury. AB - The reversible period of hypoxia and ischemia is a consequence of the function of numerous regulatory mechanisms which convert cells to a quiescent state. Thus, early changes in metabolism reflect regulatory events rather than pathological events. O2-dependent enzymes (oxidases and oxygenases) are the primary sensors for physiological responses to hypoxia, and failure of their functions are ultimately responsible for hypoxic and ischemic cell injury. At least 30 of these enzymes are known to occur in kidney, but only cytochrome oxidase has been extensively studied with regard to the above processes. Heterogeneity of subcellular oxygenation occurs as a result of the existence of clusters of mitochondria in the basolateral regions of proximal and distal tubule cells. This creates regions with very high O2 consumption rates, and results in diffusion limitations in O2 supply. Finally, dramatic progress has been made in protecting against ischemic injury through use of nonpermeant solutes to reduce cell swelling, addition of ATP-MgCl2 to stimulate recovery of cellular adenylates upon reoxygenation, use of a Ca2+ uptake blocker to prevent cellular loading of Ca2+, and addition of compounds to inhibit superoxide and H2O2 production or scavenge reactive O2 species. While the mechanistic details and complete description of metabolic effects are not yet available, the ability to alter cellular metabolism and delay or prevent irreversible injury marks a very important advance in renal physiology. PMID- 3518620 TI - Genes encoding mammalian neuroendocrine peptides: strategies toward their identification and analysis. AB - During the last five years, cDNAs and genes encoding more than 20 neuroendocrine peptides have been cloned. The information gleaned from these genes has been largely structural to this point, and illustrates the great versatility of neuroendocrine genes in generating diverse sets of bioactive peptides. An ongoing contribution of the application of recombinant DNA techniques to the neuroendocrine system promises to be the identification of novel peptides; it will require a concerted effort to determine their physiological functions. The application of recombinant DNA to the study of expression and regulation of neuroendocrine genes is still in its infancy, but a variety of newly emerging techniques promise to be useful for these approaches. Although we have considered the application of recombinant DNA only to the cloning and analysis of neuroendocrine peptide genes, molecular biology will clearly also have a major future impact in investigating aspects of other molecules involved in neuropeptide action, such as processing enzymes and peptide receptors. PMID- 3518621 TI - Integration and central processing in temperature regulation. AB - Our understanding of the neural control of body temperature has been clarified by research over the past ten years. Overall, ascending thermal inputs are integrated with other thermal and nonthermal inputs, which results in efferent signals with the spatial and temporal characteristics necessary for driving effector organs involved in thermal homeostasis. There is substantial support for the hypothesis that the afferent component of the thermoregulatory system integrates thermal stimuli into several neural patterns, the principal ones being a stepwise, switching response of neuron activity during scrotal thermal stimulation and a proportional response to other thermal inputs. Furthermore, some thermointegrative CNS neurons respond relatively rapidly or slowly during peripheral thermal stimulation, which may be critical in driving behavioral and autonomic motor outputs, respectively. The control of thermoregulatory motor outputs is multifaceted and exhibits proportional, rate-sensitive, and/or on-off regulatory patterns during thermal stimulation. These complex motor patterns indicate the presence of extensive temporal and spatial integration of ascending thermal information. This is supported by the fact that the pattern of efferent nerve activity in various motor systems (e.g. vasomotor) is vastly different from that produced by recordings of primary thermoreceptor activity. Understanding the nature and mechanisms of the CNS transduction of peripheral thermal stimuli to efferent command signals for driving thermoregulatory motor outputs will be a challenging endeavor in the future. PMID- 3518622 TI - Morphologic changes in pulmonary oxygen toxicity. PMID- 3518623 TI - Aminoglycoside research 1975-1985: prospects for development of improved agents. PMID- 3518624 TI - Prevention of traveler's diarrhea by the tablet form of bismuth subsalicylate. AB - In a randomized double-blind study, Swiss adults traveling to tropical countries for 12 to 28 days took a solid formulation of bismuth subsalicylate (1.05 or 2.1 g/day on a twice-daily regimen) or placebo. Efficacy was evaluated in 231 volunteers. Diarrheal incidence was reduced by 41% in persons taking the high dose (P = 0.007) and by 35% in those taking the low dose (P = 0.03) with excellent compliance. No serious adverse reactions occurred, but objectionable taste, constipation, and nausea were seen more frequently with active medication (P = 0.04). Twenty patients provided stool samples: no bacteria were detected in the 8 volunteers who were on active medication, but various bacteria were found in 5 of the 12 patients who had taken placebo (P = 0.04). PMID- 3518625 TI - Comparative efficacies of single intravenous doses of ceftriaxone and ampicillin for shigellosis in a placebo-controlled trial. AB - To evaluate ceftriaxone for the treatment of shigellosis, 94 adult males with acute dysentery were randomly assigned to receive ceftriaxone (1 g), ampicillin (4 g), or saline placebo intravenously in single doses in a double-blind design. Stool cultures were positive for Shigella dysenteriae in 52 patients, S. flexneri in 38 patients, and other species in 4 patients. Both ceftriaxone and ampicillin caused reductions in the mean duration of fever and the means of daily stool frequency 2 to 4 days after therapy versus placebo (P less than 0.05). The ability of ceftriaxone to reduce stool frequency during 6 days after treatment was significant in patients with S. flexneri infections (P less than 0.05), whereas S. dysenteriae infections were relatively refractory to improvement by both antibiotics. Neither drug had a significant effect on overall duration of diarrhea, blood in stool, or tenesmus. Ampicillin reduced the mean duration of positive stool cultures after treatment from 2.6 days in the placebo group to 1.1 days (P less than 0.05), whereas ceftriaxone did not affect the duration of Shigella sp. excretion. These results indicate that single intravenous doses of ceftriaxone and ampicillin caused some clinical improvement in acute shigellosis but only ampicillin exerted a bacteriological effect on Shigella sp. excretion. PMID- 3518626 TI - Sensitivity of Candida albicans to amphotericin B administered as single or fractionated doses. AB - Candida albicans cells were exposed to equal concentrations of amphotericin B (AmB) administered either as a single large dose or as repeated small doses. Toxicity to C. albicans cells was less pronounced when AmB was administered in fractionated doses. Increased catalase activity in C. albicans cells was induced after exposure to fractionated doses of AmB; this increase may have contributed to the greater resistance of cells to AmB used according to this schedule. PMID- 3518627 TI - Mutation of Escherichia coli capable of expressing gene(s) for beta-lactamase production of Citrobacter freundii. AB - A mutation in a chromosomal gene of Escherichia coli, designated reb, acted in trans to increase the expression of the cloned beta-lactamase gene of Citrobacter freundii. The reb gene was located around 99 min. Deletion mutants in the cloned gene(s) which had lost the regulatory region for induction were also constructed. PMID- 3518628 TI - Immobilized respiratory chain activities from Escherichia coli utilized to measure D- and L-lactate, succinate, L-malate, 3-glycerophosphate, pyruvate, or NAD(P)H. AB - The respiratory chain (membranous, multienzymatic system) from Escherichia coli, was coimmobilized with gelatin and insolubilized in film form by tanning with glutaraldehyde. The film was fixed onto an oxygen sensor. The enzyme electrode can be used for measuring NAD(P)H, D- and L-lactate, succinate, L-malate, 3 glycerophosphate, or pyruvate. The range of metabolites concentrations was from 1 to 50 mM. It was possible to discriminate between the different metabolites (if mixed): By inducing during bacterial growth the specific flavoproteins necessary for L-lactate, succinate, L-malate, and 3-glycerophosphate respirations. The constitutive activities are unaltered on glucose or glycerol, namely D-lactate, NAD(P)H, and pyruvate respiration. When intact bacteria were immobilized (with or without induction), D- and L-lactate, succinate, 3-glycerophosphate, and L-malate respiration were measured, no activities of pyruvate and NAD(P)H respiration were obtained. For these last activities, French press breakage (see section on Membrane Preparations) of bacteria prior to immobilization was necessary. Products of reactions can be used as enzyme inhibitors: Pyruvate inhibits D- and L-lactate; fumarate inhibits succinate, and oxaloacetate inhibits L-malate respirations. Heat denaturation of the bacteria at 55 degrees C for 1 h maintains full activity of succinate and pyruvate respiration. On the other hand, no activity of D- and L-lactate, L-malate, or NAD(P)H respiration was measurable. These enzyme electrodes have many applications in basic and applied research. PMID- 3518629 TI - Recovery, growth, and production of heat-stable enterotoxin by Escherichia coli after copper-induced injury. AB - Exposure of enterotoxigenic Escherichia coli strains to a sublethal concentration (0.75 mg/liter) of copper for 3 days at 4 degrees C induced sensitivity to deoxycholate (0.1%). When placed in a complex (brain heart infusion) or a defined amino acid salt medium, the copper-injured cells recovered their tolerance to deoxycholate in 3 and 6 h, respectively, and commenced active growth. Growth and heat-stable enterotoxin production of uninjured and copper-injured cells were studied in brain heart infusion medium. A slightly altered growth curve and an initial slow rate of toxin production were observed in injured cells when compared with those corresponding uninjured controls. However, maximum heat stable enterotoxin levels in injured cultures were comparable to those produced by uninjured cells, suggesting that the enterotoxigenic potential of copper injured cells was fully retained. PMID- 3518630 TI - Removal of endotoxin from water by microfiltration through a microporous polyethylene hollow-fiber membrane. AB - The microporous polyethylene hollow-fiber membrane has a unique microfibrile structure throughout its depth and has been found to possess the functions of filtration and adsorption of endotoxin in water. The membrane has a maximum pore diameter of approximately 0.04 micron, a diameter which is within the range of microfiltration. Approximately 10 and 20% of the endotoxin in tap water and subterranean water, respectively, was smaller than 0.025 micron. Endotoxin in these water sources was efficiently removed by the microporous polyethylene hollow-fiber membrane. Escherichia coli O113 culture broth contained 26.4% of endotoxin smaller than 0.025 micron which was also removed. Endotoxin was leaked into the filtrate only when endotoxin samples were successively passed through the membrane. These results indicate that endotoxin smaller than the pore size of the membrane was adsorbed and then leaked into the filtrate because of a reduction in binding sites. Dissociation of 3H-labeled endotoxin from the membrane was performed, resulting in the removal of endotoxin associated with the membrane by alcoholic alkali at 78% efficiency. PMID- 3518631 TI - Effect of water activity and pH on growth and toxin production by Clostridium botulinum type G. AB - The combined effect of water activity (aw) and pH on growth and toxin production by Clostridium botulinum type G strain 89 was investigated. The minimum aw at which growth and toxin formation occurred was 0.965, for media in which the pH was adjusted with either sodium chloride or sucrose. The minimum pH (at the optimum aw) for growth and toxin production of C. botulinum type G was found to be 5.6. Optimum conditions for toxin activation were a trypsin concentration of 0.1%, a pH of the medium of 6.5, and an incubation for 45 min at 37 degrees C. These data did not show evidence of heat-labile spores, since a heat shock of 75 degrees C for 10 min did not significantly decrease the spore count of strain 89G in media at pH 7.0 or 5.6. It was frequently observed that cells grown at reduced aw or pH experienced severe morphological changes. PMID- 3518632 TI - Increased adenine nucleotides in liver mitochondria after mannoheptulose injection in vivo. AB - In adult rats, mannoheptulose injection causes a transient decrease in the serum insulin-to-glucagon ratio and a concomitant increase in serum glucose concentration. These effects attain a maximum 1 h after the injection and then decline toward normal. Correlated with the hormone changes is a dramatic increase in the adenine nucleotide content (ATP + ADP + AMP) of liver mitochondria, which peaks to over 50% of control values at 1 h. The increase in mitochondrial adenine nucleotides must occur by uptake from the cytosol, because the adenine nucleotide content of the whole tissue remains constant. The accumulation of adenine nucleotides by the mitochondria probably occurs over the recently characterized carboxyatractyloside-insensitive transport pathway that allows exchange of ATP-Mg for Pi. The actual mechanism by which net uptake is regulated after mannoheptulose injection has not yet been elucidated; however, changes in the Km or Vmax of the carrier and an increase in the tissue ATP/ADP ratio were eliminated as possibilities. The increase in matrix adenine nucleotide content in response to hormone changes brought about by mannoheptulose was much greater and more reproducible than what is achieved with glucagon injection. Mannoheptulose treatment may therefore be preferable as a model for further study of hormone effects on mitochondrial function. PMID- 3518633 TI - Evidence that isoniazid and ethanol induce the same microsomal cytochrome P-450 in rat liver, an isozyme homologous to rabbit liver cytochrome P-450 isozyme 3a. AB - Cytochrome P-450j has been purified to electrophoretic homogeneity from hepatic microsomes of adult male rats administered ethanol and compared to the corresponding enzyme from isoniazid-treated rats. The enzymes isolated from ethanol- and isoniazid-treated rats have identical chromatographic properties, minimum molecular weights, spectral properties, peptide maps, NH2-terminal sequences, immunochemical reactivities, and substrate selectivities. Both preparations of cytochrome P-450j have high catalytic activity in aniline hydroxylation, butanol oxidation, and N-nitrosodimethylamine demethylation with turnover numbers of 17-18, 37-46, and 15 nmol product/min/nmol of P-450, respectively. A single immunoprecipitin band exhibiting complete identity was observed when the two preparations were tested by double diffusion analysis with antibody to isoniazid-inducible cytochrome P-450j. Ethanol- and isoniazid inducible rat liver cytochrome P-450j preparations have also been compared and contrasted with cytochrome P-450 isozyme 3a, the major ethanol-inducible isozyme from rabbit liver. The rat and rabbit liver enzymes have slightly different minimum molecular weights and somewhat different peptide maps but similar spectral, catalytic, and immunological properties, as well as significant homology in their NH2-terminal sequences. Antibody to either the rat or rabbit isozyme cross-reacts with the heterologous enzyme, showing a strong reaction of partial identity. Antibody against isozyme 3a specifically recognizes cytochrome P-450j in immunoblots of induced rat liver microsomes. Aniline hydroxylation catalyzed by the reconstituted system containing cytochrome P-450j is markedly inhibited (greater than 90%) by antibody to the rabbit protein. Furthermore, greater than 85% of butanol or aniline metabolism catalyzed by hepatic microsomes from ethanol- or isoniazid-treated rats is inhibited by antibody against isozyme 3a. Results of antibody inhibition studies suggest that cytochrome P-450j is induced four- to sixfold by ethanol or isoniazid treatment of rats. All of the evidence presented in this study indicates that the identical cytochrome P-450, P 450j, is induced in rat liver by either isoniazid or ethanol, and that this isozyme is closely related to rabbit cytochrome P-450 isozyme 3a. PMID- 3518635 TI - Characterization of cat insulin. AB - Cat insulin was isolated and both chains were characterized by determination of the primary structures. The molecule was found to differ from human insulin at four positions, A8 (Ala), A10 (Val), A18 (His), and B30 (Ala). A comparison with other known insulin structures suggests that cat insulin has an uncommon property: it appears to be the only insulin found so far with His at position A18. The difference is compatible with a conserved overall conformation but this histidine occupies a position close to the suggested receptor interacting area and may influence some binding properties. PMID- 3518634 TI - Localization of L-lactate dehydrogenase in mitochondria. AB - Relatively small but persistent amounts of L-lactate dehydrogenase (LDH) activity were found in mitochondrial preparations isolated from liver of the rat. Using a variety of cytosolic markers, it was found that essentially no cytosolic contamination was present. Respiratory velocities and respiratory control with L lactate were somewhat lower than with glutamate, but equal or superior to those with pyruvate. Agarose gel electrophoresis showed LDH isoenzymes in mitochondria similar to that in corresponding cytosol. Subtilisin BPN', a bacterial protease, was incubated with intact mitochondria and enzyme activities were measured. Following mitochondrial disruption, the proteolytic treatment was repeated. Digitonin was also used in the fractionation of mitochondria. These techniques helped to determine the location of the LDH in the mitochondria as being mainly in the outer membrane and periplasmic space. PMID- 3518636 TI - Characterization of O2 evolution by a wheat photosystem II reaction center complex isolated by a simplified method: disjunction of secondary acceptor quinone and enhanced Ca2+ demand. AB - An O2-evolving photosystem II (PSII) reaction center complex was prepared from wheat by a simple method consisting of octylglucoside solubilization of Triton PSII particles followed by one-step sucrose density gradient centrifugation. The complex contained six species of proteins including the 33-kDa extrinsic protein with the same relative abundance as in the original PSII particles, one cytochrome b559, 4 Mn, and about 40 chlorophyll (Chl) per O2-evolving unit, and evolved O2 at a high rate of 1400-1700 mumol O2/mg Chl/h. O2 evolution by the complex was dependent on acceptor species, showing a hierarchy, ferricyanide greater than dichlorobenzoquinone greater than phenylbenzoquinone greater than dimethylbenzoquinone greater than duroquinone, and insensitive to DCMU, indicative of disjunction of the secondary quinone acceptor of PSII from the electron transport pathway. O2 evolution also showed a marked dependence on Cl- and Ca2+: about 10-fold acceleration by Cl- and an additional 2- to 3-fold by Ca2+. Comparison of the dissociation constants for Cl- and Ca2+ between the complex and NaCl-washed PSII particles revealed that octylglucoside treatment gives rise to a new Ca2+-sensitive site by removal of some unknown factor(s) other than the extrinsic 22- and 16-kDa proteins, while it preserves the Cl(-) sensitive site as native as in NaCl-washed PSII particles. Analysis of the relationship between Cl- demand and Ca2+ demand revealed that Ca2+ absence noncompetitively inhibits the Cl(-)-supported O2 evolution, indicative of the independence of the binding site of these two factors. PMID- 3518637 TI - [Indication and results of bone marrow transplantation in acute leukemia]. AB - The indication and results of bone marrow transplantation (BMT) for acute leukemia were discussed focusing on data obtained by the BMT study group of the Ministry of Health and Welfare, Japan. With regard to the indication of BMT, the following factors were selected as significantly favorable: young age, in remission, no infection, complete HLA-matched marrow donor, no previous radiation treatment of the brain or lung, fractionated TBI, low dose rate, platelet transfusion from anti-CMV antibody-negative donor. Recently, the incidence of such favorable patients has increased in BMT, reflecting the improvement of results with this procedure. The long-term survival rates were 75% for ALL and 50% for ANLL when BMT was performed during the patients' first remission. These data reveal the merit of BMT as a treatment with a high rate of complete cure. PMID- 3518638 TI - Topical application of isotretinoin gel improves oral lichen planus. A double blind study. AB - In a double-blind study, 20 patients with oral lichen planus were treated twice daily with 0.1% isotretinoin gel or the vehicle alone for two months. Subsequently, patients who used the placebo received the active preparation for another two months. Patients treated with the active medication displayed significantly greater improvement than patients receiving the placebo. Patients who were treated initially with the placebo showed statistically significant improvement after receiving the topical isotretinoin treatment for two months. Side effects from using the gel were primarily a transient burning sensation or irritation on initial application. PMID- 3518639 TI - A new type of transient diabetes mellitus of infancy? AB - Two male siblings with transient diabetes mellitus were of normal birth weight, were asymptomatic, and did not require treatment with insulin. This may be a previously undescribed disorder or part of the range of transient diabetes mellitus of infancy. Previously reported infants with transient diabetes mellitus of infancy have usually been small for gestational age and have presented with glycosuric dehydration, infections, or growth failure. Insulin concentrations after oral glucose challenge showed inadequate insulin secretion with respect to the degree of hyperglycaemia in these children. Autosomal dominant inheritance may occur in some families with this disorder, and parents of some affected children may also have had asymptomatic or unrecognised transient diabetes mellitus of infancy. Leucocyte histocompatibility antigen typing of this family did not show any association of specific antigens with transient diabetes mellitus of infancy in the affected children. PMID- 3518640 TI - Metabolic rhythms in adolescents with diabetes during treatment with porcine or human insulin. AB - Metabolic rhythms were studied over 24 hours in eight adolescent diabetic patients during treatment with porcine insulin and after transfer to human insulin. Despite an increase in dose with human insulin no significant changes were found in fasting blood glucose, 24h mean blood glucose, or glycosylated haemoglobin concentrations. Significantly higher 24h mean blood lactate concentrations and lower total ketone bodies and glycerol concentrations were observed during treatment with human insulin. These findings are consistent with the increase in insulin dose and do not necessarily imply different metabolic responses to species differences in insulin. PMID- 3518641 TI - Glycine supplemented oral rehydration solutions for diarrhoea. AB - Two glycine supplemented oral rehydration solutions (ORS) and a standard ORS with sodium 60 mmol/l were compared for treatment of diarrhoeal dehydration in children. The solutions contained glycine 110 mmol/l and glucose 110 mmol/l (ORS60-Gly110), glycine 60 mmol/l and glucose 80 mmol/l (ORS60-Gly60), and glucose 144 mmol/l only (ORS60), respectively. The patients receiving ORS60 Gly110 had poor weight gain and increased stool and urine volumes after rehydration compared with the other two groups. The patients receiving ORS60 Gly60 had similar stool and urine volumes as those receiving standard ORS60. It is concluded that excess glycine in relation to sodium in an ORS may lead to osmotic diarrhoea, and a high amount of absorbed glycine may result in osmotic diuresis with poor net rehydration. Altogether, the present study failed to find any improvement ('Super-ORS') by addition of glycine to an ORS containing 60 mmol/l of sodium. PMID- 3518642 TI - Children with diabetes who need surgery. PMID- 3518643 TI - [Echodirected transperineal biopsy of the prostate: advantages and contributions to classical technics]. PMID- 3518644 TI - [Autotransplant of the testis: our experience in 6 cases]. PMID- 3518645 TI - Development of circulating antiheart antibodies as a result of coronary bypass surgery. AB - Antiheart antibodies have been implicated as a marker of postcardiotomy syndrome in patients undergoing coronary artery bypass. To assess the frequency of and contributory factors in the development of antiheart antibodies after coronary bypass procedures, 33 patients were examined for evidence of antiheart antibodies before and for seven days after routine coronary artery bypass operations. Overall titers of antiheart antibodies rose in approximately 66% of the patients. However, this rise was not accompanied by any major clinical symptoms. History of previous myocardial infarction or myocardial injury did not correlate with a higher frequency of development of antibodies. Antiheart antibodies appear to be a common consequence of coronary artery bypass operations and are not routinely associated with the development of postcardiotomy syndrome. PMID- 3518646 TI - Cold potassium cardioplegia versus topical hypothermia and intermittent aortic occlusion for myocardial protection during coronary artery surgery: a randomized clinical study. AB - The effect of two different myocardial preservation techniques on perioperative myocardial necrosis during coronary artery bypass surgery was assessed by serial myocardial creatine kinase determinations in 100 consecutive patients operated on by the same surgeon. Topical hypothermia with cold potassium cardioplegia was used randomly in 50 patients (group 1), and topical hypothermia with local interruption of the coronary circulation was used in the other 50 patients (group 2). Myocardial creatine kinase was measured by column chromatography every 6 hours for 36 hours after surgery. There was no significant difference between the two groups in terms of age, sex, functional class, extent of coronary artery disease, number of bypassed arteries, ejection fraction, or cardiopulmonary bypass time. Myocardial creatine kinase release (mean +/- standard error of the mean) was 193 +/- 33 IU/L X hours in group 1 patients operated on with cardioplegia and 210 +/- 31 IU/L X hours in group 2 patients operated on with topical hypothermia (p greater than 0.5). Myocardial creatine kinase peaks were 9.2 +/- 1.9 IU/L and 10.0 +/- 1.6 IU/L, respectively (p greater than 0.5). Perioperative myocardial infarction, as defined by serum enzyme activity and electrocardiographic criteria, occurred in 4 patients in group 1 and 3 patients in group 2. Thus, the addition of cardioplegia to topical hypothermia, although perhaps offering technical advantages, does not appear to improve myocardial protection over topical hypothermia with local interruption of the coronary circulation during coronary artery bypass surgery. PMID- 3518647 TI - [Torsion dystonia: historical evolution with a note on the Spanish contribution]. PMID- 3518648 TI - [Adult-type respiratory distress syndrome in pediatrics. Apropos of 20 cases]. AB - Twenty cases of adult-type respiratory distress syndrome (ARDS) observed in children aged less than 15 years (excluding neonates) are reported; 55% survived and 45% died. A comparative study of both groups showed that prognosis is not related to the child's condition at the time of admission. On the contrary, evolution during the first 72 hours seems to be of prime importance. Treatment included artificial ventilation with PEEP, the optimal level of which was defined by empirical means; maximal PEEP reached 13.2 +/- 4.7 cmH2O and 20.3 +/- 4 cmH2O in the surviving and the deceased groups, respectively. Maintenance to a steady level was reached by using cuffed endotracheal tubes. No correlation was found between maximal PEEP levels and pneumothorax frequency, the latter being identical in both groups. Cardiac catheterization, performed in 5 cases, was helpful in defining adequate additional therapy which improved hematosis and, when done early, appeared to favorably influence the prognosis. PMID- 3518649 TI - [Partial somatotropin deficiency in a case of chronic renal insufficiency with renal transplantation. Efficacy of treatment with human growth hormone]. AB - The authors report a case of chronic renal failure with a -4 SD growth retardation. The patient underwent dialysis and then transplantation. Investigations to determine somatotropin deficiency showed dissociated results of 4 stimulation tests: 2 normal responses and 2 low responses. Treatment with human growth hormone (10 mg/kg/year) induced a dramatic acceleration of the growth velocity, which increased from 2 to 7 cm/year. After 18 months, the gain in height was 10 cm. Data submitted by several authors on Cushing's disease and the interrelations cortisone/somatotropin secretion suggest that continuous and/or alternate corticotherapy may be the cause of this partial somatotropin deficiency. PMID- 3518650 TI - [The delta agent and its value in hepatic pathology in children]. PMID- 3518651 TI - Search for CEA-like molecules in polymorphonuclear leukocytes of non-human primates using monoclonal antibodies. AB - The monoclonal anti-CEA antibody ZIK-A42-A/C1 which reacts with NCA of human polymorphonuclear leukocytes was found to bind also to polymorphonuclear blood leukocytes of the following non-human primates tested: hamadryas baboon (Papio hamadryas), stump-tailed monkey (Macaca arctoides), pig-tailed monkey (Macaca nemestrina), and rhesus monkey (Macaca mulata). No binding was observed to mononuclear blood leukocytes. It was concluded that non-human primates contain CEA-like substances in their polymorphonuclear leukocytes as humans do and that these substances carry some identical epitopes. PMID- 3518652 TI - Oral contraceptives and cancer. AB - The use of combined oral contraceptives has been shown in a number of studies to alter a women's risk of developing some kinds of cancer. Specifically, a 50% reduction in the risk of both ovarian and endometrial cancer has been demonstrated. This protective effect appears to persist for some time after oral contraceptives are stopped. Combined oral contraceptives do not appear to effect substantially the overall risk of developing breast cancer, although some data suggest that selected subgroups of women may be at a greater risk of developing breast cancer if oral contraceptives are used at specific times in a woman's reproductive life, especially if used for long periods of time. However, the data are not entirely consistent on this issue. The effect of oral contraceptives on the risk of developing cervical cancer is also not entirely clear, although the data available suggest a slightly increased risk of intraepithelial cervical cancer with prolonged use of oral contraceptives. PMID- 3518653 TI - Adenoid squamous cell carcinoma of the nasopharynx and neck region. AB - Adenoid squamous cell carcinoma (ASCC) is a rare variant of squamous cell carcinoma. This tumor most commonly occurs in the skin of the head and neck and rarely in the vermillion of the lip, vulva, and oral cavity. This report of two patients includes the first (to our knowledge) case of ASCC in the nasopharynx. It also describes the immunocytochemical and ultrastructural features of this tumor. Our findings and a review of the literature indicate that ASCC of the upper aerodigestive tract is associated with an aggressive behavior and poor prognosis, in contrast with ASCC of the skin. PMID- 3518654 TI - Rhabdomyosarcoma of the common bile duct in an adult. AB - Rhabdomyosarcoma (RMS) of the hepatobiliary system is extremely rare in adults. To our knowledge only three cases have been reported in the literature, all involving the gallbladder. The present case concerns a 40-year-old woman who presented with epigastric pain and obstructive jaundice and was found to have a fusiform, submucosal neoplasm in the common bile duct. Histologically, the tumor presented a diagnostic problem due to a predominant sclerotic growth pattern suggesting an epithelial tumor. Extensive sampling revealed a focal alveolar growth pattern with rhabdomyoblasts, although cross striations were not seen. Electron microscopy failed to demonstrate the characteristic thick myofilaments and/or Z-band material. The diagnosis was supported by strongly positive immunohistochemical staining for myoglobin and desmin; the keratin stain was negative. A subsequent supraclavicular metastasis showed the typical histology of an alveolar RMS. The histologic features of the primary tumor suggest that RMS in this location may be underrecognized due to regional similarities to either primary or metastatic infiltrating carcinomas. PMID- 3518655 TI - Primary duodenal choriocarcinoma. AB - We report a case of nongestational extragenital choriocarcinoma arising in the duodenum of a 29-year-old woman. Immunohistochemical stains of the tumor were positive for human chorionic gonadotropin and human placental lactogen. PMID- 3518656 TI - Treatment of secondary osteoarthritis and rheumatoid arthritis by Bateman hip prosthesis. AB - The Bateman hip prosthesis was applied in reconstruction of secondary osteoarthritis and rheumatoid arthritis. Forty-five joints that could be followed up for 45-18 months (mean 26 months) were clinically and roentgenographically re examined. Forty joints (90.0%) were painless. The clinical score improved from the preoperative mean of 44.8 to the postoperative mean of 87. In 34 patients with secondary osteoarthritis, postoperative protrusion of the outer head into the acetabulum reconstructed by excavation of the previous shallow, steep architecture was only 0.8 mm (mean). Postoperative protrusion of the outer head into the acetabulum reconstructed by bone grafting was only 2.0 mm (mean) in 11 patients with rheumatoid arthritis. Roentgenograms revealed the appearance of sclerosis supermedially in the excavated acetabulum 4-6 months after the operation. This sclerotic change expanded in the entire area of contact with the outer head in 36 of 45 joints within about 1 year. Once the sclerosis had spread completely, the outer head stopped protruding into the acetabulum. A computerized simulation experiment with a rigid spring model demonstrated that central displacement of the outer head can be avoided if the continuity between the sclerosis in the articular surface of the reconstructed acetabulum and the lateral wall is restored for transmission and dispersion of the resultant head force toward the lateral wall as in normal hip joints; this verified the clinical findings. PMID- 3518657 TI - Return to work following hand burns. AB - Time to return to work following hand burns was studied in 70 patients in relation to several variables: 1. total body surface area (TBSA) burned; 2. hand burned; 3. grafting; 4. patient age; 5. occupational category. Return to work data were also compared by meta-analysis to data in prior reports on return to work in nonburn hand injuries. Patients were evaluated during their hospital stay on all independent variables, and at 8 months following discharge as to the date of return to work. Of the 70 patients selected for the study, 52 (74%) had returned to work at the 8-month assessment. The best predictor of time to return to work was TBSA burned, followed by "grafting" and "hand burned." No significant differences or predictors were found for patient age, occupational category, or between nonburn hand trauma patients in prior reports. Conclusions are drawn concerning the usefulness of these results in terms of case management and economic impact in hand-burn injuries. PMID- 3518658 TI - Upper extremity sensory feedback therapy in chronic cerebrovascular accident patients with impaired expressive aphasia and auditory comprehension. AB - Electromyographic (EMG) sensory feedback therapy (SFT) was used in the neuromuscular retraining of the nonfunctional upper extremity in five chronic left cerebrovascular accident (CVA) patients with impaired expressive and auditory comprehension. Speech diagnoses included global, moderate-to-severe Broca, and Wernicke aphasias. These patients had experienced increased despondency associated with previous therapy failures and often had indicated that they wished to have their involved extremity amputated, so that it would no longer be in the way. In this study, specific behavioral training strategies to increase patient involvement were used, including: general relaxation, modified SFT instruction, and home exercises, which were supported by family and/or friends. After an average of 50 therapy sessions, all patients were successfully retrained to use their right upper extremity at the gross-assist level. This resulted in feelings of increased self-esteem to the extent that amputation was no longer requested. It is concluded that EMG SFT can be beneficial in the neuromuscular reeducation of paretic upper extremity muscles of CVA patients with expressive aphasia and (impaired) auditory comprehension. PMID- 3518659 TI - Diagnosis and treatment of splenic fungal abscesses in the immune-suppressed patient. AB - In an 18-month period candidal splenic abscesses were diagnosed and treated in eight patients. Predisposing factors consisted of recent exposure to cytotoxic chemotherapy, long-term use of prednisone, neutropenia, antibiotic therapy for greater than three weeks, and gastrointestinal tract colonization with Candida. The patients had a clinical profile of nontoxic appearance with a temperature of more than 38.5 degrees C that was unresponsive to antibiotics, pain and tenderness over the upper abdominal quadrants, focal defects visualized on ultrasound and/or computed tomographic scans, and an elevated alkaline phosphatase level. Candida infection was confirmed by histologic examination of the liver and/or spleen in all patients. Diagnosis was made by percutaneous biopsy in one patient and exploratory laparotomy in seven. Five patients had splenectomy and antifungal drugs. In three patients the fungal abscesses resolved with amphotericin B therapy alone. Seven of eight patients were cured of their splenic abscesses, and five of eight were long-term survivors. PMID- 3518661 TI - A prospective study of ERCP and endoscopic sphincterotomy in the diagnosis and treatment of gallstone acute pancreatitis. A rational and safe approach to management. AB - From a consecutive series of 112 patients with acute pancreatitis, 70 patients with suspected gallstones were randomized to urgent endoscopic retrograde cholangiopancreatography (ERCP) (less than 72 hours) and endoscopic sphincterotomy (ES) if choledochal stones were present (n = 35), or to conventional treatment (n = 35). Endoscopic retrograde cholangiopancreatography, successful in 89% of cases, indicated choledochal stones in 11 patients, all of whom underwent successful stone retrieval by ES. Later during hospital admission, ERCP was performed in 13 more patients and choledochal calculi were extracted from two patients by ES. No complications were attributable to ERCP or ES. Two patients died of biliary pancreatitis; both had been conventionally treated and may have benefited from urgent ERCP/ES. Our experience, which extends to another 24 patients with ERCP and ten with ES during acute pancreatitis, indicates that these are safe techniques and deserve wider consideration in the management of acute pancreatitis. PMID- 3518660 TI - Results of venous reconstruction after civilian vascular trauma. AB - The treatment of venous injuries remains controversial. In an attempt to evaluate the results of current management of venous injuries, we retrospectively reviewed our experience between 1979 and 1984. During this period 142 patients had sustained injuries to 158 veins in the neck (31 patients), abdomen (45 patients), upper extremity (20 patients), and lower extremity (62 patients). Overall, 90 venous injuries (61%) were repaired, including 83% of caval and iliac vein injuries and 90% of injuries to the common femoral, superficial femoral, and popliteal veins. There was no morbidity after repair of 73 major veins. Morbidity occurred in four of 11 patients after ligation of major veins (edema in two patients and above-knee amputation in two others). Both ligation (N = 51) and repair (N = 17) of lesser veins (jugular, brachial, profunda femoral, tibial, and minor abdominal veins) resulted in no morbidity. Overall mortality was 6% with all deaths occurring in patients with abdominal venous trauma. These data indicate that repair of venous injuries can be performed without morbidity and that minor veins can be ligated without adverse sequelae. However, in view of the morbidity associated with ligation of major veins, efforts to restore flow to these injured vessels appear appropriate unless contraindicated by life threatening injury. PMID- 3518662 TI - Computed tomography in the assessment of pediatric abdominal trauma. AB - A retrospective review was conducted to determine the clinical reliability of computed tomography(ic) (CT) in the initial evaluation of pediatric blunt abdominal trauma. Sixty patients underwent CT with infusion over the two-year study period. Seventeen injuries were identified by CT scans in 12 patients. Injuries included splenic hematoma, hepatic injury, duodenal hematoma, traumatic pancreatitis, retroperitoneal hematoma, renal pelvis laceration, and perinephric hematoma. Three patients required abdominal exploration and CT findings were confirmed in these cases. Other diagnostic studies (nuclear imaging, ultrasonography, upper gastrointestinal tract studies) that were obtained in some patients also confirmed the CT findings. Patients who had normal CT scans had unremarkable hospital courses, and none required reevaluation for missed injury. Only two CT scans were inadequate due to motion artifact. PMID- 3518663 TI - The inguinal darn. AB - We performed 115 nylon darn repairs in 100 patients with inguinal hernia; 61 were primary and 54 secondary repairs, with 50 patients in each group. The Kinmonth modification of the Moloney darn was used. Thirty-seven percent of secondary repairs were done in patients with two or more previous repairs. Thirteen patients had indirect hernia repairs. The follow-up on 105 repairs in 90 patients averaged 62 months. There were two (3.5%) primary and four (8.3%) secondary repair recurrences. The six failures (5.7%) overall were either technical errors or improper patient selection. Three superficial wound infections (2.6%) healed without complications or suture sinuses. The inguinal darn for recurrent inguinal hernias appears to have a lower recurrence rate than the reported 15% to 30% following other techniques. PMID- 3518664 TI - Detection of sequences in Autographa californica nuclear polyhedrosis virus DNA, that acts as autonomous replicating sequences (ARS) in yeast. Brief report. AB - At least two regions of Autographa californica Nuclear Polyhedrosis Virus (AcMNPV) DNA contain nucleotide sequences that allowed the autonomous replication of chimaeric plasmids in Saccharomyces cerevisiae. These sequences were located around position 26 and 37 per cent on the physical map of AcNPV DNA. PMID- 3518665 TI - Grating film for use as a cover-slide in semi-quantitative and quantitative microscopic assessment of biological specimens. AB - We have patented a photographic film on which a series of parallel lines or concentric circles are reproduced, in various sizes, to provide a reference measurement for counting surfaces in a histological specimen without having to alter it in any way. The area of the preparation examined can thus be determined in numerical terms. This grating film can be used as a cover-slide for example, to calculate a surface that is different from normal, to map the distribution of different areas, etc. We use the grating film in studies of the condition of the endothelium of the carotid artery and aorta from rats fed a normolipidic diet. PMID- 3518666 TI - Partial ileal bypass surgery in the treatment of heterozygous familial hypercholesterolemia: a review. AB - Partial ileal bypass (PIB) surgery is a method in the treatment of heterozygous familial hypercholesterolemia (FH). Since the first report in 1964 about 150 cases of FH who underwent the surgical procedure have been described. This number is very low when compared to other types of cholesterol-lowering treatment. On average, PIB decreases the level of plasma total cholesterol by 35% in FH patients, and the surgical procedure can be considered the most effective, single cholesterol-lowering method. PIB-induced reduction of plasma cholesterol is permanent. Further decrease of plasma cholesterol may be obtained in combination with an inhibitor of cholesterol biosynthesis. PIB specifically lowers plasma LDL cholesterol; the concentration of HDL cholesterol is not systematically influenced. The mechanism underlying the hypocholesterolemic action of PIB is discussed. Until now there is no evidence that PIB reduces atherosclerotic coronary death in FH patients. After PIB more patients experience improvement of angina pectoris rather than deterioration (15 versus 2 out of 41), but the number of patients is too small to allow solid conclusions. In 50% of FH patients PIB may cause regression of xanthomata. Out of 209 hyperlipidemic patients described, 14 patients had postoperative complications, which caused death in 3 patients. Diarrhea is the most common side-effect of PIB; out of 99 operated patients serious diarrhea troubled 38 patients, whereas 40 patients had minor complaints during the first year postoperatively. Diarrhea may persist as long as 10 years after PIB. There is no evidence that PIB enhances gallstone formation and severely impairs liver function, but PIB may increase the incidence of renal stones. It is suggested that PIB can be considered in the treatment of FH. However, in each individual case the disadvantages and possible advantages should be carefully weighed out, and this consideration should form the basis to decide whether or not surgery is indicated. PMID- 3518667 TI - [Evolutionary histology and the theory of evolution (on the 100th anniversary of the birth of Academician A. A. Zavarzin]. AB - Darwin's theory did not touch upon the problem of evolution of tissues. An attempt made by Heckel to explain phylogeny of tissues, basing on principles of selection and divergence, failed. It was not at once understood that evolution of separate levels of organization possessed certain specificity. The theory of parallelism, suggested by A. A. Zavarzin, stated the notion on specific regularities in evolution of tissues. Having analysed the correlation between the theory of evolution and evolutional histology, A. A. Zavarzin demonstrated that darwinism developed predominantly at the theory of speciation. This approach is correct for the period of the new evolutionary synthesis, too. The synthetic theory of evolution does not take into consideration evolution of tissues. A. A. Zavarzin's theory contributed to reorganization of methodology of the evolutional biology. The historical method was enriched by a certain principle on specific regularities of evolution for each level of organization in the alive. Simultaneously, the genesis of the parallelism theory discovered that correct explanation of the regularities in evolution of tissues is possible only under conditions that the evolution of histostructures can be inserted into the evolution of ontogenesis and species. PMID- 3518669 TI - [Modification of the technic for the histochemical reaction for alcohol dehydrogenase]. PMID- 3518668 TI - [The A. A. Zavarzin and N. G. Khlopin theory of the evolution of tissues in the light of modern concepts]. PMID- 3518671 TI - [The first textbook of pathological anatomy of pediatric infectious diseases (on the 60th anniversary of publication of the book by M.A. Skvortsov)]. PMID- 3518670 TI - [Labeled lectins in the study of cell surfaces]. PMID- 3518672 TI - [60 years in pathologic anatomy]. AB - A. I. Strukov--Hero of Socialist Labour, Lenin prize winner, Honoured Scientist, Academician of the USSR Academy of Medical Sciences has been involved in a pathological anatomy for 60 years. He started studying this discipline when a student, and his first teacher was Professor V. A. Afanasyev. After a short period of work as an assistant of a Chair of Pathological Anatomy in Voronezh A. I. Strukov became a chief of a department of pathology in N. A. Semashko City Hospital in Tula. Simultaneously he attended, by correspondence, a postgraduate course in a Chair of Pathological Anatomy headed by Prof. A. I. Abrikosov at the First Moscow University. Later A. I. Strukov moved to Moscow where he started working in a laboratory of pathology of the Central Institute of Tuberculosis of the USSR Ministry of Health, headed by Prof. V. G. Stefko. He inherited from his chiefs the interest to the problem of tuberculosis and, for many years, he has been studying, together with his students, the details of morpho- and pathogenesis and pathomorphosis of this disease. The results of these studies were published in a number of monographs and journals and were included into candidate and doctor theses. A. I. Strukov developed a clinico-morphological classification of tuberculosis recognised by pathologists and clinicians of the USSR. Since 1933 A. I. Strukov worked as an assistant of A. I. Abrikosov's chair and was elected a chief of the Pathological Anatomy Chair of the First Kharkov Medical Institute. He spent the Great Patriotic War (1941-1945) in Orenburg where the Kharkov Medical Institute was evacuated. Here on the basis of local civil and military hospitals, teaching, clinical and scientific work of the institute chairs, including that of pathological anatomy, was developed. A. I. Strukov returned to Moscow in 1944, worked in Prof. V. G. Shtefko's laboratory, then was elected a Professor of a Chair of Pathological Anatomy in the First Moscow Medical Institute. In 1953, after A. I. Abrikosov has retired, A. I. Strukov became the chief of this most prominent chair of pathological anatomy in the country. Continuing the traditions of A. I. Abrikosov's school, A. I. Strukov investigates with his students various problems of pathology (tuberculosis, rheumatic diseases), develops a concept of systemic and progressing disorganisation of connective tissue in rheumatic diseases, continues studying the pathology of broncho-pulmonary lesions, cardio-vascular diseases.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3518673 TI - [The immune system of the lungs in healthy subjects and in chronic nonspecific diseases]. AB - Resistance of lung to the action of damaging factors is determined by the mechanisms of non-specific defence and immunologic responseveness that is expressed by systemic and local immune reactions. Local immune response in bronchi is brought about by a lymphoid tissue associated with bronchi. Alveolar macrophages carry out a main protective function in the respiratory parts. Participation of an immune system in the pathogenesis of chronic non-specific diseases is expressed by a lymphoid tissue hyperplasia, increased synthesis of immunoglobulins, increased number of macrophages and neutrophils. The role of an immunocomplex mechanism and cell hypersensitivity factors in the focus of damage remains unclear. A promising hypothesis in the study of immunopathology of chronic non-specific lung diseases is that of the role of an immune imbalance is their etiology and pathogenesis. PMID- 3518674 TI - Characterization and immunocytochemical localization of dentine phosphoprotein in rat and bovine teeth. AB - Dentine phosphoprotein (DPP) was isolated from unerupted bovine molars and from rat incisors. The proteins were characterized biochemically and used to immunize rabbits and guinea pigs. Antibody activity was investigated by enzyme-linked immunosorbent assay (ELISA). Guinea-pig anti-rat DPP did not cross-react with bovine DPP, but rabbit anti-bovine DPP did cross-react with rat DPP. Anti-rat DPP antiserum was applied to cryotome sections of rat molar tooth germs and DPP immunoreactivity was seen in dentine, odontoblasts, odontoblast processes and pre ameloblasts. Anti-bovine DPP antiserum reacted positively in bovine dentine and dentinal tubules. When this antiserum was applied to rat tissue, predentine was positive but dentine was negative. Adsorption experiments with DPP, purified by methods including and excluding precipitation with calcium, suggested that non calcium precipitable DPP is present in rat predentine. Rat and bovine DPP are thus species-specific and DPP is synthesized by the odontoblasts, transported through their processes and secreted into the dentine. PMID- 3518675 TI - The optical correction of pediatric aphakia. PMID- 3518676 TI - Do I take the eye out or leave it in? PMID- 3518677 TI - Enucleation vs cobalt plaque radiotherapy for malignant melanomas of the choroid and ciliary body. AB - Clinical risk factors were assessed prospectively in a nonrandomized concurrent observational study of 237 patients with posterior uveal malignant melanoma. One hundred forty of these patients were treated with enucleation, and 97 underwent cobalt plaque radiotherapy. Tumor size and location of the anterior tumor margin proved to be the most significant clinical risk factors for death from metastatic melanoma. When Cox proportional hazards modeling was used to adjust for recognized intergroup differences in risk factors, the effect of therapy (enucleation vs cobalt plaque radiotherapy) on survival time was not statistically significant. We discuss the implications of this study for a randomized clinical trial of enucleation vs cobalt plaque therapy or comparable forms of irradiation. PMID- 3518678 TI - Long-term follow-up of refractive and keratometric results of pediatric epikeratophakia. AB - To examine the long-term stability of epikeratophakia and its effect on the development of young eyes, the change in corneal curvature and refractive error over time were reviewed in pediatric patients who underwent epikeratophakia for optical correction of aphakia. Over an average follow-up time of 28.0 months, corneal curvature flattened by 1.15 diopters, or 0.53 D/yr. The average change in refractive error was -2.81 D over 23.6 months, or 1.49 D/yr. Patients younger than 1 year of age at surgery became significantly more myopic over the period of follow-up (4.75 D) than patients older than 1 year of age at surgery (2.24 D). These changes are consistent with the corneal flattening and increase in axial length expected from normal growth. Aphakic infants corrected to emmetropia with epikeratophakia will likely require correction of myopia in later childhood. PMID- 3518679 TI - Combined morphologic effects of cryolathing and lyophilization on epikeratoplasty lenticules. AB - A correlative microscopic analysis of factory-prepared epikeratoplasty lenticules, corneas stored in McCarey-Kaufman medium for two to four days, and fresh human corneas disclosed ultrastructural abnormalities in Bowman's membrane and in the corneal stroma of the lyophilized lenticules that were not present in the control corneas. These features included mottling of Bowman's membrane, with large interfibrillar spaces; a roughness to its surface; and wide interlamellar lacunae within the corneal stroma, with significant changes in interfibrillar collagen distance and fibril diameter. The morphologic features of a clinical specimen excised three months following myopic epikeratoplasty were similar to those found with the factory-prepared lenticules. Our patient's corneal curvature steepened almost 3 diopters following lenticule removal. Our results suggest that additional studies of lyophilized epikeratoplasty lenticules should be performed. PMID- 3518680 TI - Epikeratophakia for pediatric aphakia. AB - We used epikeratophakia for rehabilitation in 11 contact lens-intolerant aphakic children aged 9 months to 14 years. Minimum follow-up was five months; the longest was 12 months. There were no graft failures, and no patients were unavailable for follow-up. Objective postoperative overrefractions on all patients revealed that an average of 93% of the desired correction was obtained. Residual corrections ranged from -3.75 diopters spherical equivalent to +2.87 D. Nine of the 11 children were of verbal age; their spectacle visual acuities averaged 20/50, with a range of 20/20 to 20/80. Preverbal children all tolerated occlusive therapy, although accurate visual acuities could not be obtained. Our early results with this modality as therapy for monocular aphakia in the pediatric population have demonstrated improvement in visual function in all patients to date. PMID- 3518681 TI - Direct-smear fluorescent antibody cytology as a field diagnostic tool for trachoma. AB - A recently developed direct-smear fluorescent antibody (DFA) cytology method of detecting chlamydial infection was evaluated in an area where trachoma is endemic. Four hundred seventy-five children aged 2 to 10 years were examined, and adequate conjunctival cytology specimens were collected from 457 (96%). Trachomatous inflammatory changes were observed in 114 (25%) of the children. The DFA cytologic technique has a high specificity (100%) but a low sensitivity (8%). It offers a number of advantages over existing laboratory methods for diagnosing trachoma in the field. It is a rapid, simple, and easily transferred test that has a high specificity. Although DFA cytology shares the low sensitivity of other laboratory methods of diagnosing trachoma, we believe its logistical advantages make it the laboratory test of choice. PMID- 3518682 TI - Long-term ocular manifestations in nephropathic cystinosis. AB - Eight nephropathic-cystinotic patients having undergone renal transplantation seven to 14 years previously were studied. Serious ocular complications were noted in four of the eight cases not previously reported. These included posterior synechiae, deposition of crystals on the anterior lens surface, and decreased visual acuity accompanied by impaired visual function, as measured by psychophysical and electrodiagnostic tests when possible. PMID- 3518683 TI - HLA-DR antigens on retinal pigment epithelial cells from patients with uveitis. AB - The pathogenic mechanisms involved in immunologically associated ocular diseases are not clearly understood. To further evaluate these types of disorders, we examined the expression of HLA-DR antigen on eye sections from normal individuals and five patients (six eyes) with ocular inflammation (sympathetic ophthalmia and chronic uveitis). Using immunoperoxidase staining technique and the complement mediated cytotoxicity assay, we detected the presence of HLA-DR antigens on retinal pigment epithelial (RPE) cells from uveitic eyes. In contrast, HLA-DR antigen was not detected on RPE cells from normal ocular tissue. Our study shows that during the course of human ocular inflammatory disorders, the RPE cell is activated to express HLA-DR antigens. This antigen expression may be important in the initiation and/or perpetuation of immune reactivity in the eye. PMID- 3518684 TI - Thrombospondin: a versatile multifunctional glycoprotein. PMID- 3518685 TI - Prenatal screening. PMID- 3518686 TI - Hemodynamic and plasma renin responses to treatment of a renal arteriovenous malformation. AB - We report a case of a right renal arteriovenous malformation with high output cardiac failure and hypertension which was cured by nephrectomy. Hemodynamic findings pre- and post-operatively are presented. Plasma renin activity (PRA), both from peripheral venous and renal vein samples, was assessed. The fall in PRA associated with nephrectomy lends support to the suggestion that the renin angiotensin system plays a role in the hypertension in these patients. PMID- 3518687 TI - Chronic hepatitis: pathogenesis and treatment. PMID- 3518689 TI - Primary aldosteronism due to a malignant ovarian tumour. AB - The case of a woman with autonomous aldosteronism, hypertension, and malignant ovarian tumour is reported. Hormone studies revealed high plasma aldosterone levels, and low plasma renin concentration. Following surgical removal of a malignant sex cord stromal tumour, the hyperaldosteronism regressed, and the hypertension improved. Subsequently the tumour recurred, as did hyperaldosteronism. PMID- 3518688 TI - Sudden death due to painless spasm in near normal coronary arteries. AB - Two cases of resuscitated sudden cardiac death are described; one was due to ventricular fibrillation and the other to ventricular asystole. In both cases the underlying etiology was painless coronary spasm and no fixed coronary disease. PMID- 3518690 TI - Effect of hydration on plasma vasopressin, renin, and aldosterone responses to head-up tilt. AB - If plasma vasopressin (PVP), plasma renin (PRA), and plasma aldosterone (PA) responses to change in posture are mediated only by alterations in intrathoracic baroreceptor activity, hydration status should have minimal influence on these responses. To test this hypothesis, six male subjects underwent 45 min of 70 degree head-up tilt (HUT) following 26 h dehydration, and again, 105 min later, following rehydration. Compared with preceding supine hydrated control values, PVP, PRA, and PA increased (p less than 0.001) during dehydrated HUT, but only PVP and PRA increased during rehydrated HUT (p less than 0.001). The dissociation during rehydrated HUT of PRA and PA may have been related more to the reduction (p less than 0.001) in plasma potassium concentration than to the accompanying decrease (p less than 0.001) in plasma osmolality and sodium concentration. Although increases in PVP and PRA during HUT were attenuated (p less than 0.01) following rehydration, this attenuation was associated with the absence of symptoms of overt hypotension following rehydration. However, since rehydration did not abolish the increases in PVP and PRA induced by HUT, it is concluded that the present observations support the concept of intrathoracic baroreceptor involvement in the regulation of vasopressin secretion and renin release. PMID- 3518691 TI - Influence of inspired oxygen concentration on acceleration atelectasis. AB - The USAF is developing an On Board Oxygen Generation System (OBOGS) for use in fighter aircraft. This study was conducted to determine the inert gas dilution requirements of the OBOGS necessary to prevent acceleration atelectasis. Human subjects were exposed to either 21, 50, 70, 82.5, 95 or 100% inspired oxygen, along with an increased +Gz Simulated Aerial Combat Maneuver (SACM) profile using the USAF School of Aerospace Medicine human centrifuge. The SACM profile utilized four +4.5z peaks (136 s at this +Gz) superimposed on a +3 Gz baseline, representing a total ride time of 276 s. A significant reduction in vital capacity (VC) occurred at inspired oxygen concentrations of 70% and greater. The addition of 5% argon (a natural product of OBOGS) to pure oxygen did not reduce the magnitude of acceleration atelectasis observed, nor the severity of breathing symptoms. A 30-s exposure to positive pressure breathing at 30 mm Hg during the end of the SACM reduced the level of VC reduction caused by subjects breathing 100% oxygen during +Gz. PMID- 3518692 TI - Historic aeromedical perspective on left bundle branch block. AB - Military aviators represent a very highly trained, expensive personnel resource. It is incumbent upon the military medical care systems to manage the health aspects of this resource as wisely as possible. This can best be accomplished through a combination of preventive medicine and health promotion oriented clinical care coupled with epidemiologically sound aeromedical standards which ensure that flying safety and mission completion will not be compromised. Epidemiologically sound aeromedical standards, in most cases, can be formulated only through responsible clinical aeromedical research and investigation which is performed within the population for which the aeromedical standards are intended. PMID- 3518693 TI - 1985 Lindbergh lecture. Some personal perspectives on aviation progress. AB - Aviation has opened new opportunities for both individual achievement and public service during the past 80 years. The author discusses his experiences during the second half of the modern era of powered flight, including combat activities during World War II, work as a test pilot developing flying techniques for the first jets, challenging the world altitude record, and assessing the performance capacities of different aircraft. The lecture devotes special attention to aerobatic flying, especially the properties of the spin. The author relates these personal experiences to the responsibilities of guiding modern aviation to improved public service in the coming years. PMID- 3518694 TI - Multivariate behavioral genetics and development: an overview. PMID- 3518696 TI - Avian hormones. PMID- 3518695 TI - Twins, families, and the psychology of individual differences: the legacy of Steven G. Vandenberg. PMID- 3518697 TI - Manipulation of genes in vitro and in vivo. PMID- 3518698 TI - A technique for bisection of embryos to produce identical twins. PMID- 3518699 TI - Production of experimental chimeras in livestock by blastocyst injection. PMID- 3518700 TI - Gene transfer by direct pronuclei microinjection. PMID- 3518701 TI - Quantitative studies in ageing male and female Chbb:THOM (Wistar) rats. I. Body weight, cerebellar weight and volumes of cerebellar layers. AB - Body weight, cerebellar weight, and volumes of molecular, granular and medullary layer of the cerebellum of male and female Chbb:THOM (Wist) rats ranging in age from 6 to 34 months were measured. In male rats, peak body weight and cerebellar weight are to be expected in 20- to 22-month-old animals, with a decline of both parameters after this time. In female rats, body weight and cerebellar weight were generally lower and, at variance with male rats, both parameters increased during the whole time of observation. The cerebellar layers exhibited a different rate of volume increase with a marker increase of the medullary layer and a lesser increase of the granular and molecular layer. Thickness and volume of the molecular layer even decreased in both male and female rats after the 19th month. The relative volumes indicated a predominant growth of the hemispheres with advancing age. Our results demonstrate the need for further regional studies in male and female rats. Pros and contras in the use of rodents in geriatric research in comparison with man are discussed. PMID- 3518702 TI - Tyrosine kinase activity of insulin receptors from human placenta. Effects of autophosphorylation and cyclic AMP-dependent protein kinase. AB - The kinase activity of partially purified insulin receptor obtained from human placenta was studied. When autophosphorylation of the beta-subunit of the receptor was initiated by ATP prior to the addition of the exogenous substrate, both basal and insulin-stimulated kinase activity was increased. However, half maximum effective insulin concentrations were unchanged. Insulin receptor autophosphorylation as stimulated by ATP and insulin failed to affect significantly 125I-insulin binding to partially purified insulin receptor from human placenta. It is concluded that autophosphorylation of the insulin receptors regulates its kinase activity but not its affinity for insulin. The catalytic subunit of cyclic AMP-dependent protein kinase failed to phosphorylate either subunit of the insulin receptor, and each kinase failed to affect the affinity of the other one. Thus no functional interaction between cyclic AMP-dependent protein kinase and insulin receptors was observed in the in vitro system. PMID- 3518703 TI - Preliminary evidence for a processing error in the biosynthesis of Gaucher activator in mucolipidosis disease types II and III. AB - Activator protein (AP), which stimulated fibroblast sphingomyelinase activity, was isolated from the spleen of a patient with Gaucher's disease type I by the combined techniques of heat and alcohol denaturation, DEAE-cellulose column chromatography, gel filtration, preparative polyacrylamide-gel electrophoresis and decyl-agarose chromatography. Urea/sodium dodecyl sulphate (SDS)/polyacrylamide-gel electrophoresis showed two bands, one with an Mr of approx. 3,000 and the other with an Mr of 5,000-6,500. Similarly, SDS/polyacrylamide-gel electrophoresis performed in the absence of urea revealed the presence of two components, one of which adsorbed to a concanavalin A (Con A) column. Both components stimulated sphingomyelinase activity. On a non-denaturing polyacrylamide gel containing Triton X-100, four major components, two of which bound to Con A, were detected with the dye Stains-All. Cross-reacting material (CRM) to polyclonal Gaucher spleen AP antibodies was detected in normal fibroblasts and in fibroblasts from patients with sphingomyelinase and beta glucocerebrosidase deficiency states (Niemann-Pick and Gaucher's diseases respectively). CRM in normal fibroblasts adsorbed to Con A columns and had the same mobility on SDS/polyacrylamide-gel electrophoresis as Con A-adsorbing Gaucher spleen AP. Normal AP was not observed in mucolipidosis type II (I-cell disease) fibroblasts; instead, extracts from these cells revealed the presence of two closely migrating bands with higher Mr values than normal fibroblast CRM. Furthermore, extracts of media from I-cell fibroblast cultures, but not from control or Gaucher fibroblast cultures, contained AP activity towards sphingomyelinase and beta-glucocerebrosidase. Fibroblasts from a patient with mucolipidosis type III (pseudo-Hurler polydystrophy) showed an intermediate pattern consisting of normal as well as the higher-Mr CRM. Our data provide evidence for the existence of AP in cultured skin fibroblasts and suggest that these proteins may be targetted to the lysosome by post-translational modification in a similar manner to that reported for lysosomal enzymes. PMID- 3518704 TI - Elastinolytic activity of human cathepsin L. AB - The hydrolysis of a tritiated elastin substrate by the human cysteine proteinases cathepsins B and L has been studied. Cathepsin L was found to be at least 100 fold more active on this substrate than cathepsin B. The specific activity of cathepsin L at pH 5.5 for hydrolysis of elastin was about the same as that of pig pancreatic elastase at its optimum pH of 8.8. PMID- 3518705 TI - Trypanosoma cruzi adenylate cyclase activity. Purification and characterization. AB - Adenylate cyclase activity associated with Trypanosoma cruzi sedimentable fractions was solubilized by treatment with the non-ionic detergent Lubrol PX and 0.5 M-(NH4)2SO4. The following hydrodynamic and molecular parameters were established for a partially purified enzyme-detergent complex: sedimentation coefficient 6.2 S; Stokes radius 5.65 nm; partial specific volume 0.83 ml/g; Mr 244 000; frictional ratio 1.33. A Mr of about 124 000 was calculated for the detergent-free protein from these parameters. The pI of this enzyme activity was 6.2. A monoclonal antibody to T. cruzi adenylate cyclase was obtained, which inhibited cyclase activities from several lower eukaryotic organisms. The T. cruzi adenylate cyclase was further purified by using this antibody in immunoaffinity chromatographic columns. Fractions obtained after this chromatography showed, on SDS/polyacrylamide-gel electrophoresis, a main polypeptide band with an apparent Mr of about 56 000, which specifically reacted with the monoclonal antibody. PMID- 3518707 TI - Decreased tyrosine kinase activity of insulin receptor isolated from rat adipocytes rendered insulin-resistant by catecholamine treatment in vitro. AB - Catecholamine treatment of isolated rat adipocytes decreases insulin binding and inhibits insulin stimulation of the glucose-transport system. There is increasing evidence that the insulin signal is transmitted after insulin is bound to the receptor via a tyrosine kinase, which is an intrinsic part of the receptor. To find whether the receptor kinase is modified by catecholamines, we solubilized and partially purified the insulin receptor of isoprenaline-treated adipocytes and studied the effect of insulin on its kinase activity. (1) Insulin increased the tyrosine autophosphorylation of the insulin receptor kinase from catecholamine-treated cells only 4-fold, compared with a 12-fold stimulation in control cells. (2) The rate of insulin-stimulated 32P incorporation into the receptor of isoprenaline-treated cells at non-saturating [32P]ATP concentrations (5 muM) was decreased to 5-8% of the values for receptor from control cells. (3) 125I-insulin binding to the partially purified receptor from catecholamine treated cells was also markedly decreased. The insulin receptor from catecholamine treated cells bound 25-50% of the amount of insulin bound by the receptor from control cells at insulin concentrations of 10 pM-0.1 muM. Part of the impaired insulin-responsiveness of the receptor kinase of catecholamine treated cells is therefore explained by impaired binding properties; however, an additional inhibition of the kinase activity of the insulin receptor from catecholamine-treated cells is evident. (4) This inhibition of kinase activity decreased when the concentration of [gamma-32P]ATP in the phosphorylation assay was increased. A Lineweaver-Burk analysis revealed that the Km for ATP of the receptor kinase from isoprenaline-treated cells was increased to approx. 100 muM, compared with approx. 25 muM for receptor of control cells. (5) We conclude from the data that catecholamine treatment of rat adipocytes modulates the kinase activity of the insulin receptor by increasing its Km for ATP and that this is part of the mechanism leading to insulin-resistance in these cells. PMID- 3518708 TI - [Cell envelope-bound proteinase activities of Acinetobacter calcoaceticus]. AB - Acinetobacter calcoaceticus contains proteolytic activity after growth on various culture media. The enzyme activity could be found in the cytosolic fraction as well as in the cell envelopes (also containing the intracytoplasmic membranes). The highest proteolytic activity could be detected during the transition from the logarithmic growth phase to the stationary phase and in the early stationary phase, respectively. In the culture medium proteolytic activity was only evident in the later stationary phase. This activity was very instable and was liberated apparently by autolysis of the cells. The concentration of the nitrogen source (NH4+) in the medium (i.g. with acetate as carbon source) influences the proteinase activities of the cells. When nitrogen is limited, the proteolytic activity increases strongly in the stationary phase. The pH-profile of the azocaseinolytic activities of the cytosol was nearly the same as that of the cell envelopes (pH-optima are between 7 and 9). A partial inhibition of the proteolytic activities in the cytosol as well as in the cell envelopes could be attained by serine proteinase inhibitors. Inhibitors of thiol- and metalloproteinases showed no effects. PMID- 3518706 TI - The serC-aro A operon of Escherichia coli. A mixed function operon encoding enzymes from two different amino acid biosynthetic pathways. AB - Sub-cloning experiments aimed at precisely locating the E. coli aroA gene, which encodes the shikimate pathway enzyme 5-enolpyruvylshikimate 3-phosphate synthase, showed that in certain constructions, which remain capable of complementing an auxotrophic aroA mutation, expression of aroA is reduced. DNA sequence analysis revealed that a sequence approx. 1200 base pairs (bp) upstream of aroA is necessary for its expression. An open reading frame was identified in this region which encodes a protein of 362 amino acids with a calculated Mr of 39,834 and which ends 70 bp before the start of the aroA coding sequence. This gene has been identified as serC, the structural gene for 3-phosphoserine aminotransferase, an enzyme of the serine biosynthetic pathway. Both genes are expressed as a polycistronic message which is transcribed from a promotor located 58 bp upstream of serC. Evidence is presented which confirms that the aroA and serC genes constitute an operon which has the novel feature of encoding enzymes from two different amino acid biosynthetic pathways. PMID- 3518709 TI - Interactions of immobilized and free triazine dyes with glucose-6-phosphate dehydrogenase from yeast. AB - Glucose-6-phosphate dehydrogenase (EC 1.1.1.49) prepared from baker's yeast binds to immobilized Cibacron Blue F3G-A and Procion Red HE-3B. In this paper the two dyes are compared with respect to their use in the purification of this enzyme. Cibacron Blue chromatography was found useful at an early stage of purification for the removal of contaminating hexokinase, phosphoglucose isomerase and phosphoglucomutase. With Procion Red HE-3B Sepharose the NADP dependent enzymes phosphogluconate dehydrogenase and glutathione reductase are separable from glucose-6-phosphate dehydrogenase. Unlike Cibacron Blue gel chromatography, the enzyme can be specifically eluted from Procion Red HE-3B Sepharose by a NADP gradient. Other monochlorotriazine dyes like Xirone Brillant Red BHD, 4BHD, 6BHD and GHD and the dichlorotriazine dye Procion Brown MX-5BR immobilized to Sepharose have only little binding affinity to glucose-6-phosphate dehydrogenase. The binding behaviour of different immobilized triazine dyes for pre-purified and purified glucose-6-phosphate dehydrogenase is compared. In addition, the influence of the free dyes on the activity of glucose-6-phosphate dehydrogenase is studied. It is demonstrated that the results of kinetic and binding studies with the purified enzyme are not uncritically applicable for the selection of a dye as ligand for affinity chromatography during enzyme preparation. PMID- 3518710 TI - Inhibition of macrophage migration by a factor from ascites fluids of ovarian cancer patients. I. Biochemical characterization and purification. AB - A nonspecific inhibitor of macrophage migration was found in large quantities in the cell-free ascitic fluids from patients with ovarian tumours. MIF-like activity was assigned by the ability of various dilutions of ascitic fluids to inhibit migration of guinea pig macrophages from agarose droplets. The factor was purified in 3 subsequent steps including ion exchange chromatography, gel filtration, and isoelectric focusing. The data obtained indicate molecular heterogeneity according to net charge and molecular weights. The main MIF activity was found at about 45, 20, and 10 kD, respectively, and partially at less than 10 kD. Isoelectric focusing of the various MIF species revealed activity peaks in the pH range from 3.8 to 5.0. A further peak was detected at pH 6.0 in crude material. The factor was purified about 10 000-fold compared to the starting material. The action of OC-MIF was inhibited by L-fucose, and when target cells were incubated with alpha-L-fucosidase, they did not respond any longer to OC-MIF. Furthermore, purified MIF-like activity is a nondialyzable glycoprotein, sensitive to treatment with neuraminidase, chymotrypsin, trypsin and pronase, however, unaffected by incubation at 60 degrees C for 1 h. The physicochemical properties of OC-MIF activity studied are comparable to lymphocyte-derived conventional MIF. PMID- 3518711 TI - Inhibition of macrophage migration by a factor from ascites fluids of ovarian cancer patients. II. Production and characterization of an anti-MIF antibody. AB - A macrophage migration inhibition factor (OC-MIF) has been isolated from ascites fluid of ovarian cancer patients by affinity chromatography on L-fucose-Sepharose 6B, and characterized biochemically. OC-MIF activity was purified approximately 10 000-fold as compared to the starting material. It exhibits molecular heterogeneity with respect to net charge and molecular weights. Compared to it, purified and radioiodinated OC-MIF is fairly homogeneous and contains a major protein component with a molecular mass of about 45 kD, and two isoelectric points of 3.0-4.0 and about 5.0. Rabbits were immunized with the highly purified MIF material and an antiserum was prepared and was used to prepare immunoadsorbent beads. Beads made with anti-OC-MIF antiserum, but not with rabbit control serum, could remove specifically OC-MIF activity and showed weak reactivity towards Con A induced MIF. Using a radioimmunoassay (RIA) anti-OC-MIF antiserum reacts with OC-MIF and also with Con A induced MIF. This antigenic relationship between conventional MIF and OC-MIF and common biochemical properties suggest that the two mediator substances are very similar and may, perhaps, be identical. Furthermore, the possibility to determine various MIF activities by means of RIA was investigated. PMID- 3518712 TI - Naturally occurring masked antibodies in murine sera recognize a component of the mitotic spindle apparatus. AB - Antibody activities previously masked in autoimmune MRL and normal Balb/c mice were expressed by briefly subjecting their sera to acidic (pH 2.0) or alkaline (pH 12.0) environments. An enzyme-linked immunosorbent assay (ELISA) revealed that these pH-expressable immunoglobulins reacted with specific nucleotide-BSA antigens (primarily 5'-AMP, -GMP, -TMP) but not with single (ss)- or double (ds) stranded DNAs or with unconjugated BSA. ELISA analysis of pH-expressed antibodies purified via GMP-BSA/Sepharose indicated that they bound not only to the homologous hapten (GMP) but to AMP and TMP as well, i.e., anti-pAGT antibodies. Further, indirect immunofluorescent assays (IIF) with fixed HEp-2 cells demonstrated that purified anti-pAGT antibodies recognized an epitope within the mitotic spindle apparatus. These results document the existence of a previously undefined masked antibody population in murine sera with specificities directed toward certain nucleotides and a component of the mitotic spindle apparatus. Last, these anti-pAGT (or anti-mitotic spindle) antibodies are not restricted to murine systems inasmuch as they have been detected in every human serum (greater than 100 samples) examined thus far. PMID- 3518713 TI - Biosynthesis of reovirus-specified polypeptides. Molecular cDNA cloning and nucleotide sequence of the reovirus serotype 1 Lang strain s4 mRNA which encodes the major capsid surface polypeptide sigma 3. AB - Serotype 1 Lang strain s4 mRNA, which encodes the major capsid surface polypeptide sigma 3 of reovirions, was cloned as a cDNA:mRNA heteroduplex in Escherichia coli using phage M13. A complete consensus nucleotide sequence for s4 mRNA has been determined from cDNA clones. The Lang strain s4 mRNA is 1196 nucleotides in length and possesses an open reading frame with a coding capacity of 365 amino acids, sufficient to account for a sigma 3 polypeptide of 41,212 daltons. Comparison of the serotype 1 (Lang) s4 sequence with the serotype 3 (Dearing) s4 sequence reveals 94% homology at the nucleotide level; the predicted sigma 3 polypeptides of the Lang and Dearing strains display 96% homology at the amino acid level. Two third base C codons (leu:CUC and ser:AGC) are used about one-tenth as frequently in the reovirus s4 mRNAs as compared to mammalian cellular mRNAs. PMID- 3518714 TI - Varying brain insulin concentrations differentially regulate the fetal brain insulin receptor. AB - We investigated the downregulating effect of varying states (physiologic and pharmacologic) of systemic and intracranial hyperinsulinism on the 28 to 30 day fetal rabbit brain insulin receptor. Alloxan-induced maternal diabetes (n = 5) produced mild fetal hyperinsulinemia (D) (plasma insulin concentrations = 59.80 +/- 8.10 microU/ml, control = 26.25 +/- 3.70; p less than 0.01), whereas systemic administration (IMI) of 1.0 U (n = 4) and 2.0 U (n = 4) of insulin to the fetus resulted in moderate (103.13 +/- 34.63 microU/ml) and severe (288.3 +/- 51 microU/ml) fetal hyperinsulinemia respectively. All three states of systemic hyperinsulinemia neither altered the fetal brain insulin content nor the brain insulin receptor number and affinity. 0.01 U (n = 4) of intracranial insulin administration (ICI) increased the brain insulin content four-fold (p less than 0.01) but did not alter the brain insulin receptor number or affinity. 0.1 (n = 5) and 2.0 U (n = 7) of intracranial insulin increased the brain insulin content to supraphysiologic concentrations (p less than 0.01) and decreased the fetal brain insulin receptor number (p less than 0.01), the affinity remaining constant. We conclude that 1) regardless of the ability of insulin to cross the blood brain barrier, the downregulation of the brain insulin receptor is insulin dose-dependent and 2) the downregulation of the fetal brain insulin receptor is not a physiologic but a pharmacologic effect of insulin. PMID- 3518715 TI - Delayed appearance of liver growth hormone binding sites and of growth hormone induced somatomedin production during rat development. AB - The present study was designed to determine whether the apparent paradox of high circulating growth hormone levels in the fetus and the minimal effect of this hormone on growth might reflect a diminished responsiveness of fetal target organs to GH. Specific uptake by rat liver of [125I] bGH was very low in fetuses as compared to suckling and adult rats. Also, liver uptake of the iodinated hormone decreased proportionally with the simultaneous injection of increasing amounts of growth hormone, but was not modified by the simultaneous injection of unlabelled chemically-related hormones. Since the water content is significantly greater in fetal than adult tissues, results were expressed by liver dry weight and again, [125I] bGH liver uptake continued to increase with age. After bovine growth hormone administration to adult rats, plasma somatomedin C concentrations increased significantly, while they had no effect in fetuses. These results suggest that reduced liver somatogenic binding sites in the fetus prevents growth hormone from inducing growth-promoting effects during intrauterine life. PMID- 3518716 TI - An immunological study of a Pb-thionein like protein in rat liver. AB - Administration of a sublethal dose of lead acetate to rats induced the simultaneous synthesis of a Pb-thionein like protein (Pb-BP) and Zn-thionein in the liver. To determine of the Pb-BP is a species of metallothionein, immunological properties of this protein were investigated. The results indicate that the Pb-BP is cross-reactive with the antibody against rat Zn-thionein II, strongly suggesting that the Pb-BP is a metallothionein. PMID- 3518717 TI - Tetrathionate reductase of Salmonella thyphimurium: a molybdenum containing enzyme. AB - Use of radioactive molybdenum demonstrates that the tetrathionate reductase of Salmonella typhimurium is a molydenum containing enzyme. It is proposed that this enzyme shares with other molybdo-proteins, such as nitrate reductase, a common molybdenum containing cofactor the defect of which leads to the loss of the tetrathionate reductase and nitrate reductase activities. PMID- 3518718 TI - Induction of insulin release in fibroblasts transfected with genomic rat islet DNA. AB - L cells (tk-) were cotransfected with total genomic rat islet DNA and a plasmid containing thymidine kinase gene (ptk). Transfectants were tested for their ability to release insulin into the medium. At least 10% of the colonies contained immunoreactive insulin (IRI) during the initial two weeks. The insulin secreted competed linearly with rat insulin in RIA, the majority of the insulin antigenicity comigrating with rat insulin on G-50 Sephadex chromatography. With continuing propagation the IRI activity diminished; however 3 selected cultures demonstrated increased secretion of IRI following stimulation with glucose. These findings indicate that glucose-induced insulin secretion can be obtained in non beta cells; however the frequency of success was below one stable transfection for every 5 X 10(8) Ltk- cells exposed to the transfection procedure. PMID- 3518719 TI - ADP-ribosylation of nonmuscle actin with component I of C2 toxin. AB - C2 toxin elaborated by Clostridium botulinum type C is composed of two dissimilar protein components, designated components I and II. Component I of the toxin caused ADP-ribosylation of a protein of Mr 45,000 in chicken tissue homogenates and also purified nonmuscle but not muscle actin. The endogenous ADP-ribosylation of intracellular actin with C2 toxin was correlated with the morphological change in intact culture cells caused by the toxin. These results indicate that the biological activity of the toxin involves a novel enzymatic activity of component I, which catalyzes the preferential ADP-ribosylation of nonmuscle actin of the target cells. PMID- 3518720 TI - The binding of N-(phosphonacetyl)-L-aspartate to aspartate carbamoyltransferase of Escherichia coli. AB - A more precise description of the binding of N-(phosphonacetyl)-L- aspartate to the catalytic chains of aspartate carbamoyltransferase clarifies aspects of the specificity of this enzyme toward its substrates, carbamoylphosphate and L aspartate, and suggests a catalytic role for His-134. PMID- 3518721 TI - Reactivation of nerve agent inhibited human acetylcholinesterases by HI-6 and obidoxime. AB - Acetylcholinesterase was purified from human caudate nucleus and skeletal muscle. The enzyme preparations were used to study aging and reactivation by HI-6 and obidoxime after inhibition by soman and its isomers. HI-6 was found to be the most potent reactivator. For both enzyme preparations a higher reactivatability and a higher rate of aging were observed after inhibition by C+-soman than after inhibition by C(-)-soman. Aging was retarded by propidium diiodide. Reactivation by the two oximes was also studied after inhibition by tabun, sarin and VX. Tissue homogenates were used for this part of the work. Our conclusion is that HI 6 is superior to obidoxime for human acetylcholinesterases inhibited by soman and sarin, while obidoxime is better towards tabun-inhibited enzyme. PMID- 3518722 TI - Inhibitory effects of histidine analogues on growth and protein synthesis by Plasmodium falciparum in vitro. AB - The human malaria parasite Plasmodium falciparum synthesizes several proteins that are unusually rich in histidine. We therefore screened histidine analogues for their capacity to inhibit in vitro parasite growth. Analogues were added to cultures of ring-stage parasites, and parasite morphological development was assessed by light microscopy after a 22-hr culture. Inhibition of morphological development was identified as the appearance of condensed or pycnotic parasites rather than mature trophozoites. Inhibition of parasite protein synthesis was assessed by radioactivity counting of [3H] isoleucine incorporated into acid insoluble products and by sodium dodecyl sulfate polyacrylamide gel electrophoresis and fluorography of [3H]histidine-labeled malarial proteins. 2-F L-Histidine and 2-I-D, L-histidine exerted the most pronounced inhibitory effects, the fluoro-analogue being the more effective of the two. At a 0.125 mM concentration, both compounds inhibited parasite growth and 2-F-L-histidine also inhibited protein synthesis. At a 1.0 mM concentration, 2-azido-L-histidine, alpha-methyl-L-histidine and WR 177589A also inhibited P. falciparum growth and protein synthesis. Twenty other histidine analogues, including 5-F-L-histidine and 5-I-L-histidine, showed little or no effect under these conditions. The inhibitory histidine analogues may be of interest for antimalarial chemotherapy if they should prove to have greater effect on P. falciparum protein synthesis than on host protein synthesis. PMID- 3518723 TI - Suppressive effect of Escherichia coli on adjuvant-induced arthritis in germ-free rats. AB - Our previous finding, that germ-free F344 rats develop severe adjuvant-induced arthritis, whereas specific pathogen-free rats develop mild disease, prompted us to investigate the role of bacterial flora in promoting the development of this disease. Germ-free rats given Escherichia coli experienced disease suppression. Germ-free rats treated with 3 strains of Lactobacillus experienced an enhancement of the disease, although it was not significant. Germ-free rats treated with a combination of E coli and lactobacilli had disease suppression similar to that of E coli monoassociated rats. Thus, these findings suggest that E coli may play a dominant role in modulating the development of the disease in this particular strain of F344 rats, possibly through its lipopolysaccharide (as evidenced by positive results on limulus tests). These findings also suggest that microflora play an important role in modifying the development of joint disease. PMID- 3518724 TI - Effects of ibopamine on heart performance: a radionuclide ventriculography study in patients with idiopathic dilatative cardiomyopathy. AB - The effects of ibopamine (SB-7505, Ib), a new orally active 3,4-diisobutyryl ester of N-methyldopamine, were studied in 8 patients aged between 34-56 years with idiopathic dilatative cardiomyopathy (II-III New York Heart Association Class) diagnosed by means of right and left heart catheterization and selective coronary angiography. Equilibrium radionuclide ventriculography (RVG) was performed in baseline conditions and 1, 2, and 3 h after the administration of a single oral dose of 200-300 mg of Ib. After 2 h Ib increased cardiac output (CO) (+16%, p less than 0.05), stroke volume (SV) (+12%, p less than 0.05) and ejection fraction (EF) (+10%, p less than 0.01). Patients were then randomly treated with placebo or Ib 100 mg t.i.d. according to a double-blind cross-over design for two periods of 15 days each. At the end of each period a RVG was repeated in baseline conditions and 1, 2, and 3 h thereafter. The mean values of the four determinations where higher after Ib than after placebo (CO: +10.1%, p less than 0.01; SV: +14.1%, p less than 0.01; EF: +10.8%, p less than 0.05). Patients subsequently started a long-term treatment with Ib 100 mg t.i.d.; after 6 months patients underwent RVG 3 h after the last dose of Ib: compared with the values recorded at the same time after the short-term treatment. CO further increased by 17% (NS), SV by 22% (p less than 0.05) and EF by 24% (p less than 0.05). The treatment was well tolerated.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3518725 TI - Positive inotropic effects of ibopamine in patients with congestive heart failure. A multicenter investigation. AB - A multicenter double-blind placebo-controlled investigation was carried out in 42 patients with severe congestive heart failure who were given ibopamine (SB-7505), the 3,4-diisobutyryl ester of N-methyldopamine, for a period of 10 days in addition to previous treatment with digitalis and diuretics. Symptoms were evaluated by using a suitable score; some patients were submitted to an exercise test along with other clinical tests. Compared with placebo, ibopamine induced no significant changes in heart rate and arterial blood pressure. Clinical scores were lower after ibopamine than after placebo (p less than 0.01). Functional capacity, defined as the duration (in s) of a maximum symptom-limited exercise test using the ergometric bicycle with a constant 25-W workload, was significantly higher after ibopamine than after placebo (p less than 0.05). So a clear symptomatic improvement was observed after ibopamine in cardiac patients with prolongation of exercise time and reduced clinical scores. In conclusion, the results obtained, along with the slight improvement in the systolic time intervals, indicate that ibopamine is capable of improving cardiac performance in patients with advanced heart failure who display symptoms despite treatment with digitalis and diuretics. PMID- 3518726 TI - The efficacy of ibopamine in long-term treatment of dilated cardiomyopathy. A clinical and instrumental evaluation. AB - The aim of this study was to investigate whether long-term treatment with ibopamine (SB-7505), the 3,4-diisobutyryl ester of N-methyldopamine, in patients with severe symptomatic congestive cardiomyopathy is associated with an improvement in cardiovascular conditions. The investigation was carried out in 18 outpatients with idiopathic or post-ischemic dilated cardiomyopathy and chronic severe heart failure (NYHA (New York Heart Association) Class III-IV). Patients were randomly assigned to a protocol in which either digitalis and diuretics (8 patients, Group 2) or the same treatment plus ibopamine (10 patients, Group 1) were given. There were no significant differences between the two groups in age, weight, height, functional class and duration of symptoms. The results obtained showed that cardiovascular conditions worsened dramatically in the group of controls during the 10-week period, irrespective of the treatment with digitalis and diuretics. Some of the parameters deteriorated significantly (p less than 0.05 or less than 0.01) such as systolic and diastolic left ventricular diameters, fractional shortening, end-systolic stress and pressure/diameter ratio, and other parameters showed a tendency to become worse (exercise time, cardiothoracic ratio). On the contrary, in patients of group 1, ibopamine in association with digitalis and diuretics appeared to preserve left ventricle function from a progressive worsening. None of the parameters deteriorated with ibopamine by contrast with a sharp decrease in the control group. Some of the parameters (fractional shortening, pressure/diameter ratio, exercise time) showed a tendency to improve although not significantly. The data suggest than 10 weeks treatment with ibopamine may prevent any deterioration or even produce a mild improvement in patients with very severe congestive heart failure. PMID- 3518727 TI - Humoral and renal effects of ibopamine in normal subjects. AB - The acute effects of 50 mg of ibopamine (SB-7505), the 3,4-diisobutyryl ester of N-methyldopamine, were investigated after oral administration to 10 adult subjects without evidence of renal, hepatic or cardiovascular disease. Blood pressure and heart rate did not change while diuresis and urinary electrolyte excretion increased significantly during the 240 min of the study. Glomerular filtration rate (GFR) was also increased at 80 min after ibopamine, whereas plasma aldosterone and prolactin were slightly decreased. In contrast to dopamine, ibopamine did not stimulate plasma renin activity. These results are attributable to the ability of ibopamine to be rapidly deesterified to N methyldopamine (epinine) which has been previously shown to exert peripheral effects similar to those of dopamine. Therefore, the increased GFR can be ascribed to an enhanced renal blood flow. On the contrary, taking into account the significant increase of the fractional excretion of sodium (FeNa) the rise in sodium excretion seems to be the consequence of a direct tubular effect of epinine, even though the slight decrease in peripheral aldosterone concentration would have been a contributing factor. Urinary flow rate might be enhanced by the high sodium delivery to the distal nephron, rather than by a postulated dopaminergic inhibition of arginine-vasopressin release. PMID- 3518728 TI - Synthesis and anthelmintic activity of 2,2'-disubstituted 5,5' dibenzimidazolylsulfides and sulfones. AB - A number of substituted diphenylsulfides and sulfones (4-11) and 2,2' disubstituted-5,5'-dibenzimidazolyl sulfides and sulphones (12-19) have been synthesized starting from 5-chloro-2-nitroacetanilide and (3) 4,4' dichlorodiphenyl sulfone (9), respectively. Among the compounds tested against Ancylostoma ceylanicum in hamsters and Hymenolepis nana in rats and mice, 14, 15, 18 and 19 removed 100% of the worms at an oral dose of 25 mg/kg X 1 to 250 mg/kg X 3. Some of the compounds were tested for their blood schizontocidal activity against Plasmodium berghei in mice but none showed any activity up to an oral dose of 10 mg/kg given for 6 days. PMID- 3518729 TI - [Relative bioavailability of paracetamol from tablets and suppositories as well as of paracetamol and codeine in a combination tablet]. AB - Eight healthy male volunteers took part in this study to determine the relative bioavailability of Treuphadol oblong tablets (500 mg paracetamol), Treuphadol Plus oblong tablets (500 mg paracetamol, 30 mg codeine phosphate) and Treuphadol suppositories (750 mg paracetamol) against commercial tablets (500 mg paracetamol). Plasma levels of paracetamol and codeine, plus saliva levels of paracetamol for the two paracetamol only formulations, were determined by HPLC and the pharmacokinetic parameters established. The AUC data for paracetamol showed that all four preparations were bioequivalent. The saliva levels of paracetamol demonstrated a good correlation to the corresponding plasma levels. The pharmacokinetic data of codeine from the Treuphadol Plus tablet were compared with corresponding data from the literature. The bioequivalence of codeine when based on this comparison can also be assured. PMID- 3518730 TI - [Intragastric acidity under the prostaglandin E2 analog trimoprostil. Increased inhibitory effect through administration after meals]. AB - In this double-blind cross-over study the effect of trimoprostil (trimethyldesoxyprostaglandin E2), an orally effective prostaglandin E2 analogue, on 24-h intragastric H+-activity, nocturnal acid output, nocturnal volume secretion and meal stimulated gastrin secretion was determined in 12 healthy male volunteers. On three different days the subjects received four times a day either placebo or 1.5 mg trimoprostil 30 min before or 30 min after meals. Trimoprostil administered before or after meals reduced 24-h intragastric acidity by 27.0 and 53.9%. Nocturnal acid output was inhibited by 32.7 and 55.6%. Nocturnal volume secretion and meal stimulated gastrin secretion remained unaffected. The study shows that the antisecretory activity is significantly increased when trimoprostil is given after meals. PMID- 3518731 TI - Some aspects of clearance of mitoguazone in cancer patients and experimental cancer models. AB - Mitoguazone (methylglyoxal-bis(guanyl-hydrazone), MGBG) was studied by its first pass mechanism in both cancer patients and experimental cancer models. It appears from the study that 90% of MGBG is cleared from the plasma within minutes. 24-h recovery in the urine, however, did not exceed 16% so that 84% of the drug seems to be bound to subcellular compartments. Tissue levels of MGBG in the normal prostate ranged higher than in experimental prostate cancer type 3327 M/G, i.e. enhanced clearance from cancer tissues: polyamine biosynthetic enzymes ornithine decarboxylase as well as S-adenosylmethionine decarboxylase are contrarily affected by MGBG. PMID- 3518732 TI - The 1985 Omnibus Survey. Implications for strategic planning. PMID- 3518733 TI - Immunohistochemical localization of apolipoprotein E in atherosclerotic lesions of the aorta and coronary arteries. AB - The distribution of apolipoprotein E (apo E) immunoreactive substances (IRS) in atherosclerotic lesions and lesion-free areas of the aorta and coronary arteries obtained from 17 autopsied cases was studied using a specific anti-apo E serum and the unlabeled peroxidase-antiperoxidase (PAP) method. In fatty streak lesions of the aorta, many cells containing apo E-IRS were found in the deeper layer of the intima and diffuse staining of apo E in the extracellular spaces was also noted. In more advanced lesions apo E-positive cells could not be found. Immunohistochemical findings of coronary arteries differed distinctly from those of the aorta in that the apo-E-positive cells were absent in the deeper layer of the intima. The endothelial cells of coronary arteries, but not those of the aorta, showed positive staining for apo E. PMID- 3518734 TI - The role of ultrasound in the diagnosis of cyclosporine toxicity in renal transplantation. PMID- 3518735 TI - [Typhoid fever: its diagnosis]. PMID- 3518736 TI - [Evaluation of the methods of bacteriological diagnosis of typhoid fever in pediatrics]. PMID- 3518737 TI - The effect of reducing agents on proteolytic enzymes and oxidation of alpha 1 proteinase inhibitor. AB - We have studied the effect of the mucolytic agent N-acetylcysteine and dithiothreitol on the oxidation of alpha 1-PI by hydrogen peroxide, and their effect on porcine pancreatic elastase and leukocyte elastase. In addition, the effect of S-(carboxymethyl)cysteine (= carbocisteine, a mucolytic agent which does not have reducing properties) was studied in vitro and in patients with chronic obstructive bronchitis. Following addition of 59.6mM N-acetylcysteine, the amidolytic activity of leukocyte elastase was decreased by 55.3% and that of porcine pancreatic elastase by 57.0%. Dithiothreitol (5.7 mM) caused the loss of 97.4% and 67.6% of amidolytic activity of leukocyte elastase and porcine pancreatic elastase respectively whereas S-(carboxymethyl)cysteine had no effect. Similar results were found for the effect on elastolytic activity. Oxidation of alpha 1-PI by 8.6mM H2O2 resulted in partial loss of inhibitory function (mean 68.7% activity of native alpha 1-PI). N-Acetylcysteine and dithiothreitol prevented oxidation of alpha 1-PI when pre-incubated with H2O2 or incubated with alpha 1-PI and H2O2 simultaneously (94.5% and 94.4% activity of native alpha 1-PI for N-acetylcysteine; 78.3% and 87.6% activity for dithiothreitol - p less than 0.025). S-(Carboxymethyl)cysteine, when pre-incubated with H2O2 or incubated concurrently with alpha 1-PI and H2O2, caused a further decrease in the porcine pancreatic elastase inhibitory capacity of alpha 1-PI (53.1% and 63.0% respectively - p less than 0.025). None of the agents reversed oxidative inactivation once it had occurred. S-(Carboxymethyl)cysteine had no effect on alpha 1-PI function in sputum at the dose used. PMID- 3518738 TI - Tetrapeptide substrates for the discrimination among kallikreins and other trypsin-like serine proteinases. AB - The three tetrapeptides Ac-Phe-Arg-Arg-Val-NH2 (I), Ac-Phe-Arg-Arg-Pro-NH2 (II) and Ac-Phe-Lys-Arg-Val-NH2 (III) were shown to form a most convenient substrate system for the discrimination of the serine proteinases listed below. Tissue kallikreins (porcine pancreatic, horse and human urinary) have the unique feature of cleaving well the Arg-Arg bond in peptide I (P'2 = Val), hardly splitting it in peptide II (P'2 = Pro). The kcat/Km for the hydrolysis of peptide II by horse urinary kallikrein was 600-fold lower than that for peptide I. Trypsin, plasma kallikreins (human and rat), tonin and rat urinary kallikrein were distinguished from each other by the sequence of the N-terminal fragments formed in the hydrolysis of peptides I and/or II. Differences in the cleavage sites in these peptides are explained by differences in the specificities of the proteinase subsite S2 and/or in their preference for Arg or Lys residues. The three tetrapeptides were not substrates for plasmin. PMID- 3518739 TI - Improvement of impaired postoperative insulin action by bradykinin. AB - The effect of bradykinin on insulin-stimulated glucose metabolism was studied in 5 operated patients using the euglycemic insulin clamp technique and the forearm catheter technique. Insulin infusion [1.0 mU/(kg b.w. X min)] raised plasma insulin levels up to 73 muU/ml. Euglycemia was maintained by a computerized glucose infusion rate, amounting to 2.9 mg/(kg b.w. X min). Addition of bradykinin [1.5 micrograms/(kg b.w. X h)] resulted in a significant increase of the glucose infusion rate [+ 1.0 mg/(kg b.w. X min)] indicating elevated whole body glucose uptake. This was related to an enhanced forearm glucose uptake [+ 1.16 mumol/(100 g X min)]. Forearm blood flow remained stable. PMID- 3518740 TI - [Renin activity and plasma aldosterone level after sudden death from alcoholic intoxication]. AB - Plasma renin activity (PRA) and aldosterone concentration (PAC) were determined in early (up to 6 hours) autopsy material of 35 cases of sudden death (men aged 22-35). In half of cases alcohol was present in the blood. The same parameters were evaluated in 35 living men: 17 donors and 18 subjects with alcoholic intoxication. The presence of alcohol in the blood both in cases of sudden cardiac death (SCD) and in subjects with alcoholic intoxication was shown to result in a marked increase in PRA and PAC. Statistic analysis revealed a positive correlation between PRA and PAC in SCD in the presence of alcoholic intoxication, which is not observed when the latter is absent. These results suggest that aldosterone concentration in SCD may be increased due to some stimulating factors other than alcohol. Calcium balance disturbances could be one of them. PMID- 3518741 TI - [Effect of plasmapheresis on plasma hormone levels in patients with hereditary hypercholesterolemia]. AB - It is shown that plasmapheresis in the volume of 30-46 ml/kg using 2997 cellular separator (IBM) does not significantly reduce testosterone, estradiol, aldosterone, parathyroid hormone and calcitonin concentrations. The initially high level of insulin and C-peptide was reduced, angiotensin-I concentration lowered and somatotropic hormone concentration doubled. It is suggested that plasmapheresis stimulates lipolytic and anabolic processes in the organism. PMID- 3518742 TI - Corneal donations may help to ease family's pain. PMID- 3518743 TI - Effector mechanisms in allograft rejection. PMID- 3518744 TI - Molecular immunobiology of complement biosynthesis: a model of single-cell control of effector-inhibitor balance. PMID- 3518745 TI - Analysis of the expression and function of class-II major histocompatibility complex-encoded molecules by DNA-mediated gene transfer. PMID- 3518746 TI - The regulation and expression of c-myc in normal and malignant cells. PMID- 3518747 TI - Immunoglobulin A: strategic defense initiative at the mucosal surface. PMID- 3518748 TI - Murine major histocompatibility complex class-I mutants: molecular analysis and structure-function implications. AB - The class-I mutants have provided a model system for understanding the generation of diversity of the genes encoding the histocompatibility molecules K, D, and L, and the relationship of their structure to function. The complex nature of the alterations found in Kb molecules from mutant mice has been documented at the nucleic acid level for eight mutants. The clustered changes in the mutant genes are consistent with the hypothesis that genetic recombination between class-I genes generates the Kb mutants. Techniques using synthetic oligonucleotide probes to mutant DNA sequence demonstrated that other class-I genes were available as donors for interaction with the Kb gene to produce the mutations. Intriguingly, donor genes found in the K region (K1) and the D region (Db), as well as the Qa regions (Q4, Q10), were capable of the interactions. The amount of genetic transfer to Kb from other class-I donor genes may range from a potential minimum of 5 nucleotides to a potential maximum of 95 nucleotides. Genealogical analysis of several bm mutants has further indicated that at least some, if not all, of the gene interaction events generating Kb mutations occurred during mitotic amplification of the germ cells. Genetic recombination among class-I genes occurring in nature to the extent observed for the Kbm mutants could readily generate mosaic transplantation genes containing sequences derived from other class-I genes. Thus, it seems likely that genetic interaction plays a major role in the diversification and ongoing evolution of the MHC. The localization of altered amino acids in the in vivo mutant Kb molecules has directed our attention to recognition regions on the Kb product that play a major role in determining alloreactivity and H-2 associative recognition. The replacement of one or a few amino acids in either of the postulated recognition regions located in the alpha 1 domain (residues 70-90) or alpha 2 domain (residues 150-180) can have marked effects on biological function. While the majority of monoclonal antibodies recognize epitopes in one or the other recognition region, CTL recognize determinants dependent on the apparent interaction of amino acids located in both regions. These overall conclusions are supported to a large extent by studies on mutants derived from several sources, i.e. spontaneous mutants, mutagen-induced somatic variants, and products of hybrid H-2 genes. Studies of in vitro variants can provide a more refined approach for analysis of structure-function relationships through the introduction of minimal biochemical changes.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3518749 TI - The membrane attack complex of complement. PMID- 3518750 TI - The molecular genetics of the T-cell antigen receptor and T-cell antigen recognition. AB - The genes encoding the alpha and beta chain of the T-cell receptor and the gamma gene have been cloned, and their structure, organization, ontogeny of expression, pattern of rearrangement, and diversification are now generally understood. In most cases, the immunoglobulin paradigm applied very well to the corresponding phenomena in T cells, although as described above, some interesting and potentially important differences exist. Nevertheless, there are still many unanswered questions regarding the ontogeny and mechanism of MHC-restricted antigen recognition, and it is not clear how far the immunoglobulin model can take us in understanding these phenomena. Although the alpha/beta heterodimer looks like an antibody and the binding sites of the two molecules may be similar, the rules governing B- and T-cell activation are clearly different, and the ligand(s) bound by the receptor are still poorly characterized. In the future, T cell receptor genes, as well as those encoding the T-cell accessory molecules, will be altered in vitro and transferred into mammalian cells in culture and into whole organisms in an attempt to understand T-cell antigen recognition. These tools will allow us to manipulate the mammalian immune response in a variety of different ways that will have a profound impact both on our understanding of immunology and on medicine in the future. PMID- 3518751 TI - The physiology of B cells as studied with tumor models. AB - B-cell tumors have been extraordinary sources of information about antibodies, their genes, and the cells that express them. An important principle that has emerged from the study of lymphoid tumors is that the long-held view that malignant lymphoid cells are "frozen" at a fixed point in differentiation is not generally valid. Presentation of immunoregulatory signals to transformed B cells can profoundly influence their proliferation, morphology, differentiation, gene expression, and immunoglobulin synthesis. In addition to their responsiveness to immunoregulatory signals, some tumors of B lineage elaborate immunoregulatory signals. Until quite recently B-cell tumors were used primarily as monoclonal sources of molecules of immunological interest. While they continue to be important sources of receptors, growth and differentiation factors, differentiation antigens, and immunoregulatory factors, they are being used with increasing frequency to define the molecular events that occur in B cells subsequent to receipt of an immunoregulatory signal. While the use of tumor cells as models of normal cells is often viewed with some skepticism, it is difficult to find examples wherein tumors have been misleading. Quite to the contrary, B cell tumors have regularly provided powerful tools for dissecting the molecular events that underlie B-cell development, function, and regulation. PMID- 3518752 TI - Mechanism of cytotoxicity by natural killer (NK) cells. PMID- 3518753 TI - Cancer immunotherapy using interleukin-2 and interleukin-2-activated lymphocytes. PMID- 3518754 TI - Mandibular reconstruction. New concepts. AB - The combination of a myocutaneous flap with a three-dimensional bendable reconstruction plate has provided satisfactory results in restoration of mandibular defects following surgical resections in irradiated patients. Twenty eight patients were treated and prospectively evaluated. Patients requiring postoperative irradiation were excluded from this study. Two groups were identified. Group A (N = 23) required a myocutaneous flap to resurface the soft tissue defect and group B (N = 5) was treated by primary closure. Seventy-three percent (17 of 23) of patients in group A and 60% (three of five) in group B had received presurgical irradiation but required none after surgery. To date, 64% (18) of the patients have maintained their plates for more than one year, half of these for two years or more. Another 21% (6) have had their plates in place more than six months and the remaining 14% (four) less than six months. One plate was lost in an irradiated group B patient. PMID- 3518755 TI - Proteases and protease inhibitory activities in normal mammalian lenses and human cataractous lenses. AB - Trypsin inhibition (reduction in benzoyl arginine p-nitroanilide hydrolysis), elastase inhibition (reduction in succinyl trialanyl p-nitroanilide hydrolysis), and chymotrypsin inhibition (reduction in acetyl tyrosine ethyl ester hydrolysis) by neutral extracts of mammalian lenses were estimated. The activities were found to be markedly elevated in human cortical cataract lenses compared to normal adult lenses (antielastase 7.21 +/- 3.90 units (mean +/- SD) in cataract compared to 1.46 +/- 0.57 in normals; antitryptic, 0.54 +/- 0.38 and 0.12 +/- 0.04; antichymotryptic, 1.03 +/- 0.61 and 0.297 +/- 0.055). Antielastase activity was distinctly higher in adult normal human lenses compared to infant lenses (0.159 +/- 0.068). Elastase- and trypsin-like activities were detected at low levels in all mammalian lenses. Chymotrypsin-like activity could not be observed in the lenses. The cataractous lenses had lower trypsin- and elastase-like activities compared to normal human lenses (elastase 1.20 +/- 0.643 in normal compared to 0.062 +/- 0.035 in cataract; trypsin, 0.367 +/- 0.154 and 0.069 +/- 0.038). The role of protease: inhibitor complexes in the expression of the individual activities and their role in cataractogenesis are discussed. PMID- 3518756 TI - [In search of the classics: Sturge-Weber syndrome. 2]. PMID- 3518757 TI - [Recent progress in the study of gangliosides]. PMID- 3518758 TI - Nurse-midwifery care: 1925 to 1984. PMID- 3518759 TI - Computer-aided instruction in nursing education. PMID- 3518760 TI - Research on the profession of nursing. Nursing's heritage. PMID- 3518761 TI - Nursing education research in Canada. PMID- 3518762 TI - British royal portraits used by advertisers on early toothpaste pot lids. PMID- 3518763 TI - Echocardiographic demonstration of pulmonary valve endocarditis associated with congenital ventricular septal defect. AB - A 38 year old woman previously known to have a heart murmur presented with malaise and bloodstained sputum. Echocardiographic examination showed a subpulmonary ventricular septal defect and probable vegetations on the pulmonary valve, and blood cultures grew Escherichia coli. She made a full recovery after 6 weeks' antibiotic treatment. PMID- 3518764 TI - Atracurium in infants and children. PMID- 3518765 TI - Atracurium in patients with renal failure. Clinical trial of a new neuromuscular blocker. AB - Atracurium was given to 30 patients with terminal chronic renal insufficiency, in two regimens. Group I (20 patients) received a single dose of 0.6 mg kg-1 and group II (10 patients), received one or several injections of 0.2 mg kg-1. Tracheal intubation was performed with ease in all patients 3 min after the injection of atracurium. A supramaximal stimulus was applied to the ulnar nerve at wrist level, and thumb adduction force was recorded. Muscular blockade was 100% in 29/30 patients and 95% in one. Mean time between atracurium injection and reappearance of 25% of the initial muscular power (HT25) was 49 min. The recovery time index (IR25-75) was 12 min and did not increase after re-injection. No side effects were observed and no significant differences in any of the measurements made were seen between the two groups. PMID- 3518766 TI - Review of atracurium by continuous i.v. infusion. PMID- 3518767 TI - Administration of atracurium by infusion for long surgical procedures. Simple techniques for routine use. PMID- 3518768 TI - The alcohol dependence syndrome: a concept as stimulus to enquiry. PMID- 3518769 TI - Alcohol and alcohol problems research 9. England, Wales and Northern Ireland. PMID- 3518770 TI - Comparison of the acute vascular effects of frusemide and bumetanide. AB - The acute peripheral vascular and diuretic effects of intravenous frusemide 10 mg and 20 mg were compared with those of bumetanide 250 micrograms and 500 micrograms in a group of 10 salt depleted volunteers. Significant reductions in forearm blood flow (FBF) were observed after frusemide 10 mg (-0.77 ml 100 ml-1 min-1 P less than 0.05) and 20 mg (-0.75 ml 100 ml-1 min-1 P less than 0.01 at 15 min). No changes were observed after bumetanide. The reductions in blood flow produced by frusemide were significantly different from those of bumetanide (P less than 0.05) at 15 min. Increases in venous capacitance (VC) and mean arterial blood pressure (MAP) were observed after frusemide but these differences were not statistically different from placebo or bumetanide. No increases were seen after bumetanide. Plasma aldosterone concentrations were unchanged after either drug but plasma renin activity (PRA) was increased after frusemide 10 mg (4.42 +/- 1.01----8.50 +/- 1.90 ng A I ml-1 h-1 P less than 0.01) and 20 mg (4.01 +/- 0.72- --7.81 +/- 2.27 ng A I ml-1 h-1 P less than 0.05). No increases were observed after bumetanide and significant differences between bumetanide and frusemide were observed (P less than 0.01). This study demonstrates that the acute peripheral arterial effects of frusemide are not observed after comparable diuretic doses of bumetanide. The differences appear to be related to the ability of the drugs to stimulate acute renin release from the kidney. PMID- 3518771 TI - Slow release nifedipine and atenolol as initial treatment in blacks with malignant hypertension. AB - We have compared the efficacy and safety of slow release nifedipine and atenolol given orally as initial treatment for malignant hypertension. Twenty consecutive black patients with untreated malignant hypertension, whose diastolic pressure remained greater than 120 mm Hg after 3 h bed rest, were randomized to receive either slow release nifedipine 40 mg at 1 and 12 h, or atenolol 100 mg at 0 h only. Patients remained supine throughout the study. Blood pressure was measured using a semi-automatic recorder (Omega 1000) at 15 min intervals from -3 to 24 h. Baseline blood pressure was similar in the nifedipine (233/142 mm Hg) and atenolol (226/141 mm Hg) groups. The rate of fall of pressure was greater after nifedipine whose maximum hypotensive effect occurred 4-5 h after each dose. Blood pressure decreased more slowly and more enduringly after atenolol, although the extent of fall was the same (delta BP 5 h after first dose nifedipine = 67/41 mm Hg; delta BP 16 h after atenolol = 64/40 mm Hg). There were no precipitous falls in pressure. No patient developed focal neurological signs, nor was heart failure precipitated by either form of treatment. These results support recommendations that most patients with malignant hypertension can be managed without recourse to parenteral therapy. PMID- 3518772 TI - Quantitation of dose and concentration-effect relationships for fenclofenac in rheumatoid arthritis. AB - Response to non-steroidal anti-inflammatory drugs (NSAIDs) is not usually assessed on the basis of concentration measurements: identification of a concentration-effect relationship has proved difficult to achieve. Dose and concentration-effect relationships of fenclofenac have been determined in a group of 18 patients with rheumatoid arthritis at three dose levels (600, 1200 and 1800 mg day-1). The study was double-blind and treatments were randomised according to a Latin square design. A multiple linear regression technique (GLIM) was used in the analysis. The best model to describe the change in effect in terms of dose and concentration incorporated an average slope and an individual subject intercept for each effect measurement. On average, an improvement in grip strength of 20 mm Hg could be obtained with an increase in fenclofenac (trough) concentration of 100 micrograms ml-1. PMID- 3518773 TI - The effects of sulindac and indomethacin on the anti-hypertensive and diuretic action of hydrochlorothiazide in patients with mild to moderate essential hypertension. AB - In this double-blind two period crossover study, we investigated the effect of indomethacin and sulindac on blood pressure in 25 hypertensive patients being treated with hydrochlorothiazide. The study consisted of seven 4 week periods. In the first and the last period the patients took placebos, in period two, four and six they were treated with hydrochlorothiazide 50 mg once daily alone, and in the third and fifth period hydrochlorothiazide 50 mg once daily was given in combination with either indomethacin 50 mg twice daily or sulindac 200 mg twice daily in double-blind random order. Blood pressure, measured by sphygmomanometer and arteriosonde, and body weight were determined every 2 weeks. Compared with placebo hydrochlorothiazide decreased the mean arterial pressure by 8%. Addition of both indomethacin and sulindac resulted in only slight and generally similar changes of this blood pressure lowering effect. This was found both for the whole group and when both treatment sequence groups were analysed separately. In contrast to sulindac, indomethacin attenuated the hydrochlorothiazide-induced decreases of body weight, plasma potassium and the increase of plasma renin activity. Both non-steroidal anti-inflammatory drugs (NSAID) reduced the 24 h urinary excretion of prostaglandins (PGs), i.e. PGF2 alpha, 6 ketoPGF1 alpha and thromboxane B2 except PGE2. From this study it can be concluded that, in contrast to sulindac, indomethacin attenuated the diuretic action of hydrochlorothiazide, however apparently without consequences for its long-term blood pressure lowering effect. This study does not support the hypothesis that the difference between the two NSAIDs can be explained by different effects on renal PG synthesis. PMID- 3518774 TI - Trends in the development of new medicines by UK-owned pharmaceutical companies (1964-1980). AB - One hundred and ninety-seven new chemical entities (NCEs) were investigated in man for the first time between 1964 and 1980 by the seven UK-owned pharmaceutical companies. Thirty-five of these NCEs have been marketed and 137 withdrawn from further research and development. There was an increase in the number of NCEs investigated each year, but this was counter-balanced by an increase in the number rejected. Development times increased from about 4.5 years in the 1960s to 9 years in the 1970s with an accompanying reduction in the effective patent life. PMID- 3518775 TI - Protective effect of theophylline on histamine-induced bronchoconstriction in asthmatic children. AB - The bronchial responsiveness of a group of asthmatic children was studied using histamine stimulation after a single dose of theophylline and after placebo. Theophylline, when levels were greater than 10 micrograms ml-1 significantly reduced responsiveness but only by just over one doubling concentration of histamine (P less than 0.001). PMID- 3518776 TI - Related potential donors in renal transplantation: a high risk group for occult renal disease? PMID- 3518777 TI - Breast cancer: Keynes and conservatism. PMID- 3518778 TI - A multicentre trial of lofepramine. PMID- 3518779 TI - A general practice trial of antihypertensive therapy comparing a combination of nicardipine and chlorthalidone with atenolol and chlorthalidone. PMID- 3518780 TI - Anticoagulant treatment of unstable angina. PMID- 3518781 TI - Cellular basis of host defence in pyelonephritis. II. Acute infection. AB - We have investigated the cellular basis of host defence mechanisms in experimental pyelonephritis. Cellular components of the host defence system were depleted using cyclophosphamide, methylprednisolone or radiation. Depletion of cellular competence did not affect the course of infection during the first 16 h after challenge with Escherichia coli, but after 96 h up to a 1000-fold increase in bacterial numbers in the kidneys of cytodepleted animals was demonstrable. When quantitative aspects of the relationship between cellular competence and host defence were studied, it was found that severe depletion of cellular components was necessary before host defence mechanisms were adversely affected. Thus while cellular mechanisms are quantitatively adequate and contribute to host defence in pyelonephritis they have little impact on the immediate post-infection phase. Non-cellular factors however, do limit bacterial proliferation in the acute phase and may be important determinants in the biology of pyelonephritis. PMID- 3518782 TI - Role of insulin in the hypoglycaemic effect of sublethal Bordetella pertussis infection in mice. AB - Mice were infected intranasally with a sub-lethal dose of Bordetella pertussis organisms (1.2 x 10(5) colony forming units per mouse), control animals receiving the vehicle intranasally. The experiments were performed 14 days later. Serum glucose and insulin concentrations were studied across a 24 h period in freely fed animals and the changes in serum glucose and insulin concentrations in response to feeding were examined in mice fasted for 18 h. The responsiveness of mice to injected insulin (0.5 and 5.0 units/kg i.v.) was also examined. Pertussis infected mice developed hypoglycaemia and hyperinsulinaemia relative to the controls. These changes were present across a 24 h period although the magnitude of the differences between values seen in control and infected animals varied and the hyperinsulinaemia was not seen at all times. Infected mice showed a markedly diminished hyperglycaemia and an exaggerated hyperinsulinaemia following food ingestion, relative to normal controls. Pertussis-induced hypoglycaemia was abolished following destruction of the pancreatic islet B cells with alloxan (80 mg/kg i.v.). The serum glucose response to a low dose of insulin was significantly attenuated by B. pertussis infection although the hypoglycaemia produced by a high dose was prolonged. It was concluded that B. pertussis infection-induced hypoglycaemia was secondary to hyperinsulinaemia, possibly caused by an exaggerated insulin secretory response to food intake. PMID- 3518784 TI - Ph1 negative haematological chimaerism after marrow transplantation in Ph1 positive chronic granulocytic leukaemia. AB - A 17-year-old girl with Philadelphia chromosome (Ph1) positive chronic granulocytic leukaemia (CGL) who has undergone two bone marrow transplants from her HLA identical brother is described. Following the second transplant, cytogenetic analysis of her bone marrow cells showed haematological chimaerism with equal numbers of normal male cells and Ph1 negative female cells indicating the probable eradication of the Ph1 positive clones with the retention of normal host stem cells. PMID- 3518783 TI - Chronic idiopathic and secondary neutropenia: clinical and serological investigations. AB - Clinical data on 49 patients with chronic idiopathic neutropenia (CIN) and 42 patients with neutropenia secondary to a well-defined immunological disorder (SN) were collected and related to serological parameters. In 47% of the patients with CIN and 53% of those with SN, a positive direct immunofluorescence test was obtained with granulocytes from the patients. In the sera from the patients in the two groups, antibodies against donor granulocytes were detected by the indirect immunofluorescence test, the leucoagglutination test and/or the granulocytotoxicity test in 15%, 19% and 15%, respectively. The results of the above tests could not be correlated with any clinical or haematological parameter. Immune complexes in the serum were detected by the 125I-Clq-binding test in 29% of patients with CIN and in 58% of those with SN. The presence of serum immune complexes correlated well with the existence of a low neutrophil count, but not with the presence of recurrent infections, with bone-marrow abnormalities, or with positive reactions in other serological tests. The sera of eight out of 14 patients with CIN and seven out of 12 patients with SN had inhibitory activity for myeloid colony formation in vitro (CFU-GM). This CFU-GM inhibitory activity was correlated with the presence of recurrent infections and with hypoplasia of the myeloid compartment of the bone marrow, but not with positive reactions in other tests. We conclude that the 125I-Clq-binding test probably detects circulating immune complexes that induce a shift neutropenia, whereas serum activity inhibitory for CFU-GM possibly relates to clinically more serious forms of neutropenia. The significance of neutrophil-bound Ig and granulocyte-reactive antibodies in the serum is not clear. PMID- 3518785 TI - Successful treatment of late graft failure following T cell depleted bone marrow transplantation. PMID- 3518786 TI - Acute lymphoblastic leukaemia after bone marrow transplantation for aplastic anaemia. AB - An 11.5-year-old girl developed acute lymphoblastic leukaemia 7 months after bone marrow transplantation for severe aplastic anaemia. Before transplantation there were neither morphologic nor cytogenetic abnormalities to suggest preleukaemia. The conditioning regimen consisted only of cyclophosphamide. At the time of development of acute lymphoblastic leukaemia, chromosome analysis showed the blasts to be of host origin with clonal abnormalities including monosomy 7. Such a preleukaemic syndrome presenting as severe aplastic anaemia is a very rare event (the case reported here is the only one of 436 patients in Seattle) and cannot be reliably excluded before transplantation. PMID- 3518787 TI - A randomized comparison of glycerol-impregnated chromic catgut with untreated chromic catgut for the repair of perineal trauma. AB - Glycerol-impregnated chromic catgut and untreated chromic catgut were compared in a randomized controlled trial involving 737 consecutive women who required repair of perineal trauma following spontaneous vaginal delivery. Medical staff preference was equally divided between the two materials. More untreated chromic catgut sutures required removal both by 10 days and by 3 months postpartum. Women whose perineal trauma was repaired with glycerol-impregnated chromic catgut were 10% more likely to have perineal pain at 10 days and 33% more likely to suffer from dyspareunia in the 3 months following delivery. The high rates of maternal morbidity associated with glycerol-impregnated chromic catgut appear to preclude its use for perineal repair. PMID- 3518788 TI - Doppler ultrasound assessment of cerebral blood flow in the human fetus. AB - A mechanical sector and linear array real-time scanner combined with a pulsed Doppler system was used for recording the flow velocity waveform in the internal carotid artery, the lower thoracic part of the descending aorta and umbilical artery in the human fetus. A total of 42 fetuses in normal pregnancy and nine growth-retarded fetuses between 26 and 41 weeks gestation was studied. In normal pregnancy the mean pulsatility index (PI) in the internal carotid artery varied between 1.5 and 1.6, in the descending aorta between 1.7 and 1.8 and in the umbilical artery between 0.7 and 1.3. In the growth-retarded fetuses the PI was reduced in the internal carotid artery and raised in the descending aorta and umbilical artery, suggesting an increased peripheral vascular resistance in the fetal body and placenta and a compensatory reduction in peripheral vascular resistance in the fetal cerebrum, i.e. a brain-sparing effect in the presence of fetal hypoxia. PMID- 3518789 TI - The actions of prostaglandins and their interactions with angiotensin II in the isolated perfused human placental cotyledon. AB - The prostaglandins PGE1, PGE2, PGD2, PGF2 alpha, U46619 and 6 beta-PGI1 were administered as bolus injections both separately and in combination with angiotensin II into the fetal circulation of isolated human placental cotyledons perfused in vitro. PGF2 alpha and PGD2 caused small dose-dependent increases in fetal perfusion pressure when compared with U46619 which acted as an extremely potent vasoconstrictor of the fetal-placental vasculature. PGE1 caused very small dose-dependent decreases in fetal perfusion pressure when injected on its own. In combination with angiotensin II, PGE1, PGD2 and 6 beta-PGI1 caused significant, dose-related attenuations of the angiotensin II vasoconstrictive response whereas PGE2, PGF2 alpha and U46619 potentiated the response. Injections of angiotensin II after the infusion of indomethacin into the fetal circulation resulted in a potentiation of angiotensin II induced vasoconstriction. The results indicate that prostaglandins exert their effects on the fetal-placental circulation by modulating the actions of angiotensin II. PMID- 3518790 TI - Mid-trimester chorionic biopsy. Case report. PMID- 3518791 TI - Ligand interactions at the active site of aspartate transcarbamoylase from Escherichia coli. AB - The active site of aspartate transcarbamoylase from Escherichia coli was probed by studying the inhibitory effects of substrate analogues on the catalytic subunit of the enzyme. The inhibitors were chosen to satisfy the structural requirements for binding to either the phosphate or the dicarboxylate region. In addition, they also contained a side chain that would extend into the normal position occupied by the carbamoyl group. All the compounds tested showed competitive inhibition against carbamoyl phosphate. The ionic character of the side chain was found to be highly important in determining the affinity of the inhibitor. On the other hand, very little effect on binding was produced by changing the geometry of the functional group from trigonal to tetrahedral. Our findings suggest that the electrostatic stabilization of the negative charge that develops in the transition state may be a major factor in promoting catalysis. From the available X-ray diffraction data, we propose His-134 as the residue most likely to participate in this interaction. These results have significant implications on the design of reversible and irreversible inhibitors to this enzyme. PMID- 3518792 TI - Kinetic properties of cyanase. AB - Cyanase is an inducible enzyme in Escherichia coli that catalyzes the hydrolysis of cyanate. Bicarbonate is required for activity, perhaps as a substrate, and the initial product of the reaction is carbamate, which spontaneously breaks down to ammonia and bicarbonate [Anderson, P. M. (1980) Biochemistry 19, 2882]. The purpose of this study was to characterize the kinetic properties of cyanase. Initial velocity studies showed that both cyanate and bicarbonate act as competitive substrate inhibitors. A number of monovalent anions act as inhibitors. Azide and acetate appear to act as competitive inhibitors with respect to cyanate and bicarbonate, respectively. Chloride, bromide, nitrate, nitrite, and formate also inhibit, apparently as the result of binding at either substrate site. Malonate and several other dicarboxylic dianions at very low concentrations display "slow-binding", reversible inhibition which can be prevented by saturating concentrations of either substrate. The results are consistent with a rapid equilibrium random mechanism in which bicarbonate acts as a substrate, bicarbonate and cyanate bind at adjacent anion-binding sites, and both substrates can bind at the other substrate anion binding site to give a dead end complex. PMID- 3518793 TI - L-threonine dehydrogenase from Escherichia coli K-12: thiol-dependent activation by Mn2+. AB - Addition of 1 mM Mn2+ to all solutions in the final chromatographic step used to purify L-threonine dehydrogenase (L-threonine:NAD+ oxidoreductase, EC 1.1.1.103) from extracts of Escherichia coli K-12 routinely provides 30-40 mg of pure enzyme per 100 g wet weight of cells with specific activity = 20-30 units/mg. Enzyme dialyzed exhaustively against buffers containing Chelex-100 resin has a specific activity = 8 units/mg and contains 0.003 or 0.02 mol of Mn2+/mol of enzyme as determined by radiolabeling studies with 54Mn2+ or by atomic absorption spectroscopy, respectively. Dehydrogenase activity is completely abolished by low concentrations of either Hg2+ or Ag+; of a large spectrum of other metal ions tested, only Mn2+ and Cd2+ have an activating effect. Activation of threonine dehydrogenase by Mn2+ is thiol-dependent and is saturable with an activation Kd = 9.0 microM and a Vmax = 105 units/mg. Stoichiometry of Mn2+ binding was found to be 0.86 mol of Mn2+/mol of enzyme subunit with a dissociation constant (Kd) = 8.5 microM. Mn2+ appears to interact directly with threonine dehydrogenase; gel filtration studies with the dehydrogenase plus 54Mn2+ in the presence of either NAD+, NADH, L-threonine, or combinations thereof show that only Mn2+ coelutes with the enzyme whereas all other ligands elute in the salt front and the stoichiometry of the dehydrogenase-Mn2+ interaction is not affected in any instance. A theoretical curve fit to data for the pH-activity profile of Mn2+ saturated enzyme has a pKa = 7.95 for one proton ionization. The data establish L threonine dehydrogenase of E. coli to be a metal ion activated enzyme. PMID- 3518794 TI - Use of binding energy in catalysis analyzed by mutagenesis of the tyrosyl-tRNA synthetase. AB - The utilization of enzyme-substrate binding energy in catalysis has been investigated by experiments on mutant tyrosyl-tRNA synthetases that have been generated by site-directed mutagenesis. The mutants are poorer enzymes because they lack side chains that form hydrogen bonds with ATP and tyrosine during stages of the reaction. The hydrogen bonds are not directly involved in the chemical processes but are at some distance from the seat of reaction. The free energy profiles for the formation of enzyme-bound tyrosyl adenylate and the equilibria between the substrates and products were determined from a combination of pre-steady-state kinetics and equilibrium binding methods. By comparison of the profile of each mutant with wild-type enzyme, a picture is built up of how the course of reaction is affected by the influence of each side chain on the energies of the complexes of the enzyme with substrates, transition states, and intermediates (tyrosyl adenylate). As the activation reaction proceeds, the apparent binding energies of certain side chains with the tyrosine and nucleotide moieties increase, being weakest in the enzyme-substrate complex, stronger in the transition state, and strongest in the enzyme-intermediate complex. Most marked is the interaction of Cys-35 with the 3'-hydroxyl of the ribose. Removal of the side chain of Cys-35 leads to no change in the dissociation constant of ATP but causes a 10-fold lowering of the catalytic rate constant. It contributes no net apparent binding energy in the E X Tyr X ATP complex and stabilizes the transition state by 1.2 kcal/mol and the E X Tyr-AMP complex by 1.6 kcal/mol.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3518795 TI - Internal thermodynamics of position 51 mutants and natural variants of tyrosyl tRNA synthetase. AB - Natural variation and evolution impose structural changes on an enzyme that can affect the energetics of catalysis. The energy profile of reaction could, in theory, be altered in three distinct ways: uniform binding changes, differential binding changes, and catalysis of elementary steps. Residue threonine-51 of tyrosyl-tRNA synthetase from Bacillus stearothermophilus is subject to natural variation, being replaced by alanine and proline in the enzymes from Bacillus caldotenax and Escherichia coli, respectively. The consequences of this variation on the energetics of formation of tyrosyl adenylate have been investigated by constructing free energy profiles for wild-type and mutant enzymes constructed by introducing these amino acids into the B. stearothermophilus enzyme. Mutation of Thr-51 to alanine, proline, and cysteine by site-directed mutagenesis improves the stabilization of the transition state in the formation of tyrosyl adenylate. Most marked is the mutation Thr-51----Pro-51 which stabilizes the transition state by 2.2 kcal/mol and accelerates the forward rate 20-fold to a level near that of the enzyme from E. coli. However, the improved transition-state binding is accompanied by an even greater stabilization of tyrosyl adenylate. This reduces the rate of pyrophosphorolysis of tyrosyl adenylate and/or weakens the binding of pyrophosphate in the reverse reaction, shifting the equilibrium between enzyme-bound reactants greatly in favor of the enzyme-intermediate complex. The more stable mutant enzyme-tyrosyl adenylate complexes have lower rates of aminoacylation, suggesting that mutations which stabilize the intermediate slow down the subsequent transfer of tyrosine from tyrosyl adenylate to tRNA.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3518796 TI - pH dependence of deuterium isotope effects and tritium exchange in the bovine plasma amine oxidase reaction: a role for single-base catalysis in amine oxidation and imine exchange. AB - The pH dependence of steady-state parameters for [1,1-1H2]- and [1,1 2H2]benzylamine oxidation and of tritium exchange from [2-3H]dopamine has been measured in the bovine plasma amine oxidase reaction. Deuterium isotope effects on kcat/Km for benzylamine are observed to be constant, near the intrinsic value of 13.5, over the experimental pH range, indicating that C-H bond cleavage is fully rate limiting for this parameter. As a consequence, pKa values derived from kcat/Km profiles, 8.0 +/- 0.1 (pK1) and 9.0 +/- 0.16 (pKs), can be ascribed to microscopic pKa values for the ionization of an essential active site residue (EB1) and substrate, respectively. Profiles for kcat and Dkcat show that EB1 undergoes a perturbation from 8.0 to 5.6 +/- 0.3 (pK1') in the presence of substrate; additionally, a second ionization, pK2 = 7.25 +/- 0.25, is observed to mediate but not be essential for enzyme reoxidation. The pH dependence of the ratio of tritium exchange to product formation for dopamine also indicates base catalysis with a pKexch = 5.5 +/- 0.01, which is within experimental error of pK1'. We conclude that the data presented herein support a single residue catalyzing both substrate oxidation and exchange, consistent with recent stereochemical results that implicate a syn relationship between these processes [Farnum, M., & Klinman, J.P. (1985) Fed. Proc., Fed. Am. Soc. Exp. Biol. 44, 1055]. This conclusion contrasts with earlier kinetic data in support of a large rate differential for the exchange of hydrogen from C-1 vs. C-2 of phenethylamine derivatives [Palcic, M.M., & Klinman, J.P. (1983) Biochemistry 22, 5957 5966].(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3518797 TI - Integrated function of a kinetic proofreading mechanism: double-stage proofreading by isoleucyl-tRNA synthetase. AB - Experimental measurements for isoleucyl-tRNA synthetase proofreading valyl tRNAIle in Escherichia coli previously have been incorporated into the conventional Michaelis-Menten model for this system. This model was augmented to include two stages of proofreading--the aminoacyl adenylate and aminoacyl-tRNA stages--and used to predict the values of four additional rate constants that have been determined experimentally. The results suggest that two stages of conventional kinetic proofreading with binding sites designed for isoleucine (the "correct" substrate) are inconsistent with the experimental data, that a double stage mechanism in which one stage (the "double-sieve") involves a binding site designed for valine (the "incorrect" substrate) and the other involves a binding site designed for isoleucine is consistent with all the experimental data, and that the experimental data are not sufficiently accurate to distinguish the stage at which the double-sieve mechanism operates in vivo. Furthermore, analysis of the model suggests that four parameters have the most questionable values and that experimental refinement of their estimates will be needed to determine which of the two stages involves the double-sieve mechanism. PMID- 3518798 TI - High molecular weight forms of the insulin receptor. AB - The insulin receptor of liver, adipose, and placental plasma membranes was photoaffinity labeled with radioiodinated N epsilon B29 (monoazidobenzoyl)insulin. Three specifically labeled bands of 450, 360, and 260 kilodaltons (kDa) were identified in each tissue by polyacrylamide gel electrophoresis of the membranes solubilized in sodium dodecyl sulfate (SDS). The 360- and 260-kDa bands corresponded to partially reduced forms of the 450-kDa band. The distribution of radioactivity between the three insulin receptor bands was dependent on the tissue, the purity of the receptor preparation, and the conditions of solubilization in SDS. The 360- and 260-kDa bands became more prominent in each tissue with an increasing time of solubilization in SDS. However, with a short solubilization time in SDS, the 450-, 360-, and 260-kDa bands of the receptor were distributed approximately in a ratio of 85:15:0 in all three tissues. Inclusion of sulfhydryl alkylating reagents during solubilization in SDS altered this ratio to about 95:5:0. We conclude that the 450-kDa band represents the predominant form of the photolabeled insulin receptor and that the 260-kDa and probably the 360-kDa form as well were generated during the experimental manipulations preceding identification of the receptor. However, the appearance of the 360- and 260-kDa bands was not due to reductant present in SDS or buffer solutions and could not be accounted for by proteolytic degradation of the receptor. Furthermore, purification of the receptor over 2000-fold did not prevent the appearance of the 360- and 260-kDa bands.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3518799 TI - Evidence for hemiketals as intermediates in the inactivation of serine proteinases with halomethyl ketones. AB - The mechanism of inactivation of serine proteinases by peptide halomethyl ketone inhibitors was studied through the inhibition of trypsin with a series of model peptide ketones (Lys-Ala-LysCH2X). In this series, X is a poor leaving group with increasing electron-withdrawing capacity (X = H, CH2CO2CH3, COCH3, OCOCH3, and F), and as expected, the peptide ketones are reversible, competitive inhibitors of trypsin. The strength of binding of these inhibitors to trypsin increases with the electron-withdrawing ability of X, indicating that the inhibition constant Ki obtained is a measure of reversible hemiketal formation between the inhibitor ketone carbonyl group and the hydroxyl group of the active site serine. A Hammett plot of -log Ki vs. sigma I, the inductive substituent constant of X, reveals a linear relationship between the free energy of binding and the electron withdrawing power of X. The reversible binding constant obtained for the corresponding chloromethyl ketone Lys-Ala-LysCH2Cl falls on this line, indicating that the reversible binding involves hemiketal formation, which is followed by alkylation of the enzyme. PMID- 3518800 TI - Characterisation in vivo of the reactive thiol groups of the lactose permease from Escherichia coli and a mutant; exposure, reactivity and the effects of substrate binding. AB - The reactivity and accessibility of the reactive thiol groups of the native lactose permease and a mutant have been studied in a number of circumstances and with a number of reagents, in particular using the specific thiol-disulphide exchange reaction. Seven different reactive states of the thiol in the native protein have been characterised by their different second-order rate constants. Interconversion between these states is dependent on the magnitude of the protonmotive force, pH and substrate binding. In the absence of galactoside, reactivity is controlled by an ionisation with apparent pKa 9.3. This pKa is not affected by the protonmotive force, but it is lowered in the presence of external galactoside. The conformation adopted by the permease when in equilibrium with saturating galactoside appears to be different from that of the intermediate that accumulates during net turnover. In the former state, the reactivity of the thiol group is depressed, whereas in the latter state it is enhanced. The thiol group of the native protein is buried in a hydrophobic environment that has a dielectric constant considerably lower than that of water. The environment is not greatly perturbed by changes in the magnitude of the protonmotive force, but it is affected by the binding of galactoside. In a strain which carries the YUN mutation (Wilson, T.H. and Kusch, M. (1972) Biochim. Biophys. Acta 255, 786-797), two reactive thiols were characterised. The more reactive of the two is more exposed than the thiol group of the native molecule and is in an environment that has a dielectric constant close to that of water. The less reactive thiol appears to be more deeply buried than that of the native protein. Thus the mutation appears to produce a conformation change in the central portion of the polypeptide chain that results in greater exposure of the reactive thiol to the aqueous environment. PMID- 3518802 TI - Primary structure of the cholesterol side-chain cleavage cytochrome P-450 from bovine adrenocortical mitochondria and some aspects of its functioning on a structural level. AB - The primary structure of the cholesterol side-chain cleavage cytochrome P-450 (P 450scc) from bovine adrenocortical mitochondria has been determined. At the initial stage an exhaustive chymotryptic digestion of carboxymethylated P-450scc was performed, and the amino acid sequence of 66 peptides was determined. At the second stage an investigation of the amino acid sequence of individual fragments I (Mr 29 800) and II (Mr 26 600) of the limited trypsinolysis of P-450scc was carried out. Fragment I was digested with trypsin, Staphylococcus aureus V8 proteinase and thermolysin; fragment II was cleaved with trypsin and S. aureus V8 proteinase. In addition, the amino acid sequence of some CNBr peptides of P 450scc has been investigated. The primary structure of cytochrome P-450scc determined with protein chemistry methods proved the multistage cholesterol transformation to pregnenolone to be catalyzed by a single species of cytochrome P-450scc which consists of 481 amino acids. The results from protein sequencing of P-450scc are in good agreement with those obtained recently from nucleotide sequencing. The localization of peptide bonds cleaved under limited proteolysis of P-450 with trypsin to fragments I and II, I and III (Mr 16 800) is presented. It is shown that the transformation of P-450scc to P-420 is accompanied by the appearance of an additional trypsin-sensitive peptide bond in the N-terminal part of P-450scc. PMID- 3518801 TI - Identification of sites of cysteine misincorporation during in vivo synthesis of bacteriophage T7 0.3 protein. AB - The 0.3 protein encoded by coliphage T7 does not normally contain cysteine residues. Incorporation of [35S]cysteine can therefore be used to assay mistranslation. We have purified 0.3 protein, synthesized in the presence of [35S]cysteine, from T7 infected cells of E. coli and determined the locations of misincorporated cysteine residues. Analysis of the molecular weights (Mr) of [35S]cysteine-labeled tryptic peptides of 0.3 protein demonstrated that cysteine (encoded by UGU or UGC) is not extensively misincorporated, as might be predicted by substitution for arginine residues (encoded by CGU or CGC). Edman degradation of the amino-terminal 50 residues of [35S]cysteine-labeled 0.3 protein determined that cysteine was most frequently misincorporated at position 15, which is correctly occupied by a tyrosine residue (encoded by UAC). There are four other tyrosine codons (1 UAU; 3 UAC) in the region of the 0.3 protein studied, but these were not mistranslated. The context in which a codon is located must therefore be more important in causing mistranslation than the sequence of the codon itself. Misincorporation of [35S]cysteine was also found at positions 9 (ACC, asparagine), 16 (GAA, glutamic acid), 41 (GCC, alanine) and 42 (GAU, aspartic acid). One mistranslation event appears to increase the likelihood that the following codon will also be mistranslated. This clustering of misincorporated [35S]cysteine residues was accentuated in 0.3 protein synthesized in the presence of streptomycin. PMID- 3518803 TI - Mucus glycoprotein of human saliva: differences in the associated and covalently bound lipids with caries. AB - A high molecular weight mucus glycoprotein has been isolated from submandibular saliva of caries-resistant and caries-susceptible individuals by a procedure involving fractionation on Bio-Gel P-100 and A-50 columns followed by equilibrium density-gradient centrifugation in CsCl. The purified caries-resistant mucus glycoprotein displayed a buoyant density of 1.50 and accounted for 9.5% of the dry weight of caries-resistant saliva. The caries-susceptible mucus glycoprotein represented 14.1% of the dry weight of caries-susceptible saliva and gave a buoyant density of 1.43. Both glycoproteins exhibited similar protein and carbohydrate content, but the caries-resistant mucus glycoprotein contained 28.7% less associated lipids and 3-times less covalently bound fatty acids than the caries-susceptible mucus glycoprotein. The associated lipids were represented by neutral lipids, glycolipids and phospholipids, whereas the covalently bound fatty acids consisted mainly of hexadecanoate, octadecanoate and docosanoate. Extraction of associated lipids caused the caries-resistant glycoprotein to band in CsCl gradient at the density of 1.54 and caused the caries-susceptible glycoprotein to band at the density of 1.52. A further shift in the buoyant densities occurred following removal of the covalently bound fatty acids, and both glycoproteins banded at the density of 1.57. While the intact caries resistant and caries-susceptible glycoproteins were susceptible to proteolysis by pronase, the lipid-rich caries-susceptible glycoprotein was degraded to a lesser extent. Extraction of associated lipids increased the degradation of both glycoproteins, but the caries-susceptible glycoprotein still remained 25% less susceptible. However, the susceptibility to pronase of the delipidated and deacylated caries-resistant and caries-susceptible glycoproteins was essentially identical. The caries-resistant and caries-susceptible mucus glycoproteins also differed in susceptibility to peptic degradation. The apparent Km values for intact caries-resistant and caries-susceptible glycoproteins were 10.5 X 10(-7) M and 8.1 X 10(-7) M, while the values for the delipidated and deacylated caries resistant and caries-susceptible glycoproteins were 13.0 X 10(-7) M and 12.4 X 10(-7) M. The results suggest that the differences in the content of associated lipids and covalently bound fatty acids are responsible for the different physiochemical characteristics of caries-resistant and caries-susceptible salivary mucus glycoproteins, which may be determining factors in the resistance to caries. PMID- 3518804 TI - Riboflavin nutritional status and flavoprotein enzymes in streptozotocin-diabetic rats. AB - Riboflavin nutritional status was assessed on the basis of activity coefficients of glutathione reductase in erythrocyte hemolysates of normal and streptozotocin diabetic rats. Activity coefficient values higher than 1.3 were regarded as evidence of riboflavin deficiency. All diabetic animals were found to be riboflavin-deficient, with activity coefficient values of 1.47-2.11. Treatment of diabetic rats with either insulin or riboflavin returned their activity coefficients to normal. Rats fed a restricted diet had normal activity coefficient values. The erythrocyte glutathione reductase activity was significantly lower in diabetic rats, and the augmentation of enzyme activity in the presence of flavin-adenine dinucleotide (FAD) was 72% compared to 16% in normal rats. Hepatic activities of glutathione reductase and succinate dehydrogenase, both FAD-containing enzymes, were significantly lower in diabetic than in normal rats. Like activity coefficient values, all enzyme activities were normalized after insulin or riboflavin treatments. These data suggest that insulin and riboflavin enhance the synthesis of erythrocyte and hepatic FAD. The results of the present study suggest that experimental diabetes causes riboflavin deficiency, which in turn decreases erythrocyte and hepatic flavoprotein enzyme activities. These changes can be corrected for by either insulin or riboflavin. The pathogenesis of riboflavin deficiency in diabetes mellitus is not clearly understood. The data of the present study provide evidence in addition to the previous findings of an increased prevalence of riboflavin deficiency in genetically diabetic KK mice. PMID- 3518805 TI - Tryptophanyl-tRNA synthetase is a major soluble protein species in bovine pancreas. AB - Besides their central role in protein synthesis, aminoacyl-tRNA synthetases have been found or thought to be involved in other processes. We present here a study showing that tryptophanyl-tRNA synthetase has a surprising tissular distribution. Indeed, immunochemical determinations showed that in several bovine organs such as liver, kidney and heart, tryptophanyl-tRNA synthetase constitutes, as expected, about 0.02% of soluble proteins. In spleen, brain cortex, stomach, cerebellum or duodenum, this amount is about 10-times higher, and in pancreas it is 100-fold. There is no correlation between these amounts and the RNA content of the organs. Moreover, the concentration of another aminoacyl-tRNA synthetase (methionyl-tRNA synthetase) is higher in liver than in pancreas, while the amount of tRNATrp is not higher in pancreas than in liver as compared to other tRNAs. Among several interpretations, it is possible that tryptophanyl-tRNA synthetase is involved in a function other than tRNA aminoacylation. This unknown function would be specific to the differentiated organs, since fetal cerebellum and fetal pancreas contain the same amount of tryptophanyl-tRNA synthetase as adult liver. PMID- 3518806 TI - Expression of an active proteinase inhibitor, alpha 1-antichymotrypsin, by human breast epithelial cells. AB - The synthesis of an active proteinase inhibitor, gp 66, by human breast epithelial cells is reported. This glycoprotein is identical to serum alpha 1 antichymotrypsin, which inhibits proteinases that cleave at hydrophobic residues. Immunohistological studies show the in vivo expression on normal secretory and ductal epithelial cells and on primary and metastatic adenocarcinomas. Immunoaffinity-purified gp 66 from MCF-7 culture supernatants is an active inhibitor of chymotrypsin as determined in a fluorogenic enzyme assay and can form stable 88 kDa enzyme-inhibitor complexes. The synthesis of a functional inhibitor may represent the epithelial cell's attempt to stabilize its extracellular milieu. PMID- 3518807 TI - Evidence for the presence of phospholamban in the endoplasmic reticulum of smooth muscle. AB - In microsomal vesicles isolated from several smooth muscles many polypeptides were phosphorylated by the catalytic subunit of cyclic AMP-dependent protein kinase. In pig stomach and in rabbit and dog aorta components of Mr 22,000 and 11,000 were identified as forms of phospholamban. These polypeptides were, however, not observed in pig aorta. These phospholamban-like polypeptides presented the same electrophoretic mobility in sodium dodecyl sulphate gels as cardiac phospholamban, and the 22,000 Mr form showed a similar reaction to heat treatment in sodium dodecyl sulphate. Antibodies against purified canine cardiac phospholamban cross-reacted with the 22,000 and 11,000 Mr phosphorylatable polypeptides from smooth muscle membranes. Subcellular fractionation of porcine stomach smooth muscle indicated that phospholamban was present in the membranes of the endoplasmic reticulum and not in the plasma membranes. Phospholamban was also phosphorylated by an endogenous calcium-calmodulin-dependent protein kinase and by an endogenous cyclic AMP-dependent kinase. It is concluded that the endoplasmic reticulum of many, but possibly not all, smooth muscles contains phospholamban. However, the physiological role of phospholamban in smooth muscle remains to be established. PMID- 3518808 TI - Oxygen consumption in Plasmodium berghei-infected murine red cells: a direct spectrophotometric assay in intact erythrocytes. AB - A spectrophotometric assay has been devised to measure oxygen consumption non invasively in intact murine red cells parasitized by Plasmodium berghei. The method uses oxyhemoglobin in the erythrocytes both as a source of oxygen and as an indicator of oxygen consumption. Spectra of intact cells show broad peaks and sloping baselines due to light-scattering. In order to ascertain the number of varying components in the 370-450 nm range, the resolution of the spectra was enhanced using Fourier transforms of the frequency domain spectra. Calculation of oxygen consumption was carried out for two-component systems (oxyhemoglobin, deoxyhemoglobin) using absorbances at 415 and 431 nm. Samples prepared from highly parasitized mice (greater than 80% parasitemia, 5% hematocrit) showed oxygen consumption rates of (4-8) X 10(-8) microliter/cell per h. This rate was not attributable to the presence of white cells or reticulocytes. The rate of oxygen consumption in the erythrocytes is shown to be modulated by various agents: the respiratory inhibitors NaN3 and KCN (1 mM) reduced oxygen consumption 2-3-fold; salicylhydroxamic acid (2.5 mM) caused a 20% reduction in rate and 10 mM NaN3, completely blocked deoxygenation. Antimalarial drugs and metal-chelating agents were also tested. Chloroquine, EDTA and desferal (desferoxamine mesylate) did not decrease the deoxygenation rate of hemoglobin in parasitized cells. Quinacrine, quinine and primaquine reduced the rate of formation of deoxyhemoglobin but also produced substantial quantities of methemoglobin. The lipophilic chelator, 5-hydroxyquinoline, decreased the rate of deoxygenation one third. The spectrophotometric assay provides a convenient means to monitor oxygen consumption in parasitized red cells, to test the effects of various agents thereon, and potentially to explore possible mechanisms for oxygen utilization. PMID- 3518809 TI - The status of zinc in malaria (Plasmodium falciparum) infected human red blood cells: stage dependent accumulation, compartmentation and effect of dipicolinate. AB - The inhibitory effect of metal chelators on intraerythrocytic malarial parasites imply that trace metal have a vital role in the biology of these organisms. In the present work X-ray fluorometry was used to study the status of zinc and iron in human red blood cells infected with Plasmodium falciparum in culture conditions. It was found that while the iron level remains constant throughout the parasite cell cycle, that of zinc increases in parallel with parasite maturation to reach a 2.3-fold higher level than that of uninfected red blood cells. Compartment analysis of infected red blood cells indicated that most of this gain was associated with the parasite and some with the host-cell membrane. Analysis of the malarial pigment showed that the zinc/iron ratio was similar to that of red blood cells, implying the this compound, which results from the digestion of host-cell cytosol, sequesters the zinc of host metalloenzymes. Dipicolinic acid (DPA), like other chelators, was found to inhibit the intracellular development of the parasite with an ED50 of 1 mM. DPA does not penetrate into normal red blood cells but readily permeates into infected cells, although it does not leach out their zinc. It is uncertain whether the inhibitory effect of DPA is exerted through alterations of host cell metabolism or by directly affecting that of the parasite. The putative receptors of zinc in the infected red blood cell are discussed. PMID- 3518810 TI - Down-regulation of insulin receptors in the heart: studies on primary cultured adult cardiac myocytes. AB - Primary cultured cardiac myocytes from adult rats have been used to study insulin receptor regulation. Culturing of cells in the presence of insulin induced a dose dependent down-regulation of insulin binding with a maximal effect of 35% at an insulin concentration of 1.7 X 10(-7) mol/l. The number of high-affinity sites decreased from 110 000 to 70 000 sites per cell in control and down-regulated cells, respectively, with no change in the apparent affinity constant. Down regulation was found to be rapid (t 1/2 = 3 h) and fully reversible. Culturing of cells in the presence of cycloheximide (0.1 mmol/l) or Tris (35 mmol/l) resulted in a further time-dependent increase in insulin-induced receptor loss with no effect on insulin binding to control cells. The action of both agents was found to be additive reaching a down-regulation of 51% after a culture period of 16 h. Recovery of insulin binding activity after removal of insulin remained unaffected in the presence of cycloheximide, whereas Tris inhibited this process by 74%. In conclusion our results show that the concept of insulin-induced receptor down regulation can be extended to the adult heart muscle. Moreover the data suggest involvement of protein synthesis and receptor recycling in this process. PMID- 3518812 TI - Cytofluorescence detection of adriamycin-mitochondria interactions in isolated, perfused rat heart. AB - The major side-effect of the anthracycline anti-tumor drug adriamycin is a specific, dose-dependent cardiotoxicity. Impairment of mitochondrial function has been suggested to play an important role in this toxicity. The present study addresses the question as to whether direct drug-mitochondria interactions occur in the isolated, perfused rat heart. To this aim, cytofluorescence microscopy experiments were performed on thin cryosections. To demonstrate the applicability of this technique it is shown that adriamycin bound to isolated rat liver and heart mitochondria can be visualized through its characteristic fluorescence. Longitudinal sections from heart tissue perfused with 50 microM adriamycin display two distinct cellular sites of drug accumulation, i.e., nuclei which exhibit very bright fluorescence and, in addition, mitochondria which become significantly labeled with the drug. The mitochondrial localization of adriamycin is confirmed independently by quantification of the drug content of the mitochondrial fraction after cell fractionation. These results are discussed in the light of the potential role of adriamycin-nuclei versus adriamycin mitochondria interactions in the deterioration of heart performance. PMID- 3518811 TI - Interactions of insulin, catecholamines and adenosine in the regulation of glucose transport in isolated rat cardiac myocytes. AB - The regulation of the glucose transport system by catecholamines and insulin has been studied in isolated rat cardiomyocytes. In the basal state, 1-isoproterenol exhibited a biphasic concentration-dependent regulation of 3-O-methylglucose transport. At low concentrations (less than 10 nM), isoproterenol induced a maximal inhibition of 65-70% of the basal rates, while at higher concentrations (greater than 10 nM) a 25-70% stimulation of transport was observed. In the presence of adenosine deaminase, the inhibition of isoproterenol at low doses was attenuated. No effect of adenosine deaminase was observed on the stimulation of transport at high doses of isoproterenol. The inhibitory effect of isoproterenol returned when N6-phenylisopropyladenosine (a non-metabolizable analog of adenosine) was included along with adenosine deaminase. Dibutyryl cAMP and forskolin both inhibited basal transport rates. In the presence of maximally stimulating concentrations of insulin, cardiomyocyte 3-O-methylglucose transport was generally elevated 200-300% above basal levels. In the presence of isoproterenol, insulin stimulation was inhibited at both high and low concentrations of catecholamine, with maximum inhibition occurring at the lowest concentrations tested. When cells were incubated with both adenosine deaminase and isoproterenol, the inhibition of the insulin response was greater at all concentrations of catecholamine and was almost completely blocked at isoproterenol concentrations of 10 nM or less. Dibutyryl cAMP inhibited the insulin response to within 10% of basal transport levels, while forskolin completely inhibited all transport activity in the presence of insulin. These results suggest that catecholamines regulate basal and insulin-stimulated glucose transport via both cAMP-dependent and cAMP-independent mechanisms and that this regulation is modulated in the presence of extracellular adenosine. PMID- 3518813 TI - Purification and characterization of an endothelial cell growth factor from serum free culture medium of human diploid fibroblast cells. AB - Serum-free culture supernatants of human embryo fibroblast cells contain endothelial cell growth factor (f-ECGF) which supports the serial propagation of human umbilical vein endothelial cells in the serum-free culture medium (medium A). This growth-stimulating activity has been partially purified from serum-free culture-conditioned medium. The stability of the activity to acid (pH 4.0-4.5) was utilized for the first step in purification. f-ECGF had a high affinity to heparin-Sepharose CL-6B, and was isolated by the methods of heparin affinity, of ion-exchange and gel filtration chromatography from the serum-free culture conditioned medium preparation. The purified f-ECGF had an isoelectric point in the pH range 4.5-6, and a molecular weight of approx. 30 kDa determined by either gel filtration or SDS-polyacrylamide gradient gel electrophoresis. The f-ECGF has high affinity for concanavalin A column, and the activity was partially eluted from the column with ethylene glycol and alpha-methylmannose. The results indicate that f-ECGF is an acidic-glyco-protein with heterogeneous sugar chain(s). PMID- 3518814 TI - [Phosphorylation of light chains of myosin from rabbit skeletal muscles affects the type of conformation changes of F-actin induced by heavy meromyosin]. AB - The changes in F-actin conformation in myosin-free single ghost fiber induced by the binding of heavy meromyosin (HMM) with dephosphorylated or phosphorylated light chains-2 (LC2) have been studied by measuring intrinsic tryptophan polarized fluorescence of F-actin. It has been found that at low concentrations of Ca2+ (pCa greater than or equal to 8), the binding of HMM with dephosphorylated LC2 to F-actin in ghost fibres increases, whereas the binding of HMM with phosphorylated LC2 decreases the anisotropy of polarized tryptophan fluorescence. The effect is reversed at high concentrations of Ca2+ (pCa = 5). It has been assumed that this effect of myosin light chains phosphorylation may be due to its influence on the type of myosin head binding to F-actin. PMID- 3518815 TI - [Determination of binding constants of antibodies fractionated according to their affinity to insulin]. AB - The number of populations of antibodies differing in their affinity for insulin was determined in guinea pig antiserum. The antibody fractions differing in their affinity were obtained by affinity chromatography on an antigenic sorbent. Elution with a stepwise pH gradient from 4 to 2 differing in the number and form of the steps resulted in 10 fractions of antibodies obtained from individual animal sera. The binding constants of fractionated antibodies were determined by a bioluminescent immunocofactor method. With a change in elution pH from 4 to 2, the equilibrious binding constant of antibodies increased from 10(6) to 5 X 10(9) M-1. PMID- 3518816 TI - [Nucleotide composition and the level of DNA homology in a number of Bacillus diasticus strains]. AB - The base composition of DNA and DNA homology of a number of strains Bacillus diastaticus differing in the intensity of the amilase synthesis and some phenotipic properties have been studied. The differences in the base composition of DNA have not been found. All stains studied are characterized by the high rate of DNA homology. B. diastaticus and B. stearothermophilus have been established to be genetically similar. PMID- 3518817 TI - [Physicochemical properties of a fibrinolytic enzyme from Streptomyces thermovulgaris culture broth]. AB - Some properties of fibrinolytic enzyme from cultural fluid of Streptomyces thermovulgaris have been studied. The molecule of enzyme has been shown to consist of one polypeptide chain with molecular mass 28000 dalton, pi = 7.45-7.6. The amino acid composition of protein is determined, the protein does not contain cysteine residues. The enzyme is not thermostable, and Ca2+ ion does not exert stabilized influence. In opposition to diisopropylfluorophosphate, phenylmethylsulfonyl fluoride does not inhibit the enzyme activity. PMID- 3518818 TI - Relationship between glucose utilization rate and glucose concentration in preterm infants. AB - Within the neonatal euglycemic range, we studied the relationships among total glucose entry, intravenous glucose infusion, endogenous glucose production, glucose disposal rate and blood glucose concentration in infants less than or equal to 32 weeks gestation. [U-13C]-glucose was used as a tracer of glucose metabolism, administered as a primed constant infusion. Using a glucose clamp technique, at least one steady-state period of blood glucose concentration in 10 infants and two steady-state periods of blood glucose concentration in 6 infants were achieved. In the 6 infants studied at 2 glucose concentrations, glucose disposal rate increased with blood glucose concentration, r = 0.95, p less than 0.01, slope = 0.091 +/- 0.058 (SD) mg X min-1 X kg-1 per mg X dl-1 of glucose concentration increase. In all infants studied, intravenous glucose infusion rate was not different from glucose disposal rate, suggesting the absence of endogenous glucose production. PMID- 3518820 TI - Adrenal phenylethanolamine-N-methyltransferase activity in the young rat: influence of thyroid hormones and insulin-induced hypoglycemia. AB - The postnatal evolution of adrenal phenylethanolamine-N-methyltransferase (PNMT) activity is slightly accelerated by hypothyroidism and slowed by hyperthyroidism. In 14-day-old rats a single stimulation of the adrenals by insulin-induced hypoglycemia does not lead to any change in enzymatic activity. If the stimulation is repeated for 4 days, it leads to a net increase in adrenal PNMT activity in the control rats, while no increase occurs in hypo- or hyperthyroid animals. PMID- 3518819 TI - Growth and differentiation of fetal rat intestine transplants: dependence on insulin and growth hormone. AB - We have studied the role of hormones in the growth and differentiation of fetal rat intestine. Pieces of small intestine from 15-day fetal rats were transplanted under the renal capsule of either normal, hypophysectomized (HX), or diabetic adult rats and grown for 11 days. Intestine transplants in control hosts showed normal differentiation and they increased 60-fold in protein content and wet weight. Growth of transplants in HX and diabetic hosts was reduced by 50 and 25%, respectively. Transplants in diabetic hosts were histologically normal, while those in HX hosts failed to develop villi and discrete smooth muscle layers. Normal growth and differentiation in HX and diabetic hosts were completely restored by administration of growth hormone (GH) or insulin, respectively. Our data indicate that both GH and insulin are necessary for normal growth of the transplanted intestine during a period corresponding to late fetal and early neonatal life, but only the former is required for normal differentiation. PMID- 3518821 TI - Ultrastructure of insulin secretory granules and insulin content of fetal pancreas exposed to ethanol in utero in the rat. AB - Fetal rat pancreata exposed to ethanol in utero were examined for morphometric analysis of insulin secretory granules and insulin content. The beta-cells contained both dark and light granules, and their volume density was unaltered by maternal ethanol ingestion during pregnancy. The insulin content of pancreata of newborn rats was nearly equal in control and experimental animals. The study indicates no adverse effect of maternal ethanol ingestion on fetal pancreatic insulin concentration and insulin secretory granules. PMID- 3518822 TI - A negative, double-blind, placebo-controlled, clinical trial of verapamil in chronic schizophrenia. PMID- 3518823 TI - Relationships between insulin and glucose metabolism and pituitary-ovarian functions in fasted heifers. AB - The effects of fasting between Days 8 and 16 of the estrous cycle on plasma concentrations of luteinizing hormone (LH), progesterone, cortisol, glucose and insulin were determined in 4 fasted and 4 control heifers during an estrous cycle of fasting and in the subsequent cycle after fasting. Cortisol levels were unaffected by fasting. Concentrations of insulin and glucose, however, were decreased (p less than 0.05) by 12 and 36 h, respectively, after fasting was begun and did not return to control values until 12 h (insulin) and 4 to 7 days (glucose) after fasting ended. Concentrations of progesterone were greater (p less than 0.05) in fasted than in control heifers from Day 10 to 15 of the estrous cycle during fasting, while LH levels were lower (p less than 0.01) in fasted than in control heifers during the last 24 h of fasting. Concentrations of LH increased (p less than 0.01) abruptly in fasted heifers in the first 4 h after they were refed on Day 16 of the fasted cycle. Concentrations (means +/- SEM) of LH also were greater (p less than 0.05) in fasted (11.2 +/- 2.6 ng/ml) than in control (4.7 +/- 1.2 ng/ml) heifers during estrus of the cycle after fasting; this elevated LH was preceded by a rebound response in insulin levels in the fasted-refed heifers, with insulin increasing from 176 +/- 35 pg/ml to 1302 +/- 280 pg/ml between refeeding and estrus of the cycle after fasting. Concentrations of LH, glucose and insulin were similar in both groups after Day 2 of the postfasting cycle. Concentrations of progesterone in two fasted heifers and controls were similar during the cycle after fasting, whereas concentrations in the other fasted heifers were less than 1 ng/ml until Day 10, indicating delayed ovulation and (or) reduced luteal function. Thus, aberrant pituitary and luteal functions in fasted heifers were associated with concurrent fasting-induced changes in insulin and glucose metabolism. PMID- 3518824 TI - Granuloma and plasma cell formation induced by the subcutaneous implantation of beta-whitlockite particles. AB - In this paper, the formation of a granuloma following subcutaneous implantation of beta-whitlockite powder is described. The implants were removed after 3, 5 and 7 wk and examined histologically. In the granuloma giant cells, macrophages, lymphocytes and plasma cells are present. The presence of plasma cells indicates that not only inflammation occurs, but that an immunoresponse also takes place. Resorption and phagocytosis of particles was observed and the particles were found in the regional lymph nodes after 7 wk. beta-Whitlockite powder induces an inflammation and both a cellular and a humoral immunological response, when implanted subcutaneously. PMID- 3518826 TI - The personal computer as an aid to scientific writing. PMID- 3518825 TI - Ultrasonic tissue differentiation through the acoustic differential backscattering coefficient. PMID- 3518827 TI - DNA orientation during gel electrophoresis and its relation to electrophoretic mobility. PMID- 3518828 TI - Models of thioredoxin hairpin structures: conformational properties of beta-turn containing sequences. PMID- 3518829 TI - Effects of splenectomy on the retention of Salmonella enteritidis and on the hemopoietic response to Salmonella infection. AB - Salmonella infection induces a marked increase in the splenic granulopoiesis, but causes a reduction in hemopoiesis in the bone marrow. In this study, effects of Salmonella enteritidis infection on hemopoietic stem cells were examined in splenectomized (SX-) mice. Splenectomy emphasized hemopoietic damage in the bone marrow caused by Salmonella infection. Total nucleated cells, pluripotent stem cells (CFUs) and granulocyte-macrophage progenitor cells (GM-CFC) in the bone marrow of SX-mice all decreased markedly compared with sham-splenectomized (NX-) mice, and the recovery from the decline was also delayed. Thus, neither enhancement of the granulopoiesis nor granulopoietic recovery in the bone marrow was observed to compensate the granulopoietic response in the spleen. Splenectomy also resulted in a longlasting retention of Salmonella in the liver. The observations indicate that the spleen is the major organ to respond to bacterial invasion in regard to enhanced granulopoiesis and hence enhanced bacterial clearance. PMID- 3518830 TI - [The dual nature of lymphocyte interaction with allogenic stem cells]. AB - The interaction of lymphocytes from mouse lymph nodes with allogeneic stem cells was studied using exogenous colony formation inhibition test. Dual nature of the interaction was revealed: great amounts of lymphocytes inhibited, while small amounts stimulated colony formation. This dependence holds true for macro- and microcolonies as well as for erythrocyte and granuloid microcolonies in the bone marrow during fixation on day 8 and 11 after cell mixture transplantation. PMID- 3518831 TI - [Changes in testosterone levels in rabbit embryo testes after removal of the hypothalamus (encephalectomy)]. AB - Brain hypothalamus region was removed by encephalectomy in utero in 21-23-day-old rabbit fetuses to find out when hypothalamic control over testicular androgenous function was set up during rabbit prenatal development. Testosterone concentration in testicular tissue was measured by radioimmunoassay at different terms after the operation. Encephalectomy resulted in a reliable decrease of testosterone concentration in 29- and 25-day-old fetuses, however, no significant changes were observed in 23-day-old fetuses. The greatest reduction in hormone gland concentration was noted in 25-day-old fetuses, encephalectomized on day 23 of their development. Introduction of LH-RH to 25-day-old encephalectomized fetuses 30 min before fixation significantly increased androgen concentration in the gland. The data obtained indicate that hypothalamic control over testicular androgenous function is set up on days 23-25 of prenatal development. PMID- 3518832 TI - [Dynamics of changes in the ultrastructure of the rat cerebral cortex in the early period of acute radiation sickness caused by neutron irradiation]. AB - A 24-hour electron microscopic examination of neuronal and capillary ultrastructure in sensorimotor complex was performed after whole-body neutron irradiation of mature rats in the dose of 10 Gy. The results suggest that postradiation neuronal changes, observed for 6 hours after irradiation, are mainly caused by direct effect of ionizing radiation. At later terms this process is influenced by blood capillary lesions. The effect of neutron irradiation at the ultrastructural level is similar to that of rarely ionizing radiation. PMID- 3518833 TI - Successful donor cell engraftment in a recipient of bone marrow from a cadaveric donor. AB - A 12-year-old male with acute lymphocytic leukemia received donor bone marrow from his histocompatible father whose marrow was harvested 40 minutes postmortem after he suffered a myocardial infarction. The marrow was stored in liquid nitrogen for 17 days prior to infusion into the recipient. Trypan blue viability was greater than 99% for the fresh marrow. Progenitor cell assays revealed that 20% of the CFU-MIX, 16% of the BFU-E, 10% of the CFU-E, and 17% of the CFU-GM were spared during the cryopreservation period. Posttransplantation, the recipient had a leukocyte count greater than 10(3)/microL by day 26. Southern blotting analysis documented the donor origin of the peripheral blood mononuclear cells and granulocytes isolated 46 days posttransplantation. Unfortunately, the patient died of complications relating to graft-v-host disease 67 days following transplantation. This case demonstrates the feasibility of cadaveric marrow as a source of donor cells and is the first reported case of documented leukocyte engraftment in a recipient of cadaveric marrow. PMID- 3518835 TI - Expression of the leukocyte functional molecule (LFA-1) on mouse platelets. AB - Platelet involvement in adhesion, hemostasis, and immune adherence is mediated by functionally associated cell surface molecules. Platelets are also involved in cytolytic reactions, but little is known about the mechanisms or biologic significance of these processes. To further investigate cell surface molecules concerned with platelet function, antisera against mouse platelets, thymocytes, and macrophages and monoclonal antibodies against Mac-1 (complement receptor type 3) and leukocyte function-associated glycoprotein type 1 (LFA-1) were used to demonstrate LFA-1--like molecules on mouse platelets. The alpha subunits of platelet and thymocyte LFA-1 showed identical electrophoretic mobility but differed significantly from the alpha subunit of macrophage Mac-1. Peptide mapping demonstrated the identity of the beta subunits of these three molecules but showed that the alpha subunit of Mac-1 was distinct from the alpha subunits of platelet and thymocyte LFA-1. Platelet LFA-1, as demonstrated by surface iodination with lactoperoxidase and by labeling sialic acid residues with sodium borohydride, was not a major component of the platelet membrane. The functional significance of LFA-1 on mouse platelets has yet to be demonstrated, monoclonal antibodies against LFA-1 having little effect on adenosine diphosphate-induced platelet aggregation and immune adherence. In contrast, although Mac-1 could not be demonstrated on mouse platelets in immunoprecipitation studies, its presence was clearly demonstrated by low levels of antibody binding in enzyme-linked immunosorbent assays and by the ability of M1/70 monoclonal antibody to inhibit platelet immune adherence. Human platelets, which are inactive in immune adherence assays, are shown to lack LFA-1 and Mac-1. PMID- 3518834 TI - Adverse effect of severe marrow fibrosis on hematologic recovery after chemoradiotherapy and allogeneic bone marrow transplantation. AB - We reviewed the records and marrow biopsy specimens of 75 patients with leukemic, myelodysplastic, or myeloproliferative disorders to determine whether the presence of marrow fibrosis affected engraftment after allogeneic marrow transplantation. While 28 control patients without fibrosis achieved prompt engraftment, two of 32 patients (6%) with mild and five of 15 patients (33%) with severe fibrosis failed. The rate of myeloid recovery was significantly slower and the dependence on platelet and red blood cell transfusions was significantly longer in patients with severe fibrosis than in patients with no fibrosis. A finding of severe marrow fibrosis should therefore be taken into account when evaluating the risks and benefits of marrow transplantation. PMID- 3518836 TI - Thrombocytopenia in venocclusive disease after bone marrow transplantation or chemotherapy. AB - Hepatic venocclusive disease (VOD) is a frequent complication of bone marrow transplantation (BMT). Analysis of 13 cases observed during a 3-year period in our BMT center shows that VOD is associated with a constant peripheral thrombocytopenia and refractoriness to platelet transfusion. These signs appear in the very early stage of VOD, five to ten days before the classical signs, painful hepatomegaly and sudden weight gain. Analysis of platelet consumption, frequency of platelet transfusion and platelet recovery, and examination of known causes of peripheral thrombocytopenia (mainly allo- and autoimmunization, disseminated intravascular coagulation [DIC] and splenomegaly) lead to the conclusions that this association is not coincidental. The exact mechanism of platelet consumption in VOD is unknown. PMID- 3518837 TI - The non-producer plasma cell myeloma. Report of a case and review of the literature. AB - A case of non-producer multiple myeloma (MM) is described and compared with the previous reports. Some recurrent clinical traits seem to characterize this disease. It is interesting that reported cases seem to show a low aggressivity. Some biological problems connected with this form of disease are discussed. PMID- 3518838 TI - Sleep apnoea syndromes in adults. PMID- 3518839 TI - Computer-assisted instruction: a library service for the community teaching hospital. AB - This paper reports on five years of experience with computer-assisted instruction (CAI) at Winthrop-University Hospital, a major affiliate of the SUNY at Stony Brook School of Medicine. It compares CAI programs available from Ohio State University and Massachusetts General Hospital (accessed by telephone and modem), and software packages purchased from the Health Sciences Consortium (MED-CAPS) and Scientific American (DISCOTEST). The comparison documents one library's experience of the cost of these programs and the use made of them by medical students, house staff, and attending physicians. It describes the space allocated for necessary equipment, as well as the marketing of CAI. Finally, in view of the decision of the National Board of Medical Examiners to administer the Part III examination on computer (the so-called CBX) starting in 1988, the paper speculates on the future importance of CAI in the community teaching hospital. PMID- 3518840 TI - Nursing research: historical background and teaching information strategies. AB - The expansion of research-based literature is one of the foremost goals of the nursing profession. Linked to this goal are the utilization and further development of nursing libraries. This paper discusses some historical factors that have influenced nursing literature. It presents a model for teaching graduate nursing students the relationship between research and library information skills. PMID- 3518841 TI - Library instruction for medical students. AB - The library instruction program for medical students at the University of Tennessee Center for the Health Sciences is described. This instruction program, which was developed in cooperation with the medical faculty, is included in the College of Medicine curriculum. Library instruction is presented sequentially at scheduled times during the four-year curriculum when students need specific information. The development, implementation, and evaluation of the program are discussed. PMID- 3518842 TI - MiniMEDLINE: comment. PMID- 3518843 TI - Computers as learning resources in the health sciences: impact and issues. AB - Starting with two computer terminals in 1972, the Health Sciences Learning Resources Center of the University of Minnesota Bio-Medical Library expanded its instructional facilities to ten terminals and thirty-five microcomputers by 1985. Computer use accounted for 28% of total center circulation. The impact of these resources on health sciences curricula is described and issues related to use, support, and planning are raised and discussed. Judged by their acceptance and educational value, computers are successful health sciences learning resources at the University of Minnesota. PMID- 3518844 TI - [Register of the Academy and program of conferences]. PMID- 3518845 TI - "Women are proverbially hopeful:" Newark's voluntary hospitals, 1867-1890. PMID- 3518847 TI - A rational approach to the investigation of the gallbladder. AB - A technique for the investigation of suspected non-acute gallbladder disease is described. It is based on properly conducted oral cholecystography (OCG) augmented, when necessary, by ultrasonic examination of the gallbladder (UCG) during the patient's same visit. This regimen has been applied successfully for 5 years; the results of a recent year's work are presented and discussed. Only 12.2% of patients required both investigations and, using the OCG technique described, in only 1.1% of cases was the gallbladder inadequately opacified when subsequent UCG was normal. This approach involves no increase in work-load and provides the referring clinician with objective evidence of the presence or absence of disease following a single visit by the patient to the X-ray department. PMID- 3518846 TI - A comparative review of the Hammersmith (1971-75) and Edinburgh (1977-82) neutron therapy trials of certain cancers of the oral cavity, oropharynx, larynx and hypopharynx. Medical Research Council Neutron Therapy Working Group. AB - Because of apparent inconsistencies in the two trials of neutron therapy carried out under its auspices, the MRC in 1982 requested a comparative review of the data in the Hammersmith and Edinburgh trials in so far as the clinical material allowed of such comparison. It was clear that the two trials were not only not contemporaneous (Hammersmith 1971-75; Edinburgh 1977-82) but that they differed in site and stage of disease as well as in the parameters of radiation dosage. Only a fraction of the patients were comparable and this review, which sets out the differences in design and conduct of the two trials, focuses on squamous-cell carcinoma in the four sites--oral cavity, oropharynx, larynx and hypopharynx- which were common in both. The first 120 patients entered into the Edinburgh trial have been compared with the 95 patients selected from 161 in the Hammersmith trial who would have been eligible at Edinburgh by reason of the site of disease and histology. Thus, Hammersmith patients with tumours of salivary glands, sinuses and neck nodes were, of necessity, excluded. Within such limitations the data on case distribution, tumour size and stage, the parameters of radiation dosage and the outcome in terms of tumour control, survival and treatment morbidity have been subjected to rigorous assessment and analysis. The important aspects in which the two investigations had differed included the stage of disease (more advanced at Hammersmith, with 63% of patients having fixed nodes, compared with 27% at Edinburgh); radiation dosage (the median neutron dose being 5% lower at Edinburgh than at Hammersmith while the median photon dose was l0% higher at Edinburgh); the "photon arm" of the Edinburgh trial being on site whereas that at Hammersmith had been at multiple centres; and the years in which the trials had been carried out. The two series are comparable in terms of treatment failure (local recurrence or late radiation death) following local tumour control. The results are also consistent in associating an increased incidence of late severe radiation morbidity and of intercurrent deaths with neutron therapy. In three other respects the results of the two series differ. At Edinburgh there was advantage to the photon-treated patients in terms of overall mortality, whereas at Hammersmith the advantage was to those treated with neutrons. The incidence of tumour regression for patients randomised to photons was much lower in the Hammersmith trial than for neutrons, whereas in Edinburgh the two modalities gave similar results. PMID- 3518848 TI - Lack of discernible effect of diagnostic ultrasound on the chromosomes of cord blood lymphocytes exposed in utero. AB - The levels of either sister chromatid exchanges or chromosome breakage (as assayed by the frequency of micronuclei) in cord blood lymphocytes from a total of 62 babies were analysed. The exposure of these babies to ultrasound during gestation was determined retrospectively from medical records and the data reclassified accordingly. No correlation was seen between the levels of chromosome breakage, as measured by these two end-points, and exposure to ultrasound. PMID- 3518849 TI - Skeletal-muscle haemangioma presenting as an abdominal mass. PMID- 3518850 TI - Calcified post-traumatic renal pseudotumour. PMID- 3518851 TI - Detection of Toxocara by computed tomography. PMID- 3518852 TI - Sarcoidosis of the parotid gland. AB - The clinical and radiological features of parotid-gland sarcoidosis in 22 patients are presented. This occurred in association with systemic disease as painless, diffuse and nonnodular parotid swelling. Conventional sialography usually demonstrated normal proximal ducts, a few fragile distal ducts and non specific parenchymal nodules. Computed tomography, with or without simultaneous sialography, defined and characterised such nodules and demonstrated normal periparotid anatomy. Sialography contributes little additional information to thorough clinical examination in non-nodular or multinodular glands. However, solitary nodules appear to be better investigated by sialography, CT and CT guided aspiration, thereby allowing diagnosis and direct medical therapy and avoiding surgery. Ultrasonography and nuclear scintigraphy were of little value in this study. PMID- 3518853 TI - Protection against ionising radiation and synergism with thiols by zinc aspartate. AB - Pre-treatment with zinc aspartate protected mice against the lethal effects of radiation and raised the LD50 from 8 Gy to 12.2 Gy. Zinc chloride and zinc sulphate were clearly less active. The radioprotective effect of zinc aspartate was equivalent to cysteamine and slightly inferior to S,2-aminoethylisothiourea (AET). Zinc aspartate displayed a similar therapeutic index to the thiols but could be applied at an earlier time before irradiation. Synergistic effects occurred with the combined administration of zinc aspartate and thiols. By giving zinc aspartate with cysteamine, the LD50 was increased to 13.25 Gy and, by combining it in the optimal protocol with AET, to 17.3 Gy. The radioprotection by zinc and its synergism with thiols is explained by the stabilisation of thiols through the formation of zinc complexes. PMID- 3518854 TI - A critical review of adjuvant preoperative radiation therapy for adenocarcinoma of the rectum. PMID- 3518855 TI - Comparison of stapling and hand-suture for left-sided large bowel anastomosis. AB - One hundred patients undergoing elective left-sided colonic or rectal resections were randomly allocated to have an anastomosis performed either with the EEA stapling gun or by hand suture using a single layer of interrupted sutures. In six patients the anastomosis could not be performed with the stapling gun. Clinical leakage occurred in two of the remaining 94 cases; both had hand-sutured anastomoses. Radiological leakage was demonstrated in 13 further cases (7 stapled, 6 sutured); there was no statistical difference in leakage rate with stapled and hand-sutured anastomoses. PMID- 3518856 TI - A history of classical swine fever in Cyprus. PMID- 3518857 TI - Opportunistic bacteria isolated from the caecum of rabbits with mucoid enteritis. PMID- 3518858 TI - Relationships between sexual activity, plasma testosterone, and the volume of the sexually dimorphic nucleus of the preoptic area in prenatally stressed and non stressed rats. AB - The sexually dimorphic nucleus of the preoptic area (SDN-POA) has recently been shown to be reduced in cross-sectional area in prenatally stressed male rats. As masculine copulatory behavior is also reduced in prenatally stressed animals, the present study was designed to test a possible relationship between the entire volume of the SDN-POA and masculine sexual activity in both prenatally stressed and control adult male rats. We report here that prenatally stressed adult males have significantly reduced SDN-POA volumes, reduced levels of sexual activity and lower plasma testosterone levels as compared to control animals. Additionally, however, a strong positive relationship was demonstrated between SDN-POA volume and sexual activity in both stressed and control animals. SDN-POA volumes of sexually active animals from stressed and control groups are approximately equal. SDN-POA volumes of sexually non-active animals are also equal and are about two times smaller than those of sexually active animals, either stressed or control. Similar correlations are reported between SDN-POA volume and testosterone level, and between testosterone level and sexual activity. It is concluded that (1) SDN POA volume is predictive of sexual activity in both stressed and control male rats, (2) there is a relationship between SDN-POA volume and plasma testosterone level, and (3) the SDN-POA likely has multiple roles in the circuitry underlying masculine reproductive processes and hormone regulation. PMID- 3518859 TI - GABA imbalance in squirrel monkey after unilateral vestibular end-organ ablation. AB - Using an antibody against GABA conjugated to bovine serum albumin, GABA-like immunoreactivity was measured in vestibular nuclei and adjacent structures in normal and unilaterally vestibular-deafferentiated squirrel monkeys. Three and 6 days after end-organ ablation, GABA levels increased in lateral vestibular nucleus (LVN) on the side ipsilateral to the lesion, while GABA decreased in LVN on the side contralateral to the lesion. GABA levels in ventral cochlear nucleus or inferior cerebellar peduncle did not differ from normal in either case. PMID- 3518860 TI - Localization of S-adenosylhomocysteine hydrolase and adenosine deaminase immunoreactivities in rat brain. AB - Antisera against rat-liver S-adenosylhomocysteine hydrolase (SAH-hydrolase) and calf intestinal mucosal adenosine deaminase (ADA) were raised in rabbits and subsequently used to determine the distribution of the corresponding enzymes in rat-brain using the peroxidase-antiperoxidase immunohistochemical procedure. SAH hydrolase antigenicity was prominent in the neocortex, hippocampal formation, cerebellum and olfactory tubercle. In the cerebellum, only those cells associated with the Purkinje layer possessed pronounced reactivity with anti-SAH hydrolase. The intense staining present could be correlated mainly with nuclei, the cytosol being stained less intensely. Weak ADA antigenicity was found throughout the brain, but strong antigenic reactivity was associated with neurones in the basal hypothalamus, superior colliculus and in nerve fibres in many regions. Many ADA antigenic neurones and fibres were seen in close proximity to blood vessels. The distribution of ADA antigenicity was also studied in cat and rabbit brain. In cat brain only general staining of tissue occurred with anti-ADA and no intensely stained regions comparable to those seen in rat brain were observed. Rabbit brain showed weak specifically stained neurones only in the superior colliculus. Enzyme assays were also performed to confirm immunohistochemical findings. There appears to be little in common between regions which stained intensely with anti-SAH hydrolase and anti-ADA respectively. The possible implications of these findings are discussed. PMID- 3518861 TI - The distribution of VIP-immunoreactive neurons in the visual cortex of adult rabbits and during postnatal development. AB - In the adult rabbit, the majority of the VIP-immunoreactive neurons are distributed in layer II-III of the visual cortex. Labeled cells are also seen in layers VI, IV, V and occasionally in layer I. During postnatal development, we can see labeled neurons on the 2nd day of life, and in layers II-III-IV-V-VI on the 4th day. On the 7th day, these neurons reach a distribution typical in the adult animal. From the 2nd to the 10th day the number of VIP-neurons increases, and from the 10th day to maturity, there is a 15-20% loss in the number of labeled cells. PMID- 3518862 TI - Representations of the face, teeth and oral cavity in areas 3b and 1 of somatosensory cortex in squirrel monkeys. AB - The somatotopic organization of low threshold inputs from the face and head was determined in the lateral portion of areas 3b and 1 in squirrel monkeys. A complete, topographically organized representation was found in area 3b, and a separate, roughly parallel representation was found in adjacent area 1. In addition, there was evidence for remarkable individual variability in the representation of the lips in area 3b. PMID- 3518863 TI - Crus cerebri lesions abolish amphetamine-induced ascorbate release in the rat neostriatum. AB - An increase in the concentration of ascorbate in the extracellular fluid of the rat striatum following systemic amphetamine administration previously has been demonstrated with the use of in vivo electrochemistry, push-pull cannula and in vivo dialysis. In this report, the effect of infusions of amphetamine into the substantia nigra on extracellular ascorbate levels in the striatum is further investigated by in vivo electrochemistry. Electrolytic lesions in the crus cerebri of the striatonigral pathway abolish this effect. Furthermore, these lesions abolish the effect of systemic amphetamine in the striatum ipsilateral to the lesion but not on the contralateral side. This phenomenon is independent of neostriatal dopamine or gamma-aminobutyric acid since levels were shown to be unchanged relative to the intact side. These results lend further support to the hypothesis that ascorbate secretion in the striatum after amphetamine is mediated in the central nervous system, and indicate that a pathway that courses through the crus cerebri is necessary for this release. PMID- 3518864 TI - Bombesin inhibits growth hormone response to insulin-induced hypoglycemia in humans. AB - Intravenous administration of bombesin (5 ng/kg/min X 2.5 h) significantly reduced growth hormone (GH) response to insulin-induced (0.15 U/kg, i.v.) hypoglycemia in 8 male volunteers without affecting its basal plasma levels. These data, together with the presence of bombesin-like immunoreactivity in the human brain, suggest that--as in experimental animals--this neurogastrointestinal peptide may be of physiological significance in the control of GH secretion also in man. PMID- 3518865 TI - Substance P-containing trigeminal sensory neurons project to the nucleus of the solitary tract. AB - Intense substance P-like immunoreactivity (SPLI) was identified in fiber bundles coursing between the spinal nucleus of the trigeminal nerve and the ventrolateral nucleus of the solitary tract at the level of the area postrema. These bundles were apparent only when tissue was stained for substance P immunoreactivity and were not visible in preparations treated with antisera to somatostatin or neurotensin. Following unilateral section of the trigeminal nerve, the SPLI containing fiber bundles were absent ipsilateral to the nerve section. The fibers were absent bilaterally in rats which were previously injected with capsaicin. Unilateral removal of the nodose ganglion did not diminish the intensity or apparent number of SPLI fibers. These data indicate the presence of a trigeminosolitary projection which is composed of primary trigeminal sensory neurons containing substance P. The results provide an anatomical route by which substance P of trigeminal origin may modulate vagal or glossopharyngeal sensory information. PMID- 3518866 TI - Neuropeptide tyrosine-like immunoreactive nerve fibers in the carotid body chemoreceptor of rats. AB - Abundant NPY-immunoreactive nerve fibers were found throughout the parenchyma of the rat carotid body. They were in close proximity to smooth muscle cells and pericytes of small blood vessels intervening a narrow interstitial space of 80 150 nm. No immunoreactive nerve fibers were associated with chief or sustentacular cells. After removing the superior cervical ganglion, no immunoreactive nerve fibers were seen in the ipsilateral carotid body and the immunoreactive nerve fibers remained intact in the carotid body after cutting the ipsilateral superior cervical sympathetic trunk. The NPY-immunoreactive nerve fibers are therefore considered to be postganglionic sympathetic noradrenergic nerves. PMID- 3518867 TI - Localization of a neurectoderm-associated cell surface antigen in the developing and adult rat. AB - The distribution of a neurectoderm-associated carbohydrate antigen (termed D1.1) in tissues of the developing and adult rat was determined using indirect immunofluorescent techniques. The antigen was detected as early as embryonic days 8 and 9 when it was localized to cells within the developing neural plate and neural tube. As the central nervous system (CNS) developed, the anti-D1.1 antibody labeled neuroepithelial cells but not terminally differentiated neurons or glial cells. In addition, the notochord and somatic mesoderm were labeled transiently with the antibody. Outside of the CNS, the antibody labeled dorsal root ganglia neurons, adrenal chromaffin cells and cells of the kidney glomerulus. These tissues were labeled at embryonic day 14 and the labeling persisted in the adult. We used a sensitive immunoautoradiography assay to identify antigenic gangliosides present in extracts of these tissues. The anti D1.1 antibody recognized a ganglioside of kidney and adrenal glands that has a chromatographic mobility identical to that of the D1.1 antigen previously identified from cell lines and developing cerebellum. However, the antibody bound to a separate and distinct set of gangliosides present in extracts of adult dorsal root ganglia. Thus, the carbohydrate sequence recognized by the antibody can be associated with more than one molecular species of ganglioside. These results demonstrate that within the context of the developing CNS, the D1.1 antigen is a stage-specific embryonic antigen, but, as is the case with other cell surface carbohydrate antigens, is also found on a limited but developmentally unrelated set of tissues in the adult. PMID- 3518868 TI - Unusual morphological changes in cultured oligodendrocytes induced by cytochalasin B. AB - When cultured chick oligodendrocytes were treated with more than 1 microM of cytochalasin B (CB), an unusual effect, namely the extension of curly processes, was observed in a dose-dependent manner within 2 h after CB was added, that is, the processes with long, thin and curled shapes developed. The effect was found to be reversible and to be inhibited by colchicine. It was demonstrated by immunofluorescence that CB induced the depolymerization of actin filaments and the enhanced assembly of microtubules in cellular processes. PMID- 3518869 TI - A transient pyramidal tract projection from the visual cortex in the hamster and its removal by selective collateral elimination. AB - During the early postnatal development of the neocortex in rats there is an axonal projection from the occipital cortex (which includes the visual cortex) to the spinal cord which is subsequently completely removed through a process of selective collateral elimination. In order to determine whether a similar phenomenon occurs during the development of the hamster cortex, we have injected the retrogradely transported fluorescent dye Fast Blue (FB) into the pyramidal decussation of hamsters at various ages. In adult hamsters such an injection results in a band of labeled neurons confined to layer V and to about the rostral two-thirds of the neocortex; no labeled cells are seen in the occipital cortex. However, a similar FB injection made during the first postnatal week results after a 4-day survival in a continuous band of FB-labeled layer V neurons spread throughout the tangential extent of the neocortex, including the occipital cortex. A similar continuous band of FB labeled layer V neurons is seen throughout the tangential extent of the neocortex including the occipital region in hamsters injected during the first postnatal week but allowed to survive until the fourth week (i.e., after the restriction of the widespread neonatal pattern has occurred). Injections of the anterograde tracer wheat germ agglutinin conjugated to horseradish peroxidase made into the occipital cortex, or for comparison, into more rostral cortical regions in hamsters ranging in age from neonates to adults, reveal that the extension of pyramidal tract axons is staggered along the anterioposterior axis of the cortex such that axons originating from the posterior regions lag behind those arising from more rostral areas. The transient occipital projection appears to reach a maximum around the end of the first postnatal week: a large number of labeled occipital axons is seen in the medullary pyramidal tract, and some of these can be followed through the pyramidal decussation and into the dorsal funiculus of the spinal cord. Injections into the occipital cortex on P16 label only a few fibers in the medullary pyramidal tract, and none is labeled in hamsters injected as adults.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3518870 TI - Maturation and plasticity in the olfactory system of vertebrates. PMID- 3518871 TI - Chronic venous leg ulcers and the role of dressings in their treatment. PMID- 3518872 TI - Autoproteolytic activity in the seminal plasma of the domestic fowl. AB - Acid and neutral proteolytic activity was found in chicken seminal plasma. This proteolytic activity can markedly change the plasma polypeptide pattern due to partial protein degradation. PMID- 3518873 TI - Effect of luteinising hormone releasing hormone and its analogues on plasma luteinising hormone concentrations in incubating bantam hens. AB - The ability of synthetic vertebrate luteinising hormone releasing hormones (LHRHs) and their long-acting analogues to maintain elevated plasma luteinising hormone (LH) concentrations and to stimulate ovarian growth was investigated in incubating bantam hens. Chicken LHRH-II (pGlu1-His2-Trp3-Ser4-His5-Gly6-Trp7-Tyr8 Pro9-G ly10-NH2) was more effective than chicken LHRH-I (pGlu1-His2-Trp3-Ser4 Tyr5-Gly6-Leu7-Gln8-Pro9-Gly10-N H2) or porcine LHRH (pGlu1-His2-Trp3-Ser4-Tyr5 Gly6-Leu7-Arg8-Pro9-Gly10-N H2) in stimulating the release of LH. Long-acting analogues of chicken LHRHs (chLHRHs) were created by substituting D-amino acids in position 6. An intravenous injection (10 micrograms/bird) of D-Arg6-chLHRH-II or of a long-acting mammalian analogue of LHRH (buserelin) resulted in a sustained release of LH for up to 8 h. Less sustained releases of LH were observed after the same doses of D-Ala6-chLHRH-I or of D-Trp6-chLHRH-I. Repeated subcutaneous injections of D-Arg6-chLHRH-II or buserelin at 7 to 9 h intervals for 9 d resulted in loss of pituitary gland responsiveness to these analogues. For this reason, the treatment failed to maintain elevated plasma LH concentrations and did not stimulate the growth of the ovary or oviduct. PMID- 3518874 TI - Cellular immune mechanisms in thermally injured mice. AB - An attempt was made to establish an animal model for analysing the cellular immune alterations following thermal injury and to correlate the results with those obtained in humans. A standard burn involving 20 per cent of the body surface area was established in C57 black mice (b1). The results revealed a loss of total T cells until post-burn day 10 and an increase in B cells only during post-burn day 1. The lymphocyte proliferative response to PHA was elevated with the appearance of null cells on post-burn day 10. This observation revealed a generalized depression in the immune responses which was significant until post burn day 10. However, the results were not comparable with the human studies. PMID- 3518875 TI - Coverage of full skin thickness burns with allograft inoculated with autogenous epithelial cells. AB - Since the supply of unburned autograft skin may be insufficient to cover very extensive burns, we have prepared allograft skin inoculated with a suspension of uncultured autogenous epithelial cells and grafted this material on to full skin thickness loss wounds. There was a satisfactory 'take' and permanent healing of this mixture of heterogeneous dermis and autogenous epidermis in two out of four patients. In this preliminary report we describe the clinical and histological observations which indicate that in the two patients with successful graft 'take' the epithelial cells proliferated and formed a continuous pale-coloured layer on top of the heterogeneous dermis between 30 and 40 days after application. PMID- 3518876 TI - Cancer chemotherapeutic agents as occupational hazards: a literature review. PMID- 3518877 TI - Human tumor lines for cancer research. PMID- 3518878 TI - Protein structure and cancer. PMID- 3518879 TI - The whiplash shaken infant syndrome: what has been learned? AB - In 1974 John Caffey described a form of abuse in infants which he called "The Whiplash Shaken Infant Syndrome." This syndrome involves vigorous manual shaking of infants by the extremities or shoulders, with whiplash-induced intracranial and intraocular bleeding, but with no external signs of head trauma. This article reviews the literature on whiplash shaken infant syndrome since Caffey's original review. The bulk of this literature focuses on the use of cranial computed tomography in the diagnosis of head injury in infants. Many questions remain regarding the incidence of this syndrome, and the long term morbidity resulting from this type of injury in infants. Caffey's recommendations for routine, regular examinations of the ocular fundi in all babies, and for a massive public educational program on the hazards of shaking infants have yet to be carried out. PMID- 3518880 TI - Physical punishment of children in Denmark: an historical perspective. PMID- 3518881 TI - Individual beliefs and expectations in dental health practises. PMID- 3518882 TI - Root amputation and hemisection. Indications, technique and restoration. PMID- 3518883 TI - An uncommon adverse effect following bolus administration of intravenous dexamethasone. PMID- 3518884 TI - Effect of surgical trauma and polylactate cubes and granules on the incidence of alveolar osteitis in mandibular third molar extraction wounds. PMID- 3518885 TI - Definitive treatment of recurring reparative central giant cell granuloma. A 10 year follow-up. PMID- 3518886 TI - [Ibuprofen pre- and postoperatively in oral surgery]. PMID- 3518887 TI - A study of the effects of computer assisted instruction on the attitude and achievement of vocational nursing students. PMID- 3518888 TI - The development of computer assisted instruction for drug dosage calculations. A group endeavor. PMID- 3518889 TI - Lens-induced inflammations. AB - The authors report six cases of lens-induced inflammations that help to illustrate the wide variability and clinical overlap of these conditions. Using cytological and histopathological findings, they attempt to clarify the confusion surrounding the terminology used to label these inflammations, and outline the immune factors responsible for them. With the recent upsurge in extracapsular cataract surgery, it is important to consider lens-induced inflammations in the differential diagnosis of any postoperative uveitis or endophthalmitis. PMID- 3518890 TI - Studies on transhepatic insulin absorption. AB - The intraperitoneal administration of insulin has been recommended because it was found to effectively control the plasma glucose level. Several authors have suggested that intraperitoneal insulin administration may be more "physiological" and therefore preferable because the insulin is absorbed into the portal venous system without, however, identifying the exact pathways. The possibility that insulin is absorbed through the surface of the liver was investigated in rats. The results show that insulin is absorbed rapidly by this route, but the effect on glucose modulation is similar to that of insulin given by other routes. In contrast, the effect on glucose modulation was delayed following insulin administration into the lower peritoneal cavity with exclusion of the liver. PMID- 3518891 TI - Microbes, warfare, religion, and human institutions. AB - A significant number of practicing microbiologists are not aware of the historical impact of infectious agents on the development of human institutions. Microbes have played a profound role in warfare, religion, migration of populations, art, and in diplomacy. Boundaries of nations have changed as a result of microbial diseases. Infectious agents have terminated some kingdoms and elevated others. There is a need for microbiologists to have a historical perspective of some of the major ways in which a pathogen may influence civilized populations. Conditions may exist in contemporary society for a repeat of some of the kinds of plagues suffered by previous societies. The purpose of this paper is to review examples of situations where pathogenic microbes have forced societal modifications on centers of human population. PMID- 3518892 TI - Manganese and antibiotic biosynthesis. III. The site of manganese control of patulin production in Penicillium urticae. AB - Although manganese had been shown to be an essential requirement for patulin biosynthesis, its site of action was unknown. Four possibilities were considered. A manganese requirement for the second pathway enzyme, a decarboxylase, was discounted since mid and late pathway intermediates were not converted to patulin in manganese-deficient cultures. A major disruption in primary metabolism and hence secondary metabolism was discounted since eight primary metabolism enzymes showed no evidence of unusual changes in specific activity when normal and manganese-deficient cultures were compared. Inhibitor studies using actinomycin D and cycloheximide showed that there was no activation of preexisting enzyme proteins and that manganese did not influence translation. The inhibitor studies did show, however, that manganese exercised its effect on patulin biosynthesis by influencing the coordinate appearance of pathway enzymes though an effect at the level of transcription. PMID- 3518893 TI - [Physiopathology and surgical correction of gastroesophageal reflux: review of the issues]. AB - The authors review the pathophysiology of gastroesophageal reflux, pointing out the predominant role of the lower esophageal sphincter in antireflux mechanisms. The diagnosis of gastroesophageal reflux must be based on the results of detailed examination and other tests of which endoscopy and esophageal pH monitoring are the most important. The authors describe how to manage operation for gastroesophageal reflux so as to prevent complications. Although the Hill, Belsey and Nissen operations, referred to as valvuloplasties, have proved their effectiveness in curing gastroesophageal reflux, a review of the literature shows that better results are achieved by Nissen total fundoplication. PMID- 3518894 TI - Myomectomy. AB - If fibroids require treatment, hysterectomy is usually the therapy of choice. Myomectomy is best reserved for women who wish to preserve their uterus and have a single large fibroid tumour; it is not normally recommended for either abnormal uterine bleeding or infertility. The blood supply of leiomyomas is from the periphery and is such that degeneration frequently ensues. Degeneration, in particular the acute degeneration that may occur in pregnancy, is rarely an indication for operation. Myomectomy has been associated with considerable blood loss intraoperatively and prolonged morbidity postoperatively. The former can be avoided by limiting the uterine circulation during surgery with a uterine tourniquet and vascular clamps. Atraumatic intracapsular removal of the tumour and perfect hemostasis will minimize the latter. PMID- 3518896 TI - Freedom in practice. CMAJ 1911. PMID- 3518895 TI - Use of phototherapy for neonatal hyperbilirubinemia. Fetus and Newborn Committee, Canadian Paediatric Society. PMID- 3518897 TI - Penicillin allergy: a practical approach to management. AB - Although penicillin is nontoxic, it is highly immunogenic and is the most common drug that causes allergic reactions. A previous reaction to penicillin has been shown to be unreliable in predicting sensitivity in 75% to 90% of patients. To more accurately test for penicillin allergy, diagnostic skin test reagents have been developed; these include the major determinant (benzylpenicilloyl polylysine) and the minor determinant mixture (penicillin G potassium, benzylpenicilloate sodium and benzylpenicilloyl-N-propylamine). Penicillin skin testing has been shown to be safe and useful in predicting immediate IgE-mediated reactions (overall predictive value 99%). Reactions that occur when patients are challenged with penicillin are mild or accelerated urticarial reactions. We outline a practical and rational therapeutic approach based on the current understanding of penicillin allergy. PMID- 3518898 TI - Requirements for controlled therapeutic trials in male infertility. AB - The majority of men who present with infertility have oligospermia or asthenospermia which renders them subfertile; pregnancies occur at lower than normal rates. Currently available treatments for this group are of uncertain value. This paper outlines an approach to controlled trials to test old and new methods for their ability to improve semen quality and increase pregnancy rates. As well as careful design, the need for control groups and large numbers of subjects is emphasized. Control groups are necessary because pregnancies and apparent or real spontaneous improvements in semen test results occur without treatment. Trials to evaluate differences in pregnancy rates need to be large because pregnancy rates are low and the margin for improvement narrow. Most untreated infertile couples have average pregnancy rates of less than 5% per month, whereas pregnancy rates in the general community average 20% per month. Under these circumstances, small trials with less than 20 pregnancies are unhelpful as they are not sensitive enough to detect less than threefold differences in pregnancy rates between groups. The number of subjects required for a trial can be calculated or determined from tables or graphs. A 50% difference in pregnancy rates in two groups given alternative treatments only has a high chance of being statistically significant if there are hundreds of subjects achieving a total of approximately 200 pregnancies in the trial. Such large trials can only be performed by several centres collaborating. PMID- 3518899 TI - The use of surveys as a critical tool in consultation: the coronary primary prevention trial. AB - Selected findings from each of three surveys administered to the staff of the Canadian site of the Coronary Primary Prevention Trial during a consulting assignment are provided to illustrate the benefits of using surveys in Mental Health consultation. As demonstrated, survey results can assist the consultant to identify and prioritize staff concerns, convince management of the need for action and direct and monitor consulting activities over time. PMID- 3518900 TI - Cohort analysis of Ontario suicide rates, 1877-1976. AB - Birth cohort studies of suicide rates in Alberta, the United States and Australia indicate that within each generation, suicide rates increase with age. Such studies argue that cohort-specific suicidal risk, together with present high suicide rates among young people predict even higher rates as these generations grow older. Ontario data from a 100-year period demonstrate that within birth cohorts suicide rates consistently increase with age, peak between ages 50 and 70, then decline. Gradual increases in mean suicide rates result in every birth cohort having higher suicide rates than the preceding cohort at almost every age level. These trends combine to produce a regular birth cohort effect and a steady shift in cross-sectional data to higher rates of suicide among younger age groups. Abrupt increases in suicide rates occurring during the Great Depression had only transient effects on birth cohort and cross-sectional curves. Results provide weak support for the hypothesis of cohort-specific suicidal risk and clarify the factors which produce birth cohort effects. PMID- 3518901 TI - On the differences in the historical development of psychoanalysis in the United States and Canada. AB - Psychoanalysis developed differentially in Canada and the United States. In the United States it was geared to the model of having only physicians train in psychoanalysis, which was followed from the very beginning but in Canada the standard of the International Psycho-Analytic Association was used allowing the training of some lay analysts as well as physicians. In Canada, though very Freudian, a more integrated view of many different schools of psychoanalysis was taught as adjuncts to the Freudian view, this being based to a large degree on the British psychoanalytic model. The American Psychoanalytic suffered many splits on the issues on social factors and to some degree on political issues in the twenties and the thirties. This was avoided by the Canadian societies and institutes. The main similarities and differences in historical development are outlined and discussed. PMID- 3518902 TI - The dilemma of Howard Hughes: paradoxical behavior in compulsive disorders. AB - The history of Howard Hughes illustrates an unusual variant or end state of obsessive-compulsive neurosis in which a germ phobia coincides with the deliberate avoidance of cleaning and neglect of personal hygiene. We have reported on three patients who share similar symptomatology. In these cases, the coincidence of personal filthiness and a germ phobia appear paradoxical. PMID- 3518903 TI - Is chronic pain a variant of depressive illness? A critical review. AB - A critical review of the literature on the association of chronic pain of obscure origin and depression suggests the following: the nosological confusion in defining these two commonly occurring symptom complexes; poor sampling methods and widely ranging selection criteria; occasional lack of appropriate controls and use of unreliable instruments to measure pain and depression; and the frequently erroneous assumption that response of the pain to "antidepressant" medications implies that pain is masquerading some form of depression. All of the above observations lead to incomparable and sometimes opposing conclusions regarding the nature of the association between these two common symptom complexes. Some widespread recurring clinical features of the various studies include; a premorbid history of perfectionistic traits, an apparently minor precipitating event; and pain involving the head, face and musculoskeletal system. Otherwise, chronic pain of obscure origin appears to be a multifactorial and multifaceted problem, with each patient requiring a complete physical and psychosocial evaluation. Further understanding of this group of disorders requires studies of specific chronic pain syndromes using proper controls. PMID- 3518904 TI - Clomipramine: an antiobsessive drug. AB - In the past decade, various investigators have attempted to find new pharmacological agents for the treatment of obsessive disorders. Of these, the drug which has attracted attention and has been most promising is clomipramine. This paper attempts to review the usefulness of clomipramine in the treatment of obsessive disorder. Accidentally, it was discovered that clomipramine was effective in alleviating obsessive symptoms in depressed patients by a Spanish psychiatrist, Lopez-Ibor. Initial studies carried out mainly on patients with major depression reported that obsessive symptomatology benefited with clomipramine therapy. A number of uncontrolled and controlled studies confirmed the efficacy of this drug in obsessive neurosis. The drug improves the obsessive symptoms. Discontinuation of the drug is followed by a relapse. The efficacy, dosage, duration and side effects of treatment with clomipramine are discussed in this paper. PMID- 3518905 TI - Affective disorders and circadian rhythms. AB - Abnormal circadian rhythms have been associated with affective disorders. A review of this rapidly expanding area of investigation shows that while a clear causal relationship has not yet been proven, a knowledge of the circadian system and its dysfunction can help in understanding unipolar and bipolar depression. Evidence suggests that existing therapies such as lithium and antidepressants act upon the circadian system. Better identification of individuals at risk for affective disorders and the development of new preventive and therapeutic interventions may result from further study of circadian dysfunction. PMID- 3518906 TI - Interviewing skills in relation to psychiatric residency. AB - A review of the literature suggests that the teaching of interviewing skills in psychiatry residency programs has been largely ignored. The consequences of poor interviewing, the characteristics of good interviewing, and what is known about effective training techniques for the mastery of clinical interviewing are reviewed. The relevance of psychiatric training is discussed. Issues which warrant further research are presented. PMID- 3518907 TI - To reduce or to integrate: psychiatry's dilemma. AB - Three conceptual approaches to psychiatry may be distinguished: the somatic (biological); the psychological (psychodynamic, psychosocial); and the integrative (holistic, biopsychosocial). The first two emerged in the early nineteenth century, the third - in this century. All three continue to vie for influence today. The author traces their historical precursors and discusses their current state. He argues that psychiatrists need to apply methodological reductionism but adopt an integrative orientation in theory and clinical practice. PMID- 3518908 TI - Risk research in affective disorders and alcoholism: epidemiological surveys and trait markers. AB - Traditional designs in risk research have been in the form of epidemiologic surveys aimed at assessing a genetic contribution or search for broader indicators of vulnerability, resulting from the interaction of both nature and nurture. Recently, an interest in biological markers has resulted in the search for possible trait markers identifying more specifically, individuals with a life long risk for an illness that may be expressed or not. The contributions, limitations and evolution of these strategies are reviewed in the syndromes of affective disorders and alcoholism. Recommendations include the use of biotypes rather than phenomenotypes for the diagnosis of the index case. Current promising approaches include the study of pedigrees biased towards a particular variable, a discriminant analysis of the variation in expressivity of the syndrome and the genetic linkage studies. While there is so far no established trait marker, research strategies are emerging and withstanding the test of time. The present technological explosion will undoubtedly further our understanding of risk factors. PMID- 3518909 TI - Beta-chain human chorionic gonadotropin-producing leiomyosarcoma of the small intestine. AB - A 22-year-old patient with primary leiomyosarcoma of the small bowel presented with symptoms including nausea and vomiting, a symptom complex similar to hyperemesis gravidarum in the pregnant female. She was found to have elevated levels of serum beta-HCG which were localized to the leiomyosarcoma cells utilizing an immunoperoxidase staining technique. Thus, this patient presents evidence that beta-HCG may be produced by sarcoma cells and, therefore, that beta HCG may be used as a tumor marker in some sarcoma patients. PMID- 3518910 TI - Influence of nandrolone decanoate on weight loss in advanced non-small cell lung cancer. AB - The short term addition of nandrolone decanoate to combination chemotherapy given to patients with unresectable non-small cell lung cancer was evaluated in a randomized, prospective trial. Patients were treated with doxorubicin 50 mg/M2 intravenously, cyclophosphamide 300 mg/M2 intravenously, CCNU 50 mg/M2 orally, vincristine 1.4 mg/M2 intravenously, with and without cisplatin 50 mg/M2 intravenously, all given every 28 days. In addition, patients were randomized to receive either nandrolone decanoate 200 mg intramuscularly weekly for 4 weeks or no additional therapy. Patient age, disease extent, performance score, and pretreatment weight loss were similar in the two treatment arms. Objective antitumor response frequency was comparable on both treatment arms with median survival somewhat longer for patients receiving the androgen (median survival 5.5 months without and 8.2 months with nandrolone decanoate). There was a trend for less severe weight loss on the nandrolone decanoate arm (average weight loss 0.8 +/- 0.15 kg versus 0.21 +/- 0.18 kg, respectively), with half as many patients experiencing weight loss on nandrolone decanoate (25% versus 12%). A separate concurrent study has demonstrated decreased free testosterone levels in 66% of patients with advanced cancer studied prior to chemotherapy treatment, therefore, further prospective studies in which pretreatment testosterone levels are used to guide androgen administration are needed to define more precisely a role for androgen replacement therapy in non-small cell lung cancer. PMID- 3518911 TI - High-grade soft tissue sarcomas of the extremities. AB - From July 1975 to December 1982, 358 patients were referred to the Surgery Branch of the National Cancer Institute (NCI) with the diagnosis of soft tissue sarcoma of the extremities. Two hundred eleven of these patients presented with resectable, localized high-grade soft-tissue sarcomas and have been included in the present analysis of the management and outcome of patients with high-grade soft tissue sarcomas of the extremity treated at the NCI. One hundred forty-seven of these 211 patients have been included in randomized prospective trials. The remaining 64 patients in this analysis have been followed at the NCI, but were not included in randomized trials because of patient refusal or ineligibility. Tumor size was identified as a highly significant prognostic variable for disease free and overall survival (P2 = 0.00001 and 0.0081, respectively). Tumor site, histologic type, and microscopic margins of resection were not significant prognostic variables. There was no difference between patients undergoing amputation compared to those undergoing limb-sparing procedures plus postoperative radiotherapy in disease-free or overall survival for all 211 patients in this study (P2 = 0.068 and 0.131, respectively). A significantly greater frequency of local failure among patients treated by local excision was noted compared to patients undergoing amputation (12/128 versus 0/83, P2 = 0.004), but this did not result in decreased overall survival in patients undergoing combined modality limb-sparing procedures. Adjuvant chemotherapy significantly prolonged disease-free survival (P2 = 0.005) for the 124/211 patients treated with adjuvant chemotherapy, although analysis of overall survival did not reveal a significant increase (P2 = 0.10). In a subset of 65 patients included in a prospective randomized trial evaluating the efficacy of adjuvant chemotherapy, a significant improvement in both disease-free (P2 = 0.033) and overall (P2 = 0.055) survival was seen in patients receiving chemotherapy. Sixty-five patients developed recurrent disease (65/211, 31%) and 42 of these patients were rendered disease-free surgically. Survival from the time of first recurrence was significantly prolonged among the 42 patients who were rendered disease-free (median survival, 31 months) compared to those who were not (median survival, 9 months, P2 less than 0.001). PMID- 3518912 TI - Postoperative radiotherapy in Dukes' B and C carcinoma of the rectum and rectosigmoid. A randomized multicenter study. AB - Results obtained during the first 5 years of a randomized study of postoperative radiotherapy (50 Gy) are presented. Criteria for randomization were fulfilled in 494 of 861 patients with Dukes' B and C tumors, when the trial was closed. Severe complications from radiotherapy approximated 10%. Probability of survival without local failure within 24 months was significantly higher after radiotherapy in patients with Dukes' C tumors, and the time of local failure was delayed 1 year. Patients with Dukes' B tumors had no benefit from radiotherapy. Risks of distant metastases and death were not influenced by radiotherapy in the main groups. Plasma-CEA measurements were evaluated blindly, and radiotherapy changed the critical levels of CEA for detection of recurrent cancer. It was concluded that patients with Dukes' C tumors may benefit from radiotherapy and plasma-CEA levels are influenced by radiotherapy, which may be important, when these are used in screening for recurrent cancer. PMID- 3518913 TI - Imaging of bone tumors using a monoclonal antibody raised against human osteosarcoma. AB - The radiolabeled monoclonal antibody 791T/36 raised against a human osteosarcoma was injected into 20 patients with known or suspected bone tumors. Gamma camera images were acquired at 48 or 72 hours after injection, and assessed for antibody localization. Positive images were obtained in all five osteosarcomas and four other primary malignant sarcomas. Two of the four other primary bone tumors gave positive images. Three patients with trauma had negative images as did one patient with Paget's disease. Two patients with suppurative disease gave positive images. The antibody localized in the majority of malignant sarcomas tested. In one tumor where tissue was available, a tumor:non-tumor ratio of 2.8:1 was measured. Repeat imaging was performed in five patients. Immunoscintigraphy using the monoclonal antibody 791T/36 has shown tumor localization in patients with bone and soft tissue sarcomas. PMID- 3518914 TI - Music as an intervention in the oncology setting. PMID- 3518915 TI - Basic principles and applications of monoclonal antibodies in the management of carcinomas: the Richard and Hinda Rosenthal Foundation award lecture. PMID- 3518916 TI - Inhibition of IA positive reticulum cell sarcoma tumor cell growth in syngeneic SJL/J mice by passive administration of monoclonal anti-IA antibody. AB - SJL/J (H-2s) mice develop spontaneous reticulum cell sarcoma (RCS) tumors at the age of 8-11 months. The RCS tumor expresses IA antigens on the cell surface, stimulates syngeneic T-cell proliferation, and appears to depend on host cells' participation for its own growth. The present study investigates the role of passively administered monoclonal anti-IA antibody on RCS tumor growth. The administration of monoclonal anti-IAs antibody into SJL/J mice prior to tumor inoculation or at the same time as tumor transplantation resulted in a significant inhibition of tumor growth. Furthermore, pretreatment of RCS tumor with antibody prior to inoculation also resulted in tumor growth inhibition. The inhibition seen in all cases studied was tumor specific, since the use of normal ascites on antibody directed against unrelated antigens resulted in no inhibition of tumor growth. Examination of tumor cells derived from spleen and lymph nodes of antibody treated mice demonstrated that the observed inhibition of tumor growth was the result of a significant depletion of IA positive tumor cells. In contrast to other tumor systems studied to date whereby anti-IA antibody promotes tumor growth, the present findings demonstrate that passive administration of anti-IA antibodies inhibit RCS tumor growth in syngeneic mice. The possible mechanisms involved are discussed. PMID- 3518917 TI - Association of antigen expression and DNA ploidy in human colorectal tumors. AB - Fifty colorectal tumors were screened by indirect immunofluorescence and flow cytometry for antigen expression using a panel of monoclonal antibodies that recognize determinants preferentially expressed on tumor cells (carcinoembryonic antigen, Y haptenic blood group, 791T/36 defined antigen 791T-P72). Fifty % of the tumors expressed all three antigens, 41%, two, and 9%, one. Over a third reacted strongly with at least one monoclonal antibody, although the majority of tumors stained with a moderate intensity. Extranuclear membranes from tumors showed similar antigen expression to disaggregated tumor cells and were particularly useful for providing the relative tumor:normal tissue binding ratios. The carcinoembryonic antigen specific monoclonal antibody showed the strongest tumor selectivity with a tumor:normal tissue ratio of 24 +/- 7:1. Lack of correlation between expression of the three antigens suggested that the monoclonal antibodies recognizing them may have potential as a "cocktail." One third of the tumors contained cells with an aneuploid DNA content and expressed elevated levels of carcinoembryonic antigen and Y haptenic blood group antigen when compared to tumors with diploid DNA content. Aneuploid cells within a tumor were also preferentially stained with all of the monoclonal antibodies. PMID- 3518918 TI - Identification and partial characterization of a nucleolar antigen with a molecular weight of 145,000 found in a broad range of human cancers. AB - Previous studies in our laboratory have indicated the presence of nucleolar antigens in tumors which were not detected in normal tissues. Some of the polyclonal antisera produced in these studies were shown to identify a Mr, 145,000 nucleolar antigen on immunoblots of tumor nucleoli but not in normal human liver nucleoli. A monoclonal antibody to a Mr 145,000 nucleolar protein (p145) was produced by immunization of mice with a nucleolar extract of HeLa cells which is enriched with this antigen. The monoclonal antibody showed bright nucleolar immunofluorescence localization in a broad range of human tumors including cancers of the gastrointestinal tract, genitourinary tract, lung, liver, muscle, cartilage, and blood. The p145 nucleolar antigen was not detected in most normal human tissues or in benign tumors, with only weak nucleolar staining observed in spermatogonia of the testes and in ductal regions of some hypertrophied prostates. Nucleolar antigen p145 was extracted from HeLa cell nucleoli by homogenization in a 0.01 M Tris buffer containing 0.2% deoxycholate. On sucrose density gradient centrifugation, the antigen remained sedimented with the nucleolar ribonucleoprotein fraction. Nucleolar antigen p145 was released from ribonucleoproteins following treatment with 4 M guanidinium hydrochloride or RNase. Peptide mapping of nucleolar antigen p145 showed that it was distinct from other known nucleolar antigens. Although it remains to be determined if the p145 antigen plays a role in cell transformation, maintenance of the malignant phenotype, or in cell division, it may have value as a tumor marker or as a therapeutic target. PMID- 3518919 TI - Differential expression of endogenous lectins on the surface of nontumorigenic, tumorigenic, and metastatic cells. AB - A monoclonal antibody that was found to recognize endogenous galactoside-specific lectins of various tumor cells by immunoblot analysis was used for quantitative analyses of cell surface lectin on nontumorigenic, tumorigenic, and metastatic cells of diverse histological types and origin. Indirect immunofluorescent staining of viable cells followed by analysis with a fluorescence-activated cell sorter revealed marked differences in the amount of surface lectins between untransformed and malignant cells. While lectin was either absent or present in a very low density on the surface of normal cells, neoplastic cells were invariably stained by the antilectin antibodies. Furthermore, among related tumor cell variants of the K-1735 melanoma and UV-2237 fibrosarcoma tumor systems, cells exhibiting a higher lung-colonizing potential also expressed higher levels of cell surface lectin. These results suggest that the presence of a lectin on the cell surface may be related to neoplastic transformation and progression toward metastasis. PMID- 3518920 TI - Increased synthesis of carbamoyl-phosphate synthase II (EC 6.3.5.5) in hepatoma 3924A. AB - Carbamoyl-phosphate synthase II (glutamine-hydrolyzing) (EC 6.3.5.5) (synthase II) is the first and rate-limiting enzyme in the de novo UTP biosynthetic pathway. Leucine pulse-labeling in the rat demonstrated that in the rapidly proliferating hepatoma 3924A the ratio of radioactivity of synthase II to that of total cytosolic protein was 168.2 +/- 11.0 (SE) X 10(-3). This synthetic rate for the tumor enzyme was 9.7-fold higher than that for the liver synthase II, 17.4 +/ 4.0 X 10(-3). Since the degradation rate for hepatoma 3924A enzyme (t1/2 = 65.5 h) was similar to the rate for liver synthase II (t1/2 = 69.3 h), the increase in tumor synthase II activity and amount was due primarily to an elevation in enzyme synthesis in the presence of an unaltered catabolic rate. The results indicate that the reprogramming of gene expression in the hepatoma entails an increased production rate of the rate-limiting enzyme of UTP synthesis. This increase in the activity, concentration, and synthesis of tumor synthase II should provide a heightened capacity for the de novo pyrimidine biosynthetic pathway, thus conferring a selective advantage to the cancer cells. PMID- 3518921 TI - A human colon cancer metastasis model for radioimmunodetection. AB - One important issue in radioimmunodetection is how well the current methods can locate and disclose small metastatic foci in visceral sites. We have developed a human colonic tumor metastasis model by surgically implanting GW-39 tumor cells in the liver of unconditioned hamsters. Tumors were produced in 71 of 73 animals and were macroscopically apparent within 1 wk. In addition, multiple nodular lung metastases of GW-39 were found in about 80% of the animals given implants of tumor in the liver, but implantation of tumor in the spleen failed to show lung metastases even after 4 wk. Hamsters bearing GW-39 liver and cheek pouch grafts or normal hamsters were given injections of a mixture of 131I-labeled anti carcinoembryonic antigen antibody and 125I-labeled irrelevant immunoglobulin G. After 7 days, tumor was localized by external scintigraphy without subtraction techniques in both the liver and cheek pouch, but even in animals with extensive lung metastases we failed to unequivocally detect tumor in the lungs by external imaging or by comparing tissue counting data from uninvolved and tumor-bearing lungs. However, whole-body autoradiography confirmed specific localization of anti-carcinoembryonic antigen antibody in the tumors at all sites indicating that tissue counting and external imaging were not sensitive enough to reveal micrometastatic tumors. Thus, the current methods used for this model appear to be useful for further investigation of the radioimaging of tumors growing in visceral organs. PMID- 3518922 TI - Differential effects of phorbol esters on normal myeloid precursors and leukemic cells: basis for autologous bone marrow reconstitution in acute nonlymphocytic leukemia using phorbol ester-treated bone marrow from patients in remission. AB - The phorbol ester 12-O-tetradecanoylphorbol-13-acetate (TPA) induces macrophage like differentiation of HL60 cells and cells from patients with acute nonlymphocytic leukemia (ANLL). We assessed the use of TPA as a means of eradicating residual leukemia from remission bone marrow prior to autologous bone marrow reconstitution. A 30-min incubation with TPA led to marked growth arrest in HL60 cells and in cells from most patients with acute myelogenous leukemia and acute myelomonocytic leukemia, whereas cells from most patients with acute promyelocytic leukemia and acute undifferentiated leukemia demonstrated a lesser degree of growth arrest. Freezing and thawing, a necessary step in autologous reconstitution, had no effect on the cessation of proliferation induced in HL60 or ANLL cells preincubated with TPA for 30 min. Virtually normal myeloid precursor growth occurred in normal or remission bone marrow cells preincubated with TPA and then frozen and thawed. Based on these observations, two patients with advanced ANLL in remission underwent marrow ablative therapy followed by autologous reconstitution using TPA-treated bone marrow. Limited normal hematopoiesis was reestablished in both patients, although they subsequently experienced leukemic relapse. These studies demonstrate that in ANLL cells, TPA stimulates growth arrest; in contrast, hematopoiesis is able to proceed both in vitro and in vivo. PMID- 3518923 TI - Pharmacology of tetanus. PMID- 3518924 TI - Therapy for granulomatous angiitis. AB - The clinical diagnosis of granulomatous angiitis can be extremely difficult because of the diversity of presentation. A clinical presentation of progressive multifocal encephalopathy is most common but signs suggesting isolated mass lesions or dementia may be seen. Laboratory studies are helpful, particularly when CSF examination reveals elevated protein or a mononuclear cell response. Cerebral angiogram may demonstrate vasculitis but tissue biopsy is extremely important in firmly establishing a diagnosis. Leptomeningeal biopsy should be performed before initiation of appropriate immunosuppressive therapy and before major irreversible loss of neurologic function occurs. Corticosteroid therapy is the initial treatment of choice, although recent anecdotal reports suggest additional benefits of immunosuppressive drugs such as cytoxan in refractory cases. Whether immunosuppressive drugs should be added routinely cannot be ascertained at present. However, in view of the likelihood of an extended period of treatment, and perhaps relapses when treatment is discontinued, the need to establish an unequivocal diagnosis is of utmost importance when treating with potentially hazardous drugs. PMID- 3518926 TI - Digestion of the protein associated with muscle and liver glycogens. PMID- 3518925 TI - Phase II trials of recombinant leukocyte A interferon in disseminated malignant melanoma: results in 96 patients. AB - Ninety-six patients with advanced malignant melanoma received thrice weekly im recombinant leukocyte A interferon (Roferon-A) in three consecutive phase II trials utilizing doses of 12 X 10(6) U/m2, 50 X 10(6) U/m2, and 50 X 10(6) U/m2 plus cimetidine. The overall response rate was 22%, with median times to disease progression and survival of 3.9 and 11.3 months, respectively. For all study participants, the median times to disease progression and survival were 1.5 and 5 months, respectively. Most regressions occurred within the first month of treatment and were predominantly in soft tissue, although three patients are responding 2-3 years after onset of treatment. The most noteworthy toxic effects included a flu-type illness, anorexia, and fever (38.3-39.4 degrees C). The median weight loss was 2.1 kg on the low-dose regimen and 5.6 kg on the high-dose program. Recombinant leukocyte A interferon in the dosages and schedule that we used has definite but limited efficacy for patients with disseminated malignant melanoma. PMID- 3518927 TI - Chemical synthesis of disaccharides of the specific phenolic glycolipid antigens from Mycobacterium leprae and of related sugars. AB - O-(3,6-Di-O-methyl-beta-D-glucopyranosyl)-(1----4)-2,3,-di-O-methyl-L rhamnopyranose, which is the nonreducing disaccharide of the haptenic trisaccharide of the Mycobacterium leprae-specific, phenolic glycolipid I, O-(6-O methyl-beta-D-glucopyranosyl)-(1----4)-2,3-di-O-methyl-L-rhamn opyranose, the nonreducing end of the specific, phenolic glycolipid III, and the nonhaptenic O beta-(D-glucopyranosyl)-(1----4)-2,3-di-O-methyl-L-rhamnopyranose++ +, were synthesized in relatively good yield from 3-O-methyl-D-glucose, or D-glucose, and L-rhamnose via Koenigs-Knorr reactions. These disaccharides can be used as precursors in the synthesis of the trisaccharide unit of phenolic glycolipid I and of neoglycoconjugates suitable for the serodiagnosis of leprosy. PMID- 3518928 TI - Monoclonal antibody-defined antigens of human prostate cancer cell line PC3. AB - Over 600 hybridomas were derived from the immunization of mice with live cells and aqueous extracts of the human prostatic carcinoma cell line PC3. A total of 26 hybridomas with restricted reactivities were selected, subcloned and antibodies tested on a variety of tumor and normal cells. Seven monoclonal antibodies showed reactivity for prostate cancer and other tumor cell lines, including breast carcinomas. Three of the antibodies obtained after immunization with live cells reacted with live cells only and three of the four antibodies obtained after immunization with cell extract reacted with cell extracts and spent culture media. The fourth antibody in the latter group was reactive only in the immunoperoxidase staining assay. Antibody PrS5 recognized a 90,000 molecular weight molecule from 125I-surface-labeled cells in immunoprecipitation analysis. Antibodies PrE3 and PrD8 detected a nonacid glycolipid pentasaccharide from PC3 cells and meconium, and a glycoprotein of 115,000 molecular weight from 125I surface-labeled red blood cells. The similar patterns of reactivity in RIAs and antigen analysis suggest that antibodies PrE3 and PrD8 recognize the same molecule. The results emphasize the usefulness of immunohistochemistry in the testing of monoclonal antibodies and the impact of the form in which the antigen is presented on the resultant antibody specificity. PMID- 3518929 TI - T cell recruitment from the thymus to the spleen in tumor-bearing mice. I. Analysis of recruited cells by surface markers. AB - After inoculation of tumor cells (methylcholanthrene-induced sarcoma), the number of Thy 1+ cells and PNA (peanut agglutinin) binding cells, which were shown to be different subpopulations were increased in the spleen of thymus-intact mice, in contrast this increase was not observed in adult thymectomized mice. In experiments performed concurrently with splenic cell analysis, we found that the plasma PGE2 levels declined in parallel with the tumor growth. Prevention of such a decline of plasma PGE2 level by replenishment with exogenous PGE2 inhibited the splenic cell increase in tumor bearers. In the tumor-bearing mice, cell traffic systems from the thymus to the periphery was ascertained by injecting fluorescein diacetate (FDA) into the thymus and observing fluorescein positive cells in the periphery. We suggest that increased recruitment of thymic cells to the periphery may be mediated by PGE2 in the presence of a tumor. PMID- 3518930 TI - Serial circulating immune complex values and development of metastatic disease in breast cancer and malignant melanoma patients. AB - A polyethylene glycol precipitation technique was used to determine the levels of circulating immune complexes (CIC) in breast cancer and melanoma patients. All patients in the study had undergone surgery and were free of distant metastatic disease. CIC were measured at two to four time intervals, of 3 to 6 months each, over an average follow-up period of 13.5 months (range 7-20 months). In both groups of patients, metastatic disease developed with a higher frequency in patients who had undetectable CIC levels throughout the follow-up period or had become negative at the time metastases were discovered. PMID- 3518931 TI - The adverse effects of hormonal therapy. AB - Estrogen therapy must be cycled with progestin therapy in women with intact uteri in order to prevent uterine cancer. However, these women cannot be expected to benefit (with regard to cardiovascular disease) from any estrogen-induced changes in the lipoprotein profile, as progestins will either negate or overwhelm any estrogen effects. However, such women will definitely benefit from estrogen's effects with regard to menopausal symptoms and bone loss. These clearly beneficial effects of estrogen-progestin therapy are not outweighed by any known risks. However, in women without uteri (approximately 30 per cent of women), unopposed estrogen therapy in the menopause may protect against cardiovascular disease, as well as have beneficial effects on bone metabolism and menopausal symptoms. In this special case, the beneficial effects of unopposed estrogen therapy clearly outweigh any known risk. PMID- 3518932 TI - Identification and relative weight of cardiovascular risk factors. AB - Basic concepts of epidemiology are presented with an update on the more than 270 factors that the authors have found suggested as contributors to cardiovascular disease risk. A comprehensive classification scheme and public health and clinical implications are discussed. Based on predictions from prospective and intervention studies, up to 90 per cent of coronary heart disease could be prevented by optimization of known cardiovascular risk factors. PMID- 3518933 TI - Cardiovascular risk factors and their modification in children. AB - Normal levels and trends of cardiovascular disease risk factors in childhood have been well documented by numerous epidemiologic surveys. Expected levels of blood pressure, lipids and lipoproteins, and body size can be determined by the child's physician using race- and gender-specific grids. These grids allow for the identification and follow-up of children with high-risk profiles. Evidence of increased left ventricular mass and vascular changes in renal arteries in association with childhood blood pressure level along with atherosclerotic fatty streak and fibrous plaque development in the aorta and coronary arteries shows that children with elevated risk factors are at risk for early target organ damage. These data demonstrate the potential importance of early intervention on the natural history of cardiovascular disease. Based on our own data from the Bogalusa population, as well as evidence from other epidemiologic investigations in children, the following recommendations can be made, regardless of the risk factor variable under consideration: Cardiovascular disease risk factor variables should be measured carefully and in a serial manner to classify a child as abnormal. Serial measurements serve to reduce the effect of regression to the mean and increase the predictive value of the measurements. The misclassification of normal children into the high-risk category can be avoided by serial and replicate observations. Interventions that have attendant side effects (for example, pharmacologic therapy for high blood pressure) have to be measured against the effectiveness of diet, exercise, and other aspects of primary prevention. Risk factor levels consistently greater than the ninetieth percentile deserve medical attention. Care should be taken prior to using specific grids of normal levels of cardiovascular disease risk factors in children. The measurement techniques employed on individuals should be similar to those used by the epidemiologic study to generate the grids in a reference population. The grids should become part of the child's permanent medical record, as they provide a rapid visual assessment of the cardiovascular disease risk profile over time. High-risk trackers may require more intensive follow-up and will allow for early intervention and an assessment of the efficacy of the intervention program. In conclusion, cardiovascular disease risk factor screening in childhood is quick, effective, and inexpensive. The potential payoff in prevention of adult cardiovascular disease is enormous and allows the physician to provide more comprehensive care to a pediatric population. PMID- 3518935 TI - Risks for glucose intolerance. AB - Cardiovascular disease is the major cause of morbidity and mortality in diabetics. In this article, the prevalence of cardiovascular disease in diabetes is described, and the factors that influence the development of cardiovascular disease are explored. The interaction of other risk factors for cardiovascular disease and glucose intolerance and the question of whether glucose intolerance is truly an independent risk factor are also discussed. PMID- 3518934 TI - Risks for arterial hypertension. AB - In this article, the most important risk factors that may predict the transition from borderline to established hypertension are reviewed. Primary prevention has to focus on identifying individuals who are at highest risk and delaying or reversing further elevation of arterial pressure levels. A review of the literature indicates that several environmental and congenital factors can be identified as risk factors for the development of hypertension, including family history of essential hypertension, age, race, obesity, alcohol consumption, salt intake, hormonal status, and some stress factors. Of all diagnostic approaches to predict the development of hypertension, measurements of resting heart rate and responses to dynamic exercise have some predictive value. PMID- 3518936 TI - Adverse effects of the treatment for hyperlipidemia. AB - A variety of treatments to lower elevated plasma lipid levels in patients with hyperlipidemia are available. Adverse side effects ranging from mere annoyances to uncommon serious consequences may be associated with dietary modification, recreational physical exercise, and drug intervention. As in other clinical circumstances, risk-to-benefit ratios must be taken into consideration in the management of hyperlipidemia. PMID- 3518937 TI - Homeostatic fragility in the elderly. AB - Age-related alterations in adaptation capacity to physiologic changes in physical workload, posture, and water and electrolyte metabolism are reviewed in this article. Other than the increased prevalence of disease in the elderly, normal aging is associated with changes in hormonal secretion patterns, tissue sensitivity to hormones, control of breathing, sleep, and renal function that make this population particularly vulnerable. Orthostatic hypotension, sleep apnea, hypernatremia, hyponatremia, and hyperkalemia, as well as other conditions, are discussed in light of these changes. PMID- 3518938 TI - Renal function in the elderly. AB - A variety of anatomic abnormalities in the aging kidney have been identified, including decreased kidney size, increased glomerular sclerosis, and arteriolar vascular changes. Physiologic changes, including decreased renal blood flow, decreased glomerular filtration rate, altered renal tubular function, and altered renal endocrinologic function, have also been described. The clinical consequence of these changes is an altered ability of the aged kidney to respond to stress, either due to illness or due to therapeutic interventions by physicians. Extra caution and vigilance is therefore needed when caring for the elderly. PMID- 3518939 TI - Valvular heart disease in the elderly. AB - Patients with isolated or combined valvular heart disease who reach old age without symptoms or functional impairment can usually be managed with medical therapy. Prevention of infective endocarditis is important. When symptoms impair activities of daily living, surgery should be considered. Aortic stenosis is the most important valvular lesion in the aged and its severity is often underestimated; valve replacement markedly improves the prognosis for symptomatic patients with significant valvular obstruction. PMID- 3518940 TI - Distribution of fibrinogen and albumin in normal, ischaemic, and necrotic myocardium during the evolution of myocardial infarction: an immunohistochemical study. AB - The role of mediators of inflammation in the pathogenesis and evolution of myocardial infarction has attracted increased interest as interventions which inhibit the inflammatory response after coronary artery occlusion have been shown to decrease infarct size. The distribution of fibrinogen and albumin in ischaemia myocardium after closed chest balloon occlusion of the left anterior descending coronary artery was studied by immunohistochemical techniques in 34 dogs, and compared to morphological evaluation of cellular injury. In myocardium which was ischaemic but not necrotic (that is, glycogen loss and the absence of light and electron microscopic and tetrazolium staining evidence of necrosis, n = 8 dogs) no accumulation of these proteins was detected within the ischaemic zone. In myocardium which was necrotic by morphological criteria (n = 26 dogs), fibrinogen and albumin were detected in the necrotic fibres as early as 3 h after coronary occlusion using both the peroxidase-antiperoxidase and avidin-biotin immunostaining methods. Non-ischaemic myocardium never showed positive staining. The presence of fibrinogen and albumin in myocardial fibres appears to be specific for indicating irreversible injury. PMID- 3518941 TI - Non-invasive ultrasonic measurement of the elastic properties of the human abdominal aorta. AB - A new echo tracking device linked to real time ultrasonic B mode equipment was developed to measure non-invasively the elastic properties of the human abdominal aorta. Pulsatile diameter change and mean diameter of the abdominal aorta were measured in 61 subjects with this ultrasonic device. Strain and pressure-strain elastic modulus Ep were calculated from pulsatile diameter change, diameter, and pulse pressure obtained by the auscultatory method. Strain significantly decreased with age; 0.076(0.024) (mean(SD)) in group 1 (20 young adults below the age of 35 years); 0.048(0.024) in group 2 (21 middle aged subjects between the ages of 35 and 60 years); and 0.030(0.010) in group 3 (20 elderly subjects over the age of 60 years). Ep values were 0.99(0.34) X 10(5), 1.55(0.68) X 10(5), and 3.80(2.05) X 10(5) N X m-2 in groups 1, 2, and 3 respectively. Ep in group 3 was significantly higher than in groups 1 and 2. The regression equation relating Ep to age was Ep = (-0.72 + 0.058 X age) X 10(5) N X m-2 (r = 0.73). The Ep value and its age related increase agreed with the findings in postmortem arteries. The elastic properties of the abdominal aorta could, therefore, be determined non invasively by this ultrasonic method. PMID- 3518942 TI - Fractionation of yeast chromatin by micrococcal nuclease digestion. PMID- 3518943 TI - [Improvement of the functional capacity of hypertensive patients treated with guanfacine]. PMID- 3518944 TI - Chromosome length controls mitotic chromosome segregation in yeast. AB - We have examined the effect of physical length on the mitotic segregation of artificial chromosomes and fragments of natural yeast chromosomes. Increasing the length of artificial chromosomes decreases the rate at which they are lost during mitosis. We have made fragments of chromosome III by integrating new telomeres at different positions along the length of the chromosome. Chromosome fragments of 42 and 72 kb behave like artificial chromosomes: they are lost in mitosis much more frequently than natural chromosomes. In contrast, a chromosome fragment of 150 kb is as mitotically stable as the full-length chromosome from which it is derived. The structural instability of a short dicentric artificial chromosome demonstrates that, although short artificial chromosomes segregate poorly in mitosis, they do attach to the mitotic spindle. We discuss these results in the context of a model in which chromosome segregation is directed by the intercatenation of the segregating DNA molecules. PMID- 3518945 TI - Identification of sequences in a yeast histone promoter involved in periodic transcription. AB - Sequences between a pair of divergently transcribed histone genes in Saccharomyces cerevisiae are able to confer periodic transcription during the cell cycle. This conclusion contrasts to our previous hypothesis that an ars (autonomously replicating sequence) 3' to this locus is a transcription timer for yeast histone genes. The promoter sequences required for periodic expression have been localized by deletion analysis, and isolated elements have been analyzed by insertion into a heterologous promoter. Two cell-cycle-specific promoter functions have been identified. One function activates transcription in a cell cycle-dependent manner. The other periodically represses transcription. Negative regulation may be the predominant form of cell-cycle control, because removal of the repressing function results in constitutive expression of the histone genes. PMID- 3518946 TI - Identification and characterization of a nuclear pore complex protein. AB - We describe studies using a monoclonal antibody that recognizes a 62 kd protein (p62) of rat liver nuclei. This protein remains associated with the nuclear pore complex-lamina fraction resulting from treatment of nuclei with DNAase, RNAase, and nonionic detergent. Immunofluorescence revealed a strikingly punctate pattern of nuclear rim staining. By immunoferritin microscopy, p62 was specifically localized to the pore complex. Thus, pore complexes can be resolved by fluorescence light microscopy. Pulse chase analysis of labeled tissue culture cells showed that p62 is synthesized as a soluble cytoplasmic precursor of 61 kd, which is incorporated into the nuclear fraction with an unusually long t1/2 of about 6 hr. Incorporation is followed by modification that may involve addition of N-acetylglucosamine residues. PMID- 3518947 TI - Replacement of insulin receptor tyrosine residues 1162 and 1163 compromises insulin-stimulated kinase activity and uptake of 2-deoxyglucose. AB - Insulin stimulates the autophosphorylation of tyrosine residues of the beta subunit of the insulin receptor (IR); this modified insulin-independent kinase has increased activity toward exogenous substrates in vitro. We show here that replacement of one or both of the twin tyrosines (residues 1162 and 1163) with phenylalanine results in a dramatic reduction in or loss of insulin-activated autophosphorylation and kinase activity in vitro. In vivo, these mutations not only result in a substantial decrease in insulin-stimulated IR autophosphorylation but also in a parallel decrease in the insulin-activated uptake of 2-deoxyglucose. Furthermore, a truncated IR protein (lacking the last 112 amino acids) has an unstable beta subunit; this mutant has no kinase activity in vitro or in vivo and does not mediate insulin-stimulated uptake of 2 deoxyglucose. IR autophosphorylation is thus implicated in the regulation of IR activities, with tyrosines 1162 and 1163 as major sites of this regulation. PMID- 3518948 TI - Subcellular differentiation in sporulating yeast cells. AB - We have previously described the induction of two sets of sporulation-specific mRNAs in Saccharomyces cerevisiae. Herein we correlate the appearance of these RNAs with the major morphogenic events of sporulation, and we analyze the spatial distribution of the RNAs within the ascus. Several observations suggest that the first set of messages is involved in spore wall synthesis. In fractionation experiments, these mRNAs are detected in the ascal cytoplasm but not in developing spores, indicating that the proteinaceous component of the spore wall is synthesized from the external compartment. The second set of messages is induced later in the course of spore maturation. These mRNAs accumulate within the spores and, unlike the first set of mRNAs, are retained in mature asci until the early stages of germination. We conclude that the development of ascospores proceeds through the differentiation of functionally distinct subcellular compartments. PMID- 3518949 TI - Schizosaccharomyces pombe and Saccharomyces cerevisiae: a look at yeasts divided. PMID- 3518950 TI - A single gene from yeast for both nuclear and cytoplasmic polyadenylate-binding proteins: domain structure and expression. AB - Nuclear and cytoplasmic poly(A)-binding proteins have been purified from Saccharomyces cerevisiae, and antisera have been used to isolate a gene that encodes them. The gene occurs in a single copy on chromosome 5 and gives rise to a unique, unspliced 2.1 kb transcript. The nuclear protein appears to be derived from the cytoplasmic one by proteolytic cleavage into 53 and 17 kd polypeptides that remain associated during isolation. DNA sequence determination reveals four tandemly arrayed 90 amino acid regions of homology that probably represent poly(A)-binding domains. A 55 residue A-rich region upstream of the initiator methionine codon in the mRNA shows an affinity for poly(A)-binding protein comparable to that of poly(A)180-220, raising the possibility of feedback regulation of translation. PMID- 3518951 TI - Specific small nuclear RNAs are associated with yeast spliceosomes. AB - Two different methods have been devised for the analysis and purification of spliceosomes formed in a yeast in vitro splicing system. The first method relies on the electrophoretic separation of ribonucleoprotein particles in composite acrylamide-agarose gels. A large fraction of added substrate is located in spliceosomes, the formation of which can be shown to be dependent on the presence of both a yeast 5' splice junction and a TACTAAC box on the RNA substrate. The second method relies on oligo(dT)-cellulose chromatography of spliceosomes formed with a polyadenylated substrate. Purification of spliceosomes by either method indicates that at least three small nuclear RNAs, approximately 160, 185, and 215 nucleotides in length, are specifically associated with yeast spliceosomes. PMID- 3518952 TI - Hsp26 is not required for growth at high temperatures, nor for thermotolerance, spore development, or germination. AB - Hsp26 is one of the major heat shock proteins of eukaryotic cells. It is also strongly induced at particular times during development at normal temperatures. We have isolated the unique gene for this protein from the yeast Saccharomyces cerevisiae, and we have used it to create disruption and deletion mutations. Surprisingly, the mutations have no detectable effect on the following characteristics: growth rates at various temperatures, in fermentative or in respiratory metabolism, in rich or in minimal media; the acquisition of thermotolerance in log phase or in stationary phase cells; resistance to ethanol; spore development; thermoresistance during sporulation; spore germination; thermoresistance of mature or germinating spores; or survival after long-term storage in stationary phase or as spores. PMID- 3518953 TI - Anisomycin and cycloheximide, like growth factors, stimulate rapidly ATP turnover in 3T3 cells. AB - Addition of EGF and insulin to quiescent cultures of 3T3 cells induce a rapid stimulation of ATP turnover. We show that, like growth factors, anisomycin and cycloheximide, two inhibitors of protein synthesis, induce in 3T3 cells, a rapid increase in ATP turnover. However, this effect was not the result of the inhibition of protein synthesis since puromycin, in the same experimental conditions, did not stimulate ATP turnover. PMID- 3518954 TI - Effects of arsenate and ergot alkaloid compounds on prostacyclin synthesis in human umbilical endothelium. AB - Cultured human umbilical endothelium was incubated with various concentrations of o-arsenilic acid and ergotamine tartrate respectively for 72 hr at 37 degrees C, 5% CO2/95% air in 100% humidity. At the end of incubation, medium was removed for the determination of 6-keto-PGF1 alpha concentration by RIA method. Compared to the normal controls, arsenate (0.1 to 10.0uM) showed inhibition (17 to 24%) on the PGI2 production. Ergotamine tartrate gave an activatory effect (20 to 12%) in low concentration (0.1 to 1.0uM) incubation, but had inhibitory effect (25%) on the PGI2 production in higher concentration incubation (10.0uM). These results indicate arsenate in low and high concentrations does not play an important role on prostacyclin synthesis in human umbilical endothelium. However, ergotamine tartrate at higher concentration might be a main factor for the lower prostacyclin synthesis in Blackfoot disease, an endemic disease of the peripheral vascular system found in the southwest coast of Taiwan. PMID- 3518955 TI - Microtubule-dependent reticulopodial motility: is there a role for actin? AB - We summarize our recent immunocytochemical characterization of the reticulopodial cytoskeleton of two allogromiid foraminifers and our pharmacologic dissection of its motility. The reticulopodial microtubule cytoskeleton stained with an antiserum to brain microtubule-associated protein 2. Polymeric actin was localized in the reticulopodia by rhodamine-phalloidin staining. Microtubule inhibitors reversibly inhibited all aspects of motility; cytochalasins induced altered morphology and disorganization of motility but did not inhibit pseudopodial movements or intracellular transport. Simultaneous application of KCN and salicylhydroxamic acid (an alternative oxidase inhibitor) rapidly blocked all movement, indicating that motility is dependent on metabolic energy and that an alternative oxidative pathway functions in allogromiids. Micromanipulation and laser microsurgical experiments revealed tension throughout the reticulopodium. Our results suggest that microtubules are active components of the reticulopodial motile machinery. Actin may mediate substrate adhesion, whole-cell locomotion, pseudopodial tension, and coordination of the microtubule-based motility. PMID- 3518956 TI - Motility and centrosomal organization during sea urchin and mouse fertilization. AB - Motility and the behavior and inheritance of centrosomes are investigated during mouse and sea urchin fertilization. Sperm incorporation in sea urchins requires microfilament activity in both sperm and eggs as tested with Latrunculin A, a novel inhibitor of microfilament assembly. In contrast the mouse spermhead is incorporated in the presence of microfilament inhibitors indicating an absence of microfilament activity at this stage. Pronuclear apposition is arrested by microfilament inhibitors in fertilized mouse oocytes. The migrations of the sperm and egg nuclei during sea urchin fertilization are dependent on microtubules organized into a radial monastral array, the sperm aster. Microtubule activity is also required during pronuclear apposition in the mouse egg, but they are organized by numerous egg cytoplasmic sites. By the use of an autoimmune antibody to centrosomal material, centrosomes are detected in sea urchin sperm but not in unfertilized eggs. The sea urchin centrosome expands and duplicates during first interphase and condenses to form the mitotic poles during division. Remarkably mouse sperm do not appear to have the centrosomal antigen and instead centrosomes are found in the unfertilized oocyte. These results indicate that both microfilaments and microtubules are required for the successful completion of fertilization in both sea urchins and mice, but at different stages. Furthermore they demonstrate that centrosomes are contributed by the sperm during sea urchin fertilization, but they might be maternally inherited in mammals. PMID- 3518957 TI - Calcium-modulated contractile proteins associated with the eucaryotic centrosome. AB - Affinity-purified antibodies that recognize the 20,000-dalton molecular weight (20 kd) striated flagellar root protein of Tetraselmis striata have been used to identify antigenic homologs in other eucaryotic organisms of diverse evolutionary origins. Among the green algae, Tetraselmis and Chlamydomonas, and their colorless relative, Polytomella, the 20-kd homologs appear associated with basal bodies. This occurs most prominently in the form of flagellar roots of both striated and microtubule subtended types. Among cultured mammalian cells (PtK2 and primary mouse macrophage cell lines), flagellar root protein homologs appear as basal feet, pericentriolar fibrils, and pericentriolar satellites. Mammalian sperm cells also show flagellar root protein homologs associated with their basal bodies. We envisage a functional role for these fibrous calcium-sensitive contractile proteins in altering the orientation of centrioles or basal bodies with their associated MTOCs by responding to topological calcium fluxes. PMID- 3518958 TI - Protein-coated and polysaccharide-coated liposomes as drug carriers. AB - Saccharides on the surface of cell membranes play an important role in cell-cell recognition, which is the most important process utilizable for targeting of drugs encapsulated in an artificial cell, liposome. To design a targetable drug carrier, hence, employing synthesized or natural glycolipids as the recognition site of the liposomal drug carrier is certainly one of useful approach. On the other hand, coating the outermost surface of liposomes with polysaccharide derivatives is also another way for liposomes to be utilized as a targetable drug carrier. In this review, from such a viewpoint, the importance and usefulness of saccharide moiety on the surface of liposomes will be discussed in conjunction with the targeting of drugs. PMID- 3518959 TI - Polymeric microspheres as diagnostic tools for cell surface marker tracing. AB - The adequate expression of cell-surface receptors and antigens is an important requirement for the functional ability of living cells. A lot of different methods for cell surface marker tracing have been described; however, most of these techniques have disadvantages limiting their wide-scale utilization in routine laboratory and clinical practice. The most recent technique for these purposes, approaching near the ideal one, is based on the use of synthetic microspheric particles made of polymers which are formed mainly by emulsion or radiation polymerization of a variety of monomers. The resulting spherical particles bear hydroxyl, carboxyl, amino, or other functional groups capable of covalent binding of proteins, dyes, or chemotherapeutic agents. Fluorescent, radioactive or haptenic labels may be introduced already during the polymerization, too. There are three main fields of application of such specific labeled microspheres in cell biology: (1) detection of cell surface markers; (2) studies of phagocytosis mediated via cell surface markers; and (3) cell separation according to cell surface markers. In this review general principles of preparation and applications of polymeric microspheres in cell biology are summarized. PMID- 3518960 TI - New polymeric and oligomeric matrices as drug carriers. AB - The preparation of polymeric derivatives of drugs, in which drug moieties are covalently linked to polymeric or oligomeric matrices, in such a way that they can be released at the site of action, is one of the most promising ways to achieve results which often can be hardly obtained by other means, such as, for instance, better adsorption by some ways of administration (e.g., oral administration), preferential localization in the body, and longer duration of activity. The aim of this review is to provide an up-to-date picture of the state of art in this field. The synthetic aspects of the preparation of polymeric derivatives of drugs will be discussed, with special emphasis on general methods. The main criteria for selecting a particular type of matrix, and a particular bond between drug and matrix, in order to achieve a given purpose, will be also discussed. The main pharmacological results so far obtained by this technique will be emphasized. PMID- 3518961 TI - [Cellular immunity in children with infections of the nervous system]. PMID- 3518962 TI - [Nosocomial infections caused by Klebsiella pneumoniae in a neonatal unit and a unit for low-birth-weight infants]. PMID- 3518963 TI - Inhibitory and bactericidal activity of cefmetazole and seven other beta-lactams against different bacterial inocula. AB - The determination of the minimal inhibitory concentrations (MICs) at different bacterial inocula represents an important factor in determining the potential effectiveness of new antibiotics. MICs at different inocula (10(5) and 10(7) CFU/ml) and minimal bactericidal concentrations (MBC) of cefmetazole and seven other new cephalosporins (ceftazidime, ceftizoxime, cefamandole, ceftriaxone, cefotaxime, cefuroxime, cefoxitin) were determined by a miniaturized dilution broth method against a wide range of gram-positive, gram-negative and non fermentative bacteria. The results of the present investigation confirm that all the beta-lactams under examination including cefmetazole exert a good or satisfactory antibacterial activity against gram-positive and gram-negative bacteria; and that only ceftazidime possesses antipseudomonas activity. MBCs and MICs at heavy inoculum are two times higher than MICs at light inoculum. These results could explain the spread by different mechanisms of bacteria resistant to beta-lactam antibiotics. PMID- 3518964 TI - Microbiological perspective of ketoconazole. AB - The analysis of the results obtained in our trials, which took into account different experimental conditions, suggests that ketoconazole is a very effective anti-Candida drug. In particular, ketoconazole inhibits the development of the hyphal form of C. albicans which is highly invasive. In our trials, we were also able to demonstrate that it is possible to extend ketoconazole's range of action to gram-negative bacteria, if the drug is used in appropriate pharmaceutical forms. Moreover, its in vivo efficacy against dermatophytes and ifomycetes can also be explained by its ability to concentrate in keratinized tissues. From the investigations carried out on leukocyte populations, it has also been demonstrated that ketoconazole does not negatively interfere with the cell defense mechanisms of the host. In fact, the opsonic index and intraphagocytic killing do not significantly change in the presence of ketoconazole in therapeutic doses. PMID- 3518965 TI - Etoposide (VP-16-213) and cis-dichlorodiammineplatinum (DDP) in advanced breast carcinoma resistant to previous chemotherapy. AB - The combination of etoposide (VP-16-213) and cis-dichlorodiammineplatinum (DDP) was evaluated in 23 patients with advanced metastatic breast carcinoma who had not responded to or who had relapsed after previous two-arm chemotherapy (CMF and AV). Nineteen patients were evaluable for efficacy and one of them attained objective response. Stability of the disease was observed in 6 patients. PMID- 3518966 TI - Norfloxacin versus pipemidic acid in complicated urinary tract infections due to susceptible pathogens: a comparative clinical trial. AB - Norfloxacin (NOR) was compared to pipemidic acid (PA) in complicated urinary tract infections (UTIs) caused by pathogens susceptible to both agents to evaluate the antibacterial activity of the new 4-quinolone derivative. Sixty-five patients were randomly allocated to receive NOR or PA, 400 mg bid for 7 days, and the results evaluated for treatment efficacy at 5 weeks after completion of therapy. Overall microbiological cure was significantly greater in NOR-treated patients, as 19 of 26 were cured (73%), compared to only 16 of 39 (41%) in the PA group (p less than 0.05). Failures and relapses, considered together, were significantly (p less than 0.05) less frequent in patients treated with NOR (4/26) than in those receiving PA (18/39). Clinical response was strictly related to microbiological outcome: NOR had a broader antibacterial spectrum than PA and in this study seemed to be more efficacious in the treatment of complicated UTIs caused only by bacteria susceptible to both agents. This may be related to greater antibacterial activity and/or tissue penetration by NOR, which is thus to be preferred, according to the results of our study, in the treatment of complicated UTIs. PMID- 3518967 TI - Comparative in vitro activity and beta-lactamase stability of CGP 31523A, a new aminothiazolyl cephalosporin. AB - The in vitro activity of CGP 31523A, an aminothiazolyl cephem, was compared to that of other cephalosporins--imipenem, aztreonam, carbenicillin, and gentamicin. CGP 31523A inhibited E. coli, K. pneumoniae, P. mirabilis, C. diversus, K. oxytoca, P. stuartii, Salmonella and Shigella at less than or equal to 0.25 micrograms/ml. It was equal or 2-fold more active than cefotaxime and ceftazidime, and 4-fold more active than imipenem against these organisms. It inhibited all carbenicillin and gentamicin-resistant isolates of these species. Neisseria and Haemophilus were inhibited by less than or equal to 0.12 micrograms/ml. Some C. freundii, E. cloacae, E. aerogenes, P. vulgaris, and P. penneri had MICs greater than or equal to 16 micrograms/ml similar to cefotaxime, ceftazidime and aztreonam. Pseudomonas were resistant, MIC 128 micrograms/ml. CGP 31523A inhibited streptococci at less than or equal to 0.25 micrograms/ml with the exception of S. faecalis, and staphylococci were inhibited by 0.5 micrograms/ml but methicillin-resistant isolates were resistant. Bacteroides and some Clostridium had MICs greater than or equal to 16 micrograms/ml. CGP 31523A was less stable than cefotaxime and ceftazidime to the plasmid TEM/SHV/PSE-4 beta lactamases. Like cefotaxime it was hydrolyzed by the P. vulgaris type Ic beta lactamase but not by the type Ia enzymes. CGP 31523A was not an effective beta lactamase inhibitor nor did it induce beta-lactamases. It had overall activity comparable to available extended spectrum cephalosporins. PMID- 3518968 TI - On the distribution of genotoxic factors in various organs of mice treated with cycasin. AB - The distribution of genotoxic factors in various organs of mice treated orally with methylazoxymethanol-beta-D-glycoside (cycasin) was investigated using the DNA-repair host mediated assay. Indicator of genotoxic activity was a pair of streptomycin dependent Escherichia coli strains differing vastly in DNA repair capacity; uvrB/recA vs. uvr+/rec+. The animal-mediated assays were performed by injecting mixtures of the two strains i.v. and orally into mice, which were subsequently treated with the test chemical and from which the differential survival of the indicator bacteria present in several organs was determined. The same strains and selection procedures were also used for assessing the DNA damaging activity in vitro. In the animal-mediated assays in which cycasin was applied orally, significant effects were observed at doses of 100 and 500 mg/kg body weight. The organ distribution of genotoxic factors in the host animal was as follows: the highest genotoxic activity was observed in the liver, followed by intestine and stomach; a clear effect was also observed in the kidneys and, to a lower extent, in the blood stream and in the lungs at the highest dose administered (500 mg/kg body weight). Under in vitro conditions a marginal genotoxic effect was observed even in the absence of liver homogenate, indicating that the test compound is possible activated (hydrolysed) by the E. coli cells. Therefore the genotoxic activity of cycasin observed in the gastrointestinal tract was not unexpected, since the substance was applied orally, thereby exposing the indicator bacteria in these organs to high levels of unmetabolised compound, especially in the stomach. In the intestine members of the microbial flora probably contribute to the metabolic activation of the test compound. The occurrence of genotoxic factors remote from the gastrointestinal tract shows that the present compound or active metabolites thereof penetrate through the intestinal barrier. The extraordinarily high genotoxic activity observed in the liver suggests that the compound is additionally activated in this organ. In compliance with previous in vitro findings this second activation step might lead to the formation of the highly reactive aldehydic form of methylazoxymethanol (MAMAL) mediated by dehydrogenases. Comparison with carcinogenicity studies indicates a good correlation between the distribution of genotoxic effects as determined in the present studies and the localisation of tumors in various organs of rodents treated with cycasin. PMID- 3518970 TI - Studies on chemical carcinogens and mutagens. XXXV. Standardization of mutagenic capacities of several common alkylating agents based on the concentration-time integrated dose. PMID- 3518969 TI - Relationships between structure of 5-nitro-2-furylethylenes and their SOS function-inducing activities in Escherichia coli. AB - The SOS-function-inducing activities of 36 furylethylenes were characterized in Escherichia coli K12. The induction of the SOS function was assayed by monitoring the beta-galactosidase activity in the sulA::lacZ fusion strain PQ 37. To correct for the inhibitory effects of test compounds on mRNA or protein synthesis, the level of the constitutive alkaline phosphatase was assayed in parallel. Tested furylethylenes included nine alkylesters and eleven N-alkylamides of 5-nitro-2 furylacrylic acid (NFAA) and fourteen derivatives differing not only in substituents at exocyclic double bond, but also in the position 5 of the furan ring. The induction of the SOS-function by the derivatives depends on the presence of 5-nitrofuran centre in their molecule; side chains in the position 2 modify the degree of SOS response. SOS-inducing potency of n-alkyl congeners decreases with increasing lipophilicity. Effect of derivatives with branched alkyl substituents is lower than expected from the behavior of the n-alkyl homologues. All derivatives with positive effect on SOS-function in E. coli show mutagenic activity on Salmonella typhimurium TA98 in Ames test. PMID- 3518971 TI - Purification and characterization of type IV collagen from mouse kidney. PMID- 3518972 TI - Inhibition of intestinal alpha-glucosidases and sugar absorption by flavones. PMID- 3518973 TI - [Nail synthesis in fractures of the distal phalanx]. AB - Authors describes a new simplified approach of dorsal sectioning of the distal phalanx, with the suture of the nail. That is a simple method of treatment and its give a good results. PMID- 3518974 TI - [Pancreas transplant today: review of the literature]. AB - The authors, after analysing the world literature concerning the pancreatic transplantation, dwell in considering the problems involved in the indications and techniques of the transplantation itself. Among the several problems expecting an ultimate solution, the improvement of prophylaxis, diagnosis and treatment of rejection seems to heavily affect the future of this surgery. PMID- 3518975 TI - [Echographic control of porto-systemic anastomosis (personal cases)]. AB - The authors describe the clinical case of a patient undergoing a porto-caval shunt for portal hypertension, in which the patency of the anastomosis was checked by ultrasound examination. PMID- 3518976 TI - ["Wandering spleen": preoperative diagnosis by echotomography of the abdomen (review of the literature and report of a case)]. AB - Splenic wandering is a rare condition of upset position of spleen, due to congenital fault or to excessive looseness of the supporting apparatus of this organ. The literature reports about 180 cases thereof, few of which recognized as such before operation. Ultimate investigations, in this limited number of preoperative diagnoses, resulted angiography and hepato-splenic scintigraphy; only three times the diagnosis was correctly placed through ultra-sounds. The authors show a case, confirmed by the operative report, where the ultrasonic test allowed to place the diagnosis with certainty, and, due to a particular lot of circumstances, proved to be better than TAC. PMID- 3518977 TI - Preneoplastic lesions as end points in carcinogenicity testing. II. Preneoplasia in various non-hepatic tissues. PMID- 3518978 TI - Histochemistry of monoamine oxidase activity. PMID- 3518979 TI - Enzymology of monoamine oxidase. PMID- 3518980 TI - Effects of nifedipine on intrinsic myocardial stiffness in man. AB - To determine whether alteration of intrinsic myocardial stiffness is responsible for the reduction of left ventricular filling pressure and volume by nifedipine in patients with impaired baseline ventricular function, we evaluated the hemodynamic responses in 32 patients undergoing diagnostic cardiac catheterization. Micromanometric pressure and ventriculographic dimensional data were acquired before and 30 min after randomly assigned administration of nifedipine (20 mg sublingual) or placebo. A mathematical model requiring no assumptions about the stress-radius relationship or direct measurement of strain was used. No hemodynamic variables were changed after placebo. Left ventricular end-diastolic volume and pressure declined and cardiac output increased after nifedipine, particularly in subjects with impaired ventricular performance. Despite these salutary effects, intrinsic myocardial stiffness, elastic stiffness at a common level of stress, chamber stiffness, and rate of isovolumic relaxation were unchanged after nifedipine, even in patients with abnormal baseline ventricular function. The potent peripheral arteriodilator effect of nifedipine, rather than any direct myocardial or ventricular effects, appears to be responsible for the improved systolic and diastolic performance. PMID- 3518981 TI - Does prostacyclin enhance the selective pulmonary vasodilator effect of oxygen in children with congenital heart disease? AB - We have obtained dose-response curves for the effects of prostacyclin on the pulmonary and systemic circulations in 20 children (median age 3 years) with pulmonary hypertension complicating congenital heart disease. Results were obtained with the children breathing both air and 100% oxygen. Under both sets of conditions, remote respiratory mass spectrometry was used to measure oxygen consumption and hence cardiac output by the direct Fick principle. When the subjects breathed air, prostacyclin caused a dose-dependent fall in pulmonary vascular resistance (measured in mm Hg . liter-1 . min . m2) (11.12 to 8.07, standard error of difference [SED] = 0.5, p less than .01). The level of the pulmonary vascular resistance when the subjects breathed air during the infusion of 20 ng/kg/min prostacyclin was not significantly different from that found when they breathed 100% oxygen and did not receive the drug (8.67 vs 8.93, SED = 0.55, p = NS). When infused while the subjects breathed 100% oxygen, prostacyclin caused additional dose-dependent pulmonary vasodilation (pulmonary vascular resistance 8.93 to 7.23, SED = 0.3, p less than .01). Unlike 100% oxygen, prostacyclin was not selective, and caused tachycardia and systemic hypotension at the higher doses. These results suggest that in children with congenital heart disease 100% oxygen does not maximally vasodilate the pulmonary circulation, and further pulmonary vasodilatation can be obtained with a blood-borne agent. PMID- 3518982 TI - Magnetic resonance imaging of cardiac transplants: the evaluation of rejection of cardiac allografts with and without immunosuppression. AB - The purpose of this study was to evaluate the potential of magnetic resonance imaging (MRI) in vivo for the characterization of tissue changes associated with acute myocardial rejection after cardiac transplantation. Of 15 dogs that underwent heterotopic cardiac transplantation, six served as untreated controls, and nine received immunosuppressive therapy (25 mg/kg/day cyclosporine, 1 mg/kg/day prednisone). Serial electrocardiographically gated MRI (spin-echo technique) and histologic examinations of allograft biopsy samples were performed for each dog at 2 to 3, 7 to 10, 14 to 17, and 26 to 29 days after transplantation and immediately after animals were killed. Untreated allografts showed a significant increase (p less than .01) in T2 (spin-spin) relaxation time (T2 = 66 +/- 8 msec) and intensity values compared with values in the native hearts (T2 = 44 +/- 6 msec) as early as 1 week after transplantation. The significant difference in T2 values could be observed in vivo as well as on postmortem examination and corresponded to histologic progression of the rejection process. There was no significant difference in T1, T2, or intensity values in cyclosporine-treated allografts and native hearts except in two dogs in which T2 relaxation times and signal intensity in the transplanted hearts increased simultaneously with histologic evidence of rejection, indicating failure of immunosuppressive therapy. There was a significant correlation between histologic grading of severity of rejection and T2 relaxation times of the cardiac transplants (r = .72). Likewise, there was a significant linear relationship between T2 values in vivo and percent water content when the differences between native hearts and allografts were compared (r = .92, p less than .001).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3518983 TI - Extended wear of hard gas permeable contact lenses can induce ptosis. PMID- 3518984 TI - Ketotifen in pollen-induced asthma: a double blind placebo-controlled study. AB - Twenty-nine children with an average age of 10.5 years were studied with respect to the protective effect of ketotifen on pollen-induced bronchial asthma. All of them were sensitive to deciduous tree pollen, the diagnosis being verified by bronchial challenge. The children were stratified in matched pairs and randomly allocated to two treatment groups, placebo or ketotifen 1 mg twice daily. The study was double-blind and was performed during the whole of the deciduous tree pollen season. Daily pollen counts were made, allergic symptoms were noted, additional medication was given and the expiratory pulmonary flow was recorded. During the birch pollen peak the ketotifen group showed significantly fewer, and less severe asthma and rhinoconjunctivitis than the placebo group. The anti asthmatic medication was also used significantly less than in the placebo group. Ketotifen appeared to have good protective properties in the treatment of pollen induced asthma and rhinoconjunctivitis. PMID- 3518985 TI - Occupational asthma caused by African maple (Obeche) and Ramin: evidence of cross reactivity between these two woods. AB - Four patients with occupational asthma were studied. All patients were exposed to African maple dust and two of them were also exposed to Ramin dust. Skin tests and bronchial provocation tests with African maple extracts revealed an immediate response in all patients, and the same tests performed with Ramin extracts again revealed an immediate reaction in either exposed or non-exposed patients to Ramin wood dust. Specific IgE antibodies against African maple extracts were demonstrated in all patients as measured by a reverse enzyme immunoassay. Cross reactivity between both woods was demonstrated by a reverse enzyme immunoassay inhibition study. Unexposed persons and exposed asymptomatic workers did not exhibit reactivity to both woods in any of the tests listed above. To the best of our knowledge, this is the first article in which occupational asthma due to Ramin is defined, and cross sensitivity between two different woods is demonstrated. PMID- 3518986 TI - Potential applications of therapeutic drug monitoring in treatment of neoplastic disease by antineoplastic agents. AB - Therapeutic drug monitoring of antineoplastic agents must be considered in terms of cytotoxicity to stem cells and toxicity of normal tissues. The dose-limiting toxicity which is myelosuppression is believed to be a necessary effect for maximal antitumour effect. The areas in which therapeutic drug monitoring can play a role include: predicting patients at risk of toxicity, e.g. high dose methotrexate therapy; low bioavailability, e.g. oral 6-mercaptopurine; identifying patients at risk of treatment failure, e.g. methotrexate clearance in acute lymphoblastic leukemia. Although therapeutic drug monitoring is not clinically useful at present, the potential role it can play is illustrated for cytosine arabinoside, adriamycin and cyclophosphamide. Two problems encountered with drug monitoring of antineoplastic disease are tumour heterogeneity manifested by clonal, nutritional and physical characteristics and the common practice of combination chemotherapy. These problems must be addressed in order to make therapeutic drug monitoring a practical tool in cancer chemotherapy. Future applications of therapeutic drug monitoring will require more studies to define therapeutic ranges for single agents, patient-to-patient variation, course to-course variation and the effects of drug combinations on pharmacokinetic profiles of the drugs used. PMID- 3518987 TI - Chiral pharmacology and its consequences for therapeutic monitoring. AB - The individual enantiomers of chiral drugs may have profound differences in their pharmacologic and toxicologic properties. Their metabolism and pharmacokinetics may also differ markedly, and the presence of one enantiomer may inhibit the metabolism of the other. Stereospecificity is required in analytical methods, whether these be chromatography or radioimmunoassay. PMID- 3518988 TI - Optimization of a toxicology program. AB - This presentation covers a multiphasic approach to toxicological service. The service is to the hospital and the community as a whole. The optimization includes the analytical aspects of clinical, forensic, and industrial toxicology along with service associated with interpretations, chemical disasters and employee monitoring. PMID- 3518989 TI - Induction of drug-metabolizing enzymes: mechanisms and consequences. AB - The activity of many enzymes that carry out biotransformation of drugs and environmental chemicals can be substantially increased by prior exposure of humans or animals to a wide variety of foreign chemicals. Increased enzyme activity is due to true enzyme induction mediated by increased synthesis of mRNAs which code for specific drug-metabolizing enzymes. Several species of cytochrome P-450 are inducible as are certain conjugating enzymes such as glutathione S transferases, glucuronosyl transferases, and epoxide hydrolases. Induction of drug-metabolizing enzymes has been shown in several instances to alter the efficacy of some therapeutic agents. Induction of various species of cytochrome P 450 also is known to increase the rate at which potentially toxic reactive metabolic intermediates are formed from drugs or environmental chemicals. Overall, however, induction of drug-metabolizing enzymes appears to be a beneficial adaptive response for organisms living in a "chemically-hostile" world. PMID- 3518990 TI - Determinants of drug disposition in man. AB - This article reviews some of the important determinants of variation in drug disposition such as age, gender, body weight, diet, environmental influences, drug - protein interactions, compliance, drug - drug interactions, endogenous substances, disease states, circadian variation and genetics. PMID- 3518991 TI - Factors affecting drug biotransformation. AB - Biotransformation of drugs to polar metabolites is a key step in the termination of action and the elimination of drugs used in therapeutics. A large number of factors, including infection, alter the basal rates of drug metabolism and cause a number of untoward effects and drug interactions. Although a number of techniques have been attempted, there appears to be no easy way to determine the capacity of an individual to metabolize a specific drug and to tailor drug dosage to that individual. PMID- 3518992 TI - Genetics of drug transformation. AB - Biotransformations of drugs are controlled or strongly affected by genetic factors. During the past few years several genetic deficiencies of drug metabolizing reactions catalyzed by members of the family of cytochrome P-450 were observed. Choice of the appropriate drug to study and attention to urinary metabolites have been the essential ingredients for the recent discovery of genetic deficiencies of drug metabolism in man which include recessive deficiency of debrisoquine/sparteine metabolism and of mephenytoin metabolism. The clinical significance of these defects is discussed. Ethanol after metabolism to acetaldehyde is further metabolized to acetic acid by aldehyde dehydrogenase. Numerous isozymes of aldehyde dehydrogenase exist, one of which possesses a high affinity for acetaldehyde. Approximately 40% of the Oriental population lack this high affinity isozyme so that in these individuals who may have symptoms of flushing and other unpleasant effects the acetaldehyde formed is destroyed only at high plasma concentrations. PMID- 3518993 TI - Cyclosporine: a review of drug monitoring problems and presentation of a simple, accurate liquid chromatographic procedure that solves these problems. AB - Many studies involving large numbers of patients prove the efficacy of cyclosporine to accomplish immunosuppression following hetertopic organ transplant. In long-term follow-up, cyclosporine produces a higher level of nephropathy than does conventional immunosuppression consisting of azathioprine and prednisone. The degree of nephropathy appears to be related to blood concentration and the effect can be minimized by maintaining therapeutic trough blood concentrations. Other significant side effects (central nervous system toxicity and hirsutism) can also be minimized by low blood concentrations. Development of lymphoma secondary to Epstein-Barr virus exposure is unrelated to blood concentration. Two methods are available for therapeutic drug monitoring: radioimmunoassay (RIA) and high pressure liquid chromatography (HPLC). RIA on plasma is a standard, rapid means of obtaining a result, but that result is inaccurate due to metabolite cross-reactivity. The concentration of cyclosporine in plasma is widely variable and unrepresentative of the whole blood concentration. Plasma concentration is dependent upon the temperature of plasma separation. Whole blood analysis avoids this problem. HPLC procedures allow for whole blood analysis but are tedious and time-consuming. We present here a simple, accurate HPLC procedure that is reproducible (CV = 4.9%), sensitive (to 50 ng/mL), and fast (preparation time - 5.7 minutes, chromatography time - 20 minutes). This procedure correlates (r = 0.98) with a reference HPLC procedure and has been used in our clinical laboratory for analysis of more than 4000 specimens without apparent problem. No interferences have been identified. PMID- 3518995 TI - Limitations in the immunoturbidimetry of urinary albumin. PMID- 3518994 TI - Tissue penetration of antibiotics. AB - To be effective, antibiotics must be active against the offending pathogen(s) and must reach sufficient concentrations at the site of infection where microorganisms have induced severe inflammation. Such inflammation may, depending on the infected tissue, increase or decrease antibiotic penetration. Once it has reached the infected site an antibiotic may be inactivated locally. In this work, we have reviewed: 1. Factors modulating the penetration of antibiotics in tissues of normal and infected humans and animals; 2. The relationship between concentrations and efficacy of antimicrobials in experimental and human infections; 3. The mechanisms by which high tissue levels of antibiotics may be toxic; 4. New antibiotic targetting delivery systems which may increase tissue concentrations of antibiotics. To better understand the interaction between antimicrobial agents, pathogens in specific infected sites and the host, more experimentation dealing simultaneously with tissue penetration and antibiotic efficacy in acute and chronic infection is required. Innovative approaches to the therapy of human infections are needed. PMID- 3518996 TI - Is the dilution experiment a valid technique for assessing the validity of free thyroxin assay? PMID- 3518997 TI - A rapid enzymatic procedure for "fingerprinting" bacteria by using pattern recognition of two-dimensional fluorescence data. AB - We describe a rapid fluorescence technique for bacterial "fingerprinting," based on the differences in enzyme content and activity of various bacteria. Bacterial cells are incubated with a mixture of carefully chosen fluorogenic enzyme substrates to produce fluorophores with unique emission and excitation properties. The resulting two-dimensional fluorescence spectrum of the product mixture produces a pattern characteristic of the bacterium. A Fourier-transform based pattern recognition algorithm is used for spectral matching and for differentiating visually similar spectra. This sensitive technique is potentially applicable to differentiation and identification of bacteria in clinical laboratories. PMID- 3518998 TI - Amniography and fetography old diagnostic aids--new uses. AB - Ultrasonography replaced amniography and fetography as a diagnostic procedure in the antenatal diagnosis of congenital abnormalities in the 1970's, however, a combination with these techniques offers new diagnostic possibilities. PMID- 3518999 TI - Some medical matters in operatic literature. PMID- 3519000 TI - The scalpel and the brush. Anatomy and art from Leonardo da Vinci to Thomas Eakins. PMID- 3519001 TI - Determination of mitochondrial aspartate aminotransferase in serum. AB - Two specific and sensitive immunoassay methods for the determination of mitochondrial aspartate aminotransferase (m-AST) are described. One is a sandwich enzyme immunoassay which measures immunologically active m-AST using polystyrene balls coated with anti-m-AST antibody and peroxidase-labelled anti-m-AST antibody as the second antibody. The detection limit of this assay was 10 micrograms/l. The other is a paper disk method which measures catalytically active enzyme bound to anti m-AST antibody-conjugate paper disks. The calibration curve was linear up to 250 U/l. These assay methods were used to monitor the level of m-AST in serum. From measurements obtained by both methods, the correlation between the concentration of m-AST protein and its activity was poor (liver diseases, r = 0.539; myocardial infarction, r = 0.774) confirming that an inactive form of m AST exists in serum, and that the specific activity of serum m-AST differs in individual diseases. PMID- 3519002 TI - Tissue origin of serum placental-like alkaline phosphatase in cigarette smokers. AB - A variety of solubilised tissue extracts from cigarette smokers and non-smokers have been screened quantitatively for both placental alkaline phosphatase (PLAP) and placental-like alkaline phosphatase (PLAP-like AP) in order to identify the possible tissue origins of the circulating PLAP-like AP found in most smokers. Lung alveolar tissue, and to a lesser extent colonic tissues, contained both PLAP like AP and PLAP. Tissues from smokers and non-smokers contained comparable proportions and amounts of PLAP and PLAP-like AP. No other tissue source of PLAP like AP was found other than those previously reported for testicular, endometrial and thymic tissue. Selective release of PLAP-like AP from the lung in cigarette smokers seems likely to be a major source for this isoenzyme in peripheral circulation. PMID- 3519003 TI - Deficient activities and proteins of peroxisomal beta-oxidation enzymes in infants with Zellweger syndrome. AB - The activities and amounts of enzyme proteins of peroxisomal beta-oxidation in Japanese children with Zellweger syndrome were investigated. Cyanide-insensitive fatty acid oxidation, peroxisomal enoyl-CoA hydratase and 3-oxoacyl-CoA thiolase activities were not detectable in liver tissue at autopsy, whereas the activities of mitochondrial enoyl-CoA hydratase, 3-oxoacyl-CoA thiolase and carnitine palmitoyltransferase were similar to those in the healthy controls. On immunoblot analysis, immunoreactive proteins of peroxisomal acyl-CoA oxidase, bifunctional protein and 3-oxoacyl-CoA thiolase were not detected in the livers, kidneys and fibroblasts from the patients. Proteins of catalase and some enzymes of mitochondrial fatty acid oxidation were similar as in normal controls. These data indicate that increased levels of very-long-chain fatty acids in Zellweger syndrome are due to the lack of the enzyme proteins of peroxisomal beta oxidation. PMID- 3519004 TI - Loss of luteinizing hormone bioactivity in patients with prostatic cancer treated with an LHRH agonist and a pure antiandrogen. AB - Chronic treatment of adult men with LHRH agonists causes a decrease in serum testosterone and 5 alpha-dihydrotestosterone to castrate levels. In the presence of such low levels of circulating testicular androgens, the concentration of serum LH measured by radioimmunoassay (RIA) sometimes remains normal or is only partially inhibited. In order to assess the biological activity of circulating LH, we have used the mouse interstitial cell assay. Blood samples were obtained from patients with prostatic carcinoma treated with the LHRH agonist [D-Trp6] LHRH ethylamide in combination with the pure antiandrogen Flutamide (Euflex). While serum LH levels measured by RIA were only partially reduced from 2.2 +/- 0.3 (SEM) to 1.1 +/- 0.1 ng/ml after 3 months of therapy, bioactive LH was markedly inhibited from 0.43 +/- 0.04 to 0.030 +/- 0.007 ng/ml, thus causing the ratio of biologically active to radioimmunoassayable LH to drop from 0.26 +/- 0.03 to 0.03 +/- 0.01. In the same patients, serum testosterone levels were decreased from 3.91 +/- 0.51 to 0.14 +/- 0.05 ng/ml after 3 months of treatment. In patients treated for 6 months, the bio/immuno ratio was still reduced at 0.032 +/- 0.005. These data show a marked loss of LH biological activity during treatment of adult men with an LHRH agonist and an antiandrogen. The close parallelism observed between serum testosterone and bioactive LH levels suggests that the loss of biological activity of the gonadotrophin is mainly, if not exclusively, responsible for the inhibition of testicular androgen secretion observed during chronic treatment with LHRH agonists. PMID- 3519006 TI - Responses of neurohypophysial peptides to hypertonic saline and insulin-induced hypoglycaemia in man. AB - In order to investigate the possible role of oxytocin in osmoregulation and its response to stress, plasma immunoreactive oxytocin was measured during hypertonic saline infusion and insulin-induced hypoglycaemia in a group of normal subjects, four patients with idiopathic diabetes insipidus and one patient with DIDMOAD syndrome (the syndrome of diabetes insipidus, diabetes mellitus, optic atrophy and deafness). The results were compared with those of plasma immunoreactive vasopressin to the same stimuli. As expected, there was a rise in plasma vasopressin in the normal subjects to both tests: this was absent in the patients with diabetes insipidus. Plasma oxytocin did not rise during hypertonic saline infusion in either group of subjects. The response of oxytocin to insulin-induced hypoglycaemia (0.15 U/kg soluble insulin) in normal subjects was much more variable. One highly symptomatic volunteer showed a marked rise in oxytocin. Two subjects also showed a rise when retested with 0.19 U/kg soluble insulin. There was no response of oxytocin to a standard-dose insulin test in the patients with diabetes insipidus. The data suggest that, in man, oxytocin is not involved in osmoregulation but that it may be secreted in response to marked hypoglycaemia. PMID- 3519005 TI - Hormonal and cardiovascular responses to DDAVP in man. AB - Hormonal and cardiovascular responses to 1-desamino-8-D-arginine vasopressin (DDAVP) were investigated in six normal adult volunteers. After overnight fluid deprivation, an intravenous injection of either DDAVP (0.4 microgram/kg) or the same volume of normal saline was administered. One hour later an intravenous infusion of hypertonic saline was commenced and continued over two hours. Five minutes following the DDAVP injection, facial flushing, a fall in diastolic blood pressure by an average of 13% and a rise in pulse rate by an average of 18% were observed. There was a significant increase in plasma renin activity and plasma cortisol concentration, but no significant changes were observed in plasma concentrations of LH, FSH, TSH, prolactin or GH. Following osmotic stimulation by hypertonic saline plasma AVP rose to the same extent in both the DDAVP and control studies. DDAVP (0.4 microgram/kg) was also administered to five subjects with cranial diabetes insipidus. Again facial flushing, increased facial temperature, a fall in diastolic pressure and a rise in heart rate were all observed, suggesting that DDAVP exerts its cardiovascular actions by a mechanism other than antagonism of circulating endogenous AVP. PMID- 3519007 TI - Pseudohypoaldosteronism: decreased aldosterone levels with age without significant change in urinary sodium excretion. AB - To clarify age-related changes in the plasma renin activity (PRA)-aldosterone (ALDO) system in relation to urinary sodium (Na) excretion in pseudohypoaldosteronism type I (PHA), we followed a patient with PHA serially by measuring the hormonal balance and urinary electrolyte excretion for 5 years. The patient was diagnosed as PHA mainly on the basis of extremely high PRA (170 ng/ml/h) and ALDO (1670 ng/dl) despite massive urinary Na excretion, a normal ALDO/PRA ratio (mean value = 11), and the ineffectiveness of 9 alpha fluorocortisol (Florinef) to reduce urinary Na excretion and PRA-ALDO. The pattern of reduction in PRA-ALDO with age in this patient was almost identical with that of normal infants and children and was most remarkable during the first 18 months of life. During this period, there were statistically significant correlations between age and each of the following values: PRA (r = -0.753, n = 9, P less than 0.05), ALDO (r = -0.736, n = 11, P less than 0.01) and urinary ALDO excretion (r = -0.840, n = 9, P less than 0.01). But the reduction of PRA ALDO in this patient was not the result of increased urinary Na excretion with age. Although PRA and ALDO values in this patient did decrease with age, they were still high compared with age-matched controls, suggesting a marginal state of Na balance. Thus, we conclude that PRA-ALDO levels in PHA decrease with age in the same pattern as in normal infants and children without a significant change in urinary Na excretion, possibly through increased renal conservation of Na, the mechanism of which should be clarified in a future study. PMID- 3519008 TI - Does melatonin deficiency cause the enlarged genitalia of the fragile-X syndrome? AB - Melatonin profiles were studied in five males with cytogenetic and clinical features of the fragile-X syndrome including megalo-orchidia and macrogenitosomia. In comparison with age-matched normal controls, the fragile-X group showed lower melatonin values and a significant impairment of the nocturnal rise in this hormone. Melatonin deficiency may thus be responsible for some of the phenotypic features of this disorder. PMID- 3519009 TI - State of systemic hemodynamics in a case of juxtaglomerular cell tumor. AB - A renin-producing juxtaglomerular cell tumor was found in a 27 year-old woman. The infusion of angiotensin II analogue produced a marked decrease in arterial pressure. Oral administration of captopril also reduced her blood pressure. Although the renal vein renin did not indicate the laterality of the tumor, unilateral partial nephrectomy cured the disease. This is the first case report to describe measurement of several hemodynamic parameters before and after surgical removal of a juxtaglomerular cell tumor. PMID- 3519010 TI - Central and peripheral contributions of the renin-angiotensin system in two models of experimental hypertension in rats. AB - To examine the relationships between the central and peripheral renin angiotensin system in normotensive Wistar Kyoto (WKY) rats, two-kidney, one-clip Goldblatt renovascular hypertension (RVH), spontaneously hypertensive rats (SHR), SQ 14225 (captopril) was administered intraventricularly (IVT) and intravenously (IV) in the alternative manner and their combination. Also, the effects of IVT captopril on the peripheral sympathetic nervous system were evaluated using an intravenous injection of prazosin. IVT captopril induced a significant reduction of blood pressure in both types hypertensive rats but not in normotensive rats. Greater depressor effects of IV captopril not IV prazosin following IVT captopril were observed in RVH compared to those in SHR. These results indicate that the pressor action of the brain renin angiotensin system is closely related with the sympathetic nervous system in hypertensive conditions and that these functions are independent from the peripheral renin angiotensin system. Furthermore, their roles were different in different types of experimental hypertension in rats. PMID- 3519011 TI - Buschke-Ollendorff syndrome--disseminated dermatofibrosis with osteopoikilosis. PMID- 3519012 TI - Yaws truly--a survey of patients indexed under 'yaws' and a review of the clinical and laboratory problems of diagnosis. PMID- 3519013 TI - Lichen planus pemphigoides. PMID- 3519014 TI - The specificity of nephritogenic antibodies. III. Binding of anti-Fx1A antibodies in glomeruli is dependent on dual specificity. AB - Rabbit antibodies against rat tubular brushborder antigens (Fx1A) give rise to in situ formation of immune aggregates along the glomerular capillary walls after intravenous injection into rats. These antibodies (anti-Fx1A), able to produce heterologous immune complex glomerulopathy (HIC) in the rat, have previously been shown to bind with brushborders (anti-BB) as well as with rat thymocytes (anti T). In the present communication, this dual specificity was also demonstrated in antibodies eluted from kidneys of rats with HIC. It further appeared that, when the anti-thymocyte binding activity was selectively removed from these antibodies, using immunoabsorption with rat tissue extracts, these anti-Fx1A antibodies were no longer able to stain glomerular basement membranes (GBM) as demonstrated at the ultrastructural level using the peroxidase technique. Following perfusion of these antibodies in the normal rat kidney ex vivo, binding along the capillary walls was also below the detection level, in contrast to non anti-T depleted anti-Fx1A IgG. Biochemical analysis (including immunoblotting) showed that the anti-T moiety of anti-Fx1A was directed to a 90 kD component of Fx1A, since selective absorption of this specificity prevented staining of this 90 kD component. It is concluded, that this anti-T specificity within rabbit anti Fx1A plays a crucial role in local immune complex formation in the rat kidney ex vivo. Whether this holds also for its role in the pathogenesis of HIC in vivo awaits further confirmation. PMID- 3519016 TI - Aromatic L-amino acid decarboxylase: histochemical localization in rat kidney and lack of effect of dietary potassium or sodium loading on enzyme distribution. AB - Utilizing a mono-specific antiserum produced in rabbits to hog kidney aromatic L amino acid decarboxylase (AADC), the enzyme was localized in rat kidney by immunoperoxidase staining. AADC was located predominantly in the proximal convoluted tubules; there was also weak staining in the distal convoluted tubules and collecting ducts. An increase in dietary potassium or sodium intake produced no change in density or distribution of AADC staining in kidney. An assay of AADC enzyme activity showed no difference in cortex or medulla with chronic potassium loading. A change in distribution or activity of renal AADC does not explain the postulated dopaminergic modulation of renal function that occurs with potassium or sodium loading. PMID- 3519015 TI - A radioimmunoassay for the detection of adrenal autoantibodies. AB - A solid phase radioimmunoassay for adrenal antibodies is described. In the assay plastic tubes coated with adrenal microsomes (100 micrograms/ml) were incubated with human sera diluted from 1:50 to 1:5000 and the retained antibodies detected by subsequent incubation with 125I-labelled protein A. The method was precise over the range of serum dilution of 1:250 to 1:5000. In the group of 30 patients with Addison's disease 19 had positive results in adrenal antibody radioimmunoassay (RIA). Comparative studies of RIA and immunofluorescence (IFL) revealed that there was partial correlation of adrenal antibody results in patients with high titre antibodies whereas RIA usually was more sensitive than IFL in patients with low titre antibodies. Computerized tomography (CT) displayed bilateral adrenal atrophy in most patients who had adrenal antibodies. On the other hand, patients with low RIA results and negative IFL antibodies had predominantly adrenal calcifications on scans. PMID- 3519017 TI - Dynamic changes in plasma inactive renin levels in Bartter's syndrome after administration of captopril and angiotensin II. AB - Changes in plasma active and inactive renin concentration (ARC and IRC) after captopril administration and angiotensin II (AII) infusion were studied in six patients with Bartter's syndrome. A single oral dose of captopril (8-25 mg) lowered the blood pressure and increased both ARC and IRC. AII infusion elevated blood pressure, suppressed ARC and increased IRC. In this syndrome of high renin levels, infused AII appeared to increase inactive renin secretion by reducing its conversion to active renin. On the other hand, an acute fall in AII levels and/or renal perfusion pressure by captopril increased both active and inactive renin. This indicates that the increase in the secretion of inactive renin, stimulated by captopril, might exceed any increase in its conversion to active renin in patients with Bartter's syndrome, in whom the production of renin is accelerated, and conversion of inactive renin to active renin probably already operates near its maximum. PMID- 3519018 TI - Sar1-leu8-angiotensin II reverses the effects of captopril on renal function in rats. AB - In Inactin-anaesthetized rats inhibition of angiotensin converting enzyme by captopril resulted in a small decrease in mean arterial blood pressure accompanied by increases in the rates of glomerular filtration, water and electrolyte excretion. Infusion (100 pmol/min) of sar1-leu8-angiotensin II (sar1 leu8-AII) during continuing converting enzyme blockade reversed these changes in renal function but had no effect on arterial blood pressure. The data indicate that sar1-leu8-AII has partial agonist activity in the kidney although it acts as an antagonist of AII in the systemic circulation. This supports the proposal that angiotensin receptors within the kidney differ from those in the peripheral circulation. PMID- 3519019 TI - Haemorrhage-induced secretion of active and inactive renin in conscious and pentobarbitone-anaesthetized sheep. AB - The response of plasma levels of active and inactive renin to haemorrhage was investigated in sheep with indwelling artery and vein catheters. In conscious animals, loss of 10% of estimated blood volume over a 5 min period increased plasma active renin by a mean of 59%, a surprisingly small change. Plasma inactive renin also increased, but only by 86%. Maximum increases in both forms of renin occurred within 1 h of the haemorrhage. The effects of an equivalent blood loss were investigated in pentobarbitone-anaesthetized sheep maintained in an upright posture using padded slings. Anaesthesia per se had no effect on plasma active or inactive renin. In anaesthetized sheep, 3 h after haemorrhage, plasma active renin had increased by 403% and inactive renin by 299% above control values, but a plateau (maximum) response was not reached during this time. In both conscious and anaesthetized animals the haemorrhage-induced increases in active and inactive renin occurred in parallel. It appears that haemorrhage of this intensity is a comparatively mild stimulus to increase plasma renin concentration in conscious sheep but is much more effective in anaesthetized animals. This may be linked to anaesthetic-induced increases in prostaglandin synthesis within the kidney. PMID- 3519020 TI - Diclofenac sodium in the treatment of primary nocturnal enuresis: double-blind crossover study. AB - The prostaglandin synthesis inhibitor diclofenac sodium has been compared with a placebo in the treatment of primary nocturnal enuresis in a double-blind crossover trial. Twenty patients were entered: 14 female, six male; age range 6 17 years. The results showed that diclofenac sodium was significantly more effective than placebo in the treatment of nocturnal enuresis. PMID- 3519021 TI - Allogeneic transfusion of macrophages in acute urinary tract infection. AB - Three patients with acute urinary tract infections that failed to respond to antibiotics were treated by allogeneic peritoneal macrophage transfusions. No harmful effects were observed following macrophage transfusions and the urinary infections were eradicated in treated patients. It could be concluded that allogeneic macrophage transfusion is feasible between unrelated individuals and can combat severe resistant urinary infections. PMID- 3519022 TI - Comparison of cyclosporine nephrotoxicity with aminoglycoside nephrotoxicity. AB - Cyclosporine therapy is frequently complicated by dose related nephrotoxicity. In this review, the pharmacology, pathophysiology and clinical features of cyclosporine nephrotoxicity are contrasted with the adverse renal reactions of aminoglycoside antibiotics. From this analysis, it is apparent that these two common nephrotoxins produce renal dysfunction by different mechanisms. Aminoglycosides produce primarily direct toxic effects on the proximal tubular cell while cyclosporine nephrotoxicity is probably predominantly mediated by hemodynamic processes. PMID- 3519023 TI - Nephrotoxicity of cyclosporine A in rats with a diminished renal function. AB - We have studied the effect of cyclosporine A (CyA) in male Wistar rats with only one kidney, that had been subjected to 45 min of warm ischemia (IS + NX). The effects were compared with those obtained in rats with either one (NX) or two intact kidneys (2K). Vehicle treated rats that underwent the same surgical procedure served as controls. The GFR and the ERPF were determined during and after the treatment period. The CyA was administered i.m. daily for a period of 5 days a week for a period of 4 weeks. The dosages were 15, 30, or 60 mg/kg/day in the short-term study, and 15 mg/kg/day in the long-term study. With only 5 days of treatment, changes in the GFR induced by CyA were more pronounced in IS + NX rats when compared with NX rats. Furthermore, in contrast with NX rats, the GFR did not completely recover in IS + NX rats. During the 4 week treatment we found that in all 3 models the GFR was less in the CyA treated rats than in the vehicle treated rats. The degree of impairment of the GFR differed in the various models. At the end of the treatment period, the GFR of the CyA treated rats (expressed as a percentage of the vehicle treated rats) amounted to 84% in 2K rats, 64% in NX rats, and 46% in IS + NX rats. After cessation of the CyA administration, there was a complete recovery of the GFR to control levels in 2K and NX rats. In IS + NX rats, however, the GFR remained significantly below that of vehicle treated rats.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3519024 TI - Effect of cyclosporine A on mercury-induced autoimmune glomerulonephritis in the Brown Norway rat. AB - To test the effect of cyclosporine A (CsA) in mercuric chloride (HgCl2)-induced nephritis in the Brown-Norway (BN) rat, we treated groups of intoxicated rats with varying doses of CsA for a period of 2 months. All manifestations of HgCl2 induced disease were prevented in rats treated concurrently with CsA at either 7 or 10 mg/kg/day. Partial suppression was evident at lower daily doses, but not with bi-weekly CsA administration. The initial phase of HgCl2-induced nephritis could be completely suppressed with a short, 15 day course of CsA. The later phase of the disease could be tempered by CsA administration starting on day 10 after the first HgCl2 injection. The optimal regimen of 7 mg/kg/day for 60 days was not associated with any evidence of CsA toxicity. CsA appears to interfere with the polyclonal activation of B cells observed in HgCl2-induced autoimmune disease, accounting for its striking preventive and curative effect in this model. PMID- 3519025 TI - Effect of cyclosporine on in situ immune complex glomerulonephritis. AB - The influence of Cyclosporine A (CyA) on the development of renal injury in in situ immune complex glomerulonephritis (ICGN) in rats was examined. Left kidneys of male Wistar rats were perfused with cationized human IgG followed by an intravenous injection of rabbit anti-human IgG. CyA was given orally in a dosage of either 2.5, 15 or 25 mg/kg body weight per day in two daily injections. The amount of immune complexes deposited in the left kidney was not affected by CyA application as shown by isotopic studies. There were no differences between the control and CyA groups in respect to immunofluorescence, light and electron microscopy. Proteinuria was significantly inhibited with all treatment schedules, even when rats were first treated five days after inducing nephritis. These results show that CyA inhibits proteinuria without affecting glomerular cell accumulation/proliferation in in situ ICGN, and indicates that cellular activation at glomerular level might be prevented by CyA. PMID- 3519027 TI - Cyclosporine A nephrotoxicity in Goldblatt renovascular hypertension in rats. AB - Experiments were conducted on a renovascular model of hypertension to investigate the effect of high blood pressure and CyA nephrotoxicity combined on arteriolar and tubular morphology and renal function. A two kidney, one clip model of Goldblatt hypertension was selected in which were given 20 or 40 mg/kg/d CyA by gastric gavage for 3-4 weeks while receiving isotonic saline as drinking fluid. CyA was found to suppress feeding and drinking and, as a result, lead to volume depletion and weight loss, with a corresponding lowering of blood pressure and renal function and an increase in plasma renin. When CyA and control animals were pair-fed these effects disappeared, except for a modest depression of renal function, unaccompanied by a reduction in urinary concentrating power. Histological damage to the tubules was equally prevalent in both kidneys despite different levels of renal perfusion, suggesting that plasma concentration, rather than toxin delivery, determines tubular damage. The occurrence of arteriolopathy and glomerulosclerosis was infrequent, and if present, it was only found in the unclipped kidney and was not potentiated by CyA. Glomerular prostaglandin synthesis after substrate incubation was suppressed by CyA to an equal extent in both kidneys, clipped and unclipped. PMID- 3519026 TI - Nephrotoxicity of cyclosporine in spontaneously hypertensive rats: effects on blood pressure and vascular lesions. AB - Cyclosporine (CSA) caused functional and morphologic renal changes in spontaneously hypertensive rats. The development of hypertensive arterial lesions were accelerated by CSA. Blood pressure was significantly increased especially in young rats. The influence of age of the animals, dose and duration of CSA administration on the development of vascular lesions and blood pressure was investigated. PMID- 3519028 TI - Renal tubular transport of cyclosporine A (CSA) and associated changes in renal function. AB - In an effort to understand the mechanisms of nephrotoxicity of cyclosporine A (CSA), this study has been undertaken to evaluate the CSA clearance by the kidney and its tubular transport, with simultaneous studies on the multiple renal functional parameters. New Zealand white rabbits weighing approximately 2.5 kg were used in the study. Rabbits were infused with 14C labelled inulin to determine GFR. Blood pressure was monitored throughout the study via ear artery cannula. The rabbits were catheterized by the bladder and remained conscious throughout the entire study. When an infusional steady state was achieved, three clearance periods of 15 minutes were undertaken, followed then by a bolus of 10 mg/kg CSA, followed by an infusion of 1 mg/kg. A further three clearance periods were undertaken, studying the clearance of CSA at the same time as the GFR. Additional studies were made of plasma renin activity, aldosterone, 6-keto-PGF1 alpha, urinary sodium excretion and urinary potassium excretion rate. CSA was determined in whole blood and urine by HPLC. The results indicate that CSA, as determined by HPLC, has a whole blood renal clearance of 0.029 +/- 0.011 ml/min/kg body weight. Glomerular filtration rate showed no difference in animals pretreated with an infusion of mannitol when comparing pre- and post-CSA administration. Without mannitol, there was a significant decrease in the GFR following administration of CSA. CSA administration was accompanied by a rise in plasma renin activity in animals treated with mannitol and without mannitol. The rate of 6-keto-PGF1 alpha excretion without pretreatment with mannitol showed a significant rise following CSA administration.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3519029 TI - Problems of cyclosporine localization in the renal tissue. AB - The aim of the present investigation was to localize cyclosporine (CSA) in the rat kidney. The experimental approaches included autoradiography after i.v. injection of 3H-CSA, immunofluorescence after i.v. injection of fluorochrome labeled CSA and immunohistochemistry using the rabbit-alpha-CSA antibody. It was not possible to localize CSA in specific structures of the rat kidney. Finally, immunohistochemistry of human renal tissue gave only an unspecific staining of proximal tubular cells, which was lost when the antibody was absorbed on renal tissue homogenate. In vitro binding of 3H-CSA on renal homogenate indicated only unspecific absorption of the highly lipophilic compound; no specific binding was detected on cytosolic renal fractions. The failure to demonstrate CSA in tubular or arteriolar lesions might have been due to the fact that the affinity of binding is too low for detection, or that CSA does not accumulate within these structures. PMID- 3519030 TI - Cyclosporine A: effectiveness and toxicity in a rat model. AB - In an effort ot elucidate the effectiveness of Cyclosporine A (CyA) relative to the toxicity, Lewis to Sprague-Dawley first and second set skin transplantation and evaluation of the renal function with clearance methods was performed. CyA 12.5 mg/kg/day delayed first set rejection from 12.3 to 15.4 days (p less than 0.001), and second set from 10.5 to 12.1 days (p less than 0.05); 25 mg/kg/day prolonged the survival times to 18.3 (p less than 0.01) and 19.5 (p less than 0.002) days, respectively. The majority of the skin grafts were still not rejected at the end of the 3 weeks CyA 25 mg/kg/day treatment in contrast to the results during 12.5 mg/kg; the second set skin graft survival was significantly better (p less than 0.01) during the higher dosage. It is concluded, that CyA is not fully immunosuppressive at the 12.5 mg/kg/day dosage. In the doses 12.5 and 25 mg/kg GFR (inulin clearance [Cin]) was reduced to 80 and 48%, respectively, of the control value; the lithium clearance (CLi) was reduced to 69 and 27%. Proximal fractional reabsorption, as calculated from 1-CLi/Cin, was increased from a control value of 82% to 86 and 92% (p less than 0.02) in the 12.5 and 25 mg/kg/day group, respectively, suggesting that CyA nephrotoxicity is due to a decrease in the glomerular ultrafiltration pressure rather than being secondary to proximal tubular damage. In conclusion, in this model there does not seem to exist a therapeutic window between nephrotoxicity and the immunological effectiveness of CyA. PMID- 3519032 TI - An unusual complication of coronary bypass surgery. AB - Four cases are discussed that had a preventable complication following coronary bypass surgery. Infection was associated with retained transthoracic pacemaker leads. These case reports should serve to remind us of the importance of removal of all possible foreign objects from our patients to prevent rare but serious complications. PMID- 3519031 TI - Acute cyclosporine A nephrotoxicity in rats: which role for renin-angiotensin system and glomerular prostaglandins? AB - Cyclosporine A (CsA) is a recently introduced immunosuppressive agent that represents a significant advance in the clinical control of graft rejection. However despite the remarkable effectiveness, one of the limiting factors to a more extensive use of CsA appears to be its nephrotoxicity. CsA is reported to induce a tubular epithelial damage whereas histological examination of glomeruli does not reveal abnormalities unless particularly high doses of the drug are used. On the other hand a decrease in glomerular filtration rate (GFR) has been reported in association with acute administration of CsA. Relatively few studies are available to compare structural and functional abnormalities in the same animals after an acute administration of CsA. Here we evaluated morphological abnormalities and renal function in the same animals treated for 20 days with CsA. Moreover in the attempt to find a link between tubular damage and decrease in GFR we studied the effect of CsA on the renin-angiotensin system as well as on glomerular synthesis of prostacyclin (PGI2) and prostaglandin E2 (PGE2). Our results confirmed that CsA induces a focal damage of tubular epithelial cells with isometric vacuolization of cytoplasm. No glomerular or vascular changes have been detected at histological examination. Serum creatinine was significantly elevated after 20 days of treatment, whereas creatinine clearance showed a progressive tendency to decrease without reaching a statistical significance. Plasma renin activity was found to progressively increase during CsA administration, whereas the synthesis of PGI2 and PGE2 by isolated glomeruli was not modified in CsA-treated animals in respect to animals receiving the solvent alone.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3519033 TI - Syncope secondary to ventricular asystole in an endurance athlete. AB - Vasovagal syncope occurred in an endurance athlete prior to exercise as the result of a 22-second episode of complete heart block with ventricular asystole and subsequent sinoatrial arrest. The subject suffered a head injury but recovered without sequelae. Noninvasive cardiac testing was unrevealing. Although lesser disturbances of cardiac rhythm and conduction in athletes are not uncommon, extreme changes as illustrated by this case are rare. Close supervision of athletes undergoing exercise testing is advised. PMID- 3519034 TI - Myasthenia gravis: demonstration of membrane attack complex in muscle end-plates. AB - The membrane attack complex (MAC) assembles from C5b-9 complement components and has neoantigenic properties. Antihuman-MAC rabbit immunserum was applied in order to localize the MAC in myasthenic muscles. Using the indirect immunoperoxidase method MAC was demonstrated at the motor end-plates in eleven myasthenic patients who underwent thymectomy. This result provides direct evidence of antibody dependent complement-mediated injury of acetylcholine receptors in myasthenia gravis. PMID- 3519035 TI - Pulverized bone matrix as an injectable bone graft in rabbit radius defects. AB - A segment of the rabbit radius diaphysis was excised, demineralized, and pulverized. The demineralized matrix particles were mixed with autologous bone marrow from the femoral canal and injected into the defect from which it had been excised. On the contralateral side, the demineralized bone was reimplanted without pulverization, but with bone marrow. The bone yield was measured by radiographic planimetry and Tc99m MDP scintimetry. The forearms of the rabbits were sectioned into transverse segments, including the middle of the radius defect. The ash weights and the Ca45 content of these segments were measured. After two weeks, the ash weight was greater on the pulverized than on the unpulverized side; but by four weeks, measurements showed no difference. In general, the injectable bone matrix preparation did not interfere with bone repair. In comparing the Tc99m and Ca45 methods, the latter provided high precision data with respect to the biologic variation. PMID- 3519036 TI - The classic. Enzyme dissolution of the nucleus pulposus in humans. By Lyman W. Smith. 1964. PMID- 3519037 TI - Lacunar infarcts. PMID- 3519038 TI - A cross-cultural history of abortion. AB - Abortion is a universal phenomenon, occurring throughout recorded history and at all levels of societal organization. Techniques are highly varied, as are the circumstances under which it is practised. The status of and attitudes towards abortion in Western civilization are variable and have, in most cases, been changing. As of 1982, 10% and 18% of the world's population respectively, lived in countries where abortion was totally prohibited or where it was permitted only to save the mother's life. In the USA, various national surveys indicate liberalization of public attitudes towards pregnancy termination between 1965 and the years immediately following the Roe v. Wade Supreme Court decision (1973) which legalized abortion. More recent polls demonstrate little attitudinal change since 1972-1973: between 80% and 90% of Americans approve of abortion in the case of poor health, a seriously defective fetus, or rape, and between 40% and 50% indicate approval for all other reasons as well. Only 10% of the American population would like to see abortion prohibited under all circumstances. Sociodemographic analyses indicate that individuals who disapprove of abortion differ from those who approve of its availability in that they are more likely to be Roman Catholic or fundamentalist Protestant; are, in general, more strongly committed to organized religion; are on the traditional/conservative end of the spectrum with regard to women's role in life, premarital sex, sex education and civil liberties; and tend to have achieved a relatively low educational level. 'Pro-life' and 'pro-choice' activists tend to be women who are completely different from one another in sociodemographic characteristics and in overall values, particularly as these relate to traditional versus modern female roles. PMID- 3519039 TI - Psychiatric aspects of pregnancy termination. PMID- 3519040 TI - Impact of abortion on subsequent fecundity. AB - The impact of abortion on subsequent fecundity has been extensively studied, especially since abortion was legalized in Eastern Europe during the 1950s and 1960s and in Western Europe and the USA during the 1960s and 1970s. A review of this literature reveals a number of consistent findings. First, women who choose to have their first pregnancy terminated are at no increased risk of failing to conceive at a later date. Exceptions include abortions complicated by infection leading to pelvic inflammatory disease (PID). However, this combination of factors occurs very infrequently. Second, women whose first pregnancy is terminated by vacuum aspiration are at no increased risk of subsequent ectopic pregnancy. Exceptions may be women whose abortion is complicated by pre-existing C. trachomatis and others who experience post-abortion infection leading to PID. Third, women whose first pregnancy is terminated by vacuum aspiration are at no increased risk of subsequent mid-trimester spontaneous abortion, preterm delivery or low birthweight, when compared with women who are pregnant for the first time. Fourth, women whose first pregnancy is terminated by D&C may have an increased risk of subsequent ectopic pregnancy, mid-trimester spontaneous abortion and low birthweight. Fifth, more research is needed before it is clear whether multiple induced abortions carry an increased risk of adverse pregnancy outcomes. Finally, too little is known about fecundity following mid-trimester abortion procedures to state definitively that they carry no increased risk of adverse outcomes. However, studies to date suggest that instillation procedures carry little, if any, excess risk. Risks related to dilation and evacuation, if any, may be related to the method and extent of cervical dilation. PMID- 3519041 TI - The antiemetic activity of high-dose alizapride and high-dose metoclopramide in patients receiving cancer chemotherapy: a prospective, randomized, double-blind trial. AB - Alizapride is a new substituted benzamide with suggested superior antiemetic efficacy to and fewer side effects than metoclopramide. High-dose alizapride (4 mg/kg X five doses) was compared with high-dose metoclopramide (2 mg/kg X five doses) in a prospective, randomized, double-blind trial in 62 evaluable patients undergoing strongly emetic cancer chemotherapy. Patients receiving metoclopramide experienced significantly fewer vomiting episodes than patients receiving alizapride (median of three episodes vs. eight episodes; P less than 0.001). Metoclopramide was more effective in decreasing the volume of emesis than was alizapride (median of 100 ml vs. 360 ml; P less than 0.02). Seventy-two percent of the patients receiving alizapride and 57% of those receiving metoclopramide experienced side effects. High-dose metoclopramide is an effective antiemetic in patients receiving cancer chemotherapy. Alizapride is less effective and has more side effects than metoclopramide. We do not recommend the further use of alizapride. PMID- 3519042 TI - Effect of clonidine on plasma cortisol concentrations. AB - There is a debate whether the fall in plasma cortisol concentrations after the early morning dosing of clonidine represents drug effect or normal diurnal variation. We compared the cortisol patterns of children after a 7:30 AM oral dose of clonidine (0.075 or 0.150 mg/m2) with the cortisol concentrations that resulted from diurnal variation. Some subjects had the diurnal study on day 1 and the clonidine study on day 2, whereas for others the testing sequence was reversed. Our results indicate that clonidine, in either dose, does not cause a fall in plasma cortisol levels greater than that with normal diurnal variation. PMID- 3519043 TI - Acute effects of increasing doses of urapidil in patients with hypertension. AB - In a randomized, double-blind, dose-ranging trial, the acute antihypertensive effects of 7.5, 15, 30, 45, 60, 90, and 120 mg single daily doses of urapidil were compared with those of placebo in 10 patients with essential hypertension. Patients were randomized to either urapidil or placebo, such that each active drug day was followed by a placebo washout day. Blood pressure and heart rate responses were measured in the supine position, immediately upon standing, and after 3 to 5 minutes of standing for each dose. A variable but significant reduction in systolic and diastolic blood pressures that lasted from 4.5 to 8 hours was observed primarily at the 60, 90, and 120 mg doses (P less than 0.05). The maximum reduction in diastolic blood pressure occurred in the standing position at 3 to 5 hours after dosing. When urapidil was compared with placebo, a change from the supine to the standing positions produced a significantly larger reduction in systolic and diastolic blood pressures (P less than 0.05) but no significant change in heart rate. This suggests an acute blood pressure lowering effect of urapidil that occurs predominantly in the standing position and that does not significantly increase heart rate. PMID- 3519044 TI - High levels of growth hormone and human placental lactogen in pregnancy complicated by diabetes. AB - The possible involvement of growth hormone (GH) and human placental lactogen (HPL) in the development of diabetic tissue damage during pregnancy was studied in 16 insulin-dependent diabetic patients (IDDM), 8 gestational diabetic patients (GD) and 14 normal pregnant women. GH and HPL were elevated in pregnancies complicated by diabetes but, in contrast to the rise of HPL, GH declined throughout pregnancy in all the groups studied. The concentrations of neither correlated with plasma glucose, insulin requirement or duration of diabetes. HPL was positively correlated with urinary albumin excretion (UAE) in all 3 groups, but with blood pressure only in the IDDM group. There was also a significant and positive correlation in all patients between HPL at the end of pregnancy and placental weight. No evidence of serious tissue damage was found in either diabetic group. The vibration sensory threshold was unaffected by pregnancy and was similar to that of normal women. However, in the IDDM group UAE increased significantly postpartum when compared with second trimester values; they also had higher UAE than the other 2 groups post-delivery. A small but significant rise in diastolic blood pressure (DBP) was found in the 3 groups studied between the second and third trimester and pre-delivery. The same trend in systolic blood pressure (SBP) was seen in the diabetic groups. The IDDM had higher systolic and diastolic blood pressures than the normal women at all stages of gestation. PMID- 3519045 TI - Arginine-stimulated acute phase of insulin secretion in non-insulin-dependent diabetes in the young. AB - The acute insulin response to a 5 g pulse of arginine monohydrochloride was studied in 10 patients with non-insulin-dependent diabetes in the young (NIDDY) and 10 age-, weight- and sex-matched control subjects. All diabetics belonged to families in which non-insulin-dependent diabetes was transmitted through 3 generations. Mean peak insulin responses were similar in both groups (84.1 +/- 10.6; 68.2 +/- 8 microU/ml, p greater than 0.5). However, it is well known that hyperglycaemia accentuates the insulin response to non-glucose stimuli. To test this hypothesis, 5 of the diabetics were subjected to an intravenous insulin tolerance test, prior to the administration of the arginine pulse. At this lowered glucose level, the beta-cell secretory response was significantly decreased in the diabetics (C-peptide peak responses 2.5 +/- 0.3 vs 4.4 +/- 0.7 ng/ml, p less than 0.02). Thus it can be concluded that hyperglycaemia enhances the insulin secretory response to non-glucose stimuli and that following correction of the hyperglycaemia patients with NIDDY have an attenuated insulinaemic response. PMID- 3519046 TI - Specific thromboxane synthetase inhibition and retinopathy in insulin-dependent diabetics. AB - We have previously reported that specific thromboxane synthetase inhibition may be associated with a reduction in albumin excretion rate in insulin-dependent diabetics (IDD). We now report studies of retinal morphology assessed by serial fluorescein angiography in 25 insulin-dependent diabetics during a 16-week double blind, randomized, placebo-controlled study of the specific thromboxane synthetase inhibitor UK-38,485. Assessment of angiograms was by, computerized image analysis indicating the percentage area of vascularization and, panel scoring by 4 ophthalmologists who scored the posterior pole in each of the 4 angiograms "blind" according to a prearranged system. There was no significant change in percentage area of vascularization in either placebo or "active" group during the study. Panel scoring, however, suggested that some patients deteriorated whilst others remained unchanged or improved. There was, however, no significant difference in these parameters between those subjects on UK-38,485 and those on placebo. We conclude that specific thromboxane synthetase inhibition is not associated with any significant change in diabetic retinopathy over a 4 month period of study. PMID- 3519047 TI - Optimizing glycemic control: can insulin dependent diabetic patients rely on their perception of blood glucose fluctuations in order to make therapeutic decisions? AB - 30 insulin dependent diabetic (IDD) patients without clinically evident autonomic neuropathy were asked on 128 occasions to estimate quantitatively what they believed their capillary blood glucose (CBG) to be (predicted blood glucose--PBG) immediately before an actual CBG measurement was performed (real blood glucose- RBG). A statistically significant correlation was found between the pooled RBG's and PBG's of our patient population (r = 0.57, p less than 0.001). However, there was a notable skewing of the RBG/PBG curve, evidencing a tendency of our patients' predictions to be closer to normality. This is further documented by the fact that the mean M value of the RBG's of each of the 11 patients with more than 6 predictions was significantly greater than the mean M value of the corresponding PBG's. Within the ranges of hypoglycemia (RBG less than or equal to 3.3 mmol/l) and of normoglycemia (3.4-7.8 mmol/l) there was no correlation between RBG's and PBG's. With RBG's greater than or equal to 7.8 mmol/l the correlation was statistically significant (r = 0.41, p less than 0.01). When the pooled predictions were analyzed according to qualitative accuracy for different ranges of RBG the following trend emerges: for RBG's less than or equal to 3.3 mmol/l (60 mg%), 2/11 predictions were accurate (18%), for RBG's greater than or equal to 12.3 mmol/l (221 mg%), 30/37 (81%) and for RBG's between 3.4 and 12.2 mmol/l (61-220 mg%), 44/80 (55%). In conclusion, our patients as a whole showed an ability to discriminate between high, normal and low levels of blood glucose, albeit with a strong bias to predict values closer to the normal range.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3519048 TI - Variability of left ventricular function at diagnosis and after treatment in insulin-dependent diabetes. AB - Measurements of left ventricular ejection fraction (LVEF) were made using nuclear angiography in 9 newly-diagnosed insulin-dependent diabetic patients at diagnosis and after a period of stable control. Similar measurements were made in a control group of 10 insulin-dependent patients whose control was stable. While mean LVEF did not change significantly in either group, 5 of the newly-diagnosed patients had a significant change in LVEF (both positive and negative). None of the stable diabetic patients had any significant change in LVEF. Analysis of variance of the changes in LVEF in both groups showed a significant difference (p less than 0.002). Abnormal left ventricular function in diabetic patients may be transient, reversible and related to change in diabetic control and need not indicate structural myocardial disease such as cardiomyopathy. PMID- 3519049 TI - The diabetic response of weanling sand rats (Psammomys obesus) to diets containing different concentrations of salt bush (Atriplex halimus). AB - Understanding the sand rat's metabolic responses is necessary in order to employ the animal gainfully in the study of diabetes. Weanlings are most susceptible to the effect of diabetogenic diets. In the present experiment, weanling sand rats were fed diets at 3 levels of energy intake. The diets were based on pellets composed of different ratios of salt bush (Atriplex halimus) and a standard laboratory animal chow pellet. The results showed a significant correlation between the level of energy intake, percent body fat and signs of Type 2 diabetes. Animals with 28-30.6% body fat had blood glucose levels of 260 +/- 66 mg% and plasma insulin concentrations of greater than 558 mu u/ml, and those with 17.9-24.0% body fat had a blood glucose level of 107 +/- 19.8 mg% and a plasma insulin level of 222 +/- 35 mu u/ml. Animals with approximately 10% body fat, had a blood glucose level of 60 +/- 1.9 mg% and a plasma insulin concentration of 35 +/- 10 mu u/ml. The fattest animals had the highest percentage of glycosylated hemoglobin. The animals with the highest quantity of fat receiving high caloric intake had a lower lean body mass than those of similar weight exposed to a lower caloric intake. This result could be accounted for by assuming that the extreme hyperinsulinemia promoted fat production at the expense of lean body mass. PMID- 3519050 TI - Monoclonal antibodies against isoelectrically focused Nocardia asteroides proteins characterized by the enzyme-linked immunoelectro-transfer blot method. AB - Sera from rabbits immunized with culture filtrates and homogenates of Nocardia asteroides B1042 gave at least eight precipitin bands by immunoelectrophoresis. At least 20 proteins with isoelectric points (pls) in the pH 4 to 5.4 range were observed in isoelectric focusing patterns. The enzyme-linked immunoelectro transfer blot (EITB) assay showed that several of the isofocused proteins reacted with rabbit antisera and with sera from nocardiosis and tuberculosis patients. Antibodies against three proteins with pls of 4, 4.43, and 4.68 (antigenic factors 1,6,8) were present in nocardiosis patients' sera. The proteins were excised from isofocused gels, and IgG monoclonal antibodies (MAbs) were produced by the hybridoma method. MAbs against factors 1 and 6 did not crossreact with cytoplasmic antigens of Mycobacterium chelonae, M. intracellulare serotypes 4B and 8A, M. fortuitum, M. gordonae, or M. kansasii in the EITB method. Factor 8 (MAb) crossreacted with antigens of M. intracellulare and M. fortuitum. PMID- 3519052 TI - The stereotactic radiosurgery unit in Sheffield. PMID- 3519051 TI - The value of oblique scans in the ultrasonic examination of the abdominal aorta. AB - A method of scanning the abdominal aorta using oblique scan plans is described. In 150 patients attending for abdominal ultrasound scans these additional views resulted in an increased visualisation of the aorta and allowed the origin of both renal arteries to be demonstrated in 79% of patients; the right renal artery alone was demonstrated in 92% of patients. PMID- 3519053 TI - The optimal concentration of contrast medium for aortography and femoral arteriography: a comparison of Hexabrix 320 and Hexabrix 250. AB - A prospective double-blind randomised clinical trial of aortography and iliofemoral arteriography in 89 patients demonstrates that there is no difference in the diagnostic quality of the studies when Hexabrix 250 replaces Hexabrix 320. There is a minor reduction in patient subjective reaction, and the lower viscosity permits the use of smaller bore catheters. The major gain is that the cost of the contrast medium should be reduced by 22%. PMID- 3519054 TI - Virulence factors of urinary pathogens. PMID- 3519056 TI - Effect of indirect heating on the postural control of skin blood flow in the human foot. AB - It has been shown in previous studies that skin blood flow in the human foot falls when the extremity is placed below heart level, owing to an increase in precapillary resistance that is probably mediated by a local sympathetic axon reflex or a myogenic response. In order to clarify the influence of the central thermoregulatory mechanisms on this local postural vasoconstrictor response, 12 normal male subjects were studied under standardized conditions, at rest and during heating of the trunk with an electric blanket. Skin blood flow was measured before and during body heating using laser Doppler flowmetry with the foot maintained at heart level and placed passively 50 cm below the heart. Skin blood flow and skin temperature were determined at two sites: the plantar surface of the big toe, an area with a relatively large number of arteriovenous anastomoses, and the dorsum of the same foot, where these anastomoses are few or absent. When the foot was placed in the dependent position, skin blood flow recorded in the dorsum of the foot during indirect heating fell to a level similar to that achieved before heating. In contrast, indirect heating greatly diminished the postural fall in skin blood flow recorded in the plantar surface of the big toe. In conclusion, the partial release of sympathetic vasoconstrictor tone associated with indirect heating appears to over-ride the local postural control of cutaneous vascular tone in areas where arteriovenous anastomoses are relatively numerous. PMID- 3519055 TI - Mammalian mannose-binding proteins. PMID- 3519057 TI - Mechanisms of hepatic uptake of organic anions. PMID- 3519058 TI - Effect of guar on second-meal glucose tolerance in normal man. AB - Whole body glucose turnover and absorption of a 50 g glucose drink was studied in six healthy volunteers on two occasions, 4 h after a 'breakfast' of 50 g of glucose, mixed on one occasion with 20 g of guar gum. Plasma glucose concentrations were significantly reduced with guar gum compared with those obtained without guar gum (P less than 0.0001). Whole body glucose turnover studied by an intravenous primed dose constant infusion technique using D-[3 3H]glucose showed no significant difference between the two groups: 353 +/- 15 mmol with guar and 350 +/- 9 mmol without guar. Total oral glucose absorption, followed with a D-[1-14C]glucose tracer, was significantly decreased by guar treatment, being 219 +/- 3 mmol with guar and 239 +/- 5 mmol without guar (P less than 0.05). Serum insulin levels were lowered by guar treatment (P less than 0.05) while those of C-peptide, gastric inhibitory polypeptide, glucagon, cortisol and pancreatic polypeptide did not differ significantly. Blood lactate concentrations were raised in the guar treated group (P less than 0.05) whereas pyruvate, alanine, glycerol and 3-hydroxybutyrate concentrations did not differ significantly. These results support the suggestion that guar improves second meal tolerance to glucose by decreasing absorption. PMID- 3519059 TI - Current concepts in clinical therapeutics: major affective disorders, Part 1. AB - The epidemiology, pathophysiology, diagnosis and clinical features, and treatment of unipolar (depressive) and bipolar (manic-depressive) affective disorders are described. Disturbances of mood are the most common psychiatric disorders in adults, with 18-23% of women and 8-11% of men having at least one major depressive episode. Genetic factors are important in both depression and manic depressive illness. Depression is characterized by a persistent dysphoric mood accompanied by feelings of sadness or hopelessness nearly every day for at least two weeks. The essential feature of a manic episode is an elevated, expansive, or irritable mood associated with symptoms such as hyperactivity and lack of judgment. Treatment involves nonpharmacologic and pharmacologic interventions. Psychotherapy in patients with depression is most useful in improving social functions, while antidepressant drugs reduce relapse rates. Electroconvulsive therapy is indicated in depressed patients at immediate risk of suicide or extreme incapacitation. Tricyclic antidepressants (amitriptyline, imipramine, doxepin, notriptyline, desipramine, trimipramine), second-generation antidepressants (maprotiline, amoxapine, trazodone, bupropion), monoamine-oxidase inhibitors (phenelzine, isocarboxazid, tranylcypromine, pargyline), and lithium are useful in treating patients with affective disorders. Tricyclic agents are the mainstay of treatment for depression; newer second-generation agents should be used in specific subgroups of patients. Lithium is the drug of choice for prophylaxis in bipolar patients, whereas combinations of lithium and tricyclic agents are useful during acute episodes of depression in bipolar patients. Major affective disorders occur commonly and require a careful balance of pharmacologic and nonpharmacologic interventions for proper therapy. PMID- 3519061 TI - [Randomized clinical study of the efficacy of buflomedil in the prevention of recurrence of cerebral ischemia in comparison with anti-platelet aggregation agents]. PMID- 3519060 TI - [Drug therapy possibilities for the senile heart]. PMID- 3519062 TI - [Clinical experimentation with orgotein]. PMID- 3519063 TI - [Ewing's sarcoma: current status of its therapy]. PMID- 3519064 TI - Metabolic defects in severe combined immunodeficiency in man and animals. AB - Severe combined immunodeficiency (SCID) was originally thought to be one disease. Accumulating evidence indicates that SCID is a heterogeneous group of diseases that are clinically similar but are caused by quite different biochemical abnormalities. The best-studied form of SCID is that associated with an autosomal recessive inheritance pattern of adenosine deaminase (ADA) deficiency. Several biochemical mechanisms have been postulated to explain how a deficiency of ADA causes immune dysfunction. In forms of SCID not associated with ADA deficiency, other biochemical abnormalities have been detected. These abnormalities include deficiency in biotin-dependent carboxylases, alteration in lymphocyte surface membranes and irregularities in cytokine production. Two animal models for SCID now exist. Neither of these models is associated with ADA deficiency. Evidence for a possible defect in purine metabolism in one model has been demonstrated. PMID- 3519065 TI - The role of polyunsaturated fatty acids in fish. AB - The physical properties of polyunsaturated and saturated fatty acids are compared in relation to melting points and fluidity. The role of polyunsaturated fatty acids on membrane fluidity and membrane bound enzyme activity is discussed. The influence of the environment, particularly temperature, on poikilothermic animals is considered in relation to membrane fatty acid composition and metabolism. The metabolic role of polyunsaturated fatty acids of the (n-3) series and their interaction with arachidonate metabolism is discussed. PMID- 3519066 TI - Comparative biochemistry of acid proteinase from animal origins. AB - Acid proteinases from 17 tissues of 12 animal species were compared with respect to molecular weight, inhibition by pepstatin and activation by tripolyphosphate. Gel filtration of acid proteinases from protochordates and vertebrates showed a common elution profile and three peaks with mol. wts of -20,000, -45,000 and above 150,000 were detected with acid-denatured hemoglobin as substrate at pH 3.6. The main component of vertebrate acid proteinases was identified as cathepsin D. In the invertebrate acid proteinases, the elution profiles through gel filtration were characteristic to the tissues examined, and were not so distinct as those of vertebrates. Through a biochemical survey, the animal acid proteinase was discussed from a comparative point of view. PMID- 3519067 TI - Bacteriolytic factor in the salivary glands of Aedes aegypti. AB - Salivary gland homogenates from adult Aedes aegypti lyse Micrococcus lysodeikticus cells. The bacteriolytic factor is present in a cell type common to both male and female mosquitoes, as well as in the crop of sugar-feeding mosquitoes. The bacteriolytic factor releases digestion products from sacculi of Escherichia coli that are different from those of hen egg white lysozyme. PMID- 3519068 TI - Liver cytosolic fatty acids binding proteins in rats and Psammomys obesus: modulation in diabetes. AB - The effect of insulin on [3H]oleate binding to delipidated liver cytosolic proteins was studied in four groups of animals: untreated rats, streptozotocin induced diabetic rats, Psammomys obesus fed salt bush diet, and Psammomys obesus fed ordinary laboratory chow. The distribution of the protein bound [3H]oleate between low and high molecular weight cytosolic proteins in Psammomys differed from the distribution found in rats. Diet induced high insulin diabetes in Psammomys and streptozotocin induced low insulin diabetes in rats, modulated [3H]oleate binding in the same manner. PMID- 3519069 TI - Self-help computer conferencing. AB - Computer conferencing has become popular as an alternative to face-to-face conferencing in many kinds of organizations. Since users can participate at any time, from any terminal, computer conferencing makes communication very convenient, though many find the medium to be impersonal. This paper discusses the potential of computer conferencing to increase the number of people who participate in self-help groups, such as groups to help people lose weight or stop smoking. The kinds of interactions that make for successful self-help groups might be encouraged by a computer-conferencing format, even though there is no direct, face-to-face contact. The results of a trial smoking-cessation program which employed computer conferencing suggest that computer conferencing could play a useful role in health promotion. PMID- 3519070 TI - Knowledge-based landmarking of cephalograms. AB - Orthodontists have defined a certain number of characteristic points, or landmarks, on X-ray images of the human skull which are used to study growth or as a diagnostic aid. This work presents the first step toward an automatic extraction of these points. They are defined with respect to particular lines which are retrieved first. The original image is preprocessed with a prefiltering operator (median filter) followed by an edge detector (Mero-Vassy operator). A knowledge-based line-following algorithm is subsequently applied, involving a production system with organized sets of rules and a simple interpreter. The a priori knowledge implemented in the algorithm must take into account the fact that the lines represent biological shapes and can vary considerably from one patient to the next. The performance of the algorithm is judged with the help of objective quality criteria. Determination of the exact shapes of the lines allows the computation of the positions of the landmarks. PMID- 3519071 TI - A diagnostic method that uses causal knowledge and linear programming in the application of Bayes' formula. AB - Bayes' formula has been applied extensively in computer-based medical diagnostic systems. One assumption that is often made in the application of the formula is that the findings in a case are conditionally independent. This assumption is often invalid and leads to inaccurate posterior probability assignments to the diagnostic hypotheses. This paper discusses a method for using causal knowledge to structure findings according to their probabilistic dependencies. An inference procedure is discussed which propagates probabilities within a network of causally related findings in order to calculate posterior probabilities of diagnostic hypotheses. A linear programming technique is described that bounds the values of the propagated probabilities subject to known probabilistic constraints. PMID- 3519072 TI - Diabetes: injecting confidence. PMID- 3519073 TI - Medicare fee freeze. PMID- 3519074 TI - Hemianopia, hemiachromatopsia and the mechanisms of alexia. PMID- 3519075 TI - Norman Geschwind (1926-1984). PMID- 3519076 TI - Histones and their modifications. AB - Histones constitute the protein core around which DNA is coiled to form the basic structural unit of the chromosome known as the nucleosome. Because of the large amount of new histone needed during chromosome replication, the synthesis of histone and DNA is regulated in a complex manner. During RNA transcription and DNA replication, the basic nucleosomal structure as well as interactions between nucleosomes must be greatly altered to allow access to the appropriate enzymes and factors. The presence of extensive and varied post-translational modifications to the otherwise highly conserved histone primary sequences provides obvious opportunities for such structural alterations, but despite concentrated and sustained effort, causal connections between histone modifications and nucleosomal functions are not yet elucidated. PMID- 3519077 TI - Physicochemical properties of oilseed proteins. AB - This review attempts to consolidate the information on the physicochemical properties of proteins from groundnut, soybean, sesame seed, mustard seed, rapeseed, sunflower seed, cottonseed, and other oilseeds. It deals with the extraction and characterization of the oilseed proteins and describes the methods for isolation of the various protein fractions and determination of their physicochemical characteristics. Also discussed are the subunit composition of the oligomeric proteins, their hydrodynamic properties, and the effect of denaturants on these proteins. The similarity in the properties of the proteins from various oilseed materials is discussed. The review article aims to indicate the gaps in our knowledge about the physicochemical properties of oilseed proteins and suggests areas for future investigation. PMID- 3519078 TI - Insulin worsens ischemia-induced myocardial contracture in the isolated rat heart. AB - We used a modification of Langendorff's isolated perfused nonworking rat-heart model to study the effects of diabetes, insulin-treated diabetes, and hyperinsulinemia on left ventricular pressure, force of ventricular contraction, and myocardial contracture, before, during, and after 20 min of complete normothermic global ischemia. Untreated diabetic rat hearts behaved the same as normal hearts, but insulin-treated diabetic hearts had more ischemic and postischemic contracture (p less than .01), and less return of left ventricular function. Chronic insulin treatment potentiated ischemic contracture in diabetic and nondiabetic rat hearts. These results support the hypotheses that insulin can increase Ca++ actin-myosin ATPase activity, and increase the affinity of myofibrillar receptors for calcium, which may lead to increased ischemic contracture. Insulin as a risk factor in myocardial ischemia, cardiothoracic surgery and cardiac resuscitation, and other pathogenetic factors of "stone heart" development, deserve further investigation. PMID- 3519079 TI - Calcium uptake during insulin-aggravated ischemic myocardial contracture in the rat heart. AB - Perfusion of isolated, nondiabetic rat hearts with high concentrations of regular insulin (10 mU/ml) produced earlier onset of myocardial contracture during ischemia than control perfusions without insulin. High insulin concentrations also increased total myocardial calcium content (p less than .001) and myocardial Ca-45 uptake postischemia (p less than .05). Insulin perfusion before ischemia did not enhance calcium uptake. These results support the hypothesis that insulin may increase calcium movement across myocardial cell membranes, which may lead to increased ischemic contracture. Insulin-aggravated myocardial ischemia in cardiothoracic surgery and cardiac resuscitation deserves further investigation. PMID- 3519080 TI - Paget disease: unusual radiographic manifestations. AB - Paget disease (osteitis deformans) is not a difficult diagnosis when presented with typical radiographic features. However, an atypical appearance or an unusual location can be a diagnostic challenge, so we have emphasized the less common presentations, with their diagnostic clues. We have also considered such complications as malignant degeneration, fracture, and coexistent systemic disease, which can obscure the underlying Paget disease. The etiology, pathogenesis, and effects on bone structure and function attributed to Paget disease are updated. PMID- 3519081 TI - Diagnostic imaging of abdominal fluid collections and abscesses. AB - With today's advanced technology, the clinician and radiologist have a number of techniques with which to evaluate the abdomen for fluid collections and/or abscesses. Three points are clear from the plethora of literature concerning this subject: the need to individualize the clinical and imaging approach to each patient suspected of an abnormal fluid collection or abscess, the need to individualize the imaging procedure based upon what is done best at the institution, and the need for percutaneous aspiration of all fluid collections for diagnosis. No single imaging test is totally sensitive or specific for the detection of an infected fluid collection. Overall, CT probably does provide the most accurate means to detect an intra-abdominal abscess. Because of this, and because it is less operator dependent than ultrasound, CT is used most often as the procedure of choice at our institution. PMID- 3519082 TI - Ultrasound instrumentation. AB - This article begins by reviewing the basic physical principles of ultrasound emphasizing those factors which control the resolution of the ultrasound image. It next proceeds to a discussion of the types of ultrasound instruments currently available for diagnostic use including their method of image production and focusing as well as the system utilized for creating a real-time image. The types of scanners currently available are then grouped by certain common characteristics and the strengths and weaknesses of each type of instrument is examined. There is also a discussion of specialized ultrasound scanners such as dedicated breast scanners and doppler instruments. Finally, the paper concludes with recommendations for the most suitable instrument for various clinical situations. PMID- 3519083 TI - Crohn's disease of the upper gastrointestinal tract. AB - The transmural granulomatous inflammation of chronic nature which characterizes the Crohn's disease involves primarily the terminal ileum and colon. However, the upper gastrointestinal tract may also be affected by the same histopathological process, usually co-existent with or following Crohn's disease of the ileocecal region. Such cases can present a formidable diagnostic challenge if the clinical, endoscopic and radiographic findings are not correlated. This article describes and illustrates the spectrum of radiological manifestations of Crohn's disease and its associated complications involving the esophagus, stomach and duodenum. PMID- 3519084 TI - Effects of temperature on food proteins and its implications on functional properties. AB - This article surveys the knowledge in the area of protein structure and chemistry of denaturation prior to an indepth review of the effects of heat on soy, milk, and egg proteins. It also reviews the methods available to assess denaturation of proteins. Protein denaturation is an ambiguous phenomenon and the consequences of denaturation on the functional properties of proteins is further confounded by this ambiguity. For each of the three food proteins, the known chemistry of individual proteins is reviewed followed by observations made on changes induced by heat in each protein group. Food proteins are not pure entities and purification and physicochemical characterization of various components of the food proteins have not been thoroughly investigated. Further, food is a complex milieu of water, fat, carbohydrate, vitamin, minerals, etc. along with proteins, and processing affects not only each individual component in the food but also the nature and intensity of intercomponent interactions in a food. PMID- 3519085 TI - Off-flavors in milk. AB - This report is a review of off-flavors encountered in fluid milk. It includes sections on transmitted, microbial, lipolyzed, heated, light-activated, oxidized, and miscellaneous flavors. Finally, the flavor of ultrahigh temperature (UHT) milk is reviewed. Most of the literature cited for different off-flavors covers the period since a comprehensive review was done of milk flavors by Strobel et al. (1953). In addition to causative agents and volatile materials associated with off-flavors, methods for control of each of the off-flavors are presented. This report is designed to serve the dairy production and processing industry, students and faculty of food science curricula, dairy product evaluation students, regulatory people, and fieldmen. PMID- 3519086 TI - Radiation preservation of foods of plant origin. Part IV. Subtropical fruits: citrus, grapes, and avocados. AB - Current information on the use of ionizing radiation for improving the storage of subtropical fruits like citrus, grapes, and avocados is reviewed. The feasibility of applying radiation either alone or in combination with other physical or chemical treatments for the control of postharvest fungal diseases is considered. Irradiation effects on the physiology of the fruits as related to respiration, ethylene evolution, changes in major chemical constituents, and quality are discussed. The recent trends in the possible use of irradiation as an alternative treatment to chemical fumigants for disinfestation of citrus and avocados and the prospects for the future application of irradiation for preservation of some of these fruits are outlined. PMID- 3519087 TI - Metabolic activation of mutagenic heterocyclic aromatic amines from protein pyrolysates. AB - Mutagenic heterocyclic amines are metabolized to mutagens which act directly on Salmonella typhimurium by P-448 forms of cytochrome P-450. These direct mutagens are N-hydroxylated heterocyclic amines, such as N-hydroxy-Trp-P-1, N-hydroxy-Trp P-2, N-hydroxy-Glu-P-1, N-hydroxy-Glu-P-2, N-hydroxy-IQ, N-hydroxy-2-amino-alpha carboline (N-hydroxy-A alpha C), and N-hydroxy-2-amino-3-methyl-alpha-carboline (N-hydroxy-MeA alpha C). The treatment of rats with polychlorinated biphenyl stimulated N-hydroxylation of heterocyclic amines about 10- to 260-fold depending on the substrates used. The N-hydroxylation activities of purified cytochrome P 448-H and P-448-L were markedly different. P-448-H, which had very low activity for benzo[a] pyrene metabolic activation, showed high N-hydroxylation activity. The activity ratio P-448-H:P-448-L was markedly different depending on the amines used. This ratio was 45, 22, 3, and 0.02, respectively, for Glu-P-1, IQ, Trp-P-2, and benzo[a] pyrene. On the other hand, N-acetylation of the heterocyclic amines was very low. Although marked species differences in the N-acetylation were observed, the activities of the heterocyclic amines were about 1/100 of that of 2 aminofluorene. N-Hydroxy-Trp-P-2 could react directly to DNA, but N-hydroxy-Glu-P 1 could not. Therefore we need to consider the presence of a further activating system in mammalian and bacterial cells. We observed that N-hydroxy-Trp-P-2 was activated by prolyl-t-RNA synthetase, but N-hydroxy-Glu-P-1 was not activated by the same system. In the bacterial cells, both N-hydroxy-Trp-P-2 and N-hydroxy-Glu P-1 were not activated by prolyl-t-RNA synthetase. However, both hydroxylamines were activated by the acetyl-CoA-dependent mechanism in mammalian and bacterial cells. These results indicated that the O-acetylation is an important pathway for DNA damage by heterocyclic amines in chemical carcinogenesis. PMID- 3519088 TI - Respiratory effects of inhaled isocyanates. AB - Numerous industrial chemicals are known to cause allergic reactions in the lung. Prominent among such chemicals are isocyanates, the starting material in the production of polyurethanes. In view of the extensive worldwide production of isocyanates (1.5 million metric tons per year), and the diversity of products manufactured from isocyanates (i.e., cars, airplanes, furniture, bedding, etc.) there is considerable potential for adverse health effects associated with exposure to isocyanates. Syndromes of immediate respiratory reactivity, delayed onset sensitivity, and hypersensitivity pneumonitis have all been associated with isocyanate exposure. However, little is known concerning how sensitivity develops, which individuals are most likely to become sensitized, or how to best detect early sensitivity. Answers to such questions are beginning to emerge from the recent development of animal models of lung sensitivity. These models will be discussed together with their application to clinical situations. PMID- 3519089 TI - Experimental ocular malignant melanoma in Sinclair swine. AB - An animal model of malignant melanoma of the eye was established by transplanting a cell suspension from cutaneous melanomas into the anterior chamber of the eye in Sinclair Farm miniature swine. The frequency of tumor takes in the eye was increased from 8.9% to 22% by treating the animals simultaneously with subconjunctival triamcinolone acetonide. As an animal model for hematoporphyrin derivative--photoradiation treatment of human malignant melanoma of the eye, this does not appear to be a good research tool because of the sporadic incidence of tumor takes, the rapid growth of tumor within the eye causing glaucoma, and the dark iris pigmentation of successful tumor takes, which hides extensive underlying ciliary body tumor. PMID- 3519090 TI - Morphological study of epiretinal membrane following posterior penetrating injury in the monkey eye. AB - Posterior vitreous detachment (PVD) and epiretinal membranes occur in a number of vitreoretinal diseases. We have developed an experimental model in which we can provide the morphologic correlation of these dynamic processes. The method provides the opportunity to study epiretinal membrane formation with the scanning electron microscope (SEM); with SEM, some epiretinal membranes that could not be readily detected either clinically or by routine light microscopy can now be identified and studied in detail. We performed an experimental posterior penetrating injury with injection of autologous whole blood or blood and lens material into the vitreous. Five eyes with posterior vitreous detachment but no retinal detachment were selected for SEM. A reduction in the cortical vitreous filaments and the presence of epiretinal membranes was apparent with SEM. In most areas the epiretinal membranes were separated from the internal limiting membrane by a narrow cleft; however, limited attachment sites between the epiretinal membranes and retina were observed in areas overlying retinal blood vessels. In two eyes we observed microscopic retinal folds beneath the membranes, demonstrating a possible morphologic correlation between epiretinal cellular contraction and traction on the retina. PMID- 3519091 TI - Autoimmunity against corneal antigens. I. Isolation of a soluble 54 Kd corneal epithelium antigen. AB - Corneal epithelium antibodies were detected in patients with corneal melting disease and uveitis using an immunofluorescence technique with cryostat sections of corneas obtained from various species (man, guinea pig, rabbit, mouse, rat, cow, pig). No differences in results were found using these various substrates, indicating that the autoimmune response is directed against common non-species specific corneal epithelium antigens. The serum of a patient with corneal melting disease, containing a high antibody titer against corneal epithelium was used to identify and isolate one of the bovine corneal antigens. A 54,000 dalton protein was isolated, which was shown to be the major protein present in the corneal epithelium. Absorption studies with other tissues taken from human eyes showed that cornea epithelium, cornea devoid of epithelium, ciliary body and retina contained material which cross-reacted with the isolated bovine corneal epithelium antigen, whereas iris and sclera showed no detectable cross-reaction. The incidence of autoantibodies directed against this antigen was investigated in patients with corneal melting disease, corneal transplantion and in uveitis patients using an ELISA and comparing the results with those obtained with the immunofluorescence assay on rabbit cornea sections. A positive ELISA was always associated with a positive immunofluorescence test. The presence of antibodies against the 54 Kd antigen as detected by the ELISA could be confirmed by immunoblotting in 7 out of 9 positive sera tested. A large number of sera showed a positive immunofluorescence test but a negative ELISA against the 54 Kd corneal epithelium antigen.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3519092 TI - Acebutolol in the treatment of diabetic patients with hypertension. AB - A double-blind, parallel group comparison study was carried out in 20 diabetic patients with mild to moderate hypertension to assess the effectiveness and tolerance of acebutolol compared with placebo. After a 4-week wash-out period on placebo, patients received either 400 mg acebutolol or placebo once daily for 12 weeks and then placebo for a further 4 weeks. The results showed that acebutolol was more effective than placebo in lowering raised blood pressure in these patients. No deterioration in diabetic control occurred during the study and no significant side-effects of the drug were observed compared with placebo. In particular, the previously described side-effects of beta-blocker therapy in diabetic patients were not observed as a clinical problem in this study. PMID- 3519093 TI - A double-blind controlled study to compare the efficacy of an antacid plus oxethazaine with that of an antacid alone in the treatment of pain due to gastric or duodenal ulceration. AB - A double-blind study was carried out in 40 patients with typical ulcer pain and suffering from gastric or duodenal ulcer to compare the pain-relieving efficacy of oxethazaine/magnesium and aluminium hydroxide mixture with that of the antacid combination alone. Patients took 8 ml doses of either treatment when necessary over a period of 4 weeks. Both treatment regimens were equally effective in reducing the painful symptoms of peptic ulceration, but the total volume of medication required to achieve adequate symptomatic relief was less in patients taking antacid plus oxethazaine than in patients taking antacid alone. It is suggested that the combination of oxethazaine plus antacids, therefore, is to be preferred, because, by allowing a reduction in the intake of antacid, the risk of side-effects due to antacid therapy is thereby reduced. PMID- 3519094 TI - A comparison of plasma and synovial fluid profiles of standard and controlled release formulations of ketoprofen in patients with rheumatoid arthritis. AB - The plasma and synovial fluid profiles of standard and controlled-release formulations of ketoprofen were compared in 8 patients with rheumatoid arthritis. During chronic dosing with both forms of ketoprofen, peak drug concentrations were lower and occurred later in the synovial fluid than in the plasma. These findings were more pronounced in the case of the controlled-release formulation. The apparent elimination half-life of standard ketoprofen in synovial fluid was prolonged compared to its half-life in plasma, a finding which has not been previously documented. This may explain the clinical observation that, despite a very short plasma elimination half-life, standard ketoprofen exerts a satisfactory therapeutic effect when given twice daily. There was no accumulation of ketoprofen from either formulation in synovial fluid after steady state had been achieved. It is suggested that future pharmacological studies with anti inflammatory agents should include both synovial fluid and plasma concentration data. PMID- 3519095 TI - Hexetidine ('Oraldene'): a report on its antibacterial and antifungal properties on the oral flora in healthy subjects. AB - A randomized, double-blind crossover trial, in 10 adult healthy subjects, was carried out to compare the antibacterial and antifungal activity of a 0.1% solution of hexetidine with that of placebo. The pre-dosing oral flora of the subjects was assessed from saliva samples cultured for aerobic and anaerobic bacteria, as well as Candida albicans. Subjects then rinsed their mouths for 1 minute 3-times a day with 15 ml 0.1% hexetidine or placebo, saliva samples being collected at 2 minutes, 30 minutes, 1 hour, 3 hours and 5 hours post-dosing. Dosing was continued for 8 consecutive days on each treatment with an intervening wash-out period of 1 week. Hexetidine reduced aerobic bacterial counts on Day 1 and Day 8 by a maximum of 83% and 86%, respectively, at 2 minutes post-dosing. The reductions were statistically significantly lower than placebo up to 1 hour post-dose on Day 1 and up to 3 hours post-dose on Day 8. Similarly for anaerobic bacterial counts, 92% and 88% maximum reductions were recorded on Day 1 and Day 8, which again were significantly lower than placebo for up to 3 hours post-dose. For Candida albicans, however, the maximum reduction was 91% on the first day and 67% on Day 8, maintained for 30 minutes post-dosing. Although not eradicating completely aerobic and anaerobic bacteria, it is concluded that the substantial reduction in their numbers should prove clinically useful. PMID- 3519096 TI - Trimipramine in rheumatoid arthritis: a randomized double-blind trial in relieving pain and joint tenderness. AB - The effect of low-dose trimipramine (25 to 75 mg/day) on joint pain and tenderness in 36 patients with rheumatoid arthritis was studied in a randomized double-blind trial carried out over a period of 12 weeks. The patients were pre selected to include only patients who were depressed on a 'self-rating depression scale' but had no evidence of fibrositic 'trigger-points'. The results showed that joint pain and tenderness were significantly reduced with trimipramine, but depression scores remained unchanged. PMID- 3519097 TI - Fipexide, an effective cognition activator in the elderly: a placebo-controlled, double-blind clinical trial. AB - Forty geriatric in-patients with severe cognition disorders were randomly allocated to treatment with either 600 mg fipexide daily or placebo over a period of 3 weeks. Before and after treatment, the symptoms of cognitive performance (disorders of memory and attention, asthenia, apathy and disorders of coenaesthesia) were monitored and scored. Similarly, the Thurstone test (symbol matching test) was performed and time to completion, number of errors and exactitude index were recorded. Haemodynamics, haematology and haematochemistry investigations were made before and after treatment, and accessory symptoms of potential side-reactions were monitored by positive questioning. Treatment with fipexide was associated with a significant improvement in each and all monitored symptoms and signs to an average extent of 60%, whereas placebo was not. Similarly, the patients given fipexide experienced a significant improvement in the Thurstone test, in terms of time to completion (-22%), number of errors ( 46%) and exactitude index (+60%); again, placebo was not associated with any significant improvement (variations, respectively, of -5%, -14%, and +24%). Overall, 85% of the patients given fipexide experienced clinical improvement to a greater or lesser degree, a significantly greater proportion than that associated with placebo (25%; p less than 0.001). Tolerance, both subjective and objective, was good in both treatment groups. PMID- 3519098 TI - Pediatric toxicology: current controversies and recent advances. PMID- 3519099 TI - Genetic control of the susceptibility to infection with pathogenic bacteria. PMID- 3519100 TI - Papules. PMID- 3519101 TI - Bullous skin lesion in familial Mediterranean fever. AB - An unusual painful bullous skin lesion of the foot occurred in a 49-year-old woman as the only clinical manifestation of familial Mediterranean fever. The lesion preceded other symptoms of the disease by several years and responded only to treatment with colchicine. Recognition of this peculiar skin lesion may lead to an earlier diagnosis of the disease. PMID- 3519102 TI - Use of colchicine in Behcet's syndrome. AB - Colchicine is of benefit in the treatment of ocular, articular, oral, and genital lesions in BS. Polymorphonuclear neutrophil function, which is important in the pathogenesis of the disease, is modified by the drug. There is no evidence that colchicine alters the tendency for this disease to become chronic; however, the drug lessens the severity of certain manifestations and does not have the more deleterious side effects of prolonged steroid and immunosuppressive regimens. PMID- 3519103 TI - Efficacy of Alpha Keri after showering for treatment of xerosis. AB - The use of Alpha Keri bath oil in a postshower therapeutic regimen was effective in reducing the severity of moderate to severe xerosis. PMID- 3519104 TI - Carbohydrate metabolism and the temporal occurrence of a serotonin-like indole in the male and female reproductive tract and its relationship with PGF and infertility: a review. AB - Both in the male and in the female reproductive tract glucose can be converted via either the pentose pathway or the sorbitol pathway. It is shown that a disturbed carbohydrate metabolism can lead to infertility, i.e. in the cow and in the bull semen. Evidence is provided that the serotonin-like indole which occurs in the protein-complex and is liberated, can exert effects on the uterine endometrium comparable to those caused by serotonin. It is suggested that the indole liberated can cause ischaemia, followed by regression of the endometrium. When this occurs in repeat breeder cows, exogenous PGF given in mid-cycle on a suitable day, may restore the endometrium so that the cow can again become pregnant. The possibility is mentioned that in humans the free indole might cause regression of the endometrium and some distress symptoms, but thereafter endogenous PGF does increase the vascular permeability resulting finally in bleeding. PMID- 3519105 TI - Platelets and plasma proteins in the early phases of thrombusformation. PMID- 3519106 TI - Maimonides, an enemy of authoritarianism. PMID- 3519108 TI - Organization, development and early results of a heart transplant program. The Johns Hopkins Hospital experience. AB - Improved survival and quality of life have resulted in a resurgence in cardiac transplantation and the proliferation of centers contemplating initiation of a transplant program. Organization of such a program requires cooperation among several clinical and non-clinical departments of the hospital. Prior to implementation of such a program, a number of issues need to be addressed, including state authorization, an expeditious method for donor organ retrieval, protocols for recipient selection and evaluation, and perioperative and follow-up care of the transplant recipient. Since July of 1983, 35 patients (27 men and eight women) have undergone orthotopic cardiac transplantation. Transplantation was undertaken for cardiomyopathy (30) or end-stage ischemic heart disease (5). The mean age was 38 years (range, 16 to 57 yrs). Distant organ procurement was used for 83 percent of patients; mean ischemic time was 164 min (range, 75 to 250 min). Current immunosuppressive regimen consists of oral cyclosporine (10 mg/kg) and prednisone. Mean follow-up was 10.3 months (range, two weeks to 27 months). Transient renal dysfunction appeared early in 15 patients. Six deaths have occurred: three from rejection, one from infection, one from metastatic prostate carcinoma, and one from pulmonary hemorrhage. All but three recent patients have been rehabilitated. These initial encouraging results are a result of careful planning, institutional commitment, adequate resources and, most importantly, a dedicated transplant team. PMID- 3519107 TI - Effects of periodic positive airway pressure by mask on postoperative pulmonary function. AB - Postoperative pulmonary complications, alveolar-arteriolar oxygen difference ([A a]O2-diff), peak expiratory flow (PEF) and forced vital capacity (FVC) were compared in patients using continuous positive airway pressure (CPAP) and positive expiratory pressure (PEP) administered by face mask against those of a control group using a deep-breathing device (Triflo). Forty-three consecutive, randomized patients undergoing elective upper abdominal surgery were included. CPAP, PEP and Triflo were administered for 30 consecutive breaths in every waking hour for three days postoperatively. The (A-a)O2-difference increased equally and significantly in the three groups after surgery, reaching a maximum on the first postoperative day. After this day, however, (A-a)O2-diff decreased in the CPAP and PEP groups, being significantly lower in the PEP group compared to the control group, two days postoperatively (p less than 0.05) and significantly lower in both the PEP and CPAP groups three days postoperatively (p less than 0.001 and p less than 0.05, respectively.) PEF did not differ significantly between the groups before or after surgery, while FVC was significantly higher in the PEP and CPAP groups, compared to control, on the third postoperative day (p less than 0.05). Atelectatic consolidation was observed in six of 15 patients in the control group three days postoperatively, the incidence being significantly lower in both the PEP group (0 of 15, p less than 0.001) and the CPAP group (one of 13, p less than 0.05). We concluded that periodic face mask administration of CPAP and PEP are superior to deep breathing exercises with respect to gas exchange, preservation of lung volumes and development of atelectasis after upper abdominal surgery. We also conclude that the simple and commercially available PEP mask is as effective as the more complicated CPAP system. PMID- 3519109 TI - Role of free radicals in lung injury. AB - Free radicals (and other toxic metabolites of oxygen) are generated in most cells as a consequence of normal metabolic processes, but cells are protected from injury by antioxidant mechanisms. Several forms of lung injury appear to result from generation of toxic metabolites of oxygen in quantities which exceed the antioxidant capacity of lung cells. Several manipulations which prevent free radical production or accumulation or enhance antioxidant capacity of lung tissue may prove to be useful therapeutically in acute and chronic diseases of the lungs. PMID- 3519110 TI - Medical management of head injury. PMID- 3519111 TI - Anticoagulant therapy in right-sided thromboembolic disease. PMID- 3519112 TI - Inducible beta-lactamases are principally responsible for the naturally occurring resistance towards beta-lactam antibiotics in Proteus vulgaris. AB - The role of inducible chromosomally mediated beta-lactamases was studied in 22 Proteus vulgaris isolates by monitoring enzyme induction in the presence of various inducers such as ampicillin, cefalothin, cefuroxime, cefsulodin, 6 aminopenicillanic acid (6-APS), and imipenem. 20 of the isolates exhibited resistance to ampicillin, cefalothin, and cefuroxime, whereas 2 isolates were susceptible to these compounds. In all resistant isolates marked inoculum effects could be observed. Enzyme production proved to be transient, i.e. maximum of enzyme production was achieved after 2 or 3 h. In both sensitive isolates enzyme production did not exceed 0.021 U beta-lactamase/mg protein of the cell-free supernatant even after induction with 6-APS or imipenem, whereas it ranged from 0.46 to 6.3 U in the resistant ones. Moreover, enzyme induction was found to be concentration-dependent, as revealed by the extensive study of one of the isolates (No. 4917). Three different enzymes could be distinguished by means of isoelectric focusing with isoelectric points at 7.4, 8.8, and approximately 9.5. In the presence of 2.5 mg/l clavulanic acid even strains known to be strong enzyme producers became as susceptible as the sensitive ones: moreover, the inocolum effect was markedly reduced. These findings make it apparent that it is above all the production of inducible enzymes that is responsible for resistance to beta-lactam antibiotics in P. vulgaris. PMID- 3519113 TI - [Ceramic-aluminum implants today]. PMID- 3519114 TI - [Margins of composite preparations, danger of secondary etching, scanning electron microscopy aspects]. PMID- 3519115 TI - [Restoration of cusped teeth using composite resins: direct or indirect method?]. PMID- 3519116 TI - [Recent experiences with hydro-alginate. 45 cases--44 successes]. PMID- 3519117 TI - [Indications for free tissue transfer in comparison with alternative methods of coverage]. PMID- 3519119 TI - [Removal technics for free tissue transfer to the lower extremity. Latissimus flap--radialis flap--dorsalis pedis flap]. PMID- 3519118 TI - [Anatomic principles of free tissue transfer to the lower extremity. Latissimus flap--radialis flap--dorsalis pedis flap]. PMID- 3519120 TI - [Surgical therapy of late radiation sequelae of the gastrointestinal tract]. AB - Fifty-six operations for intestinal complications of radiation therapy were performed in 48 patients at the Second Surgical Clinic, University of Vienna between 1971 and 1985. The lesions were located in the small bowel (n = 32), the colon and rectum (n = 27) and the duodenum (n = 2). The incidence of the operations increased during the fifteen-years-period, 48.2% being performed in the last five years. 96% of the patients were females, the most frequent cause for irradiation was ovarian cancer (39.6%), followed by cervical (27%) and endometrial cancer (16.7%). 20 Patients (39.6%) had also been treated by chemotherapy. Ovarian cancer as underlying disease (56%) and chemotherapy (56%) were more frequent in small bowel lesions, than in other locations. The radiation damage presented as stenoses (n = 38), fistulas (n = 13), perforations (n = 3), one rectal ulcer and one hemorrhagic proctitis. Resection with end-to-end anastomosis (n = 15) and bypass (n = 14) were the operations most frequently performed on the small bowel, whereas most colonic and rectal lesions were treated by colostomy alone (n = 14). The postoperative course was complicated by fistulas in 7 patients, by peritonitis in 5, by pulmonary embolism in one and duodenal ulcer perforation in another case. Six patients died postoperatively (10.7%), 5 because of peritonitis. After small bowel resection complications occurred in 4 cases, and two (13%) of the patients died. Bypass in small bowel lesions performed as well as resection: 5 complications and one death (7%) occurred. Single layer suture technique performed better than two layer anastomoses. Eighteen operations with single layer anastomoses resulted in 16.7% complications and no death.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3519121 TI - [One-stage anterior resection in the therapy of high rectovaginal fistulas]. AB - In 7 patients a high recto-vaginal fistula was treated by one-stage anterior resection with hand-sutured anastomosis. The etiology of these fistulas outlines the fact that the peritoneum may wall off an inflammatory process more effectively than the vagina. Even under sterile conditions the peritoneal sealing capacity is an important factor in the healing of the rectal anastomosis. The presented hand-sutured technique takes this full into account. PMID- 3519122 TI - [Surgical treatment of large abdominal wall hernias with m. tensor fasciae latae]. PMID- 3519123 TI - [Emergency surgical treatment of a knife stab injury of the left heart ventricle]. PMID- 3519124 TI - [Anatomically related surgery of the spleen]. PMID- 3519125 TI - [Mechanical compression anastomosis (AKA-2) of the colon and rectum. Results of a prospective clinical study]. AB - Based on the highly superior mechanical and functional properties of an experimental sutureless anastomosis performed without any foreign material compared to conventional anastomosis we have introduced a sutureless compression anastomosis (AKA-2) to colorectal surgery and controlled the outcome prospectively. This type of anastomosis was employed in 30 patients with sigmoid and rectal resections for carcinomatous and inflammatory bowel disease. The first 3 patients and further 3 high-risk patients got a protective colostomy. The clinical outcome was uneventful in all patients but 2 with anastomotic fistula. Radiological controls showed no further fistula. The study revealed no negative side effects of the compression anastomosis but the procedure seems to provide considerable advantages by complete mechanical relief of the anastomosis and early epithelial covering of the anastomotic line. PMID- 3519126 TI - [Alloplastic treatment of knee ligaments. Experience using artificial support in fresh injuries of the inner ligament]. AB - From November 1983 to July 1985 a plastic reinforcement of the collateral medial ligament was performed in 14 patients. In all cases there was an additional reconstruction of the anterior cruciate ligament and a partial resection respectively refixation of the medial meniscus. In order to confirm the collateral ligament alloplastically in 6 cases a non-resorbable plastic connection (Gore-Tex patch), in 8 cases a resorbable plastic connection (PDS) was used. All the patients could be clinically reinvestigated on an average of 13 months after the operation. The results are presented. PMID- 3519127 TI - [Continence-preserving proctocolectomy]. PMID- 3519129 TI - Classic articles in colonic and rectal surgery. Joseph McDowell Mathews 1847 1928. Advancements in proctology. PMID- 3519128 TI - Detection of unrecognized liver metastases from colorectal cancers by routine use of operative ultrasonography. AB - The importance of diagnosis and detection of liver metastases cannot be overemphasized for the treatment and prognosis of colorectal cancers. As a new diagnostic technique, operative ultrasonography has been performed during 33 operations for colorectal cancers including three operations for metachronous liver metastases. Of these, in five patients (15.2 percent) ultrasonography using 5- or 7.5-MHz instruments identified metastatic tumors that had not been diagnosed during preoperative imaging studies or at exploration. Most of these tumors were approximately 1 cm in size and nonpalpable. Cases of these five patients are presented in this report. High-resolution operative ultrasonography is considered to be a valuable method for detection of unrecognized metastatic tumors and for precise localization and spatial assessment of these hepatic lesions. Because it is safe, simple, and highly sensitive, the routine use of operative ultrasound is encouraged during surgery upon colorectal cancers for systematic screening of metastatic liver tumors. PMID- 3519130 TI - Hepatic damage in neonatal rat due to E. coli endotoxin. AB - Liver from neonatal rats injected with LD50 E. coli endotoxin was studied by light and electron microscopy. By 2 hr, there was margination and migration of polymorphonuclear leukocytes. Single cell necrosis was seen after 8 hr. At 16 hr, there were numerous necrotic foci in the mid-zonal region of hepatic lobules, as well as accumulation of microvesicular fat. Necrosis and fatty change of hepatocytes were more extensive at 24 hr. Microvesicular fat accumulation may be related to alterations in fatty acid or oxidative metabolism. However, the pattern of mid-zonal damage in these animals is not typical of failure of oxidative metabolism and suggests that other mechanisms are involved. PMID- 3519131 TI - Chemotherapy of childhood acute lymphoblastic leukemia. AB - This article reviews current chemotherapy of childhood acute lymphoblastic leukemia, with particular emphasis on the pharmacology of the drugs used. In the perspective of the overall treatment plan, the use, mode of action, toxicity and pharmacology of prednisone, vincristine, L-asparaginase, cyclophosphamide, 6 mercaptopurine, methotrexate and cytosine arabinoside are reviewed. Issues relating to central nervous system prophylaxis, drug compliance, drug resistance, and treatment failure are considered. PMID- 3519132 TI - The diagnosis and management of hyperlipidemia. PMID- 3519133 TI - Fate of selectable marker DNA integrated into the genome of Nicotiana tabacum. AB - To compare the effects of different transformation methods on the integration behavior and structural stability of integrated foreign genes in plant cells, tobacco protoplasts were transformed with Escherichia coli plasmid pLGV2103neo DNA using the Ca phosphate DNA coprecipitation technique. Parallel transformations were done by cocultivation with Agrobacterium tumefaciens harboring the Ti plasmid derivatives pGV3850::2103neo or pGV3850::1103neo. A comparison of the fine structure of the integrated donor DNA obtained by direct gene transfer and by cocultivation indicates that the donor DNA in cells transformed by the former technique undergoes structural changes and concatemerizations, while the DNA integrated by the latter procedure is often unaltered. The cotransformed nopaline synthase gene, which is present in the donor Ti plasmid DNA, was inactivated in two out of nine cases. Once integrated, the arrays of selectable marker DNA appear to be structurally stable under different cell culture and selection conditions, as well as after genetic transmission. PMID- 3519134 TI - Sequence verification of mutant codon assignments in trpA of Escherichia coli. AB - Over the past 30 years, a variety of mutations have been characterized in trpA, the gene for the alpha-subunit of tryptophan synthetase in Escherichia coli. On the basis of amino acid sequence analyses, reversion studies, or suppressibility by codon-specific translational suppressors, base substitutions were deduced and codons assigned for each mutation. In the present study, three of the trpA mutants obtained over 25 years ago and a series of codon position 234 trpA mutants isolated more recently by specific selection methods have been cloned and characterized by DNA sequence analysis. Our results establish the reliability of the mutant codon assignments, confirm the validity of the selection and detection procedures used to obtain missense and nonsense mutations in trpA, and demonstrate that the trpA sequence has been stably maintained throughout 30 years of laboratory culturing and mutagenic treatments. PMID- 3519135 TI - Expression of cloned human haptoglobin and alpha 1-antitrypsin complementary DNAs in Saccharomyces cerevisiae. AB - Nucleotide sequences coding either for human preprohaptoglobin or for prohaptoglobin have been placed under the control of yeast ARG3 expression signals. Recombinant plasmids pRIT12598 and pRIT12597 express the prepro- and the pro-form of alpha 2 beta haptoglobin respectively, but at very low levels. Comparison with the expression of human pre- and mature alpha 1-antitrypsin cDNAs, cloned in the same expression vector, reveals large differences in the levels of specific proteins produced in yeast, although specific mRNA levels are similar. It is shown that presence or absence of the signal sequence in the cDNA construction results in a 20- to 30-fold difference in the yields of heterologous products. However, since haptoglobin and alpha 1-antitrypsin behave differently, the difference in expression for prohaptoglobin compared with the expression of mature alpha 1-antitrypsin is about three orders of magnitude. In addition, we provide evidence that glycosylation of both proteins can occur in yeast only when the signal sequence is present in the DNA constructions. PMID- 3519136 TI - Novel modified beta-interferons: gene cloning, expression, and biological activity in bacterial extracts. AB - A series of novel, modified interferons based on the structure of human beta interferon have been expressed in Escherichia coli. Modified interferon genes were constructed from sequences derived from the natural beta-interferon gene, a synthetic beta-interferon gene, or a specific combination of the two. A total of 23 out of the 25 novel interferons exhibited antiviral (AV) and antiproliferative (AP) activity which varied from 3 to 230% and 8 to 490% of the values for beta interferon, respectively. None of the novel interferons had only AV or AP activity, although one had a much reduced ratio of AV/AP activity compared with beta-interferon. Substitution of beta-interferon amino acids 2-7 or 28-46 resulted in interferons with significantly increased AP activity on Daudi lymphoblastoid cells (four- to fivefold). All the novel interferons except two with modifications in the 82-105 region reacted with a neutralizing beta interferon monoclonal antibody. PMID- 3519137 TI - Molecular cloning and expression in Escherichia coli of the cDNA coding for rabbit tumor necrosis factor. AB - cDNA clones containing the entire sequence of the precursor of rabbit tumor necrosis factor (TNF) were identified from a cDNA library prepared using poly(A)+RNA of lipopolysaccharide-induced rabbit alveolar cells. Synthetic oligodeoxynucleotides based on the amino acid sequence of rabbit TNF were selected by RNA blot hybridization and used as probes to screen this library. The DNA sequence and the amino acid sequence deduced from it showed very high homology to the reported DNA and amino acid sequences of human TNF. A plasmid containing the tac promoter and cDNA sequence coding for the 154-amino-acid sequence of mature rabbit TNF protein was constructed and expressed in Escherichia coli. The polypeptide produced had the characteristics of purified rabbit serum TNF and caused a necrotic response in a transplanted syngeneic tumor in mice. PMID- 3519139 TI - [Fusion of gram-negative bacteria induced by divalent cations]. PMID- 3519138 TI - Molecular cloning of the gene encoding rabbit tumor necrosis factor. AB - A rabbit genomic DNA library was screened using a cloned cDNA encoding rabbit tumor necrosis factor (TNF) as a probe. The entire gene sequence appears to be contained within a 3.2-kb Eco RI fragment. Comparison of the nucleotide sequence of the gene with that of the cDNA showed that the gene consists of four exons. The nucleotide sequence of the rabbit TNF gene is very homologous to that of the human TNF gene. Southern hybridization of the genomic DNAs showed that there is likely only a single TNF gene in each of the rabbit and human genomes. PMID- 3519140 TI - [In vivo selection of mouse bone marrow colony-forming cells transformed with a plasmid containing the bacterial gene for dihydrofolate reductase]. PMID- 3519142 TI - Heparin-associated thrombocytopenia: a prospective comparison of bovine lung heparin, manufactured by a new process, and porcine intestinal heparin. AB - Heparin-associated thrombocytopenia has been reported most commonly with bovine lung preparations. We prospectively evaluated the incidence of thrombocytopenia in 43 patients receiving intravenous continuous infusions of either bovine lung heparin, manufactured by a new process, or a standard porcine intestinal mucosa heparin for a minimum of five days in a double-blind, randomized fashion. The decision to continue heparin therapy beyond five days was made by the patient's primary physician. All patients had documented acute thromboembolic disease, pretherapy platelet counts greater than 150 000/mm3, and no evidence of prior coagulation disturbance. No patients had undergone cardiopulmonary bypass or hemodialysis within seven days previous to the initiation of heparin therapy. Thrombocytopenia was defined as a decline in platelet count from the normal range of 150 000-350 000/mm3 to less than 100 000/mm3. Thrombocytopenia occurred in one patient (4.6 percent) receiving bovine lung heparin on day nine of therapy and in no patients (0 percent) receiving porcine intestinal mucosa heparin. Adverse reactions occurred in nine patients (42.9 percent) receiving porcine intestinal heparin and five patients (22.7 percent) receiving bovine lung heparin. This difference was not statistically significant. The results of this study indicate that the incidence of thrombocytopenia is low (less than five percent) with both bovine lung heparin, manufactured by a new process, and porcine intestinal mucosa heparin when therapy is limited to short therapeutic courses (less than 1 week). PMID- 3519141 TI - Drug interactions with oral contraceptives. AB - In the very rare cases where a pregnancy occurs during oral contraceptive use, the blame is usually laid against the patient for having forgotten to take the pill. Evidence has started to accumulate to suggest that neither the patient nor the pill is at fault in some contraceptive failures. It may be because the patient is taking other medicines and these may be preventing the pill from suppressing ovulation. Most drug interactions reducing or negating contraceptive activity are due to concomitant use of drugs having microsomal enzyme-inducing activity (e.g., some antibiotics, especially rifampicin, and anticonvulsants, including phenobarbital, phenytoin, and primidone. Other antibiotics (e.g., tetracycline) may also interact by interruption of the enterohepatic circulation of contraceptive steroids. Less well appreciated, oral contraceptive steroids may themselves modify the metabolism and pharmacological activity of various other drugs (e.g., anticoagulants, benzodiazepines, beta-blockers, caffeine, corticosteroids, and tricyclic antidepressants); in this respect the oral contraceptives are acting as enzyme inhibitors. Contraceptive steroids may also interact with drugs that cause enzyme inhibition and this delays the metabolism of the hormonal agents. Interactions of this type would be expected to potentiate the action of the contraceptive steroids. It is suggested that the effects of such interaction might be presented in terms of increased incidence of side effects, including water retention, diabetogenic effects, hypertension, and an increased risk of thromboembolic disorders. The spectrum of interactions with oral contraceptives is presented in three tables. PMID- 3519143 TI - [Ultrasound-guided fine-needle puncture in the diagnosis and therapy of liver and spleen abscesses]. AB - A total of 41 diagnostic and therapeutic fine-needle aspiration punctures were performed under ultrasound control in 28 patients with solitary or multiple abscesses of liver (26) or spleen (2). Nonoperative measures (drainage-fine needle puncture, local and systemic antibiotics) cured 19 patients; in nine, primary surgical abscess drainage was performed. One operated patient with multiple liver abscesses died of generalized sepsis (mortality rate 3.6%). All 14 hepatic or splenic abscesses in which percutaneous fine-needle drainage was performed, including local and systemic antibiotic administration, were treated successfully. In two of 41 fine-needle aspiration punctures bleeding complications were recorded but did not require any treatment. The method was reliable and effective in the definitive diagnosis and treatment of hepatic and splenic abscesses, with a lower complication and mortality rate than surgical drainage. PMID- 3519144 TI - [Clinical significance of sonographically detected splenomegaly]. AB - In 502 patients, length, thickness and width of the spleen as well its location with respect to the ipsilateral kidney were determined by means of ultrasonography, and a relationship was established with the incidence of diseases accompanied by enlargement of the spleen. A significant correlation to the incidence of such diseases was found only with respect to spleen thickness. The probability of a corresponding disease was 80% for a spleen thickness of 5 cm, 90% for 6 cm and 100% for more than 7 cm. A comparison between palpation and ultrasonography supported the fact that enlargement of the spleen can, in many cases, not be ascertained by palpation, but that palpation findings are indeed positive in splenic enlargement of minor degree. The most suitable parameter for ultrasonographic detection of splenomegaly is thus spleen thickness, for which a limit value of 5 cm should be assumed. If the spleen is found to exceed this value, further examinations are indicated to clarify the underlying disease. PMID- 3519145 TI - [FLASH-tomography. A rapid imaging procedure for magnetic resonance tomography]. PMID- 3519146 TI - [Complicated malaria tropica: specific and supportive therapy in the imported diseases]. AB - Eleven of 43 nonimmune patients with falciparum malaria had one or several organ complications: cerebral malaria, acute respiratory failure, acute renal failure, secondary infection, autoimmune haemolysis, spontaneous spleen rupture, and acute pancreatitis. Parasitaemia was 0.1 to 60%. Initial antiparasitic therapy with quinine given parenterally resulted in rapid regression of parasitaemia. An additional schizonticide agent was given depending on parasitic resistance. Supportive therapy comprised intensive-care monitoring including fluid and electrolyte balance and, if necessary, early haemodialysis and (or) endotracheal intubation with PEEP breathing. In one patient with excessive parasitaemia exchange transfusion was performed. Heparin was given only in proven disseminated intravascular coagulation, corticosteroids only in persistent autoimmune haemolysis. All patients survived without suffering permanent defects. Retrospective analysis shows that, apart from rapid specific therapy, supportive treatment of the individual organ complications determines course and prognosis of complicated falciparum malaria. PMID- 3519147 TI - [Preoperative diagnosis of cystic parathyroid adenoma by ultrasonic-guided fine needle puncture and parathormone determination]. AB - In one patient with primary hyperparathyroidism, a cystic parathyroid adenoma was diagnosed pre-operatively by ultrasound-guided fine-needle aspiration biopsy and the detection of an elevated parathyroid hormone concentration in the aspirate. PMID- 3519148 TI - [Chorionic villi biopsy]. PMID- 3519149 TI - [Early recognition of osteoporosis. The current status of noninvasive methods of measuring the bone mineral content]. PMID- 3519151 TI - [Serologic studies of feeder bulls following vaccination against infectious septicemic thrombosing meningoencephalomyelitis (ISTMEM)]. PMID- 3519150 TI - [Lectins and the organotropy of metastasis]. PMID- 3519152 TI - [Follow-up studies of contamination with chloramphenicol in broiler production]. PMID- 3519153 TI - [Ethological choice studies with early weaned piglets kept on flat decks. 4. Results of studies on the preference for type of floor, surface size and padding (straw) from the viewpoint of the animal and conclusions for the evaluation of flat deck rearing with reference to all results]. PMID- 3519154 TI - [Collection of urine samples in female cattle using the diuretic furosemide]. PMID- 3519155 TI - Some cardiovascular effects of monensin. PMID- 3519156 TI - [Possibilities and limits of rapid test procedures for the detection of parathion]. PMID- 3519157 TI - [Arterial blood pressure and heart rate in heifers during mating]. PMID- 3519158 TI - [Environmental health as a task of veterinary medicine]. PMID- 3519159 TI - Blood and tissue concentrations of ampicillin in chickens. PMID- 3519160 TI - [Reference values of various urine constituents in sows]. PMID- 3519161 TI - [Unusual urinary calculus involvement in a young beagle]. PMID- 3519162 TI - [Thermoregulation and the performance of rabbits at high environmental temperatures]. PMID- 3519163 TI - [No research without the history of science]. PMID- 3519164 TI - [Fresh meat and rinderpest--problems of early trade routes]. PMID- 3519165 TI - [The military veterinary division--a retrospective view of a mobile horse clinic]. PMID- 3519166 TI - [The status of veterinary medicine 1801]. PMID- 3519167 TI - [Erwin Becker's veterinary dental treatment]. PMID- 3519168 TI - [Historical reasons for the partnership between the Helsinki Veterinary Institute and the Hannover Veterinary Institute]. PMID- 3519169 TI - [2 Middle Hesse prescription books of the 18th and 19th centuries, a comparison]. PMID- 3519170 TI - [Legislation for animal protection in Baden 1851-1933]. PMID- 3519171 TI - [Education in veterinary medicine at the Braunschweig Collegium Carolinium, 1835 1871]. PMID- 3519172 TI - [Pathogenesis and prevention of grass tetany from the physiologic viewpoint]. PMID- 3519173 TI - Digitalis and verapamil in atrial fibrillation and flutter. Is verapamil now the preferred agent? PMID- 3519174 TI - Drug treatment of epilepsy. Outlines, criticism and perspectives. AB - This article focuses on important aspects relevant to the assessment of antiepileptic treatment and critically reviews the existing knowledge in this area. The principal variables considered are the commencement of treatment, choice of appropriate drug, efficacy of monotherapy, and cessation of treatment. When seizure recurrences after the first unprovoked seizure are considered, contradictory data have been provided on the role of early (i.e. after the first seizure) therapy in preventing relapses. The choice of the appropriate drug seems to be dictated more by clinical toxicity than by truly greater efficacy since there is no evidence of significant differences in efficacy among the 'major' anticonvulsants such as phenytoin, phenobarbitone, carbamazepine and primidone. Monotherapy is the preferred treatment, at least in previously untreated patients, since up to 90% of cases are completely controlled after variable periods of observation. Cessation of therapy after prolonged seizure control is followed by relapses in a varying percentage of cases depending on several factors, among which is the duration of the period of control. As yet, a definitive comparison of the available information has been prevented by major methodological differences and by partial investigation of the various aspects of the care of the patient with epilepsy. To provide a tentative answer to some of the open questions concerning the impact of anticonvulsant therapy on the prognosis of the disease, an alternative approach has been proposed, based on the active surveillance of a cohort of newly referred patients started on monotherapy in routine care conditions over a period of more than 5 years. The feasibility of this approach is being tested in a multicentre prospective study currently in progress in Italy. PMID- 3519176 TI - The dilemma of mild hypertension. PMID- 3519175 TI - Bacterial meningitis. Rational selection and use of antibacterial drugs. AB - Bacterial meningitis is a continuing challenge. This applies especially to infections in the neonate and the elderly, and to those which are hospital acquired. Factors which maintain the high morbidity and significant mortality from this disease include microbial virulence, a limited host response to infection within the cerebrospinal fluid (CSF), where phagocyte function is often impaired and complement and opsonic antibody activity are deficient, as well as delays in diagnosis and treatment. Added to these adverse factors is the pharmacokinetic hurdle of the 'blood-brain barrier', which limits drug concentrations achievable within the CSF. Inflammatory changes certainly improve the penetration of many agents, especially the penicillins and cephalosporins, but it must be remembered that with resolution of inflammation, achievable concentrations decline. Hence, the necessity for continuing parenteral administration of antibiotics throughout the treatment period. Although penicillin G (benzylpenicillin) remains the drug of choice for both pneumococcal and meningococcal infections, increasing resistance to ampicillin among Haemophilus influenzae has lead to greater reliance on alternative agents. Chloramphenicol is widely used, yet is potentially toxic, so that therapy with cefuroxime and the newer cephalosporins has been increasingly advocated. The advent of these potent, broad spectrum cephalosporins has induced a reappraisal of the treatment of Gram-negative bacillary meningitis, where ampicillin resistance and poor CSF penetration by the aminoglycosides have contributed to an unsatisfactory impact on outcome. Agents such as cefotaxime and ceftazidime have proved effective, although greater controlled experience is required. Finally, the contagious nature of meningococcal and H. influenzae infections justifies offering chemoprophylaxis to selected contacts, with rifampicin (or minocycline for contacts of patients with meningococcal infections). PMID- 3519179 TI - Is dental caries on the increase in Kenya? PMID- 3519177 TI - Guanfacine. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic efficacy in the treatment of hypertension. AB - Guanfacine, a phenylacetyl-guanidine derivative, is a centrally acting alpha adrenoceptor agonist, with a mechanism of antihypertensive action similar to that of clonidine. It reduces blood pressure in patients with essential hypertension at least as effectively as clonidine or methyldopa. Like lower doses of clonidine, guanfacine can be given once daily due to its relatively long elimination half-life. Although dry mouth and sedation occur frequently with higher doses of guanfacine, their incidence is lower than with other centrally acting antihypertensives; in addition, other troublesome side effects such as orthostatic hypotension or sexual dysfunction also occur much less with guanfacine than with other centrally acting antihypertensive agents. While a withdrawal syndrome may occur on abruptly discontinuing guanfacine administration, the symptoms are generally mild, and the incidence of withdrawal symptoms appears lower than occurs with abrupt withdrawal of clonidine. Thus, guanfacine is an effective and well tolerated alternative to other centrally acting antihypertensive drugs. Whether its final place in therapy will be as an alternative 'second-line' drug, or as initial monotherapy in patients with mild to moderate hypertension, remains to be clarified in comparative studies with diuretics, calcium antagonists, and beta-adrenoceptor blocking drugs. PMID- 3519180 TI - Epidemiological markers of Klebsiellae infecting hospital patients. PMID- 3519178 TI - Adjuvant chemotherapy of cancer. A review of its current status. AB - Adjuvant chemotherapy can be defined as the use of drugs immediately after local control therapy to attempt eradication of residual micrometastatic disease. Conceptually, the micrometastatic disease is presumed to be outside the field of surgical excision or the area of curative intent of radiation therapy. Adjuvant chemotherapy designed to eradicate established micrometastases is a relatively new area of clinical research which began to be seriously considered in the late 1960s and reached a peak of enthusiasm a decade later. However, the early promise of adjuvant chemotherapy has not been fulfilled and the entire concept, and its biological underpinnings, are now under re-evaluation. This review considers the biological rationale for adjuvant chemotherapy and the current status of the large-scale clinical trial data base which now exists in 4 major diseases: breast cancer, osteogenic sarcoma, large bowel cancer, and gastric cancer. PMID- 3519182 TI - Infantile diarrhoea in Uganda: enteropathogenic Escherichia coli serotypes revisited. PMID- 3519181 TI - Enterotoxigenic Escherichia coli infection in childhood diarrhoea in Mombasa, Kenya. PMID- 3519183 TI - Disturbance of a met-enkephalin-like hormone in the hepatopancreas of crabs contaminated by metals. AB - This study combines trace-metal analysis with an immunofluorescent detection of a methionine-enkephalin-like substance in the digestive gland of the shore crab, Carcinus maenas L. The crabs were taken from two sites: Saint Nazaire and Le Croisic, the first being polluted in comparison to the second. The experimental crabs were also taken in Le Croisic and contaminated with Cd, Pb, Cu, and Zn during 1 to 3 weeks in the laboratory. The immunohistological observations indicate a change in the localization of the immunofluorescent methionine enkephalin-like substance in the cells of the tubules constituting the digestive gland. In crabs from the clean site, experimentally starved or not, the immunofluorescence appears mostly basal while it exhibits an apical localization in metal-contaminated crabs or crabs caught in the polluted area. The detected substance, the nature of which remains unknown, accompanies cytoplasmic secretory granules during their migration to the cellular apex preceding the apocrine secretion. This change of the immunoreactivity enables the detection of metal contamination but it is nonspecific and therefore, a general environment pollution could produce the same phenomenon. In the particular case of zinc, this alteration appears at a Zn concentration in seawater which does not disturb the natural level of this essential metal in the digestive gland of C. maenas. PMID- 3519184 TI - The history of gastrointestinal endoscopic laser hemostasis and management. PMID- 3519185 TI - Hemostasis--therapeutic alternatives to the laser. AB - In clinical practice, there are a number of other endoscopic procedures for attaining hemostasis available as alternatives to laser hemostasis. Of these the following may be emphasized: Modified electrocoagulation procedures such as EHT coagulation, bipolar or multipolar coagulation, and sclerotherapy. The efficacy of these "laser-alternative" methods of hemostasis has already been demonstrated in clinical studies, and is unquestioned. Large comparative investigations that would provide definitive information on the relative effectiveness of the various techniques, have yet to be carried out. If, however, we consider such aspects as practicability and economy, the laser would appear to be a "dinosaur" among the endoscopic procedures presently available for hemostasis. The oldest recognized fiber-endoscopic instrument for hemostasis, it is anything but highly mobile, and is bound to a fixed location. In addition, it is as expensive as a museum exhibit. If the only indication for its use were hemostasis, it would probably have vanished from the scene. PMID- 3519186 TI - Laser therapy of early gastric carcinoma. PMID- 3519187 TI - The patient in shock--clinical picture and pathophysiology. AB - The diagnosis of hemorrhagic shock can be made on the basis of a good knowledge of the clinical picture of the bleeding patient. The necessary lab tests must be carried out over a period of time to establish their evolution and thus the degree of shock. At present, attention is being focused on the microcirculation. In shock, tissue is starved of oxygen and nutrients, resulting in the liberation by degenerating cell structures of numerous substances that have an effect on vascular tone. Decompensation is accompanied by consumption coagulopathy, which also has an influence on the microcirculation. The inhibitor potential is very important here. The patient must be out of shock before endoscopy can be considered. PMID- 3519188 TI - What are the signs of recent hemorrhage, and what do they mean? Criteria for massive bleeding. AB - Hematemesis, melena, shock, vague symptoms, anemia, blood examinations and endoscopic findings are reviewed as signs of recent hemorrhage. An assessment of the condition of patients with upper GI bleeding is important for planning treatment. Therefore, in order to be able to evaluate a method of treatment of GI bleeding, reports referring to treatment of GI bleeding must contain a clear record of the severity of the patient's state and of the bleeding source. A common criterion for massive bleeding has been proposed. Specifically, a patient suffering from shock who needs more than 1,000 ml of blood or plasma expander by rapid transfusion within one hour, or more than 2,000 ml within the initial 24 hours, to stabilize his circulation, and whose Hb level is 8.0 g/dl or less, should be graded as having massive bleeding. Gastric ulcers with exposed blood vessels need endoscopic YAG laser hemostasis or ethanol injection therapy as quickly as possible, since 43% of the cases rebleed within 72 hours under conventional drug therapy, and such rebleeding can be prevented by the endoscopic hemostatic methods. PMID- 3519190 TI - Esophageal varix hemorrhage and sclerotherapy--animal studies. AB - Although endoscopic sclerosis for control of variceal hemorrhage is an old technique, many questions remain about the technique, its applications, and outcomes after use. This report summarizes recent data from animal studies that relate to clinical questions concerning esophageal varix hemorrhage and sclerotherapy. A reproducible canine model of portal hypertension and esophageal varices is described. Three different studies with this model are summarized and discussed including: comparison of methods for endoscopic control of active variceal hemorrhage, comparison of sclerosing agents using canine venous collaterals and efficacy and safety of sclerosing agents in endoscopic sclerotherapy. In our opinion, these data should assist clinicians who are evaluating or planning clinical sclerotherapy trials. PMID- 3519189 TI - The benefits of endoscopy in upper gastrointestinal bleeding. AB - Management of the patient with upper gastrointestinal bleeding is a continuing challenge to the gastroenterologist and the surgeon. Endoscopy early in the course of bleeding benefits the patient only when diagnostic accuracy is combined with definitive hemostatic therapy. Effective methods are now available for endoscopic hemostasis of bleeding ulcers and bleeding varices. However, an improvement in the outcome of gastrointestinal bleeding is not easily achieved, since age and the incidence of severe underlying disease in patients with upper G.I. hemorrhage have been steadily increasing over the years. PMID- 3519191 TI - Sclerotherapy in acute variceal bleeding: technique and results. AB - The current Cape Town management policy for patients with suspected acute variceal bleeding includes vasopressin infusion 0.4 units/minute, and emergency diagnostic endoscopy. Sengstaken balloon tube tamponade is reserved for patients with active variceal bleeding at the time of emergency endoscopy. Only these patients have early emergency sclerotherapy. The results of the Cape Town five year prospective evaluation of sclerotherapy with the rigid Negus oesophagoscope using general anaesthesia are presented. We conclude that the combined use of balloon tube tamponade and sclerotherapy has markedly simplified the management of patients with variceal bleeding at our institution. The preliminary results of the 2-year analysis of our ongoing prospective randomised controlled clinical trial comparing the above technique with a new combined paravariceal and intravariceal sclerotherapy technique using a fibreoptic endoscope without anaesthesia are presented. We conclude that both techniques successfully control acute variceal bleeding in the majority of poor-risk patients, but that the rigid scope has some advantages, particularly in those few patients who rebleed at the time of injection. We currently recommend a standard portacaval shunt or a devascularisation and transection procedure for the rare failures of sclerotherapy. Controversial areas of sclerotherapy are reviewed, and a new treatment policy for acute variceal bleeding is proposed on the basis of our experience and a review of the literature. PMID- 3519192 TI - Elective sclerotherapy--technique and results. AB - Elective sclerotherapy, to obliterate oesophageal varices, is discussed with particular reference to the results of three controlled trials. There is strong support from each of these studies for the prevention of rebleeding. However, the results for overall survival are conflicting. This discrepancy is discussed in relationship to major differences in trial design. Different techniques of injection sclerotherapy are reviewed, although there is a paucity of comparative data. A prospective study is reported in which 147 patients were followed after initial obliteration of varices, in order to document the rate of recurrence of varices, the associated rate of rebleeding and hence the need for, and timing of, follow-up endoscopy. PMID- 3519193 TI - Is there an indication for prophylactic endoscopic paravariceal injection sclerotherapy in patients with liver cirrhosis and portal hypertension? AB - From January 1, 1978, to January 1, 1980, a prospective controlled randomized trial comparing conservative treatment to prophylactic endoscopic paravariceal injection sclerotherapy of esophageal varices prior to hemorrhage was carried out. In all 71 patients liver cirrhosis was confirmed histologically. The two randomly assigned groups were comparable with respect to age, sex and degree of liver diseases and its histological type was also similar. Indications for endoscopic treatment were the existence of degree III to IV varices bearing telangiectasias on their top, and degree II to IV varices without telangiectasias but coagulation factors below 30%, or both. Six patients had to be excluded. In group IA--treatment by conservative means, clinical and endoscopic monitoring--a high rate of variceal bleeding (66%) and death (42%) was observed. Comparing these results with those of group IB treated by sclerotherapy, bleeding and death rates (6 and 6%) were found to be highly significantly lower. From January 1, 1980, to January 1, 1984 another 70 non-randomized patients were treated by prophylactic endoscopic paravariceal injection sclerotherapy. In this group II the frequency of hemorrhage was 4.5% and in-hospital mortality 13%. The main causes of death were hepatic coma, followed by hemorrhage from esophageal varices. After four years another 14 patients had died despite regular monitoring and re-injection (20%); the main causes of death were hepatic coma and hepatocellular cancer. Five patients (7%) were lost to follow up, while 42 (60%) are still living.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3519194 TI - Animal testing of endoscopic hemostasis with lasers and other devices. AB - A variety of animal models for testing endoscopic control of gastrointestinal hemorrhage are reviewed. Advantages and disadvantages of each are discussed. New types of mechanical devices for controllable injury are presented, and the efficacy of laser photocoagulators and other recently developed electronic devices on these new lesions is compared. PMID- 3519195 TI - Current status of argon laser hemostasis of bleeding ulcers. AB - Endoscopic argon laser photocoagulation has been extensively studied in animals. Clinical pilot studies and randomized controlled trials have demonstrated that argon laser endoscopic hemostasis is both safe and efficient. Specific guidelines for successful endoscopic hemostasis have been determined. The limitations of the argon laser for emergency hemostasis are a strong absorption by blood, its expense and lack of portability, the inability to tamponade or to treat tangentially, and the vaporization potential. The Nd:YAG laser shares all these limitations except that it is less absorbed by blood. Because of these limitations, GI lasers are at present being used less for emergency hemostasis than for elective tumor ablation. Some new, non-laser, thermal devices which do not have these limitations have been developed. They are currently being evaluated in randomized trials. Perhaps because of these factors, the good results obtained with lasers for emergency hemostasis of bleeding ulcers have not been translated into clinical practice at most hospitals. PMID- 3519196 TI - Laser photocoagulation for upper gastrointestinal bleeding: the American experience. AB - Laser use in the United States for the treatment of gastrointestinal disease in general, and for upper GI bleeding in particular has grown exponentially. In 1979, only 3 American medical centers were using lasers for the therapy of UGI bleeding. Today, lasers are employed in more than 200 centers. Recently, the Food and Drug Administration, which regulates its use, has ruled that it is safe and effective, and therefore is no longer considered to be an investigational device. Most commonly it is used to treat discrete lesions such as ulcers, but it has been employed for other lesions, including varices. A recent American randomized controlled trial assessing its efficacy in acute esophageal variceal bleeding, found it to be effective for initial hemostasis; however, rebleeding was common. A key question is whether or not the laser is superior to other less costly and more portable modalities for treating acute UGI bleeding. One U.S. investigator recently presented data which suggested to him that the heater probe was better than the laser. There is insufficient comparative data available to answer the critical question about the relative superiority of one endoscopic treatment modality as compared to another. Foreseeable technologic advances may make laser therapy easier and more effective. PMID- 3519197 TI - Prognostic factors in upper G.I. bleeding. AB - This presentation draws upon the experience of the O.M.G.E. Multi-national Upper G.I. Bleeding Survey, using data collected during 1980-1982 by 185 clinicians from 44 centres in 21 countries to discuss two questions. First, can prognostic factors be identified in patients presenting to hospital with upper G.I. bleeding, and if so what are they? Second, is it possible - by combining the two technologies of endoscopy and computers - to provide an individual patient with a short-term prognostic prediction sufficiently accurate to affect patient management. Amongst 4,010 patients, a number of clinical factors were found to affect short-term prognosis. These included patient age, previous history of heart or liver disease, confusion and dehydration on admission, jaundice, and ascites. Identification of the bleeding source via endoscopy was shown to aid short-term prognosis - especially in the period of the 2nd to 10th days post admission. Use of computer analysis enabled "high risk" patients to be defined (of whom 63.8% suffered further bleeding and 30.0% died), and also a comparable "low risk" group (of whom only 4% suffered further bleeding and none died). Finally, "time-dependence" studies have been used to identify a group of patients who (by the 2nd day post-admission) have a residual risk of further bleeding sufficiently low (well under 1%) to suggest that considerable resources can be saved by the judicious use of endoscopy and computer science. PMID- 3519198 TI - Reactivity of mutagenic propylene oxides with deoxynucleosides and DNA. AB - In an extension of previous studies with deoxycytidine and thymidine reactivities, propylene oxide, glycidol, epichlorohydrin, and trichloropropylene oxide were reacted with deoxyguanosine as well as deoxyadenosine and, except for the trichloro compound, with DNA. Reactivity with the purine deoxynucleosides as well as the four deoxynucleosides in DNA were quantitated by HPLC methods. Correlations were found for the reactivity with individual deoxynucleosides in solution to Taft sigma electron-withdrawing values of the substituents on the epoxides and for reaction with model nucleophiles. In general, these correlations were not as pronounced for the reactivities of the propylene oxides with the nucleosides in DNA. Correlations for reactivity of the propylene oxides with the individual deoxynucleosides in solution and in DNA, except for dThd, were indicated for mutagenicity in TA100 in the liquid-preincubation Ames test. However, this was not the case for mutagenicities determined with the plate incorporation procedure nor with TA1535, where the relative mutagenicity of trichloropropylene oxide was the outstanding difference. Trichloropropylene oxide appeared to depend upon the error-prone system in TA100 for full expression of its mutagenicity. PMID- 3519199 TI - Measurement of in vivo mutant frequency in lymphocytes in the mouse. AB - A limiting-dilution cloning technique for quantifying in vivo mutations at the hypoxanthine phosphoribosyl transferase locus in mouse splenocytes was developed. Mouse splenocytes were cultured in round-bottom microwells with irradiated feeder cells, concanavalin A, and a source of interleukin 2 at five cells/well in the absence of thioguanine, and at 5 X 10(4) cells/well in the presence of 2.5 micrograms/ml thioguanine; mutant frequency was calculated as the ratio of the cloning efficiencies with or without thioguanine. The geometric mean (95% range) for the mutant frequency in 20 mice was 1.54 X 10(-6) (4.7 X 10(-7) -2.6 X 10(6)) and whole-body X-irradiation resulted in a dose-related increase in mutant frequency of up to approximately 20 times the baseline level. The in vivo murine mutation assay should be a useful system for genotoxicity testing and may be of particular value in establishing risk estimates for human populations exposed to genotoxins. PMID- 3519200 TI - Review: Putative mutagens and carcinogens in food. VII. Genetic toxicology of the diet. A summary of a satellite symposium of the Fourth International Conference on Environmental Mutagens. Copenhagen, June 19-22, 1985. Abstracts. PMID- 3519201 TI - Cadmium-binding protein (metallothionein) in carp. AB - When carp (Cyprinus carpio) were exposed to 5 and 30 ppm Cd in the water, the contents of Cd-binding protein, which has low molecular weight, increased in the hepatopancreas, kidney, gills and gastrointestinal tract with the duration of exposure. This Cd-binding protein was purified from hepatopancreas, kidney, gills, and spleen of carp administered 2 mg/kg Cd (as CdCl2), intraperitoneally for 6 days. Two Cd-binding proteins were separated by DEAE-Sephadex A-25 column chromatography. These proteins had Cd-mercaptide bond, high cysteine contents (ca. 29-34%), but no aromatic amino acids or histidine. From these characteristics the Cd-binding proteins were identified as metallothionein. By using antiserum obtained from a rabbit to which carp hepatopancreas MT-II had been administered, immunological characteristics between hepatopancreas MT-I, II and kidney MT-II were studied, and a slight difference in antigenic determinant was observed among them. By immunological staining techniques with horseradish peroxidase, the localization of metallothionein was investigated. In the nontreated group, metallothionein was present in the acinar cells of hepatopancreas and renal convoluted tubules. In the Cd-treated group (2 mg/kg IP daily for 3 days), metallothionein was present in the nuclei, sinusoids, and extracellular space of hepatopancreas, in addition to the acinar cells. Carp were bred in 1 ppm Cd, 5 ppm Zn solution, and tap water for 14 days, following transfer to 15 ppm Cd solution, respectively. The survival ratio was the highest in the Zn group followed by Cd-treated and control groups. The metallothionein contents increased in hepatopancreas and kidney in the order: Zn greater than Cd greater than control group. PMID- 3519202 TI - Immunologic responses to inhaled cotton dust. AB - Byssinosis, a respiratory disease of workers on cotton, flax, and soft hemp, is classically characterized as shortness of breath, cough, and chest tightness on Mondays or the first day of return to work after a time off. Exposure to these vegetable dusts can also result in other respiratory diseases, and the term cotton dust-induced respiratory disease (CDIRD) is introduced. Although clinically characterized for more than a century, the underlying pathogenesis of CDIRD remains obscure. An allergic pathogenesis has been proposed. This article reviews previous and current research findings supporting this mechanism and raises the possibility that, in some individuals, CDIRD may be due to pre existing or occupationally induced mold allergy. PMID- 3519204 TI - Pulmonary function analysis in the rabbit following bronchochallenge to causative agents and mediators of the acute byssinotic response. AB - New Zealand White rabbits were acutely bronchochallenged for 5 min to ascertain airway responsiveness with six potential byssinogenic agents and mediators: 0.1 g/mL cotton dust extract (CDE), 0.1 g/mL cotton bract extract (CBE), 1 mg/mL endotoxin, 1 mg/mL n-formyl methionyl peptide (n-fMet), 10 mg/mL 5 hydroxytryptamine (5-HT), and 1 mg/mL prostaglandin F2 alpha (PGF2 alpha). Methacholine (MC), 10 mg/mL, was used as a control bronchoconstrictor. Clinically objective criteria were established using increases in resistance values compared to those obtained with saline controls. Animals were classified as: mild responders (Mi) = 125-149%; moderate responders (Mo) = 150-199%; or severe responders (S) = greater than 200%. Three of five (2Mo, 1S) rabbits showed increased pulmonary resistance to CDE bronchochallenge, 3/5 (1Mi, 1Mo, 1S) to CBE, 1/5 (Mo) to purified endotoxin, 4/5 (1Mo, 3S) to n-fMet, 3/5 (1Mi, 1Mo, 1S) to 5-HT, and 2/5 (1Mo, 1S) to PGF2 alpha. All five rabbits (1Mo, 4S) responded to MC bronchochallenge. Rabbits responded minimally to saline, the common solvent of all test agents; however, when challenged with methacholine, a known bronchoconstrictor, rabbits showed significant overt symptoms of acute respiratory distress with immediate and substantial increases in resistance over saline controls. CDE, CBE, and n-fMet inhalation challenge resulted in a majority or all animals showing increased resistance. 5-HT contained in CDE and CBE, exhibited similar resistance increases; however, endotoxin, also found in cotton dust, showed little airway reactivity. The rabbit is useful for characterizing changes in pulmonary function parameters seen in the acute byssinotic reaction. This study has demonstrated that bronchochallenge in the rabbit with potential byssinogenic agents (CDE, CBE, endotoxin, and n-fMet) and mediators (5-HT and PGF2 alpha) result in measurable changes in airway function, particularly increased resistance. Since bronchoconstriction is the major clinical manifestation of the acute byssinotic reaction in man and animals, it is likely that bronchoconstriction observed in cotton mill workers may be in part or totally the result of inherent dust constrictor substances or secondarily released mediators. PMID- 3519203 TI - Effects of airborne pollutants on mucociliary clearance. AB - The mucociliary clearance system is a first line of defense against inhaled agents, and so its compromise can adversely affect health. The purpose of this paper is to provide a review of data on the effect of in vivo air pollutant exposures on the clearance of test particles from airways. Data from both animals and humans are compared whenever possible, so that estimates of human health effects may be made. Mechanisms of action are also discussed, presenting the view that for low level exposures, changes in secretions are probably responsible for most observed changes in clearance. The pollutants pertinent to this review are those that are common in the environment and most likely to have impacts on large numbers of people: sulfur oxides, sulfuric acid mist, O3, NO2, particulates, diesel exhaust, and cigarette smoke. PMID- 3519205 TI - Vegetable dust and airway disease: inflammatory mechanisms. AB - Exposure to cotton or grain dust causes an obstructive bronchitis in certain subjects, mechanisms of which are poorly understood. A difficulty encountered in discerning mechanisms of this airway disease is the lack of knowledge of the active components of these dusts. Clinical features suggest common but not exact mechanisms of the airway disease associated with these vegetable dusts. Human and animal studies show evidence of acellular and cellular inflammatory mechanisms of the bronchoconstriction and inflammation associated with these disorders. Potential cellular sources include alveolar macrophages, polymorphonuclear leukocytes, mast cells, basophils, eosinophils and lymphocytes. Acellular origins include the complement and humoral antibody systems, both of which have been implicated, although their pathogenic role in grain or cotton dust disorders is uncertain. In this review we critically address potential inflammatory mechanisms of airway alterations resulting from cotton or grain dust exposure. General mechanisms of bronchoconstriction are first presented, then specific studies dealing with either of the two dusts are discussed. We believe this area of research may be fruitful in dissecting mechanisms of bronchoconstriction and airway inflammation, especially as more human studies are undertaken. PMID- 3519206 TI - Mutagenicity of used crankcase oils from diesel and spark ignition automobiles. AB - The Salmonella mutagenicity assay was used to compare the mutagenic activity of used crankcase oil (UCO) from diesel and spark-ignition (gasoline) engine passenger cars. UCO samples were obtained during periodic oil changes from 9 spark-ignition and 10 diesel-powered vehicles. Five samples of unused motor oil were also tested. Direct tests of UCO did not detect mutagenic activity in Salmonella typhimurium strain TA-98. Therefore, an extraction procedure was used to concentrate the mutagens and remove interfering chemicals. Extracts were tested both with and without Aroclor-1254-induced rat liver homogenate fraction (S-9). Dose-dependent mutagenicity with and without S-9 was observed in both diesel and spark-ignition engine UCO extracts. Mutagenic activity was also found in unused oil extracts, but it was lower than that in UCO extracts and generally required addition of S-9. The mutagenic potency of diesel UCO extracts was similar to that of gasoline UCO extracts, both with and without addition of S-9. This indicated that potential health risks associated with disposal, handling, and recycling of diesel UCO may not be significantly different from those of UCO from gasoline engines. PMID- 3519207 TI - A review of metal accumulation and toxicity in wild mammals. I. Mercury. AB - Release of Hg compounds into the environment from point sources has largely been curtailed due to the known impacts of Hg on biological systems. Mercury continues to be released into the environment, however, from nonpoint sources such as combustion of fossil fuels and smelting operations. While the accumulation and toxicity of Hg in aquatic biota, domestic animals, and humans is well documented, relatively little is understood about these processes in wild terrestrial mammals. The purpose of this paper is to review the available literature on Hg levels and toxicity in wild mammals (excluding marine mammals). It is clear that Hg levels are biomagnified within terrestrial food chains, where carnivores greater than omnivores greater than herbivores. Among carnivorous species, Hg levels are generally highest in fish-eating animals. There is usually a high degree of correlation of Hg levels between different animal tissues. The age and sex of an animal appear to influence observed Hg levels, but field data are conflicting for both factors. Tissue Hg levels are affected by location, with significant differences attributable to both local contamination and natural background variability. Experimental studies have shown many mammal species to sensitive to Hg intoxication, but documented incidents of Hg poisoning in wild mammals are rare. Such rarity may be more a function of our inability to observe and demonstrate Hg poisoning in wild populations, rather than an absence of the disease. PMID- 3519209 TI - Requirements for substrate recognition by bacterial leader peptidase. AB - Many secreted and membrane proteins have amino-terminal leader peptides which are essential for their insertion across the membrane bilayer. These precursor proteins, whether from prokaryotic or eukaryotic sources, can be processed to their mature forms in vitro by bacterial leader peptidase. While different leader peptides have shared features, they do not share a unique sequence at the cleavage site. To examine the requirements for substrate recognition by leader peptidase, we have truncated M13 procoat, a membrane protein precursor, from both the amino- and carboxy-terminal ends with specific proteases or chemical cleavage agents. The fragments isolated from these reactions were assayed as substrates for leader peptidase. A 16 amino acid residue peptide which spans the leader peptidase cleavage site is accurately cleaved. Neither the basic amino-terminal region nor most of the hydrophobic central region of the leader peptide are essential for accurate cleavage. PMID- 3519208 TI - Homologous chromosome recombination generating immunoglobulin allotype and isotype switch variants. AB - We investigated whether spontaneous isotype switching in monoclonal antibody producing hybridomas always occurs with genes on the same chromosome. Spleen cells of (BAB/ 25 X AKR/J) F1 mice, immunized with dansyl-keyhole limpet hemocyanin (DNS-KLH), were hybridized with NS-1 to generate hybridomas producing monoclonal anti-DNS antibodies of either the b or d haplotype of the BAB/25 or AKR/J parent, respectively. We selected isotype switch variants of such hybridomas using the fluorescence-activated cell sorter (FACS). Although in most cases the allotypic haplotype expressed by the parent and switch-variant hybridomas are the same, in one family of variants we noted a switch in haplotype along with the switch in isotype. This was noted in the selection of IgG2a switch variants from an IgG1 switch variant originally derived from an IgG3-producing parent. Biochemical and molecular studies confirm that the allotype switch variant expresses the same heavy-chain variable region gene complex as its parent hybridomas. As such, the allotype switch represents an example of spontaneous mitotic recombination between immunoglobulin heavy-chain genes, generating a single actively transcribed gene from loci previously positioned on different chromosomes. PMID- 3519210 TI - The structure of cat muscle pyruvate kinase. AB - The complete amino acid sequence of cat muscle pyruvate kinase has been determined and fitted to the 2.6 A resolution electron density map. Residues in the active site region are highly conserved in the cat muscle, chicken muscle, rat liver and yeast enzymes. The enzyme-bound magnesium, which is essential for activity, interacts with the side chain of glutamate-271 and with two main carbonyl groups. Lysine-269 is the probable acid/base catalyst responsible for the interconversion of pyruvate and enolpyruvate. A possible binding site for the essential monovalent cation is proposed. PMID- 3519211 TI - Two strains of the Madin-Darby canine kidney (MDCK) cell line have distinct glycosphingolipid compositions. AB - The glycosphingolipids (GSLs) of two sublines of Madin-Darby canine kidney (MDCK) cells, an epithelial cell line, were characterized by t.l.c., antibody overlay and mass spectrometry. The major characteristic which distinguishes the two MDCK cell strains is their trans-epithelial electrical resistance which is typically of the order of 3000 ohm.cm2 for strain I and 100 ohm.cm2 for strain II cells. Strain I and II cells were equally rich in glycolipids, the cellular GSL/phospholipid ratio being 0.04. However, while the phospholipid patterns were identical, the GSLs showed striking differences, and each cell strain expressed appreciable amounts of GSLs that were not found in the other strain. Both cell types possessed neutral GSLs with one, two or three carbohydrate moieties. The monoglycosylceramide accounted for 50% of the total GSLs in each strain. However, while in strain I cells over 90% of this monoglycosylceramide was monoglucosylceramide, in strain II cells over 90% consisted of monogalactosylceramide. In addition, MDCK strain II cells selectively expressed GSLs belonging to the globo series (26% of its neutral GSLs), including globoside and Forssman antigen, a globoside derivative. MDCK strain I cells, on the other hand, expressed another series of GSLs with 4-7 carbohydrate moieties characterized by the common sequence Hex-HexNAc-Hex-Hex-Cer. The presence of two fucosylated GSLs in these series was established. Both MDCK strain I and II cells contained negatively charged GSLs, the major component of which was the ganglioside GM3. MDCK strain II cells in addition expressed sulfatide, the sulfated derivative of galactosylceramide.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3519212 TI - Early replicative intermediates of Escherichia coli chromosome isolated from a membrane complex. AB - The replication origin region of the Escherichia coli chromosome was isolated from an outer membrane fraction. The chromosome was further purified by centrifugation in a cesium chloride gradient. Early replicative intermediates were enriched in the preparation when cytosine-1-beta-arabinofuranoside was added to the culture at the time of initiation of chromosome replication. DNA fragments with an eye structure having two branches of less than 400-500 bp in length were associated with components that were removed by phenol treatment. We conclude that the replication fork usually proceeds counter-clockwise toward the unc operon in the earliest period of replication. PMID- 3519213 TI - Refined 1.2 A crystal structure of the complex formed between subtilisin Carlsberg and the inhibitor eglin c. Molecular structure of eglin and its detailed interaction with subtilisin. AB - The crystal structure of the complex formed between eglin c, an elastase inhibitor from the medical leech, and subtilisin Carlsberg has been determined at 1.2 A resolution by a combination of Patterson search methods and isomorphous replacement techniques. The structure has been refined to a crystallographic R value of 0.18 (8-1.2 A). Eglin consists of a four-stranded beta-sheet with an alpha-helical segment and the protease-binding loop fixed on opposite sides. This loop, which contains the reactive site Leu45I--Asp46I, is mainly held in its conformation by unique electrostatic/hydrogen bond interactions of Thr44I and Asp46I with the side chains of Arg53I and Arg51I which protrude from the hydrophobic core of the molecule. The conformation around the reactive site is similar to that found in other proteinase inhibitors. The nine residues of the binding loop Gly40I--Arg48I are involved in direct contacts with subtilisin. In this interaction, eglin segment Pro42I--Thr44I forms a three-stranded anti parallel beta-sheet with subtilisin segments Gly100--Gly102 and Ser125--Gly127. The reactive site peptide bond of eglin is intact, and Ser221 OG of the enzyme is 2.81 A apart from the carbonyl carbon. PMID- 3519214 TI - Regulation of polypeptide chain initiation and activity of initiation factor eIF 2 in Chinese-hamster-ovary cell mutants containing temperature-sensitive aminoacyl-tRNA synthetases. AB - The regulation of polypeptide chain initiation has been investigated in extracts from a number of well-characterized Chinese hamster ovary (CHO) cell mutants containing different temperature-sensitive aminoacyl-tRNA synthetases. These cells exhibit a large decline in the rate of initiation when cultures are shifted from the permissive temperature of 34 degrees C to the non-permissive temperature of 39.5 degrees C. During a brief incubation with [35S]Met-tRNAMetf or [35S]methionine, formation of initiation complexes on native 40S ribosomal subunits and 80S ribosomes is severely impaired in extracts from the mutant cell lines exposed to 39.5 degrees C. Wild-type cells exposed to 39.5 degrees C do not show any inhibition of protein synthesis or initiation complex formation. Inhibition of formation of 40S initiation complexes in the extracts from mutant cells, incubated at the non-permissive temperature, is shown to be independent of possible changes in mRNA binding or the rate of polypeptide chain elongation and is not due to any decrease in the total amount of initiation factor eIF-2 present. However, assays of eIF-2 X GTP X Met-tRNAMetf ternary complex formation in postribosomal supernatants from the temperature-sensitive mutants reveal a marked defect in the activity of eIF-2 after exposure of the cells to 39.5 degrees C and addition of exogenous eIF-2 to cell-free protein-synthesizing systems from cells incubated at 34 degrees C and 39.5 degrees C eliminates the difference in activity between them. The activity of the initiation factor itself is not directly temperature-sensitive in the mutant CHO cells. The results suggest that the activity of aminoacyl-tRNA synthetases can affect the ability of eIF-2 to bind Met-tRNAMetf and form 40S initiation complexes in intact cells, indicating a regulatory link between polypeptide chain elongation and chain initiation. PMID- 3519215 TI - Amino acid sequence and disulfide bridges of subunit III, a defective endopeptidase present in the bovine pancreatic 6 S procarboxypeptidase A complex. AB - The sequence of the 240 amino acids and the position of the five S-S bridges of subunit III of the bovine pancreatic 6 S procarboxypeptidase A complex have been determined thus confirming its phylogenetic filiation with the pancreatic serine endopeptidase group. The subunit contains at equivalent positions all the elements of the catalytic site of these enzymes. The elements of a binding pocket very similar to that of porcine elastase I are also present in the protein thus accounting for its zymogen-like activity. The most obvious difference is the absence in the subunit of the two strongly hydrophobic amino acids (16 and 17 in the chymotrypsinogen numbering), which are known to participate in the stabilization of a fully functional binding pocket in active endopeptidases. Four of the five disulfide bridges of subunit III are homologous with those common to all pancreatic endopeptidases. In contrast the fifth bridge forms a very small loop of only four amino acids, which is not encountered in active endopeptidases. Other potentially lethal modifications in the structure of the subunit are not excluded. PMID- 3519216 TI - Developmentally regulated phosphoproteins associated with chromosome complexes in yeast. AB - Previous studies on our laboratory have shown that nuclear DNA from Saccharomyces cerevisiae can be isolated in the form of fast-sedimenting chromosome complexes (FSCC). In cycling cells, three FSCC forms, denoted g1 and g2, can be distinguished by their characteristic sedimentation velocities and are found correspondingly in cells in G1, S and G2 of the cell cycle, respectively. A fourth form, denoted go, is found exclusively in stationary-phase and nitrogen starved cells and defines the non-cycling state, Go. We used the differing sedimentation velocities of the FSCC of proliferating and non-cycling cells as a way to isolate and examine their associated proteins. We report here a two dimensional polyacrylamide gel electrophoresis analysis of [35S]methionine and 32PO4-labelled proteins extracted from FSCC isolated from cycling cells (g1, r and g2, collectively denoted 'cycling FSCC'), and nutritionally arrested cells (go FSCC). Among the 120 35S-labelled FSCC-associated polypeptides detected, 25 were unique to go FSCC and 7 were unique to cycling FSCC. Among the 84 32P labelled FSCC-associated polypeptides detected, 52 were unique to go FSCC and 7 were unique to cycling FSCC. Comigrating 35S and 32P-labelled polypeptides were matched in 34 of the 84 phosphorylated polypeptides, and 21 of these showed the same specificity of association to either cycling or go FSCC. This analysis demonstrates that there are major differences in the proteins associated with FSCC from cycling and nutritionally arrested cells, and indicates that a relationship exists between the growth state of the yeast cell, protein phosphorylation and chromosome-complex structure. PMID- 3519217 TI - The interaction of the trp repressor from Escherichia coli with L-tryptophan and indole propanoic acid. AB - The binding of the corepressor, L-tryptophan, and an inducer, indole propanoic acid, to the trp repressor from Escherichia coli was studied by absorbance, fluorescence, circular dichroic and proton NMR spectroscopy. The two ligands bind to the same site on the repressor in the same orientation; they are molecular competitors. The binding site is of relatively low polarity and contains at least one methyl group that lies 0.3 nm over the indole moiety near the C5 proton of the bound ligand, and an aromatic residue, probably tyrosine. The dissociation constant was determined as a function of temperature and pH. At 25 degrees C in 0.1 M phosphate buffer, pH 7.6, the dissociation constant is 18 +/- 2 microM for both ligands. In the same buffer system, the van't Hoff enthalpy for dissociation is 35.5 +/- 1 kJ/mol for tryptophan, and 30.5 +/- 2 kJ/mol for indole propanoic acid. The affinity of the repressor for indole propanoic acid is independent of pH in the range 7 less than 10, but decreases four fold for tryptophan in the same range. The amino group of tryptophan makes a significant contribution to its binding affinity. Difference NMR spectra showed that there are few changes of protein resonances on binding ligands. The NMR signals of the bound resonances were assigned by difference and nuclear Overhauser effect spectroscopy. The properties of the bound resonances are consistent with the ligands being largely immobilised within the binding site. The difference spectra, and the known functional differences of the two ligands, suggest that tryptophan induces a slightly different conformational state in the repressor from that induced by indole propanoic acid. There is no evidence for a global transition. The rate of dissociation of ligands is relatively large, being in the range 400-600 s-1. PMID- 3519219 TI - Myofibrillar interaction of blot immunoaffinity-purified antibodies against native titin as studied by direct immunofluorescence and immunogold staining. AB - Titin (also called connectin), a major but so far highly elusive myofibrillar component in striated muscle was purified from glycerinated chicken breast muscle in its native state by use of a similar purification procedure as recently introduced for purification of native titin from rabbit psoas muscle. Low-angle rotary shadowing reveals highly convoluted, long and slender strands, sometimes more extended and with nodules, but also an aggregation into filamentous bundles and reticular networks. Antisera were raised against the purified native molecule and monospecific titin antibodies prepared by a rapid nitrocellulose blot immunoaffinity-purification procedure. Titin antibodies bound to the nitrocellulose immobilized native antigen were directly conjugated with fluorescein isothiocyanate. Titin specifity of purified antibodies was checked by immunoblotting. Direct immunofluorescence of glycerinated myofibrils revealed a uniform doublet staining pattern within the sarcomeres by labelling the region of the A-I junctions and some diffuse staining in the region of the myosin filaments. The same myofibrils examined by indirect immunoelectron microscopy revealed the gold particles highly concentrated at the A-I junctions with considerable labelling within the A-bands, except in their centers. Residual I bands and Z-lines are free of label. In overstretched myofibrils immunogold staining labelled the gap filaments in the space between I- and A-bands. Isolated native thick filaments showed gold labelling of coiled superthin filaments at the ends of the thick filaments (end-filaments) and at their sides, respectively. The colloidal gold technique in combination with an affinity-purified titin antibody raised against the native molecule adds further evidence for the existence and distribution of an endosarcomeric superthin cytoskeletal filament lattice with titin as a major component. PMID- 3519218 TI - Cross-linking between 16S ribosomal RNA and protein S4 in Escherichia coli ribosomal 30S subunits effected by treatment with bisulfite/hydrazine and bromopyruvate. AB - Cytosine in nucleic acids can be modified by treatment with a mixture of bisulfite and hydrazine. The reaction is specific for single-stranded regions of nucleic acids and the product is N4-aminocytosine. Bromopyruvate has been used for alkylation of protein SH groups and through its 2-oxo group it can form a hydrazone with N4-aminocytosine. Escherichia coli ribosomal 30S subunits were treated with 1 M sodium bisulfite + 2 M hydrazine in the presence of 10 mM MgCl2 at pH 7.0 and 37 degrees C for 30 min. By this treatment, 2.4 cytosine residues/molecule 16S rRNA were derivatized into N4-aminocytosines. 35S-labeled 30S subunits were modified in this way and then treated with 10 mM bromopyruvate at pH 8.0 and 37 degrees C for 5 min. Analysis in sodium dodecyl sulfate/sucrose density gradient centrifugation showed co-sedimentation of a part of the 35S radioactivity with the RNA. The co-sedimentation was dependent on both the bisulfite/hydrazine and the bromopyruvate treatments. The RNA-protein complex was prepared from unlabeled 30S subunits. The protein portion was labeled with 125I, the RNA portion was digested with nucleases, and then the hydrazone linkage between the protein and oligonucleotides was cleaved by treatment with 0.2 M HCl. The oligonucleotides formed were removed by dialysis and the protein was identified as S4 by two-dimensional electrophoresis and by sodium dodecyl sulfate/polyacrylamide gel electrophoresis. The results indicate that the cysteinyl residue of protein S4 at position 31 from the N-terminus is located close to a cytosine residue which is non-base-paired and easily accessible by the externally present bisulfite/hydrazine reagent. PMID- 3519220 TI - Filamin and myosin are present in the secretory pole of amphibian oxyntic cells. An immunofluorescence study. AB - The presence of a filamin-like protein in oxyntic cells was established by indirect immunofluorescence microscopy. The location of this protein and myosin was studied, using specific antibodies, on frozen sections and isolated cells. Antifilamin and antimyosin reacted strongly with the luminal cytoplasm of the cells. In resting oxyntic cells, filamin appeared organized as a reticular sheet in the apical border. In stimulated cells, the apical concentration of filamin decreased, and its distribution appeared rather diffuse. This immunoreactive band seems to correspond to the cytoplasmic region where actin microfilaments have been described previously. The changes in the apical concentration of filamin, induced by the onset of HCl secretion, correlate with the ultrastructural reorganization of the actin network that occurs during the secretory cycle. The use of antimyosin antibodies showed that this protein forms an apical peripheral ring in both resting and stimulated cells. No clear changes in the distribution of myosin, in relation to secretion, could be established by immunofluorescence. These findings, taken together with published morphological and biochemical evidence, suggest that a three-dimensional network composed of actin and filamin is present in the secretory pole of resting amphibian oxyntic cells. The hypothesis that gel-sol transitions play a role in the structural reorganization of the secretory pole of these cells is supported by the present results. PMID- 3519221 TI - Induction of vimentin synthesis in mouse myeloma cells MPC-11 by 12-0 tetradecanoylphorbol-13-acetate. AB - Mouse myeloma cells (MPC-11 cell line) known to lack intermediate filaments were treated with the phorbol ester 12-0-tetradecanoylphorbol-13-acetate (TPA). Asynchronous cell cultures were screened for vimentin by indirect immunofluorescence microscopy, whole cell lysates derived from such cultures by immunoblotting using goat antiserum to vimentin. The minimum TPA concentration sufficient for the induction of vimentin synthesis was found to be 3 X 10(-9) M; substantially larger amounts of vimentin could be detected after treatment of cells with TPA at a concentration of 3 X 10(-8) M. At each effective TPA concentration tested, the maximum level of vimentin was reached after 18 to 24 h; it was dependent on the TPA concentration. In addition, vimentin synthesis was demonstrated employing two-dimensional polyacrylamide gel electrophoresis in combination with either fluorography or immunoblotting and autoradiography. Vimentin purified from TPA-treated MPC-11 cells as well as a protein species in whole lysates from cells labelled with [35S]methionine after TPA treatment for at least 2 h comigrated with vimentin isolated from Ehrlich ascites tumor cells. The fact that only poly(A) +RNA from TPA-treated MPC-11 cells was able to direct vimentin synthesis in vitro suggests that in MPC-11 cells vimentin production is regulated at the transcriptional level. PMID- 3519222 TI - Motility in the siphonous green alga Bryopsis. I. Spatial organization of the cytoskeleton and organelle movements. AB - In the giant marine green alga Bryopsis the chloroplasts are attached with their flattened, ventral sides to the inner surface of the cortical cytoplasm. They move at speeds up to 60 microns/min in the direction of the long axis of the cell either in a coordinated fashion or independently of each other. Intracellular sedimentation of chloroplasts by centrifugation leaves an intact cell cortex in which the movement of mitochondria and nuclei--normally obscured by chloroplasts- can be observed. Mitochondria display a saltatory type of movement alongside an extensive, two-dimensional system of phase-translucent channels. Nuclei appear to be entangled in the channel system and move in an unusual, rolling fashion. With a new technique involving the microsurgical removal of the chemically fixed cytoplasm from the confinement of the cell wall, this unique cell type is made accessible to immunocytochemical procedures. Microtubules (MT) can be visualized using a variety of tubulin antibodies, while actin only reacts with one monoclonal antibody out of several antibodies tested. Microtubules form a dense, two-dimensional palisade of bundles extending longitudinally in the cortical cytoplasm. Parallel arrays of actin fibers closely, but not exclusively, colocalize with the MT bundles. Particularly strong actin staining is observed near converging MT bundles underneath the tip regions of the chloroplasts. Because of the extensive superposition of actin and MTs, both cytoskeletal elements could potentially cooperate in creating the diversity of organelle movements in this alga. The respective roles of MTs and actin in chloroplast movement are experimentally tested in the accompanying paper. PMID- 3519223 TI - Motility in the siphonous green alga Bryopsis. II. Chloroplast movement requires organized arrays of both microtubules and actin filaments. AB - The cortical cytoplasm of the giant cells of Bryopsis contains hundreds of interconnected microtubule (MT) bundles aligned along the cell's long axis. Actin fibers show an extensive but not exclusive superposition with these MT bundles. Chloroplasts move parallel to the bundles. Colchicine (0.5 mM), vinblastine (0.1 mM), and the herbicide ami-prophosmethyl (APM, 1-5 microM) strongly inhibit chloroplast movement and severely disrupt both the MT and the actin network. Additionally, APM leads to the appearance of large actin bundles up to 5 microns in diameter and several tens of micron in length. Erythro-9-[3-(2 hydroxynonyl)]adenine (EHNA, 1 mM) does not block chloroplast movement, but affects chloroplast behavior by causing transient aggregations. The MT network is not significantly changed by EHNA, but actin fibers converge in large, radially symmetric complexes in regions of chloroplast aggregates. Cytochalasin D (CD, 1 10 micrograms/ml) leads to a significant but transient reduction of chloroplast speed within the first 60 min, as the actin network breaks down into small foci. Within the next 1 to 3 h of treatment, these foci segregate into massive clusters where chloroplasts remain immobilized. At the same time, chloroplast movement recovers in other areas of the cell. This recovery coincides with the reappearance of actin filament bundles in these cell regions. The MT cytoskeleton is not significantly affected by CD. These data are inconsistent with a mechanism of chloroplast movement in Bryopsis based solely on either MTs or actin, but instead they suggest an intimate interaction of both cytoskeletal networks in maintaining the spatial organization of the cytoplasm and in supporting chloroplast movement. PMID- 3519224 TI - Evaluation of total anomalous pulmonary venous drainage with cross-sectional colour-flow Doppler echocardiography. AB - Three patients with total anomalous pulmonary venous drainage (TAPVD) were studied by real-time cross-sectional colour-flow Doppler echocardiography. Serial suprasternal, parasternal and subcostal scans were obtained. In all cases surgical or angiocardiographic confirmation was available. Two patients had supracardiac drainage (to the left vertical vein or to the right superior vena cava) and one patient had infracardiac drainage. An abnormal forward flow in the left innominate vein and vertical vein was visualized in those patients with supracardiac TAPVD. Abnormal venous flow was also imaged in one patient with mixed drainage. In the patient with infradiaphragmatic TAPVD characteristic flow signals were identified in the inferior vena cava (retrograde flow) and in the descending aorta and anomalous pulmonary venous channel (forward flow). In all patients the patterns of pulmonary venous flow allowed us to distinguish TAPVD from contiguous structures and to validate two-dimensional cross-sectional imaging. PMID- 3519225 TI - Influence of prophylactic furosemide on arrhythmias in acute myocardial infarction--a controlled study. AB - In a prospective controlled study the frequency of arrhythmias during the early phase of acute myocardial infarction (AMI) was evaluated in 73 consecutive patients randomly assigned to either high or low dose furosemide prophylaxis. The high dose group (HDG) received 120 mg and the low dose group (LDG) 20 mg furosemide i.v. during the initial 24 hours in hospital. Increased diuresis, haemoconcentration and augmented heart rates were found in the HDG. No electrolyte disorders separated the groups. Hypokalemia was seen in two HDG patients and in one LDG patient on admission, and in two and three patients respectively after 24 hours. Continuous ECG recordings at a paper speed of 10 mm s-1 were obtained from all patients. Two patients in the HDG had ventricular fibrillation, none in the LDG. The number of patients with various arrhythmias was not significantly different in the two groups. Supraventricular tachyarrhythmias were more common in the HDG, whereas ventricular tachycardia and ventricular extrasystoles were seen more often in the LDG. We conclude that heart rate and recurrence of tachyarrhythmias in AMI may be influenced by furosemide therapy, seemingly through mechanisms other than electrolyte imbalance. PMID- 3519226 TI - Haemodynamic effects of insulin and beta receptor blockade during acute left ventricular failure in dogs. AB - Acute ischaemic heart failure was induced in 13 dogs by coronary embolisation. Severe dysfunction of the left ventricular (LV) performance was shown by a significant increase in LV end-diastolic pressure and significant decreases in maximum rate of LV pressure rise (LVdP/dtmax), stroke volume and cardiac output. 300 IU of fast-acting insulin was injected as a bolus dose in 7 dogs 90 min after the embolisation procedure. This was followed by infusion of glucose and potassium to maintain normal blood levels. After 15 min, insulin had significantly improved the performance of the failing left ventricle. Total peripheral resistance was decreased. Myocardial blood flow was significantly increased while myocardial oxygen consumption was unchanged. After beta receptor blockade with propranolol 0.5 mg kg-1 given intravenously, the improvement in cardiac performance was reduced, heart rate decreased, and a concomitant decrease in myocardial blood flow and oxygen consumption was recorded. Compared with values before treatment, the net effect of combined insulin and beta receptor blockade was unchanged LVdP/dtmax, LV end-diastolic pressure and cardiac output, significantly increased stroke volume and decreased heart rate, and moderately reduced total peripheral resistance and mean aortic blood pressure. Myocardial blood flow was unaltered, while myocardial oxygen consumption was significantly reduced. In the control group of 6 dogs propranolol was given before insulin, and similar haemodynamic alterations were found. PMID- 3519227 TI - Influence of nifedipine on left ventricular perfusion and function in patients with unstable angina: evaluation with radionuclide techniques. AB - In 1981, a large, double-blind, randomized trial was started in The Netherlands to evaluate the therapeutic effects of nifedipine and/or metoprolol in patients with unstable angina. This study has been called the Holland Interuniversity Nifedipine/metoprolol Trial (HINT) and required several hundred patients to establish potential therapeutic effects. From December 1982 to January 1984 the effects of nifedipine on left ventricular (LV) performance in a subgroup of 52 HINT patients were studied using radionuclide techniques. All patients (23 on nifedipine, 29 controls) underwent thallium-201 scintigraphy or radionuclide angiography just before and 48 h after the start of experimental medication. The radionuclide angiographic studies were also performed at 1 and 4 h after treatment. Nifedipine did not influence the incidence or disappearance of perfusion defects on the 48-h thallium images. No significant differences in overall LV ejection fraction (EF) were seen at any time between nifedipine treated patients and controls. However, paired observations in 37 patients showed improvement of LVEF after 48 h in 8 patients on nifedipine and in only 1 control patient. Scintigraphic measurements on admission were not related to clinical outcome after 48 h. Concomitant administration of metoprolol did not influence LVEF in either group. It is concluded that nifedipine improves LVEF after 48 h in a subset of patients with unstable angina without affecting myocardial perfusion. This finding indicates that nifedipine has a predominant effect on afterload reduction in patients with unstable angina. However, early scintigraphic measurements had no significant predictive value for subsequent cardiac events. PMID- 3519229 TI - Captopril in severe childhood hypertension--reversible anaemia with high dosage. AB - Experience with chronic inhibition of the angiotensin-converting enzyme in children is limited to cases refractory to all other forms of treatment. In reports dealing with the use of captopril (Capoten-R) in children no important side-effects are mentioned. This report describes a 7-year-old boy with severe hypertension secondary to haemolytic uraemic syndrome. Good pressure control was obtained after introduction of captopril. However, under the high initial dosage, pronounced anaemia developed within the first 3 months of treatment. The anaemia responded to dose-reduction while pressure control was maintained. Serial echocardiographic studies were performed. They illustrate the beneficial haemodynamic effects of captopril in the follow-up of children under antihypertensive treatment. Some recommendations are made on the use of captopril in children. PMID- 3519230 TI - Application of a quantitative spectrophotometric endotoxin assay on lymph and plasma from the rat. AB - A quantitative spectrophotometric assay for endotoxin, utilizing Limulus amebocyte lysate and a chromogenic peptide substrate, was standardized for the application on lymph and plasma from the rat. The influence of inhibitors and unspecific amidolytic activity, the optimal incubation times, the adhesion of endotoxin to platelets and glass surface, the variation in endotoxin standard as well as the effects of cold storage on endotoxin activity were settled. In vitro added as well as endogenously derived endotoxin was studied. The method was found to be reliable when in practical use on these media. PMID- 3519228 TI - The cephalosporin antibiotics in pediatric therapy. AB - The cephalosporins have been available for clinical use for nearly 20 years and a large number is presently marketed, including drugs with a wide range of different pharmacokinetic and microbiologic properties. While some of these agents have certain specific uses in which they excel, the cephalosporins have not replaced older antibiotics but do provide the physician with a broader range of choices for the treatment of many infections, allowing greater individualization of therapy. PMID- 3519231 TI - Rejection and survival of auxiliary partial liver grafts in non-tissue-typed pigs. AB - A technique for auxiliary heterotopic transplantation of 60% of the liver has been developed in the pig to study acute and chronic rejection. Transplantations were performed in 13 non-tissue-typed donor-recipient combinations without immunosuppressive medication. Three pigs died in the 1st postoperative week from technical problems. In the remaining 10 animals acute rejection of the graft was not found, but signs of chronic rejection developed in 6 animals. It is concluded that auxiliary partial liver transplantation is technically feasible in the pig. Although the auxiliary liver graft is subject to immune attack, long-term graft survival without immunosuppressive medication can be achieved. PMID- 3519232 TI - Adjuvant hormonotherapy for breast cancer. PMID- 3519233 TI - Antiemetic efficacy of high-dose dexamethasone: randomized, double-blind, crossover study with high-dose metoclopramide in patients receiving cancer chemotherapy. AB - A double-blind, randomized, crossover study was conducted to compare the efficacy and safety of high-dose dexamethasone and high-dose metoclopramide in the treatment of chemotherapy-induced nausea and vomiting. All entered patients had no prior chemotherapy and all received inpatient emetogenic chemotherapy mainly without cisplatin. Of the 40 evaluable patients, 23 (58%) had no vomiting with dexamethasone compared with only 11 (28%) receiving metoclopramide (P less than 0.025). Dexamethasone was found to have less adverse effect than metoclopramide on patient's appetite and activity (P less than 0.025 and P less than 0.01, respectively). Twenty-one patients (53%) developed mild to severe somnolence with metoclopramide compared to only seven (18%) who experienced this adverse effect with dexamethasone (P less than 0.01). Six patients (15%) developed extrapyramidal manifestations with metoclopramide, but none with dexamethasone. Furthermore, during dexamethasone therapy, patients developed less diaphoresis, insomnia, headache and dizziness. Upon questioning patients about their preference to future use of the antiemetic drug therapy, 28 patients (70%) preferred dexamethasone, two (5%) preferred metoclopramide and 10 (25%) found no difference. We conclude that high-dose dexamethasone has a greater antiemetic activity and is more safe than high-dose metoclopramide in patients receiving emetogenic chemotherapy mainly without cisplatin. PMID- 3519234 TI - Management of colorectal cancer. PMID- 3519235 TI - The gerbil: a unique model for research on aging. AB - The Mongolian gerbil (Meriones unguicultatus) is suggested as a model for aging research because of its unique physiological attributes, ease of handling, and because of data previously collected. Factors that demonstrate the gerbils' suitability in fulfulling practical and scientific considerations important in determining a model for aging research are listed. Additionally, several unique physiological attributes of gerbils are described. Based on these attributes and on review of research in gerbils, it is suggested that gerbils can serve as animal models for behavioral and biological processes, and for normative and pathological aspects for aging. PMID- 3519236 TI - Efficacy of and adverse effects of disopyramide. Comparison of capsules, controlled release tablets and placebo in patients with chronic ventricular arrhythmias. AB - The efficacy of disopyramide compared to placebo for exercise induced ventricular arrhythmias was tested in a double-blind randomized controlled clinical trial with cross-over design in 14 patients with coronary heart disease. Disopyramide was given as ordinary capsules (q.i.d.) or as a slow release preparation (b.i.d.) in a total dose of 600 mg per day. The placebo preparations were identical looking capsules and tablets. Each treatment period lasted one week. Efficacy was assessed by a standardized exercise test on a bicycle ergometer and a 6-h Holter monitoring at the end of each period. Plasma levels of disopyramide, measured in conjunction with exercise test, fell within therapeutic range, with a mean value of 7.9 and 8.9 mumol/l for capsules and slow release tablets, respectively. Disopyramide gave a marked and significant reduction of ventricular ectopic beats both at rest and during and after exercise. There was also a significant decrease in the number of ectopic beats recorded on tape during treatment periods compared to during placebo periods. There were no differences between the two preparations with respect to antiarrhythmic effect. Only mild side-effects, mainly mild anticholinergic symptoms, similar for both preparations were reported. No significant cardiovascular changes (heart rate and blood pressure response) were observed. PMID- 3519237 TI - Interference by sulphinpyrazone with the antihypertensive effects of oxprenolol. AB - The interfering effect of sulphinpyrazone, a uricosuric agent which reduces the activity of cyclo-oxygenase, with the antihypertensive activity of oxprenolol, a non-cardioselective beta-blocker with sympathomimetic activity, has been evaluated. Ten patients with primary arterial hypertension of mild to moderate degree entered a randomized double-blind cross-over study versus placebo. They were given oxprenolol + placebo or oxprenolol + sulphinpyrazone for 15 days, and then the treatments were crossed-over for a further 15 days. Oxprenolol significantly reduced blood pressure (161 +/- 3/101 +/- 1 vs 149 +/- 4/96 +/- 2 mmHg) and heart rate (72 +/- 3 vs 66 +/- 3 beats/min). During administration of the combination with sulphinpyrazone the blood pressure increased to its pretreatment level (156 +/- 5/101 +/- 2 mmHg). The effect of oxprenolol on heart rate was not influenced by the combined treatment (67 +/- 6 beats/min). The results may be explained by 1) sulphinpyrazone-induced inhibition of prostaglandin synthesis, which could interfere with the antihypertensive activity of oxprenolol, or 2) sulphinpyrazone-induced acceleration of the metabolism of oxprenolol. PMID- 3519238 TI - Effect of captopril on renal haemodynamics and the renin-angiotensin-aldosterone and osmoregulatory systems in essential hypertension. AB - The effect of captopril on renal plasma flow (RPF), glomerular filtration rate (GFR), plasma concentrations of renin, angiotensin II (Ang II), aldosterone (Aldo) and arginine vasopressin (AVP), serum osmolality (Sosm), free water clearance (CLH2O), fractional urinary excretion of electrolytes and blood pressure (BP), was examined in 10 patients with moderate essential hypertension. Placebo plus furosemide was given for 6 weeks, followed by a 6-week period on captopril and furosemide. The renin-angiotensin-aldosterone system was partly blocked by captopril, resulting in a 18% fall in BP. GFR was reduced by 8% during captopril treatment, whereas RPF remained unchanged. Water loading-induced suppression of Ang II and AVP was inhibited by captopril therapy. Without affecting BP in the placebo period, water loading almost abolished the captopril induced reduction in BP. It is concluded that non-acute captopril treatment of moderates essential hypertension reduces GFR slightly, possibly by producing dilatation of efferent arterioles. The antipressor effect of captopril is lessened during volume expansion, which may be secondary to reduced activity of the renin-angiotensin-aldosterone and osmoregulatory systems. PMID- 3519239 TI - Rapid recovery of in vivo prostacyclin formation after inhibition by aspirin. Evidence from measurements of the major urinary metabolite of prostacyclin by GC MS. AB - The effect of aspirin on the in vivo formation of prostacyclin and thromboxane A2 in normal healthy individuals was studied by measuring the urinary excretion of 2,3-dinor-6-keto-PGF1 alpha and 2,3-dinor-TxB2 by gas chromatography-mass spectrometry. Administration of 500 mg aspirin twice daily caused a sustained reduction in the excretion of 2,3-dinor-TxB2 to 10-15% of the predose value, while the excretion of 2,3-dinor-6-keto-PGF1 alpha was reduced for only about 3 hours after the aspirin dose. The data demonstrate a considerable difference in the inhibitory effect of aspirin on the in vivo synthesis of thromboxane A2 and prostacyclin. PMID- 3519240 TI - Bambuterol: dose response study of a new terbutaline prodrug in asthma. AB - The bronchodilator activity and side-effects of treatment for 4 days with either 0.085, 0.170 or 0.34 mg/kg bambuterol b.i.d. (a prodrug of terbutaline) or 0.071 mg/kg terbutaline t.i.d. have been evaluated over 12 h, in a double-blind, randomized crossover trial in 19 asthmatic out-patients. Plasma terbutaline concentrations after bambuterol administration were smoother, with a ratio between the maximum and minimum values of about 1.4 compared to 2.6 for terbutaline. The plasma terbutaline level rose with dose, but by less than the increase in dose. The bronchodilator effect was related to the plasma terbutaline concentration in each treatment group, so bambuterol produced more prolonged bronchodilatation than treatment with terbutaline. Tremor and cardiac side effects were most pronounced after administration of bambuterol 0.34 mg/kg. No severe side-effects were seen. Bambuterol produced stable plasma levels of terbutaline, indicating that as a prodrug of terbutaline it might possibly be administered once daily with good antiasthmatic effect. PMID- 3519241 TI - Treatment of essential hypertension with felodipine in combination with a diuretic. AB - In a double-blind cross-over study, the effect on blood pressure (BP), heart rate (HR) and plasma noradrenaline concentration (pNA) of placebo or felodipine given in addition to hydrochlorothiazide was studied in 12 male patients with essential hypertension, not satisfactorily controlled with the diuretic alone. The first dose of felodipine decreased BP and increased HR for about 6 h. After 4 weeks of treatment with felodipine, BP was reduced for 24 h, whereas HR was only transiently increased. The elimination half-life of felodipine was about 23 h. The plasma noradrenaline concentration increased after felodipine and serum uric acid decreased. Side-effects were few and usually mild. PMID- 3519242 TI - Bromocriptine in the treatment of hypertension. AB - The efficacy of bromocriptine in the treatment of hypertension was assessed in a double-blind placebo controlled cross-over study preceded by a dose titration phase. A diuretic and/or a beta-blocker were administered concomitantly in constant dosage to 11 of the 20 patients who received bromocriptine. A wide range of doses of bromocriptine was tolerated. Side-effects of vomiting and postural hypertension did not occur, possibly due to the gradual increase in the administered doses. Plasma prolactin was not raised in this population of hypertensives. In the dose titration phase (n = 20), a small fall in diastolic but not in systolic blood pressure occurred with bromocriptine, but only with the patient standing and after exercise. In the double-blind phase (n = 9), there was no significant difference in blood pressure between the bromocriptine and placebo treatments. It is concluded that bromocriptine was not effective in lowering blood pressure in the present patients with essential hypertension. PMID- 3519244 TI - Effect of an alpha-glucosidase inhibitor (BAY m 1099) on post-prandial blood glucose and insulin in type II diabetics. AB - The effect of a new alpha-glucosidase inhibitor (BAY m 1099), a 1 deoxynojirimycin derivative, was studied in 10 black patients with Type II diabetes mellitus. It produced significant lowering of blood glucose concentration after standardized maize porridge meals. No significant untoward effects were noted. BAY m 1099 appears to offer potential benefit in the management of Type II diabetics, and more extensive clinical investigation is warranted. PMID- 3519243 TI - Effects of combined therapy with amiloride and hydrochlorothiazide on plasma and total body potassium, blood pressure, and the renin-angiotensin-aldosterone system in hypertensive patients. AB - After a run-in period of 8 weeks on a regimen of hydrochlorothiazide (HCT, median dosage 75 mg/day), patients with essential hypertension were randomly allocated to continued hydrochlorothiazide therapy (Group I) or additional treatment with amiloride (Group II, median dosage 15 mg/day, or 5 mg per 25 mg hydrochlorothiazide) for the following 12 weeks. Thereafter all the patients were changed to treatment with a fixed combination tablet containing 5 mg amiloride and 50 mg hydrochlorothiazide (Moduretic), keeping the thiazide dosage unchanged for an additional 12 weeks. In Group I patients there was no change in plasma potassium, total body potassium content or the renin-angiotensin-aldosterone system during the 12 weeks on HCT. When the treatment was changed to Moduretic, significant increases were found of 10% in plasma potassium and 3% in total body potassium content. No important stimulation of the renin-angiotensin-aldosterone system was found. In Group II patients addition of an average of 15 mg amiloride to the hydrochlorothiazide treatment led to significant increases in plasma potassium and total body potassium content of approximately 15% and 4%, respectively. There was also a significant increase in the plasma concentrations of renin, angiotensin II and aldosterone. Reducing the average dose of amiloride to 7.5 mg/day by use of Moduretic did not lead to decrease in plasma potassium or total body potassium content. Plasma concentrations of renin, angiotensin II, and aldosterone were decreased, but the individual changes varied markedly and no significant overall change was found. PMID- 3519245 TI - Spontaneous paroxysmal activity induced by zero magnesium and bicuculline: suppression by NMDA antagonists and GABA mimetics. AB - Slices of rat cerebral cortex developed spontaneous paroxysmal discharges when superfused with Krebs medium containing zero Mg2+ or 50 microM bicuculline. In both situations, the N-methyl-D-aspartate (NMDA) antagonists APV, 100 microM, and ketamine, 100 microM substantially reduced the frequency of the paroxysmal events, the reduction being greater in zero Mg2+. gamma-Aminobutyric acid (GABA) 1 mM, the GABA-A agonist muscimol 2 microM and the GABA-B receptor agonist baclofen 10 microM, each reduced the frequency of events in zero Mg2+ while muscimol and GABA also reduced the amplitude of the events. GABA and baclofen were similarly effective against bicuculline-induced events but the muscimol concentration required was 5-10-fold higher. These results suggest that, under our vitro conditions, neocortical cells are normally restrained from paroxysmal discharges by Mg2+. Inhibition by GABA through GABA-A receptors and inhibition by GABA through GABA-B receptors, may also contribute to this restraint. PMID- 3519246 TI - Dissociated effects of inhibitors of enkephalin-metabolising peptidases or naloxone on various nociceptive responses. AB - The antinociceptive effects of Thiorphan, an 'enkephalinase' inhibitor, or bestatin, an aminopeptidase inhibitor, as well as of their association and the pronociceptive effects of naloxone, an opiate receptor antagonist, were evaluated in various analgesic tests in mice. These tests could be classified into two groups: (i) those tests in which the two peptidase inhibitors display naloxone sensitive antinociceptive activity, particularly when administered together, and in which naloxone displays pronociceptive activity (vocalisation, hot-plate jump, writhing), (ii) those tests in which the two peptidase inhibitors and naloxone are ineffective (tail withdrawal, hot-plate licking, tail-flick). In contrast to the above, either morphine or [Met5]enkephalin in subthreshold dosage administrated together with the peptidase inhibitors displayed antinociceptive activity in the two groups of tests. The threshold dosages of morphine were the lowest in tests of the first group. The dissociated and opposite effects of peptidase inhibitors and naloxone per se might reflect a variable participation of endogenous enkephalins (or other opioid peptides) in the control of various nociceptive responses. PMID- 3519247 TI - [Spontaneous diabetes mellitus in cynomolgus monkeys (Macaca fascicularis)]. AB - Glucose tolerance tests were performed with fourteen cynomolgus monkeys. They were divided into two groups with regard to the serum glucose level at the time of routine health-examination. Nine of them had normal glucose level (below 123 mg/dl, the normal group) and the other five monkeys exhibited hyperglycemia (the abnormal group). Fifty per cent glucose solution was administered into the saphenous vein at a dose of 4 ml/head. Blood samples were taken just before and 5, 10, 20, 30, 60 and 120 minutes after the glucose administration. K-value (K = 0.693/t 1/2 X 100) as the decreasing rate of serum glucose during from 5 to 60 minutes after the administration was calculated. Average K-value for eight monkeys of the normal group was 3.12 +/- 0.48. Both immunoreactive insulin level (IRI) and C-peptide immunoreactivity (CPR) increased just after the glucose administration and began to decrease 5 to 30 minutes after the administration in all the eight animals. Remaining one animal (No. 009) of the normal group showed 1.03 in K-value. For the abnormal group, K-value averaged 0.75 +/- 0.25. IRI was slightly higher in this group than in the 8 monkeys of the normal group. Furthermore, the abnormal group did not show any definite change of a certain trend in IRI and CPR. In conclusion, the former 8 monkeys were judged to be normal in the function of pancreatic beta-cells, and the latter 5 monkeys and No. 009 monkey were judged to be suffering from type II (noninsulin dependent) diabetes mellitus at different stages of the disease. PMID- 3519248 TI - [Comparison of characteristics between F344 and Slc:Wistar rats--Slc:Wistar rats cannot be distinguished from the F344 strain]. AB - With respect to F344/DuCrj and Slc: Wistar rats, both widely used in Japan, it was found that there is a close similarity in the changes of body weights and survival rates, and in the organ distribution and incidence of spontaneous tumors. To examine the degree of homozygosity between F344 and Slc: Wistar strains, tumor transplantation and skin grafting were performed. The bladder carcinomas that originated from F344/DuCrj rats grew subcutaneously in the other F344 strains and Slc: Wistar rats, but did not grow in the other Wistar-derived strains. The skin grafts between F344/DuCrj or F344/NSlc and Slc: Wistar rats were accepted, but those between F344/DuCrj or Slc: Wistar and the other Wistar derived strains were rejected. These results suggest that Slc: Wistar rats cannot be distinguished genetically from the F344 strain of rats. PMID- 3519249 TI - Oral filament proteins and their regulation in Tetrahymena pyriformis. AB - Two proteins from the Triton X-100-insoluble fraction of Tetrahymena pyriformis have been isolated and shown by immunological methods to be major components of a pervasive system of filaments localized within the oral apparatus. These proteins, OF-1 and OF-2, have apparent molecular weights (MWapp) in polyacrylamide gels of 87,000 and 80,000 D, respectively. Peptide maps obtained and the absence of immunological cross-reactivity suggest that these proteins are not closely related to each other. Indirect immunofluorescence studies on dividing cells have shown that the oral filament system forms late in the cell cycle. The filaments appeared first after the basal bodies in the oral primordium had organized into groups and the fission furrow had begun to form. Dedifferentiation of the oral filament system in the anterior (old) oral apparatus was also observed at this point in the cell cycle. Following this, the oral filament systems in both old and new oral apparatuses completed development synchronously. Proteins showing antigenic similarity to OF-1 were found in a number of other cell types. Tests with heterologous antisera failed to demonstrate a relationship between vertebrate cytoskeletal proteins and the oral filament proteins of Tetrahymena. PMID- 3519250 TI - Thyrotropin-induced formation of functional follicles in primary cultures of ovine thyroid cells. AB - In primary cultures of ovine thyroid cells, TSH induced the expression of several differentiated functions including the formation of follicles, and synthesis and storage of iodinated thyroglobulin in the follicular lumen. In the present report, these follicles were shown by transmission (TEM) and scanning electron microscopy (SEM) to be intact, comprised of two or more cells and to possess numerous microvilli on the inner cell membranes facing the follicular lumen. The TSH-induced formation of follicles was reversible and dynamic, with the kinetics of formation preceding that of iodination. The follicles were further demonstrated to be functional in terms of thyroglobulin storage and iodination. PMID- 3519251 TI - Transforming growth factor beta alters plasminogen activator activity in human skin fibroblasts. AB - Adult human skin fibroblasts were used as a model to study the effects of transforming growth factor beta (TGF beta) on the secreted plasminogen activator (PA) activity of cultured cells. TGF beta, at nanogram concentrations, enhanced the secretion of pro-PA from two fibroblast strains in a time- and dose-dependent manner. The induced enzymatic activity was inhibited by anti-urokinase antibodies and it co-migrated with purified urokinase in polyacrylamide gels. The secretion of PA activity was abolished when cycloheximide (0.1 microgram/ml) was added to the cultures. The activity was thus dependent on protein synthesis rather than just on direct activation of a plasminogen proactivator. TGF beta had only a slight mitogenic effect on the test cells. Epidermal growth factor (EGF), platelet-derived growth factor (PDGF) and insulin were ineffective alone in inducing PA. Insulin, on the contrary, had an inhibitory effect on the TGF beta induced PA activity. In addition to its effects on the secretion of PA, TGF beta enhanced the production of a proteinase inhibitor by these cells. The results suggest a role for TGF beta in the regulation of PA activity and pericellular proteolysis in fibroblastic cells. PMID- 3519252 TI - Flow-cytometric analysis of mitochondria-associated fluorescence in young and old human fibroblasts. AB - Rhodamine 123 fluorescence in populations of young and old human fibroblasts was analysed and quantified with a fluorescence-activated cell sorter (FACS). Old fibroblasts exhibited a higher mean relative fluorescence than young fibroblasts. Moreover, two distinct subpopulations were evident in the fluorescence distributions of old cells--but not in those of young cells. PMID- 3519253 TI - Modulators of the eukaryotic heat shock response. AB - A wide variety of agents other than heat have been reported to induce or suppress heat shock protein (hsp) synthesis in eukaryotic cells. Such agents, termed 'modulators', include inhibitors of respiration, low molecular weight nutrients, oxygen, hormones, sulfhydryl reagents, ionophores and amino acid analogues. The evidence for modulation is critically reviewed and common mechanisms of action that may relate modulation to induction by heat are discussed. PMID- 3519254 TI - Clustering of cell surface laminin enhances its association with the cytoskeleton. AB - In order to provide evidence for an association of cell surface laminin with the cytoskeleton, we have examined the detergent extractability of cell surface laminin on murine fibrosarcoma cells. We utilized indirect immunofluorescence with affinity-purified anti-laminin antibodies to determine the distribution, mobility and detergent extractability of laminin bound to the cell surface. We demonstrate that antibody induces clustering of cell surface laminin rendering it resistant to detergent extraction. At low receptor occupancy, approx. 80% of cell surface laminin is detergent-extractable. If cell surface laminin is induced to cluster with anti-laminin antibody, IB4 isolectin from Bandeiraea simplicifolia or by high receptor occupancy, then it is rendered resistant to detergent extraction. This process is temperature-sensitive and inhibited by cytochalasin D (CD). On the basis of these findings, we propose a model in which laminin anchored in the basement membrane in vivo affects the cellular cytoskeleton by facilitating the clustering of cell surface transmembrane laminin receptors which are able to interact with cellular actin. PMID- 3519255 TI - Differentiation of rat mesenchymal cells by cartilage-inducing factor. Enhanced phenotypic expression by dihydrocytochalasin B. AB - The role of cell shape in chondrogenesis was studied by using rat mesenchymal cells cultured with cartilage-inducing factor (CIF). Here we report that enhanced expression of chondroblastic markers by induced cells was attained by culturing cells in monolayer in the presence of dihydrocytochalasin B (DHCB). This effect was optimal at 3 microM DHCB and was apparent after 3 days in culture. Mesenchymal cells cultured with DHCB alone exhibited no detectable increase in cartilage proteoglycan synthesis, whereas cells cultured with 3 microM DHCB and 0.1 nM CIF showed a 4-5 fold increase in proteoglycan synthesis. When cells were cultured with CIF alone on plastic, only small increases in proteoglycan synthesis were observed. Cells cultured with CIF in monolayer and then transferred to a permissive environment (either agarose or cultured with DHCB) showed enhanced synthesis of chondroblastic proteins. These results suggest that expression, but not induction, of a chondroblastic phenotype by CIF is inhibited by growth in monolayer. The altering of cell shape with DHCB releases that inhibition. PMID- 3519256 TI - On the role of calcium in the adhesion of embryonic sea urchin cells. AB - Calcium is shown to have several roles in the adhesion of embryonic sea urchin cells. Using an assay that subdivides a cell interaction into sequential steps it is shown that Ca2+ has distinct roles in at least two separate steps. The initial binding step between blastomeres is Ca2+-sensitive, and is shown to require divalent cations themselves rather than replacement of a macromolecular material that might be removed in the absence of Ca2+. The secondary steps of adhesion involve a strengthening of the initial contacts. Ca2+ is shown to be required for at least one and probably more than one of these steps. In addition, the extracellular matrix molecule called hyalin is known to be sensitive to Ca2+ for its polymerization. Hyalin may be involved in the initial steps of cell binding measured by the assay in that cell-cell binding is partially blocked by a Fab antibody fragment directed against hyalin. Finally, two extracts, known from other studies to enhance cell aggregation, were examined for their possible relationship to the Ca2+-sensitive binding of cells. A butanol extract was shown to enhance initial binding in a Ca2+-independent manner. Cells extracted with butanol were greatly reduced in adhesiveness even in the presence of Ca2+. The second extract was obtained from cells by treatment of embryos with divalent cation-free saline. This Ca2+-sensitive factor is shown to contain hyalin which may account for some of its observed activity, though not necessarily all of it. Divalent cation-free-extracted cells regain full adhesiveness immediately upon restoration of Ca2+. Thus the extract is not essential for cell adhesiveness. Together these data show that divalent cations have several roles in the multistepped process called adhesion. PMID- 3519257 TI - Heat shock induction of intranuclear actin rods in cultured mammalian cells. AB - Incubation of cultured cells of mouse C3H-2K fibroblastic cell line and other mammalian cell lines at 42.0-43.0 degrees C for 30 min or longer caused disintegration of normal actin structures including stress fibers, and induced formation of intranuclear actin paracrystal-like structures, called actin rods. When cells exposed to the elevated temperatures were shifted back to 37 degrees C, normal actin structures were regained. Pretreatment of cells at moderately high temperatures such as 38.5 degrees C inhibited formation of the actin rods upon subsequent exposure to 42.0 degrees C. Neither microtubules nor intermediate filaments were disrupted by the heat treatment. Several heat shock proteins were found to be synthesized under the conditions where actin rods were induced. However, there is no causal relationship between two cellular events, the induction of intranuclear actin rods and the synthesis of heat shock proteins. PMID- 3519258 TI - Characterization of DNA sequences associated with residual nuclei of Saccharomyces cerevisiae. AB - We have used two different approaches to determine whether particular DNA sequences are specifically associated with high-salt-treated residual nuclei of Saccharomyces cerevisiae. First, libraries of yeast DNA in phage lambda were probed with nick-translated total nuclear or residual nuclear DNA from unsynchronized yeast cells. None of the plaques gave a significantly stronger or weaker signal with the residual nuclear probe than with the total nuclear probe. Second, DNA was purified from whole nuclei or residual nuclei which had been isolated from cells in G1, G1/S, early S, or nuclear division. This DNA was "dot blotted" and then probed with specific yeast DNA sequences. Ribosomal DNA was 2- to 3-fold enriched in residual nuclei in late G1, G1/S, and early S, and 2 microns plasmid DNA sequences were 3- to 5-fold depleted during nuclear division and early G1. However, ARS1, TRP1, CEN6, and a telomere sequence were neither enriched nor depleted at any time during the cell cycle. PMID- 3519260 TI - Phagocytosis of light- and dark-adapted rod outer segments by cultured RPE cells: a reassessment. AB - Rod outer segments (ROS) isolated from adult rat retinas are phagocytized by cultured rat retinal pigment epithelial (RPE) cells. Using a double immunofluorescent labeling procedure, we have compared the binding and ingestion of ROS isolated at different times of the day. After 2 hr of incubation, approximately 98% of the ROS are ingested, while 2% are still attached to the RPE cell surface, irrespective of the time of day or lighting conditions under which the ROS are isolated. These findings differ from those reported earlier, using a radioactive method for quantitating ROS phagocytosis (Hall, 1978). PMID- 3519259 TI - Collagen degradation and synthesis in experimental corneal grafts. AB - Thirty-two weanling New Zealand white rabbits were labelled repeatedly with [2,3 3-H]-proline for 4 weeks. Four weeks after the end of labelling, 32 rabbits underwent bilateral 6 mm trephinations for donor purposes. One control cornea of each pair was frozen at -70 degrees C. The contralateral corneas were used for autografts, allografts, and xenografts. Grafts were observed from 7-200 days, then retrephined out for determination of loss in total radioactivity in hydroxyproline (specific for collagen), increase in newly synthesized collagen, and net change in collagen mass, by comparing with the matched, ungrafted control corneas. For all three transplant groups there was a small, but significant, decrease early in total radioactivity (loss of original collagen) and a significant increase in new collagen. These data also indicated that the loss of original collagen was replaced by an equivalent or greater increase in new collagen in all transplant groups. Significant relationships between graft clarity and collagen turnover were noted in both the auto- and allograft groups. The degradation of old collagen was significantly greater in the cloudy vs. the clear grafts; however, there was no significant difference in the increase in new collagen between these groups. A progressive loss of original collagen over time was noted in the cloudy autografts, but not the allografts. A trend toward a progressive increase in new collagen was noted over time in both the cloudy auto- and allografts. No relation for these variables to time, however, was noted in the clear grafts. PMID- 3519261 TI - Neuropeptide Y and the innervation of the human eye. AB - Using the indirect immunohistochemical technique, neuropeptide Y as found in human ocular nerves. While limbal blood vessels were innervated and a few nerves were seen in the trabecular meshwork, the cornea proper contained no immunoreactive nerve fibers. Neuropeptide Y-like immunoreactive nerves supplied the iris dilator muscle and, to a lesser extent, the iris sphincter. Immunoreactive nerve fibers were present within the ciliary muscle and the ciliary processes. Neuropeptide Y-like immunoreactive choroidal nerve fibers were frequently associated with blood vessels. The apposition of immunoreactive nerve fibers and melanocytes occurred throughout the uvea. The distribution of neuropeptide Y-like immunoreactive nerves in the eye closely parallels the adrenergic innervation. Evidence linking neuropeptide Y to the ocular sympathetic innervation is discussed. PMID- 3519262 TI - Distribution of fibronectin in human and rabbit corneas. AB - In order to study the possible role of fibronectin (FN) in corneal wound healing and the relationship between FN and sensory innervation, FN was demonstrated immunohistochemically in both normal and sensorily denervated rabbit corneas and in normal or tissue-cultured human corneas. The distribution of FN was the same in the groups examined: a thin subepithelial band of FN-like immunoreactivity was seen at the level of epithelial basement membrane and at the stromal side of Descemet's membrane. Epithelial abrasions were also performed in both normal and denervated rabbit corneas. The results were compared with those obtained from organ-cultured human corneas. Following abrasion of the corneal epithelium, FN was detected in the anterior margin of the denuded stroma 18 hr after the operation in the areas where the epithelium had not healed, but not 49 hr after. Sensory denervation did not affect the distribution of FN in normal, denervated or healing rabbit cornea. It is concluded that FN is probably not controlled by sensory innervation. PMID- 3519263 TI - Recovery of CFU-GM from cryopreserved marrow and in vivo evaluation after autologous bone marrow transplantation are predictive of engraftment. AB - In 18 patients with non-Hodgkin's lymphomas or solid tumors treated with intensive chemotherapy and/or total-body irradiation followed by autologous bone marrow transplantation (ABMT), we assessed the value of granulocyte-macrophage progenitor cells (CFU-GM) monitoring to predict engraftment. We studied CFU-GM in cryopreserved marrow and attempted to settle whether detection of CFU-GM in vivo after ABMT has a predictive value on engraftment. Our data showed: The absence of linear correlation linking recovery of hematopoiesis to the dose of CFU-GM/kg infused. The existence of a CFU-GM threshold in respect to engraftment. Patients receiving doses of CFU-GM greater than 10(3)/kg had significantly faster recovery kinetics for hematopoiesis than did patients receiving doses below this threshold, with median recoveries to 0.5 and 1.0 X 10(9) neutrophils/liter, respectively, on days 14 and 15 versus days 29 and 31.5 (p less than 0.05 and p less than 0.02) and median recoveries to 1.0 and 2.5 X 10(9) leukocytes/liter respectively, on days 12.5 and 16 versus days 28 and 30.5 (p less than 0.05 and p less than 0.02). Considering the entire course of events during the first four weeks, we were able to show that white blood cell recovery was significantly faster in the group of patients receiving doses of CFU-GM greater than 10(3)/kg (p less than 0.001). Sequential studies of the reappearance of CFU-GM in marrow and peripheral blood indicated that the kinetics of CFU-GM recovery in vivo after ABMT predict engraftment. By day 7 after the graft, CFU-GM were already detectable in the marrow at a level of 10% of the dose infused for patients with optimal engraftment--median time to recovery to 1.0 and 2.5 X 10(9) leukocytes/liter and 1.0 X 10(9) neutrophils/liter on days 11, 15, and 14.5 versus days 18, 23, and 23 (p less than 0.02, less than 0.05, and less than 0.05), respectively after. On day 10 after ABMT, a 15% CFU-GM level in bone marrow confirmed engraftment, with a significant correlation of all parameters studied--1.0 and 2.5 X 10(9) leukocytes/liter (p less than 0.02 and less than 0.01), 0.5 and 1.0 X 10(9) neutrophils/liter (p less than 0.05), 50.0 and 100.0 X 10(9) platelets/liter (p less than 0.05). On day 14, a 50% CFU-GM level was reached in all patients with optimal engraftment; p less than 0.01 on 1.0, and 2.5 X 10(9) leukocytes on 0.5 and 1.0 X 10(9) neutrophils/liter. The detection of circulating CFU-GM in the blood by day 10 or 14 indicated engraftment.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3519264 TI - Evaluation of lymphocyte subsets after autologous bone marrow transplantation with marrow treated by ASTA Z 7557 in acute leukemia: incidence of the in vitro treatment. AB - The lymphocyte subset reconstitution after high-dose chemotherapy and total body irradiation followed by autologous bone marrow transplantation (ABMT) has been studied in ten patients with acute leukemia (AL) (6 ALL and 4 ANLL) in complete remission (CR). Bone marrow was treated in vitro with high-dose ASTA Z 7557, individually determined according to CFU-GM sensitivity. The different peripheral blood lymphocyte subsets were characterized by means of monoclonal antibodies (indirect immunofluorescence assay) belonging to the following classes of differentiation: OKT11-T11 (CD2), OKT3-T3 (CD3), OKT4-T4 (CD4), OKT8-T8 (CD8), OKIal-I2 (HLA-DR), Leu7 (natural killer/killer) and by means of polyspecific antiimmunoglobulin sera (direct immunofluorescence assay). Data in these ten patients were compared with those of a control group of 21 normal donors and with a control group of 14 patients in CR without ABMT. Our results showed a marked depression of the T4:T8 ratio in patients with AL before ABMT, compared with normal donors who had respective values of 1.02 and 1.33 (p less than 0.01). This depression was increased and prolonged up to day 515 after ABMT, with a value of 0.32 (p less than 0.01 compared with the pregraft situation; p less than 0.001 compared with normal donors). This T4:T8 ratio imbalance was related to the depletion of the T4+ population and to the increase of the T8+ subset. This imbalance was emphasized after ABMT. The Leu 7+ population was also increased in grafted patients compared with normal donors (p less than 0.01). The B-cell population remained unchanged throughout the study. We conclude that patients autografted with marrow treated in vitro by high-dose ASTA Z 7557 may experience a long-term T-cell subset imbalance. PMID- 3519265 TI - Aging and hematopoiesis. VI. Neutrophilia and other leukocyte changes in aged mice. AB - The concentration of blood leukocytes rose progressively as mice aged. All blood leukocytes increased, although a greater degree of increase was seen in neutrophils and monocytes than in lymphocytes and eosinophils. The total number of nucleated cells per marrow cavity of the humerus was also higher in aged than in young adult mice, the increase primarily reflecting peroxidase-positive cells. Both blood and marrow neutrophils of aged mice responded to perturbations induced by bleeding or by endotoxin injection in a manner qualitatively similar to that seen in young adults. When hematopoietic chimeras were produced by marrow transplantation, blood and marrow neutrophils were characteristic of the age of the recipient, not the cells; i.e., young mice kept a "young" neutrophil pattern and old mice kept an "old" neutrophil pattern when given marrow from either old or young mice. Colonies of granulocytes and/or monocyte-macrophages were grown from young marrow cells placed in plasma clots in Millipore chambers in the peritoneal cavity. The number of colonies was the same in young and in old mice, suggesting that long-range humoral stimulation of cell growth was similar in young and old. Thus, neutrophilia due to increased neutrophil production appears to be a normal part of the aging process in the mouse. The increase in neutrophil production may be due to a changing hematopoietic microenvironment. PMID- 3519266 TI - Abstracts. Fifteenth annual meeting, International Society for Experimental Hematology. 10-14 August, 1986, Buffalo, New York, USA. PMID- 3519267 TI - International Society for Experimental Hematology. 8 April 1986. Membership roster. PMID- 3519268 TI - Visuomotor properties of neurons of the anterior suprasylvian gyrus in the awake cat. AB - Single cell activity was recorded from the Anterior Suprasylvian (ASS) gyrus of cats trained to orient their gaze toward visual or auditory stimuli. Sixty-five fixation cells were activated or suppressed as long as the animals were attentive to a particular region of space in the tangential or in the radial direction. Most of these fixation cells were neither light nor sound sensitive. Fifty-five cells were activated in relation to saccades. Fourteen neurons were active before and 41 after the onset of saccades. Nineteen neurons were also active with spontaneous eye movements in the dark. Fifteen neurons were seemingly related to vergence. They were not light-sensitive. They were preferentially activated by visual stimuli moving in the radial direction either towards or away from animal's face. Fifty light-sensitive neurons responded to moving stimuli. Only two neurons responded to onset of eccentric stationary light-stimuli. Fifty-one neurons showed a modulation in relation to vestibular stimulation. A majority showed, in addition, a vestibulo-collic response. These data suggest that the ASS gyrus in cats has a major role in the construction of the behavioral space. PMID- 3519269 TI - Schistosoma mansoni: purification and characterization of the major acidic proteinase from adult worms. AB - We report purification of the major digestive proteinase from adult worms of Schistosoma mansoni. This enzyme is a thiol proteinase with a pH optimum of 5 and is activated by thiol reagents. It was purified 300-fold using a combination of gel chromatography and chromatofocusing. It readily hydrolyzed hemoglobin with an apparent Km of 0.29 microM and a specific activity of 27 micrograms degraded/min/mg enzyme at 37 C. Peptides with positively charged amino acids were preferentially cleaved. The enzyme degraded Boc-Arg-Arg-7-amino-4-methyl coumarin with a kcat/Km of 9083 M-1 sec-1. Lengthening the peptide chain to 3 amino acids or substituting glycine for the amino terminal arginine resulted in decreased activity. The enzyme was inhibited by chloromethylketone-derivatized peptides of similar sequence and by leupeptin. The purified proteinase exhibits microheterogeneity in different preparations with forms ranging in molecular weight from 30,000 to 35,000, and pI 5.7-6.0. PMID- 3519270 TI - Immunomodulating peptides. PMID- 3519273 TI - The effects of ethanol on embryonic actin: a possible role in teratogenesis. AB - When the neural crest is cultured in the long or short term presence of ethanol, monoclonal anti-actin reveals the development of a disorganized actin cytoskeleton. In the long term, many cells fail to differentiate morphologically, whereas in the short term already differentiated cells rapidly alter their shape and their cell-to-cell contacts. PMID- 3519272 TI - Serotonin in the human infant carotid body. AB - By immunocytochemistry serotonin was localized in the chief cells of the carotid body in human infants. Radioenzymatic measurement of the serotonin concentration revealed that it represents a significant proportion of the total amine content of the carotid body. PMID- 3519271 TI - Suitability of urethane anesthesia for physiopharmacological investigations. Part 3: Other systems and conclusions. AB - The suitability of urethane anesthesia for physiopharmacological experiments in various systems is briefly reviewed. Urethane anesthesia appears to be suitable for various types of studies on respiratory function and on reflex activation of motility of the urinary bladder and some sections of the intestinal tract. However, urethane produces a variety of potentially disturbing side-effects at endocrine and renal level. PMID- 3519274 TI - [Role of the kidneys in protecting the body from xenobiotics]. PMID- 3519275 TI - [Role of pharmacokinetics in realizing the embryotoxic action of drugs]. PMID- 3519276 TI - [Stimulation of ovulation with analogs of luliberin, androstenol and their combination with L-DOPA]. AB - The stimulating effects on ovulation of three original analogues of luliberin and three derivatives of androstenol as compared with clomiphene were shown. An increase of their effects under the conditions of activation of the adrenergic system by L-DOPA administration was also found. PMID- 3519277 TI - [Effectiveness of nonsteroidal antiphlogistics in experimental diabetes mellitus]. AB - In experiments on rats with alloxan diabetes efficacy of amidopyrine, acetylsalicylic acid, methyluracil, butadione and brufen in experimental inflammation was shown. The antiinflammatory drugs under study were found to have various effects on insulin and glucose blood levels in intact rats and those with diabetes. The increase in glucose content under the influence of methyluracil is presumably connected with the elevation of somatotrophic hormone blood level. Acetylsalicylic acid and butadione reduce the content of somatotrophic hormone. Methyluracil potentiates antiexudative effects of acetylsalicylic acid and amidopyrine. PMID- 3519279 TI - Is phospholipid a required cofactor for the activity of mammalian signal peptidase? AB - To determine whether phospholipid is required for the activity of mammalian signal peptidase, the enzyme was partially purified from porcine pancreas and then extensively freed of phospholipid by SP-Sephadex C-50 chromatography. The delipidated enzyme showed signal peptidase activity, with a low concentration of detergent. Phospholipid was found to release the enzyme from the inhibition due to excess detergent. PMID- 3519278 TI - [Results of the experimental study and clinical use of the tranquilizer mebikar]. PMID- 3519280 TI - Parvalbumin in rat kidney. Purification and localization. AB - The Ca2+-binding parvalbumin has been purified for the first time from rat kidney. Its biochemical and immunological properties were indistinguishable from the muscle counterpart. By immunohistochemical methods parvalbumin was localized in part of the distal tubule and proximal collecting duct, similar to the vitamin D-dependent Ca2+-binding protein, calbindin-28K. Parvalbumin was found to be independent of the vitamin D status of the animal since its concentration remained unchanged in kidney extracts of normal, rachitic and vitamin D-replete rats. Both proteins may be involved in the regulation of intracellular Ca2+ in kidney. PMID- 3519281 TI - Hydroxymethylglutaryl-CoA reductase--the rate-limiting enzyme of cholesterol biosynthesis. A report of a meeting held at Nijenrode Castle, Breukelen, The Netherlands, August 24, 1985. PMID- 3519282 TI - Acylated fibronectin: a new type of posttranslational modification of cellular fibronectin. AB - Human fibroblasts were labelled with either [35S]methionine or [3H]palmitate and analyzed for the presence of 35S- or 3H-labelled fibronectin by immunoprecipitation and SDS-polyacrylamide gel electrophoresis. The majority of 35S-labelled fibronectin was found in the extracellular matrix of cells which could be removed quantitatively by mild trypsin treatment. In contrast, 3H labelled fibronectin was found in a trypsin-resistant form. The 3H label of fibronectin could be identified predominantly as [3H]palmitate by HLPC analysis. The fatty acids remained stably associated with fibronectin during extraction and electrophoresis, indicating a covalent linkage. These results demonstrate that a subset of fibronectin different from extracellular matrix fibronectin is modified by acylation. PMID- 3519283 TI - Stimulation of protein synthesis, glucose uptake and lactate output by insulin and adenosine deaminase in the rat heart. AB - In the anterogradely perfused rat heart, physiological concentrations of insulin stimulated the rates and efficiencies of protein synthesis in both ventricles and atria. Half-maximal stimulation of ventricular protein synthesis was obtained at about 35 microU/ml. Glucose uptake and lactate release were also stimulated over this range of insulin concentrations. Adenosine deaminase increased protein synthesis rates in ventricles and atria in the presence of submaximally stimulating insulin concentrations (40 microU/ml) but had no effect in the absence of insulin or in the presence of maximally stimulating concentrations. The insulin sensitivities of glucose uptake and lactate release were also increased by adenosine deaminase. Adenosine may be a modulator of insulin sensitivity in the heart. PMID- 3519284 TI - Differences in cathepsin B mRNA levels in rat tissues suggest specialized functions. AB - The tissue distribution of mRNAs encoding two lysosomal proteases, cathepsin B and cathepsin D, was examined using cloned cDNAs to probe Northern and dot blots of RNAs extracted from various rat tissues. Cathepsin B mRNA showed a wide range of variation in expression in the tissues analyzed with the highest concentrations found in spleen and kidney, while the cathepsin D mRNA levels were relatively uniform in these same tissues. Significant quantities of cathepsin B mRNA were detected in total RNA from isolated islets of Langerhans but was not detectable in equivalent amounts of RNA from whole pancreas. The wide variations in tissue levels of cathepsin B mRNA suggest that tissue specific controls may regulate its expression and are compatible with the participation of this protease in specialized cellular functions other than intralysosomal protein degradation. PMID- 3519285 TI - Adjuvant chemotherapy in the treatment of breast cancer: results of a multicentre study. AB - 248 patients with locally radically treated early breast cancer (196 node positive) were randomized post-operatively between 6 courses of a 'CMF like' chemotherapy and no further treatment. Results (with a minimum of 5 years follow up on every patient) favour chemotherapy with a significant increase in the median time to recurrence from 31 to 50 months for all patients (P = 0.04) and from 26 to 49 months for node-positive patients (P = 0.023). No significant effect on survival is seen although there is a trend towards longer survival in the treated group. The regimen used was relatively non-toxic when compared to the traditional CMF with 34% of patients experiencing mild nausea and vomiting immediately post-injection and only 11% complaining of more severe nausea and vomiting. Because of this lower toxicity the treatment was found to be amenable to administration in both regional hospitals and specialized centres. PMID- 3519286 TI - Fine needle aspiration in the diagnosis of breast masses: our experience. AB - The authors compare their experience, obtained after 626 examples of fine needle aspiration cytology of the breast, with the results of other departments. The very high specificity of the test is confirmed (absence of false positive). Also false negatives are quite low (6%). Finally, the repeatibility of such a procedure and the low cost suggest inclusion of fine needle aspiration cytology in every diagnostic protocol for mammary cancer. PMID- 3519287 TI - Eponyms in oncology. Moritz Kaposi (1837-1902). PMID- 3519289 TI - Transport of essential nutrients across the blood-brain barrier of individual structures. AB - The movement of essential substrates from plasma into cerebral structures has been studied in detail in normal alert rats as well as in rats with various metabolic abnormalities. Briefly, radioactive substrates were infused i.v. to rapidly establish and maintain a trace concentration in arterial blood. The rats were killed shortly thereafter, the brain was removed and frozen, and thin sections were cut for quantitative autoradiography. The permeability-to-surface area product (PA) was calculated from the amount of radioactivity accumulated by the brain and the integral of plasma radioactivity. Influx was calculated as the product of PA times plasma substrate concentration. This approach was used to measure the influx of glucose, neutral amino acids, basic amino acids, and ketone bodies. Studies were made of normal rats, rats with portacaval shunts (a model of hepatic encephalopathy), starved rats, diabetic rats, and normal rats infused with ammonium acetate. The results demonstrate specific changes in individual transport systems, which in most cases occurred throughout the brain, although some structures were affected more than others. PMID- 3519288 TI - Blood-brain transport of nutrients. Introduction. PMID- 3519290 TI - Blood-brain barrier transport of the alpha-keto acid analogs of amino acids. AB - A number of alpha-keto acid analogs of amino acids have been found to penetrate the blood-brain barrier (BBB). Pyruvate, alpha-ketobutyrate, alpha ketoisocaproate, and alpha-keto-gamma-methiolbutyrate all cross the BBB by a carrier-mediated process and by simple diffusion. Under normal physiological conditions, diffusion accounts for roughly 15% or less of total transport. Aromatic alpha-keto acids, phenylpyruvate, and p-hydroxyphenylpyruvate do not penetrate the BBB, nor do they inhibit the transport of other alpha-keto acids. Evidence based primarily on inhibition studies indicates that the carrier mediated transport of alpha-keto acids occurs via the same carrier demonstrated previously for propionate, acetoacetate, and beta-hydroxybutyrate transport, commonly referred to as the monocarboxylate carrier. As a group, the alpha-keto acid analogs of the amino acids have the highest affinity for the carrier, followed by propionate and beta-hydroxybutyrate. Starvation for 4 days induces transport of alpha-keto acids, but transport is suppressed in rats fed commercial laboratory rations and subjected to portacaval shunts. The mitochondrial pyruvate translocator inhibitor alpha-cyanocinnamate has no effect on the BBB transport of alpha-keto acids. PMID- 3519291 TI - Neutral amino acid transport at the human blood-brain barrier. AB - Transport regulates nutrient availability in the brain, and many pathways of brain amino acid metabolism are influenced by precursor supply. Therefore, amino acid transport through the blood-brain barrier (BBB) plays an important rate affecting role in brain metabolism. Information on the Km of BBB amino acid transport provides the quantitative basis for understanding the physiological importance of BBB transport competition effects. For example, the uniquely low Km values of BBB amino acid transport as compared to other organs in the rat provides the basis for the selective vulnerability of the rat brain to changes in amino acid supply caused by nutritional factors. The development of amino acid imbalances in the human brain in parallel with amino acid imbalances in blood is likely to occur if the Km of BBB neutral amino acid transport in humans is low, e.g., 25-100 microM, as is the case for the rat. A new model system of the human BBB, the isolated human brain capillary, has been developed. Recent studies with this system indicate that the Km of phenylalanine transport into human brain microvessels is approximately the same as that found during in vivo studies with laboratory rats. These results support the emerging hypothesis that the human brain, like the rat brain, is subject to acute regulation by dietary-related amino acid imbalances, and that the major site of this regulation is the amino acid transport system at the BBB. PMID- 3519292 TI - Isosexual precocity: current concepts and recent advances. PMID- 3519293 TI - [Circulation of antistaphylococcus and antitetanus antibodies in rabbits after intravenous passive immunization]. PMID- 3519294 TI - [Remembering Prof. Karoly Balogh]. PMID- 3519295 TI - [A new method for using the roots of molars as support]. PMID- 3519296 TI - [Rhythms of the digestive system and the body's biological clocks]. AB - A hierarchic system of short-period rhythms are supposed to exist in the gastro intestinal tract (GIT). A periodical activity (PA) of the GIT was considered from the standpoint of its role in the control of intraintestinal transit. A hypothesis is proposed concerning the structure and mechanism of the PA rhythm clock. The daily interaction of own rhythms of the enterometa-sympathetic system with the food intake triggers the intramuscular oscillator, two physiologically significant signals of which (filling up of the stomach and transit to the colon) are under the control of higher nervous centers. On the basis of the intramuscular oscillator, a central also double one, is formed, and a mutual neuro-humoral interaction is established between them. Significance of this mechanism is emphasized not only for the GIT activity but as a "timer" for ultraradian rhythms as well. PMID- 3519298 TI - [Porcelain crowns with fine gold margins. Technical preparation recommendations]. PMID- 3519299 TI - [Light auto-polymerization produces color shadings depending on the skills of the technician]. PMID- 3519297 TI - [Bombesin and monoamine-containing cells of the rat stomach]. AB - Revealing of enterochromaffine and enterochromaffine-like cells of the rat stomach was undertaken under the effect of bombesin and alpha- and beta adrenoblocking agents. Fibers containing gastrin-releasing-peptide were immunohistochemically revealed in neural plexus of the rat digestive tract. Spontaneous rhythmic release of the stomach monoamine cells' secret was shown. The effect of bombesin on the enterochromaffine-like cells of the rat stomach fundus containing histamine, was shown to be actualized through beta adrenoreceptors. Serotonin excretion from the enterochromaffine cells of the stomach antrum depends neither on bombesin nor on the adrenergic effects. PMID- 3519301 TI - Assessment of epidermal atrophy in localized scleroderma (morphea). AB - The skin surface of scleroderma skin becomes glossy as a result of epidermal atrophy. In this study, the skin relief was studied in 12 patients with localized scleroderma (morphea). Measurements by a stylus method showed smoothening of the skin in all plaques studied (p less than 0.01). Ultrasound measurement showed increased skin thickness (p less than 0.01). There was no correlation between smoothening of the skin surface and increase in skin thickness, and no correlation to the duration of the plaques. It is concluded that glossy appearance of plaques of scleroderma is an early sign, which may be useful in the clinical diagnosis of scleroderma. PMID- 3519300 TI - [2 materials--a combination design color scale with no possible problems]. PMID- 3519302 TI - Dapsone in the treatment of cutaneous lupus erythematosus. AB - Thirty-three patients with chronic discoid lupus erythematosus (DLE) who had received dapsone for 1-27 months were reviewed. The dapsone treatment gave excellent results in 8 patients (24%), some effect in 8 patients (24%), while no response was seen in 17 patients (52%). Of the patients who had earlier been treated with hydroxychloroquine (HCQ), 76% responded excellently to the treatment. Of 6 patients who received a combined dapsone and HCQ therapy, 2 responded well. Six patients (18%) terminated the dapsone treatment because of side effects, none of which were serious. It is concluded that dapsone might be an alternative or a supplement to HCQ in the treatment of DLE, when the latter causes adverse reactions or fails to be effective. However, we find that HCQ remains the drug of choice when systemic treatment is needed. PMID- 3519303 TI - Good aesthetic restoration: combined techniques. PMID- 3519304 TI - Review of the main epidemiologic-etiologic evidence that implies mechanical forces as factors in osteoarthritis. PMID- 3519305 TI - Immunocytochemical localization of actin in the sperm head of Talpa europaea (Insectivora). AB - Actin in the sperm head of Talpa europaea was observed by immunofluorescence and immunoelectron microscopy. The indirect immunofluorescence technique, using both anti-actin and DNase anti-DNase methods, showed a shining fluorescent band around the sperm head in some spermatozoa, whereas in others the fluorescence was found in the postacrosomal region. Since no labeling was detected in sperms treated with NBD-phallacidin, it is likely that mature mole sperms contain G-actin but not F-actin. The results of electron microscopy indicated the deposition of the anti-actin antibodies in two places in mole spermatozoa: the postacrosomal region and the nuclear segment of the acrosome. In the first case, the actin was localized in the space between the outer surface of the postacrosomal sheath and the plasma membrane; in the second one, the actin was localized in the space between the outer acrosomal membrane and the plasma membrane. The significance of the presence of actin and its role(s) during fertilization are discussed. PMID- 3519306 TI - 2-deoxy-D-glucose metabolism in individual tissues of the rat in vivo. AB - The nature of and rates of loss of products of systemic radiolabelled 2-deoxy-D glucose in rat tissues in vivo were investigated to validate the use of this tracer to measure rates of metabolism of circulating glucose by tissues in vivo. Apparent first order rate constants for loss of products ranged from 8.0 +/- 0.10 (SD) X 10(-3) min-1 (liver) to 2.2 +/- 0.8 X 10(-3) min-1 (skeletal muscle). 2 deoxyglucose 6-phosphate was the major product found in all tissues examined except liver; all tissues contained other minor products. Products were effectively trapped by rat tissues in vivo allowing the use of this tracer for the measurement of rates of circulating glucose utilisation by tissues in vivo. PMID- 3519307 TI - Mannitol oxidase: partial purification and characterization of the membrane-bound enzyme from the snail Helix aspersa. AB - Mannitol oxidase, a membrane-bound oxidase has been purified 250-fold from snail digestive gland tissue. The activity is solubilized by a number of ionic, non ionic, and zwitterionic detergents. Purification of the solubilized enzyme was by polyethylene glycol fractionation and column chromatography using anionic exchange resins, hydroxylapatite, and gel filtration. The enzyme is stabilized by glycerol and remains active for at least one week at -20 degrees. Hydrogen peroxide is the oxygen reduction product and a mannose/hydrogen peroxide stoichiometry of 0.86 was found. D-Arabinitol and D-mannitol were the most active substrates of those tested. Results with these and other substrates suggest that the configuration around carbons-2 and -4 is critical for binding and reactivity. The apparent Km for D-mannitol is 6 mM and for oxygen, 40 microM. The pH optimum for the enzyme is between 8 and 8.5 and the isoelectric point is 5.4-5.6. PMID- 3519308 TI - Purine nucleotide metabolism: the discovery of a major new oligomeric adenosine tetraphosphate derivative in rat heart. PMID- 3519309 TI - Modulation by concanavalin A of the hormonal response in DNA-synthetic and transcriptional activity of a mouse mammary adenocarcinoma culture. AB - The tissue responds in culture differently to each of the tested hormones. Insulin, but not prolactin or hydrocortisone, was mitogenic to the culture, but did not alter the overall transcriptional activity pattern displayed by the insulin-free cultures. Prolactin stimulated transcriptional activity above control levels between days 2 and 6 of culture, but hydrocortisone was inhibitory to both DNA-synthetic and transcriptional activity of the culture. Upon initial 24-hr treatment with 50 micrograms/ml monovalent concanavalin A, the tissue altered its hormonal sensitivity in the examined activities, but the presence of any one of the hormones in the culture medium abolished the individual effect of concanavalin A. With hydrocortisone, however, the individual effects of the lectin and the hormone interacted in cultures treated with both compounds, suggesting a type of intracellular communication with the membrane, operative in this mammary cell line, that may involve channels of biochemical changes energized by a hydrocortisone stimulus. PMID- 3519310 TI - Uridine phosphorylase from Escherichia coli B. Enzymatic and molecular properties. AB - Uridine phosphorylase (EC 2.4.2.3) from Escherichia coli B is an oligomeric protein composed of four identical subunits of 29,000 mol. wt. The enzyme has four half-cystine residues per subunit titrable only in denaturing condition. No disulphide linkages either inter- or intra-chain are present. The isoelectric point is 5.25. The enzyme shows strict specificity toward uridine and 5 methyluridine and is inhibited by thymine, deoxycytidine and heavy metal ions. PMID- 3519311 TI - Yeast glyoxalase I. Circular dichroic spectra and pH effects. AB - Large scale isolation and physicochemical characterisation of yeast glyoxalase I showed that this enzyme contained small amounts of carbohydrates. Circular dichroic spectra of the enzyme measured in the presence and absence of S-(p bromobenzyl)glutathione indicated perturbation of a tyrosine on binding of this competitive inhibitor. Values of Ki for competitive inhibitors were pH invariant over the accessible pH range. PMID- 3519312 TI - DNA structure and promoter function. PMID- 3519313 TI - Functional implications of the Klenow fragment structure. PMID- 3519314 TI - Brown adipose tissue thermogenesis in obese animals. PMID- 3519315 TI - Effect of insulin receptor autophosphorylation on insulin receptor binding. AB - Insulin receptor beta-subunit autophosphorylation, the first event occurring after insulin binding, plays a crucial role in modulation of receptor-associated kinase activity towards exogenous substrates and possibly in the transmission of biological signals of insulin. Receptor autophosphorylation strongly depends on insulin receptor occupancy. Till now the effects of receptor phosphorylation on insulin binding itself have not been clarified. In the present report we demonstrate the absence of any feedback mechanism by which insulin receptor activation by phosphorylation affects binding affinity of insulin receptor itself. PMID- 3519316 TI - Degradation of porcine relaxin by glutathione-insulin transhydrogenase and a neutral peptidase. AB - The susceptibility of porcine relaxin and 125I-polytyrosyl-porcine relaxin to degradation by 3 purified enzymes involved in the degradation of insulin and proinsulin was examined. Rat liver glutathione-insulin transhydrogenase (GIT), which cleaves disulfide bonds in insulin, catalyzed a time- and concentration dependent increase in trichloroacetic acid (TCA)-soluble radioactivity of relaxin. The Sephadex G-50 profile of the reaction products revealed conversion to the A- and B-chains. Relaxin competitively inhibited the degradation of insulin by GIT; however, kinetic analysis revealed insulin to be preferred over relaxin as a substrate. Rat liver cytosol neutral thiol peptidase (NTP) catalyzed a time- and concentration-dependent increase in the TCA solubility of relaxin and a shift in the Sephadex G-50 radioactivity profile to low molecular weight products. Kinetic analysis revealed that insulin and B-chain are preferred over relaxin as substrates for NTP. A third enzyme, rat kidney neutral metalloendopeptidase, which degrades proinsulin and insulin C-peptide but not insulin, also did not degrade porcine relaxin. PMID- 3519317 TI - Degradation of luteinizing hormone-releasing hormone (LHRH) and an LHRH agonist by the rat testis. AB - Degradation of LHRH and [D-Ser(tBu)6,des-Gly-NH10(2)]LHRH ethylamide (LHRH-A), during incubation with high-speed supernatants of rat testes, as assessed by reversed-phase (RP)-HPLC fractionation of the iodinated peptides and by radioimmunoassays for LHRH or LHRH-A, was principally due to a neutral 43 000 Da peptidase with apparent Km values at 25 degrees C of 0.15 microM for LHRH and 1.19 microM for LHRH-A. The peptidase was inhibited by sulphydryl reagents, TLCK, 1,10-phenanthroline, EDTA, bacitracin, other LHRH analogues, oxytocin, [Lys8]vasopressin and somatostatin. It was predomantly located in seminiferous tubule supernatants (98% of recovered activity), with much lower levels in interstitial fluid (2%), interstitial tissue or testicular particulate fractions (less than 0.8%). Extracts of cultured immature Sertoli cells produced LHRH- and LHRH-A-degradation profiles, as assessed by RP-HPLC, that were identical to those produced by testicular supernatants. Similar levels of peptidase activity/mg protein were observed in immature and adult rat testes. These studies indicate that the principal LHRH-peptidase in the rat testis is produced by cells of the seminiferous epithelium, chiefly the Sertoli cell, and may play an important role in regulating the activity of LHRH and other peptide hormones in the testis. PMID- 3519318 TI - Cytodifferentiation and tissue phenotype change during transformation of embryonic lens epithelium to mesenchyme-like cells in vitro. AB - A number of adult and embryonic epithelia, when suspended within native type I collagen gels, give rise to elongate bipolar cells that migrate freely within the three-dimensional matrix. The morphology of these newly formed mesenchyme-like cells is indistinguishable from "true" mesenchymal cells at the light and ultrastructural level. In this report, we extend previous observations on the transformation of embryonic avian lens epithelium to mesenchyme-like cells. Lens epithelia, dissected from 12-day chick embryos, were cultured either within a collagen matrix or on a two-dimensional surface. Cells derived from explants on the surface of type I collagen express the epithelial phenotype. The cells form new basal lamina, continue to express delta-crystallin protein and secrete both type IV collagen and laminin. In contrast, epithelia suspended within collagen gels lose epithelial morphology, phenotype, and cytodifferentiation. The newly formed mesenchyme-like cells lack the ability to synthesize lens-specific delta crystallin protein, type IV collagen, and laminin. They do, however, express type I collagen de novo, a characteristic of mesenchymal cells. The changes in cytodifferentiation and tissue phenotype which occur during the transformation are stable under the conditions studied here. When mesenchyme-like cells are removed from the gel and replated onto two-dimensional surfaces, they remain bipolar, will invade collagen matrices, and are unable to synthesize delta crystallin protein. PMID- 3519319 TI - Cytoskeletal reorganization during early mammalian development: analysis using embedment-free sections. AB - We have examined cytoskeletal reorganization during early embryonic development in the hamster by employing detergent extraction to remove soluble components of the embryos and reveal the underlying structural network. This procedure allows examination of both the cortical cytoskeleton and the cytoskeleton of the egg interior. Sections of eggs and embryos were prepared for transmission electron microscopy with the removable embedding medium, diethylene glycol disterate which allows thicker sections than conventional embedment procedures thereby providing more spatial cues for studying organization. The cytoskeleton reorganizes after fertilization, at the time of compaction and again at the blastocyst stage. These cytoskeletal reorganizations are considered in terms of the blastomere polarity hypothesis and the involvement of the cytoskeleton with early embryonic development. PMID- 3519320 TI - Anti-insulin antibodies in children with type I diabetes mellitus. Genetic regulation of production and presence at diagnosis before insulin replacement. AB - We evaluated the production of antibodies against insulin in a genetically well defined population. In the first study, 124 young patients with type I diabetes for longer than 6 mo were included. Anti-insulin antibodies were detected by polyethyleneglycol (PEG) precipitation after incubation of acidified, charcoal stripped sera with 125I-labeled pork insulin and were expressed as microunits insulin bound per milliliter whole serum. For comparison, the patients were divided into six groups based on HLA DR antigens: 3/3, 3/-, 4/4, 4/-, 3/4, and -/ (-is non-DR3 or -DR4). The mean age of the patients was 14.7 +/- 0.5 yr; the duration of diabetes was 5.8 +/- 0.4 yr; and the glucose control, as measured by hemoglobin A1c was average (7.6 +/- 0.2%). There were no significant differences in any of these parameters among the patients in any of the HLA DR groups. Patients expressing DR3/3 had significantly lower insulin binding than the rest of the groups (2.5 +/- 0.4 vs. 13.6 +/- 1.4 microU/ml, P less than 0.0001). Patients with DR3/ - did not differ in insulin-binding capacity from the other groups. The type of insulin used for replacement was not correlated with the serum insulin-binding capacity. In a second study, sera from 48 children, newly diagnosed with type I diabetes, were examined for the presence of insulin binding before treatment with exogenous insulin and compared with sera from 80 children without diabetes or a family history of diabetes and from 103 unaffected HLA identical or haploidentical siblings of a child with type I diabetes.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3519322 TI - Purification and characterization of insulin-degrading enzyme from human erythrocytes. AB - An insulin-degrading enzyme (IDE) was purified from the cytosol of human erythrocytes via the use of ammonium sulfate precipitation and chromatography on columns composed of DEAE-Sephadex, pentylagarose, hydroxylapatite, chromatofocusing resins, and Ultrogel AcA-34. The final preparation was purified greater than 50,000-fold and exhibited a single protein band of Mr = 110,000 on reduced sodium dodecyl sulfate (SDS)-polyacrylamide gel electrophoresis. Cross linking of 125I-labeled insulin to the enzyme preparation labeled a protein of the same molecular weight, indicating that this band was in fact the enzyme. Intact insulin, insulin B chain, and glucagon inhibited this cross-linking half maximally at concentrations of 0.1, 1, and 1.5 microM, respectively. Under nondenaturing conditions, the enzyme had an Mr = 300,000, suggesting that the enzyme may exist under physiological conditions as a dimer or timer. The purified enzyme was inhibited by both sulfhydrylmodifying reagents and chelating agents, indicating that a free thiol and metal were both required for the activity of the enzyme. The purified enzyme was found to degrade physiological concentrations of intact insulin more rapidly than insulin B chain, although at high substrate concentrations (greater than 1 microM) the enzyme degraded B chain to a greater extent. Additional characteristics of the enzyme were a pl of 5.2 and a pH optimum of 7.0. These properties of the red blood cell (RBC) enzyme were very similar to those reported for IDEs from other tissues. Moreover, a polyclonal antiserum to the IDE from skeletal muscle was found to recognize the RBC enzyme. PMID- 3519321 TI - Effects of hyperglycemia on glucose production and utilization in humans. Measurement with [23H]-, [33H]-, and [614C]glucose. AB - Studies with tritiated isotopes of glucose have demonstrated that hyperglycemia per se stimulates glucose utilization and suppresses glucose production in humans. These conclusions rely on the assumption that tritiated glucose provides an accurate measure of glucose turnover. However, if in the presence of hyperglycemia the isotope either loses its label during "futile" cycling or retains its label during cycling through glycogen, then this assumption is not valid. To examine this question, glucose utilization and glucose production rates were measured in nine normal subjects with a simultaneous infusion of [23H]glucose, an isotope that may undergo futile cycling but does not cycle through glycogen; [614C]glucose, an isotope that may cycle through glycogen but does not futile cycle; and [33H]glucose, an isotope that can both undergo futile cycling and cycle through glycogen. In the postabsorptive state at plasma glucose concentration of 95 mg X dl-1, glucose turnover determined with [614C]glucose (2.3 +/- 0.1 mg X kg-1 X min-1) was greater than that determined with [33H]glucose (2.1 +/- 0.1 mg X kg-1 X min-1, P = 0.002) and slightly less than that determined with [23H]glucose (2.7 +/- 0.2 mg X kg-1 X min-1, P = 0.08). Plasma glucose was then raised from 95 to 135 to 175 mg X dl-1 while insulin secretion was inhibited, and circulating insulin, glucagon, and growth hormone concentrations were maintained constant by infusion of these hormones and somatostatin. Glucose production and utilization rates determined with [614C]glucose continued to be less than those determined with [23H]glucose and greater than those seen with [33H]glucose.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3519323 TI - Controlled release of insulin from polymer matrices. In vitro kinetics. AB - A biocompatible system was developed that permits continuous release of biologically active insulin from small polymer matrices. Powdered insulin particles were incorporated into an ethylene-vinyl acetate copolymer matrix. The presence of particulate insulin resulted in a matrix composed of tortuous channels and constricted pores through which release occurred. When aqueous release media permeated the matrix, the insulin dissolved and diffused slowly through this tortuous network. The large concentration of insulin within the matrix provided the driving force for release. Release kinetics from these insulin polymer matrices were enhanced by increasing the insulin solubility, the insulin powder particle size, the loading of insulin within the matrix, and the porosity of the matrix. Appropriate geometric design of the polymer matrix resulted in near-constant insulin release rates. PMID- 3519324 TI - Controlled release of insulin from polymer matrices. Control of diabetes in rats. AB - The controlled release of insulin from ethylene-vinyl acetate copolymer matrices was demonstrated for over 100 days in vivo. The matrices were designed to release sodium insulin at near-constant rates. These 0.06-cm3 implants were coated completely with an impermeable layer of polymer. An aperture was drilled in the center of one face of the matrix, restricting release through this opening. These devices were implanted into 13 streptozocin-induced diabetic rats. Plasma glucose concentrations fell from 386 +/- 18 to 119 +/- 35 mg/dl (mean +/- SEM), and urinary glucose was eliminated. Thee parameters were controlled for up to 105 days by a single implant. Glycosylated hemoglobin concentrations measured 90 days after implantation were 3.86 +/- 0.11% for the polymer-treated rats, 3.10 +/- 0.18% for the normal controls, and 5.42 +/- 0.33% for the diabetic controls. The average weight gain of the treated rats was similar to that of the controls, whereas the diabetic controls failed to thrive. In addition, all of the diabetic controls developed cataracts 1 mo after diabetes induction, whereas none of the treated rats developed cataracts. PMID- 3519325 TI - Characterization of stages in development of obesity-diabetes syndrome in sand rat (Psammomys obesus). AB - Sand rats (Psammomys obesus) maintained on a diet providing a free choice between laboratory chow and salt bush (Atriplex halimus) were classified into four groups differing in extent of the diabetic syndrome: A, normoglycemic-normoinsulinemic; B, normoglycemic-hyperinsulinemic; C, hyperglycemic-hyperinsulinemic; or D, hyperglycemic with reduced insulin levels. The metabolic pattern of these groups was characterized by measuring the uptake of fatty acid-labeled, very-low-density lipoprotein-borne triglycerides (VLDL-TG) and [3H]-2-deoxyglucose (2-DOG) into muscle and adipose tissues; incorporation of [14C]alanine into glycogen in vivo; gluconeogenesis from lactate, pyruvate, and alanine in hepatocytes; the effect of insulin on glycogen synthesis from glucose; the oxidation of albumin-bound [1 14C]palmitate and [14C]glucose in strips of soleus muscle; activities of muscle and adipose tissue lipoprotein lipase; and activities of rate-limiting enzymes of glycolysis, gluconeogenesis, and fatty acid synthesis in liver. In group A, uptake of VLDL-TG and activity of lipoprotein lipase were higher in adipose tissue and lower in muscle than in albino rats. In the liver, gluconeogenesis and the activity of phosphoenolpyruvate carboxykinase, as well as lipid synthesis and the activity of NADP-malate dehydrogenase, were higher than in albino rats, whereas activity of pyruvate kinase was lower. In group B, uptake of VLDL-TG by adipose tissue and muscle and lipoprotein lipase activity were similar or higher than in group A. Uptake of 2-DOG by muscle and adipose tissue and activity of liver phosphoenolpyruvate carboxykinase were lower than in group A. In groups C and D, uptake of VLDL-TG and lipoprotein lipase activity in muscle were further increased.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3519326 TI - Estrone treatment dissociates primary versus secondary consequences of "diabetes" (db) gene expression in mice. AB - Feeding 0.001% estrone in a diet to C57BL/KsJ mice homozygous for the recessive obesity gene "diabetes" (db) permitted dissociation of the primary consequences of obesity gene expression from the secondary consequences of diabetes effected through interaction between the db gene and other diabetogenic genes in the inbred background. Estrone-treated db/db mice were similar to untreated mutants in exhibiting hyperphagia and marked obesity. However, estrone-treated mutants did not develop the hyperinsulinemia, hyperglycemia, and islet atrophy characteristic of untreated db/db mice. Thus, expression of the primary defect could be studied in the absence of the myriad secondary sequelae elicited by chronic hyperinsulinemia and hyperglycemia. Reduced numbers of hepatocyte plasma membrane insulin receptors (50% of normal) persisted in the estrone-treated mice in the absence of hyperinsulinemia, indicating that this deficiency was a consequence of the primary genetic defect and not merely a downregulation phenomenon secondary to hyperinsulinemia. Comparison of insulin secretion from comparably sized +/+ islets versus islets from estrone-treated db/db mice showed no intrinsic defects in beta-cell sensitivity to glucose. In conclusion, db induced obesity can be dissociated from hyperinsulinemia, hyperglycemia, beta cell dysfunction, and hyperphagia but is associated with a generalized membrane defect reflected in part by the persistent deficiency of plasma membrane insulin receptors. PMID- 3519327 TI - Biofeedback and relaxation-response training in the treatment of pediatric migraine. AB - To assess the efficacy of electromyographic biofeedback, relaxation-response training and pain behavior management as a treatment for pediatric migraine, we studied 18 children between the ages of eight and 12 years (mean = 10 X 1) in a prospective, randomized, controlled investigation. Six patients received all three treatment procedures, six received relaxation-response training and pain behavior management, and the remaining six constituted a waiting-list control group. All patients kept a record of their headaches for the 15-week study period and then for four weeks one year later. Following four weeks of baseline, the treatment groups completed nine one-hour treatment sessions in 11 weeks. Both treatment groups experienced a significant reduction in headache symptoms and were significantly improved compared to the waiting-list control group by the end of treatment. The treatment groups did not differ from each other in any of these comparisons. The reduction in headache symptoms in the treatment groups was maintained one year after treatment ended. These results suggest that relaxation response training, with or without biofeedback training, combined with pain behavior management, is an effective alternative treatment for pediatric migraine. PMID- 3519328 TI - Hemispherectomy and its alternatives in the treatment of intractable epilepsy in patients with infantile hemiplegia. PMID- 3519329 TI - Chemical reactions and adherence at glass/metal interfaces: an analysis. PMID- 3519330 TI - Retentive properties of luting cements: an in vitro investigation. PMID- 3519331 TI - Accuracy of the palatal plate of removable partial dentures, and influence of laboratory handling of the investment on the accuracy. PMID- 3519332 TI - Development of carbon/graphite fiber reinforced poly (methyl methacrylate) suitable for implant-fixed dental bridges. PMID- 3519333 TI - A history of the International Association for Dental Research Wilmer Souder Award in Dental Materials, with a short biography of Wilmer Souder. PMID- 3519334 TI - Mechanical properties of post and core systems. PMID- 3519335 TI - Thermal effects on retention of resin-bonded retainers. PMID- 3519336 TI - Tensile bond strengths of dentin bonding agents to dentin. PMID- 3519337 TI - Abnormal intestinal permeability to sugars in diabetes mellitus. AB - A test of intestinal mucosal function which utilizes the differential permeability of L-rhamnose and lactulose has been reported to be helpful in the diagnosis of gluten-sensitive enteropathy. We have applied this test to 48 male subjects with diabetes mellitus to evaluate its usefulness as a screening test in diabetic patients and to further study sugar absorption in these individuals. Total urinary lactulose excretion in the 13 healthy control subjects was 54.5 +/- 8.5 mg/5 h, while excretion by diabetic patients was increased at 116.1 +/- 15.7 mg/5 h (p less than 0.01). Similarly, total L-rhamnose excretion by diabetic patients was significantly higher (139.7 +/- 14.3 mg/5 h vs 84.3 +/- 18.4 mg/5 h, p less than 0.05). The ratio of percent urinary excretion for lactulose/L rhamnose (L/R ratio) for diabetic patients (0.197 +/- 0.024) was not different from the control subjects (0.151 +/- 0.2). Nine out of 48 diabetic patients studied had lactulose/L-rhamnose ratios higher than the mean plus two standard deviations of the control group, which might lead to the diagnosis of small bowel mucosal disease. Although we may have been detecting subclinical mucosal disease or gluten sensitive enteropathy in a subgroup, it appears that this test of intestinal mucosal function should be interpreted with caution in diabetic patients. PMID- 3519338 TI - Serum immunoreactive insulin responses to a glucose load in Asian Indian and European type 2 (non-insulin-dependent) diabetic patients and control subjects. AB - The serum immunoreactive insulin response to an oral glucose load was estimated in 15 Asian Indian and 29 European non-diabetic subjects, and in 45 Asian Indian and 72 European Type 2 (non-insulin-dependent) diabetic patients. In the non diabetic group, basal insulin values were higher in the Asian Indians than the Europeans (16.7 +/- 3.0 vs. 6.9 +/- 0.7 mU/l, p less than 0.001), and remained higher throughout the glucose tolerance test. Total insulin response was also higher in the Asian Indians (p less than 0.001), and linear regression analysis revealed basal insulin, body mass index and race to be important predictors of insulin response. Amongst the diabetic patients, basal insulin values were again higher in the Asian Indians compared with the Europeans (18.0 +/- 5.0 vs. 11.5 +/ 0.9 mU/l, p less than 0.05). Total insulin response was also greater (p less than 0.01). Linear regression analysis revealed the basal insulin value to be the only significant predictor of insulin response. The results demonstrate higher insulin levels in Asian Indians than Europeans in both normal subjects and Type 2 diabetic subjects. The insulin response to a glucose load is also greater in the Asian Indians. In the control subjects, ethnic differences contribute to this response, whereas in the diabetic patients this is a function of the elevated basal insulin values of the Asian Indians. PMID- 3519339 TI - Effects of endogenous and exogenous secretin on plasma pancreatic polypeptide concentrations in dogs. AB - The effects of exogenous and endogenous secretin with or without intravenous glucose infusion upon islet hormone secretion were studied in four conscious mongrel dogs fitted with a duodenal fistula. Intravenous infusion of secretin for 1 h at doses of 0.5 and 4 U/kg raised plasma secretin concentrations to physiological and pharmacological levels respectively, without affecting plasma insulin and pancreatic polypeptide concentrations. In contrast, bolus injections of secretin at high concentrations produced significant increases of plasma insulin at 0.5 U/kg and 4 U/kg and of pancreatic polypeptide at 4 U/kg. Plasma glucagon did not change during intravenous infusion of low dose secretin (0.5 U X kg-1 X h-1), but decreased during infusion of 4 U X kg-1 X h-1 or bolus injection of secretin (0.5 U/kg). Intravenous infusion of glucose together with secretin (0.5 U/kg and 4 U/kg) did not affect plasma insulin, glucagon, or pancreatic polypeptide levels significantly compared with the changes caused by glucose infusion alone. Intraduodenal instillation of HCl, which produced plasma secretin concentrations similar to those evoked by intravenous infusion of secretin (4 U X kg-1 X h-1), led to a rise in plasma pancreatic polypeptide. It is concluded that the stimulatory effects of secretin on insulin and pancreatic polypeptide and the inhibitory effect on glucagon are pharmacological, and that increase of plasma pancreatic polypeptide after intraduodenal infusion of HCl is not mediated by endogenous secretin. PMID- 3519340 TI - Preventive effects of cyclosporin on diabetes in NOD mice. AB - Non-obese diabetic mice aged 30 to 60 days were treated orally with Cyclosporin at doses of 25, 15 and 2.5 mg/kg every 2 days until 160 days of age. Diabetes developed in 12 out of 18 oil-treated mice (67%), with partial to complete Langerhans' islet destruction associated with lymphocytic infiltration. The non obese diabetic mice showed a plasma glucose concentration of 6.62 +/- 0.92 mmol/l (mean +/- SD) at 50 days of age. The plasma glucose level of oil-treated non obese diabetic mice gradually increased after 130 days of age and reached 14.0 to 19.0 mmol/l at 160 days of age, while Cyclosporin-treated non-obese diabetic mice showed neither clear increase of plasma glucose levels nor development of insulitis. The cumulative incidence of diabetes in Cyclosporin-treated mice was significantly lower than that in oil-treated mice (p less than 0.01). Subsequently, Cyclosporin treatment was started after development of glucose intolerance. Twenty-five mg/kg of Cyclosporin was administered every 2 days for 35 days. Cyclosporin appeared to have little therapeutic effect on diabetes in non-obese diabetic mice. PMID- 3519341 TI - Developing differentiated epithelial cell cultures: airway epithelial cells. AB - Recent progress in cell culture enables us to grow and to maintain differentiated epithelial cells in a serum-free defined culture environment. Such an epithelial cell culture system free from interference by other nonepithelial cell types should be used widely in studies related to toxicology, carcinogenesis, and disease-related problems. This approach will lead to a better understanding of pathological changes indicated in the injured epithelial layer. The gap of information existing between in vivo and in vitro can be bridged together by this simple epithelial cell culture system by carefully analyzing changes of cell properties from in vivo to in vitro and by the cell separation to enrich specific cell types in preparation. Furthermore, evidence has been accumulated suggesting that the properties of epithelial cells in culture are part of the integral cellular physiologies of epithelial cells in vivo. These properties are, in most cases, related to cell injury which is reparable even in vitro if the appropriate condition is provided. Using the airway epithelial cell culture system developed in our laboratory as an example, the above points are discussed. Finally, we have shown that a differentiated tracheal epithelium with a similar polarity as in vivo was established in the described serum-free culture condition. PMID- 3519342 TI - Mechanisms of chemical toxicity and cellular protection systems. PMID- 3519343 TI - Evaluation of drug and chemical toxicity with cell culture systems. AB - Approaches to the evaluation of drug and other chemical toxicity with mammalian cell culture systems are designed to enhance the predictability of animal models. Identification of toxic agents by in vitro screening tests and studies of mechanisms through which chemicals induce critical lesions at the cellular and subcellular levels help to make those predictions sooner and perhaps single out those target sites and chemicals of most concern. PMID- 3519344 TI - Charting a course for cell culture alternatives to animal testing. AB - Cell culture systems (CCS) are finding increasing use in toxicology. They supplement and amplify existing tests in animals, and play a special role in the iterative process involved in studies of mechanisms of toxic action. The need is stressed for adequate standardization and validation of CCS, and meticulous conduct of tests using such systems. A review of some examples of current work with CCS highlights "designer" CCS, primary systems developed for research on morphological, biochemical, and other aspects of toxic action at particular target sites. An account of the use of CCS in studying the stepwise process of neoplastic transformation focuses on C3H/10T1/2 C18 cells in regard to initiation and promotion. CCS of human origin reveal the anticipated interindividual differences in metabolic characteristics and susceptibility to toxic action. Human CCS, especially primary epidermal keratinocytes, are making important contributions to understanding the actions of dioxins. Reasons for the continuing need for whole animals in toxicology are analyzed, to reveal some strategies by which CCS may prove increasingly successful as replacements. PMID- 3519345 TI - The effects of inhalation of organic chemical air contaminants on murine lung host defenses. AB - The potential health hazards of exposure to threshold limit value (TLV) concentrations of acetaldehyde, acrolein, propylene oxide, chloroform, methyl chloroform, carbon tetrachloride, allyl chloride, methylene chloride, ethylene trichloride, perchloroethylene, benzene, phenol, monochlorobenzene, and benzyl chloride, compounds which may be present in the ambient or work room atmosphere were investigated. The effects of single and multiple 3-hr inhalation exposures were evaluated in mice by monitoring changes in their susceptibility to experimentally induced streptococcus aerosol infection and pulmonary bactericidal activity to inhaled Klebsiella pneumoniae. When significant changes in these parameters were found, further exposures were performed at reduced vapor concentrations until the no-measurable-effect level was reached. Multiple exposures on 5 consecutive days were then performed at this concentration. Significant increases in susceptibility to respiratory streptococcus infection were observed after single 3-hr exposure to TLV concentrations of methylene chloride, perchloroethylene, and ethylene trichloride. For methylene chloride and perchloroethylene, these exposure conditions also resulted in significantly decreased pulmonary bactericidal activity. PMID- 3519346 TI - [Digital angiography: a new method for the study of the left ventricle]. AB - 30 patients with a previous myocardial infarction who had undergone diagnostic conventional left ventriculography and coronary arteriography had left ventriculography also performed by digital subtraction angiography after intravenous injection of contrast medium; the mean interval between the two investigations was 2.3 days. The conventional and the digital subtracted left ventricular images were computer-processed; global ejection fraction (obtained by the volumes calculated with the Dodge method) and segmental wall motion (from a quantitative analysis performed according to the Stanford method) were compared. We found a close correlation for the ejection fraction obtained by the two techniques (r = 0.89, p less than 0.01); absolute values proved to be slightly higher in the digital subtraction angiography. Segmental wall motion was significantly correlated too (p less than 0.05 for all the segments of the ventricular silhouette but for the one corresponding to the base of the heart). Digital intravenous angiography provides an accurate and less invasive method to evaluate left ventricular function. PMID- 3519347 TI - [Continuous monitoring, by invasive and non-invasive approach, of arterial pressure in clinical cardiovascular pharmacology]. PMID- 3519348 TI - Randomized, double-blind, placebo-controlled crossover trial of cimetidine and pirenzepine in nonulcer dyspepsia. AB - Nonulcer dyspepsia remains a difficult disorder to treat because it is a heterogeneous syndrome. Once patients with the irritable bowel syndrome, esophagitis, and other organic diseases are excluded, there remain patients with dyspepsia of unknown cause (termed "essential dyspepsia") and patients with dyspepsia plus symptoms of gastroesophageal reflux without esophagitis. The aim of this study was to determine whether cimetidine or pirenzepine is efficacious in relieving the symptoms of these latter subgroups. Sixty-two consecutive patients were studied who had chronic upper abdominal pain or nausea where endoscopy had shown no evidence of peptic ulceration, esophagitis, or malignancy; 47 had essential dyspepsia, and 15 had dyspepsia plus gastroesophageal reflux. They were initially randomized to either cimetidine or placebo, or pirenzepine or placebo. Patients continued each medication for 1 mo, and, after a washout period, crossed over when again symptomatic; 51 patients completed cimetidine and placebo, and 50 completed pirenzepine and placebo. The results showed that cimetidine was superior to placebo in decreasing the number of upper abdominal pain episodes weekly and the severity of pain, but the absolute improvement was small. Pirenzepine was not superior to placebo in decreasing symptoms. PMID- 3519350 TI - [Caspar Bauhin (1560-1624)]. AB - The paper describes the life and scientific work of Caspar Bauhin, whose 425th anniversary of his birth is in 1985. He is well-known in anatomy and botany and some species of plants are called after him. In anatomy his name is linked with the ileocaecal valve, though he apparently did not discover it. Especially Bauhin was engaged in improvement of anatomical and botanical nomenclature. PMID- 3519351 TI - [Pathological insertion of the placenta after the 20th week of pregnancy--its importance in the course of pregnancy and delivery]. AB - The present paper reports on the results of sonographic diagnosis of a pathologic insertion of the placenta after the 20th week of pregnancy and its importance with regard to the course of pregnancy and birth. The conversion of a primarily pathologic placental insertion to a "normal" insertion at term depends on the severity of the placental insertion disorder and the date of diagnosis. The frequency of pathologic insertions after the 20th week of pregnancy amounted to 4.2% of the patients examined. The rate of conversion from pathologic to normal placental insertion was 91%, if marginal/partial and total placenta previa are accepted as definitive diagnoses at term. The insertion remained unchanged up to term in approximately 90% of the cases in which total placenta previa was sonographically diagnosed. The sonographic diagnosis of "pathologic insertion of the placenta" after the 20th week of pregnancy is associated with severe complications in the subsequent course of pregnancy and birth. There is a significant cluster of vaginal hemorrhage in the last trimester of pregnancy; cesarean deliveries are common; there are more cases of transfer to pediatric clinics, and the incidence of retarded fetal growth and perinatal mortality is higher. The present authors believe that where the diagnosis of placenta previa has been confirmed sonographically, prophylactic measures and, in the last resort, a planned cesarean delivery can contribute to a reduction in maternal morbidity and also to a decrease in perinatal morbidity and mortality. PMID- 3519349 TI - Countercurrent mechanisms in the mammalian gastrointestinal tract. PMID- 3519352 TI - [Length of the uterine cervix toward the end of pregnancy--a sonographic study]. AB - In the last weeks of gestation a progressive effacement of the uterine cervix can be observed. 28 patients underwent sonographical investigation weekly between 30th and 40th week of gestation for measuring the cervical length. We found a significant shortening of the uterine cervix in primiparae by about 34.4%, in multiparae by about 41.9%. Sonographic measurement enables objective determination of the length of the uterine cervix and can be helpful in observing the course in cases of imminent preterm delivery. PMID- 3519353 TI - [Effects of routine administration of methylergometrin during puerperium on involution, maternal morbidity and lactation]. AB - The objective of the prospective randomized study reported here, based on 880 puerperae, was to study the effects of methylergometrin on involution, puerperal morbidity, and lactation. Over 4 weeks 444 mothers were given 0.125 mg of methylergometrin 3 times a day, while 436 were given the same dose of placebo. The following differences were found: in the treated group involution of the uterus was accelerated in the first few days following birth, but after 4 weeks there were no longer any significant differences. Post-partum pains were almost twice as intense in the treated group as in the untreated group. It proved impossible to reduce the number of cases of infection (lochiostasis, axillary temperature over 37.5 degrees C) by administering Methergin during the puerperium; following spontaneous births there were actually more cases of endometritis in the treated group. The number of patients with severe afterbleeding after spontaneous birth was also higher in this group. Lactation among untreated puerperae averaged 880 g during the first six days, while among treated patients it was only 563 g. Even after 4 weeks there were still differences in the quantity of milk produced. The incidence of infection and afterbleeding was significantly lower in mothers who breast-fed their children, irrespective of whether they had taken Methergin or not. We therefore consider that routine treatment of puerperae with methylergometrin is no longer justified; we continue to advocate breast-feeding, not least in view of the fact that it reduces maternal morbidity. PMID- 3519354 TI - [Changes in the diagnosis and therapy of extrauterine pregnancy with special emphasis on ultrasound. Study at the Gynecologic Clinic of the Dusseldorf University, 1962-1983]. AB - The diagnosis and therapy of ectopic pregnancy underwent a change with the introduction of ultrasound and the sensitive beta-hCG test. The modified management of ectopic pregnancy at the Department of Gynaecology of the University of Dusseldorf was analysed by examining the case history of 938 patients with suspected ectopic pregnancy from 1962-1983. The diagnosis ectopic pregnancy was confirmed for 348 patients (37%), whereas it was excluded in 590 cases (63%). The Pregnosticon test and the Gonavislide test yielded positive results in only little more than half of the cases with ectopic pregnancy. The Neo-Pregnosticon test was positive for 13 out of 15 patients. There was no ectopic pregnancy with a negative beta-hCG test (n = 31). Out of 261 patients examined by ultrasound, an ectopic pregnancy was proved directly four times. Sonographic pointers to an ectopic pregnancy were found with equal frequency in patients with confirmed ectopic pregnancy and in patients with excluded ectopic pregnancy (79%). In 17% of the patients with confirmed ectopic pregnancy this could not be detected by ultrasound. Out of 92 patients who had an ultrasound examination and a beta-hCG test, an intrauterine pregnancy could be excluded in spite of a positive pregnancy test in 94% of the ectopic pregnancies (n = 31) and in 31% of the cases with excluded ectopic pregnancy (n = 61). The incidence rate of ruptured tubule pregnancy was 44% before the introduction of ultrasound in 1973; it dropped subsequently to 37%. Since the introduction of the beta-hCG test in 1981 the incidence dropped further to 21%.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3519355 TI - [Prenatal ultrasonic diagnosis of severe congenital microcephaly]. AB - Antenatal ultrasound diagnosis of isolated microcephaly is difficult. Over and above this, other malformations must be safely excluded. Infants with congenital microcephaly are mentally and motorially severely retarded. Basing on two case reports with four microcephalic foetuses, the antenatal problems of sonographic diagnosis are explained. In all cases there was an isolated microcephaly without other malformations. Sonographic examination enabled early detection of three microcephalic foetuses between the 15th and 32nd week of gestation, and pregnancy could be terminated prematurely. Spontaneous delivery occurred in one pregnant woman at term; sonography had not been employed in this case. PMID- 3519356 TI - [Heat lymphocytotoxins as an index of pre-existing sensitization (presensitization) in recipients]. PMID- 3519357 TI - [Method for determining the anticomplement activity in immunoglobulin preparations]. PMID- 3519358 TI - [New method of obtaining cadaver bone marrow from the vertebral bodies]. PMID- 3519359 TI - Early polishing of amalgam restorations: a review. PMID- 3519361 TI - The Flexi-Post as a tap in post placement. PMID- 3519360 TI - From the depths of the Depression to the heights of learning. PMID- 3519362 TI - Hyper-recombining recipient strains in bacterial conjugation. AB - Using a direct enrichment and screening procedure, mutants of Escherichia coli have been isolated in which recombination frequencies for several intragenic Hfr X F- crosses are significantly higher (twofold to sixfold) than in the parental strains. These hyper-recombination mutations comprised five new mutS- and one new mutL- allele. Together with other known mut- alleles, they were analyzed for effects on intragenic recombination using several types of crosses. Hyper recombination was found for mutS-, mutL-, mutH (= mutR)- and mutU (= uvrD)-, with the largest effects seen for certain alleles of uvrD; these resulted in over 20 fold excesses in recombinant production for Hfr X F- crosses and F'-chromosome homogenotization. Spontaneous mutator ability was not always correlated with degree of hyper-recombination. PMID- 3519363 TI - Genealogy of principal strains of the yeast genetic stock center. AB - We have constructed a genealogy of strain S288C, from which many of the mutant and segregant strains currently used in studies on the genetics and molecular biology of Saccharomyces cerevisiae have been derived. We have determined that its six progenitor strains were EM93, EM126, NRRL YB-210 and the three baking strains Yeast Foam, FLD and LK. We have estimated that approximately 88% of the gene pool of S288C is contributed by strain EM93. The principal ancestral genotypes were those of segregant strains EM93-1C and EM93-3B, initially distributed by C. C. Lindegren to several laboratories. We have analyzed an isolate of lyophilized culture of strain EM93 and determined its genotype as MATa/MAT alpha SUC2/SUC2 GAL2/gal2 MAL/MAL mel/mel CUP1/cup1 FLO1/flo1. Strain EM93 is therefore the probable origin of genes SUC2, gal2, CUP1 and flo1 of S288C. We give details of the current availability of several of the progenitor strains and propose that this genealogy should be of assistance in elucidating the origins of several types of genetic and molecular heterogeneities in Saccharomyces. PMID- 3519364 TI - Expression of the Plasmodium knowlesi circumsporozoite antigen in Escherichia coli directed by Plasmodium bacterial-like promoter sequences. AB - The Plasmodium knowlesi circumsporozoite (CS) gene is expressed in Escherichia coli directly from a parasite genomic DNA fragment, using promoter and ribosome binding site (RBS) sequences present in this fragment. Transcription of the CS gene in E. coli is directed by tandem Plasmodium bacterial-like promoter elements located within the 0.5-kb EcoRI-HindIII fragment roughly 2.5 kb 5' from the CS gene within the 11-kb EcoRI parasite genomic DNA fragment. No readthrough from vector promoters or fortuitous promotion from plasmodial A + T-rich sequences was observed. The endogenous Plasmodium promoter of the CS gene does not seem to be recognized by E. coli RNA polymerases. Two tandem E. coli-recognized promoters are relatively strong judging by their ability to drive the bacterial chloramphenicol acetyl-transferase (CAT) gene. Translation of the message must be achieved by utilising an AAGAA sequence 4 bp 5' from the ATG initiation codon as RBS. PMID- 3519365 TI - Oligonucleotide directed mutagenesis of cauliflower mosaic virus DNA using a repair-resistant nucleoside analogue: identification of an agnogene initiation codon. AB - Mutation of the initiation codon of the dispensible open reading frame, ORF VII, of cauliflower mosaic virus (CaMV) delayed the appearance of disease symptoms, but the mutants reverted with high frequency. This suggests a role of this start codon in viral expression. Oligonucleotide-directed mutagenesis, utilizing a novel, repair-resistant deoxyguanosine analogue, 2'-deoxy-7-deazainosine (dDI), highly improved the yield of mutants. PMID- 3519366 TI - Matthew B. Divertie, MD. 1924-1986. PMID- 3519368 TI - Ultrasonography as a routine examination before treatment of retinal detachment due to macular hole. AB - Twelve of 25 patients were treated at the University Eye Clinic in Munster because of retinal detachment due to a macular hole. Partial fluid gas exchange (SF6), vitrectomy and SF6, or vitrectomy and silicone instillation, were used, and the patients were examined both pre- and postoperatively by ultrasonography with particular attention to the situation at the posterior pole. These echographical examinations enabled us to evaluate the following three criteria: staphyloma posticum, stiffness of the retina, and vitreous adhesions. All of these conditions mean that the prognosis will be worse if SF6 gas instillation is used alone. In these cases, a vitrectomy should also be performed or a Kloti Klemme procedure is useful when stiffness of the retina or staphyloma posticum is present. Preoperative ultrasonography is useful when setting up an adequate therapy plan. PMID- 3519367 TI - An interpretation of retinopathy of prematurity in terms of spindle cells: relationship to vitamin E prophylaxis and cryotherapy. AB - Spindle cells in the hyperoxygenated, avascular, vanguard retina are proposed to be the peripheral inducers of the neovascularization associated with retinopathy of prematurity (ROP). The induction of ROP is conceptualized in terms of three basic events. First, activation of spindle cells results initially in the increase in gap junctions between adjacent spindle cells, secondarily in the increase in cytoplasmic volume of rough endoplasmic reticulum, and ultimately in the synthesis and secretion of angiogenic factors Second, maturation of spindle cells is associated with a decrease in gap junctions, a diminished cytoplasmic volume of rough endoplasmic reticulum, and a cessation of synthesis and secretion of angiogenic factors. Third, myofibroblasts invade the vitreous concomitantly with spindle cell maturation and provide the tractional force that can produce retinal separation. The extent of interstitial retinol binding protein within the subretinal space explains the gestational-age-dependent efficacy of vitamin E in suppressing the development of severe ROP. The kinetics of both spindle cell activation/maturation and myofibroblast invasion predict the efficacy of appropriately timed and placed transretinal cryotherapy. PMID- 3519369 TI - Intracorneal bacterial colonization in a crystalline pattern. AB - We report the case of a 78-year-old woman who developed an intrastromal bacterial colonization 22 months after penetrating keratoplasty. Slit-lamp examination revealed discrete, finely branched, fernlike stromal opacities, which were histopathologically found to be large intrastromal aggregates of gram-positive cocci with almost no inflammatory cell response. PMID- 3519370 TI - Clinicopathological features of a congenital murine model of ocular toxoplasmosis. AB - Sequential clinical examination was carried out upon the eyes of mice that had been infected in utero with Toxoplasma gondii. Three patterns of clinical disease were seen. First, crystalliform cataracts, which either remained unchanged in character or occasionally became more extensive, were observed. Second, acute uveitis occurred in a small proportion of eyes, progressing into a chronic inflammatory disease with secondary opaque cataract. The third pattern comprised multiple discrete foci of deep retinal disturbance. It is suggested that these lesions were attributable to focal macrophage clusters in the sub-retinal space with overlying dome-shaped elevations of the photoreceptor matrix. The severity of disease, as assessed clinically, correlated with the underlying histopathology but not with the serological titres against Toxoplasma. Immunocytochemical staining for Toxoplasma antigen revealed only intra-retinal Toxoplasma cysts, but no free organisms or extracystic antigen were demonstrated. Selective photoreceptor destruction was the most prominent histopathological feature, implicating auto-immune mechanisms of tissue destruction. PMID- 3519371 TI - Correlation of Scheimpflug photography of the anterior eye segment with biochemical analysis of the lens. Application of a frozen-sectioning technique to investigate differences in protein distribution of single lens layers. AB - Normal and cataractous lenses were separated mechanically into lens equator and inner cylinder and the latter then sectioned in a freezing microtome. Fractions with 120-140 sections each were collected representing single lens layers, and the content of water-soluble and insoluble proteins was determined. Protein profiles for each lens layer were obtained by means of isoelectric focusing in special agarose gels. Using this microsectioning technique, it was possible to demonstrate differences in the protein distribution in single layers of both normal and cataractous human lenses. Comparison of the protein profiles of the normal lens and the lenses of different cataract morphology used in this study demonstrates the potential usefulness of this methodology for future research with cataract lenses. PMID- 3519372 TI - Ultrasonic examination of the silicone-filled eye: theoretical and practical considerations. AB - As the use of silicone oil in the treatment of complex retinal detachment becomes more frequent, an accurate assessment of ocular structures in these eyes by ultrasonic imaging is increasingly important. Because of the ultrasonic properties of silicone oil, the interpretation of ultrasound images of the silicone-filled eye is difficult. We have developed a mathematical model of ultrasound propagation in the eye. Using a computer simulation with graphic output, we have been able to make calculations concerning the interpretation and limitations of ultrasound examination in patients with intraocular silicone oil. PMID- 3519373 TI - [Enterophage as an indicator of environmental pollution by pathogenic Escherichia and Salmonella]. PMID- 3519374 TI - [Hygiene problems in F. Engels' work "The Position of the Working Class in England" (on the 140th anniversary of its publication)]. PMID- 3519375 TI - [The 1st People's Commissar of Public Health of the USSR (on the 90th anniversary of the birth of G. N. Kaminskii)]. PMID- 3519376 TI - [S. F. Khotovitskii--pages from the history of hygiene]. PMID- 3519378 TI - Design and construction of the sagittal appliance. PMID- 3519377 TI - [Experimental comparison of the methods of air sampling in health and hygiene research during bacteriological studies]. PMID- 3519379 TI - Heparin-induced thrombocytopenia. AB - Heparin-induced thrombocytopenia is the most frequent and the most important idiosyncratic haematological drug reaction. It is important for several reasons: first, because heparin is used so often, and the frequency of heparin-induced thrombocytopenia is high, the risk of a hospitalized patient developing heparin induced thrombocytopenia is high. Second, heparin-induced thrombocytopenia poses a major therapeutic dilemma for the clinician - continue the heparin and risk a worsening of the thrombocytopenia, or stop the heparin and risk extension or embolism of the thrombus. Finally, a small subset of patients with heparin induced thrombocytopenia develop the disastrous complication of heparin-induced thrombocytopenia plus arterial thrombosis. Some of these patients die. In this review, we will summarize some of the issues concerning heparin-induced thrombocytopenia, including its frequency, the various techniques used to diagnose the condition, its pathophysiology and approaches that can be used to manage patients with heparin-induced thrombocytopenia. PMID- 3519380 TI - Cardioprotective effects of defibrotide in acute lethal and nonlethal myocardial ischemia in the cat. AB - We evaluated the effects of defibrotide (D), a natural profibrinolytic and antithrombotic agent with endogenous PGI2-stimulating properties, on acute lethal and nonlethal myocardial ischemia (L-AMI and NL-AMI) in the cat. The coronary artery was occluded at 12-14 mm from its origin. In L-AMI, 12 of 15 control cats developed ventricular fibrillation and died; D (32 mg kg-1, bolus intravenously plus infusion) provided total protection against death and showed protective effects on plasma and myocardial creatine phosphokinase (CPK), hemodynamics and ECG. In NL-AMI, pretreatment of cats with D at the same dosage (intravenous infusion) reduced AMI-ST segment increases and AMI changes in hemodynamics. AMI induced changes in lactate adenosine triphosphate and CPK in ischemic tissues were prevented by D. The beneficial effects of D in NL-AMI could be partly attributed to its stimulatory effect on vascular PGI2 release; the mechanism of the impressive protection by D observed in L-AMI has still to be elucidated. PMID- 3519381 TI - Defibrotide is antithrombotic and thrombolytic against rabbit venous thrombosis. AB - Defibrotide (D) is a polydeoxyribonucleotide of mammalian origin that has no anticoagulant activity or hemodynamic effects but has considerable profibrinolytic and antithrombotic activities under several experimental conditions. In this paper the dynamics of D's antithrombotic effects after oral administration and D's thrombolystic activity after intravemous infusion on venous collagen-induced thrombosis in the rabbit are reported. D administered orally (12.5, 25 or 50 mg kg-1), from 0 to 360 min before thrombus induction, was able to impede thrombus formation in the first 2 h of growth. There is a linear correlation between the dose of D and peak activity and a correlation, described by a power function, between the dose and the area under the experimental inhibition curve. D infused intravenously (20, 31.7 or 50 mg kg-1 h-1 X 6 h) into rabbits with 24-hour-old thrombi, had significant and impressive dose-related thrombolytic activity. There is a direct relationship between the thrombolytic effect and plasma levels. In this experimental model, urokinase infused intravenously (750, 1,500 or 3,000 IU kg-1 h-1) had the same thrombolytic activity as D; heparin (76 IU kg-1 h-1) was completely ineffective and PGI2 showed a modest activity at 60 nmol kg-1 h-1. The antithrombotic and thrombolytic activities of D may be partly due to its ability to promote release of plasminogen activator factor and of prostacyclin from vascular tissue. PMID- 3519383 TI - Use of defibrotide in renal transplantation in man. AB - In transplanted patients graft rejection is the most frequent complication in the first year after surgery. Vascular lesions (necrosis, intimal proliferation, thrombosis) are signs of poor prognosis and lead to irreversible loss of renal function and graft removal in most cases. The problem of vascular rejection is still not solved and the results of therapy unsatisfactory, both because of inadequacy of diagnosis and/or inadequacy of available therapy. The role of prevention, very likely the best approach, is still sub judice. In an attempt to explore the validity of prevention, 22 transplanted patients (group A) were given a new antithrombotic agent (defibrotide) immediately after surgery, and the results were compared with those of a well-matched group of 30 patients on dipyridamole (group B). Follow-up lasted 6-19 months (mean 9.9) for group A; 5-21 months (mean 12) for group B. In group A, 8 patients (36%) had rejection episodes. Antirejection therapy was followed by recovery of renal function in all cases. In group B, 9 patients (29%) had rejection crises and graft removal was necessary in 7 instances due to severe vascular lesions. At the end of follow-up, all patients treated with defibrotide had normally functioning grafts: among the 30 patients on dipyridamole, 22 (73%) had satisfactory graft function. PMID- 3519382 TI - Effectiveness of defibrotide for prophylaxis of deep venous thrombosis after general surgery: a double-blind, placebo-controlled clinical trial. AB - The prophylactic activity of defibrotide, a new extractive antithrombotic thrombolytic agent of mammalian origin, was assessed by detection of deep venous thrombosis (DVT) in patients who underwent general elective surgery. 120 patients (aged 25-85 years, mean 55.6) were randomly assigned to defibrotide (60 patients) or to placebo (60 patients). The two groups were homogeneous for age, sex and risk factors for DVT. The active drug was given intravenously 200 mg four times a day, starting the day before the operation and then for the following 7 days. To detect DVT, 125I-fibrinogen was used, by conventional methods. Defibrotide reduced the frequency of DVT to 4/60 (7%) from 16/60 (27%) in the placebo group. The difference was highly significant (p less than 0.01). Neither side effects nor anticoagulant activity were observed. On the basis of this evidence, defibrotide may be considered an effective and well-tolerated drug for prevention of DVT. PMID- 3519384 TI - [Vasculogenic impotence]. PMID- 3519385 TI - [The influence of fat diet on plasma lipids and lipoproteins and platelet function]. PMID- 3519386 TI - [Abnormal insulin molecules: an alternative cause of diabetes?]. PMID- 3519387 TI - Intracellular ATP in a glucosephosphate isomerase mutant of Saccharomyces cerevisiae. AB - The degree of ATP depletion caused by glucose in a glucosephosphate isomerase deficient strain of Saccharomyces cerevisiae was determined. Even in the presence of a sugar normally fermentable by the mutant, the addition of glucose can decrease the intracellular ATP, depending on the competition of the sugars for transport and subsequent phosphorylation. For both parent and mutant cells, a correlation exists between the calculated velocity of ATP formation or ATP consumption during the utilization of different concentrations of sugars and the experimental intracellular ATP level. For initially resting yeast cells, a rate increase of 35 mumol per min per g ATP was calculated to increase the intracellular level of this nucleotide by 1 mumol per g cell mass. PMID- 3519389 TI - The control of adenylate cyclase activity in Escherichia coli. AB - Cell-free extract of E. coli possessed an inhibited adenylate cyclase activity after a previous anaerobic incubation of cells with glucose which is transported and metabolized. The degree of the inhibition depends on incubation conditions. Glucose analogues that are only transported but not metabolized, are not inhibitory. To restore the adenylate cyclase activity, the cells have to be cultivated aerobically prior to disintegration for a defined period of time without glucose. PMID- 3519388 TI - Fed-batch cultivation of Saccharomyces cerevisiae with increased content of delta 5,7-sterols. AB - Cultivation of Saccharomyces cerevisiae with a linear nutrient feed was used to test the validity of a mathematical model describing changes in the physiological state of the culture. Markers of these changes were the concentrations of proteins and delta 5,7-sterols in yeast dry mass. The model was used to optimize the production of these sterols with regard to the magnitude and composition of nutrient feed. PMID- 3519391 TI - Granulomatous inguinal lymphadenopathy after bilateral metatarsophalangeal joint silicone arthroplasty. AB - Silicone elastomer arthroplasties for joint diseases involving the small joints of the hands and feet have been used worldwide since the late 1960s. While reports of axillary lymphadenopathy exist, the exact incidence of subclinical adenopathy and its relationship to arthroplasty integrity have been difficult to determine. We report a patient who developed bilateral inguinal granulomatous adenopathy as a foreign body response to regionally disseminated silicone particles from bilateral metatarsophalangeal joint prostheses. PMID- 3519390 TI - Modification of T-DNA of nopaline Ti plasmid by intermediary vector and utilization of agrocin 84 sensitivity as simple criterion of conjugation transfer of modified Ti plasmid. AB - The chloramphenicol resistance gene from pSa was introduced into T-DNA of pTi T37 of Agrobacterium tumefaciens by cointegration with intermediary plasmid based on pBR322. The resulting intermediary vector was mobilized to A. tumefaciens T37 by conjugative plasmid pRK2. The RK2 plasmid also forms contegrates with pTi due to the Tn3 transposon which was used for the mobilization of modified pTi into plasmid-less A. tumefaciens strain. Transconjugants were selected on the basis of their antibiotic resistance markers and tested for agrocin sensitivity as proof of Ti plasmid transfer. Agrocin sensitivity of tranconjugants together with chloramphenicol resistance was shown to be a sufficient and simple criterion of transfer of modified Ti plasmids. Agrobacterium strains with modified Ti plasmids showed decreased virulence in consequence of the presence of additional borderline sequence inside their T-DNA. PMID- 3519392 TI - Dysbarism. A review. AB - This review of dysbarism outlines the development of the knowledge of the effects of pressure changes on tissues and organs, which is related to a complex of physical, physiological and pharmacological changes. It also shows that with the ever increasing pressures to which man is subject the effects can be regarded as total body rather than the traditional concept of a few target organs. PMID- 3519393 TI - [Recommendation for computer-assisted diagnosis in cleft jaw]. PMID- 3519395 TI - [Relation of Polish ophthalmologists of the 19th century to German ophthalmology]. PMID- 3519394 TI - [Differential diagnosis of pigmented conjunctival changes (light and electron microscopy findings)]. PMID- 3519396 TI - [Pemphigus conjunctivae]. PMID- 3519397 TI - [Occurrence and therapy of conjunctival changes in graft versus host reaction following bone marrow transplantation]. PMID- 3519398 TI - [Ananias Gabrielides and conjunctivitis]. PMID- 3519399 TI - [A nonsteroidal inflammation inhibitor in chronic conjunctivitis]. PMID- 3519401 TI - [How photography became a method in medicine. From the history of medical photography of the 19th century]. PMID- 3519400 TI - [Single dose therapy of vaginal mycoses. Effectiveness of clotrimazole and econazole]. PMID- 3519402 TI - [Comparison of a semisynthetic human insulin and swine insulin]. PMID- 3519403 TI - [Creative imagination between art and medicine. On the artistic work of Roman Hippeli]. PMID- 3519404 TI - Health promotion and disease prevention in HMOs. PMID- 3519405 TI - Capitation and conflict of interest. PMID- 3519406 TI - Medicare risk contracting: promise and problems. PMID- 3519407 TI - Alternative delivery systems and Medicare. PMID- 3519408 TI - Patient self-selection in HMOs. PMID- 3519409 TI - Effect of temperature upon potassium-stimulated insulin release and calcium entry in mouse and rat islets. AB - The effect of cooling to 27 degrees C was studied in islets of Langerhans exposed to 5 and 50 mM potassium in the absence of glucose. Membrane potential and insulin release were measured simultaneously from microdissected mouse islets while 45Ca outflow and insulin release were measured from collagenase-isolated rat islets. Cooling inhibited potassium-induced insulin release in both preparations. However, calcium entry estimated from electrical records and from 45Ca outflow experiments was only slightly affected by decreasing the temperature to 27 degrees C. It is concluded that the inhibition of insulin release caused by cooling to 27 degrees C can, within limits, be dissociated from calcium influx. PMID- 3519410 TI - Effect of pinealectomy on plasma glucose, insulin and glucagon levels in the rat. AB - In an attempt to know the role of the pineal gland on glucose homeostasis, the blood plasma concentrations of glucose, insulin and glucagon under basal conditions or after the administration of nutrients were studied in the jugular vein of conscious pinealectomized (Pn), melatonin-treated pinealectomized (Pn + Mel) and control (C) rats. Glucose levels were smaller in C than in Pn rats, while immunoreactive insulin (IRI) concentrations were significantly greater in C than in Pn rats. Contrary to this, immunoreactive glucagon (IRG) levels were significantly greater in Pn than in C animals. Melatonin treatment of Pn rats induces an increase of IRI concentrations and a reduction in IRG levels. Similar changes were obtained when hormonal determinations were carried out in portal blood plasma. Although ether anesthesia increases circulating glucagon levels in the porta and cava veins, the qualitative changes of plasma insulin and glucagon in Pn and Pn + Mel were similar to those found in conscious rats. To determine the effects of nutrients on pancreatic hormone release, intravenous arginine or oral glucose were administered to the animals of the three experimental groups. In C rats, both glucose and IRI levels reached a peak 30 minutes after glucose ingestion, decreasing thereafter. However, in Pn rats a glucose intolerance was observed, with maximum glucose and insulin concentrations at 60 minutes, while in Pn + Mel animals, glucose and IRI concentrations were in between the data obtained with the other two groups. Furthermore, glucose ingestion induced a significant reduction of IRG levels in all the groups.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3519411 TI - Is the insulin resistance of patients with noninsulin-dependent diabetes mellitus secondary to insulin deficiency? AB - Defects in both insulin secretion and action have been documented in patients with noninsulin-dependent diabetes mellitus (NIDDM), leading to the suggestion that both fasting hyperglycemia and insulin resistance in NIDDM are secondary to insulin deficiency. In order to test this hypothesis, insulin secretion (plasma insulin response to oral glucose) and insulin action (insulin clamp) were determined in 25 patients with NIDDM. The results documented relationships between incremental plasma insulin response to glucose and degree of fasting hyperglycemia (r = -.045, P less than 0.05) and insulin-stimulated glucose utilization (r = 0.25, P = NS). These data indicate that differences in insulin secretory response accounted for only approximately 20% of the variance in fasting plasma glucose level and 6% of the variance in insulin resistance in NIDDM. Thus, differences in insulin-secretory response contribute modestly to magnitude of glycemia, and not at all to variations in insulin resistance in NIDDM, permitting rejection of the hypothesis that insulin resistance is secondary to insulin deficiency. PMID- 3519412 TI - Residual B-cell function and glycaemic control in diabetic pregnancy. AB - Serum C-peptide immunoreactivity (CPR), mean blood glucose and blood glycosylated haemoglobin Hb A1c were measured in 23 insulin-dependent diabetic women at 11-12, 23-24, 33-34 and 37-38 gestational weeks in order to elucidate changes in residual B-cell function during pregnancy and their influence on the glycaemic control. CPR values generally increased at the 23-33 gestational weeks, with a significant difference between the mean of the peak values and the mean of the values at the first admission. When the subjects were divided into two groups on the basis of the residual B-cell function at the first admission, the glycaemic control during pregnancy was significantly better in those with higher residual B cell activity. The overall prevalence of marked residual B-cell activity was higher than previously reported in non-pregnant insulin-dependent diabetic subjects. The results indicate clinically important enhancement in residual B cell function during pregnancy. The mechanism of this improvement is poorly known although the more strict management of diabetes during gestation may be an important factor. PMID- 3519413 TI - Effects of prolonged (6 months) alpha-glucosidase inhibition on blood glucose control and insulin requirements in patients with insulin-dependent diabetes mellitus. AB - To examine prolonged alpha-glucosidase inhibition on blood glucose control, Acarbose, a potent alpha-glucosidase inhibitor, was administered for six months to insulin-dependent diabetic patients. Acarbose administration significantly diminished postprandial blood glucose increases by 20-30% and reduced insulin requirements by about 40% in these patients. Symptoms related to its use almost disappeared after the first month of treatment. These results suggest that prolonged alpha-glucosidase inhibition improves glucose tolerance in patients with insulin-dependent diabetes mellitus. Thus, an agent like acarbose might be a useful adjunct to insulin in the treatment of diabetic patients. PMID- 3519414 TI - Factors predicting the course of diabetes mellitus in hyperthyroid patients. AB - The relationship between changes in glucose tolerance with treatment of hyperthyroidism and various factors that might be relevant to carbohydrate metabolism were investigated in 64 hyperthyroid patients with abnormal glucose tolerance, including 35 cases with fasting plasma glucose (FPG) levels of 140 mg/dl or more. All patients had diffuse toxic goiter. After correction of the hyperthyroidism, glucose intolerance improved in almost all cases, even in cases with fasting hyperglycemia, but diabetes mellitus in patients with FPG above 140 mg/dl and/or delta IRI/delta PG X 30' during a 50-g oral glucose tolerance test below 0.10, persisted. Patients who showed diabetic glucose tolerance even after remission from thyroid dysfunction had significantly lower delta IRI/delta PG X 30' values and a higher incidence of family histories of diabetes mellitus than those not showing diabetic glucose tolerance. There were no significant differences in serum T3 and T4 levels between these two groups of patients. The findings suggest that predisposition to diabetes may be an important factor in persistent glucose intolerance in the hyperthyroidism of Graves' disease. The FPG and delta IRI/delta PG X 30' values may be useful in predicting which patients with hyperthyroidism will have permanent diabetes. PMID- 3519415 TI - A dot-immunobinding assay for antimitochondrial antibodies. AB - A dot-immunobinding assay was established for the detection of antimitochondrial antibodies. Nitrocellulose strips were coated with sonicated rat liver mitochondria and incubated in the presence of human sera. The resulting immune complexes were visualized with an enzyme-linked second antibody. Antimitochondrial antibodies were found in the sera of 96% of patients with primary biliary cirrhosis, 17% of patients with autoimmune hepatitis and 4% of patients with progressive systemic sclerosis. Sera of patients with other liver diseases or with systemic lupus erythematosus, specimens positive for M1 and M3 mitochondrial antibodies and samples from normal controls were all negative. Antinuclear and other cytoplasmic antibodies were not detected in this assay. The dot-immunobinding assay for antimitochondrial antibodies is rapid and sensitive, and obviates the need for expensive equipment. PMID- 3519416 TI - Effects of a new loop diuretic (muzolimine) in cirrhosis with ascites: comparison with furosemide. AB - Muzolimine is a loop diuretic with both the dose-dependent increasing effectiveness of loop diuretics and the long-lasting effect of thiazides. This is a potential advantage in the treatment of ascites in advanced cirrhosis since these patients have a low tolerance to sudden reductions of blood volume. Equivalent single, oral doses of furosemide (40 mg) and muzolimine (30 mg) were given to 10 cirrhotic patients with ascites and reduced renal perfusion (glomerular filtration rate = 30 to 75 ml per min). The study was preceded by 4 days of equilibration (dietary sodium 40 mmoles per day), and the drugs were alternated via a single-blind, cross-over protocol after a wash-out period of 3 days. Renal function was monitored under basal conditions and after diuretic administration through 4-hr clearance periods for 24 hr. The renin-aldosterone axis was evaluated before diuretic administration and after 8 and 24 hr. Muzolimine led to a 12-hr cumulative diuresis [AUC0-12 = 2.52 +/- 0.42 (S.E.) ml per min] and natriuresis (5.14 +/- 1.05 mmoles per hr), which were comparable to those of furosemide (2.85 +/- 0.29 ml per min and 6.75 +/- 1.63 mmoles per hr). Its effect, however, was distributed over a longer period (8 hr) than furosemide (4 hr). Muzolimine activity mainly differed from furosemide because of: significantly lower 12-hr potassium excretion (AUC0-12 = 0.28 +/- 0.82 vs. 2.69 +/- 0.46 mmoles per hr; p less than 0.005); greater sodium/chloride excretion ratio (0.45 +/- 0.08 vs. 0.26 +/- 0.06; p less than 0.025), and absence of rebound phenomena.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3519417 TI - Bile infection documented as initial event in the pathogenesis of brown pigment biliary stones. AB - Findings in two patients having brown pigment bile stones, recurrent 18 and 36 months after cholecystectomy, are reported. Present data suggest that bile infection precedes rather than follows the formation of brown stones. The present data are part of a prospective study of 600 consecutive patients who underwent operation for gallstones and in whom clinical and laboratory findings, intra- and postoperative bile culture and bile pH were related to the analysis of stone composition by X-ray diffractometry and infrared spectroscopy. Both patients during the first operation underwent cholecystectomy, sphincterotomy and T-tube drainage. Bile culture was negative both at operation and in the first 3 to 5 samples obtained from the T-tube every 2 days, while Escherichia coli was found, starting from the tenth and fourteenth postoperative days, respectively. At the second operation, typical recurrent "earthy" brown stones, easily crushed with the fingers, with no central nucleus of a different structure were found. Previous sphincterotomy became stenotic, and E. coli was found in the operative bile in a concentration higher than 10(6) per ml. It is suggested that bile infection by E. coli, in addition to bile stasis, plays a crucial role in the pathogenesis of brown pigment stones. PMID- 3519418 TI - Adult liver transplantation: an analysis of the early causes of death in 40 consecutive cases. AB - One hundred twenty-nine adult patients who received an orthotopic liver transplantation and survived at least 24 hr after surgery were evaluated. During the period of follow-up, 48 of the 129 patients (37%) died. Only 40 of these 48 patients died at our institution and were included in this study. Seventeen of the 40 deaths (42.5%) occurred during the first month after orthotopic liver transplantation and 30 of the 40 deaths (75%) occurred during the first 60 days post-orthotopic liver transplantation. Death was related to infection in 21 cases (52.5%), to multiorgan failure in 8 (20%) and to uncontrollable rejection in 3 (7.6%). The remaining eight deaths (20%) were attributed to a variety of other causes. Eleven of the 21 deaths related to infection (52%) occurred during the first month after orthotopic liver transplantation. Bacterial sepsis was the leading cause of death and accounted for 17 of the 21 deaths (81%) in which infection was present at the time of death. The most frequently isolated bacteria were Pseudomonas and other enteric Gram-negative bacilli. Three patients had complete occlusion of the hepatic artery of the grafted liver. Six patients developed massive infarction of the liver despite patent vascular anastomoses. Histological signs of rejection were seen in 9 of the 31 patients autopsied (29%), but in only 3 of these (9.6%) was rejection the principal cause of death. The biliary anastomoses were patent in all 31 cases examined at autopsy. PMID- 3519419 TI - Genetic polymorphism of human liver alcohol and aldehyde dehydrogenases, and their relationship to alcohol metabolism and alcoholism. AB - It is now widely accepted that the various pharmacologic and addictive consequences of alcohol consumption are related to the tissue concentration of ethanol or its metabolic products. The oxidative metabolism of ethanol in liver is principally catalyzed by alcohol dehydrogenase and aldehyde dehydrogenase. Both of these enzymes exist in multiple molecular forms, and genetic models have been proposed to account for the multiplicity of isoenzymes. Alcohol dehydrogenase subunits are encoded at five different gene loci, and genetic polymorphism occurs at two alcohol dehydrogenase loci. Variant isoenzymes produced at the two polymorphic alcohol dehydrogenase loci account for the differences in enzyme electrophoretic patterns observed among individuals. Some of these variant isoenzymes exhibit widely different kinetic properties, and this may account for the 2- to 3-fold variation in alcohol elimination rate among individuals. Since the protein sequence of several of the alcohol dehydrogenase subunits has been determined and several of the alcohol dehydrogenase genes has been cloned, some of the structural changes which give rise to differences in catalytic and electrophoretic properties are now known. Genetic polymorphism also occurs at the aldehyde dehydrogenase gene locus which encodes the mitochondrial low Km for acetaldehyde aldehyde dehydrogenase isoenzyme. The variant isoenzyme exhibits little or no catalytic activity. Individuals with this "null" variant have higher than normal blood acetaldehyde levels and exhibit an alcohol-flush reaction which appears to be a deterrent to heavy drinking and alcoholism.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3519421 TI - Validating the multiple indicator dilution method--a case of mistaken identity. PMID- 3519422 TI - HHS' capital plan arouses provider anxieties. PMID- 3519423 TI - Capital proposals more expensive, ICF study finds. PMID- 3519420 TI - The isolated perfused rat liver: conceptual and practical considerations. PMID- 3519424 TI - Fraud bills tighten noose around unlawful providers. PMID- 3519425 TI - Suits over capital payments? Maybe... PMID- 3519426 TI - Old/new capital issue tops FAHS' list. PMID- 3519427 TI - Artificial heart programs to grow: Jarvik. Interview by Myk Cherskov. PMID- 3519428 TI - Capital planning in a changed environment. PMID- 3519429 TI - Epithelial denudement in the gastrointestinal tracts of two bone marrow transplant recipients. AB - Examination of autopsy specimens from two patients revealed extensive denudement of gastrointestinal (GI) tract epithelium but preservation of basic mucosal structure otherwise. Each patient had received an allogeneic bone marrow transplant for acute leukemia. Although both patients experienced transient episodes of graft-versus-host disease (GVHD), neither experienced significant GI tract symptomatology. The usual explanations for GI epithelial denudement in such patients focus on the mechanisms of accelerated epithelial cell loss. Also considered in these two patients was the possibility that previous treatment(s) had severely interfered with the capacity for epithelial cell renewal. Chemotherapy, total body irradiation, or GVHD, alone or in some combination, may have depleted the stem cell populations and interfered with proliferative epithelial repair. PMID- 3519430 TI - Indirect immunofluorescence of inactive centromeres as indicator of centromeric function. AB - Two previous single case reports from the literature showed the presence or absence of centromeric antigens at the site of the inactive centromeres in one (X;X) and in one (9;11) dicentric chromosome. We studied nine different dicentric chromosomes using anticentromeric antibodies and immunofluorescence techniques. In the four autosomal dicentrics the inactive centromere was consistently positive while the dicentrics composed of two X chromosomes were either positive or negative; one case of (X;Y) dicentric was negative. The results indicate that the X chromosome mode of replication may be involved in the suppression of immunofluorescence at the site of the inactive centromere and that one centromere of the dicentric chromosome may lose its function but conserve some of its antigenic properties. This indicates that not all these antigens play a role in the microtubules-centromere interaction. PMID- 3519431 TI - Apert syndrome and fetal hydrocephaly. AB - Apert (1906) was the first to identify a syndrome characterized by the association of acrocephaly with syndactyly, acrocephalosyndactylism. Since then Apert syndrome has been recognized as a clinical entity. Although hydrocephalus was rarely reported as an associated malformation, it was suggested that hydrocephalus might be responsible for mental retardation in some cases of Apert syndrome. We report a case of Apert syndrome presenting as fetal hydrocephaly at 28 weeks gestational age, and we review the literature. We suggest that hydrocephalus should be considered as a major associated malformation, and a complete evaluation with sonogram and computed tomography scan is recommended in any newborn suspected of having Apert syndrome after routine cephalometric measurement. PMID- 3519432 TI - [Clinical importance, epidemiology and laboratory diagnosis of intestinal Cryptosporidia infection]. AB - In immunodeficient patients, particularly in those with acquired immune deficiency syndrome, cryptosporidia can cause severe, sometimes life-threatening and protracted diarrhoea. There is no specific antiparasitic therapy available so far. In AIDS patients an immunomodulatory therapy, e.g. with interleukin-2, may possibly lead to an improvement of a concomitant cryptosporidiosis. In immunocompetent patients cryptosporidia cause a mild self-limited diarrhoea. People mostly endangered are children and those who have contacts with animals. Cryptosporidia have also been found in tropical areas--especially in children--as enteropathogens. However, in other studies cryptosporidia were detected as often in children without diarrhoea. Further epidemiological investigations are necessary in order to finally evaluate the prevalence and the significance of cryptosporidia in the pathogenesis of diarrhoea. Diagnosis is based upon the detection of oocysts in the faeces. Oocysts are acid-fast in Ziehl-Neelsen staining. PMID- 3519433 TI - [Clostridium difficile-induced enterocolitis: pathogenesis, clinical course, epidemiology and laboratory diagnosis]. AB - Clostridium difficile-induced enterocolitis almost exclusively occurs associated with antibiotic exposure. The organisms produce several exotoxins of which toxins A (enterotoxin) and B (cytotoxin) are of primary importance. It is assumed that preceding antibiotic therapy creates an ecological niche allowing massive proliferation of the organisms and production of their toxins. The clinical course varies from mild diarrhoea to severe pseudomembranous colitis. Patients over 40 years of age are primarily at risk, especially when suffering from severe underlying disease or abdominal surgery. The therapy includes discontinuation of the actual antibiotic treatment, substitution of fluid and electrolytes, and causal therapy with vancomycin. In contrast to adult persons 25-60% of healthy infants excrete C. difficile and/or its toxins with their faeces. Exogenous infection by direct contact or contaminated tools and equipment is common in the hospital. The diagnosis includes: antibiotic history of the patient, clinical diagnosis (endoscopy), isolation of the organisms and demonstration of toxin production, detection of C. difficile toxins in the patient's stool. For isolation and identification appropriate methods are available. Cell culture tests for toxin detection are reliable but require experienced personnel. Immunological methods (ELISA, latex agglutination test) have been described but are not yet commercially available. PMID- 3519436 TI - [In vitro erythrophagocytosis in detecting opsonizing antibodies in a patient with Malta fever. A hypothesis on the explanation of in vivo hemophagocytosis in other patients with Malta fever]. AB - In vitro agglutination and phagocytosis of erythrocytes by homologous neutrophil granulocytes and monocytes could be observed using the blood of a healthy person (blood group A, Rh+) to detect opsonising antibodies in the serum of a patient with Malta fever (blood group O, Rh+). Agglutination and erythrophagocytosis were independent of complement or the presence of Brucella melitensis. In patients with Malta fever and blood groups O and B, respectively, antibodies could be detected on the surface of erythrocytes of blood group A when used as antigen with the help of an immunofluorescence test. The same happened with a serum of one patient with blood group A. In vivo erythrophagocytosis detected in the bone marrow of patients with Malta fever is, therefore, possibly due to common antigens of erythrocytes of blood group A and B. melitensis. PMID- 3519434 TI - [Follow-up of immunological parameters and therapy of systemic lupus erythematosus]. AB - In a longitudinal study of a female patient with systemic lupus erythematosus, we determined numbers of T-lymphocytes and subpopulations (OKT4+- and OKT8+ lymphocytes), B-lymphocytes, production of anti-double-stranded DNA antibody (anti-ds-DNA-Ab), and we investigated the effects of corticosteroids and cyclophosphamide on these parameters and clinical disease activity. The results demonstrate that an increase of OKT4+-T-lymphocytes/OKT8+-T-lymphocytes ratio apparently augments B-lymphocyte numbers resulting in anti-ds-DNA-Ab production. Whereas steroids exerted limited, possibly dose-dependent effects on this sequence, cyclophosphamide seemed to cause normalization of OKT4+/OKT8+ ratio, precipitous drop of anti-ds-DNA-Ab titers, and dramatic clinical improvement. PMID- 3519435 TI - [Lymphocyte activation by bacterial biostructures: precursor of infection-induced immune phenomena and secondary illnesses? II--Lymphocyte activation by Enterobacteriaceae]. PMID- 3519437 TI - [Antibodies against ds-DNA in systemic lupus erythematosus--value for diagnosis and determination of activity]. AB - The specificities and sensitivities of 3 methods for detection of anti-ds-DNA antibodies were investigated in 32 SLE-patients and 95 control patients with ANA greater than or equal to 1:100. The sensitivities of CL-IF-assay, filter-RIA and EIA were 47%, 78% and 87%, respectively. The according specificities were 96%, 88% and 84%. In contrast to the CL-IF-assay, the filter-RIA as well as the EIA are of major clinical importance in monitoring SLE-patients. PMID- 3519438 TI - Separate application of adjuvant and antigen: the effect of a water-in-oil emulsion on the splenic plaque-forming cell response to sheep red blood cells in mice. AB - The effect of a non-immunogenic adjuvant on the murine splenic plaque-forming cell (PFC) response against sheep red blood cells (SRBC) was studied. The adjuvant, a stable water-in-oil (W/O) emulsion, was injected intraperitoneally at the same time as or prior to the intravenous (i.v.) injection of SRBC. Enhancement of the SRBC-specific IgM-, but not IgG- and IgA-responses was observed. The stimulatory effect depended on the dose of both adjuvant and antigen and on the interval between their application. The minimal dose of adjuvant needed to induce maximal stimulation increased with the interval between the injections. Administration of an optimal adjuvant dose one week before antigen application still resulted in a clear stimulation of the response to the antigen. In adjuvant-treated animals, the primary PFC response did not exceed the maximum level reached after i.v. injection of a high dose of SRBC. Adjuvant therapy also resulted in polyclonal B cell-activation, since the number of spontaneous Ig-secreting cells in the spleen was increased. The kinetics and isotype distribution of the SRBC-specific and polyclonal responses, however, were different. Therefore, the observed stimulatory effect on the SRBC-specific PFC response cannot be explained by the polyclonal activation of the immune system. From this study it appears that injection of a W/O emulsion provokes an active stimulation of the immune system, which demonstrates that the adjuvant effect of W/O emulsions is not only passively obtained by prolonged antigen presentation by depot formation. PMID- 3519439 TI - Relationship between murine macrophage Fc receptor-mediated phagocytic function and competency for activation for non-specific tumor cytotoxicity. AB - The relationship between Fc receptor (FcR) function and activation of murine macrophage populations for non-specific tumor cytotoxicity was studied. Oil elicited inflammatory peritoneal macrophages (PM phi) from C3HeB/FeJ mice had higher FcR function upon harvest than resident PM phi from the same strain or elicited PM phi from genetically deficient C3H/HeJ mice. C3HeB/FeJ inflammatory PM phi were uniformly responsive to activation by MAF and the complement activators: LPS, Poly I:C, cobra venom factor (CVF) and zymosan for tumoricidal activity. Resident cells from the same strain and C3H/HeJ-elicited PM phi were uniformly unresponsive to the same activators. In vitro culture of C3HeB/FeJ resident PM phi with fetal bovine serum for 24-48 h produced unregulation of FcR function which coincided with a conversion from an unresponsive to a responsive state for tumoricidal activity. Reconstitution of the FcR function of C3H/HeJ elicited PM phi during 24-48 h culture with lymphokine or Poly I:C also coincided with the restoration of responsiveness to activation by LPS, CVF, and zymosan for tumor cytotoxicity. Thus, the consistent temporal relationship between upregulated FcR function and the capacity of macrophages to respond to activation for non-specific tumoricidal activity may be more than coincidental. Preincubation of responsive C3HeB/FeJ-elicited PM phi with insoluble immune complex or heat-aggregated IgG was shown to blockade FcR-mediated phagocytosis and to abrogate LPS-mediated tumoricidal activity. Interestingly, FcR blockade by IgG-opsonized sheep erythrocyte conjugates selectively inhibited activation by MAF, LPS, and Poly I:C, but had no inhibitory effect on activation by CVF or zymosan. Similar blockade of C3b receptors produced an identical pattern of selective inhibition of activation. This selective inhibition of non-specific tumoricidal activity by FcR/C3bR blockade suggests the existence of two pathways for antibody-independent activation of macrophages. PMID- 3519440 TI - Mast cell subsets in the rat distinguished immunohistochemically by their content of serine proteinases. AB - The specificities of antibodies raised in rabbits against rat mast cell proteinase 1 (RMCP 1) from connective tissue mast cells (CTMC), and against RMCP II from mucosal mast cells (MMC), were analysed by SDS-PAGE and Western blotting. Significant cross-reactivity was detected, and was eliminated by affinity purification and cross-absorption techniques. The resultant F(ab')2 antibodies, monospecific for each enzyme, were used for the immunohistochemical localization of RMCP I and II in rat tissues. Cells in skin, tongue, intestinal serosa and lung parenchyma which, by histochemical techniques, have been identified as CTMC, contained RMCP I exclusively. Cells in jejunal lamina propria and bronchial epithelium, previously classified as MMC, contained RMCP II. The results demonstrate the feasibility of distinguishing mast cell subsets by their content of serine proteinases. PMID- 3519441 TI - Evaluation of C3b/C3bi opsonization and chemiluminescence with selected yeasts and bacteria using sera of different opsonic potential. AB - C3 fragment opsonization and chemiluminescence were assessed using two yeasts (Saccharomyces cerevisiae and Candida albicans) and two strains of bacteria (Staphylococcus aureus and Escherichia coli) following incubation with sera previously shown to be either efficient or poor in the opsonization of baker's yeast. Sera with poor function consistently fixed lower levels of C3 fragments and generated less chemiluminescence with all four organisms than sera with normal function. The differences were most marked with the two yeasts. We conclude that sera with normal complement function but manifesting a relatively common defect in the opsonization of baker's yeast have a general opsonic defect. PMID- 3519442 TI - Impairment of lymphocyte proliferative responses and interleukin-2 production in susceptible (C57BL/6) mice infected with Salmonella typhimurium. AB - C57BL/6 (susceptible) and A/J (resistant) mice were infected intravenously with a temperature-sensitive mutant of Salmonella typhimurium. In C57BL/6 mice a marked depression of the proliferative response of spleen cells to B and T mitogens occurred and was maximal at 2-3 weeks post-infection, whereas only minor changes were found in A/J mice. This immunodepression was mediated, at least in part, by adherent cells. Moreover, spleen cells from infected C57BL/6 mice did not produce interleukin-2 (IL-2) after concanavalin A stimulation. The impairment of IL-2 production was not related to a defect in IL-1 release. The addition of IL-2 to spleen cells did not restore their ability to respond to mitogens. The depression of mitogenic responses in infected C57BL/6 mice occurred at a time when increased resistance was present. PMID- 3519443 TI - The differential effects of bacterial lipopolysaccharide (LPS) on splenic non lymphoid cells demonstrated by monoclonal antibodies. AB - In the present study, the effect of LPS on different splenic non-lymphoid cells was investigated. Marginal zone (MZ) macrophages, marginal metallophils and interdigitating cells (IDC) were demonstrated using specific monoclonal antibodies in a two-step immunoperoxidase procedure in combination with enzyme histochemistry. The results indicate that the number of marginal zone macrophages decreases markedly after LPS treatment, but is followed by a rapid repopulation as observed by monoclonal antibody staining and selective uptake of FITC-Ficoll. Marginal metallophils are normally located at the inner border of the marginal sinus and can specifically be identified by the monoclonal antibody MOMA-1. Following LPS stimulation, many MOMA-1-positive cells were present in the corona and central parts of the follicles, with decreasing numbers near the marginal sinus. These findings strongly suggest that LPS induces a migration of marginal metallophils towards the follicle centres. Most of the tangible body macrophages in the follicle centres appeared to be slightly MOMA-1-positive, which indicates that marginal metallophils may, at least under certain circumstances, differentiate into tangible body macrophages. In the inner PALS, many interdigitating cells, NLDC-145-positive cells, can be found. The number of NLDC 145-positive cells was shown to be severely decreased at later time-intervals after LPS administration, resulting in an almost unstained inner PALS at 2 days. In contrast to the above-mentioned splenic non-lymphoid cells, the red pulp macrophages are only minimally affected by LPS. PMID- 3519444 TI - [Bifonazole, miconazole and econazole in the treatment of pityriasis versicolor. Comparative research]. PMID- 3519445 TI - A soluble class I molecule analogous to mouse Q10 in the horse and related species. AB - Horse serum is shown to contain a soluble class I molecule analogous to the secreted Q10 molecule in the mouse. This molecule has several similarities to the recently described mouse Q10 molecule: it is smaller than membrane-bound equine class I molecules; it occurs in a high molecular mass complex of 200-300 kd in serum; and the serum levels of the equine molecule are similar to that of the Q10 molecule (about 30 micrograms/ml). A soluble molecule is also detected in the sera of species related to the horse; it has in fact been found in all the wild members of the order Perissodactyla so far tested. However, it was not detected in the serum of members of the orders Carnivora, Sirenia, Proboscidea, Artiodactyla, and Primates that were tested, nor in the serum of members of the order Rodentia other than in that of the genus Mus. PMID- 3519446 TI - A novel polymorphism of human complement component C3 detected by means of a monoclonal antibody. AB - A mouse monoclonal antibody, HAV 4-1, obtained after immunization of a BALB/c mouse with purified C3F, detected a novel genetic polymorphism of human complement component C3 in a simple immunoblotting system. The frequency of HAV 4 1-positive genes was 20.1%. Reactivity of HAV 4-1 was closely related to C3F, but certain individuals with the C3F allele did not react with HAV 4-1. Conversely, certain C3S homozygous individuals did react with HAV 4-1. The polymorphism detected by this monoclonal antibody is therefore different from the previously described polymorphism based on charge differences. PMID- 3519447 TI - Identification and characterization of the human Pgp-1 glycoprotein. AB - Two monoclonal antibodies have been raised against human Pgp-1 by the immunization of mice with human fibroblasts. The human molecule, like the previously identified mouse counterpart, is an abundant membrane protein (Mr approximately 95 000) with a broad tissue distribution. Pgp-1 is phosphorylated, and phosphoamino acid analysis demonstrates that this occurs exclusively on serine residues. A major difference between the mouse and the human is that 50 60% of human thymocytes are Pgp-1+ compared to 5-10% of mouse thymocytes at an equivalent stage in development. Immunofluorescence studies of cryostat sections showed that the majority of human medullary thymocytes are strongly stained with Pgp-1-specific antibody, whereas the expression of Pgp-1 on cortical thymocytes is much more heterogeneous. PMID- 3519449 TI - Modified scheme for identification of coliform organisms in drinking water. PMID- 3519450 TI - The CIBA award for 1985. A full circle in two generations. PMID- 3519448 TI - Forssman antigen on yolk sac derived rat tumor cells. AB - By means of indirect immunofluorescence (IFF) tests with rabbit antiserum to Forssman (F) glycolipid, expression of F antigen was investigated on 16 rat tumor cell lines; 14 chemical carcinogen-induced tumors, one yolk sac-derived (AT-1) tumor and another spontaneous tumor. Four lines of the carcinogen-induced tumors gave weakly positive reactions in the IIF tests and the AT-1 cells a strongly positive reaction. Flow fluorocytometric analyses on the AT-1 cell line revealed that some of the major and the vast majority of the minor population of the AT-1 express F antigen. Specificity of the F antigen demonstrated on AT-1 cells was determined by absorption experiments, in which absorption of the F antiserum with guinea pig kidney sediment, sheep red blood cells and F-liposome but not bovine red blood cells or G-liposome abolished the reaction. Results of this study together with those of our previous studies demonstrated that F antigen appears as a result of malignant transformation of F negative rat cells induced by chemical carcinogens, apparently "distorted differentiation" and the viral oncogenes. PMID- 3519452 TI - Identification of renin and angiotensinogen messenger RNA sequences in mouse and rat brains. AB - Components of the renin angiotensin system have been demonstrated in mouse and rat brains. However, local synthesis of renin has not been documented. In this study, we employed mouse submandibular gland renin complementary DNA (pDD-1D2) and rat liver angiotensinogen complementary DNA (pRang3) to examine whether renin and angiotensinogen RNA sequences exist in mouse and rat brain. Angiotensinogen messenger RNA sequences were readily demonstrable in whole rat and mouse brain using Northern blot hybridization analysis. Using large quantities (greater than 100 micrograms) of brain total RNA and the sensitive complementary RNA probe, we were able to detect low levels of renin RNA sequences in the brains of both species. The relatively low concentration of brain renin messenger RNA and high concentration of angiotensinogen messenger RNA raises several interesting questions about the distribution of these two proteins and their relative contribution to activity of the brain renin-angiotensin system. In summary, our data demonstrate the expression of both renin and angiotensinogen genes in mouse and rat brains and provide definitive evidence for an independent endogenous brain renin angiotensin system. PMID- 3519453 TI - [Prostaglandins. A review of its synthesis as applied to endodontics]. PMID- 3519451 TI - Prostaglandin E2 analogue elicits renal and hormonal compensatory mechanisms in human hypertension. AB - Endogenous prostaglandin E2 appears to play an important role in cardiovascular homeostasis. When administered exogenously, it is a potent vasodilator, but the requirement for intravenous administration and its short duration of action have limited studies to its acute effects. A novel prostaglandin E2 analogue, CL 115347, can be administered transdermally on a long-term basis. The cardiovascular responses to the chronic administration of CL 115347 were studied in a double-blind, placebo-controlled trial in 26 subjects with essential hypertension (16 given drug, 10 placebo) maintained on a 100-mEq sodium diet. Administration of CL 115347 produced a fall in diastolic blood pressure of 7.8 +/ 1.3 mm Hg, compared with a 2.3 +/- 1.7 mm Hg fall in controls (p = 0.02), with no change in heart rate. The direct vascular effect of the drug was confirmed by attenuation of the vasoconstrictor response to angiotensin II infusion (13.4 +/- 3.1 vs 21 +/- 2 mm Hg at 3.0 ng/kg/min; p less than 0.05). However, the chronic blood pressure effect of CL 115347 was modest. Subjects receiving active drug showed significant compensatory increases in plasma renin, aldosterone, and norepinephrine levels accompanied by sodium retention and kaliuresis. In summary, chronic administration of this prostaglandin E2 analogue resulted in a modest decrease in blood pressure and antagonism of angiotensin II-mediated vasoconstriction. However, its effects were largely offset by compensatory increases in vasoconstrictor hormones and sodium retention. PMID- 3519454 TI - [Protein deficiency, host defense and natural anti-tumor immunity]. AB - Natural immuneffector cells, namely natural killer cells and monocyte/macrophages, have become in recent years an important part of theory and practice of immunotherapy. This is especially the case for therapy of malignant tumors with biological response modifiers (BRMs). Many BRMs increase cytotoxicity against tumor cells and cell numbers of natural immuneffector cells. Protein depletion on the other hand, which often is part of malignant diseases, results in well known negative effects on acquired and specific immunity. The data which are presented here show that depressions of natural immuneffector cells in terms of cytotoxicity and cell numbers also occur after protein depletion. The same is true for their pool, the bone marrow. The potentials of BRM therapy are considerably decreased. Host defense mechanisms in normal and protein depleted nutritional status, immunological tumor defense and BRM therapy are presented in the survey. PMID- 3519455 TI - Malnutrition and metabolic abnormalities in cancer patients. AB - Malnutrition is a common problem in cancer patients. The most clear-cut cause is anorexia and a decrease in food intake. Other causes include alterations in carbohydrate, fat and protein metabolism which result in losses of energy and amino acids from the host. Understanding the pathophysiology of these changes will provide avenues to better nourish cancer patients and improve their quality of life. PMID- 3519456 TI - [Characteristics and mechanisms of tumor anorexia]. AB - Tumor anorexia can be defined as a continuous reduction in dietary intake with a steadily increased cost of energy of the organism. A possible basis for this nutritional imbalance during the course of the illness is provided by metabolic dysfunction, changes in taste, neuroendocrine alterations and behavioral factors. At the present time no uniform explanation exists, thus only adjuvant therapeutic strategies can be deducted. PMID- 3519458 TI - Enhanced levels of attachment of fibronectin-primed Treponema pallidum to extracellular matrix. AB - Freshly extracted Treponema pallidum organisms treated with exogenous human fibronectin (Fn) (Fn-primed treponemes) showed a 6- to 15-fold increased level of attachment to Fn-coated cover slips and to extracellular matrix (ECM) when compared with unprimed treponemes. Treponemes primed with collagen or laminin showed no similar enhanced binding to immobilized Fn or ECM. Preexposure of immobilized Fn and ECM to anti-Fn serum but not to anti-collagen or anti-laminin serum prevented treponemal adherence. Also, the presence of proteoglycanlike molecules such as dextran sulfate or heparan sulfate inhibited Fn-primed treponemal attachment to Fn or ECM. In contrast Fn-primed treponemes did not exhibit elevated levels of attachment to eucaryotic cell monolayers. To understand the increased tropism of Fn-primed T. pallidum organisms for Fn and ECM-like surfaces, we radiolabeled freshly extracted treponemes with [35S]methionine and examined them for the presence of surface immunoreactive Fn. Magnetic protAspheres and glass beads coated with monospecific anti-Fn serum bound only 20 to 30% of radiolabeled treponemes. Nonadherent treponemes failed to bind to gelatin-agarose, further confirming the absence of surface Fn or Fn-like material. Fn-free organisms, however, did attach to Fn-coated cover slips and to cell monolayers like treponemes of the original population. Incubation of Fn-free treponemes with human Fn resulted in almost total binding of organisms to anti-Fn antibody on glass beads and also produced increased attachment to Fn-coated cover slips and ECM. These results suggest that enhanced interactions between T. pallidum and the host are dependent on the presence of Fn on syphilis spirochetes and the specific location and orientation of Fn in vivo. PMID- 3519457 TI - Electrophoretic and serological characterization of the lipopolysaccharides of Legionella pneumophila. AB - Lipopolysaccharide (LPS) is a major constituent of the outer membrane of gram negative bacteria. We used sodium dodecyl sulfate-polyacrylamide gel electrophoresis of proteinase-K-digested cell lysates to provide preliminary data on the LPS chemotypes for 20 strains of Legionella pneumophila (serogroups 1 to 8). The profiles of all strains except Chicago 2 (serogroup 6) were similar in the number, spacing, and size distribution of the bands visualized on silver stained gels and were indicative of smooth LPS. However, compared with the bands from Salmonella minnesota smooth LPS, their banding pattern was much tighter, with three to four legionella bands for every salmonella band. The proteinase K digest of Chicago 2 was unique in that only two widely separated silver-stained bands were seen. LPS profiles of 10 serogroup 1 strains were identical, and the profile of Knoxville 1 was not altered by extensive in vitro passage. We used immunoblotting to investigate the serological specificities of the LPSs. When a rabbit antiserum prepared against a serogroup 1 strain was used to probe nitrocellulose sheets that bound LPS from strains belonging to eight different serogroups, it recognized only the LPS from the homologous serogroup. Similar results were observed with serogroup 2, 4, and 6 antisera. Our data indicate that L. pneumophila has a smooth-type LPS with an unusual banding pattern and that it is a serogroup-specific antigen. PMID- 3519459 TI - Molecular cloning of DNA coding for outer membrane proteins of Haemophilus influenzae type b. AB - DNA from Haemophilus influenzae type b was cloned in Escherichia coli with a vector lambda gt11 Amp1. Clones producing antigens reactive with hyperimmune rabbit antisera were identified by colony radioimmune assay. A second screening with hyperimmune serum adsorbed with intact H. influenzae type b bacteria was used to identify those clones producing surface-exposed outer membrane proteins. The proteins expressed in E. coli were coupled to Sepharose and used to affinity purify antibodies which were tested for reactivity with outer membrane vesicles. It was found by Western blotting that the clones were producing antigens corresponding to Mr 49,000, 39,500, and 35,000 major outer membrane protein or antigens of H. influenzae type b. Additional clones could be detected by human serum, but their reactivity was not removed when serum was adsorbed with intact bacteria. One of these studied in more detail was found to produce an antigen present in H. influenzae type b lysate but not in outer membrane vesicle preparations. PMID- 3519460 TI - Solubilization and characterization of surface antigenic components of Erysipelothrix rhusiopathiae T28. AB - The antigenicity of Erysipelothrix rhusiopathiae T28 (serotype 2) was investigated. Antigens were solubilized from the cell surface with detergents. By means of sodium dodecyl sulfate-polyacrylamide gel electrophoresis and immunoblotting it was shown that the molecular weight of the main antigenic component--a nonprotein--was 14,000 to 22,000. This major antigen was shown to be a polydisperse anionic polysaccharide located on the surface of E. rhusiopathiae. Affinity chromatography also revealed a number of immunologically active proteins with molecular weights of 78,000, 72,000, 68,000, and 48,000. PMID- 3519461 TI - Immunoglobulin G (IgG) and IgA subclass pattern of human antibodies to Shigella flexneri and Salmonella serogroup B and D lipopolysaccharide O antigens. AB - The subclass distribution of human serum antibodies to the O-antigenic lipopolysaccharides of Salmonella serogroups B and D and to Shigella flexneri serotypes 1b, 2a, and 4a lipopolysaccharide antigens were analyzed in an enzyme linked immunosorbent assay with monoclonal antibodies to the immunoglobulin subclasses. The patients had culture-verified Salmonella (17 Swedes) or Shigella flexneri (23 Vietnamese; 11 children and 12 adults) infections. Consecutive samples drawn during 1 year postinfection were investigated. Antibodies to the Salmonella antigens were mainly of the immunoglobulin G1 (IgG1), IgA1, and IgA2 subclasses. For the Salmonella serogroup B O polysaccharide, the IgA1 and IgA2 subclasses had peak values earlier than (6/9) or coinciding with the IgG1 (3/9) peak value. Furthermore, the IgA2 response to Salmonella serogroup B was positively correlated to the duration of the carrier state (P less than 0.001); the corresponding IgA1 response was less well correlated but was still significant (P less than 0.02). In the case of the Shigella flexneri O polysaccharide, specific antibodies appeared mainly in the IgG1 and IgA1 subclasses. Some IgG2 was also found, surprisingly even in very young patients. No subclass shift with time within the immunoglobulin classes was noted in any of the groups. PMID- 3519463 TI - Inhibitory effect of substituted aromatic hydrocarbons on adherence of Escherichia coli to human epithelial cells. AB - Adherence of Escherichia coli to epithelial cells is postulated to be a necessary step in the pathogenesis of urinary tract infections. Investigations have focused on the role of carbohydrates in adherence because of the ability of mannose to inhibit adherence; however, there have been several reports of an additional hydrophobic receptor. Here we describe the inhibition of adherence mediated by substituted aromatic hydrocarbon compounds and the relationship of our findings to support the role of a postulated hydrophobic-binding domain. PMID- 3519462 TI - Pulmonary microvascular injury induced by Pseudomonas aeruginosa cytotoxin in isolated rabbit lungs. AB - The effects of Pseudomonas aeruginosa cytotoxin on the pulmonary microvasculature were studied in blood-free, perfused, isolated rabbit lungs. Cytotoxin was administered to the recirculating Krebs Henseleit albumin (1%) buffer during two consecutive 30-min-perfusion phases (phases 1 and 2) at a concentration of 13 micrograms/ml, followed by a third perfusion phase (phase 3) without toxin. After perfusion phases 2 and 3, the capillary filtration coefficient (Kf,c) and vascular compliance were determined gravimetrically from two-step microvascular pressure increments under zero-flow conditions. Cytotoxin caused a continuous release of K+ and lactate dehydrogenase, which started within the first 5 min and amounted to about 50% of the total lung cellular K+ and 5 to 7% of the total lactate dehydrogenase by the end of the experiment. The toxin caused the continuous generation of prostaglandin I2, which was detectable in the perfusates of all perfusion phases at maximum values five times above the control values and which was measured in the bronchoalveolar lavage fluid at the end of the experiment. Thromboxane generation in toxin-treated lungs did not significantly exceed that of control lungs or of lungs with mechanically induced edema. Cytotoxin caused a gradual increase in pulmonary vascular resistance, to maximum values 2.5 times above the control, starting within 1 min; the increase was partially reversible after washout of the toxin. After a lag period of 20 to 30 min, the lungs gained weight, amounting to a mean gain of 9.1 g at the end of the experiments. After perfusion phases 2 and 3, an almost fourfold increase in Kf,c, which was not reversible after washout of the toxin, was measured, whereas the values of vascular compliance were not altered. We conclude that pseudomonal cytotoxin may be an important factor in the pathogenesis of prolonged microvascular injury, encountered in states of P. aeruginosa sepsis or acute lung failure with secondarily acquired P. aeruginosa pneumonia. PMID- 3519464 TI - Antibodies raised against rough mutants of Escherichia coli and Salmonella strains are opsonic only in the presence of complement. AB - The opsonic capacity of antisera raised in rabbits against rough (R) mutants and smooth (S) parent strains of Escherichia coli and Salmonella typhimurium were studied. All specific antibodies in the antisera belonged to the immunoglobulin G (IgG) class. Radioactively labeled bacteria were preincubated in various dilutions of antisera, in which complement was inactivated. Fresh normal rabbit serum, as a standard complement source, was used in some experiments. After preincubation, washed bacteria were added to normal human neutrophils. Opsonization of R mutants for 5 min in 5% fresh normal rabbit serum resulted in effective phagocytosis; S strains needed at least a 30-min opsonization time or 20 to 50% serum. After incubation for 5 min in diluted, homologous antisera, phagocytosis of S strains was optimal, but preincubation of R mutants in diluted, homologous antisera did not lead to amelioration of phagocytosis compared with that of bacteria preincubated in buffer only. However, when fresh normal serum was added to homologous antisera, uptake of R mutants occurred at a faster rate than that of bacteria opsonized in fresh serum alone. Using six clinical isolates of members of the family Enterobacteriaceae, we found that, with or without complement, antisera raised against E. coli J5 or S. typhimurium Re had, with the exception of one strain, no opsonic activity for these strains. Thus, the protective effect of R antisera in gram-negative bacteremia, as shown by several investigators, is unlikely to be mediated through enhanced opsonization of invading bacteria by IgG antibodies directed against these R mutants. PMID- 3519465 TI - Synergistic activity of rabbit granulocyte peptides against Candida albicans. AB - Rabbit granulocytes contain six antimicrobial peptides that are structurally homologous to the human neutrophil "defensins." NP-5, a rabbit defensin, lacks significant activity against Candida albicans. Nevertheless, its addition to submicromolar concentrations of rabbit NP-1, NP-2, or NP-3a potentiates their candidacidal effect. Thus, granulocyte defensins can act synergistically against potential pathogens. PMID- 3519466 TI - Protection of mice against lethal endotoxemia by a lipid A precursor. AB - Lipid X, the major biosynthetic precursor of lipid A, has recently been described. Although lipid X is a mitogen and coagulates the Limulus amebocyte lysate, we found that it is not lethal for mice, even when given in large doses (2 X 10(6) micrograms/kg). Furthermore, lipid X was found to give partial protection against a 100% lethal dose of endotoxin, even if the lipid X was given as late as 6 h after endotoxin challenge. PMID- 3519467 TI - Relative functional activity of purified human immunoglobulin G against a type III group B streptococcal strain. AB - Human immunoglobulin G (IgG) separated from whole serum by a quaternary aminoethyl-Sephadex A-50 ion exchanger was evaluated for its activity against a type III group B streptococcal strain in the newborn rat model. Separated IgG yielded approximately 70 to 80% of whole serum IgG and did not contain detectable IgM or IgA. This IgG preparation also contained similar ratios of specific type III group B streptococcal antibody to total IgG in comparison with whole serum. In vivo, 50% protection from death was achieved by 3.9 ng of type III-specific antibody per 10 g of rat body weight. This value was considerably lower than 50% protective doses obtained in our previous studies with different human IgG preparations. Further studies are needed to understand the mechanisms responsible for these differences in the functional activity of IgG antibody. PMID- 3519468 TI - Colonization of Nigerian neonates with group B streptococci and its rapid detection. AB - The rate of colonization by group B streptococci among Nigerian neonates in Abeokuta was found to be 19% (38 of 200 newborns). The recently described serotype IV was the commonest (35.1%) among the strains isolated. Three methods for the rapid detection of heavy colonization by group B streptococci in neonates were compared: Gram stain of the pharyngeal aspirate collected immediately post partum; direct application of latex agglutination to the first post-partum pharyngeal aspirate; and application of latex agglutination to selective Todd Hewitt broth, inoculated with pharyngeal aspirate and body swabs, after five hours of incubation. It seems that both latex agglutination methods can rapidly detect a considerable proportion of neonates heavily contaminated with group B streptococci intra-partum; therefore both methods deserve further evaluation. PMID- 3519469 TI - Definitions of monitoring activities and their relevance for the practice of occupational health. AB - The authors discuss the definitions of environmental monitoring (EM), biological monitoring (BM) and health surveillance (HS) as agreed upon by a CEC/NIOSH/OSHA seminar in 1980. They emphasize the essential differences in underlying principles. They add a fourth definition of biological effect monitoring (BEM). Each method has its own assets and liabilities. Moreover, EM and BM require another decision-making process (situation-centered) then BEM and HS (client entered) of measures to be taken. When the differences between the four approaches are not taken into account, valid preventive measures may be hampered. PMID- 3519470 TI - Pharmacokinetics and pharmacodynamics of epidural and intrathecal morphine. AB - Spinal opiate analgesia has opened an exciting new field of research and has also rapidly gained widespread clinical acceptance. This mode of administration has obvious and definite advantages over conventional pain therapy; however, the field is still at an early stage of development. More research is clearly needed to provide methods for coping with some of the drawbacks of this method of pain relief. Important areas for future research include (1) the CSF kinetics of opiates; (2) the physiological mechanisms underlying the rostral spread of drugs within the CSF compartment; (3) a search for safer and more selective drugs; and (4) an evaluation of the extent to which pain-modulating systems at different levels in the CNS can be regulated by opiates and drugs interfering with other neurotransmitters. In this context it is essential to emphasize the importance of simultaneous study of the pharmacokinetics and the pharmacodynamic/clinical effects in providing a rational basis for a better understanding of the mechanisms of actions underlying spinal opiate analgesia. PMID- 3519471 TI - Management of chronic pain by epidural and intrathecal opioids: newer drugs and delivery systems. PMID- 3519472 TI - Tumour basement membrane laminin in adenocarcinoma of rectum: an immunohistochemical study of biological and clinical significance. AB - Well-defined basement membrane laminin was seen in 98/158 (62%) rectal adenocarcinomas stained by an immunoperoxidase method. Only 27 (28%) patients with laminin-positive tumours developed distant metastases, compared with 39 (65%) patients with laminin-negative carcinomas. The corrected 5-year survival rates for patients with laminin-positive and laminin-negative tumours were 65% and 23%, respectively. Twenty-five out of 30 (83%) well-differentiated adenocarcinomas and only 3/15 (17%) poorly differentiated tumours contained basement membrane laminin, with moderately differentiated carcinomas showing intermediate laminin status (70/110, 64%, laminin positive). Forty-three of 60 (72%) of laminin-negative tumours had metastasized to regional lymph nodes. These data suggest that laminin may be a marker for differentiation. However, laminin status yields information about tumour behaviour which is not confined to stage and grade, and multivariate analysis shows that it is a better indicator of prognosis than tumour grade as assessed by conventional histology. Although laminin status alone is a less useful predictor of prognosis than Dukes' stage, a patient with a laminin-positive adenocarcinoma of rectum is 2.7 times as likely to survive 5 years than a patient with a laminin-negative tumour. Assessment of laminin status, together with Dukes' stage is, therefore, commended as a more precise and objective indicator of prognosis than histological degree of differentiation in colorectal carcinoma. PMID- 3519473 TI - A monoclonal antibody CIBr17 recognizes a myoepithelium-specific antigen in human mammary gland. AB - A murine monoclonal antibody (MAb) CIBr17, raised against the human breast carcinoma cell line PMC42, reacts specifically with myoepithelial cells in normal human breast. This IgGl antibody recognizes a approximately 110kDa glycoprotein that is expressed on the cell surface and junctional membranes of PMC42 monolayer cultures. The CIBr17 antigen is present in two major glycosylated forms with approximate pls of 5.2 and 5.5 respectively in PMC42 cells. The tissue specificity of CIBr17 was assessed on frozen sections of PLP-fixed tissues by means of a 4-layer immunoperoxidase technique. CIBr17 has reacted with a variety of epithelium-derived tissues and some smooth muscle cells. Within many epithelial tissues, CIBr17 has demonstrated specific staining of particular epithelial cell types. Within normal breast and most benign breast lesions, antibody CIBr17 stained only myoepithelial cells. No staining of luminal epithelium, basement membranes or stromal elements was observed. In sclerosing adenosis, CIBr17 stained areas of pronounced myoepithelial differentiation, while in duct epitheliosis variable staining of proliferating cells was observed. In breast carcinomas, CIBr17 demonstrated variable antigen expression. In most tumors, CIBr17 either did not stain any tumor cells or stained only a small number of tumor cells spread randomly throughout the tumor. In several ductal carcinomas, however, CIBr17 stained the majority of tumor cells. PMID- 3519474 TI - Products of cells cultured from gliomas. IV. Extracellular matrix proteins of gliomas. AB - Five primary and 3 established human glioma cell lines were cultured with ascorbate and examined for expression of extracellular matrix components. All lines except C6 expressed collagen as assessed by silver impregnation, immunofluorescence and lectin staining and expressed laminin and fibronectin. None expressed a lectin marker for endothelial cells. Both epithelial and mesenchymal collagens were expressed. While extracellular components of glioma lines resembled those of fibroblasts more closely than other cell types, subtle differences between gliomas and fibroblasts were present. These included more laminin and collagen type-IV antigenic reactivity and more 11-12 nm diameter extracellular fibrils from individual gliomas, and slight differences in spectra of low-molecular-weight extracellular proteins assessed by gel electrophoresis. One primary and two established glioma lines analysed for DNA content were aneuploid in contrast to diploid fibroblasts. Simultaneous expression of mesenchymal and epithelial markers suggests a dual differentiation potential of glioma cells. Results do not support an endothelial origin for cells cultured from gliomas. PMID- 3519475 TI - Fluorescent location of rat leukaemia cells in resin sections. PMID- 3519476 TI - The contrasting effects of cyclosporin-A and azathioprine on arterial blood pressure and renal function following cardiac transplantation. AB - The effects of cyclosporin-A and azathioprine on the postoperative development of systemic hypertension and renal dysfunction in patients undergoing cardiac transplantation were compared retrospectively in 18 patients receiving cyclosporin-A and in 12 patients receiving azathioprine. Twelve months postoperatively, the average mean blood pressure was 116 +/- 13 mm Hg and 98 +/- 7.5 mm Hg; the average preoperative serum creatinine was 1.2 +/- 0.3 mg% and 1.5 +/- 0.3 mg%; and the postoperative serum creatinine was 2.2 +/- 0.8 mg% and 1.1 +/- 0.2 mg% (P less than 0.0001) in the cyclosporin-A-and azathioprine-treated groups respectively. Hemodynamic studies were done to characterize the de novo postoperative hypertension developing in the cyclosporin-A group. The pre- and postoperative cardiac output was 3.7 and 4.91/min, respectively (P less than 0.01). The pre- and postoperative systemic vascular resistance was 1707 and 1941 dynes sec X cm-5, respectively (P greater than 0.2). Peripheral renin activity and 24-hour urinary catecholamine excretion were not elevated. The mechanism of the hypertension developing in cyclosporin-A-treated patients is unknown, but is associated with normalization of cardiac output, an abnormally elevated systemic vascular resistance, and modest impairment of renal function. These findings are in marked contrast to azathioprine-treated patients, in whom postoperative hypertension and renal dysfunction do not occur. These observations implicate cyclosporin-A as the major contributing factor in the development of hypertension and renal dysfunction. PMID- 3519477 TI - Modulation of murine hemopoiesis by repeated injections of a glycoprotein extract from Klebsiella pneumoniae. AB - RU 41740, an immunomodulating agent extracted from the cell wall of Klebsiella pneumoniae, was tested for its ability to modulate hemopoiesis in mice treated intraperitoneally for ten days. In such conditions, a moderate anemia could be observed, which was rapidly reversible after the end of treatment. This anemia may partly result from a decrease of bone marrow erythroid colony forming units (CFU-E), this being incompletely compensated by the intrasplenic erythropoiesis. Moreover, the amount of granulocytes and their progenitors, i.e. granulocyte/macrophage colony forming cells (GM-CFC), increased both in the bone marrow and spleen. It is proposed that this effect of RU 41740 on granulopoiesis, which could explain the better resistance to infections in treated animals as observed elsewhere, is partly related to an increase of colony stimulating activity (CSA). PMID- 3519478 TI - The influence of new thymopoietin derivatives on the immune response of inbred mice. AB - The immunomodulatory activities of new synthetic thymopoietin derivates TP4 (Arg Lys-Asp-Val) and TP3 (Arg-Lys-Asp) have been compared to those of TP5 (Arg-Lys Asp-Val-Tyr) which exhibits most of the biological activity of the native hormone and probably represents the active site. Both TP4 and TP3 are shown to exert similar immunomodulatory activities to TP5 affecting both humoral and cellular responses. Primary and secondary antibody responses of high responder mice were enhanced whilst the intensity of DTH reactivity was decreased. The effect on humoral immunity was particularly apparent following administration of TP4 or TP3 to mice undergoing primary antibody responses following immunization with sub optimal doses of antigen or suppression by CY treatment. Administration of peptide(s) elicited DTH responses in mice previously shown to exhibit genetically determined unresponsiveness: in these animals antibody responses were not modulated. The data may be interpreted that the tetra- and tri-peptide representing the N-terminal sequence of TP5 possess immunomodulatory activity which is in many aspects similar to that of TP5. The experimental systems and protocols employed are shown to be appropriate for investigating the effect(s) of potential immunomodulators on humoral and cellular immunity. PMID- 3519479 TI - Hormone and metabolite response to weight-lifting training sessions. AB - Eleven weight-trained athletes (age X +/- SD = 33 +/- 5 yrs, weight = 72 +/- 10 kg) with a maximal performance in bench press at the beginning of the study (116 +/- 19 kg) were studied at rest, after a standardized submaximal training session, and after a maximal session once a month for 4 months to study the blood metabolites and hormonal changes during weight lifting. The submaximal load was six series of eight bench presses at 70% of maximal performance presses, and the maximal load was the maximal number of repetitions at the same work load. The levels of several metabolites (lactate, glycerol, triglycerides, beta-OH butyrate) and hormones (norepinephrine and epinephrine) increased (P less than 0.05) after submaximal work and more after maximal work. Glucose, FFA, acetoacetate, insulin, testosterone, and cortisol did not change significantly or consistently. Lactate after maximal work was higher after the 4th training month (P less than 0.05). Other variables did not change much with training while the maximal number of repetitions in the last series increased slightly (P less than 0.05). In general, the changes observed were smaller than the ones reported for endurance or interval running, which use larger muscle groups. Nevertheless, weight lifting induced changes in blood metabolites which reflect a mobilization of both carbohydrates and lipids stores for energy. PMID- 3519480 TI - The energy cost of human locomotion on land and in water. AB - The energy cost of the forms of locomotion discussed throughout this article is summarized in Table 9. This table, as well as the preceding sections of this article, are designed to provide a rather comprehensive and simple set of information for potential readers: medical doctors, who should be able to prescribe to their patients (obese, hypertensive, cardiac, etc.) the correct amount and type of exercise, thus making use of exercise as of any other drug, of which it is imperative to know posology and contraindications; athletes, trainers, and sportsmen in general, who should gear correctly their diet to the type and amount of physical exercise; physical educators, who should be aware of the specific characteristics of the exercise modes they propose to their pupils, as a function of their sex, age, and athletic capacity. However, besides these practical applications, the notions discussed throughout this article bear also a more general interest. Indeed, they allow a better understanding of the motion of man, that is, of the only machine, which besides moving about, also tries to understand how he does it. PMID- 3519481 TI - Preliminary study of a Mycobacterium leprae bacterin vaccine in a human volunteer population in a nonendemic area. AB - Seventeen volunteers who had never resided in areas with significant transmission of leprosy (Hansen's disease) were inoculated intradermally with 1.5 X 10(8) killed, purified armadillo-derived Mycobacterium leprae in a standardized preparation being tested for possible vaccine use. The peak of local skin responses, consisting of induration with or without ulceration similar to the post-lepromin Mitsuda reaction, occurred between the 21st and 28th days after injection. The maximum mean induration diameter was 17.2 mm, the minimum, 6.1 mm. Sera tested with the ELISA technique revealed no humoral response to either the sonicated bacilli, M. leprae-specific phenolic glycolipid I antigen, or three semi-synthetic analogues reactive with lepromatous patients' sera. The dose of M. leprae inoculated appeared to be safe and without unacceptable reactions at the injection site. One volunteer developed a generalized skin rash parallel to the local reaction, but the relationship of the former to the inoculation was unclear. PMID- 3519482 TI - Cephalosporins in cutaneous infections. A prospective comparison of two dosage regimens of ceftazidime for therapy of skin and skin structure infections. AB - The safety and efficacy of ceftazidime administered as 0.5 g every 8 hours (q8h) or 1.0 g q8h for at least 5 days were compared in 197 patients and found to be effective in the treatment of cellulitis, abscesses, skin ulcers, and wound infections. Staphylococcus aureus was the predominant pathogen in both treatment groups with approximately half of the isolates from each treatment group being gram-positive. Pseudomonas aeruginosa was the most common gram-negative isolate. P. aeruginosa, Proteus mirabilis, and Escherichia coli each comprised 5-12% of the isolates from each treatment group. Clinical cure or improvement was achieved in 98.7% of the patients in each treatment group. Concurrently with clinically successful treatment, a high rate of bacteriologic eradication without superinfection was achieved with the 0.5-g regimen (84% of all isolates) and the 1.0-g regimen (92%). PMID- 3519483 TI - Sir Patrick Manson and tropical dermatology. PMID- 3519484 TI - Serum insulin and blood pressure in an obese population. AB - Serum insulin has been implicated as a determinant of blood pressure (BP) level in obese hypertensive individuals. We examined the relationships among fasting insulin, mean arterial pressure (MAP), body composition, and fat distribution in 204 subjects unselected for glucose tolerance. All met the criteria of taking no oral hypoglycemic agents, insulin or antihypertensive medications. 95 percent were considered obese and 78 percent were female. Mean age was 39 years (range 15 71), percent ideal body weight (IBW) 171 percent (109-332), BP 125/81 mmHg (80 181/50-110) and fasting insulin 44 microU/ml (4-196). Lean body mass (LBM) and body fat were measured by tritium dilution. The correlation coefficient between insulin and MAP was 0.32 (P less than 0.0001). Both insulin and MAP correlated highly with percentage IBW, percentage body fat, fat mass, LBM, body build and upper fat pattern. Controlling for these variables simultaneously eliminated the association between insulin and BP. By contrast, the correlations between MAP and measures of body composition and fat distribution retained significance after controlling for insulin level. These findings suggest that measures of body composition and fat distribution have a relationship with BP that is not entirely accounted for by serum insulin level, and the relationship between serum insulin and BP is indirect and largely accounted for by their mutual association with measures of body composition and fat distribution. PMID- 3519485 TI - Reinvestigation of the disulfide bridge arrangement in human pro-opiomelanocortin N-terminal segment (hNT 1-76). AB - The cystine bridge structure of the amino-terminal fragment of human pro opiomelanocortin has been reinvestigated. Highly purified amino-terminal fragment 1-76 was rapidly isolated from human pituitaries using only reverse-phase liquid chromatography (RP-HPLC). This peptide was then subjected to trypsin and V8 protease digestion and the products separated by RP-HPLC and subjected to amino acid and microsequence analysis. The results show that disulfide bridges link Cys 2 to Cys-24 and Cys-8 to Cys-20. Amino acid analysis and amino sugar determination confirm (i) the previously proposed sequence and (ii) the suggestion of the presence of two glycosylation sites in this molecule. These are most probably located at Thr-45 (O-glycosylation) and at Asn-65 (N glycosylation). PMID- 3519486 TI - Preparation and activity of nitrated insulin dimer. AB - Nitration of insulin using tetranitromethane causes polymerisation involving cross-linked tyrosyl residues. By performing this reaction with insulin crystals, in which it is known that B16 tyrosine of one monomer is closely associated with B26 of the neighbouring monomer within the dimer, it has been possible to isolate a covalent dimer of insulin cross-linked between these two tyrosines. It was, however, first necessary to block the reactive A14 tyrosine. Both rhombohedral (hexameric) and cubic (dimeric) pig insulin crystals were used, the latter proving successful in yielding a pure dimeric product as shown by oxidative sulphitolysis and HPLC. The purified nitrated dimer was biologically active (ca. 10% potency compared to monomeric insulin in a lipogenesis assay) suggesting that the residues responsible for insulin's action are present on the surface of the dimer and not buried in the interface. PMID- 3519487 TI - Cholesterol crystals in the temporal bone and the paranasal sinuses. AB - In order to study the manifestation and genesis of cholesterol deposits in the temporal bone and the paranasal sinuses, 137 temporal bones and 3 paranasal sinuses with deposits were examined. For histological study, 1036 specimens were obtained from temporal bones, and 16 specimens were obtained from paranasal sinuses. Several stages of a progressive foreign body reaction, including the appearance of histiocytes, granuloma formation and the development of granulation into scar tissue, were observed depending on the size and form of the crystals. Many large deposits were found in the temporal bones of patients with chronic non suppurative lesions. Blue eardrum and hemotympanum were seen in the last stage of this foreign body reaction in these patients. Small deposits were found in the temporal bones and the paranasal sinuses of patients with chronic suppurative lesions. Most of these deposits were found in the obstructed parts. The pathogenesis of the cholesterol deposits is suspected to be fatty degeneration of the connective tissue. PMID- 3519488 TI - [Detection of endotoxins in radiopharmaceutical preparations--I. Comparison of rabbit hyperthermia after intravenous or intrathecal administration of reference endotoxin preparations]. AB - The rise of the rabbit internal temperature after endotoxin injection is related to the route of administration. A rise of 1.71 +/- 0.411 degrees C is obtained after i.v. injection of 1 ng/kg Escherichia coli 0111.B.4 endotoxin. An increase of 1.93 +/- 0.236 degrees C is obtained after suboccipital intrathecal injection of 0.1 ng/kg of the same endotoxin; with the intrathecal route, the hyperthermia is induced by E. coli endotoxin after a dose ten times lower than with i.v. injection as shown by statistical analysis. PMID- 3519489 TI - [Detection of endotoxins in radiopharmaceutical preparations--II. Comparison of the sensitivity of methods using the rabbit and the Limulus amoebocyte lysate for the detection of endotoxins]. AB - The rise of the rabbit internal temperature after i.v. injection of an endotoxin solution is proportional to concentration. Gelation of Limulus amoebocyte, when in presence of an endotoxin solution, is also related to concentration. We compared the sensitivity of these two methods. With our experimental procedure, the rabbit is sensitive to a 0.40 ng/mL solution and the Limulus amoebocyte lysate to a 0.14 ng/mL solution. The rabbit sensitivity increase is related to the per kilogramme injected volume, whereas sensitivity is not related to the volume to check in the case of the lysate. PMID- 3519490 TI - [Detection of endotoxins in radiopharmaceutical preparations--III. Limulus test assessment using radiopharmaceutical preparations; correlation with the rabbit pyrogen test]. AB - Experiments using 17 radiopharmaceuticals containing known amounts of added endotoxin show that none of them inhibits the pyrogenic reaction of the rabbit. Gelation of the Limulus amoebocyte lysate (LAL) is inhibited by 4 of them: colloidal erbium 169Er citrate, colloidal rhenium 186Re sulfide, colloidal technetium 99mTc (Re) sulfide for liver scintigraphy and the colloidal technetium 99mTc (Re) sulfide for lymphography. This inhibition is cancelled, either by dilution or after neutral pH adjustment. Both controls were performed on 313 batches of various radiopharmaceuticals, 95% of results were identical (93% negative, 2% positive). The remaining 5% correspond to positive LAL tests vs negative rabbit tests on the same batches. No negative LAL test vs positive rabbit test was observed. PMID- 3519491 TI - Improvement of visual resolution in fluorescent scanning by a new subtraction procedure for backscatter. AB - A new subtraction method was developed to improve visual resolution in fluorescent scanning. A digital gate circuit could subtract backscatter of a fluorescing gamma ray source in real time without the need for a computer for postprocessing of the image data. PMID- 3519492 TI - Prosthodontic rehabilitation of a bulimic. A case report. PMID- 3519493 TI - A review of the periodontal, endodontic, and prosthetic considerations in odontogenous resection procedures. PMID- 3519495 TI - Determination of vitamin B12 in gruel by a radioisotope dilution assay. AB - The results obtained by a radioisotope dilution (RID) method for the determination of vitamin B12 in gruel were compared with those obtained by a standard microbiological assay with Lactobacillus leichmannii. A commercially available RID assay kit was used. A very high correlation between the results from the RID method and the microbiological method was found when the extraction procedure was the same. Digestion with buffer solution at pH 4.6 was shown to be the most suitable extraction method. The RID assay is an acceptable method for routine determinations of vitamin B12 in gruel. PMID- 3519494 TI - The use of frozen autogenous bone in grafting procedures. PMID- 3519496 TI - Serratia marcescens infections. PMID- 3519497 TI - Pseudomonas cepacia. AB - P. cepacia is reported to be an increasing cause of infection and colonization of patients in hospitals. Historically it is an important contaminant in the pharmaceutical industry. Its nutritional versatility, ability to survive and multiply in water, high intrinsic resistance to antibiotics, and ability to multiply in the majority of traditional disinfectants make it a superb agent for causing nosocomial infection. Recognition of its differences from P. aeruginosa and its ability to contaminate agents used in hospitals is important in proper treatment and infection control. PMID- 3519498 TI - Prevalence of measles antibodies in hospital personnel. AB - A community outbreak of measles prompted a serologic survey of personnel in a hospital serving that community. Two hundred sixty-six personnel, primarily physicians (129) and nurses (100), voluntarily participated. Serum specimens were initially tested by the immunofluorescent antibody and enzyme-linked immunosorbent assay (EIA) methods. Specimens with negative results by either test were further examined using the hemagglutination inhibition and plaque neutralization (PN) methods. If EIA and PN results were negative, an individual was considered susceptible. Only one of the 98 participants born during or after 1957 and none of the 168 participants born before 1957 were serosusceptible. The low rate of serosusceptibility, in contrast to previous studies of young adults, appears attributable to the sensitivity of the testing methods used. Based on our experience, institutions considering a measles serologic testing and immunization program should expect to identify very few serosusceptible personnel, even among those born during or after 1957. PMID- 3519499 TI - Review of imipenem. AB - Imipenem, a new carbapenem beta-lactam broad-spectrum antibiotic, is highly active in vitro against most aerobic and anaerobic gram-positive and gram negative bacteria isolated from infectious diseases of human beings. Except for enterococci and methicillin-resistant staphylococci most gram-positive cocci are inhibited by less than 2 micrograms/ml. Although the MIC-90 of methicillin resistant staphylococci may be less than 4 micrograms/ml, these bacteria are usually resistant to imipenem by modified testing methods. The enterococcus, S. faecalis, has an MIC-90 of less than 8 micrograms/ml but bactericidal concentration may be much higher. Most Enterobacteriaceae are highly susceptible to imipenem with MIC-90 of 0.5 to 2.0 micrograms/ml. Proteus species are less susceptible with MICs of 4 to 8 micrograms/ml. Isolates of P. aeruginosa have variable susceptibility with MICs ranging from 0.25 to 16 micrograms/ml. Pseudomonas maltophilia and P. cepacia are usually resistant to imipenem. Except for Clostridium species, most strict anaerobes are susceptible to less than 1.0 micrograms/ml of imipenem. When combined with cilastatin (1:1 ratio), the renal elimination of the active form is increased. The serum halflife in normal renal function is about 1 hour and increases to 3.4 hours in anuria. Major adverse effects are similar to those of cephalosporins except for seizures in some patients. Colonization with fungi and drug-resistant bacteria occurs in about 5% of imipenem-treated patients. Clinical studies have demonstrated efficacy in 79% to 96% of patients treated. PMID- 3519500 TI - [Diagnosis and therapy of the early stages of chronic bronchitis and emphysema]. PMID- 3519501 TI - [Chronic heart failure in the early stage]. PMID- 3519502 TI - [Findings or disease--lipid metabolism with reference to the heart]. PMID- 3519503 TI - [Onset and development of chronic pancreatitis]. PMID- 3519504 TI - [Diagnostic and therapeutic possibilities in the early stage of systemic lupus erythematosus]. PMID- 3519505 TI - [Depressive syndrome with special reference to masked depression]. PMID- 3519506 TI - [Osteoporosis--pathogenesis, prevention, therapy]. PMID- 3519507 TI - [Specialization and integration in medicine]. PMID- 3519508 TI - [Internal medicine and its branches]. PMID- 3519509 TI - [The changed occupational picture of the internist in gastroenterology]. PMID- 3519510 TI - [The occupational picture of the cardiologist]. PMID- 3519511 TI - [Status and progress in internal medicine oncology/hematology]. PMID- 3519512 TI - [Report of experiences from an internal medicine community practice]. PMID- 3519513 TI - [Specialty education of the internist in an international comparison: USA, Japan, Switzerland]. PMID- 3519514 TI - [The internal medicine university assistant as clinical researcher]. PMID- 3519515 TI - [Shock with multiple organ involvement in a 54-year-old patient 6 weeks after a fall from a moped]. PMID- 3519516 TI - [Q fever endocarditis in a 52-year-old patient]. PMID- 3519517 TI - [Severe pneumonia in an atypical course of measles]. PMID- 3519518 TI - [Painless jaundice and a space-occupying lesion in the liver hilus in a 60-year old patient]. PMID- 3519519 TI - [Neglected congenital adrenogenital syndrome (AGS) in an adult. A case report (21 hydroxylase deficiency) with a summary of the current status of therapy with reference to adulthood]. PMID- 3519520 TI - Uveitis and arthritis induced by systemic injection of streptococcal cell walls. AB - A single injection of an aqueous suspension of group A streptococcal peptidoglycan-polysaccharide complexes (PG-PS) when injected intraperitoneally into Lewis rats induced a self-limiting bilateral uveitis with associated perpetuating polyarthritis. The uveitis was characterized clinically during the first 72 h by iritis and fibrin deposition. Acutely, there was infiltration of polymorphonuclear cells. The symptoms gradually subsided, and at the close of the experiment eyes were normally clinically and histologically. In contrast, perpetuating inflammation and severe tissue injury developed in the limb. Using an enzyme immunoassay with specificity for the group A streptococcal polysaccharide, the levels of PG-PS in tissues of animals that were killed 1 to 7 days post-injection were measured. The relative amounts of antigen in eye:limb:liver of PG-PS injected animals were 1:9:170. The differences in the amounts of antigen detected in the eye and limb may help explain the development of the acute uveitis in contrast to the perpetuating polyarthritis observed on PG PS administration. The authors suggest that bacterial debris may act similarly in causing ocular inflammation in man. PMID- 3519521 TI - Role of leukocytes in ocular inflammation of tyrosinemia II. AB - In the animal model of tyrosinemia II only corneas from tyrosine(tyr)-fed rats produce chemoattractants in organ culture. To study the role of neutrophils (PMNs) in production of these chemoattractants, leukocytes (WBCs) were depleted using i.p. cyclophosphamide (CP). Saline (SAL)-treated rats maintained 18,375 +/- 894 WBC/mm3 (mean +/- SEM) with 4168 +/- 424 PMNs. Rats receiving CP (150 mg/kg day 0, 75 mg/kg day 4) has 1565 +/- 170 WBC (565 +/- 129 PMN) on day 3, and 398 +/- 68 WBC (19 +/- 5 PMN) on day 8. Rats ate a low-protein +/- 5% tyr diet on days 4-8. Only SAL-treated tyr-fed rats developed plaque-like gray epithelial lesions; histopathology showed corneal epithelial necrosis, stromal edema, and epithelial and stromal PMN infiltration. Control and CP-treated tyr-fed rat corneas showed no inflammation. On day 8 corneas were cultured in RPMI 1640 + 5% heat-inactivated fetal bovine serum. After 3 days, supernatants were assayed for chemotactic activity (leading front method); data were expressed as the percentage of peritoneal PMN migration relative to 5% zymosan-activated rat serum. The mean total migration toward 75% supernatant from SAL-treated, tyr-fed rat corneas was 79%, whereas migration toward corneal supernatants from controls and CP-treated tyr-fed rats ranged from 42-48%. Corneal extracts were assayed for proteolytic activity. WBC depletion prevented the increase in cathepsin B- and D like activities present in tyr-fed corneas, suggesting that PMNs were a major source of these enzymes. The data suggest that WBC depletion reduces both corneal inflammation in vivo and the production of chemotactic activity by tyr-fed corneas in culture. PMID- 3519522 TI - Immunization against experimental Pseudomonas aeruginosa and Serratia marcescens keratitis. Vaccination with lipopolysaccharide endotoxins and proteases. AB - Rabbits vaccinated with lipopolysaccharide endotoxins or with purified protease preparations from Pseudomonas aeruginosa and Serratia marcescens before corneal challenge with the viable bacteria exhibited significantly less corneal damage than rabbits not vaccinated with the bacterial products. However, the rabbits vaccinated with the lipopolysaccharide endotoxin preparations were significantly better protected than rabbits vaccinated with the bacterial proteases. Rabbits vaccinated with antisera raised against the proteases showed significantly less corneal damage than rabbits vaccinated with normal rabbit serum, and the passive protection was not significantly different than that elicited by active immunization against the bacterial proteases. The ability of the antiserum raised against the pseudomonas elastolytic protease to passively protect against severe corneal damage produced by experimentally induced pseudomonas keratitis was confirmed in mice. These findings support the idea that the bacterial endotoxins and proteases are virulence factors during the development of pseudomonas and serratia keratitis. PMID- 3519523 TI - Computerized search of chest radiographs for nodules. AB - A computer program that recognizes potential pulmonary nodules in PA chest radiographs has been developed. This program produces a display of candidate nodules that require interpretation by a radiologist. Some false positives are rejected by a program, the Nodule Expert. Detection performance with and without Nodule Expert has been evaluated. Using the untrained program (no Nodule Expert), and after inspecting 45 candidate nodules, a radiologist may be confident that a nodule was inspected, if one was located by the program. When pattern recognition techniques are incorporated, the number of false positives presented for inspection is reduced. The radiologist must inspect, at most, 10 candidate nodules to be confident of having inspected a nodule, if one was located by the program. Concomitant with this decrease in the candidate nodule false-positive rate is a decrease in sensitivity (film true-positive rate) from 92 to 86%. This program was trained on candidate nodules from 37 radiographs and also tested on these 37. Some of the features used by the pattern classifier to classify candidate nodules are comparable to those used by human observers. PMID- 3519524 TI - CT differentiation of pleural effusion from ascites. An evaluation of four signs using blinded analysis of 52 cases. AB - Four criteria have been described to differentiate ascites from pleural effusion by computed tomography (CT). These four signs (the diaphragm sign, the displaced crus sign, the interface sign, and the bare area sign) were compared in a retrospective blinded analysis in 52 patients with ascites, right pleural effusion, or both ascites and right pleural effusion. There were limitations with each of the four criteria. Each of the individual criteria was reliable when only one abnormal fluid collection, either pleural effusion or ascites, was present. When both a right pleural effusion and ascites were present, none of the four criteria reliably identified both fluid collections. The combined use of the four criteria, however, led to a correct identification of all the abnormal fluid collections. PMID- 3519525 TI - Incidence of fibrillation with dilute contrast media for intra-arterial coronary digital subtraction angiography. AB - State-of-the-art imaging technology such as digital subtraction angiography can produce coronary artery opacification with contrast media formulations that contain less than 170 mgI/ml. We examined the effect of electrolyte composition in such formulations on the incidence of fibrillation. Right coronary injections of contrast were made for 25 seconds in anesthetized dogs. This injection is longer than clinical injections, but the model approximates the worst condition of a wedged catheter preventing media washout. Formulations of several mixtures of meglumine and sodium diatrizoate (173 to 141 mgI/ml) and sodium diatrizoate alone (143 mgI/ml) produced fibrillation in only 10 to 20% of the injections. Meglumine diatrizoate (141 mgI/ml) and full strength meglumine/sodium diatrizoate (Angiovist 370) produced fibrillation in 100% and 50% of the injections, respectively. These animal studies demonstrate that dilute contrast media containing few or no sodium ions are more likely to induce fibrillation than Angiovist 370, whereas dilute contrast media containing sodium are the least likely to induce fibrillation. PMID- 3519526 TI - Ascorbic acid supplementation: its effects on body iron stores and white blood cells. PMID- 3519527 TI - Biographical sketches--63. Krafft-Ebing. PMID- 3519528 TI - A controlled study of dihydroergotamine in the treatment of acute migraine headache. PMID- 3519529 TI - Propranolol in the prophylaxis of migraine. PMID- 3519530 TI - Prospective payment for hospital capital by Medicare: issues and options. AB - After this year, Medicare will no longer reimburse capital-related expenses. Instead, a new approach may be implemented. Should the new capital payment scheme be prospective? Should Medicare continue to recognize return on equity? What will be the relationship between Medicare payment and health care planning? These and other questions should be asked since the answers will directly affect the health care setting. PMID- 3519531 TI - Health maintenance organizations: improvements in the regulatory environment. AB - Health maintenance organizations (HMOs) can help slow rising health care costs. State regulatory statutes are needed that will protect critical interests of HMO members while freeing HMOs from needless statutory requirements. A model HMO regulatory law is designed to strike a balance between protection of members and freedom for HMOs to deliver programs that can reduce health care costs. PMID- 3519532 TI - The strategic management of hospitals: toward an integrative approach. AB - Evidence indicates that hospital planners do not widely practice strategic management. An integrative approach to strategic management may, however, enable them to better operate in today's increasingly turbulent environment, and hospital strategists can learn from the mistakes of businesses in the corporate sector. PMID- 3519533 TI - Transfer coefficient of 226Ra from vegetation to meadow voles, Microtus pennsylvanicus, on U mill tailings. AB - The 226Ra level in vegetation growing on U mine tailings in Elliot Lake, Ontario, Canada, was 211 + 22 mBq g-1 (dry weight) compared to less than 7 mBq g-1 (dry weight) in material from a control site. Skeletons of meadow voles (Microtus pennsylvanicus) established on the tailings had concentrations of 226Ra of 6,083 +/- 673 mBq per animal in winter; 7,163 +/- 1,077 mBq per animal in spring; 1,506 +/- 625 mBq per animal in summer; and 703 +/- 59 mBq per animal in fall, compared to less than 7 mBq per animal in controls. The 226Ra transfer coefficient from vegetation to voles (defined as total millibecquerels of 226Ra in adult vole per total millibecquerels of 226Ra consumed by the vole in its lifetime) was calculated as 4.6 +/- 2.9 X 10(-2) in summer and 2.8 +/- 0.6 X 10(-2) in fall. PMID- 3519534 TI - Estimating undersupply of nursing home beds in states. AB - This examination of nursing home bed supply estimates undersupply in each of the states for the purpose of identifying the states with the greatest undersupply of beds. New data on state nursing home bed supply for the period 1979-1982 are used. The study employs selected independent variables in two different types of analyses to estimate bed supply for each state. Where a state is found to have a bed shortage, state public policymakers may wish to employ policies that differ from those suitable for states with an adequate supply of beds. Because of limitations in the data, issues of oversupply and of the extent of undersupply could not be examined. PMID- 3519535 TI - [Radiological elucidation studies in biliary tract diseases]. PMID- 3519536 TI - [Early functional treatment of the extensor tendon of the hand]. PMID- 3519537 TI - Novel heterophile chicken antigen: immunohistochemical localization using antisera to Mycobacterium smegmatis and possible association with lymphocyte maturation. AB - A novel heterophile antigen shared by Mycobacterium smegmatis and chicken tissues was demonstrated by the indirect immunoperoxidase method using antisera raised in rabbits immunized with a complete Freund's adjuvant containing killed Mycobacterium smegmatis as an immunostimulating component. This antigen was strongly expressed in medullary lymphocytes of the thymus and bursa of Fabricius, but was undetectable in lymphoid cells of the cortical regions of these organs. Only a few lymphocytes stained positively for the antigen in T- and B-cell areas of the spleen. These data suggest that the heterophile antigen is associated with the intrathymic and intrabursal maturation of chicken lymphocytes. The antigen was also detected in some nonlymphoid cells. It was not found in sheep erythrocytes, human and rat tissues or in killed bacillus Calmette--Guerin. PMID- 3519538 TI - Long-term culture of renin containing tissue. AB - Thin cortical tissue explants from kidneys of hydronephrotic mice were excised and incubated in different culture media containing growth and proliferation factors. Over a period of several months the content of renin in the explants and in the culture medium was repeatedly measured, to define the conditions necessary for the maintenance of renin production in a long-term culture. The best results were obtained when culturing the renal tissue in Dulbecco's medium (DMEM) with 10% fetal calf serum, 6 units/100 ml platelet-derived growth factor and 200 ng/ml glycylhistidyllysine. Renin was still present within the cells and in the culture medium after more than six months. Prevention of dedifferentiation, as evidenced in this case by the maintenance of renin production, seemed to be dependent on specific extracellular matrix proteins of renal origin. If the explants were dissociated from their matrix components by collagenase, a gradual loss of renin production was observed within 5 days. Complementation of the collagenase digested cell suspension with different nonrenal extracellular matrix materials did not afford the stabilizing effect of the original pericellular matrix. PMID- 3519539 TI - Ontogeny of calcitonin gene-related peptide and calcitonin in the rat thyroid. AB - In this immunohistochemical study, the ontogenic development of calcitonin-gene related peptide (CGRP) in the rat thyroid was investigated and compared with that of calcitonin using the indirect-immunofluorescence method. Parafollicular cells with immunoreactivity to both CGRP and calcitonin first appeared at an early stage of gestation (days 17 and 18) in the central portion of the thyroid. Cells immunoreactive to CGRP and calcitonin had became numerous by gestational day 22. After postnatal day 7, CGRP- and calcitonin-immunoreactive (C-IR) cells increased rapidly both in number and in the intensity of their fluorescence. In 14- to 90 day old rats, many intensely immunoreactive cells were distributed in the central portion of the thyroid. The cells immunoreactive to CGRP and to calcitonin had an almost identical ontogenic appearance. In 14-day-old and adult rats, C-IR cells also exhibited CGRP immunostaining, suggesting that these cells simultaneously produce and store CGRP during ontogeny. PMID- 3519541 TI - Heterogeneity in the myoglobin content of chicken heart Purkinje fibers. AB - The myoglobin content of chicken myocardial cells was studied using indirect immunoperoxidase histochemistry. While ordinary myocardial cells exhibited a homogeneous reaction pattern, the reactions for ventricular Purkinje fibers were remarkably heterogeneous. On the basis of the degree of staining, three types of cells, i.e., dark, intermediate, and clear, were distinguishable. In addition, the cytological heterogeneity of Purkinje cells was confirmed using conventional and immunological electron microscopy. The dark cells contained more myofibrils, mitochondria, and other organelles (e.g., ribosomes) than the clear cells. PMID- 3519540 TI - Heterogeneity of desmin, the muscle-type intermediate filament protein, in blood vessels and astrocytes. AB - Monoclonal antibodies were isolated from mice immunized with chicken gizzard desmin. Antibodies reacting with desmin on immunoblots and selectively decorating chicken and rat intestinal smooth muscle as well as the Z-line in striated muscle, were selected for this study. Based on their staining pattern on cryostat sections of chicken and rat cerebellum, spleen, kidney, aorta and femoral artery, monoclonal supernatants could be divided in three groups: (i) antibodies decorating astrocytes and vascular smooth muscle; (ii) antibodies decorating only vascular smooth muscle; (iii) antibodies decorating only astrocytes. Antibodies in group (i) and (iii) also stained GFA-negative Bergmann glia in chicken cerebellum. It is proposed that desmin may vary depending on the histological localization. PMID- 3519542 TI - Vitamin-D-dependent calcium-binding protein (CaBP-9K) in rat growth cartilage. AB - The presence of vitamin-D-dependent calcium-binding protein (CaBP-9K) in tibial growth-plate cartilage was immunohistochemically demonstrated using a specific antibody to rat duodenal CaBP-9K. The protein was found to be mainly localized in the cytoplasm of maturing chondrocytes. In hypertrophic chondrocytes, CaBP-9K concentrations decreased, and the protein was found in the cytoplasmic processes. No CaBP-specific immunoreactivity was seen in the hypertrophic chondrocytes of the lower calcified hypertrophic zone; in contrast, the protein was found in the extracellular lateral edges of longitudinal septa, i.e. where matrix vesicles are preferentially localized and where cartilage mineralization is initiated. These findings suggest that vitamin D has a direct function in this tissue. It also seems likely that CaBP-9K is an indicator of chondrocyte maturation, and that it is involved in the matrix vesicle-associated process of cartilage calcification. PMID- 3519543 TI - Adrenergic innervation of corticotropin releasing factor (CRF)-synthesizing neurons in the hypothalamic paraventricular nucleus of the rat. A combined light and electron microscopic immunocytochemical study. AB - Corticotropin releasing factor (CRF), a neuropeptide synthesized in the parvocellular subnuclei of the hypothalamic paraventricular nucleus (PVN), takes part in the regulation of different stress evoked responses of the organism. In order to elucidate the role of the central adrenergic system in the regulation of these CRF-synthesizing neurons, a novel ultrastructural immunocytochemical dual localization technique was utilized. Phenylethanolamine-N-methyltransferase (PNMT), a specific enzyme marker for the central adrenaline system, and CRF immunoreactive elements were simultaneously visualized in hypothalamic sections. PNMT-immunoreactive axon terminals established synaptic connections with somata, dendrites and spinous structures of CRF-producing neurons. This morphological finding indicates that the central adrenergic system directly influences CRF synthesizing neurons in the PVN and provides basis for a more definitive pharmacological manipulation of this system. PMID- 3519545 TI - Immunohistochemical analysis of human peripheral blood and lymphoid tissues using monoclonal antibodies immunoreactive with non-lymphoid cells. AB - Immunoperoxidase methods were used to study human peripheral blood and lymphoid tissues using a panel of monoclonal antibodies to non-lymphoid cells. The majority of peripheral blood monocytes were immunoreactive for LeuM1, LeuM2, LeuM3 and LeuM5. Rare peripheral blood monocytes were immunoreactive for R4/23. The different antibodies showed characteristic patterns of immunoreactivity in peripheral lymphoid tissues. LeuM1 was immunoreactive with scattered cells in the paracortex of lymph node and tonsil and with many cells in the marginal zone of the spleen. LeuM2 was immunoreactive with endothelial cells in lymph node and tonsil. A few cells in the red pulp of the spleen were immunoreactive for LeuM2. LeuM3 and R4/23 showed distinctive immunoreactivity in germinal centers of secondary follicles, giving a "lacy" pattern. LeuM3 was also immunoreactive with endothelium in lymph node and tonsil and with sinus lining cells in lymph node. LeuM5 was immunoreactive with macrophages in the germinal center, fibroblastic reticulum cells in the mantle zone and interdigitating reticulum cells in the paracortex of lymph node and tonsil. PMID- 3519546 TI - An immunofluorescent method for a specific demonstration of granulocytes and some of their proteins (ECP and CCP). AB - Using p-benzoquinone as a fixative the non-specific fluorescence of granulocytes and especially the eosinophils is removed for both FITC and TRITC. In this way we have been able to detect the eosinophil cationic protein (ECP) and the chymotrypsin-like cationic protein (CCP) in human lung tissue and by double immunofluorescent labelling shown that these two proteins very likely are related to eosinophils respectively the neutrophils. PMID- 3519544 TI - Increased sensitivity in peroxidase immunocytochemistry. A comparative study of a number of peroxidase visualization methods employing a model system. AB - A number of methods for demonstration of peroxidase activity have been tested on immunocytochemical nitrocellulose models. By applying a well-characterized primary antibody and Sternberger's peroxidase-antiperoxidase technique, the sensitivity of various protocols has been evaluated. Best results were obtained with diaminobenzidine as chromogen, especially in conjunction with heavy metal salts, either added directly to the medium or used as "toners" of the end product. Use of silver intensification of the diaminobenzidine/metal end-product increased sensitivity further. PMID- 3519547 TI - A post-embedding immunoelectron-microscopic demonstration of apolipoprotein-B containing lipoprotein particles in hepatocytes of fetal rats. AB - We used the protein-A gold technique to demonstrate the presence of apolipoprotein-B in ultrathin sections of fetal rat liver tissue. It was possible to show for the first time that the electron-dense, osmiophilic particles with diameters of 20-40 nm located within the RER cisternae and Golgi complexes of fetal rat hepatocytes contain apolipoprotein-B components and therefore are lipoproteins. After specific labelling an accumulation of gold label was observed on the RER cisternae, Golgi cisternae and the Golgi-associated secretory vesicles of hepatocytes. The specificity of this labelling pattern was assessed by comparison with cytochemical controls. Our qualitative findings were confirmed by a quantitative analysis of the mean labelling intensity (mean number of gold particles per square micron of the surface area of a particular cellular compartment) on the RER, Golgi complexes, mitochondria, nuclei and the remaining cytoplasm of hepatocytes. It is concluded that the hepatocytes of fetal rats are capable of forming apolipoprotein-B-containing lipoprotein particles. With respect to the size-distribution pattern of the observed intra-hepatic lipoprotein particles, we suggest that the hepatocytes of fetal rats produce lipoproteins of the low- and very low-density-lipoprotein type. PMID- 3519548 TI - Ontogenic and functional implications of the differential expression of HLA-DQ antigens on leukemic cells. AB - We have examined the HLA class II antigenic profiles on different types of leukemic cells and have attempted to relate these findings to the normal differentiation pathways of the cells from which they have arisen. Monoclonal antibodies reacting with the different HLA class II determinants, HLA-DR, DRw52(MT), and DQ, were used to study the expression of these antigens on Epstein Barr virus transformed cell lines, chronic lymphocytic leukemic cells, acute lymphoblastic leukemic blasts, acute myeloblastic leukemic blasts, and established leukemic cell lines by indirect immunofluorescence binding and immunoprecipitations. The results showed that whereas the HLA-DR and HLA DRw52(MT2) antigens are normally expressed on the majority of the cells tested, there is a different expression of the HLA-DQ antigens on acute leukemic blasts, chronic lymphocytic leukemic cells, and leukemic cell lines indicating that the DQ molecules may be differentiation antigens preferentially expressed on mature cells. Furthermore, when the pre-B cell leukemic line NALM 6 was induced to differentiate with phorbol ester (TPA), normal expression of the HLA-DQ antigen was obtained after 5 days of culture. The absence of HLA-DQ antigens from the acute leukemic blasts suggests that these immature cells "froze" in the early stages of cell differentiation. We discuss these findings in relation to the role of these HLA class II antigens in cell differentiation and the immune response. PMID- 3519549 TI - Local control and survival in early breast cancer: the Milan trial. AB - From 1973 to 1980, 701 patients with breast cancer measuring less than 2 cm in pathological diameter and with no palpable axillary lymph nodes were randomized to Halsted mastectomy (349) or to "quadrantectomy" with axillary dissection and radiotherapy to the ipsilateral breast tissue (QUART) (352). The two groups were comparable in age distribution, size and site of primary tumor; menopausal status; and frequency of axillary metastases. At 8 years, the disease-free survival was 77% for the Halsted patients and 80% for the "quadrantectomy" patients, while overall survival was 83% and 85%, respectively. Disease-free and overall survival curves show no difference between the two groups. Breast cancer of small size (less than 2 cm) may be safely treated with conservative treatment. Mutilating operations are not justified. PMID- 3519550 TI - Postoperative radiotherapy in breast cancer--long-term results from the Oslo study. AB - The long-term results of a randomized clinical trial evaluating the effect of postoperative radiotherapy as an adjuvant to radical mastectomy are presented. There were 1115 patients including 27 protocol deviants. The follow-up time is 11 20 years. In the first part a conventional roentgen unit was used, and in the second part a 60Co unit, with considerably increased dosage and altered treatment plan. Both types of radiation techniques lowered the incidence of loco-regional recurrences significantly, but had no significant influence on the overall survival. The relapse-free survival was significantly improved by 60Co radiation in Stage II patients, but was unaffected by radiation in the other subgroups. Regarding survival, Stage II patients with medially located tumors seemed to benefit more from 60Co radiation than those with lateral tumors. A significant increase in the number of deaths caused by myocardial infarction was observed in Stage I patients having 60Co radiation, indicating that the radiation dose to the heart is of significance. PMID- 3519551 TI - A prospective randomized trial comparing once-a-week vs daily radiation therapy for locally-advanced, non-metastatic, lung cancer: a preliminary report. AB - This is the first report of an on-going Phase III protocol for patients with locally-advanced, non-metastatic, measurable lung cancer. The study randomizes two arms: 6000 rad using 500 rad fractions once a week (1 X W) for 12 weeks with spinal cord (SC) protection at 3000 rad; and 6000 rad using 200 rad fractions daily (5 X W) for 6 weeks with SC protection at 4500 rad. Both arms use an initially large loco-regional field that is further reduced when tumor doses reach 3000 rad in (1 X W) arm and 5000 rad in (5 X W) arm. The protocol was activated April 1982; as of August 1984, it had accrued 100 patients of whom 68 were evaluable [29 (1 X W) and 39 (5 X W)]. There have been no major differences in tumor responses or failure patterns between the (1 X W) and (5 X W) arms; response rates have been 69 and 64%; CR 31 and 20%; total incidence of local failures 20 and 23%; and overall incidence of distant failures 34 and 43%, respectively. The (1 X W) arm has been far better tolerated with 76% of its patients free of any esophagitis and 97% without weight loss, as compared to only 33 and 67% in the (5 X W), respectively. The (1 X W) arm has not conveyed loss in tumor control effectiveness, in-treatment progression, or higher incidence of distant spread. Subacute and chronic complications have been minimal with either treatment. No fatal or life-threatening toxicities have occurred; the incidence of severe complications has been 7% in the (1 X W) arm and 8% in the (5 X W) arm. Nevertheless, the number of patients alive and at risk greater than or equal to 12 months is still relatively small; definitive statements regarding very late toxic reactions cannot yet be made. Compared to their protocyptes [a (1 X W) Pilot Study and the 6000 rad/6 weeks arm of RTOG Protocol 73-01], results in the present protocol arms have not been different from what was expected. Once a week RT yields results that appear no different from those achieved with conventional RT in lung cancer. PMID- 3519552 TI - The role of radiation therapy as an adjuvant in the treatment of breast cancer. PMID- 3519553 TI - Relationship of hepatic lipidosis to health and performance in dairy cattle. AB - In a field study of 80 cows in 9 dairy herds, serial liver biopsies were performed over the peripartum period to determine degree of hepatic lipidosis. Cattle were separated into categories of mild, moderate, and severe hepatic lipidosis on the basis of maximal amounts of hepatic triglyceride that accumulated during this period. Number of cattle with mild, moderate, and severe hepatic lipidosis were 52, 16, and 12, respectively. Cattle with severe hepatic lipidosis had greater concentrations of hepatic triglyceride before calving and after parturition, and greater serum nonesterified fatty acid concentrations and body condition loss after parturition than cattle with mild hepatic lipidosis. Rate of disease and culling and death rate because of disease were greater in cattle with severe hepatic lipidosis. Cattle with severe hepatic lipidosis had reproductive performance equal to clinically normal cattle; however, cattle with moderate hepatic lipidosis had increased days to conception, possibly related to greater milk production. PMID- 3519554 TI - Measuring social behavior: social dominance. AB - Social dominance develops more slowly when young animals are kept in intact peer groups where they need not compete for resources. Learned generalizations may cause smaller and weaker animals to accept subordinate status readily when confronted with strangers that would be formidable opponents. Sexual hormones and sensitivity to them can influence the onset of aggression and status attained. After dominance orders are established, they tend to be stable in female groups but are less so in male groups. Psychological influences can affect dominance relationships when strangers meet and social alliances within groups may affect relative status of individuals. Whether status associated with agonistic behavior is correlated with control of space and scarce resources needs to be determined for each species and each kind of resource. When such correlations exists, competitive tests and agonistic behavior associated with gaining access to scarce resources can be useful to the observer in learning about dominance relationships rapidly. Examples are given to illustrate how estimates of social dominance can be readily attained and some strengths and weaknesses of the various methods. PMID- 3519555 TI - Agonistic behavior in food animals: review of research and techniques. AB - One type of social behavior--agonistic behavior--is commonly observed among food animals. Agonistic behaviors are those behaviors which cause, threaten to cause or seek to reduce physical damage. Agonistic behavior is comprised of threats, aggression and submission. While any one of these divisions of agonistic behavior may be observed alone, they usually are found, in sequence, from the start to the end of an interaction. Food animals may show interspecific or intraspecific agonistic behaviors. Interspecific agonistic behavior has not been extensively studied but it is agriculturally important because farm workers may become injured or killed by aggressive food animals. Types of intraspecific agonistic behavior are: when animals are brought together, intermale fighting, resource defense, inter-gender fighting and aberrant aggression. Common pitfalls in research on agonistic behavior among food animals include too few replicates to detect a biological difference, the assumptions of the analysis are not met, only aggression and not submission or other agonistic behavior components are measured, incomplete description of the behaviors are reported and a complete, quantitive ethogram did not form the basis for selecting behavioral measures. PMID- 3519557 TI - Current concepts in periodontics. PMID- 3519556 TI - Variables in estimation of adipocyte size and number with a particle counter. AB - Porcine adipose tissue slices were fixed with osmium tetroxide and cells released by treatment with urea. Cell size and number were determined by an instrumental method using a particle counter. Storage of adipose tissue samples as frozen slices or in osmium, in post-osmium saline, in urea or in post-urea Triton all tended to produce less acceptable results than obtained with fresh tissue slices. Various storage conditions either tended to diminish cell size, to produce small particles or to cause aggregation. Repeatabilities of cell number, cell diameter and cell volume from multiple samples obtained from one anatomical location within an animal (perfect repeatability = 1) were .39, .52 and .65, respectively. Repeatabilities of instrument determinations were greater than .98 for cell number, cell diameter and cell volume. Cell number may be estimated from particle counts or indirectly from average size. Particle count number and that calculated from mean cell diameter were similar, whereas cell numbers estimated from mean cell volumes were smaller. Different adipose tissue depots and backfat layers had divergent cell size, making extrapolation to whole-animal cell number complex. PMID- 3519559 TI - Semi-log model for interpreting the results of swabbing surfaces naturally contaminated. AB - Two mathematical models for depicting microbial depletions during six consecutive swabbings of refrigerated tank wall and teat skin were tested. Although a second degree polynomial equation gave a better adjustment of the data, a first degree equation was preferred to calculate the total numbers of micro-organisms possibly retrieved from surfaces by swabbing. This model was used for estimating the level of milk contamination by teat skin. PMID- 3519558 TI - Effect of chlorine dioxide on selected membrane functions of Escherichia coli. AB - The mode of action of chlorine dioxide on Escherichia coli was assessed by studying outer membrane permeability to macromolecules and potassium, and observing effects on respiration. The results indicate that gross cellular damage involving significant leakage of intracellular macromolecules does not occur. There was a substantial efflux of potassium, however, and respiration was inhibited even at sublethal doses. It was concluded that the inhibition of respiration, which could be due to the damage to the cell envelope, was not the primary lethal event. Observations of the efflux of K+ strongly implicate the loss of permeability control as the primary lethal event at the physiological level, with nonspecific oxidative damage to the outer membrane leading to the destruction of the trans-membrane ionic gradient. PMID- 3519560 TI - Mechanisms of synergistic interactions between amphotericin B and flucytosine. PMID- 3519561 TI - Disc diffusion test for the determination of semi-quantitative substrate profiles of beta-lactamases. AB - The incorporation of beta-lactamases from crude, cell-free lysates incorporated into agar plates used for antibiotic sensitivity testing with sensitivity discs results in a characteristic decrease in the inhibition zones. The degree of zone reduction for a particular antibiotic depends on the substrate specificity of the enzyme involved and the concentration of the enzyme in the agar. By using this technique a distinction can be made between cephalosporinases, penicillinases and broad-spectrum enzymes. In a number of cases, the identification of the enzyme subclass is possible, provided that the relevant penicillin and cephalosporin discs are included in the test. For the elucidation of substrate profiles for routine and epidemiological purposes this method can replace other, more elaborate techniques, such as the iodometric, spectrophotometric and acidimetric methods. An analysis by this method is presented for 126, unrelated, consecutive clinical isolates. PMID- 3519562 TI - The neutralization of antibiotic action by metallic cations and iron chelators. AB - The neutralization of the action of a variety of antibiotics on klebsiellae by moderate doses of di- and tri-valent metallic cations, was measured in vitro. Some beta-lactams tested were affected by Mg++ and by Cu++. Of six tetracyclines one was moderately neutralized by Ca++, two by Mg++, three by Cu++, and all, strongly, by Fe+++. Erythromycin was affected by Ca++, lincomycin by Ca++, Mg++ and Cu++. Aminoglycosides were affected by Ca++ and Mg++ and strongly by Fe+++. Five antibiotics (three beta-lactams and two macrolides) with high MICs for klebsiellae were tested against staphylococci: most of the reversing agents were ineffective. The microbial iron chelators, desferrioxamine and enterochelin were largely inactive, affecting only two aminoglycosides. PMID- 3519563 TI - Is there a role for monotherapy with beta-lactam antibiotics in the initial empirical management of febrile neutropenic cancer patients? AB - In empirical antimicrobial chemotherapy for febrile neutropenic cancer patients, drug combinations are commonly used, and aminoglycosides are usually included for their excellent activity on Gram-negative organisms and for potential synergism. However, new beta-lactams have at least as good a spectrum and in many ways better pharmacology. More Gram-positive infections are now being reported and the sensitivity of the causative organisms varies. This provides reasons for examining alternatives to aminoglycosides, and the use of monotherapy. Clinical results suggest that the emergence of resistance may be a problem with ureidopenicillins used alone, and that double beta-lactams may be as good as but not better than standard regimens. New cephalosporins have been used alone in 14 trials (not all of them well designed) with results as good as those of standard regimens in many, although superinfection with resistant organisms has been a problem in some. It is possible that early supplementation, with aminoglycosides, of empirical monotherapy with such agents as ceftazidime may solve some of the problems posed by resistant organisms. PMID- 3519564 TI - Efficacy and safety of pefloxacin in the treatment of patients with complicated urinary tract infections. AB - One hundred and four patients with complicated urinary tract infections (prolonged severe chronic infections or with complicated postoperative conditions) were treated for ten days with pefloxacin 400 mg bid. Bacteriological eradication of the initial pathogen was achieved in 98% of the patients. After six weeks 93% of the patients were still free of the initial infecting microorganism. Clinical improvement was achieved in 77% of the patients five to seven days after cessation of treatment. The side-effects which were definitely related to pefloxacin occurred in 9% of patients and were mostly of a gastro intestinal, a neurological, or an allergic nature. No significant biochemical or haematological adverse reactions occurred. PMID- 3519565 TI - Effect of inspiratory resistance and PEEP on 99mTc-DTPA clearance. AB - Experiments were performed to determine the effect of markedly negative pleural pressure (Ppl) or positive end-expiratory pressure (PEEP) on the pulmonary clearance (k) of technetium-99m-labeled diethylenetriaminepentaacetic acid (99mTc DTPA). A submicronic aerosol containing 99mTc-DTPA was insufflated into the lungs of anesthetized intubated sheep. In six experiments k was 0.44 +/- 0.46% (SD)/min during the initial 30 min and was unchanged during the subsequent 30-min interval [k = 0.21 +/- 12%/min] when there was markedly increased inspiratory resistance. A 3-mm-diam orifice in the inspiratory tubing created the resistance. It resulted on average in a 13-cmH2O decrease in inspiratory Ppl. In eight additional experiments sheep were exposed to 2, 10, and 15 cmH2O PEEP (20 min at each level). During 2 cmH2O PEEP k = 0.47 +/- 0.15%/min, and clearance increased slightly at 10 cmH2O PEEP [0.76 +/- 0.28%/min, P less than 0.01]. When PEEP was increased to 15 cmH2O a marked increase in clearance occurred [k = 1.95 +/- 1.08%/min, P less than 0.001]. The experiments demonstrate that markedly negative inspiratory pressures do not accelerate the clearance of 99mTc-DTPA from normal lungs. The effect of PEEP on k is nonlinear, with large effects being seen only with very large increases in PEEP. PMID- 3519566 TI - Effect of raised thoracic pressure and volume on 99mTc-DTPA clearance in humans. AB - Although positive airway pressure is often used to treat acute pulmonary edema, the effects on epithelial solute flux are not well known. We measured independently the effect of 1) positive pressure and 2) voluntary hyperinflation on the clearance of inhaled technetium-99m-labeled diethylenetriaminepentaacetic acid (99mTc-DTPA) in six nonsmokers and six smokers. Lung volumes were monitored by inductance plethysmography. Each subject was studied in four situations: 1) low end-expiratory volume (LO-), 2) low volume plus 9 cmH2O continuous positive airway pressure (LO+), 3) high end-expiratory volume (HI-), and 4) high volume plus continuous positive airway pressure (HI+). The clearance half time of 99mTc DTPA for the nonsmokers decreased from 64.8 +/- 7.0 min (mean +/- SE) at LO- to 23.2 +/- 5.3 min at HI- (P less than 0.05). Positive pressure had no synergistic effect. The mean clearance half time for the smokers was faster than nonsmokers at base line but unaffected by similar changes in thoracic volume and pressure. We conclude that, in nonsmokers, positive airway pressure increases 99mTc-DTPA clearance primarily through an increase in lung volume and that smokers are immune to these effects. PMID- 3519567 TI - Factors affecting perfusion distribution in canine oleic acid pulmonary edema. AB - Factors affecting perfusion distribution in oleic acid pulmonary edema were examined in 28 anesthetized open-chest dogs. Sixteen had unilobar oleic acid edema produced by left lower lobe pulmonary artery infusion of 0.03 ml/kg of oleic acid, and 12 had the same amount of edema produced by left lower lobe endobronchial instillation of hypotonic plasma. Lobar perfusion (determined from flow probes) and lobar shunt (determined from mixed venous and lobar venous blood) were measured at base line, 1.5 h after edema, and 10 min after 10 cmH2O positive end-expiratory pressure (PEEP). Fourteen dogs (8 oleic acid, 6 plasma) received sodium nitroprusside (11.72 +/- 7.10 micrograms X kg-1 X min-1). Total and lobar shunts increased to the same extent in all animals. Lobar perfusion decreased by 49.8 +/- 4.8% without nitroprusside and 34.0 +/- 3.6% with nitroprusside in the oleic acid group, corresponding values being 40.3 +/- 0.8% and 26.4 +/- 1.7% in the hypotonic plasma group. PEEP returned perfusion and shunt to base line. In oleic acid edema, most of the decreased perfusion results from mechanical effects of the edema, a smaller fraction results from other vascular effects of the oleic acid, and approximately 30% is reversible by nitroprusside. PEEP normalizes the perfusion distribution. PMID- 3519568 TI - Pulmonary blood flow affects recovery from constriction in dog lung periphery. AB - The influence of blood flow through the pulmonary circulation on the time course of recovery of the lung periphery from challenge with three bronchoconstrictive agents was studied in dogs. The rate of perfusion of the left lower lobe was varied between 0 and 300 ml/min. A fiber-optic bronchoscope (OD = 5.5 mm) was wedged in a small airway in the same lobe, and resistance to airflow through the collateral system was continuously monitored. The lung was challenged with histamine aerosol for 1 min, or with intravenous boluses of histamine, acetylcholine, or methacholine. The time constant (tau) of recovery from each of the challenges was measured under the various pulmonary blood flow conditions. The mean tau of the recoveries from histamine was inversely related to the rate of blood flow. However, pulmonary blood flow had no effect on recovery from challenge with acetylcholine or methacholine, two agents metabolized by cholinesterase in lung tissue. From this study we conclude that recovery of the lung periphery from histamine is perfusion dependent, whereas recovery from acetylcholine or methacholine is perfusion independent. This suggests that the rate of blood flow through the pulmonary circulation could play an important role in recovery of the peripheral airways from certain mediators of bronchoconstriction. PMID- 3519569 TI - Hemodynamics of miniature swine during +Gz stress with and without anti-G support. AB - Nine unanesthetized, chronically instrumented, female miniature swine (MS) (avg wt, 39.7 kg) were exposed to head-to-tail inertial load (+Gz) levels of +3, +5, and +7 Gz for 60 s, with and without anti-G-suit inflation. Venous flow (VF) was measured by an electromagnetic flow sensor around the inferior thoracic vena cava at the diaphragm. Central venous pressure (CVP), abdominal venous pressure (AVP), eye-level blood pressure (ELBP), and esophageal pressure (EP) were also measured before, during, and after +Gz. There was a progressive significant decrease from control of both ELBP (P less than 0.001) and VF (P less than 0.05) during the three +Gz exposures, both with and without G-suit inflation. Without G-suit inflation, most of the MS were unable to tolerate +5 and +7 Gz. Although VF was significantly (P less than 0.02) improved by G-suit inflation during +Gz there was no significant difference in VF between the three +Gz levels, with or without G-suit inflation. The MS does a spontaneous straining maneuver (cyclic Valsalva) during +Gz with G-suit support. Using EP as a trigger, the data were grouped as strain or no strain (relaxation). A continuous AVP-to-CVP gradient existed during G-suit inflation, which increased dramatically during no strain with increasing +Gz, and was associated with an increase in VF. Thus, the majority of VF occurred during relaxation between strains, even though relaxation time was shortened as +Gz increased. Although ELBP is obviously dependent on cardiac output and venous return, the progressive reduction in ELBP with increased +Gz loads was not significantly related to changes in VF at the diaphragm which was maintained, although at a reduced rate, by the AVP-to-CVP gradient during G-suit inflation. PMID- 3519570 TI - In vivo estimation of tracheal wall water: effects of histamine and carbachol. AB - Based on double-indicator-dilution principles we developed and validated a new method of measuring water content in the tracheal wall by inscribing time concentration curves with the inert gas, helium and the water-soluble gas, dimethylether. In the trachea of conscious adult sheep the measurable water volume of the wall over a 15-cm length ranged between 0.50 and 0.70 ml. The tracheal radius calculated from helium volume and known tracheal length ranged between 7.4 and 9.3 mm. The corresponding measurable "water depth" ranged between 63 and 82 microns. Changes in bronchial blood flow had no consistent influence on tracheal water volume. The intravenous injection of histamine (4 micrograms/kg) increased mean water depth to between 122 and 134% of base line (P less than 0.001), whereas the intravenous injection of carbachol (4 micrograms/kg) had no effect on water depth. The production of large amounts of airway secretions produced by carbachol were removed prior to inscription of the indicator-dilution curves. These findings indicate that the double-gas-indicator technique is capable of measuring in vivo the volume of a water compartment in the tracheal wall and that this volume is increased by histamine. This method may be applicable in human subjects. PMID- 3519571 TI - Falciparum malaria--210 cases. PMID- 3519572 TI - Diagnostic evaluation of lumbo-sacral lipomas by CT and radiculosaccography. Report of 2 cases and review of the literature. PMID- 3519573 TI - Sequence of the flaA (cheC) locus of Escherichia coli and discovery of a new gene. AB - The flaA (cheC) locus from Escherichia coli is important in controlling the rotational direction of flagella during chemotaxis. The locus was sequenced, and a site of transcriptional initiation was determined. Two reading frames, flaAI and flaAII, span the locus. flaAII corresponds to certain flaA and cheC mutations, and has some unusual features in the predicted secondary structure. flaAI, however, has not been identified previously, but a flaAI deletion, which produced a truncated FlaAI peptide in minicells, clearly identified the FlaAI protein. PMID- 3519575 TI - Extracellular pullulanase of Klebsiella pneumoniae is a lipoprotein. AB - Pullulanase is a starch-debranching enzyme produced by the gram-negative bacterium Klebsiella pneumoniae. In this organism, the enzyme is first exported to the outer membrane and is subsequently released into the growth medium. Evidence reported here indicates that pullulanase is a lipoprotein. It is apparently synthesized as a precursor with a 19-residue-long signal sequence and modified by the covalent attachment of palmitate to the cysteine residue which becomes the amino terminus after cleavage of the signal sequence. In this respect, pullulanase is similar to some penicillinases produced by gram-positive bacteria which are initially exported to the cell surface and subsequently released into the medium. However, pullulanase and the penicillinases differ in one important aspect, namely, that the extracellular pullulanase still carries the covalently attached fatty acyls, whereas extracellular penicillinases lack the modified amino-terminal cysteine together with a limited number of other residues from the amino terminus. PMID- 3519574 TI - Identification, immunochemical characterization, and purification of a major lipoprotein antigen associated with the inner (cytoplasmic) membrane of Escherichia coli. AB - A major antigenic constituent of the inner membrane of Escherichia coli ML308-225 was identified as a 28.5-kilodalton lipoprotein containing covalently bound glycerol and palmitate. This lipoprotein corresponded to antigen 47 in the crossed immunoelectrophoresis profile of membrane vesicles (P. Owen and H.R. Kaback, Proc. Natl. Acad. Sci. USA 75:3148-3152, 1978) and to new lipoprotein 4 described for E. coli B by Ichihara et al. (S. Ichihara, H. Hussain, and S. Mizushima, J. Biol. Chem. 256:3125-3129, 1980). Experiments involving isopycnic centrifugation of spheroplast envelopes indicated that antigen 47 was enriched in cytoplasmic membrane subfractions of low density. The protein did not manifest an obvious association with peptidoglycan of the types displayed by the bound form of the Braun (Lpp) lipoprotein, the 21-kilodalton peptidoglycan-associated lipoprotein, or the ompF/C gene products. Antibodies specific for antigen 47 were used to demonstrate that the molecule was immunologically distinct from both the Braun lipoprotein and the peptidoglycan-associated lipoprotein of E. coli. Antigens of similar molecular mass to and cross-reacting with antigen 47 were present in the envelopes of eight type species of the Enterobacteriaceae. A protocol for the purification of antigen 47, based upon its solubility in a chloroform-methanol-water mixture, was developed. PMID- 3519576 TI - High A + T content conserved in DNA sequences upstream of leuABCD in Escherichia coli and Salmonella typhimurium. AB - The nucleotide sequence of over 800 base pairs of DNA upstream of leuP was determined for Escherichia coli and Salmonella typhimurium. In both of these enteric bacteria, approximately 500 base pairs of A + T-rich sequences separates leuP from an upstream open reading frame. Although these A + T-rich sequences share little homology, the distribution of A + T base pairs within the region is strikingly conserved. Deletion of the A + T-rich sequences upstream of the E. coli leu operon does not markedly affect the strength of the leu promoter in vivo. PMID- 3519577 TI - Isolation of Saccharomyces cerevisiae mutants constitutive for invertase synthesis. AB - A new method for detecting invertase activity in Saccharomyces cerevisiae colonies was used to screen for mutants resistant to catabolite repression of invertase. Mutations causing the highest level of derepression were located in two previously identified genes, cyc8 and tup1. Several of the cyc8 mutations, notably cyc8-10 and cyc8-11, were temperature dependent, repressed at 23 degrees C, and derepressed at 37 degrees C. The kinetics of derepression of invertase mRNA in cyc8-10 cells shifted from 23 to 37 degrees C was determined by Northern blots. Invertase mRNA was detectable at 5 min after the shift, with kinetics of accumulation very similar to that of wild-type cells shifted from high-glucose to low-glucose medium. Assays of representative enzymes showed that many but not all glucose-repressible enzymes are derepressed in both cyc8 and tup1 mutants. cyc8 and tup1 appear to be the major negative regulatory genes controlling catabolite repression in yeasts. PMID- 3519578 TI - Peptidoglycan association of bacteriophage T5 receptor in Escherichia coli K-12. AB - A total of 50% of the FhuA proteins (also called TonA proteins) present in Escherichia coli cells were associated with the peptidoglycan and 50% were free, whether or not this protein was overproduced. This FhuA-peptidoglycan association was made via the lipoprotein. PMID- 3519579 TI - New role for photoreversible pyrimidine dimers in induction of prototrophic mutations in excision-deficient Escherichia coli by UV light. AB - UV mutagenesis to His+ in certain recA441 lexA51 bacteria was not photoreversible, indicating that pyrimidine dimers are not target lesions. Photoreversibility was observed in recA+ lexA51 bacteria, showing that pyrimidine dimers are needed to activate the recA+ protein (unlike the recA441 protein) to perform a function in UV mutagenesis distinct from cleavage of the lexA repressor. PMID- 3519580 TI - Aerobic purification of hydrogenase from Rhizobium japonicum by affinity chromatography. AB - We purified active hydrogenase from free-living Rhizobium japonicum by affinity chromatography. The uptake hydrogenase of R. japonicum has been treated previously as an oxygen-sensitive protein. In this purification, however, reducing agents were not added nor was there any attempt to exclude oxygen. In fact, the addition of sodium dithionite to aerobically purified protein resulted in the rapid loss of activity. Purified hydrogenase was more stable when stored under O2 than when stored under Ar. Sodium-chloride-washed hydrogen-oxidizing membranes were solubilized in Triton X-100 and deoxycholate and loaded onto a reactive red 120-agarose column. Purified hydrogenase elutes at 0.36 M NaCl, contains a nickel, and has a pH optimum of 6.0. There was 452-fold purification resulting in a specific activity of 76.9 mumol of H2 oxidized per min per mg of protein and a yield of 17%. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis revealed subunits with estimated molecular weights of 65,000 and 33,000. Hydrogenase prepared in this manner was used to raise and affinity purify antibodies against both subunits. PMID- 3519581 TI - Probable insensitivity of mollicutes to rifampin and characterization of spiroplasmal DNA-dependent RNA polymerase. AB - The effect of rifampin on five mollicutes (Spiroplasma citri, Spiroplasma melliferum, Spiroplasma apis, Acholeplasma laidlawii, and Mycoplasma mycoides) was compared with that on Escherichia coli. We found that, in contrast to wild type E. coli, mollicutes were insensitive to rifampin. DNA-dependent RNA polymerases from S. melliferum and S. apis were purified to the stage where the enzymes were dependent on the addition of exogenous templates for activity. The enzymes were then tested for their sensitivity to rifampin. Spiroplasmal enzymes were at least 1,000 times less sensitive to rifampin than the corresponding E. coli enzyme. This result provides a molecular basis for the resistance of mollicutes to rifampin. The RNA polymerase of S. melliferum was further purified and its subunit composition was investigated. The RNA polymerase has one small and two large subunits. The structure of S. melliferum RNA polymerase therefore resembles that of the eubacterial enzymes in spite of its insensitivity to rifampin. PMID- 3519582 TI - Consequences of reduced intracellular coenzyme A content in Escherichia coli. AB - Escherichia coli beta-alanine auxotrophs (panD2) were used to manipulate the specific cellular content of coenzyme A (CoA) and assess the associated physiological effects. Growth-limiting concentrations of CoA resulted in an increase in phospholipid/protein ratio in relA1 mutants, but not in their rel+ counterparts, indicating that protein biosynthesis was more severely affected by CoA deprivation than phospholipid biosynthesis. Acetyl-CoA was the dominant component (79.8%) of the CoA pool in cells exponentially growing in glucose minimal medium, with significant concentrations of CoA (13.8%) and succinyl-CoA (5.9%) also detected. Malonyl-CoA was a minor species (0.5%), and the mixed disulfide of CoA and glutathione was not present. Acetyl-CoA was also the major constituent in cells depleted of CoA. On the other hand, succinyl-CoA was absent, suggesting that the protein synthesis defect may be due to the inability to generate sufficient quantities of precursors via the tricarboxylic acid cycle to support amino acid biosynthesis. Production of acyl carrier protein was controlled in part by the availability of CoA, and the lower concentration of acyl carrier protein in CoA-depleted cells was associated with a concomitant decrease in the saturated/unsaturated fatty acid ratio. PMID- 3519583 TI - Characterization of Escherichia coli mutants completely defective in synthesis of cyclopropane fatty acids. AB - The synthesis of cyclopropane fatty acids (CFA) in bacteria represents a biochemically and physiologically unique membrane modification whose importance for the cell remains unknown, despite extensive study of a Cfa- mutant of Escherichia coli and of the cloned cfa gene. Recently we reported the isolation of new Cfa- mutants (D. W. Grogan and J. E. Cronan, Jr., Mol. Gen. Genet. 196:367 372, 1984). Molecular-genetic and biochemical analysis indicated that these were null mutants of the E. coli cfa locus which were formed by inversions of a chromosomal segment. Isogenic Cfa+ and Cfa- strains were constructed from one such mutant and subjected to various stress conditions. In nearly all cases, both strains responded equally, but certain treatments, such as repeated freezing and thawing, favored the survival of Cfa+ strains over Cfa- strains. Though not essential, CFA thus appeared to play some beneficial role (or roles) in the bacterial cell. PMID- 3519584 TI - Suppression of growth and protein secretion defects in Escherichia coli secA mutants by decreasing protein synthesis. AB - We devised a new selection for conditionally lethal suppressors of secA mutants. This selection allows the isolation of both temperature-sensitive and cold sensitive suppressor mutations, whereas previous studies were limited to nonlethal or cold-sensitive suppressor mutations. Two temperature-sensitive suppressor mutations lie in genes required for protein synthesis: asnS, the gene for the asparaginyl-tRNA synthetase, and divE, which encodes the tRNASer1. A previously characterized mutation in alaS, the gene for the alanyl-tRNA synthetase, suppresses the growth and secretion defects of a secA mutant. Although the primary effects of these suppressor mutations are different, it is likely that they cause suppression of secA mutations by altering the rate of protein synthesis, since the protein synthesis inhibitors, chloramphenicol and tetracycline, also suppress secA mutations. Chloramphenicol also suppresses the growth defect of certain other sec mutants. We postulate that the impaired secretory capacity of sec mutants can be offset by decreasing the rate of elongation of secreted proteins or by decreasing the total amount of secreted proteins per cell. The results indicate that our initial goal to identify cellular secretory components as suppressors of secA mutations might be difficult to achieve because of a high frequency of nonspecific suppressors that alter protein synthesis. Unexpectedly, the suppressor approach provides a direct genetic selection for mutants in protein synthesis. PMID- 3519586 TI - Genetic complementation in Cryptococcus neoformans. AB - A complementation test was devised for the fungus Cryptococcus neoformans. Complementation was signalled by the growth of prototrophic heterokaryons generated in crosses of the type aB X Ab, where a and b represent any two of the genetic markers ilv1, cys1, cys2, and cys3. The cloned complementing heterokaryons formed characteristic hyphal colonies that contained both hyphae and yeast cells. The heterokaryon-derived yeasts were of three kinds: parental haploids, recombinant haploids, and diploids. PMID- 3519585 TI - Selection by genetic transformation of a Saccharomyces cerevisiae mutant defective for the nuclear uracil-DNA-glycosylase. AB - A coliphage M13 chimer containing the Saccharomyces cerevisiae TRP1 gene and ARS1 replication origin (mPY2) was grown on an ung- dut- strain of Escherichia coli. The resulting single-stranded phage DNA had 13% of thymine residues substituted by uracil. This DNA failed to transform a delta trp1 yeast strain to prototrophy. However, when a mutagenized yeast stock was transformed with uracil-containing single-stranded mPY2 DNA, unstable transformants were obtained. After plasmid segregation, about half of these were retransformed at a high frequency by uracil containing single-stranded mPY2 DNA. In vitro, these mutants were defective for uracil-DNA-glycosylase activity. They were designated ung1. Strains containing the ung1 mutation have an increased sensitivity to sodium bisulfite and sodium nitrite but a wild-type sensitivity to methyl methanesulfonate, UV light, and drugs that cause depletion of the thymidylate pool. They have a moderate mutator phenotype for nuclear but not for mitochondrial genes. A low mitochondrial uracil DNA-glycosylase activity was demonstrated in the mutant strains. PMID- 3519587 TI - Regions in Bacteroides plasmids pBFTM10 and pB8-51 that allow Escherichia coli Bacteroides shuttle vectors to be mobilized by IncP plasmids and by a conjugative Bacteroides tetracycline resistance element. AB - Bacteroides-Escherichia coli shuttle vectors containing a nonmobilizable pBR322 derivative and either pBFTM10 (pDP1, pCG30) or pB8-51 (pEG920) were mobilized by IncP plasmid R751 or pRK231 (an ampicillin-sensitive derivative of RK2) between E. coli strains and from E. coli to Bacteroides recipients. IncI alpha R64 drd-ll transferred these vectors 1,000 times less efficiently than did the IncP plasmids. pDP1, pCG30, and pEG920 could be mobilized from B. uniformis donors to both E. coli and Bacteroides recipients by a conjugative Bacteroides Tcr (Tcr ERL) element which was originally found in a clinical Bacteroides fragilis strain (B. fragilis ERL). However, the shuttle vector pE5-2, which contains pB8-51 cloned in a restriction site that prevents its mobilization by IncP or IncI alpha plasmids, also was not mobilized at detectable frequencies from Bacteroides donors by the Tcr ERL element. The mobilization frequencies of pCG30, pDP1, and pEG920 by the Tcr ERL element in B. uniformis donors to E. coli recipients was about the same as those to isogenic B. uniformis recipients. Transfer of the shuttle vectors from B. uniformis donors to E. coli occurred at the same frequencies when the matings were done aerobically or anaerobically. Growth of the B. uniformis donors in tetracycline (1 microgram/ml) prior to conjugation increased the mobilization frequencies of the vectors to both E. coli and Bacteroides recipients 50 to 100 times. PMID- 3519588 TI - The epidemiology of anxiety and panic disorders: an update. AB - Epidemiologic data on the prevalence rates for various DSM-III categories of anxiety disorders, including panic disorder, agoraphobia, and generalized anxiety disorder, are now available from several community studies of adults. High degrees of co-morbidity have been found, especially among the anxiety disorders and between anxiety and affective disorders. Risk factors for anxiety disorders include young age, female gender, and familial history. The results of twin studies suggest that genetic factors are involved in the etiology of the anxiety disorders, particularly for panic disorder and agoraphobia. Implications for case finding and family psychiatry are discussed. PMID- 3519589 TI - Pathophysiology of panic: a review of pharmacologic provocative tests and naturalistic monitoring data. AB - Panic is a psychologic symptom with prominent physiologic manifestations. Pathophysiologic theories need to explain both the central emotional state and peripheral symptoms. This paper reviews current findings and hypotheses from studies using two strategies for understanding panic. First, recent results from provocative tests using sodium lactate, caffeine, CO2, yohimbine, and isoproterenol suggest panic patients have a special sensitivity to these substances. Underlying mechanisms may be related to abnormal functioning of the central noradrenergic (locus ceruleus) system. However, cognitive and behavioral aspects of pharmacologic provocative testing need further study. Second, naturalistic studies support findings of peripheral physiologic activation during panic, but do not show evidence for sustained hyperactivity throughout the day. Studies of phobic patients demonstrate the potential for imagined fear to provoke physiologic changes, again underlining the need to pay attention to psychologic aspects of panic. PMID- 3519590 TI - Diagnostic considerations in panic disorders. AB - Approaches to the classification and treatment of anxiety have been lacking because of the unclear borders between pathologic and normal anxiety and the heterogeneity of patients called "anxious." The differentiation of panic from other anxiety states is a recent development in psychiatric nosology. The diagnosis of panic disorder and agoraphobia and their demarcation from other psychiatric and medical disorders are reviewed. Proposals to revise DSM-III criteria to provide concordance with current etiologic theories are discussed, and an overall treatment strategy that takes into account the multiple manifestations of the illness is outlined. PMID- 3519591 TI - Purification and characterization of two components of acid alpha-glucosidase from pig liver. AB - Acid alpha-glucosidase [EC 3.2.1.3] was purified from pig liver by a procedure including Sephadex G-100 affinity chromatography. Electrophoresis on SDS polyacrylamide gel of the purified enzyme indicated the presence of two components with molecular weights of 73K and 64K. The two components of the enzyme were completely separated, in reasonable yield, by chromatography on a DEAE-5PW column. Both components catalyzed the hydrolysis of the alpha-1,4 and alpha-1,6 linkages of glycogen, maltose, isomaltose, dextrin, and a synthetic glucoside at acid pH. The pH optima of both components were 4.3 for maltase and glucoamylase, and 4.8 for isomaltase and dextrinase. But as to the activity on 4MU-alpha-Glc, the pH optimum of the larger component was 4.8 and that of the smaller component 5.3. The Km values of both components for 4MU-alpha-Glc, maltose, glycogen, isomaltose, and dextrin were 1.0 X 10(-4) M, 9.1 X 10(-3) M, 16.7 mg/ml, 6.7 X 10(-2) M, and 12.5 mg/ml, respectively. Erythritol, Tris, and turanose inhibited the two components competitively. The Ki values of the larger component were 5.0 X 10(-2) M, 13.3 X 10(-3) M, and 3.2 X 10(-3) M, and those of the smaller component were 2.5 X 10(-2) M, 6.1 X 10(-3) M, and 4.7 X 10(-3) M, for erythritol, Tris, and turanose, respectively. PMID- 3519593 TI - Actin concentration and monomer-polymer ratio in developing chicken skeletal muscle. AB - The actin concentration and monomer-polymer ratio in developing chicken skeletal muscle were determined by means of a DNase I inhibition assay. The concentration of G-actin in embryonic muscle was much higher than the critical concentration for polymerization of purified actin. As muscle development progressed, the amount of total actin remarkably increased, whereas the concentration of G-actin markedly decreased, and finally in adults reached the critical concentration for polymerization of purified actin. When the monomeric actin in the soluble fraction of embryonic muscle was purified, the critical concentration for polymerization of the embryonic actin decreased to the same value as that of adult skeletal muscle actin. On the other hand, there was no difference between the crude and purified actin in the type of actin. They consisted of alpha-, beta , and gamma-actins; their amounts were in the order, beta greater than gamma greater than alpha. Furthermore, polymerization of the monomeric actin in the soluble fraction of embryonic muscle was induced by the addition of myosin or HMM. The large amount of monomeric actin in the embryonic skeletal muscle may be due to the presence of some factor(s) which inhibits actin polymerization and also to an insufficiency of myosin. PMID- 3519592 TI - Monooxygenase activity of Saccharomyces cerevisiae cells transformed with expression plasmids carrying rat cytochrome P-450MC cDNA. AB - The recombinant plasmids pAMC1 and pJMC1 were constructed; the former contained the cytochrome P-450MC (P-450MC) cDNA expression unit consisting of yeast alcohol dehydrogenase I (ADH) promoter, rat P-450MC cDNA and ADH terminator, and the Leu 2 marker gene, and the latter contained the same expression unit and the leu 2-d gene. Saccharomyces cerevisiae AH22 cells transformed with each of the recombinant plasmids were examined for plasmid copy number, P-450MC mRNA level, P 450MC content, and monooxygenase activity. The S. cerevisiae AH22/pJMC1 cells contained about 2-fold higher levels of the plasmid, P-450MC mRNA, and P-450MC than the AH22/pAMC1 cells. Monooxygenase activity towards 7-ethoxycoumarin and acetanilide of the AH22/pJMC1 cells was 1.7-fold and 1.5-fold higher than that of the AH22/pAMC1 cells, respectively, whereas the activity of the AH22/pAMC1 cells towards 7-ethoxycoumarin and acetanilide was more than 1,000-fold 10-fold higher than that of the control AH22/pAAH5 cells which contain no P-450MC cDNA, respectively. Therefore, it is likely that monooxygenase activity of the AH22 cells carrying rat P-450MC cDNA was approximately proportional to the expression level of P-450MC cDNA. PMID- 3519594 TI - Purification and properties of intracellular clotting factor, factor B, from horseshoe crab (Tachypleus tridentatus) hemocytes. AB - An intracellular clotting factor, factor B, which is closely associated with the hemolymph coagulation system of horseshoe crab (Tachypleus tridentatus), was purified and characterized. The purified preparation gave a single band (Mr = 64,000) on sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) in the absence of 2-mercaptoethanol, while three bands (Mr = 64,000, 40,000, and 25,000) were detected on SDS-PAGE after reduction. This preparation was converted by limulus clotting factor C to an activated form, factor B, with Mr = 56,000 consisting of a heavy chain (Mr = 32,000) and a light chain (Mr = 25,000) bridged by disulfide linkage(s). The factor B, which was produced separately by treating the partially purified factor B with factor C, was also purified. It gave a single band on unreduced SDS-PAGE and two bands on reduced SDS-PAGE. The purified factor B had Mr of 56,000 consisting of a heavy chain (Mr = 32,000) and a light chain (Mr = 25,000). These results indicated that the purified factor B zymogen is a mixture of single-chain and two-chain forms, both of which have the same molecular weight of 64,000, and that these two forms are converted to factor B by factor C. The diisopropyl phosphorofluoridate-sensitive site of factor B was found in the heavy chain. The reconstitution studies using purified factor C, factor B, proclotting enzyme and coagulogen in the presence of lipopolysaccharide indicated that factor B is an essential component to complete sequential activation of the limulus clotting system, and that it specifically activates proclotting enzyme to the active clotting enzyme. PMID- 3519595 TI - The heterogeneity of brewer's yeast old yellow enzyme. AB - Heterogeneity of brewer's yeast old yellow enzyme (OYE) was found by anion exchange high-performance liquid chromatography (HPLC) as well as by 13C-NMR spectroscopy of [4a-13C]FMN reconstituted into apo OYE. Though the OYE sample prepared according to the conventional procedure gave a single protein band on sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE), the OYE sample was found to consist of five species on anion-exchange HPLC. The 13C-NMR spectrum of the [4a-13C]FMN-reconstituted OYE gave multiple peaks corresponding to 4a-13C. This multiplicity indicates that this OYE preparation possesses heterogeneity in the environment surrounding FMN, i.e., the active site of OYE. The different species of OYE were separately obtained by preparative HPLC on an anion-exchange column. These species as well as the unresolved sample showed identical mobility on SDS-PAGE and similar but slightly different NADPH oxidase activities. This heterogeneity was shown not to have resulted from proteolytic modification during the conventional purification procedure, which includes autolysis of the yeast cells, since the enzyme extracted by mechanical destruction of the yeast cells in the presence of various protease inhibitors exhibited identical heterogeneity. The pure OYE forms obtained by preparative anion-exchange HPLC are homogeneous in the flavin environment as revealed by a single 13C-NMR signal for the [4a-13C]FMN-reconstituted species. PMID- 3519596 TI - A Zn2+-dependent and histone H1-specific protease in sea urchin sperm. AB - Protease activity was extracted from sea urchin sperm with 1% Triton X-100 and partially purified by DEAE-cellulose and Sephadex G-100 chromatography. The enzyme preferentially degraded histone H1, while showing only a weak activity toward other histones. Heat-denatured casein and bovine serum albumin were not digested by this enzyme under the present experimental conditions. This protease hydrolyzed only Boc-Val-Leu-Lys-MCA among various peptidyl-MCAs. The optimal pH ranged from 7 to 11. Its molecular weight was about 41,000. Among various known inhibitors of proteases, only omicron-phenanthroline effectively inhibited the activity. The enzyme was stimulated by Zn2+ or Co2+. It was inactivated by omicron-phenanthroline but could be reactivated by the addition of Zn2+ or Co2+. Therefore, this protease seems to be a metalloprotease dependent on Zn2+ or Co2+. The insensitivity of this enzyme to phosphoramidon and its very restricted substrate specificity suggest that this enzyme is very different from other metalloproteases described hitherto. PMID- 3519597 TI - Isolation and characterization of three alpha-glucosidases from the Japanese quail. AB - We have defined one type of acid alpha-glucosidase and two types of neutral alpha glucosidases from quail skeletal muscle on the basis of differences in the elution patterns on a DEAE-cellulose column. The appearance of the two neutral alpha-glucosidase isoenzymes was age-dependent. A decrease in acid alpha glucosidase activity was demonstrated in Japanese quails with glycogenosis type II. The characteristics of these three alpha-glucosidase isoenzymes are described. PMID- 3519598 TI - Selective proteolysis of cytosolic aspartate aminotransferase by a new microbial protease. AB - A protease from Streptomyces violaceochromogenes (Murao, S., Nishino, Y., & Maeda, Y. (1984) Agric. Biol. Chem. 48, 2163-2166) is known to inactivate pig heart aspartate aminotransferase [EC 2.6.1.1]. Chemical analysis of the core proteins and peptide fragments produced upon proteolysis of the aminotransferase revealed that peptide bond cleavage occurred specifically at Leu 20 with concomitant inactivation. Neither inactivation nor peptide bond cleavage was observed with the mitochondrial isoenzyme. The proteolytically produced derivative 21-412 of the cytosolic isoenzyme retained approximately 0.1% enzymic activity for transamination with natural dicarboxylic substrates. The pyridoxal form of the derivative 21-412 was fully converted by cysteinesulfinate or alanine to the pyridoxamine form and conversely the pyridoxamine form of the derivative was also fully converted by 2-oxoglutarate or pyruvate into the pyridoxal form, indicating that the derivative was still catalytically competent. However, the rates of reaction with dicarboxylic substrates were much reduced whereas the rates with monocarboxylic substrates remained at an order of magnitude similar to that observed with the native enzyme. Thus the NH2-terminal segment appears to be an import structural component which determines the substrate specificity of aspartate aminotransferase for dicarboxylic keto and amino acids. A substantial alteration in the molecular structure accompanying the loss of the NH2-terminal 20 residues was also reflected by the decrease in heat stability and in the lowering of the pKa value for His 68, which is involved in the intersubunit interaction of this dimeric enzyme. PMID- 3519599 TI - The earliest form of C-protein expressed during striated muscle development is immunologically the same as cardiac-type C-protein. AB - A monoclonal antibody (C-315) specific for cardiac-type C-protein was prepared and, in combination with other antibodies specific for fast and slow skeletal muscle C-proteins, it was used to investigate the expression of C-protein isoforms in developing striated muscle cells in vivo and in vitro. During embryonic development of skeletal muscles, a C-protein recognized by C-315 appeared first but only transiently, it being replaced subsequently by two other isoforms recognized by the antibodies to slow and fast skeletal muscle C-proteins in a fiber-type specific manner as previously demonstrated (Obinata et al. (1984) Develop. Biol. 101, 116-124). In contrast, only cardiac-type C-protein was detected in cardiac muscle throughout the developmental stages. When myogenesis in vitro was monitored using the same antibodies, C-315 binding appeared first in multinucleated myotubes as in vivo which was followed by the sequential expression of two other C-protein variants. The reactivity of C-315 as well as that of anti-slow and anti-fast skeletal C-protein antibodies persisted during muscle development in culture. Thus, this study demonstrates that the earliest form of C-protein expressed in striated muscles may either be a cardiac-type isoform or a unique embryonic protein containing an epitope in common with the adult cardiac-type protein, and that transitions of C-protein isoform expression characteristic of each fiber-type occur during muscle development in vivo but not in vitro. PMID- 3519600 TI - Biosynthesis of isoprenoids in intact cells of Escherichia coli. AB - Upon rehydration of lyophilized Escherichia coli cells with phosphate buffer containing [14C]isopentenyl pyrophosphate (IPP), 14C was incorporated into the cells. Radioactivity was found in ubiquinone-8, an unidentified precursor of ubiquinone-8, demethylmenaquinone-8 and phosphate esters of all-trans-octaprenol and cis, trans-polyprenols. On rehydration of the cells with the buffer containing geranyl pyrophosphate or farnesyl pyrophosphate in combination with [14C]IPP, higher radioactivity was incorporated into the above products and some radioactivity was found in free prenols. Fractionation of the 14C-labeled cells by sucrose-density gradient centrifugation before and after recultivation indicated that the size of 14C-labeled cells had changed during the recultivation. This shows that radioactivity of [14C]IPP was incorporated into live cells but not into dead cells. The metabolism of the radioactive products in the recultivated cells was examined. It was found that the unidentified precursor was converted to ubiquinone-8, but demethylmenaquinone-8 was not converted to menaquinone-8. "Lipid intermediates" in peptidoglycan synthesis increased in the logarithmic growth phase and decreased in the stationary phase. In the stationary phase, however, an increase in cis,trans-polyprenyl monophosphates was observed. These observations suggest the operation of the lipid cycle of peptidoglycan synthesis. PMID- 3519601 TI - Amino acid sequence of copper,zinc-superoxide dismutase from spinach leaves. AB - The complete amino acid sequence of Cu,Zn-superoxide dismutase (SOD) from spinach leaves has been determined on the basis of peptides obtained by cyanogen bromide (BrCN) cleavage and by enzymic hydrolyses with Achromobacter lyticus lysylendopeptidase, Staphylococcus aureus V8 protease, trypsin, and thermolysin. The spinach SOD consists of a total of 154 amino acid residues with alanine as the amino(N)-terminus and valine as the carboxy(C-)terminus. The present sequence, which has been established for the enzyme from a plant, is also highly homologous to those of the enzymes from other species. Especially, the residues essential for metal binding and enzyme activity have been extensively conserved among all of the Cu,Zn-SODs hitherto analyzed. PMID- 3519602 TI - Phosphoenolpyruvate carboxylase of Escherichia coli K-12. N- and C-terminal sequences and tentative assignment of the catalytically essential cysteine residue. AB - The N- and C-terminal amino acid sequences of phosphoenolpyruvate carboxylase [EC 4.1.1.31] from Escherichia coli K-12 were determined to establish the primary structure deduced from the nucleotide sequence of the cloned gene for the enzyme (Fujita, N., Miwa, T., Ishijima, S., Izui, K., & Katsuki, H. (1984) J. Biochem. 95, 909-916). As predicted from the nucleotide sequence, two polypeptides were produced upon treatment with hydroxylamine, which specifically cleaves the Asn Gly bond, and their amino acid compositions were also in accordance with those predicted. The tryptic peptides which contained cysteine residues labeled with a fluorescent reagent, N-[7-(dimethylamino)-4-methylcoumarinyl]maleimide, were isolated by high-performance liquid chromatography and partially sequenced. All of them could be assigned on the deduced primary structure. The modified cysteine residues were Cys-157, Cys-385, Cys-458, Cys-568, Cys-665, and Cys-754. Furthermore, the essential cysteine residue which is presumably located at or near the active site was tentatively identified as Cys-568, since it was consistently protected against the modification by 2-phospholactate, a substrate analog. PMID- 3519603 TI - Isoprenoid synthesis in Escherichia coli. Separation and partial purification of four enzymes involved in the synthesis. AB - Isopentenyl pyrophosphate (IPP) isomerase, farnesyl pyrophosphate (FPP) synthetase, octaprenyl pyrophosphate (OPP) synthetase and undecaprenyl pyrophosphate (UPP) synthetase were partially purified from Escherichia coli by DEAE-Toyopearl chromatography. FPP synthetase catalyzed the condensation of IPP with dimethylallyl pyrophosphate (DPP) as well as with geranyl pyrophosphate (GPP) to yield FPP as final product. OPP synthetase and UPP synthetase catalyzed the condensation of IPP with FPP to yield OPP and cis,trans-polyprenyl pyrophosphates (the C45-, C50, and C55-compound), respectively. Neither DPP nor GPP acted as a priming substrate for either enzyme. These four enzymes required Mg2+ or Mn2+ for their activities. UPP synthetase required also Triton X-100 for its activity. The addition of Triton X-100 enhanced OPP synthetase, but it did not affect IPP isomerase and FPP synthetase. It seems possible that the combination of the four enzymes ensures the in vivo synthesis of long-chain isoprenoids in E. coli. PMID- 3519604 TI - Effect of thiolactomycin on the individual enzymes of the fatty acid synthase system in Escherichia coli. AB - Thiolactomycin, an antibiotic with the structure of (4S)-(2E,5E)-2,4,6-trimethyl 3-hydroxy-2,5,7-octatriene-4-++ +thiolide, selectively inhibits type II fatty acid synthases. The mode of the thiolactomycin action on the fatty acid synthase system of Escherichia coli was investigated. Of the six individual enzymes of the fatty acid synthase system, [acyl-carrier-protein] (ACP) acetyltransferase and 3 oxoacyl-ACP synthase were inhibited by thiolactomycin. On the other hand, the other enzymes were not affected by this antibiotic. The thiolactomycin inhibition of the fatty acid synthase system was reversible. As to ACP acetyltransferase, the inhibition was competitive with respect to ACP and uncompetitive with respect to acetyl-CoA. As to 3-oxoacyl-ACP synthase, the inhibition was competitive with respect to malonyl-ACP and noncompetitive with respect to acetyl-ACP. The thiolactomycin action on the fatty acid synthase system was compared with that of cerulenin. PMID- 3519605 TI - Isolation and amino acid sequence of a peptide containing an epoxide-reactive residue from the thermolysin-digest of Scytalidium lignicolum acid protease B. AB - Scytalidium lignicolum acid protease B, a pepstatin-insensitive acid protease, was modified by 1,2-epoxy-3-(p-nitrophenoxy)propane (EPNP) with the concomitant loss of its enzyme activity, and an EPNP-labeled peptide was isolated from the thermolysin-digest of the modified enzyme by HPLC. The amino acid sequence of the peptide was determined to be Ile-Leu-Glu-Thr-Gly, which corresponds to the sequence of residue Nos. 51-55 of the enzyme. The results of treatment of the labeled peptide with hydroxylamine suggested that the EPNP moiety is ester-linked to Glu53 of the enzyme. The amino acid sequence around Glu53 of the acid protease B showed high homology with those around the active site Asp residues of calf chymosin and porcine pepsin. These results show that it is highly possible that Glu53 of the acid protease B is one of the amino acid residues involved in its catalytic activity. PMID- 3519606 TI - Processivity and kinetics of the reaction of exonuclease I from Escherichia coli with polydeoxyribonucleotides. AB - The enzyme exonuclease I from Escherichia coli hydrolyzes successive nucleotides from the 3'-termini of single-stranded deoxyribonucleotide homopolymers. When the reaction is stopped after partial hydrolysis, only intact starting material and small oligomers can be isolated. The distribution of oligomeric products varies with the base composition of the polymer but the largest oligomer that can be isolated from the reaction of exonuclease I with homopolymers of deoxyadenylate, deoxythymidylate, or deoxycytidylate is a decamer. These results suggest a model in which exonuclease I possesses at least two nucleotide binding sites. When both sites are filled, with 11-mers and longer polymers, the enzyme does not dissociate from the polymer during hydrolysis. When, with smaller oligomers, only a single site is filled, the reaction partitions at each oligomer between hydrolysis and dissociation. The kinetics of the reactions of exonuclease I with purified polydeoxyriboadenylates of defined size distributions have been investigated. The maximum rates of hydrolysis are nearly independent of polymer size while the apparent Michaelis constants are inversely proportional to the polymer size. A simple steady state model yields a kinetic equation that is consistent with our results. Competition experiments indicate that the rate at which exonuclease I associates with the 3'-terminus of a polydeoxyribonucleotide is independent of the polymer's chain length. PMID- 3519607 TI - Role of the phenylalanine B25 side chain in directing insulin interaction with its receptor. Steric and conformational effects. AB - To gain an understanding of the causes of decreased biological activity in insulins bearing amino acid substitutions at position B25 and the importance of the PheB25 side chain in directing hormone-receptor interactions, we have prepared a variety of insulin analogs and have studied both their interactions with isolated canine hepatocytes and their abilities to stimulate glucose oxidation by isolated rat adipocytes. The semisynthetic analogs fall into three structural classes: (a) analogs in which the COOH-terminal 5, 6, or 7 residues of the insulin B-chain have been deleted, but in which the COOH-terminal residue of the B-chain has been derivatized by alpha-carboxamidation; (b) analogs in which PheB25 has been replaced by unnatural aromatic or natural L-amino acids; and (c) analogs in which the COOH-terminal 5 residues of the insulin B-chain have been deleted and in which residue B25 has been replaced by selected alpha carboxamidated amino acids. Our results showed that (a) insulin residues B26-B30 can be deleted without decrease in biological potency, whereas deletion of residues B25-B30 and B24-B30 causes a marked and cumulative decrease in potency; (b) replacement of PheB25 in insulin by Leu or Ser results in analogs with biological potency even less than that observed when residues B25-B30 are deleted; (c) the side chain bulk of naphthyl(1)-alanine or naphthyl(2)-alanine at position B25 is well tolerated during insulin interactions with receptor, whereas that of homophenylalanine is not; and (d) the decreased biological potency attending substitution of insulin PheB25 by Ala, Ser, Leu, or homophenylalanine is reversed, in part or in total, by deletion of COOH-terminal residues B26-B30. Additional experiments showed that the rate of dissociation of receptor-bound 125I-labeled insulin from isolated hepatocytes is enhanced by incubating cells with insulin or [naphthyl(2)-alanineB25]insulin, but not with analogs in which PheB25 is replaced by serine, leucine, or homophenylalanine; deletion of residues B26-B30, however, results in analogs that enhance the rate of dissociation of receptor-bound insulin in all cases studied. We conclude that (a) steric hindrance involving the COOH-terminal domain of the B chain plays a major role in directing the interaction of insulin with its receptor; (b) the initial negative effect of this domain is reversed upon the filling of a site reflecting interaction of the receptor and the beta-aromatic ring of the PheB25 side chain.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3519608 TI - Regulation of tryptase from human lung mast cells by heparin. Stabilization of the active tetramer. AB - Tryptase was shown to be stabilized as an enzymatically active tetramer by association with heparin and dissociated to inactive monomers in the absence of heparin at 37 degrees C in physiologic buffer and in plasma. There was a 50% loss of tryptase activity at 37 degrees C by 6-8 min in both physiologic buffer and plasma. When heparin glycosaminoglycan was present, tryptase retained nearly full activity for 2 h in buffer and in plasma. Tryptase activity also decayed under standard assay conditions in the presence of synthetic ester and peptide substrates unless bound to heparin. That tryptase is bound to heparin at the pH and physiologic NaCl concentrations employed was shown by chromatography of tryptase on heparin-agarose, gel filtration, and velocity sedimentation. Elution of tryptase from heparin-agarose occurred at 0.8 M NaCl. Maximal stabilization of tryptase by heparin occurred at a weight ratio to tryptase that was equal to or greater than unity. Kcat/Km ratios for tryptase-heparin at 0.15 M NaCl and 37 degrees C were 0.9 X 10(6) s-1 M-1 for tosyl-L-Gly-Pro-Lys-p-nitroanilide and 1.7 X 10(6) s-1 M-1 for p-tosyl-L-arginine methyl ester and are among the highest reported for tryptic enzymes. The mechanism of heparin-dependent stabilization of tryptase was not due to indirect ion binding properties of heparin and was analyzed by Superose 12 high performance liquid chromatography. Active enzyme eluted with an apparent Mr of 132,000 +/- 10,000 (n = 3, +/- S.D.), whereas tryptase inactivated by incubation without heparin eluted with an apparent Mr of 34,000. The tetrameric structure of diisopropyl fluorophosphate-inhibited tryptase was also preserved after incubation with heparin at 37 degrees C but was reduced to monomeric subunits after incubation without heparin. That no appreciable degradation of tryptase occurs under conditions that cause dissociation of subunits was directly shown by electrophoresis in sodium dodecyl sulfate-polyacrylamide gels. Two different subunits of 34,000 and 33,000 Mr (after reduction) present in the intact enzyme (calculated to be 134,000 Mr) were also detected unchanged after inactivation of tryptase by dissociation of its subunits. Thus, the selective localization and association of heparin and tryptase in the human mast cell secretory granule most likely plays a major role in the regulation of tryptase after secretion. PMID- 3519609 TI - The beta subunit of the Escherichia coli DNA polymerase III holoenzyme interacts functionally with the catalytic core in the absence of other subunits. AB - We have previously demonstrated that the addition of a stoichiometric excess of the beta subunit of Escherichia coli DNA polymerase III holoenzyme to DNA polymerase III or holoenzyme itself can lead to an ATP-independent increase in the processivity of these enzyme forms (Crute, J. J., LaDuca, R. J., Johanson, K. O., McHenry, C. S., and Bambara, R. A. (1983) J. Biol. Chem. 258, 11344-11349). Here, we show that the beta subunit can interact directly with the catalytic core of the holoenzyme, DNA polymerase III, generating a new form of the enzyme with enhanced catalytic and processive capabilities. The addition of saturating levels of the beta subunit to the core DNA polymerase III enzyme results in as much as a 7-fold stimulation of synthetic activity. Two populations of DNA products were generated by the DNA polymerase III X beta enzyme complex. Short products resulting from the addition of 5-10 nucleotides/primer fragment were generated by DNA polymerase III in the presence and absence of added beta subunit. A second population of much longer products was generated only in beta-supplemented DNA polymerase III reactions. The DNA polymerase III-beta reaction was inhibited by single-stranded DNA binding protein and was unaffected by ATP, distinguishing it from the holoenzyme-catalyzed reaction. Complex formation of the DNA polymerase III core enzyme with beta increased the residence time of the enzyme on synthetic DNA templates. Our results demonstrate that the beta stimulation of DNA polymerase III can be attributed to a more efficient and highly processive elongation capability of the DNA polymerase III X beta complex. They also prove that at least part of beta's normal contribution to the DNA polymerase III holoenzyme reaction takes place through interaction with DNA polymerase III core enzyme components to produce the essential complex necessary for efficient elongation in vivo. PMID- 3519610 TI - Protein secretion in Tetrahymena thermophila. Characterization of the major proteinaceous secretory proteins. AB - The contents of mucocysts of the ciliated protozoan Tetrahymena thermophila comprise about 12 proteins, ranging in relative mobility (Mr) from approximately 160,000 to 8,000. There are at least four families of sulfhydryl-linked mucocyst polypeptides. One of these families includes a prominent Mr 34,000 protein, as determined by one- and two-dimensional gel electrophoresis. The Mr 34,000 protein is resolved into two species in isoelectric focusing gels, with apparent pI values of 4.8 and 4.9; most of the other mucocyst proteins also exhibit acidic apparent isoelectric points. The identity of the major Mr 34,000 protein as a bona fide mucocyst component is substantiated by indirect immunofluorescent localization of this protein in a linear punctate pattern coincident with the localization of mucocysts in these cells; this pattern of localization can be abolished by stimulation of synchronous secretion and is absent in a mutant strain devoid of these secretory organelles (Maihle, N. J., and Satir, B. H. (1985a) J. Cell Sci. 78, 49-65. PMID- 3519611 TI - The characterization of the receptor for endothelial cell growth factor by covalent ligand attachment. AB - Cellular receptors for endothelial cell growth factor (ECGF) have been demonstrated on several cell types by binding of 125I-ECGF in a specific and saturable manner (Schreiber, A. B., Kennedy, J., Kowalski, J., Friesel, R., Mehlman, T., and Maciag, T. (1985) Proc. Natl. Acad. Sci. U. S. A. 82, 6138 6142). Here we report the covalent cross-linking of 125I-ECGF to a polypeptide present on the surface of the plasma membrane of murine lung capillary endothelial cells by the homobifunctional reagent, disuccinimidyl suberate. Cross linking of cell surface associated 125I-ECGF yields a major polypeptide with an apparent molecular weight of 150,000. Experiments demonstrated that the cross linked polypeptide complex represents 125I-ECGF covalently bound specifically to a cell surface receptor because: covalent modification of the polypeptide was inhibited by excess, unlabeled ECGF; preincubation of cells with unlabeled ECGF at 37 degrees C significantly reduced cross-linking while incubation at 4 degrees C did not; other polypeptide growth factors do not compete with 125I-ECGF for cross-linking to the ECGF receptor; labeling of the polypeptide did not take place in the absence of DSS; and cells previously shown to have a paucity of ECGF receptors did not yield a cross-linked labeled receptor. These data suggest that the mitogenic events mediated by ECGF occur after occupancy of the specific cell surface polypeptide and suggest that these events are relevant to ECGF-induced signal transduction across the endothelial cell plasma membrane. PMID- 3519612 TI - Inhibition of iodothyronine transport into rat liver cells by a monoclonal antibody. AB - The role of the rat liver plasma membrane in the regulation of uptake and subsequent deiodination of thyroxine (T4) or the biologically active thyroid hormone 3,3',5-triiodothyronine (T3) was investigated. Here we report on the production of monoclonal antibodies raised against rat hepatocytes. Two antibodies were selected. Antibody ER-22 did bind to a Mr 52,000 membrane protein and inhibited the 1- and 5-min uptake of both T4 and T3 by primary cultured rat hepatocytes in a dose-dependent fashion. As the uptake of T4 and T3 depends on the presence of a sodium gradient over the plasma membrane, the inhibitory potency of ER-22 on the Na+,K+-ATPase activity was investigated. No inhibition of the uptake of 86Rb+ could be determined, indicating that antibody ER-22 is not directed against the Na+,K+-ATPase but probably the carrier protein itself. Clearance of T3 from the medium and concomitant iodide production by cultured rat hepatocytes during a 20-h incubation in the presence of ER-22 were both inhibited by 50% with respect to a control incubation in the absence of monoclonal antibody, pointing to the importance of carrier-mediated transport in cellular uptake and metabolism of T3. A second monoclonal antibody did bind to two other plasma membrane proteins but did not inhibit transport of thyroid hormone. PMID- 3519613 TI - Reduction of phosphatidylcholine turnover in a Nb 2 lymphoma cell line after prolactin treatment. A novel mechanism for control of phosphatidylcholine levels in cells. AB - Phosphatidylcholine metabolism was investigated in Nb 2 rat node lymphoma cells, a cell line which is dependent on prolactin for growth in culture. Treatment of stationary cultures with prolactin stimulated the incorporation of [methyl 3H]choline into phosphatidylcholine (1.7-fold after 4 h) and its aqueous precursors, mainly phosphocholine (1.9-fold after 4 h and 2.7-fold after 10 h). These effects were blocked by cycloheximide. Pulse-chase studies demonstrated that the reaction catalyzed by CTP:choline-phosphate cytidylyltransferase (EC 2.7.7.15) was rate-limiting for phosphatidylcholine synthesis in Nb 2 cells and that the rate of this reaction was not altered by prolactin treatment. The cell free activity of choline kinase (EC 2.7.1.32) was found to increase in correspondence with the increase in choline incorporation. This induction of choline kinase was also blocked by cycloheximide. The activities of the other enzymes of phosphatidylcholine synthesis were unchanged. These results suggest that phosphatidylcholine biosynthesis was not altered in Nb 2 cells after prolactin treatment. However, phosphatidylcholine levels increased in prolactin treated cells (1.4-fold after 16 h). Turnover of labeled phosphatidylcholine was markedly reduced in prolactin-treated cells. Calculated turnover rates for phosphatidylcholine averaged 4.2-fold lower in prolactin-treated cells, whereas the synthetic rates were similar in prolactin-treated and stationary cells. Thus, Nb 2 cells utilize a novel mechanism, reduction of turnover, to regulate the cellular levels of phosphatidylcholine during growth. PMID- 3519614 TI - Mechanisms of action of chloroalanyl antibacterial peptides. Identification of the intracellular enzymes inactivated on treatment of Escherichia coli JSR-O with the dipeptide beta Cl-LAla-beta Cl-LAla. AB - The dipeptide beta Cl-LAla-beta Cl-LAla is an antibacterial agent designed to utilize bacterial peptide transport for intracellular delivery of the alanine racemase inactivator beta Cl-LAla. The minimum inhibitory concentrations (MICs) for the peptide against Gram-negative species grown on enriched agar medium range from 1.56 to 12.5 micrograms/ml; MICs are increased to greater than 100 micrograms/ml when D-alanine is included in the medium, indicating that alanine racemase is, in fact, inhibited in sensitive species. When susceptible Gram negative cells are grown on a minimal medium, D-alanine supplementation alone does not increase the MICs for beta Cl-LAla-beta Cl-LAla, but complete protection is afforded by supplementation with D-alanine, L-valine, L-leucine, and L isoleucine. In liquid culture, the peptide is: bactericidal and lytic against Escherichia coli JSR-O growing in enriched medium or in minimal medium supplemented with the branched-chain amino acids; only inhibitory against these cells growing in minimal medium supplemented with D-alanine; and ineffective against these cells in minimal medium containing the branched-chain amino acids plus D-alanine. Cells exposed to beta Cl-LAla-beta Cl-LAla (with the protection of the four amino acids) have specific activities of both alanine racemase and transaminase B that are lower than those of cultures not treated with the peptide. Finally, E. coli JSR-O alanine racemase experiences time-dependent loss of activity when exposed to the dipeptide in the presence of aminopeptidases; the dipeptide alone is not an inactivator of the racemase in vitro. These results suggest the following mechanism of action for beta Cl-LAla-beta Cl-LAla: transport of the dipeptide into the cell; intracellular hydrolysis to give accumulation of beta Cl-LAla; and subsequent inactivation of targeted enzymes. Whether inactivation of the racemase or of the transaminase determines the pathophysiologic effects of the peptide depends on the composition of the growth medium. PMID- 3519615 TI - Reactions of Escherichia coli TEM beta-lactamase with cephalothin and with C10 dipeptidyl cephalosporin esters. AB - Two novel C10-(dipeptidyl)cephalosporin esters (3-(beta-chloro-L-alanyl-beta chloro-L-alanyloxymethyl)-7 beta-(2-thienylacetamido)-3-cephem-4-carboxylic acid (7) and sodium 3-(L-alanyl-L-alanyloxymethyl)-7 beta-(2-thienylacetamido)-3 cephem-4-carboxylate, toluene-sulfonic acid salt (18] were synthesized, and their reactions with Escherichia coli TEM beta-lactamase were examined. Kinetic parameters determined for the enzymatic reactions of 7 (Km = 0.32 mM; Vmax = 338 mumol min-1 (mg protein)-1) and of 18 (Km = 0.33 mM, Vmax = 338 mumol min-1 (mg protein)-1) demonstrate that both of the peptidyl esters are good substrates for the lactamase. In fact, the Vmax rates for 7 and 18 are each more than 4-fold greater than that obtained for cephalothin, 1 (Vmax = 78 mumol min-1 (mg protein) 1), a well characterized substrate for the lactamases. Analysis of the enzymatic reactions by high field (500 MHz) 1H NMR revealed similar patterns for fragmentation of the cephem nucleus of 1, 7, and 18. However, while hydrolysis of 1 produces acetate, cleavage of 7 and 18 releases beta Cl-LAla-beta Cl-LAla and LAla-LAla, respectively, from the dipeptidyl cephalosporin esters. Based on these findings, a strategy for co-opting the beta-lactamases of Gram-negative bacteria for "delivery" of bactericidal agents is described, and an explanation for the previously reported (Mobashery, S., Lerner, S.A., and Johnston, M. (1986) J. Am. Chem. Soc. 108, 1685) antibacterial activity of 7 is offered. PMID- 3519616 TI - Identification of fibroblasts as a major site of albumin catabolism in peripheral tissues. AB - Rat serum albumin has been labeled with dilactitol-125I-tyramine, (125I-DLT) a radioactive tracer which remains entrapped within lysosomes following cellular uptake and degradation of the carrier protein. Similar kinetics of clearance from the rat circulation were observed for albumin labeled conventionally with 125I or 125I-DLT-albumin, both proteins having circulating half-lives of approximately 2.2 days. In contrast, the recovery of whole body radioactivity had half-lives of approximately 2.2 and 5.1 days, respectively, for the two protein preparations, indicating substantial retention of degradation products derived from catabolism of 125I-DLT-albumin. Measurement of total and acid-soluble radioactivity in tissues 2 or 4 days after injection of 125I-DLT-albumin revealed that skin and muscle accounted for the largest fraction (50-60%) of degradation products in the body. Fibroblasts were identified by autoradiography as the major cell type containing radioactive degradation products in skin and muscle. Fibroblasts were isolated from skin by collagenase digestion, followed by density gradient centrifugation. The amount of acid-soluble radioactivity recovered in these cells was in excellent agreement with that predicted based on acid precipitation of solubilized whole skin preparations. These studies demonstrate for the first time that fibroblasts are a major cell type involved in the degradation of albumin in vivo. PMID- 3519617 TI - Crystallization and x-ray diffraction studies of a phosphate-binding protein involved in active transport in Escherichia coli. AB - We have obtained single crystals of a phosphate-binding protein (Mr = 34,400) that serves as initial receptor in osmotic shock-sensitive active transport in Escherichia coli. The crystals, suitable for high resolution crystallographic analysis, belong to the space group P2(1)2(1)2(1). The unit cell has dimensions of a = 41.97, b = 64.66, and c = 124.6 A and contains four protein molecules. Including this phosphate-binding protein, there are now a total of six different binding protein structures currently under investigation in our laboratory, the others being those specific for L-arabinose, D-galactose, D-maltose, sulfate, or leucine/isoleucine/valine. PMID- 3519618 TI - Translocation of nascent non-signal sequence protein in heated Escherichia coli. AB - Exposure of Escherichia coli to heat resulted in 1) selective inhibition of protein synthesis, 2) synthesis of heat shock proteins, and 3) altered subcellular distribution of newly synthesized proteins. Either 5 min or 1 h at 48 degrees C increases outer membrane proteins of Coomassie Blue-stained gels. After 1 h, there was a loss of stained proteins from the soluble fraction. Much greater changes in the distribution of radiolabeled (newly synthesized) proteins were observed, with marked increases in the number of outer membrane protein species and a corresponding loss of soluble fraction proteins. Three major species of radiolabeled proteins from heat-treated cells remain in the soluble fraction; these proteins have apparent Mr 56,000, 69,200, and 79,400. Cells were labeled with L-[35S] methionine at either 37 or 48 degrees C and chased with non radiolabeled methionine before a temperature shift to either 48 or 37 degrees C, respectively. Only proteins synthesized at elevated temperature participated in translocation. It is suggested that heat disordering of membrane lipids promotes interlipidic connections between the inner and outer membrane providing pathways for protein movement to the outer membrane and may be the mechanism whereby a cell quickly responds to environmental temperature stress. The response does not require but may trigger synthesis of mRNA. PMID- 3519619 TI - Dynamics of microtubule depolymerization in monocytes. AB - Human monocytes, which contain few interphase microtubules (35.+/- 7.7), were used to study the dynamics of microtubule depolymerization. Steady-state microtubule assembly was abruptly blocked with either high concentrations of nocodazole (10 micrograms/ml) or exposure to cold temperature (3 degrees C). At various times after inhibition of assembly, cells were processed for anti-tubulin immunofluorescence microscopy. Stained cells were observed with an intensified video camera attached to the fluorescence microscope. A tracing of the entire length of each individual microtubule was made from the image on the television monitor by focusing up and down through the cell. The tracings were then digitized into a computer. All microtubules were seen to originate from the centrosome, with an average length in control cells of 7.1 +/- 2.7 microns (n = 957 microtubules). During depolymerization, the total microtubule polymer and the number of microtubules per cell decreased rapidly. In contrast, there was a slow decrease in the average length of the persisting microtubules. The half-time for both the loss of total microtubule polymer and microtubule number per cell was approximately 40 s for nocodazole-treated cells. The rate-limiting step in the depolymerization process was the rate of initiation of disassembly. Once initiated, depolymerization appeared catastrophic. Further kinetic analysis revealed two classes of microtubules: 70% of the microtubule population was very labile and initiated depolymerization at a rate approximately 23 times faster than a minor population of persistent microtubules. Cold treatment yielded qualitatively similar characteristics of depolymerization, but the initiation rates were slower. In both cases there was a significant asynchrony and heterogeneity in the initiation of depolymerization among the population of microtubules. PMID- 3519620 TI - Intermediate filaments in muscle and epithelial cells of nematodes. AB - Current concepts of the developmentally controlled multigene family of intermediate filament (IF) proteins expect the origin of their complexity in evolutionary precursors preceding all vertebrate classes. Among invertebrates, however, firm ultrastructural as well as molecular documentation of IFs is restricted to some giant axons and to epithelia of a few molluscs and annelids. As Ascaris lumbricoides is easily dissected into clean tissues, IF expression in this large nematode was analyzed by electron microscopic and biochemical procedures and a monoclonal antibody reacting with all mammalian IF proteins. We document for the first time the presence of IFs in muscle cells of an invertebrate. They occur in three muscle types (irregular striated pharynx muscle, obliquely striated body muscle, uterus smooth muscle). IFs are also found in the epithelia studied (syncytial epidermis, intestine, ovary, testis). Immunoblots on muscles, pharynx, intestine, uterus, and epidermis identify a pair of polypeptides (with apparent molecular masses of 71 and 63 kD) as IF constituents. In vitro reconstitution of filaments was obtained with the proteins purified from body muscle. In the small nematode Caenorhabditis elegans IF proteins are so far found only in the massive desmosome-anchored tonofilament bundles which traverse a special epithelial cell type, the marginal cells of the pharynx. We speculate that IFs may occur in most but perhaps not all invertebrates and that they may not occur in all cells in large amounts. As electron micrographs of the epidermis of a planarian--a member of the Platyhelminthes--reveal IFs, the evolutionary origin of this cytoplasmic structure can be expected either among the lowest metazoa or already in some unicellular eukaryotes. PMID- 3519621 TI - Brain spectrin(240/235) and brain spectrin(240/235E): two distinct spectrin subtypes with different locations within mammalian neural cells. AB - Adult mouse brain contains at least two distinct spectrin subtypes, both consisting of 240-kD and 235-kD subunits. Brain spectrin(240/235) is found in neuronal axons, but not dendrites, when immunohistochemistry is performed with antibody raised against brain spectrin isolated from enriched synaptic/axonal membranes. A second spectrin subtype, brain spectrin(240/235E), is exclusively recognized by red blood cell spectrin antibody. Brain spectrin(240/235E) is confined to neuronal cell bodies and dendrites, and some glial cells, but is not present in axons or presynaptic terminals. PMID- 3519622 TI - Immunolocalization of the oligosaccharide trimming enzyme glucosidase II. AB - We used immunoelectron microscopy to localize glucosidase II in pig hepatocytes. The enzyme trims the two inner alpha 1,3-linked glucoses from N-linked oligosaccharide precursor chains of glycoproteins. Immunoreactive enzyme was concentrated in rough (RER) and smooth (SER) endoplasmic reticulum but not detectable in Golgi apparatus cisternae. Transitional elements of RER and smooth membraned structures close to Golgi apparatus cisternae contained labeling for glucosidase II. Specific labeling was also found in autophagosomes. These results indicate strongly that glucosidase II acts on glycoproteins before their transport to, and processing in Golgi apparatus cisternae, and suggest that an important transitional region for glucosidase II exists between RER and Golgi apparatus cisternae. Degradation in autophagolysosomes could form a normal catabolic pathway for glucosidase II. PMID- 3519623 TI - Insulin-like growth factor I regulation of transcription and replicating enzyme induction necessary for DNA synthesis. AB - Insulin-like growth factor I (IGF-I) regulation of the sequence of transcriptional, translational, and postranslational events during G1 that are necessary for DNA synthesis, and the induction of thymidine kinase and in vivo thymidylate synthase activities was studied in synchronized confluent BALB/c 3T3 mouse fibroblasts. IGF-I was the only growth factor necessary from 6 to 2 1/2 hours before S phase for onset of DNA synthesis. 5,6 dichlororibofuranosylbenzimidazole (DRB), an inhibitor of transcription, was ineffective in blocking DNA synthesis and increase of both enzyme activities during an interval of about 2 1/2 hours before S phase. Cycloheximide, an inhibitor of translation, was ineffective in blocking DNA synthesis and the increase of in vivo thymidylate synthase activity during an interval of about 1 1/2 hours before S phase but was effective in blocking the increase of thymidine kinase activity up to the G1/S boundary. The results demonstrate that IGF-I is dispensable beyond the R-point (2-3 hours before S phase), the time when serum factors are no longer necessary for the initiation of DNA synthesis, and that IGF I regulates transcriptional events necessary for both DNA synthesis and the induction of thymidine kinase and in vivo thymidylate synthase. The results also demonstrate a posttranslational interval for in vivo thymidylate synthase, suggesting posttranslational modification of this enzyme. PMID- 3519624 TI - Mechanisms of cytoskeletal regulation: modulation of aortic endothelial cell protein band 4.1 by the extracellular matrix. AB - The bovine aortic endothelial cell (BAEC) cytoskeleton is a complex structure modulated by many stimuli including release from contact inhibition and various components of the extracellular matrix (ECM). Transduction of information from the ECM to the cell nucleus proceeds via several complex pathways including the cytoskeleton. We have demonstrated the presence of an immunoreactive isoform of the human erythrocyte cytoskeletal protein band 4.1 (4.1) in BAEC. BAEC 4.1 is similar in molecular weight to the erythroid protein by immunoblot analyses and produces a similar pattern of cysteine specific cleavage products consistent with a cluster of cysteine residues previously described in the erythroid molecule. We have also examined the effects of defined ECM proteins on the distributions of cultured BAEC 4.1 and actin filaments (AF) at confluency and following release from contact inhibition. The distribution of 4.1 in BAEC on a plasma fibronectin substrate is complex, having partial codistribution with cytoplasmic AF and a unique perinuclear staining. In contrast, on a collagen type I/III substrate, 4.1 is localized, in part, to peripheral areas of cell-cell contact distinct from the dense peripheral band staining of AF. During migration on this substrate, 4.1 had a filamentous distribution having partial codistribution with AF. Indirect immunofluorescence staining of cross-sections of bovine calf aortae revealed a cortical staining pattern in the aortic endothelial cells with staining noted on the luminal and basolateral aspects of the cells. These data suggest that, in endothelial cells, protein 4.1 is a cortical membrane protein which may function to link actin filaments to other skeletal proteins such as spectrin. These findings also suggest an active role for protein 4.1 in cytoskeletal reorganization events which can occur in response to external stimuli, such as the extracellular matrix or contact with other cells. PMID- 3519625 TI - Guanidine hydrochloride denaturation studies of mutant forms of staphylococcal nuclease. AB - Several mutant forms of staphylococcal nuclease with one or two defined amino acid substitutions have been purified, and the effects of the altered amino acid sequence on the stability of the folded conformation have been analyzed by guanidine hydrochloride denaturation. Two nuc- mutations, which greatly reduced the level of enzyme activity accumulated in E coli colonies carrying a recombinant plasmid with the mutant nuc gene (ie, a NUC- phenotype), both result in protein unfolding at significantly lower guanidine hydrochloride concentrations than the wild-type protein, whereas three sup mutations isolated on the basis of their ability to suppress partially the NUC- phenotype of the above two mutations result in unfolding at significantly higher guanidine hydrochloride concentrations. Characterization of nuclease molecules with two different amino acid substitutions, either nuc- + sup pairs or sup + sup pairs, suggests that the effect of an amino acid substitution on the stability of the native conformation, as measured by the value of delta delta GD, may not be a constant, but rather a variable that is sensitive to the presence of other substitutions at distant sites in the same molecule. Surprisingly, the slopes of the log Kapp vs guanidine hydrochloride concentration plots vary by as much as 35% among the different proteins. PMID- 3519626 TI - Properties of catalase activity in vegetative and sporulating cells of yeast Saccharomyces cerevisiae. AB - Properties of catalase activities have been examined in the intact cells of early stationary phase and cells 3 hr after transfer to sporulation medium in Saccharomyces cerevisiae. The catalase activities of the two cells had a broad optimal pH from 6 to 8. Catalase activity in the intact cells increased throughout a 4-hr period of the observation following transfer to sporulation medium. Almost all the catalase activity in vegetative cells was lost by the treatment at 60 degrees C for 10 min. Catalase activities of both cells were inhibited by KCN, NaN3, o-phenanthroline, and PCMB. The catalase activity of the vegetative cells was slightly more inhibited and inactivated than that of the sporulating cells by the inhibitors and by the treatment with HCl or NaOH. PMID- 3519627 TI - Insufficient supply of reducing equivalents to the respiratory chain in cerebral cortex during severe insulin-induced hypoglycemia in cats. AB - The ability of endogenous substrates in brain to substitute for glucose as sources for energy metabolism during insulin-induced hypoglycemia was studied. The ratio of the arteriovenous difference of glucose to the arteriovenous difference of oxygen in the cerebral cortex was measured during progressive hypoglycemia in paralyzed, artificially ventilated cats that were anesthetized with pentobarbital sodium and nitrous oxide. The ratio did not change when blood glucose fell from a mean of 7.68 to approximately 2 mumol/ml. Below 2 mumol/ml the ratio decreased, indicating that substrates other than the glucose supplied by the blood were being utilized. In another series of experiments, changes in the redox state of respiratory chain NAD were monitored from the cerebral cortex using microfluorometry during the onset of hypoglycemia and the recovery. Hypoglycemia severe enough to produce isoelectric EEG was accompanied by an oxidation of NADH, demonstrating that the supply of reducing equivalents to the respiratory chain was decreased. Recovery from hypoglycemia, produced by intravenous glucose injections, was accompanied by an increase in blood glucose concentrations, the return of EEG activity, and a decrease in the NAD/NADH ratio. When blood glucose concentration reached 2.23 during the recovery, further increases in blood glucose had no effect on the redox state of NAD. Although alternative substrates appear to be utilized for energy metabolism during severe hypoglycemia, they cannot fully replace glucose as the source of reducing equivalent to the respiratory chain. PMID- 3519628 TI - Improved high-performance liquid chromatography method for quantitation of proline and hydroxyproline in biological materials. AB - Numerous high-performance liquid chromatography systems have been described for the determination of hydroxyproline (Hyp) and proline (Pro) levels in biological materials. These methods are generally complicated and have shortcomings in applicability due to poor separation, low sensitivity or derivatization associated problems. The large number of chemical components present in biological samples further complicates the analysis of Hyp which usually occurs in extremely low concentrations. The present investigation describes the development of a simple highly sensitive derivatization method which results in good separation of peaks and which is capable of quantitating less than 10 pmol of Hyp and Pro in complex test systems. The method is based on removal of o phthalaldehyde (OPA) derivatives of primary amino acids using reversed-phase chromatography, pre-column derivatization with OPA and phenylisothiocyanate, and detection of derivatized Hyp and Pro using a UV detection system. The procedure yields good peaks and a 93% recovery of Hyp and Pro provided that the analysis is initiated within 5 min of completion of OPA derivatization. While a 93% recovery of Pro was obtained up to 100 min post-derivatization with OPA, the recovery of Hyp is decreased to approximately 80% within the same time interval. PMID- 3519629 TI - Chromatographic characterization of adult and foetal rat insulin. AB - Foetal rat pancreatic rudiments explanted on day 14 of gestation were grown in organ culture in medium enriched with amino acids. The size of the insulin granules was increased, resulting in an insulin granule volume fraction greater than the volume fraction measured in pancreas grown in vivo. The pancreas was extracted and the insulin compared. Serial dilution curves of extracts of adult pancreas and pancreas grown in vitro are parallel in the insulin radioimmunoassay, whereas extracts of pancreas of foetus developing in utero appear immunologically different. Adult and foetal rat insulin (in utero) were purified using chromatography on OPTI UP C12, cellulose thin-layer chromatography plates, cellulose acetate foil electrophoresis and finally high-performance liquid chromatography. The ratio of insulin I to insulin II was found to be 1.5 for the adult and 2.7 for the foetus. These results show that there is an unequal expression of the two non-allelic genes controlling insulin biosynthesis in foetal and adult rat pancreas. PMID- 3519630 TI - Purification of guanosine triphosphate cyclohydrolase I from Escherichia coli. The use of competitive inhibitors versus substrate as ligands in affinity chromatography. AB - Different affinity chromatography ligands have been compared for the purification of guanosine triphosphate (GTP) cyclohydrolase I, an enzyme that catalyses the transformation of GTP into formate and dihydroneopterin triphosphate, the first metabolite in the biosynthetic pathway of the pterins. When this enzyme is purified by affinity chromatography on GTP-Sepharose a major fraction of the activity is lost and the yield of enzyme decreases as the amount of enzyme applied to the column decreases. The use of nucleotide competitive inhibitors (UTP and ATP) as ligands in the affinity column has shown that the extent of inactivation of the enzyme is related to the affinity of the enzyme for the ligand. Further, the extent of inactivation was reduced by reducing the length of the columns when using the same volume of GTP-Sepharose. Dihydrofolate-Sepharose gave consistently higher yields of GTP cyclohydrolase I regardless of the amount of enzyme applied, but several other proteins were also obtained. For a high purification of GTP cyclohydrolase I the best yield may be obtained with UTP as the affinity ligand and with the shortest length possible of the affinity column, and the purity of enzyme is comparable with that obtained with GTP-Sepharose. PMID- 3519631 TI - Analytical affinity chromatography in studies of molecular recognition in biology: a review. AB - Measuring macromolecular and cellular interactions remains central to the study of recognition in biology and its application in biotechnology. Analytical affinity chromatography provides a versatile methodology to detect and quantitate such interactions. Both zonal and frontal elution approaches have been developed, essentially in parallel, for analytical affinity chromatography. A close quantitative relatedness of chromatographically obtained equilibrium constants and analogous constants determined fully in solution has been found for a growing number of proteins. This consistently observed correlation has formed the basis for extending theoretical treatments in order to evaluate not only monovalent molecular systems of varying types but also multivalently interacting macromolecules, including those which exhibit cooperativity. The potential to measure chemical rate constants by affinity chromatography also has been recognized, and experimental tests of the available theory are being made. As a micromethod, the quantitative use of affinity chromatography has important applicability for biochemical analysis of an increasing array of biologically active molecules being discovered and isolated but available in only relatively small amounts. Analytical affinity chromatography thus provides a means to use matrix--mobile interactant systems to study mechanisms of biomolecular interactions and therein to attain an understanding of such interactions which often is not easily achieved by solution methods alone. PMID- 3519632 TI - Zonal chromatographic analysis of the interaction of alcohol dehydrogenase with blue-sepharose. AB - The interaction between horse liver alcohol dehydrogenase and Reactive blue 2 immobilized on Sepharose CL-6B was measured by zonal chromatography. Each protein molecule was retained by a single immobilized dye using a Blue-Sepharose column containing a total of 1.38 mM dye. However, the protein was predominantly retained by two immobilized dye molecules using a darker Blue-Sepharose column containing a total of 11.6 mM dye. The dissociation constant measured for the alcohol dehydrogenase--immobilized dye complex on each column is identical to the inhibition constant for the alcohol dehydrogenase--free Reactive blue 2 complex: 4.5 +/- 0.8 microM. PMID- 3519633 TI - Crossed affinity immunoelectrophoresis of the Escherichia coli pyruvate dehydrogenase complex. AB - The crossed immunoelectrophoretic pattern obtained with the intact pyruvate dehydrogenase complex of Escherichia coli can be modified when this technique is combined with affinity gel electrophoresis using reactive dyes coupled to agarose as ligands. The patterns that arise have been interpreted with respect to localization of the three component enzymes. This was realized by using antibodies with different specificity, active enzyme staining and E2-E3 subcomplex behaviour. Dissociation of E1 subunits occurs more easily than that of E3 but remains incomplete in this system. The free reactive Procion Blue-MX dyes tested inactivate the complex even at neutral pH. The dyes react with all three components but E3 (80%) and E2 (15-20%) retain part of their catalytic activity. Modification leads to an enhanced dissociation of E1. PMID- 3519634 TI - Particle-labelled immunoassays: a review. AB - Up to now, various types of particles have been used as labels in immunoassay. Well known examples are erythrocytes and latex particles. More recently, colloidal gold and dye particles have been introduced as a label. Each type of particle offers one (or more) method(s) of detection which depend(s) on the physical properties of the particles. In this paper, the present state-of-the-art regarding particle-labelled immunoassays will be reviewed. PMID- 3519635 TI - Bioaffinity therapy with antibodies and drugs bound to soluble synthetic polymers. AB - Soluble synthetic copolymers based on N-(2-hydroxypropyl)methacrylamide (HPMA) containing different oligopeptide side-sequences were tested as transport molecules for drugs and anti-Thy 1.2 antibodies in affinity therapy. As target cells, T lymphocytes were studied. (1) HPMA copolymers containing targeting anti Thy 1.2 antibodies are 70 times more cytotoxic against T lymphocytes than HPMA copolymers with non-specific immunoglobulin. (2) Daunomycin conjugated to a biodegradable side-sequence (Gly-Phe-Leu-Gly) is effective in a concentration 100 times lower than daunomycin conjugated to a non-cleavable sequence (Gly-Gly). (3) HPMA copolymers containing drug and targeting antibodies are effective both in vitro and in vivo. PMID- 3519636 TI - Glycidyl methacrylate copolymers as suitable supports for immobilizing antigens and antibodies. AB - Glycidyl methacrylate copolymers modified with 1,6-diaminohexane were activated with glutaraldehyde. Such activated supports were directly bound to the chosen antisera. Prepared immunosorbents contained ca. 40 mg of bound protein and were able to purify 2-5 mg of antigen (alkaline proteinases Esperase and Maxatase) per 1 g of solid support. Chaotropic agent (2.5 M ammonium thiocyanate in phosphate or Tris buffer) enabled antigen to be released quickly, the properties of the immunosorbent remaining unchanged. PMID- 3519637 TI - Divinylsulphone-activated agarose. Formation of stable and non-leaking affinity matrices by immobilization of immunoglobulins and other proteins. AB - Divinylsulphone-activated agarose is an attractive alternative to several of the activated supports usually used. Unlike CNBr-activated gels, it does not leak the immobilized protein at high pH. It reacts readily with proteins at near-neutral pH (unlike the epoxy-activated supports). Generally, divinylsulphone-activated agarose reacts with amino, hydroxyl, and sulphydryl groups, thus allowing immobilization of a wide spectrum of ligands. Moreover, it is available in an aqueous suspension free of organic solvents and neither requires time-consuming swelling nor washing. PMID- 3519638 TI - Separation of human lymphoid cells by affinity chromatography and cell surface labelling by hydroxyethyl methacrylate particles using monoclonal antibodies. AB - The hydroxyalkyl methacrylate gel Separon, Sepharose 6MB and polystyrene dishes with bound antibodies were used for affinity chromatography of cells isolated from human tonsils and peripheral blood. Enrichment of T cells by filtration through anti-human immunoglobulin Separon or Sepharose 6MB columns was comparable to that achieved by "panning" on dishes or by Nylon wool column fractionation. High enrichment of B cells was obtained when cells pretreated with monoclonal anti-T cell antibodies were fractionated on columns or dishes where anti-mouse antibody was bound. Hydroxyethyl methacrylate copolymer microspheres were conjugated with monoclonal antibodies directed against surface markers of human lymphocytes or with anti-mouse immunoglobulin antibodies and used for surface labelling of cells. The results obtained by immunofluorescence were in good correlation with labelling by hydroxyethyl methacrylate immunobeads. PMID- 3519639 TI - Biospecific sorption, Prague, 1910: Emil Starkenstein (1884-1942). AB - Emil Starkenstein's paper (1910) on the influence of chloride on the enzymatic activity of liver amylase has been considered generally as the first experimental demonstration of the biospecific adsorption of an enzyme on a solid substrate. Emil Starkenstein's life is also briefly mentioned. PMID- 3519640 TI - Isolation, characterization and standardization of a major metabolite of amodiaquine by chromatographic and spectroscopic methods. AB - The amodiaquine metabolite 2-hydroxydesethylamodiaquine (designated metabolite II), one of the two major human metabolites of this antimalarial prodrug, is characterized by chromatographic and spectroscopic methods. This metabolite has been isolated in milligram quantities from the urine of an amodiaquine-dosed individual by extraction and preparative high-performance liquid chromatography (HPLC) and standardized using nuclear magnetic resonance spectroscopy with internal standardization. Aliquots of this standard provided accurately known amounts of the compound for spectroscopic characterization, for use as an HPLC standard and for assessment of in vitro activity against malaria parasites. Knowledge of the structure of the two major metabolites of amodiaquine (the other is desethylamodiaquine) permits speculation as to the presence of three additional human metabolites, chromatographic confirmation for one of which is demonstrated. The in vitro activity of metabolite II is shown to be 1% that of amodiaquine for two chloroquine-sensitive Plasmodium falciparum strains. Should this relationship hold generally, desethylamodiaquine is the only chemical species resulting from oral dosing with amodiaquine which contributes significantly to antimalarial activity in the blood. PMID- 3519642 TI - The bias caused by high values of incidence for p1 in the odds ratio assumption that 1-p1 approximately equal to 1. PMID- 3519641 TI - Complementary use of gel permeation and reversed-phase liquid chromatography for the analysis of A14-[125I]insulin and its degradation products in isolated human monocytes. PMID- 3519643 TI - Calculation of the systemic delivery rate of insulin in normal man. AB - The accuracy with which the systemic delivery rate of insulin can be estimated from peripheral insulin concentrations was investigated in eight normal men. Endogenous insulin secretion was suppressed by somatostatin, and insulin was infused exogenously via a peripheral vein. The infusion rate was progressively increased and then decreased to stimulate the changes in insulin secretion that occur after a secretory stimulus. The infusion rate of insulin was then estimated by analyzing peripheral insulin concentrations using both single and two compartment mathematical models and was compared with the actual infusion rates. Model parameters were measured in each subject by analysis of the insulin decay curve after a bolus injection. Estimated infusion rates based on the single compartment model were 84.3 +/- 3.0% (mean +/- SE) of the actual infusion rate as it was increasing and 110.3 +/- 3.7% of the infusion rate as it was decreasing. The mean overall absolute percent error associated with this approach was 14.1 +/ 1.0% (range, 10.2-18.8%), and model estimates of the total amount of insulin infused over the duration of the experiment were 97.1 +/- 3.2% of the quantity actually infused (range, 85.4-110.7%). Estimates of the infusion rate based on a two-compartment model represented 90.3 +/- 3.1% of the actual infusion rate as it was increasing and 98.2 +/- 3.2% of the actual rate as it was falling. The area under the derived infusion rate curve was 94.8 +/- 2.8% of the area under the actual curve. The overall error associated with the use of the two-compartment model was 12.9 +/- 1.1% (range, 8.8-18.6%). Differences between the single and two-compartment models were minor and not statistically significant. These data demonstrate that under euglycemic conditions, changes in the plasma insulin concentration within the physiological range are not associated with changes in the clearance kinetic rate constants of the hormone. Furthermore, the systemic delivery rate of insulin can be accurately derived from peripheral insulin concentrations using either a single or two-compartmental model if model parameters are accurately measured in individual subjects by analysis of insulin decay curves. PMID- 3519644 TI - A double blind controlled study of the hormonal and clinical effects of bromocriptine in the polycystic ovary syndrome. AB - Previous studies on the efficacy of bromocriptine for the treatment of patients with the polycystic ovary syndrome failed to include control groups. This study, therefore, was undertaken to determine the clinical and endocrine effects of bromocriptine and a placebo (given in a random double blind fashion) in 55 patients with PCOS. The plasma levels of estrone, estradiol, testosterone, androstenedione, dehydroepiandrosterone, dehydroepiandrosterone sulfate, 17 hydroxyprogesterone, and serum PRL and gonadotropins (LH and FSH) were measured before treatment. In addition the serum PRL response to TRH and the serum LH and FSH response to GnRH were determined. The effects of acute administration of bromocriptine (2 X 2.5 mg at 12-h intervals) on serum gonadotropins and their response to GnRH were studied to explore the possibility that this test might predict the response to chronic bromocriptine treatment. Bromocriptine then was given at an initial dose of 1.25 mg twice daily. If no clinical improvement occurred 2.5 mg were given twice daily for at least 6 months. Hormonal measurements and dynamic tests were repeated after 3 and 6 months of therapy. The endocrine profile of the two groups was not different before treatment. The clinical results were not better in the treatment group than in the placebo treated patients: therapy was successful (restoration of ovulatory cycles of less than 35 days duration) in 12 of 28 patients taking bromocriptine vs. 8 of 27 taking placebo. Slight improvement (1 or 2 ovulations) occurred in 3 of 28 vs. 3 of 27, and failure (no clinical change) in 13 of 28 taking bromocriptine vs. 16 of 27 taking placebo, respectively. Serum PRL fell significantly in the bromocriptine group, and there was a significant fall in the serum LH response to GnRH in both groups. No hormonal measurement or response predicted the clinical response to treatment. The only significant effect of chronic bromocriptine therapy (5 mg/day) in patients with the polycystic ovary syndrome was to lower the serum PRL concentration. PMID- 3519645 TI - Bio- and immunoactive luteinizing hormone responses to low doses of gonadotropin releasing hormone (GnRH): dose-response curves in GnRH-deficient men. AB - Previous investigations of the effects of GnRH on pituitary LH responses in normal men required pharmacological doses of GnRH to avoid the confounding effects of endogenous GnRH secretion and employed nonphysiological dose intervals. To examine the role of GnRH in determining both the qualitative and quantitative nature of physiological LH responses, we studied five GnRH-deficient men in whom pituitary and gonadal function had been normalized with GnRH replacement. Both bio- and immunoactive LH responses were evaluated in these men after a wide range of GnRH doses (7.5-250 ng/kg) administered at a physiological frequency (every 2 h), while gonadal steroid levels were within the normal adult male range. In addition, the amplitude and contour of the immunoactive LH pulses were compared to those of 15 normal men to assure that these experiments achieved physiological pituitary responses. The relationship between bio- and immunoactive LH was compared between patients, between doses as the amount of GnRH was increased, and within pulses of LH. As the dose of GnRH was increased, both bio- and immunoactive LH responses increased in a log-linear fashion when assessed by both amplitude (r = 0.96 for bioactive LH and r = 0.98 for immunoactive LH) and area under the curve (r = 0.99 for bioactive LH and r = 0.97 for immunoactive LH). GnRH doses of 7.5 and 25 ng/kg produced LH responses with amplitudes similar to those in normal men. The relationship between bio- and immunoactive LH between patients and between differing doses of GnRH was analyzed by comparing the slopes of lines fit to individual bioactive vs. immunoactive LH plots after each dose of GnRH in each patient. There was a marked variation in the relationship of bio- to immunoactive LH between patients (P less than 0.005). No change was found in the biopotency of LH as the dose of GnRH was increased (P less than 0.10). Finally, no variation of the bioactivity of LH was evident within individual pulses. We conclude that a log-linear relationship exists between doses of GnRH that produce physiological LH pulses and both bio- and immunoactive LH responses; the bioactivity of secreted LH varies markedly between patients; the relative bioactivity of LH in an individual does not change as the dose of GnRH is increased; and no change in bioactivity of LH responses was demonstrated within pulses of LH. PMID- 3519646 TI - Receptor-mediated endocytosis of polypeptide hormones is a regulated process: inhibition of [125I]iodoinsulin internalization in hypoinsulinemic diabetes of rat and man. AB - Much data suggest that receptor-mediated endocytosis is regulated in states of hormone excess. Thus, in hyperinsulinemic states there is an accelerated loss of cell surface insulin receptors. In the present experiments we addressed this question in hypoinsulinemic states, in which insulin binding to cell surface receptors is generally increased. In hepatocytes obtained from hypoinsulinemic streptozotocin-induced diabetic rats, [125I]iodoglucagon internalization was increased, while at the same time [125I]iodoinsulin internalization was decreased. The defect in [125I]iodoinsulin internalization was corrected by insulin treatment of the animal. In peripheral blood monocytes from patients with type I insulinopenic diabetes, internalization of [125I]iodoinsulin was impaired; this defect was not present in insulin-treated patients. These data in the hypoinsulinemic rat and human diabetes suggest that receptor-mediated endocytosis is regulated in states of insulin deficiency as well as insulin excess. Delayed or reduced internalization of the insulin-receptor complex could amplify the muted signal caused by deficient hormone secretion. PMID- 3519647 TI - Dopamine inhibits the aldosterone response to upright posture. AB - Aldosterone secretion in man is stimulated by potassium, ACTH, and angiotensin II and is inhibited by dopamine (DA). In normal sodium-replete supine individuals, aldosterone secretion is under maximum tonic inhibition by DA. Dopaminergic control of aldosterone secretion is modified by dietary sodium depletion. To determine the physiological significance of dopaminergic inhibition of aldosterone secretion, we studied the effect of DA on the aldosterone response to upright posture. Twelve normal men were studied while eating an ad libitum sodium diet, and the effect of DA was determined in the supine and upright positions. Plasma aldosterone (PAC), plasma cortisol (F), plasma aldosterone-stimulating factor (ASF), PRA, and blood pressure were measured while the men were supine and after 4 h of upright posture during an infusion of 5% dextrose vehicle and during a DA infusion of 4.0 micrograms/kg X min. The men also were studied as a time control in the supine position while receiving vehicle or DA. PAC increased from a mean basal value of 20.4 +/- 3.2 ng/dl (+/- SE) by 25.9 +/- 5.1 ng/dl to a peak of 44.4 +/- 2.4 ng/dl in response to upright posture during vehicle infusion. The PAC response to upright posture was reduced to 7.4 +/- 1.8 ng/dl (P less than 0.05) when DA was infused. The increase in PRA with upright posture was 3.7 +/- 1.3 ng/ml X h during the vehicle infusion and 4.1 +/- 1.1 ng/ml X h (P = NS) during the DA infusion. ASF, F, and blood pressure were not altered by upright posture and DA. PAC did not change in the six men infused with DA while supine. Therefore, DA inhibits upright aldosterone responses without affecting PRA, ASF, or F. PMID- 3519648 TI - In memoriam John Eager Howard, M.D. PMID- 3519649 TI - Insulin antagonism is not a primary abnormality of amyotrophic lateral sclerois but is related to disease severity. AB - Sensitivity to insulin was studied in 13 patients with amyotrophic lateral sclerosis (ALS) and 10 age- and weight-matched normal subjects by performing euglycemic clamp studies at low (1.5 mU/kg X min) and high (10 mU/kg X min) insulin infusion rates. Mean glucose disposal rates were similar in the ALS patients and normal subjects at both the low [4.8 +/- 0.6 (+/- SEM) vs. 5.2 +/- 0.6 mg/kg X min] and high (9.2 +/- 1.3 vs. 9.8 +/- 0.5 mg/kg X min) insulin infusion rates, respectively. Binding of [125I] iodoinsulin to monocytes was also similar in seven patients with ALS (3.8 +/- 1.0%/10(7) cells) and 10 normal subjects (3.9 +/- 0.9). However, glucose disposal rates correlated inversely with disease severity in the ALS patients, at both the low (r = -0.76; P less than 0.01) and high (r = -0.83; P less than 0.001) insulin infusion rates. We conclude that insulin antagonism is not a primary abnormality of ALS, but may be related to the inactivity associated with disease progression. PMID- 3519650 TI - Glucoregulatory function of thyroid hormones: interaction with insulin depends on the prevailing glucose concentration. AB - The effect of elevated serum thyroid hormone concentrations on insulin-induced glucose metabolism was studied in healthy subjects before and after T4 administration (250 micrograms T4/day for 10-14 days). This treatment induced moderate hyperthyroidism (T4, 15.2 micrograms/dl; T3, 200 ng/dl). The following results were obtained. Insulin receptor binding to a 90% enriched monocyte fraction or to mitogen-stimulated cultured T lymphocytes was decreased by T4 administration, whereas insulin binding to erythrocytes was unaffected. Despite down-regulation of cellular insulin receptors, T4 administration did not alter oral glucose tolerance, but increased the disappearance of glucose after an iv load and the amount of glucose metabolized during euglycemic clamp studies infusing 1.0 or 1.5 mU insulin/kg BW X min; no effect was found at insulin infusion rates of 0.5, 2.0, and 4.0 mU/kg X min. At increasing steady state plasma glucose levels (up to 175 mg/dl) and an insulin infusion rate of 1.0 mU/kg BW X min, T4 administration reduced insulin-induced glucose metabolism. We conclude that experimental hyperthyroidism decreases insulin receptor binding but increases insulin-induced glucose metabolism during euglycemia. This may be due to the direct effect of thyroid hormones on glucose metabolism; however, during hyperglycemia, thyroid hormone induced insulin resistance is unequivocal. PMID- 3519651 TI - Effects of ketone bodies on basal and insulin-stimulated glucose utilization in man. AB - Using the euglycemic clamp technique, we investigated the effects of high ketone body levels on basal and insulin-stimulated glucose utilization in normal subjects. Infusion of sodium acetoacetate in the postabsorptive state raised ketone body levels from 150 +/- 20 (+/- SE) mumol/liter to more than 1 mmol/liter. Endogenous glucose production declined from 2.71 +/- 0.20 mg kg-1 min 1 to 1.75 + 0.26 (P less than 0.01) and glucose utilization from 2.71 +/- 0.20 to 1.98 +/- 0.17 mg kg-1 min-1 (P less than 0.01), while blood glucose was maintained at the initial level by the infusion of glucose. There were no changes in plasma glucagon, insulin, or C-peptide. Plasma nonesterified fatty acids (P less than 0.01) and blood glycerol (P less than 0.01) and alanine (P less than 0.05) decreased, while blood lactate increased (P less than 0.01). Infusion of sodium bicarbonate had no effect on glucose kinetics. The decreases in glucose utilization and endogenous glucose production during the infusion of acetoacetate were not modified when the fall of plasma nonesterified fatty acids was prevented by iv heparin injection. During control euglycemic hyperinsulinemic clamps (1 and 10 mU kg-1 min-1 insulin infusion), endogenous glucose production was suppressed at the lowest insulin infusion rate; glucose utilization increased first to 7.32 +/- 0.96 mg kg-1 min-1 and then to 16.5 +/- 1.27 mg kg-1 min-1. During euglycemic hyperinsulinemic clamps with simultaneous sodium acetoacetate infusion, similar insulin levels were attained; endogenous glucose production was also suppressed at the lowest insulin infusion rate, and insulin-stimulated glucose utilization rates (7.93 +/- 1.70 and 15.80 +/- 1.30 mg kg-1 min-1) were not modified. In conclusion, acetoacetate infusion decreased basal, but not insulin-stimulated, glucose utilization. The increase in lactate during acetoacetate infusion in the postabsorptive state suggests that ketone body acted by decreasing pyruvate oxidation. PMID- 3519652 TI - Enolase subunits in patients with neuroendocrine tumors. AB - Concentrations of the alpha-, beta-, and gamma-subunits of enolase in surgically resected tumors and serum obtained from patients with various endocrine tumors were measured by a sensitive enzyme immunoassay system. Tissue concentrations of the gamma-subunit were significantly elevated in patients with neuroendocrine tumors concurrent with high concentrations of the gamma-subunit in their serum, which fell to normal in 90% of those who underwent tumor resection. Immunohistochemical analysis revealed that considerable amounts of the gamma subunit were contained specifically in these tumors. These results indicate that the gamma-subunit of enolase is a useful marker for diagnosing and monitoring patients with neuroendocrine tumors. PMID- 3519653 TI - Clinical and laboratory features of patients with an inherited deficiency of neutrophil membrane complement receptor type 3 (CR3) and the related membrane antigens LFA-1 and p150,95. AB - Over the last 3 years a group of more than 20 patients has been described worldwide who have a similar history of recurrent bacterial infections and an inherited deficiency of three related leukocyte membrane surface antigens known as CR3, LFA-1 (lymphocyte function-associated antigen type 1), and p150,95 (function unknown). These antigens share a common beta-chain structure linked noncovalently to one of three distinct alpha-chain types. It is believed that the patients with this disease have a reduced or absent ability to synthesize the common beta subunit of the antigen family, resulting in absent or reduced expression of all three antigen family members on different leukocyte types. Neutrophils have a reduced phagocytic and respiratory burst response to bacteria and yeast as well as a reduced ability to adhere to various substrates and migrate into sites of infection. In vitro functional studies of normal neutrophils, monocytes, and lymphocytes treated with monoclonal antibodies to the individual alpha and beta chains of these antigens suggest that most of the clinical features of the patients may be due to the neutrophil and monocyte deficiency of CR3. Although natural killer-cell activity is diminished or absent, no immune deficiency of the patients' lymphocytes attributable to the absence of LFA-1 has been detected. Diagnosis of this disease has been facilitated by the commercial availability of monoclonal antibodies specific for the alpha chains of CR3 and p150,95. PMID- 3519655 TI - [Methyl bromide poisoning]. PMID- 3519654 TI - Appearance of multiple benign paraproteins during early engraftment of soy lectin T cell-depleted haploidentical bone marrow cells in severe combined immunodeficiency. AB - Recent advances in the prevention of graft-versus-host disease through postthymic T-cell depletion have allowed the use of haploidentical bone marrow cells for immunologic reconstitution of severe combined immunodeficiency disease. We report a male infant with severe combined immunodeficiency (with normal adenosine deaminase) who developed two IgG kappa and one IgA lambda paraproteins 7 weeks following the administration of 1.4 X 10(9) maternal bone marrow cells depleted of postthymic T cells by soy lectin agglutination and sheep erythrocyte rosetting. Serum IgG rose from 128 to 820 mg/dl, and IgA from 0 to 2400 mg/dl, peaking at 10 weeks postgrafting. By 14 weeks posttransplantation T-cell numbers and function had risen to normal (all dividing T cells had the donor karyotype) and paraprotein concentrations began to decline. These observations strongly suggest that the later-appearing T cells regulated the B-cell clones from which the paraproteins were derived. Failure of such function to appear could account for the increased incidence of B-cell lymphomas in severe combined immunodeficiency. PMID- 3519656 TI - [Theory and clinical applications of diagnostic imaging methods (7). Obstetrical and gynecological disorders, with reference to the diagnosis of gestation and radiation effects on the gravida]. PMID- 3519658 TI - Sorbitol-MacConkey medium for detection of Escherichia coli O157:H7 associated with hemorrhagic colitis. AB - Escherichia coli serotype O157:H7 is a recently recognized human pathogen associated with hemorrhagic colitis. Unlike most E. coli strains, E. coli O157:H7 does not ferment sorbitol. Therefore, the efficacy of MacConkey agar containing sorbitol (SMAC medium) instead of lactose as a differential medium for the detection of E. coli O157:H7 in stool cultures was determined in comparison with MacConkey agar. The relative frequency of non-sorbitol-fermenting (NSF) organisms other than E. coli O157:H7 in feces was low at 10 to 20% (95% confidence limits), and NSF organisms also occurred mostly in small numbers. In a field trial involving over 1,000 diarrheal stools, E. coli O157:H7 was isolated from 18 stools, all of which were from patients with bloody diarrhea. In every instance, the growth of E. coli O157:H7 on SMAC medium was heavy and occurred in almost pure culture as colorless NSF colonies in contrast to fecal flora, which are mostly sorbitol fermenting and hence appear pink on this medium, whereas on MacConkey agar cultures, the growth of E. coli O157:H7 was indistinguishable from fecal flora. SMAC medium permitted ready recognition of E. coli O157:H7 in stool cultures. Detection of E. coli O157:H7 on SMAC medium had a sensitivity of 100%, a specificity of 85%, and an accuracy of 86%. SMAC medium stool culture is a simple, inexpensive, rapid, and reliable means of detecting E. coli O157:H7, and we recommend routine use of SMAC medium especially for culturing bloody stools. PMID- 3519657 TI - Relationships between rotavirus diarrhea and intestinal microflora establishment in conventional and gnotobiotic mice. AB - Intestinal microflora did not play a role in the intensity or course of EDIM rotavirus-induced diarrhea, since similar results were observed in axenic and conventional mice. In conventional mice, rotavirus-induced diarrhea did not modify the establishment of Lactobacillus spp. and Escherichia coli before weaning. The consequences of diarrhea on the establishment of strictly anaerobic bacteria after weaning were studied through the measurement of two bacterial functions, the microbial barrier effect against E. coli and the development of the immunoglobulin A intestinal immune system. These two bacterial functions were expressed in a similar way in diarrheic and control mice. In young gnotobiotic mice inoculated with Clostridium perfringens or C. difficile, rotavirus infection led to an earlier development of both strains, as compared with controls. This effect was more pronounced with C. difficile. These results suggest that rotavirus infections might enhance opportunistic bacterial infections. PMID- 3519659 TI - Treponemal antibody-absorbent enzyme immunoassay for syphilis. AB - An enzyme immunoassay for the diagnosis of syphilis (ELISA-SY) was developed with solid-phase extracts of Treponema pallidum, specimen diluent containing Reiter treponeme absorbent, and three 30-min incubations. The ELISA-SY results were determined in comparison with a standardized positive control and reported as a percentage of strong positive control. In tests with 1,005 serum samples from a venereal disease clinic and other sources, 98.2% agreement was found with fluorescent treponemal antibody-absorption (FTA-ABS) results, and 98.3% agreement was found with T. pallidum passive hemagglutination (PHA) findings. Only 1 of 29 sera originally considered to be biologically false-positive by ELISA-SY; the latter specimen was also positive by PHA and FTA-ABS tests performed in our laboratories. Serum samples from clinically diagnosed syphilitics (16 primary stage isolates, 7 secondary-stage isolates, and 3-latent-stage isolates) were all positive by ELISA-SY, FTA-ABS, and PHA. Serum samples from 51 newborns suspected of having syphilis on the basis of positive cardiolipin flocculation tests showed 98% agreement of ELISA-SY results with FTA-ABS and PHA findings. Sera from all 61 patients with a variety of autoimmune and other diseases known to be associated with biologically false-positive reactions for syphilis were negative by this ELISA-SY. The specificity of the ELISA procedure for T. pallidum antibody was also confirmed immunologically by blocking experiments. PMID- 3519660 TI - Production and characterization of agglutinating monoclonal antibodies against predominant antigenic factors for Candida albicans. AB - Two clones, CA4-2 and CA5-4, which produced agglutinating monoclonal immunoglobulin M (IgM) antibodies (MAbs) against mannan antigens of Candida albicans serotype A, were established. The specificity of each MAb was determined by slide agglutination tests for cross-reactivity patterns against the homologous and six other strains of Candida and a strain of Torulopsis: C. albicans serotype B, C. tropicalis, C. guilliermondii, C. krusei, C. parapsilosis, C. pseudotropicalis, and Torulopsis glabrata. The MAb produced by CA4-2 reacted with the homologous, C. tropicalis, and T. glabrata strains, whereas the MAb produced by CA5-4 reacted with the homologous, C. albicans serotype B, and C. tropicalis strains. These results are consistent with results obtained by comparative experiments with several strains of each serotype or species. Specificity of these two MAbs by agglutination was also consistent with the cross-reactivity patterns demonstrated by indirect immunofluorescence staining. The competitive binding experiments by immunofluorescence staining with two MAbs and polyclonal factor sera (PAb factors) 5 and 6 suggested that the MAb from clone CA4-2 did not completely correspond to PAb factor 6 and that the MAb from CA5-4 was distinct from PAb factor 5 in its manner of binding to determinants (the latter was designated 5b), Cross-reactivity patterns, however, furnished evidence that these two MAbs could replace the known PAb factors 6 and 5, respectively, as reagents for aid in the identification of the strains of C. albicans and their serotypes. PMID- 3519661 TI - Enrichment for detection of Campylobacter jejuni. AB - Gifu anaerobe-modified semisolid medium supplemented with vancomycin, polymyxin B, trimethoprim, and amphotericin B can serve as an efficient enrichment for the recovery of Campylobacter jejuni under aerobic conditions. It is superior to the direct plating method in its recovery of very small numbers of C. jejuni. Blood supplementation, agitation, and elevated temperatures are not required for this improved recovery. PMID- 3519662 TI - Detection of rotavirus in stool specimens with monoclonal and polyclonal antibody based assay systems. AB - Accurate diagnosis of rotavirus is important in both clinical and research situations. A total of 100 stool specimens from children with diarrhea were tested for rotavirus by electron microscopy. These specimens were then coded and tested for rotavirus by four procedures: a monoclonal antibody-based enzyme immunoassay (EIA) (Pathfinder; Kallestad Laboratories, Inc., Austin, Tex.), two polyclonal antibody-based EIAs (Rotazyme II; Abbott Laboratories, North Chicago, Ill.; and an EIA performed with reagents from the National Institutes of Health, Bethesda, Md. [NIH reagent EIA]), and a latex agglutination (LA) assay (Rotalex; Medical Technology Corp., Somerset, N.J.). The sensitivity of the monoclonal antibody EIA (95%) was superior to those of the polyclonal antibody EIAs (73% for Rotazyme II and 57% for the NIH reagent EIA) and the LA assay (61%). The specificity of the LA assay (98%) was slightly better than those of the other systems (88 to 96%). The positive and negative predictive values of the monoclonal antibody EIA (93 and 96%, respectively) were better than those of Rotazyme II (82 and 80%, respectively), the LA assay (96 and 76%, respectively), and the NIH reagent EIA (93 and 74%, respectively). The visual readings of the monoclonal antibody EIA correlated better with the spectrophotometric optical density readings than did the visual readings of the polyclonal antibody EIAs; however, the agreement of both with electron microscopy results was poor when 1+ or plus-minus readings were observed. The monoclonal antibody EIA is more sensitive and predictive than other rotavirus detection systems and second only to the LA assay in specificity in detecting rotavirus in stool specimens. PMID- 3519663 TI - Isolation and identification of a Giardia lamblia-specific stool antigen (GSA 65) useful in coprodiagnosis of giardiasis. AB - A Giardia lamblia-specific antigen (GSA 65) was isolated from stools of G. lamblia-positive patients by crossed- and line-immunoelectrophoresis and counterimmunoelectrophoresis (CIE) in agarose by using rabbit antiserum prepared against G. lamblia cysts. CIE with rabbit anti-GSA 65 monospecific antiserum revealed that GSA 65 was present in aqueous stool eluates of giardiasis patients and in cysts and trophozoites of the parasite. Sodium dodecyl sulfate polyacrylamide gel electrophoresis of immunoaffinity-purified antigen followed by Western blotting showed that the molecular weight of this molecule was about 65,000. GSA 65 was detectable by CIE in stool eluates of 36 of 40 giardiasis patients but not in eluates of 10 G. lamblia-negative asymptomatic controls. GSA 65 was detected in stool eluates of 2 of 18 individuals with chronic diarrhea who were negative for parasites by microscopic examination. Cross-specificity studies with other genera of parasitic protozoa performed by using CIE and immunofluorescence indicated that GSA 65 was present only in strains of G. lamblia. Based on these findings, GSA 65 may prove to have an important application in the design of sensitive diagnostic tests for giardiasis. PMID- 3519664 TI - Role of proteinase in the formation of inhibitory levels of hematin by group A streptococcus cultures on blood-containing media. AB - Group A streptococci were tested for proteinase production and for the possible relationship of this production to the generation of bacteriocinlike inhibitor activity. Of 126 strains tested, 83% were positive for proteinase, and a similar distribution was found among strains isolated in association with rheumatic fever (89%) and nephritis (94%) and from uncomplicated acute infections (78%). Although application of an inhibitor production (P) typing scheme demonstrated a variety of P types, all of the proteinase-positive strains produced inhibitory activity and over 65% of these strains were P type 204. It was shown that hematin was responsible for this P type 204 activity and that it was produced only by actively proteolytic strains when grown on a hemoglobin-containing medium. Conditions optimizing proteinase production (anaerobic incubation at 37 degrees C on a test medium prepared from Columbia agar base [GIBCO Laboratories, Grand Island, N.Y.]) increased P type 204 activity. Interference with proteinase activity either by growth of the cultures at an alkaline pH or by incorporation of sub-growth inhibitory concentrations of either iodoacetic acid or lincomycin into the medium prevented production of P type 204 activity. Whether significant conversion of hemoglobin to hematin occurs in vivo and the possible implications of this conversion with regard to the pathogenesis of group A streptococcal infections remain to be determined. PMID- 3519665 TI - T-cell detection with monoclonal antibody T101 kits. AB - A solid-phase immunoadsorption procedure (Quantigen T&B cell kit; Bio-Rad Laboratories, Richmond, Calif.) employing monoclonal antibody T101 detected mean percentages of peripheral blood T cells comparable to those obtained by rosetting with sheep erythrocytes, while lower values were obtained with an indirect immunofluorescence procedure (Cytotag T&B cell kit; Hybritech, Inc., San Diego, Calif.) employing the same antibody. Therefore, T101 binding appears to be more easily detected by solid-phase immunoadsorption than by immunofluorescence microscopy. PMID- 3519667 TI - Rapid lysostaphin test to differentiate Staphylococcus and Micrococcus species. AB - A rapid, simple lysostaphin lysis susceptibility test to differentiate the genera Staphylococcus and Micrococcus was evaluated. Of 181 strains from culture collections, 95 of 95 Staphylococcus strains were lysed, and 79 of 79 Micrococcus strains were not lysed. The seven Planococcus strains were resistant. Clinical isolates (890) were tested with lysostaphin and for the ability to produce acid from glycerol in the presence of erythromycin. Overall agreement between the methods was 99.2%. All clinical Micrococcus strains (43) were resistant to lysostaphin, and all clinical Staphylococcus strains (847) were susceptible. Seven of the Staphylococcus strains did not produce acid from glycerol in the presence of erythromycin. This lysostaphin test provides results in 2 h. It is easier to perform than previously described lysostaphin lysis methods. It is also more rapid and accurate than the glycerol-erythromycin test. PMID- 3519666 TI - Appearance of specific antibody-bearing cells in human bronchial mucosa after local immunization with bacterial vaccine. AB - The immune response to local in vivo inhalation of a lysed bacteria vaccine was assessed in surgical specimens of main-stem bronchi from patients who had undergone pneumectomy for cancer. The patient population included 22 subjects; 11 of these received the aerosol vaccine twice a day for 10 days prior to surgery, while the remaining 11 patients were used as controls and were not immunized. The submucous glands of immunized subjects showed significantly more cells than did those of the controls, i.e., 62 +/- 8 versus 37 +/- 7, respectively (P less than 0.05). The following five antigens were chosen for study by fluorescence assay: Streptococcus pneumoniae types II and III, Haemophilus influenzae, Streptococcus sp. strain D19, and Klebsiella pneumoniae. An immunization-dependent correlation was found between immunoglobulin A, immunoglobulin A-bearing cells, and specific antibody-bearing cells on the one hand and three of the five antigens (S. pneumoniae types II and III and Streptococcus sp. strain D19) on the other hand. This is the first time that a relationship has been established between bacterial immunization of the lower respiratory tract and local immunoglobulin production in humans. PMID- 3519668 TI - Detection of Pseudomonas mesophilica as a source of nosocomial infections in a bone marrow transplant unit. AB - Pseudomonas mesophilica was isolated from fungal blood cultures of two bone marrow transplant recipients who consecutively occupied the same room. The isolation of P. mesophilica was temporally associated with febrile illness in these two granulocytopenic patients at 1 and 3 weeks posttransplant. A third patient, housed separately on the same bone marrow transplant unit, had nasopharyngeal colonization by this organism. Epidemiologic risk factors in common included staff, medications, and oral and perineal irrigations with tap water. Surveillance cultures detected P. mesophilica in none of 24 pharmaceutical preparations and in 10 of 40 tap water samples (100 to 600 CFU/ml) from implicated and control rooms on the same floor. Antimicrobial susceptibility testing of 14 patients and environmental isolates by agar dilution revealed similar profiles; some environmental isolates exhibited higher MICs. Because of restrictive nutritional and temperature requirements, P. mesophilica is undetected by many clinical laboratory protocols and may represent a previously undetected source of febrile illness in neutropenic patients. PMID- 3519669 TI - In vitro evaluation of combined usage of fosfomycin and 5-fluorouracil for selective isolation of Leptospira species. AB - The combined usage of fosfomycin (FOM) and 5-fluorouracil (5-FU) as selective agents for the isolation of leptospires from contaminated materials was investigated. Additive or synergistic antibacterial activity was apparent with the combination compared with each agent used separately. Of 54 bacterial strains tested, 52 were inhibited, while all 5 Leptospira strains tested were unaffected by the combined addition of FOM (400 micrograms/ml) and 5-FU (100 micrograms/ml) to Korthof medium. Furthermore, this combination successfully supported the selective growth of Leptospira interrogans serovar copenhageni in experimentally contaminated specimens. This FOM-5-FU combination is surmised to be useful for the selective isolation of leptospires from contaminated clinical, pathological, or environmental materials. PMID- 3519670 TI - Attempted isolation of viruses from myasthenia gravis thymus. AB - A systematic study of thymus homogenates and cell suspensions from 13 patients with myasthenia gravis (MG) of recent onset, and 6 non-myasthenic controls, has failed to detect or isolate virus by cell culture with 'rescue techniques', electron microscopy, or intracerebral inoculation into neonatal mice. These results do not support the case for persistent viral infection in the thymus, and impose constraints on hypotheses of a viral aetiology of MG. PMID- 3519671 TI - Isolation and characterization of a new peptide from hypothalamus and pituitary using a monoclonal antibody to LHRH. AB - A new peptide with LHRH-like immunoreactivity has been isolated from rat hypothalamus and pituitary using an immunosorbent prepared with monoclonal antibody to luteinizing hormone-releasing hormone (LHRH). This peptide contains part of the C-terminal sequence of LHRH and has a molecular weight of about 2000. It comprises over 20% of hypothalamic immunoreactivity recognized by the monoclonal antibody. Chromatographic and amino acid analysis data confirm the distinction between this peptide and LHRH. Immunocytochemical evidence is consistent with its being a normal constituent of the LHRH system, while its presence in the pituitary suggests that it may play a role in the regulation of this gland. PMID- 3519672 TI - Keys to success in lingual therapy. Part 1. PMID- 3519673 TI - Cheek bumper. PMID- 3519674 TI - Bracket positioning gauge. PMID- 3519675 TI - Posterolateral fusion for spondylolisthesis in adolescence. AB - Previous reports of posterolateral fusion for treatment of adolescent spondylolisthesis at L5-S1 suggest that persistent slippage is a significant problem in the postoperative period. Of 40 adolescent patients who underwent posterolateral fusion for L5-S1 spondylolisthesis, 23 demonstrated Grade 3 slip or worse. Two patients had progression of the slip postoperatively with subsequent spontaneous healing. All patients had complete incorporation of bone graft with resolution of neurologic deficits and pain. Improvement in results is attributed to the surgical technique and to postoperative casting. The displacement index, a new method to document relative L5-S1 position, is described. PMID- 3519676 TI - Treatment of aneurysmal bone cysts in childhood. AB - Twenty-five aneurysmal bone cysts were treated by curettage, saucerization, or resection. Healing occurred in all cysts of the long bones that were treated by saucerization and bone grafting or by resection and bone grafting. However, healing occurred in only half of the cysts of the long bones that were treated by curettage and bone grafting. In contrast, removal of the soft tissue contents from cysts of the pelvis, without curettage of bone or bone grafting, was sufficient to initiate healing. Although there was an apparent difference in the behavior of cysts of the long bones and pelvis, it is likely that the essential component of treatment at both sites is to remove the vascular soft tissue from the cyst. PMID- 3519677 TI - Group C streptococcal osteomyelitis. AB - A case of hematogenous osteomyelitis due to a group C Streptococcus (Streptococcus equisimilis) is presented because of the unusual nature of the infecting organism. Group C streptococci are common pathogens in animals but are infrequent causes of human infections. Of therapeutic concern is the observation that these isolates are frequently penicillin-tolerant. For this reason, it is important to speciate beta-hemolytic streptococcal isolates and to perform antimicrobial susceptibility studies. PMID- 3519678 TI - Multiple biological activities of human recombinant interleukin 1. AB - Complementary DNA coding for human monocyte interleukin 1 (IL-1), pI 7 form, was expressed in Escherichia coli. During purification, IL-1 activity on murine T cells was associated with the recombinant protein. Homogeneous human recombinant IL-1 (hrIL-1) was tested in several assays to demonstrate the immunological and inflammatory properties attributed to this molecule. hrIL-1 induced proliferative responses in a cloned murine T cell in the presence of suboptimal concentrations of mitogen, whereas no effect was observed with hrIL-1 alone. At concentrations of 0.05 ng/ml, hrIL-1 doubled the response to mitogen (5 X 10(6) half maximal units/mg). Human peripheral blood T cells depleted of adherent cells underwent a blastogenic response and released interleukin 2 in the presence of hrIL-1 and mitogen. hrIL-1 was a potent inflammatory agent by its ability to induce human dermal fibroblast prostaglandin E2 production in vitro and to produce monophasic (endogenous pyrogen) fever when injected into rabbits or endotoxin-resistant mice. These studies establish that the dominant pI 7 form of recombinant human IL 1 possesses immunological and inflammatory properties and acts on the central nervous system to produce fever. PMID- 3519679 TI - Defective suppression by insulin of leucine-carbon appearance and oxidation in type 1, insulin-dependent diabetes mellitus. Evidence for insulin resistance involving glucose and amino acid metabolism. AB - To determine whether a resistance to insulin in type 1, insulin-dependent diabetes mellitus (IDDM) is extended to both glucose and amino acid metabolism, six normal subjects and five patients with IDDM, maintained in euglycemia with intravenous insulin administration, were infused with L-[4,5-3H]leucine (Leu) and [1-14C]alpha ketoisocaproate (KIC). Steady-state rates of leucine-carbon appearance derived from protein breakdown (Leu + KIC Ra) and KIC (approximately leucine) oxidation were determined at basal and during sequential euglycemic, hyperinsulinemic (approximately 40, approximately 90 and approximately 1,300 microU/ml) clamps. In the euglycemic postabsorptive diabetic patients, despite basal hyperinsulinemia (24 +/- 6 microU/ml vs. 9 +/- 1 microU/ml in normals, P less than 0.05), Leu + KIC Ra (2.90 +/- 0.18 mumol/kg X min), and KIC oxidation (0.22 +/- 0.03 mumol/kg X min) were similar to normal values (Leu + KIC Ra = 2.74 +/- 0.25 mumol/kg X min) (oxidation = 0.20 +/- 0.02 mumol/kg X min). During stepwise hyperinsulinemia, Leu + KIC Ra in normals decreased to 2.08 +/- 0.19, to 2.00 +/- 0.17, and to 1.81 +/- 0.16 mumol/kg X min, but only to 2.77 +/- 0.16, to 2.63 +/- 0.16, and to 2.39 +/- 0.08 mumol/kg X min in the diabetic patients (P less than 0.05 or less vs. normals at each clamp step). KIC oxidation decreased in normal subjects to a larger extent than in the diabetic subjects. Glucose disposal was reduced at all insulin levels in the patients. In summary, in IDDM: (a) Peripheral hyperinsulinemia is required to normalize both fasting leucine metabolism and blood glucose concentrations. (b) At euglycemic hyperinsulinemic clamps, lower glucose disposal rates and a defective suppression of leucine carbon appearance and oxidation were observed. We conclude that in type 1 diabetes a resistance to the metabolic effects of insulin on both glucose and amino acid metabolism is present. PMID- 3519680 TI - Fibronectin mediates adherence of rat alveolar type II epithelial cells via the fibroblastic cell-attachment domain. AB - The lung alveolar surface is composed of types I and II epithelial cells. Extremely attenuated type I cells cover 90% of the surface and are prone to necrosis during acute lung injury. After denudation of type I cells, the alveolar epithelium is restored by proliferation of type II cells. During reepithelialization in vivo the type II cells have been observed to reorganize on an extracellular matrix that contains fibronectin. We thus sought to determine whether type II cells would adhere to purified fibronectin. Adherence assays of primary rat type II cells were performed in protein-coated bacteriologic microtiter wells for 24 h at 37 degrees C. Concentrations of fibronectin from 1 to 300 micrograms/ml mediated type II cell adherence, 10 micrograms/ml gave maximal adherence, and 4 micrograms/ml gave 50% maximal adherence. Adherence progressively increased from 1 to 72 h. Adherence on fibronectin was at least 50% greater than adherence on laminin, types I and III collagen, or IV collagen. Little or no adherence was observed on bacteriologic plastic or albumin. Spreading on these various substrata paralleled adherence. Adherence to fibronectin, laminin, and fibrinogen was specifically blocked by their respective polyclonal antibodies. Monoclonal antibodies (MoAb) to the fibronectin cell attachment domain blocked adherence to fibronectin, whereas MoAb to other domains did not. From the data reported here and the previously mentioned in vivo study we propose that fibronectin is an important functional component of the extracellular matrix that supports type II cells during alveolar reepithelialization. PMID- 3519681 TI - Posttranslational processing of secretory component in the rat jejunum by a brush border metalloprotease. AB - Secretory component (SC) is a glycoprotein that mediates the transcellular transport of polymeric immunoglobulins into external secretions. SC is synthesized and inserted into the plasma membrane of epithelial cells and hepatocytes as a transmembrane protein, where it serves as a receptor for polymeric immunoglobulins. SC is posttranslationally cleaved to a soluble protein before secretion into external fluids. In the rat jejunum, we observed that the molecular weights of both the major membrane and soluble forms of SC were 10,000 20,000 smaller than the comparable hepatic forms of the glycoprotein. We therefore set out to determine the reason for the differences in size of SC between these two tissues. The smaller size of jejunal SC was not due to the action of pancreatic proteases or differential glycosylation but was due to proteolysis by a jejunal brush border protease. The protease was characterized as a metalloprotease, with a pH optimum of approximately 5. It is present in jejunal, ileal, and renal tubular brush borders as an integral membrane constituent. When the protease was inhibited in vivo, conversion of jejunal secretory component to the smaller size was partially prevented. Thus, in the rat jejunum, SC undergoes two posttranslational proteolytic events: conversion of membrane secretory component to the soluble form and conversion of soluble SC to a smaller size by a previously undescribed brush border protease. PMID- 3519682 TI - Human fetal and adult chondrocytes. Effect of insulinlike growth factors I and II, insulin, and growth hormone on clonal growth. AB - Clonal proliferation of freshly isolated human fetal chondrocytes and adult chondrocytes in response to human insulinlike growth factors I and II (IGF I, IGF II), human biosynthetic insulin, and human growth hormone (GH) was assessed. IGF I (25 ng/ml) stimulated clonal growth of fetal chondrocytes (54 +/- 12 colonies/1,000 inserted cells, mean +/- 1 SD), but IGF II (25 ng/ml) was significantly more effective (106 +/- 12 colonies/1,000 inserted cells, P less than 0.05, unstimulated control: 14 +/- 4 colonies/1,000 inserted cells). In contrast, IGF I (25 ng/ml) was more effective in adult chondrocytes (42 +/- 6 colonies/1,000 inserted cells) than IGF II (25 ng/ml) (21 +/- 6 colonies/1,000 inserted cells; P less than 0.05, unstimulated control: 6 +/- 3 colonies/1,000 inserted cells). GH and human biosynthetic insulin did not affect clonal growth of fetal or adult chondrocytes. The clonal growth pattern of IGF-stimulated fetal and adult chondrocytes was not significantly changed when chondrocytes were first grown in monolayer culture, harvested, and then inserted in the clonal culture system. However, the adult chondrocytes showed a time-dependent decrease of stimulation of clonal growth by IGF I and II. This was not true for fetal chondrocytes. The results are compatible with the concept that IGF II is a more potent stimulant of clonal growth of chondrocytes during fetal life, whereas IGF I is more effective in stimulating clonal growth of chondrocytes during postnatal life. PMID- 3519683 TI - Activation of endogenous factor V by a homocysteine-induced vascular endothelial cell activator. AB - Vascular endothelium possesses multiple procoagulant properties, including synthesis and expression of Factor V. We studied the effects of homocysteine on the regulation of endothelial cell Factor V activity. Elevated levels of homocysteine are associated with the congenital thrombotic disorder homocystinuria. Treatment of cultured endothelial cells with 0.5-10 mM homocysteine had no effect on cell morphology, but did increase Factor V activity and prothrombin activation by Factor Xa. A radioimmunoassay for endothelial cell Factor V demonstrated that homocysteine treatment did not increase Factor V antigen levels. 125I-prothrombin was activated by treated endothelial cells and Factor Xa in the presence of thrombin inhibitors. Exogenous 125I-Factor V was cleaved by homocysteine-treated but not control endothelial cells. 125I-Factor V cleavage products distinct from those generated by thrombin and Factor Xa were identified. These data provide evidence for regulation of endothelial cell Factor V activity, and indicate that increased Factor V activity associated with homocysteine-treated vascular endothelium results primarily from induction of an activator of Factor V. PMID- 3519686 TI - Confabulation and delusional denial: frontal lobe and lateralized influences. AB - Various forms of confabulation, including denial of illness (e.g., paralysis, blindness), and conditions that often give rise to these disorders, such as cerebral disconnection, disinhibitory states, incomplete information reception, and "gap filling" are discussed. On the basis of clinical observation and a review of a number of studies, it appears that confabulatory states frequently are associated with cerebral damage that involves the right hemisphere, notably, the frontal (often bilaterally) and parietal lobes--areas intimately involved in arousal, attention, information regulation, and integration. With certain forms of injury, initially there appear disturbances in the organization, integration, and assimilation of ideas and associations, such that large gaps appear in the information transmitted to and received by the language axis of the left hemisphere. It is argued that in these instances, the language areas act so as to fill these "gaps" with information that, although inappropriate, is linked in some manner to the fragments received. In contrast, frontal lobe damage sometimes results in gross disinhibition and cortical overresponsiveness and, thus, speech release due to the flooding of the language axis (and other cortical regions) with tangential, fantastical, and grandiose associations. Other forms of confabulation also are reviewed briefly. PMID- 3519684 TI - Oxidative regulation of neutrophil elastase-alpha-1-proteinase inhibitor interactions. AB - Triggered human neutrophils were able to maintain released elastase in an active form in the presence of purified alpha-1-proteinase inhibitor (alpha-1-PI), serum or bronchoalveolar lavage fluid (BAL). The accumulation of free elastase activity was associated with a decrease in the ability of the alpha-1-PI to inhibit porcine pancreatic elastase, an increase in proteinase activity associated with alpha-2-macroglobulin, and the oxidation of alpha-1-PI to a molecule containing four methionine sulfoxide residues. Neutrophils used both hypochlorous acid and long-lived N-chloroamines to oxidize the alpha-1-PI, but hypochlorous acid was preferentially used for suppressing the activity of the antiproteinase over short distances whereas the N-chloroamines were effective even when the phagocytes and alpha-1-PI were physically separated. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis of purified alpha-1-PI, serum, or BAL that had been incubated with triggered neutrophils revealed that the released neutrophil elastase was not complexed with the antiproteinase and that a portion of the alpha-1-PI had undergone proteolysis. These data suggest that the presence of free neutrophil elastase as well as inactive, oxidized, and proteolyzed alpha-1-PI in fluids recovered from inflammatory sites in vivo could be directly mediated by triggered neutrophils alone. PMID- 3519685 TI - Effects of aging on glucose-mediated glucose disposal and glucose transport. AB - To assess the effects of aging on glucose-mediated glucose disposal and glucose transport, glucose disposal rates were measured in 10 nonelderly (32 +/- 4 yr) and 11 elderly (64 +/- 4 yr) subjects at five different plasma glucose concentrations. Glucose disposal was decreased by 30-35% in the elderly at each level of glycemia (100-350 mg/dl) in the presence of similar levels of hyperinsulinemia (approximately 100 microU/ml), and the 50% effective concentration (EC50) was similar in both the nonelderly (100 +/- 9) and elderly (103 +/- 5 mg/dl). The Michaelis constant (Km) of 3-O-methyl glucose transport in adipocytes was unchanged with aging (3.8 +/- 0.5 vs. 3.2 +/- 0.2 mM) while the maximum velocity of insulin stimulated transport was reduced by 34% in the elderly (8.3 +/- 1.3 vs. 12.6 +/- 1.5 pmol/5 X 10(4) cells per s, P less than 0.05). The insulin resistance of aging is therefore due to a reduction in the capacity of the glucose uptake system, while the affinity of glucose utilization (EC50 and Km) is unchanged. This supports the hypothesis that a reduction in the number of glucose transport and metabolic units occurs with aging, but that each unit functions normally. PMID- 3519687 TI - The treatment of primary biliary cirrhosis. PMID- 3519688 TI - Recent advances in pharmaceutical chemistry. The 4-quinolone antibiotics. PMID- 3519689 TI - Calculus revisited. A review. AB - Although there is no doubt that gingivitis can develop in the absence of supragingival calculus, it is not clear to what extent the presence of mineralized deposit enhances gingival inflammation. Partial inhibition of plaque mineralization can be accomplished by chemical agents, but there has been no demonstration in humans of a reduction in gingivitis. It remains to be established what level of inhibition (if any) is required to have more than a cosmetic effect. Since the accepted scenario is that apical growth of supragingival plaque precedes the formation of subgingival calculus, there is no longer an issue of whether subgingival calculus is the cause or the result of periodontal disease. Subgingival mineralization results from the interaction of subgingival plaque with the influx of mineral salts that is part of the serum transudate and inflammatory exudate. This chronology, however, should not be the basis for relegating calculus to the ash heap. Morphologic and analytical studies point to the porosity of calculus and retention of bacterial antigens and the presence of readily available toxic stimulators of bone resorption. When coupled with the increased build up of plaque on the surface of the calculus, the combination has the potential for extending (beyond that of plaque alone) the radius of destruction and the rate of displacement of the adjacent junctional epithelium. The centrality of thorough scaling and root planing in the successful maintenance of periodontal health supports the view that subgingival calculus contributes significantly to the chronicity and progression of the disease, even if it can no longer be considered as responsible for initiation. PMID- 3519690 TI - The osteoclast and periodontitis. AB - The osteoclast may play an important role in the variable rate of osseous destruction seen in periodontitis. Current understanding of various aspects of the osteoclast may help explain this fact. This review paper will first look at two theories of cell origin of the osteoclast: the multipotential osteoprogenitor cell theory and the hemopoietic stem cell theory. Next, ultrastructural features characteristic to the cell such as the ruffled border, clear zone, and lysosomal system, will be discussed. Thirdly, current and proposed theories on the actual mechanism of bone degradation are considered. This includes the one-cell theory and the two-cell theory. Finally, elements which activate the osteoclast are enumerated and their delicate interplay is outlined. In the context of this information, pathways found in the periodontal lesion (microbial agents, inflammatory cells and their products) which attract and activate elements of the osteoclastic system are discussed. PMID- 3519692 TI - A clinical evaluation of fixed-bridge restorations supported by the combination of teeth and osseointegrated titanium implants. AB - The present paper reports on the result of the use of osseointegrated titanium fixtures and teeth as combined abutments for fixed-bridge restorations in 10 partially dentate patients. In these patients, the remaining teeth were too few or too unfavourably distributed in the jaws to serve as sole abutments for fixed bridgework. Titanium fixtures ad modum Branemark were therefore implanted in suitable positions and used as abutments in combination with the remaining teeth. Evaluations at periods of 6 to 30 months postoperatively revealed good clinical results. Some tissue reactions, however, were also observed, indicating the presence of certain clinically significant differences in the functional behaviour of tooth abutments and titanium fixture abutments. These reactions and differences are discussed. PMID- 3519691 TI - The nature of the inflammatory infiltrates in childhood gingivitis, juvenile periodontitis and adult periodontitis: immunocytochemical studies using a monoclonal antibody to HLADr. AB - Routinely fixed and processed gingival biopsies from childhood gingivitis, juvenile periodontitis and chronic adult periodontitis patients have been stained immunocytochemically with a monoclonal anti HLADr antibody to aid in the identification and quantification of cell types in the inflammatory infiltrates. Using immunoperoxidase staining and morphological criteria, 9 cell types were quantified in 30 patients. Lesions in the 3 groups were found to differ widely both in size and composition. In the small childhood gingivitis lesions, most cells were small lymphocytes, over half of which were HLADr positive, whereas in juvenile periodontitis biopsies, well over half the infiltrate was plasma cells. The chronic adult periodontitis samples showed greater variability in composition between these 2 extremes, perhaps reflecting differences in disease activity. These results suggest that, when disease is quiescent, the volume of inflamed gingival connective tissue is small and is dominated by B-small lymphocytes, whilst on activation, the lesion increases in size and much of the B-lymphocyte population is transformed to plasma cells. This view corroborates the results of other workers with regard to juvenile periodontitis, but suggests a different interpretation of the quiescent lesion of childhood gingivitis from that current in the literature. PMID- 3519693 TI - Longitudinal evaluation of a self-inspection plaque index in periodontal recall patients. AB - This paper presents a controlled clinical trial to compare the effects of 2 programs for maintenance of oral hygiene after periodontal treatment. Oral hygiene instruction using a self-inspection plaque index was compared to traditional instruction using professional monitoring of disclosed plaque. 31 periodontal recall patients were randomly assigned to 2 groups. 15 patients in the self-inspection group were provided a manual that taught scoring of disclosed plaque on 6 teeth, a lighted dental mirror, and disclosing wafers. 16 patients in the traditional group were shown disclosed plaque in their own mouths, and were given feedback regarding oral hygiene skills. Instruction was given initially, at 2 weeks, at 1.5 months and at 3 months. The teeth were scaled at the start and at 3 months. Disclosed dentogingival plaque (before and after brushing), gingival bleeding on probing, and oral hygiene skills were assessed at 0, 1.5, 3 and 6 months. Initial mean plaque scores for only the self-inspection group decreased significantly at 1.5 months and were maintained throughout the study; however differences between groups were not observed at any time except at baseline. Gingival bleeding scores were low throughout the study for both groups. Results provide some evidence for the effectiveness of self-evaluation of disclosed plaque as a means for improving oral hygiene behavior in already-motivated patients. PMID- 3519694 TI - The effects of isocarboxazid on blood pressure and pulse. AB - In a fixed-dose inpatient study, isocarboxazid produced a dose-related lowering of systolic blood pressure at weeks 2 and 4. Systolic blood pressure was also lowered by the drug in a placebo-controlled outpatient study. The magnitude of these reductions was considerable, reaching an average of 14.6 mm in inpatients who received a 50-mg dose, and 18.7 mm in outpatients. There was no evidence for a dose-related orthostatic effect, and greater orthostasis relative to placebo was found only at week 3 in the outpatient study. Significant bradycardia was produced by isocarboxazid in outpatients at weeks 2, 3, and 4 relative to placebo, but no dose-related effect was found among inpatients. Inpatients with a baseline systolic orthostatic drop of greater than or equal to 10 mm showed a significantly better response to isocarboxazid than did those with an orthostasis of less than 10 mm. The theoretical significance of these findings is discussed. PMID- 3519695 TI - A therapeutic approach to venous ulcers. AB - Recent progress in the understanding of the pathogenesis of venous ulcers and in the biology of healing allows us to formulate a therapeutic strategy for patients with venous ulcerations. Systemic evaluation and local considerations of the ulcerated areas are important in the management of these patients. Occlusive therapy, made easier by new and more effective dressings, relieves pain, leads to better and faster healing in a moist environment, and facilitates treatment in the ambulatory setting. Fibrinolytic therapy, aimed at reducing pericapillary fibrin and restoring proper physiologic exchanges between blood and tissues, may benefit some patients with extensive and nonhealing ulcers. PMID- 3519696 TI - Cyclosporin A. AB - Cyclosporin A is a new immunosuppressive agent that selectively affects T helper cells without suppressing the bone marrow. Cyclosporin A has been used primarily to prevent rejection in organ transplantation and acute graft-versus-host disease. Studies suggest that it may be of benefit in psoriasis, pemphigus vulgaris, bullous pemphigoid, Behcet's disease, and collagen vascular disorders. Since cyclosporin A has a potentially important use in dermatology, and since a number of dermatologic side effects are seen as a consequence of its use, it is important that dermatologists be familiar with this drug. PMID- 3519697 TI - Skin closure by Nd:YAG laser welding. AB - Skin incisions 6 mm in length were made on the backs of hairless mice. Control wounds were closed with interrupted 5-0 Prolene sutures, and experimental wounds were approximated and closed by laser welding using a Nd:YAG laser. The wounds were examined daily, and specimens were excised at weekly intervals for histopathologic study, transmission electron microscopy, tensile strength determination, and type I collagen-specific messenger ribonucleic acid measurements. The laser-welded wounds demonstrated rapid healing. Histologic study showed a functional scar tissue at day 7 and a minimal residue of the original wound at day 14. Tensile strength of the control and experimental wounds was similar at all time points. The levels of collagen-specific messenger ribonucleic acid were significantly higher in the sutured group in comparison with the laser group or with normal control skin. This study suggests that laser welding might have advantages over suturing, since the former is sterile and nontactile, does not require introduction of foreign material into the wound, and provides subjectively improved cosmetic results. PMID- 3519698 TI - Multiple dermal grafts for hemifacial atrophy caused by lupus panniculitis. PMID- 3519699 TI - Lepra, psora, psoriasis. AB - This article traces the curious history of how psoriasis came to be called by its present appellation. In retelling the story, psoriasis is seen as a disease (known since antiquity) that has been confused with leprosy, with some tragic results. PMID- 3519700 TI - Primary idiopathic cutaneous pustular vasculitis. AB - Pustular cutaneous vasculitis results from a heterogeneous group of disorders characterized by pustules on purpuric bases. Although the cause of this group of conditions is diverse, the histopathologic picture of the lesions is the same, showing a Sweet's-like or leukocytoclastic vasculitis. These distinctive lesions may occur in patients with Behcet's syndrome, bowel-associated dermatosis arthritis syndrome, or chronic gonococcemia. We describe, for the first time, a patient with primary idiopathic cutaneous pustular vasculitis. This patient had evidence of both circulating immune complexes and serum enhancement of neutrophil migration. Extensive evaluation failed to reveal any underlying systemic disease. A classification of the pustular vasculitides is proposed. PMID- 3519701 TI - Bullous pemphigoid and prurigo nodularis. AB - Bullous pemphigoid is a chronic blistering disorder characterized by specific clinical, histologic, and immunofluorescent findings. Several variants have been described, including pemphigoid nodularis, which may mimic or evolve from or into prurigo nodularis. The casual relationship between prurigo nodularis and bullous pemphigoid is unknown. We describe a patient with prurigo nodularis and no immunologic evidence of pemphigoid who subsequently developed bullae. Direct immunofluorescence then confirmed the diagnosis of bullous pemphigoid. Apparently this patient had prurigo nodularis and then developed bullous pemphigoid. PMID- 3519702 TI - Purification and characterization of extracellular caseinolytic enzyme of Micrococcus sp. MCC-315 isolated from cheddar cheese. AB - Micrococcus sp. MCC-315, an organism isolated from Cheddar cheese, produced an extracellular calcium metalloenzyme. This protease was purified to homogeneity from culture supernatant by precipitation with ammonium sulfate (50 to 70% saturation) and gel filtration through Sephadex G-100, resulting in about 82 times increase of specific activity and 53% recovery of the enzyme. The protease exhibited a pH optimum at 10.6 for both whole casein and beta-casein. It had optimum activity for whole casein in the presence and absence of calcium++ at 60 and 50 degrees C, respectively, and at 37 to 40 degrees C for beta-casein with or without calcium++. The enzyme was stable at 45 degrees C but lost activity at higher temperatures. It was inhibited by heavy metal ions but calcium++, cobalt++, manganese++, strontium++, and iron++ had a slight stimulatory effect. The enzyme was inhibited completely and irreversibly by metal chelating agents. Calcium ions were required for maintenance of an active conformation of the enzyme. The enzyme had molecular weight of 28,900 and Michaelis constants 6.66 and 5.00 mg/ml for whole casein and beta-casein. Amino acid analysis of the hydrolyzed enzyme revealed the absence of sulfhydryl groups as was indicated also by lack of inhibition by thiol reagents. PMID- 3519703 TI - Effects of in vivo administration of growth hormone on milk production and in vitro hepatic metabolism in dairy cattle. AB - Bovine growth hormone (50 IU/d) or placebo injections were administered for 11 consecutive d to Holstein cows (four per treatment) in midlactation. Growth hormone injections increased milk yield, efficiency of milk production, and concentrations of growth hormone and free fatty acids in plasma. Concentrations of beta-hydroxybutyrate and acetoacetate in whole blood and glucose in plasma were not affected by treatment. Liver biopsies were taken from both groups of cows 8 d prior to and on the last day of injection. Liver slices were used for in vitro incubations with carbon-14-labeled propionate, alanine, butyrate, and palmitate. Rates of substrate metabolism before and after placebo treatment were similar. Compared with pretreatment, however, liver slices from cows receiving growth hormone had significantly higher rates of propionate conversion to both glucose and carbon dioxide. There was also a nonsignificant increase in rate of alanine conversion to glucose and carbon dioxide. Growth hormone treatment did not change in vitro production of ketones or carbon dioxide from butyrate or palminate. Results indicate that growth hormone increases hepatic capacity for propionate metabolism and supports the concept that growth hormone partitions fatty acids for preferential use by mammary tissue. PMID- 3519704 TI - Secretion and clearance rates of glucagon in dairy cows. AB - Eight Holstein cows were sampled to examine plasma concentrations of hormones and some energy related metabolites. Sampling was every hour for 12 h at about 2 wk prepartum, at 3 wk postpartum, during an energy restriction ketonemia, and after a recovery period. Cows were fed ad libitum except for four cows induced into ketonemia by restricting feed intake 50%. Pulse doses of glucagon were injected intravenously during each period. Feed restriction increased concentrations of growth hormone, acetoacetate, beta-hydroxybutyrate, and free fatty acids in blood plasma. Concentrations of insulin and glucose showed some tendencies to decrease. Distribution space and turnover rate of glucagon were not different between periods, and pool size was increased in the dry period. Metabolic clearance rate of glucagon was not significantly different between periods. Insulin and glucose concentrations were increased 1 to 2 min after injection of glucagon and remained increased for 25 min. Covariance analysis showed that glucagon injection caused glucose concentration to increase proportionally in all periods, suggesting that cows had equal gluconeogenic capacity in all periods. Basal concentration, pool size, and secretion rate of glucagon showed some tendency to be decreased during ketonemia. PMID- 3519705 TI - Gonadotropin-releasing hormone and prostaglandin F2 alpha for postpartum dairy cows: estrous, ovulation, and fertility traits. AB - A study of 234 Holstein cows was conducted to determine if early postpartum treatments of gonadotropin-releasing hormone, prostaglandin F2 alpha, or both would alter frequency and occurrence of estrus and ovulation as well as subsequent fertility. Cows in groups 1 and 2 received gonadotropin-releasing hormone (200 micrograms) between 10 and 14 d postpartum, and cows in groups 3 and 4 received saline. Ten days later, cows in groups 2 and 3 received prostaglandin F2 alpha (25 mg), and cows in groups 1 and 4 received saline. Treatment with gonadotropin-releasing hormone reduced intervals to first ovulation and first detected estrus as well as increasing the proportion of cows with three or more ovulations before first service from 57% for saline-treated controls to 83%. Treatment with prostaglandin F2 alpha reduced intervals to second and third ovulation and shortened the first estrous cycle. Treatments for cows in groups 1 and 3 increased the proportion of cows having estrous cycles of normal duration. Interval from calving to conception was reduced by 43 to 48 d for cows with an abnormal puerperium treated with either gonadotropin-releasing hormone or prostaglandin F2 alpha compared with controls (group 4) and by 27 to 29 d overall in all cows in groups 1 and 3. Cows with normal or abnormal puerperium in groups 1 and 3 required 26 to 41% fewer services per conception than controls. We conclude that treatments of gonadotropin releasing hormone or prostaglandin F2 alpha, but not the treatment combination, improved fertility of dairy cows, especially those that experienced puerperal problems. PMID- 3519706 TI - Lactational performance of various mammalian species. AB - Lactational performance varies widely among mammalian species. Lactation plays a variable role in the overall reproductive strategy. The fraction of total growth and development of the young contributed by lactation is minimal in such species as guinea pigs but is a very high proportion in some marsupials and primates. Although the overall daily capacity for transfer of energy for many species is rather constant at about 125 kcal/kg body weight.70, the proportions of nutritive constituents in milk differ greatly among species and vary during lactation. PMID- 3519708 TI - Recent advances in corpus luteum physiology. AB - Development, maintenance, and regression of the corpus luteum have been investigated for many years. However, endocrine and cellular mechanisms regulating progesterone synthesis and secretion remain unclear. Because comprehensive reviews of factors affecting luteal function have been published recently, this paper discusses several emerging concepts that may be important in understanding the regulation of luteal progesterone synthesis and secretion. Concepts discussed include preovulatory follicular determinants of subsequent luteal function, hormonal stimulation of progesterone synthesis, effect of different luteal cell types on progesterone secretion, and role of secretory granules in luteal function. PMID- 3519707 TI - Variation among species in the endocrine control of mammary growth and function: the roles of prolactin, growth hormone, and placental lactogen. AB - Prolactin, growth hormone, and placental lactogen form a family of structurally related hormones, which may have evolved from a common ancestral peptide. Prolactin and growth hormone are present in all mammals, but the biological activity associated with placental lactogen has been detected in only some groups. Attempts to detect placental lactogen using bioassay and radioreceptor assay are reported and have been unsuccessful in an insectivore (the shrew), a bat, an edentate (the armadillo), a lagomorph (the rabbit), several carnivores (dog, cat, ferret), perissodactyls (horse, zebra, rhino), and, within the artiodactyls, pigs. Placental lactogenic activity has been detected in primates (chimpanzee, orangutan), rodents (voles, Pinon mouse, guinea-pig, mara), and in numerous artiodactyls (llama, giraffe, several species of deer, antelope, gnu, gazelle, musk ox, cape buffalo, Barbary sheep, several sheep of the genus Ovis, goat, and cow). These results confirm and extend the work of others and are discussed in relation to the evolution of these hormones. In synergism with steroid and thyroid hormones, protein hormones of the prolactin and growth hormone family play a crucial role in stimulating the development of the mammary gland, the differentiation and function of mammary cells to secrete milk, and in the systemic adjustments in maternal metabolism in pregnancy and lactation. Studies in vitro have shown that mammary tissues from several species synthesize milk components in response to insulin plus adrenal corticoid plus prolactin. However, there are also species differences in minimal hormonal requirements for lactogenesis. In vivo, for example, rabbits will initiate or sustain lactation in response to prolactin alone, whereas sheep and goats require prolactin plus growth hormone plus adrenal corticoid plus thyroid hormone. Measurement of hormone concentrations in the plasma of pregnant animals shows considerable differences among species in the pattern of secretion of lactogenic hormones to bring about mammary development. A surge of prolactin secretion occurs at parturition but may not be essential in the initiation of lactation. The timing of progesterone withdrawal correlates well with lactogenesis in eutherian mammals, but species differ in the mechanisms at parturition which bring this about. Marsupials show a quite different pattern of suckling-induced lactation. In maintaining lactation the greatest contrast is between ruminants, in which growth hormone is of particular importance, and other mammals, in which reduction of prolactin secretion with bromocriptine rapidly suppresses milk synthesis and secretion.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3519709 TI - Cell signaling, permeability, and microvasculatory changes during antral follicle development in mammals. PMID- 3519710 TI - In vitro assessment of the effect of Scotchbond on the marginal leakage of class II composite restorations in primary molars. AB - By means of dye penetration, the authors determined the microleakage at the interface of class II composite restorations in thirty-eight extracted or naturally exfoliated primary molars. Scotchbond was used as the bonding agent in half of the prepared cavities' dentin and enamel; the control group (B) used Concise bonding agent in the enamel only. The use of Scotchbond in class II cavities did not prevent marginal leakage under the conditions of this study. PMID- 3519711 TI - Ectopic eruption of maxillary first permanent molars: a review. AB - This paper presents information on the ectopic eruption of the maxillary first permanent molar, a local eruption disturbance. Two types can be differentiated: reversible and self-correcting, and an irreversible type, in which the permanent molar remains locked. Many treatment methods have been suggested. PMID- 3519712 TI - Adhesion of polycarboxylate-based dental cements to enamel: an in vivo study. AB - The bond strength of two polycarboxylate and two glass ionomer cements to enamel in vivo has been measured by a tensile test method. The four cements were used to cement small stainless steel cylinders onto the facial surfaces of 11 and 21. The cylinders were removed by a tensile force applied by a handpiece containing a semi-conductor sensory unit. The results showed that all cements gave two sets of bond strength values, either a good bond corresponding to a cohesive failure, or a weak bond corresponding to an adhesive failure. The mean bond strength values were lower than those recorded in vitro, and differences among the cements were limited. PMID- 3519713 TI - The effects of sorbate on oral streptococci grown in continuous culture. AB - The antimicrobial effect of potassium sorbate on Streptococcus mutans and S. milleri grown in continuous culture was determined at pH values of 7.0, 5.5, and 5.0. Organisms were grown glucose-limited at a dilution rate of D = 0.1 h-1, corresponding to a doubling time of ca. seven hours, in a chemically defined medium under an atmosphere of 5% CO2 in N2. After equilibration at the appropriate pH level, the culture vessel was pulsed with potassium sorbate to a final concentration of 20 mmol L-1 or with sorbate followed almost immediately by a pulse of glucose (to 40 mmol L-1); that is, the cultures were exposed to transient excesses of sorbate with and without glucose--such as might occur during meals. At pH 7.0, sorbate had virtually no effect on glucose uptake and on the, albeit transient, increase in growth rate and acid production by both organisms. At pH 5.5 and 5.0, both cell viability and acid production in S. milleri were depressed following a pulse of sorbate, the effect being even more marked after a sorbate/glucose pulse. At low pH, the uptake of glucose in the presence of sorbate was drastically reduced. The effect on S. mutans was less marked, but growth and acid production were greatly depressed at pH 5.0 following consecutive pulses of sorbate. The antimicrobial effect of the widely used preservative potassium sorbate, at low pH, is confirmed for oral streptococci, and it is suggested that continuous culture offers a relevant system for testing potential antimicrobial agents. PMID- 3519714 TI - Dental caries prevalence in early Polynesians from the Hawaiian Islands. AB - We examined the skeletal remains of 1338 early Hawaiians (preserved in the Bishop Museum, Honolulu) to determine total caries and root surface caries prevalence. Specimens from seven islands were represented in the collection. Estimation of age at death was made by a combination of dental developmental staging for younger individuals and occlusal attrition and/or alveolar bone loss in adults. Museum records were also consulted for age estimation of adults which was primarily based on osteological criteria. The material was divided into six age groups. Predentate infants and edentulous adults were not included. A total of 19,425 teeth was examined. Caries lesions were observed in 462 individuals (34.5%) and 1895 teeth (9.8%). Coronal caries lesions in children and adolescents tended to be small and not particularly destructive of tooth structure. Root surface lesions in young adults were also small but increased progressively in size in the older groups, resulting in pulp exposure and coronal amputation. Although coronal caries was apparently not a significant dental health problem in children and young adults (compared with contemporary Hawaiians), root surface caries was an increasingly important source of tooth morbidity and tooth mortality in the older population groups. This age-related caries pattern was similar for all of the islands. PMID- 3519715 TI - The effect of cross-linking agents on the impact resistance of a linear poly(methyl methacrylate) denture-base polymer. AB - Eight different cross-linking agents were added to the monomer component of a linear poly(methyl methacrylate) denture-base resin in various concentrations, and their effect on the impact resistance of the cured polymer studied. The cross linking agents were chosen to provide a range of cross-linking chain lengths and degrees of chain flexibility. When tested under oral conditions, the polymers cross-linked with long and flexible chains did not show the marked reduction in impact resistance found in polymers cross-linked with shorter and stiffer cross linking chains. It seems likely that by replacing EGDMA in denture-base resins with a cross-linking agent such as PEG 600 DMA, one could use a higher concentration with a consequent improvement in solvent resistance. PMID- 3519716 TI - Computer-assisted instruction in mixed dentition analysis. AB - A computer-assisted instruction (CAI) tutorial in the basics of mixed dentition analysis was developed and evaluated as a substitute for a one-hour lecture segment on the same topic. The instructional effectiveness of the program was evaluated using an experimental CAI-lecture group design. A posttest included in the final examination for the course served to compare learning outcomes of 24 students instructed via the computer with 28 students instructed by the traditional lecture method. The results of this investigation revealed that: the CAI group performed significantly better on the posttest than did the lecture group, there was no significant correlation between posttest scores and the time used to view the program for students in the computer groups, and student attitude toward the use of this CAI program was favorable. PMID- 3519717 TI - Carcinoma of the external auditory canal: removal and prevention of stenosis. AB - The external auditory canal represents an area of high risk for recurrence of tumors. Therefore, carcinomas involving this region should be removed by Mohs chemosurgery. Healing by granulation can result in stenosis of the canal. We report a method of reconstruction to prevent stenosis of the auditory canal after chemosurgery. PMID- 3519718 TI - A randomized clinical trial of two dressing methods for the treatment of low grade pressure ulcers. PMID- 3519719 TI - Mechanisms of membrane damage and surfactant depletion in acute lung injury. PMID- 3519720 TI - Hemodynamic oxygen transport and 2,3-diphosphoglycerate changes after transfusion of patients in acute respiratory failure. AB - The goals of management of patients with respiratory failure include improving arterial oxygenation with PEEP and red cell transfusion to maintain oxygen carrying capacity, both of which contribute to improving tissue oxygen delivery. However, standard CPD-stored blood is rapidly depleted of 2,3 diphosphoglycerate (2,3 DPG) and ATP, with resultant inadequacy of the red cell oxygen transport function. In 15 patients requiring mechanical ventilation with PEEP whose initial Hct less than or equal to 35%, we studied the effect of transfusion of 7 ml/kg of CPD-stored packed red blood cells on hemodynamic and oxygen delivery variables, pulmonary venous admixture (QA/QT), and erythrocytic P50, 2,3 DPG and ATP concentrations. Hemodynamics were not significantly altered by transfusion. 2,3 DPG decreased significantly from 14.5 +/- 1.1 to 13.1 +/- 1.5 mcmol/g Hb (mean +/ SD, p less than 0.05). There was no significant change in P50 or ATP. QA/QT rose significantly, from 20.1 +/- 7.8 to 28.9 +/- 12.3% (mean +/- SD, p less than 0.02). In our patients, an increase in arterial oxygen content obtained by transfusion was not followed by any associated decrease in cardiac work, as implied by solution of equations for oxygen delivery and oxygen consumption. The rise in QA/QT is undesirable in patients requiring PEEP, since it complicates management of their mechanical ventilatory support. PMID- 3519721 TI - Tests of the accuracy of a data reduction method for determination of acoustic backscatter coefficients. AB - The accuracy of a new method for measuring ultrasonic backscatter coefficients was tested, using narrow-band pulses and well-defined media having scatterers randomly distributed in space. Experimentally determined values agree very well with theoretical values for wide ranges of experimental parameters, these ranges being applicable in measurements made on human soft tissues. An important outcome is that the method yields accurate results for scattering media positioned anywhere from the nearfield through the farfield of the nonfocused transducers employed. In addition, backscatter coefficients can be determined for a broad range of gate durations. PMID- 3519723 TI - Input on implants. PMID- 3519722 TI - Efficacy of the dentin bonding agents. Part II. A comparison of glass ionomer cement with dentin bonding agents. PMID- 3519724 TI - The presidents. LeRoy Massey Ennis 1951-1952. PMID- 3519725 TI - A visible light-cured posterior composite resin: results of a 3-year clinical evaluation. AB - Seventy-nine Class I and II light-cured composite resin restorations were evaluated for 3 years. Although the composite resin was not totally wear resistant, its overall clinical performance was acceptable, relative to most parameters of evaluation. The use of such a material in the posterior region may be justified in situations in which appearance is important, ideal circumstances predominate over conservative cavity design, and the patient understands the benefits and limitations of the procedure. PMID- 3519726 TI - Timepieces. PMID- 3519727 TI - The presidents. Otto William Brandhorst 1952-1953. PMID- 3519728 TI - Use of a posterior composite resin to restore teeth and support enamel: report of case. AB - In selected cases in which appearance is important, a posterior composite resin may be used successfully to reinforce and restore a tooth with undermined, nonfunctional cusps. The restoration of teeth with compromised functional cusps is not recommended. Once the decision has been made to restore the tooth with a posterior composite resin, care must be taken to follow a technique to prevent problems after treatment that result from microleakage and contraction shrinkage. PMID- 3519729 TI - Volumetric proportioning techniques for irreversible hydrocolloids: a comparative study. PMID- 3519730 TI - Dentistry on stamps (Hesi-Re). PMID- 3519731 TI - Effects of early reperfusion in acute myocardial infarction on arrhythmias induced by programmed stimulation: a prospective, randomized study. AB - This study compares inducibility of ventricular tachyarrhythmias by programmed electrical stimulation of the heart in patients with myocardial infarction with and without reperfusion after streptokinase therapy. Sixty-two consecutive patients admitted with an acute myocardial infarction were randomized to either combined intravenous and intracoronary streptokinase (streptokinase group) or to standard coronary care unit treatment (control group). Thirty-six of the 62 patients (21 patients from the streptokinase and 15 from the control group) with a first myocardial infarction were studied by programmed ventricular stimulation after a mean of 26 +/- 14 days. No patient had a history of antiarrhythmic drug use or documentation of a ventricular arrhythmia before the initial admission. A sustained ventricular arrhythmia was induced in 10 (48%) of the 21 patients randomized to streptokinase therapy and in all 15 (100%) control patients (p less than 0.001). Sustained monomorphic ventricular tachycardia was induced in 6 (29%) and 10 (67%) patients, respectively (p less than 0.05). To terminate an induced arrhythmia, direct current countershock was required in 33% of patients in the streptokinase group and 73% of patients in the control group (p less than 0.02). Seventeen of the 21 patients treated with streptokinase and no control patient had evidence of early reperfusion 200 +/- 70 minutes after the onset of pain. In comparison with patients without early reperfusion, patients in the reperfused group had a lower maximal serum creatine kinase value (p less than 0.01), a shorter time to peak creatine kinase value (p less than 0.001) and a higher angiographic left ventricular ejection fraction (62 versus 45%, p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3519732 TI - On physician payment reform. PMID- 3519733 TI - Mechanisms responsible for coronary vasospasm. AB - Studies have been conducted on isolated segments of the left circumflex coronary artery of the dog to gain information on the mechanism or mechanisms of vasospasm. Coronary arteries contain both postjunctional alpha 1- and beta 1 adrenoceptors, and both are accessible to norepinephrine released from the sympathetic nerves. However, owing to the dominance of the beta 1-adrenoceptors, sympathetic stimulation causes relaxation of the vascular smooth muscle. In the primary branches of the circumflex artery, only beta 1-adrenoceptors are present. In patients with spasm of the coronary arteries, blockade of the beta 1 adrenoceptors may aggravate the spasm by permitting the unopposed constrictor action of the sympathetic nerves on the alpha 1-adrenoceptors on these vessels. The blood platelets contain substances, including 5-hydroxytryptamine (serotonin) and thromboxane A2, which can cause constriction of vascular smooth muscle. These substances are released whenever platelets aggregate. The normal endothelium, by forming and releasing prostacyclin, inhibits platelet aggregation. In addition, in response to platelet products, the normal endothelium forms one or more inhibitory substances that cause relaxation of the underlying smooth muscle. Also, if any thrombin is formed, this also causes an endothelium-mediated relaxation of the artery. Patients with coronary artery spasm usually have morphologic changes in the artery at the site of the spasm. Thus, platelets can aggregate at the site and the resultant release of serotonin and thromboxane A2, acting directly on the smooth muscle, causes constriction of the artery. Hypoxia of the myocardium follows and this augments the constriction. PMID- 3519734 TI - Differential modulation of autonomic activity by ethmozin and ethacizin (analog of ethmozin) on the canine sinus node and atrioventricular junction. AB - The chronotropic and dromotropic actions of ethmozin and its diethylamine analog ethacizin were studied in the presence and absence of combined muscarinic, beta- and alpha-adrenoreceptor blockade in the intact canine heart in situ (n = 38). Injections of ethacizin, 5, 10 and 25 micrograms/ml, into the sinus node artery caused an immediate and significant (p less than 0.001) sinus bradycardia of 2, 6 and 11%, respectively. Injection of 25 and 50 micrograms/ml of ethacizin into the atrioventricular (AV) node artery significantly (p less than 0.001) prolonged AV conduction time with occasional second degree heart block. Conduction delay was located exclusively during the AH interval of the His bundle electrogram. Autonomic blockade did not alter the negative chronotropic or negative dromotropic effects of ethacizin. Ethacizin, 25 micrograms/ml, injected into the sinus node artery immediately reduced the sinus node response to vagal stimulations by 30% and the effect of acetylcholine, 0.1 micrograms/ml, injected into the sinus node artery by 50%. Ethacizin, 25 micrograms/ml, injected into the AV node artery immediately reduced the duration of complete AV block elicited by vagal stimulation or intranodal acetylcholine, 0.5 micrograms/ml, by 90%. Ethacizin caused a minor reduction in sinus node response to right stellate stimulations without, however, altering the sinus node response to intranodal norepinephrine. Ethmozin injections of up to 50 micrograms/ml into the sinus and AV node arteries had no chronotropic or dromotropic effects. Ethmozin had a minor and variable vagolytic action but significantly (p less than 0.05) reduced the sinus node response to sympathetic nerve stimulation. Hence, ethacizin, in contrast to ethmozin, has a direct depressing action on both the sinus node and the AV junction.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3519735 TI - Quantitative determination of total and specific human IgE with the use of monoclonal antibodies. AB - We have used two monoclonal antibodies (BS17 and Le27) that recognize two different epitopes of the constant region of human IgE in order to determine the total and specific IgE contained in human serum. Both types of assay are based on classic PRIST and RAST procedures and involve one or two monoclonal antibodies labeled with 125I iodine. The performance of these two assays were compared systematically with those obtained with a commercially available polyclonal tracer. We first investigated the 125I-labeling conditions for monoclonal antibodies. In our hands the best results were obtained by use of a tracer of specific radioactivity close to 10 microCi/micrograms. We have been able to demonstrate that as a consequence of its limited affinity, the radioactive tracer is always incompletely bound to the solid-phase IgE. Nonetheless, the sensitivity of the assay is comparable to that obtained with the polyclonal antibody, since less than 0.5 IU/ml can be measured by the PRIST procedure. In contrast, the dilution curves obtained in the RAST with the monoclonal antibodies are very different from those observed with the polyclonal tracer. In fact, these curves are strictly parallel to the dilution curve and to the standard curve derived from the PRIST method, thus indicating that the monoclonal antibodies recognize all IgE equally well regardless of the way in which they are bound to the solid phase. On the basis of this observation, we propose a quantitative assay of specific IgE with the PRIST standard curve as reference. Our results demonstrate that this approach is indeed possible if high-capacity, solid-phase as well as long incubation times are used. PMID- 3519736 TI - Dietary intake in the Multiple Risk Factor Intervention Trial (MRFIT): nutrient and food group changes over 6 years. AB - The Multiple Risk Factor Intervention Trial (MRFIT) was a randomized clinical trial in the primary prevention of coronary heart disease. Middle-aged men determined to be at high risk for coronary heart disease were randomized into either a special intervention (SI) group or a group referred to usual sources of medical care (UC). Twenty-four hour dietary recall data were used to monitor the nutrient intake of the MRFIT population and guide the nutrition education program for the SI group. The SI group of participants decreased intake of dietary cholesterol by 40% and saturated fatty acids by more than one-fourth and increased intake of polyunsaturated fatty acids by one-third. Evaluation of SI dietary intake data by food groups indicates that some dietary changes were relatively easy to implement, whereas others presented more of a challenge. Changes made with relative ease included increasing the consumption of fish and poultry, skim and low-fat milk, polyunsaturated margarines and oils, fruits, and low-fat breads and cereals and reducing the consumption of egg yolks. More difficult changes included eliminating, or even reducing, the intake of high-fat beef and pork, high-fat cheeses, high-fat crackers, snacks, and desserts, and increasing the intake of vegetarian meat alternatives. PMID- 3519737 TI - A long-term nutrition intervention experience: lipid responses and dietary adherence patterns in the Multiple Risk Factor Intervention Trial. AB - Nutrition counselors in the Multiple Risk Factor Intervention Trial (MRFIT) were able to help middle-aged men who were at high risk for coronary heart disease change their dietary habits, maintain those changes over time, and decrease their serum cholesterol levels. Most of a 7.5% mean serum cholesterol reduction achieved after 6 years of nutrition intervention occurred during the first year of the trial and was thereafter sustained. Total cholesterol and low-density lipoprotein cholesterol fraction decreases indicated improvement in terms of coronary heart disease risk. The food record rating, a numerical, semi-objective adherence technique that assesses a 3-day food record with respect to lipid lowering potential, was used throughout the trial to measure adherence to recommended food patterns. Participants with lower food record rating scores, which indicate better adherence, demonstrated greater reductions in serum total cholesterol, plasma total cholesterol, and low-density lipoprotein fraction cholesterol determinations on a group basis. Subjective evaluations of the suitability of home and working environments, evidence of deviation from the MRFIT food patterns, and overall nutrition program motivation also showed that as ratings in each category became more favorable, lower food record rating scores and greater blood lipid reductions were consistently observed. The subgroup of participants who were non-smokers and not hypertensive demonstrated greater lipid responses and better dietary adherence. Continued smoking and antihypertensive medications appeared to adversely influence dietary adherence and/or lipid reductions. The MRFIT experience, however, demonstrated for the first time that dietary changes and blood lipid reductions can be achieved after the initial intervention effect, despite a continued emphasis on high blood pressure management and smoking cessation. PMID- 3519738 TI - Increasing the use of meatless meals: a nutrition intervention substudy in the Multiple Risk Factor Intervention Trial (MRFIT). AB - Forty-seven participants from six MRFIT clinical centers were involved in a 3 month intensive dietary intervention program to determine the feasibility of increasing the use of meatless meals. The substudy was conducted late in the trial, and many dietary changes had already been made. The purpose, therefore, was to initiate ways to continue the maintenance of achieved serum cholesterol reductions and possibly effect additional decreases. The program consisted of an introductory session and three follow-up visits. Preplanning, contracting, self monitoring, regular follow-up, and homemaker involvement were among techniques used to help participants incorporate meatless meals into routine dietary practices. Data collection included scores from a knowledge test administered at the introductory and final visits, number of meatless meals consumed per week as contracted at the first three visits and as reported at the last three visits, and serum cholesterol and weight determinations made at each visit. Knowledge related to meatless meal concepts, such as complementary proteins, appeared to improve as the majority of substudy participants scored higher on the post-test than on the pretest. Over the substudy duration, the mean number of contracted and reported weekly meatless meals in addition to breakfast was approximately four and five, respectively. Mean serum cholesterol drop was 2.6%, and mean weight loss was about 3 lb over the 3-month period. The approach was one of the intervention techniques used to maintain serum cholesterol reductions on a long term basis, which has not been achieved in any other clinical trial with similar objectives. The described meatless meals program may prove useful to dietetic practitioners who counsel individuals in fat-modified food patterns. PMID- 3519739 TI - When interpretation masquerades as explanation. AB - The principal goal of the clinical interpretation (and of the larger clinical narrative) is to bring about insight and change in the patient, and not to present a reasoned argument that relies on public data and shared rules of evidence and logic. When the clinical account is transposed to the public domain and presented as a form of explanation, it is no longer designed for the benefit of one individual but must now be accessible to all. We are still under the shadow of Freud's five famous cases which are literary landmarks of exposition and persuasion. As a result, we are less sensitive to what happens when interpretations are substituted for explanations. The time has come to develop a new genre and a new mode of clinical reporting that would allow the reader to participate in the argument, allow him to evaluate the proposed links between evidence and conclusion (instead of relying on the authority of the analyst author), and open up the clinical report to the possibilities of refutation, disconfirmation, and falsification. PMID- 3519740 TI - Three visits to eternity: Freud, Wiesel, and Patient X. AB - Freud's experience on the Acropolis is reviewed and reappraised. Also, the experience of Elie Wiesel at the Wall in Jerusalem and Patient X's reaction visiting an Egyptian temple are examined. Carl Jung's wish to go to Rome and his inability to do so are noted. The aim of the paper is to offer deeper understanding about intense reactions many sensitive and creative people experience over travel to special places. These places are treated as idealized and ambivalently loved transference objects. Normal anticipatory pleasure prior to the trip is impaired and reality pleasure at the site cannot be enjoyed. When these spots are reached, ego regression is initiated by the intolerably intense narcissistic pleasure mobilized by the gratification of fantasies that were felt to be unrealizable. The fantasies can be conscious or unconscious and from oedipal as well as preoedipal and postoedipal developmental levels; however, they always involve the fulfillment of overwhelmingly powerful wishes. The deep ego regression, archaic fantasies, and the complex defenses mobilized are frightening since there may also be concern about ego dissolution or irreversible transformation. One highly adaptive solution which helps master these conflictual and developmental experiences is creative ego activity. While maintaining integrity for the individual ego and enhancing the self, creative work and accomplishment also enrich and advance the cultural process. PMID- 3519741 TI - Reflex sympathetic dystrophy syndrome. AB - Reflex sympathetic dystrophy syndrome is a devastating disease that is difficult to diagnose and treat. Presented here is a review of the literature explaining its clinical and radiographic findings, pathogenesis, diagnosis, and treatment modalities. PMID- 3519742 TI - The medical/surgical management of gout. AB - Hyperuricemia and gout are common clinical entities. The pathogenesis, clinical presentation, and medical/surgical management of gout are reviewed. A case of chronic tophaceous gout exemplifying the multifaceted nature of the disease is presented. PMID- 3519743 TI - Pulsatile luteinizing hormone releasing hormone treatment for induction of ovulation. Radioimmunoassay of plasma LHRH and comparative study of subcutaneous versus intravenous routes of administration. AB - To investigate the efficacy of the different routes of luteinizing hormone releasing hormone (LHRH) administration upon pituitary responsiveness, we compared plasma LHRH concentrations and pituitary LH responses in four patients with hypothalamic amenorrhea treated with pulsatile LHRH. A portable computerized infusion pump delivered sc or iv LHRH pulses of 5, 10 or 20 micrograms every 90 min. Comparison of the two modes of LHRH delivery was performed using radioimmunoassay of exogenous LHRH and studying its pharmacokinetics for a 3 pulses period. With 10 micrograms of LHRH given iv, plasma LHRH levels increased between 700 and 1000 pg/ml within 3 min and returned to basal levels in 30 min. When given sc (10 micrograms), plasma LHRH levels peaked between 80 and 100 pg/ml in 15 min and returned to basal levels 60 min later. In one patient treated with 5 micrograms per pulse iv or sc, plasma LHRH increased to 380 and 60 pg/ml respectively. In all patients, computerized analysis of LH pulses was performed during sc and iv LHRH administration. LH pulsatile release displayed a similar rhythm period with both routes. However, for the same dose of LHRH (10 micrograms), the adjusted mean of LH plasma levels was lower with the sc route. In conclusions, the pharmacokinetics of LHRH administered sc or iv displayed a similar pattern but, with equivalent doses, higher plasma LHRH levels are attained with the iv route. Concomitantly, the mean LH levels were also greater after iv administration. Ovulation can be successfully induced by both pulsatile iv and sc LHRH therapy. However, with the sc route, a higher dose of LHRH should be used to prevent a delay of ovulation or a luteal deficiency. PMID- 3519744 TI - Iodothyronine deiodination in the brain of diabetic rats: influence of thyroid status. AB - Experimental diabetes causes profound alterations in the metabolism of thyroxine (T4), including a decrease in hepatic triiodothyronine (T3) generation from T4 via 5'-deiodination (5'-D). Because 5'-D in brain differs markedly from that in liver, both in enzymatic mechanism and in the response to hypothyroidism, we studied iodothyronine deiodination, in particular T4 to T3 conversion (T4-T3), by incubating 125I T4 with particulate fractions of cerebral cortex (Cx) and cerebellum (Cm) from rats made diabetic by injection of streptozotocin. In nondiabetic thyroidectomized (Tx) rats Cx and Cm T4-T3 activity was increased approximately ten-fold and two-fold, respectively, compared with intact controls. Diabetic Tx rats did not differ from nondiabetic Tx rats in the rate of net T3 production from T4 but the formation of 3,3'-T2 was slightly reduced. Insulin treated diabetic-Tx rats showed a pattern of T4 metabolism in Cx and Cm virtually identical to that of nondiabetic Tx rats. The rate of T3 degradation, determined in parallel incubations of Cx and Cm with 125I T3, did not differ significantly among the groups, indicating that the observed differences in net T3 production were due to changes in T4 5'-D activity. Intact diabetic rats compared to nondiabetic controls showed no significant changes in T4-T3 either in Cx or in Cm. Administration of T3, 0.8 microgram per 100 g bw per day for 6 days, by constant infusion to intact rats raised T4-T3 in Cx and Cm to levels found in Tx rats. Treatment of intact diabetics with T3 caused qualitatively similar changes, i.e., a hypothyroid response.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3519745 TI - Effects of relaxin on the mouse mammary gland. III. The fat pad. AB - The effects of relaxin on the growth of the mammary fat cells of ovariectomized virgin mice have been studied histologically and morphometrically. To characterize the effects of relaxin and investigate a possible synergism in promoting growth of the mammary fat pad, some animals were treated with other mammotrophic hormones, namely estrogen and insulin. The data obtained after 18-20 h of relaxin treatment suggest that this hormone induces hypertrophy and hyperplasia of adipose cells. The degree of hypertrophy is the same if relaxin is given either alone or after estrogen priming. The action of estrogen seems to be obligatory to obtain fat cell hyperplasia. Indeed, a de novo formation of fat cells occurs in all animals treated with estrogen, either alone or in association with relaxin or insulin. However, the maximum degree of adipose cell hyperplasia was attained only when relaxin followed a pretreatment with estrogen, thus suggesting a synergistic action of these two hormones in promoting the overall growth of the mammary fat pad. These findings follow the observation that relaxin stimulates the proliferation and differentiation of epithelial and myoepithelial cells of the duct system and strongly support the idea that relaxin may be regarded as a trophic hormone for the parenchymal and stromal components of the mammary gland. PMID- 3519746 TI - The cytoskeleton and extracellular matrix of the Dupuytren's disease "myofibroblast": an immunofluorescence study of a nonmuscle cell type. AB - The cytoskeleton and the extracellular matrix of myofibroblasts in nodules from Dupuytren's diseased palmar fascia were examined by indirect immunofluorescence. Primary antibodies used as probes of these tissue compartments were directed against (1) smooth muscle myosin, (2) nonmuscle myosin--components of the cytoplasmic contractile apparatus in smooth muscle and nonmuscle cells, respectively, (3) laminin, and (4) fibronectin--extracellular glycoproteins mediating cell-matrix attachment in smooth muscle and nonmuscle fibroblastic cells, respectively. The Dupuytren's nodular cells stained for nonmuscle myosin and fibronectin but not for smooth muscle myosin or laminin; this indicated that, at the level of biochemical differentiation, these cells are a nonmuscle type. Staining for fibronectin between nodular cells was dramatically increased over that seen between fibroblasts of the normal palmar fascia. Because of the non muscle nature of the distinctive contractile cell type of the Dupuytren's nodule, we suggest that the term myofibroblast should be considered a misnomer when applied to this pathogenic cell type. PMID- 3519747 TI - Mycosis fungoides: cutaneous T cell lymphoma. PMID- 3519748 TI - Collagen expression during teratocarcinoma cell line-induced endochondral bone tumor. AB - Collagen immunotyping by indirect immunofluorescence was performed in order to investigate the sequential development of bone formation. Osseous tumors were obtained after subcutaneous injection of 3/A/1D-1 teratocarcinoma cell line into 129/Sv mice (Nicolas et al., 1980). Frozen sections of developing tumors were incubated with specific antibodies directed against Types I, II, III, IV, and IX collagens. On Day 9, the expression of Type I and Type III collagens was correlated with the proliferation of mesenchymal cells. From Day 10, chondrogenesis was characterized by the occurrence of cartilaginous collagens, Types II and IX, in the cartilage matrix. Type IV collagen was also detected in focal areas and revealed vascular invasion of the tumor. On Day 13, osteogenesis was demonstrated by the presence of Type I collagen in the bone matrix coating the surfaces. Immunolocalization of Type III collagen on the hemopoietic elements corresponded with the bone remodeling. The sequential transitions of collagen types confirm the development of an endochondral bone tumor. These results suggest that 3/A/1D-1 teratocarcinoma cell line constitutes a valuable system for in vitro study of endochondral bone formation and cell differentiation. PMID- 3519749 TI - Post-embedding colloidal gold immunolocalization of laminin to the lamina rara interna, lamina densa, and lamina rara externa of renal glomerular basement membranes. AB - Ultrastructural distribution of laminin within renal glomerular (GBM) and tubular basement membranes (TBM) was investigated using post-embedding immunolocalization with colloidal gold. Rat kidneys were fixed with 4% formaldehyde and embedded at 4 degrees C in Lowicryl K4M medium. Thin sections were then sequentially treated with affinity-purified rabbit anti-laminin IgG and anti-rabbit IgG conjugated to 10 nm diameter colloidal gold. Gold bound specifically to the GBM and TBM with particle densities of 690/micron2 and 731/micron2, respectively. In the GBM, the number of gold particles bound/micron2 of lamina densa greater than lamina rara externa greater than lamina rara interna. Closely similar binding patterns were found when kidneys were fixed with 0.5% glutaraldehyde plus 3% formaldehyde and embedded at 60 degrees C in L.R. White resin, but slightly less gold bound to sections overall than that seen with formaldehyde alone and Lowicryl. Taken together, these results illustrate that anti-laminin IgG, whether applied to fixed sections in vitro or introduced in vivo, bound to the lamina rara interna, lamina densa, and lamina rara externa of the GBM and throughout the TBM. PMID- 3519750 TI - Ultrastructural localization of glycoconjugates in the fungus Ascocalyx abietina, the Scleroderris canker agent of conifers, using lectin-gold complexes. AB - Different glycoconjugates were revealed in the fungus Ascocalyx abietina (Lagerberg.) Schlaepfer-Bernhard, by using various lectin-gold complexes. N acetylglucosamine, N-acetylgalactosamine, and D-mannose were specifically localized in cell walls of fungal cells. N-acetylneuraminic acid (sialic acid) and L-fucose were detected in structures corresponding to lipid bodies, whereas they were totally absent in the cell wall. This is the first report on the occurrence of sialic acid in fungi and of fucose in Ascomycetes. The great advantage of using lectin-gold complexes for ultrastructural localization of sugars in phytopathogenic fungi, as well as in studies concerning host-pathogen interactions, is discussed. PMID- 3519751 TI - Reticular fibroblasts in peripheral lymphoid organs identified by a monoclonal antibody. AB - We have produced a panel of monoclonal antibodies directed against nonlymphoid cells in central and peripheral lymphoid organs. In this paper we present the reactivity of one of these antibodies, ER-TR7. This antibody detects reticular fibroblasts, which constitute the cellular framework of lymphoid and nonlymphoid organs and their products. In frozen sections of the spleen incubated with this antibody, the red pulp and white pulp are clearly delineated. Furthermore, the major white pulp compartments--the follicles and periarteriolar lymphoid sheath as well as the marginal zone--are recognized by their characteristic labeling patterns. In lymph nodes, the capsule, sinuses, follicles, paracortex, and medullary cords are clearly delineated. In the thymus and bone marrow no such specialized compartments were demonstrated. ER-TR7 reacts with an intracellular component of fibroblasts. Since ER-TR7 does not react with purified laminin, collagen types I-V, fibronectin, heparan sulfate proteoglycan, entactin, or nidogen, it detects a hitherto uncharacterized antigen. The possible role of the ER-TR7 positive reticular fibroblasts in the cellular organization of peripheral lymphoid organs will be discussed. PMID- 3519752 TI - Immunocytochemical localization of cathepsin B in rat kidney. I. Light microscopic study using the indirect immunoenzyme technique. AB - Localization of cathepsin B in rat kidney was studied using immunocytochemical techniques. Cathepsin B was purified from rat liver and antibody to it was raised in rabbits. The antibody reacted with a lysosomal extract of rat kidney to form a single precipitin line in a double-diffusion test. Immunoblot analysis of lysosomal cathepsin B of rat kidney showed two species of 29K and 25K MW. After removal of Epon, semi-thin sections of glutaraldehyde-fixed tissue were stained by the indirect immunoenzyme technique. Dark-brown reaction product, indicating the antigenic sites for cathepsin B, was found in cytoplasmic granules throughout the nephron. Staining intensity and size of the positive granules varied widely in each segment of the nephron. In the glomeruli and distal tubules, a few small cytoplasmic granules were stained. In the proximal tubules, the S1 segment exhibited many large granules which were most heavily stained, whereas the S2 and S3 segments contained few positive granules. All segments of the distal tubules showed the smallest amount of positive granules. A few positive granules were also noted in the cortical and medullary collecting tubules. Control experiments confirmed the specificity of the staining. The results indicate that the major site for cathepsin B in rat kidney is the S1 segment of the proximal tubule which is known to actively take up proteins leaked through the glomerulus. PMID- 3519753 TI - Immunocytochemical localization of cathepsin B in rat kidney. II. Electron microscopic study using the protein A-gold technique. AB - Thin sections of Lowicryl K4M-embedded materials were labeled with protein A-gold complex. Gold particles representing the antigen sites for cathepsin B were exclusively confined to lysosomes of each segment of the nephron. The heaviest labeling was noted in the lysosomes of the S1 segment of the proximal tubules. Labeling intensity varied considerably with the individual lysosomes. Lysosomes of the other tubular segments, such as the S2 and S3 segments of the proximal tubules, distal convoluted tubules, and collecting tubules were weakly labeled by gold particles. Quantitative analysis of labeling density also confirmed that lysosomes in the S1 segment have the highest labeling density and that approximately 65% of labeling in the whole renal segments, except for the glomerulus, was found in the S1 segment. These results indicate that in rat kidney the lysosomes of the S1 segment are a main location of cathepsin B. Further precise observations on lysosomes of the S1 segment revealed that apical vesicles, tubules, and vacuoles were devoid of gold particles, but when the vacuoles contained fine fibrillar materials, gold labeling was detectable in such vacuoles. As the lysosomal matrix becomes denser, the labeling density is increased. Some small vesicles around the Golgi complex were also labeled. These results indicate that the endocytotic apparatus including the apical vesicles, tubules, and vacuoles contains no cathepsin B. When the vacuoles develop into phagosomes, they acquire this enzyme to digest the absorbed proteins. PMID- 3519754 TI - Aminoglycoside binding sites in Escherichia coli as revealed by neomycin-gold labeling. AB - A cytochemical technique for demonstration of neomycin binding sites by electron microscopy was developed and applied to Escherichia coli. Neomycin was conjugated chemically with bovine serum albumin (BSA). Colloidal gold was coated with the conjugated neomycin-BSA. The neomycin-BSA-gold was applied to thin sections of Epon-embedded E. coli and examined. Gold particles were observed on the outer membrane and the cytoplasmic membrane of E. coli. It was probably the ribosomes that were being labeled in the cytoplasm. Different cytochemical controls, including a number of inhibition tests and the use of BSA-gold, proved the specificity of this cytochemical technique and provided the biochemical significance of the observations. PMID- 3519755 TI - Electron microscopic localization of glutamate dehydrogenase in rat liver mitochondria by an immunogold procedure and monoclonal and polyclonal antibodies. AB - Glutamate dehydrogenase (GDH) was localized in rat liver by indirect electron microscopic immunogold, using different sizes of gold particles and monoclonal and polyclonal antibodies. Using the protein A-gold technique in double immunocytochemical experiments, both antibodies, at their optimal dilutions, gave similar results. A novel assessment of the distribution of GDH was made by measurements of the number of gold particles per square micrometer of cross sectional images of individual mitochondria. The data indicate intracellular homogeneity among mitochondria in individual parenchymal cells. The enzyme is almost absent in non-parenchymal cells. Finally, GDH was found mainly in association with the mitochondrial inner membrane. PMID- 3519756 TI - Immunocytochemical and enzyme histochemical localization of kallikrein-like enzymes in colon, intestine, and stomach of rat and cat. AB - Kallikrein was localized in goblet (or mucous) cells of rat colon and in rat and cat small intestine and stomach by two immunocytochemical techniques. A kallikrein-like enzyme was also localized by enzyme histochemistry in mast cells of colon, intestine, and stomach of the cat, where they appeared to be associated with blood vessels in the lamina propria. The mast cell enzyme, however, was not detected by immunocytochemistry using antibodies to kallikrein. Modification in the enzyme histochemical procedure (pH, fixation) yielded positive results for a kallikrein-like protease in goblet cells of the intestine and colon. The possible physiological and pathological significance of kallikrein-like enzyme in the gastrointestinal tract and elsewhere is discussed. PMID- 3519757 TI - Absence of relaxin immunostaining in the male reproductive tracts of the rat and mouse. AB - By use of the biotin-avidin immunohistochemical method and a homologous antiserum as the primary antiserum, relaxin immunostaining was absent in the testes, prostate, seminal vesicles, and epididymides of the rat. Relaxin immunostaining was also lacking when anti-porcine relaxin serum was employed as the primary antiserum. Furthermore, immunohistochemical studies for relaxin localization in the reproductive tract of the male mouse using both anti-rat and anti-porcine relaxin sera also revealed an absence of the hormone in the reproductive system of this species. Although this study suggests that immunoreactive relaxin is absent in the male reproductive tracts of both the rat and mouse, it raises some questions concerning the reports in the literature of the presence of relaxin like substances in the male reproductive tracts of other species. These reports are discussed in relation to our current results. PMID- 3519758 TI - Neurites and growth cones in the chick embryo. Enhanced tissue preservation and visualization of HRP-labeled subpopulations in serial 25-microns plastic sections cut on a rotary microtome. AB - Study of axonal guidance in developing vertebrates has been hindered by an inability to readily visualize individual growth cones, determine the neuronal population from which they originate, trace their trajectories, and discern their interactions with their embryonic environment. We report a method that combines plastic embedding and serial sectioning with horseradish peroxidase labeling of subpopulations of neurons in the chick embryo. This method labels individual neurites from the soma to the tip of the growth cones, allowing their trajectory to be inferred and their identity to be determined by the position of the somata. As sections are up to 25 micron thick, entire growth cones can often be visualized without laborious reconstruction. Tissue preservation is much better than with similar material embedded in paraffin. Sections are cut relatively quickly using a steel knife on a standard rotary microtome and are suitable for subsequent electron microscopy. PMID- 3519759 TI - Professor Jan B. Jansen in memoriam. PMID- 3519760 TI - 9-alpha-Fluorocortisol-induced hypertension: a review. PMID- 3519761 TI - Inhibition of the enzymatic reaction of renin in aggressive mice. AB - Aggressive behaviour provokes a very high increase in plasma renin in aggressive male mice. We demonstrate that this occurs in mice with high as well as low concentrations of renin in the submaxillary glands, although the highest values were seen in the former. Plasma renin and angiotensinogen concentrations, as well as plasma renin activity, were measured before and after aggression. The theoretical plasma renin activity (generation rate of angiotensin l) was calculated from kinetic parameters and the renin and angiotensinogen concentrations. The Km (Michaelis constant) was 3 mumol/l and the kcat (turnover number) was 0.15/s for the reaction between pure submaxillary mouse renin and mouse angiotensinogen. The measured plasma renin activity was much lower than that calculated from both the kinetics and the fall in angiotensinogen concentration. The decrease in angiotensinogen in vivo was independent of the renin concentration. Intraperitoneally injected renin mimicked the aggression provoked renin increase and resulted in better agreement between measured and calculated parameters. This indicates, that during aggression, the mouse can inhibit and control the renin-angiotensinogen reaction. PMID- 3519762 TI - Effects of reversible renal denervation on haemodynamic and excretory functions of the ipsilateral and contralateral kidney in the cat. AB - In anaesthetized cats reversible denervation of one kidney was performed by cooling of the left renal nerves to 3 degrees C for 16 min. The response of the left (ipsilateral) kidney was compared with the response of the right (contralateral) kidney twice in the same animal: (1) when the right kidney was still innervated, and (2) after it had been surgically denervated. Left renal nerve cooling did not cause any changes in arterial pressure. In the left kidney, blood flow, vascular conductance, sodium and water excretions increased, and renin release decreased. Simultaneously in the contralateral kidney, no haemodynamic changes were observed, glomerular filtration was only transiently decreased, whereas sodium and water excretion significantly decreased and renin release increased. When left renal nerve cooling was repeated after surgical denervation of the right kidney, similar changes were observed in the left (ipsilateral) kidney, whereas all contralateral effects were abolished. These experiments suggest that tonically active afferent fibres from one kidney exert a reflex inhibitory action on sympathetic activity directed to the contralateral kidney controlling tubular sodium reabsorption and renin release. PMID- 3519763 TI - Effects of potassium loading in normal man on dopaminergic control of mineralocorticoids and renin release. AB - The interacting effects of potassium with the dopaminergic control of mineralocorticoid release were evaluated in normal man. Sixteen male healthy volunteers [27 +/- 6 (s.d.) years] on a 200 mmol sodium (Na+) and 60 mmol potassium (K+) diet (control) received a K+ load of 200 mmol/day for 6 days (high K+ diet). Basal plasma aldosterone and 18-OH-corticosterone (18-OH-B) levels were significantly increased after 6 days of the high-K+ diet, whereas basal levels of 18-OH-deoxycorticosterone (18-OH-DOC) and corticosterone remained unchanged. Fifteen minutes after 10 mg i.v. of the dopaminergic antagonist, metoclopramide, a significant increase was only obtained for basal plasma aldosterone and 18-OH-B levels. The absolute rise of aldosterone and 18-OH-B induced by metoclopramide was greater (P less than 0.01) after K+ supplementation. However, the relative increase of these hormones was similar before and after K+ loading. Basal plasma renin activity increased significantly under high-K+ diet. The results indicate that K+ homeostasis must be taken into account when estimating absolute response of aldosterone and 18-OH-B to dopaminergic antagonism. PMID- 3519764 TI - Arterial pressure and renal function in two-kidney, one clip Goldblatt hypertensive rats maintained on a high-salt intake. AB - Arterial blood pressure and renal function of both clipped and non-clipped kidneys of benign two-kidney, one clip (2K1C) Goldblatt hypertension were evaluated in order to determine whether high-salt intake alters the course of the development and magnitude of hypertension or influences renal function. The administration of 0.9% sodium chloride as a drinking solution for 3 weeks suppressed plasma renin activity (PRA) and kidney renin content of the clipped kidney to normal values. Despite suppression of PRA and kidney renin content, the saline-drinking clipped rats still developed hypertension of the same magnitude as the water-drinking clipped rats. However, the onset of hypertension was delayed by 4 days. Urine flow, glomerular filtration rate (GFR) and sodium excretion rate from the clipped kidneys of the saline-drinking clipped rats were higher than the corresponding values in the water-drinking rats, and approached those observed in control animals. Thus, the high-salt intake which was associated with suppression of the activity of the renin-angiotensin system delayed the onset of, but not the final magnitude of, the hypertension. In addition, kidney function in the clipped kidneys of saline-drinking clipped rats was enhanced compared with that observed in the water-drinking clipped rats. PMID- 3519765 TI - Body sodium/blood volume state in normotensive members of normotensive and hypertensive families. AB - Exchangeable sodium is lower than normal in young male patients with essential hypertension. This may reflect a primary abnormality of sodium metabolism, or natriuresis caused by sodium-independent elevation of arterial pressure. To investigate this question, 31 normotensive men with positive and 31 normotensive men with negative family history of essential hypertension were studied. Blood pressure tended to be higher in the former (121/78 +/- 9/8 (s.d.) versus 113/74 +/- 11/9 mmHg; P less than 0.005); mean age, urinary sodium or potassium excretion, plasma sodium, potassium, renin activity or aldosterone levels and creatinine clearance were comparable. Exchangeable sodium and blood volume were also similar in the two groups, when expressed in absolute values (3113 +/- 306 versus 3044 +/- 242 mmol and 4902 +/- 581 versus 4769 +/- 579 ml, respectively) or in relation to body surface area (100.8 +/- 7.1 versus 100.2 +/- 6% and 103.8 +/- 12.2 versus 102 +/- 11.3%). In both groups, exchangeable sodium and blood volume were unrelated to arterial pressure. The body sodium/blood volume state is normal in normotensive subjects with positive family history. The low exchangeable sodium of young patients with essential hypertension does not appear to reflect a primary familial abnormality of body sodium metabolism. PMID- 3519766 TI - The effects of thiazide diuretics upon plasma lipoproteins. AB - In a double-blind, placebo-controlled, crossover study in 16 hypertensives, 4 weeks of 50 mg hydrochlorothiazide twice daily, caused significant elevations in total plasma cholesterol, high density lipoprotein (HDL)-cholesterol, low density lipoprotein (LDL)-cholesterol, very low density lipoprotein (VLDL)-cholesterol and triglycerides. Significant elevations in fasting plasma glucose and in plasma insulin were observed, but no correlation between individual lipid elevations and either glucose or insulin elevations was apparent. The metabolic effects developed within 2 weeks, and dissipated within 4 weeks. Changes induced within 4 weeks of treatment with hydrochlorothiazide were unaltered at 6 months. Hydrochlorothiazide induces elevation of all lipoprotein cholesterol fractions and VLDL-triglyceride. However, as the important ratio between LDL- and HDL cholesterol is unchanged, coronary risk may be unchanged. PMID- 3519767 TI - Antigen presentation by Langerhans cells in vivo: donor-derived Ia+ Langerhans cells are required for induction of delayed-type hypersensitivity but not for cytotoxic T lymphocyte responses to alloantigens. AB - T cell activation in response to allogeneic stimulation and hapten-specific delayed-contact hypersensitivity responses in vivo can be initiated by Ia-bearing epidermal Langerhans cells (LC). By using a murine heterotopic corneal allograft model, we have investigated the requirement for allogeneic LC as antigen presenting cells (APC) in the in vivo induction of delayed-type hypersensitivity (DTH) and cytolytic T lymphocyte (CTL) responses to alloantigens in fully allogeneic and H-2 I region-disparate strain combinations. LC-deficient, avascular central corneal allografts from BALB/c donors failed to induce DTH responsiveness when grafted to a subdermal bed on C57BL/6 recipients (p greater than 0.05), yet antigen-specific primary CTL reactivity developed within 7 days after grafting. LC-containing corneal-limbus allografts or central corneal allografts containing a latex bead-induced infiltrate of LC resulted in intense DTH as well as CTL responsiveness when grafted in this same strain combination. Similarly, LC-containing but not LC-deficient corneal allografts from A.TL donors induced DTH responsiveness in I region-disparate A.TH hosts despite the fact that these grafts survived for prolonged duration (less than 28 days). By contrast, CTL induction in I region-disparate hosts was independent of the presence of allogeneic LC. Corneal epithelial cells of grafts removed from I region-disparate hosts 7 days posttransplantation were shown by immunohistology to express the Iak antigens of donor origin. The possibility that bone marrow-derived allogeneic LC were a sufficient requirement for DTH induction was confirmed in experiments performed with CB6F1----B6 bone marrow chimeras used as corneal allograft donors. Corneal-limbus grafts obtained from mice 90 days after chimerization were shown by immunohistology to contain Iad-bearing CB6F1 LC as a sole source of class II alloantigens. When grafted to C57BL/6 recipients, LC-containing chimeric corneas induced DTH responsiveness that was similar in magnitude to that observed in C57BL/6 mice grafted with chimeric skin, yet no DTH response to LC-deficient chimeric central corneal grafts was observed. Moreover, in all cases, the chimeric corneal and skin allografts survived for prolonged duration (greater than 28 days). These results demonstrate that donor-derived LC act as APC in the induction of DTH responsiveness to allogeneic tissue; however, there was no apparent requirement for allogeneic LC in the induction of CTL responses to class I or class II MHC alloantigens.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3519768 TI - Murine bone marrow IgA responses to orally administered sheep erythrocytes. AB - Specific immunization protocols have been established for the induction of murine bone marrow IgA responses to the T cell-dependent (TD) antigen sheep red blood cells (SRBC). Systemic immunization, either i.p. or i.v., followed by a second injection, induced splenic IgM and IgG responses and a bone marrow IgM response. No significant IgA responses were observed in either lymphoid tissue compartment. Oral immunization with SRBC by gastric intubation for 2 days, followed 1 wk later by an i.p. injection of SRBC resulted in a splenic IgA plaque-forming cell (PFC) response, but did not elicit a bone marrow IgA response. Repeated daily gastric intubation of SRBC to C3H/HeN and C3H/HeJ mice led to the previously reported pattern of systemic unresponsiveness in C3H/HeN mice and good anamnestic type IgM, IgG, and IgA splenic anti-SRBC PFC responses in the C3H/HeJ strain upon parenteral challenge. Oral administration of SRBC for 14 days to C3H/HeN mice, followed by systemic SRBC challenge, resulted in diminished splenic PFC responses of all isotypes, whereas gastric intubation of SRBC for 28 days led to complete systemic unresponsiveness to antigen in C3H/HeN mice. Interestingly, the repeated oral administration of SRBC resulted in significant bone marrow IgA PFC responses upon i.p. challenge in both C3H/HeN and C3H/HeJ mouse strains. The bone marrow IgA responses were clearly dependent upon chronic oral exposure to SRBC, because gastric intubation with SRBC for 2 consecutive days/wk for 10 wk also induced bone marrow and splenic IgA anti-SRBC PFC responses in C3H/HeN mice. These results suggest that memory B cells reside in the bone marrow of orally immunized mice and can yield anamnestic-type responses to challenge with the inducing antigen. The memory cells may arise in the Peyer's patches of the gut and migrate to the bone marrow. The possibility that the bone marrow is a component of the common mucosal immune system in mammals is suggested by this study. PMID- 3519769 TI - The effect of 1,25-dihydroxyvitamin D3 on in vitro immunoglobulin production in human B cells. AB - 1,25-Dihydroxyvitamin D3 (1,25(OH)2D3) dose-dependently suppressed immunoglobulin (Ig) production of human B cells, as evaluated by IgG-plaque-forming cells (IgG PFC) in the culture of pokeweed mitogen (PWM)-activated B cells. Similar suppressive effect of 1,25(OH)2D3 on Ig production of B cells was observed in the Staphylococcus aureus Cowan I(SAC)-induced Ig-producing system. The mean percentage of inhibitions at a concentration of 10(-9) M were 60.0 +/- 8.2% (mean +/- SE, n = 6) and 65.1 +/- 4.7% (n = 10) in PWM- and SAC-stimulated cultures, respectively. The suppression was strongly exhibited only when 1,25(OH)2D3 was added at the start of the 6-day culture, accompanied by a decrease in DNA synthesis of B cells in both culture systems. On the other hand, the addition of 1,25(OH)2D3 on day 4, when DNA synthesis reached at plateau and IgG-PFC began to be detectable, had no noticeable affect on either the number of PFC or DNA synthesis of B cells. Furthermore, 1,25(OH)2D3 suppressed Ig production even when B cells were exposed to the agent for 4 hr after the activation with PWM or SAC, but not before the activation. These results indicate that 1,25(OH)2D3 inhibits B cell proliferation before differentiation to Ig-secreting cells, consequently reducing Ig production; and that its action appears to be mediated by the cytosol receptors expressed on activated B cells. Thus, the agent may serve as an immunoregulating hormone in vivo, as well as in vitro. PMID- 3519770 TI - Full reconstitution of the immune deficiency in scid mice with normal stem cells requires low-dose irradiation of the recipients. AB - Mice homozygous for an autosomal recessive mutation for the scid gene exhibit a defect that specifically impairs lymphoid differentiation but not myelopoiesis. Such mice can be cured of their lymphoid deficiency by grafts with normal bone marrow, although full reconstitution of lymphoid function is seldom obtained. Long-term bone marrow cultures (LTBMC) are devoid of all mature B and pre-B cells but contain lymphoid stem cells. We therefore reconstituted scid mice with LTBMC cells to study the kinetics of B lymphocyte reconstitution in normal and irradiated (4 Gy) scid recipients and in irradiated (9.5 Gy) co-isogenic C.B-17 mice. Detectable colony-forming B cells rapidly increased in the spleen and bone marrow of irradiated C.B-17 and irradiated scid recipients, reaching normal levels between 4 and 6 wk post-grafting. Unirradiated scid recipients showed limited reconstitution in spleen and very poor reconstitution in bone marrow. Unirradiated scid recipients also had relatively few surface Ig+ cells in spleen or bone marrow, whereas both groups of irradiated recipients had normal numbers between 4 and 6 wk post-reconstitution. Normal levels of cytotoxic T cell activity by 8 wk after reconstitution were observed only in the irradiated C.B-17 and irradiated scid recipients. Analysis of mice reconstituted with cells from LTBMC indicates that these cultures contain lymphoid stem cells with significant proliferative and self-renewal potential, and that full reconstitution of lymphoid function requires prior irradiation of the scid recipient. PMID- 3519771 TI - Leukocyte migration inhibitory factor (LIF) to sperm from autoimmune men in infertile couples. AB - Leukocyte migration inhibitory factor (LIF) is produced by lymphocytes with receptors specific to sensitizing antigens. This principle was used to detect possible antigenic differences between sperm of autoimmune and nonautoimmune men. Sixteen fertile and 91 infertile couples were screened for cytotoxic and hemagglutinating antibodies to sperm from their husbands and controls. Their lymphocytes were tested for the production of LIF to sperm extracts and seminal plasma from the husbands and controls by a direct leukocyte migration inhibition assay. Twenty-nine of 35 men producing LIF to sperm and/or seminal plasma were positive for sperm antibodies (p = 0.0004, vs sperm antibody-negative controls). Twenty-three of 29 wives with LIF production had sperm-autoimmune husbands (p = 0.04). Leukocyte migration was significantly inhibited in sperm-autoimmune men by autologous sperm extracts and seminal plasma in contrast to control sperm extracts and seminal plasma (p = 0.0006 and 0.001, respectively). The wives of autoimmune men had significantly higher LIF responses to their husbands' sperm extracts than to other antigens (p = 0.02). Men with cytotoxic antibodies in their seminal plasma produced LIF to autologous sperm (p = 0.001). It is suggested that certain sperm and seminal plasma antigens of autoimmune men may lead to specific humoral and cell-mediated immune responses in both partners. PMID- 3519772 TI - Production of B cell growth factor by normal human B cells. AB - Although it has been demonstrated that malignant human B cell lines are capable of producing B cell growth factor (BCGF), production of BCGF by normal B cells has not been shown. In this study, we demonstrate BCGF production by normal B cells, achieved by using human peripheral blood B cells prepared by a positive selection technique and stimulated with Staphylococcus aureus Cowan I (SAC) for 12 hr. SAC was removed from the supernatants by anti-SAC-coupled Sepharose. Supernatants absorbed with this antibody were functionally free of SAC, as demonstrated by their inability to activate resting B cells. B cells stimulated with SAC for 12 hr produced BCGF activity that was generally unmeasurable in supernatants by 36 hr. Characterization of BCGF produced by SAC-stimulated B cells revealed a m.w. of 32,000 by high-performance liquid chromatography sieving and sodium dodecyl sulfate-polyacrylamide gel electrophoresis; this BCGF was found to have an isoelectric point of 6.7. Furthermore, this BCGF lacked interleukin 1, interleukin 2, interferon, and B cell differentiation factor activity. This observation that BCGF can be produced by normal human B cells is significant because it demonstrates for the first time that normal B cells have the ability to provide their own growth factors or the growth factors for other B cells. PMID- 3519773 TI - Contributions of the Mac-1 glycoprotein family to adherence-dependent granulocyte functions: structure-function assessments employing subunit-specific monoclonal antibodies. AB - MAb directed at the alpha-subunits of Mac-1 (alpha M), LFA-1 (alpha L), p150,95 (alpha X), or their common beta-subunit were used to characterize the contributions of the Mac-1 glycoprotein family to granulocyte adherence reactions. Inhibitory effects of these MAb in incubation experiments with normal granulocytes indicated distinct adhesive contributions of each subunit. Significantly greater adherence, and inhibition of adherence by anti alpha M, alpha X, and beta MAb, was observed under chemotactic conditions designed to "up regulate" the surface expression of the alpha M beta and alpha X beta complexes. Adherence to protein-coated glass and binding of albumin-coated latex beads were significantly inhibited by anti-beta greater than anti-alpha M (OKM-10, M1/70, LM2/1.6 and OKM-1) greater than anti-alpha X greater than anti-alpha L MAb, but no effects of anti-HLA, AB, or anti-CR-1 MAb were evident. A similar rank order of inhibition was observed in granulocyte aggregation assays in response to C5a, PMA, or f-Met-Leu-Phe. Significant inhibition of directed migration by anti-beta or anti-alpha M (OKM-1 or OKM-10) MAb was observed in subagarose but not Boyden chemotaxis assays; inhibition was dependent on a continuous cell exposure to anti Mac-1 alpha or beta during the assay, suggesting that a continuum of new Mac-1 expression is required for directed translocation. Phagocytosis of Oil-Red-O paraffin or zymosan selectively opsonized with C3-derived ligands was significantly inhibited by anti-alpha M MAb (OKM-10 greater than LM2/1.6 greater than M1/70 greater than OKM-1) or by combinations of anti-alpha M + anti-CR-1 MAb, but only minimal inhibitory effects of anti-beta MAb and no effects of anti alpha L or anti-alpha X MAb were seen. Similarly, complement-dependent phagocytosis-associated lactoferrin release, ingestion, and intracellular killing of Staphylococcus aureus 502A, and binding of iC3b-opsonized SRBC, were significantly inhibited by anti-alpha M (OKM-10, M1/70) or combinations of anti alpha M + anti-CR-1 MAb, but not by anti-beta, alpha L, or alpha X MAb. Notably, none of the anti-Mac-1 MAb demonstrated inhibitory effects in assays of adherence independent functions including shape change, specific f-Met-Leu-3H-Phe binding, O-2 generation, chemiluminescence evolution, or lactoferrin release in response to PMA.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3519774 TI - Identification of two distinct factors, B151-TRF1 and B151-TRF2, inducing differentiation of activated B cells and small resting B cells into antibody producing cells. AB - We demonstrated previously that cellfree supernatant of the B151K12 T cell hybridoma (B151-CFS) contained T cell-replacing factor (here in after referred to as B151-TRF1) capable of inducing growth and differentiation of antigen-activated B cells into antigen-specific plaque-forming cells (PFC). In the present study, we have identified in B151-CFS another unique lymphokine activity (referred to as B151-TRF2), which induces polyclonal differentiation of unstimulated B cells into IgM-secreting cells without concomitant stimulation of antigen, mitogen, or anti Ig antibody. The B151-TRF2 activity induced polyclonal IgM PFC responses via the action on surface Ig-positive small resting B cells from normal unprimed mice. This activation was effective across an H-2 barrier, and apparently independent of the presence of T cells and accessory cells. Interestingly, the B151-TRF2 activity notably stimulated B cells of neonatal and mutant DBA/2Ha mice, which are nonresponders to B151-TRF1, whereas it failed to activate the xid B cells from CBA/N mice. To substantiate that B151-TRF1 and B151-TRF2 activities are mediated by mutually distinguishable molecules, an absorption experiment of B151 CFS was performed by utilizing DBA/2Ha B cells which are lacking in B151-TRF1 receptor. It was found that DBA/2Ha B cells could absorb B151-TRF2 activity but not B151-TRF1 activity. In contrast, murine chronic B cell leukemia BCL1 cells, which were shown to differentiate into IgM-secreting cells by stimulation with B151-CFS, selectively removed B151-TRF1 activity but not B151-TRF2 activity. Furthermore, biochemical analysis revealed that the B151-TRF2 was a heat (56 degrees C for 30 min)-sensitive protein with an apparent m.w. of 30,000 by gel filtration, whereas B151-TRF1 was a heat-resistant glycoprotein with m.w. of 50,000. In addition, it was shown that prostaglandin E2 selectively inhibited B151-TRF2-mediated B cell responses. These results demonstrate clearly that B151 TRF1 and B151-TRF2 are distinct B cell differentiation factors involved in the different activation pathways of distinct B cell subpopulations. The immunologic implication of B151-TRF2 activity in B cell differentiation is discussed in comparison with other lymphokines so far reported to activate small resting B cells. PMID- 3519775 TI - Slide immunoenzymatic assay for human IgE (SIA-IgE). AB - A rapid and inexpensive method is described for determination of human serum IgE using 5-microliter samples. The slide immunoenzymatic assay for IgE (SIA-IgE) is carried out on a glass slide in which up to 24 samples can be tested including controls and standards; up to four of these slides can be read automatically in conventional vertical beam readers. Flat circles on the slide are covered with a layer of biotinylated antibody specific for human IgE (trapping antibody). Five microliters of serum sample is dropped to cover each circle, and the slide is incubated. The circles are washed with water, dried, incubated under 10 microliters of enzyme-labeled antibody to human IgE, then washed again, and covered with 10 microliters of enzyme substrate. The intensity of color generated is measured at the proper wavelength. The method is simple, accurate and non radioactive and can be completed within 2 h. PMID- 3519776 TI - A modified technique for experimental skin grafting. PMID- 3519777 TI - Screening for bacterial Fc-receptor activity on nitrocellulose membranes. AB - Fc receptors released from staphylococci and streptococci could be readily detected by direct cultivation of the bacteria on nitrocellulose membranes or by microfiltration of their culture supernatants. The nitrocellulose membranes used in both assays were subsequently treated with human immunoglobulin (Ig) G. The reactions of the Fc receptor with IgG could be demonstrated by use of the respective peroxidase-labelled antibodies against IgG. The resulting color formation, which indicated Fc-receptor activity of the bacterial culture, closely corresponded to the 125I-labelled IgG-binding reactivity. PMID- 3519778 TI - A simple and rapid method for the determination of macrophage activating factor involving a new type of apparatus suitable for the measurement of macrophage chemiluminescence. AB - A simple and rapid method for the determination of macrophage activating factor is described. A new type of apparatus suitable for the measurement of macrophage chemiluminescence was devised, and the effect of lymphokines on macrophage activities was studied by measuring phorbol myristate acetate-induced luminol dependent chemiluminescence. An outstanding feature of the new apparatus is that the plastic dish used for the cell culture can be used as the vessel for the chemiluminescence reaction. When thioglycollate-elicited ICR mouse peritoneal macrophages were incubated with lymphokines, their ability to generate chemiluminescence increased rapidly, reaching a maximal level at about 4 h, and then it progressively decreased to the control level at 8 h. Although this increasing effect of lymphokines on macrophage chemiluminescence was short-lived, it could be seen at a relatively low concentration, at which lymphokine-mediated cytotoxic activity of macrophages was not observed. PMID- 3519779 TI - Direct monoclonal antibody rosetting. An effective method for weak antigen detection and large scale separation of human mononuclear cells. AB - A direct monoclonal antibody rosetting technique is described which serves as a simple, reliable, and very sensitive method for the detection of surface antigens on human leukocytes. In this technique the discriminative monoclonal anti leukocyte antibodies are directly coupled to ox erythrocytes (oxE) by use of CrCl3. The procedure can be applied to the effective separation of mononuclear cell subsets. By choosing a gradient of appropriate density labeled cells are either isolated in high purity or quantitatively eliminated. This technique proved to be particularly suitable for the large scale purification of autologous or allogeneic bone marrow transplants where either leukemic cells or T cells have to be completely eliminated without damaging sensitive stem cells. PMID- 3519780 TI - Influence of SLO4 on the leucocyte migration inhibiting factor and on the DTH response. AB - This phase I study demonstrates the immunostimulating properties of SLO4 administered by the oral route in the healthy volunteer. Responses to the test of DTH (delayed type hypersensitivity) were enhanced by SLO4 and the production of MIF (migration inhibiting factor) involved in this response was stimulated. These properties could be correlated with the previously demonstrated induction of interferon by SLO4. PMID- 3519781 TI - Padma Bhushan Dr. R. Ahmed--a life of dedication and inspirations. PMID- 3519782 TI - Prolonged viability of human skin xenografts in rats by cyclosporine. AB - The immunosuppressant cyclosporine (CSA) has shown usefulness in both animal and human transplantation. The present study investigated the effect of CSA in human to rat skin xenografts. Recipient rats received either a fresh split-thickness (0.020 in.) or full-thickness graft obtained from plastic surgery, or frozen cadaver skin. The graft bed of recipient Lewis rats was prepared by full thickness excision. Animals were maintained on CSA 25 mg/kg/day X 50 days, followed by 12.5 mg/kg 2 X/week. Control animals received an equivalent volume of vehicle. All animals receiving split-thickness grafts and treated with CSA maintained their grafts significantly longer (up to 255 days) than controls. The 2 CSA-treated full-thickness grafts and the 10 vehicle-treated controls showed clinical and microscopic signs of rejection at a mean of 6.4 days. Histologic examination of successful grafts showed areas of viable epidermis with a negligible inflammatory infiltrate. There was some loss of normal polarity and occasional apoptotic pigmented basal cells. The dermis revealed moderate fibrosis, probably secondary to the surgical procedure. Graft viability was confirmed by autoradiography. Immunohistochemical staining for S-100 protein revealed morphologic alteration of suprabasilar dendritic (Langerhans indeterminate) cells, as well as their existence in xenografts at 12 weeks posttransplantation. Toxicities reflected by weight loss and blood chemistries were felt to be dose-dependent. This in vivo model may provide a means for testing percutaneous drug penetration and pharmacokinetics in human skin, and for observing the immune component of explanted cutaneous neoplasms and dermatoses. PMID- 3519783 TI - Immunohistologic identification of antigen-presenting cells in cutaneous sarcoidosis. AB - Considerable evidence exists to show that activated T lymphocytes preferentially accumulate at sites of disease activity in sarcoidosis. Langerhans cells, which can be recognized by reactivity with an antibody to the T6 antigen are thought to play a primary role in T-lymphocyte activation by the skin, a tissue frequently involved in sarcoidosis. This immunohistologic study examined the distribution of OKT6-positive cells and surface expression of HLA-DR antigen in cutaneous sarcoid lesions. Skin specimens stained with an anti-HLA-DR antibody demonstrated diffuse staining of the granulomas. In addition, keratinocytes, which do not normally express HLA-DR antigens, were found to stain with monoclonal antibody to HLA-DR in an intercellular pattern. Examination of specimens for OKT6-reactive Langerhans cells revealed significantly greater concentrations in the epidermis overlying sarcoidal granulomas (33 +/- 7 cells/mm) than in the epidermis of age-, sex-, and race-matched controls (11 +/- 3 cells/mm, p less than 0.001). Of greater importance was the demonstration that significant numbers of OKT6 positive cells were present within the dermal sarcoid granulomas (19-208/mm2) in a distribution that paralleled that of Leu-3a-positive T lymphocytes. These data suggest that the epidermis may participate in activation of lymphocytes in cutaneous sarcoidosis, and implicate OKT6-positive cells in granuloma formation. PMID- 3519784 TI - Occurrence of donor Langerhans cells in mouse and rat chimeras and their replacement in skin grafts. AB - Evidence is presented that some endogenous Langerhans cells (LCs) may persist indefinitely in skin grafts. This evidence is based on the observation that although 2 weeks after grafting F1 hybrid mice and rats with genetically compatible skin, most of the LCs in the grafts were replaced with those of the host, some LCs of graft origin persisted for as long as the grafts were followed (154 days in mice and 249 days in rats). It has also been demonstrated that the spleen may be as good a source of LCs as the marrow. Thus, 6 weeks after lethally irradiated mice were restored with F1 hybrid spleen cells, most of the LCs in the epidermis of their pinnae were of donor origin. LCs of donor origin also were found in the epidermis of the pinnae of animals that had been inoculated at birth with spleen and lymph node cells (mice) or bone marrow cells (rats). Hence the occurrence of these cells provides another means of confirming that tolerance (chimerism) has been induced. PMID- 3519785 TI - Monoclonal antibody to a 35 kD epidermal protein induces cell detachment. AB - A murine monoclonal antibody (ECS-1) was prepared from BALB/c mice immunized with trypsinized cultured human foreskin keratinocytes. The antibody showed a pattern suggestive of intercellular staining on the nucleated layers of normal human epidermis, adult palm, mouse lip epidermis, and cultured human keratinocytes. ECS 1 stained human fetal skin by 9 weeks estimated gestational age. ECS-1 reacted with a 35 kD protein extracted from neonatal foreskin epidermis and cultured human keratinocytes. The protein required Nonidet P-40 or sodium dodecyl sulfate and mercaptoethanol for solubilization. ECS-1 induced epidermal cell detachment which was enhanced by complement. ECS-1 shares characteristics with human pemphigus antibodies. PMID- 3519786 TI - Epidermolysis bullosa acquisita antigen, a new major component of cutaneous basement membrane, is a glycoprotein with collagenous domains. AB - The epidermolysis bullosa acquisita antigen is a major constituent of the basement membrane zone beneath stratified squamous epithelium. The antigen which is recognized in extracts of skin basement membrane by Western blot analysis with polyclonal or monoclonal antiepidermolysis bullosa acquisita antigen antibodies as 2 chains (a major chain of 290,000 and a minor chain of 145,000) has a native molecular weight over 800,000. Both epidermolysis bullosa acquisita antigen chains contain carbohydrate and the 290K chain is sensitive to collagenase. PMID- 3519787 TI - Detection of Chlamydia trachomatis antigens by enzyme immunoassay and immunofluorescence in genital specimens from symptomatic and asymptomatic men and women. AB - Chlamydia trachomatis antigens were detected in populations with the following infection prevalences: 26.5% (36 of 136) of men and 27.7% (48 of 173) of women attending a sexually transmitted disease clinic, 16.3% (53 of 324) of women attending a Planned Parenthood clinic, and 3.4% (4 of 117) of an obstetrics and gynecologic practice. Compared with cell culture of the combined female cervical specimens (15.8% prevalence), the respective sensitivities of Chlamydiazyme (Abbott Laboratories, North Chicago, Illinois) and Microtrak (Syva, Palo Alto, California) were 98.3% and 87.9%, specificities were 97.5% and 98.4%, positive predictive values were 87.7% and 92.7%, and negative predictive values were 99.7% and 97.5%. Both assays were 70.0% sensitive with male urethral specimens, and the other parameters of performance ranged between 84.0% and 97.2%. The antigen detection assays, compared with culture, performed equally well in subjects without or with clinical signs. PMID- 3519788 TI - The relation between production of cytotoxin and clinical features in shigellosis. AB - The relation between in vitro production of HeLa cell cytotoxin by strains of Shigella and clinical symptomatology was determined for 35 travelers from the United States who developed shigellosis in Guadalajara, Mexico. There were 25 patients with Shigella sonnei, eight with Shigella flexneri, one with Shigella boydii, and one with Shigella dysenteriae. These strains were evaluated for in vitro production of cytotoxin. The amount of cytotoxin did not correlate with the number of stools passed, the severity of abdominal pain, or the presence of nausea or vomiting. However, patients with strains of Shigella that produced more cytotoxic activity were more likely to have fever (P less than .02) and occult blood in their stools (P less than .004). The cytotoxicity produced by 30 (86%) strains could not be neutralized with rabbit antiserum to purified, formaldehyde treated Shiga toxin from S. dysenteriae type 1 strain 60 R; the cytotoxicity of five (14%) of the strains was partially neutralized. When only nonneutralizable cytotoxin was considered, the presence of fecal leukocytes (P less than .04), as well as of occult blood (P less than .002) and fever (P less than .02), correlated with the amount of cytotoxin. The amount of nonneutralizable cytotoxin produced by shigella strains was related to the clinical findings. This cytotoxic activity was infrequently attributable to "Shiga toxin". PMID- 3519789 TI - Effect of neutralization of gastric acid on immune responses to an oral B subunit, killed whole-cell cholera vaccine. PMID- 3519790 TI - Presence of hemagglutinin/protease and other potential virulence factors in O1 and non-O1 Vibrio cholerae. PMID- 3519791 TI - The role of complement and antibody in opsonophagocytosis of type II group B streptococci. AB - The role of complement and antibody in the opsonophagocytosis of type II group B streptococci (type II GBS) was defined with sera from healthy adults and two populations with theoretical susceptibility to type II GBS infection--neonates and insulin-dependent diabetics. Significant opsonophagocytosis (bactericidal index, greater than or equal to 90%) of five clinical isolates of type II GBS lacking components of protein antigen c was demonstrated by each of 12 adult sera, as well as by agammaglobulinemic serum, a result indicating that opsonophagocytosis can proceed by antibody-independent activation of the classic complement pathway. Strains containing components of protein antigen c were somewhat more resistant to opsonin-binding activity. Four of 10 neonatal sera and nine of 15 diabetic sera exhibited inefficient opsonophagocytosis. Some of the adult sera with either high or low concentrations of specific antibody to type II GBS promoted opsonophagocytosis via the alternative complement pathway, but this response was not observed with neonatal sera. The addition of sufficient amounts of specific antibody to type II GBS to neonatal and adult diabetic sera in vitro, however, promoted efficient opsonophagocytosis via the alternative pathway. PMID- 3519792 TI - Amphotericin B-induced oxidative damage and killing of Candida albicans. AB - Amphotericin B (AmB) is known to bind to ergosterol in fungal cell membranes, but the precise mechanism of its toxicity to cells is as yet poorly understood. AmB autooxidizes, and it is possible that its antifungal effects could result from oxidative damage. Exposure of protoplasts of Candida albicans to AmB under hypoxic conditions reduced protoplast lysis by as much as 80% compared with incubations in air. Protoplasts were protected from AmB-induced lysis by exogenous catalase and/or superoxide dismutase (SOD). Whole cells of C. albicans were protected by exogenous catalase from AmB-induced leakage of [3H]leucine and from killing by AmB. Cells grown on medium inducing high levels of endogenous catalase were resistant to AmB-induced growth inhibition. In contrast, AmB induced K+ leakage was not hindered under hypoxic conditions or in the presence of catalase or SOD. Thus the lethal and lytic effects of AmB on C. albicans cells and protoplasts, but not prelethal AmB-induced K+ leakage, are mediated by oxidative damage. PMID- 3519793 TI - Neutral amino acid therapy for the management of chronic pain. PMID- 3519794 TI - Adenosine triphosphate content of Mycobacterium leprae isolated from armadillo tissue by Percoll buoyant density centrifugation. AB - A buoyant density centrifugation procedure using Percoll was developed for the isolation and purification of Mycobacterium leprae from experimentally infected armadillo liver tissue. The method separates the bacteria from host adenosine triphosphate (ATP) and tissue debris and recovers 20-25% of the bacteria within 2 2 1/2 hours under controlled conditions. The mean ATP content (585 pg/10(6] of the purified bacteria was similar to cultivable bacteria. The organisms did not leak intracellular ATP when exposed to phosphate buffer. Temperature-dependent ATP synthesis was observed within minutes and could be inhibited by 2,4 dinitrophenol. Freeze-thawing M. leprae as purified suspensions in buffer damaged the organisms, resulting in decreased ATP levels and an accelerated loss of ATP upon incubation under defined conditions. In vitro treatment with the antileprosy drug clofazimine increased the rate of ATP decay directly proportional to drug concentration. PMID- 3519795 TI - Robert Greenhill Cochrane, 1899-1985. PMID- 3519796 TI - Susceptibility of strains of Mycobacterium leprae isolated prior to 1977 from patients with previously untreated lepromatous leprosy. AB - Because of the recent spate of reports of primary resistance to dapsone among patients with lepromatous leprosy, largely to small concentrations of the drug, a survey was made of the results of dapsone-susceptibility testing of strains of Mycobacterium leprae isolated before 1977 among six laboratories which employed the mouse foot pad technique for this work prior to that time. Data have been found for strains that had been isolated from 73 patients, representing 19 countries and dependencies, with previously untreated lepromatous leprosy; all 73 strains were inhibited from multiplication by dapsone administered to mice in a concentration of 0.0001 g per 100 g mouse diet. These data suggest that the properties of M. leprae isolated from previously untreated patients with respect to susceptibility to dapsone have changed since the years preceding 1977. PMID- 3519797 TI - [Sulfone-resistance of Mycobacterium leprae--monotherapy with diaminodiphenylsulfone--the value of triple-drug combinations]. AB - While the emergence of drug resistance in Mycobacterium leprae was foreseen and known for a long time, it is now presented as a tragedy jeopardizing leprosy control through monotherapy. This resistance has been mainly reported in the United States. It is not observed in other parts of the world. In our opinion, the unfavorable observations made at present result from an incorrect implementation of dapsone (DDS) therapy in the patients, resulting in low sulfone blood levels, as a consequence of the use of complex disubstituted sulfones, insufficient daily dapsone dosages, irregular or noncompliance to treatment, premature interruption of treatment, etc. Two measures are required in order to prevent the emergence of primary or secondary resistance to dapsone in M. leprae. First, it is necessary to go back to the previous regimen of 200 mg dapsone daily in an adult. It yields the "maximum tolerated effective dosage." It should never have been rejected in favor of 100 mg daily as currently recommended at the moment. The second measure is the implementation of multiple drug therapy (MDT), using concurrently DDS in association with rifampin and clofazimine. This is a logical and rational approach, at least from a theoretical point of view. However, MDT is most unfortunately quite expensive and therefore inapplicable in most countries with high prevalence, since they are poor and underdeveloped. Implementation of MDT also raises great problems, since dosages have to be strictly adhered to in order to prevent a potentially catastrophic emergence of multiple drug resistance in M. leprae. PMID- 3519798 TI - A more malignant course of leprosy infection in armadillos after inoculation with sonicated suspension of Mycobacterium leprae. PMID- 3519799 TI - Xenograft studies in leprous neuropathy. PMID- 3519800 TI - In vitro assessment of endothelial cell response to Mycobacterium leprae. PMID- 3519801 TI - Clofazimine-resistant M. leprae. PMID- 3519802 TI - Relapse rates in lepromatous leprosy according to treatment regularity. AB - In Gudiyatham Taluk, South India, 1008 lepromatous (LL) and borderline lepromatous (BL) patients were studied. They had previously been smear positive, had attained smear negativity, and continued on DDS monotherapy. "Relapse" was defined as the reappearance of Mycobacterium leprae in skin smears. The area is endemic for leprosy. The lower relapse rates in the first three years of smear negativity alone were associated with more-regular treatment during both past smear positivity and smear negativity. From the fourth year of smear negativity onward, only the more-regular treatment during smear negativity was associated with lower relapse rates; whereas patients with more-regular treatment during past smear positivity had no lower risk of relapse than those with less-regular treatment. The finding that regularity of treatment during smear positivity seems to have no effect on relapse rates beyond the third year of smear negativity is discussed. In a leprosy-endemic area, it is argued that beyond the first three years of smear negativity in an LL or BL patient, sources of M. leprae outside the patient may be more responsible for relapse than the patient's own bacilli. PMID- 3519803 TI - Sensitization studies with potential leprosy vaccine preparations in northern Malawi. AB - This paper describes a comparison between BCG alone and two different doses of killed Mycobacterium leprae, with or without BCG, in stimulating skin-test sensitivity to two different soluble antigens prepared from M. leprae. Skin test conversion was assessed three months after vaccination. Significant rates of skin test conversion were stimulated by each of the vaccines to both skin test antigens, but the observed conversion rates differed markedly as measured by the two antigens. All of the vaccines caused ulcers at the site of injection in most subjects, and these local reactions are described. A combined vaccine containing 0.03 mg BCG plus 5 X 10(7) killed M. leprae induced high rates of "conversion" to both skin tests but caused local reactions slightly larger than those caused by BCG alone. The implications of these findings for selection of an optimal vaccine formulation for use in large-scale preventive trials are discussed. PMID- 3519804 TI - Immunohistological analysis of skin reaction to My1 derived from Mycobacterium leprae. AB - A study was made on the in situ characteristics of dermal infiltrates in a 24-hr skin reaction using monoclonal antibodies defining T-cell subsets, Ia-like antigens, Langerhans' cells, My1, and indirect immunofluorescence. The skin reaction was induced by the mycobacterial antigen My1 derived from Mycobacterium leprae. In all, 10 biopsies were studied. The infiltrates were composed of lymphocytes and polymorphonuclear leukocytes. The predominant lymphocytes in the infiltrates were activated T lymphocytes expressing OKT11, Leu3a, OKT8, and Ia like antigens. The ratio of Leu3a+:OKT8+ cells was 1.2 +/- 0.50. Some of the cells in the infiltrates showed the presence of My1, as seen by the staining with MLO6 monoclonal antibody. No difference was observed in the numbers of OKT6+ epidermal Langerhans' cells in the skin of My1 reaction biopsies and those of normal individuals. PMID- 3519805 TI - ICRC vaccine-induced changes in M. leprae-specific cell-mediated immunity in langur (Presbytis entellus) monkeys. AB - The effects of the administration of ICRC antileprosy vaccine on skin reactions and lymphocyte transformation tests (LTT) to antigens of Mycobacterium leprae have been investigated in Hanuman langur monkeys (Presbytis entellus) which live native to north India. In a majority of these monkeys, the vaccine brings about lepromin conversion associated with a change in tissue response consistent with "ugrading" of immunity. However, no concomitant changes were observed in the LTT. The significance of these observations is discussed. It is proposed that the langur monkey could be used as a laboratory model to screen "candidate" antileprosy vaccines. PMID- 3519806 TI - An ultrastructural study of the response of traumatized rabbit tibial nerve to epineurial infection with Mycobacterium leprae. AB - Crushed rabbit tibial nerves were inoculated with a suspension of living Mycobacterium leprae at and just distal to the site of nerve trauma. The resulting changes occurring over a period of time from 40 min to 72 hr post inoculation were studied electron microscopically. Bacilli were seen in perineurial cells and in macrophages that had infiltrated the perineurium adjacent to epineurial deposits of M. leprae. It is suggested that trauma may weaken the perineurial barrier and facilitate the transperineurial passage of phagocytes, some of which may be laden with M. leprae, and may thus be a means whereby M. leprae enter the endoneurium of peripheral nerves. PMID- 3519807 TI - [Clinical studies on a disorder of mineralocorticoid metabolism]. PMID- 3519808 TI - [Case reports of Angle Class III malocclusions treated with lower 2d molar extraction]. PMID- 3519809 TI - [Isolation and identification of Capnocytophaga in localized juvenile periodontitis. Preliminary study]. PMID- 3519810 TI - Specific identification of urinary fibrinogen, fibrinogen degradation products, and cross-linked fibrin degradation products in renal diseases and after renal allotransplantation. AB - We have applied a sensitive and discriminating electrophoretic technique that distinguishes between fibrinogen, fibrin polymers, fibrinogen degradation products (FDP), and cross-linked fibrin degradation products (XLDP) to evaluate urinary fibrinogen antigen in control subjects and in patients with a variety of renal diseases and after renal allograft transplantation. Although only one of 11 controls showed the trace presence of urinary fibrinogen, 14 of 28 patients with renal disease had urinary fibrinogen antigen, mostly as fibrinogen or fibrin monomer. Thrombin treatment failed to remove fibrinogen from urine, indicating that methods using this step to eliminate clottable protein will overestimate the quantity of urinary fibrinogen and fibrin degradation products. No association was found between the amount or type of antigen and the specific clinical diagnosis or the presence of proteinuria or hematuria, although urinary FDP and XLDP were found only with greater degrees of renal impairment. Fifteen patients were evaluated for 3 weeks after renal transplantation surgery by serial urine and serum electrophoretic analysis. Urinary FDP and XLDP were found significantly more often in the first week after surgery and in association with episodes of acute renal transplant rejection (ARTR) than at other times. This suggests that fibrin deposition and degradation is involved in the pathologic process of ARTR and that identification of specific XLDP and FDP could have diagnostic and prognostic application in such patients. PMID- 3519811 TI - Effect of allopurinol on the renovascular responses to adenosine. AB - It is known that renal ischemia enhances the production of adenosine, which is further metabolized by xanthine oxidase, and that the inhibition of this metabolizing enzyme by allopurinol ameliorates the consequences of renal ischemia. This study was undertaken to define the effect of allopurinol on the renal responses to adenosine. It was found that 5 minutes of intrarenal infusion of adenosine in control dogs produced a typical biphasic response characterized by an initial vasoconstriction, decreasing renal blood flow by 46.3% +/- 6.0%, followed by vasodilation, increasing renal blood flow by 8.5% +/- 3.6% above the control levels. Adenosine infusion was also accompanied by a significant reduction of plasma renin activity, from 8.4 +/- 0.6 ng/ml/hour to 3.8 +/- 0.4 ng/ml/hour. The administration of an intravenous infusion of 50 mg allopurinol did not alter the vasoconstrictor phase of adenosine--the average decrease was 41.1% +/- 3.3%; however, it prevented much of the vasodilation because renal blood flow over the 5 minutes remained 17.9% +/- 5.0% less than the levels recorded before adenosine infusion. Allopurinol also prevented the decrease of plasma renin activity, for which the average values recorded before and after adenosine were 9.6 +/- 0.6 ng/ml/hour and 8.2 +/- 0.6 ng/ml/hour, respectively. The results of this study indicate that allopurinol exerts specific effects on the vasodilatory component of adenosine and prevents the adenosine-suppressive effect on the renin-angiotensin system. PMID- 3519812 TI - Lateralization characteristics in learning disabled children. PMID- 3519813 TI - BCG, in contrast to C. parvum, does not induce increased sensitivity to the toxic effects of indomethacin in mice. AB - Treatment of mice with killed Corynebacterium parvum (also designated Propionibacterium acnes, P. acnes) or Bacille Calmette Guerin (BCG) leads to modification of several of the same host systems. However, BCG, in contrast to C. parvum, did not induce increased sensitivity to the toxic effects of indomethacin in BALB/c or C57B1/6 mice. In addition, treatment of mice with BCG did not interfere with the induction of sensitivity by C. parvum. Therefore C. parvum must uniquely induce changes in host systems which alter the sensitivity to this anti-inflammatory drug. Additional experiments with splenectomized animals revealed that the presence of this organ, which undergoes hypertrophy following C. parvum treatment, was not necessary for the induction of indomethacin sensitivity. Presentation of C. parvum via the subcutaneous route versus the intraperitoneal route revealed that the two routes were equally efficient in inducing sensitivity in C57B1/6 mice but the former route was less effective (50% deaths) than the intraperitoneal route (95% deaths) in BALB/c mice. These results indicate that host related factors (genetic) may be important in the generation of enhanced sensitivity to the toxic effects of indomethacin. PMID- 3519814 TI - [Origin of medicine in Montpellier]. PMID- 3519815 TI - [Hermann Boerhaave, microcirculationist of the 17th century]. PMID- 3519816 TI - [Marcello Malpighi: his life and works]. PMID- 3519817 TI - [Louis Sencert, vascular surgeon (1878-1924)]. PMID- 3519818 TI - [History of the discovery of blood vessels from antiquity to the Renaissance]. PMID- 3519819 TI - [Alexis Carrel]. PMID- 3519820 TI - [Rene Leriche, physician in the service of life]. PMID- 3519821 TI - [A moment in the history of angiology: the tribute of Joao Cid Dos Santos to Rene Fontaine]. PMID- 3519822 TI - Effect of glucose, NADH and NADPH on cortisol metabolism by mononuclear cells. AB - Mononuclear cell preparations are capable of metabolizing cortisol to three metabolites which lack the immunosuppressive effect of their precursor. In the present study we noted a linear correlation, up to a point, between glucose concentration and the rate of human mononuclear cell cortisol metabolism in vitro. The mechanism by which glucose exerts its effect was investigated further. We observed that: the effect of glucose on mononuclear cell cortisol metabolism was not influenced by insulin; NADPH and NADH enhanced cortisol metabolism by disrupted cells, irrespective of whether the homogenates were dialysed or not; lactate and ATP inhibited mononuclear cell cortisol metabolism and almost all the glucose used was converted to lactate. It is concluded that mononuclear cell cortisol metabolism can depend on both nucleotides. PMID- 3519823 TI - Testosterone metabolites do not participate in the control of hypothalamic LH releasing hormone. AB - To determine whether the ability of testosterone to increase intrahypothalamic LH releasing hormone (LHRH) in orchidectomized rats might be explained by the conversion of the hormone into either its 5 alpha-reduced or oestrogenic metabolites, testosterone, 5 alpha-androstan-17 beta-ol-3-one (DHT), 5 alpha androstane-3 alpha,17 beta-diol (3 alpha-diol) and 5 alpha-androstane-3 beta,17 beta-diol (3 beta-diol) (2 mg/rat per day for 6 days) and oestradiol (0.1, 0.5, 1.0 and 5.0 micrograms/rat per day for 6 days) were injected into castrated male rats. After 6 days the rats were killed and serum LH levels and intrahypothalamic LHRH stores measured using specific radioimmunoassay procedures. Testosterone and its 5 alpha-reduced metabolites were used in either the free alcohol or the propionate form (dipropionates in the case of the diols); oestradiol was used as oestradiol-17 beta or in the benzoate form. Treatment with testosterone, DHT, 3 alpha-diol and 3 beta-diol resulted in a significant decrease in serum LH levels; all the 5 alpha-reduced testosterone derivatives were more effective than testosterone in this respect. Testosterone and DHT propionates suppressed LH release following orchidectomy totally; 3 alpha-diol and 3 beta-diol dipropionates were less effective. Testosterone increased intrahypothalamic LHRH stores, this effect being much higher after testosterone propionate, i.e. when intrahypothalamic LHRH stores were restored to pre-castration levels. None of the 5 alpha-reduced steroids was capable of modifying the low intrahypothalamic levels of LHRH found following orchidectomy; only 3 alpha-diol dipropionate exhibited some activity, but this was much lower than that of testosterone propionate. Oestradiol-17 beta was totally ineffective in decreasing serum LH in orchidectomized animals; in contrast, oestradiol benzoate progressively decreased serum LH.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3519824 TI - Parental occupations and cancer: a review of the literature. AB - Parental occupation is a suspected risk factor in the occurrence of childhood cancer. Fourteen epidemiological studies investigating a possible association are reviewed and observations are found to be contradictory. Several reports show significant associations for occupations involving exposure to hydrocarbons, lead or chemicals and occupations of social classes I and II. Conversely, some studies find no association at all. Methodological variations do not account for the contrasting results so further investigation is required. PMID- 3519825 TI - Effect of a lactation nurse on the success of breast-feeding: a randomised controlled trial. AB - An evaluation of a lactation nurse by means of a randomised controlled trial is described. The lactation nurse was employed to assist, support, and encourage mothers during the early weeks after parturition in hospital and at home. All mothers who breast-fed at least once were entered into the trial. Altogether 649 mothers were interviewed 12 months later to establish the duration of breast feeding and to enquire after practices of and attitudes towards infant feeding. The lactation nurse significantly extended the duration of breast-feeding, particularly during the first four weeks and among women of lower social class. Although she did not reduce problems or change practices significantly, all the trends were consistently in the right direction. Mothers in the experimental group were more satisfied with the help they received than were mothers in the control group. It seems likely that the lactation nurse by consistent advice, assistance, support, and encouragement enabled mothers to cope more successfully with difficulties and that this led to significantly fewer ending breast-feeding prematurely. PMID- 3519826 TI - Interactions between neurites and somite cells: inhibition and stimulation of nerve growth in the chick embryo. AB - After neural processes emerge from the neural tube in the chick embryo, their growth is restricted to the cranial halves of the neighbouring somites. In this study we have developed an in vitro system to model the interactions between these tissue types. Pioneer neurites display a hierarchy of preferences in terms of the substrates they can grow on. As expected, tissue culture plastic does not support neural outgrowth, but this can be overcome by coating the plastic substrate with either collagen or poly-L-lysine. Neural crest, cranial half somite, and a number of other tissues support growth well, while caudal half somite and tail bud mesenchyme do so to a much smaller extent. The binding pattern of a variety of lectins was assessed in cryostat sections of embryos and in cultured cells of the above tissues. It was found that peanut agglutinin can discriminate between cranial and caudal sclerotome both in vitro and in the embryo, since it binds preferentially to caudal sclerotome in both cases. This difference is expressed as soon as the sclerotome forms. The significance of these findings is twofold: first, they show that the interactions that take place during peripheral neural segmentation can be modelled in vitro; second, they represent the first instance of a molecular difference between the cranial and caudal halves of the sclerotome, detectable both in culture and in the embryo. PMID- 3519827 TI - Distribution of fibronectin, laminin and entactin in the environment of migrating neural crest cells in early mouse embryos. AB - The distribution of the extracellular matrix molecules fibronectin, laminin and entactin was studied in frozen sections of 9 1/2-day mouse embryos in order to relate their presence to neural crest cell migration. It was found that all three components were present in basement membranes, laminin and entactin being mainly restricted to these. Fibronectin was present at high levels in basement membranes and extracellular spaces throughout the embryo, including the regions of neural crest cell migration. Fibronectin is known to affect migration in a variety of cell systems, so its presence in the embryo at the time of migration may indicate that it is influencing cell movement. This influence is likely to be via the cell surface through interactions with other matrix components such as glycosaminoglycans, and possibly entactin and laminin. PMID- 3519829 TI - Opsonic antibodies evoked by hybrid peptide copies of types 5 and 24 streptococcal M proteins synthesized in tandem. AB - The protective immunogenicity of a hybrid peptide containing tandem copies of types 5 and 24 epitopes was investigated. Carboxy-terminal peptides of the cyanogen bromide-derived fragment 7 (CB7) of type 24 M protein were chemically synthesized, and then extended to include the first 20 residues of the amino terminus of type 5 M protein. When emulsified in CFA and injected into rabbits without conjugation to a carrier, each of the synthetic hybrid peptides, designated S-M5(1-20)-S-CB7(23-35)C and S-M5(1-20)-S-CB(19-34), evoked opsonic antibodies against both types 5 and 24 streptococci without raising heart tissue crossreactive immunity. These results suggest that tandem hybrid peptides may provide a new approach to the development of multivalent vaccines, not only to different serotypes of group A streptococci but perhaps also to a variety of other infectious agents. PMID- 3519828 TI - Pathogenesis of shigella diarrhea. XI. Isolation of a shigella toxin-binding glycolipid from rabbit jejunum and HeLa cells and its identification as globotriaosylceramide. AB - A glycolipid that specifically binds shigella toxin was isolated from both HeLa cells and rabbit jejunal mucosa and identified as globotriaosylceramide (Gb3) by its identical mobility on HPTLC to authentic erythrocyte Gb3. Toxin also bound to a band tentatively identified as alpha-hydroxylated Gb3. In addition, toxin bound to P1 antigen present in group B human erythrocyte glycolipid extracts. The common feature of the three binding glycolipids is a terminal Gal alpha 1----4Gal disaccharide linked beta 1----4 to either Glc or GlcNAc. Globoisotriaosylceramide, which differs from Gb3 only in possessing a Gal alpha 1 ---3Gal terminal disaccharide, and LacCer, which lacks the terminal Gal residue of Gb3, were incapable of binding the toxin. Binding was shown to be mediated by the B subunit by the use of isolated toxin A and B subunits and monoclonal subunit-specific antibodies. Gb3-containing liposomes competitively inhibited the binding of toxin to HeLa cell monolayers but did not inhibit toxin-induced cytotoxicity. These studies show an identical carbohydrate-specific glycolipid receptor for shigella toxin in gut and in HeLa cells. The toxin B subunit that mediates this binding has also been shown to recognize a glycoprotein receptor with different sugar specificity. Thus, we have demonstrated that the same small (Mr 6,500) B subunit polypeptide has two distinctive carbohydrate-specific binding sites. The Gal alpha 1----4Gal disaccharide of the glycolipid toxin receptor is also recognized by the Gal-Gal pilus of uropathogenic E. coli. This suggests the possibility that the pilus and toxin B subunit contain homologous sequences. If this is true, it may be possible to use the purified Gal-Gal pilus to produce toxin-neutralizing antibodies. PMID- 3519830 TI - Experimental systemic amyloidosis induced by immunization with syngeneic organ extracts in mice. AB - Systemic amyloidosis was induced consistently in mice by intramuscular injection of syngeneic organ (liver and kidney) extracts mixed with CFA six times at weekly intervals. Syngeneic organ extract with CFA also induced amyloidosis of a lesser degree. All three strains of mice (C57BL/6, C3H/He, and BALB/c) injected with a syngeneic liver extract mixed with CFA developed systemic amyloidosis; the most prominent amyloid deposition occurred in C57BL/6 (B6) mice, followed by C3H/He and BALB/c. The amyloid substance deposited in these animals was identified as mouse amyloid A protein (AA). Furthermore, an organ specificity of the immunogen in inducing amyloidosis was suggested with liver and kidney extracts. Primed spleen cells of the immunized B6 mice were fractionated by a nylon-wool column and injected to normal recipient mice via the tail vein. Organs of the recipient mice developed systemic amyloidosis 8 wk after the transfer, and the most prominent histological changes occurred in the recipient mice given nylon-wool column adherent spleen cells. Using anti-Thy-1,2; Ly-1; Ly-2, antibody and complement, it was suggested that T cells, especially Ly-1,2,3+ T cell populations in the primed nylon-wool adherent cells, play an important role in the induction of systemic amyloidosis. It was shown further that the amyloidosis inducing substance in liver extract was composed of unstable proteins or protein bound substance. PMID- 3519832 TI - Experience with an homogeneous immunoassay for paracetamol (acetaminophen). AB - The performance of an homogeneous enzyme immunoassay (EMIT) for paracetamol (acetaminophen) as configured for the aca series of discretionary analysers (Du Pont de Nemours) was evaluated. The method as initially formulated by the manufacturers gave unacceptable performance which was improved upon, by reagent reformulation and improved kit manufacture procedures, by the manufacturer. The method was fast, precise and free from interference from a range of metabolites, drugs and endogenous physiological compounds. There was good correlation between this method and an enzymatic method for paracetamol (acetaminophen). PMID- 3519831 TI - A lymphokine that activates the cytolytic program of both cytotoxic T lymphocyte and natural killer clones. AB - A 10-12 kD lymphokine, herein termed TCAF, was recently shown to be secreted from Th after crosslinking of their antigen/MHC (T3-Ti) receptors. TCAF stimulates resting T lymphocyte proliferation via binding to surface components of the T11 pathway. To determine whether TCAF could induce antigen-independent activation of the lytic machinery of cytotoxic cells, the present studies were conducted. In the presence of TCAF, both T8+ class I MHC-specific and T4+ class II MHC-specific cytotoxic T cell clones were induced to kill targets, including those lacking the appropriate MHC molecules. This effect was unique to TCAF, since IL-1, IL-2, IFN gamma could not stimulate lytic activity. Furthermore, both T3+T11+ and T3-T11+ NK clones were triggered to lyse NK-resistant target cells. These findings suggest that TCAF can function in an antigen-independent fashion to amplify cytotoxic effector responses. PMID- 3519833 TI - Thyrotropin enzyme-immunoassay in dried blood spots: a spectrophotometric method for neonatal thyroid screening. AB - We describe an enzyme-immunoassay with photometric endpoint determination, suitable for the measurement of thyrotropin (TSH) in dried blood spotted on filter paper. Using reagents of a commercially available test kit provided for the measurement of thyrotropin in 200 microliter serum, we have adapted the method to the determination of thyrotropin in blood spots containing ca. 10 microliter blood. This was achieved by prolongation of the assay time from 3 to 20 hours, and by increasing the amount of enzyme-antibody complex. Precision and sensitivity of the blood spot assay are comparable to those of our in-house thyrotropin RIA, and the RIA/EIA correlation coefficient is 0.987 (n = 150). The advantages of EIA are the simplicity of the photometric end point determination (although strict time control has to be observed in order to avoid drifts in results), the long stability of reagents, and the non-isotopic label. The method therefore appears to be a suitable alternative to thyrotropin RIA for the determination of thyrotropin in neonatal thyroid screening. PMID- 3519834 TI - A critical review of adult health maintenance. Part 3: Prevention of cancer. AB - This is the third paper in a four-part series that presents an updated protocol for selective longitudinal health maintenance of asymptomatic adults. Selected types of cancer are reviewed with reference to six generally accepted screening criteria. A recommendation is made for each condition and compared, when appropriate, with the recommendations of the Canadian Task Force on the Periodic Health Examination and the American Cancer Society. In the fourth paper the recommendations will be combined into a practical health maintenance flow sheet for use by primary care physicians. PMID- 3519835 TI - Insulin-independent controlled physiological morphogenesis of chick muscle from fusion-capable myoblasts. AB - Thigh myogenic cells from 11-12-day-old chick embryos were cultured continuously in the presence of medium containing no chick embryo extract (CEE). It is known that CEE contains a muscle-inducing protein of 35,000 daltons. In spite of the absence of embryo extract and provided that calcium, starting at a concentration as low as 3 X 10(-4) M, was present in the tested media, typically aligned myotubes with 20 or more nuclei per fiber or abnormal myosymplasts were produced at will. In the first case, the result was systematically obtained when the media were unchanged. Consequently, the cell microenvironment remained undisturbed and therefore was autoconditioned throughout the 7 days of culture. In the second case, the result depended on the feeding schedules. Conversely, no myotubes were formed in cultures in embryo extract-free medium without calcium, irrespective of the frequency of medium changes. Insulin, a serum factor believed to be involved in syncytium formation process in vitro, was present in all tested media. Undialyzed or dialyzed fetal calf serum (FCS), used for the preparation of the media, contained 11 mu units of insulin per milliliter. The insulin content in all tested media was diluted, however, to one tenth the physiological serum concentration. The hormone did not promote any kind of myoblast fusion in any experiment in which calcium was deleted as a component of the tested media, regardless of the feeding schedule followed.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3519836 TI - Selective sequestration of an oviductal fluid glycoprotein in the perivitelline space of mouse oocytes and embryos. AB - Previously, we identified a 215 kd glycoprotein, GP215, which is associated with postovulatory oocytes and embryos, but not with preovulatory oocytes (Kapur and Johnson, '85). In this paper a polyclonal antibody that specifically recognizes GP215 has been used to study the distribution of the molecule in association with ova and preimplantation embryos and in the female reproductive tract. GP215 is present in epithelial cells lining the cranial portions of the oviduct and in oviductal fluid, ovarian bursal fluid, and medium conditioned by oviductal tissue in vitro. Immunofluorescence assays of the ovum and early embryo show that GP215 is sequestered in the perivitelline space. Since preovulatory oocytes exposed to bursal fluid in vitro acquire GP215, we hypothesize that GP215 is synthesized and secreted by the oviductal epithelium and secondarily associates with the ovulated oocyte. Sequestration of GP215 within the perivitelline space is relatively specific since mouse serum albumin, a major constituent of oviductal fluid, and other high molecular weight proteins are not similarly retained. These observations indicate that the composition of the perivitelline space may be significantly different from the greater environment external to the zona pellucida such that fertilization and early development of mammalian ova potentially take place in a distinct perivitelline microenvironment. PMID- 3519837 TI - Screening for barbiturates in vitreous humor by the EMIT-st serum enzyme immunoassay. AB - In 16 medical examiner's cases, which were found to be barbiturate-positive by thin-layer chromatographic screening of the liver, blood barbiturate concentrations were determined by gas chromatography. The corresponding vitreous humor samples were screened by the enzyme multiplied immunoassay technique, the EMIT-st serum barbiturate assay. By using the recommended dilution for detecting serum barbiturates, it was possible to detect barbiturates in vitreous humor at a toxic concentration. By using one fourth the amount of diluent, the barbiturates could be detected also at a therapeutic concentration. The EMIT-st assay proved to be useful in the screening for barbiturates in vitreous humor, a material that is readily available in forensic toxicology. PMID- 3519838 TI - A local public health experience--history of the Palm Beach County Health Department. PMID- 3519839 TI - Indigent care and public health in Florida, 1931-1985. PMID- 3519840 TI - The great typhoid epidemic in Florida, 1898. PMID- 3519841 TI - Hookworm eradication program of Florida in the early 20th century. PMID- 3519842 TI - History of tuberculosis in Florida. PMID- 3519843 TI - Mosquito control--its impact on the growth and development of Florida. PMID- 3519844 TI - The best of both worlds: general practice in rural Florida, 1928-1950. PMID- 3519845 TI - Who killed Cock Robin? PMID- 3519846 TI - Our medical heritage--a synopsis of the discipline of medical practice in Florida. PMID- 3519847 TI - [Furosemide stimulation of renin-secretion in essential hypertension]. PMID- 3519848 TI - [Ultrasonographic diagnosis of fatty liver]. PMID- 3519849 TI - The sealing ability of 5 dentin adhesive agents in composite resin fillings. PMID- 3519850 TI - Surface properties of Treponema pallidum in relation to phagocytosis by human polymorphonuclear leucocytes in vitro. AB - Surface charge and hydrophobicity of Treponema pallidum have been investigated in relation to phagocytosis by human polymorphonuclear leucocytes (PMNs) in vitro. The treponemal surface was relatively hydrophobic and negatively charged but despite these properties, phagocytosis, as assessed by luminol-enhanced chemiluminescence, was minimal in the absence of serum. Preopsonization of bacteria with serum reduced surface hydrophobicity but promoted phagocytosis, suggesting that specific immune mechanisms may be more important in controlling phagocytosis of T. pallidum in vitro than non-specific surface properties. T. pallidum evoked a much weaker chemiluminescence response from PMNs than the non pathogenic treponeme Treponema phagedenis biotype Reiterii even though similar numbers of bacteria were phagocytosed, suggesting differences in the reactivity of the surface components of the two organisms toward PMNs. The reactivity of T. pallidum towards PMNs could be increased by removal of the bacterial outer membrane by Triton X-100 treatment. These observations reinforce the suggestion that the outer surface of T. pallidum is inherently inert. PMID- 3519851 TI - Induction of beta-lactamase in Proteus vulgaris. AB - Various beta-lactam antibiotics, including monocyclic beta-lactams, induced the beta-lactamase of Proteus vulgaris; when clinical isolates were induced by benzylpenicillin, each strain produced a single beta-lactamase but the activity per milligram dry weight differed from strain to strain. The beta-lactamases of the P. vulgaris strains were heterogeneous with respect to their isoelectric points, but had almost the same specific activities, substrate specificities and Michaelis constants. The kinetics of beta-lactamase formation were investigated in three strains, each with a different beta-lactamase activity. Differential rates of enzyme synthesis and peak activity depended on the concentration of inducer. The plots of the reciprocals of the differential rates versus the reciprocals of the inducer concentrations were linear, and the maximum rate of enzyme synthesis and the concentration of the inducer giving half-maximum induction were determined from this double reciprocal plot. The maximum rates of enzyme synthesis were different in the three strains. The kinetic analysis of beta-lactamase formation revealed that the beta-lactamase activities in a single bacterial species were determined by differences in the rate of enzyme synthesis and not by differences in the properties of the enzyme. PMID- 3519852 TI - A Candida albicans mutant impaired in the utilization of N-acetylglucosamine. AB - Indicator plates containing eosin, methylene blue, glucosamine and proline were used to select mutants of Candida albicans impaired in the utilization of glucosamine. One such mutant, strain hOG298, grew on glucosamine at a slower rate than the parent and was severely impaired in growth on N-acetylglucosamine. The mutant was unable to express the first three steps in the N-acetylglucosamine pathway: viz the permease, N-acetylglucosamine kinase and N-acetylglucosamine-6 phosphate deacetylase. Glucosamine-6-phosphate deaminase was, however, induced by N-acetylglucosamine. The mutant still possessed a constitutive uptake system and kinase activity for glucosamine but glucosamine neither increased the glucosamine kinase activity nor induced N-acetylglucosamine kinase. These findings accounted for the decreased growth rate on glucosamine. The parent strain formed germ-tubes in N-acetylglucosamine or 4% (v/v) serum but the mutant formed germ-tubes only in serum. PMID- 3519853 TI - Effects of pho regulatory mutations and phoA gene amplification on alkaline phosphatase synthesis and release by lky mutants of Escherichia coli K12. AB - lky mutants of Escherichia coli K12 spontaneously released alkaline phosphatase (APase) into the extracellular medium to give up to 300 units ml-1. APase is a phosphate repressible periplasmic enzyme encoded by the gene phoA. With a view to establishing a method of easy purification, we have analysed APase synthesis and release patterns of isogenic lky strains containing either a constitutive pho regulatory mutation, or a hybrid plasmid carrying the structural gene phoA+ and pho regulatory genes, or a transducing phi 80 phoA+ phage. In the presence of the phoS2333 mutation, F- lky strains lysogenized with phi 80 phoBin phoA+ phage and grown in high phosphate medium were able to release eight times more APase activity (2300 units ml-1) than haploid strain 2336 (phoS+ lky) grown in low phosphate medium. Neither protein synthesis, the cell export machinery nor leakage mechanisms were limiting for APase release. Sufficient APase was released into the medium to facilitate its purification. PMID- 3519854 TI - Stabilization of glucose-starved Escherichia coli K12 and Salmonella typhimurium LT2 by peptidase-deficient mutants. AB - Escherichia coli K12 and Salmonella typhimurium LT2 cells were stabilized during carbon starvation in the presence of peptidase-deficient mutant strains. The rate of loss of viability of the wild-type S. typhimurium strain was decreased an average of 2-fold, and the rate for the wild-type E. coli strain was decreased about 2.3-fold, when either was starved in the presence of the multiply peptidase deficient S. typhimurium strain TN852; other peptidase-deficient strains exhibited similar stabilizing effects. Starving wild-type S. typhimurium LT2 cells utilized peptides excreted by the starving peptidase-deficient cells for protein synthesis, and, to a lesser extent, as respiratory substrates. Provision of free amino acids in steady-state levels to starving E. coli K12 cells in a cell recycle apparatus had a stabilizing effect similar to that of mixing with peptidase-deficient cells. PMID- 3519855 TI - Arginine auxotrophs of Candida albicans deficient in argininosuccinate lyase. AB - Auxotrophic mutants of Candida albicans FC18 were induced by a combination of treatments with nitrous acid and UV irradiation. Arginine (Arg-), histidine (His ) and methionine/cysteine (MetA-) auxotrophs were recovered by this means. The Arg- auxotrophs lacked active argininosuccinate lyase (EC 4.3.2.1), the enzyme catalysing the final step in arginine biosynthesis. Thus the locus may be designated arg-4. The mutant strains bearing this mutation did not form germ tubes unless the germination medium contained arginine. PMID- 3519856 TI - Purification of RNA-core induced streptolysin S, and isolation and haemolytic characteristics of the carrier-free toxin. AB - RNA-core (RNAase-resistant fraction of yeast RNA) induced streptolysin S (SLS) was purified (40% recovery) to apparent electrophoretic homogeneity by hydroxylapatite chromatography followed by gel filtration on Sephadex G-100 in the presence of 6 M-guanidine. HCl. The specific activity of the purified toxin was 3 X 10(6) haemolytic units (mg protein)-1. The Mr of the toxin was below 4000 on the basis of SDS-PAGE and 20 000 by gel filtration in guanidine. HCl. High voltage isoelectric focusing of the purified toxin allowed the isolation of the carrier-free SLS peptide for the first time. This peptide was basic (pI 9.2) as compared to native SLS (pI 3.6). The native toxin and the peptide had similar haemolytic properties except for the high lability of the peptide, which was stabilized by RNA-core. The Mr of the denatured peptide was about 1800, as estimated by gel filtration. PMID- 3519857 TI - Catabolite inactivation of the glucose transport system in Saccharomyces cerevisiae. AB - The sugar transport systems of Saccharomyces cerevisiae are irreversibly inactivated when protein synthesis is inhibited. This inactivation is responsible for the drastic decrease in fermentation observed in ammonium-starved yeast and is related to the occurrence of the Pasteur effect in these cells. Our study of the inactivation of the glucose transport system indicates that both the high affinity and the low-affinity components of this system are inactivated. Inactivation of the high-affinity component evidently requires the utilization of a fermentable substrate by the cells, since inactivation did not occur during carbon starvation, when a fermentable sugar was added to starved cells, inactivation began, when the fermentation inhibitors iodoacetate or arsenate were added in addition to sugars, the inactivation was prevented, when a non fermentable substrate was added instead of sugars, inactivation was also prevented. The inactivation of the low-affinity component appeared to show similar requirements. It is concluded that the glucose transport system in S. cerevisiae is regulated by a catabolite-inactivation process. PMID- 3519858 TI - Effects of microcin B17 on microcin B17-immune cells. AB - When microcin B17-immune cells are treated with microcin B17 they show many of the physiological effects displayed by microcin B17-sensitive cells treated in the same way. DNA replication stops immediately and several SOS functions are subsequently induced. In sensitive cells these effects are irreversible and lead to cell death, whereas in immune cells they are reversible and there is no loss of viability. This is an unusual mechanism of immunity because it does not prevent the primary action of the microcin. The implications of this mechanism concerning the mode of action of microcin B17 and the induction of the SOS system are discussed. PMID- 3519859 TI - Occurrence of ploidy shift in a strain of the imperfect yeast Candida albicans. AB - A clinical isolate of Candida albicans, a member of the Fungi Imperfecti, was polyploid as shown by the fact that it contained two kinds of nuclei, one of diploid and one of tetraploid DNA content. These determinations were made by fluorescence microscopy-photometry. The nucleus-associated organelles (NAOs), or spindle pole bodies, of yeast cells in this isolate were classified into two groups, one diploid and the other tetraploid, according to their dimensions as determined by serial thin-sectioning electron microscopy. A ploidy shift from diploid to tetraploid was found in individual cells of a culture of this isolate undergoing diphasic growth in minimal salts medium. A process of shift-down or reduction of ploidy from tetraploid to diploid was also observed by electron microscopy during these growth conditions: this appeared to occur in large cells which showed multiple spindle formation during nuclear division, a phenomenon apparently similar to the process of meiosis II during sporogenesis of Saccharomyces cerevisiae, but differing in that it produces diploid daughter nuclei by the vegetative process. PMID- 3519860 TI - The murine antibody response to lactate dehydrogenase-elevating virus. AB - Mice infected with lactate dehydrogenase-elevating virus (LDV) were found to produce high titres of IgG anti-LDV antibodies that remained elevated for more than 1 year. This response, which was T-dependent, showed a striking preponderance of IgG2a with, from one strain to another, variable proportions of IgG2b and IgG3 but always very little IgG1. The binding of these antibodies to viral protein blots showed a major reaction with VP3, the heterogeneous glycosylated material of the viral envelope. A minor reaction was also noted with VP1, the nucleocapsid protein, but no antibodies were detected against VP2, the non-glycosylated envelope protein of LDV. A similar preponderance of anti-VP3 antibodies was also observed in a large set of anti-LDV hybridomas. Analysis of VP3 with monoclonal antibodies suggested that, despite its heterogeneity, this material has a common polypeptide moiety that apparently carries two major epitopes. PMID- 3519861 TI - A hormone-sensitive communication system in an electric fish. AB - The electric communication system includes both special muscle-derived cells or electrocytes that produce species-typical electric signals, or electric organ discharges (EODs), and specialized sensory receptors, or electroreceptors, that encode the electric fields set up by EODs. Steroid hormones can influence the characteristic properties of both EODs and electroreceptors. Steroids appear to directly effect the anatomy and physiology of the electrocytes that generate an EOD. In contrast, the steroid effect on electroreceptors may be predominantly via an indirect mechanism whereby changes in the spectral characteristics of the EOD appear to induce changes in the spectral sensitivity of electroreceptors. Continued studies of electrosensory and electromotor systems will offer insights into the cellular bases for the development and evolution of steroid-sensitive pathways in the vertebrate nervous system. PMID- 3519862 TI - Cellular analyses of hormone influence on motoneuronal development and function. AB - The striated bulbocavernosus (BC) muscles of the rodent perineum are innervated by motoneurons in the spinal nucleus of the bulbocavernosus (SNB). In adulthood, the BC muscles are present in males only. However, newborn female rats have BC muscles, and SNB cells have made both anatomical and functional contact with them. Nevertheless, both motoneurons and muscles will degenerate unless androgens are administered perinatally. Such androgen treatment appears to be acting primarily on the BC muscles themselves, since the muscles are spared by androgen even after the loss of supraspinal neural afferents or even the entire lumbosacral spinal cord. Furthermore, androgen can spare SNB motoneurons that are themselves androgen insensitive. Perinatal steroid treatments can also alter the final spinal location of SNB cells as determined by retrograde tracing studies. Androgen continues to modify the morphology of the SNB system in adulthood, altering the size of both motoneurons and targets, which may be important for the reproductive function of BC muscles. Finally, the sexually dimorphic character of motoneuronal groups innervating perineal muscles seems to be common in mammals, since the homologue of the SNB, Onuf's nucleus, has more cells in males than in females in both dogs and humans. PMID- 3519864 TI - Control of the development of the ipsilateral retinothalamic projection in Xenopus laevis by thyroxine: results and speculation. AB - The ipsilateral retinothalamic projection of the frog Xenopus laevis is formed by the axons of a subset of retinal ganglion cells which are found throughout peripheral and non-nasodorsal retina. Unlike the crossed retinotectal and retinothalamic projections, which begin to form during early embryonic stages, the ipsilateral projection does not begin to develop until late in tadpole life, at stages when thyroxine first becomes detectable in the circulation. Blocking the production of thyroid hormone in tadpoles prevents the development of the ipsilateral projection, in a reversible manner. Intraocular injection of thyroxine can "rescue" the development of the projection in tadpoles which otherwise remain premetamorphic. In addition, the projection from one eye of a metamorphically-blocked tadpole can be induced to form by an intraocular injection of thyroxine at a dose which has no detectable effect on retinal development in the other, untreated eye. These results indicate that the development of the ipsilateral retinothalamic projection is dependent upon thyroxine, and strongly suggest that the hormone acts at the level of the eye, rather than at the optic chiasm or thalamic target, to bring about the development of a new pathway. A number of ways in which thyroxine might act in the system are discussed. PMID- 3519863 TI - Steroid interactions with structure and function of avian song control regions. AB - Following the pioneering work of Nottebohm, the brain regions involved in song production in songbirds have become a focus of extensive research in several laboratories. As both singing behavior and the neuroanatomy of song control regions are strongly affected by sex steroids in many songbird species, this system has become regarded as an ideal model system in which one can potentially determine how steroids affect neuronal anatomy, how altered anatomy leads to altered physiology, and how the altered physiology causes changes in singing. In the initial part of this review, I shall focus on canaries and zebra finches as most of our knowledge of the song system has been obtained from these two species. I shall describe singing behavior, the constituents of the song system, what is known of how these nuclei contribute to song, and how each is affected by steroid fluctuations. I shall then speculate on new ways of posing questions on hormone--anatomy interaction in this system (which I will illustrate with preliminary data from my own lab). This review will be brief as several reviews of aspects of the song system have recently been published (Arnold, 1982; Nottebohm, 1984; Arnold and Gorski, 1984; DeVoogd, 1984; Konishi, 1985). PMID- 3519865 TI - Neuroeffectors for vocalization in Xenopus laevis: hormonal regulation of sexual dimorphism. AB - South African clawed frogs use sex-specific vocalizations during courtship. In the male, vocalizations are under the control of gonadal androgen. Though females have moderate levels of circulating androgen, they do not give male-typical mate calls. Both muscles of the vocal organ and neurons of the central nervous system (CNS) vocal pathway are sexually dimorphic and androgen-sensitive. Recent studies suggest that the failure of androgen to masculinize adult females results from a male-specific, androgen-regulated developmental program. At metamorphosis the larynx is sexually monomorphic and feminine in morphology, muscle fiber number and androgen receptor content. During the next six months, under the influence of increasing androgen titers and high receptor levels, myoblasts proliferate in the male and muscle fibers increase at an average rate of 100/day. Females have much lower hormone levels, receptor values decline and they display no net addition of fibers. At metamorphosis, both males and females have approximately 4000 muscle fibers. By adulthood, males have eight times the female fiber number. In the CNS, adult laryngeal motor neurons are more numerous with larger somata and dendritic trees in males than in females. Certain connections of neurons in the vocal pathway are also less robust in females. Unlike the periphery, motor neuron number does not appear to be established by androgen-induced proliferation. Our current hypothesis is that androgen acts at the level of laryngeal muscle to produce more muscle fibers and thus provide more target for motor neurons in the male. This process could regulate cell number by ontogenetic cell death. In the CNS, androgen-target neurons become capable of accumulating hormone shortly before metamorphosis. Androgen receptor in laryngeal motor neurons may permit the dendritic growth characteristic of males by increasing sensitivity to afferent stimuli. Such a process could account for the observed differences in CNS vocal "circuitry" in X. laevis and thus behavioral differences between the sexes. PMID- 3519866 TI - Steroid control of neuron and muscle development during the metamorphosis of an insect. AB - Insect metamorphosis is controlled by a small ensemble of developmental hormones including a class of steroids--the ecdysteroids. In the tobacco hornworm, Manduca sexta, the progression from the larval to pupal to adult stages is controlled by the relative blood titers of ecdysteroids and juvenile hormone (JH). The cellular events in the nervous and muscular systems which accompany metamorphosis resemble those of embryonic development, but they occur in an animal which is larger and experimentally more tractable than an embryo. In this paper we review the role of ecdysteroids in directing the metamorphosis of the nervous and muscular systems in Manduca, and how JH modifies the cellular responses to the steroids. In particular, we describe how these hormones control muscle degeneration, changes in the structure and function of identified neurons, and programmed neuron death. One general finding is that interactions between cells (e.g., neurons and their target muscles) are not involved in their hormonal responses, but rather the hormones act independently and in parallel at the different sites. Another key finding is that the critical periods and hormonal requirements for the commitment to a particular differentiative pathway, and the phenotypic expression of that pathway, can differ, and are therefore experimentally separable. Finally, we find that the significance of a hormonal signal (e.g., a rise in blood ecdysteroids) is interpreted differently depending upon the previous history of hormone exposure of a neuron or muscle. This progressive change in the interpretation of hormonal signals is a major mechanism by which a limited number of hormones can orchestrate a complicated phenomenon such as metamorphosis. PMID- 3519867 TI - Dopamine metabolism in hypoxanthine-guanine phosphoribosyltransferase-deficient variants of PC12 cells. AB - Lesch-Nyhan syndrome results from a deficiency of hypoxanthine-guanine phosphoribosyltransferase (HPRT). It is manifest by behavioral abnormalities, including self-mutilation, and evidence of abnormal 3,4-dihydroxyphenylethylamine (dopamine) metabolism. To assess whether an HPRT deficiency in a dopaminergic cell can adversely affect dopamine metabolism in that cell, dopamine metabolism was examined in HPRT-deficient variants of PC12 pheochromocytoma cells and in cells that had regained HPRT activity by virtue of transformation with a recombinant retrovirus containing the human gene for HPRT. There was no correlation between HPRT activity and endogenous dopamine levels, dopamine uptake, dopamine release, or monoamine oxidase activity. Transformation with the HPRT retrovirus did not adversely affect dopamine metabolism. PMID- 3519868 TI - Trypsin activation, partial characterization, and distribution of kallikrein-like and thrombin-like proteases in the neurointermediate lobe of the rat pituitary. AB - This study examined whether the neurointermediate lobe (NIL) of the rat pituitary contains latent kallikrein- and thrombin-like proteases activated by trypsin. Partial characterization of such proteases was attempted. Also examined were the distribution of proteolytic activity within the NIL and levels in both male and female lobes. NIL homogenates were assayed for proteolytic activity at pH 8.0 before and after incubation with trypsin (10 micrograms/ml). Trypsin caused a 10 fold activation of kallikrein-like activity and a 40-fold activation of thrombin like activity in NIL homogenates. The kallikrein-like activity was separated into two components using diethylaminoethyl-Sephadex. The predominant kallikrein-like protease was a potent kininogenase closely related or identical to glandular kallikrein and was almost exclusively localized to the intermediate lobe. The second kallikrein-like protease (kallikrein A) was a weak kininogenase sensitive to inhibition by both soybean trypsin inhibitor and aprotinin and was similarly concentrated in both the neural lobe and the intermediate lobe. The thrombin-like protease was sensitive to inhibition by hirudin (a specific thrombin inhibitor), clotted fibrinogen, and was slightly more concentrated in the neural lobe than in the intermediate lobe. NILs from female rats contained approximately 40% less kallikrein activity than NILs from male rats but did not differ in their content of thrombin-like activity. PMID- 3519870 TI - Human Y-79 retinoblastoma cells exhibit specific insulin receptors. AB - The presence of insulin receptors was investigated in human Y-79 retinoblastoma cells grown in suspension culture. The binding of [125I] insulin to these cells was time, temperature, and pH dependent, was competed for by insulin and proinsulin but not other peptides, and was inhibited by antibodies against the insulin receptor. The Scatchard plot of insulin competition data was curvilinear and was resolved into a high-affinity (KD approximately 0.5 X 10(-9) M)/low capacity (approximately 3,000 sites/cell) and a low-affinity (KD approximately 1 X 10(-7) M)/high-capacity (approximately 155,000 sites/cell) component. Negative cooperativity was not found, in agreement with other studies in rodent neural cells. However, in contrast to studies with rodent cells, insulin specifically down-regulated its receptor on human Y-79 cells after prolonged exposure. In conclusion, these data show for the first time the presence of specific insulin receptors in human Y-79 retinoblastoma cells. Because these cells were previously shown to have several characteristics typical of neural cells, we propose their use as a model to study the effects of insulin on neural and retinal tissues of human origin. PMID- 3519869 TI - Extracellular overflow of neuroactive amino acids during severe insulin-induced hypoglycemia: in vivo dialysis of the rat hippocampus. AB - Hypoglycemia-evoked changes in levels of extracellular excitatory and inhibitory amino acids were studied using the microdialysis technique. A newly designed dialysis probe was inserted stereotaxically into the rat hippocampus. Animals were then subjected to insulin-induced hypoglycemia; then blood glucose levels were restored by glucose injections after a 30-min period of isoelectric electroencephalography. Dialysates were collected before, during, and after the isoelectric period. Amino acids in the dialysates were analyzed by liquid chromatography and fluorescence detection following automatic precolumn derivatization with o-phthaldialdehyde. During the isoelectric phase, the concentration of aspartate increased 15-fold, whereas glutamate, gamma-amino butyric acid, taurine, and phosphoethanolamine levels were elevated three- to sixfold. Smaller increases were observed for nonneuroactive amino acids such as asparagine, alanine, and phenylalanine. In contrast to all other amino acids, the glutamine content was reduced to less than 30% of preisoelectric values. The concentrations of the neuroactive amino acids were restored to normal in the post isoelectric phase. These data demonstrate that there is an extracellular overflow of neuroactive amino acids, especially aspartate, during severe hypoglycemia. PMID- 3519871 TI - One hundred years of epilepsy surgery: Sir Victor Horsley's contribution. PMID- 3519872 TI - Doppler diagnosis of intracranial artery occlusive disorders. AB - Pulsed wave 2 MHz Doppler with acoustical focusing was used to obtain blood flow velocity recordings through the intact cranium in 11 patients with occlusive disease of major intracranial arteries. Increased blood flow velocities were recorded from stenoses of the carotid siphon and of the middle cerebral, anterior cerebral and basilar arteries. A clear, inverse relationship existed between angiographical residual lumen diameter and flow velocity. The Kendall rank correlation coefficient (Tau) was -0.89 (p = 0.0001). Transcranial Doppler is a useful means for evaluating patients with this disorder. PMID- 3519873 TI - Abnormal arborizations of Purkinje cell dendrites in Creutzfeldt-Jakob disease: a manifestation of neuronal plasticity? AB - A case is presented of the ataxic variety of Creutzfeldt-Jakob disease with particular reference to the cerebellar cortex. The main features were loss of granule cells, subtotal in the vermis, severe in the lateral lobes, mild to moderate loss of Purkinje cells and preservation of tangential and basket fibres. The Purkinje cell dendrites showed malorientation and hypertrophy of the primary and secondary branches, the so-called "antler" or "staghorn" deformity. These findings indicate that remodelling of the dendritic tree may start early in the course of the disease even in adults, the total length of history in this case being eight months. They do not throw any additional light on the pathogenesis of the dendritic abnormalities, in particular on the controversy whether they are a non-specific response of the Purkinje cell to a variety of noxious agents or a reaction to partial deafferentation. The authors favour the latter hypothesis. PMID- 3519874 TI - Toward a definition of nurse-managed centers. PMID- 3519875 TI - History of blood gas analysis. IV. Leland Clark's oxygen electrode. AB - The electrochemical reduction of oxygen was discovered by Heinrich Danneel and Walter Nernst in 1897. Polarography using dropping mercury was discovered accidentally by Jaroslav Heyrovsky in Prague in 1922. This method produced the first measured oxygen tension values in plasma and blood in the 1940s. Brink, Davies, and Bronk implanted platinum electrodes in tissue to study oxygen supply, or availability, from about 1940, but these bare electrodes became poisoned when immersed in blood. Leland Clark sealed a platinum cathode in glass and covered it first with cellophane; he then tested silastic and polyethylene membranes. In 1954 Clark conceived and constructed the first membrane-covered oxygen electrode having both the anode and cathode behind a nonconductive polyethylene membrane. The limited permeability of polyethylene to oxygen reduced depletion of oxygen from the sample, making possible quantitative measurements of oxygen tension in blood, solutions, or gases. This invention led to the introduction of modern blood gas apparatus. PMID- 3519876 TI - Maintenance chemotherapy in adult ANLL: is it valid? PMID- 3519877 TI - Long-term follow-up of individuals undergoing allogeneic bone marrow transplantation for acute lymphocytic leukemia. PMID- 3519878 TI - Gastrointestinal involvement and multiple lymphomatous polyposis in mantle-zone lymphoma. AB - The clinical, histologic, and immunologic features of three cases of lymphoma presenting with gastrointestinal symptoms and involving the gastrointestinal tract were studied. Two of the cases had involvement of long segments of the bowel with polypoid lesions, a rare presentation of gastrointestinal lymphoma referred to as multiple lymphomatous polyposis (MLP). All cases were classified as mantle-zone lymphoma (MZL), a follicular variant of intermediate lymphocytic lymphoma (ILL) characterized by the proliferation of small atypical lymphoid cells as wide mantles surrounding benign-appearing germinal centers. The patients were typical of other patients with MZL in that they were male, middle age or older, and their clinical courses were not aggressive despite the presence of disease at an advanced stage. Our review of the literature suggests that there is an inordinate number of cases of MZL with gastrointestinal involvement. We also note that most reports of cases of MLP have described histologic lesions remarkably similar to what we have observed. We conclude that MZL may have predilection for involvement of the gastrointestinal tract, that this involvement is often in the manner of MLP, and that most cases of MLP probably have MZL or ILL. PMID- 3519879 TI - Consolidation and maintenance therapy in multiple myeloma: randomized comparison of a new approach to therapy after initial response to treatment. AB - A randomized, controlled trial was initiated in 1977 to evaluate the impact of three alternative approaches to consolidation and maintenance therapy after initial maximal response for multiple myeloma. All patients were treated initially with BCNU, cyclophosphamide, and prednisone (BCP) until a designated level of response was achieved. Responders were randomly assigned to either melphalan and prednisone (MP); prednisone, Adriamycin (Adria Laboratories, Columbus, Ohio), azathioprine, and vincristine (PAIV), or no therapy until relapse, then treatment with BCP. Initial response rates were comparable with previous trials. A small number of incremental responses were observed with both MP and PAIV. Survival was the same for all three maintenance approaches and the same as that observed in our previous continuous BCP or MP therapy. Additional or consolidation/maintenance therapy of the type administered here appears to offer little advantage once an initial response has been achieved. PMID- 3519880 TI - Alpha-2 interferon therapy of hairy-cell leukemia: a multicenter study of 64 patients. AB - Sixty-four patients with hairy-cell leukemia (HCL) (61 had undergone prior splenectomy) were treated with alpha-2 interferon (Intron A, Schering Corp, Kenilworth, NJ) subcutaneously three times per week at a dosage of 2 X 10(6) U/m2. Three patients (5%) demonstrated a complete response (CR) with apparent eradication of hairy cells from the bone marrow, 45 patients (70%) showed a partial response (PR) defined as normalization of all three blood counts associated with decreased involvement in the bone marrow, and nine patients (14%) showed a minor response that included improvement in at least one blood count. Three patients had no response, three patients died before completing 1 month of therapy, and one patient refused further therapy after 1 month of therapy. The median platelet count returned to normal by the second month of treatment. The median hemoglobin returned to greater than 12 mg/dL by the fourth month of treatment, and the median granulocyte count to greater than 1,500/mu by the fifth month of treatment. Bone marrow biopsy analysis during interferon therapy demonstrated a decrease in median hairy-cell index by more than half. Transfusion of both RBCs and platelets were decreased within 4 months of initiating treatment. Serious infections, which averaged four per month in 16 of the 64 patients before interferon therapy, were rarely observed after the first month of treatment. Treatment-induced toxicity was mild, consisting primarily of influenza like symptoms, fatigue, and minor skin disorders. Alpha-2 interferon therapy is highly effective in reversing the course of progressive HCL and should be considered the treatment of choice for a minimum of 12 months in patients who have progressive disease post-splenectomy. PMID- 3519882 TI - Amsacrine-associated cardiotoxicity: an analysis of 82 cases. AB - Amsacrine is an antileukemia drug being widely used in North America, Europe, Australia, and New Zealand. In the initial clinical trials, patients treated with amsacrine developed occasional instances of acute cardiac arrhythmias and cardiomyopathy. We review and analyze the features of cardiac abnormalities associated with amsacrine in 82 patients, 27 of whom have not been previously reported. The rest have been reported in the literature, but we have included a large amount of additional information about these patients in our analysis. We conclude that amsacrine-related cardiac events are less common than those related to anthracycline chemotherapeutic agents. Manifestations of such toxicity include ECG abnormalities, ventricular and atrial arrhythmias, sudden death, and congestive heart failure. There is little or no cumulative dose effect. Hypokalemia may be a risk factor for development of serious tachyarrhythmias, but such problems can occur despite a normal serum potassium level. Amsacrine appears to affect depolarization and repolarization of the heart, but the mechanism is unknown. PMID- 3519881 TI - Piperazinedione, total body irradiation, and autologous bone marrow transplantation in chronic myelogenous leukemia. AB - Eleven patients with Philadelphia chromosome (Ph1)-positive chronic myelogenous leukemia (CML) in blast crisis (ten patients) or accelerated disease (one patient) were treated with piperazinedione (PIP) and fractionated total body irradiation (TBI) followed by autologous bone marrow transplantation (ABMT). Three patients were transplanted with marrow from which the Ph1 clone had been eradicated by prior intensive chemotherapy. All patients responded with disappearance of blasts in bone marrow and peripheral blood. Six patients achieved a second chronic phase lasting 3 to 14 months (median, 6 months). Two patients had incomplete recovery, and three patients failed to engraft and died from infection. Transplantation with Ph1-negative bone marrow did not improve response duration or survival. Recurrence of blast crisis and incomplete engraftment continue to be the two major problems in this patient group, and more active regimens need to be investigated. PMID- 3519883 TI - Ten-year results from the National Surgical Adjuvant Breast and Bowel Project (NSABP) clinical trial evaluating the use of L-phenylalanine mustard (L-PAM) in the management of primary breast cancer. AB - Between 1972 and 1974, patients were entered into a National Surgical Adjuvant Breast and Bowel Project (NSABP) trial to evaluate L-phenylalanine mustard (L PAM) as an adjuvant to mastectomy in patients with primary breast cancer and pathologically positive axillary nodes. Overall, findings through 10 years of observation indicate an 8% difference in disease-free survival (DFS) (P = .06) and a 5% difference in survival (P = .4). Women less than or equal to 49 years of age who received L-PAM demonstrate a significant (P = .03) prolongation of DFS and a significant (P = .05) survival benefit compared with those who received a placebo. There is a 37% reduction in their mortality and a cumulative odds of survival of 1.67. In that age group, both those with one to three and greater than or equal to 4 positive nodes benefited, but the advantage was greater when there were fewer positive nodes. There was a significant (P = .009) reduction in mortality (64%) and a cumulative odds of survival of 3.25 in patients less than or equal to 49 years old with one to three positive nodes. No advantage from L PAM was observed in patients greater than or equal to 50 years old. When L-PAM response is related to nuclear grade, a marker of tumor differentiation, there is a highly significant improvement in DFS (less than .001), distant DFS (.001), and survival (.004) through 10 years of observation for all patients with tumors classified as nuclear grade poor (poorly differentiated), regardless of age and nodal status. Mortality was reduced by 32% and the cumulative odds of survival was 2.10 at 10 years. Of singular importance is the observation of a benefit in those greater than or equal to 50 years of age as well as in those less than or equal to 49 years of age with poorly differentiated tumors. There is a significant (P = .003) survival benefit for those in the older age group with a 37% reduction in mortality, and a cumulative odds of survival of 2.75. Patients in both age groups with well-differentiated tumors demonstrated no benefit from L PAM. Those who are older seem to do less well following chemotherapy. We conclude that tumor differentiation is a better discriminant of response to chemotherapy than is age, and that both younger and older women are responsive to adjuvant chemotherapy when they have poorly differentiated tumors. PMID- 3519884 TI - Drug resistance in clinical practice: patterns of treatment failure in advanced breast and ovarian cancer. AB - We have analyzed the patterns of disease progression in patients with advanced breast and ovarian cancer receiving systemic therapy. Approximately 50% of patients developed progressive disease in a new, rather than a previously documented, disease site. Even when disease progressed in a previously involved disease site, in only half the cases was this identified as the bulk disease site before commencing treatment. The CNS was rarely a new site of disease progression in our patients, a finding that contrasts with a report that identified the CNS as the predominant new disease site in advanced breast cancer patients relapsing following a complete response. Progression of disease on second line treatment commonly occurred at sites of known disease. A number of factors influencing the pattern of disease progression have been examined. Disease progression on endocrine therapy tended to be more common in a previously involved disease site than in patients receiving cytotoxic therapy. There was a trend for patients who progressed within 6 months of chemotherapy to do so in an old site, whereas new disease sites predominated among those progressing later. Strategies for overcoming the causes of treatment failure should take account of the patterns of disease progression. Our results question the wisdom of always ceasing existing therapy when progressive disease is first documented. PMID- 3519885 TI - Randomized trial of tamoxifen alone or combined with aminoglutethimide and hydrocortisone in women with metastatic breast cancer. AB - A randomized clinical trial was performed to compare the efficacy of tamoxifen (TAM) alone with that of TAM plus aminoglutethimide (AG) and hydrocortisone (HC). Patients failing TAM could receive AG and HC. Objective responses to therapy were seen in 21 of 49 TAM patients (43%) and 25 of 51 TAM, AG and HC patients (49%). Time to disease progression and survival distributions were not significantly different between the treatment arms. Toxicity was greater for patients treated with TAM, AG, and HC and the trial was discontinued early for this reason. Twenty four patients received AG and HC after TAM therapy and three (12%) achieved a response. We conclude that the combination of TAM, AG, and HC is not recommended over TAM alone because toxicity appears to outweigh any potential therapeutic advantage. PMID- 3519886 TI - A randomized trial comparing cisplatin plus cyclophosphamide versus cisplatin, doxorubicin, and cyclophosphamide in advanced ovarian cancer. AB - After primary surgery, 125 patients with epithelial ovarian cancer (International Federation of Gynaecology and Obstetrics [FIGO] 1c + IIb + IIc = 22 patients, FIGO III = 82 patients, FIGO IV = 21 patients) were randomly allocated to receive PC (cisplatin 50 mg/m2 + cyclophosphamide 600 mg/m2 on day 1 every 28 days) (corrected) or PAC (PC + doxorubicin 45 mg/m2). After six cycles, patients clinically disease-free or with resectable residual disease were submitted to second-look surgery. After restaging, patients in surgical complete response (CR) stopped treatment while those responding partially (PR) received six more courses; patients whose disease progressed were excluded from the study. Among patients with measurable disease, the following clinical response rates were observed: PC = 20% CR, 34.3% PR, 14.3% stable disease, and 31.4% progression; PAC = 40.6% CR, 15.6% PR, 12.5% stable disease, and 31.3% progression. In the 75 patients submitted to second look, the results have been the following: PC = 39.5% CR, 36.8% PR, 7.9% stable disease, and 15.8% progression; PAC = 62.2% CR, 18.9% PR, 10.8% stable disease, and 8.1% progression. The difference in surgical complete response in favor of the PAC regimen is significant (P less than .05). Median survival and progression-free survival were 800 and 400 days, respectively, for PAC arm; median survival and progression-free survival were 680 and 380 days, respectively, for PC. These differences are not significant. Probability of survival was affected by FIGO stage, amount of residual disease, histology, performance status, and response at second look, while no influence was observed according to grade of tumor differentiation and age. Our results demonstrate the usefulness of doxorubicin in terms of surgical CR. PMID- 3519887 TI - Effects of insulin, insulin-like growth factor-II, and nerve growth factor on neurite formation and survival in cultured sympathetic and sensory neurons. AB - Insulin and the insulin-like growth factors (IGFs) may directly affect the development of the nervous system. NGF, IGF-II, and insulin's effects on neurite formation and neuronal survival were studied in peripheral ganglion cell cultures from chick embryos. Neurite outgrowth was enhanced in a dose-dependent manner by insulin and IGF-II in sympathetic cell cultures. The half-maximally effective concentration, ED50, was about 0.4-0.6 nM for both polypeptides, and concentrations as low as 10 pM were active. However, in sensory neurons the ED50 for neurite outgrowth was about 30 nM for insulin and 0.1 nM for IGF-II, suggesting that these factors may have selective effects in different neuronal tissues. Neither serum nor the presence of non-neuronal cells was required for the response in sympathetic neurons. The specific anti-NGF antiserum inhibited the neurite outgrowth response to NGF but not to insulin nor IGF-II. Insulin and IGF-II additionally supported survival of sensory and sympathetic neurons; however, insulin was not as efficacious as NGF. The combination of high concentrations of NGF and insulin was no better than NGF alone in supporting sympathetic cell survival, or neurite outgrowth. This indicates that insulin acts on the same, or a subpopulation, of NGF-responsive neurons. These results support the hypothesis that insulin and its homologs belong to a broad family of neuritogenic polypeptides. PMID- 3519888 TI - Immunohistochemical demonstration of GABAergic neurons in the enteric nervous system. AB - Application of a highly specific antiserum against GABA to whole-mount preparations of the guinea pig and rat myenteric plexus resulted in discrete and unambiguous immunolabeling of a subpopulation of myenteric neuronal cell bodies and fibers. The anti-GABA antiserum, which was raised against GABA conjugated by glutaraldehyde to BSA, was applied to glutaraldehyde-fixed whole mounts and subsequently visualized using the peroxidase-antiperoxidase method. In the guinea pig ileum and colon, immunoreactive varicose nerve fibers and scattered nerve cell bodies were found within the myenteric plexus. Immunostained fibers were also seen in the tertiary plexus and in the circular muscle, running parallel to the muscle bundles. GABA immunoreactivity in these intramuscular nerves was most pronounced in the colon. In the rat, immunoreactive fibers were prominent throughout the myenteric plexus. They formed dense networks within the myenteric ganglia, which also contained immunopositive nerve cell bodies, and ran between them in the interconnecting nerves. Some immunoreactive nerve fibers were seen in the circular muscle. Control experiments using non-immune sera or adsorbed anti GABA antiserum showed no staining. These results add a definitive support to our previous suggestion that GABA serves as an autonomic neurotransmitter in vertebrates. In addition to the present immunohistochemical evidence, this hypothesis is supported by biochemical, autoradiographic, transmitter release, electrophysiological, and pharmacological studies on the enteric nervous system of several species. It is now important to determine the functional role of GABAergic neurons within the complex neuronal circuitry that controls gut functions. PMID- 3519889 TI - Properties of 2-hydroxyglutarate dehydrogenase from Fusobacterium. PMID- 3519890 TI - Three-dimensional measurement of stone cast deformation. Part 2. Effects of types of impression material and mold on the dimensional stability of stone casts. PMID- 3519891 TI - Morphometric assessment of drug effects in experimental spinal cord injury. AB - The effect of large doses of methylprednisolone sodium succinate (MPSS) and two protease inhibitors, leupeptin and bestatin, on experimental acute spinal cord injury was evaluated by morphometric analysis of degenerating axons with the aid of an automated image analyzer. Spinal cord injury was produced by epidural compression with a surgical clip on the T-11 segment in rats. The extent of axonal damage was assessed in Rexed's lamina VIII in the L-6 segment by measuring the amount of silver grains, representing degenerating axons and their terminals, using the Fink-Heimer method. The severity of axonal damage was expressed as the degeneration index: that is, the amount of silver grains in experimental animals/the amount of silver grains in cord-transected animals. When examined on the 7th postoperative day, axonal degeneration in MPSS-treated rats was significantly decreased, with an average degeneration index difference of 6 (p less than 0.05). Increased preservation of axons was seen in the leupeptin treated rats sacrificed 7, 10, and 14 days after trauma. The difference in the degeneration index between the leupeptin-treated and untreated groups was 16 on Day 7 (p less than 0.001), 12 on Day 10 (p less than 0.001), and 13 on Day 14 (p less than 0.01). Bestatin had no beneficial effect. The implications for the use of calcium-activated neutral protease inhibitors in acute spinal cord injury are discussed. PMID- 3519892 TI - High count rate first-pass radionuclide angiography using a digital gamma camera. AB - In this study, first-pass radionuclide angiography (FPRNA) was performed using a digital single-crystal gamma camera. Twenty-nine men and six women (ages 43-80, mean 61 yr) underwent FPRNA in the supine position immediately prior to cardiac catheterization. Total counts/sec in the whole field-of-view in the right ventricular phase were 150,352 +/- 26,006. Background uncorrected counts in the representative cycle were 7,651 +/- 2,527 at end-diastolie and 4,904 +/- 2,314 at end-systolie. A linear correlation between FPRNA left ventricular (LV) ejection fraction and contrast LV ejection fraction gave an r = 0.95 with an s.e.e. of 0.05. Analyses of intra- and interobserver variability gave r = 0.99 and 0.98 and an s.e.e. of 0.02 and 0.03, respectively. Spearman-Rank correlation coefficients between FPRNA and contrast angiographic wall-motion scores were greater than 0.8 for all walls, while sensitivity/specificity were 0.86/0.90, 0.76/1.00, 0.76/1.00 for anterior, apical, and inferior wall-motion abnormalities, respectively. We conclude that satisfactory counting statistics for FPRNA can be obtained with a digital gamma camera, and that accurate and reproducible measurements of global and regional left ventricular function can be obtained with this technique. PMID- 3519893 TI - Exercise increases the lung clearance of inhaled technetium-99m DTPA. AB - The regional lung clearance of a deposited aerosol of [99mTc] diethylenetriaminepentaacetic acid was successively computed at rest and at exercise in seven nonsmoking volunteers in upright posture. The subjects were seated on a bicycle with their backs against a gamma camera. At rest there was a gradient of clearance from the apex to the base of the lung, the apical clearance being significantly higher. At exercise this regional gradient was enhanced by a large and significant increase of the apical clearances (3.40 +/- 0.63% min-1 s.d. compared with 1.82 +/- 0.75% min-1 s.d. at rest, n = 7, p less than 0.01). By contrast the changes of the basal clearances were slight and unsignificant (1.46 +/- 0.71% min-1 s.d. compared with 1.40 +/- 0.82% min-1 s.d.). This increase of the apical lung clearance could be attributed primarily to the increase of apical blood flow induced by exercise and to the subsequent increase of the permeability surface area product. PMID- 3519894 TI - Validation of diagnostic software. PMID- 3519895 TI - Early friends of nuclear magnetic resonance. PMID- 3519896 TI - Scintigraphic evaluation of liver transplant function. AB - Since the initiation of liver transplantation at our institution 9 yr ago, 73 patients ranging in age from 8 mo to 64 yr have undergone this procedure. In the immediate postoperative period and at various times thereafter as deemed necessary, radionuclide studies were performed using one of the iminodiacetic acid (IDA) derivatives labeled with 99mTc. Initially, these studies were performed using labeled PIPIDA with a shift to diisopropyl IDA when this latter agent became available. The IDA agent is administered as a bolus so that the "flow" and "pooling" may be viewed immediately after injection. This is followed by sequential imaging at various times up to 24 hr, with optional graphic tracings of hepatic and bowel patterns of uptake and clearance of radioactivity. An analysis of the initial portion of the IDA scan yields useful information regarding the arterial and portal venous supply of the liver. The rapidity of hepatic concentration and excretion provides a direct measure of hepatocyte function which is particularly helpful when used sequentially to follow the response of the liver to therapy for rejection or infection. The study is also used to assess the biliary system for obstruction or leaks. PMID- 3519898 TI - Dynamic variable background subtraction: a simple means of displaying radiolabeled monoclonal antibody scintigrams. AB - Subtraction of a nonspecific radionuclide is frequently used to enhance visualization of tumors imaged by radiolabeled monoclonal antibodies. Determining the optimal amount of the nonspecific radionuclide image to subtract can be difficult. We have developed a computer program that generates a closed-loop cinematic display in which a continuously varying amount of the nonspecific radionuclide image is subtracted from the specific antibody image. Through examination of this dynamic display, a broad range of background-subtracted images can be viewed expeditiously in an effort to select the optimal level of background subtraction. This method may be useful in routinely displaying such background-subtracted studies. PMID- 3519897 TI - Effects of intracoronary thrombolysis on global left ventricular function assessed by an automated edge detection technique. AB - Three hundred and two patients with acute myocardial infarction were enrolled in a randomized multicenter trial to compare conventional treatment with attempted recanalization by intracoronary streptokinase. In a subgroup of patients, the effects of thrombolysis on left ventricular function were evaluated within 48 hr, at 2 wk, and at 3 mo after admission. Global left ventricular ejection fraction (LVEF) was obtained by radionuclide angiography and analyzed with an automatic detection program. Paired data were determined in 160 patients (control 78, thrombolysis 82) within 48 hr and at 2 wk, and in 143 patients (control 71, thrombolysis 72) at 48 hr, 2 wk, and 3 mo. It was shown that LVEF significantly improved in the thrombolysis group as compared with controls both at 2 wk (delta LVEF thrombolysis 3.9 +/- 7.9%, p less than 0.001 compared with delta LVEF control 0.6 +/- 9.7%, p = N.S.) and at 3 mo (delta LVEF thrombolysis 3.1 +/- 12.4%, p less than 0.05 compared with delta LVEF control 2.1 +/- 12.2%, p = N.S.). When patients were divided according to infarct site, however, significant improvement at 3 mo was only observed in the patients with anterior infarction (delta LVEF thrombolysis 5.5 +/- 13.1%, p less than 0.05 compared with delta LVEF control 3.3 +/- 10.4%, p = N.S.). It was shown that acute intervention with intracoronary streptokinase has a potentially favorable and lasting effect on left ventricular function in patients with anterior myocardial infarction. This improvement might be related to the rather rapid administration of thrombolytic therapy with a median time of approximately 4 hr after onset of symptoms. PMID- 3519899 TI - False-negative thallium-technetium subtraction scintigraphy. PMID- 3519900 TI - Renal tubular receptor imaging with iodine-131-labeled peanut lectin: pharmacokinetics and renal clearance mechanism in animals. AB - Intravenously administered peanut lectin (PNA), iodinated with 131I ([131I]PNA), is rapidly cleared from the plasma by the kidneys in dogs (clearance [total body] = 17.52 +/- 8.74 ml/min). Dynamic gamma camera renal scintigraphy demonstrated renal accumulation and excretion phases of the [131I]PNA renogram in dogs and rabbits (% injection dose-at-peak = 21.8 +/- 3.3% and 19.6 +/- 4.3%, time-to-peak = 44.6 +/- 4.8 min and 37.2 +/- 6.9 min, respectively). Immunoperoxidase staining of kidney sections, following i.v. administered PNA, demonstrated predominant accumulation by the proximal tubules of mice, rabbits, and dogs. The basement membrane was intensely stained at early times p.i. while intracellular and luminal PNA was evident within 1 hr. Urine analysis confirmed the presence of intact [131I]PNA in the bladder contents, while protein degradation products, and a small percentage of the free iodide (less than 5%) were noted within 1 hr p.i. The relative proportion of free iodide increased at later times p.i. (greater than 6 hr). A receptor mediated excretion mechanism is proposed for the clearance of PNA and may be useful for the study of renal tubular function. PMID- 3519901 TI - Splenic hemangioma presenting as a "hot spot" on radiocolloid scintigraphy. AB - The appearance of a splenic hemangioma on radiocolloid scintigraphy has been reported to be that of a focal photon deficient lesion. We report a case of a patient who presented with the opposite appearance--that of a splenic "hot spot." We postulate that this appearance results from increased local blood flow presenting a greater proportion of colloid to the reticuloendothelial cells surrounding the hemangioma. PMID- 3519902 TI - Urine extravasation into the scrotum. AB - A case report demonstrating urine extravasation into the scrotum following renal transplantation is presented. An anatomic explanation of the pathway of urine drainage into the scrotum is offered with a brief discussion of extravasation following renal transplantation and its detection by scintigraphy. PMID- 3519903 TI - Perfusion and receptor SPECT in the dementias--George Taplin memorial lecture. PMID- 3519904 TI - Historical roots of the healthy worker effect. PMID- 3519905 TI - Heterogeneity of periodontal diseases. PMID- 3519906 TI - Periodontal diseases in children: disease heterogeneity. PMID- 3519907 TI - Further abrasion resistance and bond strength studies of fissure sealants. AB - As part of a laboratory evaluation, measurements of abrasion loss and tensile enamel--sealant bond strengths have been made on three visible light cured sealants (two filled, one unfilled), two chemically cured sealants (one filled and one unfilled) and an experimental sealant with alumina filler particles. A UV cured filled sealant was used as a control. The unfilled sealants had abrasion loss approximately twice that of the filled commercial sealants. The experimental sealant, with filler content above 50%, had an abrasion loss approximately half that of the filled commercial sealants. The chemical cured sealants had bond strengths lower than the UV-cured control, while the bond strengths of the two visible light-cured filled sealants and the experimental sealant were not statistically different from either the unfilled visible light-cured sealant or from the UV-cured filled sealant. PMID- 3519908 TI - Noise level evaluation of dental handpieces. AB - We evaluated the noise level of fourteen air-driven handpieces, six low speed (less than 20,000 rev/min) and eight high speed (greater than 160,000 rev/min), with respect to a three-directional co-ordinate system and distances of 6, 12 and 18 in. in each chosen direction. A two-way analysis of variance of the noise level between handpieces and positions indicates that large significant differences exist amongst handpieces and in different positions, and that interaction is just barely significant. The ranking and least significant differences for the mean of all handpieces v. position and for the mean of all positions v. handpiece were compared with the results for the ranking and significances from the one-way ANOVAS for each handpiece v. position and for each position v. handpiece. A trend exists with some of the handpieces of straight design (all low speed) for increased noise levels in a direction perpendicular to the handpieces and decreased levels in a direction parallel to the handpieces. For handpieces of angled design (all high speed) both directions parallel and perpendicular (the perpendicular to the longitudinal turbine axis) to the rotor axis indicate increased noise levels. The parallel direction includes the exiting air from the exhaust port. The perpendicular direction can be indicative of an aerodynamic factor associated with the established air flow patterns. The extremes in noise level were 56.8 dBA for a low-speed handpiece of straight design at the 18 in. distance in a direction parallel to the handpiece, and 87.3 dBA for a high speed handpiece at the 6 in. distance in a perpendicular direction. PMID- 3519909 TI - The bone growth chamber for quantification of electrically induced osteogenesis. AB - A dividable titanium implant was inserted in the tibial metaphysis of rabbits, which permitted a numerical evaluation of ingrowing bone. The implant on the test side was used as cathode and was connected to a subcutaneously located stimulator delivering constant current of either 5 microA, 20 microA, or 50 microA. A corresponding control implant was inserted in the other tibia of the same animal and treated likewise, but was not connected to the stimulator. Distally to each implant, a platinum-iridium screw was inserted into the cortex and connected on the test side to the stimulator to serve as the anode. The results showed a 2.4 fold increase in bone formation with 5 microA. In the 20-microA group, there was 2.6-fold more bone in the test chambers. Direct current (DC) stimulation with 50 microA caused a clear decrease of bone volume, with an average of 48% less bone in the test implants. The results indicate that 5 and 20 microA direct current enhance bone ingrowth into a titanium implant that is used as a cathode. The osteogenesis seemed to be more pronounced in the case where the chamber was used as a cathode compared to earlier experiments in which the cathode was placed at a distance of 5 mm from the implant. PMID- 3519910 TI - Cervical spine biomechanics: a review of the literature. AB - This article reviews the many clinical and laboratory investigative research reports on the frequency, causes, and biomechanics of human cervical spine impact injuries and tolerances. Neck injury mechanisms have been hypothesized from clinically observed cervical spine injuries without laboratory verification. However, many of the laboratory experiments used static loading techniques of cervical spine segments. Only recently have dynamic impact studies been conducted. Results indicate that crown-of-head impacts can routinely produce compression of the neck with extension or flexion motion. However, the two dimensional (midsagittal) movement of the head bowing into the chest does not routinely produce flexion/compression type damage to the cervical spine. Flexion/compression damage to the cervical spine can be produced by prepositioning the subject so that upon impact, a three-dimensional motion of the head and neck occurs. Future laboratory research is needed to determine the forces and impact directions required to produce the various known fracture types and dislocations for a clear, accurate description of the cervical spine impact dynamics. PMID- 3519911 TI - [Mastoid obliteration]. PMID- 3519912 TI - Chemotherapy in giardiasis: clinical responses and in vitro drug sensitivity of human isolates in axenic culture. AB - To investigate drug sensitivities of human Giardia isolates, we developed a reproducible in vitro 3H-thymidine uptake assay to compare drug potencies. Among 13 Giardia intestinalis stocks obtained from the culture of trophozoites isolated from duodenal juice, considerable variation in susceptibility to a range of currently used drugs was found. The population doubling time of these stocks also varied widely. Clinical features in patients ranged in severity from mild chronic diarrhea to a celiac-like syndrome, with a similar variation in the degree of histologic change in the mucosa. Brush-border enzyme activities were universally reduced in children younger than 5 years of age. The two isolates with the highest ID50 values for furazolidone in vitro were from patients who had persistent symptoms after treatment with this drug; these patients subsequently responded to treatment with a nitroimidazole with greater in vitro potency. These studies suggest that biologic variants of G. intestinalis exist in humans and may in part account for the variable clinical manifestations and for some treatment failures. PMID- 3519913 TI - Upper gastrointestinal tract bleeding acquired in a pediatric intensive care unit: prophylaxis trial with cimetidine. PMID- 3519914 TI - Persistence of antibody and response to booster dose of Haemophilus influenzae type b polysaccharide diphtheria toxoid conjugate vaccine in infants immunized at 9 to 15 months of age. AB - At approximately 2 years of age, 27 infants previously immunized at 9 to 15 months of age with two doses of polyribosylribitol phosphate-diphtheria toxoid conjugate vaccine (PRP-D) and 23 infants immunized with polyribosylribitol phosphate (PRP) vaccine were given a single injection of PRP-D. Pre- and post immunization sera were obtained. No serious local or systemic reactions were observed. The PRP-D recipients had a geometric mean anti-PRP antibody level of 4.8 micrograms/ml 1 month after the second primary injection, retained 1.2 microgram/ml 1 year later, and had a level of 71 micrograms/ml after the booster immunization. In contrast, PRP recipients had a geometric mean level of 0.083 microgram/ml 1 month after the second primary injection, retained 0.042 microgram/ml 1 year later, and after a single dose of PRP-D at approximately 2 years of age had a geometric mean level of 8.6 micrograms/ml. The significantly higher antibody response in the prior PRP-D recipients suggests the recall of immunologic memory induced by the PRP-D vaccine. PMID- 3519916 TI - 3' terminal nucleotide sequence of the 17S ribosomal RNA species from Plasmodium falciparum. PMID- 3519915 TI - Systemic production of prostacyclin and thromboxane A2 does not correlate with patency of the ductus arteriosus in very low birth weight infants. AB - Urinary excretion of prostacyclin and thromboxane metabolites (2,3-dinor-6 ketoprostaglandin F1 alpha, thromboxane B2, and 2,3-dinor-thromboxane B2) as indices of systemic biosynthesis was prospectively determined in nine premature infants during the first 10 days of life, by gas chromatography-mass spectrometry. The patients ranged in gestational age from 27 to 29 weeks and in birth weight from 720 to 980 gm. Four infants developed symptomatic patent ductus arteriosus (PDA). Excretion of all metabolites exceeded adult values on the basis of body surface area at birth, reached a maximum on the fourth day of life, was related to urine output, and did not distinguish patients with and without symptomatic PDA. We conclude that neither circulating prostacyclin nor thromboxane A2 contribute significantly to the pathophysiology of symptomatic PDA in very low birth weight infants. PMID- 3519917 TI - Gwendolen Rees: a biographic sketch. PMID- 3519918 TI - The chemotherapy of parasitic infections. PMID- 3519919 TI - Blunt liver trauma in children: the role of computed tomography in diagnosis and treatment. AB - In a retrospective evaluation of 12 children with blunt liver trauma studied by computed tomography (CT), all patients studied preoperatively had subcapsular hematomas (6/6). Eleven of twelve patients had parenchymal lesions that were located predominantly in the superior subsegments of the right lobe: 9/12 posteriorly (segment no. 7) and 7/12 anteriorly (segment no. 8) where transections were most frequent. Lacerations were accompanied by intraparenchymal hematomas. Intravenous bolus contrast enhancement visualizes segmental anatomy and is absolutely necessary in order to map lacerations, recognize nonviable tissue, and relate them to major vessels. Except in critically unstable patients, noninvasive imaging of hepatic and other combined abdominal lesions can avoid diagnostic laparotomy or justify planning of a tailored, maybe less radical surgical procedure. Complications, such as abscess formation, can be demonstrated and drained percutaneously. Despite cost, CT is currently the single best imaging method in acute liver trauma. PMID- 3519920 TI - Reduction of acetohexamide by rabbit heart cytosol. AB - The acetohexamide reducing activity of cytosol of rabbit heart was compared with that of rabbit liver or kidney. The heart exhibited an approximately 2-fold higher activity than either the liver or kidney. Both aldehyde and ketone reductases may contribute to the reduction of acetohexamide by cytosol of rabbit heart. It is noteworthy that the heart is an important organ reducing acetohexamide. PMID- 3519921 TI - Disposition of glycyrrhetic acid and its glycosides in healthy subjects and patients with pseudoaldosteronism. AB - As a first step to elucidate the disposition of traditional Chinese formulations which contain licorice, the disposition of plain licorice was investigated in humans. Glycyrrhetic acid (GLA) was measured by an enzyme immuno-antibody technique. Glycyrrhetic glycosides (GLA-GS), such as glycyrrhizin, were measured after acid hydrolysis to GLA by the enzyme immuno-antibody assay. Five normal subjects were orally administered a decoction of licorice containing 133 mg of glycyrrhizin. It was found that the time required for maximum serum concentration of GLA-GS was less than 4 h after the administration. Although there were large individual differences, it was found that GLA-GS was eliminated from the blood for the most part within 72 h. On the other hand, GLA reached maximum serum concentration at about 24 h after administration and in two of the five cases it was still detected in the blood even after 96 h. Urinary excretion of GLA was about 2% of the total dose of glycyrrhizin administered. This suggested that there were great differences among the subjects in the absorption and urinary excretion of GLA-GS. The serum GLA levels in two clinical cases who presented pseudoaldosteronism by licorice containing formulations were as high as 70-80 ng/ml, with GLA-GS levels being very low. This fact suggests that pseudoaldosteronism develops in association with GLA rather than with GLA-GS. PMID- 3519922 TI - An in situ experimental model in rabbits for the study of rectal absorption. AB - An in situ experimental model of rectal absorption was studied in rabbits compared with in vivo determination of drug concentration in the plasma of postcaval vein using indomethacin as drug. Pharmacokinetic parameters were similar between in vivo and in situ. When results from both studies were compared, 60% of the drug administered to the rectum was absorbed from the superior hemorrhoidal vein and the remaining 40% was absorbed from the inferior hemorrhoidal vein. When an aspirin suppository was used in this model, the amount of unaltered aspirin absorbed in the rectal mucosa or space was greater than the absorbed salicylic acid which was metabolized or degradated from aspirin. In the case of insulin, these differences were not seen in the insulin concentration of venous plasma between insulin physiological saline and surfactant suspension. However, using the in situ model, the surfactant effect on rectal absorption of insulin was observed. From the above results, it was concluded that this in situ experimental model of rectal absorption has advantages in that it can be used directly to measure the rectal absorption rate and to determine ratios of easily metabolized and poorly absorbed drugs. Therefore, this model appears to be useful in evaluation of rectal absorption. PMID- 3519923 TI - Effects of pinacidil on renal hemodynamics and function in anesthetized dogs. AB - We studied the effects of pinacidil on renal hemodynamics and function in anesthetized dogs. An intravenous injection of pinacidil, at a dose of 0.25 mg/kg, resulted in a rapid and marked reduction of the mean systemic blood pressure (MSBP) accompanied by a significant increase in renal blood flow (RBF). There were no significant changes in glomerular filtration rate (GFR), urine flow (UF) and urinary excretion of electrolytes (UEE). When pinacidil was administered at a dose of 0.5 mg/kg, the hypotensive effect was more potent. RBF did not change, but GFR, UF and UEE significantly decreased. These antidiuretic effects were not influenced by renal denervation. Hydralazine, at doses of 0.5 and 2.0 mg/kg, caused a significant and sustained reduction of MSBP, but the effects were much less potent than those seen with pinacidil. A sustained increase in RBF was observed after hydralazine at both doses. The lower dose elicited increases in UF and UEE, although the GFR remained unchanged. The higher dose of hydralazine caused a reduction of GFR, accompanied by decreases in UF and UEE. These antidiuretic effects were abolished by renal denervation. Intravenous injection of pinacidil or hydralazine produced a significant increase in the renin secretion rate. Intrarenal arterial infusion of pinacidil (2.0 micrograms/kg/min) produced a more marked diuretic effect than hydralazine (20 micrograms/kg/min). These findings indicated that the hypotensive activity of pinacidil is more potent than that of hydralazine, and suggested that the antidiuretic action of i.v. pinacidil (0.5 mg/kg) is due to a reduction of renal perfusion pressure. Furthermore, this drug may exert an additional action in the kidney to cause diuresis. PMID- 3519924 TI - Studies of the combined use of steroid and Shosaikoto, one of the Kampohozai (Chinese traditional medicine), on pituitary adrenocortical axis function and immune responses. AB - The combined effects of Shosaikoto, one of the Kampohozai (Chinese traditional medicine), and prednisolone were examined for suppressive actions on pituitary adrenocortical axis function and immune response induced by prednisolone using rats and mice. The administration of Shosaikoto, 1.2 g/kg p.o., for 45 d showed a tendency to increase adrenal weight. By the combined use of Shosaikoto, 0.12 and 1.2 g/kg p.o., and prednisolone, 0.016 g/kg p.o., for 45 d, the decrease of adrenal weight induced by the treatment with prednisolone was restored. The administration of Shosaikoto, 1.2 g/kg p.o., elevated the blood corticosterone level. In the case of combined use, Shosaikoto, 0.12 and 1.2 g/kg p.o., inhibited the decrease of blood corticosterone level induced by the treatment with prednisolone, 0.004 g/kg p.o., and Shosaikoto, 1.2 g/kg p.o., inhibited the decrease of blood corticosterone level induced by the treatment with prednisolone, 0.016 g/kg p.o. On the other hand, the administration of Shosaikoto, 1.2 g/kg p.o., for 7 d reduced the number of hemolytic plaque forming cells (HPFC) in spleen cells. But, Shosaikoto, 1.2 g/kg p.o., administered for 7 d inhibited the decrease of the number of HPFC induced by the treatment with prednisolone, 0.01 and 0.03 g/kg s.c., for 3 d. Furthermore, Shosaikoto, 1.2 g/kg p.o., restored the number of rosette forming cell (RFC) which decreased by prednisolone, 0.03 g/kg s.c. The decrease of 7S HA titer of the serum by the treatment with prednisolone, 0.01 g/kg s.c., was also inhibited by the combination with Shosaikoto, 1.2 g/kg p.o. PMID- 3519925 TI - Life with dialysis: structured interviews provide feedback. PMID- 3519926 TI - Pain in the pediatric patient: a review of research. PMID- 3519927 TI - [An approach to development of new drugs from drug delivery researches]. PMID- 3519928 TI - Medium chain triglycerides (MCT) in aging and arteriosclerosis. AB - Some of the nutritional work with triglycerides consisting mainly of C8 and C10 fatty acids (MCT) lends itself to speculations about their influence on arteriosclerosis. Arteriosclerosis is thought to be part of the normal aging process which is due to age associated molecular biological changes. The lipid theory of arteriosclerosis is rejected. Pertinent studies with MCT include these observations. Feeding of MCT to rats resulted in animals of low body weight, small fat deposits and excellent survival rate. This deserves emphasis because of the beneficial influence of low body weight on aging and arteriosclerosis. MCT feeding was associated with low linoleate and low tocopherol requirements in rats. This may lead to reduced formation of those linoleate derived prostaglandins which favor thrombosis formation. Lower linoleate requirements may also lead to the presence of fewer uncontrolled free radicals in the cells. MCT feeding is associated with low levels of serum and liver cholesterol involving speculations that tissue conditions are such that an adaptive increase of cholesterol is unnecessary. The Demographic Yearbook of the United Nations (1978) reported that Sri Lanka has the lowest death rate from ischemic heart disease. Sri Lanka is the only of the countries giving reliable data where coconut oil (containing over 50% medium chain fatty acids) is the main dietary fat. PMID- 3519929 TI - Dietary effects of trans fatty acids. AB - The dietary effects of the trans fatty acids in hydrogenated fats in health and disease deserves consideration for at least two reasons. One, trans fatty acids are becoming increasingly important as a source of calories in all industrialized countries, and two, their structural differences from the fatty acids in unhydrogenated fats offer a means of exploring uncharted areas in lipid metabolism. Such an exploration would have been impossible twenty years ago; some areas are still inaccessible because of a lack of methodology. PMID- 3519930 TI - Polyglycerols and polyglycerol esters in nutrition, health and disease. PMID- 3519931 TI - Assessment of nutritional risks of special diets and drugs used in the management of familial hypercholesterolemia. PMID- 3519932 TI - Fats and oils as functional ingredients in the baking industry--nutritive value. PMID- 3519933 TI - Relationship between lipoperoxides and diseases. PMID- 3519934 TI - Cholesterol biodynamics in rats and humans. PMID- 3519936 TI - Stewart Eugene Reed, DPM 1906-1985. PMID- 3519935 TI - Dietary lipids as anticariogenic agents. PMID- 3519937 TI - Report of an incarcerated Lynell anterior chamber intraocular lens. AB - This is the first report to document that the polyimide loops of a Lynell glass intraocular lens can cause erosion into the ocular structure and become incarcerated by peripheral anterior synechias. A technique for removal of this anterior chamber lens is described. PMID- 3519938 TI - Influence of mebendazole on insulin secretion from isolated rat islets. AB - The antihelminthic drug mebendazole (MEB) has been reported to elevate circulating insulin levels in vivo. By using isolated perifused rat islets we tested the acute effects of this drug directly on the beta cell in the absence or presence of exogenous glucose. In the absence of glucose, MEB (40 micrograms/ml) caused a delayed but sustained increase in insulin output from the islet. Release induced by this concentration of MEB was not influenced by either forskolin (10 microM), a compound that increases islet cyclic AMP levels and potentiates glucose-induced secretion, or the absence of extracellular calcium. In the presence of a submaximal stimulatory glucose concentration (8 mM), release was dramatically potentiated by the further addition of 10 to 40 micrograms/ml of MEB. The potentiating effect of the drug on glucose-induced release was readily reversible and abolished by the omission of extracellular calcium or the addition of 10 mM mannoheptulose, a compound that blocks glucose phosphorylation. Despite its positive effects on hormone secretion, MEB did not affect glucose metabolism. MEB may prove useful for investigating the factors that regulate insulin secretion. PMID- 3519939 TI - Pharmacological properties of acetorphan, a parenterally active "enkephalinase" inhibitor. AB - Acetorphan, i.e. N-[(R,S)-3-acetylmercapto-2-benzylpropanoyl]-glycine, benzyl ester, is a lipophilic derivative of Thiorphan, a potent inhibitor of "enkephalinase" (EC 3.4.24.11). On purified enkephalinase its inhibitory potency was approximately 1000 fold less than that of Thiorphan but became close to the latter (nanomolar) when it was incubated previously with cerebral membranes. After parenteral administration to mice and rats (1-10 mg/kg) extensive inhibition of cerebral enkephalinase was shown by the depressed enzyme activity in brain membranes from treated animals and the long-lasting potentiation of analgesia elicited by (D-Ala2,Met5)enkephalin (i.c.v.). This suggests that acetorphan easily enters the brain where the active Thiorphan is released. Parenteral acetorphan elicited a series of naloxone-reversible, opioid-like effects, most of which were described previously with intracerebral Thiorphan or other enkephalinase inhibitors. Antinociceptive effects were found in some tests (hot plate jump and phenylbenzoquinone-induced writhing) but not in others (hot plate licking and tail withdrawal). "Antidepressant" effect was found in the "mouse despair" test and antidiarrhoeal effect in the rat castor oil test. Acetorphan also elicited significant increases and decreases in turnover indexes of serotonin and noradrenaline, respectively, in mouse cerebral cortex. In mice chronically treated with acetorphan, the antinociceptive activity of the compound was not modified markedly and no overt withdrawal symptom could be observed after either treatment interruption or administration of naloxone. PMID- 3519940 TI - Success with the cantilever fixed partial denture. AB - Factors necessary for longevity of cantilevered FPDs include favorable clinical conditions determined by organized data collection, sound mechanical features of the FPD, appropriate design of the cantilevered pontic, and maintenance of the supporting periodontium. PMID- 3519941 TI - Retention and stress distribution of tapered-end endodontic posts. PMID- 3519942 TI - Extension of clinical crown length. PMID- 3519943 TI - The compressive strength of nonprecious versus precious ceramometal restorations with various frame designs. AB - This study was designed as a comparative analysis of the compressive strengths of precious versus nonprecious metals with various framework designs used in clinical restorations. One hundred thirty-five statistically uniform ceramometal restorations were fabricated. The restorations were cemented to the die and then subjected to stroke-control compression forces in an Instron loading machine. Simulated clinical failure was recorded by the Instron load cell recorder in pounds of load. PMID- 3519944 TI - Acid-etched splinting to a ceramometal abutment. AB - This technique describes an acid-etch metal splint with a ceramometal abutment. The internal surface of the DuraLingual Wing Form patterns provide undercuts necessary for composite bonding. The external surface provides a smooth solid metal surface when cast. Since this system uses mechanical undercuts, the resin bonded splints can have multiple try-ins without the detrimental effects of burnishing and contamination that occur with electrolytically etched metal surfaces. If an abutment for a resin-retained fixed partial denture requires a ceramometal crown, a DuraLingual Wing Form can be incorporated onto its lingual surface thereby providing mechanical undercuts for bonding. The opposite undercuts of the crown and splint provide excellent bond strength for the system. PMID- 3519945 TI - Possible role of Koebner's phenomenon in the development of mucous membrane pemphigoid. PMID- 3519946 TI - Dimensional stability of autopolymerizing acrylic resin impression trays. AB - A study was undertaken to determine the optimal interval between fabrication of an autopolymerizing acrylic resin custom impression tray and making a final impression. Twenty mandibular arch-shaped trays, 10 each of Fastray and Formatray resin, were evaluated for dimensional change. Both materials behaved similarly. Cross-arch contraction of the borders of buccal flanges and unilateral expansion of the borders of buccal-to-lingual flanges were observed. These changes indicate distortion. Linear dimensional changes occurred throughout 6 hours, which suggests that any impression made in a methyl methacrylate acrylic resin custom impression tray should be poured as soon as is conveniently possible. Significant linear dimensional changes were observed for only 40 minutes from the initiation of tray fabrication. This study concludes that while an aged tray is preferred, it is acceptable to make an impression in an autopolymerizing resin custom impression tray after 40 minutes. PMID- 3519947 TI - Snorkel or scuba diver's denture. PMID- 3519948 TI - A method for simulating gingival color on aluminum alloy denture base. PMID- 3519949 TI - The four-step flow technique: a method for fabrication of wax patterns. AB - Wax additive techniques have focused on the formation of the occlusal surface. The four-step flow technique was developed to provide an accurate wax pattern before the formation of the occlusal surface, provide for the development of correct axial contours, and reestablish the primary importance of such contours in the development of successful cast restoration. PMID- 3519950 TI - Camouflaging partial denture clasps. PMID- 3519952 TI - The limitations of ultrasound in thyroid swellings. PMID- 3519951 TI - Louis Daniel Beauperthuy: pioneer in yellow fever and leprosy research. PMID- 3519953 TI - Can surgeons rely on ultrasonography for gallstones? PMID- 3519954 TI - A suture-jig for peripheral nerve repair. PMID- 3519956 TI - [Acute intestinal intussusception in infants and children and abdominal ultrasonography]. AB - Ultrasound imaging findings of the invaginated bud are described in 60 young children referred with a suspected acute intestinal intussusception over a period of 5 months. An initial group of 28 children were examined by ultrasonography and a barium enema for diagnostic and possible therapeutic purposes. The second series of 32 children were a therapeutic enema only when ultrasound images provided a positive diagnosis. The method is considered to be a reliable one requiring less medication, and has the principal advantage of suppression of the need for diagnostic barium enema. PMID- 3519955 TI - [Ultrasonic diagnosis in scrotal pathology. Apropos of 137 tests]. AB - Ultrasound imaging of scrotum in 137 patients detected 31 inflammatory lesions of epididymis or testis, 8 tumors, 23 cystic lesions, 21 hydroceles and 19 other affections. Medical or surgical treatment was instituted in 63% of patients, the other 37% failing to attend. Therapy was effective in 90.5% of cases (100% of fluid lesions, 80.6% of inflammatory lesions and 87.5% of tumors). Ultrasound imaging appears to be an excellent complement to clinical examination, when findings are insufficient or when examination is difficult because of severe pain, allowing identification of the fluid or solid nature of a lesion. It is also of specific value for diagnosis of subclinical tumors, surveillance of patients at risk and detailed investigation of inflammatory lesions. PMID- 3519957 TI - [X-ray computed tomographic aspects of tumors of the colon with peripheral extramucous development]. AB - The authors report three cases of a palpable abdominal mass without clinical evidence of obstruction. In each case, ultrasound diagnosed a solid tumor. Computer tomography examination measured the density of the tumor and the extension of the disease. In each case, the colonic origin was established owing to surgery. Histological examination of the three cases diagnosed a fibroma of the caecum, an enterogenic cyst of the caecum and a T-lymphosarcoma developed from the wall of the left colon. PMID- 3519958 TI - [Pseudotumoral retroperitoneal tuberculosis. Apropos of a case]. AB - A case is reported of pseudotumoral retroperitoneal tuberculosis with invasion of left supraclavicular glands. Relative diagnostic efficacy of ultrasound and CT scan imaging is discussed as well as the differential diagnosis of this exceptional lesion. Exploratory procedures suggested with this type of picture are ultrasonography. CT scanning and possibly guided needle puncture biopsy to avoid surgical exploration. The value of the scanner for follow up review of results of antituberculosis treatment is emphasized. PMID- 3519959 TI - [Left inferior vena cava. Ultrasonic diagnosis]. AB - A case of left infrarenal vena cava is detected by ultrasonography and confirmed inferior cavography. Embryogenesis of the inferior vena cava aids understanding of this type of congenital anomalies. Ultrasonographic diagnosis is based on the absence of right infrarenal vena cava, the presence of a vascular structure left to the abdominal aorta an a normal hepatic segment of inferior vena cava. PMID- 3519960 TI - [Codus: a coding system for ultrasonic examinations]. AB - A semeiologic and anatomic code for ultrasound imaging data has been in use for 3 years. A simple index, it allows coding under specific headings of almost all ultrasound record sheets and can be modified as a function of the requirement of different departments. It is also perfectly well adapted for inclusion in a data processing system. PMID- 3519961 TI - [Case of the month. Pelvic and colonic endometriosis]. PMID- 3519962 TI - [Role of digital intravenous angiography in the study of reversible cerebral ischemia]. AB - The brachiocephalic, carotid, vertebral and intra-cranial vessels of 497 patients presenting reversible ischemic attacks (R.I.A.) were evaluated with venous digital subtraction angiography (V.D.S.A.). Alterations of the vascular wall were observed in 289/497 (58.2%) patients, of whom 60% presented multiple locations (539 lesions): obstruction (12%), stenosis greater than 50% (29%), stenosis less than 50% (49.8%), kinking (9%), aneurysm (0.2%). An ulcerating arteriosclerotic plaque was observed in 24.6% of the stenoses less than 50% and in 48% of the stenoses greater than 50%. The incidence of vascular lesions was higher (p less than 0.01) in patients with multiple R.I.A. (66.6%) than in those with one isolated R.I.A. (55.6%). Among the patients (207/497) studied also with cerebral computed tomography (C.T.) no relationship could be defined between the extra cranial vascular lesions demonstrated by V.D.S.A. and the cerebral alterations shown by C.T. Among the patients (64/497) studied also with high frequency ultrasonography (U.S.), the lesion shown by V.D.S.A. could be also demonstrated by U.S. in 84.8% of cases. The personal flow-chart in the study of R.I.A. is described emphasizing the primary role played by V.D.S.A. as well as the complementary role of the other techniques, both non invasive (U.S., C.T.) and invasive (conventional or digital subtraction angiography). PMID- 3519963 TI - Free flap of gliding tissue. AB - A flap of loose connective tissue based on the thoracodorsal vein and artery and lying between the latissimus dorsi and serratus lateralis can be raised and transferred as a local or free flap. This flap has been used to reconstruct the gliding mechanism in block adhesions of the flexor tendons at wrist level. It has also been used for staged tendon and nerve reconstruction at the same site. Technical details for raising the flap are described and other flaps for similar purposes are suggested. Results of five hands in four cases, including one failure, are detailed. PMID- 3519964 TI - A simplified technique for end-to-end microanastomosis. AB - A simplified technique for end-to-end microanastomosis is presented. It combines the advantages of the anterior and posterior wall techniques; it is especially suitable when only short vessel segments are available; it eliminates severe torsion of the vessels; and it is relatively easy to perform. PMID- 3519966 TI - Association of prolonged, preterm premature rupture of the membranes and abruptio placentae. AB - Nine patients with prolonged, preterm premature rupture of the membranes (PROM) had associated abruptio placentae confirmed at delivery. Antepartum vaginal bleeding during the course of expectant management was the most common feature in the clinical course of the patients who developed abruptio placentae. Other clinical and laboratory findings suggesting the diagnosis were not present consistently. Retrospective analysis of all patients with prolonged, preterm PROM led to an estimated risk of 4% for the development of abruptio placentae during the course of expectant management of such patients. This risk estimate is three to eight times greater than that for the development of abruptio placentae in pregnancy generally. A high index of suspicion for abruptio placentae is appropriate when patients with prolonged, preterm PROM develop vaginal bleeding or any other suggestive clinical signs or symptoms of abruptio placentae during the course of expectant management. PMID- 3519965 TI - Wheezing in young children: problems of measurement and management. AB - Literature on morbidity and mortality from childhood asthma is reviewed, and data presented from a geographically defined population showing a cumulative prevalence of 25% for chronic or recurrent reversible airways obstruction in 263 children aged between five and 16 years. In 47% of these children, asthma was diagnosed when they were under the age of five years. Risks of iatrogenic damage from overdiagnosis and overtreatment are discussed. The principal objective of management of childhood asthma in general practice should not be the prevention of deaths, which now occur at rates of between two and 25 per million people, but to help children with minor asthma to conserve respiratory function and become normal adults. PMID- 3519967 TI - Ultrasonographic prenatal diagnosis of hydranencephaly. A case report. AB - Hydranencephaly was diagnosed with a prenatal ultrasound examination, and the results were correlated with the autopsy findings. PMID- 3519968 TI - Ureteral stent placement for recurrent hydronephrosis in pregnancy. A case report. AB - Conservative management of recurrent hydronephrosis in pregnancy is an alternative to surgical intervention and placement of a ureteral stent during the second trimester. PMID- 3519969 TI - Synthesis and alpha-D-glucosidase inhibitory activity of N-substituted valiolamine derivatives as potential oral antidiabetic agents. AB - Various kinds of N-substituted valiolamine derivatives, including compounds 23a, 24a, and 34a, which are structurally analogous to the key pseudodisaccharides (25a and 26a) of naturally occurring oligosaccharide alpha-D-glucosidase inhibitors, have been synthesized and estimated by the measure of inhibitory activity against porcine sucrase and maltase. The N-substituted valiolamine derivatives evaluated in this study have been found to be more potent than the corresponding N-substituted valienamine derivatives as well as the parent valiolamine. It is noteworthy that even simple N-substituted valiolamine derivatives such as N-[2-hydroxy-1-(hydroxymethyl)ethyl]-, N-[(1R,2R)-2 hydroxycyclohexyl]-, and N-[(R)-(-)-beta-hydroxyphenethyl]valiolamine (6, 8a, and 9a) have the stronger alpha-D-glucosidase inhibitory activity against porcine intestinal maltase and sucrase than naturally occurring oligosaccharide alpha-D glucosidase inhibitors. PMID- 3519971 TI - Partial lipoatrophy with insulin resistant diabetes and hyperlipidaemia (Dunnigan syndrome). AB - A family is presented in which at least five members in three generations suffered a characteristic syndrome of generalised lipoatrophy, sparing the head and neck, and muscle hypertrophy variably associated with high plasma insulin and lipid levels and insulin resistant diabetes. This pedigree contains the first documented affected male with the syndrome. The diagnosis is of practical importance since close medical supervision of asymptomatic gene carriers is likely to improve their prognosis. The findings in this family have relevance also to the study of insulin and lipid metabolism. PMID- 3519970 TI - Chromosome 1 in relation to human disease. AB - Chromosome 1 is thought to represent about 6% of the total human genome and the 85 loci so far identified may constitute about 1% of the genes present on this chromosome. The existence of at least 22 loci sufficiently polymorphic in Europeans to be useful as genetic markers has allowed the construction of an elementary genetic map. This permits comparisons with physical and chiasma maps and has demonstrated striking homologies between different regions of chromosome 1 and mouse chromosomes 1, 3, and 4. The existence of a map should be of great help in developing a more systematic approach to further mapping studies. A wide range of disease can be attributed to allelic variation on chromosome 1 and the homologies with the mouse may be useful in predicting the position of other genes involved in human disease. Rearrangements of this chromosome are a common finding in many different types of malignancy. Loss of material from the short arm and activation of one or more of the four oncogenes in this region may play an important role in the later stages of tumour development. Polymorphic markers of all kinds will be useful in the future for investigating the somatic events which have occurred during the malignant process. PMID- 3519973 TI - Evaluation of medical information science in medical education. Adopted by the Executive Council of the Association of American Medical Colleges. Washington, D.C. January 23, 1986. PMID- 3519972 TI - Of mice and men, metals and mutations. AB - Several mutations affecting the transport of copper and zinc in humans and in mice have been discovered over the last 15 years, joining the long known disturbance of copper transport in Wilson's disease. Menkes' disease (classical and mild variant forms) and X linked Ehlers-Danlos syndrome (type IX, X linked cutis laxa) have features in common with one another and with the brindled (Mobr) and blotchy (Moblo) mouse mutants, respectively. There may be one allelic series of mutants in each species or two loci may be involved in each. The toxic milk mutant (tx) in the mouse may be homologous to Wilson's disease in man. The defect of intestinal absorption of zinc in acrodermatitis enteropathica has no homologue yet in the mouse. However, the lethal milk (lm) mutant in the mouse may be homologous to a condition of zinc deficiency described in a few breastfed, low birth weight infants. Many more genetic defects of transport of copper and of zinc may await discovery. Conversely, these mutants are valuable in elucidating the normal processes of copper and zinc transport. PMID- 3519974 TI - Macrophage membrane alterations in leprosy as determined by change in sialic acid level. AB - The level of sialic acid removable by neuraminidase from macrophages of bacteriologically-positive lepromatous leprosy (B(+)LL) patient is extremely low, compared to macrophages from tuberculoid leprosy patients or normal individuals. On the other hand macrophages from long term treated bacteriologically-negative lepromatous leprosy (B(-)LL) patients show a much higher level of sialic acid. This higher level is drastically reduced when these macrophages from (B(-)LL) patients are allowed to phagocytose Mycobacterium leprae. This modulation could be host- and pathogen-specific. It is demonstrated that M. leprae infection brings out membrane changes in the macrophages leading to alteration in the surface molecules. Such membrane changes may cause hindrance in the ability of macrophages to participate successfully in the immune process. PMID- 3519975 TI - Pulmonary defence mechanism in mice. A comparative role of alveolar macrophages and polymorphonuclear cells against infection with Candida albicans. AB - The protective roles of alveolar macrophages and polymorphonuclear cells were analyzed against intratracheal challenge with Candida albicans in mice. When mice were treated with carrageenan, a known cytotoxic agent for macrophages, there was no change in susceptibilities to the challenge in terms of the survival and the progressive elimination of fungi from the lung and kidney, in spite of a decreased in vitro phagocytosis of Candida albicans by their alveolar macrophages. On the other hand, irradiated mice (whole body irradiation with 800 rads) showed an enhanced mortality and a progressive growth of Candida albicans in their lungs and kidneys, although no change was observed in the in vitro phagocytic activity of alveolar macrophages until day 6 after irradiation. In normal and carrageenan treated mice, there was a progressive increase in the recruitment of polymorphonuclear cells into the lung after the challenge as shown by bronchoalveolar lavage and histological examination. In irradiated mice, on the other hand, there was a decreased recruitment of polymorphonuclear cells at 24 hr after the challenge, and a complete impairment at a late stage. When phagocytes were obtained from normal mice and examined for in vitro phagocytic activity to Candida albicans, polymorphonuclear cells showed higher activity than that of alveolar macrophages. These results suggest that polymorphonuclear cells play a very important role in the protection against intratracheal infection with Candida albicans. PMID- 3519976 TI - Stress inoculation for acute pain: a clinical trial. AB - The study attempted a clinical evaluation of the efficacy of stress inoculation training for postoperative pain control using patients undergoing coronary artery graft surgery. A treatment group receiving stress inoculation training was compared to attention-education and no-treatment control groups. No differences were found between the groups on two pain rating measures, analgesic intake, or measures of state anxiety and depression. The ineffectiveness of stress inoculation in this study may be due to the difference between experimental and clinical pain, the multiple demands of the preoperative period, possible memory difficulties which some patients may have experienced, or the possibility that the procedure is not sufficiently potent for the intensity of this type of pain. PMID- 3519977 TI - Radiological seminar CCXLIV: Digital subtraction angiography in the diagnosis of subclavian steal. PMID- 3519978 TI - Computer-averaged views of the 70 S monosome from Escherichia coli. AB - The prokaryotic (70 S) monosome, composed of a roughly hemispherical 50 S large subunit and an elongate 30 S small subunit, appears in the electron micrograph in only a few common views representing the small number of preferred orientations assumed by the particle. Two of these, termed O and L views, have previously been characterized as the overlap and non-overlap projections; a third view, which we term the R view, represents the other endpoint of a rotational continuum with the overlap or O view. Tilt studies enabled us to calibrate this range as spanning approximately 50 degrees. The disjunct set of L views was averaged, and the reproducible resolution was determined to be 1/3.5 nm-1. The combined sets of O and R views were analyzed by correspondence analysis, and a continuous "rotation series" of subaverages was obtained. Interpretation of the views in the light of what is known about the morphologies of the individual subunits allows a general picture of the mutual fit of the subunits in the monosome to be conceived. PMID- 3519979 TI - Salt-dependent changes in the DNA binding co-operativity of Escherichia coli single strand binding protein. AB - The co-operative nature of the binding of the Escherichia coli single strand binding protein (SSB) to single-stranded nucleic acids has been examined over a range of salt concentrations (NaCl and MgCl2) to determine if different degrees of binding co-operativity are associated with the two SSB binding modes that have been identified recently. Quantitative estimates of the binding properties, including the co-operativity parameter, omega, of SSB to single-stranded DNA and RNA homopolynucleotides have been obtained from equilibrium binding isotherms, at high salt (greater than or equal to 0.2 M-NaCl), by monitoring the fluorescence quenching of the SSB upon binding. Under these high salt conditions, where only the high site size SSB binding mode exists (65 +/- 5 nucleotides per tetramer), we find only moderate co-operativity for SSB binding to both DNA and RNA, (omega = 50 +/- 10), independent of the concentration of salt. This value for omega is much lower than most previous estimates. At lower concentrations of NaCl, where the low site size SSB binding mode (33 +/- 3 nucleotides/tetramer) exists, but where SSB affinity for single-stranded DNA is too high to estimate co-operativity from classical binding isotherms, we have used an agarose gel electrophoresis technique to qualitatively examine SSB co-operativity with single-stranded (ss) M13 phage DNA. The apparent binding co-operativity increases dramatically below 0.20 M-NaCl, as judged by the extremely non-random distribution of SSB among the ssM13 DNA population at low SSB to DNA ratios. However, the highly co-operative complexes are not at equilibrium at low SSB/DNA binding densities, but are formed only transiently when SSB and ssDNA are directly mixed at low concentrations of NaCl. The conversions of these metastable, highly co-operative SSB-ssDNA complexes to their equilibrium, low co-operativity form is very slow at low concentrations of NaCl. At equilibrium, the SSB-ssDNA complexes seem to possess the same low degree of co-operativity (omega = 50 +/- 10) under all conditions tested. However, the highly co-operative mode of SSB binding, although metastable, may be important during non-equilibrium processes such as DNA replication. The possible relation between the two SSB binding modes, which differ in site size by a factor of two, and the high and low co-operativity complexes, which we report here, is discussed. PMID- 3519980 TI - Crystallization of recA protein from Proteus mirabilis. AB - The recA protein from Proteus mirabilis, which is homologous to the Escherichia coli protein, forms crystals in the orthorhombic space group P2(1)2(1)2(1). There are two 38,000 molecular weight subunits in the asymmetric unit and the unit cell dimensions are a = 57.5, b = 127.0 and c = 157.0 A. PMID- 3519981 TI - Phage and host genetic determinants of the specific anticodon loop cleavages in bacteriophage T4-infected Escherichia coli CTr5X. AB - Anticodon loop cleavages of two host tRNA species occur in bacteriophage T4 infected Escherichia coli CTr5X, a host strain restricting phage mutants deficient in polynucleotide kinase (pnk) or RNA ligase (rli). The cleavage products accumulate with the mutants but are further processed in wt infection through polynucleotide kinase and RNA ligase reactions. Inactivating mutations in stp suppress pnk- or rli- mutations in E. coli CTr5X and, as shown here, also abolish the anticodon nuclease, implicating the stp product with this activity. We show also that there exist other suppressing mutations of a pnk- (pseT2) mutation that appear not to affect the anticodon nuclease and are not in stp. It has been shown that a single locus in E. coli CTr5X, termed prr, determines the restriction of pnk- or rli- mutants. A transductant carrying prr featured upon infection the anticodon nuclease reaction products, suggesting that prr determines the specific manifestation of this activity. However, prr does not encode the tRNA species that are vulnerable to the anticodon nuclease. PMID- 3519982 TI - Assembly and disassembly of bacteriophage T4 polyheads. AB - The assembly of the product of bacteriophage T4 gene 23 (gp23), the uncleaved form of the main shell protein, has been studied. Assembly and disassembly follow the predictions for entropy-driven processes; assembly is strongly favored by conditions of high salt concentrations and high temperatures, whereas low salt and low temperatures promote disassembly. In the absence of the scaffolding core proteins in vitro, only polyheads, the tubular variant of the prohead, are produced. Kinetic studies show that the rate of polyhead dissociation depends on the concentration of associated protein, not on the number and length of the particles. Comparable to crystal formation, assembly of gp23 occurs above a critical concentration, which is dependent on salt concentration, pH and temperature. These characteristics are common to most self-assembling systems. The oligomeric states of gp23 have been investigated by analytical ultracentrifugation, which indicated the existence, at very low salt concentration and low temperature, of an equilibrium between monomers and higher oligomers, culminating in the hexamer. At pH 9.0 polyheads are completely dissociated into their monomeric gp23 subunits. Our data suggest that the hexamer is a true intermediate of polyhead assembly. PMID- 3519983 TI - Visualization of the movement of the Escherichia coli RNA polymerase along the lac UV5 promoter during the initiation of the transcription. AB - Three probes have been used to detect changes in the contacts between Escherichia coli RNA polymerase and lac UV5 promoter during the formation of the open complex and the initiation of the transcription. The results presented here show how contacts between the enzyme and the UV5 promoter are modulated concomitantly with steady-state synthesis of ApApUpU. These results suggest a movement of the enzyme during the initiation of the transcription preceding the irreversible translocation into the elongation complex. PMID- 3519984 TI - Perspective on contact lenses: profile of a researcher. PMID- 3519985 TI - Minorities and the medical profession: a historical perspective and analysis of current and future trends. PMID- 3519986 TI - American coronary primary prevention trials: implications for blacks. PMID- 3519987 TI - Tuberculous retroperitoneal lymphadenopathy mimicking metastatic pancreatic carcinoma. AB - A case of retroperitoneal lymphadenopathy of tuberculous origin is reported. Despite clear representation of retroperitoneal lym-phadenopathy by abdominal ultrasonography and computerized tomography (CT), fine-needle aspiration was inconclusive. Exploratory laparotomy was necessary to make the diagnosis. Nonsurgical diagnosis of this entity continues to be a challenge. PMID- 3519989 TI - Meharry's dental centennial: time to remember the fourth president. PMID- 3519988 TI - Update in cancer chemotherapy: gastrointestinal cancer--colorectal cancer, Part 2. AB - An update of the state of the art of cancer chemotherapeutic treatment of gastrointestinal tract cancer is described in a multi-part series. Part 1 surveyed colorectal cancer and the use of single-agent chemotherapy in the April issue of the Journal. Part 2 of colorectal cancer will describe combination chemotherapy, preoperative and postoperative radiation, and combinations of chemotherapy and radiation, and adjuvant chemotherapy.In advanced gastrointestinal tract cancer, chemotherapy is only of palliative value with response rates generally under 50 percent and survival rates of several months to one year or more. Combination chemotherapy often produces higher response rates, yet there is no acceptable evidence that survival is improved. While some adjuvant chemotherapy trials suggest improvement, major survival gains remain to be demonstrated. Uncertainty as to the role of chemotherapy in the treatment of gastrointestinal cancers may be due to lack of data. PMID- 3519990 TI - Evaluation of a patient with splenosis by various imaging modalities. AB - Three different noninvasive imaging procedures were performed in a patient after an intravenous pyelogram suggested a suprarenal mass. Presence of a mass was confirmed by ultrasonogram. Computed tomography revealed two masses in the splenic bed that showed contrast enhancement. Radionuclide scans demonstrated multiple splenic masses (splenosis). The specificity of the splenic tissue as well as the anatomic resolution were best with the radionuclide liver and spleen scan. PMID- 3519991 TI - Relative value scales and guides in medicine. PMID- 3519992 TI - Effects of a cotton bract extract on guinea pig isolated airway smooth muscle. AB - The effects of a water extract of cotton bracts (CBE) on guinea pig isolated trachealis smooth muscle was studied. The ability of CBE to evoke tension responses, to modify tissue reactivity to excitatory and inhibitory agents, and to modify electric field stimulation-induced neurogenic responses was evaluated. CBE caused contraction in low concentrations, which were not mediated by histamine H1-, muscarinic, or 5-hydroxytryptamine (5-HT) receptors, and caused relaxation in high concentrations. In the presence of CBE, the maximum contractile response to 5-HT and the sensitivity to KCl were reduced. The maximum relaxation responses and sensitivities to adenosine and ATP were increased by CBE. In contrast, contractile responses to histamine and methacholine and relaxation responses to isoproterenol were unaffected. Neurogenic cholinergic excitatory responses and neurogenic adrenergic responses did not appear to be affected by CBE. However, the relaxant effect of nonadrenergic inhibitory nerve stimulation was increased in the presence of CBE. These findings differ from previous ones observed in our laboratory for dog isolated trachealis smooth muscle preparations, which indicates that the effects of CBE in isolated airways is species-dependent. Virtually all of the contractile activity of CBE was dialyzable (molecular weight less than 14,000) and retained in ashed samples. Inorganic constituents may contribute to the spasmogenic activity of CBE. PMID- 3519993 TI - Biotransformation of 1-nitropyrene to 1-aminopyrene and N-formyl-1-aminopyrene by the human intestinal microbiota. AB - The nitropolycyclic aromatic hydrocarbon 1-nitropyrene (1-NP) is an environmental pollutant, a potent bacterial and mammalian mutagen, and a carcinogen. The metabolism of 1-NP by the human intestinal microbiota was studied using a semicontinuous culture system that simulates the colonic lumen. [3H]-1 Nitropyrene was metabolized by the intestinal microbiota to 1-aminopyrene (1-AP) and N-formyl-1-aminopyrene (FAP) as determined by high-performance liquid chromatography (HPLC) and mass spectrometry. Twenty-four hours after the addition of [3H]-1-NP, the formylated compound and 1-AP accounted for 20 and 80% of the total metabolism, respectively. This percentage increased to 66% for FAP after 24 h following 10 d of chronic exposure to unlabeled 1-NP, suggesting metabolic adaptation to 1-NP by the microbiota. Both 1-AP and FAP have been shown to be nonmutagenic towards Salmonella typhimurium TA98, which indicates that the intestinal microflora may potentially detoxify 1-NP. PMID- 3519994 TI - Tissue integration of dental endosseous implants: description and comparative analysis of the fibro-osseous integration and osseous integration systems. PMID- 3519995 TI - Tripodial subperiosteal implants. PMID- 3519996 TI - The ramus-endosseous, anterior-subperiosteal implant technique for the severely atrophic mandible. PMID- 3519997 TI - A comparison of load transfer characteristics between bilateral and continuous mesostructure bar mandibular subperiosteal implant dentures. PMID- 3519998 TI - American Academy of Implant Dentistry. Glossary of implant terms. PMID- 3519999 TI - Immunohistochemical demonstration of alpha-1-antitrypsin in renal tubular epithelia in patients with or without alpha-1-antitrypsin deficiency. PMID- 3520000 TI - Experimental immune complex glomerulonephritis: immunofluorescent, light and electron microscopic study. PMID- 3520001 TI - Greater palatine canal injection: an alternative to the posterior nasal packing and arterial ligation in epistaxis. AB - The greater palatine foramen extends in a posterosuperior direction at an angle of 60-80 degrees from the horizontal plane of the hard palate. A needle can be inserted 22-25 mm without the risk of intracranial or intraorbital injection. Sixty-one patients with posterior epistaxis were treated by greater palatine canal injection of either xylocaine 1% without epinephrine (34 cases) or sterile water (27 cases). There were no serious complications. Effective hemostasis was obtained immediately in 55 cases. Recurrent bleeding occurred in 22 cases, all of which responded to repeat injections. PMID- 3520002 TI - The distended gasless abdomen: a fertile field for ultrasound. AB - Ultrasonography has proven to be a helpful imaging modality in evaluating the child with a distended gasless abdomen. The presence of an unsuspected mass can easily be detected as well as the presence of ascites and/or abnormally dilated loops of small bowel. Thickened loops of bowel can also be easily detected in the abdomen with very little gas. Closed loop obstruction and intussusception, as well as meconium ileus equivalent (distal intestinal obstruction syndrome), are described. PMID- 3520003 TI - Sonographic demonstration of simultaneous intrauterine and extrauterine gestation. AB - Simultaneous intrauterine and ectopic pregnancies are extremely rare. The diagnosis is usually made by laparoscopy and/or laparotomy. Three cases are presented in which the diagnosis was made during sonographic examinations by simultaneous demonstration of fetal cardiac motion in both the intrauterine and extrauterine fetuses. Early diagnosis of this condition significantly reduces the morbidity and mortality of both the mother and the intrauterine gestation. PMID- 3520004 TI - A teaching file program for use in an ultrasound department. AB - A radiology teaching file program has been developed for use in an ultrasound department. Sonographic findings and diagnoses for each case are stored as groups of key words drawn from a vocabulary of up to 2000 key words created by the user. The program runs on a microcomputer and allows storage of 5000 cases per 360 kilobyte floppy disk. Data entry is accomplished entirely by ultrasound technologists based on the ultrasound report. Cases may be retrieved by selecting either individual key words or groups of key words, and the results may be printed out in a variety of formats. Experience in using the system over a 12 month period is discussed. PMID- 3520005 TI - Antenatal measurement of fetal umbilical venous flow by pulsed Doppler and B-mode ultrasonography. AB - In this study, 163 normal fetuses of between 25 and 41 weeks' gestational age were examined sonographically using B-mode and Doppler equipment to measure umbilical vein diameter, umbilical venous flow amount (UVFA) and velocity (UVFV), and abdominal area (AA). A total number of 230 examinations were performed. The relationships between gestational age and umbilical vein diameter, UVFA, UVFV, and the UVFA/AA ratio were analyzed. Throughout pregnancy, the umbilical venous blood flow velocity remained relatively constant, whereas the umbilical venous blood flow amount increased steadily with gestational age and was proportional to abdominal area. PMID- 3520006 TI - Ultrasonography in the jaundiced infant: a new approach. AB - Diagnostic ultrasonography plays a major role in the evaluation of jaundiced infants. Seventeen such infants were studied in both fasting and post-prandial states. The gallbladder and biliary tract were evaluated to define features most useful in distinguishing children with biliary atresia from those with other causes of jaundice. Demonstration of a decrease in gallbladder size following feeding virtually eliminates the diagnosis of biliary atresia, even in children with abnormal HIDA scans. PMID- 3520007 TI - Adenomyomatosis of the gallbladder: a pictorial exhibit. PMID- 3520008 TI - Inspissated bile in a neonate with cystic fibrosis. PMID- 3520009 TI - Localized deposition of Wharton's jelly: sonographic findings. PMID- 3520010 TI - Accessory hepatic fissure mimicking an acoustically shadowing lesion. PMID- 3520011 TI - Parapelvic cyst vs. hydronephrosis on coronal sonography. PMID- 3520013 TI - The management of renal angiomyolipoma. PMID- 3520012 TI - Expression of hepatitis B virus core antigen gene in Saccharomyces cerevisiae: synthesis of two polypeptides translated from different initiation codons. AB - Two recombinant plasmids were constructed that allow expression of the hepatitis B core (HBc) antigen gene in the yeast Saccharomyces cerevisiae under the control of the repressible acid phosphatase promoter. One plasmid was designed to produce polypeptide I, which consists of 183 amino acids, and the other plasmid was designed to produce polypeptide II, which has an additional 29-amino-acid sequence at the amino terminus of polypeptide I. The viral genome may code for either one or both of these two polypeptides, depending upon the selection of initiation codons. Both polypeptides produced in yeast cells reacted with anti HBc antibody and were assembled into spherical particles approximately 27 nm in diameter. Particles made of polypeptide I were stable, whereas those made of polypeptide II readily dissociated when exposed to high salt levels. The antigenicity of the HBc (as defined by its reactivity to anti-HBc antibody in the reversed passive hemagglutination assay) disappeared as the particle dissociated, leaving materials that sedimented slowly and that reacted to anti-hepatitis B e antibody. These observations strongly suggest that native viral cores are mostly (if not all) made of polypeptide I, because it is reasonably stable, and that the N-terminal portion of this polypeptide has some, but not a profound, influence on the assembly of polypeptides into particles. PMID- 3520014 TI - Report of the United States cooperative study of extracorporeal shock wave lithotripsy. AB - Extracorporeal shock wave lithotripsy effectively fragments urinary calculi in the upper urinary tract and upper ureter. These fragments pass completely by 3 months in 77.4 per cent of the patients with single stones. Risk of obstruction, increased postoperative pain, need for additional urological operations and retained fragments are low for stones less than 1 cm. in size. As the number of stones treated or single stone size increases above 1 cm. the risk for these factors increases. Adjunctive urological surgical management is required in 9 per cent of the patients preoperatively and 8 per cent postoperatively. Only 0.6 per cent of the patients require some type of open operation to resolve the stone problems after extracorporeal shock wave lithotripsy. Hemorrhage, obstruction by fragments, severe pain and urinary infection all constitute known complications and require careful urological management of all patients. Hospitalization averages 2 days after treatment and patients usually return to work within a few days after they are discharged from the hospital. PMID- 3520015 TI - Extracorporeal shock wave lithotripsy: the Methodist Hospital of Indiana experience. AB - A total of 982 patients underwent 1,416 treatments with extracorporeal shock wave lithotripsy for upper urinary tract calculi between February 23 and December 17, 1984. A single treatment was performed in 90 per cent of the patients. Morbidity was extremely low and hospital stay was short (3.0 days). Adjunctive procedures were required in 13 per cent of the patients. Of the kidneys 72 per cent were free of stones at the 3-month followup, while 23 per cent contained small (less than 5 mm.), asymptomatic fragments believed to be passable spontaneously. Only 1 per cent of the patients required surgical removal of the calculi. Morbidity was related directly to stone burden, while results were inversely related to stone burden. Extracorporeal shock wave lithotripsy is the preferred form of management for symptomatic upper ureteral and renal calculi less than 2 cm. in diameter. PMID- 3520016 TI - Multiple organ donation: its impact on the recovery of cadaver kidneys. AB - Cyclosporin A not only has improved renal allograft survival but it also has caused a renewed interest in cardiac and hepatic transplantation. The South Texas Organ Bank was sensitive to the need for multiple organ donors and also concerned that the recovery of multiple organs could have a negative impact on the quantity or quality of kidneys recovered. From July 1983 through March 1985 cadaveric kidneys were obtained from 43 renal donors and multiple vital organs were obtained from 11 additional donors. There was no statistical difference between the renal and multiple organ donors in the incidence of renal contamination, post transplant acute renal failure or renal discard rate (p greater than 0.3 in each comparison). No donor family rescinded permission for renal donation because other vital organs were requested. Urologists involved in cadaveric renal recovery are encouraged to view every cadaver donor as a potential multiple organ donor. PMID- 3520017 TI - Accurate determination of renal function in patients with intestinal urinary diversions. AB - The regular determination of renal function is a critical part of the management of patients who have had the urinary tract reconstructed with intestinal segments. These intestinal segments reabsorb urinary solutes and, thereby, complicate the determination of renal function by conventional methods. Urinary clearances of urea, creatinine and inulin were performed in patients with intestinal segments in the urinary tract and controls under varying diuretic conditions. Patients with intestinal diversions also underwent radioisotopic determination of renal function. The urinary clearances of urea, creatinine and inulin are highly dependent on the rate of urine flow in patients with intestinal segments in the urinary tract. Diuresis maximizes the urinary clearances of these solutes by minimizing intestinal reabsorption. Creatinine clearance prediction from the serum creatinine underestimates true glomerular filtration rate. Radioisotopic determination of renal function correlates poorly with true glomerular filtration rate. Only creatinine clearance measured under diuretic conditions correlates well with true renal function. Urine concentrating ability cannot be assessed accurately in patients with intestinal segments in the urinary tract, since osmolality rapidly equilibrates across the segments. PMID- 3520018 TI - Kidney growth after pyeloplasty in childhood. AB - The postoperative increase of the renal parenchyma, measured with planimetry on repeated urography films, was studied in 24 infants and children. All patients had been operated on because of unilateral stenosis of the pelvioureteral junction. When the results were analyzed in a pair-control manner the paired members were almost identical for age at operation, affected side, sex, presenting clinical sign and length of followup. The 12 patients who underwent a dismembered pyeloplasty displayed a significantly stronger mean catch-up growth of the relative parenchymal area than the 12 patients who underwent a nondismembered technique. Speculatively, this difference may reflect in part the protection of the growing renal parenchyma by the preoperatively compliant and wide renal pelvis, which had led to resection and dismembered correction. PMID- 3520020 TI - Ultrasonic recognition of a cystic seminal vesicle with ipsilateral renal agenesis. AB - We report a case of a cystic seminal vesicle detected sonographically during investigation for infertility. The importance of this lesion in cases of ipsilateral renal agenesis and the value of transrectal sonography in its detection are discussed. PMID- 3520019 TI - Percutaneous drainage of prostatic abscesses. AB - Percutaneous catheter drainage of intra-abdominal abscesses currently is a well established technique. We report on 2 anuric patients on maintenance hemodialysis who presented with a prostatic abscess. We elected to use a transperineal, percutaneous drainage technique. Adequate drainage was documented by pelvic computerized tomography scans and followup confirmed satisfactory long-term results. PMID- 3520021 TI - The ectopic ureter in men. AB - The ectopic ureter is less common in male than in female patients. It usually terminates proximally to the external sphincter in the seminal vesicle or vas deferens, and usually involves a nonduplicated drainage system of a dysplastic kidney. Men characteristically present with lower tract symptoms, often epididymitis, a cystic or boggy periprostatic mass on rectal examination and ipsilateral nonvisualization on excretory urography. The embryology, pathogenesis, diagnosis and treatment of this condition are discussed, and 4 illustrative cases are presented. PMID- 3520022 TI - Re: Silicate urolithiasis. PMID- 3520023 TI - Urinary cytology and the early detection of renal allograft rejection. AB - The appearance of pyroninophilic immunologically activated lymphocytes in the urine may be one of the earliest indications of acute rejection of a renal allograft. In a study of 50 allograft recipients there were 33 episodes of rejection within 1 month postoperatively. The presence of activated lymphocytes in the urine correlated with a clinical and biochemical diagnosis of rejection in 29 cases (88 per cent). In 20 cases (69 per cent) the activated lymphocytes were present at least 24 hours (median 2 days) before rejection was diagnosed by other means. In 2 patients (4 per cent) activated lymphocytes appeared in the urine without evidence of rejection, while 4 of 33 patients had rejection diagnosed and treated in the absence of lymphocyturia, for a false negative rate of 12 per cent. The 33 rejection episodes were treated by prednisolone and azathioprine. In 19 cases suppression of rejection correlated with the disappearance of pyroninophilic lymphocytes within 5 days, while in 10 persistent rejection was accompanied by persistent lymphocyturia. The presence of activated lymphocytes in the urine is a valuable early index of impending rejection in the transplanted kidney, and may be used with other clinical and biochemical criteria to detect the need for increased immunosuppression. PMID- 3520024 TI - Heparin inhibition of increased bacterial adherence following overdistension, ischemia and partial outlet obstruction of the rabbit urinary bladder. AB - While it is well established clinically that urinary tract infection in the presence of outflow obstruction may be associated with difficulty in eradicating bacteria, it is not clear whether this is secondary to the presence of residual urine volume or other local effects of the obstruction such as attenuation of the intrinsic antibacterial defense mechanisms of the mucosal surface. Experiments in our laboratory and others over the past several years have demonstrated that the primary antibacterial defense mechanism of the bladder is the antiadherence effect of the bladder surface mucin layer. Additional studies have shown that heparin can duplicate this antiadherence activity of bladder mucin. The present report demonstrates that one hour of overdistension or ischemia and one week of partial outlet obstruction cause a functional defect in the intrinsic antiadherence effect of the bladder mucosa as evidenced by increased bacterial adherence. This defect can be reversed by heparin exposure prior to bacterial challenge. These results indicate that partial outlet obstruction and its potential sequelae such as overdistension and, particularly, mucosal ischemia, have dramatic adverse effects on the intrinsic antiadherence defense mechanism of the bladder. These effects can be reversed by intravesical exposure to an exogenous anionic polyelectrolyte (heparin). PMID- 3520025 TI - Interaction of a pyelonephritogenic Escherichia coli strain with the tissue components of the mouse urinary tract. AB - Immediately following the introduction of cells of a pyelonephritogenic strain of Escherichia coli (expressing both GS and MS adhesins) into the mouse bladder, these cells were found to be randomly distributed on the mucosal surfaces of both the bladder and the kidney. After 24 hr. these adherent bacterial cells had proliferated to form nonrandomly distributed adherent microcolonies on both mucosal surfaces and large masses within the renal ducts. Large amounts of amorphous material, which we presume to be of both host and bacterial origin, was associated with the bacterial microcolonies on the infected tissues. The removal of urinary slime and tissue coat material by acid pretreatment increased both the degree and the apparent avidity of bacterial adhesion to the bladder mucosa. The adherent bacteria on the bladder mucosa were radically elongated, while those on the kidney mucosa usually retained their short rod-like morphological characteristics. These data suggest that pyelonephritogenic bacteria adhere to mucosal surfaces in both the bladder and kidney, and proliferate to form adherent microcolonies within which bacteria are associated with large amounts of amorphous extracellular material. PMID- 3520026 TI - Can transabdominal ultrasonography of the bladder replace cystoscopy in the followup of superficial bladder tumors? AB - Transabdominal ultrasonography of the bladder was performed on 100 patients 3 to 9 months after endoscopic resection of stage Pa or Pl transitional cell carcinoma of the bladder. In 81 patients there was a close correlation between the results of suprapubic ultrasonography and cystoscopy. In 19 patients the ultrasonography results were incorrect: 4 had false positive and 15 had false negative findings. Specificity for the diagnosis of recurrence was 90 per cent and sensitivity was 74 per cent. Transabdominal ultrasonography combined with cytology studies should be part of the diagnostic approach for recurrent superficial bladder tumors. When performed before cystoscopy these studies should reduce greatly without eliminating the frequency of this investigation. PMID- 3520027 TI - Anomalies of the inferior vena cava. AB - The inferior vena cava is formed by a complex process of embryogenesis during the sixth to tenth week of gestation. Improper completion of the process may result in four anatomic anomalies: duplication of the inferior vena cava, transposition or left-sided inferior vena cava, retroaortic left renal vein, and circumaortic left renal vein. The first two anomalies can be diagnosed by sonography and all four anomalies can be seen on CT scan of the abdomen. Duplication and transposition of the inferior vena cava should be further delineated by preoperative phlebography. Preoperative diagnosis of the anomalies should reduce the complication rate of abdominal aortic operations. PMID- 3520028 TI - Migration of a Greenfield filter to the pulmonary artery: a case report. AB - A case of Greenfield filter migration to the left pulmonary artery is presented and the pertinent literature reviewed. Technical points are made regarding the prevention and the management of proximal filter migration. PMID- 3520029 TI - Rabies in rodents and lagomorphs in the United States, 1971-1984: increased cases in the woodchuck (Marmota monax) in mid-Atlantic states. AB - A review of surveillance data on animal rabies from the Centers for Disease Control revealed 104 cases of rabies in rodents and lagomorphs for 1971 through 1984 in the United States; 80% of these were reported between 1980 and 1984. Woodchucks (Marmota monax) accounted for 64% of the cases. Most of the cases of rabies in woodchucks were associated with an epizootic of rabies in raccoons (Procyon lotor) in the mid-Atlantic states. In rabies endemic areas, humans exposed to woodchucks should receive rabies postexposure prophylaxis if the animal is not available for testing. The decision to administer postexposure prophylaxis to humans exposed to other rodents and lagomorphs should take into consideration the epidemiology of rabies in the exposing species. PMID- 3520030 TI - Spirochetes in ticks and antibodies to Borrelia burgdorferi in white-tailed deer from Connecticut, New York State, and North Carolina. AB - Ticks were screened for spirochetes and serum samples from white-tailed deer (Odocoileus virginianus) were assayed for antibodies to Borrelia burgdorferi during 1983-1984. Using fluorescein isothiocyanate-labeled rabbit antibodies produced to B. burgdorferi, the etiologic agent of Lyme disease, spirochetes were detected in Ixodes dammini (10.5% of 1,193) and Dermacentor albipictus (0.6% of 157) adults from Connecticut, I. dammini nymphs (49.1% of 108) and adults (64.7% of 99) from Armonk, New York, and in I. scapularis (0.4% of 531) and Amblyomma americanum (3.5% of 173) adults from North Carolina. Infected ticks were either seeking hosts or feeding on deer during the summer and fall. Direct fluorescent antibody staining also revealed spirochetes in two larvae of I. scapularis that emerged from eggs deposited by separate females in the laboratory. Using indirect immunofluorescence tests, antibodies to B. burgdorferi were identified in white tailed deer living in tick-infested areas of all three states. Aside from minor cross-reactivity, there was no serologic evidence of Treponema or Leptospira infections. Ixodes dammini is a primary vector of B. burgdorferi in northeastern United States, but in North Carolina, other ixodid ticks may transmit this spirochete to humans and wildlife. PMID- 3520031 TI - Absence of prenatal infection of bats with rabies virus. PMID- 3520032 TI - Evidence by the fluorescent antibody test for the occurrence of Renibacterium salmoninarum among salmonid fish in Chile. PMID- 3520033 TI - Current oxygen prescribing practices. Problems and prospects. PMID- 3520034 TI - HTLV-III antibody testing in Hong Kong. PMID- 3520035 TI - The great breathlessness mountains. PMID- 3520036 TI - Diagnostic and therapeutic technology assessment. Autologous bone marrow transplantation. PMID- 3520037 TI - [Anesthesia and hypnosis--the development of anesthesiology]. PMID- 3520038 TI - [Oculocardiac reflex and anesthesia]. PMID- 3520039 TI - [Influence of a calcium channel blocker, nicardipine, on glucoregulatory hormones and glucose metabolism]. PMID- 3520040 TI - [Immunohistochemical localization of glutathione peroxidase in the rat brain]. PMID- 3520041 TI - [Measurement of lung water with a double indicator dilution method in dogs using heat and sodium ions]. PMID- 3520042 TI - [Hormonal and hemodynamic responses during and after coronary artery bypass surgery in diabetic patients]. PMID- 3520043 TI - [An autopsy case of malignant lymphoma of the pancreas]. AB - Case reports of malignant lymphoma of the pancreas are extremely rare. We experienced a 36-year-old man with malignant lymphoma involving the pancreas associated with obstructive jaundice, confirmed by autopsy. It is very difficult to differentiate between pancreatic carcinoma and pancreatic malignant lymphoma. Age, icterus, diffuse pancreatic enlargement, pathological findings and tumor markers may be useful in suggesting lymphoma. Trials of positive biopsy, appropriate radiotherapy and chemotherapy are necessary in patients who may have malignant lymphoma of the pancreas. PMID- 3520044 TI - [ABO-incompatible bone marrow transplantation; removal of red blood cells from donor marrow by using Hemonetics model 30 blood cell separator]. PMID- 3520045 TI - [Prophylaxis of acute graft-versus-host disease after allogeneic bone marrow transplantation--combination protocol of high dose methylprednisolone, prednisolone and methotrexate]. PMID- 3520046 TI - [Evidence of bone marrow involvement by in vitro growth of lymphoma colonies in a child with non-Hodgkin's lymphoma]. PMID- 3520047 TI - [A case of interstitial pneumonia associated with chronic GVHD: the examination of pulmonary function and lung biopsy. The Bone Marrow Transplantation Team of Tokai University]. PMID- 3520048 TI - [Diagnostic imaging of systemic candidiasis--a case of non-Hodgkin's lymphoma]. PMID- 3520049 TI - [A clinicopathologic study on islets of Langerhans in cases of chronic dialysis]. PMID- 3520050 TI - [Immunohistologic study on histogenesis of benign chondroblastoma]. PMID- 3520051 TI - [Cytodiagnosis of lung cancer. Immunohistochemical findings in lung cancer]. PMID- 3520052 TI - [Indistinct band sign: a new sonographic finding in fatty liver]. PMID- 3520053 TI - [Imaging diagnosis of pheochromocytoma]. PMID- 3520054 TI - [Renal ultrasonography: diffuse parenchymal changes]. PMID- 3520055 TI - [Serial ultrasound examination in acute suppurative cholangitis--a case report]. PMID- 3520056 TI - [A case of spontaneous mesenteric hematoma]. PMID- 3520057 TI - [Digital subtraction angiography of the hepatic artery and vein in hepatic tumor]. PMID- 3520058 TI - [Control of the paralyzed upper/lower extremities by functional electrical stimulation (FES)]. PMID- 3520059 TI - [Titanium for medical and dental use]. PMID- 3520060 TI - [Distribution of laminin in the kidney]. PMID- 3520061 TI - [Role of PGE2 and PGI2 on natriuresis in perfused rat kidney]. PMID- 3520062 TI - [The antihypertensive effect and the pharmacokinetic profile of captopril retard (CS-522-R) in patients with essential hypertension]. PMID- 3520064 TI - The mechanism of the hypotensive effect of captopril (converting enzyme inhibitor) with special reference to the kallikrein-kinin and renin-angiotensin systems. AB - In order to clarify the mechanism of the hypotensive action of captopril, the acute and chronic effects of this drug on the kallikrein-kinin and renin angiotensin systems were investigated respectively in 14 and 19 patients with hypertension. To determine the acute effect, a dose of 50 mg of captopril was administered once orally. For the chronic effect, 75-300 mg of the drug was administered daily for 14 days. In observations of the acute effect, blood pressure decreased significantly at 30 min. and maximally at 60-180 min. after administration with no change in heart rate. Significant increases in blood kinin levels and plasma renin activity (PRA), and a decrease in plasma angiotensin II levels were also observed. A marked augmentation was also found in urinary kinin excretion, but not in urinary kallikrein excretion. Moreover, the changes in blood pressure significantly correlated negatively with basal PRA, basal plasma angiotensin II and the changes in blood kinin levels, and positively with the changes in plasma angiotensin II. In our study of the chronic effect of captopril, similar changes in blood kinin levels, PRA, plasma angiotensin II levels, blood pressure and heart rate to the acute effect study were observed. Significant correlations of the changes in blood pressure were found negatively with basal PRA, basal plasma angiotensin II levels and the changes in blood kinin levels and positively with the changes in plasma angiotensin II levels. In addition, significant increases in urine volume and urinary sodium excretion occurred following administration of captopril for 14 days, and both increases negatively correlated with the changes in blood pressure.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3520063 TI - Safety and efficacy of hepatitis B vaccine in hospital personnel. AB - Clinical trials of the hepatitis B vaccine developed in Japan were performed by the phase I, phase II and phase III studies. It was found that this vaccine did not only contained HBV itself but also other pathogens. It was ascertained to be adequately safe, since no major side effect was induced. After inoculation of the vaccine 3 times into 195 hospital employees, an HBs antibody seroconversion rate of 91.8% (97.0% in females and 86.3% in males) was obtained. In recipients aged more than 50 years, the rate was significantly lower. Although 8.2% of the recipients were non-responders to the vaccination, there was no significant correlation between the strength of the HBs antibody response and the lymphocyte subsets in the peripheral blood. It was observed, however, that among the non responders, the incidence of low OKT4+/OKT8+ cell ratios tended to be somewhat increased. In follow-up studies of the antibody, majority of subjects, in whom the antibody level at 1 month after the 3 inoculations was below 50 RIA units, demonstrated negative conversion within 1 or 2 years. Namely, their value were reduced to below the minimal protective antibody value for prophylaxis of HBV infection. PMID- 3520065 TI - [Histological study of the lung preserved for lung transplantation]. PMID- 3520066 TI - Responses of plasma insulin, glucagon and cortisol to cold exposure in calves. PMID- 3520067 TI - Proceedings of the Workshop on Bone Marrow Transplantation. Bethesda, Maryland, November 12-13, 1984. PMID- 3520068 TI - Identical-twin (syngeneic) marrow transplantation for hematologic cancers. AB - The Seattle Marrow Transplant Team treated about 130 patients (age 4-68 yr) for hematologic cancer with supralethal chemoradiotherapy and bone marrow transplantation (BMT) from the normal genetically identical twin. The procedure was well tolerated. The principal problem was tumor resistance. Nevertheless, BMT for acute leukemia in relapse still cured about 20% of the patients. Moreover, BMT performed while in complete remission cured about 50% of patients with acute lymphocytic leukemia or acute nonlymphocytic leukemia. Sixteen patients received transplantation in the chronic phase of Ph1+ chronic granulocytic leukemia (CGL). All showed disappearance of all Ph1+ cells. Two died of pneumonitis. Of the 14 who are alive, 3 continue to have CGL 37-76 months after BMT and 11 remain in complete hematologic and cytogenetic remission without any Ph1+ metaphases at 31 108 months (median = 68) after BMT. Thus the Ph1-positive clone can be ablated and blast crisis prevented. BMT in the accelerated or blastic phase was far less effective. Syngeneic BMT also benefited or cured patients with lymphoma, hairy cell leukemia, and multiple myeloma. Therefore, BMT should be considered for every patient who has a hematologic cancer and an identical twin. PMID- 3520069 TI - Allogeneic marrow transplantation for acute nonlymphoblastic leukemia. AB - Bone marrow transplantation (BMT) from an HLA-matched sibling donor can cure 15% of end-stage patients with refractory acute leukemia. Failures are largely due to acute or chronic graft-versus-host disease, idiopathic or cytomegalovirus associated interstitial pneumonitis, veno-occlusive disease of the liver, opportunistic infections, and leukemia relapse. The post-BMT leukemia relapse rate has been reduced from 65% to 20-40% by performing BMT in first complete remission (CR). Overall, about 50% of such patients become long-term tumor-free survivors. Younger patients do far better than older ones. A prospective comparative trial for acute nonlymphoblastic leukemia (ANL) in first CR revealed that BMT was more likely than chemotherapy to be fatal within the first 6 months after induction but that the probability of long-term tumor-free survival thereafter was significantly greater after BMT than after chemotherapy. It is recommended that patients less than 30 years old with ANL should undergo BMT while in first CR, whereas those patients over 30 years old should postpone BMT to the earliest sign of relapse. PMID- 3520071 TI - Allogeneic marrow transplantation for chronic granulocytic leukemia. AB - A retrospective analysis is presented of results obtained with allogeneic bone marrow transplantation (BMT) in three phases of Philadelphia chromosome-positive chronic granulocytic leukemia. At BMT, 23 patients were in blastic phase (BP), 33 were in accelerated phase (AP), and 45 were in chronic phase (CP). With a follow up time of 1-8 years after BMT, the probability of long-term survival was 14, 10, and 58%, respectively, for patients transplanted in BP, AP, or CP. The probability of cytogenetic relapse with or without clinical hematologic relapse at 3 years after BMT was 80, 38, and 31%, respectively, for patients transplanted in BP, AP, or CP. Splenectomy did not influence posttransplant survival. Given the dismal prognosis on conventional therapy, patients younger than 50 in BP or AP should be considered for BMT. For the patient in CP, BMT offers the possibility of cure but with a significant risk of early death. Patients under 40 who fully understand the risks and potential benefits of BMT should be offered BMT early in CP before any change to AP occurs. PMID- 3520070 TI - Modified chemotherapy with carmustine, cytarabine, cyclophosphamide, and 6 thioguanine (BACT) and autologous bone marrow transplantation in 24 poor-risk patients with acute lymphoblastic leukemia. AB - Twenty-four poor-risk patients with acute lymphoblastic leukemia received a modified regimen of carmustine, cytarabine, cyclophosphamide, and 6-thioguanine (BACT) followed by autologous bone marrow transplantation (ABMT). Nineteen patients were in second or subsequent complete remission (CR) when treated with this regimen; 3 died early, 2 died of pneumonia in CR, 11 relapsed within 3 months (median), and 3 remain in CR with no maintenance therapy 14-24 months after ABMT. Of the 5 patients with measurable disease who were treated, 3 had CR and 1 remains in CR without maintenance therapy more than 28 months after ABMT. The toxicity of this regimen was acceptable, but late pulmonary toxic effects remain a major concern. These results are poor in terms of efficacy, and new effective methods of eradicating acute lymphoblastic leukemia in patients with poor prognosis should be investigated. PMID- 3520072 TI - Bone marrow transplantation for chronic granulocytic leukemia. AB - Thirty-seven patients with chronic granulocytic leukemia have been treated with supralethal chemoradiotherapy followed by transplantation of bone marrow from HLA identical donors. All patients showed engraftment, and the Philadelphia chromosome (PH1) disappeared in each case. Four patients had syngeneic grafts before blast crisis and are still alive; 2 are in remission not maintained by therapy, and 2 others are receiving chemotherapy after having relapsed in the chronic phase. Thirty-three patients had allogeneic grafts; only 2 received the grafts during blast crisis, and neither is a long-term survivor. Of the 13 patients who had grafts in the accelerated phase, 6 died of complications related to the transplantation, and 1 died after a myeloblastic relapse. Thus 6 patients are in unmaintained remission with a median follow-up of 13 months. Eighteen patients received grafts in the chronic phase. All 10 survivors are in unmaintained remission with a median follow-up of 14 months; in this group, no patient has relapsed. The granulocytic hyperplasia of the chronic phase can be more effectively ablated than established blastic leukemia. The mortality rate of transplant-related complications must be weighted against the typical rate of progression of chronic granulocytic leukemia. Although a longer follow-up period is needed for full evaluation, bone marrow transplantation may now be offered to patients in the chronic phase in an attempt to achieve long-term survival or cure of more than one-half of these patients. PMID- 3520073 TI - Autografting for chronic granulocytic leukemia in transformation. AB - Forty-five patients were treated for chronic granulocytic leukemia (CGL) in transformation by intensive chemotherapy (23 patients) or radiochemotherapy (22 patients) followed by autologous transplantation of bone marrow (17 patients) or blood-derived hematopoietic stem cells (28 patients). Hematopoiesis was reestablished in most evaluable patients and was significantly more rapid in previously splenectomized patients or in those receiving more than 10 X 10(8) nucleated cells/kg. However, partial or complete failure of engraftment was observed in 11 patients, in most cases after autografting with marrow cells. The median survival of all patients was 4.5 months. The major cause of death was the rapid recurrence of the blast cells not eradicated by the conditioning regimen. However, 4 of the 11 patients treated during the accelerated phase are still alive in the chronic phase, 17, 23, 35, and 54 months after autografting. These results and the restoration of hematopoiesis without the Philadelphia chromosome in 5 patients suggest that autografting could be used in CGL before the onset of the blast crisis. PMID- 3520074 TI - Depletion of T-lymphocytes in donor marrow with pan-T monoclonal antibodies and complement for prevention of acute graft-versus-host disease: a pilot study on 29 patients. AB - A cooperative study was done on ex vivo treatment of bone marrow for the prevention of acute graft-versus-host disease (GvHD), in which either CD2-CD5-CD7 (14 patients) or CD2-CD3 (15 patients) monoclonal antibody cocktail and complement were used. In this study, 29 patients (12 female, 17 male; average age, 22-1/2 yr) received T-cell-depleted allograft through complement cytolysis, 26 from HLA-identical donors and 3 from HLA-mismatched donors. All of the patients had malignant disease with poor prognosis; 21 had acute leukemia, 7 had chronic granulocytic leukemia, and 1 had multiple myeloma. After bone marrow transplantation (BMT), GvHD prophylaxis was maintained in 12 patients (group 1), was stopped at day 11 in 6 patients (group 2), and was not administered to 11 patients (group 3). The treatment removed 92.65 +/- 5.36% of donor bone marrow T cells with one round of complement lysis. Of 3 patients who received mismatched transplant, 2 did not achieve engraftment. Engraftment was achieved in all of the patients who had matched BMT. Two patients had acute GvHD, 1 with grade 2 in group 1, and 1 with grade 3 in group 3. No patient has developed chronic GvHD; for 9 patients, the follow-up is longer than 6 months. Five patients relapsed within 6 months after BMT. Eighteen patients are alive and well in complete remission, with an average follow-up of 7.5, 10.6, and 2.7 months for patients in groups 1, 2, and 3, respectively. PMID- 3520075 TI - Mixed epidermal cell-lymphocyte reaction in prediction of acute graft-versus-host disease in bone marrow recipients. AB - Peripheral blood lymphocytes (PBL) and epidermal cells (EC) of 44 patients to be grafted with bone marrow from an HLA-identical sibling have been used as stimulator cells in primary cultures with effector PBL of one or several potential donors. Proliferative responses against PBL did not differ from those obtained with effector cells cultured in medium alone, whereas EC induced clearly positive proliferation in 21/53 (40%) of the pairs tested. Evaluation of 30 patients followed for more than 3 months after the graft shows that a high level of response in the mixed epidermal cell lymphocyte reaction is directly correlated with the incidence of acute graft-versus-host disease. PMID- 3520076 TI - Marrow transplantation in preleukemia. AB - Preleukemia has generally been treated by palliative measures. Several reports have indicated that cytarabine given as low-dose infusion results in responses, albeit short lived, in a fraction of patients. We have shown recently that marrow transplantation offers a useful alternative. Twelve patients have been treated and followed for a minimum of 1 year. Three were conditioned with cyclophosphamide (CY) only, and all died with recurrent or persistent disease. Nine were conditioned with CY and total-body irradiation; all but 1 had lasting engraftment, and 7 are surviving, free of disease, 16-36 (median 27) months after transplantation. These data show that marrow transplantation can provide successful therapy for preleukemia. PMID- 3520077 TI - Biologic and anatomic problems of lung shielding in whole-body irradiation. AB - Lung shielding by lead blocks for reducing the dose to the lungs in whole-body irradiation results in relative protection of the leukemia cell population. The consequence is acceptable if the dose reduction is moderate (from 10 to 8 Gy) and if the shielded volume amounts to a small fraction (5%) of the body weight. The suggestion was made that certain limits should be put on the extent of shielding, so that the shielded lung fraction represents only 60% of the total lung volume. PMID- 3520078 TI - Tumor-associated glycoprotein (TAG-72) in ovarian carcinomas defined by monoclonal antibody B72.3. AB - Murine IgG1 monoclonal antibody (MoAb) B72.3, reactive with a high molecular weight glycoprotein complex [designated tumor-associated glycoprotein-72 (TAG 72)] was shown, with the use of the avidin-biotin-complex-immunoperoxidase technique and surgically resected tissues, to be reactive with a variety of histologic tumor types. TAG-72 is expressed in at least 5% (and up to 100%) of the malignant epithelial cells in 77% (n = 52) of human primary cancers and 71% (n = 31) of metastatic ovarian cancers of the common "epithelia" histologic category. Of these, several histologic types, including serous and mucinous cystadenocarcinomas, undifferentiated carcinomas, and less common types of ovarian carcinoma, were all shown to express TAG-72. In contrast, normal ovarian tissues and 26 of 27 benign ovarian tumors of various histologic types failed to express similar levels of TAG-72. Of interest is the 1 benign tumor that demonstrated unusual glandular complexity, as well as 3 tumors designated as borderline malignancy, that contained elevated TAG-72 expression. MoAb B72.3 also was used successfully to detect ovarian carcinoma cells in 28 cytologic preparations of human serous effusions and peritoneal washings. The reactivity of MoAb B72.3 was shown to be distinct from that of MoAb OC125 and an anti-CEA MoAb B1.1. The potential applications of MoAb B72.3 in the study of human ovarian cancer cell populations, as well as in several aspects of the management of human ovarian cancer, are discussed. PMID- 3520079 TI - [Myocardial biopsy and its diagnostic possibilities in myocarditis and hypertrophic and dilated cardiomyopathies]. PMID- 3520080 TI - [Use of NMR tomography in the diagnosis of diseases of the heart and major blood vessels]. PMID- 3520081 TI - [A calendar of anniversary dates in the history of cardiology 1986]. PMID- 3520082 TI - [Role of ultrasonic echo location in the diagnosis of nonspecific thoraco abdominal aortoarteritis]. AB - Ultrasonic echo-location (UEL) was used in 14 patients with nonspecific thoracoabdominal aortoarteritis before and after surgical treatment. Ultrasonic data were compared with aortographic and intraoperative findings. Patients with atherosclerosis of the abdominal aorta and congenital hypoplasia of the latter made up the control group. UEL is regarded as a fairly informative method of the diagnosis of nonspecific aortoarteritis, as thickened walls of the aorta and other affected vessels as well as irregular indurations involving aortic walls and para-aortic fat are pathognomonic signs of nonspecific aortoarteritis that differentiate it basically from other kinds of lesions. Besides, UEL is capable of early detection of the condition and the assessment of the routes of pathologic spread. After surgery, UEL might be used to control the state of the alloprosthesis. PMID- 3520083 TI - [Comparative evaluation of prostaglandins E1 and E2 in patients with hypertension]. AB - Changes in ABP, ECG, cerebral and peripheral hemodynamics were examined in 29 patients with second-stage essential hypertension before and within 1 or 2 days after PGE1 and PGE2 infusions administered during follow-up or in the presence of a hypotensive therapy. PGE were shown to be active vasodilators increasing cerebral and peripheral circulation. Vascular PG effects persisted for 1 or 2 days after the administration. Hypertensive patients demonstrated two patterns of hemodynamic response to PGE. The patients with higher total peripheral resistance (TPR) and low stroke and cardiac indices (SI and CI) during follow-up or hypotensive treatment were more sensitive to PGE, their ABP falling because of declining TPR. The patients with high SI and normal or slightly elevated TPR were less sensitive to PGE, their ABP falling mostly at the expense of declining SI. Most patients showed changed end portion of the ventricular complex immediately after PGE administration that vanished within one or two days. In coronary patients, angina of effort occurred less frequently after PGE infusion. PMID- 3520084 TI - [Use of prazosin in patients with hypertension]. AB - Clinical trials of the alpha-adreno-blocker prazosin (Pratsiol as produced by "Orion", Finland) were carried out in 42 patients with essential hypertension, stages 2-3 by WHO classification, and 3 patients with nephrogenic hypertension. Daily doses of the drug varied between 3 and 20 mg. Good hypotensive effect was noted in 51% of patients whose cardiac index had not originally exceeded 4.5 r/min/m2 and showed no basic rise under the effect of treatment, total peripheral resistance was never below 1200 din X sec X cm-5, and heart rate kept below 80 beats per minute. In cases of higher cardiac index and heart rate values, prazosin had little or no effect. A daily dose of 8-10 mg may be considered an optimum regimen. Sinus tachycardia was the most common of side-effects. The drug was particularly effective where hypertension was combined with bradycardia. PMID- 3520085 TI - [Use of the hypotensive drug guanfacine in the treatment of patients with hypertension]. AB - The hypotensive effect of guanfacin was evaluated in 39 essentially hypertensive patients aged 18 to 64 years and treated for 2 months. Their central, and peripheral hemodynamics, intracardiac kinetics and some humoral factors responsible for vascular tonicity control were also examined. The drug can be effective in patients with second- and third-stage essential hypertension, with a good hypotensive effect being obvious within 3-5 days of treatment (3 mg daily was the highest dose). In the course of treatment, general left-ventricular pump function returned to normal in 20 patients exhibiting a good hypotensive effect. Within 2 months of treatment, originally high plasma renin activity returned to normal, and the activity of angiotensin-converting enzyme declined. PMID- 3520086 TI - [Analysis of hypotensive and hemodynamic effects of prazosin in patients with hypertension]. AB - The clinical effect of the peripheral vasodilator prazosin (Adwersuten, GDR) was studied in 51 patients with second-stage essential hypertension. A single dose of 1 to 2.5 mg produced hypotensive effect in 48 (94.1%) patients, that lasted between 3 and 4 hours, with the lowest ABP drop occurring 1.5-2.5 hours after the administration. When prazosin was given as a course of monotherapy, its daily dose varied between 3 and 20 mg (6.7 +/- 0.6 mg). A marked hypotensive effect was obtained by the end of the first week in 91.4% of patients. A 28.6% decrease in total peripheral resistance was the principal hemodynamic effect of prazosin. No significant changes of heart rate were recorded on the group basis, while side effects were noted in 7 (13.7%) patients (orthostatic hypotension and allergic response). PMID- 3520087 TI - [The renin-angiotensin-aldosterone system in children and adolescents with nephrogenic hypertension]. AB - Renin-angiotensin-aldosterone (RAA) function was studied in children with secondary hypertension of 2 varieties: vasorenal hypertension (VRH) and arterial hypertension (AH) associated with chronic pyelonephritis. Children with VRH showed RAA activation that depended on the duration of the disease for its markedness. A direct correlation found between ABP, on the one hand, and plasma renin activity and blood aldosterone level, on the other, is evidence of the latter's involvement in VRH pathogenesis. In AH that is due to chronic pyelonephritis, RAA activation was also demonstrated, however, its pathogenetic involvement was only documented in children with urinary passage disorders (vesico-renal reflux), whereas in the rest RAA activation was not a primary cause of BP elevation. PMID- 3520088 TI - [Management of patients with artificial pacemakers]. PMID- 3520089 TI - [Sleep and disorders of cardiac activity]. PMID- 3520090 TI - [Mechanism of action and the effectiveness of ethacizin in patients with paroxysmal atrioventricular nodal reciprocal tachycardia]. AB - An electrophysiologic study of ethacizin's mechanisms of action was carried out in patients with paroxysmal atrioventricular nodal tachycardia. Tachycardia was controlled by 0.5 mg/kg ethacizin in all patients. No patients demonstrated induced tachycardia in the presence of the drug, and 55% developed a complete retrograde atrioventricular block. The assessment of the preventive effect of oral ethacizin administration showed that paroxysms of tachycardia could not be provoked by esophageal electrostimulation of the heart in 87% of the patients. In the same patients, stable antiarrhythmic effect was maintained by long-term treatment with this drug. The suppression of retrograde stimulus conduction along the quick path of the atrioventricular node is assumed to be the principal electrophysiological mechanism of ethacizin action. Ethacizin can be used to control or prevent paroxysms of atrioventricular nodal tachycardia. PMID- 3520091 TI - [Effect of the intravenous administration of cordarone on the functional state of the cardiovascular system and the value of the supplementary use of corinfar]. PMID- 3520092 TI - [Use of mathematical methods of analysis of ECG data for evaluating the effectiveness of treatment of alcoholic cardiomyopathies with preparations of the phenothiazine group]. PMID- 3520093 TI - Immunochemistry of urinary calcium oxalate crystal growth inhibitor (CGI). AB - Calcium oxalate crystal growth inhibitor (CGI) was isolated from human urine in monomeric form (14,000 daltons). Antibody was elicited and purified to monospecificity by affinity chromatography. Tamm-Horsfall protein was isolated from human urine and an antibody to Tamm-Horsfall protein compared to anti-CGI. The anti-CGI reacted with its antigen on immunodiffusion, by ELISA and by Western Blotting of polyacrylamide gel electrophoresis-separated antigen. Immunofluorescent localization of CGI was found in distal renal tubules. This was precisely the localization of Tamm-Horsfall protein. Isolated Tamm-Horsfall protein was found to bind CGI which could only be partially removed with EDTA. While anti-CGI is suitable to assay CGI in human urine by ELISA techniques, it will also detect CGI that is complexed to THP. While the CGI found in human urine possesses 90% of the urinary macromolecular crystal growth inhibitor activity, THP is without effect on crystal growth, in spite of bound CGI. The balance between free CGI and that bound to Tamm-Horsfall protein may be important in the overall balance of urinary macromolecules that affect calcium oxalate nephrolithiasis. PMID- 3520094 TI - Blood pressure control in normotensive members of hypertensive families. AB - The cardiovascular pressor responses to a stepwise increase in plasma norepinephrine or angiotensin II concentrations, induced by infusions, were studied in 23 normotensive subjects with a negative and 25 with a positive family history of essential hypertension. The two study groups had a similar mean age (24 +/- 2 (SD) yr), body weight, blood pressure (112/64 +/- 10/7 mmHg), heart rate, plasma and urinary sodium and potassium, and plasma norepinephrine, epinephrine, angiotensin II, renin and aldosterone levels. However, subjects with positive history differed from those with negative history of hypertension by a decreased pressor dose of infused norepinephrine (89 +/- 29 vs. 135 +/- 66 ng/kg/min; P less than 0.005), and a significant (P less than 0.01) shift to the left of the relationship between norepinephrine-induced changes in mean arterial pressure and concomitant changes in plasma norepinephrine. In contrast, the relation between stepwise increasing plasma angiotensin II levels and induced changes in diastolic blood pressure or plasma aldosterone did not differ significantly between the two study groups. These findings delineate a distinct abnormality which may often occur in normotensive offspring of hypertensive families. It is characterized by a selectively disturbed noradrenergic blood pressure control in the presence of a normal angiotensin-mediated blood pressure and aldosterone regulation. PMID- 3520096 TI - [Plastic repair with an inguinal flap in deep burns and frostbite]. PMID- 3520095 TI - [Therapeutic study VII/81 of the treatment of acute lymphoblastic leukemia in childhood]. PMID- 3520097 TI - [Use of pig skin xenotransplants in the treatment of burns]. PMID- 3520098 TI - [Treatment of burn contractures of the upper extremities in children]. PMID- 3520099 TI - [Treatment of deep burns of the extremities after autodermoplasty in a controlled germ-free medium]. PMID- 3520100 TI - [Surgical tactics in the treatment of post-burn deformities of the palmar surface of the hand]. PMID- 3520101 TI - [Diagnosis and treatment of subcutaneous ruptures of the spleen]. PMID- 3520102 TI - [Use of potassium phosphate in the complex treatment of patients with peritonitis]. PMID- 3520103 TI - [Putrescent and septic wound complications after appendectomy]. PMID- 3520104 TI - [Current concepts in the pathogenesis, diagnosis and treatment of cholemic hemorrhages]. PMID- 3520105 TI - [Nikolai Vasil'evich Sklifosovskii (on the 150th anniversary of his birth)]. PMID- 3520106 TI - [Potentials for diagnostic endoscopy of the upper digestive tract (a review of the foreign literature since 1979)]. PMID- 3520107 TI - [Early complications in gastrointestinal surgery (a review of the literature)]. PMID- 3520108 TI - [Unresolved problems in the surgery of ulcerative pyloroduodenal stenosis (a review of the literature)]. PMID- 3520109 TI - [Results of selective proximal vagotomy in perforated pyloroduodenal ulcer]. PMID- 3520110 TI - [Guillaume Dupuytren (on the 150th anniversary of his death)]. PMID- 3520111 TI - [Diagnosis and treatment of ulcerative gastroduodenal hemorrhage]. PMID- 3520112 TI - [Characteristics of emergency surgical intervention in hemorrhaging gastroduodenal ulcers]. PMID- 3520113 TI - [Late results of rehabilitative and reconstructive operations in colostomy patients]. PMID- 3520114 TI - [Causes and prevention of puerperal incompetence of the anal sphincter]. PMID- 3520115 TI - [Ultrasonic diagnosis of cancer recurrence in men after extirpation of the rectum]. PMID- 3520116 TI - [Acid-producing function of the stomach following a selective proximal vagotomy in patients with extremely high levels of acid production]. PMID- 3520117 TI - [Echographic findings and differential diagnosis in (peri-)orbital dermoid cysts]. AB - The analysis of echographic findings in 34 patients with histologically proven dermoids revealed the following characteristic criteria: A scan sonography shows a roundish, regularly structured lesion of variably high reflectance bordered by a very high, double-peaked surface spike. There is a strong correlation between the degree of reflectivity, the consistency of the dermoid, and the composition of its contents. The B-scan shows a sharply outlined lesion with homogeneously distributed internal echos. Differential diagnoses are discussed on the basis of echographic findings and criteria. PMID- 3520118 TI - [Pseudophakic keratoplasty]. AB - The author reports on 12 unselected consecutive penetrating keratoplasties performed for pseudophakic bullous keratopathy, in which the intraocular lens was retained. The visual results achieved were significantly better than those in aphakic eyes. PMID- 3520119 TI - [Surgical pupillary dilatation within the scope of complicated retinal detachment surgery]. AB - During vitreoretinal surgery 14 aphakic patients with complicated retinal detachment were treated with 2 new techniques for surgical dilatation of a miotic and rigid pupil. In 4 cases, iris excision was not performed in the upper part of the pars pupillaris, as usual, but in the lower part. As a result, peripheral anterior synechiae due to silicone oil injection did not occur postoperatively. In the other 10 cases the pupil was temporarily stretched during the operation with 4 iris loop sutures. These sutures were laid in such a way that a retraction of the iris in the main directions of the 4 quadrants was made possible, thereby forming a large square pupil. Postoperatively, no iris damage was found in those cases where miosis had only developed during surgery. In the case of a preoperatively miotic and rigid pupil, stretching caused multiple small sphincter tears in most cases. A few weeks after surgery these patients again showed constriction of the pupil. Their pupils reacted to light, miotics, and mydriatics, but reactions were diminished. PMID- 3520120 TI - [Reis-Bucklers corneal dystrophy]. AB - In the literature two types of anterior corneal dystrophy are referred to as Reis Bucklers' dystrophy. These are the one originally described by Bucklers in 1949 and known by us as the geographical form, and a honeycomb form. On the basis of electron-microscopic findings the geographical form is considered by some authors today to be a superficial variant of the granular dystrophy (Groenouw I), while the honeycomb form is looked upon as the "true" Reis-Bucklers' dystrophy. However, there is no clinical resemblance between the honeycomb type and the dystrophy described by Bucklers. Clinically it is easy to distinguish the geographical and the honeycomb type, and this is important for the prognosis of a corneal graft. The present authors do not agree that the term granular dystrophy should include the dystrophy described by Bucklers. There is a lack of clarity concerning this type of dystrophy, and clinically it bears no resemblance to granular dystrophy. In the authors' opinion it would be preferable to speak of the geographical and the honeycomb form of Reis-Bucklers' dystrophy. PMID- 3520121 TI - [Johannes Kepler's contributions to ophthalmologic optics]. AB - Until the beginning of the 17th century it was held that an image is formed in the eye on the anterior surface of the crystalline lens. Ophthalmological optics as a scientific discipline only began with a discovery made by Johannes Kepler. Without performing new experiments, and solely by application of the laws of light refraction, he analyzed the path of light through the eye and demonstrated that an image is formed on the retina and that it is inverted. Acceptance of this discovery was impeded by contemporary prejudices which could imagine nothing but an upright image in the eye, even though this attitude could not explain certain phenomena. Kepler's discovery of the path of light in the eye made it possible to explain the following physical phenomena: central visual acuity, visual field, dark adaptation, and errors of refraction. Physiological diplopia and the mechanism of accommodation were discovered later. The law stating that the intensity of light decreases with the square of distance was also formulated by Johannes Kepler; this law, too, could only be demonstrated after the path of light through the eye had been discovered. In recent years the Keplerian telescope has assumed a practical significance in ophthalmological optics. As a reading aid for individuals with impaired vision it offers a significantly higher magnification than any other optical visual aid. PMID- 3520122 TI - [The history of glaucoma]. AB - Glaucoma has been known in medicine since Antiquity. Hippokrates described "glaykoseis" as blindness which occurs in the elderly. The English ophthalmologist Banister was the first to establish the connection between increased tension of the eyeball and glaucoma. The important invention of the ophthalmoscope by von Helmholtz (1850) made it possible to diagnose glaucomatous changes in the fundus. In 1862, Donders discovered that high intraocular pressure caused blindness and called the disease "Glaukoma simplex." Further progress in the diagnosis of glaucoma was made by the invention of the tonometer and the perimeter, and the use of cocain. The first effective surgical treatment of glaucoma, an iridectomy, was carried out by von Graefe in 1856. Drug treatment started in 1875 with the discovery of pilocarpine. PMID- 3520123 TI - [Total lid replacement by an autologous and homologous combination graft in emergencies]. AB - Report on 3 cases with total loss of a lid which required an "emergency lid" in order to protect the cornea. In all cases the tarsus was replaced by a strip of dura mater, the eye-lid skin by a free retroauricular graft. In all 3 cases the attempt was made to mobilize the levator and other adjacent tissue and fix them to the tarsus replacement. In one case the upper palpebral and bulbar conjunctiva was also replaced by 2 flaps of lip mucosa. In this case the lower half of the tarsal zone was rejected; however, the situation was mastered by tarsoconjunctival shifting of the lower lid with a free lid skin graft from the other eye. All "emergency lids" resulted in lid closure which protected the cornea sufficiently. The 2 patients in whom the upper lid was replaced had active lid movement of 3 to 4 mm. PMID- 3520124 TI - [Penetrating keratoplasty in congenital corneal opacities]. AB - The clinical course and histopathological findings in 17 cases of congenital corneal opacity treated by penetrating keratoplasty are described. On the basis of the histopathological findings 9 of the cases of corneal opacity were diagnosed as Peter's anomaly, 5 cases as sclerocornea or mesenchymal dysgenesis, 2 as choristoma, and 1 case as leukoma. Only 2 of the corneal grafts performed in these infants remained clear. The underlying disease in the 2 cases where surgery was successful was Peter's anomaly, with a clear corneal periphery. From the analysis of the corneal buttons the authors deduce that graft failure in most such cases is due to severe structural changes of the host cornea. Three findings represented consistently unfavorable signs: (1) absence of Bowman's layer; (2) absence of Descemet's membrane and (3) corneal vascularization at the cut edge of the button. Immunoreaction or infection of the graft are rare causes of graft failure. Despite the extremely poor prognosis of bilateral congenital corneal opacities, penetrating keratoplasty should be attempted. The histopathological findings may be used as prognostic criteria for graft survival or the extent of anterior segment dysgenesis. PMID- 3520125 TI - [Immune reactions following keratoplasty]. AB - On the basis of follow-up examinations of 236 penetrating keratoplasties the different forms of immune reaction were analyzed with special regard to their relationship to indication and prognosis. An immune reaction was observed in 42.8% of the cases. An epithelial Khodadoust line occurred in 17 transplants (7.2%). Nine of these were early reactions within the first two months after reoperation. Subepithelial infiltrates occurred in 14 grafts (5.9%), usually as late complications except after reoperation. Special risk factors are anterior synechiae, chronic inflammation and regrafts. The lower risk group differs from the high risk group with regard to a) the epithelial Khodadoust line (2.9% vs. 10.6%), b) the severs forms of endothelial immune reactions (4.8% vs. 32.6%), and c) the irreversible immune reactions (0% vs. 23.5%). Subepithelial infiltrates and mild forms of precipitates occurred about equally in both groups. The different forms of endothelial immune reactions are of prognostic value only in connection with the individual diagnosis and indication. About 50% of the late immune reactions were of iatrogenic origin. Misalignment of the graft can lead to a typical Khodadoust line. In one patient an irreversible immune reaction of the diffuse type was caused by YAG laser treatment of a secondary membrane. PMID- 3520126 TI - [Corneal astigmatism following cataract operations]. AB - Following a description of the surgical technique of wound opening and closure for planned extracapsular cataract extraction (ECCE) and posterior chamber lens implantation, the results, with regard to postoperative corneal astigmatism, are analyzed and discussed. In a prospective study a total of 720 cases was divided into 2 groups; the Terry surgical keratometer was used in Group I, while in Group II no postoperative measurements were performed. The results achieved in the two groups by 3 experienced surgeons were compared. Only one surgeon achieved keratometer readings which were statistically significantly lower in the early and late postoperative periods in Group I as compared to Group II. The percentage of cases with final corneal astigmatism of 2 D or less in the early and late postoperative period was higher in Group I - in which the Terry keratometer was used - than in Group II. The numerous factors influencing final postoperative corneal astigmatism are discussed. PMID- 3520127 TI - [Further studies of centering posterior chamber lenses in attempted sulcus fixation]. AB - A total of 301 posterior chamber lenses implanted consecutively by one surgeon were examined on postoperative days 3-7 with special regard to both centering and the position of the haptics. It was possible to evaluate 296 eyes. In these, 83.1% of the lenses were ideally centered, while 16.9% were found to be slightly eccentric. There was one serious lens dislocation. The position of the haptics was evaluated in 245 eyes. The attempt to fix both haptics in the sulcus was achieved in 74.7% of the cases. Of the implants fixed in the sulcus, 96.2% were ideally centered. In the remaining cases 11 lenses were fixed entirely in the capsule but in 51 one loop was in the sulcus and the other in the capsule. While the lens is usually centered well when both loops are in the capsule (81.8%), it is significantly less well centered if one loop is fixed in the sulcus and the other in the capsule (41.2%). The data are discussed. PMID- 3520128 TI - [Effect of decadron phosphate on ophthalmoscopic changes in the rat eye with intravitreal brass wires]. AB - This paper reports on ophthalmoscopic findings after implantation of 0.3 mm2 copper-zinc wires (85:15) into the vitreous body of rat eyes (2 groups of 11 animals each) and the influence of daily administration of Decadron-Phosphate, equivalent to 0.05 mg dexamethasone. This drug, injected subconjunctivally over a period of 10 days, reduces the vitreal opacities and both retinal as well as vitreal vascularization, but increases the tendency of the foreign bodies to migrate. The dose-dependent decline in bodyweight gain is an indicator of the drug's systemic effect. In order to distinguish mechanical damage from the metal intoxication, glass splinters of the same size and shape were implanted in a further series of experiments, for the purpose of comparison. PMID- 3520129 TI - Effects of oral administration of maltitol on plasma glucose, plasma sorbitol, and serum insulin levels in man. AB - The present study was aimed to investigate the metabolic effects of acute and chronic oral administration of maltitol (4-O-i-D-glucopyranosyl-D-glucitol), a hypocaloric sweetener obtained from maltose by catalytic hydrogenation. Fifty grams of maltitol induced a increase lower glycemic and insulinemic than the same dose of glucose or sucrose. No variations of plasma glucose and serum insulin levels were observed after 180 min. A slight increase of plasma maltitol was observed 45 min after maltitol. The chronic administration of maltitol (10 g 3 X daily for 5 days) induced no variations of glycemia or insulinemia when compared with the same dose of sucrose. Plasma sorbitol levels were slightly higher after maltitol than after sucrose. Low amounts of maltitol were detected in the urine and feces. PMID- 3520131 TI - Is "primary" subphrenic abscess caused by Streptococcus milleri a result of unrecognized gastrointestinal perforation? AB - An unusual case of subphrenic abscess presenting as empyema of the pleural cavity is described. The abscess developed secondarily to an occult perforation of the gastrointestinal tract, which was, diagnosed indirectly by the discovery of a fishbone within the abscess. Isolation of Streptococcus milleri from the pus was an important clue for the existence of an underlying gastrointestinal pathology. PMID- 3520130 TI - [Mid C regional parathyroid hormone in the clinical workup: diagnostic value in extrarenal (primary) and renal (secondary) hyperparathyroidism]. AB - The selective determination of mid-C-regional parathyroid hormone (mid-C-PTH) in combination with other laboratory parameters is a reliable tool for diagnosis and treatment of extra-renal (primary) and renal (secondary) hyperparathyroidism. Early stages, which show either high-to-normal serum calcium and elevated mid-C PTH or increased serum calcium but normal mid-C-PTH, can be distinguished from overt hyperparathyroidism. Alkaline phosphatase (AP) activity and mid-C-regional PTH provide biochemical confirmation of histologically classified renal osteodystrophy. Since the index AP X PTH signifies osseous changes in dialysis patients at an early stage, therapeutic regimens may be altered without additional invasive procedures. After renal transplantation mid-C-PTH normalizes and serum creatinine decreases. Increased mid-C-PTH in patients with normal renal graft function reflects autonomous PTH secretion, which requires careful monitoring to prevent PTH-induced hypercalciuria. PMID- 3520133 TI - Effects of two new alpha-glucosidase inhibitors on glycemic control in patients with insulin-dependent diabetes mellitus. AB - BAYo1248 and BAYm1099 are two new alpha-glucosidase inhibitors. Postprandial glucose tolerance was significantly improved and postprandial insulin requirements were significantly reduced as compared to placebo after breakfast and lunch when 20 mg BAYo1248 were administered prior to breakfast and after breakfast, lunch and dinner when 50 mg BAYm1099 were given prior to all three main meals. Postprandial breath H2 concentrations were mildly increased when these alpha-glucosidase inhibitors were given and no patient complained of any adverse effects (such as flatulence, abdominal pain or diarrhea). BAYo1248 and BAYm1099 might be useful adjuncts to insulin in the treatment of patients with insulin-dependent diabetes mellitus. PMID- 3520132 TI - Minoxidil and captopril in severe hypertension. AB - The antihypertensive efficacy of minoxidil and captopril was compared in 23 males with essential or renal parenchymatous hypertension refractory to conventional antihypertensive drug therapy. Following a pretreatment period the patients were randomly assigned to receive either minoxidil, 2.5 mg twice daily (n = 12), or captopril, 25 mg twice daily (n = 11). In patients with diastolic blood pressure greater than 95 mmHg, doses of minoxidil and captopril were increased in 2-week intervals. Patients who maintained diastolic pressure greater than 95 mmHg and/or those with intolerable side effects were switched over to the alternative substance. After a mean observation period of 12 weeks a significant decrease in systolic and diastolic blood pressure was observed (179/114 vs 148/92 mmHg in the minoxidil group; 176/111 vs 158/97 mmHg in the captopril group). The primary response rate was 75% in patients treated with minoxidil and 55% in those with captopril (not significant). After the change to the alternative substance two of the four non-responders on captopril and one of the two non-responders on minoxidil became responders. Side effects occurred significantly more often during minoxidil than captopril (p less than 0.05). The high efficacy of minoxidil and captopril in the treatment of severe hypertension refractory to conventional drugs was confirmed. Minoxidil lowered blood pressure slightly more than captopril, but it had a higher incidence of side effects than captopril. PMID- 3520135 TI - [V.P. Malakhov, a prominent physician of the first half of the 19th century]. PMID- 3520136 TI - [An academician of the Academy of Sciences of the Ukrainian S.S.R. M.M. Gubergrits (on the centenary of his birth)]. PMID- 3520134 TI - Acute folic acid deficiency after bone marrow transplantation. AB - After bone marrow transplantation (BMT), megaloblastic bone marrow changes are often observed that can only be partially explained by drug effects. Our goal was to find out whether folic acid deficiency represented an additional factor. The serum folic acid concentrations of 41 patients were determined regularly before and after BMT. A 2nd degree polynomial regression analysis revealed a clear and acute drop in folic acid concentrations within 7-9 days after BMT. In 19 patients the level fell below 3.0 ng/ml, the range of folic acid deficiency. The mean folic acid values without oral administration of folic acid after BMT lay significantly below the mean values with substitution (P less than 0.001). If a case of acute graft versus host disease (GvHD) was more severe than grade I, the mean folic acid levels were significantly lower (P less than 0.01). Patients with megaloblastic bone marrow changes after BMT had significantly lower folic acid values than those without such changes (P less than 0.01). The 18 patients with folic acid deficiency had a significantly higher rate of megaloblasts, binucleate erythropoietic precursors, Howell-Jolly bodies, giant myelocytes, and giant metamyelocytes in bone marrow smears than the remaining 23 patients (P less than 0.05). Folic acid deficiency did not slow down the increase in leukocytes, granulocytes, thrombocytes, or reticulocytes after BMT. There were 8.2%-9.7% hypersegmented neutrophils in the blood (normal 5%) after BMT both with and without folic acid deficiency. Folic acid deficiency after BMT was caused by insufficient intake combined with simultaneous decreased intestinal resorption and increased requirements for the regeneration of bone marrow and intestinal mucosa. PMID- 3520137 TI - [Results and prospects of studies of the physiology, morphology and pathology of the thymus gland]. PMID- 3520138 TI - [Effectiveness of levamisole in the complex treatment of patients with active forms of brucellosis]. PMID- 3520139 TI - [Clinical and pathogenetic significance of infection of erysipelas patients with the L forms of group A hemolytic Streptococcus]. PMID- 3520140 TI - [Experience using tidazin--a new Russian selective stimulant of histamine H2 receptors]. PMID- 3520141 TI - [Use of gastrocepin in middle-aged and elderly patients with peptic ulcer]. PMID- 3520142 TI - [Effectiveness of imodium in the treatment of patients with peptic ulcer and chronic gastroduodenitis associated with functional intestinal disorders]. PMID- 3520143 TI - Studies of glomerular mesangial uptake and processing of macromolecules. I. Effect of polyvinyl alcohol-induced macrophages on uptake of iron dextran. AB - The influence of prior glomerular mesangial uptake of a macromolecule that induces the infiltration of macrophages (M phi) into the mesangium on the uptake of a second macromolecule by the mesangium was studied in inbred Lewis rats. Renal transplantation of kidneys from rats previously injected with polyvinyl alcohol (PVA) was performed to avoid the potential influences of ongoing uptake of PVA and altered host milieu on the glomerular uptake of iron dextran (ID), a macromolecule that localizes primarily in the intrinsic mesangial cells of unmodified rats. In contrast to that in the recipient's native kidney, the uptake of ID was markedly increased in the glomeruli in kidneys previously exposed to PVA. This enhanced uptake was the consequence of the phagocytic activity of mesangial M phi elicited by and containing PVA since the site of increased ID content was shown by ultrastructural studies to be within mesangial M phi. Isogeneic renal transplantation per se did not influence mesangial function since the glomerular uptake of ID in donor and recipient kidneys was the same when donors were normal rats. In addition to the enhanced uptake of ID into lysosomes by mesangial M phi these cells were also much more active in the further processing of ID to ferritin particles within the cytoplasm than were intrinsic mesangial cells. These studies demonstrate that M phi attracted to the mesangium by a stimulus such as PVA may have important effects on the consequences of additional challenges to the mesangium. PMID- 3520144 TI - Localization of human eosinophil granule major basic protein, eosinophil cationic protein, and eosinophil-derived neurotoxin by immunoelectron microscopy. AB - By utilizing the colloidal gold particle technique, we localized eosinophil granule major basic protein, eosinophil cationic protein (ECP), and eosinophil derived neurotoxin (EDN) in human nasal polyp sections by immunoelectron microscopy. Sections stained with affinity chromatography purified rabbit anti human major basic protein, and subsequently with gold colloidal particle-goat anti-rabbit IgG, showed gold particles predominantly within granule cores, and not within other eosinophil organelles, plasma cells, mast cells, lymphocytes, or neutrophils. Sections stained with anti-ECP or anti-EDN showed gold particles concentrated over the granule matrix with fewer particles centrally. Control sections treated with preimmunization sera showed no staining of cells or organelles. These results verify the localization of major basic protein to the crystalloid core of the human eosinophil granule and show that ECP and EDN reside in the granule matrix. This technique provides a means of accurately locating the sites of major basic protein, ECP, and EDN deposition and thus of identifying eosinophil degranulation patterns in human disease. PMID- 3520145 TI - Topical thrombin and powdered gelfoam: an efficient hemostatic treatment for surgery. PMID- 3520146 TI - Is surgical periodontal therapy more radical than non-surgical therapy? PMID- 3520147 TI - Beginnings of the Nashville Academy of Medicine. PMID- 3520148 TI - A matrix for controlled clinical trials for the study of hepatic metastases: proceedings of a workshop. AB - A summary of a workshop held to synthesize the essential elements constituting protocols for the study of new treatments for patients with hepatic metastases is reported. An attempt was made to formulate a consensus on issues of importance in future collaborative research. A staging system was proposed that was though to be usable by clinicians. The eligibility requirements for surgical resection of hepatic metastases and for the nonsurgical treatment of hepatic metastases is discussed. Criteria for the response to treatment were formulated. The selection of appropriate control groups for new treatment strategies was discussed. PMID- 3520149 TI - An improved method for the measurement of renin release from coronal, vibratome cut kidney slices. AB - Our studies were designed to optimize a system for studying renin release in vitro. Our rat kidney slices (400 micron) were cut coronally on a vibratome, and the medullary tissue was dissected from each slice. Previous investigators obtained kidney slices by slicing sagittally, parallel to the cortical surface, with a hand-held microtome. Slicing on a vibratome and removal of the medulla ensured that the slices were of uniform thickness, weight (18.3 +/- 0.52 mg; n = 24), and renin content. Furthermore, one kidney can provide approximately 30 renal slices whereas the previous methods provided only two slices per kidney. The slices were placed in siliconized vials containing a Krebs-Ringer solution (pH 7.4) at 37 degrees C for 30 min. The Krebs-Ringer solution was decanted and replaced with fresh Krebs-Ringer solution for a 30-minute preincubation period. At the end of the 30-min preincubation period, a 0.2-ml sample was taken for the determination of renin release, and the remaining medium was decanted. Fresh Krebs-Ringer solution and the test substances were subsequently added for the incubation period. Throughout the experiment, the vials were maintained at 37 degrees C, and each vial received a gas mixture of 95% O2-5% CO2 via plastic tubing connected to a needle that was inserted into the snap-cap of each vial but did not bubble the medium. The old (bubbling) method for the bioassay of renin yielded values for renin release that were low and had large interexperimental variation (0.23 +/- 0.04 to 1.9 +/- 0.3 ng angiotensin I (AI)/mg kidney/hr; n = 24).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3520150 TI - A stochastic process determines the time at which cell division begins in Escherichia coli. AB - The theoretical distributions of cell masses in exponential cultures of bacteria were derived for both total cells and cells having formed a constriction in preparation for division. The parameters used for this derivation include the mass doubling time, tau, the T-period, and 3 statistical parameters (h, sigma 1, sigma 2) which describe the variability of the cell cycle. The theoretical distributions were compared with observed distributions from E. coli B/rA growing in glucose minimal medium (45 min doubling time) to determine whether a stochastic process in the division pathway affects the time of initiation of constriction or the duration of the constriction process. The results indicate that the stochastic process determines the onset rather than the completion of constriction and that the timing of this process is coupled (6% variability, = sigma 1) to a given cell mass. The values obtained for the duration of the T period, T = 9.3 min, and for a half-life parameter associated with the stochastic process, h = 4.3 min, agree with previously reported data. PMID- 3520151 TI - Sloppy size control of the cell division cycle. AB - In an asynchronous, exponentially proliferating cell culture there is a great deal of variability among individual cells in size at birth, size at division and generation time (= age at division). To account for this variability we assume that individual cells grow according to some given growth law and that, after reaching a minimum size, they divide with a certain probability (per unit time) which increases with increasing cell size. This model is called sloppy size control because cell division is assumed to be a random process with size dependent probability. We derive general equations for the distribution of cell size at division, the distribution of generation time, and the correlations between generation times of closely related cells. Our theoretical results are compared in detail with experimental results (obtained by Miyata and coworkers) for cell division in fission yeast, Schizosaccharomyces pombe. The agreement between theory and experiment is superior to that found for any other simple models of the coordination of cell growth and division. PMID- 3520152 TI - Fertility regulating agents from traditional Chinese medicines. AB - Chinese scientists have capitalized on the rich flora and the ethnomedical experience in China, in their pursuit of fertility regulating agents from natural products. Discoveries range from anti-implantation agents to abortifacient and pregnancy-terminating compounds, as well as a male contraceptive. Chemistry and bioactivity of these compounds and materials are reviewed in this paper, with the hope that further research and collaboration will take place to help solve the problem of population explosion. PMID- 3520153 TI - Insulin-like molecules in Momordica charantia seeds. AB - Decorticated Momordica charantia seeds were extracted and processed by a method which was developed originally for the purification of insect and annelid insulins. Essentially, the method entailed HCl--ethanol extraction, neutralization with NH4OH, gel filtration on Sephadex G-50, ion exchange chromatography on CM Sepharose CL-6B and desalting on Sephadex G-10. Of the seven fractions collected, three fractions were obtained with antilipolytic and lipogenic activities in isolated adipocytes and one fraction with only lipogenic activity. The data indicate that molecules with insulin-like bioactivity are present in Momordica charantia seeds. PMID- 3520154 TI - The intensely sweet herb, Lippia dulcis Trev.: historical uses, field inquiries, and constituents. AB - Lippia dulcis Trev. (Verbenaceae) is the source of hernandulcin, the first known intensely sweet sesquiterpenoid, a compound which is a volatile oil constituent. The literature on the uses of this species, dating back to early colonial times in Mexico, has been examined. This plant began to be used as an official drug in the late 19th century for the treatment of coughs and bronchitis, and at that time preliminary phytochemical investigations were undertaken. Field work carried out in Mexico in 1981 and 1982 has indicated that there is still an active trade involving L. dulcis, which is sold primarily in market places for its alleged abortifacient activity. We have obtained no evidence, either from the literature or from field inquiries, that L. dulcis has ever been used for sweetening foods or beverages. Fourteen L. dulcis volatile oil constituents, mainly mono- and sesquiterpenoids, were identified by gas chromatography/mass spectrometry. The toxic compound, camphor, was found to constitute 53% w/w of the volatile oil of this species. The potential use of L. dulcis for the extraction of hernandulcin is discussed. PMID- 3520155 TI - Bulgarian traditional medicine: a source of ideas for phytopharmacological investigations. AB - Some data about the use of medicinal plants in Bulgarian traditional medicine in the Middle Ages and in modern times are presented and the results of 40-year-long experimental-pharmacological investigations on many medicinal plants used in Bulgarian traditional medicine are reviewed. In-depth discussion is presented on the investigations of garlic (Allium sativum L.), a plant widely used by Bulgarian people for treating different diseases. Data from studies on a large number of plants used for treatment of hypertension, infectious diseases and as diuretic and spasmolytic remedies are summarized. PMID- 3520156 TI - Contribution to the ethnopharmacological study of the Canary Islands. AB - A large amount of ethnobotanical data of almost 200 botanical species used for medicinal purposes in the Canary Islands is presented. We are endeavouring to avoid the definitive loss of the islands' phytotherapeutic heritage, in view of the rapid social changes taking place over the last few years and hope that this work may serve to promote further pharmacological research that may confirm, scientifically and experimentally, the information presented here. A brief description of the geographical, botanical and historical circumstances is included. The species listed have been classified according to a basically therapeutical criterion. PMID- 3520157 TI - Potential antimalarial candidates from African plants: and in vitro approach using Plasmodium falciparum. AB - Twenty-one compounds isolated from nine medicinal plants used in traditional medicine in the Sudan and other African countries were examined in vitro for antimalarial activity against Plasmodium falciparum, the major human malaria parasite. Compounds tested include alkaloids, lignans, triterpenes, coumarins, limonoids and flavonoids. Most were relatively inactive; one limonoid, gedunin, had an IC50 value of about 1 microM after 48 h exposure (0.3 microM after 96 h), roughly equivalent to quinine. In this protocol, the flavonoid quercetin purified from Diosma pilosa was found to have the same activity as a commercially obtained preparation. Simple radiometric assays for antimalarial activity can thus be used to rapidly screen purified plant material or secondary plant metabolites. The high potency and efficacy of quinine and the Chinese herbal antimalarial quinghaosu (artemisinine) illustrate the merit of this approach. PMID- 3520158 TI - Prostaglandin E2, prostacyclin, and thromboxane changes during nonpulsatile cardiopulmonary bypass in humans. AB - To study the effect of lung bypass on the production of prostaglandin E2, prostacyclin, and thromboxane A2, we measured simultaneously arterial and venous plasma concentrations of prostaglandin E2, 6-keto-prostaglandin F1 alpha (stable metabolite of prostacyclin), and thromboxane B2 (stable metabolite of thromboxane A2) before, during, and after cardiopulmonary bypass. Seventeen patients (age range 46 to 69 years) undergoing aorta-coronary bypass grafts were investigated. The prostaglandin E2 production rose sharply immediately after the onset of bypass (baseline: 9.7 +/- 2.9 pg/ml to 85 +/- 16.6 pg/ml in venous and 87 +/- 12 pg/ml in arterial plasma, p less than 0.03) and rapidly decreased after pulmonary reperfusion (53 +/- 6.4 and 57 +/- 20 pg/ml, respectively, in venous and arterial plasma at the end of bypass). The increase in prostaglandin E2 was influenced by the heart-lung machine itself (as demonstrated by a closed "bypass" circuit) and by lung bypass. Pulmonary metabolism of prostaglandin E2 was maintained after bypass. The prostacyclin production rose significantly at the beginning of bypass (154 +/- 26 pg/ml venous prebypass level to 361 +/- 94 pg/ml after aortic clamping, p less than 0.03). Prostacyclin decreased progressively during rewarming of the patient, pulmonary reperfusion, and discontinuation of bypass. When prostacyclin decreased, thromboxane B2 production rose significantly and reached peak arterial levels when the lungs were reperfused (112 +/- 33 pg/ml prebypass levels to 402 +/- 101 pg/ml, p less than 0.01). Except for prostaglandin E2, there were no significant differences between arterial and venous plasma levels of these substances. The same prostanoids were also measured in five patients undergoing major orthopedic operations, and no significant changes in prostanoids were observed. Our data demonstrate significant production of prostaglandin E2 in the systemic circulation during cardiopulmonary bypass in humans. They further indicate that lung bypass disturbs the plasma prostaglandin/thromboxane balance. PMID- 3520159 TI - Clinical features of hyperosmolar hyperglycemic nonketotic diabetic coma associated with cardiac operations. AB - Hyperosmolar hyperglycemic nonketotic diabetic coma after cardiac operations was reviewed in a total of 12 patients from the literature and from my experience in an attempt to determine the clinical features of this condition. Among the unique features of this disease were the following: The mortality is high (42%). The morbidity and mortality are higher in patients with no previous history of diabetes mellitus (67% and 50%) than in those with such a history (33% and 25%). Polyuria is usually a heralding symptom. There is an average time lag of 6 days between the onset of polyuria and the established diagnosis of hyperosmolar hyperglycemic nonketotic diabetic coma. The time lag in patients who died was 7.5 +/- 0.8 days (mean +/- standard error of the mean), significantly longer than in survivors (4.5 +/- 0.8 days). Polyuria usually emerges after the stormy immediate postoperative days have passed (on postoperative day 5.3 on the average). Polyuria is generally regarded as a favorable sign not suggestive of complicating hyperosmolar hyperglycemic nonketotic diabetic coma. Therapies known to precipitate this disorder are continued even after development of polyuria. Gastrointestinal bleeding can be a precipitating factor. Hyperalimentation or elemental diet may cause dehydration and trigger hyperosmolar hyperglycemic nonketotic diabetic coma. A high or rising serum sodium concentration and/or blood urea nitrogen level with polyuria may be a warning sign of this complication. Too hasty correction of the hyperosmolar state can be dangerous. Pulmonary dysfunction may be involved in the symptoms of hyperosmolar hyperglycemic nonketotic diabetic coma. PMID- 3520160 TI - Effects of preoperative glucose-insulin-potassium on myocardial glycogen levels and on complications of mitral valve replacement. AB - Myocardial glycogen content was increased from a mean of 25.8 +/- 3.7 to 40.3 +/- 4.2 mumol/gm (p less than 0.0001) by an infusion of glucose, insulin, and potassium before mitral valve replacement. Patients who had received such an infusion and who had a higher myocardial glycogen content had a lower incidence of postoperative hypotension, less serious postoperative arrhythmias, and fewer serious complications after elective mitral valve replacement. PMID- 3520161 TI - Accelerated myocardial metabolic recovery with terminal warm blood cardioplegia. AB - Although blood cardioplegia provides excellent protection, myocardial metabolic recovery is delayed. To evaluate the benefits of a terminal warm cardioplegic infusion after cold blood cardioplegia, we performed a prospective randomized trial in 20 patients undergoing elective coronary bypass grafting. Eleven patients received cold blood cardioplegia and nine patients received cold blood cardioplegia and warm blood cardioplegia before cross-clamp removal (hot shot). The hot shot provided oxygen and removed excess lactate from the arrested heart. After the hot shot lactate was extracted by the heart and tissue adenosine triphosphate and glycogen concentrations were preserved. Atrial pacing and volume loading 3 and 4 hours postoperatively decreased myocardial lactate extraction after cold blood cardioplegia but increased lactate extraction after the hot shot. Left atrial pressures were higher at similar end-diastolic volumes (by nuclear ventriculography), which suggested decreased diastolic compliance after cold blood cardioplegia. Terminal warm blood cardioplegia accelerated myocardial metabolic recovery, preserved high-energy phosphates, improved the metabolic response to postoperative hemodynamic stresses, and reduced left atrial pressures. PMID- 3520162 TI - The effects of brain death and 24 hours' storage by hypothermic perfusion on donor heart function in the pig. AB - The effects on the myocardium of the agonal period and subsequent management have been studied in the pig. Acute ischemia of the brain led to major temporary hemodynamic changes. Brain death, with or without hemodynamic support of the circulation, led to a significant reduction in subsequent myocardial function, associated with some depletion of the myocardial high-energy phosphate and glycogen reserves, although the rate of this depletion was reduced by anaerobic glycolysis. Although 24 hours' storage by continuous hypothermic perfusion of hearts taken from control animals led to only a minimal reduction in myocardial function, storage increased the reduction in function associated with brain death when intravenous fluid and dobutamine support had been given to maintain the brain dead pig in a normotensive state. Storage, however, reduced the anaerobic metabolism seen in hearts functioning in hypotensive brain dead pigs and led to replenishment of the glycogen stores. PMID- 3520163 TI - Symposium on hypoplastic left heart syndrome. PMID- 3520165 TI - The Caring Program for Children: a pioneering effort. PMID- 3520164 TI - Effects of ex-vivo plasma adsorption over protein A sepharose in acute leukemia. AB - Plasma adsorption over immobilized Staphylococcus aureus Cowan I has resulted in tumor regression in several animal and human trials. Protein A, because of its ability to bind IgGs has been considered as the effective component of Staphylococcus aureus. In 4 patients with acute leukemia, a plasma volume of 1500 cm3 was passed in an ex-vivo system over immobilized SpA-Sepharose and then reinfused. Almost all of the IgGs contained in the plasma volume could thus be removed. Toxic side-effects were mild. No significant clinical improvement could be obtained. Plasma incubation with SpA did not modify blast cell viability or leukemic progenitor cell growth. Along with others, this study shows that Protein A is probably not the mediator of the tumoricidal responses observed in studies using adsorption over Staphylococcus aureus Cowan I. The ex-vivo system prepared for this study could also be used for plasma IgG removal for the treatment of autoimmune or immune-complex related disorders. PMID- 3520166 TI - John Jeffries: physician and balloonist. PMID- 3520167 TI - Microvascular reconstruction in the head and neck. AB - With the advent and refinement of microvascular surgical techniques, the results of reconstruction in the head and neck area have been substantially improved. Free flaps can now be moved in one stage for reconstruction of composite tissue in the head and neck area, whereas multiple procedures were often necessary to accomplish such reconstructions in the past. Skin, fat, muscle, bone, and intraoral lining can all be reestablished by using microvascular techniques. Because of the availability of microvascular surgical procedures, defects caused by cancer, congenital anomalies, or acquired disorders can now be reconstructed successfully. This article summarizes the history of microvascular operations and the development of the techniques and equipment; in addition, free tissue transfer reconstruction is compared with traditional techniques. The selection of the appropriate donor tissues and the assessment of patients preoperatively are discussed, and several illustrative case reports are presented. PMID- 3520168 TI - Clinical intracardiac electrophysiologic testing: technique, diagnostic indications, and therapeutic uses. AB - Clinical cardiac electrophysiologic testing has evolved rapidly since 1968, when the technique was first described. In an electrophysiologic study, electrode catheters are positioned within the heart to record electrical activity from the atrium, atrioventricular conduction tissue, and ventricle. Programmed stimulation is then performed, which involves pacing of the atrium or ventricle and introducing critically timed premature stimuli during sinus rhythm or paced rhythm. The use of programmed stimulation in conjunction with intracardiac recordings in electrophysiologic studies has facilitated the diagnosis of mechanisms of arrhythmias and the assessment of therapy. Electrophysiologic testing is useful in selected patients with sinus node dysfunction, conduction system disorders, supraventricular tachycardia, ventricular tachycardia, or ventricular fibrillation and in survivors of out-of-hospital cardiac arrest and patients with symptomatic but unsubstantiated rhythm disturbances. Therapeutic approaches that can be assessed by electrophysiologic testing include serial drug testing to determine the effectiveness of antiarrhythmic agents, antitachycardia pacing, the implantable defibrillator, transcatheter ablation, and electrophysiologically guided surgical procedures. In this review, we discuss the methods of electrophysiologic testing, its clinical applications in diagnosing the various cardiac rhythm disturbances, and its use in assessing various therapeutic modalities. PMID- 3520170 TI - Henri Mondor: biographer and surgeon. PMID- 3520169 TI - Paroxysmal nocturnal hemoglobinuria: erythrocyte acetylcholinesterase deficit analyzed by immunoassay and fluorescence-activated sorting. AB - An immunodisplacement assay based on a specific, solid-phase monoclonal antibody was designed to measure acetylcholinesterase in tissue extracts. Sample enzyme content was determined from the competitive reduction of binding of a purified acetylcholinesterase standard, with a detection limit of 5 ng or less. Washed erythrocyte membranes from six normal subjects averaged 1.8 units of acetylcholinesterase activity and 0.45 microgram of acetylcholinesterase content per milligram of total protein. Enzyme activity and content in samples from three patients with paroxysmal nocturnal hemoglobinuria (PNH) were reduced approximately in parallel, by as much as 70%. The residual cholinesterase had almost the same homospecific activity as the normal enzyme and was bound with equivalent affinity by six different antibodies. Therefore, the cholinesterase defect was dominated by enzyme loss rather than by structural abnormalities affecting enzyme function. Fluorescence-activated sorting of antibody-labeled erythrocytes revealed a bimodal population distribution. Up to 66% of the PNH cells lacked cholinesterase, and the rest had a near-normal enzyme content. Inasmuch as enzyme-deficient cells represent the complement-sensitive population, cell sorting may help in assessing clinical status and, perhaps, in developing new therapeutic modalities for PNH. PMID- 3520171 TI - Current status of renal transplantation--1986. AB - During the course of 3 decades, and particularly during the past 5 years, clinical renal transplantation has improved to become a safe mode of therapy for end-stage renal disease. Currently, more than 95% 1-year survival can be expected, both in patients who receive allografts from living-related donors and in those who receive cadaver kidneys. One-year living-related donor graft survival is 98%, and 1-year cadaver graft survival is 87%. Cyclosporine has been an important adjunctive immunosuppressive agent not only because of improved results but also because it has shortened hospitalization time. PMID- 3520172 TI - Comparison of haemopoiesis in young and old mice. AB - Haemopoietic status and functions have been compared in young (2-3-month-old) and old (2-2.5-year-old) BDF1 mice. The parameters measured include total marrow cellularity, CFU-S, CFU-mix, GM-CFC, BFU-E and CFU-F. In all cases the numbers of these cells in the femoral marrow of the old mice was equal to or greater than those in the femoral marrow of young mice. In addition to these parameters we have compared the ability of marrow from young and old mice to repopulate the marrow of recipient mice whose marrow had been eliminated by radiation; to grow in long-term bone marrow cultures; to produce ectopic grafts of marrow beneath the renal capsule of normal recipients; and to supply inhibitor and stimulator of stem cell proliferation in the marrow and to resynthesise these substances. We could detect no differences in any of these functions with the exception of that of resynthesis of the stem cell regulator substances, which appears to be somewhat slower in the old mice. This, however, does not impose any limitation upon the ability of the marrow to function either under normal conditions or in conditions requiring rapid proliferation. Therefore we can find no evidence whatsoever to suggest that aging of the haemopoietic system plays any part in aging of the individual or influencing the life-span. PMID- 3520173 TI - Bonding study to determine wear-resistance. PMID- 3520174 TI - Measurement and characterisation of the acoustic output of medical ultrasonic equipment. Part 1. PMID- 3520175 TI - Comparison of correlation and modulus difference processing algorithms for the determination of foetal heart rate from ultrasonic Doppler signals. PMID- 3520176 TI - Computer-controlled force transducer and ultrasonic displacement transducer to continuously record movement of a tooth during loading. PMID- 3520177 TI - Influence of simple computerized feedback on prescription charges in an ambulatory clinic. A randomized clinical trial. AB - Pharmaceuticals account for a significant portion of health care costs and are an important target for attempts at cost reductions. While many techniques have been shown effective, most are resource-intensive, have demonstrated fatigue after the intervention is ceased, and have been directed at specific items rather than total charges. The authors designed a computerized program to feed back prescription charges. The intervention is easy to execute, inexpensive, and can be maintained indefinitely. The intervention was performed in a randomized, prospective, controlled trial with the medical residents of a large county hospital. The goal was to reduce total prescribing charges and produce a meaningful financial result. The intervention reduced the mean charge for a prescription by 6.7% (P less than 0.025), but with a long latent period and minimal impact on resident knowledge of drug charges. Significant differences were seen only at the end of the study. The program was viewed positively by the residents. The low cost of the intervention yielded a benefit-to-cost ratio in excess of 50:1. Because of computerization and ongoing patient and resident randomization at the study hospital, added costs of this randomized trial in terms of computer time and research assistance were less than $1,000. PMID- 3520178 TI - [A 29-year-old male with jaundice, abdominal pain and distension after a transplant of allogeneic bone marrow for acute leukemia]. PMID- 3520179 TI - [Arterial hypertension and unilateral nephropathy. Value of the index of renal vein renin]. PMID- 3520180 TI - [Adult respiratory distress syndrome]. PMID- 3520181 TI - [Ceruletide as an analgesic in biliary and nephritic colic: comparative study]. PMID- 3520182 TI - [Pattern of type A behavior: therapeutic intervention]. PMID- 3520183 TI - Hypertensive crisis. AB - Although rare, hypertensive crises may rapidly lead to irreversible organ damage or death. Their prompt recognition, based primarily on physical signs and symptoms, is essential. Appropriately aggressive therapy, and evaluation of precipitating and exacerbating conditions, will often result in a satisfactory outcome. PMID- 3520184 TI - Emergency treatment of tachyarrhythmias. AB - The diagnosis, clinical aspects, and emergency treatment of the most common cardiac arrhythmias, including atrial flutter and fibrillation, paroxysmal supraventricular tachycardia, the Wolff-Parkinson-White syndrome, ventricular tachycardia, and torsades de pointes, are discussed. The use of the antiarrhythmic drugs most frequently utilized in clinical practice is described. PMID- 3520185 TI - Acute respiratory failure and chronic obstructive lung disease. AB - Patients with COPD who develop acute respiratory failure require special attention in their management. Patients with severe COPD often have cor pulmonale, complex acid/base compensations, and altered respiratory control mechanisms. These need to be considered when approaching the patient with an acute decompensation. Because of the improving prognosis in this group of patients, aggressive management should be undertaken using combinations of bronchodilator medications, oxygen, bronchial hygiene, and antibiotics. PMID- 3520186 TI - Clinical indicators in sepsis and septic adult respiratory distress syndrome. AB - Sepsis and septic ARDS remain clinical problems of great significance because of the numbers of patients affected each year and the high mortality associated with development of the syndrome. The standard therapies for these conditions, judicious antibiotic administration and supportive care, continue to be the mainstays of treatment for these patients, but mortality even with optimal conventional therapy is between 50% and 90% for septic ARDS. The mortality for an individual patient may be anticipated to be substantially higher or lower than these average reported values, based on the presence or absence of several clearly identified risk factors, such as advanced age, shock, evidence of multiorgan system failure, and others discussed above. Similarly, the likelihood that the septic patient will develop ARDS is increased by the appearance of shock and thrombocytopenia. Two therapies that are used extensively in the intensive care unit today--corticosteroid administration and PEEP--have not been shown to reduce the overall mortality of sepsis or septic ARDS. Newer therapeutic modalities, designed to protect against or reverse cardiovascular consequences of sepsis, reduce the incidence of multiorgan system failure, and diminish the high incidence of uncontrolled infections in these patients, are needed; investigations of these interventions are in progress. PMID- 3520187 TI - Considerations in the therapy of septic shock. AB - In summary, gram-negative sepsis is unique among infectious illnesses in that it is a disorder that recruits endogenous physiologic processes to mediate tissue injury. This host damage frequently occurs in the absence of microbial invasion of affected organs. The resultant hypotension, coagulation defects, and organ dysfunction may be associated with serious morbidity or may contribute to mortality. Ultimately, however, mortality in patients with septic shock depends on the nature of the infectious process and the severity of the underlying illnesses. Unfortunately, attempts to aggressively treat septic patients with a formidable array of antimicrobial and pharmaceutical agents have not remarkably reduced mortality. Nor does it seem likely that future elucidation of the inflammatory mechanisms of sepsis will lead to the generation of therapeutic agents that will significantly improve survival. On the other hand, prophylactic or therapeutic modalities that deter colonization or invasion by pathogenetic organisms or that alter the ability of pathogens to evoke adverse host responses may be more likely to impact on the incidence and morbidity of gram-negative bacillary infections. Until modifications in the initial interactions of gram negative pathogens with human hosts can be realized, the mortality of gram negative sepsis is likely to remain high. PMID- 3520188 TI - [Comparative studies of 3 methods of detecting Toxoplasma antibodies of the IgM class]. PMID- 3520189 TI - DNA synthesis and applications to molecular biology. PMID- 3520190 TI - Immunoliposomes: preparation, properties, and applications. PMID- 3520191 TI - Topical mucosal adhesive dosage forms. PMID- 3520192 TI - [Ultrasound diagnosis as a complement to sialography]. AB - Over a period of one year, 82 patients with chronic inflammations, concrements, abscesses, cysts, Warthin's tumours, pleomorphic adenomas, lymphonodules and neoplasms of the salivary glands were examined by ultrasound and sialography. Morphological features are described, and the validity of diagnosis by ultrasound and sialography is discussed. PMID- 3520193 TI - [Immunologic cerebrospinal fluid diagnosis using beta-2-transferrin principles and method]. AB - By using this method beta 2-transferrin, a protein variant can be identified. This variant is produced by neuraminidase activity of the brain and up to now could only be found in cerebrospinal fluid (CSF). In the analysis of CSF, by applying immunofixation with an antiserum and silver staining two bands, the beta 1-transferrin and the beta 2-transferrinband can be demonstrated. When examining serum, nasal secretion, tears, saliva and or other body fluids, only one band, the beta 1-transferrinband can be seen. It is therefore possible to identify CSF accurately. First of all methods of taking samples are explained and required analysis briefly described. Two points were of particular interest to us: The sensitivity of the method and Tracing of possible disturbing effects. Following several, different series of tests we got these results: 1 microliter pure CSF (that corresponds to approx. 1/50 of a drop) and 100 microliter CSF (two drops) per 1 ml nasal secretion can be identified by this method. It is possible that disturbing effects may be caused by blood contamination or a high protein content. For this reason haemoglobin must eliminated by using chromatography. Furthermore it is necessary to reduce a protein content of more than 5 g/l with ammonsulfat precipitation. If care is taken in respect of these two points disturbing effects can be avoided. In clinical application the immunological CSF identification seems to have a very high level of sensitivity and, in comparison with other methods many advantages. PMID- 3520194 TI - [Nuclear magnetic resonance tomography in the diagnosis of head and neck tumors. A comparison of methods]. AB - 36 patients with carcinomas of different ENT regions were investigated by means of MRI, CT and B-mode ultrasonography (US). The images were evaluated by parameters of clinical importance: tumour detectability marginal appearance, internal architecture, regional extension, and artifact degradation. The results were compared with the clinical tumour staging in accordance with the TNM system. In MRI, a multiplanar imaging of tumour extension with horizontal, frontal and sagittal sections is possible. Together with a good contrasting of the tumour against the surrounding structures, these are major advantages over CT in the imaging of carcinomas of the tonsils, the hypopharynx and the larynx. For both methods, tumours of the tongue base and the floor of the mouth are a real challenge. Lymph node metastases can be visualised with MRI, but US is the method of choice for the evaluation of cervical lymph nodes. PMID- 3520195 TI - [Immunohistologic analysis of chronic obstructive sialadenitis. I. Changes in the expression of antigens of the major histocompatibility complex]. AB - In the course of electrolyte sialadenitis progressing towards obstructive sialadenitis, changes in the epithelial expression of antigens of the major histocompatibility complex (MHC) occur even before morphological alterations and inflammatory cells can be detected. Class I antigens are enhanced and induced, and Class II antigens are induced. These changes begin focally. Only the expression of HLA-A,B,C and -DR in acinar epithelium is linked to the close vicinity of lymphohistiocytic infiltrates. In later stages of the disease the foci tend to fuse and antigenic changes are pronounced in areas of fibrosclerosis and parenchymal atrophy. The altered MHC antigen expression induced by chronical saliva congestion probably represents an important part of the postulated "immunoreaction in the duct epithelium" supposedly giving rise to this type of immunosialadenitis. PMID- 3520196 TI - [Operative therapy of deglutition paralysis]. AB - Disorder of deglutition is one of the severest signs in postoperative or posttraumatic paresis of the caudal cranial nerves. The main problem in these cases is aspiration. It is a serious disorder with potentially life-threatening pulmonary sequelae. In cases with unilateral paresis of the vagus and glossopharyngeal nerve we can consider the problem of surgical rehabilitation of swallowing as to be solved very well, as described in the present paper. However, in cases with bilateral vagus paresis we are faced with many more problems especially in the high-grade aspiration syndrome. The surgical procedures are described. PMID- 3520197 TI - Spontaneous CSF otorrhea from tegmen and posterior fossa defects. AB - Spontaneous cerebrospinal otorrhea (SCSFO) from tegmen or posterior fossa defects is uncommon. Twenty-nine cases have been detailed in the literature to date. We report an additional four cases from three patients. This group of 33 cases of SCSFO from tegmen or posterior fossa defects is characterized by certain clinical features. These patients are usually older adults (mean age 48 years, range 8 months to 80 years). Aural fullness with a serous appearing middle ear effusion, or clear otorrhea, often subsequent to tube myringotomy, are the usual initial symptoms. Meningitis was the initial manifestation in eight patients (24%), and ultimately occurred in an additional four patients (12%). The pathophysiologic basis for SCSFO from tegmen defects is discussed. Methods for diagnosing and treating CSF otorrhea from tegmen defects are reviewed. PMID- 3520198 TI - [Endoscopic sonography--diagnostic progress in the upper digestive tract?]. PMID- 3520199 TI - [A randomized, double-blind clinical trial of 2 nonionic contrast media for myelography]. PMID- 3520200 TI - [Clinical study of iohexol in a double-blind trial with ioxaglate in the angiography of the lower extremities]. PMID- 3520201 TI - Glucagon activation of the thiol:protein disulfide oxidoreductase in isolated, rat, hepatic microsomes. AB - The hepatic, microsomal, thiol:protein disulfide oxidoreductase catalyzes the glutathione (GSH) reduction of protein disulfides to sulfhydryl groups. In the presence of physiological concentrations of glucagon this activity increased from 2.3 to 6.4 fold in isolated microsomes. The stimulation had a P50 for glucagon of 7.8 X 10(-10) M which was only observed at microsomal protein concentrations of less than 100 micrograms/ml and in the presence of a GSH reducing system. This latter observation suggests that the stimulation may be inhibited by the presence of oxidized glutathione. These data support the hypothesis that glucagon may act in part by stimulating the reduction of protein disulfides by the thiol:protein disulfide oxidoreductase. PMID- 3520202 TI - Papers from the Brian L. Walker Memorial Symposium on lipids and cancer presented at the 76th AOCS (American Oil Chemists' Society) annual meeting. Philadelphia, Pennsylvania, May 1985. PMID- 3520203 TI - Immunohistochemical characterization of inflammatory infiltrates at the site of bile duct injury in primary biliary cirrhosis. AB - Surgically obtained liver specimens from four patients with primary biliary cirrhosis (PBC), Stages I-II, were studied immunohistochemically using a broad panel of monoclonal antibodies. At the site of bile-duct injury (CNSDC), the inflammatory cells were recognized to be Coulter T-11+ (directed against all T cells) and OKT-8+ (directed against cytotoxic/suppressor: C/S T-cells) cells. The MHC-class I antigen (i.e. HLA-A, B, C) was expressed weakly in the cytoplasm of the minority of damaged bile-duct epithelial cells, and the MHC-class II antigen (i.e. HLA-DR) was not expressed. Thus, OKT-8+ cells may play an important role in the immunologically mediated destruction of ductular epithelium in PBC. Strong MHC-antigen expression and OKT-8+ cell infiltration in destructive bile-duct lesions were not simultaneously observed. In the portal lymphocyte-rich areas, OKT-4+ (directed against helper/inducer: H/I T-cells) predominated over OKT-8+ cells. B-lymphocytes were present predominantly in the peripheral zones of the lymphoid aggregates. The distribution of helper/inducer T-cells and B-lymphocytes indicates that they may play a role in the induction of immunoglobulin in the lymphocyte-rich areas. The inflammatory mononuclear cells within the granuloma observed in one patient were Coulter T-11+, OKT-8+ and Leu-3a+3b+ (directed against helper/inducer T-cells) cells. PMID- 3520205 TI - Insulin dependence of M2 pyruvate kinase in primary culture of human liver. AB - In the basal state, the presence of L pyruvate kinase (LPK) was constantly observed in primary human liver cell cultures initiated from explants, when cells were examined by immunofluorescence and double labelling. After short-term insulin incubation, M pyruvate kinase (MPK) appeared. Therefore, both LPK and MPK were located in the same cells. We previously obtained the same results in isolated rat hepatocytes in which we demonstrated that short-term regulation of M2PK by insulin was a function of dose and/or incubation time. The present work established that similar conditions govern the regulation of this isozyme in vitro in human hepatocytes. PMID- 3520204 TI - Cianidanol therapy for HBe-antigen-positive chronic hepatitis: a multicentre, double-blind study. AB - The effect of cianidanol on the HBeAg/anti-HBe system in 338 patients with HBeAg positive chronic hepatitis was studied in a double-blind, randomised, placebo controlled, multicentre clinical trial. 174 patients received cianidanol in a daily dose of 1.5 g for 2 weeks, followed by 2.25 g for a further 14 weeks. 164 patients received a placebo for the same period: patients were followed up for a further 8 weeks. HBeAg and anti-HBe antibody titers were measured by R.I.A. at 4 week intervals and the results were expressed as a "cut-off index" and "inhibition percent", respectively. Liver function tests were also monitored at the same intervals. The HBeAg titer decreased by at least 50% in 44 of 144 cases treated with cianidanol (21 of 140 cases treated with placebo). The difference was significant (p less than 0.01). The HBeAg disappeared in 16 of the cianidanol cases and four of the placebo (p less than 0.05) and a seroconversion was observed in six cianidanol patients and three placebo patients. The mean HBeAg titer in the cianidanol group was significantly lower than that in the placebo group at the end of the 16 weeks of therapy (p less than 0.05). The patients whose HBeAg titer was lowered were largely those with chronic active hepatitis and had higher initial values of SGPT, SGOT and gamma-globulin than the patients whose HBeAg titers remained unchanged. The mean values for these liver function tests also fell significantly in the former sub-group. The drug was well tolerated, the only notable side effect being a transient febrile reaction in 13 patients. It is concluded that cianidanol is a useful and well-tolerated drug for improving the HBeAg/anti-HBe system in patients with HBeAg-positive chronic active hepatitis. PMID- 3520206 TI - Getting the best results from your literature search request. PMID- 3520207 TI - Gatekeeper. PMID- 3520208 TI - [Ultrasonic scanning of the bile ducts in preventive examinations]. AB - The results of the first experience in the use of ultrasonic investigation for primary diagnosis of some diseases of the gall bladder during mass screenings are analysed. Of 900 workers engaged in a factory diseases of the gall bladder (chronic cholecystitis, calculi and polyps of the gall bladder) were diagnosed in 171 (19%), of them in 15.5% the disease was first diagnosed, of these 8.7% without clinical signs. The method of ultrasonic investigation of the hepatoduodenal zone was discussed. A sonographic picture and the most typical sonographic signs of some diseases of the gall bladder were described. PMID- 3520209 TI - [Thermographic and radionuclide studies in the combined diagnosis of breast cancer]. AB - The paper is concerned with the results of examination of 157 women with breast diseases. Breast cancer was diagnosed in 94 patients, benign diseases in 63. The combined use of the thermographic and radionuclide methods was shown to raise the accuracy of breast cancer diagnosis. PMID- 3520210 TI - [Carcinogenic effect of ionizing radiations in small doses]. PMID- 3520211 TI - [Sleep and the dreams of Sancte de Sanctis]. PMID- 3520212 TI - The effect of selective beta adrenergic blockade on glucose-induced thermogenesis in man. AB - We have previously shown that the increase in energy expenditure following glucose/insulin infusion is, in large part, mediated by the sympathetic nervous system and that this sympathetic component can be blocked by the nonselective beta-1, beta-2 antagonist propranolol. To examine which beta adrenergic receptor mediates this thermogenic response, we performed euglycemic insulin clamp studies in eight healthy control subjects with and without metoprolol at a dose known to block only the beta-1 adrenergic receptor. Basal glucose oxidation and energy expenditure were similar in the control and metoprolol groups. During the last hour of the insulin clamp study, glucose oxidation (3.06 +/- 0.25 v 2.92 +/- 0.21 mg/kg X min), total body glucose uptake (8.17 +/- 0.70 v 7.13 +/- 0.49 mg/kg X min), and nonoxidative glucose uptake (5.11 +/- 0.60 v 4.21 +/- 0.44 mg/kg X min) were not different in the control compared to the metoprolol group. However, the increment in energy expenditure was inhibited by 64% during metoprolol infusion (0.04 +/- 0.01 v 0.11 +/- 0.02 kcal/min, P less than 0.01). Glucose/insulin induced thermogenesis was similarly reduced by metoprolol (2.56 +/- 0.81 v 5.04 +/- 0.74%, P less than 0.01). These results are quantitatively quite similar to those observed with propranolol. We conclude that the beta adrenergic nervous system and, specifically, the beta-1 receptor mediates the thermogenic response to glucose/insulin infusion. PMID- 3520213 TI - Comparative methods for the radiolabeling of peptides. PMID- 3520214 TI - Culture and characterization of follicular cells of the bovine anterior pituitary and pars tuberalis. PMID- 3520215 TI - Peptidergic secretory granules isolated from the brain: a model system for study of intracellular aspects of the process of peptide secretion. PMID- 3520216 TI - Mixed micelle assay of protein kinase C. PMID- 3520217 TI - Measurement of neuropeptide release: in vitro and in vivo procedures. PMID- 3520219 TI - Function of protonmotive force in translocation of protein across membranes. PMID- 3520218 TI - Synthesis and use of diacylglycerols as activators of protein kinase C in neuroendocrine tissue. PMID- 3520220 TI - ECF locus in Escherichia coli: defect in energization for ATP synthesis and active transport. PMID- 3520221 TI - Mutations in the eup locus of Escherichia coli, energy uncoupled phenotype. PMID- 3520222 TI - Oligonucleotide-directed site-specific mutagenesis of the lac permease of Escherichia coli. PMID- 3520223 TI - Binding protein-dependent active transport in Escherichia coli and Salmonella typhimurium. PMID- 3520225 TI - Reconstitution of periplasmic binding protein-dependent glutamine transport in vesicles. PMID- 3520224 TI - Calcium-induced permeabilization of the outer membrane: a method for reconstitution of periplasmic binding protein-dependent transport systems in Escherichia coli and Salmonella typhimurium. PMID- 3520226 TI - Peptide transport in bacteria. PMID- 3520227 TI - Methods for the study of the melibiose carrier of Escherichia coli. PMID- 3520228 TI - Assay, genetics, proteins, and reconstitution of proton-linked galactose, arabinose, and xylose transport systems of Escherichia coli. PMID- 3520229 TI - Purification, reconstitution, and characterization of the lac permease of Escherichia coli. PMID- 3520230 TI - Preparation of monoclonal antibodies and site-directed polyclonal antibodies against the lac permease of Escherichia coli. PMID- 3520231 TI - Glycerol facilitator in Escherichia coli. PMID- 3520232 TI - Preparation, characterization, and reconstitution of oxaloacetate decarboxylase from Klebsiella aerogenes, a sodium pump. PMID- 3520233 TI - Proton-driven bacterial flagellar motor. PMID- 3520234 TI - Measurement of citrate transport in tumor mitochondria. PMID- 3520235 TI - Partial purification and reconstitution of the tricarboxylate carrier from rat liver mitochondria. PMID- 3520236 TI - Identification of T4 gene 25 product, a component of the tail baseplate, as a 15K lysozyme. AB - The proteins synthesized in Escherichia coli B cells after infection with various T4 bacteriophage tail baseplate mutants were analysed by the immunoblotting method for the presence of the 15 Kilodalton lysozyme found in phage T4 particles. Using three different antisera: anti-phage, anti-baseplate and anti 15K lysozyme, it has been found that the 15K lysozyme is not present in lysates of bacteria infected with T4 gene 25 amber mutants. The 15K lysozyme was also found to be expressed in E. coli B cells transformed with a plasmid containing only a small portion of the T4 genome but which included T4 gene 25. These observations indicate that the 15K lysozyme is the gene 25 product. PMID- 3520237 TI - Mitotic crossing over in chromosome I disomics of Aspergillus nidulans. AB - The frequency and pattern of homologous recombination in chromosome I disomics of Aspergillus nidulans is presented. Approximately 6% of randomly selected haploid breakdown sectors are recombinant. Most of these arise from double exchange events, one of which is located in the centromere region, the other distal on the left arm. Other marked regions are rarely involved in a recombination event. Reciprocal genotypes arise in approximately equal frequencies indicating that exchange results in reciprocally recombined non-sister chromatids at the four strand stage of mitosis. Possible theories for the extreme localisation of exchange events are discussed. PMID- 3520238 TI - In vivo homologous recombination intermediates of yeast mitochondrial DNA analyzed by electron microscopy. AB - To study the structure of in vivo mitochondrial DNA recombination intermediates in Saccharomyces cerevisiae, we used a deletion mutant of the wild type mitochondrial genome. The mtDNA of this petite is composed of a direct tandem repetition of an approximately 4,600 bp monomer repeat unit with a unique HhaI restriction enzyme site per repeat. The structure of native mtDNA isolated from log phase cells, and mtDNA crosslinked in vivo with trioxsalen plus UVA irradiation, was studied by electron microscopy. Both populations contained crossed strand "Holliday" type recombination intermediates. Digestion of both non crosslinked and crosslinked mtDNA with the enzyme HhaI released X and H shaped structures composed of two monomers. Electron microscopic analysis revealed that these structures had pairs of equal length arms as required for homologous recombination intermediates and that junctions could occur at points along the entire monomer length. The percentage of recombining monomers in both non crosslinked and trioxsalen crosslinked mtDNA was calculated by quantitative analysis of all the structures present in an HhaI digest. The relationship between these values and the apparent dispersive replication of mtDNA in density shift experiments and mtDNA fragility during isolation is discussed. PMID- 3520239 TI - Inhibition of bacterial segregation by early functions of phage mu and association of replication protein B with the inner cell membrane. AB - Infection of Mu-sensitive bacteria with a recombinant lambda phage that carries the EcoRI.C fragment from the immunity end of wild type Mu DNA causes filamentous growth. Transmission electron microscopy revealed that the cell-division cycle was inhibited at, or prior to, the initiation of septation. The filamentation does not occur after infection of Mu-immune bacteria or after infection with a phage carrying the same EcoRI.C fragment, but with an IS1 insertion in gene B of Mu, showing that either gpB and/or some non-essential functions (e.g. kil) mapping downstream from the insertion are required for the inhibition of cell division. These data and previously published evidence suggest that in the "killing" of E. coli K12 by early Mu functions expressed from the cloned EcoRI.C fragment, two components have to be distinguished: one, a highly efficient elimination of plasmid DNA carrying the early Mu genes, and second, a series of interactions with host functions conducent to an inhibition of cell division. It is suggested that functions normally involved in the SOS reaction participate in the inhibition of cell division by early Mu functions. Infected bacteria synthesize the replication protein B (MR 33000) of Mu, which was found by cell fractionation experiments to be associated with the inner cell membrane. The role of this association for filamentous growth and for the integrative replication of the phage is discussed. The recombinant phage might be useful as a tool for the study of the E. coli cell division cycle. PMID- 3520240 TI - Direct evidence for autogenous regulation of the Escherichia coli genes rpoBC in vivo. AB - We have fused the rpoBC genes to the strong controllable promoter PL in phage lambda while deleting most of the intercistronic regulatory DNA and ribosomal protein genes upstream of rpoB. Induction of a lysogen carrying the recombinant prophage gave rise to a 2-3-fold oversynthesis of beta beta' in the cell whereas rpoBC-mRNA levels rose by at least 10-fold. Similar observations were made when these sequences were present in the prophage, indicating that the removal of DNA sequences up to 26 base pairs before rpoB does not affect post-transcriptional autogenous regulation of beta beta' synthesis. Overexpression of beta beta' also autogenously regulated the synthesis of the beta polypeptide from the chromosome in two strains carrying electrophoretic mobility mutations in rpoB. S1 nuclease mapping experiments indicated that this regulation was also post-transcriptional, and confirmed that phage beta-mRNA synthesis exceeded chromosomal beta-mRNA synthesis by 20-fold. The provision of excess beta alone in the cell caused autoregulation of chromosomal beta, but not beta' synthesis, indicating that beta and beta' are regulated independently. PMID- 3520241 TI - The xylABC promoter from the Pseudomonas putida TOL plasmid is activated by nitrogen regulatory genes in Escherichia coli. AB - The xylABC promoter (OP1), located on the TOL plasmid of Pseudomonas putida contains sequences homologous to the conserved regions found in nitrogen fixation (nif) promoters and in other promoters subject to nitrogen control. XylA-lac fusions were constructed in order to monitor expression from the OP1 promoter in Escherichia coli. Transcription was activated in the presence of the heterologous regulatory genes ntrC or nifA from Klebsiella pneumoniae as well as by the homologous P. putida regulatory gene xylR. In all cases activation was also dependent on the ntrA gene, whose product has been implicated as a specific sigma factor for ntr activatable operons. The 5' ends of xylA mRNA, detected by S1 nuclease mapping of in vivo transcripts, were identical in strains containing xylR, ntrC or nifA as transcriptional activators. However, activation of the K. pneumoniae nifL or nifH promoters by xylR was not detected. PMID- 3520243 TI - Phagocytosis of Leishmania infantum promastigotes by monocytes isolated from Leishmania-infected dogs. AB - Fifteen dogs with generalised leishmaniasis have been evaluated for their monocyte capacity to ingest Leishmania promastigotes. These cells displayed a lower phagocytic ability when compared to monocytes recovered from normal dogs. Moreover, sera from Leishmania-infected dogs caused a remarkable decrease of monocyte phagocytic ability in healthy dogs, whereas sera from healthy dogs could restore monocyte phagocytosis in sick animals. Similar results were seen when Candida albicans was used as stimulant. Interestingly, supernatants from polyethylenglycole (PEG) treated sera from Leishmania-infected dogs did not inhibit monocyte phagocytosis either in the autologous or in the homologous (healthy dogs) system. This suggests a possible role for serum factor(s) in the impairment of phagocytosis in Leishmania infection. PMID- 3520242 TI - Partial complementation of the UV sensitivity of E. coli and yeast excision repair mutants by the cloned denV gene of bacteriophage T4. AB - The denV gene of bacteriophage T4 was reconstituted from two overlapping DNA fragments cloned in M13 vectors. The coding region of the intact gene was tailored into a series of plasmid vectors containing different promoters suitable for expression of the gene in E. coli and in yeast. Induction of the TAC promoter with IPTG resulted in overexpression of the gene, which was lethal to E. coli. Expression of the TACdenV gene in the absence of IPTG, or the use of the yeast GAL1 or ADH promoters resulted in partial complementation of the UV sensitivity of uvrA, uvrB, uvrC and recA mutants of E. coli and rad1, rad2, rad3, rad4 and rad10 mutants of S. cerevisiae. The extent of denV-mediated reactivation of excision-defective mutants was approximately equal to that of photoreactivation of such strains. Excision proficient E. coli cells transformed with a plasmid containing the denV gene were slightly more resistant to ultraviolet (UV) radiation than control cells without the denV gene. On the other hand, excision proficient yeast cells were slightly more sensitive to killing by UV radiation following transformation with a plasmid containing the denV gene. This effect was more pronounced in yeast mutants of the RAD52 epistasis group. PMID- 3520244 TI - Incidence of enteroinvasive Escherichia coli in Spain. A 14-month prospective study. AB - Between February 1984 and May 1985, a prospective study was performed in patients with acute enteritis to determine the incidence of enteroinvasive Escherichia coli (ECEI) in our environment. Eight hundred and forty-three strains of E. coli were studied by agglutination with antisera for serogroups O28ac, 029, 0112, 0124, 0136, 0144, 0152 and 0164. Eleven strains were found to pertain to one or another of these serogroups: 6 to 029, 2 to 0124, 2 to 0164 and 1 to 0143. Of these, only the two corresponding to 0124 invaded HeLa cells and had a positive Sereny test. These strain were lysine decarboxylase and lactose negative and did not produce gas. In 125 strains that did not belong to any of the enteroinvasise serogroups indicated, but had been isolated from patients with febrile enteritis in which no other enteropathogen could be isolated (32 strains), or had metabolic characteristics of enteroinvasive Escherichia coli (93) strains, the Sereny test and invasion of HeLa cells were studied. In every case, both tests were negative. PMID- 3520245 TI - Growth of Mycoplasma mycoides subspecies mycoides on media containing various sugars and amino sugars: an ampoule microcalorimetric study. AB - The growth of Mycoplasma mycoides subspecies mycoides strain T1 on media containing various sugars, tryptose, yeast extract, salts and either pig or calf serum or a mixture of bovine serum albumin (BSA) plus lipid was followed by ampoule microcalorimetry. Power-time (p-t) curves were reproducible and showed details of growth not observable by conventional microbiological techniques. In media with metabolisable sugars p-t curves typically showed three periods of exponential increase in power separated by transient declines or plateaux. Maximum power (Pmax) was dependent upon the nature and concentration of sugar, whether ampoules were capped in air or nitrogen, and whether the medium contained pig or calf-serum or BSA plus lipid. The highest Pmax was observed in pig-serum medium with glucose, in ampoules capped in air. Decline in power from Pmax was essentially exponential. PMID- 3520246 TI - A comparative ultrastructural study of endothelial cell tubular structures from injured mouse blood-brain barrier and normal hepatic sinusoids demonstrated after perfusion fixation with osmium tetroxide. AB - Mice subjected to surgical leptomeningeal traumatic injury were fixed by perfusion with solutions containing either: (1) osmium tetroxide, (2) a mixture (cocktail) of osmium tetroxide and glutaraldehyde, or (3) a standard aldehyde fixative following the circulation of intravenously injected solutions of native ferritin (NF) or horseradish peroxidase (HRP) tracers. Endothelial cells (ECs) from injured cerebral cortex from all the above groups were examined ultrastructurally for the presence of tubular transport structures. These ECs were compared to endothelia of hepatic sinusoids which normally express numerous EC tubular profiles. Because we observed EC tubular structures in ECs of both injured brain and from liver sinusoids irrespective of fixation regime employed, we present evidence that the tubular profiles are real structures that form in vivo and which do not represent postmortem fixation artifacts. PMID- 3520247 TI - Specific binding sites for monomeric and aggregated beta 2-microglobulin on surface of groups A, B, C, and G streptococci. AB - Human beta 2-microglobulin (beta 2-m) was isolated from urine samples of patients with tubular dysfunctions and aggregated with glutaraldehyde. Four aggregates with molecular weights of 800,000, 480,000, 260,000, and 60,000 were separated by filtration on Sephacryl S-300. The aggregates and monomeric beta 2-m (11,800 MW) were subsequently labeled with 125I and tested for binding to streptococci. Group A streptococci bound only aggregated beta 2-m with a mean binding of 44.5%. Most of the group G streptococci, on the other hand, bound only monomeric beta 2-m with a mean binding of 58%. Among group B streptococci the serotypes with protein antigens interacted mainly with monomeric beta 2-m and those without protein antigens preferentially with aggregated beta 2-m. Nontypable group B streptococcal serotypes did not bind monomeric or aggregated beta 2-m. Of the streptococci belonging to group C, S. equisimilis reacted with monomeric beta 2-m and S. dysgalactiae with aggregated beta 2-m. S. equi did not interact with monomeric beta 2-m or aggregated beta 2-m. Bindings of monomeric beta 2-m and aggregated beta 2-m were saturable and could be inhibited by the respective unlabeled forms of beta 2-m. Fibrinogen, fibronectin, alpha 2-macroglobulin, haptoglobin, or immunoglobulin G did not inhibit the binding of either form of beta 2-m. The binding sites for monomeric beta 2-m were more susceptible to trypsin than those for aggregated beta 2-m. Treatment of streptococci with pronase destroyed their binding activities for monomeric and aggregated beta 2-m. Both monomeric beta 2-m and aggregated beta 2-m binding sites were sensitive to heat. The Scatchard plots of monomeric beta 2-m and aggregated beta 2-m were linear with Kd of 1.29 X 10(-9) M and 1.9 X 10(-9) M respectively. The number of binding sites per bacterium were estimated to be 81,000 for monomeric beta 2-m and 1,210 for aggregated beta 2-m. PMID- 3520249 TI - [Oral complications of marrow transplants (I)]. PMID- 3520248 TI - Opsonin effect of F(ab')2 fragment of human immunoglobulin on bacterial phagocytosis by human neutrophils. PMID- 3520250 TI - [Oral complications of marrow transplants (II)]. PMID- 3520251 TI - [Oral complications of marrow transplants (III)]. PMID- 3520252 TI - A new prostaglandin disturbance syndrome in schizophrenia: delta-6-pyroluria. AB - At least two groups of schizophrenics will be described. One such group may have a mutant delta-6-desaturase which prefers the omega-6-series essential fatty acids over the omega-3 series essential fatty acids resulting in low cis-linoleic acid blood levels. This subgroup may be related to the low histamine type schizophrenia. In contrast, we describe the possible existence of another group of schizophrenic patients with elevated cis-linoleic acid blood levels, elevated fasting insulin levels, elevated EGOT and urinary kryptopyrolle termed "delta-6 pyroluria." The etiology of this group may be due to a block instead of a mutant delta-6-desaturase. The elevated fasting insulin level may be an attempt to overcome the malfunctioning pathway. PMID- 3520253 TI - An antithrombotic role for nutritional antioxidants: implications for tumor metastasis and other pathologies. AB - Nutritional antioxidants support prostacyclin synthesis by preventing lipid hydroperoxide-mediated inhibition of prostacyclin synthetase. Recent preliminary clinical studies indicate that supplementary antioxidants exert antithrombotic effects in vivo that are most likely attributable to enhanced prostacyclin production. Optimal antioxidant nutrition may thus have preventive and therapeutic value for disorders in which inappropriate platelet aggregation plays an etiologic role, including MI, stroke, atherogenesis, pre-eclampsia, and the vascular complications of diabetes. In light of evidence that platelet aggregation encourages the implantation of hematogenous tumor metastases, supplemental antioxidants should also impede tumor dissemination--an effect which will be complemented by the immunostimulant actions of these nutrients. By exerting anticarcinogenic, immunostimulant and anti-metastatic effects, nutritional antioxidants should act to inhibit neoplasia at each stage of its development. PMID- 3520254 TI - Vascular causes of vertebral asymmetry and the laterality of scoliosis. AB - The aetiology of idiopathic scoliosis is multifactorial and complex, but the direction (laterality) of the curvature may depend on normal growth factors. It is postulated that vascular asymmetries are responsible for the left laterality of infantile thoracic scoliosis and the right laterality of adolescent thoracic scoliosis. Two hypotheses are presented. The left laterality of thoracic scoliosis in infancy may be due to the streaming of blood from the aortic arch to the right and streaming of blood from the ductus arteriosus to the left so that right vertebral arches receive better oxygenated blood, develop faster and grow larger. It is also suggested that, at a later stage, spontaneous resolution of infantile scoliosis and the right laterality of adolescent thoracic curvatures are due to the rotational force that is exerted on growing thoracic vertebrae by the asymmetrically situated descending thoracic aorta. It is emphasized that the normal growth factors that tend to a slight left thoracic scoliosis in infancy, and to a right thoracic scoliosis in adolescence, by themselves produce only a minimal scoliosis, and that progressive scoliosis involves additional unknown factors. PMID- 3520255 TI - Infective endocarditis in the 1980s. Part 1. Aetiology and diagnosis. PMID- 3520256 TI - Malarial prophylaxis. PMID- 3520257 TI - Infective endocarditis in the 1980s. Part 2. Treatment and management. PMID- 3520258 TI - Major venous thrombosis in patients with indwelling venous access catheters. AB - Two patients with Hickman catheters that were used for long-term venous access developed major venous thrombosis, one with superior vena caval and the other with subclavian vein thrombosis. This represented an incidence of 9% of all Hickman catheters that were inserted over two years in The St George Hospital. Staphylococcus epidermidis was cultured from blood that was sampled through the Hickman catheter in both patients; the organism was also cultured from the tip of the removed catheter in one patient. Transverse thoracic computerized tomographic scanning diagnosed the presence and the site of thrombosis as well as excluding the presence of a mediastinal tumour that was causing extrinsic compression. The catheter had to be removed in one patient; in the other patient, heparinization without removal resulted in the resolution of symptoms. PMID- 3520259 TI - Initial results with transvaginal, ultrasonically-guided oocyte pick-up in an Australian in-vitro fertilization programme. PMID- 3520260 TI - Complications of thiazide diuretic therapy: an update. PMID- 3520262 TI - Australian doctors and the visual arts. Part 3. Doctor-artists in Victoria. AB - The contribution of doctors to the visual arts is being discussed in a series of six articles. The first two articles dealt with doctors and the visual arts in New South Wales. In this, the third, doctor-artists in Victoria are discussed. PMID- 3520261 TI - The treatment of osteoporosis. PMID- 3520263 TI - Dr Anatoly Koryagin. PMID- 3520264 TI - Antibiotic-associated colitis caused by Clostridium difficile: relapse and risk factors. AB - Relapse is a common sequel of antibiotic-associated colitis due to Clostridium difficile. It has been suggested that Cl. difficile may persist in the stools in spite of the resolution of symptoms after treatment and this may cause the relapse. Our study was designed to define the factors that predispose to relapse and to determine if prolonging treatment to clear Cl. difficile from the stools might prevent relapse. Of 60 consecutive patients, 36 with more severe disease required treatment. Treatment with either vancomycin or bacitracin was continued until the results of the examination of stools for cytotoxin became negative and Cl. difficile could no longer be cultured (sensitivity of culture was 10-100 organisms/mL). This was achieved in 35 patients who were then followed for one month. Symptoms reappeared in 10 (28.6%) of the treated patients while Cl. difficile reappeared in the stools of an additional seven patients (20%) without the recurrence of diarrhoea. On comparing those who relapsed with those who did not, the age (67.3 +/- 5.5 years in those who relapsed compared with 51.6 +/- 4.4 years; P less than 0.025, means +/- SE) and a history of recent abdominal surgery (59% of those who relapsed compared with 17%; P less than 0.05) were significantly different. Although those who relapsed had received therapy with multiple antibiotic agents more often, this was not statistically significant. Disease was not more severe in patients who relapsed, nor was it more difficult to clear the pathogen from these patients. The 24 untreated patients did not suffer symptomatic relapse. Continuation of treatment until Cl. difficile apparently is absent from the stools is expensive and does not prevent relapse. Elderly patients and those who have recently undergone abdominal surgery are more likely to suffer a relapse. PMID- 3520265 TI - Effect of trial therapy on subsequent therapy. A review of patients with hypertension who have completed a pharmacological intervention study. AB - After a clinical trial was completed in which two commonly used antihypertensive agents (prazosin and propranolol) were compared, 20 previously untreated men with moderate, asymptomatic, essential hypertension returned to the care of their general practitioners. Twelve months later 17 patients who were still attending the same doctor demonstrated improved blood pressure control with a decrease in their lying diastolic blood pressure from 96 +/- 2 mmHg to 91 +/- 2 mmHg (P less than 0.01). Only two of the 17 patients had not by then achieved satisfactory control. Eleven patients (65%) were still taking at least one of the trial medications; clinicians seemed to prefer prazosin (10 patients). Only one of seven patients was still taking propranolol although five patients had begun treatment with other beta-blocking agents. One patient had ceased drug treatment. This survey indicates that many general practitioners are able to maintain or even improve blood pressure control in patients whose blood pressure has been stabilized initially. However, the reasons for the medication preference were unclear and studies of the clinical behaviour that influences a general practitioner's choice of medication are required. PMID- 3520266 TI - Malarial prophylaxis. PMID- 3520267 TI - Clobetasol--a potent new topical corticosteroid. PMID- 3520268 TI - Hodgkin's disease: long-term effects of therapy. PMID- 3520269 TI - [Nature, possible causes and significance of the variability of the causative agents of diseases that multiply in vectors]. PMID- 3520270 TI - [Levels and mechanisms of the regulation of the population count of the causative agents of natural focal infections]. PMID- 3520271 TI - [Natural focus nature of influenza]. PMID- 3520272 TI - [Ecological mechanisms of arbovirus evolution]. PMID- 3520273 TI - [Problems of trichinelliasis]. PMID- 3520274 TI - [Natural foci of human diseases near the Baikal and Amur railroad mainline (a review of research)]. PMID- 3520276 TI - Toxic chemical disasters and the implications of Bhopal for technology transfer. AB - The dramatic disaster in 1984 at Bhopal, India, may be overshadowed in total impact by less immediate health effects characterized by long latency, cumulative damage, and subtle impairments. Transfer of chemical technology must be accompanied by transfer of the corresponding infratechnology, toxicology, only then can the process of technology transfer be managed with fewer risks, fewer costs, and fewer tragic surprises. PMID- 3520277 TI - [Early osteopetrosis. Presentation of 2 clinical cases and new therapeutic strategies]. PMID- 3520275 TI - Public health and the civilizing process. AB - Since the Middle Ages, European society has passed through two successive stages in the "civilizing process." Each has been attended by profound changes in psychological and social codes. These are examined in relation to a greater concern with health and hygiene in response to four waves of epidemics: leprosy, plague, syphilis, and cholera. Speculations are offered about AIDS and the "civilizing process". PMID- 3520278 TI - [AIDS: recent findings and their dental implications]. PMID- 3520279 TI - [Bone grafts in reconstructive periodontal therapy. A review of the literature and clinical cases]. PMID- 3520281 TI - Women who made a difference by nursing: a historical perspective. PMID- 3520282 TI - Epidemiology of dementia. AB - Descriptive epidemiologic studies demonstrate that the risk of dementia in general and of Alzheimer's disease in particular increases with advancing age, and the risk appears to be slightly greater among women. There is no firm epidemiologic evidence to suggest that Alzheimer's disease represents two distinct conditions. Demographic projections indicate that the number of affected individuals is expected to grow as the elderly segment of our population increases. Analytic epidemiologic studies have yielded a number of positive findings, including an excess of dementia, Down's syndrome, and lymphoma in the relatives of index cases of Alzheimer's disease and a greater than expected frequency of head trauma and thyroid disease among those with Alzheimer's disease. Results have not been consistent from study to study and await further confirmation. It is hoped that findings of future analytic investigations will provide much needed information required for the development of rational programs of treatment and prevention of this major health problem. PMID- 3520280 TI - [Assessment of basophilic degranulation in relation to allergy to local anesthetics in dentistry]. PMID- 3520283 TI - Practical management strategies for families with demented victims. AB - This article describes a specific strategy for family intervention that can be used by any clinician, including the neurologist. The techniques do not require an extensive commitment of time and can be shared by members of the treatment team. The physician is in contact with the family early in the course of treatment and is therefore uniquely positioned to initiate a therapeutic program that can be carried out by other members of the treatment team. PMID- 3520284 TI - [History and future of arrhythmia surgery]. PMID- 3520285 TI - [Survey of thyroid surgery including observations from Japan and abroad]. PMID- 3520286 TI - [Orthotopic allotransplantation of the canine liver; a simplified technic with hypothermia]. AB - A simplified technique of the liver transplantation under hypothermia has been studied in dog. An immersion hypothermia was used in both the donor and the recipient. The temperature of the graft at excision was lowered to 20 degrees C with supplemental use of topical cooling. The temperature of the recipient was lowered at 27 degrees C when the transplantation was attempted. Chlorpromazine and dopamine were employed beneficially in hypothermia. No perfusion or irrigation of the graft was performed. The use of heparin was avoided. Anastomoses were carried out in turn of the proximal vena cava, portal vein, distal vena cava and the hepatic artery with a stem shaped aorta. Reperfusion was established after the completion of anastomosis between the proximal vena cava and portal vein. The anhepatic phase of the recipient was uneventfully lasted without heparinization. All dogs, 5 out of 11 without early surgical troubles survived more than 5 days. Immunosuppressive therapy was not employed except one which died of pneumonia on the 19th postoperative day. Histologically, these dogs were free from ischemic injury and/or thrombotic lesion throughout transplantation procedure. PMID- 3520287 TI - [Current pulmonary surgery]. PMID- 3520288 TI - [Thyroid nodules; evaluation of malignancy by ultrasonography]. AB - Preoperative ultrasonic examination was correlated to final pathological diagnosis in 102 cases which underwent thyroidectomy in our clinic from 1979 to May 1985. Preoperative ultrasonic diagnosis was as follows: Sensitivity was 78% (45/58 cases), and specificity was 86% (38/44 cases). Four factors in ultrasonic image were considered: Shape, boundary, internal echo and margin were featured, and correlated to malignancy in 75 cases with mainly solid nodules. Among 34 nodules with irregular shape, 33 (97%) were pathologically malignant and 40 of 42 (95%) with rugged boundary were also malignant. Whether internal echo was even or not could not be used as a diagnostic criteria. Similarly, whether a nodule had well defined margin or not was found not to be a significant criteria in order to differentiate malignant from benign lesions. In 15 of 34 cases with lymph node metastases, metastatic lymph nodes were detected by ultrasonography. Lymph node metastases must be also evaluated by ultrasonography preoperatively in thyroid diseases. Each of these factors must be considered individually in the diagnosis of thyroid nodules. By evaluation of the ultrasonography findings the pathological characteristics may be inferred, and consequently being possible to reach a correct diagnosis. PMID- 3520289 TI - [Histologic studies on canine lung transplantation]. AB - Histologic and functional investigation on lung allotransplantation was performed in 26 mongrel dogs divided into major two groups. In Group A left lung allotransplantation was carried out. These dogs were followed by administration of Cyclosporin A and Azathioprine. In dogs of Group B left lung allotransplantation and postoperative measurement of pulmonary artery (PA) pressure by contralateral PA occlusion test using modified Swan-Ganz catheter were performed. This group was subdivided into 4 groups; Group B-I: 6 hours preservation of donor's lung and administration of Cyclosporin A and Azathioprine. Group B-II: no preservation of donor's lung and administration of Cyclosporin A and Azathioprine. Group B-III: Group B-II + steroid and Group B-IV: Group B-I + steroid. In many dogs the prolongation of occurrence of acute rejection was observed Cyclosporin A. In Group A the fibrotic changes around the blood vessel and/or bronchus were detected occasionally. The appearance and desquamation of atypical type II cells were present in a few dogs. In Group B the characteristic features of acute rejection were observed. Histologic differences between groups of immediate transplantation (B-II & III) and groups with preserved lung for 6 hours (B-I & IV) were not demonstrated. There was no definite case of so-called "alveolar rejection". The mean-PA pressure of Group B rose up just after the transplantation in every dog. On postoperative 7th day the PA pressure after the right PA occlusion decreased, however it elevated again on 14th day except one dog, because of the diffuse mononuclear cell cuffing around blood vessel walls. We believe that this test is an useful examination for the evaluation of occurrence and intensity of rejection. PMID- 3520290 TI - An Ab initio study of the relationship between nitroarene mutagenicity and electron affinity. AB - Electron affinities, approximated by lowest unoccupied molecular orbital (LUMO) energies, were determined for an extensive group of nitrated polycyclic aromatic hydrocarbons by ab initio methods at the STO-3G level. Significant correlations were demonstrated between nitroarene LUMO energy and the corresponding mutagenic activity in Salmonella typhimurium strains TA98, TA100, TA1537, and TA1538. An analogous correlation using Huckel calculations was substantially poorer. A correlation between nitro group rotation and LUMO energy was related to pi conjugation about the C--N bond. Analysis of aryl substituent effects on nitrenium ion stability implicated additional nitro substitution in certain systems to be destabilizing. The results suggest a means for predicting nitroarene mutagenic activity and for assessing the role of metabolic intermediates. PMID- 3520291 TI - Salivary peroxidases. AB - Peroxidases are known to be involved in the intracellular metabolism of H2O2 coupled with various physiological functions. Apart from the thyroid gland, the enzyme has been isolated from various extrathyroidal sources of which salivary gland is one of the richest sources of the enzyme. The enzyme from bovine and goat submaxillary gland has been extensively studied in terms of their molecular, spectral, kinetic, catalytic and immunological properties and compared with the lactoperoxidase which is similar to the salivary peroxidase. The modulation of the salivary peroxidase by various factors and the probable mechanism of the modulation has been described. The enzyme has also been compared with the thyroid peroxidase as regards their physicochemical properties as well as on the immunological and functional aspects. The similarities and dissimilarities have been incorporated. The possible function of the enzyme in iodine metabolism and in bactericidal action has been discussed. PMID- 3520292 TI - Are proteins made of modules? AB - Analysis of a set of well characterized enzymes shows that the size of a protein subunit is directly related to the number of unique ligand binding functions described for the particular enzyme. The average size increment is about 5 000 Da per ligand binding function. This value corresponds very well to: (a) the amount of polypeptide chain required to form a stable folded structure, and (b) the size of polypeptide coded by the average exon. This reinforces the hypothesis that exon-coded modules are basic architectural units for proteins. Key predictive elements of this hypothesis are: 1) generally each module has a unique function, such as the ability to bind a specific ligand; 2) the size of an enzyme subunit should be determined by the number of modules required to accomplish the enzyme's biological role. PMID- 3520293 TI - Isolation and partial characterization of a type II Fc receptor from a group A streptococcus. AB - A group A streptococcal strain rich in Fc receptors was selected by an immunoblotting technique and used as the source for isolation of a functionally active Fc receptor. A variety of extraction techniques were compared including (1) heat extraction at neutral, acid or alkaline pH, (2) treatment with the enzymes mutanolysin, hyaluronidase, trypsin, papain or phage lysin, or (3) autoclaving or heating in the presence of sodium dodecyl sulfate. The most homogeneous receptor was recovered following heat extraction and contained two molecular weight forms. The major form had a molecular weight of 56 000 daltons and the minor form had a molecular weight of 38 000 daltons. These two proteins could be isolated without loss of activity by binding to and elution from a column of immobilized human IgG. An antibody prepared against a single form of the affinity purified receptor demonstrated reactivity with both molecular weight forms of the heat extracted receptor. The group A receptor was found to be both antigenically and physicochemically distinct from either the type I receptor found on the majority of Staphylococcus aureus strains or the type III Fc receptors found on the majority of group C streptococcal strains. PMID- 3520294 TI - Organ specific expression of ras oncoproteins during growth and development of the rat. AB - Expression of proteins encoded by the ras proto-oncogenes was examined in extracts from normal rat organs using anti-ras p21 antibodies generated against synthetic peptides. The highest level of ras p21 was found in brain (cerebrum) and was predominantly of c-Ha-ras origin. Levels of brain ras p21 did not vary from the newborn period of 3 months of age. Moderate levels of ras p21s were detected in lung, spleen and thymus. In contrast to the p21 in brain, these levels varied with the age of the rats and were encoded by other members of ras proto-oncogene family (Ki-ras or N-ras). This organ specific expression of different ras genes might be related to developmental control of gene expressions. PMID- 3520295 TI - [Differential morphological diagnosis of holoprosencephaly]. PMID- 3520296 TI - [Glial fibrillary acid proteins in tumors of the nervous system]. PMID- 3520297 TI - [Histological use of night-blue]. PMID- 3520298 TI - [Experiences with mucosal and skin grafts for oral mucosal defects]. PMID- 3520299 TI - [Differences in impression phases using the altered cast technic]. PMID- 3520300 TI - [2-dimensional analysis of the degree of calcification of teeth using an image processor]. PMID- 3520301 TI - Mutagenicity towards Salmonella typhimurium of some known genotoxic agents, activated by isolated hepatocytes of monkey (Macaca fascicularis). Comparison with isolated human hepatocytes. AB - This paper describes some striking differences between isolated human and monkey hepatocytes in their capacity to activate some known genotoxic agents into products mutagenic towards Salmonella typhimurium. Isolated monkey hepatocytes, in contrast to human hepatocytes, appeared to activate benzidine (BZ), N acetylbenzidine (MABZ), N,N'-diacetylbenzidine (DABZ), 2-aminofluorene (2-AF) and 2-acetylaminofluorene (2-AAF) poorly. With monkey hepatocytes BZ was slightly more mutagenic than DABZ, whereas with human hepatocytes DABZ was more active than BZ. N-Nitrosodimethylamine (DMN) and N-nitrosodiethylamine (DEN) were also found to be poorly mutagenic when activated by monkey hepatocytes, unlike the human hepatocytes. However, the polycyclic arylhydrocarbons benzo[a]pyrene (B[a]P) and 7,12-dimethylbenzanthracene (7,12-DMBA) were highly active in the presence of monkey hepatocytes, unlike the human hepatocytes. A metabolic study showed that monkey liver preparations seem to possess a higher monooxygenase activity towards B[a]P than human liver preparations. PMID- 3520302 TI - Tests which distinguish induced crossing-over and aneuploidy from secondary segregation in Aspergillus treated with chloral hydrate or gamma-rays. AB - A system of tests with the ascomycete Aspergillus nidulans was devised that can detect 3 primary effects of genotoxic agents: (1) increases in mitotic crossing over; (2) induced aneuploidy; and (3) clastogenic effects which cause chromosomal imbalance. Conidia of a new diploid tester strain, heterozygous for 4 recessive markers which alter conidial color, are treated and plated onto nonselective media. In cases of induced crossing-over, large color segments are found in normal green colonies, frequently adjacent to reciprocal twin segments. In contrast, both malsegregation and chromosome breakage produce unbalanced types which grow poorly and segregate further. Cases with yellow segregants are replated and their secondary diploid sectors tested for markers which are located on both chromosome arms in coupling with yA. Induced aneuploidy can be distinguished from chromosome breakage by the pattern of marker segregation. Any aneuploid type will produce euploid sectors solely by segregation of whole chromosomes; trisomic colonies (yA / yA / +) will show 1:2 ratios for yellow (homozygous yA) to parental green (yA/+) sectors and have characteristic phenotypes. Other induced unbalanced types, if heterozygous for deletions or aberrations may produce yellow diploid sectors by secondary crossing-over as well as by nondisjunction and such cases show unique patterns of genetic segregation and non- predictable phenotypes. As a complementary test, haploid strains are treated and induced abnormally growing types are replated and classified by phenotype. Aneuploids are unstable and produce many normal sectors, and some of these disomic or trisomic types can be visually identified.In contrast, induced deletions are lethal, and duplications or 'morphological' mutants show much more stable abnormal phenotypes. This test system was used to characterize the primary effects of gamma-rays and chloral hydrate. Results and evidence were as follows: (1) A dose-dependent increase of color segments resulting from reciprocal crossing-over was found after treatment of dividing nuclei in germinating diploid conidia with gamma-rays, but not with chloral hydrate. (2) Highly aneuploid and polyploid types were induced in diploid and haploid germinating conidia by chloral hydrate but not to any significant extent by gamma-rays. (3) gamma-Rays caused a dose- dependent increase off abnormally growing colonies when dormant or germinating diploid conidia were treated. These colonies produced secondary euploid sectors by spontaneous nondisjunction and frequently also by crossing over, which provided evidence for induced semidominant and recessive lethal mutations of many types. PMID- 3520303 TI - International Commission for Protection Against Environmental Mutagens and Carcinogens. ICPEMC Publication No. 12. Inhibitors of mutagenesis and their relevance to carcinogenesis. Report by ICPEMC Expert Group on Antimutagens and Desmutagens. PMID- 3520304 TI - Isolation and identification of rutin as the major mutagen of red wine. AB - The polyphenolics of a red wine were concentrated by salt-induced phase separation into acetone-alcohol and fractionated by Sephadex LH-20 and multi layer counter-current chromatography. The mutagenicity of each fraction was evaluated by the Salmonella mutagenesis assay. The mutagen of red wine required activation by both rat-liver microsomal enzymes and human-fecal enzymes (fecalase). The mutagenic component of red wine was purified to homogeneity by reverse-phase high-performance liquid chromatography (RPHPLC) on Lichrosorb C18 and was identified as rutin by UV spectrometry, co-chromatography with authentic standard on RPHPLC and gas-liquid chromatography/mass spectrometry. PMID- 3520305 TI - A cytogenetic study of papaya workers exposed to ethylene dibromide. AB - Ethylene dibromide (EDB) has been shown to be carcinogenic in animal studies and mutagenic in vitro. One cytogenetic study of workers exposed to low levels of EDB for short durations was negative. To test whether exposure to low levels of EDB over long periods caused cytogenetic changes, we have assessed the frequencies of sister-chromatid exchanges (SCE) and chromosomal aberrations (CA) in the peripheral blood lymphocytes of 60 men occupationally exposed to EDB. These men worked in papaya-packing plants where EDB was used to fumigate the fruit after harvest to kill fruit-fly larvae. 42 other men who worked at a nearby sugar mill served as controls. The average duration of exposure of the papaya workers was 5 years. 82 full shift personal breathing-zone air samples indicated that the papaya workers were exposed to a geometric mean of 88 ppb of EDB, as an 8-h time weighted average (TWA). Peaks up to 262 ppb were measured. The proposed OSHA 8-h TWA for EDB is 100 ppb, while NIOSH recommends 45 ppb. No differences in SCE levels were found between exposed and nonexposed workers. No differences were found in the total CA frequency between exposed and nonexposed workers. SCE levels were significantly increased in men who smoked cigarettes (p = 0.0001) and in men who smoked marijuana (p = 0.01). CA levels showed a significant increasing trend with age (p = 0.03). PMID- 3520306 TI - Mutagenicity of N-arylacetohydroxamic acids and their O-glucosides derived from chlorinated 4-nitrobiphenyl ethers. AB - The mutagenic activity of N-arylacetohydroxamic acids, their O-acetates, their O glucosides, and N-arylhydroxylamines, derived from chlorinated 4-nitrobiphenyl ethers (CNBs), was tested in the Salmonella reversion assay. N-Arylhydroxylamines were mutagenic by themselves; however, other compounds containing an N-acetyl group showed mutagenic activity in the presence of guinea pig liver S9. The mutagenic activation of the glucosides of N-arylacetohydroxamic acids was caused by Ms but not by S10.5, whereas their aglycones, N-arylacetohydroxamic acids, were activated to mutagens by both the fractions. The mutagenic activation of these compounds was inhibited by bis(p-nitrophenyl)phosphate, which indicates that enzymatic deacetylation is a crucial step in the mutagenic activation. Analysis of metabolites of the O-glucosides of N-arylacetohydroxamic acids by h.p.l.c. indicates that the corresponding deacetylated O-glucosides are primary metabolites, which decomposed to amino and azoxy (via hydroxylamine) derivatives, and that the deacetylating activity of S9 locates exclusively in Ms. PMID- 3520307 TI - Tissue culture studies of muscle disorders: Part 2. Biochemical studies, nerve muscle culture, metabolic myopathies, and animal models. AB - This review continues with studies of protein, lipid, and purine metabolism of Duchenne muscular dystrophy (DMD) cells in vitro and of muscle cells in combined culture with nerve cells. In vitro studies of human metabolic myopathies are tabulated. Results using the hamster, chicken, and mouse (dy25, dy, mdg, and mdx) myopathies are discussed. Interesting findings include suggestions of altered collagen synthesis by DMD cells. Analysis of cell proteins by two-dimensional gel electrophoresis and the use of combined nerve-muscle cultures remain important areas of development. It is disappointing that so few attempts have been made to repeat significant findings in this field, and when a number of laboratories have examined the same phenomenon, the results are often contradictory. It remains to be shown how these various abnormalities found in cells in vitro are related to each other and to those pathologic features of diseased muscle observed in vivo. PMID- 3520308 TI - A trial of flunarizine in the treatment of Duchenne muscular dystrophy. AB - Twenty-seven boys with Duchenne muscular dystrophy (DMD) entered a double-blind controlled trial of treatment with the calcium antagonist flunarizine. They were matched for age and disability. At monthly intervals, muscle power, functional ability, locomotor score, contractures, and forced vital capacity were measured by a team not involved in clinical care. Over a period of 1 year, flunarizine in a dose of up to 0.25 mg/kg/day had no effect on the clinical course of the disease. PMID- 3520309 TI - Differences in the intracellular killing of proteinase-positive and proteinase negative Candida albicans strains by granulocytes. PMID- 3520310 TI - [Occurrence of Candida albicans in human saliva in relation to its nitrate and nitrite content]. PMID- 3520311 TI - Secreted and surface antigens from larval stages of Wuchereria bancrofti, the major human lymphatic filarial parasite. AB - Antigenic proteins of microfilariae and infective larvae of Wuchereria bancrofti have been identified by intrinsic and extrinsic radiolabelling, and specific immunoprecipitation with sera from filarial patients. From 125I surface-labelling experiments, the most prominent antigen on both stages is of relative molecular mass (Mr) 17 000, while a molecule of similar size is both synthesized and released in vitro following labelling with [35S]methionine. A second similarity between the two stages is the production and secretion of a Mr 21 000 component, which is, however, not detected on the worm surfaces. A series of additional proteins from larval W. bancrofti are described from each parasite compartment (secreted, surface and somatic) and the antigenicity and specificity of these components explored with serum from patients with filariasis due to W. bancrofti or Brugia species, and with onchocerciasis. Among additional molecules released in vitro we have found a Mr 51 000 antigen from both stages, and also several proteins which are not recognised by antibody from human filarial patients. PMID- 3520312 TI - Immunoprecipitation of in vitro translation products of Fasciola hepatica RNA. AB - Incubation of in vitro translation products of RNA isolated from Fasciola hepatica with immune rat serum and sera from infected sheep resulted in the immunoprecipitation of a number of polypeptides, most of which had similar electrophoretic mobilities. Although only one of these (a 30 kDa species) correlated precisely in mobility with that of biosynthetically labelled excretory secretory (ES) antigens, this polypeptide (along with several others) was also immunoprecipitated by sheep sera raised against authentic ES antigens. This verified that the isolated RNA contained mRNA species encoding ES antigens of the parasite. In addition, immune rat serum immunoprecipitated a 64 kDa polypeptide which was not immunoprecipitated by infected sheep serum or anti-ES antigen sheep serum. The possible significance of this finding in terms of the ability of rats to develop resistance to fascioliasis in contrast to sheep which apparently cannot is discussed. PMID- 3520313 TI - Altered dihydrofolate reductase in pyrimethamine-resistant Plasmodium falciparum. AB - Dihydrofolate reductase (EC 1.5.1.3, tetrahydrofolate dehydrogenase), the target enzyme for the chemotherapeutic attack by pyrimethamine, has been studied in drug sensitive and resistant strains of Plasmodium falciparum. No evidence was found for overproduction of this enzyme in drug-resistant strains. Results presented here indicate that pyrimethamine resistance of P. falciparum depends on a modified dihydrofolate reductase, which shows less affinity for pyrimethamine and dihydrofolate. The inhibition constants for pyrimethamine increased from 0.19 nM for the drug-sensitive strain FCH-5 to 4.1 and 21.6 nM for the drug-resistant strains FVOR and K 1, respectively. In addition, the Km-values for dihydrofolate increased from 2.5 microM to 21 and 28 microM, respectively. The type of inhibition by pyrimethamine changed from competitive with respect to dihydrofolate in drug-sensitive strain to non-competitive in drug-resistant strains of P. falciparum. PMID- 3520314 TI - Multiple DNA-dependent RNA polymerases in Trypanosoma cruzi. AB - DNA-dependant RNA polymerase solubilized from cultured Trypanosoma cruzi epimastigotes was chromatographed on A-25 Sephadex and gave a single peak of activity. Subsequent phosphocellulose chromatography revealed two peaks of RNA polymerase activity. These peaks have different sensitivities to the toxin alpha amanitin. The first peak is 50% inhibited by 17.8 micrograms ml-1 amanitin while the second peak is 50% inhibited by an amanitin concentration of 44.6 micrograms ml-1. The activity of both peaks is blocked by actinomycin D, but is unaffected by rifampicin. Each peak is stimulated by Mn2+, and is optimal with single stranded DNA as a template. PMID- 3520315 TI - Effect of vasodilator therapy on mortality in chronic congestive heart failure. Results of a Veterans Administration Cooperative Study. AB - To evaluate the effects of vasodilator therapy on mortality among patients with chronic congestive heart failure, we randomly assigned 642 men with impaired cardiac function and reduced exercise tolerance who were taking digoxin and a diuretic to receive additional double-blind treatment with placebo, prazosin (20 mg per day), or the combination of hydralazine (300 mg per day) and isosorbide dinitrate (160 mg per day). Follow-up averaged 2.3 years (range, 6 months to 5.7 years). Mortality over the entire follow-up period was lower in the group that received hydralazine and isosorbide dinitrate than in the placebo group. This difference was of borderline statistical significance. For mortality by two years, a major end point specified in the protocol, the risk reduction among patients treated with both hydralazine and isosorbide dinitrate was 34 percent (P less than 0.028). The cumulative mortality rates at two years were 25.6 percent in the hydralazine--isosorbide dinitrate group and 34.3 percent in the placebo group; at three years, the mortality rate was 36.2 percent versus 46.9 percent. The mortality-risk reduction in the group treated with hydralazine and isosorbide dinitrate was 36 percent by three years. The mortality in the prazosin group was similar to that in the placebo group. Left ventricular ejection fraction (measured sequentially) rose significantly at eight weeks and at one year in the group treated with hydralazine and isosorbide dinitrate but not in the placebo or prazosin groups. Our data suggest that the addition of hydralazine and isosorbide dinitrate to the therapeutic regimen of digoxin and diuretics in patients with chronic congestive heart failure can have a favorable effect on left ventricular function and mortality. PMID- 3520316 TI - Prevention of AIDS: lessons from Osler. PMID- 3520317 TI - The effect of adjuvant chemotherapy on relapse-free survival in patients with osteosarcoma of the extremity. AB - We conducted a randomized controlled trial to determine whether intensive multi agent adjuvant chemotherapy improves the chances of relapse-free survival in patients with nonmetastatic high-grade osteosarcoma of the extremity, as compared with concurrent controls. After undergoing definitive surgery, 36 patients were randomly assigned to adjuvant chemotherapy or to observation without adjuvant treatment. At two years the actuarial relapse-free survival was 17 percent in the control group, similar to that found in studies before 1970, and 66 percent in the adjuvant-chemotherapy group (P less than 0.001). Similar results were observed among 77 additional patients who declined to undergo randomization but who elected observation or chemotherapy. We conclude that the natural history of osteosarcoma of the extremity has remained stable over the past two decades, that adjuvant chemotherapy increases the chances of relapse-free survival of patients with high-grade osteosarcoma, and that it should be given to all such patients. PMID- 3520318 TI - The effects of antihypertensive therapy on the quality of life. AB - We conducted a multicenter randomized double-blind clinical trial among 626 men with mild to moderate hypertension to determine the effects of captopril, methyldopa, and propranolol on their quality of life. Hydrochlorothiazide was added if needed to control blood pressure. After a 24-week treatment period, all three groups had similar blood-pressure control, although fewer patients taking propranolol required hydrochlorothiazide. Patients taking captopril alone or in combination with a diuretic were least likely to withdraw from treatment because of adverse effects (8 percent vs. 20 percent for methyldopa and 13 percent for propranolol). The treatment groups were similar in scores for sleep dysfunction, visual memory, and social participation. However, patients taking captopril, as compared with patients taking methyldopa, scored significantly higher (P less than 0.05 to less than 0.01) on measures of general well-being, had fewer side effects, and had better scores for work performance, visual-motor functioning, and measures of life satisfaction. Patients taking propranolol also reported better work performance than patients taking methyldopa. Patients taking captopril reported fewer side effects and less sexual dysfunction than those taking propranolol and had greater improvement (P less than 0.05 to less than 0.01) on measures of general well-being. Our findings show that antihypertensive agents have different effects on the quality of life and that these can be meaningfully assessed with available psychosocial measures. PMID- 3520319 TI - Prevention of early-onset neonatal group B streptococcal disease with selective intrapartum chemoprophylaxis. AB - Most cases of neonatal group B streptococcal disease with early onset have an intrapartum pathogenesis. Attack rates are increased substantially in infants born to mothers with prenatal group B streptococcal colonization and various perinatal risk factors (premature labor, prolonged membrane rupture, or intrapartum fever). In a randomized controlled trial, we studied the effect of selective intrapartum prophylaxis with ampicillin in 160 such high-risk women. In infants born to mothers who received intravenous ampicillin during labor, as compared with controls who received no treatment, neonatal colonization with group B streptococci was present in 8 of 85 (9 percent) versus 40 of 79 (51 percent; P less than 0.001), colonization at multiple (greater than or equal to 3) sites was observed in 3 of 85 (4 percent) versus 24 of 79 (30 percent; P less than 0.001), and bacteremia occurred in none of 85 versus 5 of 79 (6 percent; P = 0.024). The side effects of ampicillin were limited to a single episode of urticaria in a mother who had no history of penicillin allergy. We conclude that intrapartum ampicillin prophylaxis in women with positive prenatal cultures for group B streptococci who have certain perinatal risk factors can prevent early onset neonatal group B streptococcal disease. PMID- 3520320 TI - Calcium and ischemic injury. PMID- 3520321 TI - Involutional osteoporosis. PMID- 3520322 TI - Group B streptococcal infection in newborns: prevention at last? PMID- 3520323 TI - Reduced graft rejection with good HLA-A and B matching in high-risk corneal transplantation. AB - We examined the effect of matching for HLA-A and B antigens on the success of corneal transplantation in a single-center, prospective, masked study that began in March 1979. The study involved 97 consecutive recipients at high risk because of prior corneal graft rejection or serious vascularization of the native cornea. Donor corneas were selected on the basis of ABO-blood-group compatibility, a negative lymphocyte crossmatch, and optimal HLA-A and B matching; all clinical personnel were "masked" to the degree of HLA matching during the study. Among 38 patients receiving corneas with a good HLA match (two or more antigens), only 8 (21 percent) had graft rejection, as compared with 29 of 59 (49 percent) with a poor match (no or one antigen) (P less than 0.010). The mean (+/- SE) difference in rejection-free graft survival increased with time: 88.4 +/- 5.5 percent versus 73.5 +/- 5.9 percent at six months, and 80.1 +/- 7.5 percent versus 38.5 +/- 7.9 percent at two years. Cox multiple regression analysis, which included the HLA-A and B match and nine other potential confounding variables and risk factors also identified a significant (P less than 0.009) relative risk (4.6) of rejection reactions as well as irreversible graft rejection (P less than 0.016; relative risk, 11.2) with poor HLA-A and B matching. Our findings indicate that good HLA-A and B matching yields a significant long-term benefit in reducing the number of episodes of graft rejection and subsequent failure in high-risk recipients of corneal transplants. PMID- 3520324 TI - Drug therapy. Flecainide. PMID- 3520325 TI - Advances in corneal transplantation. PMID- 3520326 TI - Ultrastructural study of Candida albicans yeast after application of a ribonuclease. AB - Electron microscopy was performed on Candida albicans yeast after application of ribonuclease to clear the cytoplasmic background. In conjunction with Thiery's method of highlighting polysaccharide components, this clearing technique, which has not been used since 1959, enabled visualization of the nucleus, the mitochondria, the vacuolar system and another structure which seemed to be the Golgi apparatus. The invaginations of the plasmalemma membrane (or lomasomes) are highly developed and may be partially responsible for transporting material required for development of the cell wall, especially during budding. PMID- 3520328 TI - Variability of biochemical characteristics in strains of Trichophyton mentagrophytes. AB - The characteristics of 23 strains of Trichophyton mentagrophytes isolated from clinical samples, were studied. Sabouraud agar was the most adequate medium to inhance at their utmost the different taxonomical features. Variability of enzymatic reactions in strains of T. mentagrophytes was observed. PMID- 3520329 TI - Induction of the immune response suppression in mice inoculated with Candida albicans. AB - There is a controversy in respect to the immunological response (humoral or cellular) concerning the defense against Candida albicans. Candidosis would induce sub-populations of suppressor cells in the host cell-immune response. This report tries to show the effect of different doses of C. albicans (alive or heat killed) on the expression of cell-mediated and humoral immunity. The effect upon cell immunity was determined by inoculating different lots of singeneic mice, doses of varied concentration of C. albicans and checking for delayed-type hipersensitivity (D.T.H.). D.T.H. was also controlled in syngeneic normal mice which had previously been injected with inoculated mice spleen cells. Humoral immunity was assayed by measuring the induced blastogenesis by Pokeweed Mitogen on spleen mononuclear cells with different doses of C. albicans. Results obtained show that the different doses gave origin to: Suppression of humoral and cell response (10(8) alive); Suppression of only humoral response (10(6) alive); Suppression of cell response and increase of humoral response (10(9) dead); Increase of both responses (10(8) dead). PMID- 3520330 TI - Pulmonary aspergilloma. Case reports from Malaysia. AB - Pulmonary aspergilloma is by no means uncommon in Malaysia. The lack of documentation of its occurrence in Malaysia, is mainly due to the lack of clinical awareness, and the absence of facilities for the proper diagnosis of the infection. PMID- 3520327 TI - An overview of macrophage-fungal interactions. AB - A review of the literature (148 references) on the interactions of fungi with polymorphonuclear cells, monocytes and macrophages is presented. The interactions of Aspergillus species, Coccidioides immitis, Blastomyces dermatitidis, Histoplasma capsulatum, Cryptococcus neoformans, Candida albicans, and Candida species with human and experimental animal derived immune cells are examined in this overview. An effort has been made to present the reader with a comprehensive list of references with the intent of encouraging additional reading and research in this important area. PMID- 3520332 TI - Growth factors. From the laboratory to the clinic. PMID- 3520331 TI - Effects of a new pyrazolo [3, 4-d]pyrimidine on growth and morphology of Candida albicans. AB - A new pyrazolo [3, 4-d]pyrimidine derivative was synthesized and its antifungal activity evaluated in vitro against mycelial and yeast cells of Candida albicans. The most striking ultrastructural changes following treatment with 10-30 micrograms/ml (mycelia) and 25-75 micrograms/ml (yeasts) consisted in the deterioration of the organelle membranes and in aberrant thickenings of the cell wall. The complete disorganization of the cytoplasmic structures seemed to be the final event. PMID- 3520333 TI - Transducing proteins. Chemotaxis gene unveiled. PMID- 3520335 TI - Chernobyl: US physician tells heroic tale of Moscow. PMID- 3520334 TI - Peptide chemotaxis in E. coli involves the Tap signal transducer and the dipeptide permease. AB - Bacterial chemotaxis provides a simple model system for the more complex sensory responses of multicellular eukaryotic organisms. In Escherichia coli, methylation and demethylation of four related membrane proteins, the methyl-accepting chemotaxis proteins (or MCPs), is central to chemotactic sensing and signal transduction. Three of these proteins, Tar, Tsr and Trg, have been assigned specific roles in chemotaxis. However, the role of the fourth MCP, Tap, has remained obscure. We demonstrate here that Tap functions as a conventional signal transducer, enabling the cell to respond chemotactically to dipeptides. This provides the first evidence of specific bacterial chemotaxis towards peptides. Peptide taxis requires the function of a periplasmic component of the dipeptide permease. This protein represents the first example of a periplasmic chemoreceptor that does not have a sugar substrate. PMID- 3520336 TI - Regulation of human insulin gene expression in transgenic mice. AB - Insulin is a polypeptide hormone of major physiological importance in the regulation of fuel homeostasis in animals (reviewed in refs 1,2). It is synthesized by the beta-cells of pancreatic islets, and circulating insulin levels are regulated by several small molecules, notably glucose, amino acids, fatty acids and certain pharmacological agents. Insulin consists of two polypeptide chains (A and B, linked by disulphide bonds) that are derived from the proteolytic cleavage of proinsulin, generating equimolar amounts of the mature insulin and a connecting peptide (C-peptide). Humans, like most vertebrates, contain one proinsulin gene, although several species, including mice and rats, have two highly homologous insulin genes. We have studied the regulation of serum insulin levels and of insulin gene expression by generating a series of transgenic mice containing the human insulin gene. We report here that the human insulin gene is expressed in a tissue-specific manner in the islets of these transgenic mice, and that serum human insulin levels are properly regulated by glucose, amino acids and tolbutamide, an oral hypoglycaemic agent. PMID- 3520337 TI - Danger of delay for genetic tests. PMID- 3520338 TI - Why do disused proteins become genetically lost or repressed? PMID- 3520339 TI - Mediation of mouse natural cytotoxic activity by tumour necrosis factor. AB - Natural cell-mediated cytotoxic activity in the mouse has been associated with two types of effector cells, the natural killer (NK) cell and the natural cytotoxic (NC) cell, which seem to differ with regard to their patterns of target selectivity, cell surface characteristics and susceptibility to regulatory factors. During studies on the mechanism of action of cytotoxic molecules, it became evident that WEHI-164, the prototype NC target cell, was highly susceptible to direct lysis by both human and mouse recombinant tumour necrosis factor (TNF). Here we show that NC, but not NK activity mediated by normal splenocytes, is abrogated by rabbit antibodies to recombinant and natural TNF, respectively. Thus, the cell-mediated activity defined as NC is due to release of TNF by normal spleen cells and does not represent a unique natural effector mechanism. PMID- 3520340 TI - A block to elongation is largely responsible for decreased transcription of c-myc in differentiated HL60 cells. AB - The c-myc gene product is a nuclear protein expressed in a wide variety of cell types. It has been implicated in the control of normal cell growth as well as transformation, but its exact function is unknown. When the human promyelocytic leukaemia cell line HL60 is treated with retinoic acid, the cells differentiate into granulocytes, and there is a reduction in steady state c-myc RNA of more than 10-fold. Nuclear runoff assays show that this reduction is caused by a corresponding decrease in the transcription of exon 2. However, only a minor decrease in exon 1 transcription is observed upon differentiation. In undifferentiated HL60 cells there is an approximately 3-fold molar excess of exon 1 transcription over exon 2, and this excess increases to about 15-fold in differentiated cells. This observation suggests that a major component of c-myc transcriptional down-regulation in HL60 cells is at the level of elongation rather than at the level of initiation. The position of the elongation block was mapped to the region of the boundary between exon 1 and intron 1. During HL60 differentiation, a DNase I hypersensitive site in the chromatin about 300 bases downstream of the 5' end of of intron 1 increases in intensity relative to other sites, possibly reflecting events associated with the termination of transcription. Our runoff analysis also revealed transcription of both strands immediately upstream of exon 1 in HL60 cells. The sense strand transcription of this region produces a novel c-myc RNA which initiates several hundred bases upstream of the previously defined promoters and is found in a variety of cell types. PMID- 3520341 TI - Idealization of the hydrophobic segment of the alkaline phosphatase signal peptide. AB - Proteins secreted by prokaryotic cells are synthesized as precursors containing an amino-terminal extension sequence or signal peptide. Although these signal peptides share little primary sequence homology, recent studies suggest that they function via common pathways during the transport process and that a common element may reside in their secondary structural characteristics. We are investigating the role of an idealized hydrophobic sequence with high potential for alpha-helix formation in the Escherichia coli alkaline phosphatase signal peptide. Here, amino-acid substitutions were made using site-directed mutagenesis to produce a mutant signal sequence containing nine consecutive leucine residues in the hydrophobic core segment. Transport studies with this mutant precursor indicate that mature alkaline phosphatase is correctly targeted to the E. coli periplasm and that processing of the precursor to the mature form of the enzyme is extremely rapid. In contrast, processing is slowed when the mutant signal sequence is lengthened by the insertion of five additional leucine residues and one serine. PMID- 3520342 TI - Inducible cellular transformation by a metallothionein-ras hybrid oncogene leads to natural killer cell susceptibility. AB - Natural killer (NK) cells are lymphoid effector cells possessing spontaneous cytolytic activity against a variety of tumour targets. The fact that NK cells pre-exist at high frequency and require no lengthy activation, and the observation that differentiated and metastatic tumour cells often have a decreased sensitivity to NK cytolysis have led to the hypothesis that these cells may be involved in the earliest stages of antitumour surveillance. Central to this model is the prediction that NK sensitivity must arise during cellular transformation. To test this prediction directly, we have constructed a vector containing the transforming gene from the EJ bladder carcinoma cell line under the transcriptional control of the mouse metallothionein-I promoter. When induced with heavy metal ions, mouse fibroblast lines containing this vector become dramatically sensitive to NK-mediated cytolysis concomitant with the expression of the cellular Harvey ras (c-Ha-ras) p21 protein and with cellular transformation. PMID- 3520343 TI - Early blood grouping and transfusion in North Carolina: contributions of Laurence H. Snyder. PMID- 3520344 TI - Modern cardiologists comment on Osler. PMID- 3520345 TI - Rationing the health-care surplus: an American tragedy. PMID- 3520347 TI - [T-lymphocyte purification of donor bone marrow in allogeneic bone marrow transplantation for leukemia: a step ahead or a breakthrough?]. PMID- 3520346 TI - [Acute kidney function disorders caused by nonsteroidal anti-inflammatory agents]. PMID- 3520348 TI - [Prevention of graft-versus-host disease following allogeneic bone marrow transplantation by removal of T-cells]. PMID- 3520349 TI - [Prevention of graft-versus-host disease following allogeneic bone marrow transplantation in patients with leukemia]. PMID- 3520350 TI - Quality circles: a management strategy that works. PMID- 3520351 TI - Neonatal tetanus. PMID- 3520352 TI - Colicinogeny in colorectal cancer. AB - Colicins, bacteriocins of Escherichia coli and related bacteria of Enterobacteriaceae family, form a very heterogeneous group of antibiotically active substances of proteinaceous material. Antitumorous effect of colicins have also been demonstrated experimentally. The large bowel has been found to be a site of their native action. Therefore, our work has been aimed at investigating colicinogenicity in patients with colorectal carcinoma. From a total number of 77 patients with colorectal carcinoma, colicinogenic Escherichia coli was found in 32 persons (41.6%), whereas from a total of 160 control clinically healthy persons, colicinogenic Escherichia coli was found in 102 persons (63.8%). The difference is statistically significant (p less than 0.05). The absence of colicinogenic Escherichia coli may be one of the factors contributing to the origin and development of colorectal carcinoma in some of the patients studied. Studies of patients with adenomatous polyps, members of colon cancer families, and large prospective studies of the general population will be necessary to prove this hypothesis. PMID- 3520353 TI - Results and further perspectives of plasmocytoma chemotherapy. AB - Polychemotherapy has improved prognostic parameters of survival in patients with plasmocytoma. The mean survival in patients given long-time prednisone and melphalan treatment is 20 months, in those given polychemotherapy over 30 months. In patients with a slow disease progression the combinations COPP and VMCP give satisfactory results in about 40%, but in a majority of patients more effective treatment is necessary. The authors compare the 5-year survival of two polychemotherapy groups with the prednisone and melphalan group. The mean survival after prednisone and melphalan was 33 months, after polychemotherapy (groups COPP, VMCP) 46 months and 57 months (VMCP + M2), respectively. Survival time was influenced by the clinical stage. PMID- 3520354 TI - [The oligodontia patient: indications and treatment]. PMID- 3520355 TI - [A new method for visual tooth color determination]. PMID- 3520356 TI - [Simulation of patient management in dental education. II. A study on the validity of patient management problems]. PMID- 3520357 TI - [Oligodontia: etiology, frequency, diversity, preprosthetic orthodontics]. PMID- 3520358 TI - [Re-integrating the sick fund-insured: costs and services]. PMID- 3520359 TI - [Simulation of patient management in dental education. III. Microcomputer simulation of dental treatment planning]. PMID- 3520360 TI - [Karl Wilmanns and the vagabonds]. PMID- 3520361 TI - Cardiac complications of drastic weight reduction. PMID- 3520362 TI - Long-term effect of acarbose on diurnal serum triglyceride, glucose, insulin and adipose tissue lipoprotein lipase levels in patients with primary endogenous hypertriglyceridaemia, with or without type II diabetes. PMID- 3520363 TI - Effect of cationic proteins on the glomerular deposition of anionic proteins and immune complexes. AB - When 3 mg of cationized human IgG (cIgG, pI greater than 9) was injected intravenously into mice and followed 15 min later by 3 mg anionized bovine serum albumin (aBSA, pI = 4), deposits were detected along the capillary loops and in the mesangium. Additional infusion of immunoaffinity-purified rabbit anti-BSA antibodies 1 h later led to their deposition at the same location. Intravenous injection of an equivalent amount of preformed BSA-anti-BSA or aBSA-anti-BSA immune complexes into mice with glomerular planted cIgG gave rise to few deposits. Similarly, the perfusion of preformed aBSA-anti-BSA complexes in isolated rat kidneys with planted cIgG led to granular deposition of both, but the intensity of staining was less than when sequential perfusions were used. Cationic macromolecules bound to the glomerulus may lead to the deposition of anionic macromolecules and anionic immune complexes. PMID- 3520364 TI - [Pathological changes and their sequelae in the spinal nerve roots, spinal cord and vertebral artery in cervical spondylosis]. PMID- 3520365 TI - [Favorable outcome using indomethacin in a case of temporal arteritis]. AB - The authors described a case of temporal arteritis in which only biopsy of the artery made the correct diagnosis possible. The patient had contraindications to steroid treatment and thus a trial of Metindol therapy was undertaken. After the treatment a rapid regression of symptoms occurred. PMID- 3520366 TI - [The 150th anniversary of the discovery of demyelination foci (plaques) in disseminated sclerosis]. PMID- 3520367 TI - [A case of cerebral aspergilloma following radical operation of a cerebral aneurysm]. AB - A case of aspergillotic abscess with granuloma is reported. A 45-year-old man was admitted to our hospital on Apr. 10, 1984 due to the rupture of an aneurysm of the anterior communicating artery. Neck clipping of the aneurysm was proposed on Apr. 12, 1984, but was not performed because of cardiac arrest with unknown etiology during the operation. Neck clipping was performed on Apr. 23, 1984. Antibiotic therapy was prolonged for about three weeks. About 6 months after surgery, he was readmitted on Oct. 12, 1984 with the chief complaint of general fatigue and headache. On readmission, laboratory examinations were normal except for leukocytosis, elevated ESR and positive CRP. Neurological examination revealed left papilledema, disorientation and memory disturbance. On lumbar puncture, the cerebrospinal fluid showed 2 lymphocytes, 71 mg percent protein, 94 mg percent glucose. The skull and chest X-ray findings were normal. The CT scan revealed an irregular low density area in the left frontal lobe with abnormal enhancement. Steroids and antibiotic therapy were initiated. Since mass signs on CT scan increased gradually, partial removal of abscess and granuloma was performed on Nov. 5, 1984. From the necrotic granuloma, Aspergillus was microscopically recognized and Aspergillus fumigatus was cultured on Sabouraud's medium. Immunologically, serum immunoglobulin levels and the subset of lymphocytes were normal. Tuberculin reaction was negative. After the operation, amphotericin-B and 5-fluorocytosine (5-FC) were administered. Nevertheless mass signs on CT scan increased again. The fourth operation was performed on Dec. 6, 1984.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3520368 TI - Unconventional virus infection and neurological disease. PMID- 3520369 TI - Pathology of Creutzfeldt-Jakob disease associated with pituitary-derived human growth hormone administration. AB - This report describes the pathological features in the brain of a 22 year old woman who died with Creutzfeldt-Jakob disease 8 1/2 years after completing a 4 year course of injections of human growth hormone derived from cadaver pituitaries. Spongiform change was seen in the frontal cortex. There was gliosis and neuronal loss throughout the frontal cortex, basal ganglia, thalamus, peri aqueductal grey matter and tectum of the mid brain, pontine nuclei and dorsal medulla but no evidence of inflammation. Extensive atrophy and gliosis of the cerebellar cortex was present with widespread loss of neurons from the internal granular layer but relative sparing of Purkinje cells. Gliosis and atrophy of the mammillary bodies and gliosis of the hypothalamus may have been related to the previous surgical excision of a craniopharyngioma at the age of 2 1/2 years. The pattern of changes presented is comparable to that in other cases of Creutzfeldt Jakob disease including those previously reported after human growth hormone administration. PMID- 3520370 TI - Spongiform encephalopathy: a neurocytologist's viewpoint with a note on Alzheimer's disease. AB - Ultrastructural studies of spongiform encephalopathy (SE) reveal no very early pathological changes in kuru where membrane lamellation has been reported. This observation is challenged. In the later stages of SE, two main theories are examined--the spiroplasma theory and the prion (6 nm filament) theory. Neither are sufficiently convincing at present. In my own ultrastudies of Creutzfeldt Jakob disease brain, extensive dismantling of the dendritic microtubule cytoskeleton has been observed. Loss of dendritic cytoskeleton implies loss of dendritic cytotransport with abolition of postsynaptic events. This would explain neurological symptoms and death where other causes, pneumonia etc. are not involved. My experimental model, involving depletion or loss of dendritic microtubules, indicates that spongy vacuoles may be fixation artifacts. In a brief consideration of Alzheimer's disease, loss of dendritic microtubules has also been observed, with the implications mentioned above. Finally, the neuritic plaque will be considered. PMID- 3520371 TI - Evidence for estrogen-receptive GABAergic neurons in the preoptic/anterior hypothalamic area of the rat brain. AB - Estrogen target neurons are numerous in the medial preoptic/anterior hypothalamic area (MPO/AH) of the female rat brain, and they are thought to play a crucial role in reproductive functions. This brain region is also known to contain high concentrations of the inhibitory transmitter gamma-aminobutyric acid (GABA) and of its synthesizing enzyme glutamate decarboxylase (GAD). Since it is known that GABA is involved in the regulation of gonadotropin release from the pituitary gland it has been proposed that estrogen feedback may be mediated by this transmitter. Here we show, by a combined method of estrogen autoradiography and GAD immunocytochemistry, that estrogen-receptive neurons of GABAergic nature exist in the MPO/AH. PMID- 3520372 TI - Effects of estradiol and progesterone on immunoreactive forms of hypothalamic luteinizing hormone-releasing hormone. AB - In order to investigate mechanisms underlying the ovarian steroid action on hypothalamic luteinizing hormone-releasing hormone (LHRH) neurons, LHRH and a higher immunoreactive molecular form (MW 1,800 daltons) of the decapeptide were immunoassayed with antibodies of different specificities in hypothalamic subcellular fractions, after molecular sieve filtration on Biogel P4 columns equilibrated with 0.2 N acetic acid containing 0.02% sodium azide. The study was performed in ovariectomized (OVX), ovariectomized estradiol-implanted (OVX + E2) or OVX + E2 progesterone one-treated rats (OVX + E2 + P). The animals were killed before or during the circadian luteinizing hormone (LH) surge. The amount of LHRH like immunoreactivity recovered from the synaptosomal fraction was slightly increased in OVX + E2-implanted animals but very markedly augmented in OVX + E2 + P-treated rats. In contrast, the higher molecular form recovered from a high speed supernatant was markedly decreased in OVX + E2 + P-treated rats when compared to the other groups. At the time of maximal LH release induced by E2 + P administration, hypothalamic LHRH was markedly depleted, whereas the larger molecular form was notably augmented. The data suggest that ovarian steroids not only influence release of hypothalamic LHRH but also the processing of LHRH precursor forms. PMID- 3520373 TI - Localization of Met-enkephalin-Arg6-Gly7-Leu8 immunoreactivity in rat duodenum. AB - The distribution of Met-enkephalin-Arg6-Gly7-Leu8 (Met-ENK-Arg6-Gly7-Leu8) in the rat duodenum was determined using specific antibodies against Met-ENK-Arg6-Gly7 Leu8 and the immunofluorescence microscope technique. Met-ENK-Arg6-Gly7-Leu8 immunoreactive perikarya have been detected in the myenteric plexus. These neuronal cell bodies were large in diameter and round in shape. Met-ENK-Arg6-Gly7 Leu8 immunostained nerve fibres were noted in both the circular muscle layer and, more abundantly, in interconnecting myenteric plexus nerve fibre bundles. These findings might indicate that Met-ENK-Arg6-Gly7-Leu8 has important physiological roles as neurotransmitter and/or neuromodulator in the human and mammalian gastrointestinal tract. PMID- 3520374 TI - Muscle grafts as entries for blood-borne proteins into the extracellular space of the brain. AB - Nuchal muscle autografts of two different sizes were transplanted into rat brain parenchyma (intraparenchymal, 1.5 X 1.5 X 1 mm) and onto the surface of the brain stem (intraventricular, 2 X 2 X 1 and 1.5 X 1.5 X 1 mm). The vasculature of the transplants retained its permeability to proteins. Exogenous, intravenously injected horseradish peroxidase (HRP) and endogenous immunoglobulins (IgG) crossed the vessels of the grafts to enter the surrounding brain tissue 1 and 3 months after transplantation. HRP infiltrated about 0.46 to 4.6 mm into the extracellular spaces around the grafts 60 minutes after its intravenous injection. The penetration of HRP depended on the size and age of the graft. Infiltration was greater in 1-month-old rats with slightly larger intraventricular grafts than in those with smaller grafts. There was a tendency for the penetration of HRP to be greater from 1-month-old grafts than from 3 month-old grafts, but the difference was not statistically significant, except for the horizontal vector of spread in the intraparenchymal group. Although endogenous IgG infiltrated the surrounding brain tissue, its penetration was very limited in comparison with that of HRP. The results suggest that muscle grafts could be used as a readily available and accessible means of circumventing the blood-brain barrier selectively and focally. PMID- 3520375 TI - Current neuroradiological investigation of spontaneous hemorrhage into the craniospinal axis. AB - Increasing experience-based statistical knowledge, expertise, and technical advancements in recent years have all contributed to the facility of investigations into the cause of spontaneous neuraxis hemorrhage. The sum of the neuroradiological evaluation has become increasingly more straightforward, simpler to execute, more informative, and safer to perform. Methods of investigation include the traditional forms of radiography such as skull roentgenography and conventional anteriography. However, the contribution of high resolution computed tomography, dynamic computed tomography, and venous and arterial digital subtraction angiography has been largely responsible for the progress in this complicated area of radiological diagnosis. The future advancement of radiological evaluation in patients with craniospinal hemorrhage will lie in the technical improvements of current imaging systems, as well as in the further development and refinement of new techniques such as magnetic resonance imaging. PMID- 3520376 TI - Stereotactic surgery. PMID- 3520377 TI - Autoradiographic localization of insulin receptors in rat brain: prominence in olfactory and limbic areas. AB - The binding of 125I-labeled insulin in thin sections of frozen fresh rat brain (95% specific binding) was shown using autoradiography. By several criteria including structure-activity relationship analysis, the brain insulin receptors were qualitatively indistinguishable from insulin receptors previously characterized on brain and other more typical target tissues and distinct from receptors for the insulin-like growth factors. The 125I-labeled insulin binding sites in brain formed a distinct pattern with high levels of binding in all olfactory areas and in closely related limbic regions. Binding was also prominent in the neocortex and the accessory motor areas of the basal ganglia and the cerebellum. Among ancillary brain structures only the choroid plexus demonstrated a high density of insulin receptors. When insulin receptors were located on cortical or laminated structures, the highest binding occurred in the superficial ("molecular" or "plexiform") layer, i.e. the layer which receives afferent input and/or is rich in the dendritic branches of principal neurons (e.g. external plexiform layer of the olfactory bulb and the molecular layer of the dentate gyrus). The enrichment of insulin receptors in the olfactory and limbic systems, which is a characteristic feature of other known neuropeptides, in addition to their prevalence in the strata occupied by the dendritic fields of principle neurons, suggests a neuromodulatory function for insulin in the brain. PMID- 3520378 TI - Maturation of opioid sensitivity of fetal mouse dorsal root ganglion neuron perikarya in organotypic cultures: regulation by spinal cord. AB - Opioid agonists selectively decrease the duration of the Ca2+ component of the action potential recorded from embryonic dorsal root ganglion neurons in dissociated cell cultures. In contrast, no significant alterations in the action potentials generated by adult dorsal root ganglion neurons in vivo were detected during opioid exposure. In the present study, the perikaryal opioid sensitivity of fetal mouse dorsal root ganglion neurons was analyzed during maturation in organotypic explant cultures. To determine whether spinal cord might influence this sensitivity, neuron perikarya were tested in ganglia grown: (a) in isolation; (b) attached to spinal cord explants; and (c) attached to spinal cord, but decentralized by a dorsal root transection in mature explants 1-2 weeks before the tests. After 2-8 weeks in culture, the duration of the Ba2+-enhanced Ca2+ component of intracellularly recorded action potentials was measured prior to and during bath exposure to the opioid, [D-Ala2, D-Leu5]enkephalin. Sensitive neurons were characterized by a marked, reversible reduction (averaging about 50%) in the duration of the Ca2+ component (which was antagonized by naloxone). The fraction of opioid-sensitive neuron perikarya in dorsal root ganglia grown attached to cord explants was significantly lower (48%) than in ganglia grown isolated (78%) or decentralized in vitro (79%). The mean duration of the Ca2+ component was significantly shorter in ganglion cells which had been grown attached to cord, or subsequently decentralized, compared to cells grown in isolated ganglia (by 24 and 38%, respectively). This difference was even larger in the opioid-insensitive groups. Although opioid-sensitive perikarya in ganglia grown attached to cord had a significantly longer Ba2+-enhanced Ca2+ component than that of insensitive neurons, some of the insensitive perikarya in all 3 types of explant paradigms displayed Ca2+ components which were as prolonged as those of sensitive cells. The results obtained in this study support the hypothesis that the observed decrease in the fraction of opioid-sensitive perikarya during development of fetal mouse dorsal root ganglia is due to regulation by interactions with their central target tissue, the spinal cord. The developmental decrease in the duration of the Ca2+ component of the action potential of these ganglion cells is also enhanced by the presence of the spinal cord. However, regulation of functional opiate receptors and Ca2+ component duration of the ganglion cell perikarya appear to be independent processes. PMID- 3520379 TI - Neuropeptide Y and the ocular innervation of rat, guinea pig, cat and monkey. AB - By the immunohistofluorescence technique, peripheral nerves of the rat, guinea pig, cat and monkey eye contain a neuropeptide Y-like immunoreactive peptide. A broad distribution of immunoreactive nerve fibers is present in all four animals, innervating tissues of the aqueous humor outflow apparatus, the limbal blood vessels, and uveal blood vessels. A dense plexus of neuropeptide Y-like immunoreactive nerve fibers is present to the ciliary processes. A rich innervation exists to the iris dilator muscle, but that to the iris sphincter is modest. Throughout all regions of the uvea, neuropeptide Y-like immunoreactive nerves are associated closely with melanocytes. When acid extracts of anterior uvea and choroid from rat and guinea pig are analyzed by radioimmunoassay and reverse phase high performance liquid chromatography, the immunoreactive ocular peptide occurs in a single molecular form indistinguishable from porcine neuropeptide Y. The present findings indicate that neuropeptide Y is present in ocular nerves of rat, guinea pig, cat, and monkey. Their distribution, with a few small exceptions, closely parallels that of ocular adrenergic nerves as revealed by histofluorometric techniques. While no ocular effects of neuropeptide Y have been reported to date, its other known biological effects imply potential functions in the eye. PMID- 3520380 TI - Severity of stroke and aspirin. PMID- 3520381 TI - Neuropathologic verification of Creutzfeldt-Jakob disease in the exhumed American recipient of human pituitary growth hormone: epidemiologic and pathogenetic implications. AB - Beginning at age 12, a boy with idiopathic hypopituitarism was treated with cadaver pituitary-derived human growth hormone during the period from 1963 to 1969. Fifteen years after the last treatment, the then 32-year-old man developed Creutzfeldt-Jakob disease (CJD). The illness was atypical in showing predominantly cerebellar signs, little mental deterioration, and no abnormal movements or periodic EEG activity. Examination of the embalmed brain, 7 months after interment, revealed the characteristic changes of CJD mainly in the cerebellum and basal ganglia. This case establishes the contamination of at least two American lots of human growth hormone and, together with other cases of iatrogenic disease, suggests that virus enters the brain from the blood, rather than along neural pathways. PMID- 3520382 TI - Hyperbaric oxygen therapy in chronic stable multiple sclerosis: double-blind study. AB - We carried out a randomized, double-blind, placebo-controlled trial of hyperbaric oxygen therapy (HBO) in patients with chronic stable MS. Eighty-two patients were treated in a multiplace hyperbaric chamber with gas supplied by mask. Forty-one patients received 20 consecutive daily treatments of 100% O2 followed by 7 "booster" treatments in the next 6 months; 41 control patients received "air" (12.5% O2 at 1.75 atmospheres absolute). There was no significant difference in treatment and control groups in the Extended Kurtzke Disability scores, Kurtzke Functional scores, magnetic resonance imaging, or evoked potentials after the initial 20 treatments or after the boosters. HBO is not effective in treating chronic stable MS. PMID- 3520383 TI - Double-blind assessment of potential pergolide-induced cardiotoxicity. AB - Possible pergolide-induced cardiotoxicity has been reported in open trials. Over a 6-month period of observation, we prospectively analyzed ECGs and 24-hour ambulatory ECG in 23 patients with Parkinson's disease who were randomized in a double-blind fashion to pergolide or placebo treatments. Pergolide therapy was associated with a mild and transient bradycardiac effect, but no clinically significant cardiotoxicity. PMID- 3520384 TI - Repetitive intravenous dihydroergotamine as therapy for intractable migraine. AB - For patients with chronic intractable headache, we compared a new treatment and a traditional one. Fifty-five patients (36 dependent on ergotamine, analgesics, diazepam, or corticosteroids) were given IV dihydroergotamine (DHE) and metoclopramide every 8 hours. Fifty-four age- and sex-matched patients (38 drug dependent) were given diazepam intravenously every 8 hours. Forty-nine of the 55 DHE-treated patients became headache-free within 48 hours, and 39 of them sustained benefits in a mean follow-up of 16 months. In contrast, 7 diazepam treated patients became free of headache within 3 to 6 days, and 31 had improved somewhat in 10 days. Repetitive IV DHE helps to terminate cycles of intractable migraine. PMID- 3520385 TI - [Spectral and Doppler analysis of carotid murmurs with an Audiocontrol C-50 A frequency analyser]. PMID- 3520386 TI - [Behavior of indices of systolic output and cardiac flow in the changes in cardiac rate induced by atropine and ventricular pacing. Reliability and usefulness of the Doppler method]. PMID- 3520387 TI - [Correlations between risk factors and atherosclerotic disease of the carotid arteries. Investigation with the Duplex scanner]. PMID- 3520388 TI - Henri Hartmann, lord of the Hotel-Dieu. AB - As assistant to Professor Terrier, Henri Hartmann (1860-1952) completed his surgical training at the Hopital Bichat in Paris, where he was later to become Chief-Surgeon. In 1909 he was appointed Professor of Surgery in the Faculty of Medicine, and in 1914 he became head of the surgical clinic of the Hotel-Dieu in Paris. It was in 1921 that Hartmann proposed the operation that thereafter was to bear his name. He reported on two patients with an obstructive carcinoma of the sigmoid colon, who, after having received a proximal colostomy, underwent resection with closure of the rectal stump as cul de sac. The operative procedure is described in Hartmann's book Chirurgie du rectum, which was published in 1931. Hartmann retired in 1930, greatly respected both in his own country and abroad. PMID- 3520389 TI - [Comparison of intensified traditional insulin therapy and micropump therapy in pregnant women with type 1 diabetes mellitus]. AB - Ten pregnant women, affected by type I diabetes mellitus, observed for the first time during the II-III month of pregnancy, were examined. These patients were divided in two groups at random: group A underwent continuous subcutaneous insulin infusion with micropump CPI 9100 Lilly; group B underwent intensified insulin therapy with three daily doses of MC rapid insulin, two of which associated with MC intermediate insulin. All the patients were able to monitor their own blood glucose levels at home by means of reactive strips and reflectometer. In both the groups the mean glycemic values during fast and two hours after meals, and the eventual presence of urinary keton bodies and hypoglycemic crisis were evaluated during the course of pregnancy: these parameters turned out to be identical in the two groups. The increased need of insulin, the maternal body weight gain, the week and mode of delivery, the neonatal weight and the maternal and fetal complications also turned out to be identical in the two groups. To conclude, a good maternal metabolic control can be obtained either with the intensified conventional insulin therapy of with micropumps, if the patients, being properly instructed, are responsible for the monitoring of their own blood glucose levels at home. PMID- 3520390 TI - [Double-blind study of the bronchodilating action of the aminophylline clenbuterol combination in asthmatic patients]. AB - The results obtained with the administration of aminophylline and clenbuterol either separately or in association, to a group of patients with chronic obstructive bronchopneumopathies are reported. The two drugs had a more or less identical broncho-dilatory effect with the beta 2-stimulant acting earlier but for a shorter time. The simultaneous administration of both drugs gave distinctly better results. PMID- 3520391 TI - [Importance of hyaluronic acid in the modulation of neutrophil migration]. AB - The relationship between JA and phagocyte function has often been reported in the literature. The action of JA may either inhibit or stimulate PMNs function depending on the concentration. On the basis of this experience, the efficacy of JA action, both directly and mediated after incubation was studied. In particular phagocytosis, NBT, superoxide production and chemotaxis were studied in basal conditions and after incubation with hyaluronic acid. In particular chemotaxis was also performed to assay the chemotactic action of the medium in which the monocytes were incubated with JA and the technique was found to produce a distinct progressive improvement in the chemotactic index. In conclusion, it is hypothesised that monocytes incubated with JA produce a chemotactic factor for PMNs. PMID- 3520392 TI - [Subphrenic abscess. Importance of its pathology and ever present diagnostic and therapeutic problems]. AB - Even today subphrenic abscesses constitute a major problem for the surgeons who are at times their involuntary cause. These abscesses are characterised by a high mortality rate and difficulty of treatment. A careful review of the literature and a fortunately modest experience form the basis for an assessment of what has been achieved and what problems still remain with particular reference to new diagnostic and therapeutic techniques. PMID- 3520393 TI - [Isolated thrombosis of the left brachiocephalic venous trunk]. AB - Only Flower (1976) has reported an isolated obstruction of the left brachiocephalic venous trunk following the observation of a unilateral distension of the left superior jugular vein secondary to compression of the homolateral innominate vein during a type I dissecting aneurysm of the aorta. The rarity of the finding is the reason for the report of two cases of isolated thrombosis of the venous trunk in question observed almost simultaneously some 19 months earlier. In both cases it was possible to identify the aetiopathogenic causes as congenital or acquired constriction of the "aortosternal strait" associated with thrombophilic alteration to the blood coagulation system. PMID- 3520394 TI - [Oral contraceptives and diabetes]. AB - Some remarks are presented on the contraceptive treatment of diabetic females with emphasis on the relationship between progestins and estrogenic progestins and the metabolism of carbohydrates and fats, haemostasis and arterial hypertension. Indications for the contraceptive treatment of insulin dependent and non-insulin dependent diabetics and subjects exposed to diabetic risk are supplied. PMID- 3520395 TI - A long ascending pathway of enkephalin-like immunoreactive spinoreticular neurons in the rat. AB - In the present study, we examined whether some long ascending spinal cord neurons contain enkephalin by combining the retrograde transport of the fluorescent dye True Blue with enkephalin immunocytochemistry. Evidence is presented for the existence of enkephalin in a subpopulation of spinoreticular neurons in the rat located in the central canal region and adjacent gray matter. PMID- 3520396 TI - Insulin modulates neuronal plasma membrane development in human fetal spinal cord neurons in culture. AB - The number of intramembrane protein particles (IMP) in the protoplasmic face of the perikaryal plasma membrane was evaluated in neurons from 9 week-old and 12 week-old human fetal spinal cord in culture. An increased number of IMP was observed in membranes from 12 week-old fetal neurons when compared to membranes from 9 week-old fetal neurons. The addition of insulin (100-2500 microU/ml) to the culture media resulted in a significantly increased number of IMP in neuronal membranes. Incubation with glucose (1.5-6 mg/ml) did not modify the number of IMP and glucose did not potentiate the effect of insulin when both glucose (3 mg/ml) and insulin (500 microU/ml) were added to the culture media. The results suggest that insulin may modulate the development of neuronal membranes and that this effect is not mediated by an increased glucose utilization. PMID- 3520397 TI - Origin of the neuropeptide Y innervation of the rat retrohippocampal region. AB - Using the method of retrograde tracing of Fast Blue in combination with immunohistochemistry, the origins of the retrohippocampal neuropeptide Y (NPY) innervation was studied in the rat brain. The findings suggest that two NPY immunoreactive (NPY-i) afferent systems, one intrinsic and the other of extrinsic origin give rise to the massive NPY innervation of the retrohippocampal region, including the entorhinal area (EA). The intrinsic projections originate from multipolar and fusiform cells situated primarily in layers IV through VI of the medial and lateral EA, as well as from a small number of NPY-i basket cells situated in layer II. Other NPY-i afferents originate from cortical neurons with long association projections located in the deep layers of the perirhinal area and in the piriform cortex, as well as from cells situated throughout the rostrocaudal extent of the endopiriform nucleus, in the lateral nucleus of amygdala and in the nucleus locus coeruleus. PMID- 3520398 TI - Distribution of Met-enkephalin immunoreactive fibres in the thalamus of the cat. AB - The Met-enkephalin-like immunoreactivity was studied in the thalamus of the cat using an indirect immunoperoxidase method. The densest network of immunoreactive fibres and terminals was observed in the epithalamus and the intralaminar nuclei, particularly those located along the midline nuclei interanteromedialis, submedius, rhomboidens and reuniens. The nuclei parafascicularis and centrum medianum contained also numerous immunoreactive fibres and terminals, whereas the lamina medullaris externa had a lower density of immunoreactive terminals. Enkephalin fibres were almost totally absent in the lateral nuclei of the thalamus, and in the posterior group only the magnocellular part of the corpus geniculatum mediale contained some immunoreactive fibres. PMID- 3520399 TI - Tone-threshold mapping in the inferior colliculus of the house mouse. AB - The distribution of lowest tone-response thresholds was examined within 3 different isofrequency planes (10, 20 and 30 kHz) of the inferior colliculus (IC) of the house mouse. Lowest thresholds are located in, or slightly rostrolateral to the center of each isofrequency plane. Thresholds increase centrifugally, although in the rostrolateral direction the increase is less marked. The data show that, in addition to the dorsoventrally oriented tonotopical arrangement, there is a horizontal representation of thresholds within each isofrequency plane of the IC. PMID- 3520400 TI - Associate degree nursing programs accredited by the NLN 1985-86. PMID- 3520401 TI - Mitochondrial dysfunction and spinocerebellar degenerations. AB - A simplified classification of the spinocerebellar degenerations is proposed. Axonal ataxias include Friedreich's ataxia and other conditions involving, primarily, neurons with very long axons. Multiple system degenerations include the various olivopontocerebellar atrophies and related disorders. Ataxic encephalopathies are diffuse diseases of the nervous system in which ataxia is a prominent clinical feature. Several lines of data suggest that mitochondrial damage is a common mechanism in the spinocerebellar degenerations. Reasonable pathophysiological mechanisms can be invoked, linking mitochondrial damage to the observed pathologies (including the many cases of intermediate on variant forms). PMID- 3520402 TI - Nutrition classics. The Lancet, Vol. I for 1971: Plasma lipid and lipoprotein pattern in Greenlandic West-Coast Eskimos. By H.O. Bang, J. Dyerberg, Aase Brondum Nielsen. PMID- 3520403 TI - When an insulin-dependent diabetic must be NPO. PMID- 3520404 TI - The assessment of fetal well-being. PMID- 3520405 TI - Microbiology. PMID- 3520406 TI - The history of wound dressings. PMID- 3520407 TI - Autologous and allogeneic bone marrow transplantation. PMID- 3520408 TI - Medicine, adventure, pirates, and castaways. PMID- 3520409 TI - Treatment of acute lymphoid leukemia in children: current regimens and future prospects. PMID- 3520410 TI - Fine needle biopsy of thyroid nodules: avoiding the pitfalls. PMID- 3520411 TI - Maimonides' Medical Writings: volume I. Treatises on poisons, hemorrhoids, cohabitation. PMID- 3520412 TI - Allogeneic bone marrow transplantation at Christchurch 1979-1985. AB - Twelve bone marrow transplants have been carried out at Christchurch since 1979 in five patients with aplastic anaemia and seven with acute leukaemia. Five patients are currently alive at 77, 69, 63, 45, and seven months post-transplant. Acute and chronic graft versus host disease have been major problems and its clinical features and management are described. Long term follow-up data is presented on the four patients currently alive at between three to six years post transplant. The practical problems we have experienced by carrying out bone marrow transplants without special funding have been considerable and the implications of this are discussed. PMID- 3520413 TI - Pulmonary epithelial permeability: vascular background effects on whole lung and regional half-time values. AB - Pulmonary epithelial permeability was first measured by Jones et al. We have adapted their technique for use with a gamma camera. Both regional half-time values and background correction factors vary from apex to base in the lung. Examination of two methods of background correction show: that inter-segmental half-time comparison is possible without applying individual correction factors to regions. the use of a region of interest with similar vascular supply to that of the lung eliminates the need for a background correction technique that relies upon an intravenous injection of radioisotope. The inter-renal area provides such a vascular area. PMID- 3520414 TI - Nonmenstrual toxic shock syndrome. PMID- 3520415 TI - Voiding dysfunction in the adolescent. PMID- 3520416 TI - [Clinical study of the therapeutic efficacy of antiherpes immunoglobulin in ophthalmoherpes]. PMID- 3520417 TI - [Programmed analysis of the chief reason for failures in penetrating keratoplasty]. PMID- 3520418 TI - [Studies of immunologic markers in malignant lymphomas: diagnostic and prognostic relevance]. AB - Immunological markers important for the diagnosis of the following subtypes of Non-Hodgkin lymphomas (NHL) are discussed: lymphocytic lymphomas (i.e.: B-CLL, immunocytic NHL, prolymphocytic- and hairy cell leukemia), NHL derived from follicular center cells (centrocytic, centroblastic/centrocytic and centroblastic NHL), lymphomas with blastoid appearance (various forms of lymphoblastic and "large cell" NHL) and disorders of T lymphocytes (NHL) of peripheral T cells and T gamma lymphocytosis with neutropenia). In these disorders, the patterns of leukocyte surface antigens like T1 (CD5), Tac (CD25), CALLA (CD10), FMC7, Tu1 and Tu33 as well as staining for the terminal transferase (TdT) and of dendritic follicular cells have been examined by investigating specimens of a large group of patients. Apart from the diagnostical value, these evaluations have contributed to a better understanding of normal B cell differentiation whereas the role of marker studies as independent prognostic factors requires additional prognostic studies. Finally, the value of immunoperoxidase or alkaline phosphatase staining of cryostat sections of bone marrow biopsies is emphasized, which allowed the diagnosis and classification of 74% of 92 NHL studied by this technique. PMID- 3520419 TI - [Clinical relevance of immune phenotyping of malignant lymphomas]. AB - The characterization of malignant lymphomas with immunological methods (immunophenotyping) is gaining increasing importance in clinical hematology. Immunophenotyping is not only a basis of modern classifications of non-Hodgkin's lymphomas (e.g. the Kiel classification), it can also be helpful in the differentiation of lymphomas from epithelial or mesenchymal tumors. The immunological identification of subgroups of acute lymphocytic leukemia (c-ALL, T ALL and B-ALL) bears significant meaning for differential therapy. Other applications of immunophenotyping of malignant lymphomas in the near future will be the demonstration of receptors for certain lymphokines (e.g. for therapy with interleukin-2 or tumor-necrosis-factor), the detection of specific cell surface antigens (for immunotherapy with monoclonal antibodies) and the demonstration of immunological markers for resistance to cytotoxic drugs. A general application of immunophenotyping of malignant lymphomas in clinical hematology will depend on a better standardization of the immunological reagents, a simplification of logistic problems and a significant reduction of the costs. PMID- 3520420 TI - [Clinical and prognostic relevance of the Kiel classification of non-Hodgkin lymphomas]. AB - The Kiel classification provides a new subdivision of non-Hodgkin lymphomas into distinct entities showing different clinical and prognostic properties. In comparison with earlier classifications this system defines additional types of lymphoma (e.g. CC lymphoma, LP immunocytoma) (for abbreviations see text) which are to be considered separate entities also from a clinical point of view. By data derived from a multicenter prospective observation study (1,127 patients recruited from 1975 to 1980, follow-up until 1985) a precise definition of the clinical features of each lymphoma entity (e.g. frequency, age and sex distribution, patterns of initial involvement and spread of disease) was possible. In addition, the effect of radio- and/or chemotherapeutic measures was evaluated. Strictly localized disease (stage I/IE according to the Ann Arbor classification) occurred in 1.5 to 8% of patients with NHL of low-grade malignancy (comprising 69.4% of cases studied) and in 8 to 17% of patients with high-grade malignant NHL (comprising 30.2% of cases studied). Loco-regional irradiation alone was able to induce complete remission in 86 to 89% (CB and IB lymphomas) and in 100% (LP immunocytoma, CB-CC and CC lymphomas), respectively, of stage I/IE patients. Only CC and IB lymphomas showed a relevant risk of relapse (40% and 50%, respectively). Total lymphoid irradiation as able to induce stable complete remissions in about 50% of patients with stage III of CB-CC lymphoma. Probabilities of survival of patients with initial stages III and IV treated by several types of chemotherapy reflect different prognostic features of individual lymphoma entities.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3520421 TI - [Treatment strategies in malignant non-Hodgkin lymphomas in childhood]. AB - The prognosis of malignant non-Hodgkin lymphoma (NHL) in childhood has significantly improved due to stage-depending intensity and duration of treatment as well as the use of different therapeutic managements in non-B and B-lymphoma. According to the results of two consecutive BFM-studies (BFM-NHL 75/81, n = 116; BFM 81/83, n = 95) a curative rate of 70% may be reached with an acceptable therapeutic toxicity (under 2% deaths in the BFM-NHL-study 81/83). This result was already achieved in non-B-NHL in the study 75/81 by using an ALL therapy protocol. An improvement in the outcome of B-NHL was only achieved in the study 81/83 by introducing a new therapeutic concept including a combination of other agents and by reducing the duration of treatment to 8 weeks (stage I and II) and to 20 weeks (stage III and IV), respectively. In contrast to the non-B NHL, the prognosis of B-NHL distinctly varies according to the localized (I and II) and disseminated stage (III and IV). The probability of eventfree survival in the localized stage of B-NHL is excellent in both BFM-studies (86-100%). In the disseminated stage of B-NHL the result is not satisfying so far (61% in the study 81/83 vs. 38% in the study 75/81). The relapse cascade in non-B NHL proceeds similar to ALL in childhood. No relapses have been observed within 5 years after diagnosis. Recurrence in B-NHL only occurs within the first year after diagnosis which justifies the reduction of treatment duration. PMID- 3520422 TI - [Leukemia cell analysis in the diagnosis of ALL/AUL: clinical value of currently available methods]. AB - After morphology and cytochemistry, immunological leukemic cell diagnosis became a generally available method by the development of monoclonal antibodies. Besides an otherwise not possible classification of nonmyeloid leukemias according to T- or B-differentiation status, precision and standardization of leukemia diagnosis is accomplished by immunodiagnostic means in an experimental way, an important point for therapy studies. In children, the common ALL--a precursor B-ALL type- was prognostically more favorable than the T-ALL which differs also in clinical appearance and in prognostic factors. In adults, however, T-ALL had a better prognosis than common ALL in a prospective trial. The heterogeneous Null-ALL which makes up 23% of ALL in adults and 5% in children, was the prognostically most unfavorable form besides the rare B-ALL (1-2%), the immunophenotype being an independent prognostic variable. Immunodiagnostic means are therefore of utmost clinical importance compared to other methods such as cytogenetic and electron microscopy that are not performable in a corresponding extent. PMID- 3520423 TI - [Clinical value of various classifications in adults with AML]. AB - 111 adults with acute myeloid leukemia were classified according to the morphological, immunological and cytogenetic features of their leukemic cells. A comparison was made between the clinical parameters on prognosis of these subgroups. Hemoglobin was the only parameter among all six FAB-subgroups to show a statistical significant difference. Other differences found applied to a few subgroups only. Again, immunologically or cytogenetically characterized subgroups did not show significant differences in clinical parameters or prognosis. Patients with pseudodiploid or hyperdiploid karyotype had a lower remission rate than the remainder. However, a cluster analysis in which all three classifications together with the clinical parameters were considered was best able to characterize groups with different prognosis. PMID- 3520424 TI - [Lineage infidelity of leukemia cells]. AB - We phenotyped 548 blast populations from patients with acute de novo leukemia with a panel of 27 monoclonal antibodies and an antiserum against the enzyme terminal deoxynucleotidyl-transferase (TdT). In 56 cases (10,2%) we found a marker profile consisting of both myeloid and lymphoid characteristics (biphenotypic) leukemia = interlineage infidelity). In 49 out of the 56 cases the blast populations were clearly related to the myeloid (n = 41) or the lymphatic (n = 8) system. In those blast populations only one characteristic of the other differentiation could be detected. However, in 7 cases more than one myeloid as well as lymphatic characteristics were found on the same blast cells. In 4 cases (0.7%) the immunological phenotyping indicated the presence of two separate blast populations. The occurrence of a stem cell leukemia, an abnormal derepression of a genome, a defect of the membrane synthesis and the existence of a normal counterpart are taken into consideration as a cause of an "atypical" marker profile. PMID- 3520425 TI - [Risk groups in acute, non-lymphatic leukemia in childhood. Analysis of the results of the cooperative therapeutic studies AML-BFM 78 and 83]. AB - The analysis of the treatment results of the co-operative therapy studies BFM 78 and 83 for the treatment of acute myelogenous leukemia in children revealed the following risk factors: Death before the onset of therapy and early death occurred more frequently in children with acute monoblastic/monocytic leukemia and in children with initial WBC of greater than 100,000/microliters than in the other patient groups. The remission rate was lower in children with an initial WBC greater than 100,000/microliters (56%) than in children with an initial WBC less than 100,000/microliters (86%). In study BFM 78 the probability of a relapse free interval of 6 years is significantly lower in children with an initial WBC greater than 100,000/microliters (pCCR = 28%; SD 11%) than in children with an initial WBC less than 100,000/microliters (pCCR = 64%; SD 10%). The median follow up time is 4 3/4 years (range 2 3/4-6 3/4 years). The probability of an event free interval of 3 years was significantly lower in children with initial involvement of the CNS (pCCR = 24%, SD 12%) than in children without involvement of the CNS (pCCR = 50%; SD 5%). PMID- 3520426 TI - [Acute myeloid leukemia (AML) in adults. Further development of therapy based on clinical phase II and phase III studies]. AB - By a review of relevant clinical studies on adult AML no substantial progress can be seen in the eighties so far. After the development of successful chemotherapy regimens during the seventies, further improvement can only be expected in small steps. Clinical studies, therefore, should concentrate on the analysis of the different components and new elements of treatment in order to utilize and combine them more effectively. For this purpose, a standardization of treatment and, for many aspects, a randomized comparison is inevitable. Thus, the role of monthly maintenance as well as of a special type of immunotherapy could be elucidated for the first time by our multicenter trial. PMID- 3520427 TI - [Initial results of a study of the treatment of children with ALL recurrences]. AB - Ninety-five children and adolescents with their first relapse of ALL were treated in the multicentric prospective trial ALL-REZ BFM 83. Treatment was stratified with respect to time and site of relapse. The overall remission rate was 86.3%. In the group of patients with early relapse only 44/56 children (78.6%) achieved a second remission, whereas the remission rate was 97.4% (38/39) in patients with late relapse. The 2 year probabilities of a sustained second complete remission are 0.65 +/- 0.10, 0.33 +/- 0.09 and 0.71 +/- 0.14 for patients with late, early and isolated CNS relapses, respectively. The poorest prognosis was observed in children with early marrow relapse (0.16 +/- 0.13 after one year). PMID- 3520428 TI - [Morphology, immunohistochemistry and genetics of peripheral T cell lymphomas]. AB - T-cell lymphomas are relatively rare in our material; they comprise less than 20% of all non-Hodgkin's lymphomas. A definitive classification of the T-cell lymphomas still does not exist. Nonetheless, it is now possible to distinguish thymic and prethymic, i.e. lymphoblastic lymphomas, from postthymic, i.e. peripheral T-cell lymphomas. Of the peripheral T-cell lymphomas the following are relatively well defined: chronic lymphocytic leukemia of T type (T-CLL) and prolymphocytic leukemia of T type (T-PLL), mycosis fungoides and Sezary's syndrome, lymphoepithelioid lymphoma (Lennert's lymphoma), T-zone lymphoma T immunoblastic lymphoma, and large cell anaplastic lymphoma (so-called Ki1 lymphoma). Recently, a T-cell lymphoma termed lymphogranulomatosis X (AILD)-type was defined whose chromosomal abnormalities and rearrangement of the beta-chain of the T-cell receptor appear to distinguish it from cases of non-neoplastic lymphogranulomatosis X. Histological and cytochemical criteria enable the identification of many cases of T-cell lymphoma. By contrast, the large number of available monoclonal antibodies can do little more than confirm the T-cell nature and proliferation rate of the tumor cells. DNA rearrangement techniques now make it possible to distinguish between polyclonal and monoclonal T-cell proliferations. Lymphoepithelioid lymphoma, lymphogranulomatosis X and large cell anaplastic lymphoma (Ki1 lymphoma) are treated in detail. The boundary between Hodgkin's disease and peripheral T-cell lymphoma is not as distinct as textbooks would make it appear. PMID- 3520430 TI - Patellectomy. AB - Patellectomy has been controversial for many years. The divergence of clinical and experimental data in the literature makes it difficult to draw definitive conclusions regarding the success of the procedure. This article reviews the available literature and compares the results of patellectomies in young and old patients at The Hospital for Special Surgery. PMID- 3520429 TI - A comparative study between injectable low-temperature (70 degrees C) gutta percha and silver amalgam as a retroseal. AB - This study compared two different dental materials used in endodontic retrosealing procedures. One of these materials was a new low-temperature gutta percha product, manufactured by the Hygenic Corporation, that involved an injection technique. The second of these materials was silver amalgam. Silver amalgam was selected because it has been recognized by many clinicians as the most effective apical sealing material. Two groups of ten recently extracted teeth were endodontically prepared with one of each of the materials being tested, and the effectiveness of these materials as sealants was determined by their ability to inhibit the penetration of methylene blue dye for a predetermined period of time through the apically sealed root tips. Preliminary results obtained indicated that, although these materials were not 100% effective in inhibiting the dye penetration, each was as effective as the other when evaluated by two observers following completion of the study as determined by its experimental design. No significant difference was exhibited between the amalgam group and the gutta-percha group. The leakage of the dye that was observed in each of the groups might have been caused by the ineffectiveness of, or the ineffective use of, the nail polish or cyanoacrylate used to coat all but the apically sealed tips of the endodonticalled prepared teeth. The function of these coating materials was to prevent penetration of the dye through the surface of the body of the root.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3520431 TI - Rheumatoid arthritis of the hand. AB - Rheumatoid arthritis often begins in the hand, and upper extremity function can be seriously impaired with progression of the disease. When numerous areas are involved, a multitude of deformities can arise. Before initiating treatment of an arthritic patient, the surgeon must understand the natural course of the disease process, the response to medical treatment, and the functional limitations the disease has imposed. This article describes the examination for and treatment of this disease. PMID- 3520432 TI - [Rupture of popliteal vessels in traumatic dislocation of the crural bones]. PMID- 3520433 TI - [A method of surgical correction of spastic flexion-adduction contracture of the first finger]. PMID- 3520434 TI - [Military surgery and surgeons of the mobile army surgical unit during World War II 1941-1945]. PMID- 3520436 TI - [Retrospective analysis of the clinical and pathological data of patients with Hodgkin's disease (1975-1983)]. PMID- 3520435 TI - [Clinical characteristics and results in nalorphine therapy of acute cerebrovascular accidents]. PMID- 3520437 TI - [Miliary medicine in the late 17th century (on the tricentennial of the liberation of Buda)]. PMID- 3520438 TI - [Renaissance medicine in Esztergom]. PMID- 3520439 TI - [Aseptic necroses of the carpal bones]. AB - The most frequent aseptic necrosis in the carpal area is Kienbock's disease, followed by necrosis of the scaphoid and capitate. Necrosis of carpal bones are seen after different conditions as chronic traumatism, cerebral palsy, chemotherapy, as well as deficient vascularisation of the carpus. Varietys of the wrist joint anatomy may contribute to development of Kienbock's disease. The natural course of the disease shows progressive necrosis and bone destruction in adults. However the clinical symptomatology may show a higher degree of variation. Prevention of carpal dissociation seems to be important. Early surgery by vascularisation techniques and retention of the necrotic bone are indicated. In stages III and IV with collapsing deformity, resection-interposition arthroplasty using autologous material, or silastic spacers, have proven to be successful. PMID- 3520441 TI - Stimulation and encoding strategies for cochlear prostheses. AB - This article reviews the various stimulation and encoding strategies currently used in hearing prostheses for profoundly deaf individuals. Various designs for implanted electrode arrays, electrode drivers, and systems for transmitting signals are described. The various strategies for encoding acoustic signals for delivery as electrical stimuli to the auditory nerve are reviewed. Finally, applications of these various stimulation and encoding strategies are described using examples from different groups worldwide which have developed their own unique prosthetic devices. PMID- 3520440 TI - An historical review of optometric principles and techniques. AB - Beginning with the seventeenth century, when the main scientific foundations were laid, an account is given of the development of various clinical techniques for the assessment of visual acuity and ametropia. Both subjective and objective methods of refraction, with associated instrumentation, are reviewed. Among the more recent techniques described are meridional refraction, astigmatic decomposition, and photorefraction. In various fields, some little known contributions of particular interest are brought to light. PMID- 3520442 TI - The University of California, San Francisco/Storz cochlear implant program. AB - Using a four-channel implant system with a vocoder-based processor developed at UCSF over an extensive period of research, clinical trials of the UCSF/Storz device were initiated in February 1985 under the sponsorship of Storz Instrument Company. To date, 13 patients have been implanted with the UCSF/Storz device, 10 of whom have been fitted with their external processor and transmitter and have received at least their initial postoperative evaluations. Of these 10 patients, nine are able to use all four channels of their implant system. The device fitting/adjusting process for these patients has been remarkably easy, requiring only approximately 30 to 60 minutes. Patient results have been extremely good, with eight of the 10 patients obtaining some open-set auditory only speech understanding. Without extensive rehabilitation and training, most patients have demonstrated an improvement in speech reception over time. Lip-reading and tracking results indicate that all patients have attained an enhancement of lip reading ability with the use of the device, suggesting that improved general communication skills have been provided for each UCSF/Storz patient. PMID- 3520443 TI - The University of Melbourne/Cochlear Corporation (Nucleus) program. AB - The Nucleus multichannel cochlear prosthesis has been implanted in over 100 patients. Speech discrimination improved greatly in most patients. Overall, the results with this type of implant are very satisfactory. PMID- 3520444 TI - The Chorimac 12. A multichannel intracochlear implant for total deafness. AB - In all of our cases, phonetic discrimination has been obtained without the help of lip-reading. Speech intelligibility is generally better in postlingual deafness that in prelingual deafness. We believe this method, despite the size of the external transmitter, is best for rehabilitation of totally deaf patients. PMID- 3520445 TI - Cochlear implants: overview of safety and effectiveness. The FDA evaluation. AB - Under authority of the Federal Food, Drug, and Cosmetic Act, as amended in 1976, the Food and Drug Administration requires manufactures of new medical devices, such as cochlear implants, to demonstrate the safety and effectiveness of their devices before marketing them. This article describes the FDA review process and the kinds of data the FDA is looking for in premarket approval applications for cochlear implants. It also discusses some of the issues surrounding the premarket approval applications which have already been approved. PMID- 3520446 TI - Immunoprecipitation of malarial acid endopeptidase. AB - Electrophoresis of extracts of schizonts of Plasmodium knowlesi in non dissociating polyacrylamide gels, separates several bands of acid endopeptidase activity. A polyclonal antiserum, produced by immunization with purified merozoites, failed to distinguish between different bands of the parasite enzyme, indicating that they are serologically related. Apart from the loss of one minor peak, extraction in Triton X-100 did not reduce the enzyme's electrophoretic heterogeneity. The antiserum did not react with red cell acid proteases. PMID- 3520447 TI - Analysis of antigen switching rates in Trypanosoma brucei. AB - Previously quoted figures for the frequency of antigen switching in Trypanosoma brucei are based on incorrect assumptions. In order to determine the correct switching frequency, an equation was derived that takes the growth rates of the newly expressed antigen types into consideration as well as the proportion of switched trypanosomes and the number of generations since the population was antigenically homogeneous. When this equation was applied to published in vitro data, variable values were obtained for the switching frequency in clonal populations originally expressing one antigen type. The calculated most likely switching frequencies ranged from 1.4 X 10(-7) to 3.5 X 10(-6). This variation was probably caused by differences in the growth rates of the new antigen types in the population and failure to detect slow growing variants. To overcome these problems, an experimental procedure was developed to analyse the switching frequency in vitro. Trypanosomes were cloned and grown in parallel cultures. After an appropriate number of generations, cells expressing the original antigen type were destroyed and, from the proportion of cultures that contained new antigen types, the switching frequency was calculated. The technique minimized subculturing or other procedures that could distort the results. Although the method was optimized for analysing switching frequency, the values differed between experiments, ranging from 2.2 X 10(-7) to 2.6 X 10(-6) for one variant. Possible causes for the variations in switching frequency are discussed. PMID- 3520448 TI - Vaccinia virus: an expression vector for genes from parasites. PMID- 3520449 TI - [Changes in the individual components of lipid metabolism during dying and resuscitation under experimental therapy conditions]. PMID- 3520450 TI - [Importance of the problem of blood microrheology for pathology]. PMID- 3520451 TI - [Nerve biopotentials of denervated and autografted kidneys in dogs undergoing natural and surgical reinnervation]. PMID- 3520452 TI - [A. M. Chernukh (1916-1982)]. PMID- 3520453 TI - [The phagocyte system: methodological problems]. PMID- 3520454 TI - Pediatric pulmonology in retrospect. PMID- 3520455 TI - Acute respiratory failure in infants and children. PMID- 3520456 TI - Newer concepts of diagnostic imaging. PMID- 3520457 TI - Pediatric ultrasound: an update. PMID- 3520458 TI - Radionuclide imaging in clinical pediatrics. PMID- 3520459 TI - Hypoxic ischemic encephalopathy (asphyxia). AB - This article concerns itself with the effects of HIE on the brain of the full term infant. Several treatment options are available, with phenobarbital being the drug of choice, but the course remains observation and careful monitoring of the at-risk infant. PMID- 3520460 TI - Immunotherapy of neonatal septicemia. AB - This chapter has reviewed the deficiencies in immune defense that place the neonate, particularly the premature infant, at increased risk of invasive bacterial disease. We also have reviewed the literature on the rationale for exchange transfusion, granulocyte transfusion, intravenous immunoglobulin, and fibronectin administration as immunotherapeutic agents in infected infants. There have been no randomized controlled trials of exchange transfusion, immunoglobulin, or fibronectin administration in human infants with infection. Granulocyte transfusion in the infected newborn infant has been studied in a controlled fashion, but the results of clinical trials are conflicting. Thus, all of these interventions appear to need further evaluation. We therefore recommend that in the septic newborn infant with neutropenia and an I/T ratio greater than or equal to 0.8, who fails to demonstrate a favorable response to conventional antibacterial chemotherapy and cardiopulmonary support, the administration of approximately 1 X 10(9) irradiated granulocytes per kg may be beneficial. In the absence of equipment to isolate the granulocytes, a double-volume exchange transfusion with fresh heparinized whole blood will provide a similar quantity of functional phagocytes. PMID- 3520461 TI - Recent instrumentation. PMID- 3520462 TI - Respiratory distress syndrome. AB - Increasing knowledge of the pathophysiology of respiratory distress syndrome has led to improvements in clinical management. Future advances in prevention and therapy, including administration of agents to prevent prematurity or to accelerate lung maturation, provision of surfactant replacement, and new techniques of mechanical ventilation, will further decrease mortality and morbidity. PMID- 3520463 TI - Patent ductus arteriosus in the neonate. AB - Recently there has been a significant reappraisal of the role of PDA in the context of neonatal cardiopulmonary disease. This article reviews surgical intervention, pharmacologic treatment, and assessment of ductal patency in the neonate. PMID- 3520464 TI - Furosemide and vitamin E. Two problem drugs in neonatology. AB - This article focuses on some of the problems encountered with two of the drugs currently given to newborns. PMID- 3520465 TI - Phototherapy in a new light. AB - Visible light phototherapy has been used in the treatment of neonatal jaundice for more than 25 years. This article reviews the current state of knowledge of how phototherapy works and provides a framework for understanding why green may soon become the color of choice for phototherapy lamps. PMID- 3520466 TI - Current concepts in management of obstetric problems for pediatricians. I. Monitoring the high-risk fetus. AB - Modern pediatric/neonatal practice demands an understanding of fetal monitoring. Biochemical techniques have given way to biophysical and ultrasonographic modalities in an attempt to improve both sensitivity and specificity. Simple techniques such as fetal movement counts show promise and are being investigated. PMID- 3520467 TI - Current concepts in management of obstetric problems for pediatricians. II. Modern concepts in the management of multiple gestation. AB - The fetus in a multiple gestation is intrinsically at extreme risk. Modern obstetric management recognizes that cesarean section may lessen the risks associated with labor and delivery. A substantial percentage of cases, however, can safely deliver vaginally. PMID- 3520468 TI - Effects of the thromboxane synthetase inhibitor, dazmegrel (UK 38,485), on pulmonary gas exchange and hemodynamics in neonatal sepsis. AB - Group B streptococcal (GBS) sepsis produces arterial hypoxemia in newborns. In piglets we previously found that hypoxemia develops because of increased ventilation perfusion heterogeneity, and reduced mixed venous pO2 occurring in association with decreased pulmonary blood flow. We hypothesize that increased thromboxane A2 (TxA2) synthesis mediates the immediate alterations in gas exchange found in GBS sepsis. We studied 18 anesthetized, ventilated piglets before, during, and after a 30-min infusion of 2 X 10(9) colony forming units/kg of GBS. Nine piglets were pretreated with 8 mg/kg of dazmegrel (DAZ), a TxA2 synthetase inhibitor, and nine animals received GBS without DAZ pretreatment. Pulmonary and systemic arterial pressures, pulmonary vascular resistance, pulmonary blood flow, respiratory gas tensions, intrapulmonary shunt, and SD of pulmonary blood flow, an index of ventilation perfusion mismatching, were measured. Systemic and pulmonary arterial levels of thromboxane B2 and 6-keto PGF1 alpha were also measured. The sham-treated animals showed the expected rise in pulmonary arterial pressure from 12 +/- 3 to 29 +/- 7 torr, (p less than 0.02). By comparison, the animals pretreated with DAZ did not demonstrate pulmonary arterial hypertension and had a delay in the fall in pulmonary blood flow until 2 h postinfusion. Arterial PO2 did not decline significantly after the GBS infusion in the DAZ-pretreated animals; the untreated animals showed a significant fall in pO2 from baseline. There was no significant change in intrapulmonary shunt or SD of pulmonary blood flow compared to baseline in the DAZ-pretreated animals. The elevation in thromboxane B2 occurring with GBS sepsis did not occur in the DAZ-pretreated animals.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3520469 TI - Comparative effectiveness of amoxicillin and amoxicillin-clavulanate potassium in acute paranasal sinus infections in children: a double-blind, placebo-controlled trial. AB - This study compared the relative effectiveness of two antimicrobial preparations, amoxicillin and amoxicillin-clavulanate potassium (Augmentin), in the treatment of acute maxillary sinusitis in children 2 to 16 years of age. Of 171 children with persistent (ten to 30 days' duration) nasal discharge or daytime cough or both, 136 (80%) had abnormal maxillary sinus radiographs. These children were stratified by age and severity of symptoms and randomly assigned to receive either amoxicillin, amoxicillin-clavulanate potassium, or placebo. After the exclusion of 28 children with throat cultures positive for group A Streptococcus and 15 who did not complete their medication, the remaining 93 children were evaluated: 30 received amoxicillin, 28 received amoxicillin-clavulanate potassium, and 35 received placebo. Clinical assessment was performed at three and ten days. On each occasion, children treated with an antibiotic were more likely to be cured than children receiving placebo (P less than .01 at three days, P less than .05 at ten days). The overall cure rate was 67% for amoxicillin, 64% for amoxicillin-clavulanate potassium, and 43% for placebo. PMID- 3520470 TI - Common bile duct obstruction due to an intraluminal mass of candidiasis in a previously healthy child. AB - A 3 6/12-year-old previously healthy girl had intermittent attacks of abdominal pain following a blunt abdominal trauma. At admission to the hospital, she had jaundice and hepatomegaly. Results of laboratory tests indicated an obstructive pattern, and ultrasonography revealed an intraluminal mass in the distal common bile duct. At surgery, the mass was confirmed as the cause of obstruction, and it was removed. Microscopic analysis indicated that the amorphous material was fungi infested. Growth cultures from bile and feces yielded Candida albicans. Postoperative treatment with T-tube drainage and antimycotic drugs led to an uneventful recovery. Clinical, biochemical, and ultrasonographic follow-up have shown no evidence of recurrence. A possible cause and effect relationship between the trauma and the development of biliary obstruction is suggested. PMID- 3520471 TI - [Role of viral and bacterial infections in children with pseudotuberculosis]. PMID- 3520472 TI - [Comparative clinico-laboratory studies of acute intestinal diseases of Klebsiella and Klebsiella and Proteus etiology in young children]. PMID- 3520473 TI - Rats, fats, and history. PMID- 3520474 TI - Anthracycline antitumour agents. A review of physicochemical, analytical and stability properties. AB - A review of physicochemical and analytical properties of anthracycline antitumour agents is presented. The following subjects are discussed: protolytic equilibria, partition and partition coefficients, self-association, adsorptive properties, metal complexation, spectroscopy and chromatography. Furthermore, the stability of anthracyclines in solutions, in pharmaceutical preparations and in biological media is discussed. PMID- 3520475 TI - Electrical properties of renal collecting duct principal cell epithelium in tissue culture. AB - Whereas collecting duct epithelium in vivo is composed of principal and intercalated cells, we grew a pure principal cell epithelium using a new technique involving tissue culture. These principal cells were derived from collecting duct anlagen of newborn rabbits. We investigated the electrical properties of such epithelia in a newly designed lucite double-chamber with an inner opening of 0.08 cm2. Our observations were: mean transepithelial resistance Rte was 0.83 +/- 0.2 k omega cm2 at 37 degrees C and after preincubation in aldosterone; mean transepithelial potential difference Vte was low and variable under standard conditions and at room temperature but increased to -59.5 +/- 4.4 mV (sign referring to polarity of apical surface) after preincubation in 10(-6) mol/l aldosterone and at 37 degrees C; 10(-6) mol/l amiloride added to the apical perfusion fluid largely abolished this Vte while increasing Rte by 120%; experiments with 5 X 10(-3) mol/l BaCl2 in the apical perfusion fluid failed to change Rte and Vte significantly. This principal cell epithelium therefore has characteristics of a "tight" epithelium with active sodium transport; however, its electrical properties differ from those of the isolated perfused collecting duct segment. PMID- 3520476 TI - Effect of dehydration and rapid rehydration on renal function and on plasma renin and aldosterone levels in the black Bedouin goat. AB - Bedouin goats in the extreme deserts of the Middle East are regularly subjected to severe dehydration and possess a capacity to rapidly rehydrate by drinking large volumes of water. Urine flow, glomerular filtration rate (GFR) and effective renal plasma flow (ERPF) in the fully hydrated animals amounted to 0.74 +/- 0.4 ml X min-1, 76 +/- 29 ml X min-1 and 344 +/- 146 ml X min-1 respectively. In goats that were dehydrated to a loss of about 30% of their initial body weight, urine flow dropped to 24% of the value recorded in the hydrated animals and GFR and ERPF dropped to half their level recorded in the hydrated phase. Na and K+ excretion decreased in the water depleted goats and further decrease was recorded following drinking. Following drinking the urine flow, GFR and ERPF of the recently rehydrated goats dropped to below the rates recorded in the dehydrated animals. During the 3 h of the continuous recording that followed the drinking, all three rates did not exceed the predrinking level. Plasma renin activity amounted to 0.37 +/- 0.32 ng AI X ml-1 X h-1 in the hydrated animals. In dehydrated ones it amounted to 4.8 +/- 2.8 ng AI X ml-1 X h-1 and a further increase was recorded following drinking. Aldosterone in the hydrated goats was 5.5 +/- 4.3 ng% and increased to 13.9 +/- 2.3 ng% in the dehydrated animal and amounted to 20.1 +/- 5.5 ng% 2 h following drinking.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3520477 TI - Autonomic thermoregulation after separation of the preoptic area from the hypothalamus in rats. AB - To clarify the role of the hypothalamic preoptic area in autonomic thermoregulation, the preoptic area (POA) of rats was disconnected from the rest of the brain-stem by bilateral microknife cuts which spared or included the medial forebrain bundle. The animals' metabolic responses to exogenous norepinephrine (0.5 mg/kg, im) were then measured at ambient temperatures of 25 degrees and 15 degrees C. Oxygen uptake and colonic and tail skin temperatures were also measured at ambient temperatures of 34 degrees, 25 degrees, and 15 degrees C. Finally, the febrile response to a challenge with live Salmonella enteritidis was studied. Except for a slightly higher oxygen uptake at all ambient temperatures in the rats in which the medial forebrain bundle was cut, no differences were found in any of the variables studied between the POA disconnected and the sham-operated animals. We conclude, therefore, that the POA is not essential for the integration of autonomic thermoregulatory responses in the rat. PMID- 3520479 TI - Gerontological nursing in graduate education. PMID- 3520478 TI - Calcium and osmotic stimulation in renin release from isolated rat glomeruli. AB - The effects of changes in osmolality and calcium concentration on renin release (RR) from isolated superfused rat glomeruli were studied. The undisturbed RR followed a first order fall with a half-time of about 100 min (n = 45). Changes in the osmolality between 270 and 350 mOsm/kg resulted in dose-dependent changes in the RR rates. Hypoosmotic treatment stimulated the RR transiently, whereas hyperosmotic treatment produced a sustained inhibition. The dose-response relationship was log-linear between 270 and 320 mOsm/kg. A decrease in osmolality of 20 mOsm/kg gave proportional increases in RR irrespectively of the RR rate preceding the stimulus. Removal of calcium stimulated the RR by 10 times (n = 5, p less than 0.001) and a subsequent decrease in osmolality of 20 mOsm/kg stimulated the RR proportionally to that observed in the series containing 2 mM calcium. A decrease in osmolality was able to stimulate RR (n = 5.5, p less than 0.05) even when the calcium concentration in the medium was simultaneously raised from 0 to 2 mM. A hyperosmotic Ringer (+ 300 mOsm/kg), inhibited RR to very low levels. A subsequent removal of external calcium was now unable to stimulate the release (n = 5.5). In a less hyperosmotic Ringer (+ 50 mOsm), the RR was inhibited, but a removal of external calcium now stimulated RR. It is suggested that the osmosensitivity of the RR process reflects a waterflux-driven fusion of secretory granules with the cell membrane, and that calcium affects an intragranular equilibrium between aggregated, osmotically inert granule content and dissolved, osmotically active granule content. PMID- 3520480 TI - [Biophysical approach to cell interaction: role of rheologic parameters]. PMID- 3520481 TI - Studies on the kinetic sequence of in vitro ribosome assembly using cibacron blue F3GA as a general assembly inhibitor. AB - We have found that all E. coli ribosomal proteins strongly bind to an agarose affinity column derivatized with the dye Cibacron Blue F3GA. We have also shown that the capacity to bind the dye is lost when the proteins are organized within the structure of the ribosome or are members of pre-formed protein-RNA complexes. We conclude that the binding of ribosomal proteins to this dye involves specific protein-RNA recognition sites. These observations led us to discover that Cibacron Blue can be used to inhibit in vitro ribosome assembly at any stage of the assembly process. This has allowed us to determine a kinetic order of ribosome assembly. PMID- 3520482 TI - Two RFLPs at the human renin (ren) gene locus. PMID- 3520483 TI - Separation of chromosomal DNA molecules from C.albicans by pulsed field gel electrophoresis. AB - Modifications have been made to standard pulse field gel electrophoresis (PFGE) systems to enable very large DNA molecules to be resolved. The single most important modification was to elevate the temperature of electrophoresis to 35 degrees C. This enabled the largest Saccharomyces cerevisiae chromosome to be reproducibly resolved. More impressively, it enabled the DNA of Candida albicans to be clearly resolved into six bands, a feat which was very difficult at lower temperatures. Even so, optimal resolution could only be obtained by carefully adjusting field voltages and switching times. The DNA from the two largest C. albicans chromosomes, which was estimated to be at least 5-10Mbp in size, ran somewhat anomalously, giving fuzzy bands which did not migrate in the direction of the average electric field. That the highest molecular weight band was a distinct chromosome was demonstrated by specific hybridisation to the C. albicans ADE2 gene probe. With further fine tuning, the PFGE system described here should be capable of resolving DNA from the smallest human chromosomes. PMID- 3520485 TI - The trfB region of broad host range plasmid RK2: the nucleotide sequence reveals incC and key regulatory gene trfB/korA/korD as overlapping genes. AB - We report the nucleotide sequence of the trfB region of broad host range plasmid RK2. This region encodes the following loci: trfB, identical to korA and korD, which encodes a key transcriptional repressor of certain RK2 operons; incC, which appears to be involved in plasmid maintenance, possibley through post transcriptional regulation of trfA product levels; the start of korB, which encodes a second transcriptional repressor of operons involved in stable inheritance of RK2. These loci are expressed as part of the trfB operon. In combination with deletion analysis, transcriptional and translation fusions and 'maxicell' analysis of polypeptides, the DNA sequence allows a number of conclusions to be drawn. First, the korB ORF start codon overlaps the incC ORF stop codon, suggesting the possibility of translational coupling between these two genes. Second, the trfB ORF lies entirely within the first third of the incC ORF using a different phase. Third, the incC ORF appears to contain a second transcriptional start whose function appears to be coupled to translation of the trfB ORF. Analysis of codon usage in the region of overlap between incC and trfB suggests that the incC gene may have evolved before the trfB gene. Determination of the DNA sequence of a mutant in which the product of trfB is rendered defective for transcriptional repression reveals an amino acid alteration within a region of this polypeptide which exhibits homology to the alpha helix-turn alpha helix motif characteristic of many DNA binding proteins, and which is probably responsible for recognition of the trfB operator by this protein. PMID- 3520484 TI - Complete nucleotide sequence of the Escherichia coli recC gene and of the thyA recC intergenic region. AB - The nucleotide sequence of a 6,000 bp region of the E. coli chromosome that includes the 3' end of the coding region for the thyA gene and the entire recC gene has been determined. The proposed coding region for the RecC protein is 3369 nucleotides long, which would encode a polypeptide consisting of 1122 amino acids with a calculated molecular mass of 129 kDa. Mung bean nuclease mapping of a recC specific transcript produced in vivo indicates that transcription of recC is initiated 80 bp upstream of the translational start point. A weak promoter sequence situated 5' to the transcription initiation point has been identified. In the 1953 bp thyA-recC intergenic region there are three open reading frames that would code for polypeptides of molecular mass 30 kDa, 13.5 kDa and 12 kDa, respectively. Although the first and third of these open reading frames are preceded by possible ribosome binding sites, no obvious promoter sequences could be identified. Moreover, transcripts for these reading frames could not be detected. PMID- 3520486 TI - Sequence organization of the circular plasmid pKD1 from the yeast Kluyveromyces drosophilarum. AB - pKD1 is the only circular plasmid known in the genus Kluyveromyces. Nucleotide sequence analysis has revealed that this 4757 base-pairs long plasmid contained three major open reading frames, A, B, and C, and a pair of inverted repeats of 346 base-pairs. The molecule exists in two isomeric forms generated by internal recombination at these repeats. The functional organization of pKD1 genome appears to be quite analogous to that of the 2u plasmid of Saccharomyces cerevisiae. There is however little homology of sequences between these plasmids, except that the gene A has a dispersed but significant homology with the FLP recombinase gene of the 2u plasmid. S.cerevisiae cells can be transformed by derivatives of pKD1 carrying URA3 gene as a selection marker. PMID- 3520487 TI - Structure and gene expression of the E. coli Mn-superoxide dismutase gene. AB - Superoxide dismutase is an enzyme which converts superoxide O2- to hydrogen peroxide. Using a single synthetic oligonucleotide 33mer, we screened the E. coli DNA library and isolated a clone containing the E. coli manganese-superoxide dismutase gene. We determined the DNA sequence. The analysis of the DNA sequence and in vivo as well as in vitro transcription has shown the following. The DNA sequence suggests two possible promoters. However, only one of them seems active during normal aerobic growth. Purified RNA polymerase initiates in vitro transcription from the same promoter. It is not clear whether the second promoter is functional. It is possible that this promoter could be activated under different growth conditions. There is an inverted repeat sequence which could form a stem-loop structure downstream of the translation stop codon TAA of the Mn SOD gene. The results of the analysis of in vivo and in vitro RNA have shown that this is the transcription termination signal. Thus, the Mn-SOD gene constitutes a single gene operon. There is an almost perfect 19 base palindrome at the -35 region. The position and the size of the palindrome suggest that this could be a regulatory site. PMID- 3520488 TI - Fluorine-19 nuclear magnetic resonance study of codon-anticodon interaction in 5 fluorouracil-substituted E. coli transfer RNAs. AB - Codon-anticodon interaction was investigated in fully active 5-fluorouracil substituted E. coli tRNAVal1 (anticodon FAC) by 19F NMR spectroscopy. Binding of the codon GpUpA results in the upfield shift of a 19F resonance at 3.9 ppm in the central region of the 19F NMR spectrum, whereas trinucleotides not complementary to the anticodon have no effect. The same 19F resonance shifts upfield upon formation of an anticodon-anticodon dimer between the 19F-labeled tRNA and E. coli tRNATyr2 (anticodon QUA). These results permit assignment of the peak at 3.9 ppm to the 5-fluorouracil at position 34 in the anticodon of fluorouracil substituted tRNAVal1. The methionine codon ApUpG also causes a sequence-specific upfield shift of a peak in the central part of the 19F NMR spectrum of fluorinated E. coli tRNAMetm. However, ApUpG has no effect on the 19F spectrum of 19F-labeled E. coli tRNAMetf, indicating possible conformational differences between the anticodon loop of initiator and chain-elongating methionine tRNAs. 19F NMR experiments detect no binding of CpGpApA to the complementary FpFpCpG (replaces Tp psi pCpG) in the T-loop of 5-fluorouracil-substituted tRNAVal1, in the presence or absence of codon, suggesting that the tertiary interactions between the T- and D-loops are not disrupted by codon-anticodon interactions. PMID- 3520489 TI - Heterogeneity at the 5' end of the circumsporozoite protein gene of Plasmodium falciparum is due to a previously undescribed repeat sequence. PMID- 3520490 TI - Sequence of a region near the left end of bacteriophage T3 DNA that contains three promoters for the E. coli RNA polymerase. PMID- 3520492 TI - Similarity between oncogenic v-rel protein and regulatory fnr protein. PMID- 3520491 TI - Nucleotide sequence of the tag gene from Escherichia coli. AB - We have determined the complete nucleotide sequence of the tag gene, encoding 3 methyladenine DNA glycosylase I from Escherichia coli. From the nucleotide sequence it is deduced that the tag enzyme consists of 187 amino-acids and has a calculated molecular weight of 21.1 kdaltons. The tag enzyme is unusually rich in cysteine (8 residues) with a cluster of three consecutive cysteines near the C terminal end. The tag coded DNA glycosylase does not show significant sequence homology to the alkA coded glycosylase in spite of that both of these enzymes catalyze the release of free 3-methyladenine from alkylated DNA. PMID- 3520493 TI - Occurrence of nitroso compounds in fungi-contaminated foods: a review. AB - Dimethylnitrosamine (NDMA), diethylnitrosamine (NDEA), methylbenzylnitrosamine, and a new N-nitroso compound, N-3-methylbutyl-N-1-methylacetonylnitrosamine (NMAMBA), were found in cornbread that was inoculated with Fusarium moniliforme and underwent an incubation and the addition of a small amount of NaNO2. The carcinogenicity of NMAMBA was shown by the induction of forestomach carcinomas and liver tumors in mice and rats. Another new nitrosamine, N-2-methylpropyl-N methylacetonyl nitrosamine, was isolated in millet and wheat flour after similar treatment. Some species of fungi not only can reduce nitrates to nitrites but also can increase the amount of secondary amines in the moldy foods and provide favorable conditions for the synthesis of nitrosamines. Some fungi may utilize primary amines to synthesize nitrosamines in appropriate culture mediums. Furthermore, the cornmeal may naturally contain trace amounts of nitrosamines, as detected by a gas chromatography/thermoenergy analyzer. Prolonged feeding of F. moniliforme-inoculated cornbread alone also induced the development of forestomach carcinoma in rats. This indicates the occurrence of potential carcinogens, perhaps certain Fusarium mycotoxins, in the moldy cornbread in addition to the carcinogenic nitrosamines. Another nitroso compound, Roussin red methylester (di-mu-methanethiolatotetranitrosodiiron) was found in pickled vegetables that are eaten daily in the Linxian (China) area. Roussin Red may provide NO-2 ions, which would react readily with secondary amines to form nitrosamines. Possibly this compound is a natural tumor promoter and is able to induce epithelial hyperplasia of the upper digestive tract and forestomach papilloma in treated mice. Also, trace amounts of NDMA, NDEA, and some other nitrosamines were found in the extract of pickled vegetables. PMID- 3520494 TI - Evaluation of four substitutes for asbestos in lining casting rings. PMID- 3520495 TI - Distinguished Member Award (Charles Stebner). PMID- 3520496 TI - [Clinical significance of lysosomal enzymes and their inhibitors in diseases of the respiratory system]. PMID- 3520497 TI - [Selected aspects of metabolic activity of the lungs]. PMID- 3520498 TI - Evaluation of the pharmacodynamic and pharmacokinetic interaction between calcium antagonists and digoxin. AB - Therapeutic uses of calcium antagonists have expanded to include not only ischemic heart disease but arrhythmias, systemic hypertension, congestive heart failure, and various pulmonary and gastrointestinal diseases. Many patients receiving a calcium antagonist concomitantly receive digoxin. Although the potential interaction between these agents has frequently been investigated, literature reports are confusing and inconsistent. We summarized the pharmacodynamics, pharmacokinetics, and mechanisms of interaction to help clinicians evaluate the potential calcium antagonist-digoxin interaction. PMID- 3520500 TI - Complement in neonatal infections: an overview. PMID- 3520499 TI - The role of specific antibody in neonatal bacterial infections: an overview. AB - Neonatal infections caused by GBS are commonly associated with a deficiency of IgG antibody to the type-specific polysaccharide of the infecting organism. The prevalence and importance of human antibody to specific surface proteins, which are very common in clinical GBS strains, are unknown. Type-specific antibody is sufficiently prevalent that immunoglobulin preparations for both intramuscular and intravenous use contain animal-protective, opsonic antibody for many GBS strains. The availability of polysaccharide vaccines suggest that even more potent, "hyperimmune" preparations can be prepared from immunized volunteers. The importance of selective antibody deficiency in K1 E. coli infections of newborns is less clear. Protective, opsonic antibody is more difficult to demonstrate in human serum, but activity has been shown in some IGIV preparations. The specificity of the active antibody and the feasibility of producing hyperimmune IGIV against K1 E. coli are unknown at this time. PMID- 3520501 TI - Intravenous immunoglobulin in the treatment of neonatal sepsis: therapeutic strategies and laboratory studies. AB - IGIV appears to have a promising future in treating and perhaps preventing neonatal bacterial infections. However, all IGIV lots do not contain equal amounts of pathogen-specific IgG with functional opsonic activity. To ensure effective therapy it will be important to inform physicians that the IGIV lots available for use contain functional antibacterial antibody to the responsible pathogens. To optimize therapy IGIV may need to be given early in the infection and doses may need to be repeated if pathogen-specific antibody is rapidly depleted. Further, clinical studies will be necessary to determine if IGIV will be a valuable adjunct to antibiotic therapy in neonatal GBS infections. PMID- 3520502 TI - Intravenous immunoglobulin with high activity against group B streptococci. PMID- 3520503 TI - Intravenous IgG in combination with other modalities in the treatment of neonatal infection. PMID- 3520504 TI - Pharmacokinetics of intravenous immunoglobulin (Sandoglobulin) in neonates. AB - Sandoglobulin administration to neonates was safe at a dose of 500 mg/kg. GBS specific IgG was significantly elevated for 14 days postinfusion. Pharmacokinetic studies suggest a two-compartment model with a redistribution phase and terminal elimination phase. A half-life of 11.3 days for the initial phase and 30.7 days for the terminal phase was observed. Further, studies will be necessary to determine if IGIV therapy will be effective in preventing or treating GBS infections in neonates. PMID- 3520505 TI - Intravenous gamma-globulin in the treatment of neonatal sepsis with special reference to group B streptococci and pharmacokinetics. PMID- 3520506 TI - IgG subclasses and antibodies to group B streptococci in preterm neonates after intravenous infusion of immunoglobulin to the mothers. PMID- 3520507 TI - Potential for intravenous gamma-globulin use in neonatal gram-negative infection: an overview. PMID- 3520508 TI - Anglerfish islets contain NPY immunoreactive nerves and produce the NPY analog aPY. AB - It has recently been demonstrated that aPY, a peptide which has significant homology with neuropeptide Y (NPY) is present in extracts of anglerfish islets. The purpose of this study was to determine whether cells or nerves which contain NPY-like immunoreactivity could be identified in anglerfish islet tissue and whether aPY is synthesized by this tissue. Antisera against bovine pancreatic polypeptide (BPP), NPY and the 200 kd neurofilament polypeptide were used for immunohistochemical analysis of islets. Identical cells were stained by both the NPY and BPP antisera. The NPY and 200 kd neurofilament antisera also labeled nerve fibers in the tissue which were not stained with the BPP antiserum. The nature of the NPY-like peptide synthesized in islet cells was determined by subjecting differentially radioactively labeled Mr 2,500-8,000 peptides from islet extracts to reverse phase HPLC. Labeled aPY was unequivocally identified in the extracts and was labeled appropriately (as predicted from its sequence) with 13 different radioactive amino acids. These results demonstrate that one form of NPY-like peptide synthesized in anglerfish islets is aPY. The form of NPY-like peptide which was immunolocalized in nerves remains to be determined. PMID- 3520509 TI - Use of cryoprotectant to maintain long-term peptide immunoreactivity and tissue morphology. AB - Use of an ethylene glycol based cryoprotectant solution has been found to be effective for the long-term storage of brain tissue either in block form or as freely floating sections prior to immunocytochemical processing. Storage of tissue in the solution at -20 degrees C or 4 degrees C for up to 3 months produced no adverse effects upon tissue morphology, nor was LHRH immunoreactivity diminished or accompanied by elevated non-specific staining. Furthermore, ultrastructural analysis of cryoprotected tissue revealed excellent preservation of cellular morphology. It is anticipated that this method can find use when it is necessary or desirable for the investigator to retain tissue for later immunocytochemical or electron microscopic processing. PMID- 3520510 TI - Localization of urotensin I- and corticotropin-releasing factor-like immunoreactivity in the central nervous system of Catostomus commersoni. AB - The distribution of urotensin I (UI) and corticotropin-releasing factor (CRF) immunoreactive (IR) structures was studied in the central nervous system (CNS) of the white sucker using the peroxidase-antiperoxidase immunocytochemical procedure. The close sequence homology between both peptides resulted in a high degree of crossreactivity. This was resolved by saturating the antisera solutions with heterologous antigens and specificity tests were done by adding excess of homologous peptides. UI immunoreactivity was seen in all of the identifiable caudal spinal cord neurosecretory cells, in their processes projecting to the urophysis, in thin beaded fibres coursing along the spinal cord, in brain stem, hypothalamus, proximal pars distalis and, especially, in the telencephalon. Some IR-UI specific and IR-CRF specific parvocellular neurons were also identified in the caudo-ventral tuberal region and ventral telencephalon. The IR-CRF was mainly present in parvocellular and magnocellular perikarya of the nucleus preopticus and in the preoptic-neurohypophysial pathway. Dense networks of IR-CRF reacting beaded fibres were also located in the lateral and posterior recessus nuclei. In the pituitary, IR-CRF fibre bundles were seen mainly in the neurointermediate lobe and in the rostral pars distalis. The cells of origin of the extraurophyseal system of IR-UI fibres in the sucker CNS have not been identified. The distribution of CRF immunostaining correlates well with the documented knowledge of CNS structures involved in the control of ACTH secretion in the goldfish. The probability of the occurrence of two UI-CRF related molecules, or of two different forms resulting from a common precursor molecule, forming two separate neuronal systems in the sucker CNS seems likely. PMID- 3520512 TI - [Use of Doppler ultrasonography in the evaluation of the changes in cerebral blood flow in patients after stroke]. PMID- 3520511 TI - Role of antidiuretic activity in the inhibition of renin secretion by vasopressin in anesthetized dogs. AB - The nature of the activity of vasopressin which is responsible for the inhibition of renin secretion was studied by comparing the effects of vasopressin (AVP) and analogs of AVP in anesthetized water-loaded dogs. Infusion of AVP (1.0 ng/kg/min) increased mean arterial pressure (MAP) and decreased heart rate (HR) and free water clearance (CH2O). Plasma renin activity (PRA) decreased from 11.9 +/- 4.7 to 3.8 +/- 1.7 ng/ml/3 hr (p less than 0.05). A selective antidiuretic agonist, 1 deamino-8-D-arginine vasopressin (1.0 ng/kg/min), which had no effect on MAP or HR but was effective as AVP in decreasing CH2O, decreased PRA from 13.5 +/- 4.6 to 7.0 +/- 2.9 ng/ml/3 hr (p less than 0.05). Infusion of a selective vasoconstrictor agonist, 2-phenylalanine-8-ornithine oxytocin (1.0 ng/kg/min), increased MAP and decreased HR but did not decrease CH2O or PRA. A vasoconstrictor antagonist, d(CH2)5Tyr(Me)AVP (10 micrograms/kg), completely blocked the MAP and HR responses to AVP but did not block the decrease in CH2O or PRA (5.9 +/- 1.8 to 2.9 +/- 1.6 ng/ml/3 hr) (p less than 0.001). Infusion of the 0.45% saline vehicle had no significant effect on MAP, HR, CH2O or PRA. These results indicate that the inhibition of renin secretion by vasopressin in anesthetized water-loaded dogs is due to its antidiuretic activity. PMID- 3520513 TI - [Effect of naloxone on insulin and glucagon secretion in patients with acute renal failure]. PMID- 3520514 TI - [Carbohydrate tolerance and glucose-stimulated insulin secretion in patients treated with diltiazem]. PMID- 3520515 TI - [Clinical evaluation of the mono-peak porcine and bovine insulin preparations, Maxirapid and Lente]. PMID- 3520516 TI - [Non-enzymatic protein glycosylation and its role in the clinical pathophysiology of diabetes mellitus]. PMID- 3520517 TI - [Prions--a new microbiological and neurological problem]. PMID- 3520518 TI - [On the centenary of the publication of Wladyslaw Krajewski's article "Why are results in our surgical departments worse than those abroad?"]. PMID- 3520519 TI - [Magnesium levels in the serum and erythrocytes measured by atomic absorption spectrophotometry]. PMID- 3520520 TI - [Treatment of a stable form of coronary disease with Adalat retard]. PMID- 3520521 TI - Tachyarrhythmias. Application of new information to clinical management. AB - Currently used approaches to the management of recurrent tachycardias are defined by an understanding of the significance of the clinical presentation and the limitations of presently available laboratory methods. Selection of the appropriate laboratory technique is important and has to be based on an understanding of the goals of antiarrhythmic therapy. A systematic approach to the selection of antiarrhythmic therapy has now been developed. In selected subgroups of patients, no antiarrhythmic therapy is indicated; however, in high risk and severely symptomatic patients, aggressive laboratory investigation utilizing electrophysiologic techniques is clearly warranted and should be employed. PMID- 3520522 TI - Nondrug prescriptions for the depressed adult outpatient. PMID- 3520523 TI - The physician as an enabler of the chemically dependent patient. How to avoid the traps. PMID- 3520524 TI - Multiple sclerosis. Is the mystery beginning to unfold? PMID- 3520525 TI - Management of atrial fibrillation and flutter. A reappraisal of digitalis therapy. PMID- 3520526 TI - Lumbar puncture. Technique, indications, and complications. AB - Lumbar puncture is a safe and simple procedure that can be performed with little risk of major complication if proper technique and indications are followed. As an emergency diagnostic procedure, spinal puncture is indicated when CNS infection is suspected or to establish the diagnosis of subarachnoid hemorrhage when results of cranial computed tomography are normal. The major contraindication is elevated intracranial pressure with evidence of a mass lesion. PMID- 3520527 TI - Sense and nonsense in nutrition. PMID- 3520528 TI - Percutaneous ultrasonic lithotripsy. A simplified treatment for renal stones. PMID- 3520529 TI - Nocardiosis in the community hospital. Report of three cases. AB - Nocardiosis is an infectious disease that occurs in both normal and immunocompromised hosts. In North America, the most common presentation is that of primary subacute pneumonia. In Central and South America, primary cutaneous infections are more common. The diagnosis is often missed because of contamination of cultures and the need to culture specimens for extended periods. Because of this difficulty in diagnosis, the incidence of nocardiosis may actually be higher than what published data reveal. Incision and drainage of abscesses and extended drug therapy (eg, with sulfonamides) are the cornerstones of treatment. PMID- 3520530 TI - Nonmastectomy treatment of breast cancer. Current status of excision plus radiation. AB - Treatment of primary breast cancer with excision of the tumor plus radiation is now an accepted alternative to mastectomy in women who desire breast preservation and have a suitable clinical presentation. Tumor size and location should be carefully considered before applying treatment with this method, the primary consideration being whether the breast will be grossly distorted by excision. Women with large breasts are technically more difficult to treat and often have less satisfactory cosmetic results, but large breast size is not a contraindication to nonmastectomy procedures. A patient of any age can be treated with these procedures, but young women who undergo radiation treatment will have a longer period at risk for any late complications of irradiation. Compulsive attention to surgical and radiotherapeutic detail produces the best results. Careful and close long-term follow-up of these patients is essential because local recurrence is treatable with mastectomy. PMID- 3520531 TI - Assessment and management of the injured abdomen. PMID- 3520533 TI - Fungal infections of the skin. PMID- 3520532 TI - Chlamydial infections in man. PMID- 3520534 TI - [Removable partial dentures and their significance in contemporary prosthetics]. PMID- 3520535 TI - [Cryptococcus neoformans in patients of a Berlin lung clinic--a contribution to the diagnosis and control of Cr. neoformans mycosis]. PMID- 3520536 TI - [Comparison of 3 times weekly versus daily corticosteroid administration in sarcoidosis. A prospective, randomized multicenter study of the Scientific Society for the Therapy of Lung Diseases]. PMID- 3520537 TI - [Pulmonary aspergillosis in a child with septic granulomatosis]. PMID- 3520538 TI - Historical perspectives in preventive medicine. The first rabies vaccination: Rue d'Ulm 100 years ago. PMID- 3520539 TI - [Isolation of thyroglobulin from the bovine thyroid free of endogenous proteolytic activity]. AB - Thyroglobulin was isolated from the cattle thyroid gland by chromatography on Sephadex G-200 and Sepharose 4B. It was found homogeneous according to disc electrophoresis (pH 8.6) and analytical ultracentrifugation. However, gel filtration of thyroglobulin incubated at 37 degrees through Sepharose 6B revealed that it contained proteinases of the serine type. The conditions for the proteinases' inhibition were found. The possibility of obtaining thyroglobulin free of the proteinases by means of affinity chromatography is demonstrated. PMID- 3520540 TI - [Circulating immune complexes and insulin-binding capacity of the serum of diabetics]. AB - In 60 diabetes mellitus patients the circulating immune complexes revealed during sedimentation with polyethylene glycol, were compared with the insulin binding capacity and the levels of free and total insulin. The circulating immune complexes were detected in 15 patients, the frequency of the immune complexes in type I and II diabetes mellitus being the same. The serum insulin binding capacity, the level of total insulin and the ration of total and free insulin were much higher in the patients on a long-term insulin therapy than in those who started to receive insulin and in untreated patents. The insulin binding capacity and the insulin nonspecific binding reflecting the level of antibodies to insulin, did not correlate with the level of the immune complexes. However in type I diabetes mellitus patients the level of bound insulin showed good correlation with the level of the circulating immune complexes. The circulating immune complexes revealed during sedimentation with polyethylene glycol, reflected, in particular, insulin binding to antibodies. PMID- 3520541 TI - [Effect of enkephalins on various mechanisms regulating glycogen concentration in the liver]. AB - Experiments were staged on 97 outbred albino male rats with the body mass of 180 220 g. The administration of a stable leu-enkephalin analog to the animals did not cause significant changes of the glycogen concentration in the liver but prevented its reduction in response to catecholamines and parathyroid hormone. Simultaneously enkephalin reduced the insulin concentration in the blood. Some mechanisms of the enkephalin effect on the hormonal regulation of carbohydrate metabolism are discussed. PMID- 3520542 TI - [Effect of the administration of prednisolone, glucose and insulin during early postnatal ontogenesis on indices of carbohydrate and lipid metabolism in the adult rat]. AB - To clear out the role of early postnatal exposures in the formation of glycemic homeostasis in adult rats receiving pharmacological doses of glucocorticoids, glucose (G) or insulin (I) in the early postnatal period (starting from the 2d 8th day) indices of their carbohydrate-fat metabolism were studied. The results of these exposures were assessed by the content of 11-oxy-corticosteroids, immunoreactive insulin (IRI), glucose (G), urea and free fat acids (FFA), in the blood; by the glucose tolerance test and the animals' resistance to the diabetogenic affect of alloxan. It was shown that in all the experimental series the IRI level in the blood of the adult animals was lowered. The administration of G or glucocorticoids in the early postnatal period resulted in a decrease in the G concentration and an elevation of the FFA level in the blood, time-legged recovery of the G level in the blood up to the initial values in the glucose tolerance test in the adult animals. Glycemic load in the 1st week of the life of newborn rats increased adult animals' tolerance to the diabetogenic effect of alloxan. PMID- 3520543 TI - [Determining cardiac output by rheographic methods in thoracic surgery]. PMID- 3520544 TI - [Limited aspergillosis of the bronchi]. PMID- 3520545 TI - [Role of thoracoscopy in the diagnosis and treatment of diseases of the lungs and pleura]. PMID- 3520546 TI - [Differential diagnosis of exudative pleuritis in patients with giant follicular lymphoblastoma]. PMID- 3520547 TI - [Action of antitubercular preparations on proteinase biosynthesis in the glandular system of the digestive organs]. PMID- 3520548 TI - [Bacteriological and serological research on patients with destructive pulmonary tuberculosis complicated by a nonspecific infection]. PMID- 3520549 TI - The DNA loop model for ara repression: AraC protein occupies the proposed loop sites in vivo and repression-negative mutations lie in these same sites. AB - Two sets of experiments have been performed to test the DNA loop model of repression of the araBAD operon of Escherichia coli. First, dimethyl sulfate methylation protection measurements on normally growing cells show that the AraC regulatory protein occupies the araI site in the presence and absence of the inducer arabinose. Similarly, the araO2 site is shown to be occupied by AraC protein in the presence and absence of arabinose; however, its occupancy by AraC is greatly reduced when araI and adjacent sequences are deleted. Thus, AraC protein binds to araO2 cooperatively with some other component of the ara system located at least 60 base pairs away. Second, the mutational analysis presented here shows that the DNA components required for repression of araBAD are araI, araO2, and perhaps the araBAD operon RNA polymerase binding site. PMID- 3520550 TI - Insulin binding and insulin action in cultured fibroblasts: significant differences between a phosphoglucose isomerase-deficient mutant and the parental strain. AB - The interrelationships of hexose feeding and insulin action were studied in the Chinese hamster fibroblast cell lines 023 and DS-7. The latter, derived from 023 and deficient in phosphoglucose isomerase, has been used to map the metabolic requirements for aldohexose-mediated down-regulation or "curbing" of hexose transport. We have characterized insulin binding and the response to insulin in both cell lines to determine if the insulin-mediated stimulation of transport is similarly dependent on hexose metabolism. DS-7 cells exhibited 5-6 times as many high-affinity insulin binding sites as the parental strain. Apart from this difference, 023 and DS-7 cells showed comparable insulin binding characteristics, which are similar to those observed in other cell types. Insulin at a concentration of 1 microgram/ml (167 nM) was found to stimulate 3-O-methylglucose uptake by approximately equal to 50% in glucose-fed cells of both lines. In neither line did glucose starving significantly alter insulin binding or the insulin-induced stimulation of transport. Feeding with mannose or fructose was found to increase both parameters in 023 cells but had no effect on DS-7 cells. The increase in hexose uptake with the administration of insulin or with glucose starving was shown to be due to an increase in Vmax. Our studies suggest that insulin binding and effect are not regulated by hexose metabolism in the same manner as in the curbing process and insulin induces the recruitment of a transporter pool that is insensitive to hexose curbing. PMID- 3520551 TI - Cellular myc (c-myc) in fish (rainbow trout): its relationship to other vertebrate myc genes and to the transforming genes of the MC29 family of viruses. AB - We have isolated, cloned, and sequenced the rainbow trout (Salmo gairdneri) c-myc gene. The presumptive coding region of the trout c-myc gene shows extensive homology to the c-myc genes of chicken, mouse, and human. Comparison of nucleotide sequences reveals that human, mouse, chicken, and trout c-myc genes contain at least two coding exons, interrupted by introns of decreasing size of 1.38 kilobases (kb), 1.2 kb, 0.97 kb, and 0.33 kb, respectively. The exons are clearly delineated by donor-acceptor splice signals. The degree of nucleotide homology between trout, chicken, and human exon II is less than that observed for exon III. However, the greatest homology among these three genes is localized to two specific regions within exon II (myc boxes A and B). At the predicted amino acid level, fish c-myc shows considerable homology to vertebrate c-myc gene products. Trout c-myc is expressed in normal trout cells as a single 2.3-kb mRNA species, similar in size to other vertebrate transcripts. PMID- 3520552 TI - Identification of a telomere-binding activity from yeast. AB - In yeast, the ends of the chromosomes (telomeres) terminate in repeated poly(C1 3A) sequences. We have identified a yeast activity that binds specifically to these poly(C1-3A) repeats. An agarose gel binding assay was used to detect and characterize this activity in cell extracts using both cloned telomere DNA and yeast genomic DNA as substrates. The activity appears to bind specifically to poly(C1-3A) sequences, despite their different primary sequences, yet does not bind specifically to telomeric repeats, such as poly(C4A2), poly(C4A4), and poly (C1-8T) from other lower eukaryotes. PMID- 3520553 TI - Site-directed mutagenesis and the role of the oxyanion hole in subtilisin. AB - Oligonucleotide-directed mutagenesis was used to investigate the nature of transition state stabilization in the catalytic mechanism of the serine protease, subtilisin BPN'. The gene for this extracellular enzyme from Bacillus amyloliquefaciens has been cloned and expressed in Bacillus subtilis. In the transition state complex, the carbonyl group of the peptide bond to be hydrolyzed is believed to adopt a tetrahedral configuration rather than the ground-state planar configuration. Crystallographic studies suggest that stabilization of this activated complex is accomplished in part through the donation of a hydrogen bond from the amide side group of Asn-155 to the carbonyl oxygen of the peptide substrate. To specifically test this hypothesis, leucine was introduced at position 155. Leucine is isosteric with asparagine but is incapable of donating a hydrogen bond to the tetrahedral intermediate. The Leu-155 variant was found to have an unaltered Km but a greatly reduced catalytic rate constant, kcat, (factor of 200-300 smaller) when assayed with a peptide substrate. These kinetic results are consistent with the Asn-155 mediating stabilization of the activated complex and lend further experimental support for the transition-state stabilization hypothesis of enzyme catalysis. PMID- 3520555 TI - Toward computer-aided site-directed mutagenesis of enzymes. AB - A preliminary attempt to simulate the observed effect of a site-directed mutagenesis of rat trypsin gives encouraging results. The calculations reproduce in a semiquantitative way the observed change in the activation barrier of the rate-limiting step of amide hydrolysis. This result, which did not require any adjustable parameters, indicates that our method may provide a reliable basis for computer-aided enzyme design. In addition to the potentially practical value of the calculations, they provide important mechanistic information--that is, the change in the catalytic effect in trypsin appears to be almost exclusively due to the change in the electrostatic stabilization of the ionic configurations. This supports the view that electrostatic effects are the major factor in enzyme catalysis. PMID- 3520554 TI - Adipocyte P2 gene: developmental expression and homology of 5'-flanking sequences among fat cell-specific genes. AB - We have isolated the mouse gene encoding adipocyte P2, aP2, the differentiation dependent adipocyte protein homologous to myelin P2. The aP2 gene is present in a single copy in the mouse and is present in single or few copies in species from human to Drosophila. The entire gene spans 4 kilobases and consists of four exons encoding 25, 57, 34, and 16 amino acids; the overall exon structure is similar to the gene encoding liver fatty acid binding protein. A plasmid vector was constructed containing the entire aP2 gene with flanking sequences, modified by linker insertion. When this gene is stably introduced into 3T3-F442A cells, it is expressed only upon adipose differentiation, with a time course of induction very similar to that of the endogenous aP2 gene. We have compared the DNA sequence of the 5'-flanking region of the aP2 gene to the promoter regions of two other genes activated during adipocyte differentiation, glycerol-3-phosphate dehydrogenase and adipsin, and find a 13-base region of homology (Formula: see text) present in multiple copies in the 5'-flanking region of each gene. An adjacent 15-base sequence is present only in glycerol-3-phosphate dehydrogenase and aP2 genes. Both of these elements share homology with putative viral enhancer core sequences. These results indicate that the aP2 gene contains sequence information necessary for differentiation-dependent expression in fat cells; common elements shared by adipocyte-specific genes may play a role in this process. PMID- 3520556 TI - High content of creatine kinase in chicken retina: compartmentalized localization of creatine kinase isoenzymes in photoreceptor cells. AB - Two isoforms of creatine kinase (CK; ATP:creatine N-phosphotransferase, E.C. 2.7.3.2), brain type (BB-CK) and mitochondrial type (MiMi-CK), but not the muscle types (MM- or hybrid MB-CK), were identified by cellulose polyacetate electrophoresis and immunoblots in retina from adult chickens. Indirect immunofluorescence labeling of cryosections of retinas revealed high concentrations of BB-CK in both rod and cone photoreceptor cells. Most of the fluorescence staining with anti-B-CK antibodies was found within the myoid and the ellipsoid portions of inner segments and the peripheral region of the outer segments. Significant staining with anti-B-CK antibodies was also found in horizontal cells and in the optical nerve fibers, with additional stratified staining in the inner plexiform layer. MiMi-CK was solely demonstrated in the ellipsoid portion of the photoreceptor cells. The presence of high concentrations of compartmentalized CK isoenzymes within photoreceptor cells (approximately equal to 30 enzyme units/mg) as well as the relatively high concentration of total creatine in these cells (approximately equal to 10-15 mM) indicates an important physiological function for CK and phosphocreatine in the energy transduction of vision. PMID- 3520557 TI - A yeast mutant lacking mitochondrial manganese-superoxide dismutase is hypersensitive to oxygen. AB - The nuclear gene for manganese-containing superoxide dismutase (MnSOD; superoxide:superoxide oxidoreductase, EC 1.15.1.1) of yeast mitochondria was mapped on chromosome VIII and inactivated by gene disruption. The resulting mutant lacked any protein cross-reacting with anti-MnSOD antibodies, and its mitochondria exhibited less than 1% of the cyanide-insensitive superoxide dismutase activity found in mitochondria of the wild-type parent strain. In the absence of oxygen, the mutant grew as rapidly as the wild-type parent. However, increasing concentrations of oxygen led to a progressive inhibition of growth. The properties of this mutant provide direct evidence that MnSOD contributes to the natural protection of cells against oxygen toxicity. PMID- 3520558 TI - Developmental origins of skeletal muscle fibers: clonal analysis of myogenic cell lineages based on expression of fast and slow myosin heavy chains. AB - A clonal analysis was used to show that skeletal muscle myoblasts are committed to distinct cell lineages during development. Myoblasts taken from embryonic chicken hindlimb muscles of different ages were cultured at clonal density. The content of fast and slow classes of the myosin heavy chain isoforms in the myotubes of the resulting muscle colonies was determined immunocytochemically with specific monoclonal antibodies that served as markers for the different fiber types. The muscle colonies formed by cloning myoblasts from early hindlimbs (days 4-6 in ovo) were of three types: the most numerous type, in which all myotubes in a colony contained only the fast class of myosin heavy chain; a less numerous type, in which all myotubes in a colony contained both the fast and slow classes of myosin heavy chain isoforms; and a rare type, in which all myotubes in a colony contained only the slow class of myosin heavy chain. The muscle colonies formed by cloning myoblasts from later hindlimbs (days 10-12 in ovo) were, however, all of one type, in which every myotube in a colony contained only fast myosin heavy chain. Thus, myoblasts in the early embryo (days 4-6 in ovo) were a heterogeneous population committed to three myogenic lineages: fast, mixed fast/slow, and slow, whereas myoblasts from the later embryo (days 10-12 in ovo) were only in the fast myogenic lineage. These results suggest that muscle fiber formation is rooted in two developmental phases--an early phase in which diverse fiber types are formed from intrinsically diverse populations of myoblasts and a later phase in which fibers are formed from a single population of myoblasts. PMID- 3520559 TI - Expression of the vitellogenin gene in female and male sea urchin. AB - Expression of vitellogenin, the yolk protein precursor, is strictly regulated during development. In previous studies on a variety of organisms, vitellogenin gene expression has been shown to be restricted to one or two tissues in adult female animals. In this report we show that, in contrast, sea urchin vitellogenin is synthesized in both females and males. To identify sea urchin vitellogenin, we raised antibodies specific for the major yolk protein. We show here that a 155 kDa polypeptide, immunoprecipitable by the antibody to the major yolk protein, is synthesized in the intestines of female and male sea urchins and also in ovaries and testes. This 155-kDa polypeptide is converted to a 195-kDa vitellogenin in each of these tissues; further modification to yield the 180-kDa major yolk protein occurs only in the ovary. We have also identified a vitellogenin cDNA clone and used it to study vitellogenin mRNA production. An abundant 5.1-kilobase mRNA was found in the tissues containing vitellogenin. Our results suggest that vitellogenin may serve the following two functions in sea urchins: its classical role as a yolk protein precursor and an unidentified function required by adults of both sexes. PMID- 3520561 TI - Purification, characterization, and antitumor activity of nonrecombinant mouse tumor necrosis factor. AB - Mouse tumor necrosis factor (TNF) was purified from serum through a series of steps, and each step was monitored for L-cell cytotoxicity in vitro and tumor necrotizing activity in vivo. The two activities copurified and could not be dissociated. Purified mouse TNF has a specific activity of 2.2 X 10(7) (L-cell assay in the absence of actinomycin D) and 1 microgram causes necrosis of the standard TNF-sensitive sarcoma Meth A. TNF has a Mr of 39,000 +/- 2000 by gel filtration and a Mr of 16,000-18,000 by NaDodSO4/PAGE. Both molecular weight forms display cytotoxic and necrotizing activities. TNF has a pI of 3.9 and is destroyed by trypsin, protease, elastase, and alpha-chymotrypsin but not by neuraminidase or papain. These characteristics of nonrecombinant mouse TNF clearly resemble those of recombinant human and mouse TNF. PMID- 3520560 TI - Actively transcribed genes in the raf oncogene group, located on the X chromosome in mouse and human. AB - Murine and human cDNAs, related to but distinct from c-raf-1, have been isolated and designated mA-raf and hA-raf, respectively. The mA-raf and hA-raf cDNAs detect the same murine and human fragments in Southern blots of restriction enzyme-cleaved murine and human cellular DNA. The murine restriction enzyme fragments homologous to mA-raf cDNA cosegregate with mouse chromosome X in a panel of Chinese hamster-mouse hybrid cells, thus localizing the mA-raf locus to mouse chromosome X. Two independently segregating loci, detected by the hA-raf cDNA (or mA-raf cDNA), hA-raf-1 and hA-raf-2, are located on human chromosomes X and 7, respectively. The mA-raf locus and the hA-raf-1 locus are actively transcribed in several mouse and human cell lines. PMID- 3520562 TI - Antibodies of predetermined specificity to the major charged species of human interleukin 1. AB - The development of highly specific antisera to human interleukin 1 (IL-1) has been an elusive goal hampered mainly by the availability of only limited amounts of pure immunogen. To surmount this difficulty, three peptides of the major charged species of IL-1 (pI 6.8) were synthesized and covalently coupled to keyhole limpet hemocyanin (KLH). All three peptide-KLH conjugates raised rabbit heterologous antisera that bound intact pure IL-1 in a dose-dependent and domain specific manner. Immunoblot analysis of crude concentrated culture supernatants with these antisera showed each of them to be highly specific for mature 18-kDa IL-1. Immunoblot analysis of monocyte lysates revealed a single 33-kDa band consistent with the size of the IL-1 precursor molecule deduced from cloned cDNA. These reagents should prove to be valuable tools in the localization and measurement of IL-1 in cells and fluids and may permit the separate study of individual IL-1 species as well as discrete domains of intact IL-1 molecules. PMID- 3520563 TI - Demonstration of clonable alloreactive host T cells in a primate model for bone marrow transplantation. AB - The phenomenon of marrow rejection following supralethal radiochemotherapy was explained in the past mainly by non-T-cell mechanisms known to be resistant to high-dose irradiation. In the present study a low but significant number of radiochemoresistant-clonable T cells was found in the peripheral blood and spleen of Rhesus monkeys following the cytoreductive protocol used for treatment of leukemia patients prior to bone marrow transplantation. More than 95% of the clonable cells are concentrated in the spleen 5 days after transplant. The cells possess immune memory as demonstrated by the generation of alloreactive-specific cytotoxicity. The present findings suggest that host-versus-graft activity may be mediated by alloreactive T cells. It is hoped that elimination of such cells prior to bone marrow transplantation will increase the engraftment rate of HLA nonidentical marrow in leukemia patients. PMID- 3520564 TI - Purification and properties of the mini-F plasmid-encoded E protein needed for autonomous replication control of the plasmid. AB - Mini-F plasmid encodes a protein, E protein, that is indispensable for its autonomous replication. We have constructed a plasmid that overproduces the E protein and have purified the protein to apparent homogeneity. Using nitrocellulose filter binding and nuclease digestion assays, we demonstrated that the E protein binds to three unique regions of the mini-F DNA sequence: the replication origin (ori2) and an incompatibility locus (incB), another incompatibility locus (incC), and the promoter for the E gene. These binding sites have a common 8-base-pair sequence. These findings suggest the direct role of the E protein in initiation of mini-F replication and copy number control. They are also in line with the in vivo evidence that the incompatibility phenotype caused by incB and incC DNA is due to titration of a factor(s) indispensable for replication and that the production of the E initiator protein of the mini-F plasmid is under autoregulatory control. PMID- 3520565 TI - Characterization of human prorenin expressed in mammalian cells from cloned cDNA. AB - Human preprorenin was synthesized in Chinese hamster ovary (CHO) cells transfected with an expression vector containing renin cDNA sequences. These cells secrete an inactive form of renin (EC 3.4.23.15) that can be activated by trypsin. This inactive renin is precipitable by antibody generated against purified human renal renin and also by antisera generated to a synthetic peptide derived from the amino acid sequence of the pro segment of preprorenin (anti propeptide), indicating that the secreted inactive enzyme is a form of prorenin. Analysis of [35S]methionine-labeled proteins immunoprecipitated from CHO cell conditioned culture medium indicates that prorenin is expressed in CHO cells as two distinct forms that differ in their degree of glycosylation. In vitro trypsin activation of prorenin cleaves approximately 4.5 kDa from the protein, rendering it unreactive with the antipropeptide antiserum but still recognizable by anti renal renin antibody. These results show directly that the prorenin expressed by CHO cells is an inactive enzyme that is activated by trypsin cleavage of the pro segment. The ability to express human renin in this form will allow for the purification of both active and inactive forms of the enzyme in quantities sufficient for detailed physiological and structural studies. PMID- 3520566 TI - Translational regulation is responsible for growth-rate-dependent and stringent control of the synthesis of ribosomal proteins L11 and L1 in Escherichia coli. AB - The physiological importance of translational regulation in controlling the synthesis of ribosomal proteins from the L11 ribosomal protein operon was determined for the classical regulatory phenomena of growth rate dependence and stringent control. Translational regulation of the L11 operon by ribosomal protein L1, the L11 operon-specific translational repressor protein, was abolished by introducing a chromosomal mutation that causes an alteration of the site where L1 interacts with L11 operon mRNA. It was found that abolishing translational regulation of the L11 operon also abolished growth-rate-dependent regulation and stringent control of the L11 operon ribosomal proteins without affecting the normal regulation of ribosomal proteins from other operons that are not regulated by L1. These results show that both growth-rate-dependent control and stringent control of ribosomal protein synthesis in the L11 operon are a direct result of translational regulation. PMID- 3520567 TI - lac Repressor blocks transcribing RNA polymerase and terminates transcription. AB - Operator sequences are essential elements in many negatively controlled operons. By binding repressors, they prevent the formation of active complexes between RNA polymerase and promoters. Here we show that the Escherichia coli lac operator repressor complex also efficiently interrupts ongoing transcription. This observation suggests a mechanism of action for operators located distal to promoter sequences. PMID- 3520568 TI - Carbon source regulation of RAS1 expression in Saccharomyces cerevisiae and the phenotypes of ras2- cells. AB - Transcriptional analysis of the yeast RAS genes in different culture conditions suggests that the inability of ras2 mutants to grow in nonfermentable carbon sources results from the regulation of RAS1 mRNA expression. The amount of RAS1 mRNA is significantly repressed in cultures grown on the nonfermentable carbon sources ethanol and acetate. As a result, low RAS function should be expressed under these conditions in a ras2 mutant. This can explain the inability of ras2- cells to grow on nonfermentable carbon sources. This interpretation is supported by the finding that an extragenic suppressor of ras2- (sra6-15), which restores growth on ethanol or acetate, also leads to an increase in the amount of RAS1 mRNA under these conditions. The sra6-15 mutation does not alter the level of RAS1 mRNA in cells grown on glucose. The pattern of transcriptional regulation described for the RAS1 gene is not shared by RAS2, indicating differential control of the functionally homologous yeast RAS genes at the level of gene expression. PMID- 3520569 TI - Secretion of beta-lactamase into the periplasm of Escherichia coli: evidence for a distinct release step associated with a conformational change. AB - The secretion of beta-lactamase (EC 3.5.2.6) into the periplasm of Escherichia coli has been followed by pulse-chase labeling at 15 degrees C. Though the periplasmic fraction contains only the mature form of the enzyme, the spheroplast fraction contains the completed precursor and a hitherto undocumented processed form. When whole spheroplasts are treated with trypsin, the processed form in this fraction is completely digested. This is in contrast to the native mature enzyme localized in the periplasm, which is trypsin resistant. The beta-lactamase is evidently processed after translocation to a trypsin-sensitive form that is transiently bound to the periplasmic face of the inner membrane. The release of this processed form into the periplasm occurs concomitantly with a conformational change that results in the soluble, catalytically active, trypsin-resistant structure. PMID- 3520570 TI - Expression of cellular oncogenes in primary cells from human acute leukemias. AB - The structure and the expression of 11 cellular oncogenes (protooncogenes) were analyzed in primary cells from 20 acute lymphocytic (ALL) and 31 acute myelogenous (AML) leukemia patients. Neoplastic cells, obtained prior to initiation of therapy, were purified and classified, on the basis of both surface antigen pattern and morphology, into pre-B, B, and T ALL and M1-M5 AML. RNA was extracted and analyzed for expression of cellular oncogenes coding for nuclear proteins (c-myc, c-myb, c-fos), the beta-chain of platelet-derived growth factor (c-sis), growth factor receptors or related proteins (c-src, c-abl, c-fes, c erbB), or putative intermediate transducers of mitogenic signals (c-Ha-ras, c-Ki ras, c-N-ras). Quantitative analysis of total RNA was carried out by dot blot hybridization to specific cDNA or genomic probes. Number and size of transcripts were evaluated by blot hybridization of electrophoretically fractionated poly(A)+ RNA. Expression of c-myc and c-myb was detected in all leukemic cells at variable levels and was characterized by well-defined patterns within ALL subtypes. Conversely, significant levels of c-fos transcripts were detected only in myelomonocytic (M4) and monocytic (M5) leukemias. Among the "src-family," c-fes was expressed more in AML than ALL, and c-abl was expressed at variable but not elevated levels in all leukemia types. c-Ha-ras was uniformly expressed at low levels, as in non-neoplastic cells. c-Ki-ras transcription was detected only in T ALL; N-ras expression was barely demonstrable. The structure of these protooncogenes was not grossly modified, as evaluated by Southern analysis, except for c-myc rearrangement in B ALL. These studies indicate that cellular oncogene expression in specific subtypes of leukemic cells may relate to either the proliferative activity (c-myc, c-myb) or the differentiation state (c-fos) of the cells, or possibly to expression of receptors for putative hemopoiesis related growth factors (c-fes, c-abl). Our data provide a basis for in-depth analysis of protooncogene expression in normal and neoplastic hemopoiesis. PMID- 3520572 TI - In vitro L-A double-stranded RNA synthesis in virus-like particles from Saccharomyces cerevisiae. AB - Most strains of Saccharomyces cerevisiae harbor L-A double-stranded RNA (dsRNA), 4.5 kilobases long, contained in virus-like particles (VLPs). These L-A VLPs can be separated by CsCl density gradient centrifugation into a main peak of particles, containing full-length L-A dsRNA, which synthesizes only plus-strand single-stranded RNA (ssRNA), and a lighter fraction of VLPs, containing plus strand ssRNA, which has L-A dsRNA-synthesizing activity. This dsRNA-synthesizing activity was present in particles from logarithmically growing cells but not from stationary-phase cells. The newly synthesized strand of dsRNA in the lightest particles was full-length minus strand. All or almost all of the new minus strand was synthesized in vitro, and the rate of chain elongation was approximately 100 nucleotides per minute. The lightest particles synthesized plus-strand ssRNA only after completion of dsRNA synthesis, indicating that the same particle contains dsRNA- and ssRNA-synthesizing enzyme(s). We also observed dsRNA-synthesizing activity in L-BC dsRNA-containing particles similar to that in L-A VLPs. PMID- 3520571 TI - Host participation in plasmid maintenance: dependence upon dnaA of replicons derived from P1 and F. AB - Nonparticipation of the bacterial dnaA gene in plasmid replication has been assumed to be the general rule. In conditional dnaA mutants of Escherichia coli, only plasmid pSC101 has been shown to have a dnaA requirement. Experiments with dnaA null mutants of E. coli, presented here, show that dnaA plays a critical and direct role in the replication of miniplasmids derived from P1 and F as it does in the initiation of bacterial replication. Evidence is also presented for the existence of a dnaA-independent secondary replicon of P1 that is able to drive bacterial chromosome replication but is inadequate to support the maintenance of P1 as a plasmid in E. coli. PMID- 3520573 TI - Keratinocyte-derived T-cell growth factor: a T-cell growth factor functionally distinct from interleukin 2. AB - T-cell growth factor, more recently termed interleukin 2 (IL-2), is the product of activated T lymphocytes and is considered the principal trophic factor for T lymphocytes. The activity of IL-2 preparations is assessed by the degree to which they support the growth of various IL-2-dependent cell lines. We report that murine epidermal epithelial cells (keratinocytes) produce and release a factor that supports the growth of the helper-T-cell-derived, IL-2-dependent cell line HT-2. This substance, keratinocyte-derived T-cell growth factor (KTGF), does not support the growth of an IL-2-dependent cell line derived from cytotoxic T cells (line CTLL-2). This differential effect on IL-2-dependent cell lines is unique to KTGF. KTGF has an apparent molecular weight of 25,000-35,000 and has properties similar to those of conventional IL-2 by reversed-phase and gel-filtration HPLC analysis. However, even highly purified KTGF fails to stimulate the proliferation of CTLL-2 cells. The observation that epidermal epithelium produces a trophic factor for T lymphocytes may help explain the basis for preferential proliferation of T cells in the microenvironment of skin in certain dermatologic disorders. Further, it suggests that different IL-2-dependent T-cell lines may have distinct growth requirements and that non-lymphocyte cell types may produce factors capable of maintaining the growth of T cells. PMID- 3520574 TI - Two types of human mast cells that have distinct neutral protease compositions. AB - Two human mast cell types were identified by immunohistochemical techniques in skin, lung, and small intestine. One type contains the neutral proteases, tryptase and chymotryptic proteinase, and is termed the TC mast cell. The second type contains only tryptase and is termed the T mast cell. Both types are fixed better by Carnoy's fluid than by formalin. The percentage of mast cells accounted for by the T type was 12 in skin; 98 in mucosa and 13 in submucosa of small intestine; and 77 in bronchial/bronchiolar subepithelium, about 97 in bronchial/bronchiolar epithelium, and 93 in alveoli of lung. Dispersed lung cells contained 90% T mast cells. The mean area of TC mast cells (76 micron2) was slightly larger than that of T mast cells (66 micron2); however, there was such extensive overlap that individual mast cells belonging to different types could not be distinguished on the basis of size. The recognition of human mast cell types with distinct protease compositions suggests a higher level of complexity of human mast cell-mediated reactions than heretofore appreciated. PMID- 3520575 TI - Successful liver allografts in mice by combination with allogeneic bone marrow transplantation. AB - Successful liver allografts were established by combination with allogeneic bone marrow transplantation. When liver tissue of BALB/c (H-2d) or C57BL/6J (H-2b) mice was minced and grafted under the kidney capsules of C3H/HeN (H-2k) mice, it was rejected. However, when C3H/HeN mice were irradiated and reconstituted with T cell-depleted BALB/c or BALB/c nu/nu bone marrow cells, or with fetal liver cells of BALB/c mice, they accepted both donor (stem-cell)-type (BALB/c) and host (thymus)-type (C3H/HeN) liver tissue. Assays for both mixed-lymphocyte reaction and induction of cytotoxic T lymphocytes revealed that the newly developed T cells were tolerant of both donor (stem-cell)-type and host (thymus)-type major histocompatibility complex determinants. We propose that liver allografts combined with bone marrow transplantation should be considered as a viable therapy for patients with liver disease such as liver cirrhosis and hepatoma. PMID- 3520576 TI - Detection of circulating metastatic cells. PMID- 3520577 TI - Preclinical approaches to the development of effective immunotherapeutic protocols for the treatment of metastasis. PMID- 3520578 TI - Possible strategies for antimetastastic therapy. PMID- 3520580 TI - Is there a host response to metastasis? PMID- 3520579 TI - Assessment of antitumor (antimetastatic) efficacy of cytotoxic agents. PMID- 3520581 TI - Expression of oncogenes in cancer metastases. PMID- 3520582 TI - Formation and biological properties of isoflavonoid phytoalexins. PMID- 3520583 TI - Flavonoids in the human diet. PMID- 3520585 TI - Nature, distribution and function of plant flavonoids. PMID- 3520584 TI - Dietary effects of tannins. PMID- 3520586 TI - Taste effects of flavonoids. PMID- 3520587 TI - The metabolism of flavonoid compounds in mammals. PMID- 3520588 TI - Effects of flavonoids on the metabolism of xenobiotics. AB - Flavonoids represent a large class of naturally occurring plant constituents that are consumed in substantial amounts by experimental animals and by human beings. The ability of flavonoids to activate or inhibit the principal enzyme system involved in the metabolism of lipophilic xenobiotics, including drugs, carcinogens, insecticides and other environmental pollutants, or to induce the synthesis of this enzyme system may have significant pharmacological and toxicological importance. The significant body of literature which illustrates that flavonoids can modulate the tumorigenic activity of polycyclic hydrocarbons and other chemical carcinogens has been reviewed recently (Slaga, Di Giovanni 1984; Wiebel 1980), but further elucidation of mechanisms of action are needed. Possible effects of flavonoids on the metabolism of lipophilic normal body constituents such as steroids and bile acids should be considered, and additional research is needed to determine the extent to which dietary flavonoids can influence the in vivo metabolism of xenobiotics. PMID- 3520589 TI - Flavonoid biosynthesis, an overview. PMID- 3520590 TI - Molecular aspects of chemical carcinogens and bioflavonoids. PMID- 3520591 TI - Mutagenic and carcinogenic effects of flavonoids. PMID- 3520592 TI - Possible involvement of superoxide dismutase in the mutagenicity of quercetin in Salmonella typhimurium strain TA98. PMID- 3520593 TI - Isolation, purification and characterization of flavonoids. PMID- 3520594 TI - Antihepatotoxic flavonoids. PMID- 3520595 TI - The development of cianidanol and 3-palmitoyl-(+)-catechin as drugs for the treatment of liver diseases. PMID- 3520596 TI - Tannin-protein interactions. PMID- 3520597 TI - Physiology of flavonoids in plants. PMID- 3520598 TI - The current status of solid dispersions. PMID- 3520599 TI - Effects of intraportal prostacyclin on hepatic bile flow in the rat. AB - Prostaglandins including prostacyclin (PGI2) have been demonstrated to have choleretic properties in dogs and in this study the effect of PGI2 on bile flow in rats has been investigated. PGI2 at a dose of 250 ng kg-1 min-1 was infused into the mesenteric vein of biliary cannulated rats and bile samples were collected every 10 min. Administration of PGI2 did not produce any significant changes in bile flow and in the output of bile acids or sodium, potassium and bicarbonate as compared to controls infused with buffer alone. Similarly no differences in pancreatic juice flow or bicarbonate output were observed between PGI2 treated rats and controls. No hypotension was observed at this dose of PGI2 given intraportally indicating inactivation by the liver. Thus in the rat, unlike the dog, no effects of PGI2 on bile flow were observed but this could be related to the route of administration. PMID- 3520600 TI - Diurnal variation and exercise induced changes of prostacyclin in man. AB - The diurnal variation and exercise induced changes in urinary 6 keto PGF1 alpha excretion were determined in 33 healthy, non-smoking volunteers. 6 keto PGF1 alpha was measured in urine using a validated RIA after extraction and purification steps. A definite diurnal variation of 6 keto PGF1 alpha excretion was found. The levels were higher during the day vs. night (169 +/- 13 ng/gram creatinine vs. 130 +/- 18, p less than 0.02) with daytime levels highest during the morning as compared with the afternoon (184 +/- 37 ng/gram creatinine, 0800 1200 hr vs. 130 +/- 14, 1600-2000, p less than 0.02). In addition, 60 minutes of strenuous exercise in well-trained and untrained volunteers significantly increased urinary 6 keto PGF1 alpha as compared to levels in urine collected during a similar time period while at rest (96 +/- 14 ng/gram creatinine to 147 +/- 27, p less than 0.05). The results suggest that urinary 6 keto PGF1 alpha excretion shows diurnal variation and increases with exercise in both trained and untrained subjects. Therefore, these factors need to be considered when interpreting and designing studies utilizing measurement of 6 keto PGF1 alpha in man. PMID- 3520601 TI - Comparison of terconazole and clotrimazole vaginal tablets in the treatment of vulvovaginal candidosis. AB - The clinical efficacy of terconazole (triaconazole), a new triazole ketal structurally similar to ketoconazole, was evaluated in a single-blind, randomized comparative clinical trial including 60 patients with symptoms and clinical signs of vulvovaginal candidosis confirmed by microscopic examination and positive culture for Candida albicans. Three comparable groups were treated with 200 mg clotrimazole or 80 mg terconazole vaginal tablets once daily for 3 consecutive days, or one 240 mg terconazole vaginal tablet followed by 2 identical placebo pessaries. No differences in relief and initial symptomatic cure according to patient recordings on diary cards were demonstrated between the three regimens. Cure rates were 90% or more in all treatment groups 1 week after completion of therapy. At the second follow-up visit 3 weeks later, a significantly higher mycological cure rate (94%), due to significantly better therapeutic response in patients with recurrent vulvovaginal candidosis, was recorded after 3-day therapy with terconazole, while the mycological cure rates after clotrimazole and single dose terconazole treatment only were 65% and 55%, respectively. It was concluded that terconazole represents an efficient and well-tolerated therapeutic alternative in the topical treatment of vulvovaginal candidosis. PMID- 3520602 TI - Opioid and non-opioid components of insulin-induced feeding. AB - The present study was initiated to clarify the involvement of endogenous opioids in insulin-induced feeding. Naloxone (3 mg/kg) was injected in male Sprague Dawley rats every hour for 2 hours after insulin injection (10 U/kg). Only the first hour food intake was depressed (68% reduction). When naloxone was given only 1 hour after insulin administration, depression of food intake was not noted. When food was withheld for 2 hours after insulin injection, both naloxone and its long acting congener, naltrexone (3 mg/kg) were able to depress only the first hour feeding subsequent to food presentation. These data suggest that insulin-induced feeding can be divided into two pharmacologically distinct phases: the early phase being naloxone-sensitive while the late phase is naloxone insensitive. Furthermore, the early phase begins with the presentation of food and not with the administration of insulin. PMID- 3520603 TI - Reduction of the rewarding effect of brain stimulation by a blockade of dopamine D1 receptor with SCH 23390. AB - The subtype of dopamine receptor related to the rewarding effect of brain stimulation was determined in 17 rats. The animals were trained to contact a dry spout to receive stimulation through electrodes implanted into the lateral hypothalamic area, ventral tegmental area, or dorsal raphe nucleus. The dopamine D1 blocking agent SCH 23390, 0.08 mg/kg IP, completely suppressed responding. The D2 receptor blocker sulpiride, 50 mg/kg IP, or the serotonin receptor blocker metergoline, 5 mg/kg IP, did not suppress responding. The ED50 for SCH 23390 was 0.022 mg/kg IP. In a runway, rats were trained to run for rewarding goal stimulation consisting of a train of pulses delivered to the lateral hypothalamus. After injection of SCH 23390, 0.01 mg/kg IP, animals showed significantly slower running speed, but their speed returned to normal if the number of pulses in the goal stimulation was increased 2.6 times. These results indicate that blockade of D1 receptors, but not D2 receptors, reduces the rewarding effect of brain stimulation. PMID- 3520604 TI - [The mutagenicity of Cordemcura]. AB - The mutagenic potential of Cordemcura was investigated. Cordemcura showed no mutagenic response in the tests, either in the presence or in the absence of an activation system. PMID- 3520606 TI - Opioid mydriasis: cross-tolerance between morphine and enkephalins. AB - The occurrence of cross-tolerance between morphine and met-enkephalin, and between morphine and DADL (D-Ala-D-Leu-enkephalin) in causing mydriasis in mice was studied. Morphine-tolerant mice treated with met-enkephalin or DADL intracerebroventricularly (ICV) showed marked reduction of the pupillary effect of the endopioids. Maximal mydriasis in tolerant animals was only about 30% for met-enkephalin and 50% for DADL, compared to levels in nontolerant animals. These results are among the first to demonstrate cross-tolerance between morphine and enkephalins in intact animals and may suggest involvement of multiple opiate receptor systems in producing mydriasis. PMID- 3520605 TI - Health aspects of cannabis. AB - Marijuana seems firmly established as another social drug in Western countries, regardless of its current legal status. Patterns of use vary widely. As with other social drugs, the pattern of use is critical in determining adverse effects on health. Perhaps the major area of concern about marijuana use is among the very young. Using any drug on a regular basis that alters reality may be detrimental to the psychosocial maturation of young persons. Chronic use of marijuana may stunt the emotional growth of youngsters. Evidence for an amotivational syndrome is largely based on clinical reports; whether marijuana use is a cause or effect is uncertain. A marijuana psychosis, long rumored, has been difficult to prove. No one doubts that marijuana use may aggravate existing psychoses or other severe emotional disorders. Brain damage has not been proved. Physical dependence is rarely encountered in the usual patterns of social use, despite some degree of tolerance that may develop. The endocrine effects of the drug might be expected to delay puberty in prepubertal boys, but actual instances have been rare. As with any material that is smoked, chronic smoking of marijuana will produce bronchitis; emphysema or lung cancer have not yet been documented. Cardiovascular effects of the drug are harmful to those with preexisting heart disease; fortunately the number of users with such conditions is minimal. Fears that the drug might accumulate in the body to the point of toxicity have been groundless. The potential deleterious effects of marijuana use on driving ability seem to be self-evident; proof of such impairment has been more difficult. The drug is probably harmful when taken during pregnancy, but the risk is uncertain. One would be prudent to avoid marijuana during pregnancy, just as one would do with most other drugs not essential to life or well-being. No clinical consequences have been noted from the effects of the drug on immune response, chromosomes, or cell metabolites. Contamination of marijuana by spraying with defoliants has created the clearest danger to health; such attempts to control production should be abandoned. Therapeutic uses for marijuana, THC, or cannabinoid homologs are being actively explored. Only the synthetic homolog, nabilone, has been approved for use to control nausea and vomiting associated with cancer chemotherapy.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3520607 TI - Development of a plaque reduction assay and application to the study of psoralen damaged DNA. PMID- 3520608 TI - Kinetics of photoreactivation and liquid-holding recovery in yeast cells. PMID- 3520609 TI - Evidence from photoreactivation kinetics for multiple DNA photolyases in yeast. PMID- 3520610 TI - Enhancement of mutagenesis and human skin cancer rates resulting from increase fluences of solar ultraviolet radiation. PMID- 3520611 TI - Meal patterns of rats with dorsomedial hypothalamic nuclei lesions or sham operations. AB - Rats with bilateral dorsomedial hypothalamic electrolytic lesions (DMNL rats) are hypophagic, hypodipsic and have reduced linear and ponderal growth when compared to sham operated controls (SCON). Nevertheless, previous studies have shown that DMNL rats eat and drink adequate amounts for their size and have normal body composition. In the present study we investigated meal parameters: meal size, and frequency (both light and dark period), total intake and meal size per metabolic size (body weight 0.75). Compared to SCON, DMNL rats at twelve days post surgery weighed less, were shorter, but had a normal body composition as determined by the Lee Index, and were hypophagic (grams eaten/day). The animals were placed into individual, self-contained feeding modules and given powdered chow. After familiarization to the modules, meal parameters were recorded continuously by a computer for an eight day period. While dark phase meal frequency did not differ significantly between groups, the lesioned rats took more meals during the light period. Over the eight-day measurement period DMNL rats were hypophagic compared to SCON in absolute terms. However, when total intake and meal size were normalized to metabolic size, these two parameters did not differ significantly between groups. Upon refeeding, after a one-day fast, the initial meal size of the normally hypophagic DMNL rats exceeded that of SCON. Rats with DMNL have previously been shown to have deficits in some hypothesized short-term food intake control mechanism (e.g., cholecystokinin, glucose sensing). Thus overeating by the lesioned rats after a fast could possibly result from a specific short term control deficit.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3520612 TI - Some parameters of conditioned immunosuppression: species difference and CS-US delay. AB - Three experiments were conducted in which an illness-inducing immunosuppressant, cyclophosphamide (an unconditioned stimulus, US) was associated with a previously presented saccharin solution conditioned stimulus (CS). In each experiment, reexposure to the CS produced a conditioned suppression of the plaque-forming cell response in the experimental groups. Experiment I demonstrated this result with Fisher 344 rats. Experiment II replicated the effect with Balb/c mice. In Experiment III conditioned immunosuppression was demonstrated when mice received CS-US delays as long as 6 hours. No evidence of a delay gradient was present in either the behavioral or the immunologic data. These parallel findings offer no support for the idea of a dissociation between the taste aversion and conditioned immunosuppression processes. PMID- 3520613 TI - Effect of centrally administered interleukin-1 and endotoxin on food intake of fasted rats. AB - We have previously shown that interleukin-1 (IL-1), a polypeptide known to mediate many aspects of the acute phase response to infection, suppresses food intake when injected intraperitoneally into fasted rats. IL-1 acts at the level of the hypothalamus to induce fever. In view of the large number of peptides that have been shown to alter food intake as well as body temperature when injected intracerebroventricularly (ICV), we hypothesized that the receptor site for the anorexigenic activity of IL-1 would be located in a central nervous site bathed by the cerebrospinal fluid. In the present study, ICV injection of IL-1 or E. coli endotoxin (a stimulus for the synthesis of IL-1), significantly elevated body temperature, but did not affect food intake of fasted rats. We conclude that receptors mediating the anorexigenic actions of IL-1 or endotoxin are not located at a central nervous site bathed by the cerebrospinal fluid. Furthermore, fever per se is not responsible for the reduction in food intake seen following peripheral injection of IL-1 or endotoxin. PMID- 3520614 TI - Planning reconstruction. PMID- 3520616 TI - Effect of the deletion of a fragment dispensable for the autonomous maintenance of plasmid pT181 on the competition between incompatible plasmids. AB - The deletion of the 560-bp HindIII C fragment from pT181 derivatives does not change the stability or copy number of the plasmid but affects its ability to compete with undeleted, incompatible plasmids for maintenance in the host cell. The disadvantage of the deleted plasmids seems to be manifested at the level of replication. It results that for plasmid pT181 a sequence dispensable for autonomous maintenance and replication control could affect the outcome of the competition between autonomous, incompatible plasmids. PMID- 3520615 TI - Purification and characterization of the CopB replication control protein, and precise mapping of its target site in the R1 plasmid. AB - The CopB regulatory loop from plasmid R1 has been analyzed. The CopB protein was partially purified, but proteolytic activity in vitro resulted in the recovery of two molecular forms of the polypeptide. Both of these acted as repressors of the repA promoter and had identical activities. The smaller of the proteins was found to be the result of a specific cleavage in the normal in vivo translation product. The active form of the CopB protein is most likely a tetramer, which binds to a DNA region overlapping the repA promoter that also contains a stretch of dyad symmetry. Footprinting analysis and mutant analysis (including nucleotide sequence determination) identified this binding site within 20-25 base pairs. In agreement with in vivo results the binding between CopB and its target site is moderate compared with other operons like lac and trp. PMID- 3520617 TI - Thin polyurethane foam bandage dressing for skin-graft procedures. PMID- 3520618 TI - Frontal cranioplasty: risk factors and choice of cranial vault reconstructive material. AB - A study of patients with large cranial defects involving the frontal bone, frontal sinus, nose, and orbit does not support the contention that there is a clear superiority of reconstructive material despite a history of previous bone infection. No patient with an isolated cranial reconstruction experienced an infection despite location in the area of the frontal sinus or the use of acrylic material. All patients experiencing infection underwent simultaneous reconstruction of the frontal cranium and nose and three- or four-wall reconstruction of the orbit, where the frontal sinus had previously been eliminated and where a previous bone infection had been present. Risk factors associated with cranioplasty were timing (p = 0.001) and cranial vault reconstruction in communication with previously infected ethmoid sinuses and the nose (p = 0.03). A history of previous bone infection suggests increased risk (p = 0.15). The choice of reconstructive material was not significant, although acrylic cranioplasties did not experience the complications expected from a review of the literature. PMID- 3520619 TI - Capsular contracture: a prospective study of the effect of local antibacterial agents. AB - In a prospective, random, double-blind, and concurrently controlled clinical study of 124 patients having augmentation mammaplasty, using multiple independent subjective judges as well as objective compressibility measurements, the use of a variety of local antibacterials in or around inflatable retromammary prosthetic implants reduced the early postoperative onset of class III to IV capsular contracture by sevenfold (85 percent) and the final incidence by more than half (50 percent) (p less than 0.01). We believe this study provides the most unequivocal evidence to date that the cause of capsular contracture in retromammary augmentation is periprosthetic bacterial contamination. Irrigation with a 5 percent povidone-iodine (50 percent Betadine) solution was as effective as other techniques and is currently our procedure of choice. PMID- 3520621 TI - Lung vascular injury after Escherichia coli endotoxin and phorbol myristate acetate infusion in dogs. AB - The effects of Escherichia coli endotoxin and phorbol myristate acetate (PMA), a potential stimulator of polymorphonuclear leukocyte (PMN), on circulating PMN counts, gas exchange, protein concentration of lavage fluid, pulmonary hemodynamics and pathology of the lung were studied in ten anesthetized dogs. Six dogs were infused with 1 microgram/kg endotoxin plus 10 micrograms/kg of PMA; four other dogs were infused with the same amount of endotoxin but 5 micrograms/kg of PMA. After administration of endotoxin plus 10 micrograms/kg PMA, the number of circulating PMN (per mm3) decreased dramatically from 4081 +/- 1041 to 303 +/- 119, arterial oxygen partial pressure (PaO2) dropped to 49.1 +/- 2.4 mmHg and the arterial alveolar oxygen partial pressure difference (A-a DO2) increased significantly above baseline. Lungs from this group appeared to be grossly damaged: edema with distinct petechial hemorrhage and areas of hemorrhagic consolidation; frothy edema fluid often emanated from the tracheas. The group infused with endotoxin plus 5 micrograms/kg PMA showed no significant decrease in the number of PMN; PaO2 and A-a DO2 maintained comparatively stable. Protein concentration of lavage fluid and lung wet/dry weight ratios in dogs of 10 micrograms/kg PMA group were significantly increased (P less than 0.05) as compared to those of 5 micrograms/kg PMA group. Our study showed that the magnitude of leukopenia after endotoxin and PMA was paralleled with the severity of lung vascular injury. These results support the potential role of PMN in the pathogenesis of acute edematous lung injury. PMID- 3520620 TI - The pinwheel flap nipple and barrier areola graft reconstruction. AB - The pinwheel flap with a snug barrier areola graft appears to be an efficacious modification of Little's quadripod flap for nipple reconstruction. Further, long term evaluation is needed to test the validity of these observations over several years. PMID- 3520622 TI - Diurnal variation of insulin clearance and sensitivity in normal man. AB - Sixteen normal healthy volunteers were randomized into two groups, receiving either low doses insulin infusion clamp study (8mU/M2/min) or high dose (40mU/M2/min) to determine the diurnal insulin clearance and sensitivity. Each subject received the assigned dose of insulin clamp twice; one in the morning (0800-1000) and the other in the evening (1800-2000), each with a precedent 9 hours of fasting, respectively. The results showed that there were diurnal variation of serum insulin clearance in the high dose study (AM:791 +/- 54ml/min/M2, PM:947 +/- 53ml/min/M2, p less than 0.01), and the small dose study (AM:411 +/- 32ml/min/M2, PM:716 +/- 87ml/min/M2, p less than 0.001). Diurnal variation of insulin sensitivity as judged by dividing glucose infusion rate by the ambient serum free insulin level (M/FI ration), was only noted in the low dose insulin infusion clamp study (AM:14.6 +/- 2.4, PM:10.5 +/- 1.1, p less than 0.05). In summary, at low physiological levels of insulin the insulin sensitivity is better in the morning, whereas at both high and low insulin levels the insulin clearance of normal subject is greater in the evening. The mechanism of this diurnal variation of insulin clearance and sensitivity awaits further studies. PMID- 3520623 TI - The family of the alcoholic patient. PMID- 3520624 TI - Would Florence Nightingale support entry into practice? PMID- 3520625 TI - Potassium and rubidium permeability and potassium conductance of the beta-cell membrane in mouse islets of Langerhans. AB - The efflux of 42K+ and 86Rb+ has been studied in collagenase-isolated normal mouse islets of Langerhans. In double-labelled experiments, the ratio of efflux rate constants of Rb+ and K+ (kRb/kK) was 0.80 in 5 mM-K+ and 0 glucose. The ratio was unaffected by glucose concentrations up to 22.2 mM. In the presence of 50 mM-K+, 0 glucose, the ratio increased to 0.91 and in 50 mM-Rb+, 0 glucose and 0 K+, the ratio was 1.06. With these limitations, the results indicate that 86Rb+ is an acceptable isotope for K+. Using the Goldman model, K+ and Rb+ permeability coefficients and K+ slope and chord conductances were computed. The permeabilities decreased in glucose and in high K+ or high Rb+. In the case of high external K+, the K+ conductances increased. Also there may be more than one type of K+ channel with differing selectivities to K+ and Rb+. The addition of glucose in the presence of 50 mM-K+ had no further effect on Rb+ permeability. It is suggested that there are about ten small K+ channels open in the resting beta cell and that progressive closure of these channels is involved in the depolarization of the cell membrane that initiates spike activity. PMID- 3520626 TI - Allergen avoidance in house dust mite sensitive adult asthma. AB - Fifty adult asthmatic patients with strongly positive skinprick tests to the house dust mite were admitted into a prospective randomised controlled trial of house dust mite avoidance in the community. Twenty-two of the experimental group completed one year of dust avoidance and 19 of these tolerated the use of plastic mattress and pillow covers. Twenty of the control group (who did not alter their housecleaning habits) also completed one year of study. A fall in mite and dust levels was noted in the homes of the experimental but not the control group. Fifteen of the experimental group who completed the study were strongly RAST positive (score 3 or more) to the house dust mite. These patients had a significant improvement in FEV1/FVC, PEFR, PC20, use of treatment, and symptom score at one year, whilst the seven experimental patients who were not strongly RAST positive (score 2 or less) did not, suggesting that the change noted in the former patients was not merely due to a placebo effect. Fifteen of the control group who completed the study were also strongly RAST positive for the house dust mite and these patients showed no change in any of the parameters. This study demonstrates that adult asthmatic patients can successfully carry out house dust eradication procedures in the community over a long period of time, and that those patients who are allergic to the house dust mite appear to have both subjective and objective improvement in their asthma. PMID- 3520627 TI - House dust sensitivity and asthma. PMID- 3520628 TI - Recent advances in schistosomiasis. PMID- 3520629 TI - Primary molar stainless steel crown restoration. PMID- 3520630 TI - Maxillary arch expansion in cleft lip and palate infants prior to primary autogenous alveolar bone graft surgery. PMID- 3520631 TI - [Basic principles. Prosthetics: complete dentures (I)]. PMID- 3520632 TI - Inactivation of Saccharomyces cells by 8-methoxypsoralen plus pulsed laser irradiation in the wavelength range 308 nm-380 nm. AB - Two different strains of Saccharomyces cerevisiae, one diploid wild type and one haploid mutant deficient in excision repair were irradiated with laser pulses in the range 308 nm to 380 nm after 8-MOP treatment. Both the shoulder (Dq) and the final slope (Do) of the inactivation curves were dependent on wavelength which showed a broad minimum around 355 nm. No differences in inactivation were recorded after pulsed irradiations between the repetition rates of 5 Hz and 35 Hz. Irradiations with pulses of the energy density from 0.1 mJ/cm2 up to 26 mJ/cm2 resulted in a final slope increasing with pulse energy density. This was in contrast to the effects of irradiation alone. PMID- 3520633 TI - [Traumatic injuries of the ureter, bladder and urethra in pelvic fractures]. PMID- 3520634 TI - [Trends in gastroenterologic x-ray diagnosis]. PMID- 3520635 TI - [Results of digital subtraction angiography of patients with renovascular hypertension]. PMID- 3520636 TI - Localization of parathyroid adenoma: experiences with ultrasonography. PMID- 3520637 TI - [Value and limitations of intravesical ultrasonic examination in determining the extent of bladder neoplasms]. PMID- 3520638 TI - Computer-aided instruction in ethics for radiation therapy technology. PMID- 3520639 TI - [Sonography of adrenal gland diseases]. AB - In 60 normal control persons and 88 patients with diseases of the adrenal gland, sonographic examinations of the adrenals were carried out. Examination technique and typical sonographic findings in different adrenal lesions are presented. Normal-sized adrenal glands and space-occupying lesions measuring 8-12 mm in diameter could not be visualized in all instances. Adrenal sonography is quite suitable for a screening procedure, however, it is inferior to CT in spatial resolution and overall accuracy. In adrenal lesions exceeding 2 cm in diameter, the sensitivity of sonographic examinations equals that of computed tomography. Patients considered for surgical intervention always require exact delineation of adrenal diseases by computed tomography. PMID- 3520640 TI - [Percutaneous fine-needle biopsy of the adrenal glands]. AB - The percutaneous approach to the adrenal glands is impeded by their high paraaortal subphrenic location. Regarding the information conveyed in literature and referring to our experience, a summary of the technique, indication and findings of percutaneous biopsy of the adrenal gland is presented. Percutaneous needle biopsy of the right adrenal gland is most easily performed by lateral transhepatic approach under sonographic guidance, while in biopsy of the left adrenal gland protection of the spleen, kidney, pancreas and stomach can only be achieved by dorsal approach under CT control. At present, the main indication for biopsy of the adrenal gland still is differentiation between metastases and non functioning adenomas in tumor patients. Adequate technique provided, the sensitivity of punctures of the adrenal gland varies from 80 to 90%. Clinical suspicion of pheochromocytoma is an absolute contraindication for fine needle biopsy. PMID- 3520641 TI - [Pre- and postnatal diagnostic imaging of congenital urinary tract disorders]. AB - The prenatal diagnosis of urinary tract obstruction was made in 10 neonates. These findings were confirmed postnatally by sonography, urography, voiding cystourethrography, and scintigraphy. There were 8 neonates with unilateral obstruction of the ureter, and 2 with urethral valves and reflux. Nephrectomy because of hydronephrosis was necessary in 2 instances. The prenatal diagnosis of a urinary tract obstruction is of great importance, because the neonate may be operated upon without delay. Thus the diseased kidney can be saved. Diuretic radionuclide urography is helpful in differentiating between dilated obstructed and dilated nonobstructed kidneys. PMID- 3520642 TI - Technical factors responsible for "placental migration": sonographic assessment. AB - Whether placental migration occurs is debatable. To determine the incidence of placenta previa in early pregnancy and the frequency of placental migration, a retrospective analysis was undertaken of 2,087 consecutive obstetrical sonograms obtained during a 23-month period. Among 849 patients scanned between 14 and 26 weeks after conception, placenta previa was diagnosed using ultrasonography (US) in 53 patients (6.2%). This diagnosis was confirmed at surgery in 15 patients (1.8%); there were 12 cases of central previa and three cases of partial previa. Retrospective analysis revealed that in 25 cases, technical factors, such as an overly distended urinary bladder (19 cases) or focal uterine contractions (six cases), were responsible for the false-positive diagnoses. In the 13 remaining patients, however, there were no obvious technical difficulties to account for the diagnosis of previa. Migration did not occur in any of the patients with central previa. It appears that placental migration may occur, although less frequently than has previously been reported. Furthermore, this study suggests that migration does not occur in patients with central previa. PMID- 3520643 TI - Placental abruption and subchorionic hemorrhage in the first half of pregnancy: US appearance and clinical outcome. AB - In 30 pregnant patients who experienced vaginal bleeding between 10 and 20 weeks gestation, subchorionic hematomas were demonstrated on ultrasound examination. In 18 patients (60%), the margin of the placenta was separated from the uterine wall. In 15 patients the outcome was favorable (full-term delivery of normal infant) and in 15 patients the outcome was unfavorable (seven preterm births, four stillbirths, three spontaneous abortions, one therapeutic abortion). The major prognostic factor related to pregnancy outcome was the volume of the hematoma and, to a lesser extent, the relative volume of the hematoma (volume of hematoma divided by volume of gestational sac). For a volume less than 60 ml, the outcome tended to be favorable, and for a relative volume less than 0.4, the outcome tended to be favorable. PMID- 3520644 TI - Acute renal rejection versus acute tubular necrosis in a canine model: MR evaluation. AB - Findings of magnetic resonance (MR) imaging in acute renal rejection and acute tubular necrosis (ATN) were studied in dogs. On T1-weighted images, corticomedullary differentiation was absent in kidneys undergoing acute rejection. The loss of corticomedullary differentiation in these kidneys was secondary to a decrease in the relative signal intensity of the cortex, indicating prolongation of the T1 relaxation time of the cortex. In contrast, corticomedullary differentiation was preserved on T1-weighted images of autotransplanted kidneys and kidneys with ATN. MR imaging findings correlated with changes in water content in these three groups of kidneys. Kidneys undergoing acute rejection showed a marked increase in water content compared with kidneys in the other two groups. No change in fat content was found in any group. PMID- 3520645 TI - Trauma of the extremities: prospective comparison of digital and conventional angiography. AB - Digital subtraction angiography (DSA) and conventional film angiography (CFA) were compared prospectively in 50 patients with trauma of the extremities. Each patient underwent both procedures with comparable imaging parameters and injections. Three angiographers reviewed the angiograms for the presence of seven angiographic signs of arterial injury. The two modalities showed pseudoaneurysms, arteriovenous fistulas, vessel displacement, occlusion, and focal narrowing equally well. CFA was superior to DSA in delineating intimal dissection; DSA was better for demonstrating extravasation. Clinical follow-up demonstrated that both procedures had a sensitivity of 100%; the specificity was 94% for DSA and 97% for CFA. Neither procedure produced a false-negative result. PMID- 3520646 TI - Carotid bifurcation: results of spliced hybrid subtraction angiography compared with standard temporal and hybrid images. AB - Hybrid subtraction angiography can provide a higher percentage of two-view examinations of the carotid bifurcation. Unfortunately, hybrid images are lower in signal-to-noise ratio (S/N) than temporal subtraction angiographic images and are often described as "noisy." The present study was designed to determine if the lower S/N of hybrid subtraction angiography could be restricted to the contralateral carotid bifurcation by "splicing" a small hybrid region of interest into a larger temporal image. Twenty-two selected images were examined on four image quality scales by seven readers. Similarity of reader scoring was characterized by cluster analysis and was good. Ipsilateral carotid arteries were preferred as temporal images, and contralateral carotid arteries were preferred as hybrid images. The splice image was preferred over both. The splice image retained the superiority of temporal subtraction angiography in the region of the ipsilateral carotid artery and incorporated the superiority of hybrid subtraction angiography in the region of the contralateral carotid artery. The splice image incorporated the best features of both image modalities. PMID- 3520647 TI - Diagnostic and therapeutic percutaneous gallbladder procedures. AB - The authors report their experience with 24 patients who underwent a variety of percutaneous procedures involving the gallbladder. Twenty diagnostic and 13 therapeutic procedures were performed under sonographic, computed tomographic (CT), or fluoroscopic guidance; these procedures included biopsy of the gallbladder, diagnostic cholecystography, diagnostic aspiration of bile, gallstone dissolution and removal, cholecystostomy for drainage, and gallbladder abscess drainage. The indications for percutaneous cholecystostomy (performed in 11 patients) included relief of hydrops and empyema, gallstone dissolution, mechanical gallstone removal, and drainage for malignant obstruction. Each procedure was successful. There was one complicating episode of cholecystitis and four previously described episodes of vagal hypotension. Bile peritonitis did not occur in any of the patients. The authors discuss the various percutaneous gallbladder procedures and specific technical considerations in performing them. PMID- 3520648 TI - MR imaging in infants with airway obstruction: preliminary observations. AB - Magnetic resonance (MR) imaging of the trachea and main bronchi was performed in seven infants (aged 3-15 months) with symptoms of airway obstruction. Diagnoses made clinically, radiologically, and by transnasal flexible fiberoptic endoscopy included vascular ring (one patient), tracheal compression by the innominate artery (five patients), and tracheomalacia (one patient). MR images in sagittal and axial sections clearly demonstrated tracheal compression at the level of the innominate artery in three infants and tracheal narrowing due to a vascular ring in one patient. The other three patients had airway narrowing apparently unrelated to aberrant vascular structures on MR images. The appearance of the airways on MR images corresponded closely to endoscopic observations. It is concluded that MR imaging is capable of demonstrating airway obstruction in infants and delineating any relationship to major mediastinal blood vessels. PMID- 3520649 TI - Endotracheal tubes in neonates: sonographic positioning. AB - Twenty-one real-time sonographic determinations of endotracheal tube tip position were performed in 16 neonates. Findings were compared with those from simultaneously obtained chest radiographs. Relation of the tube tip to the aortic arch provided a reliable method of determination of appropriate position. Optimal tube tip position was seen when the tube tip was 1 cm above the arch. PMID- 3520650 TI - Graft patency evaluation with DSA after reconstructive venous surgery. AB - Evaluation of graft patency following reconstructive venous surgery may be difficult, especially in patients in whom a distal arteriovenous fistula has been constructed. We describe a method of visualizing these venous bypass grafts using digital subtraction angiography that is easy and provides satisfactory results. PMID- 3520651 TI - Cholelithiasis in the morbidly obese: diagnosis by US and oral cholecystography. AB - Forty-two morbidly obese patients underwent cholecystectomy at the time of gastroplasty, primarily for prophylactic reasons. Preoperatively, 37 patients underwent ultrasonography (US) of the gallbladder and oral cholecystography, four US only, and one oral cholecystography only. There was one indeterminate US study (2.4%) and one indeterminate oral cholecystogram (2.7%). At US study, gallstones were detected in six of the eight patients with gallstones (sensitivity = 75%), and the gallbladders of all 32 patients without gallstones were categorized as normal (specificity = 100%). The gallstones not identified measured 1-2 mm in diameter. Oral cholecystographic study enabled detection of gallstones in three of the seven patients with gallstones (sensitivity = 43%) and categorized as normal all 30 gallbladders without gallstones (specificity = 100%). The gallstones not seen were small and included those not detected by US. The results suggest that US is equal or superior to oral cholecystography for detection of cholelithiasis in obese patients. PMID- 3520652 TI - Transducer frequency considerations in intraoperative US of the spine. AB - To determine the effect of transducer frequency, we used intraoperative spinal ultrasound to study 15 patients. All patients but one had spinal stenosis and/or disk disease affecting the cervical cord (n = 5), the thoracic cord (n = 1), or the lumbosacral area (n = 8). One patient had an arteriovenous malformation of the cervical cord. Both 5-MHz and 10-MHz transducers were used in one patient; a transducer with the option of 3.5, 5, or 7.5 MHz was used in ten; and a 10-MHz transducer was used in four. We found that, intraoperatively, 10-MHz transducers currently produce the most detailed images of the spine. PMID- 3520653 TI - Unchanged size of a dilated common bile duct after a fatty meal: results and significance. AB - Sonographic measurement of common bile duct caliber alone is insufficient to ascertain the presence of obstruction. Fatty meal stimulation significantly improves diagnostic accuracy. An increase in caliber of a normal or slightly dilated common duct after the subject has ingested a fatty meal is a strong indicator of biliary obstruction, while a decrease in caliber indicates normal dynamics and virtually excludes obstruction. This study determines the significance of no change in the caliber of the dilated common bile duct of subjects who have eaten a fatty meal. Further imaging studies and clinical/laboratory follow-up of 31 patients showed that in 84% of the cases no obstruction was present. A dilated common duct that does not decrease in size after a fatty meal is not a specific indicator of obstruction. The use of invasive diagnostic procedures in these patients is not advised unless there is other evidence of biliary obstruction. PMID- 3520654 TI - Bile duct obstruction: radiologic evaluation of level, cause, and tumor resectability. AB - In a prospective study of 65 patients with bile duct obstruction, various radiologic modalities were compared for their capability to demonstrate the level and cause of obstruction and to indicate accurately tumor resectability. Ultrasound (US) was performed in 65 patients, computed tomography (CT) in 51, direct cholangiography (DC) in 57, and angiography in 35. The level of obstruction was correctly indicated by US in 95% of patients and by CT in 90%, and the cause was correctly indicated by US in 88%, by CT in 63%, and by DC in 89%. In predicting tumor resectability, US was correct in 71% of patients, compared with 42% for CT, 58% for DC, and 25% for angiography. US therefore appears to be the single most useful modality in the evaluation bile duct obstruction. PMID- 3520656 TI - Frequency-demodulated US: evaluation in the liver. Work in progress. AB - Frequency modulated (FM) imaging is a new ultrasound (US) modality that uses pulse-echo signal instantaneous frequency in addition to the conventional envelope information. Eight features of the FM image in nondiseased livers are described. The technique is evaluated in a study of 34 patients with biopsy proved diffuse liver disease. Visual grading of FM US image features shows good correlation with levels of biopsy-graded hepatic fibrosis. Patients with diffuse parenchymal liver disease often exhibit evidence of the abnormality when FM liver imaging is used, while such evidence is not as well demonstrated with conventional envelope (AM) imaging. PMID- 3520655 TI - Hepatic adenomas and focal nodular hyperplasia: dynamic CT study. AB - A retrospective, multi-institutional study was carried out on a series of 50 histologically proved benign hepatic tumors. The 27 hepatic adenomas (HAs) and 23 cases of focal nodular hyperplasia (FNH) were studied with ultrasonography (US) and dynamic computed tomography (CT). Angiography was performed in 26 cases (15 HAs, 11 FNHs); scintigraphy was not used because of its cost. US scans proved nonspecific. CT scans demonstrated hemorrhage in five HAs and were useful in characterizing tumoral vascularity and any intratumoral features such as necrosis or central fibrous scar. The presence of arterial vessels (five patients) in the projection of this central fibrous scar is suggestive of FNH. Dynamic CT scans did not show the type of tumor in most cases. In cases with lesions greater than 3 cm for which doubt as to the diagnosis persists, combined use of morphologic data, scintigraphy, dynamic CT scanning, and angiography can guide the therapeutic decision: surgery or follow-up CT study after use of oral contraceptives is stopped. PMID- 3520657 TI - Quantitative US attenuation in normal liver and in patients with diffuse liver disease: importance of fat. AB - Two methods are used to estimate ultrasound attenuation in liver. These were based on amplitude change and frequency change as a result of depth dependent attenuation. Evaluation of the two methods against a family of calibrated phantoms yielded correlation coefficients of 0.98 and 0.99, respectively. Liver attenuation in 26 control subjects was 0.50 and 0.52 dB/MHz/cm, respectively. Liver attenuation was estimated in 50 patients who later underwent liver biopsy. Comparison with quantitative histologic results showed that the presence of fat alone accounted for the increased attenuation associated with cirrhosis. Similar high attenuation values were found in patients with fatty infiltration. Fibrosis alone did not result in elevated liver attenuation. Cirrhotics without fatty infiltration had attenuation similar to that of the controls. Mechanisms of action are discussed. PMID- 3520658 TI - Hepatocellular uptake of organic anions. PMID- 3520659 TI - Lymphocytes in liver diseases. PMID- 3520660 TI - Networks of interacting mechanisms of hepatocellular degeneration and death. PMID- 3520661 TI - Interaction of alcohol and nutritional factors with hepatic fibrosis. PMID- 3520662 TI - Hypothalamic-pituitary-gonadal function in liver disease with particular attention to the endocrine effects of chronic alcohol abuse. PMID- 3520663 TI - Human hepatocyte cultures. PMID- 3520664 TI - Hepatitis B vaccine. PMID- 3520665 TI - Hepatitis delta virus disease. PMID- 3520666 TI - Chronic hepatitis in Korea. PMID- 3520667 TI - Autoimmune chronic active hepatitis: three decades of progress. PMID- 3520668 TI - Prostaglandins and renal function in cirrhosis. PMID- 3520669 TI - The management of acute variceal bleeding. PMID- 3520670 TI - Primary sclerosing cholangitis. PMID- 3520671 TI - Multistage rodent hepatocarcinogenesis. PMID- 3520672 TI - Hepatotoxic effects of oncotherapeutic agents. PMID- 3520673 TI - Ultrasound-guided transhepatic puncture in the diagnosis and management of hepatobiliary disorders. PMID- 3520674 TI - Aging and the liver. PMID- 3520676 TI - [Collagen genes and their expression in cartilage differentiation]. PMID- 3520675 TI - [Collagen--its function and metabolism]. PMID- 3520677 TI - [Active oncogenes in tumors of experimental animals]. PMID- 3520678 TI - [Recent knowledge on bacterial protein toxins]. PMID- 3520680 TI - [Structure and chemical synthesis of lipid A]. PMID- 3520679 TI - [Enterotoxins produced by enterotoxigenic Escherichia coli]. PMID- 3520681 TI - [Biological activities of synthetic lipid A and its analogs]. PMID- 3520682 TI - [Biological significance of anti-LPS factor]. PMID- 3520683 TI - [Mechanism of induction of parkinsonism by 1-methyl-4-phenyl-1,2,3,6 tetrahydropyridine (MPTP), a dopaminergic neurotoxin]. PMID- 3520684 TI - [Calmodulin--cooperative Ca2+ binding and "spike" phenomena]. PMID- 3520685 TI - Circulating and urinary thromboxane B2 metabolites in the rabbit: 11-dehydro thromboxane B2 as parameter of thromboxane production. AB - The metabolism of thromboxane B2 was studied in the rabbit. The aim of the study was to identify metabolites in blood and urine that might serve as parameters for monitoring thromboxane production in vivo. [5,6,8,9,11,12,14,15-3H8]-Thromboxane B2 was administered by i.v. injection to rabbits, and blood samples and urine were collected with brief intervals. The metabolic profiles were visualized by two-dimensional thin layer chromatography and autoradiography, and the structures of five major metabolites were determined using chromatographic and mass spectrometric methods. In urine the major metabolites were identified as 11 dehydro-TXB2 and 2,3,4,5-tetranor-TXB1, and other prominent products were 11 dehydro-2,3,4,5-tetranor-TXB1, 2,3-dinor-TXB1 and 2,3-dinor-TXB2. In the circulation, TXB2 was found to disappear rapidly. The first major metabolite to appear was 11-dehydro-TXB2, which also remained a prominent product in blood for the remainder of the experiment (90 min). With time, the profile of circulating products became closely similar to that in urine. TXB2 was not converted into 11 dehydro-TXB2 by blood cells or plasma. The dehydrogenase catalyzing its formation was tissue bound and was found to have a widespread occurrence: the highest conversion was found in lung, kidney, stomach and liver. The results of the present study suggest that 11-dehydro-TXB2 may be a suitable parameter for monitoring thromboxane production in vivo in the rabbit in blood as well as urinary samples, and possibly also several tissues. This was also demonstrated in comparative studies using radioimmunoassays for TXB2 and 11-dehydro-TXB2. PMID- 3520686 TI - [The history of psychoanalysis in Stuttgart]. PMID- 3520687 TI - [Psychoanalysis under Hitler--psychoanalysis today]. PMID- 3520689 TI - Duplicating complete dentures. PMID- 3520688 TI - [On the discussion of psychoanalysis and national socialism in the journal "Psyche"]. PMID- 3520690 TI - The direct lift-off technique for constructing porcelain margins. PMID- 3520691 TI - Autopolymerized acrylic resin custom trays for removable prosthodontics. PMID- 3520692 TI - Problems related to the successful use of overdentures. PMID- 3520693 TI - Tensile bond strengths of various alloy surface treatments for resin bonded bridges. PMID- 3520694 TI - Fabrication of denture teeth with metal occlusal surfaces. PMID- 3520695 TI - An improved cast-die system--the "box-seat" technique. PMID- 3520696 TI - The weak link in the processing of attachment dentures and how to strengthen it. PMID- 3520697 TI - Monoclonal antibodies in oncology. AB - Monoclonal antibodies (MCAs) can be used to differentiate between normal and neoplastic cells and thus exploited for diagnostic and, ultimately, therapeutic gain. The evidence for the existence of human tumour antigens is reviewed. Several areas of diagnosis are already benefiting from the application of the monoclonal technology. Immunohistology can help the pathologist with difficult diagnostic problems. New classifications of lymphoma and leukaemia can be based on specific surface molecules. Similarly, the detection of shed tumour antigens is already established as part of the routine assessment of many patients with common solid tumours. Isotopically labelled monoclonal antibodies have been used to localise primary and metastatic tumours. The use of antibodies in this way is not only a promising diagnostic tool but also the first step in studying the possibility of arming antibodies to provide therapeutic agents. Such trials are currently in progress. PMID- 3520698 TI - Repair in the mouse lung during low dose-rate irradiation. AB - The thorax of CBA mice was exposed to 60Co gamma-rays at dose rates ranging from 100 to 2 cGy/min. Iso-effect doses (ED50) were calculated for early and late lung damage from dose-response curves for breathing rate and lethality. A continuous increase in tolerance for early radiation pneumonitis was seen as the dose rate was reduced, reaching a dose recovery factor (DRF) of 2.6 at 2 cGy/min. There was significantly less dose sparing with 2 cGy/min for the rise in breathing rate during expression of late damage (DRF = 2.1). The lower DRF compared well with that obtained from late measurements of pleural fluid levels. Comparison with fractionation experiments indicated incomplete repair at 2 cGy/min with further dose recovery expected at even lower dose rates or at doses per fraction below 200 cGy. Since the dose-rate dependence of damage to haemopoietic tissue is less marked, this study predicts an advantage of employing low dose-rate total-body irradiation (TBI) in the treatment of bone-marrow transplant patients. A further gain in the therapeutic index may be expected using a hyperfractionated regime with small doses per fraction. PMID- 3520699 TI - Isolation and structures of coho salmon (Oncorhynchus kisutch) glucagon and glucagon-like peptide. AB - Glucagon and glucagon-like peptide (GLP) containing 31 amino acids have been isolated from the principal islet of coho salmon (Oncorhynchus kisutch) by gel filtration of acid alcohol extracts followed by HPLC, and the complete amino acid sequence of both peptides has been determined. Salmon glucagon is a simple 29 residue peptide differing at 3 positions when compared to catfish glucagon and at 8 positions when compared to porcine glucagon. Salmon GLP differs at 6 positions when compared with the N-terminal 31 amino acids of the 34 amino acid catfish GLP. Both coho salmon glucagon and GLP cross-react weakly in our mammalian glucagon radioimmunoassay and therefore this technique could not be used to determine tissue content. Glucagon and GLP isolated amounted to 156 micrograms/g and 350 micrograms/g wet tissue, respectively. PMID- 3520700 TI - [Isotope effects in biological processes--variation of 13C and 15N abundance in the biosphere]. PMID- 3520701 TI - [Ileal occlusion caused by the rupture and dislocation of a Celestin prosthesis. Radiological aspects. Presentation of 2 cases]. AB - When the Celestin tube is used for treatment of benign oesophageal strictures after several months structural deterioration and fatigue occur. The tube disruption and displacement are serious complications which can be early identified with routine-radiological examinations. PMID- 3520703 TI - [Preoperative localization of non-palpable breast lesions]. AB - The effectiveness of real-time sonography and mammography are examined in localizing with a hookwire (introduced via a straight needle) the nonpalpable breast lesions. The method, used for surgery or biopsy, was successful in a series of 13 patients with non-palpable breast lesions, 4 affected by carcinoma. PMID- 3520702 TI - [Hypertrophic stenosis of the pylorus. Ultrasound and traditional diagnosis. Comparison of methods]. AB - Hypertrophic pyloric stenosis (HPS) is the most frequent cause of abdominal surgery during the first months of life. A new diagnostic approach to this type of pathology is given by ultrasound examination which offers the opportunity to perform a precise study of pyloric muscle thickness, pyloric diameter width and pyloric muscle length. Ultrasound provides a quick diagnostic tool sparing radiation exposure to the patient. X-ray study is only to be reserved to the few cases in which clinical and ultrasound data are doubtful and--in all instances- to rule-out other possible causes of gastric outlet obstruction. We report 20 infants (14 males and 6 females) referred with clinical suspicion of HPS. This diagnosis has been confirmed by ultrasound in 12 cases, suspected in 1 and excluded in 7 cases. Upper gastrointestinal tract series confirmed the presence of HPS in 13 cases; discovered a huge gastroesophageal reflux in one and showed normal findings in 6 cases. PMID- 3520704 TI - [Scintigraphy of pulmonary ventilation with 99mTc-DTPA radio-aerosol. I. Semiotics of the static images]. AB - Papers on deposition pattern analyses of radio-aerosol lung scans are few and not easy to interpret as there is a general lack of technical standardization and the number of patients studied is not large. Moreover these reports have been generally obtained with non-hydrosoluble radioaerosols. In the present study 43 patients underwent conventional pulmonary function testing and lung scanning using small droplet (equal or less than 2 microns) polydisperse 99mTc-DTPA radioaerosol produced with the "Settling Bag System"--Medi 400 (Sorin). The scans were analysed by two methods: a semiquantitative method proposed by Taplin (SQT); an original simpler semiquantitative method (SQM). Correlations of SQT and SQM with FEV1 and MEF75 resulted highly significant (p less than 0,001). SQM proved to be superior to SQT as far as reproducibility is concerned. The following conclusions can be drawn: small particle 99mTc-DTPA aerosol can be easily and cheaply produced by a commercial device; such a radioaerosol is well suited for the evaluation of small and large airways patency, as reflected by MEF75 and FEV1 respectively, with a diagnostic yield comparable to non-hydrosoluble radioaerosols; the original semiquantitative description of the deposition patterns proposed and validated in this study is quite easy to implement and it yields a high correlation with pulmonary function tests; moreover such an approach does not require digital data processing; the sensitivity of 99mTc-DTPA for the diagnosis of bronchial obstruction is very high and superior to routine pulmonary function tests; in addition the ventilation scan allows the topographical localization of the obstructions themselves. PMID- 3520705 TI - [Ultrasonic diagnosis of gastrointestinal perforation]. AB - Three cases of gastrointestinal perforation diagnosed by ultrasonography (US) are described. In these patients US showed the presence of gas in peritoneum, anteriorly to the liver. Gas is easily identified by US for its unique aspects. More difficult may be the diagnosis of its site, external to the gastrointestinal tract. Differential diagnosis, limits and possible pitfalls are briefly discussed. PMID- 3520706 TI - [Present role of diagnostic imaging in the study of extensive pathology of the parotid gland]. AB - After the introduction in diagnostic imaging of CT and US beside sialography (SG), today it is possible completely evaluate the ductal system as well as the parenchima of the parotid gland. The authors examine the results and limitations of these new imaging modalities, outlining their role in the evaluation of parotid masses. Echography, because of high sensitivity, seems to be the method of choice for the first approach to this pathology, while sialography and CT can be successful in some circumstances: the first allows to easy outline the inflammatory involvement of the gland, while CT seems to be essential for the study of deeply situated tumors and for a complete spatial evaluation. PMID- 3520707 TI - [Role and possibility of intravenous digital substraction angiography in problems of renal transplantation]. AB - Intravenous Digital Subtraction Angiography (IVDSA) was used to evaluate 6 renal allograft recipients and 3 potential renal donors. In 4 potential renal donors and in 2 allograft recipients, angiographic data were confirmed by surgery. IVDSA is a safe, accurate, easily performed, outpatient procedure; in our opinion DSA should became the procedure of choice to study vascular anatomy in renal transplant evaluation. PMID- 3520708 TI - [Comparison between isteropac and a new non-ionic contrast medium for hysterosalpingography (B-15000)]. AB - The authors refer the results of a double blind hysterosalpingographic study with a traditional ionic contrast medium (Isteropac) and a new non-ionic one (B 15000). Both the contrast have provided good quality images, without significant intolerance. Moreover the new non-ionic contrast medium has shown an easier utero tubal transit with a sensible reduction of the examination length and a better diagnostic result. PMID- 3520709 TI - [Ultrasonic picture of idiopathic hemorrhagic infarct of the omentum. Presentation of a case]. PMID- 3520710 TI - [Emphysematous pyelonephritis]. PMID- 3520711 TI - [Heart transplants. The value of computerized tomography]. AB - In 9 of 12 patients who underwent cardiac transplantation computed tomography was performed. In 5 of them CT was obtained also before the surgical treatment. In all patients angio-CT technique was performed, while the ECG-gated technique was employed only before surgery. CT shows changes in morphology of both atria but over all of the right one, and rotation of the heart on the longitudinal axis. The conditions of the pericardium are particularly well demonstrated: in 5 cases pericardial effusion was observed, 3 times localized and 2 times diffuse. Only in 1 patient a small thrombus in the right atrium was demonstrated. CT allows the possibility to obtain simultaneously information on mediastinum, lungs and pleura. Pleural effusion, pulmonary infections and mediastinal complications are easily demonstrated. PMID- 3520712 TI - [Role of magnetic resonance imaging in the tissue characterization of tumors]. AB - Aim of this article is to examine the possibilities and the limits of MR imaging in oncology, with special regard to the tissue characterization of tumors. Basic information is given on the fundamental parameters of MR, and the concept of image contrast is discussed, with a comparison between the image in conventional radiology and in MR. Factors affecting MR parameters and influencing the image contrast are analyzed; they are classified as extrinsic, or connected to the patient's conditions and to technical modalities, and as intrinsic or inherent to biological factors. Intrinsic factors are scheduled in three groups: a) tissue physico-chemical structure; b) functions or physiological conditions; c) pathological aspects. One of the most important factors related with the first group is water content. The possible influences of water content on the measurement of the proton MR relaxation times are numerous and complex. As a first approximation, relaxation times are directly related to water content; nevertheless many experimental results show that this statement is not sufficient to explain the observed variations of relaxation times in different tissues and organs. Some other data are accounted for the presence of different relaxation times of water in the same sample, and for the microtrabecular structure of the cell. In normal tissues and structures, further elements are explained on the basis of simple physico-chemical characteristics. In tumors the increase of T1 and T2 observed in experimental evaluations performed on samples of tissues, was largely confirmed in the images. To an equal extent failure of specificity of the increase of relaxation times of tumors is well documented in experimental research and in clinical experiences. In experimental research a strict comparison was made between the tumor and the tissue of origin. Increase of relaxation parameters appears related to the presence of larger fluid-filled areas, to the diminution of average cell size, and to reduced amount of rough and smooth endoplasmic reticulum. In clinical experiences good results are obtained in the ascertainment of the tumors localization and extension; macroscopic aspects connected to the peritumoral structures, inhomogeneities, and necrosis are well evaluated. New data are acquired in the study of early and late effects of radiation in patients submitted to radiotherapy for various types of tumors. PMID- 3520713 TI - [Morphologic and histologic changes caused by continuous peridural analgesia in a cancer patient]. AB - The morphological and histological alterations were studied that appeared in the peridural space of a patient who was anesthetized for 114 days with a peridural catheter (Perifix-Catheter, Braun) because of intensive violent pain caused by an incurable carcinoma. No macroscopical or histological indication of inflammation could be observed in any of the peridural space and spinal canal. The only alterations detected were nonspecific foreign-body reactions, such as an increase in foreign-body gigant cells and single connective tissue adhesions. Peridural opiate analgesia combined with long-term local anesthesia (0.25% Bupivacain) provided the patient with a long period free of pain. PMID- 3520714 TI - [Nontraumatic aseptic osteonecrosis of the femoral head. Etiopathogenic, developmental and therapeutic considerations: review of the literature]. AB - Aseptic non-traumatic necrosis of the femoral head occurs in patients with very unusual general state of health. Despite the fact that the metabolic abnormalities are better known today, many problems with regard to prognosis and treatment remain. According to the author's experience and, review of the literature, the authors consider that the production of tissue repair with hypervascularity is an aggravating factor. Disturbance of lipoproteins plays a major aetiological role. Decompressive forage should be reserved for the early stages. Secondary degenerative arthritis is almost constant after conservative surgery in cases that have been assessed. The authors obtained good results after Luck's adjusted cups and they consider that this is a reliable procedure. They have observed a high level of septic complications after total prosthesis. It is thought that this is related to the general condition of the patient. PMID- 3520715 TI - [Incidental finding of suprarenal masses]. PMID- 3520716 TI - [Hepatic transplant in Wilson's disease]. PMID- 3520717 TI - [Convulsions and arterial hypertension in 3 patients who had undergone bone marrow transplant and treatment with cyclosporin A]. PMID- 3520718 TI - Postnatal development of renin-angiotensin system in rats. AB - The changes occurring in several components of the rat renin-angiotensin system (RAS) were studied for the brief postnatal period, between the fourth and tenth week of life. The parameters were: plasma renin activity (PRA), plasma renin concentration (PRC), plasma renin substrate (PRS) and the plasma angiotensin II concentration (AII). A gradual decrease in PRA with age was noticed. Between the fourth and the eighth weeks of life, this was attributed to a corresponding decline in both PRC and PRS. However, between the eighth and tenth weeks, no changes in PRA could be detected, but PRC and PRS increased, perhaps as a consequence of the changes in renal function and the AII increase observed. In this second period, simultaneously with the RAS changes described, there was reduced sodium chloride excretion as the glomerular filtration rate (GFR) stabilized. The data presented suggest that this postnatal period is critical, in rats, for the maturation of the RAS component control mechanisms; they appear to be closely related to the development of the renal function. PMID- 3520719 TI - Dopamine-beta-hydroxylase activity in plasma, spleen and adrenal gland of streptozotocin-diabetic rats: correlation with cataracts. AB - In streptozotocin-diabetic rats a large increase in plasma dopamine-beta hydroxylase activity was observed. This increase returned to control values with sufficient insulin doses (6 I.U/day); lower insulin doses did not allow normal level to be reached, a dose-dependent decrease being observed. Although the glycemia levels in the diabetic state are responsible for the plasma dopamine beta-hydroxylase, there is no exact ratio between these two parameters when diabetic animals are treated with different insulin doses which suggests not only the clearance of plasmatic dopamine-beta-hydroxylase, but a contribution from exocytotic tissues as well. In the experimental conditions, before cataracts appeared, the animals about to develop opaque lenses showed a greater dopamine beta-hydroxylase activity than those which were to remain without this complication. After three months in diabetic state, the severity of disease was evident in the animals with cataracts since they showed a significantly higher function of the sympathoadrenal axis, expressed in spleen and adrenal dopamine beta-hydroxylase activity. Plasma dopamine-beta-hydroxylase, as a minority glycoprotein can be considered a useful parameter of other mannose-terminal glycoproteins without having a well-known function, and also as a high risk protein, the accumulation of which in several places contributes to the complex pathogenic mechanism of diabetes complications. PMID- 3520720 TI - [Critical study of methods for the diagnosis of allergic asthma]. AB - A search for an allergic cause in asthma is fundamental to the diagnosis. Typically it is based on: A clinical history. Specific cutaneous and inhaled provocation tests which can produce a possible reaction (early and delayed) which are of great pathophysiological and therapeutic interest. In vitro tests (which enable the different phases of the allergic reaction to be distinguished) to know the serum IgE antibody levels (total IgE, specific IgE and their fixation to cell receptors) cell tests on the degranulation of basophils and the dosage of chemical mediators: histamine, leukotrienes, prostaglandins, P.A.F. in the serum or in the bronchial alveolar lavage liquid, from the study of cells or tissue samples. In this regard the authors stress two recent techniques enabling direct access to bronchial tissue and the pulmonary parenchyma, which are bronchoalveolar lavage and bronchial biopsy, both are possible today by using a fibroscope. The broncho-alveolar lavage still remains in the research area, and is not always well tolerated in asthmatics. It already allows a better definition of the major allergic cytological and biochemical components in asthma (IgE, IgA, albumin, phospholipids, mast cells and eosinophils). Bronchial biopsies with ultra-structural studies, and above all immunopathology (by immunofluorescent techniques and peroxidase stains) enable groups of asthmatics to be uncovered who were considered as non-allergic by the unsuspected intervention of hypersensitivity mechanisms to IgE (the presence of cells carrying IgE); these biopsies enable the importance of inflammatory factors to be confirmed and equally to establish the prognosis in certain asthmatics by the degree of irreversibility of the lesions (fibronectin).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3520721 TI - [Mechanisms of allergic asthma]. AB - The patho-physiology of allergic asthma is the result of several closely interrelated mechanisms. The hypersensitivity to mediation by IgE implies mast cell intervention and also by other non-mast cells possessing a receptor for Fc fragments of IgE. Their activation leads to the liberation of numerous mediators, some of which act directly on the bronchial smooth muscle fibres whilst others intervene by "pro-inflammatory effects". The other essential compound of asthma is non specific bronchial hyperreactivity. In reality the two phenomena are closely linked as is shown with changes in bronchial hyperreactivity after exposure or the inverse, by elimination of the allergen. The slow reaction linked to IgE by the cellular influx which it provokes in the airways amplifies the local inflammatory reaction and by this interacts with the autonomic nervous system. PMID- 3520722 TI - [Thrombotic thrombocytopenic purpura]. PMID- 3520723 TI - [Biochemical bases of iron metabolism]. PMID- 3520724 TI - [A single nocturnal dose of ranitidine in short-term therapy of duodenal ulcer. A controlled double-blind multicenter study]. PMID- 3520725 TI - [Physiopathological bases and current therapeutic trends in conservative treatment of chronic renal insufficiency]. PMID- 3520727 TI - [Myocardial biopsy]. PMID- 3520726 TI - [Multiple myeloma. Recent studies on diagnosis and clinical monitoring]. PMID- 3520728 TI - Digoxin concentrations in postmortem human tissues. AB - An extraction procedure is described that allows the application of a commercially available enzyme-multiplied immunoassay technique to the measurement of digoxin in whole blood, liver, and kidney. The concentrations of digoxin were measured in tissues obtained at autopsy from five patients who had been taking therapeutic doses of digoxin prior to death. Blood concentrations at autopsy were found to be higher than the therapeutic range, perhaps due to postmortem redistribution. Liver concentrations of digoxin showed a positive correlation with blood concentrations; this was not found for kidney concentrations of the drug. PMID- 3520729 TI - Antihypertensive effect of a new calcium channel blocker, FK 235, in essential hypertension. AB - The antihypertensive effect of a new calcium channel blocker (FK 235) were evaluated in 10 patients with mild-to-moderate essential hypertension. The study consisted of 4 weeks of placebo and 12 weeks of the drug, 2 to 4 mg twice a day. Overall systolic and diastolic blood pressures (mean +/- SE) were reduced from 173 +/- 4 to 158 +/- 2 mm Hg (p less than 0.001) and from 97 +/- 2 to 89 +/- 1 mm Hg (p less than 0.001), respectively, with a dose of 5.6 +/- 0.7 mg/day. No relevant changes in heart rate, body weight, and plasma levels of renin activity and aldosterone concentration were observed. No side effects were encountered during the therapy. Our data indicate that the novel active calcium channel blocker can be used as a safe, effective and well tolerated antihypertensive for the treatment of essential hypertension. PMID- 3520730 TI - Effect of several amino acid phosphonates and other compounds on rat brain and kidney peptidases. AB - A series of N-terminal phosphonate derivatives, H2O3PCHPhNHR (R = Leu, Phe, Trp, and/or Tyr), were synthesized with the aim of mimicking phosphoramidon, a potent inhibitor of enkephalinase, while avoiding the lability of the scissile P-N bond. All of the N-phosphonobenzyl derivatives of the amino acids, including the substituted succinylhydrazobenzophenone compounds, were inactive toward rat brain aminopeptidase and rat kidney carboxypeptidase. The N-monobenzylphosphonobenzyl derivatives, PhCH2OPO(OH)CHPhNHR, of individual amino acids and several of the N phosphonobenzyl dipeptides showed inhibition in the micromolar range toward the soluble exopeptidase but were inactive with both the brain and kidney endopeptidase. PMID- 3520731 TI - Transplantation of cryopreserved hepatocytes or liver cytosol injection in the treatment of acute liver failure in rats. AB - Intraperitoneally injected cryopreserved hepatocytes or liver cytosol were used for the treatment of acute galactosamine-induced liver failure in rats. Both methods were similarly capable to improve the survival rates as compared to control groups. Furthermore, a new viability test for transplanted hepatocytes, using a nuclearmedical tracer technique, was evaluated in this study. This test demonstrated viability of intraperitoneally transplanted hepatocytes for at least 6 days after operation. Cytosol injection should be preferred to hepatocyte transplantation in the treatment of acute liver failure, avoiding the problems of cell storage and post-transplant immunosuppression. PMID- 3520732 TI - Serial blood sampling from the portal and hepatic vein in conscious unrestrained miniature pigs. AB - A technique of implantation of portal and hepatic venous catheters in miniature pigs is described in detail. To overcome early patency loss, Swan-Ganz balloon catheters were used. Portal as well as hepatic venous catheters could be held open to withdraw blood and to apply fluids over a period of at least 50 days. The collected hepatic venous blood represents mixed hepatic outflow. The method is recommended to study absorption of drugs and substrates from the gut and their metabolism in the liver of conscious unrestrained experimental animals. PMID- 3520733 TI - The ingrowth quota of autologous spongiosa from different points of removal- experimental study in sheep. A preliminary report. AB - The importance of the point of removal for the ingrowth quota of autologous spongiosa was examined in seven sheep. In six sheep spongiosa was taken from five different regions (proximal radius, olecranon, pelvic crest, trochanter major, and proximal tibia) and was transplanted autologously. Defined corticalis defects of the tibia were the chosen sites for the heterotopic implantations. The ingrowth quota were tested by X-ray as well as scintigraphically, histologically, and fluorescent-microscopically; one animal was taken for control. A judgement was made by quantifying scintigraphy and fluorescent-microscopic histometry. Better ingrowth quota were found for spongiosa from the pelvic crest, proximal tibia, and trochanter major as compared to qualitatively clearly worse transplants from radius base and olecranon. The results from the animal experiments prove the clinical experience. PMID- 3520734 TI - Effects of captopril on hemodynamics and blood gases in chronic obstructive lung disease with pulmonary hypertension. AB - The effects of Captopril, an angiotensin-converting enzyme inhibitor, on pulmonary hemodynamics and blood gases were studied in 9 patients with chronic obstructive lung disease (COLD) and pulmonary hypertension (PA-P greater than 20 mm Hg). Hemodynamic data were recorded prior to Captopril administration (50 mg per os) and for the next 60 min. Following Captopril administration, significant reductions in mean pulmonary artery pressure (PA-P) (p less than 0.05), in mean pulmonary wedge pressure (PW-P) (p less than 0.05), and in total pulmonary resistance (TPR) were noted; significant reductions in mean brachial artery pressure (BA-P) and systemic vascular resistance (SVR) were also recorded, while cardiac output, heart rate and blood gas tensions showed no significant changes. Furthermore, the higher the hypoxemia, the greater was the reduction in BA-P (p less than 0.05). We therefore feel that Captopril, when administered to COLD patients with pulmonary hypertension, may protect the pulmonary circulation from hypoxic pulmonary vasoconstriction. PMID- 3520735 TI - Effect of ketotifen on the bronchodilating action of aminophylline. AB - The use of methyl xanthine derivatives for the treatment of bronchospasm is limited by unwanted side-effects which are frequently dose related. Potentiation of the bronchodilating effects of these derivatives would therefore have obvious clinical advantages. This paper reports the results of a trial designed to elucidate whether potentiation occurs between aminophylline and ketotifen. PMID- 3520736 TI - [Acute effects of nifedipine in severe heart failure--hemodynamics, plasma catecholamine levels, renin activity, metabolism and blood gas data]. PMID- 3520737 TI - [Glucocorticoids and macrophage functions]. PMID- 3520739 TI - Computer simulation of a clinical trial as an aid to teaching the concept of statistical significance. AB - The advent of cheap and powerful microcomputers provides opportunities for improving the teaching of statistics in medicine. This paper describes a practical exercise in which students study the concept of statistical significance using a simple computer program which simulates a clinical trial. The students are required to make decisions about patients with incomplete data and form contingency tables for analysis. This includes analysing contingency tables with several cells having small expected frequencies. The results from 25 groups of students are collected together and presented to the class. Two null hypotheses are tested, one of which is true. For the true null hypothesis the group is likely to produce, by chance, at least one significant result at the 0.05 level. For the false null hypothesis only a minority of results will be significant, because the sample size is small. This leads to a discussion of the concept of statistical significance. The simulation model is described and the advantages and potential of this type of teaching are discussed. PMID- 3520738 TI - Use of an international data bank to compare outcome following severe head injury in different centres. AB - The advantages and drawbacks of basing treatment comparisons on observational data are discussed. Recommendations are made for minimizing bias when basing comparisons on computerized data banks. A specific example is given concerning treatment following severe head injury. PMID- 3520740 TI - Surgical management of vesicoureteral reflux. PMID- 3520741 TI - Paquin revisited. PMID- 3520742 TI - Reflux. PMID- 3520743 TI - Reflux nephropathy follows obstruction or infection. PMID- 3520744 TI - Vesicoureteric reflux: radiologic aspects. PMID- 3520745 TI - [Artificial intelligence in medicine]. PMID- 3520746 TI - [From histology to the ultrasonic, radiographic and clinical expression of isolated lesions of the breast]. PMID- 3520748 TI - Exercise-induced skeletal muscle growth. Hypertrophy or hyperplasia? AB - Postnatal skeletal muscle growth in humans is generally ascribed to enlargement of existing muscle fibres rather than to cellular proliferation. Some evidence of muscle fibre division or splitting was provided in the nineteenth century. This evidence has more recently been supported by fibres obtained from regenerating muscle, and from muscle which has undergone stress-induced growth. Numerous investigators have reported indirect evidence for exercise-induced hypertrophy and hyperplasia. These findings are largely founded on secondary observations of fibre size or number differences expressed relative to muscle cross-sectional area. Since these observations in humans are open to methodological criticism, researchers have developed 3 animal models to represent exercise-induced human muscle growth. These include compensatory hypertrophy, stretch-induced hypertrophy, and weight lifting in trained animals. The results and criticisms of the experiments which have used these models are discussed in this review. In studies of muscle cross-sectional area, errors are created by fibres terminating intrafascicularly. Longitudinal growth of such fibres result in an overestimation of fibre number, and with the use of penniform muscles where fibres do not run parallel to the longitudinal axis of the muscle, the error is compounded. It was concluded that hyperplasia is not yet substantiated, and that new fibres, if present, may be the result of the development of satellite cells. Further experiments are required before a definitive answer can be provided. It is suggested that rigidly controlled exercise studies using contralateral control, fusiform muscles with analysis of individually teased muscle fibres be performed. PMID- 3520747 TI - Applied physiology of swimming. AB - Scientific research in swimming over the past 10 to 15 years has been oriented toward multiple aspects that relate to applied and basic physiology, metabolism, biochemistry, and endocrinology. This review considers recent findings on: 1) specific physical characteristics of swimmers; 2) the energetics of swimming; 3) the evaluation of aerobic fitness in swimming; and 4) some metabolic and hormonal aspects related to swimmers. Firstly, the age of finalists in Olympic swimming is not much different from that of the participants from other sports. They are taller and heavier than a reference population of the same age. The height bias in swimming may be the reason for lack of success from some Asian and African countries. Experimental data point toward greater leanness, particularly in female swimmers, than was seen 10 years ago. Overall, female swimmers present a range of 14 to 19% body fat whereas males are much lower (5 to 10%). Secondly, the relationship between O2 uptake and crawl swimming velocity (at training and competitive speeds) is thought to be linear. The energy cost varies between strokes with a dichotomy between the 2 symmetrical and the 2 asymmetrical strokes. Energy expenditure in swimming is represented by the sum of the cost of translational motion (drag) and maintenance of horizontal motion (gravity). The cost of the latter decreases as speed increases. Examination of the question of size-associated effects on the cost of swimming using Huxley's allometric equation (Y = axb) shows an almost direct relationship with passive drag. Expressing energy cost in litres of O2/m/kg is proposed as a better index of technical swimming ability than the traditional expression of VO2/distance in L/km. Thirdly, maximal direct conventional techniques used to evaluate maximal oxygen consumption (VO2 max) in swimming include free swimming, tethered swimming, and flume swimming. Despite the individual peculiarities of each method, with similar experimental conditions similar results for VO2 max will be found. Free swimming (unimpeded) using the backward extrapolation method will, however, lead to reliable and valid results obtained in a condition that is closer to the competitive situation than with a direct test. A maximal indirect field-test has been recently made available. This test can predict VO2 max with an acceptable accuracy (r = 0.877), and provides a mean to evaluate the functional maximal aerobic power in swimming which corresponds to the maximal aerobic swimming velocity.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3520749 TI - The use of laboratory test results with long distance runners. AB - Appropriate tests can be used to accurately estimate: an individual's potential for success in long distance running; his current level of conditioning; his appropriate training and racing paces; and his ideal bodyweight. The proposed tests include the study of VO2max, running efficiency, maximal steady-state, and body composition. Based on a review of the literature it was determined that VO2max, running efficiency, and body composition provide the information about long distance running potential, including specific paces for various events. Maximal steady-state running pace (pace that elicits 2 mmol/L lactate) identifies appropriate running paces for various events. Relative maximal steady-state oxygen consumption (% VO2max) identifies the current level of conditioning. A comparison of maximal steady-state, running efficiency, and body composition by assessing current status with optimums, provide guidelines for appropriate changes. PMID- 3520752 TI - [Asthma and pregnancy]. PMID- 3520751 TI - [Function-preserving and function-restoring operations in gynecology]. PMID- 3520753 TI - [Bronchial asthma and surgery]. PMID- 3520750 TI - Heat and exercise. Effects on blood volume. AB - The ability of the cardiovascular system to meet the competing demands of skin and muscle for blood flow without compromising regulation of blood pressure is a critical factor influencing the capacity for prolonged work in hot environments. Unfortunately, this competition is exacerbated by the progressive reduction in blood volume (haemoconcentration) which can occur during exercise in the heat. Thermal stress alone induces haemoconcentration only above the upper limit of the prescriptive zone. Exercise performed in a supine or seated position is associated with an initial rapid haemoconcentration, which, if the environmental temperature is high, is followed by a slower, secondary haemoconcentration. Exercise performed in a standing position is associated with variable changes in blood volume, and effects of a superimposed thermal stress are small unless dehydration supervenes. The magnitude of exercise-induced primary haemoconcentration is limited, probably by oedema-preventing mechanisms, and is inversely related to the magnitude of any preceding postural haemoconcentration. Dehydration reduces absolute blood volume (induces hypovolaemia), and accentuates exercise haemoconcentration. Heat acclimatization attenuates dehydration by inducing hypervolaemia, but still appears to accentuate exercise haemoconcentration. During exercise in the heat haemoconcentration represents an undesirable response, the effects of which can be mitigated by heat acclimatization, endurance training, and preventing dehydration. PMID- 3520754 TI - [Oxygen therapy and therapy of cor pulmonale]. PMID- 3520755 TI - [Bronchial asthma as an occupational disease]. PMID- 3520756 TI - [Asthma and infection]. PMID- 3520757 TI - [Indications and limitations of hypnosis in medicine]. PMID- 3520758 TI - [Intestinal drug smuggling: the cocaine "body-packer" syndrome]. PMID- 3520759 TI - [Clinico-immunological analysis of the effectiveness of various methods of treating rheumatoid arthritis]. PMID- 3520760 TI - [Effectiveness of the methods of reflexotherapy in the rehabilitation treatment of patients with rheumatoid arthritis]. PMID- 3520761 TI - [Principles of the pathogenetic therapy of osteoarthrosis deformans]. PMID- 3520762 TI - [Quantitative analysis by a luminescence method of antibodies against cartilage and synovial membrane proteoglycans in the serum of patients with osteoarthrosis deformans]. PMID- 3520763 TI - [Lesions of the upper segments of the gastrointestinal tract in children with scleroderma]. PMID- 3520764 TI - [Raynaud's syndrome in systemic lupus erythematosus and rheumatoid arthritis]. PMID- 3520765 TI - [Surgical treatment of pregnant women with rheumatic mitral stenosis]. PMID- 3520766 TI - [Physical work capacity in persons with a history of myocarditis as seen in the practice of a physician rheumatologist]. PMID- 3520767 TI - [Use of the leukocyte nitroblue tetrazolium reduction test in the differential diagnosis of infectious endocarditis and rheumatism]. PMID- 3520768 TI - [Aschoff-Talalaev granuloma (problems of histogenesis, evolution and clinical significance)]. PMID- 3520769 TI - [Treatment of rheumatoid arthritis with methotrexate (preliminary report)]. PMID- 3520771 TI - [Rheumatic heart disease and pregnancy]. PMID- 3520770 TI - [Clinical course, diagnosis and treatment of Sjogren's disease and syndrome]. PMID- 3520773 TI - [Working classification and nomenclature of rheumatic diseases (1985)]. PMID- 3520772 TI - [Systemic scleroderma with marked involvement of the liver of the primary biliary cirrhosis type]. PMID- 3520774 TI - [Value and limitations of ultrasonic diagnosis in pneumology]. AB - For a number of valid reasons, echotomography has the reputation of being of little interest in respiratory medicine. Its indications are certainly infrequent in everyday practice. However, if chest physicians lose interest in the technique, the paradoxal situation may arise where echotomography in respiratory medicine would be under-estimated and under-used. It would be a pity, since the technique is non-invasive and perfectly harmless. The authors review and illustrate the various indications of the method, emphasizing its interest and its limitations. PMID- 3520775 TI - Eicosanoids and the coronary circulation. PMID- 3520776 TI - Renal erythropoietin: properties and production. PMID- 3520777 TI - Asking yourself "what if?" Case planning for conversion. PMID- 3520778 TI - The precision overdenture. PMID- 3520779 TI - "Inherently reasonable" is not reasonable. PMID- 3520780 TI - Kidney morphology: update 1985. AB - Many new observations have been made correlating changes in renal morphology with changes in renal function. These changes have led to a better definition of the various segments which make up the renal tubule. These morphological patterns vary in different species as is documented by morphologic studies and by differences in the patterns of enzymes in various nephron segments. The subdivision of cells located in the mesangial region of the glomerulus into several types may provide new areas to study with respect to disease processes. PMID- 3520781 TI - Aminoglycoside nephrotoxicity. AB - Aminoglycosides are life-saving antibiotics in patients with gram negative sepsis. Renal dysfunction occurs in approximately 10% of all clinical courses of aminoglycosides. Because of close pharmacokinetic and toxicologic similarities, rats are excellent human surrogates for comparing the nephrotoxic potentials of these antibiotics. Comparisons in rats are also more sensitive than clinical comparisons due to the insensitivities of clinical renal function tests, the confounding influences present in seriously-ill patients and the inability to make morphologic comparisons in the clinic. The pathogenesis of aminoglycoside nephrotoxicity is still evolving despite extensive world-wide investigations. However, these investigations have facilitated the identification of several inhibitors of aminoglycoside nephrotoxicity. The clinical usefulness of these inhibitors must still be established. PMID- 3520782 TI - Cyclosporine nephrotoxicity. AB - Cyclosporine (CSA) is a new immunosuppressant which has selectivity for the immune system and is without systemic side effects at therapeutic doses. In contrast to the cytotoxic class of immunosuppressants, no myelotoxic, teratogenic, mutagenic, or carcinogenic effects were observed. Nevertheless, overdosage may lead to renal dysfunction, which occurs mainly in rats, and often complicates its clinical use. The experimental data also showed that significant nephrotoxicity was only caused under specific conditions at therapeutic doses. These conditions included ischemia, heminephrectomy, concomitant administration of nephrotoxic drugs, and/or genetic predisposition. Thus, concomitant renal damage is a prerequisite in order to obtain overt nephrotoxicity at therapeutic CSA doses. Since these conditions cannot be avoided in patients, nephrotoxicity often occurs at therapeutic doses in man. The rat might be a suitable experimental model of CSA nephropathy displaying similar morphologic and functional changes as observed in man. This model also allows further investigations on the pathogenic mechanisms which are elusive at the present time. PMID- 3520783 TI - [Varicose veins of the lung]. AB - Varicosity of the pulmonary veins is a rare anomaly of the pulmonary vascular system. The varices do not usually change in size over years, do not cause symptoms and need no therapy. However, raised left atrial pressure can cause increase in the diameter of pulmonary vein varices. A case of lung vein varicosity in the right middle and upper lobe associated with coarctation of the aorta and an anomalous upper-middle lobe vein was observed over a period of 10 years. Increase in left atrial pressure (aortic and relative mitral regurgitation) led to enlargement of the pulmonary veins. PMID- 3520784 TI - [Aortic wall dissection as an accidental finding in high translumbar angiography]. AB - The article reports on a translumbar angiography performed without knowledge of an actually present dissection of the wall of the aorta. The key to diagnosis and the subsequent approach are described. PMID- 3520785 TI - [Sonographic follow-up of a 2-stage renal rupture]. AB - The authors report on a two-stage rupture of the kidney that occurred in an eight year old boy after a bicycle accident and was confirmed by sonographic diagnosis and by urography and surgery. Attention is drawn to the advantage and necessity of sonography, which is rapid, can be repeated any number of times, remains non invasive and is very accurate, as a diagnostic tool in renal trauma. PMID- 3520786 TI - [Phlebography versus Doppler sonography for follow-up of venous thromboses of the legs]. AB - The authors demonstrate on the basis of a case that in known thrombosis follow-up of the course of the disease via Doppler sonography will not suffice to determine the success of the treatment. Attention is drawn to the importance of detailed examination in respect of completion or continuation of treatment. PMID- 3520787 TI - [Sonographic localization of a bullet in the pericardium]. AB - We report a case of pericardial localisation of a bullet by sonography. The metallic foreign body could be demonstrated by its typical sonographic appearance of a strongly echogenic lesion with acoustic reverberation artefacts. Sonography proved superior to the other diagnostic modalities including computed tomography. PMID- 3520788 TI - Endotoxin-induced human and porcine leucocyte reactions in vitro. AB - Tube migration of a fixed number of PMN cells in plasma (5 X 10(9) cells/l) was approximately reduced by 50% when 1 ml of cell suspension was exposed to 20 micrograms E. coli endotoxin in 100 microliter NaCl for 2 hours. Procoagulant activity in monocytes increased approximately eight-fold when 1 ml of whole blood was exposed to 2 ng endotoxin in 10 microliters NaCl for 2 hours. Chemiluminescence in both PMN cells (5 X 10(9) cells/l) and mononuclear cells (2 X 10(9) cells/l) in plasma was markedly increased when 100 microliters cell suspension was added to 100 microliters Luminol, exposed to 20 micrograms endotoxin in 100 microliters NaCl and tested immediately. Decreased lysosomal enzyme levels in PMN and mononuclear cells were demonstrated when 1 ml cells in plasma (the same cell numbers as aforementioned) were incubated for 4 hours at 37 degrees C with 200 micrograms endotoxin in 100 microliters NaCl. Similar results were obtained in human and porcine leucocytes, making the pig a suitable animal for studies of humoral and cellular reactions to infections complications following trauma and major surgery. PMID- 3520789 TI - Effect of exercise on plasma concentrations of arginine vasopressin, angiotensin II and aldosterone in hypertensive and normotensive renal transplant recipients. AB - Plasma concentrations of angiotensin II (A II), aldosterone (Aldo) and arginine vasopressin (AVP), and serum osmolality (Sosm) were determined before and after gradually increasing exercise loads on a bicycle ergometer in 10 hypertensive (group I) and 10 normotensive renal transplant recipients (group II), and in 15 healthy control subjects (group III). Working capacity was reduced in groups I and II. The A II, Aldo, AVP, Sosm increased in all groups after exercise. The A II was higher in group I than II and the percentage changes were significantly lower in groups I and II than in group III. There were no significant differences in Aldo between the groups either before or after exercise. The AVP was the same in groups I and II, and AVP in these groups was higher than in group III. The Sosm and AVP were significantly correlated in all groups. Neither A II, Aldo nor AVP were significantly correlated to systolic blood pressure (BP). Alterations in AVP, but not in A II or Aldo, were correlated to the degree of exercise load. It can be concluded that the renin-angiotensin-aldosterone system and the osmoregulatory system are stimulated during exercise in renal transplant recipients. The A II is elevated in post-renal transplant hypertension, but the responsiveness is reduced in both hypertensive and normotensive recipients. The alterations in AVP are probably secondary to changes in Sosm, and the higher AVP levels in recipients could be due to a decreased responsiveness of the renal tubules to AVP. Our findings are in good agreement with the hypothesis that hypertension after renal transplantation is angiotensin II-dependent. PMID- 3520790 TI - Changes in the hepatic capacity of urea-N synthesis, galactose elimination and antipyrine clearance following 70% hepatectomy in the rat. AB - The capacity of urea-N synthesis (CUNS), galactose elimination capacity (GEC), and antipyrine clearance (APC) was investigated in rats 0, 3, 6, 24, 96, and 240 h after 70% hepatectomy. Sham-operated animals were used as controls. The CUNS was assessed during alanine infusion as urea accumulation in total body water, corrected for intestinal hydrolysis, GEC was measured during constant galactose infusion, and APC by the one-sample method. Immediately after the 70% hepatectomy, CUNS was reduced from 8.9 +/- 2.4 to 3.9 +/- 1.1 mumol (min X 100 g body wt)-1 (mean +/- SD, p less than 0.05), that is, 0.43 times the control value. The corresponding reduction in liver weight was 0.36. After 6 h CUNS rose to 0.62 times the control values versus 0.36 for the liver weight. The recovery of GEC and APC was slower than the recovery of the liver weight, and was only restored to 0.81 and 0.59 times the control value (p less than 0.05), respectively, after 240 h. This study demonstrates that after partial hepatectomy the capacity of urea-N synthesis rate is increased, that is, a compensatory hyperfunction of the remnant liver, and that this function is restored to normal more rapidly than other measures of functional liver mass. PMID- 3520791 TI - Effect of 3-hydroxybutyrate infusion on urinary protein excretion in healthy man. AB - Diabetic ketoacidosis is often associated with a temporary increase in protein excretion, but the mechanisms are not completely known. The aim of the present study was to examine the effect of acute experimental moderate ketosis on kidney function and specifically on protein handling using an infusion of 3 hydroxybutyrate in healthy subjects. Seven young healthy males were infused with sodium 3-hydroxybutyrate, the peak blood level attained being 1.96 +/- 0.53 mmol/l (SD). The pH in blood and urine rose significantly from 7.40 +/- 0.03 to 7.45 +/- 0.05 (2p less than 0.01) and from 7.29 +/- 0.79 to 8.51 +/- 0.82 (2p less than 0.01), respectively. Urinary beta-2-microglobulin excretion rose significantly from 0.038 microgram/min x/ divided by 1.9 to 0.082 microgram/min x/ divided by 1.4 (geometric mean x/ divided by tolerance factor) (2p less than 0.01) but urinary albumin excretion was unchanged. No changes were seen in blood pressure, glomerular filtration rate and renal plasma flow. A marked reduction in urine flow from 15 to 5 ml/min was noted, but could not be attributed to changes in plasma arginine-vasopressin, which was reduced before and during infusion due to considerable oral water loading. It is concluded that moderate elevation in blood ketone body levels does not induce albuminuria. It is suggested that the temporary proteinuria present in diabetic ketoacidosis may be related to acidosis per se. PMID- 3520792 TI - The 3H-ouabain binding capacity of skeletal muscle from spontaneously hypertensive rats shows marginal changes in comparison to the major effects of differentiation, K-depletion and thyroid status. PMID- 3520793 TI - Estrogens and pancreatic cancer: some recent aspects. PMID- 3520794 TI - Gastroesophageal reflux disease. Acute and maintenance treatments with cimetidine. AB - The comparative efficacy of a 12-week acute treatment with 800 and 1600 mg cimetidine daily and the effectiveness of a 400-mg single-dose maintenance treatment versus placebo lasting 6 months were studied in a double-blind fashion in 30 and 24 patients, respectively, with gastroesophageal reflux (GER) disease. Cimetidine in a dose of 800 or 1600 mg daily resulted in a significant symptomatic improvement and a decrease in the extent of endoscopic esophagitis. An improvement in the gastroesophageal sphincter function during treatment was suggested by a significant decrease in the frequency of reflux, as evaluated by isotope scintigraphy. No significant differences were found between the two doses of cimetidine. The overall initial improvement tended to be maintained during maintenance treatment, but no significant differences were found between cimetidine and placebo. The present study thus supports the use of 800 mg of cimetidine daily for short-term treatment of GER disease but provides no support for maintenance treatment with a low dose. The study further suggests that cimetidine treatment, by reducing the tendency to GER, may induce long-lasting remission of the disease. PMID- 3520795 TI - Updating prognosis and therapeutic effect evaluation in cirrhosis with Cox's multiple regression model for time-dependent variables. AB - A multivariate Cox regression analysis with time-dependent variables has been performed on the data of 415 patients with cirrhosis included in a controlled clinical trial of 10-15 mg prednisone daily versus placebo. The analysis showed that a poor prognosis was associated with a low prothrombin index, marked ascites, GI bleeding, high age, high daily alcohol consumption, high bilirubin and alkaline phosphatase and low albumin values, little liver connective tissue inflammation, and poor nutritional status. Prothrombin index and ascites showed significant interaction with the treatment in such a manner that high prothrombin index and absence of ascites were associated with a beneficial effect of prednisone, whereas low prothrombin index and presence of ascites were associated with a harmful effect of prednisone treatment. The final model was validated in independent patients by comparing their actual survival with that predicted from the model, using a split-sample testing technique. The prognostic factors were combined with an index that can be used to update prognosis whenever changes occur in the clinical status of a patient during the course of the disease. The probability of surviving the next 3 or 6 months can be estimated from the prognostic index at any time during the course. The index may be of value for the correct timing of special therapeutic procedures such as liver transplantation. PMID- 3520796 TI - Ranitidine, 150 mg three times a day, in the treatment of reflux oesophagitis. A placebo-controlled, double-blind study. AB - The effect of ranitidine, 150 mg three times a day, in the treatment of reflux oesophagitis was studied. A double-blind method was used, and 41 patients with endoscopically verified symptomatic oesophagitis were randomly allocated to ranitidine or placebo. In addition, antacid tablets could be taken as needed. Eighteen patients in both the ranitidine and the placebo groups completed the study. Endoscopically, the healing rate was significantly higher in the ranitidine group after both 6 weeks' (p less than 0.05) and 12 weeks' (p less than 0.01) treatment. The proportion of patients whose oesophagitis healed or improved was also higher in the ranitidine group (p less than 0.05). The patients receiving ranitidine used significantly (p less than 0.002) less antacids than the controls, suggesting a favourable effect of ranitidine on the symptoms of oesophagitis. The histological study did not show significant differences between the ranitidine and the placebo groups. No serious side effects were noted. Ranitidine in a dose of 150 mg three times a day is effective and safe in the treatment of reflux oesophagitis. PMID- 3520797 TI - The endoscopic diagnosis of duodenal ulcer disease. A randomized clinical trial of bias and of interobserver variation. AB - In a randomized design we examined whether endoscopists are biased by knowledge of the radiologic diagnosis of duodenal ulcer and deformity of the duodenal bulb when recording the corresponding endoscopic diagnoses. A total of 156 patients had a barium meal and were subsequently randomized into 2 groups. In 74 of the cases the 2 endoscopists knew the result of the X-ray examination when doing the endoscopy; in 82 of the cases they did not. One endoscopist was significantly biased by his knowledge of the radiologic diagnosis of deformity of the duodenal bulb. Neither of the endoscopists was biased by his knowledge of the radiologic diagnosis of duodenal ulcer. In addition, the interobserver variation between the two endoscopists with regard to the endoscopic diagnoses of duodenal ulcer, deformity of the duodenal bulb, and duodenitis was examined. The interobserver variation was expressed by the overall agreement and by the kappa statistics, which adjusts the overall agreement for expected chance agreement. For duodenal ulcer, deformity of the duodenal bulb, and duodenitis, the overall agreements and kappa values were 0.91, 0.78, and 0.75, and 0.54, 0.42, and 0.33, respectively. PMID- 3520798 TI - Short-term treatment of duodenal ulcer. A comparison of sucralfate and cimetidine. AB - A multicenter randomized double-blind study was performed to compare a cytoprotective agent (sucralfate) and an acid-reducing agent (cimetidine) in the treatment of duodenal ulcer. Patients with acute ulcerations in the pyloric ring and duodenal bulb confirmed by endoscopy were included in the trial. All patients were examined after 4 and, if not cured, after 8 weeks. A total of 371 patients from 15 centers completed the trial. The patient groups were comparable. At 8 weeks 86% of 177 patients receiving sucralfate treatment were cured, compared with 92% of 194 receiving cimetidine (NS). The corresponding figures at 4 weeks were 71% (sucralfate) and 77% (cimetidine) (NS). The 95% confidence interval for the difference in ulcer healing efficacy of sucralfate compared with cimetidine at 8 weeks was -12% to +5%. Antacid intake and symptoms decreased rapidly in both groups. Three patients were withdrawn owing to side effects. It is concluded that sucralfate and cimetidine. representing two different approaches to ulcer therapy, are both very effective and compare well with regard to ulcer healing, symptom relief, and side effects in the short-term treatment of acute duodenal ulcer. PMID- 3520799 TI - A possible role of rifampicin in prolonging remission duration in acute myelogenous leukaemia. AB - The remission duration (RD) of 22 adult acute myelogenous leukaemia patients who received maintenance rifampicin treatment during 24 episodes was significantly longer than RD in 29 complete remission patients who received conventional maintenance chemotherapy (25 versus 9 months, p less than 0.003). Although this study was not randomized, the observed RD in the rifampicin group suggests a suppressive activity upon regrowth of residual disease in acute myelogenous leukaemia during apparent complete remission. PMID- 3520800 TI - Reptilase for ANLL with DIC. PMID- 3520801 TI - Screening monoclonal antibodies against cell-surface antigens. High frequency of natural antibodies. AB - Two commonly used methods for screening hybridoma supernatants against cell surface antigens were performed simultaneously on the supernatant culture fluids of different hybridizations, and compared with the detection of Ig secretion. Supernatants reacting with glutaraldehyde-fixed cells (ELISA (Enzyme-linked immunosorbent assay) on fixed cells) are mostly non-specific for the immunogen; in addition, with this method, only half of the antibodies detected by immunofluorescence are identified. These results can be explained by the frequent occurrence of hybridomas secreting antibodies displaying 'natural antibody' properties, which are strongly reactive with intracellular antigens, and apparently made accessible by the fixation procedure. Since artefacts impair the interpretation of results with ELISA on fixed cells, and complement-mediated cytotoxicity usually as a low yield, membrane immunofluorescence remains the best method for screening hybridoma antibodies. PMID- 3520802 TI - Natural killer and T-cell potentiation by monoclonal IgG against natural killer cell FcR(IgG) or the T3 complex. AB - Treatment of human natural killer (NK) cells with monoclonal antibodies of the IgG isotype against NK cell-FcR(IgG) increased lysis of most haematopoietic target cell lines with high or intermediate background NK susceptibility. Treatment of normal non-adherent lymphocytes with an IgG anti-T3 monoclonal antibody also increased lysis against the same target cells. Potentiating anti FcR antibodies rapidly modulated FcR activity and the capacity of the cells to act as antibody-dependent killers, although such antibodies were demonstrable for a long time at the cell surface. Anti-FcR treatment did not influence concanavalin A (Con A)-dependent killing, in contrast to anti-T3 treatment, which suppressed lectin-dependent lysis but did not influence antibody-dependent killing. The data is compatible with a 'pro-receptor' theory for FcR in NK killing, stating that such receptors may function in the same way as the T3 complex interacts with specific T cell receptors. PMID- 3520803 TI - Season of birth: schizophrenia and bipolar disorder. AB - Studies investigating the association between the risk of schizophrenia and season of birth are reviewed and the association clearly established. This association cannot be explained on the basis of age-incidence or age-prevalence artifacts. Other studies suggest there may be an association between bipolar disorder and season of birth. The leading theory in explaining the season of birth phenomenon is that a seasonal factor (such as viral infection, malnutrition, vitamin deficiency, prenatal or obstetrical complications, or ambient temperature) can damage an infant's brain and thereby predispose the child to later development of psychosis. Evidence suggests that the seasonal effect is associated with a subgroup of schizophrenics who have early onset of psychosis, less genetic loading than other schizophrenics, and better prognosis. Case-control studies are needed comparing winterborn to nonwinter-born schizophrenics. PMID- 3520804 TI - A holistic program for chronic schizophrenic patients. AB - A 10-week, inhospital holistic health program for male schizophrenic patients was compared with an equally intense social skills training program. The holistic program included training in the stress reduction techniques of exercise and meditation as well as education in stress management. Patients were also encouraged to explore the growth potential of their psychotic experiences and to develop positive beliefs about the outcome of their illness. Both groups showed similar significant decreases in psychopathology from admission to discharge, but the use of medication and a token economy milieu by all patients confounds the interpretability of this finding. After the holistic patients were discharged into the community, there was no maintenance of any of the holistic techniques. The 2-year relapse rate did not differ significantly between the two treatments. Findings from various studies associating schizophrenic relapse with stressful life events and familial tension make further experimentation with stress reduction techniques for the treatment of schizophrenia worthwhile. PMID- 3520805 TI - [Seroprevalence of human Q fever in Switzerland]. AB - In current practice, only serology, by the titration of anti-Coxiella burnetii antibodies, permits the diagnosis of acute or chronic Q fever. New serological techniques have also made it possible to more accurately determine the number of people in a community who have been affected by this infectious agent. We have thus been able to compare the results of 1437 specimens from the whole of Switzerland with 4009 taken in the Valais. The analysis of these sera by indirect microimmunofluorescence now shows that Q fever is much more prevalent than was generally estimated. However, these results vary greatly from one area and another, between 6.7% and 31.7% depending on the locality. Normally the lowest percentages were found in the big cities (from 9.5% to 12.2% in Berne, Geneva and Zurich) whilst the highest incidences were found in mountain regions (from 23.6% to 31.7% in the Tessin, Uri or the Valais). Regarding sex distribution, it was found that the incidence of Q fever is on average slightly lower (between 3% and 5%) in women than in men. It was also noted that the percentage of people having anti-Coxiella burnetii antibodies increases with age. The high incidence of Q fever in Switzerland is also of concern because of a severe and chronic form of this infection: endocarditis. PMID- 3520806 TI - [Actinomycosis of the colon: clinical, endoscopic, serological and therapeutic aspects]. AB - The case of a 73-year-old woman with extensive abdominal actinomycosis is reported. It appears to be the first case of abdominal actinomycosis in which endoscopic and serologic investigations have been performed before and after medical therapy. Ultrasonography, CT scan and surgical exploration revealed an extensive inflammatory tumor of the sigmoid colon involving the urinary bladder and uterus. Histologic examination revealed typical sulfur granules. Longterm highdose therapy with penicillin was performed. PMID- 3520807 TI - [Immunological aspects of acute renal insufficiency]. AB - Uremic patients are known to be particularly susceptible to infections and possibly cancer. They have a definite cutaneous anergy to the various antigens used to test delayed-type hypersensitivity. However, in vitro investigations of the individual functions involved in the immune response have not disclosed a profound and reproducible defect of one of these functions. This could be due to the heterogeneity of the patients studied (uremia of differing etiology, variation in metabolic and nutritional conditions, and influence of multiple complications). It is also possible that the main defect lies in regulation and cooperation between the individual functions. PMID- 3520808 TI - [Liver injuries]. AB - Mortality in blunt hepatic trauma is still high, death being most frequently caused by hemorrhage. Associated injuries are present in nearly all cases. A variety of possible surgical procedures allow treatment tailored to fit the individual situation. Even the sophisticated intensive care required by the frequent posttraumatic complications is not a substitute for adequate surgery. PMID- 3520809 TI - [Work of breathing in spontaneous respiration with continuous positive airway pressure]. AB - In postoperative respiratory failure continuous positive airway pressure (CPAP), besides improving pulmonary gas exchange, influences respiratory mechanics. Elastic and flowresistive components of respiratory work were measured in intensive care patients being weaned from the respirator. Measured values during breathing with a continuous-flow CPAP system with elastic reservoir were compared with those for O2 breathing via T-tube. Under CPAP total breathing work and resistance were reduced. Compliance, tidal volume and respiratory frequency did not change significantly. The reduction in respiratory work was primarily due to decreased nonelastic work associated with a decrease in resistance. Thus, on weaning from mechanical ventilation using a reservoir-CPAP system, the respiratory work was reduced in comparison to O2 breathing via T-tube. PMID- 3520810 TI - [The effect of positive end-expiratory pressure (PEEP) on extravascular lung water in intensive care patients]. AB - The use of positive end-expiratory pressure (PEEP) has been highly recommended because of its favourable effects on pulmonary gas exchange and circulation. It was the aim of this study to investigate the influence of PEEP on extravascular lung water (EVLW), which was estimated by the thermal-dye technique. In 12 intensive care patients PEEP was changed every 30 minutes from 0 to 5, 10, 15 and 0 cm H2O, thereby causing a non-significant increase in EVLW of 2, 10, 7 and 1%. Analysis of individual EVLW-dynamics revealed a more than 20% increase in 6 of 7 patients with normal EVLW (5.8 +/- 0.9 ml/kg), whereas this occurred in only one of the five patients with elevated EVLW (10.9 +/- 1.1 ml/kg). Intraindividual regression analysis between EVLW and PaO2/FiO2, AaDO2/FiO2, Qs/Qt, and CO revealed no correlation between these parameters. Therefore, shorttime application of PEEP did not affect EVLW. Patients with normal EVLW were more prone to show increased EVLW during PEEP than patients with elevated EVLW. PEEP induced improvement of gas exchange and pulmonary shunt were not accompanied by changes in EVLW. PMID- 3520811 TI - [The effect of cortisone on the course of respiratory and clinical parameters in ventilator patients with imminent ARDS]. AB - 24 subjects in an intensive care unit with indication for mechanical ventilation with PEEP and predisposition for ARDS have been investigated. All patients received 2 g prednisolone 8 times over 48 hours. In group A (14 patients) this was administered within the first 24 hours of the beginning of the ventilation, and in group B (10 patients) at a later stage in the therapy. Severity of the disease was assessed by TISS, and, in addition to respiratory parameters, coagulation, thrombocytes, blood sugar, lactate and phosphate were determined. The data were evaluated by exploratory data analysis with box plots and median values. According to TISS, the two groups are comparable (group A 31.5 points, group B 31.3 points, age in group A 50.6 years, in group B 54.0 years). FiO2 rose from 0.44 to 0.82 in group B and in group A declined from 0.83 to 0.3 during receipt of PaO2 of more than 60 torr. EIP (endinspiratory pressure) rose from 28.7 cm H2O to 33.5 cm H2O in group B and fell from 29 to 26 cm H2O in group A. Compliance in group B fell and remained constant at over 48 ml/cm H2O in group A. PTT and TZ were normal in both groups, and Quick time values lower in group A than in group B. Thrombocytes fell to 63,000 in group B and rose to 201,000 in group A. Lactate, phosphate and leukocytes were unchanged in both groups. No cases of pulmonary infection were observed in either group. Mortality was 50% in group A and 80% in group B. Critical evaluation of the data from this retrospective study suggest a more favourable course, especially of the respiratory parameters, if a high dose of corticosteroids is administered at an early stage (group A). PMID- 3520812 TI - [Inflammatory bowel disease and hormonal contraception]. AB - Case reports and controlled studies show a definite relationship between the use of oral contraceptives and chronic inflammatory bowel disease. Based on a review of the literature, the clinical, radiological and endoscopic features of bowel disease associated with the use of oral contraceptives are described and the pathogenesis is discussed. The use of contraceptives should be inquired into in any women presenting with chronic enteritis or colitis, since this could be of decisive prognostic and therapeutic importance. PMID- 3520813 TI - [Pulsatile tinnitus and arteriovenous fistulas of the dura mater]. AB - A series of 12 patients with angiographically proven arteriovenous fistula of the dura mater are reported. This condition is more common than might be supposed and should be considered whenever a patient complains of pulsatile tinnitus accompanied by an auscultatory bruit. Doppler sonography is the noninvasive method of choice in arriving at a precise diagnosis and guiding neurological and radiological investigations towards selective angiography of the external carotid artery, the only technique which will reveal the origin of the pedicles. Doppler sonography is also very useful in monitoring the course of the untreated disease and its postoperative course. Although these fistulae may remain asymptomatic for a long time, depending upon their drainage and localization, they may give rise to serious complications, in particular haemorrhage, which render in general surgical treatment desirable. With regard to pathogenesis, the fistulae may be congenital, but are most frequently acquired. PMID- 3520814 TI - [Transcranial Doppler sonography. A new method for the diagnosis of cerebrovascular diseases]. AB - Transcranial Doppler sonography, a new method for the evaluation of cerebrovascular disease, is presented. After outlining the technical basis, investigation technique and normal values, the authors describe the utility of the method for the evaluation of stenosis and occlusions of the extracranial and intracranial arteries, spasms after aneurysmatic subarachnoid hemorrhage, arteriovenous malformations, and patients with arrested cerebral circulation due to high intracranial pressure. The value of Doppler methods for the evaluation of cerebrovascular diseases is discussed. PMID- 3520815 TI - [Thrombotic thrombocytopenic purpura treated with prostacyclin. Apropos of 2 case reports]. AB - The syndrome of thrombotic thrombocytopenic purpura (TTP) has an uncertain course, is often fatal, and its pathogenesis is obscure. None of the treatments suggested is of proven efficacy. Two cases of TTP are reported with a favourable outcome probably due to continuous intravenous perfusion of prostacyclin combined with antiplatelet drugs for several days, after steroids, plasmapheresis and fresh plasma had failed. The two patients are at present in complete remission after 8 and 20 months under prophylactic treatment with salicylate and dipyridamole. PMID- 3520816 TI - [The concept of sonographic organ diagnosis--a contribution to quality assurance]. AB - The examination of organs with ultrasound (echoscopy) may be compared with laparoscopy. In either case the examiner must evaluate the findings and correlate them with the clinical picture directly when investigating the patient. Echoscopy thus becomes more and more specialized as technical standards rise. This also requires the complementary use of different probes. A comprehensive concept of a three-stage diagnostic procedure is suggested. PMID- 3520817 TI - [Statistical principles for the validation of diagnostic procedures. A contribution to quality assurance exemplified by Doppler sonography]. AB - This article presents an introduction to some basic considerations for the evaluation of diagnostic tests and procedures. In order to determine the characteristics of a diagnostic procedure sensitivity and specificity are estimated from results of an evaluation study. The statement of confidence limits gives an idea of the safety of the estimates. Different scales of measurement and their respective distributions must be taken into consideration. Quite often sensitivity and specificity are dependent on various threshold values. ROC-curves can be used to study this dependence. In practice the interpretation of test results relies on the predictive value. The Bayes formula permits calculation of the predictive value depending on sensitivity, specificity and prevalence. This paper illustrates the application of statistical methods by analysing data of Doppler ultrasound studies. PMID- 3520818 TI - [Determination of the acoustical properties of enamel, dentin and alveolar bone]. AB - An ultrasonic method for periodontal diagnosis has been developed by the authors. A fundamental part of this work is the evaluation of the acoustical properties of the hard tissues: enamel, dentine and alveolar bone. Using an adapted measuring device, in combination with a computer-controlled signal acquisition and analysing system, acoustical parameters (velocity, impedance and frequency dependent attenuation) are determined. The knowledge of these parameters is a prerequisite for a correct interpretation of A-mode and B-mode images, representing parts of the oral/facial aspect of a periodontium. PMID- 3520820 TI - The UCLA-Occidental-Gorbachev connection. Interview by Gina Kolata. PMID- 3520819 TI - The application of bone marrow transplantation to the treatment of genetic diseases. AB - Genetic diseases can be treated by transplantation of either normal allogeneic bone marrow or, potentially, autologous bone marrow into which the normal gene has been inserted in vitro (gene therapy). Histocompatible allogeneic bone marrow transplantation is used for the treatment of genetic diseases whose clinical expression is restricted to lymphoid or hematopoietic cells. The therapeutic role of bone marrow transplantation in the treatment of generalized genetic diseases, especially those affecting the central nervous system, is under investigation. The response of a generalized genetic disease to allogeneic bone marrow transplantation may be predicted by experiments in vitro. Gene therapy can be used only when the gene responsible for the disease has been characterized. Success of gene therapy for a specific genetic disease may be predicted by its clinical response to allogeneic bone marrow transplantation. PMID- 3520821 TI - Florida physician to be Assistant Secretary for Health. PMID- 3520822 TI - Clinical and biochemical characteristics of autoantibody systems in polymyositis and dermatomyositis. PMID- 3520823 TI - Clinical development of biological response modifiers: comparison with cytotoxic drugs. PMID- 3520824 TI - Local administration of immunomodulators. AB - This summary of results with local BRM administration has been brief because the number of clinical situations in which this approach is applicable is quite limited. On the other hand, when applied in an appropriate patient population, clinical responses are frequent. In addition, detailed study of the effector cells and cytokines that appear in responding patients may yield information concerning the mechanism of action when BRM therapy is effective. Finally, comparison of the results from clinical trials with the results in experimental animals may help to further elucidate the mechanism by which BRMs exert antitumor effects. PMID- 3520825 TI - Monoclonal antibodies: potential applications to the treatment of cancer. PMID- 3520826 TI - Active immunotherapy against cancer: present status. PMID- 3520827 TI - The adoptive immunotherapy of cancer using the transfer of activated lymphoid cells and interleukin-2. PMID- 3520828 TI - Lymphokines: from conjecture to the clinic. PMID- 3520829 TI - Differentiation factors. PMID- 3520830 TI - Delta agent (type D) hepatitis. PMID- 3520831 TI - [Marginal seal of a composite-resin restoration system with an adhesive liner]. PMID- 3520832 TI - [Marginal seal of 3 kinds of visible light-cured composite resins]. PMID- 3520833 TI - [Pulp response to a posterior composite resin restoration with enamel etching or with enamel and dentin etching]. PMID- 3520834 TI - [Cutting efficiency of dental cutting disks]. PMID- 3520835 TI - Social class and survival on the S.S. Titanic. AB - Passengers' chances of surviving the sinking of the S.S. Titanic were related to their sex and their social class: females were more likely to survive than males, and the chances of survival declined with social class as measured by the class in which the passenger travelled. The probable reasons for these differences in rates of survival are discussed as are the reasons accepted by the Mersey Committee of Inquiry into the sinking. PMID- 3520836 TI - Practical aspects of the use of photoproteins as biological calcium indicators. PMID- 3520837 TI - Video-enhanced microscopy. PMID- 3520838 TI - Intracellularly trapped pH indicators. AB - The trapped indicator technique has several advantages for monitoring intracellular pH. It can be performed with equipment available in most laboratories, using either fluorescence or absorbance measurements. It is nondestructive to cells, and fluorescein dyes seem to have little effect on cell metabolism (however, see Spray et al., 1984). Continuous real-time monitoring of intracellular pH is possible, and the method can detect changes of 0.01 pH. It is sensitive enough for studies with monolayers (Thomas et al., 1982) or individual cells (Slavik and Kotyk, 1984; Udkoff and Norman, 1979). In addition, pH changes in the cytoplasmic and mitochondrial compartments can be distinguished by judicious use of CF and F. On the negative side, one of the main problems encountered is that of leakage, especially for F. Spectral measurements must be corrected for leakage in order to assess pH accurately. Three ways of minimizing leakage are as follows: (1) Use a less leaky indicator, such as BCECF (Rink et al., 1982); (2) lower the incubation temperature; (3) continuously remove external indicator by perfusion technique (Boron, 1982). Although CFA2 specifically monitors cytoplasmic pH in several different cell types, this may not necessarily be a general phenomenon. As shown in this chapter, it can report mitochondrial pH transitions if it is first hydrolyzed by mitochondrial esterases. Thus, this specificity for the cytoplasm should be established for any new cell type studied. As a final note, Spray et al. (1984) have recently reported that the intracellular hydrolysis of certain membrane-permeant esters causes an acidification of the cytoplasm in several cell types. The acidification was considerably in excess of that expected from the small amount of acid generation caused by the esterase reaction. How general this phenomenon is remains to be established. PMID- 3520839 TI - New tetracarboxylate chelators for fluorescence measurement and photochemical manipulation of cytosolic free calcium concentrations. PMID- 3520840 TI - Membrane dynamics studied by fluorescence correlation spectroscopy and photobleaching recovery. PMID- 3520841 TI - Laser pulsed release of ATP and other optical methods in the study of muscle contraction. PMID- 3520842 TI - Optical monitoring of membrane potential: methods of multisite optical measurement. PMID- 3520843 TI - Surgical reconstruction of the proximal subclavian and vertebral arteries. AB - The diagnosis and management of atherosclerotic lesions of the extracranial internal carotid artery has become fairly well established. Symptoms of basilar artery hypoperfusion may be due to stenotic lesions at the origin of either or both vertebral arteries or the proximal subclavian artery. Surgical correction can offer relief of symptoms. For the past decade, we have used a direct anastomosis from the vertebral or subclavian artery distal to the lesion to the adjacent common carotid artery. We have done this procedure 579 times, with one death and no neurologic deficit. A lymph fistula required closure in one patient, and reoperation was necessary in three patients because of bleeding. The results have been excellent, and we continue to offer this method of restoring arterial circulation in patients with cerebellar symptoms and vertebral hypoperfusion. PMID- 3520844 TI - Delayed chest wall complications of median sternotomy. AB - Chest wall pain after coronary artery bypass surgery is often attributed to incisional pain or anxiety. Although this assumption is often correct, a small number of patients have an unrecognized chest wall complication of the median sternotomy. In this paper we identify these delayed postoperative midsternotomy complications and discuss their appropriate management. PMID- 3520845 TI - Postconcussion symptoms after head trauma: interpretation and treatment. AB - Postconcussion symptoms frequently present significant barriers to recovery after head injury. For most patients, emphasis on either organic or functional factors as the sole basis for such symptoms is unwarranted. In addition to the psychologic and behavioral impact of such deficits, recognition of cognitive deficits arising from head injury is an important means of comprehending postconcussion symptoms. We recommend structured recovery programs involving the matching of cognitive capabilities to stress level in treating postconcussion symptoms. PMID- 3520846 TI - Sociopolitical influence upon medical education: the Medical College of Alabama (1859 to 1861) as a model. PMID- 3520847 TI - Confederates, chloroform, and cataracts: Julian John Chisolm (1830-1903). PMID- 3520849 TI - Officers--Southern Medical Association 1985-1986. PMID- 3520848 TI - Discovery of the sulfa drugs. PMID- 3520850 TI - [Alcoholism as a social and hygienic problem]. PMID- 3520851 TI - [Development and current status of history of medicine in the East Germany]. PMID- 3520852 TI - [Maternal health services during World War II]. PMID- 3520853 TI - [Evacuation hospitals of the People's Commissariat of Public Health of the USSR]. PMID- 3520854 TI - [Active participant in the Revolution 1905-1907, bolshevik N.P. Sagredo]. PMID- 3520855 TI - [Evolution of the theories on the role of microorganisms in infection]. PMID- 3520856 TI - [History of the Pirogov museum (on the 175th anniversary of the birth of N.I. Pirogov)]. PMID- 3520857 TI - [A.P. Chekhov and the zemstvo physicians]. PMID- 3520858 TI - [Petr Vasil'evich Rudanovskii--the chief physician of the Demidov factories]. PMID- 3520859 TI - [The life and work of T.Ia. Takchev]. PMID- 3520860 TI - [N.I. Pirogov and the revolutionary democrats in Russia]. PMID- 3520861 TI - [V.I. Bogdanov--physician and poet-democrat]. PMID- 3520862 TI - [P.F. Lesgaft and N.I. Pirogov]. PMID- 3520863 TI - [Chekhov's meetings with physicians during his journey to the island of Sakhalin]. PMID- 3520864 TI - [Treatment of post-injection abscesses and phlegmons in patients with diabetes mellitus]. PMID- 3520865 TI - [Hyperosmolar hyperglycemic diabetic coma]. PMID- 3520866 TI - [Shoulder and scapula periarthritis]. PMID- 3520867 TI - [Comparative study of the action of hypolipemic and antioxidant drugs in ischemic heart disease]. PMID- 3520868 TI - [Effect of lidocaine and pyromecaine on cellular hemostasis and microcirculation]. PMID- 3520869 TI - [Effectiveness of cimetidine and ranitidine in peptic ulcer]. PMID- 3520870 TI - [Diagnosis of disorders of the peripheral circulation]. PMID- 3520871 TI - [Complications of hemosorption and the methods of their prevention]. PMID- 3520872 TI - [Diabetogenic effect of drugs]. PMID- 3520873 TI - [Pathogenesis of the typhoid bacterium carrier state]. PMID- 3520874 TI - [Problems of medical deontology in Tolstoy's short story "The Death of Ivan Il'ich" (on the centenary of its publication)]. PMID- 3520875 TI - [Clinico-laboratory characteristics of Yersinia infection]. PMID- 3520877 TI - [The technic of orthotopic transplantation of the heart]. PMID- 3520876 TI - Anaphylactic and anaphylactoid reactions. A review. AB - Anaphylaxis is a life-threatening, immunologically mediated reaction. "Anaphylactoid" reactions produce the same clinical syndrome but are not immunologically mediated. Vasoactive mediators of these reactions include histamine, eosinophilic chemotactic factors of anaphylaxis, slow reacting substance of anaphylaxis (a mixture of three leukotrienes, one a potent coronary vasoconstrictor), kinins, and prostaglandins. Symptoms usually occur within 15 minutes of parenteral injection of the causative agent, but can be delayed as long as 2.5 hours. Because vasodilation occurs at the capillary and postcapillary venule, resulting in loss of fluid and colloid (and hence reduction in effective plasma volume), and then shock, volume replacement is a mainstay of therapy. This article reviews the pathophysiology, incidence, and drug causes of anaphylactic/anaphylactoid reactions and proposes therapy to minimize the consequences of reactions seen by physicians treating spinal conditions. PMID- 3520878 TI - [Problems in the removal of pancreatic grafts for transplantation from the aspect of their vascular supply]. PMID- 3520880 TI - [Adult Still's disease]. PMID- 3520879 TI - [Werner's syndrome and collagen diseases]. PMID- 3520881 TI - [Efficacy of 156-S against rheumatoid arthritis]. PMID- 3520882 TI - Penbutolol in black hypertensive patients. PMID- 3520883 TI - Perspectives in the pathogenesis of halothane-induced hepatitis. AB - The evolution of today's accepted theories regarding the pathogenesis of halothane-induced hepatitis (HIH) is traced from a selection of the extensive literature covering this rare condition. Initial postulates indicted an immunological mechanism. The development of a laboratory model (starved, phenobarbitone-pretreated, hypoxic rat) uncovered two other 'triggers': highly reactive (toxic) free-radical intermediates generated from a reductive metabolic pathway; and hypoxic stress alone. None of these proposed mechanisms incontrovertibly excludes the other and complex interrelationships may exist. Continuing research utilizing sophisticated analytical tools and new HIH animal models suggests that the field remains incompletely explored. PMID- 3520884 TI - Computers and learning. PMID- 3520885 TI - Partial efficacy of clindamycin against Chlamydia trachomatis in men with nongonococcal urethritis. AB - Tetracyclines are the drugs of choice for treatment of Chlamydia trachomatis infection, but alternative antimicrobial agents are needed. Clindamycin has moderate in-vitro activity against C. trachomatis. In this study clindamycin (600 mg orally three times daily for seven days) was given to 76 men with nongonococcal urethritis. Initial microbiologic and clinical responses were significantly better in men from whom C. trachomatis was initially isolated, compared with men from whom Ureaplasma urealyticum was initially isolated, but by 42 +/- 7 days after initiation of treatment, persistence or recurrence of urethritis had occurred in 39% of men with either organism initially isolated. C. trachomatis was ultimately reisolated at follow-up evaluation from seven of 23 men who initially had had positive cultures for C. trachomatis. There was no apparent relationship between the in-vitro susceptibility of C. trachomatis and the ultimate response. These results indicate that clindamycin cannot be relied upon to eradicate C. trachomatis from men with urethritis. PMID- 3520887 TI - Cyclosporine: progress, problems, and perspectives. AB - Since it much heralded debut, cyclosporine appears to have gained a major role in organ transplantation. The drug appears to have gained widespread acceptance as the immunosuppressive treatment of choice for high-risk cadaveric renal transplant recipients as well as for extrarenal organ graft recipients who depend upon a successful allograft for survival. Most centers have utilized either HPLC or RIA assays for cyclosporine levels in blood or serum to maximize immunosuppressive therapy with minimal toxicity during the critical period of induction therapy. In most patients, the balance between therapeutic and toxic effects of cyclosporine favors the immunosuppressive efficacy of the drug. Long term consequences of cyclosporine therapy and innovative future treatment protocols will define the size of the role cyclosporine will play in the future as well as the interaction with uncast groups, such as highly presensitized patients. PMID- 3520886 TI - In-vitro and in-vivo activity of parenterally administered beta-lactam antibiotics against Chlamydia trachomatis. AB - The extended-spectrum penicillins ticarcillin, mezlocillin, and piperacillin might be useful as single agents for the treatment of pelvic infections in women if it could be shown that these drugs are active against Chlamydia trachomatis. We found that the MIC90 (concentration at which 90% of strains are inhibited) values of ticarcillin, mezlocillin, and piperacillin were 16, 16, and 64 micrograms/ml, respectively. Several cephalosporins were found to have MICs for C. trachomatis of greater than 200 micrograms/ml. Ten women with postpartum endometritis who were colonized with C. trachomatis had repeated chlamydial cultures following treatment with beta-lactam antibiotics. All seven cases treated with ticarcillin plus clavulanic acid (a beta-lactamase inhibitor) or piperacillin alone had C. trachomatis-negative cultures after treatment. Three of four of these women had negative cultures at a second follow-up visit. In contrast, the three women treated with a cephalosporin were culture-positive at their first follow-up clinic visit. These data suggest that there is a correlation between the in-vitro measurement of beta-lactam antibiotic activity against C. trachomatis and the microbiologic outcome of treatment. We conclude that the extended-spectrum penicillins deserve further evaluation as single agents for the treatment of pelvic infections in women at high risk for C. trachomatis infections. PMID- 3520888 TI - Multiple cadaveric organ procurement for transplantation with emphasis on the heart. AB - The operative technique for multiple cadaveric organ procurement is described. Delineated in detail are the means by which the cardinal principle of in situ core-cooling of different organs is applied to obtain liver, kidneys, and a heart for transplantation. PMID- 3520889 TI - Diagnosis and treatment of infection in cardiac transplant patients. AB - Despite major advances in the management of rejection and the development of newer and more potent antimicrobials, infection still constitutes a major problem in transplant patients and other immunosuppressed hosts. Infectious complications in transplant patients clearly occur in two phases. The first phase includes the first 30 to 60 days after transplantation. During this period, nosocomial bacterial infections are most commonly encountered. Pulmonary, renal, and wound infections have all been encountered, and prophylactic antibiotics appear to decrease their frequency. Opportunistic infections usually do not occur during this period unless the patient undergoes treatment for acute rejection. The second phase of infectious complications usually follows the first month after transplantation. In this period, the level of immunosuppression is high, and opportunistic infections are common. Opportunistic pulmonary infections caused by P. carinii, L. pneumophila, cytomegalovirus, Aspergillus, and Nocardia spp. all are potentially life-threatening complications to the transplant patient. Aggressive diagnostic tests such as bronchoscopy, percutaneous needle biopsy, or open lung biopsy are frequently needed to make a diagnosis. Empiric broad spectrum antimicrobial therapy is indicated in the ill patient; however, more specific therapy should be instituted once the diagnosis is confirmed. PMID- 3520890 TI - Myocardial preservation. AB - The principles used to develop techniques for myocardial preservation in cardiac surgery have been successfully applied to the protection of the donor heart in transplant surgery. This article reviews the latest advances in myocardial preservation during cardiac surgery and shows how they have been adopted in current cardiac transplant techniques. PMID- 3520891 TI - Cardiac transplantation. AB - Beginning with experimental studies in 1905, cardiac transplantation has progressed, with notable advancements in 1967 to 1968, to be a proven therapeutic modality for patients with end-stage heart disease. The Texas Heart Institute, one of the major heart transplant clinics in the world, re-established its heart transplant program in 1981 using the immunosuppressant cyclosporine. Since then (as of July 17, 1985), 74 transplant operations have been performed there with particular care to the details of donor selection, patient management, surgical procedure, and postoperative care. PMID- 3520892 TI - Cardiopulmonary transplantation. AB - Heart-lung transplantation is now an established clinical procedure. Immediate problems include satisfactory donor procurement and the control of hemostasis in patients who have had extensive previous surgery. Immediate return of normal pulmonary function is good but is not maintained in all patients. Late dyspnea has occurred in some patients, one of whom had a successful retransplant procedure. Progress is now being made in the early detection and management of late pulmonary rejection, which are likely to improve late symptomatic results and survival. PMID- 3520893 TI - Lung transplantation. AB - Over the past 20 years, many advances in surgical methods, transplantation immunology, donor organ procurement and preservation techniques, and postsurgical care regimens have influenced greatly the field of lung transplantation. The single remaining obstacle to widespread clinical success is donor lung availability. Improved methods of ex vivo lung preservation, organ donor maintenance, and donor lung retrieval after the completion of cardiac donation should help to ameliorate this problem. PMID- 3520894 TI - Kidney transplantation. AB - The current status of bone marrow transplantation is reviewed. The diseases that are treatable with marrow transplantation, the basic transplant procedure, and the potential complications of marrow transplantation are discussed in detail. The future application of marrow transplantation to additional disease processes is considered. PMID- 3520895 TI - Indications for liver transplantation in the cyclosporine era. AB - One hundred seventy orthotopic liver transplants were performed under conventional immunosuppression with azathioprine and steroids with 1- and 5-year survivals of 32.9 per cent and 20.0 per cent, respectively. Since the introduction of cyclosporine-prednisone therapy in March 1980, 313 primary orthotopic liver transplants have been performed. Actuarial survivals at 1 and 5 years have improved to 69.7 per cent and 62.8 per cent, respectively. Biliary atresia is now the most common indication for liver replacement. In adults, primary biliary cirrhosis and sclerosing cholangitis have become more common indications for transplantation, and alcoholic cirrhosis and primary liver malignancy as indications have declined. Early enthusiasm for liver transplantation in patients with hepatic cancer has been tempered by the finding that recurrence is both common and rapid. An increasing number of patients with inborn errors of metabolism originating in the liver are receiving transplants, including patients with Wilson's disease, tyrosinemia, alpha-1-antitrypsin deficiency, glycogen storage disease, familial hypercholesterolemia, and hemochromatosis. Survival in this group of patients has been excellent (74.4 per cent at 1 and 5 years). A hemophiliac who received a transplant for postnecrotic cirrhosis has survived and may have been cured of his hemophilia. About 20 per cent of patients require retransplantation for rejection, technical failure, or primary graft failure. Only four of the patients receiving retransplants under conventional immunosuppression survived beyond 6 months, and all died within 14 months of retransplantation. Sixty-eight patients have received retransplants under cyclosporine-prednisone. Thirty-one patients are surviving, all for at least 1 year. Six of the twelve patients requiring a third transplant are alive 2 to 3 years after the primary operation. An aggressive approach to retransplantation in the patient with a failed graft is justified. PMID- 3520896 TI - Pancreas transplantation. AB - The data on vascularized pancreas transplant cases reported to the old American College of Surgeons/National Institutes of Health Organ Transplant Registry from December 17, 1966, through December 31, 1984, are summarized in this article. Also described is the experience at the University of Minnesota, where more than one fifth of the transplants have been performed. The authors conclude that pancreas transplantation is now an effective treatment for human diabetes. PMID- 3520897 TI - Bone marrow transplantation. AB - The current status of bone marrow transplantation is reviewed. The diseases that are treatable with marrow transplantation, the basic transplant procedure, and the potential complications of marrow transplantation are discussed in detail. The future application of marrow transplantation to additional disease processes is considered. PMID- 3520898 TI - Organ preservation. AB - This article briefly explores the mechanisms of ischemic damage and then considers the effects of cooling and other supplementary measures that can protect organs during storage. Clinical applications of this information are considered, and likely avenues for future improvements in techniques for organ preservation are discussed. PMID- 3520899 TI - Ethical issues in transplantation. PMID- 3520900 TI - [Diabetes in children. 2. The insulins]. PMID- 3520901 TI - [Insulin injections]. PMID- 3520902 TI - A prospective comparison of gentamicin and metronidazole and moxalactam in the prevention of septic complications associated with elective operations of the colon and rectum. AB - Bacteriologic evidence suggests that Latamoxef (moxalactam) is effective against colonic bacteria which cause infection during colonic and rectal operations. In a prospective comparative study, 86 patients undergoing colorectal operations were randomized to receive intravenously 24 hour antibiotic cover with either gentamicin and metronidazole or moxalactam. Six patients (13 per cent) in the gentamicin and metronidazole group and five (12 per cent) in the moxalactam group had wound sepsis develop. Perineal wound sepsis (31 per cent) was significantly more common than abdominal wound sepsis (7 per cent). No complications were noted from the use of moxalactam. No clinical evidence of abnormal bleeding was seen and the results of studies on coagulation and platelet function postoperatively were normal. The results suggest that moxalactam provides effective, safe prophylaxis comparable with established antibiotic combinations in patients undergoing colorectal operations. PMID- 3520903 TI - Surgical treatment of diabetic nephropathy with simultaneous pancreatic duodenal and renal transplantation. AB - Twenty consecutive patients with diabetes who were dependent upon insulin underwent simultaneous pancreatic-duodenal and renal transplantation at our center between March 1984 and August 1985. Eighteen patients are alive, 17 have functioning renal allografts and 13 have normal fasting blood sugar levels and are free of insulin use. Pancreatic graft loss was secondary to venous thrombosis in four instances and inadequate perfusion in one. Graft versus host disease occurred in three patients with composite pancreatic and splenic grafts, which led to a policy of not including the spleen as part of the graft. Serum creatinine levels were a more sensitive indicator of rejection than blood sugar levels which represent a distinct advantage of the simultaneous pancreatic and renal procedure, as compared with pancreatic transplantation after renal transplantation. Duodenal intestinal anastomosis appeared to be a satisfactory way of establishing exocrine pancreatic drainage. As results of pancreatic transplantation continue to improve, this procedure should no longer be considered as experimental. PMID- 3520904 TI - A technique for safe, frequent biopsy of the liver after hepatic transplantation. AB - Valuable information can be obtained from the hepatic biopsy in patients undergoing hepatic transplantation. Biopsy of the liver can be repeatedly performed safely even in patients with severely deranged clotting function by using the technique described herein. This simple technique provides the window through which the immunologic and metabolic causes of hepatic dysfunction may be more clearly viewed and intelligently studied. PMID- 3520905 TI - Intraoperative testing for anastomoses of the gastrointestinal tract. PMID- 3520906 TI - Cancer is a complication of severe immunosuppression. AB - Diverse states of immunodeficiency are complicated by the development of various types of cancer. Most striking in nearly every type of immunodeficiency is a high incidence of a neoplasm of the immune system itself, the NHL, which consists of activated pathologic lymphocytes. Morphologically, these are mostly reticulum cell sarcomas, arise from B-cells, tend to be extranodal in distribution, have a predilection for the brain and are probably caused by EBV. If Kaposi's sarcoma is a form of lymphoreticular malignant disease, as some investigators think, the situation becomes even more intriguing. We need to intensively study the various groups of immunosuppressed patients, including those with and without tumors, to seek clues to the cause of neoplasms. Such information may shed light on the causes of similar malignant conditions that occur in the general population and on the role of the immune system in the control of cancer. Hopefully, such knowledge may lead to immunologic methods for the prevention and cure of neoplasms. PMID- 3520907 TI - Al-Zahrawi and Arabian neurosurgery, 936-1013 AD. AB - The authors highlight the neurosurgical contributions of an Arabic surgeon by the name of Abul-Qasim Al-Zahrawi, known in Western literature as Abulcasis. This man lived during the Middle Ages from 936 to 1013 AD and wrote a 30-volume treatise on medicine. A significant part of his work on surgery consists of early descriptions of neurosurgical diagnosis and treatment, including the surgical treatment of head injuries and skull fractures, spinal injuries and dislocations, hydrocephalus and subdural effusions, headache, and many other medical afflictions. He described neurosurgical instruments such as cranial drills that avoided puncture of the dura mater. Abulcasis is known for his concepts of pain as a symptom and his emphasis on anatomy of the skull and brain in relation to the neurosurgical operations of that period. Because his works were translated from Arabic to Latin, Hebrew, and Turkish with only recent or limited translation into the modern occidental languages, the historic role played by this man has been largely unknown by neurosurgeons who are not fluent in these languages. PMID- 3520908 TI - Complex immunological monitoring of breast cancer patients treated postoperatively by electron beam irradiation. AB - To monitor the electron beam therapy some immunological parameters of breast cancer patients previously undergone surgery were tested before, during and after irradiation. Immune complex levels measured by complement consumption technique were not altered by irradiation. Killer cell activity tested in so-called antibody dependent cellular cytotoxicity (ADCC) capacity assay showed a marked decrease in some cases. Based on the phagocytic capacity of the granulocytes the patients could be divided into two groups: one with declining activity and another with rising activity: The majority of the patients (22/45) were humoral leukocyte adherence inhibition (H-LAI) negative before and during irradiation. Those showed positive H-LAI indices before electron therapy had unchanged (7/45) or decreasing (9/45) tendencies during the observation period. Further study is needed to establish the clinical relevance of these in vitro assays used by us. PMID- 3520909 TI - Central trochlear palsy. AB - Historically, the trochlear (IV) nerve has been "neglected" by neurologists and ophthalmologists. However, the reported incidence of trochlear palsy in two large series has more than doubled in the past two decades, indicating increasing awareness of this nerve. Trauma is the most common cause of trochlear palsy, as the trochlear nerve is anatomically more vulnerable to trauma than the other ocular motor nerves. Trochlear palsy can also be caused by vascular and inflammatory diseases, congenital factors, toxic substances and tumors. Diplopia secondary to vertical and horizontal deviation is the most common presentation. The trochlear nerve has a relatively high recovery rate after the underlying cause of injury has been corrected. In this article, the anatomy and physiology of the trochlear nerve are described, and the various etiologies, methods of diagnosis and differential diagnosis of trochlear palsy are reviewed. PMID- 3520910 TI - Nonocular manifestations of parenteral drug abuse. AB - The nonocular manifestations of parenteral drug abuse are presented to familiarize the ophthalmologist with this ever growing, medical and psychosocial problem. The ophthalmologist, like other primary care physicians, may be the first professional to encounter these patients whose substance abuse may lead to a wider spectrum of physical and psychiatric illness. The variety, history, and manifestations of abused substances are discussed. PMID- 3520912 TI - Ex Errato Lux. Concept and development of the Verhoeff Society. AB - With a history of 39 years, Verhoeff Society is one of the oldest subspecialty groups in ophthalmology. The society was formed to establish a forum to discuss ophthalmic pathology. This paper details the original inception of the Society, its current activities and its influence in the development of ophthalmic pathology clubs in the U.S. and across the world. PMID- 3520911 TI - Spectacles: past, present, and future. AB - The history of spectacles is reviewed with particular attention to recent developments in lens materials. The author advocates the use of polycarbonate, a high resin plastic, because of its strength, high refractive index, light weight, and resistance to fogging. PMID- 3520913 TI - The effect of biliary obstruction on a gram-negative bacteremic challenge: a preliminary report. AB - Alterations in the sequestration and destruction of bacteria were studied after 10 days of biliary obstruction. Intraperitoneal injection of radiolabeled Escherichia coli was used to study bacterial localization in rats 10 days after common duct ligation and transection or sham celiotomy. Animals were sacrificed 4 hours later and uptake by liver, spleen, lung, and kidney were studied with a scintillation counter. No significant difference in localization between the two groups was noted. Bacteremia was induced in a second set of animals and quantitative bacterial organ cultures were performed. Significantly more viable organisms were identified in lung, liver, and kidney of animals that underwent common duct ligation and transection, when compared with controls that underwent sham celiotomy. This suggests that there is a defect in bacterial killing after 10 days of biliary obstruction. The inability to effectively clear and kill gram negative bacteria in patients with biliary obstruction may account for some of the clinical complications seen in this patient population. PMID- 3520914 TI - Carnitine metabolism during fasting in dogs. AB - During starvation, a series of changes in whole body fuel use occur that result in conservation of fuel, particularly protein. Use of fat stores for ketone production and direct oxidation of fat as a primary fuel are characteristic of starvation. However, the mechanism by which this change develops is unclear. Carnitine is an important compound in the control of fat metabolism, since long chain free fatty acids must be coupled with it to cross the mitochondrial membrane. This study attempts to define, in the fasting dog model, the interaction between plasma and muscle carnitine, its acyl esters, and the energy substrates available. Eight adult beagle dogs were studied during an 8-day period of starvation. Muscle and plasma were analyzed for free carnitine (FC), acid soluble fraction, and long-chain esters (LCE), as well as substrate hormone profiles. Total carnitine (TC) and short-chain esters (SCE) were calculated. Muscle was analyzed for carnitine palmityl transferase activity (CPT). These measurements were performed on days 3, 5, and 8. There was a significant (p less than 0.05) loss in weight on days 3, 5, and 8. TC and FC increased significantly (p less 0.05) only on day 8; this occurred simultaneously with a significant (p less than 0.05) decrease in CPT. It was preceded by a significant (p less than 0.05) and persistent increase in plasma TC, FC, and LCE that developed on day 3. During starvation there was an increase in plasma carnitine levels before changes in muscle. The increase in muscle carnitine occurred between days 5 and 8 of starvation and seemed to be associated with a fall in CPT. This may be responsible either for or secondary to the decrease in metabolic rate that occurs during prolonged starvation. PMID- 3520915 TI - Gastric acid secretion and gut hormone release in patients undergoing pancreaticoduodenectomy. AB - The changes in gastric acid secretion and gut hormone release were investigated in 11 patients who underwent pancreaticoduodenectomy. The amount of acid output showed normoacidity before surgery and hypoacidity after surgery. No peptic ulcers were detectable after surgery. Plasma gastrin levels were markedly reduced after surgery both in the fasting state and after a test meal loading. Although fasting plasma levels of both gastric inhibitory polypeptide (GIP) and insulin after surgery were close to those before surgery, the response of these hormones to the meal was significantly reduced after surgery. On the other hand, blood glucose concentrations increased gradually after feeding, and the elevation was greatly prolonged after surgery compared with preoperative levels. From these results, it is concluded that peptic ulcer will not occur if subtotal gastrectomy is performed during Whipple's procedure. It is presumed that the diminished release of gut hormones such as gastrin, GIP, and insulin was due to the massive resection of the distal stomach, the upper small intestine, and the head of the pancreas and to the diversion of the stream of food from the duodenum to the jejunum. It is also assumed that the glucose-dependent insulinotropic action of GIP would be impaired by the procedure. PMID- 3520917 TI - [Associated autoimmune and immunodeficiency states in a patient with systemic lupus erythematosus complicated by suppurative infection. Clinical and immunological effectiveness of treatment with T-activin and methylxanthines]. PMID- 3520916 TI - Interaction of prostaglandins, activated complement, and granulocytes in clinical sepsis and hypotension. AB - Activated complement, thromboxane A2, prostacyclin, and activated granulocytes have been implicated in hemodynamic dysfunction after trauma, in sepsis, and in hypovolemic and septic shock. This study evaluated the interaction of plasma concentrations of complement components C3a and C5a, thromboxane B2 (TxB), prostaglandin 6-keto-F1 alpha (PGI), and granulocyte aggregation in clinical sepsis and hypotension. Forty-eight critically ill patients were followed clinically for as long as 10 days. Plasma C3a, C5a, TxB, and PGI were measured daily by the radioimmunoassay method. Granulocyte aggregation, the percentage of maximum aggregation of zymosan-activated plasma standard curves, was performed with patient plasma and normal human leukocytes. Patients were studied in four groups: group I, nonseptic, normotensive; group II, hypovolemic shock, group III, normotensive severe sepsis; and group IV, septic shock. Plasma from 12 normal adults was the control value. PGI, TxB, C3a, C5a, and granulocyte aggregation in patients were greater than that in the control subjects. Granulocyte aggregation was increased in groups III and IV versus groups I and II. C3a was increased in group IV versus groups II and III. C5a and TxB did not vary between groups. PGI was greatly increased in group IV compared with groups I through III. C3a and C5a decreased in nonsurvivors. PaO2/FiO2 ratios correlated directly with PGI and inversely with C3a and TxB/PGI. Plasma PGI and C3a are increased in septic shock. C3a and TxB/PGI imbalances are involved in hypovolemic and septic shock. PMID- 3520919 TI - [Exercise-induced asthma]. PMID- 3520918 TI - [Role of the eicosanoids: prostaglandins, prostacyclin, thromboxane and leukotrienes in the pathogenesis of bronchial asthma and other lung diseases]. PMID- 3520920 TI - [Role of mononuclear leukocytes and cellular immunity in kidney damage in patients with nephritis]. PMID- 3520921 TI - [Postoperative hypothyroidism]. PMID- 3520922 TI - [Computerized tomography: current status and developmental trends]. PMID- 3520923 TI - [Determining myoglobinemia in acute myocardial infarction by the immunoenzyme method]. AB - Like radioimmunoassay, immunoenzyme assay permits detecting myoglobinemia both in healthy persons and in patients with acute myocardial infarction (AMI). In AMI patients, myoglobinemia reaches a maximum 5 to 12 hours since the onset of a powerful anginal attack whereupon it gradually and spasmodically decreases, without returning to normal toward outcome of the 3d day of the observation period. A single assay of myoglobinemia in AMI patients is of diagnostic importance within 2 to 27 hours since the disease onset. PMID- 3520924 TI - [Streptodecase in myocardial infarction in middle-aged and elderly persons]. AB - A study was made of the effect of a single intravenous injection of streptodecase and heparin in the treatment of elderly and senile patients with myocardial infarction during short-term (under 6 h) and late (over 30 h) periods of development. It was confirmed that streptodecase had a specific selective effect on the fibrinolytic system of the blood, with the risk of the development of hemorrhagic and thromboembolic complications being minimal. Allergic reactions to streptodecase were recorded in 1 out of 12 patients examined. It was marked that streptodecase produced an insignificant prolonged effect while the drug action lasted maximally 48 to 72 h since the moment of administration. The effect of streptodecase depended on the degree of atherosclerotic involvement of the vessels and was more remarkable in elderly and senile persons. No significant differences were found in the efficacy and duration of the action of the drug administered during short-term and late periods of myocardial infarction development. It is not excluded that streptodecase can be used in higher doses or repeatedly in the immediate 36 to 48 h in the treatment of certain patients groups. The combined use of streptodecase and heparin was discovered to be mandatory for restricting the effect of secondary hypercoagulation. PMID- 3520925 TI - [First results of the clinical use of ethacizin in patients with paroxysmal atrial fibrillation]. AB - Fifty-six patients with frequently occurring paroxysms of atrial fibrillation were examined for the clinical efficacy of a new antiarrhythmic drug etacyzine (a diethylamine analog of etmozin). The use of the drug in doses of 50 to 70 mg intravenously and in doses in 150 to 200 mg per os a day removed and prevented the occurrence of atrial fibrillation paroxysms in 60 to 65% of cases, whereas etmozin in doses of 50 mg intravenously and 600 to 800 mg per os day did not produce any positive anti-arrthythma effect in the patients. The prolonged use of etacyzine (up to 1 year and over) exerted a beneficial antiarrhythmic action almost in all the patients. The drug did not provoke any serious side effects. However, in some patients, the use of the drug promoted a substantial prolongation of the P-Q interval and widening of the QRS complex of the ECG. In one female patient, the drug caused a paradoxical repetition of the ventricular rhythm. PMID- 3520926 TI - [Single-photon emission computerized tomography in the diagnosis of liver diseases]. AB - A comprehensive examination of patients with various liver diseases was performed using the methods of axial x-ray computerized tomography, ultrasound scanning compared to plane liver scintigraphy with 99m TC-colloid and a new method of one photon emission computerized tomography (OECT). The sensitivity of the OECT, SG and USE methods was 92.7; 75.6 and 91.4% respectively, and specificity 88.0; 72.0 and 80.0%. The authors discussed the advantages of the OECT method and its diagnostic value in liver focal and diffuse lesions. PMID- 3520927 TI - [Dynamics of the dermograms in patients with focal pneumonia]. AB - Dermograms were examined over time in patients with focal pneumonia running an acute, protracted and unfavourable course. Prognostically significant differences in the dermograms were revealed in patients of the three groups. Attempts were made to correct the deficiency of the migration of immunocompetent cells to the cutaneous window in patients with pneumonia taking an unfavourable course. PMID- 3520929 TI - [Isadrinosol in pulmonological practice]. PMID- 3520928 TI - [Therapeutic activity of Oriprim in bronchopulmonary diseases]. AB - A new chemotherapeutic drug oriprim was used for therapy of 36 patients with bronchopulmonary pathology. Its therapeutic efficacy was noted in 83.3% of the cases. In 6 patients oriprim therapy turned out to be ineffective as a result of early side-effects. The drug was effective in pneumococcal infection. In suspicion of anaerobic infection (B. fragilis, etc) oriprim was given in combination with metronidazole. PMID- 3520930 TI - [Early hematopoietic cell precursors]. PMID- 3520931 TI - [Problems of pulmonology and scientific-technical progress]. PMID- 3520932 TI - [Therapeutic effectiveness of hemodes in patients with chronic bronchitis with drug allergy]. PMID- 3520933 TI - [Effectiveness of using diucifon in patients with chronic pulmonary pathology]. PMID- 3520934 TI - Assessment of mineral fibres from human lung tissue. PMID- 3520936 TI - Monoclonal antibodies to human 54,000 molecular weight plasminogen activator inhibitor from fibrosarcoma cells--inhibitor neutralization and one-step affinity purification. AB - Mouse monoclonal antibodies were derived against a plasminogen activator inhibitor with a mol. wt. of approximately 54,000 (54 K) from the human fibrosarcoma cell line HT-1080. Screening for hybrids producing antibodies directed against the inhibitor was performed with enzyme-linked immunosorbent assay and SDS-polyacrylamide gel electrophoresis (SDS-PAGE) followed by immunoblotting. Four clones of hybridomas producing IgG1 antibodies were further characterized. The inhibitor was purified approximately 50-fold to homogeneity from conditioned cell culture fluid with a yield of approximately 85% by a one step procedure using Sepharose-conjugated monoclonal antibody. In the 125I-fibrin plate assay one of the antibodies neutralized the effect of the inhibitor on urokinase-type plasminogen activator. Two of the antibodies bound complexes between urokinase-type plasminogen activator and inhibitor while the remaining two antibodies did not. The antibodies could be used for immunocytochemical localization of the inhibitor in HT-1080 cells. All four antibodies cross-reacted with a plasminogen activator inhibitor derived from cultured human umbilical cord endothelial cells. PMID- 3520937 TI - Electroblot and immunoperoxidase staining for rapid screening of the abnormalities of the multimeric structure of von Willebrand factor in von Willebrand's disease. AB - A new electrophoretic method is described for rapid screening of abnormalities of the multimeric structure of von Willebrand factor in von Willebrand's disease. The method is based on the transfer of the separated proteins from agarose gels onto nitrocellulose foils followed by immunoperoxidase staining. It has the advantage of not requiring radio-iodinated antibodies and reduces the working time for the entire procedure from 5-6 days to 3 days. Electroblotting followed by immunoperoxidase staining differentiates patients with intact multimeric structure from those without intermediate and/or large multimers. The more subtle defects of the inner structure of the smallest multimers found in patients with type II von Willebrand's disease can also be identified. A potential disadvantage of electroblotting and immunoperoxidase staining is the lesser sensitivity of this technique, which results in the detection of a smaller number of multimers (11-12 bands) than by autoradiography without transfer onto nitrocellulose (16-17 bands). PMID- 3520938 TI - The systemic fibrinolytic effect of BRL 26921 during the treatment of acute peripheral arterial occlusions. AB - BRL 26921 is a new acylated streptokinase-plasminogen complex which may have a more specific local thrombolytic effect than streptokinase or urokinase. 34 patients with acute peripheral arterial occlusions were given eight hourly bolus injections of 5 mg BRL 26921 for up to 72 h. Systemic fibrinolysis was observed in all patients yet in only 24% was the occluding thrombus lysed. 44% of the patients had haemorrhagic complications and 24% suffered further thrombotic events during or soon after treatment. There was no correlation between the degree of systemic fibrinolysis produced and dissolution of the thrombi. The degree of systemic fibrinolysis did not affect the complication rate. There is no evidence from this study that BRL 26921 has a specific local thrombolytic effect. PMID- 3520939 TI - Visualization of von Willebrand factor multimers by enzyme-conjugated secondary antibodies. AB - A method for visualization of the multimeric forms of von Willebrand Factor (vWF) in plasma and platelets is described. The method is based upon: 1) Separation of the vWF multimers by SDS-agarose electrophoresis, 2) Subsequent blotting of the vWF multimers onto nitrocellulose, 3) Immunolocalization and visualization of the vWF pattern by the sequential incubation of the blot with primary vWF antiserum, peroxidase- or beta-galactosidase-conjugated secondary antibodies and a relevant chromogenic substrate. PMID- 3520940 TI - Ajoene, the antiplatelet principle of garlic, synergistically potentiates the antiaggregatory action of prostacyclin, forskolin, indomethacin and dypiridamole on human platelets. AB - Ajoene, the major antiplatelet compound derived from garlic, synergistically potentiates the antiaggregatory action of prostacyclin, forskolin, indomethacin and dypiridamole. For collagen-induced platelet aggregation in human PRP, the ID50 for ajoene is 95 +/- 5 microM. However, in the presence of the antiaggregatory drugs mentioned above, the ID50 for ajoene decreases more than what would be predicted on the basis of simple additive effects. Similarly, the ID50 for prostacyclin decreases from 1 nM to 0.15 nM in the presence of 80 microM ajoene. Isobolic curves for the various combinations of ajoene with prostacyclin or indomethacin exhibit departure from linearity, as predicted for a potentiated synergism between ajoene and these drugs. Dypiridamole, which in PRP has very little effect on the dose-response curve for ajoene, when assayed in whole blood decreases the ID50 for ajoene by a factor of four. These results demonstrate that the antithrombotic potential of ajoene is substantially increased in the presence of physiologically and pharmacologically active antiplatelet agents. PMID- 3520935 TI - Pathogenesis of pleurisy, pleural fibrosis, and mesothelial proliferation. PMID- 3520941 TI - Hemostatic effects of microfibrillar collagen hemostat (MCH) in experimental coagulopathy model and its mechanism of hemostasis. PMID- 3520942 TI - Marion I. Barnhart (23 September, 1921-23 December, 1985). PMID- 3520943 TI - Production of eicosanoids by deendothelialized rabbit aorta: interaction between platelets and vascular wall in the synthesis of prostacyclin. AB - Production of eicosanoids by deendothelialized aorta in response to continuous infusions of arachidonic acid and platelet suspensions was determined in a rabbit aorta perfusion model. 6-keto-PGF1 alpha production was stimulated by AA infusion in a dose-related manner. Infusion of AA at 4 micrograms/ml/min led to an initial production rate of 0.64 +/- 0.29 ng/min which gradually increased to 0.93 +/- 0.11 ng/min at the 20th min of infusion. When the concentration of AA infusion was increased to 10 micrograms/ml/min, 6-keto-PGF1 alpha production increased to 1.14 +/- 0.86 ng/min initially but declined with time. PGE2 production in response to AA 10 micrograms/min/ml was steady at around 5 ng/min while PGF2 alpha and TXB2 production were only slightly above the control. Perfusion of rabbit washed platelet suspensions at a rate of 3 X 10(8) plt/ml/min raised 6KPGF1 alpha production. The production was further increased when platelets were pretreated with 1-benzylimidazole (5 mM), along with a concurrent reduction in TXB2 release. Pretreatment of platelets with aspirin, on the other hand, abolished the increase in 6KPGF1 alpha production. Our data indicated that the vascular smooth muscle cells can efficiently utilize PGH2 produced by platelets to synthesize PGI2. PMID- 3520944 TI - [Nutritional aspects in relation to the feline urological syndrome (FUS)]. AB - The 'ideal' diet for minimising FUS risk may not involve a single food but would aim, by various measures, to achieve the conditions listed below: Low urine pH. This may entail the use of urinary acidifiers which must be consumed with or in the food. Some researchers say that the alkaline tide effect must be abolished for the treatment to be completely effective. Low magnesium intake. One figure quoted is a magnesium concentration of 20 mg per 100 kcal DE (about 0.08% dry matter) or less. Nevertheless is appears that FUS risk is appreciably increased only when magnesium concentration reaches about 0.25% dry matter. High urine volume. This entails an adequate water intake with the amount of faecal water maintained as low as possible. This in turn means highly digestible, 'low bulk' foods. Having said this, these aspects are probably important only for the susceptible cats in the population and if all the conditions are achieved the type of diet fed is unlikely to be a crucial factor. PMID- 3520945 TI - [Standardization of the isolation of Salmonella from food and feed stuff]. AB - Developments in the standardization of the methods used in the isolation of Salmonella are reviewed from the sixties when it was noticed for the first time that different results were obtained when different methods were used, via the seventies when a single method was standardized and ultimately internationally accepted in the late seventies, followed by the finding that differences in results between laboratories were still obtained despite standardization and that this could only be overcome by the development of reference samples, with which each laboratory could check the performance of the standard method. Once reference material had been developed in the early eighties, the need for a standard method came to an end. Everyone can use the method of his choice today as long as reproducibility of the results is ensured. Reproducibility may be tested with the reference material. PMID- 3520946 TI - [Detection of low numbers of malignant cells in patients with leukemia or non Hodgkin lymphoma: use of immunological markers]. AB - Several different techniques have been used for the detection of low numbers of malignant cells in patients with leukemia or non-Hodgkin lymphoma, e.g. cytomorphology, cytogenetics, recombinant DNA techniques and immunological marker analysis. The detection limit of most techniques, however, is not lower than 1% (i.e. 1 malignant cell in 100 normal cells). Most immunological markers represent differentiation antigens, which are also expressed by normal cells. Nevertheless, it is possible to use these differentiation antigens for the detection of low numbers of malignant cells, since the occurrence of positive cells outside their normal homing areas can be indicative of malignancy. A useful marker for the detection of low numbers of acute lymphoblastic leukemia (ALL) cells in the cerebrospinal fluid is terminal deoxynucleotidyl transferase (TdT). Although TdT positive cells normally occur in low frequencies in bone marrow and blood, the combined detection of TdT and a T cell marker at the single cell level, allows detection of very low numbers of T-ALL cells. The detection limit of this technique is at least 0.01%. Such a low detection limit allows the adjustment of remission and staging criteria as well as the individualization of therapy. PMID- 3520947 TI - [Terminal deoxynucleotidyltransferase (TdT)-positive cells in cerebrospinal fluid of children with leukemia or non-Hodgkin lymphoma: implications for the diagnosis of central nervous system leukemia]. AB - Identification of terminal deoxynucleotidyl transferase (TdT) positive cells in sites other than bone marrow, thymus, lymph nodes and peripheral blood is indicative of a TdT positive lymphoproliferative disease. We therefore employed both a TdT-immunofluorescence (IF) assay and conventional cytomorphology to examine the cells in 421 cerebrospinal fluid samples from 60 children with a TdT positive acute lymphoblastic leukemia or non-Hodgkin lymphoma, at diagnosis as well as during follow-up. The results of the TdT assay were compared with those obtained by cytomorphological analysis of the same sample. The authors conclude that the TdT-IF assay is a valuable additional tool in diagnosing TdT positive central nervous system leukemia. It offers more reliable and conclusive diagnoses than cell count and cytomorphology alone, which might avoid both under- and overtreatment of the patient. PMID- 3520948 TI - [Echography of the normal kidney in infants]. AB - In 33 infants from 0 to 11 months old, apparently without urinary tract disease, the kidneys were examined sonographically. Renal length was correlated with age and bodyweight. The renal echopattern was studied: Normal kidneys in newborn and young infants have several distinct sonographic features: the renal cortex is more echogenic, the medullary pyramids are prominent and relatively anechoic, the central sinus echo is reduced. This pattern occurs until the age of 3 months and changes to the adult pattern at the age of 5 months. PMID- 3520949 TI - [The enlarged kidney in infancy--echographic findings]. AB - Experience in the use of ultrasound to evaluate renal masses during infancy is reported. Ultrasonography revealed hydronefrosis (20 cases), multicystic kidney (5 cases), polycystic kidney disease (3 cases) and neoplasm (4 cases). The differential diagnosis between hydronefrosis and multicystic kidney can be difficult. Hydronefrosis is diagnosed by the demonstration of communication between adjacent fluid-filled spaces. PMID- 3520950 TI - An eight-year study of HLA typing proficiency in Eurotransplant. AB - The main purpose of Eurotransplant, an international organ exchange organisation, is to maximize the survival time of transplanted organs through tissue typing and matching. Regular proficiency testings are necessary to assess the reproducibility and the reliability of the HLA typings performed by the individual typing centres. Two different protocols have been used: 1) since 1978, 35 samples of blood and donor spleen were used for cell exchanges (CE) and typed by all participating laboratories; 2) since 1977 samples of donor spleen have been shipped to the reference laboratory in Leiden for retyping (RD) resulting in over 2600 comparable HLA typings. The discrepancy rates of the HLA-A, B, C and DR specificities were analysed over the years. A large number of discrepancies was due to false negative assignments which led to assumed homozygosity at one or more HLA-loci. The recognition of HLA-DR has improved dramatically but with much variation per DR specificity. The concordancy rates for HLA-AB + DR have improved from 40% in 1981 to 91% for CE and 80% for RD typings in 1984. The reproducibility of DR typings in individual laboratories also has improved greatly but there is still considerable variation between the different laboratories. PMID- 3520951 TI - A possible split of antigen DQw1 identified by antiserum T3516. AB - One of the human class II antigens DQw1, which was officially recognized at the 9th International Histocompatibility Workshop in 1984, has a comparatively broad spectrum. One multiparous woman's serum was confirmed to have an antibody which shows a reaction pattern of short DQw1 or a split of DQw1. Our analysis was performed with a population study, two-dimensional gel electrophoresis and blocking experiment by monoclonal antibodies. PMID- 3520952 TI - [Ultrasonic diagnosis in gynecology in small animals]. AB - After a short introduction into the basics and the different methods of sonography a description of the ultrasonographic diagnosis of gynaecological diseases in small animals is given. The ultrasonographic method is indicated in all gynaecological diseases after the anamnesis, clinical and laboratory work up and before x-rays and invasive methods will be used. The sonographic characteristics for interpretation are described. Typical sonographic findings are demonstrated in 16 cases as in diseases of the cervix (inflammation, cyst), uterus (pregnancy, endometritis - pyometra), ovaries (cysts), and mamma (lactation, abscesses, tumors). PMID- 3520953 TI - [Experiences with local administration of herd-specific vaccines]. AB - The results of oral vaccination of 388 calves with herd-specific vaccines against E. coli are described. Innocuity was optimal, whereas the potency was estimated not as efficient as parenteral vaccination of the dam (in 22% of the cases), i.e., transient diseases in vaccinated calves occurred there. Further the results of intranasal vaccination of 496 cattle against salmonellosis are reported. Salmonella excretion in the faeces was stopped within 1-3 weeks post vaccination in 75% of the herds. In one case it took 3 months to reach this effect. A few permanent excretor cattle remained in two other cases. PMID- 3520954 TI - Susceptibility of fetal rat endocrine pancreas to the diabetogenic action of cyproheptadine. AB - The susceptibility of fetal endocrine pancreas to the diabetogenic action of cyproheptadine was investigated. Cyproheptadine (5 or 11 mg/kg) or water (control) was given orally once daily to pregnant rats on Days 13.5-20.5 or on Days 19.5-20.5 of gestation. Fetuses were obtained by cesarean section 24 hr after the last dose. Serum and pancreatic immunoreactive insulin and serum glucose from maternal and fetal animals were measured. Differences in maternal pancreatic insulin, serum insulin, and glucose between control and treated groups were not detected. In contrast, fetal pancreatic and serum insulin concentrations in animals exposed to 2 or 8 doses of cyproheptadine were less than 50% those of control. Drug treatment did not alter fetal pancreatic glucagon, pancreatic somatostatin, serum glucose, pancreas weight, or body weight. The drug-related depletion of fetal pancreatic insulin was reversible; the level returned to normal 3 days after cessation of the drug treatment. A similar depletion of fetal insulin was observed after 8 oral doses (11 mg/kg) of desmethylcyproheptadine, a metabolite which lacks the antiserotonin-antihistaminic properties of the parent compound. In vitro experiments showed that cyproheptadine inhibited the biosynthesis and release of insulin in fetal rat pancreas. These results indicate that cyproheptadine, when given to pregnant rats using a dose which produces no apparent effects in the maternal endocrine pancreas, causes abnormalities in the function of the insulin-secreting B cells in the fetal endocrine pancreas. PMID- 3520955 TI - A critical reappraisal of the use of enzyme-linked immunosorbent assays in the study of snake bite. AB - The enzyme-linked immunosorbent assay (ELISA) has been the most widely used serological test in snake bite immunodiagnosis and epidemiology. The technique has been applied, however, without due consideration of the many factors which would affect an inherently sensitive test system, especially in tropical rural areas where large scale snake bite studies are usually carried out. This review discusses the effects of non-specific reactivity, cross reactivity and the quality of reagents on both the sensitivity and specificity of venom antigen and antibody detection assays. Simple laboratory modifications to optimize the assays are described. The importance of using the predictive value to assess the validity of applying the same test system in different circumstances is stressed. To fulfil its potential as the most versatile immunoassay technique in snake bite research, the test conditions of the ELISA will have to be much more stringently controlled in future. PMID- 3520956 TI - Chemical studies on protease A of Bitis arietans (puff adder) venom. AB - Protease A of Bitis arietans venom is probably a metalloprotease, since it is inhibited by o-phenanthroline and contains 0.77 moles of zinc per mole protein. The enzyme comprises 213 amino acids, including 9 methionine residues and one free sulphydryl group. It contains one polypeptide chain, which is terminated at the carboxyl end by serine. The amino terminal sequence of protease A is: Arg-Ser Ser-Asp-Pro-Asn-Lys-Tyr-Phe-Asn-Val-Ile-Val-Val-Val-Asp-Asn-Arg- Met-Val-Asn-Tyr Tyr-Lys-Gly-Glu-Leu-Asn-Lys-Ile-Thr-. Despite difficulties with 'insoluble peptide core' formation, a number of peptides were purified from peptic and tryptic digests of S-derivatized protease A. PMID- 3520957 TI - Isolation and characterization of a proteolytic factor from the venom of Vipera palaestinae. AB - A proteolytic enzyme which is active on collagen and gelatin was isolated from the venom of Vipera palaestinae. The enzyme showed an optimal temperature of 45 degrees C and an optimal pH of 8.0. It was inhibited by snake blood serum, but not by EDTA or trypsin inhibitors. The enzyme was completely separated from one of the venom hemorrhagins, which accompanied it through the purification procedure. The possible evolution of hemorrhagins from proteolytic enzymes is discussed. PMID- 3520958 TI - Immunological effects of honey bee (Apis mellifera) venom using BALB/c mice. AB - Honey bee venom at concentrations up to 50 micrograms/ml was not toxic in vitro for unstimulated murine splenic lymphocytes, as assayed by tritiated thymidine incorporation. However, venom concentrations greater than 6 micrograms/ml significantly (P less than 0.01) inhibited concanavalin A (con A) simulation of murine lymphocytes. In contrast to this finding, the splenic lymphocytes from mice receiving 4 s.c. injections of honey been venom on alternate days were significantly (P less than 0.01) enhanced in their proliferative response to con A compared to a sham-injected group of mice. Mice injected with the venom prior to and following an injection of sheep red blood cells produced significantly more direct IgM plaques (P less than 0.02) than the sham-injected group. In this study both suppression and enhancement of immune reactivity was seen using honey bee venom when assayed on the splenic lymphocytes of BALB/c mice. PMID- 3520959 TI - Genotoxic evaluation of the offgassing products of particle board. AB - It has been recognized that people are spending more time indoors and that pollutants are being found in elevated concentrations in this environment. Because the constituents of indoor air pollution can vary relative to a large number of factors, the nature of the indoor environment is extremely difficult to study. Of the materials used in construction of buildings which can elute complex mixtures of organic compounds, products such as particle board, plywood and insulation are known to release formaldehyde into the indoor environment. We have employed a modification of the Ames Salmonella/microsome assay with both DNA repair-proficient and -deficient strains and determined that one such material, particle board, emitted mutagenic and genotoxic substances. The materials offgassing from the particle board demonstrated a dose-related response in both mutagenicity and toxicity. It was also observed that incubation at 37 degrees C produced a decrease in both endpoints which was related to time of incubation. In addition, detectable amounts of twelve other organic compounds were identified as offgassing from the incubated particle board. PMID- 3520960 TI - Relationship between oxidative metabolites of hydrazine and hydrazine-induced mutagenicity. AB - Hydrazine (Hz) mutagenicity was observed in a test using Escherichia coli B/r strain, WP2 uvrA and was enhanced by the addition of rat liver microsomal fraction containing a generating system, while the enhanced mutagenicity was diminished by the addition of metyrapone to the microsome-free levels. On the other hand, an NADPH-dependent difference spectrum of the metabolic intermediate of Hz-complex, characterized by a maximum level of 448 nm, was also inhibited by metyrapone. The results show that the oxidative intermediates, which are diimide and its precursor, hydrazine free radical [Biochem. Biophys. Res. Commun., 133 (1986) 1086], are responsible not only for hepatotoxicity but also for the enhancement of genotoxicity or mutagenicity. PMID- 3520961 TI - Alcian blue method for attaching glycol methacrylate bone marrow sections to glass slides. PMID- 3520962 TI - Polyester wadding for specimen orientation during embedding in methacrylates. AB - Polyester fibers are not dissolved by either glycol methacrylate or methyl methacrylate. Commercial polyester wadding is consequently an advantageous material to use in getting precise orientation of tissue specimens during embedding in methacrylates. PMID- 3520963 TI - [Method for the surgical treatment of periodontal diseases using a fetal bone graft and a device for its performance]. PMID- 3520964 TI - [Experience with the ambulatory surgical treatment of periodontitis]. PMID- 3520965 TI - [Indications for prosthesis of the anterior teeth with porcelain, plastic and combined crowns]. PMID- 3520966 TI - [Use of ion-exchange materials in dentistry]. PMID- 3520967 TI - [Method for the prosthesis of the edentulous jaws when the retention sites are in the alveolar process]. PMID- 3520968 TI - [Distribution of the masticatory pressure on the tissues of the prosthetic bed from a removable denture made via a functional-differential cast]. PMID- 3520969 TI - [Adhesive powders--an agent for improving the retention of removable dentures. I. The laboratory evaluation of their adhesive properties]. PMID- 3520970 TI - [Thermometry in the orthodontic clinic]. PMID- 3520971 TI - [Bar clasp dentures]. PMID- 3520972 TI - [The processes of fibrin formation and fibrinolysis in periodontal physiology and pathology]. PMID- 3520973 TI - [Validation of the requirements for an experimental mandibular fracture model and for a method of consolidating its fragments]. PMID- 3520975 TI - Stroke outcome research. PMID- 3520974 TI - Carotid endarterectomy studies: a glimmering of science. PMID- 3520976 TI - Multicenter retrospective review of results and complications of carotid endarterectomy in 1981. AB - A multicenter retrospective audit of carotid endarterectomies performed during 1981 was completed with 46 institutions contributing 3,328 cases. Overall, there was a 2.5% risk of transient neurological dysfunction following surgery and a 6% risk of stroke or death. The intra-institutional combined major morbidity and mortality varied from 21% to 0. Those institutions with greater than 700 beds had a statistically lower incidence of stroke or death than did other institutions. The incidence of stroke or death postoperatively was significantly lower for patients who were operated on for amaurosis fugax or for unspecified reasons. Those patients who were operated on for a progressing stroke had a higher incidence of stroke but this group was at greatest risk for stroke without surgery. The incidence of postoperative stroke or death was related to the type of arterial repair; vein patch grafting was statistically better than both fabric patch grafting and primary closure. When all patients who were not monitored during surgery were compared to all patients who had electroencephalographic (EEG) monitoring, there was found to be a significant statistical difference in favor of the EEG group. Endarterectomy combined with coronary artery bypass or simultaneous bilateral endarterectomies had a statistically significant higher incidence of stroke or death than did unilateral carotid endarterectomy. PMID- 3520977 TI - Visual disturbance and carotid artery disease. 500 symptomatic patients studied by non-invasive carotid artery testing including B-mode ultrasonography. AB - Non-invasive carotid artery testing was performed on 500 consecutive patients with visual disturbances not related to local ophthalmic pathology to determine the extent of carotid artery disease, particularly in patients with symptoms not typical of amaurosis fugax. Three hundred eighty six patients (77.2%) had an abnormal study. However, the incidence of hemodynamically significant lesions was only 16%. The patients could be divided into three groups: Patients with symptoms that could be explained on an ocular basis, including amaurosis fugax, had a 79% incidence of ipsilateral carotid plaques. Patients with symptoms which could not be easily explained on an ocular basis, such as bilateral blurred vision, bilateral visual loss (both transient and permanent), and homonymous hemianopsia had an incidence of carotid artery plaques similar to patients with amaurosis fugax. Patients with unilateral blurred vision and bilateral scintillations had a lower incidence (57%) of carotid plaques than the other groups. Younger symptomatic patients had less carotid plaques than the overall series. Twenty-one percent of patients under age 50 had the Doppler finding of early systolic flutter turbulence, which is usually of mitral valve origin. Women predominated in the under 50 age group by about 2:1. In view of the prevalence of carotid plaques in the population of patients with visual symptoms other than amaurosis fugax, evaluation of these patients with non-invasive testing is indicated to determine which of these patients has hemodynamically significant obstruction to flow at the carotid artery bifurcation. PMID- 3520978 TI - A new combination therapy for selective and prolonged antiplatelet effect: results in the dog. AB - This study characterizes the effect of dazmegrel, a thromboxane synthetase inhibitor, on platelet function in the dog and introduces its potential use in combination with aspirin therapy. Ex vivo testing of dazmegrel alone was performed with three dosages and three administration regimens. Platelet aggregation response, malondialdehyde formation and prostaglandin metabolites generation were evaluated. To maintain complete thromboxane A2 inhibition, dazmegrel had to be given 3 times per day at dosages of not less than 6 mg/kg. The same result was achieved with a single daily administration of combined dazmegrel and aspirin in equal dosages of 3 mg/kg. Dazmegrel, both alone and with aspirin, increased and sustained heightened levels of prostacyclin, unlike the simultaneous inhibition of both prostaglandin metabolites seen with aspirin therapy alone. Because the combination of dazmegrel and aspirin effectively blocks thromboxane A2 formation and also enhances prostacyclin formation, the synergistic action of these agents increases their combined antiplatelet effect to a level not attainable by either agent alone. The significance of this combined therapy warrants further experimental study and may soon merit clinical trial for the prevention of stroke and other major thrombotic complications. PMID- 3520979 TI - Cicatrizing conjunctivitis. PMID- 3520980 TI - The defences of the ocular surface. AB - Bacterial infection may be responsible for mild self-limiting disease, chronic disease or acute and devasting ocular destruction. This paper and those that follow deal with some of the clinical forms of disease which are encountered, the bacteria responsible, the mechanism of invasion and the natural defences and clinical management, including selection and delivery of antibiotics. PMID- 3520981 TI - Bacterial classification and diagnosis. PMID- 3520982 TI - Bacterial conjunctivitis. PMID- 3520983 TI - Acute bacterial infection of the eye: bacterial keratitis and endophthalmitis. AB - Bacterial keratitis and endophthalmitis are serious disorders which can result in partial or total loss of vision. The epidemiology, common aetiopathogens, clinical features, diagnostic techniques and management are reviewed with an emphasis on laboratory diagnosis and antimicrobial therapy. PMID- 3520984 TI - Infection in the compromised eye. PMID- 3520985 TI - Functional preservation of the mammalian kidney. VII. Autologous transplantation of dog kidneys after treatment with dimethylsulfoxide (2.8 and 4.2 M). AB - This research demonstrates that dog kidneys perfused with dimethylsulfoxide (Me2SO) in likely cryoprotective concentrations (2.8 M) can survive as the sole source of renal support when autologously transplanted. Kidneys were perfused in vitro with Me2SO in one of two vehicles: solution A (K+-Mg2+-rich) or RPS-2 (K+ glucose-rich). Me2SO concentration in the vehicle was gradually increased to maximum (2.8 or 4.2 M) over a period of 28 to 35 min, held for 5-10 min, then decreased over 55-65 min. All groups except one consisted of 5 kidneys perfused at 25 degrees C. Survivors were dogs living 21 days postoperatively. The first group received kidneys perfused with solution A; 5 dogs survived, serum creatinine on day 21 [Cr], [mean +/- SE] = 1.3 +/- 0.1. The second group received RPS-2 kidneys; 4 survived, Cr=1.4 +/- 0.1. The third group received solution A kidneys with 2.8 M Me2SO; 3 survived, Cr=2.7 +/- 1.3. The fourth group received RPS-2 kidneys with 2.8 M Me2SO; 5 survived, Cr=1.2 +/- 0.2. The fifth group received RPS-2 kidneys with 4.2 M Me2SO; 2 survived, Cr=1.7 +/- 0.3. One group of 6 dogs received kidneys perfused at 10 degrees C with 4.2 M Me2SO in RPS-2; one survived, Cr=1.4. Results demonstrate beneficial interaction of vehicle with Me2SO and the efficacy of 25 degrees C perfusion. PMID- 3520986 TI - The prognostic value of the eosinophil in acute renal allograft rejection. AB - A case report of marked peripheral blood eosinophilia and eosinophilic infiltration of a rejected renal allograft in a transplant recipient stimulated our review of the clinical course of 132 consecutive renal transplant recipients. A total of 187 acute rejections occurred in 112 patients. Diagnosis was made by renal biopsy in 124 cases. The percentage of eosinophils in the leukocyte differential of patients with irreversible rejection was 5.2 +/- 5.7 (mean +/- SD) versus that seen in patients with reversible rejection, 2.9 +/- 3.5 (P less than .05). The difference in the total eosinophil counts in each group was not statistically significant. Patients with peripheral blood eosinophil percentages greater than or equal to 4% had a 37.9% irreversible rejection rate, whereas those who had less than 4%, had a 22.4% loss rate (P less than .01). Six of seven patients with greater than or equal to 2% eosinophils in the inflammatory infiltrate of their renal allograft lost their kidney, whereas grafts with less than 2% eosinophils had a 36.8% loss rate (P less than .02). We conclude that the increased presence of eosinophils in the peripheral blood and/or renal allograft biopsy specimen is an adverse prognostic factor for acute rejection outcome. PMID- 3520987 TI - Use of a prognostic index in evaluation of liver transplantation for primary biliary cirrhosis. AB - In the Cambridge/King's College Hospital program, one of the main criteria for recommendation of a liver transplant for a patient with primary biliary cirrhosis (PBC), as in other types of end-stage liver disease, has been the overall assessment that survival was likely to be less than one year. In the present study, a recently developed prognostic model, based on six variables, was used retrospectively to estimate the likely survival without transplantation of the first 29 patients receiving a transplant for PBC. Median estimated survival time for the complete group of patients was five months and in only four patients was survival in the absence of transplantation estimated to be more than one year. Comparison of actual survival curves after transplantation with the estimated survival in the absence of such a procedure shows that, despite an initial higher mortality related to surgery and the immediate postoperative period, grafting was associated with a statistically significant improvement in overall survival. No correlation between the outcome after transplantation and the severity of preexisting liver disease, (as assessed by the expected survival) could be determined, but further assessment of preoperative variables is warranted. PMID- 3520988 TI - Prophylactic use of OKT3 monoclonal antibody in cadaver kidney recipients. Utilization of OKT3 as the sole immunosuppressive agent. AB - We describe the first clinical trial of OKT3, a monoclonal anti-T-cell antibody, for prevention of kidney transplant rejection. 13 patients receiving a first cadaveric kidney transplant were randomly assigned to conventional treatment with azathioprine and high-dose steroids (7 patients) or to treatment with daily injection of OKT3 alone (6 patients). The first OKT3 injection resulted in a dramatic decrease in T3+, T4+, and T8+ cells, while patients simultaneously experienced fever, chills, and diarrhea. These symptoms did not recur with subsequent injections. All six OKT3-treated patients had a rejection necessitating introduction of steroids 12.8 +/- 2.9 days after surgery. Rejection was related to appearance of anti-OKT3 antibodies leading to disappearance of detectable OKT3 in the serum. Modulating (T3-, T4+ or T3-, T8+) cells were observed in all patients but were functionally inactive. As no rejection was observed before day 9 posttransplant, despite the lack of additional immunosuppressive agents, we conclude that OKT3 is a powerful, well-tolerated immunosuppressive agent. However, it is highly immunogenic and anti-OKT3 antibodies lead to loss of clinical effectiveness in this protocol. The use of OKT3 alone for prevention of kidney graft rejection cannot be recommended until a method for reducing the effects of anti-OKT3 immunization is developed. PMID- 3520989 TI - Inhibition of rat skin allograft rejection by cyclosporine. In situ characterization of the impaired local immune response. AB - Cyclosporine (CsA) is known to induce long-term survival of skin allografts, although the cellular mechanisms responsible for this effect are not well understood. To further define the effects of CsA-induced immunosuppression, we performed a morphological and immunohistological study of acute skin allograft rejection in the rat, comparing untreated and CsA-treated animals. Three significant differences were found between grafts in CsA-treated and untreated rats. First, CsA-allografts contained fewer MRC OX-8+ cytotoxic T cells than untreated allografts. Second, although the presence and numbers of infiltrating macrophages (W3/25+, W3/13- cells) was not influenced by CsA treatment, CsA treatment blocked expression of a macrophage membrane activation antigen, defined by the monoclonal antibody A1-3, which has previously been linked with development of macrophage procoagulant activity (PCA). Third, diminution in MRC OX-8+ lymphocytes and A1-3+ macrophages in CsA allografts was associated with an absence of the widespread thrombotic and necrotizing microvascular injury typical of acute rejection in untreated rats. We conclude that prolongation of skin allograft survival by CsA is related to its ability to prevent cell mediated injury to the endothelium of graft vessels, and possibly also to inhibition of macrophage PCA with consequent reduced thrombus formation. PMID- 3520990 TI - The specificity of nephritogenic antibodies. IV. Binding of monoclonal antithymocyte antibodies to rat kidney. AB - Polyclonal rabbit antirat thymocyte serum (ATS) has been shown to form in situ glomerular immune aggregates following perfusion into normal rat kidney ex vivo. This may be due to the presence of T-cell-like epitopes in the rat kidney, or it may be a result of contaminating anti-connective-tissue antibodies in ATS. To exclude the latter possibility we investigated binding to the rat kidney of three different (mouse) monoclonal antirat thymocyte antibodies (anti-T-cell MoAbs), directed to Thy 1.1 antigen, as well as (control) anti-B-cell MoAbs. The MoAbs were incubated in vitro with kidney sections or perfused into the blood-free rat kidney ex vivo. It was shown using immunofluorescence (IF) and immunoelectron microscopy (IEM) (peroxidase technique) that the anti-T-cell MoAbs used, in contrast to anti-B-cell MoAbs, are able to bind with glomerular capillary walls, and with mesangial structures after incubation in vitro or perfusion ex vivo. Although staining patterns are not completely identical, the reaction product is clearly demonstrated throughout the glomerular basement membrane (GBM) and along the plasma membranes of endothelial and epithelial cells, after contact with either of the three anti-T-cell MoAbs used. It is concluded that the presence of T-cell-like epitopes in the rat kidney may lead to immune complex formation following contact with anti-T-cell MoAbs. The nephritogenicity of rabbit ATS, as well as of some batches of clinically used ATS, may also be explained by this mechanism rather than by the usually assumed presence of contaminating antibodies in these polyclonal antisera. PMID- 3520991 TI - Functional characterization of prethymic T cells committed to alloreactivity. AB - The results of previous experiments on MHC fully allogenic bone marrow transplantation (BMT) in nonthymectomizd recipients indicated that anti-MHC alloreactivity starts to become irreversibly committed at the prethymic level. This is a matter of some controversy. Since it is possible that conflicting results depend on the methods chosen, we reexamined our previous results by applying two new approaches. Adult thymectomized (ATX) Balb/c mice received a syngeneic fetal thymus either 3 weeks before or 3 weeks after lethal irradiation and reconstitution with C57BL/6 BM incubated in antiserum. Since monoclonal antibodies such as anti-Thy 1 are of limited value for investigations of the above type (Thy 1 antigen crosses the prethymic/thymic border), we used two highly selective, excessively cytotoxic xenoantisera for incubation of the donor BM--either a specific anti-T cell serum (SAT) that eliminated only mature T cells, or a specific antilymphocyte serum (SAL) that reacted additionally with a subset of prethymic T cells (PTC). In both experimental approaches the results were similar: Recipients of SAT-BM developed antihost reactivity, in contrast to recipients of SAL-BM. SAT-BM recipients became immunodeficient, whereas SAL-BM chimeras were immunocompetent. Late mortality was observed only following SAT treatment. Preliminary morphological findings in the lymphoid tissue of BM recipients agree fully with the functional observations. We conclude that the data confirm our previous results in nonthymectomized BM recipients--i.e., PTCs initiate antihost reactivity in MHC fully allogeneic BMT--and PTC commitment is thymus/thymus factor independent. These conclusions are discussed with regard to the problems of MHC allogeneic clinical BMT. PMID- 3520992 TI - Donor-type MHC-positive cells in the host spleen after rat organ transplantation. Differences between pancreas and heart allograft recipients. PMID- 3520993 TI - The rationale for antimitotic treatment prior to bone marrow transplantation. PMID- 3520994 TI - Cyclosporine and familial Mediterranean fever amyloidosis. PMID- 3520995 TI - Superoxide dismutase decrease in cardiac transplants. PMID- 3520996 TI - Erythromycin and cyclosporine. PMID- 3520997 TI - International symposium on medical, ethical, and economic aspects of organ transplantation and procurement. Cleveland, Ohio, November 7-9, 1985. PMID- 3520998 TI - Renal transplantation in Saudi Arabia. AB - One-year actuarial patient and graft survivals of 98% and 95% were obtained. Donor-specific transfusions were widely used in both the living-related donor kidney recipients as well as recipients of kidneys from distantly and unrelated individuals. The underlying health problems that are still endemic to this region will probably be reflected to a greater extent in longer term follow-up. PMID- 3520999 TI - Cyclosporine as initial treatment for first acute rejection episodes in renal transplantation. PMID- 3521000 TI - The role of antilymphocyte globulin in cadaver renal transplantation. PMID- 3521002 TI - Results of artificial heart implantation in man. PMID- 3521003 TI - The use of the mechanical heart: alternative to or support for heart transplantation. PMID- 3521004 TI - Review of xenografts in organ transplantation. AB - Xenografts may provide one approach for resolving organ procurement problems for clinical transplantation. Also, they would allow surgical procedures to be done in an elective, highly organized fashion. The process of xenograft rejection qualitatively resembles allograft rejection in that both cellular and humoral immune mechanisms are involved, but differs quantitatively depending on the genetic disparity between the donor and the recipient. Thus, with minor disparity rejection is mediated primarily by cellular mechanisms whereas with major disparity the process is a violent one, mediated primarily by humoral mechanisms. Immunosuppressive regimen in most of the clinical studies has included azathioprine, steroids, antilymphocyte globulin (ALG), Actinomycin-C, and local graft irradiation. Other modalities including cyclosporin, which have shown improved xenograft survival in animal models, have not yet been tested critically in a clinical setting. It is doubtful that the present battery of immunosuppressive agents would improve xenograft survival comparable to that observed with allografts. The clinical experience in xenografts to date has involved primarily renal and to some extent liver and heart transplants from chimpanzee and baboon donors. These studies demonstrated clearly that the transplanted organ was capable of function in the human recipient; however, the patient and graft survival in general have been poor. On the other hand, the one case of renal xenograft surviving for nine months is intriguing and certainly provides rationale for future investigations. PMID- 3521005 TI - Observations on cardiac xenotransplantation. PMID- 3521006 TI - [Processes of the differentiation and reproduction of different types of muscle cells]. AB - The present review is regarding a vast evidence on reproduction, differentiation, and regenerative capacity of various muscle cells on the basis of A. A. Zavarzin's (Senior) parallelism conception. It is specially emphasized that parallelism in the subcellular organization of contractile structures of somatic and of heart muscle goes well together with a totally different principle of organization of these cellular elements (symplasts, or cells, respectively), and with different mechanisms of their histogenesis and regeneration (proliferation of, respectively, myoblasts, or immature myocytes). According to their ultrastructure and pattern of interrelation between proliferation and differentiation process, muscles of lymphatic hearts are closer to somatic muscles rather than to ordinary myocardium. Special attention is called to paradoxical situations, such as the presence of satellite-like cells in the myocardium of Decapoda, DNA-synthesizing capacity observed in the nuclei of growing somatic muscles of the silkworm, or DNA-synthesizing and chromosome reproducing capacity of adult primate and human cardiomyocytes. PMID- 3521007 TI - [Characteristics of the organization of cell proliferation in plants in relation to the problem of stem cells]. AB - Cellular patterns of continual cell proliferation are considered in plants and animals. In plants, the cells, analogous to the animal stem cells, can be formed many times during plant ontogenesis. Their functioning as stem cells is determined by their position in the growing organ. This is the reason why a plant can grow for a very long time. There are some common features of cellular patterns of proliferation in plants and animals providing the stability and optimal subordination between cell proliferation, differentiation and function. PMID- 3521008 TI - [Proliferative and differentiation potentials of skeletogenic bone marrow colony forming cells]. AB - The clonal nature of bone marrow fibroblast colonies derived from clonogenic bone marrow osteogenic cells (CFUf) was proved by the chromosome analysis. During subsequent passages of multi-colony derived bone marrow fibroblast strains there occurs a pronounced increase in the cell number and in the number of osteogenic units (tested by transplantation in diffusion chambers). Single colony-derived strains are capable of forming bone and cartilage simultaneously. It follows that CFUf or part of them are clonogenic cells with high proliferative potentials and are common precursors for bone and cartilage tissue. Thus, CFUf may be regarded as osteogenic stem cells. PMID- 3521009 TI - [Determination of the DNA-synthesizing cell count by the immunofluorescence method]. AB - In DNA-synthesizing cells DNA is partially single-stranded. Anti-thymidine antibodies, while specifically reacting with this DNA, form a complex which may be revealed using indirect immunofluorescent technique. A comparative determination of DNA-synthesizing cell number in tumor tissue (larynx squamous cell carcinoma) was performed using immunofluorescent technique and radioautography. The former method showed the labeling index (LI) to vary from 1.2 to 9.9%, while the latter showed it to vary from 1.0 to 8.2%. The correlation ratio between the LI values obtained by the two techniques was 0.79. To eliminate a possible reaction of anti-thymidine antibodies with cellular RNA, specimens were preincubated in solutions with RNAase. No more than 6 hours were required to stain specimens using this LI estimation technique. This investigation allows to reveal DNA synthesizing cells not only in the periphery of a histological section, as does routinely radioautography, but also in its centre. PMID- 3521010 TI - [Academician Aleksei Alekseevich Zavarzin (on the centenary of his birth)]. PMID- 3521011 TI - [Structure of the centriolar complex in the hepatocytes of intact and regenerating mouse live]. AB - The structure of the cellular center in polyploid hepatocytes of intact and regenerating liver of adult mice has been studied. It was shown that the structure of the centriolar complex depends on stages of the cellular cycle. No pericentriolar structures (such as satellites, appendages and others) and cytoplasmic microtubules were found in the centriolar complex within G0-period. The satellites and appendages are formed in the half of the centrioles within G1 period. The microtubules can branch off some satellites; the daughter centrioles begin to form within S-period; there are diplosomes in the cells within G2 period, some mother centrioles are surrounded with the fine fibrillar halo. It is concluded that the structure of the centriolar complex within G0-period is distinguished by that within G1-period. The structure of the centriolar complex in polyploid hepatocytes has the same feature of reorganization in certain interphase periods of the cell cycle as in diploid cells of some cultured cells and the thyroid epithelium. PMID- 3521012 TI - [Structural changes in the contractile proteins of muscle fiber studied by polarization ultraviolet fluorescence microscopy. IX. The effect of the pH and ionic strength of the solution on the conformational restructurings of F-actin induced by the binding of heavy meromyosin]. AB - The dependence of F-actin conformational changes induced by the F-actin-HMM complex on pH and ionic strength was found by polarized ultraviolet fluorescence microscopy. It is discovered that pH affects sufficiently the cooperativity of F actin structural changes, while the ionic strength affects their depth. The actomyosin complex was supposed to be at least in two structural states, differing in their orientation as well as in flexibility of F-actin monomers. PMID- 3521013 TI - [Measurement of the albumin content in individual cells]. AB - A cytophotometric method is proposed for albumin determination in particular cells based on the immunoenzymatic detection of this protein with immuno peroxidase complexes. The relative contents of albumin in hepatocytes of mouse in two inbred stocks were measured by two independent methods, and the results obtained well compared. PMID- 3521014 TI - [Investigation of Soviet microcarriers for cell cultivation]. AB - Home made and foreign preparations (6 patterns in each) were tested as microcarriers for cultivation of anchorage-dependent cells in the medium supplemented with 0.25% enzymatic hydrolysate of muscles and 10-20% animal serum. The best results were obtained with microcarriers DEAE-2.5, Cytodex-1, and DEAE cellulose. Using home microcarriers DEAE-2.5, continuous swine embryo kidney cells and primary chick embryo cells yielded, respectively, 9-11 and 3-4 times increase. PMID- 3521015 TI - Controlled clinical trial of 4 short-course regimens of chemotherapy (three 6 month and one 8-month) for pulmonary tuberculosis: final report. East and Central African/British Medical Research Council Fifth Collaborative Study. AB - The bacteriological relapse rates up to 30 months after the start of chemotherapy have been compared for 4 daily short-course regimens for pulmonary tuberculosis. All 4 had the same initial 2-month intensive phase of streptomycin, isoniazid, rifampicin and pyrazinamide (SHRZ) followed by isoniazid plus rifampicin for 4 months (4HR), or isoniazid plus pyrazinamide for 4 months (4HZ), or isoniazid alone for 4 months (4H), or isoniazid alone for 6 months (6H). In patients with fully sensitive strains pretreatment, the 6-month regimen with rifampicin throughout (4HR) was highly effective, only 2% of 166 patients relapsing bacteriologically in 24 months of follow-up after stopping chemotherapy. This regimen was significantly better than the 4H regimen which had a relapse rate of 10% in 156 patients (P less than 0.02) and the 4HZ regimen which had a relapse rate of 8% in 164 patients (P = 0.05). The 6H regimen was also highly effective, only 3% of the 123 patients relapsing, compared with 10% of the 156 on the 4H regimen (P = 0.06). The relapse rate of the regimen with pyrazinamide throughout (4HZ), was not significantly different from that of either of the regimens with isoniazid alone in the continuation phase. All except 3 (1 4HR, 1 4HZ, 1 4H) of the 36 relapses were with fully drug-sensitive strains. In patients with strains resistant to isoniazid alone pretreatment none of the 23 on the 4HR or 4HZ regimens had an unfavourable bacteriological status at the end of chemotherapy compared with 8 of the 17 patients (P less than 0.005) on 4H or 6H regimens. Of the patients assessed, 3 of 20 receiving rifampicin or pyrazinamide throughout relapsed compared with 2 of 8 who did not. PMID- 3521017 TI - [The renal graft in Tunisia: 1977 to 1984]. PMID- 3521016 TI - Serodiagnosis of intestinal tuberculosis by enzyme immunoassay and soluble antigen fluorescent antibody tests using a saline extracted antigen. AB - The efficacy of enzyme-linked immunosorbent assay (ELISA) and soluble antigen fluorescent antibody (SAFA) tests in the diagnosis of intestinal tuberculosis was compared using saline extracted surface antigen of M. tuberculosis H37Ra. Of the 24 proved cases of intestinal tuberculosis ELISA detected positivity in 92% compared with 83% detected by the SAFA test. The 2 tests showed a strong correlation with each other and yielded a clear cut difference between patients and controls, although there was some degree of overlap. PMID- 3521018 TI - The microvascular localization of laminin and fibronectin in scleroderma muscle by immune electron microscopy. AB - Immune electron microscopy using a peroxidase-antiperoxidase (PAP) technique was done on muscle biopsies from patients with scleroderma (PSS), rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and normal controls, in order to localize laminin and fibronectin in the muscle capillary basement membrane (BM). Three patterns of staining were noted for the 2 antigens: in/out, diffuse and negative. Staining patterns in PSS biopsies were markedly different from both the normal and disease controls. For laminin the expected in/out pattern was rare in PSS, with virtually all biopsies being either diffuse or negative. In the case of fibronectin, the staining patterns were of equal frequency in PSS, whereas in the control groups diffuse staining was rare. These findings suggest that in addition to the morphologic abnormalities previously noted in PSS muscle capillary BM, there is also an alteration in the distribution of specific BM components in PSS. PMID- 3521019 TI - Hepatic iron overload in renal transplant recipients: ultrastructural observations. AB - This study describes the ultrastructural features of hemosiderosis occurring in five transplant recipients. Iron deposits in the form of homogeneous and heterogeneous siderosomes (iron-laden lysosomes) were found within the hepatocytes and macrophages in areas of fibrosis, and to a lesser degree within Kupffer cells and bile duct epithelium. Disruption of siderosomal membranes with extrusion of ferritin particles into the cytosol was demonstrated in these specimens and may be significant in the pathogenesis of hepatocellular injury. PMID- 3521020 TI - Insular amyloid in a case of type III glycogenosis with a special reference to the origin of amyloid fibrils. AB - Amyloid depositions of pancreatic islets were investigated with electron microscopy in a case of type III glycogenosis. Beta cells adjoining small amyloid depositions were shown to have cytoplasmic invaginations where closely packed amyloid fibrils were disclosed regularly orientated amyloid bundles. In the cytoplasm of the beta cells, some membrane-bounded vesicles contained amyloid fibrils and a few beta granules directly transformed into the fibrils within the vesicles. These findings indicate that, at least in this case, the beta cells play a crucial role in the formation of insular amyloid. PMID- 3521021 TI - Contrast and resolution of scanning transmission electron microscope imaging modes. AB - Image blurring due to delocalization of inelastic events was studied for scanning transmission electron microscopy (STEM) of unstained thin sections. The delocalization probability was obtained from the angular distribution of inelastic scattering, which was calculated from experimental electron loss spectra of organic samples. This probability was implemented in a Monte Carlo program to simulate the effects of multiple scattering and delocalization for STEM images collected by either the annular detector or the spectrometer, and images generated by a combination of these two signals. Depending on the illumination, the detector geometry and the energy-loss range selected for imaging the annular detector image is blurred by a non-negligible fraction of inelastically scattered electrons. Simultaneous acquisition of an inelastic image using a spectrometer allows the blurring to be reduced by calculation of either the ratio or the difference of the two darkfield signals. While inherent nonlinearities reduce the interpretability of ratio-contrast images, difference contrast improves the visibility of details submerged in a diffuse background without introducing artifacts. PMID- 3521022 TI - Sonographic depiction of the endometrium during normal cycles. AB - Pelvic sonograms were performed every 2-3 days in 10 volunteers in order to study changes in thickness and texture that occur in the normal endometrium. A total of 75 sonograms were performed. The accuracy of sonographic estimates of endometrial thickness was also evaluated in eight patients who underwent hysterectomy for reasons unrelated to the uterus. The majority of sonographic measurements of endometrial thickness in these patients were within 1 mm of the actual thickness as measured in the unfixed specimen. In all of the individuals studied, sonography was able to depict changes in the thickness and texture of the endometrium which corresponded to the various phases of its development. Specifically, the average thicknesses of the endometrium were greater in the secretory phase (3.6 +/- 1.4 mm) than in the proliferative phase (2.9 +/- 1.0 mm) (p less than or equal to 0.05). The texture of the endometrium varied throughout the cycle with the hypoechoic texture slightly more common than echoic in the proliferative phase, whereas the echogenic appearance was most common in the secretory phase. Those technical factors which optimized sonographic depiction of the endometrium are discussed, as well as the possible clinical applications of the sonographic depiction of normal and abnormal endometria. PMID- 3521023 TI - Ultrasound monitoring of fetal behaviour. PMID- 3521024 TI - Antenatal recognition of cerebral anomalies. AB - Modern ultrasound equipments allow a detailed investigation of the fetal brain from a very early stage of development. Congenital anomalies arising from or involving the central nervous system can be accurately predicted. On the basis of their personal experience, which includes 48 cases, and of a review of the current literature, the authors discuss criteria for the intrauterine diagnosis and obstetrical management of intracranial anomalies such as hydrocephalus, holoprosencephaly, cephaloceles, porencephaly, hydranencephaly, and microcephaly. PMID- 3521025 TI - Reduced error in double beam Doppler ultrasound flow velocity measurement. PMID- 3521026 TI - Cardiovascular applications of multi-gate pulsed Doppler systems. PMID- 3521027 TI - Duplex scanning in presumably normal persons of different ages. AB - Ultrasonic duplex scanning was used for flow velocity measurement in the extracranial carotid vessels in 92 presumably healthy volunteers aged 20-82 and in 14 patients aged 23-72 with normal carotid vessels on angiography. Velocities were examined as a function of age, diameter, blood pressure, side, or position in the vessel. The peak systolic velocities and late diastolic velocities in the CCA showed an age-dependent decrease (p less than 0.001), and the same was true of the peak systolic velocity in the proximal ICA on the right side (p less than 0.05) and the late diastolic velocity in the right (p less than 0.01) and left (p less than 0.001) proximal ICA. The change in velocity was inversely correlated to diameter and blood pressure. The systolic and late diastolic velocities were significantly (p less than 0.05 and 0.001 respectively) faster in the left CCA at low position than in the right, and, conversely, in the right ICA (p less than 0.05) than in the left. At CCA high position faster diastolic velocities were noted than at CCA low, on both sides. All age-dependent quotients comprised a peak systolic velocity in the CCA, whereas the quotient between the late distolic velocities in ICA and high did not show age dependency. Reproducibility of peak systolic and late diastolic velocities in the CCA, ICA, and ECA, expressed as the mean percentage difference, varied between 6.4 +/- 4.6% and 12.7 +/- 6.4%. PMID- 3521028 TI - Characteristics of blood flow velocity in the hypertensive canine pulmonary artery. AB - Pulmonary artery blood flow velocity was measured in 15 dogs by a recently developed direct intraluminal pulsed Doppler technique. Changes in velocity characteristics under conditions of experimentally induced hypoxic pulmonary hypertension were observed. Experimental conditions (fractional inspired oxygen concentration = 0.10) produced significant increases in mean pulmonary artery pressure and pulmonary vascular resistance. Overall and maximal negative velocity increased with pulmonary hypertension. Negative velocity occurred predominantly in the posterior half of the pulmonary artery during both control and experimental conditions. With pulmonary hypertension, diastolic negative velocity increased only in the posterior half of the pulmonary artery and systolic negative velocity decreased only in the anterior half. More basic knowledge of pulmonary artery blood flow characteristics may facilitate an informed approach to noninvasive detection of pulmonary hypertension. Direct measurements by this recently developed intraluminal technique will be useful in studying various conditions with altered pulmonary blood flow. PMID- 3521029 TI - Influence of spectral broadening on continuous wave Doppler ultrasound spectra: a geometric approach. AB - A model is presented that enables the detailed effects of spectral broadening to be calculated for a continuous wave (CW) Doppler system by using geometric boundary arguments. The model assumes a uniform distribution of isotropic scatterers and treats the transmitter and receiver crystals as incremental sources and receivers. Detailed results for rectangular and circular geometries are presented in order to provide a physical understanding of the manner in which spectral broadening arises. Results are given for the circular geometry, to illustrate the manner in which the received spectrum is affected by the transducer size and distance from the vessel. PMID- 3521030 TI - Evaluation of frequency dependence of backscatter coefficient in normal and atherosclerotic aortic walls. AB - For five groups of aortic specimens (normals and with different degrees of atherosclerosis) the ultrasonic backscatter coefficient was measured as a function of frequency in the range 4-15 MHz. The results of the study are related to two classes of structure, connective and fatty tissue (whose relative amount in the arterial wall is related to the different stages of atherosclerosis), as the main determinants of the scattering from aorta. The structure of connective tissue in the aorta produces a power law frequency dependence of the backscatter coefficient typical of small scale structures (Ka much less than 1). Fatty tissue introduces a frequency dependence of the backscatter coefficient typical of structures of intermediate scale (Ka approximately equal to 1). Biochemical composition and structure of normal and atherosclerotic aorta therefore, specifically affect the employed acoustical parameter. PMID- 3521031 TI - The locations of peak pressures and peak intensities in finite amplitude beams from a pulsed focused transducer. AB - The effect of finite-amplitude distortion on the positions of peak pressures and peak intensities in beams generated in water by pulsed focused transducers has been investigated experimentally. The pulses generated by three single-element, circular, focused transducers with nominal frequencies of 2.25, 3.5, and 5.0 MHz have been investigated with pressures at the transducer P0 being varied over the range 10 kPa to 1.4 MPa. Measurements were made using a 9 micron thick polyvinylidene difluoride membrane hydrophone. In all cases the locations of peak pressures were not stationary as the field strength was altered. As P0 increased, the distance from the transducer to the positive peak initially increased, and then decreased. The distance to the negative, or decompression peak decreased monotonically with increasing P0. The location of peak pulse intensity integral was found to alter slightly with power, taking a position between the peak positive and negative pressures. PMID- 3521032 TI - Bibliography of biomedical ultrasound. No. 54. PMID- 3521033 TI - [Autologous spongiosaplasty in the treatment of chronic osteomyelitis]. AB - The most promising method of filling up osteomyelitic bone deficiencies is the transplantation of fresh autologous spongiosa as soon as the infection is under control. The fundamental principles of surgical therapy of septic focuses must not be neglected. A spongiosa graft into the florid infection has only little chances of success. The stability of the deficiency is decisive for the success of the transplantation. In case of infection it is necessary as far as possible to choose a point remote from the septic focus for the grafting of the osteosynthetic material. PMID- 3521034 TI - [Experiences with free and pedicled muscle tissue graft in the treatment of chronic post-traumatic osteomyelitis]. AB - A relapse-free condition and/or healing of chronic posttraumatic osteomyelitis is obtained by 1. radical excision of the infected tissue, 2. absolute mechanical immobility in the area of the fracture, 3. optimized blood supply of soft tissues. The perfusion of soft tissues around the osteomyelitic focus is often disturbed due to large scar fields caused by injuries or repeated surgical interventions. It can be improved by means of plastic surgery with local muscle flaps or by transplantation of a free muscle flap with microsurgical connection of vessels. All muscles in which the axial vessels are predominant can be used for plastic surgery with local muscle flaps. In the leg, these are above all the musculi gastrocnemii and the musculus soleus. After having applied this method in six patients, we noticed that infection control could be achieved by this procedure after six to twelve months. When a free muscle flap (musculus latissimus dorsi) is used, the local soft tissue perfusion can be considerably ameliorated by these rather large muscle flaps, irrespective of the local blood flow after epicentric microsurgical connection of vessels. This is the precondition for the healing of the infection. Based on our own results, we discuss the difficulty to indicate exactly the duration and extent of the increased perfusion of transplanted muscles. As is shown by the clinical results available up to now, these two procedures make possible a considerably reduced recurrence rate in chronic posttraumatic osteomyelitis. PMID- 3521035 TI - [Use of bone scintigraphy in the evaluation of bone involvement by prostatic cancer treated with a LHRH-antiandrogen combination]. PMID- 3521036 TI - [Scintigraphic evaluation of esophagogastric function]. PMID- 3521037 TI - [Scintigraphic studies of the adrenal and parathyroid glands]. PMID- 3521038 TI - [Current concepts on the treatment of ischemic cerebrovascular disease]. PMID- 3521039 TI - A simplified method for determination of pyridoxal phosphate in biological samples. AB - A new method for the determination of pyridoxal phosphate in plasma and in cerebrospinal fluid is described. It is based on the generally accepted apotyrosine decarboxylase method, but, in stead of following the decarboxylation rate using 14C- och 3H-labelled tyrosine, a high performance liquid chromatography (HPLC) method for separation of tyrosine and tyramine is used. This procedure is recommended as it is less time consuming and avoids utilizing radioactive material. PMID- 3521040 TI - Studies of drug-treated diabetes in the county of Jamtland, Sweden, based on prescription of insulin and oral antidiabetic drugs. AB - Epidemiological data on drug-treated diabetes mellitus was obtained by analyzing prescriptions of insulin and oral antidiabetics in the county of Jamtland Sweden. During a 12-year period, from 1971 to 1982, the prevalence of diabetes increased from 1.5% to 2.2%, while there was no significant change in the annual incidence of around 2.7/1000 inhabitants. Women displayed a considerable higher prevalence and incidence than men in the over 70 age-group, while in the 50 - 69 age-group there was a male dominance. A significant change in the prescription pattern with an increased use of insulin and decreased use of oral antidiabetics was observed during the period. More patients were started on oral antidiabetics during the first part of the year than during the latter. PMID- 3521041 TI - [Clinical evaluation of the effectiveness of estracyt and radiation therapy in the treatment of stages II and III prostatic cancer]. PMID- 3521042 TI - Attenuation estimation on phantoms--a stability test. AB - Global and local attenuation coefficient estimates were calculated using three methods: the envelope peak method, the central-frequency-downshift method, and the zero-crossing method. The results show that for each method the error of the local estimate with respect to the global estimate is increased as the sample volume is decreased. While the performances of the latter two methods are comparable, the performance of the envelope peak method is significantly superior. PMID- 3521043 TI - Speckle reduction in pulse echo imaging using phase insensitive and phase sensitive signal processing techniques. AB - In conventional B-scan imaging, speckle often distorts the true representation of small structures and lesions and hence reduces the diagnostic potential of the technique. Considerable speckle reduction has been achieved with an f/2.4, cone hybrid system by cutting the large aperture transducers into sectors, and using either phase insensitive sector addition (PISA), phase insensitive sector multiplication (PISM), or an rf multiplicative processing technique. We have compared two modes of operation with the hybrid system. In the first, the cone acts as transmitter, and each sector of the f/2.4 spherical aperture is a receiver. In the second mode, the f/2.4 sphere acts as transmitter, and each sector of the cone is a receiver. Quantitative assessment using the contrast to speckle ratio developed by Patterson et al, indicates that processing under both modes results in reduced speckle noise and improved image quality, with the cone sector receive (rx) geometry offering the greatest improvement. PMID- 3521044 TI - Eleventh International Symposium on Ultrasonic Imaging and Tissue Characterization. June 2-4, 1986, Washington, DC. Abstracts. PMID- 3521045 TI - [Acquired renal cysts in maintenance dialysis patients]. AB - Ultrasonographic examination of the kidneys of 111 patients on long term maintenance hemodialysis was performed. None of the patients had genuine polycystic kidney disease. In many patients acquired cysts were found. Frequency and volume of these cysts were the same on the right and left side. There was no correlation between the age of the patients and the number of cysts. There were no differences concerning sex and type of primary renal disease. There was a significant positive correlation between time on maintenance hemodialysis and number of cysts but no correlation between number of cysts and hemoglobin concentration. This is in contrast to data in the literature. Clinical relevance of acquired kidney cysts in dialysis patients concerns hematuria, retroperitoneal bleeding, kidney stone formation, septicemia and malignancy. PMID- 3521046 TI - [Effect of the angiotensin II analog saralasin before donor nephrectomy on primary transplant function]. AB - Cadaver kidney donors were treated with Angiotensin II-Analogon-Saralasin before nephrectomy in order to reduce the rate of acute renal failure. Eighteen (64.3%) of the recipients of the 30 donor kidneys pretreated with Saralasin were primarily free from dialysis. Six recipients showed acute renal failure. Two donor kidneys never resumed their function and no reports could be obtained on two organs. In the control-group with no pre-treatment, acute renal failure appeared significantly more often (67.3%). Thus only 32.7% of the recipients needed no further dialysis. This difference is statistically significant. PMID- 3521047 TI - [Nephrotoxicity of ionic and nonionic contrast media in selective renovasography]. AB - Nephrotoxic effect of ionic and non-ionic contrast media was examined in a doubleblind study by evaluation of serum creatinine, blood urea nitrogen, urine volume, urinary protein excretion and erythrocyturia before and after selective renovasography. In 19 of 22 patients reliable results were obtained. With optimal hydration before and after renovasography no significant differences between both administered contrast media (Rayvist 300 and Omnipaque 300) could be found by evaluation of the aforementioned parameters. In 3 patients with preexistent proteinuria (greater than 200 mg/l) urine protein excretion remained at the same or a lower level after application of the non-ionic contrast medium Omnipaque 300. Three patients with proteinuria tended to increase the proteinuria after administration of the ionic contrast medium (Rayvist 300) up to 48 h after angiography indicating a higher nephrotoxic potential of ionic contrast media in patients with preexistent renal disease. The constant values of urine volume and serum creatinine indicate an absence of clinically relevant nephrotoxicity of both contrast media in this study when administered in well-hydrated patients. This emphasizes the importance of sufficient hydration in prophylaxis of nephrotoxic effects, especially in patients with risk factors. PMID- 3521048 TI - Comparison of renal transplantation and dialysis in rehabilitation of diabetic end-stage renal disease patients. AB - We have reviewed the outcome of replacement therapy for end-stage renal disease (ESRD) in 100 diabetic patients with emphasis on late complications, extrarenal diabetic manifestations, and overall patient rehabilitation. Long-term complications, other than myocardial infarction, were not different after renal transplantation compared with chronic dialysis. Overall rehabilitation was better after renal transplantation compared with chronic dialysis (p less than 0.05). Retinopathy and neuropathy were more stable with renal transplantation and peritoneal dialysis compared with hemodialysis (p less than 0.05). These factors should be considered along with expected patient survival when deciding between different treatment modalities for diabetic ESRD. PMID- 3521049 TI - Impact of magnetic resonance on staging of renal carcinoma. AB - Computerized tomography (CT), ultrasound, and angiography have been used for staging renal cell carcinoma. CT has proven to be the most reliable and sensitive of these techniques. Magnetic resonance (MR) has emerged recently as a viable alternative imaging modality. Five patients with renal cell carcinoma and suspected caval involvement were evaluated by CT, ultrasound, and MR. Caval extension and the differentiation of intra-versus retrocaval tumor was seen with greater clarity on MR scans; perinephric extension was seen equally well with both modalities. The primary tumor itself was better defined with CT. In patients with equivocal findings regarding the renal veins or inferior vena cava, MR is a valuable adjunct in preoperative evaluation. In patients at high risk for contrast administration, MR is the staging modality of choice. PMID- 3521050 TI - Dietl's crises. PMID- 3521051 TI - Distribution status of the cotton rat (Sigmodon hispidus) in Colorado. PMID- 3521052 TI - [Experimental and clinical studies of variants of keratophakia surgery]. PMID- 3521053 TI - [Annular keratorrhaphy (preliminary report)]. PMID- 3521054 TI - [Experience with plastic surgery operations on the adnexa oculi]. PMID- 3521055 TI - [Acoustic scanning in determining the indications for and the evaluation of the effectiveness of vitrectomy in traumatic hemophthalmia]. PMID- 3521056 TI - Cesarean section. Anesthetic management and surgical technique. AB - Cesarean section can be an elective procedure but more often it is an emergency procedure that is made necessary because of dystocia. A successful outcome for both the maternal and fetal patients is primarily dependent on a thorough understanding of the physiologic alterations during normal and abnormal pregnancy and parturition. A complete history and physical examination are necessary for assessment of the dam and planning of fluid therapy and anesthetic technique. Timely coordination of presurgical preparation, anesthesia, and the surgical procedure is crucial. Because little documentation exists to prove that any one anesthetic protocol is best, this article will stress the basic principles of obstetrical anesthesia and patient management. PMID- 3521057 TI - A review of teat factors in bovine E coli mastitis. AB - Escherichia coli mastitis was first reproduced in 1903 by sticking the organism to teat orifices. E coli is very common in the environment of housed dairy cows and mastitis can easily be reproduced experimentally by the introduction of as few as 20 organisms into the teat cistern via the teat duct. It is generally accepted that this is the route of natural infection but the processes by which the organisms traverse the teat duct remain unclear. The literature is reviewed and the facts and hypotheses are considered. PMID- 3521058 TI - Potential danger to pregnant women of Chlamydia psittaci from sheep. PMID- 3521059 TI - Incidence of clinical mastitis in a cohort of British dairy herds. AB - A three-year survey to determine the incidence of clinical mastitis and the associated bacteria in dairy herds in England and Wales is described. Escherichia coli was the predominant organism in each year. Streptococcus uberis and Staphylococcus aureus were important for part for each year. The annual incidence of mastitis declined from 54.6 cases per 100 cows in 1980 to 41.2 in 1982. The incidence increased with age and declined with increasing herd size. The culling rate due solely to mastitis was 3 per cent. Strep uberis was the pathogen most frequently isolated from clinical cases which occurred in the dry period. Thirty per cent of all cases recurred at least once and staphylococcal cases exhibited the highest frequency of recurrence. PMID- 3521061 TI - Ultrasonic diagnosis of pregnancy. PMID- 3521060 TI - Disease associated with Mycoplasma mycoides, subspecies mycoides in sheep in Nigeria. PMID- 3521062 TI - [Ultrasonic and computed tomographic semeiotics of cholelithiasis]. PMID- 3521063 TI - [Radiation and complex therapy of malignant lymphomas (review of the literature)]. PMID- 3521064 TI - [Current methods of clinical topometry and their value in the pre-irradiation preparation of patients (review of the literature)]. PMID- 3521065 TI - Monoclonal antibodies directed towards the two major cell populations in the bursa of Fabricius of the chicken. AB - Two mouse monoclonal IgM antibodies, B.1 and B.2, have been produced using the mouse myeloma cell line Sp2/0-Ag 14 and spleen cells from mice immunized with chicken bursa cells. The binding of the monoclonal antibodies to cells in suspension or tissue sections was demonstrated by means of the unlabeled peroxidase-antiperoxidase method. B.1 recognizes 61% of the bursa cells, 10-14% of the cells of spleen and of the peripheral mononuclear blood leukocytes and 1% of the thymus cells. The B.1+ cells are regarded as B cells. Their location in tissue sections corresponds with the known B-dependent areas of lymphoid organs. Competitive binding and double marker experiments proved that the B.1 antigen is distinct from surface immunoglobulin (Ig). In the bursa all B.1+ cells are also Ig+, whereas in the thymus, spleen and blood only about 90% of the B.1+ cells show this conformity. B.2 mainly recognizes so called reticular epithelial and reticular cells of the bursa (36%), thymus (20%) and spleen (13%). The B.2+ cells represent the second major cell population of the bursa. PMID- 3521066 TI - A monoclonal antibody that identifies mature T lymphocytes of cattle. AB - Hybridomas to bovine leukocytes were produced by immunization of BALB/C mice with bovine lymphoblasts and fusion of the mouse spleen cells with mouse myeloma cells. Monoclonal antibodies (MABs) were tested against various cell populations by indirect fluorescent microscopy using fluorochrome conjugated antibodies to mouse immunoglobulins. MAB-15, one of the resulting MABs obtained after cloning antibody-producing hybridomas, reacted with 56.8 +/- 8.4% of peripheral blood mononuclear cells (PBMC). MAB-15 did not react with monocytes or B cells, but did react with T cells (fluorescein isothiocyanate-conjugated peanut agglutinin positive cells). MAB-15 reacted with 3.2% of thymocytes from adult cattle. In addition to reacting with T cells, MAB-15 reacted with neutrophils and eosinophils. MAB-15 was characterized as an IgM antibody that was unable to lyse PBMC in the presence of complement. Thus, MAB-15 is a useful marker of mature T cells in the mononuclear cell population. PMID- 3521067 TI - Humoral immunity in the prepatent primary infection of dogs with Echinococcus granulosus. AB - Twenty-one parasite-naive dogs were infected with 60,000 protoscolices of Echinococcus granulosus. Transformation of peripheral lymphocytes was investigated before and 29 days after the infection, immunoglobulin concentration and anti-hydatid fluid protein (HFP) titers in serum and feces before and at 35 days of infection, skin reactivity to HFP at 36 days, and characteristics of the parasites at 40 days. The infection caused a significant depression of the spontaneous, lipopolysaccharide-stimulated, and purified protein derivative stimulated blastogenesis. Responses to phytohemagglutinin were unchanged and reactivity to concanavalin A was enhanced with the infection. Only the concentrations of IgG and IgA in the serum and IgA in the feces increased significantly after infection. Fifteen (71%) dogs produced significant serum titers of anti-HFP hemagglutinins but copro-antibodies were detectable in only 3 dogs at minimum titers. Titers were abolished by treatment with 2 mercaptoethanol. The serum of 11 (52%) dogs transferred passive cutaneous anaphylaxis to guinea pigs but none transferred skin reactivity to pups or rabbits. Five and 1 (but not 0.2) micrograms of HFP caused skin reactivity in 4 parasite-naive dogs. Nineteen (90.5%) infected dogs reacted significantly to skin inoculation of 0.2 microgram of HFP at 0.5 hours and 13 (62%) at 6 hours. The 7 dogs with the highest anti-HFP serum titers or the greatest skin reactivity at 6 hours had significantly less mature or fewer tissue parasites, respectively, than the 7 dogs with the smallest responses. Since there was evidence that the specific immunity was still developing at the time of the study, these results indicate that immunological diagnosis of, and artificial immunization against, canine echinococcosis are feasible. PMID- 3521069 TI - Hexon trimerization occurring in an assembly-defective, 100K temperature sensitive mutant of adenovirus 2. AB - Analysis of 100K-defective temperature-sensitive adenovirus mutants confirmed the multifunctional character of the nonstructural, virus-coded 100K protein. In addition to its function in hexon trimerization (altered in H5ts1), and its possible direct or indirect role in hexon transport to nucleus (mutated in H2ts118), genetic and biochemical evidence was presented that 100K play some critical role in the scaffolding process of adenovirus capsid. This function appeared to be defective in H2ts107 and to map between coordinates 69.0 and 69.9, leftward from the H5ts1 lesion (70-73 map units; Arrand, 1978). This corresponded to the central domain of the 100K protein, between amino acid 300 and 400 from the N end. DNA sequencing of cloned fragments of H2ts107 DNA overlapping the mutation revealed two point mutations on the same codon at nucleotide 25,082 and 25,083 (GAC----GCA), corresponding to a nonconservative amino acid change (aspartic acid----alanine) at position 324 in the 100K sequence. 100K of adenovirus 2 wild type (WT) was found to bind in significant amounts to novobiocin-affinity column, and to be coeluted with hexon, penton, IIIa, and cellular topoisomerase II activity, by novobiocin- or ATP-Mg2+-containing buffers. H2ts107 100K also bound to novobiocin column, but the elution pattern differed from that of WT, suggesting some alteration in the affinity of the mutated 100K for novobiocin. The same behavior on affinity column as H2ts107 100K was observed for 90K, a cleavage product of the 100K, found in great abundance in H2ts107 at 39.5 degrees and corresponding to the C-terminal moiety of the 100K molecule. This implied that the "novobiocin-binding" domain of the 100K was not confined at its N terminus, and was altered in the H2ts107 mutant. PMID- 3521071 TI - Two-dimensional analysis of African swine fever virus proteins and proteins induced in infected cells. AB - Two-dimensional (2D) analysis of African swine fever (ASF) virus purified by Percoll gradient centrifugation resolves 54 structural proteins, 30 in conventional IEF gels and 24 in NEPHGE gels, while only 26 structural proteins are separated by SDS-PAGE. The two main bands separated by SDS-PAGE, with mol wt 150K and 72K, correspond to single spots in 2D gels. Other bands, including major bands of 38K, 35K, 24K, 17K, and 15.5K mol wt, correspond to multiple proteins of the same molecular weight but different pI. One hundred six virus-specific proteins were resolved by 2D analysis, 59 in conventional IEF gels and 47 in NEPHGE gels. Thirty-five of the virus-specific proteins are early proteins, synthesized before DNA replication, and the remaining 71 proteins are late proteins. Early proteins belong to two groups: 11 transient early proteins are synthesized only early in infection and the other 24 are persistent early proteins, synthesized at both early and late phases. Treatment with cytosine arabinoside prevents the synthesis of late proteins and blocks the shut-off of the synthesis of transient early proteins. Eleven structural proteins are major early proteins and 28 are late proteins. The remaining 15 structural proteins migrate in 2D gels like cellular proteins. Three of these cellular proteins, with mol wt 58K, 56K, and 45K were identified by immunoblotting as alpha-tubulin, beta tubulin, and actin, respectively. PMID- 3521070 TI - The internal polyadenylate tract of yeast killer virus M1 double-stranded RNA is variable in length. AB - The 1.8-kbp M1 double-stranded (ds) RNA from type 1 killer strains of Saccharomyces cerevisiae contains an internal 200-bp adenine- and uracil-rich region. We have previously demonstrated that this region consists primarily of adenine residues on the plus strand of M1 dsRNA and on the full-length, in vitro synthesized (+) transcript (denoted m) of M1 dsRNA, neither of which contains 3' terminal polyadenylate. We now show that there is variability in the length of the polyadenylate tracts of m transcripts synthesized in vitro by virions purified from either of the K1 diploid killer strains A364A X S7 or A364A X 1384. This variability reflects size differences seen in the corresponding M1 dsRNA genomes which, along with other data presented, localizes the variability in the length of M1 dsRNA to the adenine- and uracil-rich region. PMID- 3521072 TI - [Hygienic evaluation of the results of sanitary bacteriological research on water quality]. PMID- 3521073 TI - [Experience in treating mandibular progenia by split sliding osteotomy]. PMID- 3521074 TI - [History of the military medical periodical press]. PMID- 3521075 TI - [Military medical literature during World War II]. PMID- 3521068 TI - Modulation of phagocytic cell function. AB - Phagocytosis is an important factor in the defense of the host against all kinds of microorganisms. The process of phagocytosis of microorganisms by phagocytes can be separated into distinct but interrelated phases: adherence, chemotaxis, opsonization, attachment, ingestion, degranulation and killing. Phagocytosis is accompanied by an increase in oxygen metabolism in which H2O2 and activated oxygen species are generated. Modulation of phagocytic cell function can be brought about by a variety of substances. Microorganisms produce and contain components which influence the process of phagocytosis. Surrounding tissue cells and the phagocytes themselves produce biologically active molecules that modulate phagocytosis. PMID- 3521076 TI - [The 50th anniversary of Ievpatoriia as an all-union pediatric sanatorium]. PMID- 3521077 TI - [Status of oncological services and statistics on malignant neoplasms in pre revolutionary Russia]. PMID- 3521078 TI - [Carcinogenic activity of components of polymeric materials]. PMID- 3521079 TI - Enrichment of human bone marrow aspirates for low-density mononuclear cells using a haemonetics discontinuous blood cell separator. AB - Isopycnic density floatation centrifugation has been proven to be a suitable technique to enrich bone marrow aspirates for clonogenic cells on a small scale. We have tested a Haemonetics semicontinuous blood cell separator in order to process large volumes of bone marrow with minimal bone marrow manipulation. The efficacy of isopycnic density floatation was tested in a one and a two-step procedure. Both procedures showed a recovery of about 20% of the nucleated cells and 1-2% of the erythrocytes. The enrichment of clonogenic cells in the one-step procedure appeared superior to the two-step enrichment, first separating buffy coat cells. The recovery of clonogenic cells was 70 and 50%, respectively. Repopulation capacity of the low-density cell fraction containing the clonogenic cells was excellent after autologous reinfusion (6 cases) and allogeneic bone marrow transplantation (3 cases). Fast enrichment of large volumes of bone marrow aspirates with low-density cells containing the clonogenic cells by isopycnic density floatation centrifugation can be done safely using a Haemonetics blood cell separator. PMID- 3521080 TI - Detection of anti-Lea in Le(a-b+) individuals by kinetic ELISA. AB - Utilizing a kinetic enzyme-linked antiglobulin binding assay, eight examples of anti-Lea were detected in individuals whose Lewis phenotype is Le(a-b+). These antibodies were not detectable by routine hemagglutination techniques, but were indistinguishable from anti-Lea made by Le(a-b-) individuals in terms of their immunologic fine specificity. However, unlike most anti-Lea antibodies from Le(a b-) individuals, none of the anti-Lea antibodies had an IgG component. Anti-Lea antibodies in Le(a-b+) individuals may represent immune responses on the continuum between autoimmunity and alloimmunity. PMID- 3521081 TI - Identification of anti-Lea by platelet complement fixation. AB - Two anti-Lea sera which were able to detect Lea antigen on platelets were identified in a screening for anti-platelet antibodies by means of a platelet complement fixation test. These two antisera hemolyzed erythrocytes without enzyme treatment. The anti-Lea activity could be completely absorbed by red cells, platelets and lymphocytes of Le(a+b-) donors but not by cells from Le(a b+) or Le(a-b-) donors. The antibody activity against red cells was eliminated by treatment of the antisera with dithiothreitol, thereby suggesting that the activity resided in the IgM class of immunoglobulins. As the anti-Lea was more reactive at 37 degrees C than at room temperature against both red cells and platelets, we suggest that transfusion of platelets of Lea-negative donors should be considered for patients with this type of anti-Lea. PMID- 3521082 TI - Three sera defining a new granulocyte-monocyte-T-lymphocyte antigen. AB - Three sera containing antibodies recognizing a previously undescribed antigen on granulocytes were found during testing of sera from multiparous donors. All of the antibody producers were in good health. None had a history of transfusion. Using the granulocyte agglutination assay the sera recognize a single antigen which is not associated with the neutrophil antigens NA1, NA2, NB1, NC1, ND1, NE1, 5a, 5b, 9a, nor common red blood cell or HLA antigens. The three sera did not react with autologous cells or with the cells of the other antibody producers. Granulocytes from one antibody producer did not absorb antibody activity from any of the three sera. The antigen was found in large quantities on granulocytes and monocytes, in smaller quantities on T lymphocytes, and not on B lymphocytes, red cells, and platelets. The sera reacted with 340 of 343 random donors (99.1%) and were negative with the same donor cells. Family studies showed autosomal dominant inheritance of the antigen. Five of 12 sibs in three families lacked this antigen (not statistically different from the expected ratio). The calculated gene frequency for the gene controlling the production of this antigen is 0.906. There appeared to be no association to the HLA, NA or Rh loci or to the X or Y chromosomes. None of the infants of these three women showed clinical signs of alloimmune neonatal neutropenia. PMID- 3521084 TI - [Clinico-epidemiological characteristics of pseudotuberculosis]. PMID- 3521083 TI - [The clinical use of apilacum (a review of the literature)]. PMID- 3521085 TI - [Streptococcal flora of the nasopharynx in rheumatism (a review of the literature)]. PMID- 3521086 TI - [Dynamics of biochemical indicators and bile microflora after local antibiotic therapy in patients with cholecystitis]. PMID- 3521087 TI - [Antioxidant therapy in various clinico-biochemical variants of ischemic heart disease]. PMID- 3521088 TI - [Improvement in the early diagnosis of peptic ulcer using a computer and automated systems]. PMID- 3521089 TI - [Treatment and training methods in cochleovestibular disorders in children (review of the literature)]. PMID- 3521090 TI - [Effect of a warming microclimate on the health of workers (review of the literature)]. PMID- 3521091 TI - [Mixed connective tissue disease]. PMID- 3521092 TI - [Doppler echocardiography--its principles and technical realization]. PMID- 3521093 TI - Absence of islet cell autoantibodies in Jamaican blacks with diabetes mellitus. PMID- 3521095 TI - Plasmids and pestilence--biological and clinical aspects of bubonic plague. PMID- 3521094 TI - The expanding role of oxygen free radicals in clinical medicine. AB - In 1969 McCord and Fridovich discovered superoxide dismutase, which converts the oxygen free radical O(2) (-) to hydrogen peroxide H(2)O(2). In the presence of excess O(2) (-), H(2)O(2) may then undergo further reduction to the highly toxic hydroxyl radical, OH(*). Since the description of this enzymatic process, there has been explosive growth in related biochemical research, which has now percolated through to clinical investigation. The hypoxanthine-xanthine oxidase system originally used as a radical production model has a close counterpart in the ischemia-reperfusion phenomenon purported to cause diseases of heart, brain and gastrointestinal tract, and free radicals are now known to have a critical role in postphagocytic bacterial killing. Prototypic deficiency diseases such as chronic granulomatous disease are now recognized. Some evidence indicates that excess states such as perhaps Batten's disease also occur, and environmental influences such as selenium and vitamin E deficiency may augment free radical levels. Many disorders including microvasculopathies, noncardiogenic pulmonary edema, glomerulopathies and radiation damage may owe part of their proximate pathogenesis to free radicals. Control of tissue free radical levels is now pharmacologically feasible and perhaps justified for specific diseases. PMID- 3521096 TI - Ethics remain at the heart of medicine. Physicians and entrepreneurship. PMID- 3521098 TI - Imhotep and medicine--a reevaluation. PMID- 3521100 TI - [Jan Radlica, an outstanding Polish physician and politician at the end of the 14th century]. PMID- 3521099 TI - [Interaction between smoking and drugs]. PMID- 3521097 TI - Response of paraneoplastic syndromes to antineoplastic therapy. AB - The development of a clinically apparent paraneoplastic syndrome in a patient with malignant disease is cause for considerable concern as the symptoms can be as serious and difficult to deal with as those produced by the cancer itself. While the information in the medical literature concerning the response of paraneoplastic processes to specific antineoplastic therapy is limited, case reports and small series would suggest that a number of syndromes are alleviated with successful treatment of the underlying neoplasm. As treatment programs for advanced malignant disease improve, a larger percentage of patients suffering from the effects of paraneoplastic processes will benefit from therapy directed at their cancer. PMID- 3521101 TI - [Gastric emptying]. PMID- 3521102 TI - [Discussion of various pathological cases during the sessions of the Wilno Medical Society headed by Prof. Jedrzej Sniadecki]. PMID- 3521105 TI - [Addison's disease with enlarged adrenal glands in sonography and computer tomography. Differential diagnostic considerations based on 2 cases of tuberculous adrenalitis]. AB - One of the major causes of chronic adrenal insufficiency (Addison's disease) is tuberculous adrenalopathy. Since sonography and computed tomography have become generally available in recent years and are of potential help in the diagnosis of this disease the merits of these methods are discussed in the light of 2 cases of adrenal tuberculosis, followed by a review of the literature. Adrenal calcification is the most significant, although not specific sign of adrenal insufficiency due to tuberculosis. Computed tomography has proven to be the method of choice in the non-invasive diagnosis of tuberculous adrenalopathy and in the monitoring of tuberculostatic treatment in this disease. Sonography is helpful as a preliminary investigation. PMID- 3521104 TI - [Billroth and his time; selected passages from his letters]. AB - Billroth's life and work are illustrated by selected excerpts from his letters written to outstanding personalities and colleagues. Not only his medical activities, but also his initiative in the planning of the Rudolfinerhaus hospital, and the reconstruction of his own department and the building of the Medical Association house in the Frankgasse are described. In addition, his love of music and his deep friendship with Johannes Brahms are demonstrated by these letters. PMID- 3521106 TI - [Methodological and experimental studies of jet ventilation--indications and limits of the procedure]. AB - Results of experimental and methodical investigations of so-called "Injector Ventilation" or jet ventilation verify procedures' safety regarding ventilation and anaesthesia management. Classification of jet ventilation permits delimitation to IPPV and different methods of HFV. Resulting from considerations, especially based on reported insignificancy of "Venturi-Effect" under clinical conditions, authors suggest use of unitary term "Normo-Frequent Jet Ventilation" (NFJV). PMID- 3521103 TI - [Therapy of duodenal ulcer and pyloric ulcer with 800 mg cimetidine nightly]. AB - The efficacy of cimetidine 400 mg b.i.d. as compared with a single evening dose 800 mg was evaluated in a single-blind multicentre trial involving 86 patients with endoscopically proven duodenal or pyloric ulcer. After four weeks of treatment the healing rates were 64.4% (29/45) with 400 mg cimetidine twice daily and 78% (32/41) with 800 mg nocte; after eight weeks the corresponding rates were 77.7% (35/45) and 85.3% (35/41). Administration of 800 mg cimetidine every evening is, consequently, at least as effective as a twice-daily regimen. In the second half of the treatment period it was significantly more effective in reducing pain and antacid consumption. The single noctural dose takes the pathogenetic importance of overnight gastric acidity into consideration, entails a simplification of therapy and may improve patient compliance. It should, therefore, take preference over the conventional twice-daily regimen. PMID- 3521107 TI - [Ars medica Anhaltina: on the 225th anniversary of the death of Johann Theodor Eller (1689-1760)]. AB - The 225th anniversary of Johann Theodor Eller's death in connection with the 275th anniversary of the foundation of the Berlin Charite gives occasion to bring back life and work of a physician who became active in determining the profile in several directions. To Eller's most important achievements in Berlin belong the Medicinal Edict of 1725 as well as the management of the citizens' hospital opened in 1727. PMID- 3521108 TI - [Chronic mucocutaneous candida mycosis (CMCC) caused by a T-cell defect]. AB - It is reported on a 42-year-old book-keeper with the granulomatous variant of the chronic mucocutaneous candidiasis which could be followed up for 28 years. The intensive systemic treatment with nystatin, 5-fluorocytosin and miconazol combined with the subcutaneous injection of transfer-factor and the local application of ointments containing nystatin and clotrimazol did not only lead to the complete clearing of the lesions (4 years without any relapse), but also to the normalization of the T-lymphocyte count and the reconstitution of the formerly negative delayed type skin reactivity to candidin. PMID- 3521109 TI - Choledochal cyst type I: successful endoscopic balloon dilatation of the distal common bile duct and sphincter of Oddi: a case report. AB - A 12-year-old boy with a choledochal cyst type I is reported with clinical features of abdominal pain, postprandial vomiting, weight loss and fatigue since 3 months. Diagnosis was made by ultrasound and confirmed by computer-assisted tomography (CAT) and endoscopic retrograde cholangiography (ERC). Instead of the usual surgical treatment balloon dilatation of the sphincter of Oddi and the distal common bile duct was performed by endoscopic means. The patient was relieved from his complaints, gained weight and felt healthy again. Sonographic and endoscopic reexamination had proven that the diameter of the common bile duct had diminished from 3,0 to 2,6 cm. Endoscopic balloon dilatation of choledochal cysts type I may be a valuable alternative to surgical treatment. PMID- 3521111 TI - [Acardius--prenatal diagnosis and pregnancy in 2 twin pregnancies]. AB - The development of acardiac monsters had been observed in less than 200 cases. Antenatal diagnosis can be performed in the 2nd trimenon. We report about two twin pregnancies with acardius acephalus. In one case the beginning of cardiac failure was detected by ultrasound in the 28th week. Transplacental treatment of the fetus with beta-acetyldigoxine was successful during a period of seven weeks. In both cases delivery was performed in the 35. and 36. week of gestation--the twins are still alive. PMID- 3521110 TI - [Prenatal sonographic diagnosis and clinical consequences in small intestine obstruction]. AB - Fetal intestinal obstructions can be diagnosed and differentiated from other intra-abdominal lesions with prenatal sonography. The characteristic signs are persistent echo-free areas in the fetal abdomen which frequently show peristaltic movements, and the accompanying polyhydramnios. A vaginal delivery near term is desirable and tocolytic agents and therapeutic amniocentesis should be used in the event of premature labour and maternal distress due to polyhydramnios. Premature labour also necessitates the induction of pulmonary maturation with corticoids. At least weekly ultrasonic controls are advisable to detect the rare bowel perforation. In the case of an intestinal rupture, the risk of prematurity must be weighed against the risk of abacterial meconium peritonitis before labour is induced. Own observations in five prenatally diagnosed intestinal obstructions and a review of the literature confirm the proposed management in these infants. PMID- 3521112 TI - [Crosti's dorsal reticulosis--a histiocytic lymphoma of a low degree of malignancy]. AB - We report on the clinical and histological course of a lymphoma-like process similar to Crosti's dorsal reticulosis. Histological findings revealed a non epidermotropic mixed cellular infiltration of histiocytes und T-lymphocytes with high and spontaneous cell destruction. We also observed high radiosensitivity. PMID- 3521113 TI - [Drug-induced pemphigus]. AB - A review of the literature on previous cases of drug-induced pemphigus as well as two case reports of pyritinole-induced pemphigus show a few characteristics: D penicillamine was responsible in 42 cases, pyritinole in 4 cases, the two case reports included. Superficial pemphigus was seen in about 75% of the cases, most times associated with preexistent autoimmunological disorders. Immunological findings were identical with normal, non-drug-induced pemphigus, while the prognosis was better under mostly necessary immunosuppressive therapy at relatively low doses. PMID- 3521114 TI - [Etiology of acrodermatitis chronica atrophicans and erythema chronicum migrans]. AB - In Lyme's disease (LD) as well as in the European form of erythema chronicum migrans (ECM), the etiologic agents are spirochetes. As fas as we know by now, these microbes are closely related but not identical. Consequently, LD and ECM should be regarded as closely related but not as identical diseases. The sera of our 21 patients suffering from acrodermatitis chronica atrophicans (ACA) contained elevated antibody titers directed against the etiological agent found in ECM. These findings strongly suggest that ACA is also induced by spirochetes possibly by the same microbes found in ECM. PMID- 3521115 TI - [Possibilities of ultrasound diagnosis in dermatology]. AB - At present, ultrasound is the only available non-invasive method to give information about in vivo structures of the skin. We report on the most important physical fundamentals and technical requirements for diagnostic ultrasound in dermatology. Furthermore we discuss the actual clinical use of the technique. PMID- 3521116 TI - [Keratoacanthoma]. AB - We give a brief review concerning morphogenesis, growth pattern, as well as clinical and histopathological definition of keratoacanthoma. The treatment of choice is excision of the tumor and postsurgical histological verification. PMID- 3521117 TI - [Psychosomatic criteria in the treatment of atopic neurodermatitis]. AB - We report on psychosomatic aspects regarding out-patient and hospital treatment of atopic dermatitis, including information concerning the disease, motivation for psychotherapeutic forms of treatment (relaxation, diagnostic and therapeutic conversation), as well as psychosomatic indicators for the discharge from hospital. PMID- 3521118 TI - The establishment of Plasmodium berghei in mosquitoes of a refractory and a susceptible line of Anopheles atroparvus. AB - The events between the ingestion of Plasmodium berghei-infected mouse blood and the establishment of the ookinetes in the epithelium of the midgut in refractory (R) and susceptible (S) Anopheles atroparvus are described. Simultaneously fed, fully engorged female mosquitoes were randomly assigned to dissection at 22, 28, 32, 48 h and 10 days (controls) after the infective feed (post-infection: p.i.). Serial transverse sections of 6 micron were cut. Every 10th section was studied. The maturation of ookinetes was monitored at 16, 19 and 22 h p.i. The infections in R and S mosquitoes developed similarly with regard to the maturation of ookinetes and the number of mature ookinetes in the lumen of the midgut. The semiquantitative evaluation of the envelopment of the food bolus by the peritrophic layer showed that this layer cannot function as a physical barrier against migrating ookinetes. In the midgut epithelium the number of ookinetes decreased significantly with time in both R and S mosquitoes, but a similar number of penetrations was recorded for both types of mosquito. In S mosquitoes maximal 1% of the ookinetes present in the midgut formed an oocyst. In both R and S mosquitoes a substantial loss of parasites was found, first in the lumen of the midgut and second after penetration of the midgut epithelium by the mature ookinetes. Relatively few parasites develop into oocysts in S, but hardly any do so in R individuals. The factors in control of refractoriness are likely to operate on early oocyst development. PMID- 3521119 TI - [Enchondromatoses of the hand]. AB - In the introduction the authors report on the suspected theories of origin of the enchondromas: some believe that they are the result of disintegration of islands of cartilage from the epiphyseal growth cartilage, while in the opinion of others they are brought about by disturbances of blood supply in the metaphyseal vessels during enchondral growth. No evidence of heredity has yet been established. Surgical treatment and late results are described taking the course of disease of a patient who is now 33 years old as an example. This patient had grotesque tumors on both hands; the tumors not only disfigured the limbs but also constituted a functional handicap. Surgery was indicated for both esthetic and functional reasons. For large tumors, with destruction of the substantia corticalis or regions close to the joint, cross-section or segmental resection is given as the therapy of choice, and if possible segmental resection is to be preferred, filling the defect with loosely emplaced autologous spongiosa. After this procedure the hand does not have to be immobilized for as long as after a cross-section. In this patient, after a total of 16 procedures on both hands, there have been no recurrences in the ten years of the follow-up period. The same applies to two other patients with multiple enchondromas (which were admittedly less severe) who were followed up between 3 and just under 8 years after surgery. It is stressed that growing tumors which disturb the function or appearance of the hand should be surgically treated in childhood, but that by no means every enchondroma seen in enchondromatosis requires such therapy. PMID- 3521120 TI - [Demonstration of the neonatal hip joint by the anatomic frontal plane and ultrasound]. AB - Sonographic hip diagnosis depends on anatomical identification. Makromorphological studies by plastination and cryosectioning was done using small hips. Details of the anatomy are presented. Different positions of the proximal femur are demonstrated, as well as the physiological development of the hip. PMID- 3521121 TI - [Stress fractures of the navicular bone of the foot]. AB - Stress fractures of the navicular bone are considered rare. Therefore, the authors report on 29 cases treated during the last 3 years, which must be defined as sports injuries and occurred primarily among women athletes (68%). In view of the different symptoms and duration of the course a differentiated diagnostic and therapeutic approach is required; this is illustrated with reference to the author's experience with 35 cases. PMID- 3521122 TI - [Theoretical basis for evaluation, methods of monitoring and correcting the effect of emotions on cosmonaut behavior]. PMID- 3521123 TI - [Principles of filtration and resonance tuning of cyclic neural circuits in the theory of higher nervous activity]. PMID- 3521124 TI - [Thrombohemorrhagic theory of general pathology]. PMID- 3521125 TI - Cardiac transplants in Virginia: progress report. PMID- 3521126 TI - [Kidney patients want to keep transplantation legislation]. PMID- 3521128 TI - [Methisazone in the treatment of lichen ruber plabus]. PMID- 3521127 TI - [Complex treatment of alopecia with preparations of zinc and copper]. PMID- 3521129 TI - [Clinico-pathophysiologic analysis of the pathogenesis of fever in the Jarisch Herxheimer-Lukashevich syndrome]. PMID- 3521130 TI - [A case of intolerance for cytostatics in reticulosarcomatosis of the skin]. PMID- 3521131 TI - [Abul Kasim al-Zahrawi on skin and venereal diseases]. PMID- 3521132 TI - [Chief trends in research into the neurochemical mechanisms of learning and memory]. PMID- 3521134 TI - [Experimental modeling of the cellular mechanisms of various psychopathological syndromes]. PMID- 3521133 TI - [System mechanisms of higher nervous activity]. PMID- 3521135 TI - [Structuro-functional basis of complex forms of higher nervous activity]. PMID- 3521136 TI - [Pressing problems in the study of higher nervous activity in man]. PMID- 3521137 TI - The diagnosis and course of antenatal urinary tract dilatation. AB - During 1980-1984 the ultrasound examination (US) performed in the third trimester revealed urinary tract dilatation in 18 foetuses. After delivery all the infants were reexamined within the first weeks with US, intravenous pyelography and micturition urethrocystography to confirm the malformation. Pelvic dilatation was seen in 12 foetuses, 5 bilaterally. The dilatation was caused by pelviureteric obstruction in 6 infants, 4 of which were operated on with dismembered pyeloplasty. In 6 infants the dilatation was caused by distal ureteric stenoses, and 5 of them were operated on. Two foetuses with dilated pelvis and ureter had distal ureteric stenosis and both were operated. Four infants with the diagnosis of unilateral multicystic kidney, confirmed postnatally, were nephrectomised. At the follow-up the kidney function was normal in 15 infants and slightly decreased in 3 infants with bilateral malformations. The antenatal US revealed pelvic dilatation, but the diagnosis of a dilated ureter was inaccurate. Prenatal urinary tract dilatation should be controlled via US shortly after delivery and, if persistent, evaluated further by means of x-ray examinations. PMID- 3521138 TI - [Modern diagnosis and therapy of traumatic hemobilia in childhood]. AB - The authors report on the first case of haematobilia diagnosed in childhood by means of sonography. Massive haematemesis occurred in a six-year-old boy on the 57th postoperative day after an oversewn rupture of the liver. Sonography revealed an atonic gallbladder with stratification phenomena and free floating highly reflecting coagulates, as well as pulsations and flow phenomena in an area of the size of a bean at the floor of a necrotic cavity of the liver (aneurysm). Relaparotomy was done by locating the aneurysm via sonography and performing a purse-string ligature. The high mortality rate of 10 to 20% can be reduced if the gradually evolving condition is identified at an early stage, which means that regular sonographic examinations should be conducted in the postoperative control of liver rupture. Intraoperative sonography with sterilisable sound heads enables accurate location of the source of bleeding. PMID- 3521139 TI - [Bridging extensive esophageal atresias by a peritoneal transplant]. AB - A method is presented that represents a modification of Rehbein's perlon filament technique for treating extensive oesophageal atresias. This new approach enables, in case of congenital oesophageal defects exceeding three vertebral bodies in length, to eventually perform end-to-end anastomosis of the patient's oesophagus. For this purpose, the distance between the mobilised oesophageal segments that are interconnected by means of a centrally positioned perlon filament, is additionally bridged over with a peritoneal cylinder in the sense of an autotransplant. The advantages of the method are the creation of a wide preformed channel for subsequent bougineages, the protective effect exercised on the mediastinum to prevent possible inflammatory conditions, and especially the continuous traction exercised on both oesophageal pouches by the shrinking of the transplant resulting in a ring-shaped stenosis that is easy to resect and can be bypassed via end-to-end anastomosis. We treated according to this method from 1982 onwards seven children with congenital oesophageal atresias extending over the length of three to seven vertebral bodies; four of these patients now present with patent oesophageal passage. PMID- 3521140 TI - [Experiences with sonographically guided percutaneous nephrostomy]. AB - It is reported on 65 sonographically directed percutaneous nephrostomies in 47 patients. In the description of the technique it is particularly referred to the advantages of a rigid bouginage system, an exact local anaesthesia and a transparenchymal access to the pyelon. Complications due to the intervention occurred in 4 patients. 10 postrenal anurias were cured and 9 out of 10 patients with a urosepsis due to urinary obstruction were successfully treated. The percutaneous nephrostomy is recommended as a slightly traumatising access to the cavity system of the kidneys, which is to be used also in patients who cannot tolerate an open operation on account of a reduced general condition. PMID- 3521141 TI - [Ludwig Traube's contribution to nephrology]. AB - Ludwig Traube (1818-1876), director of the Propaedeutic Clinic of the Charite, analysed the kidney diseases by means of simple clinical and morphological techniques. He subdivided the morbus Brightii into a diffuse and interstitial nephritis, the amyloid kidney and the congestion kidney; he explained the pathophysiology of the clinical manifestations of these diseases; 125 years ago he interpreted uraemic convulsions as an expression of the cerebral ischaemia; he devoted himself particularly to the connections between cardiac and renal diseases and described the renal hypertension. He made proposals to the prophylaxis of the catheter sepsis. He deserves a lasting remembrance as the pioneer of nephrology in the German-speaking countries. PMID- 3521142 TI - [Phases of historical research from the beginning of the 20th century]. PMID- 3521143 TI - [On the history of the Pathology Museum at the Charite in Berlin]. AB - A museum was founded by Rudolf Virchow at the Institute for Pathology of the Charite. Although initially based on the pathologic specimens collected by his predecessors, Virchow's tremendous efforts lead a rapid increase in the number of specimens and these numbered more than 23,000 at the time of his death. In accord with Virchow's wishes a special building was constructed to house the collection and to make it accessible to the public. It was opened on June 27, 1899. Most of the specimens were destroyed as a result of the war during 1939-1945. About 500 specimens from Virchow's famous collection have survived and are exhibited at present at the Charite's Institute of Pathology. PMID- 3521144 TI - [Preoperative staging and follow-up in rectal cancer using endorectal sonography]. AB - 32 patients suffering from rectal carcinoma were examined by endorectal sonography. The preoperative staging by sonography was compared with digital palpation, colon enema and computertomography of the pelvis. In 90% of the cases the sonographic determination of the grade of invasion was identical to the histopathological examination. The efficiency of local destruction methods of rectal carcinoma (cryotherapy) can be controlled by this method. PMID- 3521146 TI - [Management of wound ruptures]. PMID- 3521145 TI - [Technic and indications of peranal electrosurgical resection of the rectal wall]. PMID- 3521147 TI - [Dynamic, proximal muscular pedicled anterior cruciate ligamentplasty (Lindemann). Subjective and objective results in 260 knee joints]. AB - Surgical replacement of the anterior cruciate ligament (Lindemann's procedure) is recommended for recent intraligamentary lesions as well as for chronic lesions of the anterior cruciate ligament, since very favourable results had been obtained from 260 cases. That assessment is based on questionnaire interviews with patients and on objectivated conclusions from post-surgical follow-up checks. Additional reconstruction proved to be necessary in many instances. The patient's cooperation and surgical after-care are of crucial importance. PMID- 3521148 TI - [Surgical treatment of 3d degree burns with mixed homologous/autologous and heterologous/autologous full-thickness skin grafts. Comparison of results with native and frozen homologous and heterologous tissues in animal experiments]. PMID- 3521149 TI - [Our surgical heritage. Heinrich Adolf von Bardeleben and his time]. PMID- 3521151 TI - [Sonographically detectable changes in placental structures in pregnancy. 4. Statistical comparison of the frequency distribution of placental stages 0-3 in newborn infants in a pregnancy of 37-42 weeks duration]. AB - Among women with a duration of pregnancy between 37 and 42 gestational weeks procentual frequency, confidence intervals of O. Bunke, pounts of separability and areas of unsharpners were analysed. 1412 sonographical examinations were done in 645 pregnant women. Stage 0 was found statistically significant more frequent with error of probability alpha = 0.05 until the 30. week of pregnancy, stage 1 between the 21. and 36. week of pregnancy, stage 2 between the 33. and 36. gestational week and stage 3 in 37. and 38. week. Transformation (areas of unsharpness) from stage 0 to stage 1 occurs between the 24. and 32. gestational week, from stage 1 to stage 2 between the 31. and 34. week, from stage 2 to stage 3 between the 36. and 42. gestational week. PMID- 3521150 TI - [Experiences with a special consultation for breast diseases]. AB - In this paper results in diagnostics and therapy are presented of 185 patients with breast diseases obtained during special consultation hours. The greatest part of the breast diseases are fibrocystic mastopathies. Very good therapeutic results have been achieved using the phytotherapeutic agent Mastodynon. Emphasis is laid on the increasing importance of the histological findings and hormon receptor determination. PMID- 3521152 TI - [Sonographically detectable changes in placental structures in pregnancy. 5. Statistical comparison of the frequency distribution of placental stages 0-3 in newborn infants in a pregnancy of less than 37 weeks duration]. AB - The analysis of sonographically provable changes of placental structures in 97 pregnant women (202 examination) shows in cases with a duration of pregnancy less than 37 gestational weeks that stage 0 could be found statistically significant more frequent until the 32nd week of pregnancy, stage 1 in the whole pregnancy, stage 2 and 3 between the 29. and 36. gestational week. Stage 0 and 1 don't effect prematurity; however stages 2 and 3 could be proved before the 32nd or 34th week of pregnancy in 41 or 100% of examination respectively and effect a premature birth. Stage 2 could be proved 2,8 times more frequent and stage 3 4 times more frequent in premature babies than in newborns with a normal duration of pregnancy. PMID- 3521153 TI - [Sonographically detectable changes in placental structures in pregnancy. 6. Effect of sonographic placental morphology on premature labor and intrauterine growth retardation]. AB - Influence of sonographically demonstrable changes of placental structure on prematurity and intrauterine retardation was analysed and concerning its statistical rehability in 807 gravids. While the stages 0 and 1 don't effect prematurity and intrauterine retardation, the stage 2 is accompanied premature infant of normal birthweight if proved before the 32nd week of pregnancy. If stage 3 appears before the 34. week of pregnancy we found in 30.6% a small for date newborn, in 64% a normal weight and in 80% a small for date premature newborn. In comparison with the normal weight newborn the difference is statistically significant with an error probability of alpha = 0.05. PMID- 3521154 TI - [Morbidity and mortality in 1984-1985 of premature infants in breech presentation with a birth weight equal to or less than 1,500 g. A prospective study on the question of vaginal or abdominal delivery]. AB - The effect of the obstetrician's choice for delivery route on the early morbidity and mortality of very low birth weight infants in breech presentation (less than or equal to 1500 g) was studied prospectively in 22 children. Criteria of the morbidity were beside antenatal cardiotocogram, the Apgar-score at 1, 5 and 60 min., the cord venous pH-value and the duration of assisted ventilation after immediate delivery. From the first to 28th day of life we continuously analyzed the lowest oxygen pressure, the highest carbon dioxide pressure, therapy with NaHCO3 and the duration of assisted ventilation. But there were no significant differences in morbidity data and mortality between the newborn infants after vaginal and abdominal delivery. However the brief duration of assisted ventilation and brief ventilation time with a FiO2 greater than 0.3, after abdominal delivery were striking despite of a negative starting point of these children. For that reason we are of opinion that a well-timed abdominal delivery of very low birth weight infants in breech presentation shows a favourable influence on the normalization of metabolic and respirations data in the postnatal period and by this on the early morbidity. PMID- 3521155 TI - [Rare coincidence of Ehlers-Danlos syndrome, diabetes mellitus and pregnancy]. AB - A report is given about a seldom coincidence of Ehlers-Danlos-Syndrome, diabetes mellitus and pregnancy in a 31 year old patient.--The course of pregnancy was uncomplicated except a cervical insufficiency and a secondary wound healing of the episiotomy. The exact diagnosis of the Ehlers-Danlos-syndrome should be done already before pregnancy. PMID- 3521156 TI - [Aleksandr Mikhailovich Ugolev (on his 60th birthday)]. PMID- 3521157 TI - [Creative legacy of microbiologist and Academician of the Academy of Sciences of the Ukrainian SSR V. G. Drobot'ko (on the centenary of his birth)]. PMID- 3521158 TI - [Dynamics of Shigella interaction with the epithelium in the infection process]. AB - The study of the adhesion of Shigella flexneri to intestinal mucosal explants from human postabortion fetuses, used as an experimental model, has revealed that the process of interaction between the infective agent and the epithelium develops in accordance with Langmuir's equation of the adsorption isotherm. The specific biological feature of the adhesive interaction between bacteria and the mucous membrane is the fact that the effective adhesion of microbes is possible only in case of their high concentration on the surface of the mucous membrane. In case of their low concentration in the parietal layer no microbial adhesion is observed, whereas epithelial villi infected with shigellae and fixed to the mucous membrane of the explant produce a high parietal concentration of the infective agents, which leads to the increase of adhesion by more than two orders. PMID- 3521159 TI - [New R-plasmids in strains of Serratia marcescens with multiple drug resistance]. AB - In 4 S. marcescens polyresistant strains isolated from patients conjugative plasmids transferred to Escherichia coli have been detected. Two of these strains carry each one plasmid which codes resistance to 10 different antibiotics, including aminoglycosides which rarely occur in our country, and belongs to group IncC. The third strain is the host of 2 plasmids. One of them is similar to the above-mentioned 2 plasmids with respect to the incompatibility group and a set of markers, but additionally codes resistance to cephalosporins; the second plasmid has been determined as belonging to group IncM, unstable and capable of rendering the cells highly resistant only to aminoglycosides. And, finally, the fourth strain also carries 2 plasmids: one of them is unstable and belongs, supposedly, to group IncI alpha, and the second plasmid is stable and belongs to group IncM. The plasmid of group IncI alpha differs from all other plasmids of our Serratia by its capacity of rendering the cells highly resistant to chloramphenicol. PMID- 3521160 TI - [Development of a solid-phase immunoenzyme method for determining the antibody level in the blood sera of persons vaccinated with influenza vaccine]. AB - To control the effectiveness of vaccination against influenza, the optimum conditions for making the enzyme-linked immunosorbent assay (ELISA) with a view to determine the level of anti-influenza antibodies in human blood sera have been established. The kinetics of influenza virus adsorption in the wells of ELISA polystyrene plates and the kinetics of the interaction between the immobilized antigen and species-specific peroxidase-labeled antibodies have been studied. The method has been shown to be more sensitive than the hemagglutination inhibition test in the determination of seroconversion in persons immunized with influenza vaccine. PMID- 3521161 TI - [Cytotoxic effect of lymphocytes on autologous blood monocytes in the presence of streptococcal group A antigens in patients with primary erysipelas]. AB - The present work deals with a modification of the cytotoxic test for the determination of the cytotoxic activity of lymphocytes in infectious diseases. This modification is based on the use of the suspension of mononuclear blood cells, simultaneously containing effector cells (sensitized lymphocytes) and target cells (autologous monocytes). The cytotoxic effect on monocytes is observed after the preliminary incubation of nonadhering cells (lymphocytes) with the antigen of microorganisms causing the infectious process. A statistically significant increase in the cytotoxic activity of lymphocytes was recorded in patients with primary erysipelas at the acute period of the disease. The cytotoxic effect has been found to persist at a high level for two weeks. By the end of the disease this effect drops to the level characteristic of clinically normal persons. An elevated level of the cytotoxic activity of lymphocytes in the presence of streptococcal antigens of one type has been detected in 72% of patients with primary erysipelas. This indicates that type-nonspecific streptococcal antigens take part in the formation of delayed hypersensitivity, which is also confirmed by the data obtained in animal experiments. PMID- 3521162 TI - [Determination of specific hemolysins in brucellosis patients in the indirect hemolysis reaction]. AB - A total of 400 persons, 136 of them normal or with non-brucellar infection and 264 with chronic brucellosis, have been examined. Specific antibodies (hemolysins) have been detected by the indirect hemolysis test only in the brucellosis patients. High specificity and sensitivity of this test make it possible to recommend it for the diagnosis of brucellosis in humans. PMID- 3521164 TI - [Pathogenesis and diagnosis of osteochondrosis of the spine and its neurologic manifestations: status of the problem and research prospects]. AB - On the basis of a critical analysis of literature data and his own observations the author puts forward a concept of the pathogenesis of vertebral osteochondrosis and attendant neurological disturbances. The article also deals with the diagnosis and prospects of investigation of these fairly prevalent diseases which have a large socio-economical impact. PMID- 3521163 TI - [Biology of the causative agent of melioidosis]. PMID- 3521165 TI - [Status and prospects for follow-up evaluation of the results of treating alcoholics (review of the foreign literature)]. PMID- 3521166 TI - Further studies on the quaternary structure of yeast casein kinase II. AB - Casein kinase type II were isolated by the same procedure, from rat liver, human placenta, Querin carcinoma and yeast, and characterized. The mammalian enzymes were composed of three subunits alpha, alpha' and beta, whereas yeast kinase was composed of two subunits alpha and alpha'. It was shown that the catalytic activity, substrate and phosphate donor specificity, sensitivity to heparin and spermine were the same for all the kinases tested. The results give additional support to the suggestion [1] that the beta subunit is not required for optimal activity and specificity of yeast casein kinase II. The quaternary structure of the yeast enzyme of a molecular weight of approximately 150 000 is proposed as alpha2 alpha'2. PMID- 3521167 TI - Recurrent pulmonary embolism: importance, diagnosis, management and prevention. AB - Pulmonary emboli, even small, cause irreparable lung damage. Recurrent pulmonary emboli further increase the amount of non functional lung tissue and may result in incapacitating respiratory disease or death. It is therefore mandatory that the disease be correctly diagnosed and adequately treated. As prevention is better than cure, every patient presenting with clinical signs of deep venous thrombosis (DVT) should be correctly explored. The site and size of thrombosis must be visualized preferably with contrast venography with imaging of the veins of the limbs, iliac veins and vena cava. Risk factors such as obesity, immobilization etc. must be taken into account. Underlying disease such as heart disease and venous insufficiency must be treated. Malignancy must be looked for as in a recent series of patients with primary DVT which were studied, 15% presented with an up till then unknown malignant disease. In patients presenting with recurrent DVT this percentage rose to 20%. When a patient presents with DVT of the femoro-iliac vena cava axis, aggressive treatment must be adopted. Fibrinolysis or if this is contra-indicated, thrombectomy will be used. A vena cava filter may be necessary and longterm anticoagulation is mandatory. The same rationale is applicable in cases of pulmonary embolus whether it is a primary event or a recurrence. PMID- 3521168 TI - [Role of catheterization and pneumoangiography in moderately severe pulmonary embolism]. AB - In patients with moderate pulmonary embolic disease, angiography is regarded as the most reliable procedure for establishing the diagnosis. Digital subtraction angiography (DSA) is easier to perform than conventional pneumoangiography (presently carried out in some selected cases only) and has become the diagnostic procedure of choice for pulmonary embolism. DSA achieves satisfactory results and is still more accurate when it is performed after perfusion/ventilation lung scans. In patients with acute embolus, usually hospitalized in the intensive care unit. Swan-Ganz catheterization provides the clinician with a great degree of haematologic information that enables him to select the appropriate therapeutic choice, which most often has to be determined in emergency. PMID- 3521169 TI - [Use of Unilab Surgibone xenoimplants to bridge large bone defects in experiments on rabbits]. PMID- 3521170 TI - Pulmonary platelet trapping in Escherichia coli endotoxin-injected dogs treated with methylprednisolone, ibuprofen and naloxone. AB - Adult respiratory distress syndrome (ARDS) is a common and serious complication of septic shock. Pulmonary trapping of platelets (PPT) and leukocytes, and release of vasoactive and toxic substances such as prostaglandins, lysozymes and oxygen-radicals have been implicated as mediators of the lung injury. beta Endorphin is regarded as one of the substances released during shock, and has been shown to cause cell damage similar to that seen with endotoxin, and also PPT. We recently reported that combined treatment with methylprednisolone, ibuprofen and naloxone significantly increased lasting survival in an LD100 canine endotoxin shock model. In the present study the effects of these drugs in various combinations were evaluated as regards blood pressure, hematocrit, peripheral platelet and leukocyte counts, intestinal damage and PPT in the same model. The effects of combined treatment were significantly decreased PPT, rise in blood pressure and abolition of bloody diarrhea. We concluded that ibuprofen and naloxone have additive action and that methylprednisolone has no effect on PPT. PMID- 3521171 TI - [Aminoglutethimide in advanced breast cancer. Multicenter trial comparing 500 mg and 1000 mg per day]. PMID- 3521172 TI - Development of monoclonal antibodies that recognize antigens associated with human cervical carcinoma. AB - Six monoclonal antibodies, generated by immunization of mice with human cervical carcinoma cells maintained in tissue culture or with cells from fresh tumor tissue, reacted specifically with the malignant cells in 71% to 90% of the tumor tissue imprints and cervical smears containing neoplastic cells but not with normal cervical epithelial cells in smears from 21 to 23 healthy donors. Antibody CE 402 bound to epithelial cells associated with regeneration in 2 of the 23 normal smears tested. Considerable heterogeneity of antibody binding by malignant cells was observed. Antibody CE 400 was the most reactive, binding to more than 50% of the tumor cells in all reactive specimens. Five of these monoclonal antibodies detected protein antigens in the 80 K to 110 K molecular weight range. Our studies demonstrate the feasibility of producing monoclonal antibodies with selected specificity for cervical carcinoma. These antibodies may be of considerable diagnostic value. PMID- 3521173 TI - Differential diagnosis of lymph node aspirates by intermediate filament typing of tumor cells. AB - Twenty-one lymph node aspirates for which a differential diagnosis was difficult or not possible by light microscopy alone were selected for further study by intermediate filament typing. The use of four monoclonal antibodies specific for different keratin subsets or for vimentin resulted in a definitive diagnosis in all instances. The results show that use of these antibodies can improve the accuracy of cytologic diagnosis and provide further evidence that intermediate filament typing can help differentiate (1) malignant melanoma from adenocarcinoma, (2) malignant lymphoma from small-cell anaplastic carcinoma and (3) squamous-cell carcinoma from adenocarcinoma. Intermediate filament typing can also be used to identify very small numbers of carcinoma cells in specimens that are apparently negative for tumor cells by light microscopy. The method is quick, relatively simple, reliable and unambiguous, provided that appropriate questions are asked and antibodies with well-defined specificities are used. PMID- 3521174 TI - An immunoperoxidase study of S-100 protein in neoplastic cells in serous effusions. Use as a marker for melanoma. AB - S-100 protein has been demonstrated on histologic sections in a number of neural and nonneural tissues, including a variety of neoplasms. Since pleural or peritoneal effusions are frequently the initial presentation of cancer, a study was undertaken to determine if S-100 protein in exfoliated cancer cells could be used as a marker for melanoma. Cells in 36 serous fluids obtained from 32 patients were retrospectively examined for S-100 protein by the peroxidase antiperoxidase technique. All samples had been previously studied as Papanicolaou stained cytology specimens, and 25 samples had been studied by transmission electron microscopy. All benign effusions were negative for S-100 protein. Malignant effusions were negative except for some that contained malignant melanoma cells: two of five pigmented melanomas and both cases of amelanotic melanoma. This study indicates that S-100 protein in malignant cells is a useful marker for malignant melanomas, especially the amelanotic type. PMID- 3521175 TI - The efficiency of the Cytobrush versus the cotton swab in the collection of endocervical cells in cervical smears. AB - In 30 patients whose last cervical smear had lacked endocervical cells, two new samples were collected, one with a cotton-tipped applicator and the other with the recently developed Cytobrush cervical brush. With the cotton swab, no endocervical cells were present in the repeat smears of 21 patients, as compared with only 3 Cytobrush smears lacking endocervical cells; the difference is statistically significant (P less than .001). Quantitatively, the cellular yield with the Cytobrush was larger. It is concluded that the use of the cervical brush to collect material for cervical smears is more effective and provides a higher yield of cells than the use of the conventional cotton swab. The importance of the presence of endocervical cells in a smear as evidence that the transformation zone has been properly sampled is also discussed. PMID- 3521176 TI - Consequences of the introduction of combined spatula and Cytobrush sampling for cervical cytology. Improvements in smear quality and detection rates. AB - One of the most important yardsticks for evaluating sampling for the detection of premalignant and malignant cervical lesions is the percentage of smears that contain cells from the transformation zone. Until February 1985, all smears made by around 500 different general practitioners were taken with a modified Ayre spatula. In the period February to October 1985, 24,496 smears of spatula samples and 5,716 smears prepared by combined spatula-Cytobrush sampling were analyzed. With the introduction of the combined spatula-Cytobrush method, the rate of smears containing cells from the transformation zone (adequate smears) rose from 84% to 98%. With the spatula-alone method, there were large differences between the rates of adequate smears from the various doctors; with the combined spatula Cytobrush method, all participating doctors were without exception highly successful. The positive cytology rate was significantly higher in the combined spatula-Cytobrush smears (0.75%) as compared with the spatula-alone smears (0.38%). There was also a change in the diagnostic pattern in that more premalignant changes of the glandular epithelium of the endocervix were detected. One case of early invasive adenocarcinoma of the endocervix, in which the combined spatula-Cytobrush smears was positive and the repeat spatula-alone smear made by the gynecologist was negative, is discussed in detail. We anticipate that, with the large-scale introduction of the Cytobrush sampling method, fewer repeat smears will be required and, in addition, the observed relative increase of endocervical adenocarcinoma of the endocervix will be halted. In addition, there will be fewer false-negative smears. PMID- 3521177 TI - Cutaneous and mucosal manifestations of the deep mycotic infections. AB - The deep mycoses are increasing in importance both as opportunistic infections and from exposure in geographically defined areas. Diagnosis may be difficult in both groups. Mucosal involvement may be non-specific (e.g., in disseminated candidiasis) or highly predictive of disseminated disease (e.g., histoplasmosis, blastomycosis and paracoccidioidomycosis). Skin involvement is generally uncommon in disseminated aspergillosis, mucormycosis and cryptococcosis but is more common in candidemia and coccidioidomycosis. Manifestations of mucosal and cutaneous lesions of the deep mycoses are reviewed and the need for an aggressive diagnostic approach stressed. Culture is more specific than histopathologic examination alone but the latter may have to suffice in some cases. Control of underlying disease and administration of amphotericin B remain the mainstays of therapy. Ketoconazole is being evaluated as an alternative in therapy of some deep mycoses. PMID- 3521178 TI - Effect of human calcitonin (hCT) on glucose- and arginine-stimulated insulin secretion. AB - Many studies have shown that in normal man salmon and porcine CT administration in bolus inhibits the release of TSH, LH, GH, and glucose- or arginine-induced insulin secretion. In the present study we investigated the effects of human synthetic calcitonin (hCT) on glucose- or arginine-induced insulin secretion in man. Twenty-two subjects were submitted to i.v. administration of hCT during glucose or arginine test. In our opinion, the most interesting results are those observed with arginine plus hCT at two different dosages (25 micrograms and 12.5 micrograms infused in 30 min). In fact arginine plus hCT (25 micrograms in 30 min) administration induced a significant increase of glycemia at 5, 10 and 20 min (p less than 0.01) and at 30 min (p less than 0.05) and a significant decrease of IRI at 5, 10, 20 and 30 min (p less than 0.001) and at 45 min (p less than 0.005). The highest plasma CT levels were observed at 15 and 30 min (490 and 540 pg X ml-1). Arginine plus hCT (12.5 micrograms in 30 min) infusion induced a similar significant increase in plasma glucose at 10, and 20 min (p less than 0.05) and at 30 min (p less than 0.01) and a significant decrease of plasma IRI at 10 min (p less than 0.05) at 20 min and 30 min (p less than 0.005). The highest plasma CT levels were reached at 20 min and 30 min (250 and 270 pg X ml 1, respectively). Our results clearly demonstrate that physiologic doses of hCT are able to inhibit arginine induced insulin secretion in normal man. Since insulin induces hypercalcemia and food ingestion increases both insulin and CT, one could hypothesize that CT inhibits insulin secretion thus controlling post prandial hypercalcemia by its osteotrophic effect and by its action upon calcium redistributed within the cells. PMID- 3521179 TI - A technique for the isolation of highly viable pancreatic B-cells from ob/ob mice. AB - A method has been developed to prepare free islet cells in suspension from adult ob/ob-mice. About 200 collagenase-isolated pancreatic islets were pooled in 4 ml of calcium-free Krebs-Ringer-HEPES buffer supplemented with 1 mM EGTA and 10 micrograms/ml DNAase. The islets were gently shaken in a water-bath for 10 min at 30 degrees C. Then, the cell suspension was filtered through a nylon screen and centrifuged through ice-cold, dense albumin. The isolated cells, of which more than 99% were B-cells, appeared well preserved both in light- and electron microscopy. Out of the isolated cells, 7.1 +/- 0.5% took up Evans Blue and were thus considered non-viable. PMID- 3521180 TI - Biosynthetic human insulin does not modify circulating lipid and apolipoprotein concentrations in type I diabetic patients. AB - Since insulin modulates key enzymes of lipid metabolism, different biological activities of biosynthetic human insulin (BHI) and conventional insulins might induce different plasma lipid and apolipoprotein patterns in diabetic patients chronically treated with the former or the latter insulin preparation. In this study we have evaluated the effects of 3 months of therapy with BHI on plasma lipid and apolipoprotein concentrations in a group of type I diabetics previously treated with insulin of animal origin and the results have been compared with those from diabetics maintained on conventional insulin therapy. In the latter, no change occurred in the clinical and metabolic parameters. Patients transferred to BHI showed lower HDL-cholesterol and HDL3-cholesterol levels at 30 days from the beginning of BHI treatment, and both parameters returned to, and were maintained the basal values at subsequent controls. Total cholesterol, HDL2 cholesterol, triglycerides, apolipoproteins AI, AII and B remained substantially constant throughout the study. Glycometabolic control, which was evaluated by fasting plasma glucose and glycosylated hemoglobin, exhibited a transient, moderate deterioration at the 30-day control, and returned to basal level in the following weeks. No major change was noted as far as daily insulin dosage and relative body weight were concerned. Thus, long-term BHI treatment of type I diabetics does not cause any major change in plasma lipid and apolipoprotein patterns in comparison with animal insulin therapy, so that the validity of using BHI in the treatment of type I diabetes is confirmed. PMID- 3521181 TI - Guar-pasta: a new diet for obese subjects? AB - A pasta containing 10% guar-flour was successfully prepared and administered to ten obese women in a seven-day experimental design which included: a control meal (day 1) containing alimentary wheat-pasta, a first guar-pasta meal (day 2), to assess the acute effects of guar-pasta, a second guar-pasta meal (day 7), performed after four days of a weight-maintenance diet containing one guar-pasta meal per day. Compared to wheat-pasta, guar-pasta significantly lowered glucose and insulin response, as well as fasting total cholesterol. Moreover, it had excellent palatability and no gastrointestinal side-effects. PMID- 3521182 TI - Divergent effects of dietary chloride restriction on aldosterone biosynthesis and the renin-angiotensin system in rats. AB - The effects of dietary chloride restriction - alone or combined with sodium and potassium restriction - on aldosterone biosynthesis and the renin-angiotensin system were studied in rats. Treatment with a chloride-deficient diet led to a temporary decrease in the capsular adrenal conversions of corticosterone to 18 hydroxycorticosterone and aldosterone (manifest after 2 weeks but not longer apparent after 3 weeks), which was accompanied by a progressive rise in plasma renin activity and a moderate fall in plasma potassium. Combined restriction of sodium, potassium and chloride elicited a decreased activity of the enzyme(s) involved in late steps in aldosterone biosynthesis, an elevation of plasma renin activity to excessively high levels and a substantial hypokalaemia. Chloride repletion of these rats by the addition of NH4Cl or CaCl2 to their drinking fluid stimulated aldosterone biosynthesis while lowering plasma renin activity and raising plasma potassium. According to these observations, dietary chloride deficiency is another example of an experimental situation in which a high activity of the renin-angiotensin system contrasts with an unchanged or suppressed aldosterone biosynthesis. Most likely, this divergence is at least partly due to hypokalaemia which is induced during long-term chloride deficiency by a yet unknown mechanism. PMID- 3521183 TI - Treatment of Turner's syndrome with methionyl human growth hormone for six months. AB - Twenty patients with Turner's syndrome were treated with methionyl human growth hormone (met-hGH) produced by recombinant DNA technology. Plasma non-esterified fatty acid (NEFA) (mean +/- SEM) increased significantly from 0.52 +/- 0.06 to 1.30 +/- 0.09 mEq/l at 4 h after the first administration of 4 IU of met-hGH (P less than 0.001). Basal plasma somatomedin C (SM) levels were within the normal range; however, they increased significantly at 24 h after the first three daily injections of 4 IU of met-hGH (basal, 0.92 +/- 0.14; 24 h, 1.39 +/- 0.16; 48 h, 1.68 +/- 0.19; 72 h, 1.91 +/- 0.22 U/ml; P less than 0.001). For long-term treatment, the patients were given 16 IU of met-hGH per week for 6 months. The height increase during treatment was greater in 16 patients, but smaller in 4 than before treatment. The heights increased between 1.4 and 3.7 cm during 6 months of treatment, which corresponds to between 2.8 and 7.4 cm/year. The mean increase of 5.7 +/- 0.4 cm/year was greater than the pretreatment value of 3.7 +/ 0.2 cm/year (P less than 0.001). There was a positive correlation between growth rate and maximum increase in SM (r = 0.51, P less than 0.05). Antibody against hGH appeared in 3 patients after 2 months; 10 of the 20 patients had antibody after 6 months of treatment. However, the antibody did not suppress the growth effect of met-hGH. Otherwise there were no significant changes in physical, blood, or urine examinations. These results indicate that hGH treatment is useful for the acceleration of growth velocity in patients with Turner's syndrome. PMID- 3521184 TI - Continuous reaction times in cerebral dysfunction. AB - The Continuous Reaction Times (CRT) method was used to examine pharmacological, psychiatric, medical and neurological problems in clinical practice where a detailed neuropsychological examination with a test battery was not possible. Either 100 visual or 150 auditory stimuli were given within a period of 6 1/2 or 10 min respectively, and the patients were instructed to react as quickly as possible to every stimulus. The same CRT method was applied to heterogeneous groups of patients with cerebral dysfunction and control subjects. The results demonstrated that it was useful as a screening test for the presence of cerebral dysfunction and was especially sensitive to progressive diseases. Its discriminative power was equivalent to more sophisticated and complex psychological tests. Even if CRT is a valid and reliable method of testing cerebral affection, the neural background for the reaction time process is still unknown and the test did not distinguish between patients with right- or left hemisphere lesions and was not influenced by the etiology of the disease. CRT is therefore considered a provisional method, suggestive only for the actual diagnostic procedures. Only when the patients have a well-defined diagnosis e.g. a diffuse cerebral affection caused by a drug or a metabolic disorder can CRT be recommended as a measure of the degree of lowered consciousness. PMID- 3521185 TI - Clozapine in the treatment of tremor. AB - In an open trial 25 tremor patients were treated with clozapine in small doses (18-75 mg per day). The effect was measured with a new movement analyzer. Nine of 12 essential tremor patients were greatly improved. In six of nine patients with Parkinson tremor and in two combined essential tremor/Parkinson tremor patients tremor almost disappeared. Sedation is a major side effect, but decreases in most patients with time. The risk of agranulocytosis makes blood control necessary. PMID- 3521187 TI - Advanced stage III ovarian carcinoma. Prospective randomized trials comparing radiotherapy and chemotherapy. AB - A prospective randomized trial was carried out in 128 patients with advanced stage III ovarian tumors of serous and anaplastic type, to compare the effects of radiotherapy, single-drug chemotherapy and combination chemotherapy on operability and survival. The effect on operability was about the same for radiotherapy as for combination chemotherapy, whereas single-drug chemotherapy was less effective. The effect on survival was significantly greater with the combination chemotherapy than with radiotherapy and single-drug chemotherapy, which were roughly similar. This better survival with combination chemotherapy was observed in both poorly and moderately differentiated tumors. PMID- 3521186 TI - Pathological pregnancies. Results of amniotic fluid studies and fetal outcome. AB - Late amniocenteses (greater than 20 weeks' gestation) were performed in 114 pregnancies with no a priori genetic risk, but referred because of abnormal clinical and/or ultrasound findings suggesting fetal malformations. Reasons for referral included polyhydramnios (51 cases), oligohydramnios (15 cases), fetal growth retardation (FGR) (16 cases) and abnormal fetal ultrasound findings excluding anencephaly (32 cases). In 42 of these cases, referral was motivated by a combination of the above abnormal findings. When polyhydramnios was the sole anomaly (25 cases), 5 fetuses were malformed (20%), abnormal fetal karyotype and/or elevated amniotic fluid alphafetoprotein (AFP) were demonstrated in 2 cases. Oligohydramnios was the sole anomaly in one case; the infant died of prematurity. Fetal growth retardation was the sole anomaly in 14 cases, 11 otherwise normal newborns were small for date, 2 died at birth and 1 was malformed (1/14, 7%). In this group all fetal karyotypes were normal and in 2 cases amniotic fluid AFP were increased. In the 32 pregnancies without abnormal amniotic fluid volume and/or FGR and with fetal malformation(s) suggested by ultrasound, all malformations except one (ovarian cyst possibly ruptured during birth) were confirmed at birth, amniotic fluid AFP was elevated, and/or karyotype was abnormal in 6 cases. In 42 pregnancies where more than one alarm sign was present, abnormal karyotype and/or elevated amniotic fluid AFP level were recorded in 21 of the 39 cases where amniocentesis was performed, 33 fetuses were malformed (79%) and 13 died in the perinatal period (31%). The high incidence of abnormal results of amniocentesis found in this survey of pathological pregnancies, particularly in those with multiple alarm signs, emphasizes the need for amniocentesis in these situations. PMID- 3521188 TI - Acetylcholinesterase activity in amniotic fluid of normal and anencephalic fetus in diamniotic twin pregnancy. PMID- 3521189 TI - Fat necrosis in human acute pancreatitis. An immunohistological study. AB - Localization of phospholipase A2, lipase and colipase immunoreactivity were studied in paraffin embedded tissue sections. The samples were taken from the pancreas of 12 patients suffering from acute haemorrhagic necrotizing pancreatitis, and from diseased adipose tissue of 7 patients suffering from traumatic mammary fat necrosis. Peroxidase-antiperoxidase immunohistology revealed consistent positive reaction against phospholipase A2, lipase and colipase at the border of fat necrosis in pancreatic interlobular adipose tissue and in peripancreatic, mesenterial and retroperitoneal fat. The fat necroses of the breast were devoid of reaction. The results support the idea that in addition to lipase colipase and phospholipase A2 participate in the development of fat necrosis in acute pancreatitis. Pancreatic lipolytic enzymes are not present in the adipose tissue in mammary fat necrosis. PMID- 3521190 TI - Immunohistological skin investigations in patients with the acquired immune deficiency syndrome. AB - Twenty-one male patients with acquired immune deficiency syndrome (AIDS), 6 male patients with AIDS-related complex (ARC) and 23 controls' had a punch biopsy taken from clinically unaffected skin of the buttock. Vertical skin sections were examined by immunofluorescence for in vivo deposits of immunoglobulins (Ig) and other plasma proteins, as well as for morphology and distribution of Langerhans cells (LC). Deposits of IgM in the dermo-epidermal junction zone (DEJ) were found in one patient with ARC. Apart from this single finding, no in vivo deposits of IgG, IgM, IgA, IgD, IgE, complement C1q and C3, fibrinogen or albumin were demonstrated in epidermis, DEJ or dermal vessel walls, either in patients or in controls. Epidermal LC were more superficially situated in patients as compared to controls. No differences in number and localisation of dermal LC were seen. We concluded that it was not possible to confirm a recent report of in vivo Ig deposits in the epidermis of patients with AIDS. The abnormalities observed in epidermal LC should be interpreted together with the recent finding of reduced numbers of epidermal LC; they thus support the hypothesis that LC are involved in the pathological processes in AIDS. PMID- 3521191 TI - Relation between alloxan-induced plasma membrane dysfunction and inhibition of insulin secretion in pancreatic B-cells in vivo. AB - The acute effects of alloxan on plasma membrane function and insulin content of pancreatic B-cells were investigated in vivo. Rats received a single injection of alloxan, 75 mg/kg b.w. intravenously. The animals were sacrificed up to 24 h after treatment. The membrane damage was evaluated by a dye-exclusion test, demonstrating cells unable to exclude Evans blue/albumin (EBA) complexes. The insulin content was demonstrated by immunofluorescence. The alloxan injection resulted in a transient decrease in insulin content, later followed by a sustained increase, indicating inhibition of secretion. Increased levels of insulin were evident 50 min after alloxan treatment, and concomitantly an increasing number of injured, i.e. EBA-positive, cells could be demonstrated in the islets. Inhibition of insulin secretion appeared to precede inhibition of insulin synthesis as well as development of membrane dysfunction. It is suggested that the early inhibition of insulin secretion, induced by alloxan, is due to interference with cytoplasmic sulfhydryl and disulfide containing proteins. PMID- 3521192 TI - Calcium channel blockers and pulmonary hypertension. AB - In vascular smooth muscle from the pulmonary circulation, potassium evoked contractions are abolished in calcium-free medium and by calcium channel blockers (CCB). Noradrenaline, histamine, and serotonin induced contractions are partly resistant. Pulmonary arterial hypertension may occur both as a primary disorder and secondary to cardiac and pulmonary diseases; in both types there may be a component of pulmonary arterial vasoconstriction. In animal models, hypoxic pulmonary hypertension is counteracted by CCBs, nifedipine being particular effective. In patients with this disorder, CCBs also seem able to lower pulmonary arterial pressure and vascular resistance, but no controlled trials documenting their clinical efficacy have been performed. This is valid also for primary pulmonary hypertension, where some of the CCBs may have clinical value. PMID- 3521194 TI - Migraine treatment with calcium channel blockers. AB - Irrespective of their mechanism of action, which so far has not been clarified, calcium channel blockers (CCBs) have a documented prophylactic effect on classical and common migraine, as well as on cluster headache. The drugs may reduce migraine prodromes, the frequency of migraine attacks, and also decrease the severity and possibly the duration of these attacks. Notably, their optimum effect is often seen after more than 2 months of treatment. Side effects seem to be few and mild. Whether or not there are differences in therapeutic efficacy between different CCBs is presently unclear. As comparisons with other alternatives of treatment are sparse, the place of CCBs in migraine therapy remains to be established. PMID- 3521193 TI - Cerebral vasospasm and calcium channel blockade. Nimodipine treatment in patients with aneurysmal subarachnoid hemorrhage. AB - In patients with aneurysmal subarachnoid hemorrhage (SAH), delayed ischemic cerebral dysfunction (DID or symptomatic vasospasm) with subsequent fixed neurological dysfunction (FND) is a frequent and most feared complication induced by the hemorrhage. Aneurysm operation during the acute stage with intraoperative evacuation of bloodcontaminated cerebrospinal fluid (CSF) from the basal cisterns and subarachnoid spaces has reduced this complication. Nevertheless despite early operation, DID with FND occurs in 13-20% or more. In a series of 100 individuals with a ruptured supratentorial aneurysm, who were subjected to aneurysm operation in the acute stage and who subsequently received intravenous treatment with the calcium channel blocker nimodipine, the occurrence of DID with FND was reduced to 5%. PMID- 3521195 TI - Cardioplegia and myocardial ischemia during cardiopulmonary bypass. AB - Presently myocardial protection can be obtained in three main ways: 1) energy conservation through chemical induction of rapid and complete diastolic arrest, 2) slowing of the metabolic rate and degradative process through the use of hypothermia, and 3) prevention or reversal of unfavourable ischemic-induced changes with various protective agents. These methods of myocardial protection and their effectiveness, the calcium metabolism during myocardial ischemia, and the effects of calcium channel blockers are briefly reviewed and discussed. It is stressed that myocardial protection during ischemic arrest is a complex entity, and that new modes of myocardial protection are needed in the future. PMID- 3521196 TI - Effects of calcium channel blockers on the female genital tract. AB - Contractile activity and vascular resistance in the female genital tract are influenced by several smooth muscle tissues with individual mechanisms for control of mechanical activation. Calcium channel blockers have potent relaxant effects on preparations of human myometrium. The myometrial arteries utilize multiple sources of calcium for contractile activation, and excitation contraction coupling in isolated vessels from non-pregnant uteri seems comparatively less sensitive to nifedipine than in corresponding myometrial preparations. Contractile activation of myometrial and placental arteries at term is inhibited by nitrendipine and nifedipine. Human oviductal smooth muscle depends on superficially bound calcium for mechanical activation, but only phasic contractions can be abolished by nifedipine, while tonic contractions induced by various agents are more resistant to the calcium channel blocker. Menstrual uterine contractions and pain are effectively counteracted by nifedipine in normal and dysmenorrhoeic women. Such therapy may represent an alternative principle in the treatment of dysmenorrhea. Nifedipine has potent relaxant effects on the mid-term pregnant and the post-partum uterus and calcium channel blockers may prove useful in the treatment of premature labor. Nifedipine and related compounds may further show effective in the treatment of pregnancy associated hypertension. Whether such treatment in late pregnancy involves maintained or even improved placental perfusion could be assumed from in vitro data but needs further studies. PMID- 3521197 TI - Effects of calcium channel blockers on urinary tract smooth muscle. AB - Influx of calcium from the extracellular medium seems to be important for spontaneous as well as agonist-induced contractile activity in urinary tract smooth muscle. To a various extent this calcium influx occurs through pathways which can be blocked by calcium channel blockers. These drugs effectively suppress spontaneous ureteral activity in vitro. Whether they affect ureteral motility in vivo or whether they can counteract ureteral spasm associated with ureteral stones have not been established. Calcium channel blockers partially block electrically as well as agonist-induced detrusor contractions. Some of these drugs abolish even atropine-resistant contractile responses induced by electrical stimulation in detrusor muscle. Drugs with combined antimuscarinic and calcium channel blocking effect therefore have an attractive effect profile. Experiences with calcium channel blockers in the treatment of patients with 'unstable bladder' are limited, but results obtained with terodiline seem promising. Even if calcium channel blockers reduce agonist-induced contraction in isolated urethral muscle, their clinical effect on urethral function seems to be small. The effects of calcium blockers on urinary tract smooth muscle may be clinically useful and deserve further study. PMID- 3521198 TI - The relationship between macro- and microcirculation clinical aspects. AB - A large number of methods are today available for the clinical evaluation of the arterial blood supply to an extremity or part of an extremity. However, these methods are not sensitive enough for determining the nutritional status of a tissue in the extremity affected by vascular disorders. This is especially true for the skin where most of the blood is used for thermoregulation and only a small fraction goes through the nutritional capillaries. Blood may enter the subpapillary vascular network through AV-shunts and bypass the nutritional skin capillaries. Therefore microcirculatory methods has to be used in order to be able to evaluate the nutritional status of a certain skin area. One of the clinically most useful methods for this purpose is vital capillary microscopy. By classifying structural changes of the nutritional capillaries in an area susceptible to ischemia, the risk of necrosis can be evaluated. Marked discrepancies between the total circulation of the are and the nutritional status of the tissue can be seen especially in patients with peripheral vascular disorders and/or diabetes. The total circulation may be markedly reduced but necrosis does not occur until the nutritional circulation of the ischemic skin area is completely abolished for a certain period of time. On the other hand it is sometimes seen in clinical practise that ischemic skin necrosis may develop in a region with rather good macrocirculation. These findings are of utmost importance when the effect of a certain treatment should be evaluated. The effect has to be studied directly in the target organ, and that is the nutritional vascular bed of the ischemic area. PMID- 3521199 TI - Hemodynamic effects of calcium channel blockers in essential hypertension. AB - Calcium channel blockers decrease blood pressure in essential hypertension due to a marked reduction of systemic vascular resistance (arteriolar tone). They also dilate conducting arteries but have no venodilatory effect in antihypertensive doses. With the dihydropyridines (e.g. nifedipine) and diltiazem there is a transient increase in heart rate and cardiac output but this is not observed with verapamil. The vasodilatory responsiveness in the resistance vessels to calcium channel blockers is selectively enhanced in patients with established essential hypertension but not in the early borderline phase of hypertension. During treatment with chlorthalidone, atenolol, acebutolol or nitrendipine for four to six weeks the reduction of blood pressure is accompanied by a selective decrease in the vasodilatory responsiveness to calcium channel blockers. PMID- 3521200 TI - Calcium channel blockade and renal function. AB - Since calcium channel blocking agents were introduced into the treatment of hypertension their influence on renal function has become an important issue. In animal experiments calcium channel blocking agents have been shown to increase renal blood flow and glomerular filtration rate and to augment urine flow and electrolyte excretion. In human acute studies the administration of calcium channel blocking agents have elicited similar renal hemodynamic and diuretic effects. Clinical studies on the renal effects of long-term treatment are however still lacking. Studies on the effect on renin release have given divergent results. In acute experiments renin release is increased by calcium channel blocking agents. In long-term treatment, however, no change in peripheral plasma levels of renin has been demonstrated. The influence of decreased renal function on the pharmacokinetics of calcium channel blocking agents has been studied in patients with renal disease. For verapamil the volume of distribution is smaller in uremic patients than in normals and both metabolic and renal clearances are decreased. For nifedipine, on the other hand, similar plasma levels, plasma half life and total plasma clearance are found in uremic patients and normal subjects. PMID- 3521201 TI - Visualization of regenerating sciatic nerve fibres by neurofilament immunohistochemistry. AB - Regeneration of injured sciatic nerve in rats was studied with an immunohistochemical technique visualizing neurofilaments in nerve fibres as well as S-100 protein in Schwann cells. Outgrowing axons with delicate sprouts could be demonstrated along pathways formed by Schwann cells. In contrast, axons which had stopped growing or were degenerating showed bulb-like swellings in their terminal parts. The use of immunohistochemical techniques offers advantages over conventional neurohistochemical staining methods, enabling more detailed observations of nerve regeneration mechanisms in animals. PMID- 3521202 TI - Pilocarpine-stimulated salivary flow rate and salivary glucose concentration in alloxan diabetic rats. Influence of severity and duration of diabetes. AB - Pilocarpine-stimulated salivary flow rate and glucose concentration were estimated in short-term (1 month) and long-term (12 months) alloxan diabetic rats and in age-matched nondiabetic controls. Diabetic rats had significantly decreased salivary flow rate which was negatively correlated to blood glucose concentration. They also had increased salivary glucose levels, which were positively correlated to blood glucose values, when the blood glucose values were above 15 mmol l-1, suggesting a threshold mechanism for salivary glucose excretion. The long-term diabetic rats had significantly higher salivary flow rates than the short-term diabetics. Insulin therapy in short-term diabetic rats improved the salivary parameters and normalized blood glucose levels, indicating that the salivary abnormalities are reversible - at least in the short-term perspective - and reflect the metabolic derangements of the diabetes. The results suggest that reduced salivary flow rate and increased salivary glucose concentration might be of importance for the development of the periodontal disease and caries seen in diabetic rats. PMID- 3521203 TI - Intravenous uridine treatment antagonizes hypoglycaemia-induced reduction in brain somatostatin-like immunoreactivity. AB - By means of radioimmunoassay procedures, cholecystokinin-(CCK) and somatostatin (SRIF) like immunoreactivity have been studied in the dorsal hippocampal formation and in the frontoparietal cortex of the male rat in insulin-induced hypoglycaemia, leading to an isoelectric EEG pattern. It has been demonstrated that severe hypoglycaemia of 40-min-duration produces a disappearance of SRIF but not of CCK-like immunoreactivity in both cortical regions. It was found that an i.v. injection of uridine but not of saline could significantly counteract the disappearance of SRIF-like immunoreactivity induced by severe hypoglycaemia in both cortical areas. Uridine did not by itself change plasma glucose levels. It is suggested that uridine may prevent release and/or increase synthesis of cortical SRIF peptides in severe hypoglycaemia, possibly due to an action on the metabolism (e.g. by enhancing the resynthesis of phosphatidyl inositol) within the tissue of the cerebral cortex and/or on putative pyrimidine binding sites in the brain controlling SRIF synthesis and/or release. It is possible that uridine in this way may improve recovery of neuronal function within SRIF-immunoreactive neurons of the cerebral cortex after severe hypoglycaemia (which also may be true in other states of reduced metabolic support). These findings suggest a possibility to use uridine in the treatment of Alzheimer's disease and Status epilepticus. PMID- 3521204 TI - Flow distribution between the endocrine and exocrine parts of the isolated rat pancreas during perfusion in vitro with different glucose concentrations. AB - Previous studies in our laboratory have indicated that pancreatic islet blood flow is stimulated by glucose. In an attempt to evaluate to what extent intrapancreatic control mechanisms are involved in the glucose modulation of islet blood flow the distribution of flow between the endocrine and exocrine parts of the rat pancreas during perfusion in vitro with different glucose concentrations have now been studied. For this purpose pancreatic glands from 29 rats were perfused at a flow rate of 1.5 ml min-1 for 95 min with low (2.8 mM) or high (16.7 mM) glucose-containing media. Maintenance of vascular reactivity of this preparation in spite of a marked exocrine oedema was confirmed by administration to the perfusion medium of adrenaline, which immediately raised the perfusion pressure. Insulin concentrations in the effluent media were measured to correlate rates of insulin release to changes in islet flow and to assess the functional viability of the preparation. In each experiment non radioactive microspheres with a diameter of 10 micron were injected into the perfusion medium at one of four time-points: 15, 30, 35 or 80 min after the beginning of the perfusion. Two of these injections (15 and 80 min) took place during perfusion with the low-glucose media and the remaining two during perfusion with high-glucose medium. The microspheres were counted separately in the endocrine and exocrine parts of the pancreas. The results showed that all preparations had a biphasic insulin response to glucose.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3521206 TI - Digital angiography in pulmonary embolism. AB - Pulmonary digital subtraction angiography was diagnostic in 98.3 per cent of patients with possible acute pulmonary embolism. The procedure was well tolerated even in severely ill patients. A large image intensifier made simultaneous imaging of both lungs possible, reducing the number of contrast injections necessary. Small volumes of low iso-osmolar concentration of modern contrast media were used. There was no need for catheterization of the pulmonary artery. Theoretical considerations and our limited experience indicate that this will reduce the number of complications compared with conventional pulmonary angiography. The procedure is rapidly performed and the diagnostic accuracy high. This makes digital subtraction angiography cost effective. Digital pulmonary angiography can be recommended as the primary diagnostic method in most patients with possible pulmonary embolism. PMID- 3521205 TI - Evidence indicating trophic importance of IGF-I in regenerating peripheral nerves. AB - The mechanisms influencing regeneration of peripheral nerves are incompletely known, but growth factors are supposed to play a key role. In the present study, we demonstrate, with the aid of immunohistochemical methods, that somatomedin C (Sm-C/insulin-like growth factor I/IGF-I) rapidly increased from low to high concentrations, reaching peak values in 2 weeks, in regenerating sciatic nerves of adult rats. In addition, IGF-I was demonstrated extracellularly, never observed in the control nerves. Reactive Schwann cells appeared to be the major source for IGF-synthesis. Higher concentrations were seen in tubulated nerves as compared to sutured ones. It is proposed that IGF-I exerts important growth supporting effects on regenerating peripheral nerves. PMID- 3521207 TI - Long-term sequelae of calf vein thrombosis treated with heparin or low-dose streptokinase. AB - A prospective randomized study was performed to investigate the long-term sequelae of calf vein thrombosis (CVT) and correlate them to the success of the initial treatment. Thirty-six patients with symptomatic CVT, verified by venography, were treated with heparin or low-dose streptokinase (SK) combined with low-dose heparin. Venography was repeated after 1 week, and long-term follow up was performed clinically and with foot volumetry after an average of 5 years. Since the low-dose SK regimen led to serious hemorrhagic side-effects in a parallel study, the present investigation was discontinued prematurely. The thrombolysis achieved was greater with SK but, since the initial thrombi were somewhat larger in this group, no significant difference in the average size of the thrombi after therapy could be displayed between the groups. The long-term sequelae and results of foot volumetry were also equal. Signs or symptoms of venous insufficiency were found in 37%, and foot volumetry showed deep venous insufficiency in 26% of the cases. There was a correlation between the hemodynamic change, as assessed by foot volumetry, and the venographic severity. This relation was stronger for the size of the thrombus after treatment than for the initial size. Thus, it seems important to limit the extent of a CVT in order to minimize the long-term sequelae, but administration of SK is not justified due to side-effects. PMID- 3521208 TI - Antihypertensive and biochemical effects of different doses of hydrochlorothiazide alone or in combination with triamterene. AB - The antihypertensive and biochemical effects of 25 mg hydrochlorothiazide alone or 50 mg hydrochlorothiazide alone or in combination with triamterene (either 37.5 or 75 mg) once daily were studied in 26 patients with essential hypertension. After a 5-week run-in period the patients were randomized to receive active therapy in a cross-over manner. Each treatment period lasted 3 months. All drugs significantly (p less than 0.01) lowered both systolic and diastolic blood pressure. There were no differences in blood pressure between the medication periods. Serum potassium concentration was slightly lower during all medication periods than during the run-in period. This change was statistically significant (p less than 0.01) only on 50 mg hydrochlorothiazide daily. There were no significant changes in serum magnesium during any of the periods compared to the run-in period. The lowest values were recorded on 50 mg hydrochlorothiazide alone and the highest on 50 mg hydrochlorothiazide plus 75 mg triamterene daily. A slight increase in serum urate was recorded in all medication periods compared to the run-in period. No significant changes were observed in serum total cholesterol, HDL cholesterol or triglycerides between any of the periods. It can be concluded that 25 mg of hydrochlorothiazide is as effective in lowering blood pressure as higher doses of the diuretic. Higher doses of thiazides will in some patients cause adverse metabolic reactions of which the fall in serum potassium and magnesium is effectively hindered by triamterene. PMID- 3521209 TI - [The journal Actas Luso-Espanolas de Neurologia, Psiquiatria i Ciencias Afines (original research, clinical and classical notes) from its founding in 1940 until 1982]. PMID- 3521210 TI - Naturally occurring monobactams. PMID- 3521211 TI - Enzyme-linked immunoassays for the detection of microbial antigens and their antibodies. PMID- 3521212 TI - Survival of, and genetic transfer by, genetically engineered bacteria in natural environments. PMID- 3521213 TI - Ion-selective electrodes. PMID- 3521214 TI - Bile acids. PMID- 3521215 TI - Artificial enzymes and enzyme models. PMID- 3521216 TI - Succinyl-CoA synthetase structure-function relationships and other considerations. PMID- 3521218 TI - Superoxide dismutases. PMID- 3521217 TI - Beta-leucine and the beta-keto pathway of leucine metabolism. PMID- 3521220 TI - Animal models of mineralocorticoid resistance. PMID- 3521219 TI - Glucocorticoid receptors and glucocorticoid resistance in human leukemia in vivo and in vitro. AB - Clinical measurements quantitating glucocorticoid receptor sites in leukemic blasts may give useful prognostic information. In childhood ALL, where the most data is available, "high" receptor content in peripheral or marrow blasts correlated with likelihood of remission on therapy, longer durations of remission and better prognosis generally. In lymphomas and CLL as well, high receptor content correlated with likelihood of response to steroid therapy, though the number of studies is less. In AML the correlation with receptor site content is moot, and in other leukemias the reports are less complete. A model system for childhood ALL is provided by CEM cells, a glucocorticoid sensitive human cell line from a patient with the disease. These cells have glucocorticoid receptors which must be filled by hormone for greater than 24 hr for cell lysis to begin. Four types of glucocorticoid resistance have been identified thus far in clones of these cells. Their distinctive properties are described and their relevance to clinical situations briefly discussed. PMID- 3521221 TI - Androgen resistance in man. PMID- 3521222 TI - Animal models of androgen insensitivity. PMID- 3521223 TI - Estrogen and antiestrogen resistance in human breast cancer cell lines. PMID- 3521224 TI - Altered estrogen action in the senescent rat uterus: a model for steroid resistance during aging. AB - The estrogen stimulated rat uterus serves as a useful model to examine steroid resistance during aging. This system exhibits receptor loss, impaired stimulation of RNA polymerase II and defects in nuclear translocation (or enhanced association) of receptor-estradiol complexes. All of these defects appear to contribute in part to decreased estrogen responsiveness of the senescent rodent uterus. PMID- 3521225 TI - Post-traumatic stress disorder. PMID- 3521226 TI - Descriptive epidemiologic studies of head injury in the United States: 1974-1984. PMID- 3521227 TI - Rehabilitation of cognitive and behavioral dysfunction in head injury. PMID- 3521228 TI - The physical abuse of children. A hurt greater than pain. PMID- 3521229 TI - Present day status of the chemical face peel. AB - A phenol chemical face peel restores a clean, youthful appearance by removing the fine wrinkles of the tired, aged face. This procedure has the additional advantage of decreasing the rate of appearance of precancerous and probably early cancerous lesions of the photoaged skin of the face. Knowledge of the history, theory, histology, and technique are made current. A comprehensive review demonstrates that pigmentary changes, third degree scarring, and cardiac arrhythmias appear to be the main complications. The technique is safe and effective if used in a judicious manner. PMID- 3521230 TI - The management of ala ptosis in Oriental rhinoplasty. AB - We use the term ala ptosis to describe a condition in which the nostril sidewall is bulbous with overhanging of the alar margin. This hides the columella from view, especially in profile. The management of ala ptosis in Oriental rhinoplasty is done in two steps, i.e., to reduce the bulbous nostril sidewall by manipulating the alar cartilage and to reduce the alar margin to a gentle, graceful curve by means of selective rim excision after wide undermining of the ala. The definitive alar margin runs more or less parallel to the white roll of the upper lip. PMID- 3521231 TI - The correction of the prominent ear. AB - The prominent ear was first noted in the medical literature to be a social and psychological disturbance in 1881, when Ely suggested the first technique for the correction of this condition. Since Ely many surgeons have tried to find the best solution for this deformity; however, because of the specific cartilagenous architecture of the auricle, no one has yet designed an acceptable and secure technique. The successful reconstructured auricle should be the result of tackling all components of the deformity, namely, the absence of the antihelix and the aloofing of the concha from the mastoid. Mustarde's technique and the various anterior scoring methods do not deal with the conchal component of the protruded ear, nor do they give a fully satisfactory formation of the antihelix when one of these methods is used alone. This article presents the author's preferred technique for reconstructing the auricle, simultaneously using Mustarde's mattress sutures, Cochrane's anterior scoring of the antihelix, and the approximating of the concha to the mastoid. PMID- 3521232 TI - Simplified harvesting of the ear cartilage graft. AB - A simplified technique of harvesting of the ear cartilage graft is described which (1) uses a postauricular incision to minimize the visible scars, (2) removes the whole floor of the conchal fossa to avoid the irregularities, and (3) uses a tie-over dressing to eliminate the need for a head dressing. This technique has been used on 88 patients with one visible and tender medial irregularity, and three minor palpable, but invisible irregularities. PMID- 3521233 TI - Correction of the inverted nipple. AB - A simple procedure for correction of inverted nipples is described. The key to the method is the preparation of 2 deepithelized dermal flaps after supplementing the volume of tissue beneath the nipple, and preventing recurrence of the deformity with slings. PMID- 3521234 TI - Coronary thrombolytic therapy: state of the art. AB - Ischemic heart disease remains a significant cause of morbidity and mortality in the United States. Thrombolytic therapy has given physicians the capability of limiting the amount of myocardial damage that occurs when there is an acute coronary artery thrombosis and resulting myocardial infarction. This review summarizes current concepts about action mechanisms of the major thrombolytic agents, the technique and clinical results of intracoronary thrombolytic therapy, intravenous vs intracoronary administration, postthrombolytic management of underlying coronary artery disease, new agents being developed, and directions for future investigations. PMID- 3521235 TI - Sonography of the neonatal craniocervical junction. AB - To determine the value of ultrasound scanning of the craniocervical junction in neonates via a posterior approach, we examined 50 infants with normal posterior fossae, 10 with congenital abnormalities, and eight with intracranial hemorrhage. Good evaluation of the cisterna magna, medulla, tonsils, vermis, cervical cord, and central canal was possible in most cases. In nine patients with spinal dysraphism, all displayed a Chiari II malformation; of these, a kink at the medullary cord junction was seen in six, and a cerebellar peg was noted in four. In one case, the Chiari malformation was confirmed by myelography, and all nine patients had some of the intracranial features of Chiari II malformation seen via the standard anterior fontanelle approach. The 10th patient in this group had a quadrigeminal plate cyst and gross hydrocephalus. In another four infants, diffuse subarachnoid blood in the cisterna magna was seen after recent intraventricular hemorrhage. A further two of four patients with posthemorrhagic hydrocephalus had localized clots. Direct scanning at the craniocervical junction was easily performed and allowed good evaluation of this area in normal infants and in patients with Chiari II malformation. This technique also allowed visualization of subarachnoid blood and clots obstructing the outlet of the fourth ventricle. PMID- 3521236 TI - Fine needle aspiration biopsy: the role of immediate cytologic assessment. AB - Fifty-two thoracic and 89 abdominal aspiration biopsy specimens assessed immediately by microscopic examination were evaluated prospectively. These biopsies were compared retrospectively with an equal number and type of biopsies that were not assessed immediately by microscopic examination. The comparison was made to determine whether the diagnostic accuracy and the complication rates of fine needle aspiration cytology would be improved by immediate microscopic assessment. The accuracy of fine needle aspiration biopsy with and without immediate cytologic assessment for the thoracic aspirates was 92% and 85%, and for the abdominal aspirates it was 74% and 81%, respectively. The complication rates with and without immediate assessment for the thoracic aspirates was 40% and 35%, and for the abdominal aspirates it was 7% and 6%, respectively. Immediate cytologic assessment did not change the accuracy or complication rates of fine needle aspiration biopsy significantly, but we believe that it provided greater educational benefits for fellows and staff in cytopathology and interventional radiology. PMID- 3521237 TI - MRI simulator for instruction in pulse-sequence selection. AB - An ordinary desk-top microcomputer was programmed to simulate MR images for specified spin-echo pulse sequences. Model pixel maps of proton density and T1 and T2 relaxation times were made from published estimated values for regions of the human head, neck, and spine. Images were generated and displayed from the model maps and user-specified pulse-sequence parameters in less than 30 sec/image. Models for various pathologic conditions, including calcification, subacute hemorrhage, porencephaly, lipoma, and multiple sclerosis, were superimposed on the images of normal anatomy to create unknown cases. Simulated images can easily demonstrate the effect of pulse-sequence selection on the contrast of normal structures and pathologic conditions. Use of simulated images is an excellent technique for gaining experience in pulse-sequence selection. Low cost microcomputers can provide adequate image detail and reasonable image display time of synthetic MR images for teaching purposes. PMID- 3521238 TI - Intraosseous and intradiscal gas in association with spinal infection: report of three cases. AB - The detection of a vacuum phenomenon within the intervertebral disk usually confirms the diagnosis of degenerative disease rather than an infective process. A similar phenomenon in the vertebral body generally indicates ischemic necrosis. However, spinal infection may rarely be accompanied by intradiscal or intraosseous gas so that the latter finding does not entirely exclude the possibility of infection. Three cases are reported to illustrate gas formation in association with vertebral infection. PMID- 3521239 TI - [In vitro immunologic diagnosis of hypersensitivity to vegetables]. AB - Acute reaction to food allergens is a fairly common problem that is often seen in the allergist's office, its incidence being specially high in childhood. Milk and eggs are the most common sensitizing foods, but usually the type of food allergens responsible for these reactions varies according to food habits in different countries. Legumes occupy an important role in the Spanish diet, being responsible for a large number of allergic reactions. It has been shown that legumes occupy the fourth place in importance among the food allergens, inducing hypersensitivity reactions in Spanish children. This article describes five patients with clinical features suggestive of being mediated by IgE antibodies specific for different legumes. In all the cases, disorders appeared immediately after the ingestion or even the inhalation of vapours from cooked legumes (lentil, bean or chick-pea). Clinical features consisted of: urticaria, angioedema, abdominal symptoms and rhinoconjunctivitis and/or asthma. The five patients required hospital emergency care on several occasions. Two patients suffered also from seasonal pollinosis with rhinoconjunctivitis and asthma. All the patients complained of these type of disorders with any legume, but lentil was found to induce the most severe reactions and it was therefore selected for this study. The presence of specific IgE antibodies was demonstrated in vivo in all the patients by means of skin prick-test. It was performed using a lentil extract prepared in our laboratory. Negative controls were also included. A reverse enzymeimmunoassay (REIA) revealed the presence of specific IgE antibodies in the sera of the five subjects.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3521240 TI - [Rhinitis with intolerance to non-steroidal anti-inflammatory agents. Report of 3 cases]. AB - Lumry described 6 patients who presented hypertrophic rhinosinusitis, positive nasal eosinophilia and intolerance to nonsteroidal antiinflammatory drugs, manifested exclusively with naso-ocular symptomatology. We present three patients with clinical manifestations of chronic rhinitis who had noticed before their first visit that several nonsteroidal antiinflammatory drugs precipitated their nasal symptomatology. None of them had ever presented with asthma symptoms. All of them had nasal polyps. The nasal smear showed eosinophilia of 20 to 45%. All three had sinusitis radiologically. The spirometric values were within normal limits (V.C., FEV1, MMEF25-75%). Skin tests with different inhalants antigens using the prick test technique as well as skin tests with pyrazolones (Phenyldimetrylpyrazolone: 25 and 250 mg./ml.; dipyrone: 4 and 44 mg./ml.; amidopyrine: 2.2 and 22 mg./ml.) using the intradermal technique were negative. Serum IgE (Phadezym IgE-Pharmacia) showed values of 23.9, 17.1 and 25.8 IU/ml. respectively. The bronchial inhalation challenge test with methacholine was positive with PD20FVE1 of 14 and 4.8 mg./ml. in two of our patients. Different nonsteroidal antiinflammatory drugs were administered to each patient in different days orally, with intervals of 7 and 25 days (aspirin 500 mg., dipyrone 575 mg., indomethacin 25 mg., naproxen 500 mg.) as well as tartrazine (50 mg.), paracetamol (500 mg.) and lactose as placebo. With 30 minutes intervals and up to three hours after drug administration, the symptoms were observed and spirometry was carried out. Steroids and antihistamines were suspended at least 48 hours before the test. Acetyl-salicylic acid, dipyrone, indomethacin and naproxen produced naso-ocular symptomatology without any objective reduction of FEV1; but paracetamol and tartrazine were well tolerated.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3521241 TI - Immunological consequences of vasectomy and consideration of some of their implications. AB - The immunological consequences of vasectomy are manifested via the development of humoral and cell-mediated responses. In the present overview the immunological sequelae of those responses in man ranging from their methods of detection, of antigen and antibody, principally at the humoral level; local effects on the reproductive tract; circulating immune complexes and the critical area of reanastomosis are considered. PMID- 3521242 TI - Deaf-mutia: responses to alienation by the deaf in the mid-nineteenth century. PMID- 3521243 TI - Urinary tract infections. PMID- 3521244 TI - Management of hypertension. PMID- 3521245 TI - A randomized controlled trial of intravenous streptokinase in evolving acute myocardial infarction. AB - To determine the efficacy of intravenous streptokinase in acute myocardial infarction, 52 patients were randomized to intravenous streptokinase or control groups. Time from onset of infarction to randomization was similar in the streptokinase group and control group, 4.9 +/- 2.1 hours vs 5.4 +/- 2.4 hours, respectively. The 28 streptokinase patients received an intravenous infusion of 700,000 units of streptokinase followed by full-dose anticoagulation. The 24 control patients received normal saline solution followed by full-dose anticoagulation. Of 28 streptokinase patients, 12 (43%) had noninvasive evidence of reperfusion by early peaking of serum creatine kinase (peak creatine kinase less than 16 hours after onset of infarction) vs 3 of 24 control patients (13%), p less than 0.02. Two streptokinase patients (7%) had reperfusion arrhythmias during streptokinase infusion. One streptokinase patient (4%) and two control patients (8%) died during hospitalization. At angiography (16 +/- 5 days after infarction) 22 of 26 streptokinase patients (85%) had a patent infarct-related coronary artery compared to 8 of 20 control patients (40%), p less than 0.01. Comparison of radionuclide left ventricular ejection fraction assessed acutely (28 +/- 10 hours after infarction) with left ventricular ejection fraction at hospital discharge (15 +/- 3 days after infarction) showed no significant improvement in either the streptokinase or control group, 0% and +1%, respectively. At follow-up 13 +/- 7 months after infarction, total mortality rate was similar in the streptokinase group and control group, 17.8% (5 of 28 streptokinase patients) and 20.8% (5 of 24 control patients), respectively.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3521246 TI - Supraventricular tachyarrhythmias: their evaluation and therapy. PMID- 3521247 TI - Treatment of hyperlipidemia. AB - The correlation between elevated cholesterol and coronary artery disease (CAD) has emerged slowly, with the strongest statistical links appearing recently. Every major epidemiologic study carried out to date has verified the association between the concentration of serum cholesterol and the risk of CAD. Despite this, much of the medical profession continues to underrate the significance of cholesterol and lipoproteins. Programs to increase physicians' awareness of this problem are essential. The National Heart, Lung, and Blood Institute's Coronary Primary Prevention Trial showed that diet and drug therapy lower cholesterol by 9% and low density lipoprotein (LDL) cholesterol by 12.5%, on average, in at-risk patients compared with control subjects. CAD death or nonfatal myocardial infarctions were reduced collectively by 19%. Significant decreases also occurred in the incidence of angina pectoris, new positive electrocardiograms and coronary artery bypass surgery. Data from a number of important secondary prevention trials also support lowering cholesterol and LDL to retard the growth of atherosclerotic plaque. The risk from LDL elevations depends on the extent of the increase, the concentration of high density lipoprotein cholesterol and the presence of other major risk factors (e.g., hypertension and smoking). The ratio of total cholesterol or LDL to the high density lipoprotein concentration is the best indicator for CAD risk. Monitoring cholesterol levels should become an annual routine in the physician's office. A simple, economical blood test for cholesterol, which should be widely available soon, will make screening programs possible, but before such screening begins, plans must be in place for follow-up. The identification of high risk persons and their treatment with diet and, when necessary, drugs are essential.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3521248 TI - Hypertriglyceridemia and carbohydrate intolerance: interrelations and therapeutic implications. AB - Atherosclerosis, the most frequent complication of diabetes, could be the result of hyperlipidemia, among other factors. Mounting evidence suggests that reducing the concentration of triglyceride-rich lipoprotein, which influences the production of the possibly atherogenic intermediate density lipoprotein (IDL), might diminish the circulating level of potentially atherogenic lipoproteins. Hypertriglyceridemia, even in the absence of obesity, is associated with insulin resistance. To compensate, pancreatic B cells respond to glucose challenge by producing hyperinsulinemia. If the B cells cannot respond adequately, carbohydrate intolerance ensues. Insulin-treated diabetics may also become hyperinsulinemic because routine insulin injection may not reflect physiologic need and because the insulin is administered peripherally rather than portally. Hyperinsulinemia increases the production of circulating triglyceride. It appears to do this in rats by causing the production of more triglyceride-rich lipoprotein particles rather than by increasing the triglyceride content of each particle. Further, at least in rats, the insulin-induced increase in triglyceride production requires the presence of supplementary dietary fructose. Hyperinsulinemia also increases the activity of adipose tissue lipoprotein lipase and the degradation of very low density lipoprotein (VLDL). The concentration of VLDL depends on balance of production and degradation. Accelerated VLDL degradation leads to an increase in IDL production. Because there is mounting evidence that IDL may be atherogenic, this cycle could accelerate atherogenesis. As such, it is reasonable to postulate that reducing the concentration of triglyceride-rich lipoproteins would break this cycle and would diminish the circulating level of potentially atherogenic lipoproteins. PMID- 3521249 TI - Overview: extending the indications for treating hypercholesterolemia. PMID- 3521250 TI - Role of risk factor management in progression and regression of coronary and femoral artery atherosclerosis. AB - The results of 3 recently completed studies usher in a new era in the treatment of coronary atherosclerosis and its sequelae. In aggregate, these results show that reductions in low density lipoprotein (LDL) cholesterol or reductions in the ratio of total to high density lipoprotein (HDL) cholesterol by either diet or drugs or both are effective in primary and secondary prevention of coronary artery disease (CAD). In the Lipid Research Clinics' Coronary Primary Prevention Trial, reducing levels of LDL cholesterol, regardless of whether the primary intervention was diet or drug, correlated with a reduction in CAD events. In the National Heart, Lung, and Blood Institute's Type II Coronary Intervention Study, CAD progression at 5 years was inversely related to a change in the ratio of HDL cholesterol to total cholesterol. In the Leiden Intervention Trial, cessation of coronary artery atherosclerotic lesion growth correlated with the ratio of total cholesterol to HDL cholesterol. Several trials now under way will test the effects of much more substantial reductions of LDL cholesterol (up to 50%) and increments in HDL cholesterol (up to 25%) on interrupting the progression or inducing the regression of coronary artery atherosclerosis. Even small reductions in the progression of coronary artery lesions or induction of their regression should produce major reductions in morbidity and mortality from CAD. The importance of secondary prevention also extends to patients after coronary artery bypass surgery, because the likelihood of graft occlusion is likewise related to the patient's lipid profile. Further, the importance of primary prevention of atherosclerosis through modification of lipids and lipoprotein cholesterol in the first-degree relatives of young victims of atherosclerosis cannot be overemphasized. PMID- 3521251 TI - Comparative hemodynamic and clinical effects of long-term treatment with prazosin and captopril for severe chronic congestive heart failure secondary to coronary artery disease or idiopathic dilated cardiomyopathy. AB - Short- and long-term hemodynamic and clinical responses to sequential therapy with prazosin (15 mg/day for 3 to 12 weeks) and captopril (75 to 300 mg/day for 2 to 15 weeks) were compared in 22 patients with severe chronic congestive heart failure. First doses of prazosin produced marked increases in cardiac index and stroke volume index (p less than 0.01), but these effects were lost during long term treatment. First doses of captopril produced only modest increases in both variables, but these persisted without attenuation during prolonged therapy. Both drugs produced immediate decreases in left ventricular filling pressure, mean arterial pressure, mean right atrial pressure and systemic vascular resistance; these changes became significantly attenuated (p less than 0.01) with prazosin but not with captopril. At the end of treatment, stroke volume index was significantly higher and right and left ventricular filling pressures were significantly lower with captopril than with prazosin (p less than 0.05 to 0.01). Only 8 of the 22 patients (36%) treated with prazosin benefited clinically, whereas 14 of 19 patients (74%) treated with captopril felt that they had improved (p less than 0.05). These differences could not have been predicted by comparing responses to first doses of the 2 drugs. These findings indicate that the choice of 1 vasodilator drug over another in patients with congestive heart failure should be based on studies that compare their long-term rather than short term hemodynamic and clinical effects. PMID- 3521252 TI - Collagen types I, III, and V in human embryonic and fetal skin. AB - The dermis of human skin develops embryonically from lateral plate mesoderm and is established in an adult-like pattern by the end of the first trimester of gestation. In this study the structure, biochemistry, and immunocytochemistry of collagenous matrix in embryonic and fetal dermis during the period of 5 to 26 weeks of gestation was investigated. The dermis at five weeks contains fine, individual collagen fibrils draped over the surfaces of mesenchymal cells. With increasing age, collagen matrix increases in abundance in the extracellular space. The size of fibril diameters increases, and greater numbers of fibrils associate into fiber bundles. By 15 weeks, papillary and reticular regions are recognized. Larger-diameter fibrils, larger fibers, denser accumulations of collagen, and fewer cells distinguish the deeper reticular region from the finer, more cellular papillary region located beneath the epidermis. The distribution of collagen types I, III, and V were studied at the light microscope level by immunoperoxidase staining and at the ultrastructural level by transmission (TEM) and scanning electron microscopy (SEM) with immunogold labeling. By immunoperoxidase, types I and III were found to be evenly distributed, regardless of fetal age, throughout the dermal and subdermal connective tissue with an intensification of staining at the dermal-epidermal junction (DEJ). Staining for types III and V collagen was concentrated around blood vessels. Type V collagen was also localized in basal and periderm cells of the epidermis. By immuno-SEM, types I and III were found associated with collagen fibrils, and type V was localized to dermal cell surfaces and to a more limited extent with fibrils. The results of biochemical analyses for relative amounts of types I, III, and V collagen in fetal skin extracts were consistent with immunoperoxidase data. Type I collagen was 70-75%, type III collagen was 18-21%, and type V was 6-8% of the total of these collagens at all gestational ages tested, compared to 85-90% type I, 8-11% type III, and 2-4% type V in adult skin. The enrichment of both types III and V collagen in fetal skin may reflect in part the proportion of vessel- and nerve-associated collagen versus dermal fibrillar collagen. The accumulation of dermal fibrillar collagen with increasing age would enhance the estimated proportion of type I collagen, even though the ratios of type III to I in dermal collagen fibrils may be similar at all ages. PMID- 3521253 TI - Hypnotherapy for chronic tongue sucking: a case study. PMID- 3521254 TI - Formulation and evaluation of supplementary foods for Thai pregnant women. AB - To improve maternal nutritional status and to ameliorate protein-energy malnutrition in pregnant women and infants, supplementary foods for rural pregnant women were formulated and evaluated. Six formulas with protein and energy contents of 16-22 g and 350-500 kcal/100 g food, respectively, were developed from locally available raw materials. A field evaluation of formulas I and V was conducted at the regional MCH Center at Rajchaburi, about 120 km from Bangkok. Formulas providing 13 g protein and 350 kcal per day were given to two groups of mothers in the first or second pregnancy, starting at 28 +/- 2 wk of gestation. A third group, unsupplemented, served as controls. Maternal weight gain and left mid-arm circumference were measured every 2 wk. Birth weight, length, head and chest circumferences of newborns, and placental weight were significantly higher in both supplemented groups. These findings suggest that among undernourished mothers, supplementation of as little as 13 g protein and 350 kcal daily during the last trimester can significantly improve maternal weight gain and birth weight of newborns. PMID- 3521255 TI - Benzydamine HCl, a new agent for the treatment of radiation mucositis of the oropharynx. AB - Benzydamine HCl is a new nonsteroidal analgesic and anti-inflammatory compound which is not chemically related to local anesthetics such as procaine and xylocaine. A double-blind, randomized clinical investigation was carried out to determine the analgesic and anti-inflammatory effectiveness of benzydamine HCl in patients with radiation-induced mucositis of the oropharynx. Of the 67 patients in the study, 37 were on benzydamine and 30 on placebo. Patients developed radiation mucositis, hyperemia, and throat pain when the total radiation dose reached above 2,000 rad over 2 weeks (200 rad per fraction, five treatments per week). Analysis of the data showed that benzydamine HCl used as a rinse/gargle provided a statistically significant and clinically meaningful alleviation of the symptoms of oropharyngeal mucositis. There was also significant improvement in terms of reduction in hyperemia and mucositis in benzydamine group. No systemic side effects associated with benzydamine medication were noted. In view of the relative ineffectiveness of systemic analgesics and topical anesthetics for these conditions, benzydamine HCl promises to be a useful addition to the therapeutic armamentarium. PMID- 3521256 TI - Surgery for neonatal acalculous cholecystitis. PMID- 3521257 TI - The role of dietary protein in progressive renal disease. AB - Recently, a renewed interest in the role of dietary protein intake in the treatment of progressive renal disease has occurred. Early investigators suggested that high protein intake had a deleterious effect on renal function. Animals fed a high protein intake had more proteinuria and more-extensive glomerular sclerosis compared with animals fed a normal protein intake. More recent investigations have revealed that not only will a high protein intake exacerbate renal disease but a low protein intake will slow and/or prevent decline in renal function and the severity of renal histologic changes. These studies have provided the stimulus for investigations involving humans. Such studies suggest that patients with progressive renal disease of various causes, when placed on low-protein diets (0.6 g/kg/d), exhibit a slowing of the decline in renal function. The mechanism of the halting of such progression has been suggested to be a reduction in the hyperfiltration that occurs in the remaining nephrons after renal injury is established. Micropuncture studies have indicated that after the kidney has suffered injury, either through disease process or surgical removal, the unaffected nephrons try to maintain overall function, with individual nephrons increasing their filtration. This increase in single-nephron glomerular filtration rate (GFR) is accompanied by increases in single-nephron blood flow and an increase in transcapillary pressure, with altered membrane permeability, resulting in increased proteinuria. This increase in filtered albumin is taken up by the mesangium, with resulting mesangial expansion and glomerular sclerosis, with impingement on the glomerular filtering surface area, ultimately resulting in further decreases in GFR. Lowering protein intake will prevent this hyperfiltration, albuminuria, and the histologic changes. Furthermore, whether reduced protein intake is needed during times of physiologic increases in GFR (pregnancy, unilateral nephrectomy) is not clear. The processes that occur from the time after ingestion of protein to changes in GFR are not known but are probably mediated by systemic or intrarenal hormones. When adjusting protein intake, the minimum recommended dietary allowance for daily protein requirements must be considered. In adults, this level is 0.5 g/kg/d, with lower intakes requiring supplementation with essential amino acids. Requirements for children vary according to age--the younger the child, the higher the requirement. Minimum requirements for children with renal insufficiency have not been established.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3521259 TI - Efficacy of activated charcoal in reducing intestinal gas: a double-blind clinical trial. AB - Available data on the efficacy of activated charcoal in reducing lower intestinal gas and accompanying symptoms are conflicting. We conducted a double-blind clinical trial on two population groups in the United States (n = 30) and India (n = 69) known to differ in their dietary habits and ecology of gut flora. Using lactulose as the substrate, breath hydrogen levels were measured to quantify the amount of gas produced in the colon. In comparison to a placebo, activated charcoal significantly (p less than 0.05) reduced breath hydrogen levels in both the population groups. Symptoms of bloating and abdominal cramps attributable to gaseousness were also significantly reduced in both groups by activated charcoal. PMID- 3521258 TI - Effectiveness of rimantadine prophylaxis of children within families. AB - With recent studies suggesting that children are the main introducers of influenza infections into families, we conducted a placebo-controlled, double blind, randomized trial to study the prophylactic effectiveness of rimantadine hydrochloride in children on the transmission of influenza A infections within families. One hundred forty-five volunteers from 35 families completed this study during a naturally occurring outbreak of influenza A (H1N1) infection. Influenza infections, defined as a positive viral throat culture or a fourfold increase in antibody titer, occurred in 31.7% of children in the placebo group and 2.9% of children in the rimantadine group. Clinical illness with laboratory evidence of influenza infection occurred in 17.0% of children in the placebo group and 0% of children in the rimantadine group. Rimantadine was well tolerated by the children, with no significant difference in reported side effects between the placebo and rimantadine groups. Influenza A infection occurred in 19.0% of adults whose children were receiving a placebo and 8.8% of adults whose children were receiving rimantadine. On the basis of our study, rimantadine prophylaxis of children appears to be an effective method to prevent influenza A infection in children. Additional studies are needed to demonstrate the effects of rimantadine prophylaxis of children on the incidence of influenza A infection in their parents. PMID- 3521260 TI - Tuberculosis--a bridge to chronic disease epidemiology. PMID- 3521262 TI - In wartime: options for epidemiology. PMID- 3521261 TI - Total energy intake: implications for epidemiologic analyses. AB - Associations between intake of specific nutrients and disease cannot be considered primary effects of diet if they are simply the result of differences between cases and noncases in body size, physical activity, and metabolic efficiency. Epidemiologic studies of diet and disease should therefore be directed at the effect of nutrient intakes independent of total caloric intake in most instances. This is not accomplished with nutrient density measures of dietary intake but can be achieved by employing nutrient intakes adjusted for caloric intake by regression analysis. While pitfalls in the manipulation and interpretation of energy intake data in epidemiologic studies have been emphasized, these considerations also highlight the usefulness of obtaining a measurement of total caloric intake. For instance, if a questionnaire obtained information on only cholesterol intake in a study of coronary heart disease, it is possible that no association with disease would be found even if a real positive effect of a high cholesterol diet existed, since the caloric intake of cases is likely to be less than that of noncases. Such a finding could be appropriately interpreted if an estimate of total caloric intake were available. The relationships between dietary factors and disease are complex. Even with carefully collected measures of intake, consideration of the biologic implications of various analytic approaches is needed to avoid misleading conclusions. PMID- 3521263 TI - Interaction between leukocytes and serum plasminogen: an essential mechanism in peripheral blood fibrinolytic activity. AB - Intense fibrinolytic activity (FA) by granulocytes, mononuclear adherent cells, and natural killer (NK) cells was demonstrated by using 125I-fibrin-coated wells. This FA was greatly dependent on serum plasminogen, provided that serum inhibitors were destroyed by heating at 56 degrees C. Using monoclonal antibodies, it was also observed that these leukocytes produce urokinase and that this enzyme is secreted during adhesion by mononuclear adherent cells and during the cytotoxicity reaction against neoplastic cells by NK cells. Since cell intactness is necessary for leukocyte-serum interaction, stress is placed on the membrane function. We conclude that leukocytes are essential in peripheral blood FA and that transport of urokinase by circulating cells, inside their cytoplasm, could offset its lack of affinity for fibrin and thus avoid undesirable systemic effects. PMID- 3521264 TI - The effects of splenectomy on engraftment and platelet transfusion requirements in patients with chronic myelogenous leukemia undergoing marrow transplantation. AB - Granulocyte and platelet recovery as well as platelet transfusion requirements following allogeneic marrow transplantation were analyzed in 67 patients with chronic myelogenous leukemia in the chronic phase. Twenty patients had splenectomy prior to transplantation. Forty-seven patients were transplanted without splenectomy, 21 of whom had splenic enlargement by physical examination. There were no differences in the proportion of patients with granulocyte recovery, but the recovery of peripheral granulocytes to levels of 200, 500 and 1,000/mm3 occurred more rapidly in the splenectomy group than in the no splenectomy group. Patients with splenectomy received platelet transfusions for a mean of 10 (2-36) days as compared to 20 (3-82) days for patients without splenectomy (p less than .001). Eighteen (90%) patients with splenectomy became platelet transfusion independent at a median of 16 (2-32) days after transplantation as compared to 40 (85%) patients without splenectomy who became transfusion independent at a median of 28 (15-86) days (p less than .001). The proportion of patients achieving platelet levels of 50 and 100 X 10(3)/mm3 did not differ between the two groups (p = .07), but patients in the splenectomy group achieved these levels more rapidly following transplant (p less than .001). One of 17 evaluable patients in the splenectomy group and 31 of 46 in the no splenectomy group became refractory to random platelets (p less than .001) and required platelets from family members or unrelated completely or partially HLA matched donors. In the no-splenectomy group, splenic size did not affect the speed of granulocyte or platelet recovery or platelet transfusion requirements.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3521266 TI - Pulmonary calcinosis after renal transplantation in pediatric patients. AB - Pulmonary calcinosis is a recognized complication of renal failure. The resulting pulmonary compromise may be severe or even fatal. The potential contribution of hypercalcemia, hyperphosphatemia, and increased calcium-phosphorus product to the development of pulmonary calcinosis has been controversial. We describe four patients (ages 2 1/4 to 18 years) who had severe pulmonary calcinosis and respiratory failure within three to five days after renal transplantation. Initial clinical and roentgenographic findings suggested noncardiogenic pulmonary edema. Marked pulmonary hypertension was present in the two patients in whom pulmonary artery pressure data were available. Other clinical features in common included poor allograft function with persistent uremia requiring dialysis and evidence of moderate to severe secondary hyperparathyroidism. In three of the patients, the calcium-phosphorus product increased markedly after transplantation, to peak values of 122 to 147. This increase occurred at the same time as the onset of respiratory failure. Peak serum calcium levels were 10.0 to 11.0 mg/dL and peak serum phosphorus levels were 9.2 to 13.5 mg/dL. All patients died of respiratory failure five to 58 days after transplantation. The posttransplantation period may be a time of increased risk of potentially fatal pulmonary calcinosis in pediatric renal transplant recipients. The diagnosis should be considered in any patient with respiratory failure of unknown cause following renal transplantation. PMID- 3521265 TI - A role for antiidiotypic antibodies in immunologically mediated nephritis. AB - In summary, evidence exists that immunologically mediated renal diseases can be modulated by interfering with the mechanism of production of autoantibodies by specific antiidiotypic immunity. However, more studies are necessary to establish efficient and safe parameters from which to suggest such treatment in human immune nephritides. Although the evidence is still circumstantial, it is necessary to keep in mind that antiidiotypic antibodies may also add to glomerular immune deposits and potentially could contribute to the chronicity of some forms of immunologic nephritis. The fate of the majority of immunologic nephritides is a slow progression toward end-stage renal insufficiency. Although in most cases the etiology remains to be determined, it is generally felt that a better understanding of the initial immune dysregulation may lead to a greater possibility of control and cure. In this perspective, new directions of research, such as the one reviewed here, should be considered. Modulation of the damaging autoimmune responses in SLE or Goodpasture's Syndrome might be possible. For instance, the identification of a cross-reacting idiotype among anti-GBM antibodies would be the first step for a possible future use of natural or synthetic idiotypes for autovaccination purposes. Antiidiotype antibodies, particularly in the form of monoclonal chimaeric (mouse/human) hybridomas, could be utilized for passive immunosuppression, particularly in combination with plasmapheresis, with or without conventional immunosuppressive drugs. Clearly, this is part of a long-term process that may or may not be realized. The success of new forms of specific immunologic treatment for kidney diseases may ultimately depend upon ongoing efforts in the study of the new molecular aspects of regulation of potential nephritogenic immune responses. PMID- 3521267 TI - Re-evaluation of urine mutagenicity of pharmacy personnel exposed to antineoplastic agents. PMID- 3521268 TI - Roster of residents completing ASHP-accredited programs in calendar year 1986. American Society of Hospital Pharmacists. PMID- 3521270 TI - Empiric antibiotic therapy for granulocytopenic cancer patients. AB - Many cancer patients become granulocytopenic as a result of therapy and, as such, are likely to have fever during neutropenic episodes. Approximately 20 percent of these episodes have an associated gram-negative rod bacteremia; these infections occur among the most profoundly granulocytopenic patients and are associated with the highest mortality. Most infections are caused by one of three organisms: Escherichia coli, Pseudomonas aeruginosa, or Klebsiella pneumoniae. The standard approach to therapy has been the empiric utilization of an antibiotic combination, most often an aminoglycoside with either an anti-Pseudomonas penicillin or a cephalosporin. In patients for whom concern about aminoglycoside associated nephro- or ototoxicity is high, a double beta-lactam combination has been considered. Also, with the introduction of increasingly active, exceptionally broad-spectrum antimicrobials, empiric therapy with single agents has been considered. Beta-lactam/aminoglycoside combinations more often than not are synergistic, although antagonism can be detected on occasion. Some double beta-lactam combinations demonstrate antagonism, whereas in other cases, synergism, or at least partial synergism, can be observed. Antibiotic combinations can be evaluated through in vitro models, such as the capillary model system, or through animal models designed to mimic the neutropenic state with gram-negative bacteremia, to determine potential agents or combinations of agents for this patient population. These preclinical approaches have suggested that some agents may prove effective as monotherapy and, indeed, have been comparable in activity to some of the standard antibiotic combinations. However, clinical trials have had insufficient numbers of particularly high-risk patients with profound, persistent granulocytopenia and gram-negative rod bacteremia to be able to assess their usefulness in such patients. In general, it still appears to be advantageous to use combinations such as those used in the most recent European Organization for Research on Treatment of Cancer antimicrobial trial, which compared azlocillin/amikacin with ceftazidime/amikacin. In order to reduce aminoglycoside toxicity, patients were randomly assigned to receive amikacin either for a short period or for the entire length of therapy. The study should help to determine whether it is possible to maintain the advantages of two-drug combinations while reducing the disadvantages of prolonged aminoglycoside therapy. PMID- 3521269 TI - A double beta-lactam combination versus an aminoglycoside-containing regimen as empiric antibiotic therapy for febrile granulocytopenic cancer patients. AB - The double beta-lactam combination of moxalactam plus piperacillin was compared with the aminoglycoside-containing regimen of moxalactam plus amikacin in a prospective, randomized trial of empiric therapy for 302 febrile episodes in granulocytopenic cancer patients. The moxalactam/piperacillin regimen was found to be as effective as the moxalactam/amikacin regimen (70 percent overall responses); responses with moxalactam/piperacillin and moxalactam/amikacin were similar for microbiologically documented infections (24 of 37, 65 percent, versus 20 of 35, 57 percent), for the subgroup with bacteremias (19 of 32 versus 14 of 28), and for clinically documented infections (41 of 58, 71 percent, versus 40 of 48, 83 percent). Responses were similar also for bacteremia in patients with persistent, profound (less than 100/microliter) granulocytopenia. Among profoundly (less than 100/microliter) granulocytopenic patients with gram negative bacteremia, an increase in the granulocyte count to more than 100/microliter during therapy and a peak bactericidal activity of 1:16 or more (the latter noted in seven of nine moxalactam/piperacillin trials and six of nine moxalactam/amikacin trials) correlated with a favorable clinical response in 85 percent (p less than or equal to 0.00003) and 92 percent (p less than or equal to 0.044), respectively. Although serious side effects were minimal with either regimen, the double beta-lactam combination was associated with significantly less frequent nephrotoxicity (two of 145 versus 12 of 130; p less than or equal to 0.003) and ototoxicity (none of 34 versus seven of 34; p less than or equal to 0.006). The double beta-lactam combination of moxalactam plus piperacillin was found to be as effective as moxalactam plus amikacin but to have significantly less nephro- and ototoxicity. PMID- 3521271 TI - Concept of empiric therapy with antibiotic combinations. Indications and limits. AB - It appears that the use of antibiotic combinations, especially synergistic ones, is indicated for the management of gram-negative bacillary sepsis in granulocytopenic patients. Synergism is a valuable factor in increasing the serum bactericidal activity, which is highly likely to be important for a favorable outcome in these infections. The potential side effects of antimicrobial combinations should not deter clinicians from their use. The most frequently used combinations for gram-negative bacillary infections are those involving beta lactams and aminoglycosides. Other potentially synergistic combinations exist as well; however, the clinical experience with these combinations is limited, and, as with double beta-lactam combinations, their potential for antagonism necessitates care when using them. Besides gram-negative bacillary sepsis in granulocytopenic patients, severe staphylococcal infections might represent an indication for the use of combination therapy, especially in patients with compromised mechanisms of defense against infection. PMID- 3521272 TI - Empiric antimicrobial therapy with aztreonam or ceftazidime in gram-negative septicemia. AB - In an open, comparative study, 225 patients with severe underlying diseases and suspected gram-negative bacillary septicemia were randomly assigned to receive aztreonam or ceftazidime empirically, 2 g intravenously three times daily. Twenty five patients in the aztreonam group and 22 in the ceftazidime group had blood cultures that grew aerobic gram-negative bacilli and were evaluable for response to therapy. All pathogenic strains were sensitive to treatment. In the aztreonam group, 22 (88 percent) patients had cures, three (12 percent) had failures, and seven (28 percent) had development of superinfections (five were caused by gram positive cocci and two by fungi). In the ceftazidime group, 18 (82 percent) patients had cures, one had improvement, three (14 percent) had failures, and three had superinfections. The median peak serum bactericidal activity was 1:2,048 after aztreonam administration and 1:512 after ceftazidime administration. Failures were not related to resistant strains or to low serum bactericidal activity. PMID- 3521273 TI - Monotherapy for empiric treatment of fever in granulocytopenic cancer patients. AB - Infection remains a major complication of severe granulocytopenia. The administration of empiric antibiotic therapy at the first sign of infection or fever has significantly reduced the sequelae of infection in such compromised patients. Yet, the appropriate composition of the empiric antibiotic regimen continues to be debated. Antibiotic combinations have been the standard approach; multiple studies have confirmed the importance of antibiotic combinations in patients who are profoundly granulocytopenic and have gram-negative rod bacteremia. The presence of a synergistic antibacterial effect and high serum bactericidal activity of the antimicrobial regimen improves the response rate in such severe infectious episodes. However, the occurrence of such infections at certain centers is declining, and the introduction of new, highly active, broad spectrum beta-lactam antibiotics has raised the question of using a single agent, or monotherapy, as empiric treatment of febrile granulocytopenic cancer patients. Approximately 20 studies have been completed, and although these trials have demonstrated support for this approach, caution must be exercised because of the inconsistent study designs, wide range of response definitions, small patient numbers, and limited frequency of treated documented infections. Therefore, at present, a broad-spectrum antibiotic combination still remains the treatment of choice for empiric therapy of febrile granulocytopenic cancer patients. Carefully designed, prospective, randomized, double-blind trials investigating new approaches, such as monotherapy, must continue. PMID- 3521274 TI - New therapies for aplastic anemia. PMID- 3521275 TI - Management of advanced stage squamous cell carcinoma of the head and neck. AB - Squamous cell tumors of the head and neck make up 5% of tumors diagnosed in this country. The combination of excessive tobacco and alcohol use is the most common causative factor for these tumors. Their natural history is characterized by a tendency for early local-regional recurrence and the late appearance of distant metastases. A significant proportion of patients present with advanced (stage III or IV) disease, which has a poor prognosis when treated with surgery and radiotherapy. The use of adjuvant chemotherapy with surgery and radiotherapy in previously untreated patients holds promise for improving cure rates in patients with this disease. The use of chemotherapy in patients with recurrent head and neck tumors results in response in approximately one third of patients. The majority of these responses are partial and short-lived, but those patients achieving a complete remission appear to have a significant prolongation of survival. The combination of chemotherapy and radiotherapy in patients with advanced disease is being tested in a number of trials. It is hoped that this combination will increase the response rate and result in prolonged survival. PMID- 3521276 TI - Treatment of silastic catheter-induced central vein septic thrombophlebitis. AB - Two patients with surgically implanted right atrial silastic catheters for home hyperalimentation developed central vein septic thrombophlebitis. Initial treatment including removal of the catheter and antibiotic therapy was unsuccessful and both patients had persistent fever and bacteremia. A clinical and microbiologic response occurred when anticoagulation therapy with heparin was added to the treatment regimen. Although a surgical approach has been emphasized in patients with peripheral vein suppurative thrombophlebitis, anticoagulation therapy may be a useful alternative in the treatment of patients with central vein infection. PMID- 3521278 TI - Evaluation of serum CA125 values in healthy individuals and pregnant women. AB - CA125 is an antigenic determinant associated with human epithelial ovarian carcinoma. This study was undertaken to evaluate the distribution of serum CA125 levels and the effect of smoking on these levels among healthy individuals and clarify the relation of maternal serum CA125 level and pregnancy. Among 552 healthy individuals, the distribution of serum CA125 values was demonstrated to resemble logarithmic normal distribution. Analysis of variance about age and sex revealed apparent elevation of values for women under 49 years of age in comparison with those for women over 50 years of age and men. Values for these two groups were 143 units/ml for the former and 32 units/ml for the latter, with a 99.7% confidence limit. These values exclude 99.3% of the former and 99.7% of the latter. Serum CA125 values were not affected by smoking. The measurement of serum CA125 levels in 71 pregnant women disclosed a significant elevation during the first trimester in comparison with nonpregnant women under 49 years of age. These results indicate that CA125 values must be deliberatively evaluated in young women, especially during first trimester of pregnancy. PMID- 3521277 TI - The effect of naproxen on acute mountain sickness and vascular responses to hypoxia. AB - The role of prostaglandins in the pathogenesis of acute mountain sickness and two hypoxia-induced vascular responses was evaluated using the cyclooxygenase inhibitor naproxen. Eleven men spent 24 hours at sea level, followed by 34 hours of decompression to 428 mm Hg while receiving naproxen (N), 250 mg twice daily or placebo (P) in a double-blind crossover trial. Serum naproxen levels measured by high pressure liquid chromatography were not changed by hypoxia. The severity of acute mountain sickness (AMS) by the Environmental Symptom Questionnaire scores and observer assessment were unaffected by drug treatment. Retinal artery diameter measured from projected fundus photographs was increased after 27 hours at altitude (11.4 +/- .5 mm) vs. sea level (9.4 +/- .5 mm, p less than 0.05) during both trials. Upright mean arterial pressure fell after 6 hours at altitude (79 +/- 3 mm Hg during N and P vs. 92 +/- 3 at sea level, p less than 0.01). Minute ventilation, end expiratory alveolar PO2 and PCO2 did not differ between drug trials. This study suggests vasodilating prostaglandins do not have a major role in the genesis of AMS, hypoxia-induced retinal vasodilatation, or postural blood pressure responses in man. PMID- 3521279 TI - Antioxidants in sickle cell disease: the in vitro effects of ascorbic acid. AB - The authors examined the ability of antioxidants to prevent in vitro oxidant damage to the sickle red blood cell (RBC). One millimolar ascorbic acid and alpha mercaptopropionylglycine significantly (p less than 0.005) protected against RBC Heinz body formation during incubation with acetylphenylhydrazine, while cysteine, cysteamine, and methionine did not. The effect of ascorbic acid was concentration dependent with concentrations as low as 0.1 mM having significant antioxidant effects. Ascorbic acid protected the RBC against hydrogen peroxide induced hemolysis as well (p less than 0.05). Ascorbic acid had a significant stimulatory effect on the rate of glucose oxidation by the pentose phosphate shunt (PPS), especially in the sickle RBC. Ascorbic acid did not protect the RBC from a patient with chronic hemolytic anemia due to G6PDTorrance from Heinz body formation, suggesting that an intact PPS is necessary for ascorbic acid to express its antioxidant properties. These data suggest that clinical trials should be undertaken to examine the efficacy of ascorbic acid in the treatment of SCD. PMID- 3521280 TI - Pathogenesis of type 2 diabetes mellitus: an interpretation of current data. AB - The available evidence concerning the pathogenesis of type 2 diabetes mellitus suggests that although insulin antagonism is common to many patient groups (i.e., obese, older), overt NIDDM will only develop in a subset who may have a genetic susceptibility for inadequate beta-cell reserves. Since the role of a receptor defect in causing type 2 diabetes is doubtful, the insulin antagonism in these patients is due to a post-receptor defect. PMID- 3521281 TI - Introduction to living history--biography of Arthur Barclay Chapman. PMID- 3521282 TI - Living history--a biography of Arthur B. Chapman. PMID- 3521283 TI - Ectopic pregnancy on the rise. PMID- 3521284 TI - Corneal transplantation. PMID- 3521285 TI - Do-it-yourself lit searching. PMID- 3521286 TI - In the mind's eye. PMID- 3521287 TI - A visit to Scutari (Florence Nightingale). PMID- 3521288 TI - Carcinogens: are some risks acceptable? PMID- 3521289 TI - Books that help. A nurse's guide to self-health books. PMID- 3521290 TI - Ultrasonographic evidence of uterine malignancy in the postmenopausal uterus. AB - The sonographically enlarged uterine cavity in the postmenopausal woman has been described as indicative of uterine malignancy. In this study, in 10 of 15 cases of proven uterine malignancy with prior pelvic sonographic studies there was evidence predicting the diagnosis. In 10 of 12 cases with positive sonographic findings, uterine malignancy was found at operation. This reveals a 67% rate of success as to the value of negative sonographic findings and an 83% rate of success with positive findings. Pelvic sonography is not a screening test for uterine malignancy, but if positive findings are present, surgical investigation is indicated. PMID- 3521291 TI - Modified retropubic cystourethropexy. AB - A variation of retropubic suspension of the urethrovesical junction was performed on 26 patients with urinary stress incontinence. Access to the retropubic space was through a low transverse muscle-splitting incision. Surgical technique consisted of securing a helical Prolene suture in the paraurethral fascia at each side of the bladder neck. Each suture was then passed through the abdominal wall fascia, exiting just above the symphysis pubis on either side of the midline, and tied to the opposite suture above the rectus fascia. The desired amount of elevation of the vesical neck was gauged by a Q-tip applicator inserted into the urethra just before the Prolene sutures were tied down. A cystotomy was performed to rule out any inadvertent penetration of the bladder by the nonabsorbable suture material, and the bladder was drained suprapubicly. The small number of cases and short follow-up times do not allow conclusions to be drawn at this time, but results to date have been encouraging. PMID- 3521292 TI - Chorionic villus sampling in continuing pregnancies. I. Low fetal loss rates in initial 109 cases. AB - Among the first 150 women who agreed to have chorionic villus sampling after receiving counseling and giving informed consent, 41 proved ineligible. In six (5.5%) of the remaining 109 cases in which chorionic villus sampling was performed, we were unsuccessful in obtaining an adequate amount of villi to permit diagnostic testing. In the single loss, fetal viability was confirmed 2 weeks after sampling; however, fetal death became evident 3 weeks later. In four (3.7%) cases the pregnancies were terminated because of abnormal results, and in one (0.9%) case the pregnancy was electively terminated after normal results. Among the 41 completed pregnancies no anomalies were evident in the infants. There were two premature deliveries; one of these two infants died shortly after birth following premature rupture of the membranes at 29 weeks' gestation. All undelivered cases were progressing normally at the time of submission. PMID- 3521293 TI - Ultrasonic hyperthermia and radiation in the management of intraocular malignant melanoma. AB - Hyperthermia and radiation were used in combination to treat four patients with choroidal malignant melanoma. This technique uses ultrasonically induced hyperthermia synergistically with radiation to destroy tumor cells. The lower levels of radiation used should avoid the late vascular and inflammatory complications seen in conventional radiation therapy. Tumors were scanned by a computerized diagnostic ultrasound system before treatment and assigned an acoustic tissue type on the basis of a statistical comparison of their ultrasound backscatter spectrum with spectra of tumors of known pathologic status. During the follow-up period, the longest of which was 15 months, all tumors demonstrated regression patterns consistent with choroidal tumors of the same acoustic tissue types treated with conventional radiation therapy. PMID- 3521294 TI - Foreign-body giant cell reaction to liquid silicone. AB - Although intravitreal injections of liquid silicone have long been used in complicated retinal detachments and long-term complications such as keratopathy, glaucoma, and cataract are well-known, the effect of liquid silicone on the retina, iris, and angle structures is not as well defined. Histopathologic study of one human eye that was enucleated 20 months after liquid silicone injection showed an intraocular foreign-body giant cell reaction. PMID- 3521295 TI - Effect of trephine tilt on corneal button dimensions. AB - Wound disparity, mismatch between the size and shape of the donor corneal button and its wound, probably determines the direction and amount of postkeratoplasty astigmatism. Tilting a hand-held trephine is thought to contribute to an oval wound and to wound disparity. We examined the contribution of trephine tilt to wound size and shape. Eyebank eyes were hand trephined at 0, 5, 10, 15, 20, and 25 degrees of tilt. The button endothelial edges were analyzed by the photogrammetric index method. All index values were significantly different from those for a theoretically circular or symmetric button. Although the most oval buttons were at 20 and 25 degrees, buttons were similarly oval and asymmetric for trephine tilt from 0 to 15 degrees. Neither ovality nor asymmetry correlated with angle of tilt. Even when no attempt is made to tilt a hand-held trephine, oval and irregularly shaped wounds may result. PMID- 3521296 TI - Myopic shift in refraction after penetrating keratoplasty with pediatric donor tissue. PMID- 3521297 TI - An occupational therapy protocol for assessing infants and toddlers who fail to thrive. AB - Children who "fail to thrive" are frequently referred to occupational therapists. Yet there is no organized protocol that therapists could use to assess these children. This paper reviews criteria that distinguish organic from nonorganic "failure to thrive" and describes the occupational therapist's contribution to the evaluation process. An occupational therapy protocol is presented to facilitate a thorough assessment, emphasizing feeding issues and caretaker-child interaction. PMID- 3521298 TI - The literature of occupational therapy: a citation analysis study. AB - A citation analysis was done on literature cited in 1978, 1980, and 1982 issues of the American Journal of Occupational Therapy. The results confirmed two impressions. The body of literature specific to occupational therapy is very small. But the body of literature potentially relevant to the work of the occupational therapist is very large, covering many disciplines. An unexpected finding was the reliance on older literature. Implications of these three findings are discussed. PMID- 3521299 TI - The self-esteem of adolescents with cerebral palsy. AB - This paper examined the self-esteem of 22 adolescents with cerebral palsy (CP) (11 girls, 11 boys) who were matched by sex, school, age, and IQ with 22 nondisabled adolescents. Subjects completed the Tennessee Self-Concept Scale (TSCS), the Family Adaptability and Cohesion Evaluation Scale II (FACES II), and a demographic questionnaire. Multivariate analysis of variance revealed that the girls with CP scored significantly lower than the boys with CP, the nondisabled boys, and nondisabled girls on physical self-esteem, and the nondisabled girls and boys with CP on social self-esteem. The scores of the boys with CP were similar to those of the nondisabled groups. This differential effect of disability on males and females is discussed in terms of the interactionist theory and the implications for occupational therapy. PMID- 3521300 TI - Shear strength of brackets bonded to anterior and posterior teeth. AB - A study was undertaken to determine the maximum shear strength of brackets bonded to anterior and posterior teeth. Brackets were bonded to two groups comprising 12 incisor and 12 molar teeth. After storage in water at 37 degrees C for 10 days, each bracket was tested to failure in a shear mode in a Instron machine. The mean value for the incisors was 164.3 +/- 35.1 kg/cm2 (16.1 +/- 3.4 MPa) and 115.7 +/- 41.1 kg/cm2 (11 +/- 4.0 MPa) for molars. These values, analyzed in a two-tailed test, were statistically different at the 0.01 level of confidence. It was concluded that differences in etching patterns do not necessarily affect shear bond strength and that the predominantly weak link in the bonding chain was at the bracket/resin interface. The lower values for molar teeth may relate to adaptation of the bracket and nonuniform resin thickness. PMID- 3521301 TI - Phenotypic transformation of macrophages to Langerhans cells in the skin. AB - Langerhans cells, important participants in the cutaneous cellular immune response, are markedly diminished in skin of patients undergoing allogeneic bone marrow transplantation during the first 4 weeks after this procedure. To determine the mechanism responsible for the subsequent repopulation of these cells, the authors studied the immunophenotypic and morphologic profiles of sequential skin biopsies during the posttransplantation period. Cells with surface antigens of monocytes/macrophages within the superficial dermis were gradually replaced by dermal and epidermal dendritic cells exhibiting coexpression of monocyte/macrophage and Langerhans cell surface antigens. Ultrastructural examination revealed that many of these cells contained both prominent phagolysosomes and Birbeck granules. Antigenically and structurally mature Langerhans cells were observed within the epidermis by the end of the second month after transplantation. Phenotypic transformation of phagocytic dermal macrophages to Langerhans cells appears to represent a mechanism for repopulation of Langerhans cells during the period of immunologic reconstitution in this patient population. PMID- 3521302 TI - Follicular large cell lymphoma. An immunophenotype study. AB - The authors investigated 17 cases of follicular large cell lymphoma using monoclonal antibodies applied to frozen sections. The neoplastic cells in 11 cases (65%) showed evidence of immunoglobulin expression similar to the reported percentage of immunoglobulin expressing diffuse large cell lymphomas and lower than seen in low grade follicular lymphomas. All cases showed expression of the B lineage markers T015, B1, and 4G7, and HLA-DR. CALLA was present in all but 1 case, similar to that reported for follicular lymphomas, and much higher than reported for diffuse large cell lymphoma. Approximately one-half of the cases showed weak expression of Tac, 5 cases expressed B2 (C3d), and 3 cases expressed T05 (C3b). Variable expression was seen for the Ki-67 antigen. A CR4/23+, B2+, T05+ dendritic population was identified in all cases. An interfollicular host T cell infiltrate was noted, mainly phenotypic helper cells. This study demonstrates that follicular large cell lymphoma has immunologic similarities to both diffuse large cell lymphoma and the low grade follicular lymphomas. PMID- 3521304 TI - Preservation of otologic homografts. AB - Techniques for preservation of homografts for replacement of tympanic membranes, ossicles, closure of the oval window, and canalplasty remain controversial. Review of 300 articles reveals no evidence opposing the harvesting of grafts from living patients or cadavers, or the prolonged storage of these materials in antibacterial solutions. It appears to be important to store the grafting material long enough to reduce antigenicity. Numerous techniques and materials are being used with success. Additional research on antigens, histologic fate of grafts, long-term success, and complications is essential to determine ideal grafting materials, preservatives, and techniques. PMID- 3521303 TI - Studies of progressive glomerular sclerosis in the rat. AB - To obtain a better understanding of the sequential development of sclerosis in immune glomerular disease, the authors induced experimental membranous nephropathy in unilaterally nephrectomized rats and evaluated the lesions that developed over a 35-week period. Serial renal biopsies were examined by light and immunofluorescence microscopy for IgG, C3, neoantigens of the membrane attack complex (MAC), and interstitial (Type III) and basement membrane (Type IV) collagen. Urinary protein excretion increased from 208 +/- 19 mg/day to 308 +/- 36 mg/day during the period of observation. Progressive mesangial sclerosis, crescent formation, and interstitial fibrosis developed in association with deposition of Type IV but not Type III collagen in the glomeruli. Capillary wall deposits of IgG, C3, and MAC gradually decreased, whereas coarse granular deposits of C3 and MAC were visible in sclerotic areas beginning at 8 weeks. The appearance of complement components in early sclerotic lesions raises the possibility that they are of pathogenetic importance. The absence of interstitial collagen in sclerotic glomeruli suggests that the components of the lesion are produced solely by glomerular cells. PMID- 3521305 TI - Otosclerosis 1981 to 1985. Our four-year review and current perspective. PMID- 3521306 TI - Mandibular symphysis (medial suture) closure in modern Homo sapiens: preliminary evidence from archaeological populations. AB - Four archaeologically derived populations of human infants provide evidence for age at closure of the mandibular suture. These data suggest fusion by 7-8 months of age, with a range from 6 to 9 months. This provides a useful tool for age identification of the remains of young children recovered from archaeological and other contexts. PMID- 3521307 TI - Perinatal mortality at pre-Columbian Teotihuacan. AB - The skeletal population of 166 individuals from a low-status apartment compound of the pre-Columbian city of Teotihuacan contained 52 perinatal individuals. The most perilous time of the lifespan was around birth, as revealed by life table analysis. Femur length was not increasing during the last month of gestation, and individuals were probably shorter somatically at birth than modern standards or historic-period Arikara skeletal controls. The possibility of intrauterine growth retardation is investigated through paleo-pathological indicators of prenatal growth arrest. The evidence of prenatal stress and the high rate of mortality at birth seem to indicate that this New World preindustrial urban population faced similar health and nutritional stresses as Old World preindustrial cities. PMID- 3521308 TI - Synergistic improvement of glucose tolerance by sucrose feeding and exercise training. AB - The interactive effects of exercise training (5-7 wk) and sucrose consumption (ad libitum feeding of a 32% sucrose solution and Purina chow) on intravenous glucose tolerance and plasma insulin levels were investigated using a 2 X 2 experimental design. Rats were divided in Purina-sedentary, Purina-trained, sucrose-sedentary, and sucrose-trained groups. Sucrose feeding of sedentary animals significantly increased basal and glucose-stimulated insulin levels and improved basal glycemia and glucose tolerance. On the other hand, exercise training of Purina-fed animals significantly reduced basal as well as glucose-stimulated insulinemia without altering basal glycemia or glucose tolerance. Such a sparing effect of exercise training on insulin requirements was not as evident in rats consuming sucrose. These animals displayed a reduced basal glycemia (P less than 0.01) with normal basal insulin levels. Their glucose tolerance was markedly improved (P less than 0.01) but their insulin response during intravenous glucose tolerance test remained as high as in sucrose-sedentary animals. Results from these studies indicate that sucrose feeding of sedentary animals leads to hyperinsulinemia without compensatory insulin resistance, resulting in an improvement of glucose tolerance, exercise training increases the sensitivity of peripheral tissues to insulin, and the marked improvement of glucose tolerance observed in sucrose trained animals results from a synergistic combination of the above two factors, i.e., increased insulinemia (induced by diet) and enhanced insulin sensitivity (induced by training). PMID- 3521309 TI - Role of glutamine in adaptations in nitrogen metabolism during fasting. AB - The present study examines the effect of glutamine infusion on the interorgan fluxes of glutamine, alanine, urea, and ammonia with progressive fasting. Experiments were carried out in two groups of conscious dogs with catheters previously implanted in an artery and in the hepatic, portal, and renal veins. Group I (n = 12) was fasted for 24 h, and group II (n = 10) was fasted for 96 h. On the day of the study, seven animals of group I and five of group II received a constant infusion of glutamine (3.0 mumol . kg-1 . min-1) for 1 h, and the rest (controls) received saline. Four-day fasting produced ketosis with a compensated metabolic acidosis. The demand for glutamine by the kidneys and gut increased, and the liver switched from net glutamine utilization to that of net production. The kidneys (33%) and gut (230%) increased their production of ammonia, while their release of alanine decreased. The estimated efflux of glutamine by skeletal muscle, however, did not change. All of the infused glutamine was cleared by the splanchnic and renal tissues. In group I, there was increased gut production of alanine, which was matched by increased hepatic alanine uptake and urea production. No such changes were observed in Group II. There was, however, an increase in hepatic uptake of ammonia. Finally, glutamine infusion did not alter glutamine or alanine output by skeletal muscle in group I, while it decreased efflux of alanine but not that of glutamine in group II. The data emphasize the complex interdependence of the liver, gut, kidneys, and skeletal muscle in nitrogen sparing.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3521310 TI - Effect of sepsis on activity of pyruvate dehydrogenase complex in skeletal muscle and liver. AB - The effect of chronic sepsis on the concentration of active pyruvate dehydrogenase complex has been investigated in liver and skeletal muscle of normal, sterile inflammatory, and chronic septic (small and large abscess) animals. Hyperdynamic sepsis was induced by the intraperitoneal introduction of a rat fecal-agar pellet of known size and bacterial composition (Escherichia coli + Bacteroides fragilis). Total pyruvate dehydrogenase complex activity was not altered in either liver or skeletal muscle in any of the conditions studied. In hepatic tissue, sterile inflammation increased the proportion of active complex 2.5-fold compared with control. The same increase in the concentration of active complex was observed in animals with a small abscess. When the abscess size was increased (large abscess), the concentration of active complex was decreased relative to sterile inflammatory or small abscess septic animals. In contrast to liver, sterile inflammation did not alter the proportion of active complex in skeletal muscle. Sepsis (either small or large septic abscess) resulted in threefold decrease in the concentration of active complex relative to control or sterile inflammatory animals. Changes in the concentration of active complex did not appear to be dependent on the ATP/ADP concentration ratio or tissue pyruvate levels but were consistent with changes in the acetyl-coenzyme A-to-coenzyme A concentration ratio. The mechanism responsible for altered concentration of active complex may be mediated through changes in the activity of the pyruvate dehydrogenase kinase, secondary to alterations in the effector concentration ratios. PMID- 3521312 TI - Effects of short-term hyperglycemia on insulin secretion in normal humans. AB - Stepwise glucose clamps were used to study beta-cell insulin response to glucose in normal and noninsulin-dependent diabetic subjects and to study changes in response after hyperglycemia. In normal subjects, insulin increment, delta I, correlated with glucose increment above basal, delta G, during the first 6 min of hyperglycemia, r = 0.748, P less than 0.0001. After 1 h of hyperglycemia, mean delta I/ delta G was reduced from 50 to 23 (mean difference 23 +/- 5) pmol/mmol, P = 0.0002; but delta I/% change in glucose (delta G') was unaltered (2.3 vs. 1.7, mean difference 0.4 +/- 0.3 pmol/%). Second-phase response correlated with mean glucose elevation (r = 0.835, P less than 0.0001), and no plateau was reached after 3 h at 3 mmol/l above basal glucose (rate of change of insulin concentration = 0.5; range, 0.3-0.8 pmol . l-1 . min-1). In diabetic subjects, delta I/ delta G was 20% of normal, while delta I/ delta G' was 63% of normal and second-phase response 30% of normal. We conclude that hyperglycemia per se reduces delta I/ delta G and must be considered when assessing insulin responses. Noninsulin-dependent diabetic subjects have defective first- and second-phase responses. PMID- 3521311 TI - Effect of infusing epinephrine on liver and muscle glycogenolysis during exercise in rats. AB - To determine the possibility of a threshold concentration of plasma epinephrine that stimulates liver glycogenolysis during exercise, adrenodemedullated (ADM) and sham-operated (SHAM) rats were infused with saline or epinephrine at rates that produced plasma concentrations ranging between 0.01 ng/ml (0.06 nM) and 4.3 ng/ml (23.7 nM). During the infusion rats were run on a rodent treadmill for 0, 30, or 60 min at 21 m/min up a 15% grade. Liver glycogen decreased at similar rates in all exercising rats regardless of plasma epinephrine concentration. Epinephrine infusion stimulated significant muscle glycogen depletion in the soleus and red and white vastus lateralis muscles. ADM saline-infused animals exhibited the least muscle glycogen depletion. Blood glucose and lactate in exercising ADM rats increased as the epinephrine infusion concentration increased. During exercise, there was no epinephrine concentration that stimulated liver glycogenolysis more effectively than physiological saline. PMID- 3521313 TI - In vivo metabolic changes as studied longitudinally after ventromedial hypothalamic lesions. AB - Ventromedial hypothalamic (VMH)-lesioned rats were tested 1 and 6 wk after the lesions to determine, by euglycemic-hyperinsulinemic clamps, their tissue response to insulin. One week after the lesions, total glucose metabolism was more sensitive and responsive to insulin than in age-matched controls. In the two groups, hepatic glucose production was suppressed at almost identical insulin concentrations (approximately 550 microU/ml). Six weeks after the VMH lesions, the increased insulin responsiveness of total glucose metabolism disappeared and glucose metabolism became less insulin sensitive (right, shifted dose-response curve) than that of control animals. Furthermore, hepatic glucose production of VMH-lesioned rats was now inhibited by 45% at most and at the supraphysiological insulin concentration of 16,000 microU/ml, while it was totally suppressed by 550 microU/ml of the hormone in age-matched controls. This defect was accompanied by a lack of decrease in plasma glucagon levels during the clamps carried out at maximal insulin concentration. In summary, in a first phase after VMH lesion, rats are hypersensitive and hyperresponsive to insulin; and in a later phase, when obesity is well established, VMH-lesioned rats become insulin resistant and are characterized by a decreased in vivo sensitivity and responsiveness of liver and muscles to the hormone. PMID- 3521314 TI - Adaptive changes in insulin and glucagon secretion during cold acclimation in the rat. AB - Arginine-stimulated insulin and glucagon outputs from isolated perfused pancreata of warm-acclimated and 2-, 4-, and 6-wk cold-acclimated rats (4 degrees C) were determined to assess whether observed changes in these parameters were a result of cold exposure per se or a part of the adaptive process of cold acclimation. Progressive and sequential changes were seen in both insulin and glucagon outputs. At 2 wk cold acclimation, glucagon rose and insulin output tended to fall, at 4 wk, glucagon output remained elevated and insulin output was further reduced, and at 6 wk, glucagon output had returned to control levels, whereas insulin output was substantially further reduced. These changes resulted in reduction of the insulin-to-glucagon molar ratio of the total arginine-induced output from 7.27 +/- 1.76 (SE) in the warm acclimate to 2.31 +/- 0.79 (SE) at 2 wk, 1.42 +/- 0.29 (SE) at 4 wk, and 1.26 +/- 0.21 (SE) at 6 wk cold acclimation. The data do not provide in vitro support for the hypothesis that changes in pancreatic hormone secretion in vivo are a consequence of cold exposure and not cold acclimation. PMID- 3521315 TI - Effect of free fatty acids on blood amino acid levels in human. AB - Raised plasma free fatty acid (FFA) levels effectively impede glucose uptake in vivo, thereby conserving plasma glucose and sparing glycogen. To test whether FFA have any effect on blood amino acid levels, we infused Intralipid plus heparin or saline into healthy volunteers under four different experimental conditions: A) overnight fast; B) euglycemic hyperinsulinemia (approximately 100 microU/ml); C) hyperglycemic (approximately 200 mg/100 ml) hyperinsulinemia (approximately 50 microU/ml); and D) hyperglycemic (approximately 300 mg/100 ml) normoinsulinemia (approximately 20 microU/ml). In the fasting state (A), lipid infusion was associated with lower blood levels of most amino acids, both branched chain and glucogenic. This effect, however, could not be ascribed to lipid infusion alone, because plasma insulin levels were also stimulated. The clamp studies (B, C, and D) allowed to assess the influence of lipid on blood amino acid levels at similar plasma insulin and glucose levels. It was thus observed that lipid infusion has a significant hypoaminoacidemic effect of its own under both euglycemic (B) and hyperglycemic (C) conditions; this effect involved many glucogenic amino acids (alanine, glycine, phenylalanine, serine, threonine, and cystine) but none of the branched-chain amino acids (leucine, isoleucine, and valine). In marked contrast, normoinsulinemic hyperglycemia (D), with or without lipid infusion, caused no change in the blood level of any measured amino acid. We conclude that lipid infusion has a hypoaminoacidemic action. We also suggest that this action is permitted by insulin and may involve specific metabolic interactions (e.g., reduced availability of glucose-derived pyruvate or glycerophosphate) as well as enhanced uptake by the liver. PMID- 3521316 TI - Changes in leucine kinetics during meal absorption: effects of dietary leucine availability. AB - Whole-body leucine and alpha-ketoisocaproate (KIC) metabolism were estimated in mature dogs fed a complete meal, a meal devoid of branched-chain amino acids, and a meal devoid of all amino acids. Using a constant infusion of [4,5-3H]leucine and alpha-[1-14C]ketoisocaproate (KIC), combined with dietary [5,5,5-2H3]leucine, the rate of whole-body proteolysis, protein synthesis, leucine oxidation, and interconversion of leucine and KIC were estimated along with the rate of leucine absorption. Ingestion of the complete meal resulted in a decrease in the rate of endogenous proteolysis, a small increase in the estimated rate of leucine entering protein, and a twofold increase in the rate of leucine oxidation. Ingestion of either the meal devoid of branched-chain amino acids or devoid of all amino acids resulted in a decrease in estimates of whole-body rates of proteolysis and protein synthesis, decreased leucine oxidation, and a decrease in the interconversion of leucine and KIC. The decrease in whole-body proteolysis was closely associated with the rise in plasma insulin concentrations following meal ingestion. Together these data suggest that the transition from tissue catabolism to anabolism is the result, at least in part, of decreased whole-body proteolysis. This meal-related decrease in proteolysis is independent of the dietary amino acid composition or content. In contrast, the rate of protein synthesis was sustained only when the meal complete in all amino acids was provided, indicating an overriding control of protein synthesis by amino acid availability. PMID- 3521318 TI - Heredity and changes in hormones and metabolic rates with short-term training. AB - The purpose of this experiment was to assess the effects of a 22-day training program on resting metabolic rate (RMR), thermic effect of a meal (TEM), and associated hormonal changes. Six pairs of male monozygotic twins were submitted to a 22-day ergocycle exercise program designed to induce a deficit in energy balance of 4.2 MJ per day. RMR and TEM after a 4.2-MJ meal challenge were measured before and after training. Results indicated that RMR and TEM did not change significantly, although a large variation in response between twin pairs was observed. Moreover, training reduced (P less than 0.05) basal and postprandial insulin response, plasma thyroid hormones triiodothyronine (T3), thyroxine (T4), and FT4 (P less than 0.05). Absolute changes in RMR and TEM exhibited significant within-pair resemblance in response, with intraclass correlations reaching r = 0.81 (P less than 0.05) and r = 0.72 (P less than 0.05), respectively. Changes in T4 and FT4 also exhibited moderate within-pair resemblance (0.42 less than or equal to r less than or equal to 0.71). These results suggest that short-term exercise training does not modify RMR and TEM but can significantly decrease plasma levels of insulin and thyroid hormones. Moreover, the similarity of response within twin pairs suggests that heredity plays a role in determining RMR, TEM, and thyroid hormone adaptation to exercise training generating a negative energy balance. PMID- 3521317 TI - Influence of calcium and other divalent cations on protein turnover in rat skeletal muscle. AB - When rat muscles were incubated in Ca2+-free media, their rates of protein break down were significantly lower than in complete medium (2.58 mM Ca2+). Dantrolene and 3,4,5-trimethoxybenzoic acid 8-(diethylamino)octyl ester, inhibitors of Ca2+ release from the sarcoplasmic reticulum, also reduced muscle proteolysis. When Ca2+ was added (up to 5.16 mM), proteolysis increased progressively up to 70% in the intact soleus and extensor digitorum longus muscles and up to 300% in the cut diaphragm preparation. Addition of Ca2+ did not affect the muscles' ATP or phosphocreatine content and increased protein synthesis slightly or not at all. Sr2+, Ba2+, and Mn2+ also increased proteolysis, but were less effective than Ca2+. Mg2+ inhibited the enhancement of proteolysis by Ca2+. This stimulation by Ca2+ was not affected by inhibitors of voltage-dependent Ca2+ channels, calmodulin, metalloendoproteases, microfilament or microtubule formation, or mersalyl. High Ca2+ levels also increased prostaglandin (PG) E2 production, although a rise in PGE2 did not appear essential for the increased proteolysis. The proteolysis induced by Ca2+ was prevented in muscles treated with Ep-475 or leupeptin. By contrast, these inhibitors of thiol proteases did not affect protein breakdown in Ca2+-free medium. Thus extracellular Ca2+ activates and Mg2+ inhibits a proteolytic pathway involving thiol proteases. PMID- 3521319 TI - Comparison of thermogenic effect of fructose and glucose in normal humans. AB - After nutrient ingestion there is an increase in energy expenditure that has been referred to as dietary-induced thermogenesis. In the present study we have employed indirect calorimetry to compare the increment in energy expenditure after the ingestion of 75 g of glucose or fructose in 17 healthy volunteers. During the 4 h after glucose ingestion the plasma insulin concentration increased by 33 +/- 4 microU/ml and this was associated with a significant increase in carbohydrate oxidation and decrement in lipid oxidation. Energy expenditure increased by 0.08 +/- 0.01 kcal/min. When fructose was ingested, the plasma insulin concentration increased by only 8 +/- 2 microU/ml vs. glucose. Nonetheless, the increments in carbohydrate oxidation and decrement in lipid oxidation were significantly greater than with glucose. The increment in energy expenditure was also greater with fructose. When the mean increment in plasma insulin concentration after fructose was reproduced using the insulin clamp technique, the increase in carbohydrate oxidation and decrement in lipid oxidation were markedly reduced compared with the fructose-ingestion study; energy expenditure failed to increase above basal levels. To examine the role of the adrenergic nervous system in fructose-induced thermogenesis, fructose ingestion was also performed during beta-adrenergic blockade with propranolol. The increase in energy expenditure during fructose plus propranolol was lower than with fructose ingestion alone. These results indicate that the stimulation of thermogenesis after carbohydrate ingestion is related to an augmentation of cellular metabolism and is not dependent on an increase in the plasma insulin concentration per se.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3521321 TI - Intestinal mucosa in diabetes: synthesis of total proteins and sucrase isomaltase. AB - The effects of insulin deficiency on nitrogen metabolism in muscle and liver have been extensively studied with recent in vivo demonstration of impaired protein synthesis in rats with streptozotocin-induced diabetes. Despite the significant contribution of small intestinal mucosa to overall protein metabolism, the effects of insulin deficiency on intestinal protein synthesis have not been completely defined. We studied the effects of streptozotocin-induced diabetes on total protein synthesis by small intestinal mucosa and on synthesis of a single enzyme protein of the enterocyte brush-border membrane sucrase-isomaltase. We used the flooding-dose technique of McNurlan, Tomkins, and Garlick (Biochem. J. 178: 373-379, 1979) to minimize the difficulties of measuring specific radioactivity of precursor phenylalanine and determined incorporation into mucosal proteins and sucrase-isomaltase 20 min after injection of the labeled amino acid. Diabetes did not alter mucosal mass as determined by weight and content of protein and DNA during the 5 days after injection of streptozotocin. Increased rates of sucrase-isomaltase synthesis developed beginning on day 3, and those of total protein developed on day 5. Thus intestinal mucosal protein synthesis is not an insulin-sensitive process. PMID- 3521320 TI - Formation and transport of chylomicrons by enterocytes to the lymphatics. AB - Digestion of triglyceride in the intestine results in the production of 2 monoglyceride and fatty acid. Phosphatidylcholine is hydrolyzed in the lumen to form lysophosphatidylcholine before its absorption. These digestion products are absorbed by the enterocytes through simple diffusion. In contrast, cholesterol absorption seems specific and is energy dependent. After entry into the enterocytes, these lipid digestion products migrate to the endoplasmic reticulum. Both fatty acid-binding protein and sterol carrier protein may be involved in the intracellular transport of fatty acid and cholesterol, respectively. Through predominantly the monoglyceride pathway, monoglycerides and fatty acids are resynthesized to form triglyceride in the endoplasmic reticulum. The lipid droplets, coated with cholesterol, phospholipid, and apolipoproteins, are then further processed in the Golgi apparatus before being released by the enterocytes through exocytosis. As yet, little is known of the factors regulating the formation and release of these chylomicrons by the enterocytes. Although apolipoprotein B is a prerequisite for the formation of chylomicrons, the question of whether its supply is rate limiting for chylomicron formation remains to be demonstrated. Other factors that may play a role in chylomicron formation are luminal phospholipid supply, Ca2+, and microtubules. Chylomicrons and very low-density lipoproteins are probably produced by the enterocytes via different pathways. For example, Pluronic L-81, a hydrophobic surfactant, affects only chylomicron formation and has little effect on very low-density lipoprotein production. The movement of chylomicrons from the intercellular space through the basement membrane to the lamina propria is not fully understood. Once inside the lamina propria, the movement of chylomicrons is probably by diffusion and is greatly facilitated by interstitial hydration; thus the lymphogogic effect of fat absorption may serve an important function for the transfer of chylomicrons from the enterocytes to the lacteal. PMID- 3521323 TI - Dopamine receptors modulate sodium excretion in denervated kidney. AB - Dopamine (DA) modulates sodium excretion by the innervated kidney. To examine the role of DA in the denervated (DNX) kidney the effects of the DA1/DA2 antagonist cis-flupenthixol (group 2, n = 7) (10 nmol X kg-1 X min-1), given intravenously in saline-loaded Wistar-Kyoto rats after acute unilateral left DNX, were compared with a placebo group (group 1, n = 7) and a group that received the DA1 antagonist SCH 23390 (group 3, n = 7) at 2.5 nmol X kg-1 X min-1. Pentobarbital sodium anesthesia was employed. Adequacy of DNX was assessed by a natriuresis and decrease in renal norepinephrine content in the DNX kidney and an antinatriuresis in the innervated right kidney. Mean arterial pressure slightly decreased in the placebo group (group 1, 106.7 +/- 2.2 vs. 99.3 +/- 2.4 mmHg) and after cis flupenthixol (group 2, 108.8 +/- 2.7 vs. 92.8 +/- 1.8 mmHg) but not after SCH 23390 (group 3, 105.6 +/- 1.6 vs. 103 +/- 1.1 mmHg). Glomerular filtration rate was not affected by placebo or SCH 23390 in the DNX or innervated kidney but did slightly decrease after cis-flupenthixol in the DNX kidney. Sodium and water excretion after drug administration differed among the groups. In the DNX kidney urine flow decreased only in group 2, whereas fractional sodium excretion decreased modestly (P less than 0.05 paired t test) with SCH 23390 (3.53 +/- 0.34 vs. 2.89 +/- 0.20%) markedly with cis-flupenthixol (3.18 +/- 0.50 vs. 1.21 +/- 0.18%) and was unchanged in the placebo group (3.25 +/- 0.61 vs. 3.45 +/- 0.45%).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3521322 TI - Processing of epidermal growth factor by suckling and adult rat intestinal cells. AB - Preparations of intestinal villus and crypt cells were isolated from jejunal segments of suckling (14-day-old) and adult (6- to 7-wk-old) rats. These cell preparations were incubated with 125I-labeled epidermal growth factor (EGF) at 37 degrees C to determine the extent of cellular processing of 125I-EGF in vitro. 125I-EGF bound specifically to both crypt and villus cells of suckling rats and was internalized and degraded to similar extents in both cell preparations. Analysis of the 125I radioactivity in the medium and cellular extract by gel filtration on Sephadex G-25 columns demonstrated the presence of [125I]iodotyrosine (24-31%) following 30 min of incubation. This degradation of EGF was accompanied by a loss in the capacity to bind to anti-EGF antibodies (34 52%) and A431 cells (28-48%). Binding, internalization, and processing of 125I EGF by crypt cell preparations of adult rats was similar to that of suckling rats. In contrast, little degradation of 125I-EGF to iodotyrosine and loss of cell binding capability occurred following incubation with adult villus cells. However, a considerable loss in binding to anti-EGF antibody was detected (48%). The results indicate that isolated intestinal cells are capable of degrading 125I EGF in vitro in a manner similar to that seen after oral feeding in vivo. They also indicate differences in the processing of 125I-EGF by isolated villus cells of adult compared with suckling rat. PMID- 3521324 TI - Phorbol ester-stimulated phosphorylation of basolateral membranes from canine kidney. AB - To determine whether protein kinase C is present in the basolateral membrane of the renal proximal tubular cell, we performed experiments to ascertain whether specific binding of [3H]phorbol 12,13-dibutyrate could be demonstrated in basolateral membranes isolated from canine kidney. Specific binding was demonstrable that was half maximal at between 10(-7) and 10(-8) M phorbol 12,13 dibutyrate. Binding was inhibited by 12-O-tetradecanoylphorbol-13-acetate (TPA) and other tumor-promoting phorbol esters, but not by inactive phorbol esters, including 4 alpha-phorbol. Incubation of basolateral membranes with TPA and phorbol 12,13-dibutyrate, but not with 4 alpha-phorbol, in the presence of submicromolar concentrations of free calcium, enhanced phosphorylation of several proteins demonstrable in autoradiograms of sodium dodecyl sulfate-polyacrylamide gels originating from membranes subsequently exposed to [gamma-32P]ATP for 30 s. Dephosphorylation of [32P]phosphoproteins was observed in gels from membranes incubated with [gamma-32P]ATP over time. TPA-stimulated phosphorylation of one protein band with Mr 135,000 was quantitated and was found to increase as a function of [TPA]. Half-maximal TPA-stimulated phosphorylation of this protein band occurred at slightly less than 10(-9) M TPA. Our findings are consistent with a role for protein kinase C-effected phosphorylation of basolateral membrane proteins in the mediation or modulation of hormonal actions in the proximal tubular cell. PMID- 3521326 TI - Electrophysiology of sodium-coupled transport in proximal renal tubules. AB - Effects of sodium-coupled transport on intracellular electrolytes and electrical properties of proximal renal tubule cells are described in this review. Simultaneous with addition of substrate for sodium-coupled transport to luminal perfusates, both cell membranes depolarize. The luminal cell membrane depolarizes due to opening of sodium-cotransport pathways. The depolarization of the peritubular cell membrane during sodium-coupled transport is primarily due to a circular current reentering the lumen via the paracellular pathway. The depolarization leads to a transient decrease of basolateral potassium conductance that in turn amplifies the depolarization. However, within 5-10 min of continued exposure to substrate, potassium conductance increases again, and peritubular cell membrane repolarizes. During depolarization the driving force of peritubular bicarbonate exit is reduced. As a result net alkalinization of the cell prevails despite an increase of intracellular sodium activity, which reduces the driving force for the sodium-hydrogen ion exchanger and would thus have been expected to acidify the cell. No evidence is obtained for regulatory inhibition of sodium coupled transport by intracellular sodium or calcium. Rather, luminal cotransport is altered by the change of driving forces. PMID- 3521325 TI - Endotoxemic acute renal failure in awake rats. AB - The sequence of changes in renal function in endotoxemic acute renal failure (ARF) and the role of hypotension and systemic hemodynamics were evaluated in awake female Sprague-Dawley rats given an intravenous bolus of Escherichia coli endotoxin (20-40 mg/kg). After endotoxin ARF was abrupt in onset as glomerular filtration rate (GFR) fell promptly and progressively by 53% within 3.5 h, whereas renal blood flow decreased by 42% and renal vascular resistance nearly doubled. Systemic hemodynamics remained stable, including mean arterial blood pressure, cardiac output, and total peripheral resistance. Early endotoxemic ARF was associated with oliguria and sodium retention, a finding consistent with intact tubular function. Three and one-half hours after endotoxin, however, fractional water and sodium excretion were significantly increased. Ultrastructural studies then demonstrated sequestration of phagocytic leukocytes and intracellular edema in the peritubular capillaries with normal glomeruli. The decrease in GFR was spontaneously reversible within 7-9 days. Extracellular fluid volume expansion with saline either before or 24 h after administration of endotoxin failed to prevent the decrease in GFR or to normalize renal function. The data suggest that endotoxin has direct renal effects. The endothelial cells may be the primary target of endotoxin in the kidney. PMID- 3521327 TI - Prostaglandin E2 but not I2 restores furosemide response in indomethacin-treated rats. AB - Indomethacin attenuates furosemide's natriuretic response. Although this has been attributed to cyclooxygenase inhibition, attempts to correlate prostaglandin (PG) production with furosemide's natriuresis have led some investigators to conclude that prostaglandins are not involved in this response. This study was designed to evaluate the effects of intraaortic administration of PGE2, PGI2 (100 ng X kg-1 X min-1), or the vasodilators secretin or bradykinin (75 microU X kg-1 X min-1) on the furosemide-indomethacin antagonism. Fractional sodium excretion (FENa) during furosemide administration was 4.59 +/- 0.50% in control rats but 1.84 +/- 0.33% in indomethacin-treated rats (Indo) (P less than 0.001). PGE2 prevented indomethacin from attenuating furosemide's response (FENa, 3.91 +/- 0.25%; P = NS vs. control; P less than 0.01 vs. Indo). PGI2, however, failed to prevent the furosemide-indomethacin antagonism (FeNa, 1.94 +/- 0.59%, P less than 0.001 vs. control; P = NS vs. Indo). Inulin clearance, arterial pressure, filtered sodium load, and renal blood flow were not different between groups. Neither secretin nor bradykinin prevented the indomethacin-furosemide antagonism. This study is consistent with the hypothesis that indomethacin antagonizes furosemide's natriuretic response by prostaglandin synthesis inhibition. Furthermore, PGE2 seems to restore furosemide's response through actions other than a vasodilatory effect. PMID- 3521328 TI - Angiotensin II inhibition with captopril on plasma ADH, PG synthesis, and renal function in humans. AB - Using captopril (C), an angiotensin (ANG) I converting-enzyme inhibitor, to increase endogenous prostaglandins (PGs) and to decrease endogenous ANG II synthesis, we studied the relationship between endogenous ANG II, PG, and antidiuretic hormone (ADH) release in seven normal volunteers before (control study) and after inhibition of PG synthesis by a single dose of aspirin (ASA study). In the control study, following the administration of 100 mg of C, there was a significant increase of plasma PGE2, plasma-renin activity (PRA), and urinary PGE2 and 6-keto-PGF1 alpha and a decrease of plasma ADH. Glomerular filtration rate (GFR) and renal plasma flow (RPF) were unaffected by C; urine output, fractional sodium excretion (FENa), and osmolal clearance (Cosmol) increased; and urinary osmolality (Uosmol) decreased significantly after C. In the ASA study PG were undetectable in plasma and significantly reduced in urine 1 h after aspirin and did not increase when C was added. Plasma ADH decreased and PRA increased, as in the control study, after C, whereas GFR, RPF, urine output, FENa, Cosmol, and Uosmol were unchanged. These results suggest that the effect of C on ADH release may be mediated, to a large extent, by a fall in endogenous circulating ANG II, since ADH decreased in the presence of both high or undetectable levels of PGE2. The results also suggest that the increase in PGE2 induced by C may precipitate the diuretic and natriuretic effects of acute C administration. PMID- 3521329 TI - Interaction between epinephrine and renal nerves in control of renin secretion rate. AB - To determine whether the increase in renin secretion rate (RSR) produced by the beta 2-adrenoceptor agonist epinephrine was dependent on intact renal innervation, epinephrine (10 ng X kg-1 X min-1) was infused bilaterally into an innervated and a denervated kidney (ira) of the same anesthetized dog at spontaneous and reduced renal arterial pressure (decreases RAP, 100 mmHg). Epinephrine ira did not affect mean arterial pressure, renal hemodynamics, or urinary sodium excretion of either kidney. At spontaneous RAP epinephrine ira increased RSR from 633 +/- 134 to 926 +/- 137 ng/min in innervated kidneys but did not change RSR in denervated kidneys. decreases RAP in the presence of epinephrine ira resulted in an increase in RSR from 969 +/- 248 to 2,564 +/- 630 ng/min in innervated kidneys, which was greater than that produced in the absence of epinephrine, from 741 +/- 244 to 1,606 +/- 431 ng/min. In denervated kidneys decreases RAP resulted in similar increases in RSR in the absence and presence of epinephrine ira from 41 +/- 15 to 166 +/- 60 ng/min and from 59 +/- 210 to 235 +/ 78 ng/min, respectively. These results demonstrate that the increase in RSR produced by epinephrine is dependent on intact renal innervation at spontaneous and decreases RAP and suggest that epinephrine increases RSR by a prejunctional mechanism. The beta 1-adrenoceptor antagonist metoprolol (0.3-0.5 microgram X kg 1 X min-1 ira) abolished the enhanced RSR response to decreases RAP produced by epinephrine ira. Similarly, the beta 2-adrenoceptor antagonist ICI 118551 (0.005 0.25 microgram X kg-1 X min-1 ira) abolished the enhanced RSR response to decreases RAP produced by epinephrine.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3521330 TI - Endothelial extraction of tracer water is independent of temperature in dog lungs. AB - Diffusion and viscosity-dependent flow rates generally decrease with decrease of temperature in biological systems. We have examined the extraction (Ec) of tracer water in isolated dog lungs perfused near 37 degrees C and near 15 degrees C with multiple-indicator dilution experiments. If Ec were barrier limited, Ec should be less at lower temperatures. Two runs at 37 degrees C were followed by two runs at 15 degrees C. Evans blue (T-1824) was used as vascular reference, and tritium oxide (THO) was used as water tracer. Values of Ec were based on the ratio of the areas under the two indicator curves from appearance time to time of peak of T 1824. Values for permeability-surface area (PS) products were calculated from the classical Crone relationship in 14 experiments with a total of 56 runs. Neither Ec nor PS decreased with temperature. Instead, modest but statistically significant increases were found. We conclude that the extraction of tracer water in these preparations is not barrier limited. PMID- 3521331 TI - Vascular reactivity of contralateral kidney in awake Goldblatt hypertensive dog. AB - Sixteen dogs were instrumented for recording mean arterial blood pressure (MAP) and blood flow from the left renal artery (RBF) and for intra-arterial infusions of norepinephrine (NE) and angiotensin II (ANG II). Nine dogs (group 1) were studied while normotensive and also when hypertensive. Seven control dogs (group 2) were studied only when normotensive. In a control session conducted in group 1 and at weekly intervals for up to 6-12 wk after the right renal artery was clipped, infusions of NE and ANG II were given intra-arterially to produce graded decreases in RBF. Group 2 was studied similarly in a control session and 4-7 wk later. Regressions of the values of percent change RBF (arc sin transformation) on the concentrations of NE and ANG II in renal arterial blood estimated the renal vascular reactivity of the hypertensives' contralateral kidney and the normotensives' kidney. In group 1, during the postclipping intervals when MAP and plasma renin activity were increased, the renal vascular reactivity to NE, but not to ANG II was increased. This was based on the significant elevation above the X axis in the postclipping regressions. In group 2, MAP, plasma renin activity, and renal vascular reactivity to NE and ANG II were unchanged over the 4- to 7-wk interval of study. These results indicate that the contralateral kidney develops an increased vascular reactivity to NE but not to ANG II in Goldblatt hypertension. PMID- 3521333 TI - Effect of fatty acid on performance and lipid content of hearts from diabetic rabbits. AB - The relationship of external work to exogenous substrate supply and whole heart lipid content was studied in hearts isolated from 27 normal and 24 alloxan diabetic rabbits. In addition, we evaluated hearts from seven rabbits after 4 days of untreated diabetes followed by 10 days of insulin therapy. Hearts were retrogradely perfused with erythrocyte-enriched modified Krebs-Henseleit media in which glucose, palmitate, and insulin were present in concentrations simulating diabetic plasma (13 mM, 0.4 mM, and 15 microU/ml, respectively). Diabetes was associated with a greater than 40% reduction in peak left ventricular systolic pressure, dP/dtmax, and left ventricular pressure-time index (P less than 0.01 for each). Perfusion of hearts from six diabetic animals with low concentrations of exogenous fatty acid (0.06 mM) normalized left ventricular (LV) performance. Insulin therapy also completely normalized LV performance. This improvement was associated with lower heart fatty acid and triacylglycerol content. These studies suggest that the myocardial dysfunction in hearts from rabbits with alloxan induced diabetes of 2-wk duration may be, in part, due to enhanced sensitivity to deleterious effects of high exogenous levels of fatty acid. PMID- 3521332 TI - Myocardial extraction and retention of 2-iododesmethylimipramine: a novel flow marker. AB - An ideal deposition marker for measuring regional flow is completely extracted during transcapillary passage and permanently retained. beta-Labeled desmethylimipramine ([3H]DMI) is a nearly ideal flow marker. To obtain gamma- and positron-emitting markers, DMI was iodinated to form 2-iododesmethylimipramine (IDMI). IDMI was more lipophilic than DMI. In isolated saline-perfused rabbit hearts its transorgan extraction was greater than 99%; and retention was greater than 98% at 5 min at mean flows of up to 3.5 ml X g-1 X min-1. During washout, the fractional escape rate was less than 0.1% X min-1 and was independent of flow. In isolated blood-perfused rabbit hearts, extraction was still 98%, but retention was as low as 86% after 5 min at a flow of 1.6 ml X g-1 X min-1. The fractional escape rate was up to 2% X min-1 but independent of flow. Despite this relatively rapid loss, regional IDMI deposition remains proportional to regional flow for many minutes. Therefore IDMI is useful as an externally detectable "molecular microsphere" for myocardial flow imaging in vivo. PMID- 3521334 TI - Cardiac myocyte stiffness following extraction with detergent and high salt solutions. AB - Myocytes were prepared from enzymatically digested adult rat hearts and attached to concentric double-barreled suction micropipettes. Myocyte stiffness was calculated as the ratio of the oscillatory tension-to-strain amplitude, where the strain was produced by an applied 5-Hz perturbation. Stiffness, as a function of cell length, was measured in relaxing solution (pCa = 9) as the control solution, 0.5% Triton X-100 detergent, 0.47 M KCl, and 0.6 M KI. Ultrastructure of unattached cells in each solution is illustrated with electron micrographs. The dependence of cell stiffness on cell length was described by an exponential relation with a length constant that increased slightly in detergent, whereas the stiffness at control length appeared to fall. The major fall in absolute stiffness occurred with myosin extraction in KCl. Both the stiffness at control length and the slope of the ln stiffness-to-length relation declined with the disappearance of the A band. A further, but smaller, decline of stiffness occurred with KI extraction of the thin filaments. A highly compliant "ghost" remained after KI extraction but the stiffness-to-length relation was still measurable. The fall in stiffness with myosin extraction is discussed in relation to cytoskeletal filaments (titin, nebulin, and intermediate filaments. PMID- 3521335 TI - Adrenergic influence on hormonal and hepatic metabolic response to exercise in rats. AB - The adrenergic control of the hormonal and hepatic metabolic response to exercise was studied in untrained fed male rats. Rats were injected intraperitoneally with either saline, the alpha-adrenergic antagonist phentolamine, or the beta adrenergic antagonist propranolol 30 min before exercise. The rats swam for 50 min in 34-35 degrees C water with a tail weight (5% of body wt). Exercise resulted in a suppression of plasma insulin in all treatment groups; however, plasma glucagon increased only in the propranolol group. The liver glycogen content was decreased with exercise only in the saline and propranolol groups. Likewise, phosphorylating respiration of liver mitochondria isolated after exercise was higher only in the saline and propranolol groups. Thus phentolamine pretreatment blocked the liver glycogen depletion and the increased liver mitochondrial phosphorylating respiration observed after exercise in fed rats. The results suggest that alpha-adrenergic mechanisms are operant with exercise and stimulate liver glycogenolysis and mitochondrial phosphorylating respiration. PMID- 3521336 TI - Scaling of physiological responses: a new approach for hemorrhagic shock. AB - Standard protocols used to study hemorrhagic shock involve sampling at fixed time intervals and generating a time-based composite curve from each experiment. Although each animal may show the same sequence of responses, the time, rate, and size of the response varies from animal to animal. As a result, sampling times may be inappropriate to identify sharp transitions in the measured parameters, and the composite curves do not reflect the size and shape of the individual responses. This report evaluates several approaches to normalizing hematocrit and blood glucose data obtained from a constant-pressure model of hemorrhagic shock in fed and fasted and dehydrated animals to see if phase relationships and fractional responses from individual animals can be made coherent. Scaling for fractional blood loss on the x-axis and maximal response on the y-axis resulted in convergence of the results from individual animals and different experimental series. Data from a constant rate of hemorrhage model also converged after scaling. A method for prospectively defining the scale and adjusting sampling frequency for individual animals is given. PMID- 3521338 TI - Structural-functional relationship along the distal nephron. AB - The distal tubule, which includes the thick ascending limb (TAL), the macula densa, and the distal convoluted tubule (DCT), and the collecting duct are structurally heterogeneous, thus reflecting the functional heterogeneity that is also present. As the TAL ascends from medulla to cortex, the surface area of the apical plasma membrane increases while that of the basolateral membrane decreases. The structure of the DCT resembles that of the medullary TAL. An excellent correlation exists between structure, Na-K-ATPase activity, and NaCl reabsorptive capacity in the distal tubule. The collecting duct is subdivided into the initial collecting tubule (IC), and cortical (CCD), outer medullary (OMCD), and inner medullary (IMCD) collecting ducts. Between the distal tubule and the collecting duct is a transition region termed the connecting segment or connecting tubule (CNT). Considerable structural heterogeneity exists along the collecting duct within the two major cell populations, the intercalated cells and the principal cells. In the CNT, the ICT, and the CCD, potassium loading and mineralocorticoids stimulate Na-K-ATPase activity and cause proliferation of the basolateral membrane of CNT cells and principal cells, thus identifying the cells responsible for mineralocorticoid-stimulated potassium secretion in these regions. Finally, at least two morphologically distinct populations of intercalated cells exist, types A and B. In the rat, type A predominates in the CNT and the OMCD and is believed to be responsible for H+ secretion, at least in the OMCD. Type B predominates in the CCD, where it may be involved in bicarbonate secretion. PMID- 3521337 TI - Control of sodium excretion by angiotensin II: intrarenal mechanisms and blood pressure regulation. AB - Angiotensin II (ANG II) is one of the body's most powerful regulators of Na excretion, operating through extrarenal mechanisms, such as stimulation of aldosterone secretion, as well as intrarenal mechanisms. Considerable evidence suggests that the intrarenal actions of ANG II are quantitatively more important than changes in aldosterone secretion in the normal day-to-day regulation of Na balance and arterial pressure. ANG II at physiological concentrations increases proximal tubular reabsorption, but further studies are needed to determine whether ANG II also has an important effect on more distal tubular segments. ANG II also markedly constricts efferent arterioles, tending to increase Na reabsorption by altering peritubular capillary physical forces and also helping to prevent excessive decreases in glomerular filtration rate. ANG II may also decrease Na excretion and increase urine concentrating ability by reducing renal medullary blood flow. Regulation of Na excretion by ANG II is closely linked with arterial pressure control and volume homeostasis through the renal pressure natriuresis mechanism. Under many physiological conditions, such as changes in Na intake, ANG II greatly multiplies the effectiveness of the pressure natriuresis mechanism to prevent fluctuations in body fluid volume and arterial pressure. In circumstances associated with circulatory depression, such as decreased cardiac function, reductions in blood pressure and increased ANG II formation cause Na retention until arterial pressure is restored to normal. However, in pathophysiological conditions in which ANG II is inappropriately elevated, increased arterial pressure (hypertension) is required for the kidney to "escape" the potent antinatriuretic actions of ANG II and to return Na excretion to normal via the pressure natriuresis mechanism. PMID- 3521339 TI - Depression in the medically ill: an overview. AB - Depressive symptoms and syndromes are common in the medically ill, although they are frequently unrecognized and untreated. The authors review the epidemiology, differential diagnosis, clinical presentations, and response to treatment of this clinical problem. They address such methodological issues in the current literature in this area as the advantages and limitations of standardized assessment measures and discuss treatment modalities for depression in the medically ill, including antidepressant medication and ECT. This clinical problem warrants attention for a variety of reasons: its prevalence, associated morbidity, and treatability. Elucidation of the mechanisms of depression in the medically ill may also contribute to a broader understanding of depression in other populations. PMID- 3521340 TI - Paranoid disorder: the Soviet viewpoint. AB - The Russian-language psychiatric literature on the paranoid disorders was reviewed for a recent 10-year period. The authors were from a variety of facilities and geographic locations. Bibliography references were primarily European, although 41% of the articles included references to American publications. The paranoid patient population was similar to that in the United States. There was extensive longitudinal study of the disorders; epidemiologic investigations, diagnostic classification, pharmacotherapy, treatment outcome, and etiologic theories allowed comparison with these issues in the United States. PMID- 3521341 TI - Physician ratings of appropriate indications for six medical and surgical procedures. AB - We convened three panels of physicians to rate the appropriateness of a large number of indications for performing a total of six medical and surgical procedures. The panels followed a modified Delphi process. Panelists separately assigned initial ratings, then met in Santa Monica, California where they received reports showing their initial ratings and the distribution of the other panelists ratings. They discussed the indications and revised the indications lists, then individually assigned final ratings. There was generally better agreement on the final ratings than on the initial ratings. Based on reasonable criteria for agreement and disagreement, and excluding one outlying procedure, the panelists agreed on ratings for 42 to 56 per cent of the indications, and disagreed on 11 to 29 per cent. PMID- 3521342 TI - The American Journal of Public Health, 1911-85. PMID- 3521343 TI - One century after Louis Pasteur's victory against rabies. PMID- 3521344 TI - Sports anemia: a review of the literature. AB - Sports anemia has been referred to as an anemic or borderline anemic state in physically active individuals, particularly athletes. This paper is a review of literature on sports anemia, including whom it may affect and its effect on performance, and its diagnosis. In general, sports anemia has been found to be a self-limiting condition and usually does not require treatment. PMID- 3521345 TI - Leukocytic infiltrates in idiopathic dilated cardiomyopathy. A source of confusion with active myocarditis. AB - The histologic criteria for the endomyocardial biopsy diagnosis of idiopathic dilated cardiomyopathy (IDCM) and active idiopathic/viral myocarditis are unclear. The present study was undertaken to characterize the nature of the inflammatory cell infiltrates in IDCM and thereby refine the differential diagnostic criteria for distinguishing IDCM from myocarditis using endomyocardial biopsy. We examined a mean of 6.2 large random sections from excised hearts of all cardiac transplant recipients at Stanford University with a diagnosis of IDCM, from June 1968 through June 1984. The 108 cases were evaluated for inflammatory cell type, extent, and location. Thirteen percent had no infiltrate, 32.5% had 1-5 foci of at least five inflammatory cells, 47% had 6-30 foci, and 7.5% had 30 or more foci. The infiltrates were primarily lymphocytic; while they were usually in the myocardial parenchyma, infiltrates were also located in zones of fibrosis, the endocardium, the epicardium, and surrounding vessels. Pretransplant biopsies in 56 of the 108 cases were available for review, and 55% of these contained inflammatory cell infiltrates. Agreement between the presence of infiltrates in the biopsy and the resected heart was obtained in 64%. This study highlights the high incidence of inflammatory cell infiltrates in the hearts of patients with IDCM. It reinforces the need for interpreting lymphocytic infiltrates in an endomyocardial biopsy with caution, as their mere presence does not necessarily imply a diagnosis of active myocarditis. PMID- 3521346 TI - A salute to Robert M. Zollinger, MD. PMID- 3521347 TI - Vignettes from memories of growing up with Robert. PMID- 3521348 TI - Colonel Robert M. Zollinger in World War II. PMID- 3521349 TI - Reflections of a successor to Dr. Robert M. Zollinger. PMID- 3521350 TI - A half century of selected recollections from a Big Z watcher. PMID- 3521352 TI - Robert M. Zollinger and France. PMID- 3521353 TI - Technetium 99m-DTPA microcapsules: a new preparation for gastric emptying studies. AB - Technetium 99m-DTPA microcapsules have been developed to measure gastric emptying. Such capsules not only provide high labeling efficiency in vitro, but demonstrate limited dissociation in vivo, resulting in decreased error during measurement. In normal control subjects, the half-life ranged from 40 to 80 minutes under the aforementioned conditions. PMID- 3521351 TI - A vigorous leader (R.M. Zollinger). PMID- 3521354 TI - The laser in surgery. A 23 year perspective. AB - Clinically silent malignant tumor recurrence or metastasis can be treated by laser resection or vaporization as well as by a second-look procedure suggested by an increasing level of carcinoembryonic antigen. Laser resection enables surgeons to resect multiple small metastases that would not normally be resectable. The surgical limitations of each laser unit and each wavelength must be identified. The laser is now used by gynecologists, neurosurgeons, otolaryngologists, ophthalmologists, and oncologic surgeons to rapidly and precisely resect or vaporize tissues and, in some cases, to extend tumor-free survival. Twenty-three years after its first experimental use, the laser has established itself as an important surgical tool. PMID- 3521355 TI - Coach Zollinger. PMID- 3521356 TI - One man's pursuit of excellence. PMID- 3521357 TI - Iatrogenic hemobilia. AB - Biliary tract hemorrhage is increasingly reported as a complication of diagnostic and therapeutic interventions on the liver and the bile ducts. Major hemobilia with profuse, even life-threatening, hemorrhage which necessitates emergency surgical intervention is uncommon. Minor hemobilia with melena or clot production in the ducts, although more common, may cause diagnostic difficulties. Diagnosis is obtained either endoscopically to demonstrate bleeding through the papilla of Vater, or through hepatic arteriography, which has the advantage of indicating the location of the lesion. Operative treatment with resection of the lesion or ligature of the hepatic artery or a branch has been replaced by embolization of the affected artery. Diagnostic procedures that may cause hemobilia include percutaneous needle biopsy and transhepatic cholangiography. The risk of hemorrhage increases if a catheter is left in place for drainage. Difficult extractions of common duct stones may cause hemorrhage due to lesions of the vulnerable duct mucosa. Finally, spontaneous hemobilia may, like hematuria or epistaxis, be caused by an overdose of anticoagulants. PMID- 3521358 TI - Frank Hastings Hamilton: medical educator and surgeon to President Garfield. AB - Frank Hastings Hamilton was a pioneer in academic surgery. His career involved the development of several medical schools. At the request of Mrs. Garfield, Hamilton was consulted after the shooting of President James Garfield. Surgical thinking at that time did not favor operation for gunshot wounds. Garfield's death reflected the lack of understanding in trauma care during that era. Hamilton's many contributions to medical education shall be remembered. PMID- 3521359 TI - [Presence of gold in the oral mucosa of wearers of gold alloy prostheses]. PMID- 3521360 TI - M. Lois Murphy, M.D. PMID- 3521361 TI - Early studies of Burkitt's tumor in Africa. AB - While still a trainee in oncology, John Ziegler had the unexpected opportunity to direct a Burkitt's tumor research project in Africa. He was given a leading role in conducting early studies on the treatment of this tumor. Dr. Ziegler's youthful zeal, administrative talent, and scientific ingenuity enabled him, in a relatively short time, to carry out fundamental studies on treatment of Burkitt's tumor as well to establish an outstanding center for cancer research in tropical Africa. The lessons learned from these studies have become principles for treatment of many other human cancers. PMID- 3521362 TI - Hyperglucagonemia in L-asparaginase induced diabetes mellitus. PMID- 3521363 TI - Diphtheria and Alaska. PMID- 3521364 TI - Immunoreactivity to material like vasoactive intestinal polypeptide in epidermal cells of lichen sclerosus et atrophicus. AB - Immunoreactivity to material like vasoactive intestinal polypeptide was found to occur within certain cellular elements of the epidermis in two patients out of four who had lesions of lichen sclerosus et atrophicus. No specific immunofluorescence to the material could be seen in the dermis, apart from single immunoreactive nerve fibers. PMID- 3521365 TI - Thomas Hodgkin (1798-1866). PMID- 3521366 TI - The man behind the eponym. Vittorio Mibelli and the tale of "porokeratosis". PMID- 3521367 TI - Jews in dermatology. PMID- 3521368 TI - Clinical assessment of cognition in alcoholism. PMID- 3521369 TI - Multifactorial etiology of neuropsychological impairment in alcoholics. PMID- 3521371 TI - Implications of cognitive impairment for the treatment of alcoholism. AB - Recent findings are summarized on neuropsychological deficits among alcoholics, recovery of neuropsychological functioning, and the relationships between neuropsychological functioning and the outcomes of alcoholism treatment. It is suggested that alcoholism treatment programs be modified for neuropsychologically impaired patients. Specific recommendations are made for modified treatment approaches, as well as for research studies in the area of treatment for neuropsychologically impaired alcoholics. PMID- 3521370 TI - Neuropsychological recovery in alcoholics: endogenous and exogenous processes. PMID- 3521372 TI - Alcohol: high density lipoproteins, apolipoproteins. AB - Plasma lipids, including high density lipoproteins (HDL) components, were studied in 26 healthy male alcohol abusers. Age- and gender-matched controls denied the use of substances or behaviors associated with increased HDL. On admission to abstinence treatment, the alcohol abusers' total cholesterol and triglycerides were usually normal. Their HDL-cholesterol levels were high, and fell to normal within 2 weeks of sobriety. Apolipoprotein (APO) AI and AII were high initially and also became normal in 2 weeks. APO A I and II to HDL-cholesterol ratios appeared to change during abstinence, while APO AI/AII did not. APO CIII, high initially, fell during treatment, but was still high after 4 weeks of sobriety. Therefore, alcohol seems to affect several components of HDL and these HDL changes move toward normal at different rates. If alcohol is protective against some cardiovascular disease, it remains to be established whether HDL is involved and which HDL component is most important. PMID- 3521373 TI - Cranial electrotherapy stimulation as a treatment for anxiety in chemically dependent persons. AB - Cranial electrotherapy stimulation (CES) is reported to be an effective treatment for anxiety, a major presenting symptom among chemically dependent patients. In this study, 40 inpatient alcohol and/or polydrug users were given CES or sham CES in a double blind design. An additional 20 patients served as normal hospital routine controls. Dependent measures of anxiety were the Profile of Mood States, the Institute for Personality and Ability Testing Anxiety Scale, and the State/Trait Anxiety Index. CES-treated patients showed significantly greater improvement on all anxiety measures than did either control group. There were no differences in response between older and younger patients, or between the primarily drug or alcohol abusers. No placebo effect was found on any of our measures. It is concluded tht CES is a clinically significant addition to the treatment regimen for this patient population. PMID- 3521374 TI - Ethanol-induced intrauterine growth retardation: correlation with placental glucose transfer. AB - Placental transfer of glucose and alanine analogs was studied at term in ethanol fed and control rats. Ethanol was provided as 30% of the caloric intake throughout gestation. Control groups received isocaloric liquid diet without ethanol by pair-feeding (PF) or ad libitum (AF). On the 22nd day of pregnancy, the rats were injected with a mixture of [3H]2-deoxyglucose and [14C]alpha aminoisobutyric acid. The ratios of fetal:maternal plasma radioactivities 1 hr later were used to compare placental transfer between the groups. Mean +/- SE body weight of EF fetuses (4.54 +/- 0.07 g) was significantly lower than that of PF (4.88 +/- 0.06 g) or AF (5.17 +/- 0.09 g) fetuses. Maternal ethanol ingestion reduced placental transfer of 2-deoxyglucose and alpha-aminoisobutyric acid by 12% and 35%, respectively. Placental transfer of both analogs was not affected in the PF controls. The weight of EF fetuses correlated (p less than 0.001) with transfer of 2-deoxyglucose to the fetus. This relationship was also found in the control groups. Fetal body weight did not show a strong correlation with alpha aminoisobutyric acid transfer. Thus, impaired transfer of glucose to the fetus may play a significant role in the growth retardation observed in fetuses of ethanol-fed rats. PMID- 3521375 TI - Effects of acute and chronic ethanol exposure on the response of rat aorta to a thromboxane mimic, U46619. AB - The spasmogenic properties of a stable thromboxane mimic, U46619, were determined in the isolated rat aorta after 1, 4, 8, or 12 hr of acute ethanol exposure in vitro or after 12 days of chronic exposure by inhalation. Acute ethanol exposure (87-822 mM) increased the baseline tension of aortic rings in a concentration dependent manner. Moderate concentrations of ethanol (11 and 43 mM) decreased the maximum tensile response of rat aortic rings to U46619 after 8 and 4 hr of exposure, respectively. In contrast, higher ethanol concentrations (87 and 411 mM) did not significantly effect the maximum tensile response to U46619. Ethanol at 822 mM completely inhibited the response to U46619 and this inhibition could be 85% reversed after removal of ethanol. The inhibitory effect of 1.64 M ethanol was irreversible. Sensitivity to U46619 was inversely related to the ethanol concentration (greater than or equal to 43 mM) and incubation time. Similarly, chronic exposure to moderate blood ethanol levels (92-198 mg/100 ml) for 12 days decreased the maximum tensile response whereas high levels did not effect aortic contractility in vitro. Sensitivity of aorta from rats with mean blood ethanol levels greater than or equal to 92 mg/100 ml decreased at least one order of magnitude. The results suggest that the effect of physiologically tolerable ethanol concentrations on the amplitude of the tensile response to U46619 is biphasic both during acute exposure in vitro or following a chronic exposure period in vivo and the inhibitory effect on sensitivity for U46619 is both concentration- and time-dependent in the rat aorta preparation. PMID- 3521376 TI - The prevalence of type A personality in the children of alcoholics. AB - Three studies are reported which investigate the prevalency of an excess risk of type A personality in the children of alcoholics (COAs). Reports in the clinical literature suggest there is an excess risk of type A in COAs, but this has never been empirically demonstrated. The Matthews Youth Test for Health (MYTH) was administered to nonalcoholic mothers of 46 COAs and 65 matched controls to measure children's type A competitiveness and impatience-aggression. Results were significant only for greater impatience-aggression in COAs. In a second study, 104 COAs and controls matched for age, sex, race, and father's occupational status were rated by military fathers of intact families using MYTH. The results of the first study were not replicated for COAs, and there was no correlation between a father's Jenkins Activity Scale (JAS) score and his child's type A personality. A third study of 70 matched COAs and controls used the Hunter-Wolf A B Rating scale, a self-rating scale for children and found no significant differences in children's type A personalities based on membership in an alcoholic family, sex, or birth order. It was concluded that the discrepancy between clinical reports and the present data may have been due to misperceptions about successful, hardworking COAs who, particularly in contrast to their more notorious siblings, may be viewed as "workaholics" and improperly labeled as type A personalities. PMID- 3521377 TI - Effects of ethanol exposure during the third trimester equivalent on neuron number in rat hippocampus and dentate gyrus. AB - An artificial rearing procedure was used to expose neonatal rats to a formula containing 3.74% ethanol during postnatal days 4 through 10. This treatment produced a mean blood ethanol concentration of 379.8 +/- 17.3 mg/dl. When the pups were killed on the afternoon of postnatal day 10, brain weight to body weight ratio in the ethanol-exposed rats was reduced 22.4% and 21.5% compared to suckle and pair-fed controls, respectively. Ethanol exposure also resulted in a 16% reduction of neurons in hippocampal field CA4, compared to controls, but did not produce deficits in fields CA1 or CA3. There was also a 10% increase in the number of neurons (a population of cells in the midst of a proliferative phase at the time of the exposure) in the granule cell layer of the dentate gyrus. The ethanol exposure did not affect cell size in any of the four neuron populations measured. These results suggest, that within the dose and timing parameters examined, ethanol exposure during the third trimester equivalent appears to be preferentially harmful to specific populations of developing neurons. PMID- 3521378 TI - Dose and route of administration alter the relative elimination of ethanol by long-sleep and short-sleep mice. AB - The elimination of ethanol following the intravenous and intraperitoneal administration of five ethanol doses was measured in two mouse lines, the long sleep (LS) and short-sleep (SS), that differ markedly in central nervous system sensitivity to ethanol. Both dose and route of administration affected the relative ethanol elimination in these two mouse lines. When the ethanol was given i.v., a steady increase in elimination rate was seen in the SS mice as the dose was increased. In the LS mice, consistent changes in rate with dose were not seen. At the lower doses tested, the LS eliminated ethanol more rapidly than did the SS but at higher doses the mouse lines did not differ. When the ethanol was given i.p., increases in rate with dose were not seen. Rather, the SS elimination rate remained constant as the dose was increased, whereas in the LS a decrease in rate was observed. As a consequence, the SS eliminated ethanol more rapidly than did the LS at higher doses. A potential explanation for these results is that ethanol elimination, following the administration of large doses, is affected by both enzymological factors and central nervous system sensitivity to ethanol. The central nervous system factors may be mediated via ethanol-induced hypothermia. PMID- 3521379 TI - Effects of ethanol on monoamine and amino acid release from cerebral cortical slices of the alcohol-preferring P line of rats. AB - The effects of 250 mg/100 ml ethanol on the efflux of 3,4-dihydroxyphenylacetic acid (DOPAC) and the 35 mM K+-stimulated, Ca2+-dependent release of norepinephrine (NE), dopamine (DA), serotonin (5-HT), gamma-aminobutyric acid (GABA), glutamate, and aspartate from cerebral cortical slices of the alcohol preferring P line of rats and stock Wistar rats were studied. The K+-stimulated, Ca2+-dependent release of GABA for the P rats was 35% lower, while the release of glutamate was almost twice that of the stock animals. The release of the other compounds was similar for the two groups. Addition of 250 mg/100 ml ethanol to the superfusion media did not alter the release of NE, DA, and 5-HT nor the efflux of DOPAC from cortical slices of either group of rats. However, the K+ stimulated, Ca2+-dependent release of GABA, glutamate, and aspartate was significantly enhanced by ethanol for both the P and stock group of rats. These in vitro data do not support a direct action of ethanol on DA, NE, and 5-HT release or on DOPAC efflux, but suggest a direct action on the transmitter release process for GABA, glutamate, and aspartate in the cerebral cortex. PMID- 3521380 TI - Effect of nicotine and alcohol pretreatment on the gastric mucosal damage induced by aspirin, phenylbutazone, and reserpine in rats. AB - The effect of nicotine and alcohol pretreatment by feeding nicotine (2.5 mg/100 ml), alcohol (25%, v/v) and their combination (nicotine 2.5 mg/100 ml + alcohol 25%, v/v) in drinking water ad libitum for 21 days was studied on the gastric mucosal damage induced by aspirin, phenylbutazone, and reserpine in rats. When given alone, neither nicotine nor alcohol produced any visibly discernible gastric lesions. Their concurrent administration, however, produced minor injury to the gastric mucosa appearing as 5-7 circular ulcers of less than 1 mm in diameter. Pretreatment with nicotine, alcohol, and their combination resulted in the significant augmentation of gastric ulcers produced by aspirin, phenylbutazone, and reserpine. The augmentation of gastric lesions in the group pretreated with the combination of nicotine and alcohol was significantly greater than in the groups treated by either of them alone. The effect of nicotine on the mucus neck cell population of the gastric mucosa and pancreatic bicarbonate secretion, and the gastric mucosal damaging effect of chronic alcohol treatment may be responsible for the potentiation of ulcerogenic effects of aspirin, phenylbutazone, and reserpine. PMID- 3521381 TI - [Treatment of allergic rhinitis with ketotifen. A double-blind vs. placebo study]. PMID- 3521382 TI - Long-term safety and efficacy of budesonide nasal aerosol in perennial rhinitis. A 12-month multicentre study. AB - A long-term safety study of intranasally administered budesonide, a topical glucocorticoid, has been performed. 104 patients with perennial rhinitis, allergic or non-allergic, participated in a multicentre study in seven ENT clinics utilising an identical protocol. A budesonide dosage of 400 micrograms/day was used as starting dose, but the patients were at liberty to reduce the daily dose to 200 micrograms. The patients were observed at intervals up to 12 months. At the entry and follow-up visits the following parameters were recorded: rhinoscopic findings, nasal symptom scores, blood chemistry, hematology, urinalysis and determination of plasma cortisol levels before and after stimulation with ACTH (Synacthen). Nasal biopsies taken from 50 of the patients at the beginning and completion of the study were examined in a blinded way by an independent pathologist. The analysis revealed no histopathological changes of the nasal mucosa. At rhinoscopy no signs of atrophy or candida were reported. Lividity of the nasal mucosa was significantly reduced during the trial, which was also the case for nasal congestion and secretion. All nasal symptom parameters assessed by the patients were significantly reduced from baseline during the follow-up period. No clinically significant changes in the hematological and blood chemistry parameters were observed. Plasma cortisol analysis before and after challenge with ACTH revealed no influence on the hypothalamic pituitary adrenal axis. No tachyphylaxis was observed; on the contrary, there was a clear tendency for reduction of the daily dose of budesonide necessary to keep the patients symptom-free.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3521383 TI - Increased sensitivity in antigen detection during immunoblot analysis resulting from antigen enrichment via immunoprecipitation. AB - The sensitivity in antigen detection during immunoblot analysis is greatly increased if the antigen is first immunoprecipitated from the crude extract before electrophoresis and transfer to nitrocellulose. Not only does the method allow detection of antigens which are minor components of crude mixtures or antigens which cannot be radiolabeled, but the method also resolves problems, such as high background, which are often associated with immunoprecipitation. Also, by modifying the method, whether or not monoclonal antibodies recognize the same or different antigens and/or epitopes can be easily determined. PMID- 3521384 TI - Thermal analysis. PMID- 3521385 TI - Molecular fluorescence, phosphorescence, and chemiluminescence spectrometry. PMID- 3521386 TI - Mass spectrometry. PMID- 3521387 TI - Column liquid chromatography. PMID- 3521388 TI - Raman spectroscopy. PMID- 3521390 TI - [In memoriam Hartwig Kuhlenbeck]. PMID- 3521389 TI - Drug antibody measurement by homogeneous enzyme immunoassay with amperometric detection. PMID- 3521391 TI - [In memoriam Hans Elias]. PMID- 3521392 TI - Hemodynamic effects of positive end-expiratory pressure during continuous venous air embolism in the dog. AB - Positive end-expiratory pressure (PEEP) may decrease venous air embolism (VAE) by increasing venous pressure at the incision level. Because PEEP and VAE can both increase pulmonary vascular resistance, it is possible that the application of PEEP during VAE may increase right atrial pressure (RAP) relative to left atrial pressure (LAP) and thereby reverse the normal interatrial pressure gradient, allowing paradoxical air embolism in patients with a probe-patent foramen ovale. We studied atrial pressures during 0, 4, and 8 mmHg PEEP before and during continuous VAE in both supine and upright tilted dogs. Both PEEP and VAE increased pulmonary artery pressure and resistance. Prior to VAE, PEEP increased both RAP and LAP but did not affect the interatrial pressure gradient. VAE alone did not affect RAP, LAP, or the interatrial pressure gradient. Application of PEEP during VAE had similar effects as at baseline, namely an increase in RAP and LAP with no change in the interatrial pressure gradient. Although RAP exceeded LAP more frequently in the upright than in the supine dogs, the effects of PEEP and VAE on atrial pressures were similar in both groups. Our finding that PEEP and VAE did not disproportionately increase RAP compared with LAP is consistent with other studies demonstrating preservation of right ventricular function in situations of increased right ventricular afterload. PMID- 3521393 TI - Artificial ventilation of a canine model of bronchopleural fistula. AB - The authors studied the abnormalities of gas exchange and lung mechanics in a canine model of bronchopleural fistula during intermittent positive pressure ventilation (IPPV) and high-frequency oscillatory ventilation (HFOV). The left lower lobe bronchus was opened to atmosphere and it was determined that end expired volume was best maintained at frequencies of 45-50 breaths/min. during IPPV. Comparing alternating periods of IPPV and HFOV in six dogs (Group I) at matched airway opening pressure (Pao), we found that Pao2 decreased significantly to 68 +/- 14 mmHg and 69 +/- 24 mmHg, respectively, on opening the fistula. In a second group of six dogs (Group 2), when Pao was increased by additional bias flow into the ventilatory circuit during both IPPV and HFOV, Pao2 increased significantly to 89 +/- 12 mmHg and 87 +/- 8 mmHg, respectively. Repeating Group 2 studies after induction of oleic acid low-pressure pulmonary edema demonstrated that conventional IPPV was associated with large intrapulmonary shunts. HFOV, however, maintained gas exchange at near baseline values. For both Group 1 and Group 2, the calculated gas flow through the fistula was significantly less at all levels of airway pressure during HFOV. The authors conclude that HFOV offers advantages over conventional IPPV in the maintenance of oxygenation and in the reduction of gas leak through the fistula. PMID- 3521394 TI - Effects of meperidine spinal anesthesia on hemodynamics, plasma catecholamines, angiotensin I, aldosterone, and histamine concentrations in elderly men. PMID- 3521395 TI - More on eponyms used in anesthesiology. PMID- 3521396 TI - [Effect of the type of microbial toxin on the character of pulmonary function disorders in septic shock]. PMID- 3521397 TI - [Problems in clinical algosimetry and analgosimetry]. PMID- 3521398 TI - [Seal failure of the respiratory circuit during artificial ventilation of the lungs]. PMID- 3521399 TI - [The 25-year-old Department of Medical Parasitology and the 10-year-old Reference Laboratory for Medical Arachno-entomology of East Germany at the Leipzig District Sanitary Inspection Service and District Institute]. AB - Review of the most important contributions of the-25-year-old Department of Medical Parasitology and of the ten-year-old Reference Laboratory for Medical Arachno-Entomology at the Sanitary Inspection and Institute, District of Leipzig, as an example for the performance of hygienic zoology in the German Democratic Republic. PMID- 3521400 TI - [Dr. Gerhard Hartwich at 60]. PMID- 3521401 TI - Effects of ethaverine hydrochloride on the walking tolerance of patients with intermittent claudication. AB - The effect of ethaverine hydrochloride on exercise tolerance of patients with intermittent claudication was evaluated in a double-blind, placebo-controlled study conducted at three sites. Forty-five patients with symptoms of occlusive arterial insufficiency of the lower extremities were randomly assigned to receive ethaverine 200 mg or placebo four times daily. The patients were evaluated biweekly for 12 weeks with treadmill claudication tests, patient and investigator assessments of symptom severity, and reports of adverse reactions. Doppler ankle/brachial pressure ratios were recorded for 26 patients. Walking tolerance improved for patients in both groups during the course of the study. Increases in distance-to-claudication were significantly greater for patients receiving ethaverine after 6, 8, 10, and 12 weeks of therapy. Ankle/brachial pressure index after exercise was unchanged in both groups. Incidence of adverse reactions was similar for the two groups. Although patients were generally unaware of any improvement in symptoms, the investigators judged significant relief of claudication among those receiving ethaverine compared to those receiving placebo. It was concluded that ethaverine safely increased distance-to claudication in patients with intermittent claudication. PMID- 3521402 TI - Diagnosis and management of allergic bronchopulmonary aspergillosis. PMID- 3521403 TI - Effects of prednisolone on glucose tolerance and insulin secretion in the dog. AB - Effects of prednisolone on glucose tolerance and insulin secretion were evaluated in healthy dogs. Dogs were given 1 mg of prednisolone/kg of body weight/day (n = 5) or 2 mg of prednisolone/kg/day (n = 6) orally for 3 weeks. Intravenous glucose tolerance tests (600 mg/kg) were administered before and after treatment to evaluate plasma glucose in fasting dogs, glucose fractional clearance rate, serum insulin in fasting dogs, insulin peak response, total insulin secretion, and insulinogenic index. A significant difference (P less than 0.05) in plasma glucose in fasting dogs was observed for the 2 mg/kg dose, although values were still within the reference range. There was no significant effect on glucose fractional clearance rate (glucose tolerance) or insulin secretion. Seemingly, peripheral insulin resistance resulting in hyperinsulinemia or decreased glucose tolerance could not be identified in association with 1 or 2 mg of prednisolone/kg/day for 3 weeks in healthy dogs. PMID- 3521404 TI - Effects of acetylpromazine on the hemodynamics of the equine metatarsal artery, as determined by two-dimensional real-time and pulsed Doppler ultrasonography. AB - Heart rate, blood velocity, volumetric blood flow, and arterial diameter for 10 horses given acetylpromazine were determined from measurements of the dorsal metatarsal artery 3 (the great metatarsal artery), using 2-dimensional real-time and gated pulsed Doppler ultrasonography. Acetylpromazine induced significant increases in arterial diameter (P less than 0.01) and volumetric flow rate (P less than 0.05)--all compatible with adrenergic blockade. There was a trend indicating that there was increased blood velocity. Heart rate was unchanged. PMID- 3521405 TI - Effect of captopril on the progression of induced pyelonephritis in the rat. AB - The effect of captopril, an angiotensin-converting enzyme inhibitor, was studied in rats subjected to Escherichia coli pyelonephritis. Eight weeks after pyelonephritis was induced in male Sprague-Dawley rats, the rats were randomly assigned to treatment groups based on urinary protein excretion. In experiment 1, rats were given captopril, 50 mg/kg of body weight, or saline solution via daily intraperitoneal injection. To eliminate complications with captopril-induced peritonitis, experiment 2 was performed in which rats were given the same treatment by daily gavage. In both experiments, 24-hour urinary protein excretion in the saline-treated rats was significantly greater than that of the captopril treated rats after 12 weeks of treatment (P less than 0.05). Plasma urea nitrogen, plasma creatinine, and endogenous creatinine clearance did not differ between treatment groups during the course of therapy in experiment 1. There were no differences in these values in experiment 2, except at week 8 of treatment when the captopril-treated rats had significantly lower plasma creatinine and higher endogenous creatinine clearance than did the saline-treated rats (P less than 0.05). There was also no difference between treatment groups in the degree of morphologic renal damage based on light microscopic evaluation of kidneys at the end of treatment. PMID- 3521406 TI - In vitro and in vivo association of African swine fever virus with swine erythrocytes. AB - The association of African swine fever virus (ASFV) with swine erythrocytes in vivo, in high titers, was verified by inoculating 30 pigs with 17 ASFV isolates and assaying their plasma and washed erythrocyte fractions for residual virus. Viral antigens were specifically localized on the surface of in vitro and in vivo swine erythrocytes, using the fluorescent antibody technique and 3 monoclonal antibodies specific for ASFV. The same monoclonal antibodies immunoprecipitated virus-specific polypeptides of molecular weights 13 kd and 73 kd from ASFV infected Vero cells. Erythrocytes from viremic swine infected with Lisbon-60, Dominican Republic, Badajoz-M98, or Cameroon isolates of ASFV were studied by transmission electron microscopy. Virus was found in membrane depressions at the surface of erythrocytes. These surface depressions resembled stages of smooth surfaced pits. Erythrocytes from viremic pigs were fragile osmotically. PMID- 3521407 TI - Etiologic significance of bacterial isolates from rams with palpable epididymitis. AB - Identified and partly identified bacterial isolates were obtained from 48 rams of various breeds that had unilateral or bilateral epididymitis. Most of the animals were approximately 1 year of age; a few were older. Brucella ovis, Actinobacillus spp, Corynebacterium spp, Haemophilus spp, Acinetobacter spp, Escherichia coli, Moraxella spp, Staphylococcus spp, Pasteurella spp, Streptococcus spp, and Chlamydia psittaci were isolated. A vaccine strain of B ovis, isolated species of bacteria, and mixtures of isolates of tissue homogenates containing all isolates except B ovis and C psittaci were inoculated via the mucous membranes of the eyes, nares, and prepuce. Palpable epididymitis was not produced by the inoculations. The vaccine strain of B ovis induced complement-fixation reaction in 11 of 20 rams. PMID- 3521408 TI - Induction of ovulation in anestrous mares with pulsatile administration of gonadotropin-releasing hormone. AB - Four seasonally anestrous mares (Standardbred), housed under a nonstimulatory photoperiod of 8 hours light:16 hours dark, were administered gonadotropin releasing hormone (GnRH) in a pulsatile pattern (50 or 250 micrograms of GnRH/hour) for 8 to 18 days during February and March 1985. Treatment with GnRH, irrespective of dose or month, induced an increase in serum luteinizing hormone from a mean pretreatment value typical of anestrus (0.58 +/- 0.02 ng/ml +/- SE) to 10.84 +/- 1.27 ng/ml on day 8 of GnRH treatment. Ovulation in the 4 mares occurred 8.8 +/- 0.7 days after the initiation of pulsatile GnRH administration. In each instance, ovulation was followed by a functional corpus luteum, as indicated by a luteal phase (defined as the number of days on which serum levels of progesterone were greater than 1.0 ng/ml) which lasted 14.5 +/- 0.6 days. These results indicate that infusion of GnRH in a pulsatile pattern is effective in inducing follicular development and ovulation in anestrous mares in the absence of a stimulatory photoperiod. PMID- 3521409 TI - Awards for distinguished scientific contributions: 1985. PMID- 3521410 TI - Distinguished scientific award for the applications of psychology: 1985. PMID- 3521411 TI - Distinguished scientific awards for an early career contribution to psychology: 1985. PMID- 3521413 TI - Awards for distinguished contributions to psychology in the public interest: 1985. PMID- 3521412 TI - Awards for distinguished professional contributions: 1985. PMID- 3521414 TI - Assessment of lung injury in the adult respiratory distress syndrome using multiple indicator dilution curves. AB - To assess its usefulness as an index of lung injury in critically ill patients with respiratory failure, the lung microvascular permeability surface area product for urea (14C-PSu) was measured using a multiple radioisotopic indicator dilution technique in 10 patients with the adult respiratory distress syndrome (ARDS) and in a control population of 5 patients without ARDS. The mean values for 14C-PSu and for extravascular lung water (EVLW) were both significantly elevated in patients with ARDS compared with those in control patients (14C-PSu: 18.7 +/- 4.4 versus 7.6 +/- 0.7, p less than 0.05; EVLW: 676 +/- 55 versus 269 +/ 53, p less than 0.001); 14C-PSu and EVLW were significantly correlated (R = 0.52, p less than 0.001). In the patients with ARDS, 14C-PSu and oxygenation, assessed as the alveolar-arterial oxygen difference, did not appear to be correlated. Repeated measurements of 14C-PSu were variable in the 3 control patients in whom 4 or more measurements were obtained (SD = 50, 57, and 54% of the mean values, respectively); 14C-PSu did not predict clinical outcome assessed by survival of individual patients with ARDS. These data suggest that measurement of 14C-PSu in critically ill patients is a clinically applicable parameter that reflects the degree of microvascular injury in groups of patients. However, our study did not indicate a clear advantage of 14C-PSu over EVLW in assessing lung injury in this patient population. The variability in 14C-PSu control patients also suggests that directional changes in 14C-PSu, as a measure of changes in the degree of lung microvascular dysfunction, should be interpreted with caution. PMID- 3521415 TI - Interpretation of pulmonary artery wedge pressure and pullback blood gas determinations during positive end-expiratory pressure ventilation and after exclusion of the bronchial circulation in the dog. AB - Left atrial pressure (LAP) and pulmonary artery wedge pressure (PWP) were measured at different heights during graded increases in positive end-expiratory pressure (PEEP). Six healthy anesthetized dogs were placed in lateral decubitus positions with a balloon-tipped pulmonary artery catheter inserted in each lung. PWP in the gravitationally superior lung overestimated LAP at 15 and at 20 cm H2O PEEP (p less than 0.05). PWP in the dependent lung was virtually identical to LAP at all degrees of PEEP. Wedge blood could be aspirated through the distal lumen of the pulmonary artery catheters during balloon inflation at all degrees of PEEP except for 3 attempts. PCO2 in wedge blood in both the nondependent and dependent lungs at all degrees of PEEP was consistently lower than PCO2 in arterial blood (p less than 0.05). Wedge blood was arterialized, i.e., oxygen saturation greater than 95%, in all but 4 specimens. Surgical elimination of the bronchial artery supply to the lung in 3 dogs did not affect PWP or blood gas measurements. We conclude that in this animal model: (1) the tip of a pulmonary artery catheter must be below the level of the left atrium, Zone III location, to accurately reflect LAP at high degrees of PEEP; (2) arterialization of wedge blood samples does not guarantee that PWP reflects LAP; (3) bronchial artery blood supply does not affect PWP or wedge blood gas measurements, even at high degrees of PEEP. PMID- 3521416 TI - Value of chest ultrasonography versus decubitus roentgenography for thoracentesis. AB - Chest ultrasonography (CU) has been advocated as an effective tool for diagnosis and localization of pleural fluid. Studies to date supporting the technique have been anecdotal and nonrandomized. To determine if CU was beneficial when thoracentesis was performed by clinicians or house staff, we evaluated prospectively 205 patients presenting with pleural effusion at 2 community teaching hospitals. Decubitus roentgenograms were obtained on all patients, but CU with targeting by skin marker was performed on a randomized basis. Results were evaluated as to (1) whether the quantity of fluid obtained was sufficient for the intent of the procedure, (2) the number of needle insertions required to obtain the fluid, and (3) the incidence of complications such as pneumothorax. One hundred three effusions were evaluated by CU and 102 by roentgenography alone. The effusions in each group were stratified as small (obliteration of less than half of the hemidiaphragm on roentgenogram) or large. Small effusions were further stratified as free flowing or loculated (no layering of fluid on decubitus roentgenograms). By chi-square test, CU was significantly superior to decubitus roentgenograms alone for obtaining adequate fluid samples in small effusions (p less than 0.01). This was true regardless of whether the effusion was loculated (p less than 0.02) or free flowing (p less than 0.05). The technique had no such advantage in large effusions. We did not find that CU significantly reduced the need for multiple attempts nor incidence of complications in any group. PMID- 3521417 TI - Characterization of the airway response to inhaled leukotriene D4 in normal subjects. AB - To better understand the role of leukotriene D4 (LTD4) in the pathogenesis of airway hyperreactivity, we administered aerosolized LTD4 on multiple occasions to 6 normal subjects and measured specific airway conductance (SGaw) by body plethysmography and the flow rate at 30% of vital capacity from partial forced expiratory maneuvers (V30P). Dose-response curves generated from standard bronchoprovocation tests revealed that LTD4 was 280 to 590 times more potent as a bronchoconstrictor than was methacholine. The airway response to single bronchoconstricting doses of LTD4 administered on separate days was reproducible for SGaw (r = 0.86, p less than 0.05) and V30P (r = 0.95, p less than 0.005). The response to 3 consecutive single-dose LTD4 challenges performed on the same day, allowing SGaw and V30P to return to greater than 90% of the control value between challenges, demonstrated tachyphylaxis: the response to the third dose was significantly less than the response to the first dose for SGaw (p less than 0.001) and for V30P (p less than 0.01). A single bronchoconstricting dose of LTD4, given before a standard methacholine dose-response challenge, lowered the concentration of methacholine needed to decrease V30P 30% (p less than 0.05) and SGaw 35% (p = 0.09). A single bronchoconstricting dose of methacholine preceding a standard methacholine challenge did not have this effect. LTD4 and methacholine demonstrated a cumulative dose-effect when progressively higher concentrations were inhaled. In summary, the airway response to LTD4 is reproducible, exhibits tachyphylaxis, and a cumulative dose-effect occurs. As well, LTD4 increases the responsiveness of normal airways to methacholine. PMID- 3521418 TI - Biochemical analysis of nasal secretions induced by methacholine, histamine, and allergen provocations. AB - Nasal provocation tests with methacholine, histamine, and allergen were performed outside the pollen season in 26 pollen-allergic subjects with the aim of sampling nasal secretions for biochemical characterization. Sugar analyses showed that methacholine-induced secretions were a mixture of serous and mucous glycoproteins. Compared with published sputum values, the levels of proteins and sugars were approximately 5 times lower in the methacholine-induced secretions (protein, 6 mg/ml; hexose, 2 mg/ml), whereas the albumin concentrations were comparable (1 mg/ml). Histamine-induced secretions as well contained a mixture of serous and mucous glycoproteins and a high albumin level (3 mg/ml), indicating a relatively higher degree of transudation than in methacholine- and allergen induced secretions. Allergen-induced secretions had a low dry weight (mean, 19 mg/g; p less than 0.05) and protein (mean, 4 mg/ml; p less than 0.01) content compared with that in methacholine- and histamine-induced secretions; they contained mainly mucous glycoprotein, and the albumin level was relatively low. Thus, nasal secretions have lower dry weight, sugar and protein content than does sputum; histamine provokes marked transudation; methacholine and allergen do not; methacholine and histamine produce a mixture of serous and mucous glycoproteins; allergen produces mainly mucous glycoproteins. PMID- 3521419 TI - Bronchoscopy and Bactec for the diagnosis of tuberculosis. State of the art, or a brief dissertation on the efficient search for the tubercle bacillus? PMID- 3521420 TI - Oxygen delivery and uptake in the adult respiratory distress syndrome. Lack of relationship when measured independently in patients with normal blood lactate concentrations. AB - This study was designed to determine whether acute alterations in oxygen delivery (DO2) induced by the institution of positive end-expiratory pressure (PEEP) would affect oxygen uptake (VO2) in patients with adult respiratory distress syndrome (ARDS). In 8 patients with ARDS who exhibited normal blood lactate concentrations, we evaluated the relationship between DO2 and VO2 during 3 consecutive periods: intermittent positive pressure ventilation (IPPV), continuous positive pressure ventilation (CPPV) with a 10 cm H2O PEEP, and finally CPPV with volume loading. Oxygen uptake was measured directly with a mass spectrometer system. Oxygen delivery was calculated as the product of cardiac output (thermodilution) and arterial blood oxygen content (Lex-O2-Con analyzer). By comparison with the IPPV period, application of PEEP led to a decrease of DO2, which returned to baseline values when volume loading was added to PEEP. In none of the patients did VO2 parallel the changes of DO2. They demonstrated, therefore, a properly enhanced oxygen extraction during the PEEP-induced decrease of DO2. We conclude that, when measured independently, DO2 and VO2 are not correlated in patients with ARDS with normal blood lactate who are mechanically ventilated with PEEP. PMID- 3521421 TI - Survival following hepatic transplantation in the cyclosporine era. AB - In a series of 50 consecutive patients receiving 55 hepatic transplants, the 6 month survival was 76 per cent. Mortality was considerably higher in patients with complications of advanced liver failure (56%) than in patients that were not hospital-confined preceding the transplant procedure (10%). The causes of death were related primarily to technical errors, and uncommonly caused by rejection or uncontrollable infection. This striking change in the cause of death occurring in the cyclosporine era results from the use of more specific immunosuppression and close scrutiny of the allograft with frequent hepatic biopsy. Both of these principles diminish the reliance on high-dose corticosteroid therapy, and therefore promote wound healing and resistance to fatal infection. PMID- 3521422 TI - The early diagnosis of splenic abscess. AB - Five cases of splenic abscess seen between 1970 and 1984 are reviewed. The predisposing factors included preceding pyogenic infection, sickle cell disease, and contiguous disease in the pancreas. Abdominal pain and fever were the most frequent presenting symptoms. The most common physical finding was left upper quadrant (LUQ) abdominal tenderness. All patients were treated with splenectomy. In one patient percutaneous drainage was attempted prior to splenectomy but failed. The mortality rate was 20 per cent. Radiologic procedures developed in the last ten years make possible the early diagnosis and treatment of splenic abscess. The treatment of choice remains antibiotics followed by splenectomy. PMID- 3521423 TI - Hyperparathyroid crisis reviewed: a role for parenteral cimetidine? AB - Hyperparathyroid crisis secondary to primary hyperparathyroidism has variously been described as hypercalcemic crisis, parathyroid storm, and parathyroid intoxication as well as other equally descriptive terms. Whatever the nomenclature, all emphasize the seriousness and urgency of the condition. Although fewer than 200 cases have been described since the first report by Hanes in 1939, it is generally agreed that hyperparathyroid crisis is more prevalent than commonly appreciated. The signs and symptoms of the syndrome are believed due not only to the presence of hypercalcemia, but to the toxic effects of parathormone as well. Its wide, but nonspecific clinical spectrum makes it easily confused with other causes of rapidly fatal cardiovascular or renal disease. The mortality in untreated cases is essentially 100 per cent. With combined medical surgical treatment, it is still reported as high as 60 per cent. Three patients with severe hyperparathyroid syndrome are reported. Effective control of both hypercalcemia and the toxic effects of acute hyperparathyroid crisis was achieved with the use of parenteral cimetidine. Definitive surgical removal of a solitary parathyroid adenoma was performed in all three patients. The intimate relationship of the bioavailability of cimetidine and its effect in primary hyperparathyroidism is clearly demonstrated. An analogy to the use of cimetidine in Zollinger-Ellison syndrome is made. Both are endocrinopathies that require doses of cimetidine in excess of that normally considered therapeutic for peptic ulcer disease. The signs and symptoms of hyperparathyroid crisis as well as current modalities of treatment are reviewed. It is concluded that parenteral cimetidine is an important aid in the management of acute hyperparathyroid syndromes secondary to primary hyperparathyroidism. PMID- 3521424 TI - Long-term renal function in kidney donors: a comparison of donors and their siblings. AB - To assess the effects of unilateral nephrectomy, we evaluated renal function and hypertension in kidney donors who had had nephrectomies 10 years ago or more and siblings who had not had nephrectomies. No statistically significant difference was found between the prevalence of hypertension in donors and siblings. Serum creatinine concentrations were 20% higher in donors and creatinine clearances, 20% lower than corresponding values in siblings. Twenty-four-hour urinary protein excretion increased in all donors after nephrectomy and was more marked in men than women. Of the 38 donors, 12 excreted more than 150 mg/24 h of urinary protein, but only 2 excreted more than 300 mg/24 h. The presence of proteinuria did not correlate with the presence of hypertension, level of renal function, or time since nephrectomy. We conclude that, with the exception of mild proteinuria of unknown clinical significance, unilateral nephrectomy is not associated with adverse effects on kidney function. PMID- 3521425 TI - Ethical and financial issues in autologous marrow transplantation: a symposium sponsored by the University of Nebraska Medical Center. PMID- 3521426 TI - Co-trimoxazole desensitization in bone marrow transplantation. PMID- 3521428 TI - Trimethoprim-sulfamethoxazole or pentamidine for Pneumocystis carinii pneumonia in the acquired immunodeficiency syndrome. A prospective randomized trial. AB - Forty patients with the acquired immunodeficiency syndrome (AIDS) and their first episodes of Pneumocystis carinii pneumonia were assigned at random to receive either trimethoprim-sulfamethoxazole or pentamidine isethionate. The two groups did not differ significantly in the severity of pulmonary or systemic processes at enrollment. Five patients treated initially with trimethoprim-sulfamethoxazole and one patient treated initially with pentamidine died during the 21-day treatment period (p = 0.09, Fisher's exact test). No significant differences were seen between groups in rates of improvement, pulmonary function tests, or 67Ga uptake by the lungs in the survivors at completion of therapy. Adverse reactions necessitated changing from the initial drug in 10 patients in the trimethoprim sulfamethoxazole group and 11 in the pentamidine group. Minor reactions occurred in all patients. In patients with AIDS, trimethoprim-sulfamethoxazole and pentamidine do not have statistically significant differences in efficacy or frequency of adverse reactions. PMID- 3521427 TI - Treatment of donor bone marrow with monoclonal anti-T-cell antibody and complement for the prevention of graft-versus-host disease. A prospective, randomized, double-blind trial. AB - The effects of ex-vivo depletion of T lymphocytes from donor bone marrow using a monoclonal anti-T-cell antibody (CT-2) and complement on the outcome of allogeneic bone marrow transplantation was evaluated in a prospective, randomized, double-blind study of 40 patients with leukemia. Patients receiving T cell-depleted bone marrow had a lower incidence of acute graft-versus-host disease than control patients (3 of 20 compared with 13 of 20; p = 0.004), and mortality due to acute graft-versus-host disease was reduced. Five patients in the T-cell-depletion group developed graft failure; all control patients had sustained engraftment (p less than 0.05). Clinically apparent relapse of leukemia occurred in 7 patients from the T-cell-depletion group and in 2 controls (p, not significant). Cytogenetic evidence of residual leukemia was also detected in the 5 patients with graft failure without overt relapse. Infections and overall survival were similar in the two groups. The effects of T-cell depletion on engraftment and recurrence of leukemia require further evaluation. PMID- 3521429 TI - Mitoxantrone: a new anticancer drug with significant clinical activity. AB - Clinical studies using mitoxantrone, an anthraquinone, were begun in the United States in 1979. Subsequent phase II and III trials have shown that mitoxantrone has significant clinical activity in patients with breast cancer, acute leukemia, and lymphoma. The drug has antiviral, antibacterial, antiprotozoal, immunomodulating, and antineoplastic properties and is mutagenic in some animal systems. Its mechanism of action seems to involve both DNA intercalation and nonintercalative electrostatic interactions. The dose-limiting toxicity is myelosuppression when the drug is given on a single-dose, every-3-week schedule and mucositis when it is given daily for 5 days. Other toxicities include gastrointestinal and cardiac effects, the gastrointestinal toxicity being less severe and less frequent than that with the anthracycline anticancer drugs. Because of its low incidence of serious toxicities and effectiveness in treating certain solid tumors and leukemias, mitoxantrone is a promising new agent in the treatment of cancer. PMID- 3521431 TI - [Hospital Medical Society of Paris. 1986. List of members]. PMID- 3521430 TI - [Physiopathology of primary hyperlipidemias]. AB - The authors review the present status of our knowledge of the physiopathology of primary hyperlipidaemia. The mechanisms of familial hypercholesterolaemia (reduction in the number of LDL receptors on the surface of hepatic and extrahepatic cells) and of type III hyperlipidaemia (an apo E abnormality associated with another metabolic disorder) are relatively well known. However, the physiopathology of the other hyperlipidaemias remains obscure: polygenic hypercholesterolaemia probably due to a disorder of hepatic LDL receptors; combined familial hyperlipidaemia probably due to abnormally high hepatic apo B synthesis; hyperlipidaemia related to defective chylomicron catabolism in which the lipase system plays a central role and hypertriglyceridaemia caused by an association of genetic and environmental factors. PMID- 3521432 TI - [Autologous graft of bone marrow in hematology. Development of concepts]. PMID- 3521433 TI - [Autograft of bone marrow for the treatment of acute leukemia: in vitro efficacy of anti-leukemic purification]. AB - Autologous bone marrow transplantation (ABMT) is a new technique which is currently being evaluated in the treatment of leukemias, lymphomas, and a few solid tumors. In patients with acute leukemia (AL), high dose therapy + ABMT is of little benefit if done at time of relapse. On the other hand, when used for consolidation of remission, either with cleansed or non cleansed marrow, it may improve disease-free survival. In patients with acute myelocytic leukemia (AML) autografted during their 1st remission, the probability of remaining in remission at 2 years is 70 p. 100. It is slightly lower for patients with acute lymphocytic leukemia (ALL): 55 p. 100. The different techniques of cleansing the marrow, monoclonal antibodies, immunotoxins, drugs, are reviewed in this paper. A comparison of these techniques in term of tumor log cell kill is provided. ABMT is the best second line therapy for non-Hodgkin lymphomas (NHL), either after relapse after conventional chemotherapy or partial failure (partial remission). In these patients, the probability of remaining in remission at 3 years is about 50 p. 100. ABMT is currently under trial in the treatment of solid tumors and some success has been obtained in carcinoma of the ovary, non-seminomatous tumor of the testis, neuroblastoma, and some selected breast cancers. PMID- 3521434 TI - Insulin receptor as a tyrosine protein kinase. PMID- 3521435 TI - Functional domains of the nicotinic acetylcholine receptor. AB - The nicotinic acetylcholine receptor is a multisubunit, membrane-spanning protein that contains a gated, cation-conducting channel. Our approach to the understanding of the function of this receptor in molecular terms has been to locate its functionally significant sites in the sequences of its subunits and in its three-dimensional structure. In addition, we have tried to correlate transitions in the properties of these sites with functional transitions of the receptor. On binding acetylcholine, the nicotinic acetylcholine receptor enters at least two transient states, the open state and the rapid-onset desensitized state, and, in the continued presence of agonist, finally subsides into the slow onset desensitized state. The transitions of the receptor between these various states are susceptible to regulation by acetylcholine and its congeners acting at one type of site and by a broad class of noncompetitive inhibitors (NCIs), including local anesthetics, acting at other sites. The chain composition of the receptor is alpha 2 beta gamma delta. The two acetylcholine binding sites are on the alpha chains, and two residues contributing to these sites, Cys-192 and Cys 193, have been identified. Furthermore, these adjacent Cys residues are cross linked by a disulfide bond. In the quaternary structure of the receptor, the chains appear to be arranged in the order alpha gamma alpha beta delta around a central channel. Both the alpha and beta chains contribute to functionally significant NCI binding sites. The addition to receptor-rich membrane from Torpedo electric tissue of agonists (but not competitive antagonists) renders these NCI sites susceptible to photolabeling by the NCI quinacrine azide (QA). Furthermore, this susceptibility is transient, arising in milliseconds and subsiding in hundreds of milliseconds. These transiently susceptible sites are protected by other NCIs against photolabeling by QA. The time-course of the susceptibility and its dependence on agonist-concentration suggest that it might be the transient, rapid-onset desensitized state of the receptor that is most susceptible to photolabeling by QA. PMID- 3521436 TI - Simultaneous bilateral ocular metastases from a gastric carcinoma. AB - Metastatic tumors are the most common intraocular neoplasms. A rare case of adenocarcinoma of the stomach with simultaneous presentation of bilateral intraocular metastases is reported with a review of the literature. The prompt improvement in vision that occurred in this patient following radiation therapy underscores its important role in reducing the visual morbidity of patients with metastatic intraocular tumors. PMID- 3521437 TI - Predictive value of serologic tests for syphilis in otology. AB - Otologic syphilis (luetic inner ear disease) usually is diagnosed by positive serologic tests and by exclusion of other possible causes. Because the FTA-ABS for syphilis is exquisitely sensitive in all but early primary cases, a positive FTA-ABS result and coincident inner ear disease often are thought to be diagnostic of syphilitic inner ear disease. The result is a management dilemma: are there false-positive results in misdiagnosed cases? Over 4 years, the authors performed a prospective study with time-matched controls to determine the predictive value of serologic tests and prevalence of syphilis in otology. Thirty one cases of otologic syphilis were diagnosed in 5,439 new (different) patients with otologic complaints. In the geographic area studied, this prevalence (570/100,000) was 25-fold greater than that of all reported cases of syphilis in the general population (22.7/100,000). The defined sensitivity of the FTA-ABS (100%) was nearly twofold greater than the measured sensitivity of the rapid plasma reagin (RPR, 55%) in otologic syphilis. Specificities were comparable; therefore, a positive FTA-ABS had higher predictive value than a positive RPR. The prevalence-related predictive value of a positive FTA-ABS (22%) was more than twice that of the RPR (9%) in otology. The predictive value of a positive FTA-ABS in otology was 11-fold greater than that of the FTA-ABS in the general population (2%). Therefore, in suspect cases the FTA-ABS should be used to screen for otologic syphilis in an otologic practice. At a prevalence of 570 cases in 100,000 patients, only 22% of otologic patients with positive FTA-ABS results actually have otologic syphilis. Because disease morbidity can be far worse than treatment morbidity, however, positive results should be considered true positives to avoid misdiagnosis in potentially infected patients. In suspect cases with positive FTA-ABS, therefore, treatment should be recommended unless specific contraindications exist. PMID- 3521438 TI - A method for the histopathological analysis of the temporal bone and the eustachian tube and its accessory structures. AB - A very important contribution to the study of otitis media, one of the diseases most often seen in pediatric patients, is the collection, processing, and study of the specimens of the temporal bone and the entire eustachian tube. During the last few years, we have collected, processed, and studied 100 such specimens, and through these experiences our technique has become refined. We now have some important suggestions for otologists interested in the histological study of otitis media as well as in the pathology of the eustachian tube and its relation to middle ear abnormalities. This report details the most successful method for the study of eustachian tube abnormalities and their relationship to middle ear effusion. PMID- 3521439 TI - [Deposits of immune complexes in rheumatoid nodule]. AB - The classical histological features of rheumatoid nodules are similar to those of subcutaneous granuloma annulare and necrobiosis lipoidica. The same applied to the DIF images of these lesions. Rheumatoid nodules are more frequent in patients with high rheumatoid factor. Lesions of cutaneous vasculitis are a sign of severity associated with other extra-articular manifestations. Our results are consistent with those of other studies which demonstrated the presence of Ig and/or C deposits in vessels and sometimes at the dermis-epidermis junction. The deposits found in vessels are usually formed of IgM and C3, more rarely of IgG. Those found at the dermis-epidermis junction consist of IgG, IgM and C3. Immune complex deposits in the walls of venules represent the primary mechanism of leukocytoclastic vasculitis. The presence of such deposits on vessels with muscular wall in rheumatoid arthritis suggests an identical pathogenetic mechanism. No alteration of the basal membrane has been noted. The role of deposits at the dermis-epidermis junction has not yet been elucidated. PMID- 3521440 TI - [Onycholysis]. PMID- 3521441 TI - Selenium yeast. AB - Baker's yeast is able to assimilate carbon, nitrogen, phosphorus and sulphur sources together with a great number of minerals and trace elements into a palatable, nutritious product. The metabolism of yeast is precisely controlled during the production growth phase and thus it is possible to determine the composition of the product by controlling the raw materials. Because of existing deficiencies in the availability of certain trace elements, mainly selenium, in Finnish diets, we started testing the possibilities for enriching yeast with this essential trace element about five years ago. We have succeeded in developing a special yeast product with a selenium concentration of 500 mg/kg dry matter. Selenium was expected, because of its structural similarity to sulphur, to replace sulphur in the biosynthetic reactions of the yeast cell. We have recently studied the incorporation and distribution of selenium in yeast with radioactive selenium (75Se). Analysis of the protein fraction of selenium yeast has shown that selenium is present in all the major soluble proteins. Selenomethionine was identified as the major selenium-containing compound in the protein fraction as well as in the whole cell. PMID- 3521442 TI - Effect of pirmenol on premature atrial complexes. AB - Suppression of premature atrial complexes by pirmenol, a new Class I antiarrhythmic agent, was examined following oral and intravenous routes of administration. In 4 patients, single intravenous doses of 50 to 150 mg reduced premature atrial beats greater than or equal to 90% for 2 to 4 h. Oral doses of 75 to 200 mg twice daily induced a mean arrhythmia reduction of greater than or equal to 80% in 5 out of 9 patients during a 24-h electrocardiographic recording compared with a baseline period of 48 h. No significant side-effects occurred. The results indicate that pirmenol effectively suppresses premature atrial complexes, which may be of value in the prevention of supraventricular tachyarrhythmias. PMID- 3521443 TI - Comparison of low doses of hydrochlorothiazide plus amiloride and hydrochlorothiazide alone in hypertension in elderly patients. AB - A randomised, double-blind study comparing 25 mg of hydrochlorothiazide plus 2.5 mg of amiloride with 25 mg of hydrochlorothiazide alone was conducted in 40 elderly patients with mild to moderate hypertension. After 8 weeks of treatment, the target blood pressure, supine diastolic blood pressure less than 90 mm Hg, was obtained in 73% of the hydrochlorothiazide plus amiloride treated patients (n = 17) and in 41% of the hydrochlorothiazide treated patients (n = 19; p less than 0.05). However, there was no statistically significant difference in blood pressure reduction between the 2 groups. Four patients dropped out, 3 of them due to side-effects. Serum potassium and magnesium concentrations were reduced in the hydrochlorothiazide group and serum sodium concentration in the hydrochlorothiazide plus amiloride group. Our results suggest that in elderly hypertensive subjects, a higher proportion of patients could be managed with the low dose hydrochlorothiazide plus amiloride regimen than with the low dose hydrochlorothiazide regimen. PMID- 3521444 TI - Effect of cholestyramine on acute diarrhoea in children receiving rapid oral rehydration and full feedings. AB - Cholestyramine 2 g twice daily for 3 days was compared to an equivalent placebo in a randomized double-blind study of infants hospitalized for acute diarrhoea. All the patients received oral rehydration with the WHO solution, and full feedings were reintroduced after 6-10 hours' rehydration. Cholestyramine therapy, initiated at the time of feedings, significantly shortened the duration of watery diarrhoea (0.8 +/- 0.6 vs. 2.3 +/- 1.6 days, p less than 0.005), although it did not significantly reduce the total stool volume. No adverse effects were associated with cholestyramine treatment. It is concluded that diarrhoea patients treated according to the present WHO guidelines may benefit from short adjunct therapy with cholestyramine. PMID- 3521445 TI - Therapeutic immunosuppression in cardiac transplantation. AB - There is continual re-evaluation of immunosuppressive protocols as clinical experience increases in cardiac allotransplantation. Loyola University Medical Center has performed 44 heart transplants over a span of 18 months. The initial protocol was a distillate of several established regimens (Stanford, Pittsburgh, and Papworth). Since its inception, cyclosporine loading dosage has been reduced between 20 to 50 percent. Azathioprine in graded dosage is automatically added immediately post transplantation, corticosteroids are rapidly decreased, and cumulative antithymocyte globulin dosage is less. Except for the use of methotrexate as a last alternative, rejection episodes are treated conventionally. Very little nephrotoxicity has occurred with any of the protocols. PMID- 3521446 TI - [Lasers and digestive system cancers]. PMID- 3521447 TI - Androgen receptors and partial androgen insensitivity in male pseudohermaphroditism. AB - Male pseudohermaphroditism can occur either as a result of inadequate fetal androgen secretion or ineffective androgen action. Partial androgen insensitivity syndrome is related to a decrease in the binding capacity of target cells androgen receptors. However, the biochemical expression of these syndromes is variable: although a low concentration of androgen receptors is observed in 75% of the cases, a normal binding capacity is sometimes reported. If the presence of androgen receptors is necessary for hormonal action, it is not sufficient since the receptor has to conserve its functional integrity. Several qualitative abnormalities of the androgen receptor have been described and could thus explain the disturbance in the androgen mechanism of action. The study of androgen dependent proteins and other androgen-receptor "markers" should offer the clinician a better management of partial androgen insensitivity and allow, in amniotic or trophoblastic cells, a prenatal diagnosis of androgen resistance in high-risk families. PMID- 3521448 TI - [Influence of glucose on the conversion of galactose into galactitol in the young adult]. AB - The levels of galactose and galactitol in the sera of 6 young adults after ingestion of 0.25 g/kg of galactose alone or with the same quantity of glucose were studied. The results showed that: glucose decreased significantly the galactosemia and galactitolemia observed after ingestion of galactose alone; repeated consumption on 4 consecutive days of galactose alone induced an increase in galactosemia, and more significantly in galactitolemia. The addition of glucose to galactose in the same conditions abolished these effects. PMID- 3521449 TI - Effect of dietary vitamin E on the vitamin E status in the BB rat during development and after the onset of diabetes. AB - Weanling diabetes-prone BB rats were fed AIN-76 diets containing high (HE, 1 g/kg diet), basal (NE, 0.2 g/kg) or low (LE, trace) vitamin E and were killed at 21, 42 or 60 days of age. Plasma and tissues (adrenals, pancreas, spleen, thymus, liver, brown and white adipose tissue, muscle and testes) were analysed for vitamin E. Vitamin E levels reflected the level in the diet and no diabetic animals were detected at these times. In a second experiment, a total of 90 diabetes-prone BB rats were kept on diets LE and HE for 6 months or until they became diabetic. 11/45 on LE and 5/45 on HE became diabetic. Again, plasma and tissue levels of vitamin E reflected the levels in the diet with the exception of the thymus of diabetic rats fed the high vitamin E diet. Thymus vitamin E levels (microgram/g tissue) were 1.8 and 1.2 in LE-fed diabetics and asymptomatic rats, respectively; and 22.7 and 49.5 in HE-fed diabetics and asymptomatic rats, respectively. The last 2 values were significantly different (p less than 0.005). There were no other differences in plasma or tissue levels of vitamin E in these groups of animals. These findings suggest that high dietary vitamin E may decrease the incidence of diabetes in animals which are able to accumulate sufficient amounts of the vitamin in the thymus. Since the thymus plays a key role in the maturation of T cell populations, which appear to be altered in this disease, it seems possible that the protective effect may be exerted at this level. PMID- 3521450 TI - [Radiological exploration of the inferior vena cava in nephroepithelioma]. AB - The development of non-invasive procedures, namely ultrasonography and computed tomography, has modified the strategy for evaluating the spread of a nephroepithelioma to the inferior vena cava. When a complete study can be performed, ultrasonography is the most informative method. Angiographic studies are only performed as the second choice. PMID- 3521451 TI - On becoming and being a pharmacologist. PMID- 3521452 TI - Renal calcium metabolism and diuretics. AB - Diuretic agents have variable effects on calcium excretion as studied in vivo and in isolated kidneys and nephron segments. Generally, by increasing sodium and water excretion, diuretics will cause a concomitant increase in calcium excretion. As they diminish blood volume and alter renal hemodynamics, diuretics enhance calcium reabsorption in the proximal tubule, modulating their usual effects on calcium excretion. These general effects can be further modulated by additional metabolic actions. For instance, chronic administration of thiazide diuretics may diminish calcium excretion on the basis of altered levels of or responsiveness to PTH. Agents such as acetazolamide, which diminish bicarbonate reabsorption in the proximal tubule, will cause a modest calciuria, if any, because of reabsorption of the increased delivery of calcium, but not sodium, at the distal nephron. Agents acting in the loop of Henle that increase chloride excretion relative to sodium tend to cause greater calcium excretion. Finally, agents that act beyond the loop of Henle, which have their primary effects on cation excretion, tend to cause lesser degrees of calcium excretion, especially relative to sodium. These principles indicate that it may be appropriate to select a specific diuretic agent for different patients, depending upon the state of their calcium balance. It also may be possible to predict alterations in calcium balance, so that these may be anticipated and compensated for with patients on long-term therapy with various diuretic agents. PMID- 3521453 TI - Marine pharmacology: bioactive molecules from the sea. PMID- 3521454 TI - The pharmacology of intravascular radiocontrast media. PMID- 3521455 TI - Leukocytes and ischemia-induced myocardial injury. PMID- 3521456 TI - Current antidepressants. PMID- 3521457 TI - The metabolism of xenobiotics by certain extrahepatic organs and its relation to toxicity. PMID- 3521458 TI - Control by drugs of renal potassium handling. AB - This review has focused on the influence of several diuretic drugs on potassium handling by the kidney. One class of drugs (loop diuretics) acts by directly inhibiting a potassium absorptive mechanism in the luminal membrane of cells of the thick ascending limb of Henle's loop. Two other groups of diuretics affect potassium transport indirectly by inhibiting salt and water absorption upstream from the potassium secretory site in the late distal tubule: carbonic anhydrase inhibitors act in the proximal tubule; thiazides act in the early distal tubule. The subsequent increase in lumen flow rate then stimulates net potassium secretion by the distal tubule. A fourth class of drugs (spironolactone) acts by antagonizing the response of the distal tubule to aldosterone. These drugs decrease the ability of aldosterone to stimulate distal potassium secretion. Finally, a fifth group of drugs (potassium-sparing diuretics) decreases potassium secretion by increasing the luminal membrane voltage and thus decreasing the electrochemical gradient for potassium exit from the cell. PMID- 3521459 TI - The regulation of cytochrome P-450 gene expression. PMID- 3521460 TI - The biological basis and measurement of thresholds. PMID- 3521461 TI - Molecular pharmacology of botulinum toxin and tetanus toxin. PMID- 3521462 TI - Electrophysiological correlates of sensorimotor system neurotoxicology. PMID- 3521463 TI - Toxicological aspects of alterations of pulmonary macrophage function. PMID- 3521464 TI - Review of reviews. PMID- 3521465 TI - Drug ototoxicity. PMID- 3521466 TI - [Preparative synthesis of the antiviral nucleoside 9-beta-D arabinofuranosyladenine by using bacterial cells]. AB - The conditions of synthesis of 9-beta-D-arabinofuranosyladenine, an antiviral nucleoside by intact cells of Escherichia coli capable of adenine transarabinosylation were studied. The cells were grown in meat-peptone broth supplemented with yeast extract. Cytosine arabinoside served as a donor of the arabinose residues. The pH value, temperature of the reaction medium and concentration of phosphate ions in it were shown to be significant factors defining the cell activity. Under optimal reaction conditions: 0.03 M potassium phosphate buffer, pH 6.75; 0.03 M cytosine arabinoside; 0.01 M adenine; 5 per cent of the cells; incubation time 12 hours; incubation temperature 60 degrees C the efficiency of 9-beta-D-arabinofuranosyladenine synthesis reached 90-95 mol % with respect to the initial adenine level. PMID- 3521467 TI - [Mathematical modelling of the interaction of the plague capsular antigen with antibodies of varying affinity]. AB - The group of high affinity antibodies is advantageous in antigen binding because of different dissociation rates of the antigen-antibody complexes. An antigen interacts with such a group in accordance with the value of the parameters characterizing the group and the antigen. The unbound antigen interacts with the subsequent group by the affinity value and so on. This is the basis of the presented model of univalent antigen interaction with antibodies of different affinity. The model values of the concentration of the bound and free antigens were close to the experimental ones for hyperimmune antiplague horse serum and monoclonal antibodies. The correspondence of the model values to the experimental ones is in favour of the suggested explanation of antigen interaction with antibodies of different affinity. It is advisable that the results be taken into account in estimation of biotechnological possibilities of the preparation of high affinity antibodies. PMID- 3521468 TI - [Use of DNA-DNA hybridization methods for studying the epidemiology and evolutionary similarity of drug resistance determinants]. AB - A procedure for rapid mass assay of clinical strains of microorganisms based on DNA-DNA hybridization was developed. Epidemiology of the gentamicin resistance determinant cloned earlier from clinical strains of the same hospital was studied and its plasmid localization in representatives of various genera of Enterobacteriaceae was confirmed. The studies on dot-hybridization showed that in three antibiotic-producing organisms, i.e. S. fradiae 918 producing neomycin, M. purpurea 1535 producing gentamicin and S. rimosus 65 producing oxytetracycline there were DNA sequences homologous to those of the gentamicin resistance determinant cloned from the clinical isolates. PMID- 3521469 TI - [Conjugative R-plasmids simultaneously belonging to the 2 incompatibility groups INC I zeta and INC B]. AB - Five plasmids detected in the clinical strains of Shigella were studied. The plasmids had similar phenotypes of antibiotic resistance and allotted streptomycin and tetracycline resistance to the host cell. None of them allotted the bacterial cells with sensitivity to phages specific for the Inc groups F, N, P and I. The molecular weights of the plasmids ranged from 47 to 50 MD. The studies on the incompatibility showed that pKMR 227, pKMR 228-1, pKMR 231, pKMR 242-1 and pKMR 245 plasmids simultaneously belonged to two Inc groups: Inc I zeta and Inc B. Two plasmids, i.e. R 805a and R 861a simultaneously belonging to the two Inc groups: Inc I zeta and Inc B are described in the literature. pKMR 231 and pKMR 242-1 plasmids detected by the authors differ from them by the antibiotic resistance phenotype. The other three pKMR plasmids in addition differ from them by belonging to Fin. PMID- 3521470 TI - [Diagnostic preparations based on monoclonal antibodies]. AB - The specific activity of diagnostic preparations based on monoclonal IgM MAK-14-7 interacting with the antigens of the Venezuela equine encephalomyelitis virus, monoclonal IgG KAMA-51 interacting with the antigens of the forest spring encephalitis virus and monoclonal IgA OKA and IgM OKA binding to the antigens of the vaccine virus was studied by the enzymatic immunological and immunofluorescent tests. Both the ascitic preparations of the antibodies and the fluorescein isothiocyanate-conjugated reagents such as MAK-FITC, KAMA-FITC and OKA-FITC were characterized by high specificity and activity. The specific sensitivity and activity of the monoclonal immunoglobulins was completely maintained in the mixed and combined preparations. PMID- 3521471 TI - [Genetic and molecular characteristics of the conjugative R-plasmids of S. typhimurium]. AB - The molecular genetic properties of R plasmids from 8 strains of S. typhimurium isolated in hospitals of the Far East of the USSR were studied. It was shown that conjugative R plasmids of S. typhimurium were characterized by belonging to the Inc F1 group, rigorous control of replication, the fi+ type and the transfer frequency of 10(-3) to 10(-4) per a donor cell. The plasmid profile of the S. typhimurium strains was represented by 2 plasmids: conjugative with a molecular weight of about 64 MD and nonconjugative with a molecular weight of 2 MD. The conjugative R plasmids of the hospital strain VG 103 of S. typhimurium were characterized by molecular genetic identity. They were derivatives of the pVG 103 plasmid. PMID- 3521472 TI - [Monocyclic beta-lactam antibiotics]. PMID- 3521473 TI - In vivo evaluation of A-56619 (difloxacin) and A-56620: new aryl fluoroquinolones. AB - A-56619 and A-56620 are two new aryl-fluoroquinolones which are as potent as or more potent than norfloxacin when administered orally and subcutaneously in mouse protection tests against Staphylococcus aureus, Streptococcus pyogenes, and Streptococcus pneumoniae. A-56619 and A-56620 were more potent than norfloxacin when administered orally against Escherichia coli, Proteus mirabilis, Serratia marcescens, and Pseudomonas aeruginosa. A-56620 was as potent or two- to threefold more potent than norfloxacin when administered subcutaneously against members of the family Enterobacteriaceae and Pseudomonas aeruginosa. Infection with Salmonella typhimurium was more effectively treated with A-56619 (50% effective dose [ED50], 1.4 mg/kg per day) than with norfloxacin (ED50, 62.8 mg/kg per day). E. coli or Pseudomonas pyelonephritis in mice was more effectively treated with A-56619 or A-56620 than with norfloxacin. After oral treatment, the ED50s of A-56619 and A-56620 were less than 12.5 mg/kg per day against E. coli and 62.9 and 38 mg/kg per day against P. aeruginosa pyelonephritis, respectively. Norfloxacin was ineffective at 200 mg/kg per day against E. coli or P. aeruginosa pyelonephritis. A-56619 and A-56620 were also more potent than norfloxacin in treatment of mixed bacterial pyelonephritis caused by E. coli and Streptococcus faecalis. A-56619 was at least 30 times more potent than norfloxacin and A-56620 was 4 to 11 times more potent than norfloxacin when administered against Klebsiella pneumonia in mice. A-56619 and A-56620 were at least 2 to 10 times more potent than norfloxacin against Staphylococcus aureus infections in immunosuppressed mice. A-56619 was equally potent in all in vivo tests when administered orally or subcutaneously, whereas A-56620 was similar to norfloxacin in being more potent when administered subcutaneously. The peak serum levels after subcutaneous and oral administration of A-56619 and A-56620 were higher than that of norfloxacin. The serum hal-lives of A-56619 and A-56620 after subcutaneous and oral administration were longer than the serum half-life of norfloxacin. PMID- 3521474 TI - Emergence of aminoglycoside 3-N-acetyltransferase IV in Escherichia coli and Salmonella typhimurium isolated from animals in France. AB - We studied two outbreaks of calf salmonellosis caused by apramycin and gentamicin resistant Salmonella typhimurium strains. In both cases, the responsible strains were resistant to ampicillin, chloramphenicol, kanamycin, streptomycin, tetracycline, and trimethoprim; one strain was also resistant to nalidixic acid in one outbreak. A systematic survey of the intestinal Escherichia coli strains of calves from the two affected flocks showed that 11 of 24 animals sampled were also colonized by apramycin- and gentamicin-resistant E. coli strains. These isolates belonged to four biotypes and were resistant to ampicillin, chloramphenicol, kanamycin, streptomycin, tetracycline, trimethoprim, and nalidixic acid. All of the strains were resistant to high levels of apramycin (MICs, 512 to 1,024 micrograms/ml) and to gentamicin (MICs, 8 to 32 micrograms/ml), and these resistances were always transferred en bloc. In S. typhimurium, this coresistance was borne by plasmids that were approximately 39 kilobases long (outbreak 1) or 90 kilobases long (outbreak 2), whereas in E. coli, the coresistance was due to plasmids that were approximately 110 kilobases long in both outbreaks. The two plasmids of Salmonella and four plasmids of E. coli encoded type IV aminoglycoside 3-N-acetyltransferases. The intensive use of curative and preventive treatments in calf production could be responsible for the emergence of enzymic resistance to apramycin and gentamicin. PMID- 3521475 TI - Prospective randomized comparison of three antibiotic regimens for empirical therapy of suspected bacteremic infection in febrile granulocytopenic patients. AB - The standard regimen used by members of the European Organization for Research on Treatment of Cancer Antimicrobial Therapy Cooperative Group for empiric therapy of febrile neutropenic cancer patients has been treatment with ticarcillin plus amikacin. A three-arm prospective randomized controlled trial was performed to determine whether the extended-spectrum antipseudomonal penicillin azlocillin or the extended-spectrum cephalosporin cefotaxime had more or less efficacy than the beta-lactam in the ticarcillin-plus-amikacin regimen. A total of 742 patients from 22 institutions were evaluated. Single gram-negative rod bacteremias accounted for 83 episodes, and it was among these patients that the prognosis was least satisfactory, leading to a more intensive evaluation of this patient group. In these patients the azlocillin-plus-amikacin regimen resulted in a 66% response rate, compared with a 37% response rate for patients who received cefotaxime plus amikacin (P = 0.080) and a 47% response rate for patients who received ticarcillin plus amikacin (P = 0.207). The patients with gram-negative rod bacteremias and persistently profound granulocytopenia had substantially poorer response rates (37%) than the patients with rising granulocyte counts (73%; P = 0.004). A logistic regression analysis indicated that the following factors also affected infection resolution: beta-lactam utilization in the regimen (azlocillin was better than ticarcillin or cefotaxime), resolution of profound granulocytopenia (less than 100 cells per microliter) during therapy, and susceptibility to the beta-lactam antibiotic. PMID- 3521476 TI - A 19F nuclear magnetic resonance study of uptake and metabolism of 5 fluorocytosine in susceptible and resistant strains of Candida albicans. AB - The metabolism of the antifungal drug 5-fluorocytosine (5-FC) was studied in intact viable cells of Candida albicans by 19F nuclear magnetic resonance (NMR). The uptake of the drug and its conversion to the deaminated product 5 fluorouracil (5-FU) were easily observed by NMR analysis of both the cells and the supernatants of the incubation mixture. In the 5-FC-resistant mutant D14 of C. albicans, which lacked cytosine deaminase activity, the resonance peak of 5-FU was not observed. In intact cells of all 5-FC-susceptible strains the metabolism of 5-FU progressed to the formation of other fluorinated derivatives which were visualized as a single, broad resonance band at a lower field with respect to 5 FC and 5-FU. This band was resolved into three distinct peaks in the acid extract of treated cells, one of these peaks being attributable to 5-fluoro-dUMP (5 FdUMP). In strain 72R of C. albicans, which is 5-FC resistant because of a low level of UMP-pyrophosphorylase activity, the broad, low-field resonance band was detected later and with much less intensity than in the 5-FC-sensitive strains. This suggests that, besides 5-FdUMP, this band is also contributed to by 5-FUMP and possibly other phosphorylated derivatives. 19F NMR analysis also revealed that a significant amount of 5-FU is secreted into the external medium, the rate of secretion being higher in 5-FC-resistant strain 72R than in 5-FC-sensitive strain 72S. Although not all resonances were definitely identified, this study shows that 19F NMR spectroscopy may be an important tool for noninvasive analysis of the metabolism of fluorinated drugs in yeasts. PMID- 3521477 TI - Cloning and molecular epidemiology of plasmid-determined fosfomycin resistance. AB - The plasmid determinant of resistance to fosfomycin (For) was cloned into pBR322 and located in a 0.7-kilobase segment of DNA by transposon mutagenesis and in vitro deletion analysis. It encodes an 18-kilodalton protein located in the cytoplasm of resistant cells. Its synthesis is constitutive. The For genetic determinant is common to all plasmids isolated since 1975 in an hospital environment as determined by DNA-DNA hybridization. However, plasmids which carry For can be divided into two groups on the basis of size, pattern of antibiotic resistances, incompatibility specificity, and restriction and hybridization properties. PMID- 3521478 TI - Plasmid-encoded amikacin resistance in multiresistant strains of Klebsiella pneumoniae isolated from neonates with meningitis. AB - Two multiresistant Klebsiella pneumoniae strains isolated from cerebrospinal fluid of human neonates were analyzed for their plasmid content. Two of the plasmids harbored by these strains, pJHCMW1 (11 kilobase pairs) and pJHCMW4 (75 kilobase pairs), carried genetic determinants for amikacin resistance. These plasmids also encoded resistance to kanamycin, tobramycin, and ampicillin which could be transferred to Escherichia coli by conjugation. Extracts from transconjugant derivatives carrying pJHCMW4 produced an acetyltransferase activity that acetylated all three aminoglycosides. Transconjugant derivatives carrying pJHCMW1 encoded both acetylating and phosphorylating activities. Southern blot hybridization analysis indicated considerable DNA homology between these two plasmids. PMID- 3521479 TI - Possible physiological functions of penicillin-binding proteins in Staphylococcus aureus. AB - There are four penicillin-binding proteins (PBPs) in Staphylococcus aureus, of which PBPs 2 and 3 are essential. Cefotaxime binds selectively to PBP 2, and cephalexin binds to PBP 3, each at its respective MIC. The morphology of S. aureus strains grown in the presence of the two antibiotics was examined by phase contrast and scanning electron microscopy. Exposure of the cells to cefotaxime at concentrations at which it bound selectively to PBP 2 resulted in the extrusion of cytoplasm and cell lysis, whereas exposure to cephalexin at concentrations at which it bound exclusively to PBP 3 resulted in cell enlargement and the cessation of septation. The latter morphological response was very similar to that produced by norfloxacin. The results suggest that in S. aureus, PBP 2 may be the primary peptidoglycan transpeptidase, and PBP 3 may be involved in septation. PMID- 3521480 TI - Oral rimantadine hydrochloride therapy of influenza A virus H3N2 subtype infection in adults. AB - In a randomized, double-blind trial involving patients with uncomplicated influenza A H3N2 subtype virus infection, rimantadine treatment (200 mg/day for 5 days) was associated with significant reductions in nasal secretion viral titers (days 2 through 4), maximal temperature (days 2 and 3), time until defervescence (mean, 37 h shorter), and systemic symptoms compared with placebo treatment. PMID- 3521481 TI - Dissemination of the tetM tetracycline resistance determinant to Ureaplasma urealyticum. AB - Ureaplasma urealyticum is an organism considered susceptible to tetracycline. Ten tetracycline-resistant (Tcr) clinical isolates and Tcr serotype 9 were examined. All contained DNA sequences homologous to the streptococcal determinant tetM. They differed from each other on sodium dodecyl sulfate-polyacrylamide gel electrophoresis, Southern blots, and immunoblots and appeared to represent different strains. PMID- 3521482 TI - Reduction of cephamycin concentrations at the infection site in mice with experimental peritoneal infection caused by cephalosporinase-producing bacteria. AB - In an experimental model of peritoneal infection by cephalosporinase- (Ia and Ic) producing bacteria in mice, the reduction of cefoxitin, cefmetazole, and cefazolin concentrations in peritoneal fluid was observed in the mice infected with the Ia enzyme producer, whereas cefbuperazone concentrations were not reduced. PMID- 3521483 TI - Synergistic action of nikkomycins X and Z with papulacandin B on whole cells and regenerating protoplasts of Candida albicans. AB - Combinations of nikkomycin X (NX) or nikkomycin Z (NZ), known inhibitors of chitin synthesis in fungi, together with papulacandin B (PB), an inhibitor of beta-glucan synthesis, were tested for synergistic activity against four isolates of Candida albicans by using the broth microdilution checkerboard technique and a method to assess the regeneration of cell wall material in protoplasts. The construction of isobolograms from the data generated by the checkerboard determinations revealed a synergistic effect for the two classes of compounds against all strains. The combination of NX and PB was more effective than the combination of NZ and PB, perhaps reflecting the lower Ki value of NX. While the presence of NX and NZ reduced chitin synthesis, as determined by staining with calcofluor white and assaying with a microfluorimeter, cells treated with PB demonstrated an increased synthesis of chitin. Protoplast regeneration experiments using similar concentrations of the two classes of compounds resulted in comparable findings. The combination of NX and PB resulted in a greater inhibition of chitin synthesis than did equivalent combinations of NZ and PB. These data suggest that combinations of agents active against cell wall synthesis in fungi may prove more useful as chemotherapeutic agents than such compounds used singly. PMID- 3521484 TI - Evaluation of pefloxacin in experimental Escherichia coli meningitis. AB - The therapeutic efficacy of the fluoroquinolone pefloxacin mesylate was compared with those of cefotaxime and chloramphenicol in a rabbit model of Escherichia coli meningitis. The mean percent penetration (+/- the standard deviation) of pefloxacin (range, 1 to 30 mg/kg per h) into cerebrospinal fluid of infected rabbits was 51.3 +/- 14.0 compared with 11.1 +/- 1.0 for cefotaxime (100 mg/kg per h) and 22.3 +/- 1.5 for chloramphenicol (60 mg/kg per h). The rate of bacterial killing (delta log10 CFU/ml per h) did not change over a dosage range of 1 to 15 mg/kg per h (-0.37 +/- 0.15, 20% sterile). At 30 mg/kg per h, the rate achieved (-0.77 +/- 0.18, 100% sterile) was comparable to that of cefotaxime ( 0.88 +/- 0.23, 100% sterile) and superior to that of chloramphenicol (-0.10 +/- 0.14, 0% sterile). PMID- 3521485 TI - Novobiocin antagonism of amastigotes of Trypanosoma cruzi growing in cell-free medium. AB - Inhibitors of the enzyme bacterial topoisomerase II (DNA gyrase) were evaluated for activity against Trypanosoma cruzi (Brazil strain), based on the theoretical need for a topoisomerase II in the replication of the kinetoplast DNA network. Novobiocin (500 micrograms/ml) antagonized amastigotes of T. cruzi growing in a cell-free medium at 37 degrees C, as manifested by inhibition of multiplication, abnormal morphology of Giemsa-stained organisms, and delayed or absent growth of cells upon subculturing in a drug-free medium. In contrast, novobiocin (1,000 micrograms/ml) essentially had no effect on the multiplication and motility of epimastigotes growing in a cell-free medium at 27 degrees C. This resistance of epimastigotes represented a difference in the physiology of this morphologic stage and not in the temperature of experimentation, because novobiocin inhibited multiplication of amastigotes at 27 degrees C as well and accelerated transformation to epimastigotes. With T. cruzi growing within cultured human fibroblasts, novobiocin (200 micrograms/ml) markedly inhibited transformation of intracellular amastigotes to trypomastigotes. Clorobiocin, a structural analog of novobiocin and likewise an inhibitor of the B subunit of bacterial topoisomerase II, was five times more potent on a molar basis than novobiocin was in antagonism of amastigotes growing in a cell-free medium and did not antagonize epimastigotes. Coumermycin A1, another analog of novobiocin, and five 4-quinolone antibacterial agents, antagonists of the A subunit of bacterial topoisomerase II, inhibited neither amastigotes nor epimastigotes. These experiments indicate that novobiocin and clorobiocin represent a new structural class of drugs with activity against T. cruzi. Whether the mechanism of action of these drugs involves antagonism of a T. cruzi topoisomerase II or an unrelated target is yet to be determined. PMID- 3521486 TI - Isolation, characterization, and mode of action on Escherichia coli strains of microcin D93. AB - Microcin D93 is an antibiotic substance produced by Escherichia coli strains which harbor the 5.5-kilobase plasmid pMccD93. Its production is unaffected by the use of different carbon and ammonia sources, different phosphate concentrations, or mitomycin C. We developed a method for purifying this microcin based on gel permeation chromatography and reverse-phase high-pressure liquid chromatography. The antibiotic appears to be a small, hydrophilic, basic peptide, active on E. coli and Proteus, Citrobacter, and Pseudomonas species and much more active on recA strains than on their isogenic wild type. Diminution of the rate of DNA biosynthesis without any apparent effect on other macromolecules appears to be a primary effect in the action of microcin D93. PMID- 3521487 TI - A placebo-controlled trial of topical 8% arildone cream early in recurrent genital herpes. AB - Arildone is an aryl diketone which is inhibitory in vitro against herpes simplex virus type 2 at a concentration of 2 micrograms/ml or less. One hundred forty five patients with recurrent genital herpes were enrolled in a multicenter, randomized, placebo-controlled, double-blind trial to evaluate the efficacy and safety of an 8% arildone cream. Patients initiated therapy a mean of 9.9 h and a maximum of 24 h after the reported onset of lesions and applied medication 6 times daily for 7 days. The duration of viral shedding was shorter among women (P less than 0.05) and the duration of local itching was shorter among men (P less than 0.05) in patients that received arildone than in those that received placebo, but there were no significant differences between treatment groups in duration of pain, time to crusting or healing of lesions, or percentage of patients developing new lesions. Mild local irritation after application of ointment was common and occurred equally in both treatment groups. Despite early application, topical arildone cream was ineffective in the therapy of acute recurrences of genital herpes. PMID- 3521488 TI - Canavanine resistance in Cryptococcus neoformans. AB - All of the isolates of Cryptococcus neoformans var. gattii which we tested were resistant to greater than or equal to 3.5 mM canavanine. All of the serotype D isolates and 28% of the serotype A isolates of C. neoformans var. neoformans tested were susceptible to less than or equal to 18 microM canavanine, whereas the remaining 72% of the serotype A isolates were as resistant as the C. neoformans gattii isolates. In the naturally resistant isolates, the mechanism of resistance appeared to be decomposition of canavanine to a nontoxic product. However, in a resistant mutant derived from a naturally susceptible isolate, the mechanism of resistance was an impaired uptake system for canavanine. The toxic effect of canavanine in Cryptococcus results from the incorporation of canavanine into the protein component that is essential for the synthesis of proteins and RNAs. PMID- 3521489 TI - Plasmid-mediated high-level resistance to erythromycin in Escherichia coli. AB - Escherichia coli BM2195 was found to be resistant to high levels of erythromycin. This new resistance phenotype was due to the constitutive synthesis of an erythromycin esterase which inactivates the antibiotic. The gene conferring resistance to erythromycin in this strain is carried on a 61-kilobase self transferable plasmid, pIP1100, belonging to incompatibility group X. PMID- 3521490 TI - Differences in susceptibility to quinolones of outer membrane mutants of Salmonella typhimurium and Escherichia coli. AB - The mechanism of penetration of quinolones through the bacterial outer membrane was studied with lipopolysaccharide-deficient and porin-deficient mutants. The data indicated that the lipopolysaccharide layer might form a permeability barrier for hydrophobic quinolones such as nalidixic acid but not for hydrophilic quinolones such as norfloxacin and ciprofloxacin. The results also showed that quinolones with a low relative hydrophobicity appeared to permeate through OmpF porin, whereas quinolones with a low relative hydrophobicity appeared to permeate through OmpF porin, whereas quinolones with a high relative hydrophobicity appeared to permeate through both OmpF porin and phospholipid bilayers. PMID- 3521492 TI - Purification and properties of glucosidase I from mung bean seedlings. AB - The microsomal enzyme fraction from mung bean seedlings was found to contain glucosidase activity capable of releasing [3H]glucose from the glucose-labeled Glc3Man9GlcNAc. The enzymatic activity could be released in a soluble form by treating the microsomal particles with 1.5% Triton X-100. When the solubilized enzyme fraction was chromatographed on DE-52, it was possible to resolve glucosidase I activity (measured by the release of [3H]glucose from Glc3Man9GlcNAc) from glucosidase II (measured by release of [3H]glucose from Glc2Man9GlcNAc). The glucosidase I was purified about 200-fold by chromatography on hydroxylapatite, Sephadex G-200, dextran-Sepharose, and concanavalin A Sepharose. The purified enzyme was free of glucosidase II and aryl-glucosidase activities. Only a single glucose residue could be released from the Glc3Man9GlcNAc by this purified enzyme and the other product was the Glc2Man9GlcNAc. Furthermore, this enzyme was inhibited in a dose-dependent manner by kojibiose, an alpha-1,2-linked glucose disaccharide, but not by other alpha linked glucose disaccharides. These data indicate that this glucosidase is a specific alpha-1,2-glucosidase. The pH optimum for the glucosidase I was about 6.3 to 6.5, and no requirements for divalent cations were observed. The enzyme was inhibited strongly by the glucosidase processing inhibitors, castanospermine and deoxynojirimycin, and less strongly by the plant pyrrolidine alkaloid, 2,5 dihydroxymethyl-3,4-dihydroxypyrrolidine. However, the enzyme was not inhibited by the mannosidase processing inhibitors, swainsonine, deoxymannojirimycin or 1,4 dideoxy-1,4-imino-D-mannitol. The stability of the enzyme under various conditions and other properties of the enzyme were determined. PMID- 3521491 TI - Polysaccharide lyases. AB - Polysaccharide lyases (or eliminases) are a class of enzymes (EC 4.2.2.-) that act to cleave certain activated glycosidic linkages present in acidic polysaccharides. These enzymes act through an eliminase mechanism, rather than through hydrolysis, resulting in unsaturated oligosaccharide products. Acidic polysaccharides are ubiquitous and so are the lyases that degrade them. This review article examines lyases that act on acidic polysaccharides of plant, animal, and microbial origin. These lyases are predominantly of microbial origin and come from a wide variety of both pathogenic and nonpathogenic bacteria and fungi. The lyases discussed include alginate lyase (EC 4.2.2.3), pectin lyase (EC 4.2.2.10), pectate lyase (EC 4.2.2.2), oligogalacturonide lyase (EC 4.2.2.6), exopolygalacturonate lyase (EC 4.2.2.9), chondroitin lyases (EC 4.2.2.4 and EC 4.2.2.5), hyaluronate lyase (EC 4.2.2.1), heparin lyase (EC 4.2.2.7), heparan lyase (EC 4.2.2.8), and other unclassified lyases. This review examines the sources, regulation, purification, and properties of these polysaccharide lyases. PMID- 3521493 TI - [Electrolyte abnormalities associated with cancer: a review]. AB - There are a variety of water and electrolyte disorders in patients with cancer. These disorders occur during the growth of tumors, generally as a consequence of inadequate intake and absorption of electrolytes, renal failure secondary to tumor or rapid tumor destruction and production of metabolically active substances by the tumor. In this paper, the electrolyte abnormalities associated with cancer were reviewed. Hyponatremia is one of the most common clinical electrolyte abnormalities in advanced cancer. Some patients may have hyponatremia, in spite of increased total body sodium and absence of a defect in water diuresis. This status is designated as "sick cell syndrome" or "essential hyponatremia". In addition, the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) in association with various tumors has been described. This syndrome is principally due to water retention, but can also be due to continuous urinary loss of sodium, and hypo-osmolality. Hypercalcemia is associated with coexistent primary hyperparathyroidism, prostaglandin (PGE2) or osteoclast-activating factor. It now seems likely that ectopic PTH is rarely the cause of hypercalcemia in nonparathyroid cancer. There are no data supporting the ectopic production of vitamin D-like substance as an important factor in the hypercalcemia of cancer. There are three general categories in which patients with hypercalcemia and cancer may be placed: those with bone metastases, those without bone metastases of solid tumors and those with hematologic malignancies. Hypokalemia is associated with ectopic ACTH- and insulin--producing tumors, and is often found in patients with mucin-secreting, potassium-losing adenocarcinoma of the colon. PMID- 3521494 TI - [Clinical trial of bestrabucil (KM 2210) on hematopoietic malignancies]. AB - Twenty-one patients were entered for a clinical study of KM 2210, the benzoate of an estradiol-chlorambucil conjugate, in the treatment of hematopoietic malignancies. These included 4 cases of chronic lymphocytic leukemia (CLL), 5 cases of chronic myelogenous leukemia (CML), 5 cases of malignant lymphoma (ML) and 7 cases of multiple myeloma (MM). Twelve cases had prior chemotherapy. KM 2210 was given orally at a dose of 50-300 mg daily. Of 19 evaluable cases, two cases with CLL achieved complete response and 6 cases including 2 with CLL, 2 with CML and 3 with ML achieved partial response. There were no responders among the cases of MM. The partial and complete response rate was 47%. Toxicity included mild breast or nipple pain (28.6%), genital bleeding (9.5%), appetite loss (9.5%) and gynecomastia (4.8%). These side effects may have been due to increased levels of estrogen. Hematopoietic toxicity was mild and well tolerated. No cardiac, hepatic or renal toxicity was observed in this study. These results suggest that KM 2210 might be an effective candidate for the treatment of hematopoietic malignancies, especially CLL. PMID- 3521495 TI - The generalized atrophic benign form of junctional epidermolysis bullosa. Experience with four patients in the United States. AB - We encountered four patients in the United States with the generalized atrophic benign form of junctional epidermolysis bullosa (epidermolysis bullosa atrophicans generalisata mitis, nonlethal junctional epidermolysis bullosa). Prior to the performance of definitive diagnostic studies, each patient had been thought for at least a decade to have either a dystrophic or simplex form of epidermolysis bullosa. Each patient had generalized blisters since birth that healed with atrophy and mild scarring but without milia or contractures. Two of the four patients had experienced laryngeal involvement during childhood. In each patient, correct diagnosis was finally established by either electron microscopic examination or immunofluorescence mapping of skin sections from induced blisters. PMID- 3521496 TI - Recurrent neural tube defects, risk factors and vitamins. AB - Data from our trial of periconceptional vitamin supplementation for the prevention of neural tube defects have been analysed to assess the influence of various factors on recurrence rates of neural tube defect. Our data suggest that the risk of recurrence of neural tube defect is influenced by the number of previous neural tube defects, area of residence, immediately prior miscarriage, and interpregnancy interval. None of these factors, however, contributed any significant differential risk between supplemented and unsupplemented mothers. Hence we conclude that the highly significant difference in recurrence rates of neural tube defect between supplemented and unsupplemented mothers was due to vitamin supplementation. PMID- 3521497 TI - Neonatal malaria and obstructive jaundice. AB - A case is presented of transplacental malaria in an infant associated with persistent conjugated hyperbilirubinaemia and liver disease. PMID- 3521498 TI - Epoche in retinopathy of prematurity. PMID- 3521499 TI - Residual insulin secretion in insulin dependent diabetes mellitus. PMID- 3521500 TI - Further discussion concerning porphyria cutanea tarda and TCDD exposure. AB - Past reports have correlated a diagnosis of porphyria cutanea tarda (PCT) with exposure to 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD). Re-examination of the literature, however, has caused us to question the conclusion of a relationship between acquired PCT and TCDD. The major considerations at issue were: (1) whether the diagnostic label of PCT was applied excessively to cases with findings that are nonspecific; (2) whether the clinical conditions suggestive of PCT were the likely results of exposure to another chemical, for example hexachlorobenzene (HCB); and (3) whether a causal link between PCT and TCDD is reasonably substantiated by the facts. Based on the re-evaluation of the literature, the known effects of HCB and TCDD, and the follow-up results from the chemical plant, we submit that HCB alone, or HCB in combination with other polychlorinated aromatic hydrocarbons, may have been responsible for the effects observed and the subsequent correlation to PCT. PMID- 3521501 TI - [Monitoring of malaria in Belgium through a network of microbiology laboratories]. PMID- 3521502 TI - [Principle immunological factors and the blood-brain barrier in cerebral malaria in children in endemic countries (Zaire)]. PMID- 3521503 TI - Malaria vaccine trials: a guided step into the unknown. PMID- 3521504 TI - Isolation of saprophytic Cryptococcus neoformans var. neoformans in Kinshasa, Zaire. PMID- 3521505 TI - Multiresistant Salmonella typhimurium panophtalmia in an immunocompetent infant. PMID- 3521506 TI - Effects of preoperative medications on gastric pH, volume, and flora. AB - Aspiration of acid gastric juice poses a potential threat during operations. Many anesthesiologists use a variety of agents aimed at decreasing gastric volume and/or acidity. The effect of three agents on gastric volume, pH, and flora, and the effect of cefazolin on gastric flora in morbidly obese patients were studied. Cefazolin did not sterilize the gastric lumen. Almost one-half of patients not treated with an H2 blocker had a pH below 2.5 and a gastric volume of 20 ml or more. Five had both a low pH and significant volume and, thus, the potential for lethal aspiration. Two doses of cimetidine, 300 mgm orally, or of ranitidine, 150 orally, the evening before and the morning of operation decreased gastric volume and raised pH reliably to a level that should be protective from fatal aspiration. However, gastric cultures after these drugs were positive 86% of the time with a larger variety of organisms than in the untreated stomachs. Metoclopramide failed to decrease gastric volume or raise pH. Transoperative cefazolin was used in all patients. Clinical infection was not a problem. PMID- 3521507 TI - Development and organization of a multiple organ transplantation program. AB - Multiple organ transplantation has come of age. Indications are that it will continue to grow, if not flourish. The complexity of modern surgical care, its multiperson dependency, and the need for the surgeon to retain knowledge and involvement with his patient's care and problems are nowhere more evident than in multiple organ transplantation. Each organ presents its own associated challenges, the prime solution of which lies with a skillful and dedicated surgeon; but with all organs there are challenges of expectantly waiting patients, housing during the wait and for postoperative observation, procurement, erratic scheduling of the operating room, nursing, social service, immunosuppression, immunopathology, interest of hospital public relations and of the news media, and perennial care. This report concerns the growth and development of the multiple organ transplant program at the University Health Center of Pittsburgh and describes some answers to the challenges presented. PMID- 3521508 TI - Segmental pancreatic autotransplantation with pancreatic ductal occlusion after near total or total pancreatic resection for chronic pancreatitis. Results at 5- to 54-month follow-up evaluation. AB - Reported are eight patients with idiopathic chronic pancreatitis and two patients with alcoholic pancreatitis who had near total distal pancreatectomy for disabling pain and underwent simultaneous segmental pancreatic autotransplantation of the body and tail of the gland to the femoral area in an attempt to prevent or delay the onset of diabetes. The median follow-up period was 31 months, and follow-up study in nine patients ranged from 24 to 54 months. Patency of the grafts was determined by angiography and selected percutaneous venous assays for insulin. Islet cell function was determined by oral glucose tolerance tests, intravenous (I.V.) glucose tolerance tests, and I.V. glucagon stimulation studies. Segmental autotransplantation was technically successful in eight patients, only one of whom required insulin (at 2 years after grafting). The other seven patients with technically successful grafts have remained insulin independent, including two patients who later underwent pyloric preserving pancreatoduodenectomy for completion pancreatectomy. Variable pain relief was observed in patients who underwent near total pancreatectomy, but pain was unrelieved in those patients who underwent limited distal resection. Patients with idiopathic pancreatitis appear to have better pain relief and preservation of endocrine function than alcoholic patients. Segmental pancreatic autotransplantation prevents or delays the onset of diabetes mellitus and should be considered as an alternative for those patients who require extensive pancreatic resection for chronic pancreatitis. PMID- 3521509 TI - Living related kidney donors. A 14-year experience. AB - Living related donor (LRD) nephrectomies are controversial due to the risks to the donor and improved cadaveric graft survival using cyclosporine A. Between December 22, 1970, and December 31, 1984, 1096 renal transplants were performed at a single institution, 314 (28.6%) from LRD. The average age was 34.3 years (range: 18-67); none had preoperative hypertension. All nephrectomies were performed transabdominally. Major perioperative complications occurred in 22 (7.0%). These include wound infections (3.5%), pancreatitis (1.0%), injuries to spleen (1.0%) or adrenal gland (0.3%) requiring removal, pneumonitis (0.6%), ulnar nerve palsy (0.6%), femoral artery thrombosis after arteriogram (0.3%), pulmonary embolus (0.3%), and upper pole infarct of contralateral kidney (0.3%). There are six known deaths in this series, none of which were related to the operation. Major late complications were seen in 50 (20.0%) of 250 patients followed for 6 to 175 months (mean 53.1 months). These included definite hypertension (5.6%), suture granuloma (4.4%), incisional hernia (3.6%), proteinuria (2.4%), bowel obstruction (2.0%), nephrolithiasis (1.2%), wound infection (0.4%), scrotal hydrocele (0.4%), and chronic pancreatitis (0.4%). While the risk of hypertension appears to increase as the interval from donation increases, no cases of renal failure after donation have been noted, and negligible proteinuria among those followed long-term has been seen in this series. It is felt that living related kidney donation is justified when the relative is sincerely motivated and well informed prior to donation. PMID- 3521511 TI - Juxtarenal infrarenal abdominal aortic aneurysm. Special diagnostic and therapeutic considerations. AB - Juxtarenal infrarenal abdominal aortic aneurysms are defined as those aneurysms that involve the infrarenal abdominal aorta adjacent to or including the lower margin of renal artery origins. The misinterpretation of findings at exploratory operation or special studies may suggest renal artery involvement and result in abandonment of operation and/or referral to distant centers, thus delaying treatment. This report is concerned with 101 patients with a median age of 68 who had such aneurysms, all referred with a diagnosis of renal or visceral arterial involvement either after exploratory operation (32), because of aneurysmal size (12), or due to misinterpretation of special studies (57). Computed tomographic (CT) scans, ultrasounds, and aortograms in the anterio-posterior projection frequently suggested renal artery involvement due to the fact that the upper end of aneurysm frequently lay over the renal artery origins due to infrarenal aortic elongation and buckling of the aorta at the renal artery level. The true nature of the lesion was best demonstrated by aortography performed in the lateral position. The operation producing the best results was one performed through a midline abdominal incision. The aorta is cross-clamped at the diaphragm and the proximal anastomosis is performed from inside the aneurysm at the renal artery level. The graft then is clamped and the other clamp removed to restore flow in the visceral vessels while the distal anastomosis is completed. Early survival occurred in 93% of patients employing the operation, despite the fact that other conditions frequently were present: renal insufficiency in 19, rupture in seven, renal artery occlusive disease in 20, chronic obstructive pulmonary disease in 34, and hypertension in 77. PMID- 3521512 TI - Samuel Robinson, pioneer thoracic surgeon (1875-1947). AB - Sam Robinson was born in Augusta, ME, in 1875. A graduate of Harvard Medical School, and of the Massachusetts General Hospital (MGH), he worked in the laboratory of Walter Cannon. While a junior at MGH he spent four months abroad with Ferdinand Sauerbruch. He returned to Boston and remained there until 1912, performing his first successful lobectomy for bronchiectasis in 1909. He made important contributions to the management of pneumothorax during operation, notably Sam Robinson's box. In 1912 he moved to Clifton Springs, NY. From 1915 to 1917 he was the first Chief of Thoracic Surgery at the Mayo Clinic. Illness, probably bronchiectasis, led him to abandon academic thoracic surgery in 1918 and retire to Santa Barbara, CA, where he practiced general surgery until 1947. He was President of the Association for Thoracic Surgery in 1922. In addition to the use of positive pressure and early resections, his contributions include artificial pneumothorax for tuberculosis and management of acute and chronic empyema. His colorful writings provide a vivid picture of the early days of our specialty. PMID- 3521510 TI - Recurrent versus residual carotid stenosis. Incidence detected by Doppler ultrasound. AB - A sterile Doppler probe was used for intraoperative monitoring of the integrity of carotid endarterectomy of 125 vessels of 107 patients. Our objective was to reduce the contribution of residual carotid lesions to recurrent stenosis, which was evaluated by Doppler spectrum analysis in the early (less than 3 months, 66 arteries) and late (3-77 months, mean 32 months, 47 arteries) postoperative period. Intraoperative Doppler monitoring detected residual occlusion in six (4.8%) external carotid arteries and stenosis in ten (8.0%) internal carotid arteries permitting selected arteriography and correction of all significant lesions. Follow-up revealed one (1.5%) asymptomatic common carotid occlusion at 6 weeks and three (6.4%) asymptomatic internal carotid stenoses at 6, 10 and 25 months after operation. When compared to previous published experience, these results suggest that intraoperative correction of residual carotid obstruction detected by Doppler ultrasound may reduce the incidence of postoperative "recurrent" carotid stenosis. PMID- 3521513 TI - Isolation and characterization of a rabbit sperm tail protein. AB - Rabbit sperm tails were obtained by a nitrogen cavitation procedure and separated by discontinuous sucrose gradient centrifugation. Proteins were extracted from sperm tails with 3[(3-cholamidopropyl)-dimethylammonio]-1-propane sulfonate (CHAPS) and separative disk electrophoresis and DEAE-trisacryl column chromatography. A protein with an estimated mol wt of 20.1 +/- 1.1 kD was isolated and found to be homogeneous by SDS-PAGE and designated as rSMP-B. The isoelectric point of rSMP-B was in the range of pH 4.4-4.7. The amino acid composition was determined, and glycine was identified as the N-terminal residue. Antisera were raised against purified rSMP-B. Using a peroxidase-antiperoxidase method, the rSMP-B antigen was located on the surface of the midpiece and tail of the sperm. Testis sections showed intense staining of late spermatids located within the seminiferous tubules. Adult male rabbits were inoculated with rSMP-B protein and Freund's adjuvant. The testis and epididymis of the immunized animals showed absence of sperm. The immunolocalization findings and the immunization data suggest that rSMP-B is formed in late spermatid and that it is an essential structural component of sperm. PMID- 3521514 TI - [Problems raised by the possible contamination of food by phthalates]. PMID- 3521515 TI - Concentration-dependent protection by captopril against ischemia-reperfusion injury in the isolated rat heart. AB - The purpose of this study was to investigate the protective effects of captopril at three concentrations (1, 10 and 80 micrograms/ml) against reperfusion injury after 15 min of coronary ligation in the isolated perfused rat heart. During ischemia, the apex displacement (AD) and pressure rate index (PI) decreased markedly and only in the presence of 80 micrograms captopril less reduction of the PI was obtained (p less than 0.05). Upon reperfusion, the AD and PI improved significantly in all captopril treated hearts, depending on the concentration used, whereas the untreated hearts showed a further deterioration (p less than 0.05). Ventricular fibrillation upon reperfusion occurred in 6/6 untreated hearts, but only in 4/6 hearts at 1 microgram/ml, in 2/6 hearts at 10 micrograms/ml and 0/6 hearts at 80 micrograms/ml captopril with a significantly shorter duration (p less than 0.05). In control hearts a marked overflow of purines and norepinephrine was found in the coronary effluent upon reperfusion. In contrast, captopril decreased purine overflow, most at 80 micrograms/ml, and norepinephrine levels were undetectable at all concentrations. These results indicate concentration-dependent protective effects of captopril after local ischemia and reperfusion, already present at therapeutic levels. Reduction of cellular injury and suppression of NE release appear to play an important role in the improvement of mechanical function and the reduction of reperfusion arrhythmias. PMID- 3521516 TI - Regulation of renin secretion in conscious adrenalectomized rats with glucocorticoid-induced hypertension. AB - The effect of adrenalectomy on renin secretion was investigated in conscious rats with glucocorticoid-induced hypertension. Adrenalectomized and sham-operated rats were made hypertensive with methylprednisolone acetate (20 mg/kg s.c. once/week X 2 weeks) supplemented with deoxycorticosterone pivalate (10 mg/kg s.c. once/week X 2 weeks). During the 2 week developmental phase of hypertension, tap water or isotonic saline was given as drinking fluid to respectively 10 and 13 adrenalectomized rats and 10 and 11 sham-operated rats. On the day of the acute administration of captopril or vehicle there was no significant difference in body weight, mean blood pressure, heart rate, serum electrolytes and plasma norepinephrine levels between the 4 groups of rats. Circulating epinephrine could not be detected in adrenalectomized rats. Plasma renin activity was markedly higher in adrenalectomized rats than in the sham-operated rats even after sodium supplementation. Captopril (10 mg/kg i.v.) produced no significant blood pressure lowering effect in rats given tap water to drink, either adrenalectomized (n = 11) or sham-operated (n = 10). These findings indicate that the activation of the renin-angiotensin system in adrenalectomized rats with glucocorticoid-induced hypertension is not directly mediated by the development of adrenal failure. They also show that the maintenance of high blood pressure in this form of experimental hypertension is not significantly enhanced when renin secretion is stimulated by adrenalectomy. PMID- 3521517 TI - Hypoglycemic activity of MTP-1403 (2-amino-7,8-dihydro-4-piperazinyl-6H thiopyrano 3,2-d pyrimidine), a new hypoglycemic agent. AB - 2-Amino-7,8-dihydro-4-piperazinyl-6H-thiopyrano 3,2-d pyrimidine (MTP-1403) is a new oral hypoglycemic agent structurally different from any existing hypoglycemic drugs. MTP-1403 lowered fasting plasma level and dose-dependently improved glucose tolerance test without increasing insulin secretory response to glucose. MTP-1403 caused a decrease in fasting plasma glucose level in mild alloxan induced diabetic rats but not in the rats suffering from ketosis. MTP-1403 markedly improved the oral glucose tolerance test in the genetically diabetic KK mice. These results suggest that hypoglycemic activity of MTP-1403 may be mechanically different from sulfonylureas and biguanides and beneficial to type II diabetics with hyperinsulinemia and insulin resistance. PMID- 3521518 TI - Oral bacitracin vs vancomycin therapy for Clostridium difficile-induced diarrhea. A randomized double-blind trial. AB - The effectiveness of a ten-day course of either oral bacitracin or oral vancomycin hydrochloride for treatment of Clostridium difficile-induced antibiotic-associated diarrhea was compared in a randomized double-blind study. Bacitracin was as effective as vancomycin in resolving diarrhea; most patients responded within five days of therapy with either drug. Three patients receiving bacitracin worsened during therapy; two of these were considered treatment failures. Neither C difficile nor its toxin was detected in stool samples collected on the final day of therapy in 71% of patients (10/14) receiving vancomycin and in 30% (3/10) receiving bacitracin. Five patients receiving bacitracin and three receiving vancomycin had at least one recurrence. Low but nontoxic concentrations of bacitracin were detected in serum samples collected from 11 patients. Oral bacitracin at this dosage level was as effective as vancomycin in resolving the symptoms of C difficile-induced antibiotic-associated diarrhea in most patients but was less effective in eradicating C difficile and its toxin from patients' stools. PMID- 3521519 TI - Chlorzoxazone hepatotoxic reactions. An analysis of 21 identified or presumed cases. AB - A drug rechallenge proved chlorzoxazone to be hepatotoxic in a patient who had been treated with a combination of it and acetaminophen (Parafon Forte) for several months. Failure to demonstrate a toxic response to acetaminophen coupled with a dramatic response to a single dose of chlorzoxazone implicated chlorzoxazone as the hepatotoxic agent. A review of US Food and Drug Administration records and cases reported in the medical literature disclosed 23 cases of chlorzoxazone-associated hepatotoxic reactions occurring since 1970. These cases were examined in terms of age, duration of therapy, other confounding etiologic factors, and ultimate outcome. There were two deaths involving hepatic failure. Reports of adverse reactions among six commonly used analgesic-muscle relaxants in Sweden have indicated a low, but comparatively greater, incidence of hepatotoxic reactions associated with a chlorzoxazone-containing compound. PMID- 3521520 TI - Rarity of failure of penicillin prophylaxis to prevent postsplenectomy sepsis. AB - All splenectomized individuals are at risk of developing pneumococcal sepsis, but most reports fail to mention how many patients are given prophylactic penicillin therapy. Fourteen reported cases of postsplenectomy bacterial sepsis in patients receiving prophylactic penicillin therapy are reviewed. In only five cases, the patients had penicillin-sensitive pneumococcal infection. Hence, the exact frequency of the failure of penicillin prophylaxis cannot be calculated, but it appears to be very rare. Continuous antibiotic prophylaxis used indefinitely and pneumococcal vaccine are both strongly recommended for all children and adults undergoing splenectomy. PMID- 3521521 TI - Therapy of bacteremia in an outpatient with acquired immunodeficiency syndrome. PMID- 3521522 TI - Intracellular cations and diuretic therapy following acute myocardial infarction. AB - In a controlled, prospective, randomized study of the effects of diuretic therapy on serum, lymphocyte, and erythrocyte potassium, magnesium, and calcium concentrations, 155 patients were followed up for six months after experiencing acute myocardial infarction. Of these, 48 patients received furosemide and potassium; 37 patients received hydrochlorothiazide and amiloride hydrochloride; and 70 patients did not require diuretics. Lymphocyte and erythrocyte cation concentrations were all statistically significantly lower in the furosemide treated patients when compared with the patients in the nondiuretic-therapy group or the hydrochlorothiazide-amiloride-treated group, with no change in serum levels. Since the combination of low intracellular potassium and magnesium concentrations in patients with recent myocardial infarction may be of importance in the cause of arrhythmias, we suggest that potassium- (and magnesium-) sparing diuretics be used in the treatment of patients, when necessary, unless their diuretic needs cannot be met by such agents. PMID- 3521523 TI - Antihypertensive therapy with triamterene-hydrochlorothiazide vs amiloride hydrochlorothiazide. Comparison of effects on urinary prostaglandin E2 excretion. AB - Amiloride hydrochloride has now been recognized as a safe and effective potassium sparing diuretic alternative to triamterene with a similar mechanism of pharmacologic activity. Studies were undertaken to assess the difference between therapy with the triamterene-hydrochlorothiazide combination (Dyazide) and an amiloride hydrochloride-hydrochlorothiazide combination (Moduretic) on renal prostaglandin production, since an increase in renal prostaglandin synthesis has been shown to mediate or enhance the pharmacologic action of certain diuretic drugs. Eight subjects treated for four weeks with triamterene-hydrochlorothiazide were compared with nine patients similarly treated with amiloride hydrochlorothiazide. A 24-hour urine sample for prostaglandin E2 (PGE2) assay was collected under control conditions and after six weeks of therapy with either diuretic in all patients. The PGE2 excretion increased in the amiloride hydrochlorothiazide-treated group; in the other group PGE2 excretion actually declined. It is concluded from these studies that therapy with amiloride hydrochlorothiazide enhanced renal PGE2 production, whereas that with triamterene hydrochlorothiazide actually decreased renal PGE2 production. This difference is an important renal consequence of the use of either drug and should be considered in the choice between these diuretic combinations. PMID- 3521524 TI - Doxepin treatment of depressed patients with chronic obstructive pulmonary disease. AB - During each of two six-week treatment periods, 12 depressed outpatients with chronic obstructive pulmonary disease received increasing doses of doxepin hydrochloride or a placebo as tolerated. The mean maximal doses of doxepin hydrochloride and placebo were 105 and 128 mg, respectively. Three of the 12 patients dropped out because of doxepin's side effects. The depression and anxiety scores at the end of the treatment periods were virtually identical and not significantly different from baseline scores. Changes in the 12-minute walking distance were more closely correlated with changes in the depression and anxiety scores than with changes in the forced expiratory volume in 1 s or forced vital capacity. Thus, doxepin is ineffective in treating depressed patients with chronic obstructive pulmonary disease; improvements in the 12-minute walking distance were closely correlated with improvements in the depression or anxiety scores. PMID- 3521525 TI - An approach to the management of the poisoned patient. AB - Our systematic approach to the evaluation and treatment of the acutely poisoned patient involves establishing an accurate diagnosis and prognosis that often may be based on quantitation of the blood concentration of the toxic substance. The major feature of this approach is the proper selection of treatment(s) for the poisoned patient, ie, decontamination and supportive care and, in some cases, antidotal therapy and/or active removal of the toxic substance. Invasive, expensive methods of active removal (eg, hemodialysis or hemoperfusion) are generally recommended only if specific criteria are satisfied. Noninvasive, inexpensive methods of active removal (eg, manipulation of urinary pH or the oral administration of multiple doses of activated charcoal) may have significant utility in the treatment of poisoned patients not requiring invasive methods. This systematic approach to the poisoned patient should lead to an effective use of treatment modalities with minimal risks and optimal clinical results. PMID- 3521527 TI - Lung sounds for the clinician. AB - Recent interest in lung sound physiology has led to a sharp increase in the publication of articles that describe new techniques of examining lung sounds. Although most of the results of these investigations are of interest primarily to other researchers, several have practical value and should be of interest to the clinician because of the objective support that they lend to various aspects of the physical examination. This short review provides an outline of recent work relating to vesicular lung sounds, crackles, and wheezes. The information is presented with emphasis on practical applications. PMID- 3521526 TI - Hypoprothrombinemia in patients with cancer receiving cefoperazone and mezlocillin. AB - Forty-one patients with cancer who were receiving cefoperazone sodium plus mezlocillin sodium were prospectively followed up for the development of abnormal bleeding or hypoprothrombinemia. Ten of 41 patients developed an increased prothrombin time, three with a hemorrhagic episode. Serum transport proteins and serum carotene were measured in 18 patients, six of whom developed hypoprothrombinemia. Low serum prealbumin and low serum carotene levels were associated with the development of hypoprothrombinemia. Patients with cancer are especially predisposed to the development of antibiotic-associated hypoprothrombinemia. This is probably a result of protein-calorie malnutrition and low vitamin K stores. PMID- 3521528 TI - Current concepts in brain resuscitation. AB - In spite of the tremendous amount of effort and money put forth to reduce morbidity and mortality associated with global cerebral ischemia, the outlook for patients suffering an ischemic insult remains dismal. The lack of a sufficient substrate supply during the period of ischemia as well as the production of toxic metabolites in response to ischemia have been incriminated as key factors causing brain damage. As discussed in this article, modes of therapy have included efforts to minimize the duration of ischemia (eg, effective cardiopulmonary resuscitation, hemodilution, heparinization, calcium antagonists) and decrease the production of toxic metabolites (eg, barbiturates, calcium antagonists). Although the barbiturates have also been proposed to decrease the metabolic needs during ischemia, they have no therapeutic value for global cerebral ischemia. The initial evaluation of the calcium antagonists has been more promising. PMID- 3521529 TI - LD-carboxypeptidase activity in Escherichia coli. I. The LD-carboxypeptidase activity in ether treated cells. AB - The activities of the LD-carboxypeptidases of Escherichia coli K 12 and of a mutant strain 155 with reduced activities were studied with the aid of ether treated cells. Evidence was obtained that was consistent with the suggestion that in both strains two LD-carboxypeptidase activities are present. Activity I degrades the nucleotide activated precursor UDP-MurNAc-tetrapeptide and activity II splits off D-alanine residues from position 4 of the peptide subunits in the nascent murein. In the mutant strain activity I is reduced 10fold compared with strain K 12, whereas activity II is not affected. The two activities could be distinguished with regard to their sensitivity to D-amino acids and the beta lactam antibiotic thienamycin. PMID- 3521530 TI - LD-carboxypeptidase activity in Escherichia coli. II. Isolation, purification and characterization of the enzyme from E. coli K 12. AB - A LD-carboxypeptidase from Escherichia coli K 12 was isolated by Tris-EDTA treatment and purified to electrophoretic homogeneity by DEAE-cellulose chromatography. The enzyme has a molecular weight of approximately 12,000 as determined by sodium dodecyl sulfate-polyacrylamide electrophoresis and by Sephadex G-100 gel filtration. The studies of the substrate specificity of the enzyme revealed that UDP-MurNAc-tetrapeptide is a superior substrate, with a Km value of 1 X 10(-4) mol/l. The activity of the LD-carboxypeptidase was inhibited by D-amino acids and the beta-lactam antibiotic nocardicin A. Ki values of 0.3 and 43 mmol/l were determined for nocardicin A and D-homoserine, respectively. The properties of the purified enzyme correspond to activity I in ether treated cells. PMID- 3521531 TI - Borderline and schizotypal personality disorders treated with low-dose thiothixene vs placebo. AB - Fifty outpatients with borderline and/or schizotypal personality disorder were randomly allocated to thiothixene (Navane) or placebo treatment that was continued for 12 weeks. The mean daily dosage of thiothixene hydrochloride in the final week of the study was 8.7 mg, a lower dosage than is used in outpatient schizophrenics. Significant drug-placebo differences were found, regardless of diagnosis, on "illusions," "ideas of reference," "psychoticism," "obsessive compulsive symptoms," and "phobic anxiety," but not on "depression." Thiothixene seems to have more than an antipsychotic effect. Since response to treatment studies are a means for reformulating diagnostic concepts, we suggest a subdiagnosis defined by those symptoms that are drug-responsive, some of which are not included in current diagnostic criteria. Patients with borderline and schizotypal disorder without the foregoing symptoms probably would not profit from thiothixene and might needlessly be placed at risk for adverse drug effects. PMID- 3521532 TI - Progress in pharmacotherapy of borderline disorders. A double-blind study of amitriptyline, haloperidol, and placebo. AB - In symptomatic patients with borderline disorder, we conducted a double-blind, placebo-controlled trial of haloperidol and amitriptyline hydrochloride to test the differential efficacy of medication against the affective and schizotypal symptoms that characterize the disorder. Sixty-one patients, diagnosed by the Diagnostic Interview for Borderline of Gunderson et al, completed randomized trials of haloperidol (n = 21), amitriptyline (n = 20), and placebo (n = 20). Medications were given in dose ranges of 4 to 16 mg for haloperidol (mean, 7.24 mg) and 100 to 175 mg for amitriptyline hydrochloride (mean, 147.62 mg) for five week periods, with weekly self-rated and observer-rated measures of mood, schizotypal symptoms, and global functioning. Haloperidol was superior to both amitriptyline and placebo on a composite measure of overall symptom severity, with no difference between amitriptyline and placebo. Haloperidol produced significant improvement on a broad spectrum of symptom patterns, including depression, anxiety, hostility, paranoid ideation, and psychoticism. In contrast, amitriptyline was minimally effective, with small gains limited to some areas of depressive content. The magnitude of change tended to be modest and was more apparent in self-rated than observer-rated measures. PMID- 3521533 TI - Renal neoplasia and acquired cystic kidney disease in patients receiving long term dialysis. AB - Acquired cystic disease (ACD) is a recently described phenomenon occurring in the native kidneys of patients treated with long-term dialysis. Renal cell carcinoma is being diagnosed with increasing frequency in patients with chronic renal failure. In most, but not all, instances the cancers develop in association with ACD. Careful microscopic examination of end-stage kidneys undergoing dialysis discloses cysts lined with hyperplastic cells. Papillary hyperplasia of cyst epithelium is recorded in virtually every detailed pathology report of tumors arising in ACD and is the likely pathogenetic basis for the development of renal tumors in cystic kidneys undergoing dialysis. The pathology of ACD and its related neoplasms is reviewed. An estimate is made of the incidence of ACD and renal cell carcinoma in patients receiving dialysis by tabulating data from studies published in medical journals. Acquired cystic disease is found in approximately 35% of patients treated by long-term hemodialysis. Renal cell carcinoma occurs in approximately 5.8% of cases of ACD. Most of the cancers are found incidentally at autopsy or by examination of kidneys from bilateral nephrectomies and are of little clinical significance, but occasional cases present aggressive neoplasms that metastasize and cause the deaths of patients. PMID- 3521534 TI - Malignant lymphoma in transplanted renal pelvis. AB - A middle-aged man with chronic renal failure received a renal transplant from his healthy daughter. Two years later, malignant lymphoma developed in the transplanted renal pelvis. The lymphoma was found to be B-cell immunoblastic lymphoma bearing monoclonal IgG and kappa immunoglobulin, and it was of recipient origin. PMID- 3521535 TI - Peliosis of the spleen in a patient with cirrhosis of the liver. AB - Peliosis is a rare entity usually encountered in the liver and occasionally also found concurrently in the spleen. We studied a case of isolated peliosis of the spleen found incidentally at autopsy in a patient with hepatitis B virus associated cirrhosis of the liver. PMID- 3521537 TI - Presentation of intraosseous vascularization by sequential maceration. AB - Using the example of a knee joint, an injection-maceration technique used to present the pattern of arterial vessels inside and outside the bone is described. Femur and tibia are fixed in a rigid position by central cemented shafts, after synthetic resin has been injected i.a. into preparations of the thigh. The actual maceration of soft tissue is not done as a single process but in several steps. In this way, breaking of fine vessel ends as a result of mechanical overload is avoided. After the soft tissue has been completely removed, the bone surface is coated with resin, while the articular surface is left uncoated. In the final step the three-dimensional structure of the bone surface and the pattern of the periosteal vessels remain unchanged. The method described allows presentation of intraosseous arterial vessels less than 20 micron in diameter. The results that can be obtained are demonstrated using the example of arterial supply of the patella and of the condyles of the femur. PMID- 3521536 TI - Analysis of 75 operated thoracolumbar fractures and fracture dislocations with and without neurological deficit. AB - Seventy-five surgically treated patients with thoracolumbar fractures and fracture dislocations, operated on between 1978 and 1982 at the Orthopedic Department of the University of Basel, were analyzed. The follow-up ranged from 18 months to 6 years. There were 45 men and 21 women, and 60% of the patients were not more than 30 years old. Additional injuries were common: 30% of the patients had craniocerebral injuries and 20% were polytraumatized. Ninety-six percent of all patients reached a hospital within 6 h, but only 23% initially presented at a center for spinal surgery. Sixteen patients had anterior surgery (fusion alone or with plating), and two of these had laminectomy as a second operation. Fifty-seven patients had posterior surgery, in 34 cases combined with a laminectomy. The Harrington instrumentation was used 45 times (29 distraction, 14 compression, and two combinations of distraction and compression rods). Luque rods with segmental sublaminar wiring was used seven times, the locking-hook distraction-rod system of Jacobs twice, and miscellaneous procedures five times. A total of 24 patients (greater than 30%) presenting neurological deficits improved postoperatively. None of the 18 patients with normal neurological findings deteriorated during the operation. Neurological improvement was seen more frequently after early than after delayed surgery, but the difference was not statistically significant. Laminectomy had no statistically significant effect on postoperative neurological status. Twenty-two patients required reoperation because of insufficient or failed instrumentation. Luque instrumentation had the highest rate of reoperations. Anterior surgery did not prove superior to posterior procedures. Hospitalization and immobilization time was significantly reduced with surgery for the neurologically normal or minimally damaged patients, but not for completely or incompletely paraplegic patients. Postoperative back pain occurred in 22 patients, of whom 14 had nonanatomic postoperative reductions. Complications directly due to the surgery were rare. It is our conclusion that the instrumentation used in this series was not good enough to be proposed for standardized use. These technically unsatisfactory results induced the development of the internal fixator system in the senior author's (E.M.) department. PMID- 3521538 TI - Stress management in rehabilitation. AB - Chronic disability, especially of an acquired nature, is a stressor which requires significant adjustment and adaptation. This ongoing demand for change represents an additional source of stress for disabled as as compared with nondisabled individuals. In response to this need, a stress management program was established for groups of outpatients at an adult rehabilitation center. The program consists of eight 2-hour sessions and is delivered within a psychoeducational context. The present study evaluates the efficacy of the program, based upon a series of six groups. A total of 40 participants, comprised primarily of patients with chronic pain, chronic obstructive pulmonary disease, and multiple sclerosis, were assessed on psychometric and psychophysiologic measures both before and after the program. Results indicated a significant decrease at posttest in state anxiety, as well as a significant decrease on a measure of somatization, suggesting less preoccupation with physical symptoms following completion of the training. These findings suggest that rehabilitation patients can profit from self-control techniques taught in a stress management program. Since anxiety can negatively influence the course of many disabilities, the benefits accrued from stress management skills may have generalized effects. PMID- 3521539 TI - Hemodynamic indicators of postthrombotic sequelae. AB - Single or repetitive episodes of lower-extremity venous thrombosis may result in venous obstruction, valvular incompetence, and the postthrombotic syndrome. Seventy-seven patients with ileofemoral deep venous thrombosis diagnosed with biplane phlebograms received routine anticoagulant therapy and follow-up with clinical and noninvasive vascular examinations (reflux photoplethysmography, Doppler ultrasonography, and venous outflow plethysmography). The results of the final visit (mean, 25 months; range, three to 50 months) revealed that 53 patients (69%) had evidence of edema and/or hyperpigmentation and five patients (6%) had ulceration. Doppler ultrasonography was 77% sensitive (41 of 53 patients) and 95% specific (41 of 43 patients) at identifying patients with postthrombotic sequelae. We conclude that noninvasive testing throughout the rehabilitative period following acute deep venous thrombosis will identify patients at risk for postthrombotic symptoms. This information may alert the clinician toward initiating elastic compressive therapy in hopes of prolonging a disease-free interval. PMID- 3521540 TI - Aseptic hip necrosis after renal transplantation. AB - To help determine the etiology of posttransplant aseptic hip necrosis, 11 stable renal allograft recipients (group A) who developed aseptic hip necrosis were compared with 89 patients (group B) without this complication. A comparison of mean age, duration of dialysis, mean daily prednisone dose, and incidence of rejection in the first year following transplant, sex, donor source, incidence of posttransplant parathyroidectomy, and mean serum calcium and alkaline phosphatase levels identified no significant differences between groups A and B. The mean serum creatinine value at three (2.2 +/- 0.31 mg/dL [190 +/- 30 mumol/L] vs 1.9 +/- 0.10 mg/dL [170 +/- 10 mumol/L]) and 12 (2.3 +/- 0.35 mg/dL [200 +/- 30 mumol/L] vs 1.9 +/- 0.10 mg/dL [170 +/- 10 mumol/L]) months and the serum phosphate value at three (3.0 +/- 0.19 mg/dL [0.97 +/- 0.06 mmol/L] vs 2.8 +/- 0.08 mg/dL [0.90 +/- 0.03 mmol/L]) and six (3.2 +/- 0.25 mg/dL [1.03 +/- 0.08 mmol/L] vs 2.9 +/- 0.25 mg/dL [0.94 +/- 0.08 mmol/L]) months were significantly greater in group A. Eight patients in group A underwent 13 total hip replacement an average of 16.5 +/- 3.1 months following transplant without significant complications. In conclusion, posttransplant aseptic hip necrosis occurs frequently, and renal allograft dysfunction may contribute significantly to its pathogenesis. When indicated, total hip replacement is both safe and effective. PMID- 3521541 TI - Antacid vs sucralfate in preventing acute gastrointestinal tract bleeding in abdominal aortic surgery. A randomized trial in 50 patients. AB - We carried out a randomized, controlled trial of sucralfate vs antacid as prophylaxis against upper gastrointestinal tract bleeding in 50 patients who had undergone abdominal aortic surgery. The groups were similar in age, sex, duration of prophylaxis, and number of risk factors per patient. No patient in the antacid group had upper gastrointestinal tract bleeding. One patient in the sucralfate group had frank bleeding from the nasogastric tube; however, she also had a coagulopathy and thrombocytopenia. The bleeding stopped when these conditions were corrected. No complications occurred in the sucralfate group; five patients in the antacid group had minor complications. Sucralfate was as effective as antacid in this trial, and it resulted in a considerable saving in nursing time. PMID- 3521542 TI - What is there that is not poison? A study of the Third Defense by Paracelsus. PMID- 3521543 TI - Morphological and biochemical correlates of chemical induced injury in the lung. A discussion. AB - We have reviewed some of the factors which contribute to lung damage by various toxicants. These include disposition of the chemical, its metabolism, individual cell type susceptibility and the potential for the tissue to repair. We have discussed the use of biochemical parameters to measure the functional activity of individual cell types in order to predict the damage to specific cell types and concluded that careful morphological analysis of lung tissue is likely to provide a more sensitive and informative measure of specific cell type injury. However, in order to investigate the mechanism of toxicity of pulmonary toxicants it is essential to establish the primary biochemical event that leads to cell damage and morphological change. The importance of separating the relevant biochemical change(s) from the cascade of biochemical events associated with dead and dying cells and the reparative response of the lung is emphasised. PMID- 3521544 TI - Fusion of Semliki Forest virus infected Aedes albopictus cells at low pH is a fusion from within. AB - Herein, it is shown for the first time that the mechanism of fusion followed in Aedes albopictus cells infected with Semliki Forest virus induced by low pH exposure is a "fusion from within". Several parameters were studied disclosing that the development of the fusion capacity of the cells is directly related to the synthesis of viral specific products. These findings were further substantiated by utilizing various chemicals to inhibit viral specific events during infection, protein synthesis and maturation. Removal of exogenous virions produced at 16 hours post infection by proteinase K digestion clearly revealed that the viral proteins located at the cell surface and not the exogenous virions were responsible for the fusogenic activity. The presence of these viral proteins at the cell surface was disclosed by immunofluorescence employing anti-SFV antibodies elicited in rabbits. Additional evidence for the participation of the viral proteins at the cell surface in the fusion reaction was obtained by Bromelaine digestion which inhibited the fusion and tunicamycin treatment which only partially inhibited the fusion but revealed the inevitable presence of the E1 protein. PMID- 3521546 TI - Effect of carboxylic ionophores on measles virus hemagglutinin protein. AB - We have studied the effect of two carboxylic ionophores, monensin and laidlomycin, on the replication of measles virus in KB cells. The yield of infectious virus was markedly depressed at the concentrations of the ionophores which had no effect on overall viral protein synthesis. The ionophores selectively blocked the migration of hemagglutinin (H) glycoprotein from Golgi apparatus to the cell surface. As a result, H glycoprotein is prevented from being converted from incompletely glycosylated form to the mature form. The inhibitory effect on the transport and glycosylation of H was reversed, although gradually, upon the removal of the ionophores. PMID- 3521547 TI - [Heterogeneity of mast cells--with special reference to the mucosal mast cell]. PMID- 3521545 TI - Polypeptide analysis with monoclonal antibodies of A type inclusion bodies induced by cowpox virus. AB - The antigen in A type inclusion bodies (ATIB) induced by cowpox virus (CPV) was examined by immunofluorescent staining with monoclonal antibodies and polypeptide analysis. In the immunofluorescence (IF) test, these monoclonal antibodies reacted only with cytoplasmic inclusion bodies in cells infected with CPV. The fluorescence became detectable in the cells 6-9 hours after infection with CPV. No fluorescence was detectable in cells infected with CPV in the presence of cytosine-I-beta-D-arabinofuranosyl-HCl (Ara C) or in cells infected with other poxviruses, such as vaccinia virus (VV) or Shope fibroma virus (SFV). On Western blotting and immunoprecipitation followed by SDS-polyacrylamide gel electrophoresis (SDS-PAGE), only one component with a molecular weight of about 160,000 (160 K) was detected in CPV-infected cells. This 160 K polypeptide was first detectable 12 hours after infection of cells with CPV, and was not detectable in infected cells in the presence of Ara C. The 160 K polypeptide was not detected in cells infected with VV or SFV, or in virions purified from CPV-, VV- or SFV-infected cells. PMID- 3521549 TI - [Morphologic features of the epithelium of the small and large intestine in cell culture]. PMID- 3521550 TI - [Participation of pathologists in the activities of the Vilnius Medical Society (on the 25th anniversary of the Vilnius Society of Pathologists)]. PMID- 3521548 TI - [The dot immunobinding assay for specific IgE and IgG antibodies to Dermatophagoides farinae]. PMID- 3521551 TI - [DNA cell content in benign and malignant tumors of various sites]. AB - Three basic approaches to the problem of DNA content in normal and malignant cells are presented. The literature analysis (48 references) indicates the possibility of diagnosis of malignant condition in some tissues on the basis of DNA content measurement if a high number of aneuploid cells non-characteristic for a given state are present in the sample. The question of the correlation between the DNA content and prognosis remains open until now. Although some approaches appear to be perspective at present, literature analysis does not give the evidence of feasibility of using the flow methods for massive screening. PMID- 3521552 TI - A tribute to the founder of the ISAO--Dr. Yukihiko Nose. PMID- 3521553 TI - Historical perspective on the development of the artificial kidney. PMID- 3521554 TI - Paul Broca's less heralded contributions to aphasia research. Historical perspective and contemporary relevance. AB - In addition to discovering the dominant role of the left hemisphere for language and describing what is now known as Broca's aphasia, Paul Broca made other insightful, but less well-recalled, aphasiologic observations. He distinguished symptoms of Wernicke's aphasia five years before Carl Wernicke's famous monograph, and he was the first to exploit the surgical relevance of language localization. Broca investigated the anatomic substrate of language laterality by comparing the relative weights of the two hemispheres and the two frontal lobes. He considered language lateralization from a developmental point of view and in relation to handedness. A relatively small portion of Broca's prodigious scientific career was devoted to the study of aphasia, but his seminal work encompasses a number of issues of contemporary concern. PMID- 3521556 TI - 'Keratoconfusion'. PMID- 3521555 TI - The immunohistochemical distribution of collagens type IV, V, VI and of laminin in the human oral mucosa. AB - The distribution of collagens type V (form AB2) and VI was investigated on cryostat sections of normal human oral mucosa by indirect immunofluorescence. For comparison, antibodies to fragments of type IV collagen and laminin were also used to delineate basement membrane containing structures. All antibodies used were raised against human proteins. Type V collagen appeared as a microfibrillar structure throughout the interstitium, apparently touching but not being present within epithelial or vascular basement membranes. Microfibrils in blood vessel walls were limited to the intimal layer. Pericellular areas were not specifically stained. Type VI collagen appeared as an almost amorphous stromal structure becoming more prominent and more fibrillar in the upper connective tissue papillae. Intense staining was observed in the media of blood vessels and around smooth muscle cells. A possible role of type VI collagen in tissue stabilization may be expected from this ubiquitous and abundant distribution. The findings identify types V and VI collagen as important structures in the oral mucosa and serve as a basis for understanding morbid changes. PMID- 3521557 TI - Aminozolamide gel. A trial of a topical carbonic anhydrase inhibitor in ocular hypertension. AB - A topical carbonic anhydrase inhibitor, 6-amino-2-benzothiazolesulfonamide (aminozolamide), which is an analogue of ethoxzolamide, was studied in 18 patients with ocular hypertension. Significant lowering of intraocular pressure was achieved with a single 50-microL gel application compared with the untreated control eye. The onset of action occurred within two hours and lasted at least eight hours. No systemic side effects were elicited. Topical carbonic anhydrase inhibitors may be an important alternative in the medical management of glaucoma. PMID- 3521558 TI - Intravenous pulse methylprednisolone therapy in severe inflammatory eye disease. AB - Seventeen patients with severe ocular inflammatory disease were treated with intermittent pulse doses of intravenous methylprednisolone. There were five patients with chronic posterior uveitis, five with retinal vasculitis, three with scleritis, two with chronic anterior uveitis, one with pars planitis, and one with Mooren's ulcer. A standard protocol of intravenous administration of methylprednisolone was followed. In 15 of 17 patients receiving this therapy, visual acuity improved or stayed constant. Side effects included psychological disturbances, hypertension, and elevated glucose levels, but cessation of treatment was not necessary in any patient. Pulse methylprednisolone treatment appears to be an effective therapy for several forms of severe inflammatory eye disease and minimizes the potential side effects of more conventional regimens of corticosteroid administration. PMID- 3521560 TI - Glycolytic activity in the human cornea monitored with nuclear magnetic resonance spectroscopy. AB - This study confirms the feasibility of using nuclear magnetic resonance (NMR) spectroscopy to assess, noninvasively, glucose metabolism in isolated corneal tissue. Glycolytic activity of human corneas was analyzed by high-resolution NMR spectroscopy and spectrophotometric coupling assays. Glucose utilization and lactate formation were readily demonstrated in incubating intact and deepithelialized human corneas utilizing an NMR spectrometer with an array of spectra taken at ten-minute intervals over a period of nine hours. The lactate formation rate by biochemical coupling assays was determined to be approximately 0.50 mumol/hr in the intact cornea and 0.20 mumol/hr in the de-epithelialized cornea. Analysis by NMR spectroscopy of the rate of glucose utilization and lactate formation may be a useful means of determining human donor corneal viability. PMID- 3521559 TI - Treatment of onchocerciasis. The ocular effects of ivermectin and diethylcarbamazine. AB - The ocular changes that occur with diethylcarbamazine treatment of onchocerciasis seriously restrict its usefulness. Ivermectin, a newly developed antifilarial drug, was compared with diethylcarbamazine for treatment of onchocerciasis in a double-masked, placebo-controlled trial. Thirty men with moderate to severe infection and ocular involvement were randomly assigned to receive ivermectin as a single oral dose (200 micrograms/kg), diethylcarbamazine (administered for eight days), or placebo. Detailed ocular examinations were performed serially over a 12-month period. Diethylcarbamazine treatment caused a marked increase in living and dead microfilariae in the cornea, punctate opacities, and limbitis during the first week of therapy. Ivermectin had no such effect. However, ivermectin therapy resulted in a long-term reduction in intraocular microfilariae comparable to that seen with diethylcarbamazine. Ivermectin appears to have few ocular complications and be a better-tolerated and more effective microfilaricidal agent than diethylcarbamazine for the treatment of onchocerciasis. PMID- 3521561 TI - Effect of timolol on aqueous humor protein concentration in the human eye. AB - We performed a double-masked, controlled study investigating the increase in the protein concentration in aqueous humor after topical timolol maleate administration. Forty patients scheduled to undergo intracapsular cataract surgery were included in the study. Either timolol ophthalmic solution or the vehicle of timolol alone (control) were applied topically in a randomized fashion, and aqueous humor was collected during surgery. Protein concentrations were determined by gel-filtration chromatography. The total protein concentration as well as the concentration of high and medium molecular weight proteins were significantly elevated in the timolol-treated group. The relation of the levels of the three different molecular weight classes did not differ significantly between the two groups, indicating that undisturbed protein filtration in the face of reduced aqueous humor production--and not a change in the permeability of the blood-aqueous barrier--is responsible for the increase in concentration. PMID- 3521562 TI - Semicircular flap revisited. AB - The semicircular flap of Tenzel has proved to be an excellent reconstructive procedure for central eyelid defects. Although originally described for defects measuring half of the eyelid, we have found that it may be used for defects greater than 60% in the lower eyelid, if the lower eyelid retractors and inferior orbital septum are identified and severed from their attachments. This is the key factor in the mobilization and advancement of this flap. It may, in many circumstances, obviate the need for a more complicated reconstructive procedure. PMID- 3521563 TI - Surgical practice kit. Ophthalmic suture simulator. AB - A practice surgery device used for training novice ophthalmic surgeons employs an inflatable bladder that supports a human bank scleral shell. The sclera is used for placement of sutures. A light source and universal joint to support a syringe are mounted on a 25 X 15-cm base. Glycerin-preserved sclera is available from many eye banks. Up to 100 practice sutures may be placed in each scleral shell. This device allows the beginning surgeon the opportunity to obtain a feel for needle passage through tissue. Technique for the use of loupe or microscope magnification can also be developed. In addition, a deflation of the scleral "globe" occurs when a needle is placed too deeply. This emphasizes the need of superficial suture placement. PMID- 3521564 TI - Mechanisms of movement in outer hair cells and a possible structural basis. AB - Isolated outer hair cells were found to slowly shorten when subjected to a solution that would induce contraction in a muscle fibre. Two possible mechanisms underlying this behaviour emerge from ultrastructural and immunocytochemical investigations. Antibody labelling at the electron microscopic level demonstrates that actin is present not only in the stereocilia and in the cuticular plate but also along the wall of outer hair cells, between the plasma membrane and the subsurface fenestrated cisternae. The latter are interconnected by regularly spaced pillars, resembling those seen between the T-tubules and sarcoplasmic reticulum in muscle fibres. Contraction also results from the application of positively charged macromolecules to the bathing solution. This implies sensitivity of the membrane-associated complex (the cortex system) to an electrical current. A second contractile system may reside in the cytoplasm, where calmodulin is present in contracted hair cells. This protein is a calcium binding control protein for contraction-like events in smooth muscle and non muscle cells. The unique presence of the cortex system in outer hair cells, and its absence in inner hair cells, indicates a functional significance that relates to a motor function of outer hair cells in hearing. PMID- 3521565 TI - Immunocytological distribution of the tumor antigen TA-4: expression during carcinogenesis and maturation of squamous epithelium of human uterine cervix. PMID- 3521566 TI - The estimation of fetal weight using an ultrasonic parallel planimetric area method. PMID- 3521567 TI - Demonstration of immunoreactive LHRH in the human ovaries by peroxidase immunocytochemistry. PMID- 3521568 TI - Ultrasonic evaluation and classification of ovarian tumors. PMID- 3521569 TI - Treatment of acute rejection episodes in dog renal allograft recipients receiving cyclosporin A:ATG vs prednisolone. AB - Prednisolone and antithymocyte globulin (ATG) were compared for their abilities to reverse acute rejection in cyclosporin A-treated canine graft recipients. Outbred dogs bearing kidney allografts were treated with a suboptimal dose of cyclosporin A (10 mg kg-1); at the onset of an acute rejection episode, animals received daily prednisolone (40 mg kg-1) or ATG (20 mg kg-1) until serum creatinine levels decreased. In seven untreated allograft recipients, rejection was first diagnosed at a mean 4.4 days post-transplant. In 23 dogs receiving cyclosporin A, rejection was first diagnosed in all dogs at a mean 43.6 days post transplant. Compared to ATG, prednisolone was more successful in the reversal of primary acute rejection episodes (5/8 and 7/8 reversals, respectively) and produced a quicker return to normal renal function (mean 15.4 and 6.8 days, respectively). ATG therapy, however, resulted in fewer subsequent acute rejection episodes than prednisolone therapy (mean 1/5 and 6/7 developed secondary rejection episodes, respectively); the possible advantage of 'clonal depletion' following ATG therapy is discussed. PMID- 3521570 TI - Early vascularization of syngeneic, allogeneic and xenogeneic skin grafts. AB - The vascularization of syngeneic, allogeneic and xenogeneic skin grafts 3-4 days after grafting was studied in inbred rats by injecting hosts with 51Cr labelled red cells on the third day and counting graft radioactivity on the fourth day. Vascularization as determined by this method was quantitatively similar in syngeneic, allogeneic and mammalian xenogeneic grafts, while the vascularization of non-mammalian xenografts was significantly inferior. For any one donor-host combination, full-thickness grafts contained relatively more blood than did split thickness grafts, presumably because of the large vessels in the deep part of the dermis in full-thickness grafts. Full-thickness neonatal grafts were vascularized similarly to full-thickness adult skin grafts. Grafted skin contained relatively more blood than did the corresponding normal skin. Reconstituted freeze dried allogeneic skin grafts contained virtually no blood, a phenomenon possibly analogous to the 'no reflow' phenomenon of microsurgery. The inferior vascularization of non-mammalian xenografts is more plausibly explained on the basis of defective self recognition than as representing a reaction to foreign determinants. These results do not necessarily indicate that one type of graft is better than another in clinical practice. But if the beneficial effects of temporary skin grafts do indeed depend on their capacity to become vascularized, fresh skin appears preferable to reconstituted freeze dried skin. PMID- 3521571 TI - Epidermoid cyst of the spleen. AB - Epidermoid cysts of the spleen are extremely rare, occurring mainly in people under 20 years of age. They are thought to originate from an abnormality in the development of the spleen during the seventh week of embryological life, when the spleen is close to the mesonephric tissues. Cysts present as an asymptomatic abdominal mass or with pain in the left upper quadrant and/or the left shoulder. In the past the recommended treatment has been splenectomy, but with the changing attitudes towards splenic surgery a more conservative approach is now employed. Drainage under radiographic guidance, deroofing with external drainage or simply deroofing with drainage into the peritoneal cavity are now more popular techniques (along with simple cystectomy). Complications are few, although those associated with deroofing and internal drainage are inadequately investigated. PMID- 3521572 TI - Chlamydial infections in infancy. AB - Non-gonococcal ophthalmia neonatorum was the first recognized manifestation of sexually transmitted chlamydial infection and for many years it was thought to be the only manifestation in infants born to infected mothers. In the 20 years since techniques for isolation of Chlamydia trachomatis in cell culture were described, many important effects of chlamydial infection, including afebrile pneumonia in infants, have been established. Prospective studies have determined the incidence of chlamydial infection in pregnant women and the risk of transmission of infection to their infants. They have shown that these are among the commonest perinatal infections. It is estimated that at least 1% of infants in this community have chlamydial conjunctivitis and up to 5/1000 will develop pneumonia. Chlamydial infections are characterized by a subacute onset and, without appropriate treatment, a prolonged course. Although they are rarely fatal, symptoms are sometimes severe and there may be long-term sequelae. The recent development of rapid and relatively inexpensive methods for direct detection of chlamydiae in clinical specimens will facilitate the diagnosis and treatment of infections in infants. PMID- 3521573 TI - Strategic aeromedical evacuation: the inaugural flight. AB - Strategic aeromedical evacuation, a vital subsystem of the overall aeromedical airlift system, had its beginning in a confidential, poorly planned, poorly coordinated Air Transport Command flight from Karachi, Pakistan (then part of India) to Washington, DC, in January 1943. That the flight was successfully completed was due in large measure to the untiring efforts of the nurse, Second Lieutenant Elsie S. Ott, aboard the flight. Lessons learned in the form of recommendations made by Lt. Ott were implemented to improve succeeding strategic aeromedical evacuation missions. Largely through Lt. Ott's efforts, long range aeromedical evacuation was demonstrated to be a practicable method of transportation for seriously ill and wounded patients. A new dimension had been added to the overall aeromedical airlift mission. PMID- 3521574 TI - Recent developments in coagulation and fibrinolysis. Biochemical, diagnostical, and therapeutical aspects. Dedicated to Professor Dr. Norbert Heimburger. PMID- 3521575 TI - Pathobiochemistry of sepsis: role of proteinases, proteinase inhibitors and oxidizing agents. AB - Degradation of structural elements and excessive consumption of humoral factors, especially of plasma proteinase inhibitors, by proteolysis and/or oxidation is a major cause of multiple organ failure in sepsis or septic shock. Such pathobiochemical reactions seem to be induced primarily by extracellularly liberated lysosomal proteins from PMN granulocytes (e.g. elastase, cathepsin G, myeloperoxidase, lactoferrin) as well as oxygen radicals produced during extensive phagocytosis. In clinical studies on septicemia and septic shock the consumption of plasma proteins including proteinase inhibitors was inversely correlated to the liberation of lysosomal factors, especially the granulocytic elastase. Administration of relatively specific elastase-cathepsin G-inhibitors (Bowman-Birk inhibitor, eglin) in experimental septicemia proved to be a promising therapeutic approach to reduce consumption of plasma proteinase inhibitors and development of interstitial lung edema in severe inflammation. PMID- 3521576 TI - [Hereditary angioneurotic edema: pathophysiology and therapy]. AB - The hereditary angioneurotic edema (HANE), owing to its characteristic clinical symptom, episodic formation of localized edema, has been the subject to be discussed in relation to the problems of the mechanism for the edema formation. On the other hand, when HANE is considered from the point of view on the abnormality in the plasma proteinase systems, it has been thought to be a suitable hereditary defect which enables to investigate into the interactions of the plasma proteinase systems. However, when the clinical course of the disease is correlated with the changes in the plasma proteinase systems, it appears very likely to state that HANE is a very unique model disease, in which edema attacks are elicited by the interactions between plasma proteinase systems and vascular system of the microcirculation, that are triggered by the exogenous stimuli under the influence of the control functions of the endocrine systems. PMID- 3521577 TI - Localization of thymostimulin in mouse and rat thymuses. AB - Anti-bovine thymostimulin serum reacts with reticulo-epithelial cells in the cortex and in the medulla of rat and mouse thymuses. The immuno-reaction is present in a smaller number of cells which have more pallid color than those found in calf thymus. Comparative examination as to the distribution of other thymic factors and as to species-specificity was conducted. PMID- 3521578 TI - In vitro (supravital) fluorescence cytochemistry. PMID- 3521580 TI - [Ultrasound diagnosis of the neonatal and infant hip with special reference to the detection of the decentering effect]. PMID- 3521579 TI - Prostacyclin prevents ventricular fibrillation in a canine model of sudden cardiac death. AB - The antifibrillatory, antithrombotic and hemodynamic properties of intraventricular prostacyclin (PGI2) application were studied in conscious canine model of sudden cardiac death. In anesthetized dogs, a wire electrode was implanted into the left circumflex coronary artery (LCX) and acute myocardial ischemia was produced by 90 min occlusion of the left anterior descending coronary artery (LAD) followed by reperfusion. An intracardiac pressure transducer measured ventricular pressure, heart rate, filling pressure and dP/dt. The ECG was obtained from subcutaneous chest needles. Six days later while in ambulatory state, a 180 microA DC current was applied for 4 h to the LCX intimal lining in Tris-HCl (n = 10) and PGI2-treated dogs (50 and 100 ng/kg/min, 11 and 12 dogs, respectively). Myocardial injury and coronary thrombosis induced by electrical stimulation produced ventricular fibrillation in all vehicle-treated dogs at 145 +/- 33 min (mean +/- S.D.). In PGI2-treated hearts only 2 animals fibrillated at 150 +/- 29 min and 180 +/- 52 min following 50 and 100 ng/kg/min of the prostanoid, respectively. Thus, 18/23 PGI2-treated dogs survived 4 h electrical stimulation of the artery. Within the LAD perfusion zone infarction was observed of equal volumes in vehicle and PGI2-treated animals. No ischemia occurred distal to the LCX coronary thrombosis. Ventricular pressure fell in all groups. Heart rate increased in the controls and those animals treated with 50 ng/kg/min PGI2 while 100 ng/kg/min PGI2 increased heart rate by 22 +/- 5% (p less than 0.05). Filling pressure increased in controls but fell in the PGI2-treated hearts. The results indicate that PGI2 can prevent ventricular fibrillation resulting from acute ischemia at a site distant to previous myocardial ischemia with superimposed intimal injury and coronary thrombosis. The PGI2 properties are due to prevention of coronary thrombosis and the occlusion of the artery. Antifibrillatory effects of the prostanoids are suggested. PMID- 3521581 TI - The origin of the concept of 'doubles'. PMID- 3521582 TI - Review of 106 cases with the syndrome of Capgras. PMID- 3521583 TI - Joseph Capgras and his syndrome. PMID- 3521584 TI - Kinetic mechanism of Escherichia coli isocitrate dehydrogenase and its inhibition by glyoxylate and oxaloacetate. AB - The inhibition of Escherichia coli isocitrate dehydrogenase by glyoxylate and oxaloacetate was examined. The shapes of the progress curves in the presence of the inhibitors depended on the order of addition of the assay components. When isocitrate dehydrogenase or NADP+ was added last, the rate slowly decreased until a new, inhibited, steady state was obtained. When isocitrate was added last, the initial rate was almost zero, but the rate increased slowly until the same steady state value was obtained. Glyoxylate and oxaloacetate gave competitive inhibition against isocitrate and uncompetitive inhibition against NADP+. Product-inhibition studies showed that isocitrate dehydrogenase obeys a compulsory-order mechanism, with coenzyme binding first. Glyoxylate and oxaloacetate bind to and dissociate from isocitrate dehydrogenase slowly. These observations can account for the shapes of the progress curves observed in the presence of the inhibitors. Condensation of glyoxylate and oxaloacetate produced an extremely potent inhibitor of isocitrate dehydrogenase. Analysis of the reaction by h.p.l.c. showed that this correlated with the formation of oxalomalate. This compound decomposed spontaneously in assay mixtures, giving 4-hydroxy-2-oxoglutarate, which was a much less potent inhibitor of the enzyme. Oxalomalate inhibited isocitrate dehydrogenase competitively with respect to isocitrate and was a very poor substrate for the enzyme. The data suggest that the inhibition of isocitrate dehydrogenase by glyoxylate and oxaloacetate is not physiologically significant. PMID- 3521585 TI - Structural and kinetic studies on beta-lactamase K1 from Klebsiella aerogenes. AB - beta-Lactamase K1 from Klebsiella aerogenes 1082E hydrolyses both penicillins and cephalosporins comparably and is inhibited by mercurials but not by cloxacillin. These properties distinguish it from those other beta-lactamases that have been allotted to classes on the basis of their amino sequences. beta-Lactamase K1 has been isolated by affinity chromatography; its composition shows resemblances to class A beta-lactamases. Moreover, the N-terminal sequence is similar to those of class A beta-lactamases: there is about 30% identity over the first 32 residues. Furthermore, a putative active-site octapeptide has been isolated and its sequence is similar to the region around the active-site serine residue in class A beta-lactamases. There is one thiol group in beta-lactamase K1; it is not essential for activity. The pH-dependence of kcat. and kcat./Km for the hydrolysis of benzylpenicillin by beta-lactamase K1 were closely similar, suggesting that the rate-determining step is cleavage of the beta-lactam ring. PMID- 3521586 TI - Human low-Mr kininogen contains three copies of a cystatin sequence that are divergent in structure and in inhibitory activity for cysteine proteinases. AB - We point out that human low-Mr kininogen contains three cystatin-like sequences, rather than two, as had previously been thought. The protein was purified by affinity chromatography on carboxymethyl-papain-Sepharose, and subjected to limited proteolysis by trypsin and chymotrypsin. Fragments were isolated, and three corresponding to the individual cystatin-like domains were identified. By comparison with the known amino acid sequence of the protein they were numbered 1 to 3 from the N-terminus. Domain 1 was not found to have any inhibitory activity for cysteine proteinases, which is consistent with the absence of residues that are highly conserved in inhibitors of the cystatin superfamily, and have previously been suggested to be essential for activity. Domain 2 was a good inhibitor of chicken calpain, and also papain and cathepsin L. Domain 3 showed negligible inhibition of calpain, but inhibited papain and cathepsin L strongly. The probable arrangement of disulphide bonds in the heavy chain of low-Mr kininogen is deduced from the homology with the cystatins and other evidence contained in the present paper. PMID- 3521587 TI - Effects of monensin on insulin interactions with isolated hepatocytes. Evidence for inhibition of receptor recycling and insulin degradation. AB - Recent evidence suggests that, during endocytosis, receptors for many polypeptide ligands are spared degradation and are recycled to the plasma membrane for re utilization. The univalent ionophore monensin was shown to inhibit membrane recycling. We therefore examined its effects on insulin interactions with isolated rat hepatocytes to characterize further receptor endocytosis and recycling in these cells. At 10 degrees C, in the absence of endocytosis, no change in insulin binding was observed. However, at 37 degrees C a concentration dependent decrease in 125I-insulin binding was seen in the presence of insulin; this reached a maximum of 60% at 1 nM-insulin. Competitive binding studies showed this to be due to a 50-60% decrease in cell-surface insulin-receptor concentration, although the total cellular receptor concentration remained unchanged, suggesting that monensin causes the intracellular sequestration of receptors. Time-course studies of the processing of 2.5 nM-insulin showed that monensin produced a 50-60% decrease in surface binding, accompanied by a similar decrease in internalization and total inhibition of insulin degradation. When hepatocytes with 125I-insulin prebound to their surface receptors at 10 degrees C were warmed to 37 degrees C, monensin had no effect on internalization, but caused marked impairment of intracellular insulin degradation. It is concluded that monensin inhibits receptor recycling and cellular insulin degradation. PMID- 3521588 TI - Gaining access to the cytosol: the technique and some applications of electropermeabilization. PMID- 3521589 TI - Evidence that insulin and guanosine triphosphate regulate dephosphorylation of the beta-subunit of the insulin receptor in sarcolemma membranes isolated from skeletal muscle. AB - When sarcolemma membranes isolated from rat skeletal muscle were incubated with [gamma-32P]ATP, a membrane protein of apparent Mr 95,000 was rapidly phosphorylated, with the 32P content reaching a maximum within 2 s. On the basis of immunoprecipitation with anti-insulin-receptor antiserum, phosphoamino acid analysis and Mr, this protein probably represents the beta-subunit of the insulin receptor. Similarly, on incubation of the membrane with adenosine 5'-[gamma [35S]thio] triphosphate the 95 kDa protein was thiophosphorylated, indicating thiophosphorylation of the beta-subunit of the insulin receptor on the basis of immunoprecipitation studies. The effect of insulin on the phosphorylation of this protein in the membrane was studied. Insulin induced a 20% decrease in the 32P labelling of the protein when the membranes were phosphorylated for 10 s. This insulin effect was dose-dependent, with half-maximal effect obtained at 2-3 nM insulin. Addition of GTP, but not GDP or guanosine 5'-[beta, gamma imido]triphosphate, enhanced the effect to 35% inhibition, with half-maximal effect of GTP obtained at 0.5 microM. GTP had no effect on the phosphorylation of the protein in the absence of insulin. Analysis of this insulin effect showed that insulin increased the rate of dephosphorylation of the 95 kDa protein in the membrane. In contrast, insulin had no effect on thiophosphorylation of the 95 kDa membrane protein after incubation with adenosine 5'-[gamma [35S]thio]triphosphate. Since thiophosphorylated proteins are less sensitive to phosphatase action, these investigations suggest that insulin stimulated a protein phosphatase activity in a GTP-dependent manner. The possibility that GTP regulatory proteins are involved in the action of insulin on the phosphorylation of the insulin receptor and other membrane proteins is discussed. PMID- 3521590 TI - Experimental hyperthyroidism does not induce hepatic insulin resistance in the miniature pig. AB - The effect of hypo- and hyper-thyroidism on insulin-mediated alterations in tracer-determined glucose kinetics and the arterial concentration of gluconeogenic precursors were investigated in 24 h-starved conscious unrestrained miniature pigs. Hyperinsulinaemia (about 40 microunits/ml) decreased blood glucose and, transiently, glucose output at unaltered glucose utilization in all thyroid states: this effect was pronounced in hyperthyroid (-50%) and less in hypothyroid pigs (-25%) compared with euthyroid controls (-35%). We conclude that moderate experimental hyperthyroidism does not induce hepatic insulin resistance, whereas hypothyroidism slightly impairs insulin action with respect to the regulation of glucose output. PMID- 3521592 TI - Quinohaemoprotein alcohol dehydrogenase apoenzyme from Pseudomonas testosteroni. AB - Cell-free extracts of Pseudomonas testosteroni, grown on alcohols, contain quinoprotein alcohol dehydrogenase apoenzyme, as was demonstrated by the detection of dye-linked alcohol dehydrogenase activity after the addition of PQQ (pyrroloquinoline quinone). The apoenzyme was purified to homogeneity, and the holoenzyme was characterized. Primary alcohols (except methanol), secondary alcohols and aldehydes were substrates, and a broad range of dyes functioned as artificial electron acceptor. Optimal activity was observed at pH 7.7, and the presence of Ca2+ in the assay appeared to be essential for activity. The apoenzyme was found to be a monomer (Mr 67,000 +/- 5000), with an absorption spectrum similar to that of oxidized cytochrome c. After reconstitution to the holoenzyme by the addition of PQQ, addition of substrate changed the absorption spectrum to that of reduced cytochrome c, indicating that the haem c group participated in the enzymic mechanism. The enzyme contained one haem c group, and full reconstitution was achieved with 1 mol of PQQ/mol. In view of the aberrant properties, it is proposed to distinguish the enzyme from the common quinoprotein alcohol dehydrogenases by using the name 'quinohaemoprotein alcohol dehydrogenase'. Incorporation of PQQ into the growth medium resulted in a significant shortening of lag time and increase in growth rate. Therefore PQQ appears to be a vitamin for this organism during growth on alcohols, reconstituting the apoenzyme to a functional holoenzyme. PMID- 3521591 TI - The cloning and sequence analysis of the aspC and tyrB genes from Escherichia coli K12. Comparison of the primary structures of the aspartate aminotransferase and aromatic aminotransferase of E. coli with those of the pig aspartate aminotransferase isoenzymes. AB - In this paper we describe the cloning and sequence analysis of the tyrB and aspC genes from Escherichia coli K12, which encode the aromatic aminotransferase and aspartate aminotransferase respectively. The tyrB gene was isolated from a cosmid carrying the nearby dnaB gene, identified by its ability to complement a dnaB lesion. Deletion and linker insertion analysis located the tyrB gene to a 1.7 kilobase NruI-HindIII-digest fragment. Sequence analysis revealed a gene encoding a 43 000 Da polypeptide. The gene starts with a GTG codon and is closely followed by a structure resembling a rho independent terminator. The aspC gene was cloned by screening gene banks, prepared from a prototrophic E. coli K12 strain, for plasmids able to complement the aspC tyrB lesions in the aminotransferase deficient strain HW225. Sub-cloning and deletion analysis located the aspC gene on a 1.8-kilobase HincII-StuI-digest fragment. Sequence analysis revealed the presence of a gene encoding a 43 000 Da protein, the sequence of which is identical with that previously obtained for the aspartate aminotransferase from E. coli B. Considerable overproduction of the two enzymes was demonstrated. We compared the deduced protein sequences with those of the pig mitochondrial and cytoplasmic aspartate aminotransferases. From the extensive homology observed we are able to propose that the two E. coli enzymes possess subunit structures, subunit interactions and coenzyme-binding and substrate-binding sites that are very similar both to each other and to those of the mammalian enzymes and therefore must also have very similar catalytic mechanisms. Comparison of the aspC and tyrB gene sequences reveals that they appear to have diverged as much as is possible within the constraints of functionality and codon usage. PMID- 3521593 TI - A probable new pathway for the biosynthesis of putrescine in Escherichia coli. AB - Some cultures of Escherichia coli BGA8, a mutant unable to synthesize putrescine, showed a change of behaviour and could grow almost equally well in either the absence or the presence of polyamines after repeated periods of polyamine starvation. Experiments in vivo with radioactive precursors showed that the bacteria which evaded the polyamine requirement had recovered their ability to synthesize putrescine from glucose or glutamic acid, but not from ornithine or arginine. These results are in agreement with the fact that the polyamine independent cells were still deficient in the enzymes ornithine decarboxylase and agmatinase. Our findings seem to indicate the existence of a new pathway synthesize putrescine which does not involve ornithine or arginine as intermediates. PMID- 3521594 TI - Trypsin-catalysed formation of pig des-(23-63)-proinsulin from desoctapeptide (B23-30)-insulin. AB - Incubation of pig desoctapeptide-(B23-30)-insulin with trypsin in solvent systems consisting of dimethyl sulphoxide, butane-1,4-diol and Tris buffer resulted in the formation of an extra peptide bond between Arg-B22 and Gly-A1 in the DOPI molecule. This DOPI derivative can also be regarded as pig des-(23-63) proinsulin. The structure of the new, previously unreported, proinsulin analogue was determined on the basis of amino acid analysis, dansylation and digestion with Staphylococcus aureus V8 proteinase. Receptor-binding ability of des-(23-63) proinsulin was 20% of that of pig desoctapeptide-(B23-30)-insulin and 0.02% of that of pig insulin. PMID- 3521595 TI - The regulatory properties of yeast pyruvate kinase. Effect of fructose 1,6 bisphosphate. AB - The kinetics of pyruvate kinase from Saccharomyces cerevisiae were studied in assays at pH 6.2 at 25 degrees C as a function of the concentrations of the substrates ADP, phosphoenolpyruvate and Mg2+ and the concentration of the effector fructose 1,6-bisphosphate. The enzyme was activated by 100 mM-K+ and 32 mM-NH4+ throughout. It was found that an increase in the fructose bisphosphate concentration from 24 microM to 1.2 mM brings about a transition from a sigmoidal to a non-inflected form in the relationships v = f([phosphoenolpyruvate]) and v = f([Mg2+]) together with a large increase in the affinity of these substrates for the enzyme. The binding behaviour of ADP is barely affected by the same change in effector concentration. By contrast, increase in fructose bisphosphate concentration below 24 microM increases the affinity of the enzyme for all its substrates and the sigmoidicity of the corresponding velocity-substrate concentration relationships. As a result of this change in behaviour it has been found impossible to represent all the data by the exponential model for a regulatory enzyme, and it is suggested (supported by comparisons with previous work) that the failure may reflect a secondary action of the effector upon the enzyme. PMID- 3521596 TI - The regulatory properties of yeast pyruvate kinase. Effect of pH. AB - The kinetics of pyruvate kinase from Saccharomyces cerevisiae were studied at 25 degrees C as a function of the concentrations of the substrates ADP, phosphoenolpyruvate and Mg2+ and the effector H+ in the pH range 5-6.6. The enzyme was activated by 100 mM-K+ and 32 mM-NH4+ throughout. It was found that the data could be described by the exponential model for a regulatory enzyme. On that basis, it was concluded that the binding of H+ is positively interactive and that the protonated enzyme is catalytically inactive. It was also found that H+ interacts positively with phosphoenolpyruvate but negatively with both ADP and Mg2+. PMID- 3521597 TI - The regulatory properties of yeast pyruvate kinase. Effects of NH4+ and K+ concentrations. AB - The kinetics of pyruvate kinase from Saccharomyces cerevisiae were studied at 25 degrees C and pH 6.2 as a function of the concentrations of ADP, phosphoenolpyruvate, Mg2+ and either NH4+ or K+. The data were analysed by the exponential model for four substrates, obtained by extension of the model described by Ainsworth, Kinderlerer & Gregory [(1983) Biochem. J. 209, 401-411]. On that basis, it was concluded that NH4+ binding is almost non-interactive but leads to the appearance of positive interaction in the velocity response to increase in its concentration because of positive interactions with phosphoenolpyruvate and Mg2+. The data obtained with K+ lead to the same conclusions and differ only in suggesting that NH4+ is bound more strongly to the enzyme than is K+. Both data sets are used as the basis for a discussion of the substrate interactions of pyruvate kinase and it appears therefrom that the heterotropic interactions accord with what is known of the events that take place at the active site during catalysis. The paper also reports a determination of the dissociation constants for the NH4+ complexes with ADP and phosphoenolpyruvate and an examination of the simultaneous activation of pyruvate kinase by K+ and NH4+ ions. PMID- 3521598 TI - Effects of ketoconazole on sterol biosynthesis by Trypanosoma cruzi epimastigotes. AB - Reproduction of Trypanosoma cruzi epimastigotes in a liver infusion-tryptose serum medium was inhibited by the antimycotic agent ketoconazole. Effective drug concentrations also blocked the biosynthesis of the parasite's fungal-type sterols at the stage of C-14 demethylation, as demonstrated by radioisotopic, chromatographic and mass spectrometric methods. Coincidently, a 4,4,14 alpha trimethyl sterol, 24-methylenedihydrolanosterol, accumulated and came to replace as much as three fourths of the free sterol content of the cells. Precedents from studies with fungi are invoked to suggest that the cytotoxicity of ketoconazole for T. cruzi is a consequence of the inability of 24-methylenedihydrolanosterol to perform the membrane lipid bilayer functions of the normal epimastigote sterols. PMID- 3521599 TI - Stimulation of phosphatidylcholine synthesis by insulin and ATP in isolated rat adipocyte plasma membranes. AB - Added individually or together, insulin and/or ATP significantly and rapidly increased the concentration of phosphatidylcholine in an enriched plasma membrane preparation from rat adipocytes. The increase in phosphatidylcholine synthesis mediated by insulin or ATP was suppressed by the phospholipid methyltransferase inhibitor, S-adenosylhomocysteine. These results suggest that the activity of phospholipid methyltransferase from adipocyte plasma membranes may be increased by phosphorylation and that insulin may further increase the activity of the phosphorylated phospholipid methyltransferase by an alternative pathway. PMID- 3521600 TI - Conjugal transfer of hydrogen-oxidizing ability of Alcaligenes hydrogenophilus to Pseudomonas oxalaticus. AB - Conjugal transfer of hydrogen-oxidizing ability (Hox) of the hydrogen bacterium Alcaligenes hydrogenophilus was examined. Intraspecific cross of plasmid pHG21-a that encodes hydrogenases that mediate hydrogen oxidation was most frequent at 25 C; the optimal temperature for growth was 30 C. The plasmid could be transferred from A. hydrogenophilus to Pseudomonas oxalaticus OX1 and OX4, and the resulting strains gained the capacity for autotrophic growth with H2 and CO2. Plasmid pHG21 a was maintained in P. oxalaticus OX1 and OX4 as stably as in A. hydrogenophilus. PMID- 3521601 TI - Isolation of hydrogen-oxidation gene from Alcaligenes hydrogenophilus and its expression in Pseudomonas oxalaticus. AB - A gene bank of a megaplasmid encoding the hydrogen-oxidizing enzyme system (Hox) in Alcaligenes hydrogenophilus was constructed using a broad host range cosmid vector pVK102, and established in Escherichia coli. Hybrid cosmids containing hox genes were identified by transferring the bank into Pseudomonas oxalaticus OX1 and screening colonies for the ability of H2-dependent autotrophic growth. About 800 colonies were formed under autotrophic conditions. One of the Hox+ transconjugants was isolated and its hydrogenases activities were measured. Although soluble hydrogenase was not detected, the Hox+ transconjugant had four times the membrane-bound hydrogenase activity of A. hydrogenophilus. PMID- 3521602 TI - Collagen processing in ras-transfected mouse mammary epithelial cells. AB - A mouse mammary epithelial cell line (NMuMG), after transfection with the c-rasH oncogene, forms invasive tumors in nude mice. NMuMG and NMuMG/p-rasH cells produce similar amounts of collagen (mostly type IV) when grown on plastic. NMuMG cells respond to growth on collagen gels by increasing the rate of collagen synthesis and deposition by 100%, unlike NMuMG/p-rasH cells which synthesize similar amounts of collagen whether grown on plastic or collagen gels. These results suggest that ras transformation partially inhibits the interaction between epithelial cells and the surrounding stroma that is necessary for basement membrane deposition in vivo and consequently may facilitate the invasion of the stroma by transfected cells. PMID- 3521603 TI - Regulation of the activity of 3-hydroxy-3-methylglutaryl coenzyme A reductase by insulin. AB - In hypophysectomized--diabetic rats full restoration of hepatic HMG-CoA reductase activity required administration of both triiodothyronine and insulin. Giving triiodothyronine alone resulted in full restoration of reductase mRNA and immunoreactive protein but not of enzyme activity. Increasing the ratio of dithiothreitol to microsomal protein resulted in full HMG-CoA reductase activity. With 5mM glutathione, HMG-CoA reductase activity was 5 to 10 fold higher in non diabetic animals. The data suggest that insulin acts by increasing the portion of HMG-CoA reductase present in its active free sulfhydryl form. PMID- 3521604 TI - Receptor binding and negative cooperativity of a mutant insulin, [LeuA3]-insulin. AB - [LeuA3]-insulin, the third mutant insulin, was semisynthesized and was studied for receptor binding and negative cooperative effects. Receptor binding and biological effects of the mutant insulin were 0.3-0.5% of normal, the lowest among three mutant insulins. However, negative cooperative effects of the mutant insulin were almost normal at higher concentration (greater than 10(-6) M). Monoclonal anti-insulin antibody binding studies revealed that carboxyterminal region of B chain was relatively unchanged. These results suggest that N-terminal region of A-chain extending to A3 is important for receptor binding and confirm that A3 does not play an important role for negative cooperativity. PMID- 3521605 TI - Impaired insulin receptor phosphorylation in skeletal muscle membranes of db/db mice: the use of a novel skeletal muscle plasma membrane preparation to compare insulin binding and stimulation of receptor phosphorylation. AB - A method has been developed to isolate skeletal muscle plasma membranes from mice in good yield without harsh extraction procedures. The method involves perfusion of mouse hindquarters with a calcium-deficient buffer containing collagenase and hyaluronidase. This is followed by gentle disruption, filtration, and differential centrifugations. The entire procedure takes about six hours and the yield is approximately 4 mg. protein from 10 g. equivalent of hindquarter muscle. The preparation contained predominantly plasma membranes based on specific activities of marker enzymes, electron microscopic data, and specific binding sites for insulin and a -adrenergic ligand. Studies using such preparations from lean, 4-5 week old and 12-20 week old db/db mice showed marked reduction in the phosphorylation of the 95 kDa subunit of the insulin receptor of the obese mice with no change in insulin binding. In addition, there was a progressive reduction in insulin sensitivity in stimulating receptor phosphorylation in the db/db mice. PMID- 3521606 TI - Comparative immuno-removal: a novel method for estimating the concentration of an unknown immunoreactive compound. AB - We describe a method for estimating the molar concentration of an unknown immunoreactive compound. The amount of antibody required to bind half of a standard is compared to the amount required to bind half of an equal number of immunoreactive equivalents of the unknown. We demonstrate the utility of the method using a morphine antibody affinity resin and compounds structurally related to morphine. PMID- 3521607 TI - The interrelationships among poly(ADP-ribosyl)ation, DNA synthesis and mammary gland differentiation. AB - Because mammary epithelium from virgin mice must undergo DNA synthesis prior to differentiation and because poly(ADP-ribosyl)ation has been linked to the cell cycle, it was hypothesized that this requirement for DNA synthesis might be related to the poly(ADP-ribosyl)ation of nuclear proteins. However, 3 methoxybenzamide, an inhibitor of poly(ADP-ribosyl)ation, stimulates alpha lactalbumin accumulation even when added after DNA replication is completed. Furthermore, in parous mice this compound is still effective when DNA synthesis is blocked by cytosine arabinoside-beta-D-arabinofuranoside. Therefore, poly(ADP ribosyl)ation appears to be associated, not with DNA synthesis, but with some other event in mammary gland differentiation. PMID- 3521608 TI - Stereo-selective interaction of enantiomers of diniconazole, a fungicide, with purified P-450/14DM from yeast. AB - R(-) isomer of diniconazole [S-3308L, (E)-1-(2,4-dichlorophenyl)-4,4-dimethyl-2 (1,2,4-triazol-l-yl)-1-+ ++penten-3-ol], a newly developed fungicide strongly inhibited lanosterol 14 alpha-demethylation catalyzed by a yeast cytochrome P-450 (P-450/14DM). On the other hand, S(+) isomer of diniconazole was a weaker inhibitor for P-450/14DM. The R(-) isomer combined with both ferric and ferrous P 450/14DM and interfered binding of CO to the cytochrome. The S(+) isomer also interacted with both forms of P-450/14DM but the absorption spectra of the S(+) diniconazole complexes were different from those of the R(-)-diniconazole complexes. Furthermore, S(+) isomer did not significantly interfere the binding of CO to P-450/14DM. These observations suggest that P-450/14DM discriminates enantiomers of diniconazole and the R(-) isomer is more favorably fit for the active site of the cytochrome. PMID- 3521609 TI - Two activated forms of protease-sensitive protein kinase isolated from rat liver plasma membrane. AB - Rat liver plasma membrane contains a protease-activated kinase which corresponds to protein kinase C. When the solubilized enzyme was digested with trypsin in the absence of NaCl, a partially activated form with an approximate molecular weight of 8 X 10(4) was produced. However, another active form of molecular weight of 5 X 10(4) was obtained when the enzyme was digested in the presence of NaCl. The larger molecular weight form was converted to the smaller form by tryptic digestion in the presence of NaCl. These results suggest the existence of two protease-activated forms of protein kinase C. PMID- 3521610 TI - Reexamination of the activation of yeast proteinase B at pH 5: loss of inhibition effect of proteinase B inhibitors. AB - The activation of yeast proteinase B at pH 5 has been suggested to be due to the degradation of a specific inhibitor for the enzyme, IB, by proteinase A. However, we found that when pepstatin, which completely inhibits proteinase A, was included in the pH 5 activation mixture, the same time-dependent activation of proteinase B was observed. Furthermore, proteinase B preparations that were void of proteinase A activity were still activated by incubation at pH 5. We found that the activation of proteinase B at pH 5 was due primarily to the irreversible loss of inhibitory effect of IB, which can be resolved by isoelectrofocusing into four distinct bands with isoelectric points of 4.6, 6.1, 6.8 and 7.6. These four forms of IB showed varying degrees of stability at pH 5, which may explain some of the differing observations reported in the past. PMID- 3521611 TI - Rehabilitation for rheumatoid arthritis patients. A controlled trial. AB - For 1 year we obtained questionnaire and clinical measures from 2 cohorts of rheumatoid arthritis patients: 49 experimental patients who were admitted for an average of 13 days to a university-based rheumatology rehabilitation unit, and 43 control patients who received care from rheumatologists associated with another teaching hospital. At 1 year, after controlling for groups differences, the experimental patients demonstrated significant (P less than 0.05) improvement compared with control patients in several functional status, mental health, and disease activity measures. PMID- 3521612 TI - Evaluation of amitriptyline in primary fibrositis. A double-blind, placebo controlled study. AB - Seventy patients with primary fibrositis satisfying Smythe's criteria were studied in a 9-week double-blind trial comparing 50 mg amitriptyline with placebo. Fifty-nine patients completed the trial: 27 were treated with amitriptyline, and 32 took a placebo. The patients who received amitriptyline improved significantly in their morning stiffness and pain analog scores at 5 and 9 weeks, compared with baseline scores, whereas no changes were noted in these parameters in the placebo group. Fibrocytic point tenderness did not improve significantly in either of the treatment groups. When compared with the placebo group, the amitriptyline group improved significantly with respect to sleep pattern and patient and physician global assessments. Our data indicate that amitriptyline has some therapeutic benefit in patients with primary fibrositis. PMID- 3521613 TI - An animal model of antibody binding in cutaneous lupus. AB - To study antibody binding in cutaneous lupus, we used human skin grafted onto nude mice. By immunofluorescence examination, mice injected with anti-Ro (SS-A) sera from subacute cutaneous or neonatal lupus erythematosus patients showed evidence of human IgG deposited in the skin, while mice injected with anti-native DNA or normal sera did not. We present evidence that there is specific binding of anti-Ro (SS-A) antibodies to Ro (SS-A) antigen in the skin, and we propose that these antibodies may be directly involved in cutaneous disease. PMID- 3521614 TI - Temporary salvage of ischemic myocardium by the protease inhibitor bis[ethyl(2R,3R)-3-[(S)-methyl-1-[4-(2,3,4-trimethoxyphenyl-methyl) piperazin-1 ylcarbonyl]butyl-carbonyl]oxiran-2-carbo xylate]sulfate. AB - The administration (i.v., 20, 40 and 60 mg/kg) of the thiol protease inhibitor bis[ethyl(2R, 3R)-3-[(S)-methyl-1-[4-(2,3,4-trimethoxyphenyl-methyl) piperazin-1 ylcarbonyl] butyl-carbonyl] oxiran-2-carboxylate]sulfate (NCO-700), before and/or after the coronary ligation significantly reduced the necrotic mass in the rabbit left ventricle and also prevented the creatine phosphokinase loss in the ischemic myocardium up to 3 h and not at 6 h after the ligation. The activities of both calcium-activated neutral protease and cathepsin B in the subendo- and subepicardial layers of the ischemic, marginal or control myocardium of dog were inhibited by the NCO-700 administration (20 mg/kg i.v.) after the coronary ligation. A hemodynamic study using heart-lung preparation of the dog demonstrated a dose-dependent coronary dilatation with weak and transient negative ino- and chronotropic effects. These data suggested that NCO-700 sensitive protease(s) is(are) included in the step of myocardial cell degradation and that NCO-700 temporarily salvages it, as is important for the recent PTCR (percutaneous transluminal coronary reperfusion) therapy. PMID- 3521616 TI - Beneficial effects of sodium salt of 17(R)-methyl-20-isopropylidenecarbacyclin on experimentally-induced ischemic hind limb lesions and blood viscosity. AB - The occlusion of the femoral artery of rats induced reproducible hind limb lesions resembling thromboangiitis and obliterative arteriosclerosis. 17(R) Methyl-20-isopropylidenecarbacyclin (CS-570), as well as alprostadil (PGE1), ticlopidine and pentoxifylline, inhibited the lesions. The occlusion of the femoral artery of rabbits caused elevation of the viscosity of the returning venous blood and echinocytic shape changes of erythrocytes. CS-570, as well as PGE1, also inhibited these changes. The decreased deformability of erythrocytes of rats under acidic conditions was improved by CS-570 and PGE1. The usefulness of CS-570 for the treatment of periferal arterial diseases was suggested. PMID- 3521615 TI - Antithrombotic effects of sodium salt of 17(R)-methyl-20 isopropylidenecarbacyclin in the arteriole of the hamster cheek pouch. AB - Antithrombotic effects of sodium salt of 17(R)-methyl-20 isopropylidenecarbacyclin (CS-570), a chemically stable prostaglandin I2 (PGI2, epoprostenol, prostacyclin) derivative, were investigated in the arteriole of the hamster cheek pouch. A microthrombus was produced by a slight mechanical injury followed by iontophoretic application of adenosine diphosphate (ADP) to an arteriole of 70 to 100 micron in diameter. The platelet thrombus size was determined with a video image processor. With this technique, a reproducible and quantitatively measurable periodical thrombus was obtained. CS-570 inhibited the thrombus formation dose-dependently. The potency of CS-570 was about 1/8 that of PGI2 and 6 times that of carbacyclin when infused i.v. CS-570 also decomposed an established thrombus. Alprostadil (PGE1), dipyridamole and ticlopidine failed to show inhibitory effects. The antithrombotic effect of CS-570 was definitely demonstrated. PMID- 3521617 TI - Effect of curcumin on platelet aggregation and vascular prostacyclin synthesis. AB - In vitro and ex vivo effects of 1,7-bis(4-hydroxy-3-methoxyphenyl)-1,6-heptadiene 3,5-dione (diferuloylmethane, curcumin) and acetylsalicylic acid (ASA) on the synthesis of prostacyclin (PGI2) and on platelet aggregation has been studied in rat. Both drugs inhibited adenosine diphosphate (ADP)-, epinephrine (adrenaline)- and collagen-induced platelet aggregation in monkey plasma. Pretreatment with ASA (25-100 mg/kg), but not curcumin (100-300 mg/kg), inhibited PGI2 synthesis in rat aorta. In the in vitro system, too, curcumin caused a slight increase in the synthesis of PGI2, while ASA inhibited it. Curcumin may, therefore, be preferable in patients prone to vascular thrombosis and requiring antiarthritic therapy. PMID- 3521618 TI - Piroxicam capsules versus suppositories: a pharmacokinetic and clinical trial. AB - 15 patients with rheumatoid arthritis or osteoarthritis received a single dose (20 mg) piroxicam (Felden) as suppository. Serum piroxicam concentrations were assayed by fluorometry 1, 2, 4, and 8 h after the installation of the suppository, the mean values being 1.3, 1.9, 1.8, and 1.8 mg/l, respectively. Then the patients continued on oral piroxicam 20 mg daily for maximum 3 weeks, and serum piroxicam levels (mean 6.3 mg/l) were checked at the end of this period. Nine patients then continued on piroxicam suppositories 20 mg daily for one week, and serum piroxicam levels (mean 4.5 mg/l) were again assayed at the end of this maintenance. Pain at rest, pain on motion, and joint movement restriction were scored on day 1, after oral maintenance, and after rectal maintenance. Reduced scores were found with time, but the only statistically significant effect was in the overall subjective pain relief measured after oral maintenance. Rectal irritation was recorded in one patient. It is concluded that a) absorption of piroxicam from suppository was adequate, b) it was possible to maintain adequate serum piroxicam levels by repeated administration of suppository for one week, and c) the gastrointestinal toleration was acceptable in these patients selected for showing poor tolerance towards other nonsteroidal antiinflammatories. PMID- 3521620 TI - Survey of ASHA members employed in school settings. Report of the committee on language, speech and hearing services in the schools. PMID- 3521619 TI - Lack of efficacy of dried garlic in patients with hyperlipoproteinemia. AB - The effects of dried garlic on blood lipids, apolipoproteins and blood coagulation parameters in hyperlipemic patients were studies in two controlled, randomized, double-blind studies. Both studies comprised placebo and therapy periods of 6 weeks each. The doses administered were 3 X 198 mg in Study I (34 patients) and 3 X 450 mg in Study II (51 patients). In both studies, the following serum parameters were measured every 3 weeks: total cholesterol, HDL (high density lipoprotein)- and LDL (low density lipoprotein)-cholesterol, triglycerides and several safety parameters. In addition, apolipoproteins A and B, euglobulin lysis time, fibrin split products, prothrombin time, whole blood coagulation time and fibrinogen levels were determined in the second study only. The results indicated that neither dosage of dried garlic showed any significant effect on any of the parameters measured. It is therefore concluded that, if there is any effect of garlic on the parameters measured, it is not apparent when using a dried preparation in the dosage studied. PMID- 3521621 TI - Collective bargaining: what can it do for you? PMID- 3521622 TI - Working parents: leave of absence and child care. PMID- 3521623 TI - Hypercholesterolemia and aortic glycosaminoglycans of rabbits fed semi-purified diets containing sucrose and lactose. AB - This study was designed to evaluate the role of dietary sucrose and lactose in a semipurified diet as initiating factors for aortic glycosaminoglycan (GAG) and lipid changes. Rabbits were fed sucrose or lactose as 40% by weight of a semi purified, cholesterol-free diet for 10 weeks. At the end of the feeding period there was no macroscopic evidence of atherosclerosis. Sucrose-fed rabbits had significantly higher plasma cholesterol and phospholipid levels than the lactose fed rabbits and triglyceride levels were variably elevated in the sucrose group. Analysis of plasma lipoproteins indicated that sucrose elevated VLDL and LDL when compared to lactose. Only the higher molecular weight form of apo B (apo BH) could be demonstrated when apo B components of isolated lipoproteins were analyzed. Sucrose-fed rabbits had significantly more aortic cholesterol, cholesteryl ester and phospholipid and tended to have more GAG/mg dry defatted aorta than the lactose-fed rabbits. Plasma cholesterol levels correlated with aortic lipids and in the sucrose group, aortic cholesteryl ester and cholesterol were strongly correlated with aortic GAG particularly hyaluronic acid. Results suggest that the semi-purified diet alters aortic GAG composition but in order for the initiation of cholesterol accumulation a significant increase in plasma lipoprotein cholesterol is necessary. PMID- 3521625 TI - Epithelia of endodermal derivation in teratomas. AB - This work is concerned with the histological features of endoderma-derived epithelia in a series of 48 benign teratomas. The intestine-type epithelium had the histochemical characteristics of that of the large intestine. It occasionally showed argentaffin cells, Paneth cells and accessory structures, such as a basement membrane, bundles of smooth muscle fibers and lymphoid aggregates including IgA-secreting plasma cells. In a teratoma, there was transitional-type epithelium. The respiratory-type epithelium included the basic cell types of the normotopic. It often rested on a basement membrane, and was occasionally surrounded by seromucous glands, cartilage plaques, muscle fibers and lymphoid aggregates. PMID- 3521624 TI - [Craniofacial granulomatous lesions]. AB - Granulomatous lesions of the cranio-facial area are frequent and various in their nature: lymphohistiocytic with or without eosinophils, tuberculoid-like with epithelioid and giant cells, or sometimes made essentially of giant cells. Their etiology can be known or easy to find: foreign body granuloma, sarcoidosis, leprosy, rhinoscleroma, fungal diseases especially zygomycosis and rhinosporidiosis, parasitic diseases. The lethal midline granuloma is a clinical entity characterized by its necrotic and relentlessly progressive destructive presentation. After elimination of a malignant process, especially lymphoid, and of a Wegener's granulomatosis the diagnosis will be "idiopathic midline non healing granuloma". Some of them will stay located at the facial area; others will disseminate as a malignant disease. Central giant cell granuloma and histiocytosis X, especially eosinophilic granuloma, are two other varieties of granuloma, different of the former granulomatous infiltrates by their clinical presentation and their evolution. PMID- 3521626 TI - [Renal lesions induced by cyclosporin. Apropos of 4 renal biopsies and 22 necropsies of recipients of heart transplant]. AB - The morphological study of kidney in patients without any preexistent renal disease and treated by cyclosporine corroborated the nephrotoxicity of this immunosuppressive drug. 4 biopsies (in 2 patients with Behcet's disease, in 1 recipient of allogenic medullary graft and 1 recipient of heart transplant) were performed for acute renal failure observed in a variable time after the beginning of treatment (7th day to 14 months). In two cases, they demonstrated obvious vascular lesions (arteriolar or glomerular thrombosis, fibrinoid necrosis) and they detected constantly changes of proximal convoluted tubules (epithelial vacuolization or necrosis, calcifications). In addition, the ultrastructural study performed in all cases showed a striking increase of lysosomes and some giant mitochondria. The 8 autopsies of recipients with heart transplants treated by cyclosporine for more than 1 month corroborated also these renal changes which were always correlated with biological perturbations of the renal function (increase of level of serum creatinine). Besides the proximal convoluted tubular lesions (vacuolization, necrosis and calcifications), an obvious increase of the interstitial tissue proportional to the long time of treatment was always detected. PMID- 3521627 TI - [Mononuclear phagocyte system. Morphology and function of the principal constituting cells]. AB - Histo-monocytes are cells playing an important role in host defense reaction and purification of the organism. These cells belong to a new system of highly phagocytic mononuclear cells termed "mononuclear phagocyte system". This system includes the promonocytes and their precursors in the bone marrow, the monocytes in the peripheral blood and the different types of histiocytes and macrophages particularly Kupffer cells. Histiocytes can also transform into epithelioid cells and giant cells. The inclusion of all these cells in this system is based on similarities in the morphology, function, origin and kinetics of the phagocytes. The most important morphologic characteristics of these cells are described. It is also shown that the mononuclear phagocytic system is a secretory system. The different types of products are described. Recently, so-called accessory cells of the immunity were described, comprising dendritic reticular cells from the follicles and interdigitating reticular cells from the deep cortical zone of the lymph node. Those cells belong both probably to the system. The cells of this system are engaged in the clearance of multiple organs, in the inflammatory process, in the immune response and in the immune surveillance against tumor. PMID- 3521628 TI - [Fibroadenoma of the breast with atypical clear-cell epithelial hyperplasia. Apropos of 7 cases. Immunohistochemical study]. AB - We report 7 cases of unusual fibroadenomas of the breast. They are characterized by an exuberant cellular proliferation within the ductal lumens. They appear in young women from 20 to 40 years old. These lesions are histologically identical to those described by Azzopardi (1979) under the name of "Argyrophilic cells in fibroadenomas" and by Eusebi and Azzopardi (1980) and by Govoni (1981) and called "Lobular endocrine neoplasia in fibroadenoma of the Breast". An immunohistochemical study reveals a major positivity of these cells, in all cases, with Antikeratin Antibody (anti Kl1) and with Epithelial Membrane Antigen (anti EMA) proving the epithelial origin of these cells. There cells cannot yet be regarded as belonging to the neuro-endocrine group, because of the negativity, in all cases of Grimelius and Bodian stains, and of the very heterogeneous positivity observed with Neuron-Specific Enolase antibody (anti NSE) and with anti Human Natural Killer antibody (anti HNK). These cellular proliferations seem to us, on the microscopical point of view related to the atypical epithelial hyperplasias of the breast, and different from the in situ lobular carcinoma. Thus we propose to call these lesions "variant of the breast fibroadenoma" characterized by an atypical epithelial clear cell hyperplasia. The treatment of these lesions merely consists of a lumpectomy. Only one case is associated with an eleven years free of disease follow-up: a follow-up comprised between on to fifteen months is observed in the others cases. The knowledge of these benign lesions appears to us very important, to avoid improper treatment caused by an erroneous diagnosis of carcinoma developing in a breast fibroadenoma. PMID- 3521629 TI - [Hyalinosis cutis and mucosae. Ultrastructural histochemical aspects indicating intracellular accumulation of glycosaminoglycans]. AB - The exact nature of the genetic defect of hyalinosis cutis et mucosae or d'Urbach Whiete syndrome is still matter of controversy. The present article reports on three new cases in which several different ultrastructural and biochemical investigations add more arguments to support an anomaly of the glycosaminoglycans degradation in the dermal fibroblasts. Cationic dyes as polyethyleneimine and alcian blue show an intense ultrastructural staining of the abnormal basal laminae and the intracellular lysosomal bodies in cultured fibroblasts. These are related to the accumulation of anionic charged proteoglycans. The primary defect of hyalinosis cutis et mucosae is likely due to a lysosomal defect so far not biochemically defined. PMID- 3521630 TI - [Excision and fixation of the central nervous system]. PMID- 3521631 TI - Controlling stress in the home and the workplace. PMID- 3521632 TI - Computer-aided instruction in the emergency department. AB - Computer-aided teaching in the emergency department offers an important adjunct to traditional lectures and bedside clinical teaching. Using an integrated software system, lessons and patient simulations were created for the emergency department. Case simulations were more frequently used than more traditional question and answer formats. Acceptance and usage rates are high and remain so even after the initial novelty of the system declined. To be useful, such a system should be accessible over extended hours, and lessons should be brief and simple to execute. PMID- 3521633 TI - Trauma: an annotated bibliography of the recent literature. PMID- 3521634 TI - Computer-based interactive instruction in trauma. PMID- 3521635 TI - Prenatal diagnosis of fetal abdominal masses by ultrasonography. AB - A case of prenatally diagnosed ovarian cyst is presented to illustrate the value of sonograms during pregnancy. This tool warns the perinatal health team of abnormalities which otherwise might go undiagnosed until severe complications have occurred. PMID- 3521636 TI - Decreasing frequency of iatrogenic neonatal respiratory distress syndrome. AB - A retrospective study was undertaken to evaluate the obstetric events preceding delivery of infants who developed respiratory distress syndrome (RDS) at one New York City hospital between January 1970 and July 1973, and January 1980 and July 1983. Elective delivery without adequate documentation of fetal maturity occurred in 7 (11.1%) of 63 pregnancies resulting in RDS during 1970-1973 as compared to only 1 (1.4%) of 71 pregnancies resulting in RDS during 1980-1983 (P less than 0.05). This decline in "iatrogenic" RDS presumably reflects improved physician diligence in the prevention of unnecessary RDS, increased availability of ultrasound and fetal lung maturity studies, and advances in the application and interpretation of these diagnostic procedures. PMID- 3521637 TI - Prenatal ultrasonic diagnosis of arteriovenous malformation of the vein of Galen. AB - A case of an arteriovenous malformation of the vein of Galen diagnosed in utero by ultrasound is presented. Upon review of the literature only two cases of prenatal sonographic diagnosis of this entity have been described. The prenatal sonographic features of this rare disorder are discussed. PMID- 3521638 TI - The relationship between mean abdominal diameter and femur length in normal and impaired fetal growth. AB - The relationship of fetal mean abdominal diameter (MAD) to fetal femur length (FL) in clinically normal pregnancies and 37 cases of intrauterine growth retardation (IUGR) was studied. The normal relationship of FL to MAD is closely described by the equation: log (MAD) = 3.326 + (0.185 X FL). r = .953, P less than .001. In the growth retarded infants, 59% of the abdominal measurements fell below the lower 75% confidence limit. Of the abdominal measurements derived from infants with birthweight greater than 2 SD below the mean for gestational age, 86% fell below the lower 75% confidence limit. These data show the MAD is selectively depressed in many, but not all cases of IUGR and particularly in the more severely affected infant, but the technique is not sufficiently discriminant to be used by itself for the detection of IUGR. Detection of an anomaly of this relationship would be strong supportive evidence of IUGR independent of gestational age and possibly identifies infants growth retarded specifically due to chronic deprivation. PMID- 3521639 TI - Current status and prospects for some improved and new bacterial vaccines. PMID- 3521640 TI - Legal approaches to smoking deterrence. PMID- 3521641 TI - Behavioral and environmental interventions for reducing motor vehicle trauma. PMID- 3521642 TI - Carcinogenesis modeling: from molecular biology to epidemiology. PMID- 3521643 TI - Mild hypertension: the question of treatment. PMID- 3521644 TI - International drug regulation. PMID- 3521645 TI - Monitoring for congenital malformations. AB - Many countries instituted birth defects monitoring systems in the wake of the thalidomide tragedy. Having these systems in place will shorten the time before an alarm is signaled, should a teratogen of the potency of thalidomide be introduced. However, with stronger laws and regulations for testing drugs for adverse reproductive outcomes, a tragedy on the scale of thalidomide from ingestion of prescribed drugs by pregnant women is unlikely. Prospective parents could be exposed at the critical times to new physical, infectious, or nondrug chemical agents teratogenically as potent as thalidomide. (Teratogenic agents whose widespread use antedates monitoring will not cause rate changes or clusters detectable by monitoring.) What seems more likely is that the introduction of "weakly" teratogenic agents, or the inadvertent use of new drugs that are teratogenic, like isotretinoin, will be responsible for increases in birth defects. In neither of these situations are large numbers of cases likely to accumulate in short periods of time, particularly in the relatively small catchment areas (fewer than 50 to 100,000 births per year) of many monitoring programs. In addition to having to cope with this problem of rare outcomes, many monitoring systems have not been able to obtain complete ascertainment of CMs, at least not from single, rapidly reporting sources. Two remedies to these inadequacies are possible: Expand the catchment area. All births in the US, for instance, could be monitored if information on specific CMs was included on birth certificates, which were then transmitted to a central agency that could analyse the data rapidly. Alternatively, if different monitoring systems had comparable methods of ascertainment and diagnostic classifications, their data could be pooled with greater reliability than is currently possible. CMs in newborns are only one indicator of teratogenicity. At least 20% of all conceptions end in spontaneous abortions. A much higher proportion of abortuses have chromosome abnormalities, congenital malformations, or both, than newborns. The time necessary for such outcomes to manifest after the introduction of a new teratogen could be considerably shorter than the time before significant increases of CMs occurred in liveborns and stillborns. Monitoring the spontaneous abortion rate or chromosomal and other abnormalities in abortuses would be an important adjunct to monitoring newborns. However, since some teratogens may only cause CMs in newborns, the current approach to monitoring should not be abandoned. Moreover, the problems of ascertainment encountered in monitoring newborns are greater still in monitoring abortuses.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3521646 TI - Geographic analysis of disease and care. PMID- 3521647 TI - Occupational health: the intersection between clinical medicine and public health. PMID- 3521648 TI - Relative risk and odds ratio regression. PMID- 3521649 TI - Practice-based recording as an epidemiological tool. PMID- 3521650 TI - Reimbursement incentives for hospital care. PMID- 3521651 TI - Delayed health hazards of pesticide exposure. PMID- 3521652 TI - Dietary aspects of the treatment of hypertension. AB - Based upon currently available evidence, a practical dietary prescription should be: For the overweight, weight reduction should be the primary goal. For all hypertensives, dietary sodium should be restricted to a 2 g (88 mmol/d) level. Potassium intake need not be specifically increased since it will rise with a lowered sodium intake. Those who are hypokalemic may benefit from potassium supplementation. Supplemental magnesium and calcium should only be given to those who are deficient, until additional evidence of their efficacy is available. Caution is advised in not reducing the dietary sources of calcium when dietary sodium is reduced. More fiber and less saturated fat are beneficial for other reasons and may also help to lower the blood pressure. Alcohol should be limited to two ounces per day. The 1984 report of the Joint National Committee (23) recommends that "nonpharmacologic approaches [be] used both as definitive intervention and as an adjunct to drug therapy." In addressing the 40% of all hypertensives who are in the 90 to 94 mmHg range, the report states, "Nonpharmacologic therapy should be pursued aggressively while blood pressures are carefully monitored." Dietary changes are the major components of nondrug therapy. They should be enthusiastically offered to all hypertensives, while providing the various motivational tools and follow-up procedures that are readily available to maximize their acceptance and effectiveness. PMID- 3521653 TI - Anorexia nervosa and bulimia. PMID- 3521654 TI - Roundtable: Part I. The Dublin trial of fetal heart rate monitoring: the final word? PMID- 3521655 TI - Early days of molecular biology in the California Institute of Technology. PMID- 3521656 TI - Active transport in Escherichia coli: passage to permease. PMID- 3521657 TI - Identifying nonpolar transbilayer helices in amino acid sequences of membrane proteins. PMID- 3521658 TI - Mass mapping with the scanning transmission electron microscope. PMID- 3521659 TI - Applications of NMR to studies of tissue metabolism. PMID- 3521660 TI - Recombinant lipoproteins: implications for structure and assembly of native lipoproteins. PMID- 3521661 TI - Antifreeze glycoproteins from polar fish blood. AB - Existing experimental evidence strongly suggests that the mechanism of activity of the Antarctic AFGP molecules is the inhibition of ice growth by competitive adsorption onto the growth sites of ice. The data further suggest the blocking of the formation of large critical nuclei for ice growth. Experiments showing that the longer polymers (AFGP 1-5) have different growth-prevention properties with different types of ice than the shorter polymers (AFGP 6-8) provide additional evidence that crystal size and habits are linked to function. Four main observations have been used in AFGP studies: (a) The ice crystal habit (size) affects the activity, (b) AFGP is on the surface of ice crystals, as shown by surface second harmonic generation (SSHG), (c) the presence of AFGP lowers the surface energy at the ice-solution interface, and (d) kinetic calculations of the inhibition of ice-crystal growth fit adsorption isotherms. In particular, AFGP 4 fits a Langmuirian adsorption curve. On the detailed mechanistic side, there is a need to quantify the competitive rates of water-molecule attachment to ice as well as the rates of adsorption-desorption of AFGP on the ice surface. Toward this end, experiments are currently being conducted to examine the differential growth rates of ice crystals freely growing into a solution of AFGP. Direct observation of the adsorption and desorption of AFGP on the ice surface is possible in principle using the SSHG technique. A nonperturbative probe method that can differentiate adsorbed AFGP from the solution phase molecules is needed. Finally, a mechanistic description of molecular function is never complete unless the detailed molecular binding to the surface is elucidated. This task has not been accomplished yet, and thus there is still a question as to which molecular group is actually adsorbed onto the surface and for how long. Theoretically, as we have seen, the departure from Langmuirian adsorption is pronounced for small AFGP molecules under certain conditions. More refinements of the ideas of intermolecular or intramolecular cooperative interaction of AFGP on the ice surface are needed. PMID- 3521662 TI - Computational analysis of genetic sequences. PMID- 3521663 TI - Naltrexone: useful tool in the treatment of heroin users: a review of the literature. PMID- 3521664 TI - Hypertension in cadaver kidney transplantation. PMID- 3521665 TI - Nocardiosis in the immunocompromised host. PMID- 3521666 TI - [Value of the course of respiratory pressure in evaluating lung function in artificial respiration. 1. Theoretical principles]. PMID- 3521667 TI - [The CPAP system with control of rebreathing]. PMID- 3521668 TI - Carbamazepine and ethanol elicited responses in rodents. AB - The interaction between carbamazepine, and anticonvulsant with clinical efficacy in alcohol withdrawal syndrome, and ethanol was studied in rodents. Voluntary intake of ethanol by the rat was the behavioral performance test used to assess one aspect of such interaction. Carbamazepine, 50 mg/kg, IP, caused aversion to ethanol drinking. The drug was devoid of action on rat hepatic ethanol and acetaldehyde metabolizing enzymes, i.e., alcohol- and aldehyde dehydrogenase, and on testicular aldehyde dehydrogenase. The moderate induction of the latter by prolonged ethanol consumption was antagonized by a single dose of carbamazepine (50 mg/kg). Administration of carbamazepine, 50 mg/kg twice daily for three consecutive days, moderately inhibited mouse liver alcohol dehydrogenase in the male but not in the female mouse. This treatment did not alter endogenous mouse cardiac lactate dehydrogenase isoenzymes or hepatic aldehyde dehydrogenase in either sex. The enzymatic portion of the study suggests species and sex differences in the effects of carbamazepine studied. The reduction of voluntary drinking of ethanol by carbamazepine may have clinical implications, e.g., the extension of its use in alcohol withdrawal phase to alcohol abstinence. PMID- 3521669 TI - The Sister Kenny Clinics: what endures? PMID- 3521670 TI - The Delphi technique in practice. PMID- 3521671 TI - [Evaluation of the in vitro activity of aztreonam on 1990 gram-negative bacterial strains recently isolated in Campania hospitals]. AB - The in vitro activity of aztreonam, leader of a new class of antibiotics, the monobactams, has been investigated. The effectiveness of the new molecule on 1990 strains of Gram-negative clinical isolates has been compared to that of some other drugs widely utilized for the treatment of nosocomial infections. Aztreonam has shown the highest activity against all the tested strains, with a geometrical mean of MICs (MG) of 0.37 and a MIC 90 of 8 micrograms/ml. PMID- 3521672 TI - Trypanosoma lewisi in liquid culture: findings and comparisons with different types of media. Culture medium for Trypanosoma lewisi. AB - The culture technique used proved to be more simple and economical than the different culture methods described in literature. This process permits the in vitro growth of parasites for a period long enough (10 days) to determine the possible activity of drugs. On the 10th day the cultures are infectious. PMID- 3521673 TI - A method for the rapid detection of streptococcal group A antigen by specific monoclonal antibody. AB - In this study we evaluate the efficacy of a method for the rapid detection of group A streptococci employing a hybridoma mouse antibody specific against group A streptococcal carbohydrate. Using coagglutination technique we demonstrated an absolute specificity. The sensitivity was absolute if the preparation contained greater than or equal to 5 X 10(4) cocci. This test seems therefore a valid criterion for symptomatic patients with a larger number of group A streptococci in throat specimens, more sensitive than other methods, but not sensitive enough for carriers of few bacteria. PMID- 3521674 TI - Acoustic neurinoma diagnostic model evaluation using decision support systems. AB - Three acoustic neurinoma (hereafter called acoustic neuroma) diagnostic models (Jenkins, Le Liever, Kaseff) were implemented as rule-based decision support systems and evaluated from the perspective of sensitivity, specificity, and US dollar cost, using a data base of 95 case histories suggestive of acoustic neuroma. The specificities of the models were equivalent (.97). The Jenkins model had the highest sensitivity (.96) and the highest average cost ($1470.99). The sensitivities and average costs of the Le Liever and Kaseff models were comparable (.84 vs. .82, and $1092.38 vs $1114.17, respectively). We observed that omitting brain-stem evoked response and electronystagmography testing from the Le Liever model subjected four (4.2%) more patients without acoustic neuroma to air contrast computed tomography, increased sensitivity to .89, and decreased the average cost to $774.75, without affecting specificity. We discuss the reasons for the slightly improved sensitivity and the impact of decision support systems on the clinician. PMID- 3521675 TI - Biosynthetic controls that determine the branching and microheterogeneity of protein-bound oligosaccharides. AB - Detailed studies on the enzyme machinery responsible for the biosynthesis of protein-bound oligosaccharides of the Asn-GlcNAc and Ser(Thr)-GalNAc linkage types have allowed the formulation of some general rules which explain, at least in part, the branching patterns and microheterogeneity of these structures. These rules are discussed under the following headings: competition of two or more enzymes for a common substrate; controls at the level of enzyme substrate specificity (e.g., critical sugar residues which turn enzyme activity on or off, branch specificity, and the role of the polypeptide in the glycoprotein substrate); substrate availability. PMID- 3521676 TI - Gastric proteases of the Greenland cod Gadus ogac. II. Structural properties. AB - Three gastric proteases were isolated from the stomach mucosa of the Greenland cod (Gadus ogac). The cod proteases were all less stable to heating and protease 1 retained less activity at 5 degrees C when the pH was greater than 5 in comparison with porcine pepsin. The activities of cod proteases 1 and 2, with hemoglobin as the substrate, were doubled in the presence of 25 mM NaCl, while cod protease 3 and porcine pepsin were not stimulated by the salt. The cod proteases did not cross-react with antibodies raised against porcine pepsin. However, some cross-reactivity was noted with antibodies raised against proteases from psychotrophic pseudomonads. The molecular weights of all the cod proteases were in the range of 36,000-38,000. The amino acid compositions of the cod proteases as compared by the Metzger difference index differed from the mammalian gastric proteases by about the same extent that pepsin, gastricsin, and chymosin differ from each other. Of the cod enzymes, protease 1 differed from mammalian gastric proteases, while cod proteases 3 was more like chymosin with respect to amino acid composition. Cod protease 1 had the lowest hydrophobicity index and chymosin had the highest. The hydrophobicity indices of cod proteases 2 and 3 were intermediate between that of porcine pepsin and bovine chymosin. It is suggested that the Greenland cod proteases represent less differentiated forms of gastric proteases than the mammalian pepsins, gastricsins, and chymosins. PMID- 3521677 TI - Artificial respiration and survival time in anaesthetized rat after injection of gaboon viper (Bitis gabonica) venom. PMID- 3521678 TI - [Comparison between a computerized morphometric analysis and microscopic observation of exfoliative cytology of the uterine cervix]. PMID- 3521679 TI - [Fibrinolytic activity of the seminal fluid: methodological accuracy]. PMID- 3521680 TI - [IgM type antibodies against delta hepatitis virus: qualitative analysis]. PMID- 3521682 TI - Glycosylation accelerates albumin degradation in normal and diabetic dogs. AB - Nonenzymatic glycosylation of albumin was associated with an increased catabolic rate and decreased protein half-life in both normal and diabetic animals. The fractional catabolic rate of glycosylated albumin was increased significantly over albumin, from 0.100 +/- 0.004/day to 0.131 +/- 0.007/day in normal animals and from 0.104 +/- 0.004/day to 0.138 +/- 0.007/day when these animals were made diabetic with alloxan. The half-lives of Alb and GlyAlb in normal dogs were 6.81 +/- 0.12 days and 4.97 +/- 0.21 days, respectively. In diabetic animals, the half lives of Alb and GlyAlb were 7.48 +/- 0.21 and 5.21 +/- 0.24 days, respectively. The increased catabolism of GlyAlb may reflect chronic increased extravasation of glycosylated plasma proteins, which are known to be increased in diabetes, into the microvascular wall. PMID- 3521681 TI - Regulation of muscle pyruvate metabolism during exercise. AB - Pyruvate dehydrogenase and phosphoenolpyruvate carboxykinase are important enzymes in the regulation of muscle pyruvate metabolism and their in vitro measured activities have been studied in muscle from rested and exercised rats. In addition, the muscle concentration of metabolic intermediates associated with pyruvate metabolism has been measured after exercise. Phosphoenolpyruvate concentration was decreased to less than half the value found in rested muscle but pyruvate concentration did not change. This suggests an increase in the in vivo rate of conversion of phosphoenolpyruvate to pyruvate. Concentrations of malate and aspartate increased two- to threefold which suggests that oxaloacetate concentration was also increased. An increase in oxaloacetate availability would increase acetyl CoA metabolism and therefore would increase pyruvate dehydrogenase activity in vivo. The basal activity of pyruvate dehydrogenase measured in vitro increased approximately twofold after 2 hr of exercise and returned to control values 5 min after the cessation of exercise. Total pyruvate dehydrogenase activity (activated to the maximal extent) was not changed by exercise. Muscle PEPCK activity was also increased during exercise suggesting an increased rate of conversion of oxaloacetate to pyruvate to provide net oxidation of oxaloacetate and other citric acid cycle intermediates. Results of this study demonstrate that the rates of formation and metabolism of pyruvate are increased during exercise. PMID- 3521684 TI - [In search of classics. Sturge-Weber syndrome]. PMID- 3521683 TI - Total and peroxisomal fatty acid oxidation by liver homogenates from autopsied Reye's and control subjects. AB - To determine whether the accumulation of liver triglyceride in Reye's syndrome could be due to a block in beta-oxidation of the fatty acids, the ability of Reye's and control liver homogenates from samples obtained at autopsy to oxidize fatty acids was examined. Total fatty acid oxidation as measured by oxidation of [1-14C]oleoyl CoA, which mostly represents mitochondrial activity, was comparable between the groups. Peroxisomal fatty acid oxidation was, likewise, similar despite the reported increase in the numbers and sizes of these organelles. This disparity could not be explained by an artifactual dilution of product by accumulated endogenous substrate. Inference is made that active peroxisomal beta oxidation may contribute to the increased short chain fatty CoA content of liver which was reported earlier. PMID- 3521685 TI - Immobilization-associated osteoporosis in primates. AB - The progressive osteopenic changes in tibial compact bone in adult male monkeys (Macaca nemestrina) were examined histologically during chronic studies of immobilization. The animals were restrained in a semirecumbent position, which reduces normally occurring stresses in the lower extremities and results in bone mass loss. The longest immobilization studies were of 7 months duration. Losses of haversian bone tended to occur predominantly in the proximal tibia and were characterized by increased activation with excessive depth of penetration of osteoclastic activity. There was no apparent regulation of the size and orientation of resorption cavities. Rapid bone loss seen during 10 weeks of immobilization appeared to be due to unrestrained osteoclastic activity without controls and regulation, which are characteristic of adaptive systems. The general pattern of loss persisted throughout 7 months of immobilization. Clear cut evidence of a formation phase in haversian bone was seen only after 2 months of reambulation. During this period osteoblasts accumulated within resorption cavities, and there was matrix apposition. Within 6 months of recovery there was increased bone turnover, and resorption cavities with diameters of 500-1500 micron were filled partially with new bone; the mean wall thickness of new bone was 2 to 3 times larger than normal. In addition there were numerous remodeling sites that were of normal size and orientation. Trabecular bone was lost during immobilization, and it is probable that losses of large trabecular plates are not replaced, and consequently original bone volume in the cross section is not recovered. In this immobilization model we observed bone resorption occurring for long periods without apparent interruption.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3521686 TI - Isolation and characterization of a metalloprotease associated with chicken epiphyseal cartilage matrix vesicles. AB - A metalloprotease has been isolated from matrix vesicles of chicken epiphyseal cartilage and subsequently characterized. Matrix vesicles obtained by collagenase digestion and differential centrifugation were further purified by Sepharose CL2B gel filtration. The protease was solubilized from the vesicles by treatment with deoxycholate and freeze-thawing, and then isolated by Sephadex G150 gel filtration. Disc electrophoresis of the enzyme, which displayed protease activity toward azocasein substrate, gave a single protein band. Based on molecular weight (MW) determination, lack of immunocross reactivity, and differences in electrophoretic migration, there is little possibility of any contamination with external protease from the commercial collagenase used for vesicle preparation. The matrix vesicle protease had a MW of 33,000 and a pH optimum of 7.2 and was completely inhibited by 0.1 mM EDTA and 0.2 mM o-phenanthroline. alpha 2 Macroglobulin, ovalbumin, cysteine, penicillamine, ethane-1-hydroxy-1, 1 diphosphonate (EHDP) and pyrophosphate at higher concentrations were also inhibitory. The inhibition by omicron-phenanthroline was reversed by Co2+, Zn2+, Fe2+, and Cu2+. Protease activity was most abundant in the heavy fraction of matrix vesicles fractionated by discontinuous sucrose density gradient centrifugation. Release of this protease at the calcifying front could degrade noncollagenous protein moieties that inhibit precipitation of minerals in the extravesicular matrix and thus facilitate mineralization. PMID- 3521687 TI - Temporomandibular disorders: management of internal derangement. PMID- 3521688 TI - Wilkinson memorial lecture. Frank Wilkinson: the man and the Eastman. PMID- 3521689 TI - A simplified procedure for estimating the level of Streptococcus mutans in the mouth. PMID- 3521690 TI - In vivo production of prostacyclin and thromboxane in patients with acute myocardial infarction. AB - The in vivo production of prostacyclin and thromboxane was monitored by measuring their major urinary metabolites 2,3-dinor-thromboxane B2 and 2,3-dinor-6-keto prostaglandin F1 alpha in ten patients with acute myocardial infarction, five on standard treatment and five receiving prostacyclin infusion. During acute myocardial infarction excretion of 2,3-dinor-thromboxane B2 and 2,3-dinor-6-keto prostaglandin F1 alpha, measured by a gas chromatography-mass spectrometry method with deuterated internal standards, was significantly increased. This indicates that thromboxane and prostacyclin synthesis are increased during the development of acute myocardial infarction. The excretion data for 2,3-dinor-thromboxane B2 showed that after administration of aspirin there was less pronounced and more variable inhibition than expected. Prostacyclin infusion did not markedly affect the excretion of the thromboxane metabolite. PMID- 3521691 TI - Captopril and opiate antagonism in essential hypertension. AB - Six patients maintained on 50-100 mg captopril, for 2-25 months, were administered captopril 50 mg orally, together with either naloxone or 0.9% saline vehicle (placebo) given intravenously, in a double-blind crossover study. Naloxone did not appear to modify the circulatory effects of captopril in these patients, in contrast to earlier findings after acute captopril administration in normotensives. The results do not support an important endogenous opioid role in the chronic antihypertensive effect of captopril, but provide evidence that different mechanisms may contribute to the early short term falls in blood pressure, compared to the later long term effects. PMID- 3521692 TI - Interaction between cyclosporin A and phenobarbitone. PMID- 3521693 TI - Semiquantitative oestrogen receptor assay in formalin-fixed paraffin sections of human breast cancer tissue using monoclonal antibodies. PMID- 3521695 TI - Thyroid blood group isoantigen expression: a parallel with ABH isoantigen expression in the distal colon. AB - An interesting and not previously reported parallel has been observed between the known pattern of ABO (H) blood group isoantigen expression in normal and neoplastic colonic epithelium and that in the thyroid. Epithelial expression of blood group isoantigens was not observed in 16 specimens of normal or non neoplastic thyroid tissue. This contrasts with the progressive re-expression of these antigens in neoplastic thyroid tissue. Blood group isoantigens were detected in two of eight papillary adenomas and 13 of 17 papillary carcinomas. Antigen expression was in part related to differentiation, and stained cells were less readily detected in follicular tumours, only one of five adenomas and two of seven carcinomas displaying blood group antigens while three medullary and two anaplastic carcinomas were antigen-deficient. PMID- 3521696 TI - High dose chemotherapy and autologous bone marrow transplantation in refractory Hodgkin's disease. AB - Seventeen patients with Hodgkin's disease (HD) were treated with high-dose chemotherapy followed by autologous bone marrow transplantation (ABMT). Eleven patients were resistant to initial therapy. Three patients had relapsed and were still responders to second or third line therapy. Three patients had relapsed but were progressing under second or third line therapy. Pre-ABMT chemotherapy included high dose cyclophosphamide in all patients (50 mg Kg-1 day-1 bolus for 4 days), most often associated with BCNU or CCNU, aracytine and 6 thioguanine. Four patients received additional TBI (10 Gy). In 9 patients complete remission (CR) was achieved, 4 failed to respond and 4 cases were not evaluable due to early death. Among CR patients, 2 died from late toxicity, 4 relapsed between the 2nd and 5th months, but 3 patients remain in CR, off therapy at 25+, 43+, and 66+ months, including 1/11 initially resistant and 2/6 who had relapsed. There were 9 treatment related deaths: 6 due to infection, 1 cardiac failure and 2 multiorgan failure. The high complete response rate in these heavily pretreated patients suggests that there may be an indication for high dose therapy earlier in resistant HD. Moreover under such conditions, treatment related morbidity would be expected to be lower. PMID- 3521694 TI - The distribution of the c-myc oncogene product in malignant lymphomas and various normal tissues as demonstrated by immunocytochemistry. AB - The expression of c-myc was studied in 51 malignant lymphomas and in a variety of normal tissues by immunocytochemistry using monoclonal antibodies raised to different synthetic peptides and reacting monospecifically with the c-myc product (p62c-myc). The c-myc product was detected in only a minority of malignant lymphomas principally those containing cells with immunoblastic characteristics, and was predominantly localised to the cytoplasm. In normal lymphoid tissues only plasma cells and histiocytes were found to have immunoreactivity. In non-lymphoid normal tissues, however, the c-myc product was distributed widely. Marked differences in its intracellular distribution were apparent in different tissues. These findings suggest that the relationship of p62c-myc expression to cell division may be more complex than previously suggested by in vitro studies, and raise the possibility that it may have other functions within the cell. PMID- 3521697 TI - Assays of damage to the alimentary canal. PMID- 3521698 TI - Assessment of cytotoxic injury to bone marrow. PMID- 3521699 TI - Residual radiation injury in the haematopoietic system of mice: defects in the stem cell compartment. PMID- 3521700 TI - Approach to the radiosensitivity of antibody dependent cellular cytotoxicity. PMID- 3521701 TI - Vascular irradiation damage: its cellular basis and likely consequences. PMID- 3521702 TI - Radiation-induced damage in the central nervous system: an interpretation of target cell responses. PMID- 3521703 TI - Thyroid and mammary radiobiology: radiogenic damage to glandular tissue. PMID- 3521704 TI - The cellular basis of renal injury by radiation. PMID- 3521705 TI - Physiological factors effecting renal radiation tolerance: a guide to the treatment of late effects. PMID- 3521706 TI - Mechanism of bladder damage and repair after treatment with radiation and cytostatic drugs. PMID- 3521707 TI - The cellular basis of skin injury after cytotoxic insult. PMID- 3521708 TI - Modulation of anti-tumour immunity and the effect of bacterial endotoxin on the growth of different syngeneic tumours from small inocula in mice. AB - Studies were undertaken to determine the influence of E. coli lipopolysaccharide (LPS) on the growth of various doses of two antigenically-distinct syngeneic murine fibrosarcomas designated H1 and H7. The 'weakly' antigenic H1 tumour injected subcutaneously (s.c.) along the abdominal wall was profoundly susceptible to the growth-potentiating effects of a single intraperitoneal (i.p.) injection of 2 micrograms LPS, administered concurrently. 'Sneaking through' effects in control mice were observed with doses of 10 and 100 H1 tumour cells. Rejection of medium-sized inocula 25 or 500 H1 tumour cells were abolished by the administration of LPS. In contrast, the 'strongly' antigenic H7 tumour did not exhibit the 'sneaking through' phenomenon and its growth was only temporarily affected by LPS. Studies were also performed to determine the effect of LPS on the kinetics of delayed-type hypersensitivity (DTH) induced by mitomycin C treated (MCT) H1 or H7 tumour cells inoculated s.c. into the footpads of mice. The 'strongly' antigenic MCT H7 tumour cells induced consecutive waves of footpad swelling of diminishing intensity and corresponded to periods of anti-tumour resistance. The specific phase of MCT H7-induced footpad swelling, maximal at day 6, was delayed in its induction if LPS was administered concurrently with MCT H7 tumour cells. In contrast, the 'weakly' antigenic MCT H1 tumour cells induced only one specific phase of footpad swelling which was rapidly down-regulated. The induction of immunity by MCT H1 tumour cells was also delayed by the concomitant administration of LPS. Because the 'weakly' antigenic H1 tumour was unable to sustain consecutive waves of anti-tumour immunity, the delay in the expression of such immunity by LPS allowed the H1 tumour cells to multiply to eventually overwhelm a rapidly down-regulated immune response. In contrast, the incidence of tumours arising from the 'strongly' antigenic H7 tumour cells was not significantly affected in LPS-treated mice because the tumour cells which escaped the first encounter with delayed anti-tumour immunity, succumbed to subsequent waves of resistance in both normal and LPS-treated mice injected with fewer than 1 X 10(5) H7 tumour cells. PMID- 3521709 TI - Ritodrine-responsive bullous pemphigoid in a patient with AIDS-related complex. PMID- 3521710 TI - Anatomical distribution and immunological characteristics of epidermolysis bullosa acquisita antigen and bullous pemphigoid antigen. AB - A Japanese patient with epidermolysis bullosa acquisita (EBA) was autopsied, and direct immunofluorescence (DIF) testing was performed. Using this patient's serum (EBA serum) and three bullous pemphigoid (BP) sera, the anatomical distribution and immunological characteristics of EBA antigen and BP antigen were investigated by indirect immunofluorescence (IIF). EBA antigen showed the same anatomical distribution as BP antigen in DIF and IIF studies; both antigens were limited to the skin, tongue, oesophagus, trachea, cornea and bladder. EBA antigen was located on the dermal side of both NaCl and PBS-separated skin, whereas BP antigen was limited to the epidermal side. Ethanol fixation abrogated the antigenic stability of BP antigen, but not that of EBA antigen. No difference was found when acetone or formalin fixation was used. The separation methods and prefixation in ethanol could be useful techniques applicable to the classification of the bullous disorders which manifest circulating anti-BMZ antibodies. PMID- 3521711 TI - Immunohistological reactivity pattern of the anti-cutaneous T-cell lymphoma antibody BE2. AB - It has been reported that the monoclonal antibody BE2, raised against leukaemic T cells, reacts specifically with malignant lymphoid cells and represents a valuable reagent for the early identification of cutaneous T-cell lymphomas. To test this hypothesis, a comprehensive range of nodal and cutaneous biopsies have been examined immunohistologically using single and double immunoenzymatic and immunofluorescent staining methods. BE2 showed a broad range of reactivity, consistently labelling normal endothelial cells, B-lymphocytes in mantle and marginal zones, T-lymphocytes in the paracortex of lymph nodes and medulla of thymus, as well as a variety of different macrophage types, including Langerhans cells and dermal macrophages. Furthermore, although BE2-positive T-lymphocytes were most frequent in malignant lymphomas, they were also found in four of 19 benign dermatoses. We conclude that BE2 is neither T-cell nor tumour-cell specific, and that use of this reagent on tissue sections is unlikely to improve the diagnosis of cutaneous lymphomas. PMID- 3521712 TI - Graft rejection following HLA matched T-lymphocyte depleted bone marrow transplantation. AB - Bone marrow graft rejection following HLA-matched bone marrow transplantation (BMT) for leukaemia has been a rare problem. However, with the introduction of T lymphocyte depleted BMT, graft rejection is recognized as a new complication. At the Royal Free Hospital (RFH) in London T-depletion is achieved using two monoclonal antibodies with complement mediated lysis. The methodology was extended to other centres and in total 56 patients have received T-depleted, HLA matched BMT. Twelve of 56 patients have had graft rejection. At the RFH three of 41 (7%) patients have had rejection whereas at collaborating centres nine of 15 (60%) patients have had rejection. We have investigated these rejections in order to identify factor(s) responsible. Rejection was not restricted by patient or donor characteristics, nor disease status. Patient management, chemotherapy conditioning, efficiency of T-depletion, graft versus host disease (GvHD), and infection post BMT, were not consistently implicated. The major difference between the RFH and all other centres was in the radiotherapy (RT) conditioning: The RFH prescribed a single fraction of 7.5 Gy total body irradiation (TBI) whilst collaborating centres gave 10 or 12 Gy fractionated TBI. We conclude that the different incidence of rejection (7% v. 60%) relates primarily to the RT conditioning although the mechanisms(s) of rejection remain unknown. We conclude that where T-depleted BMT is used, compensation by more intensive RT conditioning is required in order to avert graft rejection. PMID- 3521713 TI - Female marrow donors increase the risk of acute graft-versus-host disease: effect of donor age and parity and analysis of cell subpopulations in the donor marrow inoculum. AB - We evaluated 27 factors for their influence on acute graft-versus-host disease (GVHD) in 40 recipients of HLA-identical sibling marrow transplants. These factors included the doses of mononuclear cell subpopulations present in the donor marrow inoculum quantitated using a panel of monoclonal antibodies. Female donors were associated with increased severity of acute GVHD, and the older the female donor the greater this effect. Increasing donor parity was also associated with an increased risk of acute GVHD. The number of T cells, T cells subsets, natural killer cells and monocytes infused did not influence the incidence or severity of acute GVHD in this study, and we could not explain the influence of female donors and of female donor age on acute GVHD by the cellular content of their marrow inocula. We postulate that non-HLA histocompatibility antigen disparity is a more important determinant for acute GVHD than the number of infused donor T cells, especially when female donors are used. The association between acute GVHD and increasing parity suggests that some female marrow donors have been pre-sensitized to their respective recipients by preceding pregnancies. PMID- 3521714 TI - A reappraisal of the effects of iron and desferrioxamine on the growth of Plasmodium falciparum 'in vitro': the unimportance of serum iron. AB - It has been suggested that P. falciparum takes up iron from serum and that desferrioxamine, an iron chelating agent, inhibits parasite growth. We have now shown, however, that when all the iron is transferrin bound, P. falciparum, in culture, takes up less than 7 pmol Fe/10(9) parasites/24 h and that incorporation is increased only in the presence of a high molecular weight iron complex not naturally found in serum. Furthermore, removal of iron serum did not reduce parasite growth, and addition of excess iron was inhibitory. Desferrioxamine inhibited growth, but this inhibition was reduced under conditions in which the transfer of iron from transferrin to desferrioxamine was accelerated. We conclude that P. falciparum does not directly utilize serum iron and that desferrioxamine does not inhibit the parasite by interfering with the supply of iron from the incubation medium. The results are relevant to clinical data which suggest that added nutritional iron enhances the host susceptibility to malaria. PMID- 3521715 TI - Cytochemical determination of heterozygous glucose-6-phosphate dehydrogenase deficiency in erythrocytes. PMID- 3521716 TI - Serum beta 2-microglobulin in myelomatosis. PMID- 3521717 TI - Oral acyclovir (Zovirax) in herpes simplex dendritic corneal ulceration. AB - Sixty patients with simple dendritic corneal ulceration were randomly assigned to double blind treatment with either acyclovir tablets (400 mg) or acyclovir ophthalmic ointment administered five times daily. There was no significant difference in the proportions of patients healed in either treatment group (88.9% on oral acyclovir and 96.6% on acyclovir ointment). The median healing time was five days in both groups. No systemic or significant local side effects were noted in either treatment group. Trough levels of acyclovir in the tear fluid of those who received the oral preparation were within or above the range of mean in vitro ID50 levels for herpes simplex virus type 1. We conclude that oral administration of acyclovir (400 mg, five times daily) may be an effective alternative to topical therapy in selected patients. PMID- 3521718 TI - Ocular sequelae of preterm birth and their relation to ultrasound evidence of cerebral damage. AB - The eyes of 177 very preterm (less than 33 weeks' gestation) infants, born between 1979 and 1982 and admitted to a neonatal intensive care unit, were examined as part of an ongoing follow-up study of neurodevelopmental outcome. Ocular pathology was diagnosed in 37 (21%) of the 177 infants: 14 (8%) had retinopathy of prematurity (ROP)--progressive in three--and nine (5%) infants had delayed visual maturation (DVM). The ocular pathology was permanent in 26 (15%) of the 177 infants. Refractive errors were the commonest problem and accounted for permanent sequelae in eight of the 14 infants with ROP and two of the nine with DVM. The presence or absence of ROP was related to a wide range of prospectively coded perinatal variables and to the results of routine neonatal ultrasound brain scans and neurodevelopmental follow-up assessments made in the first 18 months of life. As in previous studies, infants with ROP were of shorter gestation, lower birth weight, and required oxygen therapy for longer than unaffected infants, but the condition was only weakly associated with other indices of respiratory illness. In contrast, ROP was strongly associated with evidence of brain damage, often consistent with hypoxic ischaemic injury. We conclude that an underlying lesion in ROP may be hypoxic ischaemic damage to the retinal circulation. PMID- 3521719 TI - Use of penetrating keratoplasty in acute bacterial keratitis. AB - Twenty-three patients with bacterial keratitis had penetrating keratoplasties performed for deep indolent ulceration or descemetoceles, during the acute period. The period in hospital (17.6 days) was significantly lower than for a control group (35.4 days) who were treated medically and had subsequent grafts. The number of grafts remaining clear was similar, 70% and 72% respectively. Eleven patients (48%) of those who had an acute graft achieved corrected visual acuities of 6/12 or better. No cases of reinfection occurred and no eyes were lost. PMID- 3521720 TI - tRNA topography during translocation: steady-state and kinetic fluorescence energy-transfer studies. AB - The distances between the anticodon loops of fluorescent tRNAPhe bound to the E site and to either the A or the P site of poly(U)-programmed Escherichia coli ribosomes were measured by fluorescence energy transfer. Donor and acceptor molecules were wybutine and proflavin, respectively, both located 3' to the anticodon of tRNAPhe. The anticodon loops were found to be separated by 42 +/- 10 A (A to E site) and 34 +/- 8 A (P to E site). The latter distance is much larger than the one measured between the anticodon loops of A and P site bound tRNAs [24 +/- 4 A; Paulsen, H., Robertson, J. M., & Wintermeyer, W. (1983) J. Mol. Biol. 167, 411-426], rendering unlikely simultaneous codon-anticodon interaction in the P and E sites. In kinetic stopped-flow measurements, the energy transfer between the anticodon loops of the tRNA molecules was followed during translocation. The transfer efficiency decreases in three steps with apparent rate constants on the order of 1, 0.1, and 0.01 s-1. The fast step is ascribed to the simultaneous displacement of the deacylated tRNAPhe out of the P site and of the N-AcPhe tRNAPhe from the A site to the P site. The distance between the anticodon loops does not change appreciably during this reaction. A significant separation of the two tRNAs occurs during the intermediate and the slow steps. The latter most likely represents a rearrangement of the posttranslocation complex containing both tRNA molecules.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3521721 TI - Binding of Escherichia coli ribosomal protein S8 to 16S rRNA: kinetic and thermodynamic characterization. AB - A sensitive membrane filter assay has been used to examine the kinetic and equilibrium properties of the interactions between Escherichia coli ribosomal protein S8 and 16S rRNA. In standard conditions (0 degrees C, pH 7.5, 20 mM Mg2+, 0.35 M KCl) the apparent association constant is 5 +/- 0.5 X 10(-7) M-1. The interaction is highly specific, and the kinetics of the reaction are consistent with the apparent association constant. Nevertheless, the rate of association is somewhat slower than that expected for a diffusion-controlled reaction, suggesting some steric constraint. The association is only slightly affected by temperature (delta H = -1.8 kcal/mol). The entropy change [delta S = +29 cal/(mol K)] is clearly the main driving force for the reaction. The salt dependence of Ka reveals that five ions are released upon binding at pH 7.5 and in the presence of 10 mM magnesium. The substitution of various anions for Cl- has an appreciable effect on the magnitude of Ka, following the order CH3COO- greater than Cl- greater than Br-, thus indicating the existence of anion binding site(s) on S8. An equal number of ions were released when Cl- was replaced by CH3COO-, but the absence of anion release upon binding cannot be excluded. On the other hand, the free energy of binding appears not to be exclusively electrostatic in nature. The effect of pH on both temperature and ionic strength dependence of Ka has been examined. It appears that protonation of residue(s) (with pK congruent to 9) increases the affinity via a generalized charge effect. On the other hand, deprotonation of some residue(s) with a pK congruent to 5-6 seems to be required for binding. Furthermore, the unique cysteine present in S8 was shown to be essential for binding. PMID- 3521722 TI - Proteins from the prokaryotic nucleoid: 1H NMR study of the quaternary structure of Escherichia coli DNA binding protein NS (HU). AB - The quaternary interactions of Escherichia coli DNA binding proteins NS1, NS2, and NS (NS1 + NS2) have been studied by 1H NMR spectroscopy at 400 MHz following the reversible spectral changes produced by temperature increases on the resonances (Phe ring and His C-2 protons) whose spectral characteristics reflect the formation and dissociation of either homologous or heterologous interactions. These changes include (a) a progressive intensity decrease of the Phe resonances shifted to high field by stacking interactions, (b) a progressive intensity increase of the resonances due to freely rotating Phe, and (c) splitting of the His C-2 proton resonance. The association constants and thermodynamic parameters for the homologous and heterologous interactions were calculated from the molar fractions of the relevant molecular species by assuming that the above effects are due to the existence of simple association equilibria. It was found that two (out of three) phenylalanine residues of each polypeptide chain are involved in quaternary interactions. Quantitative data concerning the internal mobility and mutual orientations in aggregates of these Phe rings were also obtained. From the calculated association constants, from comparison of these data with recent protein-protein cross-linking results [Losso, M. A., Pawlik, R. T., Canonaco, M. A., & Gualerzi, C. O. (1986) Eur. J. Biochem. 155, 27-32], and from other considerations, we suggest that even though stacking of the Phe rings occurs at the interface between monomers, the temperature-dependent alteration of the Phe spectrum monitors shifts of the dimer in equilibrium tetramer equilibrium whereas the splitting of the His C-2 proton resonance most likely monitors the equilibrium between tetramers and larger aggregates. PMID- 3521723 TI - Circular dichroism and 500-MHz proton magnetic resonance studies of the interaction of Escherichia coli translational initiation factor 3 protein with the 16S ribosomal RNA 3' cloacin fragment. AB - The RNA helix destabilizing properties of Escherichia coli initiation factor 3 protein (IF3), and its affinity for an evolutionarily conserved sequence at the 3' end of 16S rRNA, led us to examine the details of the protein-nucleic acid interactions upon IF3 binding to the 49-nucleotide 3'-terminal cloacin DF13 fragment of 16S rRNA by studying the circular dichroism (CD) and proton magnetic resonance spectra of the RNA, the protein, and their complex. In a physiological tris(hydroxymethyl)aminomethane buffer, where the interaction is primarily nonionic and sequence specific, addition of IF3 decreases the RNA 268-nm CD peak hyperbolically by 19% to an end point of about one IF3 per RNA strand. The titration curve is best fit by an association constant of (1.80 +/- 0.05) X 10(7) M-1, within the range estimated by a nuclease mapping study of the same system [Wickstrom, E. (1983) Nucleic Acids Res. 11, 2035-2052]. In a low-salt phosphate buffer without Mg2+, where the interaction is primarily ionic and nonspecific, titration with IF3 decreases the peak CD sigmoidally by 35% to an end point of two IF3 per strand. The titration curve is best fit by an intrinsic association constant of (1.7 +/- 0.7) X 10(6) M-1 for each IF3 and a cooperativity constant of 33 +/- 6. In a physiological phosphate buffer lacking Mg2+, the dispersion of aromatic proton magnetic resonance peaks and upfield-shifted methyl proton resonances indicates a high degree of secondary and tertiary structure in the protein. In an equimolar mixture of IF3 and RNA cloacin fragment, several changes in identifiable IF3 and RNA resonances are observed.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3521724 TI - Identification of a novel serum protein secreted by lung carcinoma cells. AB - The murine anti-human lung tumor monoclonal antibody L3 recognizes antigens found both in the medium of cultured carcinoma cells and in normal human serum. Sequential immunoprecipitation experiments indicate that the L3 antigen is also recognized by a previously described monoclonal antibody directed against a melanoma-associated antigen [Natali, P. G., Wilson, B. S., Imai, K., Bigotti, A., & Ferrone, S. (1982) Cancer Res. 42, 583-589]. This antibody precipitated a Mr 76000 glycoprotein from metabolically labeled extracts of the lung carcinoma cell line Calu-1 and a Mr 94 000 glycoprotein from labeled culture medium. Pulse-chase experiments suggested a precursor-product relationship between these molecules. Analysis of glycosidase sensitivities of the two forms indicated that maturation of carbohydrate side chains correlated with the apparent increase in molecular weights. L3 antigenic activity, measured in a competitive radiometric cell binding assay, was purified more than 90-fold from serum-free medium of Calu-1 cells and more than 3000-fold from normal human serum. The major immunoreactive components purified from culture medium and serum were identical with respect to apparent molecular weight, electrophoretic mobility, pI, glycosidase sensitivity, and V8 protease fingerprints. In addition, the sequence of the amino-terminal 16 N-terminal amino acid residues of the major immunoreactive species from both sources was identical. The properties of the L3 antigen did not correspond to those of any known protein, suggesting that this serum protein has not been previously characterized. PMID- 3521725 TI - Allosteric sensitivity in hemoglobin at the alpha-subunit N-terminus studied by hydrogen exchange. AB - Allosteric structure change in human hemoglobin was studied by hydrogen-tritium exchange methods. The functional labeling method used takes advantage of the change in H-exchange rate at allosterically involved sites to selectively label, with tritium, H-exchange sites that are fast in one protein state and slow in another. The position of the labeled sites can then be located by the medium resolution fragmentation-separation method. These methods reveal 5 allosterically sensitive, H-bonded, peptide NH's within the first 12 residues of the alpha chain. All five exchange with solvent protons at similar rates in deoxyhemoglobin (T form), and all shift to a new rate, about 30-fold faster, in the liganded protein (R) form. This indicates a decrease in structural stability at the alpha chain N-terminus in going from the T to the R form, consistent with the loss of stabilizing interactions in that segment. The results indicate a loss of perhaps 2 kcal/mol in stabilization free energy and thus document a significant role for changes at the alpha-chain N-terminus in the allosteric transition. PMID- 3521726 TI - Xenopus nucleoplasmin: egg vs. oocyte. AB - Nucleoplasmin has been purified from either oocytes or unfertilized eggs of the frog, Xenopus laevis. We find that the pentameric form of egg nucleoplasmin exhibits an apparent molecular mass approximately 15 000 daltons larger than its oocyte counterpart upon sodium dodecyl sulfate (SDS)-acrylamide gel electrophoresis. Egg nucleoplasmin monomers are more heterogeneous, substantially more acidic, and overall larger in apparent molecular weight than oocyte nucleoplasmin monomers when analyzed by isoelectric focusing or SDS gel electrophoresis. Protease digestions indicate that the structural differences between egg and oocyte nucleoplasmin are primarily confined to the N-terminal halves of the proteins. The structural diversity observed is accompanied by a difference in the ability of nucleoplasmin from the two sources to act as a nucleosome assembly agent in vitro. Egg nucleoplasmin efficiently promotes the formation of nucleosomes onto circular pBR322 DNA in vitro at physiological ionic strength and at physiological histone:DNA ratios, while oocyte nucleoplasmin is markedly deficient in serving as an in vitro chromatin assembly agent under all conditions which we have tested. Treatment of egg nucleoplasmin in vitro with alkaline phosphatase demonstrates that the structural diversity between egg and oocyte nucleoplasmin results primarily from extensive additional phosphorylation of the egg protein. The relevance of nucleoplasmin phosphorylation in leading to differences in the chromatin assembly activity of this protein both in vitro and in vivo is considered. PMID- 3521727 TI - Heterogeneity of lipid A: structural determination by 13C and 31P NMR of lipid A fractions from lipopolysaccharide of Escherichia coli 0111. AB - Purified lipid A from Escherichia coli 0111 was fractionated by thin-layer chromatography, and seven major bands were studied by 13C and 31P NMR. All lipid A fractions except one had fatty acids, 3-hydroxytetradecanoic acid, 3 (acyloxy)tetradecanoic acid, and phosphate groups bonded to the diglucosamine backbone. The remaining fraction was shown to be phosphatidylethanolamine. The number of substituents found showed that in all fractions all sites available for C-acylation (C-3, C-4, and C-3') and N-acylation (C-2 and C-2') carried acylic substituents. The number, ranging from four to six, and type of ester-bound carboxylic acid residues as well as the number of phosphate groups differed among the fractions. The three fastest moving bands all had three unsubstituted hydroxy fatty acids and one phosphate group (C-4'), while the slower moving bands had four hydroxy fatty acids and two phosphate groups. Unsubstituted 3 hydroxytetradecanoic acid residues were amide-bound to the disaccharide in all but one of the fractions. In summary, the heterogeneity of E. coli 0111 lipid A is found to be a consequence of a variation of the number and composition of carboxylic acid residues and of varying phosphate content. PMID- 3521728 TI - Small-angle neutron scattering study of the ternary complex formed between bacterial elongation factor Tu, guanosine 5'-triphosphate, and valyl-tRNAVal. AB - The formation of the ternary complex between bacterial elongation factor Tu, GTP, and valyl-tRNAVal has been studied by small-angle neutron scattering. Titrations of the protein with amino-acyl-tRNA solutions in both H2O and 70% D2O confirm the expected stoichiometry. The molecular weight obtained for the protein alone is significantly higher than expected and can be explained by postulating a monomer dimer equilibrium. The titration data are then internally consistent with a dissociation of the dimer on ternary complex formation. The radius of gyration for the ternary complex and the calculation of the separation of the centers of mass of the protein and tRNA components suggest a compact model for the ternary complex. PMID- 3521729 TI - Binding of Escherichia coli protein synthesis initiation factor IF1 to 30S ribosomal subunits measured by fluorescence polarization. AB - The interaction of initiation factor IF1 with 30S ribosomal subunits was measured quantitatively by fluorescence polarization. Purified IF1 was treated with 2 iminothiolane and N-[[(iodoacetyl)-amino]ethyl]-5-naphthylamine-1-sulfonic acid in order to prepare a covalent fluorescent derivative without eliminating positive charges on the protein required for biochemical activity. The fluorescent-labeled IF1 binds to 30S subunits and promotes the formation of N formylmethionyl-tRNA complexes with 70S ribosomes. Analyses of mixtures of fluorescent-labeled IF1 and 30S ribosomal subunits with an SLM 4800 spectrofluorometer showed little change in fluorescence spectra or lifetimes upon binding, but a difference in polarization between free and bound forms is measurable. Bound to free ratios were calculated from polarization data and used in Scatchard plots to determine equilibrium binding constants and number of binding sites per ribosomal subunit. Competition between derivatized and nonderivatized forms of IF1 was quantified, and association constants for the native factor were determined: (5 +/- 1) X 10(5) M-1 with IF1 alone; (3.6 +/- 0.4) X 10(7) M-1 with IF3; (1.1 +/- 0.2) X 10(8) M-1 with IF2; (2.5 +/- 0.5) X 10(8) M-1 with both IF2 and IF3. In all cases, 0.9-1.1 binding sites per 30S subunit were detected. Divalent cations have little effect on affinities, whereas increasing monovalent cations inhibit binding. On the basis of the association constants, we predict that greater than 90% of native 30S subunits are complexed with all three initiation factors in intact bacterial cells. PMID- 3521730 TI - Basic proline-rich proteins from human parotid saliva: complete covalent structures of proteins IB-1 and IB-6. AB - The complete amino acid sequences of two basic proline-rich proteins, IB-1 and IB 6, from human parotid saliva have been determined. Fragments for sequence analysis were obtained by enzymatic digestions. The proteins have molecular weights of 9571 (IB-1) and 11,530 (IB-6) and contain 34 and 39 mol % proline, respectively. IB-1 and IB-6 contain an identical sequence of 54 residues except for an alanine in position 52 of IB-6, where IB-1 has proline. An unusually high number of repeated sequences occurs in both molecules. IB-1 has a blocked amino terminal residue, pyroglutamic acid, and also contains one phosphoserine residue in position 8. The relationship of these proteins to the basic proline-rich protein IB-9 [Kauffman, D., Wong, R., Bennick, A., & Keller, P. (1982) Biochemistry 21, 6558-6562] and to other salivary proline-rich proteins is discussed. PMID- 3521731 TI - Anti-peptide antibodies and proteases as structural probes for the lactose/H+ transporter of Escherichia coli: a loop around amino acid residue 130 faces the cytoplasmic side of the membrane. AB - From the amino acid sequence of the Escherichia coli lactose/H+ transporter, 7 hydrophilic segments were selected, 8-13 amino acids in length, and chemically synthesized, and anti-peptide antibodies were raised in rabbits. Apart from the antiserum to the synthetic COOH terminus (P408-417), which reacted strongly with the lactose/H+ transporter and has previously been used to localize the COOH terminus on the cytoplasmic face of the membrane, only those antibodies directed against the peptide corresponding to amino acid residues 125-135 (P125-135) exhibited a marked reaction with the transporter, while antibodies to the five other peptides reacted very weakly or not at all, suggesting that most of the hydrophilic segments are conformationally restricted or buried in the interior of the protein. Thermolysin treatment destroys the epitope on the transporter which is recognized by anti-P125-135 antibodies. Comparison of the kinetics and the extent of proteolysis of the transporter in right-side-out or inside-out cytoplasmic membrane vesicles or in reconstituted proteoliposomes suggests that the hydrophilic sequence from amino acid 125 to amino acid 135 is accessible to thermolysin only from one side, corresponding to the cytoplasmic face of the membrane. Furthermore, the experiments demonstrate that the transporter is inserted bimodally in a nonpreferential fashion into the proteoliposomes, confirming earlier results using antibodies to the synthetic COOH terminus of the transporter in conjunction with carboxypeptidase A treatment. PMID- 3521732 TI - Human plasma prekallikrein, a zymogen to a serine protease that contains four tandem repeats. AB - The amino acid sequence of human plasma prekallikrein was determined by a combination of automated Edman degradation and cDNA sequencing techniques. Human plasma prekallikrein was fragmented with cyanogen bromide, and 13 homogeneous peptides were isolated and sequenced. Cyanogen bromide peptides containing carbohydrate were further digested with trypsin, and the peptides containing carbohydrate were isolated and sequenced. Five asparagine-linked carbohydrate attachment sites were identified. The sequence determined by Edman degradation was aligned with the amino acid sequence predicted from cDNAs isolated from a lambda gt11 expression library. This library contained cDNA inserts prepared from human liver poly(A) RNA. Analysis of the cDNA indicated that human plasma prekallikrein is synthesized as a precursor with a signal peptide of 19 amino acids. The mature form of the protein that circulates in blood is a single-chain polypeptide of 619 amino acids. Plasma prekallikrein is converted to plasma kallikrein by factor XIIa by the cleavage of an internal Arg-Ile bond. Plasma kallikrein is composed of a heavy chain (371 amino acids) and a light chain (248 amino acids), and these 2 chains are held together by a disulfide bond. The heavy chain of plasma kallikrein originates from the amino-terminal end of the zymogen and is composed of 4 tandem repeats that are 90 or 91 amino acid residues in length. These repeat sequences are also homologous to those in human factor XI. The light chain of plasma kallikrein contains the catalytic portion of the enzyme and is homologous to the trypsin family of serine proteases. PMID- 3521733 TI - Kinetics of intracellular degradation of newly synthesized collagen. AB - The objective of this work was to determine the time dependence of the basal component of intracellular degradation of newly synthesized collagen. Chick embryo tendon fibroblasts were incubated with [14C]proline, and degradation was quantified by measuring hydroxy[14C]proline in a low molecular weight fraction. When cultures were pulse labeled for 15 min and then incubated under chase conditions for 105 min, the amount of degraded collagen attained a value equal to approximately 20% of the amount synthesized during the labeling period; the data were fit with a simple exponential function that had a 40-min rise time and a 12 min lag time. In continuously labeled cultures, the rates of collagen synthesis and secretion reached constant values within 15 and 45 min, respectively. Degradation products were first detected 6-9 min after collagen synthesis began and were transported out of the cells more rapidly than intact collagenous molecules; however, percent degradation increased slowly and did not reach a constant value even after 240 min of incubation. Since collagen degradation lags collagen synthesis, it follows that degradation is a posttranslational, rather than a cotranslational, process, and since degradation and secretion are kinetically distinguishable, it follows that they occur in parallel pathways. A simple nonlinear model for posttranslational processing of collagen is proposed. PMID- 3521734 TI - Isolation and properties of N epsilon-hydroxylysine:acetyl coenzyme A N epsilon transacetylase from Escherichia coli pABN11. AB - The enzyme N epsilon-hydroxylysine acetylase has been isolated from Escherichia coli 294 carrying recombinant plasmid ABN11. Activity of the enzyme was followed by measurement of the rate of appearance of 2-nitro-5-thiobenzoate, the product of cleavage of 5,5'-dithiobis(2-nitrobenzoate) by free coenzyme A released from its acetyl derivative. The enzyme bound firmly to Reactive Blue 2-Sepharose CL-6B and was eluated with 1.5 M KCl. The protein gave a single band, corresponding to a Mr of 33,000, on polyacrylamide gel electrophoresis in sodium dodecyl sulfate. In contrast, gel filtration of the native enzyme gave a Mr of 150,000-200,000. A sequence analysis of the DNA at the junction of the first and second genes in the aerobactin operon, considered in conjunction with the N-terminal amino acid sequence of the isolated protein, enabled the conclusion that the acetylase is specified by the second gene in the complex. The enzyme transfers the acetyl moiety from acetyl coenzyme A to a variety of hydroxylamines, with N epsilon hydroxylysine as the preferred substrate. In agreement with the results found by affinity chromatography, Coomassie Blue was observed to act as a potent inhibitor. PMID- 3521735 TI - Conformational effects of ligand binding on the beta 2 subunit of Escherichia coli tryptophan synthase analyzed with monoclonal antibodies. AB - Five monoclonal antibodies recognizing five different epitopes of the native beta 2 subunit of Escherichia coli tryptophan synthase (EC 4.1.2.20) were used to analyze the conformational changes occurring upon ligand binding or chemical modifications of the enzyme. For this purpose, the affinities of each antibody for the different forms of the enzyme were determined by using an enzyme-linked immunosorbent assay which allows measurement of the dissociation constant of antigen-antibody equilibrium in solution. The fixation of the coenzyme pyridoxal 5'-phosphate and the substrate L-serine modifies the affinity constants of most of the antibodies for the enzyme, thus showing the existence of extended conformational rearrangements of the protein. The association of the alpha subunit with the beta 2 subunit, which brings about an increase of the tryptophan synthase activity and abolishes the serine deaminase activity of beta 2, is accompanied by an important conformational change of the N-terminal domain of beta 2 (F1) since none of the anti-F1 monoclonal antibodies can bind to alpha 2 beta 2. Similarly, chemical modifications of beta 2 which are known to produce significant effects on the enzymatic activities of beta 2 result in changes of the affinities of the monoclonal antibodies which can be interpreted as the acquisition of different conformational states of the enzyme. PMID- 3521736 TI - Oxidation-reduction properties of glycolate oxidase. AB - This is the first report of the redox potentials of glycolate oxidase. The pH dependence of the redox behavior as well as the effects of activators and inhibitors was studied. At pH 7.1 in 10 mM imidazole-chloride, Eo1' (EF1ox/EF1-.) is -0.033 +/- 0.010 V and Eo2' (EF1-./EF1redH-) is -0.017 +/- 0.017 V vs. the standard hydrogen electrode at 10 degrees C. A maximum of 29% flavin mononucleotide (FMN) anion radical is stabilized at half-reduction at pH 7.1 and 10 degrees C. Both redox couples of glycolate oxidase are pH-dependent from pH 7 to pH 9, and the FMN anion radical is stabilized in this range. The redox potentials of glycolate oxidase are shifted markedly positive of those of unbound FMN, consistent with the enzyme's function. The midpoint potential of glycolate oxidase is more positive than that of the glyoxalate/glycolate couple, and two electron reduction of glycolate oxidase is thermodynamically favorable. The redox behavior of glycolate oxidase markedly contrasts that of other flavoprotein oxidases. For most flavoprotein oxidases, Eo1' is independent of pH from pH 7 to pH 9 and is much more positive than Eo2', which is pH-dependent. We present a mechanism that suggests a structural basis for the positive shifts and pH dependence of both Eo1' and Eo2' of glycolate oxidase. PMID- 3521737 TI - Energetics of proline racemase: tracer perturbation experiments using [14C]proline that measure the interconversion rate of the two forms of free enzyme. AB - Proline racemase exists in two states, one of which binds and isomerizes L proline and the other of which binds and isomerizes D-proline. In the enzyme catalyzed racemization of proline at high substrate concentrations, the interconversion of the two forms of the free enzyme becomes rate limiting. The tracer perturbation method of Britton (1966, 1973) vividly demonstrates the kinetic importance of this enzyme interconversion under oversaturating conditions and allows an estimate of the rate constant for this reaction of 10(5) s-1. It is further shown that the enzyme is bound state saturated and the peak-switch concentration, Cp, is 125 mM. At substrate concentrations higher than 125 mM the enzyme becomes oversaturated, and the reaction rate is limited by the transition state for the interconversion of two forms of the free enzyme. It seems likely that the two free enzyme forms differ only in the protonation states of the acidic and basic groups at the active site. PMID- 3521738 TI - Energetics of proline racemase: transition-state fractionation factors for the two protons involved in the catalytic steps. AB - The isotope effects for the interconversion of L-proline and D-proline, catalyzed by proline racemase, have been determined in the saturated region with both [2 2H]proline and [2-3H]proline. The deuterium fractionation factors for each of the protons in flight have been obtained from two kinds of experiment: by measuring the rate of racemization of one [2-2H]proline enantiomer as it racemizes into an equilibrated pool of unlabeled proline and by measuring the deuterium content of a proline sample at the optical rotation maximum that occurs when an equimolar mixture of one deuterium-labeled enantiomer and the other unlabeled enantiomer runs to equilibrium. The tritium fractionation factors for each of the protons in flight have been determined from measurements of the rate of loss of tritium to the solvent as one [2-3H]proline enantiomer runs to equilibrium. Good agreement is found among the fractionation factors determined by each method. The deuterium fractionation factors for the two protons are not identical: that for the proton derived from L-proline is 0.375 and that for the proton derived from D-proline is 0.44. This difference has been confirmed by a double-competition experiment in which the optical rotation of a mixture of DL-[2-2H]proline and unlabeled DL proline is followed with time. The rotation (initially zero) passes through a maximum, from which the ratio of the two fractionation factors (0.86) is obtained. These data, coupled with the equilibrium fractionation factor for the 2 position of proline (which has been determined to be 1.17), provide the transition-state factors for each of the in-flight protons, and delineate the nature of the transition state(s) for the enzyme-catalyzed racemization. PMID- 3521739 TI - Energetics of proline racemase: double fractionation experiment, a test for concertedness and for transition-state dominance. AB - To test whether a reaction involving the making and/or breaking of two bonds at two sites is concerted (and proceeds through a single transition state) or is stepwise (and involves a reaction intermediate in which only one bond has been made or broken), we have measured the isotopic fractionation at one site as a function of isotopic substitution at the other site. In the case of proline racemase, the discrimination against solvent deuterium in the product when the reaction is run in mixed H2O-D2O is measured for the reaction both of [2 1H]proline and of [2-2H]proline. The isotopic fractionation at the solvent site may in principle be smaller, the same, or larger, when the 2H-labeled substrate is used rather than the 1H substrate, and--depending upon the nature of the catalyzing groups--this information indicates whether the reaction is stepwise, or concerted, or whether an isotopically insensitive transition state is partially rate determining. Experimentally, we have found that the discrimination against solvent deuterium in the product L-proline is the same, whether D-[2 1H]proline or D-[2-2H]proline is the substrate. This result requires that the substrate and product "on-off" steps are faster than the racemization step and that the racemization reaction proceeds either in a concerted manner or in a stepwise fashion involving enzyme catalytic groups (e.g., thiols) having ground state fractionation factors around 0.5. PMID- 3521740 TI - Photoreversal-dependent release of thymidine and thymidine monophosphate from pyrimidine dimer-containing DNA excision fragments isolated from ultraviolet damaged human fibroblasts. AB - To elucidate the enzymatic excision-repair process operative on cyclobutane-type pyrimidine photodimers in human dermal fibroblasts, we have examined excised dimer-containing material recovered in the trichloroacetic acid soluble fraction from far-ultraviolet-irradiated (254 nm, 40 J m-2) and incubated (24 h) cell cultures. The excised DNA photoproducts were found in oligonucleotide fragments with an estimated mean chain length of approximately 3.7 bases. Exposure of these isolated excision fragments, labeled with [3H]thymidine (dT), to a secondary, dimer-photoreversing fluence of far-UV (5.5 kJ m-2) resulted in the release of free dT and thymidine monophosphate (TMP). Photorelease of these two radioactive species was measured by high-performance liquid chromatography, with TMP being detected as the increase in dT following bacterial alkaline phosphatase treatment. These data imply that the photoliberated dT and TMP moieties were attached to the excision fragments solely by the cyclobutane ring of the dimer. No evidence was obtained for the photoliberation of free thymine, thus corroborating a conclusion reached by others that the excision of dimers in human cells is not initiated by scission of an intradimer N-glycosyl bond. The sum of the tritium label recovered in dT plus TMP corresponded to approximately 40% of that disappearing from thymine-containing dimers on photoreversal, suggesting that in about 80% of the isolated excision fragments the dimer is located at one end of the oligonucleotide and contains a break in its internal phosphodiester bond.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3521741 TI - Glutathione reductase from Escherichia coli: cloning and sequence analysis of the gene and relationship to other flavoprotein disulfide oxidoreductases. AB - A glutathione reductase negative strain of Escherichia coli K-12 was isolated as a thermoresistant survivor when a gor::MuctsAp lysogen was subjected to elevated temperature. It was found that in addition to being ampicillin sensitive this mutant was hypersensitive to arsenate, which may be connected with the fact that the gor gene maps between 77 and 78 min on the E. coli genome, close to the pit locus encoding the major arsenate transport system of E. coli. A derivative of this mutant was used as the recipient in a screen of the Clarke and Carbon hybrid plasmid bank of E. coli DNA. A plasmid, pGR, was isolated that encodes both an arsenate-resistance element and glutathione reductase. Restriction mapping of this plasmid showed that the insert DNA is approximately 10 kilobase pairs in length, and a fragment of the gor gene was identified that allowed the gor gene to be accurately mapped on pGR by a combination of restriction analysis and Southern blotting. The DNA sequence of the gor gene was determined and found to encode a protein of 450 amino acid residues. The glutathione reductase of E. coli is very homologous to the human enzyme and is also related (though less closely) to other flavoprotein disulfide oxidoreductases whose sequences are available. These enzymes have retained a common mechanism while evolving different specificities. PMID- 3521742 TI - Effect of tunicamycin on thiamine transport in Saccharomyces cerevisiae. AB - The activity of thiamine transport in Saccharomyces cerevisiae was decreased by the treatment with tunicamycin without affecting the growth of yeast cells. Although the total activity of a soluble thiamine-binding protein in yeast periplasm, which is known to be a glycoprotein, was decreased by tunicamycin treatment, the activity of thiamine uptake by yeast protoplasts was inhibited as much as by whole cells. Furthermore, tunicamycin decreased the activity of the membrane-bound thiamine-binding protein in a dose dependent way and in parallel with the thiamine transport activity. These findings suggested that the membrane bound thiamine-binding protein is a glycoprotein which plays a functional role in thiamine transport in S. cerevisiae. PMID- 3521743 TI - Fibroblast growth factor induces a transient net K+ influx carried by the bumetanide-sensitive transporter in quiescent BALB/c 3T3 fibroblasts. AB - The bumetanide-sensitive transport system performed a net efflux of K+ in serum deprived quiescent cells. The addition of partially purified fibroblast growth factor (FGF) to G0/G1 phase 3T3 fibroblasts induced a transient net influx of K+, carried out by the bumetanide-sensitive transport system for 2-6 minutes. The stimulation of the bumetanide-sensitive K+ influx by FGF was followed by stimulation of the ouabain-sensitive K+ influx. In addition, both the bumetanide sensitive and the ouabain-sensitive K+ influxes were found to be similarly stimulated when the G0/G1 3T3 cells were treated with insulin. These results suggest that growth factors such as FGF and insulin induce a change in the action of the bumetanide-sensitive transporter from performing net K+ efflux along its concentration gradient to an uphill transport pumping of K+ into the cell. We propose, therefore, that the bumetanide-sensitive transporter contributes to the increase in the intracellular K+ (and probable Na+) stimulated by growth factors such as FGF and insulin in early G1 phase of the cell cycle. PMID- 3521745 TI - Alteration of the exonuclease activities of DNA polymerase I by captan. AB - DNA polymerase I is a multifaceted enzyme with one polymerizing and two exonuclease activities. Captan was previously shown to be an inhibitor of this enzyme's polymerizing activity and this report measures the effects of captan on the two exonuclease activities. When the holoenzyme was tested, captan enhanced the degradation of poly(dA-dT), T7 DNA and, to a significantly lesser extent, heat-denatured DNA. However, when the effects of captan were tested as a function of substrate concentration, the stimulatory influence was measured only at high substrate concentrations. At low concentrations of DNA, captan was inhibitory. Inhibition and enhancement each showed an ED50 of the same value (approx. 100 microM). By assaying the two exonuclease activities separately it was shown that the differential effect on the holoenzyme by captan was the result of a combined inhibition of the 3'----5' exonuclease and enhancement of the 5'----3' exonuclease. Klenow fragment with poly(dA-dT) as substrate was used to assay for 3'----5' exonuclease activity. Captan inhibited this exonuclease and the inhibition could be prevented by the addition of greater concentrations of substrate. Holoenzyme and poly(rA)-poly(dT) were used to assay for 5'----3' exonucleolysis, which was enhanced at higher concentrations of substrate in the presence of captan. PMID- 3521744 TI - Anion transport systems in the plasma membrane of vertebrate cells. AB - In the case of the red blood cell, anion transport is a highly specific one-for one exchange catalyzed by a major membrane protein known as band 3 or as capnophorin. This red cell anion-exchange system mediates the Cl-(-)HCO3- exchange responsible for most of the bicarbonate transport capacity of the blood. The rapidly expanding knowledge of the molecular biology and the transport kinetics of this specialized transport system is very briefly reviewed in Section III. Exchange diffusion mechanisms for anions are found in many cells other than erythrocytes. The exchange diffusion system in Ehrlich cells has several similarities to that in red cells. In several cell types (subsection IV-B), there is evidence that intracellular pH regulation depends on Cl-(-)HCO3- exchange processes. Anion exchange in other single cells is described in Section IV, and its role in pH regulation is described in Section VII. Anion exchange mechanism operating in parallel with, and only functionally linked to Na+-H+ or K+-H+ exchange mechanisms can also play a role in cell volume regulation as described in Section VII. In the Ehrlich ascites cell and other vertebrate cells, electroneutral anion transfer has been found to occur also by a cotransport system for cations and chloride operating in parallel with the exchange diffusion system. The cotransport system is capable of mediating secondary active chloride influx. In avian red cells, the cotransport system has been shown to be activated by adrenergic agonists and by cyclic AMP, suggesting that the cotransport is involved in regulatory processes (see subsection V-A.). In several cell types, cotransport systems are activated and play a role during volume regulation, as described in Section V and in Section VII. It is also likely that this secondary active cotransport of chloride plays a significant role for the apparently active extrusion of acid equivalents from certain cells. If a continuous influx of chloride against an electrochemical gradient is maintained by a cotransport system, the chloride disequilibrium can drive an influx of bicarbonate through the anion exchange mechanism, as described in Section VII. Finally, even the electrodiffusion of anions is shown to be regulated, and in Ehrlich cells and human lymphocytes an activation of the anion diffusion pathway plays a major role in cell volume regulation as described in Section VI and subsection VII B.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3521746 TI - Docosapolyenoic fatty acids and human endothelial cells. AB - The total fatty acids in human endothelial cells include approximately 5% each of 22:4(n-6), 22:5(n-3) and 22:6(n-3), whereas 22:5(n-6) is present only in trace amounts. This study evaluates the effect of three of these fatty acids bound to albumin on lipid composition and prostacyclin (prostaglandin I2) synthesis in primary cultures of endothelial cell monolayers. 22:4(n-6), 22:5(n-6) and 22:6(n 3) were all incorporated into total phospholipids. 20:4(n-6) was reduced in phospholipids in all cells incubated with the three different docosaenoic fatty acids. This reduction was abolished when equimolar concentrations of 20:4(n-6) and the separate docosaenoic fatty acid were added to the medium simultaneously. 22:4(n-6) incorporation into the free fatty acids was associated with an increase of 20:4(n-6) in this fraction. 22:4(n-6), 22:5(n-6) and 22:5(n-3) all reduced the synthesis of prostacyclin measured as 6-ketoprostaglandin F1 alpha. These effects were reversed by simultaneous incubation with 20:4(n-6). This study shows that three of the docosaenoic fatty acids present in human endothelial cells of the (n 6) and (n-3) family were all incorporated into endothelial cells with a simultaneous reduction in 20:4(n-6). The three fatty acids reduced the synthesis of prostacyclin. PMID- 3521747 TI - Biosynthesis, processing and secretion of mucus glycoprotein in the rat stomach. AB - For the study of the biosynthesis, processing and secretion of mucus glycoproteins in rat gastric mucous cells, antibodies were raised against purified gastric mucus glycoproteins and against deglycosylated gastric mucus glycoproteins. Indirect immunofluorescence analysis of gastric mucosa sections revealed that both antibodies specifically labelled the mucus glycoprotein synthesizing cells in the gastric mucosa. Stomach segments were pulse-labelled with [35S]cysteine and chased for various times. The radioactively labelled (glyco)proteins were quantitatively immunoprecipitated and analyzed by SDS polyacrylamide gel electrophoresis. Less than 3% of the total radioactivity incorporated in protein was found to be present in mucus glycoproteins. Antibodies raised against native mucus glycoproteins recognized only high molecular-weight mucus glycoproteins, while the antibodies against deglycosylated glycoproteins also bound to probable precursor forms. The synthesis of mature mucus glycoproteins (Mr greater than 300 000) required about 90 min. After 3 h of chase, only a small portion of the pulse-labelled mucus glycoproteins had been secreted; the majority of the radioactive glycoproteins at that time was still associated with the tissue. Immature (glyco)proteins were not secreted into the medium. PMID- 3521748 TI - Pinocytosis and degradation of exogenous proteins by cystinotic fibroblasts. AB - Lysosomes of cystinotic human fibroblasts contain over 100-times the normal concentration of cystine. The high cystine concentration (probably in the millimolar range) might be expected to inhibit intralysosomal protein breakdown. A comparison of pinocytosis and degradation of five 125I-labelled proteins (bovine serum albumin, formaldehyde-denatured bovine serum albumin, bovine pancreatic ribonuclease A and porcine lactate dehydrogenase isoenzymes H4 and M4) by human fibroblasts has been made, using one cystinotic and two normal cell lines. The proteins each entered fibroblasts by adsorptive pinocytosis and were then degraded within the lysosomes by enzymes susceptible to leupeptin, the thiol proteinase inhibitor. Each protein was captured by the fibroblasts at a characteristic rate, which was not different in cystinotic cells. Normal and cystinotic fibroblasts did not differ in their proteolytic capacity, as measured in extracts of disrupted cells. In intact fibroblasts, four of the five proteins were rapidly and fully digested following pinocytosis, in both cystinotic and normal cells. However, with formaldehyde-denatured albumin, the most resistant to degradation of the proteins tested, or with some other proteins in the presence of leupeptin, when the proteolytic capacity of lysosomes is diminished, intralysosomal degradation of pinocytosed protein was incomplete. Moreover, under these conditions, cystinotic cells demonstrated a lower rate of protein digestion than normal cells. It is concluded that pinocytic capture, rather than intralysosomal proteolysis, is commonly the rate-limiting step in the overall process of uptake and degradation of proteins by fibroblasts, and that intralysosomal cystine inhibits digestion of pinocytosed protein only in circumstances when degradation becomes the rate-limiting step. PMID- 3521749 TI - Stimulation of insulin release by the phorbol ester 12-O-tetradecanoylphorbol 13 acetate in the clonal cell line RINm5F despite a lowering of the free cytoplasmic Ca2+ concentration. AB - The effects of 12-O-tetradecanoylphorbol 13-acetate (TPA) on the handling of Ca2+ and insulin release were investigated in the clonal insulin-producing cell line RINm5F. The presence of the phorbol ester lowered the free cytoplasmic Ca2+ and suppressed the increase obtained by depolarization with high concentrations of K+. Despite the lowering in cytoplasmic Ca2+ by TPA, there was a concomitant stimulation of insulin release indicating that one feature of protein kinase C activation is to make the secretory system more sensitive to Ca2+. Furthermore, there was no interaction of TPA with the mechanisms responsible for inositol 1,4,5-tris(phosphate) induced Ca2+ release or Ca2+ uptake in permeabilized cells. Although TPA slightly depolarized the RINm5F cells there was no interference with K+-induced depolarization. It is suggested that an additional effect of protein kinase C activation in these cells, is to stimulate the extrusion of Ca2+ over the plasma membrane. PMID- 3521750 TI - Metal release from dental biomaterials. AB - Levels of corrosion products released from dental alloys in natural or synthetic saliva, i.e. from amalgams, cobalt, gold, nickel, iron, or titanium based alloys have been surveyed. The amounts of Ag, Au, Cd, Co, Cr, Cu, Hg, Mo, Ti or Ni released from such alloys, either in vitro or in vivo during animal tests or during clinical usage have been compiled. The quantities released have been adapted to a 'standard restored man' with a specified number of restorations or a specified construction with a defined surface area, and compared to man's food and drink intake of similar elements. This was done as one approach to a security analysis of wearing dental alloys. In view of the assessment of extensive corrosion testing using electrochemical methods, rather scarce information seems presently available pertinent to release kinetics of specific elements in various biological environments like saliva or saliva substitutes. Several examinations indicate that mercury released from amalgams could be a substantial part of man's daily intake of this element, e.g. in the initial period following insertion, as well as on a long-term basis. From a copper amalgam cadmium could be released in vitro in amounts close to food and drink intake. The mercury release from the amalgam surface seems to be strongly influenced by the interaction of mechanical forces, e.g. chewing, and seems to be released according to a cyclic pattern. From a base metal alloy with high nickel content nickel could be released in vitro at the same level as from food and drink intake. However, from cobalt based alloys the nickel release seems insignificant in this context. The elemental release from the other alloys seemed to be far below the intake of similar elements from food and drink. Release under static and dynamic conditions has been discussed. PMID- 3521751 TI - An ultrastructural characterization of the interface between bone and sputtered titanium or stainless steel surfaces. AB - Experimental implants of polycarbonate covered with a thin metallic layer were inserted in the rabbit tibial metaphysis. The implants had either a magnetron sputtered 316 L stainless steel or commercially pure titanium surface (or an evaporated commercially pure titanium surface). The aim of the experiment was to investigate the interfacial arrangements between bone and the coatings used. Three months after implant insertion, the animals were sacrificed and the intact interface between bone and metal analysed using ultrastructural techniques. In the case of stainless steel a coat of 1-2 cellular layers separating the bone from the metal was found. Inflammatory cells were abundant as well as a wide proteoglycan coat lacking collagen filaments. In the case of titanium there were no cells in the interface which consisted instead of a proteoglycan layer of about 200-400 A width. Bundles of collagen appeared at a minimum distance of 1000 2000 A from the metal surface. Calcium deposits were sometimes seen in direct contact (resolution level 30-50 A) with the titanium oxide. There were no ultrastructural differences in tissue reactions when magnetron sputtered titanium surfaces were compared with evaporated ones. PMID- 3521752 TI - Kin recognition: functions and mechanisms. A review. PMID- 3521753 TI - Treatment effects in competing-risks analysis of prostate cancer data. AB - Green and Byar (1980, Bulletin Cancer, Paris, 67, 477-488) have analysed some data from a randomised clinical trial comparing treatment for patients with prostate cancer in stages 3 and 4. These authors assessed the effects of treatment on survival using an exponential regression model with treatment by covariate interactions. Clinical considerations led to conclusions being drawn about the relationship between treatment and different causes of death. This paper presents a more direct approach for assessing treatment effect based on a model which recognizes the competing-risks nature of the problem. Methods for choosing the optimal treatment for particular patients, one of the aims of the Green and Byar work, are also discussed. PMID- 3521755 TI - Photoregulation of plant gene expression. PMID- 3521754 TI - Conformational dynamics of two histidine-binding proteins of Salmonella typhimurium. AB - The Salmonella typhimurium periplasmic histidine-binding J-protein is one of four proteins encoded by the histidine transport operon. Mutant J-protein hisJ5625 binds L-histidine, but does not transport it. The tertiary structure and conformational dynamics of native and mutant J-protein have been compared using steady state fluorescence, fluorescence polarization, and fluorescence energy transfer measurements. The two proteins have different three-dimensional structures and exhibit different responses to histidine binding. Ligand-induced conformational changes were demonstrated in both J-proteins using fluorescence energy transfer (distant reporter method) between the single tryptophan residue per mole of protein and a fluorescein-labeled methionine residue. However, the conformational change of the mutant protein is qualitatively and quantitatively different from that of the wild-type protein. Moreover, the microenvironment of the tryptophan and its distance from the labeled methionine (44A for the wild type, 60A for the mutant J-protein) are different in the two proteins. In conclusion, these results indicate that the specific conformational change induced in the wild type J-protein is a necessary requirement for the transport of L-histidine. PMID- 3521756 TI - Immunoperoxidase localization of type X collagen in chick tibiae. AB - Type X collagen was prepared from medium of long-term cultures of embryonic chick tibiotarsal chondrocytes. Antibodies to type X collagen were raised and used in immunoperoxidase localization studies with embryonic and growing chick tibiotarsus. Strong anti-type X collagen reactivity was detected mainly in the region of hypertrophic chondrocytes, and to a lesser extent in the zone of calcified cartilage. No reactivity was detected in the proliferative zone nor the superficial layer of the cartilage growth plate. These results suggest that type X collagen may play a key role in matrix calcification during growth and development of the skeletal system. PMID- 3521757 TI - 2-ketoglutarate generation in pancreatic B-cell mitochondria regulates insulin secretory action of amino acids and 2-keto acids. AB - The various neutral amino acids and aliphatic 2-keto acids exhibit differential effects on insulin secretion. The common denominator for all these effects is the 2-ketoglutarate generation in the pancreatic B-cell mitochondria. The neutral amino acids L-leucine and L-norvaline and the aliphatic ketomonocarboxylic acids 2-ketoisocaproate, 2-ketocaproate, 2-ketovalerate, and 2-keto-3-methylvalerate all stimulate insulin secretion and increase 2-ketoglutarate generation in pancreatic B-cell mitochondria through activation of glutamate dehydrogenase and transamination with L-glutamate and L-glutamine, respectively. The neutral amino acids L-valine, L-norleucine, and L-alanine and the aliphatic 2-keto acids 2 ketoisovalerate and pyruvate do not stimulate insulin secretion and do not increase 2-ketoglutarate generation in pancreatic B-cell mitochondria. Inhibition of 2-keto acid induced insulin secretion by L-valine and L-isoleucine is accompanied by reduced 2-ketoglutarate generation in pancreatic B-cell mitochondria. Thus intramitochondrial 2-ketoglutarate generation in pancreatic B cells may regulate the insulin secretory potency of amino acids and 2-keto acids. PMID- 3521758 TI - The response of muscle protein synthesis to nutrient intake in postabsorptive rats: the role of insulin and amino acids. AB - In 12 h fasted rats, rates of muscle protein synthesis were stimulated by refeeding for 1 h and by intragastric or intravenous infusion of an amino acid plus glucose mixture for 1 hr, but not by intravenous infusion of amino acids alone for 1 h. Intravenous injection of anti-insulin serum suppressed the response to feeding and to intragastric infusion, but not to intravenous infusion. It is concluded that the response of muscle protein synthesis to food intake is mediated by both insulin and amino acids acting in concert. PMID- 3521759 TI - Relating damped oscillations to sustained limit cycles describing real and ideal batch fermentation processes. AB - A batch fermentation model is presented in which the specific growth rate and yield functions are chosen such that sustained oscillations in both the cell and substrate concentration occur. This phenomenon is shown to be a Hopf bifurcation in the underlying system of non-linear ordinary differential equations which comprises the model. It is shown that for oscillations in the substrate concentration to occur it is necessary for the yield term to depend on both the cell and substrate levels. PMID- 3521760 TI - Expression of p53 in human leukemia and lymphoma. AB - Analysis of fresh human tumors have indicated that patients with B type lymphoproliferative diseases and the majority of patients with acute lymphoblastic leukemia (ALL) express elevated levels of p53 production. It is suggested that in these human malignancies, p53 may provide a novel tool for monitoring cancer activity. Conversely, p53 is not expressed in acute myeloid leukemias, myeloproliferative diseases, or myeloid leukemic cell lines. Analysis of the p53 gene structure indicated the existence of similar patterns of p53 restriction fragments in producer and nonproducer cells, which suggests that the p53 gene is not altered in the latter. However, in one case of acute promyelocytic leukemia (APL), we have observed a rearrangement in the p53 gene. Karyotype analysis has indicated that these APL cells do not contain the typical 15;17 translocation. In other APL patients who exhibit a 15;17 translocation, we found no genomic changes of the p53, suggesting that the p53 gene, which was recently mapped to the short arm of chromosome 17 in the human, is not structurally related to the typical chromosomal break point found in the long arm of chromosome 17 of APL patients. PMID- 3521762 TI - Ultrastructural localization of coagulation factor V in human platelets. AB - The distribution and transport in platelets of human coagulation Factor V was investigated by immunofluorescent and immunoelectron microscopy. In resting intact platelets, little surface staining was observed by immunofluorescence. In permeable resting cells, punctate staining similar to that reported for fibrinogen (Fbg), thrombospondin (TSP), fibronectin (Fn), von Willebrand factor (VWF), B-thromboglobulin (BTG), and platelet Factor 4 (PF4) was observed. Double label immunofluorescent staining for Fbg and Factor V demonstrated colocalization, suggesting their presence in the same intracellular structure. Thrombin stimulation induced the appearance of larger (approximately 0.5 mu) immunofluorescent masses of these proteins which exactly colocalized. Thus, at the light level, Factor V and Fbg are localized in the same structure in resting and thrombin-stimulated cells. On the ultrastructural level, an alpha granule localization for Fbg has previously been established. We have extended our immunofluorescent observations regarding the localization of Factor V in human platelets by use of transmission electron microscopy of antibody-stained ultrathin frozen sections. In resting cells, staining of virtually all alpha granules was observed for Factor V. In contrast, consistent staining was absent from other organelles including plasma membranes, mitochondria, and vacuolar structures which may represent the open canalicular system. These data thus establish at the ultrastructural level an alpha granule localization of human coagulation Factor V. PMID- 3521761 TI - Marrow transplantation for severe aplastic anemia: methotrexate alone compared with a combination of methotrexate and cyclosporine for prevention of acute graft versus-host disease. AB - Forty-six patients with severe aplastic anemia (median age, 23 years) were treated with high-dose cyclophosphamide followed by infusion of marrow from an HLA-identical family member. To evaluate postgrafting prophylaxis for graft-v host disease (GVHD), they were entered into a prospective randomized trial comparing the effect of a combination of methotrexate and cyclosporine (n = 22) to that of methotrexate alone (n = 24). Forty-four of the forty-six patients had evidence of sustained marrow engraftment. Only one patient in each of the two study groups showed graft rejection. A significant reduction in the cumulative incidence of grades II to IV acute GVHD was seen in patients given methotrexate/cyclosporine (18%) compared with those given methotrexate alone (53%) (P = .012). In three patients given methotrexate alone, grade III developed, and in six, grade IV acute GVHD developed, compared with none given methotrexate/cyclosporine. Eighteen of the 22 patients given methotrexate/cyclosporine and 15 of the 24 given methotrexate alone are alive between 5.5 and 44.5 months (median, 18 months), with actuarial survival rates at 2 years of 82% and 60%, respectively (P = .062). The incidence of fatal infections was higher in patients given methotrexate alone, whereas there are as yet no significant differences in the incidence of chronic GVHD. We conclude that methotrexate/cyclosporine treatment resulted in a significant decrease in the incidence and severity of acute GVHD in patients who received transplants for severe aplastic anemia and thus an improvement in survival. PMID- 3521763 TI - Spurious detection of terminal deoxynucleotidyl transferase in phytohemagglutinin stimulated lymphocytes. AB - Expression of terminal transferase (TdT) is believed to be restricted to primitive lymphoid cells; recently, however, indirect immunofluorescent (IF) assays have been used to demonstrate the apparent presence of TdT in phytohemagglutinin (PHA)-stimulated peripheral blood lymphocytes and in various nonlymphoid malignancies. Using an IF assay, we found that a heteroantiserum to TdT reacted with cultured and PHA-stimulated human peripheral blood mononuclear cells, but we were unable to confirm the presence of TdT in these cells using immunoblotting and biochemical assays. We conclude that the IF results are spurious and most likely represent recognition by the heteroantiserum of inducible protein(s) other than TdT. PMID- 3521764 TI - Dye-mediated photolysis of human neuroblastoma cells: implications for autologous bone marrow transplantation. AB - Cells from three different human neuroblastoma cell lines and normal human bone marrow cells were exposed to the lipophilic fluorescent dye, merocyanine 540 (MC 540), and white light. In vitro clonogenic tumor cells were inactivated up to 25,000 times more rapidly than multipotent hematopoietic progenitor cells (CFU GEMM). It is conceivable that this pronounced difference in sensitivity to MC 540 mediated photolysis can be exploited for the selective killing of residual neuroblastoma cells in autologous remission marrow grafts. PMID- 3521765 TI - The contribution of leukocyte proteases to fibrinolysis. AB - Polymorphonuclear leukocytes accumulate within blood clots and may contribute to fibrinolysis. The primary fibrinolytic enzymes of neutrophils are cathepsin G and elastase. Fibrin can be exposed to these granular enzymes as a result of cell lysis, phagocytosis of fibrin, or secretion of the enzymes from the cells. Neutrophil secretion occurs in association with blood coagulation and is dependent upon a plasma factor(s) and calcium. After secretion, the enzymes can degrade fibrin within a plasma environment. This is demonstrated by the inhibition of fibrinolysis by specific inhibitors of elastase and the augmentation of fibrinolysis by neutralization of the primary plasma inhibitor of elastase, alpha 1-proteinase inhibitor. A radioimmunoassay which discriminates elastase from plasmic degradation products of fibrinogen has been developed. In this assay, elastase elicited degradation products of fibrin(ogen) were detected in certain pathophysiologic plasma samples. Taken together, these findings indicate a role for leukocyte proteases in physiological fibrinolysis. PMID- 3521767 TI - Adjuvant tamoxifen in postmenopausal breast cancer: preliminary results of a randomized trial. AB - Between May 1978 and March 1982, 179 postmenopausal women with operable breast cancer were randomized to receive either adjuvant tamoxifen, 40 mg daily for three years (TAM group), or no further treatment (controls). The difference in five-year survival rates (61% in the control group, 72% in the TAM group) was not statistically significant. However, there was a significant improvement in disease-free survival in the TAM group (61%) relative to the controls (44%) (p = 0.008). In estrogen receptor positive patients, tamoxifen improved both the disease-free rate (47% controls, 80% with tamoxifen) and the survival rate (63% to 83%). Similar results were observed in progesterone receptor positive patients. In patients that were estrogen receptor negative, tamoxifen modified neither the survival rate nor the disease-free interval. PMID- 3521766 TI - Cytogenetic studies in bone marrow transplant recipients. AB - Chromosome studies were performed in 24 patients who underwent allogeneic bone marrow transplantation (BMT) for severe aplastic anaemia (8), chronic myeloid leukemia (5 in chronic, 2 in accelerated phase and 1 in lymphoid blast crisis), acute myeloid leukemia (6), acute lymphoblastic leukemia in relapse (1) and Hodgkin's disease (1). Donor-cell type engraftment was demonstrated in 21 patients: in all 17 sex-mismatched transplants and - as demonstrated by reconstitution with Ph-negative cell populations - in 4 CML patients with a sex matched donor. Recipient-type mitoses were seen in the bone marrow of 5 cases (1 SAA, 3 CML, 1 AML) after transplantation. They were only observed on one occasion in patients with SAA (4 of 25 on day 33) and AML (44 of 50 on day 14). Despite the continued demonstration of some Ph-positive mitoses in 3 patients with CML up to day 28, 323 and 451 after BMT, respectively, all surviving CML patients are still in complete haematological and clinical remission. So far the significance of these cytogenetically abnormal persisting host cells remains unknown. PMID- 3521768 TI - Influence of nitrilotriacetic acid on Cd2+ uptake by yeast. PMID- 3521769 TI - Medical Nemesis, Paris, 1894: Leon Daudet's Les Morticoles. PMID- 3521770 TI - Who's looney now?: the insanity case of John Armstrong Chaloner. PMID- 3521771 TI - Female lay managers and scientific pediatrics at Nursery and Child's Hospital, 1854-1910. PMID- 3521772 TI - Scribonius Largus on the medical profession. PMID- 3521773 TI - An illustration of skin graft rejection and sympathetic medicine from 1661. PMID- 3521774 TI - The physician in Nazi Germany. "Arzte im Nationalsozialismus". By Fridolf Kudlien (ed.). An essay review. PMID- 3521775 TI - Damage to hearing arising from leisure noise. Medical Research Council Institute of Hearing Research. AB - This paper presents the main findings of a review of the literature on leisure noise (sociacusis) published elsewhere (MRC Institute of Hearing Research, 1985). From this, it has been possible to draw certain limited conclusions, despite the research's generally poor design, methodology and reporting. Given that the present occupational hearing conservation programme in the U.K. is geared to levels of 90 dB(A), non-occupational noise exposure is unlikely to constitute a major source of noise-induced hearing loss in the U.K. population. The Review contains recommendations for research to fill gaps in the literature. Some of the most important questions remain unanswered or unasked even in the most heavily researched categories such as amplified music. While sound levels have been fairly well described more attention needs to be paid to the often neglected parameters of leisure noise exposure, i.e. the numbers exposed and the patterns and durations of their exposures. The outstanding need in leisure noise research is for a large, random-sample, whole-population survey in the U.K. of the numbers exposed and the patterns of exposure to leisure noise in general and amplified music in particular. PMID- 3521776 TI - [Baron Jules Francois (1907-1984)]. PMID- 3521777 TI - Ultrasonographic and clinical characteristics of orbital pseudotumours. PMID- 3521778 TI - Prostacyclin in therapeutics. PMID- 3521779 TI - Thyroidectomy. AB - Of all operations in general surgery, those on the thyroid have a special esteem, because the introduction of safe thyroid surgery by masters like Joll and Dunhill in this country and Crile and Lahey in the United States saved young lives, and returned the unpleasant features associated with untreated thyrotoxicosis to normal. The emphasis of these Princes of Surgery to anatomic detail and careful surgery with good haemostasis remain the hallmark of thyroid surgery today. PMID- 3521780 TI - Hyperbaric oxygen therapy in multiple sclerosis. PMID- 3521781 TI - Origin of carcinomas causing bladder neck obstruction demonstrated by immunoperoxidase localisation of specific antigens. AB - The immunohistological demonstration of prostate specific acid phosphatase, prostate specific antigen, epithelial membrane antigen and keratin was used to ascertain the origin of five advanced carcinomas involving the bladder neck and causing obstruction. Five prostatic carcinomas, 10 transitional cell and 10 squamous cell carcinomas with schistosomiasis of the bladder were studied for comparison. The concomitant localisation of prostate specific antigen and keratin was most useful in ascertaining the origin of tumour invading the bladder in contrast to the multiple use of other epithelial markers. It showed that 2/5 were of prostatic origin and 3/5 were urothelial. The markers did not discriminate with certainty between invasive poorly differentiated transitional or squamous cell carcinomas. PMID- 3521782 TI - A simple approach to the entire urethra. PMID- 3521783 TI - Surgical drainage: an historical perspective. PMID- 3521784 TI - Randomized trial of oral adjuvant razoxane (ICRF 159) in resectable colorectal cancer: five-year follow-up. AB - Razoxane is one of the few agents which has shown activity in the treatment of advanced colorectal cancer. The drug has therefore been evaluated in a prospective randomized controlled trial as an adjuvant to surgery for resectable colorectal cancer. The results to median follow-up of 5 years are reported here. Accrual has ceased and a total of 272 patients entered the trial (133 control, 139 treatment). Treated patients received razoxane postoperatively on a continuous, long-term basis while control patients received identical clinical care but no adjuvant chemotherapy. Analysis of the results shows a significant prolongation of the time to recurrence for Dukes' C patients. All other groups including the overall analysis show no benefit although there is a consistent trend in favour of the treated patients except in Dukes' group 'D'. Razoxane is tolerated well by patients and causes minimal side-effects. However acute leukaemia occurred in three patients (2.45 per cent) after prolonged exposure to the drug and further evaluation should be in patients who are at high risk of developing recurrent cancer, in whom such a risk may be acceptable. It is concluded that razoxane is suitable for further evaluation in colorectal cancer and for incorporation into combination chemotherapy regimens. PMID- 3521785 TI - Endoluminal ultrasound in the assessment of local invasion in rectal cancer. AB - A new method for staging local invasion in rectal cancer has been assessed. Thirty-eight patients with primary rectal cancers have been examined pre operatively with endoluminal rectal ultrasound and results compared with histological analysis of resected specimens in 33 cases. Three patients who also underwent laparotomy but not resection had good evidence of both stage T3 (1) and T4 (2) disease. The coefficient of correlation between ultrasonic and histological staging was 0.93 (P less than 0.001). Invasion beyond the muscularis propria was predicted with a sensitivity of 96 per cent, specificity of 92 per cent and a predictive value of 96 per cent. PMID- 3521786 TI - Asystole and electromechanical dissociation. PMID- 3521787 TI - Cytoarchitecture, synaptic organization and fiber connections of the nucleus olfactoretinalis in a teleost (Navodon modestus). AB - Cytoarchitecture, synaptic organization and fiber connections of the nucleus olfactoretinalis (NOR) in a teleost, Navodon modestus, have been studied light- and electron-microscopically using an HRP or HRP-degeneration combined method. Following HRP injections into the optic nerve, most contralateral and a few ipsilateral neurons in the NOR were labeled. There are two types of neurons in NOR. Type I neurons have a medium-sized spindle-shaped soma with a round nucleus, and type II neurons have a large oval soma with an invaginated nucleus and contain cored vesicles (80-130 nm in diameter). Afferent terminals which form synaptic contacts with cell bodies of NOR neurons were classified into 3 types according to their morphological characteristics; S, F1 and F2 terminals. S terminals originated in ipsilateral area ventralis telencephali pars supracommissuralis (Vs). These terminals contain both spherical and cored vesicles, and make synaptic contacts with both type I and type II neurons. F1 terminals, which originated in ipsilateral area dorsalis telencephali pars posterior (Dp), are large in profile, and contain flat vesicles and mitochondria with irregularly arranged cristae. These terminals make synaptic contacts only with type I neurons. F2 terminals are small in profile, and contain flat vesicles, cored vesicles and small mitochondria with regularly arranged cristae. F2 terminals make synaptic contacts with both type I and type II neurons. The functional significance of NOR and the relationship between NOR and the ganglion of the nervus terminalis are discussed. PMID- 3521788 TI - Somatostatin-like neurons are expressed in fetal neocortical homografts in adult rat spinal cord. AB - Fetal central nervous system homografts to adult spinal cord are considered a potential aid for recovery of function after paraplegia. This study utilizes somatostatin (SOM) immunohistochemistry to study the organization of an embryonic day 14 (E14) neocortical homograft into the spinal cord of an adult host over 6 postoperative months. Although the E14 homograft does not contain SOM-positive cells, SOM-reactive neurons are expressed by 30 days postimplantation and are still present in 6-month-old homografts. SOM-immunoreactive neurons are bitufted or multipolar and have dendrites that are confined to the graft. The homograft contains SOM-immunoreactive axons entering and/or exiting from lamina II in the host dorsal horn and SOM-positive homografted neurons send axons into the host ventral columns. These data show that the SOM peptide neocortical phenotype is preserved in homografts to spinal cord but there is anatomical host-homograft integration. PMID- 3521789 TI - Colocalization of angiotensinogen and glial fibrillary acidic protein in astrocytes in rat brain. AB - Angiotensinogen is produced in the brain, but its precise localization and the cells in the central nervous system producing it are unknown. We have performed a double staining test for angiotensinogen and glial fibrillary acidic protein in rat brain and report here that these proteins colocalize in astrocytes. PMID- 3521790 TI - [Comparison of the effects of conventional insulin therapy and the insulin infusion pump on blood glucose values in pregnant diabetics]. PMID- 3521791 TI - [Regimen sanitatis scholae Salernitanae in the Matej Bela edition]. PMID- 3521792 TI - Generation of autograft; the state of the art. PMID- 3521793 TI - Use of tissue expanders after burns and other injuries. AB - During the first year of use of tissue expansion at the Birmingham Accident Hospital, 24 patients had expansion procedures at 29 sites. Most of these were to revise burn scars. A number of complications occurred and five procedures were abandoned. The advantages and problems of the technique are discussed. PMID- 3521794 TI - Transplantation of anastomosed vascular allomentum and split thickness autogenous skin grafting for repair of deep electrical burns of the wrist. AB - The use of allomentum to replace automentum or skin flaps in treating 3 patients with severe electrical burns of the wrist is discussed, as are the specific advantages and disadvantages, and the prospects for clinical use of the technique. PMID- 3521795 TI - Conservative treatment of 725 burned children hospitalized in 10 years. AB - Seven hundred and twenty-five children were hospitalized in the paediatric burn unit of Brugmann University Hospital during the past 10 years. The majority of the patients were under 5 years of age and presented with scalds on less than 10 per cent of the body surface area. As burn depth was difficult to assess on admission, a conservative form of treatment was performed including a daily bath containing chlorhexidine and silver sulphadiazine dressings. Contamination of the wounds was observed in 80 per cent of the larger than 20 per cent surface burns but only 18 cases (2.4 per cent) of the series needed administration of systemic antibiotics for repeated contamination. No lethal septicaemia was observed. Mean inpatient time ranged between 16 days for ungrafted patients to 69 days for over 20 per cent surface grafted patients. The lower iatrogenic risks (anaesthesia and donor site morbidity) seemed important enough to justify conservative treatment in children despite a slightly longer hospitalization time. PMID- 3521796 TI - Screening for the early detection of cancer. PMID- 3521797 TI - [Intravenous therapy]. PMID- 3521798 TI - The comparative efficacy of cimetidine and ranitidine in controlling gastric pH in critically ill patients. AB - The comparative efficacy of intravenous cimetidine and ranitidine in controlling gastric pH in 100 intensive care unit patients was assessed in a double blind, prospective, randomized study. The total number of gastric pH determinations and the number of pH determinations with pH less than five were recorded. Patients received either cimetidine or ranitidine via continuous infusion, with dosage adjustments for patients with renal insufficiency. Antacids were administered each time the gastric pH was less than five. There was no difference overall in the number of patients who had at least one gastric pH determination less than pH 5. There was however, a larger proportion of patients with greater than or equal to 10, greater than or equal to 15, greater than or equal to 20 and greater than or equal to 25 per cent of gastric pH determination less than pH 5 in the cimetidine group than in the ranitidine group. This difference was statistically significant for greater than or equal to 25 per cent. The drugs were well tolerated. Ranitidine was as effective as cimetidine and possibly more so in controlling gastric pH. PMID- 3521799 TI - Misinterpretation of pressure measurements from the pulmonary artery catheter. PMID- 3521800 TI - Anaesthesia and allergic drug reactions. PMID- 3521801 TI - Anaesthetic considerations in high-risk pregnancy. AB - The pathophysiology, and principles of obstetric and anaesthetic management, of two high-risk situations have been reviewed. Information sources related to two additional problems are provided. The encouraging decline witnessed in perinatal morbidity and mortality in recent years, stems from multidisciplinary team care in tertiary centres. The obstetric anaesthetist who understands the pathophysiology of high-risk pregnancy, and the principles which underlie patient management, becomes an irreplaceable member of such perinatal care teams. PMID- 3521802 TI - Anaesthesia for thoracic surgery: recent advances. PMID- 3521803 TI - CPR 1986. PMID- 3521804 TI - Recent advances in local anaesthesia. AB - In general, the cardiovascular system is more resistant to the toxic actions of local anaesthetics than is the central nervous system. However, if sufficient doses and blood levels of local anaesthetics are achieved, signs of profound cardiovascular depression may be observed. Differences exist between local anaesthetics in terms of their relative potential for cardiotoxicity. The CC/CNS ratio for bupivacaine and etiodcaine is less than for lidocaine. In addition, bupivacaine may precipitate ventricular arrhythmias and ventricular fibrillation. Local tissue toxicity can occur following the administration of local anaesthetics. In general, neural tissue appears to be relatively resistant to the irritant effects of local anaesthetic drugs. However, large dosages of chloroprocaine solutions administered intrathecally have been associated with prolonged sensory-motor deficits in a few patients due probably to the low pH and presence of sodium bisulfite in the chloroprocaine solutions. In general, the incidence of toxic reactions to local anaesthetic agents is extremely low. However, as with any class of pharmacological agents, local anaesthetics may cause severe toxic reactions, due usually to the improper use of these drugs. PMID- 3521805 TI - Diaphragmatic fatigue and blood flow distribution in shock. PMID- 3521806 TI - Acute renal failure: update. PMID- 3521808 TI - Periodontics. Treatment of juvenile periodontitis. PMID- 3521807 TI - A profile of dental clinic patients. Report of a survey. PMID- 3521809 TI - The Harvard experience. PMID- 3521810 TI - A Swedish model of prelicensure general practice residency. PMID- 3521811 TI - Benefits and implications of prelicensure for the public. PMID- 3521812 TI - Impact on general practice. PMID- 3521813 TI - Clotrimazole troche (Bay b5097) in the treatment of oropharyngeal candidiasis and the evaluation of the test-strip, Microstix-Candida. PMID- 3521814 TI - [Psychosomatic aspects of myofascial pain]. PMID- 3521815 TI - [Treatment of congestive heart failure: new concepts]. AB - In the past, hemodynamic factors, in congestive heart failure were considered as being of major importance in the production of the major symptoms and signs of the disease: peripheral (increased oxygen extraction, flow redistribution) or central (Starling's law, myocardial contractility). More recently, excessive hormonal compensation has been felt to be more important such as: The renine angiotensin-aldosterone axis, Circulating catecholamines, Arginin-vasopressin. These hormones are responsible for water and sodium retention, tachycardia and increase in peripheral resistance. Newer agents such as Captopril are effective in blocking the action of these endocrine factors. PMID- 3521816 TI - Cloning and characterization of chromosomally encoded cephalosporinase gene of Enterobacter cloacae. AB - The cephalosporinase gene, cpa, which codes for an inducible class I chromosomal beta-lactamase in Enterobacter cloacae was cloned on a fragment of 6.05 kilobase pairs inserted into plasmid pACYC184 and transferred into Escherichia coli HB101 recipient cells. The constructed hybrid plasmid, designated pGGQ101, carried a genomic fragment which retained its parental inducibility characteristics, although its expression level in transformed E. coli cells fell to 40-65% of its initial level in E. cloacae. The localization of the cpa gene on pGGQ101 plasmid was determined by Bal31 exonuclease deletion mapping and further confirmed by subcloning HindIII-AvaI restriction fragment on pMB9 plasmid vector. Labeling with [35S]methionine of pGGQ101 specified proteins in a minicell system showed that six or seven proteins are encoded by the insert. Two proteins with apparent molecular mass of 42 000 and 39 500 daltons, respectively, most probably represent the premature and mature cephalosporinase forms. PMID- 3521817 TI - Identification of staphylococci from bovine udders: evaluation of the API 20GP system. AB - The API 20GP system (Analytab Products, Plainview, NY) correctly identified 56.1% of staphylococci isolated from the bovine mammary gland. The system identified 90.2% of Staphylococcus aureus strains, but failed to recognize strains of Staphylcoccus hyicus and others. Poor performance was attributed to the limited number of veterinary strains contained in the profile index data base. The API 20GP was determined to be an unacceptable method for identification of staphylococci isolated from the bovine mammary gland. PMID- 3521818 TI - Creutzfeldt-Jakob disease: correlation of focal electroencephalographic abnormalities and clinical signs. AB - Three patients are described with pathologically verified Creutzfeldt-Jakob disease (CJD) who presented with localizing clinical signs accompanied by focal electroencephalographic abnormalities including periodic lateralized epileptiform discharges (PLEDS). With further progression of the disease, diffuse background slowing and continuous bisynchronous periodic discharges appeared in all three cases. There was good correlation between the initial focal clinical manifestations and the EEG findings. PMID- 3521819 TI - Idiopathic spasmodic torticollis: pathophysiology and treatment. PMID- 3521820 TI - Continuing interest in the Franklin expeditions. PMID- 3521821 TI - The last Franklin expedition: report of a postmortem examination of a crew member. PMID- 3521822 TI - Infant botulism: a rare entity in Canada? PMID- 3521823 TI - Occupational asthma. PMID- 3521824 TI - The atopic worker. PMID- 3521826 TI - Diagnosis of allergic contact dermatitis of occupational origin. PMID- 3521825 TI - Pathogenesis of occupational lung disease. PMID- 3521827 TI - Mechanisms in contact dermatitis. PMID- 3521828 TI - Lewis a antigen in transitional cell tumors of the urinary bladder. AB - The failure of A,B,H antigens as prognostic parameters in noninvasive bladder cancer of blood group O individuals, who constitute 44% of the population, encouraged the evaluation of the closely related Lewis a antigen. Ninety-three tumors of the urinary bladder were stained employing the Tween 20 (Merck) modified immunoperoxidase staining technique and serial dilution of monoclonal anti-Lewis a antibodies. On the basis of recent findings in non-neoplastic ureter urothelium of erythrocyte Lea+b-, Lea-b+, and Lea-b- individuals, alterations in tumors, except eight from Lea-b- individuals, were quantified on a scale from 0 (normal) to 3 (total loss). Scores were related to the pathologic stage and grade (P less than 0.01), and, in stage Pa tumors, to the clinical course: recurrence rate (P less than 0.10), stroma invasive recurrence, and/or papillomatosis (P less than 0.05). Although further studies are needed the current study points to Lewis a antigen determination as an advantageous prognostic tool in stage Pa tumors of the urinary bladder of Lea-b+ and Lea+b- individuals, who, together, constitute 94% of the population. PMID- 3521829 TI - Distribution of collagen type IV in soft tissue tumors. An immunohistochemical study. AB - The distribution of collagen type IV, one of the major constituents of basement membrane, was studied immunohistologically in a series of 103 soft tissue tumors including those of peripheral nerve origin, smooth muscle origin, striated muscle origin, fibrous tissue origin, fibrohistiocytic origin, adipose tissue origin, synovial tissue origin, and blood vessel origin, paragangliomas, alveolar soft part sarcomas, granular cell tumors, and epithelioid sarcomas. Intensely positive staining for collagen type IV was observed in neurilemomas, neurofibromas, malignant schwannomas, and blood vessel tumors. Weakly to moderately positive staining was seen in leiomyomas, angiomyomas, and leiomyosarcomas. In contrast, synovial, fibroblastic and fibrohistiocytic tumors, benign or malignant, were negative. In paragangliomas, granular cell tumors, and alveolar soft part sarcomas, positive staining was evident surrounding nests or clusters of tumor cells. In all tumors, staining for collagen type IV clearly illustrated the vascular pattern. PMID- 3521830 TI - Chondrosarcoma with additional mesenchymal component (dedifferentiated chondrosarcoma). II. An immunohistochemical and electron microscopic study. AB - Light microscopic, immunocytochemical and ultrastructural studies were performed on chondrosarcomas which contained a second, noncartilagenous mesenchymal component. Attention was focused on the nonchondroid portion of each tumor in an attempt to elucidate the histogenesis of this mixed variant of chondrosarcoma. The immunoreactivity of 20 tumors was studied using antisera for S-100 protein, alpha-1-antitrypsin, alpha-1-antichymotrypsin, smooth muscle myosin, desmin, and myoglobin. Cells of the nonchondroid portion stained for alpha-1-antichymotrypsin in 12 of 20 cases, and these were predominantly tumors that had been classified as fibrosarcoma or malignant fibrous histiocytoma by conventional light microscopic study. Staining for S-100 protein was consistently negative, whereas the chondrosarcoma component stained in 14 cases. Six tumors stained for desmin, and four of the six were positive for myoglobin and two for smooth muscle myosin; in four, a rhabdomyosarcomatous component was identified in the hematoxylin and eosin-stained sections. Electron microscopic study was performed on ten tumors and there was a good correlation between the immunohistochemical and ultrastructural findings. Three of the ten were pure rhabdomyosarcomas while the others displayed a range of ultrastructural appearances that can be seen in fibrosarcomas and malignant fibrous histiocytomas. The findings from this study support the view that the tumors are formed by the synchronous differentiation of two separate clones of cells. PMID- 3521831 TI - Myxopapillary ependymoma of the filum terminale. A light and electron microscopic study. AB - The histology of a myxopapillary ependymoma of the filum terminale in a 15-year old girl was studied by light and electron microscopy. The neoplasm contained both papillary and compact areas of cell growth. The papillary regions consisted of vacuolated cuboidal cells arranged around hyaline/vascular cores that were variably mucin-positive. In the compact regions, the tumor cells were intensely immunoreactive for glial fibrillary acidic protein and occasionally formed perivascular pseudorosettes. Ultrastructural examination revealed interdigitating cell processes, sometimes resting on a basement membrane. Surface specializations included numerous microvilli and occasional cilia. The cilia had an abnormal microtubular pattern (e.g., 8 + 1, 7 + 0). The cytoplasm of the tumor cells contained numerous 7-10 nm intermediate filaments and large numbers of abnormal microtubular aggregates, consisting of 4 to 50 single microtubules enclosed by a limiting membrane. These microtubular aggregates may represent a characteristic feature of myxopapillary ependymoma of the filum terminale. PMID- 3521832 TI - Preoperative radiation and surgery for cancer of the rectum. Veterans Administration Surgical Oncology Group Trial II. AB - In a prospective randomized trial, 361 male patients with histologically proven adenocarcinoma of the rectum, judged preoperatively to require abdominoperineal resection (APR), were treated by surgery alone or were given 3,150 rads of preoperative radiotherapy. Surgical resection was done on 320 patients, 262 having "curative" APR. Only moderate symptoms from radiotherapy were noted and postoperative complications and 30-day mortality were similar in both groups. Five-year survival for curative APR was the same in both groups (50% for both treated and control patients). The incidence of positive lymph nodes in the resected specimens was 35% in treated and 41% in controls. In the first preoperative radiotherapy trial conducted by the group, 5-year survival in patients undergoing "curative" APR was 47% in treated versus 34% in control groups. Additionally, the difference in positive lymph nodes in the resected specimens was substantially greater in the first trial (26% in treated versus 44% in controls). PMID- 3521833 TI - Advances in pediatric tumor imaging. AB - The continuing improvement in the outlook for pediatric malignant disease depends on modern imaging techniques. The roles of magnetic resonance imaging, computed tomography, ultrasound, nuclear radiology, and angiography are discussed in relationship to the accurate staging of the primary tumor and the effect of therapy. PMID- 3521834 TI - Indications for and benefits of intensive therapies in treatment of childhood cancers. AB - There has been a striking improvement in the overall numbers of children and adolescents who become disease-free and remain disease-free as a result of intensive therapy as defined today, for the following cancers: acute nonlymphocytic leukemia (ANLL), non-Hodgkin's lymphoma (NHL), poor risk acute lymphocytic leukemia (ALL), osteosarcoma, and Ewing's sarcoma. The therapy for each of these tumors, with the exception of osteosarcoma, consisted of combination chemotherapy with or without radiotherapy and was started as soon after diagnosis as possible. Aggressive therapy of osteosarcoma has consisted of surgical removal of lung metastases and chemotherapy. Intensive chemotherapy recently has included the use of high doses of certain drugs such as cytosine arabinoside (Ara-C), methotrexate, VP-16-213 and melphalan in the treatment of patients with tumors that are currently difficult to treat. PMID- 3521836 TI - The community physician's involvement in clinical trials and home treatment. AB - The advances in outcome of children with cancer in the last four decades have been remarkable. The improvement, however, has not been uniform. It has recently been shown that the outcome of children with medulloblastoma treated at nonuniversity cancer centers has been less successful than those who were treated at the university cancer centers. Protocol treatment and location of treatment has been correlated with outcome in children with acute lymphocytic leukemia. Cooperative group protocols, used in the clinical setting of pediatric oncologists, with extensive resources and major referral center backup, have improved the prognosis of childhood ALL. Therefore, to improve outcome of pediatric cancer patients a multidisciplinary team at a center with partnership of community physician (CP) would be helpful. The CP can assume an extremely important role in shared management of children with cancer. Major involvement can be anticipated in areas including: chemotherapeutic treatment, immunization, infection surveillance and treatment, detection of disease recurrence, and late effects of cancer treatment. A CP could decrease the financial burden, and help alleviate the anxieties and emotional stresses placed upon the patients and parents. More importantly, the CP can facilitate home terminal care when necessary. These CP-referral center arrangements are of value to the CP, as well, through their educational and psychological benefits. PMID- 3521835 TI - Problems of intensive therapy in childhood cancer. AB - Tremendous progress has been made in the treatment of childhood cancers. Certain hematologic malignancies have an impressive cure rate with the current intensive antineoplastic treatment regimens. There is optimism that the treatment of children who have advanced stage solid tumors with intensive, multimodality therapy may improve their chances for long-term survival. These treatment programs, though potentially curative, are highly toxic, with severe myelosuppression and damage to other organ systems. An awareness of these potential toxicities, an understanding of how to prevent or minimize certain problems, and the ability to treat those complications which do arise are all essential to the successful management of childhood cancer. PMID- 3521837 TI - Recent developments in pediatric neuro-oncology. AB - Although brain tumors represent the second most common malignancy in childhood, there are only 1200 to 1500 children diagnosed with brain tumors each year in the US. Approximately 50% of these children are treated at university or cancer treatment centers. Thus, therapeutic trials by default rather than design have been restricted to small numbers of patients. Information on histopathologic groupings, incidence of various tumor types according to age, general treatment trends and survival statistics are available from the Surveillance, Epidemiology, and End Results (SEER) registries of the National Cancer Institute. Although survivals in brain tumor cancers are worse than in other forms of childhood cancer, treatment advances in surgery, radiation and chemotherapy have significantly improved survivals in at least one brain tumor of childhood, medulloblastoma. Ironically, this treatment may have significant long-term adverse effects on intellect, endocrine function, and on the development of second malignancies. Prompt recognition of these delayed effects is of clinical importance, as some effects are amenable to treatment and others may be prevented by careful monitoring of drug and radiation administration. PMID- 3521838 TI - Current status of bone marrow transplantation in pediatric oncology. AB - Histocompatible bone marrow transplantation (BMT) is the treatment of choice for pediatric patients with second remission acute lymphoblastic leukemia or acute myelogenous leukemia (AML) and has been successfully used to treat patients with first remission AML and stable-phase chronic myelogenous leukemia. The principle causes of transplantation failure are recurrent leukemia and therapeutic toxicities, including idiopathic interstitial pneumonitis and graft versus host disease (GVHD). The likelihood of leukemic relapse is related primarily to the remission status of the patient; patients in first remission have a lower relapse rate than patients in second remission, and the relapse rate of both is less than that of patients in relapse. Interstitial pneumonitis is due, in part, to the total body irradiation (TBI) that is used to cytoreduce the patients. TBI administration has been modified to reduce its toxicity. Acute and chronic GVHD are due to the immuno-aggression of donor T-lymphocytes against recipient non-HLA antigens. The in vitro removal of the T-lymphocytes from the donor bone marrow inoculum reduces the incidence of acute and chronic GVHD but may have the adverse effect of reducing hematopoietic engraftment and increasing leukemic relapse since the graft versus leukemia effect may be eliminated. The expanding role of BMT includes its use in the treatment of nonleukemic neoplasms (neuroblastoma, solid tumors) and the use of histoincompatible BMT for eligible patients without histocompatible donors. PMID- 3521839 TI - Targeted drug delivery. AB - Cancer chemotherapy drugs are neither specific, i.e., they do not act exclusively on the metabolic pathways of cancer cells, nor are they targeted solely toward cancer cells. However, recent research has begun to address, in part, the latter issue. Improved delivery of chemotherapeutic agents to tumor tissue in man appears to be an achievable goal in the next decade. Improved drug delivery includes developing predictive models that allow for laboratory assessment of the best treatment for a patient's cancer without exposing the patient to an empirical trial or to the possible morbidity from exposure to a less useful drug, or to the loss of time in the fight against cancer because of ineffectual therapy. Monoclonal antibodies directed against tumor-associated antigens have the potential to achieve major advances in targeted drug delivery. Monoclonal antibodies may have direct antitumor effects, or they can be used as "homing devices" when attached to a payload and can guide diagnostic or therapeutic agents to the targeted tissues. Carrier systems of all types have become available; these include liposomes and polymeric compounds which can carry drugs, radionuclides, toxins, or other materials in a protected environment. These carriers can also be bound to monoclonal antibodies for possible targeted delivery. Pharmacological sanctuaries have been recognized as a problem in cancer treatment. The best known of these is the central nervous system (CNS). Techniques to temporarily disrupt the blood-brain barrier are now appearing. Mechanisms to administer therapy directly into the CNS are also being reassessed. Implantable pumps and reservoirs have been used to treat selected organs or for regional perfusions. Other treatments that are regional in scope include administration directly into a cavity or into a tumor. Computerized implantable devices should play a major role in cancer therapy in the future, in pain control as well as antibiotic and hormone administration. In recent years, mathematical models have been developed that can more accurately predict drug distribution and metabolism in various tissues of the body. Such models point the way to more logical designs of chemotherapeutic administration. The expanded use of autologous bone marrow transplantation, along with improving techniques of "purging" the marrow of tumor cells before reinfusion can be anticipated. Pro drugs are substances that must be biotransformed in vivo to exert their pharmacologic effect.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3521840 TI - Prospects for monoclonal antibody therapy of leukemia and lymphoma. AB - The development of monoclonal antibodies has led to renewed interest in the use of antibodies to treat malignant disease. Unfortunately, treatment with unmodified antibodies has been disappointing. Therapy with unmodified antibodies has been limited by the failure of host effector mechanisms to eliminate antibody coated tumor cells and by the emergence of variant cells lacking the target antigen. The use of antibodies as carriers of radionuclides has the potential for overcoming both these limitations because the conjugates will be directly cytotoxic and a conjugate bound to a cell surface will deliver radiation to adjacent cells lacking the target antigen. Experimental and clinical therapy trials of radionuclide antibody conjugates have yielded promising results with both tumor-specific antibody and with antibodies against differentiation antigens. Bone marrow toxicity has been dose limiting. Bone marrow support will most likely be required for the treatment of leukemia and lymphoma due to the marrow involvement with malignant cells. In the case of solid tumors, bone marrow infusion may allow administration of curative doses of radionuclide conjugates. Although at an early stage in development, radiolabeled antibodies have the potential for contributing significantly to the therapy of malignant disease. PMID- 3521841 TI - Priorities for the future for clinical research. Center perspective. AB - Clinical research has by and large been responsible for the success achieved in treating pediatric cancer during the last 20 years. An important milestone has recently been reached with the passing of the halfway mark in the goal of curing all childhood cancer. It is important to re-evaluate our priorities and set future goals. The large multi-institutional cooperative groups have been the mainstay of past successes and should as their major goal continue work towards improvements in survival, particularly for those malignancies which continue to have a poor prognosis. The second priority should be the identification of potential long-term effects of childhood cancer and the effects associated with therapy. Concomitant with improvements in the cure rate it is our responsibility to ensure that cured patients can have the opportunity to enjoy productive, useful and happy lives. The third priority is to foster research of pilot clinical research to serve as a source of ideas to be used for future Phase III clinical trials. Moreover, increased efforts should be directed towards aspects of preventive oncology which requires increased knowledge regarding the etiology of childhood cancers. PMID- 3521842 TI - 5-Fluorouracil chemotherapy and pelvic radiation in the treatment of large bowel cancer. Decreased toxicity in combined treatment with 5-fluorouracil administration through the intraperitoneal route. AB - Multimodality cancer therapy commonly involves the interactions of surgeon, radiation therapist, and medical oncologist. This prospective study was undertaken to record possible adverse effects of surgery, external beam radiation therapy, and 5-fluorouracil (5-FU) chemotherapy in the treatment of large bowel cancer. The dose of 5-FU by the intraperitoneal (IP) or intravenous (IV) routes was diminished when pelvic radiation therapy was given. The reduction in drug dose that was required was much greater when 5-FU was given IV as compared to IP. The proportion of patients remaining on IV 5-FU chemotherapy was significantly reduced when the patient received pelvic radiation. There was a significant increase in leukopenia and thrombocytopenia when patients received pelvic radiation. Hematologic toxicity was more severe when there was IV compared with IP administration of 5-FU. Pelvic radiation therapy diminished the patient's capacity to receive chemotherapy because of hematologic toxicity. The locoregional administration of 5-FU chemotherapy was better tolerated as part of a multimodality treatment regimen than was systemic administration. PMID- 3521843 TI - The antiemetic efficacy of secobarbital and chlorpromazine compared to metoclopramide, diphenhydramine, and dexamethasone. A randomized trial. AB - The efficacy of secobarbital sodium plus chlorpromazine (SC) in the prevention of cisplatin induced emesis was compared to the combination of metoclopramide, diphenhydramine, and dexamethasone (MDD). Twenty-three patients were entered onto protocol. Eighteen were evaluable. Good to excellent antiemetic prophylaxis was obtained in 72% with MDD versus 17% with SC (P less than 0.01). Sedation and anticholinergic side effects were more common with SC. Extrapyramidal reactions were more commonly seen with MDD. Significantly more patients preferred the combination of metoclopramide, diphenhydramine, and dexamethasone (P less than 0.05). PMID- 3521844 TI - Bone marrow transplantation in lymphomatoid granulomatosis. Report of a case. AB - Lymphomatoid granulomatosis is an unusual disorder histologically characterized by an angiocentric, angiodestructive mixed cellular infiltrate. The most frequent clinical manifestations are seen in the lungs, the skin, and the central nervous system. Progression to lymphoma may occur, particularly in patients who are anergic. The authors report the case of a boy who had had a splenectomy at 2 years of age for presumed Evan's syndrome, and two episodes of pneumococcal meningitis at 5 and 10 years of age. At 14 years, he had severe respiratory compromise, and a lung biopsy specimen showed lymphomatoid granulomatosis. The liver and bone marrow also were affected. Improvement occurred with multiagent chemotherapy, but he had multiple relapses. A bone marrow transplant was performed using a human leukocyte antigen (HLA) identical mixed lymphocyte culture (MLC) nonreactive brother as the donor. He remains in remission more than 3 years post-transplant. In addition, his abnormal immune function has improved. PMID- 3521845 TI - Clinical pharmacology of monoamine oxidase inhibitors. PMID- 3521846 TI - Phase I study of carboplatin (CBDCA) in children with cancer. AB - A phase I study of carboplatin (CBDCA) was performed in 40 children with advanced cancer. A single course of CBDCA consisted of 4 weekly 1-hour infusions followed by a 2-week rest. The starting dose of 100 mg/m2/week was 66% of the maximum tolerated dose in adults. Escalated dose levels given were: 125, 150, 175, and 210 mg/m2. Myelosuppression was dose limiting, with thrombocytopenia more pronounced than leukopenia. There was no evidence of cumulative toxicity. The maximum tolerated dose for children with solid tumors was 210 mg/m2/week X 4. Other side effects included transient nausea and vomiting at the higher dose levels and non-dose-related, reversible changes in creatinine clearance. One patient developed hives. No hepatic toxicity was seen. Among the 28 evaluable patients with solid tumors, one of ten with osteogenic sarcoma had complete disappearance of a lung nodule for 15+ months. Two of four patients with medulloblastoma had partial responses by clinical and computerized tomographic scan for 4 and 10 months. All three responders had received prior cisplatin therapy. CBDCA has major advantages over cisplatin in terms of reduced toxicity. Responses observed in patients previously treated with cisplatin are encouraging. The recommended phase II dose for children with solid tumors is 175 mg/m2/week X 4 with a 2-week rest. PMID- 3521847 TI - Trial of high-dose cytarabine, cyclophosphamide, total-body irradiation, and autologous marrow transplantation for refractory lymphoma. AB - Twenty-one patients with advanced non-Hodgkin's lymphoma or Hodgkin's disease who had failed to be cured with standard therapy were the subjects of this clinical trial. The patients received cytarabine (3 g/m2 at 12-hour intervals for six or eight doses), cyclophosphamide (90 mg/kg once), and total-body irradiation (one 900-cGy fraction or five 250-cGy fractions). Bone marrow was aspirated and cryopreserved before treatment and reinfused after the completion of radiotherapy. Eighteen patients (86%) had objective response and 12 (57%) achieved complete response. Three patients remain in continuous complete remission for 566+, 604+, and 1035+ days after marrow infusion. Six complete responders had tumor recurrence. One of these patients developed a localized lymphoma of another histology that was successfully treated with local radiotherapy and the patient is currently well 1004+ days after marrow infusion. Another relapsing patient responded to a brief course of salvage chemotherapy and is in remission at 1271+ days. Three of the complete responders died from infectious complications. This regimen was associated with significant toxicity. Six patients died from sepsis during the period of aplasia and three others died from interstitial pneumonia 42-105 days after marrow infusion. Although this regimen demonstrated a high level of antitumor activity, the value of adding high dose cytarabine to the combination of cyclophosphamide and total-body irradiation remains unclear and would require a randomized clinical trial to demonstrate. PMID- 3521848 TI - Phase II evaluation of mitoxantrone in advanced renal cell carcinoma: a Southeastern Cancer Study Group Trial. PMID- 3521849 TI - Phase II evaluation of mitolactol in squamous cell carcinoma of the head and neck: a Southeastern Cancer Study Group Trial. PMID- 3521850 TI - Weekly mitoxantrone in the treatment of advanced pancreatic carcinoma: a Southeastern Cancer Study Group Trial. PMID- 3521851 TI - Limited activity of carboplatin in malignant lymphoma. PMID- 3521852 TI - Scientific basis for the clinical use of superoxide dismutase. PMID- 3521854 TI - Coronary bypass surgery for patients with renal transplantation. AB - CABG was performed in a patient with severe angina pectoris who had previous successful renal transplantation. Renal function, blood biochemistry and lymphocytes T and B did not show significant changes in the postoperative period. No postoperative complications were observed. The use of immunosuppressive drugs did not add risk of infection. One year after the procedure the patient is asymptomatic. PMID- 3521853 TI - Mechanism(s) of in vitro macrophage activation with Nocardia rubra cell wall skeleton: the effects on macrophage activating factor production by lymphocytes. AB - BALB/c mouse peritoneal macrophages prepared from WPC which had been treated with N. CWS demonstrated potent cytostatic activity against syngeneic Meth A fibrosarcoma cells. The maximum cytostatic activity developed in the macrophages when WPC were incubated with 25 micrograms/ml N. CWS for 3 days. NAPC from BALB/c mice given an i.p. injection with 100 micrograms N. CWS 7 days previously (N. CWS NAPC) or supernatants from N. CWS-NAPC also activated peritoneal macrophages in vitro. However, when peritoneal macrophages were incubated with N. CWS in the absence of NAPC, or when T cells were depleted from WPC by treatment with anti Thy 1.2 antibody and complement, N. CWS failed to enhance the cytostatic activity of the macrophages. Furthermore, thioglycollate-elicited peritoneal macrophages from C3H/HeN mice increased their cytolytic properties by incubation with supernatant fluids from N. CWS-treated spleen cells. These findings suggest that in vitro macrophage activation with N. CWS depends on MAF secreted from T lymphocytes. PMID- 3521855 TI - Comparison of diflunisal and acetaminophen with codeine in the treatment of mild to moderate pain due to strains and sprains. AB - Fifty college athletes with acute sprains and strains from football-related activities were randomly assigned to treatment with either diflunisal or acetaminophen with codeine for seven days. Additional treatment in both groups included rest, elevation, local application of cold or heat, splinting, and physical therapy, as indicated. Both treatment groups exhibited clinically significant improvements in pain, tenderness, and swelling. The results of this study show that diflunisal, a peripherally acting nonnarcotic nonsteroidal anti inflammatory agent with analgesic properties, was as effective as acetaminophen with codeine in relieving mild to moderate pain due to musculo-skeletal sprains and strains. The long duration of action of diflunisal permits less frequent dosing, an important consideration when prescribing medication for active young adults. PMID- 3521856 TI - Multicenter study comparing 0.05% gel formulations of desoximetasone and fluocinonide in patients with scalp psoriasis. AB - A double-blind, multicenter study was conducted to evaluate and compare the safety and efficacy of desoximetasone gel 0.05% and fluocinonide gel 0.05% in patients with scalp psoriasis. One hundred twenty-five patients were enrolled in this randomized, parallel-group trial. Responses based on clinical assessment in 123 patients showed that the desoximetasone gel formulation is a safe and effective treatment for psoriasis of the scalp. Although efficacy appears equivalent to that of fluocinonide gel 0.05% in treating psoriasis of the scalp, desoximetasone appears to be slightly better tolerated and better accepted cosmetically. PMID- 3521857 TI - Zopiclone: a new nonbenzodiazepine hypnotic used in general practice. AB - Ninety-one insomniacs completed a four-week study of the efficacy and safety of zopiclone (Z), 7.5 mg. Patients were randomly allocated to one of two groups, each of which received placebo (P) during one week of the study. Forty-six subjects received medication in the sequence of ZPZZ, and 45 received it in the sequence of ZZPZ. Twice each week, patients filled out presleep and postsleep questionnaires and reported their morning complaints. Compared with placebo, zopiclone produced statistically significant improvements (P less than 0.05) in sleep induction time, duration of sleep, number of awakenings per night, quality and soundness of sleep, morning state of rest, and daytime sleepiness. Headache, dizziness, nausea, and bitter taste were the predominant complaints. Zopiclone can be considered an efficient and safe hypnotic for chronic insomnia. PMID- 3521858 TI - Controlled clinical trial of imidazole.2-hydroxybenzoate (ITF 182) versus sulindac in patients with rheumatoid arthritis. AB - The efficacy and safety of the nonsteroidal anti-inflammatory drugs imidazole.2 hydroxybenzoate and sulindac were compared in 30 patients with classical or definite rheumatoid arthritis. The trial was designed as a randomized parallel group study comprising 15 patients given imidazole.2-hydroxybenzoate and 15 given sulindac orally for 28 days. Patients in both groups improved significantly in almost all of the variables evaluated. Imidazole.2-hydroxybenzoate was more effective than sulindac on Ritchie's articular index, left hand proximal interphalangeal joint circumference, erythrocyte sedimentation rate, and C reactive protein. The incidence of side effects was significantly higher in patients treated with sulindac. PMID- 3521859 TI - Double-blind study of a new antimuscarinic, cimetropium bromide, in patients with irritable bowel syndrome. AB - Forty patients with irritable bowel syndrome were randomly allocated to treatment with octylonium bromide (20 mg TID) or cimetropium bromide (50 mg BID) in a double-blind trial lasting for six weeks. Drugs were taken before meals, according to a double-blind schedule. Clinical evaluations were made of digestive and other symptoms, objective findings (pain at palpation, contracted colon, tympanites), and overall effectiveness of treatment. Statistically significant decreases in severity of abdominal pain and subjective scores for bowel habits were obtained in both groups. The only statistically significant differences between treatments were in nondigestive symptoms (asthenia, palpitations, tremor, headache, etc.), which improved more in the cimetropium bromide group. No severe side effects were observed in either treatment group. PMID- 3521861 TI - A scanning acoustic microscope study of the small caries lesion in human enamel. PMID- 3521860 TI - Double-blind comparison of ketoprofen and mefenamic acid in the treatment of primary dysmenorrhea. AB - Forty women with moderate to severe primary dysmenorrhea participated in a two month, double-blind, crossover trial comparing ketoprofen with mefenamic acid. Treatment with ketoprofen provided rapid and marked pain relief similar to that afforded by mefenamic acid. This improvement in symptoms was accompanied by an amelioration of the disability score, which was equivalent for both drugs. There were no differences between the two treatments with respect to duration of menses or amount of menstrual flow. Patients rated both drugs as equally effective and had no preference for one treatment over the other. One patient dropped out because of a mild allergic reaction to ketoprofen. All other side effects were not severe, although slightly more gastrointestinal reactions were observed with ketoprofen. It is concluded that ketoprofen is as safe and effective as mefenamic acid in the treatment of primary dysmenorrhea. PMID- 3521862 TI - Further development of a computer-aided image analysis method of quantifying radiolucencies in approximal enamel. PMID- 3521863 TI - The occurrence of gamma-aminobutyric acid (GABA)-containing cells in cultures of retinas from the human fetus. AB - gamma-Aminobutyric acid (GABA) immunoreactivity is demonstrated by the indirect immunofluorescence technique in a small population of retinal neurons cultured from human fetuses. Positive staining was restricted to a few cells and could be observed as soon as the cells became attached to the substrate (within 5 hr). It is therefore concluded that the GABA-positive cells are determined prenatally. The GABA-positive cells grow processes during development in culture and remain constant in numbers. These cells have a different morphology from either GFAP positive cells or serotonin-accumulating cells. It is suggested that the GABA positive cells in culture are probably amacrine neurones. Cultures of human retinal dissociates may therefore provide an alternative means of studying specific cell types should a constant supply of living human retinas be difficult to obtain. PMID- 3521864 TI - [The importance of nonspecific immunotherapy in Hodgkin's disease. Experience of the first comprehensive control team in the Department of General Medicine at Charles University in Prague]. PMID- 3521865 TI - [Man's perception of comets and momentoes of them]. PMID- 3521866 TI - [The contribution of 19th century Czech pathology to the study of heart diseases]. PMID- 3521867 TI - [Indications and contraindications for liver transplantation]. PMID- 3521868 TI - [One of the little known developers of electrocardiography]. PMID- 3521869 TI - [Detection of acute toxoplasmosis by the immunoadsorption method combined with agglutination (IgM-ISA)]. PMID- 3521870 TI - [The parachutists from Resslov Street. The last testimony]. PMID- 3521871 TI - [History of the neuron theory and the dialectico-materialist concept of structure function relationships in the nervous system]. PMID- 3521872 TI - [Number sets and hallucinogens and early paleolithic Moravian shaman-medicine men. An amulet from Predmost for pregnant women which bears a calculation of the time of the first movements of the child to the time of birth by a multiplication of sets]. PMID- 3521873 TI - [Reminiscences of 30 years ago]. PMID- 3521874 TI - [History of a world-wide priority originating in Prague]. PMID- 3521875 TI - [Abdominal ultrasonography in the diagnosis of focal liver processes]. PMID- 3521876 TI - [The significance of ultrasonography for the detection of outflow tract obstruction in transplanted kidneys]. PMID- 3521877 TI - [100 years since the founding of the Czech Propedeutic Clinic]. PMID- 3521878 TI - Immunocytochemistry of GABA in the antennal lobes of the sphinx moth Manduca sexta. AB - We have prepared and characterized specific rabbit antisera against gamma aminobutyric acid (GABA) coupled covalently to bovine serum albumin and keyhole limpet hemocyanin. Using these antisera in immunocytochemical staining procedures, we have probed the antennal lobes and their afferent and efferent fiber tracts in the sphinx moth Manduca sexta for GABA-like immunoreactivity in order to map putatively GABAergic central neurons in the central antennal-sensory pathway. About 30% of the neuronal somata in the large lateral group of cell bodies in the antennal lobe are GABA-immunoreactive; cells in the medial and anterior groups of antennal-lobe cells did not exhibit GABA-like immunoreactivity. GABA-immunoreactive neurites had arborizations in all of the glomeruli in the antennal lobe. Double-labeling experiments involving tandem intracellular staining with Lucifer Yellow and immunocytochemical staining for GABA-like immunoreactivity demonstrated that at least some of the GABA immunoreactive cells in the antennal lobe are amacrine local interneurons. Several fiber tracts that carry axons of antennal-lobe projection neurons exhibited GABA-immunoreactive fibers. Among the possibly GABA-containing projection neurons are several cells, with somata in the lateral group of the antennal lobe, that send their axons directly to the lateral protocerebrum. PMID- 3521879 TI - A reinvestigation of the Gn-RH (gonadotrophin-releasing hormone) systems in the goldfish brain using antibodies to salmon Gn-RH. AB - The organization of Gn-RH systems in the brain of teleosts has been investigated previously by immunohistochemistry using antibodies against the mammalian decapeptide which differs from the teleostean factor. Here, we report the distribution of immunoreactive Gn-RH in the brain of goldfish using antibodies against synthetic teleost peptide. Immunoreactive structures are found along a column extending from the rostral olfactory bulbs to the pituitary stalk. Cell bodies are observed within the olfactory nerves and bulbs, along the ventromedial telencephalon, the ventrolateral preoptic area and the latero-basal hypothalamus. Large perikarya are detected in the dorsal midbrain tegmentum, immediately caudal to the posterior commissure. A prominent pathway was traced from the cells located in the olfactory nerves through the medial olfactory tract and along all the perikarya described above to the pituitary stalk. In the pituitary, projections are restricted to the proximal pars distalis. A second immunoreactive pathway ascends more dorsally in the telencephalon and arches to the periventricular regions of the diencephalon. Part of this pathway forms a periventricular network in the dorsal and posterior hypothalamus, whereas other projections continue caudally to the medulla oblongata and the spinal cord. Lesions of the ventral preoptic area demonstrate that most of the fibers detected in the pituitary originate from the preoptic region. PMID- 3521880 TI - Fine structure of the malaria parasite Plasmodium falciparum in human hepatocytes in vitro. AB - Recent advances in the ability to culture the hepatic forms of mammalian malaria parasites, particularly of the important human pathogen Plasmodium falciparum have provided novel opportunities to study the ultrastructural organisation of the parasite in its natural host cell the human hepatocyte. In this electron microscopic and immunofluorescence study we have found the morphology of both parasite and host cell to be well preserved. The exoerythrocytic forms, which may be found at densities of up to 100/cm2, grow at rates comparable to that in vivo in the chimpanzee. In the multiplying 5- and 7-day schizogonic forms of the ultrastructural organisation of the parasite bears striking resemblances to other mammalian parasites, e.g., the secretory activity and distribution of the peripheral vacuole system, but also homology with avian parasites, e.g., in nuclear and nucleolar structure and mitochondrial form. The latter homologies support earlier suggestions of the close phylogenetic relationship of P. falciparum with the avian parasites. Evidence is also presented showing the persistence of the cytoskeleton of the invasive sporozoite within the cytoplasm of the ensuing rapidly growing vegetative parasites. PMID- 3521881 TI - Antigenic profiles of human, bovine and canine articular chondrocytes. AB - Human, bovine and canine articular chondrocytes have been shown to bear cartilage matrix, chondrocyte-specific and histocompatibility antigens. These cell-surface antigens of chondrocytes were demonstrated both simultaneously and separately either by complement-mediated cytotoxicity or by immunohistochemical reactions. The chondrocyte-specific antigens involve subsets of species-common and species specific determinants, which are also present on the surfaces of rib and laryngeal chondrocytes. In addition to these antigens, human and calf articular chondrocytes also express unique cell-surface components that are capable of producing a blastogenic stimulation of autologous T-lymphocytes in vitro. These putative autoantigens segregated from lymphocytes in vivo could be released in trauma and in inflammatory joint diseases triggering the immune system of the host. PMID- 3521883 TI - Direct projections to the rat pineal gland via the stria medullaris thalami. An anterograde tracing study by use of horseradish peroxidase. AB - The possible presence of a direct nervous projection from the paraventricular nucleus (PVN) of the hypothalamus to the pineal gland of the rat was investigated by means of the anterograde neuron-tracing method using horseradish peroxidase. The tracer was injected unilaterally into the PVN and the animals were allowed to survive between 12 and 26 h. Numerous peroxidase-positive fibers were observed, ipsilateral to the injection site, in the stria medullaris thalami and could be followed into the medial habenular nucleus and the habenular commissure. From there, fibers penetrated into the deep pineal gland (lamina intercalaris), and further into the pineal stalk. These data support results of previous investigations describing retrograde labeling of the PVN following intrapineal injections of horseradish peroxidase and are in accordance with recent experiments demonstrating an influence of the PVN on electrical and biochemical activity of the pineal gland. PMID- 3521882 TI - Actin, myosin, and laminin localization in retinal vessels of the rat. AB - Actin, myosin, and laminin have been localized in retinal vessels of normal rats by fluorescence microscopy. Actin was localized with the fluorescent F-actin binding toxin nitrobenzoxadiazole phallacidin (NBD-Ph). Indirect immunofluorescence was used to localize myosin and laminin. In addition, laminin localization was also performed with the Protein A-horseradish peroxidase (PA HRP) method. NBD-Ph staining gave strong fluorescence in both retinal capillaries and larger vessels. Anti-myosin fluorescence could also be observed in trypsin digests of the retinal vasculature. Strong fluorescence of PA-HRP reaction product could be detected in the walls of vessels exposed to anti-laminin antibody. Actin distribution in vessels of the RCS rat with inherited retinal degeneration (retinal dystrophic RCS rat) was also studied. After exposure to NBD Ph, all capillaries showed fluorescence. However, it was more intense in many of the capillaries in the outer retina, which also appeared morphologically abnormal. Electron microscopy of retinal capillaries fixed in 2.5% glutaraldehyde containing 8% tannic acid revealed numerous microfilaments in the pericyte cytoplasm and some in the basal portion of endothelial cells. In pericytes, these microfilaments are in close association with the endothelial side of the cell. Tangential sections through this region indicate that these filaments may be anchored to the membrane at this site. PMID- 3521884 TI - S-100 proteins. AB - S-100 is a group of closely related, small, acidic Ca2+-binding proteins (S 100a0, S-100a and S-100b, which are alpha alpha, alpha beta, and beta beta in composition, respectively). S-100 is structurally related to calmodulin and other Ca2+-binding proteins. S-100 is abundant in the brain and is contained in well defined cell types of both neuroectodermal and non-neuroectodermal origin, as well as in their neoplastic counterparts. In the mammalian brain, S-100a and S 100b are confined to glial cells, while S-100a0 is neuronal in localization. Single S-100 isoforms bind Ca2+ with nearly the same affinity. K+ antagonizes the binding of Ca2+ to high affinity sites on S-100. S-100 binds Zn2+ with high affinity. S-100 is found in a soluble and a membrane-bound form and has the ability to interact with artificial and natural membranes. S-100 has no enzymatic activity. S-100 has been involved in several activities including memory processes, regulation of diffusion of monovalent cations across membranes, modulation of the physical state of membranes, regulation of the phosphorylation of several proteins, control of the assembly-disassembly of microtubules. Some of these effects are strictly Ca2+-dependent, while other are not. S-100 is being secreted or released to the extracellular space. In some cases, this event is hormonally regulated. Several S-100 binding proteins are being described. PMID- 3521885 TI - [Current status and trends in sterilization and disinfection in China]. PMID- 3521886 TI - [Relation between the water supply and the occurrence of Legionella infections]. PMID- 3521887 TI - [Epidemiology of Angiostrongylus cantonensis in Guangzhou]. PMID- 3521888 TI - [Neonatal epidemic diarrhea caused by Proteus mirabilis]. PMID- 3521889 TI - Yeast killer toxin: site-directed mutations implicate the precursor protein as the immunity component. AB - Yeast killer toxin and a component giving immunity to it are both encoded by a gene specifying a single 35 kd precursor polypeptide. This precursor is composed of a leader peptide, the alpha and beta subunits of the secreted toxin, and a glycosylated gamma peptide separating the latter. The toxin subunits are proteolytically processed from the precursor during toxin secretion. Using site directed mutagenesis, we have identified a region of the precursor gene necessary for expression of the immunity phenotype. This immunity-coding region extends through the C-terminal half of the alpha subunit into the N-terminal part of the gamma glycopeptide. Mutations in other parts of the gene allow full immunity but produce precursors that fail to be processed. The precursor can therefore confer immunity, and we propose that it does so in the wild type by competing with mature toxin for binding to a membrane receptor. PMID- 3521890 TI - Nucleotide sequence of the triosephosphate isomerase gene from Aspergillus nidulans: implications for a differential loss of introns. AB - A functional cDNA from Aspergillus nidulans encoding triosephosphate isomerase (TPI) was isolated by its ability to complement a tpi1 mutation in Saccharomyces cerevisiae. This cDNA was used to obtain the corresponding gene, tpiA. Alignment of the cDNA and genomic DNA nucleotide sequences indicated that tpiA contains five introns. The intron positions in the tpiA gene were compared with those in the TPI genes of human, chicken, and maize. One intron is present at an identical position in all four organisms, two other introns are located in similar positions in A. nidulans and maize, and the remaining two introns are unique to A. nidulans. These Aspergillus-specific introns are located in regions of the protein that were predicted to be interrupted by introns based on analysis of a Go plot of chicken TPI. These comparisons are discussed in relation to the evolution of introns within TPI genes. PMID- 3521891 TI - The HTS1 gene encodes both the cytoplasmic and mitochondrial histidine tRNA synthetases of S. cerevisiae. AB - The gene encoding the histidine-tRNA synthetase (HTS1) has two in-frame translation start sites located 60 bp apart. One set of HTS1 transcripts (long) initiates upstream of both ATG codons, and the other set (short) initiates between the two ATG codons and therefore contains only the downstream ATG. A mutation that destroys the first AUG on the long message results in the Pet- (respiratory deficient) phenotype, but does not affect either the level of the cytoplasmic histidine-tRNA synthetase or viability. Mutations distal to the second ATG lead to loss of cytoplasmic synthetase function, lethality and respiratory deficiency. These phenotypes can be explained if the longer message were to encode the mitochondrial synthetase and the shorter message were to encode the cytoplasmic histidine-tRNA synthetase. PMID- 3521892 TI - The stability of E. coli gene transcripts is dependent on determinants localized to specific mRNA segments. AB - To map the structural features responsible for the 5-fold difference in stability of the E. coli ompA and bla gene transcripts, we have constructed gene fusions that encode chimeric ompA/bla transcripts and a deletion that eliminates a large internal segment of bla mRNA. Shortening of bla transcripts by internal deletion or replacement of the 3' end with the corresponding segment of the ompA transcript had little effect on bla mRNA stability. However, fusion of a 5' terminal 147 nucleotide segment of the ompA message 5' to full-length or truncated bla transcripts increased the half-life of the bla segments 3- to 5 fold. These and other findings indicate that E. coli transcripts contain discrete structural determinants of stability and instability that can influence the decay rate of linked mRNA segments derived from other genes. PMID- 3521893 TI - Cytoplasmic determinants for cell lineage specification in ascidian embryos. PMID- 3521894 TI - Polyvalent polymeric drug carriers. AB - A number of drug-carrier systems have been considered, so far, for time controlled delivery, targeting, and decrease of toxicity of biologically active compounds. Many of these drug carriers are based on synthetic polymers. Prerequisites for polymeric drug carriers and the need for polyvalent systems capable of carrying different drugs are examined from the viewpoint of effective pharmaceutical uses. The cases of microcapsules, microspheres, nanoparticles, and emulsions based on polymers are recalled. Of particular interest are copolymers, such as amphiphilic block-copolymers and partially quaternized polytertiary amines, that can form hydrophobic microdomains in aqueous media. Discussions are focused on the capability of the corresponding microphases to solubilize, carry, and release lipophilic drugs. The present state of the art is illustrated by recent examples. PMID- 3521895 TI - Effects of different modes of strength training on body composition and anthropometry. AB - This article deals with the effects of conventional strength training and circuit resistance training on changes in body composition parameters. Recent data are provided on the technique of arm radiography to quantify changes in arm muscle and fat following strength development with hydraulic resistance exercise equipment. PMID- 3521896 TI - Anabolic steroids and training. AB - Based on the currently known actions of androgens as anabolic compounds, we conclude that skeletal muscle represents a relatively minor target for anabolic steroids, if the androgen receptor is considered a limiting step in steroid action. The possibility exists that steroids are able to exert other cellular effects such as through regulation of post-transcriptional events or through the glucocorticoid receptor. Muscle overload by weight training may also increase the number of androgen binding sites, thus making the trained muscles more susceptible to anabolic compounds. Women with fewer circulating androgens and more androgen receptors than men are likely to be influenced to a greater extent than men by anabolic steroid administration. However, a great deal of research is needed to explore these possibilities and to further substantiate the biochemical functioning and mechanisms of anabolic steroid action in muscle. PMID- 3521897 TI - Athletic training in chronic obstructive pulmonary disease. AB - Chronic obstructive pulmonary disease (COPD) is a common and very debilitating disease in the United States. COPD is characterized by plugging of airways with secretions, impaired airway integrity with airway collapse with effort, bronchospasm, frequent infections, destruction of alveolar tissue, and ventilation-to-perfusion inequality. This results in abnormalities in pulmonary mechanics and respiratory gas exchange, all of which make hyperventilation much less effective. However, research has shown that the pulmonary patient can improve work capacity in an exercise training program. Training also alleviates the severe emotional problems of anxiety, depression, and social isolation frequently present in COPD sufferers. Even the lowest level patient can frequently improve in a training program, and guidelines for the implementation of such a therapeutic regimen are provided. PMID- 3521898 TI - Cardiorespiratory exercise training in children. AB - Definitive statements concerning the cardiorespiratory effects of exercise training in children cannot be made. Few carefully controlled and well-defined exercise training studies including important cardiorespiratory variables have been conducted. Generally, it appears that the response to training in pubescent and postpubescent children is not different from what is observed in adults. PMID- 3521899 TI - Physical training for the elderly. AB - Current activity patterns and fitness status of the average senior citizen are explored and contrasted with the condition of the elderly international competitor. The response to training and how it is modified by age, disease, and medication are discussed. An optimum training regimen is proposed, and specific precautions and contraindications to training are noted. PMID- 3521900 TI - Does exercise training affect reproductive hormones in women? AB - In recent years, reproductive disorders in athletes have been observed in increasing numbers and proportions as larger numbers of women are participating in more strenuous athletic activities. Clinical problems with infertility and decreased bone density have been reported in this group, which has prided itself on its health. Hypoestrogenic women, including amenorrheic athletes, should definitely seek medical treatment for the prevention of osteoporosis, but before women sacrifice the many benefits of strenuous exercise, it is appropriate to consider the strength of the evidence that exercise training in particular, rather than other, extraneous aspects of athletic training, is responsible for the hormonal changes associated with reproductive disorders. This review has examined this first link in the postulated causal chain between exercise and these clinical conditions. In this review, only those studies that have compared trained or highly trained women with untrained or less-trained women, either cross-sectionally or longitudinally have been considered. In assessing the credibility of the reported results, we have found that the extensive precautions, painstaking techniques, and powerful protocols required for studying the question have only slowly been appreciated and never fully implemented by investigators. As a result, most of the published results are of little value. The few studies less susceptible to such criticism are consistent in their observations of gonadotropin and ovarian steroid suppression in women participating in athletic training. Nevertheless, even these results may have been biased by confounding factors, and thus at the present time the first link in the causal chain of events from exercise training to infertility and fractures cannot be regarded as proven. If the observed suppression of reproductive hormones is, indeed, due to exercise training, it may be dependent upon either the intensity of exercise training or the rate at which the intensity is increased. A dependence upon the rate at which exercise intensity is increased may explain why large proportions of athletes at all exercise intensity levels remain eumenorrheic. If future studies eliminate the biasing effects of known confounding factors and confirm that the female reproductive system can be suppressed by exercise training in particular, then additional research will be needed to determine the training intensity or rate of change in intensity required for these effects to occur. Research will also be needed to determine how gynecologic age, body composition, diet, and psychologic status may exaggerate or attenuate these effects.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3521901 TI - Some considerations of exercise during pregnancy. AB - In this review the physiologic responses to exercise during pregnancy and the outcome of pregnancies from studies of animal models and human subjects are presented. Based on the clinical concerns about exercise participation during pregnancy and the studies presented herein, certain recommendations for an exercise program for the pregnant woman are given. PMID- 3521902 TI - Central circulatory adaptations to exercise training in health and disease. AB - Cross-sectional and longitudinal studies are reviewed that address the effects of training on several measures of central circulatory function, including gas exchange, cardiac output, left ventricular structure, and left ventricular function. Responses to training in healthy individuals, athletes, and patients with ischemic cardiovascular disease are compared. PMID- 3521903 TI - Delayed onset muscle soreness and training. AB - The perception of muscle soreness is probably due to the activation of free nerve endings around muscle fibers. These nerve endings serve as receptors of noxious stimuli associated with muscle damage. Modulation of soreness may take place at the peripheral receptor sites or at a central or spinal level. This multilevel modulation may explain the large intersubject variation in the perception of muscle soreness. The type of exercise that produces the greatest degree of soreness is eccentric exercise, although isometric exercise may also result in soreness. Eccentric exercise has been shown to produce muscle cellular damage and decrements in motor performance as well. Although training is considered to prevent muscle soreness, even trained individuals will become sore following a novel or unaccustomed exercise bout. Thus, training is specific to the type of exercise performed. Our laboratories have shown that the performance of a single exercise bout will have an effect on a subsequent similar bout given up to 6 weeks later. Thus, when a second bout of downhill running was given to subjects 6 weeks after the first bout, with no intervening exercise, less soreness developed, and muscle damage was estimated to be reduced. The explanation for this long-lasting prophylactic or "training effect" is currently under investigation in our laboratories. PMID- 3521904 TI - [The disappearing twin--a new phenomenon in ultrasonic diagnosis in pregnancy]. PMID- 3521905 TI - [Themes in our profession on coins and medals]. PMID- 3521906 TI - [The effect of insulin on lipid metabolism in latent gestational diabetes. Relation to the weight of the neonate]. PMID- 3521907 TI - [100 years' publishing activity at the 1st Gynecologic-Obstetrical Clinic of Bratislava (1885-1984)]. PMID- 3521908 TI - [Beta 2 microglobulin in reproductive immunology]. PMID- 3521909 TI - [Functional adaptation of contractile proteins]. PMID- 3521910 TI - [Fatigue in respiratory muscles]. PMID- 3521911 TI - [The beginnings of modern Czech biology, physiology and medicine. Jan Marek Marci of Kronland (Ioannes Marcus Marci 1595-1667): the physiology and psychology of perception, memory and imagination]. PMID- 3521912 TI - [Biochemistry of cartilage proteoglycans]. PMID- 3521913 TI - [The glasses and vision of Bedrich Smetana]. PMID- 3521914 TI - [100 years since the death of Dr. Jiri Czarda, founder of the first Czech hospital for diseases of the ear and nose]. PMID- 3521915 TI - [Sonographic study of the head of neonates and infants using the SAL 20 (Thosiba) apparatus]. PMID- 3521916 TI - [Doubts and uncertainties in the immunodiagnosis of juvenile bronchial asthma]. PMID- 3521917 TI - [25 years' activity of the Institute of Health Information and Statistics (1960 1985)]. PMID- 3521918 TI - The influence of antifungal drugs on adherence of Candida albicans to buccal epithelial cells. AB - The adherence of two strains of Candida albicans serotype A to human epithelial cells was measured after exposure to different concentrations of amphotericin B, 5-fluorocytosine, nystatin, miconazole and ketoconazole. Germ-tube formation after different exposure times to the antifungal drugs as a preliminary test was carried out. Pretreatment of blastospores with minimum inhibitory concentrations (MIC) and sub-MIC (1/2 and 1/4 of MIC values) for 3 and 72 h did not affect adherence for all drugs tested except amphotericin B. This antimycotic agent reduces significantly the adherence either after 3 or 72 h exposure time. The other antifungal drugs interfere with adherence only after 72 h and at the highest concentrations tested, above MIC values. The decrease in adherence by antifungal drugs suggests that some of these drugs would be useful in the prophylaxis of patients at high risk for candidosis. PMID- 3521919 TI - Studies on chemical carcinogens and mutagens. XXXVI. Apparent activation energy from mutagenic modification induced in E. coli by alkylating agents. Estimation from mutation frequency. PMID- 3521920 TI - Petite induction in yeast, Saccharomyces cerevisiae, by phenanthridinium compounds: promotive effects of propidium iodide on mutagenesis by ethidium bromide or 8-deaminoethidium chloride. PMID- 3521921 TI - [Primary testicular tumors in children. Apropos of 23 cases]. AB - 23 cases of primary testicular tumors (TT) were observed in 6 different French divisions of Pediatric Surgery during a 10 year period. This series combined with a survey of the literature serve to stress the rarity of such tumors in boys under the age of 15 years. Yolk sac tumors are the most frequent ones (40%), followed by teratomas (32.5%) which, in children and in this localization, are almost always benign tumors of nongerminal origin, in particular rhabdomyosarcomas and tumors of sexual cords, represent 22% of an TT. They are different from what is observed in adults, in whom the most frequent tumors are seminomas, embryonal carcinomas and teratocarcinomas. Most testicular tumors reveal themselves as unilateral testicular masses. High serum alpha-foeto-protein is specific to yolk sac tumors and its post-operative surveillance is mandatory. Scrotal ultrasonography constitutes the main investigation in view of diagnosis and also serves to detect less evident tumors in case of precocious puberty, gynecomastia. Since lymphatic invasions are unusual in children, surgical exploration of the retro-peritoneal space is no longer considered necessary for the stagging and is replaced nowadays by ultrasonography and CT scan. In case of teratomas and others benign tumors, high inguinal orchiectomy is sufficient; in certain cases (well-delineated and superficial tumor in single-testis), tumorectomy alone is possible. As concerns Yolk sac tumors, the addition of chemotherapy from the age of 2, cures more than 90% of stage I tumors; radiotherapy is necessary when it comes to stage II or III. As for testicular rhabdomyosarcomas, in which prognosis is better than in others areas, the combination of surgery, chemotherapy and perhaps radiotherapy is able to cure from 80 to 90% of them. PMID- 3521922 TI - [The valves of the posterior urethra]. AB - 75 cases of posterior urethra valves have been seen and treated from 1952 to 1984. The average follow-up is 11 years. The clinical symptomatology is described and the different treatments are analyzed from a critical point of view. A the present time the progress made by pediatric intensive care, minimization of endoscopes, better understanding of lesions, indicate that the only treatment has to be the valves. A urinary diversion is to be considered only if the life of the boy is in danger. It is rare to have to reimplant the ureters. 3 boys died. From the cases with long follow-up, 4 have high blood pressure, 16 have renal insufficiency, of these one had a successful renal transplant, 6 are dialyzed. The problems of urinary continence and fertility are discussed. PMID- 3521923 TI - Extravascular transport in normal and tumor tissues. AB - The transport characteristics of the normal and tumor tissue extravascular space provide the basis for the determination of the optimal dosage and schedule regimes of various pharmacological agents in detection and treatment of cancer. In order for the drug to reach the cellular space where most therapeutic action takes place, several transport steps must first occur: (1) tissue perfusion; (2) permeation across the capillary wall; (3) transport through interstitial space; and (4) transport across the cell membrane. Any of these steps including intracellular events such as metabolism can be the rate-limiting step to uptake of the drug, and these rate-limiting steps may be different in normal and tumor tissues. This review examines these transport limitations, first from an experimental point of view and then from a modeling point of view. Various types of experimental tumor models which have been used in animals to represent human tumors are discussed. Then, mathematical models of extravascular transport are discussed from the prespective of two approaches: compartmental and distributed. Compartmental models lump one or more sections of a tissue or body into a "compartment" to describe the time course of disposition of a substance. These models contain "effective" parameters which represent the entire compartment. Distributed models consider the structural and morphological aspects of the tissue to determine the transport properties of that tissue. These distributed models describe both the temporal and spatial distribution of a substance in tissues. Each of these modeling techniques is described in detail with applications for cancer detection and treatment in mind. PMID- 3521924 TI - Nodular lymphomas: current concepts. AB - The past several years have witnessed innovative approaches to clinical management as well as significant insights into the basic biology of the nodular lymphomas. Clinical studies have explored two apparently widely disparate approaches to the treatment of patients with nodular lymphoma. On the one hand, withholding initial therapy (watch and wait) has proved to be a viable option in the management of some patients. This approach has provided information regarding the natural history of disease, such as the relative incidence of spontaneous tumor regression vs. histologic transformation to more aggressive forms of lymphoma. Alternatively, recent data also suggest that the administration of intensive chemotherapy, shown to induce long-term remissions in a high percentage of patients with diffuse aggressive lymphomas, may also produce a significant number of durable remissions in at least certain histologic subtypes of nodular lymphomas. Clinical studies which attempt to achieve a synthesis of the above two approaches are currently in progress. Advances in immunology and molecular biology have also found application in the study of nodular lymphoma. Monoclonal antibodies have been employed diagnostically, as, for example, in detecting small numbers of persistent abnormal lymphoid clones in patients in apparent remission, and therapeutically, as exemplified by the clinical use in vivo of monoclonal antibodies directed against unique idiotypic determinants expressed by surface immunoglobulin on the malignant B lymphocytes. The demonstration of the immunoglobulin gene rearrangements in nodular lymphoma cells has established a more definitive criterion for their phenotypic characterization. Finally, molecular cloning of the breakpoint of the t(14; 18) chromosome translocation frequently found in nodular lymphoma cells has led to the identification of a potential new transforming gene which could be activated as a direct consequence of its rearrangement in proximity to the immunoglobulin in heavy chain gene locus. PMID- 3521925 TI - Tumor cell metastasis. AB - Local tissue invasion and the formation of metastatic lesions are characteristic properties of many malignant tumors. The formation of metastases is a complex process involving the passage of tumor cells from the site of the primary bulk tumor through successive connective tissue barriers, ultimately resulting in the growth of secondary tumor cell colonies in distinct target organ locations. At many stages in the metastatic process, tumor cells interact with multiple components of the extracellular matrix. Recently, the importance of basement membrane as a barrier to invasive cells has been recognized. In the course of the transition from in situ to invasive carcinoma, normal or dysplastic epithelial cells residing on a basement membrane are replaced by neoplastic cells which subsequently invade the basement membrane and enter the underlying stroma. Once in the stroma, tumor cells can then penetrate the walls of blood vessels or the lymphatic system and enter into the circulation. Circulating tumor cells next arrest in the lumina of small vessels, invade the vessel wall, and leave the circulation. These cells are now directly exposed to the extracellular matrix of a target organ where they may grow to form secondary tumors. Throughout the metastatic process tumor cells are thus in contact with, and are potentially responsive to, various components of the extracellular matrix. This review provides a survey of the recent advances in our understanding of the interactions of metastatic tumor cells with the extracellular matrix. Specifically, the role of basement membrane as a barrier to metastatic tumor cells is examined. PMID- 3521926 TI - Pharmacokinetics and plasma protein binding of two platinum cytostatics CHIP and CBDCA in rats. AB - Plasma protein binding and pharmacokinetic parameters of CHIP (cis-dichloro-trans dihydroxy-bis-isopropylamine platinum IV) and CBDCA (cis-diammine-1,1-cyclobutane dicarboxylate platinum II) were investigated in male Wistar rats. The plasma clearance of total and non-protein-bound platinum was determined and compared with that of 99mTc-DTPA. For binding experiments, a novel, simple, and quick method based on adsorption of non-protein-bound platinum species to charcoal was used. The clearance of total platinum after CHIP and CBDCA administration was markedly lower than the glomerular filtration rate (determined as the clearance of 99mTc-DTPA). The renal clearance of non-protein-bound platinum corresponded to 168% and 50% of the glomerular filtration rate for CHIP and CBDCA, respectively. These studies suggested that CHIP was excreted by the rat kidney. PMID- 3521927 TI - Structure-activity relationship of retinoids on lobuloalveolar differentiation of cultured mouse mammary glands. AB - The influence of 28 retinoids on the structural differentiation of mouse mammary glands in whole organ cultures was examined. Mammary glands from BALB/c mice pretreated with steroids (estradiol and progesterone) and cultured in the presence of lactogenic hormones (insulin, prolactin, hydrocortisone and aldosterone) differentiate into lobuloalveolar structures. These differentiation processes were inhibited by retinoic acid at 10(-6) M and by the arotinoid containing tetramethylated tetraline (Ro 13-7410) at 10(-10) M. The presence of this arotinoid for as little as 5 min, followed by incubation in control medium, irreversibly suppressed lobuloalveolar differentiation. After pre-incubation of mammary glands in control medium for 3 days, the arotinoids no longer suppressed the differentiation of lobuloalveolar structures. Structure-activity relationships of selected retinoids with marked differences in their biological activity were similar to those reported. The mouse mammary gland in whole organ culture may be a suitable and useful bioassay system for selecting retinoids which affect differentiation processes and may thus be helpful in the treatment of oncological diseases. PMID- 3521928 TI - Synthesis and mutagenicity of 3,3'-dihalogenated benzidines. AB - 3,3'-Difluorobenzidine (F2Bz), and 3,3'-dibromobenzidine (Br2Bz) were synthesized and compared with 3,3'-dichlorobenzidine (Cl2Bz) for ability to revert Salmonella typhimurium. The relative mutagenicities in all systems are Cl2Bz approximately equal to Br2Bz greater than F2Bz greater than Bz. F2Bz, Cl2Bz, and Br2Bz are direct-acting mutagens towards S. typhimurium strain TA98. The acetylase deficient derivative TA98/1,8-DNP6 displays no resistance to induction of mutagenesis by these compounds, in the absence of mammalian activation. With addition of hamster hepatic S-9 activation the mutagenicity of these compounds increases greatly. TA98/1,8-DNP6 shows some resistance to this mutagenicity. Multiple mechanisms must exist for the genotoxicity of 3,3'-dihalogenated benzidines. PMID- 3521929 TI - Potentiated cardiodepressant effect of serum by endotoxin in adrenalectomized rats. AB - We have previously shown that in intact rats (IT) a sublethal and nonhypotensive dose (2 mg/kg IV) of Escherichia coli endotoxin was able to induce the early and sustained release of a lipid-soluble cardiodepressant factor, decreasing contractility of cultured rat heart cells by about 35%. As a humoral mediation may also be envisaged in cardiac dysfunction observed by other investigators in adrenal insufficiency, this study was designed to assess serum cardiodepressant effects of endotoxin in 6-10-day, saline-maintained, adrenalectomized rats (ADX). In ADX 2 mg/kg endotoxin caused severe hypotension and 100% lethality within the first 90 min. To obtain in ADX a depressant effect of serum on cultured heart cells fairly similar to that observed in IT, it was necessary to reduce the endotoxin dose by about 200 times (0.01 mg/kg). The latter proved sublethal and nonhypotensive in ADX and was without depressant effect of serum in IT. Serum from ADX (no endotoxin) induced a slight but significant decrease by about 9% in cultured heart cell contractility when compared to serum from IT or sham-operated controls. These data show that adrenalectomy confers a cardiodepressant effect on rat serum and potentiates the release of endotoxin-induced cardiodepressant substance(s) without relation to systemic hypotension. PMID- 3521930 TI - Metabolic effects of sodium dichloroacetate in endotoxemic minipigs. AB - Lactic acidosis is significant in the pathophysiology of endotoxicosis. By increasing the activity of pyruvate dehydrogenase, sodium dichloroacetate (DCA) decreases lactate production and may be useful as a therapy for endotoxic shock. Five (n = 5) 50-80-kg Yucatan minipigs were fitted with jugular, portal, hepatic vein, and carotid artery catheters, and hepatic artery and portal vein flow cuffs to quantitate transhepatic kinetics of glucose, lactate, and insulin. Three days later, they were placed in slings, and a primed-continuous intravenous infusion of 3-tritiated glucose was initiated to monitor whole body glucose kinetics. Following a 3-hour control period, an intravenous infusion of E. coli endotoxin (LPS) was administered at 15 micrograms/kg/hr for 6 hours. After 1 hour of LPS infusion, DCA was administered as a primed (30 mg/kg)-continuous (30 mg/kg/hr) intravenous infusion for 5 hours. These DCA-treated endotoxemic minipigs (group DE) were compared statistically to a group (n = 8) of minipigs given endotoxin only (group E). Group DE arterial lactate concentrations eventually decreased (19.2 +/- 1.0 mg/dl) significantly (P less than or equal to 0.05) below group E (39.3 +/- 7.7 mg/dl) in the last hour of DCA infusion. The progressive hypoglycemia of group DE decreased below that of group E and became significantly (P less than or equal to 0.05) lower in the last hour of the experiment (33.6 +/- 11.5 vs 50.6 +/- 10.0 mg/dl, respectively) due to decreased hepatic gluconeogenesis as evidenced by a lower relative rate of appearance (%Ra) of glucose and decreased hepatic glucose output and lactate extraction. A large relative decrease in pancreatic output of insulin in group DE contributed to the lower serum insulin levels than group E throughout the treatment period. Lethality in group DE (60%) was unaltered from that of group E (67%). Despite its ability to decrease arterial lactate concentrations, DCA alone does not appear to be an effective treatment for endotoxicosis. PMID- 3521931 TI - Increased survival with calcium antagonists in antibiotic-treated bacteremia. AB - This study was done to test the effectiveness of calcium antagonists on survival in a bacteremic model. Swiss albino mice were injected intraperitoneally with live Escherichia coli at an LD90 dose. When antibiotic treatment was delayed for 3 hr after E coli challenge, there was a mortality range of 30-50% for the gentamicin-treated mice and 40-60% for the cefoxitin-treated mice. A calcium antagonist, either nifedipine or verapamil, was added to this model in different dosages and at different time intervals. Nifedipine yielded a significantly lower mortality both with gentamicin and with cefoxitin. Verapamil did not affect mortality with cefoxitin but did improve survival with gentamicin. Effective dosages occur within a narrow range. The results are encouraging and call for further studies with calcium antagonists to ascertain their prospective usefulness as additives to septic shock treatment. PMID- 3521932 TI - Metabolism after trauma and in sepsis. PMID- 3521933 TI - An epilogue on the editorship. PMID- 3521934 TI - Role of the renin-angiotensin system in the control of vasopressin secretion in conscious dogs. AB - The present studies were designed to evaluate the physiological significance of angiotensin II in the control of vasopressin secretion in conscious dogs. They demonstrated that exogenous angiotensin II (10 ng/kg per min) increased vasopressin secretion more when the pressor effect of angiotensin II was abolished. The fact that endogenous angiotensin II levels are normally increased without an increase in arterial pressure suggests that angiotensin II may play a greater role in the control of vasopressin secretion than was previously thought. The present study also evaluated the role of endogenous angiotensin II in the control of vasopressin secretion during sodium depletion, a state in which angiotensin II levels are elevated. Intracarotid infusion of a low dose of the angiotensin II antagonist, saralasin, decreased plasma vasopressin concentration, suggesting that endogenous angiotensin II acts in an area of the brain perfused by the carotid arteries to stimulate vasopressin secretion in sodium-deprived dogs. Finally, the present experiments evaluated the role of angiotensin II in baroreceptor reflex control of vasopressin secretion. Baroreflex function was assessed by examining the relationship between the change in blood pressure and the log of the change in vasopressin secretion over a range of blood pressure levels. Exogenous angiotensin II (10 ng/kg per min) altered baroreflex function by causing a shift of this relationship to a higher pressure level in sodium replete dogs. In sodium-depleted dogs, inhibition of the renin-angiotensin system with saralasin or captopril produced an opposite shift. These results suggest that endogenous angiotensin II may be necessary for the maintenance of normal baroreflex control of vasopressin secretion during sodium depletion. Collectively, these results support the hypothesis that endogenous angiotensin II plays a role in the control of vasopressin secretion. PMID- 3521936 TI - Wrap it to go. Treat lab cases with tender loving care. PMID- 3521935 TI - Decreased basal cardiac interstitial norepinephrine release after neuronal uptake inhibition in dogs. AB - The effect of neuronal uptake inhibition on basal interstitial release of norepinephrine in the canine heart was examined by use of the multiple tracer dilution-bulk balance technique. A kinetic model incorporating the effects of flow, capillary permeability-surface product for norepinephrine, the interstitial uptake rate constant for neurotransmitter, and plasma norepinephrine input and output values was used to estimate rates of uptake from and release of norepinephrine into the interstitial space. The intravenous injection of the neuronal uptake inhibitor desipramine in anesthetized dogs under basal conditions reduced interstitial uptake of tracer norepinephrine in the heart, without significant changes in plasma concentration of norepinephrine in aorta and coronary sinus. The lack of change in the arteriovenous balance for norepinephrine across the heart, in the face of the lowered uptake for this amine, suggested that the liberation of norepinephrine by cardiac sympathetic fibers was reduced. Analysis of the data with the norepinephrine tracer kinetic bulk model showed that, after desipramine, the interstitial release of norepinephrine was reduced to the same extent as uptake was diminished. As a result, the concentration of norepinephrine in the extracellular space of the heart did not increase significantly. The findings indicate the presence of a presynaptic neuronal feedback inhibition of release, which serves to fine tune the myocardial interstitial concentration of norepinephrine in the basal state; with this, after desipramine, both norepinephrine uptake and release are correspondingly diminished. PMID- 3521937 TI - Milk intolerance in children. PMID- 3521938 TI - The great debate: immunotherapy and asthma. PMID- 3521940 TI - Immunoassays for low concentrations of albumin in urine. AB - We have developed and validated simple, rapid immunoassays to measure concentrations of albumin in urine ranging from 5 to 200 mg/L. We use antiserum to human albumin, raised in sheep, and we separate the antibody-bound and free fractions of albumin by using a second antiserum, produced in donkeys, against the Fc fragment of sheep IgG. These two antisera can be mixed and added to assay tubes as a single reagent without inhibiting antigen binding. Samples or standards are incubated for at least 30 min with fluorescein-labeled albumin and the premixed antiserum reagent. After brief centrifugation, the supernate is discarded and the precipitate containing the bound fraction is dissolved and its fluorescence measured. Alternatively, 125I-labeled albumin can be used as tracer with all other reagents unchanged; in this case one simply counts the radioactivity of the bound fraction. A reference interval of less than 0.2-2.8 mg/mmol of creatinine was obtained for untimed, daytime, midstream urine specimens from 80 healthy subjects. PMID- 3521939 TI - The porphyrias: recent advances. AB - Recent research has elucidated several of the hitherto poorly understood steps in heme synthesis. This review describes this metabolic pathway and pinpoints the enzymatic blockages in the various porphyrias. Recent advances in the understanding of the etiology of porphyria cutanea tarda are discussed, as are the abnormalities of porphyrin metabolism seen in chronic renal failure and in lead poisoning. An outline is given of the clinical and biochemical abnormalities seen in the porphyrias. Included is an algorithm to aid in the differential diagnosis of these diseases, and a brief review of the new analytical techniques available for the identification and quantification of porphyrins and their precursors in body fluids. PMID- 3521941 TI - Calculating unknown concentrations from nonlinear standard curves. AB - We describe an algorithm and program for calculating unknown concentration values from nonlinear standard data. The program was developed as an alternative to current data-handling techniques used for therapeutic drug enzyme immunoassay (EMIT) systems. The shape of the standard curve for a given analyte is required to be stable through the lifetime of a reagent lot. The relationship between the net change in milliabsorbance and the natural log of standard concentration is linearized once for each lot of reagents. For each subsequent time the assay is performed, one corrects the individual standard points by using the linearized relationship. Unknown concentrations are then calculated by using quadratic Lagrangian interpolation. The algorithm is faster and simpler than curve-fitting by nonlinear least squares, gives comparable results for unknowns, and rejects fewer assays for poor curve fit. PMID- 3521943 TI - A competitive immunoenzymometric assay for albumin in urine. AB - I describe a competitive immunoenzymometric assay for urinary albumin, with use of an immobilized albumin-thyroglobulin conjugate and an affinity-purified antibody. The assay is rapid, easy to perform, has a range of 0.5 to 78 mg/L, and is ideally suited for screening purposes. Higher concentrations may be assayed by further dilution of the urine sample. Results compare favorably with those of a commercially available radioimmunoassay kit. PMID- 3521942 TI - Laser-excited immunofluorometric assay of prolactin, with use of antibodies coupled to lanthanide-labeled diethylenetriaminepentaacetic acid. AB - We describe an immunofluorometric assay for prolactin based on lanthanide labeling of a monoclonal antibody and measuring time-resolved fluorescence. In this "sandwich"-type assay, the label (Eu3+) was bound to the second antibody by means of a simple, rapid method involving the anhydride of diethylenetriaminepentaacetic acid. To measure the photoluminescence of europium (or other lanthanides), we have developed a time-resolved fluorometer with a nitrogen laser as the pulsed excitation source. During the assay, the solid-phase antibody immobilized inside a polystyrene tube is incubated with the plasma sample and the second antibody in a one-step procedure. Results for 67 human plasmas correlated well (r = 0.98) with those by an immunoradiometric method. PMID- 3521944 TI - An optimized method for measuring cyclosporin A with 125I-labeled cyclosporin. AB - We evaluated the use of the new iodinated ligand for the in vitro measurement of cyclosporin A by radioimmunoassay (RIA). Substitution of the iodinated cyclosporin (125I-CyA) for the corresponding tritium-labeled analog (3H-CyA) considerably simplifies and accelerates the currently available RIA, and improves its precision. Analysis of the respective dose-response curves showed that the 50% B0 value was lower for the 125I-CyA assay than for the 3H-CyA assay (37 vs 77 micrograms/L). Use of whole-blood specimens minimized interferences from temperature and hematocrit. We conclude that the use of 125I-CyA in a commercially available RIA for whole-blood specimens is accessible to most laboratories and provides rapid, reproducible data for management of transplant patients. PMID- 3521945 TI - Rapid enzymatic pretreatment of samples before determining chromium in serum or plasma. AB - A simplified method for preparing blood serum and plasma for Zeeman electrothermal atomic absorption spectrometry is described and applied to the measurement of chromium in human serum and plasma. This enzymatic degradation with bacterial protease (EC 3.4.21.3) requires little laboratory apparatus, decreases the work and time of sample preparation, and obviates some potential sources of contamination. We used bovine reference serum (USDA No. 7292) to validate Cr concentration. There was less Cr in serum than in plasma, whether sodium heparin or sodium citrate was used as anticoagulant. For six human subjects, Cr in serum averaged 0.15 (SD 0.02) micrograms/L, 0.26 (SD 0.03) micrograms/L in heparinized plasma, and 0.28 (SD 0.02) micrograms/L in citrated plasma. We postulate that the Cr concentration is lower in serum because some of the Cr binds to proteins complexed with the clot in the coagulation process. PMID- 3521946 TI - Evaluation of the Hybritech Photon Analyzer and of an improved procedure for choriogonadotropin in serum. AB - We evaluated the Hybritech Photon Analyzer for its applicability to enzyme immunoassays. This instrument measures absorbances only at 405, 450, and 490 nm. Photometric linearity was good at all three wavelengths. However, the true absorbance range at these wavelengths was 0-1.6 A instead of 0-2.0 A as specified by the manufacturer. We also evaluated the Hybritech "Tandem-E" method for quantifying choriogonadotropin (hCG) in serum. A modification of the recommended procedure improved the precision of the assay. The detection limit of the modified procedure, 1 int. unit/L, permits reliable assays of hCG at concentrations near the upper limit of normal (3 int. units/L). Results by both procedures varied linearly with hCG concentrations up to 250 int. units/L. The Photon Analyzer eliminates the need for manual calculations. Quantitative results agree within +/- 1% with those measured in the "Stasar III" spectrophotometer. PMID- 3521947 TI - False increases in serum creatine kinase MB isoenzyme detected in two patients by the Behring CK-MB quantitative immunometric assay. PMID- 3521948 TI - Discrepancies in digoxin results between two fluorescence immunoassays. PMID- 3521949 TI - Two rapid, sensitive, and specific immunoenzymatic assays of human choriogonadotropin in urine evaluated. PMID- 3521950 TI - Sensitive quantitation of carcinoembryonic antigen in cerebrospinal fluid and its barrier-dependent differentiation. AB - Modification of an enzyme immunoassay using beads as solid phase allows the detection of 3 pg/ml carcinoembryonic antigen (CEA). The beads are shown to be advantageous for the extraction of proteins in highly diluted antigen solutions thus replacing a need for concentration of the sample. The mean concentration of CEA in pooled cerebrospinal fluid (CSF) from 120 control persons was shown to be 2.7 pg/ml. The mean of the CSF/serum concentration quotients of CEA was 0.0015 for normal blood CSF barrier function with a corresponding mean albumin CSF/serum quotient of 0.0048. From the ratio of these two quotients (QCEA/QA = 0.31) and the corresponding biological variation we constructed the normal range of an evaluation graph. In the range of a blood CSF barrier dysfunction, the discrimination line between values with or without a local CEA synthesis in brain was determined to be QCEA = 0.7 QA. Twenty-five out of 383 control persons and 29 out of 45 patients with a tumor metastasis had evaluable quotients. The evaluation graph had a high significance with respect to the identification of tumor metastasis: from a group of patients with a confirmed leptomeningeal metastasis 13 out of 13 and from a group of patients with intraparenchymatous tumor metastasis 10 out of 16 could be identified by CSF analysis. The CEA CSF/serum concentration quotient fits well in the concept of a molecular size dependent filter function of the blood CSF barrier. PMID- 3521952 TI - Serum calcium status in health and disease: a comparison of measured and derived parameters. AB - The relationship of serum ionised calcium to total calcium was investigated in three series of experiments, each using different ion-selective electrodes. In the first, total and ionised calcium were measured in healthy and patient groups to compare the predictive value of each estimation. In the second and third studies, measured ionised calcium was compared with ionised calcium calculated using 5 different formulae, and with total calcium, both uncorrected, and adjusted for varying protein content using eight formulae. In 144 of 149 healthy subjects, serum ionised calcium and total calcium were normal. There were discrepancies between serum ionised calcium and total calcium in 135 of 572 patients with conditions associated with abnormal calcium metabolism. Correction of total calcium, or calculation of ionised calcium did not significantly improve this figure. Thus, corrected or derived calcium values will not substitute for ionised calcium determination in patients with abnormal calcium metabolism. PMID- 3521951 TI - Changes in fatty acid profiles of plasma, erythrocytes and polymorphonuclear leukocytes in induced hypothyroidism in man: indirect evidence for altered delta 6 desaturase activity. AB - Thirteen patients who were athyreotic as a consequence of ablation treatment for well-differentiated thyroid cancer were studied during triiodothyronine supplementation, and subsequently at the end of a two weeks withdrawal of this medication. Serum and plasma lipid concentrations, erythrocyte cholesterol content and plasma and erythrocyte total fatty acid patterns were measured. In addition, total fatty acid profiles of polymorphonuclear leukocytes of eight patients and scanning electron microscopic studies of erythrocytes of nine patients were made. We observed an increase of the serum concentrations of total and unesterified cholesterol and phospholipids in all patients. Except for two, all patients showed an increase in the serum triglyceride concentration. The relative amounts of 18:2c,omega 6 rose and those of 20:3c,omega 6 fell in all studied compartments. In addition, the relative amounts of all other omega 6 fatty acids, 22:6c,omega 3, 20:3c,omega 9, 16:0, 18:0, and total saturated fatty acids decreased in plasma, whereas the levels of all monounsaturated fatty acids increased in the erythrocytes. The level of 20:3c,omega 9 rose in the erythrocytes and the 20:3c,omega 9/20:4c,omega 6 ratio rose in the polymorphonuclear leukocytes. The erythrocyte total fatty acids and cholesterol content and their ratio did not change, nor was any alteration seen in the red cell morphology by scanning electron microscopy. This study reveals that the induction of hypothyroidism in man changes fatty acid patterns of plasma, erythrocytes and polymorphonuclear leukocytes. The nature of these alterations suggests especially a disturbance in the delta 6 desaturase activity. The data point to the possibility of a derangement of eicosanoid synthesis in hypothyroidism. PMID- 3521953 TI - Diurnal patterns of blood pressure, heart rate and vasoactive hormones in normal man. AB - In order to determine arterial pressure and vasoactive hormone relationships in normotensive man, we measured intra-arterial pressure continuously along with hourly venous hormone levels (renin, angiotensin II, aldosterone and catecholamines) for 24 hours in 5 healthy volunteers under standardized conditions. Mean 24-hour levels of intra-arterial pressure 106/63 +/- 5.4/4.9 mmHg were much lower than in patients with mild essential hypertension studied earlier. A common diurnal pattern was seen for plasma renin, angiotensin II, and catecholamines, with higher levels in the day time and lower levels at night. Aldosterone levels however, paralleled those of cortisol at night. Plasma norepinephrine levels showed close, positive correlations with arterial pressure in all volunteers. We conclude that the level of blood pressure as measured continuously over 24 hours is lower than might be expected from regular clinic recordings; that aldosterone regulation is contributed to by ACTH in the nocturnal hours; and that fluctuations in arterial pressure and sympathetic activity over 24 hours are closely coupled. PMID- 3521954 TI - Changing concepts of active androgens in blood. AB - We have provided a brief historical review of developments in our understanding of the endocrine mechanisms underlying the expression of androgen action in women. An alternative to the free hormone concept is considered which proposes that, at least in some target cells, androgens bound to SHBG are the biologically relevant molecules. In nearly every instance, the changes in blood levels of SHBG that have been observed are consistent with this idea. At present there are only bits of direct evidence to support the hypothetical mechanism proposed. As already mentioned, control of androgen action at the level of cellular uptake would provide obvious advantages as well as a potential mechanism to explain the antagonism between androgens and oestrogens which is still a mystery. It is important to note that the proposed mechanism is not obligatory for androgen or other steroid hormone action. Synthetic steroids which do not bind to SHBG or CBG clearly can gain access to target cells by simple diffusion and bind to intracellular receptors. Compounds such as methyltestosterone and dexamethasone are metabolized much more slowly than their natural counterparts and therefore are cleared slowly from the circulation. It is possible that the well-known difficulties in selecting appropriate therapeutic regimens with such compounds is related to the fact that they bypass an important regulatory step in steroid hormone action-modulated entry into target cells. Hopefully, the recent development of powerful new tools of molecular endocrinology will hasten the answer to the question: What is the active androgen in blood? PMID- 3521955 TI - Serum bioavailability of sex steroid hormones. AB - This chapter has reviewed the factors underlying the transport of testosterone and oestradiol into tissues in vivo. The following points have been emphasized. Albumin-bound testosterone is nearly freely available for transport into brain and liver and is partially available for transport into salivary gland and lymph node; testosterone transport into hair follicles has not been measured thus far. SHBG-bound testosterone is not available for transport into tissues; SHBG-bound oestradiol is available for transport into liver, salivary gland, and lymph node, bug not into brain under normal conditions. The transport of hormone from the circulating plasma protein-bound pool involves tissue-mediated enhanced dissociation of the hormone from the protein without significant exodus of the plasma protein from the microcirculation compartment. The tissue-mediated enhanced dissociation mechanism varies in activity between different organs and is a much more important factor than organ differences in capillary transit times in regulating the amplification of hormone delivery to different tissues. The concentration of free testosterone inside cells in the absence of significant cellular metabolism of the hormone is nearly ten times greater than the concentration of free testosterone in vitro, but is nearly equal to the concentration of free plus albumin-bound hormone. In the presence of active tissue metabolism of hormone, the concentration of cellular free testosterone may be much less than the albumin-bound hormone and may fortuitously approximate the concentration of free testosterone in vitro. This is the situation in salivary gland; the low concentration of testosterone in saliva appears to be due to active salivary metabolism of the hormone, since both free and albumin-bound testosterone are available for transport into salivary gland. PMID- 3521956 TI - Dihydrotestosterone metabolism. PMID- 3521957 TI - Peripheral androgens and the role of androstanediol glucuronide. PMID- 3521958 TI - Hair follicles and associated glands as androgen targets. AB - The growth of hair, except that on the scalp, and the secretion of sebum are, in general, under the major influence of androgens. However, the responses of the hair follicles and their associated glands vary greatly between sites and between individuals. On the face, trunk and extremities the most important role of testosterone is to increase the period of activity, the anagen phase, of the hair follicle, though it also increases the rate of growth, thickness, extent of medullation and pigmentation of the hair. These effects involve high levels of hormone and its conversion to 5 alpha-dihydrotestosterone in the target organ. In contrast, the lower pubic triangle develops luxuriantly even in absence of 5 alpha-reductase. In the sebaceous glands, cell replication and lipid synthesis do not seem to be identically controlled, since they respond differently to inhibitors. The response of the sebaceous glands to androgens involves the interaction at the target site of pituitary factors, for which growth hormone, prolactin, and melanocyte stimulating hormone are all putative candidates. The most important scientific and clinical question is whether, in any particular circumstances, the degree of response of the hair follicles or sebaceous glands is determined by the level of available androgen or by the sensitivity of the target organ. While it is true that some patients with hirsutism or acne have above normal levels of plasma androgens or below normal levels of SHBG, a substantial proportion are normal in all respects. Moreover, the rates of hair growth on the extremities or of sebum excretion on the forehead do not seem to be correlated either positively with plasma androgens or negatively with SHBG, though they each have been shown to be correlated with circulating 5 alpha dihydrotestosterone. The conclusion must be that, although male-type hair growth and high sebaceous secretion may be caused by, or at least accompanied by, high levels of free testosterone, the critical factor is more likely to be the peripheral response. PMID- 3521959 TI - Treatment of hirsutism with 5 alpha-reductase inhibitors. AB - Much os the evidence gathered from studies of 5 alpha-reductase activity levels and androgen metabolism in the skin of hirsute women and the excretion of androgen metabolites by hirsute women indicates that 5 alpha-reduced androgens are probably of primary importance in hirsutism. Unfortunately, until very recently, the lack of a suitable 5 alpha-reductase inhibitor made it very difficult to adequately test the hypothesis that such an inhibitor might be useful in the treatment of hirsutism and certain other androgen-related diseases. No substance was available which had good, unambiguous activity in vivo as a 5 alpha-reductase inhibitor. A number of 4-azasteroids have now been found to possess excellent 5 alpha-reductase inhibitory activity both in vitro and in vivo. Among other properties, several of these compounds show little or no affinity for the androgen receptor of rat prostate cytosol, they attenuate the growth promoting effect of T, but not DHT, on the ventral prostate of castrated male rats, they cause a marked reduction in prostatic DHT concentration in acutely treated rats and dogs and they bring about a significant decline in prostate size in chronically treated rats and dogs. It is expected that, in the near future, one or more of these highly active 5 alpha-reductase inhibitors will be tested in the clinic as a treatment for hirsutism. The results of those studies will be awaited with a great deal of interest since they should considerably advance our understanding of this disease and possibly contribute to its control. PMID- 3521960 TI - Measurement of hair growth. PMID- 3521961 TI - The distribution and quantification of the Langerhans cell in normal human epidermis. PMID- 3521962 TI - Daniel Turner, and the first controlled therapeutic trial in dermatology. PMID- 3521963 TI - Verapamil-induced secretion of active and inactive renin in conscious sheep. AB - Regulation of plasma active and inactive renin was investigated using conscious sheep with indwelling artery, vein and bladder catheters. Control and experimental studies were carried out in the same animals on different days. The calcium antagonist drug verapamil was given as an initial bolus injection (0.5 mg/kg) followed by a continuous infusion (0.1 mg/kg per h) over a 2.5 h period. Plasma active and inactive renin changed in parallel. Both were significantly increased within 15 min of the initial drug dose and both attained a peak increase after 45 min. Thereafter, the two forms of renin returned to basal levels despite continued infusion of the drug. Effective renal plasma flow (CPAH) was also transiently increased by verapamil and followed a similar time course to changes in plasma active and inactive renin concentration. Arterial blood pressure, however, remained suppressed by verapamil for the duration of the study. Verapamil did not alter urine flow or sodium and potassium excretion rates. These results are discussed in relation to the possible link between intrarenal haemodynamics and renin secretion in conscious and in anaesthetized animals and also in relation to the concept that variation in the relative amounts of active and inactive renin secreted in differing physiological situations represents a mechanism for regulating the renin-angiotensin system. PMID- 3521964 TI - Effects of captopril on the sleep EEG of spontaneously hypertensive rats. AB - Intracerebroventricular captopril produces significantly different effects on the sleep electroencephalogram (EEG) of normotensive Wistar-Kyoto (WK) and spontaneously hypertensive rats (SHR). The compound produces a definite pattern of decrease in the percentage and power of the lower frequency EEG of the SHR. Corresponding action on the WK was confined to a general decrease in the power of the EEG. These findings suggest that certain components of the central renin angiotensin system in the SHR are abnormal. PMID- 3521965 TI - Environmental control in management of immunodeficient patients: experience with "David". AB - Environmental control in managing patients with immunodeficiency ranges from the exceedingly complex to the relatively simple. At one end of the spectrum is the total isolation technology applied to David, the "Bubble Boy" who lived his entire life behind sterile plastic barriers. At the other end of the spectrum is the simpler technology applied to patients receiving bone marrow transplants who are maintained in ordinary private hospital rooms and attended by personnel who merely observe handwashing precautions. Most properly performed and controlled studies of the use of special isolation procedures to reduce infections derive from patients receiving bone marrow transplants for conditions of aplastic anemia and leukemia or patients receiving chemotherapy for malignancy. The design of isolation procedures for immunodeficient patients borrows from these studies because of the relatively small number of immunodeficient patients. These studies have shown that laminar airflow rooms produce a significantly lower incidence of infections but may not change the mortality of all patients. Also, protective isolation has clearly reduced the incidence and severity of graft-versus-host disease in transplanted patients with aplastic anemia. Recently there has been a trend away from strict isolation procedures because careful studies have indicated that host rather than acquired pathogens are responsible for at least 85% of infections in these special patients. Also, the human stress of prolonged isolation is becoming increasingly recognized. The complex and expensive isolation techniques that were used in David's case are no longer being utilized in immunodeficient subjects, partly because new transplantation technology has made it possible to cross histocompatibility barriers, obviating the need for permanent isolation. PMID- 3521966 TI - Reconstitution of T-cell deficiency by thymic hormone or thymus transplantation therapy. AB - Correction of T-cell defects by either thymic hormone treatment or thymus transplantation has proven to be more difficult clinically than historically anticipated. Because the precise action of thymic hormones is unknown and because these hormones act upon post-thymic cells, therapeutic attempts may fail owing to lack of sufficient substrate population. Results of thymic transplantation suggest that this procedure may be best utilized for the treatment of mild T-cell defects, rather than as complete replacement treatment for severe deficiency. Future clinical trials of thymic transplantation or thymic hormone appear justified in narrowly circumscribed and well-characterized conditions. PMID- 3521967 TI - Antibody-treated bone marrow transplantation for patients with severe combined immune deficiency. AB - Histocompatible bone marrow transplantation is the treatment of choice for patients with severe combined immunodeficiency (SCID). Patients without histocompatible donors have been treated with a variety of nontransplant therapies; however, normal immunocompetence has not been achieved. Bone marrow transplantation with untreated histoincompatible bone marrow has resulted in fatal graft-versus-host disease and/or no lymphoid engraftment. Based upon murine experiments, the use of monoclonal antibody- and complement-treated parental bone marrow has been used to successfully transplant SCID patients. Monoclonal antibodies to a variety of T-lymphocyte differentiation antigens (OKT-3, T-12, CT 2, and Leu-1) have been used. The antibody-treated transplants differ in several important respects from histocompatible transplants for SCID. Many recipients for treated marrow grafts require immunosuppression. In certain cases, hematopoietic stem cell ablation with total body irradiation (TBI) or busulfan has been required to achieve stable lymphoid engraftment although the biological basis for the requirement for hematopoietic stem cell elimination is unclear. The use of antibody-treated parental bone marrow is the most effective form of therapy for patients with SCID who do not have a histocompatible donor. PMID- 3521968 TI - Molecular genetics and potential gene therapy. AB - Contemporary molecular techniques including gene cloning, DNA sequencing, and gene transfer permit precise and comprehensive analysis of genetic disorders. For example, the molecular basis of hemoglobin synthesis disorders (the thalassemias) can now be ascribed to more than 30 different specific mutations. These affect virtually all aspects of gene expression. The more recent capacity to reintroduce cloned genes into mammalian cells in a functional form has raised the prospect of gene therapy, that is, the replacement of an abnormal gene with its normal counterpart or merely the introduction of a normal gene into a cell containing a defective copy. Genetic correction of enzyme-deficiency disorders whose effects are manifest in bone-marrow-derived cells seems most likely to be amenable to "somatic" (as opposed to germ line) gene therapy. Treatment of severe combined immunodeficiency due to adenosine deaminase (ADA) deficiency may be a suitable model for this approach. This report will review the molecular genetics of ADA, the methods by which ADA gene sequences may be transferred into various cells, and goals for current and future research. PMID- 3521969 TI - Ontogeny of B cells and pathogenesis of humoral immunodeficiencies. AB - Studies of B-cell ontogeny have played an important role in furthering our understanding of the pathogenesis of immunodeficiencies. Development of clonal diversity for both T and B cells begins during the first trimester and is far advanced by midgestation. Fetal and neonatal B cells have a limited capacity to express IgG and IgA antibody responses, although precursors expressing these immunoglobulin classes are present. T-and B-cell interactions in the neonate are dominated by suppression. T helper cells are present and functional, but their capacity to drive IgG and IgA responses is impaired. This paper will review the major steps in ontogenetic development of B cells and the functions associated with each differentiation stage. Possible pathogenetic mechanisms of several humoral immunodeficiency diseases are reviewed from the perspective of the normal progression of B-cell differentiation. PMID- 3521970 TI - Phagocytic defects--monocytes/macrophages. AB - Mononuclear phagocytes originate from stem cells in the bone marrow which differentiate from monoblasts into promonocytes, then into circulating blood monocytes. Subsequently the monocytes can develop into macrophages and reside in a variety of tissues. Mononuclear phagocytes have cell surface receptors for a variety of substances (e.g., IgG, complement components, fibronectin, and sugars) and are capable of secreting a number of mediators (enzymes, complement components, coagulation components, and monokines). The tissue macrophages adapt to their environment and express unique differentiated functions that are related to various anatomic sites and organs (e.g., Kupffer cells, pulmonary alveolar macrophages, osteoclasts, microglia). Macrophages have the capacity to become "activated" by both specific and nonspecific immunologic stimuli and the "activated" macrophage has enhanced functional capabilities (e.g., tumoricidal, microbicidal, phagocytosis, secretion of mediators). Abnormal monocyte/macrophage function may be acquired or may be due to genetic or developmental disorders. Because of their central role in host defense (in inflammatory responses, in antigen presentation, and in immunoregulatory networks), monocyte/macrophage dysfunction may result in one or more pathophysiologic consequences: defects in monocyte maturation, deficiencies in the clearance of physiologic substrates in lysosomal diseases (e.g., Gaucher's disease, mucopolysaccharidoses, osteopetrosis, metachromatic leukodystrophy), decreased synthesis and secretion of mediators (complement component deficiencies), defects in microbicidal activity (chronic granulomatous disease) and defects which are acquired following infection and during chemotherapy (e.g., acquired immune deficiency syndrome). PMID- 3521971 TI - Infectious complications of the primary immunodeficiencies. AB - The primary manifestation of the immunodeficiencies is undue susceptibility to infection. This means too many, too severe, too prolonged, too complicated and too unusual infections. Infections in immunodeficiency have a characteristic cause depending on the nature of the immune deficiency. Antibody deficiencies are associated with infections with gram-positive infections. Cellular immune deficiencies are associated with mycobacterial, protozoan, fungus, virus, and opportunistic bacterial infection. Phagocytic disorders are associated with staphylococcal, fungal, and gram-negative organisms. Complement disorders are associated by neisserial infections. Infections have also been implicated in the pathogenesis of some immunodeficiencies in some circumstances. These include human T lymphotropic virus type III (HTLV-III), rubella virus, cytomegalovirus, and Epstein-Barr virus. Several infectious syndromes in specific immunodeficiencies have been identified. Examples include enteric cytopathic human orphan (ECHO) virus encephalitis in agammaglobulinemia, and meningococcal meningitis in C6 deficiency. Infections can also be induced by live vaccines given in immunodeficiency (e.g., paralytic polio in agammaglobulinemia.) Unusual infectious syndromes will be illustrated including parainfluenza infection in severe combined and immunodeficiency, Legionella pneumonia in chronic granulomatous disease, and Cryptosporidium infection in hyper-IgM immunodeficiency. PMID- 3521972 TI - Cartilage hair hypoplasia: immunological aspects and their clinical implications. AB - Cartilage hair hypoplasia (CHH) is an autosomal recessive form of short-limbed dwarfism prevalent among the Old Order Amish. Mild to moderately severe cellular immunodeficiency is associated with this disorder. Antibody synthesis is, however, normal in CHH. Individuals affected with CHH were found to have marked impairment of T-lymphocyte function due to an intrinsic defect in cell proliferation. Defective proliferation was also found in B cells and fibroblasts from CHH individuals suggesting that impaired T-cell function reflects a generalized defect in cell proliferation in this syndrome. Studies of cytotoxic mechanisms in CHH patients revealed that proliferation-dependent mechanisms (e.g., cell-mediated cytotoxicity and natural killer [NK]-like activity) were markedly impaired while proliferation-independent NK activity was normal. In spite of impairment of T-cell function, an increased incidence of malignancy was not observed in CHH patients. These observations suggest that NK activity is vital in host defense against malignancies and that marked impairment of T-cell mediated immunity need not be associated with an increased susceptibility to malignancy if NK function is preserved. PMID- 3521973 TI - Usual interstitial pneumonitis is a T-cell alveolitis. AB - Usual interstitial pneumonitis (UIP) is an idiopathic inflammatory disorder that produces scarring of the lung parenchyma. We studied open-lung biopsies of 13 patients with UIP using immunohistological staining and monoclonal antibodies. T lymphocytes (Leu 4+) accounted for 59% of cells in the alveolar septal infiltrates in UIP and OKT8+ cells accounted for the majority of T lymphocytes in most cases. OKM1+ granulocytes comprised a smaller percentage (14%) of the alveolar infiltrates. Granulocytes were most frequent within cystic airspaces and inflamed small airways. Class II HLA (Ia) antigens were expressed on lymphocytes, macrophages, endothelial cells, and alveolar type II cells in lungs with UIP. This study demonstrates that altered immunoregulatory subsets are present in the lungs of patients with UIP and suggests the possibility that activated T cells may play a role in the pathogenesis of this disorder. PMID- 3521974 TI - Activation of complement by intermediate filaments of glomerular epithelial cells. AB - Glomerular visceral epithelial cells, podocytes, have been shown by immunofluorescence and immunoperoxidase staining methods to bind serum complement (C) components in vitro. Binding of Clq, C4, and C3 was demonstrated and the C4 and C3 binding could be inhibited by EDTA. Thus complement binding had the capacity to cause antibody-independent activation of the "classical" C pathway. The C-binding structures had the same distribution as intermediate filaments (IMFs) of vimentin but not desmin or keratin types. By ultrastructural immunohistochemical staining C3 was observed in association with cytoskeletal IMFs. PMID- 3521975 TI - Serial immunologic studies in recipients of hepatic allografts. AB - Thirty recipients of hepatic allografts had serial immunologic evaluations. Prior to transplant, patients had marked depression of lymphocyte subsets and impaired in vitro immunoglobulin synthesis, while phytohemagglutinin responsiveness was similar to that of controls. Following transplantation and introduction of cyclosporine and low-dose steroid therapy, there was a significant decline in both T cell subsets, but only the T4 population remained significantly depressed throughout the entire study period. The T4:T8 ratio in 5 patients who experienced acute rejection episodes was 1.4 +/- 0.6 prior to transplant. It increased to a mean of 2.0 +/- 0.6 by the time the diagnosis of rejection was made. By contrast, 12 subjects transplanted during a similar time period who did not demonstrate rejection had a T4:T8 ratio of 4.0 +/- 3.9 prior to transplant which fell to 1.5 +/- 0.6 (P less than 0.01) by 1 week post-transplant. In all 12 of these, the T4:T8 ratio fell in the 7 days post-transplant. The results indicate that monitoring the T4:T8 ratio in hepatic allograft recipients may be a useful marker for determining patients at risk for a rejection episode. PMID- 3521976 TI - Photosensitivity and photodermatitis in childhood. AB - Photosensitivity disorders of children are uncommon, except for banal overexposure reactions to sunlight. Although the long-term sequelae of chronic or intense sun exposure are not often seen in children, physicians should advise patients of the harmful effects and irreversible skin damage that results from unduly prolonged sun exposure. Damage accumulates over the years to cause premature aging, senile elastosis, actinic keratoses, and squamous- and basal cell carcinomas. Besides the pigmentary changes, wrinkles, and skin cancers- genuine sources of altered appearance and morbidity--we now know that sunburned children develop a higher incidence of melanoma, which is not a rare cause of death in young adults. In Australia, where the incidence of melanoma is highest, a strong correlation exists for melanoma in children who get sunburn before the age of 10. Also, the incidence of melanoma is 50 times as great in bikini wearers who get sunburn as in girls who wear one-piece bathing suits. PMID- 3521977 TI - Lupus erythematosus in childhood. AB - Lupus erythematosus in childhood comprises the following distinctive lupus subsets: neonatal lupus erythematosus, systemic lupus erythematosus, discoid lupus erythematosus, subacute cutaneous lupus erythematosus, complement deficiency syndromes with subacute cutaneous lupus lesions, and lupus panniculitis. The clinical features and pathogeneses of each of these lupus syndromes is discussed in this review. PMID- 3521978 TI - Significant melanocytic lesions in infancy, childhood, and adolescence. AB - Malignant melanoma is diagnosed yearly in approximately 300 persons under age 20 in the United States. Relatively recent advances in dermatology include the recognition of lesions felt to be potential precursors of malignant melanoma. Small congenital melanocytic nevi, present in 1 per cent of all newborn infants, may have a small but definite potential for developing malignant melanoma. Furthermore, despite inconclusive data, many leading dermatologists now advocate removal of these small congenital lesions. Giant congenital melanocytic nevi, with their strong predilection for undergoing malignant change, are removed surgically at an early age, often in multistaged procedures. Dermabrasion, once felt to have a role in the treatment of giant congenital nevi, does not remove the malignant potential of these lesions. The dysplastic nevus syndrome, recognized in 1976, identifies individuals at increased risk for developing melanoma. Adolescents who have the dysplastic nevus syndrome or who are members of families with the syndrome require close medical supervision and patient education. The benign Spitz nevus, with its histologic similarity to malignant melanoma, continues to challenge the dermatopathologist and clinician. These lesions--the Spitz nevus, dysplastic nevus, congenital melanocytic nevus, and malignant melanoma--must all be actively considered when regarding the many other benign melanocytic lesions found in infancy, childhood, and adolescence. PMID- 3521979 TI - Bacterial and candidal cutaneous infections in the neonate. AB - The skin and oral cavity of the neonate are colonized by a variety of organisms during the first few days of life. Some of these organisms constitute normal flora, but others are true pathogens or are capable of pathogenicity when host or environmental factors are altered in their favor. Cutaneous bacterial and yeast infections that afflict the newborn are discussed in terms of clinical presentation, laboratory evaluation, and appropriate management. PMID- 3521980 TI - An allergist's view of atopic dermatitis. AB - Based on the disagreements about the role of atopy in the condition known as atopic dermatitis, it is not surprising that there have been divergent views concerning the appropriate treatment of the disease. A large population of physicians, including most dermatologists and some allergists, believe that the fundamental approach to a successful outcome of the dermatitis is to control the itching and to improve the chronic dryness of the skin. Following a completely different approach are physicians, including many allergists, who are convinced that atopic dermatitis usually involves an imbalance of, or an abnormality in, the immunologic system. For this group, one of the main features of treatment is to remove or avoid offending allergens. Because of the demonstrated pathogenic role of food allergy in the majority of patients with eczema, any child with chronic moderate or severe disease that requires daily medications should be considered for allergic evaluation of this disorder. Further studies still need to be performed concerning the role of environmental and food allergens and the early- and late-phase reactions in atopic dermatitis. PMID- 3521981 TI - The biologic basis of the ichthyoses. AB - The ichthyoses, a heterogeneous group of disorders characterized by scaling, have become an unexpectedly rich source of information on normal epidermal biology and cell cohesion and dishesion. In spite of recent success with systemic retinoid therapy, the ichthyoses remain a challenging problem concerning treatment. Nosology and classification are unfinished, and the analysis of biochemical abnormalities promises a refinement in diagnosis. PMID- 3521982 TI - Bullous diseases of childhood. AB - Although the bullous diseases of childhood are rare, their differential diagnosis is vast. A logical approach to these disorders exists, and a careful history and examination of a patient will usually lead to a correct diagnosis. Confirmation of this diagnosis may depend on sophisticated laboratory procedures including immunofluorescence, electron microscopy, and tissue culture. This article reviews the clinical features, ultrastructural findings, and treatment of the various inherited forms of epidermolysis bullosa and the acquired bullous diseases, including chronic bullous disease of childhood, dermatitis herpetiformis, bullous pemphigoid, and pemphigus. PMID- 3521983 TI - Mechanisms of biologic aging. AB - The authors outline the progression of thought on the mechanism of the aging process, giving emphasis to environmental factors that influence genetic events. Discussion is limited to those theories that explain fundamental causes of aging and have a firm thermodynamic basis. The authors propose that the cumulative result of continual oxidative stress and other thermodynamic processes (such as amino-acid racemization and nonenzymatic glycosylation), resulting in altered function and increasing the net entropy of living systems, governs the rate of the aging process. PMID- 3521984 TI - Morphology of aged skin. AB - Despite an overall thinning of the epidermis and focal areas of cytologic atypia, there was no morphologic evidence that the protective function of this tissue was compromised by age. The characteristic morphologic markers associated with the keratinization process were not altered either in appearance or in amounts. A well-formed stratum corneum was present, suggestive that barrier ability is not compromised in senile skin. Whereas alterations in the aged epidermis are slight, the dermal-epidermal changes are marked and have greater physiologic consequences. The major change is a relatively flat dermal-epidermal junction because of retraction of the epidermal papillae as well as the microprojections of basal cells into the dermis. This flattening results in a more fragile tissue less resistant to shearing forces. Retraction of the epidermal downgrowths may also explain the loss in proliferative capacity associated with the aged epidermis. The major alterations in the aged dermis concern the architecture of the collagen and elastin networks. Both fibrous components appear more compact because of a decrease in the voids or spaces between the fibers; the spaces resulted from a loss of ground substance. Collagen bundles appear to unravel, and the individual elastic fibers show signs of elastolysis. The net effect of these fibrous rearrangements and alterations is a dermis that is less stretchable, less resilient, more lax, and prone to wrinkling. PMID- 3521985 TI - Elastic fiber and microvascular abnormalities in aging skin. AB - In summary, the aging process in skin has at least two major manifestations: elastic fiber abnormalities involving degradation and assembly, and microvascular wall alterations of widening and atrophy depending upon the functional state of the veil cell. The abnormalities of the elastic fiber network most likely correlate with the increasing cutaneous laxity associated with aging. The microvascular abnormalities are not easily related to any specific clinical feature of aging skin. The finding of identical abnormalities in the skin of juvenile diabetics strengthens this hypothesis, as well as suggesting that these alterations are accelerated in diabetic patients. Diabetic skin might be another model system for studying cutaneous aging. PMID- 3521986 TI - The lives of pigment cells. AB - Most pigment cells during embryogenesis arise from the cranial or truncal portion of the neural crest and migrate to the skin, hair bulbs, choroid of the eye, the inner ear, leptomeninges, and other tissues. Cells of the retinal pigment epithelium come from a different source, namely, the primitive forebrain, and are involved in the formation of the retina and the optic nerves and tracts. Most pigment cells in all parts of the body seem to be constant in number and function until approximately middle age (the fourth or fifth decade of life). Thereafter, the number of melanocytes in the skin, hair, and eyes and the number of nevi begin to decrease. One function of pigment cells may be to eradicate oxygen radicals that are responsible in part for inducing malignancies and are also involved in the aging process. Possibly one result of the loss of melanocytes from the various organs is acceleration of the aging process in a permissive environment for the development of malignancies. PMID- 3521987 TI - Physiologic changes in older skin. AB - Clearly, like all other organ systems, the skin undergoes physiologic decline with advancing age. In the elderly, the stratum corneum may not be as capable of acting as a barrier. Once noxious substances penetrate, they are less likely to be cleared rapidly and often will not provoke any integumental reactions or pain sensations that would serve as warning signals to the aged. Thus older individuals are not only more vulnerable to environmental insults but also fail to recognize that they are being adversely affected. As a result, these substances may accumulate following repeated exposure to the point that the threshold for clinical display is exceeded, whereas the threshold would never be reached in younger individuals. Thus it is not surprising that many of the common problems of the elderly are likely to represent subtle, chronic irritant dermatitis. Then, too, because cellular turnover and repair are much slower, the time to recover from such damaging insults is prolonged. In conclusion, I would like to stress that one of the most important observations to come out of our studies is that there exist cutaneous clues to an individual's physiologic age. It is generally appreciated that some elderly individuals seem to be much more youthful and others much older than their stated ages, suggesting that there may be a wide gap between chronologic and physiologic age. Indeed, one of the central concerns of gerontology is to develop methods by which physiologic aging can be monitored. We are certainly not the first to realize that the skin and its appendages may furnish useful markers of physiologic age.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3521988 TI - Connective tissue biochemistry of the aging dermis. Age-related alterations in collagen and elastin. AB - Cutaneous aging represents a complex situation in which at least two independent factors--innate aging and solar exposure--contribute to the development of degenerative changes in the dermis. The biochemical and ultrastructural evidence reviewed in this article indicates that reduced collagen deposition, as a result of diminished collagen biosynthesis and reduced proliferative capacity of the fibroblasts, could explain the development of dermal atrophy and would relate to poor wound healing in the elderly. At the same time, perturbations in the supramolecular organization of the elastic fiber network lead to alterations in the mechanical properties of the skin, as manifested by loose and sagging skin with reduced resilience and elasticity. PMID- 3521989 TI - Effect of age on epidermal immune function. AB - Like other systems in the body, the immune system deteriorates with age. Age related changes in epidermal immune function include morphologic and functional changes in Langerhans cells, decreased production and response to epidermal thymocyte-activating factor (ETAF), and altered allergic contact dermatitis. These may be primary age-related changes in epidermal immune function or may be secondary to aging of the organism. In either case, the age-related changes in epidermal immunity may contribute to the increased susceptibility to cutaneous infections and neoplasms with advancing age. PMID- 3521990 TI - Percutaneous absorption in the aged. AB - The work described in this article reveals a remarkable lack of consensus as to whether percutaneous absorption changes as humans grow older. The data that have been recorded point to possible significant alterations in the barrier function with age. The importance of these observations with respect to dermatopharmacology and dermatotoxicology is clear. The absence of a clearly defined relationship between aging, percutaneous penetration, and the properties of the molecules crossing the skin barrier represents an unacceptable gap in fundamental dermatologic knowledge. With the changing demographic pattern of Western civilization and the increasing awareness of human subjects for the condition of their skin, and the potential for drug delivery via their skin, it is crucial that we begin to establish precisely how the barrier function alters with increasing age. The answer to this question may permit unique improvements in the quality of both local and systemic health in aging populations. PMID- 3521991 TI - Skin cancer in the elderly. AB - This article discusses the relation between aging and development of nonmelanoma skin cancer. Possible age-related risk factors for development of such cancers are cumulative exposure to ultraviolet irradiation from the sun, decreased DNA repair capacity, decreased immunosurveillance, reduced melanocyte density, and altered dermal matrix. Clinical features of basal-cell carcinoma, squamous-cell carcinoma, and keratoacanthoma are discussed. PMID- 3521992 TI - Cutaneous malignant melanoma in the older patient. AB - Malignant melanoma can be a devastating disease, especially in the elderly patient. These patients may be affected by types of malignant melanoma that are seen less frequently in younger patients, namely lentigo maligna melanoma and acral lentiginous melanoma. In patients with stage I disease, age per se does not correlate directly with prognosis. However, tumor thickness does correlate directly with prognosis, and because elderly patients tend to present with thicker lesions, they have prognostically poorer outcomes. Currently one can only speculate as to why the elderly have on average thicker lesions. Surgical excision continues to be the treatment of choice for malignant melanoma. Many elderly patients are not able to tolerate more invasive procedures, such as lymph node dissections. At this point, the physician should work with the patient and the patient's family to assess the needs of each and to develop a clear medical plan. One should maintain an optimistic attitude in dealing with malignant melanoma in elderly patients. Although much work remains to be done with regard to developing new, effective therapies, even today the majority of elderly patients with malignant melanoma will not die from their disease. PMID- 3521993 TI - Wound healing and aging. AB - From these observations and others not described in this article, it is clear that there are age-dependent differences in wound healing. Classically, observers have divided the response to injury into three large phases: inflammatory, proliferative, and remodeling. As indicated elsewhere in this volume, the inflammatory response is decreased with age, and undoubtedly this bears on some of the alterations in healing. The proliferative phase traditionally includes cell migration, proliferation, and maturation, all of which are changed with age. Remodeling encompasses the tertiary binding of collagen molecules, which is also altered with age. Although all of these stages of wound healing differ with age, the changes are qualitative. Events begin later, proceed more slowly, and often do not reach the same level. However, there are neither new events nor an absence of expected events. This is clearly evident by the ease with which the most radical elective surgical wounds heal in the elderly patient. The ability of the aged to heal so well illustrates, therefore, not that their healing processes are equal to those of the young, but rather that our healing capacity is far in excess of what is needed. PMID- 3521994 TI - Common skin problems in the elderly. AB - Aging of the skin is still an inevitable and unavoidable process. The cutaneous problems associated with aging can be annoying, cosmetically unacceptable, or, in some cases, life-threatening. Fortunately, with the increased interest in geriatric medicine, a much broader range of therapeutic modalities is now available to treat these disorders. PMID- 3521995 TI - The psychology of appearance in the elderly. AB - Appearance counts heavily in human affairs. The good-looking have many advantages. These benefits also extend to old age. Elderly persons who preserve a youthful appearance (look young for their age) are likely to be more optimistic, more outgoing, and more social. They rate themselves more highly on many psychologic dimensions. Those who look older than their stated age die earlier and are not as healthy physiologically. Cosmetics can help the elderly attain some of the benefits enjoyed by the physically attractive. PMID- 3521996 TI - Sun-induced aging. Clinical and laboratory observations in man. AB - Chronic sun exposure can result in numerous changes in human skin, particularly the skin of fair-skinned individuals. These changes include wrinkling, elastosis, actinic keratoses, irregular pigmentation, telangiectasia, and skin cancer. Most of these alterations had formerly been considered to be caused by UVB wavelengths, which are the wavelengths probably most responsible. However, a number of recent studies have demonstrated that UVA can also cause burning, elastosis, and skin cancer. Thus, individuals exposed to intense UVB from sunlight coupled with intense UVA from suntan parlors are likely at increased risk. PMID- 3521997 TI - Photoaging. Manifestations, prevention, and treatment. AB - In recent years there has been a growing awareness that many of the so-called attributes of aging skin are, instead, a reflection of environmental assault upon exposed areas of the body. Of special import are the deleterious effects of solar radiation on dermal connective tissue, leading to the visible manifestations of photoaging. Often termed "premature aging," the salient features of the process are distinctly different from those found in normal intrinsic aging. In general, chronically irradiated skin is metabolically hyperactive with epidermal hyperplasia and neoplasia, increased production of elastic fibers, GAGs, accelerated breakdown and synthesis of collagen, and enhanced inflammatory processes. In contrast, protected aged skin is usually characterized by a slow decline in many of these components. Experimental studies with animal models have confirmed the notion that the shorter, more energetic portion of the ultraviolet spectrum (UVB) is responsible for the dermal connective tissue destruction observed in photoaged skin. More recently, it has been shown that UVA and infrared radiation contribute significantly to photoaging, producing, among other changes, severe elastosis. Because the three broad wavebands are inseparably linked in terrestrial sunlight, all are of concern in the photoaging of human skin. Photoaged skin has been thought to be irreversibly damaged. However, our findings indicate that destruction and repair go on simultaneously under continued assault by actinic radiation. The balance is shifted toward repair when the radiation stress is relieved. Both epidermis and dermis are capable of moderate self-restoration when exogenous injury ceases, either by avoidance of sunlight or by the use of broad-spectrum, high-SPF sunscreens. Repair of the dermis, characterized by broad regions of new collagen deposited subepidermally, can be pharmacologically enhanced by topical application of retinoic acid. Although early protection from sunlight, before severe photodamage occurs, is most desirable, it is deemed advisable to counsel even older persons with photoaged skin to adopt protective measures, thereby allowing repair processes to occur. PMID- 3521998 TI - Hyperchloremic metabolic acidosis with high serum potassium in renal transplant recipients: a cyclosporine A associated side effect. AB - In four out of 23 renal transplant recipients treated with cyclosporine A (CyA) and prednisone, hyperchloremic metabolic acidosis with high serum potassium was detected. The patients with metabolic acidosis had a normal anion gap and they all had a urine pH less than 6.0. Plasma renin activity (PRA) was in the low normal range and serum aldosterone in the normal range. Following reduction of the CyA dose, serum bicarbonate increased, serum chloride and serum potassium fell. None of these parameters, however, became normal. Because of morphological changes and sustained reduced renal function, two patients were switched from CyA to azathioprine plus prednisone. Within two weeks after switching, serum bicarbonate, serum chloride, and serum potassium normalized. These data suggest, that CyA induces dose dependent hyperchloremic metabolic acidosis with high serum potassium in renal transplant recipients. PMID- 3521999 TI - Influence of cadaver donor age on renal graft survival. AB - It has been suggested that kidneys from young and old donors do less well after transplantation. We have studied this problem in a retrospective analysis of all cadaveric transplants performed in our center during the last 10 years. All patients were followed for at least six months. Recipients younger than 16 years were excluded from this analysis. Thirty-six patients received a kidney from a donor younger than 11 years (group A), 374 received a kidney from a donor aged between 11 and 51 years (group B) and 21 a kidney from a donor aged older than 51 years (group C). In the young donor age group graft survival was significantly worse than in the two other groups with a one year graft survival of 45.6%, 75.0% and 75.9% for group A, B and C respectively. There were significantly more technical failures in group A, but if these were excluded a significant difference in graft survival remained present. At three months there were no significant differences in hypertension, proteinuria, or serum creatinine between the three groups. These results suggest that young but not old donor kidneys have a worse graft survival. This decreased graft survival is only partly caused by technical problems. Therefore young grafts also seem to be more susceptible to the host's immune response. PMID- 3522001 TI - Case report of renal failure during norfloxacin therapy. PMID- 3522000 TI - The clinical use of serum beta-2-microglobulin and fractional beta-2 microglobulin excretion in IgA nephropathy. AB - We measured serum beta-2-microglobulin (B2-m) and fractional beta-2-microglobulin excretion in 29 patients with IgA nephropathy. The mean serum B2-m in IgA nephropathy patients was significantly higher than that of healthy controls (p less than 0.025). The serum B2-m correlated well with serum creatinine and endogenous creatinine clearance (p less than 0.01). Patients with diffuse mesangial proliferation and glomerulosclerosis had a significantly higher level of B2-m than those with minor glomerular pathology (p less than 0.01). Patients with hypertension had significantly different levels of serum B2-m from normotensive patients (p less than 0.01). The mean fractional B2-m excretion in IgA nephropathy patients was significantly higher than that of healthy controls (p less than 0.001). Patients with moderate tubulo-interstitial involvement had significantly higher fractional B2-m excretion than those with mild tubulo interstitial changes (p less than 0.01). Our study suggests that serum B2-m and fractional B2-m excretion may be useful indicators in the long-term prognosis of patients with IgA nephropathy. PMID- 3522002 TI - Alfred Blalock. PMID- 3522004 TI - Rene Laennec. PMID- 3522005 TI - Operations for cervical incompetence. AB - At present, cervical cerclage is indicated in those patients with a classic history of cervical incompetence. For the majority of these patients, a postconceptional cerclage procedure is better suited because it is done after the fetus has been evaluated ultrasonographically for obvious abnormalities and after the risk for spontaneous abortion is past. The greatest experience is with the Shirodkar and the McDonald procedures; allowing for operator differences, neither appears to have an important advantage. The transabdominal cervicoisthmic cerclage may be a useful postconceptional procedure in the selected patient whose cervix is either markedly foreshortened, deeply lacerated, or infected. Preconceptional cerclages are best reserved for those rare patients in whom a markedly foreshortened incompetent cervix is associated with early second trimester pregnancy losses (preconceptional isthmic cerclage) or in whom the cervix has a single, identifiable scar or deep laceration extending through the internal os (Lash procedure). PMID- 3522003 TI - Comparison of dopamine and dobutamine in patients requiring postoperative circulatory support. AB - We compared dopamine and dobutamine following cardiac surgery in a sequential cross-over study of 9 patients who required inotropic support after volume replenishment. Seven patients had mitral valve replacement, 2 with simultaneous coronary revascularization (CABG), and 1 each with simultaneous tricuspid annuloplasty and aortic valve replacement; 1 had isolated CABG and 1 had repair of a postinfarction ventricular septal defect. Heart rate, right and left atrial pressures, pulmonary and mean arterial pressure, systemic and pulmonary vascular resistance, and cardiac index were measured and calculated. Inotropic support with dopamine or dobutamine was begun for treatment of low cardiac index within 12 hours postoperatively. Measurements were made after 20 minutes on either agent at 5-10 micrograms/kg per min when cardiac output and general clinical state were stable. Each patient was then switched to the other agent at approximately the same dose rate, titrating the dosage to the same cardiac output, and repeat measurements were made at 20 minutes when again stable. Similar dosages of dopamine (6.2 +/- 1.7 micrograms/kg/min) and dobutamine (6.7 +/- 2.5 micrograms/kg/min) produced equivalent heart rate (103 +/- 19 vs. 102 +/- 13 beats/min, p = NS), cardiac index (2.8 +/- 1.1 vs. 2.9 +/- 1.2 l/min/m2, p = NS), and pulmonary arterial pressure and vascular resistance. Mean systemic arterial pressure was significantly lower with dobutamine (59 +/- 5 vs. 67 +/- 7 mmHg, p less than 0.05) as were mean left (14 +/- 5 vs. 18 +/- 6 mmHg, p less than 0.0001) and right (9 +/- 2 vs. 11 +/- 2 mmHg, p less than 0.05) arterial pressures.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3522006 TI - Multiple gestation. PMID- 3522007 TI - Forceps delivery. PMID- 3522008 TI - Episiotomy: techniques and indications. PMID- 3522009 TI - Primary care in the postmenopausal woman. AB - For the obstetrician/gynecologist to function as a primary care physician he or she must be aware of all aspects of the patient's health care needs. Nutrition, weight control, exercise programs, and immunization are essential components of health maintenance. One must be alert to the development of chronic disease and disability, and utilize available screening techniques wisely and effectively. Education can increase compliance and sometimes modify harmful behavior. Informing the patient regarding common changes at menopause and beyond may smooth the transition. A sympathetic and supportive approach, along with judicious use of pharmacologic agents, should help each woman maintain the level of performance to which she is accustomed. PMID- 3522010 TI - Medical problems associated with aging. PMID- 3522011 TI - Estrogen replacement therapy. AB - The popularity of estrogen therapy for the menopausal woman seems to be on the rise again, with new evidence on the risks and treatment of osteoporosis and the protective effect of progestin on the endometrium becoming clearer. The risks of estrogen treatment must remain a prime concern of the practitioner, and hazards may be minimized through careful patient selection, education, examination, treatment, and follow-up. The resurgence of interest in the plight of the menopausal woman has stimulated an increasing number of competent investigators to attempt to solve the mysteries that until recently have been evaluated and treated by anecdote and homeopathic ministrations. PMID- 3522012 TI - Postmenopausal bleeding and the endometrium. AB - The postmenopausal endometrium possesses the potential for development of endometrial adenocarcinoma, the most common female genital tract malignancy. An understanding of this tissue and its response to hormone stimulation is essential for the establishment of rational plans for clinical management. Recently, new techniques for in-office endometrial sampling have been described and advocated. These methods have proven to be fairly accurate diagnostic methods and have potential value for screening, especially among high-risk patients. Patients with postmenopausal bleeding are at such great risk for carcinoma that definitive, more traditional methods, particularly D & C, must usually be employed before the malignancy can be adequately ruled out. PMID- 3522013 TI - Gynecologic surgery in the elderly patient. PMID- 3522014 TI - Anatomic structures of the thoracic outlet. By H. Minor Nichols. 1967. PMID- 3522016 TI - The Classic. Surgical treatment for symptoms produced by cervical ribs and the scalenus anticus muscle. By Alfred Washington Adson. 1947. PMID- 3522015 TI - Biodegradable bone repair materials. Synthetic polymers and ceramics. AB - Many different materials have been used by orthopedic and maxillofacial surgeons to repair bony deficiencies. This review is limited to those materials that have been shown to be tissue-tolerant and biodegradable, and to include certain synthetic polymers and ceramics. There are many possible applications for these agents. Special terms and concepts are germane to an understanding of polymers and ceramics. PMID- 3522017 TI - Complete fracture-dislocation of the thoracic spine associated with spontaneous neurologic decompression. A case report. AB - "Complete" fracture-dislocation of the thoracic spine without neurologic deficit, a rarely described injury, occurred in a 29-year-old coal miner. Partial lesions or those without neurologic deficit may be associated with spontaneous decompression. Gross translational displacement of one vertebrae on another generally compresses interposed neural structures between the columns and/or fragments. Multiple pedicular fractures or posterior column disruption from the displaced anterior column functionally widens the neural canal, even with vertebral bodies side by side. The rib cage stabilizes the thoracic spine, decreasing the risk of neurologic injury. Although many surgeons proclaim the advantages of early open reduction and internal fixation, reduction may not always be necessary in this type of severe injury. Reduction entails highly significant risks, especially in neurologically uncompromised individuals with severe thoracic displacement. PMID- 3522018 TI - Chondrocalcin and the calcification of cartilage. A review. AB - A protein recently identified and named chondrocalcin is associated with the calcification of hyaline cartilage matrix in health and disease. Chondrocalcin is absent from noncalcifying growth plate cartilages in disease. It is also present in noncalcifying developing epiphyseal cartilage. The molecule appears to be synthesized and secreted by chondrocytes, particularly those committed to becoming hypertrophic. It is not detectable in developing or mature bone, teeth, or other tissues, although trace amounts are present in blood. The assigned molecular weight is 69,000. The protein is basic and is constructed of two subunits of 35,500 and 34,500. PMID- 3522019 TI - Blood supply of the knee joint. A microangiographic study in children and adults. AB - The knee joint blood supply is derived from a rich anastomosis of the five major constant arteries, namely, the superior medial and lateral, the middle (posterior), and the inferior medial and lateral genicular arteries. Anastomosis also occurs with descending genicular arteries and the anterior tibial recurrent artery. These branches form anastomoses in and around the knee joint, while each major vessel was noted to provide the respective major blood supply to specific areas. The most obvious difference between vascularization of child and adult knees was the separation of vessels and relative avascularity of epiphyseal plate areas; such persisted until closure of the epiphyseal plate. The regions representing the seals of plate closure had less rich vascularization. A rich intraosseous blood supply was defined in the femoral and tibial condyles and the patella. Similarly, the adjacent and superficial soft tissues, including major ligaments and peripheral parts of the menisci, were richly vascularized. Areas of separated vascularization in children may have relevance to epiphyseal injury, growth deformity, Osgood-Schlatter disease, and hematogenous osteomyelitis. In adults, such information may be relevant to high tibial osteotomy, meniscus and cruciate ligament repair, and surgery utilizing the semitendinosus tendon, fascia lata, or patella tendon grafts. PMID- 3522020 TI - The repair of major osteochondral defects in joint surfaces by neochondrogenesis with autogenous osteoperiosteal grafts stimulated by continuous passive motion. An experimental investigation in the rabbit. AB - The purpose of this investigation was to determine the effects of continuous passive motion (CPM) on the chondrogenic potential of autogenous osteoperiosteal grafts to repair major osteochondral defects. A 3.5-mm-wide circular full thickness defect was drilled in one medial femoral condyle of 55 adolescent New Zealand rabbits. A graft of periosteum from the proximal tibia was wrapped around a disc of bone from the same area (cambium layer of the periosteum facing outward), then press-fitted into the defect. The rabbits were treated by either immobilization (Imm) or intermittent active motion (IAM) for five weeks, or by continuous passive motion (CPM) for two weeks followed by IAM for three weeks. A control group (no osteoperiosteal graft in the defect) was also treated by CPM for two weeks and IAM for three weeks. At five weeks, hyaline cartilage was the predominant tissue in only 10% of the defects in the Imm, IAM, and control groups, compared with 70% in the CPM group (p less than .025). Bonding of the newly formed tissue to the adjacent cartilage was significantly better in the CPM group. PMID- 3522021 TI - Bone and cartilage allotransplantation. A review of 14 years of research and clinical studies. AB - The authors review their experience of over 14 years in the field of osteochondral allotransplantation. Experimental studies demonstrated the immunogenicity of bone and cartilage, immunosuppression in skeletal transplantation models, and a subset of myeloid cells within bone marrow with strong immunogenic properties. Clinical results of knee joint resurfacing with fresh small-fragment osteochondral allografts have been best in posttraumatic joints. Experience with allograft reconstructions of skeletal defects after tumor surgery has been gratifying as a limb salvage procedure. Microvascular fibular autografts have been an important adjunct in massive reconstructive osteochondral transplantation. PMID- 3522022 TI - A scientific basis for surgery in rheumatoid arthritis. AB - Understanding a disease process provides the scientific basis for specific treatment. In rheumatoid arthritis (RA), disease(s) of unknown cause, the lack of knowledge about the intrinsic involvement of the articular collagenous tissues (ACT) as a site for the deposition and persistence of immune complexes may have led to poor long-term results of surgery, especially synovectomy. Because we may now presume that immune complexes in ACT provide inflammatory, immune foci for chronic synovitis, ablative surgery of the damaged cartilaginous tissues is a specific remedy. Such knowledge may be used judiciously with techniques of fusion, resection, and arthroplasty to improve and maintain the long-term function of patients with the crippling seropositive form of the disease. PMID- 3522023 TI - Bone block transfer of coracoacromial ligament in acromioclavicular injury. AB - A bone block transfer of coracoacromial ligament into the medullary canal of the clavicle for Grade III acromioclavicular injury was developed in an attempt to prevent occasional pullout of the ligament in the procedure described by Weaver and Dunn. Fifteen consecutive cases (12 acute, three chronic) with Grade III acromioclavicular injury were treated by this method. All but one patient regained painless full range of shoulder motion. All patients returned to previous activity. Failure of coracoclavicular reconstruction occurred in one case. Asymptomatic focal myositis ossificans developed in four cases with no functional deficit. PMID- 3522024 TI - An unusual fracture of the talus associated with a bimalleolar ankle fracture. A case report and review of the literature. AB - A 53-year-old man sustained a fall from 1.25 m, injuring his hindfoot and ankle. Roentgenographic examination demonstrated a displaced vertical fracture through the neck of the talus with dislocation at the subtalar and tibiotalar joints (Hawkins Group III) and an ipsilateral bimalleolar fracture. Prompt anatomic reduction of the talus and bimalleolar fracture with rigid internal fixation was performed. Roentgenograms three years postinjury confirmed solid union of all fractures. Avascular necrosis of the talus had not occurred. Minimally disabling post-traumatic arthritis as both the ankle and subtalar joints was the only sequela. Only four similar injuries seem to have been reported previously in the literature. Despite the generally high incidence of avascular necrosis in Hawkins Group III talar neck fractures, none of these four cases developed this complication. A possible explanation is that with the presence of ipsilateral bimalleolar fracture, there is preservation of the extraosseous vascular supply that accompanies the deltoid and talofibular ligamentous complexes. PMID- 3522025 TI - Osteonecrosis of bone. Current concepts as to etiology and pathogenesis. AB - Experimental and some clinical evidence suggest that one or more mechanisms, alone or in combination, induce bone necrosis. These include marrow cell hypertrophy, microembolic phenomena, and lipid-induced osteocyte necrosis. Such events may result in local inflammatory exudates and/or vascular impedence. Either may effect an increase in the hydrostatic pressures in bone with the potential to limit blood flow and magnify the initial insult. Further experimental investigations are necessary to gain knowledge of etiologic mechanisms and a rational means of prophylaxis or treatment. PMID- 3522026 TI - Percutaneous bone marrow grafting of fractures and bony defects. An experimental study in rabbits. AB - Since bone marrow has been shown to contain osteoprogenitor cells, an experiment was devised to test its effects when injected percutaneously into osteotomies and 2-cm bony defects produced in rabbit radii. The parameters tested included callus volume, breaking load, tensile strength, and cross-sectional area of callus at the fracture or bony defect site. At two weeks postgrafting callus volume was significantly higher (p less than 0.01) in the grafted radii than in the contralateral saline controls. By four weeks all four parameters were significantly greater in the bone marrow grafted radii than in the contralateral saline controls. Serial radiographs and histology confirm this advanced fracture healing in the grafted bones. The earlier and more abundant callus, at the bone marrow grafted sites, was felt to provide earlier and greater stability, resulting in decreased early healing time when contrasted with the saline controls. Similarly, the bony defects that were grafted with bone marrow united by a bony bridge, whereas the saline controls did not. Percutaneous bone marrow grafting is a simple semi-invasive technique that may have potential clinical applications. PMID- 3522027 TI - Six-year results with a microporous-coated metal hip prosthesis. AB - In an attempt to obtain bone ingrowth into a microporous-coated metal implant, a hip prosthesis with a pore width of approximately 50 microns was used in 34 cases. Implants revised up to six years following surgery have all shown fibrous tissue ingrowth only. Neither sinkage nor osteoporosis was observed. Revision was made difficult by the presence of a collar obstructing access to the proximal junction between the implant and bone. PMID- 3522028 TI - Menstruation. A hazard in radionuclide renal transplant evaluation. AB - Serial Tc-99m DTPA studies were performed to evaluate renal transplant blood flow and function in a 34-year-old woman. A hypervascular pelvic mass with increased blood pool activity was intermittently identified. This hypervascular lesion suggested a pathologic condition of the pelvis, and its blood pool simulated bladder activity, confusing interpretation of renal function. This perplexing vascular lesion was the uterus, with varying degrees of blood flow and blood pool activity depending on the timing of the renal study in relation to the menstrual cycle. PMID- 3522029 TI - Hypoglycemia and hyperglycemia in tiny infants. AB - When the maternal supply of glucose is removed, endogenous hepatic glucose production and enteral or parenteral nutrition become the primary source of glucose supply. Because of this, the 1000-gm infant has special problems with glucose homeostasis. This article reviews these particular difficulties. PMID- 3522030 TI - The correlation between blood levels of ibuprofen and clinical analgesic response. AB - A clinical trial comparing ibuprofen, 400, 600, and 800 mg, with aluminum ibuprofen, 400 mg, and placebo was conducted in patients with moderate or severe pain subsequent to third molar extraction. Pain intensity ratings and ibuprofen serum levels were obtained at baseline, 30 minutes, 1 hour, and hourly thereafter for 3 hours. Pain intensity ratings were also obtained at hours 4, 5, and 6. Serum levels at 1, 2, and 3 hours correlated significantly with the log dose of ibuprofen (r = 0.35, 0.49, and 0.48, respectively) and with global analgesic response as measured by the percentage of the sum of the pain intensity scores (r = 0.28, 0.34, and 0.26, respectively). However, possibly because of differences in drug formulation, the percentage of the sum of the pain intensity scores did not correlate significantly with log dose. The highest correlations were found between contemporaneous serum levels and pain intensity difference values, particularly at hour 1 (r = 0.54). Our results support the proposition that increased ibuprofen serum levels lead to increased analgesia. PMID- 3522031 TI - Character of adverse effects of prophylactic lidocaine in the coronary care unit. AB - Adverse effects of lidocaine therapy for proved or suspected myocardial infarction were evaluated for 48 hours in 285 patients arriving at the hospital within 6 hours of the onset of chest pain. More adverse effects occurred in patients receiving lidocaine (51%) than in those receiving placebo (16%; P less than 0.0001). Patients receiving lidocaine had more adverse effects in the first 12 hours as compared with the second 12 hours (50% vs. 19%; P less than 0.001). Patients without infarction who received lidocaine had more adverse effects than similarly dosed patients with infarction (64% vs. 39%; P = 0.002). The proportion of major adverse effects in those patients having any adverse effect was much greater in the last 24 hours as compared with the first 24 hours (86% vs. 32%; P = 0.006). All life-threatening problems (n = 5) occurred in the first 24 hours, most frequently in the first hour. Lidocaine levels were only weakly related to adverse effects potentially caused by lidocaine toxicity. We conclude that the adverse effects of prophylactic lidocaine have been understated in the past and may negate its antiarrhythmic efficacy. PMID- 3522032 TI - The history of computing. AB - This article follows the development of computerized devices from the primitive manual systems of the ancient world to the sophisticated electronic devices of today. PMID- 3522033 TI - Computer applications in plastic surgery training programs. AB - In this article three simple applications for microcomputers in the training program setting are explained. All three are also useful in a private practice setting. The ability to conduct a literature search from your own office and the ability to manage lists of clinical cases have important research as well as educational advantages. The computerized in-service examination takes an already useful educational tool and adds a new dimension. PMID- 3522034 TI - Computerized anatomy instruction. AB - A self-paced gross anatomy teaching package is under development using computer generated anatomic images controlled by branching instructional software on a personal computer. The package is designed to overcome several problems encountered in the traditional study of anatomy. The capabilities, strengths, and weaknesses of computer-assisted instruction are highlighted. PMID- 3522035 TI - Automated analysis of peripheral nerve regeneration. AB - Techniques of computerized analysis of nerve and muscle electrical activity are described. The applications of time and frequency domain analysis in peripheral nerve regeneration are discussed. PMID- 3522036 TI - Computed tomography--its principles and application to the diagnosis of facial fractures. AB - The introduction of microcomputers with their chips of integrated circuits and ability to rapidly perform thousands of complex mathematical instructions has enabled the clinician to readily use and manipulate tomographically acquired data from relatively narrow body slices. These data allow identification of complex injuries and disease states through the construction of detailed anatomic images and the differentiation of structures of low densities and those of subtle density differences. PMID- 3522037 TI - Computed tomography of head and neck malignancies. AB - This article briefly describes the clinical features of the most common malignant neoplasms of the head and neck region. The diagnostic approach and contribution of computed tomography is discussed. CT is presently considered the method of choice in noninvasive evaluation of these neoplasms. PMID- 3522038 TI - Computer use in the medical specialties. AB - This article summarizes new and innovative uses of the computer in various medical applications. It highlights the use of this technology in the fields of Cardiology, Radiology, Rehabilitative Medicine, Laboratory Medicine, and so on. It also discusses future uses in aiding the handicapped patient to ambulate, the deaf to hear, and the blind to see. PMID- 3522039 TI - Incidence of fibrillation with isotonic contrast media for intra-arterial coronary digital subtraction angiography. AB - Intra-arterial digital subtraction angiography (DSA) can produce coronary artery opacification with isotonic contrast media. In this study we have examined the importance of electrolyte composition in isotonic formulations on the incidence of fibrillation. Right coronary injections of media were made for 25 s in anesthetized dogs. Isotonic meglumine diatrizoate and iohexol produced fibrillation in more than 68% of the injections, while sodium diatrizoate, saline, meglumine/sodium ioxaglate and iohexol with added sodium diatrizoate never produced fibrillation. These animal studies demonstrate a significantly higher risk of fibrillation (p less than 0.005) with isotonic nonionic and ionic media not containing sodium ions. PMID- 3522040 TI - Iohexol 240 mgr I/ml and metrizamide 240 mgr I/ml in lumbar myelography. Report from a randomized double blind study. AB - A parallel, double blind, randomized study, comparing iohexol 240 mg I/ml and metrizamide 240 mg I/ml in lumbar myelography was carried out. Fifty patients were admitted to the study, and 1 patient was excluded after entry. Of the 49 patients included, 28 were males and 21 females, aged between 18 and 72 years. A dose of 10.5 ml of contrast medium was administered. A detailed neurological examination, and measurement of blood pressure and heart rate were performed before and 24 h after myelography. EEG was recorded in 37 patients. All patients were observed for adverse reactions for 48 h. Adverse reactions were reported in 14 of 26 patients examined with iohexol, and in 13 of 23 patients examined with metrizamide. EEG changes were observed in 7 patients examined with metrizamide, no changes were observed in patients examined with iohexol. The image quality was judged good or excellent in all cases, with the upper level of contrast medium brought to the level of L1 in the majority of cases. PMID- 3522041 TI - Spontaneous thrombolysis of a large caval thrombus after insertion of an inferior vena cava filter: diagnosis and follow-up by ultrasound. AB - In the ultrasonic evaluation of a patient with a right-sided subphrenic abscess, coincidentally, a large inferior vena cava thrombus was found and subsequently proved by cavography. Considering the clinical condition of the patient, abdominal surgery was not performed, and instead a percutaneously inserted caval filter was successfully placed above the thrombus. The patient received oral anticoagulant therapy and after 6 weeks, ultrasound demonstrated complete thrombolysis. PMID- 3522042 TI - Renovascular hypertension and digital subtraction analysis. AB - Intravenous digital subtraction angiography (DSA) is a good imaging modality for the renal arteries and their main branches. Using an anterior-posterior beam direction, a considerable reduction in X-ray exposition is achieved, and by taking 3 runs with the patient in prone position, the renal arteries are adequately visualized in a high percentage. Nevertheless we advocate arterial DSA as a screening procedure for renovascular hypertension, especially in younger patients, because of the higher diagnostic output and the possibility of taking therapeutic action in the same session in about 1 out of 3 patients. PMID- 3522043 TI - Cavernous transformation of the portal vein: sonographic and computed-tomography findings. AB - A case of cavernous transformation of the portal vein detected by sonography and computed tomography is presented. PMID- 3522044 TI - Uncommon sonographic appearance of an obstructed uterus. A case report. AB - A case of obstruction of the uterus caused by recurrent cervical carcinoma is presented. The ultrasonic appearance of the obstructed uterus changed into a very unusual picture due to rapid tumor infiltration in a short period of time. PMID- 3522045 TI - Cavernous hemangioma of the adrenal gland. AB - Cavernous hemangioma of the adrenal gland is a rare lesion and is seldom examined radiographically. In our case, on staging of gynecological carcinoma, a tumor with calcifications was found in the right adrenal region. On sonography it was of mixed echogenicity, enhanced only poorly on computed tomography and had long standing contrast-filled lakes on angiography. Surgery revealed a cavernous hemangioma. PMID- 3522046 TI - Does MURCS association represent an actual nonrandom complex of malformations? AB - The MURCS association was first suggested by Duncan in 1979 as a distinctive nonrandom association of congenital anomalies involving the Mullerian duct, the kidneys and the cervicothoracic spine. Two personal cases, highly resembling Duncan's description, are reported. In our opinion, they seem to support somehow the hypothesis that MURCS association should be considered as an autonomous pathological entity. The great phenotypical variability and the still unknown etiopathogenetic mechanism are particularly stressed. PMID- 3522047 TI - Relationship of the sympathetic nervous system to lower motor neurone lesions and the bladder. PMID- 3522048 TI - The molecular genetics of collagen disorders. PMID- 3522049 TI - Blood rheology in arterial disease. PMID- 3522050 TI - Selective renal medullary damage and hypertension in the rat: the role of vasopressin. AB - The induction of selective renal medullary damage by 2-bromoethylamine hydrobromide (BEA) results in polyuria and raised blood pressure. In view of the likely elevation of plasma vasopressin we have investigated the role of vasopressin (AVP) in the elevated blood pressure in this model. Plasma vasopressin levels in BEA pretreated rats were raised significantly (2 +/- 0.6 pg/ml vs 0.8 +/- 0.1 in normal rat, P less than 0.05) but not to pressor levels. In addition, pressor responsiveness was investigated in renal medullary damaged rats. There was a reduced response to vasopressin and noradrenaline but no alteration with angiotensin II. A specific V1, receptor AVP antagonist [d(CH2)5Tyr(Me)AVP] produced no fall in blood pressure but returned the noradrenaline dose-response curve to normal. This suggests an interaction between vasopressin and the sympathetic nervous system in this model. Thus there is no evidence that vasopressin contributes to the rise in blood pressure produced by chemical renal medullectomy and other mechanisms have to be sought. PMID- 3522051 TI - Infused salbutamol accentuates acid-induced lung injury in the rat. AB - The effect in the rat of salbutamol infusion (1 microgram min-1 kg-1) on acid induced lung injury has been determined. Severity of lung injury was assessed by two techniques: the pulmonary clearance of 99mTc-diethylenetriaminepenta-acetate (99mTc-DTPA) and the lung wet/dry weight ratio, giving indices of alveolar epithelial permeability and transendothelial water filtration respectively. Mean half-time of clearance of 99mTc-DTPA was increased significantly in rats who had intratracheal acid-induced injury and control (saline) intravenous infusion (19.4 +/- 2.6 min) compared with non-acid-treated rats (98.1 +/- 7.2) (P less than 0.0001). However, those animals who had intratracheal acid injury and subsequent salbutamol intravenous infusion had significantly faster clearance (11.5 +/- 1.9) than the acid and control infusion group (P less than 0.05). Gravimetric lung water in the acid-only rats (expressed as wet/dry weight ratio) was increased significantly (6.4 +/- 0.3) compared with the non-acid-treated controls (5.4 +/- 0.2) (P less than 0.01). Acid-treated rats who had salbutamol infused had dramatically increased lung water (10.0 +/- 0.6) (P less than 0.001 vs acid and control infusion). Intravenous salbutamol infusion itself produced no significant difference in the results for both techniques, compared with the non-acid-treated time-course controls. Infused salbutamol accentuates acid-induced lung injury in the rat. Possible factors responsible for these findings include beta 2 adrenergic agonist mediated inhibition of hypoxic pulmonary vasoconstriction (HPV) and a predominant beta 1-adrenergic agonist inotropic effect of salbutamol with resultant rise in pulmonary artery pressure. PMID- 3522052 TI - The current status of mechanical circulatory support. AB - In summary, techniques for support of a failing circulation have advanced steadily over the past thirty years. Just as the use of the intra-aortic balloon pump has permitted successful treatment of certain groups of high-risk patients, so increasing application of more invasive techniques of mechanical circulatory support has extended the range of surgical endeavour. Nevertheless, it is evident that further advances in the design and construction of mechanical circulatory support devices are most likely to occur in conjunction with developments in bioengineering technology. These advances will in turn demand analysis by means of careful animal and clinical investigations. Although the general clinical use of an off-the-shelf mechanical ventricular support will give rise to major financial and ethical problems it is likely that application of these devices may herald a new era in the field of artificial organ replacement. PMID- 3522053 TI - Current concepts in clinical therapeutics: major affective disorders, Part 2. PMID- 3522054 TI - Miconazole-induced alteration in tobramycin pharmacokinetics. PMID- 3522055 TI - Is tobramycin less nephrotoxic than gentamicin? PMID- 3522056 TI - Secondary acute myeloid leukaemia in a boy with T-cell lymphoma: successful treatment by bone marrow transplantation. PMID- 3522057 TI - Factors influencing G-tolerance. PMID- 3522058 TI - Evaluation of a modified acetylene rebreathing method for the determination of cardiac output. AB - In order to evaluate a computerized modified acetylene rebreathing method for the determination of cardiac output, 15 healthy subjects were studied at different levels of their maximal oxygen uptake (VO2max). Submaximal exercise was performed on a cycle ergometer and maximal exercise on a treadmill. Oxygen uptake, heart rate, and cardiac output (acetylene method) were determined in all test situations. In seven subjects simultaneous determinations of cardiac output were made by a modified acetylene rebreathing method (QA) and a dye dilution method (QD). Furthermore, a new resting rebreathing technique was used. The methodological error for QA (means of double samples) was 0.37 litre min-1 (2.8%) in the same individual at 150 W. The corresponding values between individuals were 0.71 (rest), 0.41 (50 W), 0.69 (150 W), and 0.40 litre min-1 (VO2max). Thus the methodological error of the modified acetylene method was very low. There was a significant difference (P less than 0.01), however, between the acetylene method and the dye dilution method, which showed a lower value for QA at all levels. This was probably due to the long response time of the mass spectrometer combined with anatomical and physiological arteriovenous shunt effects in the lungs during exercise. When these factors were considered the correcting formula was: QAc = QA + 0.005 X Q2A. There was no significant difference between the corrected cardiac output values (QAc), and the corresponding QD values. In conclusion, this modified acetylene rebreathing method is a very useful non invasive method for measuring cardiac output at rest as well as during heavy exercise. PMID- 3522059 TI - Fibre orientation in the left ventricle and its influence on local pressure length loop analysis in cats. AB - Deviation from local fibre orientation may seriously affect quantification of myocardial segment work, as measured by implanted ultrasound crystals. Crystal pairs were positioned in mid-wall layers with known directions to the long axis of the heart. One transmitter and four receiving crystals covered a sector on the anterior ventricular wall of 100 degrees. The results show a strong influence of alignment to fibre direction on the pressure-length loop area; the relation followed a cos2 psi function where psi denotes the angle between the crystal pair direction and fibre direction established by microscopy. The angle between the mid-wall muscle fibres on the anterior aspect of the left ventricle and the long axis of the heart varied between 62 degrees and 90 degrees with a mean value of 76 degrees. This study shows that pressure-length loop quantitation depends strongly on crystal alignment to cardiac muscle fibres through which the ultrasound passes. PMID- 3522060 TI - [Therapeutic problems in acute and chronic hepatic diseases]. PMID- 3522061 TI - [Comparison of nadolol and chlorthalidone in hypertensive subjects resistant to therapy with only captopril]. PMID- 3522062 TI - [Post-infarct ventricular aneurysms]. PMID- 3522063 TI - [Toxicity and hepatotoxicity of halothane]. PMID- 3522064 TI - [Alpha-amylase and glucosidase inhibitors]. PMID- 3522065 TI - [Orthostatic hypotension]. PMID- 3522066 TI - The physiology of the nose. AB - The nose, as an organ initiating reflexes affecting itself and the rest of the body, and as a target organ of control, is highly complex. Its innervation includes parasympathetic, sympathetic, sensory/afferent, and somatic motor nerves, which combine in a variety of morphologic pathways. The vasculature of the nose contains capacitance vessels such as sinusoids and distensible venules, as well as arteriovenous anastomoses, arterioles, capillaries, and venules. The secretory tissue of the nose includes epithelial cells, submucosal glands, and relatively large anterior or lateral serous glands; in addition, some species have specialized secretory glands. The nose is the source of many powerful reflexes, including the diving response, sneeze and sniff reflexes, and reflexes affecting autonomic nervous function to the cardiovascular system, airways in the lungs, the larynx, and other organs. Axon reflex control of the nasal vasculature is also important. The nasal vasculature can be shown to be under parasympathetic and sympathetic control, but there is little precise information concerning the effect of nerves on different types of blood vessels. Pharmacologic experiments show that vascular resistance and vascular volume can be separately influenced by nerves and mediators, and that vascular resistance and airway resistance are not necessarily inversely related. Nasal secretion is also under the influence of both parasympathetic and sympathetic nerves, and can be induced by a wide range of neurotransmitters and mediators. In general, the concentrations needed to promote secretion are considerably higher than those that affect vascular resistance, at least with regard to the lateral nasal gland of the dog. In humans, nasal patency is affected by several nervous inputs, presumably acting via vascular beds. The nasal cycle is the alternation of resistances between the two sides of the nose, on which other changes are superimposed. In exercise and hyperpnea, nasal airflow resistance decreases, presumably with vascular decongestion. Recent studies of the crutch reflex (the ipsilateral nasal congestion caused by stimulation of the axilla) show that some of the reflex inputs to the nose can be unilateral. PMID- 3522067 TI - The muscles of the upper airways. AB - The upper airways are a complex structure with multiple functions; many of the muscles participate in the act of respiration. The neural control of upper airway muscles is distinct from that of chest wall muscles under a variety of circumstances. Coordinated activation of upper airway muscles, both regionally and inter-regionally, results in changes in upper airway size and resistance, alterations in the route of airflow, and increases in the ability of the airways to resist collapse. Several disorders have now been described in which neuromuscular drive abnormalities and/or mechanical dysfunction of the upper airways occur, resulting in clinical disease. PMID- 3522068 TI - Laryngeal receptors and their reflex responses. AB - The afferent activity originating from the larynx shows a considerable respiratory modulation. Receptors responding to pressure changes, inspiratory airflow (cold), and laryngeal movements have been identified. In addition, other receptors without a respiratory modulation are also described. Possible reflex effects of these receptors on breathing pattern, upper airway patency, and defense mechanisms in both adults and newborns are discussed. PMID- 3522069 TI - Parasympathetic motor pathways to the trachea: recent morphologic and electrophysiologic studies. AB - The distinctive features of the parasympathetic motor pathway to the trachea include: preganglionic fibers, many with an inspiratory rhythm, that converge onto ganglion cells and excite them through nicotinic receptors; an elaborate plexus of nerves and ganglia that covers the posterior surface of the trachea and extends anteriorly between each cartilaginous ring; ganglion cell bodies with heterogeneous morphologic and electrical properties--some large, others small, some with an inspiratory rhythm, and others with an expiratory rhythm; the trachealis muscle, which contracts with an inspiratory rhythm and closely parallels activity in the phrenic nerve. PMID- 3522070 TI - Regulation of airway secretory cells. AB - Inhaled particles are cleared from the airways by ciliary transport of a discontinuous mucous layer. The effectiveness of this process depends on the viscoelastic properties of the secretion, which in turn depend on the composition and interaction of the glycoprotein constituents. In human airways, two major cell types in the surface epithelium (goblet and ciliated) and two in the submucosal glands (serous and mucous) are known to contain mucin- and/or serum type glycoproteins. This article summarizes current knowledge regarding the secretable products of each of these cell types and the conditions under which they are released into the airway lumen. PMID- 3522071 TI - Isolation and culture of submucosal gland cells. AB - Submucosal glands of the airways of higher mammalian species are complex structures that are located in the submucosal tissue of the tracheobronchial tree. The glands open onto the airways via ciliated ducts, which lead into the collecting ducts. Mucous and serous tubules lead from the collecting ducts and compose the glandular acini. The acini secrete primarily mucous glycoproteins, with the serous cells secreting mainly neutral mucins and the mucous cells, acidic mucins. Serous cells also participate in the transport of IgA and the secretion of lysozyme. Serous cells may also secrete electrolytes, thereby creating an osmotic gradient that may mediate water secretion. Evidence indicates that the cholinergic, adrenergic, and noncholinergic, nonadrenergic nervous systems may be important in the control of secretion by submucosal glands. The manner in which these systems interact to achieve control is still under investigation. In addition, a variety of local mediators, such as histamine and prostaglandins, influence submucosal glandular function. Studying the submucosal glandular physiology and pathophysiology has been difficult due to the cellular and structural complexity of the glands. Recently, methods have been developed to isolate and culture submucosal gland cells. The techniques seem to preserve cellular functions, and as such should prove to be valuable models for understanding these important secretory cells. PMID- 3522072 TI - Mucociliary clearance in the trachea. AB - Tracheal mucociliary clearance is governed by the interplay between ciliary activity and secretory functions of the epithelium. These functions are altered transiently by various physiologic and injurious stimuli, and chronically in asthma, chronic bronchitis, cystic fibrosis, and other forms of airway disease. In general, these conditions are associated with a depression in mucociliary clearance that may predispose to respiratory infections and the accumulation of secretions. PMID- 3522073 TI - Abnormal respiratory epithelial ion transport in cystic fibrosis. AB - The respiratory epithelium of cystic fibrosis patients exhibits excessive sodium (and volume) absorption and an absence of chloride (and volume) secretion in response to usual stimuli. These abnormalities likely contribute to the pathophysiology of cystic fibrosis lung disease, and provide a rationale for a novel therapeutic approach to this problem. PMID- 3522074 TI - Ion transport by tracheal epithelial cells in culture. AB - In culture, cells from the dog tracheal epithelium form confluent cell sheets that have ion transport processes similar to those of the original tissue. Cell sheets grown from "normal" human tracheal mucosa resemble those of the dog in the presence of active chloride secretion, which can be stimulated by endogenous mediators. Tracheal cells cultured from patients with cystic fibrosis lack chloride secretion because their apical membranes are impermeable to this anion. PMID- 3522075 TI - Home monitoring of diabetes mellitus--a quiet revolution. 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- 3522076 TI - Rapid methods in microbiology for in-office testing. AB - There are now a variety of rapid test methods available to assist in the diagnosis of the three most common infectious diseases seen in ambulatory medicine: pharyngitis, urinary tract infection, and venereal disease. Before choosing to implement any of these methods, several aspects should be carefully considered. The objectives met by onsite testing should be clearly identified and the appropriate test chosen to meet those objectives. For example, if the goal is to establish a diagnosis while the patient is still available in the office, a test method that requires more than 20 to 30 minutes to perform will not fulfill the objective. Similarly, if tests must be batched for maximum efficiency, timeliness of results will be compromised. The prevalence of the specific agent or disease in the patient population should be established, as prevalence will significantly influence the predictive value of a diagnostic test. The lower the prevalence of a disease, the lower the predictive value of a positive result and the higher the predictive value of a negative result. Conversely, the higher the prevalence, the higher the positive predictive value and the lower the negative predictive value. Thus, in one setting a test may serve best as a screen to rule out disease and, in another setting, as a confirmatory test to establish a diagnosis. The impact of false-positive and/or false-negative results must be clearly appreciated to avoid diagnostic errors. The technical features of a test method should be carefully appraised. How difficult is the test to perform and what skill level is necessary to ensure the validity of results? How much quality control is necessary? How much additional equipment is needed to perform the assay, and does the equipment have multiple applications or just a single application? Finally, does the cost-benefit ratio of providing on-site testing exceed that of referring the specimens to a reference laboratory? PMID- 3522077 TI - Proficiency of office microbiology testing. AB - Microbiology proficiency testing results from smaller physicians' office laboratories in the state of Pennsylvania are reviewed. Possible reasons for lower performance levels are discussed, and some approaches to improving microbiology proficiency in this setting are suggested. PMID- 3522078 TI - Issues and trends in the regulation of office-based clinical laboratories. AB - Office-based clinical laboratories are the least regulated of all laboratories as a result of familiar forces in the politics of the regulation of medicine. This article discusses the evolution of these regulations and summarizes the applicability and intent of federal and state rules. Counterbalancing forces in the present political and medical environment tending simultaneously toward greater and lesser regulation are discussed. PMID- 3522079 TI - The immunology of ageing. PMID- 3522080 TI - Connective tissue disease in the elderly. AB - The prevalence of the inflammatory disorders of connective tissue in the older age group is quite likely underestimated at the present time; and, in most instances, age-related factors influencing clinical expression and autoreactivity have not been intensively studied. The array of connective tissue disease that usually targets the young adult emerges in the older age group as well; and, selectively in the elderly, GCA and PMR are found. The association of malignancy with PM/DM is increased with advanced age. In view of the therapeutic implications, early diagnosis is essential, but this can be especially difficult in the setting of problems related to the ageing process. PMID- 3522081 TI - Ageing in relation to the pathogenesis of osteoarthritis. PMID- 3522082 TI - The clinical evaluation of osteoarthritis in the elderly. PMID- 3522083 TI - Implications of drug therapy in the elderly. PMID- 3522084 TI - Surgical treatment of arthritis in the elderly. AB - Arthritis in the elderly can be very effectively treated by a combination of careful orthopaedic and rheumatological assessment. The overall functional assessment, and definition of the aims and likely results of surgical treatment by the team approach, involving occupational therapists, physiotherapists and social workers, are important for success. There are many worthwhile surgical procedures available to relieve pain, and restore mobility and independence to those affected by osteoarthritis and rheumatoid arthritis. PMID- 3522085 TI - Polymyalgia rheumatica. PMID- 3522086 TI - Metabolic bone disease and Paget's disease in the elderly. Part I: Metabolic bone disease. PMID- 3522087 TI - Isolation of Campylobacter jejuni in Hunan, the People's Republic of China: epidemiology and comparison of Chinese and American methodology. AB - The incidence of infection with Campylobacter jejuni was determined in individuals with and without diarrheal disease seen at a hospital in Changsha, China. Stool specimens were cultured by two methods: one developed by the Chinese and a second control method used commonly in the United States. Among people with diarrhea, 18.7% of the 48 children and 8.7% of 104 adults were infected with Campylobacter jejuni. In the group without diarrhea, 8.6% of 105 children but none of 76 adults tested had the organism in their stool. Of the 27 total positive cultures, the Chinese method was positive in 26, compared with 21 for the control method. The Chinese culture method was at least as sensitive and specific as the American method. The biochemical characteristics and antibiotic sensitivities of Chinese isolates were similar to organisms isolated in other parts of the world. This study shows that Campylobacter jejuni is a common enteric pathogen in China and that the asymptomatic carrier state of this organism is significant in children. PMID- 3522088 TI - In vitro evaluation of cefixime (FK027, FR17027, CL284635): spectrum against recent clinical isolates, comparative antimicrobial activity, beta-lactamase stability, and preliminary susceptibility testing criteria. AB - Cefixime, a new orally absorbed cephalosporin, was compared by in vitro testing with other oral beta-lactams, including cephalexin, cefaclor, cefuroxime, amoxicillin, and amoxicillin + clavulanate. Enterobacteriaceae were inhibited by lower concentrations of cefixime than any of the reference drugs; 90% and 95% were inhibited by less than or equal to 1.0 and less than or equal to 8.0 micrograms/ml, respectively. Cefixime was the least active among these drugs against staphylococci, with only 31% of 1106 strains inhibited by less than or equal to 8.0 micrograms/ml and less than 1% by less than or equal to 1.0 microgram/ml. Enterococci and pseudomonads were not susceptible to any of the drugs tested. Penicillin-resistant pneumococci were relatively resistant to cefixime, but penicillin-susceptible pneumococci were very susceptible to cefixime. Other streptococci were generally susceptible to all compounds tested, with relative activities of amoxicillin greater than cefaclor and cefuroxime greater than cefixime greater than cephalexin. Cefixime was inactive against Bacteroides species. A slight inoculum effect occurred with cefixime with inocolum concentrations varying from 10(5) to 10(6) colony forming units per milliliter, but this was more marked at 10(7) colony forming units per milliliter. Cefixime was resistant to hydrolysis by seven common beta-lactamases. It inhibited the hydrolysis of nitrocefin only by type 1 cephalosporinases. The disk diffusion zone diameter breakpoints for the 30-micrograms cefixime disk were determined by regression analysis to be greater than or equal to 27 mm (susceptible) and less than or equal to 23 mm (resistant), respectively corresponding to minimal inhibitory concentration breakpoints of less than or equal to 1.0 and greater than or equal to 4.0 micrograms/ml. Because of the high interpretive error rate (13.8%) and the occurrence of these breakpoints on the parabolic portion of the regression curve, we recommend further evaluation of cefixime disks with lower potencies. PMID- 3522089 TI - Amikacin-induced alterations in the structure of gram-negative bacilli. AB - Exposure of some species of Enterobacteriaceae and of Pseudomonas aeruginosa to amikacin results in structural alterations which coincide with a decrease in the number of colony forming units. Escherichia coli when exposed to amikacin at a concentration twice the minimum inhibitory concentration for 2 hr shows a reduction in the number of ribosomes in the center of the cell and an aggregation of nuclear material in a peculiar concentric pattern we called "tornado image." After 2-4 hr of exposure to amikacin at concentrations of two to five times the minimal inhibitory concentration, all species tested showed in addition to alterations in the distribution of ribosomes, ruptures in the cytoplasmic membrane, damaged cell walls, and in some instances complete loss of cellular shape. It appears that amikacin produces a lytic death of bacteria. PMID- 3522091 TI - Management of chronic ventricular arrhythmias. PMID- 3522090 TI - Production of extracellular enzymes and cytotoxicity by Vibrio vulnificus. AB - Thirty-three strains of Vibrio vulnificus of clinical and environmental origin were examined for production of 12 extracellular enzymes of potential importance to the virulence of this bacterium. Strains of Vibrio vulnificus were consistent in their production of protease, mucinase, lipase, chondroitinase, hyaluronidase, DNase, sulfatase, and hemolysin. No differences between clinical and environmental isolates were noted. Although none of the enzymes appeared to correlate with the ability of these strains to produce lethality in mice, the production of hemolysin and of a protease with activity against native serum albumin may be significant in the pathogenesis of the potentially fatal infections produced by this organism. The production of several of these exoenzymes also appeared to correlate with pathogenicity in the seven other Vibrio species examined. Culture filtrates of all virulent strains of Vibrio vulnificus were cytotoxic for Chinese hamster ovary cells, whereas those of the strains of Vibrio parahaemolyticus and Vibrio alginolyticus examined lacked this activity. PMID- 3522092 TI - Murine monoclonal antibodies recognizing rabbit proteoglycans. AB - Alterations in the structure and composition of sulfated proteoglycans are found in aging and osteoarthritic rabbits. Monoclonal antibodies (mAB) recognizing specific epitopes of rabbit cartilage proteoglycans would be useful in documenting proteoglycan changes during pathophysiological responses resulting in osteoarthritic pathology in rabbit synovial joints after partial medial meniscectomy. To this point, Balb/c mice were immunized with rabbit proteoglycan (fraction A1D1D1) extracted from xiphoid process. Murine spleen cells were used to prepare hybridomas by fusion with the tumor cell line SP 2/0-Ag 14. Nine mAbs were found to bind to A1D1D1 in a solid phase radioimmunoassay. Binding curves, utilizing A1D1D1 as ligand, resulted in the assignment of mAbs to 3 classes - high, moderate and poor binding mAbs. Binding avidity was independent of immunoglobulin subclass. A1D1D1 was digested with trypsin, chromatographed on DEAE-cellulose and tryptic peptides further resolved by dissociative CsCl density gradient centrifugation. The mAbs were studied in detail utilizing competitive inhibition assays of the resolved peptide fragments. Three types of antigenic fine specificity were observed; a mAb (2G2) which recognized a recurrent epitope on the native A1D1D1, a mAb (2E9) which recognized a single protein epitope, in that it bound to a tryptic peptide that contained a high gluNH2:galNH2 and a mAb (6C9) which preferentially recognized a recurring epitope on heat-treated (50 degrees C minutes) A1D1D1. In this analysis, the epitopes of these mAbs appear to be associated with the core protein since only one mAb (2C7) was competitively inhibited from binding to native A1D1D1 by glycosaminoglycans, hyaluronic acid and oligosaccharides of hyaluronic acid. Direct immunofluorescence staining of rabbit hip, shoulder and knee cartilage showed a differential staining pattern of extracellular matrix with the various mAbs. FITC-2G2 stained the interterritorial matrix intensely; and also the perilacunae zones, whereas FITC-2E9 and FITC-6C9 appeared restricted to the perilacunae regions. PMID- 3522094 TI - Uptake and incorporation of 14C-labelled carbohydrates in the tissues of the reproductive system of the female fowl. AB - The in vivo incorporation of radioactivity from [14C]GlcN, [14C]GalN, [14C]Glc and [14C]Gal, for different time intervals between 1 and 240 hr into whole tissues, acetone extracted tissues and MPS-P of the different parts of the reproductive system of the female fowl was studied. The incorporation of radioactivity was much more extensive when [14C]GlcN was injected than when [14C]GalN was injected. The incorporation of radioactivity was much more extensive when [14C]HexN was injected than when the corresponding [14C]Hex was injected. This difference of incorporation was greater in the MPS-P than in the fresh or acetone extracted tissues. A comparison was undertaken in the extent that radioactivity was incorporated among the different parts of the reproductive system of the fowl when [14C]HexN and 14C[Hex] were administered. PMID- 3522093 TI - Species differences in the expression of caseinolytic proteinases and plasminogen activators by bone marrow cells. AB - Intact viable bone marrow cells from hamsters (Mesocricetus aruatus), rat (Rattus norvegicus), guinea pig (Cavia porcella) and rabbit (Oryctolagus cuniculus) were analyzed for caseinolytic proteinases and plasminogen activator activity. Species specific quantitative and qualitative differences in caseinolytic activity were detected. Quantitative and qualitative differences in plasminogen activator expression were observed. Cellular fractionation experiments revealed a heterogenous distribution of plasminogen activator activity among subpopulations of cells. The plasminogen activator activity associated with bone marrow cells behaved as ectoenzymes. These results indicated that different species may regulate bone marrow cell proteinase activity in a species-specific manner, compatible with their unique regulatory requirements. PMID- 3522095 TI - An expert systems facility for mumps. AB - This paper describes extensions to the Mumps language which facilitate writing expert systems in Mumps. These extensions are based upon the Prolog language and utilize the existing Mumps global array data base as well as other aspects of the Mumps environment. Details are given of an experimental implementation of the interpreter written in C for the Unix operating system. PMID- 3522097 TI - Chemotherapeutic approach to periodontal disease. PMID- 3522096 TI - A new strategy for clinical decision making: censors and neuroendocrinological diseases. AB - A patient rarely has a single, isolated disease. The situation is usually much more complex since the different parts of the human organism and its metabolism interact with each other on multiple levels and follow several feedback patterns. These interactions and feedback patterns become even more complex when the effects of the external environment are considered. When several diseases are present, the first steps in medical diagnosis are to determine whether one of the diseases interacts with ("Censors") or changes the significant symptoms, signs, or results of the laboratory tests of the other diseases. We will try, within this paper, to go beyond the scope of the first generation of Artificial Intelligence systems in medicine to determine the effects of two diseases on each other. One important part of the effect of two diseases on each other is the effect of Censors. In addition, causal reasoning, reasoning by analogy, and learning from precedents are important and necessary for a human-like expert in medicine. Their application to thyroid diseases, with an implemented system, are considered in this paper. PMID- 3522098 TI - A new approach to cast post and core fabrication. PMID- 3522099 TI - Rotational-path partial dentures: problems and potential. PMID- 3522100 TI - Special problems in restorative dentistry for wind musicians: four cases. PMID- 3522101 TI - Antenatal care. Time to relax. PMID- 3522102 TI - Infant feeding: pap's progress. PMID- 3522103 TI - The nature of the antigen-antibody bond and the factors affecting its association and dissociation. AB - Considering that generally both Coulombic and van der Waals' bonds occur in AG-AB interactions, for AG-AB dissociation both interactions have to be made repulsive simultaneously. The theory and practice of repulsive van der Waals' interactions are outlined. Also treated are the hysteresis of AG-AB dissociation contrasted with the inhibition of association; dissociation of hydrogen bonds; dissociation by haptens; dissociation by alteration of tertiary and secondary configurations; and physical methods of dissociation. PMID- 3522104 TI - Inducible lymphokines of T cell tumors. AB - T lymphocytes comprise a major class of lymphocytes and are themselves functionally heterogeneous. Some T lymphocyte functions are mediated by soluble products called lymphokines. Different lymphokines promote the activation, growth and differentiation of T and B lymphocytes, macrophages, and hemopoietic cells. Lymphokine production is associated with, but not limited to, helper T cells, and usually follows antigenic or mitogenic stimulation. The recognition that some lymphokines are produced after stimulation of neoplastic T cells has proved advantageous in the study of these molecules. T cell tumors are monoclonal, grow easily in vitro, and may produce fewer lymphokines than normal T cells. Thus, the purification and biochemical and biological characterization of some lymphokines have been facilitated by the availability of these tumors. More recently, T cell tumors have been used for evaluating the molecular structure of lymphokine encoding genes. They have also provided information relevant to our understanding of the nature of T cell neoplasia. PMID- 3522106 TI - Pressure support ventilation. PMID- 3522105 TI - Tobramycin therapy for lethal sepsis in the dog. AB - Antimicrobial effectiveness and effect on survival of single-dose vs. multiple dose aminoglycoside antibiotic therapy (with and without steroid) for lethal sepsis were evaluated. Adult dogs of either sex were anesthetized, divided into five groups, and infused iv for one hour with Escherichia coli. Group A was given no drug. Group B was given a 45-mg/kg, 10-min iv injection of tobramycin (TOB) at 65 min. Group C was given a 3-mg/kg, 10-min TOB injection at 65 min, followed by an 8.25-mg/kg iv infusion for 285 min, and three 11.25-mg/kg intramuscular injections at 6, 12, and 18 h (total 45 mg/kg). Group D was given the same TOB regimen as B, plus a 30-mg/kg iv injection and 30-mg/kg iv infusion of methylprednisolone sodium succinate (MPSS) from 15 to 360 min. Group E was given the same TOB regimen as C, plus the same MPSS regimen as D. Treated dogs also received 11.25 mg/kg of TOB daily for 4 days. The percent surviving more than 7 days was 0, 0, 17%, 83%, and 83%, for groups A through E, respectively. By 4 h, TOB-treated groups had significantly (p less than .05) lower E. coli blood levels than group A. Also E. coli levels in group B were significantly (p less than .05) lower than those in groups C, D, or E. High trough serum TOB concentrations were associated with death and very low levels with recovery. Serum urea nitrogen and creatinine concentrations increased in all groups, but returned to normal by 7 days in survivors.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3522107 TI - Comparison of high-frequency negative-pressure oscillation with conventional mechanical ventilation in normal and saline-lavaged cats. AB - We modified a negative-pressure respirator to produce high-frequency, subatmospheric pressure oscillations around the chest. The effects of negative pressure oscillation (NPO) on gas exchange, lung volume, compliance and cardiovascular variables were compared to those of conventional intermittent positive-pressure ventilation (IPPV) at 30 breath/min, using cats with normal and surfactant-depleted lungs. For frequencies in both normal lungs (1, 3, 4, 5, and 7 Hz) and saline-lavaged lungs (3, 5, and 7 Hz), peak inflating pressures were lower during NPO. Oxygenation was similar for both modes of ventilation. In cats with normal lungs, PaCO2 was significantly lower during NPO at 3 and 4 Hz (mean 24 torr) than during IPPV (mean 30 torr); normocapnia was maintained at the other frequencies. In damaged lungs, NPO and IPPV at 3 and 5 Hz resulted in similar CO2 removal, but PaCO2 was significantly higher during NPO at 7 Hz. Oscillatory tidal volumes decreased with increasing frequencies: in normal lungs, mean oscillatory tidal volume was 4.4 ml/kg at 1 Hz and 2.3 ml/kg at 7 Hz; in damaged lungs it was 6.5 ml/kg at 3 Hz and 3.2 ml/kg at 7 Hz. At 3 Hz and above, NPO was associated with a larger functional residual capacity than during sequences of IPPV matched for end-expiratory transthoracic pressure. There were no significant differences in respiratory system compliance, cardiac output, and pulmonary vascular resistance between both modes of ventilation. Further studies are warranted to investigate the potential clinical usefulness of NPO. PMID- 3522108 TI - Prolonged endotracheal intubation vs. tracheostomy. AB - A trend has developed in recent years to employ longer periods of endotracheal intubation before performing tracheostomy. This review summarizes the advantages, disadvantages, pathology, and complications associated with both means of airway control. Although endotracheal intubation for up to 3 wk has been tolerated without sequelae, the optimal time to perform a tracheostomy remains controversial. PMID- 3522109 TI - Manganese: its acquisition by and function in the lactic acid bacteria. AB - The transition metal manganese is considered to be a minor micronutrient in both pro- and eukaryotes, usually being required from the environment at subnanomolar levels. Until recently, Mn was only known to function in cells as a cofactor for a few enzymatic reactions. A notable exception has been reported in many lactic acid bacterial species which require micromolar medium Mn levels for growth and contain up to 35 mM Mn. These high Mn concentrations are accompanied by the near or complete absence of intracellular iron and superoxide dismutase (SOD). Lacking hemes, Lactobacillus plantarum and related species contain a unique Mn-cofactored catalase as well as millimolar Mn(II) in a nonenzymic complex performing the function of the micromolar superoxide dismutase found in most other aerotolerant cells. The high Mn(II) levels are accumulated via an efficient active transport system and are stored intracellularly in a high molecular weight complex. Study of Lactobacillus plantarum has provided an interesting example of the substitution of Mn for Fe in several of the biological roles of Fe, an alternative mechanism of aerotolerance, and a better understanding of the unique biochemistry of the lactic acid bacteria. PMID- 3522110 TI - Management of chronic renal failure in children. PMID- 3522111 TI - Myocutaneous and muscle flaps: refinements and new applications. PMID- 3522112 TI - Rectal prolapse. PMID- 3522113 TI - Arteriogenic erectile impotence. AB - Organic causes of erectile impotence, including penile arterial insufficiency, is far more frequent than previously assumed. The aim of this review (based on the literature and previous works of the author) is to define arteriogenic erectile impotence, and to describe its pathophysiological and clinical features, the diagnostic approach, differential diagnostic aspects and possible treatment of this type of impotence. Erectile impotence is inability to react to relevant sexual stimulation, with a change in pelvic and penile hemodynamics that will increase the pressure in the cavernous bodies thus enabling vaginal intromission without special precautions; as well as inability to maintain this pressure ordinarily until ejaculation occurs. Arteriogenic erectile impotence is erectile impotence caused by insufficient arterial blood supply to the cavernous bodies regardless of the arterial disease or abnormality responsible for the insufficiency. The normal mechanism of erection is not fully understood. Accumulation of blood under pressure in the cavernous body is brought about by dilation of the arteries to the cavernous spaces and closure of the drainage from the cavernous body. The drainage blockade is active and located just inside the tunica albuginea at the origin of the emissary veins. The mechanism is probably related to the smooth muscles of the cavernous body which become relaxed at the start of erection. Furthermore, passive out-flow restriction probably supporting the active closure when the cavernous body is distended. The autonomic nerves regulating the erection come from Th10-L2 and S2-S4 and pass the pelvic plexus. The target organ neurotransmitters are probably vasoactive intestinal polypeptide and catecholamines. Penile arterial insufficiency can be demonstrated by penile blood pressure measurement either as a simple measurement, or, better, as pelvic steal test and hyperemic stress test. Ultrasonic Doppler pulse curve analysis is another way of demonstrating penile arterial insufficiency. Visualization of the arterial disease causing penile arterial insufficiency requires bilateral selective internal iliac arteriography.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3522114 TI - Silver acetate gum as a deterrent to smoking. AB - Silver acetate chewing gum, a nonprescription medication, produces an unpleasant metallic taste in the mouth of individuals who consume tobacco products in conjunction with this smoking deterrent. Use of the product leads to self-induced aversive conditioning. In the present double-blind controlled study, subjects using silver acetate for three weeks of treatment had a smoking cessation rate of 15 out of 136 (11 percent, p = 0.02). Placebo subjects had a smoking cessation rate of 6 out of 146 (4 percent, p = .102). Without further treatment, the group using silver acetate demonstrated a 7 percent nonsmoking rate at four months compared with a 3 percent nonsmoking rate for the placebo group. Silver acetate demonstrated a modest benefit over placebo as a smoking deterrent in a minimal intervention and highly cost-effective treatment setting. PMID- 3522115 TI - Gas exchange during mechanical ventilation and spontaneous breathing. Intermittent mandatory ventilation after open heart surgery. AB - Pulmonary gas exchange rates in eight patients after open heart surgery were studied during weaning from the ventilator. We investigated continuous positive pressure ventilation (CPPV), intermittent mandatory ventilation (IMV) and spontaneous breathing with continuous positive airway pressure (CPAP). During each mode of ventilation we measured: CO2 production (VCO2), O2 consumption (VO2), cardiac output (CO), PaO2, Qs/QT and functional residual capacity (FRC). In addition, we analyzed in each single breath: tidal volume (VT), series dead space volume (Vds), alveolar ventilation, alveolar efficiency for CO2 elimination (alv eff CO2) and end-tidal CO2 concentration (FCO2et). We compared the results of CPPV, IMV and CPAP and the mandatory breaths (MB) with the spontaneous breaths (SB) measured during IMV. CO was low during CPPV, when the patient still deeply sedated; it was increased in IMV and remained constant in the following CPAP period. VCO2 and VO2 did not differ significantly when switching from IMV to CPAP; therefore, work due to breathing seemed not to be reduced by the mandatory breath during IMV. Oxygenation (PaO2, Qs/QT) did not change significantly when switching from one mode to the other. FRC was constant when changing from CPPV to IMV, did not alter within the IMV-cycle and was reduced significantly when switching from IMV to CPAP. Dead space ventilation was reduced in SB (compared to MB). The latter result is discussed on the basis of two mechanisms: Vds was reduced and alv eff CO2 was increased. We conclude that compared to CPPV, IMV decreases mean alveolar pressure and reduces dead space ventilation at constant FRC and with constant oxygenation. This may explain why, in the weaning process, IMV makes it possible to start spontaneous breathing very early. PMID- 3522117 TI - Systemic zygomycosis diagnosed by fine needle aspiration and confirmed with enzyme immunoassay. AB - A diagnosis of systemic zygomycosis made by fine needle aspiration of a kidney abscess was confirmed with a serum enzyme immunoassay for Zygomycetes. The serum immunoassay may provide a method for rapid diagnosis and obviate major invasive diagnostic procedures in establishing the diagnosis of zygomycosis. PMID- 3522118 TI - CPAP with minimal work of breathing. PMID- 3522116 TI - Bronchogenic carcinoma, massive hemoptysis, and systemic air embolus. AB - A 57-year-old woman with squamous carcinoma of the right lung (hilum) developed acute massive hemoptysis with syncope and hypotension. Resuscitation was complicated by the development of massive systemic air embolus, and the patient died. PMID- 3522119 TI - Prevalence of bronchial hyperresponsiveness in highly trained athletes. AB - Previous studies indicated that the prevalence of symptomatic asthma is about 4 to 7 percent. No similar studies exist to suggest the prevalence of asthma in highly trained competitive athletes, since asthma is thought to be an uncommon disease in this population. We became concerned, therefore, when a large number of football players developed symptoms consistent with asthma during preparation in California for the Rose Bowl in December 1981. We studied the team and found 12 percent of the football players admitted to a history of asthma, whereas none of the members of the university basketball team and 7 percent of a group of sophomore medical students and physician assistant students gave a history of asthma. Furthermore, 19 percent of the football players indicated that at some time they had chest tightness, cough, wheezing, or prolonged shortness of breath after exercise; 12 percent of the basketball players and 37 percent of the students indicated such a history. We examined each of these three groups for non specific bronchial hyperresponsiveness to inhaled methacholine using a modified methacholine bronchoprovocation (MBP) challenge and found that 76 of 151 (50 percent) football players tested had positive tests; 76 percent of those with symptoms had positive results of inhalation tests and 47 percent of those with minimal or no symptoms had positive test results. In addition, four of 16 (25 percent) basketball players and 69 of 167 (41 percent) students had positive MBP tests. These studies indicate that bronchial hyperresponsiveness to inhaled methacholine is much more common in these young adults than has previously been suspected. PMID- 3522120 TI - Cardiac transplant patient at one year. Cyclosporine vs conventional immunosuppression. AB - From March 1, 1979 thru September 30, 1984 we performed 56 cardiac transplants (Tx). The first 32 patients received conventional immunosuppression therapy consisting of azathioprine/prednisone (I/P), while the subsequent 24 patients received cyclosporine/prednisone (C/P). Twenty-one of 32 I/P patients ages 39 +/- 3 years (SEM), and 16 of 24 eligible C/P patients ages 36 +/- 3 years, survived one year with follow-up through September 30, 1985. The one year post-transplant course of these 37 patients was evaluated by chart review. While donor ages are similar, ischemic time was shorter in the conventionally treated patients. The initial hospital stay for I/P vs C/P was 67 +/- 6 vs 33 +/- 3 days (p less than .05), at a total cost of $49,900 +/- $5,800 vs $53,800 +/- $10,000. During the first year following transplantation, the I/P patients required an additional 34 +/- 7 days of hospitalization, while C/P patients required 16 +/- 10 days. Over the first year, the number of infections and rejections differed at 2.8 +/- 0.6 per I/P patient vs 1.2 +/- 0.3 per C/P patient, and 2.5 +/- 0.4 per patient vs 1.5 +/- 0.3 per patient respectively (p less than .05). Renal function test results were better in the I/P group. Results of cardiac catheterization performed at one year were similar except for cardiac index and stroke volume index, both being higher in the C/P group. Coronary anatomy was considered normal in all. These data indicate that while overall survival is similar, a shortened post-transplant hospital course with fewer necessary hospitalizations, rejection episodes and infection episodes characterizes the first year in survivors receiving C/P immunosuppression. While both groups had multiple hemo-dynamic abnormalities as compared to normal subjects, cardiac index and stroke volume index were improved in the C/P group. Therapy with C/P represents an advance in immunosuppression for cardiac transplantation as compared to I/P; however, decreased renal function and diastolic hypertension were problems in the C/P group. PMID- 3522121 TI - Platelet sensitivity to prostacyclin in smokers and non-smokers. AB - Platelet activating effect of cigarette smoking appears to be important in the development of atherosclerosis. We previously demonstrated a reduced sensitivity of platelets to exogenous prostacyclin (PGI2) in vitro from patients with proven atherosclerotic disease, indicating a possible role of altered platelet function in the development of atherosclerosis. We now hypothesize that cigarette smoking might be an important cause of altered platelet sensitivity to PGI2 observed in patients with atherosclerosis. To test this hypothesis, the response of platelets to exogenous PGI2 was tested in chronic smokers and non-smokers, prior to and after smoking two cigarettes (active smoking) and prior to and after exposure to a tobacco smoke-contaminated atmosphere (passive smoking). This study indicates that platelets of chronic smokers are less sensitive to exogenous PGI2 than platelets of non-smokers. In addition, active as well as passive smoking decreases platelet sensitivity to PGI2 in non-smokers, whereas chronic smokers exhibit no further decline. We conclude that decreased platelet sensitivity to PGI2 might be an important contributing factor to the altered platelet function observed in patients with atherosclerosis. PMID- 3522122 TI - Mechanisms of decreased left ventricular preload during continuous positive pressure ventilation in ARDS. AB - Continuous positive pressure ventilation is associated with a reduction in left ventricular preload and cardiac output, but the mechanisms responsible are controversial. The decrease in left ventricular preload may result exclusively from a decreased systemic venous return due to increased pleural pressure, or from an additional effect such as decreased left ventricular compliance. To determine the mechanisms responsible, we studied the changes in cardiac output induced by continuous positive pressure ventilation in eight patients with the adult respiratory distress syndrome. We measured cardiac output by thermodilution, and biventricular ejection fraction by equilibrium gated blood pool scintigraphy. Biventricular end-diastolic volumes were then calculated by dividing stroke volume by ejection fraction. As positive end-expiratory pressure increased from 0 to 20 cm H2O, stroke volume and biventricular end-diastolic volumes fell about 25 percent, and biventricular ejection fraction remained unchanged. At 20 cm H2O positive end-expiratory pressure, volume expansion for normalizing cardiac output restored biventricular end-diastolic volumes without markedly changing biventricular end-diastolic transmural pressures. The primary cause of the reduction in left ventricular preload with continuous positive pressure ventilation appears to be a fall in venous return and hence in right ventricular stroke volume, without evidence of change in left ventricular diastolic compliance. PMID- 3522123 TI - Complications associated with thoracocentesis. AB - In order to determine the spectrum and frequency of complications associated with thoracocentesis, we decided to audit prospectively all thoracocentesis performed in the medical service at our institution. Over a ten-month interval, 125 procedures were performed. We identified 114 (91 percent) prospectively, 11 retrospectively by a computer-assisted review of discharge summaries. Forty-six percent of the procedures were complicated by at least one adverse occurrence. Complications considered major occurred in 14 percent, minor in 33 percent. The major complications included 14 pneumothoraces (three required tube thoracostomies and one percutaneous aspiration), one splenic laceration, one sheared-off catheter, and one pneumohemothorax. The minor complications included pain in 28, persistent cough in 14, dry taps in 16, and subcutaneous fluid collections in four patients. We conclude that thoracocentesis can carry the risk of frequent morbidity even when a lecture and printed guidelines on performing thoracocentesis have been given and experienced individuals are in attendance during the performance of the procedure. Our study suggests a portion of this morbidity may be from poor technique, inability to adequately identify landmarks, and improper utilization of a needle-catheter apparatus. Suggestions for correction of these problems are made. PMID- 3522124 TI - Long-term mechanical ventilation. Guidelines for management in the home and at alternate community sites. Report of the Ad Hoc Committee, Respiratory Care Section, American College of Chest Physicians. PMID- 3522125 TI - [Resection of the pelvis due to bone tumor. The first case treated in the Rizzoli Orthopedic Institute in 1914]. PMID- 3522126 TI - [Evaluation of ultrasonography and hormonal monitoring in early abortion]. PMID- 3522127 TI - [Epidemiological study of high-risk factors in ovarian carcinoma]. PMID- 3522128 TI - Applied aspects of chronoergohygiene. AB - Chronoergohygiene defines a field of study set on optimizing the work timing compared to the desiderata of human physiology in order to improve the working conditions. Production systems follow their own laws with a timing resulting from economic, technological and natural factors; this timing could contrast with che chronological variables of the person 'involved'. Important aspects to be considered in this regard concern: a energy expense and nutrition, in relation to the mechanization and automation of the working tasks, sociocultural models, individual behaviors in eating habits; b. work performance, with particular reference to the modifications during the life-span and the rhythmic variations in the circadian period; c. toxicologic risks, considering problems of chronokinetics of the toxic agent and of 'chronoesthesia' of the body functions and apparatuses; d. work and social organization, with special reference to shift work, work pace and commuting. The research for a dynamic evaluation of the human machine interaction in time and into forms of chronological compatibility between man and work organization should optimize industrial hygiene. PMID- 3522129 TI - [Relation between urinary hydroxyproline and child growth and development]. PMID- 3522130 TI - [Pancreaticoduodenectomy and gastro-intestinal hormones]. PMID- 3522131 TI - Classic articles in colonic and rectal surgery. Charles Aubrey Pannett 1884-1969. Resection of the rectum with restoration of continuity. PMID- 3522133 TI - Ovarian and omental ependymomas in peritoneal washings: cytologic and immunocytochemical features. AB - The cytologic findings in peritoneal washings of two women, one of whom had an ovarian ependymoma and the other a primary omental ependymoma, are reported. The ependymomas were characterized by the presence of numerous, isolated, spindle and stellate cells as well as groups of cells forming true rosettes. The tumor cells displayed slightly pleomorphic, round-to-oval eccentric nuclei and abundant fibrillary cytoplasm with tapering cytoplasmic processes. In addition, one of the patients had numerous papillae and cell clusters with associated psammoma bodies indistinguishable from those found in low-grade serous carcinoma. The demonstration of glial fibrillary acidic protein (GFAP) in both cases by immunocytochemical procedures indicates the usefulness of this method in cytologic preparations to confirm the diagnosis of these uncommon neoplasms. PMID- 3522132 TI - Why have controlled trials failed to demonstrate a benefit of esophagogastroduodenoscopy in acute upper gastrointestinal bleeding? A probability model analysis. AB - Numerous prospective randomized trials have failed to demonstrate a benefit attributable to early diagnostic esophagogastroduodenoscopy (EGD) in acute upper gastrointestinal bleeding (UGIB). The clinical implications of these studies have received extensive editorial comment and analysis. We have employed a probability model to further analyze the reasons why these studies have failed to demonstrate an impact of EGD on UGIB. The clinical course of each bleeding lesion can be predicted from the literature. For each lesion, the mortality associated with early specific intervention afforded by an early specific diagnosis can be compared with the mortality of intervention delayed by applying EGD only to those patients who have a complicated course marked by continued bleeding or rebleeding. Using optimistic assumptions that would tend to overstate the impact of EGD, this analysis estimates the maximum decrease in overall mortality in any of these trials afforded by early diagnostic EGD to be 1.2% which would require randomization of over 5000 patients to demonstrate this benefit in a prospective trial. PMID- 3522134 TI - Intraoperative cytodiagnosis of pancreatic adenosquamous carcinoma: a case report. AB - The cytologic diagnosis by intraoperative fine-needle aspiration of a case of partially cystic adenosquamous carcinoma of the pancreas is reported. Tissue for histologic confirmation was not obtained. Confirmatory ultrastructural and immunochemical findings are thus presented. PMID- 3522135 TI - The negative immunocytochemical result: what does it mean? PMID- 3522136 TI - Malignant thymic neoplasms: diagnosis by fine-needle aspiration biopsy with histologic, immunocytochemical, and ultrastructural confirmation. AB - Two cases of malignant thymic neoplasms diagnosed by transthoracic fine-needle aspiration (FNA) biopsy under fluoroscopic and computerized axial tomography (CT) guidance with histologic, immunocytochemical, and ultrastructural confirmation are presented. The clinical and cytomorphologic features of the first case were typical of a malignant thymoma. A characteristic biphasic cell population of benign epithelial cells and mature lymphocytes was seen in Diff-Quik- and Papanicolaou-stained smears from the anterior mediastinal mass and the paravertebral metastasis and was confirmed by histologic examination. Immunoperoxidase studies for T and B cell subsets demonstrated lymphocytes with the thymic lymphocyte phenotype (Leu 6). Electron microscopic (EM) examination revealed epithelial cells with desmosomal attachments, tonofilaments, and extended cell processes along with mature lymphocytes. FNA biopsy of the second case demonstrated features of a thymic carcinoma. Individually scattered and loosely clustered small groups of markedly anaplastic and pleomorphic large cells were seen both in the Diff-Quik- and Papanicolaou-stained smears. EM performed on the FNA specimen demonstrated the poorly differentiated epithelial nature of the malignancy. The mediastinal mass was partially resected and demonstrated an undifferentiated carcinoma staining positively for low-molecular-weight cytokeratin. Ultrastructure demonstrated cell attachments and relationships consistent with carcinoma. The lack of a lung or other extrapulmonary primary tumor was consistent with a thymic carcinoma. These cases demonstrate the value of performing EM and immunocytochemistry on material obtained by fine-needle aspiration, which can aid in establishing the correct diagnosis and facilitate the clinical management of patients with malignant thymic neoplasms. PMID- 3522137 TI - CT-guided stereotactic biopsy of intracranial lesions: correlation between core biopsy and aspiration smear. AB - Computerized tomography (CT)-guided stereotactic biopsies of intracranial lesions in 29 patients were analyzed, paying particular attention to the correlation between core biopsies and aspiration smears. Seven percent were nondiagnostic due to sampling error. Discrepancies occurred between core biopsies and aspiration smears in 10% of the cases. In two instances of such discrepancies, cytologic findings on the aspiration smear yielded the diagnosis of metastatic tumor. One patient, with herpetic encephalitis, was diagnosed by electron microscopic review of the core biopsy only. One patient died of an intraoperative hemorrhage, a complication of the fine-needle technique. PMID- 3522138 TI - Application of cell-image analysis to the diagnosis of cellular atypias in sputum: a review. AB - The incidence of carcinoma of the lung continues to steadily rise, and attempts at early diagnosis to improve prognosis have not yet been rewarding. The goal of our research is to decrease the incidence of lung cancer by detecting premalignant bronchial dysplasias in individuals in whom development of lung cancer is potentially preventable. To achieve this, we have developed an atypia status index (ASI)--the assignment of numerical values to the various stages of atypical bronchial epithelial cells in sputum, and a cell atypia profile (CAP)- an ASI-generated scale of 200 such atypical bronchial epithelial cells in a single sputum specimen. Computerized cell-image analysis techniques and statistical data analysis are used to generate the ASIs and CAPs for each subject. This study is a step toward the development of an automated cell-image analysis system for mass screening of premalignant atypias in sputum of those considered at high risk for lung cancer (i.e., men and women of 40 yr of age and older, with more than 20 pack-yr of cigarette smoking). PMID- 3522139 TI - Activation of glucose transport in muscle by exercise. PMID- 3522140 TI - Physical training and insulin sensitivity. AB - In conclusion, a large body of available evidence indicates that the degree of physical conditioning is an important determinant of insulin sensitivity and overall glucose tolerance. Both acute exercise and chronic physical training are associated with enhanced disposal of a glucose load. Conversely, physical inactivity leads to a deterioration in glucose tolerance. The primary tissue responsible for accelerated glucose disposal following exercise is muscle. After an acute bout of exercise, enhanced glucose transport and augmented glycogen synthesis are largely responsible for the improvement in glucose tolerance. The beneficial effects of chronic physical training on glucose metabolism appear to be explained by multiple factors, including increased muscle mass, augmented muscle blood flow and capillary area, enhanced mitochondrial oxidative enzyme capacity, and activation of the glucose transport system. Despite these well documented effects of training on glucose metabolism, the precise role of exercise in the treatment of diabetic patients remains to be established. In insulin-dependent (type I) diabetic individuals, acute exercise has been shown to be a helpful adjunct in establishing good glycemic control. However, the role of acute exercise in helping to smooth out glycemic control in non-insulin-dependent (type II) diabetic patients has received little attention. The role of chronic physical training in the treatment of both insulin-dependent (type I) and non insulin-dependent (type II) diabetic individuals remains to be established. PMID- 3522141 TI - Atherosclerosis and physical activity. PMID- 3522143 TI - Exercise, resting metabolic rate, and thermogenesis. PMID- 3522142 TI - Exercise and physical training: effects on insulin sensitivity and glucose metabolism. PMID- 3522144 TI - Therapy and better quality of life: the dichotomous role of exercise in diabetes mellitus. PMID- 3522145 TI - Long-term in vitro effects of insulin on insulin binding and glucose transport. AB - The long-term in vitro effects of insulin on insulin binding and glucose transport were studied using rat adipocytes in a time-dependent manner. Isolated fat cells were incubated with insulin (100 ng/ml) for 4, 8 and 24 h in a TCM 199 medium, at 37 degrees C, and then insulin binding (37 degrees C, 60 min) and 3-O methylglucose transport (37 degrees C, 2 s) were determined. Decreased insulin binding was demonstrated in the cells incubated with insulin for 8 h, and Scatchard analysis revealed that receptor number was decreased to 61.7% of that of control cells. Thus, insulin-induced down regulation of receptors was evident after 8 h incubation with insulin. On the other hand, 8 h incubation with insulin resulted in markedly increased basal (i.e., in the absence of insulin) glucose transport up to 246% of control values. In the cells incubated with insulin for 24 h, maximally insulin-stimulated glucose transport was significantly increased up to 248% of control value. Thus, these results suggested that insulin-induced down regulation of receptors appeared to be coupled with increased cell-surface glucose transporters, and that there was a time-lag between down regulation of insulin receptors and increase of available glucose transporters in the plasma membrane. PMID- 3522146 TI - Inhibitory effect of anoxia on 125I-insulin binding by rat hepatocytes. AB - We have examined the possibility that 125I-insulin binding by isolated rat hepatocytes is modulated by cellular ATP levels. To avoid complications due to ATP-dependent internalization of bound insulin, 125I-insulin binding was determined at 10 degrees C; at this temperature, equilibrium binding was achieved after incubation for 4-6 h. When hepatocytes were incubated at 37 degrees C under anaerobic conditions, ATP levels and 125I-insulin binding were both lowered by about 65%. Anoxia inhibited the association of 125I-insulin with the hepatocyte receptor; the dissociation of insulin from hepatocytes was not affected. Cellular ATP levels and 125I-insulin binding were both restored when anaerobic cells were incubated further at 37 degrees C under aerobic conditions. When anaerobic cells were incubated in air at 10 degrees C during the insulin binding assay, 125I insulin binding recovered completely, but ATP levels were unaffected. The inhibitory effect of anoxia on 125I-insulin binding was not due to any effect on 125I-insulin degradation or on cell viability. We conclude (1) that the ability of hepatocytes to bind insulin can be modulated on a short-term basis in response to the metabolic status of the cell, and (2) that modulation of the liver cell insulin receptor is not a function of cellular ATP levels. PMID- 3522147 TI - Glucose tolerance, blood lipid, insulin and glucagon concentration after single or continuous administration of aspartame in diabetics. AB - A nutritive sweetener, aspartame (L-aspartyl-L-phenylalanine methylester) was administered orally to normal controls and diabetic patients in order to evaluate effects on blood glucose, lipids and pancreatic hormone secretion. An oral glucose tolerance test was also performed in the same subjects as a control study of aspartame administration. In 7 normal controls and 22 untreated diabetics, a single dose of 500 mg aspartame, equivalent to 100 g glucose in sweetness, induced no increase in blood glucose concentration. Rather, a small but significant decrease in blood glucose was noticed 2 or 3 h after administration. The decrease in blood glucose was found to be smallest in the control and became greater as the diabetes increased in severity. No significant change in blood insulin or glucagon concentration during a 3-h period was observed in either the controls or the diabetics. The second study was designed to determine the effects of 2 weeks' continuous administration of 125 mg aspartame, equal in sweetness to the mean daily consumption of sugar (20-30 g) in Japan, to 9 hospitalized diabetics with steady-state glycemic control. The glucose tolerance showed no significant change after 2 weeks' administration. Fasting, 1 h and 2 h postprandial blood glucose, blood cholesterol, triglyceride and HDL-cholesterol were also unaffected. From these and other published results, aspartame would seem to be a useful alternative nutrient sweetener for patients with diabetes mellitus. PMID- 3522148 TI - Decreased insulin binding to pancreatic islets of genetically obese (fa/fa) rats. AB - Binding of insulin and insulin secretion were studied in isolated pancreatic islets of homozygous obese fa/fa rats, their lean littermates (Fa/?) and Wistar rats. Despite normoglycemia fa/fa rats exhibit hyperinsulinemia. Glucose-induced insulin secretion from pancreatic islets in vitro was increased by more than 50% in fa/fa rats compared with islets of lean littermates and normal Wistar rats when calculated per microgram islet protein. Exogenous insulin inhibited glucose (16.7 mM)-induced insulin secretion in islets of either of these rats, and maximum inhibition was rather the same (secretion was reduced by 62.3-65.6%). However, the EC50 (half-maximal effective concentration) for inhibition was increased in fa/fa rats being 1.4 +/- 0.1 nM compared with 0.6 +/- 0.2 and 0.5 +/ 0.2 nM in lean littermates and Wistar rats, respectively (P less than 0.05 vs. fa/fa rats). Islets of fa/fa rats found 24% less [125I]insulin (P less than 0.01) than islets of lean littermates and of Wistar rats. Scatchard analysis of data of displacement of [125I]insulin binding by native insulin showed 2 binding sites; a decrease in the number of high affinity insulin binding sites (Bmax) from 4.2 +/- 1.3 and 4.7 +/- 1.6 fmol/mg protein to 2.6 +/- 0.7 fmol/mg protein was calculated when islets of lean littermates and normal Wistar rats were compared to islets of fa/fa rats. The Kd of the high affinity binding site was not changed (0.77 +/- 0.06, 0.78 +/- 0.11 and 0.61 +/- 0.14 nM, respectively).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3522149 TI - Autoradiographic analysis of 125I-insulin-like growth factor II internalization into pancreatic acini. AB - The internalization and intracellular distribution of 125I-insulin-like growth factor II (125I-IGF II) in mouse isolated pancreatic acini was studied by electron microscope autoradiography. 125I-IGF II was rapidly internalized; after 30 min over 70% of silver grains derived from the bound hormone were localized over the interior of the cells. The grain distribution from 125I-IGF II differed significantly from both a random grain distribution and that derived from bound 125I-insulin. The majority of intracellular 125I-IGF II grains were over the endoplasmic reticulum and Golgi; the Golgi showed the highest density of intracellular grains. Pretreatment of acini with 10 nM cholecystokinin octapeptide (CCK 8) reduced both the amount of acinar-associated IGF II and the density of intracellular 125I-IGF II grains. Moreover, CCK 8 altered the relative distribution of grains from 125I-IGF II between organelles. These studies indicate, therefore, that 125I-IGF II is internalized by pancreatic acini, and that this internalization is regulated by CCK 8. PMID- 3522150 TI - Further evidence for insulin hypersecretion not as an initial event but as a consequence of body growth and maturation in juvenile-onset obesity. AB - According to our previous study, hyperinsulinism develops not before 10 years of age despite the presence of obesity but during the maturation years of 10-20. We aimed here at examining the growth-related islet B-cell change together with pituitary activity in non-familial juvenile obesity. Measurement of 24 h urine hormones was shown to be useful for evaluation of the diurnal hormones in plasma. In 56 non-obese and obese juveniles, a significantly positive correlation was found between age (6-18 years) and 24 h urine insulin and c-peptide, thus indicating that the age-related absolute value of body weight significantly affects insulin and c-peptide excretions both in non-obese and obese subjects. Consequently, urinary insulin and c-peptide excretions per kg of body weight were highly similar between obese and non-obese juveniles. However, when the lower specific gravity of fat mass compared with lean body mass and the relative shortage of circulating plasma in fat tissues are taken into consideration, it is obvious that obesity by itself specifically augments this physiologic B-cell maturation between 10 and 20 years of age. The possible interactions of growth hormone and pituitary gonadotropin in hyperinsulinism are discussed. PMID- 3522151 TI - [Enhanced expression of cloned genes as a result of the use of the polycistron operon system]. PMID- 3522152 TI - [Metabolic limiting of the effectiveness of Escherichia coli K802 growth in a chemostat]. PMID- 3522153 TI - Correlation between structure and biological properties of cephalosporins: the discovery of ceftriaxone. AB - A research programme on cephalosporins was conducted in the author's laboratory with the aim of creating compounds with improved antibacterial and pharmacokinetic properties. In the first phase of this programme, great attention was paid to the study of how the structure of a 3-heterocyclic-thiomethyl side chain is capable of influencing antibiotic activity within a large series of model compounds possessing the same acyl side chain (2-thienylacetyl) as cephalothin. Several structural and physico-chemical features of the heterocyclic thiols used and the corresponding cephalosporins were correlated with in vitro and in vivo activity. As a result of these studies, the enolic 2-methyl-6-hydroxy 5-oxo-as-triazine-3-thiol was identified as the most interesting substituent, since the corresponding cephalosporin showed a valuable resistance breakthrough against several cephalothin-resistant Proteus strains. Consequently, further studies involving the use of different acyl side chains were performed. The introduction of the basic 2-(2-amino-4-thiazolyl)-2-(Z)-methoxyimino-acetyl side chain finally led to ceftriaxone, which has a very long elimination half-life of 8 hours, high beta-lactamase stability and extremely high chemotherapeutic efficacy against a broad spectrum of Gram-positive and Gram-negative pathogens. Owing to these properties, ceftriaxone is the first beta-lactam antibiotic suitable for once-daily administration. PMID- 3522154 TI - In vitro activity of pefloxacin. AB - A broth dilution method was used to measure the minimal inhibitory concentrations of pefloxacin, a new quinolone derivative. Because this new agent could be used in systemic infections, mezlocillin, cefotaxime, ceftazidime and amikacin were used as comparative agents. Pefloxacin was found to be more active than mezlocillin and as active as or more active than cefotaxime, ceftazidime and amikacin. With the exception of Serratia marcescens, only 7% of Enterobacteriaceae strains were resistant to pefloxacin with a MIC greater than 8 micrograms/ml. Pefloxacin was also found to be the best agent against the non fermenters Staphylococcus aureus and St. epidermidis. Resistance to ampicillin, carbenicillin and gentamicin did not affect the effectiveness of pefloxacin. However, pefloxacin appeared more susceptible to nalidixic acid resistance, with MICs four to sixfold higher. PMID- 3522155 TI - Correlation of beta-lactamase stability and antibacterial activity of beta lactams in beta-lactamase-producing bacteria and respective transconjugants. AB - A total of 343 Gram-negative bacteria were isolated and identified from urine specimens of patients with urinary tract infections. All the bacteria were investigated for their production of beta-lactamases by the nitrocefin test. beta lactamase-producing strains were tested by the Datta method to detect any transfer of beta-lactamase production to a receiving E. coli K12 RN-strain. MICs of six beta-lactamase-stable compounds (ceftazidime, ceftriaxone, cefamandole, cefoxitin, cefotaxime, cefuroxime) were determined against all the beta-lactamase transferring bacteria and their respective transconjugants by a miniaturized dilution broth method. beta-lactamases produced by donors and transconjugants were purified and identified by determination of the isoelectric point by focusing; their hydrolytic activity was assessed by a spectrophotometric method using cytochrome c reduction. A total of 129 bacteria out of 343 produced beta lactamases and 27 of these transferred the beta-lactamase production by conjugation. The beta-lactamases isolated from donors and transconjugants had the same pl and the same substrate profile. Ceftazidime was more stable to all the beta-lactamases isolated and more active against all the bacteria examined than the other compounds. PMID- 3522156 TI - Bactericidal effects induced by laser irradiation and haematoporphyrin against gram-positive and gram-negative microorganisms. AB - Laser irradiation of tissues treated in vivo with haematoporphyrin (Hpr) is known to result in a cytocidal effect, reportedly more pronounced in tumour tissues. To ascertain whether this cytocidal phenomenon can occur not only in eukaryotic but also in prokaryotic cells, the authors devised a model system in vitro consisting of bacterial cultures in liquid and in solid media. Bacteria photosensitized with Hpr were subsequently exposed to laser beams and to daylight; then normal microbiological techniques were used to determine whether any bactericidal effect occurred. Satisfactory results were achieved, particularly against Gram-positive microorganisms; a partial inhibition of Gram-negative microorganisms was also observed. PMID- 3522157 TI - Comparison of brodimoprim and doxycycline in acute respiratory tract infections. A double-blind clinical trial. AB - Brodimoprim and doxycycline monotherapies were compared in the treatment of acute respiratory tract infections in a randomized double-blind trial. The brodimoprim dose was 400 mg as a single loading dose followed by 200 mg for 10 days at bedtime. The corresponding doses of doxycycline were 200 and 100 mg respectively. Both treatment groups consisted of 30 patients. In the brodimoprim group, 23 patients recovered completely, five improved and two did not respond. In the doxycycline group, 26 patients recovered completely, three improved and one was considered a failure. Only one patient in the brodimoprim group had moderate diarrhoea. PMID- 3522158 TI - Evaluation of a stable 5-F prostacyclin analogue as an antithrombotic agent in haemodialysis. AB - Prostacyclin has been used as a substitute for heparin in renal dialysis because of its potent antiplatelet activity and its short half-life. However, it is difficult to use because of its instability in neutral buffer and its hypotensive activity at antithrombotic doses. SC-39902, a 5-F prostacyclin analogue, has an ED50 of 17.7 micrograms/kg i.v. against ADP-induced thrombocytopenia in rats. The ED25 for hypotensive activity is 7.0 micrograms/kg i.v. The therapeutic index (blood pressure ED25/antiplatelet ED50) of 0.40 is 3.6 times better than that of PGI2 (0.11). SC-39902 supports clot-free dialysis in dogs at 4.0 micrograms/kg/min (ED100 for dialysis) with a 26% change in blood pressure at the 100% effective dose as compared with 0.052 microgram/kg/min required for PGI2 with a 32% change in blood pressure. The authors conclude that SC-39902 will provide the desirable antiplatelet/antithrombotic activities of PGI2 without instability and buffer incompatability problems. However, at the ED100 for dialysis, SC-39902 does have haemodynamic activity and, thus, a therapeutic index which is greater than four times that of PGI2 in rats is required for a PGI2 analogue to have less hypotensive activity during dialysis. PMID- 3522159 TI - Piretanide in the treatment of essential hypertension. A double-blind comparison versus placebo. AB - In a randomized, double-blind parallel group study the 24-hour hypotensive effect of piretanide and its influence on biochemical variables were compared with those of placebo in patients with mild to moderate essential hypertension. Sixty patients entered the study, all of whom met the inclusion criteria (RRdiast between 95 and 120 mmHg). There was no drop-out during the study, so that the results of all 60 patients were statistically analysed. Piretanide produced a significant reduction of both systolic and diastolic blood pressure over 24 hours which was evident at four weeks and was maintained and further enhanced over the ensuing trial period. A mean maximal fall (at 12 weeks) of 10.7% (BPdiast supine) was observed. Placebo tablets did not produce any clinically relevant changes in systolic blood pressure, whereas a slight decrease was seen in diastolic blood pressure. This blood pressure reduction was significantly less in the placebo group than in the piretanide group at the end of the study (weeks 10 and 12). Dose doubling was needed in 13 of the 30 patients in the piretanide group, whereas as many as 20 out of 30 patients needed dose doubling in the placebo group. Pulse rate did not change relevantly during the trial in either group. A slight reduction in body weight was observed in the piretanide group. The mean values of serum potassium and sodium showed a slight decrease but remained within the normal range during the study period. A small increase in serum phosphorus was noted. None of these changes required any specific measures.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3522160 TI - Ketoconazole treatment of chronic mucocutaneous candidiasis. AB - The authors report the results of treatment with ketoconazole in 8 patients with chronic mucocutaneous candidiasis (CMC). The drug, administered in the dose of 200 mg once a day orally for a period of time varying from 2 to 12 months, led to improvement in or elimination of clinical symptoms in all patients. One patient had a relapse on suspension of treatment, but this regressed rapidly on resumption of ketoconazole. In 7 cases there were no side-effects. In one case there was an increase in serum liver enzymes which disappeared spontaneously 7 days after suspension of treatment. These results appear encouraging in view of the difficulty of treating this disease, which is often resistant to conventional antifungal therapy. PMID- 3522161 TI - Ketoconazole: therapeutic results obtained in the district of Cagliari. AB - The therapeutic results of ketoconazole treatment in 61 patients affected by mycoses at various locations are reported. The mycotic conditions in these patients were: pityriasis versicolor (26), tinea cruris (14), tinea corporis (8), tinea pedis (6), kerion celsi (6) and monilial granuloma (1). Clinical and mycological cure was obtained in 56 cases (91.8%) over a mean treatment period from a minimum of 29 days (pityriasis versicolor) to a maximum of 39 days (tinea pedis) and 150 days (monilial granuloma), with a mean daily dosage of 200 mg in adults and 100 mg in children. The authors stress the high level of tolerability of the drug and its high therapeutic activity. They indicate the conditions for its use in superficial epidermomycoses and kerion celsi and note its unparalleled effect in chronic mucocutaneous candidosis. PMID- 3522162 TI - Prophylaxis of mycotic infections in immunocompromised patients: a review of 27 reports and publications. AB - During the last three years, several studies have investigated the potential of ketoconazole for antifungal prophylaxis in immunocompromised patients. Ketoconazole 200 mg o.d. seems to have some effect, but this daily dose is considered too low. Studies using higher doses suggest an increased prophylactic effect with 400 mg and adequate prophylaxis with 600 mg ketoconazole daily. When compared with other antifungals, ketoconazole seems to be superior to nystatin and as effective as amphotericin B (500 mg t.i.d.). PMID- 3522163 TI - Drug-induced fever. AB - Humans maintain body temperature within a narrow range. Drug administration can upset the usual balance and cause a fever. The drug may interfere with heat dissipation peripherally, increase the rate of metabolism, evoke a cellular or humoral immune response, mimic endogenous pyrogen, or damage tissues. The fever may be a result of the pharmacological action of the drug or some other unrelated effect. Drug-induced fever is most commonly the result of a hypersensitivity reaction and its characteristics resemble those of an allergic reaction. The fever most commonly occurs after 7 to 10 days of drug administration, persists as long as the drug is continued, disappears soon after stopping the drug, and will rapidly reappear if the drug is restarted. The agents most commonly associated with causing fever include the penicillins, cephalosporins, antituberculars, quinidine, procainamide, methyldopa, and phenytoin. PMID- 3522165 TI - The surgical management of glue ear. PMID- 3522164 TI - Erythromycin-cyclosporin interaction. PMID- 3522166 TI - [Sonographic diagnosis of arterial occlusive disease]. AB - In 32 patients presenting symptoms of arterial occlusive disease, 50 lower limbs were examined both by ultrasonography and angiography (DSA). Sonography was performed using a 5.0 MHz real-time scanner; common femoral, superficial femoral and deep femoral arteries were visualized continuously in whole length. In 84% both the results from sonography and digital subtraction angiography verified or excluded arterial occlusion. Since lack of pulsation is the ultrasonic criterion of occlusion, real-time ultrasound does not differentiate between haemodynamically effective high-grade stenosis and total occlusion. PMID- 3522167 TI - [Pest control--what is it?]. PMID- 3522168 TI - [Biological aspects of the regulation of vertebrate populations]. PMID- 3522169 TI - [Legislative aspects of animal protection with regard to control measures]. PMID- 3522170 TI - [Control of rodents and moles in gardens and in agriculture and forestry]. PMID- 3522171 TI - [Regulation of rodents in residential areas: rats and house mice]. PMID- 3522172 TI - [Control measures of game vertebrates from the veterinary and hunting viewpoint]. PMID- 3522173 TI - [Control of mammals and birds in airports]. PMID- 3522174 TI - [Control of gulls and other bird species]. PMID- 3522175 TI - [Control of birds in the agricultural area: the rook and carrion crow]. PMID- 3522176 TI - [Control of birds in the agricultural area: the ring dove]. PMID- 3522177 TI - [Control of birds in the agricultural area: the house and field sparrow]. PMID- 3522178 TI - [Control measures in the mute swan, gray goose and mallard]. PMID- 3522179 TI - [Control of birds in specially cultivated areas and food industries]. PMID- 3522181 TI - [Chemical control methods in animal protection legislation on damage-adjusting vertebrate populations]. PMID- 3522180 TI - [Ruling on various pest-control substances to be included in the code of legislation as a basis for the evaluation of the legal mercy killing of animals]. PMID- 3522182 TI - [Attitude to control measures from the viewpoint of administration]. PMID- 3522183 TI - [Roentgenologic demonstration of the epi- and apophyses of the forelimb skeleton of a 2.2 Pudu pudu (Molina, 1782) from the time of birth to around 2 months of age, supplemented by findings in a 0.1 12-year-old pudu]. PMID- 3522184 TI - [Medical nomenclature--is it still current?]. PMID- 3522185 TI - [Chromophobe cells and their significance as folliculostellate cells in the pars distalis adenohypophysis in cattle]. PMID- 3522186 TI - [Comparative anatomy of the skeletal muscles of fallow deer (Dama dama L. 1758), sheep (Ovis aries L. 1758) and goat (Capra hircus L. 1758). II: Skin muscles of the head and facial muscles]. PMID- 3522187 TI - [Imaging technic in the diagnosis and treatment of occult infections]. PMID- 3522188 TI - [Polymorphic tularemia]. PMID- 3522189 TI - [Chronic encephalitis caused by mumps virus]. PMID- 3522190 TI - Nasal physiology. PMID- 3522191 TI - Classical approaches to the diagnosis of allergy. PMID- 3522192 TI - Newer approaches to the diagnosis of rhinitis. PMID- 3522193 TI - Immunotherapy update. PMID- 3522194 TI - Occasional survey: ultrasound and C.T. scanning. PMID- 3522195 TI - Long term postnatal development of insulin secretion in early premature infants. AB - The postnatal development of insulin secretion was studied in a group of premature infants (26-30 weeks gestation at birth) for periods up to 110 days after birth and in a small group of full-term infants (38-42 weeks gestation) for up to 47 days after birth. Circulating insulin levels were measured before, and at 30 min after the commencement of a glucose infusion given either parenterally or enterally depending on conceptual age and the mode of nutrition of the infant. The insulin response was assessed as the ratio of the increase in plasma insulin concentration to the increase in blood glucose concentration at 30 min. There was a small insulin response to glucose on day 1 in the premature infants and this increased slowly over the remainder of the study period regardless of the route of administration of glucose or of the mode of nutrition. The full-term infants were more responsive over the seven postnatal weeks in which they were studied. It is concluded that early premature infants can take up to eighteen weeks to develop an ability to respond fully to hyperglycaemia with insulin secretion even though full oral nutrition had been established over the last twelve weeks. PMID- 3522196 TI - [Role of vitamins E and C in the development of the malignant process]. AB - The data on the influence of antioxidant vitamins (E and C) on the growth of induced and transplantable tumours in animals and on the development of cancer process in man as well as on the course of chemo- and radiotherapy are analyzed; a degree of vitamin provision of the tumour-bearing organism is discussed. Special attention is paid to optimal doses of the above mentioned vitamins. The necessity of combined application of antioxidant vitamins in cancer therapy is established. PMID- 3522197 TI - [Ultrastructural organization of the blood lymphoid cells in hairy cell leukemia]. AB - The cytochemical, immunological, and ultrastructural peculiarities of the hairy cell leukemia cells are studied. The hairy cells can be identified by characteristic of ultrastructure of organellae: numerous thin processes on the plasma membrane, large cytoplasmic area, well developed granular endoplasmic reticulum, numerous vesicules and electron dense granules, a well differentiated lobulated nucleus with a large nucleolus in which the granular component predominates. PMID- 3522198 TI - [Changes in the proteolytic activity and components of the blood kallikrein-kinin system during the growth and metastasis of experimental neoplasms]. AB - Changes in the total blood proteolytic activity, prekallikrein level, serum kallikrein inhibitors and other proteinases were studied during the growth and metastatic spreading of different experimental tumours. It has been established that the dissemination and metastatic spreading of Guerin carcinoma inoculated intratesticularly to rats is accompanied by a decrease in the content of prekallikrein and serum kallikrein inhibitors, which shows the activation of blood kinins. Changes in the total proteolysis and in prekallikrein content in mice with carcinoma 3LL and melanoma B-16 are of two-phase character: at the first stage after tumour inoculation there occurs an increase in the proteolytic activity and in prekallikrein content. At the second stage (14 to 28 days) characterized by the appearance of lung metastases, quite a pronounced and stable inhibition of the total proteolysis and of prekallikrein level was observed together with an increased level of proteinase inhibitors. The data obtained show that disturbances in the reactions of limited proteolysis, in particular shifts of the blood kallikrein-kinin system, play a definite role in the development of the metastatic process. PMID- 3522199 TI - Procedures for respiratory function. AB - The emergency practitioner has a wide array of procedures in his armamentarium for the diagnosis of pulmonary dysfunction. The combination of blood gas analysis, spirometry, peak expiratory measurements, and trans-tissue monitors, coupled with clinical and radiographic findings, can offer a concise picture of pulmonary status. Further emergency medicine research in these areas will provide exciting methods of assessing and monitoring treatment responses for patients with pulmonary dysfunction. PMID- 3522200 TI - Emergency thoracotomy. AB - Emergency thoracotomy is a valuable therapeutic modality for the moribund patient when trauma is the cause of the shock state. It is a procedure that requires an understanding of the technique and indications and should be instituted based on the indications listed above. There is probably no reason to do this procedure in the patient who is in extremis as a result of blunt trauma, because results have been universally dismal in these patients. In the patient with a rapidly expanding abdomen resulting from trauma and who is moribund, opening the chest and cross-clamping the aorta may be beneficial. Emergency thoracotomy does not take the place of volume replacement and definitive surgical care for the trauma patient. PMID- 3522201 TI - Interventions in acute myocardial infarction. AB - Myocardial reperfusion therapy of myocardial infarction (MI) recently has gained widespread clinical acceptance. Because emergency care physicians often have contact with these patients, they must make early decisions regarding this type of therapy. This summary attempts to outline the pathogenesis of acute MI and the pathophysiology of myocardial reperfusion and summarizes the clinical trials of differing methods of achieving coronary reperfusion. With these data, it is hoped that physicians can make decisions offering optimal therapy for patients with myocardial infarction. PMID- 3522202 TI - Recent advances in intravenous therapy. AB - For trauma resuscitation, the American College of Surgeons Committee on Trauma recommends at least two large-bore intravenous lines for rapid fluid administration. Access to venous circulation may be difficult and challenging in emergency situations. The physician should be accomplished in numerous intravenous access techniques. Knowledge of flow characteristics for intravenous catheters will aid in the appropriate choice of equipment for successful emergency resuscitation. PMID- 3522203 TI - Peritoneal lavage and other diagnostic procedures in blunt abdominal trauma. AB - Diagnostic procedures such as peritoneal lavage, computed tomography, emergency angiography, nuclear scintigraphy, and contrast studies of the gastrointestinal and urinary tracts can assist in the identification, quantification, and localization of injury after blunt abdominal trauma. Use of these procedures should be determined by careful clinically assessment as part of an aggressive approach to the diagnosis of the injured patient. PMID- 3522204 TI - Urologic procedures. AB - The relief of bladder outlet obstruction can be accomplished by several procedures. In the absence of trauma, the simplest of these is passage of a Foley catheter. When the genitourinary system has been subjected to trauma, it is important to assess its integrity before instrumentation is performed. Radiographic assessment is performed most often with the use of contrast media. PMID- 3522205 TI - Antimicrobial treatment of minor soft tissue lacerations: a critical review. AB - This article is a collective review of all the prospective clinical studies that assessed the therapeutic value of antibiotics in minor soft tissue lacerations. This review critically evaluates each study that tests the hypothesis that antibiotic treatment reduces the incidence of infection. Even though the design of each of the studies was scientifically inadequate, important factors were identified that influenced the incidence of infection. On the basis of this collective review as well as other studies, indications for antibiotic therapy of minor soft tissue lacerations have been identified. Future clinical studies must be designed to test more precisely the validity of these recommendations. PMID- 3522206 TI - Is there a role for osmotic events in the exocytotic release of insulin? AB - The possible role of an osmotic lysis of insulin granules during exocytosis has been studied in perifused mouse pancreatic islets. Raising the osmolarity of the extracellular medium by addition of 400 mM sucrose reversibly inhibited glucose stimulated insulin release. This inhibition was accompanied by a decrease in the rates of 86Rb+ or 45Ca2+ efflux from the islets. Increasing the osmolarity and restoring a normotonic medium in the presence of a nonstimulatory concentration of glucose accelerated 86Rb+ and 45Ca2+ efflux and augmented basal insulin release in both the presence and absence of Ca2+. Hyperosmolarity did not prevent a rise in glucose concentration from decreasing 86Rb+ efflux from islet cells or from inhibiting 45Ca2+ efflux in Ca2+-free medium. However, the stimulation of 45Ca2+ efflux otherwise produced by glucose in the presence of Ca2+ was abolished, and the stimulation of insulin release was almost suppressed. Hyperosmolarity also strongly impaired the release of insulin during stimulation by eight experimental conditions known to act through at least partially different mechanisms. The changes in 45Ca2+ efflux brought about by these different agents were also altered by hyperosmolarity, whether they resulted from direct mobilization of intracellular Ca2+ or were secondary to increased Ca2+ influx. The blockade of insulin release by hyperosmolarity, whatever the mode of action of the stimulus, is compatible with the participation of osmotic events in exocytosis. However, the marked alterations in Ca2+ handling that occur concomitantly and might account for the inhibition of release make it impossible to demonstrate their exact role in intact islet cells. PMID- 3522207 TI - Biosynthesis, glycosylation, and secretion of rat luteinizing hormone alpha- and beta-subunits: differential effects of orchiectomy and gonadotropin-releasing hormone. AB - We have studied the de novo biosynthesis and secretion of LH subunits in pituitary quarters from orchiectomized and intact control adult male rats and their regulation by GnRH. After labeling with [35S]cystine ([35S]Cys), [35S]methionine, or [3H]glucosamine ([3H]GlcN) in the presence or absence of 10( 8) M GnRH, tissue lysates and media were immunoprecipitated with antisera to LH beta, then LH alpha (after removal of TSH by immunoprecipitation with anti-TSH beta), and the products were analyzed by sodium dodecyl sulfate gradient gel electrophoresis. During a 12-min pulse labeling with [35S]methionine, three forms of immunoreactive alpha were labeled at 21,000, 18,000, and 12,000 mol wt. After a 30-min chase with excess unlabeled methionine, the 12,000 form decreased from 10% to 3% of total radioactivity, while the 21,000 form increased from 57% to 69%, implying a precursor-product relationship. Neither orchiectomy nor GnRH had any effect on [35S]Cys or [3H]GlcN incorporation into intracellular or secreted total proteins. After a 6-h continuous labeling, incorporation of [35S]Cys into intracellular combined LH alpha in castrates was 158% of the control value, combined LH beta was 304%, and free alpha was 466%. The [3H]GlcN to [35S]Cys ratio, reflecting relative glycosylation, was unchanged in castrates for total proteins or LH alpha and somewhat decreased for LH beta and free alpha. Orchiectomy increased [35S]Cys-labeled secreted LH beta and free alpha to 183% and 231% of control values, respectively. Relative glycosylation of secreted LH alpha, LH beta, and free alpha was unchanged in castrates. Incorporation of [35S]Cys into intracellular combined LH alpha, LH beta and free alpha-subunit was unaffected by GnRH in pituitaries from intact rats. In castrates, LH alpha was unchanged, but LH beta and free alpha were slightly increased. Incorporation of [3H]GlcN into intracellular combined LH alpha, LH beta, and free alpha was increased with GnRH in both intacts and castrates, such that the 3H to 35S ratio, reflecting relative glycosylation, was also increased with GnRH. In castrates, the ratios, as a percentage of the control, were, respectively 250%, 250%, and 223% for LH alpha, LH beta, and free alpha. In intact animals, the ratios were 221%, 281%, and 143%, respectively. Incorporation of both [35S]Cys and [3H]GlcN into secreted subunits was increased in most instances, such that the 3H to 35S ratio was increased only for LH beta.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3522208 TI - Glucagon alters insulin binding to isolated rat epididymal adipocytes: possible role of adenosine 3',5'-monophosphate in modification of insulin action. AB - Effects of glucagon on insulin action in rat epididymal adipocytes were studied in vitro. [125I]iodoinsulin binding to isolated adipocytes was inhibited by preincubation of the cells with isoproterenol, epinephrine, or glucagon. Fifty percent inhibition was observed with 2 X 10(-8) M glucagon, 10(-6) M isoproterenol, and 10(-7) M epinephrine. Maximal (90%) inhibition induced by glucagon was observed at 10(-6) M. In Scatchard analysis, [125I]iodoinsulin competition data generated curvilinear plots in buffer- and glucagon-treated cells. Pretreatment of the cells with (Bu)2cAMP reduced insulin binding activity. However, the simultaneous addition of (Bu)2cAMP with [125I]iodoinsulin did not produce the inhibition of the binding when the cells were not pretreated with the agent. cAMP level in the cells was increased by incubation with glucagon. 3-O [Methyl-3H]methylglucose uptake by isolated adipocytes was inhibited by pretreatment of the cells with glucagon. These results suggest that glucagon regulates insulin action through decrease in insulin receptor activity, and that it is possible that the inhibition is mediated by cAMP production in adipocytes. PMID- 3522209 TI - Synthesis and release of luteinizing hormone by rat anterior pituitary cells: effects of cytochalasins B and D. AB - We determined the role of microfilaments in regulating LH synthesis (translation or glycosylation) and release from cultured rat anterior pituitary cells under basal and GnRH-stimulated conditions. Cells were pretreated for 2 h with microfilament-disrupting drugs, cytochalasin B (CB; 2 and 20 microM) or cytochalasin D (CD; 1 and 10 microM). LH synthesis and release were measured after 4 h of incubation with or without 1 nM GnRH and drugs. LH translation and glycosylation were monitored by measuring the incorporation of [14C]alanine and [3H]glucosamine, respectively, into total (cell and medium) immunoprecipitable LH. Immunoreactive LH (IRLH) in medium and cells was measured by RIA. GnRH at 1 nM significantly (P less than 0.01) increased the release of IRLH and total [3H]LH (glycosylation), but had no effect on total [14C]LH (translation), uptake, or incorporation of precursors into total protein. Neither CB (2 and 20 microM) nor CD (10 microM) altered basal or GnRH-stimulated IRHL release. Neither drug altered basal medium concentrations of [3H]LH or [14C]LH. In contrast, both CB and CD reduced (P less than 0.01) GnRH-stimulated [3H]LH in the medium and total system (LH glycosylation). CB reduced (P less than 0.01) [3H]glucosamine uptake, total [3H]protein synthesis, and basal level of total [3H]LH, while CD had no effects on these parameters. Thus, CD exerted a more specific inhibitory effect on GnRH-stimulated LH glycosylation than CB. CB (2 and 20 microM) increased (P less than 0.01), while CD (10 microM) decreased (P less than 0.01) [14C]alanine uptake, total [14C]LH, and [14C]protein under both basal and GnRH-stimulated conditions. These results demonstrated that while the cytochalasins did not inhibit either basal or GnRH-stimulated IRLH release, they did inhibit GnRH stimulated LH glycosylation, although the effect of CB was due partially to reduced [3H]glucosamine uptake. Integrity of microfilaments appears to be important for GnRH-enhanced LH glycosylation, but not for GnRH-enhanced LH release. PMID- 3522210 TI - Development of brain insulin receptors: structural and functional studies of insulin receptors from whole brain and primary cell cultures. AB - We studied the structural and functional characteristics of insulin receptors from rat brain and liver from late gestation through adulthood as well as from cultured neuronal and glial cells from neonatal rats. Specific insulin binding was present on membrane preparations from brain and liver at all stages of development studied, with maximal binding in neonates greater than 19-day-old fetuses greater than adults for both brain and liver. Maximal specific binding to cultured neuronal and glial cell membranes was similar (6.2% vs. 7.1%, respectively). [125I]Iodoinsulin cross-linking to the insulin receptor demonstrated that the mol wt (Mr) of the brain alpha-subunit was less than that of the liver alpha-subunit at all stages. [125I]Iodoinsulin cross-linking also demonstrated that the glial cell alpha-subunit (Mr, 130,000) migrated on sodium dodecyl sulfate-polyacrylamide gel electrophoresis to a position intermediate between the liver (Mr, 135,000) and brain (Mr, 119,000), whereas the neuronal cell alpha-subunit (Mr, 118,000) comigrated with the brain alpha-subunit. In solubilized lectin-purified preparations from brain and liver during development as well as from neuronal and glial cells, insulin stimulated phosphorylation of the beta-subunit. The Mr of the brain beta-subunit, as determined by migration on sodium dodecyl sulfate-polyacrylamide gel electrophoresis, was less than that of the liver beta-subunit. The neuronal cell beta-subunit comigrated with the brain beta-subunit while the glial cell beta-subunit migrated to a position intermediate between the brain and liver beta-subunit. Solubilized lectin purified preparations from all tissues demonstrated insulin-stimulable phosphorylation of exogenous substrates. From these studies we conclude that 1) functional insulin receptors are present in the brain during development in the rat; and 2) the structural differences demonstrated between neuronal and glial cell and between brain and nonneuronal insulin receptors taken together with previously demonstrated functional differences of the insulin receptor on these tissues suggest a unique function for insulin receptors on neuronal tissues. PMID- 3522212 TI - Effects of L-leucine on palmitate metabolism and insulin release by isolated islets of fed and starved rats. AB - The occurrence of lipid metabolic changes associated with L-leucine (10 mM) stimulation of insulin release was investigated in isolated islets from either fed or starved rats. L-Leucine-stimulated secretion was potentiated by 3 mM glucose and/or 0.5 mM palmitate and was unaffected by 48 h of starvation. Islet palmitate oxidation showed a maximum rate at 3 mM glucose, and starvation increased it almost 2-fold. Regardless of the nutritional state, L-leucine strongly reduced the oxidation of palmitate and increased its incorporation into islet triacylglycerols and phospholipids at 3 mM glucose. This shift of fatty acid metabolism toward esterification might play a role in the mechanism of potentiation of the islet secretory response to L-leucine by glucose and palmitate. PMID- 3522211 TI - Evidence for activation of the central nervous system-pituitary mechanism for gonadotropin secretion at the time of puberty in the male rat. AB - During sexual development in the male rat, serum testosterone (T) levels increase markedly at 45-60 days of age. At the time of the pubertal rise in T levels, activation of the hypothalamic-pituitary axis is difficult to demonstrate, since there is little change in serum LH levels and a decrease in serum FSH levels. We determined whether experimental maintenance of stable pubertal T levels in these animals as they passed through the normal age of puberty would allow demonstration of a major increase in serum gonadotropin levels. At 14-15 days of age, male rats were castrated and outfitted with either T-containing or empty Silastic capsules. Another group of rats was left intact and outfitted with empty capsules. At various times between 29 and 58 days of age, blood was drawn for measurement of serum LH, FSH, and T levels. In the T-implanted castrated rats, serum T levels were comparable to those in midpubertal intact rats, without significant differences among age groups. In this setting of stable T levels, serum LH and FSH were suppressed to levels at or below those in pubertal intact rats until 51 days of age, when they increased significantly into the untreated castrate range. In contrast, untreated castrate animals demonstrated markedly reduced serum T and elevated LH and FSH levels that did not change significantly throughout the entire study. In intact rats, serum T levels were stable until 58 days of age, when they increased over 2-fold; serum LH levels did not change significantly with age, and serum FSH levels decreased significantly by 54 days of age. A separate group of rats was castrated and outfitted with T-containing Silastic capsules at 21 days of age. In these animals, there were significant increases in hypothalamic LHRH, norepinephrine (NE), and dopamine levels and NE turnover rate at 56 compared to 36 days of age. We conclude that stable pubertal levels of T are able to suppress gonadotropin levels in castrated rats until the normal age of puberty, at which time LH and FSH levels increase markedly. This decrease in sensitivity of the hypothalamic-pituitary axis to T negative feedback at puberty is accompanied by increases in hypothalamic LHRH, NE, and dopamine levels and NE turnover rate. These results provide direct evidence for activation of the central nervous system-pituitary mechanism regulating gonadotropin secretion at puberty in the male rat.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3522213 TI - Selective impairment of pancreatic A cell suppression by glucose during acute alloxan-induced insulinopenia: in vitro study on isolated perfused rat pancreas. AB - This study was performed in order to investigate the role of insulin in the modulation of pancreatic A cell response to glucose. The isolated perfused rat pancreas model was used: intraislet insulinopenia was induced in vitro by 0.56 mM alloxan infusion over 15 min. Alloxan caused a transitory insulin release but did not affect glucagon secretion. Exposure to alloxan completely abolished insulin response to 20 mM arginine, 1.6 mM glucose, and 11.1 mM glucose. Glucagon response to 20 mM arginine and 1.6 mM glucose was unchanged by alloxan pretreatment compared to control pancreata not treated with alloxan. However, the suppression of glucagon release by 11.1 mM glucose was abolished in the alloxan experiments. Twenty milliunits per ml of insulin infused during 11.1 mM glucose infusion restored glycemic suppression of glucagon release, but it produced only a slight inhibitory effect on A cell function in the presence of 3.9 mM glucose. Our study indicates that glucose is the physiological suppressor of the pancreatic A cell and that, in this regard, insulin exerts only a permissive effect. PMID- 3522214 TI - In memoriam John Eager Howard, M.D. PMID- 3522215 TI - Changes in the rate of carrier-mediated glucose transport by mouse mammary epithelial cells during ontogeny: hormone dependence delineated in vitro. AB - Epithelial cells were isolated from mammary glands of mice in various physiological states, and the rate of carrier-mediated glucose transport was determined with 3-O-methylglucose. The basal rate (in the absence of exogenous insulin) increases about 40-fold as the animal of origin progresses from the virgin to the midlactating state and declines precipitously during involution. Insulin does not acutely stimulate carrier-mediated transport by cells isolated from virgin or lactating mice and evokes only about a 50% enhancement of this transport rate in the cells derived from pregnant and early postlactational animals. However, culture of mammary explants from pregnant mice in the presence of insulin, cortisol, and PRL before isolation of the epithelial cells results in a 400% increase in the basal rate of carrier-mediated glucose transport in the absence of exogenous hormones; this effect requires 3 days of incubation. The enhanced rate is equivalent to that in cells freshly isolated from animals in early lactation. Insulin-like growth factor I can mimic the chronic effect of insulin, but multiplication-stimulating activity, epidermal growth factor, and 20% fetal calf serum do not supplant insulin in this system. The maximum velocity, but not the Km, of 3-O-methylglucose transport is markedly increased during ontogeny; this is compatible with an increase in the number of functional transporters during development. The results suggest that insulin and/or insulin like growth factor I are implicated in development of the high basal rate of carrier-mediated glucose transport in mammary cells from lactating mice. PMID- 3522216 TI - Root curvature localizations as indicators of post length in various tooth groups. PMID- 3522217 TI - Early cellular events in pulmonary fibrosis. AB - In this review we have surveyed recent investigations of early cellular events in pulmonary fibrosis both in animal models and in human diseases. Analysis of the interactions of the numerous cell types in the lung following injury is an almost overwhelmingly complex enterprise. In the animal models experimental design has a profound effect on results, making it difficult to compare studies when species, fibrogenic agent, dose, route of exposure, schedule of administration, time course, and analytical methods may not be equivalent. In human diseases we are rarely able to obtain data at precisely the same time point in the course of the disease even among patients in the same study, and possible confounding variables present are legion. Transcending these difficulties for the moment, can we draw any conclusions from our current knowledge of early cellular interactions in pulmonary fibrosis? What is striking is not that there are so many agents that can potentially induce pulmonary fibrosis, but that the lung has such capabilities for recovery. Although the major effector cells may all initially participate in damaging the lung and initiating fibrosis, there is evidence that they may also have the capacity to participate in subsequent repair. Macrophages may initially recruit fibroblasts and stimulate them to proliferate, only to suppress them subsequently. Macrophage production of prostaglandins can lead to suppression of macrophage, neutrophil and lymphocyte responses, thus attenuating tissue injury and the development of fibrosis. Neutrophils may initially release toxic metabolites and enzymes that damage parenchyma. However, there is evidence that they may later play a role in attenuating fibrosis, perhaps through collagenase secretion, or through as yet unknown mechanisms. Lymphocytes may initially participate in a number of damaging ways by secreting chemoattractants for other cells and participating in destructive autoimmune processes. However, there is evidence that subpopulations of T cells may dramatically shift during the course of fibrosis, leading to attenuation of the process. It may thus be useful to consider irreversible pulmonary fibrosis as the end result of a process in which the balance of normal injury/repair mechanisms is disrupted. There is clearly no single "fibrogenic event." Rather, there seem to be a number of places where disruption of balance/repair processes may begin. In diseases of unknown etiology such as sarcoidosis or IPF, loss of control may occur at the genetic level, leading to the destructive alveolitis that is the apparent precursor of fibrosis.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3522218 TI - Hormonal and local factors influence antioxidant enzyme activity of rat fetal lung cells in vitro. AB - Monolayer cultures of fetal rat mixed lung cells respond to sublethal concentrations (50%) of oxygen by a reduced growth rate. Exposure to 95% O2 causes growth arrest and cell loss. In the presence of serum the addition of dexamethasone (5.5 nM), tri-iodothyronine (5.5 nM), or insulin (5 microU/ml) appeared to increase the cytotoxicity of 95% O2. Under growth-arrested conditions, in the absence of serum or elevated O2 concentrations, all three agents influence cellular antioxidant enzyme activities. Dexamethasone (0.055 nM) increased CuZn superoxide dismutase activity by 72% and glutathione peroxidase activity by 94%. Triiodothyronine (5.5 nM) increased CuZn superoxide dismutase activity 93%. Insulin (5 microU/ml) increased CuZn superoxide dismutase activity 90%, and catalase activity 58%. Dexamethasone, but not tri-iodothyronine or insulin, seems to have a protective effect against subsequent acute hyperoxia under serum-free conditions. Local non-hormonal factors may also influence lung cell responses to acute increases in oxygen concentrations, since cells acutely exposed to 50% or 95% O2 release a transferable factor(s) into their culture medium which increases antioxidant enzyme activities of non-hyperoxic lung cells. PMID- 3522219 TI - Epilepsy, viewed metaphysically: an interpretation of the biblical story of the epileptic boy and of Raphael's transfiguration. AB - Raphael's last painting reveals, in the upper half of the picture, Christ's transfiguration on Mount Tabor and, in the lower half, the young boy's epileptic seizure at the foot of the mountain in the presence of the other disciples. Raphael depicts both events, which are told in succession in the Gospels, as if they took place at the same time. By synchronizing both scenes Raphael demonstrated a significant correspondence between Christ and the epileptic boy, which reveals the epileptic seizure as a symbolic representation of a transcendent event. This metaphysical aspect of epilepsy depicted by Raphael can also be found in the corresponding biblical passages. In the Gospels, the metamorphosis caused by the epileptic seizure is used as a simile for Christ's transfiguration through suffering, death, and resurrection. PMID- 3522220 TI - Characterization of the promoter of the large ribosomal RNA gene in yeast mitochondria and separation of mitochondrial RNA polymerase into two different functional components. AB - We have characterized a DNA sequence that functions in recognition of the promoter of the mitochondrial large rRNA gene by the yeast mtRNA polymerase. Promoter-containing DNA fragments were mutagenized and used as templates to study initiation of transcription in vitro with a partially purified mtRNA polymerase preparation. Deletion mutants, in which increasing stretches of DNA were removed from regions flanking the promoter, define a short area essential for correct initiation of transcription. It virtually coincides with a highly conserved stretch of nine nucleotides that is found immediately upstream of all transcriptional start sites described thus far. Two different point mutations within this nonanucleotide sequence drastically reduce promoter function. Conversely a single point mutation that results in the formation of a nonanucleotide sequence 99 nucleotides upstream of the large rRNA gene leads to a new, efficient transcription initiation site. MtRNA polymerase can be resolved into two different components by chromatography on Blue Sepharose: one retaining the capacity to synthesize RNA, the other conferring the correct specificity of initiation to the catalytic component. PMID- 3522221 TI - Enzymatic 2'-O-methylation of the wobble nucleoside of eukaryotic tRNAPhe: specificity depends on structural elements outside the anticodon loop. AB - We have investigated the specificity of the enzyme tRNA (wobble guanosine 2'-O )methyltransferase which catalyses the maturation of guanosine-34 of eukaryotic tRNAPhe to the 2'-O-methyl derivative Gm-34. This study was done by micro injection into Xenopus laevis oocytes of restructured yeast tRNAPhe in which the anticodon GmAA and the 3' adjacent nucleotide 'Y' were substituted by various tetranucleotides. The results indicate that the enzyme is cytoplasmic; the chemical nature of the bases of the anticodon and its 3' adjacent nucleotide is not critical for the methylation of G-34; the size of the anticodon loop is however important; structural features beyond the anticodon loop are involved in the specific recognition of the tRNA by the enzyme since Escherichia coli tRNAPhe and four chimeric yeast tRNAs carrying the GAA anticodon are not substrates; unexpectedly, the 2'-O-methylation is not restricted to G-34 since C-34, U-34 and A-34 in restructured yeast tRNAPhe also became methylated. It seems probable that the tRNA (wobble guanosine 2'-O-)methyltransferase is not specific for the type of nucleotide-34 in eukaryotic tRNAPhe; however the existence in the oocyte of several methylation enzymes specific for each nucleotide-34 has not yet been ruled out. PMID- 3522222 TI - Wounding a fibroblast monolayer results in the rapid induction of the c-fos proto oncogene. AB - The c-fos gene has previously been shown to be transiently induced within minutes after the stimulation of mouse fibroblasts with growth factors. Induction of c fos was observed specifically with competence factors (e.g., platelet-derived growth factor), not with progression factors (e.g., platelet-poor plasma), suggesting a role for c-fos in conferring competence on fibroblasts. To test this hypothesis we have analyzed c-fos expression in NIH 3T3 cells that were made competent in a different way, namely by wounding a confluent monolayer of cells. Using antibodies raised against either a synthetic fos peptide or a beta galactosidase--fos fusion protein, we show in this study that in the majority of cells lining the wound c-fos protein is rapidly and transiently induced to high levels. No induction is observed in cells at a distance from the wound greater than approximately 5 cell layers. Induction is equally efficient in both serum containing and serum-free medium, and is similar in cells that were deprived of fetal calf serum for 40 h prior to making the wound. Our observations support the hypothesis that c-fos may be involved in inducing the 'competent state' in fibroblasts and suggests an early role for c-fos in wound healing and tissue regeneration. PMID- 3522223 TI - Impaired assembly and transport of HLA-A and -B antigens in a mutant TxB cell hybrid. AB - Biosynthesis of HLA class I antigens has been studied in a variant B-LCLxT-LCL hybrid, 174XCEM.T2. This cell line encodes HLA-A2 and -B5, but expresses only small amounts of A2 antigen and undetectable B5 antigen at the cell surface due to a mutation inactivating a trans-acting regulatory gene encoded within the class II region of the human major histocompatibility complex. Northern blot analysis with HLA-A- and HLA-B-specific probes shows that 174XCEM.T2 synthesizes quantities of A and B locus mRNA comparable with its class I antigen-positive parent cell line. Immune precipitation studies indicate that 174XCEM.T2 synthesizes normal HLA heavy chains and beta 2-microglobulin which fail to form dimers. The heavy chains are N-glycosylated normally, but processing of the glycan to the complex form does not occur. In addition, free heavy chains in this cell line are not phosphorylated. Thus, the majority of class I heavy chains in 174XCEM.T2 do not combine with beta 2-microglobulin, and are not processed or transported to the cell surface. As both subunits are synthesized in normal amounts, we propose that an additional molecule absent from 174XCEM.T2 and encoded by an HLA-linked gene is necessary for efficient assembly of class I antigen subunits. PMID- 3522224 TI - Cryptosporidiosis. PMID- 3522225 TI - Complement activating and opsonic capacity of monoclonal antibodies raised against Escherichia coli O111 and its rough mutant J5. AB - Six monoclonal antibodies raised against Escherichia coli O111 and against its rough mutant J5 (chemotype Rc) were studied. One IgG2A, one IgM anti-J5, and one IgG2A anti-O111 monoclonal antibody did not bind to lipopolysaccharides of the homologous strain, but cross-reacted with heterologous gram-negative rods in an enzyme-linked immunosorbent assay. These three monoclonal antibodies activated complement when incubated with homologous or heterologous strains, but were opsonic neither in the presence nor in the absence of complement. The other three monoclonal antibodies were directed against lipopolysaccharide of the homologous strain, but showed no cross-reactivity. The IgG3 and one IgM anti-J5 monoclonal antibodies activated complement and were opsonic only in the presence of complement. The IgM anti-O111 monoclonal antibody activated complement and was opsonic both in the presence and absence of complement. Thus, the outcome of the interaction between bacteria, antibodies, and complement is influenced primarily by whether antibodies are directed against lipopolysaccharides or against other cell wall components. PMID- 3522226 TI - Faecal carriage of group B streptococci. AB - A study of 1,138 primarily healthy subjects of various ages and sex was conducted to determine the faecal isolation rate of group B streptococci. Five percent of 284 neonates (less than or equal to 5 days old) and 4% of 267 healthy children (1 15 years old) were found to be faecal carriers. Adults were more frequently faecal carriers than children, group B streptococci being isolated in 15% of 361 adults and 11% of 226 pregnant patients. The isolation rate was independent of sex at all ages. Although group B streptococci were found more frequently in rectal than in faecal specimens from pregnant women (p less than or equal to 0.001), the isolation rate for faecal specimens could be increased by using a more selective broth. Forty-four percent of strains isolated from faeces of 105 subjects belonged to serotype III, 27% to type Ia, 15% to type Ib, 11% to type II and 3% were nontypeable. The same serotype of group B streptococci was usually present at different sites in each subject. PMID- 3522227 TI - Complete amino acid sequence of plastocyanin from a green alga, Enteromorpha prolifera. AB - The complete amino acid sequence of the plastocyanin from the green alga Enteromorpha prolifera has been determined by Edman degradation of the intact molecule and fragments produced by enzymatic cleavage of the polypeptide chain with chymotrypsin, Staphylococcus aureus protease, proline-specific endopeptidase, Lys-C endopeptidase and trypsin. The molecule consists of 98 amino acid residues with a calculated relative molecular mass of 10103. The amino acid sequence of E. prolifera plastocyanin shows a high degree of homology with those plastocyanins from other algae and higher plants. In particular, the four residues which are copper ligands in other plastocyanins and in the bacterial electron transport protein azurin (two histidines, one cysteine and one methionine) are conserved. Five out of the six acidic amino acid side-chains which create an 'acidic patch' on the surface of plastocyanin from Populus nigra var. italica [Colman, P. M. et al. (1978) Nature (Lond.) 272, 319-324] are conserved in the amino acid sequence of E. prolifera plastocyanin. PMID- 3522228 TI - Sonography of the tongue and floor of mouth. Part I: Anatomy. AB - Normal structures of the tongue and floor of the mouth were studied using anatomic sections cut with a stainless steel band saw. The sections were performed on the same planes as used in US and CT scanning. The ultrasound studies were carried out with 20 young and healthy volunteers. CT images were obtained from head-neck preparations that were subsequently used for anatomic sectioning. On comparing these sections to US and CT images, normal structures including intrinsic and extrinsic tongue muscles, vessels and salivary glands were identified. Knowledge of the anatomic landmarks is mandatory for optimal US image reading. PMID- 3522229 TI - Sonography of the tongue and floor of mouth. Part II: Neoplasms of the tongue. AB - Frequently, correct evaluation of space-occupying lesions in the tongue is not possible with clinical methods only. In an attempt to assess the value of sonography in the detection of tongue lesions, we used submental sonography to examine 62 patients with suspicious palpatory findings upon physical examination of the tongue. Ultrasound detected 45 out of 47 tumours that were eventually confirmed either by surgery or by biopsy. Inadequate technique was the only factor that affected the detection rate. Sonography appears to be a reasonable guide in determining size and site of a tumour of the tongue. Thus, more precision in therapy planning may be achieved. PMID- 3522230 TI - Ultrasonography of the pancreatic tail through spleen and through fluid-filled stomach. AB - In the present study ultrasonography observed the tail of the pancreas more frequently through the spleen than by any other approach. If the splenic approach fails, examination through the fluid-filled stomach may be tried. PMID- 3522231 TI - Splenic abscess on ultrasonography. AB - The characteristic sonographic features in 32 splenic abscesses (25 of which were retrieved from the world literature) were splenomegaly, associated with an-or hypoechoic masses of different sizes and shapes, demarcated by irregular walls, containing echogenic foci of variable intensity and demonstrating little or no sonic through-transmission. Although these splenic features are not pathognomonic for abscesses, they can be correlated with other incidental abdominal sonographic findings and the presenting clinical symptoms, can direct percutaneous needle punctures and can enable a prompt diagnosis. Immediate surgery is usually curative, and is necessary to improve the high mortality rate in untreated cases. PMID- 3522232 TI - The diagnostic value of renal cortex-to-medulla contrast on magnetic resonance images. AB - The diagnostic value of magnetic resonance contrast between the renal cortex and renal medulla as an indicator of renal disease was retrospectively studied in 38 patients (ten patients with a variety of diseases affecting the renal parenchyma, nine with renal obstruction, four with diffusely infiltrating renal-cell carcinoma, one with renal hematoma, nine with normally functioning renal allograft, and five with renal allograft failure). Twelve normal volunteers served as controls. On spin-echo (SE) images (TR 0.5 sec, TE 28 msec), the cortex to-medulla contrast was present in the kidneys of all the normal volunteers (19% contrast +/- 2% S.D.) and in all the normally functioning allografts (17% contrast +/- 2% S.D.). Decrease or absence of cortex-to-medulla contrast (SE image with TR 0.5 sec and TE 28 msec) was found to be a sensitive but nonspecific sign of renal disease. It occurred in renal diseases of various causes and was produced by different pathophysiologic mechanisms such as edema, scarring, and tissue replacement by neoplasm or hematoma. Of the calculated T1 and T2 relaxation times and spin density of the cortex and the medulla, the T1 changes most consistently reflected renal disease. PMID- 3522233 TI - Value of ultrasound in localizing the internal mammary vessels. AB - The authors discuss the value of ultrasound in determining the depth of the internal mammary vessels und their distance from the medial line. Real-time imaging with a high frequency transducer and a pulsed Doppler system gave highly accurate results. Depending on the intercostal space, the depth of internal mammary vessels varies from 17 to 22 mm. The distance of the internal mammary vessels from the medial line is a function of the intercostal space and the body side, and varies from 25 to 33 mm. Results were found to vary as a function of patient height and weight; likewise, mastectomy was seen responsible for a modification of 2 mm in measurements. Precise localization of the internal mammary vessels allows optimization of radiotherapy, and this rapid examination should be performed just prior to the start of irradiation. PMID- 3522234 TI - Concomitant thyroid disease in hyperparathyroidism. Reasons for unsatisfactory ultrasonographical localization of parathyroid glands. AB - Ultrasonic localization of enlarged parathyroid glands has been attempted in a consecutive series of 23 patients with primary hyperparathyroidism. Seven of 15 patients with operatively verified diagnosis, had predictive ultrasound scans (47% consistency) and 10 of 16 adenomas were identified (63%). A possible explanation for these unsatisfactory results could be a high incidence of coexisting nodular thyroid lesions, and significantly enlarged thyroid glands in these patients. PMID- 3522235 TI - Ventricular arrhythmias, left ventricular function and mortality after acute myocardial infarction. AB - Ventricular arrhythmias constitute an independent risk in the year following a myocardial infarction. The risk is moderate, but certainly not negligible. We still do not know whether ablation of the arrhythmias can improve survival. Further controlled drug trials are still needed to assess the possible benefit and hazards of treating frequent and repetitive ventricular premature beats in the first few months after an acute myocardial infarction. PMID- 3522236 TI - Mechanisms involved in reperfusion arrhythmias. AB - Clinical and experimental studies indicate that reperfusion of the ischaemic myocardium may play an important role in the genesis of life-threatening arrhythmias. Reflow may occur as a result of abrupt cessation of coronary artery spasm or upon dislodgment of platelet aggregates with the attendant washout of products of cellular ischaemia. The released substances exert a transient but potent arrhythmogenic effect. Calcium channel blocking agents, by virtue of their broad spectrum of action, can interrupt the cascade of events leading to arrhythmias. In experimental animals, verapamil has been shown to reduce vulnerability to ventricular fibrillation during sympathetic stimulation and to prevent spontaneous fibrillation during both myocardial ischaemia and reperfusion. Comparable antifibrillatory effects have been observed with diltiazem and prenylamine. Tiapamil is effective during sympathetic stimulation and myocardial ischaemia but not during reperfusion. Nifedipine appears to exert a moderate antifibrillatory influence during myocardial ischaemia and is ineffectual in preventing reperfusion-induced fibrillation. These observations indicate that calcium channel blocking agents differ considerably in their ability to suppress arrhythmias during myocardial ischaemia and reperfusion. Their effectiveness appears to depend critically both on the pathophysiologic mechanisms and on the pharmacologic profile of the individual agent. PMID- 3522237 TI - Current status of calcium channel blocking drugs after myocardial infarction. AB - This review critically evaluates the recently reported clinical trials involving the administration of nifedipine and verapamil after myocardial infarction and highlights the ongoing trials with diltiazem. Acute short-term administration of nifedipine and verapamil initiated within hours after onset of suspected myocardial infarction had no beneficial influence on enzymatic infarct size, progression to acute myocardial infarction, or mortality. A short-term, diltiazem non-transmural infarction trial has recently been completed with results pending, and two major long-term, post-infarction trials with nifedipine and diltiazem are currently in progress. The current status of calcium channel blocking drugs for reducing mortality after myocardial infarction is comparable to the status of beta blockers in the mid-1970s. PMID- 3522238 TI - Neurological prognosis of high-risk preterm infants with peri-intraventricular hemorrhage and ventricular dilatation. AB - Fifty-eight preterm neonates evaluated by real-time sonographic scanning of the head were prospectively studied. They were divided into three groups: 13 with peri-intraventricular hemorrhage (PIVH) alone, 19 with subsequent ventricular dilatation and 26 control infants without ultrasound evidence of PIVH. At 12 months of age detailed neurological follow-up assessment was carried out. Five (8.6%) patients had major handicaps, 34 minor neurological abnormalities. The severity of the PIVH correlated with the neurologic outcome (p less than 0.02). The incidence of major handicaps was significantly greater in the group with ventricular dilatation (p less than 0.03). Among the infants with PIVH, major handicaps were only present if associated with grade III and IV. Severe posthemorrhagic ventricular dilatation increased the risk for major handicaps. Adverse neurological sequelae at follow-up appeared to be attributable to the extent of PIVH and aggravated by severe ventricular enlargement. PMID- 3522239 TI - Isoelectric focusing and two-dimensional gel electrophoresis in plasma and cerebrospinal fluid from patients with dementia. AB - IgG profiles of cerebrospinal fluid (CSF) and plasma from patients with Alzheimer's disease/senile dementia of Alzheimer type, multi-infarct dementia and aged nondemented individuals were analyzed using isoelectric focusing (IEF) followed by immunofixation and high resolution two-dimensional polyacrylamide gel electrophoresis (PAGE). The IEF profiles of plasma and CSF in patients with dementia were diffuse and lacked oligoclonal bands and were identical to those of nondemented individuals. The investigation of plasma and CSF by two-dimensional PAGE did not reveal any specific protein pattern in the demented individuals compared to the controls. PMID- 3522240 TI - Festschrift. 20 years European Society for Surgical Research. PMID- 3522241 TI - Dipyridamole-induced coronary vasodilation in human transplanted heart: preliminary report. AB - Coronary sinus blood flow and resistance were studied before and after intravenous dipyridamole in 4 patients with transplanted heart and normal coronary arteriogram treated by cyclosporine-prednisolone. Results were compared to those of a normal group of 7 subjects. Left ventricular endomyocardial biopsies were performed in the heart transplanted group. Mean right atrial pressure, cardiac index and left ventricular function were normal in the transplanted heart group. Mean aortic pressure and systemic vascular resistances were significantly higher in the transplanted group than in normals (p less than 0.01), but coronary resistance were similar. Dipyridamole-induced vasodilation resulted in an increased coronary sinus blood flow and a decreased coronary resistance in both groups, but these effects were reduced in 1 patient with a transplanted heart that evidenced an important perivascular fibrosis after a subacute rejection. In conclusion, this preliminary report of coronary blood flow in patients with transplanted heart indicates that the ability of coronary sinus blood flow to increase after dipyridamole is normal in the transplanted heart without allograft rejection. A major limitation in coronary vasodilation was observed in 1 patient with rejection antecedents and perivascular fibrosis, which could play a role in left ventricular function deterioration in some patients after heart transplantation. PMID- 3522242 TI - Ultrasound evaluation of atherosclerosis. Methodological problems and technological developments. AB - The evaluation of atherosclerosis requires the definition of the object to be measured and of the questions the investigation is required to answer. In the first part of this paper some of the problems that arise when planning and defining evaluation of atherosclerosis are discussed. The second part is a review of the principal methods based on ultrasound technology. The working principles and clinical applications of each method are discussed. The rationale of each type of instrument with respect to others is highlighted. PMID- 3522243 TI - Present state of intentional hemodilution. AB - Preoperative intentional hemodilution is induced by isovolemic exchange of whole blood with colloid solutions in order to gain autologous blood while maintaining normovolemia. The basic mechanism that compensates for the fall of oxygen capacity of the diluted blood is the rise in cardiac output, and organ blood flow, factors that result from the improved fluidity of blood at lower hematocrits. Normal tissues maintain adequate oxygenation during hemodilution through the enhanced redistribution of blood. In ischemic tissues this effect is enhanced, and causes an increase in the oxygenation of ischemic tissues. Limited preoperative and intraoperative hemodilution are alternatives to donor blood transfusion in patients undergoing elective surgery. In shock patients the hemodilution achieved with red cell free primary volume substitutes is an effective treatment for shock-induced microcirculatory disorders; furthermore, intentional hemodilution is the most effectual hemorheological therapy for the treatment of ischemic disease. PMID- 3522244 TI - Specific lysis of murine cells expressing HLA molecules by allospecific human and murine H-2-restricted anti-HLA T killer lymphocytes. AB - The lysis by human and murine anti-HLA cytolytic T lymphocytes (CTL) of murine cells expressing class I HLA molecule after gene transfection has been studied using two different murine cells: LMTK- and P815-HTR-TK-. Weak but significant HLA-A11-specific lysis was found occasionally with human CTL on the HLA-A11+ L cells. On the contrary, P815-A11 or P815-A2 cells were lysed strongly and specifically by HLA-A11 or HLA-A2-specific human CTL. The T8+T4- phenotype of the effector cells was confirmed and the reaction was inhibited by anti-HLA class I monoclonal antibodies. Despite their higher sensitivity to human CTL, the P815 HLA+ cells did not express higher levels of HLA antigens than L cells, and the presence or the absence of human beta 2 microglobulin was irrelevant. Anti-human LFA-1 antibodies abrogated the lysis of P815-A11+ cells showing that the LFA-1 receptor which is apparently lacking on the L cell surface was on the contrary expressed on P815 cells. On the other hand, murine anti-HLA CTL have been prepared by immunizing mice against syngeneic HLA-A11+ L cells. They lysed very efficiently and specifically these cells, but appeared completely devoid of activity against human HLA-A11 target cells. This barrier was apparently due to the H-2 restriction of these H-2k anti-HLA murine CTL, as shown by their inability to lyse allogeneic H-2d cells expressing HLA-A11, and by the blocking of their activity by anti H-2k antibodies. By contrast, xenogeneic anti-HLA CTL obtained by immunizing murine lymphocytes against human cells lysed both human and murine HLA+ cells but they reacted with a monomorphic epitope of the HLA molecule in a nonrestricted way. These results show that human cells lyse very efficiently P815 murine cells expressing HLA class I antigens; the higher sensitivity of P815 cells compared to L cells is probably due to the presence of a LFA-1 receptor on these cells; a class I molecule of human origin can be seen as an H-2-restricted minor histocompatibility antigen in another species. PMID- 3522245 TI - Liver-associated macrophage precursors as natural cytotoxic effectors against Candida albicans and Yac-1 cells. AB - Liver nonparenchymal cells of maleic anhydride divinyl ether or cyclophosphamide treated mice were assayed for cytotoxic activity against the yeast form of Candida albicans. A strong increase in this activity was observed after both in vivo treatments, as compared to untreated control mice. The effector cell was enriched by nylon wool passage and separation of nonadherent liver nonparenchymal cells on a discontinuous Percoll gradient. By means of direct and indirect rosetting techniques, based on the presence of Fc receptors and the F4/80 and M143 macrophage surface markers, we could separate a nearly homogeneous effector cell population. It displayed, besides the candidacidal activity, Fc receptors and the M143 and F4/80 antigens, also strong natural cytotoxicity against Yac-1 lymphoma cells. When cultured in medium containing colony-stimulating factor-1, this effector population reacted with a strong proliferative response as measured through incorporation of tritiated thymidine. The data presented show that nonadherent, nonphagocytic macrophage precursors, which we characterized previously from in vitro bone marrow cultures, occur in vivo as organ-associated effector cells in the liver after elicitation with maleic anhydride divinyl ether or cyclophosphamide. These macrophage precursors have prior to their maturation the ability to serve as a microbicidal and tumoricidal natural killer cell. PMID- 3522246 TI - Monoclonal antibodies against leucoagglutinin-reactive human T lymphocyte surface components. Two antibodies which inhibit cell-mediated cytotoxicity at a post binding stage. AB - Two out of 20 monoclonal antibodies (IgM, kappa), mAb 3192 and mAb K3G, raised against leucoagglutinin-reactive components on human T cells, effectively blocked lymphocyte-mediated cytotoxicity in vitro. No antigenic polypeptide reactive with these antibodies has been identified thus far. However, they have previously been shown to react specifically with certain neutral glycolipids obtained from spleen. Both mAb inhibited the cytotoxicity of natural killer (NK) cells against K562 cells, antibody-dependent cellular cytotoxicity (ADCC) towards antibody coated bovine erythrocytes and cytotoxic T lymphocyte activity against allogeneic target cells. In both NK and ADCC, preincubation of the lymphocytes with different antibody concentrations resulted in a dose-dependent reduction of cytotoxicity. In contrast, preincubation of the target cells had no effect indicating that the mAb inhibited cytotoxicity at the effector cell level. When studied at the single-cell level, the mAb did not alter the number of lymphocytes forming conjugates with K562 but significantly reduced the frequency of conjugates containing dead target cells. Addition of the mAb to preformed conjugates resulted in a dose-dependent reduction in the proportion of conjugates containing dead target cells. Furthermore, mAb 3192 did not reduce the number of lymphocytes forming rosettes with bovine erythrocytes, indicating that inhibition of ADCC was not due to blocking of the effector cell-target cell interaction mediated by the Fc receptor of the effector cells. Taken together, these results suggest that the mAb inhibited cytotoxicity by interfering with a post-binding step common for the different cytotoxicity systems. PMID- 3522247 TI - Monoclonal antibodies against idiotypic determinant(s) of the T cell receptor from HPB-ALL cells induce IL2 production in Jurkat cells without apparent evidence of binding. AB - Two monoclonal antibodies (mAb) directed against idiotypic determinants of the T cell receptor (anti-Ti) from HPB-ALL cells induce interleukin 2 (IL2) production in Jurkat T cells without evidence of binding to these cells as judged by fluorescence-activated cell sorter (FACS) analysis, indirect antibody-binding radioimmunoassay and direct binding studies with 125I-labeled mAb. The IL2 response induced by these mAb observed both in the presence and absence of phorbol myristate acetate was in the range of that obtained when Jurkat cells were stimulated with phytohemagglutinin or anti-T3 mAb (Leu 4). The idiotypic specificity of the two anti-HPB-ALL Ti mAb was demonstrated by several criteria. Both mAb bound specifically to HPB-ALL cells as determined by radioimmunoassay or FACS analysis but not with 8 other T cell lines. The anti-HPB-ALL Ti mAb precipitated a disulfide-linked heterodimer of 85 kDa only from 125I-labeled HPB ALL cells and not from other cell lines tested. Incubation of HPB-ALL cells with anti-T3 abrogated the expression of T3 and induced co-modulation of the idiotypic structures detected by the two anti-HPB-ALL Ti mAb. Conversely, incubation of HPB ALL cells with either one of the anti-Ti mAb abrogated the expression of T3 and of the idiotypic structures. Our results suggest that mAb with an apparent unique specificity for the receptor of the immunizing T cell line HPB-ALL can activate Jurkat cells by a very weak cross-reaction with these cells, which is not detectable by conventional binding tests. PMID- 3522249 TI - Thymic nurse cells: a school for alloreactive and autoreactive cortical thymocytes? AB - The possibilities for functional analysis of thymic nurse cells (TNC) have so far been hampered by the low yield of these cells by means of gradient centrifugation and their fragility preventing purification by a fluorescence-activated cell sorter. Furthermore, they are extremely unstable in cell culture. Here we present functional data obtained by the analysis of single TNC in an avian system: the chicken with its extramaternal embryonic development prompted us to use the chorioallantoic membrane (CAM) pock formation assay to investigate the possible graft-vs.-host reactivity (GVHR) of TNC lymphocytes (TNC-L). The CAM assay proved to be an optimal and unique "cell culture" system for the investigation of the functional characteristics of TNC. Our data show that TNC-L, unexpectedly, are able to exert a GVHR on allogeneic CAM with the very high efficiency of 1/13 as compared to thymocytes of the same donors showing a GVHR efficiency of 1/350. TNC L are even able to induce GVH-like reactions in syngeneic combinations, while thymocytes and peripheral blood lymphocytes from the same donors always remain negative. PMID- 3522248 TI - Contact interaction between lymphocytes is a general event following activation and is mediated by LFA-1. AB - When lymphocytes are activated in vitro, discrete cell-cell contacts are initiated which result in cluster formation. This contact interaction is found in syngeneic or allogeneic mixed leukocyte reactions as well as in mitogen stimulated cultures (concanavalin A, periodate, lipopolysaccharide). T cells as well as B cells display the binding phenomenon. This activation-dependent lymphocyte-lymphocyte adhesion involves LFA-1, since monoclonal antibodies (including Fab fragments) against this molecule inhibit adhesion between clustering lymphocytes in a dose-dependent manner, whereas antibodies directed to several other cell surface antigens are inactive. Since a wide variety of functional interactions are inhibited by antibodies to LFA-1, it may be concluded that LFA-1-mediated cell contact is a discrete and essential step between a recognition event and the generation of functional activities by lymphocytes in general. PMID- 3522251 TI - Direct bonding: crystal growth as an alternative to acid-etching? PMID- 3522250 TI - Effects of histamine-receptor antagonists on histamine-stimulated renin secretion. AB - The effects of histamine H1- and H2-receptor antagonists on histamine-stimulated renin secretion were examined in anesthetized dogs. Tripelennamine (H1 blocker) further enhanced renin secretion in the presence of exogenous histamine. Moreover, tripelennamine alone increased renin secretion. These effects are probably due to non-specific properties of the drug and not to interaction of tripelennamine with H1 receptors. Conversely, cimetidine (H2 blocker) significantly inhibited histamine-induced increases in renin secretion, renal blood flow, and sodium excretion without any changes in mean arterial blood pressure or glomerular filtration rate. Cimetidine alone had no effect. We conclude that H2 receptors mediate the effect of histamine on renin secretion in dogs with innervated, intact kidneys. PMID- 3522252 TI - Bond strength of orthodontic attachments to enamel from unerupted and erupted young permanent teeth. PMID- 3522253 TI - The effect of dummy-sucking on the occlusion: a review. PMID- 3522254 TI - Correction of unilateral crossbite in the deciduous dentition. PMID- 3522255 TI - Isolation of ts mutant cells which arrest in G1/G0 phase at the non-permissive temperature in the presence of appropriate growth factors from a Fischer rat cell line, 3Y1. AB - Two types of cell-cycle-ts mutants were isolated from Fischer rat cell line, 3Y1, and characterized. Clones in one complementation group, tsJT51 and tsJT341, grew at 34 degrees C in the presence of 10% fetal bovine serum (FBS). When the cells growing at 34 degrees C were transferred to 39.5 degrees C, they were arrested alive in G1/G0 phase in the presence of both FBS and epidermal growth factor (EGF), but died in the presence of one of these growth factors. The cells in the other complementation group, tsJT59, tsJT308, tsJT314 and tsJT349, grew at 34 degrees C in the presence of 10% FBS. When the cells growing at 34 degrees C were transferred to 39.5 degrees C, they were arrested alive in G1/G0 phase in the simultaneous presence of FBS, EGF and insulin, but died quickly if one of these growth factors was lacking. Growth-arrested cells at 39.5 degrees C were viable at least one or two weeks and had a potency to resume growth following the shift down of temperature. Those are assumed to be ts mutant cells which enter and stay in G1/G0 phase from the cell cycle at the non-permissive temperature only in the presence of appropriate growth factors. PMID- 3522256 TI - Immunolocalization of nucleolar proteins after D-galactosamine-induced inhibition of transcription in rat hepatocytes. Maintenance of association of RNA polymerase I with inactivated nucleolar chromatin. AB - The fate of defined nucleolar constituents during D-galactosamine-induced inhibition of transcription and the accompanying extensive structural changes such as nucleolar segregation, fragmentation and disappearance of the granular components was studied by light and electron microscopic immunolocalization, using antibodies to different nucleolar components. In contrast to other inhibitors such as actinomycin D, we show that preribosomal components as monitored by a ribosomal protein leave the nucleolus, while a large proportion of RNA polymerase I remains associated with the nucleolar chromatin, i.e. probably the pre-rRNA genes, during inactivation of transcription. These small structures containing the RNA polymerase I are characterized by low electron density and resemble the 'fibrillar centers' of normal nucleoli. The results are discussed in relation to current concepts of the functional topology of the nucleolus. PMID- 3522257 TI - Avian type VI collagen. Monoclonal antibody production and immunohistochemical identification as a major connective tissue component of cornea and skeletal muscle. AB - Two monoclonal antibodies have been characterized as being against avian type VI collagen. By competition ELISA, the antibodies bound to the native type VI collagen molecule but not to its separated chains or to any of the other native collagen types tested. By rotary shadowing analysis of complexes of antibody-type VI collagen monomers, one of the antibodies (VI-EC6) has been shown to bind to a site in the triple helical domain of the molecule. The site at which this antibody binds to the dimeric form of type VI collagen is consistent with the previously proposed model for a supramolecular organization of the molecule (Furthmayr et al., Biochem j 211 (1983) 303) in which the monomers are arranged in an antiparallel, slightly staggered overlap. Immunofluorescence analyses of sections of chicken eyes and skeletal muscle demonstrate that type VI collagen is a major component of most stromal matrices. PMID- 3522259 TI - The expression in meiosis of genes which are transcribed periodically in the mitotic cell cycle of budding yeast. AB - The mitotic cell cycle genes CDC 8, 9 and 21 in Saccharomyces cerevisiae, together with the histone H2A gene, are transcribed discontinuously in meiosis. Message from all four genes initially declines in amount, then increases abruptly to reach maximal levels during premeiotic DNA synthesis before again declining. This response occurs only in meiotic cells; in asporogenous diploids the transcript simply declines in amount. In contrast, message from four genes with no known specific meiotic function (including the actin gene) shows the same profile in both sporogenous and asporogenous diploids. In mitotic cells the three CDC genes appear to be transcribed at the same time in the cell cycle, whereas in meiosis their transcripts accumulate with different kinetics, suggesting either that they have different turnover rates in meiotic cells or that the timing of their transcription is different. PMID- 3522258 TI - Basement membrane components produced by a mouse ascites teratocarcinoma TB24. Analysis with monoclonal and polyclonal antibodies. AB - Monoclonal antibodies were produced against two basement membrane glycoproteins, laminin and entactin. The specificity of the antibodies and the absence of cross reactivity were established by radio-immunoprecipitation of mouse ascites teratocarcinoma cell lysates. This teratocarcinoma, TB24, formed large embryoid bodies filled with extracellular matrix. The major component of the matrix was laminin. Abundant entactin, substantial amounts of fibronectin and rather little collagen type IV were also found in the matrix by biochemical and immunofluorescence analyses. TB24 teratocarcinoma appears to be a good model to test anti-basement membrane antibodies and to isolate certain extracellular matrix components in preparative quantities. PMID- 3522260 TI - Plasmodium falciparum and P. knowlesi: initial identification and characterization of malaria synthesized glycolipids. AB - This is the first report establishing the existence of glycolipids synthesized by plasmodia, in particular Plasmodium falciparum. Trophozoites, schizonts, gametocytes, and gametes were metabolically labeled in vitro with [3H]glucosamine, [3H]galactose, [3H]glucose, [3H]mannose, [3H]fucose, [32P]inorganic phosphate, or [35S]sulfate, and total lipid extracts analyzed by high-performance thin-layer chromatography and autoradiography or fluorography. Parasites incorporated [3H]monosaccharides into distinctly different series of molecules previously undescribed. Three properties of [3H]glucosamine labeled molecules indicate they are glycolipids. First, labeled molecules have lipid solubility properties. Second, mobility on thin-layer chromatography was characteristic of glycolipids. Third, following acid hydrolysis, [3H]glucosamine was recovered from a total lipid extract of labeled parasites demonstrating that glucosamine is a constituent of some of these lipid molecules. Most of these glycolipids are neutral and alkali labile. The majority of these glycolipids differs from several synthesized phospholipids. None of these glycolipids was sulfated. Plasmodial glycolipid synthesis occurs concomitantly with glycoprotein synthesis, and both increase during schizogony. Many of these glycolipids appear to be identical among three strains of P. falciparum and between two species, P. falciparum and P. knowlesi. In contrast, there are stage specific differences in glycolipid synthesis among rings, schizonts, gametocytes, and a mixture of gametes plus zygotes of P. falciparum, examples of both erythrocytic and vector forms of the parasite. PMID- 3522261 TI - Leishmania mexicana: amastigote hydrolases in unusual lysosomes. AB - Leishmania mexicana mexicana (M379) amastigotes were found to contain much higher activities than cultured promastigotes of five putative lysosomal enzymes: cysteine proteinase; arylsulfatase (EC 3.1.6.1); beta-glucuronidase (EC 3.2.1.31); DNase (EC 3.1.22.1), and RNase (EC 3.1.27.1). The release profiles of the first three of these enzymes from digitonin-permeabilized amastigotes suggests that they are located within organelles. Cytochemical staining for cysteine proteinase, using gold labeled antibodies and arylsulfatase, showed that both were present in large organelles previously named "megasomes." Comparative studies with L. mexicana amazonensis (LV78), L. donovani donovani (LV9), and L. major (LV39) revealed that L. mexicana amazonensis was similar to L. mexicana mexicana in possessing both high amastigote cysteine proteinase activity and large numbers of megasome organelles in amastigotes, whereas the other two species lacked both these features. The results suggest that the presence of numerous lysosome-like organelles in the amastigote is a characteristic of the L. mexicana group of parasites. PMID- 3522262 TI - Plasmodium falciparum: induction, selection, and characterization of pyrimethamine-resistant mutants. AB - We have selected eight pyrimethamine resistant mutants of a cloned, drug sensitive, Plasmodium falciparum malaria parasite, strain FCR3. The mutants exhibited resistance to between 10 and 200 times higher concentrations of drug than the wild type parasite. The mutants were selected from cultured parasites that were either unmutagenized or N-methyl-N'-nitro-N-nitrosoguanidine mutagenized. One mutant was shown to contain a mutant dihydrofolate reductase enzyme in parasite extracts that exhibited (1) a five- to ninefold reduction in its binding of methotrexate, (2) an undetectable enzyme activity based on the spectrophotometric conversion of dihydrofolate to tetrahydrofolate, and (3) essentially normal amounts of the parasite's bifunctional thymidylate synthetase dihydrofolate reductase enzyme. Other mutants exhibited both normal dihydrofolate reductase specific activity and normal enzyme sensitivity to the inhibitory activity of the drug. PMID- 3522263 TI - Plasmodium berghei: reduction of the mouse's specific lymphoproliferative response in relation to corticosterone and pregnancy. AB - Spleen cells from mice immune to Plasmodium berghei exhibited a significantly increased in vitro proliferative response to parasitized reticulocytes compared to spleen cells from normal mice. The specific response to malaria antigen was decreased in spleen cells from pregnant immune mice in contrast to the nonspecific response to the mitogen phytohemagglutinin. Addition of mouse serum to spleen cell cultures of immune mice depressed both the phytohemagglutinin and the specific proliferative response, whereas serum of pregnant mice exerted an even stronger inhibition than serum of nonpregnant mice. Charcoal adsorption of mouse sera for the elimination of steroid hormones removed the serum dependent immunosuppression from normal as well as pregnant serum. Corticosterone added to the spleen cell cultures depressed also the proliferative response. These findings demonstrate that the response to malaria antigen is decreased in immune mice during pregnancy. The possible effect of serum corticosterone on the depression of the immune response is discussed. PMID- 3522264 TI - Vascular changes associated with growth of primary and transplantable pancreatic adenocarcinomas induced in Syrian golden hamsters by N-nitrosobis(2 oxopropyl)amine (BOP) and N-nitrosobis(2-hydroxypropyl)amine (BHP). AB - Microangiographic and histological methods were used to characterize vascular structure of primary and transplantable pancreatic adenocarcinomas induced by propylnitrosamines in Syrian golden hamsters. Originally of well-differentiated tubular morphology, serial transplantation subcutaneously to the back region was not associated with change in histopathological pattern or increase in invasive or metastatic potential. In contrast, pancreatic subserosal grafts displayed prominent invasion of surrounding tissues. Whereas primary tumors induced by N nitrosobis(2-oxopropyl)amine (BOP) and those transplanted subserosally were characterized by hypovascularity, subcutaneous transplantation resulted in hypervascular tumors. Encasement, which is defined as invasion of normal arteries by the tumor, showing uneven caliber, irregular outline, appeared on earlier microangiographic findings rather than luminal irregularity, which is change of tumor vessels in neovascularization and occurs in tumor blood vessels subsequent to transplantation. The vascular component of subcutaneously transplanted tumors had a total vessel length ranging from 9.2 +/- 0.7 mm to 18.1 +/- 1.1 mm, a total vessel surface from 2.5 +/- 0.4 mm2 to 9.3 +/- 0.6 mm2 and a total vessel volume from 0.07 +/- 0.02 mm3 to 0.49 +/- 0.04 mm3, indicating that the vessels were of relatively large diameter and short length. PMID- 3522265 TI - Carcinogenesis and ageing--VII. Carcinogenic effect of single total-body X-ray irradiation in young and old female rats. AB - Female rats aged 3 and 14 months were exposed to single X-ray irradiation at a dose of 4 Gy. Total frequency of neoplasms and that of malignant tumors in the younger age group amounted to 78 or 42%, and in the older age age group to 66 and 31% respectively, while in the corresponding age groups the figures were as follows: 48 or 7% (p less than 0.05). The comparative analysis of the carcinogenic effect of irradiation in young and old rats has revealed that sensitivity of the mammary gland epithelium, ovarian tissue and thyroid epithelium to malignant actions of irradiation decreases with age. The paramount importance in modification of tissue sensitivity to carcinogenic action of irradiation in ageing is suggested to be related to age-dependent changes in the proliferative activity of the target tissues. PMID- 3522266 TI - Thiamine-binding activity of Saccharomyces cerevisiae plasma membrane. AB - The specific binding activity to [14C]thiamine was found to be located in hte plasma membrane of Saccharomyces cerevisiae. The activity was inhibited by several thiamine analogs and it was hardly detectable in the plasma membrane from a thiamine transport mutant of Saccharomyces cerevisiae. Some properties of the thiamine-binding activity of yeast plasma membrane are discussed in connection with those of the thiamine transport system. PMID- 3522267 TI - Renal effects of the inhibitor of thromboxane A2-synthetase OKY-046. AB - Acute renal failure (ARF) was associated with increased urinary thromboxane (TXA2) excretion and lessened excretion of sodium (UNaV) and fractional excretion of sodium (FENa%). The inhibitor of thromboxane A2-synthetase OKY-046 enhanced sodium excretion and fractional excretion of sodium in normal and saline loaded animals whereas it partially prevented the reduction in sodium excretion and creatinine clearance and significantly increased fractional excretion of sodium in glycerol treated rats suggesting a partial protection against the development of acute renal failure. PMID- 3522268 TI - [The adsorption of oral drugs: factors influencing the process]. PMID- 3522269 TI - [Effect of antioxidants on the synthesis of prostaglandins, prostacyclin and thromboxane in different layers of the kidneys of old rats]. AB - The effects of L-tocopherol and synthetic antioxidants on synthesis of prostaglandins, thromboxane B2 and prostacyclin in different layers of the kidney against the background of chronic administration of polyene antibiotics (amphotericin B, levorin, nystatin) were studied in the experiments on aged rats. It was concluded that synthetic antioxidants regulate synthesis of these biologically active substances and also are able to protect the organ from the damaging effect of polyene antibiotics. PMID- 3522270 TI - [Effect of lithium oxybutyrate on the viability of preserved donor kidney]. AB - The experiments on 10 dogs showed that replacement of sodium oxybutyrate for lithium oxybutyrate in the solution for preservation increases the period of preserving the structural and functional integrity of the donor kidney, contributes to its survival and delays the development of the transplant rejection. PMID- 3522271 TI - [N-pyrazolyl-2-nitrobenzamides with antifungal activity]. AB - Novel N-pyrazolyl-2-nitrobenzamides variously substituted on the pyrazole nucleus were prepared. The products obtained together with some other N-substituted 2 nitrobenzamides were tested for their antifungal activity against Cryptococcus neoformans and Candida albicans. The results of the antimicrobial assay showed different behaviours of the organisms used with regard to the derivatives tested. PMID- 3522272 TI - Reinvestigation of the roles of the carboxyl groups of glutathione with yeast glyoxalase I. Implications as to the mechanism and coenzymic role of glutathione. AB - A number of carboxyl-substituted S-blocked glutathiones have been shown to be competitive inhibitors of yeast glyoxalase I at 25 degrees C, pH 6.6. Amidation of the glycyl carboxyl group of S-(p-bromobenzyl)glutathione has no appreciable effect on binding whilst methylation reduces binding by 8.9-fold, indicating a steric constraint and the possible presence of a hydrogen bond in this region of the enzyme. Amidation of both carboxyl groups of S-(p-bromobenzyl)glutathione reduces binding significantly by 237-fold; this result agrees with electrostatic interaction of the Glu COO- group with a group located within the enzyme surface as opposed to the Gly COO- group, previously proposed. PMID- 3522273 TI - A portal-arterial glucose concentration gradient as a signal for an insulin dependent net glucose uptake in perfused rat liver. AB - Since in the usual perfusion of isolated rat liver via the portal vein an insulin dependent increase of hepatic glucose uptake could not be demonstrated, the possibility was considered that hepatic glucose uptake might not be a function of the absolute concentration of this substrate but of its concentration gradient between the portal vein and the hepatic artery. Therefore a new method was established for the simultaneous perfusion of isolated rat liver via both the hepatic artery (20-35% flow) and the portal vein (80-65% flow). When glucose was offered in a concentration gradient, 9.5 mM in the portal vein and 6 mM in the hepatic artery, insulin given via both vessels caused a shift from net glucose release to uptake. This insulin-dependent shift was not observed when glucose was offered without a gradient or with an inverse gradient, 6 mM in the portal vein and 9.5 mM in the hepatic artery. Using a portal-arterial glucose gradient as a signal the liver might be able to differentiate between endogenous and exogenous glucose. PMID- 3522274 TI - On the sequence homology of the ribosomal proteins, Escherichia coli S11, yeast rp59 and Chinese hamster S14. AB - A strong sequence homology was found among the ribosomal proteins of the different species, S11 of Escherichia coli, rp59 of Saccharomyces cerevisiae and S14 of Chinese hamster ovary cell. The significance of this series of highly conserved proteins is discussed. PMID- 3522275 TI - The effects of 1-aminooxy-3-aminopropane and S-(5'-deoxy-5' adenosyl)methylthioethylhydroxylamine on ornithine decarboxylase and S-adenosyl-L methionine decarboxylase from Escherichia coli. AB - 1-Aminooxy-3-aminopropane (APA) was shown to be a potent competitive inhibitor (Ki = 1.0 nM) of partially purified Escherichia coli ornithine decarboxylase. APA did not inhibit S-adenosyl-L-methionine decarboxylase and spermidine from E. coli. S-(5'-Deoxy-5'-adenosyl)methylthioethylhydroxylamine (AMA), which is a structural analogue of decarboxylated S-adenosyl-L-methionine, was for the first time shown to be an irreversible inhibitor of bacterial S-adenosyl-L-methionine decarboxylase and a competitive inhibitor (Ki = 47 microM) of bacterial ornithine decarboxylase. AMA had no effect on spermidine synthase. PMID- 3522276 TI - Circular dichroism studies on the signal sequence of E. coli alkaline phosphatase indicate the presence of both alpha-helix and beta-structure in hydrophobic environments. AB - The conformations of a synthetic peptide corresponding to the signal sequence of E. coli alkaline phosphatase, Lys-Gln-Ser-Thr-Ile-Ala-Leu-Ala-Leu-Leu-Pro-Leu-Leu Phe-Thr-Pro-Val-Thr- Lys- Ala-OCH3, have been examined in different environments by circular dichroism spectroscopy. In trifluoroethanol, methanol and aqueous mixtures of these solvents, the signal peptide has largely random conformation (approximately 80%) with small amounts of alpha-helix and beta-structure. However, in micellar environment, there is a significant increase in ordered conformation with both alpha-helix and beta-structure being present, unlike in other signal sequences reported in the literature, where only the alpha-helical conformation has been observed. Hence, an alpha-helical conformation may not be as stringent a requirement as overall hydrophobicity for recognition of signal sequences by the cell's export machinery. PMID- 3522277 TI - Microelectrode studies of D-glucose- and K+-induced changes in membrane potential of electrofused insulin-producing cells. AB - In the present study electrical field-induced fusion has been applied to both normal pancreatic islet cells isolated from obese hyperglycemic mice and clonal insulin-producing cells (RINm5F) derived from a transplantable rat insulinoma. The fused cells were then punctured with microelectrodes to measure changes in membrane potential after exposure to stimulatory concentrations of D-glucose or K+. Fused cells of normal islet cellular origin revealed a resting membrane potential of -60 mV and were depolarized by 24 or 27 mV after exposure to 11 mM D glucose or 30 mM K+. Although D-glucose induced depolarization, it was not possible to establish the existence of an oscillating burst pattern superimposed by action potentials. The resting membrane potential of the fused RINm5F cells was also -60 mV and decreased to -30 mV after exposure to 30 mM K+. As judged from the membrane potential measurements, the reconstitution of the plasma membrane subsequent to electrical breakdown is essentially the same whether the giant cells originated from normal islet cells or RINm5F cells. PMID- 3522278 TI - Uptake and fate of absorbed amino acids and peptides in the mammalian intestine. AB - Intraluminal and brush-border digestion of proteins results in a mixture of amino acids and small peptides. Thirteen brush-border peptidases have been described. Despite all of these enzymes, some peptides escape digestion and are absorbed intact. The assimilated products of protein digestion can follow multiple paths: absorption into the blood as amino acids or small peptides, metabolism within the enterocyte, incorporation into proteins of the enterocyte, and incorporation into proteins to be secreted into plasma. Unlike other tissues, the intestinal mucosa is not very responsive to metabolic regulation as regards amino acid uptake or regulation of protein synthesis. Most effects after dietary manipulation or drug or hormonal stimulation are modes (two-to fivefold increases). This constitutive metabolism of amino acids in the intestinal mucosa is consistent with its essential role in absorption. The mucosa also is a major contributor to apolipoproteins, which are probably the quantitatively most important proteins secreted from the intestine. Alterations in apoprotein secretion have been noted after fat feeding, and are both transcriptionally and translationally regulated. Although the fractional renewal rate of protein in the intestine is the highest of any tissue in the body, the quantitative importance of alterations in protein synthesis or secretion to the fate of intracellular amino acids is not known. PMID- 3522279 TI - Preservation of human eggs and embryos. PMID- 3522280 TI - Menotropins and sonography. PMID- 3522281 TI - Immunoperoxidase localization of prolactin in endometrium during normal menstrual, luteal phase defect, and corrected luteal phase defect cycles. AB - An avidin-biotin immunoperoxidase staining technique for human prolactin (hPRL) was developed for determination of the location of PRL-producing cells in the endometrium of women with normal menstrual cycles (NMC), luteal phase defects (LPD), and corrected LPD cycles (CLPD). One hundred eight biopsy specimens were studied. Fifty-six patients had NMC, 29 had LPD, and 23 had CLPD. Only decidualized stromal cells stained specifically for hPRL. There was no specific staining in specimens dated earlier than day 25. All specimens dated later than day 25 exhibited decidual cell staining. In specimens dated day 25, 15 of 20 NMC, 5 of 11 CLPD, and 6 of 10 LPD demonstrated decidual staining (P greater than 0.1). These findings suggest that decidual cells are responsible for hPRL production in late secretory endometrium and that the ability of decidual cells to stain for hPRL is dependent on the histologic date of the endometrium and not on the diagnosis of LPD or CLPD. PMID- 3522282 TI - Inhibition of sperm penetration through human zona pellucida by antisperm antibodies. AB - An in vitro penetration test using human spermatozoa, sera, and eggs stored in a highly concentrated salt solution was designed for examination of the effect of antisperm antibodies on the process of fertilization. Spermatozoa from a healthy fertile donor incubated in modified Biggers, Whiiten and Whittingham (BWW) medium containing 7.5% antisperm-antibody-negative serum, could penetrate through the zonae pellucidae of the stored eggs, but not when the spermatozoa from the same donor had been incubated in modified BWW medium containing 7.5% antisperm antibody-positive serum. After the antisperm-antibody-positive serum was absorbed with washed spermatozoa, the sperm penetration was not blocked. Therefore, antisperm antibodies appear to block human sperm penetration through the human zona pellucida. PMID- 3522283 TI - [Effect of dietary factors and insulin on the concentration of alpha-tocopherol in the organs of the young white rat]. PMID- 3522284 TI - [Relation between glucose resorption and enzyme activity of the brush border of enterocytes in the rat and the level of endogenous serotonin]. AB - Experiments in rats revealed a direct dependence of the absorbing and secretory activities of the small intestine on the level of endogenous serotonin and its concentration in the intestine contents. PMID- 3522285 TI - [A device for stereotaxic fixation of the skull of the alert rat during electrophysiologic and microiontophoretic studies of individual neurons]. PMID- 3522286 TI - The indigent care crisis: do nurses care? PMID- 3522287 TI - Tolerance of skin allografts incompatible at the entire H-2 complex induced in adult mice by the post-transplant treatment. AB - Permanent tolerance of the entire H-2 complex incompatible B10 skin allografts was induced in adult B10.A mice by post-transplant treatment. Recipient mice were treated with heterologous antithymocyte serum (ATS) and specific tissue extracts or monoclonal antibodies anti-Thy-1.2. Combination of treatments with the specific tissue extracts and monoclonal antibodies leads to a high degree of tolerance in the majority of ATS-treated animals. Results thus show that it is possible to induce long-term tolerance of the entire H-2 complex incompatible skin allografts in mice using specific and non-specific immunosuppression given in the post-transplant period. PMID- 3522288 TI - Influence of the incubation of cells with zinc and lithium ions on GVH reactivity of cells and on their ability to form haemopoietic colonies. AB - Mouse spleen and bone marrow cells were incubated for 2 h with ZnCl2 and Li2SO4 at different concentrations and tested for the ability to evoke the graft-versus host reactions (GVHR) and to form pluripotent haemopoietic colonies. ZnCl2 at concentrations 5 X 10(-6) to 5 X 10(-4) M inhibited the regional GVHR. At a concentration of 5 X 10(-6) ZnCl2 also inhibited the ability to elicit the systemic GVHR in irradiated mice. Haemopoiesis was stimulated in cells incubated with ZnCl2 at concentration 5 X 10(-6) M, it was inhibited after incubation of A/01a cells with 5 X 10(-4) M ZnCl2, whereas cells from non-inbred ICR mice were stimulated by the latter concentration of ZnCl2 for haemopoiesis. Li2SO4 inhibited the ability to induce the regional GVHR at concentrations of 5 X 10(-3) and 10(-2) M, had no effect on survival of mice during the systemic GVHR and exerted rather an inhibitory effect on haemopoiesis. PMID- 3522289 TI - State-of-the-art treatment of congestive heart failure. PMID- 3522290 TI - Dr. William Heberden, Sr.'s note on Dr. William Harvey. PMID- 3522291 TI - Treatment of common orofacial conditions. AB - The conditions discussed in this article are those most likely to cause a patient to seek emergency care, primarily for pain. All the characteristics given for the conditions to aid in the diagnosis do not necessarily need to be present and other characteristics not mentioned may in fact be present. A complete differential diagnosis, especially of more obscure lesions, was also not attempted. An attempt was made to provide the practitioner with enough information to develop a working diagnosis from which to alleviate the patient's discomfort. A definitive diagnosis may not be available in an emergency setting. However, it must be emphasized that the final responsibility of the dentist is to make a definitive diagnosis at a later time if one cannot be made when emergency treatment is sought. Alleviating pain without dealing with the underlying cause may be more detrimental to the patient's health in the long run, as palliative therapy may mask a more severe condition. PMID- 3522292 TI - Complications and prognostic considerations in operative dentistry. AB - Several aspects of routine operative treatment procedures may result in particularly challenging problems and complications. This article reviews the potential for such complications with emphasis on the ultimate treatment prognosis. PMID- 3522293 TI - Prosthodontics. Diagnostic, treatment planning, and prognostic considerations. AB - The prosthodontic rehabilitation of a patient is usually the culmination of a patient's dental treatment. In order to maximize the prognosis, it is necessary to understand the patient, to make a thorough diagnosis, to coordinate the restoration with the other disciplines of dentistry, and to be knowledgeable of the spectrum of treatment modalities available. PMID- 3522294 TI - Prosthodontics. Urgent care. AB - There are an infinite number of responses to prosthodontic urgent care situations. A knowledge of acrylic resins combined with imagination and a clear understanding of the patient's chief complaint will allow the dentist to respond in an effective manner. PMID- 3522295 TI - Oral surgery. AB - An overview of the various possibilities for oral surgery urgent care to the oral region has been presented. Modern treatment procedures have been described. The recent advances in dental science have become superior to what they were just a few short years ago; however, we must never forget the variabilities of human responses to any of our treatment techniques, and we must not be dogmatic in our approach. We should all be able to diagnose, interpret, and alter any of our treatment techniques as necessary. PMID- 3522296 TI - [In vitro effect of PUVA therapy on intracellular killing in psoriasis patients]. PMID- 3522297 TI - Castable ceramics. PMID- 3522298 TI - Injection packing of acrylic resin: an improved technique. PMID- 3522299 TI - Metabolic response to intravenous infusion of porcine and semi-synthetic human insulin in insulin-dependent diabetic men. AB - The response of intermediary metabolite concentrations was measured in six insulin-dependent diabetic men during intravenous low-dose incremental insulin infusion. Insulin was infused during consecutive hours at rates of 0.01 u/kg/h, 0.05 u/kg/h and 0.10 u/kg/h. Each patient was studied on two occasions a month apart using either highly purified porcine or semi-synthetic human short-acting insulin. No difference was observed in the changes in blood glucose, lactate, pyruvate, glycerol, alanine, total ketone bodies or plasma non-esterified fatty acids. Thus no difference could be identified in the actions of intravenous porcine and semi-synthetic human insulin on carbohydrate, fat or ketone body metabolism in vivo. PMID- 3522300 TI - Evidence for normal in vitro Ca2+-stimulated insulin release in rats with non insulin-dependent diabetes. AB - Non-insulin-dependent diabetes (NIDD) was induced in adult rats following a neonatal injection of streptozotocin. Rats with NIDD exhibited moderate basal hyperglycemia (less than 2g/l) with defective glucose-induced insulin secretion and preserved or enhanced responsiveness to various non-glucose secretagogues. The possible sites of defects in the B cells of these diabetic rats are at present unknown. Extracellular Ca2+ at concentrations exceeding 10 mmol/l causes a dose-related stimulation of insulin release by the perfused normal rat pancreas. This technique provokes an increase of cytosolic Ca2+ accumulation in the B cell sufficient to trigger activation of the microtubular-microfilamentous effector system responsible for the exocytosis of insulin granules. It is therefore possible to compare functional efficiency of this process in the B cells of diabetic rats to that in the normal B cells. Results obtained in response to Ca2+ stimulation over the range 10-13.5 mmol/l provide evidence that the insulin release is stimulated in the pancreas of diabetic rats to the same extent as that in the controls, in both the kinetic and the quantitative aspect of the response. These data are compatible with the idea that in the B cells of rats with NIDD : 1) the effector system of insulin secretion is not grossly altered and 2) the lesion responsible for the loss of glucose-induced insulin secretion occurs before the effector system, involving either the mechanism by which glucose is metabolized as previously proposed by us, or another step yet to be identified. PMID- 3522301 TI - Antigenicity of semisynthetic human insulin in newly diagnosed type I diabetic patients: difference between short and intermediate acting preparations. PMID- 3522302 TI - Does growth hormone play a role in the impaired glucose tolerance of thyrotoxicosis? PMID- 3522303 TI - [Glycemia, glycosuria, or both?]. PMID- 3522304 TI - The van Deventer lecture. Hendrik van Deventer. PMID- 3522305 TI - Fetal behaviour in type-1 diabetic women. AB - Real-time ultrasound observation of fetal movement patterns can be used to assess the development of the motor component of the nervous system. Data are presented on the emergence of fetal movements in the first trimester of pregnancy, and on the development of fetal behavioural states in the third trimester, in women with type-1 (insulin dependent) diabetes. In the first trimester there is a delay in emergence of movement patterns. This delay is, however, not specific but parallels that of growth. In the third trimester there is a delay in emergence of fetal behavioural states. It is concluded that a tight metabolic control, achieved with continuous insulin infusion, does not prevent these disturbances in development. PMID- 3522306 TI - Severe intrauterine growth retardation; assessment of its origin from fetal arterial flow velocity waveforms. AB - Doppler blood flow velocity waveforms in the umbilical artery and fetal internal carotid artery were recorded in a total of 10 patients with severe intrauterine growth retardation (IUGR) and marked oligohydramnios to establish a fetal or utero-placental origin of IUGR. Gestational age varied between 28 and 37 wk. Negative maternal serology ruled out fetal infections. In six patients, IUGR was associated with abnormal flow velocity waveforms, indicating utero-placental insufficiency. Following delivery, these infants showed no structural defects; moderate to marked placental infarction was documented in 4 out of 6 cases. In the remaining four patients, IUGR was associated with normal flow velocity waveforms, suggesting a fetal origin of the IUGR. Following delivery, all four infants revealed structural defects, only one of which was diagnosed prenatally. Twice an abnormal karyotype was the underlying cause. There was no placental infarction. These preliminary data suggest that combined recording of the flow velocity waveform in the above-mentioned vessels may provide valuable additional information as to the cause of IUGR and as such be helpful in determining obstetric management. PMID- 3522307 TI - Screening for Ureaplasma urealyticum infections in the neonate and the association with prematurity. AB - Ureaplasma urealyticum has been implicated in gynaecological, obstetrical and neonatal pathology. Increased levels of C-reactive protein and total IgM concentrations in cord blood have often been used as a screening method for infectious disease in the fetus and the newborn. Analysis of the isolation rate of U. urealyticum in function of the concentrations of these two parameters in cord blood showed that U. urealyticum was significantly (P less than 0.05) more frequently isolated when CRP was above normal in cord blood. No correlation between the IgM level in the newborn and the presence of U. urealyticum could be established. A significant relationship was found (P less than 0.01) between Ureaplasma isolation in the urine of mother and child on the one hand and gestational age on the other hand, which supports the hypothesis that U. urealyticum may play a role in preterm delivery. PMID- 3522308 TI - Prenatal diagnosis and management of some fetal intrathoracic abnormalities. AB - Nine cases of fetal intrathoracic anomalies detected in utero and followed to birth are reviewed. There were 6 congenital diaphragmatic hernias (CDH), one congenital pleural effusion and two isolated cysts of the lung. All these conditions were potentially responsible for neonatal respiratory distress and received early intensive treatment after maternal transport and delivery had been arranged in a center with thoracic surgical facilities available. The risks of a delayed or missed diagnosis were thus avoided, especially for CDH. Despite intensive, traditional, respiratory support, started in the delivery room, mortality among prenatally detected cases of CDH was paradoxically high (83%), compared to mortality among 7 cases of CDH not detected in utero, referred in the same period to our Institution, and symptomatic within 6 h from birth (63%). With prenatal diagnosis the total number of CDH cases referred to a surgical center before birth increases. Many cases which would never have been treated in the past because of death before referral and treatment for severe pulmonary hypoplasia not compatible with life are thus observed and sometimes treated. Nevertheless, lung development continues to be a determining factor for survival even when intensive treatment at birth is available. Responsiveness to therapy is unpredictable before birth and proposed antenatal treatment is still far from being a realistic option. For the other three newborns, where a pleural effusion and pulmonary cysts were found, prenatal diagnosis helped to start appropriate treatment and to prevent neonatal hypoxia in two of them. In the third case, with an incommunicant, isolated pulmonary cyst, the outcome would have been favourable even without a prenatal diagnosis. PMID- 3522309 TI - Intracervical application of prostaglandin E2 tablets for elective induction of labor in grand multiparae: a prospective controlled study. AB - In a prospective and controlled study labor was induced electively in 150 grand multiparae (GM) between 38 and 42 wk gestation by intracervical application of PGE2 tablets (induction group). Another 150 GM who went into labor spontaneously served as controls for comparison of labor characteristics and outcome (control group). In the induction group labor was successfully induced in 147 GM (98.0%), of whom 142 (96.5%) delivered vaginally. The mean duration of the active phase of labor was 2.1 +/- 0.79 h in GM who delivered on the first day of induction and 2.8 +/- 0.47 h in women who delivered on the second day, as compared to 4.7 +/- 2.2 h in the controls. Similarly, the mean duration of the second and third stage was longer in the controls. Operative deliveries were 2--3-times more frequent among controls, as were complications in the second and third stages. The group profiles of the I.U.P. charts indicating rise time, fall time, amplitude and Montevideo units at different stages of cervical dilatation showed significant differences at 4-5 cm dilatation only between the two groups of women. It is concluded that elective induction in GM between 38 and 42 wk is safe for mother and fetus. PMID- 3522310 TI - Trisomy 18: the value of late prenatal diagnosis. AB - Diagnosis of trisomy 18 was made in 2 fetuses late in pregnancy. Both pregnancies were complicated by polyhydramnios coexisting with fetal growth retardation. The significance of these findings, and the advantages and limitations of late prenatal diagnosis of fetal chromosomal abnormality are discussed. PMID- 3522311 TI - A double-blind study comparing ibuprofen 1800 mg or 2400 mg daily and placebo in sports injuries. AB - In a double-blind, placebo-controlled study of forty-six patients with acute ligamentous damage of the knee, ibuprofen in dosages 1800 mg and 2400 mg produced significant improvements in joint mobility, weight bearing ability and match fitness. Joint effusion, pain on stress and pain severity was significantly improved by all three treatments. Only two patients reported side-effects (one while taking placebo and one taking ibuprofen 2400 mg). The study confirmed the efficacy and excellent tolerance to ibuprofen in patients with sports injuries to the knee. PMID- 3522312 TI - The steady-state pharmacokinetics of tamoxifen and its metabolites in breast cancer patients. AB - The steady-state pharmacokinetics of tamoxifen and its metabolites was studied in sixteen patients with advanced mammary cancer. Patients were randomized to receive tamoxifen given as Tamofen, Leiras, or as Nolvadex, ICI, 20 mg twice daily for 16 weeks in a cross-over study. Plasma and urine samples were analyzed during one dose interval (12 h) after treatment for 8 and 16 weeks. The concentrations of tamoxifen, N-desmethyltamoxifen, N,N-desdimethyltamoxifen, and metabolite Y were determined in plasma and the areas under the plasma level curves were calculated. 4-Hydroxytamoxifen was not found in plasma. In urine samples only tamoxifen and N-desmethyltamoxifen were above the detection limits even though metabolite Y was also analyzed after acid hydrolysis. There were no statistically significant differences in the concentrations of tamoxifen and its metabolites between the two preparations. The results of nonresponders did not differ from those of responders. Liver metastases had no effect on the metabolism of tamoxifen. PMID- 3522313 TI - LHRH promotes the synthesis and release of a 87,000 Da protein (GP-87) by enriched gonadotrophs. AB - Protein secretion by cultured pituitary cells from 14-day-old female rats was estimated using [35S]methionine incorporation followed by either one- or two dimensional electrophoresis and autoradiography. Stimulation of total cells or gonadotrophs by LHRH promoted the synthesis and release of a specific polypeptide (apparent molecular weight 87,000, pI = 4.6). Silver staining of cellular proteins from both gonadotroph-enriched and gonadotroph-depleted populations prepared by centrifugal elutriation revealed a high concentration of this polypeptide in the gonadotrophs and a very low level in the other cell population. This species was thus called Gonadotrope Polypeptide GP-87. Release of labeled GP-87 by gonadotrophs was both time dependent (up to 4 h) and LHRH dose dependent (from 10(-9) M to 10(-7) M) as was the release of LH. Attempts to precipitate GP-87 from the incubation medium with anti-LH antiserum were unsuccessful suggesting that GP-87 is not a 'big' form of LH. TRH neither stimulated the release of GP-87 from gonadotrophs nor from lactotrophs though it did stimulated PRL release. From these data, we conclude that gonadotrophs in culture synthesize a specific polypeptide (GP-87), LHRH stimulates both the synthesis and release of GP-87, and the pituitary cell response is peptide specific. The LHRH-induced synthesis and release of GP-87 could be an important step in the molecular processes that regulate gonadotrophin secretion. PMID- 3522314 TI - Anterior pituitary glandular kallikrein: trypsin activation and estrogen regulation. AB - Discrepant reports exist regarding the presence of glandular kallikrein or other trypsin-like serine proteases in the pituitary. The existence of pituitary kallikreins in latent forms could explain these discrepancies. I report that trypsin treatment of rat anterior pituitary homogenates activates two serine proteases which generate kinins from kininogen and selectively cleave chromogenic substrates for kallikreins. One protease (enzymatically and immunologically resembling glandular kallikrein) and activated 5-fold by trypsin and was 20 times more abundant in female than in male lobes due to hormonal regulation by ovarian estrogens. The second kallikrein (activated 20-fold by trypsin) was unaffected by estrogens. The results demonstrate that rat anterior pituitary kallikreins predominantly exist in latent forms requiring activation for detection. Additionally, glandular kallikrein is a major estrogen-induced protein in the rat anterior pituitary. No other member of this large protease family is known to be regulated by estrogens. PMID- 3522315 TI - Occurrence of dawn phenomenon without change in insulin clearance in patients with insulin-dependent diabetes mellitus. AB - To assess the possible role of increased insulin clearance in the pathogenesis of the dawn phenomenon, we compared plasma free-insulin concentrations, free-insulin clearance rates, and plasma glucose concentrations in eight subjects with insulin dependent diabetes mellitus (IDDM) during infusion of insulin from midnight to 0800 h (0.15 mU . kg-1 . min-1) with a Biostator and a Harvard pump. During infusion of insulin with the Biostator, plasma free insulin decreased 40% (from 14 +/- 1 to 9 +/- 1 microU/ml, P less than .01), insulin clearance increased 54% (from 11 +/- 1 to 17 +/- 2 ml/min, P less than .05), and plasma glucose increased from 101 +/- 4 to 217 +/- 27 mg/dl, P less than .01. During infusion of insulin with the Harvard pump, neither plasma free insulin (14 +/- vs. 13 +/- 1 microU/ml) nor free-insulin clearance (12 +/- 2 vs. 13 +/- 2 ml/min) changed significantly, but plasma glucose increased from 100 +/- 3 to 167 +/- 21 mg/dl, P less than .01. The increases in plasma glucose during infusion of insulin with the Biostator and the Harvard pump were not significantly different (t = 1.44, P = .19). When insulin was delivered directly into test tubes with the Biostator and the Harvard pump, insulin concentrations in the test tubes decreased 46% over 8 h (P less than .05) with the Biostator, whereas no decrease was observed with the Harvard pump.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3522316 TI - Insulin-like material in parotid and submaxillary salivary glands of normal and diabetic adult male mice. AB - Acid-ethanol extracts of homogenates from the parotid and submaxillary salivary glands of normal and streptozocin-induced diabetic adult male mice were investigated for insulin-like material. Extracts of both the parotid and submaxillary glands contained insulin-like immunoreactivity. The values were 156 +/- 72 ng/g wet tissue in the parotid and 104 +/- 36 ng/g wet tissue in the submaxillary gland. Fractionation of this material on Sephadex G-50 (superfine) columns revealed a single peak corresponding to the elution volume of isotopically labeled insulin. Isolated fat cells were stimulated by these extracts to convert [14C]glucose to 14CO2. This effect was blocked by preincubation with anti-insulin serum. It was observed with the avidin-biotin immunocytochemical technique that both the parotid and submaxillary glands of adult male mice possess a population of cells containing an insulin-like material. After intraperitoneal injection of streptozocin there was a marked decrease of insulin-like material extractable from both the parotid and submaxillary glands. However, this beta-cell cytotoxic agent did not completely destroy the salivary cells containing the insulin-like material. These data suggest that both the parotid and submaxillary salivary glands may be extrapancreatic sources of insulin in mice. PMID- 3522317 TI - Insulin deficiency alters cellular cholesterol metabolism in murine macrophages. AB - Mice made insulin deficient by the injection of streptozocin develop hyperglycemia and hypertriglyceridemia with triglyceride-rich, very-low-density lipoproteins (VLDLs). Thioglycolate-elicited peritoneal macrophages freshly isolated from insulin-deficient mice have increased activity of 3-hydroxy-3 methylglutaryl coenzyme A reductase, which is reflected in a greater rate of cholesterol synthesis by these macrophages. In contrast, thioglycolate-elicited macrophages from control mice with diet-induced hypertriglyceridemia had normal levels of 3-hydroxy-3-methylglutaryl coenzyme A reductase activity. Cell surface receptors responsible for VLDL uptake are decreased in macrophages isolated from insulin-deficient mice, although receptors for acetylated low-density lipoproteins are not altered. Insulin treatment of insulin-deficient mice lowers plasma glucose and triglyceride concentrations. Additionally, insulin treatment returns the activity of 3-hydroxy-3-methylglutaryl coenzyme A reductase and the rate of cholesterol synthesis in thioglycolate-elicited macrophages to normal while increasing the number of receptors responsible for VLDL uptake. It is suggested that the increases in 3-hydroxy-3-methylglutaryl coenzyme A reductase activity and the rate of cholesterol synthesis in macrophages isolated from insulin-deficient mice are secondary to the reduction in the number of receptors responsible for VLDL uptake induced by insulin deficiency. These alterations in the cholesterol metabolism of macrophages occurring with insulin deficiency may have important implications for the atherosclerotic process in diabetes mellitus. PMID- 3522318 TI - Islet insulin release and net calcium retention in vitro in vitamin D-deficient rats. AB - In our previous studies, perifused islets from vitamin D-deficient (D-def) rats showed marked impairment of glucose-induced biphasic release, accounted for at least in part by a decrease in food intake. In studies reported here, we test whether D-def rat islets have an impaired response to 5.6 mM glucose or tolbutamide, (T), and if so, whether this impairment is related to a decrease in food intake or a defect in islet calcium metabolism. We isolated islets of normal rats, D-def rats, and rats pair fed (PF) to D-def rats. Biphasic insulin release from perifused islets and net 45Ca retention in lot-incubated islets were measured in response to 5.6 mM glucose, 0.37 mM T, or both. Compared with secretion from normal islets, biphasic insulin release from islets of both D-def rats and PF rats was diminished by greater than 50% in response to 5.6 mM glucose alone or 5.6 mM glucose plus T. Insulin secretion was not significantly different between islets of D-def rats and islets of PF rats. In contrast, net calcium retention in islets of D-def rats was decreased to 68% of retention in islets of PF rats. However, net calcium retention in islets of both PF and D-def rats increased in response to T. The pair-feeding experiments suggest that the decrease in insulin release from islets of D-def rats is due to the decrease in food intake associated with the D-def state.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3522319 TI - Relative importance of first- and second-phase insulin secretion in glucose homeostasis in conscious dog. II. Effects on gluconeogenesis. AB - The normal pancreatic response to an exogenous glucagon infusion is a biphasic release of insulin. In our study the ability of each component of insulin release to counter the effects of the glucagon on gluconeogenesis and alanine metabolism was assessed by mimicking first- and/or second-phase insulin release with infusions of somatostatin and intraportal insulin. When a fourfold increase in glucagon was brought about in the presence of fixed basal insulin release, there was a large increase in overall glucose production and gluconeogenesis. The increase in the conversion of [14C]alanine into [14C]glucose (169 +/- 42%, P less than .05) was accompanied by an increase in the fractional extraction of alanine by the liver (FEA 0.32 +/- 0.06 to 0.66 +/- 0.10, P less than .05) and net hepatic alanine uptake (NHAU 2.97 +/- 0.45 to 4.61 +/- 0.48 mumol . kg-1 . min-1, P less than .05). Simulated first-phase insulin release had no effect on the ability of glucagon to increase FEA (0.32 +/- 0.03 to 0.66 +/- 0.03, P less than .05) or NHAU (3.69 +/- 0.80 to 5.10 +/- 0.69 mumol . kg-1 . min-1, P less than .05) but did limit the increase in overall gluconeogenic conversion (114 +/- 37%). Second-phase insulin release had no effect on either the glucagon-induced increase in FEA (0.35 +/- 0.08 to 0.73 +/- 0.04) or NHAU (3.35 +/- 0.92 to 5.13 +/- 0.85 mumol . kg-1 . min-1) but completely inhibited the increase in overall gluconeogenic conversion.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3522320 TI - Effect of acute exercise on insulin generation of pyruvate dehydrogenase activator by rat liver and adipocyte plasma membranes. AB - Groups of young adult rats with body weights of 125-135 g (group A) or 300-400 g (group B) were subjected to one bout of prolonged exercise to exhaustion on a treadmill and were studied 2 h postexercise. Liver glycogen levels were markedly depleted in the exercised rats. Adipocytes from group A exercised rats showed a significantly greater increase in pyruvate dehydrogenase (PDH) activity in response to insulin than those from sedentary controls. Incubation with insulin of liver particulate fractions from exercised group A rats resulted in an increased production of a mitochondrial PDH activator compared with preparations from sedentary controls. The tissues of both exercised and sedentary group B rats were less responsive to insulin than those of the smaller rats. A significant effect of exercise on increased production of a PDH activator in response to insulin was found only in experiments in which adipocyte plasma membranes were coincubated with mitochondria and insulin. For group B rats exercise provided no significant enhancement of insulin activation of intact adipocyte PDH or stimulation of the production of a PDH activator by liver particulate preparations. Insulin binding to fat cells was not affected by exercise. Group A rats made insulin resistant by a high-fat diet did not respond to exercise by significantly increasing the insulin stimulation of PDH activator by liver membranes. The enhancing effect of a single bout of exercise on insulin response was not readily demonstrable in rats resistant to insulin either in association with age and weight or with a high-fat diet.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3522321 TI - Non-invasive assessment of neonatal cerebral function. PMID- 3522322 TI - Skeletal muscle adaptability. I: Review of basic properties. PMID- 3522323 TI - Electronystagmography in peripheral lesions. PMID- 3522324 TI - The histopathology of the pancreas in type 1 (insulin-dependent) diabetes mellitus: a 25-year review of deaths in patients under 20 years of age in the United Kingdom. AB - A 25-year computerised survey of deaths in the United Kingdom among diabetic patients of 19 years of age and under was performed. Suitable pancreatic material was available in 119 out of the 498 identified patients. The duration of diabetes was known in 95 of the 119 patients. In 60 patients it had been present for less than 1 year. Insulitis was present in 47 of the 60 patients (78%) with recent onset disease, and was also found in 3 patients who had been treated for diabetes for between 1 and 6 years. In cases in which it was identified, insulitis affected 23% of islets containing insulin, but affected only 1% of islets which were insulin deficient, thus supporting the concept that insulitis represents an immunologically mediated destruction of insulin secreting B cells. Four patients appeared to have a different disease from classical Type 1 (insulin-dependent) diabetes in that there was no evidence of insulitis and all islets contained insulin. The age of onset of diabetes was eighteen months or less in these patients. PMID- 3522325 TI - Blood pressure in children, adolescents and young adults with type 1 (insulin dependent) diabetes. AB - Blood pressure has been measured by a single observer using a standardised technique in 163 Type 1 (insulin-dependent) diabetic patients aged 4 to 32 years, 232 of their non-diabetic siblings in the same age range and in 292 of their natural parents. Results for each sex were examined separately by analysis of variance. Systolic pressures were not significantly different overall nor in any single 4-year age band. In contrast, phase IV diastolic pressure was slightly but significantly higher in the diabetic males than in their sibling group overall (increment = +2.8 mmHg; p less than 0.03), a difference also shown individually within the 16-20 year age band (81.3 versus 76.5 mmHg, p less than 0.025). There were no significant differences in diastolic pressure between the female groups, and no effect of duration of diabetes on blood pressure was shown in either sex. Eighteen of 97 male diabetic patients (19%) had mean blood pressures above the 90th centile for age, derived from the sibling data, compared with 12 of 137 siblings (9%, p = 0.05). The higher blood pressures among the diabetic males could not be explained solely by early nephropathy; familial factors appeared to be important in the determination of elevated blood pressure in this group as well as in the siblings. Alone, these small differences in blood pressure are unlikely to make a major contribution to the incidence of diabetic vascular disease, but the isolated increase in diastolic pressure may indicate altered vascular regulation in Type 1 diabetes. PMID- 3522326 TI - Increased transcapillary escape rate of albumin in type 1 (insulin-dependent) diabetic patients with microalbuminuria. AB - The transcapillary escape rate, intravascular mass and outflux of albumin were measured in 75 Type 1 (insulin-dependent) diabetic patients. The groups were defined as: group 1: normal urinary albumin excretion, less than 30 mg/24 h (n = 21); group 2: microalbuminuria, 30-300 mg/24 h (n = 36); group 3: diabetic nephropathy, less than 300 mg/24 h (n = 18). Fifteen sex- and age-matched non diabetic persons served as control subjects. The diabetes duration was: group 1: 20 +/- 9 years, group 2: 17 +/- 5 years, group 3: 19 +/- 7 years. The transcapillary escape rate of albumin was similar in controls and group 1 (5.0 +/ 1.8 versus 5.2 +/- 1.5%) and was significantly higher in the microalbuminuric group 2 and group 3 (8.1 +/- 2.2 versus 8.1 +/- 2.3%). The differences were not explained by differences in metabolic control or blood pressure at the time of investigation. The outflux of albumin was also higher in group 2 than in group 1 and controls (7.1 +/- 2.0 versus 5.3 +/- 1.5 and 5.1 +/- 2.0 g/h X 1.73 m2). It was indistinguishable from controls in group 3 (5.8 +/- 1.5 g/h X 1.73 m2) because of a reduced intravascular mass of albumin (p less than 0.01) in group 3. In conclusion, a universal vascular leakage of albumin is an early event in the development of diabetic nephropathy, with the leakage of albumin being fully developed in the microalbuminuric patient. In contrast, long-term diabetic patients with normal urinary albumin excretion have a normal transcapillary escape rate of albumin. PMID- 3522327 TI - Assay of glucose transport in human fat cells obtained by needle biopsy. AB - A method was developed for repeated measurements of glucose transport in human fat cells obtained by needle biopsy aspiration. Assay conditions, reproducibility and normal values of the measurements are described. Transport rates were measured in the absence and presence (25, 50, 100, 200, 800 pmol/l; 8, 80 nmol/l) of insulin using U-(14C)-D-glucose as the tracer. The extracellular glucose concentration was 1.5 mumol/l. The reproducibility of glucose transport measurements was assessed by taking two needle biopsies from opposite sides of the same subject (n = 11). The mean coefficient of variation for maximal glucose transport was 11 +/- 6%. In 14 subjects, a needle biopsy sample was aspirated immediately prior to surgical removal of fat. The maximal insulin-stimulated glucose transport rates averaged 143 +/- 15 and 143 +/- 15 fl/cell X s, and the ED50:s 218 +/- 124 and 160 +/- 28 pmol/l (NS) in fat cells prepared from needle biopsy and surgically removed adipose tissue respectively. The mean coefficient of variation for maximal glucose transport in needle vs. surgical samples was 11 +/- 2%. In 6 subjects, a surgical biopsy was taken twice, with a 1-week interval. The coefficient of variation averaged 9 +/- 2%. We conclude that measurement of glucose transport rates can be done with similar accuracy using fat cells isolated from needle biopsy aspirates and surgically removed adipose tissue. Use of needle biopsy samples permits, however, study of glucose transport in repeat samples of human fat cells, and may therefore be a useful tool for any perturbation studies. PMID- 3522328 TI - Physiologic and cellular insulin action in a glucose-intolerant model of type 2 (non-insulin-dependent) diabetes in rats. AB - A B-cell-deficient model for Type 2 (non-insulin-dependent) diabetes mellitus has been investigated with regard to insulin action at the cellular level. Two-day old male Sprague Dawley rats were injected with streptozotocin (90 mg/kg) or citrate buffer. At 6 weeks streptozotocin-treated animals were hyperglycaemic and exhibited glucose intolerance, e.g. at 45 min post-glucose (1.5 g/kg) the change in serum glucose level from baseline was 6 +/- 7 mg% in control rats vs. 212 +/- 18 mg% for the streptozotocin-treated rats. Basal activity and insulin action in isolated adipocytes, as estimated by 2-deoxyglucose uptake and glucose metabolism, were not influenced by streptozotocin treatment. For example, uptake of 0.1 mmol/1 2-deoxyglucose at 1000 microU insulin/ml was 58 +/- 8 pmol/10(5) cells min-1 vs 54 +/- 6 pmol for adipocytes isolated from experimental vs. control animals. Although serum insulin levels in streptozotocin-treated rats were significantly decreased (p less than 0.05), there was no difference in insulin receptor number or affinity. Glucose intolerance present in this model is similar to that in Type 2 diabetes. However, concomitant insulin intolerance was not observed. Taken together with our findings of unaltered insulin action at the cellular level, this suggests that the pathogenesis of insulin resistance is not dependent on glucose intolerance. Moreover, this hyperglycaemic model is responsive to oral hypoglycaemic agents and can be used to establish their direct effects on physiologic and cellular insulin action. PMID- 3522329 TI - Longitudinal studies on the development of diabetes in individual Macaca nigra. AB - Development of spontaneous diabetes has been monitored in individual Macaca nigra. In this study, pancreatic biopsies were taken, islets were assessed morphologically, and results were related to the metabolic/clinical status. A biopsy or autopsy sample was obtained 4 to 10 years later, and the islet morphological state was again related to the metabolic/clinical status. Metabolic deterioration was correlated to the islet lesion, in which there was gradual loss of islet secretory cells and concurrent amyloid deposition. As nondiabetic monkeys with 0 to 3% islet amyloid progressed up to 20 to 40% amyloid, the insulin secretion and glucose clearance were both decreased (p less than or equal to 0.01), and the glucose and glucagon levels increased (p = 0.05). Impaired monkeys progressed to overt diabetes when islet amyloid exceeded 50 to 60%. Diabetic monkeys developed hyperglycaemia, along with impaired insulin secretion and glucose clearance (p less than 0.01). Loss of islet cells results in metabolic deterioration. The lesion precedes development of overt diabetes in Macaca nigra. PMID- 3522330 TI - Insulin receptors in lizard brain and liver: structural and functional studies of alpha and beta subunits demonstrate evolutionary conservation. AB - Specific insulin receptors are present in the liver and brain of the lizard Anolis carolinesis. In this study, the specific binding of 125I-insulin to the receptors showed time, temperature and pH dependency. Specific binding to crude membranes prepared from brain was 1-2% of the total radioactivity added compared to 4-5% in the crude membranes prepared from liver. Solubilization and wheat germ agglutinin purification of the membranes resulted in an increase in the specific binding (per mg of protein) between 6 and 32 times for liver membranes and 13-186 for brain membranes. Binding inhibition of tracer insulin by unlabeled porcine insulin was characteristic for insulin receptors with 50% inhibition for liver crude membranes at 60 ng/ml of porcine insulin and 0.7 ng/ml for purified brain insulin receptors. Chicken insulin was 2- to 3-fold more potent and proinsulin about 100 times less potent than porcine insulin. The alpha-subunits of liver and brain had apparent molecular weights on sodium dodecyl sulfate polyacrylamide gel electrophoresis of 135 kDa and 120 kDa respectively. Apparent molecular weights of beta subunits were 92 kDa for both tissues. Insulin stimulated phosphorylation of the beta subunit of both brain and liver receptors. Both tissues demonstrated tyrosine-specific phosphorylation, which was stimulated by insulin, of exogenously added artificial substrates. In addition, purified brain insulin receptor preparations contained an endogenous protein with apparent molecular weight of 105 kDa, whose phosphorylation was stimulated by insulin (10(-7) mol/l). This phosphoprotein was not immunoprecipitated by anti-insulin receptor antibodies. These studies suggest that the structural differences between brain and liver receptors previously demonstrated in the rat are also present in the lizard, which is about 300,000,000 years older than the mammalian species. Thus, there is strong evolutionary conservation of the brain insulin receptor. PMID- 3522331 TI - Production and characterization of a monoclonal islet cell surface autoantibody from the BB rat. AB - Islet cell surface autoantibodies are present in the serum of the spontaneously diabetic BB rat. The availability in large quantities of such autoantibodies should help us understand their significance in vivo. Fusions between BB rat lymphocytes and rat myeloma cells were screened by cellular enzyme linked immunosorbent assay and indirect immunofluorescence on rat living cells. They resulted in a stable hybridoma, called IC2, secreting a monoclonal immunoglobulin M specific for the surface of rat islet cells. This monoclonal antibody was found to bind to the surface of 56% normal rat islet cells and 72% rat insulinoma cells. Protease treatment of rat islet cells resulted in a subsequent 72-100% binding inhibition of IC2 to the surface of these cells, suggesting that IC2 specific antigen is a protein. PMID- 3522332 TI - Insulin autoantibodies in the pre-diabetic period: correlation with islet cell antibodies and development of diabetes. AB - IgG and IgM class insulin autoantibodies were measured by an enzyme-linked immunosorbent assay in sera from members of the Barts-Windsor-Middlesex prospective family study for Type 1 (insulin-dependent) diabetes. One hundred and twelve individuals from 28 families were selected for study on the basis of a clearly defined islet cell antibody status. IgG insulin autoantibodies were found to be significantly associated with islet cell antibody positive (n = 30) versus islet cell antibody negative (n = 57) first degree family relatives (p = 0.002), with increased significance (p = 0.0003) if complement-fixing (CF)-islet cell antibody individuals (n = 20) only were considered. In addition, a significant association of IgG insulin autoantibodies with subsequent development of diabetes was observed within the CF-islet cell antibody positive group (p less than 0.0003). No such associations were found for IgM insulin autoantibodies, but a higher prevalence of these autoantibodies was observed in islet cell antibody negative first degree relatives (n = 57) compared with a control group of 73 Blood Bank donors (p = 0.00007), and they were significantly associated with siblings (n = 48) rather than parents (n = 39), (p = 0.001). We conclude that the presence of IgG insulin autoantibodies and CF-islet cell antibodies confer more risk for future development of diabetes than the presence of either marker alone. PMID- 3522333 TI - [Prevalence of atherosclerotic lesions of the carotid bifurcation found with echo doppler (duplex) technic in patient candidates for aortocoronary bypass]. AB - The association of an overt coronary artery disease with a cerebrovascular disease is frequently reported. However the real prevalence of atherosclerotic lesions at the carotid bifurcation in coronary patients is not well established. The aim of our study was to evaluate the prevalence of atherosclerotic involvement of the extracranial carotid arteries in a group of 141 patients undergoing coronary artery by-pass graft (CABG) and to verify whether any correlations between coronary and carotid artery disease exist. The extracranial carotid arteries have been studied by means of an echo-doppler (duplex) system, which combines a B-mode images with a pulsed doppler. A high prevalence (17.02%) of patients with a severe (greater than 50% diameter reduction) carotid involvement was detected (Tab. II). However, no correlations between the coronary and the carotid disease were found in terms of extension and severity (Tab. V). In conclusion, a systematic evaluation of the carotid arteries is recommendable in the coronary patients, candidates to CABG, even in the absence of cerebrovascular symptoms. PMID- 3522334 TI - [Disorders of renin secretion in arterial hypertension]. AB - The present work is devoted to investigate the meaning of disorders in renin secretion in primary and secondary hypertension and report the results of bayesan analysis applied to a group of 125 hypertensives who underwent selective renal angiography and polydistrictual renal vein samplings for the determination of plasma renin activity for diagnostic and therapeutic purposes. Data obtained from statistical analysis allow specifications on the prevalence of disorders, rates of false positives and false negatives, predictive value, diagnostic value, sensitivity and specificity. The weighted data are useful to validate the reliability of the renin renal vein measurements which are used in clinical practice for identifying the potentially surgically curable forms of arterial hypertension. PMID- 3522335 TI - [The heart transplant today]. PMID- 3522336 TI - [Randomized therapeutic trials in the treatment of acute pancreatitis]. PMID- 3522337 TI - [Ultrasonics in the diagnosis of carcinoma of the extrahepatic bile ducts]. PMID- 3522338 TI - [Gallbladder emptying in patients with cirrhosis]. PMID- 3522339 TI - Ontogenic and phylogenic studies of intestinal, hepatic, and placental alkaline phosphatases. Evidence that intestinal alkaline phosphatase is a late evolutionary development. AB - We have studied the intrauterine development of guinea pig and rat organ phosphatases using biochemical, immunologic, and histologic techniques. In all organs tested the features of the adult phosphatase activity were achieved during the second or third gestational phases. In the rat, the tissue-unspecific phosphatase activity was found by immunoprecipitation with antiserum to rat liver phosphatase in all gestational phases in liver and placenta. The high liver activity in the first phase of gestation corresponded to hematopoietic cells. Hepatocyte phosphatase did not appear until the second gestational phase. The tissue-unspecific phosphatase activity was found in the first and second gestational phase in surface intestinal epithelial cells, even after crypt formation occurred. Once phosphatase appeared in enterocytes on villi, only the intestinal-type enzyme was detected. Alkaline phosphatase was measured in the liver and intestine from animals in various phyla. In fish and reptiles, the intestinal activity had the enzymatic characteristics of the tissue-unspecific enzyme. The appearance of intestinal alkaline phosphatase with unique properties and high specific activity is a characteristic of mammals. PMID- 3522340 TI - Isolation and characterization of Crohn's disease tissue-specific glycoproteins. AB - Two Crohn's disease tissue-specific proteins are identified and purified several thousand-fold from crude tissue extracts by different chromatographic procedures. The two proteins migrate in sodium dodecyl sulfate-polyacrylamide gel electrophoresis as 200-210-kilodalton and 150-160-kilodalton species. They are glycoproteins, as evidenced by their binding to concanavalin A-Sepharose 4B and positive staining with Schiff's reagent. Specific immunoreactivity of the two glycoproteins against Crohn's disease sera was demonstrated by immunotransblot analysis. All but one of the operative specimens of colon or small intestine (or both) from 13 patients with Crohn's disease contained either or both of the proteins; they were not detected in specimens of colon from 5 patients with ulcerative colitis, 1 patient with diverticulitis, 1 patient with ischemic colitis, from the normal bowel segments resected from 3 patients with colon cancer, and from two normal ileal tissue specimens. The two glycoproteins did not react with antihuman IgG, IgM, and IgA, suggesting that they are not immunoglobulins. The purified glycoproteins may provide important leads toward the understanding of the pathogenesis of Crohn's disease. PMID- 3522341 TI - Endoscopic ultrasonography of non-Hodgkin lymphoma of the stomach. AB - Endoscopic ultrasonography was performed in 8 patients with non-Hodgkin lymphoma of the stomach. Findings consisted of intramural infiltration or mucosal alteration together with perigastric lymph nodes, or both. Lymph node involvement was suggested by the presence of inhomogeneous hypoechoic echopatterns with clearly demarcated borders. Endoscopic ultrasonography was more accurate than computed tomography scan in the detection of transmural extent of malignancy and adjacent lymph node involvement. Because of the limited penetration depth of endoscopic ultrasonography, approximately 10 cm, more distant lymph nodes might be more clearly detected with computed tomography scan. Endoscopic ultrasonography was also more accurate than endoscopy and barium meal in the assessment of gastric wall infiltration. The resectability of gastric non-Hodgkin lymphoma was reliably detected by endoscopic ultrasonography before surgery. Endoscopic ultrasonography appears to be a sensitive diagnostic modality for detection, staging, and follow-up in gastric non-Hodgkin lymphoma. Technical improvements may further enhance the diagnostic value of this new procedure. PMID- 3522342 TI - Bacterial contamination of pancreatic necrosis. A prospective clinical study. AB - In a prospective clinical study including 114 patients with acute necrotizing pancreatitis, but excluding patients with a pancreatic abscess, necrotic material obtained at surgery was tested bacteriologically. Intestinal microorganisms were cultured in 39.4% of the cases. The contamination rate was 23.8% in patients operated on during the first 7 days of the attack; it rose to 71.4% in the third week and decreased to 32.5% after the fourth week. Intra- and extrapancreatic necrosis was more widespread and pancreatitis-associated ascites was more frequent in patients with proven contamination. The number of objective signs was 4.5 (median) and postoperative mortality was 37.8% in bacteriologically positive subjects, whereas the number was 3.5 (median) and mortality was 8.7% in bacteriologically negative patients. Morphologic and clinical alterations were more severe, and the mortality rate was significantly elevated, in patients with a short history of disease and bacterial contamination of necrotic tissue. All 5 patients with pancreatic sepsis who were operated on in the first 7 days of the disease, as compared with 2 of 16 patients with sterile necrosis, died. Thus, it is demonstrated that bacterial contamination of pancreatic necrosis occurs early and frequently, causing a significant increase in morbidity and mortality, particularly when it develops in the initial stages of the attack. PMID- 3522343 TI - Resolution of diffuse granulomatous fibrosis of the liver with antituberculous chemotherapy. AB - A 71-yr-old man with pulmonary tuberculosis developed jaundice, and an ultrasound examination suggested hepatolithiasis. The liver was markedly enlarged and of stony consistency. Two 2.5-cm biopsy specimens of the liver each disclosed diffuse fibrosis with giant cells; practically no normal parenchyma was seen. Ultrasonography and computed tomography disclosed multiple intrahepatic calcifications, and percutaneous cholangiography revealed stenosis of the right hepatic duct. One year after treatment with antituberculous drugs, liver biopsy specimens taken from the same areas of the liver showed nearly normal histology. PMID- 3522344 TI - Tularemic hepatitis presenting as obstructive jaundice. AB - A 56-yr-old man was admitted for evaluation of fever, chills, jaundice, and alcoholic stools. Laboratory studies suggested a cholestatic process. Ultrasonography, computed tomography, and transhepatic cholangiography failed to reveal any abnormalities. Acute infection with Francisella tularensis was confirmed serologically, and a liver biopsy revealed cholestatic hepatitis with focal coagulative necrosis. Recovery was coincident with antibiotic therapy. PMID- 3522345 TI - Ultrasonography and diffuse hepatic disease. PMID- 3522346 TI - Endosonographic evaluation of mural abnormalities of the upper gastrointestinal tract. AB - An end-viewing fiberoptic gastroscope was modified to incorporate a high resolution linear array real-time ultrasound transducer 7 cm proximal to the flexible tip of the instrument. This endoscope was used to evaluate 20 patients suspected of having mural disease of the upper gastrointestinal tract and five normal subjects. The endosonographic examination defined esophageal, stomach, and duodenal wall thickness in normal subjects. In patients with pathological findings, both diffuse and acoustically focal lesions were demonstrated, and the extent of these lesions were outlined. With focal masses, endosonographic findings also demonstrated echogenic differences between various submucosal tumors reflecting their differing etiology. The extent of invasion and adenopathy were identified in a patient with gastric carcinoma. With diffuse lesions, the depth of involvement could be outlined sonographically, but etiologic diagnosis depended on biopsy. Extrinsic masses with secondary invasion of the wall of the upper gastrointestinal tract were defined in six patients. It is suggested that endosonography may prove to be a useful technique for evaluation of mural, invasive extramural, and diffuse lesions of the upper gastrointestinal tract. PMID- 3522347 TI - The effect of oral potassium chloride on upper gastrointestinal mucosa in healthy subjects: healing of lesions despite continuing treatment. AB - The effects of two dosage forms of wax-polymer matrix potassium chloride on the upper gastrointestinal mucosa were compared with placebo in 44 healthy volunteers. After 2 weeks of potassium chloride treatment, mucosal toxicity was observed. There was no correlation between the presence of lesions and symptoms. Six of seven volunteers with lesions healed spontaneously despite continuing treatment with potassium chloride. PMID- 3522348 TI - [Breast sonography with the new water bath scanning technics]. AB - At 1188 patients we investigated the value of sonography of the breast in the detection of malignancies. We used 2 automatic multitransducer water-bath scanners, at first the 3 MH Octoson, then System 1, a dedicated 4 MH water-bath breast scanner which allows for compound and simple scans in any scanning plane. The sensitivity for detection of 63 malignancies was 87%. Other pathologies were 18 fibroadenomas, 160 cysts, 6 abscesses, 2 fatty necroses, 2 papillomas, 9 prostheses, one of them broken. The difficulties associated with differential diagnosis in breast sonography are discussed in detail. PMID- 3522349 TI - [Prenatal diagnosis from chorionic villi: results in Munster]. AB - We report on our experience with the first 46 diagnostic chorionic villi samplings in Munster. A new echogenic plastic catheter is used. The observed abortion rate is in accordance with international experience. PMID- 3522350 TI - [Human erythrocyte peptidases]. PMID- 3522351 TI - [Determining hepatitis B virus markers in blood donors and patients by the immunoenzyme method]. PMID- 3522352 TI - [Obtaining autologous bone marrow from the vertebral bodies of tissue donors]. PMID- 3522353 TI - Dopamine receptors in normal and diabetic liver plasma membrane. AB - Dopamine binding to liver plasma membrane isolated from diabetic livers was significantly reduced (P less than 0.01) as compared to dopamine binding to the normal membrane. Diabetic membranes exhibited a significant decrease (P less than 0.01) in specific dopamine binding as compared to the normal membranes; whereas no significant change (P less than 0.5) was noticed in the nonspecific binding patterns. The dopamine binding capacity of both membranes is temperature dependent. Procaine at different concentrations inhibited significantly (P less than 0.01) dopamine binding to normal and diabetic membranes. Treatment of the normal and diabetic membranes with insulin showed a 33% decrease in the binding capacity of the normal and 42% decrease in the binding capacity of the diabetic membrane. PMID- 3522354 TI - Comparison of shear bond strength and film thickness of bonding resins for resin retained appliances. PMID- 3522355 TI - Prevention of marginal leakage by four dentinal adhesives. PMID- 3522356 TI - High-level expression vectors to synthesize unfused proteins in Escherichia coli. AB - A new class of plasmid vectors (pANK-12, pANH-1, and pPL2) for synthesizing unfused proteins was constructed by inserting synthetic linkers at the NdeI site (CATATG) of plasmid pJL6, which contains the lambda cII gene initiator codon. These expression vectors contain the lambda pL promoter, the cII ribosome-binding site, cII start codon and unique restriction sites (KpnI, Asp718, HpaI, BamHI) downstream from the initiator ATG for expression of unfused proteins. The main advantage of these vectors is that any DNA fragment with an open reading frame that does not possess a start and/or a stop codon can be directed to overproduce protein in an unfused form. PMID- 3522357 TI - Characteristics of normal and maturity-onset diabetic (type II diabetes) cell cultures: life spans and DNA synthetic capabilities. AB - The replicative ability of fibroblasts derived from normal and type II diabetic (non-insulin-dependent) donors and their DNA synthetic capabilities in response to serum and insulin (+/- dexamethasone) have been studied. Comparative replicative life spans of the fibroblasts studied using several lots of serum showed no significant differences between the two donor groups with any lot of serum (p greater than 0.05). Insulin (i.e. 700 nM) and serum (10% v/v) stimulation of DNA synthesis in normal and type II diabetic cultures exhibited no differences in responses. The insulin:control ratios of the normal vs. type II diabetic were 1.61 +/- 0.08 vs. 1.81 +/- 0.11, respectively (p greater than 0.05) while the serum:control ratios were 3.55 +/- 0.58 vs. 4.02 +/- 0.54, respectively (p greater than 0.05). Dexamethasone amplification of the insulin-stimulated DNA synthetic response over a range of insulin concentrations (i.e. 1.6-66.6 nM) expressed no differences between the two donor groups. Additionally, calculation of the insulin concentration necessary for the half-maximal response showed no differences between the normal and diabetic groups (3.47 +/- 0.5 vs. 4.44 +/- 0.8 nM, respectively) (p greater than 0.05). The data suggest that there are no general age-related abnormalities inherent to the type II diabetic cultured cell. PMID- 3522358 TI - [Leonardo da Vinci or the solitude of the spirit]. PMID- 3522359 TI - On the history of the plaster cast and its roots in Arabic medicine. PMID- 3522360 TI - [Anatomy and philosophy: Niels Stensen (1638-1686) and a friend of his youth, Spinoza (1632-1677)]. PMID- 3522361 TI - [Medical history studies on the problem of medical malpractice and medical liability. A 19th century medical law regulating medical liability questions]. PMID- 3522362 TI - [Magic and forensic medicine in the 16th to 18th centuries]. PMID- 3522363 TI - [Use of programmed microcalculators for processing the data from medico-hygienic studies]. PMID- 3522364 TI - [Embryotoxic and teratogenic effects of the components of polymer materials]. PMID- 3522365 TI - [Autologous microsurgical transposition of segments of the uterine horns in the rat]. PMID- 3522366 TI - [A prominent Soviet specialist in public health, A.A. Letavet, on the hazards of testing nuclear weapons]. PMID- 3522367 TI - [A method of transrectal ultrasonography in the diagnosis of the degree of progression of cervical cancer]. PMID- 3522368 TI - [The pulmonary and hepatic reflex in the ultrasonographic picture as an indicator of fetal lung maturity]. PMID- 3522369 TI - [Diagnostic accuracy of vaginal smears and histopathologic studies in the early detection of cervical cancer]. PMID- 3522370 TI - [Ultrasonographic measurement of the thickness of fetal subcutaneous tissue in physiologic pregnancy and in pregnancy complicated by fetal hypotrophy]. PMID- 3522371 TI - Salt or no salt in the treatment of cirrhotic ascites: a randomised study. AB - To compare the effect of diet, cirrhotic patients with ascites were randomised into two treatment groups: (1) a low sodium diet (21 mmol) per day or (2) an unrestricted sodium intake. Both groups received effective doses of diuretics (spironolactone or, if necessary, spironolactone and furosemide. One hundred and forty patients from 12 liver units were included according to well defined criteria (group 1: 76; group 2: 64). After an initial four to seven day period of bed rest and salt restriction (21 mmol sodium pd), randomisation was done in each centre. We saw no significant difference between the two groups with respect to clinical and biochemical data; mortality or withdrawal (definitive or temporary) because of biochemical disturbances (group 1: 34%, group 2: 22%); the time for complete disappearance of ascites was significantly shorter (p = 0.014) for the salt restricted patients actuarial survival (curves plotted up to the 120th day) was not statistically different (p = 0.18), but division into subgroups using various prognostic factors showed that survival was significantly better for salt restricted patients without previous gastrointestinal bleeding (p = 0.02); hospitalisation time and costs were identical in both groups. We conclude that the advantage of a normal salt diet was not shown in this study. PMID- 3522372 TI - Comparison of the two time schedules for endoscopic sclerotherapy: a prospective randomised controlled study. AB - To compare the efficacy and safety of one week versus three weeks interval treatment schedules of endoscopic sclerotherapy, injections were carried out in a prospective manner in 96 patients with variceal bleeding; 47 on a one week and 49 on a three weeks treatment schedule. Weekly endoscopic sclerotherapy eradicated oesophageal varices significantly (p less than 0.01) earlier (mean +/- SD 7.1 +/- 2.43 weeks) as compared with the three weeks regimen (mean +/- SD 14.86 +/- 4.86 weeks). The rebleeding rate was also significantly less (p less than 0.05) with weekly endoscopic sclerotherapy (8.5%) as compared with three weeks endoscopic sclerotherapy treatment (26.5%). The amount of alcohol and the number of endoscopic sclerotherapy courses required for complete variceal eradication did not differ significantly between the two groups. Patients undergoing weekly injections were seen to have significantly more oesophageal ulcers (p less than 0.01) as compared with the three weeks group, necessitating at times (23%) postponement of the procedure. There was, however, no difference between the two groups in the frequency of oesophageal stricture formation, dysphagia, retrosternal pain, and fever. Mortality was also similar in the two groups. It can be concluded that a weekly schedule of endoscopic sclerotherapy appears superior to a three weeks schedule. PMID- 3522373 TI - Hepatosplenic schistosomiasis: a clinical review. PMID- 3522374 TI - Carcinoma of the colon presenting as bilateral ovarian tumors during pregnancy. AB - A case of adenocarcinoma of the descending colon during pregnancy is reported. The patient presented with bilateral large ovarian tumors in pregnancy, and surgery was performed for a presumed ovarian cancer. Only a small, 1 X 1-cm primary focus of adenocarcinoma was found in the resected descending colon. The association of pregnancy and colon cancer above the peritoneal reflection is rare, and only 20 such patients have previously been reported. PMID- 3522375 TI - [Deep burns of the skullcap]. AB - Deep burns of the skull are uncommon. In fire burned victims we sometimes found a necrosis of the outer table of the skull. Grafting with split thickness skin is generally successful, when the outer table is removed. Complete destruction of the skull was found in 2% of electrical injuries. The treatment with local rotation flaps gives good cover for the dura. The trapezius muscle flap or free flaps with microvascular anastomoses are alternative methods. Skull defects should be replaced with bone and we used autologous split grafts in three cases successfully. In order to replace hair loss, hair pieces and wigs were used. In some cases local flaps can introduce hair bearing skin. PMID- 3522376 TI - [Skin-soft tissue replacement on the lower leg--therapy and prophylaxis of osteomyelitis]. AB - The adequate and early replacement of soft tissue in the lower leg is equivalent to the management of bone and prevention of osteomyelitis. The acute or delayed primary management of soft tissue loss with early flap coverage prevents infections. In the treatment of osteomyelitis, flap coverage provides the necessary blood supply for healing. In the first stage we remove bone until bleeding indicates viable tissue, gentamycin-PMMA-chains are introduced before flap coverage. In the second stage, if necessary, we substitute the gentamycin PMMA-chains with bone graft. PMID- 3522377 TI - [The modern treatment of peptic ulcer disease]. PMID- 3522378 TI - [Difficulties in the psychiatric diagnosis of adolescents]. PMID- 3522379 TI - [Urinary tract infection in young women]. PMID- 3522380 TI - [Bone marrow transplantation in non-malignant diseases]. PMID- 3522381 TI - Trypsin-sensitive plasmodia in the liver of post-infection rats and rhesus monkeys. AB - Kupffer cells from the liver and erythrocytes from peripheral blood were collected at the post-patent period from albino rats infected earlier with Plasmodium berghei and rhesus monkeys infected earlier with P. cynomolgi var. bastianelli or P. knowlesi. The cells were subinoculated into individual normal recipients. These recipients subsequently showed parasitaemia in their circulation. The parasites present in Kupffer cell preparations were found to be sensitive to trypsin treatment, while those in erythrocytes were found to be resistant to trypsin treatment. This differential sensitivity of parasites to trypsin was observed in all the three species of plasmodia studied so far. PMID- 3522382 TI - The absence of an interaction between a Microtus pennsylvanicus density cycle and Dermacentor variabilis infestation levels. PMID- 3522383 TI - On the problem of retarding definitive host (s.l.). AB - The significance of the species and individual level in determining the hosts as a category of helminth life cycles is pointed out. From the viewpoint of species level, the categories of intermediate host and definitive host are ascribed to certain organisms as representatives of a certain species on the basis of the fact that a respective stage of helminth life cycle can take place inside them. From the viewpoint of individual level, these types of hosts are determined on the basis of associations between the helminth individual and host individual. In order to avoid discrepancies, which might occur in determining the host type in these ways, it is proposed that the organism, which was determined as intermediate or definitive host at the species level, should be regarded identically also at the individual level. In addition, the existence of retarding definitive host (s.l.) is substantiated on the example of helminths which survived the interorgan migrations and passed to the offsprings through the intrauterine or transmammary route. PMID- 3522384 TI - [The gold nose of Emperor Otto III--the road to a legend]. PMID- 3522385 TI - The gastric mucosal barrier. PMID- 3522386 TI - [Investigation of a growth factor for cultured rat fetal spinal motor neurons]. AB - The hypothesis that amyotrophic lateral sclerosis (ALS) might be the disorder of "motor nerve growth factor" has been proposed, being based on the results of the research in tissue culture. The evidence of putative growth factor for spinal motor neurons has been searched, but not found yet. To investigate the growth factor for cultured rat fetal ventral spinal cord neurons two experiments were carried out. One experiment was to evaluate the rat fetal age-related dependency or requirement of putative growth factor in fetal calf serum and non-neuronal cells in cultured ret fetal ventral spinal cord neurons. Another experiment was the evaluation of the possibility as the growth factor of insulin, 5-alpha dihydrotestosterone, epidermal growth factor and fibroblast growth factor for cultured rat fetal ventral spinal cord neurons. The following results were obtained from these experiments; Insulin was found to be acting like a growth factor for rat fetal ventral spinal cord neurons, showing neurite promoting effect and choline acetyltransferase activity stimulating effect. 5-alpha dihydrotestosterone had neurite promoting effect on cultured rat fetal ventral spinal cord neurons without choline acetyltransferase activity stimulating effect. Epidermal growth factor and fibroblast growth factor which are regarded as insulin-related growth factor did not show apparent neurotrophic effect on cultured rat fetal ventral spinal cord neurons. There was a big difference in dependency or requirement of putative growth factor in fetal calf serum and non neuronal cell between cultured rat fetal 13-15 day old ventral spinal cord neurons and cultured rat fetal 16-18 day old fetal ventral spinal cord neurons. It is necessary to consider about the rat fetal age on the evaluation of the effect of putative growth factor for cultured rat fetal ventral spinal cord neurons. PMID- 3522387 TI - [A study on the location of synthetic sites of the fourth and fifth components of the complement system in allogeneic bone marrow chimeras and hepatocyte transplantation chimeras]. AB - In this study, the tissue sites for synthesis of fourth and fifth components of complement (C4, C5) have been investigated by using allogeneic bone marrow chimeras and bone marrow chimeras which were transplanted in addition with hepatocytes. One group of chimeric mice was prepared by transplanting bone marrow cells from C5-sufficient donor mice into irradiated C5-deficient recipients or vice versa, and another group was prepared by transplanting marrow cells from mice which produced high level of C4 into irradiated recipients which were characterized by having low level of C4 or vice versa. The results showed that C4 or C5 antigens were present in the sera of the chimeras only when recipients were strains which were characterized by having high C4 level or were C5-sufficient mice, respectively. These findings indicate that circulating C4 and C5 in the blood are not synthesized primarily by cells that are descendants of bone marrow cells in these chimeric mice. However, when hepatocytes isolated from the C5 sufficient strain were inoculated into the spleens of C5-deficient bone marrow chimeras, detectable amounts of C5 were present in the sera. These results indicate that C5 protein is synthesized and delivered to the blood in vivo by liver cells. PMID- 3522388 TI - Effects of vesicle-adipocyte interaction on regulation of insulin receptor recycling. AB - The effect of interacting isolated rat adipocytes with small, unilammelar vesicles on insulin receptor internalization and processing was studied. Treatment of freshly isolated cells with vesicles containing phosphatidylcholine and phosphatidylserine followed by incubation in 35 mM Tris-containing buffer considerably reduced the chloroquine-induced increase in cell-associated 125I insulin and significantly inhibited the time and insulin dependent loss of surface insulin receptors. The internal receptor pool, as measured by insulin binding to detergent solubilized adipocytes, was relatively smaller in vesicle treated cells. Concomitant with a slower rate of receptor internalization, insulin-sensitive hexose uptake also demonstrated significantly slower kinetics of decreased response with time. These results support the conclusion that pretreatment of fat cells with phospholipid vesicles inhibits normal insulin receptor cycling. PMID- 3522389 TI - Effect of adrenalectomy on in vivo glucose metabolism in insulin resistant Zucker obese rats. AB - Lean (Fa/?) and obese (fa/fa) Zucker rats were adrenalectomized (ADX) in order to assess the contribution of adrenal hormones to insulin resistance of the obese Zucker rat. Glucose utilization was measured using an insulin suppression test. Sham-operated obese rats gained almost twice as much weight as sham-operated lean littermates. However, body weight gain of ADX animals was comparable in both genotypes. It was significantly less than that of the respective sham-operated controls. Body weight differences can be accounted for almost entirely by a marked loss of adipose tissue. Although insulin resistance may be attributable to obesity in part, steroid hormones are thought to be directly antagonistic to insulin for glucose metabolism. Adrenalectomy resulted in a decrease in serum glucose concentrations for both lean and obese Zucker rats compared with their respective sham-operated groups. Serum insulin concentration of lean ADX rats was 23% of sham-operated controls; in obese ADX rats, it was 9% of controls. Elevated levels of steady state serum glucose (SSSG) levels in sham-operated obese rats demonstrate a marked resistance to insulin induced glucose uptake compared with sham-operated lean animals. Adrenalectomy caused a marked improvement in insulin sensitivity of obese rats. The hyperglycemic SSSG levels of the obese rats were reduced 2.5 times by ADX. These results indicate that insulin resistance of Zucker obese rats can be ameliorated by ADX, suggesting adrenal hormones contribute to insulin resistance in these animals. PMID- 3522390 TI - Adipose tissue metabolism in sheep: response to season and its modulation by reproductive state. AB - Seasonal changes in subcutaneous adipose tissue metabolism and serum metabolite and hormone concentrations are described in virgin ewes fed a fixed amount of a cereal mixture plus hay ad libitum. Body weight, adipocyte mean cell volume, the rates of fatty acid and acylglycerol glycerol synthesis, and lipoprotein lipase activity increased from October to May and then decreased over the following five months. These changes are probably due to an increase in voluntary food intake leading to increased availability of acetate for fatty acid synthesis and also a probable rise in serum insulin concentration. Seasonal changes in adipose tissue metabolism in sheep are modulated by pregnancy and lactation, possibly mediated in part by changes in the serum insulin: growth hormone ratio. Although seasonal changes in adipose tissue metabolism are paralleled by changes in serum prolactin concentration, prolactin probably does not have a direct effect on adipose tissue metabolism. PMID- 3522391 TI - Alpha cell autoantibodies: immunological and metabolic follow-up study. AB - We studied glucagon responses to OGTT and insulin and arginine stimulation in 12 out of 21 patients who were found positive for alpha cell autoantibodies (ACA) during routine screening procedures for autoimmunity in a group of 4080 individuals. The study was repeated in 8 subjects after an average observation period of 42 months. In both studies glucagon plasma levels were normal and independent of ACA titres, ACA ability to fix complement and ACA ability to cross react with duodenal alpha cells. The clinical significance of ACA remains to be elucidated. PMID- 3522392 TI - The renin-angiotensin system in hypothyroidism of short duration. AB - In six hypothyroid patients (2 male, 4 females, ages 22 through 59 years), plasma renin activity (PRA) and aldosterone (Aldo) were measured when the patients were euthyroid on levothyroxine therapy and one month after the therapy was stopped. Colonic mucosal potential differences were measured during the hypothyroid and euthyroid stages, and catecholamine sensitivity was determined by the blood pressure response to infused norepinephrine. Significant differences were observed in the PRA and aldosterone concentrations which were 4.1 +/- 2.5 ng/ml/h and 9.4 +/- 5.9 ng/dl, respectively in the hypothyroid stage and 6.9 +/- 2.3 ng/ml/h and 15.2 +/- 7.3 ng/dl, respectively when the patients were made euthyroid. The colonic mucosal potential differences (which reflect increased endogenous mineralocorticoid activity), became more electronegative after correction of hypothyroidism (-16.8 +/- 7.5 mV vs -32 +/- 18.2 mV; P less than 0.04) concentrations. Statistically significant decreases in norepinephrine pressor effects were observed in hypothyroid patients when compared to the euthyroid state (7.4 +/- 2.3 vs 10.9 +/- 1.9 micrograms/ng/min; P less than 0.01). It is concluded that patients with hypothyroidism have a hormonal pattern reminiscent of "low renin hypertension", and exhibit decreased sensitivity to catecholamines. Such changes are corrected when the patients become euthyroid on levothyroxine therapy. PMID- 3522393 TI - Extraskeletal myxoid chondrosarcoma: a histochemical and immunohistochemical study. AB - In reviewing a large series of soft tissue sarcomas, nine cases of extraskeletal myxoid chondrosarcoma have been retrieved. These tumours, which principally presented in middle-aged adults, have been examined histochemically to determine the heteroglycan content of their myxoid matrix and immunohistochemically for the presence of S-100 protein. The principal mucopolysaccharides identified were chondroitin-4 and 6-sulphate and keratan sulphate; each of the tumours was S-100 positive. The relevance of these findings to the histogenesis and differential diagnosis of these uncommon neoplasms is discussed. PMID- 3522394 TI - Enteroendocrine cell hyperplasia, carcinoid tumours and adenocarcinoma in long standing ulcerative colitis. AB - Chronic ulcerative colitis may be accompanied by a variety of epithelial changes, including loss of goblet cells, Paneth cell metaplasia, villous metaplasia, and dysplasia. Total colitis is also accompanied by an increased incidence of adenocarcinoma. All these changes are assumed to be secondary to repeated mucosal damage, but how they develop is unknown. Little attention has been paid to the enteroendocrine cell population, despite the postulated role of these cells as producers of trophic hormones. We describe two patients with long-standing ulcerative colitis who developed both adenocarcinoma and carcinoid tumours. In both, there were increased numbers of enteroendocrine cells in the uninvolved colonic mucosa. We suggest that an increased enteroendocrine cell mass may be part of a non-specific reaction to chronic mucosal injury, and by producing an elevated level of trophic hormones may act as a promoter in the development of neoplasia. PMID- 3522395 TI - Regulation of estrogen-stimulated lordosis behavior and hypothalamic progestin receptor induction by antiestrogens in female rats. AB - Two estrogen antagonists, CI-628 (CI) and tamoxifen (TX), were used to examine the relationship between estrogen priming of lordosis behavior and progestin receptor induction in the hypothalamus-preoptic area (HPOA) of ovariectomized female rats. Lordosis behavior was assessed by measuring lordosis quotients (LQ) in response to injection of 2 micrograms of estradiol benzoate (EB) followed 48 hr later by 500 micrograms of progesterone (P). Behavior testing began 4 hr after P injection. The effects of antiestrogens were assessed by injecting CI and TX (1 2 mg) from 0 to 48 hr prior to EB. Levels of cytosol progestin receptor in the HPOA were determined by quantifying the specific binding of 0.5 nM [3H]R5020 to cytosols from animals receiving the same EB and antiestrogen treatments used in behavioral testing. TX given concurrently with or CI given 2 hr before EB abolished both lordosis behavior and induction of HPOA progestin receptors. In contrast, CI given 12 hr prior to EB abolished lordosis but permitted a 95% elevation in the concentration of progestin binding sites in the HPOA. TX or CI given 48 hr before EB resulted in moderate levels of lordosis (mean LQs from 56 to 69) and induction of HPOA progestin receptors from 85 to 130% above noninjected controls. However, CI given 24 hr prior to EB produced less than a 40% increase in brain R5020 binding even though lordosis behavior was equivalent to that seen in the 48-hr animals (mean LQ = 53). These data indicate that the effects of antiestrogens on female sexual behavior and on the synthesis of brain progestin receptors depend on which antiestrogen is used and the time interval between administration of estrogen and antiestrogen. They also demonstrate that under some conditions estrogen induction of cytosol progestin receptors in the HPOA can be dissociated from estrogen priming of lordosis behavior in rats. PMID- 3522396 TI - HCFA's dialysis cuts may prompt consolidation. PMID- 3522397 TI - Providers call '87 PPS increase 'unacceptable'. PMID- 3522399 TI - Former risk contractors are leery of rule changes. PMID- 3522398 TI - Capital proposal hurts all hospital categories: study. PMID- 3522400 TI - IMC trouble may influence HCFA Medicare ruling. PMID- 3522401 TI - Physicians say 'no thanks' to the Medicare deal. PMID- 3522402 TI - Deregulation of health care: myth of the '80s? PMID- 3522403 TI - Medicare delays place collection gains in jeopardy. PMID- 3522404 TI - Transplants force larger payment, access issues. Interview by Emily Friedman. PMID- 3522405 TI - HCFA urged to speed approval of technologies. PMID- 3522406 TI - A product of the C4B locus lacking hemolytic activity. AB - An unusual C4B allotype, C4B 4I, was identified in a study of C4 polymorphism in Japanese. This variant was defined as C4B using a murine monoclonal antibody specific for the C4d region of C4B. Hemolytic assay, however, revealed that the C4 variant, C4 BI was hemolytically inactive in contrast to other well-defined C4B locus products. PMID- 3522407 TI - Volatile fatty acid findings in vaginal fluid compared with symptoms, signs, other laboratory results, and susceptibility to tinidazole of malodorous vaginal discharges. AB - The relevance of volatile fatty acids as a diagnostic test in 79 women with abnormal vaginal discharge was evaluated by a blind, randomised, and placebo controlled trial of tinidazole as a single oral 2 g dose. Automated gas chromatography of ether extracts of discharges taken before treatment showed volatile fatty acids in 18. Volatile fatty acids correlated with malodorous, colour, and microscopically assessed altered bacterial flora and clue cells. At follow up one week later, the odour, colour, and volatile fatty acids in the vaginal discharge of women treated with tinidazole had become normal more often than in those receiving placebo. The disappearance of volatile fatty acids correlated with clinically assessed improvement in women treated with tinidazole. The volatile fatty acid test as an indicator of anaerobic bacterial flora is objective, technically simple and fast, has few problems of sample size and transportation, and may be useful in the aetiological classification and follow up treatment of non-specific vaginal discharges. PMID- 3522408 TI - Immunotherapeutic effect of the lactobacillus vaccine, Solco Trichovac, in trichomoniasis is not mediated by antibodies cross reacting with Trichomonas vaginalis. AB - According to the producers of the lactobacillus vaccine, Solco Trichovac, its therapeutic effect in trichomoniasis is achieved by antibodies that are induced by the vaccination and cross react with Trichomonas vaginalis. Common antigens of Lactobacillus acidophilus from Solco Trichovac vaccine and T vaginalis were therefore sought by three different seroreactions. Immune serum against Lacidophilus obtained by vaccinating two healthy human volunteers and two rabbits with the original Solco Trichovac vaccine, as well as hyperimmune rabbit antiserum to T vaginalis, were tested with each of the two micro-organisms. No evidence of antigenic similarity between L acidophilus and T vaginalis was obtained with either serum in any of the three serological tests. A non-specific immunostimulatory effect therefore seems to be a more probable explanation of the mode of action of Solco Trichovac vaccine. PMID- 3522409 TI - Comparison of direct immunofluorescence and cell culture detecting Chlamydia trachomatis. PMID- 3522410 TI - Antigenic contents of Treponema pallidum preparations. AB - In investigations of syphilis various Treponema pallidum antigens are used to study the immune responses of naturally or experimentally infected hosts. In the past these antigen preparations have rarely been examined for their antigenic contents and activity. In the present study, supernatant, sediment, and solubilised preparations of T pallidum Nichols strain (20 X 10(9) organisms/ml) and T phagedenis biotype Reiter were examined by modified counterimmunoelectrophoresis and immunoblotting for their antigenic contents. No T pallidum antigen was seen in the supernatant fraction, which contained cross reacting (Reiter) antigens and rabbit serum proteins. The remaining T pallidum preparations contained T pallidum antigens, cross reacting treponemal (Reiter) antigens, and rabbit serum proteins. These findings suggest that T pallidum preparations should be examined qualitatively and quantitatively before they are used for monitoring immune responses and interpreting data. Technology for these examinations is available. PMID- 3522411 TI - Production of monoclonal antibody SP-21 to colon-ovarian tumor antigen, COTA. AB - An IgG monoclonal antibody, SP-21, directed against colon-ovarian tumor antigen, COTA, is reported. The antibody had no reactivity with CEA, normal colonic mucin, CSAp, ABO blood group antigens, or with normal human lung, liver, spleen, kidney, plasma and saliva in studies using the enzyme-linked immunoassay method (ELISA). Immunoperoxidase staining of colon, lung, kidney, and prostate cancer tissues and benign and inflammatory colon disease tissues revealed a specificity identical to that of the polyclonal (goat) anti-COTA antibodies. PMID- 3522413 TI - Acute glomerulonephritis after intravenous injection of monoclonal anti-thymocyte antibodies in the rat. AB - Female Wistar rats were injected with (mouse) monoclonal antibodies (Moabs) of different IgG subclasses directed to rat thymocytes or rat tumor cells. Following intravenous injection of antithymocyte Moabs, glomerular binding of mouse IgG was observed during the first 4 days along the GBM and in the mesangium. No staining for mouse IgG was detected in anti-tumor Moab injected rats. Animals injected with IgG 2a anti-thymocyte Moab developed glomerulonephritis and a massive proteinuria in contrast to rats injected with IgG 1 Moab which is non-complement fixing. The glomerulonephritis lesion consisted of microaneurysms and focal and segmental proliferation. Deposits of complement and fibrin could be detected exclusively in rats injected with IgG 2a anti-thymocyte Moab during the whole observation period of 14 days. This is the first demonstration of overt glomerulonephritis lesions on the injection of monoclonal antibodies. PMID- 3522412 TI - Generation of a monoclonal anti-GP70 antibody and characterization of its reactivity with various human cell lines and cells from leukemia-lymphoma patients. AB - Monoclonal anti GP-70 antibodies (BI) were generated in mice and used for screening of various malignant and non-malignant cell lines. The reactivity of these monoclonal antibodies was compared with that obtained with the polyclonal anti GP-70 antibody described in earlier studies [1-3]. The results indicated complete similarity in reactivity of both of the antibodies used. Furthermore, the reactivity of BI antibodies with cell samples obtained from a variety of leukemia and lymphoma patients and with peripheral blood samples from healthy blood donors was also very similar to the pattern of specificity described in earlier reports for the polyclonal preparation. From these studies we conclude that the monoclonal antibodies can substitute the polyclonal anti GP-70 antibodies in the diagnosis and subtyping of B-type leukemias and lymphomas. PMID- 3522414 TI - Depression of cellular immunity after open-heart surgery. AB - Using a whole blood test system we investigated cell-mediated immunity in 45 patients undergoing open-heart surgery. The peripheral blood lymphocytes were stimulated with the nonspecific mitogens phytohemagglutinin, concanavalin A and pokeweed mitogen, one bacterial recall antigen, tuberculin PPD, and one viral antigen, herpes simplex virus. The patients were tested three times: pre operatively, and seven days and 2 wks post-operatively. There were no significant differences between a control group of healthy blood donors and the patient group tested preoperatively. However, seven days after operation we observed a clear decrease of the reactions to all stimulants. Two weeks after operation there was an increase of lymphocyte proliferation data in regard to tuberculin PPD and herpes simplex virus. Concerning the nonspecific mitogens PHA and PWM, there was only a tendency of an increase. We believe that two weeks after operation is too short an interval to notice a full normalization of the cellular immune functions. In comparison with the conventional system of isolated lymphocytes, the whole blood technique is advantageous in investigating cell-mediated immunity, particularly if the patient groups are large. PMID- 3522415 TI - Suppression of skin allograft rejection by post-transplantation administration of specific anti-lymphocyte serum. AB - An heterologous anti-lymphocyte serum ALS(I-GR), was raised in rabbits by immunization with draining lymph node cells of AKR mice which had rejected DBA/2 skin allografts. Treatment of AKR mice with this ALS on the 4th day after DBA/2 skin grafting, significantly prolonged the survival of the graft in comparison with that in allografted mice treated with normal rabbit serum. In contrast, ALS prepared against unsensitized lymph node cells was found to be ineffective when administered after transplantation. A further prolongation of allograft survival was obtained when ALS(I-GR) was administered to recipients on days +4 and +7. ALS(I-GR) seemed to specifically suppress the rejection of DBA/2, but not of C57 BL/6 skin grafts. The suppressive action of ALS(I-GR) was not due to cross reactive (anti-DBA) antibodies and was probably directed against idiotypic determinants on antigen-stimulated cells. PMID- 3522416 TI - In vitro adhesion of urinary & bowel Escherichia coli from patients with urinary tract infection. PMID- 3522417 TI - Histochemical copper, copper associated protein & immunohistochemical ceruloplasmin in adult liver biopsy. PMID- 3522418 TI - Definitions and characteristics of sodium sensitivity and blood pressure resistance. AB - Sensitivity and resistance to the effects of sodium were evaluated in normotensive and hypertensive humans by two approaches. Blood pressure was measured after an intravenous infusion of 2 L of normal (0.9%) saline and after sodium and volume depletion induced by a low sodium diet and furosemide administration in 378 normal volunteers and 198 subjects with essential hypertension. Those in whom mean arterial blood pressure decreased by at least 10 mm Hg after sodium and volume depletion were considered sodium-sensitive, and those with a decrease of 5 mm Hg or less (including an increase in pressure) were considered sodium-resistant. The second study utilized the blood pressure response to modest dietary sodium restriction in 74 normotensive subjects to identify sodium sensitivity and resistance. In both studies the responses were heterogeneous. In the first study significantly more hypertensive subjects were sodium-sensitive, as compared with those in the normotensive group (p less than 0.001). Plasma renin activity (low, normal, or high) did not predict sodium responses. In both groups sodium-sensitive individuals were significantly older (p less than 0.001) and had lower baseline renin values than sodium-resistant subjects. Factors related to the change in mean arterial blood pressure after sodium and volume depletion included baseline pressure (r = -0.54, p less than 0.001) and age (r = -0.16, p = 0.002 in the normotensive group; r = -0.28, p less than 0.001 in the hypertensive group). The response to dietary sodium restriction was also correlated with baseline pressure (r = 0.61, p less than 0.001) and the initial urinary sodium excretion (r = 0.27, p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3522419 TI - Decreased venous distensibility and reduced renin responsiveness in hypertension. AB - Abnormalities of renin release and of venous distensibility have been described in essential hypertension. We have postulated that decreased venous distensibility could contribute to the blunted renin response to upright posture in hypertension. Stiffer veins might prevent venous pooling in the lower extremities, which in turn might affect the stretch on cardiopulmonary mechanoreceptors, thereby influencing the reflex release of renin. We investigated this hypothesis in the present study of 47 patients with mild hypertension and 26 (male) healthy volunteers of similar age and race. To induce isolated changes in the stretch of cardiopulmonary mechanoreceptors, systemic hemodynamics were measured before and after thigh cuff inflation at 60 mm Hg for 30 minutes. Cardiac output was determined by dye dilution. Before the intervention, variable thigh cuff pressures were used to measure venous pressure volume with mercury-in-Silastic strain gauge plethysmography. Venous distensibility was diminished in hypertension, as evidenced by a shift in the calf venous volume/pressure curve toward the pressure axis. During the 30-minute experiment, the hypertensive subjects had less blood pooling in their legs in response to thigh cuff inflation, as compared with the control subjects. The hemodynamic and renin responses reflected this diminished effect of thigh cuff inflation on venous return. The smaller increase of renin in the hypertensive group was associated with a smaller fall in the stroke index and right atrial pressure; the reflex rise in the heart rate was also decreased. By pooling blood in the lower extremities, thigh cuff inflation simulates upright posture. It is customary to classify the renin status of hypertensive patients according to the renin response to upright posture.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3522420 TI - Biochemical similarity of expressed human prorenin and native inactive renin. AB - Prorenin is secreted by mammalian cells transfected with a human preprorenin expression construct. The purpose of this investigation was to compare the physicochemical properties of expressed prorenin in culture medium with the known characteristics of human inactive renin, which accounts for nearly half the renin in plasma and kidney. We found that expressed human prorenin strongly resembles human renal and plasma inactive renin. The expressed prorenin was inactive and could be equally activated by acid (dialysis to pH 3.3) or trypsin. Acid activation was completely reversible; reexposure to acid could reactivate the expressed inactive renin. Exposure to cold (-5 degrees C for 3 days) could also activate expressed renin. The Michaelis-Menten constant of acid-activated expressed renin with sheep substrate was 0.29 microM, and the pH optimum was 7.8. Expressed inactive renin bound to a cibacron-blue affinity column and could be eluted with 0.5M NaCl. All the above characteristics resemble those of human renal and plasma inactive renin. In addition, the molecular weight of expressed prorenin and human chorionic renin was 47,000, as determined by sodium dodecyl sulfate-polyacrylamide gel electrophoresis, and 46,000, as measured by high performance liquid chromatography. These data, taken together with the published observation that native human inactive renin cross-reacts with antibodies generated against amino acid sequences in the prosegment of renin, provide strong support for the hypothesis that human inactive renin is prorenin. PMID- 3522421 TI - Extrarenal prorenin in plasma requires an activator of renal origin. AB - Plasma prorenin may be of renal or extrarenal origin, and its conversion to renin may be catalyzed by renal or extrarenal enzymes. We tested the effect of bilateral nephrectomy and sham bilateral nephrectomy on plasma renin and prorenin in dogs, using low (3 mg/ml) and high (5 mg/ml) concentrations of trypsin to activate the prorenin. In the nephrectomized dogs, active plasma renin quickly disappeared, whereas plasma prorenin (inactive renin) increased by up to 300% during the first 24 hours after surgery, suggesting that it was released rapidly from a major extrarenal source but not converted to renin in the absence of the kidneys. In the sham surgery (control) group, plasma renin activity increased by up to 400% in the first 24 hours but returned almost to baseline by 48 hours, whereas prorenin remained at the preoperative value or fell below it. The quantity of prorenin varied greatly between the groups according to the time after surgery and the different concentrations of trypsin used. In the nephrectomy group, low and high trypsin levels resulted in similar prorenin values during the first 3 hours, but later on, the high trypsin level resulted in about twice as much prorenin. In the control group, high trypsin levels generally produced lower prorenin values than did low trypsin levels. Since trypsin is believed to interact with endogenous convertase enzymes in converting prorenin, a high requirement for it after bilateral nephrectomy suggests that removal of the kidneys causes a deficiency of such convertases. Conversely, the low requirement for trypsin after the stress of sham surgery suggests enhanced plasma convertase activity in the presence of the kidneys.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3522422 TI - The pressor and metabolic effects of alcohol in normotensive subjects. AB - Changes in blood pressure, pulse rate, and plasma catecholamines, renin activity, cortisol, and calcium were studied in 16 normotensive subjects (eight with a family history of hypertension) for 5 hours following ingestion of alcohol-free and alcohol-loaded beer. Both systolic and diastolic blood pressure rose after alcohol consumption; maximum responses occurred at peak blood alcohol concentrations and were significantly higher than those seen after placebo. Pulse rate was also significantly higher after alcohol ingestion and continued to rise throughout the study. There was no difference in the pressor response to alcohol between the groups with and without a family history of hypertension. No difference was found in plasma norepinephrine or epinephrine levels between alcohol and placebo phases. However, subjects with no family history of hypertension had significantly higher plasma norepinephrine levels (p less than 0.01) than did those with a family history during both the alcohol and placebo phases, although baseline blood pressures were not significantly different. Plasma epinephrine level was similar in both groups. Plasma renin activity was unchanged throughout, but plasma cortisol fell during both phases. Plasma calcium showed a small but significant fall with alcohol consumption in both groups (p less than 0.001). These results indicate that in normotensive subjects alcohol ingestion causes a rise in systolic and diastolic blood pressure that is not influenced by a family history of hypertension. This effect does not appear to be sympathetically mediated but may be due to a direct vasoconstrictor effect of alcohol, possibly with an alcohol-induced shift in intracellular calcium. PMID- 3522423 TI - Antenatal diagnosis of genetic disorders. PMID- 3522424 TI - Quantification of specific antibody response to Cryptosporidium antigens by laser densitometry. AB - Cryptosporidium spp. is a protozoan parasite with worldwide distribution associated with diarrhea in immunocompromised patients (particularly those with acquired immunodeficiency syndrome [AIDS]) and in immunocompetent humans. Immunoglobulin M (IgM) and IgG antibody responses are readily detected by an enzyme-linked immunosorbent assay. To determine which Cryptosporidium antigens invoke antibody responses in humans, we performed polyacrylamide gel electrophoresis using purified oocysts, followed by Western blots with human sera from various populations. Of 40 sera from persons with cryptosporidiosis (24 AIDS and 16 non-AIDS patients), in 37 (93%) a 23,000-dalton antigen measured quantitatively by laser densitometry was recognized. Of 63 sera from IgM- or IgG positive individuals, as determined by enzyme-linked immunosorbent assay, in 58 (92%) this same antigen was recognized. Up to three additional bands between 125,000 and 175,000 daltons were identified by some of these sera. These results suggest that most persons infected with Cryptosporidium spp. produce antibodies which recognize at least one common low-molecular-weight antigen. Isolation of this antigen will be useful in development of diagnostic tests and may be important in the study of immunity. PMID- 3522425 TI - Isolation of a germ-tube-forming revertant from Candida albicans B311V6. AB - We describe and partially characterize the isolation of a germ-tube-positive revertant from Candida albicans B311V6. This revertant has all of the properties of a germ-tube-forming strain of C. albicans except that it appears to have a nutrition defect. PMID- 3522426 TI - Two toxin-converting phages from Escherichia coli O157:H7 strain 933 encode antigenically distinct toxins with similar biologic activities. AB - Escherichia coli O157:H7 strain 933 contains two distinct toxin-converting phages (933J and 933W). The biologic activities and antigenic relationship between the toxins produced by 933J and 933W lysogens of E. coli K-12, as well as the homology of the genes that encode the two toxins, were examined in this study. The 933J and 933W toxins, like Shiga toxin produced by Shigella dysenteriae type 1, were cytotoxic for the same cell lines, caused paralysis and death in mice, and caused fluid accumulation in rabbit ileal segments. The cytotoxic activity of 933J toxin for HeLa cells was neutralized by anti-Shiga toxin, whereas the activity of 933W toxin was not neutralized by this antiserum. In contrast, an antiserum prepared against E. coli K-12(933W) neutralized 933W toxin but not 933J toxin or Shiga toxin. For E. coli 933, most of the cell-associated cytotoxin was neutralized by anti-Shiga toxin, whereas most of the extracellular cytotoxin was neutralized by anti-933W toxin. However, a mixture of these antisera indicated the presence of both toxins in cell lysates and culture supernatants. Among 50 elevated cytotoxin-producing strains of E. coli, we identified 11 strains isolated from cases of diarrhea, hemorrhagic colitis, or hemolytic uremic syndrome that produced cell-associated cytotoxins which were neutralized by the 933W antitoxin. Southern hybridization studies showed that the cloned toxin structural genes from phage 933J hybridized with DNA from phage 933W under conditions estimated to allow no more than 26% base-pair mismatch. These findings indicate that E. coli produces two genetically related but antigenically distinct cytotoxins with similar biologic activities which we propose to name Shiga-like toxins I and II. Strains of E. coli that produce elevated levels of Shiga-like toxin I or Shiga-like toxin II, or both, have been associated with the clinical syndromes of diarrhea, hemorrhagic colitis, and hemolytic uremic syndrome. PMID- 3522427 TI - Serological characterization and gene localization of an Escherichia coli expressed 37-kilodalton Treponema pallidum antigen. AB - A recombinant plasmid containing a 5.6-kilobase-pair DNA fragment of the Treponema pallidum genome was characterized by endonuclease mapping, and the encoded proteins were expressed in Escherichia coli and analyzed by use of in vitro transcription and translation. One of the proteins, identified as having a molecular weight of 37,000 (37K protein), was selected for further study. Initially, the seroreactivity of the partially purified 37K antigen was demonstrated by immunoblotting. After its purification to near homogeneity, the cloned T. pallidum protein was assessed for diagnostic significance by radioimmunoassay. Although first identified as seroreactive by screening with secondary syphilitic sera (T. E. Fehniger, A. M. Walfield, T. M. Cunningham, J. D. Radolf, J. N. Miller, and M. A. Lovett, Abstr. Annu. Meet. Am. Soc. Microbiol. 1985, B156, p. 44), the antigen was shown to be serologically reactive with antibodies in serum from all stages of syphilis but was not recognized by serum from controls by both immunoblotting and radioimmune assay. Further, a monospecific polyclonal rabbit antiserum generated to the 37K antigen recognized a polypeptide of the same molecular weight from T. pallidum but did not efficiently recognize proteins from five nonpathogenic treponemes tested. Therefore, because of reactivity with and specificity for T. pallidum antibodies, the 37K antigen may be of serodiagnostic value in the detection of syphilis. PMID- 3522428 TI - Bactericidal action of eosinophils from normal human blood. AB - The ability of normal human eosinophils to ingest and kill Staphylococcus aureus and Escherichia coli was investigated and compared with the reactions shown by neutrophils from the same donors. The rate of phagocytosis of S. aureus by eosinophils was 50% of that shown by neutrophils. Unlike neutrophils, eosinophils were not able to kill ingested S. aureus at low bacterium/phagocyte ratios. The degree of S. aureus killing increased with increasing ratios, being equal to that of neutrophils when bacterium/phagocyte ratios of about 15 were used. This was probably due to a better triggering of the eosinophil oxidase system at high bacterium/phagocyte ratios. The early kinetics of the association of bacteria with eosinophils, the perforation of the bacterial envelope and the inactivation of bacterial proteins, was monitored in the ML-35 mutant strain of E. coli. The association of E. coli with eosinophils was 70% of that with neutrophils. Eosinophils had only 25% of the capacity of neutrophils to perforate the E. coli envelope. E. coli loses its colony-forming ability when the bacterial envelope has been perforated, indicating that eosinophils also kill E. coli more slowly than do neutrophils. This was confirmed with a plating assay for colony formation. The perforation of E. coli is independent of peroxidase-mediated reactions. Hence, the defective bactericidal action of eosinophils is probably not related to the differences between myeloperoxidase and eosinophil peroxidase. On the other hand, the inactivation of bacterial proteins is peroxidase dependent and was also seen to occur to a lesser extent in eosinophils compared with neutrophils. We conclude that eosinophils ingest E. coli but only slowly perforate (kill) these bacteria and barely inactivate the bacterial enzymes. In contrast, neutrophils quickly ingest and perforate (kill) E. coli and quickly inactivate the bacterial enzymes. PMID- 3522429 TI - Electron microscopy of Treponema pallidum (Nichols) cultivated in tissue cultures of Sf1Ep cells. AB - The in vitro interaction between Treponema pallidum and Sf1Ep cells during treponemal replication was investigated by using transmission electron microscopy. The Sf1Ep cells grown on Teflon-treated cover slips after 12 days of cocultivation were fixed in situ, overlaid with agar, embedded, and vertically sectioned. Large numbers of treponemes were found extracellularly not only at the upper cell surfaces but also in the narrow spaces between the cells and between the cells and the cover slips. These narrow spaces supported treponemal growth and survival, as did those at the upper cell surfaces. Although few in number, organisms were also seen in cell vacuoles either surrounded by a membrane or free in the cytoplasm. Some extracellular treponemes attached to host cells by body spirals or the terminal end and formed electron-dense layers at attachment sites. Some treponemes were often surrounded with amorphous, extracellular material which appeared to "connect" them to host cell surface. After 12 days of cocultivation, host cells showed excessive vacuolation and appeared to be damaged. This did not seem to be due to treponemal infection alone, because cells from uninfected cultures also showed similar vacuolation. PMID- 3522430 TI - Antigenicity of Campylobacter jejuni flagella. AB - We studied the antigenicity of a wild-type flagellate and motile (F+M+) Campylobacter jejuni strain (81116) and two daughter mutants, one flagellate and immotile (F+M-) and one aflagellate and immotile (F-M-). By sodium dodecyl sulfate-polyacrylamide gel electrophoresis of acid-extracted surface proteins, a 63-kilodalton (kDa) band identified from sheared flagella as the flagellar protein was present in the F+M+ and F+M- strains but not in the F-M- strain. No other differences in protein profile among the three strains were noted. By Western blotting, serum from rabbits immunized with either the F+M+ or F-M- strain detected a 63-kDa protein in the F+M+ and F+M- strains but not in the F-M- strain. That the F-M- antiserum recognized the 63-kDa band suggests that small amounts of this protein or a cross-reacting antigen is present on the F-M- strain. By counterimmunoelectrophoresis of the acid-extracted preparations with immune sera, all three strains were found to share three major antigens, but a fourth antigen with a net positive charge was present only in the F+M+ and F+M- strains. Antisera to five C. jejuni and two Campylobacter fetus strains recognized the 63-kDa protein of purified F+M+ flagella in Western blots, demonstrating a common antigen is present, but enzyme-linked immunosorbent assay results suggest that the sharing of this antigen among Campylobacter strains is variable. PMID- 3522431 TI - Enhancement of Escherichia coli adherence to epithelial cells derived from estrogen-stimulated rats. AB - The effect of exogenous estrogen administered to male and oophorectomized female rats was investigated with regard to in vitro adherence of eight uropathogenic strains of Escherichia coli to exfoliated bladder and vaginal epithelial cells. Uroepithelial cells obtained from estrogenized male and estrogenized oophorectomized female rats and vaginal cells obtained from estrogenized oophorectomized female rats demonstrated significantly enhanced (P less than 0.005) host cell avidity for E. coli attachment, irrespective of bacterial adhesin expressed, when compared with such cells from nonestrogenized male and female oophorectomized rats. These animal studies suggest that female reproductive hormones may contribute to urinary-tract infection in premenopausal females by enhancing susceptibility to E. coli colonization of uroepithelial cells. PMID- 3522432 TI - Comparison of immunoblot analyses of spherule-endospore-phase extracellular protein and mycelial-phase antigen of Coccidioides immitis. AB - The extracellular proteins produced by Coccidioides immitis during growth of the spherule-endospore-phase and mycelial-phase antigen (coccidioidin) were studied by polyacrylamide gel electrophoresis followed by immunoblot analysis to detect specific serologic function. Filtrates obtained from 28- and 120-h growth of the spherule-endospore phase were compared with each other and with coccidioidin by using negative, immunoglobulin M (IgM) precipitin-positive, or complement fixation-positive pooled and single human sera followed by peroxidase-labeled anti-human IgA, IgE, IgG, or IgM (heavy chain specific) or peroxidase-labeled concanavalin A to detect the reaction. A total of 35 bands was seen in the stained gels. Different patterns were noted among the two spherule-endospore preparations and unheated and heated coccidioidin. At least 15 electrophoretically separate antigens were detected with positive serum ranging in approximate molecular weight (Mr) from 100,000 to 18,000. Most were clustered between 45 and 60 kilodaltons (kDa). Common bands were noted at 48 and 18 kDa. At least one band at 48 kDa was strongly reactive with complement fixation-positive serum demonstrated by reaction with anti-IgG and anti-IgE. In contrast, doublet bands in the 50- to 65-kDa area were highly reactive with IgM precipitin-positive serum detected by anti-IgM. IgM antibodies present in both positive sera reacted with a band at 46 kDa which was not reactive with IgG. Heating the antigens altered the reactivity of many of the antigens, including the 48-kDa band, but not the 46-kDa band. PMID- 3522433 TI - Application of multilocus enzyme gel electrophoresis to Haemophilus influenzae. AB - Multilocus enzyme electrophoresis was adapted to the study of Haemophilus influenzae. Protein extracts from sonicated whole bacteria were subjected to starch gel electrophoresis. After staining with substrates, the position of each isoenzyme (electromorph) was registered. Each isolate was assigned an electrophoretic type (ET) by the combination of electromorphs for the enzymes stained. Twenty-seven enzymes were tested; 12 were expressed in H. influenzae. Six enzymes were selected for subsequent study: malate dehydrogenase (MDH), phenylalanylleucine peptidase (PE2), 6-phosphogluconate dehydrogenase (6PG), adenylate kinase (AK), glucose 6-phosphate dehydrogenase (G6P), and phosphoglucose isomerase (PGI). They were polymorphic and occurred in all isolates. Six electromorphs were found for PE2, G6P, and PGI, five for MDH, four for 6PG, and three for AK. PE2, G6P, and PGI contributed most of the ET resolution (48 of 49 ETs). Multilocus enzyme electrophoresis showed several advantages over previous typing techniques. An ET could be assigned to both typable and nontypable (NT) isolates. The technique was powerful in resolving differences among isolates. The 94 isolates comprised 49 ETs, five biotypes, and six capsular types and NT isolates. Strains known to be related expressed the same ET, e.g., RAB b+ and b-, ET12; Ma a+ and a-, ET1. ET variability among type b isolates was low; 26 of 28 clinical isolates expressed ET14; 2 of 28 expressed ET13 and ET15, differing from ET14 by one electromorph each. In contrast, the 47 NT isolates comprised 38 different ETs. No ETs were shared between non-type b capsulated strains and type b or NT strains. Interestingly, five NT isolates expressed the same ET as type b strains. (iv) Strains of the same capsular type but different biotypes expressed different ETs. ET determinations will thus be useful in studying the epidemiology and evolution of H. influenzae. PMID- 3522434 TI - Long-term effects of whole-body vibration: a critical survey of the literature. AB - The relevant literature on the long-term effects of whole-body vibration (wbv) was analyzed in order to obtain condensed information concerning a possibly higher health risk due to long-term exposure, the relationships between the quality of exposure (intensity, duration, frequency) and pathological effects, the significance of individual factors, conclusions for standard setting, and medical health care of workers exposed to wbv. Vibration exposure was characterized by measured values in one third of papers, whereas more than 30% of the publications selected did not contain any exposure data. Health data of about 43 000 workers exposed to wbv and 24 000 persons in control groups were reported. The results indicate an increased health risk of the spine and of the peripheral nervous system after intense long-term wbv. With a lower probability, the digestive system, the peripheral veins, the female reproductive organs, and the vestibular system were also affected. Long-term effects on other organs cannot be precluded. Wbv can worsen certain endogenous conditions. Specific diagnostic features of pathological changes induced by wbv with frequencies below 20 Hz do not exist. On average, the health risk increases with higher intensity or duration of exposure, however, quantitative exposure-effect relationships cannot be derived at present. Since wbv near the Exposure Limit of the International Standard IS 2631 is not completely safe, this survey provides arguments in favour of a lower limit. Contra-indications for professional exposure to wbv and further research needs are discussed. PMID- 3522435 TI - Histologic identification of cellular differences that may contribute to the reduced immunogenicity of transplanted neonatal versus adult skin tissue. AB - Neonatal epidermal sections obtained within 24 h after birth from C3H/He mice along with adult epidermis from the same strain were evaluated for the presence of epidermal dendritic cells (Langerhans cells) by three staining methods: immunofluorescence, gold sodium thiomalate and adenosine triphosphatase (ATPase) activity. The results obtained indicate that Langerhans cells are present in both groups of tissue, but lack Ia antigen expression in the neonate. This lack of Ia antigen expression may contribute to the superiority of neonatal donor skin for transplantation over that from adult donors in the murine allograft model. PMID- 3522436 TI - Intracellular immunoglobulins in human milk macrophages. Ultrastructural localization and factors affecting the kinetics of immunoglobulin release. AB - Immunoglobulins (Ig) were localized by immunofluorescence and immunoperoxidase techniques inside human milk macrophages (HMM phi). Immunoelectron microscopy was employed to study the distribution and localization of Ig within HMM phi. IgA and IgM were detected inside phagocytic vacuoles of different sizes in the vicinity of the cellular membrane and in the periphery of larger vacuoles with a dense and homogeneous content. The intramacrophagic IgA represents 5-10% of the total milk IgA. The in vitro release of IgA into the medium was quantitated using an enzyme linked immunoabsorbent assay. The amount of IgA released was in most samples around 1,720-5,200 ng/10(6) HMM phi. The concentrations of IgM and IgG released by HMM phi were approximately 50-600 and 20-40 ng/10(6) HMM phi, respectively. The concentrations of Ig determined in the lysated pellets of HMM phi ranged between 2 and 100 micrograms/10(6) HMM phi for IgA and around 500 ng/10(6) HMM phi for IgM. Increased IgA release occurred when HMM phi were cultured in medium with a pH lower than 3. IgA concentrations were not very different between pH 5 and pH 7 and alkalinization of the medium did not produce any significant effect on IgA release. Release of IgA and IgM was not significantly increased when HMM phi were cultured in the presence of phorbol myristate acetate, formylated peptides, latex particles, lymphocyte-derived chemotactic factor or cholate. The kinetic study of IgA release by HMM phi, both with or without adding these stimuli to in vitro culture, indicates that IgA release depends on time and that these substances do not have any effect on it. PMID- 3522437 TI - Class-specific antibody determination against Aspergillus fumigatus by means of the enzyme-linked immunosorbent assay. III. Comparative study: IgG, IgA, IgM ELISA titers, precipitating antibodies and IgE binding after fractionation of the antigen. AB - IgG, IgA and IgM ELISA antibody titers against Aspergillus fumigatus were elevated in sera of patients with aspergilloma and allergic bronchopulmonary aspergillosis (ABPA), showing higher titers for the IgG antibodies compared with the IgA and IgM antibodies. No differences were found between titers of identical antibody classes in the two groups of sera. IgG and IgA ELISA titers were highly specific whereas IgM ELISA showed more unspecific binding of IgM antibodies. Antibodies, as measured by ELISA, studied after fractionation of the antigen into fractions of decreasing molecular weight, showed a preferential binding by the high molecular weight fractions. Precipitating antibodies studied in patient sera did not always correspond with the IgG ELISA titers. IgE antibody binding was observed in all fractions from Sephadex G-100 fractionated components; maximum binding was found with fractions of 28,000-60,000 daltons. The low molecular weight fractions (18,000-less than 5,000 daltons) showed less IgE binding but the quantity of this fraction was higher. The discrepancies noted between the IgG and IgA ELISA titers and the binding of IgM or IgE antibodies indicate that antigenic components may in part differ in the binding of antibody classes. PMID- 3522438 TI - New monoclonal antibodies specific for human sarcomas. AB - Monoclonal antibodies (MAbs) against sarcoma-associated cell membrane antigens were prepared by immunizing BALB/c mice with tumor cells from a human osteosarcoma, TPX, grown as a xenograft in athymic BALB/c nude mice. Spleen cells from immunized mice were hybridized with X-63 Ag. 8.653 mouse myeloma cells which yielded 260 growing hybridomas. Seven of these produced antibodies that bound to TPX cells and to cells from another osteosarcoma, but not to autologous skin fibroblasts. MAbs from 2 (TP-1 and TP-3) of these 7 clones did not cross-react with non-sarcomatous tumor cells or peripheral blood lymphocytes. Immunohistochemical studies on frozen tissue sections showed that the TP-1 (IgG 2a) and TP-3 (IgG-2b) antibodies had characteristic and identical specificity profiles. Binding of TP-1 (TP-3) was demonstrated to 15/15 (15/15) osteosarcomas, 3/3 (2/2) synovial sarcomas, 7/9 (6/8) malignant fibrous histiocytomas, 2/2 (1/1) malignant hemangiopericytomas, 1/2 (1/2) chondrosarcomas and 3/6 (1/3) unclassified sarcomas. The antibodies did not bind to any of 16 sarcomas belonging to other histological subtypes, including liposarcomas and leio- and rhabdomyosarcomas. Moreover, they failed to bind to sections of 66 different non sarcomatous malignancies, or to any of a range of normal adult and fetal tissues, although some weak staining of proximal kidney tubules was seen. The restricted specificity of these antibodies to some major subtypes of human sarcomas makes them promising tools for identification and subclassification of sarcomas. PMID- 3522439 TI - Gut-associated lymphoid tissue and 1,2-dimethylhydrazine intestinal tumors in the rat: an histological and immunoenzymatic study. AB - The association between chemically-induced intestinal carcinoma and gut lymphoid patches was studied in 20 male Sprague-Dawley rats 7 months after the first of 16 weekly injections of 1,2 dimethylhydrazine (DMH). The lymphoid patches of DMH treated rats and of 14 untreated control animals were systematically studied histologically on sections of "swiss-rolled" whole intestine. It was found that 78% of the small-intestine carcinomas and 73% of the colorectal carcinomas were associated with intestinal lymphoid patches. Furthermore, misplaced and often atypical glandular crypts were often found in the parafollicular or interfollicular areas of lymphoid patches, in treated as well as in control animals. These glands could be the origin of the lymphoid-patch-associated carcinoma. Immunohistological staining with monoclonal antibodies (MAbs) against T-lymphocyte antigens or anti-IgM serum labelling B lymphocytes clearly localized early carcinoma and atypical glands in the T-dependent, interfollicular and parafollicular area of lymphoid follicles. An MAb directed against la-antigen stained some well-differentiated carcinomas and some atypical glands found in control rats. On the other hand, lymphoid patches, when not invaded by a carcinoma, were not modified in their number, size, morphology or cellular composition in DMH-treated rats as compared to control animals. PMID- 3522440 TI - Cardiovascular device regulation in the United States--views from a former FDA scientist. PMID- 3522441 TI - On the clinical value of thallium-201 washout analysis in the detection of multiple jeopardized myocardial regions. AB - In this study the relative importance of visual assessment and quantitative analysis myocardial stress perfusion scintigraphy in 72 patients with a 40% incidence of triple-vessel coronary disease was tested. The quantitative analysis of the uptake scintigram in combination with a washout rate study of thallium-201 was not superior to the visual analysis with regard to the overall detection of significant coronary disease (obstructions of at least 50%). The sensitivity of the quantitative analysis was 0.85 for the entire population and 0.90 for the triple-vessel disease group (specificity 0.90). Detection of jeopardized myocardial flow regions in patients with triple-vessel disease, however, resulted in a significantly better identification by quantitative analysis. Of the 87 jeopardized flow regions in the 29 patients with triple-vessel disease, 62 regions were detected by the quantitative analysis whereas 48 regions were noted by the visual evaluation. The post-test likelihood of this regional quantitative analysis with respect to the triple-vessel disease was 66%. The incidence of global ischemia as detected by washout abnormalities in cases with no or a maximum of one regional uptake defect was 7%. PMID- 3522442 TI - Clinical trial with CO-1177: a preliminary report. AB - The therapeutical efficacy and the clinical and biological tolerance of a treatment with a new mucolytic agent, CO-1177 (Nesosteine), were assessed by evaluating clinical symptoms and functional respiratory parameters in 40 patients suffering from acute relapsing bronchitic syndrome. The therapy was performed for 15 days, at the dosage of one vial given intramuscularly twice daily for the first seven days and then of one tablet orally thrice daily for the remaining eight days. A marked mucolytic activity of the drug was clearly evident from the first days of treatment, with consequent loosening of secretions obstructing the bronchial tract, and prompt improvement both of clinical symptoms and of functional parameters in all the patients. In no case was clinical or biohumoral intolerance observed. PMID- 3522443 TI - Ambroxol for prophylaxis and treatment of bronchopulmonary complications after chest surgery. AB - A double-blind clinical trial has been carried out with 40 patients hospitalized for thoracic pathology requiring surgery (cancer of the lungs, hamartoma, pleural mesothelioma, bullous dystrophy or emphysema of the lung). The purpose was to determine the effectiveness of the drug in preventing and in treating postoperative bronchopulmonary complications. The results showed that the patients treated with 1g of ambroxol for three days before surgery, on the day of the operation and for five days afterwards had a more rapid turnover of intra alveolar surface tension and better re-expansion of the pulmonary parenchyma after surgery. They also had better mucociliary clearance of the respiratory tract. These improvements are indispensable for limiting bronchopulmonary complications after chest surgery. PMID- 3522445 TI - Effect of indomethacin on glucose absorption and insulin release in patients with impaired glucose tolerance. AB - Determinations of the levels of blood glucose and of serum insulin-like activity were made in 12 patients with impaired glucose absorption treated with indomethacin 4 x 25 mg for a day. By comparing the results with untreated control patients, it was found that the peak blood level of glucose, and the serum level of insulin-like activity, could be significantly decreased by this oral administration of indomethacin. The decrease of blood level of glucose appeared 0.5 h before the decrease of insulin-like activity in these patients with impaired glucose tolerance. PMID- 3522444 TI - Treatment of post-menopausal osteoporosis with phosphate and intermittent calcitonin. AB - The progression of osteoporosis depends on an imbalance between the relative rate of bone resorption and formation leading to a decrease in bone mass. The stimulation of bone turnover, also apparently heretical, might be necessary in order to be able to make the skeletons of elderly patients become highly cellular, a prerequisite for significant restoration of bone tissue. Given the usual correlation between bone resorption and bone formation a treatment which only increases bone turnover is unlikely to increase bone mass. For this reason, it is necessary to add sequentially a drug able to block bone destruction and lead to a transient uncoupling. Forty-seven post-menopausal women with vertebral osteopenia, with one or more atraumatic spinal compression fractures were included in a double-blind randomized study in four groups. The control group (PL) (n = 9) received a placebo injection and placebo tablets. The calcitonin group (CT) (n = 15) received CT injection and placebo tablets. The phosphate group (Pi) (n = 10) received a placebo injection and phosphate tablets. The calcitonin and phosphate group (CT + Pi) (n = 13) received calcitonin injection and phosphate tablets. The duration of treatment was six months. Transiliac bone biopsies were taken before and at the end of treatment. No significant changes were noted for the (CT + Pi) group. Trabecular bone volume increased by 31% by the end of treatment. Trabecular osteoblastic surface showed a mean increase of 143% of trabecular surface. Trabecular osteoid surface showed a mean increase of 85%.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3522446 TI - Relapsing polychondritis. PMID- 3522447 TI - Pathogenesis of progressive systemic sclerosis. PMID- 3522448 TI - Clobetasol propionate cream versus halcinonide cream in psoriasis. PMID- 3522449 TI - Estrogen receptor immunocytochemical assay (ER-ICA) in human endometrium. AB - An estrogen receptor immunocytochemical assay (ER-ICA) was applied to 15 tissue samples from human endometrium: five proliferative, five secretory, three carcinomas, and two atypical hyperplasias. A monoclonal anti-ER (H 222 SP gamma, Abbott Lab.) and peroxidase antiperoxidase method were applied on frozen sections, 5 micron thick for light microscopy (LM), 100 micron thick for electron microscopy (preembedding). Positive ER staining was quantitated on tissue sections (LM) using a computerized system of image analysis referred to as SAMBA 200 (Thomson TITN). Positive immunostaining was observed in the nuclei of both epithelial and stromal cells in normal and disordered endometrium. SAMBA 200 quantitative analysis permitted an accurate quantification of ER-positive staining. From this preliminary study it is concluded that (a) ER-ICA constitutes a reliable method to study the ER heterogeneous distribution in tissues and the precise intracellular ER localization, which is not feasible by ER biochemical binding assays; (b) SAMBA 200 analysis of the immunostained tissue sections permits an accurate and reproducible method of evaluating the results to quantitate the staining intensity and to determine the percentage of positive cells and the distribution of positive staining of the various tissue structures (glands and stroma). PMID- 3522451 TI - A controlled trial using ephedrine in the treatment of obesity. PMID- 3522450 TI - Lack of thermogenic response to glucose/insulin infusion in diabetic obese subjects. AB - The change in energy expenditure consecutive to the infusion of glucose/insulin was examined in 17 non-obese (ten young, seven middle-aged) and 27 diabetic and non-diabetic obese subjects by employing the euglycemic insulin clamp technique in conjunction with continuous indirect calorimetry. The obese subjects were divided into four groups according to their response to a 100-g oral glucose test: group A, normal glucose tolerance; group B, impaired glucose tolerance; group C, diabetes with increased insulin response; group D, diabetes with reduced insulin response. The glucose/insulin infusion provoked an increase in energy expenditure in both young and middle-aged controls (+8.2 +/- 1.3 percent and +5.9 +/- 0.5 percent over the preinfusion baseline respectively), but a lower increase in the non-diabetic obese groups A and B (+4.0 +/- 0.7 percent and +2.0 +/- 1.0 percent over the preinfusion baseline respectively, P less than 0.05 and P less than 0.01 vs young controls). However, in the diabetic obese groups C and D, energy expenditure failed to increase in response to the glucose/insulin infusion (mean change: +0.1 +/- 1.0 percent and -2.0 +/- 1.9 percent (P less than 0.01, vs middle-aged) over the preinfusion baseline respectively). When the glucose induced thermogenesis (GIT) was related to the glucose uptake--taking into account the hepatic glucose production--the GIT was found to be similarly reduced in the diabetics groups (C and D). The net change in the rate of energy expenditure was found to be significantly correlated with the rate of glucose uptake (r = +0.647, n = 44, P less than 0.001) when all the individuals were pooled. In conclusion, this study shows that the low glucose-induced thermogenesis in obese diabetics during glucose insulin infusion is mainly related to a reduced rate of glucose uptake; in addition, inhibition of gluconeogenesis by the glucose/insulin infusion may also contribute to decrease the thermogenic response. PMID- 3522452 TI - Naloxone modulates gustatory perception, but not insulin and C-peptide release, in sham-fed human subjects. AB - In order to determine the role of the endogenous opiatergic system in modulation of human pancreatic B-cell function and taste perception, we measured the reactivity of gustatory receptors (electrogustometry), insulin and C-peptide serum concentration (radioimmunoassay) in six normal men (aged 24-26 years) during sham feeding and 0.8 mg of naloxone or placebo (saline) administration. We did not observe any differences in insulin and C-peptide concentrations during tease feeding independently of placebo or naloxone infusion. The verge of electric reactivity of gustatory perception significantly decreased in the period of food presentation and saline administration but did not change under naloxone. Our electrogustometry results support the hypothesis pointing out the role of endogenous opiates in modulation of human taste. PMID- 3522453 TI - Adrenalectomy reduces but does not reverse obesity in ob/ob mice. AB - Bilateral adrenalectomy (ADX) of 4-month-old ob/ob mice led to reduced rates of body weight gain, a complete cessation of fat deposition and increased percentage carcass protein and ash during a 2-month observation period after surgery. However, ADX obese mice were still heavier and had more body fat and lower concentrations of carcass protein and ash than intact sex-matched littermate lean mice at the end of the experiment. When adrenalectomy was performed in younger obese mice before the syndrome was fully expressed (23 +/- 2 days of age), body weight gain was reduced by 40 per cent and fat deposition by 50 per cent during the next 3.5 months, but each was still greater than that of littermate lean mice. Despite the lower rate of weight gain after adrenalectomy, the skeletal and lean body growth of the early ADX obese mice equalled that of both obese and lean mice fed ad libitum. When the carcass composition of early ADX obese mice was compared with that of intact obese mice which were calorically restricted to the same rate of body weight gain, the ADX group had significantly less carcass fat (28 per cent) and more protein (50 per cent) and ash (20 per cent) than the dieted obese mice. In both experiments adrenalectomy led to reduced circulating immunoreactive insulin levels, although hyperinsulinemia persisted. The present results show that adrenalectomy is an effective tool for ameliorating the severity of many aspects of the ob/ob syndrome, particularly when compared with caloric restriction, but the procedure does not entirely reverse the deranged metabolism or abnormal carcass composition of these mice. PMID- 3522454 TI - Adipocyte heat production before and after weight reduction by gastroplasty. AB - Fifteen grossly obese patients were studied before and 6-8 months after gastroplasty. Their mean body weight decreased by 30% (from 127 +/- 13 to 97 +/- 14 kg, mean +/- SD). The preoperative hyperinsulinemia, hyperglucosemia and hyperglucagonemia were significantly reduced at follow up. Liproprotein lipase activity, measured in post-heparin plasma, was slightly reduced and did not change after weight reduction. Variables reflecting thyroid function were within the reference ranges; small but statistically significant reductions in serum thyroxine and reverse triiodothyronine levels were recorded. Adipocyte heat production, reflecting total cellular metabolic activity and registered by microcalorimetry, was significantly decreased before surgery (by about 60 per cent when expressed per g tissue and by about 20 per cent when expressed per cell) and increased significantly at follow-up; expressed per cell, the heat production was normalized, but expressed per g tissue the values were still about 15 per cent before those of a control group. The results indicate that the reduced adipocyte heat production in obese individuals is a consequent rather than a cause of severe obesity. PMID- 3522455 TI - Lens guide suture for transport and fixation in secondary IOL implantation after intracapsular extraction. AB - The authors, after analyzing the different clinical situations where a secondary IOL implantation is indicated, describe 3 surgical techniques based on a common premise relying on the use of lens guide sutures for transportation or transportation and permanent fixation of the IOL's loops. The transportation sutures makes secondary implantation easier in anterior chamber lenses in technique I. The double purpose of transportation and permanent fixation at the angle permits a safe procedure with anterior chamber lenses in cases with no iris support in technique II and the possibility of sulcus or ciliary body fixation of a J type posterior chamber lens after ICCE in technique III. PMID- 3522456 TI - The effects of various modes of therapy for end stage renal disease on cognitive performance in a pediatric population--a preliminary report. AB - Visuomotor, visuoanalytic, vigilance, and verbal memory functions of sixty-eight children and adolescents with renal disease were assessed. All patients with renal disease either had successful kidney transplants, were receiving dialysis therapy by hemodialysis or continuous ambulatory peritoneal dialysis (CAPD), or had advanced renal failure not yet requiring dialysis. The patients showed a deficit in visuomotor skills related to attentional and visuoanalytic function. The transplant recipients appeared to be the least affected. Children undergoing dialysis therapy by CAPD or who had received a successful kidney transplant showed better performance on vigilance and memory tasks than the patients who received therapy by hemodialysis. There were correlations in all groups between performance on the memory tasks and performance on the vigilance tasks suggesting that the memory dysfunction in uremia is related in part to an attentional deficit. PMID- 3522457 TI - Cyclosporin A in nephrotic syndrome of childhood--a 14 month experience. AB - Cyclosporin A (CsA) in combination with 6-methylprednisolone was administered over a six-month period to 10 children with nephrotic syndrome (6 frequently relapsing and 4 steroid resistant) at a dose providing blood CsA concentrations of 200-400 ng/ml. In frequent relapsers 6-methylprednisolone was given initially at a dose of 60 mg/m2/day and subsequently at a dose of 35 mg/m2/48 h. In steroid resistant cases the steroid was given at an initial dose of 1 mg/kg tapering to 0.35 mg/kg by the end of the first month and to 0.22 mg/kg by the fourth month being also administered at the same dosage during the fifth and the sixth month. Among the frequent relapsers there were 30 relapsers in 116 months before CsA and 1 relapse during 70 months after CsA (in 5 patients urine was protein free and 1 relapsed after 7 months. Two of the steroid resistant cases healed. There was a modest incidence of CsA toxicity as evidenced by the usual clinical monitoring and by evaluation of creatinine clearance, plasma potassium and evolution of renal parenchymal cells as studied in the course of sequential fine needle aspiration biopsies. PMID- 3522458 TI - Preliminary results of low-dose cyclosporin A in pediatric renal transplantation. PMID- 3522459 TI - Hypokalemic alkalosis, hyperreninemia, aldosteronism, normal blood pressure and normal juxtaglomerular apparatus--a new syndrome of renal alkalosis. AB - An infant with hypokalemic alkalosis, hyperreninemia, aldosteronism, normal blood pressure and normal juxtaglomerular apparatus (JGA) is described. This infant, along with other similar patients reported in the literature, represents a new syndrome of renal alkalosis, clinically and chemically similar to Bartter's syndrome, but without hyperplasia of the JGA. PMID- 3522460 TI - Neuropsychiatric complications of AIDS: a literature review. AB - Acquired immune deficiency syndrome (AIDS) has become a major public health problem with over 12,000 cases and 6,000 deaths reported to date. Although there has been an explosion of knowledge in the virology, immunology and pathology of AIDS, relatively little has been written on the neuropsychiatric aspects. This report reviews the existing literature on the neuropsychiatric complications of AIDS. As many as 40 percent of patients with AIDS have neurologic complications at some point in their illness. These complications include either focal deficits attributable to opportunistic organisms infecting the CNS or diffuse encephalopathy caused by viral infection or lymphoma infiltration. Psychiatric complications include major depression, adjustment disorder with depressed mood, and organic brain syndrome with affective, delusional or demented features. Inpatient and consulting psychiatrists must be alert to these complications of AIDS so as to make accurate diagnoses and deliver appropriate therapy. Further studies, integrating both psychiatric and neurologic perspectives, are needed to better elucidate the neuropsychiatric complications of AIDS and help plan appropriate therapeutic interventions. PMID- 3522461 TI - A review of the EEG literature on Ganser's syndrome. AB - Ganser's syndrome has been classified as a histrionic disorder, a psychotic illness, a dissociative disorder, a factitious disorder, and an organic illness. The possibility of an underlying organic component to Ganser's syndrome is often implicated. A case which includes CT scan and EEG tests is presented and the EEG data in patients with Ganser's syndrome are reviewed. The majority of EEG data was not suggestive of any specific organic illness. PMID- 3522462 TI - The place of Germanic language and culture in Freud's discovery of psychoanalysis between 1895 and 1900. AB - Freud's self-analysed dreams between 1895 and 1900 point out: His attachment to his German mother tongue and the use of its peculiarities to represent certain polymorphous perverse fantasies of childhood (voyeurism, masochistic mostly); the recourse to living foreign languages (English and French mostly) to name the parts of the self both left alive and foreign to the consciousness; the use of Latin and Greek words to constitute one scientific universal language fitting to the knowledge of the unconscious. For Freud, the German culture is the culture to which he belongs; the antique Mediterranean culture being the culture of reference. It allows him to get free from the motherly symbiosis and to discover the Oedipus complex. The variety of languages and cultures is necessary to the preconscious activity of the psychoanalyst to whom it provides 'intermediate ideas'. PMID- 3522463 TI - The use of recombinant DNA techniques to study radiation-induced damage, repair and genetic change in mammalian cells. AB - A brief Introduction is given to appropriate elements of recombinant DNA techniques and applications to problems in radiobiology are reviewed with illustrative detail. Examples are included of studies with both 254 nm ultraviolet light (u.v.) and ionizing radiation (i.r.) and the review progresses from the molecular analysis of DNA damage in vitro through to the nature of consequent cellular responses. The section on the Molecular distribution of DNA damage (section 2) focuses on the use of defined DNA molecules to assess the nature, sites and frequency of radiation damage. Recombinant DNA techniques have also been used in the study of enzyme-DNA interactions, to comment upon the role of specific types and sites of damage in producing cellular responses. The use of DNA-mediated gene transfer to assess damage and repair (section 3) indicates that recombinant DNA molecules can be used to implicate (or reject) specific types of DNA damage in gene inactivation. Some gene-transfer assays may also be able to confirm the presence of specific repair functions in mammalian cells. Restriction endonucleases are essential for the construction of recombinant DNA molecules, but their ability to cut DNA at specific sequences is also being exploited to implicate the double-strand break as an important type of damage leading to the well-characterized responses of irradiated cells. The DNA double strand break: use of restriction endonucleases to model radiation damage (section 4) documents experiments showing that blunt-ended cuts introduced into cellular DNA are able to produce chromosome aberrations and cell death. Assays based upon the introduction of restriction endonuclease-cut plasmids into radiosensitive and normal cells suggest that sensitivity is in some instances, e.g. the radiosensitive disorder ataxia-telangiectasia, a result of excessive degradation of DNA around broken ends. Identification and cloning of DNA repair genes (section 5) reviews the successful cloning of one human repair gene and the putative identification of others, as well as the lack of success in identifying genes complementing radiosensitive human disorders. Analysis of radiation-induced genetic change (section 6) links the types of DNA damage observed in defined DNA molecules with the types of mutations occurring in irradiated prokaryotes. In mammalian cells recombinant DNA techniques have allowed the nature of mutational changes to be determined for the first time: to date it seems that u.v. produces mainly small (point) mutations while i.r. produces mainly large changes (deletions/rearrangements).(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3522464 TI - Effects of local convective cooling and rewarming on skin blood flow. AB - Local areas of the thighs, palms and fingertips of ten healthy subjects were exposed to cold (10 degrees C) and warm (40 degrees C) air flows of three different velocities, 0.25, 0.50 and 0.75 m/s. The rewarming followed immediately after the cooling. Each climatic condition was applied for 45 min. Skin blood flow and skin temperature were continuously measured by laser Doppler flowmetry and thermometry, respectively. Significant (p less than 0.01 or less) reductions in both skin blood flow and skin temperature, compared to the levels recorded in the room climate, were observed at all the test sites and for all the cooling climates. During cooling no significant differences were obtained between skin blood flow levels reached for the different air velocities, except for the palm (p less than 0.01). Rewarming by the air velocities 0.25 and 0.50 m/s could not even bring the palm skin blood flow back to the precooling levels, while the fingertip (except for the low air velocity) and the thigh showed a hyperaemic reaction. The discrepancies in response pattern between the test sites are interpreted to be due to their different microvasculature and vasomotor innervation. The relationship between skin blood flow and skin temperature was found to be exponential. The correlation coefficients were 0.84, 0.72 and 0.85 for the thigh, palm and fingertip, respectively. PMID- 3522465 TI - Nursing in Israel--a review of the past, pre-state and early post-state period. AB - This study, presented at the ICN Congress in Tel Aviv, June 1985, tries to show nurses as a vibrant force of individuals and groups bent on instituting care or bringing about changes in the health community. Their activities, for the most part undocumented, have been forgotten or taken for granted, and notes, if written, remain unread. The story of their deeds is based on interviews with nurses and examination of the remaining shards, reports, articles and other archives materials. Nurses appear as administrators and as staff working under extreme difficulties in a country with few facilities and little manpower. PMID- 3522466 TI - The place of antibiotics in the prevention of post-appendicectomy sepsis: a prospective study of 400 cases. AB - Post-appendicectomy sepsis still causes considerable morbidity and prolongs hospital stay. A large amount of recent work has gone into attempts to reduce such problems using various topical and systemic agents in differing regimes, with wide variation in their results. The aim of our study was to examine further the effectiveness of those different lines of prophylaxis against placebo in reducing post-appendicectomy sepsis. It is a comparative study of 400 cases of uncomplicated appendicitis operated upon by three senior Surgeons. The cases were allocated randomly in equal number to four groups according to the prophylactic antibiotic regime used: (a) Placebo; (b) Metronidazole alone; (c) Metronidazole and cefazolin; (d) Metronidazole and tobramycin. Antibiotics were given preoperatively with premedication and continued postoperatively for three days. The patients were checked for signs of sepsis during hospital stay and weekly up to a minimum of four weeks after discharge. They were also compared as far as their hospital stay is concerned. The conclusion of this study is that a combination of an antibiotic aimed at aerobes (cefazolin or tobramycin) with another aiming at anaerobes (metronidazole) is the best prophylactic regime against post-appendicectomy sepsis. PMID- 3522467 TI - Abdominal hydatid disease: follow-up of mebendazole therapy by CT and ultrasonography. AB - Computed tomography (CT) and Ultrasonography (US) were used for the diagnosis and follow-up of 10 cases of abdominal hydatid disease receiving treatment with Mebendazole because of a relative contraindication to surgery. With the exception of one case, the duration of follow-up varied from 20-36 months. There was an estimated 60% decrease in cyst size in one case, 10% decrease in another, unchanged in six (mostly calcified ones) and 60% increase in one case. CT density measurements of fluid content of the cysts increased in three cases accompanied by increased internal echoes on US in one case. The number and size of daughter cysts were reduced in one case and more calcification was noted in two cases. There was an overall slow and poor response to treatment and four cases eventually had surgery. PMID- 3522468 TI - N-acetylcysteine in the prevention of cyclophosphamide induced haemorrhagic cystitis. AB - Cyclophosphamide, an alkylating agent used in the chemotherapeutic treatment of neoplasias, is metabolized into active substances capable of damaging the urothelium when in contact with some enzymes. Amongst several alternative proposals for the treatment and prevention of hemorrhagic cystitis induced by cyclophosphamide the use of a mucolytic agent, N-acetylcysteine is found. An experimental study performed in rats proved the efficacy of the drug in the prevention of hemorrhagic cystitis. Bladder protection was achieved in 33% of the animals with preventive treatment with N-acetylcysteine instead of 60% in the group which did not receive the drug. PMID- 3522469 TI - Increased incidence of renal allograft thrombosis under cyclosporine immunosuppression. AB - Six of 325 patients undergoing renal transplantation under combined cyclosporine (CsA)-prednisone immunosuppression displayed renal artery thrombosis between 4 and 12 days after transplantation. All six patients had satisfactory initial revascularization, as ascertained by radionuclide scan and renal function. In none was the thrombosis considered to be secondary to rejection, either by clinical course or upon renal biopsy. Since there was no clear etiologic factor and since none of the overlapping 297 patients treated with azathioprine prednisone displayed this complication, these cases appear to support the hypothesis that CsA alters intravascular hemostatic homeostasis. Data in experimental models are consistent with a predisposing factor to thrombosis, namely CsA reduces the synthesis of prostacyclin stimulating factors, leading to decreased prostacyclin production by vascular endothelial cells, and to failure to inhibit platelet aggregation. PMID- 3522470 TI - Regional intra-vascular and intra-lymphatic therapy of neoplastic diseases: a review. AB - The aims of regional therapy are to increase the exposure of regional confined cancers to drugs and to decrease their systemic levels. Two main approaches are available: intra-vascular and intra-lymphatic (I.L.) therapy. The former is comprised of different methods of delivering chemo-radio therapeutic agents directly to the tumor, i.e. intra-arterial infusion (I.A.I.), isolation perfusion (I.P.), tourniquet infusion (T.I.), trans-catheter embolization (T.C.E.) and intra-portal infusion (I.P.I.). The main aim of the latter is the prevention or cure of lymphatic metastases. So far none of the reported methods have been universally accepted. Pharmacokinetic studies have recently made I.A.I. a more rational method: the increase in regional exposure achieved is a direct function of the total body clearance of a drug and an inverse function of the regional arterial blood flow. I.A.I. is most effective in the treatment of hepatic metastases from carcinoid and colo-rectal cancer. I.P. gives objective response in 50% of recurrent melanomas. T.I., T.C.E., I.P.I. and I.L. therapy are still experimental methods. However, the future for regional therapy appears exciting, since pharmacological and technological developments seem to have greatly improved its potential effectiveness as a cancer treatment. PMID- 3522471 TI - Ultrasonographic diagnosis of acute appendicitis in surgical indication. AB - The visualization rate and cross section width of the appendix were compared with the severity of appendicitis by using ultrasonography in 77 patients with acute appendicitis. An appendicitis echo was obtained in 100% of phlegmonous and gangrenous appendicitis cases in which emergency surgery was indicated, but in only 32% of catarrhal appendicitis cases in which conservative therapy was generally indicated. The cross section width of the appendix was 19.00 +/- 2.76 mm in gangrenous appendicitis, 15.22 +/- 3.73 mm in phlegmonous appendicitis and 9.50 +/- 1.76 mm in catarrhal appendicitis; i.e. the severer the inflammation the longer the diameter (p less than 0.01). A fluid echo, which suggests the existence of a complication, was observed in patients with gangrenous and phlegmonous appendicitis. The above facts suggest that ultrasonographic examination can be useful in assessing the severity of acute appendicitis. PMID- 3522472 TI - Spontaneous renal allograft rupture. Clinical and pathological patterns. AB - Rupture of an allografted kidney occurred in five patients 5-17 days after transplantation. In one patient the microscopic pathological changes corresponded with the nodose polyarteritis pattern. In four patients interstitial rejection nephritis with severe haemorrhage and haematoma was found. It is suggested that the bleeding is due to peristatic hyperaemia and defects in the inner elastic membranes. In one case multifocal necrotizing arteriopathy was the main pathogenetic factor. PMID- 3522473 TI - Embolization of the kidney in secondary renal hypertension as an alternative to surgical nephrectomy. An experimental study. AB - Embolization of the renal arterial bed with embolization agent Vilan 500 was performed in 13 dogs. Embolized kidneys shrink after the procedure and the functional parenchyma is extinguished. Peripheral PRA values were followed to find out whether renin production by the embolized kidney is extinguished (the non-embolized kidney was surgically removed). In nine of the thirteen dogs peripheral PRA decreased below 0.5 ng/ml/h; this renin activity can be considered extrarenal. Embolization of the kidneys with Vilan 500 can thus substitute surgical nephrectomy in patients with secondary renal hypertension. PMID- 3522474 TI - The influence of the H-2 receptor antagonist ranitidine on cadaver kidney allograft function. AB - To assess the influence of ranitidine on kidney allograft function a double blind, placebo-controlled clinical study in 42 cadaver kidney recipients has been performed. Patients received ranitidine or placebo for 1 month. Four years after transplantation 81% of the patients in the control group were alive; 67% in the control and 71% in the ranitidine group with functioning grafts. These differences were statistically not significant. However, a slightly more intensive steroid therapy was given to keep the ranitidine patients adequately immunosuppressed. Ranitidine thus can be safely used in kidney graft recipients. Because of a lack of gastrointestinal complications in both groups, no conclusions can be drawn regarding the prophylactic value of ranitidine. PMID- 3522475 TI - Imaging of pulmonary embolism. PMID- 3522476 TI - Left upper quadrant pain and intermittent bacteremia. PMID- 3522477 TI - In vitro fertilization 1986. New procedures and new questions. AB - The number of infertile couples undergoing treatment by means of in vitro fertilization and embryo replacement is still increasing at a logarithmic rate from the first successful delivery in July 1978. At the present time, several hundred centers around the world are treating patients and had produced in excess of 2,200 live births by fall of 1985. Recent advances including better treatment regimens to increase the number of recoverable oocytes, refinements of laboratory procedures, less invasive oocyte recovery procedures, and the development of embryo freezing should lead to wider availability, lower cost, and most importantly, higher success rates of successful pregnancy establishment. Along with these advantages, the increased number of oocytes and embryo freezing have raised certain questions concerning the rights and obligations of doctors, parents, and even embryos. PMID- 3522478 TI - Biographical sketches--64. Fitz. PMID- 3522479 TI - Wilhelm Schallmayer and the logic of German eugenics. PMID- 3522480 TI - "Confessing a murder". Darwin's first revelations about transmutation. PMID- 3522481 TI - A combination drug treatment for acute common migraine. PMID- 3522482 TI - Prophylaxis of migraine: a comparison between naproxen sodium and pizotifen. PMID- 3522483 TI - Migraine and platelet aggregation in patients treated with low dose acetylsalicylic acid. PMID- 3522484 TI - [Clinical aspects of progressive systemic scleroderma (PSS). Multicenter studies of 194 patients]. AB - Patients from five German Departments of Dermatology (Dusseldorf, Erlangen, Frankfurt am Main, Hamburg and Munich) affected with progressive systemic scleroderma (PSS) were classified and examined. The results of the clinical investigations are presented. In order to guarantee a uniform classification of all patients, the patients were divided into three groups according to the distribution of the affected skin: type I consisted of those with acrosclerosis distal to the wrist, type II had scleroderma extending along the wrist in a proximal direction, and type III had diffuse scleroderma beginning on the trunk. Altogether, 194 patients with PSS were investigated, and the following distribution was found: type I, 32%; type II, 60%; type III, 7%; 1% of the patients could not be classified. The distribution according to the patients' sex and age was in good agreement with published reference data. The incidence, significance, and localization of the major symptoms were investigated. The Raynaud symptom could be identified as being the main clinical symptom in 90% of the patients. Joint involvements (10%-73% depending in the applied parameters), dysphagia (51%), and rest dyspnea (30%) contributed to the main internal symptoms. The extensive clinical, chemical, and immunological results are summarized. In 80% of the cases, high ANA titers could be detected, but these were not correlated to the type of disease. PMID- 3522485 TI - A review of studies of the impact of insurance on the demand and utilization of specialty mental health services. AB - Insurers and employers perceive the demand for mental health care to be highly responsive to the terms of insurance. Better coverage, it is believed, would increase demand, increasing expenditures through use of services that may be discretionary in nature. This article attempts to shed light on this issue by summarizing and evaluating the results of more than 40 published and unpublished studies. The major criterion for inclusion was the availability of information on the size of the population covered, so that rates of utilization could be calculated. More recent studies are emphasized. If research at the population level using aggregate utilization as a dependent variable is the "first generation of research," studies of individual use over a period of a year constitutes the "second generation." The emerging research on episodes of treatment represents a new "third generation" of studies. If some progress can be made on issues of ways in which patients form expectations about their treatment and its cost, this new generation of research promises to model demand response more precisely to coverage terms that change within a year, such as deductibles or limits. PMID- 3522486 TI - Epiglottitis in immunocompromised patients. AB - Modern medical oncology has made dramatic improvements in the prognosis of many malignancies. Many of the treatment regimens used by the chemotherapist have the potential to profoundly depress the immune system. At UCLA Medical Center, three patients developed epiglottitis secondary to the fungus Candida albicans, while profoundly immunocompromised. All three had severe pain and odynophagia. The patients were all managed medically and none went on to airway obstruction. The natural history of this process is reviewed. PMID- 3522487 TI - Pathogenetic mechanisms in chronic pulmonary hypertension. PMID- 3522488 TI - Cardiovascular function in secondary pulmonary hypertension. PMID- 3522489 TI - Approach to the diagnosis of secondary pulmonary hypertension: the chest roentgenogram as a diagnostic tool. PMID- 3522490 TI - Perfusion scans and pulmonary angiography. PMID- 3522491 TI - Unstable angina before and after infarction: thoughts on pathogenesis and therapeutic strategies. AB - The pathophysiology of unstable angina both before and after infarction is incompletely understood, because the patient population with the diagnosis of unstable angina is not uniform and the definition of this condition is not precise. The question must be asked, "Why does a patient suddenly become unstable?" Several conditions can be responsible alone or in combination with each other. These conditions include extracardiac (aggravating) factors, rapid progression of coronary atherosclerosis, rapid decrease in coronary lumen size as a result of hemorrhage into an atherosclerotic plaque, transient platelet aggregation in severely diseased vessels, transient coronary artery thrombosis, and abnormal coronary artery vasoconstriction (spasm) in normal or diseased vessels. Fig. 1 summarizes a hypothetical scheme relating the above conditions to the degree of coronary artery stenosis. In patients with unstable angina before infarction, most investigators believe that severe coronary atherosclerosis and its consequences are the major pathogenic mechanisms when ischemic heart disease is present. If spasm is the mechanism, then the use of vasodilators is warranted. However, if thrombosis is clearly defined, then thrombolytic therapy in the early stages seems reasonable. If severe coronary artery disease is found (with or without thrombosis), therapy with anticoagulants such as intravenous heparin during the acute phase of the illness can be argued strongly. A similar argument could be made for the use of antiplatelet agents during the convalescent phase. If extracardiac (aggravating) factors are present, they must be corrected appropriately.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3522492 TI - Pieter van Duijn. PMID- 3522494 TI - Localization properties of fluorescence cytochemical enzyme procedures. AB - Fluorescence enzyme cytochemical procedures will contribute significantly to biomedical problems where knowledge of the enzymic composition of individual cells is important. Compared with the number of absorbance enzyme cytochemical methods, relatively few fluorescence procedures have been reported. In this paper, the merits of the described methods are discussed. A distinction is made between methods with and without a capture reaction. Only a few methods satisfy the requirement of accurate localization of the final product and high signal to noise ratios. Thus, there still is a need for valid fluorescence cytochemical enzyme methods. It is concluded that the bottle neck for valid fluorescence cytochemical enzyme methods is the development of efficient fluorogenic capture reactions for the primary enzyme products. PMID- 3522495 TI - Identification of osteocytes in osteoblast-like cell cultures using a monoclonal antibody specifically directed against osteocytes. AB - The development of a monoclonal antibody, OB 7.3, directed against a cell surface antigenic site on osteocytes is described. Osteoblast-like cells were enzymatically isolated from calvaria of chicken embryos after removal of the periostea. The cells were cultured for 6 days, harvested and used to immunize mice. One of the monoclonal antibodies obtained, OB 7.3, reacted specifically with the cell surface of osteocytes. In frozen sections of bone only osteocytes were stained, all other cells present, including mature osteoblasts, were negative. Liver, kidney, spleen, intestine, bloodvessel and skin were also completely negative. Using the monoclonal OB 7.3, positive cells could be demonstrated in sparse osteoblast-like cell cultures. The OB 7.3 positive cells had a stellate morphology and were therefore identified as osteocytes. They behaved in culture as osteocytes in bone tissue in that they formed a network of cell processes connecting osteocytes with each other or with other neighbouring cells. Monoclonal OB 7.3 offers the possibility of isolating osteocytes thereby providing the means for a detailed study of their biochemical properties. PMID- 3522496 TI - Fluorescein and tetramethyl rhodamine as haptens in enzyme immunohistochemistry. AB - Fluorescein (Fl) and tetramethyl rhodamine (Rh) were evaluated as possible candidates for a double hapten sandwich system in enzyme immunohistology. Monoclonal antibodies were raised against Fl and Rh. Their fine-specificity was tested with a competition-like assay. A pair of Mab's was selected for immunohistology in which they functioned as a bridge between Fl/Rh conjugated antibodies and Fl/Rh labeled peroxidase and alkaline phosphatase, respectively. The binding of fluorescein labeled antibodies could be successfully demonstrated in histological slides. A large variability in the efficacy of staining was observed in the case of rhodamine labeled antibodies. The phenomenon is explained by assuming that tetramethyl rhodamine isothiocyanate reacts preferentially with lysine residues near to, or embedded in, hydrophobic regions in a protein. This condition may reduce the accessibility of the Rh moiety for anti-Rh antibodies. PMID- 3522493 TI - Matrix models. Essential tools for microscopic cytochemical research. AB - An overview is given of the preparation and use of model systems for cytochemistry, dealing with quantitative as well as qualitative aspects. Descriptions are given of the various possibilities to prepare cytochemical matrix models, ranging from macroscopic and microscopic films, to models with more cell-like dimensions as agarose beads, artificial cells and erythrocyte ghosts. Such models allow the study of a large variety of cytochemical processes. Their potentialities are demonstrated in a number of specific applications, comprising: the study of the influence of fixation on cellular processes, reaction specificity and reaction kinetics, quality of reagents and biochemical calibration in cytochemical staining; factors influencing localization of the specific endproduct in enzyme cytochemistry; immunocytochemistry and hybridocytochemistry. PMID- 3522497 TI - Localisation of oxytocin, vasopressin and parts of precursors in the human neonatal adrenal. AB - Being a possible alternative source for the production of vasopressin (AVP) and oxytocin (OXT), a study was undertaken of the fetal adrenal. The concentrations of these peptides within the fetal adrenal turned out to be low, viz., approx. 1 pg/mg in the rat and within the pg/g range in the human. Immunocytochemistry was performed either on conventional autopsy material kept till 12 years in paraffin blocks, or on more recently obtained formalin or glutaraldehyde-paraformaldehyde fixed material. In both types of material staining was good. In order to localize AVP cells, anti-AVP, an antibody against its associated neurophysin (anti-NSN) or an antibody raised against the c-terminal glycopeptide part of the AVP precursor (anti-GP) was used. OXT cells were localized by means of anti-OXT or an auto antibody of a multiple sclerosis patient (auto-MS) probably recognizing OXT neurophysin. The antibodies were characterized on human and rat brain material. In the external zone of the definitive cortex, apart from parenchyma cells, anti AVP, anti-NSN and anti-GP stained fibre-like structures running in the connective tissue septa and around parenchyma cells and the cytoplasma of these cells. Anti OXT and auto-MS stained droplets in the cytoplasm of the fetal zone cells. Similar distinct staining patterns for AVP and OXT cells were obtained in human anencephalics. These observations show that the peptides are not derived from the fetal brain, but are rather produced in the fetal adrenal cortex.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3522498 TI - Cytological features of serotonin-containing neurons and their processes in the retina of the carp (Cyprinus carpio). An immunohistochemical study using flat mount preparations. AB - The morphological features of serotonin-containing neurons (SCNs) and their processes in the retina of the carp (Cyprinus carpio) were immunohistochemically studied by applying a modified peroxidase-antiperoxidase technique using flat mount preparations. The somata of immunoreactive SCNs were mostly located in the innermost part of the inner nuclear layer (INL). These cells were distributed at a density of 64.8 cells/mm2, this being similar to the density of dopamine containing interplexiform cells. The processes of the SCNs ramified successively into two finer branches, eventually forming a broad, extensive network in the thin layer just subjacent to the plane of the somata of the SCNs. Processes originating from neighboring SCNs exhibited cytoplasmatic continuity with each other at the lightmicroscope level. Due to their location and cytological features, these SCNs appeared to correspond to amacrine cells. PMID- 3522499 TI - Immunocytochemical localization of proteins in differentiating tissues of Pisum sativum. AB - Although there may be documented morphological changes during development, it is obvious that important changes in protein content occur in a vascular plant during the several stages of differentiation. In the absence of the latter information, an approach has been established for the localization of antigenic proteins in developing tissues of Pisum sativum. Monoclonal antibodies were raised to proteins extracted from pea internode tissue, and employed for the localization of three proteins in tissue sections. One of the proteins has two polypeptide subunits with molecular weights of 25,000 and 40,000 daltons, and the antibody binds to both of them. The three monoclonal antibodies produce different patterns of cellular localization in the tissue sections, as visualized by indirect immunocytochemical labeling. In another series of analyses, quantitative and qualitative differences in the protein contents of apical shoot tissue and mature internode shoot tissue have been found. These studies were based on the use of Western blots with both polyclonal (rabbit) antibodies and monoclonal (mouse) antibodies. PMID- 3522501 TI - [Biometry as a methodologic principle of clinical research in otorhinolaryngology]. AB - The basic biometric theories for different types of clinical studies in Oto-Rhino Laryngology are presented with a minimum use of formulae. A check-list is sketched with all points to be taken into account in the design of a study. The prerequisites for organisation of work and data processing are outlined. The understanding of this methodological basis can be very helpful in promoting the collaboration of clinicians and statisticians in pursuing successful clinical investigations in the field of Oto-Rhino-Laryngology. PMID- 3522500 TI - FMRF-amide immunoreactivity in the mammalian gastroenteropancreatic neuroendocrine system. AB - The presence of FMRF-amide, a cardioactive tetrapeptide, was studied by immunocytochemistry in human and rat gastric antrum and pancreas, and in the ovine, bovine, canine and rabbit pancreas. In human and rat gastric antrum, numerous cells contained FMRF-amide immunoreactive material. By staining of serial sections and by double staining, colocalization of immunoreactivity for gastrin and FMRF-amide was observed in part of the gastrin cells. In the pancreas of these and the other species, immunoreactivity for FMRF-amide was located both in acinar and islet endocrine cells. Colocalization of FMRF-amide and pancreatic polypeptide was found in a proportion of pancreatic polypeptide cells in the pancreas. FMRF-amide immunoreactivity never colocalized with the other neurohormonal peptides which occur in the gastric antrum and the pancreas. Our observations show that neuroendocrine cells occur in the gastric antrum and pancreas which are exclusively immunoreactive or gastrin and for pancreatic polypeptide respectively. In addition cells occur which show immunoreactivity for FMRF-amide as well as for gastrin in the gastric antrum and with antiserum to FMRF-amide as well as for pancreatic polypeptide in the pancreas. It is concluded that FMRF-amide antibodies probably recognize a substance in G and PP cells which is not identical but may be structurally related to gastrin and pancreatic polypeptide. PMID- 3522502 TI - [Experiences using open rhinoplasty]. AB - In our opinion the procedure recommended by Goodman is very appropriate for modern rhinoplastic surgery. From our own experience of 34 cases we present 3 examples of an asymmetric nasal tip, a hanging columella and a wide saddle nose. The most obvious advantage of the external septorhinoplasty was the excellent exposure, especially of the nasal tip. We used nasal autografts only for the correction of the deformities. PMID- 3522503 TI - Clinical utility of serologic HLA-DR antigen identification using activated T lymphocytes. AB - Clinical experience has shown that it is often difficult to identify HLA-DR antigens on peripheral blood from long-term dialysis patients, leukemic patients, or blood in poor condition due to age of specimen or delivery conditions. We have found that we can accurately detect HLA-DR antigens on peripheral blood T cells that have been activated with PHA and expanded with commercially available Interleukin 2. An advantage of this technique is that a minimal number of peripheral blood cells is required at the initiation of T-cell activation. The expansion of T cells to a number sufficient for HLA-DR analysis requires 7 to 10 days. To test the validity of this protocol, we analyzed the HLA-DR antigens on a total of 13 normal donors using both conventional techniques and activated T cells. In every case, HLA-DR detection was identical by both methods, and no false positive or negative reactions were observed. Next, we used activated T cells to analyze the HLA-DR antigens in patients that had been difficult or impossible to DR type using conventional methods. We successfully identified HLA DR antigens on 16 of 16 bone marrow transplant candidates who were previously untypable. We also identified HLA-DR antigens in all of the eight renal dialysis patients who had been untypable on several previous occasions. Subsequent phenotypic analysis of family members for those patients confirmed that the HLA DR antigens genetically transmitted from family were detected by this method. In summary, we consider that activated T cells can be used effectively and reliably for analysis of HLA-DR antigens for patients who are otherwise difficult to type by conventional methods. PMID- 3522504 TI - Postoperative whole lung irradiation with or without adriamycin in osteogenic sarcoma. AB - Thirty-six patients with histologically proven osteogenic sarcoma of the extremities, treated between September 1975 and April 1978, are the subject of this report. The primary tumor was treated with radical surgery. Patients received 2000 cGy whole lung irradiation postoperatively in an attempt to control micrometastases to the lung. Twenty-nine of the patients were given Adriamycin (60 mg/m2 IV every 6 weeks for a total dose of 550 mg/m2) in addition to the irradiation. The median, disease-free interval was 118 days for the seven patients treated with lung irradiation only. The median overall survival for these patients is 241 days, with one patient alive with disease. All patients developed lung metastasis. For the 29 patients treated with postoperative lung irradiation and Adriamycin, the median disease-free interval was 372 days, and the median overall survival is 843 days. Nineteen of the patients recurred (65.5%). The differences are statistically significant (p less than or equal to 0.003, median disease-free survival and p less than or equal to 0.03, median survival). This study supports the role of whole lung irradiation plus Adriamycin, in the control of micrometastases in osteogenic sarcoma of the extremities and suggests that additional clinical trials are warranted. PMID- 3522505 TI - Fractionated low doses of abdominal irradiation alters jejunal uptake of nutrients. AB - Abdominal radiation is associated with changes in intestinal uptake of nutrients that begins within three days and persist for over 33 weeks. Clinically, fractionated doses of radiation (FDR) are used in an attempt to minimize the complications of this therapy, but the effects of fractionated doses of radiation on intestinal transport have not been defined. Accordingly, an in vitro technique was used to assess the jejunal and ileal uptake of varying concentrations of glucose and leucine, as well as the uptake of single concentrations of fatty acids and decanol in rats exposed 3, 7, and 14 days previously to a course of 200 cGy given on each of five consecutive days. FDR was associated with an increase in the uptake of decanol, and therefore a decrease in the effective resistance of the unstirred water layer. FDR had a variable effect on the uptake of glucose and leucine, with a decline in the value of the Michaelis constant (Km) and the passive permeability coefficient for glucose (Pd), whereas the Km for leucine was unchanged and the Pd for leucine was variably affected by FDR. The maximal transport rate (Jdm) for leucine progressively rose following FDR, whereas the Jdm for glucose initially rose, then fell. The uptake of galactose and medium chain-length fatty acids was unchanged by FDR, whereas the jejunal uptake of myristic acid rose, and the uptake of cholic acid declined, then returned to normal. FDR was associated with greater body weight gain and jejunal and ileal weight, but these changes did not adequately explain the variable alterations in the kinetics of uptake. The changes in nutrient uptake following FDR differed from the absorption changes occurring after a single dose of radiation. Thus, fractionated doses of abdominal radiation produce complex changes in the intestinal uptake of actively and passively transported nutrients, and these variable changes are influenced by the time following radiation exposure and by the solute studied. PMID- 3522506 TI - Hermann Heineke. PMID- 3522507 TI - Piracetam and event-related potentials in dyslexic males. AB - The effect of piracetam on visual event-related potentials (ERP) was investigated in a double-blind placebo-controlled study. Eight- to 12-year-old dyslexic males were randomly assigned to 3.3 g/day of piracetam or matching placebo in two divided doses over a 12-week period. Children performed a vigilance task in which they pressed a key when two alphabetic letters or shapes occurred in sequence. ERPs to letters and shapes, for active and passive responses, were recorded at the vertex and left and right parietal areas of the scalp. Performance measures included letter- and form-hits, misses, commission errors and reaction times. Piracetam increased the amplitude of a late positive component (believed to correspond to P300) at the vertex for letter-hits. Piracetam also increased the latency of this component in both hemispheres, but only for active responses (letter-hits) in the left hemisphere and passive responses (correct rejections and misses) in the right hemisphere. Although piracetam did not significantly affect performance, reaction time to letter-hits was significantly correlated with the latency of the P300 component, suggesting that letters created increased effort or attentional demand on the subjects compared with forms. An early ERP component (P225) also showed increased amplitude to piracetam in both hemispheres and effects were limited to form-hits. These effects were thought to possibly reflect slow negative potentials arising from stimulus anticipation in the CNV like paradigm. In view of the small sample size, the results were cautiously interpreted as indicating a facilitation of verbal processing mechanisms responsible for analyzing the verbal significance of visual stimuli. PMID- 3522508 TI - Effects of piracetam on developmental dyslexia. AB - A new class of drugs (nootropics) are viewed from the perspective of their neuropsychological effect upon developmental dyslexia. Evidence from both the preclinical and clinical work conducted on Piracetam is briefly reviewed. The latest research on the effects of Piracetam in dyslexia shows a convergence of results. Attempts to replicate these results with dyslexia have only met with success in the areas of reading rate. In an attempt to find an independent replication of the Chase et al. (1984) finding, the author provides additional evidence on the effects of Piracetam on reading Rate X Accuracy in dyslexics. PMID- 3522509 TI - Evaluation of the efficacy of piracetam in treating information processing, reading and writing disorders in dyslexic children. AB - Piracetam, a new class of drug (nootropil) thought to enhance specific cognitive skills, was given in a 3300 mg daily dose to half of a group of fifty-five dyslexic boys aged 8-13 years, in a 12-week, double-blind, placebo-controlled study. The other half of the subjects received placebo. All subjects met the following criteria: normal intelligence, normal educational opportunities, no severe emotional problems, no neurological handicaps, good physical health, not taking other psychotropic medication, and scoring at least one and one half years below their mental age equivalent on the Gilmore Oral Reading Test. Non-verbal (auditory and visual) and verbal perceptual, and memory skills were examined, and reading, spelling, language and writing abilities were measured using standardized instruments. Compared to the placebo control group, individuals treated with Piracetam did not show statistically significant improvements above their baseline scores on measures of perception, memory, language, reading accuracy or comprehension, or writing accuracy. However, reading speed and numbers of words written in a timed period were significantly enhanced in subjects treated with Piracetam as compared to placebo. Effective reading and writing ability, taking both rate and accuracy into consideration, were also significantly improved in the Piracetam as compared to the placebo treatment group. The medication was well-tolerated and medical examinations showed no significant adverse reactions. These results encourage further study of Piracetam to determine more precisely the mechanism of action by which specific cognitive skills are affected. PMID- 3522510 TI - The effect of piracetam on short- and long-term verbal retrieval in dyslexic boys. AB - Studies of 60 dyslexic boys age 8-14, carefully selected for exclusion of intellectual, sensory, psychiatric and neurological impairment and educational deprivation, were conducted to determine the efficacy of Piracetam, over a 12 week period, in improving reading and other related skills. There were no changes at the end of 12 weeks to distinguish the groups in accuracy or comprehension of prose-reading. Short-term memory gains, however, were recorded for the treated group on two different tests, digit span, and a test (Neimark) of immediate and delayed recall. The mean digit span scaled score for the entire group was one S.D. below their mean IQ. Considering only the performance of children whose digit span scaled scores were one S.D. or below the mean (7 or less), the treated group made a significant gain at the end of 12 weeks. On the Neimark test the treated group was significantly superior to the untreated group on first trial learning and they also lost significantly fewer object names after a delay. Improved retrieval from long-term storage could be demonstrated for the treated group on the rapid automatized naming test. Although there was no significant difference between the group at screening, the treated group was significantly faster on letter naming at the end of the drug trial. The treated group also improved their single word reading on the WRAT. PMID- 3522511 TI - How accurately do pregnant adolescents estimate their weight prior to pregnancy? AB - An accurate determination of maternal prepregnancy weight (PPW) is critical because it is used to calculate weight gain during pregnancy and is one of the best correlates of infant birthweight. The PPW recorded in the prenatal record is usually obtained as part of the patient's history. This study compares PPWs reported by a group of 76 adolescent women (stated weight) with actual weights taken and recorded in medical and school health records by health professionals prior to conception. Simple correlations and a linear regression were used for data analysis. A highly significant correlation (0.98) was found between the stated and actual PPW. Overweight girls tended to underestimate their PPW. These findings suggest that the PPW estimates by adolescents with an identifiable source of medical care are accurate enough to be used to estimate weight gain during pregnancy. PMID- 3522512 TI - Rudimentary uterine horn with adenomyosis and pelvic endometriosis in a 23-year old girl. AB - A case of rudimentary uterine horn with adenomyosis and pelvic endometriosis in a 23-year-old girl is presented. The association of endometriosis and uterine anomalies is discussed. The difficulty in the management of adenomyosis in adolescence is stressed. PMID- 3522513 TI - Amended insulin:glucose ratio. PMID- 3522514 TI - B-mode ultrasonography of the bovine udder and teat. AB - The udders and teats of cows were examined by brightness mode (B-mode) ultrasonography. A 5-MHz linear array transducer and a 5-MHz or 10-MHz mechanical sector transducer were used in the examinations. In lactating animals, the teat sinus, gland sinus, and lactiferous ducts were imaged easily. The scans also allowed visualization of the layers of the teat wall. The annular fold and the folding of the mucosa at the junction of the teat sinus and the papillary duct were seen best with the 5-MHz and 10-MHz mechanical sector transducers. In one cow lacking milk flow from one quarter, a mass at the junction of the papillary duct and the teat sinus was observed ultrasonographically. Surgical removal of the mass resulted in a return of milk flow from that quarter. PMID- 3522515 TI - Lack of correlation between fertility and sperm numbers in male rats treated with histrelin, a potent LHRH agonist. AB - Adult male rats were treated daily for up to 8 weeks with histrelin, [(ImBzl)-D His6, Pro9-NEt]LHRH, to study the antifertility effects of this LHRH agonist. Although serum testosterone concentrations and testicular sperm numbers were significantly decreased by weeks 2 and 4 respectively, a reduction in fertility, as judged by the mean number of fetuses per mated female, was not observed until the sixth week of treatment. Furthermore, the number of spermatozoa in the cauda epididymidis of treated rats did not decrease below initial control levels at any time during the study and full fertility returned within 4 weeks after histrelin treatment was stopped. Thus, the lack of correlation between fertility and testicular and epididymal sperm numbers suggests that the antifertility effects of LHRH agonists are not due solely to reduced sperm numbers, but also result from androgen deficiency. PMID- 3522516 TI - Alpha-glucosidase as a specific epididymal enzyme marker. Its validity for the etiologic diagnosis of azoospermia. AB - Azoospermic semen was obtained from 39 vasectomized men and 93 patients consulting for infertility. The latter underwent bioclinical investigations including measurement of plasma FSH and testicular biopsies. Carnitine content and alpha-glucosidase activity in semen samples were measured. The activity of alpha-glucosidase was determined systematically by a semiquantitative microtechnique and was verified by a spectrophotometric assay. A positive correlation was observed between carnitine and alpha-glucosidase activity. Both parameters were severely diminished in semen from the vasectomized men and the patients suffering from a complete obstruction of the genital tract. Enzyme activity was the most discriminant parameter in terms of sensitivity and specificity. The measurement of alpha-glucosidase in semen is a simple and sensitive method for determining the origin of azoospermia when used in conjunction with assays for plasma FSH. PMID- 3522517 TI - High-resolution scanning-electron microscopy of stereocilia using the osmium thiocarbohydrazide coating technique. AB - Further observations on the detailed morphology of stereocilia have been made using high-resolution scanning-electron microscopy of osmium-thiocarbohydrazide coated guinea pig cochleae. Three types of cross-link have been observed between stereocilia. Side-to-side and row-to-row linkages are composed of a filamentous network whilst upward-pointing links are a fine single strand, often with a terminal widening. The stereocilia have rough surfaces. These features are observed on both inner and outer hair cells despite reported sensitivity to long periods of osmium fixation. We suggest that osmium sensitivity may be altered by the buffering conditions used during preparation. The observations on osmium coated material correspond more closely with those made using transmission electron microscopy than those made using other scanning-electron microscopical preparation techniques, since gold-coating artefacts are absent and the degree of specimen collapse is less. This has enabled us to observe fine details of the links and their attachments which have not been reported previously in SEM. PMID- 3522519 TI - Use of chlortetracycline for treatment of new feedlot cattle. AB - Two 56-d shipping fever trials of similar design were conducted the same season (fall) at Kansas State University (KSU) and at Purdue University (PU) to compare various levels of chlortetracycline (0 or 350 mg X head-1 X d-1 continuously or 1, 2 or 4 g X head-1 X d-1 for the first 14 d). Weanling crossbred steer calves were utilized (210 head of Angus X Simmental, averaging 197 kg, at KSU; 268 head of Angus X Hereford, averaging 192 kg, at PU). For the first 28 d in the KSU trial (October 13 to December 8), cattle that received 4 g X head-1 X d-1 the first 14 d gained more rapidly (P less than .05) than cattle fed 350 mg X head-1 X d-1 continuously or than the controls that received no chlortetracycline (CTC; 1.05 vs .92 or .93 kg/d, respectively). Cattle that received 4 g CTC X head-1 X d 1 for the first 14 d required less (P less than .05) dry matter per kg gain than steers that received 350 mg X head-1 X d-1 continuously over the 56-d period. In the PU trial (October 6 through December 1), all CTC treatments resulted in increased feed efficiency (P less than .05) over the controls through 28 d, and the 4 g X head-1 d-1 for 14 d and 350 mg X head-1 X d-1 continuously, improved feed efficiency over the other groups for the 56-d period.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3522518 TI - Women's health from a woman's point of view: a review of the literature. PMID- 3522520 TI - Effects of intermittent injections of LHRH on specific binding of 125I-labeled gonadotropins to granulosa and theca, and concentrations of steroids in serum and ovarian follicles during postpartum anovulation in suckled beef cows. AB - To examine ovarian follicular response to low-dose injections of luteinizing hormone-releasing hormone (LHRH), 32 anovulatory, suckled beef cows were allotted to one of four treatment groups and injected with either saline or 500 ng LHRH every 2 h for 48 or 96 h, starting 21.4 +/- .4 d after parturition. Two hours after the last injection of LHRH, cows were ovariectomized and 10 to 15 ovarian follicles per pair of ovaries were removed and categorized by diameter as small (1.0 to 3.9 mm), medium (4.0 to 7.9 mm) or large (greater than or equal to 8.0 mm). Injections of LHRH did not affect (P greater than .10) steroid levels in small follicles or numbers of gonadotropin receptors in small and medium follicles. Concentrations of progesterone in fluid of medium follicles increased 1.5-fold (P less than .05) after 96 h of LHRH, whereas concentrations of estradiol and androstenedione were unchanged. In fluid of large follicles, concentrations of progesterone were fourfold greater (P less than .05) in LHRH treated than in control cows at 48 h, but by 96 h progesterone was twofold greater (P less than .05) in control than LHRH-treated cows. In large follicles, concentrations of estradiol were unchanged (P greater than .10) after 48 h of LHRH injections but after 96 h estradiol was twofold greater (P less than .05) in LHRH-treated than control cows. Increased concentrations of estradiol in large follicles coincided with increased numbers of binding sites for human chorionic gonadotropin (hCG) but not follicle stimulating hormone (FSH) in granulosa and theca.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3522521 TI - Effects of pulsatile injection of GnRH into 6- to 14-wk-old Holstein bulls. AB - With the goal of hastening puberty, we evaluated the effects of dose of gonadotropin releasing hormone (GnRH) during pulsatile injection on luteinizing hormone (LH) secretion in bulls 6, 10 or 14 wk old, and of pulsatile administration of GnRH every 2 h to bulls from 6 to 12 wk of age on reproductive development. Based on response to the last three of 12 bihourly injections of 20, 200 or 2,000 ng GnRH/kg, only the two higher doses of GnRH induced secretion of LH at 6 wk. At all ages, 200 ng GnRH/kg induced maximal discharges of LH. Based on comparisons between seven treated bulls and their identical twins, bihourly injections of GnRH starting on d 42 elicited discharge of LH for less than or equal to 4 d in progeny of one sire and greater than 28 d but less than 42 d in progeny of another sire. After 14 d of treatment, both elicited and spontaneous discharges of LH were smaller in all treated bulls. Within 2 d after cessation of GnRH injections on d 84, LH discharges were similar in frequency and amplitude in treated and control twins. Testicular and body growth were similar in treated and control bulls, but puberty was delayed (P less than .05) in bulls in which exogenous GnRH suppressed endogenous discharges of LH. PMID- 3522522 TI - A laboratory microcosm (artificial mouth) for the culture and continuous pH measurement of oral bacteria on surfaces. AB - A laboratory microcosm has been designed for the cultivation of bacteria on surfaces subjected to an adjustable supply of fluids. Bacteria are grown as a microbial film on halved premolar teeth, mounted back to back. Synthetic saliva is dropped slowly over the teeth throughout experiments. A nutrient supplement is provided at regular intervals. The drops of fluid retained by the teeth can be sampled for metabolic end-products. Alternatively, a miniature glass electrode may be set into one half of a tooth assembly to monitor the pH continuously at the stagnation site between tooth segments. Up to six replicate culture flasks and six electrodes can be accommodated in a single experiment. Satisfactory electrode performance was maintained during 66 h experiments. In initial 48 h experiments, teeth were inoculated with Streptococcus rattus BHT or 'Streptococcus mitior' LPA-1 in pure culture and provided with 1% (w/v) glucose for 1 h every 6 h. Bacteria produced typical responses to glucose feeds leading to the formation of 'Stephan'-like curves of pH-fall. Under these conditions, 'Strep. mitior' was more acidogenic than Strep. rattus and the pattern of acid production was distinct for each organism. PMID- 3522523 TI - Submicroscopical changes in Klebsiella pneumoniae cells treated with concentrated sucrose and polyethylene glycol 400 solutions. AB - This study reports the extent and character of plasmolysis and other morphological changes as shown by electron microscopy in a strain of Klebsiella pneumoniae and with sucrose or polyethylene glycol 400 (PEG-400) as the plasmolysing agent at a water activity of 0.935. Both solutes produced severe plasmolysis in K. pneumoniae cells; PEG-400 also caused some cell wall collapse and finger like extrusions to emerge from the bacterial cell. PMID- 3522524 TI - The destruction of Salmonella typhimurium in chicken exudate by different freeze thaw treatments. AB - Antibacterial treatments for frozen poultry, including holding at -5 degrees C and slow thawing at 4 degrees C to which exponential phase cells of Salmonella typhimurium were susceptible, were found to be relatively ineffective against stationary phase cells. Exposure of the latter, however, to a pre-freezing triple stress treatment of cold-shock exposure at 5 degrees C to a solution containing 5 mg/l of free available chlorine in 1% succinic acid (pH 2.5) for 20 min substantially lowered the resistance of the cells to subsequent freezing, storage and thawing in poultry flesh exudate. Cell survival was further decreased by storage of exudate at -18 degrees C for 28 d and this reduced the proportion of stationary phase cells to less than 1% of initial numbers, with a concomitant increase in sensitivity to deoxycholate. Such a combined pre-treatment may have practical potential for salmonella decontamination in the production of frozen poultry. PMID- 3522525 TI - Selection of pH buffers for use in conductimetric microbiological assays. AB - Many metabolic activities of micro-organisms lead to changes in the pH value of cultures and consequently pH buffer compounds are potentially a major source of conductivity changes in cultures. To maximize changes in conductivity associated with microbial growth the pH buffer-associated changes should occur in a direction that reinforces those due to other metabolic activities. In agreement with this, studies with Escherichia coli showed that fermentation of glucose and aerobic growth on L-alanine yielded greater changes in the conductivity of media containing Tris(hydroxymethyl)aminomethane or L-histidine buffers than in a medium containing phosphate buffer, whereas aerobic growth on glucose or succinate yielded greater changes with phosphate buffer than with Tris(hydroxymethyl)aminomethane or L-histidine buffers. Criteria for the selection of appropriate pH buffer compounds are presented. PMID- 3522526 TI - Identification and distribution of Pseudomonas stutzeri in clinical material. AB - During the 19 year period ending December 1984, 114 (2.4%) of 4840 strains of Gram-negative non-fermentative bacteria submitted, mainly by laboratories in the UK, to the National Collection of Type Cultures for computer-assisted identification were strains of Pseudomonas stutzeri. These figures suggest that Ps. stutzeri is a relatively uncommon species in clinical material in the UK but that when it does occur laboratories have difficulty in identifying it. The sources from which the strains were isolated and also characteristics of the species by which it may be recognized are reported. The clinical significance of Ps. stutzeri is discussed and also the susceptibility of this species to antimicrobial agents. PMID- 3522527 TI - Rapid enzymatic method for measurement of serum flucytosine levels. AB - Creatinine iminohydrolase (EC 3.5.4.21) quantitatively releases ammonia from flucytosine (5FC) as well as from creatinine. Using 39 sera from eight patients receiving the combination of amphotericin B with 5FC, we demonstrated that this rapid enzymatic reaction provides a valid measure of 5FC levels. The correlation coefficients (r), comparing this method with 5FC bioassay and high-pressure liquid chromatography measurements, were 0.78 and 0.87, respectively. This technique offers a precise alternative to the currently employed methods of measuring 5FC levels. In contrast to other methods, this enzymatic technique is rapid, simple, inexpensive, and has the potential for widespread availability. PMID- 3522528 TI - Prophylactic Timentin in patients undergoing thoracic or vascular surgery. AB - Timentin (ticarcillin + clavulanic acid) and cefamandole were compared in 484 patients undergoing elective thoracic or vascular surgery. Two hundred and forty eight patients received three 3 g/200 mg injections of Timentin and 236 patients received three 0.75 g injections of cefamandole. The patients were evaluated at discharge. Among the 248 patients given Timentin, only six (2.4%) had a post operative infection, while nine (3.8%) of the 236 patients given cefamandole had a post-operative infection. There was no statistically significant difference between the two treatment regimes. This comparative study shows that Timentin may be used for antibiotic prophylaxis of clean vascular or thoracic surgery. PMID- 3522529 TI - A randomized trial of Timentin and tobramycin versus piperacillin and tobramycin in febrile neutropenic patients. AB - The efficacy of ticarcillin and clavulanic acid (Timentin) was assessed in a regimen combined with tobramycin in febrile episodes in neutropenic patients. After randomization, 151 patients were assessable following treatment with either Timentin and tobramycin or piperacillin and tobramycin. The overall success rate was 70% in the Timentin and tobramycin group and 71% when piperacillin and tobramycin were given: when no infection could be demonstrated efficacy was 73% in the Timentin group, 65% when only clinical or radiological evidence of infection was present and 63% with conclusive microbiology. The figures in the groups treated with the piperacillin-containing regimen were 83%, 79%, and 50% respectively. There was no significant difference between the treatment groups. In septicaemic patients, the Timentin regimen was effective in 55% of cases, while the piperacillin group was successful in 40%. Timentin is a useful addition to the agents suitable for the treatment of febrile neutropenic patients. PMID- 3522530 TI - A comparison of agar dilution, identification of beta-lactamases and disc diffusion methods for assessing the sensitivity to ticarcillin-clavulanic acid. AB - The in-vitro antibacterial activity of Timentin has been evaluated with a view to proposing valid criteria for sensitivity and resistance. Minimal inhibitory concentrations (MIC) were determined for 284 strains including Enterobacteriaceae, Pseudomonas aeruginosa, Acinetobacter spp., staphylococci and enterococci. The same strains were also used for the determination of inhibition zones around discs containing 75 micrograms ticarcillin and 10 micrograms clavulanic acid, and a straight regression line was drawn correlating MIC with inhibition zones. The bacterial population was subsequently grouped according to the diameters of inhibition zones of the antibiogram for 2427 strains of Enterobacteriaceae classified by phenotypes. The comparison of MICs of Timentin and ticarcillin for these strains shows that for penicillinase-producing strains, the Timentin MIC is lower than for ticarcillin whereas cephalosporinase-producing strains have equal MICs for the two. Finally strains that produce many different beta-lactamases are not affected by the presence of clavulanic acid. These results should make it possible to propose provisional zone diameters for determining sensitivity and resistance to Timentin. PMID- 3522531 TI - Control of larynx during loaded breathing in normal subjects. AB - We examined laryngeal resistance (Rla) in six normal subjects in control and four kinds of loaded breathing: hypercapnia, chest strapping, added external resistance, and inhaled methacholine. Rla was measured with a low-frequency sound methed (Sekizawa et al., J. Appl. Physiol. 55: 591-597, 1983). In control and the four kinds of loaded breathing, changes in Rla were tightly coupled with ventilation and Rla decreased during inspiration and increased during expiration. Hypercapnia and chest strapping significantly decreased Rla in both inspiration and expiration in all subjects. Added external resistance decreased inspiratory Rla in all subjects, but decreased expiratory Rla in three subjects, did not change it in two subjects, and increased it in one subject. Inhaled methacholine increased Rla in both inspiration and expiration in all subjects. The present study suggests that although laryngeal movement is tightly coupled with ventilation, laryngeal aperture may be determined by the complex competition of dilating and constricting mechanisms associated with the activity of the respiratory center and neural reflexes from the airway. PMID- 3522532 TI - Effects of irradiation on endothelial cell-polymorphonuclear leukocyte interactions. AB - Prominent early effects of irradiation include neutrophilic vasculitis and interstitial inflammation. To examine the role of the endothelium in these events, bovine aortic endothelial cells (EC) were irradiated (5 Gy) under ambient conditions followed by measurements of neutrophil chemotaxis toward conditioned media and adherence to EC. Neutrophil chemotactic activity increased at 4, 24, and 72 h in both the sham-treated (4.2 +/- 2.5, 15.2 +/- 4.8, and 20.0 +/- 2.7 microns, respectively) and irradiated EC-conditioned media (5.0 +/- 2.1, 18.7 +/- 4.5, and 24.1 +/- 3.4 microns, respectively), and the difference between them was significant at 72 h. The chemoattractant was trypsin sensitive, heat resistant, and chemotactic. It was not present in the EC sonicate. Adherence of neutrophils to EC that were irradiated 4 h earlier (19.3 +/- 4.2%) increased compared with controls (11.1 +/- 2.4%) and was similar to EC pretreated with zymosan-activated serum (22.0 +/- 4.0%), which is a potent inducer of adherence. Thus, following irradiation, bovine aortic EC have greater neutrophil chemotactic activity in their media and are more adherent to polymorphonuclear leukocytes. PMID- 3522534 TI - Functional myocardial perfusion imaging by digital subtraction coronary arteriography: comparison of contrast decay rates in normal and ischemic myocardium. PMID- 3522533 TI - Effects of induced bronchoconstriction on pulmonary blood flow. AB - Allergic bronchoconstriction may be associated with hemodynamic alterations due to changes in respiratory mechanics (or the associated changes in arterial blood gas composition) or the cardiovascular effects of chemical mediators. In an attempt to differentiate between these two possible mechanisms, we obtained measurements of hemodynamics, respiratory mechanics, and O2 consumption (VO2) in nine asymptomatic adult ragweed asthmatics before and after inhalation challenge with either ragweed extract or methacholine. We measured specific airway conductance (sGaw) by body plethysmography, pleural pressure with an esophageal balloon catheter, pulmonary blood flow (Q) and VO2 by a rebreathing technique, and heart rate. For a similar degree of bronchoconstriction after the two types of challenge (mean +/- SD sGaw 0.06 +/- 0.03 and 0.05 +/- 0.02 cmH2O-1 . s-1, P = NS), mean Q increased by 29 and 29%, and mean VO2 by 33 and 37% 15-20 min after ragweed and methacholine, respectively. Since heart rate did not change, there was a concomitant increase in mean stroke volume by 25 and 35%, respectively (P less than 0.05). The respiratory pleural pressure swings during quiet breathing and the rebreathing maneuver and the work of breathing during rebreathing also increased to a similar degree after the two types of challenge. These observations suggest that, if chemical mediators are released into the circulation during antigen-induced bronchoconstriction, their blood concentrations are too low for appreciable cardiovascular effects. The increase in rebreathing cardiac output during allergic and nonallergic bronchoconstriction is probably due to increases in intrathoracic pressure swings and in the work of breathing. PMID- 3522535 TI - Rickettsial perimyocarditis--a follow-up study. AB - Sera and lymphocytes from a 37-year-old male patient with acute perimyocarditis during a Q-fever endemic were analyzed for antibody and cell-mediated immune reactions and followed up 28 months later. Circulating autoantibodies against myocardial tissue were assessed by indirect immunofluorescence. Cytolysis of vital contracting rat cardiocytes, by antimyolemmal antibodies and complement, and lymphocytotoxicity, with and without the patient's serum, were evaluated and compared with the results obtained in ten patients suffering from Q-fever without perimyocardial involvement and with 40 healthy subjects. Antimyolemmal antibodies (AMLA), a muscle-specific subtype of antisarcolemmal antibodies, were demonstrated by immunofluorescence in the one patient with Q-fever perimyocarditis in titers of up to 1:320 but not in the controls. AMLA induced cytolysis of myocytes in the presence of complement. Both AMLA and cytolytic serum activity could be absorbed in all sera of this patient by using Coxiella burnetii. Only marginal lymphocytotoxicity against heterologous cardiocytes was detected in the early phase and again during the follow-up 2 years later in the Q fever myocarditis patient but not in any of the noncarditic Q-fever cases nor in controls. It is postulated that cross-reacting, complement-fixing, cytolytic autoantibodies against the cardiac myolemma are operative either as a cause of cardiac damage or a consequence, pointing to a secondary immunopathogenesis of chronic Q-fever perimyocarditis. PMID- 3522536 TI - Enzyme immunoassay-based survey of prevalence of gentamicin in serum of marketed swine. AB - Sera from 3182 swine from a national sampling were tested in the gentamicin enzyme immunoassay. Of the sera tested, 6 (0.19%) contained gentamicin. Only 1 serum may have been associated with muscle levels above the tolerance. During the survey, a single analyst processed 300 samples daily. The immunoassay survey was an effective and economical method of obtaining information on the prevalence of a residue. PMID- 3522537 TI - Enumeration of total bacteria and coliforms in milk by dry rehydratable film methods: collaborative study. AB - Eleven laboratories participated in a collaborative study to compare the dry rehydratable film (Petrifilm SM and Petrifilm VRB) methods, respectively, to the standard plate count (SPC) and violet red bile agar (VRBA) standard methods for estimation of total bacteria and coliform counts in raw and homogenized pasteurized milk. Each laboratory analyzed 16 samples (8 different samples in blind duplicate) for total count by both the SPC and Petrifilm SM methods. A second set of 16 samples was analyzed by the VRBA and Petrifilm VRB methods. The repeatability standard deviations (the square root of the between-replicates variance) of the SPC, Petrifilm SM, VRBA, and Petrifilm VRB methods were 0.05104, 0.0444, 0.14606, and 0.13806, respectively; the reproducibility standard deviations were 0.7197, 0.06380, 0.15326, and 0.13806, respectively. The difference between the mean log10 SPC and the mean log10 Petrifilm SM results was 0.027. For the VRBA and Petrifilm VRB methods, the mean log10 difference was 0.013. These results generally indicate the suitability of the dry rehydratable film methods as alternatives to the SPC and VRBA methods for milk samples. The methods have been adopted official first action. PMID- 3522538 TI - DNA colony hybridization method using synthetic oligonucleotides to detect enterotoxigenic Escherichia coli: collaborative study. AB - The genes that encode several of the enterotoxins produced by Escherichia coli have been cloned by recombinant DNA techniques. When the nucleotide sequence of these genes is determined, defined sequence oligonucleotides that include a part of these genes may be synthesized. A 22-base DNA hybridization probe was produced for each of 2 heat-stable E. coli enterotoxin (ST) genes: STH, from strains originally isolated from humans; and STP, from strains first found in pigs. For this study, 32P end-labeled DNA probes, sonicated calf thymus DNA, and 3 known and 20 unknown (10 ST-positive and 10 ST-negative) strains were sent to each of 23 collaborators. Cultures were spotted onto an agar-based medium and grown into colonies, which were transferred by blotting to cellulose filters, lysed by alkali and steam, and used for DNA colony hybridization with the ST DNA probes. Strains containing an ST gene were recognized as dark spots on an autoradiogram. Of the 460 samples analyzed, 440 (95.7%) were correctly classified by the collaborators. The method has been adopted official first action. PMID- 3522539 TI - BPA and the debut of Kodachrome. PMID- 3522540 TI - Role and specificity of plasmid RP4-encoded DNA primase in bacterial conjugation. AB - The role of the DNA primase of IncP plasmids was examined with a derivative of RP4 containing Tn7 in the primase gene (pri). The mutant was defective in mediating bacterial conjugation, with the deficiency varying according to the bacterial strains used as donors and recipients. Complementation tests involving recombinant plasmids carrying cloned fragments of RP4 indicated that the primase acts to promote some event in the recipient cell after DNA transfer and that this requirement can be satisfied by plasmid primase made in the donor cell. It is proposed that the enzyme or its products or both are transmitted to the recipient cell during conjugation, and the role of the enzyme in the conjugative processing of RP4 is discussed. Specificity of plasmid primases was assessed with derivatives of RP4 and the IncI1 plasmid ColIb-P9, which is known to encode a DNA primase active in conjugation. When supplied in the donor cell, neither of the primases encoded by these plasmids substituted effectively in the nonhomologous conjugation system. Since ColIb primase provided in the recipient cell acted weakly on transferred RP4 DNA, it is suggested that the specificity of these enzymes reflects their inability to be transmitted via the conjugation apparatus of the nonhomologous plasmid. PMID- 3522541 TI - Characterization of mutational specificity within the lacI gene for a mutD5 mutator strain of Escherichia coli defective in 3'----5' exonuclease (proofreading) activity. AB - The mutD (dnaQ) gene of Escherichia coli codes for the epsilon subunit of the DNA polymerase III holoenzyme which is involved in 3'----5' exonuclease proofreading activity. We determined the mutational specificity of the mutator allele, mutD5, in the lacI gene of E. coli. The mutD5 mutation preferentially produces single base substitutions as judged from the enhanced fraction of lacI nonsense mutations and the spectrum of sequenced dominant lacI (lacId) and constitutive lacO (lacOc) mutations which were predominantly (69/71) single nucleotide substitutions. The distribution of amber lacI and sequenced lacId mutations revealed that transitions occur more frequently than transversions. A . T----G . C and G . C----A . T transitions were equally frequent and, with one major exception, evenly distributed among numerous sites. Among the transversions, A . T----T . A events were the most common, A . T----C . G substitutions were rare, and G . C----C . G changes were not detected. Transversions were unequally distributed among a limited number of sites with obvious hotspots. All 11 sequenced transversions had a consensus neighboring sequence of 5'-C-C-(mutated G or A)-C-3'. Although no large deletions or complex mutational events were recovered, sequencing revealed that mutD5 induced single nucleotide deletions within consecutive G X C sequences. An extraordinary A . T----G . C transition hotspot occurred at nucleotide position +6 in the lac operator region; the mutD5 mutation frequency of this single base pair was calculated to be 1.2 X 10(-3). PMID- 3522542 TI - Role of apparent membrane growth initiation sites during photosynthetic membrane development in synchronously dividing Rhodopseudomonas sphaeroides. AB - Sites of intracytoplasmic membrane growth and temporal relations in the assembly of photosynthetic units were examined in synchronously dividing Rhodopseudomonas sphaeroides cells. After rate-zone sedimentation of cell-free extracts, apparent sites of initiation of intracytoplasmic membrane growth formed an upper pigmented band that sedimented more slowly than the intracytoplasmic membrane-derived chromatophore fraction. Throughout the cell cycle, the levels of the peripheral B800-850 light-harvesting pigment-protein complex relative to those of the core B875 complex in the upper pigmented fraction were only about half those of chromatophores. Pulse-labeling studies with L-[35S]methionine indicated that the rates of assembly of proteins in the upper pigmented fraction were much higher than those of chromatophores throughout the cell cycle; rates for the reaction center polypeptides were estimated to be approximately 3.5-fold higher than in chromatophores when the two membrane fractions were equalized on a protein basis. In pulse-chase studies, radioactivity of the reaction center and B875 polypeptides increased significantly in chromatophores and decreased in the upper pigmented band during cell division. These data suggest that the B875 reaction center cores of the photosynthetic units are inserted preferentially into sites of membrane growth initiation isolated in the upper pigmented band and that the incomplete photosynthetic units are transferred from their sites of assembly into the intracytoplasmic membrane during cell division. These results suggested further that B800-850 is added directly to the intracytoplasmic membrane throughout the cell cycle. PMID- 3522544 TI - Bacteriophage-resistant mutants of Bacillus thuringiensis with decreased virulence in pupae of Hyalophora cecropia. AB - Starting from a crystal-negative parental strain of Bacillus thuringiensis, we isolated certain bacteriophage-resistant mutants which showed decreased virulence in pupae of the cecropia moth (Hyalophora cecropia). These strains (class I mutants) were highly pleiotropic and showed resistance to seven or eight different phages, sensitivity to methicillin, and loss of flagella. They were also more sensitive to cecropia immune hemolymph in vitro. In addition, the export of at least three proteins was reduced. Revertants (class II mutants) were sensitive to phages, virulent, and resistant to penicillin derivatives. One class II mutant was a complete revertant in all properties examined. The other class II mutant was an incomplete revertant still susceptible to immune hemolymph and with repressed export of proteins. Virulence was not coupled to phage resistance as such or to lack of flagella because other mutants affected in these properties were virulent. Other factors which could be excluded as causes of virulence were production of extracellular protease and hemolysin. PMID- 3522543 TI - Effects of signal sequence mutations on the kinetics of alkaline phosphatase export to the periplasm in Escherichia coli. AB - We isolated a collection of mutants defective in the export of alkaline phosphatase to the periplasm. Two classes of mutants were obtained: one class with lesions unlinked to the phoA gene and a second class harboring linked mutations. Among the former class, one mutant is cold sensitive for growth and may be defective in a component of the Escherichia coli secretory apparatus. Included in the latter class are 47 mutants which are characterized in detail in this report. To facilitate DNA sequence analysis of these mutants, we devised a convenient method that relies on homologous recombination in vivo to transfer phoA mutations from the bacterial chromosome directly onto the genome of a single stranded M13 phage vector. DNA sequence analysis revealed that our collection of mutants comprises six unique mutations, all of which reside in the phoA signal sequence coding region and lend further support to the notion that the length of the hydrophobic core of the signal sequence is crucial for its function in protein export. Kinetic studies showed that in these mutants, the small fraction of alkaline phosphatase which succeeds in reaching a periplasmic location, despite a defective signal sequence, is translocated across the membrane in a slow, posttranslational fashion. PMID- 3522545 TI - Expression of the unassembled capsid protein during infection of Shigella sonnei by bacteriophage T7 results in DNA damage that is repairable by bacteriophage T3, but not T7, DNA ligase. AB - The abortive infection of bacteriophage T7 in Shigella sonnei D2 371-48 is characterized by a premature inhibition of phage DNA replication and nucleolytic breakdown of all phage DNA. Mutations in T7 gene 10 which are recessive to the presence of the wild-type allele can alleviate the restriction of phage growth. Phage T3 productively infects S. sonnei D2 371-48, as does a T7-T3 hybrid phage that contains, in particular, a gene 10 of T7 origin. It is the presence of T3 DNA ligase that allows phage growth on S. sonnei D2 371-48, and this enzyme can also rescue wild-type T7 from the abortive infection. T7+ is therefore functionally ligase deficient during the infection of S. sonnei D2 371-48; this deficiency is a result of the expression of the phage capsid protein, but it is independent of the assembly of the protein into a procapsid or other morphogenetic structure. PMID- 3522546 TI - Intracellular Trp repressor levels in Escherichia coli. AB - A radioimmunoassay for the Trp repressor protein of Escherichia coli was developed with antisera raised against purified Trp repressor protein. This assay was used to directly measure the intracellular Trp repressor content in several E. coli K-12 and B/r strains. Repressor levels varied from 2.5- to 3-fold in response to L-tryptophan concentration in the growth medium (15 to 44 ng of repressor per mg of protein). Neither cell growth rate nor culture age had a significant effect on repressor concentrations within the cell. Addition of L tryptophan to the growth medium resulted in lowered intracellular levels of Trp repressor. The absolute amounts of native Trp repressor molecules per cell varied between 120 and 375 dimers in the presence and absence of L-tryptophan in the culture medium, respectively. Assuming an intracellular volume of 7.3 microliters/10(10) E. coli cells, the Trp repressor concentration varied from 270 to 850 nM in response to extracellular tryptophan levels. These findings represent the first direct measurements of Trp repressor levels in E. coli and confirm the autoregulatory nature of the trpR gene. PMID- 3522547 TI - Molecular cloning, DNA sequencing, and enzymatic analyses of two Escherichia coli pyruvate oxidase mutants defective in activation by lipids. AB - Two Escherichia coli pyruvate oxidase (EC 1.2.2.2) mutant genes, poxB3 and poxB4, were cloned on plasmid pBR322. The poxB3 mutant oxidase which was described previously (Y. Y. Chang and J. E. Cronan, Jr., Proc. Natl. Acad. Sci. USA 81:4348 4352, 1984) was deficient in lipid activation but retained full catalytic activity. The poxB3 mutation was located in the C-terminal half of the gene, and the nucleotide alteration has been determined by DNA sequencing of this part of the gene and by comparing the sequence with that of the wild-type strain (C. Grabau and J. E. Cronan, Jr., submitted for publication). The poxB3 oxidase mutation is the substitution of a serine residue for Pro-536. poxB4, another pyruvate oxidase mutant gene, was also deficient in lipid activation. The major difference between the poxB3 and poxB4 oxidase was in the binding of Triton detergents. The poxB4 mutation was also located in the C-terminal half of the gene, and sequence analysis has shown that only one nucleotide base was altered, which resulted in Ala-467 being converted to a threonine residue. The results of the amino acid substitutions in the mutant proteins, leading to the functional alteration of the enzyme, are discussed. PMID- 3522548 TI - Synthesis of linear plasmid multimers in Escherichia coli K-12. AB - Linear plasmid multimers were identified in extracts of recB21 recC22 strains containing derivatives of the ColE1-type plasmids pACYC184 and pBR322. A mutation in sbcB increases the proportion of plasmid DNA as linear multimers. A model to explain this is based on proposed roles of RecBC enzyme and SbcB enzyme (DNA exonuclease I) in preventing two types of rolling-circle DNA synthesis. Support for this hypothesis was obtained by derepressing synthesis of an inhibitor of RecBC enzyme and observing a difference in control of linear multimer synthesis and monomer circle replication. Reinitiation of rolling-circle DNA synthesis was proposed to occur by recA+-dependent and recA+-independent recombination events involving linear multimers. The presence of linear plasmid multimers in recB and recC mutants sheds new light on plasmid recombination frequencies in various mutant strains. PMID- 3522549 TI - Cloning, mapping, and sequencing of plasmid R100 traM and finP genes. AB - The fertility control gene finP, the transfer gene traM, and the transfer origin, oriT, of plasmid R100 were isolated on a single 1.2-kilobase EcoRV fragment and were then subcloned as HaeIII fragments. The sequence of the 754-base-pair finP containing fragment is reported here. In addition to the finP gene, the sequence includes all but two bases of the R100 traM open reading frame and apparently all of the leader mRNA sequence and amino end of the traJ gene of R100. The sequence contains two open reading frames which encode small proteins on the opposite strand from the traM and traJ genes. It also shows two sets of inverted repeats that have the characteristics of transcription terminators. One set is positioned as if it was the traM terminator, and the other set, which is downstream from the first, sits in the middle of the leader mRNA sequence for traJ. On the bottom strand, this inverted repeat has the structure of a rho-independent terminator. Other less-stable inverted repeats overlap this second terminator in the same way as is seen in attenuation sequences, and the two separate small open reading frames on the bottom strand also totally overlap the stem of the rho-independent terminator, suggesting that their translation would cause shifting of termination to the bottom strand homolog of the putative traM terminator. The finP gene product was not identified, but the gene was mapped to the sequence which contains the traJ gene. It either overlaps traJ or is antisense to it. PMID- 3522550 TI - Effects of salts on the lethality of paraquat. AB - Escherichia coli suffered 95 to 100% lethality when exposed to 1.0 mM paraquat for 30 min at 37 degrees C in aerobic nutrient broth medium but did not lose viability when the exposure was done in Vogel Bonner or tryptic soy yeast extract medium. Paraquat was, however, bacteriostatic in all of these media. Salts, added to the nutrient broth medium, protected against the lethality of paraquat, whereas sucrose did not. Salts of divalent cations were much more effective than salts of monovalent cations. Paraquat increases cyanide-resistant respiration by E. coli; salts added before, but not after, the paraquat diminished this effect. 2,4-Dinitrophenol similarly decreased the cyanide-resistant respiration when added before, but not after, the paraquat. The lethality imposed by paraquat correlated with the rate of cyanide-resistant respiration whether this respiration was modulated by varying salt concentration at a fixed concentration of paraquat or by varying paraquat concentration at a fixed concentration of salt. We conclude that salts or 2,4-dinitrophenol interferes with the active uptake of paraquat by E. coli and thus prevents its lethal effect. The salt concentrations found in a number of commonly used microbiological media are sufficient to exert this effect. PMID- 3522551 TI - Anaerobically induced genes of Escherichia coli. AB - A collection of anaerobically induced gene fusions were isolated, and representative isolates were characterized with respect to their regulatory properties, phenotypes, and approximate map locations. Four fusion strains that had defects in the anaerobic metabolism of asparagine or aspartate were found. These fusions were all repressed by alternate electron acceptors, ammonia, and glucose but were induced by other sugars. Several other fusion strains which demonstrated no observable phenotype showed diverse regulatory responses. The anaerobically induced fusions were scattered around the Escherichia coli chromosome more or less at random, suggesting that all the isolates examined were in separate genes. PMID- 3522552 TI - Cloning, expression, and mapping of the Aeromonas hydrophila aerolysin gene determinant in Escherichia coli K-12. AB - DNA sequences corresponding to the aerolysin gene (aer) of Aeromonas hydrophila AH2 DNA were identified by screening a cosmid gene library for hemolytic and cytotoxic activities. A plasmid containing a 5.8-kilobase EcoRI fragment of A. hydrophila DNA was required for full expression of the hemolytic and cytotoxic phenotype in Escherichia coli K-12. Deletion analysis and transposon mutagenesis allowed us to localize the gene product to 1.4 kilobases of Aeromonas DNA and define flanking DNA regions affecting aerolysin production. The reduced hemolytic activity with plasmids lacking these flanking regions is associated with a temporal delay in the appearance of hemolytic activity and is not a result of a loss of transport functions. The aerolysin gene product was detected as a 54,000 dalton protein in E. coli maxicells harboring aer plasmids and by immunoblotting E. coli whole cells carrying aer plasmids. We suggest that the gene coding aerolysin be designated aerA and that regions downstream and upstream of aerA which modulate its expression and activity be designated aerB and aerC, respectively. PMID- 3522553 TI - Isolation and characterization of the Vibrio cholerae recA gene. AB - A 3.6-kilobase PstI fragment was isolated from a Vibrio cholerae chromosomal DNA library and shown to encode RecA-like activity in complementation studies with Escherichia coli recA mutants. Although DNA hybridization experiments failed to detect any homology between the E. coli and V. cholerae recA genes, hyperimmune antiserum produced against purified E. coli RecA protein recognized epitopes shared by the V. cholerae protein. The V. cholerae chromosomal fragments, when cloned and transferred to E. coli, provided the missing recA functions, including resistance to the alkylating agent methyl methanesulfonate, resistance to UV irradiation, and promotion of homologous recombination in Hfr mating experiments. PMID- 3522554 TI - Role of leader peptide synthesis in tryptophanase operon expression in Escherichia coli K-12. AB - We used site-directed mutagenesis to replace the Escherichia coli tryptophanase (tna) operon leader peptide start codon with AUC. This change greatly decreased the uninduced rate of tna operon expression, and it also lowered the response to inducer. We conclude that leader peptide synthesis plays an essential role in tna operon expression. PMID- 3522555 TI - Genetic and molecular analyses of Escherichia coli N-acetylneuraminate lyase gene. AB - Two plasmids containing the N-acetylneuraminate lyase (NALase) gene (nanA) of Escherichia coli, pNL1 and pNL4, were constructed. Immunoprecipitation analysis indicated that the 35,000-dalton protein encoded in pNL4 was NALase. The synthesis of NALase in E. coli carrying these plasmids was constitutive. PMID- 3522556 TI - Mutant of Salmonella typhimurium LT2 deficient in DNA adenine methylation. AB - A mutant of Salmonella typhimurium LT2 deficient in methylation of the adenine residues in the sequence 5'-GATC-3' was isolated. The mutation (dam-1) was linked to the cysG locus, and the properties of the mutant were similar to those of Escherichia coli dam mutants. Reversion of the hisC3076 frameshift marker by 9 aminoacridine was substantially enhanced by the dam-1 mutation, implying a direct role for adenine methylation in the prevention of frameshift mutation induction. PMID- 3522557 TI - Localization of the exposed N-terminal region of the B800-850 alpha and beta light-harvesting polypeptides on the cytoplasmic surface of Rhodopseudomonas capsulata chromatophores. AB - Proteinase K and trypsin were used to determine the orientation of the light harvesting B800-850 alpha and beta polypeptides within the chromatophores (inside out membrane vesicles) of the mutant strain Y5 of Rhodopseudomonas capsulata. With proteinase K 7 amino acid residues of the B800-850 alpha polypeptide were cleaved off up to position Trp-7--Thr-8 of the N terminus, and 11 residues were cleaved off up to position Leu-11-Ser-12 of the beta chain N terminus. The C termini of the B800-850 alpha and beta polypeptides, including the hydrophobic transmembrane portions, remained intact. It is proposed that the N termini of the alpha and beta subunits, each containing one transmembrane alpha-helical span, are exposed on the cytoplasmic membrane surface and the C termini are exposed to or directed toward the periplasm. PMID- 3522559 TI - Tranylcypromine: patterns and predictors of response. AB - Data on 58 patients with major depressive episodes treated with tranylcypromine in the course of two controlled, 4-week trials were examined for clinical predictors of favorable response and patterns of symptom improvement and side effects. Predictors of positive outcome with tranylcypromine were associated with greater initial severity on the Hamilton Rating Scale for Depression (HAM-D) ratings of depressed mood, psychomotor retardation, and weight loss, and with lower initial severity on ratings of middle and late insomnia. Distinct quality of depressed mood predicted poorer response; endogenicity, as defined by Research Diagnostic Criteria or the Nies-Robinson Diagnostic Index, failed to predict outcome. Analysis of improvement on individual symptom items of the HAM-D and Zung Self-Rating Depression Scale indicated a generalized patholysis except in a few areas such as appetite/weight loss and insomnia, which may reflect specific side effects of tranylcypromine. PMID- 3522558 TI - Phenelzine for chronic depression: a study of continuation treatment. AB - Several controlled studies have demonstrated the efficacy of continuation therapy with tricyclic antidepressants, but little is known about continuation therapy with the monoamine oxidase inhibitors. Moreover, the usefulness of continuation antidepressant therapy in patients with chronic depressive disorders has not been evaluated. This pilot study reports initial results of a double-blind continuation trial of phenelzine or placebo following an initial antidepressant response to phenelzine in 12 patients who met DSM-III criteria for dysthymic disorder. All 7 patients randomized to placebo relapsed, whereas only 1 of the 5 patients who continued to receive phenelzine relapsed. These results suggest that continuation therapy with phenelzine may be useful in maintaining clinical response after acute treatment. PMID- 3522560 TI - A comparison of simulation programs for endodontic review. AB - Computer-Based Instruction (CBI) has been gaining increasing popularity in the health professions and especially in dental education, but its development is seldom problem-free. This paper describes a longitudinal study of endodontic simulations for senior dental students which employ latent image, computer assisted video interactive (CAVI), and computer text instruction (CTI). Particular attention is devoted to developmental problems, use of time and manpower, and student performance on and reaction to the pilot test. Preliminary results of the pilot testing demonstrate favorable student performance on the computer-based mode, as well as an enthusiastic acceptance of this format. Future directions and goals of the study are included. PMID- 3522561 TI - Authoring systems and assumptions about them. AB - More authoring systems are beginning to appear and there is greater consumer interest as microcomputers have become more widely used by less sophisticated users. Better methods are needed for evaluating systems and investigating assumptions regarding their development and use. Suggestion for selecting systems include assessing local needs, establishing familiarity through literature reviews, demonstrations, and hands on experience, applying criteria, and addressing the assumptions which motivate authoring system use. The marketplace and the technology are rapidly changing. For example, system vendors are beginning to adopt marketing efforts which are targeted toward either hardware sales, publishing, or instructional development services, instead of general audiences. Existing systems use traditional programming techniques to create conventional "frame-based" instruction, but more intelligent authoring aids are in the offing Even though the technology is advancing rapidly many of the evaluation methods and measurement problems discussed here can still be presumed to apply. They are probably more stable than the technology. PMID- 3522563 TI - Two-electron reduced mercuric reductase binds Hg(II) to the active site dithiol but does not catalyze Hg(II) reduction. AB - Mercuric reductase contains FAD and a redox-active disulfide which is reduced to a thiol/thiolate pair in two-electron reduced enzyme (EH2) (Fox, B. and Walsh, C.T. (1982) J. Biol. Chem. 257, 2498-2503). A charge transfer interaction between the thiolate and oxidized FAD gives EH2 a characteristic absorption spectrum, very similar to that found with other flavoprotein disulfide oxidoreductases. We have examined the reaction of EH2 with HgCl2 (+/- mercaptoethanol) in stopped flow kinetic and static titration experiments. In the absence of mercaptoethanol, reaction of EH2 with HgCl2 yields a final spectrum which is indistinguishable from that of oxidized enzyme. The nature of the final species was examined by titration of enzyme thiols with 5,5'-dithiobis-2,2'-nitrobenzoic acid under denaturing conditions in the presence of NaI to displace any Hg(II) bound to enzyme thiols. These studies demonstrate that EH2 tightly complexes Hg(II) with its active site thiols, but is incapable of reducing Hg(II) to Hg0. For the latter reaction to occur, additional reducing equivalents are required. In catalysis, the enzyme must first be reduced to EH2 after which it cycles between EH2 and EH2 X NADPH forms. This is in contrast to other flavoprotein disulfide oxidoreductases which cycle between Eox and EH2 forms in catalysis (Williams, C. H., Jr. (1976) in The Enzymes (Boyer, P. D., ed) 3rd Ed., Vol. 13, pp. 89-173, Academic Press, New York). With mercuric reductase, exogenous thiols are required for catalytic reduction of Hg(II) to Hg0. We have shown that this is due to prevention or reversal of formation of an abortive complex of Hg(II) with the thiol/thiolate pair of EH2. PMID- 3522564 TI - Identification and analysis of the maize P700 chlorophyll a apoproteins PSI-A1 and PSI-A2 by high pressure liquid chromatography analysis and partial sequence determination. AB - We recently described a pair of partially homologous maize chloroplast genes, one of which was shown to code for an apoprotein of the P700 chlorophyll a complex of photosystem I (Fish, L.E., Kuck, U., and Bogorad, L. (1985) J. Biol. Chem. 260, 1413-1421). Two chlorophyll-free apoprotein bands from maize chlorophyll-protein complex I (CPI) can be resolved on lithium dodecyl sulfate (LDS)-urea polyacrylamide gels. Proteins in both bands react with antibodies prepared against CPI, but antibodies prepared against two synthetic peptides corresponding to predicted sequences of PSI-A1 react only with the upper band. The presence of products of the two genes, ps1A1 and ps1A2, in CPI was verified by analysis of cyanogen bromide (CNBr) fragments of the lower apoprotein band obtained from LDS urea polyacrylamide gels by reverse-phase high pressure liquid chromatography. Amino-terminal sequencing of five CNBr fragments indicates that the lower band contains a product of the ps1A2 gene. The possibility of extensive processing was investigated because the apparent molecular masses of the maize CPI proteins are about 58-70 kDa on LDS-polyacrylamide gels rather than the predicted sizes of about 83 kDa. Antibodies against a synthetic peptide corresponding to a predicted sequence in PSI-A1 were used to determine that the amino-terminal end of PSI-A1 is intact beyond about position 52. The amino-terminal CNBr fragment of PSI-A2 was identified by sequencing, indicating that the amino-terminal end of PSI-A2 is not processed. The carboxyl-terminal CNBr fragment of PSI-A2 was also identified by sequencing. These results indicate that the PSI-A1 and PSI-A2 polypeptides are not extensively processed, although some processing at the carboxyl-terminal end has not been ruled out. PMID- 3522562 TI - Phospholipid transfer proteins: mechanism of action. AB - Phospholipid transfer proteins are generally localized in the cytosolic fraction of cells and are capable of catalyzing the flux of phospholipid molecules among membranes. Artificial membranes also participate in protein-catalyzed phospholipid movements. In this review the major phospholipid transfer proteins are discussed with respect to their phospholipid substrate specificity and the contributions of membrane physical properties to this process. The phenomenon of net transfer of phospholipids is described. The use of various kinetic approaches to the study of these catalysts is reviewed. A detailed consideration of the distinct phospholipid binding and membrane interaction domains of one phospholipid transfer protein is presented. Finally, some recent applications of phospholipid transfer proteins to the examination of membrane structure and function and further directions for the continued research activity with this class of proteins are summarized. PMID- 3522565 TI - The determination of enzyme-substrate dissociation rates by dynamic isotope exchange enhancement experiments. AB - A new method for the determination of dissociation rates of enzyme-substrate complexes has been developed. The rate of exchange of a labeled product back into the substrate is measured during catalysis of the forward reaction when the forward reaction is kept far from equilibrium by the enzymatic removal of the nonexchanging product. The ratio of the exchange rate and the net rate for product formation is then determined at various concentrations of the exchanging product. A plot of this ratio is a diagnostic indication of the kinetic mechanism and the relative rates of product dissociation from the binary and ternary enzyme complexes. This technique has been applied to the reaction catalyzed by bovine liver argininosuccinate lyase. The ratio for the rate of exchange of fumarate into argininosuccinate and the net rate for product formation was found to increase with the concentration of fumarate but to reach a limit of 3.3. The ratio of rates was half-maximal at 36 mM fumarate. The data have been interpreted to indicate the argininosuccinate lyase has a random kinetic mechanism. The calculated lower limit for the rate of release of arginine from the enzyme fumarate-arginine complex is 0.35 times as fast as the Vmax in the reverse direction. The rate of release of arginine from the enzyme-arginine binary complex is 210 times faster than Vmax in the reverse direction. PMID- 3522566 TI - Reverse reaction of smooth muscle myosin light chain kinase. Formation of ATP from phosphorylated light chain plus ADP. AB - Incubation of smooth muscle phosphorylated heavy meromyosin in the presence of myosin light chain kinase, calmodulin, ADP, and Ca2+ results in a decrease of the protein-bound phosphate. The dephosphorylation is not due to phosphatase activity and is dependent on the presence of ADP and the active ternary myosin light chain kinase complex. Using 32P-labeled phosphorylated 20,000-dalton light chains as the phosphate donor, the formation of ATP from ADP can be demonstrated. This reaction requires the presence of Ca2+, calmodulin, and myosin light chain kinase. These results indicate that myosin light chain kinase can catalyze a reverse reaction and form ATP from ADP and phosphorylated substrate. The rate of the reverse reaction, kcat/KLC approximately 0.21 min-1 microM-1, is considerably slower than the forward reaction under similar conditions and is therefore detectable only at relatively high concentrations of myosin light chain kinase. For the reverse reaction, KmADP is approximately 30 microM and ATP is a competitive inhibitor, KIATP approximately 88 microM. For the forward reaction, measured with both isolated light chains and intact myosin, KmATP is approximately 100 microM and ADP is a competitive inhibitor, KiADP approximately 140 microM (myosin) and 120 microM (light chains). Thus, the affinity of ATP for the forward and reverse reactions is similar, but the affinity of ADP is higher for the reverse reaction. From the light chain dependence of the two reactions, the following was calculated: forward, Km = 5 microM, kcat = 1720 min-1, and reverse, Km = 130 microM, kcat = 27 min-1. In contrast to the data obtained with isolated light chains, it is suggested that, with intact myosin as substrate, the Km term is primarily responsible for determining the rate of the reverse reaction. With light chains phosphorylated at serine 19 and threonine 18, it was shown that both sites act as a phosphate donor, although the reverse reaction for threonine 18 is slower than that for serine 19. PMID- 3522567 TI - Second messenger function of inositol 1,4,5-trisphosphate. Early changes in inositol phosphates, cytosolic Ca2+, and insulin release in carbamylcholine stimulated RINm5F cells. AB - The second messenger function of inositol 1,4,5-trisphosphate (Ins-1,4,5-P3) was investigated in carbamylcholine-stimulated RINm5F cells by analysis of the early changes in inositol phosphates, cytosolic free Ca2+ concentration ([Ca2+]i), and insulin secretion. After a lag of 2 s, [Ca2+]i rose to a peak at 13 +/- 2 s, a response which was due mainly to mobilization from intracellular stores since it persisted even in the absence of extracellular Ca2+. The Ca2+ response had already declined toward prestimulatory levels by the time insulin secretion reached its maximal rate (2-3 min). Although the rises in inositol trisphosphate preceded those of both inositol bisphosphate and monophosphate, all three attained maximal concentrations after 1 min and remained elevated for at least 10 min. The accumulation of inositol trisphosphate was truly Ca2+-independent since it persisted under conditions in which the rise in [Ca2+]i was abolished by prior depletion of intracellular Ca2+ pools. Further analysis by high performance liquid chromatography revealed the presence of the two isomers, Ins-1,4,5-P3 and Ins-1,3,4-P3 in stimulated cells. The latter was virtually absent under nonstimulatory conditions but started to accumulate after a 5-s lag and reached maximal levels after 30 s of stimulation. Ins-1,4,5-P3 doubled within 1 s of carbamylcholine addition, reached a peak after 5 s, and, although declining thereafter, remained slightly elevated for at least 3 min. Hence, both the onset and peak of the rise of Ins-1,4,5-P3 preceded that of [Ca2+]i, which in turn preceded the peak in insulin release. These results strongly suggest that Ins 1,4,5-P3 acts as the second messenger by which carbamylcholine mobilizes intracellular Ca2+ during the initiation of insulin release. PMID- 3522568 TI - Dopamine D1 receptors characterized with [3H]SCH 23390. Solubilization of a guanine nucleotide-sensitive form of the receptor. AB - Dopamine D1 receptors were solubilized from canine and bovine striatal membranes with the detergent digitonin. The receptors retained the pharmacological characteristics of membrane-bound D1 receptors, as assessed by the binding of the selective antagonist [3H]SCH 23390. The binding of [3H]SCH 23390 to solubilized receptor preparations was specific, saturable, and reversible, with a dissociation constant of 5 nM. Dopaminergic antagonists and agonists inhibited [3H]SCH 23390 binding in a stereoselective and concentration-dependent manner with an appropriate rank order of potency for D1 receptors. Moreover, agonist high affinity binding to D1 receptors and its sensitivity to guanine nucleotides was preserved following solubilization, with agonist dissociation constants virtually identical to those observed with membrane-bound receptors. To ascertain the molecular basis for the existence of an agonist-high affinity receptor complex, D1 receptors labeled with [3H] dopamine (agonist) or [3H]SCH 23390 (antagonist) prior to, or following, solubilization were subjected to high pressure liquid steric-exclusion chromatography. All agonist- and antagonist labeled receptor species elute as the same apparent molecular size. Treatment of brain membranes with the guanine nucleotide guanyl-5'-yl imidodiphosphate prior to solubilization prevented the retention of [3H]dopamine but not [3H]SCH 23390 labeled soluble receptors. This suggests that the same guanine nucleotide dopamine D1 receptor complex formed in membranes is stable to solubilization and confers agonist high affinity binding in soluble preparations. These results contrast with those reported on the digitonin-solubilized dopamine D2 receptor, and the molecular mechanism responsible for this difference remains to be elucidated. PMID- 3522569 TI - Characterization of rat liver endosomal fractions. In vivo activation of insulin stimulable receptor kinase in these structures. AB - A protocol employing discontinuous sucrose gradient centrifugation was developed to prepare light mitochondrial (L) and Golgi fraction endosomes from simultaneously prepared parent L and microsomal fractions. As judged by the concentration of labeled hormone postinjection, L intermediate and heavy endosome subfractions were 40- to 175-fold purified and Golgi intermediate and heavy endosome subfractions were 30- to 45-fold purified. On electron microscopy, L endosomal fractions contained a predominance of lipoprotein-filled vesicles and were less heterogeneous than corresponding Golgi endosomal fractions. All endosomal fractions were enriched in receptors for insulin and prolactin but binding sites for the former were more broadly distributed in other subfractions than those for the latter. On Percoll gradient centrifugation, L endosomal fractions yielded one peak (rho 1.057) corresponding to the heavier of two peaks seen in Golgi endosomal fractions. The protein composition of high density L and Golgi endosomes, as assessed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis, was similar. The bulk of marker enzymes assayed did not migrate with the endosomal components. Combined acid phosphatase cytochemistry and electron microscope radioautography established that about 80% of the L endosomes contained no acid phosphatase. By affinity labeling and immunological titration with insulin receptor antibody, insulin receptors were identical in L and Golgi endosomes. Insulin-stimulable receptor kinase was demonstrable in both L and Golgi endosome fractions. Following in vivo insulin administration, the insulin receptor kinase in both L and Golgi endosomes was significantly activated. This activated state was not inhibited by a large excess of antiserum to insulin and thus not due to insulin contaminating the partially purified receptor preparation. These observations are compatible with the maintenance and/or initiation of hormone-dependent phosphorylations intracellularly. PMID- 3522570 TI - Preparation and use of synthetic cell culture surfaces. A new reagent for the covalent immobilization of proteins and glycoproteins on a nonionic inert matrix. AB - To study cell interactions with external molecules immobilized on a chemically defined nonionic, inert matrix, we have prepared flat polyacrylamide matrices containing covalently attached carbohydrate or protein. A new acrylamide derivative, containing a terminal 1,2-dihydroxy group, was synthesized and then copolymerized with acrylamide and bisacrylamide to make 20% polyacrylamide matrices, which could be oxidized with NaIO4 to generate reactive aldehyde groups. Molecules containing a free amine (e.g. proteins or glycopeptides) can be coupled to the aldehyde-activated matrix by formation of a Schiff base and reduction with NaCNBH3 to form a stable -CH2-NH-bond. Unreacted aldehyde groups are reduced to hydroxyl groups with NaBH4. In order to immobilize polysaccharides on the activated surfaces, these molecules are first modified to contain a free amine. We have described a procedure to convert purified hyaluronic acid oligosaccharides to a reactive alkylamine derivative uniquely modified at the reducing end (Raja, R. H., LeBoeuf, R. D., Stone, G. W., and Weigel, P. H. (1984) Anal. Biochem. 139, 168-177). The covalent attachment of [3H]hyaluronate-amine, [14C]ethanolamine, or 125I-bovine serum albumin, to activated surfaces was complete within 5-24 h. The amount immobilized was directly proportional to the amine concentration and to the aldehyde content of the matrix and inversely proportional to the molecular weight of the amine. About 90% of the available aldehyde groups reacted with ethanolamine, whereas less than 0.01% reacted with albumin. Molecules larger than 3300 Da were excluded from the interior of the matrix and could therefore only be attached to the surface of the matrix. These synthetic surfaces can be used in long term culture experiments to study cellular interactions with virtually any type of immobilized molecule. PMID- 3522571 TI - Lipopolysaccharide-mediated induction of RNA polymerase I activity and amount in murine B lymphocytes. AB - The effect of lipopolysaccharide on RNA polymerase I activity in primary cultures of murine B lymphocytes has been examined. In cells treated with mitogen for 48 h, the activity of RNA polymerase I was approximately 15 times greater than in control cells. In situ localization of RNA polymerase I using indirect immunofluorescence indicated that there was at least a 10-fold increase in the amount of this enzyme associated with nucleoli of 48 h mitogen-treated cells relative to control cells. Immunoblotting experiments demonstrated a similar increase in the concentration of the 190-kDa subunit bound to DNA; the concentrations of the other polymerase I-associated polypeptides did not correlate with rRNA synthesis. Assuming 1 mol of the 190-kDa polypeptide/mol of polymerase I, it was estimated that 2,300 and 30,000 molecules of enzyme were associated with rDNA in the unstimulated and stimulated B cell, respectively. Thus, an increased cellular concentration of the 190-kDa subunit of RNA polymerase I and its association with ribosomal DNA may be a crucial step in rRNA synthesis. PMID- 3522572 TI - Isolation and amino acid sequence of cyclophilin. AB - Cyclophilin, a specific cyclosporin A-binding protein has been purified to homogeneity from human spleen and bovine thymus cytosol. Purification of bovine and human cyclophilin was achieved by large scale molecular filtrations, Matrex Blue A affinity chromatography, preparative isoelectric focusing, phenyl Sepharose chromatography, and weak cation exchange high performance liquid chromatography. Major and minor bovine and human cyclophilin isoforms were identified and found to have an apparent molecular weight of 17,000 and very similar amino acid compositions. The complete amino acid sequence of the major bovine cyclophilin isoform (163 residues, Mr 17,737) was determined from analysis of peptides derived by endoproteinase lysine C and cyanogen bromide cleavage and an NH2-terminal sequence of the intact protein. The first 72 NH2-terminal residues of the major human cyclophilin isoform were also determined and found to be identical to bovine cyclophilin. A computer search of cyclophilin with the National Biomedical Research Foundation database (3,182 protein sequences) did not detect any significant homologies. Cyclophilin represents a new class of abundant, highly conserved cytosolic proteins that probably play an important role in the regulation of T lymphocyte activation and proliferation. PMID- 3522573 TI - Isozymes of phosphorylase kinase in rabbit skeletal muscle. Functional implications of differences in phosphorylase kinase and phosphorylase activities in individual muscle fibers. AB - Immunological and microanalytical methods were used to investigate the two isozymes of phosphorylase kinase, enzyme w and enzyme r, in psoas major and tibialis anterior muscles. Peptide mapping experiments indicated that the alpha subunit of enzyme w and alpha' subunit of enzyme r were structurally very similar. Both subunits were completely immunoprecipitated from muscle extracts with an antibody specific for the beta subunit of the kinase, indicating that alpha and alpha' subunits are completely assembled with beta subunits in adult muscle fibers. The relative amounts of enzymes w and r in single fibers were determined from amounts of alpha and alpha' subunits, which were detected by immunoblotting. Phosphorylase kinase and phosphorylase activities were measured in the same fibers, as well as in individual fibers from diaphragm and soleus muscles. Slow oxidative fibers were found to contain low levels of enzyme r, but almost no enzyme w. Considerably more enzyme r was present in fast oxidative glycolytic fibers. Fast glycolytic fibers contained the most enzyme w, and the highest levels of enzyme r were found in a subgroup of such fibers. Interestingly, more than half of the fast glycolytic fibers analyzed contained both isozymes. In these fibers phosphorylase was positively correlated with enzyme w, but negatively correlated with enzyme r. Total kinase activity ranged 30-fold from the highest in one of the psoas fibers to the lowest in one of the soleus fibers and was closely correlated with the phosphorylase levels. In psoas and soleus fibers, calculated absolute maximal rates for phosphorylase b to a conversion varied almost 2,500-fold. PMID- 3522574 TI - Insulin provokes a transient activation of phospholipase C in the rat epididymal fat pad. AB - Insulin is known to increase the de novo synthesis of inositol phospholipids in rat epididymal fat pads. We presently examined the effects of insulin on the hydrolysis of inositol phospholipids in this tissue. Relatively small (30-40%) but significant increases in inositol phosphates (mono-, di-, and tri-) were apparent within 30-60 s of insulin treatment in fat pads (and adipocytes); thereafter, inositol phosphates returned to control levels. These rapid insulin induced increases in inositol phosphates appeared to be due to phospholipase C mediated hydrolysis of inositol phospholipids, since there were associated transient decreases in these lipids during 32P pulse-chase experiments. Increases in the synthesis of inositol phospholipids were also apparent within a few minutes of insulin treatment and persisted for at least 2 h. We conclude that, in the rat epididymal fat pad, insulin has two phospholipid effects, viz. a transient activation of phospholipase C, and a persistent increase in de novo phospholipid synthesis. PMID- 3522575 TI - Different interactions used by Cro repressor in specific and nonspecific DNA binding. AB - The mode of interaction of Cro repressor with specific and nonspecific sites on DNA was explored by chemical modification and protection of lysine and tyrosine residues. Cro has 8 lysines. In the presence of DNA, lysines 32 and 56 are fully protected and lysines 21, 62, and 63 are partially protected from alkylation. However, the terminal amino group and lysines 8, 18, and 39 are not protected. Location of the protected and unprotected lysines on the three-dimensional Cro structure defines a DNA-binding region. The results provide direct experimental support for a mode of interaction between Cro and DNA, in which Cro buries its 2 fold related alpha-helices in consecutive DNA major grooves (Anderson, W. F., Ohlendorf, D. H., Takeda, Y., and Matthews, B. W. (1981) Nature 290, 754-758; Ohlendorf, D. H., Anderson, W. F., Fisher, R. G., Takeda, Y., and Matthews, B. W. (1982) Nature 298, 718-723). In the model, the carboxyl-terminal part of Cro was tentatively presumed to interact with the DNA minor groove. Protection of lysines 62 and 63 confirms the involvement of the carboxyl terminus in DNA binding. Although nonspecific and specific DNA protect the same lysine residues, there are differences in the nature of the interaction of Cro with nonspecific and specific DNA. Cro-nonspecific DNA interaction is salt-sensitive, suggesting that the interaction is predominantly electrostatic. On the other hand, Cro-specific DNA interaction is salt-resistant, suggesting that the interaction may include nonelectrostatic components (hydrogen bonds and hydrophobic interactions) as well. Protection experiments of tyrosine residues (against iodination) suggest that the conformation of Cro repressor changes in two stages: first, when Cro binds at nonspecific sites, and, second, when Cro binds to specific sites on DNA. PMID- 3522576 TI - Reaction of neutral endopeptidase 24.11 (enkephalinase) with arginine reagents. AB - The effect of the arginine-specific reagents phenylglyoxal and butanedione on the activity of neutral endopeptidase 24.11 ("enkephalinase") was determined. Inactivation of the enzyme by butanedione is completely protected by methionine enkephalin, but only partially protected by methionine-enkephalinamide. In contrast, phenylglyoxal inactivation of the enzyme exhibits saturation kinetics with a Kd of 20 mM. The enzyme is only partially protected against phenylglyoxal inactivation by both methionine-enkephalin and its amide, indicating that phenylglyoxal reacts at two sites. Reaction of the enzyme with phenylglyoxal in the presence of saturating methionine-enkephalin involves the direct reaction of the reagent with the enzyme-substrate complex. Enzyme treated with butanedione or with phenylglyoxal (at site 1) exhibits a 3-5 decrease in substrate binding with little change in kcat. In contrast, reaction with phenylglyoxal in the presence of saturating methionine-enkephalin shows little change in substrate binding but a 4-fold decrease in kcat. Enzyme inactivation involves the incorporation of approximately 1 mol of phenylglyoxal/enzyme subunit in the absence of methionine enkephalin and approximately 2.5 mol of phenylglyoxal/enzyme subunit in the presence of saturating methionine-enkephalin. These results suggest that an arginine residue on the enzyme is involved in substrate binding. PMID- 3522577 TI - Recycling of photoaffinity-labeled insulin receptors in rat adipocytes. Dissociation of insulin-receptor complexes is not required for receptor recycling. AB - We have used an iodinated, photoreactive analog of insulin, 125I-B2(2-nitro-4 azidophenylacetyl)-des-PheB1-insulin, to covalently label insulin receptors on the cell surface of isolated rat adipocytes. Following internalization of the labeled insulin-receptor complexes at 37 degrees C, we measured the rate and extent of recycling of these complexes using trypsin to distinguish receptors on the cell surface from those inside the cell. The return of internalized photoaffinity-labeled receptors to the cell surface was very rapid at 37 degrees C proceeding with an apparent t 1/2 of 6 min. About 95% of the labeled receptors present in the cell 20 min after the initiation of endocytosis returned to the cell surface by 40 min. Recycling was slower at 25 and 16 degrees C compared to 37 degrees C and essentially negligible at 12 degrees C or in the presence of energy depleters. Addition of excess unlabeled insulin had no effect on the recycling of photoaffinity-labeled insulin receptor complexes, whereas monensin, chloroquine, and Tris partially inhibited this process. These data indicate that dissociation of insulin from internalized receptors is not necessary for insulin receptor recycling. Furthermore, agents which have been shown to prevent vesicular acidification inhibit the recycling of insulin receptors by a mechanism other than prevention of ligand dissociation. PMID- 3522578 TI - Isolation and structure of the second of two major peptide products from the precursor to an anglerfish peptide homologous to neuropeptide Y. AB - The peptide hormone recently isolated from anglerfish endocrine pancreas (aPY) (Andrews, P. C., Hawke, D., Shively, J.E., and Dixon, J.E. (1985) Endocrinology 116, 2677-2681), is a member of a family of peptide hormones which includes pancreatic polypeptide, neuropeptide Y, and the gut peptide YY. A 30-residue carboxyl-terminal fragment of the precursor to aPY has been purified from anglerfish endocrine pancreas in two steps using both classical chromatographic methods and reversed-phase high pressure liquid chromatography. It was identified by sequence homology with the analogous peptide from human preproneuropeptide Y. The sequence was found by Edman degradation and fast atom bombardment mass spectrometry to be SSPEEAVAWLLFKADPSQDIEPRLDDDNAW. The high yield of this fragment (6.5 nmol . g-1) is similar to that previously reported for aPY (7.9 nmol . g-1) and suggests that it is a major product of pro-aPY processing. The data indicate that pro-aPY is proteolytically processed into two major products: the 37-residue aPY and the 30-residue carboxyl-terminal fragment. PMID- 3522579 TI - Mechanism of control of adenylate cyclase activity in yeast by fermentable sugars and carbonyl cyanide m-chlorophenylhydrazone. AB - The phosphorylation of fructose-1,6-bisphosphatase is preceded by a transient increase in the intracellular level of cyclic AMP which activates a cyclic AMP dependent protein kinase (Pohlig, G., and Holzer, H. (1985) J. Biol. Chem. 260, 13818-13823). Possible mechanisms by which sugars or ionophores might activate adenylate cyclase and thereby lead to an increase in cyclic AMP concentrations were studied. Studies with permeabilized yeast cells demonstrated that neither sugar intermediates nor carbonyl cyanide m-chlorophenylhydrazone are able to increase adenylate cyclase activity. In the light of striking differences of the effects of fermentable sugars and of carbonyl cyanide m-chlorophenylhydrazone on parameters characterizing the membrane potential, it seems not reasonable that the activity of adenylate is under control of the membrane potential. Rapid quenching of 9-aminoacridine fluorescence after addition of fermentable sugars to starved yeast cells indicated an intracellular acidification. The 31P NMR technique showed a fast drop of the intracellular pH from 6.9 to 6.55 or 6.4 immediately after addition of glucose or carbonyl cyanide m chlorophenylhydrazone. The time course of the decrease of the cytosolic pH coincides with the transient increase of cyclic AMP concentration and the 50% inactivation of fructose-1,6-bisphosphatase under the conditions of the NMR experiments. Kinetic studies of adenylate cyclase activity showed an approximately 2-fold increase of activity when the pH was decreased from 7.0 to 6.5, which is the result of a decrease in the apparent Km for ATP with no change in Vmax. These studies suggest that activation of adenylate cyclase by decrease in the cytosolic pH starts a chain of events leading to accumulation of cyclic AMP and phosphorylation of fructose-1,6-bisphosphatase. PMID- 3522580 TI - Thrombin-like enzyme from the venom of Bitis gabonica. Purification, properties, and coagulant actions. AB - Gabonase, an enzyme which acts on fibrinogen and factor XIII in uniquely thrombin like ways, was purified to electrophoretic homogeneity from the venom of Bitis gabonica. On sodium dodecyl sulfate-polyacrylamide electrophoresis, the reduced protein behaved as a single chain with Mr = 30,600. The enzyme contains 20.6% carbohydrate, no free sulfhydryl groups and hence, from amino acid analysis, five disulfide bonds. Its extinction coefficient (E1%1cm) at 280 nm is 9.6. Its pI is 5.3. Gabonase has an active serine residue, is inactivated by phenylmethanesulfonyl fluoride, and has an active histidine which reacts with the chloromethyl ketone of tosyl-L-lysine. Its NH2-terminal amino acid sequence (Val Val-Gly-Gly-Ala-Glu-Cys-Lys-Ile-Asp-Gly-His-Arg-Cys-Leu-Ala-Leu-Leu -Tyr-) is homologous to the B chain of thrombin. The activity of the enzyme is stabilized by calcium ion. It exhibits strong N alpha-p-tosyl-L-arginine methyl esterase activity, hydrolyzes tripeptide nitroanilide derivatives weakly or not at all, and cleaves no peptide bonds in insulin, glucagon, or the S peptide of ribonuclease. Gabonase clots fibrinogen with a specific activity of 45 NIH thrombin-equivalent units/mg, releasing both fibrinopeptides A and B and showing substrate inhibition at fibrinogen concentrations of 3 mg/ml or greater. The enzyme also activates factor XIII. It is not inactivated by either heparin or hirudin. PMID- 3522581 TI - Chicken liver H-protein, a component of the glycine cleavage system. Amino acid sequence and identification of the N epsilon-lipoyllysine residue. AB - The complete amino acid sequence of H-protein from chicken liver was determined by aligning peptides obtained by cyanogen bromide, endoproteinase Lys-C, Staphylococcus aureus V8 protease, and chymotrypsin cleavage together with the partial NH2- and COOH-terminal sequence of the intact protein. H-protein consists of 125 amino acids and a lipoic acid moiety linked to lysine 59. The sequence is: (sequence in text). The lysyl residue involved in lipoic acid attachment is indicated with an asterisk. The molecular weight including lipoic acid is calculated to be 13,883. From the secondary structure predicted by the method of Chou and Fasman (Chou, P. Y., and Fasman, G. D. (1978) Adv. Enzymol. 47, 45-148) the lipoic acid binding region shows alpha-helical structure and is predicted to be an interior portion of the protein from the hydropathic profile according to Kyte and Doolittle (Kyte, J., and Doolittle, R. F. (1982) J. Mol. Biol. 157, 105 132). PMID- 3522582 TI - Proteolysis of tubulin and the substructure of the tubulin dimer. AB - The alpha and beta subunits of tubulin each have a single highly reactive site for a variety of proteases that divides each subunit into two unequal regions. The position of cleavage is not the same for alpha and beta, since alpha is consistently cleaved into about 38- and 14-kDa pieces, while beta is cleaved into about 34- and 21-kDa pieces. The larger fragment is amino-terminal in both subunits as shown: by size reduction of the smaller fragment by subtilisin (which cleaves at the extreme carboxyl-terminal end), but no change in size of the larger fragment; by the charge/mass ratios of the proteolytic fragments; and by sequence analysis which locates trypsin cleavage after residue 339 (alpha) and chymotrypsin cleavage after residue 281 (beta). Since this cleavage pattern of the alpha and beta subunits is found for very different proteases, we suggest that it is determined by structural features of the tubulin molecule. The two pieces of each subunit remain associated following cleavage. While both cleavage sites are exposed in the free dimer, assembly of dimers into microtubules or sheets protects the internal site against cleavage. By contrast, the carboxyl terminal subtilisin-sensitive sites remain exposed. Based on these results we propose a model for the substructure of the tubulin dimer that accommodates internal cleavage in the dimer but not the polymer, access to the COOH termini in both forms, and the orientation of the dimer in the polymer. PMID- 3522583 TI - Reconstitution of sugar phosphate transport systems of Escherichia coli. AB - Studies with Escherichia coli cells showed that the transport systems encoded by glpT (sn-glycerol 3-phosphate transport) and uhpT (hexose phosphate transport) catalyze a reversible 32Pi:Pi exchange. This reaction could be used to monitor the glpT or uhpT activities during reconstitution. Membranes from suitably constructed strains were extracted with octylglucoside in the presence of lipid and glycerol, and proteoliposomes were formed by dilution in 0.1 M KPi (pH 7). Both reconstituted systems mediated a 32Pi:Pi exchange which was blocked by the appropriate heterologous substrate, sn-glycerol 3-phosphate (G3P) or 2 deoxyglucose 6-phosphate (2DG6P), with an apparent Ki near 50 microM. In the absence of an imposed cation-motive gradient, Pi-loaded proteoliposomes also transported the expected physiological substrate; Michaelis constants for the transport of G3P or 2DG6P were near 20 microM. The heterologous exchange showed a maximal velocity of 130 nmol/min/mg protein via the glpT system and 11 nmol/min/mg protein for the uhpT system. This difference was expected because the G3P transport activity had been reconstituted from a strain carrying multiple copies of the glpT gene. Taken together, these results suggest that anion exchange may be the molecular basis for transport by the glpT and uhpT proteins. PMID- 3522584 TI - The major surface protein of Leishmania promastigotes is a protease. AB - The major surface protein of Leishmania promastigotes is evolutionarily conserved and is found in isolates of L. donovani, L. major, L. tropica, L. mexicana, and L. braziliensis. The data provided in this communication demonstrate that in L. major this integral membrane protein is a protease, which we now designate promastigote surface protease. The enzyme has an alkaline pH optimum and is active both in its detergent-solubilized form and at the surface of living or fixed promastigotes. A water-soluble form of promastigote surface protease is obtained following digestion with the phospholipase C responsible for the release of the variant surface glycoprotein of Trypanosoma brucei. Possible biological functions of promastigote surface protease during the life cycle of Leishmania parasites are discussed. PMID- 3522585 TI - Identification of sequence homology between human plasma apolipoprotein B-100 and apolipoprotein B-48. AB - The structural relationship between apolipoprotein B-100 (apo-B-100) and apolipoprotein B-48 (apo-B-48) has not been elucidated. A peptide fragment (MDB 18) of approximately 6 kDa was isolated from a tryptic digest of apo-B-100. The sequence of the first 22 amino acids of MDB-18 was determined by Edman degradation. A 15-residue peptide corresponding to this sequence was synthesized by the solid-phase method and was utilized to develop a sequence-specific polyclonal antibody. On immunoblot analysis, the antibody recognized both intact apo-B-100 and apo-B-48. In addition, preincubating the antibody with the synthetic peptide abolished the recognition of both apo-B-100 and apo-B-48. These data are interpreted as indicating that there is an amino acid sequence homology between apo-B-100 and apo-B-48. Since the MDB-18 peptide is located in the carboxyl region of the B-100 molecule, we propose apo-B-100 and apo-B-48 share a common carboxyl region sequence. PMID- 3522586 TI - Mutants of Saccharomyces cerevisiae defective in sn-glycerol-3-phosphate acyltransferase. Simultaneous loss of dihydroxyacetone phosphate acyltransferase indicates a common gene. AB - Fourteen independent mutants of Saccharomyces cerevisiae defective in sn-glycerol 3-phosphate acyltransferase activity were isolated using a colony autoradiographic screening technique. All 14 mutants were similarly defective in dihydroxyacetone phosphate acyltransferase activity. The mutations were recessive and fell into a single complementation group. Tetrad analysis gave results consistent with mutations in a single nuclear gene affecting both activities. sn Glycerol-3-phosphate acyltransferase activity from different mutant strains exhibited different substrate dependencies and differing responses to temperature, detergent, and pH. In each case, the response of the dihydroxyacetone phosphate acyltransferase activity was similar to that of the sn glycerol-3-phosphate acyltransferase. These results are consistent with the mutations occurring in the structural gene. The data also establish that the predominant dihydroxyacetone phosphate acyltransferase activity in yeast is a second activity of the sn-glycerol-3-phosphate acyltransferase. PMID- 3522587 TI - The synthesis of adenine-modified analogs of adenosylcobalamin and their coenzymic function in the reaction catalyzed by diol dehydrase. AB - Five analogs of adenosylcobalamin modified in the adenine moiety of the Co beta ligand were synthesized and tested for coenzymic function with diol dehydrase of Klebsiella pneumoniae ATCC 8724. 1-Deaza and 3-deaza analogs of adenosylcobalamin were active as coenzyme, whereas 7-deaza and N6,N6-dimethyl derivatives and guanosylcobalamin did not show detectable coenzymic activity. 7-Deaza and N6,N6 dimethyl analogs acted as strong competitive inhibitors with respect to adenosylcobalamin. The formation of cob(II)alamin as intermediate in the catalytic reaction was spectroscopically observed with catalytically active complexes of the enzyme with 1-deaza and 3-deaza analogs in the presence of 1,2 propanediol, but not with complexes with the inactive analogs. Oxygen sensitivity of the enzyme-analog complexes suggests that the carbon-cobalt bond of 1-deaza and 3-deaza analogs becomes activated by the enzyme even in the absence of substrate. These results indicate that the importance of the nitrogen atoms in the adenine moiety of the coenzyme for manifestation of catalytic function and for activation of the carbon-cobalt bond decreases in the following order: N-7 greater than 6-NH2 greater than N-3 greater than N-1. The dissociation constant for 5'-deoxyadenosine determined by equilibrium dialysis at 37 degrees C was about 23 microM. PMID- 3522588 TI - A nuclear mutant of Saccharomyces cerevisiae deficient in mitochondrial DNA replication and polymerase activity. AB - We have isolated a thermosensitive mutant which is transformed into a population of cells devoid of mitochondrial DNA (rho 0 cells) at 35 degrees C and is deficient in mitochondrial (mt) DNA polymerase activity. A single recessive nuclear mutation (mip1) is responsible for rho 0 phenotype and mtDNA polymerase deficiency in vitro. At 25 degrees C (or 30 degrees C) a dominant suppressor mutation (SUP) masks the deficiency in vivo. The meiotic segregants (mip1 sup) which do not harbor the suppressor have a rho 0 phenotype both at 25 and 35 degrees C. They have no mtDNA polymerase activity, in contrast with MIP rho 0 mutants of mitochondrial inheritance which do exhibit mtDNA polymerase activity. In the thermosensitive mutant (mip1 SUP), the replication of mtDNA observed in vivo at 30 degrees C is completely abolished at 35 degrees C. In the meiotic segregants (mip1 sup), no mtDNA replication takes place at 30 and 35 degrees C. The synthesis of nuclear DNA is not affected. DNA polymerases may have replicative and/or repair activity. There is no evidence that mip mutants are deficient in mtDNA repair. In contrast the MIP gene product is strictly required for the replication of mtDNA and for the expression of the mtDNA polymerase activity. This enzyme might be the replicase of mtDNA. PMID- 3522590 TI - Molecular cloning and sequencing of the sppA gene and characterization of the encoded protease IV, a signal peptide peptidase, of Escherichia coli. AB - Clones carrying a gene causing overproduction of protease IV, a signal peptide peptidase of Escherichia coli, were isolated from the Clarke and Carbon's collection. Restriction mapping analysis revealed that pLC7-10 and pLC40-13, thus isolated, shared the same chromosomal DNA region. The 2.3-kilobase RsaI-SalI fragment in this region, which was found to carry the gene, was subjected to nucleotide sequence determination. Only one long open reading frame was found. The hypothetical polypeptide sequence deduced from the DNA sequence has a molecular mass of 67,241 daltons. The putative gene was named sppA. Protease IV was purified to homogeneity from the cytoplasmic membrane of an overproducing strain harboring a sppA gene-carrying plasmid. The purified enzyme gave a single polypeptide band of 67,000-dalton molecular mass on sodium dodecyl sulfate polyacrylamide gel. This molecular mass and the amino acid composition of the purified enzyme were consistent with the deduced primary structure of the sppA gene product. The molecular mass thus determined was almost twice as large as that previously reported by Pacaud (Pacaud, M. (1982) J. Biol. Chem. 257, 4333 4339). A cross-linking study revealed that protease IV is a tetramer of the polypeptide. From these results, we conclude that protease IV is a tetramer of the sppA gene product. PMID- 3522589 TI - Porcine spleen cathepsin B is an exopeptidase. AB - The major cathepsin B isozyme CB-I purified from porcine spleens was studied for its specificity against various peptide and denatured protein substrates. The enzyme degraded all the peptide substrates by an exopeptidase activity. The substrates were degraded mainly by a dipeptidyl carboxypeptidase activity of the enzyme except for angiotensin I, from which a COOH-terminal leucine residue was released. The enzyme failed to hydrolyze peptides having a proline or cysteic acid in the COOH-terminal, penultimate, and antepenultimate positions. Reduced and carboxymethylated soybean trypsin inhibitor was degraded by the same dipeptidyl carboxypeptidase action of cathepsin B. No significant endopeptidase activity was observed. These results do not support the general assumption that cathepsin B has both endo- and exopeptidase activities, neither do these observations support the postulation that cathepsin B might be involved in the in vivo proteolytic processing of protein precursors. We propose that the biological role of this enzyme is mainly the degradation of tissue proteins in lysosomes. PMID- 3522592 TI - Perforated demineralized bone matrix: a new form of osteoinductive biomaterial. AB - This study was undertaken to evaluate a new osteoinductive material--perforated decalcified bone matrix (PDBM). Subcutaneous implantation of PDBM induces multiple centers of endochondral osteogenesis with subsequent resorption of bone matrix and its replacement by new bone. PDBM should therefore prove useful as a research model to study osteoinduction and in the clinical situation in orthopedic and reconstructive surgery for the filling of bone defects and stimulation of fracture healing. PMID- 3522591 TI - Phosphorylation of histones is stimulated by phorbol esters in quiescent Reuber H35 hepatoma cells. AB - Histones isolated from Reuber H35 rat hepatoma cells treated with the tumor promoter 12-O-tetradecanoylphorbol-13-acetate (TPA) were examined for possible alterations in phosphorylation. Incorporation of 32P orthophosphate into individual acid-extracted histones was monitored by autoradiography and scintillation counting of polyacrylamide gels or by reverse-phase high performance liquid chromatography. Treatment of quiescent H35 cells (arrested by serum starvation) with submicromolar doses of TPA resulted in a rapid and specific increase in phosphorylation of histones H2B and H1(0). Smaller increases in phosphorylation were observed for H4. No significant change in phosphorylation of the major H1 histones or H2A were observed after 1 h of treatment. The phosphorylation was TPA dose-dependent, with a maximum increase of approximately 14-fold for H2B, 11-fold for H1(0), and 2-fold for H4 achieved at 0.8 M TPA. The nonpromoting parent compound phorbol did not induce any of these changes. Furthermore, the mitogenic hormone insulin did not cause a similar pattern of histone phosphorylation, suggesting that the effect observed was not due to a general mitogenic response in the H35 hepatoma cells. Addition of 8-Br-cAMP also failed to reproduce the effect of TPA on histone phosphorylation, suggesting that cAMP-dependent protein kinases are not likely to be involved in mediating this response to TPA. PMID- 3522593 TI - Pulmonary reaction to intravenously injected polymer beads. AB - The purpose of this study was to characterize the foreign body reaction in the mouse lung following embolization of intravenously injected divinylbenzene copolymer beads. In contrast to usual surgical implantation, this model dissociates the local foreign body reaction to the beads (in the lung) from inflammation and repair of tissue injury associated with implantation (peripheral site of injection). Quantitative determinations of pulmonary granuloma area using light microscopic morphometric measurements on tissue sections confirmed that the intensity of pulmonary inflammatory reaction increased rapidly to a maximum at 48 h following injection, with a volume exceeding 10 times that of the bead; at this time, the cellular exudate was 90% polymorphonuclear leukocytes. Thereafter, the inflammatory reaction decreased in intensity, and individual lesions became progressively richer in mononuclear cells (60% at 4 days and greater thereafter). Determination of intra- and interobserver variability indicated that maximal data precision was attained by measurement of the cross-sectional areas of as few as 10 granulomas in each of five animals for each set of specific experimental conditions. Collagen was undetectable in granulomas at 7 weeks and 6 months, suggesting that the usual fibrous capsule forming in response to surgically implanted biomaterials is largely caused by repair of surgical trauma. The volume of inflammatory exudate at 48 h was reduced 68-86% by the nonsteroidal antiinflammatory agents indomethacin, aspirin, and ibuprofen and the antiinflammatory steroid methylprednisolone. Thus, the pulmonary bead granuloma model is a quantitative, reliable, and economical approach to investigating some aspects of biomaterial/time interactions in the absence of super-imposed surgical trauma. PMID- 3522594 TI - Displacements of precious and nonprecious dental bridges utilizing endosseous implants as distal abutments. AB - An investigation was conducted to establish qualitative trends regarding to relative displacements exhibited by the distal and mesial abutments in a five unit fixed dental bridge as a function of bridge material and implant design utilized in the distal abutment site. Both Au and Ni-based bridge systems utilizing double, natural-tooth mesial abutments and three types of distal abutments (natural second molar, blade dental implant, and hollow-basket implant) were tested on a dried human mandible and subjected to a controlled force applied distally. Dial gauges were positioned around each abutment site bilaterally to provide displacement data in the x(mesial/distal), y(buccal/lingual, and z(occlusal/gingival) directions. The results indicate some significant differences exist in the displacement profiles exhibited by the bridge systems as a function of both bridge material and abutment type. PMID- 3522595 TI - Effect of pore size of porous bead carriers immobilizing antibody on IgE absorption. AB - Immunoglobulin E (IgE) adsorption was studied using antihuman IgE antibody immobilized on alkylamine glass carriers with different pore sizes (Controlled Pore Glass [CPG]) to determine the effect of pore size on IgE absorption in therapeutic immuno-adsorbents. With a series of CPGs whose pore sizes were in the range of 170 to 1400 A, CPGs possessing pore sizes larger than 500 A had higher IgE absorption. A CPG (500-A pore size) with the spacer arm 20 A long did not give better IgE removal than CPG without the spacer arm, since the spacer prevented the immobilization of a sufficient amount of the antibody on the carrier because of steric hindrance. However, the antibodies, once immobilized on CPG with the spacer arm, bound the same amount of IgE molecules (antigens) as those immobilized on CPG without the spacer arm. PMID- 3522596 TI - A new stitch for ligament-tendon fixation. Brief note. PMID- 3522598 TI - Original papers. Changing concepts in vascular surgery. By Michael E. DeBakey. 1959. PMID- 3522597 TI - Arthritis presumably caused by Chlamydia in Reiter syndrome. Case report with electron microscopic studies. PMID- 3522599 TI - Abdominal aortic aneurysm: incidence in a population at risk. AB - One hundred twenty patients aged fifty years and over underwent screening by ultrasound for abdominal aortic aneurysms as part of their routine follow-up visit to a cardiologist. The overall incidence of aneurysm greater than or equal to 4 centimeters in diameter was 5%. In the 84 men with aortas less than 4 centimeters, the average aorta size was 2.4 centimeters. In the 30 women with aortas less than 4 centimeters, the average aorta size was significantly smaller, 1.9 centimeters (p less than .001). It was discovered that men who smoke and have hypertension have a statistically significant increase in aorta size compared to those men without these risk factors (less than .05). The results indicate that the incidence of abdominal aortic aneurysm is probably high enough in this population to justify screening by ultrasound. PMID- 3522600 TI - Technique of closure of median sternotomy with trans-sternal figure-of-eight wires. AB - A technique of closure of median sternotomy with trans-sternal figure-of-eight wires is described. This method has the advantages of very stable sternotomy and can be performed by the surgeon without need for surgical assistance. This technique has resulted in 0.4% incidence of dehiscence and no sternal infections. PMID- 3522601 TI - Differential contributions of Ng-CAM and N-CAM to cell adhesion in different neural regions. AB - Individual neurons can express both the neural cell adhesion molecule (N-CAM) and the neuron-glia cell adhesion molecule (Ng-CAM) at their cell surfaces. To determine how the functions of the two molecules may be differentially controlled, we have used specific antibodies to each cell adhesion molecule (CAM) to perturb its function, first in brain membrane vesicle aggregation and then in tissue culture assays testing the fasciculation of neurite outgrowths from cultured dorsal root ganglia, the migration of granule cells in cerebellar explants, and the formation of histological layers in the developing retina. Our strategy was initially to delineate further the binding mechanisms for each CAM. Antibodies to Ng-CAM and N-CAM each inhibited brain membrane vesicle aggregation but the binding mechanisms of the two CAMs differed. As expected from the known homophilic binding mechanism of N-CAM, anti-N-CAM-coated vesicles did not co aggregate with uncoated vesicles. Anti-Ng-CAM-coated vesicles readily co aggregated with uncoated vesicles in accord with a postulated heterophilic binding mechanism. It was also shown that N-CAM was not a ligand for Ng-CAM. In contrast to assays with brain membrane vesicles, cellular systems can reveal functional differences for each CAM reflecting its relative amount (prevalence modulation) and location (polarity modulation). Consistent with this, each of the three cellular processes examined in vitro was preferentially inhibited only by anti-N-CAM or by anti-Ng-CAM antibodies. Both neurite fasciculation and the migration of cerebellar granule cells were preferentially inhibited by anti-Ng CAM antibodies. Anti-N-CAM antibodies inhibited the formation of histological layers in the retina. The data on perturbation by antibodies were correlated with the relative levels of expression of Ng-CAM and N-CAM in each of these different neural regions. Quantitative immunoblotting experiments indicated that the relative Ng-CAM/N-CAM ratios in comparable extracts of brain, dorsal root ganglia, and retina were respectively 0.32, 0.81, and 0.04. During culture of dorsal root ganglia in the presence of nerve growth factor, the Ng-CAM/N-CAM ratio rose to 4.95 in neurite outgrowths and 1.99 in the ganglion proper, reflecting both polarity and prevalence modulation. These results suggest that the relative ability of anti-Ng-CAM and anti-N-CAM antibodies to inhibit cell cell interactions in different neural tissues is strongly correlated with the local Ng-CAM/N-CAM ratio.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3522602 TI - Specific asparagine-linked oligosaccharides are not required for certain neuron neuron and neuron-Schwann cell interactions. AB - To determine whether specific asparagine-linked (N-linked) oligosaccharides present in cell surface glycoproteins are required for cell-cell interactions within the peripheral nervous system, we have used castanospermine to inhibit maturation of N-linked sugars in cell cultures of neurons or neurons plus Schwann cells. Maximally 10-15% of the N-linked oligosaccharides on neuronal proteins have normal structure when cells are cultured in the presence of 250 micrograms/ml castanospermine; the remaining oligosaccharides are present as immature carbohydrate chains not normally found in these glycoproteins. Although cultures were treated for 2 wk with castanospermine, cells always remained viable and appeared healthy. We have analyzed several biological responses of embryonic dorsal root ganglion neurons, with or without added purified populations of Schwann cells, in the presence of castanospermine. We have observed that a normal complement of mature, N-linked sugars are not required for neurite outgrowth, neuron-Schwann cell adhesion, neuron-induced Schwann cell proliferation, or ensheathment of neurites by Schwann cells. Treatment of neuronal cultures with castanospermine increases the propensity of neurites to fasciculate. Extracellular matrix deposition by Schwann cells and myelination of neurons by Schwann cells are greatly diminished in the presence of castanospermine as assayed by electron microscopy and immunocytochemistry, suggesting that specific N-linked oligosaccharides are required for the expression of these cellular functions. PMID- 3522603 TI - Heterogeneous distribution of the cAMP receptor protein RII in the nervous system: evidence for its intracellular accumulation on microtubules, microtubule organizing centers, and in the area of the Golgi complex. AB - The cellular and subcellular distribution of the regulatory subunit RII of cAMP dependent protein kinase was studied by light and electron microscopy immunocytochemistry in tissue sections from rat brain and in primary cultures of brain cells. RII immunoreactivity was present in most neurons, although at variable concentration. In addition, RII was also detectable in other cell types including glia, neuroepithelial cells, and cells of mesenchymal origin. In the cell cytoplasm, RII immunoreactivity was concentrated at certain sites. An accumulation of RII immunoreactivity was found in all RII-positive cells at the Golgi area, precisely at a region directly adjacent to one of the two major faces of the Golgi complex. RII was also highly concentrated in some microtubule-rich cell processes such as cilia and neuronal dendrites, but was below detectability in most axons. In neurons, its concentration in dendrites is consistent with the previously demonstrated high affinity interaction between RII and the dendritic microtubule-associated protein 2. In addition, RII was accumulated at basal bodies of cilia and at centrosomes, i.e., sites known to act as microtubule organizers. RII-labeled centrosomes, however, were visible only in cells where the Golgi complex had a pericentrosomal organization, and not in cells where the Golgi complex was perinuclear such as in neurons and glia in situ. We hypothesize that centrosomal RII is bound to the pericentriolar microtubule-organizing material and that this material remains associated with the trans region of the Golgi complex when the latter is no longer associated with the centrosome. Our results suggest a key but not obligatory role of cAMP in the Golgi-centrosomal area, the headquarters of cell polarity, mobility and intracellular traffic, and in the function of a subpopulation of microtubules. PMID- 3522604 TI - Surface and intracellular distribution of a putative neuronal nicotinic acetylcholine receptor. AB - Chick ciliary ganglion neurons have a membrane component that shares an antigenic determinant with the main immunogenic region (MIR) of nicotinic acetylcholine receptors from skeletal muscle and electric organ. Previous studies have shown that the component has many of the properties expected for a ganglionic nicotinic acetylcholine receptor, and that its distribution on the neuron surface in vivo is restricted predominantly to synaptic membrane. Here we report the presence of a large intracellular pool of the putative receptor in embryonic neurons and demonstrate that it is associated with organelles known to comprise the biosynthetic and regulatory pathways of integral plasma membrane proteins. Embryonic chick ciliary ganglia were lightly fixed, saponin-permeabilized, incubated with an anti-MIR monoclonal antibody (mAb) followed by horseradish peroxidase-conjugated secondary antibody, reacted for peroxidase activity, and examined by electron microscopy. Deposits of reaction product were associated with synaptic membrane, small portions of the pseudodendrite surface membrane, most of the rough endoplasmic reticulum, small portions of the nuclear envelope, some Golgi complexes, and a few coated pits, coated vesicles, multivesicular bodies, and smooth-membraned vacuoles. No other labeling was present in the neurons. The labeling was specific in that it was not present when the anti-MIR mAb was replaced with either nonimmune serum or mAbs of different specificity. Chick dorsal root ganglion neurons thought to lack nicotinic acetylcholine receptors were not labeled by the anti-MIR mAb. Substantial intracellular populations have also been reported for the muscle acetylcholine receptor and brain voltage-dependent sodium channel alpha-subunit. This may represent a general pattern for multisubunit membrane proteins during development. PMID- 3522605 TI - Rat retinal pigment epithelial cells show specificity of phagocytosis in vitro. AB - The retinal pigment epithelial (RPE) cell of the eye normally phagocytozes only retinal rod outer segments (ROS). The specificity of this phagocytic process was examined by incubating RPE cells with a variety of particle types. Confluent RPE cell cultures were incubated for 3 h at 37 degrees C in the presence of rat ROS, rat red blood cells (RBC), algae, bacteria, or yeast. Other cell cultures were incubated with equal numbers of ROS and one other particle type. Quantitative scanning electron microscopy was used to determine the numbers and morphology of particles bound to RPE cells, while double immunofluorescence labeling (Chaitin, M. H., and M. O. Hall, 1983, Invest. Ophthalmol. Vis. Sci., 24:812-820) was used to quantitate particle binding and ingestion. Both assays demonstrated phagocytosis to be a highly specific process. RPE cells bound 40-250 X more ROS than RBC, 30 X more ROS than algae, and 5 X more ROS than bacteria or yeast. Ingestion was more specific than binding; RPE cells ingested 970 X more ROS than RBC, 140 X more ROS than bacteria, and 35 X more ROS than yeast. The phagocytic preference for ROS was maintained in competition experiments with other particle types. Serum was found to be essential for phagocytosis. This study demonstrates that both the binding and ingestion phases of phagocytosis are highly specific processes. PMID- 3522606 TI - Differentiation-dependent changes in the solubility of a 195-kD protein in human epidermal keratinocytes. AB - We have prepared a monoclonal antibody, AE11, that recognizes specifically a 195 kD protein (pI 5.4) of human keratinocytes. This antigen constitutes approximately 0.01-0.1% of total protein in keratinocytes of skin, esophagus, and cornea, and is readily detectable in these cells by immunofluorescent staining and immunoblotting. However, it is barely detectable in MCF mammary carcinoma cells and HeLa cells, and is undetectable in nonepithelial cell types. Results from serial extraction experiments have shown that this protein exists in two distinct pools: a Tris-soluble, and a Tris-insoluble but urea- or SDS-soluble one. The distribution of the 195-kD protein between these two pools appears to be differentiation-related, since relatively undifferentiated cells selected by a low-calcium medium contain primarily the soluble form, while highly differentiated cells contain mainly the insoluble form. Data from immunofluorescent staining and trypsin-sensitivity experiments suggest that the soluble form is cytoplasmic, whereas the insoluble form is submembranously located at the cell periphery of upper, differentiated cells. The insoluble, cell peripheral form of the 195-kD antigen increases progressively during epidermal differentiation; its insolubility appears to be related to the formation of disulfide-bond(s). These results indicate that the 195-kD protein, which has recently been suggested to be involved in cornified envelope formation (Simon, M., and H. Green, 1985, Cell, 36:827-834), undergoes significant changes in its solubility characteristics and intracellular location during keratinocyte maturation. PMID- 3522607 TI - Transient inactivation of the thylakoid photosystem II light-harvesting protein kinase system and concomitant changes in intramembrane particle size during photoinhibition of Chlamydomonas reinhardtii. AB - Light-dependent reduction of the plastoquinone pool regulates the activity of the thylakoid-bound protein kinase which phosphorylates the light harvesting chlorophyll a,b-protein complex (LHC II) and regulates energy distribution between photosystems II (PS II) and I (Staehelin, L. A., and C. J. Arntzen, 1983, J. Cell Biol., 97:1327-1337). Since reduction of plastoquinone by PS II is abolished in photoinhibited thylakoids due to loss of the secondary electron acceptor QB protein (Kyle, D. J., I. Ohad, and C. J. Arntzen, 1984, Proc. Natl. Acad. Sci. USA, 81:4070-4074), it was of interest to examine the activity of the LHC II protein kinase system during photoinhibition and recovery of PS II activity. The kinase activity was assessed both in vivo and in vitro in Chlamydomonas cells exposed to high light intensity (photoinhibition) and recovery at low light intensity. The kinase activity was progressively reduced during photoinhibition and became undetectable after 90 min. The inactive LHC II kinase system could not be reactivated in vitro either by light or by reduction of the plastoquinone pool following addition of reduced duroquinone (TMQH2). The LHC II polypeptides were dephosphorylated in vivo when cells, prelabeled with [32P]orthophosphate before exposure to high light intensity, were transferred to photoinhibiting light in the presence of [32P]orthophosphate. In vivo recovery of the LHC II-kinase activity, elicited by the addition of TMQH2 to the assay system, did not require restoration of QB-dependent electron flow or de novo protein synthesis, either in the cytoplasm or in the chloroplast. Mild sonication of thylakoids isolated from photoinhibited cells restored the ability of the LHC II protein kinase system to be activated in vitro by addition to TMQH2. Restoration of the light-activated LHC-II kinase required recovery of QB dependent electron flow. At the structural level, photoinhibition did not affect the ratio of grana/stroma thylakoids. A reduction of approximately 20% of the 11 17-nm intramembrane particles and an equivalent increase in the number of 6-10.5 nm particles was observed on the E-fracture faces of stacked thylakoid membranes. Similar but smaller changes were observed also on the E-fracture faces of unstacked thylakoid membranes (more 10-14-nm and less 6-9-nm particles) and P fracture faces of stacked thylakoid membranes (more 6-8- and less 9.5-13-nm particles). All these structural changes were reversed to normal values during recovery of PS II activity.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3522608 TI - Control of type IV collagen production in rat mammary epithelial and myoepithelial-like cells. AB - A rat mammary myoepithelial-like cell line (Rama 401) produces 3.5 times more type IV collagen than a mammary epithelial cell line (Rama 25), as measured by the formation of protein hydroxyproline. However, using quantitative "dot" hybridization techniques, the level of poly (A)-containing mRNA hybridizing to a type IV collagen cDNA probe is only 50% higher in Rama 401 cells than in Rama 25 cells. The total amount of hydroxyproline synthesized per cell by the two cell lines is similar. However, in the Rama 25 cells approximately 70% of the hydroxyproline is found as free hydroxyproline against 13% for Rama 401 cells. When Rama 25 cells are grown on collagen gels, they accumulate 2.5-fold more type IV collagen. However, type IV collagen mRNA levels are only 30% higher in Rama 25 cells grown on collagen. The total amount of hydroxyproline synthesized is the same as cells grown on plastic, whereas the extent of collagen degradation is reduced from 71% to 30% in cells grown on collagen gels. No degradation of type IV collagen can be detected in the culture medium of Rama 25 cells. These results indicate that the increased accumulation of type IV collagen in Rama 401 cells is not due to increased synthesis but to a decreased rate of intracellular degradation, and that for Rama 25 cells, the extracellular matrix modulates type IV collagen production by regulating the rate of intracellular collagen degradation. PMID- 3522609 TI - Refolding of serine proteinases. AB - Bovine trypsinogen and chymotrypsinogen were successfully refolded as the mixed disulfide of glutathione using cysteine as the disulfide interchange catalyst. The native structures were regenerated with yields of 40%-50% at pH 8.6 and 4 degrees C, and the half-time for the refolding was approximately 60-75 min. We then refolded threonine-neochymotrypsinogen, which is a two-chain structure held together by disulfide bonds and produced on cleavage of Tyr 146-Thr 147 in native chymotrypsinogen [Duda CT, Light A, J Biol Chem 257 9866-9871, 1982]. Neochymotrypsinogen was denatured and fully reduced, and the thiols were converted to the mixed disulfide of glutathione. The two polypeptide fragments, representing the amino- and carboxyl-terminal domains, were separated on Sephadex G-75. Mixtures of the polypeptide fragments varying in the ratio of their concentration from 1:5 to 5:1 were refolded with yields of 21-28%. The lack of dependence on the concentration of either fragment and the relatively high yields suggest independent folding of the amino- and carboxyl-terminal domains. When the globular structures of the domains formed, they then interacted with one another and produced the native intermolecular disulfide bridge and the proper geometry of the active site. PMID- 3522611 TI - Protein composition of nuclear matrix preparations from HeLa cells: an immunochemical approach. AB - Procedures for the isolation of HeLa S3 nuclear matrices were re-examined with special emphasis on the use of various nucleases and detergents as well as on the ionic strength of the final salt extraction. The protein composition of the resulting nuclear matrix preparations was analysed by one- and two-dimensional gel electrophoresis and found to be extremely reproducible. By means of co electrophoresis several typical cytoskeletal proteins (actin, vimentin and cytokeratins) and heterogeneous nuclear RNA (hnRNA)-associated core proteins (hnRNP) were shown to be present in such nuclear matrix preparations. The nature of some other protein components was elucidated using two-dimensional immunoblotting and immunofluorescence. For this purpose mouse monoclonal antibodies to cytoskeletal components (vimentin, cytokeratins), small nuclear RNP (70 X 10(3) Mr protein of U1-RNP), hnRNP (C1/C2) and the pore-complex lamina (lamins A, B and C) were used next to human autoimmune sera obtained from patients with connective tissue diseases and directed against the residual nucleoli and the internal fibrillar mass. These antibodies enabled us to identify a number of proteins present specifically in the nuclear matrix and to show that part of the cytoskeletal proteins are still present in the isolated structures. PMID- 3522610 TI - Relationship between protease activity and a sialoglycopeptide inhibitor isolated from bovine brain. AB - We have recently described the isolation and purification to homogeneity of a new sialoglycopeptide from bovine brain cell surfaces that reversibly inhibits protein synthesis and DNA synthesis of normal but not transformed cells. Active inhibitory preparations, however, were shown to contain a protease activity that was not lost upon purification. Several experiments were performed to establish the relationship between the proteolytic activity of the sialoglycopeptide and the biological inhibitory activity. Both the protease activity and inhibitory activity were stable at pH 6-8 but were reduced or completely destroyed below pH 4 and above pH 9. Acid inactivation was reversible and upon dialysis, both the biological inhibitory and protease activities were regained. Deglycosylation and CNBr cleavage indicated that the polypeptide backbone, rather than carbohydrate moiety, played an important role in the protease and biological inhibitory activities. Furthermore, chemical modification of amino and tyrosine groups indicated that both residues are essential for both activities. Thus, the biological inhibitory activity and protease activity are very closely related and most likely reside with the same polypeptide sequence. PMID- 3522612 TI - Pollen-stigma interactions in Brassica. IV. Structural reorganization in the pollen grains during hydration. AB - With the aid of osmium tetroxide vapour, dry pollen and pollen at various stages of hydration has been fixed anhydrously for examination with the transmission electron microscope (TEM). In addition to establishing features characteristic of grains at different states of hydration, this technique has enabled the detection of a superficial layer investing both the exine and the pollen coating. This layer, some 10 nm in depth, binds both lanthanum and Alcian Blue and is shown to be the first component of the pollen grain to make contact with the stigmatic pellicle. The use of vapour fixation has also rendered it possible to chart the passage of water into the pollen grains with great accuracy, for each level of hydration displays a strikingly different cytoplasmic organization. For example, dry pollen is characterized by the presence of unusual structures at the protoplast surface and large numbers of spherical fibrillar bodies, whilst the protoplast of hydrating pollen is conspicuously stratified and contains a peripheral layer of membranous cisternae, subjacent to which is a fibrillar matrix derived from the spherical bodies found in the dry grains. Vapour-fixed, fully hydrated pollen resembles conventionally fixed grains. The pollen coating appears electron-translucent after anhydrous fixation and contains discrete, slightly rounded bodies some 50 nm in diameter. The uptake of water by grains on the stigma is accompanied by conspicuous structural changes in this layer for, after a short period in contact with the papillar surface, the spherical bodies rapidly disappear and the coat becomes electron-opaque. Close examination of this 'converted' coating reveals the presence of membranous vesicles and other structural components. PMID- 3522613 TI - Immunocytochemical differentiation of microtubules in the cytoskeleton of Giardia lamblia using monoclonal antibodies to alpha-tubulin and polyclonal antibodies to associated low molecular weight proteins. AB - In interphase trophozoites of Giardia lamblia, separate populations of microtubules constitute the four parts of the mastigont apparatus: flagella, ventral disc, funis and median body. Antigenic differences between the tubules have been investigated by light and electron immunocytochemistry after labelling with two monoclonal antibodies to alpha-tubulin (YL 1/2 and YOL 1/34 clones), and with polyclonal antibodies to Giardia tubule-associated proteins. Both anti tubulins stained all tubules after isolated structures were fixed in formaldehyde, but different patterns of reactivity were shown by unfixed tubules. YL 1/2 antibodies labelled flagellar axonemes and basal bodies, funis and median body tubules. Disc microtubules were mostly unlabelled, but the antibody bound strongly to the outer edge of the disc where the ends of tubules are embedded. YOL 1/34 antibodies stained disc tubules uniformly, and cross-reacted with the median body but not with tubules of axonemes, basal bodies or funis. Antibodies to giardins 14A and 14B (approximately 30 000 Mr filament-forming proteins) localized these proteins in the microribbons attached to disc microtubules. The median body was also labelled by anti-giardins, indicating an ontogenetic relationship between this organelle and the ventral disc. A second set of approximately 30 000 Mr proteins with no immunoreactivity to anti-giardin was found in flagella purified without removing flagellar membranes. These polypeptides were Triton-soluble and therefore probably originated from an extra axonemal site. A rabbit antiserum to the labile flagellar proteins specifically stained the two ventral flagella, but not the other six flagella on this cell. PMID- 3522614 TI - Mitosis in the fission yeast Schizosaccharomyces pombe as revealed by freeze substitution electron microscopy. AB - Nuclear division in Schizosaccharomyces pombe has been studied in transmission electron micrographs of sections of cells fixed by a method of freeze substitution. We have found cytoplasmic microtubules in the vicinity of the spindle pole bodies and two kinds of microtubules, short discontinuous ones and long, parallel ones in the intranuclear mitotic spindle. For most of the time taken by nuclear division the spindle pole bodies face each other squarely across the nuclear space but early in mitosis they briefly appear twisted out of alignment with each other, thereby imparting a sigmoidal shape to the bundle of spindle microtubules extending between them. This configuration is interpreted as indicating active participation of the spindle in the initial elongation of the dividing nucleus. It is proposed that mitosis is accompanied by the shortening of chromosomal microtubules simultaneously with the elongation of the central pole to-pole bundle of microtubules of the intranuclear spindle. Daughter nuclei are separated by the sliding apart of interdigitating microtubules of the spindle at telophase. Some of the latter bear dense knobs at their ends. PMID- 3522615 TI - Clonal analysis of expression of epithelial antigens in cultures of normal human breast. AB - Cells from normal human breast epithelium were cloned in monolayer culture and the clones were stained with monoclonal antibodies. Tissue was from reduction mammoplasty operations. Cloning efficiencies were 5-30%. Two types of clone were identified: 10 to 30% were of relatively spread cells whose boundaries were often difficult to see by phase-contrast microscopy but where they were visible they appeared as dark lines. The edges of the clones usually appeared to be under tension. These clones were stained by two monoclonal antibodies, LICR-LON-M8 and M24, that stain luminal epithelial cells in the intact tissue, but not myoepithelial or stromal cells. Within a clone the cells showed a full range of antigenic phenotypes. This was confirmed for clones grown from single cells that had been isolated manually. The second type of clone was more compact with little evidence of tension at the edges, and cell boundaries were clearly visible and bright under phase contrast. These clones were not stained by antibodies M8 or M24. Both types of clone stained with a third monoclonal antibody that is specific for luminal epithelial cells in the intact tissue, LICR-LON-M18, but the distribution of staining was different in the different types of clone. The simplest interpretation of the two types of clone is that luminal epithelial cells give rise to the spread type of clone while the myoepithelial cells give rise to the more abundant and vigorous compact clones. Alternatively, the compact clones may be from luminal epithelial cells that have lost differentiated characteristics. PMID- 3522616 TI - [Rational practice of preventive antibiotic therapy in surgery]. AB - The use of preventive antibiotic therapy to reduce frequency and severity of infections related to certain surgical acts still remains a subject of polemic and confusion. The need to employ definitions and therefore a common language to arrive at a consensus in each surgical team and for each surgical procedure is emphasized. The major principles guiding bacteriologic objectives are discussed, as well as the choice of corresponding antibiotic and its mode of administration. PMID- 3522617 TI - The dawn phenomenon does not occur in normal elderly subjects. AB - To determine whether the dawn phenomenon occurs in normal elderly subjects and thus contributes to the progressive mild fasting hyperglycemia of aging, we examined the effect of physiological insulin levels on glucose disposal and hepatic glucose production (HGO) between 0530 and 0800 h, and 0930 and 1200 h. Paired euglycemic insulin clamp studies (8 mU/m2 X min) were performed on healthy old subjects (n = 5), employing [3H]glucose methodology to measure glucose production and disposal rates. Basal plasma insulin, GH, glucagon, and cortisol levels, and HGO and glucose disposal rates were similar before each study. Steady state plasma insulin values were slightly, but not significantly, lower during the dawn study [dawn: 20.3 +/- 1.1 (SE); control: 23.5 +/- 2.1 microU/ml, P = 0.08]. Insulin clearance rates were higher during the dawn study (dawn: 523 +/- 16; control: 430 +/- 19 ml/m2 X min, P less than 0.01). Maximum glucose disposal rates (dawn: 3.10 +/- 0.24; control: 3.03 +/- 0.23 mg/kg X min) and minimum HGO levels (dawn: 0.83 +/- 0.09; control: 0.62 +/- 0.03 mg/kg X min) were not significantly different in each part of the study. There was a significant decrease in plasma GH during the dawn (P less than 0.01, analysis of variance) but not the control studies. There was no difference in cortisol levels during the euglycemic clamp between the dawn and control studies. The mean decrement in glucagon during the insulin infusion was similar in each part of the study. We conclude that the dawn phenomenon does not occur in healthy elderly subjects despite an increase in insulin clearance during the dawn period. PMID- 3522618 TI - Serum luteinizing hormone (LH) biological activity in castrated patients with cancer of the prostate receiving a pure antiandrogen and in estrogen-pretreated patients treated with an LH-releasing hormone agonist and antiandrogen. AB - We recently reported almost complete disappearance of serum LH biological activity in previously untreated patients with advanced prostatic cancer receiving combined therapy with a LHRH agonist and a pure antiandrogen. This decrease in LH bioactivity was most likely responsible for the fall of circulating testosterone to castration levels during such treatment. Since patients previously treated with high doses of estrogens or orchiectomy before receiving combined therapy had a less favorable response to the new treatment, we measured serum LH levels by RIA and the mouse interstitial cell bioassay in these 2 groups of patients. Serum samples were obtained from 14 men with advanced prostatic cancer treated from 9-41 months (24 +/- 9 months) with diethylstilbestrol before receiving 500 micrograms/day LHRH agonist ([D Trp6]LH/RH ethylamide) in combination with 3 daily oral doses of 250 mg pure antiandrogen flutamide and from 21 men castrated for at least 9 months (32 +/- 26 months) before receiving the antiandrogen alone. In previously castrated patients, both bio- and immunoactive LH serum levels were elevated and did not change during at least 3 months of antiandrogen treatment. In estrogen-pretreated men, however, bioactive LH concentrations declined from 1.2 +/- 0.5 (+/- SEM) to 0.04 +/- 0.01 ng/ml after 1 month of combined treatment and remained low thereafter, while serum LH levels, measured by RIA, did not significantly decline (1.4 +/- 0.5 vs. 0.9 +/- 0.1 ng/ml on days--2 and 30, respectively). This decrease in LH biopotency caused the biological to immunological activity ratio to fall from 0.5 +/- 0.2 before the onset of the combined therapy to 0.05 +/- 0.01 after 3 months. Thus, estrogen pretreatment did not prevent the ability of the LHRH agonist-antiandrogen combination to decrease serum LH biological activity. Moreover, the absence of an effect in castrated patients receiving antiandrogen alone indicates that the LHRH agonist, and not flutamide, was responsible for the effects of the combined therapy. PMID- 3522619 TI - Total pancreatectomy increases the metabolic response to glucagon in humans. AB - To evaluate the impact of glucagon deficiency on the response to glucagon replacement, we infused physiological doses of glucagon (1.25 ng/kg X min) into 9 totally pancreatectomized (PX) diabetic patients (C-peptide, undetectable) 1) for 24 h during their usual diet and insulin regimen and/or 2) for 6 h in a fasted insulin-withdrawn state. During both glucagon infusions, plasma glucagon rose from 46 +/- 2 (+/- SE) pg/ml (0-10% 3500 mol wt glucagon) to 112 +/- 9 pg/ml. In the 24-h study (n = 4), glucagon significantly increased mean 24-h glucose levels (272 +/- 27 mg/dl; P less than 0.05) and glycosuria (29 +/- 5 g/day; P less than 0.01) compared to preinfusion (158 +/- 14 mg/dl and 4 +/- 4 g/day, respectively) and postinfusion (200 +/- 35 mg/dl and 3 +/- 2 g/day) control periods. Blood ketones did not change. The 24-h glucagon infusion significantly lowered the fasting levels of the glucogenic amino acids aspartate (43%; P less than 0.01), threonine (46%; P less than 0.05), serine (46%; P less than 0.02), glycine (47%; P less than 0.01), and methionine (34%; P less than 0.02). Fasting alanine levels decreased from 835 +/- 236 to 393 +/- 66 microM (P less than 0.05). The 6-h glucagon infusion caused a 101 +/- 14 mg/dl maximal plasma glucose increment in PX (n = 8) vs. 33 +/- 11 in 5 insulin-withdrawn type I diabetic patients serving as controls (P = 0.022). Furthermore, when glucagon was infused at a higher rate (3 ng/kg X min) in 12 additional type I diabetic patients, the mean maximal plasma glucose increment (54 +/- 15 mg/dl) was still less than half that in PX, despite a 3-fold higher infusion plasma glucagon level (326 +/- 37 pg/ml). The 6 h glucagon infusion caused a significant decrease in the concentrations of glucogenic amino acids in the glucagon-deficient patients, but not in the type I diabetic patients. We conclude that 1) glucagon replacement in the PX patient markedly alters blood glucose and glucogenic amino acids, but not ketone levels; and 2) the metabolic response to glucagon is considerably more pronounced in PX patients than in type I diabetic patients. These data suggest that glucagon responsiveness is enhanced in the chronic hormone-deficient state. PMID- 3522620 TI - Effect of obesity on ambient plasma glucose, free fatty acid, insulin, growth hormone, and glucagon concentrations. AB - Fasting and postprandial plasma concentrations of glucose, FFA, insulin, glucagon, and GH concentrations were determined in 10 nonobese and 10 obese subjects with normal glucose tolerance. Measurements were made at 0800 h (after a 14-h fast) and at hourly intervals from then until 1600 h. During this time period all individuals ate breakfast at 0800 h (20% of total daily calories) and lunch (40% of total daily calories). Although plasma glucose concentrations were similar throughout the 8-h period in the 2 groups, plasma insulin concentrations were significantly (P less than 0.001) higher in the obese individuals. However, despite the presence of hyperinsulinemia, the obese group also had higher (P less than 0.001) plasma FFA concentration throughout the day. On the other hand, both the absolute and the relative declines in plasma FFA concentration after meals were similar in the 2 groups. Since plasma glucagon and GH concentrations were similar in the 2 groups, altered production of these lipolytic hormones was not responsible for the elevated plasma FFA levels in the obese individuals. These data document the presence in obese individuals of a disassociation in their ability to maintain normal plasma glucose as opposed to plasma FFA homeostasis, and indicate that the increase in plasma FFA concentrations in obesity occurs in the presence of hyperinsulinemia and is not related to abnormalities of either glucagon or GH secretion. PMID- 3522621 TI - Incretin effects of increasing glucose loads in man calculated from venous insulin and C-peptide responses. AB - Integrated insulin secretion rates calculated from peripheral venous C-peptide measurements by two-compartment kinetic analysis were measured in six young normal subjects after increasing oral glucose loads of 25, 50, and 100 g and respective isoglycemic glucose infusions. The differences in B-cell secretory responses between oral and iv glucose challenges were attributed to factors other than glycemia itself (incretin effect). Both insulin and C-peptide concentrations as well as calculated integrated insulin secretion rates increased with increasing oral glucose loads. Due to the similarity in the glucose profiles after all oral loads, almost identical amounts of iv glucose (approximately 20 g) were infused in all "isoglycemic" infusion experiments, with resulting similar hormone profiles and insulin secretion rates. The percent contribution of incretin factors to total immunoreactive insulin responses after 25, 50, and 100 g glucose (85.6%, 74.9%, and 93.0%; response to oral load, 100%) was significantly higher than their contribution to integrated C-peptide responses (27.6-62.9%) or calculated integrated insulin secretion rates (19.2-61.0%). These findings indicate that the degree of incretin stimulation of insulin secretion depends on the amount of glucose ingested. A discrepancy between the estimates of the incretin effect derived from peripheral venous insulin responses, on the one hand, and C-peptide responses or calculated insulin secretion rates, on the other hand, exists. Inasmuch as peripheral insulin values reflect both insulin secretion and hepatic insulin removal, this discrepancy suggests that elimination kinetics of insulin differ between oral and iv glucose administration. This difference can be related to a significantly reduced fractional hepatic insulin extraction after oral (46.9-54.6%) compared to iv (63.4-76.5%) glucose administration when calculated by a three-compartment kinetic model. This reduction in fractional hepatic insulin extraction could be caused by gastrointestinal factors (hormones or nerves) stimulated in the course of glucose ingestion. PMID- 3522622 TI - Activation of protein kinase-C stimulates human granulosa-luteal cell prostacyclin production. AB - To study the production of prostacyclin (PGI2) by human granulosa-luteal cells in vitro, individual follicles from clomiphene/human menopausal gonadotropin stimulated cycles of patients undergoing in vitro fertilization were aspirated 36 h after the administration of hCG. Granulosa cells were isolated and cultured for 48 h to regain responsiveness to hCG. The cells were then recultured for 3 days in the presence of a protein kinase-C activator, 12-O-tetradecanoylphorbol-13 acetate (TPA), hCG, cholera toxin, and indomethacin. The media were assayed for 6 keto-prostaglandin F1 alpha (PGF1 alpha), a stable hydration product of PGI2. TPA increased granulosa cell PGI2 production 20-fold. The increase in PG synthesis was detectable at 12 h, was maximal at 72 h, and was prevented by indomethacin. The increase in PG production was specific to TPA and did not occur when an inactive phorbol ester, 4 alpha-phorbol-12,13-didecanoate, was used. hCG and cholera toxin stimulated granulosa cell cAMP production, but not PGI2 synthesis. Thus, human granulosa cells produce PGI2 by protein kinase-C-mediated mechanisms. PMID- 3522623 TI - Insulin oscillations per se do not affect glucose turnover parameters in normal man. AB - To compare the metabolic effects of pulsatile vs. continuous iv insulin infusion, normal men had two glucose-controlled iv glucose infusions using the Biostator for 260 min, during which endogenous pancreatic hormone secretion was inhibited by a somatostatin infusion and glucagon was replaced by continuous glucagon infusion. The two tests were performed at 1-week intervals, during which human insulin was infused either continuously at a constant rate of 0.2 mU kg-1 min-1 or in a pulsatile manner at a rate of 1.3 mU kg-1 min-1 with a switching on/off length of 2/11 min. Blood glucose levels and glucose infusion rates (GIR) were continuously monitored, and glucose turnover was estimated using a [3H]glucose infusion. In both tests, plasma C-peptide dropped markedly, whereas plasma glucagon levels were about twice basal values. Plasma insulin averaged 7 mU liter 1 during continuous infusion and oscillated between 1.5 and 35 mU liter-1 during pulsatile delivery. During the first 30-60 min of both tests, the glucose appearance rate and endogenous glucose production (EGP) increased, resulting in moderate hyperglycemia, which completely suppressed GIR. During the last 65 min, EGP declined, while the glucose disappearance rate and the glucose MCR increased, so that GIR increased progressively to maintain the blood glucose clamped at about 5 mmol liter-1. During this period, no significant differences were found between the two modes of insulin administration for any of the parameters studied. Thus, continuous and pulsatile insulin iv infusion, resulting in physiological peripheral plasma insulin levels, altered the glucose turnover parameters equally, in particular inhibiting EGP, which was stimulated by glucagon during the first part of the study, and stimulating peripheral glucose uptake at the end of the study period. PMID- 3522624 TI - Evaluation and optimization of the DNA filter assay for direct detection of enterotoxigenic Escherichia coli in the presence of stool coliforms. AB - Direct detection of enterotoxigenic Escherichia coli (ETEC) in mixed cultures by DNA filter assay was affected by the presence of other bacteria in the cultures. By shortening incubation to 6 h, bacterial overgrowth was minimized, allowing direct detection of ETEC in stools or mixed cultures initially containing 0.2 to 3% ETEC. PMID- 3522625 TI - Routine evaluation of the nonradiometric BACTEC NR 660 system. AB - The present study compares the sensitivity, accuracy, and practicability of a nonradiometric blood culture system with those of the standard blood culture system in use in our laboratory. A total of 1,080 sets of four blood cultures bottles were compared, giving 143 positive aerobic-medium associations and 139 positive anaerobic-medium associations. The conventional system recovered 171 isolates, whereas the BACTEC NR 660 system (Johnston Laboratories, Towson, Md.) recovered 155 isolated. There were no significant differences in total isolates with either system (P more than 0.05). The BACTEC NR 660 system recovered a slightly lower number of Serratia marcescens and Streptococcus faecalis but a higher number of Pneumococcus spp. The mean detection times were 55.9 h with the conventional system and 31.6 h with the BACTEC NR 660 system (P less than 0.001). Our results demonstrate that the BACTEC NR 660 system is suitable for routine use. PMID- 3522626 TI - Comparative evaluation of enzyme-linked immunosorbent assay for the diagnosis of pulmonary echinococcosis. AB - An enzyme-linked immunosorbent assay was done for the detection of immunoglobulin G and M (IgG and IgM) antibodies to Echinococcus granulosus in surgically proved cases of hydatidosis, especially pulmonary hydatidosis, by use of human hydatid cyst fluid antigen and soluble scolex antigen. This assay was compared with the following standardized techniques: the indirect hemagglutination test, the indirect immunofluorescent antibody test, and Casoni's intradermal test. The enzyme-linked immunosorbent assay, with either of the antigens (human hydatid cyst fluid or soluble scolex antigen), was more sensitive and specific than the other techniques in diagnosing cases of hydatidosis, especially hydatid disease of the lung. PMID- 3522627 TI - Enzyme-linked immunosorbent assay for shigella toxin. AB - An enzyme-linked immunosorbent assay (ELISA) was developed for the detection of shigella toxin. For the assay, a mouse monoclonal antibody against the B subunit of the toxin and a rabbit polyclonal antibody against the holotoxin were employed. The monoclonal antibody was used to coat wells of a microtiter plate, and the polyclonal antibody preparation was used as the detecting antibody. The amount of bound polyclonal antibody was determined by using a goat anti-rabbit immunoglobulin G-alkaline phosphatase conjugate and substrate. The ELISA was able to detect as little as 12 pg (0.06 ng/ml) of shigella toxin. The assay was specific for shigella toxin, not detecting a variety of other bacterial enterotoxins and lethal toxins. The ELISA values correlated well with cytotoxin activity during toxin purification. Shigella toxin was detected by ELISA and by immunoblot analysis in human fecal specimens from persons with S. dysenteriae infections, demonstrating that this toxin is produced in vivo. PMID- 3522628 TI - Studies on the mechanism of insulin resistance in the liver from humans with noninsulin-dependent diabetes. Insulin action and binding in isolated hepatocytes, insulin receptor structure, and kinase activity. AB - We have developed a method to isolate insulin-responsive human hepatocytes from an intraoperative liver biopsy to study insulin action and resistance in man. Hepatocytes from obese patients with noninsulin-dependent diabetes were resistant to maximal insulin concentration, and those from obese controls to submaximal insulin concentration in comparison to nonobese controls. Insulin binding per cell number was similar in all groups. However, insulin binding per surface area was decreased in the two obese groups because their hepatocytes were larger. In addition, the pool of detergent-extractable receptor was further decreased in diabetics. Insulin receptors in all groups were unaltered as determined by affinity-labeling methods. However, insulin-stimulated insulin receptor kinase activity was decreased in diabetics. Thus, in obesity, decreased surface binding could explain resistance to submaximal insulin concentrations. In diabetes, diminished insulin-stimulated protein kinase activity and decreased intracellular pool of receptors could provide an explanation for postinsulin-binding defect(s) of insulin action in human liver. PMID- 3522629 TI - Binding interaction studies of selected receptor subpopulations after partial cross-linking receptor-ligand complexes with a photoactivated heterobifunctional reagent. AB - Certain hormonal and nonhormonal binding systems such as the leukoagglutinin lymphocyte model exhibit complex receptor-ligand interactions that result in nonlinear Scatchard plots. Such plots are interpreted as indicating either homogeneous negatively interacting binding sites or heterogeneous sites with different and fixed affinity. We assessed the validity of these interpretations in our system by conjugating the ligand to a photoactivated heterobifunctional agent and cross-linking the conjugate to a subset of receptors before studying the binding interactions of non-cross-linked sites. Conjugation did not qualitatively or quantitatively affect the binding properties of the ligand. Cross-linking was specific, efficient, and stable and had no effect on irrelevant surface receptors. Cross-linking of only 3% of the total receptors resulted in 50% decreased ligand binding to high affinity sites consistent with a calculated inactivation of 85% and 2% of high and low affinity sites, respectively. Such preferential inactivation of high affinity sites in an unequivocal demonstration of binding sites heterogeneity in this system and shows a clear rejection of the homogeneous cooperation model. PMID- 3522630 TI - Methylphenidate and cognitive therapy in children with attention deficit disorder: a double-blind trial. AB - Stimulant medications have been the treatment of choice for children with Attention Deficit Disorder (ADD), yet long-term benefits have not been found. The present study examined the ability of an adjunctive cognitive behavioral self control therapy program to improve upon these long-term results. Findings only partially supported the efficacy of the cognitive therapy, as demonstrated on the Matching Familiar Figures Test of impulsivity. However, this improvement did not persist over time. Results are discussed in terms of the need for pediatricians to consider individual differences in therapeutic response across patients. PMID- 3522631 TI - Fantasy in children and adolescents with chronic illness. PMID- 3522632 TI - Approaches to the demonstration of congenital heart disease. AB - Advances in antenatal screening techniques have increased the interest in obtaining a detailed pathological correlation with the ultrasonographic findings obtained before death. As a consequence, inadequacies in traditional methods used by pathologists to display congenital malformations have been brought to light. We describe a simple technique of inflation and wax impregnation for the permanent proof of congenital heart defects that can be used in routine perinatal necropsies. PMID- 3522633 TI - Immunocytochemical characterisation of cutaneous lymphomas other than mycosis fungoides. AB - The immunophenotypic properties of 25 cutaneous non-Hodgkin lymphomas other than mycosis fungoides or Sezary syndrome were investigated and correlated with clinical and histopathological data. The 11 low grade lymphomas were all of B cell origin, whereas the 14 high grade lymphomas comprised B and T cell tumours, true histiocytic proliferations, and one "nul" cell lymphoid neoplasm. For the high grade lymphomas correct prediction of the immunological phenotype based on morphological criteria was only possible in three cases. In contrast, all of the low grade lymphomas showed the non-epidermotropic infiltration pattern considered to be characteristic of cutaneous B cell tumours. For these conditions, however, immunophenotypic investigations provided a convenient means of improving discrimination between benign (polyclonal) and malignant (monoclonal) lesions, and also showed similarities with nodal lymphomas in terms of expression of lymphoid subset markers and composition of the non-neoplastic white cell infiltrate. No differences were identified between primary and secondary or concurrent cutaneous and extracutaneous lymphomas. Cutaneous non-Hodgkin lymphomas other than mycosis fungoides or Sezary syndrome constitute a heterogeneous group of neoplasms and most of these disorders are likely to represent cutaneous equivalents of nodal malignancies. Immunophenotypic investigations form a useful supplement to their histogenetic characterisation and may provide a common conceptual basis for their classification. PMID- 3522634 TI - Presence of 3-fucosyl-N-acetyllactosamine shown by monoclonal antibody AGF 4.48 in Reed-Sternberg cells. AB - A series of 50 specimens of Hodgkin's disease and 10 of reactive follicular hyperplasia were examined by means of indirect immunoperoxidase staining with a monoclonal antibody AGF 4.48: this is known to bind to 3-fucosyl-N acetyllactosamine, which, in particular, is expressed by granulocyte series cells. Most Reed-Sternberg and many Hodgkin's cells were labelled by the antibody after pretreatment with neuraminidase. Routinely processed paraffin wax embedded sections proved suitable for staining. The findings were comparable with those reported by others with monoclonal antibodies to various other granulocyte markers. This technique is of potential diagnostic value. PMID- 3522635 TI - Manual or radiometric method for detection of bacteraemia. PMID- 3522636 TI - Demonstration of carcinoembryonic antigen (CEA) expression in normal, chronically inflamed, and malignant pancreatic tissue by immunohistochemistry. AB - The expression of carcinoembryonic antigen (CEA) was evaluated by immunoperoxidase staining with two anti-CEA monoclonal antibodies in normal, chronically inflamed, and malignant pancreatic tissue. Positive staining was not observed in normal specimens. In pancreatic cancer the expression of CEA was related to the degree of differentiation of the tumour. Positive staining was also observed in chronic pancreatitis. PMID- 3522637 TI - Comparison of radiometric and gas capture system for blood cultures. AB - A single bottle blood culture system that detects the gas produced by micro organisms from substrates in a specially formulated medium was compared with the Bactec radiometric system. A total of 725 blood samples collected from patients with suspected bacteraemia yielded 75 clinically important isolates. Fifty five (73%) of these cultures were detected by both methods, 16 (21%) by only the Bactec system, and four (5%) by only the Oxoid system. No significant differences were found between the two systems after allowance was made for the different volume of sample inoculated into each system. PMID- 3522638 TI - Kit systems for identifying gram negative aerobic bacilli: report of the Welsh Standing Specialist Advisory Working Group in Microbiology. AB - Under the auspices of the Welsh Standing Specialist Advisory Working Group in Microbiology (WMG) 10 clinical microbiology laboratories in Wales undertook a collaborative study to assess 10 commercial kits for the identification of aerobic Gram negative bacilli. In excess of 1000 such strains were examined in parallel with each kit system. Accuracy, reproducibility of accuracy, and reproducibility alone were assessed, together with the cost effectiveness of the kits used. A ranking order of kit performance based on the above variables was drawn up. PMID- 3522640 TI - Examination and recording of large format histopathological specimens. PMID- 3522639 TI - Evaluation of lymph node imprint in rapid diagnosis of lymph node biopsy specimens. PMID- 3522641 TI - Comparison of API-10S strips and tube tests for biotyping Haemophilus influenzae. PMID- 3522642 TI - Identification of Legionella pneumophila with commercially available immunofluorescence test. PMID- 3522643 TI - Conference on clinical trials in periodontal diseases. Chicago, USA, May 21-23, 1985. Dedicated to the memory of John W. Fertig, Ph.D. PMID- 3522644 TI - Gingivitis. AB - Gingivitis is caused by substances derived from microbial plaque accumulating at or near the gingival sulcus; all other suspected local and systemic etiologic factors either enhance plaque accumulation or retention, or enhance the susceptibility of the gingival tissue to microbial attack. Microbial species specifically associated with gingival health include Streptococcus sanguis 1, S. D-7, and Fusobacterium naviforme. Bacteria involved in the etiology of gingivitis include specific species of Streptococcus, Fusobacterium, Actinomyces, Veillonella, and Treponema and possibly Bacteroides, Capnocytophaga, and Eikenella. Microbial colonization and participation is sequential, with the complexity of the associated flora increasing with time. The pathogenesis has been separated into the initial, early, and established stages, each with characteristic features. The initial lesion is an acute inflammation which can be induced experimentally by application of extracts of plaque bacteria to normal gingiva. The early lesion is characterized by a lymphoid cell infiltrate predominated by T lymphocytes, characteristic of lesions seen at sites of cell mediated hypersensitivity reactions. The early lesion can be induced by application of purified contact antigens to the gingival tissues of previously sensitized animals. As the clinical condition worsens, the established lesion appears, predominated by B lymphocytes and plasma cells. Established lesions may remain stable for indefinite periods of time, they may revert, or they may progress. Periodontal destruction does not result from the conversion of a predominantly T cell to a predominantly B cell lesion as has been suggested, but rather from episodes of acute inflammation. Clinical manifestations of gingivitis are episodic phenomena characterized by discontinuous bursts of acute inflammation. Most lesions are transient or persistent but not progressive. Attachment loss may precede alveolar bone loss and may occur without the manifestations of a concurrent or a precursor gingivitis. On the other hand, the evidence indicates that a portion of gingivitis lesions can and does progress to periodontitis. Gingivitis and the periodontal microflora differ in children and adults. Clinical signs of gingivitis either do not appear as plaque accumulates, or they are greatly delayed in children, and the inflammatory infiltrate consists mostly of T lymphocytes. The conversion to a B cell lesion does not appear to occur. The evidence supports the conclusion that gingivitis is a disease, and that control and prevention is a worthwhile goal and a health benefit.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3522646 TI - Current status of indices of gingivitis. AB - Gingival indices are used to describe the relative status of the degree of either health, disease, or both, of the gingival tissues. Most of the indices incorporate a graduated scale with definite upper and lower limits. All gingival indices rely on one or more of the following criteria: color, contour, bleeding, extent of involvement, crevicular fluid flow. Some indices have shown a correlation between the various criteria used and histologic signs of inflammation, particularly in the case of bleeding and visual signs of inflammation. In this paper, a number of indices to assess gingival health have been reviewed; their sensitivity varies and the type of index used will be dependent on the objective of the study to be conducted. PMID- 3522645 TI - Epidemiology of gingivitis. AB - In recent years, tremendous strides have been made in understanding the etiology of gingivitis. This increase in knowledge has come, for the most part, from basic research in oral microbiology, immunology, histology and pathology. Over the past decade, less progress has been made in further refining the epidemiological relationships between gingivitis and various host and environmental factors. The major restraint has been the great difficulty in reliably measuring gingival inflammation. This problem has resulted in great inter- and intra-study variation in diagnosing the prevalence and severity of gingivitis in human populations. Consequently, it is almost impossible to estimate longitudinal trends in gingivitis and it is nearly as difficult to make comparisons among different population groups studied by different examiners. Nevertheless, by focusing on the most apparent and robust epidemiological relationships, an instructive overview of the epidemiology of gingivitis can be gained. A number of host and environmental factors have been studied in relation to gingivitis and some of these will be reviewed. With respect to age, there is general concensus that marginal gingivitis begins in early childhood, increases in prevalence and severity to the early teenage years, thereafter subsiding slightly and leveling off for the remainder of the second decade of life. Gingivitis during the adult period is much more difficult to characterize due to paucity of data. Estimates of the general prevalence of adult gingivitis vary from approximately 50 to 100% for dentate subjects. In terms of gingivitis prevalence, the dentate elderly do not deviate appreciably from the general adult pattern. When adjusted for cohort effects, gingival disease appears to be on the decline.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3522647 TI - A procedure for evaluating the reliability of a gingivitis index. AB - A methodology is presented for assessing the reliability of an ordinarily-scaled index and is illustrated by using data from a clinical trial in which gingival inflammation was assessed with the PMGI index, independently, by 5 examiners. One of the examiners was an experienced examiner, the others newly trained. All subjects were evaluated by each examiner initially and at the end of the study period. The reliability of the average score per subject, maximum score per subject, and the % of affected sites per person are estimated by the intraclass correlation coefficient. Procedures are presented that utilize various forms of the weighted kappa statistic for dissecting patterns in examiner agreement for specific sites, types of site, all sites, and for the individual components and categories of the index. It is shown how these procedures can be useful for training and calibrating multiple examiners, who will be using such an index in a clinical study, so that adequate reliability levels can be realized. PMID- 3522648 TI - Design and analysis of plaque and gingivitis clinical trials. AB - It is most important that the proper design of a clinical trial be developed prior to the start of the study. Such a design is one that will not tend to find a treatment to be effective when it really is ineffective, and will not tend to miss a good treatment when it really is effective. The questions to be answered by a clinical trial must be decided in advance and will help determine the design. Trials should take into consideration how the agent is to be used: carefully controlled, ordinary use, subject or professionally applied, etc. The double-blind parallel randomized trial is preferred to the double blind cross over design, except possibly for a professionally applied treatment which does not leach into the saliva or affect the oral microflora. Blocking or stratification tends to increase the efficiency of a clinical trial, and also may produce more information on the agent's effectiveness. Stratification is preferred to blocking, particularly when subjects enter the trial serially over time. Subjects should be stratified by age, sex and baseline level of plaque or gingivitis. Stratification permits a check on whether the effect of treatment is atypically strong or weak for certain types of patients. Where possible, the same examiner should examine the same patients throughout the study. Examiners should be self-calibrated to reduce intra-examiner error. Plaque and gingivitis trials should be at least of 6 months duration and may be preventive or therapeutic in nature. The preferred statistical analysis when 2 treatments are being compared is a comparison of mean changes in plaque or gingivitis scores by the independent sample t-test. An analysis of covariance using the baseline scores as the covariate may improve power somewhat. When pairwise t-tests are performed in comparing several treatments, multiple comparison criteria are indicated. Parametric rather than nonparametric tests are preferred since they usually have more power. The square root of whole mouth means in gingivitis clinical trials is the preferred transformation to obtain greater power and to produce approximately normal distributions. PMID- 3522649 TI - Design of clinical trials for chronic diseases: implications for periodontal disease. AB - In order to make effective use of the statistical theory of design of clinical trials for chronic diseases such as periodontal disease, certain issues must be considered. Any clinical trial requires that the disease definition be well specified; that patient eligibility be explicit; that the observation times be explicit; that the duration and endpoint of therapy be specified; that the duration of subsequent followup observation be specified; and that the unit of observation (e.g., tooth, set of teeth, patient) be defined. In a chronic disease, the potential biases that can readily be introduced by self-selection of patients who enter the trial and/or who return for subsequent observation become more important, because subjects are required to remain on treatment and/or observation for prolonged periods. Further, the cyclical nature of some chronic diseases may require special attention to baseline definitions of active disease and disease outcome. These issues are illustrated with examples from clinical trials of hypertension, breast cancer screening, and Polycythemia Vera. Implications for periodontal disease are discussed. PMID- 3522650 TI - Pathogenesis of periodontitis. AB - Periodontitis is an inflammatory disease of the periodontium which is characterized by a progressive destruction of the tissues supporting the tooth. Its primary etiology is an ill-defined series of microbial infections which may be composed of only some of the more than 300 species of bacteria currently recognized in the oral cavity. The disease is currently considered to progress as periodic, relatively short episodes of rapid tissue destruction followed by some repair, and prolonged intervening periods of disease remission. Despite the apparent random distribution of episodes of disease activity, the resulting tissue breakdown exhibits a symmetrical pattern of alveolar bone loss and pocket formation which is common to several forms of periodontitis, although the distribution of the most affected teeth and surfaces may vary among diseases (e.g., juvenile periodontitis versus adult periodontitis or rapidly progressive periodontitis). Several reports have indicated that bacterial cells can be found in the pocket wall of periodontitis lesions. The translocation of bacteria into the tissues from the pocket environment is quite common, as evidenced by the common occurrence of bacteremias in patients with periodontitis following relatively minor events such as chewing and oral hygiene procedures. However, it is important to distinguish between the passive introduction of bacteria into periodontal tissues and frank invasion as might occur in an acute infection, since the pathological implications may be quite different. PMID- 3522651 TI - Attachment level changes in destructive periodontal diseases. AB - The present communication attempts to summarize some of the features of attachment loss which are of interest to the clinician and the statistician analyzing data from clinical trials. These include the measurements employed to detect changes in attachment level, the nature of the destructive disease process and the effects of therapy on the attachment level measurements. Although there are several difficulties associated with the attachment level measurement, at the present time it appears to be the best estimator of periodontal attachment available. The overall standard deviation of this measurement in greater than 46,000 replicate measurements at periodontal sites in 58 subjects was 0.78 mm (range 0.4 to 1.2 mm). In the periodontally healthy subject, the length of the attachment measured around 28 teeth is approximately 700 mm. Therefore, there are approximately 1400 adjacent points along the periodontal attachment where a measurement could be made using a periodontal probe with a 0.5 mm diameter tip. If 6 measurements were recorded per tooth, then approximately 12% of the possible probable points would be evaluated. Recent data indicate that destructive periodontal diseases progress with acute bursts of activity rather than as slowly progressive, continual processes. Such findings suggest new models of attachment loss progression. In one likely model, destructive periodontal diseases would progress by asynchronous bursts of activity at individual sites which occur with greater frequency during a finite period of time in an individual's life. 3 major patterns of attachment loss could be distinguished when frequency distributions of attachment level measurements were constructed for 61 destructive periodontal disease subjects. Pattern I (30 subjects) exhibited a bimodal distribution with localized destruction occurring at less than 34% of sites. Pattern II (14 subjects) exhibited more widespread disease (greater than 33% of sites affected) with a trimodal frequency distribution. Pattern III (17 subjects) exhibited a unimodal distribution in which virtually all sites were affected. The proportions of Fusobacterium nucleatum, Streptococcus intermedius and Eikenella corrodens in subgingival plaque samples were significantly elevated in sites of subjects with patterns II and III (the widespread disease groups). Bacteroides intermedius, Streptococcus uberis and Actinobacillus actinomycetemcomitans were elevated in sampled sites of localized disease subjects (pattern I). The effects of therapy by Widman flap surgery and systemic tetracycline were examined by several statistical analyses.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3522652 TI - Analysis of data from clinical studies of localized juvenile periodontitis. AB - Data from 27 subjects with localized juvenile periodontitis were used to compute estimates of the intraclass correlation coefficient for initial periodontal pocket depth measurements and total subgingival Actinobacillus actinomycetemcomitans counts, and for changes from pre- to post-treatment in periodontal pocket depth, probing attachment level and Actinobacillus actinomycetemcomitans counts. The estimates for the clinical parameters were considerably higher than those found in a similar study of adult periodontitis. On the average, the estimates for the intraclass correlation coefficients for Actinobacillus actinomycetemcomitans counts did not differ markedly from the corresponding estimates for the clinical parameters. Although the results of this study indicate that the major component of variability in parameters commonly used in studies of periodontal disease can be attributed to site-specific factors, sites within subjects cannot be considered statistically independent. For the analysis of data arising from studies of periodontal disease, it is recommended that statistical techniques, like the nested mixed effects analysis of variance model be employed, which account for this dependence. These techniques will allow meaningful biological questions concerning site-specific phenomenon to be answered. However, changes in clinical and microbiological parameters, when therapeutic measures are employed on localized juvenile periodontitis patients, are often dramatic enough to allow informal data presentation. PMID- 3522653 TI - Design of clinical trials of traditional therapies of periodontitis. AB - The present paper on the design of clinical trials of periodontal therapy first addresses the issue of the etiology of periodontal disease. It is suggested that most if not all forms of destructive periodontal disease are caused by microorganisms and that there are different forms of disease with different microbial etiologies. The progressive nature of destructive periodontal disease is subsequently discussed and it is emphasized that, in a given patient, periodontal sites which show signs of inflammation and attachment loss may not over a period of several months and years show further sign of attachment loss. The present methods of assessing periodontal disease do not allow us to discriminate between potentially active and inactive sites in untreated patients. The significance and variability of indicators of periodontal disease such as bleeding on probing, probing pocket depth and probing attachment level measurements are discussed. The errors inherent in the various measurements are analyzed and suggestions are presented describing how alterations in any of the above parameters could be identified and presented in a clinical trial. Of concern for the statistical analysis of clinical data of periodontal disease is the definition of the "experimental unit". For a number of years, the "experimental unit" in periodontal trials was the patient. It is clear, however, that different sites within the same individual show different patterns of disease progression and lesion morphology and often respond differently to periodontal therapy. Statistical analyses must consequently be designed which recognize differences in site-to-site infection and lesion morphology within a common host. Until such analyses are available, the investigator should be wary of pooling data within the same individual, since such pooling may obscure meaningful alternatives which may take place in individual periodontal sites. Some goals of periodontal therapy are subsequently identified. 4 goals are discussed more in detail, namely: to establish conditions which will allow the patient to maintain a dentition without further breakdown of the periodontium; to reduce pocket depth to establish an anatomy in the dentogingival region which with proper maintainance care will prevent the re-establishment of the subgingival infection; to gain attachment as a result of treatment; to assess the effect of a certain chemotherapeutic agent on periodontal disease. PMID- 3522654 TI - Design and analysis considerations for a longitudinal study of periodontal disease. AB - Perception and concern for the health changes in our aging population led the Veterans Administration to initiate an interdisciplinary and longitudinal investigation of the aging process, the Veterans Administration Normative Aging Study, in 1963. A cohort of the 2,280 healthy men of this study self-selected to enroll in the dental longitudinal study, an investigation of oral health in these healthy males. In 1968, 1,221 men between the ages of 25 and 75 began with a baseline cycle of 5 general series of examinations, including an interim health history and survey of dietary habits; masticatory performance and taste thresholds; salivary analyses; oral cytologic and radiographic survey and comprehensive clinical data on caries and periodontal status. Design considerations for the Dental Longitudinal Study included prospective planning of specific oral variables to be recorded, and provision of collection techniques to allow for additional analyses based on a wide menu of retrospective data. The volunteer cohort was screened to obtain men who met stringent general health criteria, who represented wide socioeconomic ranges and would likely remain geographically stable. Importantly, enrollment in the parent study was without regard for dental status or oral health. Administrative design considerations included orderly transfer for exam data to machine-readable format by use of optical scan forms designed to register specific oral variables, with security preserved for the primary source records and rapid record retrieval. Additional data collection requiring manual coding was designed to transfer spreadsheets of clinical impressions and diagnoses to computer retrieval protocols. Provisions for recording of exceptional circumstances, i.e., salient oral pathology, were recognized and the optical scan forms modified to index and retrieve such cases.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3522655 TI - Considerations in the statistical analysis of clinical trials in periodontitis. AB - Adult periodontitis has been described as a chronic infectious process exhibiting sporadic, acute exacerbations which cause quantal, localized losses of dental attachment. Many analytic problems of periodontal trials are similar to those of other chronic diseases. However, the episodic, localized, infrequent, and relatively unpredictable behavior of exacerbations, coupled with measurement error difficulties, cause some specific problems. Considerable controversy exists as to the proper selection and treatment of multiple site data from the same patient for group comparisons for epidemiologic or therapeutic evaluative purposes. This paper comments, with varying degrees of emphasis, on several issues pertinent to the analysis of periodontal trials. Considerable attention is given to the ways in which measurement variability may distort analytic results. Statistical treatments of multiple site data for descriptive summaries are distinguished from treatments for formal statistical inference to validate therapeutic effects. Evidence suggesting that sites behave independently is contested. For inferential analyses directed at therapeutic or preventive effects, analytic models based on site independence are deemed unsatisfactory. Methods of summarization that may yield more powerful analyses than all-site mean scores, while retaining appropriate treatment of inter-site associations, are suggested. Brief comments and opinions on an assortment of other issues in clinical trial analysis are preferred. PMID- 3522656 TI - Indicators of periodontal disease activity: an evaluation. AB - It is becoming increasingly apparent that the traditional clinical criteria are inadequate for: determining active disease sites in periodontitis, monitoring quantitatively the response to therapy or measuring the degree of susceptibility to future breakdown. In an attempt to develop objective measures, a wide variety of studies have been undertaken using saliva, blood, plaque and gingival crevicular fluid (GCF) as the specimen source. Examination has included: specific bacteria and their products; host cells and their products (enzymatic and antibacterial, both immunologic and non-immunologic); products of tissue injury derived from local epithelial and connective tissues and bone. Although most of the work to date has failed to provide reliable aids to the clinician, refinements in techniques for sampling and the availability of more sophisticated analytic techniques give cause for optimism. Methods proposed for detection of disease-associated bacteria in subgingival plaque vary in their sensitivity and specificity. Dark field microscopy shows some correlation with existing disease; however, the limited specificity of this method imposes severe restrictions on its usefulness. Highly specific polyclonal and monoclonal antisera to suspected pathogens Bacteroides gingivalis and Actinobacillus actinomycetemcomitans have been developed and improved methods of identification of these microbes in plaque by ELISA immunofluorescence and flow cytometry are under development. With respect to the host response, a strong correlation between antibody patterns to specific bacteria and periodontal disease categories appears to be emerging. Although most studies have focused on serum antibody derived from peripheral blood, a shift to detection of local antibody response appears to be likely. Techniques of measurement that are exquisitely sensitive have been developed for detection of major immune recognition proteins such as antibody and complement in crevicular fluid. Research efforts attempting to correlate local antibody response to local disease activity are underway. Measurement of GCF flow rate, endotoxin, H2S, butyrate and a variety of enzymes (e.g., collagenase, arylsulfatase, B-glucuronidase) show good correlation with levels of gingivitis. In periodontitis, the most promising markers of tissue breakdown are prostaglandins of the E series, the enzymes collagenase and aspartate aminotransferase, sulfated glycosaminoglycans, osteoclastic activating factor and bone resorptive capacity of crevicular cells. Assay of the migration of crevicular leucocytes in vivo can serve as an indicator of a defect in host resistance.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3522657 TI - A custom incisal guide table. PMID- 3522658 TI - Intraspinal transplantation of embryonic spinal cord tissue in neonatal and adult rats. AB - Fetal rat spinal cord tissue was obtained on gestational day 14 (E14) and transplanted into 2-4-mm-long intraspinal cavities produced by partial spinal cord lesions in adult and neonatal rats. At regular post-transplantation intervals, light and electron microscopy, autoradiographic demonstration of tritiated thymidine labelling, and immunocytochemical localization of glial fibrillary acidic protein (GFAP) were used to identify surviving donor tissues and to study their differentiation and extent of fusion with recipient spinal cords. In some experiments, wheat germ agglutinin-conjugated horseradish peroxidase (WGA-HRP) was also employed to examine whether neurons within the grafts projected axons into the host spinal cord and vice versa. Lastly, immunocytochemistry was used to determine whether any supraspinal serotoninergic (5-HT) axons from the host extended into the transplants. Over 80% of the grafts survived in lesions of both the neonatal and adult rat spinal cord for periods of 1-16 months (duration of experiment), and considerable maturation of donor tissue was evidenced, which even included the appearance of some topographical features of the normal spinal cord. Many of the transplants extended the entire length of the lesion, and were often closely apposed to the injured surfaces of the recipient spinal cords without an intervening dense glial scar. At post transplantation intervals of 2-4 months, injection of WGA-HRP into the host spinal cord (5 mm from the transplant in adult animals or as much as 20 mm in neonatal recipients) demonstrated retrogradely labelled neurons and anterogradely labelled axons in the grafts. Likewise, injecting WGA-HRP into transplants in adult recipients resulted in labelling of neurons in adjacent segments of the host spinal cord; some labelled axons, derived from donor neurons, were also present in neighboring spinal gray matter. Finally, immunocytochemistry revealed 5-HT-like immunoreactive fibers in transplants that had been prelabelled with tritiated thymidine. These observations demonstrate the potential of embryonic spinal cord transplants to replace damaged intraspinal neuronal populations and to restore some degree of anatomical continuity between the isolated rostral and caudal stumps of the injured mammalian spinal cord. PMID- 3522659 TI - Neurotensin in the rat parabrachial region: ultrastructural localization and extrinsic sources of immunoreactivity. AB - We sought to determine (1) the ultrastructural localization and (2) the extrinsic sources of neurotensin-like immunoreactivity (NTLI) in the parabrachial region (PBR). The brains from untreated adult male rats and from others that received intraventricular injections of colchicine (100 micrograms/7.5 microliters saline) 24 hours prior to death were fixed by perfusion with acrolein or glutaraldehyde and paraformaldehyde. Coronal sections were immunocytochemically labeled with a polyclonal rabbit antiserum to neurotensin and the PAP method. Western dot-blots and immunocytochemical labeling with adsorbed antiserum revealed significant cross-reaction only against NT, NT8-13, and glutamine (Gln)4-NT. In the ultrastructural study, the most numerous labeled profiles were axons and axon terminals in both colchicine-treated and control animals. The terminals containing NTLI were characterized by a mixed population of small, clear and large, dense core vesicles; asymmetric junctions principally with unlabeled dendrites; and a few synaptic specializations with unlabeled axon terminals. Compared to axon terminals, relatively few perikarya or dendrites had detectable levels of NTLI in either untreated or colchicine-treated animals. The labeled perikarya measured 8-10 microns in longest cross-sectional diameter, contained NTLI throughout a narrow rim of cytoplasm, and received a few somatic synapses from unlabeled terminals. From the relative density of axon terminals and sparsity of perikarya and dendrites, we conclude that the NTLI in the PBR is principally derived from extrinsic neurons. However, the intrinsic neurons with NTLI may also contribute to the immunoreactivity in the axon terminals of the PBR. We sought to determine the precise location of the extrinsic neurons that contribute to the NTLI in axon terminals in the PBR. Following unilateral injections of wheat germ agglutinin-conjugated horseradish peroxidase (WGA-HRP), dual labeling was most evident in a large population of neurons located in the dorsal, medial and commissural nuclei of the solitary tracts, ipsilateral to the side of the injection. However, a few perikarya containing both the retrogradely transported WGA-HRP and immunocytochemical labels for NT were also detected in the caudal ventrolateral reticular formation, the locus coeruleus, and the paraventricular and lateral hypothalamic nuclei. We conclude that (1) NT or a closely related peptide is present in intrinsic neurons and multiple afferent pathways to the PBR; and (2) the axon terminals with NTLI have synaptic interactions with dendrites of intrinsic neurons and with axon terminals that may have either extrinsic or intrinsic origins. PMID- 3522660 TI - Cell surface changes in the developing optic nerve of mice. AB - A recently defined antibody to a cell surface protein, M6, inhibits neurite outgrowth in culture (Lagenaur, Fushiki, and Schachner: Soc. Neurosci. Abstr. 10:739, '84). In the developing mouse, the antibody stains all parts of the primary optic pathway at birth. Over the next week, staining is lost from the proximal segment of the optic nerve and a week later from the more central part of the nerve. By contrast staining persists through adulthood in the optic fiber layer of the retina. This means that single axons in the mature optic nerve express the antigen over only the proximal few millimeters of their course and over their terminal region. The results are discussed in relation to the overall maturation of the optic pathway and to the processes of membrane maturation and myelination. PMID- 3522661 TI - Cytochemical identification of cholinergic amacrine cells in cat retina. AB - Golgi studies of cat retina have revealed the presence of matching subpopulations of starburst-like amacrine and displaced amacrine cells that are morphologically similar to the cholinergic cells of rabbit retina. The displaced amacrines appear identical with the A14 cells described by Kolb et al. (Kolb, Nelson, and Mariani: Vision Res. 21:1081-1114, 1981). In order to determine whether these cells may be cholinergic, we carried out autoradiography to localize newly synthesized (3H)acetylcholine and immunocytochemistry to demonstrate the distribution of choline acetyltransferase. Autoradiographs showed labeling in somas of both amacrine and displaced amacrine cells. Choline acetyltransferase was found in amacrine cells that ramify in sublamina a of the inner plexiform layer and in displaced amacrine cells ramifying in sublamina b. The pattern of cholinergic neurons in the cat is similar to that in other vertebrates and suggests that acetylcholine may play an important and consistent role in retinal function. PMID- 3522662 TI - Distribution of neurons and axons immunoreactive with antisera against neuropeptide Y in the normal human hippocampus. AB - The detailed distribution of neuropeptide tyrosine (neuropeptide Y; NPY) immunoreactive neurons and fibers is given for the normal human hippocampus. These neuronal elements are detected by a polyclonal antibody raised against the unconjugated peptide and controls were obtained by using liquid phase absorption immunocytochemistry. The description covers the distribution in the area dentata, the hippocampal subfields CA3 and CA1, the subicular complex, and the entorhinal area. Each region is distinct in its NPY content. In general, the hippocampal NPY immunoreactive neurons fall into distinct classes--large hilar neurons; cortical small bipolar or bitufted neurons; medium-sized multipolar neurons in the deep cortical layers; and finally the distinct, small bipolar NPY neurons of the white matter bundles. None of the NPY neurons are pyramidal; many are likely to be local circuit neurons, but some appear to have extrinsic connections. The NPY immunoreactive axonal innervation is dense throughout the hippocampus but shows distinct regional differences in the hippocampal subdivisions. The area dentata has hilar NPY immunoreactive neurons and radial varicose fibers scattered throughout without a clear laminar preference. Subfield CA3 is comparatively the weakest NPY-containing region and contrasts with CA1, which is well endowed with reactive neurons and a rich and unusual axonal innervation, with distinct laminar axonal specializations. The subicular complex is well endowed with cells and fibers and the parasubiculum consistently displays unusually heavy NPY innervation. The entorhinal area exhibits a rich cortical distribution pattern, like that previously described for the human cerebral cortex (Chan-Palay et al; J. Comp. Neurol. 238:382-390, '85a,b). The fimbria, alveus, and angular bundle have NPY neurons embedded within the white matter. Like the NPY immunoreactive innervation of the hippocampal regions of laboratory animals, the human NPY innervation seems to follow a common fundamental pattern with respect to cell locations, cell morphology, and axonal innervation. The difference, however, is the greater complexity and profusion of the NPY-immunoreactive axonal plexuses in the human hippocampus. This rich peptide network within the hippocampus with likely extrahippocampal interconnections raises questions concerning coexistence with other neuroactive substances, the functions of such substantial networks, and how they are altered in human neurological disease. PMID- 3522663 TI - Distribution of altered hippocampal neurons and axons immunoreactive with antisera against neuropeptide Y in Alzheimer's-type dementia. AB - This paper provides detailed information on the distribution of neuropeptide tyrosine (neuropeptide Y; NPY) immunoreactive neurons and fibers in the hippocampal region of eight neuropathologically confirmed cases of Alzheimer's type dementia (ATD) at postmortem. These neuronal networks are detected by a polyclonal antibody raised against the unconjugated peptide and controls were obtained by using liquid phase absorption immunocytochemistry. The description covers the subfields area dentata, CA3 and CA1, the subicular complex, and the entorhinal area. The hippocampal regions in which the NPY-i neuron networks are most severely affected are the hilus, CA1, the parasubiculum, and the entorhinal cortex. Less obvious reductions occurred in CA3, subiculum, and the presubiculum. Parallel semiquantitative estimates were made of the numbers of neuritic plaques and neurofibrillary tangles in the other hippocampus of the brains in every ATD case. The areas of heaviest pathological changes by these indices are CA1 and the entorhinal cortex. The subicular complex CA3 and the area dentata are less affected. These findings show that the areas with the most severe loss of NPY-i neurons and axons, CA1 and the entorhinal cortex, are the same as those areas most severely affected by the other indices of ATD. Thus NPY-i networks are involved in the ATD disease process. However, other NPY-i networks survive, in some subfields better than in others. The cumulative evidence suggests a population of hippocampal peptide neurons that are remarkably resistant in terminal neurological disease. These neurons have the capability to participate in the maintenance of minimal functioning circuits in target areas of the disease and as such hold significant links for our understanding of synaptic plasticity in disease. PMID- 3522664 TI - Distribution of gamma-aminobutyric acid-immunoreactive neurons in the septal region of the rat brain. AB - The distribution of gamma-aminobutyric acid-immunoreactive (GABA-I) elements was examined in the septal region of the rat brain. The indirect peroxidase antiperoxidase technique was used with anti-GABA antibodies in normal and colchicine-pretreated rats, with or without use of detergent in the incubation medium. Intraventricular injection of colchicine did not result in any change in the staining of neuronal perikarya. Intraseptal injections increased the intensity of labelling of GABA-I cell bodies in the lateral septal nucleus and increased the number of labelled cells in the medial septal nucleus and diagonal band of Broca (dbB). Triton X-100 added to the incubation media decreased the intensity of staining and number of GABA-I somata in all septal nuclei with a concentration-dependent effect. No change was observed concerning GABA-I varicosities. The septal area, including the lateral, medial, and triangular septal nuclei; the anterior rudiment of the hippocampus; the island of Calleja magna; the septofimbrial nucleus; the bed nucleus of the stria terminalis; and the dbB showed a strong reaction to anti-GABA antibodies with regard to GABA containing surrounding structures. GABA-I axonal varicosities were observed in all the regions with an uneven distribution. The highest density was found in the dorsal and ventral parts of the lateral septal nucleus and in a band situated between the dbB and the nucleus accumbens. Labelled varicosities were frequently observed surrounding GABA-I and nonimmunoreactive cell bodies. GABA-I somata ranged from 10 to 30 micron in diameter. Small neurons were present in great number at the ventricular border and in the zona limitans. Medium-size and large neurons were mostly observed in the medial part of the dorsal lateral nucleus and in the intermediate lateral nucleus.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3522665 TI - Ichthyosis bullosa of Siemens: a unique type of epidermolytic hyperkeratosis. AB - We report the second family of ichthyosis bullosa, an entity that was first described by Siemens in 1937 and since then has fallen into oblivion. Clinically, ichthyosis bullosa is characterized by blistering resembling epidermolysis bullosa simplex and by generalized, yet circumscribed dark gray hyperkeratoses covering mainly the arms and the legs. Lichenification and superficially denuded areas (mauserung) are further prominent features. Histology disclosed intracorneal blister formation corresponding to the mauserung phenomenon and epidermolytic hyperkeratosis that was confined to the granular layer and to the uppermost layers of the prickle cells. On electron microscopic examination the keratinocytes of these layers displayed structural alterations of tonofilaments as usually observed in epidermolytic hyperkeratosis. Thus ichthyosis bullosa shares with bullous ichthyosiform erythroderma blistering and epidermolytic hyperkeratosis, but can be distinguished from this wellknown disease by the lack of erythroderma, by the mauserung phenomenon, by the confinement of acanthokeratolysis to the superficial layers of the epidermis, and by intracorneal blistering. PMID- 3522666 TI - A case of linear IgA disease presenting initially with IgG immune deposits. AB - We describe a case of linear IgA bullous disease initially presenting with histopathologic and immunofluorescent findings consistent with bullous pemphigoid. Initial immunofluorescent studies demonstrated a predominance of linear IgG at the basement membrane zone (BMZ) of perilesional skin and a low titer circulating IgG anti-BMZ antibody. Repeat studies 3 years later revealed a predominance of linear IgA immune deposits at the BMZ and no circulating anti-BMZ antibody. Dapsone therapy was initiated at this time with a good therapeutic response noted. Suction blister studies, immunoelectron microscopy, split skin immunofluorescent studies and Western immune blot were performed and provided indirect evidence that the BMZ antigen in this case is distinct from the bullous pemphigoid antigen component of the BMZ. PMID- 3522667 TI - Extragenital syphilitic chancres. PMID- 3522668 TI - Effects of tissue-destructive technics on wound healing. PMID- 3522669 TI - Drug-induced bullous lichen planus in a patient with diabetes mellitus and liver disease. PMID- 3522670 TI - Ofuji's disease: a follow-up. PMID- 3522671 TI - The birth of the blues. PMID- 3522673 TI - Giant cell lichenoid dermatitis. AB - A case of drug-induced lichenoid dermatitis with an unusual epidermotropic multinucleated giant cell inflammatory response is reported. The patient is a 52 year-old white woman who is steroid-dependent because of long-standing systemic lupus erythematosus. At the time of presentation of her generalized papulosquamous pruritic eruption, she was taking oral antihypertensive medications (methyldopa and chlorothiazide). After discontinuation of these medications and local treatment with topical corticosteroids, the skin eruption dramatically improved. Microscopically, the skin lesions had a lichenoid inflammatory pattern, with multiple cytoid bodies, multinucleated giant cells, and a mixed chronic inflammatory infiltrate that included lymphocytes, histiocytes, and eosinophils. PMID- 3522672 TI - Reflections on dermatology. The seventh annual Samuel J. Zakon lectureship of the History of Dermatology Society, Dec. 8, 1985, Las Vegas, NV. PMID- 3522674 TI - Pancreatic A and B cell stimulation in euthermic and hibernating marmots (Marmota flaviventris): effects of glucose and arginine administration. AB - In euthermic and hibernating marmots (Marmota flaviventris), the pancreatic A and B cells respond in the appropriate secretory manner to glucose or arginine injection. Although reduced, this response, is clearly present in hibernating marmots. When glucose is administered to euthermic or hibernating marmots, plasma insulin concentrations rise and glucagon levels fall. While similar results are obtained in hibernation, the time period of the response is much longer due to the slowing of temperature dependent metabolic processes. Injection of L-arginine stimulates an increase in plasma glucose, insulin, and glucagon as expected. Measurements of plasma glucose, insulin, and glucagon under basal conditions, suggest that there are no significant differences between any phase of hibernation (eg. entrance, deep hibernation, arousal) and euthermia. These results provide indirect evidence that the pancreatic A and B cells of hibernating marmots continue to function in order to help regulate plasma glucose concentration. PMID- 3522675 TI - S-100 protein-positive cells in hidrocystomas. AB - The histogenesis of hidrocystomas was examined by the use of immunostaining for S 100 protein. In normal sweat glands, S-100 protein was found exclusively in the secretory cells of eccrine glands, whereas this protein was not present in the other parts of eccrine glands or at any levels of the structure of apocrine glands. On the bases of this immunostaining pattern in normal sweat glands, we attempted to correlate the origin of 8 cases of hidrocystoma to the presence of S 100 protein-positive cells. S-100 protein was detected in the cells of one solitary eccrine hidrocystoma, but not in those of 2 cases of "classic", multiple lesion type of eccrine hidrocystoma. This indicated that the former arose from the secretory portion of the eccrine gland and the latter from the eccrine ductal cells. Two of the 5 cases of apocrine hidrocystoma showed positive staining in a part of the lining cells of the cyst wall, while the other 3 cases were negative to this protein. This finding suggests that some of the tumors diagnosed morphologically as apocrine hidrocystoma differentiate in the direction of eccrine secretory cells. In addition to S-100 protein, we also surveyed for the presence of carcinoembryonic antigen (CEA), and all cases examined were consistently positive to this substance. The detection of S-100 protein was considered to be more helpful in classifying hidrocystomas than that of CEA. PMID- 3522676 TI - Osteoid and bone formation in desmoplastic malignant melanoma. AB - A 77-year-old man presented a recurrent subungual malignant melanoma with desmoplastic features in which heterotopic bone had developed. Histological, histochemical and immunohistochemical findings confirmed the diagnosis of malignant melanoma. Electron microscopic findings suggest that desmoplasia is the result of fibroblastic differentiation of spindle melanoma cells. PMID- 3522677 TI - The identification of molluscum infection by immunohistochemical means. AB - Tissue obtained from formalin-fixed, paraffin-embedded blocks containing molluscum contagiosum virus was used as a source of antigen to generate a polyclonal antibody against molluscum contagiosum virus. This antibody recognized an antigen in molluscum bodies which was preserved during routine fixation and embedding. The antibody can be used with standard immunohistochemical methods to identify molluscum contagiosuminfection in inflamed and distorted tissue specimens. Our data indicate that paraffin-embedded, formalin-fixed material can be used as an antigenic source to generate antibodies with diagnostic potential. PMID- 3522678 TI - Genetic methods of improving dairy cattle for the south: a review and prospects from Regional Project S-49. AB - Objectives of Southern Regional Research Project S-49, comprising eight contributing experiment stations, are to determine direct response to selection in milk and the resultant correlated responses in nonyield traits, to define and evaluate selection criteria for total economic merit or profit, to quantify genetic and environmental components of underlying physiological characters responsible for genetic gains in economically important traits, to determine interactions of genotype by environment, and to estimate genetic values for males and females. More than 150 scientific articles from S-49 have been published in journals from 1975 to 1985. These results have contributed in a major way in identifying issues and understanding the genetic control of cow performance and economics of genetic improvement programs. PMID- 3522679 TI - Milk progesterone enzyme immunoassay: modifications and a field trial for pregnancy detection in dairy cows. AB - A milk progesterone enzyme immunoassay was modified to shorten the antibody:antigen incubation time and tested in a field trial. Coupling the antibody to paper fibers at pH 7 increased the binding activity of the paper antibody conjugate to allow incubation for 3 h at room temperature with no significant loss of competitive binding of progesterone. The relationship between progesterone concentrations measured by the modified and original enzyme immunoassays was r = .94 (n = 80 pairs). Milk samples (n = 67) collected 21 d after artificial insemination were classified by the original and modified methods as being from pregnant or nonpregnant cows using both spectrophotometric and visual evaluations. Comparison to subsequent rectal palpation or return to estrus showed that the two methods were comparable. A field trial was conducted involving 622 cows and 40 producers using the modified enzyme immunoassay method. The overall field trial accuracy of the enzyme immunoassay in diagnosing the cow's reproductive status for a single sample on d 21 after breeding was 71% for correct diagnosis of pregnancy and 81% for correct diagnosis of nonpregnancy. It was concluded that the modified method is a valuable technique for rapid monitoring of milk progesterone concentrations. PMID- 3522680 TI - Efficacy of morantel tartrate on milk production of dairy cows: a field study. AB - Eighty Holstein herds on Quebec Dairy Herd Analysis Service were paired into 40 blocks of two herds each to test the effects of systematic deworming with morantel tartrate. Cows in treated herds were given morantel tartrate in May, June, and July, and cows in control herds were given a placebo of ground corn, wheat bran, and barley; both products were administered at 1 kg/1000 kg body weight. Records were obtained from May 1983 to April 1984. Each farm was visited monthly from May to October 1983 to obtain herbage samples and fecal grab samples from a random 10% of lactating cows. Production records were obtained for the year prior to commencement of this trial for covariate analysis. Fecal worm egg counts and infective larvae counts in pasture were reduced by 83 and 93%, respectively, in treated herds. The pattern of worm egg excretion differed between groups due to repeated treatments with morantel. Treated herds produced 323 kg more milk per cow per yr and 1.2 kg per cow per d more fat-corrected milk than controls. Milk fat and protein percentages did not differ between groups for the 12 mo. Deworming lactating dairy cows at the beginning of and during the pasture season improved production performance. PMID- 3522681 TI - Effects of endotoxin on mammary secretion of lactating goats. AB - The objectives were to describe the magnitude and time course of changes in milk pH, Na, K, lactose, and somatic cells and to determine if paracellular pathways were altered after infusion of Escherichia coli endotoxin (serotype #0128:AB12) to produce inflammation in one-half of the udder of the goat. Intramammary infusion of endotoxin increased pH, number of somatic cells, and Na and decreased K and lactose in milk. Sodium and number of somatic cells were increased by as little as .1 microgram of endotoxin; .25 microgram produced changes in most of the other parameters; maximal effect was elicited by 1 microgram of endotoxin. The gland response peaked from 5 to 7 h after infusion of endotoxin with an increase in milk cellularity as the only significant effect noted in the control gland. Infusion of [14C]lactose into the gland and [99mTc]albumin into the blood demonstrated that large molecules were more able to cross into and out of udder halves after endotoxin treatment. It is suggested that ion interchange rather than bulk flow across paracellular paths is responsible for changes. In addition, endotoxin appeared to reduce lactose secretion and synthesis. PMID- 3522682 TI - Autoregulation of alimentary and hepatic ketogenesis in sheep. AB - To determine the mechanism of autoregulation of ketogenesis, beta-hydroxybutyrate was infused into 5 normal; 3 diabetic, insulin-treated; and 3 diabetic, untreated anesthetized sheep. Net flux of fatty acids, acetoacetate, beta-hydroxybutyrate, and insulin were measured across splanchnic tissues by multiplying venoarterial differences by blood flow. beta-hydroxybutyrate depressed fatty acid concentrations and hepatic uptake. This decrease in hepatic uptake was not due solely to decreased concentrations, because hepatic extraction decreased 40% in normal and insulin-treated sheep. Portal-drained visceral release of acetoacetate was increased by beta-hydroxybutyrate infusion in normal and insulin-treated sheep, but this was associated with even larger increases in hepatic uptake, resulting in decreased total splanchnic release. Portal-drained viscera switched from release to uptake of beta-hydroxybutyrate in both normal and insulin-treated animals, but hepatic release increased slightly in normal sheep. beta hydroxybutyrate increased insulin concentration, pancreatic production, and hepatic uptake. Because effects of ketone infusion on net fluxes of fatty acids, acetoacetate, and beta-hydroxybutyrate were similar in normal and diabetic, insulin-treated sheep but were diminished or totally absent in diabetic, untreated animals, the mechanism of autoregulation of ketogenesis may be mediated at the insulin receptor or at the site of hepatic fatty acid uptake. PMID- 3522683 TI - Comparing classroom and clinic measures of attention deficit disorder: differential, idiosyncratic, and dose-response effects of methylphenidate. PMID- 3522684 TI - [Optical impressions in the computer-assisted design and fabrication of dental crowns]. PMID- 3522685 TI - Oral health certificate and denturology. PMID- 3522686 TI - International dermatosurgery: use of medial plantar based skin flaps for correction of foot defects. AB - The recently described instep island flap can be used to restore foot tissue deficits, however, its usefulness is limited by the length of the neurovascular pedicle and by the small surface of the flap. This flap can also be used as a free or as a cross-foot flap. We describe our experience with 10 patients. Heel defects in seven of them were corrected by the instep island flap. In the other three cases, the technique was modified, and the flap was obtained from the contralateral side, by a cross-foot flap. In these last three cases, sensibility was obtained by neurorrhaphy, with excellent results. PMID- 3522687 TI - Evidence for the presence of sex and aggregation pheromones from Triatoma mazzottii (Hemiptera: Reduviidae). PMID- 3522688 TI - The inhibitory effect of selenium on mice inoculated with B16 melanoma cells. PMID- 3522689 TI - Hyperlipoproteinaemia and xanthomatosis as a model of cholesterol ester accumulation. PMID- 3522690 TI - Hepatitis B serum markers in porphyria cutanea tarda. PMID- 3522691 TI - Comparative reactivity of a panel of monoclonal antibodies on Yucatan mini-pig and human skin. PMID- 3522692 TI - Genetic control of sulbenicillin (SBPC)-induced T cell proliferation in mice. PMID- 3522693 TI - Malignant hemangioendothelioma in discoid lupus erythematosus. PMID- 3522694 TI - Sweat gland necrosis in drug-induced coma: a light and direct immunofluorescence study. PMID- 3522695 TI - Dyskeratosis congenita: report of the first case from India. PMID- 3522696 TI - A case of male SLE--with special reference to familial occurrence and HLA. PMID- 3522697 TI - Basal cell epithelioma with dermal melanocytes: a case report. PMID- 3522698 TI - Neuron-specific enolase (NSE): a specific marker for Merkel cells in human epidermis. PMID- 3522699 TI - The immunohistopathologic study of scabies by the PAP method--identification of IgE positive mast cells. PMID- 3522700 TI - Methods of measuring the attenuation of hearing protection devices. AB - The published literature describing three real-ear-attenuation-at-threshold (REAT), nine above-threshold, and four objective methods of measuring hearing protector attenuation is reviewed and analyzed with regard to the accuracy, practicality, and applicability of the various techniques. The analysis indicates that the REAT method is one of the most accurate available techniques since it assesses all of the sound paths to the occluded ear and, depending upon the experimenter's intention, can reflect actual in-use attenuation as well. An artifact in the REAT paradigm is that masking in the occluded ear due to physiological noise can spuriously increase low-frequency (less than or equal to 500 Hz) attenuation, although the error never exceeds approximately 5 dB, regardless of the device, except below 125 Hz. Since the preponderance of available data indicates that attenuation is independent of sound level for intentionally linear protectors, the use of above-threshold procedures to evaluate attenuation is not a necessity. An exception exists in the case of impulsive noises, for which the existing data are not unequivocal with regard to hearing protector response characteristics. Two of the objective methods (acoustical test fixture and microphone in real ear) are considerable time savers. All objective procedures are lacking in their ability to accurately determine the importance of the flanking bone-conduction paths, although some authors have incorporated this feature as a post-measurement correction. The microphone in real-ear approach is suggested to be one of the most promising for future standardization efforts and research purposes, and the acoustical test fixture technique is recommended (with certain reservations) for quality control and buyer acceptance testing. PMID- 3522701 TI - References to contemporary papers on acoustics. PMID- 3522702 TI - Nurse administered oral hygiene: is there a scientific basis? AB - The concept of nurse administered oral hygiene is developed in a summary of selected nursing, medical and dental literature. The purpose of the review is to identify implications for nursing practice and research. The significance of oral hygiene to nursing is presented from physiologic, pathophysiologic, psychosocial, epidemiologic and economic perspectives. Tools, chemicals and frequency for nurse administered oral hygiene are discussed in relation to dental theory and relevant nursing research is critically reviewed. The therapeutic value of common commercial products, such as the foamstick and the lemon and glycerol swab, is not established in the literature. Methodological issues, implications for practice and suggestions for future research are presented. PMID- 3522703 TI - Market research: an area in need of nurse researchers. PMID- 3522704 TI - Orotic acid, arginine, and hepatotoxicity. AB - This communication presents evidence from the literature and recent experiments that describe circumstances wherein arginine may be a conditional dietary essential. Previous work has established that the synthesis of orotic acid (OA), the first pyrimidine formed in the de novo pathway of nucleic acid synthesis, becomes elevated whenever the ammonia load exceeds the capacity of the urea cycle. Under these circumstances, the common intermediate, carbamyl phosphate, leaks from the mitochondria and induces OA synthesis in the cytoplasm. This leads to increased OA excretion in the urine as pyrimidine synthesis escapes feedback control. A deficiency of urea cycle substrates such as arginine, and administration of certain drugs, ammonium salts, urease, or excess amino acids raises orotic acid excretion. Our recent experiments in rats show that OA excretion is also elevated after partial hepatectomy following galactosamine administration, exposure to carbon tetrachloride, or feeding 36% of calories as ethanol. The elevation in OA excretion was suppressed by dietary supplementation with arginine, implying that arginine is conditionally essential. Adult human male alcoholics showed elevated urinary orotic acid-to-creatinine ratios early after drinking episodes, which declined with time following abstinence. Such evidence shows that well studied hepatotoxins and surgical liver injury affect pathways of ammonia metabolism and suggests that urinary orotic acid can be an indicator of hepatotoxicity and increased needs for arginine. Arginine-deficient diets and alcohol feeding both enhance fatty deposition in the liver, which can be worsened by high fat intakes in rats. Alcoholism, various other diseases, and fasting and realimentation change orotic acid excretion. Such responses will have to be taken into account in establishing "normal values" for OA excretion. PMID- 3522705 TI - Nasal-sinus-pulmonary reflexes and bronchial asthma. PMID- 3522706 TI - Antigens and allergens of Aspergillus fumigatus. II. Their further identification and partial characterization of a major allergen (Ag 3). AB - These further studies demonstrated that most antigens and allergens detected by allergic bronchopulmonary aspergillosis (ABPA) sera were recognized by rabbit antiserum, and a major allergenic component, Ag 3, as previously demonstrated by self-crossed radioimmunoelectrophoresis, was identified in the conventional system. Affinocrossed immunoelectrophoresis with concanavalin A indicated that for the patients with ABPA, although the major antigens contained alpha-D-manno- or alpha-D-glucopyranoside terminal residues, the major allergenic components did not. Fractionation of the salt-precipitated, protein-enriched fraction by gel filtration on Sephacryl S-200, monitored by fused-rocket immunoelectrophoresis/fused-rocket radioimmunoelectrophoresis with both the ABPA serum pool and specific rabbit antisera, revealed that most of the antigens were in a molecular weight range greater than 43 kd, whereas the allergens spread from as low as 10 to greater than 100 kd. The major allergen, Ag 3, was identified and demonstrated to have a molecular weight of approximately 24 kd. This component does not bind to concanavalin A and is also very heat labile. PMID- 3522707 TI - Correlation between A-mode ultrasound and radiography in the diagnosis of maxillary sinusitis. AB - A-mode ultrasound examination of the maxillary sinuses with the Echosine and Sinusvu 2500 units was compared with roentgenographic examination in the diagnosis of maxillary and frontal sinusitis. A-mode ultrasound was primarily useful in the detection of secretions within the sinus and not mucosal thickening. Both ultrasound devices had high specificities (92% for Echosine and 94% for Sinusvu 2500) in the diagnosis of maxillary sinusitis, but the Echosine had a greater overall sensitivity (61%) than the Sinusvu 2500 (29%). More significantly, as the opacification of the roentgenogram increased (a higher probability of secretion), the Echosine demonstrated better agreement with the x ray film. Ultrasound appeared to be less helpful in diagnosing frontal sinusitis, but there were too few cases of frontal sinusitis for statistical analysis. The Echosine is a useful screening device because of the high specificity of a positive result. Although A-mode ultrasound provides limited value in diagnosing mucosal thickening, it is particularly useful in following the course of therapy once a positive diagnosis of sinusitis has been established without subjecting the patient to additional x-ray exposure. PMID- 3522708 TI - Antigens and allergens of Aspergillus fumigatus. I. Characterization by quantitative immunoelectrophoretic techniques. AB - Both the IgG (precipitinogen) and IgE combining components of Aspergillus fumigatus have been studied by quantitative immunoelectrophoretic techniques with sera of patients with allergic bronchopulmonary aspergillosis and specific rabbit antisera. Considerable batch-to-batch variation in biochemical properties and in immunologic (both antigenic and allergenic) activity was revealed in identically prepared culture-filtrate antigens of the same strain of A. fumigatus. Profiles of crossed immunoelectrophoresis/crossed radioimmunoelectrophoresis appeared to vary qualitatively; however, the differences in antigenicity and allergenicity were demonstrated by crossed-line immunoelectrophoretic techniques to be essentially quantitative rather than qualitative in nature. Both types of activity were concentrated in the protein fraction obtained by salt precipitation, and little activity remained in the predominantly polysaccharide supernatant that accounted for greater than 30% (dry weight) of the antigenic extract. Heat-stability studies demonstrated a varied pattern of denaturation. Certain allergenic components were stable to considerable heating, and the extracts so treated were still active on skin testing. PMID- 3522709 TI - Serum IgA antibodies to Aspergillus fumigatus in various stages of allergic bronchopulmonary aspergillosis. AB - With double antibody ELISA, serum IgA antibodies against Aspergillus fumigatus (Af) were measured from patients in stages I through V allergic bronchopulmonary aspergillosis (ABPA). All sera from patients with ABPA demonstrated considerably greater values for IgA-Af than sera from nonatopic subjects. When this sera was compared with sera from patients with asthma and immediate cutaneous reactivity to Aspergillus, the present studies documented markedly elevated serum IgA-Af in the acute, exacerbation, and fibrotic stages of ABPA. Some patients in remission or corticosteroid-dependent asthma stages also demonstrated increased values. Because the major stimulus to antibody production occurs in the lung in response to presence of Af hyphae, polymeric IgA antibodies could potentially contribute to immunologic lung damage in ABPA. Finally, large dose alternate day or daily prednisone that was administered to patients in the fibrotic stage of ABPA did not prevent the marked production of isotypic antibodies to Af. PMID- 3522710 TI - Proper application of available laboratory tests for adverse reactions to foods and food additives. PMID- 3522712 TI - The elderly and drug interactions. PMID- 3522711 TI - Adverse reactions to foods: relevance to psychiatric disorders. AB - There is some evidence in the literature that adverse reactions to foods can contribute to behavioral dysfunction. In view of what is known about food and behavior, this suggestion is entirely plausible. However, clear demonstrations of adverse behavioral reactions to foods have not been reported. The major methodologic problems are those of defining suitable baseline conditions and dealing with large ranges in dose, time course, and severity of reactions among putatively food-sensitive individuals. These problems, although large, are surmountable. Another problem for studies in this area is nomenclature. The imprecision with which terms are used undoubtedly will diminish as the various mechanisms by which food can affect individuals are delineated. Until these issues are clarified, we are confronted with a group of patients who are convinced that their symptoms are somehow related to the food that they eat. Some basic guidelines may help in the initial screening of these patients. If a history of behavioral dysfunction related to food intolerance occurs in the context of other signs of allergy or hypersensitivity, it seems prudent to evaluate and treat the allergic or hypersensitivity condition and note the effect of that treatment on behavior. If the food complaints occur in the context of marked suggestibility and large numbers of unexplained complaints are registered without any evidence of allergy or hypersensitivity, a diagnosis of somatization disorder should be entertained. If food complaints occur in a patient who does not meet the criteria for somatization disorder, a working diagnosis of undiagnosed medical condition should be entertained.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3522713 TI - Role of heme and iron metabolism in controlling protein synthesis. PMID- 3522714 TI - Vision care and health insurance coverage. AB - This paper presents an overview of third party coverage for optometric services. A questionnaire survey of insurance companies was conducted to determine the extent of major medical coverage for specific optometric services. The influence of freedom of choice laws, expanded scope, pharmaceutical agent legislation and the Medicare program is discussed. The proper use of accepted diagnostic and procedural codes is underscored. PMID- 3522715 TI - Determination of rat beta 2-microglobulin in urine and in serum. I. Development of an immunoassay based on latex particles agglutination. AB - Rat beta 2-microglobulin has been isolated from the urine of rats pretreated with sodium chromate. The purified protein was used to raise antisera in two rabbits. Treatment of the antisera with ammonium sulphate followed by gel chromatography led to an immunoglobulin fraction which was used to coat latex particles by physical adsorption. The latex suspension was used in an automated system including an optical particle counter to analyse the protein in serum, urine and cerebrospinal fluid. Serum contains 5.8 mg of beta 2-microglobulin/l, of which 33% is found as a 55000 dalton complex while 66% is present as the 'free' protein. The daily urinary excretion of beta 2-microglobulin in females is about 2 micrograms of which 7% is found to be a 65000-dalton complex while 92% is the free protein. From this, it can be calculated that the fractional urinary excretion of beta 2-microglobulin is about 0.03%. The cerebrospinal fluid contains about 1 mg of beta 2-microglobulin/l. Preliminary tests also suggest that the method can be adapted for non-automated turbidimetric detection. In the automated assay, the within- and between-assay coefficients of variation are less than 10% for the three biological fluids tested. The analytical recovery in the urine is 93%. In urine, beta 2-microglobulin undergoes proteolytic degradation at pH below 6. This does not represent a serious drawback to its use as a sensitive index of tubular function since in most experimental circumstances, rats excrete urine with a pH above this value. PMID- 3522716 TI - Determination of rat beta 2-microglobulin in urine and in serum. II. Application of its urinary measurement to selected nephrotoxicity models. AB - beta 2-microglobulin (beta 2-m) was measured in the urine of rats by a specific immunoassay based on latex particles agglutination. The excretion of this protein was compared to the excretion of the enzyme beta-N-acetyl-D-glucosaminidase (NAG), albumin and amino acids in rats treated with either a single dose of sodium chromate (5 and 10 mg kg-1), repeated doses of gentamicin (5 and 20 mg kg 1), or cadmium (1 mg kg-1), and in aging rats (from 2 to 20 months). All treatments resulted in an early increased excretion of beta 2-m indicative of functional alterations of the proximal tubular cells. An increased NAG excretion was observed only at the highest dose of chromate and in the cadmium model but the relative increases of beta 2-m were much larger (up to 200 times the control values against four times the control values for NAG). From 2 to 20 months of age, urinary beta 2-m increases by a factor of four. Aminoacids excretion showed little sensitivity in the various models. Albumin showed little variations in purely tubular or in the tubular phase of renal injury but the chronic progressive nephrosis of aging rats caused a 40-fold increase in its excretion between 2 and 20 months of age. Therefore urinary beta 2-m, albumin and albumin/beta 2-m ratio provide useful tools in the assessment of nephrotoxicity and of its mechanisms in various experimental models. PMID- 3522717 TI - [Repair of the orbital cavity by a dermoadipose graft after enucleation]. AB - Dermis fat graft as a movable implant within the muscle cone is considered. The graft's survival depends mainly on its early vascularization which is bound to dermis, quality of the socket and suture of the recti muscles. The results of the twenty three first grafts emphasize two types of indications: Essential indications for the treatment of enophthalmos and for the treatment of migrated or extruded orbital implants. Relative indications: primary grafts and dermis-fat implantation for the treatment of contracted sockets. PMID- 3522718 TI - [Radial keratotomy]. PMID- 3522720 TI - A bibliography of doctoral dissertations on aging from American institutions of higher learning, 1983-1985. PMID- 3522719 TI - [Bibliographic survey. The Irvine-Gass syndrome]. PMID- 3522722 TI - [Immunocytopathology of tumors of the breast. Test of 2 monoclonal antibodies on the products of cytologic aspiration of breast tumors and metastases]. AB - Two monoclonal antibodies selected for specific well-developed antigens in certain epithelial tumors were used in accordance with immuno methods for marking tissues. They were used on samples of cells obtained by aspiration from malignant lesions and from benign lesions of the breast and from lymph node metastases as well as from adenocarcinomata of the skin of the breasts. No work has yet published about one of these markers (anti-breast carcinoma). The positive results that we have obtained give hope that a new approach to the microscopic diagnosis of the cells of the breast in very early tumors is on its way, as well as the precise diagnosis of metastases. PMID- 3522721 TI - [Metabolism of sex hormones and adipose tissue]. AB - Adipose tissue is a catchment area for storing, converting and releasing the sex hormones. The role of adipose tissue in the general metabolism of endogenous and exogenous steroids deserves to be considered seeing how big the volume of fat is in the human body. The fatty pool of sex steroids seems to be greater than the plasma pool. Hormones which have been stored can be released by adipocytes into the general circulation even if they have been converted while in the adipocytes. Similarly, androgens are changed by adipose tissue into oestrogens by aromatisation and are liberated. This extraglandular production of oestrogens can have clinical and pathological consequences. PMID- 3522723 TI - [Preoperative dilatation of the cervix uteri by vaginal application of 9-deoxo 16, 16-dimethyl-9-methylene PGE2 in pregnancy interruption during the 1st trimester. Double-blind clinical study]. AB - Single vaginal application of a suppository containing 10 mg of 9-deoxo-16-PGE2 3 hours prior to suction curettage in nulliparous women with gestational ages from 8 to 12 weeks resulted in significant cervical softening (p less than 0.0001), and facilitated additional instrumental dilatation when required. Moderate side effects occurred in the majority of treated patients, disappeared however with appropriate medication. This procedure may thus be considered as effective, safe and reliable. PMID- 3522724 TI - Bad debts and hospital rate-setting. AB - This paper examines the economic foundations for mandatory discounts for insurers based on differences in bad debts experience. It considers critically the arguments Blue Cross plans use in several states. On both equity and efficiency grounds, discounts for actual bad debts are shown to be inappropriate. In contrast, it is shown that there are equity and efficiency reasons to grant a discount for insurance policies which avert bad debt, but that the appropriate discount is less than the amount of bad debt averted. The appropriate discount depends on the size of the subsidy needed to bring about purchase of debt averting coverage. In some circumstances, this subsidy equals the underwriting loss on the coverage minus any tax subsidy the insurer receives. PMID- 3522725 TI - Epithelioid haemangioendothelioma. A case report. AB - Epithelioid haemangioendothelioma of the liver is an extremely rare tumour which has only recently been recognised. This report describes the clinical, radiological and histological findings in a case of a primary epithelioid haemangioendothelioma of the liver. The case highlights some of the difficulties in establishing the diagnosis, and in its differentiation from Budd-Chiari syndrome and veno-occlusive disease. The patient has subsequently undergone successful orthotopic hepatic transplantation. PMID- 3522726 TI - Treatment of ascites in patients with cirrhosis of the liver. PMID- 3522727 TI - Medical museum notes (Dr. Alexander T. Ross). PMID- 3522728 TI - [Classification of neurons in the visual cortex of the guinea pig (Cavia porcellus). A combined Golgi-Nissl study using deimpregnation technics]. AB - The aim of the investigation is the identification of neuronal types in the visual cortex of the guinea pig (Cavia porcellus) in Nissl preparations. In two rapid Golgi series (modified by Fairen et al. 1977) and nine Golgi-Kopsch series eleven neuronal types could be classified: 1. Neurons with long axonal main stems: Pyramidal cells (layers II-VI), pyramid-like cells (layers I, VI), spiny stellate cells (layer IV). 2. Neurons with locally distributed axons: large and small aspiny cells (layers II-VI), neuroglioform cells (layers I-VI), large sparsely spiny cells with ascending axons (Martinotti cells) (layers III-VI), small sparsely spiny cells with variable axons (layer IV), bipolar cells (layers II-VI), chandelier cells (layers II, III), double bouquet cells (layers II, III), and 3. a horizontal cell in layer I without an impregnated axon. To identify Nissl stained somata, Golgi impregnated neurons were deimpregnated. Now cytoplasmic and nuclear features can be compared. In order to get a survey about the variability of the somal features, we have deimpregnated 245 neurons on the whole using either gold chloride (Fairen et al. 1977) combined with the rapid Golgi method, modified by Fairen et al. (1977), or a diluted solution of ammonia (Braak and Braak 1982) combined with the Golgi-Kopsch method, nonembedded, in glycerol stored material and in celloidin embedded sections, resp. After deimpregnation several neuronal classes could be distinguished considering at first the width of the cytoplasm and the localization of the nucleus. There are Nissl stained somata with corresponding features: 1. Pyramidal cells, pyramid like cells, and spiny stellate cells of the layer IV with relatively broad cytoplasm and bright, centrally localized nuclei. 2. Large aspiny cells which vary in somal sizes and shapes with very broad cytoplasm and bright, centrally or excentrally localized nuclei. 3. Small aspiny cells, some of the neuroglioform cells, and small sparsely spiny cells of layer IV have more or less broad cytoplasm but in the most cases excentrally localized nuclei. 4. The remaining neuroglioform cells, bipolar cells, and the horizontal cell of layer I are particularly poor in cytoplasm. The somata of these neuronal types are small, those of the bipolar cells are vertically orientated. 5. Like the bipolar cells large sparsely spiny cells with ascending axons Martinotti cells), chandelier cells, and double bouquet cells are also polarized neurons, but larger and not always vertically oriented.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3522729 TI - Nosocomial infection in a children's hospital. A retrospective study. AB - The investigations the frequency of the occurrences of hospital infections were carried in a General Pediatric Ward. Most of the infections (77 per cent) appeared in children up to one year of age. The hospital infections mostly affected children residing in rural areas. The etiological agent was E. coli (36 per cent), Proteus (22.7 per cent) Klebsiella and Staphylococcus. The infections caused by E. coli mainly appeared in girls, others- in boys. The frequency of the occurrences of hospital infections was also analysed with respect to the primary disease of a child. In most cases of additional infections were found in children with upper respiratory tract infections, pneumonia and bronchitis. The above differences are statistically valid. PMID- 3522730 TI - Bacterial antagonists of Shigellae. AB - Bacterial antagonism between a microorganisms and Shigella sonnei strains was studied in model experiments simulating conditions of the natural aquatic environment. In these studies surface waste samples from the river Vltava served as the experimental environment. To ensure bacteriologically defined conditions all water samples were heat-sterilized prior to antagonism testing. Consistently with the literature data and author's own observations the following bacterial species and genera were chosen as test organisms to be tested for antagonism against Shigella sonnei strains in water; E. coli, Citrobacter, Enterobacter, Klebsiella pneumoniae, Proteus, Pseudomonas aeruginosa and the fecal streptococci S. fecalis and S. faecium. Presence or absence of microbial antagonism against shigellae was determined in the experimental water medium contaminated with shigella-test organism mixtures of density ratios within the range 1 : 1 through 1 : 10(4). The highest degree of antagonism was observed with Pseudomonas aeruginosa that at density ratio 1 : 1 inhibited the Shigella sonnei growth in water within 42 hours of incubation. A similar degree of antagonism was also observed with Klebsiella pneumoniae at the density ratio 1 : 10(1) and with Enterobacter aerogenes at 1 : 10(2). At lower density ratios the antagonism exhibited by these two species was also present, but occurred much later, i.e. after 72 hours up to 5 days. The remaining test organisms used showed no antagonistic action Shigella sonnei strain in the model aquatic environment. PMID- 3522731 TI - A monoclonal antibody specific for a monocyte-macrophage membrane component blocks the human monocyte response to migration inhibitory factor. AB - In our study of the human monocyte response to migration inhibitory factor (MIF), we screened murine anti-monocyte monoclonal antibodies (MAb) for their ability to affect the MIF response. When blood monocytes were preincubated for 30 min at 37 degrees C with MAb of various cell specificities, it was found that Mo3e-MAb could inhibit the monocyte response to MIF. This effect was observed at an antibody concentration of 0.37 microgram/10(6) monocytes. This blocking activity appeared to be specific for Mo3e-MAb, since MAb specific for Mo1, Mo2, Mo4, alveolar macrophage (PAM-1), and platelet (Plt-1) antigens were unable to block the MIF response. Specificity was also shown by experiments performed with MAb similar to Mo3e-MAb in their immunofluorescence staining patterns. Two MAb of this type were not able to block the MIF response. All of these MAb are of the IgM isotype, and therefore it is unlikely that the blocking activity of Mo3e-MAb is mediated by the Fc receptor. These studies suggest that Mo3e-MAb may represent an anti-MIF receptor antibody. Mo3e-MAb recognizes a protease-sensitive antigen of 80 kD and 50 kD that is weakly expressed on fresh blood monocytes but is up modulated by stimulation of monocytes with bacterial lipopolysaccharide, muramyl dipeptide, or phorbol compounds. Mo3e is also expressed by human myeloid cell lines, U-937 and HL-60, that have been stimulated in culture by biologically active phorbol diester compounds. PMID- 3522732 TI - Differential expression of HLA class II antigens in fetal human spleen: relationship of HLA-DP, DQ, and DR to immunoglobulin expression. AB - Frozen sections of human fetal spleen from 12 to 20 wk gestation were examined by using polyclonal antibodies to Ig isotypes, monoclonal antibodies to HLA class II subregion locus products, B and T cells, and follicular dendritic cells. Scattered lymphoid cells in spleen sections from fetuses of 12 to 13 wk gestational age expressed IgM but not IgD. The appearance of lymphoid cells expressing IgD occurred at 14 to 15 wk before the formation of loose clusters of B cells at 16 wk. IgD expression was associated mainly with cells in these clusters, which by 17 wk had become definite follicles. Follicular dendritic cells were not detectable until 20 wk. OKT3-positive T cells were not detected until 17 wk, and at 20 wk constituted 5% of the nucleated cell population. HLA-DR and DP-positive lymphocytes and macrophages were detectable in fetal spleen from 12 wk onward; DR was expressed on more cells than DP, and the numbers of cells stained by HLA-DR-specific monoclonal antibodies exceeded the number of Ig positive cells in all spleens examined. HLA-DQ was expressed by consistently fewer cells than HLA-DR and -DP in all spleens tested. The small number of DQ positive cells in spleens from 12- to 13-wk fetuses had the morphology of macrophages; HLA-DQ expression by lymphoid cells followed a similar pattern to IgD expression and was associated mainly with follicular lymphocytes. It could be demonstrated by double-labeling experiments that all follicular IgM-positive cells in 17- to 20-wk spleens expressed HLA-DP, DQ, and DR antigens: IgM-positive cells in 12- to 16-wk spleens and interfollicular IgM-positive cells in 17- to 20 wk spleens all expressed HLA-DR, but only 59% and 43% expressed DP and DQ, respectively. Ninety-one to 100% of IgD-positive cells in all spleens examined expressed HLA-DQ in addition to DR and DP. In these experiments IgD-negative, DQ positive cells had the morphologic appearance characteristic of macrophages. These data suggest that class II antigens are differentially expressed on developing lymphoid cells; DR and DP expression occurring in the earliest spleens examined, with expression of DP on a subpopulation of DR-positive cells; IgD and DQ expression appears to be coincident on maturing B cells as they begin to form follicles. An immunoregulatory role for HLA-DQ in B cell development is implicated and remains to be fully investigated. PMID- 3522733 TI - Regulation of the BALB/c anti-p-azophenylarsonate antibody response by monoclonal anti-idiotype. II. Idiotope expression in serum and its regulation. AB - Five murine monoclonal antibody (mAb) anti-idiotypes (id), shown in the accompanying report by binding studies to be reactive with five different id on a single member of the 5AF6 family of BALB/c antibodies against the p azophenylarsonate (Ar) hapten, were used to examine the distribution of their recognized id among anti-Ar in BALB/c and other mouse strains immunized with keyhole limpet hemocyanin-Ar (KLH-Ar). Differences in id expression in BALB/c and other strains substantiate that all five monoclonal anti-id reacted with different id. This suggests that the anti-id repertoire for a single antibody molecule may be extensive. Two of the anti-id reacted with id that were found in virtually all KLH-Ar immunized BALB/c mice, but constituted only a subset (approximately 33%) of the antibodies representing the 5AF6 family. The other three anti-id reacted with id infrequently expressed among BALB/c anti-Ar. Other mouse strains producing 5AF6 family anti-Ar antibodies also produced antibodies recognized by mAb 2CB8 and 6BA1; however, the three id infrequently expressed in BALB/c mice were produced in higher quantities and in a greater percent of mice. Monoclonal anti-id were capable of suppressing a portion but not all of the 5AF6 family of anti-Ar antibodies. Four of the five anti-id suppressed a greater fraction of the 5AF6 family than that id represented in a normal immune response, suggesting that suppression was mediated via an id other than that recognized by these monoclonal anti-id. Overall, the results indicate that an extensive repertoire of anti-id can be produced against a single id antibody, but suppression induced by treatment with these anti-id in this model is presumably mediated via another as yet unidentified id determinant(s). PMID- 3522734 TI - Macrophage-mediated fungistasis: requirement for a macromolecular component in serum. AB - Peritoneal macrophages from Mycobacterium bovis- or Toxoplasma gondii-infected mice cultured in vitro in Dulbecco's medium containing 10% fetal bovine serum (FBS) and endotoxin stopped replication of Cryptococcus neoformans for 30 hr, whereas yeast cells cultured alone reproduced with a 3.0-hr doubling time. Without at least 5% FBS, macrophage fungistasis was poor. FBS without macrophages enhanced the growth rate of cryptococci. Macrophages preincubated in vitro for 24 hr without serum became fungistatic when challenged with cryptococci in medium with FBS but were not fungistatic without FBS. Macrophages preincubated in medium with FBS were never subsequently fungistatic. Dialyzed, heated (56 degrees C, 30 min), or delipidated FBS supported macrophage fungistasis, whereas FBS heated at 70 degrees C for 30 min did not. FBS contained no measurable opsonic activity for C. neoformans. Inclusion of endotoxin and/or murine IFN-gamma over wide concentration ranges did not substitute for FBS. Ultrafiltration estimation of FBS activity localized to 50 to 150 Kd. By gel filtration chromatography, FBS activity ran in the 25 to 100 Kd range. Dye-ligand affinity chromatography on Cibacron blue agarose gel dissociated the FBS activity from the albumin and lipoprotein fractions. Anion-exchange chromatography on DEAE-Sephacel revealed activity in the first fraction eluting at low ionic strength, pointing to a protein(s) with an isoelectric point toward neutral. Activated macrophages can prevent microbial replication within host tissues; the local environment is critical for fulfillment of this important physiologic function. These results point to a macromolecular factor(s) present in serum that is essential for full fungistatic capability of activated macrophages. PMID- 3522735 TI - Cyclophilin: distribution and variant properties in normal and neoplastic tissues. AB - The cytosolic concentration, Mr, and isoforms of cyclophilin (CyP), a specific cytosolic binding protein for cyclosporin A (CsA), were determined in normal and neoplastic human tissues as well as tissues from species of diverse phylogeny. CyP was present in all tissues examined; however, concentrations varied significantly among different tissue types. The CyP concentration was highest in lymphoblasts from a patient with T cell acute lymphocytic leukemia (1.15 micrograms/mg protein) and Hodgkin's and non-Hodgkin's lymphomas. CyP concentration in colon adenocarcinomas was twofold to threefold greater than that found in adjacent normal tissue. CyP from all normal and neoplastic human tissues examined had an apparent Mr of 17,000 determined by gel filtration HPLC. Major (pI 8.6 to 8.7) and minor (pI 6.7 to 6.9) CyP isoforms were identified in all human and murine tissue extracts by column sucrose gradient isoelectrofocusing; however, the ratio of the major to minor isoform varied widely. Among other species examined, significant concentrations of CyP were detected in cytosol extracts from sponges (Microciona prolifera), yeast (Saccharomyces cerevisiae), mushrooms, the giant cockroach (Blaberus discoidalis), and a trematode (Schistosoma mansoni). By contrast, CyP was not detectable in extracts of Escherichia coli. A twofold to threefold elevation in the CyP content of murine splenocytes was detected 72 hr after Con A stimulation. A survey of a variety of natural products, synthetic compounds, and immunoregulating agents has failed thus far to identify compounds capable of competing with CsA for binding to CyP. The broad tissue and phylogenetic distribution of CyP, its highly conserved structure, and its increased content after mitogenic stimulation suggest a fundamental role in cellular metabolism. PMID- 3522736 TI - The mouse leukocyte adhesion proteins Mac-1 and LFA-1: studies on mRNA translation and protein glycosylation with emphasis on Mac-1. AB - Translation in vitro of mRNA and immunoprecipitation with specific rabbit antisera showed that the unglycosylated precursor polypeptides of the mouse Mac-1 and lymphocyte function associated antigen (LFA-1) alpha subunits are 130,000 Mr and 140,000 Mr, respectively. Furthermore, polysomes purified by using anti-Mac-1 IgG yielded a similar major product of translation in vitro of Mr = 130,000. The Mac-1 and LFA-1 alpha subunit translation products are immunologically noncross reactive, showing that differences between these related proteins are not due to post-translational processing. Mac-1 and LFA-1 alpha subunits could only be in vitro translated from mRNA from cell lines the surfaces of which express the corresponding Mac-1 and LFA-1 alpha-beta complexes, showing tissue-specific expression is regulated at the mRNA level. The glycosylation of Mac-1 was examined by both translation in vitro in the presence of dog pancreas microsomes and by biosynthesis in vivo and treatment with tunicamycin, endoglycosidase H, and the deglycosylating agent trifluoromethane sulfonic acid. High mannose oligosaccharides are added to the Mac-1 alpha and beta polypeptide backbones of Mr = 130,000 and 72,000, respectively, to yield precursors of Mr = 164,000 and 91,000, respectively. The alpha and beta subunit precursors are then processed with partial conversion of high mannose to complex type carbohydrate to yield the mature subunits of Mr = 170,000 and 95,000, respectively. PMID- 3522737 TI - Role of self carriers in the immune response and tolerance. X. A lymphoid dendritic-like tumor, P388AD.2, acts as a novel immunogenic carrier for hapten. AB - Hapten-modified spleen cells, peritoneal exudate cells, and certain lymphoid tumors preferentially induce specific tolerance after i.v. administration. In contrast to these tolerogenic carrier cells, we found that a haptenated lymphoid dendritic-like tumor, P388AD.2, acts as a potent immunogen after i.v. injection. The immunogenicity of P388AD.2 was analyzed by measuring the specific augmentation of plaque-forming cell (PFC) responses when spleen cells from mice previously injected with haptenated tumor cells were challenged in vitro with thymus-independent antigens. Optimal immunization was found to be dependent on cell dose and hapten concentrations. Further studies indicated that P388AD.2 elicited a response which was T cell-dependent and which involved both the so called Lyb-3,5,7- and Lyb-3,5,7+ B cell populations. Injection of haptenated tumor into different mouse strains suggested that H-2 compatibility was required to prime B cells in vivo, although significant augmentation could also be achieved in allogeneic C57B1/6J mice. The enhanced PFC responses elicited in H-2b mice could not be explained by allo-recognition of class I or II MHC determinants. In toto, these results suggest that P388AD.2 acts as a unique accessory cell for the presentation of hapten-modified self. PMID- 3522738 TI - Stimulation of human neutrophil Fc receptor-mediated phagocytosis by a low molecular weight cytokine. AB - Human neutrophil Fc receptor-mediated phagocytosis can be markedly enhanced by a low m.w. (less than 10,000) heat-labile cytokine(s) derived from specifically stimulated human mononuclear cells and from a human T cell line, MO(t). PMN incubated with supernatant from control mononuclear leukocyte (MNL) culture bound EIgG (percentage of rosettes = 73.7% +/- 7.1) but did not ingest the attached targets (phagocytic index, PI = 40.7 +/- 9.5) as efficiently as PMN incubated with supernatant from adherent MNL, which had ingested EIgG and were then cocultured with nonadherent MNL (PI = 264.3 +/- 46.3). Cytokine-containing supernatants were fractionated on YM-10 Centricon microconcentrators, and the effluent (YM-10E) was found to contain the phagocytosis-enhancing activity. Optimal Fc receptor-mediated ingestion by YM-10E-stimulated PMN required a critical level of target-bound IgG; stimulation was dose dependent and detectable after 5 min at 37 degrees C with a maximal response by 15 min. Monoclonal antibody 3G8 (anti-PMN Fc receptor) inhibited in a dose-dependent fashion both Fc receptor-mediated rosette formation and ingestion by nonstimulated and YM-10E stimulated PMN. Solid-phase 3G8 Fab had the same effect. A previously undescribed monoclonal antibody, 1C2, exhibited a different pattern of inhibition. It had no effect on rosetting or ingestion of EIgG by nonstimulated PMN; however, it inhibited EIgG phagocytosis by YM-10E-stimulated PMN down to the level of nonstimulated ingestion without affecting rosette formation. Solid-phase 1C2 had the same effect. These data indicate that phagocytosis mediated by 3G8-positive Fc receptors may be enhanced by cytokine(s) stimulation in a manner requiring the molecule recognized by 1C2. Monoclonal antibodies to the alpha-chain of CR3 had only minimal effects on YM-10E-stimulated ingestion. Fluorescence flow cytometry of YM-10E-stimulated PMN, indirectly stained with 3G8 or 1C2, indicated that cytokine enhancement of EIgG ingestion occurred without an increase in either 3G8 or 1C2 binding sites. These data show that the low avidity Fc receptor, which binds immune complexes, may be functionally modulated at sites of inflammation where PMN and macrophages mediate clearance and destruction of immune complexes and opsonized particles. PMID- 3522739 TI - Slower processing, weaker beta 2-M association, and lower surface expression of H 2Ld are influenced by its amino terminus. AB - To determine why Ld antigens are expressed on the cell surface at levels three to four times lower than Dd or Kd antigens, pulse-chase experiments were used to compare their rates of biosynthesis and processing. Electrophoresis on sodium dodecyl sulfate gradient polyacrylamide gels resolved immunoprecipitates of each of these histocompatibility complex class I molecules into a slower and faster species. During the chase period, the faster migrating species appeared to be converted to the slower migrating species in a time-dependent manner. However, the conversion of Ld from the faster to the slower migrating species proceeded significantly more slowly than did the conversion of either Dd or Kd. Endoglycosidase H sensitivity and cell surface radiolabeling were used to determine the glycosylation state and cell location of each species of Ld and Dd. The results from these experiments, along with the pulse-chase studies and cytofluorometric analyses, suggest that Ld possesses a much slower rate of processing from a faster migrating, high mannose-bearing species to a slower migrating, complex oligosaccharide-bearing species found on the cell surface. Analysis of the beta 2-microglobulin (beta 2-m) association confirmed that Ld is associated with less beta 2-m than Dd. To localize the structures on class I molecules influencing their surface expression, rate of processing, and beta 2-m association, the Ddm1 molecule was analyzed. The Ddm1 molecule of the mutant B10.D2-H-2dm1 has previously been shown to be a chimeric Dd (amino-terminal)/Ld (carboxyl-terminal) polypeptide. The surface expression, processing and beta 2-m association of Ddm1 were found to be similar to Dd rather than Ld, suggesting that each of these phenomena are influenced by protein structure in the amino terminus. PMID- 3522740 TI - Plasma kallikrein during experimentally induced allergic rhinitis: role in kinin formation and contribution to TAME-esterase activity in nasal secretions. AB - We have shown recently that kinins are generated during experimentally induced allergic rhinitis in man, and have demonstrated that substrates for kinin-forming enzymes are provided during the allergic response by a transudation of kininogens from plasma into nasal secretions. In light of this increased vascular permeability during the allergic reaction, we have extended our studies on the mechanisms of kinin formation to examine the potential involvement of plasma kallikrein. Allergic individuals (n = 7) and nonallergic controls (n = 7) were challenged intranasally with an allergen, and nasal lavages, obtained before and after challenge, were assayed for immunoreactive human plasma kallikrein/prekallikrein (iHPK). Post-challenge iHPK values were significantly elevated (p less than 0.01) in the allergic group (353 +/- 394 ng/ml; x +/- SD) as compared to the nonallergics (19 +/- 22 ng/ml), and correlated with increases in kinins, histamine, and N-alpha-tosyl-L-arginine methyl esterase (TAME esterase) activity and with the onset of clinical symptoms. Gel filtration studies revealed that plasma prekallikrein is activated during the allergic response and contributes to kinin formation prior to interaction with plasma protease inhibitors. We also show that the majority of the TAME-esterase activity detected in nasal secretions during the allergic response is due to activities consistent with a plasma kallikrein/alpha 2-macroglobulin complex and with mast cell tryptase. PMID- 3522741 TI - A colorimetric microassay for opsonins by reduction of NBT in phagocytosing bovine polymorphs. AB - The adaptation of the reduction of nitro blue tetrazolium (NBT) by phagocytes to the measurement of the opsonising capacity of serum or milk whey is described. A dose-response curve of the absorbance of solubilised reduced NBT to the concentration of opsonins, along with a close correlation (r = 0.94) between the colorimetric NBT assay and ingestion of group B streptococci (as measured by reduction of [3H]thymidine incorporation by extracellular bacteria), was established. This NBT reduction test, employing 96-well flat-bottom microtitre plates, is simple, semiautomated, requires a low number of PMN, and is applicable to a large number of samples, which renders it useful as a screening test for the opsonising capacity of sera or other biologic fluids. PMID- 3522742 TI - A rapid radiometric assay for measuring phagocytosis of Saccharomyces cerevisiae in macrophage cultures. AB - A new assay was developed to measure yeast phagocytosis in cultures of murine resident peritoneal macrophages. Saccharomyces cerevisiae was radiolabeled during exponential growth in nutrient broth supplemented with [3H]glucose. Following ingestion of the radiolabeled heat-killed yeast particles for 15 min, phagocytic capacities were measured in harvested macrophage lysates by liquid scintillation spectrometry. The new procedure compares favorably with light microscopic techniques and appears to be a more sensitive method for quantitating phagocytic function. Dose-response studies indicate, that over a wide range of dexamethasone concentrations, the radiometric procedure consistently measures greater inhibitory effects for the steroid induced suppression of phagocytosis. PMID- 3522743 TI - Parasite-infected-cell-agglutination and indirect immunofluorescence assays for detection of human serum antibodies bound to antigens on Plasmodium falciparum infected erythrocytes. AB - Two methods are described for detecting the binding of serum antibodies from adults in an endemic malarious area (The Gambia) to surface antigens on Plasmodium falciparum-infected erythrocytes. An antibody-mediated parasite infected-cell-agglutination assay (without secondary antibody) and an indirect immunofluorescence assay employing an anti-Fc secondary reagent were used to detect bound antibody. The surface of erythrocytes containing mature parasites bound antibody, but the surface of uninfected cells or cells containing early parasite stages did not react. Serum from 'non-immune' Europeans did not agglutinate infected erythrocytes, however, in the immunofluorescence test with anti-Ig and anti-F(ab')2 secondary reagents we could detect the binding of IgG antibody from 'non-immune' European serum to a small proportion of infected cells. In contrast to the results with freshly collected isolates, antibodies from sera of Gambian adults did not bind to the surface of infected cells from five different culture-adapted isolates of P. falciparum. These assays are suitable for studies on the antigenic diversity of erythrocyte antigens in natural infections and specific antibody responses to these antigens in infected patients. PMID- 3522744 TI - Effective avidin coating of erythrocytes by disulfide bond formation. Production of a stable rosetting agent for multiple applications. AB - A method is described for covalently coupling avidin to the membrane of glutaraldehyde-treated erythrocytes. The method is based on the use of the heterobifunctional coupling reagent N-succinimidyl-3-(2-pyridyldithio)propionate (SPDP) and appears to be more effective than other protein coupling techniques. The resulting avidin-coated red cells are very stable and can be stored for more than 1 year without aggregation or loss of biotin-binding activity. They can be used in various rosetting assays and were tested for T cell depletion or negative cell selection with five biotinylated monoclonal antibodies. PMID- 3522745 TI - Measurement of spontaneous and stimulated anti-microsomal antibody synthesis in vitro by avidin-biotin enzyme immunoassay. AB - The spontaneous and stimulated anti-microsomal (anti-Mic) antibody synthesis in vitro by peripheral blood lymphocytes (PBL) from patients with Hashimoto's thyroiditis (HT) was studied by a highly sensitive and thyroid microsome-specific enzyme immunoassay using an avidin-biotin system (A-B EIA). Since the amount of the synthesized anti-Mic antibody by PBL in vitro is very small, it is difficult to study its kinetics and response to mitogens or the specific antigen by conventional assay systems. We applied the avidin-biotin system to conventional indirect EIA and established an assay system which was about four times as sensitive as indirect EIA. PBL from patients with HT synthesized significant amount of IgG anti-Mic antibody spontaneously but those from normal individuals and patients with rheumatoid arthritis did not. IgG anti-Mic antibody synthesis with pokeweed mitogen stimulation was increased in all HT patients and that with thyroid microsome stimulation was increased in three out of five patients. These results indicate that A-B EIA is a useful system to study the mechanism of anti Mic antibody synthesis in vitro. PMID- 3522746 TI - Development of an enzyme immunoassay for the quantitation of cellular antigen expression. AB - An enzyme immunoassay is described which can be used to quantitate the cellular expression of antigens recognised by mouse monoclonal antibodies (mAb). To provide the sensitivity required, complexes of alkaline phosphatase and mouse monoclonal anti-alkaline phosphatase (APAAP) have been used. The speed and reproducibility of the assay was improved with the aid of immunofiltration methodology. Quantitative measurement of HLA-DR antigen expression by ELISA did not correlate directly with the number of mononuclear cells scored positive following immunohistochemical staining of cytocentrifuged preparations. In patients with rheumatoid arthritis, more HLA-DR was expressed on synovial fluid mononuclear cells than on the corresponding cells obtained from peripheral blood. PMID- 3522747 TI - A multiple sample immunoblotting system (MSIS) for the intrinsic detection of antinuclear autoantibodies. AB - A multiple sample immunoblotting system (MSIS) is described. The MSIS permits the detection and classification of antinuclear antibodies (ANA) according to the pattern of antigenic polypeptides recognized in four different extracts: calf thymus whole tissue, nuclear extract, and two ammonium sulphate fractions of the nuclear extract. The procedure permits the classification of anti-RNP, anti-SS/B and anti-Sm, and the detection of new ANAs in sera from SLE patients. The reaction patterns presented are specific and unambiguous, and make the use of validated control sera unnecessary. PMID- 3522748 TI - Bacteraemia in diabetics. AB - During a period of 22 months one or more episodes of bacteraemia were detected in 168 patients in hospital. Of these, 29% also had diabetes compared with 10% of the total number of patients admitted to hospital during this time (P less than 0.001). The diabetics with bacteraemia were elderly and diabetes had usually been present for many years. Most of them were not receiving insulin at the time bacteraemia was diagnosed. Escherichia coli was the commonest pathogen (33%) in the diabetics, the main source of infection being the urinary tract. This finding may be due to diabetic autonomic neuropathy, which leads to a poorly emptying, chronically infected bladder. Urinary tract infections with bacteraemia in elderly diabetics are often accompanied by vague non-specific symptoms and poor diabetic control. Fever is infrequent. Prompt antibiotic therapy and insulin injections to control the diabetes usually cure these serious infections. PMID- 3522749 TI - Augmentin (amoxycillin-clavulanic acid) compared with amoxycillin alone in the treatment of urinary tract infections in the elderly. AB - Sixty-seven patients (mean age 82 years) with urinary tract infection were treated with either Augmentin or amoxycillin in a double-blind randomised trial. Of the 52 patients who completed 5 days treatment, 21/24 (87.5%) responded to Augmentin but only 12/28 (43%) responded to amoxycillin. Five of eight patients who had failed to respond to amoxycillin responded to Augmentin. PMID- 3522750 TI - Salmonellosis in patients with primary hypogammaglobulinaemia. AB - Three of 20 patients with primary hypogammaglobulinaemia developed Salmonella gastroenteritis. Two of them who also had low concentrations of serum IgG and pernicious anaemia were clinically septicaemic. Patients with primary hypogammaglobulinaemia have previously been thought not to be more susceptible to Salmonella infection but a combination of low gastric acidity and impaired humoral immunity may predispose them to such infection. PMID- 3522752 TI - Bovine tuberculosis of the skin. PMID- 3522751 TI - Clostridium difficile in habitats other than the human gastro-intestinal tract. PMID- 3522753 TI - Basal cell carcinomas grown in nude mice produce and deposit fibronectin in the extracellular matrix. AB - Epidermal cells in vitro produce and deposit fibronectin (FN) in the pericellular matrix. Such FN production by epidermal cells may be involved in vivo in wound reepithelialization, tissue morphogenesis, and growth of epithelial tumors. The purpose of this study was to examine whether the FN, previously shown to be within and surrounding human basal cell carcinoma (BCC) lobules, was in part the product of epidermal-derived tumor cells. To examine this question we took advantage of our ability to grow human BCC in nude mice. Since we could demonstrate that all stromal cells surrounding the BCC were of mouse origin, antibodies specific for human FN would distinguish epithelial-derived FN from mesenchymal-derived FN. Five solid BCCs were implanted subcutaneously in nude mice. Growing tumors were removed after 60 days, snap-frozen, sectioned on a cryostat, and verified microscopically as BCC. The Hoescht DNA stain, which can distinguish mouse and human nuclei, demonstrated that mouse, not human, fibroblasts occupied the stroma surrounding each tumor lobule. Sections of all 5 BCCs were stained by immunofluorescence and immunoperoxidase techniques with antibodies to bullous pemphigoid (BP) antigen, laminin (LM), and FN. BP antigen and LM were present at the basement membrane zone (BMZ) of all tumor lobules as previously described for in situ BCC. FN staining was present along the BMZ, within the tumor lobules, and in the surrounding stroma. Antibodies to human FN were passed over a mouse FN affinity column to absorb antibodies which cross reacted with mouse FN. The resultant antibody preparation, which was specific for human FN in this system, continued to demonstrate FN along the BMZ and within the tumors, but failed to stain FN in more distant stroma. Epidermal-derived cells, therefore, can synthesize and deposit FN in vivo in adjacent extracellular matrix. We speculate that this FN matrix may facilitate growth of BCC in this model. PMID- 3522754 TI - Cell surface carbohydrate changes during embryonic and fetal skin development. AB - Monoclonal antibodies to four type 2 chain carbohydrate antigens were used for immunohistochemical studies of embryonic and fetal skin. The antibodies detected N-acetyllactosamine and 3 fucosyl substitutes of this, blood group antigen H, Lex, and Ley. Periderm consistently stained for N-acetyllactosamine, Lex and Ley. The H antigen showed a variable and weak expression on peridermal cells from day 57 to day 84 estimated gestation age (EGA). After this period the H antigen was no longer expressed at peridermal cells. In the epidermis, N-acetyllactosamine was present on all cells until the age of 15 weeks EGA. After this period N acetyllactosamine could only be demonstrated on basal cells after treatment with neuraminidase, indicating a masking of N-acetyllactosamine by sialic acid. The H antigen could not be demonstrated in the epithelium before 14 weeks EGA. At this time it appeared on spinous and granular cells in the epithelium. Lex stained both basal cells and intermediate cells positively, until keratinization around week 20 EGA. Ley is never expressed on basal cells. It is weakly expressed by intermediate cells from week 14 EGA. Our study demonstrates that N acetyllactosamine is maximally expressed at the early stages of development, but may later be modified either by sialylation or fucosylation into blood group H or Lex, or by Ley substances, respectively. The orderly and well-defined changes observed during skin differentiation are in agreement with other studies, which have demonstrated the existence of chemically defined cell surface changes accompanying cell differentiation. PMID- 3522755 TI - Melanosomal antigenic expression on the cell surface and intracellular subunits within melanogenic compartments of pigment cells: analysis by antimelanosome associated monoclonal antibody. AB - Antimelanosome-associated monoclonal antibody has recognized the common antigenic determinant of melanosomes and cell surface of pigment cells, and it is suggested that melanosomes play a significant role as an antigen in progressive depigmentary disorders, in which melanocytes are selectively altered and disappear presumably by auto-antibodies in vivo. Mouse myeloma cells were fused with spleen cells from BALB/c mice immunized with a melanosomal fraction separated from human melanotic melanoma cells (Mm-1-JCK). The monoclonal antibody (MoAb) A4F11 has been found to react with premelanosomes, melanosomes, and probably with Golgi-associated endoplasmic reticulum lysosomes, but not with mitochondria, nuclei, and cytosol from human melanoma cells, by immunoelectron microscopy using the saponin permeation method, which was carried out together with indirect radioimmunoassay and quantitative absorption assay. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis and immunoblotting using melanosome preparations have revealed the antigen(s) reactive with the MoAb A4F11 in 3 bands corresponding to Mr 50,000, 18,000, and 17,000. Cell binding assay has shown the reactivity of the MoAb A4F11 with the cell surface of human normal melanocytes and melanoma cells, but not with other mammalian melanoma cells or with human nonpigment cells examined. Indirect immunofluorescence on cultured cells and frozen sections has revealed distinct granular reactivity not only with human melanotic melanoma, but also with junctional and intradermal nevi, cultured malignant blue nevus cells, as well as normal melanocytes. The above evidence has indicated the presence of an antigenic determinant common to the intracellular melanogenic compartments and to the cell surface of human pigment cells, regardless of their oncogenic differentiation status. PMID- 3522756 TI - Infant botulism: anticipating the second decade. PMID- 3522757 TI - Humoral antibody responses to specific antigens of Coccidioides immitis. AB - To identify antigens important to the diagnosis or pathogenesis of coccidioidomycosis, we analyzed three coccidioidal extracts by immunoblotting techniques with sera from patients infected with Coccidioides immitis and from immunized rabbits. When denatured fungal extracts were used, sera from at least 9 of 10 patients reacted with antigens of 100, 60, and 45 kilodaltons (kDa). By agar diffusion, the 100-kDa antigen appeared to be identical to the conventional tube precipitin antigen. Five of the six sera from patients with pulmonary syndromes reacted with another antigen of 70 kDa, but sera from patients with disseminated disease did not react with this antigen. Both the 100-kDa and the 70 kDa antigens were present in the 70-130-kDa region of the nondenatured fungal extracts. Our results suggest that the 100-kDa antigen may be useful in future diagnostic tests and that the 70-kDa antigen may identify patients whose infection is confined to the chest. PMID- 3522758 TI - Development of murine monoclonal antibodies to Pneumocystis carinii. AB - Relatively little is known about the antigenic structure of Pneumocystis carinii and the immunopathogenesis of pneumonitis caused by P. carinii. To begin to define the antigenic character of the surface of this organism, we have produced murine monoclonal antibodies that react with the surface of P. carinii (obtained from rats), as detected by immunofluorescence and immunoelectron microscopy. Immunoblot analysis revealed that the six antibodies described in this report bound an antigen with an apparent molecular mass of 90,000-95,000 daltons. Although all six monoclonal antibodies bound P. carinii obtained from rats, only one (5E12) was also able to bind P. carinii obtained from rabbits, ferrets, and a human; this result demonstrated that isolates of P. carinii obtained from different species are not antigenically identical. PMID- 3522759 TI - Treatment of verrucae vulgaris with alpha 2 interferon. PMID- 3522761 TI - Epidemiology of recurrent vulvovaginal candidiasis: identification and strain differentiation of Candida albicans. PMID- 3522760 TI - Production of Shiga-like toxin by Escherichia coli. PMID- 3522762 TI - Serological evidence of infection with Plasmodium and Toxoplasma in blood donors to Ain-Shams University Hospital. PMID- 3522763 TI - Serologic determination of toxoplasmosis in patients with clinical manifestations. PMID- 3522764 TI - Immune T-cells and their lymphokines enhance phagocytosis of merozoites by macrophages. PMID- 3522765 TI - The practical use of thermocouples for temperature measurement in clinical hyperthermia. AB - The use of thermocouples as invasive thermometers in clinical hyperthermia is comprehensively and critically reviewed. The ability to construct thermocouple probes as small-bore, multiple junction assemblies is a major reason for their popularity and full constructional details are given. The potential sources of measurement error when using thermocouples both in temperature gradients and in electromagnetic or ultrasonic heating fields are discussed. Emphasis is placed upon simple practical solutions to these problems and a combination of good measurement practice and electrical filtering can reduce errors to an insignificant level. Techniques are suggested for the assessment of thermocouple performance during clinical measurement. With careful use, thermocouples can be reliable and convenient thermometers. PMID- 3522766 TI - [Antenatal diagnosis of congenital heart diseases and fetal arrhythmias]. AB - Fetal echocardiographic, electrocardiographic, and pulsed Doppler ultrasonic examinations were performed to detect congenital heart anomalies and fetal arrhythmias antenatally, from April 1980 to March 1985. In nineteen subjects, these techniques revealed premature atrial contractions (PAC) in five fetuses, PAC and blocked PAC in two, PAC and premature ventricular contraction (PVC) in one, PAC, blocked PAC and PVC in one, sinus bradycardia in one, congenital complete atrio-ventricular block in one, atrial septal defect with PAC and PVC in one, fetal unilateral hydronephrosis with PAC and PVC in one, complicated heart anomalies with dilated colon in one, single atrium and ventricle with esophageal and anal atresiae in one, complicated heart anomalies with encephalocele and single umbilical artery in one, and asymmetrical septal hypertrophy in one, antenatally. In nine out of fifteen cases with fetal arrhythmias, the arrhythmia resolved within the first month of life. Sustained arrhythmias occurred in three cases. In three cases with fetal arrhythmias, in utero therapies with Coenzyme Q10(CoQ10) were performed, and anti-arrhythmic effects of CoQ10 recognized. Deaths occurred in three cases with complicated heart anomalies. PMID- 3522767 TI - [Prostacyclin and thromboxane A2 in umbilical circulation in relation to preeclampsia]. AB - In the present study, metabolites of prostacyclin (PGI2) and thromboxane A2 (TxA2), 6-oxoprostaglandin F1 alpha (PGF1 alpha) and thromboxane B2 (TxB2) in the umbilical circulation were determined. Also the baseline and substrate stimulated synthesis and release of these compounds in the umbilical vessels were measured. Umbilical serum 6-oxo-PGF1 alpha levels were significantly higher while no consistent pattern was found for TxB2. The 6-oxo-PGF1 alpha levels in the umbilical artery (UA) were revealed to be significantly lower in preeclamptic patients (PRC) while TxB2 levels were higher. These levels in the umbilical veins (UV) showed no difference. The base line release of 6-oxo-PGF1 alpha and TxB2 from UA and UV showed no statistical difference. With a saturating dose of sodium arachidonate (A . A), both UA and UV tissue showed marked enhancement in the release of the two, in which 6-oxo-PGF1 alpha from UV was significantly higher than that from UA while TxB2 was without statistical difference. Between normal subjects and PRC, there was no difference in the base line release of 6-oxo-PGF1 alpha from UA, while TxB2 was higher in PRC. Substrate A . A did not enhance the release of 6-oxo-PGF1 alpha in the PRC, but the mean TxB2 release tended to increase both in the control and PRC. Present data indicate that the impaired metabolism, especially that of TxA2, and an imbalance between PGI2 and TxA2 may be involved in the development of PRC. PMID- 3522768 TI - Fetal blood velocity waveforms in uncomplicated pregnancy. AB - Umbilical artery velocity waves were measured in fetuses from 94 normal pregnant women. In all, 183 determinations were carried out from the 14th to the 40th week of gestation. A combination of pulsed echo and real-time scanning was used to obtain blood waveforms from the umbilical arteries. The umbilical artery velocity wave can be readily differentiated from other fetal signals by its pattern. The systolic peak of the velocity wave was divided by the end diastolic value, thereby giving an S/D ratio. The S/D ratio in normal pregnancy declined from 7.6 to 2.0 from 14 to 40 weeks. Analysis of these waveforms indicated that the placenta is an organ of low vascular resistance and that placental resistance to blood flow declines with advancing gestational age in normal pregnancy. The umbilical artery S/D ratio provides a new and non-invasive marker of fetoplacental blood flow resistance. PMID- 3522769 TI - Antibodies to phenolic glycolipid-1 and to whole Mycobacterium leprae in leprosy patients: evolution during therapy. AB - Sera from 92 patients were tested by the ELISA method for the presence of IgM antibodies to phenolic glycolipid-1 (PGL-1) of Mycobacterium leprae, and of both IgM and IgG antibodies to the whole M. leprae bacillus. All untreated lepromatous patients exhibited high antibody levels in all three assays. A sharp decline of IgM antibodies to PGL-1 and whole M. leprae was observed during the first two years of therapy, while IgG antibodies to whole M. leprae showed a progressive decrease only over a number of years. Low titers of IgM antibodies to PGL-1 and IgG antibodies to whole M. leprae could be detected in about 50% and 75% of patients, respectively, after more than ten years of treatment, with only 15% showing persisting IgM antibodies to the whole bacillus. Antibody levels as measured by the three assays used were correlated with the bacterial index in patients treated for less than four years. In patients treated longer than four years, only IgM antibodies, whether directed to PGL-1 or to whole M. leprae, remained correlated to the bacillary load. Tuberculoid patients exhibited a different antibody pattern, showing a lower frequency (and lower levels) of antibodies of PGL-1 and of IgG antibodies to whole M. leprae than lepromatous patients, and no detectable IgM antibodies to the whole bacillus. IgG antibodies to whole M. leprae were more frequently noted than antibodies to PGL-1, the latter declining more rapidly during therapy. PMID- 3522770 TI - Superiority of the neonatally thymectomized Lewis rat (NTLR) to monitor a clinical trial in lepromatous leprosy of the two regimens of rifampin and dapsone. AB - The ability of the neonatally thymectomized Lewis rat (NTLR) and the congenitally athymic (nude) rat systems to detect low numbers of viable Mycobacterium leprae in tissues from lepromatous leprosy patients undergoing short-course chemotherapy was compared with that of the commonly employed mouse foot pad assay. Fifteen previously untreated lepromatous patients were randomly assigned to treatment regimens of either a single initial 1500 mg dose of rifampin plus daily doses of 100 mg of dapsone, or weekly doses of 900 mg of rifampin plus daily doses of 100 mg of dapsone. Four skin biopsies from each patient taken sequentially up to one month after initiation of therapy were used as the source of the M. leprae inocula. Only 2 of 57 skin biopsies (2%) proved positive for viable M. leprae following direct inoculation into mouse foot pads. However, 30 of 58 patient biopsies (52%) provided positive for viable M. leprae following direct passage into NTLR foot pads or in subsequent mouse subpassage. In contrast, the nude rat was observed to be a poor monitor of such trials. Although not statistically significant, the regimen consisting of a single dose of rifampin plus daily dapsone resulted in a lower percentage of biopsies found to contain viable M. leprae at each of the four sampling intervals. PMID- 3522771 TI - Prophylactic/therapeutic effects and induction of reversal reactions with thymus transplantation in Mycobacterium leprae-infected nude mice. AB - The study results indicated that thymus transplantation was effective in suppressing the growth of Mycobacterium leprae in the nude mouse, and also suggested that thymus transplantation was effective as immunotherapy of experimental leprosy in nude mice. The histopathological findings revealed the induction of reversal reactions in those animals receiving thymus transplants. PMID- 3522773 TI - Lysis of M. leprae by macrophages in vitro. PMID- 3522772 TI - Leprosy and social class in the Middle Ages. PMID- 3522774 TI - A multifactorial culture medium with growth factors from leprosy-derived mycobacteria proposed in cultivation trials for Mycobacterium leprae. PMID- 3522775 TI - [Maltose, D-glucose, alpha-amylase and alpha-glucosidase in the saliva of periodontally diseased patients]. PMID- 3522777 TI - [Clinical study of the measurement of gingival crevicular fluid]. PMID- 3522776 TI - [Dental stain removal (2)]. PMID- 3522778 TI - [Effect of bacterial protease and alloxan diabetes on wound healing in the gingiva of rats]. PMID- 3522779 TI - Artificial intelligence in medicine--is it ready? PMID- 3522780 TI - ICU monitoring of ventilation distribution. AB - The oxygen washin method has been shown to be a practical way to measure functional residual capacity (FRC) in the intensive care unit. The ventilator oxygen concentration is increased and measurements of respiratory flow and oxygen concentration at the mouth are made with the patient monitoring system. No additional personnel, bedside equipment or ventilator attachments are required. A feasibility study was performed to determine if this method could be used to estimate a continuous distribution of ventilation with respect to ventilation to volume ratio VA/V. Due to gas mixing in the ventilator, the inspired oxygen fraction does not increase instantaneously to its new value. An equation was derived which models the lung as 50 discrete compartments and accounts for the transient change in mean inspired oxygen fraction. A digital computer simulation demonstrated good distribution recovery for one and two mode ventilation distributions. Continuous distributions were computed for four post cardiac surgery patients at four levels of positive end expiratory pressure (PEEP). In these patients a linear increase in the amount of ventilation in the normal VA/V range occurred with increasing PEEP, i.e., slow and fast spaces tended to move centrally toward a more normal VA/V range. At zero PEEP 26% of the ventilation occurred in the normal range and this increased to 49% at 15 PEEP. Dead space fraction was poorly estimated and spurious modes occurred in the high VA/V range. PMID- 3522781 TI - Pneumatic nasal catheters: advantages and drawbacks. AB - The authors present their experience with pneumatic nasal catheters in cases of epistaxis. Among the advantages of this method over tamponade with petroleum jelly-covered gauze are: Effective tamponade without causing hypoxia, carbon dioxide retention or additional loading of the cardiopulmonary system; Less need for sedation; and Easy application and removal. Conversely, its most important adverse effect is the possibility of pressure necrosis of the nasal mucosa and nasal septum. This can be greatly reduced by considering a few technical recommendations. PMID- 3522783 TI - Apolipophorin III in locusts: purification and characterization. AB - Three molecular species of apolipophorin III were purified from adult locust hemolymph by gel filtration and ion-exchange chromatography, and named apo-III-a, apo-III-b, and apo-III-c, respectively. They were indistinguishable by SDS polyacrylamide gel electrophoresis, immunodiffusion, and in amino acid composition; however, they had different isoelectric points (5.43 for a, 5.11 for b, and 4.98 for c) and, therefore, could be separated by native- or urea-gel electrophoresis. All three apo-IIIs were glycoproteins and contained fucose, mannose, and glucosamine. The total sugar content amounted to about 11% for each of the three apo-IIIs. The molecular weight of apo-III determined by SDS polyacrylamide gel electrophoresis was approximately 20,000, almost equivalent to the native molecular weight (approximately 19,000) estimated by the sedimentation equilibrium method. This indicated that the locust apo-III exists in hemolymph as a monomeric form. It was demonstrated that a total 9 moles of apo-III (2 moles apo-III-a, 6 moles apo-III-b, and 1 mole apo-III-c) associate with each mole of lipophorin in response to the action of locust adipokinetic hormone. PMID- 3522782 TI - Plasma lipid transfer proteins. PMID- 3522784 TI - The history of the "Le Fort I osteotomy". AB - The history of temporary mobilisation of the upper jaw is described. The operation was first described 130 years ago for removal of a nasopharyngeal tumour. The maxilla was split at the level now known as a Le Fort I osteotomy. A further 80 years elapsed before this operation became part of the surgical treatment of skeletal deformities of the face. PMID- 3522785 TI - The autoclaved autogenous bone graft as a re-implant. Results of animal experiments. AB - The use of autoclaved bone grafts was studied in animal experiments. First we checked the immunological response in inbred rats. No antigen-antibody reaction could be detected after syngenic and allogenic autoclaved bone grafting. The bone healing of autogenous autoclaved rib grafts of different length was tested in inbred dogs. After polychrome sequential marking we investigated the periosteal and endosteal osteogenic repair of the transplant-area using different histological techniques. Simultaneously we observed the slow destruction and lysis of the autoclaved graft. In our opinion the use of autoclaved autogenous bone graft is possible, under stable conditions, for immediate reconstruction of the mandible in tumour surgery. PMID- 3522786 TI - The autoclaved autogenous reimplant, an immediately replaced, mineral frame. AB - Due to our good experimental results with an immediate mandibular body replacement after resections we report our clinical and histological findings of a 35 weeks-lasting transplantation of autoclaved bone. We could not confirm a "foreign body" reaction and absent bone-resorption by osteoclasts, described by Harding in 1957. During metal removal after the 28th week postoperatively we observed clinically a good incorporation of the graft and the histological evaluation of the 28th and 35th week specimens showed an excellent bony bridging of the osteotomy, non-irritant incorporation of the graft and a beginning remodelling of the mineral frame which had functioned as an immediate space retainer. PMID- 3522787 TI - [Computerized records in vascular pathology. II. Computer-assisted management of records in cerebrovascular pathology]. AB - Computerized processing of data from patients with cerebro-vascular disease should improve interpretation of results of complementary examinations by allowing their comparison with arteriography and operative findings. It should also allow comparison of postoperative clinical and angiographic findings in order to analyse results obtained in an identical manner, and to provide a basis for discussion of therapeutic indications. Spontaneous evolution of atheromatous lesions can finally be compared with the course after surgery. PMID- 3522788 TI - [Computerized records in vascular pathology. III. Computer-assisted management in chronic arteriopathies of lower limbs]. AB - Computerized processing of data from patients with chronic arterial disease of lower limbs has been an unsuccessful venture in many cases. This is due essentially to the complexity of the case-reports to be analyzed. In addition, the objectives are not the same if it concerns an angiologist or a vascular surgeon, or relates to an outpatient or hospital sector. Certain exploratory procedures such as Doppler and arteriography have not yet been the object of an agreement with respect to their results. An approach to the problem is proposed with respect to the polyvalent basic elements and then the more specific features as a function of the specific activity of the doctor concerned. PMID- 3522789 TI - [Computerized records in vascular pathology. IV. Computer-assisted management in Raynaud's phenomenon]. AB - The "dead finger" was first introduced into medical language in 1862 during the inaugural thesis of Maurice Raynaud: "of local asphyxia and symmetrical gangrene of the extremities". It has never ceased to stimulate interest since that date and to excite passionate speeches. Numerous reports of studies have been published since 1862 and "Raynaud's disease" has become a "syndrome", "phenomenon" or even "idiopathic disease" as a function of the author and the prevailing fashion, thus increasing the original confusion. However, it is now recognized that vasomotor disorders are not due to a single cause: apart from the primary forms of apparently purely spasmodic etiology, numerous affections accompanying these anomalies have been discovered. PMID- 3522790 TI - [Computerized records in vascular pathology. V. Computer-assisted management of records in venous pathology]. AB - Computerized processing of data from patients with venous disease concerns mainly those with chronic venous insufficiency and venous thromboembolic disease. It is of particular interest for epidemiologic studies of venous disease, explorations (functional, phlebographic) and proposed therapies. Progress in these 3 sectors requires computerized processing of data from case-reports and standardization of the noting of these data. PMID- 3522791 TI - [Value of a defibrinating agent in potentiating therapeutic thrombolysis in severe pulmonary embolism]. PMID- 3522792 TI - [Plethysmographic Allen's test]. PMID- 3522793 TI - Evaluating the contribution to a hospital of specific physicians through the use of a financial and social weighting criterion developed on a microcomputer. AB - This paper will address how a hospital was able to utilize a microcomputer to determine weighting criteria to allocate Medicaid patient days to certain physicians when the State reduced the allowable days by 59 percent. The allocation basis had to address the following: the hospital's mission, financial viability, the impact on its teaching programs and university affiliations and antitrust and anticompetition laws and regulations. PMID- 3522794 TI - Design of a management support system for hospital strategic planning. AB - Recent changes in the health care industry that foster competition are drastically affecting hospital planning and marketing activities. Increased price competition, the development of less costly alternative health care delivery systems and providers, and the shift to prospective average-cost reimbursement for Medicare beneficiaries are major factors promoting a new emphasis on strategic hospital planning. Hospital information systems do not currently support the sophisticated data-collection and analysis requirements that will be needed to implement strategic planning activities. New data must be collected and old data must be analyzed and stored in new ways. New hospital information systems designs are needed to cope with the change in the economic structure of the health care industry and its effects on hospital information needs. This paper proposes a system design for a management support system that will assist hospital administrators and planners in analyzing internal organizational data and external industry data to develop strategic planning objectives, strategies, and business plans. Analysis of the structure and process of hospital strategic planning was performed to identify the information needs of hospital planners. A prototype system is currently being implemented at the University of Arizona. The system provides an integrating framework for data base management systems, executive information systems, model management systems, and dialogue management systems. Objective analytical models and subjective strategic planning models are available to assist with idea structuring and decision processing. PMID- 3522795 TI - Combination of radioimmunoassay and immunoperoxidase methods in the diagnosis of prolactinoma. PMID- 3522796 TI - Randomized comparative study on the treatment of vaginal mycosis by single dose of isoconazole and multiple dose of nystatin. PMID- 3522797 TI - Abnormal accumulation of sulphated materials in lens tissue of mice with the aphakia mutation. AB - Sulphated materials were tested for in the eyes of late gestational and postnatal normal mice and mice with the aphakia mutation using Spicer's high iron diamine staining method. Qualitative identification of these materials was attempted with bovine testicular hyaluronidase and nitrous acid digestion methods. The grossly abnormal morphology of the aphakia lens made it necessary to confirm identification of lens-derived tissue by testing for lens crystallins using standard immunohistological methods. As seen in normal mouse lens maturation, accumulated inter- and intracellular sulphated materials were observed in aphakia lens tissue from just before birth through juvenile maturation. Large cyst-like structures consisting of lens-derived tissue were commonly seen in the eyes of young postnatal mutant mice. Sulphated materials formed basal lamina-like structures on many of these lens-derived units, but a well-defined lens capsule never formed. Abnormal fibrillar structures rich in sulphated materials were seen in the intraocular cavity in many older mutant specimens, most of which were largely resistant to both digestion methods. These results indicate that the potential to elaborate sulphated materials qualitatively similar to those seen in normal mouse lens maturation is present in the aphakia mutant, although the mode of accumulation is grossly disturbed. PMID- 3522798 TI - Development of multiple organ-localized autoimmune diseases in nude mice after reconstitution of T cell function by rat fetal thymus graft. AB - Restoration of T cell function of athymic BALB/c nu/nu mice was investigated after transplantation of xenogeneic thymic rudiments from 15-d-old embryonic rats into kidney subcapsule. The rudiments developed well and formed a proper thymus structure composed of donor epithelia and host lymphocytes. Examination of antibody responses to SRBC revealed that approximately half the normal number of indirect PFCs were observed. Skin grafts from syngeneic BALB/c mice and thymic donor rat strains were accepted, whereas those from allogeneic mice and the rats of other than donor strains were vigorously rejected. Thymus-grafted nude mice under a conventional environment survived without any evident infectious diseases. Histological and immunofluorescence studies, however, showed a high incidence of multiple organ-localized autoimmune diseases in thyroid, salivary gland, stomach, adrenal, prostate, ovary, and testis in mice that produced the corresponding autoantibodies. These results together suggested that rat thymic grafts reconstituted T cell functions of nu/nu mice to a considerable degree, but that organ-localized autoimmune diseases developed, probably because certain auto antigens of the recipients were recognized by the newly reconstituted host immunity. PMID- 3522801 TI - Interstitial pregnancy: pitfalls in ultrasound interpretation. PMID- 3522799 TI - A critical review of adult health maintenance: Part 4. Prevention of metabolic, behavioral, and miscellaneous conditions. AB - This is the last article in a four-part series that presents an updated protocol for selective longitudinal health maintenance of asymptomatic adults. Nine metabolic, behavioral, and miscellaneous conditions are reviewed with reference to six generally accepted screening criteria. A recommendation is made for each condition and is compared, when appropriate, with the recommendations of the Canadian Task Force on the Periodic Health Examination. The recommendations for all 30 conditions reviewed in this four-part series are combined into a practical health maintenance flow sheet for use by primary care physicians. PMID- 3522800 TI - Lower genitourinary infections in women. AB - Vaginitis, cystitis, urethritis, and cervicitis are common diagnoses made in women attending family physicians' offices. Recent research has fundamentally altered available information on the diagnosis and management of these common genitourinary infections. This clinical review discusses presenting symptoms, physical findings, laboratory diagnostic aids, treatment, and follow-up for each lower genitourinary syndrome in women concluding with a summary flow chart illustrating an overall recommended approach. PMID- 3522802 TI - Proposals for capitation reimbursement of physician fees. PMID- 3522804 TI - Detection of early hemagglutination inhibitory antibodies to rubella virus by pretreatment of sera with streptococcal cells. AB - A technique that is based on absorption of sera with streptococcal cells and hemagglutination inhibition (HI) was evaluated for its feasibility for serologic diagnosis of recent rubella. The mixture of AR1 and AW43 cells removes IgG and IgA from the kaolin-treated sera, leaving IgM and a trace of IgA, probably oligomeric IgA. Consequently, after the absorption with streptococci, the HI antibodies are detectable exclusively in the early sera of patients with rubella. The streptococci (AR1 and AW43) have several advantages as the absorbent over the staphylococcus (Cowan I) that has been used routinely. PMID- 3522805 TI - Detection of respiratory syncytial virus in nasopharyngeal secretions by enzyme linked immunosorbent assay, indirect immunofluorescence, and virus isolation: a comparative study. AB - An enzyme-linked immunosorbent assay (ELISA) was developed for the detection of respiratory syncytial virus (RSV) antigens in nasopharyngeal secretions (NPS) from children with acute respiratory disease. Antisera against RSV nucleocapsids were used as immunoreagents for this test system. The results obtained by RSV antigen ELISA were compared to those of indirect immunofluorescence (IF) and tissue culture virus isolation (TC). Of the 404 NPS obtained, 278 were tested in parallel by ELISA and IF and 205 by ELISA and TC, and 89 were screened in parallel by all three methods. The sensitivity of ELISA in relation to IF was 86.7%, the specificity 95.7%. Sensitivity and specificity obtained by ELISA were 89.9% and 94.4%, respectively, compared to TC. False-negative results were obtained with all three test systems used. PMID- 3522803 TI - Patterns of sarcomere activation, temperature dependence, and effect of ryanodine in chemically skinned cardiac fibers. AB - Functionally skinned and electrochemically shunted myocytes were prepared by perfusing rat hearts with collagenase in order to obtain a technically improved measurement of sarcomere dynamics and to evaluate the role of sarcoplasmic reticulum in situ with respect to contractile activation. In the presence of micromolar calcium, the myocytes exhibited phasic and propagated contraction waves beginning at one end and proceeding along the myocyte. Beating rates, the propagation velocity of the activation wave, and single sarcomere shortening and relaxation velocities were obtained by manual or automated analysis of 16-mm film recorded at 170 frames/s from a camera attached to a microscope that was equipped with a temperature-controlled stage. In parallel experiments, calcium accumulation by the sarcoplasmic reticulum of the myocytes in situ was measured by direct isotopic tracer methods. The frequency (10-38 min-1) of spontaneous contractions, the velocity (1.9-7.4 microns . s-1) of sarcomere shortening, and the velocity (1.7-6.8 microns . s-1) of sarcomere relaxation displayed identical temperature dependences (Q10 = 2.2), which are similar to that of the calcium pump of sarcoplasmic reticulum and are consistent with a rate limit imposed by enzyme-catalyzed mechanisms on all these parameters. On the other hand, the velocity (77-159 microns . s-1) of sequential sarcomere activation displayed a lower temperature dependence (Q10 = 1.5), which is consistent with a diffusion limited and self-propagating release of calcium from one sarcomere to the other. The phasic contractile activity of the dissociated myocytes was inhibited by 10( 8)-10(6) M ryanodine (and not by myolemmal calcium blockers) under conditions in which calcium accumulation by sarcoplasmic reticulum in situ was demonstrated to proceed optimally. The effect of ryanodine is attributed to an interaction of this drug with sarcotubular structures, producing inhibition of calcium release from the sarcoplasmic reticulum. The consequent lack of sarcomere activation underlines the role of sarcoplasmic reticulum uptake and release in the phasic contractile activation of the electrochemically shunted myocytes. PMID- 3522806 TI - Intraneuronal IgG in the central nervous system. AB - The rat central nervous system was examined immunocytochemically for the presence of endogenous IgG. Examination of representative sections of the neuraxis revealed specific staining for IgG in the pia mater and pial vasculature, the ependyma, and diffusely in the hypothalamus and area postrema where the blood brain barrier is permeable to large molecules. In addition, intraneuronal staining for IgG was noted in specific nuclei including the ventral horn nuclei and intermediolateral nuclei of the spinal cord, the dorsal motor nucleus of the vagus, the nucleus ambiguous, the motor nucleus of the trigeminal, the hypoglossal, facial, and oculomotor nuclei, nuclei projecting to the pituitary and area postrema, and Purkinje cells. The uptake of immunoglobins by these cell groups may have important implications for the pathogenesis of motor and autonomic neuropathies and neuropathies. PMID- 3522807 TI - The effect of continuous subcutaneous insulin infusion therapy on morphological and biochemical abnormalities of peripheral nerves in experimental diabetes. AB - Diabetes mellitus was induced in rats by the administration of streptozotocin and observations have been made over a period of 2 months in 3 groups of animals: controls, untreated diabetics and diabetics treated with continuous subcutaneous insulin infusion (CSII) therapy, using a 14-day Alzet osmotic minipump. Optimal control of day-to-day and 24-h blood glucose levels was achieved in diabetic animals treated with CSII. Body weight and skeletal growth, assessed by measurements of tibial length, were decreased in untreated diabetic rats and were normalized by insulin treatment. The concentrations of glucose, sorbitol and fructose in the nerves of diabetic animals were significantly increased and that of myoinositol significantly decreased; CSII therapy normalized these levels to those of age-matched controls. External myelinated fibre diameter in the tibial nerve was significantly less in untreated diabetic rats as compared with age matched controls. In the insulin-treated group, fibre diameter significantly increased as compared with untreated diabetics and there was no significant difference between insulin-treated and control animals. Teased fibre preparations from the tibial nerve revealed very few abnormal fibres in all the three groups and no significant difference was detected between any of the groups. Continuous subcutaneous insulin infusion therapy, therefore, corrected biochemical abnormalities and also normalized myelinated fibre diameter in the peripheral nerves of experimental diabetic animals. The paradoxical excess of axonal degeneration that has been reported with conventional insulin treatment was not observed. PMID- 3522808 TI - Glial fibrillary acidic protein in radial glia of early human fetal cerebrum: a light and electron microscopic immunoperoxidase study. AB - In order to assess the nature of glial fibrillary acidic protein (GFAP) immunoreactivity in the radial glia of early human fetal cerebrum, full thickness blocks from the midconvexity of the frontoparietal region of the cerebrum of 25 human fetuses ranging from ten to 20 weeks of ovulation age were studied by light and electron microscopic (EM) immunoperoxidase methods. The presence of GFAP within radial glia was demonstrated in vibratome sections, in de-eponized 1 micron sections and in paraffin-embedded sections both at light and EM levels in suitably fixed human fetal cerebral tissue. The results indicate that the pattern of GFAP immunoreactivity observed in "routinely" processed autopsy brains, in which fixation is suboptimal, must be interpreted with care. PMID- 3522809 TI - Regional specialization of the radial glial cells of the adult frog spinal cord. AB - The amphibian spinal cord is characterized by the presence of radially oriented astrocytic glial cells. These cells have their somata located in the grey matter of the spinal cord and radial processes that extend from the soma through the grey and white matters to the pial surface of the cord. Here we show that these radial glial cells are the predominant cell type labelled by horseradish peroxidase (HRP) when the marker is applied to the surface of the cord. The morphology of the HRP-labelled processes of an individual cell is different as they pass through the grey and white matter regions of the cord. By indirect immunofluorescence on frozen sections we show that the binding of an antibody raised against mammalian glial fibrillary acidic protein (GFAP) is preferentially localized in those areas of the glial process that traverse the white matter of the spinal cord. By transmission electron microscopy we confirm that there are no astrocyte cell bodies either at the pial surface or throughout the white matter region of the cord. These results demonstrate that all the astrocytes in the adult frog spinal cord can be selectively labelled through the application of HRP to the surface of the cord, and that the processes of these labelled cells display regional morphological and biochemical specializations depending on their location in the cord. We propose that these astrocytes may play an important role in setting up the grey-white matter arrangement of the amphibian spinal cord and that a single astrocyte of the frog spinal cord may combine the properties and functions of both grey and white matter mammalian astrocytes. PMID- 3522810 TI - Extracranial to intracranial bypass and the prevention of stroke. PMID- 3522811 TI - Increased GFAp levels in CSF as a marker of organicity in patients with Alzheimer's disease and other types of irreversible chronic organic brain syndrome. AB - Glial fibrillary acidic protein (GFAp), an astrocyte-specific protein, was determined in cerebrospinal fluid (CSF) of adults and children with global cognitive dysfunction. In children CSF-GFAp values were not closely associated with organic brain disease. However, GFAp values in CSF were increased in 65 of 121 samples of adults with dementia, independent of its cause. GFAp values were not correlated with the severity of the dementia. Increased levels in the CSF are believed to indicate reactive gliosis in most patients with dementia, whereas GFAp levels in encephalitic patients normalize after clinical recovery. PMID- 3522812 TI - Some comments on the occurrence of multiple sclerosis in the Faroe Islands. AB - Some factors which might be related to the marked increase in multiple sclerosis in the Faroe Islands in mid-century were studied. Of these, only the occupation by British troops in World War II was found to be significant. A vague relationship with industrial changes earlier in the century was also found. These findings are discussed with caution with respect to the close association between population on the one hand and all features tested as well as multiple sclerosis on the other. PMID- 3522813 TI - The effect of sorbinil treatment on red cell sorbitol levels and clinical and electrophysiological parameters of diabetic neuropathy. AB - A randomized placebo-controlled double-blind cross-over study was conducted in order to examine the effect of an aldose reductase inhibitor, sorbinil (100 mg daily for 4 weeks), on red cell sorbitol concentration and clinical and electrophysiological parameters of diabetic neuropathy. A total of 31 diabetic patients with either clinically or electrophysiologically verified diabetic neuropathy were studied. Red cell sorbitol levels decreased significantly to the levels reported in non-diabetic subjects, but there were no significant changes in symptoms, signs, vibration perception thresholds or nerve conduction variables. One patient had transient skin rash, fever, myalgia and leucopenia, but no other significant adverse effects were found. PMID- 3522814 TI - Common carotid blood flow in patients with hypertension and stenosis of the internal carotid artery. AB - Common carotid blood flow has been measured using pulsed Doppler techniques in hypertensive patients over 45 years of age, with and without stenosis of the internal carotid artery. In hypertensive patients without stenosis, arterial diameter remained within the normal range, whereas blood flow velocity and blood flow were significantly reduced. Vascular resistance was significantly increased but did not change markedly after administration of the vasodilating drug isosorbid dinitrate. Patients with hypertension and stenosis of the internal carotid artery were compared with two different populations used as controls: In comparison with hypertensive patients without stenosis of the internal carotid artery, both arterial diameter and blood flow velocity were reduced, leading to a more pronounced decrease in blood flow; and in comparison with normotensive patients with stenosis of the internal carotid artery, common carotid blood flow was more reduced at any degree of stenosis. In a subset of patients, blood flow returned toward normal ranges after endarterectomy. The study suggested that in patients with hypertension without stenosis of the internal carotid artery, the decrease in blood flow is due to a decrease in blood flow velocity with normal arterial diameter despite the elevated blood pressure, and in patients with hypertension and stenosis of the internal carotid artery, blood flow was more reduced than in the normotensive patients with stenosis of the internal carotid artery, suggesting that caution must be taken with indications of antihypertensive treatment. PMID- 3522815 TI - Coarctation hypertension is renovascular, modified by ambulation. Coarctation hypertension renovascular variant. AB - In coarctation, bipedal exercise induces a pressure triad: exaggerated systolic arm hypertension, unchanging leg pressure, and markedly increased systolic gradient. Constancy of leg pressure derives from the lower body sharing the poststenotic compartment with the kidneys. Exercise-induced poststenotic hypotension stimulates the juxtaglomerular apparatus (JGA) to raise renal pressure to pre-exercise levels. Ambulation during the greater part of each day stimulates the JGA repetitively. Thereby, this chronic Single-Kidney-Goldblatt model is modified by increased plasma renin, fluid volumes, and cardiac output. It also accounts for hyper-responsive renin output after renin blockage and for mild poststenotic hypertension. Hypertension after repair which corrected the resting gradient, is almost always associated with the exercise triad, indicating that renal ischemia exists during ambulation. Thus, residual hypertension usually means residual coarctation. Mesenteric ischemia complicating postoperative paradoxic hypertension is probably due to spasm in the superior mesenteric artery and not to fixed occlusion of necrotizing arteritis. PMID- 3522816 TI - Hypertension in black patients. Epidemiologic and pathophysiologic considerations. AB - In summary, the black patient with hypertension represents a challenge. This pathophysiologic state exists with much greater prevalence than in the nonblack population. The exact reasons for this are unknown, but because tribal blacks in Africa do not have hypertension, one might speculate that alterations in life style, including increased stress and dietary alterations, play a large role. The black hypertensive patient also appears to differ from the white hypertensive patient in that he/she shows a tendency to volume expansion, low renin state, early nephrosclerosis, and lowered renal blood flow. Other parameters of the advanced hypertensive state, such as lowered cardiac output and increased total peripheral resistance, seem to be in common with the white patient with hypertension. The black patient is also unique in that he/she demonstrated less response to beta-adrenergic blocking agents and seems to require diuretic therapy under most circumstances. These considerations, as well as a discussion of appropriate therapy in black and white hypertensive patients, need to be considered in further detail. PMID- 3522817 TI - The value of hepatic ultrasound and biochemical liver tests in screening for liver metastases. AB - The records of 92 patients with a known diagnosis of extrahepatic cancer who had undergone hepatic ultrasound, biochemical liver tests (alkaline phosphatase, SGOT, lactic dehydrogenase, and bilirubin levels), and subsequent liver biopsy or autopsy within a 6-week period were reviewed. The sensitivity, specificity, and accuracy of the ultrasound and biochemical tests in the detection of metastatic liver disease were calculated. Although there was no significant difference in the sensitivity of either examination, the ultrasound demonstrated higher specificity and accuracy than the biochemical liver tests. The high sensitivity of hepatic ultrasound prevailed even in patients with normal biochemical liver tests. The sensitivity of hepatic ultrasound was significantly lower in patients with lymphoma compared with patients with colorectal cancer (50% v 100%, P less than .05). Notable incidental extrahepatic findings were reported in 25% of the ultrasound examinations. In institutions skilled in sonography, hepatic ultrasound may be a superior tool in the detection of liver metastases in most solid tumors, excluding lymphoma, and offers the additional advantage of simultaneous biliary tract and perihepatic visualization. PMID- 3522818 TI - Antiemetics in children receiving cancer chemotherapy: a double-blind prospective randomized study comparing metoclopramide with chlorpromazine. AB - This is the first prospective randomized study comparing commonly used antiemetics in children receiving cancer chemotherapy. We compared metoclopramide (MCP) with chlorpromazine (CLP), both administered in conventional doses, in 50 cancer patients aged 6 to 18 years who were receiving emetic chemotherapy. CLP proved significantly better than MCP in reducing both the frequency of vomiting (P less than .05) and the duration of nausea and vomiting (P less than .025). Extrapyramidal reactions (EPRs) were more common in MCP-treated patients. We conclude that, in the standard doses used, CLP is a better overall antiemetic than MCP for children receiving intensive chemotherapy. However, further prospective pediatric studies of antiemetic combinations are needed. PMID- 3522819 TI - Lack of evidence for a role of chemotherapy in the routine management of locally advanced head and neck cancer. AB - Numerous single-arm studies have shown that chemotherapy may produce a high rate of response and rapid shrinkage of tumor when used before radiation and/or surgery in patients with squamous-cell carcinoma of the head and neck. Despite this high rate of tumor response, randomized controlled trials do not indicate any consistent improvement in survival for patients receiving chemotherapy as compared with patients receiving local treatment alone. This population of patients often has poor performance status, and chemotherapy invariable adds some toxicity. Also, studies in animals suggest that some types of chemotherapy given before local radiation or surgery might increase the probability of distant metastases. Apart from pilot studies of feasibility, all future trials of chemotherapy should involve a randomized comparison with a group of patients receiving radiation and/or surgery alone. At present, chemotherapy has no place in the routine management of primary head and neck cancer. PMID- 3522820 TI - Intraperitoneal chemotherapy: a review. PMID- 3522821 TI - Stereotaxic biopsy of intrinsic lesions of the brain stem. AB - Despite improved brain-stem imaging by magnetic resonance and high-resolution x ray computerized tomography, definitive diagnosis and therapy of intrinsic lesions of the brain stem require histological verification. A stereotaxic approach to brain-stem lesions provides a high yield of positive histological diagnosis with a low incidence of morbidity. A series of 14 stereotaxic procedures performed on 12 patients with intrinsic lesions of the mesencephalon, pons, and medulla is reviewed. A detailed description of the transfrontal approach used by the authors is presented. Definitive pathological diagnosis was obtained in all patients. There was no operative mortality and only one case of permanent neurological deficit. The significance of accurate histological diagnosis in the therapy of brain-stem lesions is discussed. PMID- 3522822 TI - Changes in superior sagittal sinus pressure in children with head elevation, jugular venous compression, and PEEP. AB - Air embolism is a potential hazard during craniotomy whenever intracranial venous pressure is subatmospheric. In order to better understand both the risk of air embolism and its treatment in neurosurgical patients, the authors have investigated the relationship of superior sagittal sinus pressure (SSP) to head position in 15 children and examined the effects of both jugular venous compression and positive end-expiratory airway pressure (PEEP) on SSP. Progressive head elevation significantly decreased mean SSP and, in five patients, SSP was less than 0 mm Hg at 90 degrees torso elevation. A PEEP of 10 cm H2O was ineffective in significantly increasing SSP at any degree of head elevation, whereas bilateral internal jugular compression always caused a significant increase in SSP. The authors conclude that children are at risk for venous air embolism when undergoing suboccipital craniectomy in the sitting position because intracranial venous pressure is often subatmospheric when the head is elevated. Furthermore, maintaining PEEP does not appear to be a reliable treatment for increasing SSP, whereas bilateral internal jugular compression is effective. PMID- 3522823 TI - Double-headed stereotaxic carrier apparatus for insertion of depth electrodes. Technical note. AB - A carrier device has been developed for use with a sterotaxic apparatus. It can be attached to the OBT frame or to any Leksell-type frame. With this carrier, intracranial insertion of commercially available depth electrodes with built-in connectors is possible. By using two different heads mounted on a single carrier, the surgeon can perform a transcutaneous twist-drill trephination and attach the screws through a chuck, adjust the device in the horizontal plane, and then insert and anchor the electrodes by using a small platform with a hinged roof. PMID- 3522824 TI - Mechanism of gallium-67 accumulation in tumors. AB - Neoplasms are characterized by increased perfusion, increased permeability of their capillary beds to macromolecules, and a delay in new lymphatic vessel growth. These lead to the increased entry and residency time of macromolecules in the interstitial space of tumors. Multiple factors contribute to the localization of 67Ga in tumors. Adequate blood supply is essential; at areas with no blood supply such as the necrotic center of a large tumor, there is no 67Ga accumulation. Gallium-67, mainly in the form of transferrin-67Ga complex, is delivered to the tumor through capillaries with increased permeability. In tumors, some 67Ga is taken up by tumor cells; some may also be taken up by inflammatory cells when they are present. Gallium-67 binding proteins, such as lactoferrin or ferritin, may also contribute to the accumulation and retention of 67Ga in tumors; however, their roles are less clear. The intensity of these various factors determine their relative contribution and the degree of 67Ga accumulation in tumors. PMID- 3522826 TI - The noninvasive vascular laboratory. An update. Part III: Current uses- evaluation of the venous system (3). PMID- 3522825 TI - Competitive interaction of iron and zinc in the diet: consequences for human nutrition. AB - The degree to which inhibitors of zinc bioavailability actually influence the zinc status of humans who consume usual meals and diets is not known. The interaction of iron and zinc and competitive inhibition of zinc uptake by excess iron in ratios of 2:1 or greater, when the total amount of ionic species is greater than 25 mg, appear to have a measurable effect on human zinc nutriture. The physiological basis is the competition of these chemically similar ions for some portions of a common absorptive pathway shared between inorganic (nonheme) iron and zinc; this has been demonstrated in animal experiments and in zinc absorption studies in human volunteers. Thus, studies involving formula-fed infants, experimental zinc-depletion diets and pregnant women who took prenatal vitamin-mineral supplements containing high levels of iron have shown growth delay (infants) and a decreased circulating zinc pool (all age groups), suggesting a determinant impact of excessively high Fe/Zn ratios in the diet. Consideration of solutions to these problems, including conscious adjustment of the Fe/Zn ratios in human diets, foods and therapeutic nutrient supplements in order to reduce the zinc-inhibiting effects of iron, should become a priority in policy and marketing discussions within government regulatory agencies, industry and the scientific community of human and clinical nutritionists. PMID- 3522827 TI - Revascularization of reversed dermis grafts. AB - The process of vascularization and the vascular patterns in reversed dermis grafts (RDG) and full-thickness skin grafts (FTSG) in the rat were studied at various intervals after transplantation by a combination of microangiography and histologic techniques. In the early stages the RDG became vascularized more rapidly than the FTSG. However, the inflammatory reaction in the RDG persisted for longer periods than that in the FTSG in the later stages. The prolonged inflammatory reaction in the RDG was presumed to be due to the lack of epidermis for two to three weeks after surgery. Comparatively severe contraction of RDG may result from this prolonged inflammation and the delayed epithelialization. PMID- 3522829 TI - Management of osteomyelitis and nonunion of the mandible in a patient with progressive systemic sclerosis. PMID- 3522828 TI - Comparative study of alloplastic materials for temporomandibular joint disc replacement in rabbits. AB - Young adult, white New Zealand rabbits underwent either sham surgical procedures or discectomy. In the animals that underwent discectomy, either reinforced silicone or polytetrafluoroethylene-aluminum oxide (PTFE-Al2O3) implants were placed in the glenoid fossa. During gross sectioning, the silicone implants could be easily displaced from the specimen, while the PTFE-Al2O3 implants were firmly anchored. Histologically, fragmentation of the implants was seen in the silicone group; 21.4% of the implants placed were torn. Foreign body giant cell reactions reached a peak after eight weeks. Associated fibrosis and foreign body giant cell reactions were seen, resulting in a thickened capsule and resorption of the condyle and articular fossa. In the PTFE-Al2O3 group there was marked osteoclastic activity, with resorption and severe degenerative changes in both the condyle and glenoid fossa. The foreign body giant cell reaction was severe at all time intervals and increased with time. Tearing of the implant was observed in 46.2% of the joints. These results indicate a need for further evaluation of these materials as disc replacements in humans. PMID- 3522830 TI - Perspectives on occult bacteremia in children. AB - Bacteremia in young children seen in the outpatient clinic is a reasonably frequent occurrence with occasionally serious sequelae; most patients, however, do quite well. The problem is more perplexing in infants and young children with high fever and no apparent focus of infection. Laboratory tests and clinical observations help to determine which children are at low risk of occult bacteremia and need not have blood cultured; testing and assessment are much less predictive of the child who does have occult bacteremia. Currently, it is unclear whether treating all patients at risk is warranted. In any case, very close follow-up of the patient who is sent home from the outpatient department with high fever is desirable. The prevalence of serious infections caused by pneumococcus, Hib, and meningococcus warrants continued research on the development of vaccines that effectively prevent these infections. PMID- 3522831 TI - Neonatal aortic thrombosis: recent experience. AB - To evaluate the course, use of diagnostic modalities, management, and outcome of aortic thrombosis associated with umbilical artery catheterization, we reviewed 20 cases of aortic thrombosis diagnosed by ultrasonography (n = 16) or aortography (n = 4) over 4 years. Fourteen of 20 infants had severe perinatal asphyxia, suggesting that asphyxia predisposes to aortic thrombosis. Ultrasonography provided information about the size, location, and configuration of the thrombus and was useful in following thrombus size with therapy. Radionuclide renography-scintigraphy demonstrated abnormal renal function in all 11 patients scanned. Six patients with minor thrombosis (hypertension as the only sign) improved without specific therapy. Nine infants had moderate thrombosis (multiple signs but normal urine output); all survived with a variety of therapies; two were not given anticoagulant or fibrinolytic agents; three improved with heparin alone; and one had surgery without recurrence of the thrombus. Resolution of moderate thrombosis followed streptokinase therapy in two of three infants. All five babies with anuria from major thrombosis died. Hepatic infarction associated with aortic thrombosis was found in three of three autopsies. PMID- 3522832 TI - Cefuroxime versus ampicillin plus chloramphenicol in childhood bacterial meningitis: a multicenter randomized controlled trial. AB - In a multicenter randomized trial, 107 children with bacterial meningitis were initially given either cefuroxime or ampicillin plus chloramphenicol. Patients were alternately assigned to 7- or 10-day courses of the designated antimicrobial regimen. CSF isolates included Haemophilus influenzae type b (89, of which 25% were beta-lactamase positive), Streptococcus pneumoniae, and Neisseria meningitidis. Although mean CSF bactericidal titers against Haemophilus isolates were 1:6 in each treatment group, H. influenzae was cultured from CSF in four of 39 patients receiving cefuroxime, 24 to 48 hours after initiation of therapy, compared with none of 40 patients given ampicillin plus chloramphenicol (P = 0.11). Clinical cure rates were similar (95%); one death occurred in each group. One child given cefuroxime had persistent meningitis after 5 days of therapy, and mastoiditis with secondary bacteremia developed in one on day 10. Three patients had relapse or reinfection. One patient who received cefuroxime for 10 days had a relapse of epiglottitis 17 days later, and of the patients given ampicillin plus chloramphenicol, one had a relapse of meningitis 1 week after 7 days of therapy, and bacteremia developed in one 42 days after completion of 10 days of therapy. No increase in either in-hospital complications or relapses occurred with a 7-day treatment course. Proof of the equivalence of the antibiotic regimens and the efficacy of 7-day courses of treatment, as well as the consequences of delayed CSF sterilization, will require additional investigation. PMID- 3522833 TI - Sensory and perceptual processes in early infancy. PMID- 3522834 TI - Learning in infancy: cognitive development in babies. PMID- 3522835 TI - Environmental context of child development. PMID- 3522836 TI - Group A streptococcal supraglottitis. AB - We describe four children with severe supraglottic infections caused by group A beta-hemolytic streptococci. In each case the clinical presentation suggested Hemophilus influenzae epiglottitis. In only one patient was there significant involvement of the epiglottis, whereas all had striking inflammation of the aryepiglottic folds. Group A beta-hemolytic streptococcus was isolated in blood cultures in two patients and from the supraglottic area and trachea in two others. Fever persisted for 6 to 22 days, and tracheal intubation was necessary for 2 to 16 days, despite appropriate antibiotic therapy. The evolution of streptococcal supraglottitis may be protracted, and it must be managed accordingly. PMID- 3522837 TI - Emotional correlates and consequences of birth defects. PMID- 3522838 TI - Malignant hyperthermia. PMID- 3522839 TI - Candida albicans adherence in newborn infants. AB - Adherence of Candida albicans to buccal epithelial cells from full-term infants was significantly lower than adherence to epithelial cells from premature infants and healthy school-age children, until the full-term infants reached 5 days of age. Adherence in premature infants (gestational age 28-39 weeks) at birth was more than twice that of term infants and remained unchanged during the first week of life. Differences in Candida adherence in premature and term newborns may be due to developmental, salivary, receptor site or other unknown factors. PMID- 3522840 TI - Pathogenesis of vaginal candidiasis: studies with a mutant which has reduced ability to adhere in vitro. AB - A spontaneous, cerulenin-resistant mutant of Candida albicans (strain 4918-10) was found to adhere less readily to human vaginal mucosal cells in vitro than a wild type C. albicans (strain 4918). In a murine model of vaginal infection, strain 4918-10 was found to be less virulent than wild type C. albicans, i.e., the infection rate caused by 4918-10 was only 31% of that observed with wild type, 4918. A chitin-soluble extract (CSE) prepared from 4918 blocked attachment of yeast cells to human vaginal epithelial cells, while CSE from 4918-10 did not significantly reduce the attachment of yeasts to vaginal cells. Both 4918 and 4918-10 produced hyphae in vitro and in vivo, were negative for proteinase production and grew equally well at 28 degrees C and 37 degrees C. The data suggest that adherence to vaginal mucosa may be an important determinant in the pathogenesis of vaginal infection caused by C. albicans. PMID- 3522842 TI - A Candida albicans rough-type mutant with increased cell surface hydrophobicity and a structural defect in the cell wall mannan. AB - A Candida albicans rough-type mutant showing increased hydrophobicity of the cell surface was isolated. The mutant cells contained about one-quarter as much mannan as the wild type, and were defective in antigenic factors 1, 4, 5, and 6. Acetolysis fingerprinting demonstrated that the mutant mannan had a structural defect in its carbohydrate skeleton. PMID- 3522841 TI - The mode of antifungal action of tolnaftate. AB - The anti-dermatophyte agent tolnaftate was compared with the allylamine antifungal compounds naftifine and terbinafine. Tolnaftate was shown to inhibit sterol biosynthesis at the level of squalene epoxidation and squalene was shown to accumulate in dermatophytes grown in its presence. Biochemical studies in whole and broken cells supported this conclusion and showed that the compound was active against squalene epoxidation in broken C. albicans cells, but was much less potent against whole cells. These results suggested there was a barrier to penetration in these yeasts. PMID- 3522843 TI - Epikeratophakia in children with traumatic cataracts. AB - Epikeratophakia provides a permanent optical correction for aphakia in children with congenital or traumatic cataracts; suturing the epikeratophakia graft onto the cornea eliminates the problems of contact lens or spectacle non-compliance in these young and generally uncooperative patients and provides tectonic support to scarred and irregular corneas. Eighteen children under the age of six years underwent epikeratophakia for the correction of aphakia after the removal of trauma-induced cataracts. Graft success rate was 88%; the average change in keratometry in the patients with successful grafts was 14.82 +/- 2.0 diopters. In the 13 patients eligible for visual acuity tabulation, preoperative acuities ranged from light perception to 20/200, and postoperative acuities ranged from hand motions to 20/30. Ten (77%) had acuities of 20/80 or better. Poor results in three patients with less than 20/200 acuities were likely the results of non compliance with amblyopia therapy. Present work indicates that in cases of traumatic cataract, the epikeratophakia procedure facilitates amblyopia therapy and decreases the astigmatism in scarred and irregular corneas. PMID- 3522844 TI - Recent developments related to retinoblastoma. PMID- 3522845 TI - Primary hyperparathyroidism in infancy. AB - Primary hyperparathyroidism in the neonate is a rare and often fatal disorder. These infants typically display severe hypercalcemia, respiratory distress, muscular hypotonia, and skeletal demineralization. They are usually diagnosed within the first three months of life and have hyperplasia of the four parathyroid glands. Twenty-nine infants with primary hyperparathyroidism are reported in the literature. Mortality is 87.5% in medically managed patients and 24% in surgically managed patients. Surgical management has not been satisfactory, in that recurrent hypercalcemia has been encountered in most patients undergoing subtotal parathyroidectomy, and total parathyroidectomy has resulted in the need for lifelong calcium and vitamin D supplementation. We have recently cared for a term newborn female in whom the diagnosis of primary hyperparathyroidism was made clinically on the second day of life, and later was confirmed biochemically. The baby underwent neck exploration on the 11th day of life and was successfully treated with total parathyroidectomy and parathyroid autotransplantation. Although initially rendered eucalcemic, the infant subsequently developed recurrent hypercalcemia requiring the removal of some of the autograft. Currently, the child is more than 2 years following surgery, growing well, and off all medication. The world literature is reviewed in this report of one of the first and the youngest infants, to our knowledge, to undergo parathyroid autotransplantation. In view of its success in avoiding the complication of repeated neck exploration for recurrent hyperparathyroidism or the creation of permanent hypoparathyroidism, we recommend this surgical approach for the rare neonate with primary hyperparathyroidism. PMID- 3522846 TI - Auxiliary transplantation of the fetal liver. I. Development of a sheep model. AB - Current methods of orthotopic liver transplantation are expensive, entail high morbidity and mortality, and are limited by a serious shortage of donor organs for the pediatric recipient. Auxiliary transplantation of livers from anencephalics is a potential solution to the problems of size discrepancy and organ availability for the pediatric patient. To investigate the feasibility of auxiliary fetal liver transplantation, we have developed a sheep model of auxiliary transplantation of the fetal liver into the adult neck. We report here the results of the transplantation of 32 fetal lamb livers ranging in age from 100 to 140 days gestation (term 145 days). We conclude that (1) fetal organ harvest can be effectively accomplished by surface cooling followed by umbilical cold perfusion; (2) auxiliary transplantation of the fetal lamb liver is technically feasible; (3) the fetal liver can survive on umbilical inflow alone but function is improved by hepatic arterial inflow; and (4) the fetal liver is sensitive to excessive flow or pressure and is best transplanted in a parallel vascular arrangement. Auxiliary transplantation of the fetal liver is a promising alternative to current methods of liver transplantation. PMID- 3522847 TI - Portal vein ultrasonography in the early diagnosis of necrotizing enterocolitis. AB - The nonoperative diagnosis of necrotizing enterocolitis (NEC) is dependent upon the radiographic finding of pneumatosis intestinalis. A significant number of neonates develop clinical signs compatible with NEC but nondiagnostic radiographs. This can result in delayed, inappropriate, or unnecessary therapy. This paper presents experience with portal vein (PV) ultrasonography in the diagnosis of NEC. Since January 1984, 15 newborns with suspected NEC have undergone PV ultrasonography (mean gestation 33 weeks, mean weight 1,705 g). Each had developed abdominal distention with evidence of sepsis. Stool was positive for occult blood in 11. Abdominal radiographs were interpreted as abnormal but nonspecific in 10 neonates, definite pneumatosis in 3, and normal in 2. No infant had portal vein air on plain abdominal radiograph. Occult PV air was detected by ultrasonography in five infants. These included all infants with obvious pneumatosis, a newborn with a nonspecific radiograph and a neonate with a "normal" x-ray. Of the ten infants without PV air on ultrasound, clinical symptoms resolved without specific therapy in seven. Two infants were proven to have nonenteric sepsis, and the remaining newborn developed intestinal necrosis secondary to aortic thrombus. In the five infants with occult PV air on ultrasound, two subsequently required intestinal resection. The remaining three were treated medically for ten days without sequelae. PV ultrasonography has proven to be a helpful adjunct in the early diagnosis of NEC. This diagnostic maneuver, when applied appropriately, may enable early therapy of the infant with NEC and avoid inappropriate or unnecessary therapy in the suspected case. PMID- 3522848 TI - Comparative effects of dopamine, naloxone, and prostacyclin in the resuscitation of fecal-Escherichia coli peritonitis-induced septic shock in neonatal swine. AB - To explain the high neonatal mortality from peritonitis-induced septic shock despite current resuscitation practices, the efficacy of dopamine, naloxone, and prostacyclin was evaluated in an experimental neonatal model. Hemodynamics were monitored and survival was measured in anesthetized neonatal swine, which were subjected to fatal fecal-Escherichia coli peritonitis-induced septic shock. All the animals received fluid resuscitation, antibiotics, and bicarbonate to correct acidosis. Pharmacologic resuscitation began when cardiac output dropped below baseline in the experimental groups. Although significant differences were observed between groups in cardiac output, mean arterial and mean pulmonary arterial pressures, left ventricular stroke work, stroke volume, and pulmonary vascular resistance indices (P less than 0.02), and each animal exhibited favorable hemodynamic responses during the first several hours of dopamine and naloxone infusion, these drugs failed to prolong survival. Also, 5 of the 9 naloxone-treated pigs (56%), died with histologically proven intestinal ischemia (P less than 0.02). Thus, dopamine, naloxone, and prostacyclin (at doses commonly recommended for the treatment of septic shock) fail to positively influence the fatal course of this condition, and the use of naloxone in this model is associated with profound intestinal ischemia. PMID- 3522849 TI - Preliminary clinical evaluation of dentinal and enamel bonding in primary anterior teeth. PMID- 3522850 TI - Effect of periodontal therapy on patients maintained for 15 years or longer. A retrospective study. AB - A retrospective study of tooth loss in 211 patients who were treated for periodontal disease in private practice and maintained for 15 to 34 years on 3- to 6-month recall schedules is reported. The average age of the patients was 42 years, and the average length of time in maintenance was 22 years. On the basis of response to therapy, the patients were classified as Well-Maintained (62%), Downhill (28%) and Extreme Downhill (10%). Seven hundred and seventy-one (771) teeth were lost (13.4%) due to all causes. Molar teeth are the most prone to loss and the mandibular cuspid is the most resistant. The importance of maintenance therapy is emphasized. PMID- 3522851 TI - Chlorhexidine. An adjunct to periodontal therapy. AB - Chlorhexidine is an effective antimicrobial agent. Its application can enhance periodontal therapy. The pharmacology of chlorhexidine and suggestions for its use are outlined. In addition, its potential for inducing cancer and bacterial resistance are discussed. PMID- 3522852 TI - [Studies on experimental chemotherapy of dermatomycosis and candidiasis. X. Mechanism of the antifungal action of propiolic acid (beta-naphthyl)methyl ester]. PMID- 3522853 TI - Plantar skin graft complications in a diabetic male. PMID- 3522854 TI - Brachymetatarsia. A review of the literature and case report. PMID- 3522855 TI - Pyoderma gangrenosum. A literature review and case report. PMID- 3522856 TI - [The role of citric acid in the repair of the attachment apparatus. Review of the literature]. PMID- 3522857 TI - [The Langerhans cell: a vector of periodontal immunity?]. PMID- 3522858 TI - Regional differences in relaxation of electric field-stimulated canine airway smooth muscle by verapamil, isoproterenol and prostaglandin E2. AB - Regional differences in contraction produced by methacholine and electric field stimulation (EFS) and in relaxation produced by isoproterenol, prostaglandin E2 and verapamil were studied in isolated canine airway smooth muscle in vitro. Low frequency EFS (3 Hz, 0.5 msec, 50 V) contracted thoracic trachealis to 43% of maximal EFS response, whereas cervical trachealis contracted to only 14% of maximum. EFS at 10 Hz produced 75% of the maximal response in both regions of the trachea. These EFS responses were abolished by 0.1 microM tetrodotoxin and 1.0 microM atropine. Contraction produced by EFS was also matched in each tissue by contraction with methacholine. The concentrations of methacholine that matched EFS at 10 Hz were 52 +/- 7, 378 +/- 84 and 66 +/- 11 nM for cervical and thoracic trachealis and lobar bronchi, respectively. Both EFS and matched methacholine contractions of cervical trachealis and lobar bronchi were completely relaxed by isoproterenol, whereas thoracic trachealis relaxed maximally to only 60% of induced tone. When verapamil was used to relax EFS and matched methacholine contractions, cervical trachealis was completely relaxed whereas thoracic trachealis relaxed to 15% of induced tone. Although there was a regional difference in the relaxant potency of isoproterenol and, to some extent, verapamil, there was no difference in isoproterenol or verapamil EC50 values for EFS vs. matched methacholine contractions within each region. In contrast, EFS contractions of thoracic trachealis were more sensitive to prostaglandin E2 induced relaxation than were matched methacholine contractions. These data demonstrate marked differences in cholinergic and beta adrenergic receptor mediated responses between regions of the tracheobronchial tree.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3522859 TI - A review of techniques of crown fabrication for existing removable partial dentures. AB - Fourteen methods for making a crown to fit an RPD have been described. The techniques have been briefly reviewed and classified to indicate whether crown pattern construction is direct, direct-indirect, or indirect, and whether the RPD is needed in the laboratory phase. The choice of a technique appears to be a matter of personal preference for the dentist. PMID- 3522860 TI - Factors influencing the retention and resistance of preparations for cast intracoronal restorations. AB - The many different aspects of preparation design that have been tested have been reviewed, and the following guidelines can be drawn: Retention is specifically related to a single path of insertion and the larger that path, the greater the retention. Intracoronal restorations transmit stress to the tooth structure, whether of the "slice" type or the proximal boxes/flares combination. Rounded internal angles will reduce the stress and cusps should be onlaid whenever possible. The slice preparation displays weakness at the lingual entrant angle, which should therefore be reduced to increase the bulk of gold. Proximal boxes aid retention in slice and flared preparations, and the occlusal isthmus also helps in flared preparations. By their nature, intracoronal restorations provide resistance to nonaxial dislodging forces, and features such as the occlusal isthmus and proximal boxes and grooves will obviously also increase this resistance. Thus it would seem that all intracoronal restorations should have rounded internal line angles, slice preparations should incorporate proximal boxes and have adequate bulk in weak areas, and cusps should be protected in all but the smallest of restorations. PMID- 3522861 TI - The effect of a new sprue design on the castability of a base-metal alloy. PMID- 3522862 TI - Retention of etched base metal dowels with resin cement and bonding agent. PMID- 3522863 TI - Fracture resistance of teeth with resin-bonded restorations. PMID- 3522865 TI - Comparative study of the bond strengths of three abrasion-resistant plastic denture teeth bonded to a cross-linked and a grafted, cross-linked denture base material. PMID- 3522864 TI - Effect of a benzoic acid-detergent germicide on denture-borne Candida albicans. AB - Benzoic acid combined with a detergent was used to safely and effectively decontaminate dentures colonized with Candida albicans. Surface decontamination was accomplished by soaking the dentures in the germicide solution for a period of 6 hours to overnight. Decontamination may occur in as little as 10 minutes when soaking is combined with ultrasonic enhancement. PMID- 3522866 TI - The transosteal implant: a 17-year review and report. AB - The survival percentage for the transosteal implant is 80.9% +/- 0.04 and predictably satisfactory host site responses may be anticipated at the 100% level after the second successful year in situ. The benefits of the transosteal implant are its unsophisticated design with a straight uncomplicated cervix, a simple surgical technique, economy, immediate fixation and readiness for use, modesty of size, versatility (it may be used singly or in diverse multiples in association with teeth or other implants), ease of removal when indicated, and universality of application to a broad variety of anatomic and prosthetic situations. PMID- 3522867 TI - Oral complications of experimental plasma exchange in head and neck cancer. PMID- 3522869 TI - Preventing fractures of maxillary overdentures. PMID- 3522868 TI - Report of Committee on Scientific Investigation of the American Academy of Restorative Dentistry. AB - A few personal points seem appropriate in summary. It is axiomatic that while research solves problems, it also creates them. As an example, it is an accepted fact that dentistry more than any other profession has made serious inroads into putting itself out of business through research. Each year this report takes note of the reduction in dental caries in children, which has thus triggered a change in the nature of general practice. Be this as it may, it is well to acknowledge that major dental diseases are not disappearing, but their patterns in the population are changing, accompanied by an expansion of other services. Despite the optimistic picture painted earlier in this report, it is grossly premature to acclaim the elimination of caries, and thereby a significant segment of restorative dentistry. Of course the younger age groups have been the major beneficiaries of caries reduction. As the child ages from 9 to 16 years, the percentage of mouths free of caries drops by one half. In addition, the disease pattern in the adult population is being altered because of a longer life span and loss of fewer teeth. Unquestionably what we will, and are already seeing, is not an elimination of restorative dentistry but a different target and changes in procedures because of new materials, therapy, and expanded scope of services. There is yet another subtle change in the trend of dental research and it deals with the reduction in the number of dental schools worldwide and smaller class sizes in those schools. Dental research thereby suffers because of the traditional link between education and research. Thus the potential pool of researchers becomes smaller and research monies for training programs for dental investigators, particularly in clinical research, decreases. This year a surprising number of articles are concerned with manpower as it relates to research priorities. So, it is indeed a time that both the profession and the scientific community find filled with controversy and frustration. Yet never has there been a time that offers more in challenges and rewards. PMID- 3522870 TI - The use of porcelain-fused-to-metal restorations in current dental practice: a survey. AB - The survey of members and guests of the American Academy of Esthetic Dentistry revealed the following: Porcelain-fused-to-metal crowns are the most commonly used crowns in dentistry, Cast gold crowns are infrequently placed compared to PFM, most dentists consider PFM crowns extremely successful restorations; although porcelain occlusal surfaces are considered acceptable by most dentists, dentists prefer metal on occlusal surfaces for restorations in their own mouths; the anterior 3/4 crown is infrequently placed, but the posterior 3/4 crown is commonly used; the Cerestore crown is gaining acceptance; Porcelain-jacket-crown use is reduced, but still a viable alternative; and the most desired improvement for PFM restorations was less wear on opposing teeth. PMID- 3522871 TI - Retentive characteristics of different magnetic systems for dental applications. AB - Six magnet-keeper systems were tested to determine the relationship between an air gap and the resulting breakaway force. The maximum retention was obtained when the magnet and keeper were in apposition. However, as the air gap increased in 0.1 mm increments, the breakaway force diminished rapidly initially and, then began to taper off at 0.2 to 0.3 mm. Ideally, the preferred placement of the magnet into the denture is with a carefully controlled system to provide an air gap. Then the magnet is attached with a minimal amount of autopolymerizing acrylic resin. PMID- 3522872 TI - Laboratory management of Molloplast-B-lined dentures. AB - A detailed description of the laboratory processing procedures for Molloplast-B lined dentures that varies from those offered by the manufacturer has proved to be effective. The processing technique for Molloplast-B-lined dentures is very sensitive, consequently, no steps should be omitted. Because these procedures are time-consuming, the minimal time required is 3 full working days in the laboratory. PMID- 3522873 TI - Refitting complete dentures in patients with severe tissue undercuts. PMID- 3522874 TI - Investing and packing removable partial denture bases to minimize vertical processing error. PMID- 3522875 TI - Retention and resistance in preparations for extracoronal restorations. Part I: Theoretic studies. PMID- 3522876 TI - A cast core system with interlocking posts. AB - Endodontically treated multirooted posterior teeth can be predictably and conservatively restored by using a combination of cast cores and multiple narrow diameter, parallel serrated stainless steel posts. PMID- 3522877 TI - Internal porosity in conically sprued base-metal castings. PMID- 3522878 TI - Clinically oriented evaluation of the accuracy of commonly used impression materials. AB - The elastomeric impression materials used in this study exhibited comparable clinical accuracy when properly handled. In general, they were significantly more accurate than reversible hydrocolloid. In fact, because of their excellent dimensional stability, impressions made with addition curing silicone-base or polyether rubber impression materials remained accurate even after 1 week. Elastomeric impression materials have established themselves with reversible hydrocolloids as elastic impression materials that are capable of producing clinically accurate dies with an excellent replication of surface detail. PMID- 3522879 TI - Bond strengths of etched base metals: effects of errors in surface area estimation. PMID- 3522880 TI - Resin-bonded prostheses: microleakage and luting agent thickness of etched and cast-meshwork retainers. AB - The purpose of this study was to compare in vitro marginal leakage, metal surface features, and luting resin film thickness between electrolytically etched and cast mesh resin-bonded retainer designs. The rate of microleakage along an etched metal-composite interface appears to be considerably slower than along a cast mesh-composite interface. Significant differences in surface area between these two retention systems, especially at the margin, is thought to be primarily responsible. Whether such a microleakage difference will be meaningful in terms of clinical longevity remains a matter for further study. Luting resin thickness was found to be significantly less for etched retainers. This may be due to characteristics of framework adaptation to the teeth under the conditions of this investigation. PMID- 3522881 TI - The use of an attachment system for overlay prostheses. AB - The attachment system presented offers a prefabricated pin and post technique or use of a plastic pattern in a metal casting. Both provide the advantages of positive retention, stress-breaking effect, ease of maintenance, clinical or laboratory activation, and simplicity of technique. Both have the disadvantages of nonadjustable retention, nonparallelism of post portion to root axis, and unknown long-term effect. The casting system is the preferred method because of its accurate fit and smaller occlusal height. PMID- 3522882 TI - Modifications of existing prosthesis with osseointegrated implants. PMID- 3522883 TI - Construction of an artificial saliva reservoir in an existing maxillary denture. AB - A technique is presented for the construction of an artificial saliva reservoir in an existing denture. Compared with the construction of a new reservoir denture, adapting an existing denture can reduce the cost by approximately two thirds. PMID- 3522884 TI - Diagnosis and treatment of myofacial pain-dysfunction (MPD) syndrome. AB - The successful management of patients with MPD syndrome is dependent on establishing an accurate diagnosis and using proper therapy based on an understanding of the etiology of the disorder. Establishing an accurate diagnosis is accomplished by taking a careful history, doing a thorough examination, and having a knowledge of the various other conditions that can produce signs and symptoms similar to those of MPD syndrome. Using proper therapy is related to recognition that MPD syndrome is a stress-induced psychophysiologic disease originating in the muscles of mastication and not an organic disease arising in the temporomandibular joint. Thus, therapy should be directed at reducing stress, relaxing tense jaw muscles, and creating an awareness by the patient of the causes of the problem, rather than at analyzing occlusion, measuring joint spaces, and producing irreversible structural changes in the dentition and the articulation. Because good results can be achieved with these uncomplicated, reversible forms of therapy, it is important that the clinician does not succumb to an unproven fad or use of an irreversible procedure that will not achieve better results. PMID- 3522885 TI - Esthetic veneer cementation. PMID- 3522886 TI - Shear strength of lingual rest seats prepared in bonded composite. AB - A study based on the single criterion of resistance to loading forces was conducted to investigate the suitability of lingual composite rest seats for anterior teeth. The minimum acceptable resistance level was chosen from a review of the literature; other basic criteria were described; and the desirability of this technique was discussed. PMID- 3522887 TI - Androgen-induced alterations in vocalizations of female Xenopus laevis: modifiability and constraints. AB - We examined effects of exogenous androgen (testosterone and dihydrotestosterone) on vocalizations of ovariectomized, adult female South African clawed frogs, Xenopus laevis. When paired with sexually active males, all ovariectomized females exhibited ticking, the unreceptive or 'release' call. Ticking consists of low amplitude, regularly spaced clicks with a mean interclick interval of 154 ms. When androgen-treated and paired with sexually active males, these ovariectomized females also exhibited an aberrant call (atypical ticking) in which click multiples replaced the single clicks of ticking. Mean ICI's for atypical ticking were 37 ms for click doublets and 22 ms for click quadruplets. Androgen treatment decreased the total time spent vocalizing (typical and atypical ticking) by ovariectomized females. All androgen-treated females were then tested repeatedly with sexually receptive females in an attempt to elicit the male-typical vocalization, mate calling. Six of 17 females did not vocalize at all, even when gonadotropin injected. Eight females gave rapid (mean ICI, 36 ms) trains of clicks in an irregular temporal pattern (tick-like calls). Three females gave brief trills with alternating fast and slow components. Comparison of mate call like vocalizations of androgen-treated females to mate calling of males reveals that calls in females are considerably shorter in duration (female: 0.32 min versus male: 45 min) and slower in tempo (ICI's; fast trill, female: 21 ms, male: 14 ms; slow trill, female: 36 ms, male: 28 ms). Incomplete masculinization of the vocal pattern of females by androgen treatment in adulthood may be due to developmental constraints on the modifiability of the neurons and muscles responsible for calling. PMID- 3522888 TI - Regulation of (3H) arginine8 vasopressin binding to the rat renal medulla by guanine nucleotides. AB - In rat renal medullary membranes, we have examined modulatory effects of guanine nucleotides on binding of arginine8 vasopressin (AVP) to its receptor. Equilibrium binding studies analyzed by an iterative curve fitting program revealed an interaction of (3H) AVP with a single class of binding sites with a dissociation constant of 1.4 +/- 0.2 nM and a binding site concentration of 201 +/- 37 fmol/mg protein (n = 6). With the addition of 100 microM guanylyl imidodiphosphate (Gpp(NH)p), the binding site concentration was significantly (p less than 0.01) reduced to 151 +/- 36 fmol/mg protein with no change in receptor affinity. The nonhydrolyzable analogues, guanosine-5'-0-(3-thiophosphate) and Gpp(NH)p were the most potent inhibitors of (3H) AVP binding. Guanosine 5' triphosphate and guanosine-5'-diphosphate were both relatively poor inhibitors. Guanosine-5'-monophosphate and adenosine 5'-triphosphate did not inhibit (3H) AVP binding at concentrations up to 100 microM. Furthermore, 100 microM Gpp(NH)p accelerated the dissociation of (3H) AVP from the receptor. We conclude that guanine nucleotides are important modulators of AVP binding to the V2 receptor subtype in the renal medulla. PMID- 3522889 TI - A review of female cattle reproduction with special reference to a comparison between buffaloes, cows and zebu. PMID- 3522890 TI - Growth and regression of ovarian follicles during the follicular phase of the oestrous cycle in heifers undergoing spontaneous and PGF-2 alpha-induced luteolysis. AB - Ultrasonography was used to monitor the growth, ovulation and regression of individual ovarian follicles greater than or equal to 5 mm during the late luteal and follicular phases of the oestrous cycle in heifers treated with injections of PGF-2 alpha to induce luteolysis and in heifers undergoing spontaneous luteolysis. Six heifers were given a single injection of PGF-2 alpha between Day 12 and 15 of the oestrous cycle and their ovaries were examined daily by transrectal ultrasonography until ovulation occurred. Another group of 5 heifers was examined daily by ultrasound from Day 14 or 15 of the cycle through spontaneous luteolysis and ovulation. Blood samples were taken twice daily from this group and analysed for progesterone to determine when luteolysis occurred. All heifers were checked for oestrous behaviour twice daily. Mean diameters of ovulatory follicles on each of the 3 days before oestrus were not different between PGF-2 alpha-treated and untreated heifers. In both groups there was large variation among heifers in the sizes and growth rates of the ovulatory follicles. At 3 days before oestrus the diameters of ovulatory follicles were between 7.5 and 11 mm in PGF-2 alpha-treated heifers and between 6 and 11.5 mm in untreated heifers. Non-ovulatory follicles decreased in size during the 3 days before oestrus and the number of non-ovulatory follicles within the size ranges of ovulatory follicles decreased. The ovulatory follicle was not consistently the largest follicle on the ovaries until the day of oestrus but was always one of the 2 largest follicles during the 3 days before oestrus.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3522891 TI - Chronic measurement, using a Doppler probe, of uterine artery flow in the gravid guinea-pig. AB - A chronic animal model is described which permits for the first time the continuous measurement of uterine artery blood flow velocity in the pregnant guinea-pig by using a miniaturized Doppler flow probe. Preliminary validation revealed that alterations in actual blood flow are directly and proportionally related to the change in the Doppler shift (r = 0.984) from 0 to 100 ml/h. The velocity signal baseline was as stable as that of systemic blood pressure. Depending upon the individual animal's flow velocity, a deviation of 2-5% from baseline was statistically significant. With experience, greater than 90% of preparations were successful and a 30-day interval was often available for study. Uterine artery flow velocity increased steadily between 45 and 55 days of gestation. Instrumentation did not result in fetal growth retardation. A reduction in flow velocity occurred during general anaesthesia using ketamine and the antianxietal xylazine. In agreement with the reports of other investigators using a different model, both hydralazine and angiotensin II increased uterine blood velocity and adrenaline reduced it. PMID- 3522892 TI - Influence of the embryo on the distribution of maternal immunoglobulins in the mouse uterus. AB - The effect of the embryo on the distribution of IgA, IgG and IgM was studied by an immunoperoxidase technique on mouse uterine sections, (1) during the first part of pregnancy and pseudopregnancy, and (2) in delayed implantation combined with different progesterone-oestradiol treatments designed to extend the delay or induce implantation, and in nonpregnant ovariectomized mice similarly treated. The number of glandular lumina containing IgA increased particularly from the implantation period, but in pseudopregnancy this number decreased from the morning of Day 4, and afterwards continued to decline. In delayed implantation, the number of glandular lumina containing IgA also rose considerably when implantation was induced by oestradiol, whereas under the same progesterone oestradiol treatment, nonpregnant ovariectomized animals displayed no such increase. Significant staining for IgG in the stroma was observed on Day 4 of pregnancy and pseudopregnancy but prolonged staining for IgG was observed only during pregnancy. In addition, significant numbers of IgA-plasma cells in the stroma were observed mostly in uteri containing embryos. These results indicate that embryos might affect the process by which ovarian hormones regulate IgA and IgG distribution. PMID- 3522893 TI - Effects of oestradiol-17 beta and progesterone on the number of plasma cells in uteri of ovariectomized mice. AB - Immunoglobulins A and G were localized by immunoperoxidase labelling in uteri of ovariectomized mice treated with oestradiol-17 beta and progesterone. The administration of oestradiol or progesterone alone to ovariectomized mice for 3 days increased the number of IgA plasma cells from about 1 to 14 per histological section. When the two hormones were administered simultaneously for 3 days the number of plasma cells per section was equal to or greater than with either hormone alone. Treatment with oestradiol followed by progesterone in a sequence that prepares the uterus for implantation resulted in about 31 IgA plasma cells per section. Counts of IgG plasma cells showed similar trends but the numbers were smaller. The results indicate that progesterone increases rather than decreases the number of plasma cells in the mouse uterus. This is consistent with observations on intact mice during oestrus and pregnancy and suggests that the marked increase in endometrial plasma cells at the time of implantation in mice is a response to progesterone acting on an oestrogen-primed uterus. PMID- 3522894 TI - Neonatal herpes simplex virus infections. Presentation and management. AB - Neonatal herpes simplex virus (HSV) infections are recognized to be severe because of their association with significant morbidity and mortality. Through ongoing studies performed by the National Institute of Allergy and Infectious Diseases Collaborative Antiviral Study Group, the presentation, natural history, outcome and value of antiviral chemotherapy have been considered. Infants developing neonatal HSV infections can be classified according to the extent of disease, disseminated or localized. Localized infection can be subdivided into either central nervous system (CNS) disease, occurring in 35% of infected infants, or skin, eye and mouth (SEM) disease, in 41% of infants. Disseminated disease accounts for 24% of neonatal HSV infection. Therapeutic outcome depends upon disease classification. Administration of either 15 or 30 mg/kg/day of vidarabine resulted in significantly decreased mortality for infants with life threatening disseminated and CNS disease as compared to placebo recipients. Approximately one-third of children developed normally following disseminated disease or CNS infection. When disease was localized to the SEM, no death occurred, and 88% of treated infants developed normally. While these data indicate that therapy is effective for management of infants with neonatal HSV infection, improvements are necessary. Hopefully, a study in progress will demonstrate improved outcome with acyclovir treatment. PMID- 3522895 TI - Acyclovir for genital herpes simplex virus infections. A review. AB - Genital herpes simplex virus (HSV) causes a common and debilitating infection seen by the gynecologist and obstetrician. Over the last decade this disease has become nearly an epidemic in the United States. A recent, major advance in antiviral chemotherapy, acyclovir, allows safe, effective treatment and suppression of HSV infection. PMID- 3522896 TI - Oral contraception, 1986. Focus on Triphasil. AB - Clinical studies of 8,349 cycles of a triphasic oral contraceptive have shown it to be safe, effective and well tolerated. PMID- 3522897 TI - The clinical application of an ELISA technique for the detection of antihistone antibodies. AB - A rapid reproducible technique for measuring antihistone antibodies is described in which unfractioned nuclear histones covalently bonded to plastic discs are employed in an ELISA system. All 20 patients with drug induced lupus erythematosus had antihistone antibodies, usually at high titer. In contrast, 22% of 18 asymptomatic patients with drug induced antinuclear antibodies (ANA), 15% of 20 patients with seropositive RA and 42% of 60 patients with systemic lupus erythematosus (SLE) had detectable antihistone antibodies. High titers of antihistone antibodies were not seen in drug induced ANA or RA. This assay differentiates between patients with drug induced lupus and drug induced ANA (p less than 0.01) and drug induced lupus erythematosus and SLE (p less than 0.01). In patients with SLE antihistone antibodies had no association with disease activity. PMID- 3522899 TI - Pectoralis pyomyositis: an unusual cause of chest wall pain in a patient with diabetes mellitus and rheumatoid arthritis. AB - We describe a case of isolated pectoralis swelling and tenderness, without systemic signs of infection, in a North American adult with diabetes mellitus and rheumatoid arthritis. The etiology was discovered to be pyomyositis, usually thought to be a disease of tropical climates. It is the first such case with group B Streptococcus as the causative organism. PMID- 3522898 TI - Immunofluorescent analysis of experimental osteoarthritic cartilage and synovium: evidence for selective deposition of immunoglobulin and complement in cartilaginous tissues. AB - Femoral and tibial cartilage as well as synovium derived from knees of nonoperated, sham-operated and partially meniscectomized NZW rabbits were studied using fluorescein conjugated goat IgG, goat antirabbit IgM, IgG and C3. Nonoperated and sham-operated animals revealed negative or minimal staining. Cartilaginous tissues from animals after partial meniscectomy showed uniform deposition of rabbit IgG and C3 in parallel at the surface; contralateral knees from these animals were negative for similar staining patterns. The data indicate that IgG and C3 deposition occurs in experimental secondary osteoarthritis and that immune complex deposition may contribute to the pathology of osteoarthritis. PMID- 3522900 TI - Sternoclavicular joint infection with group B streptococcus. PMID- 3522901 TI - Transsphenoidal surgery for Cushing's syndrome. PMID- 3522902 TI - Sunscreens. PMID- 3522903 TI - Psychotherapy research: physiological measures and intrapsychic events. PMID- 3522905 TI - Complications of gynaecological cancer surgery: a review. PMID- 3522904 TI - Gilles de la Tourette syndrome: a review. PMID- 3522906 TI - Anaesthesia in Japan: past and present. PMID- 3522907 TI - Postoperative gastric aspirations reduced by glycopyrrolate during upper abdominal surgery. AB - Glycopyrrolate is shown to reduce the incidence of large volumes (more than 40 ml) of postoperative gastric contents, but not the pH, after major abdominal operations and reduce the consequent risk of regurgitation. It should be preferred to atropine during these procedures. PMID- 3522908 TI - Psychotherapy--the transformation of meanings: discussion paper. AB - This paper presents the hypothesis that psychotherapy seeks to produce changes in attitudes and behaviour through transformation of meanings. Patients come to psychotherapy because they are demoralized by the menacing meanings of their symptoms. The psychotherapist collaborates with the patient in formulating a plausible story that makes the meanings of the symptoms more benign and provides procedures for combating them, thereby enabling the patient to regain his morale. As a result, he feels better and functions more effectively, leading to progressive improvement. Various implications and limitations of this hypothesis are explored. PMID- 3522909 TI - Whither therapeutics? An enquiry into drug use from historical principles: Part I. PMID- 3522910 TI - Vesiculobullous eruption in systemic lupus erythematosus: demonstration of common anti-DNA antibody idiotype at the dermo-epidermal junction. PMID- 3522911 TI - Viral infection in cystic fibrosis. PMID- 3522912 TI - Screening, early neonatal diagnosis and prenatal diagnosis. PMID- 3522913 TI - Nasal polyposis, opaque paranasal sinuses and usually normal hearing: the otorhinolaryngological features of cystic fibrosis. PMID- 3522914 TI - Gastrointestinal tract and nutrition in cystic fibrosis: pathophysiology. PMID- 3522915 TI - Current clinical management of hepatic problems in cystic fibrosis. PMID- 3522916 TI - Pathogenesis and management of arthropathy in cystic fibrosis. PMID- 3522917 TI - An overview of the management of cystic fibrosis. PMID- 3522918 TI - Strain specific responses of inbred rats on the severity of experimental autoimmune glomerulonephritis. AB - Experimental autoimmune glomerulonephritis with pulmonary hemorrhage was induced in rats of 4 inbred strains, F344/DuCrj, LEW/Crj, WKY/NCrj and SHR/NCrj, by the injection of a nephritogenic antigen from bovine glomerular basement membrane. The severity and clinical course of glomerulonephritis within the strains were very similar, but those between the strains were different. Among them, F344 rats demonstrated mild glomerulonephritis with petechial pulmonary hemorrhage. LEW rats showed more severe symptoms from pulmonary hemorrhage than F344 rats and had heavy, long-lasting proteinuria that caused nephrotic syndrome. WKY rats showed very severe glomerulonephritis with pulmonary hemorrhage, and had azotemia by 4 weeks after the injection. SHR rats had both severe glomerulonephritis and severe pulmonary hemorrhage. Investigation of the dose-effect relationship of the nephritogenic antigen in F344 and WKY rats revealed that the minimum dose required to induce nephritis in F344 and WKY rats was 10 micrograms and 3 micrograms respectively, and that the injection of more than a certain amount (i.e., 30 micrograms in F344, 10 micrograms in WKY) of the antigenic material induced almost the same severity of disease. These results indicate that genetic differences in experimental animals influence the severity of renal damage, suggesting that the use of inbred strains is necessary for adequate study of experimental glomerulonephritis. PMID- 3522919 TI - Gene conversion in Escherichia coli. Resolution of heteroallelic mismatched nucleotides by co-repair. AB - We have constructed heteroduplex plasmid DNA that is similar in structure to the heteroduplex DNA expected to be produced during genetic recombination of plasmids, and studied its repair after transformation into different Escherichia coli strains. The heteroduplex DNA was constructed using two different parental plasmids, each of which contained a different ten-nucleotide insertion mutation. The effect of different defined states of dam-methylation on repair was also examined. We found that heteroduplex DNA repair occurred prior to the replication of the substrate DNA 60 to 80% of the time, regardless of the state of DNA methylation. Most excision/synthesis tracts covered two markers separated by 1243 base-pairs, and this process has been termed co-repair. The most efficient co repair pathway was the Dam-instructed repair pathway that required the mutH, mutL, mutS and uvrD gene products and preferentially used the methylated strand as the template for DNA synthesis. If there was no methylation asymmetry, mismatch nucleotide repair occurred with a similar frequency; however, no strand bias was observed. Co-repair of symmetrically methylated heteroduplex DNA required the mutS and uvrD gene products, while repair of unmethylated heteroduplex DNA also required the mutL and mutH gene products. PMID- 3522921 TI - Crystallization of a type III chloramphenicol acetyl transferase. AB - A type III variant of chloramphenicol acetyl transferase was purified from Escherichia coli and crystallized in the presence of cobaltic hexamine chloride and 2-methyl-2, 4-pentandiol. Two crystal forms were obtained, one of which proved to be suitable for high-resolution X-ray diffraction studies. The space group of this form is R32 with aR = 74.5 A, alpha R = 92.5 degrees, with a monomer (Mr 25,000) in the asymmetric unit. The crystals diffract to 1.7 A resolution. The crystal symmetry has led to a re-evaluation of the oligomeric symmetry of the enzyme and the proposal that it is a trimer rather than a tetramer, the quaternary structure predicted previously from studies of the association of hybrid s subunits. PMID- 3522920 TI - Altered 40 S ribosomal subunits in omnipotent suppressors of yeast. AB - The five suppressors SUP35, SUP43, SUP44, SUP45 and SUP46, each mapping at a different chromosomal locus in the yeast Saccharomyces cerevisiae, suppress a wide range of mutations, including representatives of all three types of nonsense mutations, UAA, UAG and UGA. We have demonstrated that ribosomes from the four suppressors SUP35, SUP44, SUP45 and SUP46 translate polyuridylate templates in vitro with higher errors than ribosomes from the normal stain, and that this misreading is substantially enhanced by the antibiotic paromomycin. Furthermore, ribosomal subunit mixing experiments established that the 40 S ribosomal subunit, and this subunit only, is responsible for the higher levels of misreading. Thus, the gene products of SUP35, SUP44, SUP45 and SUP46 are components of the 40 S subunit or are enzymes that modify the subunit. In addition, a protein from the 40 S subunit of the SUP35 suppressor has an altered electrophoretic mobility; this protein is distinct from the altered protein previously uncovered in the 40 S subunit of the SUP46 suppressor. In contrast to the ribosomes from the four suppressors SUP35, SUP44, SUP45 and SUP46, the ribosomes from the SUP43 suppressor do not significantly misread polyuridylate templates in vitro, suggesting that this locus may not encode a ribosomal component or that the misreading is highly specific. PMID- 3522922 TI - Ultrastructural localization of phenylethanolamine N-methyltransferase in sensory and motor nuclei of the vagus nerve. AB - The ultrastructural localization of phenylethanolamine N-methyltransferase (PNMT), the enzyme used in the final step in the synthesis of adrenaline, was examined in the medial nuclei of the solitary tracts (m-NTS) and in the dorsal motor nuclei of the vagus. Adult rats were anesthetized with Nembutal (50 mg/kg intraperitoneally), and the brains were fixed by vascular perfusion with a solution containing 3.75% acrolein and 2% paraformaldehyde in 0.1 M phosphate buffer. Coronal Vibratome sections were collected through the intermediate portions of the m-NTS at the level of the area postrema. These sections were immunocytochemically labeled employing a rabbit polyclonal antiserum against PNMT and the peroxidase-antiperoxidase method. Immunoreactivity was detected in perikarya, dendrites, and axon terminals in the intermediate portion of the m NTS. The labeled perikarya were either small (10-15 microns diameter) and oval or large 20-30 microns) with two or more proximal processes. The PNMT-containing dendrites received synaptic input from unlabeled, small (0.5-1.0 microns) and large (2-3 microns) vagal-like afferents as well as from a few terminals, which also showed PNMT immunoreactivity. Axons and axon terminals containing immunoreactive PNMT were more frequently observed than the perikarya or dendrites in the m-NTS and were the only labeled profiles in the dorsal motor nuclei. In both regions the PNMT-labeled terminals formed principally symmetric synapses with unlabeled dendrites. However, a few asymmetric axodendritic and symmetric axosomatic synapses also were detected. These findings indicate that the adrenergic neurons may have multiple, but principally inhibitory, actions on other neurons within cardiovagal portions of baroreflex pathways. PMID- 3522923 TI - GM1 ganglioside counteracts selective neurotoxin-induced lesion of developing serotonin neurons in rat spinal cord. AB - The effect of exogenous monosialoganglioside GM1 on neurotoxin-induced lesioning of bulbo-spinal serotonergic neurons of newborn rats was studied by means of biochemical and immunocytochemical techniques. 5,7-dihydroxytryptamine (5,7-HT, a selective serotonin neurotoxin) treatment of newborn rats caused a pronounced reduction of 5-hydroxytryptamine (5-HT) and 5-hydroxyindoleacetic acid (5-HIAA) levels in the thoracic and lumbar spinal cord, while an increase of 5-HT and 5 HIAA was found in the pons medulla. These biochemical alterations were regionally correlated with similar changes in 5-HT nerve terminal density analyzed by image analysis. GM1 administration (30 mg/kg for 4 consecutive days) antagonized the reduction of 5-HT and 5-HIAA levels induced by 5,7-HT treatment in the lumbar spinal cord of 2-month-old rats, as well as the decrease of 5-HT nerve terminal density in both thoracic and lumbar spinal cord of 1- and 2-month-old rats. A minor counteracting effect of GM1 was found in the pons medulla where the neurotoxin induced an increase of 5-HT and 5-HIAA levels. These data support the hypothesis that GM1 may have a preventing action on retrograde degenerative processes following chemical lesion and/or a growth-stimulating effect on injured 5-HT neurons. PMID- 3522924 TI - Plasma levels and urinary excretion of batroxobin and its defibrinogenating effects in various animal species. AB - The plasma levels and urinary excretion of batroxobin administered to 6 species of animals were examined by an enzyme immunoassay method. Defibrinogenating effect of batroxobin was also studied in those species. The plasma levels of immunoreactive batroxobin disappeared exponentially in all the animals and differences in half-life were observed to occur according to species. The elimination half-life of immunoreactive batroxobin in the plasma was the largest in dogs, followed by rats, monkeys, guinea pigs, mice and rabbits. The extent of the defibrinogenating effect was also noted to vary according to the species, being greatest in dogs and then monkeys, mice, rats, guinea pigs and rabbits. Following the continuous infusion of batroxobin into dogs, its level in the plasma remained high over a considerable period of time and the defibrinogenating effect lasted in corresponding to its plasma level. The urinary excretion of immunoreactive batroxobin was quite small in these species, being 0.2-1.9% of the original dose. PMID- 3522925 TI - Antenatal sonographic findings in trisomy 18. AB - The clinical and sonographic findings of trisomy 18 are varied. Fifteen cases of trisomy 18 were retrospectively reviewed with attention to demonstrable antenatal sonographic features. Certain combinations of findings, particularly in the third trimester, seem highly suggestive of this diagnosis. A late antepartum diagnosis is warranted because of the poor prognosis. PMID- 3522926 TI - The fetal subarachnoid cisterns: an ultrasound study with report of a case of congenital communicating hydrocephalus. AB - The intracranial anatomy of 351 normal fetuses, ranging from 15 to 42 weeks' gestational age, was investigated sonographically in an attempt to define the normal sonographic anatomy of the subarachnoid spaces during intrauterine development. The triangular velum, vein of Galen, ambient, interpeduncular, chiasmatic, Sylvian, and supracerebellar cisterns and the cisterna magna were easily recognized in the vast majority of cases as fluid-filled spaces following the contour of the brain. A large fluid layer, overlying the cerebral convexities, was seen in early gestation and subsequently disappeared. Evaluation of the subarachnoid cisterns in a fetus with ventriculomegaly allowed the prenatal diagnosis of communicating hydrocephalus. Knowledge of the normal sonographic anatomy of the subarachnoid spaces is useful both in avoiding misinterpretation of the normal sonogram and in the differential diagnosis of congenital hydrocephalus. PMID- 3522927 TI - Laboratory assessment of ultrasonic needle and catheter visualization. AB - In the first portion of this experiment, seven different catheter materials were tested as to their sonographic visualization in vitro. While five of the seven catheter materials had good to excellent sonographic detection, nylon and polyethylene catheters were poorly visualized. Additionally, various methods of improved needle visualization were tested. Sonographic needle visualization was aided by a variety of methods including either roughening or scoring the outer needle or inner stylet and placement of a guidewire through the needle. When the needle was placed in solid tissue, injection of water through the needle tip was thought to be more advantageous for tip visualization than use of air as an acoustic marker. PMID- 3522928 TI - Fractional spine length: a new parameter for assessing fetal growth. AB - Sonographic measurement of a segment of the lower thoracic and lumbar fetal spine was performed on 218 normal fetuses of between 15 and 42 weeks' gestational age (GA) to establish a new parameter for assessing fetal growth. The increase of the fractional spine length (FSL) was represented by the equation: FSL = -37.62 + 4.36 (GA) - 0.04 (GA)2, with R2 = 0.92. The FSL also correlates strongly with fetal femur length (FL): FSL = 5.36 + 0.82 (FL), with R2 = 0.93. The ratio FSL/abdominal circumference (AC) X 100 was relatively constant at 20.4 +/- 3.1 (mean +/- 2 standard deviations) from 19 to 42 weeks in contrast to the ratio FL/AC X 100, which was constant at 22.3 +/- 2.4 (mean +/- 2 SD) only after 23 weeks. Nine of 10 small-for-gestational age fetuses examined during the study had a FSL within the normal range, as well as two fetuses who were thanatophoric dwarfs. The FSL provides a new ultrasonic longitudinal measurement of the fetus which may be used in addition to the femur length in fetal growth assessment. PMID- 3522929 TI - The retrolenticular afterglow: an echo enhancement artifact. AB - A mathematical model for a sonogram containing a circular object with a sonic speed less than that of its surroundings was constructed. The circular object acts as a lens to the ultrasound beam, which explains the refractive artifacts often observed. An unexpected artifact is also predicted, a region of increased echogenicity, which the authors named the retrolenticular afterglow, since it occurs behind a lens-like structure. An experiment was designed to show the appearance of this artifact occurring distal to an ethyl alcohol-filled cylindrical well in a tissue equivalent phantom. PMID- 3522930 TI - The antenatal diagnosis of diaphragmatic anomalies. AB - In an evaluation of eight fetal diaphragmatic anomalies a number of suggestive antenatal ultrasound findings were identified. The feature most suggestive of a posterolateral hernia (foramen of Bochdalek) is malposition of the heart. Peristalsis of chest contents or movement of abdominal contents into the chest on inspiration are more specific findings. Absence of an intra-abdominal stomach, a small abdominal circumference, and a cystic or solid mass in the chest are suggestive but not specific. It may be difficult or impossible to distinguish a posterolateral diaphragmatic defect from the much less frequent eventration of the diaphragm. An anteromedial defect of the diaphragm (foramen of Morgagni) presented as an intrathoracic anterior solid mass and should be considered in the differential diagnosis of an anterior chest mass. Although all three types of defects are frequently associated with additional anomalies, severe pulmonary hypoplasia is not a complication of eventration or anteromedial defects. PMID- 3522931 TI - Pseudo perisplenic "fluid collections": a clue to normal liver and spleen echogenic texture. AB - In a number of cases the ultrasound examination of the left upper quadrant showed an appearance suggesting a fluid collection around the superior and lateral aspects of the spleen. Subsequent investigations including careful real-time evaluation, computed tomography, and magnetic resonance imaging have demonstrated that the pseudo-"fluid collection" is the normal left lobe of the liver extending into the left subdiaphragmatic space to lie superior and even lateral to the spleen. The echogenicity of the normal liver was observed to be less than that of the normal spleen. The ability to simultaneously visualize both the liver and the normal spleen at the same depth and the same field of view gives a true indication of the relative echogenic consistency of the liver and the spleen, which is different from that which had been previously reported. PMID- 3522932 TI - Sonography of pseudomyxoma peritonei. PMID- 3522933 TI - The importance of karyotype determination in a fetus with ventriculomegaly and spina bifida discovered during the third trimester. PMID- 3522934 TI - Leiomyoma of the bladder: sonographic and urographic findings. PMID- 3522935 TI - Prenatal sonographic visualization of the inner ear. PMID- 3522936 TI - Abruptio placentae: apparent thickening of the placenta caused by hyperechoic retroplacental clot. PMID- 3522937 TI - Clinical pharmacokinetics of flumequine in calves. AB - The minimal inhibitory concentration (MIC) of flumequine for 249 Salmonella, 126 Escherichia coli, and 22 Pasteurella multocida isolates recovered from clinical cases of neonatal calf diarrhoea, pneumonia and sudden death was less than or equal to 0.78 microgram/ml. The pharmacokinetics of flumequine in calves was investigated after intravenous (i.v.), intramuscular (i.m.) and oral administration. The two-compartment open model was used for the analysis of serum drug concentrations measured after rapid i.v. ('bolus') injection. The distribution half-life (t1/2 alpha) was 13 min, elimination half-life (t1/2 beta) was 2.25 h, the apparent area volume of distribution (Vd(area)), and the volume of distribution at steady state (Vd(ss)) were 1.48 and 1.43 l/kg, respectively. Flumequine was quickly and completely absorbed into the systemic circulation after i.m. administration of a soluble drug formulation; a mean peak serum drug concentration (Cmax) of 6.2 micrograms/ml was attained 30 min after treatment at 10 mg/kg and was similar to the concentration measured 30 min after an equal dose of the drug was injected i.v. On the other hand, the i.m. bioavailability of two injectable oily suspensions of the drug was 44%; both formulations failed to produce serum drug concentrations of potential clinical significance after administration at 20 mg/kg. The drug was rapidly absorbed after oral administration; the oral bioavailability ranged between 55.7% for the 5 mg/kg dose and 92.5% for the 20 mg/kg dose. Concomitant i.m. or oral administration of probenecid at 40 mg/kg did not change the Cmax of the flumequine but slightly decreased its elimination rate. Flumequine was 74.5% bound in serum. Kinetic data generated from single dose i.v., i.m. and oral drug administration were used to calculate practical dosage recommendations. Calculations showed that the soluble drug formulation should be administered i.m. at 25 mg/kg every 12 h, or alternatively at 50 mg/kg every 24 h. The drug should be administered orally at 30 and 60 mg/kg every 12 and 24 h, respectively. Very large, and in our opinion impractical, doses of flumequine formulated as oily suspension are required to produce serum drug concentrations of potential clinical value. PMID- 3522938 TI - Dismembered nonstented ureteroureterostomy using the carbon dioxide laser in the rabbit: comparison with suture anastomosis. AB - End-to-end laser welding of transected nonspatulated ureters was compared to conventional spatulated suture anastomosis in 3 kg. rabbits. Nonspatulated sutureless ureteral welding was achieved in 12 rabbits with low energy levels from a carbon dioxide laser. In 12 other rabbits spatulated end-to-end anastomoses were performed with interrupted 7-zero chromic catgut sutures. Patency rate in the welded ureters was 92 per cent, compared to 83 per cent for the suture anastomoses. Histological changes in welded ureters were similar to the sutured ureters. Ureteral welding is achieved in far less time than suture anastomosis. PMID- 3522939 TI - Orthoplasty in epispadias. AB - Orthoplasty (a term used in Europe to refer to chordee excision and penile straightening) in patients with epispadias has provided less than ideal results in the past. We propose a sequential stepwise approach for the assessment and correction of the corporeal deformity, incorporating dermal grafts on the dorsal aspect of the corpora cavernosa when necessary to achieve functional penile lengthening and straightening. Success, defined as significant improvement in functional penile length, a penis that dangles at 45 degrees below the horizontal and over-all improvement in cosmetic result, was achieved in 7 of 8 patients. PMID- 3522940 TI - Reflux: a career experience. PMID- 3522941 TI - Transitional neonatal hydronephrosis: fact or fantasy? AB - Hydronephrosis secondary to an anomalous ureteropelvic junction was detected antenatally in more than 60 neonatal renal units Those 21 units that exhibited partial obstruction or dilatation without obstruction were selected for this study. They were assessed and followed by serial diuretic isotope renography (99mtechnetium-diethylenetriaminepentaacetic acid augmented with furosemide) and ultrasonography. Excretory urography was used selectively. Of the 17 renal units that could be assessed 88 per cent demonstrated labile ureteropelvic junctions. Indeed, in 3 to 6 months, when the definitive status seemed to be attained, 41 per cent (7 units) had deteriorated, 12 per cent (2 units) remained stable and 47 per cent (8 units) underwent spontaneous improvement. We recommend a 3 to 6-month observation period for patients with hydronephrosis secondary to ureteropelvic junction anomalies when definite obstruction cannot be confirmed by isotope renography. PMID- 3522942 TI - New approaches to the diagnosis and treatment of venous obstruction. AB - Diagnosis of chronic venous obstruction has hitherto depended on phlebographic assessment alone. The pitfalls in this method are noted and two simple hemodynamic techniques for measurement of venous obstruction are described. The techniques are easily performed, have a high degree of sensitivity and specificity, and are particularly useful in assessing various therapeutic approaches to venous obstruction. Our experience with a variety of surgical procedures for venous obstruction is described. Two such new procedures, primary arteriovenous fistula and perforator bypass for peripheral venous obstruction, are described in detail. PMID- 3522943 TI - Prostacyclin synthetase activity in human diabetic and nondiabetic vascular tissue. AB - A decrease in the formation of prostacyclin (PGI2), a potent vasodilating and platelet antiaggregatory substance, has been implicated in the pathogenesis of diabetic vasculopathy. This defect, as well as others, may contribute to imbalances in the thrombo-regulatory system resulting in enhanced platelet aggregability, accelerated atherosclerosis, and subsequent vessel injury. Until recently the major thrust of relevant literature has been directed toward abnormalities in PGI2 quantity or function in vascular tissue from experimentally induced diabetic animal models. For the past 2 years our laboratory has studied prostaglandin metabolism in human diabetic and nondiabetic blood vessels. We determined prostacyclin synthetase (PGI2ase) activity in saphenous veins of diabetic and nondiabetic patients (HSV-D and HSV-ND) undergoing coronary artery bypass grafts and in tibial arteries and tibial veins of diabetic patients (HTA-D and HTV-D) and nondiabetic patients (HTA-ND and HTV-ND) undergoing limb amputation for arterial disease of the lower extremity. Carbon 14-labeled prostaglandin endoperoxide (PGH2) was incubated for 2 minutes with vascular microsomal protein. The products were separated via thin-layer chromatography and quantified by radiochromatographic scan. PGI2ase activity was determined by the formation of 6-keto-PGF1 alpha, the stable breakdown product of PGI2. Results of this study indicate that the microsomal fractions of all vascular tissues studied contain an active PGI2ase capable of forming PGI2; formation is enzymatic, as the amount of product increased with increasing microsomal protein concentration; there is no significant difference in PGI2ase activity between HSV-D and HSV-ND; PGI2ase activity in HTA-D and HTV-D is less than in HSV-D and HSV-ND.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3522944 TI - Late hemodynamic sequelae of deep venous thrombosis. AB - Twenty-nine limbs in 19 patients who had deep venous thrombosis documented by phlebography were studied by hemodynamic techniques 2 to 13 years later (mean, 7 years). Two limbs were found to be "normal." Nine limbs were hemodynamically obstructed; the remaining 18 limbs had developed reflux abnormality. All of the nine limbs with obstruction demonstrated symptoms of severe swelling or ulceration. In contrast, limbs with valve reflux were either asymptomatic or had only mild to moderately severe symptoms. Correspondingly, the reflux hemodynamic derangement was also mild, with reflux confined to a single level (commonly the popliteal valve). The implications of the differences in clinical presentation and hemodynamic profile between this group with post-thrombotic valve reflux and the typical patient with stasis caused by chronic venous insufficiency are explored. The natural history of stasis sequelae of deep venous thrombosis has apparently changed somewhat since the introduction of anticoagulation therapy. PMID- 3522945 TI - Neurosurgeons address EC/IC study; question controlled surgical trials. PMID- 3522946 TI - The treatment of sleep apnea. PMID- 3522947 TI - The management of ruptured abdominal aortic aneurysms in rural Colorado. With a historical note on Kit Carson's death. AB - Kit Carson died of a ruptured aneurysm in rural Colorado in 1868. Since that time, techniques for management of aortic aneurysms have been developed and disseminated to rural areas with small hospitals. A survey of six Colorado rural hospitals' experience with ruptured abdominal aortic aneurysms is presented. Fifty-seven ruptured aneurysms had been managed during periods ranging from three to ten years. The average time to the operating room was 3.5 to 4.0 hours after hospital arrival and less than 45 minutes after diagnosis. Of those cases arriving with a systolic blood pressure less than 100 mm Hg, the mortality was 56%. The overall mortality was 53%. Groups are analyzed according to preoperative delay, occurrence of shock, and other risk factors. The results are compared with several series from metropolitan hospitals. Techniques of management that are of potential benefit in low-volume vascular case settings are discussed. PMID- 3522948 TI - Role of angiotensin II in the pathogenesis of hyperdipsia in chronic renal failure. AB - The relation of thirst to the renin-angiotensin system was examined in 38 patients with chronic renal failure receiving hemodialysis treatment. They were classified into three groups, ie, group 1 (19 patients), no or modest thirst; group 2 (13 patients), moderate thirst; and group 3 (six patients), excessive thirst. The plasma renin activity, plasma angiotensin II levels, and interdialytic weight gains of groups 1 to 3 significantly increased in a progressive manner with intensity of thirst. The hyperdipsia experienced by four patients in group 3 ameliorated after administration of an angiotensin-converting enzyme inhibitor. The hyperdipsia of some patients with chronic renal failure therefore appears to be mediated by increased production of endogenous angiotensin II. PMID- 3522949 TI - The accident at Chernobyl and the medical response. PMID- 3522950 TI - Landmark article Nov 3, 1962: New method for terminating cardiac arrhythmias. Use of synchronized capacitor discharge. By Bernard Lown, Raghavan Amarasingham, and Jose Neuman. PMID- 3522951 TI - Landmark perspective: The new era of cardioversion. PMID- 3522952 TI - Can 'fewer patients, studied more intensively,' solve historic problems of MS clinical trials? PMID- 3522953 TI - Treatment of streptococcal pharyngitis revisited. AB - Penicillin has remained the drug of choice for treatment of patients with streptococcal pharyngitis for the past four decades. From the early 1950s into the 1970s, a single injection of intramuscular penicillin G benzathine, alone or in combination with penicillin G procaine, was the preferred treatment. Because this regimen consistently produced the highest cure rate and because compliance was assured, it evolved as the gold standard with which other treatment regimens were compared. In the late 1960s and the 1970s, studies showed that in private practice settings with counseling as to the need to take oral penicillin for a full ten days to prevent rheumatic fever, good compliance with results equal to intramuscular penicillin G benzathine could be achieved. By the early 1980s, oral treatment was preferred by most primary physicians in the United States. Oral penicillin V in a dosage of 250 mg, twice daily for ten days, affords optimal treatment for children. In areas where rheumatic fever is still prevalent, particularly in poor and crowded inner-city populations where medical care is episodic, follow-up may be lacking, and compliance in taking oral penicillin cannot be relied on, treatment with intramuscular penicillin G benzathine remains preferred. Studies now confirm that early treatment of streptococcal pharyngitis can reduce the duration of symptoms to less than 24 hours in most cases, decrease the incidence of suppurative complications, limit spread of the disease in the family and community, and permit earlier return of the child to school. Recently developed tests that permit rapid, laboratory-confirmed diagnosis of streptococcal pharyngitis directly on the throat swab at the initial clinic visit may soon guide early treatment with these inherent benefits. PMID- 3522954 TI - Prevention of venous thrombosis and pulmonary embolism. PMID- 3522955 TI - Enhanced red cell sodium permeability in patients with borderline hypertension. AB - Red cell membrane sodium permeability was studied in 41 untreated patients with essential hypertension (20 borderline hypertensives and 21 established hypertensives) and 21 age matched normotensive subjects by means of the measurement of unidirectional passive influx of 22Na+ into ouabain-treated erythrocytes. The mean value (+/- SD) of 22Na+ influx was greater in the hypertensives than in the normotensives (0.183 +/- 0.047 vs 0.152 +/- 0.047 mmol/l . cells/hr, respectively, p less than 0.02). Among the patients with essential hypertension, the borderline hypertensives demonstrated a higher 22Na+ influx than the established hypertensives (0.207 +/- 0.043 vs 0.160 +/- 0.038 mmol/l . cells/hr, respectively, p less than 0.001), and 22Na+ influx positively correlated with plasma renin activity (r = 0.44, p less than 0.005). In 16 of 20 borderline hypertensives, 5 year blood pressure changes were examined retrospectively, and a positive correlation was observed between mean blood pressure increase and 22Na+ influx value in these subjects (r = 0.64, p less than 0.01). These results suggest that passive sodium influx may be altered in the course of the development of hypertension in relation to the changes in blood pressure level and that enhanced sodium permeability may be a characteristic of the early stage of essential hypertension. PMID- 3522956 TI - [A case of lung cancer with bullous pemphigoid]. AB - A 79-year-old man was admitted to our hospital for radiation therapy for lung cancer on July 24, 1984. In the course of radiation therapy, many bullas were recognized on his trunk. The lesion was diagnosed as bullous pemphigoid. To date, about 27 cases of malignant tumor with bullous pemphigoid have been reported in Japan. At present, the causal relation between malignant tumor and bullous pemphigoid has not been establishes. In our case, the bullous lesions disappeared during the course of radiation therapy, and the patient has been in good general condition for nine months without recurrence of metastasis of lung cancer. PMID- 3522958 TI - [Present status of nuclear hematology]. PMID- 3522957 TI - [Phase II and III studies of vindesine in children with leukemia and lymphoma]. PMID- 3522959 TI - [Six cases of abdominal fatty masses--evaluation by ultrasonography and CT]. PMID- 3522960 TI - [Ultrasonography of breast cancer]. PMID- 3522961 TI - [A case of Wilson disease with a nodular lesion in the liver]. PMID- 3522962 TI - [The estimation of a midline dose to the body by transit dose measurement; a simple method of dosimetry in total body irradiation]. PMID- 3522963 TI - [A study on the depth of cancerous invasion in the gastric wall by endoscopic ultrasonography]. PMID- 3522964 TI - [Effect of oligopeptides as intraluminal substrates upon brush border aminopeptidase and cytosol peptidase activities]. PMID- 3522965 TI - [Experimental ulcerative colitis induced by Escherichia coli in rabbits]. PMID- 3522966 TI - [Pulsed Doppler method for differential diagnosis of liver tumor]. PMID- 3522967 TI - [Lessons from the history of midwifery: for new development in midwifery practice]. PMID- 3522969 TI - [Clinical diagnosis in obstetrics. 14. Diagnosis of ectopic pregnancy]. PMID- 3522968 TI - [Changes in midwifery practice. 12. Background of the view on midwifery held by the nurses at GHQ]. PMID- 3522970 TI - [Clinical tests in obstetrics. 15. diagnosis of IUGR]. PMID- 3522971 TI - Push/pull HDF--first clinical experience. PMID- 3522972 TI - Effects of some commercial proteins on dog renin activity. PMID- 3522973 TI - Immediate blood pressure response to 1 Sar-8Ile-angiotensins II and its modification by sodium depletion. PMID- 3522974 TI - Study on intraglomerular fibronectin in primary and secondary glomerular lesions. PMID- 3522975 TI - [Visual information processing from the retina to the prefrontal cortex]. AB - Studies on the neural bases of visual information processing were reviewed by tracing connections from the retina to the prefrontal cortex in the monkey; i.e., retina--lateral geniculate body (LGB)--striate cortex--prestriate cortex- inferotemporal (IT) cortex or posterior parietal (PP) cortex--prefrontal cortex. The retinotopy exists up to the level of prestriate cortex, but it is lost in the IT or PP cortex. A general tendency is observed that the later is the stage of information processing, the longer is the latency of cell activity changes, the larger is the size of receptive field, and more complex become trigger features. Small spot stimuli activate retinal ganglion cells or LGB cells while bars or edges with proper orientation are trigger stimuli for striate and some prestriate cells. In restricted prestriate areas, cells which are selective to color or movement are observed. IT cells are activated by complex pattern stimuli, while PP cells are selective to spatial aspects of the stimulus. Some prefrontal cells encode the meaning of the stimulus independent of its physical properties. PMID- 3522976 TI - Immunohistochemical demonstration of juxtaglomerular cells in the kidneys of domestic mammals and fowls. PMID- 3522977 TI - Malpractice suits, liability insurance, and tort reform: crises with implications for every emergency nurse. PMID- 3522978 TI - Nursing diagnosis: defining it and fitting it into the nursing process. PMID- 3522979 TI - A 57-year-old man with bleeding esophageal varices. PMID- 3522980 TI - Nursing management of children during a mild to moderate asthma attack. PMID- 3522981 TI - Telephone protocols for pediatric assessment and advice. PMID- 3522983 TI - Rhabdomyolysis. PMID- 3522982 TI - RN to BSN: what program is best for you? PMID- 3522984 TI - Implementation of primary nursing in one emergency department. PMID- 3522985 TI - Functional health pattern assessment in the emergency department. PMID- 3522986 TI - Legal terminology and how to avoid a lawsuit. PMID- 3522987 TI - Prevention of hepatitis B in emergency nurses. PMID- 3522988 TI - Governmental affairs: a Minnesota story. PMID- 3522989 TI - Law and the emergency nurse. Your deposition. PMID- 3522990 TI - Standardized care plans. Maxillofacial trauma. PMID- 3522991 TI - A trauma patient with bruised flanks. Triage decisions. PMID- 3522992 TI - Emergency care guidelines (revised). PMID- 3522993 TI - Trauma care in space. PMID- 3522994 TI - Liability insurance crisis in America. PMID- 3522995 TI - Heterophil Forssman glycoprotein and adenovirus 12: transformed rat cell lines. AB - Immunobiological significance of Forssman (F) glycoprotein expressed on rat tumor cells derived from transfection of a fibroblast line with whole DNA (WY-3); EcoRI C fragment, 0-16.5 map units (CY-1); and Accl-H fragment, 0-4.7 map units (HY-1) of adenovirus 12 was investigated. Culturing of F-positive WY-3 and CY-1 cells, but not F-negative HY-1 cells, with monoclonal rat F-antibody resulted in the blocking of their cell-cell adhesion and attachment to plastic surface and inhibition of their growth. Immunization of WY-3 or CY-1 tumor-bearing F344 rats with sheep red blood cells or purified F-antigen in adjuvants brought regression of the tumor in 13 of 19 rats. No such antitumor effect was observed in F negative HY-1 tumor-bearing rats upon immunization with the F-antigens. Results of this study indicated that the membrane glycoprotein with F-epitope may play a role in lodgement of the tumor cells in vitro and serve as an in vivo target of specific immune effectors. PMID- 3522997 TI - Inhibitory effect of medroxyprogesterone acetate on foreign body tumorigenesis in mice. AB - This paper reports on the investigation of the effect of medroxyprogesterone acetate (MPA) on foreign body tumorigenesis that resulted from sc implantation of a glass cylinder. Adult BALB/c mice of both sexes bearing the foreign body were separated into groups. Group 1 received 40 mg MPA sc every 2 months during 1 year, in the vicinity of the glass cylinder; group 2 received the same MPA treatment in the contralateral flank; and group 3 received no hormonal treatment. Sarcomas developed in 4 of 39, 9 of 41, and 17 of 39 mice, respectively. With the use of an evaluation based on the number of high-risk mice per time interval, the MPA inhibitory effect was found to be statistically significant in both groups: 26, 53, and 79% tumor incidence, respectively. A decrease in the rate of tumor development also was observed but only in mice treated with MPA in situ. An unexpected side effect of continuous MPA administration in females was the appearance of adenocarcinomas. PMID- 3522996 TI - Induction of a novel Ca2+-dependent chymotrypsin-like serine protease by tumor promoters in rat livers. AB - Induction of a microsomal Ca2+-dependent serine protease by hepatic tumor promoters was studied. Male F344 rats were fed a diet containing one of the following promoting agents: phenobarbital (CAS: 50-06-6), dichlorophenyltrichloroethane (CAS: 50-29-3), butylated hydroxytoluene, ethyl alpha-chlorophenoxyisobutyrate (CAS: 128-95-0), or 17-alpha-ethynylestradiol (CAS: 57-63-6) or a nonpromoting agent, diphenylhydantoin (CAS: 57-41-0), for 1 week. By treatment with promoters, the protease activity in the microsomal fraction was increased to threefold to fivefold that of control, whereas only a slight increase of activity was found after diphenylhydantoin treatment. The Ca2+ dependent protease activity was determined with the use of N-benzoyl-L-tyrosine ethyl ester as the substrate in a medium containing 50 mM CaCl2 for its maximal activity. This protease was preferentially localized in the smooth microsomal membrane and strongly inhibited by diisopropyl phosphorofluoridate (CAS: 55-91 4), and the optimum pH of the activity was 7.8. It appears that the Ca2+ dependent serine protease measured by using a chymotrypsin substrate is a novel protease, and induction of its activity by hepatic tumor-promoting agents is a common and specific phenomenon. PMID- 3522998 TI - [Effectiveness of amiodarone in patients with exercise-induced angina pectoris]. PMID- 3522999 TI - [Use of aminophylline in the treatment of sinus bradyarrhythmias]. PMID- 3523000 TI - [Cardiac sarcoidosis (CS)]. PMID- 3523001 TI - [Cellular mechanisms of cardiac arrhythmias. II. Conduction disorders]. PMID- 3523002 TI - Characterization of mononuclear cell subsets in renal cellular interstitial infiltrates. AB - Indirect immunoperoxidase analysis using monoclonal antibodies (Mo Ab) was performed in 33 renal biopsies with interstitial cellular infiltration obtained from non-transplanted patients. We reviewed four acute interstitial nephritis (IN), three chronic IN, four granulomatous IN, four acute tubular necrosis, four vasculitis, seven primary glomerulonephritis and seven active lupus nephritis (LN). We used Mo Ab recognizing T and B cell markers [OKT3, OKT8, T4, B1, IOT14 (IL2 receptor)], HLA-DR related antigen (I2) and monocytes/macrophages (LeuM3). In all cases the interstitial cellular infiltrates were predominantly T cells, whereas the B cell population accounted for less than 20% of the infiltrate. LeuM3+ cells were present in 28 of 32 cases, usually in a lesser proportion than T cells. IOT14+ cells were exceptional. T4+/T8+ cells were clearly greater than one in three acute IN, three granulomatous IN, two LN and two vasculitis. The T8+ cell population predominated in one case of chronic IN related to a non-steroidal anti-inflammatory drug. In all the remaining cases T4+ and T8+ cells were equally present. Aberrant strong HLA-DR expression within tubular cells was noted in nine cases (4 LN) irrespective of the presence of tubular lesions. On the basis of the phenotypic analysis, our data do not support a specific pattern of the infiltrate in regard to a given etiology and thus cannot be used as a diagnostic tool. However, such analysis may aid in understanding the mechanisms of tissue injury. PMID- 3523003 TI - Long-term blood pressure and renal function in kidney donors. AB - We have reexamined 68 (92%) of 74 donors accepted at this center nine to 15 years ago. There was a moderate but significant increase in BP, and ten donors (15%) were hypertensive at the follow-up. Twenty-six donors (38%) had albumin excretion over 10 micrograms/min or excretion of total protein over 185 mg/24 hr. In four of 16 with increased excretion of total protein, this exceeded 400 mg/24 hr, and in three donors this could be due to an intercurrent disease. Ccr averaged 78.4% of preoperative values, and was less than 50% (range 32 to 49%) in eight donors. The compensatory increase (median 30.5 mliter/min/1.73m2) was inversely correlated with age and BP. Aspects of tubular function were assessed by the diluting capacity during water diuresis and by urinary excretion of beta 2 microglobulin and N-acetyl-beta-glucosaminidase. No consistent abnormalities were observed. A subgroup of donors (N = 32) was compared with a matched control group. Urinary albumin excretion among the donors was significantly higher compared to the controls, both in absolute terms (5.4 vs. 3.3 micrograms/min, P less than 0.002) and as percent of total protein excretion (7.6 vs. 5.7%, P less than 0.05). Otherwise no consistent differences were observed. The development of BP over time warrants further observations, but there is no evidence that uninephrectomy represents a long-term risk to the donors' health. PMID- 3523004 TI - Childhood membranoproliferative glomerulonephritis: an approach to management. PMID- 3523005 TI - Immunocytochemical localization of renin and kallikrein in the rat renal cortex. AB - Immunocytochemical studies in the past, using alternate serial sections to localize individual antigens, concluded that there was no close relationship between renin- and kallikrein-containing structures in the rat kidney. We have investigated this relationship by simultaneously localizing renin and kallikrein in the same section using immunoperoxidase with two different chromogens. Analysis of serial kidney sections from three rats indicated that kallikrein containing late distal tubular cells corresponded in their distribution to connecting tubule cells. They were observed in the proximity (less than 3 micrograms) of renin-containing JG cells in 66.6% of the superficial (N = 30), 46.6% of the midcortical (N = 15) and 26.7% of the juxtamedullary (N = 15) afferent arterioles surveyed. When traced through serial sections, 90% of the afferent arterioles from superficial glomeruli (N = 30), 86.7% of the afferent arterioles from midcortical glomeruli (N = 15) and 73.3% of those from juxtamedullary glomeruli (N = 15) came within 3 micrograms of a late distal tubule showing some kallikrein-positive cells. These cells were adjacent to the afferent arteriole in 67 to 80% of the arterioles surveyed. This spatial relationship suggests an anatomical basis for a possible interaction between the afferent arteriole, containing renin-positive JG cells, and kallikrein-positive late distal tubular cells. PMID- 3523006 TI - Luminal uptake and intracellular transport of insulin in renal proximal tubules. AB - It is generally accepted that proteins taken up from the renal tubular fluid are transported into lysosomes in proximal tubule cells. Recently, however, it has been postulated that insulin in isolated perfused rat kidneys did not accumulate in lysosomes but to a certain degree in the Golgi region. The present study was undertaken to investigate the intracellular handling of biologically unaltered insulin in rat renal proximal tubule cells. Rats were prepared for in vivo micropuncture and either a colloidal gold insulin complex or insulin monoiodinated in the A-14 position (125I-insulin) was microinfused into proximal tubules. After 5, 10, 25 or 60 min the tubules were fixed by microinfusion of glutaraldehyde and processed for electron microscopy or electron microscope autoradiography. A qualitative analysis of tubules infused with colloidal gold insulin or 125I-insulin showed that insulin was taken up by endocytosis and transported to lysosomes, and a quantitative autoradiographic analysis of the 125I-insulin microinfused tubules showed that the grain density after five min was significantly increased for endocytic vacuoles and for lysosomes. After 60 min the grain density was still significant over lysosomes. The accumulation of grains was non-significant over all other areas analyzed at any time. This study shows that insulin is taken up from the luminal side of the proximal tubule by endocytosis and transported to the lysosomes. There was no significant transport to the Golgi region. PMID- 3523007 TI - [Resection of the distal segment of the posterior tibial veins in post-thrombotic disease of the lower extremities]. PMID- 3523008 TI - [Use of low-frequency ultrasonics in the complex treatment of trophic ulcers]. PMID- 3523009 TI - [Use of high-frequency flow ventilation of the lungs]. PMID- 3523010 TI - [Therapeutic endoscopy in esophageal varices (review of the foreign literature)]. PMID- 3523011 TI - [Various problems of the etiology and pathogenesis of lung abscesses (review of the literature)]. PMID- 3523012 TI - [Aleksandr Aleksandrovich Vishnevskii (on his 80th birthday)]. PMID- 3523013 TI - [Treatment of penetrating injuries of the esophagus]. PMID- 3523014 TI - [Diagnosis and treatment of spontaneous rupture of the esophagus]. PMID- 3523015 TI - [Evaluation of the methods of reconstructing the femoral and deep femoral segments in femoro-popliteal occlusions]. PMID- 3523016 TI - [Therapy of acute keratoconus]. AB - The incidence of acute keratoconus has increased in recent years. A defect of the endothelium and Descemet's membrane allows the aqueous to flow into the stroma. The therapy of choice is penetrating keratoplasty. The discussion concerning the best time for the operation is still going on. The present authors have performed penetrating keratoplasties on 9 patients at the acute stage during the last 2 years. The results show that early surgery can prevent progression of the symptoms, with corneal edema and pannus, and subsequent complications. PMID- 3523017 TI - [Results following free skin transplantations]. AB - The present paper reports on the technique and results of free full-thickness skin grafts after tumor excision in 23 cases. The functional and cosmetic results were good or even excellent. No ischemia or shrinkage of the grafts was observed. The difference in color between the graft and the surrounding skin disappeared within months. The author recommends free skin grafting in particular for defects of the inner canthus, where the results obtained are much better than those achieved with the Fricke operation, which are cosmetically poor. PMID- 3523018 TI - [Trypan blue and alizarin red S sequential staining with subsequent fixation. A modified technic for the study of the corneal endothelium]. AB - A sequential corneal endothelium staining technique with trypan blue (TB)- alizarin red S (ARS)--ethanol-trypan blue is described which can be performed in a few minutes. The first step permits the TB exclusion to be determined as a criterion of normal endothelial cell function. The two following steps permit intercellular staining by ARS and nuclear staining by TB. After each staining procedure, fixation can be performed by methanol or ethanol, both with full thickness corneal preparations or endothelial flat mounts. In flat preparations, the focussing problems and optical artifacts of full-thickness mounts can be avoided. These modifications render simple sequential staining with subsequent fixation a complement and alternative to specular microscopy and to the customary complicated silver staining of corneal endothelium. PMID- 3523019 TI - [Hodgkin's lymphoma studies in pediatrics--an example of efficiency and cooperation]. PMID- 3523020 TI - [Combined treatment strategy in over 200 children with Hodgkin's disease: graduated chemotherapy, involved field irradiation with low dosage and selective splenectomy. A report of the cooperative therapy study DAL-HD-82]. AB - It was the aim of the cooperative therapy study HD-82 for children with Hodgkin's disease to reduce chemo- and radiotherapy and to investigate of a strategy for selective splenectomy previously developed in the Hodgkin study HD-78. Between December 1981 and December 1984 207 patients (131 boys and 76 girls) below 16 years of age were enrolled in this study. In 174 out of 207 patients (84.1%) the criteria for selective splenectomy were applied i.e. the spleen was only removed when the splenic surface was nodular or when the lymphnodes at the splenic hilus and/or the pancreatic tail were enlarged. 69 out of 174 patients (39.7%) had a splenectomy. 50 of the removed 69 spleens (72%) showed histological evidence of Hodgkin's disease. These results were comparable to the 36% and 73% predicted from the retrospective analysis in the HD-78 study. According to the stage of Hodgkin's disease three different treatment groups with 2, 4 and 6 cycles of OPPA/COPP were formed (stage I/IIA, IIB/IIIA and IIIB/IV). Radiation therapy was given as involved field irradiation with a total dose of 35, 30 and 25 Gy depending on the extent of the chemotherapy. 203 patients were treated according to the protocol. Until the 30th of November 1985 3 patients died from intercurrent disease during a follow-up period of 11 to 47 months (median 29 months). 5 patients relapsed. The probability for disease-free survival after 3 1/2 years is 96% for the total group and 99%, 96% and 87% for the three treatment groups including 100, 53 and 50 patients in each group respectively. CONCLUSIONS: 1. The OPPA/COPP chemotherapy eliminates reliably occult microfoci. 2. The radiation doses in combination with the chemotherapy are sufficient to prevent local recurrences. 3. The decisional model for selective splenectomy has proved to be extremely valuable prospectively. PMID- 3523021 TI - [Results of ultrasonic, computer tomography and clinical findings for the detection of abdominal involvement in Hodgkin's disease in childhood--a retrospective statistical analysis of 145 patients in the therapeutic study DAL HD-82]. AB - It was the aim of the study to develop a method that would fairly reliably predict abdominal involvement in patients with Hodgkin's disease. Using sonography (SG), computerized tomography (CT) and clinical findings we wanted to restrict laparotomy to patients with a high probability of abdominal involvement. 145 patients of the therapy study HD-82, who had preoperative abdominal SG or CT, were analyzed. All had a laparotomy, 61 had a splenectomy and 9 a partial splenectomy. The incidence of abdominal involvement was 36%. Using 2 X 2 contingency tables as well as the X2-test 7 out of 13 parameters tested had a highly significant correlation to abdominal involvement. These 7 parameters were analyzed with the linear-logistic regression model of COX. The three most valuable individual parameters "abdomen in SG and/or CT abnormal", "B symptomatology" and "involvement of the hilar lymphnodes of the lung" contain almost all the information concerning abdominal involvement. All the other parameters are no longer significant when used in combination with these three and thus can be disregarded. For practical purposes one can omit the "B symptomatology" as well, because the combination of the other two parameters has the smallest number of false positive results, while the number of false negative results is only slightly increased. Using these data we developed a decisional model for selective laparotomy, which allows a 50% reduction of laparotomies. This method can only be used in combination with a therapy concept that contains chemotherapy for all patients. PMID- 3523022 TI - [Bone marrow transplantation in leukemias in the absence of HLA-identical siblings--results of the 4th meeting of experts of the Kind-Philipp Foundation at Reisenburg 11/12 November 1985]. AB - During recent years allogeneic bone marrow transplantation has been shown to be of clear value in the therapy of childhood leukemia. Presently the availability of an HLA identical sibling is necessary. Recently there are several attempts to pass this natural barrier. Possible alternatives are autologous transplantation or the use of an nonidentical family member or an identical unrelated person as a donor. Members of 17 bone marrow transplantation teams of the western world discussed during two days the various possibilities and the results obtained up to now. The paper reflects the state of the art as it was represented during the meeting. This is meant to help advice patients with leukemia and their parents on the further therapeutic proceedings. PMID- 3523023 TI - [Acute lymphoblastic leukemia in childhood: the COALL studies]. AB - In the cooperative study COALL-80 151 children with acute lymphoblastic leukemia were treated according to the modified protocol BFM 79/81. The probability of continuous complete remission (CCR) for the total group is 74% after 6 years. In the subsequent study COALL-82 high-risk patients (initial white blood count greater than or equal to 25/nl or T-cell leukemia and acute undifferentiated leukemia) received additional high-dose methotrexate as fifth drug in the intensive phase and the combination VM-26/arabinosyl-cytosine in the reinduction phase. In all others patients (low-risk group) intermediate-dose methotrexate was substituted for the myelosuppressive agent cyclophosphamide in the intensive phase. Reinduction was no longer given in the low-risk group. In both risk groups cranial irradiation was postponed until after the intensive phase therapy. Radiotherapy was withheld for a group with minimal risk (white blood count less than 3/nl, liver/spleen less than 3 cm). The probability of CCR for the total group of 129 patients is 64% after 3.5 years. The comparative analysis between the studies COALL-82 and COALL-80 shows that low-risk patients have an equally high probability of continuous hematologic remission (91% vs. 85%) despite reduction of therapy in COALL-82. High-risk patients, however, had a significantly higher rate of bone marrow relapses; in this group the probability of continuous hematologic remission is 52% in COALL-82 vs. 73% in COALL-80. Also relapses in the central nervous system in irradiated patients were significantly more frequent in COALL-82 than in COALL-80 (12% vs. 4%) whereas the group of patients without radiotherapy has remained free of relapse. The possible influence of the modifications in therapy in study COALL-82 on the higher relapse rate is discussed. PMID- 3523024 TI - [Current results of cooperative AML therapy studies in children: BFM-78 and 83]. AB - 271 children with AML entered the cooperative studies BFM-78 (151 pat.) and BFM 83 (120 pat.) since Dec. 1, 1978. In the second study BFM-83 the 8-10 week intensive induction/consolidation therapy of study BFM-78 was preceded by an 8 day intensive therapy consisting of cytosine arabinoside, daunorubicin and VP-16. 10 children died prior to starting the protocol therapy from hemorrhage and/or leukostasis. 80% of the 261 protocol patients achieved a complete remission. 7% were early deaths by hemorrhage and/or leukostasis 3% died of other complications. 10% were partial or nonresponders. 54 relapses, 11 with CNS involvement have occurred in study BFM-78 after a follow up of 2.10-6.7 years (median 4.10 yrs.). The life table probabilities for event free survival (EFS) and event free interval (EFI) after 6.7 years are 37% (SD 4%) and 47% (SD 5%) respectively. The results of study BFM-83 after a follow up of 0.3-2.8 years (median 1.8 yrs.) are: 23 relapses, EFS 40% (SD 10%) and EFI 48% (SD 12%). So far, the overall results of both studies are nearly identical. The analyses of the prognostic factors show that initial hyperleukocytosis (greater than or equal to 100 X 10(3)/mm3) represents a high risk for early fatal hemorrhage and/or leukostasis, for nonresponse and for the incidence of relapses. Initial deaths caused by hemorrhage and/or leukostasis occur also significantly more often in patients with M5-subtype and extramedullary organ involvement. Additional strategies for achieving a better prognosis in high risk patients are necessary. PMID- 3523025 TI - [Rhabdomyosarcoma: morphology and cellular differentiation]. AB - 544 malignant soft tissue tumors have been collected at the Pediatric Tumor Registry in Kiel including 300 cases of rhabdomyosarcoma (55%). In 237 of the 300 cases the diagnosis is certain. Liposarcoma and malignant fibrous histiocytoma which are typical tumors of adult age are rare in our material. Among rhabdomyosarcomas embryonal rhabdomyosarcoma (eRMS) clearly predominates accounting for almost 72% of all rhabdomyosarcomas. Differentiation of tumor cells in eRMS may vary considerably. Therefore, three groups of eRMS were distinguished and analyzed for clinico-pathologic features: 1. Primitive eRMS with less than 10 rhabdomyoblasts. 2. Intermediate eRMS with 10-50% rhabdomyoblasts. 3. Well differentiated eRMS with greater than 50% rhabdomyoblasts. By immunohistochemistry, vimentin positive cells were found in all three groups. The number of desmin positive cells depended upon the grade of differentiation. Thus, there were more desmin positive cells in well differentiated eRMS. Primitive and well differentiated eRMS were predominantly located in the head and neck area, intermediate eRMS in the abdomen. Primitive eRMS were noted in higher stages than tumors of the other two groups. Response to chemotherapy as evaluated in the 7th week of treatment was better in well differentiated eRMS. Moreover, patients of this group achieved more often complete remission. It is concluded from the present study that differentiation in eRMS may have an influence on the clinical presentation and clinical course of the disease. Therefore, this question should be investigated in more detail in a larger prospective study. PMID- 3523026 TI - [Results of treatment of rhabdomyosarcomas (RMS) in children. A report of the Cooperative Soft Tissue Sarcoma Study (CWS-81) of the Society of Pediatric Oncology]. AB - This analysis refers to 129 children with RMS who were treated between 1981 and 1985 according to the protocol guidelines of the CWS-81 study. The duration of chemotherapy depended on the initial post-operative stage. Patients with stage I and IIA were not to receive any radiotherapy, and patients with primary stage III were treated according to the results of a 16-week chemotherapy treatment: either without radiation (stage Ipc), or with radiotherapy using 40 Gy (stage (IIpc) or 50 Gy (stage IIIpc). The median time of observation was 27 months (Juni 1985). The essential results of the study are as follow: RMS of the extremities in stages I and IIA need radiotherapy, contrary to all other localisations with the same stages. Patients with RMS stage III who are tumor-free after initial chemotherapy (histologically checked) do not need radiotherapy. Patients with microscopic residue (IIpc) or macroscopic residue (IIIpc) after pretreatment showed no difference in their local relapse rate, whereas metastases were found only in the group having macroscopic tumor residue up to week 16. An additional examination of this study observed tumor response during initial chemotherapy and its relationship to prognosis. This analysis showed that the degree of tumor regression per unit of time permits the most favorable prognostic statement. Patients with clinical complete remission after 7/9 weeks showed a 100% relapse free chance of survival, independent of localisation, tumor size or histological subtype. Those with a tumor reduction of greater than 2/3 but no complete remission showed 67% chance of survival, and those with greater than 1/3-2/3 tumor reduction had 25%. Tumor response kinetics under initial chemotherapy allows better individual therapy in the future. The overall result of the study concerning localisation and stage corresponds to that of the IRS I and II studies. Patients with undifferentiated sarcomas, extraossary Ewing's sarcoma and synovial sarcomas can be treated according to the same principles as RMS, since no significant differences in prognosis could be found. PMID- 3523027 TI - [Analysis of prognostic factors in rhabdomyosarcoma. Preliminary univariate and multivariate results of the Cooperative Soft Tissue Sarcoma Study (CWS-81)]. AB - The characteristics of 129 children with rhabdomyosarcoma entered into the CWS-81 study between 1981 and 1984 were examined for their relationship to prognosis. Prognosis was defined as relapse-free survival time. The trial was stratified to clinical groups depending on the surgical procedure at onset. So, each group had to be analysed separately. The patient characteristics of group I/IIA mostly related to prognosis were primary site (disease in extremities, unfavorable; paratesticular primary, favorable) and tumor infiltration into adjacent bone (bone infiltration, unfavorable). In group IIB/III the degree of tumor response within 7-9 weeks, chemotherapy exclusively given, was the only characteristic significantly related to prognosis (greater than 2/3 tumor reduction, favorable; less than 2/3 tumor reduction, unfavorable). Other prognostic factors as histological subtype, primary site, tumor diameter, lymph node involvement, bone infiltration, sex and age had no significant influence. The tumor diameter was the only characteristic with significant influence in group IV. The larger the tumor diameter, the poorer was prognosis. Furthermore, the alveolar subtype was seen predominantly in non-responding tumors of group IV. In group III, we fitted the patient characteristics in a multivariate regression model (Cox's model). The degree of tumor response within 7-9 weeks was analysed to be the main hazard function related to prognosis. In future, the degree of tumor response within a certain time can be used as the measurement of effectiveness of chemotherapy. So, in patients of group III and IV a risk adapted therapeutic procedure can be undertaken. PMID- 3523029 TI - [30th anniversary of the Pirogov Museum]. PMID- 3523030 TI - [50th anniversary of the publication of the collected transactions of the Moscow Basmannyi Model Hospital]. PMID- 3523028 TI - [Persisting hyperlipidemias as risk factors of diabetic macroangiopathy]. AB - Severe forms of arterial occlusive diseases occurred more frequently in 11 insulin-treated diabetics with persisting hyperlipidemia than in 10 control subjects who were 11 years older. Triglycerides and cholesterol of total serum and of VLDL were 2-7 times higher (P less than 0.01); however, LDL-cholesterol was 2 times lower than in control subjects (P less than 0.025). HDL-cholesterol was not significantly different in either group. After insulin administration (81 U/die vs 37 U/die, P less than 0.00251), the increased lipids were only insignificantly reduced, while LDL-cholesterol and the ratio of LDL-/HDL cholesterol was even increased (P less than 0.0025 and P less than 0.05). In contrast to control subjects, VLDL-cholesterol was positively correlated to the tolbutamide-induced insulin reserve (before insulin administration) and to the diurnal insulin dosage (after insulin administration) (P less than 0.01 and P less than 0.001). The results show that the atherosclerotic risk in diabetics with persisting hyperlipidemia is higher than in control subjects and that the risk is distinguished by increased VLDL-cholesterol in correlation with increased insulin concentrations. Since the atherosclerotic risk is even more accentuated by the fact that insulin administration increases LDL-cholesterol, insulin therapy must be observed carefully in these patients. PMID- 3523031 TI - [The outstanding Russian surgeon and clinician P. N. Savenko (on the 190th anniversary of his birth)]. PMID- 3523032 TI - [Double-blind research on the anti-arrhythmia effect of ethacizin]. PMID- 3523034 TI - [Association of botulism and salmonellosis]. PMID- 3523033 TI - [Diabetic autonomic myocardiodystrophy (a review of the foreign literature)]. PMID- 3523035 TI - [Institute of Chief Therapists of the Fronts (from the history of Soviet military field therapy)]. PMID- 3523036 TI - [Student and medical circle of A. P. Chekhov during the Moscow period of his life (on the 125th anniversary of the birth of the writer)]. PMID- 3523037 TI - Control of Shigella flexneri in Celebes black macaques (Macaca nigra). AB - Stool specimens collected systematically from a group of Celebes black macaques (Macaca nigra) with a high incidence of diarrhea were examined microbiologically. Numerous isolates of Shigella flexneri, Campylobacter jejuni and pathogenic Escherichia coli were recovered. Previous parasitology reports had revealed that the majority of the animals had Balantidium coli. Subsequently, the group was treated with trimethoprim-sulfamethoxazole, erythromycin and tetracycline. After treatment, Shigella flexneri was not detected in the stool of any animal for 1 year, and the clinical condition of the group was improved. Reduced recovery rates were obtained with other enteric pathogens. PMID- 3523038 TI - Natural exposure of Wisconsin dogs to the Lyme disease spirochete (Borrelia burgdorferi). AB - Lyme disease, a tick-borne disease caused by Borrelia burgdorferi, has been described recently in dogs. In a serologic survey of specimens obtained from March to September 1984, 53% of 380 dogs from two USDA licensed vendors in Wisconsin were positive for indirect immunofluorescent antibodies to B. burgdorferi at a serum dilution of 1:64 or greater. B. burgdorferi was cultured from the blood of 8/111 dogs. These findings suggest that exposure to this spirochete is common in endemic areas and that this zoonotic disease is of importance to veterinarians and researchers. PMID- 3523039 TI - Acute cutaneous graft-versus-host disease to minor histocompatibility antigens in a murine model. Evidence that large granular lymphocytes are effector cells in the immune response. AB - We studied the morphologic and immunophenotypic characteristics of inflammatory infiltrates in the skin of mice with acute graft-versus-host disease induced by bone marrow transplantation between strains differing only in minor histocompatibility antigens. The strain combinations employed (B10.Br - greater than CBA) have been shown to produce a lethal graft-versus-host disease with clinical severity proportional to the number of T lymphocytes added to the donor marrow inoculum. Transplant recipients developed pronounced clinical signs of graft-versus-host disease, including copious diarrhea and weight loss, and histologic alterations in skin strikingly similar to this disease in humans. Our findings indicate that the preponderant mononuclear cell in lesional skin from these animals has phenotypic characteristics of a natural killer cell. This cell was often found in apposition with necrotic epidermal cells. The origin, function, and potential relevance of natural killer cells in lesion formation in this experimental model are discussed. PMID- 3523040 TI - Portable modular transducer system for the measurement of stabilizing forces in TLS-HKA orthoses. AB - We describe an instrumentation package built for the measurement of stabilizing forces in thoraco-lumbar-sacral-hip-knee-ankle orthoses. The system uses inexpensive and robust transducers mounted on the orthoses. Instrumentation is contained in a back-pack; the associated software package may be used for a wide variety of transducer applications. PMID- 3523041 TI - Prophylaxis of complications after urological abdominal surgery by substitution of plasma proteins. AB - A prospective randomized trial on 94 patients undergoing urological-abdominal surgery has been carried out to evaluate the effect of postoperatively administered plasma proteins. A significant difference in the incidence of bronchopulmonary complications has been found between the treatment group and the control group. This may be due to the substitution of alpha 1-antitrypsin as indicated by assaying alpha-antitrypsin activity. A positive trend, but no significant differences, could be demonstrated for wound healing and the need for antibiotics, postoperatively. PMID- 3523042 TI - Cholesonographic characteristics of cystic duct metastasis causing acute acalculous cholecystitis: case report. AB - A variety of epithelial malignancies are capable of metastasizing to the bile ducts and gall bladder in a fashion distinct from concurrent spread to the liver. Ultrasonography has proved useful in evaluating obstructive jaundice in this setting and, in the case described, accurately diagnosed acute acalculous cholecystitis caused by a solitary metastasis from carcinoma of the breast to the cystic duct. Exploratory laparotomy confirmed the accuracy of this preoperative diagnosis. PMID- 3523043 TI - Adjuvant chemo-immunotherapy in stage II carcinoma of the breast. AB - From July of 1974 to June of 1978, 131 patients with Stage II carcinoma of the breast were randomly assigned to one of three treatment arms in order to assess the efficacy of adding immunotherapy to adjuvant chemotherapy. All patients had metastases in the axillary lymph nodes, but no clinical evidence of systemic disease. Prognostic factors were relatively equally distributed among the three treatment arms. All patients received adjuvant chemotherapy consisting of cytoxan, methotrexate, and 5-fluorouracil (CMF). In addition, patients received adjuvant immunotherapy consisting of Bacille Calmette Guerin (BCG) or BCG plus a tumor cell vaccine. This vaccine was a mixture of allogeneic breast cancer cell lines grown in tissue culture. Fourteen patients receiving tumor cell vaccine developed hepatitis B, leading to the abandonment of this arm of the study. Side effects of chemotherapy were tolerable. No statistically significant difference could be demonstrated in recurrence rate or survival. However, the two groups receiving adjuvant chemo-immunotherapy had a slightly shorter time to recurrence and lower overall survival. The use of chemo-immunotherapy as administered in this study did not improve the clinical course of patients with Stage II breast cancer and was associated with significant morbidity. PMID- 3523045 TI - Polyps of the gallbladder. AB - One of the unusual problems associated with gallbladder disease is a polyp discovered by either ultrasonography or by oral cholecystogram. We report a recent experience of two cases of polyps of the gallbladder removed by cholecystectomy. The incidence of gallbladder polyps of any type is quite varied in the medical literature. Eighty percent of polyps occur in females, and these occur after the third decade of life. The polyps can either be cholesterol or inflammatory polyps that are not really benign tumors but just reactions of the gallbladder wall. The true mucosal benign lesions are either adenomyomas or papillomas. The adenomyomas and papillomas have malignant potential. There are case reports of carcinoma in situ and cancer arising from these lesions. The treatment for a gallbladder polyp is a cholecystectomy. PMID- 3523044 TI - Endocrine function after immunosuppression of pancreatic allograft by ionizing irradiation in the primate. AB - The object of this preliminary study was to evaluate the endocrine function after heterotopic intraperitoneal segmental pancreatic allotransplantation with unligated duct in irradiated, totally pancreatectomized primates. All allograft recipients received, pre- and peroperative donor-specific blood transfusions and peroperative external irradiation from a linear accelerator; 200 rads was administered weekly and increased to a total dose of 1,500 rads. Pancreatic transplantation was performed between 2 and 6 weeks after completion of irradiation and preoperative blood transfusions. As previously reported, only minimal pancreatic allograft survival was achieved following preoperative irradiation. One recipient remained normoglycaemic for greater than 100 days after transplantation, the longest surviving pancreatic allograft recipient reported from this laboratory. Intravenous glucose tolerance test results in this recipient revealed normoglycaemia, reduced K-value, hypoinsulinaemia, normal glucagon response, reduced C-peptide values, and moderate glucose intolerance. Aortography and electron-microscopic examination of allograft biopsy tissue confirmed the presence of a functioning allograft. PMID- 3523046 TI - Testicular neoplasm diagnosed by ultrasound. AB - The diagnosis of testicular cancer is usually made by the findings of a testicular mass on physical examination. In rare cases a young man will present with retroperitoneal nodes and a normal testicular examination. In such cases a testicular ultrasound may localize the testis which harbors a subclinical neoplasm. In addition serum markers of B-HCG and AFP are essential. As a screening procedure a urine pregnancy test is helpful, since it can be obtained quickly while quantitative B-HCG and APF results are delayed. PMID- 3523047 TI - Small bowel lymphoma associated with AIDS. AB - Patients with the Acquired Immunodeficiency Syndrome (AIDS) are known to be at increased risk for developing malignancy; however, the spectrum that these malignancies encompass has not been fully defined. An unusual case of a 32 year old homosexual male with AIDS who developed two spontaneous small bowel perforations is presented. The diagnosis of primary histiocytic lymphoma of the small intestine was established only after his second operation. PMID- 3523048 TI - Problems and possibilities in the use of traditional drugs. AB - Research and development of traditional drugs, as tools in health care, need a special approach, preferably in a multidisciplinary setting. With special reference to the situation of the indigenous medicine in Sri Lanka, an ethnopharmacognostic approach which has been practised there during the last 4 years is outlined. Besides the study of literature data the significance and relevancy of a field inquiry into the nature, the position and the use of traditional drugs is stressed. In such field inquiries a questionnaire which covers the problems of an ethnobotanical, ethnopharmaceutical, ethnopharmacological and ethnomedical nature is used. The problems encountered are discussed according to four categories: the non-professional users, the professionals who prescribe the drugs and direct the medications, the professional producers and the non-professional preparation of drugs. The possibilities for advancement of traditional medicine is outlined as a programmed development aiming at standardization of the quality of ingredients and manufacturing processes and schemes of quality control. However, simultaneous clinical research along with experimentally based standardized production is of vital importance. Within the framework of such developmental endeavours serious scientific attention should be given to conceptual aspects of the traditional system and the context in which their drugs are used. Finally it is argued that major advancements of traditional medicine will only be achieved if research programmes are focused on clear-cut topics. PMID- 3523049 TI - Method of heart transplantation for treatment of hypoplastic left heart syndrome. AB - Technical details of investigational orthotopic cardiac transplantation for management of hypoplastic left heart syndrome in a neonate are presented. Extracorporeal perfusion technique and need for extensive aortic arch reconstruction are emphasized. Although this experience was with a subhuman primate (baboon) donor, source of donor graft makes little difference with regards to the unique technical aspects of cardiac transplantation in a ductus dependent newborn infant with a diminutive aortic arch. PMID- 3523050 TI - Isolation of neurons suitable for patch-clamping from adult mammalian central nervous systems. AB - A method is described for the isolation of neurons from defined regions of the mammalian central nervous system, by a combination of mechanical and enzymatic means. The procedure liberates neurons free of cellular debris and glial investments, allowing the formation of giga-ohm seals with patch clamp electrodes. The characteristic morphology of neurons is maintained, together with the diversity of active channels evident in the intact nervous system. PMID- 3523051 TI - In memoriam Hymen Samuel Mayerson, 1900-1985. PMID- 3523052 TI - Systemic stress, magnesium status and cardiovascular damage. AB - Evidence is given that cardiovascular damage due to systemic stress is potentiated by a coexisting Mg deficit. Supplementation with Mg is not only a suitable measure to eliminate this risk factor, but can also increase resistance against stressors in experimental animals, livestock and probably in man, too. When Mg is supplied in larger amounts by the oral route, care must be paid to bioavailability and acid base status. PMID- 3523053 TI - Magnesium and cardiac arrhythmias. AB - The effectiveness of magnesium therapy in intractable ventricular tachycardia and ventricular fibrillation was documented in patients not only with hypomagnesemia, but also in patients with normomagnesemia. It was also effective in ventricular tachycardia characterized by 'torsades de pointes' and in massive digoxin intoxication. Prospectively, parenteral magnesium therapy was also effective in controlling the ventricular rate in multifocal atrial tachycardia (8 patients) by reducing the number and the rate of ectopic atrial foci. Parenteral magnesium sulfate administration, 10-15 ml of 20% MgSO4 in 1 min and 500 ml of 2% MgSO4 in 5 h in patients without renal failure was found to be safe and effective. Magnesium sulfate prevented hyperpotassemia in massive digoxin intoxication and tended to produce hypopotassemia in other patients necessitating concomitant use of potassium chloride. PMID- 3523054 TI - Magnesium and potassium interrelationships in cardiac arrhythmias. AB - Depletion of K and Mg appears to play a significant role in the ventricular tachyarrhythmias seen in alcoholic patients, patients treated with diuretics and/or patients with digitalis toxicity. A therapeutic strategy is suggested by the observation that hypokalemic patients have a 38-42% incidence of concurrent hypomagnesemia: that Mg as well as K should be replenished in all hypokalemic patients who suffer from alcoholism or who are receiving diuretics and/or digitalis because of the ventricular tachyarrhythmias which accompany these clinical states. Routine serum Mg determination will contribute significantly towards identifying patients at risk for cardiac arrhythmias due to Mg depletion. PMID- 3523055 TI - Biochemistry and pathophysiology of congestive heart failure: is there a role for magnesium? AB - Congestive heart failure (CHF) represents a pathophysiologic state in which cardiac output is inadequate to meet the metabolic needs of multiple organ systems. The primary pathologic event in CHF is a marked, sustained reduction in the intrinsic contractility of the heart. A review of the current knowledge regarding the etiology and progression of CHF reveals that it is associated with profound biochemical, peripheral hemodynamic (increased peripheral vascular resistance), and electrolyte disturbances. In addition to sodium and water retention, CHF is often associated with hypokalemia and hypomagnesemia as well as tissue deficits in K and Mg. Cardiac glycosides and diuretics (loop and distal types) often exacerbate, or result in, hypokalemia and hypomagnesemia, which may lead to cardiac arrhythmias and sudden cardiac death. Deficits in extracellular and vascular tissue Mg lead to peripheral vasoconstriction; this together with K deficits and the release of neurohumoral substances may be responsible in large measure for the increase in peripheral vascular resistance commonly noted in CHF. More attention must be paid to the careful monitoring of electrolyte levels (Na, K, Mg) in tissues (possibly lymphocytes) and plasma of CHF patients. Deficits in either K or Mg must be corrected in CHF. The nonspecific vasodilator properties of Mg2+ together with its ability to unload the heart should be considered as an important adjunct tool in the management of CHF. PMID- 3523057 TI - Pregnancy-induced hypertension and low birth weight in magnesium-deficient ewes. AB - The fetal and maternal morbidity and mortality from the hypertensive disease states of pregnancy is a major problem. While much is known about the syndrome, the cause has been elusive. The ewe was chosen to test a hypothesis that depletion of magnesium may be involved. Twelve Finnish ewes were subjected to low magnesium diets with half given magnesium in the water. Tests included measurement of blood pressure in the waking state and by noninvasive technique. Magnesium levels were measured by atomic absorption spectrophotometry in the plasma and tissue of the ear tips. Findings included significant elevation of arterial blood pressure, reduction in fetal weight with pathologic confirmation of placental and renal lesions which were similar to those seen in the human condition. Significant lowering of both plasma and tissue of magnesium was noted. The hypothesis was supported and extended to include possible interaction with prostacyclin and thromboxane as intermediaries in a hypomagnesic coagulative angiopathy. This entity would also explain the association of migraine in the eclamptic and preeclamptic syndrome reported by previous authors. The success of parenteral magnesium in the treatment of these human conditions is therefore more than purely empiric. PMID- 3523056 TI - Magnesium, lipids and vascular diseases. Experimental evidence in animal models. AB - The possible role of Mg in the pathogenesis of vascular disease has recently received increasing attention. Accumulating evidence indicates that Mg strongly influences vascular tone and responsiveness to pressor agents and that Mg deficiency may be associated with an increased risk of hypertension. Moreover, experimental Mg deficiency produces vascular lesions with calcifications while increasing the dietary intake of Mg has been shown to prevent atheroma and thrombotic complications. The modifications of lipid metabolism during experimental Mg deficiency have been recently characterized. Severe Mg deficiency in weanling rats produces a marked hypertriglyceridemia and a decrease in the percentage of cholesterol transported by high-density lipoprotein. The decreased clearance of circulating triglycerides appears to be the major mechanism contributing to hyperlipemia. The same animals were found to have a reduced insulin response after intravenous glucose challenge and a slight reduction in heparin release lipoprotein lipase. A marked reduction in plasma activity of LCAT and a significant decrease in esterified/total plasma cholesterol ratio have also been reported. Severe Mg deficiency in weanling rats produces marked changes in the fatty acid pattern of total plasma lipids, as shown by decreased levels of stearic acid, increased of oleic acid and linoleic acid, and decreased levels of arachidonic acid. Platelets from Mg-deficient rats become more sensitive to thrombin. Such an increased sensitivity of platelets may in turn play an important role in initiating the vascular lesion as well as in thrombotic complications. In view of these experimental data in animal models, more work seems necessary in man to assess the effect of Mg on lipid metabolism and vascular disease. PMID- 3523058 TI - Type A behavior and magnesium metabolism. AB - An analysis of the literature suggests the possible role of Mg deficiency in the susceptibility to cardiovascular diseases, observed among subjects displaying a type A behavior pattern. Experimental data which support this hypothesis are reviewed. Type A subjects are more sensitive to stress and produce more catecholamines than type B subjects. This, in turn, seems to induce an intracellular Mg loss. In the long run, type A individuals would develop a state of Mg deficiency, which may promote a greater sensitivity to stress and, ultimately, lead to the development of cardiovascular problems. The relationships between Mg, catecholamines, stress and genetic factors are discussed with respect to the genesis of the type A behavior pattern and disease susceptibility. PMID- 3523059 TI - The role of ATP-magnesium in ischemia and shock. AB - Although much is known about the role of Mg in cardiomyopathies of different etiology, very little is known about the changes in hepatic Mg levels following hemorrhagic shock or ischemia to the liver. Information available indicates that tissue and mitochondrial Mg levels may be altered following shock and ischemia and that such alterations may be responsible for the depressed cellular function during those conditions. MgCl2 administration following shock or ischemia was ineffective in improving tissue and mitochondrial Mg levels and cellular functions. Administration of ATP complexed with MgCl2, however, increased tissue and mitochondrial Mg levels, tissue ATP stores and cellular functions and proved beneficial for the survival of animals. ATP-MgCl2 administration also increased cardiac output while decreasing myocardial as well as total body O2 consumption. The potential mechanisms of the beneficial effects of ATP-MgCl2 are discussed. ATP-MgCl2 can be given safely to humans and it decreases myocardial O2 consumption and increases cardiac output without producing hypotension. A clinical trial of ATP-MgCl2 in patients with various adverse circulatory conditions is underway at our institution. PMID- 3523060 TI - Midwestern physician first describes sickle cell anemia. PMID- 3523061 TI - Immunologic mechanisms in the maternal-fetal relationship. AB - Until recently, the immunologic tolerance between a mother and her allogeneic fetus has been a highly speculative and poorly understood phenomenon. New data indicate that maternal acceptance of the fetal allograft necessitates a specific, protective immune response. This specific recognition apparently involves unique placental antigens with genes that are closely linked to HLA loci. Lack of recognition of these antigens, as in matings between partners with similar HLA profiles, may result in repeated spontaneous abortions caused by unsuppressed rejection mechanisms. PMID- 3523062 TI - Low-energy laser treatment of pain and wounds: hype, hope, or hokum? PMID- 3523063 TI - Effect of age on calcium release from mouse calvaria in tissue culture. AB - The effect of age on calcium release in organ culture was studied using calvaria from 5-, 14-, 30-, and 75-day-old mice. The results demonstrated a different and characteristic calcium release pattern over the 14-day culture period for untreated calvaria of different ages. Since calcium release in all cultures was abolished by procedures such as boiling, multiple freezing and thawing, maintaining cultures in an oxygen-free gas phase, or maintaining cultures in a non-nutritive medium, it was concluded that the calcium release from older calvaria was due to a cell-mediated process. Histological observations demonstrating the presence of Howship's lacunae and active osteoclastic resorption confirmed that calcium release from older calvaria was due to an active bone resorption process. Parathyroid hormone did not substantially alter the general pattern of calcium release exhibited by different aged calvaria. However, it tended to exaggerate the magnitude of the response. Indomethacin and dexamethasone inhibited calcium release from untreated 5- and 75-day-old calvaria suggesting that prostaglandin biosynthesis was involved in the calcium release process. Direct measurements of PGE2 and PGI2 released into the culture medium gave results consistent with this hypothesis, although it is conceivable that indomethacin and dexamethasone might have influenced calcium release by other mechanisms. PMID- 3523064 TI - Physician satisfaction with patient encounters. Reliability and validity of an encounter-specific questionnaire. AB - While patient satisfaction has been studied extensively and considered an outcome measure of physician-patient encounters, physician satisfaction has received limited consideration. The reliability and validity of an "encounter-specific" physician satisfaction scale were examined. The Delphi technique was used to develop a 39-item questionnaire comprising four hypothesized domains of physician satisfaction: interactive, personal, professional, and contextual. Factor analysis supported two of the four hypothesized categories. Exclusion of all items not contributing to the reliability of the two subscales or differentiating between high and low scores in an item analysis allowed a condensation of the scale. This 16-item scale was tested in a second phase of the study, which supported the reliability and validity of the two-dimension encounter-specific physician satisfaction scale. Further use of the scale may prove useful in exploring this neglected component of physician-patient encounters. PMID- 3523065 TI - Estimating pharmacy level prescription drug acquisition costs for third-party reimbursement. AB - Accurate payment for the acquisition costs of drug products dispensed is an important consideration in a third-party prescription drug program. Two alternative methods of estimating these costs among pharmacies were derived and compared. First, pharmacists were surveyed to determine the purchase discounts offered to them by wholesalers. A 10.00% modal and 11.35% mean discount resulted for 73 responding pharmacists. Second, cost-plus percents derived from gross profit margins of wholesalers were calculated and applied to wholesaler product costs to estimate pharmacy level acquisition costs. Cost-plus percents derived from National Median and Southwestern Region wholesaler figures were 9.27% and 10.10%, respectively. A comparison showed the two methods of estimating acquisition costs would result in similar acquisition cost estimates. Adopting a cost-plus estimating approach is recommended because it avoids potential pricing manipulations by wholesalers and manufacturers that would negate improvements in drug product reimbursement accuracy. PMID- 3523066 TI - Medicare beneficiary decision making about health insurance. Implications for a voucher system. AB - A two-phase study involving focus group interviews and a survey of 2,016 Medicare beneficiaries was conducted to examine beneficiary decision making about health insurance under a hypothetical Medicare voucher program. Some of the major findings were that: beneficiaries lack important information about Medicare and health insurance in general; plans with physician restrictions, no restrictions on hospitals, and benefits for custodial long-term care at home or in nursing homes are most preferred when prices are roughly equal to actuarial costs; plan features often interact rather than combined additively to affect choices; price sensitivity is small in comparison with sensitivity to other plan features; price sensitivity is particularly small for plans with custodial long-term care benefits; Medicare would not experience substantial selection bias in a voluntary system containing a wide range of plans preferred by beneficiaries; physician restricted plans would experience favorable selection; plans with long-term custodial care benefits would experience some adverse selection which might be handled by modest price adjustments in view of the relatively low price elasticity of preferences. PMID- 3523067 TI - Choice of payment plan in the Medicare capitation demonstration. AB - This article identifies factors that influence the choice between joining an HMO and remaining with the traditional fee-for-service system among aged Medicare beneficiaries in three communities. Sources of marketing information were found to be strongly and positively related to the decision to join the HMO. Among beneficiaries who had to switch providers to join, persons who had a prior usual source of care and those who were satisfied with the amount of paperwork required to use that source of care were less likely to enroll in the HMO. Persons who did not have to switch providers to join the HMO were more likely to enroll in the prepaid program if they were satisfied with the amount of paperwork involved in using the HMO prior to the demonstration. Differences among the three communities suggest that the barrier to HMO enrollment presented by having a prior source of care who is not affiliated with the HMO may attenuate as the number of competing HMOs in the community increases, making the medical care environment more competitive. In the community with the most HMOs, persons who already had supplemental insurance were less likely to enroll than those who did not. None of the six HMOs studied experienced adverse selection, based on pre-enrollment health status. PMID- 3523068 TI - [Cyclosporin in heart transplant: a developing treatment]. PMID- 3523069 TI - [Eikenella corrodens. A seldom encountered germ in pulmonary infections]. PMID- 3523070 TI - [Digital hippocratism and hypertrophic osteoarthropathy. Definition and etiopathogenesis]. PMID- 3523071 TI - [Sublingual captopril in the treatment of hypertensive crises]. PMID- 3523072 TI - [Neuropathologic lesions in heart transplants]. PMID- 3523073 TI - [Felty's syndrome]. PMID- 3523074 TI - [The glucagon test as a criterion of insulin administration in clinical practice]. PMID- 3523075 TI - Advocacy or folly: the Alleged Lunatics' Friend Society, 1845-63. PMID- 3523076 TI - Dr Thomas Beddoes and James Watt: preparatory work 1794-96 for the Bristol Pneumatic Institute. PMID- 3523077 TI - William Heberden the elder (1710-1801): aspects of his London practice. PMID- 3523078 TI - Yellow fever in South Wales, 1865. PMID- 3523079 TI - Suspected endemic syphilis (treponarid) in sixteenth-century Norway. PMID- 3523080 TI - Illustrations from the Wellcome Institute Library. Earl's Court House from John Hunter to Robert Gardiner Hill. PMID- 3523081 TI - [AIDS and fungal infections]. PMID- 3523082 TI - [Drug-induced ocular side effects--an overview]. PMID- 3523083 TI - [Bronchoscopy in the diagnosis and treatment of lung diseases--an overview]. PMID- 3523084 TI - [Liver transplantation--experiences from Gothenburg]. PMID- 3523085 TI - Cartilage grafting in facial reconstruction with special consideration of irradiated grafts. AB - The search for the perfect facial implant for reconstruction of the face continues. Cartilage, once thought to be an undesirable graft material because of its propensity for absorption, has regained popularity in the past decade. Various preparation techniques have been employed to ensure graft sterility and diminished absorption. An improved understanding of cartilage structure and physiology has shed considerable light on the host-graft relationship. Gamma irradiation is a time-honored method of preservation. An experiment was undertaken to investigate the physiology of irradiated cartilage grafts following prolonged implantation on the facial skeleton of sheep and dog. Merthiolate preserved grafts were used as controls. Direct observation, histochemical techniques, autoradiography, and transmission electron micrography were used to determine chondrocyte viability and matrix composition. It was surprising to note that following implantation of 16 to 72 months, complete resorption was seen in 87.7% of the irradiated grafts and in 43.8% of the Merthiolate stored controls. Many of the grafts acquired chondrocytes from the host and produced new proteoglycan matrix as well as undergoing some degree of ossification. A comparison to the clinical situation in humans is made. PMID- 3523087 TI - Directory of otolaryngologic societies. PMID- 3523086 TI - Repair of large wounds on the back. PMID- 3523088 TI - Biological effects of laser welding on vascular healing. AB - The feasibility of welding thin-walled microvessels by laser has been established. This report summarizes our experience using laser welding to repair thick-walled, high-pressure, 4 to 8-mm canine arteries using CO2, Nd:YAG, and argon lasers. The CO2 laser did not produce seals that could withstand arterial pressure. Nd:YAG laser welds were initially successful, but the majority failed within 20 to 40 minutes. The argon laser uniformly sealed 2-cm-length arteriotomies that healed rapidly within 4 to 6 weeks and had less foreign body response compared to sutured controls. Laser welding may represent an alternative for repair of small- and large-diameter vessels with several advantages compared to conventional suture techniques. PMID- 3523089 TI - [Captopril in the treatment of resistant arterial hypertension]. PMID- 3523090 TI - [Complement--mechanisms of activation, regulation and biologic role]. PMID- 3523091 TI - [The lazaretto in Split in the 19th century]. PMID- 3523092 TI - [Ultrasonic detection of malformations of the fetal skeleton]. PMID- 3523093 TI - [Immunosuppressive treatment using cyclosporin in kidney transplantation]. PMID- 3523094 TI - Brain anoxia releases striatal dopamine in rats. AB - Immediately following death resulting from discontinuance of artificial respiration in anesthetized rats, a large increase in electrochemically reactive materials in the extracellular fluid was detected by in vivo voltammetry with an electrode in the striatum. The use of in vivo brain dialysis permitted identification of the reactive material as dopamine. The release of dopamine occurred about 6 minutes after cessation of artificial respiration and death. A similar release of dopamine was found after intrastriatal ouabain administration. A large release of dopamine might result in irreversible tissue damage in certain pathological conditions such as stroke or anoxia. PMID- 3523096 TI - Selective dopamine D2 receptor reduction enhances a D1-mediated oral dyskinesia in rats. AB - We have previously shown, through the use of selective D1 and D2 dopamine receptor interactive drugs, that repetitive jaw movements in rats can be produced by activation of the D1 system or blockade of the D2 system. In the present study we have shown that genetic or developmental factors resulting in a lesser number of D2--relative to D1--receptors is associated with repetitive jaw movements. We have found in two strains of rats with different striatal D2 to D1 ratios, the strain with fewer D2 sites had more jaw movements. We also found that experimental reduction of D2 receptors via prenatal intervention resulted in an increase in spontaneous jaw movements, as did aging, which is accompanied by a decrease in the number of D2 receptors. The findings of these studies carried out in rats, parallel, in a number of ways, findings in human oral dyskinesia associated with either aging or neuroleptic treatment. PMID- 3523095 TI - Epithelium modulates the reactivity of ovalbumin-sensitized guinea-pig airway smooth muscle. AB - Mechanical removal of the airway epithelium alters the in vitro reactivity of airway smooth muscle. The modulation of reactivity may involve the release of inhibitory and excitatory factors from epithelial cells. Guinea pigs sensitized with ovalbumin have been used as an animal model of airway hyperreactivity. We evaluated the influence of the epithelium on the reactivity of in vitro tracheal smooth muscle from control and ovalbumin-sensitized guinea pigs, and the extent to which the presence of the epithelium affects the contractile response to in vitro challenge with ovalbumin. In both control and ovalbumin-sensitized tissues, epithelium removal increased the sensitivity of the preparations to histamine, methacholine and isoproterenol to a similar extent, i.e., 2- to 2.5-fold. Epithelium removal resulted in an 8.1-fold increase in sensitivity to ovalbumin in sensitized tissues. The epithelium appears not only to modulate the reactivity of the tissues to bronchoactive agents, but it also influences the magnitude of the contractile response following antigen challenge. PMID- 3523097 TI - [Chemo- and radiotherapy of patients with different types of malignant neoplasms]. PMID- 3523098 TI - [Tolerance to physical exertion of patients with lymphoproliferative disorders following whole-body therapeutic gamma-irradiation]. PMID- 3523099 TI - [They saved the dearest thing]. PMID- 3523100 TI - [In a single formation]. PMID- 3523101 TI - Habitual physical activity in children: methodology and findings in health and disease. AB - Habitual physical activity in children has become a major field of interest for many exercise and sport scientists as well as for pediatric clinicians who specialize in the prevention of and rehabilitation from hypokinetic diseases. This paper discusses the state of the art concerning the measurement of habitual physical activity, identifies factors which may cause hypo-activity in children, and outlines specific problems on which research should be focused. The areas addressed include: the use of different field methods to measure physical activity and methodological constraints in young children; the level of daily activity in healthy children; and, finally, some aspects of reduced habitual physical activity in pediatric diseases. PMID- 3523102 TI - Anaerobic characteristics in male children and adolescents. AB - Only sparse information has been published on the effects of growth, development, and maturation on the ability to perform high intensity, short-term "anaerobic" tasks. Cross-sectional studies on Italian, African, British, and American females and males have indicated an age-related progression in the performance of the Margaria step-running test. Children had a distinctly lower mechanical power output than adolescents and young adults, both in absolute terms and when divided by body weight, or by fat-free mass. Data are presented on some 300 10- to 45-yr old Israeli males who performed the Wingate anaerobic test by cycling or by arm cranking. Both the peak power at any 5-s period and the mean power throughout the test were lowest in the children, whether expressed in absolute power units or corrected for body weight. Performance progressed with age and reached the highest values at the end of the third decade for cycling and at the end of the second decade for arm cranking. This pattern is unlike that described for maximal O2 uptake per kg body weight which, in males, remains virtually unchanged from childhood to young adulthood. In females, maximal O2 uptake per kg is even higher in children than among adolescents or adults. Biochemical correlates of such a low anaerobic performance in children are their lower maximal lactate concentration in muscle and blood, lower rate of anaerobic glycolysis, and lower levels of acidosis at maximal exercise. The mechanisms for the relatively deficient anaerobic characteristics of children are not clear. PMID- 3523103 TI - Longitudinal approach to assessing maximal aerobic power during growth: the European experience. AB - This review deals with the principle and constraints of conducting longitudinal studies on exercise in children. As with cross-sectional studies, longitudinal ones have advantages and constraints: the different types of such designs as mass studies, population studies, or prospective cohort studies should be therefore selected to minimize their possible drawbacks. Other problems of longitudinal studies, such as the age span studied, time and sequential measurement effects, or interventional effects, have to be controlled by statistical measures and study design. In longitudinal studies ad hoc research groups working in field laboratories are for many reasons more flexible than permanent teams using institutional laboratories. Only direct determinations of maximal aerobic power should be used in longitudinal studies. These should be accompanied by such measurements as body height, body mass, lean body mass, and peak height velocity and by such health indicators as daily physical activity, blood pressure, smoking habits, and blood lipids. Examples for this approach are given in this paper, and general issues of longitudinal studies are discussed from the economic and ethical point of view. PMID- 3523104 TI - Development of neuromuscular specialization. AB - This review outlines recent advances in understanding the program of muscle specialization during development and discusses some of the controls over this process. The scheme of fiber heterogeneity is laid down very early in myogenesis and, at least in the chicken, it appears to be intrinsically determined by the limb, independent of neuromuscular contact. In mature muscle, specialized fibers are usually intermingled in a mosaic. This results from the pattern of muscle assembly from primary and secondary generation cells as these distinct generations commonly express different phenotypes. The muscle develops in this way as secondary cells use the walls of primary myotubes as a scaffold to support their differentiation. This process may be regulated by transient expression of N CAMs. Myoblasts left after N CAMs are no longer expressed may become the satellite cells of mature muscle. In the rat, primary cells all initially express slow myosin, whereas most secondary cells are fast in phenotype. Post-partum, the initial plan of fiber specialization is modulated. In developing slow muscles many secondary generation fibers convert from a fast to a slow phenotype, whereas in developing fast muscles, primary slow fibers transform to a fast phenotype. Hormones, particularly thyroid hormone, play a significant role in this modification. The role of the nerve is less well understood. PMID- 3523105 TI - History of exercise-induced asthma. AB - Strenuous exercise prolonged for several minutes can cause airway obstruction in asthmatic subjects. Initial obstruction becomes most extreme 5-10 min after the completion of exercise and usually remits within a few minutes but may recur 3-6 h later. The response to exercise depends upon the type of exercise. Swimming is less likely to cause exercise-induced asthma than running. Recent exercise or pretreatment with a bronchodilator or cromolyn can inhibit exercise-induced asthma. Nasal breathing or inhalation of warm, fully humidified air during exercise can minimize exercise-induced asthma. Local changes in osmolarity or cooling of mast cells probably causes release of mediators that cause airway obstruction. PMID- 3523106 TI - Exercise intensity, training, diet, and lactate concentration in muscle and blood. AB - With some, but not all, types and intensities of exercise, lactate accumulates in the blood and in the muscles engaged in the exercise. A great deal of attention has been directed towards attempting to understand the dynamics of lactate production and removal at the onset of exercise, during exercise, and during the recovery process following exercise. It has been hoped that an unravelling of these events would provide a key to understanding cellular metabolism and its regulation during exercise. The purpose of this introductory paper to a symposium on lactate is to present a brief overview of some of the conditions that influence the rate and magnitude of lactate accumulation during exercise. It is pointed out that many conditions influence the rate and magnitude of the accumulation of lactate in blood and muscles. Included are diet, state of physical fitness, and the type and duration of the exercise. We have cautioned against trying to evaluate the state of oxygen delivery to muscle and the state of tissue oxygenation from the appearance of lactate in blood. We have pointed out the positive aspects of lactate production based on how it augments the cellular supply of ATP, thereby allowing for high intensity exercise, and also the negative aspects that develop as a result the reduction in pH which adversely influences many cellular processes essential for muscular activity. PMID- 3523107 TI - The lactate shuttle during exercise and recovery. AB - Most (75%+) of the lactate formed during sustained, steady-rate exercise is removed by oxidation during exercise, and only a minor fraction (approximately 20%) is converted to glucose. Significant lactate extraction occurs during net lactate release from active skeletal muscle; the total lactate extraction approximates half the net chemical release. Of the lactate which appears in blood, most of this will be removed and combusted by oxidative (muscle) fibers in the active bed and the heart. The "shuttling" of oxidizable substrate in the form of lactate from areas of high glycogenolytic rate to areas of high cellular respiration through the interstitium and vasculature appears to represent an important means by which substrate is distributed, metabolic "waste" is removed, and the functions of various tissues are coordinated during exercise. During recovery from sustained exhausting exercise, most of the lactate accumulated during exercise will continue to be removed by direct oxidation. However, as the muscle respiratory rate declines in recovery, lactate becomes the preferred substrate for hepatic gluconeogenesis. Practically all of the newly formed liver glucose will be released into the circulation to serve as a precursor for cardiac and skeletal muscle glycogen repletion. Liver glycogen depots will not be restored, and muscle glycogen will not be completely restored until refeeding. This is because the diversion of lactate carbon to oxidation during exercise and recovery represents an irreversible loss of gluconeogenic precursor and because the processes of protein proteolysis and gluconeogenesis from amino acids are insufficient to achieve complete glycogen restitution after exhausting exercise.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3523108 TI - [Epidemiological aspects of malaria in 2 villages of the Manyemen forest region (Cameroon, southwest province)]. AB - In terms of parasitaemia in blood, the prevalence was 18.7% for Plasmodium falciparum, 10.5% for P. ovale and 1% for P. malariae in the villages of Mungo Ndor and Kokobuma. The plasmodial index of children from 2 to 9 years of age was 38.2% and the spleen index 26.6%, with a mean HACKETT score of 1.56. Malaria is thus meso-endemic in the region. The immunofluorescent test performed with a P. falciparum antigen was positive in 66% of the children in the same age group. Parasites were seen in 15% of new-born children. The malaria infection indices were higher in Mungo Ndor, which is located on the main road in the vicinity of the Manyemen hospital, than in Kokobuma. Morbidity and mortality due to malaria remain major problems in this part of the South-West Province, in spite of improving primary health care facilities and free chloroquine distribution. Anopheles gambiae is the main vector of malaria in the area, and transmission is interrupted only during the short dry season. PMID- 3523109 TI - [Value of a papain-treated homologous microfilarial antigen in the diagnosis of filariasis due to Wuchereria bancrofti var. pacifica. Analysis of 237 cases]. AB - An indirect immunofluorescence assay using papain treated microfilariae (IFI-WBp) has been performed to attempt diagnosis of bancroftian filariasis. The authors have analysed 237 bed-rests of patients consulting for specific and non specific lymphangitis, chyluria, elephantiasis, hydrocele or just asymptomatic hypereosinophilia. Taking into account the clinical aspects, the parasitological and the serological results, they have shown the efficiency of IFI-WBp (titre greater than 80) to diagnose filariasis in French Polynesia where only one species of filaria is present (Wuchereria bancrofti var. pacifica.) PMID- 3523110 TI - Spiral interrupted suturing technique for microvascular anastomosis: a comparative study. AB - This is an experimental study comparing the suturing time and patency rate of a spiral interrupted suturing technique to those of conventional interrupted and continuous suturing technique in end-to-end as well as end-to-side anastomosis. The spiral interrupted suturing technique requires less time for either end-to end or end-to-side anastomosis than conventional interrupted suturing technique, and does not result in stenosis as shown in the venous end-to-end anastomosis by continuous suturing technique. PMID- 3523111 TI - Six models of heterotopic rat liver transplantation: introducing a reverse circulation model. AB - Six different models of heterotopic partial (30%) liver transplant techniques were enumerated step-by-step with the special introduction of a so-called nonregenerative model in which the afferent blood supply to the liver graft was the host's systemic blood while the reverse circulation model was to receive the host's portal blood via the suprahepatic vena cava. The reverse circulation model needs further investigation as to its applicability, but the nonregenerative partial liver transplant model certainly deserves attention because of its importance for possible infusion studies using various hepatic nutrients, hormones, and enzymes. PMID- 3523112 TI - Phaeohyphomycosis caused by the fungal genera Bipolaris and Exserohilum. A report of 9 cases and review of the literature. AB - We have reported 7 new cases of Bipolaris infection and 2 of Exserohilum infection, which demonstrate the capability of these 2 genera to cause invasive as well as "allergic" disease. As noted previously, it is likely that all of the cases of "Helminthosporium" and Drechslera infections reported in the literature were caused by Bipolaris or Exserohilum. Infections due to these 2 genera are probably more common than previously recognized. They should be included in the differential diagnosis of central nervous system and disseminated fungal disease, sinusitis, keratitis, peritonitis associated with continuous ambulatory peritoneal dialysis, and allergic bronchopulmonary disease. These various entities have distinct histopathologic characteristics. With disseminated disease in the immunocompromised patient, the most frequent findings are acute inflammation with prominent vascular invasion, thrombosis, and infarction. In contrast, granulomatous inflammation and leukocytoclastic vasculitis are seen in meningoencephalitis caused by these fungi. The histologic features of allergic bronchopulmonary disease and sinusitis are similar. A chronic inflammatory infiltrate of lymphocytes, plasma cells and eosinophils within edematous granulation tissue is found in addition to squamous metaplasia and thickening of the basement membrane. Infections caused by Bipolaris/Exserohilum and Aspergillus show many clinical and pathologic similarities despite the lack of taxonomic relationship between these fungi. Both cause disseminated disease in immunocompromised patients that is characterized by tissue necrosis and vascular invasion. Both cause central nervous system disease, osteomyelitis, and sinusitis and are associated with allergic bronchopulmonary disease. Sinusitis, the most common form of disease caused by Bipolaris and Exserohilum, occurs in otherwise healthy patients with nasal polyposis and allergic rhinitis. Although pathologic evidence of bone invasion may not be found, there frequently is radiographic evidence of invasive disease. Most patients who are treated initially with surgical debridement and amphotericin B have apparently been cured. However, longer follow-up will be necessary in these patients. Amphotericin B appears to be the treatment of choice for invasive infections caused by Bipolaris/Exserohilum species. Ketoconazole and other imidazole derivatives may also be effective in certain of the disease entities caused by these black moulds; however, their role has yet to be defined.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3523113 TI - Moderate alcohol consumption and coronary artery disease. A review. AB - An inverse association between moderate alcohol consumption and coronary artery disease has been demonstrated in epidemiologic studies of diverse design. These include ecologic correlations, case-control, longitudinal and clinical studies. The consistency, strength and independence of the inverse relationship argues persuasively for a causal association. These data also suggest that both abstention and heavy alcohol use are associated with an increased risk for coronary artery disease. The effect of moderate alcohol consumption on lipoprotein and apolipoprotein levels is a biologically plausible and likely mechanism for this inverse association. Alcohol consumption elevates HDL cholesterol, although it is unclear whether the HDL subfractions HDL-2 and HDL-3 are beneficially altered. Recent evidence, however, suggests that the apolipoproteins may be more important indicators of coronary artery disease, and moderate alcohol consumption does beneficially alter these proteins. Alcohol may also affect coronary artery disease by other mechanisms, which may include fibrinolytic activity, coagulation, blood pressure, coronary vasoreactivity, and sociobehavioral factors. PMID- 3523115 TI - Nicotinic-cholinergic involvement in arginine-vasopressin response to insulin induced hypoglycemia in normal men. AB - In order to establish whether arginine-vasopressin (AVP) release in response to insulin-induced hypoglycemia is mediated by a muscarinic and/or nicotinic cholinergic pathway, 12 normal men had an insulin tolerance test (ITT) in basal conditions and after treatment with the muscarinic receptor blocker pirenzepine (40 mg IV (intravenously) ten minutes before ITT in six subjects) or the nicotinic receptor antagonist trimethaphan (0.3 mg/min X 30 min IV before ITT in six subjects). The drugs did not modify arterial blood pressure nor produce side effects capable of altering AVP secretion. Pirenzepine administration did not change AVP response to hypoglycemia, whereas trimethaphan significantly reduced AVP increase by about 50% during the ITT. These data suggest the involvement of a cholinergic-nicotinic mechanism in regulation of AVP response to hypoglycemia. PMID- 3523114 TI - Trichosporonosis in patients with neoplastic disease. AB - Trichosporonosis due to Trichosporon beigelii or T. capitatum is an infrequent but potentially fatal invasive fungal infection in cancer patients. We studied epidemiologic, clinical, pathologic, and microbiologic features of this infection during a 7-year period at the University of Maryland Cancer Center. Fifteen patients with involvement by Trichosporon were identified: 5 were infected, 5 were possibly infected, and 5 were colonized but not infected by Trichosporon. Four of the infected patients had trichosporonemia and/or positive skin biopsy cultures as the first evidence of infection. The fifth infected patient had positive marrow and skin biopsy cultures. Serial surveillance cultures of infected patients showed preceding Trichosporon colonization in only 1 of 5 cases. Pulmonary infiltrates in 3 infected patients correlated at postmortem examination with Trichosporon pneumonia. Renal dysfunction marked by proteinuria, hematuria, red blood cell casts and azotemia correlated with widespread glomerular infiltration with the fungus. The five infected patients died of their infection, whereas the 2 possibly infected patients who died succumbed to their underlying illness. Trichosporonemia may have been averted in possibly infected patients because of a shorter median duration of profound (less than 100/microliter) neutropenia (5 days) when compared to that of infected patients (20 days). No environmental source of Trichosporon was found in environmental surveillance cultures of food, air, or inanimate surfaces. In vitro studies of three pathogenic strains showed resistance to 5-fluorocytosine but susceptibility to amphotericin B, ketoconazole, and miconazole. Norfloxacin augmented the in vitro antifungal activity of amphotericin B. Trichosporon must be considered an opportunistic pathogen that can cause serious infections among patients with cancer. PMID- 3523116 TI - Metabolism and transport of dehydroascorbic acid in erythrocytes of "spontaneous diabetic BB/W" Wistar rats. AB - Rates of uptake and reduction of dehydroascorbic acid in erythrocytes of "Spontaneous diabetic BB/W" and control Wistar rats were determined. Lysed cells reduced 14C-dehydroascorbic acid more rapidly than intact cells did, suggesting that membrane transport is a rate-limiting step. Diabetic rats had lower plasma levels of ascorbic acid but more rapid reduction of dehydroascorbic acid than control animals. The results indicate more rapid transport of dehydroascorbic acid into erythrocytes of prediabetic "BB/W" rats than Wistar rats. PMID- 3523117 TI - Symptomatic reactive hypoglycemia during glucose tolerance test in lithium treated patients. AB - Glucose, insulin, glucagon, and cortisol responses during a five-hour oral glucose tolerance test (GTT) were evaluated in nine patients with bipolar affective disorders who were receiving lithium treatment and in seven control patients with bipolar affective disorders who were not receiving any treatment. Both the lithium-treated and the control patients were in stable mood at the time of GTT. During GTT mean nadir serum glucose of 48 +/- 2 mg/dL in the lithium treated patients was significantly lower (P less than 0.001) than mean nadir serum glucose of 62 +/- 2 mg/dL observed in the control subjects. Seven of these nine lithium-treated patients, but none of the control patients, experienced hypoglycemic symptoms coinciding with low serum glucose concentration. In response to hypoglycemia, mean serum cortisol significantly rose (P less than 0.01) to 22 +/- 3 micrograms/dL in the lithium-treated patients, whereas mean serum cortisol levels gradually declined to 10 +/- 2 micrograms/dL in the control patients at 300 minutes. Despite symptomatic postglucose hypoglycemia, plasma glucagon levels in the lithium-treated patients were similar to those observed in the control patients. These findings suggest that chronic lithium treatment is associated with a symptomatic and biochemical hypoglycemia during GTT, which is characterized by a rise in serum cortisol but by lack of appropriate rise in plasma glucagon concentrations. PMID- 3523118 TI - Effect of impaired glucose tolerance and type II diabetes on resting metabolic rate and thermic response to a glucose meal in obese women. AB - We examined the hypothesis that patients with impaired glucose tolerance or type II diabetes mellitus have reduced glucose-induced thermogenesis and that this perpetuates obesity in them by reducing energy expenditure. The thermic response after a 75-g glucose meal for 150 minutes was significantly lower in five obese women with diabetes (7.18 +/- 1.8 kcal) and five other obese women with impaired glucose tolerance (6.4 +/- 0.8 kcal) than in five obese women with normal glucose tolerance (16.7 +/- 2.4 kcal) and five lean healthy control subjects (14.0 +/- 2.2 kcal, P less than 0.05). However, obese women with diabetes or impaired glucose tolerance had a significantly higher resting metabolic rate (RMR) (307.0 +/- 9.7 mL O2/min) than predicted for them on the basis of their age, body weight, and total body potassium (274.8 +/- 8.0 mL O2/min, p less than 0.01). The predicted RMR in obese women with normal glucose tolerance test (GTT) (286.0 +/- 5.0 mL O2/min) was not different from their observed RMR (272.0 +/- 6.0). Thus the total energy expenditure during the meal of obese women with diabetes (254 +/ 32 kcal/150 min) and obese women with impaired glucose tolerance (221 +/- 5 kcal/150 min) was higher than that of obese women with normal glucose tolerance (201 +/- 9 kcal/150 min). All three obese groups had a higher total energy expenditure than the lean group (158 +/- 4 kcal/150 min, P less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3523119 TI - Effect of insulin antibodies and their kinetic characteristics on plasma free insulin dynamics in patients with diabetes mellitus. AB - To determine the influence of insulin antibodies (and their equilibrium kinetic properties) on the pharmacokinetics of insulin, we examined the relationship between insulin antibody binding and the initial rate of increase, time to peak, and return to baseline of therapeutic doses of insulin injected subcutaneously (0.15 U/kg) and the half-life, distribution space, and metabolic clearance rate of intravenously infused insulin (2 mU/kg/min) in insulin-treated patients with diabetes mellitus. Compared to age-weight-matched nondiabetic subjects, the diabetic subjects had reduced initial rates of increase (0.33 +/- 0.2 v 0.44 +/- 0.03 microU/mL/min, P less than 0.05), delayed time to peak (130 +/- 12 v 86 +/- 8 min, p less than 0.02), and prolonged return to baseline (485 +/- 37 v 313 +/- 13 min, P less than 0.01) of plasma free insulin levels after subcutaneous injection of insulin, and a prolonged half-life (19.8 +/- 5.8 v 4.3 +/- 0.3 min, P less than 0.02), increased distribution space (904 +/- 284 v 109 +/- 10 mL/kg, P less than 0.001), and augmented metabolic clearance rate (28.5 +/- 1.8 v 17.3 +/- 0.7 mL/kg/min, P less than 0.001) after intravenously infused insulin. All of these abnormal parameters were significantly correlated with binding of insulin to insulin antibodies at tracer insulin concentrations (Bo) and with the high affinity of insulin antibody binding sites as determined by Scatchard analysis. However, patients with 125I insulin antibody binding (Bo) less than 10 percent had normal or near normal plasma free insulin pharmacokinetics.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3523120 TI - Effect of epinephrine infusion and adrenergic blockade on glucose oxidation in conscious dogs. AB - The effect of combined alpha- and beta-adrenergic blockade, and the effect of epinephrine infusion, on the rate of glucose oxidation has been tested in conscious dogs. The dogs were prepared seven to ten days before the experiment with chronic catheters and tracheostomy. Glucose oxidation was measured by means of the primed-constant infusion of U-14C-glucose and indirect calorimetry. Six experimental groups were tested. In all groups, insulin and glucagon concentrations were held constant throughout by the inhibition of their secretion with somatostatin and intraportal replacement at basal rates. All experiments consisted of two two-hour periods. In half of the experiments, combined alpha- and beta-adrenergic blockade was administered in the second period, and in the other experiments, epinephrine was infused in the second period. The adrenergic blockade or epinephrine infusion (E) was performed in three different groups. In one, free fatty acid (FFA) levels were allowed to change spontaneously in response to blockade or E; in a second group, liposyn and heparin were infused throughout periods 1 and 2 in order to maintain FFA levels at high, constant levels; and in a third group, FFA levels were maintained at a constant low level in periods 1 and 2 by means of an infusion of nicotinic acid. In all cases tested, epinephrine infusion caused an increase in the rate of glucose oxidation. Adrenergic blockade also caused an increase in glucose oxidation when FFA levels were allowed to spontaneously fall; but when FFA levels were held constant (either high or low), there was no effect on glucose oxidation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3523121 TI - Immunochemical techniques. Part I: Hybridoma technology and monoclonal antibodies. PMID- 3523122 TI - Production and characterization of bovine immunoglobulins from bovine X murine hybridomas. PMID- 3523123 TI - Serum-free medium for hybridoma and parental myeloma cell cultivation. PMID- 3523125 TI - A rapid technique using radiolabeled soluble antigen to screen hybridoma culture supernatants. PMID- 3523124 TI - Semiautomated plaque method for the detection of antibody-forming cell clones. PMID- 3523126 TI - The dot immunobinding assay. PMID- 3523127 TI - Detection of antibody-secreting hybridomas with diazobenzyloxymethyl paper. PMID- 3523129 TI - Slide immunoenzymatic assay (SIA) in hybridoma technology. PMID- 3523128 TI - The use of alkaline phosphatase-conjugated anti-immunoglobulin with immunoblots for determining the specificity of monoclonal antibodies to protein mixtures. PMID- 3523130 TI - Use of mouse and human monoclonal antibodies in enzyme immunofiltration. PMID- 3523131 TI - Measurement of monoclonal immunoglobulin concentrations in hybridoma cultures by competitive inhibition enzyme immunoassay. PMID- 3523132 TI - Immunohistochemical techniques using monoclonal antibodies. PMID- 3523133 TI - Method for rapid detection of membrane antigens by immunofluorescence and its application to screening monoclonal antibodies. PMID- 3523134 TI - The use of rat monoclonal antibodies to characterize, quantify, and purify polyclonal or monoclonal mouse IgM. PMID- 3523135 TI - Tritium radiolabeling of antibodies to high specific activity with N-succinimidyl [2,3-3H]propionate: use in detecting and analyzing monoclonal antibodies. PMID- 3523136 TI - Determination of the true immunoreactive fraction of monoclonal antibodies after radiolabeling. PMID- 3523137 TI - Immunoaffinity isolation of membrane antigens with biotinylated monoclonal antibodies and streptavidin-agarose. PMID- 3523138 TI - Cytotoxicity assays based on the use of antibody secretion as a measure of hybridoma viability. PMID- 3523139 TI - Screening for monoclonal antibodies to human cellular and soluble antigens. PMID- 3523140 TI - Stepwise amplified immunoenzyme staining techniques for the detection of monoclonal antibodies and antigens. PMID- 3523141 TI - Introduction to the plasma lipoproteins. PMID- 3523142 TI - Molecular and cell biology of lipoprotein biosynthesis. PMID- 3523143 TI - Comparative analysis of mammalian plasma lipoproteins. PMID- 3523144 TI - Characterization of apolipoprotein B-containing lipoproteins. PMID- 3523145 TI - Methods for visualization of the LDL pathway in cultured human fibroblasts. AB - A number of different light and electron microscopic probes have been developed for visualizing the LDL pathway. These probes give a consistent picture of the endocytic process and allow the identification of various cellular organelles through which ligand traffics on the way to the lysosome. Moreover, the pathway, with some variation, appears to be the same for other ligands that are taken up by receptor-mediated endocytosis. These methodologies have been the foundation for studying such issues as the role of coated pits in endocytosis, the route of receptor recycling during endocytosis, and the role of coated pits in clustering of receptors on the cell surface. These reagents should prove useful in future studies to understand better the cell biology of receptor-mediated endocytosis. PMID- 3523146 TI - Detection of animal cell LDL mutants by replica plating. PMID- 3523147 TI - Immunochemical measurement of apolipoprotein synthesis in cell and organ culture. PMID- 3523148 TI - Lipoprotein synthesis and secretion by cultured hepatocytes. PMID- 3523150 TI - Plasma lipoprotein conversions. PMID- 3523149 TI - Morphological localization of apolipoproteins and their mRNA by immunocytochemistry and in situ nucleic acid hybridization. PMID- 3523151 TI - Kinetic analysis using specific radioactivity data. PMID- 3523153 TI - Metabolism of apolipoprotein C. PMID- 3523152 TI - Metabolism of the apolipoprotein B-containing lipoproteins. AB - This chapter was designed to describe the approaches one can take to study the metabolism of the apoB-containing particles in vivo. The focus has been to blend (1) what is the current tracer kinetics analysis methodology and (2) what are the current experimental protocols being used into a total picture so that the experimentalist wishing to perform such studies may have a better perspective of the strong points and pitfalls of this important experimental tool. Hence, these points have been summarized from the point of view of what caveats are associated with each methodology. Recognition of these is essential to avoid reaching potentially erroneous conclusions. More important, attention has been focused on the realization that certain methodologies can be chosen depending upon what questions are being asked. Finally, areas where future development is needed in order to proceed to the next level of understanding are pointed out in the context of using tracer kinetic analysis as an integral part of a total experimental design. PMID- 3523154 TI - Separation and analysis of lipoproteins by gel filtration. PMID- 3523155 TI - Direct determination of apolipoprotein C-III specific activity using immunoaffinity chromatography. PMID- 3523156 TI - In vivo metabolism of apolipoprotein E in humans. AB - A method for the investigation of the in vivo metabolism of apoE in humans has been described. In this method, isolated apoE is radioiodinated by the iodine monochloride method and reassociated with lipoproteins. Detailed studies have established that the radiolabeled apoE prepared by this procedure uniformly labels the different plasma lipoprotein pools. The study subjects are studied in steady state on a dietary regimen with multiple feedings. The kinetic results are analyzed by either multiexponential curve fitting or by computer-assisted multicompartmental modeling techniques. Examples of the types of results that may be obtained utilizing these methods are described. PMID- 3523157 TI - Phosphorylation-dephosphorylation of apolipoprotein B. PMID- 3523158 TI - Receptor-independent low-density lipoprotein catabolism. AB - Cultured cells, animal models, and man all possess mechanisms for LDL degradation that do not require the agency of the high-affinity receptor. In healthy individuals their functional significance can be determined using LDL which has been modified by specific chemical reactions designed to inhibit it receptor binding. Although the precise nature of the pathways has not been defined, there is evidence to implicate the monocyte-macrophage system in the process. PMID- 3523159 TI - Role of the liver in lipoprotein catabolism. PMID- 3523160 TI - Reverse cholesterol transport. PMID- 3523161 TI - Preparation, characterization, and measurement of lipoprotein lipase. PMID- 3523162 TI - Assays of the in vitro metabolism of very-low-density lipoproteins in whole plasma by purified lipoprotein lipase. PMID- 3523163 TI - Mechanism of action of lipoprotein lipase. PMID- 3523164 TI - Lysolecithin acyltransferase of human plasma: assay and characterization of enzyme activity. PMID- 3523165 TI - Hemagglutination induced by lipopolysaccharides and lipid A. PMID- 3523166 TI - Protective efficacy against group B streptococcal infection in neonatal mice delivered from preimmunized pregnants. AB - Neonatal mice delivered from mothers preimmunized with heated or formalinized whole cell vaccines of type Ia, Ia/c and III/c group B streptococci were infected with each type of bacteria, and then serum antibodies of mothers and neonates who survived the experiments were measured by enzyme-linked immunosorbent assay. The relationship between the protectivity in neonate mice and the antibody titers to the type specific polysaccharide antigens and the protein c antigen of their sera were examined. In the Ia-immunized group which showed high protection against the type Ia infection, anti-Ia IgG antibody titers were low, and anti-protein c IgG antibody was not detected. Type Ia/c and III/c vaccines were highly effective against both type Ia/c and III/c infection, but less effective in type Ia infection. The protein c antigen was identified in both type strains by the double diffusion assay, and the IgG antibodies to the protein c were significantly high in sera of both maternal mice immunized with types Ia/c or III/c organisms and their newborn infants. High titers of the protein c IgG antibody retained 3 to 4 weeks after the last injection of vaccines which corresponded to the period of pregnancy and lactation. Small amounts of IgM antibody to all antigens were detected only in maternal sera. These results suggest that IgG antibodies to the protein c antigen and to the type-specific polysaccharide antigens are equally important protective factors which are transferable from preimmunized mothers to their newborn infants through placenta and/or lactation. PMID- 3523167 TI - [Fibrinolytic activity of Bacillus mesentericus strains]. AB - Two Bacillus mesentericus strains with a high activity of proteolytic enzymes having the thrombolytic action were selected from a group of its collection strains. The effect of different carbon sources on the synthesis of proteases was studied. A growth medium containing potato broth (10%), peptone (0.5%) and lactose (0.5%) allowed one to obtain a cultural broth dissolving human blood clots within 2.5 to 3 hours in experiments in vitro. PMID- 3523168 TI - [Acinetobacter calcoaceticus strain with a wide spectrum of utilizing aromatic compounds and carrying a plasmid for resorcin degradation]. AB - A bacterial strain was isolated from soil and identified as Acinetobacter calcoaceticus var. lwoffii. The strain can utilize a wide spectrum of aromatic compounds. It carries a transmissive plasmid pBSW13 which determines resorcin utilization via the ortho pathway including the following steps: resorcin hydroxyhydroquinone-maleylacetate-beta-ketoadipi c acid. The plasmid has been transferred by conjugation into the recipient strains of A. calcoaceticus 5734 CCM rifr, Escherichia coli J-53 met-pro-rifr and Klebsiella sp. Plasmid DNA with a molecular mass close to that of phage gamma was detected by electrophoresis in the donor and recombinant strains. The degradation of other substrates is not a phenotypic expression of the genes of this plasmid. PMID- 3523169 TI - [Effect of osmotic shock on the viability, optical density and permeability of heated Escherichia coli cells]. AB - The object of this work was to study the effect of a short incubation in 0.01 M tris buffer, pH 7.0, with a different NaCl content (0-10%) on the viability, optic density and permeability of intact and heated at 52 degrees C Escherichia coli B/r cells. In contrast to the intact cells, the viability of the heated cells depended on osmotic pressure in the medium into which they were transferred after heating. The survival rate was highest when the cells were transferred into an isotonic buffer. In the case of hypotonic and hypertonic media, the survival rate of the cells decreased owing to the death of cells which were responsible for the formation of small colonies under the isotonic conditions. This was accompanied with a more intensive drop in the optic density of bacterial suspensions while their permeability increased (when the cells were transferred into the hypotonic conditions). The role of membranes in the processes of bacterial heat inactivation is discussed on the basis of the results obtained. PMID- 3523170 TI - [Subordination of the taxa of gram-negative bacteria determined by numerical analysis methods]. AB - Various numerical methods were used to estimate the coordination of taxa of gram negative aerobic and facultative anaerobic organoheterotrophic and chemolithotrophic bacteria. Stable phena were found to be formed by cultures belonging to the families Rhizobiaceae, Halobacteriaceae, Enterobacteriaceae, Nitrobacteriaceae (except the genus Nitrobacter), and Methylomonadaceae (except the genus Methylococcus). The unstable position was found in the genera Thermus, Zoogloea, Xanthomonas, Sulfolobus, Methylococcus, Alcaligenes, Brucella, and Acetobacter. The greatest scatter among the objects being analysed was detected among genera belonging to the family Pseudomonadaceae. The taxonomic position of these genera must be defined more precisely. The family Methylomonadaceae is related to such physiologically unique groups of microorganisms as nitrifying, sulfate-reducing, extreme thermophilic and halophilic forms. All in all, the data reported in this work show that numerical analysis can be used to specify the classification structure of bacteria. In a number of cases, the results are consistent with those changes which are performed in the Bergey Manual 9 using logical analysis (for instance, concerning the position of the genera Gluconobacter, Acetobacter, Beijerinckia, and Derxia). PMID- 3523171 TI - [Aminoglygoside nephrotoxicity]. AB - Aminoglycoside nephrotoxicity is a big problem to all physicians and patients. In this review, prevention of nephrotoxicity, monitoring of the aminoglycoside therapy and also clinical laboratory findings during therapy are discussed. PMID- 3523172 TI - [Malaria vaccine research]. AB - In 1976 "The Immunology of Malaria Scientific Working Group" was established. The target of the organization was to study especially P. falciparum and other malaria strains antigens and then prepare a suitable vaccine against them. They carried out many experiments until the end of 1985, when they made the remarkable discovery by isolating the P. falciparum sporozoite surface antigen and named it "the Circumsporozoite" (CS) protein. Therefore they are hopeful to prepare a sporozoite vaccine in the very near future. PMID- 3523173 TI - Computerizing clinical patient problems: an evolving tool for medical education. AB - A natural language, free enquiry patient simulation of high fidelity has been developed using low cost microcomputer technology. The simulation is flexible, portable, responsive to individual student needs, and does not require computer literacy. The design is based on the principles of problem-based self-directed learning. The simulation is useful in individual and group learning and evaluation of data management and clinical reasoning skills. PMID- 3523174 TI - The anaemia of chronic renal failure: a potentially treatable catabolic phenomenon? AB - It is proposed that the anaemia of chronic renal failure and the apparent lack of erythropoietin response is a result of increased proteolytic and lysosomal enzyme action on both the red cell and erythropoietin itself. Removal of the sialic acid from the red cell membrane is known to cause sequestration and a shortened cell survival. Similarly removal of sialic acid from the carbohydrate coat of erythropoietin both increases clearance by the liver and renders it susceptible to cleavage into inactive fragments by proteolytic attack. If the hypothesis is correct therapeutic intervention using enzyme inhibitors may offer hope for the amelioration of the anaemia. PMID- 3523175 TI - The effective mass concept: theoretical and quantitative analysis of the forbidden indicator phenomenon. AB - This paper describes the concept of effective mass, which provides a quantitative explanation for the forbidden indicator phenomenon. The forbidden indicator phenomenon pertains to the problems encountered when the concentration of an indicator used to measure volume or flow by the indicator-dilution technique approaches the concentration of the solution to which it is to be added. This phenomenon is of particular concern when applying the saline-dilution method with hypertonic saline, to measurement of cardiac output. Clinically, one would like to give as little additional salt to a patient as possible while maintaining a signal-to-noise ratio adequate to give reliable results. This paper develops an equation that permits accurate calculation of volume or flow by the indicator dilution method, even when indicator solutions with concentrations approaching that of the original solution are used (i.e., the forbidden indicator). The validity of this equation is demonstrated experimentally using the saline dilution method to measure flow in a hydraulic model of the circulation. PMID- 3523177 TI - The management of alcohol withdrawal. AB - Alcohol withdrawal is a common condition which often complicates intercurrent illness. Its severity and course are determined largely by the setting in which it occurs. This article discusses the history, pathophysiology, pathogenesis and principles of the treatment of alcohol withdrawal. The importance of environment and basic nursing care are stressed and the use of drugs is discussed. A withdrawal assessment scale is also included. PMID- 3523176 TI - Chemoprophylaxis of malaria. PMID- 3523178 TI - Intrahepatic cholestasis associated with an enlarged gall-bladder. AB - A 60-year-old man with a history of ingesting herbal medication and a 59-year-old woman with malignant lymphoma presented with painless jaundice and palpably enlarged gall-bladders. Abdominal ultrasonography confirmed that the gall bladders were enlarged, but showed normal-sized biliary trees with no stones. The final diagnoses for these patients were drug-induced hepatitis with intrahepatic cholestasis and lymphomatous infiltration of the liver, respectively. A palpable gall bladder in cholestatic jaundice may not always be caused by extrahepatic biliary obstruction, and ultrasonography is very useful in ruling this out. PMID- 3523179 TI - Australian doctors and the visual arts. Part 4. Doctors as supporters of art galleries and artists in Victoria. AB - The contribution of doctors to the visual arts is being discussed in a series of six articles. Doctor-artists in New South Wales and Victoria, and doctors as collectors, donors, gallery supporters and writers in New South Wales, have been discussed in earlier articles. This, the fourth article, deals with doctors as supporters of art galleries and artists in Victoria. PMID- 3523180 TI - Mexiletine for arrhythmias. PMID- 3523181 TI - Butoconazole for vulvovaginal candidiasis. PMID- 3523182 TI - Cefotetan disodium (Cefotan). PMID- 3523183 TI - Use of monoclonal antibody for the detection of Lassa virus antibody and antigen in patients with Lassa fever. PMID- 3523185 TI - Expression of Lassa virus nucleocapsid gene fragments in bacteria. PMID- 3523184 TI - Studies on immunity to lymphocytic choriomeningitis virus. PMID- 3523186 TI - [Histologic picture of herpetic keratitis in material obtained in keratoplasty]. PMID- 3523188 TI - A molecular view of fatty acid catabolism in Escherichia coli. PMID- 3523191 TI - Adaptation to chronic potassium loading in normal man. AB - To analyze factors involved in the maintenance of potassium balance during increased intake, 6 healthy males were studied on a normal (80 mEq) and high (300 mEq) potassium diet. After 18 days of potassium-rich diet, urinary potassium excretion had increased from 50 +/- 12 to 233 +/- 45 mEq/day. Plasma renin activity and body weight were unchanged, serum potassium and plasma aldosterone somewhat increased, and the ratio of plasma aldosterone to renin activity consistently elevated. Acetazolamide injection (1 g i.v.) increased sodium and potassium excretion rates equally on the two diets indicating that a sudden increase in distal solute delivery was not handled differently after potassium loading. The reaction to a high dose of aldosterone (1 mg i.v. followed by 0.5 mg/h infusion) in terms of sodium retention and potassium excretion was also comparable, indicating no altered sensitivity to aldosterone after adaptation to the potassium-rich diet. By contrast, the aldosterone antagonist canrenoate (100 mg i.v.) acutely raised NaCl excretion without changing the potassium excretion during the high potassium diet, but did not affect NaCl excretion during the normal diet. Subsequent oral administration of spironolactone for 5 days (200 mg daily) caused a more negative sodium balance associated with more weight loss and rise in renin activity during the potassium rich diet. Surprisingly we noticed no fall in renal potassium excretion in this period, but mean serum potassium was raised by 0.3-0.4 mEq/l at the end. These results suggest that adaptation of a healthy subject to a potassium-rich diet does not involve intrinsic changes of the distal tubule, but a shift of sodium reabsorption from a proximal to a distal (aldosterone-sensitive) nephron level.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3523192 TI - [Efficacy of the clonidine test in the evaluation of growth hormone secretion in childhood and comparison with the insulin test]. PMID- 3523193 TI - Short history of plaster-of-Paris cast immobilization. PMID- 3523194 TI - New technologies, old lessons--what programmed learning can teach us. PMID- 3523187 TI - Heteroduplex deoxyribonucleic acid base mismatch repair in bacteria. PMID- 3523190 TI - Models of cell differentiation in conidial fungi. PMID- 3523195 TI - Integrating computers into the curriculum: a development project. PMID- 3523189 TI - Signal exchange in plant-microbe interactions. PMID- 3523196 TI - Clinical teaching: an historical perspective. PMID- 3523197 TI - Chronic meningitis. PMID- 3523198 TI - Conventional and molecular techniques for the laboratory diagnosis of infections of the central nervous system. AB - This article discusses general principles of laboratory diagnosis, detection of microbial antigens, specific chemical reactants associated with inflammation of the CNS, and diagnostic tests in development for the laboratory diagnosis of infectious meningitis. PMID- 3523199 TI - CNS tuberculosis. AB - Tuberculous meningitis is a rare, treatable neurologic disorder, in which early recognition is paramount because outcome depends greatly on the speed with which therapy is initiated. Patients with meningitis and CSF findings of low glucose, elevated protein and pleocytosis with evidence of tuberculosis elsewhere in the body (chest radiographs, positive tuberculin skin test), or a history of exposure to tuberculosis should be treated immediately with antituberculous medication. When the diagnosis remains uncertain, serial examination of the CSF for tuberculous organisms will often yield positive results. The CT scan may show hydrocephalus, a basilar arachnoiditis, or intraparenchymal lesions: tuberculomas. Hydrocephalus may respond to early shunting. Tuberculomas are best treated medically. Therapy should include INH and rifampin; ethambutol and pyrazinamide are suggested for the first 2 months of therapy. Steroids may be useful in diminishing the inflammatory response when altered consciousness or focal neurologic signs are present. PMID- 3523200 TI - Fungal infections of the CNS. AB - Most CNS fungal infections can be divided into those that occur in normal hosts and those that occur in the immunosuppressed host. Cryptococcal infection, however, is common in both groups. The usual clinical presentation of a CNS fungal infection is chronic headache and mental status change. The CSF shows a lymphocytic meningitis with low sugar and high protein. Amphotericin B remains the drug of choice for most CNS fungal infections. PMID- 3523201 TI - Parasitic infections of the central nervous system. AB - The authors give a comprehensive review of the epidemiology, clinical presentations, diagnosis and current therapy of parasitic infections with CNS manifestations in both the normal and immunocompromised host. These include toxoplasmosis, malaria, amebiasis, neurocystcersosis, hydatid disease, and trichinosis. Additional sections cover disseminated strongyloidiasis, eosinophilic meningitis, visceral and ocular larva migrans, schistosomiasis, and cerebral paragonimiasis. Emphasis is on the neurologic complications of these diseases and their presentations in populations at increased risk for acquiring or reactivating these infections. PMID- 3523202 TI - Disorders that mimic CNS infections. AB - A variety of inflammatory and neoplastic disorders can cause signs, symptoms, and laboratory abnormalities suggesting CNS infection. The distinction usually can be made through careful consideration of the entire clinical picture and the judicious use of additional laboratory tests. PMID- 3523203 TI - Experimental models of CNS infections. Contributions to concepts of disease and treatment. AB - Lessons learned from studies of experimental meningitis and brain abscess in animal models of infection represent major, highly significant contributions to our understanding of the pathogenesis and antimicrobial chemotherapy of these infections. For example, studies of experimental meningitis in rabbits demonstrated that the subarachnoid space is deficient in local host defenses, a finding that explains why only bactericidal antibiotic regimens are effective in treating this disease; studies of the efficacy of corticosteroids as adjunctive therapy for meningitis yielded data indicating that both beneficial and detrimental effects on the host are imparted by these compounds. These and a number of other key investigations of experimental meningitis and brain abscess, the results of these investigations, and the clinical significance of these results are presented in this article. PMID- 3523205 TI - Bacterial infections of the central nervous system in neurosurgery. AB - CNS infections following clean neurosurgery are uncommon but occur with increased frequency following neurotrauma and placement of CSF shunts and ventriculostomies. When faced with the possibility of meningitis or brain abscess in these settings, the clinician must aggressively seek definitive diagnostic information by means of CT scanning and cell counts, Gram stain, and culture of the CSF. Appropriate empiric therapy should then be administered promptly to achieve cidal activity in the CSF against the most likely infecting pathogens. Prophylaxis for clean neurosurgery and for placement of CSF shunts has been advocated by several investigators. However, regimens are many, and data are few and conflicting. When given, prophylaxis should be administered only during the intraoperative period. There is, at best, a weak scientific basis for what remains a widespread practice. PMID- 3523204 TI - CNS diseases associated with varicella zoster virus and herpes simplex virus infection. Pathogenesis and current therapy. AB - In recent years, herpes simplex virus has been recognized as an important CNS pathogen in neonates and adults. The recent development of effective antiviral therapy has substantially reduced the excessive morbidity and mortality associated with these infections. For neonatal herpes simplex infections, the current drug of choice is vidarabine. The results of ongoing clinical trials comparing vidarabine with acyclovir in neonatal herpes may lead to a change in the recommended therapy. In the adult, the therapy of choice for herpes simplex encephalitis is acyclovir. Although effective, the present therapies for herpes simplex infections of the CNS leave much room for improvement. In addition to the development of more effective antiviral drugs and less invasive diagnostic techniques, prevention of these often devastating infections will be important in reducing morbidity and mortality. The CNS diseases associated with varicella and herpes zoster may have a different pathogenesis. The implication for therapy in these diseases favors nonspecific supportive therapy in the varicella-associated syndromes. The few anecdotal reports of the use of vidarabine and acyclovir in herpes zoster encephalitis and the histopathologic evidence suggesting viral invasion of the CNS in many cases of zoster-associated neurologic syndromes makes the use of specific antiviral therapy in zoster encephalomyelitis more rational. However, appropriate therapeutic recommendations will have to be based on controlled clinical trials that have not yet been performed. PMID- 3523206 TI - Glass ionomer cements (a review). PMID- 3523207 TI - An overview of tooth-colored restoration. PMID- 3523208 TI - On the multiplicity of the enzyme catalase in mammalian liver. AB - The literature on the complex multiplicity of mammalian catalase and the nature of the epigenetic modifications undergone by this enzyme has been reviewed, along with relevant comment on the subcellular localization and biological role of the enzyme. The epigenetic causations of multiplicity are established as being multifactorial and include oxidoreductive conversions of sulphydryl groups, the covalent attachment of carbohydrate, and partial proteolysis of the enzyme. Each of these epigenetic transformations may give rise to sets of multiple forms, and overlaps between these separate sets may give rise to extremely complex multiplicity patterns. It is concluded that any interpretation of catalase multiplicity which places emphasis on a single epigenetic causation is not compatible with the scope and variety of the available data on this enzyme. Instead, a holistic approach is urged - one giving due emphasis to the multiple causation of catalase multiplicity, and the interrelationships of these causations in the cellular situation. Rather than viewing the multiplicity of this enzyme as merely a series of interesting chemical modifications, emphasis is directed towards the fact that catalase heterogeneity provides a sensitive indication of the functional variations which occur within separate compartments of the subcellular structure, and hence becomes an essential element in any satisfactory understanding of the role of this enzyme in cellular processes. PMID- 3523209 TI - Studies on the biological activity of an insulin-stimulating peptide from a tryptic digest of bovine serum albumin. AB - A two-chain polypeptide, which corresponds to amino acid residues 115-143 and 144 184(185) of bovine serum albumin, connected to each other by a disulfide bridge, potentiated the effects of insulin on glucose transport and glucose metabolism in isolated rat adipocytes. Although the peptide alone had little activity, it shifted the concentration-response curves of insulin-stimulated D-[1-14C]glucose oxidation, 2-deoxyglucose transport, and lipid synthesis from D-[U-14C]glucose to lower insulin concentrations. It also increased the maximal responses of these parameters to insulin. However, it did not affect insulin binding to adipocytes. The peptide protected insulin considerably from degradation, but this effect alone cannot account for its effect in increasing the maximal responses to the hormone, and even when degradation of a submaximal concentration of insulin was suppressed by bacitracin, the peptide still had an enhancing effect. These results suggest not only that the peptide influences a step distal to receptor mediated insulin binding but also that inhibition of insulin degradation alone cannot explain its total effect. The peptide lost its insulin-stimulating activity completely when it was further digested with V8 or lysine-specific endopeptidase, or when it was reduced and then carboxamidomethylated or oxidized with performic acid. Similar active tryptic fragments were obtained from human and rat albumins. Insulin-stimulating peptides should be useful in studies on the mechanisms of insulin action including both the sensitivities and responsiveness of target cells to the hormone. PMID- 3523210 TI - Regulation of liver and brain hexose monophosphate dehydrogenases by insulin and dietary intake in the female rat. AB - Liver glucose 6-phosphate dehydrogenase and phosphogluconate dehydrogenase activities were significantly decreased in both diabetic and fasted rats. Treatment of diabetic rats with insulin resulted in liver glucose 6-phosphate dehydrogenase and phosphogluconate dehydrogenase activities that were significantly greater than controls. Insulin promoted an increase in food consumption that was blocked by adrenaline. Insulin, when administered together with adrenaline, restored hepatic glucose 6-phosphate dehydrogenase and phosphogluconate dehydrogenase activities of diabetic animals to control values, without altering food consumption. Brain glucose 6-phosphate dehydrogenase and phosphogluconate dehydrogenase activities were not significantly altered by either dietary restriction, diabetes or insulin treatment. These results demonstrate a dissociation between the action of insulin on hepatic glucose 6 phosphate dehydrogenase activity and its action to increase food intake. PMID- 3523211 TI - Purification and properties of dipeptidase from Escherichia coli AJ005. AB - A Co2+-dependent dipeptidase from E. coli strain AJ005, a peptidase-deficient mutant, was purified with streptomycin sulfate, ammonium sulfate and DEAE cellulose. The purified dipeptidase increased by about 106-fold in specific activity, with dilysine as a substrate. The dipeptidase cleaved dilysine to two lysines among the lysine homopolymers, the possibility remaining that it is active toward peptides other than dilysine, since it was investigated in the present study only for activity toward lysine homopolymers. Activity was inhibited 54% by 10(-3) M KCN and completely by 10(-3) M PCMB, EDTA and benzethonium chloride, but not at all by soybean trypsin inhibitors. 78% and 95% of its activity was lost with 30 minutes' treatment at 45 degrees C and 50 degrees C, respectively. The apparent Km value was 6.7 X 10(-4) M for dilysine. It is probable that the dipeptidase differs from dipeptidase DP. PMID- 3523212 TI - The cell and molecular biology of fish oogenesis. PMID- 3523213 TI - [Differential diagnostic and therapeutic problems in a neuroblastoma patient with hypertension]. AB - A 2 1/2 year old dystrophic girl with polyuria and polydipsia was found to have an arterial hypertension, increased catecholamines in serum and urine, and a suprarenal tumour was diagnosed by ultrasonic scan. By means of histology and staging a neuroblastoma grade 3 was revealed. The sonography and Iodine-benzyl guadinin-scintigraphy gave the clearest information about the tumour. Before operating it is necessary to stabilize the blood pressure at a normal level with alpha and beta blocking substances, in order to reduce the risk of an intraoperative hypertonic crisis and a vasodilative shock after tumour extirpation. PMID- 3523214 TI - Health implications of smokeless tobacco use. PMID- 3523215 TI - [Mechanical analysis of design parameters of bonded bridges. 1. Effect of metal frame thickness and shape on peeling loads]. PMID- 3523216 TI - [Fundamental studies on all-ceramic crowns. 1. Fit of all-ceramic crowns]. PMID- 3523218 TI - [New porcelains furnace using an infra-red ray heating element. 1. Shear bond testing and surface roughness of dental porcelains]. PMID- 3523217 TI - [Autopolymerized resins containing 4-META for prosthetic use. 2. Adhesive strength and physical properties of experimentally produced MB-3 and MB-4]. PMID- 3523219 TI - [Fundamental studies of impression methods. 3. Seating speed and holding pressure of impression trays]. PMID- 3523220 TI - [The effect of the shape of the wing portions of an anterior acid-etched fixed partial denture on the bond strength to abutment teeth]. PMID- 3523221 TI - Upper gastrointestinal endoscopy: update 1986. PMID- 3523223 TI - Mutagenesis by normal metabolites in Escherichia coli: phenylalanine mutagenesis is dependent on error-prone DNA repair. AB - In search of a model for the production of 'spontaneous' mutations induced by DNA damage produced during normal metabolism, 19 amino acids were tested for mutagenicity in Escherichia coli K-12 uvrB. Cystine, and, to a lesser extent, arginine and threonine were found to be antimutagenic; only phenylalanine was found to be mutagenic. At 2 mM, phenylalanine induced mutants at 1.5-2-fold above background [lacZ53(amber)----Lac+, rifampicin resistance (missense), and bacteriophage T6 resistance]. Tyrosine and, to a lesser extent, tryptophan (each at 2 mM) inhibited the mutagenicity of phenylalanine. Phenylalanine mutagenesis was detected in the uvrB strain, but not in the wild-type, uvrB umuC or uvrB lexA strains. Thus, phenylalanine seems to cause the production of excisable lesions ('UV-like'?) in DNA, which, if not excised, can induce mutations via error-prone DNA repair. PMID- 3523222 TI - Dichotomy in the mutagenicity and genotoxicity of nitropyrenes: apparent effect of the number of electrons involved in nitroreduction. PMID- 3523224 TI - Genetic analysis of DNA repair in Aspergillus: evidence for different types of MMS-sensitive hyperrec mutants. AB - To identify genes which affect DNA repair and possibly recombination in Aspergillus nidulans, mutants hypersensitive to methyl methanesulphonate (MMS) were induced with ultraviolet light (UV) or gamma-rays. About half of them contained associated translocations and many were hypersensitive to UV and/or defective in meiosis. Two are alleles of the known uvsB gene while most others define new genes. In addition, among available uvs mutants many were found to be MMS-sensitive. Some of the various uncharacterized ones were identified as alleles of known uvs, but 5 of them were mapped in 2 new genes, uvsH and uvsJ. To identify functional and epistatic groups, mutants from each uvs gene were tested for effects on recombination and mutation, and double mutant uvs strains were compared for UV survival to their component single mutant strains. 3 epistatic pairs were identified, (1) uvsF and H, (2) uvsB and D, and (3) uvsC and E. Conclusive interpair tests were difficult, because such double mutant combinations were frequently lethal or nearly so. The first pair, uvsF and H, shared some of the properties of excision-defective mutants, both uvs being very highly sensitive to UV for mutation as well as survival. But unlike such mutants, uvsH was also sensitive to gamma-rays and defective in meiosis. Both uvs showed normal levels of meiotic recombination, but greatly increased spontaneous mitotic crossing-over, being the most "hyperrec" types among all uvs. The second pair, uvsB and uvsC, which was similarly hyperrec showed only slight increases of UV induced mutation (less than 2-fold). As a main effect, these uvs caused very high frequencies of unbalanced, unstable segregants from diploid conidia (30 X), but few of these were recognizable aneuploids. The third pair, uvsC and E, which are known to be rec- for gene conversion, caused reduced mitotic crossing-over in diploids and increased levels of haploid segregants. These mutants are spontaneous mutators, but showed less UV-induced mutation than wild-type controls. PMID- 3523225 TI - 25 years of a unique chromosome-breakage system. I. Principal features and comparison to other systems. AB - The principal features of the D. robusta chromosome-breakage system are reviewed and compared to intrinsic chromosome-breakage systems in other Drosophila species, particularly the 'hybrid dysgenesis' systems of D. melanogaster. The data indicate that the D. robusta system is unique in many respects, especially in its combination of a reciprocal cross effect, traceable to its maternal or cytoplasmic inheritance, exclusive susceptibility of the paternal chromosomes, and the randomness of the breaks on the chromosomes. PMID- 3523226 TI - DNA-repair characterization of cdc40-1, a cell-cycle mutant of Saccharomyces cerevisiae. AB - The cell-cycle specific mutation cdc40-1, which has been previously shown to be sensitive to MMS at the restrictive temperature, was further characterized as a DNA-repair-deficient mutation. cdc40-1 mutants shown only slight sensitivity to UV irradiation. Double mutant studies shown that rad6-l is epistatic to cdc40-1 with respect to sensitivity to UV irradiation and MMS. rad50-1 is epistatic to cdc40-1 with respect to MMS sensitivity in G1 stationary cells, but not in logarithmic cultures. An additive effect is seen between cdc40-1 and rad50-1 with respect to UV irradiation. cdc40-1 mutants are defective in UV-induced mutagenesis at the restrictive temperature. UV-induced levels of recombination are normal at both temperatures, while MMS-induced recombination is enhanced at the restrictive temperature. PMID- 3523227 TI - Mechanism of inhibition of bacteriophage T7 DNA synthesis in Escherichia coli B cells infected by alkylated bacteriophage T7. AB - Quantitative analysis of DNA replication, in E. coli B cells infected by methyl methanesulfonate-treated bacteriophage T7, showed that production of phage DNA was delayed and decreased. The cause of the delay appeared to be a delay in host DNA breakdown, the process which provides nucleotides for phage-DNA synthesis. In addition, reutilisation of host-derived nucleotides was impaired. These observations can be accounted for by a model in which methyl groups on phage DNA slow down DNA injection and also reduce the replicational template activity of the DNA once it has entered the cell. Repair of alkylated phage DNA may be required not only for replication but also for normal injection of DNA. PMID- 3523228 TI - Repair of DNA double-strand breaks in UV-irradiated Escherichia coli uvrB recF cells is inhibited by rich growth medium. AB - Ultraviolet (UV)-irradiated uvrB recF and uvrB recB cells of Escherichia coli K 12 showed similar radiation sensitivities when plated on minimal growth medium (MM), however, the uvrB recF cells were much more UV radiation-sensitive than the uvrB recB cells when plated on rich growth medium. Sedimentation analysis of the DNA from UV-irradiated uvrB recF cells suggests that the rich medium killing of uvrB recF cells is due to the inhibition of the repair of UV-radiation-induced DNA double-strand breaks, i.e., the killing is due to the inhibition of the recB dependent pathway of postreplication repair. Furthermore, we demonstrated that the DNA double-strand breaks that were formed in UV-irradiated uvrB recA200(Ts) cells incubated at 42 degrees C in rich growth medium were not repaired whether the medium during subsequent repair incubation at 30 degrees C was MM or rich growth medium, while DNA double-strand breaks that were formed in MM at 42 degrees C could be repaired in MM or in rich growth medium at 30 degrees C. How the absence of an abrupt slowing of DNA synthesis when UV-irradiated cells are held in rich growth medium (Sharma and Smith, 1985b) may prevent the repair of these DNA double-strand breaks is discussed. PMID- 3523229 TI - Potassium chromate potentiates frameshift mutagenesis in E. coli and S. typhimurium. AB - Possible comutagenic effects of chromate on frameshift mutagenesis were studied in bacterial assays. In these experiments, cells were treated with potassium chromate and 9-aminoacridine either singly or in combination. Results were analyzed to detect synergistic, additive and antagonistic responses. Data from these investigations show a clear potentiation of 9-aminoacridine-induced mutagenesis in the presence of chromate in S. typhimurium strain TA1537. Results from cell viability assays shows that the effect is not due to a toxicity artifact. Similar results are obtained in E. coli strains 343/358 (repair proficient parental strain), 343/415 (recA-deficient), and 343/435 (mismatch repair-deficient). These data indicate the neither induction of recA-protein nor inhibition of mismatch repair is involved in the action of chromate. In E. coli strain 343/447 (DNA polymerase I deficient), the potentiation was observed at lower concentrations of chromate. This finding suggests that polymerase I functions in recovery of cells from 9-aminoacridine-induced DNA damage and that its absence allows some of this damage to be dealt with in a manner which promotes mutagenesis in the presence of chromate. One possible explanation of these findings is that chromate and 9-aminoacridine react chemically to produce a unique mutagen and that damage caused by this mutagen is repaired via some excision process. However, no reaction between chromate and 9-aminoacridine could be detected by TLC under conditions similar to those in the bacterial assays, even at very high concentrations of both agents. Thus, it seems most likely that the potentiation is due to some action of chromate on repair and/or replication at sites of 9-aminoacridine intercalation. Chromate appears, then, to have significant comutagenic actions in bacterial systems. PMID- 3523230 TI - Mutagenicity of CL 64855, a potent anti-Trypanosoma cruzi drug. AB - The nitroimidazole-thiadiazole derivative CL 64855 (2-amino-5 (1-methyl-5-nitro-2 imidazolyl)-1,3,4-thiadiazole), a potent antimicrobial agent with curative action against Trypanosoma cruzi, was assayed in the Salmonella/microsome test. CL 64855 proved to be a potent mutagen to the frameshift indicator tester strains TA98 and TA102. No activity was observed with the base-pair substitution mutagen indicator strain TA100 in spot tests. No significant increase in the number of induced mutants could be detected in the presence of rat-liver microsome fraction. The excision-repair-deficient strain TA98 was much more sensitive to the killing action of CL 64855 than TA102, a repair-proficient strain. Possible differences among the mutagenic effects of CL 64855 and those observed with other anti trypanosomal drugs are discussed. PMID- 3523231 TI - Cytostatic, cytotoxic and mutagenic effects of voacristine, an indole alkaloid in wild-type and repair-deficient yeasts. AB - Voacristine, an indole alkaloid isolated from the leaves of Ervatamia coronaria (Stapf.) (Apocynaceae) has dose-dependent cytostatic and cytotoxic effects on cultures of Saccharomyces cerevisiae. These inhibitory effects take place only in growing cells. Among the different repair-deficient mutants examined, a mutant defective in excision-resynthesis repair pathway (rad3-e5) was found to be the most sensitive to such a toxic effect. The mutant rad52-1 blocked in the DNA strand break repair pathway showed an intermediary sensitivity to the lethal effect induced by this indole alkaloid, whereas the mutant defective in the mutagenic repair pathway (rad6-1) demonstrated practically the same sensitivity as the wild-type strain. The nuclear reversion mutation for the locus lysl-1 was induced by voacristine, whereas the mitochondrial "petite" mutation was not induced by this alkaloid. These results indicate that the lesions induced by voacristine in vivo are likely to be of the adducts type; such damage is repairable in the wild-type; the DNA strand break repair pathway plays a minor role in the repair of voacristine-induced lesions. PMID- 3523232 TI - Mutagenicity of synthetic racemic fecapentaene-12. PMID- 3523233 TI - Genetic activity of 2-aminofluorene in the salmonella/erythrocyte mutagenicity assay. AB - In a previous study, we demonstrated the activation of cyclophosphamide by mouse erythrocytes in a yeast test using the D7 strain of Saccharomyces cerevisiae. The present study provides further information on the ability of washed red blood cells from mice to activate 2-aminofluorene (2-AF) detected as an increase in mutation frequency of the tester strain, TA1538 (frameshift mutation) of Salmonella typhimurium. The 2-AF was tested at different concentrations (1-8 micrograms/plate) using both the liquid-suspension test and the agar-plate test. For comparison, the bioactivation of 2-AF by the hepatic postmitochondrial supernatant (S9 fraction) from Aroclor-1254-induced rats was studied. 2-AF was only found to be clearly mutagenic in the agar-plate test with both activation systems. The genetic response obtained with the erythrocytes appeared to be related to the number of cells/plate. At the lowest dose, slight differences are observed when genotoxic effects were compared to those with the S9 fraction. PMID- 3523234 TI - Mutagenic potential of cordycepin (3'-deoxyadenosine) in salmonella and soybean tester strains. AB - Cordycepin (3'-deoxyadenosine), which is known to inhibit the repair of potentially lethal damage in irradiated cells, induced mutations in both Salmonella and soybean test systems. PMID- 3523235 TI - Mutagenic and comutagenic effects of ethionine in Escherichia coli K12. AB - A possible mutagenic and comutagenic activity of ethionine, an analog of the amino acid methionine, was investigated in several mutant strains of E. coli K12. Ethionine was found to act as a weak mutagen only in a mismatch repair deficient mutator strain (mutL) and as a comutagen with 2-aminopurine (2AP) in a wild type E. coli. The latter effect was nor observed in a restriction-deficient strain (r ) nor in a recombination or SOS-deficient recA strain. These effects are interpreted as a consequence of restriction-induced double-strand breaks in hypomethylated E. coli DNA resulting in induction of the SOS mutator effect which generates predominantly mismatch correctable untargeted mutations. PMID- 3523236 TI - Effect of saccharin on the meiotic division of Saccharomyces cerevisiae. AB - The effect of saccharin on the occurrence of meiotic diploid and disomic products in Saccharomyces cerevisiae was investigated. It was found that this substance inhibits the sporulation process in a dose-dependent manner, is ineffectual on recombination frequency, and slightly increases the occurrence of diploid and disomic meiotic products. It is demonstrated that the formation of diploid meiotic products is a consequence of random nuclear fusions at the end of the meiotic process or of endomitosis preceding meiosis. PMID- 3523237 TI - VI International Congress on Neuromuscular Diseases. Los Angeles, California, July 6-11, 1986. Dedicated to the memory of G. Milton Shy. Abstracts. PMID- 3523238 TI - Infectivity of Plasmodium berghei sporozoites measured with a DNA probe. AB - A 2.3 kb, 32P-labeled repetitive DNA probe of Plasmodium berghei was used to measure the amount of parasite DNA in the liver of Norway Brown rats and mice infected with sporozoites. Standard hybridization curves were obtained by probing different amounts (100 pg to 1 microgram) of P. berghei DNA immobilized on nitrocellulose filters. Host DNA did not interfere with hybridization specificity and sensitivity. A 100-fold increase in hepatic parasite DNA was detected between 25 h post-infection and the peak of parasite proliferation, detected at 44 h. The amount of parasite DNA increased with the number of injected sporozoites. At 5 h post-infection, a large proportion of parasite DNA was found in the spleen. However, this diminished with time and was negligible in amount at 25 h. A significant number of viable sporozoites were probably cleared in the spleen, since considerably more parasite DNA was found in the livers of splenectomized rats than in sham-operated counterparts. Although older rats develop much lower parasitemias upon inoculation of sporozoites, no significant differences were observed in the amount of parasite DNA in rats, 43 and 152 days old, injected with equal numbers of sporozoites. The higher resistance to malaria displayed by older rats is probably controlled by post-hepatic events. The infectivity of sporozoites for A/J mice was calculated to be about 1/20th that of Norway Brown rats. PMID- 3523239 TI - Fumarate reductase and other mitochondrial activities in Trypanosoma cruzi. AB - Subcellular fractions obtained from Trypanosoma cruzi epimastigotes broken by freezing and thawing were assayed for fumarate reductase activity with reduced methyl viologen as electron donor and fumarate as electron acceptor under anaerobic conditions. Two distinct activities were detected: one in the mitochondrial membranes, 115 mU(mg protein)-1, accounting for 96% of the total and the other in the cytosol, 3 mU(mg protein)-1, accounting for 3% of the total. The activity of membrane-bound fumarate reductase correlated statistically with either the activity or the amount of mitochondrial markers such as succinate and NADH dehydrogenases, cytochromes b + c558, cytochrome a611 and 5,7-diene sterols in the obtained subcellular fractions (580 X g, 12 000 X g, and 105 000 X g sediments and supernatant). Mitochondrial fumarate reductase was inhibited by succinate, malonate, cyanide, and 2-thenoyltrifluoroacetone (TTFA); whereas the soluble enzyme was inhibited by succinate and not by TTFA. The 12 000 X g sediment (mitochondrial membranes) showed after dithionite addition, absorption maxima at 611, 560 and 530 nm accounting for the presence of cytochrome b560, c558 and a611. A CO-binding cytochrome o was also detected. A scheme of the T. cruzi mitochondrial respiratory chain is presented. PMID- 3523240 TI - Staphylococcus aureus nasal carriage and infection in patients on hemodialysis. Efficacy of antibiotic prophylaxis. AB - We conducted a five-year prospective controlled study of prophylaxis of Staphylococcus aureus nasal carriage and infection among patients in a hemodialysis unit. Carriers tended to have chronic colonization with a single phage type. S. aureus infections occurred significantly more frequently in carriers than in noncarriers and, in 93 percent of the infected carriers, were caused by the same phage type as that carried in the nares. Neither intravenous vancomycin nor topical bacitracin was found to be efficacious in eradicating nasal carriage. However, oral rifampin given for five days decreased S. aureus carriage over a one-month follow-up period, but within three months colonization of the nares recurred in most carriers, often with an S. aureus of the original phage type. Carriers were then randomly assigned to receive either rifampin or no prophylaxis. Rifampin was readministered at three-month intervals if culture of the anterior nares yielded S. aureus. Infections with S. aureus occurred significantly more frequently in carriers given no prophylaxis than in those given a full course of rifampin. S. aureus resistant to rifampin was isolated from the anterior nares of four patients, but these isolates were not implicated in any infections. The incidence of infection at the dialysis access site, skin, and soft tissue of patients on hemodialysis can be decreased by interventions directed at nasal carriage of S. aureus. PMID- 3523241 TI - Autologous bone marrow transplantation in patients with acute nonlymphocytic leukemia, using ex vivo marrow treatment with 4-hydroperoxycyclophosphamide. AB - We studied 25 patients with acute nonlymphocytic leukemia in second remission (20 patients) or third remission (5 patients) in whom autologous bone marrow transplantation was performed with use of marrow incubated ex vivo with the alkylating agent 4-hydroperoxycyclophosphamide. Patients received intensive cytoreductive therapy with busulfan and cyclophosphamide or cyclophosphamide and total body irradiation, followed by an infusion of marrow that had been collected in remission, treated with 4-hydroperoxycyclophosphamide, and cryopreserved. Four patients died from bacterial or fungal sepsis within the first month after transplantation, and one patient with persistent marrow hypoplasia died from gram negative sepsis 155 days after infusion with autologous marrow. In the remaining patients, peripheral-blood levels of neutrophils in excess of 0.5 X 10(9) per liter and platelet counts over 50 X 10(9) per liter were attained at median intervals of 29 and 57 days after transplantation, respectively. Nine patients had leukemic relapses at 73 to 316 days (median, 182 days) after infusion of autologous marrow, for an actuarial relapse rate of 46 percent. Eleven patients (eight in second remission and three in third) remained in remission at a median of more than 400 days (range, greater than 230 to greater than 1653 days) after transplantation. The observed disease-free survival after transplantation with autologous marrow treated with 4-hydroperoxycyclophosphamide compares favorably with the results of syngeneic or allogeneic transplantation in similar groups of patients. PMID- 3523242 TI - In search of the subcutaneous-insulin-resistance syndrome. AB - In numerous patients with diabetes mellitus, a defect in the absorption of subcutaneously injected insulin has been suspected as an explanation for diabetic instability. The common clinical characteristic of these patients is poor metabolic control when insulin is injected subcutaneously, but good metabolic control when the insulin is infused intravenously. We have used three approaches to attempt to identify patients with "subcutaneous-insulin resistance." First, we performed a series of studies of subcutaneous-insulin absorption in 16 patients referred to us with a presumptive diagnosis of resistance to subcutaneous insulin; in none of these patients did we detect an abnormal response of blood glucose levels to insulin administered subcutaneously. Plasma free-insulin levels rose normally after injection. Second, we assayed insulin-degrading activity in subcutaneous biopsy specimens obtained from 25 patients throughout North America and Europe who had been diagnosed as resistant to subcutaneous insulin. In none of these patients did the insulin-degrading activity of subcutaneous tissue exceed the mean value (+/- 2 SD) of eight subcutaneous biopsy specimens obtained from control patients with diabetes. Third, we performed studies of tritiated insulin absorption in three additional diabetic patients and three control patients with nonbrittle diabetes. These studies also suggested normal absorption of insulin. In none of the patients we studied were we able to confirm the clinical diagnosis of subcutaneous-insulin resistance. We therefore conclude that this syndrome is extremely rare and that misdiagnosis is common. PMID- 3523243 TI - The treatment of trigeminal neuralgia (tic douloureux). PMID- 3523244 TI - New promise for autologous marrow transplants in leukemia. PMID- 3523245 TI - Impaired insulin action in puberty. A contributing factor to poor glycemic control in adolescents with diabetes. AB - Patients with insulin-dependent diabetes mellitus often have poor metabolic control during puberty. To determine whether puberty is associated with decreased insulin-stimulated glucose metabolism, we compared the results of euglycemic insulin-clamp studies in adults and prepubertal and pubertal children with and without insulin-dependent diabetes. In nondiabetic pubertal children, insulin stimulated glucose metabolism (201 +/- 12 mg per square meter of body surface area per minute) was sharply reduced, as compared with that of prepubertal children and adults (316 +/- 34 and 290 +/- 21 mg per square meter, respectively; P less than 0.01), despite comparable hyperinsulinemia (insulin levels of 80 to 90 microU per milliliter). Similarly, the response to insulin was 25 to 30 percent lower in the diabetic pubertal children than in the diabetic prepubertal children (P less than 0.05) and adults (P = 0.07). At each stage of development, the stimulating effect of insulin on glucose metabolism was decreased by 33 to 42 percent in the children with diabetes (P less than 0.01). In all the groups of children studied, the response to insulin was inversely correlated with mean 24 hour levels of growth hormone (r = -0.52, P = 0.01). Among the diabetic children, the glycosylated hemoglobin levels were substantially higher in the pubertal children than in the prepubertal children (P less than 0.02), although the daily insulin doses tended to be higher. These data suggest that insulin resistance occurs during puberty in both normal children and children with diabetes. The combined adverse effects of puberty and diabetes on insulin action may help explain why control of glycemia is so difficult to achieve in adolescent patients. PMID- 3523246 TI - Hyperinsulinemia in a population at high risk for non-insulin-dependent diabetes mellitus. AB - The prevalence of non-insulin-dependent diabetes mellitus (NIDDM) is higher in Mexican Americans than in non-Hispanic white Americans, even after adjustment for the former's greater overall and more centralized adiposity. We postulated that this excess risk of NIDDM could be due to resistance to insulin. We performed oral glucose-tolerance tests with measurements of serum insulin concentrations in 225 Mexican Americans and 180 non-Hispanic whites without diabetes as part of the San Antonio Heart Study, a population-based study of risk factors for diabetes. Changes in serum insulin concentrations in response to the glucose challenge were quantified by the area under the serum insulin curve. Overall adiposity was characterized by body-mass index, and regional body-fat distribution by the ratio of subscapular to triceps skinfolds and the ratio of waist to hip circumference. After adjustment for these indicators of adiposity and also for differences in glucose tolerance, Mexican Americans were found to have significantly greater areas under the serum insulin curve than non-Hispanic whites. These data suggest that, like other populations at high risk for NIDDM such as Pima Indians and Micronesians, Mexican Americans have more hyperinsulinemia than can be accounted for by their adiposity. PMID- 3523247 TI - Natural course of insulin resistance in type I diabetes. AB - To examine the natural course of insulin action in Type I diabetes, we followed 15 patients prospectively for one year after the diagnosis of diabetes and also performed a cross-sectional study of 53 additional patients who had had diabetes for 2 to 32 years. Two weeks after diagnosis, the rate of glucose uptake during hyperinsulinemia, a measure of insulin action, was 32 percent lower in the patients with diabetes than in 30 matched normal subjects (P less than 0.01), but it rose to normal during the subsequent three months. At three months after diagnosis, 9 of 21 patients (43 percent) were in clinical remission and did not require insulin therapy. In these patients, insulin action was 40 percent greater (P less than 0.002) than in the patients who continued to need insulin treatment. Fasting plasma C-peptide levels were slightly but not significantly higher in the patients who had a remission than in the other patients. In patients who had had diabetes for one year or more, insulin action was also reduced by an average of 40 percent (although there was considerable variation between patients), and it was inversely related to glycemic control and relative body weight. Thus, in patients with newly diagnosed Type I diabetes, a transient normalization of insulin action may occur after an initial reduction, along with a partial recovery of endogenous insulin secretion, and these events may contribute to the development of a clinical remission ("honeymoon" period). A majority of patients with diabetes of long duration are characterized by varying degrees of insulin resistance. PMID- 3523248 TI - Botulism in an adult associated with food-borne intestinal infection with Clostridium botulinum. PMID- 3523249 TI - Infant botulism in adults. PMID- 3523250 TI - Intensive retreatment of childhood acute lymphoblastic leukemia in first bone marrow relapse. A Pediatric Oncology Group Study. AB - We devised a plan of intensive chemotherapy to address the problem of inadequate results of treatment in children with acute lymphoblastic leukemia in first bone marrow relapse. Immediately after remission was induced with four conventional drugs, a two-week intensification course of teniposide and cytarabine was given to eradicate subclinical leukemia. Patients in remission were then treated for two years with rapid rotation of pairs of drugs that were not cross-resistant and periodic courses of the same agents used to induce remission. A second complete remission was induced in 31 of the 39 patients in whom response to chemotherapy could be assessed. The probability of maintaining bone marrow remission in these patients for one year was 0.38 +/- 0.19 (95 percent confidence interval); the two year probability was 0.29 +/- 0.17. Seven patients completed the treatment program, five of whom have been in continuous second complete remission 17 to 20 months after the cessation of therapy. Children whose initial bone marrow remission lasted less than 18 months had significantly poorer responses to retreatment than did those with a longer first remission (P = 0.004). Intensive chemotherapy, as described here, may save half of the children with acute lymphoblastic leukemia in whom bone marrow relapse occurs after a relatively long initial remission. PMID- 3523251 TI - Abnormal proteins in the cerebrospinal fluid of patients with Creutzfeldt-Jakob disease. AB - We studied more than 300 cerebrospinal fluid proteins from 21 patients with Creutzfeldt-Jakob disease. We also examined cerebrospinal fluid from 100 normal controls and more than 400 patients with various neurologic disorders other than Creutzfeldt-Jakob disease. Four abnormal proteins that were identified in the patients with Creutzfeldt-Jakob disease were absent in the normal persons. Two of these proteins (Mr [relative molecular mass], 40,000; pl [isoelectric point], 5.7 and Mr 40,000; pl 5.9) were also present in some patients with multiple sclerosis, herpes simplex encephalitis, schizophrenia, Parkinson's disease, or Guillain-Barre or Behcet's syndrome. Two proteins (Mr 26,000; pl 5.2 and Mr 29,000; pl 5.1) were present in all patients with Creutzfeldt-Jakob disease and in 5 of 10 patients with herpes simplex encephalitis, but in none of the other control groups. A subsequent blinded study of these cerebrospinal fluid proteins from patients with Creutzfeldt-Jakob disease, Alzheimer's disease, Huntington's disease, multi-infarct dementia, parkinsonism dementia of Guam, or the specific dementia of the acquired immunodeficiency syndrome resulted in the ability to distinguish all cases of Creutzfeldt-Jakob disease from the other types of dementia. Although the identity and origin of the abnormal spinal fluid proteins are not yet known, these preliminary results suggest that their presence may help in the diagnosis of Creutzfeldt-Jakob disease. PMID- 3523252 TI - Immune responses to yeast and mycelial forms of Candida albicans in intraperitoneally infected mice. AB - Candida albicans E-139 produced pure mycelial and yeast cultures in a low sulphate medium at different temperatures. The influence of the morphological phase, dose and viability of the fungi on the kinetic of delayed-type hypersensitivity (DTH) and anti-mycelial and anti-yeast antibodies have been studied in mice injected intraperitoneally. The mycelial form elicited higher DTH levels than the yeast phase. This effect seems to be related to its antigenic properties. The effect of dose on the immune response depends on the viability of the fungus. The mycelial cytoplasmic antigens were more effective than the yeast ones in detecting antibodies induced during the experiments, particularly during the later stages of the observation periods, suggesting that such antigens may be useful in the serodiagnosis of Candida infections. PMID- 3523253 TI - Effect of elevated temperatures and low levels of trace metals on the growth and phenotypic development of Candida albicans. AB - A combination of elevated temperatures (within the human febrile range) and trace metal chelation were investigated for their effects on the inhibition of growth and phenotypic development of the dimorphic yeast Candida albicans (strain 3153A). The ability of specific cations to relieve the phenotypic inhibition that occurred also was tested. Elevated temperatures alone (to 41 degrees C) only delayed the timing of the phenotypic development. When compared to the results obtained at 37 degrees C, the recombination of elevated temperature and addition of the trace metal chelator, 1,10-phenanthroline, did not further suppress phenotypic development, but the combination did decrease the viability of C. albicans. When 24 to 48 h stationary phase singlet cells were released into a medium containing 100 microM 1,10-phenanthroline (pH 6.5), supplemental iron (200 microM) alleviated the suppression of mycelium formation at 41 degrees C, whereas under conditions favoring bud formation (pH 4.5), both iron and zinc circumvented suppression and promoted budding. Through studies on the interaction of temperature stress and trace metal availability our data revealed the requirement for iron mycelium formation whereas both iron and zinc may be needed for bud formation. PMID- 3523254 TI - In vitro modification of Candida albicans invasiveness. AB - Candida albicans produces germ-tubes (GT) when it is incubated in animal or human serum. This dimorphism is responsible for its invasive ability. The purpose of the present paper is (1) to evaluate the ability of rat peritoneal macrophages to inhibit GT production of ingested Candida albicans, obtained from immunized rats and then activated in vitro with Candida-induced lymphokines; (2) to determinate any possible alteration of phagocytic and candidacidal activities. The phagocytes were obtained from rats immunized with viable C. albicans. Some of them were exposed to Candida-induced lymphokines in order to activate the macrophages in vitro. The monolayers of activated, immune and normal macrophages were infected with a C. albicans suspension during 4 hr. Activated macrophages presented not only the highest phagocytic and candidacidal activities but a noticeable inhibition of GT formation and incremented candidacidal activity. PMID- 3523255 TI - Monoclonal antibodies. Kidney rejection at bay. PMID- 3523257 TI - AIDS. New centres for clinical trials. PMID- 3523256 TI - Site-directed mutagenesis of the regulatory light-chain Ca2+/Mg2+ binding site and its role in hybrid myosins. AB - The regulatory light chains, small polypeptides located on the myosin head, regulate the interaction of myosin with actin in response to either Ca2+ or phosphorylation. The demonstration that the regulatory light chains on scallop myosin can be replaced by light chains from other myosins has allowed us to compare the functional capabilities of different light chains, but has not enabled us to probe the role of features, such as the Ca2+/Mg2+ binding site, that are common to all of them. Here, we describe the use of site-directed mutagenesis to study the function of that site. We synthesized the chicken skeletal myosin light chain in Escherichia coli and constructed mutants with substitutions within the Ca2+/Mg2+ binding site. When the aspartate residues at the first and sixth Ca2+ coordination positions are replaced by uncharged alanines, the light chains have a reduced Ca2+ binding capacity but still bind to scallop myosin with high affinity. Unlike the wild-type skeletal light chain which inhibits myosin interaction with actin, the mutants activate it. Thus, an intact Ca2+/Mg2+ binding site in the N-terminal region of the light chain is essential for regulating the interaction of myosin with actin. PMID- 3523258 TI - The mystery of declining tooth decay. AB - Large temporal reductions in tooth decay, which cannot be attributed to fluoridation, have been observed in both unfluoridated and fluoridated areas of at least eight developed countries over the past thirty years. It is now time for a scientific re-examination of the alleged enormous benefits of fluoridation. PMID- 3523259 TI - [The troublesome beginnings of smallpox prevention]. PMID- 3523260 TI - [The long road from mouse to man]. PMID- 3523261 TI - [Heart transplantation in the Netherlands: number and costs]. PMID- 3523262 TI - [Combinations of insulin preparations: one or the other]. PMID- 3523263 TI - [Echography and fertility studies]. PMID- 3523264 TI - [Fronto-ethmoidal mucopyocele is adequately diagnosed by echography]. PMID- 3523265 TI - [Psychosocial aspects of heart transplantation]. PMID- 3523266 TI - The autopsy in medical science and clinical practice: where have we been and where are we going? PMID- 3523267 TI - [Pemphigoid and cerebral infarct. Syntropy of 2 diseases? Case report]. AB - We report on two patients who suffered from bullous pemphigoid and developed cerebral infarctions during the course of this autoimmune dermatosis. The first patient who had a bullous dermatosis for three weeks presented with a sudden paresis of her right arm. She improved under steroid therapy and developed a left sided hemiparesis after steroids were reduced for diagnostic purposes. The second patient developed signs of brain stem infarction during the course of full-blown bullous pemphigoid. Neither patient had known risk factors, signs of atherosclerosis or cardiac embolism. Both patients improved with steroids and azathioprine. PMID- 3523268 TI - Anterior pituitary dysfunction in patients with chronic renal failure treated by hemodialysis or continuous ambulatory peritoneal dialysis. AB - Cortisol, prolactin, and growth hormone responses to insulin-induced hypoglycemia were measured in 20 patients undergoing continuous ambulatory peritoneal dialysis or intermittent hemodialysis. The plasma cortisol responses were normal; however, the increments in serum prolactin and growth hormone concentrations were impaired in most patients. The growth hormone responses were lower (p less than 0.05) in those patients treated by continuous ambulatory peritoneal dialysis, but there were no other significant differences between the two patient groups. These results show that anterior pituitary dysfunction persists in some patients with chronic renal failure despite maintenance dialysis therapy. PMID- 3523269 TI - Isolated hypoaldosteronism and abnormalities in renin, kallikrein, and prostaglandin. AB - To further define the pathophysiology of the syndrome of acquired isolated hypoaldosteronism, we determined plasma concentrations of active and inactive renin and urinary kallikrein and prostaglandin E2 excretion rates in 11 patients with the syndrome, 12 patients with similar serum creatinine levels, but without hyperkalemia, and in 12 normotensive patients with normal renal function and low plasma renin activities (PRA). Ten of 11 patients with the syndrome had low baseline PRA, and, unlike the control groups, six of 11 failed to double their PRA after furosemide stimulation. There were also consistent abnormalities in the percentage of inactive renin, no patient having a value less than and no control subjects having a value greater than 65%. Seven of 11 patients had prostaglandin E2 excretion rates lower than either control groups. Urinary kallikrein excretion rates in the patients with isolated hypoaldosteronism were significantly lower than in the control groups, but increased in response to therapy with fludrocortisone. PMID- 3523270 TI - Cyclosporin and prednisolone: do they prevent recurrence of focal segmental glomerulosclerosis? PMID- 3523271 TI - [Prospective trial of treating aneurysmal meningeal hemorrhage by delayed operation under cover of antifibrinolytic therapy]. AB - Seventy patients with subarachnoid haemorrhage due to ruptured intracranial aneurysms were managed by delayed intervention (third week) along with the prescription of antifibrinolytic drugs (tranexamic acid 6 g/daily). During the pre-operative period, 41 patients stayed in the same clinical status as on admission or improved, whereas 29 deteriorated due to rebleeding (4 cases), vasospasm (18 cases), large hematoma (4 cases), hydrocephalus (2 cases) and postarteriographic accident (1 case). Clipping the aneurysm was finally achieved in 42 patients only; with 3 deaths, 3 severe sequellae, 8 light handicaps, and 28 patients considered as cured with returning to previous occupations. As far as the whole series is concerned, these results yield a 38.5% rate of mortality, 20% morbidity, and 41.5% recovery. It is concluded that 1) Tranexamic acid was effective in reducing the risk or rebleeding, 2) Third week delayed intervention associated with this drug significantly reduced the operative mortality, but probably favoured vasospasm, and finally had no beneficial effect on the overall results concerning the entire series of patients. PMID- 3523272 TI - [Value of the orbito-fronto-temporo-malar approach in the excision of various meningiomas of the sphenoidal crest]. AB - The authors describe the use of orbito-fronto-temporo-malar for sphenoidal meningiomas. The resection is followed by bone reconstruction. They discuss the advantages and indications for this approach and reconstruction. PMID- 3523273 TI - The subcellular localization of glutamate dehydrogenase (GDH): is GDH a marker for mitochondria in brain? AB - Glutamate dehydrogenase (GDH, EC 1.4.1.2) has long been used as a marker for mitochondria in brain and other tissues, despite reports indicating that GDH is also present in nuclei of liver and dorsal root ganglia. To examine whether GDH can be used as a marker to differentiate between mitochondria and nuclei in the brain, we have measured GDH by enzymatic activity and on immunoblots in rat brain mitochondria and nuclei which were highly enriched by density-gradient centrifugation methods. The activity of GDH was enriched in the nuclear fraction as well as in the mitochondrial fraction, while the activities of other "mitochondrial" enzymes (fumarase, NAD-isocitrate dehydrogenase and pyruvate dehydrogenase complex) were enriched only in the mitochondrial fraction. Immunoblots using polyclonal antibodies against bovine liver GDH confirmed the presence of GDH in the rat brain nuclear and mitochondrial fractions. The GDH in these two subcellular fractions had a very similar molecular weight of 56,000 daltons. The mitochondrial and nuclear GDH differed, however, in their susceptibility to solubilization by detergents and salts. The mitochondrial GDH could be solubilized by extraction with low concentrations of detergents (0.1% Triton X-100 and 0.1% Lubrol PX), while the nuclear GDH could be solubilized only by elevated concentrations of detergents (0.3% each) plus KCl (greater than 150 mM). Our results indicate that GDH is present in both nuclei and mitochondria in rat brain. The notion that GDH may serve as a marker for mitochondria needs to be re-evaluated. PMID- 3523274 TI - [Evaluation of computerized tomography-guided stereotactic evacuation of putaminal hematomas by somatosensory evoked potentials]. AB - Computerized tomography (CT) guided stereotactic evacuation of intracerebral hematomas is effective and little invasive treatment at subacute or chronic stage. Somatosensory evoked potentials (SEPs) of 23 patients with putaminal hemorrhage whose stereotactic evacuations were performed from day 4 to day 24 are studied about surgical result and CT findings. As for SEP, N20 which is thought to be generated in the thalamus or in the primary parietal area receiving direct projections from the thalamus is used for comparison with functional recovery. Among 12 patients whose N20s before the evacuation showed normal, 9 had good recovery of their hemiplegia. Motor recovery tended to begin quickly after the evacuation and the evacuation of hematomas were thought to make better result than conservative treatment. CT findings of 9 patients with good recovery revealed that the hematomas didn't invade to the internal capsule or invaded to the posterior part of the posterior limb alone. Among 3 patients whose N20s before the evacuation were not distinct and those after the evacuation were normal, 2 had good recovery of their hemiplegia. As those hematomas were relatively large but located laterally, the internal capsule was seem to be not invaded but only compressed. Among 8 patients whose N20s were not distinct both before and after the evacuation, 7 could not get the recovery of their hemiplegia. CT findings of them revealed that the hematomas were large or invaded toward the internal capsule and thalamus. From this study N20s of SEPs are thought to be useful to the decision of indication and the prediction of the functional prognosis about stereotactic evacuation of putaminal hemorrhage. PMID- 3523275 TI - Cardiovascular effects of chronic naloxone infusion in normal dogs. AB - It has now been established that there is an interaction between the cardiovascular control systems and opiate substances. To assess the role of endogenous opiates in the long-term control of blood pressure, the opiate antagonist naloxone (0.5 mg/kg/24 h) was infused intravenously for 7 days. Chronic blockade of endogenous opiates resulted in an elevation in arterial blood pressure which averaged 11% and was sustained throughout the infusion period. This was accompanied by a significant decrease in plasma renin activity averaging -59%. These data provide support for a tonic role of opioids in the long-term control of the cardiovascular system which may involve baroreceptor function. PMID- 3523276 TI - Microvasculature of human micro- and macroprolactinomas. A morphological study. AB - A morphological study has been undertaken on the capillaries of 9 microprolactinomas and 9 macroprolactinomas, surgically removed from untreated patients. The study was carried out utilizing light and electron microscopic techniques and electron microscopic morphometry. The frequency of the capillaries and their structural appearance were taken into account. The frequency of capillaries was found to be very different in micro- and macroadenomas. In microadenomas 51.1 capillaries/0.1 mm2 of tissue section were observed; this value was not significantly different from that found in normal human pituitaries (62.0/0.1 mm2). In contrast, in macroprolactinomas a much lower degree of vascularization was found (9.3 capillaries/0.1 mm2 of tissue section). The capillary abnormalities previously reported for pituitary adenomas (endothelial thickening, swelling and blebbing, loss of fenestration, multilayered basal membrane, etc.) were observed in all prolactinomas studied, but no differences were found between the two types of tumors. In both types of tumors, the capillaries generally looked mature. Very rare sprouting capillaries were observed. Angiogenesis is likely to be slow, in agreement with the low frequency of capillaries in the more rapidly proliferating tumors such as macroprolactinomas. The different frequency of capillaries in micro- and macroprolactinomas could have some important consequences as to the regulation of the hormonal secretion. In fact, the different blood supply to the small and large tumors could result in a different availability of regulatory factors for the two types of tumors. PMID- 3523277 TI - Gonadotropin-releasing hormone neuronal system of the white-footed mouse, Peromyscus leucopus. AB - The cytoarchitecture of the gonadotropin-releasing hormone (GnRH) neuronal system of the female white-footed mouse (Peromyscus leucopus) was characterized using immunocytochemical procedures on thick vibratome sections. Most of the labelled cell bodies are organized loosely into three groups associated with the periventricular region of the medial preoptic area, the diagonal band of Broca, and the olfactory peduncle. A small number of cells are scattered throughout the medial septum, retrochiasmatic area, and in the posterior hypothalamus, lateral from the median eminence (ME). Labelled fibers are distributed widely throughout the brain, with heavy concentrations within the ME and the organum vasculosum of the lamina terminalis (OVLT). A subchiasmatic pathway for GnRH fibers, which courses from the OVLT to the ME, was identified. Fiber plexuses are present in the olfactory bulbs, accessory olfactory bulbs, triangular nucleus of the septum, medial habenular nucleus, and the amygdala. The ependymal layer of the third ventricle that is associated with the ME and OVLT contains large numbers of GnRH fibers, some of which appear to extend into the ventricular lumen. The wide dispersion of the GnRH neuronal system throughout the brain of P. leucopus is evidence that, in addition to its role as a gonadotropin-releasing hormone, GnRH may have a neurophysiologic function in the central nervous system of this species. PMID- 3523278 TI - Hypothalamic and pituitary enzymatic degradation of luteinizing hormone-releasing hormone during the 4-day estrous cycle of the rat. Assessment by high-performance liquid chromatography. AB - Luteinizing hormone-releasing hormone (LHRH) degrading activity may be of physiological significance as a mechanism capable of partial regulation of hypothalamic LHRH release as well as LHRH levels at the gonadotroph. The possibility of cyclic fluctuations in LHRH-degrading activity was investigated in female rat hypothalami and pituitaries. These tissues were collected at selected time points during the 4-day estrous cycle, homogenized, and centrifuged at 100,000 g. Supernatants were incubated with synthetic LHRH, the reactions terminated, and the decapeptide and its products separated by high-performance liquid chromatography. Degradation of LHRH incubated with active cytosol was estimated by comparison of integrated LHRH peak area with that from incubations with heat-inactivated cytosol. Hypothalamic LHRH degradation was depressed during the latter hours of diestrus 2, a time during which the LHRH content in the hypothalamus has been reported to be increasing. From diestrus 24.00 h to proestrus 15.00 h, there was a significant increase in degrading activity. This was then followed by a decline from 15.00 to 18.00 h proestrus; at the time of the LH surge, the activity had not undergone significant increase in comparison to 18.00 h. Pituitary LHRH degradation was significantly increased during the 6 hour period preceding the surge, but was significantly depressed at the surge. The hypothalamic reduction in activity associated with diestrus 2 as well as the hypothalamic and pituitary reductions associated with proestrus may represent a permissive effect allowing increased LHRH accumulation in the hypothalamus and its prolonged action in the pituitary.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3523279 TI - Activation of estradiol-positive feedback at puberty: estradiol sensitizes the LHRH-releasing system at two different biochemical steps. AB - Experiments were performed to examine whether estradiol (E2) can influence some of the intraneuronal mechanisms involved in luteinizing hormone-releasing hormone (LHRH) release during the onset of puberty in the female rat. The capacity of median eminence (ME) nerve terminals to secrete LHRH, as determined by both their basal release of LHRH and by their response to prostaglandin E2 (PGE2) in vitro, increased significantly during the juvenile-early peripubertal periods of development (postnatal days 22-34). Ovariectomy (OVX) on day 22 led to a striking reduction in LHRH response to PGE2 on day 34. E2 administered via s.c. Silastic capsules, at a dose that reproduces juvenile serum E2 levels, restored the response. Simulation of first proestrous serum E2 levels in late juvenile (28-day old) female rats enhanced both the sensitivity and the responsiveness of LHRH containing terminals to PGE2. Furthermore, E2 enhanced the sensitivity and the responsiveness of LHRH terminals to norepinephrine (NE). This effect appeared to be related to both the increased LHRH response to PGE2 and an enhanced sensitivity of the PGE2-synthesizing pathway to NE. This is because MEs from E2 treated rats showed a marked increase in PGE2 release in response to a NE concentration which was barely effective in untreated controls. It is suggested that one of the mechanisms by which E2 activates the first preovulatory discharge of LHRH release in the female rat is by facilitating the occurrence of two different but sequentially related biochemical events: the stimulation of PGE2 formation by NE and the enhancement of LHRH release by PGE2.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3523280 TI - Postnatal morphological changes in rat LHRH neurons correlated with sexual maturation. AB - The postnatal development of the luteinizing hormone-releasing hormone (LHRH) system in male and female rats was investigated using light microscopic immunocytochemistry. An identical number of immunoreactive LHRH cells (about 1,300) was observed for males and females throughout development. Two LHRH cell types, based on morphological appearance, were present in both sexes: smooth LHRH cells and LHRH cells with spine-like processes (irregular LHRH cells). In both sexes, the number of smooth LHRH cells decreases and the number of irregular LHRH cells increases during postnatal life, stabilizing shortly after puberty. We propose that smooth LHRH cells transform into irregular LHRH cells during the development of reproductive maturation. PMID- 3523281 TI - Propranolol in psychiatry. Therapeutic uses and side effects. AB - There are speculations that beta-adrenergic blocking agents are useful in the treatment of psychiatric disorders. Clinically, propranolol, an agent of this group, has been investigated in the treatment of various clinical disorders including schizophrenia, other psychoses, anxiety disorders, and stress reactions. This paper critically evaluates its efficacy in these disorders and provides a useful clinical perspective. In addition, propranolol produces a number of psychiatric side effects which are due to its central action or due to the peripheral receptor blockade. In addition, idiosyncratic reactions as well as withdrawal effects have also been reported to produce psychiatric side effects. It is important that the physician who wishes to use this drug know the existing knowledge of its usefulness in the treatment of psychiatric disorders as well as its psychiatric side effects. PMID- 3523282 TI - Some correlations in geriatric patients between EEG parameters and clinical status as evaluated using the observer-rated SCAG rating scale. A retrospective study. AB - In a retrospective analysis, correlations were sought between pretreatment electroencephalographic and clinical data obtained in 18 therapeutic studies conducted in elderly patients according to almost identical protocols. Power spectrum analysis was applied to the EEG tracings, while clinical status was observer-rated using the Sandoz clinical assessment - geriatric (SCAG) scale. The study population comprised a total of 286 patients between the ages of 51 and 97 years (median age 70 years), 162 of whom were male (median age 68 years) and 124 female (median age 73 years). A 2-week washout period and several 'adaptation recordings' preceded the pretreatment EEGs used in this analysis. These tracings were recorded under resting conditions between 8 and 10 a.m. and were followed by an assessment of clinical status. Spearman rank correlations with 4 EEG parameters--total slow waves, alpha and beta waves, and dominant alpha frequency- were computed for all 18 SCAG items and for 'overall impression of patient' as well as for 5 SCAG factors. All 96 - (19 + 5) X 4 - correlation coefficients were formally tested for statistical significance at the nominal level of alpha = 0.05. In this analysis, 9 of the 18 items, 'overall impression' and two of the factors ('apathy' and 'somatic dysfunction') showed nominally significant correlations with at least 1 of the 4 EEG variables. As expected, a positive correlation was found between percentage slow-wave activity and degree of clinical impairment. In addition correlations were identified between clinical data and alpha and beta activity.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3523284 TI - [Improvement of the definition of carotid stenosis with duplex-scanners and with frequency analysis]. PMID- 3523283 TI - Intra-arterial digital subtraction angiography of the carotid arteries. Special reference to contrast media. AB - A cross-over test in intra-arterial digital subtraction angiography (IADSA) of the carotid arteries was performed in 50 patients to evaluate image quality and side-effects with iohexol and metrizoate injected at concentrations of 100 mg I/ml by hand. The image quality was excellent or good in all cases. Although the severity and the frequency of side-effects were higher with metrizoate, both contrast media were suitable for IADSA at this low concentration. No complications were seen. It was assumed that the risk with IADSA was less than that of conventional precerebral angiography when performed semi-selectively and with small amounts of contrast media, as in this study. PMID- 3523285 TI - [Correlations between risk factors and morphology of carotid atherosclerotic lesions studied with the Duplex-Scanner]. PMID- 3523287 TI - [Oddi's sphincterectomy technic. Risk factors and prevention of immediate and long-term failures]. PMID- 3523286 TI - [Current views on the etiopathogenesis of hypertrophic cardiomyopathy]. PMID- 3523288 TI - [Digital arteriography. Critical findings after 3 years' use]. PMID- 3523289 TI - [Clinical aspects of goiter today]. PMID- 3523290 TI - [Use of the circular mechanical stapler in digestive surgery. Critical analysis]. PMID- 3523291 TI - [Our experience in the surgical treatment of severe obesity with latero-lateral jejunoileal bypass. Preliminary results]. PMID- 3523292 TI - [Bassini's contribution to hernia surgery on the centennial of the operation. The view of an American surgeon]. PMID- 3523293 TI - [Considerations on the strategy and surgical technics in traumatic injuries of the rectum]. PMID- 3523294 TI - [Dissection of the inferior mesenteric artery in recto-colonic resection. Anatomic bases and oncologic radicality]. PMID- 3523295 TI - [Manual suture or mechanical suture after total gastrectomy of neoplasms of the stomach]. PMID- 3523296 TI - [Limitations of echotomography in the evaluation of cholestasis]. PMID- 3523297 TI - In memoriam. Dr. M. C. A. Klinkenbergh. PMID- 3523298 TI - [Use of pirenzepine in prevention of stress ulcers in high-risk surgical patients]. AB - In an endoscopic controlled trial the effectiveness of pirenzepine in preventing stress ulcer in high risk patients for surgical operation was studied. 40 patients of both sexes aged between 19-72 were at random distributed to pirenzepine treatment (10 mg e.v./8 hours, starting the day before surgery to 10th day after it), or to "void" period (without specific therapy). Endoscopic findings was performed before and after treatment and every patient was daily monitored for: dyspepsia, defecation, residual intragastric volume, intestinal peristalsis, beginning oral food intake, haemodynamic and metabolic parameters. The results obtained showed the gastric and duodenal cyto-protective effect and the better post-operative clinical course, when pirenzepine was administered by parenteral infusion. PMID- 3523299 TI - [Diagnostic problems in spontaneous bacterial peritonitis]. AB - In spontaneous bacterial peritonitis (SBP) the ascitic fluid culture (certain criterion of diagnosis) may be negative despite an evident clinical and biochemical picture. Therefore the diagnosis may be sometimes more "probable" than "certain". The authors performed a comparative analytical study--from a clinical, biochemical and prognostic point of view--between a group of 10 "probable" SBP (10 cirrhotic pts.) and 9 "certain" SBP (9 cirrhotic pts.). 115 "normal ascitic fluids" (negative culture in absence of any SBP-symptoms), collected from 82 cirrhotic pts., were used as control group. The ascitic concentration of white blood cells (WBC)/mmc and polymorphonuclear cells (PMN)/mmc was significantly different between the SBP and control group (p less than 0.001) and between the "certain" and "probable" SBP (p less than 0.02). The latter have a mean WBC and PMN/mmc count that is lower than the "certain" SBP and on the contrary a significantly higher ascitic glucose content (p less than 0.05). Probably that means a lower ascitic bacterial inoculum, which is below the threshold of detectability by current culture techniques. Serum laboratory tests showed no differences between the "probable" and the "certain" SBP groups, although, however they were worse than the control group. The symptoms and the prognosis resulted nearly the same in both groups. In spite of a high rate of recovery (57.9%) the global survival at the follow-up (10 +/- 5.2 months, range 6 19) was only 26.3%. The wide clinical, biochemical and prognostic overlap of the two groups leads us to consider as "certain" all the cases of "probable" SBP. Owing to the fact that only an early recognition and therapy are known to affect the prognosis significantly, the obvious conclusion is that in the SBP the suspicion is more important that the diagnostic certainty. Furthermore--in agreement with previous studies--the cutoff limit of 250 PMN/mmc has shown the best statistical diagnostic value for a rapid diagnosis (sensibility 100%, diagnostic accuracy 92.5%, negative predictive value 100%, likelihood ratio 1.9). PMID- 3523300 TI - [Clinico-statistical considerations on the agreement between echographic and biopsy findings in hepatopathies of the diffuse type]. AB - A comparison between echographic and bioptic findings in diffuse liver disease is reported. The data obtained are compared with those quoted in the literature and found to be very similar. Finally echography is identified as the indispensable examination of choice. PMID- 3523301 TI - [Urinary infections caused by yeasts]. AB - Remarks are presented on the significance of yeasts found in urine samples. Initially an incidence of 4.5% and 4.7% was reported but more careful clinical and microbiological assessment in two later series revealed a 3.5% and 3.4% incidence of yeast-induced UTI. A very recent survey revealed yeast-induced UTI in 3.4% of inpatients and 0.35% of outpatients. The percentages refer to the total number of positive and negative samples examined. Finally risk factors and the distribution of these infections in terms of age, sex and hospital department are discussed. PMID- 3523302 TI - [Nonketotic hyperosmolar coma. Clinical aspects and treatment in 12 cases]. AB - Non-ketotic hyperosmolar diabetic coma is a complication of diabetes characterised by extreme dehydration, plasmatic hyperosmolarity and the absence of ketosis. The mortality rate is very high, especially in elderly subjects with type II diabetes. A personal series of 12 cases is reported with an assessment of general features, triggering factors, biochemical parameters at onset and treatment given. The data confirm reports in the literature and the results show the therapeutic superiority of continuous endovenous infusions of insulin at 3-10 mu/hour over other treatment protocols. PMID- 3523303 TI - [Subarachnoid hemorrhage caused by rupture of cerebral aneurysm. Value of neuroradiological studies]. AB - The role of neuroradiological examinations in the diagnosis and in the therapeutical indication of intracranial aneurysm are analyzed and discussed on the basis of a large review of the literature. Skull X-rays, Ct scan with and without intravenous contrast enhancement, magnetic resonance imaging and angiographic have different role and different timing. They are critically evaluated in order to point out an up-to-date diagnostic phase. PMID- 3523304 TI - [Cardiac protection and antihypertensive therapy: facts and theories]. AB - After a brief introduction on the problems involved in the interpretation of long term trials, the methods and the results of large clinical trials, on cardioprotection (defined as the ability of a drug to reduce mortality from all causes or fatal cardiovascular events) are reviewed, with the aim of providing useful clinical information for the treatment of the hypertensive patients. At the end of the review the author draws the following conclusions: The benefits of antihypertensive therapy reported in male patients suffering from severe hypertension are such that further controlled trials with placebo are not acceptable from an ethical point of view. The incidence of fatal and non fatal cardiovascular events is relatively low in mild uncomplicated hypertension but increases three-fold in the presence or organ involvement. A statistically significant reduction of mortality from all causes and of fatal cardiovascular events has been obtained in such patients by means of antihypertensive treatment in the Australian trial, contrary to the results of the MRC trial and the Oslo study. Furthermore, the HDFP trial has shown that mortality from all causes an fatal cardiovascular events are less frequent among patients in stepped care than among those in referred care. The EWPHE trial has demonstrated that antihypertensive treatment reduces non fatal complications and probably reduces mortality in elderly hypertensive patients. Diuretics, sympatholytics and beta blockers have been used in the large trials on cardioprotection. When several trials prove the equivalence of drugs of different efficacy and safety, it is acceptable to extend the results obtained with such drugs to the therapeutic class they belong to. An example is represented by the results of the MRC and IPPPSH trials on cardioprotection with beta-blockers in male non-smokers suffering from mild-moderate hypertension. PMID- 3523305 TI - [Relations between the site of insulin absorption and hypoglycemia in insulin dependent diabetes during physical exertion]. AB - Hypoglycaemia often arises after physical exercise in insulin-dependent diabetics treated with fast and slow acting insulin. Some claim that this is closely linked to the injection site for fast insulin and related to altered mobilization of the hormone from its subcutaneous deposit. Others attribute it to hyperinsulinism. The hypoglycaemia occurring after physical exercise in subjects treated with slow insulin and that arising even hours after physical exercise are then considered. PMID- 3523306 TI - [Doppler ultrasound method in the study of vertigo syndrome]. AB - Doppler C.W. technique represents a non-invasive, singular method to evaluate cerebrovascular diseases; therefore is now considered a screening method for vascular insufficiency, particularly in basilar artery insufficiency. Subclavian steal syndrome functional evaluation by Doppler C.W. is an important complement to angiographic studies. PMID- 3523307 TI - [Acetylsalicylic acid in the treatment of ischemic cerebrovascular disorders]. AB - An examination of 80 patients with ischaemic cerebrovascular disease, subdivided into 5 groups according to platelet antiaggregant treatment, demonstrated the insufficient effectiveness of acetylsalicylic acid in preventing recurrences. The drug failure can most probably be attributed to its particular action mechanism or to dosage. PMID- 3523308 TI - [Autoimmune aspects of a case of chronic interstitial cystitis]. AB - Chronic interstitial cystitis is a disease characterized by clinical recurring cystitis with histopathological aspects of a chronic aspecific inflammation of the bladder. Etiopathogenesis is still unknown, even if autoimmunity has been hypothesized in some cases. In this paper we report an immunopathologic and immunohistochemical study on a case of chronic interstitial cystitis. The inappropriate immunologic behaviour of the lymphocyte populations, the inhibition of leukocytes migration with bladder extracts and the immunofluorescent findings of IgG and C3 deposits in the mucosa support the hypothesis of an autoimmune pathogenesis of the disease. PMID- 3523309 TI - [Echographic semeiotics and preterm labor]. PMID- 3523310 TI - [Diagnosis of gestational age in the 20th week of pregnancy]. PMID- 3523311 TI - Molecular association of two neural cell adhesion molecules within the surface membrane of cultured mouse neuroblastoma cells. AB - The neural cell adhesion molecule L1 can be induced by antibodies in indirect immunofluorescence procedures to co-redistribute on the surface membrane of cultured mouse neuroblastoma cells with the 180 kDa component of N-CAM, but not with the 140 kDa component of N-CAM, the H-2 histocompatibility antigen or antigens recognized by polyspecific antibodies to mouse liver membranes. These observations indicate a differential and close molecular association between L1 and the N-CAM component with the larger intracellular domain. PMID- 3523312 TI - Synapses between GABA-immunoreactive axonal and dendritic elements in monkey substantia nigra. AB - gamma-Aminobutyric acid (GABA)-positive elements in the monkey substantia nigra pars reticulata (SNr) were identified using the peroxidase-antiperoxidase immunocytochemical technique with a direct GABA antibody. Light-microscopic examination revealed fine-caliber immunostained fibers piercing the cerebral peduncle and entering the SNr, where they formed a dense plexus. Ultrastructural observations included boutons with densely packed ovoid synaptic vesicles forming synapses with labeled and unlabeled dendritic elements. Most terminals contained small dark mitochondria, although some endings held larger, paler and fewer of these organelles. The synapses observed between GABA-immunoreactive profiles may represent the morphologic basis for disinhibition of pars compacta neurons reported to follow neostriatal or pallidal stimulation. PMID- 3523313 TI - Effects of salmon calcitonin on plasma renin activity and systolic blood pressure in the rat. AB - Salmon calcitonin, centrally injected, increased plasma renin activity and blood pressure in rats. It is possible that the peptide through an action on the central serotonergic tone stimulated plasma renin activity with subsequent enhancement of blood pressure. Conversely, peripheral administration of the peptide increased plasma renin activity but did not cause changes in blood pressure. Probably, the enhancement of renin may be a physiological response to the renal activity of calcitonin; however, this activity does not seem to involve urinary prostaglandins. PMID- 3523314 TI - The anti-excitotoxic effects of certain anesthetics, analgesics and sedative hypnotics. AB - Various agents were tested for their ability to antagonize the acute excitotoxic action of N-methyl-DL-aspartate (NMA) and kainic acid (KA) on neurons in the in vitro chick embryo retina. The following compounds (in order of descending potencies) were effective in completely blocking the neurotoxic activity of NMA: phencyclidine, ketamine, (+/-)-SKF 10,047, pentazocine, D-aminophosphonovalerate, D-amino-phosphonoheptanoate, D-alpha-aminoadipate, OH-quinoxaline carboxylate, kynurenate, (+/-)-cis-2,3-piperidine dicarboxylate, secobarbital, amobarbital and pentobarbital. The latter 6 agents also protected against KA toxicity but complete protection was observed only from relatively high concentrations. At 20 mM, Mg2+ blocked NMA toxicity but at concentrations up to 30 mM did not block KA toxicity. Compounds that failed to block either NMA or KA toxicity include D- and L-aminophosphonobutyrate, L-glutamic acid diethyl ester, xanthurenate, GABA and taurine. The chick embryo retina is a useful preparation for identifying agents that have either excitotoxic or anti-excitotoxic activity. PMID- 3523316 TI - Advantages of supplementary alanine in infants with genetic defects of amino acid metabolism. PMID- 3523315 TI - Insulin excites neurons of the area postrema and causes emesis. AB - Responses of neurons of the canine area postrema were recorded to ionophoretic application of insulin, apomorphine, leucine-enkephalin and glutamate. Each excited the neurons directly in a dose-dependent fashion. Like apomorphine and leucine enkephalin, which are known to induce emesis by activation of area postrema neurons, insulin given systemically induced emesis in intact dogs but not in animals with area postrema ablations. These results provide further support for a critical role of the area postrema in triggering the emetic reflex, and are the first definitive demonstration of a direct excitatory action of insulin on mammalian neurons. PMID- 3523317 TI - Vitamin E status of premature infants. PMID- 3523319 TI - Hospital influences on early infant feeding practices. PMID- 3523320 TI - Nutrition classics. Proceedings of the National Academy of Sciences of the United States of America, August 1975, Volume 72: Thromboxanes: a new group of biologically active compounds derived from prostaglandin endoperoxides. By Mats Hamberg, Jan Svensson, and Bengt Samuelsson. PMID- 3523318 TI - Breast-fed infants grow more slowly than infants fed formula and solids. PMID- 3523321 TI - When a non-death death occurs. PMID- 3523323 TI - Hospital planner: an introduction to executive decision making. PMID- 3523322 TI - Organ shortages: attitude problems? PMID- 3523325 TI - Dental sealants: a new addition to the New York Medicaid services regimen. PMID- 3523324 TI - Mercury: health hazards in dentistry. Literature review and recommendations. PMID- 3523326 TI - Scintigraphic patterns of acute vascular occlusion following renal transplantation. PMID- 3523327 TI - Regional distribution of emptying index (RDEI)--a new method for visualizing the stomach evacuatory function. A preliminary report. PMID- 3523328 TI - Naproxen reduces idiopathic but not fibromyoma-induced menorrhagia. AB - To compare the effect of naproxen on idiopathic and myoma-induced menorrhagia, 11 women with myomatosus uterus and 14 women with idiopathic menorrhagia (menstrual blood loss greater than 80 mL) were treated in a double-blind trial with placebo or naproxen during four consecutive menstruations. Placebo had no effect on menstrual blood loss. Naproxen (500 to 1000 mg daily for five days) reduced menstrual blood loss by 35.7% in women with idiopathic menorrhagia, but it had no consistent effect on myoma-induced menorrhagia. No side effects occurred during naproxen use. Thus, naproxen may prove a suitable treatment for idiopathic but not for myoma-induced menorrhagia. PMID- 3523329 TI - Decreased birth weight and femur length in fetuses of patients with the sickle cell trait. AB - The mean birth weight in women with the sickle-cell trait (Hb-AS) was less than in a matched population (Hb-AA), and the difference was statistically significant. Ultrasonic fetal biparietal diameter measurements in 30 patients with Hb-AS fell within normal limits, but mean femur lengths were found to be reduced at each gestational period when compared with similar measurements in patients with normal hemoglobin. PMID- 3523330 TI - Preinduction cervical ripening with prostaglandin E2 intracervical gel. AB - A double-blind, placebo-controlled, dose-ranging study was undertaken to evaluate the efficacy of two doses of intracervical prostaglandin E2 gel in patients with unfavorable Bishop scores. Mean change in Bishop score, success of softening, time to labor, and time to delivery were all significantly different in the two treatment groups as compared with the placebo group. Twenty-three of 30 treated patients had uterine contractions lasting greater than four hours and eight patients delivered during the observation period. Moreover, one case of uterine hyperactivity and five cases of severe fetal heart rate decelerations were noted in the treatment groups. Although efficacious for cervical ripening, caution is warranted when using this technique in patients at risk for placental insufficiency. PMID- 3523331 TI - Umbilical blood flow velocity waveforms in different maternal positions and with epidural analgesia. AB - Umbilical blood flow velocity waves were measured in the fetuses of healthy parturients in early active labor to assess the influence of different maternal positions (N = 16) and of epidural analgesia (N = 16). The ratio of systolic peak to diastolic trough (S/D) of the umbilical blood flow velocity wave is reflective of vascular resistance distal to the point of measurement on the fetal side of the placenta. Umbilical blood flow velocity wave S/D ratios were significantly higher in the supine than in either lateral position indicating that umbilical artery vascular resistance is increased when the mother lies supine. After epidural blockade, the S/D ratios were unchanged in three and lowered to varying degrees in 13 parturients indicating that this method of pain relief beneficially affects umbilical artery vascular resistance. PMID- 3523332 TI - Five hundred cases of amniocentesis without bloody tap. AB - Five hundred amniocenteses were carried out at midtrimester for prenatal diagnosis. A 22-gauge spinal needle with a stylet was used. The needle was guided by a real-time sector ultrasonograph. A transducer was placed adjacent to the puncture site and the needle tip was observed entering the amniotic cavity. By this technique, a bloody tap was avoided. There were only three (0.6%) spontaneous abortions in this group of 496 patients. Amniocentesis guided by ultrasound is a safe method for the mother and the fetus. PMID- 3523333 TI - Amniotic epithelial ultrastructure in normal, polyhydramnic, and oligohydramnic pregnancies. AB - The ultrastructure of the amniotic epithelial cells from normal, polyhydramnic, and oligohydramnic pregnancies were studied with the transmission electron microscope. The amniotic epithelial cell layer from normal pregnancies was 8- to 12-mu thick. In polyhydramnic pregnancies the cell layer varied widely from the normal thickness to as much as 18 to 56 mu in diabetic patients. Other ultrastructural changes observed in pregnancies complicated by polyhydramnios were abnormal microvilli, diminished intercellular canals, increased tonofilaments, and decreased rough-surfaced endoplasmic reticulum. In pregnancies complicated by oligohydramnios the thickness of the cell layer was 3 to 6 mu. The amniotic epithelial cells had increased tonofilaments, decreased desmosomes, collapsed and fused intercellular canals, and caused a marked decrease of the Golgi apparatus and the rough-surfaced endoplasmic reticulum. The sparse microvilli were short, plump, and had bizarre shapes. PMID- 3523334 TI - Retropubic cystourethropexy: a review of two operative procedures with long-term follow-up. AB - The purpose of this report is to present a personal experience, with an up to 16 year follow-up, in the management of stress urinary incontinence using a retropubic cystourethropexy. An attempt is made to prove that, in addition to the standard Kelly anterior colporrhaphy, a transvaginal retropubic cystourethropexy helps to improve long-term results. Also, the results of transvaginal retropubic cystourethropexy (modified Pereyra procedure) and abdominal retropubic cystourethropexy (modified Marshall-Marchetti-Krantz procedure) are reviewed. Two hundred fifty-two patients received a modified Pereyra procedure and 490 patients underwent a modified Marshall-Marchetti-Krantz procedure in a 17-year period. The final corrected results of both of these procedures indicate that the percentage of patients clinically cured are almost identical (93%). Thus, for the treatment of genuine stress urinary incontinence, either the modified Pereyra procedure plus anterior colporrhaphy or the Marshall-Marchetti-Krantz procedure can be used with almost identical results. The route of the procedure performed, either abdominally or vaginally, is often determined by associated findings. PMID- 3523335 TI - [Prevention of astigmatism during penetrating keratoplasty]. PMID- 3523336 TI - [Meridional wedge keratoplasty in myopia]. PMID- 3523337 TI - [Possibilities for the hemodynamic study of the eye using the Dopscan ultrasonic apparatus]. PMID- 3523338 TI - [Use of indomethacin in ophthalmology]. PMID- 3523339 TI - [Comment on the paper by Manfreda et al., Comparison between biochemical and histochemical hormone receptor determination in breast cancer]. PMID- 3523340 TI - [Comments on the paper by Schrock et al., The simultaneous determination of Ca 125 and D-dimer in plasma and ascitic fluid in ovarian cancer]. PMID- 3523341 TI - [Tumor markers in the diagnosis of ascitic and pleural puncture fluids]. AB - The identification of carcinoma cells in ascitic and pleural effusions by the detection of tumor markers was studied using an indirect immunoperoxidase method. Punctates from 56 patients with carcinomas, 18 with other malignant diseases and 10 with benign diseases were examined. In 35% of carcinomatous punctates tumor cells were stained by a CEA antiserum. No positive cells were found, however, in non-carcinomatous benign or malignant effusions. The immunocytochemical staining of CEA could detect tumor cells in 36% of carcinoma cases classified suspicious or negative using conventional cytology only. A TPA antiserum as well as the monoclonal antibody OC 125 stained cells in carcinomatous as well as in non carcinomatous malignant and in benign punctates. PMID- 3523342 TI - [Prevalence and etiology of mental problems in tumor patients]. AB - Data obtained from a questionnaire completed by 177 cancer patients were analyzed for prevalence of depressive and anxiety disorders and aspects of coping behavior. We found a high correlation between frequency of depressive symptoms and the period time after which cancer was diagnosed. According to data reported by other authors, prevalence of depression ranged between 21% and 32%. Anxiety disorders were found in about 40% of all cancer patients. Chemotherapy seems to be very stressing: During the course of therapy, we found a duplication of depressive symptoms, severe depression increases from 0% to 17%. Personality traits possibly predict anticipated nausea and vomiting (ANV). Patients with ANV show higher values in depression, anxiety, fatalism, but lower ones in internal control measured before chemotherapy. PMID- 3523343 TI - [Local application of mitoxantrone in inoperable, stenosing esophageal carcinoma. Preliminary report]. AB - Two cases histories demonstrate the efficacy of mitoxantrone, a cytotoxic substance, after local application in inoperable, recurrent esophageal carcinoma. The drug is well tolerated. Local or systemic side-effects have not been observed so far. Up to 20 mg of mitoxantrone were administered at multiple sites into the tumor mass via the esophageal sclerosing system. So far the technique has been applied in 5 cases, and in each one we observed a transitory subjective and objective response. PMID- 3523344 TI - [Effect of different glucocorticoids on the in vitro cell kinetics of human hematopoiesis represented by a bone marrow culture and by phytohemagglutinin- and pokeweed mitogen-stimulated blood cultures]. AB - The effect of nine glucocorticoids, DHEA, cyclohexanol and dextran sulphate on the hematopoietic proliferation was investigated. Three glucocorticoids inhibited the proliferation of normal bone marrow cells, the others enhanced it. The T-cell stimulation was not inhibited by fluorcortolone contrary to prednisolone. Specially the proliferation of acute myeloid leukemic blasts was inhibited by fluorcortolone hemisulfate, which significantly stimulated the proliferation of normal bone cells. PMID- 3523345 TI - [Characterization of lymphoid cells by monoclonal antibodies in patients with gynecologic carcinomas]. AB - Lymphoid subsets in the venous blood of 109 patients with various gynecologic malignancies were determined by monoclonal antibodies and compared with the results of 92 women without malignant disease. The patients were followed up for one year to study the influence of therapy on lymphoid cells. The results before treatment showed little difference between the two groups. In stage III and IV, total lymphocyte counts and OKT3+, OKT4+, OKT8+ and OKM1+ subsets were significantly lower compared with stage I and II. Radiation therapy caused a significant and long-lasting decrease of nearly all lymphoid cells. Patients who relapsed or died during the observation period had significantly diminished levels of OKT3- and OKT8-positive cells before treatment. PMID- 3523346 TI - [Immunoglobulins for the prevention of radiation pneumonitis following large volume irradiation in bronchial carcinoma]. AB - In a randomized study 20 patients with non small cell lung cancer were treated for cure at a linear accelerator. Before, during and after treatment levels of immunoglobulins were measured. At the end of radiation therapy levels of IgA, IgG and IgM decreased. After therapy they increased slowly. 3 months after irradiation the average immunoglobulin levels showed a reduction of 16%. After substitution of immunoglobulins no decrease of the levels was seen. After substitution of immunoglobulins the Karnofsky index was significantly higher. Substituted patients showed a lower rate of radiation pneumonitis. PMID- 3523347 TI - The composite resin short-post: a review of 625 teeth. PMID- 3523348 TI - [Transplantation of nuclei into mammalian ova]. AB - A review of experimental studies of nuclear transplantation in mammals. The possibility of parthenogenesis in mammals is discussed on the basis of the results reviewed. Discrepancies in the data obtained by different authors are also discussed. PMID- 3523349 TI - [Role of the cytoskeleton in the spreading process of epithelial cells]. AB - The role of microtubules and actin filaments in spreading of the IAR-2 cells isolated from the rat liver was studied. At the glass surface in the standard medium the cells rapidly assumed a discoidal form soon after inoculation. In the colcemid-containing medium the spreading is disturbed and delayed. In the cytochalasin D-containing medium the cells form two or more long processes. The effects of these drugs are reversible. It is supposed that microtubules are essential for sending cytoplasmic processes and stabilizing those processes and lamellae which have no numerous and stable contacts with the substrate, e.g., the processes which form at the early stages of spreading or the elongated processes of polarized cells. Bundles of actin microfilaments are essential, in particular, to ensure the discoidal form of epithelial cells. Microtubules appear to prevent the actin cytoskeleton contraction. PMID- 3523350 TI - [Appearance of a factor stimulating oocyte maturation in the karyoplasm of the oocytes of the green toad, the clawed toad and the starred sturgeon]. AB - The karyoplasm (the contents of germinal vesicle) of the Bufo viridis, Xenopus laevis, and Acipenser stellatus oocytes maturing under the influence of progesterone acquires the ability to induce the maturation (germinal vesicle breakdown) of the full grown oocytes, when injected into them. This ability arises in the karyoplasm earlier than in the cytoplasm and is preserved until the germinal vesicle breakdown. PMID- 3523351 TI - An upper eyelid cyst from migration of a hard corneal contact lens. AB - A migrated polymethylmethacrylate contact lens in the upper eyelid presented as a mass of unknown etiology. The lens had been unknowingly retained in the eyelid for seven years, after it had migrated through the conjunctiva of the superior fornix, and then moved in front of the levator aponeurosis and upper tarsal plate, where it lay encysted by conjunctiva. We believe that having sequestered conjunctival epithelium around the lens explains the minimal nature of the inflammatory and secretory responses necessary to allow such a protracted period of retention. PMID- 3523352 TI - Cystoid macular edema following penetrating keratoplasty: incidence and prognosis. AB - The incidence of clinically significant and angiographically documented cystoid macular edema (CME) following penetrating keratoplasty was studied in a consecutive series of 102 eyes over an average follow-up of 30 months. CME was seen only in the aphakic eyes. Twenty out of 68 eyes in this group developed CME. There was a statistically significant higher incidence of CME in eyes undergoing vitrectomy than in eyes not undergoing vitrectomy (p less than .01). Also, there was a higher incidence of CME in eyes with aphakic bullous keratopathy (p less than .01) and pseudophakic bullous keratopathy (p less than .05), when compared to eyes undergoing combined cataract extraction and corneal transplantation. All eyes with CME were empirically treated with oral prednisone (two eyes) or oral ibuprofen (18 eyes). Over an average follow-up of nine months, 13 of these eyes showed complete resolution of their CME with improvement in visual acuity to 20/60 or better in 12 eyes. PMID- 3523353 TI - A new bridle suture for cataract surgery. PMID- 3523354 TI - Lattice dystrophy of the cornea. A clinical and histopathologic study. AB - Four members of a family were affected with lattice dystrophy of the cornea. One of them showed recurrence of the disease in the corneal graft in one eye 9 years after a keratoplasty, and a very advanced stage of the disease in the fellow eye. Therefore a keratoplasty was done in this eye. The corneal button was thoroughly investigated by means of histochemistry, electron microscopy and X-ray electron microanalysis. Two young members of the family showing early signs of the disease were followed up for 2 years. It has been possible to observe the evolution of their lesions. Histopathological examinations revealed the presence of two different types of abnormal deposits under the epithelium and in the stroma. X ray electron microanalysis of the stromal deposits revealed a substantial increase in sulphur content. PMID- 3523355 TI - Infectious retinitis. Diagnostic modalities. AB - Advances in surgical techniques have made vitreoretinal and sclerochorio-retinal biopsies part of the available diagnostic armamentarium of the ophthalmologist. Special studies can be performed on tissue obtained in this way in order to provide a specific etiologic diagnosis of virus associated pathology. The advantages and disadvantages of immunopathologic and ultrastructural methods, tissue culture, and nucleic acid hybridization techniques for viral identification are compared and discussed. PMID- 3523356 TI - Fluorescein angiography complication survey. AB - This is a report on the results of a national survey designed to study the nature and frequency of moderate and severe complications of intravenous fluorescein angiography. In this survey, 2434 responding ophthalmologists reported on 221,781 fluorescein angiograms performed in the year 1984. Adverse reactions were classified as mild, moderate, severe, and death, depending on the duration of the effect, the necessity for medical intervention, the time required for its resolution, and the final outcome. The frequency rate for a moderate reaction was (1:63), for a severe reaction (1:1900), and for death (1:222,000). A review of previous studies on adverse reactions to the drug, a compilation of suggested methods for the amelioration and prevention of the complications, and a comparison of the responses of the general ophthalmic public to the members of The Macula Society are also reported. PMID- 3523357 TI - Pneumatic retinopexy. A two-step outpatient operation without conjunctival incision. AB - 1,000 consecutive patients operated for retinal detachment were studied prospectively to determine the incidence of complications. Two parts of the operation were responsible for most of the vision-threatening complications: subretinal fluid drainage and the scleral buckle. In an attempt to reduce the complications of retinal detachment surgery, we have utilized a simplified procedure of transconjunctival cryotherapy and intravitreal gas injection with postoperative positioning. This study was limited to detachments with one or more breaks within one clock hour located within the superior eight clock hours of the fundus without signs of proliferative vitreoretinopathy. In a series of 20 consecutive patients, retinal reattachment was initially achieved in all cases. There were two recurrences that were reattached with scleral buckling. The final cure rate for the single pneumatic procedure, with six months follow-up, was 90%. No major complications were observed. This preliminary report suggests that pneumatic retinopexy has the advantages of reduced tissue trauma, no hospitalization, minimal complications, and reduced expense. The major disadvantage is the need for postoperative positioning for five days. PMID- 3523358 TI - Ocular and systemic findings in relapsing polychondritis. AB - The ocular and systemic findings in 112 Mayo Clinic patients with relapsing polychondritis were reviewed. The incidence of males and females was equal, with median age at diagnosis of 51 years and the median follow-up of 6 years. Most patients had several organ systems involved at the time of the diagnosis. Twenty one patients had ocular symptoms at the onset, and 57 developed ocular symptoms during their course. Major ocular complications included proptosis, lid edema, episcleritis/scleritis, corneal infiltrates/thinning, iridocyclitis, retinopathy, and optic neuritis. The major system involvement included otorhinolaryngeal, respiratory, arthritic, renal, cardiovascular, dermatologic, and neurologic diseases. Generally, laboratory studies were not helpful in making the diagnosis but were valuable in monitoring the disease. Based on the experience in these cases, the indications for the various therapeutic modalities are offered. PMID- 3523359 TI - Sympathetic ophthalmia. Immunopathological findings. AB - Ocular tissue from six patients with a clinical diagnosis of sympathetic ophthalmia (SO) was examined using immunohistochemical techniques. All patients presented with a history of bilateral panuveitis after penetrating ocular injury or multiple intraocular surgeries and clinical features of SO. In four cases, classic histopathological features of SO were observed, including granulomatous uveal tract infiltration and subretinal pigment epithelium (RPE) collections of inflammatory cells (Dalen-Fuchs nodules). Bone marrow derived monocytes were the major cellular components in these granulomas. In two cases, histopathology failed to demonstrate typical Dalen-Fuchs nodules or granulomas in the choroid. However, the choroidal infiltrates were composed primarily of T-helper and B lymphocytes, without macrophages or epithelioid cells. The eyes examined in this report indicate that a varied spectrum of immunopathological and histopathological findings may occur in clinically diagnosed SO. PMID- 3523360 TI - A brief history of ophthalmic publications in America. AB - The recent establishment of a rare book collection as part of the American Academy of Ophthalmology Foundation Museum gives Academy members additional access to an important facet of our ophthalmic heritage. Many 17th and 18th century works, such as those of Cotton Mather and Philip Syng Physick, long remained in manuscript form. Published works on ophthalmology first appeared as chapters in surgical texts. Ophthalmology texts authored by Americans followed the important texts from England and the Continent, and the works of Frick (1823) and Littell (1837) deserve special mention. Other works, including the memoirs of Elisha North, the founder of the first American eye infirmary, and the transcript of the trial of George McClellan following failed cataract surgery, give vivid insights into our country's ophthalmic beginnings. PMID- 3523361 TI - The localization of a Mason-Pfizer monkey virus-related antigen in jaagsiekte tumour tissue and cell lines. AB - Mason-Pfizer monkey virus-related antigen was detected in 3 out of 5 jaagsiekte lungs examined using a direct immunoperoxidase staining technique with anti-MPMV p27 serum. Most of the antigen was localized in the alveolar lumina of the lesions. The reaction was further characterised on immune blots and found to involve a protein with a molecular mass of 29 000 daltons (JSRV p29). JSRV p29 antigen was also detected in 2 jaagsiekte cell lines. PMID- 3523362 TI - Gingival basement membrane antigens in desquamative lesions of the gingiva. AB - Desquamative gingival lesions are a clinical manifestation of several entities where histologic alterations in the gingival basement membrane are frequent. Normal and lesional gingival specimens from six patients with desquamative lesions of the gingiva associated with cicatricial pemphigoid or lichen planus and from one normal subject were examined by indirect immunofluorescence for immunologic alterations in basement membrane antigens. In four out of five desquamative gingival lesions from patients with lichen planus, type IV collagen and EBA basement membrane antigens were interrupted, thickened, or partially or completely absent as compared to normal gingiva. One specimen showed multiplication and duplication of the basement membrane. In the two desquamative gingival lesions from patients with cicatricial pemphigoid, type IV collagen was either partially absent or associated with the connective tissue side of the subepithelial bullae. These results suggest structural alterations in antigens within the basement membrane of patients with desquamative lesions of the gingiva. PMID- 3523363 TI - Temporal crest canal: case report and statistics on a rare mandibular variant. AB - A child's mandible retrieved from a North American archaeological site had an anomalous canal 2 mm in diameter and 10 mm long, opening posteriorly behind the temporal crest and anteriorly in the retromolar fossa. Radiographic analysis revealed a second canal passing down from the temporal crest canal (TCC) toward the molar roots. A survey of retromolar variants in a large skeletal series (N2391) revealed TCC present in 1.7% of all persons on average, ranging up to 23% in certain population samples. It appeared to be more common in males than in females and in native Americans than in other racial groups. From its location and orientation, TCC was inferred to have conveyed all or part of the buccal nerve. The clinical significance of this variant is that pain fibers from the molar roots joining the nerve as it runs in this canal would exit the bone behind the temporal crest, thus escaping anesthetization in routine injections for inferior alveolar and buccal nerve block. PMID- 3523364 TI - An immunoperoxidase investigation of S-100 protein in the epithelial component of Warthin's tumor. AB - Using the peroxidase-antiperoxidase (PAP) immunohistochemical method, we studied the epithelial component of Warthin's tumor of the human salivary gland with respect to the presence of S-100-protein-positive cells. The tumor epithelium consisted of two layers of oxyphilic cells (an apical layer of tall columnar cells and a basal layer of small cuboidal cells) and irregularly shaped, dendritic cells scattering throughout the neoplastic epithelial cells. Two types of the oxyphilic cells were devoid of the immunoreaction products for S-100 protein. However, in the epithelial layer of Warthin's tumor, S-100-protein positive material was observed in the cytoplasm and nuclei of dendritic cells. They were more abundant in the lymphoid tissue than in the neoplastic epithelium. The morphologic appearance of these cells was identical to that of Langerhans' cells, which were absent from the normal human salivary glands. The presence of these cells, which have a special function of antigen presentation in immune responses, indicates that delayed hypersensitivity may be the main pathogenic factor in the development of Warthin's tumor. PMID- 3523365 TI - A method of distinguishing between amalgam and graphite in tissue. AB - The clinical and histologic appearance of amalgam and graphite tattoos are similar; both appear as dark particles, although amalgam, after degradation, displays a characteristic binding to blood vessels, nerves, basement membrane, and fibers. Graphite particles also consistently exhibit a light yellow peripheral birefringence under strong polarized light. Amalgam particles may exhibit a similar birefringence, but often it is weak or absent. When histologic sections containing particles exhibiting birefringence are treated with 10% ammonium sulfide solution, graphite is unaltered, whereas the birefringence of amalgam particles, if present, is changed to orange, or the particles undergo dissolution. PMID- 3523366 TI - Dermatitis herpetiformis: oral lesions as an early manifestation. AB - Dermatitis herpetiformis is an uncommon chronic skin disease that rarely affects the oral cavity. An unusual case of dermatitis herpetiformis, starting with oral lesions 6 months prior to the onset of skin lesions, is reported. The diagnosis was based on the typical histopathologic features and on positive direct immunofluorescence. The literature is briefly reviewed. Evaluation of laboratory findings, clinical picture, and response to sulfones is essential to the final diagnosis and is emphasized. PMID- 3523367 TI - Flunarizine treatment in dizzy patients with vestibular hyperreactivity and hyperventilation. AB - Flunarizine (10 mg/day) was given in an open pilot study to 14 patients with the primary complaint of dizziness, who showed vestibular hyperreactivity in the velocity step (VS) test and were proven to have a hyperventilation syndrome (HVS) without any other disease. The VS test was repeated after 4-6 weeks of treatment. Twelve of these HVS patients reported alleviation of dizziness. Objective evaluation of the results of treatment was attempted by defining suitable response parameters and comparing their values to those obtained in a control group of 14 healthy volunteers tested twice with the same interval. A significant decrease in right-left asymmetry in the VS responses of the patients on drug was found. PMID- 3523368 TI - Efficacy of endonasal neomycin-tixocortol pivalate irrigation in the treatment of chronic allergic and bacterial sinusitis. AB - 60 patients, aged 15-51 years, with chronic allergic or bacterial maxillary sinusitis, were entered in a controlled, double-blind study comparing the efficacy of endonasal irrigations of tixocortol pivalate (Pivalone)-neomycin and neomycin. The treatment lasted 11 days and was administered once daily. A ventilometric measurement of sinus pressure was performed every two endonasal irrigations to assess treatment efficacy. The percentage of nasal deobstruction was significantly higher with tixocortol pivalate-neomycin than with neomycin alone by the fifth examination (9th day) regardless of the etiology of the sinusitis (allergic or bacterial). After 11 days of treatment, significantly better results were obtained in cases of bacterial sinusitis (94% deobstruction with tixocortol pivalate-neomycin versus 74% with neomycin) than in cases of allergic sinusitis (69% deobstruction with tixocortol pivalate-neomycin versus 36% with neomycin). PMID- 3523369 TI - Sympathomimetics in nasal allergy. AB - The effect of a topically administered alpha-adrenoceptor agonist (phenylpropanolamine) after allergen challenge was evaluated in a placebo controlled double-blind crossover study in 10 subjects with allergic rhinitis in an asymptomatic period. The nasal airway resistance was objectively measured by anterior rhinomanometry after nasal allergen challenge. The degree of nasal blockage, secretion and the number of sneezes were registered in a score. Nasal airway resistance and the degree of blockage were found to be significantly reduced. Thus, alpha-adrenoceptor agonists might be used topically for symptomatic treatment of allergic rhinitis comprising mucosal congestion. PMID- 3523370 TI - Leishmaniasis donovani presenting as an isolated lesion in the larynx. AB - A case of leishmaniasis of the larynx caused by Leishmania donovani occurring in a 42-year-old man is reported. The oral cavity and the upper respiratory tract are commonly involved in mucocutaneous American leishmaniasis, but are less frequently reported in the 'Old World'. The primary and isolated location in the larynx is exceptional. The immunoperoxidase technique using antisera to anti-L. donovani is a useful method to identify the parasite. PMID- 3523371 TI - [The 50th anniversary of the 1st Congress of Orthopedists and Traumatologists of the Ukraine]. PMID- 3523372 TI - [Endogenous prostaglandin E2 levels in the gastric mucosa of patients with stomach ulcer]. PMID- 3523373 TI - [Incrustation of the IUD, demonstrated by ultrasonography]. PMID- 3523374 TI - [Plasma thromboxane and prostacyclin metabolite ratio in atherosclerosis and diabetic angiopathy]. PMID- 3523375 TI - [Management of lactation deficiency in the immediate postpartum period]. PMID- 3523376 TI - [Arteriovenous fistula diagnosed by pulmonary perfusion scintigraphy]. PMID- 3523377 TI - [Dr. Bela Molnar. On the centenary of his birth]. PMID- 3523378 TI - [Kornel Chyzer, born 150 years ago]. PMID- 3523379 TI - [Results of cefoperazone (Cefobid) therapy in exceptionally severe infections in infants and young children]. PMID- 3523380 TI - [The effect of adebit on carbohydrate and insulin metabolism in childhood obesity]. PMID- 3523381 TI - [Association of Budd-Chiari syndrome with vena cava inferior occlusion verified by sonography and cavography]. PMID- 3523382 TI - [Remembering the centenary of the death of Bela Issekutz]. PMID- 3523383 TI - [The work of Tibor Lehoczky (1897-1971)]. PMID- 3523384 TI - [The acetylator phenotype affects the antipyrine metabolism inhibiting action of cimetidine]. PMID- 3523385 TI - [Captopril and the endogenous opioid system in essential hypertension]. PMID- 3523386 TI - [Evolution of dentistry in Austria. 2. Moriz Heider, a reluctant dentist]. PMID- 3523387 TI - [Evolution of dentistry in Austria. 3. Heider's legacy]. PMID- 3523388 TI - [Prevention of the resorption of costal cartilage transplants subjected to the action of hydrochloric acid]. PMID- 3523390 TI - [Systemic cartilage disease]. PMID- 3523389 TI - [Use of corneometry in audiology]. PMID- 3523391 TI - [A time table of knowledge and discoveries in the fields of epidemiology and bacteriology in synchronoptic relation to other world and cultural historical data]. PMID- 3523392 TI - [Detection of tolerance to diphtheria-pertussis-tetanus vaccines]. PMID- 3523393 TI - Iontophoresis of vincristine versus saline in post-herpetic neuralgia. A controlled trial. AB - Twenty patients with post-herpetic neuralgia (median duration 28.5 months) were randomly allocated to receive transdermal iontophoresis of either vincristine or saline. Although significant improvement in pain by word score and visual analogue scale (P = 0.05) was reported by 6 out of 10 of the vincristine group, none of the patients considered themselves 'cured.' There was no significant change in the saline group. No adverse haematological or neurological side effects were seen, but skin irritation and painless electrical burns were common in both groups. The dramatic relief of pain in patients with post-herpetic neuralgia of 3 months or less reported elsewhere was not seen in our group who had pain of a longer duration. This present trial does not confirm the value of vincristine iontophoresis in the treatment of post-herpetic neuralgia of over 6 months duration. PMID- 3523394 TI - Cognitive and relaxation treatment of paediatric migraine. AB - The present study compared the efficacy of two active treatments, relaxation training and cognitive coping, with a non-specific placebo control in the treatment of 42 children and adolescents with migraine. The first treatment is a simplified version of progressive deep muscle relaxation; the second, a form of cognitive restructuring involving the alteration of dysfunctional thought processes. The results demonstrated that each active treatment was superior to the non-specific intervention in reducing overall headache activity and frequency but not duration or intensity. There were no differences between the experimental groups, and both continued to improve through a 16-week follow-up period, but the control group did not. Initial level of headache severity was an important factor in treatment outcome, with children with severe headaches responding better than those with milder headaches. Possible reasons for the differential treatment effects are discussed, and the implications for future research are considered. PMID- 3523395 TI - GSR feedback and Schultz relaxation in tension headaches: a comparative study. AB - A comparative study of the use of GSR feedback (n = 16) and Schultz relaxation (n = 15) with patients presenting tension headaches showed that there was no significant improvement in the group treated by relaxation at the end of the treatment whereas the group treated by GSR feedback showed significant improvements with respect to frequency and intensity of headaches and to anxiety as measured by subjects' self-evaluation (P less than 0.05). Intergroup comparison demonstrated a greater improvement in headache intensity for the GSR feedback group than for the relaxation group (P less than 0.05) at the post treatment stage. Likewise, the percentage of patients showing at least 50% improvement as to headache frequency was significantly higher (P less than 0.05) in the GSR feedback than in the relaxation group. High pre-treatment EMG and high pre-treatment weekly pain level indicate a good prognosis of improvement with respect to post-treatment headache frequency and intensity respectively in the case of the GSR feedback group. We found no prognostic factor for post-treatment clinical improvement in the relaxation group. PMID- 3523396 TI - Imipramine reduces experimental pain. AB - In a homogeneous sample of 20 healthy male students, the analgesic effects of the tricyclic antidepressant imipramine (100 mg) were compared to those of the narcotic meperidine (150 mg) and a further tricyclic compound with assumed analgesic properties (fluradoline, 450 mg). Drugs were orally administered, using a placebo controlled, double-blind repeated measures Latin Square design. Phasic pain was induced by intracutaneous electrical shocks with random intensities and interstimulus intervals. Each stimulus block consisted of 80 stimuli and lasted for 20 min. Pain estimates, somatosensory evoked cerebral potentials (SSEPs) and power spectral density of the electroencephalogram (EEG) were measured under each drug condition. Under placebo, pain ratings and SSEP amplitudes were constant within the entire session lasting for approximately 4 h. Meperidine analgesia was evident within 30 min of drug application, reaching a maximum after about 90 min. Imipramine produced a comparable degree of pain reduction, however, with a delay of 2 h. Under both drugs, the decrease in pain ratings was accompanied by decreased amplitudes of the late components of the SSEP, as well as by a reduction in alpha activity and an enhancement of slow EEG waves. Effects of fluradoline on experimental pain could not be affirmed. These findings are discussed in terms of pain relief and decrease in vigilance. PMID- 3523397 TI - Anti-gamete antibodies block transmission of human vivax malaria to mosquitoes. AB - Antibodies were raised in rabbits by immunizing against fresh unfixed or cryopreserved female gametes of the human malaria pathogen Plasmodium vivax. The antibodies were shown to react with the surface of gametes by the indirect immunofluorescent test. When parasite isolates from P. vivax infected individuals were fed through a membrane to Anopheles tessellatus mosquitoes in the presence of immune rabbit sera, they completely blocked the infectivity of the parasite isolates to the vector. Immunoglobulins separated from these sera also blocked infectivity to the same extent as did the immune sera indicating that antibodies were responsible for the transmission blocking effect of the sera. This study indicated that P. vivax like other malaria parasites is highly susceptible to anti gamete transmission blocking immunity. PMID- 3523398 TI - Protective immunity to malaria. Studies with cloned lines of Plasmodium chabaudi chabaudi and P. berghei in CBA/Ca mice. II. The effectiveness and inter- or intra species specificity of the passive transfer of immunity with serum. AB - Serum was obtained from CBA/Ca mice infected, reinfected or superinfected with parasites taken one or two syringe passages from cryopreserved reference stabilates derived from cloned lines of the AS or CB isolates of P.c. chabaudi. Serum was also collected from mice superinfected with parasites derived from a cloned line of P. berghei KSP-11. When injected into normal syngeneic recipients subsequently challenged with homologous or heterologous parasites, these sera mediated some or all of the following modifications to the breakthrough parasitaemias which invariably occurred (i) an extension of the pre-patent period (ii) an extension of the time taken for the parasitaemia to reach 2% (iii) a reduction of peak parasitaemia (iv) protraction of the initial peak of parasitaemia. These modifications were particularly evident with serum from superinfected mice and to a lesser extent with serum from animals reinfected once after recovery from a primary infection. Serum taken during the course of such a primary infection produced extended pre-2% periods, other effects being only marginal. Serum mediated modifications produced by reinfection and superinfection serum appeared largely species-specific with a limited degree of cross reactivity. Intraspecific specificity was also apparent with serum from P.c. chabaudi AS or CB reinfected or superinfected mice, although marginal cross immunity was again observed. When analysed by the fluorescent antibody technique on smears of methanol fixed parasitized erythrocytes, reinfection and superinfection sera were almost totally cross-reactive both within and across species. Preliminary evidence that parasites breaking through the effects of these sera may constitute a phenotypic antigenic variant is presented and possible mechanisms for the parasitaemia modifying effects of the various sera discussed. PMID- 3523399 TI - Factitious hyponatremia in a patient with cholestatic jaundice following bone marrow transplantation. AB - We report a case of factitious hyponatremia in a boy who had received a bone marrow transplant for acute myeloid leukemia. Following transplantation, he developed graft-versus-host disease and obstructive jaundice. The pseudohyponatremia was found to be due to hyperlipidemia, but there were some unusual features. The patient's plasma triglyceride concentration was not significantly raised, but he had an extremely elevated cholesterol concentration, probably due to the presence of lipoprotein-X. His plasma, when first separated at room temperature, was icteric and relatively clear but developed a dense turbidity on being frozen at -20 degrees C. PMID- 3523400 TI - The liver sinusoidal cells. Their role in disorders of the liver, lipoprotein metabolism and atherogenesis. AB - A review of the morphological and metabolic interactions between hepatocytes, the various sinusoidal cells and sinusoidal blood is presented. This field of investigation is rapidly expanding, with widespread implications in the regulation of physiological processes and diseases in the liver and other organs. Although most of the review is of already published work, some areas incorporate personal speculations of the probable role of sinusoidal cells in disease processes. PMID- 3523401 TI - New applications of old antimicrobials. PMID- 3523402 TI - Antiviral chemotherapy. AB - The above discussion is not intended to be exhaustive but rather to discuss several compounds which are particularly promising at this time. There is no question that great strides have been made in the development of antiviral compounds over the past couple of decades. Many questions remain unanswered such as long-term effects on the host, possible emergence of resistant viruses, optimal routes of administration, and the proper regimens for particular viruses and diseases. In addition, current studies are evaluating combinations of antiviral agents as well as combination therapy involving interferon or antibody or immunity stimulants along with an antiviral agent. Surprising progress has been made to date resulting not only in new therapeutic modalities but promising a new era of progress. PMID- 3523403 TI - Anaerobic infections. PMID- 3523404 TI - Pertussis immunization. PMID- 3523405 TI - The treatment of bacterial meningitis. PMID- 3523406 TI - Haemophilus influenzae type b polysaccharide vaccine. PMID- 3523407 TI - The role of ultrasonography in the evaluation of vomiting in infants. PMID- 3523408 TI - Congenital hepatic fibrosis with saccular dilatation of intrahepatic bile ducts and infantile polycystic kidneys. AB - A case report is presented of a child who died in the neonatal period and who had the sonographic findings of multiple, tubular, fluid-filled spaces in the liver characteristic of Caroli's disease. There was an echodense renal cortex and pyramids. Necropsy findings were consistent with Caroli's disease but the liver also showed evidence of congenital hepatic fibrosis and there was infantile type polycystic disease of the kidneys. PMID- 3523410 TI - 23rd congress of the European Society of Pediatric Radiology. Barcelona, Spain, 21-23 May 1986. PMID- 3523409 TI - Transitional cell papilloma of the bladder. AB - Bladder tumors of epithelial origin are rare in children. A 7-year-old male presented with intermittent painless hematuria. An ultrasound examination of the bladder revealed a single polypoid mass which proved to be a transitional cell papilloma. PMID- 3523411 TI - Insulin stimulates amino acid and lipid metabolism in isolated fetal rat hepatocytes. AB - Although fetal hyperinsulinemia is associated with excessive deposition of glycogen in liver, both in vivo and in vitro studies show little effect of insulin on glycogen synthesis from glucose or the activity of the enzyme glycogen synthase in the fetus. To investigate whether lack of insulin effect extends to other fetal metabolic processes, we compared the influence of insulin on amino acid uptake (14C-alpha-aminoisobutyric acid) and lipid synthesis [14C-acetate) in freshly isolated hepatocytes from 21-day fetal (F) and adult (A) rats. Viability of F and A hepatocytes was documented by trypan blue exclusion (greater than 90%). In A, insulin stimulated 14C-alpha-aminoisobutyric acid uptake in a dose dependent manner with an apparent Km at 2 ng/ml and a Vmax at 10 ng/ml. When corrected for cell surface area, F cells responded to insulin in a similar dose response manner, although absolute values per 1 X 10(6) cells always remained lower. In contrast, whereas A cells demonstrated a typical dose dependent response of 14C-acetate incorporation into lipid with a Km at 5 ng/ml and Vmax at 10 ng/ml of insulin, F cells remained totally unresponsive when the concentration of acetate was 5 mM or less. However, at higher medium acetate concentrations (15 30 mM) fetal responses were equal to or greater than that of adult, both basally and with insulin. These findings suggest differences in the maturation of insulin mediated processes in fetal rat hepatocytes; effects on amino acid uptake appear earlier than those on lipid or glycogen synthesis. PMID- 3523412 TI - Postheparin plasma lipoprotein and hepatic lipase activities in hyperinsulinemic infants of diabetic mothers and in large-for-date infants at birth. AB - To study postheparin plasma lipase activities in nonfed newborn infants immediately after birth and to investigate the possible influence of fetal hyperinsulinemia on lipoprotein lipase activity, we measured lipoprotein and hepatic lipase activities in 55 macrosomic newborn infants: group I consisted of 21 infants born to mothers with insulin-dependent diabetes. The infants were hyperinsulinemic at birth and had hypoglycemia and poor lipolysis at the age of 2 h. Group II consisted of 18 infants born to mothers with gestational diabetes. Group III consisted of 16 large-for-date infants born to nondiabetic mothers. The mean postheparin plasma lipoprotein lipase activities at 2 h of age were similar (mean 36 mumol free fatty acids/ml/h; SEM 15) in groups I-III. Lipoprotein lipase activity correlated negatively with cord-serum triglycerides (range 0.13-1.2 mmol/liter) but did not correlate with serum insulin (range 5.4-524 microU/ml) or C-peptide (range 0.6-21.0 micrograms/liter). Hepatic lipase activity was somewhat higher in group I (mean 68 mumol free fatty acids/ml/h; SEM 23) than in groups II and III (mean 55 mumol free fatty acids/ml/h; SEM 14). Hemoglobin Alc was the only important factor explaining the difference in hepatic lipase activities between groups. Lipoproteins and apolipoproteins A-I, A-II, and B were similar in all three groups. We conclude that in large-for-date infants lipoprotein lipase is active at birth without exogenous fat induction, and that these infants are capable of hydrolyzing fat, their main source of energy, immediately after birth. In addition, we conclude that postheparin plasma lipoprotein lipase activity is not affected by fetal hyperinsulinemia. PMID- 3523413 TI - Seat restraint contamination and cleaning. AB - This study was undertaken to demonstrate that seat restraints are unlikely vehicles for the transmission of pathogenic bacteria from infant to infant in seat restraint loaner programs. Simple surface cleaning with antibacterial solutions is sufficient to prepare seats for reloaning. PMID- 3523414 TI - Efficacy of computer-assisted management of respiratory failure in neonates. AB - We modified an algorithm for mechanical ventilation of infants with respiratory distress syndrome to create an interactive user-friendly computer program. To determine the effectiveness of this computer program, we evaluated the correction of deranged arterial blood gases in three groups of neonates: group I, treated before the introduction of the computer into the nursery; group II, managed by pediatric residents with the guidance of the computer program; group III, treated after the introduction of the computer into the nursery but managed without consideration of the computer output. Arterial blood gas values improved more frequently in the neonates managed with computer consultation (group II, 65/75, 87%) than in both control groups (group I, 37/57, 65%, P less than .005; and group III, 46/63, 73%, P less than .05). Furthermore, increases in ventilatory support in the presence of normal arterial blood gas values occurred only in patients managed without computer guidance. In a teaching institution, more effective care of neonates with respiratory failure may be facilitated by computer-assisted management of mechanical ventilators. PMID- 3523416 TI - Congenital microcephaly due to vascular disruption: in utero documentation. AB - Death in utero of one member of a monozygotic twin pair has been associated with vascular disruptive phenomena in the surviving twin. It has been hypothesized that this event initiates clot formation in the surviving twin with consequent necrosis of tissues distal to the occluded vessels. This case report describes onset in utero of multicystic encephalomalacia and microcephaly in a surviving twin whose brain appeared normal on ultrasound scanning before death of the cotwin at 21 weeks' gestation. The case provides further support for the hypothesized pathogenetic sequence and illustrates the importance of reviewing all prenatal ultrasound scans in infants with congenital microcephaly. PMID- 3523415 TI - Ultrasonography in the radiologic evaluation of children with urinary tract infection. AB - A prospective blind study comparing the findings of ultrasonography, intravenous pyelography, and voiding cystourethrography was conducted on 81 patients to examine the place of ultrasonography in the initial radiologic evaluation of children with urinary tract infection. The patients' mean age was 4.8 years; 15 were male. Forty-eight were inpatients (mean age, 3.2 years) and 33 were outpatients (mean age 7.2 years). In 29 patients (35.8%) abnormality of the urinary system was detected by one or more of the three imaging procedures; 21 were inpatients and eight were outpatients. The most frequent finding was vesicoureteral reflux, occurring in 62.1% of the pathologic cases. The findings at ultrasonography correlated well with those of intravenous pyelography in 73 of the 81 studies (90.1%), but they failed to demonstrate double collecting systems and several of the minor changes. However, ultrasonography in combination with cystourethrography identified all patients who had abnormal urinary systems, except for two children with negligible findings. Moreover, ultrasonography and cystourethrography together identified all 11 patients, nine of them inpatients, in whom surgical treatment was indicated. It is concluded that ultrasonography can successfully replace intravenous pyelography as a screening imaging procedure for the urinary system, but because of the superiority of intravenous pyelography in the detection of some types of lesions, intravenous pyelography will be required whenever ultrasonography or cystourethrography results are abnormal.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3523417 TI - Neonatal neurosonographic correlates of cerebral palsy in preterm infants. AB - Serial neurosonographic examinations are routinely performed at frequent intervals during the nursery course of all preterm infants of 33 weeks or less gestation who are admitted to the intensive care nursery of Thomas Jefferson University Hospital. After discharge, the following survivors during the past 5 years had repeated ultrasound examinations until the anterior fontanel closed and clinical assessments until the presence or absence of cerebral palsy at a minimum age of 12 months was established: all infants with grade III/IV intracranial hemorrhage, periventricular echodensity and periventricular cyst formation, selected infants with either normal ultrasound findings or grade I/II intracranial hemorrhage. Fifteen survivors were found to have cerebral palsy, and all had at least one of the following ultrasound abnormalities: diffuse, bilateral, and multiple periventricular cysts 3 mm or more in diameter that persisted beyond term age, bilateral asymmetrical dilation of the lateral ventricles following grade III intracranial hemorrhage with small periventricular cysts, and ventricular porencephaly following an ipsilateral grade IV intracranial hemorrhage. The periventricular cysts were usually preceded by extensive echodensities of the white matter surrounding the lateral ventricles; these findings were suggestive of periventricular leukomalacia and were the most common abnormal findings on ultrasound in the infants with cerebral palsy. Of 124 infants without cerebral palsy, 121 had no or less severe abnormal findings on ultrasound; the exceptions were three infants with bilateral persistent large periventricular cysts who had normal motor development in late infancy. PMID- 3523418 TI - [Acute generalized exanthematic pustulosis in children. Apropos of a case]. AB - A seven year old girl without any personal or familial history of psoriasis presented with a maculo-papular then pustular, uniformly generalized eruption. She also had fever, neutrophilic granulocytosis, conjunctivitis and vulvitis. There was no evidence for bacterial or viral aetiology. Skin biopsy showed spongiform multilocular pustules and a vasculitis. The child recovered spontaneously within one week without further relapse. PMID- 3523419 TI - [Intolerance to cow's milk proteins. I--Clinical and biological manifestations]. PMID- 3523420 TI - Proceedings of the International Symposium on "The role and significance of international cooperation in the biomedical sciences." Dedicated to the memory of Dr. Rodney R. Porter. Washington, D.C., September 21-23, 1983. PMID- 3523421 TI - Understanding blood and hemoglobin: an example of international relations in science. PMID- 3523422 TI - Development of concepts of protein structure. PMID- 3523423 TI - Doing research in the Intramural Program of the National Institutes of Health. PMID- 3523424 TI - Four decades of Franco-American collaboration in biochemistry and molecular biology. PMID- 3523425 TI - How embryologists became developmental biologists and other matters. PMID- 3523426 TI - Turning points in cellular immunology: the skein untangled through a global invisible college. PMID- 3523427 TI - The glorious days of cellular immunology: New York University years and beyond, an international experience. PMID- 3523428 TI - The role and significance of international cooperation in the biomedical sciences. Historical background. PMID- 3523429 TI - From high-molecular-weight protein models to enzyme engineering: research at the Weizmann Institute of Science. PMID- 3523430 TI - Shaping research in gene expression: role of the Cambridge Medical Research Council Laboratory of Molecular Biology. PMID- 3523431 TI - The Pringle and Kirk four-bar crossed linkage and the "safety-knee". PMID- 3523432 TI - Bouncy knee in a semi-automatic knee lock prosthesis. AB - The Bouncy Knee concept has previously proved of value when fitted to stabilised knee units of active amputees. The stance phase flex-extend action afforded by a Bouncy Knee increased the symmetry of gait and also gave better tolerance to slopes and uneven ground. A bouncy function has now been incorporated into a knee of the semi-automatic knee lock design in a pilot laboratory trial involving six patients. These less active patients did not show consistent changes in symmetry of gait, but demonstrated an improved ability to walk on slopes and increased their walking range. Subjective response was positive, as noted in the previous trials. PMID- 3523433 TI - [Imaging of cardiovascular disease--its dynamic analysis]. PMID- 3523434 TI - Home care agencies and community health services accredited by NLN October 1985. PMID- 3523435 TI - [Eperythrozoonosis in swine--an overlooked disease?]. AB - In the present work a review is given on the aetiology, clinical symptoms, prevalence and significance of the disease eperythrozoonosis in swine. Clinical outbreaks are characterized by fever, anemia and icterus. Clinical signs are most likely to be observed in young suckling piglets and in sows at the time of farrowing. In most cases infection with Eperythrozoon suis leads to a carrier state of symptomless, subclinical infection which, however, may be activated under conditions of stress. Eperythrozoonosis in swine has been reported from the USA, England, Federal Republic of Germany, Belgium and a few other countries. Due to the latent nature and the non-specific clinical symptoms of the disease it seems likely that the prevalence of E. suis in swine populations may be considerably greater than the number of clinical cases might lead one to suppose. So far, E. suis has not been diagnosed in Scandinavia, but it should not be excluded that eperythrozoonosis may exist as a neglected disease in Nordic swine herds as well. PMID- 3523436 TI - The minimal duplex DNA sequence required for site-specific recombination promoted by the FLP protein of yeast in vitro. AB - The 2-micron plasmid of the yeast Saccharomyces cerevisiae codes for a site specific recombinase ('FLP') that efficiently catalyses recombination across the plasmid's two 599 bp repeats both in vivo and in vitro. We have used the partially purified FLP protein to define the minimal duplex DNA sequence required for intra- and intermolecular recombination in vitro. Previous DNase footprinting experiments had shown that FLP protected 50 bp of DNA around the recombination site. We made BAL31 deletions and synthetic FLP sites to show that the minimal length of the site that was able to recombine with a wild-type site was 22 bp. The site consists of two 7 bp inverted repeats surrounding an 8 bp core region. We also showed that the deleted sites recombined with themselves and that one of three 13 bp repeated elements within the FLP target sequence was not necessary for efficient recombination in vitro. Mutants lacking this redundant 13 bp element required a lower amount of FLP recombinase to achieve maximal yield of recombination than the wild type site. Finally, we discuss the structure of the FLP site in relation to the proposed function of FLP recombination in copy number amplification of the 2-micron plasmid in vivo. PMID- 3523437 TI - The involvement of host replication proteins and of specific origin sequences in the in vitro replication of miniplasmid R1 DNA. AB - The in vitro replication of R1 miniplasmid promoted by purified preparations of the plasmid encoded RepA protein in cell extracts of E. coli is resistant to rifampicin and can be completely inhibited by antibodies against DnaG, the primase of the cell, as well as by antibodies against proteins DnaB and SSB. R1 replication is abolished in extracts deficient in the DnaA protein. This deficiency is efficiently complemented by purified preparations of the DnaA protein. The in vitro replication of plasmid R1 is also abolished in DnaC deficient extracts and by a 10 bp deletion (nucleotides 1463-1472) within the minimal origin region. These data indicate the requirement of the DnaA, DnaB, DnaC, DnaG and SSB replication proteins of the host, as well as of specific oriR1 sequences for the RepA dependent replication of plasmid R1. The implications of these results for the initiation of R1 replication are discussed. PMID- 3523438 TI - Analysis of the nucleotide sequence of the ereB gene encoding the erythromycin esterase type II. AB - We have determined the nucleotide sequence of the ereB gene of plasmid pIP1527 which confers high-level resistance to erythromycin by inactivation in Escherichia coli. The open reading frame of the ereB gene, 1257-bp, was defined by initiation and termination codons and by cloning in vitro. The corresponding protein has a calculated Mr of 48,118 in close agreement with a previous estimation, 51,000, by electrophoresis of minicell extracts in SDS-polyacrylamide gels. The structure of the modified erythromycin was determined by physico chemical techniques including mass spectrometry, infrared spectrophotometry and 13C nuclear magnetic resonance. The data obtained indicated that like ereA (Ounissi and Courvalin, 1985) ereB encodes an erythromycin esterase. Comparison of the amino acid sequences of the two isozymes did not reveal any statistically significant homology. Analysis of the nucleotide sequence of the ereB gene suggests that this resistance determinant should be exogenous to E. coli. PMID- 3523439 TI - Fast quantification of nucleic acid hybrids by affinity-based hybrid collection. AB - A hybridization technique for the quantification of nucleic acids is described. In the method a probe pair is allowed to form hybrids with the target nucleic acid in solution. One of the probes has been modified with an affinity label, by which the formed hybrids can be isolated after the reaction. Streptavidin-agarose was used to capture hybrids containing biotinylated DNA. The hybrids were measured using radioiodine as label on the second probe. The rate of the hybridization reaction in solution is fast, allowing the whole procedure to be carried out in 3 h. The method is quantitative with a detection limit of 4 X 10(5) molecules (0.67 attomoles) target DNA. The test is insensitive to impurities in biological samples, which are analyzed without purification of the target DNA. Non-isotopic measurement of the hybrids can also be applied. In this case the hybrids are bound to microtitration wells and detected spectrophotometrically by peroxidase-catalyzed colour development. PMID- 3523441 TI - Geminivirus coat protein gene promoter sequences can function in Escherichia coli. PMID- 3523442 TI - Dental care for the elderly. PMID- 3523440 TI - The gene II proteins of the filamentous phages IKe and Ff (M13, fd and f1) are not functionally interchangeable during viral strand replication. AB - Gene II protein is the only phage-encoded protein required for the double stranded DNA replication of the distantly related filamentous phages IKe and Ff (M13, fd and f1). Complementation studies have demonstrated that, despite a significant degree of homology between the nucleotide sequences of the gene II's of IKe and Ff and the core's (domains A) of their viral strand replication origins, the biological functions of the gene II proteins are not interchangeable. The specificity of these proteins is not determined by the nucleotide sequence (domain B) which is required for efficient initiation of viral strand replication of Ff. In fact, our data indicate that a sequence with a similar function as domain B in Ff does not form part of the viral strand replication origin of IKe. PMID- 3523443 TI - Informed consent. The great conspiracy. PMID- 3523444 TI - Shattering the Nightingale myth. PMID- 3523445 TI - [Etiopathogenesis of spontaneous pneumothorax]. PMID- 3523446 TI - [Bone marrow aplasia]. AB - Aplastic anaemia is a haematological syndrome in which pancytopenia is due to a depletion, damage of inhibition of hemopoietic stem cells. The pathogenetic factors are still unclear: damage or inhibition of hemopoietic stem cells may be direct or indirect mediated through changes in the cellular humoral environment; evidence is accumulating that in some cases these processes are of autoimmune nature. The prognostic evaluation is based on hematological parameters at diagnosis: severe aplastic anemia (SAA) is defined by the following criteria: neutrophils less than 0.5 X 10(9)/l; reticulocytes less than 0.5 X 10(9)/l and platelets less than 20 X 10(9)/l. Survival rates in children with SAA are poor; the probability of survival at 1 year from diagnosis being 10%. In this form treatment is based on supportive therapy (transfusion and prevention of infections) and on a specific therapy: immunosuppression and/or BMT. BMT is reserved to patient with an HLA identical sibling donor and may be curative in 70 80% of cases. To date the use of antilymphocytoglobulin in SAA has also given satisfactory results with a favorable response in 50-60% of cases. PMID- 3523447 TI - [Secondary prevention of ischemic heart disease. Evaluation of platelet function in patients treated with anticoagulants and cod liver oil]. PMID- 3523448 TI - [Development of aspirin tolerance in hypersensitive persons. II. Clinical usefulness and the mechanisms of the phenomenon of aspirin tolerance]. PMID- 3523449 TI - [New theories on the pathogenesis and methods of treating thrombotic thrombocytopenic purpura (Moschkowitz disease)]. PMID- 3523450 TI - Ultrasound assessment of ductal closure, pulmonary blood flow velocity, and systolic pulmonary arterial pressure in healthy neonates. AB - Ultrasound Doppler was used to establish time of ductal closure, normal values for blood flow velocity in the pulmonary artery (PA), and time interval between pulmonary valve closure (Pc) and tricuspid valve opening (To) in 37 healthy neonates. Ductal closure had occurred in 23% of the children within 12 h after delivery and in 53% during the next 12 h. No open ductus was found after 30 h of age. Maximal blood flow velocity was 0.90 +/- 0.09 (SD) m/s during the first five days of life and 1.12 +/- 0.17 m/s at the age of 14-30 days. The Pc-To interval is known to reflect systolic PA pressure in adults. The Pc-To interval decreased significantly (p less than 0.01) from an average of 0.059 +/- 0.016 s at 3.5-12 h of age to 0.048 +/- 0.011 at 19-36 h of age and thereafter successively to 0.027 +/- 0.004 s at 20-30 days of age. This value is only slightly higher than that of 0.015-0.020 s for normal adults at comparable heart rates. These data suggest a rather sharp decline of systolic PA pressure during the first day of life and thereafter a slower decline; normal adult values are approached but not reached at 3-4 weeks of age. The Pc-To value seems to be of limited value in the early neonatal period, because even normal neonates have increased values with a large individual variation. After 3-4 weeks of age, an increased value should be taken as an indication of increased systolic PA pressure. PMID- 3523451 TI - Myocardial infarction in a child with Salmonella enterocolitis. AB - The case history and findings of a seven-month-old North American Indian girl with myocardial infarction following a prolonged febrile seizure associated with Salmonella typhimurium enterocolitis are presented and discussed. This appears to be a unique observation not previously described in the literature. PMID- 3523452 TI - Acute infectious diarrhea. I. Epidemiology, etiology and pathogenesis. PMID- 3523453 TI - Trimethoprim-sulfamethoxazole treatment of cholangitis complicating congenital hepatic fibrosis. PMID- 3523454 TI - Fungemia due to Fusarium solani in an immunocompromised child. PMID- 3523455 TI - Suppurative thrombophlebitis with sepsis due to Candida albicans: an unusual complication of intravenous therapy in cystic fibrosis. PMID- 3523456 TI - Bloodstream invasion with Shigella sonnei in an asymptomatic newborn infant. PMID- 3523457 TI - Ceftazidime vs. standard therapy for pediatric meningitis: therapeutic, pharmacologic and epidemiologic observations. AB - One hundred patients ages 1 month to 15 years received either ceftazidime (CZ) at a dose of 150 mg/kg/day divided every 8 hours or conventional treatment with chloramphenicol and ampicillin (CA). Seventy-eight had isolates recovered from the cerebrospinal fluid: 40 (51%) were Haemophilus influenzae (all ampicillin susceptible); 16 (21%) were Streptococcus pneumoniae; 14 (18%) were Neisseria meningitidis; 3 (4%) were salmonellae; 1 (2%) was Pseudomonas; and 1 (2%) was Group B Streptococcus. Six patients with negative cerebrospinal fluid culture had positive latex agglutination (two H. influenzae, three N. meningitidis, one S. pneumoniae). Sixty-one patients had positive blood cultures. CZ inhibited 100% of H. influenzae at 0.78 micrograms/ml, S. pneumoniae at 0.39, N. meningitidis at 0.04 and salmonellae at 0.39 micrograms/ml. The mean peak serum concentration of CZ was 36.4 micrograms/ml with a mean cerebrospinal fluid level of 7.4 micrograms/ml. If one eliminates from the statistics those patients who died less than or equal to 24 hours after admission, five (10%) of 49 patients treated with CZ died, one (2%) improved and 43 (88%) were cured. Overall 29 patients died, 12 receiving CZ (20%) and 8 receiving CA (21%). There were no significant CZ-related toxicities. Gross neurologic sequelae were noted in 5% of 38 CZ patients and 4% of 28 CA patients. CZ compared favorably to CA for treatment of meningitis. PMID- 3523458 TI - Treatment of bacterial meningitis with ceftazidime. AB - Ceftazidime was prospectively evaluated in the treatment of bacterial meningitis in 19 pediatric patients. Haemophilus influenzae type b (HIB) was the etiologic agent in 17 patients, and Streptococcus pneumonia and Neisseria meningitidis were the etiologic agents in one patient each. Ceftazidime was administered intravenously in a dosage of 150 mg/kg/day divided into eight hourly doses for a mean of 15 days (range, 14 to 22 days) for H. influenzae type b meningitis. The clinical and microbiologic response was appropriate in all cases. The mean ceftazidime CSF concentration was 6.7 micrograms/ml at approximately 2 hours following iv infusions. This concentration was 16- to greater than 100-fold the minimal bactericidal concentration determined for the isolated pathogens. These preliminary observations support ceftazidime as a candidate cephalosporin for the treatment of bacterial meningitis caused by H. influenzae. Additional study is required to further define its role in meningitis caused by S. pneumoniae and N. meningitidis. PMID- 3523459 TI - Meningitis complicating acute bacteremic facial cellulitis. AB - Eighty cases of acute bacteremic facial cellulitis, 34 buccal and 46 preseptal, were reviewed from the years 1977 through 1982. The epidemiology, clinical presentation, laboratory parameters and course of cellulitis in these two locations were similar. The white blood cell count was over 15,000 in three fourths of the patients. Haemophilus influenzae type b was cultured from the blood of 67 patients, Streptococcus pneumoniae from 12 and Streptococcus pyogenes from 1. Seven patients had culture-proved meningitis, six with H. influenzae type b and one with S. pneumoniae. Five of these patients had sparse clinical evidence of meningitis, and three of these had meningitis apparent by culture only. We conclude that meningitis may occur in association with acute bacteremic facial cellulitis and may be inapparent both clinically and by initial laboratory examination. We suggest aggressive initial evaluation and treatment of these infants pending culture results. PMID- 3523460 TI - Imipenem-cilastatin: the first thienamycin antibiotic. PMID- 3523461 TI - Infections due to Chlamydia trachomatis from infancy to adolescence. PMID- 3523462 TI - Hemophagocytic histiocytosis associated with Serratia marcescens septicemia. PMID- 3523463 TI - Encephalitis lethargica and the development of neuropsychiatry. AB - This article presents a comprehensive overview of the subject including historical background, general features and neuropathology, and contributions to clinical phenomenology. PMID- 3523464 TI - Historical perspective on neurobehavior. AB - The current penetration of psychology, psychiatry, and sociology by neurobiologists is traced from its slow inception in the nineteenth century to the exponential explosion of information in recent decades, which has shown that behavior is a biosocial phenomenon, resulting from interactions between the brain and the environment. Therefore, to exclude either from the equation is to invite error. PMID- 3523465 TI - [Clinical aspects of gastroesophageal reflux in children]. PMID- 3523466 TI - Free vascularized bone transfers for nonunions, segmental gaps, and following tumor resection. AB - Free vascularized bone transfer is recognized as a valuable technique for skeletal reconstruction and salvage with certain nonunions, skeletal defects, and following tumor resection. This procedure is most often indicated for reconstruction of lengthy skeletal defects or under circumstances where conventional bone grafting techniques are unlikely to succeed. Factors affecting selection of donor bone and technical peculiarities relative to the recipient sites are discussed. The results of 49 cases at the Mayo Clinic for management of nonunion, segmental gaps or following tumor resection suggest a union rate of 82%. The most consistent rate of success was found for reconstruction of defects affecting the tibia, mandible or forearm bones. PMID- 3523467 TI - Microvascular transfer of the fibula for necrosis of the femoral head. PMID- 3523468 TI - Diaper dermatitis: frequency and severity among a general infant population. AB - The frequency and severity of diaper dermatitis was measured among a midwestern suburban population of 1089 infants ranging in age from 1 to 20 months. No diagnosis of specific etiology was made. Fecal samples were collected and analyzed for Candida albicans, and information on family characteristics, infant diet, general health, history of rash, and diapering habits and practices was collected by questionnaire. The distribution of the severity of observed diaper rash can be described as a logarithmic-normal function, implying several multiplicative causative factors. Within the total severity range, there appear to be three subcategories of diaper rash, differing in some manner, perhaps reflecting different etiologies. The frequency of observed diaper rash was a function of the maturity of the infant, reaching a maximum around 9 to 12 months of age. The prevalence of severe rash correlated with the presence and level of fecal C. albicans. Infants diapered exclusively in disposable diapers showed less rash (P less than 0.001) than those diapered exclusively or sometimes in cloth diapers. PMID- 3523469 TI - A solitary variant of congenital self-healing reticulohistiocytosis: solitary Hashimoto-Pritzker disease. AB - Four neonates had solitary, congenital, rapidly growing, spontaneously ulcerating tumors of the face, trunk, and extremities. No extracutaneous involvement was found, and all lesions spontaneously involuted. Mononuclear cells of the cutaneous infiltrate were Langerhans' cells. These findings expand the spectrum of congenital self-healing reticulohistiocytosis. PMID- 3523470 TI - Human insulin. Its development and clinical use. AB - With the recent availability of human insulin, we have entered a new era in therapy for diabetes mellitus. Human insulin is not a cure for diabetes; however, no disadvantages are known to be associated with its use at present. Human insulin costs less than the other purified insulins, and because of its potential advantages, human insulin deserves consideration for use in all newly diagnosed insulin- dependent diabetics. PMID- 3523471 TI - Insulin therapy in diabetes. The importance of good glucose control. AB - Good blood glucose control is desirable to prevent or retard the chronic complications of diabetes mellitus. In diabetics who have a nearly normal hemoglobin A1c (glycohemoglobin) concentration and who can adjust their diet and activities to avoid hypoglycemia, one insulin injection daily may be adequate. In most insulin-dependent diabetics, however, a more complicated insulin regimen, tailored to the patient's needs, is required. The best treatment regimen is one that causes minimal disruption in the patient's life-style, costs little, yet produces good results. Glucose levels should be assessed frequently and therapy adjusted as needed. Although good glucose control is difficult to achieve, new monitoring techniques and insulin delivery systems have made the goal more attainable than ever before. By following the motto "Recheck often and change PRN," physicians can achieve the goal in more patients and thus help reduce the chronic complications of diabetes mellitus. PMID- 3523472 TI - Diagnostic techniques in prostatic cancer. AB - At present no single test is effective in detecting prostatic carcinoma, although some newer tests show promise. Several investigators are working to increase the specificity and sensitivity of various radioimmunoassays for prostatic cancer detection, but to date this research has not been rewarding. Careful rectal examination and close attention to the patient's symptoms may still be the only keys to diagnosis. Patients in their 50s and 60s with acute onset of symptoms have a relatively high incidence of prostatic carcinoma. These patients should have a rectal examination and aspiration biopsy cytology of any suspicious areas found on examination. Possibly these patients should have aspiration biopsy cytology even in the absence of suspicious findings to screen for disease before it becomes an obvious clinical entity. This is perhaps the best approach to prostatic cancer, ie, attack at a time in which there are fewer cells and a greater chance of cure. PMID- 3523473 TI - Use of egg washwater pH to prevent survival of Salmonella at moderate temperatures. AB - The survival and thermal resistance of Salmonella typhimurium N+L141083 was examined in egg washwater at moderate temperatures over a range of pH values. Salmonella were able to grow at 38 and 42 C when washwater pH was less than or equal to 9.5, but substantial lethality was noted at greater than or equal to pH 10. At pH 10.5 and 11, Salmonella were eliminated within 5 hr. At 6 C, Salmonella levels were maintained for 18 hr without lethality up to pH 11. At pH 11, some lethality was noted after 5 hr. A D42 value at pH 7.0 could not be calculated, but at pH 10, a value of 40.8 sec was determined. Narrow range pH paper (pH 8 to 10) responded to egg washwater contact at or above pH 10 with a clear color reaction. Below pH 10, the paper signalled the need for addition of alkaline detergent to prevent the growth of Salmonella. PMID- 3523474 TI - [Bronchial hyperreactivity. Methods of detection with pharmacologic substances]. PMID- 3523475 TI - The prenatal diagnosis of the Walker-Warburg syndrome. AB - On the basis of physical features and autopsy findings, a child with congenital hydrocephalus, bilateral microphthalmia, myopathy, severe developmental retardation and multiple brain malformations was diagnosed to have the Walker Warburg Syndrome (WWS). During a subsequent pregnancy in this family, a fetus at risk for this autosomal recessive condition was evaluated with serial ultrasound examinations. At 15 weeks of gestation an encephalocele was noted. Disproportionately slow growth of the head compared to the body was noted at 36 weeks. At birth, the diagnosis of WWS was confirmed in the child due to the presence of microcephaly, an encephalocele, a meningocele and bilateral microphthalmia. This is the first reported case of the early prenatal diagnosis of this recently categorized genetic condition, in which the major features are hydrocephalus, multiple central nervous system malformations, microphthalmia with ocular malformations, severe psychomotor retardation, congenital myopathy and a very limited life expectancy. PMID- 3523476 TI - Congenital chylothorax--prenatal ultrasonic diagnosis and successful post partum management. AB - The prenatal diagnosis by ultrasound of congenital chylothorax is described allowing early intervention immediately after delivery. Unilateral fluid collection in the right lung with marked displacement of the heart to the left were the most prominent sonographic signs. Post partum thoracocentesis and chylus fluid drainage served as a life saving procedure. PMID- 3523477 TI - Prenatal ultrasonic diagnosis of radial-ray aplasia and renal anomalies (acro renal syndrome). AB - Prenatal ultrasonic diagnosis of a rare case of radial ray aplasia and crossed renal ectopy is described in an affected sibling of a family where the father and his son suffer from this rare syndrome. The prenatal diagnosis enabled early pregnancy termination. PMID- 3523478 TI - Inducible production of c-fos antisense RNA inhibits 3T3 cell proliferation. AB - Antisense RNA complementary to c-fos mRNA was produced in mouse 3T3 cells by gene transfer techniques. Transcriptional units were constructed consisting of a steroid-inducible mouse mammary tumor virus (MMTV) promoter, mouse or human 5' c fos gene fragments in either the sense (5' to 3') or antisense (3' to 5') orientation, and splice and poly(A) signals from the human beta-globin gene. A gene that confers neomycin resistance was included in the vectors to allow isolation of stable transformants. Dexamethasone caused a marked induction of hybrid MMTV-fos-globin RNA. Induction of the hybrid transcript containing antisense c-fos RNA decreased colony formation following DNA transfer and inhibited the proliferation of cells into which the antisense transcriptional unit had been integrated. In contrast, colony formation and cell proliferation were not inhibited by induction of hybrid RNA containing c-fos RNA sequences in the sense orientation. These results indicate that the strategy of generating antisense RNA to inhibit gene expression may be useful in delineating the function of protooncogenes. The c-fos gene product appears to have a required role in normal cell division. PMID- 3523479 TI - Odorant-binding protein: localization to nasal glands and secretions. AB - An odorant-binding protein (OBP) was isolated from bovine olfactory and respiratory mucosa. We have produced polyclonal antisera to this protein and report its immunohistochemical localization to mucus-secreting glands of the olfactory and respiratory mucosa. Although OBP was originally isolated as a pyrazine binding protein, both rat and bovine OBP also bind the odorants [3H]methyldihydrojasmonate and 3,7-dimethyl-octan-1-ol as well as 2-isobutyl-3 [3H]methoxypyrazine. We detect substantial odorant-binding activity attributable to OBP in secreted rat nasal mucus and tears but not in saliva, suggesting a role for OBP in transporting or concentrating odorants. PMID- 3523480 TI - Mutations affecting the signal sequence alter synthesis and secretion of yeast invertase. AB - Insertion mutations previously constructed within the proximal region of the yeast invertase signal sequence did not interfere with secretion or glycosylation of the enzyme. We now describe deletion mutations within the same signal sequence. Large deletions truncating the hydrophobic core of the signal peptide prevented both secretion and glycosylation of the enzyme and increased the intracellular concentration of nonglycosylated invertase. This increase was coupled with the appearance of a new invertase polypeptide, 2 kilodaltons larger than cytoplasmic invertase. The new polypeptide was consistent in size with uncleaved (signal peptide intact) pre-secretory invertase previously identified by using in vitro translation (apparent molecular mass, 62 kilodaltons). The data on enzyme activity indicate that invertase whose secretion is aborted by large deletion mutations augments the normal pool of cytoplasmic invertase found in sucrose-fermenting yeast cells. PMID- 3523481 TI - Extracellular localization of pokeweed antiviral protein. AB - Pokeweed antiviral protein is an enzyme of Mr 29,000 known to inactivate a wide variety of eukaryotic ribosomes. We have used electron microscopy to show that the antibody specific for the protein is bound within the cell wall matrix of leaf mesophyll cells from Phytolacca americana. Any penetration or breakage of the cell wall and membrane could allow the enzyme to enter the cytoplasm, where it is likely to inhibit protein synthesis in the damaged cell. We speculate that pokeweed antiviral protein is a defensive agent whose principal function is probably antiviral. PMID- 3523482 TI - Intracellular site of insulin action: mitochondrial Krebs cycle. AB - Effect of insulin on the oxidation of carbons-1,4 and -2,3 of succinate and their incorporation into protein were studied in isolated rat hepatocytes and diaphragm muscle pieces. Oxidation of carbons-2,3 of succinate and their incorporation into hepatocyte protein were stimulated significantly by insulin. Insulin had only a trivial effect on 14CO2 formation from the carboxyl carbons of succinate. These data suggest that insulin affects only those carbons of succinate that are metabolized in the intramitochondrial Krebs cycle. PMID- 3523483 TI - Cell cycle-specific replication of Escherichia coli minichromosomes. AB - The timing of Escherichia coli minichromosome replication in the cell division cycle was examined using an improved procedure for studying plasmid replication frequency. Cultures growing exponentially in glucose/Casamino acids minimal medium were pulse-labeled with [3H]thymidine, and the radioactivity incorporated into plasmid DNA in cells of different ages was analyzed. At the end of the labeling period the bacteria were bound to the surface of a nitrocellulose membrane filter, and the radioactivity in new daughter cells, which eluted continuously from the membrane, was quantitated following agarose gel electrophoresis. The minichromosomes replicated during a discrete interval in the cell division cycle that appeared to coincide with initiation of chromosome replication. In contrast, plasmid pBR322 replicated throughout the division cycle at a rate that increased gradually as a function of cell age. The difference in minichromosome and pBR322 replication was clearly discernible in cells harboring both plasmids. It was also found that the 16 kD gene adjacent to oriC was not a determinant of the timing of minichromosome replication during the division cycle. The results are consistent with the conclusion that minichromosome replication frequency is governed by the same mechanism that controls chromosome replication. PMID- 3523484 TI - Mutants of Salmonella typhimurium that cannot survive within the macrophage are avirulent. AB - Salmonella typhimurium is a facultative intracellular pathogen capable of surviving within phagocytic cells of the reticuloendothelial system. To identify the genes important for intracellular survival, 9516 independent Tn10 insertional mutations were isolated in a virulent strain of S. typhimurium. By using an in vitro assay for survival within macrophages, 83 Tn10 mutants have been identified that have a diminished capacity for intracellular survival (designated MS or macrophage survival mutants). All of the MS mutants are less virulent than the parent strain in vivo, demonstrating that, for Salmonella, survival within the macrophage is essential for virulence. Thirty-seven of the MS mutants have been characterized as to their phenotype, including several mutations that confer sensitivity to specific microbiocidal mechanisms of the macrophage. PMID- 3523485 TI - Sequence homology requirements for intermolecular recombination in mammalian cells. AB - We have examined the homology requirements for intermolecular recombination between plasmids introduced into human, monkey, and bacterial cells. Variable size-deletion derivatives of the prokaryotic-eukaryotic shuttle vector pSV2neo were constructed. Each of these plasmids was mixed with another pSV2neo plasmid containing a different, nonoverlapping deletion. Recombination was measured in mammalian cells and bacteria by the frequency of reconstruction of an intact neo gene. We observed that 25 base pairs of homologous sequence is sufficient to yield recombinant products, implying that synapsis and homologous pairing can occur with this level of homology. Examination of the products revealed that nonreciprocal recombination played a role in the generation of normal neo genes. In addition coconversion of linked markers was observed. Exonucleolytic action seems to play a role in gene conversion. PMID- 3523486 TI - Suppression of tumorigenicity with continued expression of the c-Ha-ras oncogene in EJ bladder carcinoma-human fibroblast hybrid cells. AB - A human tumor cell line (EJ) expressing an activated c-Ha-ras oncogene was fused with a normal human fibroblast cell line. This fusion resulted in hybrids that behaved as transformed cells in culture but failed to form tumors in nude (athymic) mice. After repeated cell passage, two tumorigenic segregants of the hybrids arose in culture. The levels of expression of activated c-Ha-ras mRNA and its protein product, p21, were similar in the EJ cell line, the nontumorigenic hybrids, and the tumorigenic segregants. DNA transfections of the hybrids were performed with activated c-Ha-ras plasmid constructs, and transfectants expressing a 2-fold level of c-Ha-ras relative to the hybrid cells were found to maintain the nontumorigenic phenotype. We suggest that expression of the active c Ha-ras oncogene is insufficient for the malignant transformation of these human cells. PMID- 3523487 TI - Analysis of the structure, transcripts, and protein products of bcl-2, the gene involved in human follicular lymphoma. AB - We have determined that the bcl-2 (B-cell leukemia/lymphoma 2) gene is transcribed into three overlapping mRNAs, and we have cloned bcl-2 cDNA sequences. Sequence analysis of the bcl-2 cDNA clones and comparison of their sequences to their genomic counterparts indicate that the bcl-2 gene contains at least two exons. The three bcl-2 transcripts, which are 8.5, 5.5, and 3.5 kilobases (kb) long, overlap within the first exon, but only the 8.5-kb and 5.5 kb transcripts contain sequences of the second exon. The 8.5-kb and 5.5-kb transcripts seem to use different polyadenylylation sites. Sequence analysis of the cDNA clones corresponding to the 5.5-kb and 3.5-kb mRNAs indicates that the two bcl-2 transcripts carry two overlapping open reading frames, one of which is 717 nucleotides long and codes for a protein (bcl-2 alpha) of 239 amino acids and a molecular mass of 26 kDa, while the other codes for a protein of 205 amino acids (bcl-2 beta, molecular mass 22 kDa) that is identical to bcl-2 alpha except at the carboxyl terminus. The bcl-2 protein products in follicular lymphomas with or without bcl-2 rearrangements are identical to the normal bcl-2 products. PMID- 3523489 TI - Production of a monoclonal antibody specific for seminomas and dysgerminomas. AB - A monoclonal antibody (M2A, IgG2a) was produced against a cultured human ovarian epithelial adenocarcinoma cell line, HEY. Monoclonal antibody M2A reacted with a glycoprotein of molecular weight 40,000 on the surface of HEY cells. The affinity constant of the monoclonal antibody M2A for HEY cells was 10(9) M-1, and the number of binding sites on HEY cells was 2 X 10(4) per cell. The monoclonal antibody produced positive immunoperoxidase staining of fetal (but not adult) testis and of seminomas and dysgerminomas but did not stain various normal adult tissues or other gonadal or extragonadal tumors. Monoclonal antibody M2A may be useful for confirming a histological diagnosis of seminoma and dysgerminoma. PMID- 3523490 TI - Ciclosporin. Forward. PMID- 3523488 TI - Experimental metastasis in nude mice of NIH 3T3 cells containing various ras genes. AB - These studies have compared the ability of NIH 3T3 cells containing different ras oncogenes to form tumor nodules in the lungs of nude mice after tail vein injection. The genes studied include the normal cellular and bladder tumor ras genes, recombinant viral/cellular ras genes, recombinant yeast/mammalian ras genes, and a constructed gene with yeast RAS1 sequences significantly modified by deletions and an oncogenic mutation. The results show that NIH 3T3 cells containing these genes readily form lethal tumor nodules in the lungs of nude mice after tail vein injection. No control NIH 3T3 cells formed lung tumors within 66 days. Although there were some quantitative differences in the potencies of the various lines, the striking conclusion is that NIH 3T3 cells transformed by either normal or activated mammalian ras genes form approximately equal numbers of experimental lung metastases. In addition, cells transformed by a significantly modified yeast RAS1 gene containing a purposefully introduced oncogenic mutation were also equally active in this assay. The amount of p21 (the 21-kDa protein encoded by ras), as measured by immunoprecipitation, was approximately the same in the parent lines before injection as in the tumors recovered after injection. This result indicates that there is no selection for metastatic sublines containing larger quantities of p21. Transfection of EJ bladder tumor ras DNA into NIH 3T3 cells followed by injection 3 days later into the tail veins of nude/beige mice indicated that the EJ ras gene can confer a metastatic phenotype within 3.5 cell generations without selection or clonal growth in vitro. Thus, the biochemical changes initiated after introduction of the c-Ha-ras gene into NIH 3T3 cells result in the almost immediate acquisition of phenotypes necessary for experimental metastasis. PMID- 3523491 TI - Ciclosporin. Historical background. PMID- 3523492 TI - Clinical transplantation--overview. PMID- 3523493 TI - Ciclosporin in renal transplantation. PMID- 3523494 TI - Multicenter impact of ciclosporin on cadaver kidney graft survival. PMID- 3523495 TI - Bone marrow transplantation with ciclosporin. PMID- 3523496 TI - Cyclosporin. Bioanalytical considerations. PMID- 3523497 TI - Ciclosporin and its future. PMID- 3523498 TI - Fructose: metabolism and short-term effects on carbohydrate and purine metabolic pathways. PMID- 3523499 TI - Morphological changes of organs after sucrose or fructose feeding. PMID- 3523500 TI - Dietary carbohydrate and energy balance. AB - It seems to be well established that the thermogenic response to various di- and mono-saccharides is not identical, with the greatest immediate response seen after fructose per se or in sucrose. There is also tendency for weight loss to be greater on a diet with a high proportion of glucose than a comparable diet with sucrose, both in man and male rats. PMID- 3523501 TI - 'Disaccharide effect'--comparison of metabolic effects of the intake of disaccharides and of their monosaccharide constituents. PMID- 3523502 TI - Effects of acute and long-term fructose administration on liver lipid metabolism. PMID- 3523503 TI - Effects of dietary sucrose or fructose on carbohydrate and lipid metabolism. Animal studies. PMID- 3523504 TI - Metabolic responses to dietary carbohydrates: interactions of dietary and hereditary factors. AB - It has been demonstrated that the metabolic responses to ingested carbohydrate depend on the genetic make-up of the recipient; the type of the ingested carbohydrate molecule, and the amount and nature of protein, fat and the different trace elements in the diet. All of these elements affect the glucose tolerance, the insulin response, the number of insulin receptors and the blood lipids and the hepatic content and synthesis. The metabolic responses differ between and within species. Experiments with the selection and feeding of animals with different genetic susceptibility to the same carbohydrate intake may explain why individuals or groups with different sensitivity may develop high blood glucose and/or lipid levels, whereas other individuals will retain normal values on consuming the same amount of the carbohydrate. This also explains why, in the same community, only a certain percentage of the population will develop diabetes or carbohydrate-induced lipidemia while others will not. PMID- 3523505 TI - Genetic polymorphism of mephenytoin metabolism. PMID- 3523506 TI - Polymorphic oxidation of debrisoquine and sparteine. PMID- 3523507 TI - Slow hydroxylation of tricyclic antidepressants--relationship to polymorphic drug oxidation. AB - There are marked interindividual differences in Css of tricyclic antidepressants. These are due mainly to corresponding differences in the rate of oxidative metabolism of these drugs. Twin, family, and cross-over studies with nortriptyline (NT) and desmethylimipramine (DMI) show that their kinetics and hydroxylation (Css, Kel, and Vd) are controlled mainly by genetic factors (in drug-free individuals). Slow hydroxylators are at risk of developing excessive plasma concentrations of NT and DMI when given per se or when formed from the tertiary amines amitriptyline and imipramine. Classic antidepressants have fairly well established concentration-effect curves in endogenous depression. Severe toxicity usually occurs at supratherapeutic plasma levels and might be prevented by tailoring the dosage according to the individual's drug hydroxylating capacity. Monitoring drug plasma levels is particularly relevant in slow hydroxylators (Sjoqvist et al, 1980). There is a strong association between an individual's ability to hydroxylate NT and DMI and his debrisoquine (D) hydroxylation phenotype. The D hydroxylation index will predict the patient's capacity to hydroxylate NT and DMI and hence Css during therapy. Possibly, similar hydroxylases are involved in the 4-hydroxylation of debrisoquine, in the stereospecific E-10-hydroxylation of NT, and in the 2-hydroxylation of DMI. By contrast, demethylation of AT (and probably other tertiary tricyclics) does not significantly correlate to debrisoquine hydroxylation except in non-smoking individuals. The increasing knowledge about the clinical pharmacokinetics of tricyclic antidepressants is a distinct advantage over that of the new generation of antidepressants, where little is known about concentration-effect relationships and factors governing their rate of metabolism. Possible interethnic differences in the metabolism of these essential drugs should be explored in epidemiologically sound investigations. PMID- 3523508 TI - Ethnic differences in reactions to drugs and xenobiotics. Acetylation. PMID- 3523509 TI - Ethnic differences in reactions to drugs and xenobiotics. Conjugation reactions. PMID- 3523510 TI - Ethnics differences in the reactions to drugs and xenobiotics. Antihypertensive agents. AB - Ethnic differences in responsiveness to certain antihypertensive agents have been demonstrated between blacks and whites. Whites exhibit a greater average fall in blood pressure following beta adrenergic blocking drugs and converting enzyme inhibitors than do blacks. On the other hand, the blood pressure of blacks is more responsive to diuretics. While the causes for these ethnic differences are unknown several explanations have been offered. The plasma renin activity of whites tends to be higher than that of blacks. More whites have high or normal plasma renin activity as opposed to blacks who have mostly low renin hypertension. ACE inhibitors and beta blockers may be more effective in whites because these drugs reduce the activity of the renin-angiotensin system. Blacks, on the other hand, are more responsive to diuretics possibly because they have more of a volume dependent hypertension and tend to retain sodium longer than whites. PMID- 3523511 TI - Ethnic differences in reactions to drugs and xenobiotics. Caffeine and other drugs. AB - I have presented some diverse case reports which illustrate several variations on the theme of this conference. A study of caffeine metabolites revealed two kinds of interethnic variation, one pertaining to the well-known acetylation polymorphism affecting the secondary metabolism of the parent drug; the other consisted of a difference in paraxanthine excretion which might indicate an ethnic difference in renal function. Older data on the pharmacokinetics of the antihistaminic drug diphenhydramine also suggested interethnic variables in the fate of the drug which do not necessarily involve metabolizing capacity. In short, pharmacokinetic factors other than metabolism may make additional contributions to ethnic differences in drug response. Studies of taste and smell are not only models of receptor variability but they may be used to reveal underlying biochemical differences. Furthermore, a polymorphism in tasting ability constituted an epidemiological risk factor for thyroid disease which was greatly enhanced in the presence of an appropriate human leukocyte antigen (HLA, histocompatibility gene). It is clear that the HLA complex will have to be increasingly considered in relation to pharmacological responses. Variabilities of superoxide dismutase and of various enzymes involved in heme production were described briefly because of their inherent or historical interest. In each case, however, the occurrence of variants was confined to small population groups as an expression of founder effects and regional polymorphism. Several other instances of ethnic differences in drug response were merely cited. PMID- 3523512 TI - Ethnic differences in reactions to drugs and xenobiotics. Other protein variants with pharmacogenetic consequences: albumin and orosomucoid. PMID- 3523513 TI - Ethnic differences in reactions to drugs and xenobiotics. Clinical and molecular studies of alpha 1-antitrypsin deficiency. PMID- 3523514 TI - Ethnic differences in reactions to drugs and xenobiotics. Nutrition as an environmental influence on chemical metabolism in man. PMID- 3523515 TI - Dynamic interactions among host factors that influence antipyrine metabolism: implications for the design and interpretation of studies on ethnic pharmacokinetic variations. PMID- 3523516 TI - Current cellular assays for measuring clinical drug metabolizing capacity--impact of new molecular biologic techniques. PMID- 3523517 TI - Ethnic differences in reactions to drugs and xenobiotics. Therapy. PMID- 3523518 TI - Ethanol oxidation: ethnic variations in metabolism and response. PMID- 3523519 TI - Old and new aspects of megakaryocyte development and function. PMID- 3523520 TI - Thrombopoietin: past, present and future. PMID- 3523521 TI - Evidence for multiple levels of regulation in hematopoiesis. PMID- 3523522 TI - Immunological and cytochemical characterization of megakaryocytic lineage leukemia. AB - Morphology alone, even at the ultrastructural level is insufficient for identification of PMKB. With LM cytochemistry, no specific enzymes can be demonstrated in human PMKB. PPO, which is distinct from granulocytic peroxidases, is present in the ER of platelets, MK and PMKB. Thus, for several years, PPO detection has constituted the only marker for the reliable diagnosis of AMKL. However PPO detection requires EM studies which may present difficulties for routine diagnosis. The limitation of this cytochemical method results from the fact that other heme enzymes are also detected in ER from several non-MK cells when appropriate and sensitive cytochemical methods are used. In addition, partial PPO deficiency can be detected in AMKL. The establishment of a large panel of monoclonal and polyclonal antibodies against platelet proteins present either on the membrane or within alpha-granules has permitted determination of the phenotype of normal PMKB which differentiate from CFU-MK in the early days of in vitro culture. The immunologic phenotypes of leukemic PMKB are identical to those of their normal counterparts but their maturation is blocked at different levels corresponding to three main different phenotypes; PPO is expressed in all phenotypes. The most immature or PMKB I is HLA-DR+, 80 H 5 or MY 9+ (myeloid lineage antigens also expressed on stem cells); PMKB II lack this labeling but acquire platelet Gp IIb, IIIa while GpIb identified by monoclonal antibody AN 51 is absent or weak. PMKB III which represent the more frequent phenotype express all Gp and exhibit diffuse cytoplasmic labeling for vWF, PF4, TPS, fibrinogen, in the absence of alpha-granules at EM level. Changes in the phenotype (from III and II to I) can be observed during the evolution of the same patient. In spite of a partial PPO deficiency in blasts and platelets from several cases of AMKL, PPO appears to be the earliest and most sensitive marker. PMID- 3523523 TI - Megakaryocyte colony stimulating activity (Mk-CSA) in serum from patients undergoing bone marrow transplantation. PMID- 3523524 TI - From precursor to product: how do megakaryocytes produce platelets? AB - While the production of a subcellular particle that can be used as a basic building block for clot formation may be a significant adaptive advantage for mammals, little is known about the exact process by which platelets are produced. Studies of platelet heterogeneity suggest that platelet production is regulated to maintain a constant platelet mass. The number of platelets produced in a given interval is determined primarily by the number of cells differentiating along the megakaryocytic pathway and changes in the rate at which platelets are produced take several days to occur. In contrast, the mean platelet volume (MPV) appears to be determined by the conditions under which the platelets are produced and can be increased within hours of a change in platelet demand. This latter observation, coupled with the observation that megakaryocytes are active, motile cells responsive to a variety of humoral agonists suggests that platelet production is a dynamic process which is under tight regulatory control. Various issues of platelet production are considered in relationship to these observations. An approach to establishing a test model for platelet release is discussed. PMID- 3523525 TI - Ultrastructural organization of maturing megakaryocytes. PMID- 3523526 TI - Ultrastructural aspects of platelet production. PMID- 3523527 TI - Evidence that platelets are produced in the pulmonary circulation by a physical process. PMID- 3523528 TI - Deviation from lognormality in platelet volume distributions. Inferences about the mechanism of thrombopoiesis. PMID- 3523529 TI - A non-programmatic approach to hemopoiesis. AB - The currently prevailing concept of hemopoietic differentiation is that the pathway starts at the multipotential stem cell and proceeds in a programmatic, relatively fixed fashion to the development of circulating blood cells. We have presented considerations supporting a more dynamic regulation. Self-renewal capacity within a compartment is seen as a measure of the cell's resistance to differentiation pressures. Mutable environmental factors, including feedback interactions, are proposed to regulate in each compartment the relative probabilities of renewal and maturation. We question the rigid distinction between multipotential and committed cells, generally believed to be separated by a discrete "determination" event. We prefer to see commitment as a manifestation of a gradually increasing bias for a given developmental fate. Such commitment might be modulated under different environmental conditions. Multipotency and stemness are two aspects of cellular resistance to maturation pressures. PMID- 3523530 TI - Postirradiation thrombocytopoiesis: suppression, recovery, compensatory states, and macromegakaryocytosis. AB - Two unusual features of the regulation of megakaryocytopoiesis have been found in irradiated mice. The first is that the response to thrombocytopenia loses its specificity for thrombocytopoiesis when the thrombocytopenia is induced at the time of exposure to sublethal doses of radiation. Under these conditions, there is stimulation of both thrombocytopoiesis and erythropoiesis. The second unusual feature is that a completely or partially compensated hypomegakaryocytic state may develop after "recovery" from the earlier severe postirradiation myelodepression. Occurrence of this condition is not dependent on the presence or absence of the spleen. It is characterized by a dissociation between platelet and megakaryocyte numbers, with platelets being relatively higher. There is an associated increase in mean megakaryocyte size. Both the megakaryocytopenia and macromegakaryocytosis are due to a deficiency of smaller megakaryocytes in the marrow. The postirradiation abnormality of megakaryocyte size distribution can not be accounted for by irradiation-induced abnormalities of either hemopoietic or stromal cells. The degree of megakaryocytic macrocytosis does not correlate with the platelet or megakaryocyte count after recovery from sublethal irradiation or after recovery from lethal irradiation and rescue with normal bone marrow cells. Megakaryocytic macrocytosis, as identified by an increase in average size of mature cells, occurs in response to thrombocytopenia and in several hypomegakaryocytic states in which thrombocytopenia is absent or is mild in degree. Comparison of size distribution curves, analysis of sizes of immature megakaryocytes, and determination of the stability of the megakaryocyte count indicate that different mechanisms probably prevail. The presence or absence of thrombopoietin or other megakaryocyte growth factors in these conditions may provide clues about the mechanisms. PMID- 3523531 TI - Home chemotherapy: problems, pitfalls, considerations, and solutions. PMID- 3523532 TI - Participation of community medical oncologists in clinical research trials. PMID- 3523533 TI - Reliability of videotape technology in assessing the efficacy of anti-emetic drugs. PMID- 3523534 TI - The value of dexamethasone when added to combination drug therapy in the prevention of cisplatin-induced nausea and vomiting, evaluated by time-lapse video technology. PMID- 3523535 TI - The Twin Tiers Community Clinical Oncology Program (TTCCOP) experience: the first year. PMID- 3523536 TI - An overview of critical issues for administrative action in the 1980s in determining cancer program viability. PMID- 3523537 TI - Gender differences in prostacyclin and prostaglandin E2 synthesis by human endothelial cells. AB - The incidence of atherosclerosis and thrombosis is higher in males than in females. Gender differences in prostacyclin synthesis by rat aortic rings have been described. In this paper, sex differences in prostacyclin (PGI2, measured as 6-keto PGF1 alpha) and prostaglandin E2 (PGE2) synthesis by human endothelial cells isolated from the vein of umbilical cords are reported. Cells isolated from cords from male babies synthesized more prostacyclin and PGE2 than cells isolated from those from female babies when the cells were stimulated with 0.125 units of thrombin. The difference in PGI2 was eliminated by incubation with 0.5 units of thrombin. PGE2 synthesis was higher in males than in females using both 0.125 and 0.5 units of thrombin. Incubation of the cells with culture medium containing 20% heat inactivated plasma from either male or female subjects did not have an effect upon prostaglandin synthesis. Our results support previous evidence obtained using rat aortas and show a higher response of male cells to thrombin stimulation than that of female cells. PMID- 3523538 TI - Serum triglycerides and HDL cholesterol from SHR after evening primrose oil and other polyunsaturated fats. AB - Spontaneously hypertensive rats (SHR) were fed diets enriched with evening primrose (EPO), sunflower (SO) and linseed oils (LO) as well as palm kernel fat (PKF), the latter being deficient in polyunsarated fatty acids (PUFA). In SHR fed EPO serum triglycerides were lowest and HDL1 cholesterol was highest as compared to the other groups of animals. Total cholesterol was not different. The data suggest that - as with blood pressure - serum lipids and lipoproteins might be influenced most effectively by EPO in comparison to other polyunsaturated fats. PMID- 3523539 TI - Prostacyclin synthesis stimulating plasma factor in patients with primary hyperlipoproteinemia--effect of dietary and drug treatment. AB - Recent data have demonstrated a possible pathogenetic influence of the prostacyclin synthesis stimulating plasma factor (PF) in various diseases. Studying this PF in 26 patients with primary hyperlipoproteinemia (HLP) we examined patients suffering from types IIa (n = 8), IIb (n = 6) and IV (n = 12) classified according to Fredrickson. Plasma was withdrawn at the detection of the HLP, 4 weeks after a dietary intervention and again 4 weeks after the beginning of a drug treatment. Using various test models such as rat and minipig aortic tissue, human aorta and saphenous vein as well as cultured endothelial and smooth muscle cells, the data reveal an in part significant improvement of PF running parallel with the improvement of HLP. These findings suggest that even though a significant difference between healthy controls and patients suffering from severe atherosclerosis has not been found, there occurs a significant improvement of PF in hyperlipidemic patients after successful treatment. Thus, it can be concluded that normalization of PF is one of the many factors improving the hemostatic balance in patients undergoing beneficial dietary or drug treatment. PMID- 3523540 TI - Effect of a single pentoxifylline administration on platelet sensitivity, plasma factor activity, plasma-6-oxo-PGF1 alpha and thromboxane B2 in healthy volunteers. AB - In eight male healthy volunteers aged 25-38 years 300 mg pentoxifylline (Trental, Hoechst AG, Frankfurt/M., Germany) were administered intravenously by a short term infusion for 10 minutes. Blood was withdrawn before as well as 30, 60, 90 and 120 minutes after the infusion. Throughout the entire investigation the volunteers were kept in an upright sitting position in a comfortable chair. Plasma levels of 6-oxo-PGF1 alpha and thromboxane B2 (TXB2), PGI2 release stimulating plasma factor (PF) activity and the platelet sensitivity to PGE and PGI respectively were evaluated at each interval. Plasma levels of 6-oxo-PGF1 alpha exhibited a significant (p less than 0.001) increase in mean values after pentoxifylline administration, reaching the maximum at 60 minutes after infusion. Only a trend (p less than 0.05) was detectable for a decrease in plasma TXB2 values. The PF activity did not change throughout the follow-up period. The platelet sensitivity to PGI2, however, exhibited a significant (p less than 0.01) increase as did sensitivity to PGE1 (p less than 0.005). These results are in accordance with earlier data showing that pentoxifylline is able to increase PGI formation by various tissues. The findings suggest, that the beneficial effects reported for this compound in clinical use might in part be due to its positive effects in local hemostatic regulation. PMID- 3523541 TI - Biological profile of a bioactive aortic substance (BAS), released by vessel rings from indomethacin-treated rats. AB - The biological activity of a stable unknown material(s), generated by aortic rings (bioactive aortic substance = BAS) isolated from rats injected with a high dose of indomethacin, was explored on contractions of several smooth muscle preparations from normal rats and its effects compared with those elicited by prostacyclin (PGI2) or by 6-keto-prostaglandin F1 alpha (6-k-PGF1 alpha). The BAS evoked, as did PGI2 or 6-k-PGF1 alpha, positive inotropism in strips from rat stomach, ileum and urinary bladder, but failed to influence uterine contractions as did prostacyclin or its non-enzymatic metabolite. When tested in rat aortic strips both, PGI2 and the BAS produced relaxation, whereas 6-k-PGF1 alpha was not active. Moreover, lipid substances present in the incubates of aortic rings, were extracted and explored for effects on contractions of rat aortic strips and on arachidonate-evoked human platelet aggregation. These extracts were devoid of influence on both parameters. On the contrary, dried aqueous residues, after the lipid extraction of the supernatants of aortic ring incubates, exhibited human platelet antiaggregatory capacity as well as the ability to evoke positive and negative inotropism similar to those triggered by the BAS in different smooth muscle preparations. Experiments with BAS were also performed employing smooth muscle strips exposed to indomethacin, atropine, propranolol, phentolamine and cyproheptadine. The presence of these antagonists of several neuromodulators and of indomethacin failed to alter de BAS-induced inotropic capacity observed in controls. The findings suggest that the effects attributable to the BAS are not subserved by prostacyclin or other prostanoids, nor by acetylcholine, norepinephrine, histamine or 6-OH-tryptamine. PMID- 3523542 TI - The influence of lipoproteins (LDL and HDL) on PGI2-formation by isolated aortic preparations of rabbits. AB - The influence of LDL- and HDL-concentrations of 0.5-2.0 mg/ml and 0.25-1.0 mg/ml respectively, from male and female donors on the formation of PGI2 in isolated aortic preparations was investigated under in vitro conditions. LDL of male donors inhibited endogenous PGI2-formation and the conversion of exogenous PBH2 to PGI2. On the other hand the highest concentration of HDL induced an increase in the basal and in the stimulated PGI2-formation. Lipoproteins of female donors showed no or only a weak stimulating effect on PGI2-formation. Human serum albumin in comparable concentrations of 1-50 mg/ml remained without influence. The importance of the results for cardiovascular diseases is discussed. PMID- 3523543 TI - Biological half-life of prostacyclin and 6-oxo-PGF1 alpha levels in plasma of patients with colonic cancer. AB - Prostaglandins have been shown to play a central role in the formation of cancer. The synthesis of prostacyclin and its bioavailability may be an important local determinant for metastasis. As the amount of the biologically active substance is dependent in part on the half-life (T/2) we examined the question as to whether the T/2 of prostaglandin I2 (PGI2) is altered in patients suffering from colonic cancer at various stages of the disease. In addition, the influence of various therapeutic regimens was investigated. In 58 patients with various stages of colonic cancer no significant difference in PGI2-T/2 could be detected. No significant difference could be found before (10, 11 +/- 1, 9 min) and after (10, 03 +/- 1, 8 min) tumor resection, before (9, 89 +/- 1, 5 min) and after 10, 35 +/ 1,8 min) chemotherapy, before (10, 36 +/- 1, 5 min) and after (10, 89 +/- 2, 31 min) irradiation as well as before (8, 86 +/- 1, 9 min) and after (9, 07 +/- 1, 2 min) tumor resection at least 4 to 6 years ago. In 14 healthy people PGI2-T/2 (10, 05 +/- 2, 1 min) did not differ significantly. In all the 58 patients the plasma levels of 6-oxo-PGF1 alpha, the stable derivative of PGI2 were measured. As compared to healthy controls (less than 1 pg/ml) the actual 6-oxo-PGF1 alpha values of patients with colonic cancer were significantly increased. However, no correlation to the T/2 of PGI2 (r between 0, 03 and 0, 21, n.s.) in plasma in vitro could be discovered. After curative tumor resection and after chemotherapy the plasma levels of 6-oxo-PGF1 alpha were significantly lower than before. The data suggest that in patients suffering from colonic cancer the speed of degradation of PGI2 is not a key determinant in local hemostatic dysregulation favouring early metastasis. However, PGI2 or its stable derivatives may be involved in the development of colonic cancer. PMID- 3523544 TI - Peroxide mediated effects of homocysteine on arterial prostacyclin synthesis. AB - The effects of homocysteine on the synthesis of arterial prostacyclin (PGI2) were investigated. Homocysteine at 10 mM and 1 mM concentration inhibited PGI2 synthesis from both exogenous and endogenous arachidonic acid. While concentrations of 100 microM and 1 microM stimulated PGI2 synthesis. Similar inhibitory effects of H2O2 on PGI2 synthesis were observed. High concentrations (100 microM and 500 microM) of H2O2 inhibited PGI2 production while low concentrations (1 microM) of H2O2 stimulated it. Catalase overcame the inhibitory effect of H2O2 (100 microM). Homocysteine induced O2 uptake and catalase inhibited the O2 uptake by homocysteine. Thus the inhibitory and stimulatory effect of homocysteine may be dependent on the oxidation of homocysteine and subsequent H2O2 generation. PMID- 3523545 TI - Effects of CDP-choline on platelet aggregation and the antiaggregatory activity of arterial wall in the rat. AB - The effects of the acute (250 mg/kg) and chronic (250 mg/kg for two weeks) treatments with CDP-choline on platelet aggregation and thromboxane formation and on the platelet antiaggregatory activity of thoracic aorta, have been studied in the rat. The acute administration resulted mainly in reduced platelet reactivity to aggregating agents, with no change of platelet thromboxane formation. The antiaggregatory activity of aortic walls was also concomitantly reduced. After chronic treatment, the major effect was a greater antiaggregatory activity of the vessel wall in respect of the control values, whereas platelet function was not affected. CDP-choline treatment, thus exerts favourable effects especially in the acute treatment, by reducing platelet reactivity. PMID- 3523546 TI - [The detection of antibodies against D-penicillamine. 3. Detection of antibodies against D-penicillamine in the serum of patients with Wilson's disease treated with D-penicillamine--preliminary results]. AB - 121 serum samples from 54 patients with Wilson's disease were tested for antibodies against D-penicillamine by indirect immunofluorescence (DASS-system). IgG antibodies were found in 44 serum samples from 16 patients (31% of all patients). The incidence of serum antibodies was higher in patients with side effects during therapy with D-penicillamine (10 of 13 patients 77%) compared to 6 of 39 15% in patients without side effects. The titre of antibodies was higher in patients with side effects. The antibodies bound complement demonstrated by double immunofluorescence. These observations indicate that complement binding IgG antibodies to D-penicillamine are involved in pathogenesis of side effects during therapy with D-penicillamine. PMID- 3523547 TI - [Thrombocyte aggregation inhibitors--a new class of active substances. 2. Chemical and pharmacologic aspects of some agents]. PMID- 3523548 TI - [The history of pharmaceutical science. 15. Development of pharmacy at the University of Greifswald between 1903 and 1968]. AB - The paper is the first part of an extensive investigation about the development of pharmaceutical science at a university. The major purpose of this research is to show separately aspects of scientific organisation, the personel structure, the material-technical premise, teaching and research. Studies of the development of scientific organisation structures have carried out about several centuries, from the first teaching in the medical faculty in 1559, from the establishment of the section of pharmaceutical chemistry in the chemical institute in 1903, the foundation of the Institute of pharmaceutical chemistry in 1946 up to the "Department of Pharmacy Greifswald" in 1968. PMID- 3523549 TI - Antimicrobial activity of essential oils from Sideritis species. PMID- 3523550 TI - A controlled comparison of clonidine and doxepin in the treatment of the opiate withdrawal syndrome. AB - Clonidine and doxepin alleviate the symptoms of the opiate withdrawal syndrome. Clonidine was slightly more effective in controlling sweating, hot flushes, palpitations and nausea, and doxepin was slightly more effective in relieving the craving for opiates, lassitude and depression. Adverse effects such as sedation, dry mouth and falls in blood pressure occurred in both groups. There were six cases of collapse during treatment with high doses of doxepin, whereas only one subjective circulatory effect occurred in the clonidine group. At these high doses, doxepin may cause orthostatic hypotension via a peripheral alpha-receptor blockade. Clonidine reduced pulse rate whereas doxepin, with its anticholinergic action and indirectly via its alpha-receptor blocking action, raised it. Several patients in the doxepin group hat fits, as opposed to only one in the clonidine group. It is possible that the use of barbiturates had reduced the convulsive threshold in some of our patients. Overall, clonidine and doxepin were equipotent at adequate individual dose levels, and both were well tolerated. In this trial, serious side-effects occurred less often in the clonidine group. PMID- 3523551 TI - Effect of helium-neon laser on musculoskeletal trigger points. AB - Cold lasers have been proposed recently as a therapeutic tool for treating a wide variety of pathological conditions, including wounds, arthritis, orthopedic problems, and pain. These proposed therapeutic effects largely have been unsubstantiated by research. A randomized, double blind study was undertaken to ascertain the effect of a helium-neon (He-Ne) laser on the resistance of areas of skin overlying musculoskeletal trigger points. These areas usually demonstrate decreased skin resistance when compared with the surrounding tissue. Thirty patients with musculoskeletal trigger points were assigned randomly to either an experimental or a placebo group. In addition to standard physical therapy, each patient received three 15-second applications of a He-Ne laser or placebo "stimulation" from an identical unit that did not emit a laser. The results of a two-way analysis of covariance with one repeated measure showed a statistically significant increase (p less than .007) in skin resistance. This increase in an abnormal skin resistance pattern may accompany the resolution of pathological conditions. PMID- 3523552 TI - In vitro antimalarial activity of Brucea javanica against multi-drug resistant Plasmodium falciparum. PMID- 3523553 TI - Human adjuvant disease, possible autoimmune disease after silicone implantation: a review of the literature, case studies, and speculation for the future. PMID- 3523555 TI - Webril dressing for extremity wounds. PMID- 3523554 TI - Bernard and Huette: Operative Medicine. PMID- 3523556 TI - Aesthetic surgery of the supraorbital ridge and forehead structures. AB - A physical anthropologic basis for aesthetic evaluation of the supraorbital ridges and forehead is described. The structures included for evaluation and possible treatment are the supraorbital ridges, relation of the orbital walls to the eyes, the temporal ridges, and slope of the forehead. All can be altered by reduction contouring or augmentation using methods described. Twenty-one patients are presented having procedures for purely aesthetic reasons. If more than 5 to 6 mm of augmentation or reduction is desired, the deformity is more than aesthetic and should be treated by a craniofacial team. The aesthetic restructuring procedures described are done using tissue localized to the cranium and have proven to be safe and free of complications in the patients treated. Physical anthropology helps to put the aesthetics of these procedures on a firmer basis and to determine which patients may require more than an extracranial aesthetic procedure. PMID- 3523557 TI - Complex maxillary fractures: role of buttress reconstruction and immediate bone grafts. AB - Between 1978 and 1984, 558 patients with complex facial fractures have been treated. One hundred and seventy-one of these patients have had complex Le Fort fractures of the maxilla. In this group of patients, the importance of direct anatomic reconstruction of the anterior maxillary buttresses has been assessed. Complete exposure of the injured buttresses will facilitate assessment of the exact fracture pattern. Direct fixation of the medial and lateral maxillary buttresses on each side, in combination with immediate bone-graft reinforcement or replacement of comminuted or missing buttresses, will facilitate the reconstruction of even the most severely injured maxilla in one stage. This approach is combined with similar reconstructive techniques in other areas of the craniofacial skeleton. Associated mandibular fractures are managed with rigid internal fixation utilizing A-O techniques. The use of these techniques dramatically facilitates airway management and simplifies the treatment of the edentulous patient, the patient with bilateral condylar neck fractures, and those patients with sagittal splitting of the maxilla and palate. The use of both internal craniofacial suspension wires and external craniofacial suspension devices has become largely unnecessary, and reconstruction of even the most complex injuries in one stage with minimal complications and secondary deformities is made possible. PMID- 3523558 TI - Long-term stability of Teflon orbital implants. AB - Teflon orbital floor implants have become controversial owing to reports of implant-related complications. To determine the actual incidence of Teflon implant-related complications and factors associated with complications, we conducted a long-term follow-up study of 77 selected patients. We obtained data on 35 implants in 31 patients with a mean follow-up period of 16 years, representing an experience of 528 patient-implant years. The short-term complication rate (within 1 month of surgery) was 3.9 percent. The long-term complication rate was 2.8 percent. Concomitant antral packing and implantation of Teflon sheet were associated with a markedly higher risk of implant pocket infection. There was no case of implant migration with proper fixation. Facial growth was normal in three children in the series. We conclude that Teflon sheet is well-tolerated in the orbit in the long term. The low complication rate can be further reduced with proper fixation of the implant and avoidance of antral packing at the time of implantation. PMID- 3523559 TI - Fibular osteoseptocutaneous flap: anatomic study and clinical application. AB - The vascularized fibular graft has been expanded to an osteoseptocutaneous flap by including a cutaneous flap on the lateral aspect of the lower leg. The cutaneous flap can serve not only for postoperative monitoring of the grafted fibula, but also as extra skin coverage to replace substantial skin defects or prevent tight closure of the wound. From anatomic studies of 20 cadaver legs and 15 clinical cases, it has been possible to demonstrate adequate circulation to the skin of the lateral aspect of the lower leg from the septocutaneous branches of the peroneal artery alone. This finding has allowed the development of a new concept and technique to elevate the fibula as an osteoseptocutaneous flap for reconstruction which provides the following advantages: Elevation of the fibular osteoseptocutaneous unit is easy and fast. The cutaneous flap of the fibular osteoseptocutaneous unit can slide almost freely while attached to the paper-thin posterior crural septum without being tethered by a bulky muscle cuff, facilitating the setting of the fibular osteocutaneous flap when the bone and skin are widely separated. Intraoperatively, in a situation in which it is necessary to change from originally selected recipient vessels to ones more suitable, the thin posterior crural septum can be folded around the fibula allowing more flexibility in choice of recipient vessels. The fibular osteoseptocutaneous flap meets the criteria outlined for composite tissue reconstruction of defects of the extremities.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3523560 TI - Experimental study and clinical use of the fasciosteal flap. AB - Thirty-seven domestic rabbits, 4 dogs, and 2 freshly amputated human limbs were divided into three groups as three different models of fasciosteal flaps that were taken from the distal radii or the tibiae. Through the methods of histology, fluorochrome bone labeling, and perfusing stain, it was confirmed that viability of the bone graft can be maintained by blood flow by means of the fascial route. This technique was used for treating eight patients with nonunion of such different fractured sites as the scaphoid, the talus, and so forth or with osteomyelitic tibial defects or both skin and tibial defects. With 8 to 15 months of follow-up, the osteomyelitis cleared uneventfully and the fracture healed. Patients recovered their normal function. We think that there are at least three routes for the blood supply from deep fascia to bone: direct blood supply, blood supply by means of bone membrane, and blood supply by means of the intermuscular septum. We feel that the fasciosteal flap is an ideal random-pattern vascularized bone graft. PMID- 3523561 TI - Treatment of a giant congenital hairy nevus of the ear. AB - A split-thickness skin graft from the abdomen was successfully used to resurface the entire auricle following full-thickness excision of a congenital nevocellular nevus. We found no previous report describing the use of skin grafts to successfully resurface the entire ear and achieve an acceptable aesthetic result. PMID- 3523562 TI - Thomas Brian Gunning and his splint. PMID- 3523563 TI - Abortion: the new debate. AB - The course of the debate on abortion following the 1973 Supreme Court decision legalizing abortion has been marked by a variety of medical and scientific developments. Many of these new developments have important legal, psychologic, social, moral, and political implications. The cumulative impact of all these developments may pose a significant challenge to the social and legal foundations of Roe v. Wade. PMID- 3523564 TI - Doctors and rationing: the end of the honor system. AB - Physicians have traditionally held that to participate in "rationing" or resource allocation would betray their duty to advocate for everything possible for the patient. However, the record of physician behavior belies that, indicating instead that they have always rationed health care and their own time and services. Physician resistance to calls for "rationing" today appears to be based more on the nature of the process and on the fact that this process is being taken out of the hands of physicians. If American medicine does not rethink its own stance and develop not only a stronger resource allocation ethic but also a means of implementing it, it is unlikely that physicians will continue as the guardians of the quality of care and patient service. PMID- 3523565 TI - [Effect of a single dose of ethanol on mental and psychomotor efficiency]. PMID- 3523566 TI - [The defense mechanisms of the personality--a review of concepts]. PMID- 3523567 TI - Sartre and psychoanalysis. AB - Why read Sartre? Such is the question which is addressed in this article. In a series of publications, principally his monumental Being and Nothingness (1943), the French philosopher of existentialism challenged traditional psychoanalysis with his "existential psychoanalysis." It has remained a matter of debate whether Sartre's alternative approach to the analysis of human motivation and behavior has any value for the psychoanalytic therapist or theorist. In recent publications two clinicians, Charles Hanly (1979) and Richard Chessick (1984), who have read Sartre extensively, respond negatively, arguing that there is nothing productive in Sartre's challenge to Freudian psychoanalysis. In this article I would like to take issue with that point of view and argue that there is indeed much to be gained from reading Sartre, that the challenge which he poses to traditional psychoanalytic thinking with his "existential psychoanalysis" is in fact a productive one for the contemporary clinician and theorist. PMID- 3523568 TI - David McKenzie Rioch, MD, 1900-1985. Three eulogies. PMID- 3523569 TI - Bradyphrenia in parkinsonism: a historical review. AB - The development over the last 60 years of the concept of bradyphrenia, a syndrome including slowing of cognitive processing in parkinsonism, is described. Psychic akinesia and subcortical dementia are seen as more recent synonyms for this syndrome. Its relations to akinesia and the psychomotor retardation of depression are considered in a historical context, as are its implications for the relation of neurological and psychiatric disorder. PMID- 3523570 TI - Hypnotic relaxation in the treatment of premature labor. AB - Hypnotic relaxation was used as an adjunct to pharmacologic treatment with 39 women hospitalized for premature contractions in pregnancy. The control group received medication alone and consisted of 70 women. Treatment was started at the time of hospitalization and lasted for 3 hr on the average. Patients were also given cassettes with a hypnotic-relaxation exercise for daily practice. The rate of pregnancy prolongation was significantly higher for the hypnotic-relaxation than for the medication-alone group. Infant weight also showed the advantage of the hypnotic-relaxation treatment. Background variables of the two groups were compared and it was shown that they could not have explained the treatment effect obtained. PMID- 3523571 TI - Ceruletide for schizophrenia: a review. PMID- 3523572 TI - Clinical evaluation of ceruletide in schizophrenia: a multi-institutional cooperative double-blind controlled study. PMID- 3523573 TI - Fenfluramine treatment of childhood attention deficit disorder with hyperactivity: a preliminary report. PMID- 3523574 TI - The relationship of antiobsessional and antidepressant effects of tricyclic antidepressants. PMID- 3523575 TI - Amitriptyline and haloperidol in unstable and schizotypal borderline disorders. PMID- 3523576 TI - A review of controlled studies of adinazolam mesylate in patients with major depressive disorder. PMID- 3523577 TI - Methylphenidate: rate-dependent effects on hyperactivity. PMID- 3523578 TI - The therapeutic effect of clonidine in attention deficit disorder with hyperactivity: a comparison with placebo and methylphenidate. PMID- 3523579 TI - The use of MK-801, a novel sympathomimetic, in adults with attention deficit disorder, residual type. PMID- 3523580 TI - Microprocessor-based assessment of attention deficit disorders (ADD). PMID- 3523581 TI - Expert systems in psychiatry. PMID- 3523582 TI - Gingival retraction preference of dentists in general practice. PMID- 3523583 TI - Resolving aesthetic complications with osseointegration using a double-casting prosthesis. PMID- 3523584 TI - Reconstruction of a severely abraded dentition using an overdenture. PMID- 3523585 TI - A technique for improving the marginal fit of temporary acrylic resin crowns using injection of self-curing acrylic resin. PMID- 3523586 TI - Resin bonded fixed partial dentures utilizing additional pin retention. PMID- 3523587 TI - Ultrasound case history: hydrocephaly. PMID- 3523589 TI - [Value of angle measurements in hip sonography. Methodological and technical analysis]. AB - The Graf classification of sonographic hip-studies is based upon angle measurements. 167 patients have been examined and evaluated in a double-blind study of the reproducibility of these measurements and the resulting classification. The resulting ranges for the different types were compared with the values given by Graf. The influence of the investigator, the interpreter and of the chosen section plane were analysed and compared with the difference in classifying based upon visual impression. The global impression of the operator proves to be the most reliable basis for interpreting the ultrasound study (variation of 6%), while the measured angle beta (+/- 35% deviation) seems not to be as useful. PMID- 3523588 TI - Radionuclide localisation of parathyroid abnormality. AB - There is much discussion about the ideal method for pre-operative localisation of parathyroid abnormality, ie, adenoma or hyperplasia, but as yet there is no simple and/or non-invasive screening method available. Different clinical centres have access to different imaging modalities and therefore use a variety of techniques ranging from ultrasound to direct venous sampling. This paper presents a version of a dual radionuclide computerised subtraction procedure, but the author wishes to point out that this technique is still undergoing research. PMID- 3523590 TI - Sensitivity and specificity of first screen mammography in the Canadian National Breast Screening Study: a preliminary report from five centers. AB - Sensitivity and specificity of first screen mammography in a randomized screening trial at five centers are reported. A total of 23,101 women underwent mammography; in 139, breast cancer was detected at first screening; in 20, less than 12 months after first screening; and in 47, at second screening. All 206 cancer cases were histologically confirmed, and 174 were defined as being detectable at first screening. Average length of follow-up for all women was 3.2 years. Interpretations of first screen mammograms by the center radiologists were matched to known outcomes. Simultaneous blind review was performed by a single reference radiologist with mammograms from all 206 cancer cases and those of a random sample of 739 women not known to have breast cancer at 15 months or more after initial screening. Overall, the five screening centers achieved a sensitivity of 69% (range, 60%-78%), a specificity of 94% (range, 93%-96%), a positive predictive value of 8.6% (range, 3%-16%), and a negative predictive value of 99.7% (range, 99.6%-99.9%). PMID- 3523591 TI - Pancreatic metastases: US evaluation. AB - The sonographic appearance of histologically verified pancreatic metastases is reported in seven patients with advanced spread of tumor. All metastases appeared as homogeneous, solid, space-occupying lesions with a more hypoechoic internal structure than the pancreatic parenchyma. In five cases, multiple metastases were demonstrated; in two cases, there was a solitary metastasis in the head and tail of the pancreas. Pancreatic metastases are diagnosed infrequently because of the paucity of clinical symptoms and the small size of the foci. In six patients, the diameters of the metastases were 0.5-2.0 cm, and only three patients had organ related clinical symptoms. The putative diagnosis of organ metastases must be made when multiple hypoechoic foci can be demonstrated in the pancreas in a patient with a malignant tumor. Pancreatic carcinoma, acute pancreatitis, and focal infiltrates in Hodgkin and non-Hodgkin lymphomas must be considered when diagnosing multiple pancreatic lesions. PMID- 3523592 TI - Ectopic pregnancy: a malpractice paradigm. AB - Subtle sonographic findings and other nonspecific clinical presentations often lead to missed diagnoses that can have significant legal implications. This communication discusses current diagnostic and laboratory methods used to evaluate patients with a suspected ectopic pregnancy in light of the concepts of "missed lesions" as they relate to negligence and malpractice theory. PMID- 3523593 TI - Intrauterine growth retardation: predictive value of US criteria for antenatal diagnosis. AB - We critically analyzed published data on proposed sonographic criteria for intrauterine growth retardation (IUGR) to determine the positive and negative predictive values of the criteria. The data were drawn from 21 studies and encompassed nine distinct criteria for which the sensitivity and specificity could be determined. Predictive values were computed using Bayes theorem, based on an IUGR prevalence rate of 10%. Seven of the nine criteria had positive predictive values of less than 50%, indicating that a fetus with an abnormal test result according to any of these criteria is more likely to be normal than growth retarded. The best criterion involves the ratio of head circumference to abdominal circumference, but even with this criterion, fully 38% of fetuses with abnormal test result will not be growth retarded. We conclude that none of the proposed criteria allows a confident antenatal diagnosis of IUGR to be made. Future prospective studies may reveal new criteria, or combinations of existing ones, that are highly predictive for this condition. PMID- 3523594 TI - Varicoceles: combined sonography and thermography in diagnosis and posttherapeutic evaluation. AB - One hundred eighteen patients with clinically suspected varicocele were examined with thermography and sonography before phlebography of the internal spermatic vein (ISV). The combination of sonography and thermography led to an exact differentiation among eight patients with normal findings (6.8%), 103 with left sided varicoceles (87.3%), six with bilateral varicoceles (5.1%), and one with a right-sided varicocele (0.85%). The accuracy of thermography was 98.4% and of sonography, 92.7%. With sonography, venous dilatation was detected when the patients were upright and the Valsalva maneuver was being performed. Thermography was more sensitive than sonography in detecting persistent varicocele in 63 patients reexamined after sclerotherapy. Sclerotherapy within the inguinal segment of the ISV gave better results (82.9%) than that within the proximal segment (77.3%). PMID- 3523595 TI - Inferior vena caval filters: noninvasive evaluation. AB - Transvenous inferior vena caval filters were placed in 32 patients (21 bird's nest [BN] and 11 Kimray-Greenfield [K-G] filters). Positive contrast cavography was performed before and immediately after filter placement as well as during long-term follow-up studies. In 23 patients, computed tomographic (CT) scanning was also performed; in 10 patients, real-time ultrasound (US) study was used as an adjunct. CT scans of the BN filter showed one case of hemorrhage and one case of air embolism, both of which were not recognized at cavography. CT scanning of the K-G filter demonstrated two cases of deep penetration of the prongs and one large retroperitoneal hematoma. Real-time US scanning played a major role in checking the final position of the filter and in determining its stability during repositioning of the upper prongs of one BN filter. Noninvasive examinations, including CT and US scanning, are valuable adjuncts in immediate and long-term follow-up study of patients with inferior vena caval filters. PMID- 3523596 TI - Urologic complications following renal transplantation: role of interventional radiologic procedures. AB - Seventy renal transplant recipients with suspected urologic problems underwent interventional radiologic procedures for further diagnosis and treatment. We found that 28 patients did not have urologic complications. The other 42 patients demonstrated a total of 62 complications, including 40 cases of obstruction, 12 cases of extravasation, and ten collections of pararenal fluid. Ultrasound and nuclear renal scans with both technetium-99m DTPA and iodine-131 hippuran were found to be sensitive screening techniques for the detection of these complications. Fifty of the 51 abnormalities were detected using a combination of these techniques. Percutaneous methods alone were successful in treating 15 urinary obstructions, eight pararenal fluid collections, and five urinary extravasations. We encountered six procedure-related complications, and there were three delayed infectious complications that were related to indwelling nephrostomy tubes. One of these three complications resulted in death. The results of our study suggest that invasive radiologic procedures can be safely used to diagnose and treat urologic complications in renal transplant recipients. PMID- 3523597 TI - Dynamic digital subtraction imaging using fast low-angle shot MR movie sequence. AB - High-quality magnetic resonance (MR) images can be recorded within seconds with the use of fast low-angle shot (FLASH) MR imaging. This technique also gives new access to the time evolution of both periodic functions, such as cardiac motion, and nonperiodic physiologic processes, such as flow within internal organs. The time course and regional distribution of dynamic processes detectable by FLASH MR movies are often demonstrated best within series of difference images obtained by digital subtraction of the original data, especially after the use of MR contrast agents. In addition, quantitative information is provided by the analysis of time intensity profiles for selected regions of interest. Dynamic digital subtraction MR imaging was evaluated in rabbit brain and kidney using a 2.3-T, 40-cm-bore magnet. The time resolution was 1.5 seconds for brain studies and 28 seconds for kidney studies. The total examination times were 1.5 and 30 minutes, respectively. PMID- 3523598 TI - Pulsed-injection method for blood flow velocity measurement in intraarterial digital subtraction angiography. AB - The pulsed-injection method for measuring the velocity of blood flow in intraarterial digital subtraction angiography is described. With this technique, contrast material is injected at a pulsing frequency as high as 15 Hz, so that two or more boluses can be imaged simultaneously. The velocity of flow is determined by measuring the spacing between the boluses and multiplying it by the pulsing frequency. Results of tests with phantoms correlate well with flow measurements obtained with a graduated cylinder for velocities ranging from 8 to 60 cm/sec. The potential of the method for time-dependent velocity measurement has been demonstrated with simulated pulsatile flows. PMID- 3523599 TI - Threatened abortion: sonographic distinction of normal and abnormal gestation sacs. PMID- 3523600 TI - Movement-related activity in the premotor cortex of rhesus macaques. PMID- 3523601 TI - Activity of forelimb motor units and corticomotoneuronal cells during ramp-and hold torque responses: comparisons with oculomotor cells. PMID- 3523602 TI - Role of the basal ganglia in the initiation of saccadic eye movements. PMID- 3523603 TI - Organization and properties of spinal motoneurones and motor units. PMID- 3523604 TI - Brainstem neurons are peculiar for oculomotor organization. PMID- 3523605 TI - Learning in the motor system. PMID- 3523606 TI - Extraocular motoneuron behavior in synergistic action. PMID- 3523607 TI - Parametric adjustments in the oculomotor system. PMID- 3523608 TI - Recovery of some vestibuloocular and vestibulospinal functions following unilateral labyrinthectomy. PMID- 3523609 TI - The effect of gaze motor signals and spatially directed attention on eye movements and visual perception. PMID- 3523610 TI - Is the oculomotor system a cartoon of motor control? PMID- 3523611 TI - Some concluding remarks about general concepts in studies of the skeletomotor system. PMID- 3523612 TI - What are the afferents of origin of the human stretch reflex, and is it a purely spinal reaction? PMID- 3523613 TI - Experimental evidence for the existence of a proprioceptive transcortical loop. PMID- 3523614 TI - Visual inputs relevant for the optokinetic nystagmus in mammals. PMID- 3523615 TI - Anatomy of premotor centers in the reticular formation controlling oculomotor, skeletomotor and autonomic motor systems. PMID- 3523616 TI - The organization of thalamic inputs to the "premotor" areas. PMID- 3523617 TI - Cross-sectional echocardiographic assessment of regional left ventricular performance and myocardial perfusion. PMID- 3523618 TI - Potential approaches to evaluating the cardiovascular system using NMR. AB - The current status and some of the future possibilities for nuclear magnetic resonance imaging of the cardiovascular system have been described. With many of these possibilities there is overlap with existing techniques. For example, functional analysis of the left ventricle can be obtained using either echocardiography or radionuclide techniques. With current instrumentation and current costs, these conventional techniques could frequently provide a more cost effective approach for morphologic and functional assessment of the cardiovascular system. Nevertheless, because of the excellent resolution, the inherent contrast, the sensitivity to blood motion, the three-dimensional nature, and the lack of ionizing radiation, the cardiovascular morphologic imaging capabilities of NMR may provide justification for such applications. However, for NMR to achieve its most important status as a cardiovascular imaging technique, some of its unique possibilities will need to be developed. These include the ability to reproducibly depict the proximal coronary arteries, to define regional myocardial blood flow distribution, to evaluate regional high energy phosphate or other metabolic activity; and to characterize myocardial disease using proton T1 and T2 alterations. PMID- 3523619 TI - Noncardiac causes of angina-like chest pain. PMID- 3523620 TI - The cholinergic systems in brain and spinal cord. PMID- 3523621 TI - [Phospholipases A2 from snake and bee venoms]. PMID- 3523622 TI - [Escherichia coli alkaline phosphatase]. PMID- 3523623 TI - Formation of prostanoids in human umbilical vessels perfused in vitro. AB - Four major prostanoids (6-keto-PGF1 alpha, PGE2, PGF2 alpha and TXB2) were measured by specific radioimmunoassays in the outputs from human umbilical vessels perfused in vitro. As evaluated by scanning electron microscopy (SEM) only few blood platelets were attached to the vessel wall. After an initial flush with decreasing concentrations of all four prostanoids, a stable stage was reached, lasting for 4-5 hours. During this stage the production could be inhibited by indomethacin and only slightly stimulated with arachidonic acid. The TXA2 synthetase inhibitor UK 38485 depressed the TXB2 production, while only slightly affecting the other three prostanoids at very high concentrations. The arteries produced relatively more 6-keto-PGF1 alpha than did the vein. PMID- 3523624 TI - Prostacyclin and thromboxane formation in human umbilical arteries following stimulation with vasoactive autacoids. AB - The formation of prostacyclin (PGI2) and thromboxane A2 (TXA2) (measured as the stable metabolites 6-keto-PGF1 alpha and TXB2) during stimulation with vasoactive autacoids was registered in human umbilical arteries perfused in vitro. Responses were registered within 3-4 minutes after addition of the substances. Both angiotensin I and II were found to increase the formation of PGI2 while depressing that of TXA2. Serotonin increased the formation of TXA2 but not that of PGI2. Both PGE2 and PGF2 alpha stimulated the PGI2 formation. The TXA2 mimetic U46619, increased PGI2 production, whereas PGI2 slightly increased the formation of TXA2. All responses were found to be completely inhibited by indomethacin. PMID- 3523625 TI - Seminal prostaglandins in men with subnormal sperm motility and therapeutic treatment. AB - The contents of prostaglandins in seminal plasma from a total of 73 men were evaluated. The subjects were grouped as follows: normospermic men, patients with impaired motility, patients with small untreated varicocele and patients with impaired motility and Kallikrein therapy. Sperm density, morphology and motility were examined. High performance reversed phase liquid chromatography (HPLC) in combination with specific radioimmunoassays were used for the determination of PGE2, PGI2 and PGF2 alpha. There was a significant difference (p less than 0.025; F-test) between the PGI2 concentrations in patients with impaired motility (5.6 +/- 1.4 pg/mg protein) and normal men (8.8 +/- 3.7 pg/mg protein). PGE2 and PGF2 alpha were significantly different in patients with varicocele (p less than 0.025, F-test). Wide ranges of prostaglandins occurred in the Kallikrein-group with no significant differences. We conclude that: a) PGI2 is an additional prostaglandin compound in seminal plasma, b) its measurement may not be useful as diagnostic parameter in subfertile men and c) Kallikrein has no influence on the prostaglandin content in seminal plasma and other seminal parameters as motility, motility index and sperm counts. PMID- 3523626 TI - [Results of treating gonorrhea with a single dose of 3.5 g ampicillin combined with probenecid]. PMID- 3523627 TI - [A test of leukocyte migration stimulated with a protein factor from the neutrophils of patients with psoriasis]. PMID- 3523628 TI - [Evaluation of the immunoenzyme test Gonozyme (Abbott) in the diagnosis of gonorrhea. Preliminary report]. PMID- 3523629 TI - [Syphilis and gonorrhea in 18th century Poland]. PMID- 3523630 TI - [The psyche and tuberculosis: the libido organization of Franz Kafka]. PMID- 3523631 TI - [Family scenes. Goethe's fantasy world and the construction of the novel "Werther"]. PMID- 3523632 TI - [The salvation dream of Richard Wagner]. PMID- 3523633 TI - The Schubiger screwblock-Dolder bar-joint mandibular overdenture. PMID- 3523634 TI - Solidification patterns of single crowns and three-unit bridge castings. PMID- 3523635 TI - Controlling the fit of dental castings using proper die preparation techniques. PMID- 3523637 TI - Side effects from angiographic contrast media. Subjective, objective, instrumental and laboratorial. PMID- 3523636 TI - Use of ornidazole in fractionated radiotherapy: dose tolerance, serum and tumour tissue concentration. AB - Sensitizing and neurotoxic effect of ornidazole, was tested in a double-blind randomized study in patients with carcinoma of the cervix and larynx. Ornidazole or placebo were given orally, two times weekly, for 3 weeks. Dose was 2.5 g/m2 for each administration. Total dose given was 15 g/m2. Radiation therapy was given 3 h after the drug administration. Ornidazole was well tolerated in the majority of the patients. No neurotoxic side effects, such as peripheral neuropathy or convulsion, were observed with a total dose of up to 30 g. Dizziness, somnolence and nausea were the prominent acute side effects, seen mostly (70%) in women. In the placebo group this rate was 17% (p less than 0.01). No important side effect was observed in men receiving ornidazole. Serum concentration of ornidazole reached the maximum level in 2-4 h after oral administration and ranged (23 patients) from 65.1 to 139.8 micrograms/ml. Mean half-life was 15.6 +/- 2.8 h. Peak concentration in tumour tissue was achieved 1 3 h after the administration, ranging from 13.0 to 78.0 micrograms/g. Tumour concentration of ornidazole ranged from 14 to 93% of the serum concentration at the time of irradiation. PMID- 3523638 TI - Contrast media in angiography. State of the art and future prospects. PMID- 3523639 TI - Measurement of intra-arterial blood pressure in the evaluation of contrast media for arteriography. PMID- 3523641 TI - The use of a low osmolar contrast-medium (ioxaglate) in peripheral angiography. Clinical trials in 168 pediatric patients. PMID- 3523640 TI - Clinical trials in adults. PMID- 3523642 TI - Present and future prospects for angiographic techniques. PMID- 3523643 TI - Evaluation of the influence of contrast media viscosity on DSA. Suggestions for an ideal angiographic contrast. PMID- 3523644 TI - Intrinsic limitations of quantitative functional studies and clinical efficacy evaluation of different contrast media in DSA. PMID- 3523645 TI - Intra-arterial digital subtraction angiography. PMID- 3523646 TI - Methodology and strategy in clinical research with contrast media. PMID- 3523647 TI - [Dental prosthetics, is it an art or a science?]. PMID- 3523648 TI - [Immunopathology of insulin-dependent diabetes. New hypothesis]. PMID- 3523649 TI - [Duration of the antianginal effect of oral molsidomine in exertion angina. Double-blind, crossed and randomized study]. PMID- 3523650 TI - [Primary tuberculous pericarditis]. PMID- 3523651 TI - [Prolactin in plasma and ascitic fluid in hepatic cirrhosis. Its relation to plasma and urinary electrolytes]. PMID- 3523652 TI - [Surgical technics in experimental transplantation of the liver. I. Heterotopic transplant]. PMID- 3523653 TI - [Solitary splenic abscess]. PMID- 3523654 TI - [Hormonal control of the development and activity of the mammary gland]. PMID- 3523655 TI - [Synthesis of milk proteins]. AB - This review, written for non-specialists, describes briefly the steps of protein biosynthesis from their precursors in the blood to the excreted molecules, taking rat gamma-casein as an example. A schematic description is given of the procedures employed for preparing cDNAs which can provide the sequences of the corresponding mRNAs and proteins. Recent findings concerning milk proteins are briefly mentioned, and in particular those dealing with sequence determinations of mRNAs coding for milk proteins from several species. PMID- 3523656 TI - Regulation of metabolism during lactation in the rat. AB - The physiological, endocrine and biochemical alterations which occur in the lactating rat to allow direction of the nutrients (glucose, amino acids, non esterified fatty acids, triacylglycerols) to the lactating gland are described. In addition, the short-term changes in the rate of synthesis of milk constituents and the mechanisms whereby they occur are discussed. PMID- 3523657 TI - Changes in energy metabolism during the suckling and weaning period in the newborn. AB - In most of the mammals, birth and weaning are two periods of nutritional transitions. Whereas the fetus oxidizes mainly glucose, lactate and aminoacids, the newborn is fed with milk, a high fat, low carbohydrate diet. At weaning, milk is replaced progressively by the adult diet which contains less fat and more carbohydrate. In the hours and days following birth, the newborn adapts itself to the new nutritional environment by increasing its capacity to produce glucose de novo (gluconeogenesis) in order to satisfy its high glucose needs. Oxidation of fatty acids is enhanced in the liver and at the peripheral level. Ketone bodies synthetized from fatty acids in the liver in large amounts are utilized by other tissues and specially the brain where they can met energetic and synthetic needs. In the rat, during the suckling period, lipogenesis is decreased in the liver and in white adipose tissue and triglyceride accretion is minimized. At weaning, these adaptations are reversed: decreased gluconeogenic and oxidative capacity of the liver, decrease of the role of ketone bodies, increase of the lipogenic rate in the liver and the adipose tissue, storage of triglycerides. The nutritional and hormonal factors involved in these metabolic adaptations are numerous but insulin and glucagon might play a major role. PMID- 3523658 TI - Nutritional advantages of constituents of infant formulae formerly called "humanised". PMID- 3523659 TI - [Kinetics of establishment of digestive microflora in the human newborn infant as a function of the kind of milk]. AB - The digestive tract of human infants, sterile at birth, is colonized by some bacterial genera within less than 48 h. Among the factors involved in the implantation of a given bacterial genus, the type of milk fed plays a major role. We studied the development of fecal flora in 1 to 8-day old babies, either breast fed or bottle-fed with humanized milk. In breast-fed infants the microflora reached an equilibrium towards the age of 5 days and then hardly varied until the change of feeding. Escherichia coli and Streptococcus were established first and Bifidobacterium later. At the age of 5 days, the strictly anaerobic flora was exclusively composed of Bifidobacterium in 85% of cases. The development of other strictly anaerobic bacteria was repressed, particularly that of Bacteroides. In infants receiving humanized milk, Escherichia coli (or sometimes other enterobacteria) also appeared very early in the digestive tract. However, the strictly anaerobic flora was either absent (40% of cases) or composed of one or more genera (e.g. Bacteroides, Bifidobacterium, Plectridium). These findings in human infants show that it is mainly the establishment of the strictly anaerobic flora which is affected by the type of milk fed. PMID- 3523660 TI - Alzheimer's disease: a multisystem disorder. PMID- 3523661 TI - Methacholine inhalation challenge after rapid saline infusion in healthy subjects. AB - Five healthy subjects were challenged with methacholine on 2 different days, 1 week apart, the second day after acute intravenous 30 ml/kg 0.9% saline infusion. After infusion, we observed a significant reduction in vital capacity (VC), maximal expiratory volume in 1 s (FEV1), provocation dose producing a 35% fall in SGaw (PD35SGaw) and in 25% of maximal expiratory flow (MEF25), and an increase in the slopes of log dose-response curves. Our results suggest an increased bronchial reactivity in acute minimal interstitial lung edema. PMID- 3523662 TI - Effect of diltiazem on methacholine-induced bronchoconstriction in extrinsic asthmatics. AB - The protective effect of the calcium antagonist diltiazem on methacholine-induced bronchoconstriction was investigated in 19 extrinsic asthmatics. A double-blind cross-over design was used (diltiazem vs. placebo, administered orally for 1 week). We found no significant difference between the two treatment regimens when expressed as the provocation dose of methacholine causing a 20% drop in forced expired volume in 1 s (PD20 FEV1). Some individual patients might nevertheless gain some benefit from diltiazem as an additional treatment in difficult-to manage asthma. PMID- 3523663 TI - Effects of divided doses of a bronchodilator aerosol and the intervening time interval on the forced expiration. AB - Twelve patients with bronchial asthma participated in a blind, randomized, crossover study comparing the effects of 500 micrograms terbutaline in one inhalation, 125 micrograms in four inhalations taken in rapid succession, and 125 micrograms in four inhalations taken with an intervening time interval of 30 min. There were no significant differences between the three modes of inhalation of 500 micrograms terbutaline in any of the spirometric variables, i.e., 1-second forced expiratory volume, forced vital capacity, and maximal airflows when 50 and 75% of the forced vital capacity was exhaled from the total lung capacity. However, there were neither any significant differences between the levels of bronchodilation reached after administration of 500 micrograms and 2 or 3 X 125 micrograms terbutaline with an intervening time interval of 30 min. The time interval between the divided doses was possibly too long to achieve maximum accumulated effect of the four divided doses. PMID- 3523664 TI - Enprofylline and theophylline slow-eroding tablets in the treatment of asthma: a comparison. AB - Fifteen asthmatic outpatients were randomly treated during two periods of 14 days each with sustained-release preparations of either enprofylline (3-propyl xanthine) or theophylline (Theo-Dur) in a double-blind crossover study. After 4 days of treatment the mean daily doses of enprofylline and theophylline, which were 14.1 and 16.2 mg/kg/day, produced mean plasma concentrations of 4.9 and 12.7 micrograms/ml, respectively. Taking into account all the parameters used to evaluate the antiasthmatic effects, the peak expiratory flow, the number of puffs used from a beta-agonist aerosol, the asthma symptom score and the patients' preferred period, enprofylline was found to be better than theophylline. Enprofylline produced more headaches during the 1st week than theophylline did. However, during the 2nd week the score for headaches decreased to the same level as in the theophylline treatment group. Thus, enprofylline and theophylline seem to have comparable bronchodilator properties and side-effects in the long-term treatment of asthma. PMID- 3523665 TI - [Studies on the mutagenicity test methods: comparison of the screening methods using Salmonella typhimurium and Saccharomyces cerevisiae]. AB - Twenty-two acridine compounds and eleven phenanthridinium derivatives were tested for the induction of mutation in both eukaryotic, Saccharomyces cerevisiae and bacterial, Salmonella typhimurium. Summarized and discussed about the relationships between mutagenic activity and chemical structure of their compounds. Some metal compounds were examined for the induction of mitotic crossing over, mitotic gene conversion and reversion in yeast. Furthermore, the effects of the cell growth at the presence of these metal compounds on the mutations induced by nitrous acid was also examined. Mutagenic susceptibility of the yeast to these metal compounds on the comparison to the bacteria and the mechanisms of metal mutagenicity were discussed. PMID- 3523666 TI - [Use of monoclonal antibodies for determining plasma renin]. PMID- 3523667 TI - [New diagnostic imaging: ultrasonic diagnosis]. PMID- 3523668 TI - [Hormonal and multi-chemotherapeutic treatment in breast cancer. Current therapeutic possibilities]. PMID- 3523669 TI - [Properties and indications of potassium-sparing diuretics]. PMID- 3523670 TI - [Facial pain]. PMID- 3523671 TI - [Iatrogenic pathology of the eye]. PMID- 3523672 TI - [Diabetes therapy 1986. A review]. PMID- 3523673 TI - [Classification and diagnosis of diabetes mellitus]. PMID- 3523674 TI - [Intensified insulin therapy with multiple insulin injections or insulin pumps]. PMID- 3523675 TI - [Human insulin]. PMID- 3523676 TI - [Guidelines of the Swiss Diabetic Association concerning pregnancy in diabetes]. PMID- 3523677 TI - [Automobile driving ability in diabetes mellitus]. PMID- 3523678 TI - [Diabetic nephropathy]. PMID- 3523679 TI - [Effect of sobrerol (Lysmucol) aerosols on bronchial motility]. PMID- 3523680 TI - [The King and the psychiatrist--a double tragedy (Ludwig II, Bernhard von Gudden)]. PMID- 3523681 TI - [From diagnostic to surgical arthroscopy of the knee joint]. PMID- 3523682 TI - [Eclamptic fits: etiologic mechanisms, clinical aspects and therapy]. PMID- 3523683 TI - [Status epilepticus in childhood]. PMID- 3523684 TI - [Hereditary ichthyoses]. PMID- 3523685 TI - [Lasers: applications in ORL and broncho-esophagology]. PMID- 3523686 TI - [Creutzfeldt-Jakob disease in the Paris area: ethnic origin of the patients]. AB - Twenty six (27 p. 100) of 96 patients dying from Creutzfeldt-Jakob disease in the Paris metropolitan area between 1968 and 1982 were born in foreign countries although the proportion of foreign-born residents account for only 15 p. 100 of the population. The annual mortality rate of Creutzfeldt-Jakob's disease in this group of foreign-born cases (1.33 per million) was twice that of French-born residents (0.64 per million). Twenty of the 26 foreign-born cases originated from countries surrounding the Mediterranean sea, and 5 of 7 familial cases belonged to 2 Tunisian families. There was no spatial clustering of foreign-born cases and no relationship between their Paris residence and the percent of foreign-born people living in the same area. The disproportionate frequency of Creutzfeldt Jakob's disease among foreign-born residents thus seems to be a contributing factor to the higher prevalence of Creutzfeldt-Jakob's disease in Paris when compared to the rest of France. It further suggests that the prevalence of Creutzfeldt-Jakob's disease in Mediterranean countries may be greater than expected. PMID- 3523687 TI - [Neurologic manifestations of the acquired immunodeficiency syndrome]. AB - Recognition of the neurological symptoms and signs of the acquired immunodeficiency syndrome (AIDS) since 1982 has demonstrated the involvement of the nervous system in approximately one third of the cases. Certain opportunistic infections or tumors had been previously described in the course of immunodeficiency states of other origins: cerebral toxoplasmosis, cryptococcosis, progressive multifocal leukoencephalopathy, atypical mycobacteriosis and cerebral lymphoma. Other disorders such as subacute encephalitis raise specific etiopathogenic questions. Several of these affections can be associated or succeed each other and this is the natural course in AIDS. The detection of those conditions that are curable, among which toxoplasmosis, is of primary importance. PMID- 3523688 TI - [The use of music in the dental office. Myth or reality?]. PMID- 3523689 TI - [Ceramic crowns on a pressed aluminum coping]. PMID- 3523690 TI - [What's new in bonding? From splints to the bonded splint-bridges]. PMID- 3523691 TI - [How are complaints managed after placement of complete dentures?]. PMID- 3523692 TI - [Methodical and rational design of a tracing for a cast removable metal plate, which was made for a case of edentulousness]. PMID- 3523693 TI - [Composite resin surface bonded veneers]. PMID- 3523694 TI - [Quantitative study of the form and size of the occlusal surface of mandibular complete dentures in the edentulous mouth with flat or negative residual ridges]. PMID- 3523695 TI - Fungal peritonitis in patients receiving peritoneal dialysis: experience with 11 patients and review of the literature. AB - Despite progress in decreasing the incidence of and improving the therapy for bacterial peritonitis in patients receiving peritoneal dialysis, fungal peritonitis has emerged as a relatively common infection. Hospitalization, recent prior episodes of peritonitis, and antibacterial therapy appear to predispose patients to this infection. Clinically, fungal peritonitis cannot be differentiated from bacterial peritonitis except by gram stain and culture of the dialysate. The most commonly made serious error is the failure to initiate appropriate therapy quickly enough on the basis of these diagnostic parameters. For patients who no longer require dialysis, those for whom a change to hemodialysis is preferred, and those with concomitant life-threatening illness, the recommended therapy for fungal peritonitis is removal of the dialysis catheter and the institution of therapy with systemic antifungal agents. For patients who are hemodynamically and metabolically stable and for whom continued peritoneal dialysis is desirable, a trial of antifungal chemotherapy before removal of the catheter may be indicated. PMID- 3523696 TI - Ocular parasitic infection in Thailand. AB - Parasitic infestation is a major health problem in tropical countries. Increasing tourism and the influx of refugees from Southeast Asia demand a greater awareness of ocular parasitology. In Thailand, cysticercosis, gnathostomiasis, and angiostrongyliasis are the three commonest ocular parasitic diseases. No antiparasitic drugs are yet available to treat ocular involvement, and therapeutic success depends upon early and complete surgical removal. Because the eye is the only site at which direct visualization and surgical removal are possible, ocular examination is crucial to diagnosis and treatment. PMID- 3523697 TI - Abortion and perinatal sepsis associated with campylobacter infection. AB - Fetal loss or neonatal sepsis associated with campylobacter infection during pregnancy is infrequently recognized. As reported herein, one case of premature labor and neonatal sepsis due to Campylobacter fetus subspecies fetus was treated successfully with ampicillin and gentamicin. Only 19 similar cases have been cited in the literature. A review of these 19 cases reveals that the Campylobacter species involved were probably C. fetus subspecies fetus in nine instances, Campylobacter jejuni in nine, and Campylobacter coli in one. There were no significant species-related differences in clinical presentation or outcome. Eighteen of 20 pregnancies (including tht described herein) ended prematurely at 13-32 weeks of gestation. All of the mothers survived, but fetal/neonatal mortality was 80%. The pathogenesis of campylobacter infection in this situation probably involves maternal bacteremia originating from the bowel, with subsequent feto-placental involvement. Early recognition and treatment may improve fetal/neonatal outcome. PMID- 3523698 TI - Streptococcal puerperal sepsis and obstetric infections: a historical perspective. AB - The streptococcus, responsible for inestimable morbidity and mortality among parturient women since the 16th century, is no longer a significant cause of puerperal infection. Although the problem of the group A streptococcus in obstetrics has abated, the obstetrician is now confronted with the group B streptococcus, which is a major cause of fetal, neonatal, and maternal morbidity and mortality. Some historical insight into the infectious disease problems encountered by obstetric practitioners during the last four centuries allows comparison and contrast between the historic scourge of childbed fever and present day obstetric infections. PMID- 3523699 TI - Treatment of Listeria monocytogenes infection with trimethoprim-sulfamethoxazole: case report and review of the literature. AB - A 55-year-old female recipient of an orthotopic liver transplant, who was receiving azathioprine, prednisone and cyclosporin, developed bacteremia due to Listeria monocytogenes. Because of a penicillin allergy, the patient was treated primarIly with trimethoprim-sulfamethoxazole, to which she responded well. The prior literature on use of trimethoprim-sulfamethoxazole in listeria infections is reviewed, and future recommendations are considered. On the basis of the experience described in this case report as well as a review of the literature, trimethoprim-sulfamethoxazole appears to be an effective treatment of listeria infections. PMID- 3523700 TI - Nontyphoid salmonellosis in renal transplant recipients: report of five cases and review of the literature. AB - Five cases of nontyphoid salmonella infection among renal transplant recipients are reported, and 32 cases from the literature are reviewed. Contrary to the nontyphoid salmonella infection in normal hosts, such infection in renal transplant recipients manifested as bacteremia (62%) and in extraintestinal foci (35%). Asymptomatic bacteriuria, at times prolonged, was common, whereas gastrointestinal symptoms were noted in only 19%. The course of infection may be prolonged, with relapse occurring in 43.2% and death in 5.4%. Extraintestinal manifestations were located at very unusual sites, such as testes, maxillary sinus, axillary vein thrombus, and hemodialysis fistula. Because relapses were so frequent, the suggestion is made that every effort be made to find silent foci of infection after clinical recovery and to eradicate such foci with prolonged antibiotic therapy and with surgical measures, if necessary. Stool and urine should be screened for nontyphoid Salmonella before and after transplantation. PMID- 3523701 TI - Rhinocerebral mucormycosis in renal transplant recipients: report of three cases and review of the literature. AB - Mucormycosis is an opportunistic infection caused by fungi of the order Mucorales. The commonest clinical form is rhinocerebral mucormycosis, which has been described as characteristically complicating diabetes mellitus and leukemia. Three patients with rhinocerebral mucormycosis complicating renal transplantation are described, and 11 additional cases recorded in the English-language medical literature are reviewed. The mean age of the 14 patients was 36 years, and the ratio of males to females was 1.8:1. Diabetes mellitus was present in only five patients, and polycystic kidney was the most common underlying renal disease. Most kidney grafts were obtained from cadavers. Eight patients had evidence of graft rejection, and the majority had been receiving corticosteroids and azathioprine. The initial manifestations of infections became evident two days to four years after transplantation (median, two months). Facial swelling, tissue necrosis, and cranial nerve involvement were common. Seven of 14 cases occurred in Israel, a finding suggesting the intervention of local factors. Despite antifungal and/or surgical therapy, nine patients died as a consequence of the infection days to months after diagnosis. Although a rare complication, rhinocerebral mucormycosis remains a serious threat to the kidney transplant recipient. PMID- 3523702 TI - Reciprocal relationships between undernutrition and the parasitic disease visceral leishmaniasis. AB - Little is known about the interrelationship between undernutrition and parasitic infections in areas of the world where both are prevalent. The associations between undernutrition and visceral leishmaniasis, an important protozoal disease, were assessed in a study of residents of an area in Brazil with endemic leishmaniasis. Mid-arm anthropometry was used to assess fat and muscle area. Children with visceral leishmaniasis came from large families (9.6 +/- 1.1 members vs. 6.8 +/- 0.7 members in neighborhood control families), and patient housemates had fat areas that were 78% (P less than .05) those of age- and sex matched neighborhood controls. The children with visceral leishmaniasis who were studied four months or less after diagnosis had fat areas that were 66% (P less than .05) those of age- and sex-matched household controls or 41% (P less than .01) those of neighborhood controls and muscle areas that were 81% (P less than .025) those of household controls or 75% (P less than .05) those of of neighborhood controls. It is hypothesized, on the basis of these data and other findings, that undernutrition is associated with the development of clinically apparent visceral leishmaniasis and that the disease itself has a profound effect on nutritional status, resulting in loss of both muscle and fat, effects that possibly are mediated by interleukin-1 and/or other factors produced by Leishmania donovani-infected macrophages. PMID- 3523703 TI - Selective primary health care. XXIV. Malaria. AB - The eradication of malaria remains an elusive goal in many tropical and subtropical countries, even though methods are available that, if used correctly, will permit control of the disease in most area. These methods include chemotherapy directed against the parasite in the human host and such antivector techniques as a reduction of mosquito breeding sites and an attack on the aquatic and adult stages of mosquitoes. The direction of a malaria control program requires a detailed understanding of malaria epidemiology and control measures as well as flexibility in their application to different epidemiologic situations. In most developing countries, the success of a malaria control effort will depend on a well-functioning primary health care system and active community participation in control activities. PMID- 3523705 TI - Classics in infectious diseases. Observations on the pathology and treatment of necrosis. By Nathan Smith. 1827. PMID- 3523704 TI - Chemotherapeutic approach to control of onchocerciasis. AB - Onchocerciasis is one of the leading causes of blindness in the developing world. An estimated 40 million people are afflicted with this parasitic disease. World Health Organization vector control programs have had considerable success in interrupting the parasite transmission cycle in selected savanna regions of West Africa, but chemotherapeutic agents suitable for massive treatment campaigns have not been available. Controlled clinical studies have indicated that a single oral dose of ivermectin is safer and more effective therapy for onchocerciasis than the the standard seven- to 10-day course of diethylcarbamazine, the current drug of choice, and that ivermectin causes a more prolonged reduction in dermal microfilarial density. Patients treated with ivermectin are unable to infect the blackfly vector as long as the dermal microfilarial density remains low; therefore, once- or twice-yearly administration of ivermectin in community-wide therapy programs, either alone or in combination with vector control measures, may successfully interrupt transmission of the parasite and eventually eliminate the disease. PMID- 3523706 TI - Travelers' diarrhea: an overview. AB - The diarrhea of travelers is a syndrome and not a disease; its history is reviewed here. Dysentery is caused by agents that damage the epithelium of the intestinal tract; diarrhea results from the response of intact intestinal cells to toxins that stimulate enzymatic processes to release liquid and ions. Toxigenic Escherichia coli, the most frequent pathogen in diarrhea, produces a recognizable, benign syndrome; however, other agents of disease, including viruses, bacteria, and protozoa, are responsible for a significant proportion of cases of diarrhea. Hygienic precautions are generally advised, despite the lack of evidence supporting their efficacy. Antibiotic prophylaxis is effective in reducing the incidence of diarrhea caused by E. coli but may not be desirable because of toxicity and the possibility of complicating the diagnostic process. Diagnosis requires better laboratory methods than are usually available but can be made with limited accuracy by a clinician acquainted with the various manifestations of potential causes. Treatment after diarrhea has started should be limited to fluid and ion replacement, with the possible addition of drugs that reduce intestinal motility, although some advocate the use of antibiotics at this time. The number of people traveling, especially to developing countries, continues to increase. This trend would expand enormously if the fear of diarrhea were removed. PMID- 3523707 TI - Epidemiology of travelers' diarrhea: current perspectives. AB - Identification of the characteristics that make certain travelers more likely to develop diarrhea, the most common illness affecting international travelers, can lead to prevention of the illness and to improved understanding of endemic diarrheal disease in developing countries. Travelers' diarrhea, a syndrome with a spectrum of clinical symptoms, is most frequently characterized by watery diarrhea, cramps, and nausea. The highest attack rates have been reported in travelers from the United States or northern Europe to less-developed, particularly tropical, countries. Among travelers from less-developed countries, diarrhea has been correlated with higher socioeconomic status. The findings that country of origin and socioeconomic status may affect the frequency of previous exposures to enteric pathogens suggest that persons with prolonged exposure acquire immunity and are at lower risk of developing travelers' diarrhea. Although few studies have shown a clear correlation between the eating of specific foods and the development of travelers' diarrhea, the syndrome has been associated with eating in public places. PMID- 3523708 TI - Epidemiologic studies of travelers' diarrhea, severe gastrointestinal infections, and cholera. AB - A retrospective survey, which is based on interviews conducted between 1975 and 1984 with 20,000 European tourists returning from 15 destinations in various climatic zones, demonstrates that travelers' diarrhea is the most frequent health problem encountered by travelers in the tropics. The incidence varied from 4% to 51%, depending on the destination. High-risk groups were persons younger than 30 years, adventurous travelers, and travelers with preexisting gastrointestinal illnesses. Illness acquired at various geographic regions showed only minor differences in chronology and symptomatology. The clinical course of travelers' diarrhea was usually short and mild. Additionally, by longitudinal and retrospective analyses, the incidence and prognosis of gastrointestinal infections of greater severity that were acquired after a short stay in a developing country, such as giardiasis, amebiasis, typhoid fever, and cholera, were evaluated; typhoid fever and cholera, in particular, were found to be quite rare. PMID- 3523709 TI - Etiology and epidemiology of travelers' diarrhea in Asia. AB - Travelers' diarrhea in Asia has been studied among Peace Corps volunteers in Thailand, Japanese travelers, foreign residents in Bangladesh, guests in hotels, and members of various tour groups. Rates of diarrheal attack of greater than 50% during four- to six-week sojourns were reported for these groups. Among travelers with diarrhea, the most commonly isolated pathogen was enterotoxigenic Escherichia coli (20%-34%), followed by Salmonella (11%-15%), Shigella (4%-7%), Campylobacter (2%-5%), and Vibrio parahaemolyticus (1%-13%). In 9%-22% of diarrheal episodes, multiple pathogens were recovered. Among Japanese travelers, Salmonella was more commonly acquired in the Far East; Shigella and Campylobacter, in the Indian subcontinent; and V. parahaemolyticus, in Southeast Asia. Aeromonas hydrophila and Plesiomonas shigelloides were commonly isolated from ill travelers in Thailand but less frequently from other travelers. Protozoa and Vibrio species other than V. parahaemolyticus were isolated in less than 5% of episodes. PMID- 3523710 TI - Environmental interventions for the prevention of travelers' diarrhea. AB - The diarrheal illnesses affecting travelers to areas with low standards of hygiene are due to exposure to microbial agents not in wide circulation in the travelers' home area. A major objective for the prevention of travelers' diarrhea should be to minimize exposure to these infectious agents. Studies of sporadic and epidemic travelers' diarrhea have shown that contaminated food and water are usually the most important vehicles for transmission of these agents. Travelers must know which foods and water sources to avoid and which they may reasonably be assured are safe. Also, methods for disinfecting potentially contaminated sources must be simple and practical. Acceptable methods for ensuring the safety of food and drink are amply documented in the literature. However, although the consumption of certain foods and beverages is clearly associated with an increased risk of developing travelers' diarrhea, in some retrospective studies adherence to strict dietary rules generally did not appear to diminish the incidence. Despite these findings, whose validity may have been weakened by study design flaws, careful attention to the preparation and choice of food and beverage is recommended for prevention of both diarrheal and nondiarrheal illnesses. PMID- 3523711 TI - Prevention of travelers' diarrhea by nonantibiotic drugs. AB - Travelers have resorted to a variety of drugs for prevention of diarrhea. No beneficial prophylactic effect has been confirmed for halogenated hydroxyquinoline, lactobacilli, antimotility drugs, ethacridine, and various other agents. In contrast, bismuth subsalicylate (BSS) in liquid form reduced the incidence of diarrhea in students from the United States living in Mexico and in tablet form in volunteers challenged by enterotoxigenic Escherichia coli. In tourists visiting various developing countries, a randomized, double-blind study was conducted in which 390 persons received a total of 2.1 or 1.05 g of BSS daily or placebo in tablet form in two doses. BSS reduced the incidence of diarrhea by 41% in the high-dose group and by 35% in the low-dose group without causing important adverse reactions. PMID- 3523712 TI - Antimicrobial prophylaxis of travelers' diarrhea: a selected summary. AB - This paper summarizes the published controlled studies of the prophylaxis of travelers' diarrhea in which the following drugs have been used: neomycin, nonabsorbable sulfonamides, Streptotriad, doxycycline, erythromycin, and mecillinam. These studies have shown that antimicrobial prophylaxis can be highly effective in preventing episodes of travelers' diarrhea. The protection, however, lasts only as long as the drugs are being taken; there is no evidence that subclinical infections occur while the drug is being taken. None of the data suggest that antimicrobial prophylaxis increases the probability of infection with drug-resistant enteric pathogens. In these studies few subjects have experienced adverse drug reactions; however, the number of subjects has been too small to allow determination of accurate incidence data. Antimicrobial prophylaxis for travelers' diarrhea can be effectively and safely used on an individualized basis for persons traveling to areas of high risk. PMID- 3523713 TI - Antimicrobial agents in the prevention of travelers' diarrhea. AB - Each of 433 adults traveling to Guadalajara, Mexico, from the United States during summer months was enrolled in one of four clinical trials of the protective effect of antimicrobial agents against travelers' diarrhea. Only one (2%) of 57 subjects taking trimethoprim-sulfamethoxazole (160 mg/800 mg daily) experienced diarrhea during a two-week study, whereas eight (14%) of 58 subjects taking trimethoprim alone (200 mg daily) and 10 (33%) of 30 taking placebo developed illness (P less than .05 and P less than .0001, respectively). Diarrhea occurred significantly less frequently among subjects receiving trimethoprim than among placebo recipients (P less than .05). None of 11 students given bicozamycin (500 mg four times daily) developed diarrhea during a three-week study, whereas 10 (53%) of 19 placebo recipients became ill (P = .003). Four (7%) of 54 subjects receiving norfloxacin (400 mg daily) experienced diarrhea during a two-week study; in contrast, 34 (60%) of 57 placebo recipients developed diarrhea (P less than .0001). The various antimicrobial agents prevented illness due to enterotoxigenic Escherichia coli and Shigella as well as that unassociated with a pathogen. The drugs were well tolerated. Current evidence suggests that trimethoprim-sulfamethoxazole is the optimal antimicrobial agent available for prophylaxis of travelers' diarrhea. PMID- 3523714 TI - Resistance of Shigella, Salmonella, and other selected enteric pathogens to antimicrobial agents. AB - Antimicrobial agents are commonly used therapeutically and prophylactically for travelers' diarrhea. Resistance of enteric pathogens to these agents may prevent the success of such therapy, with the result depending upon the level of resistance and the drug concentrations achieved in the gastrointestinal tract. Data from a number of geographic locations were collected in order to determine whether consistent trends exist and whether predictions can be made regarding the susceptibility of various enteric pathogens worldwide. These data showed marked variability in the prevalence of resistance. Among Shigella, the percentage of strains resistant to commonly used agents varied within the following ranges: ampicillin, 7% (Dacca) to 87% (Thailand); tetracycline, 11% (Sri Lanka) to 91% (Mexico); and trimethoprim-sulfamethoxazole, 0 (Dacca, 1980) to 55% (Dacca, 1984). Resistance in Salmonella strains showed a similar marked variability. Few strains of enteroxigenic Escherichia coli (less than or equal to 10%) were resistant to trimethoprim-sulfamethoxazole. Relatively recent isolates of all pathogens examined tended to be more resistant than earlier isolates to trimethoprim-sulfamethoxazole as well as to other agents. PMID- 3523715 TI - Treatment of travelers' diarrhea: fluid and dietary management. AB - Travelers' diarrhea is associated with a mild or moderately severe loss of fluid and electrolytes. Severe fluid deficits are encountered only rarely. Mortality associated with fluid deficits is very rare; significant morbidity occurs only in older adults or in patients with chronic intestinal diseases or other chronic diseases (cardiac, pulmonary, or renal). Treatment of fluid and electrolyte deficits may be effectively achieved by rehydration with oral rehydration solution (World Health Organization) or with a commercial solution of similar composition. Dietary recommendations should emphasize the necessity of resuming a normal diet once a reduction in symptoms makes this feasible. Eating small portions frequently and omitting caffeine and lactose-containing food and drink may be advantageous. PMID- 3523716 TI - Nonantibiotic therapy for travelers' diarrhea. AB - Several trials have shown that nonantibiotic drugs are efficacious in the treatment of travelers' diarrhea. When compared with placebo (P less than .025), bismuth subsalicylate (Pepto-Bismol) taken orally at a dosage of as low as 30 ml every half hour for eight doses was shown to be effective in reducing the frequently of episodes of diarrhea. Preliminary results indicated that loperamide (two 2-mg capsules followed by one capsule after each loose bowel movement) was more effective (P less than .025) than bismuth subsalicylate in relieving diarrhea. Likewise, preliminary results showed that BW942c, an unlicensed endorphin-like pentapeptide, offered more relief of diarrhea in the first 12 hr of therapy than did trimethoprim-sulfamethoxazole (P = .02) or placebo (P = .0007). Use of a nonantibiotic drug for empiric treatment of travelers' diarrhea appears to be a reasonable approach, especially for patients with mild to moderate disease and with no evidence of high fever or dysentery. PMID- 3523717 TI - Antimicrobial therapy for infectious diarrhea. AB - Acute diarrheal disease may be due to viral, bacterial, or protozoal enteropathogens. In our current state of knowledge and medical practice, specific antiviral agents are not used in the treatment of known or presumed viral diarrhea. In contrast, for a number of the bacterial and protozoal diarrheal infections, therapy with certain antimicrobial agents can significantly ameliorate the severity and duration of illness and curtail the excretion of the pathogen. A recurring theme encountered in reviewing information on the therapy for diarrheal infections is that demonstration of the susceptibility in vitro of a bacterial pathogen to a particular antibiotic by no means assures clinical success. Many antibiotics that show potent activity in vitro have little or no efficacy in vivo. Controlled clinical trials are necessary to assess the clinical and bacteriologic efficacy of an antibiotic in diarrheal infections. PMID- 3523718 TI - Antimicrobial therapy for travelers' diarrhea. AB - Three clinical trials were carried out to examine the efficacy of various antimicrobial agents in the treatment of travelers' diarrhea among students from the United States in Mexico. Thirty-seven subjects received twice daily for five days 160 mg of trimethoprim (TMP) and 800 mg of sulfamethoxazole (SMZ), 38 received 200 mg of TMP, and 35 received a placebo. Another group of students were given 100 mg of furazolidone (47 students) or ampicillin (47 students) four times a day for five days. In the third study, 500 mg of bicozamycin (72 students) or a placebo (68 students) was given four times a day for three days. Most students who received TMP-SMZ (78%), TMP (84%), or bicozamycin (85%) had recovered by 48 hr after initiation of treatment, as compared with 14% and 47% in the corresponding placebo groups and 55% in the furazolidone group. The agents had a positive effect for all etiologic categories, including diarrhea due to enterotoxigenic Escherichia coli and Shigella strains and illness without any established etiologic agents. Treatment failures were unusual with TMP-SMZ, TMP, and bicozamycin therapy (5% vs. 39% for the placebo-treated students). The drugs were well tolerated. The use of TMP-SMZ or TMP alone in the empiric treatment of moderate to severe travelers' diarrhea is advocated. PMID- 3523719 TI - Chronic diarrhea in travelers: diagnostic and therapeutic considerations. AB - Although the epidemiology, and pathophysiology of travelers' diarrhea are well understood, the long-term consequences of this syndrome are poorly appreciated. Many people struck with travelers' diarrhea do not completely recover but rather develop one of several chronic diarrheal syndromes. In some patients an episode of travelers' diarrhea seems to unmask a preexistent, underlying gastrointestinal disorder. The frequency of these complications and the magnitude of this problem are unknown. The differential diagnosis, diagnostic workup, and treatment of such patients have been outlined; unfortunately, many patients with chronic diarrhea elude diagnosis, and treatment is problematic. Some of the questions that must be answered include the following: What is the magnitude of the problem of chronic diarrhea following travelers' diarrhea? What is the natural history of patients with this syndrome? Which individuals are most likely to develop a chronic diarrheal syndrome, and can they be identified in advance? Are new etiologic agents involved in these chronic diarrheal syndromes? Answers to these questions will require well-organized, multicenter studies of a large number of travelers to various locales. PMID- 3523720 TI - [Current findings on acute leukemia]. PMID- 3523722 TI - The invisible single cast broken-stress bridge. PMID- 3523721 TI - [From Freud's side]. PMID- 3523723 TI - New rare earth magnetic technology: the Jackson solid state attachment system. PMID- 3523724 TI - Exercises to ease pain after abdominal surgery. PMID- 3523725 TI - [Intraoperative sonography to localize a kidney tumor]. AB - The authors present the case of a 61-year old man with microhematuria, in whom the preoperative diagnostic work-up (urography, percutaneous sonography, CT, retrograde pyelogram) had led to the diagnosis of a right sided renal tumour. Intraoperatively a kidney tumour was neither seen nor palpated. However, the mass was clearly outlined by intraoperative sonography. The following nephrectomy revealed an intrarenal adenocarcinoma of the kidney of 2.5 cm diameter. PMID- 3523726 TI - Sources of error in ultrasonography. AB - Sonograms often contain distortions and ghosts that may result in misinterpretations. The present work deals with some common artifacts and explains the reasons behind them. It is generally impossible to eliminate these effects, but if they are known, and if the equipment is used correctly and the examiner has sufficient experience of scanning, misdiagnoses can generally be avoided. PMID- 3523727 TI - [Biliary ascariasis]. AB - Biliary ascariasis is a complication of intestinal ascariasis. This results in characteristic findings in the intravenous cholangiocholecystogram and in the sonogram. Characteristic signs of biliary ascariasis are, in the longitudinal section, the "strip sign", "spaghetti sign", "inner tube sign", and in transverse section "a bull's eye in the triple O". The helminth can travel from out of the biliary duct system back into the intestines, so that control examinations can even be negative. PMID- 3523728 TI - [Automated diagnosis--new possibilities through user-specific software]. AB - After four years of development and testing, we have devised a software system especially adapted to the recording, storage and monitoring of radiological findings. After full implementation of this system, sufficient practical experience has been collected for effecting a comprehensive assessment. The qualitative and quantitative aspects of a discipline-specific software are described in detail and can be used for comparison with other EDP systems. The two essential criteria for the practicability and acceptance of a system for automatized collection and recording of findings are a short interaction time at the input terminal and a high degree of logical and reference flexibility enabling individual formulation and patient-related specificity of the textual formulation of findings comparable with conventional sound dictation. By means of interlinking of information with other processing programmes it becomes possible to continue data processing for each case in both administrative and research aspects after a single input operation of patient and examination data. PMID- 3523729 TI - [Renal transplantation]. PMID- 3523730 TI - [Transplantation of the liver]. PMID- 3523731 TI - [Transplantation of the pancreas]. PMID- 3523732 TI - [The cost of renal transplantation. An interview with H. Kreis by J. Deleuze]. PMID- 3523734 TI - Cumulative index 1980-1984. PMID- 3523733 TI - Centrifugal extension of coronary intimal necrotic areas. AB - The use of serial cross-sections, camera lucida drawings and photographic reconstruction of longitudinally cut samples, revealed that about half of intimal necrotic areas present in the coronary arteries of subjects aged 41-50 years exhibited a longitudinal diameter greater than 1.0 cm, occurring as very long lesions. In the 16 intimal necrotic areas included in a tridimensional study the longitudinal diameter was 7.8 times greater than the transverse one and 11.3 times greater than the luminal-medial diameter. The important centrifugal extension of coronary intimal necrotic areas during the fifth decade of life, particularly in male subjects, could not be detected grossly; it required a meticulous light microscopic examination of stained tissue section. This centrifugal extension was sometimes associated with the presence of a "border zone" of intermediate injury developed at the point where the intimal necrotic area irradiated in the direction of blood flow. This distal side of the lesion appeared as a highly irregular boundary with numerous peninsulas of interdigitating necrotic and apparently normal connective tissue. The present results, associated with those of our previous reports, support the view that human atherosclerosis has many attributes of a necrotizing arteriopathy. PMID- 3523735 TI - [Early excision and grafting in facial burns]. AB - Early excision and graft surgery is now a routinely used procedure, but whereas its application for burns of the hand has been well determined it is employed less extensively for facial lesions. It is a heavy and very hemorrhagic surgery requiring close cooperation between surgeons and intensive care physicians. Its use for the face is not easy to define, difficulties arising because of the need to establish the depth of the burn, the hemorrhagic risk involved and the need for effective compression after graft surgery. PMID- 3523736 TI - [An anniversary of Czechoslovak phoniatry]. PMID- 3523738 TI - High circulating levels of 25-hydroxyvitamin D3 in renal stone formers with hyperabsorptive hypercalciuria. AB - Normocalcaemic male stone formers, 31-51 years old (n = 108) on a free diet, were divided into a hypercalciuric group (n = 47) with calcium excretion rates higher than 8.0 mmol/24 h, a normocalciuric group (n = 32) with calcium excretion rates below 6.1 mmol/24 h and an intermediate group (n = 29). There were no statistically significant differences between the hypercalciuric and the normocalciuric groups with respect to serum levels of calcium, phosphate, creatinine, urate, ALAT, albumin, PTH, 1,25-dihydroxyvitamin D or urinary excretion of cAMP. The group of patients with high calcium excretion had significantly higher serum levels of 25-hydroxyvitamin D3 (75 +/- 4 nmol/l) than the group with low calcium excretion (57 +/- 4 nmol/l) (p less than 0.002), while the group of patients with intermediate calcium excretion had 25-hydroxyvitamin D3 levels between the other two groups (69 +/- 4 nmol/l). A highly accurate method based on isotope dilution-mass spectrometry was used to assay 25 hydroxyvitamin D3. Of the patients with hypercalciuria (n = 47), seven were classified as hyperabsorbers on the basis of calcium load tests. These patients were found to have even higher serum levels of 25-hydroxyvitamin D3 (108 +/- 10 nmol/l)--significantly higher than that of the hypercalciuric patients as a whole. The above study was carried out in March 1983. In September, the group of patients with high urinary calcium excretion also had significantly higher levels of 25-hydroxyvitamin D3 than the group of patients with low calcium excretion.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3523737 TI - Effect on renal haemodynamics, glomerular filtration rate and albumin excretion of high oral protein load. AB - The effect on glomerular filtration rate (GFR), renal plasma flow (RPF) and excretion of albumin and beta-2-microglobulin in the urine after a high oral protein or amino acid load was investigated in young healthy males. After both test meals an increase in GFR of 10%, and in RPF of about 9-18%, was seen. The filtration fraction and albumin excretion rates were unchanged. The increase in GFR was significant from 20 to 60 min after intake of meat and remained elevated for more than 2 h. After the meat meal, a decrease in renal vascular resistance and an increase in S-creatinine, S-phosphate, S-carbamide and beta-2 microglobulin excretion rates was seen, but not after the amino acid load. During the experiments a gradual decrease in S-protein was noted. We conclude that the increase in RPF and GFR caused by intake of protein or amino acids in short-term experiments is not associated with impaired permselective properties of the glomerular membrane expressed in the albumin excretion rate. PMID- 3523739 TI - Antacids in the treatment of gastroduodenal ulcer. PMID- 3523740 TI - Effects of omeprazole in duodenal ulcer patients. AB - The efficacy of and tolerance to omeprazole, 40 mg/day, was studied in an open label study in 18 patients with endoscopically verified duodenal ulcers. The effects of the drug on the oxyntic mucosa and pentagastrin-stimulated acid secretion during and after treatment were also studied. Fifteen patients completed the final endoscopy. The ulcers were healed in all after 4 weeks' treatment. Both basal and peak acid output were significantly reduced during omeprazole treatment, whereas 4 weeks after the cessation of treatment neither basal nor peak acid output differed from the pretreatment levels. Fasting serum gastrin levels rose by 56% during treatment but had returned to pretreatment values when tested again 4 weeks after the end of the treatment period. Histological examination of the biopsy specimens taken before and after treatment showed that omeprazole had no significant effect on the volume densities of either parietal or endocrine cells. We conclude that omeprazole is of value in the treatment of duodenal ulcer and that the effects of the drug on acid output and serum gastrin levels are fully reversible. PMID- 3523741 TI - Gastric secretion and reflux pattern in reflux oesophagitis before and during ranitidine treatment. AB - Ranitidine (150 mg X 2) and placebo were given to 42 patients with reflux oesophagitis for 8 weeks by the double-blind crossover technique. Gastric secretion tests and 24-h pH monitoring at two different oesophageal levels were performed before and during the treatment periods. Gastric hypersecretion was present in 76%. Ninety-seven per cent had reflux for more than 1% of 24 h, and 67% for more than 4.2%. Ranitidine reduced basal and stimulated gastric acid output and secretion rates (p less than 0.001), total reflux time to the lower level (p less than 0.05), and number of reflux episodes to the upper and lower levels of the oesophagus in the supine position. Basal, maximal, and peak acid output, gastric secretion rates, number of reflux episodes, and total reflux time at the upper oesophageal level in the supine position were significantly more reduced in symptomatic responders than in non-responders. No correlation was found between ranitidine-induced reduction of gastric secretion and length of oesophageal reflux time. PMID- 3523742 TI - [Development of the direction of investigation in soil and water public health of the Institute of Water, Soil and Air Public Health]. PMID- 3523743 TI - [Microbiologic studies as a contribution to the ground water protection concept]. PMID- 3523744 TI - [Therapy of bleeding esophageal varices. Attempt at a position statement]. AB - In recent years the technique of selective portasystemic shunting (Warren procedure) and sclerotherapy, and also the possibility of lowering portal pressure with beta-blockers, have changed the approach to management of patients with bleeding esophageal varices. Treatment of these patients is reviewed in the light of experience of 204 cases and the literature. The advantages and disadvantages of vasopressin, balloon tamponade, sclerotherapy, transhepatic embolization and various shunt and non-shunt operations in the acute phase are presented. For elective cases the discussion centers mainly on treatment by distal splenorenal shunt and sclerotherapy. PMID- 3523745 TI - [Selection of chloroquine-resistant Plasmodium falciparum strains in tourists under chemoprophylaxis]. AB - In a prospective study 20 P. falciparum isolates imported from Africa by non immune tourists were investigated for chloroquine sensitivity using the in vitro microtest and the results were compared with the plasma chloroquine concentration. All 6 patients taking correct chloroquine prophylaxis (chloroquine plasma levels between 0.1-0.5 nmol/ml) harboured highly resistant P. falciparum strains (schizont maturation at 3.2 and 6.4 nmol/ml blood in 3 patients each). In the 4 patients with inadequate prophylaxis (plasma levels between 0.02-0.1 nmol/ml) the degree of resistance was lower (at 1.6 and 6.4 nmol/ml blood in 2 patients each). Chloroquine-sensitive strains were found only in patients with chloroquine plasma levels below 0.02 nmol/ml and in 4 of 5 patients who did not show chloroquine in the plasma. Selection of chloroquine-resistant P. falciparum strains under short term chloroquine chemoprophylaxis appears to be highly probable. PMID- 3523746 TI - [Popular medical literature in days of yore]. AB - The first books of popular medicine appeared during the Enlightenment in the 18th century. Some of these writings are examined in more detail, with sidelights on the popular medical literature of today. PMID- 3523747 TI - [Glomerular erythrocytes in urine. Identification and significance]. AB - The glomerular origin of microhematuria can often be identified by typical changes in erythrocyte morphology when the urinary sediment is examined with a phase contrast microscope. The so-called "glomerular erythrocytes" appear in uneven annular shape (ring forms) or as fragmented, crushed and ruptured cells (destroyed forms). Non-glomerular erythrocytes originating from the urinary tract have different morphological characteristics. The occurrence of only a few glomerular erythrocytes (0-2 per high power field) is a normal finding. The morphological characteristics of the erythrocytes should be analyzed as the first step in the work up of microhematuria. In the case of clearcut glomerular microhematuria, unnecessary urological or radiographical investigation can thus be avoided. PMID- 3523748 TI - [New findings on echinococcosis]. AB - The following new aspects of cystic and alveolar echinococcosis (= infections with the metacestode stages of Echinococcus granulosus and E. multilocularis respectively) are reported: identification of a Swiss E. granulosus isolate as "cattle strain" which differs from the "sheep strain"; new observations on proliferation and metastasis formation of larval E. multilocularis; information on chemotherapy of human echinococcosis; recent developments in immunoserology. The latter includes a new technique for serological differential diagnosis of cystic and alveolar echinococcosis, the determination of parasite-specific immunoglobulin classes (IgG, IgM, IgA and IgE) and circulating antigens in ELISA, and the introduction of arc-5 detection in routine serodiagnosis. A highly purified, species-specific antigen from E. multilocularis is now available for seroepidemiological studies. PMID- 3523749 TI - [Parafix--a new parapulpal screw]. PMID- 3523750 TI - [Class-V fillings with Super-Bond. The 2-year results]. PMID- 3523751 TI - [Martin Schlenker (1839-1909)]. PMID- 3523752 TI - The sources of lead in blood: a critical review. PMID- 3523753 TI - Elemental composition of ancient Japanese bones. AB - Excavated bones (rib) obtained from 50 sites in Japan were measured by ICP atomic emission spectrometry and atomic absorption spectrometry for concentration of 19 elements, including Al, B, Ca, Cd, Cr, Co, Cu, Fe, K, Mg, Mn, Na, Ni, P, Pb, Sr, Ti, V and Zn. One hundred and forty-one specimens were classified into five groups according to Japanese prehistoric and historic eras (Jomon, Yayoi, Kofun, Kamakura and Muromachi, and Edo). The elements, with concentrations which showed no significant change with era were Al, B and Cr. Average concentrations of Ca were in the range 2-2.5 X 10(-1) g g-1 and those of P ranged from 1.1 to 1.3 X 10(-1) g g-1, indicating a well-preserved bone mineral matrix. The Ca/P ratio (mol/mol) was lowest in the Edo group--1.48 as compared with 1.54-1.66 in the other groups. Among the elements which showed changes with era were Pb, Fe, Co and Mn, all of which showed remarkably elevated concentrations in the Edo group. In addition to this unique elemental composition of Edo bones, samples from the Kofun era showed a completely different composition from those of other periods, i.e. they had the highest concentrations of Cd, Zn and Mg, and the lowest concentrations of Cu, K, Ni and Sr. The cause of the elevated Pb concentration in Edo bones is discussed in relation to human activities which may have led to environmental Pb pollution. PMID- 3523754 TI - Interleukin-2 induction of T-cell G1 progression and c-myb expression. AB - In studies to determine the biochemical mechanisms responsible for cell proliferation, synchronized T cells were used as a model for cellular growth control. By metabolic and morphologic criteria, it was found that activation of the T-cell antigen receptor rendered the cells responsive to interleukin-2 (IL 2), but did not move them through the cell cycle. Instead, IL-2 stimulated G1 progression to S phase, or lymphocyte "blastic transformation." During IL-2 promoted G1 progression, expression of the cellular proto-oncogene c-myb was induced transiently at six to seven times basal levels, maximal levels occurring at the midpoint of G1. PMID- 3523755 TI - Soviets presented plans for Chernobyl study. PMID- 3523756 TI - Human endothelial cell growth factor: cloning, nucleotide sequence, and chromosome localization. AB - Several of the endothelial cell polypeptide mitogens that have been described probably play a role in blood vessel homeostasis. Two overlapping complementary DNA clones encoding human endothelial cell growth factor (ECGF) were isolated from a human brain stem complementary DNA library. Southern blot analysis suggested that there is a single copy of the ECGF gene and that it maps to human chromosome 5 at bands 5q31.3 to 33.2 A 4.8-kilobase messenger RNA was present in human brain stem messenger RNA. The complete amino acid sequence of human ECGF was deduced from the nucleic acid sequence of these clones; it encompasses all the well-characterized acidic endothelial cell polypeptide mitogens described by several laboratories. The ECGF-encoding open reading frame is flanked by translation stop codons and provides no signal peptide or internal hydrophobic domain for the secretion of ECGF. This property is shared by human interleukin-1, which is approximately 30 percent homologous to ECGF. PMID- 3523757 TI - Self-assembling cytotoxins. AB - Decanal and N-amino-N'-1-octylguanidine (AOG), combined at 28 microM each, mediated erythrocyte lysis within 80 minutes under physiological conditions. By contrast, no lysis was observed after 20 hours with either decanal (56 microM) or AOG (100 microM) alone. The pronounced synergism observed for these chemicals and similar reactive pairs of chemicals is due to the self-assembly of more cytotoxic hydrazones in situ. Decanal and AOG also exhibit synergistic activity against cultured human cells (HeLa) and bacteria (Escherichia coli J96). This synergism may be useful in the design of cytotoxins that would self-assemble selectively from nontoxic precursors within tumors, while sparing normal tissue. PMID- 3523758 TI - The 35-nucleotide spliced leader sequence is common to all trypanosome messenger RNA's. AB - In Trypanosomatidae the messenger RNA's (mRNA's) that code for the variant surface glycoproteins (VSG's), tubulins, calmodulin, and at least a subset of other proteins contain a common 35-nucleotide leader sequence at their 5' ends. Hybrid-arrested in vitro translation has been used to show that all mRNA's in both African and South American trypanosomes contain this 35-nucleotide sequence. Oligonucleotides complementary to this sequence blocked translation of all trypanosome mRNA's in a rabbit reticulocyte lysate system, but did not inhibit translation of mRNA's from other organisms lacking this sequence. An oligonucleotide complementary to the VSG mRNA downstream from the spliced leader sequence arrested only VSG synthesis. Thus, the 35-nucleotide leader sequence is a general feature of all trypanosome mRNA's. The high specificity of oligonucleotides complementary to the spliced leader for their target sequence suggests that analogues permeable to the cell membrane may be useful in the treatment of trypanosomal infections. PMID- 3523759 TI - Regulation by growth hormone of number of chondrocytes containing IGF-I in rat growth plate. AB - Whether growth hormone stimulates longitudinal bone growth by a direct effect at the site of the growth plate or indirectly by increasing the concentration of circulating somatomedins (insulin-like growth factors) has been the subject of controversy. Immunohistochemical methods were used to explore the localization and distribution of insulin-like growth factor I (IGF-I) immunoreactivity in the epiphyseal growth plate of the proximal tibia of male rats. Cells in the proliferative zone of the growth plate of normal rats exhibited a bright immunofluorescence, whereas cells in the germinal and hypertrophic zones stained only weakly. In rats subjected to hypophysectomy, the number of fluorescent cells was markedly reduced. When the hypophysectomized rats were treated with growth hormone, either systemically or at the site of the growth plate, the number of IGF-I-immunoreactive cells in the proliferative zone was increased. The results show that IGF-I is produced in proliferative chondrocytes in the growth plate and that the number of IGF-I-containing cells is directly regulated by growth hormone. These findings suggest that IGF-I has a specific role in the clonal expansion of differentiated chondrocytes and exerts its function locally through autocrine or paracrine mechanisms. PMID- 3523760 TI - Petersdorf to head medical colleges. PMID- 3523761 TI - [Transpedicular repositioning and spongioplasty in fractures of the vertebral bodies of the lower thoracic and lumbar spine]. PMID- 3523762 TI - Congenital abnormalities of the ureter. PMID- 3523763 TI - Solitary filling defects of the ureter. PMID- 3523764 TI - The dilated ureter. PMID- 3523765 TI - Case report 356: Multiple findings of renal osteodystrophy reflected in the vertebral bodies and apophyseal joints of the cervical spine. PMID- 3523766 TI - [The sterile room]. PMID- 3523767 TI - Evaluation of abdominal pain: clinicians' performance compared with three protocols. AB - Clinical findings in ambulatory patients with abdominal pain, presenting themselves to general medical practitioners, were analyzed by three different protocols: an algorithm using a branched-chain logic, a linear discriminant rule, and bayesian analysis. All methods missed some serious diagnoses. None was as effective as the clinician at distinguishing nonspecific abdominal pain (NSAP) from more serious conditions. PMID- 3523768 TI - Digital subtraction arthrography of the prosthetic hip. AB - Digital subtraction techniques are easily adapted to the evaluation of loosening in total hip prostheses, allowing real time review of injection dynamics and data manipulation after the study. We have successfully used both standard radiographic and digital imaging techniques in the evaluation of 15 prosthetic hip joints. The digital results are comparable to and often better than those of standard radiographic techniques for the evaluation of loosening in total hip prostheses. PMID- 3523769 TI - Lymphomatoid papulosis. AB - In this review, we discuss the clinical and histologic features of lymphomatoid papulosis, a cutaneous disorder characterized by recurrent eruptions of self healing papules and small nodules with histologic findings suggestive of malignant lymphoma. Possible causes of this peculiar disease are discussed in the light of recent investigation. Recognition is important to avoid misdiagnosis and overly aggressive therapy, but it should be remembered that a small number of cases have been reported to progress to malignant lymphoma. PMID- 3523770 TI - Eating disorders: diagnosis and management by the internist. AB - Anorexia nervosa and bulimia are two of the four eating disorders that appear to be increasingly prevalent. Each has its own diagnostic criteria and medical hazards, though certain features are shared. It is important for internists to be aware of these disorders, since their management is best accomplished by a team consisting of an internist, a psychotherapist, and a nutritionist. The internist's key role in anorexia nervosa is in encouraging and coordinating treatment; in bulimia it is in making a diagnosis. In both, the internist is called upon to recognize and treat medical complications and to collaborate in the management and follow-up of these patients. PMID- 3523771 TI - Leukocytosis in pharyngitis due to group A beta-hemolytic Streptococcus. PMID- 3523772 TI - [History of Raynaud's phenomenon]. PMID- 3523774 TI - [J.W. Wylie and his role in the devleopment of Russian medicine]. PMID- 3523773 TI - [Lenin's "Iskra" on the role and health status of adolescent workers in Russia]. PMID- 3523775 TI - [The first permanent hospital in Russia]. PMID- 3523776 TI - [The origin of relics of Russian medical literature]. PMID- 3523777 TI - [Participation of Moscow transplantation centers in the international kidney transplantation program]. PMID- 3523778 TI - [Treatment of fetal hypoxia with glucose solutions]. PMID- 3523779 TI - [The Instituto Nacional de Ortopedia]. PMID- 3523780 TI - [Initial work on public health research in Mexico]. PMID- 3523781 TI - [Research and teaching in public health. History of the relations between the universities and the government]. PMID- 3523782 TI - [Miguel E. Bustamante and public health]. PMID- 3523783 TI - [Miguel E. Bustamante and the University]. PMID- 3523784 TI - [Miguel E. Bustamante and the Academia Nacional de Medicina]. PMID- 3523785 TI - [The effect of sensitization to HLA-alloantigens in recipients on the fate of cadaveric renal transplantation]. PMID- 3523786 TI - [Prenatal determination of fetal sex using ultrasound]. PMID- 3523787 TI - [Diagnosis of varicocele: comparative studies using Doppler sonography and phlebography of the internal spermatic vein]. PMID- 3523788 TI - [Comparison of an ionic (ioglicinate) with a non-ionic (iohexol) contrast medium in renal computed tomography]. PMID- 3523789 TI - [Adverse reactions during ascending cervical myelography using iopamidol and metrizamide--a double-blind study]. PMID- 3523790 TI - [Present possibilities of surgical treatment of central stenosis and occlusion of the branches of the aortic arch]. PMID- 3523791 TI - [A technic for blind closure of the intestine]. PMID- 3523793 TI - Colloidal bismuth subcitrate in peptic ulcer disease. AB - The pharmacological mechanism of ulcer coating and cytoprotection associated with colloidal bismuth have important therapeutic implications for the management of peptic ulcer disease. While the short-term healing rate is similar to that obtained by the H2 antagonists, the relapse rate appears lower. PMID- 3523792 TI - Comparison of pirenzepine with cimetidine in duodenal ulcer disease. A short-term and maintenance study. AB - Sixty-seven patients with endoscopically proven duodenal ulceration were entered into a double-blind study and randomized to treatment with pirenzepine (PZ) (Gastrozepin; Boehringer Ingelheim) 50 mg twice daily or cimetidine (CM) (Tagamet; Smith Kline & French Laboratories) 400 mg twice daily, given 30 minutes before breakfast and supper. Patients underwent endoscopic examination before entry, at 4 weeks, and at 8 weeks if unhealed at 4 weeks. Once healing was achieved, 43 patients were entered into a single-blind maintenance study with either PZ 50 mg at night or CM 400 mg at night according to their original randomization. CM had a slight, but not significant, advantage over PZ after 4 weeks, but the 8-week data showed identical healing rates. The relapse rate appeared to be higher in the PZ-treated group, but this difference was also not significant. It is suggested that the evening dose of PZ be amended to 50 or perhaps 100 mg before bed in the short-term treatment of duodenal ulcer, and that a dose of 100 mg at night be considered for maintenance therapy in certain high risk populations. PMID- 3523794 TI - [Digital subtraction angiography]. AB - Between 10 February 1983 and 9 November 1984 482 patients were investigated by digital subtraction angiography, mainly for carotid arterial disease and problems associated with transplanted kidneys. The use of abdominal compression and antispasmodics are essential to minimize bowel artefacts for intraabdominal arterial examinations. The apparatus is advantageous for interventional radiologists. Images are immediately seen, can be stored on analogue tape, digitalized and obtained with smaller volumes of contrast medium and without arterial catheterization. Movement artefacts, however, can cause problems. PMID- 3523795 TI - A DNA polymorphism in the human low-density lipoprotein receptor gene. AB - A new restriction fragment length polymorphism (RFLP) in the low-density lipoprotein receptor gene is described using the Stu I restriction endonuclease and a cDNA probe. The frequency of the two RFLP alleles was determined in 60 unrelated white subjects and 11.7% of them were found to be heterozygous for the polymorphism. Mendelian segregation of the RFLP was found in 3 informative families. The possible use of the RFLP in the diagnosis of familial hypercholesterolaemia in South Africa is discussed. PMID- 3523796 TI - Antihypertensive effects of acebutolol plus hydrochlorothiazide and hydrochlorothiazide alone in black patients. AB - Fifty black (Zulu) men, aged 20-60 years, with mild-to-moderate essential hypertension participated in a double-blind randomized parallel-group study lasting 12 weeks. Study drugs were acebutolol 200 mg plus hydrochlorothiazide 12.5 mg (Secadrex; Maybaker) (SDX) or hydrochlorothiazide 25 mg (HCT) given as a single tablet once daily under supervision. Following a 4-week washout period and after protocol exclusions and withdrawals, a total of 37 patients took the active preparations for 6 weeks, 33 for 7 weeks and 32 for 8 weeks. Of 17 patients treated with SDX, 16 responded satisfactorily; 20 patients were treated with HCT and 18 responded satisfactorily. No important biochemical or haematological changes occurred and no serious adverse reactions were noted. Mild-to-moderate essential hypertension was effectively controlled in a significant proportion of both treatment groups. PMID- 3523797 TI - [Quantification of fibronectin in the plasma, cerebrospinal fluid and amniotic fluid by enzymo-immunoanalysis]. PMID- 3523798 TI - [Coexistence of implantation and autologous blastic crisis after bone marrow transplant in chronic myeloid leukemia]. PMID- 3523799 TI - A two year experience with 99mTC HIDA cholescintigraphy in teaching hospital practice. AB - One hundred and thirty-four sequential patients who underwent 99mTC HIDA cholescintigraphy have been studied. Patients were investigated for suspected acute cholecystitis, chronic cholelithiasis, enterogastric reflux or jaundice, and in the assessment of biliary tract drainage after transplantation of the liver and other operations of the biliary tract. The technique is most valuable in the diagnosis of acute cholecystitis when its accuracy rate is 96 per cent; it is also useful in the assessment of postoperative biliary drainage. It is least helpful in the investigation of jaundice and suspected chronic cholelithiasis. PMID- 3523800 TI - Low flow venovenous bypasses in small dogs and pediatric patients undergoing replacement of the liver. AB - A venovenous bypass for transplantation of the liver was developed and evaluated in dogs and applied clinically, with flows that averaged less than 500 milliliters per minute. Fatal pulmonary emboli were seen in two of 40 experiments. The venovenous flow in the four pediatric recipients was 200 to 1,200 milliliters per minute, and there were no complications. PMID- 3523801 TI - The life of Carl Beck and an important interval with Alexis Carrel. AB - Carl Beck was a surgeon associated with the University of Illinois College of Medicine between 1898 and 1917. With Alexis Carrel, Beck developed an operation that used the stomach for replacement of the esophagus. Beck had an illustrious career and a close personal and professional relationship with Carrel. PMID- 3523802 TI - Advances in the management of carcinoma of the breast. AB - It is clear from this review that, although we may still be a long way from the eventual cure of carcinoma of the breast, we have advanced from the days of a unified approach to the disease by standard local radical treatment. Of great importance is the understanding that one person (the surgeon) can no longer treat the disease alone, but that he or she should be a member of a multi-disciplinary team in which surgical skills make a unique and significant contribution. We are fortunate in Edinburgh to have such a team, and I am grateful to my colleagues for their cooperation and help. PMID- 3523803 TI - An overview of the history and biologic properties of tumor necrosis factors. PMID- 3523805 TI - Diltiazem: dose it affect vasospasm? AB - Calcium antagonists are being investigated for their role in preventing or ameliorating the vasospasm associated with subarachnoid hemorrhage. We have done a phase I and phase II type trial of diltiazem. No effect on spasm was documented. A tendency to increase the bleeding time was noted, but no detrimental clinical effect occurred. The rebleed rate was not changed. It appears that further study of diltiazem through a proper randomized study would not be cost- or time-effective. PMID- 3523804 TI - The adoptive immunotherapy of cancer using lymphokine activated killer cells and recombinant interleukin-2. PMID- 3523807 TI - Ocular torticollis. AB - Torticollis can arise from nonocular (usually musculoskeletal) and ocular conditions. Abnormal head position for ocular reasons is usually assumed in order to maintain binocularity and/or to optimize visual acuity. A variety of conditions may be responsible. The sensory organ of position sense, the labyrinth, lies within the inner ear and it relates to eye movement in both a dynamic and static fashion. The Bielschowsky head tilt test is based on the functioning of the otolithic apparatus and is the primary test in evaluating abnormal head position. Treatment is usually surgical, with extent and location dependent upon on the underlying cause. While corrective surgery has usually been done on an elective basis for cosmetic purposes, there is evidence that uncorrected torticollis can cause musculoskeletal problems. This review describes the physiological bases for ocular torticollis and the diagnosis and treatment of its various underlying causes. PMID- 3523806 TI - Squamous cell carcinoma of the eyelid. AB - The occurrence of squamous cell carcinoma of the lid is reviewed with emphasis upon the incidence, clinical presentation, pathophysiology and methods of treatment. Squamous cell carcinoma accounts for about 9% of all eyelid malignancies, although it is frequently over-diagnosed by pathologists and confused histologically with other benign entities. This lesion occurs most commonly in elderly, fair-complexioned individuals with a history of chronic sun exposure and skin damage. In the lids, squamous cell carcinoma shows a variety of clinical appearances although it usually presents as a painless, hyperkeratotic lesion that gradually enlarges and eventually ulcerates. There is a tendency for lower lid and lid margin involvement. This potentially lethal neoplasm is capable of aggressive local spread or metastasis to regional lymph nodes. The development of squamous cell carcinoma is thought to progress through phases of intraepithelial squamous dysplasia and intraepidermal squamous cell carcinoma before invasive squamous cell carcinoma occurs. Various treatment modalities have been advocated including surgical extirpation with histologic control, radiation therapy and cryotherapy. PMID- 3523808 TI - Dr. Halsted's hernia. PMID- 3523809 TI - Oral health patterns in a Swedish county population aged 65 and above. AB - The aims of the study were to survey oral health and related conditions in the population of non-institutionalized elderly people in Orebro County, Sweden, and to analyze the relative importance of certain factors within the oral health pattern. A random sample was taken of 500 non-institutionalized individuals, stratified according to age (65-74/75+) and residence (densely-populated areas/rest of county). Out of these subjects 305 were examined clinically; 158 interviewed by telephone. Totally 46% were edentulous; 35% in age group 65-74, 63% in age group 75+; 36% of the men were edentulous, 53% of the women. The lowest prevalence of edentulousness (9%) was found among married/cohabiting men in group 65-74 years, densely-populated areas. The mean number of remaining teeth in dentulous subjects was 17.1 in group 65-74 densely-populated areas; 10.1 in group 75+ rest of county. Regarding dental status the group 65-74 densely populated areas consistently showed the best values, the group 75+ rest of county consistently showed the poorest values. Two subgroups diverged from the general pattern: the men in group 65-74 rest of county often showed poorer values than the others in aged 65-74; the men in group 75+ densely-populated areas often showed better values than the others aged 75+. The periodontal conditions were good or fairly good. Only 4% of the teeth had periodontal pockets 6 mm or deeper. Measured radiographically, about half of the teeth had 80% or more of the original bone level intact; 87% of the teeth had 60% or more of the original bone level remaining. Only 28% of the subjects had no periapical destruction. Ten percent of the teeth showed periapical destructions - 27% of root filled teeth; 6% in teeth without root fillings. Eighteen percent of the teeth were root filled - 27% of maxillary teeth, 11% of mandibular teeth. The root fillings were evaluated "not acceptable" in 69% of the teeth. Periapical destructions were more frequent in teeth with "not acceptable" root fillings as compared to those "acceptable" root filled. Socio-economic conditions were highly correlated with a number of dental parameters. In men those who were not married or cohabiting showed the poorest values; in women the differences were smaller but the highest prevalence of edentulousness was found in widows.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3523810 TI - On the functional deformation of extensive fixed partial dentures. An experimental clinical and epidemiological study. PMID- 3523811 TI - Gingival enlargement. A comparison between cyclosporine and azathioprine treated renal allograft recipients. AB - The immunosuppressive drug cyclosporine (CsA) which is used to facilitate renal transplantations, has shown several side effects. Gingival hyperplasia has been demonstrated in animal experiments and also during treatment of humans. In the present study the prevalence of gingival enlargement was investigated in a group of patients treated with CsA. The results were compared with those obtained from a time matched control group of patients treated with azathioprine. The CsA treated patients showed a high prevalence of gingival enlargement, while the azathioprine treated patients showed none. Edentulous patients showed no gingival enlargement. The gingival enlargement was confined to the free gingiva and the interdental papilla, and had a rough surface, with small fissures. It was extremely fragile and bled on probing. Oral hygiene measures showed a slight reduction of the size of the gingival enlargement. PMID- 3523812 TI - [Armed Forces dental care history]. PMID- 3523813 TI - Medical education in Texas: the growth of schools. PMID- 3523815 TI - On the quantification of prothrombin from different species using Echis carinatus as activator. AB - The generation of thrombin-like activity from rat, human, bovine and mouse prothrombin by Echis carinatus venom (ECV) treatment was compared using a partially purified system (i.e. whole ECV and isolated prothrombin). A rapid increase in coagulant activity was obtained within 0.5 to 2 min., being constant upon further incubation for 60 min. A large variation in coagulant activity of the ECV generated thrombin from the four species was found, whereas no differences were found for the amidolytic activities. The coagulant activities of the ECV generated thrombin was also low compared with the corresponding thrombin activities obtained by physiological activation. Coagulant activity of the ECV generated thrombin levelled off at increasing concentration of prothrombin in the sample as measured by the one-stage coagulation assay. By measuring amidolytic activity a linear relationship to the concentration of prothrombin was found, however. These findings indicate that ECV converts prothrombin from the four different species to a thrombin-like protein with properties distinct from alpha thrombin. The lack of linearity in the ECV generated clot activity with increasing concentration of prothrombin could be explained by assuming a dimerization of the thrombin-like protein molecules making them less accessible to fibrinogen. The significance of these observations for the quantification of prothrombin from different species is discussed. PMID- 3523814 TI - [The pill and cancer]. PMID- 3523817 TI - [Sudden infant death. Cardiac death elicited by the fear paralysis reflex?]. PMID- 3523816 TI - Platelet aggregation is not essential for xenograft rejection. AB - Five rabbit kidneys were perfused at 80 mm Hg with heparinized human blood, five with platelet poor human blood, and five with human blood added prostacyclin. Time until blood flow decreased to 2 ml/min was significantly delayed by removal of platelets or addition of prostacyclin. Histological examination did not reveal any difference between the groups. It is concluded that platelets play an enhancing role, but they are not essential for xenograft rejection. PMID- 3523818 TI - [Passive fear--a possible cause of sudden infant death?]. PMID- 3523819 TI - [Tibial shaft fractures. Plate osteosynthesis versus non-operative treatment]. PMID- 3523820 TI - [Acute soft tissue injuries in joints and bones]. PMID- 3523821 TI - [Piroxicam and naproxen in acute soft tissue injuries]. PMID- 3523822 TI - [Prenatal diagnosis of malformations by ultrasonics]. PMID- 3523823 TI - [Preoperative localization of parathyroid tumors. CT and ultrasonics before surgery of primary hyperparathyroidism]. PMID- 3523824 TI - [Residual curarization after reversal with neostigmine]. PMID- 3523825 TI - [Ultrasonic diagnosis in parenchymal liver disease]. PMID- 3523826 TI - [Treatment of acute biliary and kidney/urether pain. A comparative study of the effects of intravenous injections of buprenorphine, indomethacin and pethidine]. PMID- 3523827 TI - [Roentgentherapy of warts]. PMID- 3523828 TI - [Nonimmunologic hydrops fetalis. 6 years' material]. PMID- 3523829 TI - [Dicor crowns]. PMID- 3523830 TI - Revised classification of the DLA loci by serological studies. AB - Peripheral blood mononuclear cells from DLA typed dogs were treated with rabbit anti-dog-beta 2-microglobulin and subsequently with goat-anti-rabbit immunoglobulin in order to aggregate the DLA class I molecules on the cell membrane (lysostrip). Utilizing a panel of 70 defined DLA-A and DLA-B antisera, lymphocytes treated in this way showed resistance to complement dependent lysis with monospecific DLA-A sera only, whereas reactivity of DLA-B antisera was not blocked; on the contrary, complete lympholysis with each DLA-B antiserum was recognized. Thus, the DLA-B antigens, evidently not associated with beta 2 microglobulin, are designated as candidates for class II gene products. The different reactions of DLA-C antisera after lysostrip did not allow a precise assignment of this antigen series as yet. PMID- 3523831 TI - Effects of gentamicin on the renal uptake of endogenous and exogenous protein in conscious rats. AB - To study the effect of gentamicin on the renal uptake of proteins, Sprague-Dawley female rats were intravenously injected with solutions containing unlabeled human beta 2-microglobulin (beta 2-m), retinol-binding protein, and increasing amounts of gentamicin (from 0.063 up to 31.5 mg/kg). The concentrations of human proteins and that of endogenous beta 2-m, albumin, and IgG in the urine collected during the 2 hr following the injection were determined by immunoassays. Gentamicin transiently increased the urinary excretion of rat and human beta 2-m in a dose dependent manner. The mean relative increase of rat beta 2-m excretion ranged from 2 at a gentamicin dose of 0.06 mg/kg up to 500 at a gentamicin dose of 31.5 mg/kg. By contrast, the urinary excretion of other proteins was only increased by a factor of 2 to 5 at the highest dose of gentamicin. The relative increase of the urinary excretion of proteins was positively correlated with the fractional reabsorption of the proteins by the rat kidney. The inhibitory effect of gentamicin on the renal uptake of protein was very similar to that observed in rats injected with polycationic proteins like lysozyme and cytochrome C. These observations, combined with the fact that gentamicin, like proteins, enters the tubular cell by adsorptive endocytosis, strongly suggest that this drug competes with proteins for common binding sites on the apical tubular membrane and for subsequent endocytosis. Furthermore, the iv injection of large amounts of gentamicin and polycationic proteins induces a lysosomal enzymuria which very likely is a manifestation of an increased exocytosis. PMID- 3523832 TI - Development of sensitive bacterial tests, exemplified by two mycotoxins. AB - For a sensitive bacterial test for mycotoxins the cup plate assay, based on growth inhibition, was optimised with Bacillus thuringiensis as test strain. Bacillus thuringiensis allowed the detection of 1.25 microgram kojic acid. A minimal amount of 12.5 micrograms kojic acid or 1.25 micrograms patulin was detectable by means of pigment suppression with isolated mutants of Serratia marcescens, whereas the wild type of this strain was insensitive. PMID- 3523833 TI - In vitro activation of isophosphamide and trophosphamide to metabolites mutagenic for bacteria. AB - The ability of S9 liver fractions from uninduced rats to activate isophosphamide (IP) and trophosphamide (TP) to metabolites mutagenic for bacteria was compared to that of S9 fractions prepared from rats pretreated in vivo with three inducers of hepatic monooxygenase. Pretreatment of rats with phenobarbital (PB) and Aroclor 1254 increased IP and TP mutagenic activation by S9 fractions as compared to control and 3-methylcholanthrene (3-MC)-induced rat liver S9. Furthermore, the effect of mixed-function oxidase inhibitors, such as alpha-naphthoflavone, metyrapone and SKF 525-A on S9-mediated mutagenic activation of IP and TP was investigated. The data obtained suggest the involvement of a PB-inducible form of cytochrome P-450 in the activation of IP and TP to mutagenic species. PMID- 3523834 TI - Light-polymerizing plastics as slide mounting media. AB - Currently available mounting media require solvent evaporation for hardening. This process is slow and often is complicated by the formation of air spaces under the coverslip. Light-polymerizing plastics are introduced as histologic mounting media that eliminate these problems because they harden quickly when exposed to ultraviolet light and, therefore, do not depend upon solvent evaporation. These light-polymerizing plastics are easy to use, permit rapid and controlled hardening, and eliminate the formation of air spaces under the coverslip. The optical characteristics are satisfactory for light and fluorescence microscopy. PMID- 3523835 TI - Birefringent objects visualized by circular polarization microscopy. AB - In the standard polarizing microscope, birefringent material appears bright only if its optic axis is oblique to the axes of the polarizer and analyzer filters; consequently, an object may be visualized as several disconnected bright regions. This confusing appearance is avoided if the crossed plane polarizers of the conventional microscope are replaced by circular polarizers of opposite handedness. All orientations of the optic axis in the focal plane then become equivalent; objects generally appear uniformly bright. Ordinary microscopes are easily modified to use this technic with readily available components. PMID- 3523836 TI - Permanent preservation of whole alizarin red S skeletons by clearing and embedding in polyester resins. AB - A one-step clearing and embedding procedure for alizarin red S stained skeletons is described. Embryos are fixed in formalin, skinned and eviscerated. After staining in a 10 mg/liter solution of alizarin red S in 5% aqueous KOH, specimens are dehydrated in a graded series of acetone-polyester monomer solutions. Finally, the specimens are embedded at room temperature in the polyester resin. A special reusable metallic mold is described for embedment of large fetuses. Specimens previously cleared in glycerol can be processed with this method. PMID- 3523837 TI - Immunological determination of labeling index on human tumor tissue sections using monoclonal anti-BrdUrd antibody. AB - The use of a monoclonal antibody against the thymidine analogue bromodeoxyuridine together with an in vitro labeling technique allowed rapid determination of the labeling index in human tumors. The labeling index estimated by these relatively simple immunofluorescence or immunoenzymatic staining methods was equivalent to that obtained by autoradiography. The interpretation of the preparations is easy since there is a minimum of background staining. This immunohistochemical technique combined with in vitro labeling provides a suitable alternative for determining the labeling index of human tumors. PMID- 3523838 TI - Application of glycol methacrylate embedding to herbarium specimens of fruits. AB - Aldehyde fixation and glycol methacrylate embedding were applied to herbarium specimens of fruits of the Compositae. Sections 1-2 micron thick were cut with glass knives. Softening was unnecessary and the hydrophilic properties of the resin permitted staining with a number of dyes. Specimens were examined with bright field and polarized light microscopy. The technique gives good structural preservation and resolution even with 81-year-old herbarium material. PMID- 3523839 TI - A method for preparing whole-body sections suitable for autoradiographic, histological and histochemical studies. AB - A method for the preparation of whole-body sections suitable for autoradiographic and histochemical study is described. Radioactive calcium chloride or [14C]proline was injected into the abdominal cavity of a rat. Thirty-five minutes after injection of calcium chloride or 40 min after injection of proline the rat was frozen in a mixture of hexane and solid carbon dioxide and blocked in 5% sodium carboxymethyl cellulose. The carboxymethyl cellulose block was trimmed and a piece of copy paper was attached to the surface of the block with cellulose tape. Cryotome sections cut from the block were transferred from the paper to a glass slide coated with synthetic rubber adhesive. For whole-body autoradiography, sections were freeze-dried for 2 days and then placed against X ray film. For light microscopic autoradiography, the freeze-dried sections were covered with a dried film of photographic emulsion. For histochemical use, the sections were fixed by raising the temperature to 4 C after immersion in 100% ethanol below -10 C. For histological observation, sections were postfixed with 2.5% glutaraldehyde and stained. Whole-body and light microscopic autoradiographs showed that sections so prepared could be used for the demonstration of soluble substances in whole-body sections and for detailed autoradiography at the light microscopic level, and the stained sections could be used for histological and histochemical studies. PMID- 3523840 TI - Improved stability of a purified glycol methacrylate preparation: comments. PMID- 3523841 TI - [Isolation of a luminescent serum for detecting Streptococcus mutans]. PMID- 3523842 TI - [Experimental study of the dispersion of microflora by dental drills]. PMID- 3523843 TI - [Alcohol-caused injury to the tissues of the maxillofacial area and its sequelae]. PMID- 3523844 TI - [Method of intraoral echography]. PMID- 3523845 TI - [Surgical methods of restoring the palatopharyngeal closure following unsuccessful uranoplasty outcomes]. PMID- 3523846 TI - [Surgical treatment of habitual dislocation of the mandible]. PMID- 3523847 TI - [Experience in splinting the anterior teeth in periodontal diseases]. PMID- 3523848 TI - [Hereditary disorders of enamel development]. PMID- 3523850 TI - [Current laboratory methods of examination in the medico-legal expert evaluation of substantial evidence of biological origin]. PMID- 3523849 TI - Oral contraceptives and life expectancy. AB - Life expectancy for women in the United States is 77.34 years; women who take oral contraceptives (OCs) for five years before the age of 30 can expect to live about four days longer. This is due primarily to protection against ovarian and endometrial cancers. For women taking pills for five years in their thirties there is a maximum loss of 18 days on the average that is attributable to OC use, and for women over 45 this rises to 80 days. The decreased life expectancy is due mainly to the increased mortality from myocardial infarction and stroke. This is substantially less than life lost due to use of a variety of other substances, most notably tobacco. PMID- 3523851 TI - [Study of the process of ethanol formation in the early postmortem period]. PMID- 3523852 TI - Cardiovascular drugs. II: Digoxin. PMID- 3523853 TI - Single-reagent polarization fluoroimmunoassay for theophylline in serum. AB - A polarization fluoroimmunoassay for theophylline was developed employing fluorescein-labeled drug and antiserum precombined in a single reagent. Assay was performed simply by addition of sample to an aliquot of the single reagent, incubation, and determination of fluorescence polarization. Because of the relatively rapid dissociation kinetics of the labeled drug from antibody binding, added unlabeled theophylline caused displacement within a practical time period. The precision, accuracy, and specificity of the simplified single-reagent assay were similar to those obtained by a conventional immunoassay procedure using the same reagents. Results for the assay of patients' serum specimens correlated well with those by an established enzymoimmunoassay. PMID- 3523854 TI - An enzymatic factor may interfere with the digoxin assay on the Stratus analyzer. PMID- 3523855 TI - Increased Con-A-induced thymocyte proliferation and de novo Qa-2 antigen expression in Qa-2-depleted thymocyte cultures. AB - We have recently shown that thymocyte activation is associated with a strong increase of Qa-2 antigen expression. Contrary to what could be predicted from these results, the initial depletion of Qa-2+ cells from PNA- thymocytes increases the Con-A-induced proliferation. Qa-2+ cells not only reappeared after activation, but were enhanced in Qa-2-depleted PNA- cells compared to the control. The newly formed Qa-2+ population contained a higher percentage of Lyt 1+2- cells and thus seems to be different from the Qa-2+ pool initially present. PMID- 3523856 TI - The adjustable suture: a clinician's experience. PMID- 3523857 TI - Treatment of congenital cataracts and persistent hyperplastic primary vitreous. PMID- 3523858 TI - Various causes for enlargement of extraocular muscles. PMID- 3523859 TI - Adjustable sutures in strabismus. PMID- 3523860 TI - A review of the malaria situation in Zimbabwe with special reference to the period 1972-1981. AB - Information on the prevalence, incidence, and geographical distribution of malaria in Zimbabwe is reviewed. Malaria control operations carried out during the last 30 years are briefly described together with available information of their impact on malaria. From 1972 to 1981, 51,962 positive blood slides were submitted to Blair Research Laboratory from health institutions, of which 97.8% were Plasmodium falciparum, 1.8% P. malariae and 0.3% P. ovale. Blood slide surveys undertaken from 1969 to 1981 during which time 156,194 slides were examined showed P. falciparum to constitute 92.5% of malaria infections, P. malariae 8.3% and P. ovale 0.7%. The data from active and passive case finding are used to describe the seasonal and geographical pattern of malaria in Zimbabwe. The seasonal peak of transmission occurs from February to May each year with very low transmission from July to October. Endemicity of malaria is shown to be markedly influenced by altitude varying from hyperendemic in the low altitude areas to hypoendemic or absent on the central watershed. PMID- 3523861 TI - Vectors of Wuchereria bancrofti in the Sepik Provinces of Papua New Guinea. AB - The vectors of Wuchereria bancrofti were investigated in two areas of the Sepik Provinces of Papua New Guinea. At the village of Yauatong, indoor-resting Anopheles punctulatus had an infection rate of 47.3% and an infective rate of 3.4%. No infections occurred in 382 Culex annulirostris obtained in night-landing catches. At the village of Yankok only An. koliensis contained infective larvae but An. punctulatus and Cx quinquefasciatus were infected. Probit values of the cumulative percentages of filariae-positive mosquitoes plotted against the logarithm of the corresponding filaria count are illustrated. PMID- 3523862 TI - Falciparum malaria highly resistant to chloroquine in Western Kenya. Case report. PMID- 3523863 TI - Improved method for isolating Trypanosoma congolense from mice. PMID- 3523864 TI - A new technique for drug susceptibility tests for Plasmodium falciparum by ethidium bromide fluoroassay. AB - When Plasmodium falciparum parasites were stained with the fluorescent dye ethidium bromide, the fluorescence intensity of the solubilized parasites was correlated with the amount of nucleic acid present. It was possible to monitor development of the parasites from ring form to schizont by the fluoroassay. The assay system was applied to in vitro drug susceptibility tests on malaria parasites. PMID- 3523865 TI - In situ detection of amastigotes in American cutaneous leishmaniasis, using monoclonal antibodies. AB - Using an immunoperoxidase technique we have applied monoclonal antibodies against American Leishmania for the detection of amastigotes in biopsies from cutaneous leishmaniasis patients. The immunocytochemical procedure was notably superior to conventional histological staining in terms of the visualization and definition of the amastigotes. This technique could eventually prove to be of value in epidemiological studies, and possibly have prognostic importance, by allowing the in situ characterization of the species of infecting organism. PMID- 3523866 TI - Analysis of resistance to pyrimethamine/sulphadoxine of isolates of Plasmodium falciparum from Eastern Thailand. AB - The in vitro susceptibility of five field isolates of Plasmodium falciparum from the region of the Thai-Kampuchean border to pyrimethamine, sulphadoxine, and their combination, was determined using a microtitre test system and media deficient in p-aminobenzoic acid and folic acid. Two-fold serial dilutions of pyrimethamine ranging from concentrations of 8.0 to 0.125 microM and sulphadoxine ranging from 800 to 50 microM were evaluated for antimalarial activity. Viability was based on the maturation of the ring stages to normally-appearing schizonts. Tested singly the parasites had an average ID90 of 3.82 microM for pyrimethamine and greater than 800 microM for sulphadoxine. Analysis of the drugs interaction showed maximum potentiation at approximately 0.8 microM of pyrimethamine and 80 microM of sulphadoxine. These results suggest that resistance to Fansidar is due to the resistance to both components. Although there was a potentiating effect it was probably not sufficient enough for the drugs to be effective in vivo. This may, in part, explain the reduction in clinical cures with the sulphadoxine pyrimethamine combination in eastern Thailand. PMID- 3523867 TI - Severe and complicated malaria. World Health Organization Malaria Action Programme. PMID- 3523868 TI - Dr. Albert L. Shelton (1875-1922) and the Tibetan Collection in the Newark (New Jersey) Museum. PMID- 3523869 TI - Architectural concepts in 1909 and their influence on the College building design. PMID- 3523870 TI - Recruitment of unrelated persons as bone marrow donors. A preliminary experience. AB - Seven hundred and sixty-three blood donors previously typed for HLA-A and B antigens were asked to consider donating bone marrow to unrelated patients for whom no HLA-matched sibling was available. Eighty-eight percent (668) indicated willingness to donate marrow, and of these, 615 (81%) participated in testing and 53 (7%) were unable to participate at the time of the request. Donors matched for HLA-A, B, C, and DR antigens and compatible in the mixed-leukocyte culture reaction were identified for 12 patients and eight transplants were performed. Engraftment was successful in all eight patients. In this article the factors considered in planning the program, the protocol eventually developed, the problems encountered, and critical issues of informed consent and donor confidentiality are reviewed. PMID- 3523871 TI - Development and operation of a program to obtain volunteer bone marrow donors unrelated to the patient. AB - Because of recent increases in bone marrow transplantation, the lack of available matched sibling donors has become a problem. This study investigated the feasibility of obtaining volunteer bone marrow donors unrelated to the patient. A program was developed to inform potential donors and obtain their consent for listing in a bone marrow donor registry. Sixty-six percent of whole blood or apheresis donors agreed to participate in the program. There were no demographic differences between those who accepted or declined to participate. Religion, experiences with medical practices, and the attitude of the potential donor's spouse were important factors in the decision to participate. A search for donors was initiated for 127 patients. Thirty searches were not completed, primarily because of patient-related problems. A total of 713 HLA-A and -B antigen identical donors was located for 63 of the 97 (65%) patients. A total of 40 HLA A, -B, and -DR antigen-identical donors was located for 18 of these 63 patients. Six of these 18 patients then had one or more donors (total, 9) whose lymphocytes did not react in mixed lymphocyte culture. Thus, using the file of 2147 donors, an HLA-identical donor was located for 6 percent of the 97 patients. None of these patients has yet received a transplant; in four cases this was due to patient-related and in two cases donor-related reasons. The cost to establish the donor program averaged $33.46 (1984) per donor for donors already typed for HLA-A and -B antigens. This experience indicated that, given thorough information about bone marrow donation and transplantation, a majority of blood and apheresis donors will volunteer to donate bone marrow, without feeling pressure to do so. A relatively small donor file provided donors for 6 percent of patients. The long term value of bone marrow transplantation using unrelated donors and the optimum size of the donor file remain to be established. PMID- 3523872 TI - On willingness to be a bone marrow donor. AB - The authors studied factors that may influence the willingness of apheresis donors to consider bone marrow donation to an unrelated recipient. Donors were sent questionnaires describing bone marrow transplantation and the role of the donor. The information about degree of risk to the donor was varied from low to high risk. Two other factors that might influence donor motivation also were presented: probability of actually being asked to participate (high or low), and "salience of responsibility," which defines the stress to donate based on the number of persons being asked (large or small group). The degree of risk presented strongly affected willingness to volunteer, but the two motivation factors had no effect. The factor of risk negatively affected women more than men, and negatively affected those with family responsibilities more than single donors. Other findings were: men were more willing then women to donate marrow; those with few donations were among the most willing; and those who knew others who had either needed or provided blood products were also among the most willing. PMID- 3523873 TI - A monoclonal anti-C4d that demonstrates a specificity related to anti-Ch. AB - A monoclonal anti-C4d reagent, L003, agglutinated untreated and trypsin-treated C4A Rodgers(Rg)- and C4B Chido(Ch)-coated red cells. Inhibition of the agglutination, regardless of the Rg/Ch phenotype of the C4 coat, showed Ch specificity, more precisely, for the Ch1 determinant. C4A allotypes that express Ch1 and Ch3 rather than Rg1 and Rg2, and C4B allotypes that express Rg1 rather than Ch1, Ch2, or Ch3 confirmed that the inhibition specificity in serologic tests was anti-Ch1 and not anti-C4B. PMID- 3523874 TI - HLA antigens on red cells. Implications for achieving low HLA antigen content in blood transfusions. AB - HLA antigens on red cells were measured using the W6/32 monoclonal antibody as well as with other monoclonal antibodies directed to monomorphic determinants of HLA Class I molecules. Antibody binding was quantitated indirectly by either radioimmunoassay or flow cytometry. Red cells from approximately 50 percent of blood donors bound HLA-A, B, and C antibodies but not antibodies to HLA-DR or those directed to other leukocyte-specific antigens. Persons with HLA-B7-positive lymphocytes consistently expressed measurable red cell HLA antigens. However, 35 percent of donors with HLA-B7-negative lymphocytes also expressed HLA on red cells, and this expression did not correlate with any other HLA antigen. Storage did not affect expression of HLA antigens in red cells stored at 4 degrees C for 21 days or in red cells that had been cryopreserved. Contrary to previous reports, red cells expressing HLA antigens also had beta-2-microglobulin detected, suggesting that the HLA molecules in red cells are similar to those in lymphocytes and other cells, and consequently, that they have the potential to be immunogenic. These results demonstrate that patients requiring multiple transfusions will be exposed to HLA antigens even if they receive blood units depleted of leukocytes and platelets. PMID- 3523875 TI - Bacterial proliferation in platelet concentrates. AB - Growth curves of bacteria in platelet concentrates were studied to determine whether increasing the shelf-life of platelets from 3 to 7 days might have contributed to the increased number of deaths caused by contaminated platelets that have been reported to the FDA since 1980. Platelets inoculated with 10(3) organisms or more showed logarithmic bacterial growth throughout the 7 days of storage or until the platelets became visibly abnormal. With an inoculum of 10(2) organisms or less, proliferation patterns were variable: 20 percent (%) showed uninhibited logarithmic growth and 50 percent (%) remained sterile throughout the 7 days. In another 30 percent (%), bacterial growth was temporarily suppressed for 5 to 6 days before bacteria actively proliferated. These data support the hypothesis that bacterial contamination of platelets not clinically significant at 3 days of storage might become so during the current 7 day shelf life. PMID- 3523876 TI - Prolonged survival of cardiac allografts in rats following the administration of heat-treated donor lymphocytes. A possible immunosuppressive role for class I major histocompatibility complex antigens. AB - Pretransplant transfusions of spleen and lymph node cells heated to 45 degrees C or 50 degrees C for 1 hr prolong the survival of subsequent donor-specific heart grafts in the fully allogeneic donor-host combination DA (RT1a)----AS (RT1l). The results are comparable to survival times recorded following pretransplant transfusions of purified donor specific red blood cells (RBC) in the same strain combination. Both class I and class II major histocompatibility complex (MHC) antigens are serologically detectable on heat-treated cells; by contrast only class I antigens are expressed on red blood cells. Although heat-treated cells stimulate alloantibody formation, they fail to provoke a proliferative response in an in vivo host-versus-graft assay. Both red blood cells and heat-treated inocula persist in the host for long periods, possibly an important consideration in relation to their capacity to prolong the survival of subsequent donor strain allografts. The experimental data support the contention that class I MHC antigens can be immunosuppressive in the context of allografting. The present results recall the experiments carried out early in the century, which used heat treated tumor cells to prolong the survival of subsequent viable tumor allografts, and which are sometimes cited as the first example of active enhancement. PMID- 3523877 TI - Correction of equine severe combined immunodeficiency by bone marrow transplantation. AB - A 32-day-old horse with severe combined immunodeficiency was transplanted with equine bone marrow cells in an attempt to establish immunologic responsiveness. A histocompatible, mixed-leukocyte-culture-nonreactive, sex-matched, full sibling was used as the donor. Recipient total lymphocyte count, T and B lymphocyte numbers, and response of peripheral blood mononuclear cells to phytolectin stimulation increased by 14 days following transplantation. Circulating lymphocytes exceeded 1000 cells/microliter blood by 40 days posttransplantation, and by 170 days following transplantation, T and B lymphocyte numbers had reached normal values. The foal demonstrated significant primary and secondary antibody responses when immunized with bacteriophage phi X 174 at 100 and 142 days posttransplantation. Concentrations of IgG and IgM remained within the normal range following cessation of i.v. plasma therapy 156 days after transplantation. More than 300 days following transplantation, the foal remains healthy and is growing normally. At no time during the posttransplant period was there detectable evidence of graft-versus-host disease. PMID- 3523878 TI - A prospective analysis of the accuracy and cost-effectiveness of digital subtraction angiography for living-related renal donor evaluation. AB - From 1982 to 1984, we conducted a prospective study to evaluate the usefulness of i.v. renal digital subtraction angiography (DSA) for living-related donor (LRD) evaluation. Twenty-eight LRDs were evaluated with the traditional approach of intravenous pyelography (IVP) and standard catheter arteriography (SCA) (group 1). During the same period, 33 LRDs underwent renal DSA and IVP from a single i.v. contrast injection (group 2). If renal arterial imaging with DSA was considered satisfactory, no further radiographic studies were done (group 2-A, n = 23). If renal arterial imaging with DSA was not satisfactory, SCA was then obtained (group 2-B, n = 10). DSA alone accurately defined the number and location of renal arteries in 21 of 23 patients from group 2-A, and in 5 of 10 patients from group 2-B. The major limitation of DSA was in patients with multiple renal arteries; accurate imaging was obtained in only 7 of these 13 patients (54%). In group 2 overall, preoperative renal imaging was not accurate in 2 of 33 patients (6%); in both cases, an unsuspected polar artery was found at nephrectomy. The mean cost per patient of all radiographic renal imaging studies was $953.00 for group 2 and $1721.00 for group 1. These data suggest that the approach of preferentially evaluating LRDs with DSA-IVP, and obtaining SCA only if DSA yields poor visualization, is more cost-effective but not as accurate as the traditional policy of obtaining SCA and IVP in all cases. PMID- 3523879 TI - Multivariate analysis of risk factors in cadaver donor kidney transplantation. AB - Data collected prospectively on 3811 kidney transplants performed between June 1977 and July 1982 with follow-up to July 1984 by the 42 member institutions of the South-Eastern Organ Procurement foundation were analyzed to identify factors associated with graft and patient outcome in patients not receiving cyclosporine. Multivariate Cox regression analysis was used to examine the association and relative risk of 24 variables with three actuarial outcomes: overall graft failure, irreversible rejection, and patient death. Factors having no suggested association with any outcome included: recipient sex, history of pregnancy, blood group, and time on dialysis; organ preservation method, time and source; donor race; crossmatch test sensitivity; and annual center transplant rate. In decreasing order of relative risk, the factors most significantly associated with irreversible rejection were: loss of two or more prior grafts, low HLA-A,B match, lack of pretransplant blood transfusion, high (greater than 60%) pretransplant sensitization to leukocyte (HLA) antigens, and delayed graft function. Splenectomy, insulin-dependent diabetes, and antilymphocyte serum therapy provided the greatest risk of patient death. Factors such as recipient age, race, and native nephrectomy had suggested associations with outcome. By adding each center as a separate covariate in the analysis, other center-dependent factors were quantitated and found in some cases to have a highly significant association with graft and patient outcome. These results provide a basis for evaluating the potential risk of graft loss or patient death for those prospective cadaver kidney transplant recipients not being considered for cyclosporine therapy. PMID- 3523880 TI - Renal transplants from HLA-haploidentical living-related donors. The influence of donor-specific transfusions and different immunosuppressive regimens. AB - A total of 151 potential recipients of kidney grafts from one-HLA-haplotype mismatched MLC-positive (RR greater than 20%) donors treated during 1980-1984 was investigated. The recipients were divided retrospectively into four groups: (A) 42 patients who received pretransplant donor-specific transfusions (DST) and posttransplant azathioprine/prednisolone (DST-only); (B) 10 patients who received DST with azathioprine before and azathioprine/prednisolone after grafting (DST aza); (C) 42 patients who received no pretreatment and azathiprione/prednisolone posttransplant (aza group) and (D) 57 patients who also received no pretreatment but cyclosporine/prednisolone posttransplant (CsA group). DST-only led to persistently positive crossmatch in nine (21%) and transient positive crossmatch in two patients, while no sensitization occurred in the DST-aza group. Posttransplant, early acute rejection episodes were frequent in the DST-only group, but no graft was lost to acute rejection during first year; one-year graft survival (GS) = 94%. Similar GS (93%) was obtained in the CsA group, while in the aza group poorer results were obtained; GS = 69%. In the DST-aza group clinical problems including serious infections were observed. As CsA treatment without DST gave as high graft survival as in the DST groups, but avoided the sensitization risk by DST alone and the bone marrow complications of DST-aza, such treatment has become our preferred therapy for haploidentical renal transplants. PMID- 3523881 TI - Immunogenetic and clinical factors affecting renal transplantation. A rigorous analysis of data recorded by the UK Transplant Service. AB - A total of 3653 first cadaver kidney transplants in nondiabetic recipients over 15 years of age, performed in 30 transplant centers throughout the United Kingdom between 1978 and 1983, were analyzed to discover which of many recorded recipient, donor, surgical, and tissue-matching variables were important for graft survival, and in which postoperative period they exerted their maximum influence. A considerable effort was invested in checking the validity of the data and the appropriateness of the statistical methods. The duration of dialysis prior to transplantation was associated with a substantially reduced risk of graft failure, particularly at later postoperative times. Good HLA-B locus matching was also found to enhance graft survival--but, by contrast, HLA-A locus matching showed no significant effect on survival. Recipient age over 45 years, high serum reactivity, and grafts with anoxia time (the interval between circulatory arrest and perfusion with ice) exceeding 10 min were found to be associated with poor graft survival. Trends in survival were identified across calendar years of transplant, such that early graft failure (0-15 days) had increased in recent years, whereas later graft failure (greater than 15 days) had declined. PMID- 3523882 TI - Analyzing transplant survival data. AB - Stratified proportional hazards regression is described as a method of estimating multifactorially preoperative factor effects on graft survival--and, at the same time, making due allowances for unknown transplant-center-specific influences. The multifactorial aspect of the method overcomes the biases inherent in analyzing transplant survival data one factor at a time, and stratification allows the data from many centers to be used simultaneously without the dangers associated with simple pooling of data from many sources. The proportionality and regression assumptions implicit in the method enable the data to be used efficiently, but must be validated on the data. Methods by which these assumptions may be relaxed are described--in particular, the stratified piece wise proportional hazards regression method. PMID- 3523883 TI - Potential utilization of a national HLA-typed donor pool for bone marrow transplantation. AB - Most individuals with diseases potentially treatable by bone marrow transplantation lack an HLA-identical sibling donor. The annual incidence of 11 diseases probably or possibly benefitted by bone marrow transplantation was corrected for patient and disease characteristics to determine annual adjusted incidences. These data were used to project the number of individuals who might receive transplants using an HLA-typed national bone marrow donor pool. Estimates of transplant outcome were then utilized to predict potential annual benefit. Approximately 12,000 individuals annually are predicted to be candidates for transplantation from a national donor pool. Using indicated projected benefits, this could result in benefit to approximately 5000 individuals. Such a pool may also be useful for individuals accidently exposed to radiation. PMID- 3523884 TI - Immune transfer studies in canine allogeneic marrow graft donor-recipient pairs. AB - Transfer of immunity occurring with bone marrow grafting was studied using the dog as a preclinical model. Allogeneic bone marrow transplantation (BMT) was performed between DLA-identical beagle litter-mates. The donors were immunized with tetanus toxoid (TT) or sheep red blood cells (SRBC), and their humoral response was monitored by hemagglutination. The recipients of bone marrow from TT immunized donors showed a marked increase of antibody titer one week posttransplantation, while in the recipients of marrow from SRBC immunized donors the antibody titers were considerably lower. Within the following 60 days the antibody titers in both groups diminished gradually to pregrafting levels. Control experiments in which cell-free plasma from donors immunized with TT and SRBC respectively was transfused indicated that the initial rise of specific antibody titers after marrow grafting is likely to be due to a passive transfer of humoral immunity. A single challenge of these marrow graft recipients with the respective antigen 15-18 weeks posttransplantation led to a secondary type of humoral immune response. In addition, it could be demonstrated that transfer of memory against TT or SRBC was independent from the actual antibody titer and the time of vaccination of the donor. One dog was immunized with TT after serving as marrow donor. When the donor had shown an antibody response, a peripheral blood leukocytes (PBL) transfusion was given to his chimera. Subsequent challenge of the latter resulted in a secondary type of specific antibody response. This indicates that specific cellular-bound immunological memory can be transferred after BMT from the donor to his allogeneic bone marrow chimera by transfusion of peripheral blood leukocytes. The data presented may be of importance in clinical BMT to protect patients during the phase of reduced immune reactivity by transfer of memory cells from histocompatible immunized donors. PMID- 3523885 TI - Serology of liver transplantation in the rat. I. Alloantibody responses and evidence for tolerance in a nonrejector combination. AB - The antibody response against class I and class II RT1 antigens has been studied in PVG rats grafted with DA liver. In this nonrejector combination, liver grafts survive permanently in all normal recipients and in about 50% of recipients presensitized by a DA skin graft, with concurrent induction of transplant tolerance for other DA organs and skin. Using a two-stage radioimmunoassay, the anti-class I (RT1Aa) levels in sera of normal PVG recipients of DA liver grafts were found to be low (maximal titer 1:50 serum dilution or less); after peaking at 2 weeks posttransplantation, they diminished to background levels by 6 weeks. The anti-RT1Aa response showed a close parallel to cell-mediated rejection events in the liver graft recipients. In contrast, anti-class II (RT1Ba/Da) responses reached much higher titers (over 1:1000), which were maintained for several weeks before declining after 4 months. Similar observations were made in presensitized recipients. The induction of tolerance in the alloantibody response was indicated by the inability of DA skin grafts to restimulate anti-RT1 antibody in liver recipients. The observations support the picture of "split tolerance" indicated by previous cellular studies in this combination. PMID- 3523886 TI - Liver transplantation in Crigler-Najjar syndrome. A case report. PMID- 3523887 TI - Bile duct varices. An alternative to portoportal anastomosis in liver transplantation. PMID- 3523888 TI - Prolongation of cardiac allograft survival with BN 52021, a specific antagonist of platelet-activating factor. PMID- 3523889 TI - The specific distribution of glycolipid-based blood group A antigens in human kidney related to A1/A2, Lewis, and secretor status of single individuals. A possible molecular explanation for the successful transplantation of A2 kidneys into O recipients. PMID- 3523890 TI - Hyperacute rejection of a renal allograft in the presence of anti-HLA-Cw5 antibody. PMID- 3523891 TI - Urine cytology in relation to urinary tract malignancies in renal transplant patients. PMID- 3523892 TI - Prolongation of canine cardiac allograft survival using donor-specific buffy coat pretransfusions. PMID- 3523893 TI - Diagnostic evaluation of cholestatic patients. PMID- 3523894 TI - Childhood membranoproliferative glomerulonephritis: a histopathological and immunofluorescent study of 104 cases. PMID- 3523895 TI - [Methods of isolating serum lipoproteins]. AB - The methods of serum lipoproteins separation are considered. Advantages and faults of ultracentrifugation, electrophoresis, precipitation, gel chromatography, immune-specific and filtration methods for isolation of the lipid protein complexes are briefly characterized. The prospects of the separation methods for investigation of the lipid-protein particle structure and rapid hyperlipoproteinemias screening are discussed. PMID- 3523896 TI - [Correction of proteolysis disturbances and erythrocyte resistance in experimental burns by the antioxidant carbaton]. AB - The total proteolytic activity in blood and tissues and peroxide resistance of erythrocytes were studied in animals at different stages of burn disease. Carbaton, an antioxidant of a pyridine series, is analyzed for its effect on these indices. Considerable activation of proteolysis in tissues and a decrease of the erythrocyte resistance at burn shock and septicotoxemia stages are established. Carbaton being applied as a drug, influences positively the studied processes; a degree of the shift correction depends on the preparation dose. PMID- 3523897 TI - [Immunologically active peptides stimulating the T-cell system]. AB - The known immunologically active peptides are compared from the standpoint of their chemical structure. Homologous potentially active fragments are determined. The revealed regularities in formation of peptides and active sites of proteins permit supposing that the process of peptide biogenesis from precursors involve the quasicyclization simultaneously with the limited proteolysis. PMID- 3523898 TI - [Liver transplantation]. PMID- 3523899 TI - [Home monitoring of blood glucose in children with diabetes mellitus]. PMID- 3523900 TI - [Insulin 100]. PMID- 3523901 TI - [Early mobilization of flexor tendons after primary suture]. PMID- 3523902 TI - [Diclofenac compared with lidocaine in the treatment of myofascial pain by injections]. PMID- 3523903 TI - [The specific gravity of urine determined with a colorimetric strip. A clinical trial]. PMID- 3523904 TI - [Atracurium (Tracrium)--a clinical comparison with pancuronium. 2 non depolarizing neuromuscular blockers used with modified neuroleptic anesthesia]. PMID- 3523905 TI - [A comparative study of metabolic control and patient preference in the treatment with human insulin in 40/100 IE/ml strengths. An open cross-over study]. PMID- 3523906 TI - [The slimming pill Minuscal does not stimulate energy expenditure]. PMID- 3523907 TI - [A comparison of the occurrence of side-effects of ioxaglinic acid (Hexabrix) and metrizoate (Isopaque Amin) in hysterosalpingography. A randomized prospective study]. PMID- 3523908 TI - [Lumbar pain in parturient women treated with sterile water injections]. PMID- 3523909 TI - [Treatment of impetigo in general practice. Comparison of 3 locally administered antibiotics]. PMID- 3523910 TI - [Surgery and laser treatment of podophyllin-resistant condylomata acuminata]. PMID- 3523911 TI - [Treatment of mild hypertension]. PMID- 3523912 TI - [Hyposensitization in allergic conditions. Evaluation of the clinical effect in allergic bronchial asthma]. PMID- 3523913 TI - [Interactions between antiepileptic drugs and other preparations]. PMID- 3523914 TI - [Naproxen (Naprosyn) and mobilization in the treatment of acute ankle sprains]. PMID- 3523915 TI - [Ultrasonic scanning after the legal termination of pregnancy with complications]. PMID- 3523916 TI - [Disopyramide and lignocaine in the treatment of ventricular arrhythmia in patients with acute ischemic heart disease]. PMID- 3523917 TI - [Legionella pneumophila pneumonia with lung abscess in a recipient of a cadaver kidney]. PMID- 3523918 TI - [Cystitis emphysematosa]. PMID- 3523919 TI - [The value of acetylcysteine in the collection of sputum]. PMID- 3523920 TI - Ultrasound in the study of atherosclerosis. AB - Ultrasound has come to play an increasingly important role in investigating atherosclerosis. The simple, continuous wave directional devices may be used to measure limb blood pressure and assess velocity patterns from accessible arteries. The recent combined B-mode and pulsed Doppler systems are being used regularly to study the carotid bifurcation in the neck. With improvements in image resolution, Doppler technology and signal processing methods, it is now feasible to evaluate the morphology of the plaque and accurately predict the degree of stenosis by the recorded velocity changes in the residual lumen. By the development of transducers of low transmitting frequency (less than 5 mHz), it is now possible to evaluate arteries at greater depth such as the renal and mesenteric vessels. Duplex scanning promises to become the definitive, noninvasive method of assessing both the anatomy and flow characteristics of all major arteries outside the thorax and skull that are common sites for the development of atherosclerosis. PMID- 3523921 TI - Age-related changes in carotid artery wall properties in men. AB - Changes in distensibility and cross-sectional compliance of the common carotid artery with age were studied in 80 presumed healthy volunteers, varying in age between 20 and 69 y. The distensibility was assessed from the relative increase in arterial diameter during systole normalized with respect to the arterial pulse pressure. The cross-sectional compliance was obtained by multiplying the distensibility by the arterial diameter. The relative diameter changes of the common carotid artery during the cardiac cycle were recorded on-line with a high resolution multigate pulsed Doppler system. The arterial diameter was assessed from the width of the velocity profiles which can also be recorded on-line with this system. Arterial pulse pressure was determined from brachial artery cuff blood pressure measurements. Both distensibility and cross-sectional compliance of the common carotid artery decreased linearly with age, starting in the third age decade. The reduction in the latter parameter was less pronounced, probably as a consequence of an increase in arterial diameter with age. PMID- 3523922 TI - Doppler ultrasound assessment of the femoro-popliteal segment: comparison of different methods using ROC curve analysis. AB - Coexisting aorto-iliac and femoro-popliteal occlusive lesions remain a problem in vascular surgery. Arteriography does not provide information on their relative contributions to the presenting symptoms. The success of proximal reconstruction alone in such cases depends to some extent on the haemodynamic significance of the femoro-popliteal disease which will remain. Several noninvasive Doppler methods have been recommended for haemodynamic assessment of the femoro-popliteal segment. These methods were studied in 72 limbs of 38 patients. The results are compared using receiver operating characteristic curve analysis. The best single test in this group of patients was normalised transit time which was significantly better than pulsatility index damping factor (p less than 0.01). The addition of damping factor to normalised transit time tended to give some improvement but this was not statistically significant in the clinically relevant part of the ROC curve. PMID- 3523923 TI - Ultrasound properties of lung tissue and their measurements. AB - In-vitro measurements have been carried out for the group velocity and the attenuation, in dB/cm, in cow lung tissue. The velocity and the attenuation were measured both as a function of air content, from 32 to 68%, and as a function of frequency, from 10 to 800 KHz. The group velocity was determined from measurement of the phase difference between the transmitted and incident acoustic signal while the attenuation was measured from the insertion loss with correction for the water-lung interface transmission losses. The measured group velocities indicate only a small degree of dispersion, but a strong dependence on air content. The attenuation is very high and exhibits strong frequency dependence, but weak air content dependence. PMID- 3523924 TI - Bibliography of biomedical ultrasound. No. 55. PMID- 3523925 TI - Small kidney and hypertension: selection of patients for surgery. AB - We studied 37 patients with various degrees of hypertension and a small unilateral kidney. Renal vein renin studies were shown to be positive on 19 occasions and negative on 18. Of those positive, 10 had severe and 1 moderate hypertension. Surgery cured 63.3%. In 27% blood pressure improved and 1 patient failed to respond. Eight patients had mild hypertension with a positive renal vein renin ratio (RVRR), but on observation their home blood pressures were normal without medication and they were not considered for surgery. Eighteen patients with mild hypertension and negative RVRR were also not operated. We believe that RVRR is important for a surgical decision, but only in severe and moderate hypertensives. In mild hypertension, measurement of blood pressure at home is normal on most occasions. These are hyperreactive patients and should not have surgery, regardless of the results of their RVRRs. PMID- 3523926 TI - Clinical applications of monoclonal antibody technology. AB - Although monoclonal antibody technology has only been with us for slightly more than 10 years, it has already had a great impact on both basic science and clinical medicine. The ability to use these antibodies as highly specific and sensitive reagents that are consistent from batch to batch is invaluable. Because of this ability, monoclonal antibodies are assuming an ever more important role in laboratory assays. In addition, immunohistochemical techniques employing monoclonal antibodies enhance the histologic characterization of pathologic specimens. These clinical benefits are real but are often hidden from the eyes of the physician taking care of his patient. However, other newer uses of monoclonal antibodies are much more spectacular. Clinical imaging with monoclonal antibodies has been shown to be feasible in a variety of systems. Antibodies to colon cancer and melanoma have detected metastatic tumors that were otherwise hidden clinically. Despite these triumphs, the routine use of radioimmunodetection employing radiolabeled monoclonal antibodies has not yet arrived. However, the preliminary data obtained so far are very promising, and radioimmunodetection may well serve to be an important method for diagnosing a variety of cancers in the near future. Immunotherapy is actively being explored in a number of centers but at this stage is strictly experimental. Whether this will be an important addition to our therapeutic armamentarium should be defined over the next several years. The monoclonal antibodies that are currently used for clinical studies are murine, that is, they are mouse antibodies. Although these antibodies have been well tolerated in a number of studies, human monoclonal antibodies would be theoretically more desirable. Preliminary efforts to produce human monoclonal antibodies reactive with tumor-associated antigens have been reported. Future directions of monoclonal antibody technology will employ greater production of human monoclonal antibodies. In addition, the evaluation of antibody conjugates for clinical diagnosis and therapy will continue to be explored. PMID- 3523927 TI - Venous access techniques. AB - Venous access techniques have evolved to include a variety of methods that can be tailored to a number of specific needs. The use of central venous catheters for short- and long-term venous access, newer methods of central venous access using totally implantable devices, and the evolution of current hemodialysis are reviewed. Advantages, disadvantages, complications, and long-term considerations for vascular access procedures are analyzed. PMID- 3523928 TI - Technical advances in radiation therapy. AB - Substantial advances have been made in radiation therapy. Many of these advances can be applied in most radiation therapy departments without expensive improvements in equipment. Changes in radiation fractionation, chemotherapeutic sensitization, intraoperative radiation, and interstitial implants can be performed with experience and improved physician training in most medium-sized departments. Advances that require investments in expensive equipment such as particle radiation and hyperthermia will need to be evaluated at designated treatment centers. PMID- 3523929 TI - Flow cytometry in urologic oncology. AB - Flow cytometers have proved to be useful research tools in cellular biology. By using these devices, rapid and objective measurements of a variety of cellular parameters can be made on a cell-by-cell basis. The application of flow cytometers to the study of urologic neoplasms is at present very preliminary. The available literature on the flow cytometric study of urologic tumors is presented and discussed. PMID- 3523930 TI - Magnetic resonance imaging of the genitourinary tract. AB - MRI is in its infancy as a clinical imaging tool. It is undergoing intensive investigation in various areas of the body. Evaluation of the brain and spine is superb, and in some areas of the brain, like the posterior fossa, it is thought to be superior to CT. Evolving indications for body scanning include staging of pelvic malignancies, evaluation of liver malignancy, evaluation and staging of musculoskeletal problems, and, to a lesser degree, staging of renal malignancies and evaluation of vascular disease. The main problem in body imaging stems from image degradation because of respiratory motion that is transmitted to upper abdominal organs. Respiratory gating of image acquisition or utilization of short heavily T1-weighted pulse sequences will likely overcome this problem in due time. Minimizing motion artifact will make MR images comparable to, if not better than, CT images with regard to transverse anatomic display, and MR images have the added advantage of multiplanar scanning, which can be done directly, without need of additional computer reconstruction time and without having to move the patient. The second major problem in MRI is the lack of understanding of equipment potential. Unlike conventional radiography and CT, in which the behavior of the X-ray beam is understood with regard to image formation, in MRI new parameters are used to generate images. As stated earlier, MR signal intensity is due to hydrogen concentration, T1 and T2 relaxation times of the tissue, and flow of protons through the imaged volume. How these factors are weighted depends on pulse sequence selection, and thus image contrast and information content of the scans change. On the surface, these images display anatomic information as do other imaging modalities, but manipulation of pulse sequences may ultimately lead to the ability to demonstrate physiologic and chemical parameters previously unavailable in imaging. Current research is geared to help extract this data by testing new pulse sequences, using different types of receiver RF coils, and using MR-specific contrast materials. Minor MRI problems such as long scan times are being dealt with to decrease time to an acceptable length. The nonvisualization of soft tissue calcifications will probably remain a problem that may have to be weighed against other known advantages. At this time further research and clinical experience are the key to what is needed in MRI, to gain further knowledge with regard to imaging physiologic phenomena, such as flow and spectroscopy, and possibly to monitor the chemical basis of disease.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3523931 TI - Sonography in transitional cell carcinoma of the renal pelvis. AB - Real-time ultrasound examination of the kidneys was performed in 11 patients with transitional cell carcinoma of the renal collecting system. Each sonogram revealed a zone in the renal sinus which was less echogenic than the normal sinus and which corresponded to the extent of the tumor. Although the specificity and sensitivity of this finding are not yet known, this appearance should suggest the diagnosis of transitional cell carcinoma. PMID- 3523932 TI - Crossed fused renal ectopia: sonographic diagnosis. AB - Five cases of crossed fused renal ectopia, all confirmed by either computed tomographic scan or intravenous urography, were diagnosed sonographically. The sonographic appearance of this entity consists of a characteristic anterior and/or posterior notch, difference in orientation of the 2 collecting systems in the fused kidneys, and absence of a kidney in the contralateral renal fossa, or elsewhere in the body, such as the pelvis. The inability to diagnose this condition correctly may lead to the misdiagnosis of a renal mass or infiltrative disease occupying the contralateral renal fossa. Computed tomographic scans will also identify the anomaly. PMID- 3523933 TI - Renal candidiasis of the infant: ultrasound evaluation. AB - Sonographic diagnosis of 3 cases of renal candidiasis led to early diagnosis and treatment. Echogenic densities within a dilated pyelocalyceal system appeared to be the classic finding for obstructing candidal bezoars or candidal pyonephrosis in the premature neonate. Sonography was useful in guiding diagnostic and therapeutic percutaneous nephrostomies of very premature (900 and 750 g) infants. The ultrasonic findings of moderate echogenicity within dilated collecting systems in premature infants suggest pyonephrosis. Candidiasis should be considered as a prime cause. PMID- 3523934 TI - Sonographic evaluation of the rejecting ureter. AB - In 10 mongrel dogs, the sonographic features of the pelvocaliceal system and ureteral peristalsis during acute rejection were correlated with the electromyographic (EMG) findings and histologic appearance. There were significant alterations of the ureteral dynamics during rejection as demonstrated by changes in the pressure tracings, the progressive decrease of electrical activity of the ureteral muscle, and decreased peristalsis with pelvicaliectasis as demonstrated on real-time ultrasound. The sonographic changes of peripelvic and periureteral thickening corresponded to histologic changes of edema and inflammatory infiltrate with disruption of the muscular layer. In the presence of clinical and sonographic findings of kidney rejection, the demonstration of hydronephrosis and thickened pelvic wall should be considered as another measure of the rejection process. PMID- 3523935 TI - Scar sign of renal oncocytoma: magnetic resonance imaging appearance and lack of specificity. AB - This case report illustrates the magnetic resonance imaging (MRI) appearance of a typically asymptomatic renal oncocytoma as a homogeneous mass of medium signal with a stellate central region of decreased signal, representing the central scar. The MRI was correlated with computed tomography (CT), ultrasound (US), and gross pathologic appearance. The appearance of a central scar is not specific for oncocytoma and does not exclude renal cell carcinoma, as illustrated by a second case. PMID- 3523937 TI - Sternotomy and portal triad division for cadaver donor nephrectomy. AB - Modification of the en bloc resection of kidneys for cadaveric kidney transplant patient is described. A median sternotomy and division of the portal triad provide excellent exposure of the upper aorta above the celiac axis. This approach has been used in 40 cadaveric donors with no complications. PMID- 3523936 TI - Ultrasound evaluation of uncommon renal transplant complications. AB - Twenty-five patients who had undergone renal transplants developed uncommon complications that were detected and followed serially with sonography. Two patients developed renal calculi, which produced hydronephrosis in both instances. Other uncommon causes of postoperative hydronephrosis occurred in 5 cases; the causes included ureteral necrosis, ureteral stricture, and a renocutaneous fistula. Eight cases of renal infarction, manifesting 3 different sonographic appearances, were encountered. The presence and disappearance of postoperative gas in the collecting system were documented in 3 patients. The other unusual abnormalities detected involving the transplanted kidney include tuberculosis, pyonephrosis, 3 solitary cysts, a corpus lutem cyst simulating a perinephric fluid collection, and massive urinary ascites. PMID- 3523938 TI - Results of another trial of chemotherapy with and without hormones in patients with newly diagnosed metastatic prostate cancer. AB - From July, 1980, to June, 1983, 319 patients with newly diagnosed metastatic prostatic cancer were randomized to one of three treatment protocols: diethylstilbestrol (DES) or bilateral orchiectomy, cyclophosphamide plus 5 fluorouracil plus DES, and estramustine phosphate (Emcyt). Ninety-three per cent of 296 patients were eligible for evaluation. This report shows no difference in survival, disease-free progression time, or status regarding pain at entry. Other prognostic factors failed to reveal any difference within any of the treatment protocols. PMID- 3523939 TI - [Rehabilitative operations on the iris]. PMID- 3523940 TI - [Patient dispensary care following keratoplasty]. PMID- 3523941 TI - [Simplified modification of an epikeratophakia operation (initial experience)]. PMID- 3523942 TI - [Use of a contact lens-eyeglass telescopic system in asthenopia]. PMID- 3523943 TI - [Method for the mathematical coding of the middle ear elements]. PMID- 3523944 TI - [Surgical method of restoring the voice after complete removal of the larynx]. PMID- 3523945 TI - [Function of the vestibular analyzer in persons of various ages]. PMID- 3523946 TI - [Hearing function in diabetes mellitus]. PMID- 3523947 TI - [The 50th anniversary of the Moscow Ear, Nose and Throat Research Institute of the Ministry of Public Health of the RSFSR]. PMID- 3523948 TI - [Surgery on the stomach in the treatment of pathologic obesity]. PMID- 3523949 TI - [Intraoperative Doppler testing of the efficacy of correcting the valves of deep veins with a framework coil]. AB - The ultrasonic dopplerography was used in 37 patients as control of correction of profound vein valves. Local anesthesia was used in 12 patients, general anesthesia was used in 25 patients. The first group of patients performed the Valsalva test themselves, in the second group it was substituted by manual compression of the frontal abdominal wall. The results obtained show that intraoperative dopplerography allows methodological and technical errors to be corrected during the operation. The control is found to be more effective provided that the patient performs the Valsalva test himself during correction of the valve. The routine method of selection of the spiral diameter is thought to be fairly rational. PMID- 3523950 TI - [Echography in the differential diagnosis of mechanical and parenchymatous jaundice]. AB - The authors have examined 280 patients with the syndrome of jaundice and bilirubinemia of more than 21 mumol/l in order to establish echographic differential diagnostic criteria of mechanical and parenchymatous jaundice. The method of echography enabled the correct type of jaundice to be established in 97% of cases, in 73.8%--the level, length and origin of obstruction. The data presented allow to recommend echography as the method of choice in differential diagnosis of diseases accompanied by jaundice. PMID- 3523951 TI - [Choosing a method of treating suppurative lactational mastitis]. AB - The abscessing form of lactation mastitis as well as subaureolar abscesses with small foci (not more than 3-4 cm) should be expediently treated by a puncture method. In large foci permanent drainage should be used. Limited foci (up to 1 1.5 quadrants) in phlegmonous-abscessing form of mastitis must be carefully dissected. Treatment by incisions is indicated in cases with infiltrative abscessing form of mastitis. Local treatment must be supplemented by antibacterial and detoxication therapy and by the means enhancing the organism resistance. PMID- 3523953 TI - Computers in veterinary practice. PMID- 3523952 TI - [Computer tomography, echography and thermography in the diagnosis of extrarenal complications in a transplant]. AB - Computed tomography, echography and thermography were used for detection of extrarenal complications in 22 patients at different time after kidney transplantation. Morbid perirenal formations were found in 12 patients (hematoma in 4 patients, abscess--in 2, lymphocele--in 5, urinoma in 1). The complex of these methods allows to detect and establish the character of the peritransplant fluid collections. PMID- 3523954 TI - Computer applications. An overview. AB - Applications are programs that are designed for specific tasks. They may be written by the ultimate user or by commercial programmers. Personally written software offers the benefit of a custom solution and adaptability to changing conditions but at a very high cost. Vendor software is cheaper, but more general in nature. It may be difficult for some practitioners to find commercial software that exactly duplicates their operation, and adaptations will add expense. Software maintenance may not be available or it may mean additional cost. Veterinarians can profit from practice management packages, computer-aided diagnostics, educational software, and other programs. Computers must solve the users' problems or they are worthless. With appropriate applications, they represent one of the most cost-effective instruments in the practice. PMID- 3523955 TI - Computers as medical management tools. Computer-assisted diagnosis and medical decision support. AB - The potential of computers to assist veterinarians in medical management is reviewed. It is argued that computers will contribute to improved patient care by solving the information retrieval and processing problems in medicine. Strategies to accomplish this goal are discussed in detail, and criteria for evaluating diagnostic information systems are proposed. PMID- 3523956 TI - Special medical applications of computers. AB - The use of small computers for assistance in medical diagnosis is examined in light of their limitations, particularly in a veterinary clinical setting. Various approaches to these problems are discussed with an eye towards "appropriate technology" for the veterinary practice. The author describes two "expert systems" he devised that enable the small computer to aid in the analysis of laboratory data and in the clinical diagnosis of veterinary patients. PMID- 3523957 TI - Computer applications in veterinary medical education. AB - This is a review of the various computer applications used in veterinary medical education. The various applications include drill-and-practice, tutorial, problem solving, testing, educational management programs, educational games, word processing, educational utilities, authoring programs, and simulations. PMID- 3523958 TI - The AAHA Computer Program. American Animal Hospital Association. AB - The American Animal Hospital Association Computer Program should benefit all small animal practitioners. Through the availability of well-researched and well developed certified software, veterinarians will have increased confidence in their purchase decisions. With the expansion of computer applications to improve practice management efficiency, veterinary computer systems will further justify their initial expense. The development of the Association's veterinary computer network will provide a variety of important services to the profession. PMID- 3523959 TI - Observations on the incidence of clinical bovine mastitis in non-lactating cows in England and Wales. AB - Epidemiological features of clinical mastitis in dry cows from a three year prospective study are described. Two hundred and seventy-three herds in England and Wales participated in the first year (1980) and 209 and 159 of them continued in the study in the subsequent two years. Clinical mastitis was recorded in 1.5 per cent of cows during the dry period in each of the three years. These cases represented between 3.6 and 4.2 per cent of samples from all clinical cases examined. The incidence of clinical mastitis in dry cows increased during the winter housing period (October to March), a peak occurring at the end of this period. A secondary peak in incidence was recorded in August. Streptococcus uberis was the predominant pathogen. Variations in the monthly incidences of cases associated with the major mastitis pathogens were observed. A greater proportion of cases which occurred during the dry period exhibited systemic signs than of cases which occurred during lactation, with the exception of cases associated with Escherichia coli. The risk of clinical mastitis was apparently higher during the last 30 days of the dry period than during the earlier stages of the dry period. PMID- 3523960 TI - Treatment of canine nasal aspergillosis with systemic ketoconazole and topical enilconazole. PMID- 3523961 TI - Pharmacokinetics of cefoperazone in the cow by the intramammary route and its effect on mastitis pathogens in vitro. AB - The pharmacokinetic and microbiological properties of a new third generation cephalosporin, cefoperazone, when given by the intramammary route to the cow are described. Cefoperazone is excreted from the udder over a three- to five-day period following a single infusion of 250 mg in an oil base into each of all four quarters. By the fifth milking after treatment the mean bucket (composite) concentration of cefoperazone was below 0.01 microgram/ml. The minimal inhibitory concentrations for 470 pathogens isolated from cases of mastitis were determined. A few exotic species were resistant but all the usual isolates were sensitive. No signs of transferable drug resistance from known multiple drug-resistant strains were detected. PMID- 3523962 TI - Studies on the purification of the leucocidin of Fusobacterium necrophorum and its neutralization by specific antisera. AB - Leucocidin from several strains of Fusobacterium necrophorum was partially purified by gel filtration on Fractogel HW55 (F), the majority of the activity being present in the 50 ml of filtrate collected after 1.1 void volumes had passed through the column (termed Fraction 1, or #1). The material also contained lipopolysaccharide in 12.5% SDS-PAGE gels run under reducing conditions, but the protein did not migrate into 7.5% PAGE gels run under non-reducing conditions. Rabbit and bovine antisera to the leucocidin possessed antibodies against antigens in concentrated, washed culture supernates from toxigenic F. necrophorum and neutralized the leucocidal activity of such supernates. Absorption of the antisera with homologous, washed F. necrophorum cells reduced ELISA antibody titres by greater than 50%, but decreased neutralization titres by 15%. Absorbed rabbit IgG anti-#1 precipitated a single rocket in crossed immunoelectrophoresis and identified two proteins, of molecular weights (M.W.) 14 000 and 13 000, and 1 protein of M.W. 13 500 in immunoblots from toxigenic and non-toxigenic strains, respectively. An additional protein of M.E. 103 000 was present after SDS-PAGE separation of supernates from toxigenic but not non-toxigenic F. necrophorum and was not present in whole cell components. It was considered that the leucocidin may be present in a dimeric form in culture supernates from toxigenic strains. Antisera to leucocidins from several strains of F. necrophorum exhibited variable neutralization titres against leucocidins from heterologous bacteria. PMID- 3523963 TI - Bacteriostatic activity of bovine milk lactoferrin against mastitic bacteria. AB - The bacteriostatic activity of bovine lactoferrin (Lf) against mastitic bacteria was assessed with an in vitro microassay. The most susceptible species was Escherichia coli; all of the 35 isolates tested were susceptible to bacteriostasis by apo-Lf (0.1 mg ml-1), although a few strains showed a lower degree of inhibition. Heterogeneity among strains was more pronounced among 10 isolates of Staphylococcus aureus, four of which were apparently unaffected by apo-Lf (1 mg ml-1). Under the same conditions, Streptococcus agalactiae (six isolates) and Str. uberis (five isolates) resisted the bacteriostatic action of apo-Lf. PMID- 3523964 TI - [Therapeutic effect and residues of a Gentavet preparation in chicks, piglets and calves]. AB - Studied were the therapeutic and prophylactic effects of the preparation Gentavet (containing gentamycin complex II) with pigs, birds and calves affected with colibacteriosis. It was found that in conc. 80,000 IU (0.08 g or 0.8 g) with the drinking water (1 lit.) given 14 days to birds lowered the mortality rate to a higher extent than Avimycin (containing oxitetracycline and neomycin). At the rate of 10,000 IU (0.01 g or 0.1 g) per kg body mass, orally, split in two for 24 h with newborn pigs Gentavet produced a very good prophylactic effect, and when used at a higher rate--16,000 IU (0.016 g or 0.16 g) per kg under the same conditions up to 90 per cent of the pigs with polyenteritis recovered. At 10,000 IU (0.01 g or 0.1 g) per kg body mass, orally, split in two for 24 h with newborn calves with colibacteriosis produced therapeutic and prophylactic effects. Gentamycin complex II residual amounts remained longest in the parenchymal tissue of the kidneys and liver. The withdrawal times in slaughtering birds, pigs, and calves treated with Gentavet should last from 30 to 46 days (31 days for birds, 46 days for pigs and calves of up to 100 kg, and 30 days for heifers of up to 400 500 kg). This period could be shortened 4 to 5 days if both kidneys and liver are to be eliminated after slaughter. PMID- 3523965 TI - [Action of fenitrothion (Agria 1050) on the development of a surgical infection with Corynebacterium pyogenes in sheep]. AB - Investigations were carried out on twelve Starozagorska breed sheep divided into two groups of 6 animals each. All sheep were treated with phenitrothion (Agria 50) at the rate of 300 mg per kg body mass, singly, by means of a stomach tube. At the first hour of treatment the sheep of the second group were injected with 3 cm3 broth culture of Corynebacterium pyogenes. The general condition, the manifestation of signs of toxicity, and some paraclinical indices were followed up. The animals of the first group exhibited symptoms of toxicity and changes in the paraclinical indices, which was characteristic of the weak form of the infection course. Those of the second group developed the disease at a rapid course, with affection of the general state, atony of the forestomach, substantial changes in the hemopoiesis, the enzyme activity, the glycogenesis process, and the blood picture (erythropenia, drop of the hemoglobin content, higher erythrocyte sedimentation rate, leukocytosis with neutrophilia, strong drop of plasmal and serum cholinesterase, hyperglycaemia). Results pointed to the fact that Agria-1050 intoxication aggravated the course of the supurative surgical infection. PMID- 3523966 TI - [Demonstration of the M-protein of the Newcastle disease virus by current immunochemical methods]. AB - The immunosorbent micromethod with the use of nitrocellulose paper was employed for the first time to demonstrate subviral antigens from animal origin, such as the M-protein of the Newcastle Disease virus. The method proved to be highly effective. It was useful in discovering amounts as high as 10-20 ng of the antigen, while with the use of the enzyme-linked immunosorbent assay (ELISA) amounts of about 200 ng could be evaluated. The immunosorbent micromethod performed on nitrocellulose paper was readily applicable as compared to all previously employed highly sensitive methods, and could be used successfully in immunochemical investigations. PMID- 3523967 TI - [Data on equine veterinary medicine in the reign of Czar Simeon]. PMID- 3523968 TI - A remarkable Romanian scientist: Dr. Nicolae N. Stroian (1888-1969). PMID- 3523970 TI - Restriction of frog virus 3 polypeptide synthesis to immediate early and delayed early species by supraoptimal temperatures. AB - Multiplication of frog virus 3 (FV 3) occurs in mammalian cells provided they are incubated at temperatures lower than 33 degrees. The expression of the viral genome at supraoptimal temperatures was followed by analyzing the polypeptides produced in CHO-infected cells and comparing with those obtained under restrictive conditions provoked by amino acid analogs or metabolic inhibitors. Late polypeptides were not detected at 33 degrees and the number of delayed early species decreased gradually with increasing temperatures consequently the synthesis of all delayed early proteins was not turned on in response to a unique event. At 37 degrees the synthesis was limited to the immediate early species, i.e., the proteins synthesized after cycloheximide reversal. Temperature shift experiments suggested that delayed early genes remained untranscribed at 37 degrees. Thus, incubation of FV 3-infected mammalian cells at 37 degrees provides a unique way of limiting viral synthesis to immediate early proteins without the side-effect provoked by inhibitors. PMID- 3523969 TI - Anti-influenza antibody assay by light scattering. AB - A physical method based on light scattering at 90 degrees was used to make evident the specific interaction between influenza virus and influenza antiserum. Purified virus put in contact with different dilutions of normal chicken serum exhibited a dose-effect dependence, which was significantly different from that corresponding to the virus-antiserum interaction. The maximum dilution of anti influenza rabbit serum allowing the detection of the specific interaction between serum and infected allantoic fluid was then established. This value was considered to represent the "light scattering titer" of the antiserum. PMID- 3523971 TI - Thermosensitivity of frog virus 3 genome expression: defect in early transcription. AB - The influence of temperature on the transcription of the frog virus 3 genome was studied in CHO cells infected both at 29 and at 37 degrees, the nonpermissive temperature for virus multiplication. It was definitely established that late genes were not transcribed at 37 degrees. Although immediate early genes were expressed at 37 degrees, their transcription was altered but there was no sequestration of mRNAs in the nucleus which could impair their translation; these viral mRNAs were also efficiently translated in vitro. These results indicate that an immediate early viral protein involved in the transcription of delayed early genes is likely to be thermosensitive. Furthermore, one event taking place at the very beginning of the infection, possibly related to the activity of a viral structural component, facilitates the transcription of immediate early genes at 29 degrees and this step is partially impaired at 37 degrees. PMID- 3523972 TI - Responses of spatial mechanisms can explain hyperacuity. AB - A recently developed nonlinear mathematical model for spatial pattern discrimination, which is formally analogous to line element models in color vision, was applied to a variety of hyperacuity tasks. The computed results are in reasonable agreement with data on vernier acuity as a function of line length and separation, chevron acuity, periodic vernier acuity using sinusoidal lines, three line bisection acuity, vernier acuity using cosine gratings, and spatial interference with vernier acuity. In agreement with model predictions, data are presented showing that vernier acuity improves as a power function of contrast. It is concluded that the nonlinear, contrast dependent responses of visual mechanisms tuned for size and orientation can explain a wide range of hyperacuity and other spatial pattern discrimination tasks. PMID- 3523973 TI - [Doppler assessment of transvalvular pressure gradients in stenoses of the bicuspid valve and aorta]. PMID- 3523974 TI - [Treatment of type I diabetics with a combination of Superdep + DEP + NZI and an adjustment of the insulin dosage by means of a Biostator]. PMID- 3523975 TI - [Clinical experience with the antiarrhythmic propafenone (Rytmonorm)]. PMID- 3523976 TI - [Use of lithium oxybutyrate in the combined therapy of burn injury patients]. PMID- 3523977 TI - [Clinical picture and diagnosis of acute radiation sickness]. PMID- 3523979 TI - [Complete single-stage surgical treatment of severe eye wounds]. PMID- 3523980 TI - [The volume of surgical interventions in triage at evacuation hospitals during World War II]. PMID- 3523978 TI - [Chlamydia and urogenital chlamydioses (a review of the literature)]. PMID- 3523981 TI - [Possibility of contact thermometry in the early diagnosis of viral hepatitis and acute intestinal infections]. PMID- 3523982 TI - [Nikolai Vasil'evich Sklifosovskii (on the 150th anniversary of his birth)]. PMID- 3523983 TI - [Mental disorders in poisonings by anticholinergic agents]. PMID- 3523984 TI - [Verification of medical measuring methods]. PMID- 3523985 TI - [Cyanosis in a patient with an atrial septal defect without pulmonary hypertension]. PMID- 3523986 TI - [Relation between the changes in thiamine metabolism and energy processes in erythrocytes of patients with diabetes mellitus and approaches to their correction with drugs]. AB - Erythrocytes, obtained from blood of 12 patients with diabetes mellitus and of 6 donors, were incubated in isotonic medium at 37 degrees within 180 min. Patterns of thiamin metabolism (activity of transketolase and TDP-effect), of glycolysis (content of glucose, lactate) and of energy metabolism (ATP, ADP, AMP and 2,3 DPG) were studied during the incubation. The ratios of energy-synthesizing and energy-consuming reactions were shifted towards the latter reactions in erythrocytes of the patients, which appears to be among the factors responsible for impairment of thiamin metabolism in diabetes. In order to correct the impairments found some drugs, such as insulin, thiamin, cocarboxylase, thiamin combined with adenine were added into the incubation medium. Insulin and cocarboxylase as well as insulin combined with thiamin and adenine exhibited the best effect on the patterns studied; these drugs normalized the vitamin B1 metabolism and improved the parameters of energy metabolism within 120 min of incubation in erythrocytes isolated from blood of patients with diabetes mellitus. PMID- 3523987 TI - [A solid-phase immunoenzyme method of the quantitative determination of insulin antibodies]. AB - A test system for quantitative estimation of antibodies towards insulin was developed using the solid phase immunoenzymatic procedure. The test system was calibrated using affinity antibodies towards insulin, obtained after immunosorption of blood plasma of insulin-resistant patient with diabetes. The normal content of autoantibodies, estimated by means of the procedure in human blood serum, constituted 35.2 X 10(-3) +/- 12.4 X 10(-3) g/l. In the patients with diabetes increased content of autoantibodies towards insulin was usually determined--70 X 10(-3)-180 X 10(-3) g/l. PMID- 3523988 TI - [Enkephalin-forming enzymes (review)]. PMID- 3523989 TI - [Biochemical mechanisms of the effect of low molecular weight organochlorine aliphatic compounds on humans and animals (review)]. AB - Data on the effects of 1,1,1-trichlorethane and tetrachlorethylene on human and animal organisms are reviewed. These compounds are used in industry and in homeservice. The review deals with some aspects of the action of these organic solvents at the subcellular level. PMID- 3523991 TI - [Methodological features of assessing the effectiveness of adjuvant therapy in clinical trials]. PMID- 3523990 TI - [Propolis as an inhibitor of free radical lipid oxidation in salmonellosis]. AB - Lipid peroxidation was activated in salmonellosis. Content of hydroperoxides and malonic dialdehyde was increased in mice liver tissue. At the same time, the activity of antioxidative enzymes was altered. Continuous administration of propolis stabilized lipid peroxidation, thus suggesting that the substance could be used as a drug in medicine. PMID- 3523992 TI - [Modern classifications of non-Hodgkin lymphomas]. PMID- 3523993 TI - [Potentials for the ultrasonic diagnosis of laryngopharyngeal cancer metastases to the cervical lymph nodes]. AB - The potentialities of ultrasonic tomography in diagnosis of metastases into cervical lymph nodes were assessed in 15 patients with laryngopharyngeal cancer before surgery. The data were compared with those obtained in the course of morphologic examination of resected lymph nodes. Ultrasonic tomography provided reliable information on the extent and site of lymph node involvement in 71.4% of node--positive cases of laryngopharyngeal cancer. Correct ultrasonographic diagnosis of lymph node involvement was made in only 42% of cases of impalpable node disease. PMID- 3523994 TI - HBV vaccinations in medical and paramedical staff: the impact of age on immunization results. AB - Medical and paramedical staff from hospitals in the Antwerp area and from the Antwerp blood transfusion centre were vaccinated with the HBV vaccine (Hevac B) that was first commercialized in Belgium. The vaccinations resulted in 82% seroconversions with anti-HBs formation. Age seems to affect adversely the vaccination results, especially in people over 40 years. PMID- 3523995 TI - On the specificity of human anti-H antibodies. AB - Anti-H antibodies from 2 homogeneous subgroups of H-deficient individuals (Bombay and Reunion phenotypes) were studied for their specificity with regard to synthetic H oligosaccharides. It appears that Bombay individuals synthesize large amounts of both anti-H type 2 and anti-H type 1 antibodies, whereas Reunion individuals may possess strong anti-H type 1 antibodies, but have only weak anti H type 2 antibodies in their serum. This can be explained by the presence of small amounts of H-type 2 determinants on the erythrocytes of Reunion individuals contrasting with the complete lack of H determinants on the red cells of Bombay individuals. PMID- 3523996 TI - [Functional status of the pancreatic islet system in peptic ulcer patients]. PMID- 3523997 TI - [Relation between the function of a renal allograft and the degree of histocompatibility with respect to the HLA system antigens]. PMID- 3523998 TI - [Dynamic model of the circadian rhythm of renin activity and aldosterone concentration in the blood plasma of hypertension patients]. PMID- 3523999 TI - [Effect of insulin hypoglycemia on the functional activity of the adrenal cortex in stomach cancer patients]. PMID- 3524000 TI - [Role of temperature-sensitive mutants in the natural evolution of the influenza virus]. PMID- 3524001 TI - [Indirect immunoenzyme method for the laboratory diagnosis of Lassa and Ebola hemorrhagic fevers]. AB - Conditions for performing solid-phase indirect enzyme-immunoassay (SPEIA) for the detection of Lassa and Ebola virus antigens and antibodies to them using horseradish peroxidase-labeled antispecific globulins were developed. The method is highly sensitive, specific, and reproducible. By this method, antigens of Lassa and Ebola viruses could be detected in tissue culture fluid of the infected cell cultures and in animal organ suspensions. Detection of antibodies to Lassa and Ebola viruses in human convalescent sera and in normal donors by means of SPEIA opens possibilities for its use in large-scale diagnostic and seroepidemiological surveys. PMID- 3524002 TI - [Virus-induced antigens in human tumors]. AB - Solid-phase radioimmunoassay (SPRIA) was used for examinations of human malignant tumors for the presence of retrovirus D-induced antigen and of blood sera from cancer patients for the presence of antibody to this antigen. Various tumor specimens differently reacted to anti-HEp-2 serum, the background values of binding of this serum with normal tissues (liver, lung, spleen) and leukemic cells from leukemia patients being low. The majority of the sera from cancer patients were found to contain antibody to HEp-2 antigen. No correlation was established between high levels of the antigen in tumors and high antibody titres in the blood sera of the same patients. PMID- 3524003 TI - [Method for detecting antimeasles antihemolysins in sera]. PMID- 3524005 TI - The 1933 Chicago outbreak of amebiasis. PMID- 3524004 TI - Clinical aspects of adult epiglottitis. AB - Epiglottitis in adults has been considered a medical rarity. Recent evidence suggests that this disorder is seen in adults regularly, though uncommonly, in clinical practice. We present 14 cases of adult epiglottitis. Most cases were blood culture-negative; Hemophilus influenzae was isolated from blood cultures in two cases and Hemophilus parainfluenzae in one case. There were no deaths. Epiglottitis in adults differs from pediatric epiglottitis in the mode of presentation, bacterial cause and clinical course. PMID- 3524006 TI - [The life and work of Odon Bujwid--a Polish physician, social worker and Esperanto expert]. PMID- 3524007 TI - [Henryk Fryderyk Hoyer--the founder of Polish histology]. PMID- 3524008 TI - [Cumulative effects of smoking and exposure to asbestos on the development of various neoplasms]. PMID- 3524009 TI - [Clinical significance of atrial fibrillation]. PMID- 3524010 TI - [On the centenary of the publication of the first urology textbook in Poland]. PMID- 3524012 TI - [The struggle with tuberculosis in the countryside of Poland between world wars]. PMID- 3524011 TI - [Kazimierz Dluski--the originator of the modern sanatorium treatment of tuberculosis in Poland]. PMID- 3524013 TI - [Forgotten periodical of Silesian medical students]. PMID- 3524014 TI - [Evaluation of the effectiveness of the preparation Eqvalan in the control of Nematoda in horses]. PMID- 3524015 TI - [Familial juvenile nephronophthisis--a cause of chronic renal failure in childhood]. AB - Familial juvenile nephronophthisis (FJN) represents an important cause of chronic renal insufficiency in the first two decades of life. Its frequency is reported to vary between 7 and 20% of all cases of terminal renal failure in childhood. Usually the onset is insidious, with polyuria, polydipsia and anaemia being the main clinical features. The diagnosis is based on clinical, laboratory and pathological findings. The purpose of our report is to emphasize the importance of this pathological entity with respect to the clinical symptoms and signs and diagnostic approach on the basis of the case reports of four patients. PMID- 3524016 TI - [Norfloxacin in the treatment of urinary tract infections]. AB - 28 patients with urinary tract infections (UTI) were treated with norfloxacin 2 X 400 mg daily for 9 days. 14 of these patients had complicated UTI (stones, obstruction). The main pathogens were E. coli and Proteus mirabilis. On the third day of treatment all bacteria were eradicated. One week after therapy all patients with uncomplicated UTI were cured and, likewise, 9 of 14 with complicated UTI. There was no laboratory evidence of adverse effects. 6 patients reported only mild side effects such as epigastric pain, dizziness and pruritus, which did not necessitate discontinuation of norfloxacin. Norfloxacin appears to be safe and effective in the treatment of UTI. PMID- 3524017 TI - [Cyanoacrylate tissue gluing in corneal perforations]. AB - Three cases of corneal perforation which were treated with tissue adhesive (Histoacryl) are reported. The first case showed free fistulation after perforating keratoplasty, whilst the second had a trophic ulcer and the third had a traumatic corneal laceration with loss of corneal tissue. Treatment was successful in all three cases. The surgical technique, results and possible complications are mentioned. PMID- 3524018 TI - [Reconstruction of the medial canthal area and lower eyelid]. AB - This paper presents the case report of a patient with an extensive tumour of the lower eyelid and the medial canthal area treated by a combination of two surgical procedures. We combined the method described by Hughes and modified by Smith--a tarsoconjunctival graft from the upper eyelid--for reconstruction of the canthal area with a Tenzel lateral rotation skin flap. The combination of these methods enables the transplanted part of the tarsal tissue to be kept relatively small, which reduces the risk of postoperative complications of the upper eyelid. Moreover, with the rotation flap it is possible to control the tension of the lower eyelid exactly. The postoperative result is satisfactory. PMID- 3524019 TI - [Etiology of infectious diseases of the outside of the eye]. AB - This study emphasizes the importance of accurate diagnosis and therapy. Modern laboratory techniques were used to scan conjunctival swabs from 287 patients with 305 red eyes between 1.1. 1985 and 1.6. 1985. 17 patients (5.9%) showed Chlamydia infection. The main bacterial organism found was Staphylococcus, mostly of a resistant strain. Allergic conjunctivitis and typical viral infections were not considered in this study. As reported in the recent literature eye infections caused by Chlamydia trachomatis are increasing in number. PMID- 3524020 TI - [Clinical microbiology and chemotherapy in the spirit of Escherich]. AB - One hundred years ago Billroth and Escherich were engaged with microbiological investigations. They are representative of intimate relationship between clinic and microbiological laboratory. In 1979 the Department of Chemotherapy was founded and this tradition was resumed and continued. PMID- 3524021 TI - [Escherichia coli in biotechnology]. AB - Escherichia coli plays a central role in modern biotechnology i.e. gene technology and fermentation. This article summarizes the basic principles of genetic engineering using human type I interferon genes as an example. The second part describes the advantages and the problems encountered using E. coli as a production organism. PMID- 3524022 TI - [Interferon-alpha in the treatment of hematologic neoplasms]. AB - This report aims to review briefly the current status of treatment of haematological malignancies with interferon-alpha (IFN-alpha). Overall hairy cell leukemia and chronic myelogenous leukemia appear to be most sensitive to IFN alpha. We started to investigate, how interferon exerts its antileukemic activity and in which way interferon therapy can be optimized. Our preliminary results fail to support the view of interferon mediated enhancement of host responses. They rather indicate direct effects of IFN on leukemic cells in vitro. By means of IFN-dependent biological markers (e.g. beta-2-microglobulin, neopterin) clinically effective but atoxic doses of IFN-alpha could be defined for HCL and CML. In final conclusion, the recent studies on the clinical efficacy of IFN alpha revealed its potent antitumoral effect in hematological malignancies. However, the further proof of the potential benefit of IFN treatment versus conventional therapeutic strategies remains to be elucidated. PMID- 3524024 TI - Donor-specific transfusions in living-related transplantation. PMID- 3524023 TI - Complications of cyclosporin therapy. PMID- 3524025 TI - Total lymphoid irradiation in renal transplantation. PMID- 3524026 TI - Renal transplantation between identical twins: a review. PMID- 3524027 TI - Cancer after transplantation. PMID- 3524028 TI - Renal transplantation in the diabetic. PMID- 3524029 TI - Progress in segmental pancreatic transplantation. PMID- 3524030 TI - Liver transplantation in the adult. PMID- 3524031 TI - Liver transplantation in the child. PMID- 3524032 TI - Clinical cancer. 5. Progress in acute leukemia. PMID- 3524033 TI - Nutrition education in America: from day one. PMID- 3524034 TI - [Role of anaerobic bacteria in endogenous infection]. PMID- 3524035 TI - [Diseases in man caused by members of the Campylobacter genus]. PMID- 3524036 TI - [Diagnosis of anaerobic infections]. PMID- 3524037 TI - [Sporeless anaerobic bacteria in surgery]. PMID- 3524038 TI - [Branched-chain amino acids in the treatment of latent porto-systemic encephalopathy. A placebo-controlled double-blind cross-over study]. AB - In a doubleblind cross-over placebo-controlled trial the efficiency of oral treatment with branched chain amino acids was investigated in 22 inpatients with liver cirrhosis. In all patients evidence of latent (subclinical) portalsystemic encephalopathy was obtained by using an extensive psychometric test programme. Patients received a defined diet of 35 cal/kg/day containing 1 g of protein. In addition, branched chain amino acids or casein in a dosage of 0.25 g/kg/day was administered in a cross-over fashion, each for 1 week. Semiquantitative nitrogen balance increased during both treatments, with a tendency towards a larger increase during branched chain amino acid treatment. At the same time ammonia concentration tended to decrease during branched chain amino acid treatment. Taking into account the cross-over design, significant improvements attributable to branched chain amino acid treatment could be demonstrated in psychomotor functions (line tracing, tapping, steadiness, auditory reaction time), attention (digit table), and practical intelligence (digit symbol, number connection test). PMID- 3524039 TI - [Ars medica Anhaltina (II): Carl Ferdinand Graefe (1787-1840) and the Alexisbad spa]. AB - In 1985 the spa Alexisbad in the Harz Mountains celebrated the 175th anniversary of its creation. Its establishment is to be seen in close connection with the activities of the subsequent Berlin professor in ordinary Carl Ferdinand Graefe (1787-1840) in Anhalt-Bernburg. The early development of the spa which for a certain time was fused with the Beringerbrunnen in Suderode is characterized by the activities of several engaged sanatory physicians whose spectre of task allows insights in the balneological organisation of the 19th century. PMID- 3524040 TI - [Rational procedures in the differential diagnosis of jaundice]. AB - In jaundice after exclusions of prehepatic and functional hepatogenic hyperbilirubinaemias the sonography should pre-eminently be used as a riskless, economical and qualified investigation method, taking into consideration clinical and laboratory-chemical data. If sonographically the findings of an intrahepatic cholostatis are shown, in therapeutic relevance the histological clarification must follow. Only in unequivocal focal changes of the liver (perhaps thin needle puncture) further investigations are unnecessary. If there are findings of an extrahepatic cholostasis, in a not unequivocal sonographic result or before a surgical intervention further aimed investigations, such as ERCP, PTC and CT, are necessary for the exact clarification of the cause of the obstruction of the bile ducts. PMID- 3524041 TI - [Effect of immunoreactivity to candidin on phagocytic performance and intracellular killing of live fungi by polymorphonuclear granulocytes]. AB - Positive results of the intracutaneous test with Candida were associated with an increased phagocytosis (p-trend) and an increase of the intracellular killing (p less than or equal to 0.01) of Candida albicans by polymorphonuclear granulocytes. PMID- 3524042 TI - [Autologous heterotopic partial transplantation of the pancreas in the dogs with reference to different drainage methods]. AB - Pancreatic autotransplantation is a necessary requirement for studies on the technical aspects of pancreatic grafting. In the allograft model immunological problems influences the graft survival. In 25 mongrel dogs the left limb of the pancreas was transplanted into the grain with end to side vascular anastomosis. The body and right limb of the pancreas was removed and discarded. We have compared various technique for management the exocrine pancreas section (Neoprene injected duct; open duct technique). Currently the rate of complications in segmental pancreas autotransplantation was high especially in Neoprene injected dogs. Reasons for this result from technical failures like venous thrombosis and pancreatitis. In every case it was possible to ameliorate the diabetes mellitus up to the 7th day. Histological we found dilated interlobe space up to 7 days after transplantation with open ducts and there were no signs of disturbance in the endocrine tissue. In the Neoprene-injected group we found a severe intraacinous oedema and 5 days after transplantation already a beginning fibrosis with destroyed islets of Langerhans. PMID- 3524043 TI - Infective endocarditis of native and prosthetic valves--the case for prompt surgical intervention? A retrospective analysis of factors affecting survival. PMID- 3524044 TI - Combined treatment of valvular and coronary heart disease during the last 10 years. PMID- 3524045 TI - [Some methodical aspects of the leukocyte adherence inhibition test (LAI)]. PMID- 3524046 TI - [The 100th volume of "Zeitschrift fur mikroskopisch-anatomische Forschung" and the 100th birthday of its founder Hermann Stieve]. PMID- 3524047 TI - [An embedding and sectioning device for the preparation of defined thick sections of biological soft tissues]. PMID- 3524048 TI - Outer periarterial lymphatic sheath of the human spleen. PMID- 3524049 TI - [Otto Deiters (1834-1863)--his life and neuroanatomical work]. PMID- 3524050 TI - Study of live recombinant cold-adapted influenza bivalent vaccine of type A for use in children: an epidemiological control trial. AB - Live cold-adapted recombinant bivalent vaccine of influenza type A was studied in a controlled field trial in 1982-1983 among nearly 30,000 children 3-15 years old. The bivalent vaccine consisted of recombinants 47/25/1 (H1N1) and 47/7/2 (H3N2) of wild-type viruses A/Brazil/11/78 (H1N1) and A/Bangkok/1/79 (H3N2) with cold-adapted donor A/Leningrad/134/47/57 (H2N2). The recombinants which received mutant nonglycoprotein genes from cold-adapted donor did not suppress each other after simultaneous inoculation of children and stimulated antibody response to both strains. The bivalent vaccine was completely attenuated for children. It caused less than 1% transient febrile reactions during five days after the first vaccination, including double seronegative individuals with low antibody titres to both vaccinal strains. The cold-adapted bivalent vaccine tested proved to be safe for children according to the analysis of morbidity studies among vaccines and a control group performed during the five days and the following six months after the first immunization. There is a similar distribution of non-influenza illnesses and a statistically significant decrease in influenza-like diseases among vaccines compared to the control group. In the four months after the immunization programme was completed, epidemics of influenza A H1N1 and H3N2 occurred. The incidence of influenza-like diseases was approximately 50% less in the vaccinated than in the control groups. This is the first evidence of safety and protective efficacy of recombinant live influenza vaccine for children 3-15 years of age. PMID- 3524051 TI - [The teachings of I. P. Pavlov and modern medicine]. PMID- 3524052 TI - [Pavlovian principles of nervosism and the importance of modern neuropharmacologic drugs to medicine]. PMID- 3524053 TI - [Morphological bases of the radiation therapy of bone tumors]. PMID- 3524054 TI - [Results of a phase-I clinical study of carboplatin--(cyclobutane-1,1 dicarboxylate)diamineplatinum (II)]. PMID- 3524055 TI - [Problems of etiology and medical thinking]. PMID- 3524056 TI - [Short history of the development, characteristics and outlook for the use of magnetic resonance in medicine]. PMID- 3524057 TI - [The orientational and exploratory reaction and emotional factors in adaptive behavior]. PMID- 3524058 TI - [Bactericidal properties of the skin in response to exposure to atmospheric fronts]. PMID- 3524059 TI - [Paleopathologic findings concerning syphilis]. PMID- 3524060 TI - [Sources of dermatology in Armenian medicine of the 9th-14th centuries]. PMID- 3524061 TI - [Aurelius Cornelius Celsus on cutaneous and venereal diseases]. PMID- 3524063 TI - [Bleeding as a complication after oral surgery]. PMID- 3524062 TI - Role of the nuclear matrix in adenovirus maturation. AB - The nuclear matrix has been implicated in several important cellular processes. In this paper, we investigate the role of the nuclear matrix in adenovirus type 2 assembly. Electron microscopic examination of nuclear matrices isolated from adenovirus infected Hep-2 cells clearly reveals that late in the lytic cycle, adenovirus capsids are intimately associated with the nuclear matrix. SDS-PAGE analysis showed that the viral core polypeptides V, PVII and 11 kDa were enriched in the nuclear matrix fraction. After a 3 h chase period a constant high ratio of PVII to VII prevailed in the nuclear matrix suggesting that mostly young virions and viral cores are bound to this structure. Most of the virus maturation endoproteinase activity co-purified with the nuclear matrix and the data suggest that the enzyme may be released from fragile young virions or assembly intermediates. Together these experiments suggest that the nuclear matrix is the site of adenovirus assembly and that mature virions may be released from the matrix by the viral endoproteinase. PMID- 3524064 TI - Experience with quality control in clinical chemistry. AB - The introduction of statistical quality control of clinical chemical analyses has not only provided documentation of the reliability of analytical results and led to improvements in reliability, it has also led to marked improvements in the methods, reagents, calibration materials, control specimens and equipment used. Beyond this, the availability of reliable analytical results has enabled further development of the theoretical concepts underlying thought and action in clinical chemistry. The present paper provides an overview of developments in quality control in the Federal Republic of Germany since 1964. The uniform basic program for quality control with control specimens, as set forth in the Guidelines of the Medical Society of West Germany and required in all states of the country since 1971, is described and our experience with it discussed. Internal quality control consists of separate precision control and accuracy control procedures. External quality control in the form of short-term interlaboratory surveys with control specimens provides an objective check on accuracy. The assigned values for the required accuracy control specimens are determined under routine conditions in particularly well-equipped and well-staffed laboratories headed by particularly highly qualified individuals. The laboratories are independent of the manufacturers of control specimens, calibration materials, reagents and equipment. Over the years, the assigned value determinations have also provided valuable information about the structure of the data and about the reliability criteria for the analytical results. Based on the experience gained with this system, a new concept for quality control was developed in which the method dependent assigned values are replaced by method-independent reference method values. The requirements for quality control, i.e., the maximum acceptable imprecision and the maximum acceptable deviation of the analytical results from the reference method value or the assigned value, are specified after consideration of the clinical requirements, that is, their effects on medical decision-making. PMID- 3524065 TI - [Stomach tolerance of indomethacin derivatives: an endoscopic comparative study in healthy probands]. AB - The effect of 5 days' treatment with indomethacin, acemethacin and proglumethacin on the gastroduodenal mucosa was endoscopically evaluated in healthy volunteers. In a randomised double-blind crossover system 16 subjects received 50 mg t.i.d. indomethacin and 60 mg t.i.d. acemethacin, and a further 16 volunteers received 50 mg t.i.d. indomethacin and 150 mg t.i.d. proglumethacin. After 5 days both proglumethacin and acemethacin caused significantly less gastroduodenal lesions than indomethacin. Possible reasons for the apparently better gastro-duodenal tolerability of both indomethacin derivatives are discussed. PMID- 3524066 TI - [Does simultaneous administration of a PGE1 analog prevent indomethacin damage to human gastric mucosa? An endoscopic double-blind study]. AB - The influence on gastroduodenal mucosa of indomethacin (50 mg t.i.d.) administration for 6 days was investigated in 7 healthy volunteers in a double blind randomized crossover study with and without concomitant administration of MDL 646, 400 micrograms q.i.d. and 800 micrograms q.i.d. Indomethacin induced a gastroduodenal lesion index of 2.4 +/- 0.1. Neither of the prostaglandin E1 analogue dosages afforded significant protection of gastric and duodenal mucosa (2.1 +/- 0.4 in the presence of 400 micrograms q.i.d. and 1.9 +/- 0.4 in the presence of 800 micrograms q.i.d.). Major side effects were not observed. PMID- 3524067 TI - Pharmacotherapy of osteoarthritis with particular reference to night pain (double blind trial of pirprofen and piroxicam). AB - The study confirmed the usefulness of both pirprofen and piroxicam in a short term treatment of decompensated osteoarthritis of weight-bearing joints associated with night pain. Both drugs were fairly tolerated. The tolerance of pirprofen was somewhat better then that of piroxicam. PMID- 3524068 TI - [Anastomosis of the total calyx system in solitary kidney with an ileal loop]. AB - In a female patient with a solitary kidney the authors achieved a maximum drainage by means of an ileoneocystostomy comprehending the whole calyx system with lateral drainage between kidney and urinary bladder. The indication for this intervention was made in a much extended calyx system with stone formation, in which case the ureter and the urethra remained intact. The result of the operation and the function of the drainage were satisfactory after 2 years. PMID- 3524069 TI - [History of the pathologico-anatomical service of the Red Army in the Great Patriotic War 1941-45]. AB - The history of the rise of the pathology service in the military-medical service of the Red Army is described along with an explanation of its indispensible contribution to the combat effort. The goals of the service include evaluation of the work of the military-medical establishments using summarized clinico anatomical analyses of pathology data. This allowed the heads of the military medical service to rapidly recognize and alter organizational and therapeutic diagnostic weaknesses in various stages of medical evacuation and to improve the activity of the therapeutic evacuation centres. The pathology service also established the causes of death among persons wounded in battle. It evaluated the significance of the type, timing, intensity and shortcomings of treatment prior to death. The pathology of war trauma, regeneration, the pathogenesis of infections complications and influence of treatment on their development and course were also studied. The organizational structure of the service, its branches (front and army laboratories of pathology, department of pathology of major hospitals) working under the guidance of the Central Laboratory of Pathology (CLP), is described. The documents which were the basis of the work of these laboratories are reviewed. The great services of M. F. Glazunov and N. A. Krajevskij - chiefs of the CLP - in organization and guidance (both practical and scientific) are honored. PMID- 3524070 TI - [Ultrastructure of immunocytes in the lymph of the thoracic duct during rejection of the allogenically transplanted heart in the dog]. AB - Substructural changes in the immunocytes of thoracic duct lymphatic fluid were studied in allogeneous heart transplant experiments on 47 dogs in an effort to identify factors associated with or inductive of the process of rejection. The initial changes could be shown to be related to the inevitable trauma associated with the transplant procedure. At the same time evidence of increased physiologic activity of the cells begins to appear and lymphoplasmocytes begin to enter the process along with the onset of antibody production. Immediately before rejection occurs, the number of lymphoplasmocytes increases which however often show degenerative changes on ultrastructural examination. PMID- 3524071 TI - [Rheumatoid joint swellings in post-traumatic pancreatitis in childhood]. PMID- 3524072 TI - [Forensic evaluation of medical malpractice from the historical viewpoint]. AB - Damage caused to patients by medical treatment, including surgery, used to be covered by penal law for long periods in the past. This had entailed considerable difficulties primarily in surgical practice. Reported in this paper are court rulings in the course of history. This is out of question in the GDR. Surgical interventions cannot be penalized. PMID- 3524073 TI - [Value of the oral glucose tolerance test for diagnosis of intrauterine fetal retardation]. AB - Oral glucose tolerance test using 50 g glucose has been done in 76 pregnant women. The newborns were subdivided in 3 groups: under the 5., under the 10. and above the 10. weight percentile. The glucose tolerance test had no predictive value for the diagnosis of intrauterine growth retardation. PMID- 3524074 TI - [The history of modern neurosurgery]. PMID- 3524075 TI - [A simple aid for the localization of intracranial tumors in cerebral computer tomography]. AB - The exact localizing co-ordination of small intracranial, space-occupying processes is sometimes difficult. As a simple aid for exact localization of such processes a "rod headband" is presented, which consists of a leather strap with exchangeable plastic rods and can be put on the patient's forehead for a CT examination. The artifact-free representation of the little rods in the axial CT layers makes it possible to localize intracranial processes more exactly. Until now, the "rod headband" has been used for ten patients with the following indications: Needle biopsies of intracranial space-occupying processes, cerebral abscess punctures, haematoma punctures, and as a pre-operative localization aid for intracranial tumours. PMID- 3524076 TI - [Detection of IPNV-antibodies in trout sera with an indirect immunofluorescence technic]. PMID- 3524077 TI - [Bacteria of the genus Acinetobacter. Methods for their isolation and primary identification]. AB - A liquid accumulation medium and a solid isolation medium for primary identification of bacteria of the genus Acinetobacter have been proposed. Both media have identical composition and contain ethanol as the only source of carbon and energy and sodium ammonium phosphate as the source of nitrogen. Besides, the modification of Baumann's medium with sodium acetate as the source of carbon and potassium nitrate as the source of nitrogen has been developed. This modified medium has simplified composition and is not inferior to the above-mentioned media in selectivity, though its use gives less satisfactory results. The two proposed media, both liquid and solid, are recommended for wide use. PMID- 3524078 TI - [Comparative evaluation of different methods for typing bacteria in the genus Proteus]. AB - The work presents the comparative evaluation of different methods used for differentiating bacteria of the genus Proteus. A scheme of the combined typing of Proteus is presented. This scheme includes the determination of enzymatic and serological variants with the subsequent additional bacteriocinogenic and phage typing. Among the Proteus strains in our collection (600 strains), 123 sero enzymatic variants, 71 enzymo-lysogenic variants, 64 enzymo-bacteriocinogenic variants, 162 sero-lysogenic variants, 164 sero-bacteriocinogenic variants and 52 bacteriocinogeno-lysogenic variants have been detected. PMID- 3524079 TI - [Biochemical properties of Shigella flexneri and their practical significance]. AB - As the result of the study of 921 S. flexneri strains 1-6 and 4 (IV: 7,8), isolated in 31 regions of the USSR in 1975-1984, their biochemical characterization by 33 tests was made. All the strains under study proved to be typical in most of their constant signs, only some of strains 2a showed deviations in mannitol and some of strains 4a, in acetate. In strains of serovar 6, circulating in the USSR, specific features with respect to dulcitol and xylose were noted. The possibility of the biochemical subserovar typing of S. flexneri 1 5, X- and Y-var., with respect to maltose, arabinose, sorbitol and rhamnose was confirmed. PMID- 3524080 TI - [Characteristics of the tissue population cycle of shigellae]. AB - In experiments on human fetal intestinal explants infected with shigellae the specific multiplication rate of these infective agents, found to be 0.026, and the maximum level of their accumulation in erythrocytes, reaching 22-36 microbes per cell, have been determined. These phenomena can be observed after at least 3 hour incubation and end in the release of the infective agents from the affected area with shedding epithelial elements (villi). Shigellae, aggregated in the shed villi easily adhering to the unaffected mucosa, ensure the intensive invasion of the epithelium, which leads to the continuation of the process. The regularity thus revealed indicates that the population cycle of the development of shigellae is limited by short intervals of 3-4 hours. During these intervals the repeated invasion and the release of shigellae, together with the shed epithelium, into the chyme-containing intestinal cavity occur. The conditions for the multiplication of shigellae and their specific multiplication rate in chyme are minimal (0.016). PMID- 3524081 TI - [Immunocytochemistry of Clostridium novyi antigens. Electron microscopic research]. AB - The dynamics of the synthesis, transfer and excretion of toxin in C. novyi, growing in a liquid culture medium, have been studied on the level of bacterial ultrastructure by means of immunoferritin techniques modified by the authors. As revealed in this study, the basic mechanism of toxin excretion is realized by the active transfer of toxin through the enveloping structures after its accumulation in the periplasmatic space. In ageing cultures toxin may also be released in the process of bacteriolysis with the degradation of bacterial structures. PMID- 3524082 TI - [Natural population migration and the dysentery epidemic process]. AB - The complex analysis of materials obtained in different regions and territories of the Far East makes it possible to establish that the natural migration of population affects dysentery morbidity by enhancing the susceptibility of human population to this infection. The internal mechanisms of the influence exerted on morbidity by the natural migration of population is disclosed from the viewpoint of the theory of the self regulation of the epidemic process. PMID- 3524083 TI - [Effect of the lymphocytosis-stimulating factor from Bordetella pertussis on murine lymphoid and hemopoietic cells]. AB - Effect of B. pertussis lymphocytosis-promoting factor (LPF) on the lympho hematopoietic system of mice was studied. The injection of LPF was shown to sharply enhance endogenous colony formation and to induce a severe depletion of thymus cells, reaching its maximum of day 4. Thymocytes obtained on day 2 or 3 after the injection of LPF produced a suppressive effect on endogenous colony formation. The proliferative activity of hematopoietic stem cells sharply increased under the influence of LPF, though it had no radioprotective action. On the following day after the injection of LPF a steep rise in the number of hematopoietic stem cells was observed in the blood of mice: their content increased 20-fold in comparison with the control level. These data may be important for the evaluation of the side effects of pertussis vaccine on the lympho-hematopoietic system. PMID- 3524084 TI - [Quantitative immunofluorescence. Aspects of its practical use]. PMID- 3524085 TI - [Anti-idiotypes. The prospects for their use in microbiology]. PMID- 3524086 TI - [An autolyzed antigen-extracted alloimplant (AAA bone)--a new bone derivative tested in rabbits]. PMID- 3524087 TI - [Use of a strip of the ilio-tibial tract to reinforce a suture in the anterior cruciate ligament]. PMID- 3524088 TI - Separate thoracic and abdominal lymph flow in the dog. AB - We present results from an improved dog model, in which lymph flows from the thorax and abdomen are separated. The effect of increased alveolar pressure on lymph flows was studied by the application of positive end expiratory pressure (PEEP). Mean (+/- SD) thoracic lymph flow in 10 dogs was 4.1 ml/h (+/- 2.9) before, and 27.0 ml/h (+/- 17) after the induction of lung damage with oleic acid. Thoracic lymph flow was depressed by 50% with the application of a PEEP of 1.0 kPa (10 cm H2O), both before and after lung damage, thus impeding the drainage of the lung tissue. Abdominal lymph flow increased from 57 +/- 29 ml/h to 111 +/- 65 ml/h with the application of a PEEP of 1.0 kPa. These simulated events in a surgical area demonstrate the risk of causing excessive edema with PEEP. We conclude that if the application of PEEP in a clinical situation is necessary then the additional risk factors (increased extravascular lung water, increased edema in surgical areas) that have been presented should be taken into consideration. PMID- 3524089 TI - Thrombophlebitis and septicemia--complications related to intravascular devices and their prophylaxis. A review. PMID- 3524090 TI - [History of the Manchurian Medical School Anatomy Department]. PMID- 3524091 TI - Regional cerebral blood flow after occlusion of the middle cerebral artery. AB - Occlusions of the middle cerebral artery (MCA) are mostly of embolic origin (appr. 80%) and give rise to about one third of all ischemic strokes, most of these being major strokes. MCA occlusions lasting for less than 1/2 h are tolerated without occurrence of permanent tissue damage. Occlusions lasting between 1/2 h to 4-8 h lead to permanent tissue damage and neurological deficits that are proportional to the duration of occlusion. Maximal tissue damage is obtained after 4-8 h occlusion. A cerebral blood flow of 8-23 ml/100 gr/min is sufficient for cellular viability but insufficient for normal tissue function ("ischemic penumbra"). Cellular function is completely abolished in the interval 8-16 ml/100 gr/min and flow at that level is tolerated only for 1-3 h before neuronal death ensues. In the interval 18-23 ml/100 gr/min there is some functional activity although it is reduced. Experimental and clinical evidence suggests that flow in this interval may be tolerated for several days, months or even longer ("chronic ischemic penumbra"). After MCA occlusion the blood flow falls below 8 ml/100 gr/min in most cases and permanent MCA occlusion always leads to relatively large areas of frank infarction. The ischemic infarcts may be surrounded by collaterally perfused areas where the blood flow is pressure dependent (impaired autoregulation) and quite commonly insufficient for normal neuronal function (below 23 ml/100 gr/min). Such collaterally perfused areas may include a "chronic ischemic penumbra". Emboli causing MCA occlusions commonly disintegrate and/or migrate more peripherally within the first few weeks post stroke. This leads to reperfusion and changes of ischemic infarcts into hyperemic infarcts where flow is severely increased. The vascular reactivity is completely abolished in hyperemic infarcts and the hyperemic state lasts for about two weeks. Probably, anemic infarcts are equivalent to ischemic infarcts while the hemorrhagic variety is equivalent to hyperemic infarcts. The "partial infarct" with selective neuronal necrosis occurs in experimental animals after MCA occlusions of less than four h but not after permanent MCA occlusion. The significance of partial infarction in human stroke is not clarified. The extent of irreversible tissue damage can be reduced only if therapy sets in within 4-8 h after the occlusion. If a "chronic penumbra" exists the extension of reversible tissue damage can be reduced if therapy aimed at increasing the blood flow in the penumbra sets in within weeks or even months after the stroke.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3524092 TI - Comparison of mefenamic acid and propranolol with placebo in migraine prophylaxis. AB - The prophylactic effects of the antiprostaglandin agent mefenamic acid on migraine attacks were compared with propranolol or placebo in a double-blind crossover study of 29 patients. In the 17 patients who completed the trial the frequency of attacks and their total duration were significantly reduced during mefenamic acid therapy or propranolol therapy as compared to placebo. There were no significant effects of mefenamic acid or propranolol on average duration or severity of migraine attacks. The study suggests that mefenamic acid and propranolol are equally effective for migraine prophylaxis. PMID- 3524093 TI - Effect of occlusal adjustment on mandibular dysfunction. A double-blind study. AB - A group of headache patients who also had many signs and symptoms of mandibular dysfunction were randomly assigned to treatment and placebo groups. All 48 patients in the treatment group received occlusal adjustment and 19 of them also splint therapy. In the placebo group all 43 patients received mock adjustment. The changes in symptoms and signs of mandibular dysfunction were evaluated after 8 months in the treatment group and after 4 months in the placebo group, in a double-blind design. Placebo treatment and real treatment were equally effective in relieving symptoms of mandibular dysfunction, but there was significantly more reduction in signs of dysfunction in the treatment group than in the placebo group. When tested statistically, this reduction appeared to be independent of the use of splints as an aid to treatment. It can be concluded that the elimination of occlusal disturbances was an effective treatment for mandibular dysfunction. PMID- 3524094 TI - Vestibular and lingual muscular pressure on complete maxillary dentures. AB - Denture retention may be defined as the ability of a denture to remain seated on the supporting tissues under various conditions. Soft tissue function influences the retention of removable prostheses by exerting pressure against the polished surfaces. The magnitude of this pressure on complete maxillary dentures under experimental conditions was studied. Five denture wearers participated. Miniature pressure transducers were placed at nine selected locations on the polished surfaces of the dentures: one on each tuberosity, three along the vibration line, and four on the vestibular flanges. The transducers were flush with the polished surfaces but discernible to the participants. Ultra-thin electrical wires connected the transducers to a power supply and recording equipment. Loading the incisors with 40 N in a cranial direction elicited soft-tissue pressure against the transducers. The highest values were recorded in the region of the tuberosities (51 kPa). Intermediary values were recorded along the vibration line (27 kPa), and the lowest pressure was recorded on the vestibular flanges (17 kPa). PMID- 3524095 TI - Effects on retention of reducing the palatal coverage of complete maxillary dentures. AB - Twenty patients with complete dentures in both jaws gave up their maxillary ones for experimental purposes for 4 weeks while new dentures were made. The experimental dentures were reduced palatally to a new U-shaped border situated approximately 10 mm from the dental arch. Denture retention, defined as the ability of a denture to remain seated on the supporting tissues under various conditions, was measured as resistance towards cranially directed tilting loads, using a miniature bite force recorder. Dislodgement-provoking loads were applied to the first bicuspid on both sides and to the central incisors. The retention measurements were performed before and immediately after reduction of the palatal coverage and, finally, after 4 weeks. Interview questions were posed concerning the subjects' experience of denture retention and some other aspects of oral comfort. The interviews were carried out before reduction of the palatal coverage and after 2 and 4 weeks. The results of the experimental dislodgement tests suggested that the ability to withstand tilting loads was insignificantly altered by reduction of the palatal coverage. This finding was in agreement with responses indicating that retention during meals remained unchanged. However, several individuals reported that denture retention between meals was impaired. Three denture wearers reported that reduction of the palatal coverage influenced their sense of taste positively, and one reported that an occasional gagging tendency had disappeared. At the end of the experiment the participants were given the choice of a new conventional denture or a new denture without palatal coverage.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3524096 TI - Serum uric acid correlates with beta 2-microglobulin in pre-eclampsia. AB - In order to evaluate renal tubular function, beta 2-microglobulin was measured in serum and urine from 15 patients with severe pre-eclampsia and 13 normal pregnant women. In the pre-eclamptic group, the serum beta 2-microglobulin level was significantly higher (p less than 0.05) and urinary excretion/24h significantly lower (p less than 0.05), than in the normal pregnant group. A positive linear correlation between serum uric acid and beta 2-microglobulin was observed both in the pre-eclamptic group (r = 0.79, p less than 0.001) and in the normal pregnant group (r = 0.58, p less than 0.05). This may indicate that production and renal handling of these two substances are interdependent. Tubular function is reduced in normal pregnancy, whereas increased 'net tubular reabsorption' of uric acid and beta 2-microglobulin occurs in pre-eclampsia. The cause of the observed changes in tubular function is still obscure. PMID- 3524097 TI - Ultrasonic assessment of cervix in 'at risk' patients. AB - One hundred and fifteen women were considered to be at risk of cervical incompetence, judging from their previous history. They were scanned serially from the first trimester to 32 weeks of gestation. Of the 115, 75 women were found to have defective cervix, as assessed on the basis of its length, its overall width and the width of the cervical canal at the level of the internal cervical os, and herniation of the amniotic membrane, with or without fetal parts, into the cervical canal. Sixteen of the 75 women with ultrasonically diagnosed cervical incompetence aborted, 40 needed cervical cerclage, 24 gave birth premature (24 to 34 weeks). Of the 115 women, 40 did not have ultrasonic evidence of cervical incompetence and only one patient gave birth at 36 weeks' gestation, while 39 patients gave birth between 37 and 42 weeks. These 40 women would have had cervical cerclage on the basis of clinical history alone. Ultrasound is an objective method of diagnosing the incompetent cervix and also helps to avoid unnecessary cerclage operations on the basis of history alone. PMID- 3524098 TI - Growth in breech presentation. Ultrasound and post-partal assessment of growth in 225 fetuses presenting by the breech in the 33rd gestational week. AB - 225 fetuses with ultrasonically determined gestational age were shown by ultrasound to be in breech presentation in the 33rd gestational week. The biparietal diameter (BPD) and the mean of two perpendicular abdominal diameters (AD) were measured ultrasonically in gestational weeks 33, 35, and 38. Based on these measurements, fetal weight was estimated and compared with weight, length, and head circumference at birth and at 18 months of age. 42% of the fetuses were born in breech presentation (breech group) and 58% in vertex presentation (vertex group). The mean birth weight corrected for gestational age was 4.9% lower in the breech group than in the vertex group, which corresponds to the lower intra uterine values of BPD and AD found in the breech group. The weight differences at birth still persisted at 18 months of age. There were no differences between the groups regarding head circumference or length, either at birth or at 18 months of age. PMID- 3524099 TI - Intra-uterine weight curves obtained by ultrasound. AB - Using multiple regression analysis, a formula was evolved for estimating fetal weight in utero, based on fetal biparietal diameter (BPD), abdominal diameter (AD) (mean of two orthogonal readings), and femur length (FL), measured by ultrasound within 48 hours before delivery or legal abortion in a stratified sample of 89 pregnancies, approx. 10 in each 500-g weight class up to 5 000 g. Tested on 135 neonates of varying birth weights, the formula evolved, wt = BPD0.972 X AD1.743 X FL0.367 X 10(-2.647), neither under- nor over-estimated weight in any weight class, the error in estimates having a standard deviation of 7.1%, and maximum error being 18% of true weight. To establish an intrauterine growth curve, the formula was applied to 177 longitudinal measurements in 19 normal pregnancies; the estimated weight against gestational age (GA) curve so obtained best fitted a third-degree equation, wt = 1443.4 - 32.32 X GA + 0.203 X GA2 - 0.000215 X GA3 (r2 = 0.978), tallying closely with the birth weight curve obtained in the same population from 4743 pregnancies where gestational age had been assessed by ultrasound in early pregnancy. The present two growth curves, based on fetometry and on birth weight, differ from previous curves used almost universally by pediatricians. PMID- 3524100 TI - [Diaphyseal pseudoarthrosis of the humerus. Clinical and radiographic results in 147 surgical cases]. PMID- 3524101 TI - Nervus facialis (N. VII). PMID- 3524102 TI - Facial nerve surgery. PMID- 3524103 TI - Nerve suturing and grafting. PMID- 3524104 TI - Oral rehydration therapy in malnourished infants with infectious diarrhoea. AB - The clinical response and changes in water and salt homeostasis was studied for 36 hours during oral rehydration therapy with a rehydration solution containing 60 mmol sodium/l (ORS60) in 14 malnourished 3- to 15-month-old Turkish infants with acute infectious diarrhoea. All patients were successfully rehydrated with this treatment. Sodium was efficiently absorbed from the gut and water balance was rapidly restored. Because of excess fluid retention following the initial rehydration period about 50% of the patients became oedematous. Urine volume and urinary sodium excretion were found to be much lower than in well-nourished patients of the same age with acute diarrhoea who were treated in the same way. In all of the malnourished infants the serum sodium level remained within the normal range during treatment. The results show that malnourished infants retain much more fluid and sodium than infants who are in a normal nutritional state. Excessive retention of water and salt seem to be due to an inability of the kidneys to control sodium and fluid homeostasis while orally administered sodium and fluid are being absorbed from the gut. The results show that ORT is safe and efficient in the treatment of malnourished infants with acute diarrhoea. But since these infants run a high risk of developing a severe retention of fluid and salt, and consequently may develop circulatory failure due to hypervolaemia during oral rehydration therapy, it is important to carefully monitor the volume of fluid that is given. PMID- 3524105 TI - Periventricular leukomalacia: ultrasonic diagnosis and neurological outcome. AB - The ultrasonographic findings and neurological development of 15 preterm infants, born between August 1981 and July 1984, who developed periventricular leukomalacia (P.V.L.) are described. The incidence of P.V.L. in infants with a birth weight less than 1 500 g was 2.3%. Nine of the 15 infants demonstrated areas of increased echogenicity in the periventricular regions prior to the development of cystic changes. The mean age for the appearance of cysts was 26 days. At follow-up 14 infants showed evidence of abnormal motor development and 8 infants had visual defects. All infants appear to have normal hearing, but 3 infants show signs of delayed speech. To date, only 2 infants demonstrate signs of mental retardation, but many of the infants are too young to assess intelligence accurately. PMID- 3524106 TI - Local urokinase for the treatment of ventriculitis complications. PMID- 3524107 TI - An infant with simultaneous beta-lactamase-positive Haemophilus influenzae meningitis and beta-lactamase-negative H. influenzae septicemia, Escherichia coli pyelonephritis and herpes encephalitis. AB - We describe an infant with meningitis and septicemia due to infection with two different strains of Haemophilus influenzae, with a urinary tract infection due to Escherichia coli and in whom herpes virus encephalitis was diagnosed within three days. Acinetobacter calcoaceticus septicemia developed three weeks later. No immunological deficiency could be demonstrated in the patient who recovered finally, albeit with sequelae due to encephalitis. PMID- 3524108 TI - Endocrine cell carcinoma of extrahepatic bile duct. AB - An endocrine cell carcinoma of the extrahepatic bile duct in a 79-year-old man is described. The patient had complaints of jaundice and epigastric pain due to a small tumor located at the confluence of the common hepatic duct with the cystic duct. Microscopically, the tumor showed a well differentiated tubular adenocarcinoma and was confined to the mucosa. Numerous tumor cells showed argyrophil and/or argentaffin reactions. Immunoperoxidase staining revealed that the tumor tissue contained somatostatin-, gastrin-and serotonin-immunoreactive cells. From these findings the tumor was diagnosed as endocrine cell carcinoma. Four years later he remains well without any evidence of recurrence or metastasis. The histogenesis of endocrine cells in the biliary tract is briefly discussed. PMID- 3524109 TI - Aggregation of fibronectin by asbestos fibers in the pericellular matrix of cultured human fibroblasts. AB - Asbestos fibers, silica dust and glass fibers induced aggregation of the pericellular matrix fibronectin when added to the growth medium of cultured human fibroblasts as judged by immunofluorescence microscopy. Direct binding experiments and analysis of the bound proteins by (SDS-polyacrylamide gel electrophoresis) revealed an adsorption of purified plasma fibronectin to glass fibers, amosite, crocidolite and silica but not to anthophyllite and chrysotile A and B. The results suggest that aggregation of the pericellular fibronectin by these fibrogenic materials may be involved in the initial stages of the development of fibrosis in vivo. PMID- 3524110 TI - Bronchial carcinoids and phaeochromocytomas. A comparative study with special emphasis on S-100 protein, serotonin and neuron-specific enolase (NSE) immunoreactivity. AB - A comparative study of bronchial carcinoids (9 cases) and phaeochromocytomas (8 cases) were performed. Both types of tumour exhibited neuron-specific enolase (NSE) immunoreactivity and an argyrophil reaction, and displayed a few scattered argentaffin and serotonin immunoreactive tumour cells. In addition, four of the nine bronchial carcinoids and six of the eight phaeochromocytomas were S-100 protein immunoreactive. The stained cells were located mainly in the periphery of the tumour cell aggregates and possessed long cytoplasmic processes surrounding unreactive tumour cells. The similarity between the two tumour types, especially in their morphology and S-100 protein immunoreactivity, indicates that bronchial carcinoids, or at least some of them, are histogenetically closely related to phaeochromocytomas and might derive from the peripheral nervous system. PMID- 3524111 TI - Evaluation of rapid methods for the detection of bacteriuria (screening) in primary health care. AB - The diagnostic performance of six methods for bacteriuria testing has been studied in 781 urine specimens obtained in primary health care, using conventional culture as reference method. The cut-off limits for classification of test results into positive and negative have been optimized with respect to diagnostic performance in primary health care. With optimized tests the following diagnostic efficiencies were obtained: Bacterial ATP, 0.94; Bacterial count in sediment, 0.93; Nitrite test, 0.92; Dipslide test, 0.92; White cell count in sediment; 0.87; Goffulocyte esterase test; 0.83. The diagnostic performance was also studied for all combinations of two tests. The highest diagnostic efficiency (0.96) was obtained by combining the ATP and dipslide tests. High diagnostic efficiencies can be obtained by a rapid primary test, using other tests for follow-up testing of specimens with intermediate or uninterpretable primary results. The most promising results were obtained by using ATP as the primary test, with follow-up testing of specimens with 3-25 nmol/l of ATP (12 per cent of the specimens). Follow-up testing by conventional culture resulted in overall diagnostic efficiency of 0.98. By performing the nitrite test on specimens with intermediary ATP-results, 81 per cent of the patients with UTI can be classified without culture. Only patients with intermediary ATP and negative nitrite results (10 per cent of the total number) will have to wait for final diagnosis based on conventional culture. Some alternative strategies to combine available methods are discussed in detail. Major advantages of the ATP test are that the test can be performed while the patients are waiting; it provides a numerical and objective result, and, in contrast to culture, it is not influenced by adhesion of bacteria to somatic cells. PMID- 3524112 TI - Evaluation of Minibact, a new system for rapid identification of Enterobacteriaceae. Comparison of Minibact, Micro-ID and API 20E with a conventional method as reference. AB - Minibact, a new system for four-hour identification of Enterobacteriaceae, combined with a computer identification system, was compared with Micro-ID and API 20E in testing 110 strains of Enterobacteriaceae. Minibact gave identification rates of 96.4% at species level and 96.4% at genus level; the corresponding values for Micro-ID were 87.3% and 91.8%, and for API 20E 91.8% and 94.5%. In conclusion, Minibact combined with a computer identification program gave high identification rates fully comparable to those of Micro-ID and API 20E, and the system might be an alternative to conventional identification systems in clinical microbiological departments. PMID- 3524113 TI - Morphological study of the in vitro cytotoxic effect of alpha-hemolytic E. coli bacteria and culture supernatants on human blood granulocytes and monocytes. AB - The morphological changes of human blood granulocytes and monocytes caused in vitro by alpha-hemolytic strains of E. coli and bacteria-free culture supernatants of these bacteria were studied by light- and transmission electron microscopy. The following sequence of cellular alterations were observed: Cessation of intracellular cytoplasmic streaming and cellular movements succeeded by extension of cytoplasmic pseudopodia, degranulation and development of cytoplasmic and nuclear edema. Within two hours the leukocytes appeared as empty sacks. Finally, long straight filaments were formed between the cells. The changes induced by alpha-hemolytic bacteria and culture supernatants containing free alpha-hemolysin appeared to be identical. The cytotoxic effect became more pronounced as the numbers of bacteria, the hemolytic activity of growth supernatants or the period of incubation were increased. A beta-hemolytic and a nonhemolytic E. coli strain were not cytotoxic. PMID- 3524114 TI - On the muscarinic receptors in the urinary bladder and the putative subclassification of muscarinic receptors. AB - The muscarinic cholinergic receptors in the urinary bladders of man, guinea pig, rat and rabbit were studied by means of a receptor binding technique, with l quinuclidinyl [phenyl 4-3H]benzilate, (-)3H-QNB, as radioligand. The potential role of the receptors in the supersensitivity of the rat bladder to muscarinic agonists, following parasympathetic denervation, hypertrophy and urinary diversion, was also investigated. In addition, the binding of various unlabelled antimuscarinic drugs in the guinea pig bladder was compared to that in other tissues in order to study the putative muscarinic receptor subtypes, commonly referred to as M1 and M2. According to this classification the putative M1 receptors prevail in discrete areas of the brain, whereas the M2-receptors predominate in peripheral tissues, such as the exocrine glands and smooth muscles. The receptor density (but not the qualitative properties of the receptors) in the bladder differed between the species. The affinities of various antimuscarinic drugs were virtually identical in the guinea pig and human bladders. In both species, the binding data were found to correlate with functional in vitro data. In the rat bladder, the receptor density was increased after denervation but decreased, below control values, when the denervation was combined with urinary diversion. A decrease was also found after urinary diversion of innervated bladders, whereas the receptor density was unaffected by hypertrophy. These results suggest that the receptors are not involved in the development of supersensitivity and that the receptor levels may be influenced by the functional state of the bladder. Binding studies with classical muscarinic antagonists indicated that the receptors in the guinea pig bladder are indistinguishable from those in the ileum, heart, parotid gland and cerebral cortex. However, four drugs--namely, oxybutynin, dicyclomine, benzhexol and pirenzepine had a much higher affinity for the receptors in the parotid gland and cortex than for those in the other tissues. Moreover, dicyclomine and benzhexol, like pirenzepine, seemed in the cortex to distinguish between two classes of sites exhibiting high and low affinity. The high affinity sites could be selectively labelled with 3H-benzhexol. The ability of oxybutynin, dicyclomine, benzhexol and pirenzepine to discriminate between the receptors in the parotid gland and those in smooth muscle provides further evidence that the M1/M2 concept is inaccurate. The present data indicate that there may be three classes of muscarinic antagonist binding sites. PMID- 3524115 TI - Repeated exercise regulates glucose transport capacity in skeletal muscle. AB - The present study was undertaken to test the hypothesis that a muscle's habitual level of contractile activity might act as a long-term regulator of glucose transport capacity. Rats were rendered severely diabetic by injection of streptozotocin, 125 mg kg-1 body wt. Three days after the injection, insulin stimulated and contraction-induced 3-methylglucose transport in the in vitro epitrochlearis muscle preparation was reduced to 25% and 52% of control capacity, respectively (P less than 0.001). However, when repeated 1-h swimming sessions (twice a day) were introduced during the 3 days of insulin deficiency, the reduction in contraction-induced glucose transport capacity was completely abolished. This indicates that the habitual level of contractile activity of a muscle regulates its capacity for exercise-stimulated glucose transport. Furthermore, one exercise session and a maximal insulin stimulus had an additive effect on 3-methylglucose transport, suggesting that there are two pools of intracellular glucose transporters or two mechanisms for mobilizing the same pool. PMID- 3524116 TI - Sympathetic nerve activity and central haemodynamics during mechanical ventilation with positive end-expiratory pressure in rats. AB - The aim of this study was to examine the effects of mechanical ventilation with increasing levels of positive end-expiratory pressure (PEEP) on sympathetic nerve activity (SNA), cardiac output (CO), stroke volume (SV), heart rate (HR), central blood volume (CBV), total peripheral resistance (TPR), mean arterial pressure (MAP), pulse pressure (PP) and right and left atrial transmural pressure in chloralose anaesthetized rats before and after vagotomy. Changing ventilatory pattern from spontaneous breathing (SB) to artificial ventilation with 10 cm H2O PEEP in intact animals caused a significant fall in CO, SV and CBV (42, 48 and 17%, respectively) and an increase in SNA, HR and TPR (90, 13 and 83%, respectively). The MAP increased slightly but significantly from 103 +/- 4 to 107 +/- 4 mmHg while PP decreased from 48 +/- 2 to 37 +/- 3, from spontaneous breathing (SB) to 10 cm H2O PEEP. Transmural left atrial pressure decreased significantly from 4.5 +/- 0.3 to 3.0 +/- 0.4 mmHg. After vagotomy, MAP and CO were significantly lower at 10 cm H2O PEEP and PP and SV were significantly lower at all levels of positive end-expiratory pressure than the corresponding prevagotomy values. In spite of a greater fall in MAP and PP during PEEP after vagotomy, the absolute and relative increase of SNA was significantly lower compared to corresponding prevagotomy values. We conclude that reflex cardiovascular adjustments elicited by ventilation with PEEP are not solely due to unloading of arterial baroreceptors as has been claimed by others. Unloading of cardiac receptors with tonically active inhibitory afferents in the vagi is probably also of great importance for the excitation of the sympathetic nervous system during mechanical ventilation with PEEP. PMID- 3524117 TI - Effects of small changes of plasma vasopressin on subcutaneous and skeletal muscle blood flow in man. AB - The effect of vasopressin (AVP) on subcutaneous blood flow was studied by the 133Xenon wash-out method in 13 healthy subjects during three consecutive infusions of synthetic AVP, using increasing infusion rates. In seven of them, both subcutaneous and skeletal muscle blood flows were measured during the first infusion. The preinfusion, and infusion pAVP levels were 1.6 +/- 0.4, 3.4 +/- 0.4, 4.9 +/- 0.5 and 8.8 +/- 0.7 pg ml-1, respectively (mean +/- SE). The values are within the range normally found during dehydration. During the AVP infusions, the blood flow in subcutaneous tissues decreased 30-40% and the vascular resistance increased 60-80%. Neither heart rate nor blood pressure change significantly during the infusions. Plasma renin activity (PRA) decreased significantly. After cessation of the infusions, blood flow and vascular resistance rapidly returned to preinfusion values, while PRA increased very slowly. Skeletal muscle and subcutaneous tissues blood flows were found to be equally sensitive to small changes in the pAVP level. The present study has demonstrated that even minor increments of pAVP levels, as seen during dehydration, can significantly alter the regional blood flow in subcutaneous and skeletal muscle tissues in man. PMID- 3524118 TI - Unilateral denervation of the rat urinary bladder and reinnervation: a predominance for ipsilateral changes. AB - Unilateral removal of the pelvic ganglion affected the bladder-half on the denervated side more profoundly than that on the non-denervated side. At an early stage (3-7 days) the former was heavier, had a lower choline acetyltransferase activity, developed less tension to nerve stimulation and, in course of time, became more sensitized to methacholine in vitro than the latter. At a late stage (30-60 days) the nerve-evoked contractile responses on the denervated side had increased, which was almost wholly attributed to the atropine-sensitive part of the contraction, but the recovery was not complete. On the non-denervated side the nerve-evoked responses were not significantly changed. It was calculated that in the normally innervated bladders 25-30% of the cholinergic nerves of each half were of contralateral origin. The figure was lower (18%) for the nerves mediating the atropine-resistant response. PMID- 3524119 TI - A comparative study on the antipsychotic properties of desenkephalin-gamma endorphin and ceruletide in schizophrenic patients. AB - The neuropeptides desenkephalin-gamma-endorphin (DE gamma E) and ceruletide were administered intramuscularly to patients with schizophrenic psychoses following a double-blind placebo-controlled design, including a total of 44 subjects. Neuroleptic medication was continued during the experimental period, which was started with one placebo injection for all patients. One week later subjects received a single intramuscular injection with 3 mg DE gamma E, 40 micrograms ceruletide or placebo. After an interval of 10 days, the patients received six similar injections over a period of 2 weeks. Treatment with either peptides resulted in a decrease of psychotic symptomatology as compared to placebo treatment. The beneficial effect of the peptides lasted at least 2 weeks after the experimental treatment period. Of the 14 patients treated with placebo only, three showed a slight response. Of the 30 patients treated with the neuropeptides, eight did not respond (DE gamma E: 3; ceruletide: 5), eight had a slight response (DE gamma E: 6; ceruletide: 2) and 14 responded moderately or markedly (DE gamma E: 6; ceruletide: 8). No obvious difference between the effects of the two neuropeptides was found, besides a somewhat earlier onset of the effect of ceruletide. Patients presenting relatively less negative psychotic symptoms were particularly susceptible to treatment with either peptide. Apart from slight and short-lasting gastrointestinal complaints after the first injections with ceruletide in some patients, no side effects were observed. PMID- 3524120 TI - Hypothalamo-pituitary-adrenal response to insulin-induced hypoglycemia in subjects with different degrees of obesity. PMID- 3524121 TI - [Malignant forms of Plasmodium falciparum malaria]. PMID- 3524122 TI - [Correia Garcao and dermatology]. PMID- 3524123 TI - [Creutzfeldt-Jakob disease]. PMID- 3524125 TI - [Re: Transplantation of kidneys from children to adults]. PMID- 3524124 TI - ["It happened 75 years ago". The Spanish Association of Urology founded 19 January 1911]. PMID- 3524126 TI - [Ectopic ureterocele in duplicated kidney. Prenatal diagnosis with early post natal surgery. Contribution of 2 cases]. PMID- 3524127 TI - [Renal function: implications in the normal and abnormal development of the urinary tract; role of echography]. PMID- 3524128 TI - [Sepsis caused by suppuration of a simple renal cyst]. PMID- 3524129 TI - [Adrenal masses accidentally discovered. An increasingly frequent pathology]. PMID- 3524130 TI - Jarvis Edwin Seegmiller: his contribution to research on purine metabolism, a background to the Fifth International Symposium on Human Purine and Pyrimidine Metabolism--July 28th to August 1st, 1985, San Diego, California, U.S.A. PMID- 3524131 TI - Purine and pyrimidine metabolism in man V. Part A: Clinical aspects including molecular genetics. Festschrift for J.E. Seegmiller. PMID- 3524132 TI - Bone marrow transplantation in Lesch-Nyhan disease. PMID- 3524133 TI - An appreciation of DeWitt Stetten, Jr. PMID- 3524134 TI - Expression of murine ADA cDNA in bacterial and mammalian cells. PMID- 3524136 TI - A study of adenosine deaminases in human sera. PMID- 3524135 TI - Sequence of the E. coli APRT gene. PMID- 3524137 TI - Zinc-mediated urate binding to human albumin. PMID- 3524138 TI - Spontaneous variations in the renal handling of uric acid. PMID- 3524139 TI - A new family with APRT partial deficiency: studies on purine and uric acid metabolism. PMID- 3524140 TI - The effects of ADA inhibition on B cell differentiation in the rat. PMID- 3524142 TI - Alcohol and substance use and abuse in women and children. PMID- 3524141 TI - Inhibition of 3H-thymidine incorporation by guanosine and deoxyguanosine in human lymphoid cells. PMID- 3524143 TI - [Early marriages in the 12th to 19th centuries]. PMID- 3524144 TI - Prof. Dr. Dankwart Ackermann--the 20th anniversary of his death. PMID- 3524145 TI - An assay for proteoglycanase (PGase) and it's application to articular chondrocyte cultures. AB - The role of PGase in the degradation of cartilage proteoglycans (PG) is still unclear. Although several assays are available, there still exists some problems in the sensitivity, specificity and simplicity of these procedures. We therefore decided to develop an improved assay for PGase in order to detect small quantities of enzyme activity in the culture medium of articular chondrocytes. As substrates of PGase, we prepared fluorescein isothiocyanate labelled core protein (FITC-PGC) and fluorescein amine labelled hyaluronic acid-proteoglycan subunit complex (FAHA-PGS) from new born calf costal cartilages. PGase activity was estimated from the change of elution profile of Sepharose CL-4B chromatography of fluorescein labelled substrates after incubation with the activated enzyme solution. For measurement of PGase in large numbers of samples, we developed the microultrafiltration method using ultrafiltration membrane (MPS-I kit, Amicon). The concentrated media of articular chondrocyte cultures was used for the investigation of the nature of PGase(s) derived from articular chondrocytes. It was found that APMA, CoCl2, and CaCl2 were needed for activation of the enzyme. Sephadex-G75 gel chromatography of the crude enzyme solution suggests that the molecular weight of PGase from rabbit articular chondrocytes was approximately 5 X 10(4) daltons. From the results of gel chromatography of the digested FITC-PGC and FAHA-PGS it was concluded that one of the sites of attack of the chondrocyte secreted PGase might be near the hyaluronic acid binding region of core protein. The effects of various agents on the production of PGase were also studied. Interleukin-I was found to stimulate PGase production in cultured articular chondrocytes. PMID- 3524147 TI - Changes in cartilage proteoglycan structure during ageing: origin and effects--a review. PMID- 3524146 TI - The effect of interleukin-1 on connective tissue metabolism and its relevance to arthritis. AB - Interleukin-1 (IL-1) is the name given to a family of related proteins showing a variety of activities. It was originally shown to be produced by monocytes and macrophages but is now known to be produced by numerous cell types, including synovial cells. From the point of view of arthritis, its most interesting activities are those on connective tissue cells in vitro. These include stimulation of production of prostaglandins, plasminogen activator and metalloproteinases such as collagenase and proteoglycanase. IL-1 is also mitogenic for synoviocytes and bone cells, and can alter rates of production of extracellular matrix constituents. The presence of IL-1 in synovial fluids from rheumatoid and osteoarthritic joints and its actions on connective tissues in vitro suggest that IL-1 may play an important role in the pathogenesis of arthritis. There are several potential cellular sources of IL-1 in the inflamed rheumatoid joint and interactions between these cells, T lymphocytes and plasma cells may continually induce IL-1 so contributing to the chronicity of the disease. The mechanism of action of IL-1 on connective tissue cells is at present uncertain though preliminary studies suggest that IL-1 may induce cellular responses by stimulating phosphoinositide turnover and possibly protein kinase C activity. PMID- 3524148 TI - The mechanisms of cartilage catabolism. PMID- 3524150 TI - [Ureterovesicle reimplantation by the extravesicular anterior approach. Analysis of 800 primary transplantations]. PMID- 3524149 TI - Mononuclear cell factor modulates the concomitant release of proteoglycan and latent proteinase by human articular cartilage in organ culture. PMID- 3524151 TI - [Tumors of the bladder and peroperative genitourinary ultrasonography. A proposal for echographic classification]. PMID- 3524152 TI - [Multiple imaging procedures including MRI in bladder cancer]. AB - Endoscopic photography, double contrast cystography, transurethral echography, X ray CT scan, and MRI (magnetic resonance imaging) were utilized for the staging diagnosis of the four patients with carcinoma of the bladder. In the first case, a 70-year-old man, since all of the five imaging procedures suggested a superficial and pedunculated tumor, his bladder cancer was considered T1. The classification of stage T3 carcinoma was made for the second 86-year-old male. Because all of his imaging examinations showed a tumor infiltrating deep muscle and penetrating the bladder wall. The third case was a 36-year-old male. His clinical stage was diagnosed as T2 or T3a by cystophotography, double contrast cystogram, ultrasonography, and X-ray CT scan. However, MRI showed only thickened bladder wall and the infiltrating tumor could not be distinguished from the hypertrophic wall. The last patient, a 85-year-old female, had a smaller Ta cancer. Her double contrast cystography revealed the small tumor at the lateral bladder wall. But, the tumor could not be detected by transaxial, sagittal and coronal scans. Multiple imaging procedures combining MRI and staging diagnosis of the bladder carcinoma were discussed. PMID- 3524153 TI - [New hemostatic therapy of bleeding of bladder by technique of drip-irrigation using a thrombin solution]. AB - To control the bleeding from the bladder caused by radiation cystitis or transurethral surgery, drip-irrigation of bladder by indwelling a three-way Foley catheter using a thrombin solution, as a clotting agent, was done in 10 patients. Five hundreds ml of solution containing 25,000 units of thrombin was dripped out within 3 hours and repeated 2 times a day for 2 to 7 days. The results were excellent in 2 cases, good in 6 cases and poor in 2 cases. No remarkable side effects were observed. PMID- 3524154 TI - [Two cases of bladder leiomyoma]. AB - Two cases of leiomyoma of the bladder are reported. The first case was a 79-year old female who presented with gross hematuria and frequent urination. Cystoscopy disclosed a large tumor covered by intact mucosa. This lesion was further evaluated by ultrasound, and was thought to be a submucosal tumor of the bladder. The second case was a 43-year-old female who was referred for further investigation of left giant hydronephrosis. During the investigation, submucosal tumor was incidentally found. Concerning the etiology of the hydronephrosis, left ureteral stenosis due to a previous gynecological operation was suspected. These lesions proved to be leiomyoma of the bladder histologically, and were successfully enucleated. Difficulty in diagnosis of this disease and controversy as to the optimal treatment prompted us to report these cases and to review 68 cases reported in the Japanese literature. PMID- 3524155 TI - [A case of intrascrotal pseudocyst]. AB - A 37-year-old male visited our hospital with the chief complaint of a mass about the size of a hens egg in the right scrotum. Before hospitalization, he had noticed the abnormal intrascrotal mass. The mass gradually enlarged with pain, so he was admitted on May 23, 1982. Under the diagnosis of intrascrotal tumor, the mass was removed. It was a cyst with enriched geratinoid contents enclosed with thick granulation tissue and adhered to the tunica vaginalis externally. Pathological findings revealed it to be an intrascrotal pseudocyst. Discussion is made in relation to the histological genesis of this lesion. PMID- 3524156 TI - [A case of bilateral reticulum cell sarcoma of the testis]. AB - A case of reticulum cell sarcoma of bilateral testis is described. The patient was a 58-year-old man who complained of painless swelling of the right scrotal contents. He was treated by bilateral high orchiectomy. The right testicular tumor was histologically diagnosed as reticulum cell sarcoma, and the left testicular tumor was also diagnosed as RCS. Chemotherapy (vincristin, Endoxan, 6 MP and prednisolone) was performed, and the patient has been doing well without any clinical evidence of recurrence. The literature is reviewed briefly. PMID- 3524157 TI - [Clinical study of cinoxacin in acute simple cystitis]. AB - Cinoxacin (CINX) was administered twice a day for 7 consecutive days (400 mg X 2/day) to 34 female patients suffering from acute simple cystitis. The overall clinical efficacy was excellent in 15 cases (94%) and moderate in one case (6%) according to the criteria for clinical evaluation by the UTI committee. The efficacy was not determined in 18 cases. Bacteriological examination revealed 11 cases of single infection by E. coli, 2 cases of single infection by P. cepacia and S. epidermidis and one case of single infection by S. sunguis. MIC of E. coli ranged from 3.13 to 6.25 micrograms/ml. MIC of P. cepacia was 3.13 micrograms/ml and MIC of S. epidermidis more than 100 micrograms/ml. All the strains were eradicated with the efficacy of 100%. There was no relapse of acute simple cystitis in 16 cases after 7 days treatment of CINX. No serious side effects were recognized except for slight general fatigue and heart burn in 2 cases. It was thus concluded that CINX is clinically effective and safe for acute simple cystitis caused by E. coli and P. cepacia. PMID- 3524158 TI - Interstitial radiation therapy for hepatic metastases: sonographic guidance for applicator placement. AB - A new technique is reported for the treatment of hepatic metastases using sonography-directed percutaneous placement of a 14-gauge needle applicator and a high-intensity "remote afterloading" iridium-192 (Ir-192) source for interstitial radiation therapy. The results with six patients show that the procedure is easily performed, patient tolerance is good, and there is minimal disruption of the patient's lifestyle. Hospitalizations have been less than 24 hr. Partial response or stable disease in the liver was observed in all six patients. Tumoricidal doses up to 5000 rad (cGy) in a single treatment with durations from 7 to 41 min were achieved in small volumes (less than 25 cm3) with no clinically significant toxicity on follow-up evaluations from 2-6 months. The technique appears to ablate discrete metastatic tumor deposits in the liver. PMID- 3524159 TI - CT and sonography of multiple bile-duct hamartomas simulating malignant liver disease (case report). PMID- 3524160 TI - Pancreatic pseudomass caused by the second portion of the duodenum: a pitfall during water-aided sonography (technical note). PMID- 3524161 TI - Ossification center of the infant hip: sonographic and radiographic correlation. AB - A new sonographic technique for evaluating the ossification center of the infant's hip allowed identification of the ossific nucleus before it could be visualized radiographically. With this technique, delay in ossification associated with hip pathology can also be recognized. Proper assessment of the size of the ossific nucleus requires scanning in orthogonal planes. Acoustic shadowing causes the growing ossification center to appear curved and may make the medial acetabulum and triradiate cartilage difficult to identify. Sonographic hip evaluation usually ceases to be reliable in children over 1 year old. PMID- 3524162 TI - Neonatal umbilical artery pseudoaneurysm: sonographic evaluation (case report). PMID- 3524163 TI - MRI in infants and children with spinal dysraphism. AB - Magnetic resonance imaging (MRI) of the spine was used in 37 infants and children to assess the potential of this new technology to evaluate suspected lumbosacral dysraphic myelodysplasia. Eighteen of these patients had correlative metrizamide myelotomography and metrizamide computed tomography (CT). MRI using a spin-echo pulse sequence with short repetition times (TR) and echo delay times (TE) affords optimal delineation of normal and abnormal spinal cord morphology in the lumbosacral region. Coronal projections usually provide an adequate demonstration of the normal conus medullaris for screening purposes; however, multiplanar acquisitions are necessary for more complete delineation of the dysraphic myelopathy. The sensitivity of MRI compares favorably with metrizamide tomography and CT, although these procedures provide somewhat better specificity. These results suggest that MRI is a reliable, noninvasive procedure to screen patients for lumbosacral dysraphism. PMID- 3524164 TI - Microbubbles as a contrast agent for neurosonography and ultrasound-guided catheter manipulation: in vitro studies. AB - Tissue-equivalent ultrasound phantoms, including models of the ventricular system and cyst phantoms, may be useful for developing expertise in both biopsy procedures and shunt catheter placement that use ultrasound guidance. These phantoms have been constructed (1) to assess the ability to position biopsy needles and manipulate shunt catheters with conventional angiographic guidewires and (2) to evaluate the usefulness of microbubbles as an ultrasound contrast agent. Optimal catheter and needle position and catheter patency are demonstrated with microbubbles generated by hand injection of small volumes of saline, a safe ultrasound contrast agent that, to our knowledge, has not been previously exploited in neurosonography. Microbubbles can define biopsy needle location without direct imaging of the biopsy needle; they can also define the extent of communication or separation of fluid-filled or loculated spaces. PMID- 3524165 TI - Assessment of ventricular shunt patency by sonography: a new noninvasive test. AB - This report describes a new test of patency of the ventricular component of a ventriculoperitoneal shunt that precludes injection into the shunt reservoir. Preliminary clinical experience confirms that digital compression of the ventricular shunt reservoir (Cordis standard and pediatric reservoir), while occluding the shunt distal to the reservoir, generates microbubbles that increase the echogenicity of the catheter, demonstrating shunt patency. In vitro, the extrusion of microbubbles from catheter side holes can be imaged during digital compression of the reservoir, but so far this has not been imaged in patients as a direct sign of shunt patency. A sonographic means of assessing shunt function offers the advantage of simultaneously imaging the ventricular catheter, determining its location, and assessing the etiology of shunt failure. Its usefulness is limited to pediatric cases in which an adequate transfontanelle cranial sonographic study can be obtained and to individuals with large craniotomy defects. PMID- 3524166 TI - Pelvimetry revisited. PMID- 3524167 TI - Programs and services for the deaf in the United States. III. Supportive and rehabilitative services. PMID- 3524168 TI - Programs and services for the deaf in the United States. II. Educational programs and services. PMID- 3524169 TI - The effects of captopril on serum digoxin and urinary urea and digoxin clearances in patients with congestive heart failure. AB - The effect of captopril as long-term treatment in 20 patients with congestive heart failure has been studied in a double-blind trial. Captopril caused a significant increase in serum digoxin levels. No patients developed evidence of digoxin toxicity. Serum and total body potassium rose and the frequency of ventricular arrhythmias showed a modest decline. Creatinine clearance and radioisotopically measured glomerular filtration rate fell, but there was a poor relationship between these and the increase in serum digoxin. In a further open study on 12 patients, creatinine, urea, and digoxin clearance were significantly reduced by captopril. However, digoxin clearance declined more than creatinine clearance (89 +/- 25 mumol/L to 69 +/- 22 mumol/L and 81 +/- 14 mumol/L to 72 +/- 19 mumol/L, respectively, p less than 0.05 for the difference). Fractional excretion of urea and digoxin filtered at the glomerulus declined, indicating greater tubular reabsorption or reduced tubular secretion of these compounds. Captopril causes an increase in serum digoxin by reducing renal clearance of the drug. PMID- 3524170 TI - Value and limitations of Doppler ultrasound in the evaluation of aortic stenosis: a statistical analysis of 70 consecutive patients. AB - Continuous-mode Doppler ultrasound and cardiac catheterization were performed within 1.4 +/- 2.0 days in 70 patients, aged 26 to 84 (mean 67 +/- 11) years, with suspected aortic stenosis. Optimal Doppler spectral display signal was recorded from the apical window in 43% of the patients, the second or third right parasternal area in 34%, and from the suprasternal notch view in 20% of the patients. Aortic valve gradients by Doppler ultrasound were calculated by the simplified Bernoulli equation: pressure gradient = 4X (velocity). There was an overall fair correlation between the peak gradient by Doppler technique and both the maximal instantaneous (r = 0.66) and peak-to-peak aortic pressure gradient (r = 0.68) obtained at catheterization and a good correlation (r = 0.75) between mean gradient by Doppler technique and catheterization. These correlation coefficients improved significantly in the last 51 patients as compared to the initial 19 patients of the study. Of the last 51 patients, correlation was better in those in normal sinus rhythm as compared to those in atrial fibrillation, and in patients with no or insignificant coexistent AR as compared to those with greater than or equal to 2+ AR. The age of the patient and the status of cardiac output did not significantly affect the accuracy of correlations. We conclude that measurements of aortic valve gradient by continuous-mode Doppler ultrasound may not correlate closely with those by catheterization when the experience with the Doppler technique is limited and when patients in atrial fibrillation or with significant coexistent AR are studied. PMID- 3524171 TI - Similarity of anomalous origin of right pulmonary artery from the ascending aorta to d-transposition of the great arteries: 2D echographic and Doppler study. PMID- 3524172 TI - Hemodynamic effects of moricizine at rest and during supine bicycle exercise: results in patients with ventricular tachycardia and left ventricular dysfunction. AB - To evaluate the hemodynamic effects of moricizine, 20 patients with frequent nonsustained ventricular tachycardia (VT) with a mean left ventricular ejection fraction (EF) of 39 +/- 14% were enrolled in a prospective single-blind, placebo controlled study. Hemodynamic measurements were performed at rest and during supine bicycle exercise on placebo and moricizine therapy (10 mg/kg/day). Although 16 of 19 patients experienced no rest or exercise deterioration in hemodynamic parameters during drug dosing, three patients had acute deterioration of pulmonary capillary wedge pressure and cardiac index (CI) on moricizine. During follow-up of 6 +/- 3 months, two subgroups were identified: 10 of 19 patients had effective long-term reduction in VT, whereas 9 of 19 patients had poor control of ventricular arrhythmia or congestive heart failure and were discontinued from the trial. Baseline EF and hemodynamic parameters at rest were similar in both patient subgroups. However, protocol dropouts had a hemodynamic response to exercise on moricizine that was significantly depressed as compared to patients with a favorable antiarrhythmic outcome (p less than 0.02). The following hemodynamic profile characterizes patients unlikely to have an antiarrhythmic response to moricizine: an increase in CI of less than 1.0 L/min/m2 and no increase in left ventricular stroke work index during supine exercise. PMID- 3524174 TI - American pharmacy in transition: forecasts for selective survival. PMID- 3524173 TI - The use of intravenous digital subtraction angiography in the evaluation of tetralogy of Fallot. AB - Sixteen patients with tetralogy of Fallot were studied with intravenous digital subtraction angiography (DSA). Of these, 11 were males and five were females, ranging in age from 26 months to 54 years, with a mean age of 22 years at the time of the initial study. Twenty-two DSA studies were performed in the 16 patients, in seven patients preoperatively, in 12 patients postoperatively, and in three patients both pre- and postoperatively. In the seven patients studied preoperatively, all DSA studies were considered technically adequate as corroborative evidence in the diagnosis of tetralogy of Fallot. All associated cardiac abnormalities were adequately demonstrated. The 16 postoperative studies on 12 patients were performed to evaluate the adequacy of the surgery and/or postoperative complications. These studies were judged as technically satisfactory. The authors utilized intravenous DSA in the pre- and postoperative evaluation of 16 patients with tetralogy of Fallot and found that reliable angiographic information was provided and that this technique may serve as a useful adjunct with other noninvasive and invasive tests in the preoperative and postoperative evaluation of these patients. PMID- 3524175 TI - Health policy for treating hyperlipidemia: analogy with hypertension and prospects for the next decade. AB - Over the past 15 years, efforts by the health profession to detect and treat high blood pressure have grown remarkably successful. A similar growth now seems likely for high blood cholesterol. Three factors are responsible: the continuing emergence of scientific evidence corroborating the benefit of lowering high blood cholesterol levels by diet or drugs, the formulation in 1984 of more specific health policy guidelines by the Consensus Development Conference on Lowering Blood Cholesterol and the creation in 1985 of the National Cholesterol Education Program. This program has been designed to enhance preventive activities by the public and by health care professionals. Its success will depend in part on resolving problems with the efficacy and acceptability of life-style and drug interventions for lowering blood cholesterol levels. PMID- 3524176 TI - Controlled studies of the efficacy and safety of combined probucol-colestipol therapy. AB - A comprehensive clinical evaluation of the effects of combined probucol colestipol therapy was undertaken in 71 hypercholesterolemic patients. In the first 18-month double-blind, double-placebo, crossover study, the effects of 1 g/day of probucol and 20 g/day of colestipol were compared with the drugs used singly in 47 patients. The combination decreased low density lipoprotein (LDL) cholesterol from a diet-placebo baseline of 242 +/- 51 mg/dl to 171 +/- 41 mg/dl. LDL cholesterol levels were decreased by more than 30% in 49% of patients, and by more than 40% in 17% of patients. Combined drug use eliminated the gastrointestinal side effects of single-drug administration or diminished their severity. Twenty-two patients who complained of resin-induced constipation entered a 19-month continuation trial that called for a half-dose of colestipol during combination treatment. This therapy decreased the LDL baseline level of 239 +/- 46 mg/dl by more than 25% in 41% of patients, and by more than 45% in 9% of patients. All patients were able to tolerate the modified probucol-colestipol therapy. Finally, a comparison was made between the hypocholesterolemic effects of combined probucol-colestipol therapy obtained after 1 and 3 years in 24 patients. These were sustained in all but 5 patients. Combined probucol colestipol therapy increases the hypocholesterolemic effects and decreases the gastrointestinal side effects of either drug used alone. In patients who cannot tolerate full doses of resin, a half-dose may render the drug more acceptable without diminishing its lipid-lowering effect. PMID- 3524177 TI - Effects of combined probucol-colestipol treatment for familial hypercholesterolemia and coronary artery disease. AB - To evaluate the effect of hypercholesterolemic treatment on coronary artery disease in patients known to be susceptible to disease progression, 44 patients with familial hypercholesterolemia and coronary artery disease were started on a lipid-lowering diet and either probucol (1 g/day) or colestipol (30 g/day). After 5 months of monotherapy, all patients went on a regimen of diet and 2-drug therapy. To date, combination therapy has continued for 3.4 to 4.1 years, and has resulted in the following changes from baseline in mean serum lipid levels: 48.5% in total cholesterol, -53.3% in low density lipoprotein cholesterol, -30.0% in high density lipoprotein cholesterol and +14.5% in triglycerides. The reduction in low density lipoprotein cholesterol apparently improved the clinical status of these patients despite the associated drop in high density lipoprotein cholesterol. In the 19 patients who underwent coronary arteriography before admission to the study, follow-up arteriograms showed that combined treatment stabilized the progression of established lesions and prevented the formation of new ones. Side effects occurred mainly with monotherapy and during the early phase of combination therapy. Reactions included diarrhea, constipation, other vague abdominal symptoms, headache and joint stiffness. In all instances, the side effects gradually subsided after the institution of combination therapy. The combination of probucol and colestipol plus diet appears to be effective in treating most patients with familial hypercholesterolemia. PMID- 3524179 TI - George Edward Burch, MD, 1910-1986. PMID- 3524178 TI - Calcium channel blockers in systemic hypertension. PMID- 3524180 TI - William Withering revisited: 200 years of the foxglove. PMID- 3524181 TI - Effect of timolol on mortality and reinfarction after acute myocardial infarction: prognostic importance of heart rate at rest. AB - Long-term timolol treatment after acute myocardial infarction is associated with a significant reduction in mortality and nonfatal reinfarction. To evaluate whether the reduction in mortality and morbidity is exclusively or partly dependent on a reduction in heart rate (HR), cardiac events in the Norwegian Timolol Multicenter Study were analyzed according to resting HR at baseline and at 1 month of follow-up Resting HR at baseline was a significant predictor of total death and all events (total death plus nonfatal reinfarction) both in placebo- and in timolol-treated patients. In the placebo group the median resting HR was unchanged from baseline to 1 month control (72 beats/min), but was reduced from 72 beats/min to 56 beats/min in the timolol group. Resting HR during follow up remained a significant predictor of total death. Further, mortality at a given HR during treatment was not markedly different whether the HR was spontaneous or caused by timolol. Timolol treatment was related to a significant reduction in mortality, and this study suggests that the major effect of timolol treatment on mortality after acute myocardial infarction may be attributed to the reduction in HR. Timolol treatment was also associated with an overall reduction in nonfatal reinfarction. However, nonfatal reinfarction was inversely related to resting HR during follow-up, indicating that although coronary artery occlusion in low-risk patients may cause nonfatal reinfarction, the outcome in high-risk patients is more likely to be death. When analyzing mortality and nonfatal reinfarction combined, timolol treatment was related to a reduction in cardiac events at any given HR, suggesting that factors in addition to HR reduction are important in the protective effects of timolol. PMID- 3524182 TI - Randomized double-blind trial of intravenous streptokinase for acute myocardial infarction. AB - To determine the efficacy of intravenously administered streptokinase (SK) on infarct artery patency, global left ventricular (LV) function and clinical course in transmural acute myocardial infarction (AMI), 38 patients were studied using a randomized, double-blind, placebo-controlled scheme. Nineteen patients received 1.0 million units of SK followed by 72 hours of heparin infusion and 19 received placebo followed by heparin infusion, all within 5 hours (mean 3.3 hours) after AMI onset. Patients ineligible for inclusion in the randomized trial were followed as a second, "historical control" group. Compared with placebo, SK caused a higher frequency of enzymatic evidence of reperfusion (6% vs 79%, p less than 0.001) and of patent infarct-related arteries at predischarge coronary arteriography (64% vs 88%, difference not significant). (Patients in the control group had a relatively low frequency of spontaneous thrombolysis--28%.) In the SK group LV ejection fraction increased from early (average 7.3 hours after AMI) to late (predischarge) study (from 40% early to 47% late, p less than 0.05); in the placebo group LV ejection fraction did not change significantly (from 41% to 42%). Predischarge exercise radionuclide ventriculography showed mild and similar degrees of inducible ischemia in both groups. After a mean of 12.8 months of follow-up, 1 SK patient and 4 placebo patients had died (difference not significant). In conclusion, intravenous SK is efficacious for thrombolysis in patients with AMI. It improves global LV function without augmenting exercise inducible ischemia. PMID- 3524183 TI - Selected mechanisms of diuretic-induced electrolyte changes. AB - Thiazide diuretic therapy has been associated with several biochemical electrolyte imbalances including potassium loss. The onset, duration and magnitude of potassium excretion can influence decisions concerning drug therapy, particularly in hypertensive patients at risk if they develop diuretic-induced hypokalemia. The potassium depletion seen during the course of antihypertensive therapy with thiazides is brought about by 2 primary mechanisms: the increased delivery of sodium to the distal tubules for sodium-potassium exchange, and the development of secondary hyperaldosteronism, which causes resorption of sodium with a loss of potassium into the urine. The diuresis caused by thiazides is maximal between 8 and 12 hours. However, resultant volume contraction stimulates elevated serum aldosterone levels, which can be present for 24 hours or longer. Therefore, potassium loss may exceed the period of diuresis. Diuretics are effective antihypertensive therapy in many patients with mild hypertension. Potassium-sparing agents can offset potassium imbalance that often occurs with diuretics, and thus, these agents have become an important addition to the physician's treatment armamentarium for appropriate patients. PMID- 3524184 TI - Role of diuretics in treatment of essential hypertension. AB - Oral diuretics have traditionally been first-line (step 1) agents for initiating antihypertensive therapy in the stepped-care approach to management. They have a generally favorable side effects profile as well as several other attributes that make them particularly useful in this role. They are effective as monotherapy in many patients, convenient, easy to titrate, comparatively inexpensive and are well tolerated by most patients. They do not cause salt and water retention, which can lead to pseudotolerance. Monotherapy with a diuretic adequately controls hypertension in many patients with mild hypertension (diastolic blood pressure between 90 and 104 mm Hg). When therapy is initiated with a nondiuretic agent and an additional drug is needed, a diuretic can be used to advantage as step 2 in many patients. PMID- 3524185 TI - Hypokalemia in thiazide-treated systemic hypertension. AB - Potassium supplementation in diuretic-induced hypokalemia (serum potassium less than 3.5 mmol/liter) in patients being treated for hypertension is a common event. In a previous study 40 mmol/day of orally administered potassium was not effective in preventing diuretic-induced hypokalemia in patients who had previously developed hypokalemia while being treated for hypertension with hydrochlorothiazide. In the study reported here dosages as high as 60 to 80 mmol/day of orally administered potassium failed to prevent hypokalemia in 7 of 19 hypertensive patients who were receiving hydrochlorothiazide. Potassium supplementation was compared with the potassium-sparing diuretic amiloride. The study design was open label and subject matched with crossover of therapeutic regimens. PMID- 3524186 TI - The effects of orchidectomy and replacement therapy on the ultrastructure and gonadotropin-releasing hormone content of the median eminence of the rat. AB - The effects of 2 weeks of orchidectomy and replacement therapy with testosterone upon the content and distribution of gonadotropin-releasing hormone (GnRH) in the median eminence were determined by means of radioimmunoassay and electron microscopy. Photographic montages were prepared from electron micrographs of the lateral median eminence at the point of deepest invagination of the tuberoinfundibular sulcus. Morphometric analysis of photographs of tissues immunohistochemically stained for GnRH was performed to determine changes in the volume density of GnRH-containing axon profiles following the experimental treatments. A decrease in GnRH content after orchidectomy was observed both by morphometric analysis of axon volume density and radioimmunoassay of total GnRH content. Testosterone treatment of orchidectomized animals prevented the postorchidectomy loss of GnRH. Morphometric analysis of conventional electron micrographs revealed an increase in the number of axons containing no dense-core vesicles following orchidectomy, but no decrease in volume density of the neuropil. The results indicate that the change in volume density of immunostained axons was related to the loss of immunostainable dense-core vesicles and not to a change in the size or number of axons. The area corresponding to the location of the highest concentration of GnRH-containing axons was observed to be largely avascular and separated from the vessels of the tuberoinfundibular sulcus by a "border zone" composed of glial foot processes. The unique morphology of the GnRH area has suggested the name "compact zone" to distinguish it from the palisade zone with which it is continuous medially. GnRH axons in this region are probably part of a tract extending farther caudally rather than a terminal field. PMID- 3524187 TI - Nutritional status of diabetic and nondiabetic patients after renal transplantation. AB - To assess whether there was improvement in the nutritional status of Type I insulin-dependent diabetics treated with renal transplantation as compared with dialysis, 24 diabetics and 21 nondiabetics were studied 22.6 +/- 23.8 mo after transplantation. Nutritional assessment included weight, height, triceps skinfold thickness, midarm muscle circumference (MAMC), serum albumin, and transferrin. Mean age of the 28 males and 17 females was 37.1 +/- 9.4 yr. Weight of diabetics increased from 55.6 +/- 8.4 kg to 61.5 +/- 9.5 kg (p less than 0.05); weight for height, from 81 +/- 8% to 95 +/- 9% (p less than 0.001); and serum albumin, from 3.8 +/- 0.5 gm/dl to 4.3 +/- 0.4 gm/dl (p less than 0.001). Weight also increased significantly in nondiabetics from 64.5 +/- 10.5 kg to 72.1 +/- 13.5 kg (p = 0.05); weight for height, from 96 +/- 15% to 108 +/- 16% (p less than 0.05); but not albumin, 4.1 +/- 0.7 gm/dl to 4.4 +/- 0.6 gm/dl (p greater than 0.05). Serum transferrin was 210 +/- 62 mg/dl in diabetics and 226 +/- 52 mg/dl in nondiabetics. Forty-two percent of diabetics and 29% of nondiabetics had a MAMC less than 5th percentile, indicating protein-calorie malnutrition. Results suggest a significant improvement in nutritional status after transplantation in both diabetics and nondiabetics, but particularly in the diabetic group. PMID- 3524188 TI - Serum-cholesterol response to dietary cholesterol: a re-evaluation. AB - The data from the literature in which the serum-cholesterol response has been measured following a change in cholesterol intake have been re-evaluated. The overall data appear to be best explained by exponential equations. However, very large differences in response have been reported for similar changes in cholesterol intake and no predictive equation can explain such values. It is concluded that over the range of cholesterol intakes of practical interest--0 to 400 mg/1000 kcal--the usual response is approximately linear, each 1 mg/1000 kcal resulting in an expected increase of serum cholesterol of approximately 0.1 mg/dl. With a 2500 kcal diet, an increase in intake of 100 mg/day would be expected to increase serum cholesterol by approximately 4 mg/dl. PMID- 3524189 TI - Clinical trial of cisplatin and intensive course 5-fluorouracil for the treatment of advanced colorectal cancer. AB - A clinical trial of 5-day Cisplatin combined with loading course 5-fluorouracil (5-FU) was conducted in 37 patients with advanced colorectal carcinoma. Objective tumor responses were seen in 10 of 34 patients (29%) who had not received prior chemotherapy. The estimated median survival for previously untreated patients is 26 weeks measured from the onset of therapy. Toxicity consisted primarily of leukopenia, vomiting, and reversible renal insufficiency. This combination of cisplatin and intensive course 5-FU has demonstrated Phase II activity in patients with advanced colorectal cancer. A controlled trial is now in progress to prospectively compare this regimen with full dose single agent 5-FU. PMID- 3524191 TI - Identification of adenocarcinoma in cytospin preparations of effusions using monoclonal antibody B72.3. AB - Metastatic adenocarcinoma in human effusions can be difficult to distinguish from reactive mesothelial cells, particularly if the malignant cells are rare, have bland cytologic features, or occur as single cells rather than clusters of cells. Monoclonal antibody (MAb) B72.3, generated against a membrane-enriched fraction of breast carcinoma, has been shown to be reactive with formalin-fixed, paraffin embedded tissue sections of human breast and colon carcinomas but not with sarcomas, melanomas, hematopoietic neoplasms, or a variety of normal adult tissues. The authors have adapted the avidin-biotin-immunoperoxidase method using MAb B72.3 to evaluate cytospin preparations of pleural and peritoneal effusions for the presence of adenocarcinoma cells. The cytospin method was selected because it provides a rapid, efficient, and inexpensive means of evaluating effusions for cellular content. Reactive effusions from patients with no history of adenocarcinoma as well as obviously malignant effusions from patients with documented adenocarcinoma were studied. MAb B72.3 demonstrated no reactivity with any of the variety of cell types in the reactive specimens from patients without a history of adenocarcinoma. In contrast, in all of the malignant effusions studied, 10-90% of the nonhematopoietic cells demonstrated reactivity with MAb B72.3. In addition, MAb B72.3 highlighted occult adenocarcinoma cells in cytospin preparations of effusion fluids from patients with a primary diagnosis of adenocarcinoma in which no definite malignant cells could be identified using standard cytologic criteria. PMID- 3524190 TI - COTA (colon-ovarian tumor antigen). An immunohistochemical study. AB - A goat anti-serum was prepared against mucinous ovarian cyst fluid and absorbed with normal colon and a variety of normal tissues until the only residual immunoreactivity was directed against colon cancer and ovarian tumor mucin. The set of antigenic determinants defined by this anti-serum has been called COTA, standing for colon-ovarian-tumor-antigen. This highly absorbed anti-serum (anti COTA) was used for immunohistochemical staining of 42 different tissues in parallel with staining with a goat anti-CEA, which was also highly absorbed. The results suggest that COTA is a highly sensitive and specific antigen for colon carcinoma and may have potential for the early detection of malignant changes predictive of cancer of the colon. PMID- 3524192 TI - Colonic biopsy in verotoxin-induced hemorrhagic colitis and thrombotic thrombocytopenic purpura (TTP). AB - Sporadic cases and occasional outbreaks of hemorrhagic colitis recently have been associated with the rare Escherichia coli serotype O157:H7, which is now recognized as an important identifiable cause of bloody diarrhea in patients in whom more common gut pathogens cannot be detected. The authors report such a case in a 49-year-old woman who developed thrombotic thrombocytopenic purpura (TTP) and hemorrhagic transverse and descending colitis with a lesion having many of the features of pseudomembranous colitis. While pseudomembrane formation has been described in the hemolytic uremic syndrome (HUS), these features have not, to the authors' knowledge, been described in a patient with hemorrhagic colitis and TTP secondary to a verotoxin-producing serotype of E. coli. PMID- 3524193 TI - Immunoperoxidase staining for S-100 protein in the diagnosis of eosinophilic granuloma of lung. PMID- 3524194 TI - Monitoring of ionized calcium during human hepatic transplantation. Critical values and their relevance to cardiac and hemodynamic management. AB - During human hepatic transplantation, ionized calcium (ICa) measured in whole blood with an ion-selective electrode varied greatly from ICa predicted from total calcium (TCa), protein, albumin, and pH, by means of recently published nomograms. Measurement of ICa was necessary because the interaction of citrate in transfused blood and calcium chloride (administered to offset citrate binding) caused large variations in TCa. During hepatic transplantation, ICa and electrolyte measurements were obtained at approximately 15-minute intervals or more frequently if indicated by changing cardiac status. In one patient, hemodynamic instability was accompanied by a large decrease in ICa, which then was followed by cardiac arrest aggravated by myocardial depression from inadequate ICa. Cardiovascular phenomena associated with ionized hypocalcemia suggest that the critical value for ICa should be no more than 0.4 mmol/L (1.6 mg/dL) below the reference range mean. The authors propose critical limits for ICa and discuss their significance in clinical management of tetany, hypotension, arrythmias, and cardiac arrest. PMID- 3524195 TI - Bone marrow morphology and immunology in systemic amyloidosis. AB - Bone marrow specimens from 45 patients presenting with signs and symptoms of systemic amyloidosis were studied to assess the degree and pattern of plasmacytosis and its clonality, using immunohistologic technics. Twenty-four of 35 patients with primary amyloidosis had monoclonal plasma cells, while 11 had polyclonal plasma cells. Five patients with secondary amyloidosis and five with familial amyloidosis had a mild polyclonal plasmacytosis. The authors' data suggest that there may be two subgroups of patients with primary amyloidosis: those with monoclonal plasmacytosis representing part of the spectrum of plasma cell dyscrasias, and those in which a monoclonal plasmacytosis cannot be documented. Immunohistologic staining of bone marrows in patients with amyloidosis may be of future value in characterizing subtypes of amyloidosis and evaluating their relationship to multiple myeloma. PMID- 3524196 TI - Diagnosis of cerebral atrophy in infants by near-field cranial sonography. AB - Cranial sonography is the ideal imaging tool for use in infants. However, it has not been used for the diagnosis of cerebral atrophy in infants as the subarachnoid space has been a "blind spot" with ultrasound. We evaluated cerebral atrophy by a unique application of cranial sonography that we have termed the near-field method, and compared these results with those of cranial computed tomography (CT). We examined 106 infants with the near-field method of cranial sonography. Eleven patients fitted our sonographic criteria for cerebral atrophy. Cranial CT was done in eight of the 11 patients with sonographic findings of cerebral atrophy and was consistent with the diagnoses of cerebral atrophy in all cases. Of these eight patients, one had cerebral atrophy and subdural effusion seen by both near-field sonography and cranial CT. Cranial CT was performed in eight of the 95 patients with normal sonographic findings, and all results were normal. All patients with cerebral atrophy determined by cranial CT were found to have cerebral atrophy by near-field sonography. Likewise, all patients without cerebral atrophy by cranial CT were not found to have cerebral atrophy CA by near field sonography. The near-field method of cranial sonography therefore appears to have a sensitivity and specificity of 100% with cranial CT as a referral method. PMID- 3524197 TI - Asymptomatic primary hyperparathyroidism in children. Newer methods of preoperative diagnosis. AB - An asymptomatic 11-year-old boy was found to have primary hyperparathyroid secondary to an isolated parathyroid adenoma. This rare disorder of childhood can have asymptomatic hypercalcemia as its only manifestation. Parathyroid hormone assays and studies of urinary calcium excretion, especially the calcium creatinine clearance ratio, distinguish parathyroid hormone excess from hypocalciuric forms of hypercalcemia. Real-time ultrasonography and dual-isotope subtraction scanning provide accurate, noninvasive, preoperative localization of abnormal parathyroid tissue. The prognosis of untreated, asymptomatic primary hyperparathyroidism in children is not known, and the indications for surgery are unclear. Diagnostic certainty is, therefore, especially important prior to surgical exploration. PMID- 3524198 TI - The assassination of the late President John F. Kennedy. An academician's thoughts. AB - Another look is taken at the murder case of the late President John F. Kennedy. The overall pattern established by various investigations should force any reasonable person to conclude that a conspiracy of greater or lesser proportions did exist. The actors in that conspiracy have not been identified. The role of Lee Harvey Oswald in the event is still obscure. The art and science of pathology, in this case, failed the nation. Federal agencies were incompetent and possibly criminally negligent in their handling of the case. The fact that more than a single gunman was involved in the murder seems indubitable. Scientists, as scientists, have contributed all that they can to resolving the case. Suppression, modification, and destruction of evidence crucial to the case by those having it in custody have been completed so effectively that one esteemed historian has asserted, "at least some of those responsible for the murder of a President of the United States got away with it." PMID- 3524199 TI - Analytical potential for multiple cause-of-death data. PMID- 3524200 TI - Family history of coronary heart disease: is it an independent risk factor? PMID- 3524201 TI - Contaminated produce--a common source for two outbreaks of Shigella gastroenteritis. AB - Simultaneous outbreaks of Shigella sonnei gastroenteritis occurred in October 1983 at two Texas university campuses 60 miles (96 km) apart. There were no common food handlers, recreational activities, water sources or swimming areas to explain the introduction of Shigella at both campuses. However, tossed salads were found to be associated with illness at both campuses. The investigation disclosed that both schools had received produce shipments from the same company during the week preceding these outbreaks. Shigella isolates from cases at both universities, sent to the Centers for Disease Control for plasmid analysis and colicin typing, were found to be identical. The same organism was evidently not a frequent cause of shigellosis within a 160-mile (256 km) radius of these universities since only 19% of control isolates chosen from this area were identical to the type which caused these outbreaks. This is the first report of two related outbreaks of shigellosis that were caused by a contaminated food source and not by a food handler. Simultaneous foodborne outbreaks of shigellosis should trigger a search for potential contamination at every step of food handling from farm to kitchen. PMID- 3524202 TI - Bone marrow transplantation for good-risk patients with leukemia in a university affiliated hospital. AB - Of the first 14 patients with acute or chronic leukemia to undergo bone marrow transplantation at our hospital, 9 (64%), all good-risk, are still alive in remission at 18 to 42 months of follow-up (mean, 29 months) with their Karnofsky performance status between 80% and 100%. The conditioning regimen of fractionated dose irradiation and high-dose chemotherapy eradicated their disease; only two patients relapsed after transplantation. Toxicity was acceptable. Acute graft versus-host disease developed in six patients (43%) (grade I or II in four, grade IV in two) and progressed to chronic graft-versus-host disease in four. Viral pneumonitis developed in three patients (21%), but none had idiopathic interstitial pneumonitis. The mean hospital charge was $54,355. These preliminary results suggest that good-risk patients with acute or chronic leukemia can be treated with bone marrow transplantation in a university affiliated hospital with appropriate staff and support facilities and achieve results comparable to those in research institutions at a competitive cost. PMID- 3524203 TI - Evaluation of parathyroid autograft growth and function in hemodialysis patients. AB - The aim of our study was to evaluate the function and growth of parathyroid tissue autografted into the forearm of hemodialysis patients using several presently available methods. In a dynamic study, the secretory function of autografted tissue was evaluated in seven patients using either zero calcium dialysate or calcium infusion. In an additional prospective study, seven patients had repeated determinations of plasma immunoreactive parathyroid hormone (iPTH) concentration on samples from both forearms, a radionuclide evaluation of autograft function using thallium-201 chloride, and real time ultrasonography. Light microscopy analysis was performed in two patients. The dynamic study demonstrated that induction of hypocalcemia was followed by an increase, and induction of hypercalcemia by a decrease, in circulating iPTH in both forearms using three different radioimmunoassays, similar to what has been reported for normal parathyroid tissue. A significant gradient (ie, greater than 2.0) of plasma iPTH concentration in samples from both forearms was observed in only three out of the seven patients of the prospective study. Two of these patients disclosed an increased uptake of 201TI chloride at the site of autografted tissue and had an echographically detectable mass. In both, hyperplastic parathyroid tissue was removed. At present, the remaining third patient does not have other features of recurrent hyperparathyroidism. In conclusion, autotransplanted parathyroid tissue of hemodialysis patients shows an adequate response to physiologic stimuli such as hypo- and hypercalcemia. Dynamic tests, therefore, appear to be a useful tool in the assessment of its function. In addition, radionuclide and echographic studies may be reliable adjuncts in the detection of marked parathyroid autograft hyperplasia. PMID- 3524204 TI - Transplant ureteral obstruction masquerading as recurrent rejection episodes: management by percutaneous antegrade balloon dilatation. AB - We report a 52-year-old male renal transplant recipient who had three "rejection episodes." The first of these responded to conventional antirejection therapy; however, the next two episodes showed incomplete responses to treatment for rejection. At subsequent presentation with deteriorating renal function, ureteral obstruction was evident and was relieved with percutaneous antegrade balloon dilatation with a return of his plasma creatinine to normal. Obstruction of the ureter was a major component in our patient's course given the lack of response to conventional antirejection therapy and the normalization of renal function with relief of the documented ureteral stenosis. This case illustrates that ureteral obstruction can mimic rejection in the renal transplant recipient. Management of ureteral stenosis in transplant patients with percutaneous antegrade balloon dilatation appears to be an effective procedure and can supplant the need for open surgical procedures. PMID- 3524205 TI - Renal disease and drug metabolism: an overview. AB - Renal disease will perturb the disposition of drugs that primarily depend upon renal excretory function for elimination. While changes in drug half-life (T1/2) are often cited as evidence of altered drug disposition, it must be remembered that T1/2 is a dependent variable whose magnitude varies directly with volume of distribution (Vd) and indirectly with total body clearance (ClT). ClT is the one term that succinctly describes drug elimination. ClT is defined as the sum of the renal (ClR) and nonrenal (ClNR), or metabolic, clearances of a drug. Renal failure has been shown to alter the hepatic microsomal mixed-function oxidase system of drug metabolizing enzymes. Therefore, in end-stage renal failure, the potential exists for the modification of the disposition of drugs whose elimination is primarily hepatic. The kidneys themselves contain many of the enzymes important in hepatic drug metabolism. Drugs such as morphine, paracetamol, and p-aminobenzoic acid are metabolized in the kidney and experimental renal disease has been shown to reduce drug metabolism in the diseased kidney compared with the contralateral normal kidney. Renal disease, then, has the potential to alter not only the renal clearance of unchanged drug but also may substantially modify the metabolic transformation of drugs in both the liver and the kidneys. It can no longer be assumed that the pharmacokinetics of drugs that are disposed mainly by metabolism will be unaltered in renal failure. PMID- 3524207 TI - Online information retrieval in pharmacy and related fields. AB - Online information retrieval in pharmacy and related fields is described. Factors involved in determining whether to conduct an online search are discussed, including characteristics of appropriate and less suitable topics, advantages and limitations of online searching versus manual searching, and possible types of searches. The process of preparing for an online search, involving the determination of search vocabulary, relevant citations, important authors, time frame, special categories (such as language, publication type, and reviews), and the number of citations needed, as well as choosing a database, is explained. Sample search strategies on MEDLINE and IPA are illustrated to demonstrate the basic search commands and to compare file retrievals on the sample subject. Pharmacy-related bibliographic databases, general-interest databases, end-user search services, and full-text and numeric databases are profiled. Online database searching can be a cost-efficient and flexible alternative to manual literature searching for pharmacists. Although most online searching is currently conducted by librarian-search specialists, end-user searching is a growing trend, as is the availability of full-text databases. PMID- 3524206 TI - Compatibility of aminophylline and methylprednisolone sodium succinate intravenous admixtures. AB - The stability of aminophylline and methylprednisolone sodium succinate in admixtures containing both drugs was studied. Admixtures containing aminophylline 1.0 mg/mL and methylprednisolone sodium succinate 2.0 and 0.5 mg/mL were prepared in both 5% dextrose injection and 0.9% sodium chloride injection. Each admixture was prepared in triplicate and samples were kept at room temperature in glass. Immediately after admixture and at one, two, and three 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. Control solutions containing only one of the two drugs were also tested. No visual changes were observed. The admixtures had higher pH values after aminophylline was added, but pH of the samples did not change significantly. Aminophylline concentrations did not change significantly throughout the study period. In 0.9% sodium chloride admixtures with methylprednisolone sodium succinate 0.5 mg/mL, less than 90% of the initial methylprednisolone concentration remained at two hours at the 2.0 mg/mL initial concentration, less than 90% remained at three hours. However, methylprednisolone alcohol (a pharmacologically active form of methylprednisolone sodium succinate) was detected in increasing concentrations after the first hour. Aminophylline in a final concentration of 1.0 mg/mL or less can be mixed with methylprednisolone sodium succinate in a final concentration of 2.0 mg/mL or less in 5% dextrose injection or 0.9% sodium chloride injection and administered intravenously within three hours after mixing. PMID- 3524208 TI - Oncogenes, viruses, or rheumogenes? PMID- 3524209 TI - Immunofluorescence assay using Crohn's disease tissue-injected athymic nude mouse lymph nodes in the diagnosis of inflammatory bowel diseases. AB - Sometimes, even after extensive investigative efforts, the diagnosis of inflammatory bowel disease remains in doubt. The accurate diagnosis is important if appropriate therapy is to be instituted. A simple indirect immunofluorescence assay that tests the patient's serum against lymphoid tissues from athymic nude (nu/nu) mice receiving injections of filtrates of Crohn's disease tissue is proposed. Eighty percent of serum samples from patients with active, symptomatic Crohn's disease give positive results of immunofluorescence when tested with these lymphoid tissues. The false-positive rate has been very low (less than 10 percent). Because this assay is fairly sensitive and least invasive, it was used for the clarification of many puzzling cases that were seen at the Albert Einstein College of Medicine over the past three years. Ten of these cases were selected for illustration and discussion and are presented in this report. PMID- 3524210 TI - Acute renal failure. Pathogenesis and prevention. PMID- 3524211 TI - Chronic myeloid leukemia. PMID- 3524212 TI - Management of myelodysplastic syndromes. AB - The treatment of myelodysplastic syndromes is reviewed, with emphasis on recently published clinical trials. Pyridoxine is rarely effective, but a trial in patients with refractory anemia with ringed sideroblasts is justifiable. Corticosteroids do not appear indicated unless in vitro data suggest response. Androgens are generally not beneficial, although danazol merits further evaluation. Both 13-cis-retinoic acid and low-dose cytosine arabinoside have considerable toxicity and yield short-lived partial responses that may not have a significant impact on survival. Combination chemotherapy may be considered in selected patients with refractory anemia with excess of blasts, refractory anemia with excess of blasts in transformation, and chronic myelomonocytic leukemia; however, in general, its toxicity outweighs potential benefit. For unusual patients under 30 years old, bone marrow transplantation should be considered as first-line therapy. Until more effective and less toxic agents are available, supportive care may still be the most appropriate therapy for many of these generally elderly patients. PMID- 3524213 TI - Polymicrobial cholangitis and Kaposi's sarcoma in blood product transfusion related acquired immune deficiency syndrome. AB - Before presenting to the Mayo Clinic, a 24-year-old white woman had received 35 transfusions of blood products over a 72-hour period in February 1981. Two and one half years later, the diagnosis of polymicrobial cholangitis (Cryptosporidium, Candida albicans, and Klebsiella pneumoniae) was established. Further evaluation demonstrated profound helper T lymphocyte suppression, disseminated Mycobacterium avium-intracellular infection with mycobacteremia, and Kaposi's sarcoma of lymphoid tissue, confirming a diagnosis of acquired immune deficiency syndrome (AIDS). This case represents an unusual infectious complication of AIDS. Additionally, this is believed to be the first report of Kaposi's sarcoma occurring in a patient with AIDS associated with blood product transfusion. PMID- 3524214 TI - Risk factors and comparisons of clinical nephrotoxicity of aminoglycosides. AB - Controversy continues regarding risk factors for nephrotoxicity and the possible differences in nephrotoxicity rates associated with the aminoglycosides commonly used in clinical practice. Review of published data, including 27 comparative clinical studies, indicates the following: sensitive markers of tubular toxicity do not correlate directly with clinically significant diminution in glomerular filtration rate; of all the proposed risk factors, few are consistently found; despite numerous studies, some with potential drawbacks, no current aminoglycoside has been shown to be consistently and conclusively less nephrotoxic than another; and, as per a previous recommendation, the choice of an aminoglycoside should not be made on the basis of nephrologic criteria. PMID- 3524215 TI - Aminoglycoside toxicity in infants and children. AB - The aminoglycosides are frequently prescribed for infants and children, especially newborn infants with suspected or documented sepsis or meningitis. In older infants and children, the aminoglycosides are commonly used to treat acute respiratory exacerbations in patients with cystic fibrosis, intra-abdominal sepsis, complicated urinary tract infections, and other infections caused by gram negative enteric bacilli. Although these drugs are generally well tolerated and efficacious, there is relatively little information on toxicity in pediatric patients. The potential for ototoxicity from the aminoglycosides, especially streptomycin, kanamycin, and gentamicin, was evaluated in seven prospective, controlled studies of 1,321 newborn infants. Although the designs and follow-up periods were different among the studies, the audiometric tests were similar and appropriate for age. Three studies measured auditory brain stem response during the neonatal and early infancy periods. With the exception of one study, ototoxicity occurred less frequently in aminoglycoside-treated patients than it did in untreated control patients. One study from Canada demonstrated abnormal brain stem response audiograms in gentamicin- or tobramycin-treated neonates compared with normal brain stem response audiograms in untreated control subjects. That study, however, was flawed by the small number of patients evaluated and the lack of follow-up of any patients. Nephrotoxicity appears to be rare in neonates, although one study in this age group showed an elevated N acetyl-beta-glucosaminidase excretion rate in gentamicin-treated infants compared with rates in infants treated with amikacin or chloramphenicol. In that study, no attempt was made to correlate lysosomal injury with clinical or conventional laboratory evidence of nephrotoxicity. The toxicity of the aminoglycosides in older infants and children has not been adequately assessed. The broadest experience with these compounds has been in patients with cystic fibrosis, and most open studies in these patients have indicated a relative lack of ototoxicity and nephrotoxicity. It should be emphasized, however, that the standard dosage of aminoglycosides in patients with cystic fibrosis frequently results in serum concentrations that are lower than anticipated because of a relatively larger volume of drug distribution and a greater urinary excretion rate. The lack of reports on aminoglycoside-associated toxic effects in children suggests that these compounds are safe and well tolerated in this age group. PMID- 3524216 TI - Aminoglycoside antibiotics in infectious diseases. An overview. AB - This article presents an overview of the aminoglycoside antibiotics used in clinical practice. Facts concerning the discovery and properties of the aminoglycosides are followed by information about spectrums of activity and mechanisms of action and resistance. Individual compounds are compared and proposals on the possibilities for their clinical use, both as single drugs and in combination with beta-lactam antibiotics, are made. The importance placed on measuring the serum concentrations of aminoglycoside antibiotics should serve as a remainder that this procedure is important, on one hand, to increase clinical efficacy and, on the other, to reduce the side effects of these antibiotics. Finally, the aminoglycosides are compared briefly with other antibacterial compounds, some of which are very new. There is no doubt that in the future the aminoglycosides will continue to occupy an important place in the treatment of severe infections, although newly developed agents appear to be effective complements. PMID- 3524217 TI - Management of intra-abdominal sepsis. AB - Intra-abdominal sepsis most frequently follows penetrating or blunt abdominal trauma or perforated appendicitis or diverticulitis. The initial leakage of the endogenous gastrointestinal microflora into the peritoneal cavity results in peritonitis and secondary septicemia, which is frequently followed by localized intra-abdominal abscess. These infections are most frequently polymicrobial and relate directly to the unique endogenous microflora at the various levels of the gastrointestinal tract. The treatment of intra-abdominal sepsis is primarily centered around prompt, appropriate surgical intervention. Parenterally administered antibiotics are also required to decrease the chance of local bacterial infection or septicemia. The choice of the appropriate agent(s) to be used initially, before the results of culture and sensitivity reports are available, depends primarily on the clinical presentation and also on whether the intra-abdominal infection occurred in the community or within the hospital setting. Clinical and experimental studies of intra-abdominal sepsis have largely stressed the use of antibiotic agents that have a spectrum of activity effective against the aerobic coliforms and anaerobic Bacteroides fragilis. PMID- 3524218 TI - Comparative review of combination therapy: two beta-lactams versus beta-lactam plus aminoglycoside. AB - Febrile neutropenic patients are usually treated with a combination of a beta lactam and an aminoglycoside. Since Pseudomonas aeruginosa is an important pathogen in these patients, the empiric use of possibly synergistic combinations against that organism has been traditionally recommended. The recent appearance of beta-lactams more active against P. aeruginosa and the well-known nephrotoxicity of aminoglycosides have led some to advocate the use of beta lactam combinations for empiric treatment of fever in neutropenic cancer patients. This article reviews the available literature on the controlled use of combinations of beta-lactams in the treatment of febrile neutropenic patients as compared with that of combinations of beta-lactams and aminoglycosides. The review includes comparison of overall response, response in patients with septicemia or other infections, response associated with different pathogens, the effect of profound neutropenia, and an evaluation of the toxicities encountered. Overall, these results show that response rates with a combination of two beta lactams are similar to those obtained with the combinations of a beta-lactam and an aminoglycoside for infections in patients with serious underlying disease and compromised mechanisms of defense. They also suggest that the steady emergence of resistance of pathogens to beta-lactams has often been overcome by the use of newer drugs in regard to infections caused by the Enterobacteriaceae but much less effectively in regard to P. aeruginosa. There are still important theoretic reasons for preferring an aminoglycoside-containing combination as empiric therapy in febrile neutropenic patients, and our overall conclusion is that it would be appropriate to conduct a large-scale trial comparing beta-lactam combinations with the traditional beta-lactam plus aminoglycoside regimens in that setting. PMID- 3524219 TI - Qualitative overview of randomized trials of aminoglycosides. AB - A qualitative overview was conducted of randomized clinical trials comparing two or more of the following aminoglycoside antibiotics--amikacin. gentamicin, netilmicin, sisomicin, and tobramycin--with respect to efficacy, nephrotoxicity, or auditory toxicity. Design features considered included number of participants in each treatment arm, proportion of randomized participants available for analysis, blinding of evaluators, and report of statistically significant results. The proportion of participants eligible for analysis was less than or equal to 75 percent for 66 percent of the comparisons regarding nephrotoxicity, 43 percent regarding efficacy, and 19 percent regarding auditory toxicity. Twenty nine percent of the trials reported that evaluators were blinded to treatment group assignments. The results of most trials showed no significant differences, although sample sizes were, in general, smaller than necessary to detect moderate differences. Quantitative overviews may be a useful means of detecting real differences in risk that are not apparent from the results of several individual small trials. PMID- 3524220 TI - In vitro evaluations of amikacin: an assessment of the currently used methods of disk diffusion and dilution susceptibility, antimicrobial synergy, and the measurement of amikacin concentrations. AB - The amikacin antimicrobial susceptibility tests were reviewed and found to be acceptable for clinical laboratory use. The early change from the 10-micrograms to the 30-micrograms diagnostic disk concentrations has resulted in reasonable accuracy, according to data from surveys of the College of American Pathologists, and acceptable discrimination between susceptible and resistant microorganisms. Similarly, standardized dilution susceptibility methods have proven acceptable, but great care must be exercised to select an agar medium in which performance was evaluated by the criteria of the National Committee for Clinical Laboratory Standards. Breakpoint concentrations selected as susceptible for amikacin (equal to or less than 16 micrograms/ml) were based on infected patient pharmacokinetics and previously correlated with patient bacteriologic outcome. Amikacin serum levels have been accurately measured by numerous procedures, including gas-liquid chromatography, radioimmunoassay, radioenzymatic assay, bioassay, and latex agglutination tests. Recent surveys of the College of American Pathologists support the earlier suspicions of lower accuracy and specificity with the bioassay method. Care must be taken to rapidly and appropriately process specimens from patients receiving concurrent high doses of antipseudomonal penicillins because of documented inactivation of some aminoglycosides by these penicillins. Amikacin is less affected by these beta-lactams. Evaluations of the antibacterial activity of amikacin in combination with other antimicrobial agents, principally the beta-lactams, continue to show high rates of enhanced killing or synergy. Although the methods for assessment of synergy have not been standardized, remarkably favorable and similar results between laboratories have been reported. PMID- 3524221 TI - Comparative study of ototoxicity and nephrotoxicity in patients randomly assigned to treatment with amikacin or gentamicin. AB - Fifty-four patients treated with gentamicin and 52 patients treated with amikacin were evaluated for nephrotoxicity and ototoxicity in a prospective, randomized, blinded comparative trail. According to our definition of nephrotoxicity (an increase in serum creatinine levels to at least 50 percent and 0.5 mg/dl above the baseline value), nephrotoxicity occurred in eight (15 percent) of the patients who were treated with gentamicin and none of the patients who were treated with amikacin (p = 0.006). Using several other definitions of nephrotoxicity, the differences in incidence between the treatment arms were not significant. Nephrotoxicity appeared to be associated with impaired baseline renal function, greater age, and the presence of bacteremia. Ototoxicity occurred in six (11 percent) of the 54 gentamicin-treated patients; auditory toxicity occurred in three patients, and toxic changes were observed in three of the 33 patients who could also be evaluated for vestibular toxicity. Similarly, ototoxicity was observed in seven (13 percent) of the 52 amikacin-treated patients; auditory toxicity occurred in four patients, and of the 34 patients who could also be evaluated for vestibular toxicity, three exhibited vestibular toxicity without auditory toxicity are one experienced vestibular effects in addition to those affecting the cochlea. We observed a modest association of ototoxicity with nephrotoxicity and with an elevated mean trough aminoglycoside serum level. The results of this study indicate that amikacin may be less nephrotoxic than gentamicin in humans; however, the broad applicability of this finding to other patient populations is uncertain. PMID- 3524222 TI - Progressive tubulointerstitial renal disease in infancy with associated hepatic abnormalities. AB - Clinical, pathologic, and biochemical data are reported in two male infants who had rapidly progressive renal failure, enlarged kidneys, hepatosplenomegaly, and fat malabsorption. One infant, studied prior to the onset of significant renal insufficiency, manifested renal Fanconi syndrome, hyperparathyroidism, and marked hypocalcemia. After a brief period of dialysis, both received renal transplants. Neither has clinical evidence of reoccurrence of the renal disorder in the transplant, but both still have hepatic abnormalities. Morphologic features present in both patients include a renal lesion characterized by tubulointerstitial injury with a tubulocystic component and hepatic abnormalities with bile duct proliferation, portal fibrosis, and inflammation. These cases do not readily conform to any single published diagnostic category, including nephronophthisis-congenital hepatic fibrosis or infantile polycystic kidney disease, and appear to be unique. PMID- 3524223 TI - Identification of unsuspected thyroid carcinoma using immunoperoxidase for thyroglobulin. AB - Two patients with poorly differentiated metastatic cancer were shown to have metastatic thyroid carcinoma. Each patient had poorly differentiated cancer and remaining thyroid tissue in the neck. The diagnosis was secured using the immunoperoxidase technique with an antibody against thyroglobulin. The proper evaluation of patients with carcinoma of unknown primary involves specific tissue identification using special techniques in pathology. PMID- 3524224 TI - Cryptococcal infections in patients with acquired immune deficiency syndrome. AB - Cryptococcus neoformans is a major pathogen in patients with acquired immune deficiency syndrome and was found to infect 13.3 percent of such patients seen at two medical centers. Serum cryptococcal antigen levels were as high as 1:2,000,000 and, despite therapy, often remained elevated. Antigen titers in the cerebrospinal fluid generally declined at an expected rate in the survivors. The significance of high antigen titers in the blood after a prolonged course of therapy with amphotericin B and 5-flucytosine is unknown. PMID- 3524225 TI - Relationship of staphylococcal tolerance, teichoic acid antibody, and serum bactericidal activity to therapeutic outcome in Staphylococcus aureus bacteremia. AB - A randomized cooperative study of therapy for Staphylococcus aureus bacteremia was conducted in which nafcillin was given for four or six weeks to patients with clinical endocarditis and for two or four weeks to those without evidence of endocarditis. Eighty-four patients were enrolled, and 32 completed treatment, all of whom had bacteriologic cures. Three patients, treated for two weeks, had complications that were undetectable by assay of serum teichoic acid antibody. Data were insufficient to allow conclusions regarding the optimal duration of therapy for patients with or without endocarditis. However, the results suggest that neither clinical nor immunologic methods can reliably detect complications in patients treated for two weeks only. In addition, patients infected with tolerant organisms remained febrile longer than those infected with nontolerant strains but did not require additional antibiotics for cure. Peak serum bactericidal activity at a dilution of 1:8 or greater was present in all patients. Serum bactericidal activity of 1:8 prior to an antibiotic dose was not necessary for cure. PMID- 3524226 TI - Randomized trial of computer-assisted insulin delivery in patients with type I diabetes beginning pump therapy. AB - Sixteen patients with type I diabetes were randomly assigned to two groups to evaluate the utility of computer-assisted insulin dosage decision-making. All patients used the same solid-phase reagent strip system for glucose measurement and the same pump. The standard group (n = 9) used standard algorithms for insulin adjustment, whereas the computer group (n = 7) relied on interactive instruction from a small, inexpensive (less than $100) computer. At the beginning of the study, there were no significant differences between groups in C-peptide level, hemoglobin A1c level, age, or duration of diabetes. Mean blood glucose level during the study for the computer group was 121 mg/dl (6.7 mM), which was significantly lower (p less than 0.01) than glucose levels charted by the standard group: 148 mg/dl (8.2 mM). Mean number of blood glucose values charted by the computer group (58 per week) was significantly (p less than 0.01) greater than the number charted by the standard group (51 per week). Hemoglobin A1c values at six weeks correlated with the mean number of blood glucose values charted per week of the study. There was no difference between groups in symptomatic hypoglycemic episodes. Computer-assisted insulin dose decision-making is feasible, safe, and effective in enabling persons with type I diabetes mellitus to achieve lower mean blood glucose values over a six-week period while initiating pump therapy. PMID- 3524227 TI - Alzheimer's disease. PMID- 3524228 TI - Excessive sodium retention as a characteristic of salt-sensitive hypertension. AB - To investigate the possibility that salt-sensitive hypertensives have deficient sodium excretion, the sodium retained by 20 hypertensive patients during a salt load (SL = 3.88 mEq/Kg/day) was calculated for 3 days immediately after 4 days of sodium deprivation (SD = 9 mEq/d). Patients were divided into two groups by arterial pressure responses to SD: responders (N = 10) whose pressures became normal rapidly and averaged less than 140/90 during SD and nonresponders (n = 10) whose pressures were not affected. Sodium retention (mEq/Kg) during SL was calculated as cumulative sodium intake minus cumulative urinary sodium divided by body weight. Responders retained more sodium during SL than nonresponders (3.71 +/- 0.96 [SD] vs. 2.52 +/- 1.05 mEq/Kg, p less than 0.02). This could not be explained by a measurable decrease in filtered sodium load since creatinine clearance was the same in each group. Neither was it associated with differences in plasma renin activity (PRA) or aldosterone excretion rates (AER). Whereas PRA was significantly lower in responders at the end of SD, AER was not different; with SL, group values were equally suppressed. Also sodium excretion was not correlated with arterial pressure except in non-responders on the last day of SL. These data indicate that salt-sensitive hypertensives handle sodium differently than nonsalt-sensitive hypertensives. PMID- 3524229 TI - Relationships between human blood groups, bacterial pathogens, and urinary tract infections. AB - Blood groups of 137 patients with acute pyelonephritis and chronic upper tract infection, cystitis, and asymptomatic bacteriuria were compared with those of a normal uninfected control population. In addition, the identified uropathogens were categorized according to the patient's blood group. There was a significant association between the diagnosis of chronic upper tract infection and blood group B as compared with controls (p = less than 0.05, chi 2). Analysis of the bacterial isolates showed that more patients with blood group B had infections with Pseudomonas sp., Klebsiella pneumoniae, and Proteus sp. than was expected; and fewer patients with blood group A had infections with Pseudomonas than predicted (p = less than 0.05, chi 2). There was an increased number of patients in blood group AB with infections caused by Escherichia coli and Klebsiella pneumoniae. These results suggest that an individual's blood group may be a significant factor in the host-response to bacterial invasion and influence the development of infection with certain gram-negative bacilli. PMID- 3524231 TI - Treatment of Duchenne muscular dystrophy with growth hormone inhibitors. AB - A controlled, double-blind therapeutic trial with the drug mazindol, a growth hormone inhibitor, was performed in a pair of 7 1/2 year-old monozygotic twins, with Duchenne muscular dystrophy (DMD). The rationale for this trial was based on a patient (reported previously) affected simultaneously with DMD and growth hormone (GH) deficiency, who is showing a benign course of the dystrophic process and is still walking at 18 years. One of the twins received 2 mg of mazindol daily, while the other received a placebo. The assessment, repeated every 2 months, included weight and height measurements, functional and motor ability tests, ergometry and determinations of serum enzymes and GH levels. After one year of trial the code was broken and it was seen that the twin under placebo treatment was strikingly worse than his brother, the progression of whose condition was practically arrested. These results strongly suggest that treatment with a GH inhibitor is beneficial for DMD patients. PMID- 3524232 TI - The indirectly obtained fetal heart rate: comparison of first- and second generation electronic fetal monitors. AB - Fetal heart rate variability has become an essential component in evaluation of the fetus during continuous electronic fetal monitoring. Because of technical deficiencies of monitoring equipment, fetal heart rate variability may not always be available, such as during indirect monitoring of the fetus. In lieu of integration, a mathematical procedure called autocorrelation has, with the use of microprocessors, been incorporated into the fetal monitor, creating the "second generation" of electronic fetal monitoring. This study examined the accuracy of the first- and second-generation monitors by comparing simultaneously obtained indirect and direct real-time fetal heart rate data. The second-generation monitor produced an indirectly obtained fetal heart rate that was more accurate when compared with the directly obtained data than that with the first-generation fetal monitor. In addition, the variation in data from the first-generation monitor was substantially higher than that with the second-generation monitor. It is concluded that the fetal heart rate tracing from the second-generation monitor is more accurate when compared with the fetal electrocardiogram and may facilitate a truer interpretation of fetal heart rate variability than that obtained with the first-generation monitor. PMID- 3524230 TI - High frequency positive pressure ventilation in experimental meconium aspiration syndrome. AB - To compare high frequency positive pressure ventilation (HFV) to conventional ventilation (CV) in experimental meconium aspiration syndrome (MAS) adult rabbits were randomly assigned to one of four groups: sham (G1) n = 10, control (G2) n = 12, CV (G3) n = 6, and HFV (G4) n = 6. All animals were stabilized on an FI O2 of 0.70 after a tracheostomy and arterial line were placed. The alveolar-arterial oxygen difference (A-aDO2) was calculated for each blood gas measurement and mean airway pressure (MAP) measured in CV and HFV at the time of each blood gas. Human meconium (2 ml/kg of 25% solution) was instilled intratracheally (MI) in groups 2 4. Group 3 was then placed on conventional ventilation with a rate of 40 BPM while Group 4 with a rate of 400 BPM. Analysis of variance was used to compare A aDO2 and MAP. There was no significant difference between group 4 and group 2, while there was a significant difference between group 3 and groups 2 and 4. Sustained inflation of 25 cm H2O as used for 20 seconds was used before HFV in a fifth group (n = 6) that was added to the study and was otherwise identical to HFV. There was no significant difference between the fifth group and group 2 or group 4. Our findings indicate HFV is not efficacious in experimental MAS whether or not sustained inflation is used. PMID- 3524233 TI - Plasma vasoactive intestinal polypeptide, insulin, gastric inhibitory polypeptide, and blood glucose in late pregnancy and during and after delivery. AB - The plasma levels of the gastrointestinal regulatory peptides vasoactive intestinal polypeptide, insulin, and gastric inhibitory polypeptide, as well as blood glucose, were measured in six healthy women before, during, and after normal parturition at term. Plasma levels of vasoactive intestinal polypeptide increased significantly (p less than 0.05) during delivery and remained significantly elevated for 15 minutes post partum. Plasma insulin levels rose significantly (p less than 0.05) within 5 minutes after delivery and stayed three fold and significantly elevated for 120 minutes post partum. Plasma levels of gastric inhibitory polypeptide decreased significantly (p less than 0.05) between 5 and 30 minutes after delivery. Blood glucose levels were significantly (p less than 0.05) increased during labor, delivery, and the early postpartum period compared to late pregnancy. These findings suggest a mediating role for vasoactive intestinal polypeptide, insulin, and gastric inhibitory polypeptide in the physiologic adaptations to normal pregnancy, delivery, and the postpartum period. PMID- 3524234 TI - Fetal acoustic stimulation testing. II. A randomized clinical comparison with the nonstress test. AB - Antepartum fetal heart rate testing, specifically the nonstress test, is of accepted value in the antenatal surveillance of high-risk pregnancies. Fetal rest activity cycles coupled with arbitrary test intervals appear to lead to falsely nonreactive tests. Methods to alter fetal behavioral states have not been uniformly successful. A retrospective analysis of the adjunctive use of acoustic stimulation at our institution demonstrated a 50% reduction in the number of nonreactive tests. Consequently a prospective randomized clinical trial was undertaken to compare the standard nonstress test with the fetal acoustic stimulation test. Those patients randomized to the fetal acoustic stimulation test underwent transabdominal acoustic stimulation with a Model 5C electronic artificial larynx. The incidence of nonreactive tests was 14% in the control group and 9% in the study group (chi 2 = 11.09, p = 0.004). A significant reduction in testing time was also observed. The fetal acoustic stimulation test offers advantages over the traditional nonstress test by lowering the incidence of nonreactive tests and reducing testing time. PMID- 3524235 TI - The "vanishing twin": ultrasonographic assessment of fetal disappearance in the first trimester. AB - Review of the sonographic findings of 1000 pregnancies with viable gestations in the first trimester revealed a minimum incidence of twinning of 3.29%. Of these, 21.2% demonstrated the "vanishing twin" phenomenon, often with associated bleeding, but with a good prognosis for the remaining fetus. Ovulation induction did not appear to alter these data. The sonographic criteria for "vanishing twin" are discussed. The incidence of multiple gestation is 3.29% to 5.39%, higher than previously believed. PMID- 3524236 TI - Evidence of cyclic alterations of thyroid size during the menstrual cycle in healthy women. AB - Serum levels of thyroxine, triiodothyronine, triiodothyronine resin uptake, thyroxine-binding globulin, thyrotropin, and ultrasonically determined thyroid gland volume were investigated weekly in 11 healthy women during a normal menstrual cycle, and in five healthy men once a week for 5 consecutive weeks. In the men the thyroid volume was unaltered. In the women, however, a mean variation in thyroid volume of approximately 50% between minimum values (15.4 +/- 3.1 ml, day 9) and maximum values (24.4 +/- 4.8 ml, day 23) was found (p less than 0.01), although no significant differences in the other thyroid variables could be demonstrated. The menstrual cycle seems to be associated with cyclic alterations of thyroid size in healthy women unexplained by alterations in thyroid function variables. This information should be taken into account when goiter frequency, goitrogenic action of drugs, and goiter treatment effects are evaluated. PMID- 3524237 TI - Limitations of using maximum vertical pocket and other sonographic evaluations of amniotic fluid volume to predict fetal growth: technical or physiologic? AB - Maximum vertical pocket measurement and subjective sonographic impression of amniotic fluid volume were studied in 487 selected pregnancies. Opiate abuse, suspected fetal growth retardation, and suspected postterm gestation were negatively correlated with maximum vertical pocket; suspected fetal growth acceleration and increasing birth weight were positively correlated. Maximum vertical pocket appeared to peak at 31 to 33 weeks (p less than 0.05), and was related to fetal growth (p less than 0.001). Subjective sonographic evaluation of amniotic fluid volume yielded comparable results. Unfortunately, neither technique could be used to accurately predict the birth of a small, appropriate, or large for gestational age infant in the individual pregnancy. Abnormal fetal growth could be reliably excluded in only a small number of cases. This and previous studies suggest that diagnosis of abnormal fetal growth by means of sonographic amniotic fluid volume evaluation could be limited by physiologic variation rather than technical error in measurement. PMID- 3524238 TI - Functional development of human eye movement in utero assessed quantitatively with real-time ultrasound. AB - Functional development of eye movement in the human fetus in utero was assessed quantitatively, with real-time ultrasound. A pair of lens-derived echoes was used as a landmark to evaluate positional deviation with eye movement. The frequency of eye movement was measured either with 1-minute continuous observations or at 1 minute cross sections. Two hundred forty-five normal fetuses between 18 and 42 weeks of gestation were studied. Three critical ages, with respect to physiologic development of fetal eye movements, were evident: 22 to 25, 30 to 33, and 38 to 41 weeks. The first and the second indicate the onset of the moderate-frequency and high-frequency eye movements, thereby implying a transition, presumably to a state of so-called rapid eye movement and a rise of rapid eye movement, respectively. The third represents full maturation of the mechanisms, that is, non-rapid eye movement and rapid eye movement. PMID- 3524239 TI - Recurrent carcinoma in situ of the vulva in a skin graft. AB - Skinning vulvectomy has been a recommended treatment for carcinoma in situ of the vulva. We report a case of recurrent carcinoma in situ occurring in the skin graft of a patient with previous skinning vulvectomy. PMID- 3524240 TI - Personal protection against sexually transmitted diseases. AB - Primary prevention of sexually transmitted diseases has received little emphasis in control programs. To evaluate the effectiveness of prevention strategies, we reviewed the world's literature on this topic. Use of condoms and spermicides greatly reduces the risk of gonorrhea, and barrier methods are practical and acceptable. Certain systemic antibiotics are effective, but for practical reasons, their use cannot be recommended. Washing or urinating after sexual exposure does not appear to protect against infection. Although the effectiveness of modifying sexual behavior to reduce the risk of sexually transmitted diseases has not been evaluated, many people have changed or are willing to change their behavior. Even if preventive measures are used consistently by only a minority of persons at risk, rates of sexually transmitted diseases would decline rapidly. In this era of sexually transmitted diseases that are not readily cured by antibiotics, use of effective preventive measures should be strongly encouraged. PMID- 3524241 TI - Update on prenatal steroid for prevention of respiratory distress. Report of a conference--September 26-28, 1985. PMID- 3524242 TI - Prenatal diagnosis of craniofacial malformations with ultrasonography. AB - Although the utility of ultrasound in the prenatal diagnosis of many congenital anomalies is well established, its accuracy in detecting craniofacial malformations has not been examined in a large series. Sonographic examinations of 223 patients at risk for fetuses with craniofacial malformations were performed between 18 and 40 weeks. The risk factors included a familial history of craniofacial malformations, extrafacial anomalies diagnosed on ultrasound, fetal chromosomal aberrations, and maternal drug intake. Sonographic diagnosis was possible in 151 (67.7%) patients on the first scan and in 47 (21.1%) patients on the second scan and was not possible in 25 patients (11.2%). Of the 198 cases diagnosed antenatally, craniofacial malformation was detected in 14 and confirmed postnatally. No false positive diagnoses were made. A negative diagnosis of craniofacial malformation was made in 184 cases with two false negative results (1.0%). Anomalies diagnosed sonographically included anophthalmia, anterior cleft lip and/or palate, hypotelorism, hypertelorism, and micrognathia. The results of this study demonstrate that ultrasound is an accurate and reliable tool for the prenatal diagnosis of craniofacial malformations. PMID- 3524243 TI - Sequelae of induced first-trimester abortion. A prospective study assessing the role of postabortal pelvic inflammatory disease and prophylactic antibiotics. AB - A follow-up study was undertaken in 493 women who had participated in a clinical, controlled trial with the object of assessing the role of postabortal pelvic inflammatory disease and prophylactic antibiotics in the development of sequelae. Information about dysmenorrhea, dyspareunia, chronic pelvic pain, episodes of pelvic inflammatory disease, infertility, births, induced and spontaneous abortions, and ectopic pregnancies were obtained from 382 of the women and from 38 of 40 women who had contracted postabortal pelvic inflammatory disease during the previous study. Significantly elevated rates in women with postabortal pelvic inflammatory disease compared with women without this disease were found for spontaneous abortion (22% versus 5%, p less than 0.0005), secondary infertility (10% versus 2%, p less than 0.05), dyspareunia (20% versus 5%, p less than 0.005), and chronic pelvic pain (14% versus 2%, p less than 0.001). Nonsignificant differences were observed for ectopic pregnancy and dysmenorrhea. A new episode of pelvic inflammatory disease within the first year after abortion was observed more often in women with postabortal pelvic inflammatory disease than in women without infection (41% versus 5%, p less than 0.0001). Prophylactic antibiotics decreased the rates of spontaneous abortion and dyspareunia (p less than 0.05 in both instances). PMID- 3524244 TI - Central retinal artery occlusion in Sneddon's disease associated with antiphospholipid antibodies. AB - A 33-year-old woman with retinal artery occlusion also had Sneddon's disease (livedo reticularis, neurologic abnormalities, and labile hypertension). While retinal artery occlusive disease obviously must be added to the symptomatic spectrum of this rare disorder, the detection of antiphospholipid antibodies in this patient has pathogenetic implications. PMID- 3524245 TI - Penetrating keratoplasty after placement of a temporary keratoprosthesis during pars plana vitrectomy. AB - Five eyes of five patients with opaque corneas underwent penetrating keratoplasty after pars plana vitrectomy. In each case, the Landers-Foulks temporary keratoprosthesis provided visualization of the vitreous cavity and retina, allowed successful removal of hemorrhagic vitreous, and permitted retinal reattachment. Corneal grafts remained clear in two eyes; three grafts developed stromal edema. Useful postoperative vision was achieved in two eyes. However, proliferative vitreoretinopathy, postoperative hypotony, atrophia bulbi, and corneal edema resulted in poor vision in three eyes. PMID- 3524246 TI - Contact lens surface changes after exposure to surfactant and abrasive cleaning procedures. AB - Proper lens maintenance is required if contact lens wear is to be successful. Poor compliance or inadequate cleaning may lead to contact lens failures and potentially damage to the eye. With phase contrast microscopy, we addressed the effect of cleaning systems on the physical integrity of a surface-modified lens- the Silcon contact lens. Several cleaners were evaluated for their ability to clean Silcon lenses with minimal damage to the lens surface. The data demonstrated that: all cleaning techniques alter the surface appearance; scratches develop more readily on lenses received with surface irregularities; wettability does not correlate with the extent of surface scratching; recommended cleaning procedures do not directly alter the wettability of the contact lens material; and phase contrast microscopy may be a useful addition to laboratory quality control. PMID- 3524247 TI - Divergence insufficiency: characteristics, diagnosis, and treatment. AB - Although the entity of divergence insufficiency was described as early as 1886 by Duane, it has received relatively little attention in the literature. Patients presenting with a greater eso deviation at distance than at near, a concomitant deviation, and diplopia pose a challenging and critical diagnostic and therapeutic puzzle for the clinician. Divergence insufficiency, a benign condition, must be differentiated from divergence paralysis and sixth nerve palsy, two conditions that present with somewhat similar findings yet have underlying etiologies of a serious nature. This paper reviews the literature and clarifies the etiology, diagnosis, and treatment of divergence insufficiency and related conditions. PMID- 3524248 TI - Method of evaluating ultrasonic pachometers. AB - Although many ultrasonic pachometers are commercially available, little has been reported about their performance. We outline a technique for evaluating the accuracy of ultrasonic pachometers by simulating corneal thickness measurements using hydrogel contact lenses. On-eye contact lens thickness is determined using ultrasonic and optical pachometry. Absolute lens thickness is determined using a thickness gauge. Comparisons are made between measurements from the ultrasonic pachometer and measurements from the thickness gauge and optical pachometer. We used this technique to evaluate the performance of the Vida-55 ultrasonic pachometer. This technique was also used to determine the ultrasonic velocity for cat corneal tissue and two hydrogel lens materials. We determined the velocity of ultrasound in cat corneal tissue to be 1590 m/s at 33 degrees C. The velocity of ultrasound in hydroxyethyl methacrylate (HEMA) was 1740 +/- 24 m/s and 1700 +/- 40 m/s in Snoflex 50. We found the Vida-55 pachometer measured corneal thickness accurately when the appropriate ultrasound velocity was used (SEM = 6 microns). PMID- 3524249 TI - A review of tooth formation in children with cleft lip/palate. AB - The literature on tooth formation in children with cleft lip and/or palate is reviewed. The main focus of interest is the association of cleft type and dental abnormalities in number, size, shape, timing of formation, and eruption and cause of the abnormalities. The upper lateral incisor is the most susceptible to injury in the area of cleft in both deciduous and permanent dentitions. This tooth is affected in most instances, even in the cases of microforms of the cleft lip. The prevalence of hypodontia increases strongly with the severity of cleft. More teeth are congenitally missing from the upper jaw than from the lower jaw; however, in the permanent dentition both jaws are affected. Very high prevalence of hypodontia are observed in connection with the Van der Woude syndrome associated with cleft and with the Pierre Robin anomaly. Hypodontia is similarly prevalent in subjects with isolated cleft palate with and without a positive family history of clefts. The prevalence of hypodontia varies largely in different populations. Asymmetric formation of the contralateral teeth is a milder form of hypodontia. The prevalence of asymmetrically developing pairs of teeth is far more common in children with clefts than in children with normal palates or lips. In the permanent dentition the timing of tooth formation is delayed in children from all cleft groups compared to noncleft children. The delay lengthens (with increasing severity of cleft) from 0.3 to 0.7 years and is similar in all permanent teeth in both jaws. In children with hypodontia, the delay is still more severe. As the child becomes older, the delay may increase.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3524250 TI - Cleft lip and palate: the orthodontist's youngest patient. PMID- 3524251 TI - Neutropenic responses to intradermal injections of Escherichia coli. Effects on the kinetics of polymorphonuclear leukocyte emigration. AB - Killed Escherichia coli organisms injected intradermally into rabbits induced significant neutropenia and provoked a rapid rise in body temperature. Both the magnitude and the duration of the neutropenia were dose-dependent. After recovery from neutropenia, the rabbits became refractory to its redevelopment when subsequently given an equivalent dose of E coli. The influence of neutropenia and the subsequent refractory period on the rate of polymorphonuclear leukocyte (PMN) emigration into inflammatory sites was examined. Killed E coli organisms (6 X 10(8) per site) were injected into two groups of 20 intradermal sites in each rabbit. The first group (Group F) preceded the second (Group S) by 6 hours. The kinetics of PMN emigration, quantitated with 51Cr-labeled cells, differed in the two groups. In Group S sites an intense PMN influx was measured at 0-4 hours, and subsequently the extent of PMN emigration rapidly declined. In Group F sites a minute PMN influx was detected during the first 4 hours, coinciding with a marked neutropenia. The maximal PMN influx into Group F sites was measured between 6 and 10 hours. Microscopic sections at 4 hours showed a scanty PMN infiltrate and numerous bacteria in the dermis of Group F sites, while extensive phagocytosis of bacteria by PMNs was apparent in Group S sites. By comparing the extent of bacterial phagocytosis in 4-hour-old sites with the magnitudes of PMN emigration between 6 and 10 hours in both groups, we concluded that the phagocytic elimination of killed E coli was not a major mechanism regulating the cessation of local PMN emigration. Instead, we propose that tachyphylaxis or desensitization of sites to inflammatory factors released from E coli is the responsible mechanism. PMID- 3524252 TI - Immunohistochemical study of human pulmonary surfactant apoproteins with monoclonal antibodies. Pathologic application for hyaline membrane disease. AB - Three monoclonal antibodies, PC6, PE10, and PE12, were used for immunohistochemical studies of human lungs by immunoperoxidase staining. Monoclonal antibodies PC6 and PE10 against pulmonary surfactant apoproteins stained faint granules in the cytoplasm of some alveolar wall cells in adult lung. These stained cells appeared to be alveolar Type II cells. A fetal lung of 20 weeks' gestation had no any positive staining. However, a few scattered positive cells were observed in a newborn lung of 31 weeks' gestation, and the stained cells increased progressively with increasing gestational age. The positively stained cells were very few in the lungs of newborns who died of respiratory distress syndrome (RDS), but the lungs of newborns who died of other causes after recovery from RDS showed many positively stained cells. These results suggest that the immunohistochemical demonstration of the monoclonal antibodies PC6 and PE10 could be a good pathodiagnostic indicator reflecting the localization and development of pulmonary surfactant by alveolar Type II cells. On the other hand, monoclonal antibody PE12 was found to recognize the antigen that occurs on the surfaces of the alveoli of fetal, newborn, and adult lungs as one component of the alveolar lining layer, different from pulmonary surfactant. PMID- 3524253 TI - Polymorphonuclear leukocyte-dependent plasma leakage in the rabbit skin is enhanced or inhibited by prostacyclin, depending on the route of administration. AB - Experiments were designed to test for possible differing modulatory effects of either intravascular or extravascular prostaglandins (PGs) on local edema induced by intradermally injected inflammatory mediators in the rabbit. Local extravascular PGI2, PGE2 and 15-methyl-PGE1, with similar potencies, had a marked potentiating effect on local edema induced by C5a des Arg. Local extravascular PGI2 also potentiated edema when tested with leukotriene B4 (LTB4), bradykinin, and histamine. However, intravenously infused PGI2 at 50 ng/kg/min reversed the enhancing effect of local extravascular PGI2. At this dose the attenuating effect of PGI2 was selective for the polymorphonuclear (PMN) leukocyte-dependent edema induced by C5a des Arg and LTB4, but had no effect on edema induced by the nonchemoattractants histamine and bradykinin. Similarly, edema induced by N formyl-methionyl-leucyl-phenylalanine was suppressed, but not that induced by platelet activating factor. 15-Methyl-PGE1, at 300 ng/kg administered systemically (subcutaneously), also selectively suppressed PMN-dependent edema. However, at higher doses of 3 and 60 micrograms/kg attenuation was nonselective and associated with a fall in systemic arterial blood pressure. These experiments demonstrate that the site of PG generation and action is an important determinant of its influence on edema formation. PMID- 3524255 TI - Porous-bottom dishes for culture of polarized cells. AB - Porous-bottom dishes offer several advantages for growing and studying epithelia in culture. Many epithelia differentiate more on porous surfaces than on plastic tissue culture dishes. In addition, separate solutions can be maintained on each side of the epithelium and can be sampled easily for studies of transport and other polarized functions. We describe the fabrication of dishes with a cellulose ester filter, a collagen-coated polycarbonate filter, or a collagen membrane forming the surface for cell attachment at the bottom of the dish. PMID- 3524256 TI - Characteristics of rat hindlimbs perfused with erythrocyte- and albumin-free medium. AB - The isolated rat hindlimb was perfused with Krebs-bicarbonate buffer without erythrocytes and albumin in a flow-through mode at 32 degrees C, and the viability and metabolic characteristics of perfused skeletal muscle were examined. 1) With the flow rate at 15 ml X min-1 X leg-1, glucose and O2 uptake, lactate release, lactate-to-pyruvate ratio in effluent, and tissue creatine phosphate and adenine nucleotides remained constant at rest during perfusion for 90 min. The twitch tension changed little over perfusion. 2) When the leg was stimulated at a frequency below 0.5 Hz, the standard flow rate adequately delivered O2 to the perfused leg. Sciatic nerve stimulation enhanced glucose uptake in the absence of insulin. 3) The stimulatory effect of insulin on glucose uptake was observed with a concentration as low as 0.1 mU/ml, and maximal effect was at approximately mU/ml, with a nearly eightfold increase in glucose uptake. 4) Epinephrine and isoproterenol at a concentration of 0.5 nM stimulated lactate release, with maximal effect at 5 nM. The response to catecholamines was reversible and reproducible with a single preparation during the perfusion period of 120 min. The results indicated that the perfusion of hindlimb with a hemoglobin- and albumin-free medium is a convenient and reliable tool for the biochemical investigations of the integral function of hindlimb skeletal muscle. PMID- 3524257 TI - Epinephrine is not critical to prevention of hypoglycemia during exercise in humans. AB - We documented stability of plasma glucose concentrations and glucose production and utilization rates, and levels of other metabolic substrates and regulatory factors, during the islet clamp (somatostatin infusion with glucagon and insulin replacement) in the absence of an intervention in five normal humans and further applied this technique to the study of glucoregulation during moderate exercise. Based on previous evidence that sympathochromaffin activation plays a primary role in the prevention of hypoglycemia during exercise, the role of adrenomedullary catecholamines was assessed by exercise (60% of maximum oxygen consumption for 60 min) studies in four bilaterally adrenalectomized, epinephrine deficient humans under two conditions: control (saline infusion) and islet clamp. Increased glucose utilization and production rates were matched and plasma glucose was unchanged during exercise under both conditions. Thus adrenomedullary catecholamines including epinephrine are not critical to glucoregulation during moderate exercise in humans even when changes in insulin and glucagon are prevented. These findings provide further support for the suggestion that sympathetic neural norepinephrine is the operative catecholamine in the prevention of hypoglycemia during exercise in humans. PMID- 3524258 TI - Additive effects of prior exercise and insulin on glucose and AIB uptake by rat muscle. AB - After exercise of moderate intensity the ability of insulin to stimulate the uptake of glucose and alpha-aminoisobutyric acid (AIB) in perfused rat muscle is enhanced in a parallel fashion. The present study was designed to examine the effect of intense exercise on the subsequent uptake of these substrates. For this purpose, rats fed ad libitum were run on a treadmill for 50 min at high intensity and glucose and AIB uptake by muscle were then assessed in the isolated perfused hindquarter preparation. In confirmation of previous studies, 30 min after such exercise the absolute rate of glucose uptake in the presence of 20,000 microU/ml of insulin was greater due to additive effects of insulin and prior exercise. A novel finding was that 150 min postexercise the rate of glucose uptake was still increased in the presence of a supramaximal concentration of insulin, but entirely due to an increase in insulin responsiveness. The uptake of AIB and its response to insulin in general paralleled that of glucose. The results indicate that both glucose and AIB uptake by skeletal muscle in the presence of a supramaximal concentration of insulin are increased after intense exercise. They suggest that this is initially due to an additive effect of insulin and exercise and later due to an increase in insulin responsiveness. The findings are compatible with the notion that after exercise insulin is able to recruit or activate glucose (and possibly AIB) transporters in muscle, that it does not affect in the resting state. PMID- 3524259 TI - Net substrates balance across hindlimb in conscious rabbit during late pregnancy. AB - The present work performed in rabbits was designed to investigate whether changes in skeletal muscle metabolism could contribute to glucose homeostasis during late pregnancy a time at which there is a large glucose demand of the gravid uterus. We therefore studied the net substrate balance of glucose, lactate, free fatty acids, and ketone bodies across the hindlimb of pregnant animals (days 24 and 30) and virgin animals. Our data show that on day 24 the basal rate of glucose uptake is similar to that observed in virgin rabbits, but it decreases by approximately 60% on day 30 despite comparable levels of blood glucose and plasma insulin at both gestational ages. A moderate hyperglycemia (20% above basal level) and hyperinsulinemia (2- to 3-fold above basal level) sustained for 80 min failed to increase glucose uptake except in virgin animals. Estimates of the contribution of substrates to oxidative metabolism indicate that free fatty acids could represent the major fuel in all groups, whereas glucose would be of minor importance especially at term. It is concluded that in pregnancy a) under normoglycemia there is a reduced insulin effect on glucose uptake and b) under moderate hyperglycemia and hyperinsulinemia the insulin resistance results from an impaired stimulation of glucose uptake. Sparing glucose from the skeletal muscle, the mother can direct more glucose toward the uterus without marked increase in her production rate. PMID- 3524260 TI - Hormones in perinatal rat and spiny mouse: relation to altricial and precocial timing of birth. AB - Rat (Rattus norvegicus) and spiny mouse (Acomys cahirinus) are closely related murine species that, due to their altricial (rat) and precocial (spiny mouse) modes of development, differ in the developmental timing of birth. A comparison between the developmental profiles of plasma glucagon, insulin, thyroxine, triiodothyronine, and glucocorticosteroid hormone was carried out to elucidate the question to what extent these hormonal profiles were related to the timing of birth. Although corticosterone is the major circulating glucocorticosteroid in rat, only cortisol was found in the spiny mouse. The onset of increases in glucocorticosteroid and thyroid hormone levels occurred at the same developmental time points in both species. A neonatal increase in triiodothyronine levels was observed in the spiny mouse only. In both species the immediate perinatal period was characterized by decreases in the ratio of insulin and glucagon levels and the level of glucocorticosteroids. The observed developmental patterns of hormonal levels were found to be consistent with the observed developmental pattern of enzymic maturation in the respiratory and gastrointestinal tract, which play a critical role in the adaptation to the extrauterine environment. PMID- 3524261 TI - Effect of gestational hyperglycemia on insulin secretion in vivo and in vitro by fetal rat pancreas. AB - The effects of gestational hyperglycemia on B-cell function were studied in near term fetuses from unrestrained pregnant rats made slightly or highly hyperglycemic using continuous glucose infusion during the last week of pregnancy. Pancreatic and plasma insulin and insulin secretion in vitro were studied in the fetuses. Compared with controls, slightly hyperglycemic fetuses showed increased pancreatic and plasma insulin concentrations and similar insulin release in response to glucose in vitro. In highly hyperglycemic fetuses, pancreatic and plasma insulin concentrations were unchanged compared with controls, and insulin release in vitro was insensitive to glucose and to the mixture glucose plus theophylline. These results confirm that glucose is able to stimulate insulin secretion in normal or slightly hyperglycemic fetuses and suggest that severe hyperglycemia per se, without association of other metabolic disorders or toxic injuries, profoundly alters the stimulus-secretion coupling of the fetal rat B-cell. PMID- 3524262 TI - Plasma cholecystokinin and pancreatic growth during adaptation to dietary protein. AB - The relationship among plasma cholecystokinin (CCK), pancreatic growth, and food intake was studied in rats over a 2-wk period of adaptation from a very low protein to a very high-protein diet. Rats adapted to a control diet (5% casein) were killed at 0900 (without fasting) at 0 h, 12 h, 24 h, 48 h, 7 days, or 14 days after transfer to a high-protein diet (75% casein). CCK was measured by bioassay using isolated pancreatic acini. Plasma CCK in high protein-fed rats was increased approximately threefold in the first 24 h, but returned to control (approximately 2.5 pM) values by day 7. Pancreatic weight, DNA, protein, and chymotrypsin(ogen) significantly increased to maximal values by day 7 in high protein-fed rats. Food intake in high protein-fed rats was inhibited by 47% after 24 h but returned to control values by day 7. The results indicate that high protein diets initially increase CCK release and increase pancreatic protease secretory capacity and that, when pancreatic protease secretion is sufficient to match protein digestive requirements, the stimulus for CCK secretion is reduced and plasma CCK returns to normal. The pronounced but transient inhibition of food intake in high protein-fed rats is consistent with a role for CCK in regulation of food intake. PMID- 3524263 TI - Renin release from different parts of rat afferent arterioles in vitro. AB - A technique was designed to study renin release from superfused rat glomeruli with short attached arterioles (SAG), from single glomeruli with long attached arterioles (LAG), and from single afferent arterioles (AA). The preparations obtained by magnetic isolation and microdissection were superfused individually, and the renin release was measured by an ultramicroradioimmunoassay with a detection limit of 3 X 10(-9) Goldblatt units. The renin content of one SAG was about one-fifth of that contained in one AA. Isoprenaline (10(-5) M) did not change renin release from SAG, whereas renin release from AA and LAG increased threefold (P less than 0.01). A 30-mosmol/kg reduction in medium sodium chloride concentration increased renin release from SAG 50% (P less than 0.01). This challenge caused no change in renin release from AA. It is concluded that the isoprenaline-sensitive juxtaglomerular (JG) cells are located in the afferent arteriole only at some distance from the glomerulus, whereas those cells sensitive to sodium chloride are located within and/or close to the glomerulus. PMID- 3524264 TI - Effect of amino acid infusion on renal hemodynamics in humans. AB - The effect of amino acid (AA) infusion on renal hemodynamics was examined in 19 healthy subjects. Thirteen subjects participated in the first protocol (normal protein intake) and six in the second protocol (low protein intake). The first protocol consisted of three studies: study 1 (n = 13), AA were infused over 3 h to increase plasma amino acid levels two- to threefold; study 2 (n = 7), AA were infused with somatostatin and peripheral replacement of insulin, glucagon, and growth hormone; study 3 (n = 6), somatostatin was infused with basal hormonal replacement as in study 2. During study 1, glomerular filtration rate (GFR) rose by 20% (from 107 +/- 5 to 128 +/- 4 ml . 1.73 m-2 . min-1, P less than 0.001). Renal plasma flow (RPF) increased by a similar percentage (599 +/- 35 to 704 +/- 33 ml . 1.73 m-2 . min-1, P less than 0.001). When somatostatin was infused with AA (study 2), neither GFR nor RPF changed from base line. Somatostatin infusion alone (study 3) had no effect on GFR or RPF. During protocol 2, six subjects received a low-protein diet (40 g/day) for 7 days and AA were infused as per study 1. Base-line GFR (104 +/- 5 to 96 +/- 4 ml . 1.73 m-2 . min-1 and RPF (593 +/- 32 to 507 +/- 23 ml . 1.73 m-2 . min-1) both decreased (P less than 0.02) after the low-protein diet.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3524265 TI - Dietary protein increases plasma renin and reduces pressor reactivity to angiotensin II. AB - The effect of dietary protein on the renin-angiotensin system was studied in rats. Rats were fed isocaloric, 50% (high protein, HP), or 6% (low protein, LP) protein diets with identical electrolyte content for 10 days. Food intake and electrolyte excretion were equivalent on the two diets. Plasma renin activity (PRA) was higher in HP (10.0 +/- 2.5 vs. 3.5 +/- 0.5 ng ANG I . ml-1 . h-1, P less than 0.02) as was plasma aldosterone. However, in conscious rats mean arterial pressure (MAP) was not different between groups. The pressor response to graded doses of angiotensin II (ANG II) was diminished by 30-60% with HP (all doses, P less than 0.05). ANG II binding by mesenteric artery smooth muscle particles did not differ between HP and LP. Chronic administration of captopril did not normalize the pressor response in HP. Urinary prostaglandin (PG) E and 6 keto-PGF1 alpha excretion was markedly increased by the HP diet. Acute inhibition of prostaglandin synthesis with meclofenamate restored the pressor response to ANG II in HP to that in LP. In summary, a HP diet increased PRA, plasma aldosterone, urinary PGE, and 6-keto-PGF1 alpha and decreased pressor responsiveness to ANG II. Resistance to ANG II was not reversed by chronic converting enzyme inhibition but was abolished by inhibition of prostaglandin synthesis. PMID- 3524266 TI - System A amino acid transport in incubated muscle: effects of insulin and acute uremia. AB - The insulin-stimulated increase in amino acid uptake in most cells and tissues involves stimulation of system A transport. In muscle the probes used to study this process have not been specific, making it difficult to determine whether system A is abnormal in insulin-resistant states, such as acute renal failure (ARF). To circumvent this problem, we studied 2-(methylamino) isobutyrate (MeAIB) transport. Its specificity for system A in incubated rat epitrochlearis muscles was documented by showing its uptake by only one carrier that is sodium dependent and insulin responsive and that exhibits adaptive regulation in response to starvation. Using this specific probe we determined whether insulin-stimulated amino acid transport by system A is impaired by ARF. MeAIB uptake was linear for 3 h in muscles of ARF and sham-operated (SO) rats. In the absence (basal) or presence of insulin, MeAIB uptake was significantly lower in ARF, yet the stimulation by insulin was similar in both groups. Likewise, the insulin dose response relationship confirmed that physiological levels of insulin (less than or equal to 10(2) microU/ml) increased transport by a similar degree. At greater than or equal to 10(2) microU/ml insulin there was a plateau in MeAIB transport in ARF but not in SO muscles. Thus basal system A transport is depressed in ARF, but the stimulation of system A by physiological levels of insulin is preserved. At pharmacological levels of insulin system A transport is impaired by ARF. PMID- 3524267 TI - System ASC and sodium-independent neutral amino acid transport in muscle of uremic rats. AB - Neutral amino acids are transported by systems A, ASC, and L. In the previous companion study we demonstrated that 2-(methylamino) isobutyrate (MeAIB) is a specific substrate for system A in muscle and that stimulation of system A by physiological concentrations of insulin is preserved in acute uremia (ARF). Insulin-stimulated uptake of the nonspecific probes cycloleucine and alpha aminoisobutyrate (AIB) is reportedly blunted by uremia; the cause of this and whether transport by systems ASC and L is defective are unknown. In this study we examined these questions using incubated epitrochlearis muscles from normal fed, ARF, and sham-operated control (SO) rats. System ASC was studied by measuring AIB and cycloleucine uptake in the presence of inhibitors of systems A and L, MeAIB and 2-amino-2-norbornane carboxylic acid (BCH), respectively. System L was defined as sodium-independent uptake suppressible by BCH. Excess MeAIB completely inhibited insulin-stimulated AIB and cycloleucine uptake, indicating that system A is the only insulin-responsive neutral amino acid carrier in muscle. In ARF and SO mucles both AIB and cycloleucine uptake were indistinguishable in the absence or presence of insulin. Moreover, ARF caused no detectable abnormality in transport by systems ASC and L. PMID- 3524269 TI - Retraction. Sympathetic effects on spontaneous activity in bovine mesenteric lymphatics. PMID- 3524268 TI - Prostaglandins stimulate calcium-linked changes in heart mitochondrial respiration. AB - This study was done to determine the influence of prostaglandins (PGs) on oxidative phosphorylation and Ca-related changes in cardiac mitochondria. For most of the experiments mitochondria were isolated by using a nagarse homogenization combination method that yields both subsarcolemmal and interfibrillar populations. When Ca (30-420 microM) was added a progressive stimulation in resting respiration was observed. Similarly, preaddition of Ca inhibited subsequent oxidative phosphorylation when ADP was added to the same preparation. The effect of calcium was enhanced by pretreating mitochondria with PGs E2, F2 alpha, and I2 (prostacyclin). Three PG concentrations, 100 pg/ml, 1 ng/ml, and 10 ng/ml were evaluated. For the most part the effect of PGs was concentration dependent with the exception of PGE2, which showed no effect at the highest concentration. The effects of PGs were observed when both NADH (pyruvate malate) and succinate-linked respiratory substrates were used. Similar effects were evident when mitochondria were harvested using a non-nagarse homogenization method that yields a primarily subsarcolemmal population, although this preparation exhibited substantially higher sensitivity to Ca. None of the PGs had any direct effect on either resting respiration rate or oxidative phosphorylation in the absence of Ca, irrespective of isolation procedure or choice of substrate. The study demonstrates that PGs can augment Ca-related changes in cardiac mitochondrial respiration through an as yet unknown mechanism. The results may be important in understanding the role of endogenously synthesized PGs in cardiac pathology associated with defective intracellular Ca homeostasis. PMID- 3524270 TI - Dissociation of adenosine from metabolic regulation of coronary flow in the lamb. AB - The objective of these studies was to evaluate the contribution of an adenosine mechanism to metabolic regulation of coronary flow. Cardiac O2 metabolism (MVO2) was altered by changing cardiac output while aortic pressure and heart rate were held constant (paced). Ganglionic (tetraethylammonium chloride) and beta blockade (propranolol) were employed. Relationships of coronary flow to MVO2 were determined in control and alloxan diabetic animals. The latter have previously been shown to have reduced sensitivity to adenosine [Am. J. Physiol. 243 (Heart Circ. Physiol. 12): H252-H258, 1982]. In each group, responses were measured before and after adenosine receptor blockade with aminophylline (10 mg/kg). Responses to infused adenosine were also compared. A linear relationship between adenosine infusion rate and flow was found in all conditions. Aminophylline caused a 70% reduction in adenosine sensitivity in controls. In the diabetics, adenosine sensitivity was much reduced and was identical with blocked controls. A close correlation between left ventricular work and MVO2 was found in both groups. Coronary flow increased linearly with MVO2, and the slopes before and after aminophylline were identical. Myocardial O2 extraction remained unchanged. The same relationships were found in the diabetics, and responses did not differ from controls. Thus, in two conditions of sharply reduced sensitivity to exogeneous adenosine, coronary flow (and resistance) were as equally well matched to MVO2 as in controls. These data suggest that mechanisms other than, or in addition to, adenosine provide the close link between MVO2 and coronary flow with changing cardiac work loads. PMID- 3524271 TI - Suppression of plasma renin and aldosterone in stress-salt hypertension in dogs. AB - Plasma renin activity (PRA) and plasma aldosterone concentrations (PAC) of 12 intact chronically instrumented dogs were measured at midday after 1) 7-12 days of normal sodium intake and no behavioral stress, 2) 7-12 days of continuous saline infusion (1.34 l/day) only, and/or 3) 7-12 days of saline infusion and avoidance-conditioning sessions. The saline infusion procedure did not significantly change arterial pressure or heart rate relative to base line but was associated with a consistent decrease in PRA (-0.90 +/- 0.38 ng angiotensin I . ml-1 . h-1) and PAC (-3.6 +/- 1.1 ng/dl). The combination of saline infusion and avoidance conditioning resulted in significant elevations in arterial pressure, but, again, both PRA (-1.46 +/- 0.16 ng angiotensin I . ml-1 . h-1) and PAC (-3.7 +/- 1.1 ng/dl) were significantly decreased. These results show that high sodium intake decreased aldosterone via suppression of renin release but do not rule out a possible hypertensinogenic role for stress-induced adrenocorticotrophic hormone-sensitive corticoids. PMID- 3524272 TI - Effect of hypophysectomy on dipsogenic stimuli: evidence for angiotensin supersensitivity. AB - The effects of long-term hypophysectomy on renin secretion and the renin and drinking responses to isoproterenol were investigated in male rats. Drinking responses to angiotensin II, hypertonic saline, and water deprivation for 24 h were also measured. Plasma renin activity and plasma angiotensin II were variably lower in rats that had been hypophysectomized for 21 days than in intact controls. Angiotensinogen was also reduced, but plasma renin concentration was not. Isoproterenol produced a smaller increase in plasma renin activity in hypophysectomized rats than it did in controls, but with the one dose of isoproterenol that was tested, the increase in plasma renin concentration was comparable in the two groups. However, the drinking responses to isoproterenol were greater in the hypophysectomized rats. The drinking responses produced by infusion of angiotensin II were also greater, but the responses to infusion of hypertonic saline and to 24 h of water deprivation were not. The data suggest that in rats hypophysectomized for 21 days the circumventricular organs that mediate thirst are hyperresponsive to circulating angiotensin II, possibly because the relatively low circulating angiotensin II levels permit the upregulation of angiotensin II receptors in these structures. PMID- 3524273 TI - Pancreatic adaptation in VMH obesity: in vivo compensatory response to altered neural input. AB - The objective of these studies was to determine the impact of enhanced insulin response to glucose (glucose responsiveness) and altered neurotransmitter sensitivity of the pancreatic islet previously observed after ventromedial hypothalamic (VMH) lesion on the glucose regulatory system in the whole animal. Female Wistar (220 g) rats received bilateral electrolytic VMH lesions and were implanted with cardiac and femoral cannulas under anesthesia. After recovery, experimental studies were conducted in 2-h-fasted lightly heparinized conscious rats. Plasma glucose declined at 1 and 2 wk after lesion and returned gradually to basal levels by 4 wk, whereas plasma insulin was elevated at 1 wk and remained elevated at 4.5 wk after lesion. Glucose responsiveness was increased threefold 1 wk after lesion. Acetylcholine sensitivity, measured by insulin response to an acetylcholine analogue, was decreased at 1, 2, and 4 wk after lesion, whereas norepinephrine sensitivity, measured by norepinephrine inhibition of the insulin response to intravenous glucose, was significantly increased 1 wk after VMH lesion. These studies suggest that the observed alterations at the level of the pancreatic islet led to a shift in the operating point of the glucose regulatory system of the whole animal and that changes in neurotransmitter sensitivity reflect a pancreatic adaptation subsequent to the establishment of enhanced glucose responsiveness. This shift in operating point may be secondary to altered neural input and may be essential to pancreatic and, thus, metabolic adaptation to the VMH lesion-induced obese state. PMID- 3524274 TI - Malignant hyperthermia and ECT. AB - The malignant hyperthermia syndrome is a rare hypermetabolic state that occurs in patients after the administration of certain drugs, most frequently anesthetics and/or succinylcholine. In view of the widespread use of succinylcholine to induce muscle relaxation prior to ECT, it is important that the individual who administers succinylcholine in this setting be familiar with the syndrome and its treatment. This report reviews what is known about malignant hyperthermia and proposes a course of action when the syndrome occurs in a patient undergoing ECT or a patient with known susceptibility to malignant hyperthermia needs ECT. PMID- 3524275 TI - Who introduced the English-speaking world to Sigmund Freud? PMID- 3524276 TI - Freud and traumatic neurosis. PMID- 3524277 TI - Carol C. Nadelson, M.D., one hundred fourteenth president, 1985- 1986, American Psychiatric Association. PMID- 3524278 TI - Correlates of lateral ventricular size in chronic schizophrenia, I: Behavioral and treatment response measures. AB - The ventricle-brain ratio (VBR) of 28 drug-free male schizophrenic inpatients was significantly higher than that of 21 matched normal control subjects and was not related to severity of positive or negative symptoms. Response to haloperidol in an open 6-week trial using a fixed-dose schedule was not predicted by severity of positive or negative symptoms or by VBR. The nine severely deteriorated patients with chronic "Kraepelinian" schizophrenia had left lateral ventricles 28% larger than their right, whereas the control subjects and other schizophrenic patients did not show ventricular asymmetry. PMID- 3524254 TI - Myocardial diseases of animals. AB - In this review we have attempted a comprehensive compilation of the cardiac morphologic changes that occur in spontaneous and experimental myocardial diseases of animals. Our coverage addresses diseases of mammals and birds and includes these diseases found in both domesticated and wild animals. A similar review of the myocardial diseases in this broad range of animal species has not been attempted previously. We have summarized and illustrated the gross, microscopic, and ultrastructural alterations for these myocardial diseases; and, whenever possible, we have reviewed their biochemical pathogenesis. We have arranged the myocardial diseases for presentation and discussion according to an etiologic classification with seven categories. These include a group of idiopathic or primary cardiomyopathies recognized in man (hypertrophic, dilated, and restrictive types) and a large group of secondary cardiomyopathies with known causes, such as inherited tendency; nutritional deficiency; toxicity; physical injury and shock; endocrine disorders, and myocarditides of viral, bacterial, and protozoal causation. Considerable overlap exists between each of the etiologic groups in the spectrum of pathologic alterations seen in the myocardium. These include various degenerative changes, myocyte necrosis, and inflammatory lesions. However, some diseases show rather characteristic myocardial alterations such as vacuolar degeneration in anthracycline cardiotoxicity, myofibrillar lysis in furazolidone cardiotoxicity, calcification in calcinosis of mice, glycogen accumulation in the glycogenoses, lipofuscinosis in cattle, fatty degeneration in erucic acid cardiotoxicity, myofiber disarray in hypertrophic cardiomyopathy, and lymphocytic inflammation with inclusion bodies in canine parvoviral myocarditis. The myocardial diseases represent the largest group in the spectrum of spontaneous cardiac diseases of animals. Pericardial and endocardial diseases and congential cardiac diseases are seen less frequently; and, in contrast to man, coronary artery disease and myocardial ischemia are rather infrequent in animals. The present review shows clearly that the spectrum of myocardial diseases in animals is enlarging and that many newly recognized diseases are emerging and assuming considerable importance. For example, various heritable cardiomyopathies have recently been described in the KK mouse, cattle, and rats. Increasingly recognized myocardial diseases include cardiomyopathies in cats, dogs, and birds; anthracycline cardiotoxicity; furazolidone cardiotoxicity; ionophore cardiotoxicity; myocardial damage associated with central nervous system injuries; myocardial hypertrophy in PMID- 3524279 TI - Comparative psychological disturbance in patients with pancreatic and gastric cancer. AB - One hundred and seven patients with advanced pancreatic cancer and 111 patients with advanced gastric cancer, stratified for key medical and sociodemographic variables, were assessed with the Profile of Mood States before beginning combination chemotherapy in a national cancer clinical trials group. The pancreatic cancer patients had significantly higher self-ratings of depression, tension-anxiety, fatigue, confusion-bewilderment, and total mood disturbance; no difference was found in vigor or anger-hostility. These data support prior observations that patients with advanced pancreatic cancer experience significantly greater general psychological disturbance than patients with another type of advanced abdominal neoplasm. PMID- 3524280 TI - Health care of poverty and nonpoverty children in Iowa. AB - Responses to a survey of 637 Iowa children under age six years from Aid to Families with Dependent Children (AFDC) households was conducted through telephone interviews with parents and compared to a second sample of children in 760 randomly sampled households. Utilization of health services for children in the AFDC sample was similar to that of nonpoverty children and superior to that of other poverty children. Irrespective of Medicaid coverage, poverty children's health care differed from that of nonpoverty children in the following ways: less well care from a private practice or pediatrician, seeing the same health professional at each well visit less often, receiving immunizations at the same place as source of well care, examination by a physician at the most recent well visit, sick care at the same place as well care. PMID- 3524281 TI - Ultrasound measurement of the anterior leg compartment. AB - Eight male subjects, weighing 65 to 83 kg and between 22 and 34 years of age, were measured for depth changes in the anterior leg compartment at rest and following treadmill running and weighted dorsiflexion exercises. Measurements were obtained from ultrasound scans at two points on the leg. The results showed no significant differences in the compartment's depth between rest and treadmill exercise, while significant changes were noted between rest and dorsiflexion exercises. These results suggest that the anterior leg muscles were maximally functioning during the dorsiflexion exercises, but not during the treadmill exercises. It is concluded that the ultrasound can be used to detect depth changes, and hence volume changes, in muscle compartments and may have potential use in combination with other techniques as a noninvasive diagnostic tool in assessing changes in a muscle compartment. PMID- 3524283 TI - Specificity of skeletal muscle actin. PMID- 3524282 TI - Cutaneous follicular lymphoma. AB - Fifteen cases of cutaneous follicular lymphoma were evaluated clinically, histologically, and immunologically. Nine of the patients presented with skin disease alone, which showed a predilection for the scalp and forehead. The six remaining cases had either concurrent or secondary cutaneous involvement. All of the cases had a nodular configuration which was evident histologically or immunologically. In many cases, the diagnostic microscopic fields were in the deep dermis or subcutis, with nonspecific inflammation in the superficial dermis. The cases consisted of five small cleaved, seven mixed, and three large cell follicular lymphomas. A senior dermatopathologist diagnosed four of the 15 cases as benign, indicating the difficulty of diagnosis by morphology alone when the biopsy is small or the inflammatory component is prominent. This underscores the importance of large, deep biopsies for accurate histologic diagnosis. Immunological studies confirmed the B cell lineage of these lesions. An unexpectedly high proportion of immunoglobulin-negative cases (eight cases) was found, especially among the primary cutaneous follicular lymphomas (six of nine cases). Immunoglobulin-expressing cases exhibited monotypic immunoglobulin light chain staining of tumor cells. In all cases, the dendritic reticulum cell network within lymphoma follicles lacked the polytypic immunoglobulin complexes characteristic of reactive follicles. As described previously for follicular lymphomas in lymph nodes, many cases exhibited polytypic follicular mantle zones similar to reactive follicles. The low-grade nature of these lymphomas was supported by clinical follow-up. We conclude that given adequate sampling, cutaneous follicular lymphomas can usually be diagnosed by histologic criteria similar to those used for lymph nodes; however, immunohistologic studies are an important adjunct. PMID- 3524285 TI - In vitro growth inhibition of Plasmodium falciparum by sera from tropical splenomegaly syndrome patients. AB - Sera from tropical splenomegaly syndrome (TSS) and non-TSS patients from the same village were examined for their ability to inhibit the in vitro growth of Plasmodium falciparum. Using synchronized malaria cultures, sera from both groups inhibited parasite development only if added before merozoite reinvasion of erythrocytes had occurred. There was no significant difference in the degree or apparent mechanism of inhibition caused by TSS and non-TSS sera. These results suggest that the aberrant immune response that results in TSS may not be associated with the elaboration of unique serum factors that differentially inhibit growth of the parasite in vitro. PMID- 3524284 TI - Antioxidants do not prevent the in vitro induction of Plasmodium falciparum crisis forms by human malaria-immune, TB or rabbit TNF serum. AB - Cultured Plasmodium falciparum was retarded in intraerythrocytic development by serum from malaria-immune adults, by human TB serum, and by rabbit tumor necrosis serum. Neither the potency nor efficacy of any of these sera was altered by a variety of antioxidants or oxygen-free radial scavengers, including ascorbate, alpha-tocopherol, BHT, cystine or cysteine, glutathione, histidine, phenylalanine, tryptophan, tyrosine, superoxide dismutase, catalase (or combination of the two enzymes), or by reducing the ambient O2 tension to 1%. It is thus unlikely that the antiparasitic activity of these inhibitory sera can be attributed to oxidative mechanisms. PMID- 3524286 TI - High level of sensitivity to chloroquine of 72 Plasmodium falciparum isolates from southern Cameroon in January 1985. AB - The sensitivity to chloroquine, quinine and mefloquine of Plasmodium falciparum isolates from 3 areas of southwest Cameroon was evaluated using an in vitro microtest with estimation of parasite growth by 3H-hypoxanthine incorporation. Among 2,429 children examined, P. falciparum was found on thin smears in 124 of them, 76 isolates were submitted to in vitro tests and 72 were successful. In the locations studied, some of which are close to the area of Limbe where in vivo resistance has been reported, all 72 isolates were found fully sensitive to low concentrations of chloroquine (mean EC50 5.9 ng/ml or 18.5 nmol/l of medium). In 47 of these isolates simultaneously tested using WHO microtest predosed plates, the sensitivity was identical. Out of 39 tests performed with quinine, 35 were successful. While most strains responded to low concentrations, some showed a decreased sensitivity to the drug, the EC50 of 4 of them being in the range 230 300 nmol/l. Each of the 17 isolates tested with mefloquine was susceptible to very low concentrations of freshly prepared drug solution. While chloroquine resistant strains may already exist in Cameroon, the present study suggests that they would be restricted to a limited area and are not widespread. Data also suggest that monitoring of the sensitivity of P. falciparum to quinine might soon be necessary. PMID- 3524287 TI - Decreased sensitivity to chloroquine and quinine of some Plasmodium falciparum strains from Senegal in September 1984. AB - The in vitro sensitivity of 135 Plasmodium falciparum isolates collected in the areas of Thies and Kaolack, Senegal, were studied in September 1984, by means of the 48 hr microtest with 3H-hypoxanthine incorporation. Results are available in 110 of 135 cases studied (81%). The isolates collected around Kaolack were found on average less sensitive to chloroquine than those from Thies (mean EC50 28 and 17 nmol/l of medium, respectively, P less than 0.05) and in 1 isolate a high degree of resistance was found (EC50 178 nmol/l). Some of those isolates also were studied using the WHO standard microtest and similar results were recorded. With both assays probit regression lines show EC99 in Kaolack greater than 114 nmol/l. These data suggest that in 1984 chloroquine resistance was possibly emerging in the extreme west of Africa. Sensitivity to quinine could be evaluated in 15 of 24 isolates tested. One of them, originating from Thies, was highly resistant to this drug (EC50 760 nmol/l) and 2 additional isolates with EC50s of 370 and 274 nmol have decreased sensitivity. These results suggest that quinine, as well as chloroquine, sensitivity should be monitored in the African region. PMID- 3524288 TI - Dot-immunobinding assay in the serodiagnosis of human hydatid disease. AB - A rapid and convenient procedure for the indirect serological detection of anti Echinococcus antibodies in human hydatid disease is described. Sheep hydatid cyst fluid was spotted on nitrocellulose membranes. All remaining unbound sites on the membrane were blocked with polyxyethylene sorbitan monolaurate (Tween 20). The immobilized antigens were then reacted first with human serum to be diagnosed followed by reaction with horse anti-human IgG conjugated with peroxidase or protein A conjugated with peroxidase. The conjugated enzyme was then detected by the formation of the blue-brown precipitate which permanently stained the nitrocellulose membrane when the peroxidase reacted with benzidine-HCl and hydrogen peroxide. The results indicate that the dot-immunobinding assay is sensitive, specific, economical, fast and safe for serodiagnosis of hydatid disease. This is the first report of diagnosing human hydatid disease by the dot immunobinding assay. PMID- 3524289 TI - Echotomographic and serologic screening for hydatidosis in a Tunisian village. AB - Echotomographic and serologic screening for hydatidosis was carried out in 1,650 subjects aged over 5 years in a village located in a high risk region of central Tunisia. Echotomography detected liver cysts in 6 subjects (prevalence rate: 3.6 per 1,000). These 6 cases were among the 7 positive cases detected by ELISA. In all 6, the diagnosis of liver cysts was confirmed. No other localization was found in any of the subjects including one with a positive ELISA and a normal echotomographic examination. This work demonstrates the high feasibility of echotomography in the field and confirms the high prevalence rate of hydatidosis in the community. PMID- 3524290 TI - MASH, military medicine, and beyond: mainstream or tributary? PMID- 3524291 TI - Liver transplantation at UCLA. Program development, organization, initiation, and early results. AB - The development of a liver transplantation program requires a multidisciplinary approach which can only be provided in a large tertiary referral medical center. Preparation for the clinical program involves training of all team members, both in the animal laboratory and at an established liver transplant center. A special commitment from the medical center to the program is essential and involves medical, nursing, and administrative divisions, blood bank, social service, and operating room personnel, and intensive care unit facilities. With careful planning, a successful liver transplant program can be realized from the onset. In the first 2 years of UCLA's liver transplant program, 62 transplants in 50 patients were performed. The overall survival rate was 72 percent with no operative deaths. Thirty-four of 36 surviving patients have returned to useful, productive lives after orthotopic liver transplantation. PMID- 3524292 TI - Epithelialized microvascular iliac crest flap for reconstruction of subglottic and upper tracheal stenosis: a preliminary report. AB - A new method for the management of laryngotracheal stenosis using an epithelialized microvascular iliac crest flap is described. This flap offers firm support to the frontal wall, an inner epithelial lining, and is well vascularized. The operation must be carried out in two sessions: skin grafting the flap and transfer with interposition of the flap. In the reconstruction procedure, the otolaryngologist and an experienced microvascular surgeon should cooperate. The method is suitable particularly for solving severe stenosis of the cricoid region and of the upper part of the trachea. PMID- 3524293 TI - Bulimia: a historical overview. PMID- 3524294 TI - Medication in the treatment of bulimia. PMID- 3524295 TI - [Histomorphological, histoenzymatic and ultrastructural changes in the placenta in pregnant women with habitual abortions and skin grafts]. PMID- 3524297 TI - [Placental maturity determined by ultrasound in women pregnant with twins]. PMID- 3524296 TI - [Abruptio placentae]. PMID- 3524298 TI - [Relationship between placental maturity determined by ultrasound and fetal maturity in pregnant diabetics]. PMID- 3524299 TI - [Our experience in treating habitual abortions by skin grafts]. PMID- 3524300 TI - [Spontaneous and induced fetal diuresis]. PMID- 3524301 TI - [Antenatal diagnosis of fetal genetic damages (a review of the results of the 1st 150 early transabdominal amniocenteses)]. PMID- 3524302 TI - Around the world in 100 diseases. PMID- 3524303 TI - The molluscum body. The Henderson-Paterson body with Lipschutz granules. PMID- 3524304 TI - Office at the seclusion of a leper. Translated by Rotha Mary Clay, 1909. PMID- 3524305 TI - [The history of anesthesia at the Heidelberg University]. AB - An account is given on the development of general anaesthesia at the university clinics of Heidelberg. During the last century mainly chloroform was employed for general anaesthesia. Important events were the first demonstration of Koller's local anaesthesia in the eye in 1884, the first intubation for anaesthesia in Heidelberg, performed by F. Kuhn of Kassel and the development by M. Neu of a rotameter apparatus for nitrous oxide/oxygen anaesthesia in 1910. From 1932 on the surgeon M. Kirschner advanced the methods of high pressure infiltration for regional anaesthesia and segmental hypobaric spinal anaesthesia. In 1951 K. H. Bauer requested R. Frey to set up an "anaesthesia squad" consisting of 2 physicians and 3 nurses to become the nucleus of today's Institute of Anaesthesiology, with O. H. Just as its first professor and chairman. PMID- 3524306 TI - C. Langton Hewer. PMID- 3524308 TI - Paradoxical air embolism during neurosurgery. PMID- 3524307 TI - Premedication with cimetidine and metoclopramide. Effect on the risk factors of acid aspiration. AB - A randomised, double-blind, placebo-controlled parallel study was conducted in adult females to evaluate the efficacy and safety of a combination of cimetidine 300 mg orally and metoclopramide 10 or 20 mg intravenously in reducing pre operative residual gastric volume and raising gastric pH. The effect of preoperative metoclopramide on postoperative nausea and vomiting was also investigated. Oral cimetidine was given approximately 2-2.5 hours before, and intravenous metoclopramide either 15 or 30 minutes prior to induction of anaesthesia. The study showed that placebo-treated patients undergoing outpatient operations have an increased risk of acid aspiration because of high residual gastric volume and low pH and increased risk of serious pulmonary injury should acid aspiration occur. Metoclopramide 10 or 20 mg intravenously prior to induction of anaesthesia was effective in reducing the residual gastric volume significantly, but not in raising pH. The combination of cimetidine and metoclopramide, as well as cimetidine alone, reduced the risk factors of acid aspiration by raising gastric pH and reducing residual volume. No anti-emetic effect of metoclopramide was observed. Higher doses of metoclopramide (20 mg) produced significant side effects (flushing, dizziness, extrapyramidal side effects), but were only marginally more effective than 10 mg doses in reducing residual gastric volume. PMID- 3524309 TI - Enzyme immunoassay of the receptors for modified low density lipoprotein. AB - Mouse macrophages (line J 774) were incubated with monospecific goat anti-low density lipoprotein antibodies, which were conjugated to horseradish peroxidase (AB-HRP). Addition of low density lipoprotein (LDL) modified by treatment with malondialdehyde to cultures of these cells resulted in a dose-dependent increase in the amount of cell-associated enzyme activity. The concentration curve was hyperbolic with half-saturation of modified LDL at a concentration of about 3 micrograms/ml. This effect was completely blocked by polyinosinic acid and was not observed in experiments with human fibroblasts, which do not exhibit high affinity binding sites that recognize chemically modified LDL. Our data indicate that receptor-mediated endocytosis of AB-HRP in the presence of native or modified LDL may be used as very simple, efficient, and sensitive assay for investigation of the scavenger receptors for modified LDL. PMID- 3524310 TI - Isolation of human complement component C3 from small volumes of plasma. AB - A method for the isolation of 8-10 mg of human C3 from 20 ml of plasma is described. The procedure is simple and rapid with excellent yields in hemolytic activity (74%) and antigenic activity (68.7%). It consists of polyethylene glycol precipitation, DEAE-Sephacel chromatography, and immunoadsorption. The final product is free of contaminating proteins as assessed by sodium dodecyl sulfate polyacrylamide gel electrophoresis. The simplicity and speed of this procedure allow for the continual availability of hemolytically active C3. PMID- 3524311 TI - Quantitation of single- and double-strand DNA breaks in vitro and in vivo. AB - This communication describes a rapid and convenient procedure for quantitation of strand breaks in bacterial DNA, both in vitro and in vivo, using agarose gel electrophoresis. The electrophoretic determination of single strand breaks is carried out in alkaline medium, followed by renaturation of the gel and intercalation of the fluorescent dye, ethidium bromide. Double-strand breaks are determined by electrophoresis in neutral medium containing the dye. The distribution of DNA fragment sizes, the determination of the number-average molecular weight, the quantitation of the average number of DNA breaks per molecule, and the ratio between the single- and double-strand breaks are evaluated from microdensitometric scanning of the gels. The application of this analysis to damage caused by a combination of ascorbate and copper is demonstrated. PMID- 3524312 TI - Assay of unesterified 7-oxocholesterol in human serum by isotope dilution-mass spectrometry. AB - A sensitive and accurate assay was developed for 7-oxocholesterol, one of the major autooxidation products of cholesterol. The assay is based on mass spectrometry with use of 2H7-labeled 7-oxocholesterol as internal standard. A fixed amount of internal standard (500 ng) is added to a fixed amount of sample (serum, 1 ml). After extraction with chloroform and purification by thin-layer chromatography, the isolated nonesterified 7-oxocholesterol is reduced by sodium borohydride to give a mixture of 7 alpha- and 7 beta-hydroxycholesterol, mainly 7 beta-hydroxycholesterol. After derivatization with trimethylsilyl reagent, the ratio between unlabeled and deuterium-labeled 7 beta-hydroxycholesterol is determined by selected monitoring of the ions at m/z 456 (corresponding to the M 90 fragment in the mass spectrum of the derivative of unlabeled 7 beta hydroxycholesterol) and m/z 463 (corresponding to the same fragment in the mass spectrum of the derivative of 2H7-labeled 7 beta-hydroxycholesterol). The amount of 7-oxocholesterol is calculated with use of a standard curve obtained by analyses of standard mixtures of unlabeled and 2H7-labeled 7-oxocholesterol carried through the whole procedure. The detection limit of the assay was found to be about 15 ng/ml. The coefficient of variation was 7-8% in the concentration range 60-340 ng/ml. Serum collected in the presence of antioxidants and analyzed immediately contained less than 70 ng/ml of 7-oxocholesterol, and in some cases the concentration was below the detection limit of the assay. It is concluded that the concentration of 7-oxocholesterol in serum is low under normal conditions in vivo, probably due to presence of effective antioxidative and/or metabolizing systems. PMID- 3524313 TI - A differential scanning calorimeter for ice nucleation distribution studies- application to bacterial nucleators. AB - A differential scanning calorimeter has been developed for the automatic detection and measurement of dropwise freezing within a sample of 100-200 water drops. A typical drop size of 1 microliter is employed. The sample is distributed on flat, square (4-cm) thermoelectric sensors and the temperature is scanned downward by conductive cooling to a liquid nitrogen bath. The rate of cooling, typically 1 degree C/min, is set by the choice of a heat conduction rod between the calorimeter and the liquid nitrogen bath. The voltages from the thermopiles along with a system temperature-measuring thermocouple are continuously monitored by digital voltmeters and recorded every half-second in a computer memory. A freezing event in a drop is detected by a characteristic voltage signal whose integral with time is proportional to the size of the drop and its heat of fusion. The half-life of a freezing event signal is 10 s for a 1-microliter drop. The integrated signal produced from multiple freezing events is shown to provide a direct measure of the number of drops frozen at a given temperature. A distribution curve and its smoothed derivative can be constructed directly from these measurements. The instrument, which is termed an "ice nucleometer," is illustrated in determining the ice nucleation distribution in a population of Escherichia coli harboring cloned ice nucleation genes. PMID- 3524314 TI - Partitioning in aqueous two-phase systems: an overview. PMID- 3524315 TI - A case of double superior vena cava and classification of Japanese cases reported. AB - The author' case was a 74 year-old Japanese female who died of senility. This case had a small-sized communicating branch corresponding to the left brachiocephalic vein and uniting bilateral superior venae cavae. 2 anastomotic branches were observed among the azygos, the hemi-azygos and the accessory hemiazygos vein, and also a small anastomotic branch between the accessory hemiazygos vein and the left s.v.c. The venous valves were observed in both of the internal jugular, both of the external jugular and both of the subclavian veins. We also referred to 56 Japanese cases of d.s.v.c. including this case and classified it in accordance with the method of McCOTTER (1916), and they were shown in Table 1. In Japan, there were 17 (30.4%) cases of d.s.v.c. without a communicating branch and 22 (39.3%) cases with the communicating branch. Therefore, a comparison between the figures of McCotter and the present author's showed the reverse result. PMID- 3524316 TI - Remodeling of bone and bones: effects of altered mechanical stress on the regeneration of transplanted bones. AB - We divided 116 rats weighing 50 gm into four groups with tails either left in situ or transplanted as follows: straight in situ: untreated controls; bent in situ: five caudal vertebrae (CV) in the loop; straight transplants: three CV skinned and transplanted autologously; and bent transplants: five CV skinned, bent to form a loop, and transplanted autologously. Tails were radiographed weekly up to 6 weeks and at 12 weeks, and microradiographic and histological studies were undertaken on selected specimens. At 12 weeks the bones in the apex of the loop of tails left in situ appeared bent with a straight-to-convex shaft on the outer side and a thicker, more concave one on the inner side. In the transplanted bent segments the bone shaft died and initially the reverse occurred: the outer shaft thickened and the inner resorbed completely. A new concave inner diaphysis then formed so that the bones in both instances were essentially similar in final shape. In the bent transplants the surviving osteogenic tissues regenerated and, adapting to the altered forces, formed a new bone shaft. This involved a change in the direction, amount, and nature of endochondral, periosteal, and regenerative growth and subsequent remodeling of bone. The results support previous observations that, within limits, the strain in the osteogenic envelope is an important factor in adaptation of bones to changing stress and that, where the envelope is deficient, the surviving tissues have the capacity to regenerate and repair defects in the bone so that it best resists the changing stresses applied to it. PMID- 3524317 TI - CPAP oxygenation during one-lung ventilation using an underwater seal assembly. PMID- 3524318 TI - Organ blood flow during high-frequency ventilation at low and high airway pressure in dogs. AB - Using the radiolabeled microsphere technique, the authors studied hemodynamic variables and regional blood flow to multiple peripheral organs during conventional positive-pressure ventilation (CV) and high-frequency ventilation (HFV) at low and high mean airway pressure (Paw). Twenty supine anesthetized, paralyzed dogs were ventilated using CV (14-16 breaths/min) and HFV (rate = 10 Hz) in random order. In the first group (low Paw, n = 10), Paw was maintained at 3 cmH2O during CV and HFV. In the second group (high Paw, n = 10), Paw was increased to 13 cmH2O during CV and HFV. Pulmonary capillary wedge pressure and right atrial pressure remained constant during low and high Paw trials. No differences in heart rate, systemic arterial pressure, intracranial pressure, or cardiac output were noted during CV and HFV within the low and high Paw groups. In addition, blood flow to multiple peripheral organs during CV and HFV remained constant within each Paw group, except for a small decrease in cerebellar blood flow during HFV at high Paw trials showed a significant decrease in hepatic arterial and outer kidney cortical flow at high Paw. Total cerebral blood flow was decreased at high Paw, as were regional flows to diencephalon, midbrain, pons, medulla, and cerebellum. However, these differences were not attributable to differences in cerebral perfusion pressure or intracranial pressure, and cerebral oxygen delivery was not different between high Paw and low Paw groups. It is concluded that under conditions of similar Paw in anesthetized dogs, HFV does not significantly alter hemodynamic patterns or regional circulation relative to CV. PMID- 3524319 TI - Review of Clostridium difficile-associated diseases. AB - Clostridium difficile has recently become recognized as an important nosocomial pathogen. This review summarizes what is known about the isolation of the organism, the spectrum of clinical disease, virulence factors, treatments, and methods of prevention. Risk factors for C. difficile disease are also discussed. The most important risk factor is the use of certain antibiotics (ampicillin, cephalosporins, and clindamycin). C. difficile is associated with 96% to 100% of cases of pseudomembraneous colitis, 60% to 75% of antibiotic-associated cases of colitis, and 11% to 33% of antibiotic-associated cases of diarrhea. Other risk factors include gastrointestinal manipulations, advanced age, female sex, inflammatory bowel disease, cancer chemotherapy, and renal disorders. Hospital outbreaks of C. difficile disease are examined. Data from nosocomial outbreaks support transmission of C. difficile by contaminated fomites and hand carriage by hospital personnel. PMID- 3524320 TI - The efficacy of ketotifen in a controlled double-blind food challenge study in patients with food allergy. AB - The effectiveness of oral ketotifen was compared with that of placebo in 26 patients with food allergy in a randomized, double-blind parallel study. Patients were selected on the basis of food allergy as established by history, clinical improvement after an exclusion diet, and reappearance of the symptoms after a challenge with the food. Thirteen patients were given ketotifen and 13, placebo. Ketotifen or placebo were administered twice daily for 1 month after the first oral provocation test and the last dose was given 12 hours before the second oral provocation test. Ketotifen protected patients (7/13) significantly more than placebo (2/13; P less than .05). The results of this study suggest that ketotifen may be useful for some patients with food allergy. PMID- 3524321 TI - [Assessment of ventricular function by thermodilution in controlled ventilation with positive end expiratory pressure]. AB - Controlled mechanical ventilation with PEEP can induce important haemodynamic modifications. The aim of this study was to focus on right ventricular function, often altered with that kind of respiratory support. Bed-side assessment of right ventricular function was made possible through thermodilution technique. Eleven patients receiving PEEP from 0 to 15 cmH2O were studied. Right ventricular end diastolic volume (RVEDV), cardiac output (CO) and right ventricular ejection fraction (RVEF) were obtained for each patient. Increasing PEEP produced the same disturbances in nine patients, i.e. decreased RVEF. Blood volume expansion brought back to normal the haemodynamic values. Two patients had a decrease in CO and RVEF associated with an increase in RVEDV. In one of these two patients, dobutamine corrected the RV dysfunction. Using thermodilution technique, abnormalities of RV preload can be accurately assessed. From these data, the most appropriate treatment can then be chosen. PMID- 3524322 TI - [Effect of positive end expiratory pressure on arterial oxygenation during bronchoalveolar lavage for proteinosis]. AB - To maintain good cellular oxygenation during bronchopulmonary lavage for alveolar proteinosis is often a difficult problem to solve. A case is reported of alveolar proteinosis in whom four lavages were performed. Details of the technique are discussed, as are the problems with expedients used to improve PaO2. The use of a 10 cmH2O positive end-expiratory pressure was useful only during the "in-phase"; in the "out-phase", it worsened the PaO2. PaO2 during lavage in patients with alveolar proteinosis can only be improved by three ways: cancellation of the shunt during lung filling and, during the "out-phase", an increase in FIO2 or pulmonary artery occlusion by a balloon. PMID- 3524323 TI - Alkaline ingestions. AB - Alkaline ingestion is a potentially life-threatening problem that may confront the emergency physician. It is similar to many other toxins in that children and those who attempt suicide are its most common victims; however, implications in terms of initial stabilization and definitive care are quite distinct. Mucosal exposure to lye results in a quick, deep liquefactive necrosis. Consequently, blind nasotracheal intubation may result in the perforation of damaged tissues in the pharynx and trachea. For similar reasons, the blind passage of a nasogastric tube is contraindicated. The use of diluents in this setting is controversial. If a diluent is used, water and milk are considered the liquids of choice. They may be used to irrigate oropharyngeal burns, but are contraindicated in the face of respiratory compromise, shock, liquid lye ingestion, and perforation of the esophagus or stomach. Cathartics and charcoal are not used after alkaline ingestion. Cathartics, however, are used in miniature alkaline battery ingestions to diminish bowel transit time. Esophagoscopy should be done within 12 to 24 hours after ingestion to directly observe the extent of damage. This procedure should be stopped at the first sign of injury to protect against iatrogenic esophageal perforation. Steroids should be started for circumferential esophageal burns and in those patients with significant injury who are unable to undergo esophagoscopy. IV antibiotics are administered for gastrointestinal perforation and may be used concomitantly with steroids. Miniature alkaline batteries lodged in the esophagus must be removed immediately. The available modalities include fluoroscopy-directed Foley catheter removal, endoscopy, and surgery.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3524324 TI - Monoclonal antibodies produced to Streptococcus agalactiae. AB - Two monoclonal antibodies produced against Streptococcus agalactiae were studied for their specificity and sensitivity. Both reacted strongly in the enzyme-linked immunosorbent assay and indirect fluorescent antibody test with S agalactiae, but did not react with other gram-positive organisms frequently found in test herds in Mississippi. A procedure for using monoclonal antibodies in the detection of S agalactiae-infected milk samples is proposed. PMID- 3524325 TI - Comparison of diluents for maintaining the viability of Cowdria ruminantium. AB - Thirteen solutions were compared to determine the optimal diluent for preservation of the viability of the Kwanyanga isolate of Cowdria ruminantium. They included the 2 diluents commonly used with C ruminantium and diluents proved effective with other rickettsiae. The capability of each diluent to maintain the viability of C ruminantium over a 3-hour period at room temperature was assessed by comparing the survival distributions of groups of outbred albino mice after they were inoculated IV with infected liver homogenates. The results indicated that the Snyder I diluent was significantly better at maintaining the viability of C ruminantium than were the other diluents studied. PMID- 3524326 TI - Fluorescent antibody technique to detect Cowdria ruminantium in in vitro-cultured macrophages and buffy coats from cattle, sheep, and goats. AB - Fluorescent antibody tests, Giemsa stain, and electron microscopy were used to detect colonies of Cowdria ruminantium in in vitro-cultured macrophages and buffy coats from heartwater-infected cattle, sheep, and goats. Antibodies were obtained from C ruminantium-infected cattle, sheep, and goats treated with a small dose of oxytetracycline HCl. Cowdria ruminantium elementary bodies were small-coccus forms (0.14 micron) and large-coccus forms (0.22 micron to 0.6 micron). The size of inclusion bodies varied from 1.5 micron to 2 micron. Inclusion bodies and elementary bodies were observed in the cytoplasm of macrophages and neutrophils. PMID- 3524327 TI - Immunofluorescent evaluation of the lower respiratory tract of healthy horses and of horses with chronic bronchiolitis. AB - Pulmonary parenchymal tissues from 6 healthy horses and from 9 horses with chronic bronchiolitis were evaluated by use of an indirect immunofluorescent technique. In horses of both groups, the diffuse interstitial immunofluorescence was most intense for immunoglobulin (Ig)G, moderate for IgA, and minimal for IgM. Intensity of fluorescence was increased markedly in diseased lungs exposed to anti-IgA and anti-IgG. Around small bronchi and large bronchioles of healthy horses, IgA-containing cells generally were more numerous than were IgG-Fc fragment (Fc)-containing cells; in small bronchioles, however, IgA-containing cells and IgG (Fc)-containing cells were identified with approximately equal frequency. Immunoglobulin-containing cell types usually were located in the lamina propria and submucosa of airways, with occasional Ig-containing cells seen interepithelially and intraluminally; IgG (T)- and IgM-containing plasma cells were observed infrequently in the same regions. The number of Ig-containing cells became fewer as the diameter of the airway decreased; therefore, at the level of the terminal bronchiole, Ig-containing cells only were observed occasionally. This pattern of Ig-containing cell distribution was similar in horses with chronic bronchiolitis; however, horses with chronic bronchiolitis had more IgA containing cells forming perivascular and peribronchiolar cuffs than did healthy horses. The number of IgG (Fc)-containing lymphocytes and non-Ig-stainable lymphocytes also were higher in horses with chronic bronchiolitis than in healthy horses, but the number did not approach the magnitude of that observed for IgA containing cells. One horse had deposits of complement C3 and IgG (Fc) within alveolar septa. PMID- 3524328 TI - Critical test and safety evaluations of an oral paste preparation of mebendazole and trichlorfon in horses. AB - Critical tests were done on 24 naturally parasitized horses to compare the antiparasitic activity of an oral paste preparation of mebendazole and trichlorfon with that of the marketed powder formulation. Each formulation was administered at the recommended dosages of 8.8 mg of mebendazole and 40 mg of trichlorfon/kg of body weight. Efficacy of the paste formulation ranged from 97.7% to 100% against 2nd- and 3rd-stage Gasterophilus spp, adult Strongylus vulgaris, S edentatus, Parascaris equorum, small strongyles; and larval and adult forms of Oxyuris equi. Adverse effects were generally limited to slight softening of the feces. Mild and transient restlessness or sweating were also observed in 2 of 12 horses treated with the paste formulation. The toxic effects of the paste, administered at 2.2 times the therapeutic dose, were examined in 6 horses and compared with the effects of a nonmedicated paste, administered in similar volumes to 6 other horses. Drug-related changes were not detected in clinical chemical analyses, hematologic values, or liver function tests. Transient clinical signs of organophosphate toxicosis (primarily the passage of loose feces) and prolonged inhibition of erythrocyte cholinesterase activity were evident within 1 hour after drug treatment. These effects were similar to those reported for the 2.2 X dose of marketed powder formulation. PMID- 3524329 TI - Efficacy of flunixin meglumine for the treatment of endotoxin-induced bovine mastitis. AB - The clinical effect of flunixin meglumine administration was determined in cows with acute mastitis induced by intramammary administration of endotoxin. In 12 lactating cows, 10 micrograms of Escherichia coli 026:B6 endotoxin were administered via a teat cannula into the teat cistern of single randomly selected rear quarters. Cows were challenge exposed as pairs. One cow in each pair was administered parenteral flunixin meglumine (6 cows) and 1 cow per pair was administered saline solution (6 cows). Multiple doses (7) of 1.1 mg of flunixin meglumine/kg of body weight or saline solution were administered at 8-hour intervals beginning 2 hours after endotoxin. Cow and quarter clinical signs as well as milk somatic cell concentrations, bovine serum albumin, electrical conductivity, and milk production were determined before and for 14 days after endotoxin inoculation. Intramammary endotoxin produced signs characteristic of acute coliform mastitis. Quarter and systemic abnormalities occurred and milk production was reduced by approximately 50% at 12 hours after endotoxin. Flunixin meglumine therapy significantly (P less than or equal to 0.05) reduced rectal temperatures and quarter signs of inflammation and improved clinically graded depression when compared with these signs in saline solution-treated controls. Milk production and laboratory indicators of inflammation in milk were not significantly (P greater than 0.05) different for flunixin meglumine vs saline solution controls. The clinical response observed was consistent with the antipyretic, analgesic, and anti-inflammatory properties of flunixin meglumine. PMID- 3524330 TI - Hemodynamic effects of acute pneumonia experimentally induced in newborn calves inoculated with Pasteurella haemolytica. AB - Hemodynamic responses to acute pneumonia and to hypoxia were investigated in 10 newborn calves. Experiments were performed on heparinized, anesthesized and ventilated calves. Control calves were inoculated intratracheally with bovine fetal serum. Pneumonia was induced in treated calves by intratracheal inoculation with P haemolytica suspended in bovine fetal serum. Before inoculation (base line), at the time of inoculation (T = 0), and at 30-minute intervals for 3 hours, pulmonary arterial pressure (Ppa), systemic arterial pressure, cardiac output (CO), arterial blood gases, pulmonary vascular resistance (PVR), and systemic vascular resistance were determined. At T = 0, calves in both groups became hypoxemic, alveolar-arterial O2 difference, PVR, and Ppa increased, and CO and systemic vascular resistance remained unchanged. At subsequent measurement intervals, all values returned to base-line in control calves, whereas treated calves had progressive hypoxemia associated with a decrease in Ppa and PVR, with no change in CO. Three hours after inoculation and after inhalation of 10% O2 in N2, PVR increased significantly in the control calves. In the treated group, hypoxia did not increase the resistance, compared with base-line and 3-hour values. The data indicate decreased Ppa during pneumonic pasteurellosis is because of a decrease in PVR and that pneumonia may attenuate the normal pulmonary hypoxic vasoconstrictor response. PMID- 3524331 TI - Placebo problems in psychotherapy research. Social-psychological alternatives to chemotherapy concepts. PMID- 3524332 TI - Right and left ventricular pressure-volume response to elevated pericardial pressure. AB - Because of the close anatomic connections, the volume in 1 ventricle can directly influence the volume in the other ventricle. We examined this ventricular mechanical coupling at elevated pericardial pressures in 6 mongrel dogs. The animals were anesthetized and were mechanically ventilated with intermittent positive-pressure ventilation. Right and left ventricular volumes and pressures and pericardial pressure were simultaneously measured during control and after infusing 25, 50, and 75 ml of saline with dextran into the pericardial cavity. The ventricular volumes were calculated from cine-radiographic positions of endocardial, radiopaque markers. In the control state, right ventricular end diastolic volume (RVEDV) increased 9.2 +/- 0.9 ml (p less than 0.05) during expiration, whereas left ventricular end-diastolic pressure (LVEDP) increased 0.6 +/- 0.7 mmHg and left ventricular end-diastolic volume (LVEDV) decreased 0.6 +/- 0.4 ml. The increased transmural LVEDP with a decreased LVEDV indicates an apparent left ventricular distensibility decrease as right ventricular diastolic volume increased, possibly because of ventricular interdependence. At the highest pericardial pressure, RVEDV increased 6.7 +/- 1.4 ml (p less than 0.05) during expiration as LVEDP increased 1.2 +/- 0.6 mm Hg and LVEDV decreased 2.0 +/- 0.6 ml (p less than 0.05). Thus, at the higher pericardial pressures, smaller changes in RVEDV produced significantly greater changes in LVEDV. This coupling between the ventricles was further examined in 5 hearts studied postmortem. The hearts were placed in cold cardioplegic solution and balloons were inserted into both ventricles.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3524333 TI - Pleural involvement in B-cell chronic lymphocytic leukemia associated with a T cell-rich "reactive" pleural effusion. AB - Because pleural involvement by chronic lymphocytic leukemia (CLL) is virtually impossible to distinguish from inflammatory disorders using cytologic or histopathologic methods, many investigators have relied on immunologic studies of mononuclear cells isolated from lymphocytic pleural effusions to make the distinction. A patient with B-cell CLL is reported in whom pleural involvement was documented using the frozen-section immunoperoxidase technique on a pleural biopsy even though cells isolated from the associated effusion showed only a small polyclonal B-cell population and a predominance of T cells. No other cause for this "reactive" effusion could be identified. The implications of this previously unreported finding of pleural B-cell CLL infiltration associated with a reactive effusion are discussed. PMID- 3524334 TI - A controlled clinical trial of 3- and 5-month regimens in the treatment of sputum positive pulmonary tuberculosis in South India. Tuberculosis Research Centre, Madras, and National Tuberculosis Institute, Bangalore. AB - A controlled comparison of 3 short-course regimens was undertaken in patients with newly diagnosed, sputum-positive, pulmonary tuberculosis in South India. The regimens were: R3: rifampin plus streptomycin plus isoniazid plus pyrazinamide daily for 3 months; 5: the same as regimen R3 followed by streptomycin plus isoniazid plus pyrazinamide twice weekly for 2 months; Z5: the same as regimen R5 but without rifampin. The distributions of various pretreatment characteristics were similar in the 3 series. At the end of treatment, 6 patients (3 R3, 3 Z5) of 694 (228 R3, 230 R5, 236 Z5) with drug-sensitive organisms initially were classified as having an unfavorable response. By 24 months (21 months of follow up for the R3 regimen and 19 months for the R5 and Z5 regimens), a bacteriologic relapse requiring treatment occurred in 20% of 200 R3, 4% of 187 R5, and 13% of 199 Z5 patients, the difference between the R3 and R5 series being highly significant (p = 0.00001). Considering patients with cultures initially resistant to isoniazid, 4 of 57 in the R3 and R5 series combined had an unfavorable response to treatment compared with 13 of 26 in the Z5 series (p less than 0.0001). Of the 4 patients with an unfavorable response in the R3 and R5 series combined, resistance to rifampin emerged in 2. Complaints of arthralgia were made by 45% of the R3 and R5 patients combined and 70% of the Z5 patients (p less than 0.00001). However, chemotherapy was modified in only 5 and 12%, respectively. Jaundice occurred in 7% of the R3 and R5 patients and 1% of the Z5 patients (p less than 0.00001). PMID- 3524335 TI - Ascorbic acid does not augment the restoration effect of iron treatment for empty iron stores in patients after gastrointestinal surgery. AB - The effect of a 6-week combined treatment with ferrous sulfate (80 mg Fe++ three times daily) and ascorbic acid (75 mg three times daily) on the empty iron stores in 20 patients after gastrointestinal surgery was examined from changes of serum ferritin. One group of 20 patients with similar clinical characteristics served as controls. The treatment replaced the empty iron stores. Since mean serum ferritin concentrations increased from 9 +/- 8 to 29 +/- 11 micrograms/l (P less than 0.001) in males and from 8 +/- 8 to 26 +/- 10 micrograms/l (P less than 0.001) in the females. Also blood hemoglobin and serum iron concentrations increased significantly (P less than 0.01). Among the controls there were no marked changes in serum ferritin, blood hemoglobin or serum iron concentrations. However, the increase of serum ferritin caused by this combined treatment was similar with that caused previously by pure ferrous sulfate treatment. Thus, it is considered that the combined treatment with ferrous sulfate (80 mg Fe++ three times daily) and ascorbic acid (75 mg three times daily) restores the empty iron stores in patients after gastrointestinal surgery, but that the increase is not augmented by the ascorbic acid. Thus, a pure iron therapy is recommended to fill up the empty iron stores in these patients. PMID- 3524336 TI - [Abdominal tuberculosis in children. A review apropos of 13 cases]. AB - Thirteen cases of abdominal tuberculosis are presented; some of them in active or symptomatic stage and others in latent or abdominal calcification form. Many of these patients were diagnosed through the finding of a source of infected cattle after diagnosis of one of symptomatic patients. Pathogenesis, clinical findings and diagnostic difficulty are commented, as well a sanitary importance of the problem, since M. bovis is still a currently found organism in daily practice. PMID- 3524337 TI - Serum enzyme assays in the diagnosis of acute myocardial infarction. Recommendations based on a quantitative analysis. AB - In the last 20 years, serum enzyme and isoenzyme levels have become the final arbiters by which acute myocardial infarction is diagnosed or excluded. We review the characteristics of these enzymes, the methods and limitations of commonly used assays, and data on diagnostic accuracy and clinical implications of enzyme levels in various settings and offer recommendations on their optimal use. Because of the poor sensitivity of single measurements of cardiac enzyme levels, these assays should not be used in the emergency room to exclude myocardial infarction. If myocardial infarction is suspected, levels of creatine kinase and its MB fraction should be measured at admission and about 12 and 24 hours later. If a myocardial infarction may have occurred more than 24 hours before evaluation, then lactate dehydrogenase isoenzyme measurements may increase diagnostic accuracy. Used properly, these assays are remarkably sensitive, but like all tests, optimal interpretation requires insight into technical pitfalls and other causes of misleading results. PMID- 3524338 TI - Pituitary tumors secreting growth hormone and prolactin. AB - The pathophysiology of functional adenomas of the anterior pituitary gland can be understood in the context of the central neural control of anterior pituitary secretion and by the fact that the cell types of the anterior pituitary gland generally express a single polypeptide hormone. Functional pituitary adenomas arise de novo from one or more of these cell types, but a defect in hypothalamic regulation can contribute to tumorigenesis and sometimes result in persistent tumor recurrence despite local surgical cure. The recent advances in molecular biology, radioimmunoassay, neuroradiology, and transsphenoidal microneurosurgery techniques have greatly improved our understanding of the pathophysiology of these tumors, enhanced diagnostic accuracy, and led to newer medical and surgical therapeutic approaches. This conference reviews the molecular and cellular pathophysiology, causes, diagnosis, clinical features, and medical and surgical management of the two common functional pituitary adenomas, prolactinoma and somatotropinoma. PMID- 3524340 TI - Determination of medical disability. PMID- 3524339 TI - Blood glucose control and diabetic complications. AB - Two hypotheses have been advanced to explain the appearance of microvascular complications in diabetic patients with glycemic control. The genetic hypothesis suggests that the development of diabetic complications is genetically determined and independent of diabetic control, whereas the metabolic hypothesis suggests that long-term hyperglycemia causes the subsequent development of small-blood vessel complications. We review data that either support or reject these hypotheses and suggest a third unifying hypothesis. PMID- 3524341 TI - Protection against hepatitis B after marrow transplantation. PMID- 3524342 TI - Cardiac angiography and renal dysfunction. PMID- 3524343 TI - Human immunodeficiency virus infection in transplant recipients. PMID- 3524344 TI - Captopril and onycholysis. PMID- 3524345 TI - Which medical journals have the greatest impact? AB - High-impact medical journals are identified using data from the 1981 and 1982 Journal Citation Reports. The Journal Citation Reports are an annual supplement to the Science Citation Index. Journals publish different types of editorial matter, much of which does not report substantive research. A special algorithm is used to calculate the number of substantial or "meaty" items. In 1981 The Lancet and The New England Journal of Medicine ranked highest among 78 journals in citations received; 53,945 and 47,887, respectively. These journals also have the highest impact factor, the average number of citations received by items in a journal's 1980 and 1981 issues. The British Medical Journal was highest in 1981 immediacy index, the measure of how quickly a journal's 1981 items were cited in 1981. PMID- 3524346 TI - Enzymatic control of estrogen production in human breast cancer: relative significance of aromatase versus sulfatase pathways. AB - One-third of the cases of breast cancer in postmenopausal women are hormone dependent and the lesions regress upon treatment with antiestrogens or inhibition of estrogen biosynthesis. In these patients, estrogens are synthesized in extraglandular tissues from adrenal precursors and re-enter plasma to produce estrone levels of 52 +/- 6.5 pg/ml (mean +/- SEM) and estradiol concentrations of 13.1 +/- 0.7 pg/ml. However, the fact that the levels of estrogen in breast tumor tissue are an order of magnitude higher than plasma levels suggested the possibility of in situ estrogen production. To address this possibility, we measured several enzymes involved in estradiol biosynthesis in human tumors. Forty-eight of 61 tumors contained aromatase (estrogen synthetase) activity ranging from 5-80 pg/gm protein per hour. By comparison, the levels of estrone sulfatase were 10(6) higher, ranging from 0.8-125 micrograms/gm protein per hour. Because the sulfatase enzyme was of lower affinity (i.e., Km = 27 microM) than that of aromatase (i.e., 0.027 microM), the amount of estrogen formed under conditions of similar substrate concentrations was compared and found to be 10 fold higher via the sulfatase enzyme. In 41 additional tumors, the 17 beta hydroxysteroid dehydrogenase enzyme, catalyzing the conversion of estrone to estradiol, was uniformly present. To test the biologic relevance of the estrone sulfate to estrone to estradiol pathway, estrogen-dependent nitrosomethylurea rat mammary tumors were grown in soft agar in the presence of estrone sulfate. Concentrations of estrone sulfate of 10(-6) microM significantly (p less than 0.01) stimulated colony formation in this system in which 75.5-98.6% of estrone sulfate was converted to estrone and 0.2 to 6% to estradiol. These data support the hypothesis that mammary carcinomas can synthesize estradiol in situ from circulating estrogen precursor and that local conversion is biologically important. On the basis of comparative data, the estrone sulfate to estrone to estradiol pathway is quantitatively more important than that involving androstenedione to estrone to estradiol. PMID- 3524347 TI - Estradiol/progesterone interaction in normal and pathologic breast cells. AB - In most target cells of the female genital tract, adequate cell differentiation is obtained via the successive and synergistic actions of estradiol (E2) and progesterone (P). This mainly due to the fact that progesterone receptor (PR) synthesis involves the prior action of estradiol through its receptor (ER). In normal breast, E2 stimulates the growth of the ductal system whereas lobular development depends on progesterone secretion. In other words E2 + P, when secreted in an adequate balance, permit the complete and proper development of the mammary gland. On the other hand progesterone may also have an antagonistic action against E2. The antiestrogen activity of progesterone is mediated through a decrease in the replenishment of E2 receptor and the synthesis of 17 beta hydroxysteroid dehydrogenase, which leads to an accelerated metabolism of E2 to E1 in the target organ itself. These biochemical events, which have been well documented in the endometrium, have also been shown in cultures of normal breast epithelial cells as well as in differentiated fibroadenomas with high cellular density. In addition, data from the literature show that E2 added to human breast cells increases cell multiplication by means, eventually, of the synthesis of growth factors. Progesterone and progestins have a reverse effect. Data from our laboratory indicate that in normal cultured cells E2 and progestins are also antagonists with regard to cell multiplication. From these different data, it is postulated that in human beings, long periods of a luteal-phase defect leading to an unopposed estrogen effect might be a promoter of carcinogenesis in the breast. PMID- 3524348 TI - Interaction between estrogen receptor and subcellular structures of target cells: nuclear localization of unoccupied receptor and its modification induced by estradiol. AB - Experimental conditions affecting the partitioning of the estrogen receptor were studied. Homogenization of rat uteri at 25 degrees C resulted in a particulate partitioning of the estrogen receptor. The use of frozen tissue (-70 degrees C) or pre-exposure of the tissue to 0 degrees C prior to 25 degrees C homogenization, homogenization at 0 degrees C and tissue dilution all induced soluble partitioning of the receptor. The estrogen receptor found in the particulate fraction was mostly associated with the nuclei, even in the absence of hormone. The interaction between estradiol and the estrogen receptor induced modification in the receptor's charge and size that promoted its cold-insensitive association with the nuclei of target cells. These modifications were studied in a cell-free in vitro system and were reversibly blocked by molybdate. Similar changes occurred in vivo when estradiol interacted with the receptor in the nuclei of target cells. PMID- 3524349 TI - Steroid hormone receptor regulation by various hormonal factors during mammary development and growth in the normal mouse. AB - The studies described herein are focused on the nature and regulation of estrogen receptors in normal mammary tissue, with the rationale that manipulation of these receptors is the sole basis for endocrine therapy of human breast cancer. Various features of this complex system have been uncovered by our studies. The presence of different forms of cytosol estrogen receptor, fluctuating in unison with glandular stimulation, results in differential responsiveness of the cells. Tissue that is relatively estrogen-starved presents its receptors in a form that avidly attract the limited available ligands and can hastily put them to use in the nucleus. In contrast, the receptor system in the highly stimulated state displays a sort of refractoriness to estrogen, being relatively sluggish in its responsiveness. Once formed, however, these latter complexes are probably far more effective in terms of eliciting estrogenic responses, since they have an enhanced affinity for DNA and a prolonged half-life. (Table; see text) Prolactin is clearly a very important mediator of the action of estrogen on the mammary gland estrogen receptors, presenting a tissue-specific difference in comparison with the regulation of the uterine estrogen-receptor system. An odd finding was that prolactin inhibits nuclear retention of the estrogen receptor (and probably the progesterone receptor), an effect that is counterproductive to its very strong positive action on the level of intracellular receptor. Perhaps prolactin is the gross effector of receptor fluctuation, allowing estrogen the privilege of dictating the degree of receptor function; indeed our data on the dose responsiveness of estrogen action and the effects of bromocriptine indicate that a portion of the estrogenic stimulation is not mediated by prolactin. An interesting sidelight of these studies was the finding that high levels of bromocriptine, pharmacologic in terms of prolactin suppression, exhibited an inhibitory effect on nuclear retention of estrogen receptors that was independent of, and did not prevent subsequent elicitation of, the action of prolactin on the receptors. The role of prolactin in tumorigenesis is well established in experimental animals, but its role in the human disease is not clear. Although prolactin receptors have been measured in human breast cancer, there does not appear to be any distinguishable correlation with the presence of estrogen or progesterone receptors. While it is a bit premature to draw conclusions, initial trials of bromocriptine usage have not been supportive of beneficial effects of such treatment.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3524350 TI - The 52K estrogen-regulated protein secreted by breast cancer cells and its clinical potential. PMID- 3524351 TI - Hormone-responsive creatine kinase in normal and neoplastic mammary glands. PMID- 3524352 TI - Morphologic and functional aspects of apocrine metaplasia in dysplastic and neoplastic breast tissue. PMID- 3524353 TI - The endocrinology of the abnormal male breast. PMID- 3524354 TI - Hormones in milk. AB - Protein hormones (especially prolactin) and steroid hormones (gestagens, estrogens, corticoids, and androgens) can be detected by bioassay and radioimmunoassay in milk in a variety of species. In addition, milk contains vitamin D and beta-casomorphins (opiate-like peptides). It has been assumed that most of the hormones are transferred into milk by diffusion. However, evidence is available for active mechanisms like those for progesterone in goats and prolactin in cows. Most of the hormone profiles in milk are similar to the ones in blood plasma. Hormone concentrations in milk seem to be a good estimate of the average hormone content in plasma, especially for the measurement of longer lasting secretory activities like progesterone and estrogen release during the estrous cycle or seasonal changes of prolactin in ruminants. Determination of progesterone and estrone sulfate in milk serves as a diagnostic tool in fertility control, especially in cows. Enzyme immunoassay kits are available for this monitoring purpose. Exogenously administered hormones are also transferred into milk. Residue studies have shown that the dilution is so great that it may be assumed that there is no potential risk for the consumer. PMID- 3524355 TI - Alveolar macrophage phagocytosis in sarcoidosis. The role of activated lymphocytes. PMID- 3524356 TI - Alveolar lymphocyte activation during sarcoidosis. PMID- 3524357 TI - In vitro granuloma-like formations in bronchoalveolar cell cultures from patients with sarcoidosis. PMID- 3524358 TI - Complement activity in pulmonary fluid during sarcoidosis. PMID- 3524359 TI - Louis E. Siltzbach Memorial Lecture. Concepts of pathogenesis and lung reactivity in hypersensitivity pneumonitis. AB - It is surprising that forms of hypersensitivity pneumonitis do not occur more frequently, given the variety of biologic dusts and airborne antigens that have been found to cause disease. Exposure is almost universal in some occupations that involve handling animals or feed products, and development of humoral immunity occurs in most; however, overt respiratory illness is relatively infrequent or not easily recognized by the subject. What differs between symptomatic and asymptomatic subjects is not certain, but unique host resistance or susceptibility, as the case may be, appears to be a factor. This may have a genetic basis, but this has not been investigated vigorously. With repeated airborne exposure to appropriate antigens, a humoral and a local respiratory antibody response occur but perhaps with little disease consequence, as most subjects so immunized remain clinically asymptomatic. So far as is known, there is no other route of antigenic exposure except through the respiratory tract, but contact with the antigens could occur on the skin or on mucosal surfaces such as the conjunctiva, or antigens could be ingested by swallowing nasopharyngeal secretions. Except for serum antibodies, however, there is little documentation that other systemic organs are affected, as may occur with sarcoidosis. Of course there is great variability in the age of the subjects and the dosage of antigen to which the subject is exposed, and the frequency and duration of exposure can vary considerably. All of these would seem to be easily tested, however, in an animal model where most of the variables could be independently controlled and varied at will. Even the genetic and aging factors, which are the most difficult parameters to control in humans, could be investigated. Yet, it has been very difficult and perplexing not to have created a more faithful model of hypersensitivity pneumonitis in the laboratory. It is virtually impossible to cause predictable lung disease without the use of an adjuvant that will induce some measure of delayed or cellular hyperreactivity. The acute lung disease caused by antigen-antibody reactions seems too explosive and severe, for its acute disease counterpart of hypersensitivity pneumonitis in humans and the persistence of histologic changes in lung tissue is brief and is usually resolved within 1-2 weeks. A chronic model producing granulomas and fibrosis has been difficult to construct, although the work reported by Fulmer and colleagues is very encouraging.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3524360 TI - The Langerhans' cell in human pathology. PMID- 3524361 TI - Assessment of respiratory epithelial permeability by bronchoalveolar lavage and aerosolized 99mTc-DTPA in patients with sarcoidosis. PMID- 3524362 TI - Inhibition by cyclosporin A of streptococcal cell wall-induced hepatic granulomas in LEW/N rats. AB - A single intraperitoneal injection of an aqueous suspension of group A streptococcal cell wall fragments into susceptible LEW/N female rats results in the development of noncaseating hepatic granulomas as a consequence of deposition and persistence of the cell walls in the liver. We have studied the effect of daily intramuscular injections of CS-A, an inhibitor of T lymphocyte activation, on granuloma formation. CS-A-treatment resulted in the pronounced inhibition of granuloma formation, although no appreciable differences in quantity of streptococcal cell wall antigens, which were deposited in the liver, could be demonstrated. These data suggest that activated T lymphocytes play a key role in the pathogenesis of this granulomatous process. PMID- 3524363 TI - Primary biliary cirrhosis. The present position. PMID- 3524364 TI - Functional aspects of mononuclear phagocyte involvement in lung inflammation. AB - The theme we have presented herein is that of the adaptability of the mononuclear phagocyte. This has been illustrated by discussing the mechanisms underlying the emigration of blood monocytes into peripheral tissues and organs under steady state and inflammatory conditions. Our basic tenet is that monocytes represent a relatively homogeneous cell population which migrates, either randomly or selectively, into a tissue and matures, following interaction with tissue components (be they normal or inflammatory), into macrophages characteristic of that tissue. Thus it is the interaction of a mononuclear phagocyte with an inflammatory stimulus that directs the phagocyte to mature into an inflammatory macrophage. Finally, we have also discussed how stimulus impingement on macrophages influences the products these cells secrete. We conclude that macrophages are essential to both the degradative and remodeling phases of an inflammatory response. PMID- 3524365 TI - International controlled clinical trial of prednisone therapy in pulmonary sarcoidosis. PMID- 3524366 TI - The possible influence of corticosteroid therapy on the natural course of pulmonary sarcoidosis. Late results of a continuing clinical study. PMID- 3524367 TI - Genetic and functional analysis of beta tubulin in Aspergillus nidulans. PMID- 3524368 TI - Differential structure and distribution of the high molecular weight brain microtubule-associated proteins, MAP-1 and MAP-2. PMID- 3524369 TI - Microtubule-associated proteins in the developing brain. PMID- 3524370 TI - Distribution of MAP-4 in cells and in adult and developing mouse tissues. PMID- 3524371 TI - Isolation of mitotic microtubule-associated proteins from sea urchin eggs. AB - We have used a taxol-based microtubule purification procedure and monoclonal antibodies to isolate and characterize the MAPs of mitotic spindle microtubules in the fertilized sea urchin egg. In so doing, we hope to have identified some of the essential working parts of the mitotic apparatus, namely those proteins that regulate the assembly, disassembly, organization and mechanochemical properties of spindle microtubules. The results of this effort strongly suggest that a rich diversity of polypeptides associate with mitotic spindle microtubules. Whether each of these represents an individual protein species is not currently known. It is possible, for example, that particular spindle MAPs comprise multiple, distinct subunits. This would not be surprising in light of the facts that both MAP-1 and MAP-2 contain lower molecular weight subunits, and that axonemal dyneins are complex assemblies of several polypeptide species. Our future efforts with the sea urchin system will be to determine how the various mitotic spindle MAPs we have identified function individually and in concert, and how those functions contribute to the mechanochemical properties of the spindle. PMID- 3524372 TI - Calcium and calmodulin in the regulation of the microtubular cytoskeleton. PMID- 3524373 TI - Control of microtubule assembly-disassembly in lysed-cell models. PMID- 3524374 TI - Isolation of microtubule-secretory granule complexes from the anglerfish endocrine pancreas. PMID- 3524375 TI - Mitochondrial localization of a microtubule-related protein. PMID- 3524376 TI - Range of environmental stimuli producing nociceptive suppression: implications for neural mechanisms. AB - Initial studies of environmentally induced analgesia in the rat established several important characteristics of this phenomenon. We demonstrated that stressful environmental stimuli were not sufficient to produce nociceptive suppression. However, emphasis by many researchers on stress-related analgesia has limited studies of the range of environmental contexts producing nociceptive suppression and handicapped efforts to describe neural mechanisms mediating EIA. Another feature of EIA was the observation that the nervous system might contain multiple opiate and non-opiate systems capable of modulating nociceptive responses. Although previous research had recognized the possibility of endogenous opiate analgesic systems, little attention had been given to non opiate analgesic mechanisms. Since it seems unlikely that multiple systems would serve purely redundant roles, it seemed reasonable to speculate that at least some of these systems may mediate other modulatory functions in addition to regulating sensory information on noxious stimuli. The observation that some environmental conditions could increase nociceptive responses certainly indicated that environmentally induced nociceptive modulation was not restricted to analgesia. These and other observations lead us to suspect that neural mechanisms mediating at least some forms of EIA could be related to mechanisms mediating more general modulating processes associated with selective attention, orienting, or arousal. Subsequent studies in the primate established that changes in vigilance demands, stimulus relevance, and stimulus predictability could modulate responses of medullary dorsal horn nociceptors coding sensory-discriminative information on noxious thermal stimuli. However, these studies provided no information on the neural mechanisms mediating this modulation. Later studies in cats described an endogenous, non-narcotic analgesic system representing a subcomponent of a larger cholinergic system principally involved in regulating animals' responsiveness to external stimuli. Research also indicated that this cholinergic analgesic system could function physiologically to modulate nociceptive responsiveness in the presence of certain environmental stimuli but not others. Considered together, data from these studies indicate that, while stress is not sufficient to produce analgesia, a variety of environmental conditions can modulate nociceptive input. A number of different neural systems could contribute EIA associated with various stimuli. It is possible that the regulation of nociceptive input is not the exclusive, or even principal, consequence of normal activity within certain of these systems. PMID- 3524377 TI - Analgesia following defeat in an aggressive encounter: development of tolerance and changes in opioid receptors. PMID- 3524378 TI - Multiple neurochemical and hormonal mechanisms of stress-induced analgesia. PMID- 3524379 TI - Behavioral and neurochemical consequences associated with stressors. AB - A series of neurochemical changes occur in response to stressors that may permit the organism to contend with environmental demands. When the organism is exposed to a stressor the utilization and synthesis of brain NE and DA increases. Under conditions where utilization exceeds synthesis, owing either to the nature of the stressor (uncontrollability), experiential factors (e.g., prior exposure to acute stressors), or organismic variables (e.g., strain, age), reductions of the amine may be incurred. It is suggested that the reduced amine concentrations leave the organism less well prepared to deal with the demands placed upon it, and ultimately increase vulnerability to psychological disturbances. It follows that the more persistent the amine reduction, the greater the probability of pathology being engendered. In effect, in our analyses of stressor effects it is not sufficient merely to determine whether amine reductions occur, but also to assess the ability of the system to re-establish adequate levels and turnover. Additionally, since stressors may result in the conditioning or sensitization of neurochemical processes, it is essential not only to assess the immediate impact of the stressor, but also the neurochemical variations that occur upon re exposure to stressors or cues associated with the stressor. In considering the consequences of stressors and the potential implications for human pathology, it is important to consider the impact of chronic stressors. After all, many stressors encountered by humans are chronic in nature, particularly if one considers ruminations associated with the aversive event. It seems that with repeated stressor application a further series of adaptive neurochemical changes occur. The activity of tyrosine hydroxylase is increased, and concentrations of NE and DA approach those of nonstressed animals. Indeed, it appears that after stressor termination the increased amine synthesis may persist for some time leading to a further increase of amine concentrations, which may enable the organism to deal with environmental demands. In addition, receptor variations may occur, including down-regulation of beta-NE receptors, and possibly alterations of alpha-1 and alpha-2 receptors as well. It is believed that the receptor variations may be the essential element in maintaining the integrity of the organism. It is our contention that where such adaptive changes do not occur or are slow in occurring, pharmacological intervention may be necessary to engender such neuronal variations. PMID- 3524380 TI - Catalepsy induced by body pinch: relation to stress-induced analgesia. PMID- 3524381 TI - Electroconvulsive shock activates endogenous opioid systems: behavioral and biochemical correlates. AB - From the evidence reviewed above, there is little doubt that ECS activates endogenous opioids and modifies their receptors. Thus, this form of SIA is accompanied by many other corollaries of opioid-like actions, including catalepsy, similar EEG patterns, common autonomic effects, and increases in opioid receptor binding sites. Investigations have further indicated that the amnestic effects of ECS can also be attenuated by naloxone, and that pituitary derived opioids may play an important role as a predominant source of opioids that contribute to these opioid-like effects following ECS. It is hoped that these many attempts to correlate SIA with other behavioral and physiological endpoints following ECS will provide a more global perspective on the role of endogenous opioid systems in ECS. From these results, it is suggested that other forms of SIA may also share many of these properties in common with ECS-induced SIA. Nonetheless, ECS and other forms of SIA, such as cold water exposure and restraint, share with ECS a common history of clinical use in the treatment of human depression. It is possible that the common thread linking these experimental observations to endogenous opioid systems may provide new insights into the cause and treatment of mental disorders as well as the perception of pain. PMID- 3524382 TI - Relation of stress-induced analgesia to stimulation-produced analgesia. PMID- 3524383 TI - Neuropharmacological and neuroendocrine substrates of stress-induced analgesia. PMID- 3524384 TI - Involvement of humoral factors in the mechanism of stress-induced analgesia in mice. PMID- 3524385 TI - The relationship between cardiovascular and pain regulatory systems. AB - An increasing amount of anatomical, physiological, and pharmacological evidence suggest that pain inhibitory circuitry is linked with cardiovascular regulatory systems in man and laboratory animals. Induction of hypertension in rats by different methods (mineralocorticoid treatment, stenosis of renal artery, or social deprivation) is associated with reduced responsiveness to noxious thermal stimuli (hot-plate) or to noxious mechanical stimuli (paw pressure). Genetically hypertension-prone rats derived from the SABRA strain and spontaneously hypertensive rats derived from Wistar/Kyoto strain also display a similar hypoalgesia. Acute increases in blood pressure are associated with reduced sensitivity to painful stimuli. Additionally, the interaction between blood pressure and pain perception has also been supported by the demonstration that various experimental interventions that diminish the magnitude of hypertension also attenuate the hypoalgesia. Recent clinical findings are also in agreement with the laboratory animal findings since sensory and pain thresholds have been shown to be significantly higher in unmedicated essential hypertensive subjects compared to normotensive controls. Thus, the human data corroborate animal data and suggest that a relation between blood pressure and pain sensitivity is likely to be a general phenomenon. It is unlikely that damage to peripheral pain fibers caused by a change in blood pressure contributes to the observed hypoalgesia. Naloxone, which has no effect on blood pressure, returns the pain sensitivity to normal levels. Behavioral tests (open field and motor activity cage) of normotensive and of renal and genetically (SBH and SHR) hypertensive rats exclude the possibility of a general motor deficit in hypertensive rats. Endogenous opioid peptides in central and peripheral nervous systems as well as in endocrine organs are implicated, although non-opioid mechanisms are also evident. Activation of baroreceptor afferents by acute or chronic increases in arterial or venous blood pressure may play an important role in the somatosensory responses associated with the increase in blood pressure. Coordinated cardiovascular-pain regulatory responses may be part of an adaptive mechanism that helps the body to face stressful events. PMID- 3524386 TI - The role of sinoaortic and cardiopulmonary baroreceptor reflex arcs in nociception and stress-induced analgesia. PMID- 3524388 TI - Stressor controllability and stress-induced analgesia. PMID- 3524387 TI - Conditioned fear-induced opiate analgesia: a competing motivational state theory of stress analgesia. PMID- 3524389 TI - Hyperalgesia induced by emotional stress in the rat: an experimental animal model of human anxiogenic hyperalgesia. PMID- 3524390 TI - Characteristics of analgesias induced by brief or prolonged stress. AB - Some characteristics of the effects of brief and prolonged stress on tail-flick latency are described. The pharmacological profiles of the latency responses to 30 sec and 30 min footshock are strikingly different. Thus, the increase of tail flick latency after 30 sec shock is unaffected by naloxone and enhanced by drugs which decrease 5HT or DA-dependent transmission, while the increase after 30 min shock is blocked by naloxone and also by the above drugs. The increased tail flick latency after 30 sec shock only occurs if tail-flick latency is also determined before shock. This finding, together with the attenuation or enhancement of the post-shock response by drugs that similarly affect conditioned avoidance behavior, suggests that the increased latency after brief shock occurs through a mechanism that is related to passive avoidance learning. Finally, a new approach to the investigation of stress-induced analgesia is described in which neurochemical changes during prolonged immobilization stress are repeatedly monitored using cisternal CSF samples taken in parallel with tail-flick latency measurements. PMID- 3524391 TI - Cytometry in the clinical laboratory: quo vadis? PMID- 3524392 TI - Methodological considerations for implementation of lymphocyte subset analysis in a clinical reference laboratory. AB - As the diagnostic utility of lymphocyte subset analysis has been recognized in the clinical research laboratory, a wide variety of reagents and cell preparation, staining and analysis methods have also been described. Methods that are perfectly suitable for analysis of smaller sample numbers in the biological or clinical research setting are not always appropriate and/or applicable in the setting of a high volume clinical reference laboratory. We describe here some of the specific considerations involved in choosing a method for flow cytometric analysis which minimizes sample preparation and data analysis time while maximizing sample stability, viability, and reproducibility. Monoclonal T- and B cell reagents from three manufacturers were found to give equivalent results for a reference population of healthy individuals. This was true whether direct or indirect immunofluorescence staining was used and whether cells were prepared by Ficoll-Hypaque fractionation (FH) or by lysis of whole blood. When B cells were enumerated using a polyclonal anti-immunoglobulin reagent, less cytophilic immunoglobulin staining was present after lysis than after FH preparation. However, both preparation methods required additional incubation at 37 degrees C to obtain results concordant with monoclonal B-cell reagents. Standard reagents were chosen on the basis of maximum positive/negative separation and the availability of appropriate negative controls. The effects of collection medium and storage conditions on sample stability and reproducibility of subset analysis were also assessed. Specimens collected in heparin and stored at room temperature in buffered medium gave reproducible results for 3 days after specimen collection, using either FH or lysis as the preparation method. General strategies for instrument optimization, quality control, and biohazard containment are also discussed. PMID- 3524393 TI - The assessment of the chemotherapeutic effects of vinca alkaloids by immunofluorescence and flow cytometry. AB - The effects of the vinca alkaloids on the rates of DNA synthesis in the human pancreatic carcinoma line, MIA Pa Ca-2 have been studied by a new technique for measuring cell kinetics and DNA synthesis by flow cytometry and immunofluorescence. The method employs a monoclonal antibody that is highly specific for bromodeoxyuridine or iododeoxyuridine. The drugs vincristine and vindesine do not appear to have a direct effect on DNA synthesis rate across S phase, whereas DHAD, a compound that has been found previously to affect DNA synthesis, does appear by this technique to inhibit DNA synthesis at specific segments of S phase. That vincristine does not block cells in S phase by inhibiting DNA synthesis is borne out of the observation that cells blocked in S or G2 + M can still incorporate BrdUrd at a high rate in these phases of the cell cycle. PMID- 3524394 TI - Genetic engineering of extracellular enzyme systems of Bacilli. PMID- 3524395 TI - Stability of continuous culture with recombinant organisms. AB - It was found that both poor selection pressure and a variable rate of plasmid loss were present in the system studied and that both have significant effects on continuous reactor operation. At least some of these effects were analyzed by a simple model. At this point, experimental analysis for extracellular levels of tryptophan sufficient to support X- growth (1-4 mg/l) has given contradictory results. This has at least partially indicated the effect may be an intracellular one, and thus the culture history would be critical in such experiments. Since the system studied is not atypical of recombinant cultures, it leads one to speculate on the generality of the phenomena and its extent in other cultures. If important, the use of double auxotrophs or auxotrophs that are mutant in a metabolite for which the cell has a greater growth requirement should be used. Additionally, the presence of higher copy numbers in yeast at lower growth rates also leads one to speculate on how these apparently contradictory phenomena are related. PMID- 3524396 TI - Characterization of the expression of conalbumin and ovalbumin sequences cloned into the PstI site of pBR322. PMID- 3524397 TI - Studies of host-plasmid interactions in recombinant microorganisms. AB - Plasmid genes redirect some components of cellular metabolism into synthesis of plasmid gene products and additional plasmids. The stoichiometric and kinetic implications of these host-plasmid interactions have been investigated theoretically and experimentally. Using known pathway energetics, maximum theoretical yield factors based on ATP, glucose, and O2 have been estimated for recombinant Escherichia coli and compared with corresponding estimates for host cells alone, indicating major changes in carbon and energetic stoichiometry in recombinant cells in cases of high cloned gene expression. The influence of the number of plasmids in recombinant E. coli has been experimentally characterized using a series of pMB1 derivatives stably propagated at copy numbers from 12 to 408. Recombinant cell growth rate declines monotonically as plasmid content increases as does efficiency of plasmid gene expression. A detailed metabolically structured single-cell model for E. coli has successfully simulated these trends. Interrelationships among number of plasmids per cell, induction of expression of a plasmid gene, and recombinant population growth rate have been experimentally delineated for Saccharomyces cerevisiae containing plasmid pLGSD5 and derivatives in which the 2-micron origin of replication has been replaced by a cloned ARS1 sequence or its deletion fragments. The CEN4 centromere sequence has been included in some of these plasmids to provide more regular segregation. Specific growth rate of these recombinant yeasts exhibits a maximum as a function of plasmid content, an effect attributed to the interplay between beneficial effects of the plasmid in selective medium and parasitic effects on metabolism at larger plasmid content or with more plasmid gene expression activity. The yeast strains investigated exhibit substantial segregational instability that was characterized using a rapid-flow cytometry measurement based upon single-cell deletion of E. coli beta-galactosidase activity in recombinant cells. PMID- 3524398 TI - Design and operating strategies for immobilized living cell reactor systems. Part II. Production of hormones by recombinant organisms. PMID- 3524399 TI - Model for the dynamics of colicin plasmids in continuous culture. AB - Bacteriocin plasmids may be useful in preventing plasmid instability because the bacteriocin they produce selectively kills otherwise identical bacterial cells lacking the plasmid. This capability may allow plasmid-bearing cells to persist despite the problems of growth-rate depression and segregational plasmid loss that often lead to displacement by plasmid-free cells. In order to determine the conditions under which bacteriocin plasmids can prevent instability, we have developed and analyzed a mathematical model for the growth of colicin plasmid bearing E. coli in continuous culture. Model behavior compares successfully with experimental results of Adams et al. Dependence of the system dynamic behavior on key parameters has been elucidated and a simple parameter criterion for prevention of plasmid instability has been derived. The possibility of instability prevention was found to be extremely sensitive to dilution rate. PMID- 3524401 TI - [Culture systems for production of promastigote and amastigote forms of Leishmania. Application to serological diagnosis and therapeutic trials]. AB - Several species of leishmania and three methods of cultivation: monophasic, biphasic and co-cultivation were used in a compared study bearing on the intensive production of leishmania. In addition by applying, a new in vivo model, comprising an injection of sarcomatous cells and promastigotes into BALB/c mice and also an extraction on a discontinuous gradient (Radioselectan 60%), it was possible to obtain highly purified isolates of amastigote forms. The use of two antigens: promastigotes and amastigotes, is to be recommended for the serological diagnosis, by indirect immunofluorescence, of kala-azar. The new in vivo model merits further consideration for research concerning new molecules active against leishmania. PMID- 3524400 TI - Rhodopsin, the visual pigment, and bacteriorhodopsin. PMID- 3524402 TI - [Intermediate hosts of Echinococcus multilocularis in northeastern France. Description of lesions found in 3 naturally infested rodent species]. AB - The authors describe lesions of Echinococcus multilocularis larvae found in one of 476 Clethrionomys glareolus and one of 16 Arvicola terrestris examined from Lorraine and in four Microtus arvalis from Jura. The receptivity of each of these host-species is discussed. PMID- 3524403 TI - [Advisability of medical transportation for x-ray computed tomography in cases of neonatal brain lesions]. PMID- 3524404 TI - [Asymptomatic hemorrhagic cerebral infarction in a term newborn infant]. PMID- 3524405 TI - Arthur Hedley Clarence Visick FRCS 1897-1949. PMID- 3524406 TI - Radiological diagnosis of liver tumours. PMID- 3524407 TI - Evaluation of resectability of liver cancer. PMID- 3524408 TI - Arterial devascularisation procedures in the treatment of liver cancer. PMID- 3524409 TI - Embolization of the hepatic artery in liver cancer. PMID- 3524410 TI - [Gastroduodenal ulcer and psychology]. AB - Ulcers do not necessarily and uniquely constitute a psychogenic disease. Life events may play a role in certain subjects but their occurrence is neither necessary (absence in numerous ulcerous patients) nor sufficient (presence in controls) for triggering ulcerous development. While the actual experiences involved are important, there is no personality type linked to development of ulcers. Some specialists call attention to a tendency to react to conflicts according to a particular pattern (dependence-independence, passivity hyperactivity); others refer to various modes of personality breakdown ot to the accentuation of certain personality traits. At the present time there is no satisfactory explanation of the mechanism governing the links between psychological disturbances and gastroduodenal anatomical lesions. The role of psychotherapy in the treatment of ulcers is poorly understood. PMID- 3524411 TI - Macrophage activation and differentiation. PMID- 3524412 TI - [Neuroanatomical study of micturition]. AB - There are three superimposed centres of micturition: the sacral spinal centre, which is the oldest centre controlled by the pontine centre situated in the brain stem, which in turn is under the control of multiple subconscious structures: cerebellum, striate nucleus, hypothalamus and conscious structures: limbic cortex, frontal ascending and parietal ascending circumduction. The nervous pathways consist of the classical spinal pathways as far as their point of emergence. The innervation involves 2 systems:--a supra-levator system consisting of the essentially sympathetic superior hypogastric plexus and the essentially parasympathetic inferior hypogastric plexus which innervates the seminal tract, the bladder and the prostatic urethra;--a infra-levator system consisting of the internal pudendal nerve which innervates the striated sphincter. PMID- 3524413 TI - [Pheochromocytoma with multiple localizations manifested by a hemorrhagic bladder tumor]. AB - Pheochromocytoma is an endocrine tumor derived from neuroectodermal tissue. Pheochromocytomas usually arises in the adrenal glands but may develop in other organs. We report a case of pheochromocytoma of the bladder with hematuria as the presenting symptom. This tumor was removed by partial cystectomy. Following this procedure, biologic disorders persisted (catecholamines, vandylmandelic acid and metanephrines) leading to the diagnosis of an adrenal pheochromocytoma. The patient recovered after removal of the adrenal tumor. Discussion, review of the literature and bibliography. PMID- 3524414 TI - Immunohistochemical analysis of the cellular infiltrate in multiple sclerosis lesions. AB - Immunohistochemical staining of 16 brains post mortem from patients with progressive multiple sclerosis and of two biopsy specimens from patients with acute demyelinating disease was performed using a panel of monoclonal antibodies reactive with T cells and T-cell subsets, B cells, and Ia (HLA-DR) antigens. Lymphocytic perivascular cuffs were most prominent at the edge of active plaques and were occasionally seen in areas with no evidence of demyelination or macrophage infiltration. Perivascular cuffs consisted predominantly of T cells and Ia+ cells, with many T8+ cells and variable numbers of T4+ cells. T8/T4 ratios in cuffs varied between 1:1 and 50:1. In normal-appearing white matter, cuffs were sparse and were predominantly T8+. The distribution of T cells in the parenchyma resembled that seen in perivascular cuffs, namely, predominantly T8+ cells and variable numbers of T4+ cells. Many Ia+ cells were present in active lesions, and the majority of these cells appeared, by histological criteria, to be macrophages. Tissue macrophages were also stained lightly by the anti-T4 antibody. No brain had more T4+ than T8+ cells, determined using both T4 and Leu3a monoclonal antibodies. B1+ cells were rare. These results suggest that the cellular infiltrate in multiple sclerosis consists predominantly of T cells and macrophages and that there is an overrepresentation of T8+ cells compared with T4+ cells. PMID- 3524415 TI - [Properties of the extracellular proteases of Hypomyces rosellus]. AB - A protease complex with high caseinolytic activity capable of hydrolysing various protein substrates was isolated from the culture fluid of Hypomyces rosellus. The preparation is stable at pH 6.0-11.0. The temperature optimum of its activity and stability is 50 degrees C. The protease complex preserves its initial activity at 4 degrees C for a month. PMID- 3524416 TI - [Possible use of plasmids for studying the effect of space flight factors on biological objects]. AB - The action of space flight factors on the phenotype and certain molecular and genetic parameters of E. coli plasmids (R, Col, Hly and others) was studied. The E. coli strains were grown and multiplied in the "Cytos" apparatus during the orbital flight of "Salyut-7" in June 1982. A synchronous experiment in the "Cytos" apparatus was performed under the Earth conditions. It was shown that space flight factors had no effect on the properties of the test strains and plasmids (antibiotic resistance, capacity for production of colicin, hemolysin, restriction endonuclease, conjugative capacity, frequency of conjugative transfers and molecular weight). PMID- 3524417 TI - [Toxic properties of the double-stranded RNA of virus-like particles from Saccharomyces cerevisiae killer yeasts]. AB - The toxic properties of dsRNA isolated from S. cerevisiae were studied on noninbred albino mice. The preparation was administered intraperitoneally. The lots of the yeast dsRNA consisted of highly and moderately toxic compounds. The toxicity level was directly associated with the content of the dsRNA in the preparation. Administration of the preparation in doses equal to the maximum tolerance dose and 1/5 of LD50 had no significant effect on the motor activity, temperature and weight of the animals. However, it induced marked morphological impairments in the gastrointestinal tract, liver and kidneys and pronounced shifts in the hematological indices. 1/50 of LD50 had no significant effect on the physiological, hematological and morphological indices of the organs. No capacity for the yeast dsRNA cumulation in the host was observed. PMID- 3524418 TI - Amoxicillin-clavulanic acid versus cefaclor in the treatment of urinary tract infections and their effects on the urogenital and rectal flora. AB - In a double-blind randomized study, amoxicillin-clavulanic acid (AM-CL) was compared with cefaclor for the treatment of acute urinary tract infections in 107 college women. A total of 53 patients received amoxicillin (250 mg) and clavulanic acid as the potassium salt (125 mg), and 54 received cefaclor (250 mg); each drug was administered every 8 h for 10 days. The cure rates at 1 and 4 weeks after treatment were 96 and 78%, respectively, in the AM-CL group and 92 and 75%, respectively, in the cefaclor group (P greater than 0.10). After AM-CL treatment, the prevalence of amoxicillin-resistant Escherichia coli significantly increased in the rectal flora. Also, the frequency of bacterial resistance to amoxicillin, AM-CL, and cefaclor increased among the urinary pathogens causing subsequent urinary tract infections (P less than 0.05). There were no adverse reactions in the cefaclor group; however, six patients in the AM-CL group (12%) experienced diarrhea, nausea, or vomiting (P less than 0.05). Elevated transaminase enzyme levels were observed in 23% of the patients in the AM-CL group and in 6% of the patients in the cefaclor group (P less than 0.05). Symptomatic Candida vaginitis developed in 16 and 13% of the patients in the AM CL and cefaclor groups, respectively (P greater than 0.10). PMID- 3524419 TI - Randomized evaluation of ceftazidime or ticarcillin and tobramycin for the treatment of osteomyelitis caused by gram-negative bacilli. AB - Ceftazidime, a new cephalosporin with enhanced activity against aerobic gram negative bacilli, was compared with tobramycin and ticarcillin in a randomized clinical trial. Efficacy and safety were evaluated in 18 patients (17 males, 1 female) with gram-negative osteomyelitis. All organisms were susceptible to the treatment antibiotics(s). There were nine patients treated with tobramycin and ticarcillin for 27 to 62 days (mean, 42 days), and nine patients were treated with 4 g of ceftazidime per day for 26 to 63 days (mean, 45 days). All nine patients receiving tobramycin and ticarcillin had the osteomyelitis arrested after the initial treatment. Follow-up was for 2 to 38 months (mean, 22 months). Of nine patients receiving ceftazidime three were initial treatment failures. Follow-up was for 13 to 31 months (mean, 21 months). A patient receiving ceftazidime had a transient rise in serum glutamic oxalacetic transaminase and serum glutamic pyruvic transaminase. There were three treatment failures in the ceftazidime group; no failures occurred in the group receiving the combination of ticarcillin and tobramycin. A larger series would be required to detect a significant difference between the two treatment groups. PMID- 3524420 TI - Preliminary trial of recombinant fibroblast interferon in chronic hepatitis B virus infection. AB - Five patients with chronic hepatitis B were treated with 8-day courses of leukocyte (alpha) interferon (5 X 10(6) U/day) and with 8-day courses of recombinant fibroblast (betaser) interferon at dosages of 5 X 10(6), 35 X 10(6), and 105 X 10(6) U/day. Inhibition of hepatitis B virus replication as evidenced by a decrease in DNA polymerase (DNAP) activity was seen during all treatment courses. Equivalent reduction in DNAP was seen from the low-dose alpha and beta ser regimens, but beta ser interferon at 35 X 10(6) U/day achieved a significantly greater decrease in DNAP activity than did the low-dose regimens. In no patient, however, was permanent loss of DNAP noted. Because of dose limiting toxicity, only two patients were escalated to the 105 X 10(6)-U/day dosage level. Transient proteinuria was noted in two patients while they were receiving interferon. This has not been noted in other patients receiving this preparation and could not be explained by the development of anti-interferon antibodies. This study has defined an appropriate dosage for future longer-term trials of this agent alone and in combination with other antivirals for the treatment of chronic hepatitis B. PMID- 3524421 TI - Successful treatment of a pancreatic Nocardia asteroides abscess with amikacin and surgical drainage. AB - A retroperitoneal Nocardia asteroides abscess was diagnosed in a 76-year-old patient. Trimethoprimsulfamethoxazole treatment for 6.5 weeks failed after surgical drainage of the abscess, and superinfection occurred. Subsequent treatment with amikacin resulted in a cure after 7 weeks. Amikacin might significantly shorten the duration of treatment in disseminated nocardiosis. PMID- 3524422 TI - Mechanism of resistance to silver ions in Klebsiella pneumoniae. AB - The uptake of silver by an experimentally derived silver-resistant Klebsiella pneumoniae strain was three to four times lower than the uptake by a susceptible strain. Spheroplasts of the two strains showed no difference in uptake. AgNO3 at a concentration of 40 micrograms/ml decreased the succinate dehydrogenase activity in susceptible and resistant strains by 100 and 18%, respectively. More than one resistance mechanism may be involved. PMID- 3524423 TI - Hydrophobic polyoxins are resistant to intracellular degradation in Candida albicans. AB - Two novel polyoxins, N-epsilon-(octanoyl)-lysyl-uracil polyoxin C (Oct-Lys-UPOC) and N-gamma-(octyl)-glutaminyluracil polyoxin C (Oct-Gln-UPOC), were synthesized by reacting uracil polyoxin C with the appropriate amino acid p-nitrophenyl ester. Oct-Lys-UPOC and Oct-Gln-UPOC were strong inhibitors (Kis = 1.7 X 10(-6)M) of chitin synthetase from Candida albicans membrane preparations. In a permeabilized-cell assay, Oct-Gln-UPOC had a 10-fold-lower inhibitory activity toward chitin synthetase than did the Oct-Lys-UPOC analog. Both compounds were resistant to hydrolysis by a cell extract of C. albicans H317; however, Oct-Gln UPOC was hydrolyzed with a half-life of 23 min by a permeabilized-cell preparation. Oct-Lys-UPOC was resistant to hydrolysis by permeabilized cells. Oct Gln-UPOC and Oct-Lys-UPOC did not compete with the transport of peptides or uridine into the cell. At concentrations up to 2 mM these two new polyoxins were ineffective in the inhibition of cell growth or reduction of cell viability, but they induced aberrant morphologies in C. albicans at a concentration of 0.25 mM. These data suggest that polyoxins containing hydrophobic amino acids retain strong chitin synthetase inhibitory activity and are resistant to cellular hydrolysis. They provide the first example of effective synthetic chitin synthetase inhibitors which are stable inside C. albicans. PMID- 3524424 TI - Influence of endotoxin on the intrarenal distribution of gentamicin, netilmicin, tobramycin, amikacin, and cephalothin. AB - Multiple factors may modify the pharmacokinetics of aminoglycosides and increase their nephrotoxic potential. In this study, we investigated the influence of Escherichia coli endotoxin on the renal handling of several aminoglycosides and one cephalosporin. Drug levels in the renal parenchyma, as well as several parameters of renal function and histology, were compared in rats treated with endotoxin (0.25 mg/kg) and normal rats treated with either gentamicin (10 mg/kg), netilmicin (10 mg/kg), tobramycin (10 mg/kg), amikacin (50 mg/kg), or cephalothin (100 mg/kg). Blood pressure and pulse rate were recorded. Endotoxin was associated with a decrease in the half-life and in the apparent volume of distribution of gentamicin. The endotoxin-injected animals accumulated significantly (P less than 0.05) more aminoglycosides in their kidneys than the normal animals. The amount of cephalothin recovered in the renal parenchyma was identical in both groups. Slight decreases in the glomerular filtration rate and renal plasma flow were observed after endotoxin treatment. Blood pressure and cardiac frequency were minimally affected by endotoxin. No histological lesions were observed by light microscopy in animals receiving endotoxin. Thus, endotoxin modifies the renal handling of aminoglycosides in the absence of any major physiological disturbance or histological change. By increasing the total amount of drug within the kidneys, endotoxin might increase the nephrotoxic potential of aminoglycosides. PMID- 3524425 TI - Emergence of trimethoprim resistance in relation to drug consumption in a Finnish hospital from 1971 through 1984. AB - Emergence of trimethoprim resistance among urinary tract Escherichia coli strains, isolated mostly from long-term patients in the Turku City Hospital, Turku, Finland, was studied from 1971 through 1984. Emergence of resistance to trimethoprim was associated with changes in the consumption of both trimethoprim sulfamethoxazole and trimethoprim, with occurrence of high-level trimethoprim resistance and sequences homologous to trimethoprim resistance transposon Tn7. Since 1971, resistance of E. coli to trimethoprim-sulfamethoxazole increased from 8 to between 32 and 35% in 1983 and 1984; resistance to sulfamethoxazole varied from 39 to between 40 and 44%. The frequency of DNA sequence homology with our Tn7 probe among trimethoprim-resistant E. coli strains was 42% from 1980 to 1981 and 64% in 1983 (P less than 0.005). Fourteen years after the introduction of trimethoprim therapy in this hospital, resistance has reached the level of resistance to sulfonamide. PMID- 3524426 TI - Studies of antimicrobial resistance genes using DNA probes. PMID- 3524427 TI - Complementation analysis of resistance to 5-fluorocytosine in Candida albicans. AB - A complementation test was devised to study allelism among the genetic determinants of resistance to 5-fluorocytosine in Candida albicans. Complementation was demonstrated in control hybrids produced by crossing a resistant strain that was deficient in cytosine deaminase activity with four other resistant strains deficient in UMP pyrophosphorylase activity. This complementation test was used to test allelism of the resistance determinants present in five clinical isolates. All were found to bear recessive alleles of the locus (FCY1) that determined 5-fluorocytosine resistance associated with low levels of UMP pyrophosphorylase activity. PMID- 3524428 TI - Randomized comparison of cefamandole, cefazolin, and cefuroxime prophylaxis in open-heart surgery. AB - A total of 337 patients undergoing coronary artery bypass grafting or cardiac valve replacement were randomly assigned to receive cefazolin (1 g every 8 h [q8h]), cefamandole (2 g q6h), or cefuroxime (1.5 g q12h) as an intravenous antibiotic prophylaxis. All drugs were administered within 60 min before the initial incision and were continued for 48 h postoperatively. No adverse effects related to the study drugs were observed. The percentage of patients with postoperative infection was 9% for the cefazolin group, 6% for the cefamandole group, and 5% for the cefuroxime group or 6.5% overall. There were more infection sites in patients treated with cefazolin than in those treated with cefuroxime (P = 0.05) or cefamandole (P = 0.06). Fewer wound infections occurred with cefuroxime (P less than 0.01) and cefamandole (P = 0.06) than with cefazolin. Analyses of the prophylactic regimens used in this study showed cefazolin and cefuroxime to be less costly than cefamandole. PMID- 3524429 TI - Influence of inflammation on the efficacy of antibiotic treatment of experimental pyelonephritis. AB - An acute exudative Escherichia coli pyelonephritis rat model was used to study the influence of progressive pyelonephritis on the efficacy of antibiotic treatment. In this model, transient ureteral obstruction after E. coli bladder inoculation induces early bacterial multiplication in the kidney parenchyma, and the bacterial counts peak by 48 h. The inflammatory response (assessed by the increase in kidney weight) is somewhat delayed, starting 36 h after inoculation and peaking by 72 h. Groups of rats received 4 doses over 48 h of saline, ceftriaxone (100 mg/kg), or ceftriaxone (100 mg/kg) plus gentamicin (4 mg/kg). These treatments were initiated 24, 36, 48, or 72 h after bladder inoculation. Antibiotic treatment started at 24 h was significantly more effective in reducing bacterial counts in the kidney parenchyma than at any later therapy onset. Only when started 24 h after inoculation was the synergistic combination of ceftriaxone plus gentamicin more effective in reducing bacterial counts than ceftriaxone alone. Ceftriaxone and ceftriaxone plus gentamicin regimens started at 24 h reduced significantly (by 42 and 55%, respectively) the incidence of acute exudative pyelonephritis when compared with the incidence in saline-treated controls. Early therapy onset (24 h) strikingly reduced the development of the inflammatory response. This reduction was less marked when antibiotic therapy was started at 36 h and no longer apparent when therapy onset was delayed up to 48 or 72 h. In conclusion, the efficacy of antibiotics in eradicating bacteria from the kidney parenchyma and in preventing acute exudative pyelonephritis was markedly hampered by the development of pyelonephritis. PMID- 3524430 TI - Quaternary ammonium compounds efficiently inhibit Plasmodium falciparum growth in vitro by impairment of choline transport. AB - Hemicholinium 3, decamethonium, and decyltrimethylammonium previously have been demonstrated to be efficient inhibitors, with 50% inhibitory concentrations of 4 X 10(-6), 10(-6), and 7 X 10(-7) M, respectively. We show that lengthening of the alkyl chain of decyltrimethylammonium by successive additions of two carbon atoms up to hexadecyltrimethylammonium results in a very low 50% inhibitory concentration of 5 X 10(-7) M for dodecyltrimethylammonium. Furthermore, hemicholinium 3 and decamethonium exerted their antiplasmodial activity, regardless of the developmental stage of the parasite, whereas decyltrimethylammonium was particularly lethal for the mature forms. After infected erythrocytes with radioactive choline were supplied, the determination of the water-soluble choline-containing compounds, as well as the assay of choline kinase activity, showed that the specific inhibition of phosphatidylcholine biosynthesis is related to the impairment of choline entry into erythrocytes. Thus, the impairment of the transport of choline, a natural polar head group of phospholipids, appears to be lethal for Plasmodium falciparum in vitro and could be a reasonable approach for a new malaria chemotherapy. PMID- 3524431 TI - Bactericidal effects of ticarcillin-clavulanic acid against beta-lactamase producing bacteria in vivo. AB - The comparative efficacies of ticarcillin and ticarcillin plus clavulanic acid have been determined in the mouse against experimental infections caused by ticarcillin-resistant bacteria. The infections studied comprised an intraperitoneal infection, local tissue infections, pyelonephritis, and pneumonia. Both ticarcillin and clavulanic acid penetrated readily to the sites of infection studied and at the doses employed were present at concentrations of the same order as those obtained in humans after the administration of ticarcillin-clavulanic acid formulations (Timentin; Beecham). At these concentrations, the ticarcillin-clavulanic acid combination caused significant bactericidal effects at the sites of infection against the ticarcillin-resistant strains of Bacteroides fragilis, Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Staphylococcus aureus investigated. The efficacy of ticarcillin plus clavulanic acid against the infections resistant to therapy with ticarcillin demonstrated the beta-lactamase-inhibitory activity of clavulanic acid in vivo. PMID- 3524432 TI - Affinity of cephalosporins for beta-lactamases as a factor in antibacterial efficacy. AB - Strains of Escherichia coli, Enterobacter aerogenes, and Enterobacter cloacae that were resistant to ceftazidime (MIC greater than 16 micrograms/ml) but susceptible to BMY 28142 (MIC less than 4 micrograms/ml) were found to contain higher levels of beta-lactamase activity (50- to 3,340-fold) than control strains of the corresponding species. Ceftazidime was at least as resistant as BMY 28142 to hydrolysis by these enzymes. However, the apparent Ki of BMY 28142 for each enzyme was larger (8- to greater than 20-fold) than that of ceftazidime; i.e., the affinity of these enzymes for BMY 28142 appeared to be lower than that for ceftazidime. Thus, BMY 28142 was affected less than ceftazidime by a mechanism of resistance that depends, at least in part, on the relative affinities of cephalosporins for the beta-lactamases of these species. These results indicate that the affinity between a beta-lactamase and a cephalosporin may be a distinguishing factor in the evaluation of beta-lactamase-resistant cephalosporins and suggest that affinity can play a major role in susceptibility to highly beta-lactamase-resistant cephalosporins. PMID- 3524433 TI - Ergosterol biosynthesis inhibition by the thiocarbamate antifungal agents tolnaftate and tolciclate. AB - The thiocarbamate antimycotics tolnaftate and tolciclate blocked sterol biosynthesis in fungal cells and cell extracts, with accumulation of squalene. This point of action was confirmed by the direct inhibition of microsomal squalene epoxidase from Candida albicans. There was no inhibition of other steps in ergosterol biosynthesis. In whole Candida cells, ergosterol biosynthesis inhibition was not complete at drug concentrations up to 100 mg/liter, whereas full inhibition occurred in a cell-free test system. Rat liver cell-free cholesterol biosynthesis was much less sensitive to the drugs. The biochemical action of tolnaftate and tolciclate is thus similar to that of the allylamine antimycotics naftifine and terbinafine. PMID- 3524434 TI - Comparison of norfloxacin and nalidixic acid for treatment of dysentery caused by Shigella dysenteriae type 1 in adults. AB - A severe epidemic of dysentery began late in 1979 in northeast Zaire and spread to Rwanda, Burundi, and Tanzania. The epidemic strain is a multiply resistant Shigella dysenteriae type 1, which acquired resistance against trimethoprim and more recently against nalidixic acid in the course of the epidemic. A comparative open trial in Rwandan adults with Shiga dysentery involved 18 patients treated with norfloxacin at 400 mg twice daily and 12 patients treated with nalidixic acid at 1 g three times daily for 5 days. All isolates showed in vitro susceptibility to both drugs. Though norfloxacin eliminated Shigella organisms from stools more rapidly than nalidixic acid, its clinical superiority did not reach the level of significance. Norfloxacin is a promising drug and is more effective than nalidixic acid in the treatment of multiresistant shigellosis. PMID- 3524435 TI - Autoradiography of tobramycin uptake by the proximal and distal tubules of normal and endotoxin-treated rats. AB - Multiple factors may modify the pharmacokinetics of aminoglycosides and increase their nephrotoxic potential. In the present study, the influence of Escherichia coli endotoxin on the renal handling of [3H]tobramycin was investigated. The accumulation of [3H]tobramycin in proximal tubules, distal tubules, and collecting ducts was compared in both normal and endotoxin-injected (0.25 mg/kg) rats. Histological observations were also made. Blood pressure and cardiac frequency were recorded, and renal function was evaluated with labeled inulin and p-aminohippuric acid. Following administration of endotoxin, disturbed intrarenal localization of the drug was noted. Grain counts were affected in both proximal and distal tubules. Increased labeling was observed at all time intervals in the proximal tubules. In the distal tubules of endotoxemic animals we could detect higher amounts of drug at 10 and 60 min in the medulla and at 10 min in the cortex. Not all of the tubules were labeled to the same extent. No histological lesion was noted on light microscopy in animals receiving either normal saline or endotoxin. The dose of endotoxin used resulted in very fine physiological disturbance. Both blood pressure and cardiac frequency were minimally affected by endotoxin. Decreases in glomerular filtration rate and renal plasma flow were observed. However, none of these changes was statistically significant. The present study has shown that low doses of endotoxin alter the renal handling of aminoglycosides in the absence of any major physiological disturbance or histological changes. By increasing the total amount of drug within the kidney, endotoxin might increase the nephrotoxic potential of aminoglycosides. PMID- 3524436 TI - Role of a novel antidiarrheal agent, BW942C, alone or in combination with trimethoprim-sulfamethoxazole in the treatment of traveler's diarrhea. AB - The efficacy of BW942C, a novel enkephalinlike pentapeptide antidiarrheal agent, was compared with the efficacy of trimethoprim-sulfamethoxazole (TMP-SMX) and the combination of the two agents in a placebo-controlled trial of the 72-h treatment of acute diarrhea. Subjects with diarrhea but without bloody stools or fever greater than 102 degrees F (38.9 degrees C) were enrolled. Administered to 134 U.S. adults with diarrhea that developed shortly after their arrival in Guadalajara, Mexico, BW942C was more efficacious than TMP-SMX in relieving diarrhea and cramps in the first 12 h of therapy, especially among subjects with diarrhea caused by enterotoxigenic E. coli. In the BW942C treatment group, 25% of subjects eventually took additional therapy because their diarrhea did not respond to BW942C alone. Neurological side effects such as dizziness and light headedness occurred more frequently among BW942C-treated subjects. Therapy for 3 days with TMP-SMX provided lasting relief comparable with previously reported 5 day therapy. Use of the combination of both agents provided the benefits of prompt relief afforded by BW942C and lasting relief afforded by TMP-SMX. BW942C might prove to be an agent suitable for the treatment of acute diarrhea, with TMP SMX reserved for treatment of those who do not respond adequately. The empiric use of the combination of BW942C and TMP-SMX appears appropriate for the treatment of severe nondysenteric disease. PMID- 3524437 TI - Determination of kanamycin concentration in serum by substrate-labeled fluorescent immunoassay. AB - A homogeneous substrate-labeled fluorescent immunoassay was developed for the measurement of kanamycin concentrations in serum. A fluorogenic drug reagent (FDR) (beta-galactosyl-umbelliferone-tobramycin) was prepared that is nonfluorescent under the conditions of the assay but is hydrolyzed upon catalysis by beta-galactosidase to yield a fluorescent product. Binding of the FDR to the antiserum to kanamycin prevented enzyme hydrolysis. The fixed level of FDR in the assay competed with kanamycin in the sample for a limited number of antibody binding sites. Unbound FDR was hydrolyzed by beta-galactosidase to release a fluorescent product that is proportional to the kanamycin concentration in the sample. The assay exhibited good sensitivity, precision, and accuracy and correlated well with other methods. PMID- 3524438 TI - Canine model for the simultaneous measurement of antibiotic levels in tissues and bacterial killing rate. AB - Antibiotic levels in serum are commonly used to guide antibiotic therapy. The antibiotic levels in interstitial fluid are a more accurate reflection of the efficacy of antibiotic penetration into the tissues. Although there are experimental models for determining interstitial fluid levels, there is no model for measuring the in vivo killing of bacteria, which is the endpoint of antibiotic therapy. We developed an accurate, reliable animal model which allows measurement of the in vivo killing of bacteria along with a determination of antibiotic levels in tissues. Modified Sykes-Moore chambers were applied to the dissected external oblique muscle of 14 dogs. The chambers were inoculated with clinical isolates of Staphylococcus aureus or Escherichia coli. The dogs were treated with cefoxitin or gentamicin. Quantitative cultures were performed, and the antibiotic levels in interstitial fluid were determined. PMID- 3524439 TI - Single-dose tioconazole compared with 3-day clotrimazole treatment in vulvovaginal candidiasis. AB - A total of 80 patients were equally randomized to receive a single dose of 6.5% tioconazole ointment or a 3-day course of 100-mg clotrimazole vaginal tablets for the treatment of vulvovaginal candidiasis. Of the 32 evaluable patients treated with tioconazole, 27 (84%) remained asymptomatic 4 weeks posttreatment, compared with 28 of 33 patients (85%) treated with clotrimazole. A total of 34 patients in each group could be evaluated for mycological response based on culture results 1 and 4 weeks after treatment. Twenty patients (59%) who received tioconazole and twenty-one patients (62%) who received clotrimazole remained culture negative 4 weeks after therapy. Of 40 patients who received tioconazole, 12 (30%) experienced local irritation or itching, compared with 2 of 40 patients (5%) treated with clotrimazole (P less than 0.01). Single-dose tioconazole ointment was as effective as a 3-day course of clotrimazole tablets, but significantly more patients in the tioconazole-treated group experienced local side effects. PMID- 3524440 TI - Multiple low-level antibiotic resistance in Aeromonas salmonicida. AB - Mutants with multiple low-level antibiotic resistance were isolated from virulent wild-type Aeromonas salmonicida strains exposed to a low concentration of any one of several low-molecular-mass (approximately 635 daltons or less) antibiotics. Multiple resistance was toward beta-lactam compounds (penicillin G, ampicillin, cloxacillin), quinolones (flumequine, oxolinic acid, nalidixic acid), tetracyclines, chloramphenicol, and novobiocin. Susceptibilities of the mutants toward several higher-molecular-mass (greater than 700 daltons) hydrophobic or polycationic antibiotics such as rifampin, erythromycin, polymyxin B, and streptomycin sulfate were not affected. The mutants were obtained at frequencies suggesting point mutations. Outer membrane protein profiles, examined by sodium dodecyl sulfate-polyacrylamide gel electrophoresis, revealed that all multiple low-level resistant mutants were deficient in a major protein of approximately 38.5 kilodaltons and contained a major protein of approximately 37 kilodaltons which was not present in significant amounts in the wild-type strains. In addition, these mutants lacked exoprotease activity. Furthermore, mutants isolated as deficient in exoprotease were found, with the exception of one avirulent strain, to exhibit multiple low-level antibiotic resistance and the outer membrane protein changes. PMID- 3524441 TI - Intranasal interferon (rIFN-alpha A, Ro 22-8181) for contact prophylaxis against common cold: a randomized, double-blind and placebo-controlled field study. AB - The prophylactic efficacy of low-dose intranasal recombinant leucocyte interferon alpha (rIFN-alpha A, Ro 22-8181) was investigated under field conditions in 147 families (n = 587 participants), randomized to receive placebo or rIFN-alpha A intranasally in daily doses of 1.5 or 0.3 X 10(6) IU. Treatment was started within 2 days after the appearance of an index case in the household and was continued for 5 days. Clinical data of the index case and of all members of the household were recorded for 10 days. In index cases and all ill contact persons nasal washes were collected for rhinovirus isolation and immunochemical detection of other respiratory viruses. The local tolerance of the intranasal rIFN-alpha A was excellent. Both doses of rIFN-alpha A failed to exert therapeutic effects on established common cold or to prevent the spread of common cold within families. Prophylactic treatment with 1.5 X 10(6) IU did however shorten the duration of the cold (median of 2 days vs. 4 in the placebo group, P = 0.01) and reduced the severity of any ensuing common cold (median total score of 10.5 vs. 30, P less than 0.001). No correlation was found between viral etiology (55% rhinoviruses vs. 13% other respiratory viruses, n = 122 nasal washes) and prophylactic efficacy or clinical severity. PMID- 3524442 TI - Molecular events associated with glucose repression of invertase in Saccharomyces cerevisiae. AB - When S. cerevisiae growing in the presence of glucose (repressive condition) was shifted to higher temperatures, invertase was secreted. This secretion required protein synthesis, but was independent of RNA formation (Mormeneo & Sentandreu 1982). In addition accumulation of invertasespecific messenger RNA occurred in the absence of protein synthesis but was expressed only after synthesis of protein. Invertase mRNA was continuously synthesized under repressive conditions and the levels of this mRNA were regulated by the presence of glucose. The hexose regulated the concentration of this mRNA at the level of transcription and/or by sensitization of this messenger RNA. The expression of the invertase mRNA present in the cells under repressive conditions was also regulated by glucose at the level of translation and/or secretion. As a result of these processes, under repressive conditions invertase is eliminated before secretion takes place. PMID- 3524443 TI - Evaluation of laboratory diagnosis of toxoplasmosis by means of an ELISA-triple test. Detection of class specific IgG, IgM and circulating antigen. AB - The combination of three parameters (IgG, IgM and circulating antigen) in a so called 'ELISA triple test' was suggested for advantageous diagnosing of human toxoplasmosis. A qualitative assay was used with the following arbitrary assumptions: IgG antibodies reflect an infection, IgM antibodies reflect a recent (primary) infection and circulating antigens reflect an active infection. The three assays were performed simultaneously in one microtiter plate. This approach was tested with 1091 patient sera submitted for routine diagnosis. In comparison with conventional indirect immunofluorescence and complement fixation test it was observed that combinations indicating a recently acquired infection (combinations with IgM and/or circulating antigen) mainly paralleled low or negligible conventional antibody titers. No strict association was seen between particular combinations and certain clinical symptoms suggestive for toxoplasmosis. In conclusion it was stated that the triple test for support of clinical diagnosis has some advantages but that a strong need exists to be able to demonstrate exacerbation or reinfections which are generally not characterised by IgM antibody formation of free circulating antigens but may be the reason for elevated conventional antibody titers. PMID- 3524444 TI - Urinary pathogenicity of Proteus mirabilis strains isolated from faeces or urine. AB - Urinary and faecal isolates of Proteus mirabilis were studied with respect to a number of bacterial properties as possible virulence factors in the pathogenesis of urinary tract infections: experimental virulence in a mouse model, haemolysin production, haemagglutinating properties, hydrophobicity of the bacterial surface, sensitivity to the bactericidal effect of human serum, serotype and cell invasiveness. Urinary isolates were slightly more virulent than faecal isolates in the mouse model. No other significant differences were found between both groups. So urinary strains seem to be selected from the faecal reservoir mainly on the basis of their prevalence in the faeces and not on the basis of the possession of particular virulence factors. PMID- 3524445 TI - The effect of the dissolved oxygen concentration and anabolic limitations on the behaviour of Rhizobium ORS571 in chemostat cultures. AB - Chemostat cultures of Rhizobium ORS571 limited by the supply of oxygen or an anabolic substrate contained poly-beta-hydroxybutyrate (PHB). Low amounts of PHB (about 10%) were present in ammonia- or nitrate-limited cultures; higher amounts were found in Mg++-limited cultures (about 20%) and in oxygen-limited nitrogen fixing cultures (37%). A method is described to calculate YATP values (g PHB-free biomass . mol-1 ATP) from the Ysucc values (g dry wt . mol-1 succinate) measured. Ysucc and YATP values in cultures limited by the supply of an anabolic substrate and in the oxygen-limited ammonia-assimilating culture were much lower than the values found in the PHB-free succinate-limited cultures. This shows that uncoupling of growth and energy production occurred. Therefore, H2/N2 ratio (mol hydrogen formed per mol nitrogen fixed) in nitrogen-fixing cultures could not be calculated from the comparison of the YATP value found in the nitrogen-fixing culture and the value found in the corresponding ammonia-assimilating culture. Although the optimal dissolved oxygen concentration (d.o.c.) for nitrogen-fixing cultures of Rhizobium ORS571 is 5 or 10 microM, nitrogen-fixing cultures could be obtained up to a d.o.c. of 40 microM. Not only nitrogenase but also hydrogenase was active at this d.o.c. However, accumulation of PHB (10%) may indicate that cultures grown at unfavourable oxygen concentrations (15-40 microM O2) were N limited rather than energy-limited, which may be the result of partial inactivation or repression of nitrogenase at a higher d.o.c. PMID- 3524446 TI - The functional localization of cytochromes b in the respiratory chain of anaerobically grown Proteus mirabilis. AB - The functional localization of the cytochromes b found in anaerobically grown Proteus mirabilis was investigated. From light absorption spectra, scanned during uninhibited and HQNO-inhibited electron transport to various electron acceptors, it was concluded that all cytochromes b function between two HQNO inhibition sites, or more probably in a Q- or b-cycle. PMID- 3524447 TI - Preservation of Thiobacillus ferrooxidans and Thiobacillus thiooxidans with activity check. AB - Cultures of Thiobacillus ferrooxidans and Thiobacillus thiooxidans, used in biohydrometallurgical processes of economic importance, are very difficult to preserve by conventional methods. Hence, to preserve the cultures with their activity intact, various techniques were tried, after determining their respective activity in terms of Iron Oxidation Rate (IOR) and Sulfur Oxidation Rate (SOR). Among the methods tested, along with the recommended method of serial transfer in a liquid medium, were methods such as lyophilization, storage in a liquid nitrogen and mixing with sterile, inert carriers like lignite or chalcopyrite ores. After a period check-up at 4 months and 8 months storage, it was found that out of these methods, mixing with sterile ore followed by storage at 8 degrees C, kept both types of activities intact. The temperature of storage was observed to have a definite effect on activity, in that when the preserved cultures were stored at 8 degrees C, the activity was retained, whereas at 28-30 degrees C (RT) storage, the activity of all the cultures preserved by various techniques, dropped significantly. PMID- 3524448 TI - Experimental haematogenous pyelonephritis in mice with uropathogenic, enteropathogenic and enterotoxigenic Escherichia coli. AB - Acute haematogenous pyelonephritis was produced with known uropathogenic (075), enteropathogenic (0111) and enterotoxigenic (H10407) Escherichia coli in mice. The enterotoxigenic E. coli showed the highest bacterial counts in kidney and urine and was found to have the same potential for causing pyelonephritis as a known pyelonephritogenic strain both in untreated and corticosteroid treated mice. Enteropathogenic E. coli was found to be less pyelonephritogenic in untreated mice, but under the effect of corticosteroids it showed similar pyelonephritogenic potential. PMID- 3524449 TI - All nurses, not just OR nurses, must be concerned about regulations affecting patient care. PMID- 3524450 TI - Preoperative skin decontamination. A study on efficiency and effect. PMID- 3524451 TI - Programmed training of visual discriminations: a comparison of techniques. AB - The efficiency of three discrimination training procedures was compared for mentally handicapped children trained on a shape discrimination presented via a microcomputer. Each of three groups received one of the following training procedures; graded stimulus fading; graded prompt fading, a procedure approximating behavior modification prompting techniques; trial-and-error training. The stimulus fading and graded prompting procedures were equivalent in terms of the number of steps and criteria for fading. Results showed the two programmed techniques did not differ significantly, but both were significantly superior to trial-and-error learning in terms of number of children reaching criterion, number of trials to criterion, and number of errors. The training procedures were continued for subjects from each of the three groups for an additional two problems, followed by a trial-and-error test problem. Over the additional training problems the pattern of differences between the groups in number of errors remained significant, however differences between the groups in number of trials to criterion decreased. There were no significant differences in any of the measures on the trial-and-error test problem. Results are discussed in relation to the literature on errorless learning techniques, and the implications for applied training procedures are elucidated. PMID- 3524452 TI - Comparison of membrane filter, multiple-fermentation-tube, and presence-absence techniques for detecting total coliforms in small community water systems. AB - Methods for detecting total coliform bacteria in drinking water were compared using 1,483 different drinking water samples from 15 small community water systems in Vermont and New Hampshire. The methods included the membrane filter (MF) technique, a 10-tube fermentation tube (FT) technique, and the presence absence (P-A) test. Each technique was evaluated using a 100-ml drinking water sample. Of the 1,483 samples tested, 336 (23%) contained coliforms as indicated by either one, two, or all three techniques. The FT detected 82%, the P-A detected 88%, and the MF detected 64% of these positives. All techniques simultaneously detected 55% of the positives. Evaluation of the confirmation efficiency of the P-A technique showed 94% of the presumptive positives confirming as coliforms. Thirteen different species of coliforms were identified from the 37 tests in which the P-A was positive but the MF and FT were negative. The P-A test was simple to inoculate and interpret and was considerably more sensitive than the MF and slightly more sensitive than the FT in detecting coliforms in this type of drinking water supply. PMID- 3524453 TI - Recovery and diversity of heterotrophic bacteria from chlorinated drinking waters. AB - Heterotrophic bacteria were enumerated from the Seattle drinking water catchment basins and distribution system. The highest bacterial recoveries were obtained by using a very dilute medium containing 0.01% peptone as the primary carbon source. Other factors favoring high recovery were the use of incubation temperatures close to that of the habitat and an extended incubation (28 days or longer provided the highest counts). Total bacterial counts were determined by using acridine orange staining. With one exception, all acridine orange counts in chlorinated samples were lower than those in prechlorinated reservoir water, indicating that chlorination often reduces the number of acridine orange detectable bacteria. Source waters had higher diversity index values than did samples examined following chlorination and storage in reservoirs. Shannon index values based upon colony morphology were in excess of 4.0 for prechlorinated source waters, whereas the values for final chlorinated tap waters were lower than 2.9. It is not known whether the reduction in diversity was due solely to chlorination or in part to other factors in the water treatment and distribution system. Based upon the results of this investigation, we provide a list of recommendations for changes in the procedures used for the enumeration of heterotrophic bacteria from drinking waters. PMID- 3524454 TI - A simple and generally applicable procedure for releasing DNA from bacterial cells. AB - Treatment of Staphylococcus simulans biovar staphylolyticus cells with acetone before digestion with lysozyme made the cells susceptible to lysis by sodium dodecyl sulfate. This technique was found to be useful for releasing DNA from a wide variety of gram-positive and gram-negative organisms. PMID- 3524455 TI - Isolation of indigenous wastewater bacterial strains capable of mobilizing plasmid pBR325. AB - Members of the family Enterobacteriaceae have been isolated from raw wastewater, identified, and characterized with respect to their plasmid content and antibiotic resistance. Several strains possessing both antibiotic resistance and high-molecular-weight plasmid(s) transferred their resistance characteristics to recipient cells during a 25 h coincubation. Eight were characterized (six Escherichia coli and two Klebsiella pneumoniae); each produced 10(2) to 10(7) transconjugants per ml by the end of the incubation period. They were also able to mobilize pBR325 from a laboratory E. coli strain into plasmid-free recipients to yield 10(2) to 10(7) transconjugants per ml. These transconjugants possessed phenotypic characteristics specified by pBR325, the R plasmid, and the chromosome of the recipient. Many transconjugants exhibited recombinational rearrangements of the acquired plasmid material. PMID- 3524457 TI - Toxicity of organic acids for repair-deficient strains of Escherichia coli. AB - The wild-type strain and four DNA repair-deficient strains (uvrA6, uvrB5, recA56, and polA1) of Escherichia coli K-12 were treated with acetic acid, lactic acid, and p-aminobenzoic acid at pH 3.5 during their stationary phase of growth. All three acids were highly toxic to the polymerase-deficient strain. The greater sensitivity of the strain carrying the polA1 gene than its isogenic pol+ derivatives suggested that damage caused by acidity requires polA+ gene products for repair. PMID- 3524456 TI - Methodology for enumeration of coliphages in foods. AB - The effects of eluent composition, pH, and chaotropic agents on the recovery of T2, MS2, and indigenous coliphages from various foods were investigated. Additionally, methods of sample suspension and clarification were evaluated for coliphage recovery and application to various foods. Clarified sample suspensions were assayed for coliphages with a modified agar layer technique and appropriate Escherichia coli hosts. Centrifugation and polypropylene mesh filtration were more rapid and effective than glass wool filtration for clarification of sample suspensions and subsequent recovery of coliphages. Blending, stomaching, and shaking procedures were generally comparable for sample liquefaction and release of coliphages from foods. Complex basal eluents, EC medium and 1% casein, were generally more effective than a less complex eluent, phosphate buffer, for elution of coliphages from foods. For most foods, incorporation of sodium chloride or chaotropic agents, i.e., sodium trichloroacetate, urea, Tween 80, Triton X-100, and sodium nitrate, into basal eluents did not enhance recovery of coliphages. Indigenous coliphage recovery was not affected by sample suspension pH over a range of 6.0 to 9.0. With an optimal procedure, i.e., EC medium eluent, blending, and centrifugation, the recovery of T2 and MS2 ranged from 48 to 81% and from 58 to 100%, respectively, depending on the food type. PMID- 3524458 TI - Improved immunological membrane filter method for detection of food-borne Salmonella strains. AB - An improved membrane filter method that involves the use of an enzyme-labeled antibody stain has been developed for the rapid detection of Salmonella species in foods. The procedure is carried out directly on a hydrophobic grid-membrane filter without requiring transfer by blotting to nitrocellulose. Pure cultures of 54 Salmonella species and 10 foods artificially contaminated with Salmonella colindale gave a positive reaction in which Salmonella colonies were visible as purple dots. Of 11 nonsalmonella organisms, only Citrobacter freundii reacted with Spicer-Edwards antiserum. Of 22 naturally contaminated food samples, 10 were positive for both the hydrophobic grid-membrane filter procedure of the Association of Official Analytical Chemists and the improved enzyme-labeled antibody stain method, and there was perfect agreement between the methods. Of these 10 positive samples, one was negative by the Health Protection Branch method; of the negative samples, two were positive by this latter method. The improved enzyme-labeled antibody stain method allows detection of Salmonella spp. in foods within 48 h, requires little equipment, and is inexpensive, easy to perform, and suitable for automated detection. PMID- 3524459 TI - Chitinase determinants of Vibrio vulnificus: gene cloning and applications of a chitinase probe. AB - To initiate study of the genetic control of chitinolytic activity in vibrios, the chitobiase gene was isolated by cloning chromosomal DNA prepared from Vibrio vulnificus. Chimeric plasmids were constructed from Sau3A I partial digests of chromosomal DNA by ligating 5 to 15-kilobase fragments into the BamHI site, i.e., in the Tcr gene, of pBR322 (Amr Tcr). The resulting plasmids were transformed into Escherichia coli DH1. Chitobiase activity of the insert-bearing clones was detected by using a chromogenic substrate, p-nitrophenyl-N-acetyl-beta, D glucosaminide, and confirmed by the appearance of a fluorescent end product from the hydrolysis of 4-methylumbelliferyl-beta,D-N-N'-diacetylchitobiose. Endochitinase activity was demonstrated by liberation of water-soluble products produced by the degradation of [3H]chitin. Transformation of E. coli Y10R (lacY) with plasmids from chitinase-positive clones restored the lactose-positive phenotype, suggesting the presence of a permease associated with chitinase activity. Physical mapping of plasmids containing the chitinase determinants indicate that transcription of these genes in E. coli may be initiated at a V. vulnificus promoter. PMID- 3524461 TI - Mapping of the triazine binding site to a highly conserved region of the QB protein. AB - A number of herbicide classes, including the s-triazines and ureas (atrazine, diuron) inhibit photosynthetic electron transport via a direct interaction with the QB-protein. This protein, also known as the 32-kDa protein or herbicide binding protein, is believed to bind the plastoquinone QB, which functions as the second stable electron acceptor at the reducing side of Photosystem II. The site of covalent attachment of the photoaffinity herbicide analog azido-[14C]atrazine to the QB-protein of spinach chloroplast thylakoid membranes has been determined. Two amino acid residues are labeled; one residue is methionine-214, the other lies between histidine-215 and arginine-225. Both residues are within a region of the amino acid sequence which is highly conserved between the QB-protein and the L and M reaction center proteins of Rhodopseudomonas capsulata and R. sphaeroides. This region includes the site of a mutation which results in diuron resistance in Chlamydomonas reinhardi (valine-219). However, this region is well removed from point mutations at phenylalanine-255 (which gives rise to atrazine resistance in C. reinhardi) and at serine-264, (which results in extreme atrazine resistance in C. reinhardi and naturally occurring weed biotypes). The patterns of labeling and mutation imply that the quinone and herbicide binding site is formed by at least two protein domains. PMID- 3524460 TI - Proteolytic activity of the ruminal bacterium Butyrivibrio fibrisolvens. AB - The proteolytic activity of Butyrivibrio fibrisolvens, a ubiquitously distributed bacterial species in the gastrointestinal tracts of ruminants and other mammals, was characterized. The relative proteolytic activity (micrograms of azocasein degraded per hour per milligram of protein) varied greatly with the strain: 0 to 1 for strains D1, D16f, E21C, and X6C61; 7 to 15 for strains IL631, NOR37, S2, LM8/1B, and X10C34; and 90 to 590 for strains 12, 49 H17C, CF4c, CF3, CF1B, and R28. The activity levels of the last group of strains were equal to or greater than those found with Bacteroides amylophilus or Bacteroides ruminicola. With the exception of strain R28 activity, 90% or more of the proteolytic activity was associated with the culture fluid and not the cells. Strain 49 produced proteolytic activity constitutively, but the level of activity (units per milligram of protein) was modulated by growth parameters. With various carbohydrates added to the growth medium, the proteolytic activities of strain 49 were positively correlated with the growth rate. However, when the growth rate varied with the use of different nitrogen sources, a similar correlation was not found. The highest activity level was observed with Casamino Acids (1 g/liter), but this level was reduced by ca. 70% with Trypticase (BBL Microbiology Systems, Cockeysville, Md.) or casein (1 g/liter) and by 85% with ammonium chloride (10 mM) as the sole nitrogen source. The addition of ammonium chloride (1 to 10 mM) to media with low levels of Casamino Acids or Trypticase resulted in lower proteolytic activities but not as low as seen when the complex nitrogen sources were increased to high levels (20 g/liter).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3524462 TI - [Endoscopic therapy of digestive cancer]. AB - We have treated early gastric cancer by means of endoscopical photocoagulation using a Nd-YAG laser since December 1980, particularly in inoperable cases due to other complications or old age. Forty-seven lesions found in 41 patients have so far been photocoagulated and followed up. By this treatment, cancer cells disappeared in 42 out of 47 lesions, although 2 cases died of other diseases and recurrence was experienced in 3 cases. In addition to photocoagulation therapy using a laser, we have recently developed a large-biopsy technique called strip biopsy in order to get sufficient tissue for diagnosis in comparison with bite biopsy. By this method, we are able to resect the full thickness of the mucosa including the submucosal layer up to a size of about 4 cm, without any severe complication such as hemorrhage and perforation. We succeeded in resecting the early gastric cancer in 34 lesions in 31 patients. Of course, the combination therapy of endoscopical photocoagulation and strip biopsy seems to be reasonable for the therapy of early gastric cancer. For the purpose of improving endoscopy therapy for early gastric cancer, accurate diagnosis particularly with regard to the depth of invasion of cancer cells must be performed. In this sense, we have attempted to improve the resolution of the ultrasonic endoscope. Ultrasonic endoscopy can yield more accurate information about the depth of invasion and its metastasis to the lymph nodes. Therefore, ultrasonic endoscopy is excellent, not only for making sure of the grade of gastric cancer, but also for the detection of its recurrence, which can not be observed by ordinary endoscopy. It is obvious that surgical resection is a superior therapy for gastric cancer. In this sense, endoscopic therapy could be regarded as an "orphan" in this field. However, in the combination of endoscopic therapy and ultrasonic endoscopy, endoscopic therapy for gastric cancer should be acknowledged to be equal to surgical therapy. PMID- 3524463 TI - [Immunotherapy of acute myelogenous leukemia (AML) in adults with the Nocardia rubra cell wall skeleton]. AB - The effect of immunotherapy with Nocardia rubra cell-wall skeleton (N-CWS) on the remission duration and survival of adults with acute myelogenous leukemia (AML) was studied in a prospective randomized controlled study. After having been induced into complete remission and consolidated, 73 patients were randomized either to maintenance chemotherapy or maintenance chemotherapy plus immunotherapy with N-CWS and irradiated allogeneic AML cells. Thirty-four patients in the chemotherapy group and 32 in the chemoimmunotherapy group were evaluable. Six months after the closure of the study, the immunotherapy showed a borderline beneficial effect on remission duration (p = 0.080) and on survival length (p = 0.098). When the data were analyzed at 42 months after entry, there was a borderline significant difference in remission duration (p = 0.066) between the two groups, prolonging the 50% remission period by 120 days, but no significant differences in survival length (p = 0.306), although the 50% survival was 168 days longer in the chemoimmunotherapy group. Thus, immunotherapy with N-CWS and irradiated allogeneic AML cells seems to be active in the treatment of adult AML when used for maintenance therapy in combination with chemotherapy. PMID- 3524464 TI - [Inhibition of the development of thermotolerance by combined treatment with an anticancer drug or benzylidene glucopyranose with the hyperthermia]. AB - Transitional thermotolerance develops during (at below circa 43 degrees C) or after (at above circa 43 degrees C) hyperthermic treatment, increases through the first 6 h, is maintained for circa 24 h and disappears at circa 72 h after the hyperthermia. Therefore, a once every three days modality of hyperthermic treatment is preferred among the clinical institutions where therapeutic hyperthermia is provided. In the present communication, the inhibition of thermotolerance development by combined treatment of anticancer drug or benzylidene glucopyranose with hyperthermia and its related problems are reported. PMID- 3524465 TI - [Surgery and adjuvant therapy of non-small cell lung cancer]. AB - Bronchial arterial infusion of chemotherapeutic agents (BAI), radiation therapy, chemotherapy and immunotherapy were used as surgical adjuvant therapy for non small cell lung cancer, and the clinical effects of these treatment modalities on survival rates were evaluated. BAI brought about a decrease of tumor size, but no significant effect on survival rats was noted. Postoperative radiation therapy on P-N2 cases exerted no significant effect on the survival rate, but when immunotherapy was combined with radiation therapy, there was a significant prolongation of the survival rate. As for post-operative chemotherapy, three types of combination chemotherapy have been performed over the past twelve years: short-term chemotherapy (S-C), long-term intermittent chemotherapy (L-I-C), and long-term continuous chemotherapy (L-C-C). Retrospective comparison of survival rates between these three methods was carried out. The survival rate of the group which was treated by L-I-C showed better results than those obtained by S-C. The group treated by L-C-C showed a much better survival rate than that treated by L C-C: Stage I + II cases that underwent curative resection and were treated by L-I C showed a significantly better survival rate than those treated by S-C. Furthermore, the survival rate of stage III cases with curative resection was improved by L-C-C (CQ+CPA+ADM+5-FU) with statistical significance. To evaluate the clinical efficacy of OK-432, a streptococcal preparation, as an immunotherapeutic agent for lung cancer, patients admitted between 1975 and 1982 were randomized into two groups: (1) an immunochemotherapy group and (2) a chemotherapy group (control group). For both groups, the same L-I-C was administered in accordance with the cancer histological cell type. There were 119 resected cases in the immunochemotherapy group and 115 cases in the control group, that were eligible for evaluation of long-term survival after surgery. Overall, the cases in the immunochemotherapy group showed a better survival rate than the control group, and this difference was statistically significant. In addition, statistically significant improvements of survival rate by the immunotherapy were observed for the following items; resected stage I + II cases, resected stage III + IV cases, cases with curative resection, cases with non curative resection and resected epidermoid carcinoma. On the other hand, there were no statistically significant differences between the two groups in cases of adenocarcinoma.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3524466 TI - [Adjuvant therapy of breast cancer]. AB - The results of short-term intravenous adjuvant therapy with mitomycin C or cyclophosphamide in mastectomized cases were prospectively investigated. Statistically, this chemotherapy proved effective in cases without metastasis and in those with only 1 to 2 metastases in the axillary lymph nodes. With regard to menopausal status, this adjuvant systemic therapy was effective in premenopausal cases with statistical significance. In a trial, 1,000 cases of breast cancer were divided into two groups by the envelope method, and cyclophosphamide, 150 mg/day, was orally administered to one of the groups for 34 days (total dose, 5,100 mg) to investigate the utility of the chemotherapy in comparison with the control group not given adjuvant therapy. It was found that the adjuvant therapy was effective in cases with few metastases and that even the results obtained in cases with many metastases were better than in cases not given adjuvant therapy. In a preliminary trial, tamoxifen as an adjuvant endocrine therapy was orally administered at a daily dose of 20 mg for a prospective period of 3 years in advanced cases with 8 or more metastases in the axillary lymph nodes and the results over 1 to 2 years were analyzed. Improvement in therapeutic effect was found in these cases with 8 or more metastases in which previous adjuvant therapy had been ineffective. PMID- 3524467 TI - [Diagnosis of malignant thyroid tumor using high-frequency ultrasonography with piezoelectric transducer, soft X-rays and aspiration biopsy cytology]. AB - Diagnosis of thyroid cancer has been based mainly on palpation and also soft X rays because of its calcification. As the gland itself is very small and Aspiration Biopsy Cytology (ABC) has had a high level of diagnostic accuracy the clinical significance of ultrasonography did not become apparent for a long time. However, recently it has become possible to carry out detailed study and to detect suspect histological structures, following the remarkable progress which has been made in ultrasonography, using a high-frequency piezoelectric transducer. A single mechanical arch scanner, with a piezoelectric 7.5-MHz transducer (SAL-25A Toshiba Corp.) was employed for examination using the water bath method. The rates of correct diagnosis for each of the above methods among 847 nodular goiters including 184 malignant tumors which were microscopically examined were shown to be: ultrasonography 89.7%, soft X-rays 66.9% and ABC 86.4%. Ultrasonography was capable to revealing a few cases which could not be shown by ABC or soft X-rays. Using these three methods jointly, there was 1 false positive and no false negative cases. This study revealed that combined diagnosis with ultrasonography using a high-frequency piezoelectric transducer improved the accuracy of examination of malignant thyroid tumors. PMID- 3524468 TI - [Medical images; the clinical significance of the medical images of thyroid cancer]. AB - Supplementary diagnosing methods for thyroid cancer were discussed, with particular reference to medical images. Although palpation is, of course, essential in the examination of nodules, we have also used soft X-rays and I-123 scintigraphy, as well as Tl-201 scintigraphy, ultrasonography and aspiration biopsy. In addition, various diagnosing methods have been employed to determine the degree of invasion in advanced cancer patients, such as CT scan for observing invasion of the surrounding tissues, naso-tracheoscopy for invasion of the trachea and a flow meter for vascular tracts. When the tumor size is under 2 cm, we use soft X-rays, ultrasonography and sometimes try additional aspiration biopsy. When the tumor is smaller, aspiration biopsy is employed with ultrasonography. For tumors larger than 2 cm, we use soft-X-rays, I-123 scintigraphy and ultrasonography. Tl-201 scintigraphy is employed to determine operative indication, following which aspiration biopsy and CT scan are performed. CT scan, tracheofiberscopy and doppler flow studies are carried out for advanced cancer cases to determine the degree of invasion of carcinomas. PMID- 3524469 TI - [A comparative diagnostic study of staging in renal cell carcinoma]. AB - A comparative diagnostic study was carried out on 56 patients with pathologically proven renal cell carcinoma which had been staged by CT, US, angiography (AG) and lymphography (LG) between June, 1980, and May, 1985. Each study was performed within two weeks. The confirmation of the tumor extent was established by surgery and microscopic examination in all patients except three, in whom the extent of the tumor was determined at autopsy. The staging was performed according to the "General Rules for Clinical and Pathological Studies on Renal Carcinoma (Japanese Edition, Tokyo, 1983)". CT and AG were performed in all cases. It was also studied how far various factors such as histologic architecture, cell type, grade, growth mode, tumor necrosis and bleeding were related with prognosis, and how to evaluate them in imaging modality. Concerning the T factor, there was no difference in diagnostic ability between images, and since prognosis of T4 was inferior to those of T2 and T3, diagnosis of T4 was seen to require particular attention. Drawing ability of N and V factors was poor in US. In LG, evaluation of regional lymph nodes was difficult, so this seems to be an unnecessary examination because CT can provide sufficient evaluation. By imaging modality, diagnosis of architecture and cell type was difficult. By AG, avascular to hypovascular tumors were of solid type, and there were many spindle or pleomorphic cell types and combination of tubular-granular types, while the papillary type was few. By macroscopic growth mode, the infiltrating type was poor in prognosis, and the presence or absence of halo was evaluated by CT and AG. Prognosis was favorable in cases having no necrosis in the tumor or accompanied by hemorrhage. For the purpose of diagnosis, CT was found to be sufficient, and it was concluded that AG may be used only for the purpose of renal arterial embolization as a preoperative treatment of low-stage cases subjected to nephrectomy. US is sufficient only if satisfying the role of screening. PMID- 3524470 TI - President Cleveland's palatal tumor. PMID- 3524471 TI - Effect of intralesional alpha 2-interferon on actinic keratoses. AB - The effect of intralesional alpha 2-interferon (IFN) on actinic keratoses was examined in this two-part study. In phase I, 11 of 12 lesions cleared following nine injections of IFN (5 X 10(5) IU per dose) compared with none of 12 keratoses injected with placebo. Smaller doses of IFN (1 X 10(5) IU and 1 X 10(4) IU per injection) produced clearing of 42% and 58% of lesions, respectively. The second phase, which was designed to investigate the optimum schedule for treatment with IFN, showed that a minimum of six injections of IFN (5 X 10(5) IU per injection) was necessary to clear 14 of 15 actinic keratoses. Although this mode of delivery is not practical for clinical use, intralesional alpha 2-IFN demonstrates biologic activity against actinic keratoses. PMID- 3524472 TI - Hemorrhagic bullae associated with Vibrio vulnificus septicemia. Report of two cases. AB - Bullous lesions associated with Vibrio vulnificus infection developed in two patients, both of whom had hepatic cirrhosis. One patient had a recent history of ingestion of raw oysters, while the other patient had recently exposed skin lacerations to sea water. Both patients died within 24 hours of hospitalization, in spite of antibiotic treatment. Vibrio vulnificus was isolated from blood and bullae in both patients. Histologic examination of skin biopsy specimens revealed epidermal/dermal separation and clusters of bacteria within dermal vessels with a negligible inflammatory response. PMID- 3524473 TI - Ribavirin aerosol for acute bronchiolitis. AB - A randomised double blind placebo controlled trial of treatment with an aerosolised antiviral agent, ribavirin, was conducted in 26 infants with clinically diagnosed bronchiolitis. Nebulised ribavirin (14 infants) or normal saline aerosol (12 infants) was given for 18 hours a day for at least three days. Respiratory syncytial virus was identified in nasal secretions from 20 cases (10 from both groups). Trends in seven out of eight clinical variables favoured active treatment. Ribavirin aerosol was associated with significantly faster improvement in cough and crepitations and more rapid rate of fall in respiratory and heart rates. In the 20 infants from whose nasal secretions respiratory syncytial virus was identified most variables favoured treatment with ribavirin, with significant reduction in chest recession. No difference was found in the rate of clearance of respiratory syncytial virus. The treatment was well tolerated as judged clinically and from the results of haematological and biochemical studies. The study suggests nebulised ribavirin may have a place in the treatment of some cases of bronchiolitis. PMID- 3524474 TI - Face mask physiotherapy in cystic fibrosis. AB - The use of the 'PEP' mask with forced expiratory coughing was compared with conventional physiotherapy over a one month period. No difference was shown in symptom scores, sputum production, or simple lung function tests. The mask was well accepted and allowed independent treatment by older patients. PMID- 3524475 TI - Vanishing earrings. AB - Four children who presented with impacted earrings are described. We suggest that the insertion of earrings in children under 10 years has hazards and recommend the use of sterling silver or 9 ct gold if the procedure is to be done in young children. PMID- 3524476 TI - Cyclosporin-A-induced hair growth in human renal allograft recipients and alopecia areata. PMID- 3524477 TI - Determination of genotoxic polycyclic aromatic hydrocarbons in a sediment from the Black River (Ohio). PMID- 3524478 TI - [The contradictory Nesbit operation of Peyronie's disease (experience in 17 cases)]. PMID- 3524479 TI - Improved method of isolating bacteria from joint fluids by the use of blood culture bottles. AB - An analysis of 47 episodes of bacterial arthritis showed that applying a blood culture procedure to the culture of joint fluids gave positive results in 10 cases (21%) that were negative by conventional methods. When follow up samples taken during antibiotic treatment were considered the proportion of false negatives eliminated rose to 40%. The respective advantages of using a large volume of inoculum and a large volume of medium are that very low numbers of viable bacteria in infected fluid can be detected, and that growth inhibitors are diluted. PMID- 3524480 TI - Gastrin, gastric acid secretion, and gastric microflora in patients with rheumatoid arthritis. AB - The relation between the basal and stimulated gastric acid secretion, plasma gastrin, and the gastric microflora was examined in 45 patients with rheumatoid arthritis. Sixteen patients (36%) had basal achlorhydria, and of these, 10 (22%) had achlorhydria or hypochlorhydria after stimulation with pentagastrin. The peak acid output and acidity showed inverse correlation with the disease duration but were not associated with age or with the degree of physical disability. Hypergastrinaemia was found in nine patients (20%), of whom 6 (13%) had significant titres of parietal cell antibody. The acidity of the peak acid output showed negative correlation with plasma gastrin. It was confirmed that the gastric secretory state is a determinant of plasma gastrin levels and in addition influences the growth of micro-organisms in the gastric lumen. The type of microflora in the non-acid stomach was similar to that found in the saliva. A subgroup of eight females was identified who showed low gastric acid secretion rates, positive bacterial cultures, and atlantoaxial subluxation. Gastrin- and insulin-like immunoreactivities were found in joint fluid. The concentrations reflected their plasma levels, suggesting that the peptides are not released at the inflammatory site, but rather that they reach synovial fluid from circulating blood. PMID- 3524481 TI - Continuous-wave versus range-gated pulsed Doppler power frequency spectrum analysis in the detection of carotid arterial occlusive disease. AB - Two types of ultrasonic Doppler velocity metering devices currently used in the detection of extracranial carotid artery disease, the continuous-wave (CW) and the range-gated pulsed (RP) Doppler systems, were compared in the present study. Power frequency spectrum analysis (PFSA) was performed on 130 carotid arterial bifurcations with a CW Doppler and 81 carotid arteries with an RP Doppler system. All results were compared with angiographic findings. The frequency bandwidth at 50% peak power (f50%), a quantitative index for defining spectral broadening, detected stenoses equal to or greater than 50% diameter reduction with 93% sensitivity, 92% specificity, and 92% accuracy with the CW system. With the RP Doppler, the same degree of stenosis was identified with 94% sensitivity, 93% specificity, and 93% accuracy. Compared with angiographic classification into 0 24%, 25-49%, and 50-99% diameter reduction categories, CW Doppler PFSA and an 85% overall accuracy, and the RP Doppler overall accuracy was 86%. CW Doppler also correctly identified 15 of 16 internal carotid artery (ICA) occlusions; 8 of 8 ICA occlusions were correctly identified with the RP Doppler. Thus, both techniques detected carotid artery disease with comparable results. For research and ease of operation, an RP Doppler system with a variable sampling volume appears to be most desirable. However, a standard CW system is superior if utility and cost-effectiveness are of prime importance. PMID- 3524482 TI - In vivo response of Plasmodium falciparum to different doses of chloroquine in semi-immune children in Liberia, West Africa. AB - The efficacy of different doses of chloroquine in suppressing patent parasitaemia was investigated in 326 children two to 12 years old, living in six villages with holoendemic malaria. The children were given single doses (2, 3, 5-7 or 9-12 mg base kg-1) or a standard treatment over three days (25 mg base kg-1). Parasite prevalences were recorded after one, two, three, four, six and eight weeks. Complete clearance of Plasmodium falciparum trophozoites (TC) by day 7 was achieved by a dosage of 9-12 mg kg-1. By probit analysis of log dose response, 50% clearance (TC50) was established at about 1.5 mg kg-1, whereas a TC95 required 5.5 mg kg-1. The reappearance of patent parasitaemia was dependent on the dose of chloroquine given and on malaria transmission. After the standard dose treatment, only one re-infection in 56 children appeared within 21 days despite high sporozoite inoculation rates in the area. The dosage of 9-12 mg kg-1 yielded a hundredfold reduction of mean parasite density in the children if calculated over a four-week period. It may represent a suitable monthly regimen in a malaria control scheme in a holoendemic area with high P. falciparum sensitivity to chloroquine. PMID- 3524483 TI - A two year follow-up of persons with a positive fluorescent antibody test for Rhodesian sleeping sickness in the Luangwa Valley, Zambia. PMID- 3524484 TI - Application of an in vivo culture model for the diagnosis of cutaneous leishmaniasis. PMID- 3524485 TI - Sensitivity in vivo of Plasmodium falciparum to chloroquine and pyrimethamine/sulfadoxine in a coastal area of Tanzania. AB - The in vivo response of Plasmodium falciparum to chloroquine and to pyrimethamine/sulfadoxine was studied for seven days in schoolchildren from two villages 30 to 40 km north of Dar es Salaam. Standard therapeutic regimen of chloroquine (25 mg base kg-1) failed to clear parasitaemia in 17 of 62 (27%) treated subjects. In contrast, standard treatment with pyrimethamine/sulfadoxine cleared the parasitaemia in all 44 treated subjects within five days. Hence, in the studied area, the therapeutic effect of sulfadoxine/pyrimethamine was superior to that of chloroquine. PMID- 3524486 TI - A technique of right ventricular outflow tract patching with autogenous pericardium. AB - A simple, efficient method of right ventricular outflow tract patching, which reduces the need for assistance, is described. PMID- 3524487 TI - Cardiac surgery in patients with end-stage renal disease. AB - In a retrospective study we analyzed the clinical features of 85 patients with end-stage renal disease who underwent cardiac operation. Seventy-eight patients were from reports in the literature, and 7 were from our experience. The cardiac procedures were primarily valve replacements and aortocoronary bypass (ACB) operations. The indication for valve replacement was most commonly infective endocarditis (73%), affecting most frequently the aortic valve (68%). The most common organism was Staphylococcus aureus, and there was a recent episode of angioaccess site infection in at least 17.5% of patients with documented endocarditis. The 30-day mortality was 57% for patients undergoing emergency valve replacement and only 3% for similar elective operations. Cumulative survival at 48 months was equal to that of the overall hemodialysis population not having cardiac operations. The mean age (50 years), male to female ratio (9:1), number of vessels bypassed per patient (2.4), and operative mortality for ACB were equal to those reported in comparable series of patients with normal renal function. Cumulative survival at 48 months for ACB patients was similar (60% versus 56%) to that of the overall hemodialysis population. Cardiac operations can be performed safely in patients with end-stage renal disease; the morbidity and mortality are similar to those encountered in patients with normal renal function. The long-term survival after cardiac procedures in patients with end-stage renal disease is similar to that reported for the overall hemodialysis population not having cardiac operations. PMID- 3524488 TI - Addition of papaverine to cardioplegia does not reduce myocardial necrosis. AB - In a randomized, double-blind prospective study involving 495 patients, we investigated whether the addition of papaverine, 60 mg, to our existing regimen of cold cardioplegia would reduce myocardial necrosis during elective coronary artery bypass operations. Twenty-one (4.2%) patients sustained acute postoperative myocardial infarctions (MI), and 7 (1.4%) died during hospitalization. Neither MI nor death was related to papaverine supplementation. Among 469 patients without postoperative MI, levels of the myocardial-specific isoenzyme of creatine phosphokinase measured 10 hours after aortic cross-clamping were related to ischemic cross-clamp time, but not to papaverine supplementation of cardioplegia. At declamping after completion of distal anastomoses, ventricular fibrillation was more common after cardioplegia without papaverine (32% versus 9%). No other differences between the two groups were found in intraoperative and postoperative hemodynamics, difficulty of weaning from bypass, or postoperative volume requirements. We identified three risk factors for postoperative MI: ECG evidence of new ischemia prior to bypass, unusual technical difficulty with distal anastomoses for the surgeon, and prolonged time of ischemia. We conclude that addition of papaverine to our cardioplegia regimen did not affect outcome or nonspecific myocardial necrosis. PMID- 3524489 TI - In vivo and in vitro studies of the non-adrenergic non-cholinergic nervous system of the guinea-pig airways. AB - Functional studies indicate that the regulation of the tone in the guinea-pig airways in part involves non-adrenergic non-cholinergic (NANC) neural mechanisms. The characteristics of the relaxation induced by field stimulation of the non adrenergic inhibitory neural system differed from those of the relaxation induced by purine derivatives. Furthermore, the presence of a maximally relaxant concentration of a purine or VIP did not affect the neurogenic inhibition. Thus, other transmitter candidates for the NANC inhibitory response than purines and VIP should be searched for. An atropine-resistant neurogenic bronchoconstriction was found to be abolished by capsaicin pretreatment. Capsaicin also reduced the lung content of substance P-like immunoreactivity. A tachykinin, possibly a neurokinin A-like peptide, has been considered to be the mediator of the NANC neural bronchoconstriction. Moreover, activation of NANC nerves may enhance airway microvascular permeability to macromolecules. Whether NANC nerves are involved in the neurogenic control of secretion from submucosal glands and of mucociliary clearance in guinea-pig airways remains to be shown. PMID- 3524490 TI - The action of purines on human airways. PMID- 3524491 TI - Non-adrenergic non-cholinergic nervous control of gastrointestinal motility patterns. AB - Non-adrenergic non-cholinergic neurons seem to play an important role in regulation of movements in all parts of the gut. Inhibitory non-adrenergic non cholinergic neurons mediate a number of descending and ascending reflex effects of physiological and pathophysiological relevance. However, our knowledge in this field is still limited. Development of specific blockers for the non-adrenergic non-cholinergic transmitter substances would help to increase our understanding of gastrointestinal motor functions in health and disease. PMID- 3524492 TI - Identification and treatment of metabolic abnormalities in patients with vertigo. AB - Hyperinsulinism, impaired glucose tolerance, and hypertriglyceridemia may be risk factors for atherosclerotic heart disease and have also been described in patients with vertigo, whose symptoms and findings responded to appropriate dietary therapy. We studied 100 patients in an otolaryngology practice to determine the role of these abnormalities in identifying patients suitable for dietary therapy and to assess the efficacy of dietary therapy in the treatment of vertigo in such selected patients. The determination of hyperinsulinism and hypertriglyceridemia were of value as supplements to the traditional glucose tolerance test in detecting reversible metabolic vertigo. Reactive hypoglycemia was found in only four patients and thus appears overdiagnosed as a cause of vertigo. Insulin resistance appears to be the basic abnormality in this syndrome, which, in our series, occurred predominantly in overweight patients. PMID- 3524493 TI - Effect of esophageal variceal sclerotherapy (EVS) on lung function. A prospective controlled study. AB - A prospective, controlled study to determine the short- and long-term effects of esophageal variceal sclerotherapy (EVS) on lung function was carried out on 11 patients with cirrhotic portal hypertension and variceal hemorrhage. Eleven patients with chronic liver disease undergoing diagnostic endoscopy served as controls. There was no difference in lung function tests and gas exchange in both the EVS or control groups after either procedure. No change in these parameters was noted during follow-up on continued sclerotherapy in the EVS group. Ventilation-perfusion scans and chest roentgenograms, performed before and after EVS, demonstrated no significant change. We conclude that in patients with stable liver disease and without hepatic failure, EVS does not result in serious short- and long-term impairment of lung function. PMID- 3524494 TI - Revaccination of renal transplant and hemodialysis recipients with pneumococcal vaccine. AB - Two years after pneumococcal vaccine was given to patients on a university renal transplant and hemodialysis service, vaccine failures began to occur. Serologic studies showed a threefold decrease in antibody levels during this period, from 913 ng of antibody nitrogen per milliliter to 315 ng/mL. The decrease was greater in patients undergoing hemodialysis than in renal transplant recipients (879 to 215 ng/mL vs 932 to 385 ng/mL). The lowest antibody levels were to types 4, 6A, and 19F. Patients were revaccinated, without serious reactions, and pneumococcal infections decreased as they had after the original vaccination program. After revaccination, there was a twofold increase in antibody levels (315 to 602 ng/mL), but the levels did not reach those seen after primary vaccination. The increase was greater in hemodialysis than in renal transplant recipients (215 to 757 ng/mL vs 385 to 536 ng/mL). This experience indicates that pneumococcal vaccines may be effective in patients undergoing hemodialysis and in asplenic renal transplant recipients, but these groups will require revaccination sooner than normal subjects to maintain immunity. PMID- 3524495 TI - Mode of transmission of Legionella pneumophila. A critical review. PMID- 3524496 TI - Maimonides the physician. PMID- 3524497 TI - Immunological evidence for the involvement of cell wall proteins in phosphate uptake in the yeast Saccharomyces cerevisiae. AB - Immunological cross-reactivity between cell wall proteins obtained from two yeast genera (Candida tropicalis and Saccharomyces cerevisiae) is reported. Specific retention of two cell wall proteins from Saccharomyces cerevisiae by an immunoabsorbent column coupled with antibodies against phosphate binding protein 2(PiBP2) from Candida tropicalis allowed to generate antibodies against the proteins from S. cerevisiae. These antibodies were effective in inhibiting phosphate uptake by S. cerevisiae cells. The proteins from S. cerevisiae displayed a phosphate binding activity which was inhibited in the presence of the forementioned antibodies. These results and the observation that the amount of these proteins in the shock fluid was dependent of the growth conditions (i.e., in the presence or in the absence of phosphate) support the idea that these proteins are involved in the high affinity phosphate transport system. PMID- 3524498 TI - Lipopolysaccharide of Providencia rettgeri. Chemical studies and taxonomical implications. AB - The chemical constitutional analysis of the lipopolysaccharide (LPS) isolated from Providencia rettgeri was carried out. Polyacrylamide gel electrophoresis using sodium dodecylsulfate or sodium deoxycholate showed that the lipopolysaccharide mostly consisted of short sugar chains. The lipid A was precipitated out after mild acid hydrolysis of LPS. From the supernatant degraded polysaccharide and unsubstituted core fractions were isolated. Compositional analysis of the core material revealed the presence of galacturonic acid, galactose, glucose, glucosamine, L-glycero-D-manno-heptose, 3-deoxy-D-manno octulosonic acid, alanine and phosphorus. Methylation analysis of the core material indicated the presence of terminal units of glucose, galacturonic acid and glucosamine. The chemical structure of the lipid A was elucidated. It constitutes a beta-1,6-glucosamine disaccharide substituted on either side by ester and glycosidically-bond phosphate residues. The ester-bound phosphate was found to be substituted by a 4-amino-4-deoxy-L-arabinosyl residue. The amino groups of the backbone disaccharide are N-acylated by 3-O-(14:0)14:0 and 3-O 14:0. Two hydroxyl groups of the disaccharide are esterified by 3-O-(14:0)14:0 and 3-O-14:0. The taxonomical importance of these structural details will be discussed. PMID- 3524499 TI - [The effect of intravenous administration of butyrate, isobutyrate, isovalerate and capronate to calves, young cattle and cattle on the blood plasma levels of glucose, insulin, free fatty acids and total alpha-amino-nitrogen]. PMID- 3524500 TI - [The effect of intravenous administration of butyrate, isobutyrate, isovalerate and capronate on the blood plasma levels in sheep of glucose, insulin, free fatty acids and total alpha-amino-nitrogen]. PMID- 3524501 TI - Randomized clinical trials in breast cancer: a tabular summary. Part 1: Primary breast cancer. AB - Treatment results of randomized clinical trials on primary breast cancer are given by tables including surgical treatment and adjuvant modalities like chemo-, hormone-, and immunotherapy. PMID- 3524502 TI - Formation of lymph follicles in draining lymph nodes after local injection of various antigenic substances in mice. AB - Formation of lymph follicles in draining popliteal lymph nodes was examined in 8 week-old, male C57Bl/6 mice which had been injected in the rear footpad with any one of eleven test substances including thymus-dependent and thymus-independent antigens, and killed after 6-14 days. HGG (10-100 micrograms), MGG, tetanus and diphtheria toxoids (2-10 Lf) and influenza HA vaccine (35 CCA) induced germinal centers in association with existing follicles, but failed to produce new follicles in draining nodes. KLH (10-100 micrograms), SRBC (1 X 10(8)) and formalin-killed pertussis organisms (5 X 10(8)) induced germinal centers in existing follicles and also produced new follicles which soon developed germinal centers. Levan and PVP (10-100 micrograms) induced neither germinal centers nor new follicles. Ferritin (100 micrograms) virtually failed to induce germinal centers but produced a significant number of new primary follicles. In further experiments, artificially aggregated substances were examined with regards to their ability of inducing lymph follicle formation in draining nodes. Precipitated proteins such as alum-precipitated PHA, HGG, tetanus and diphtheria toxoids, "Sepharose"-PHA and "Sepharose"-HGG induced a significant number of new follicles. These observations suggest that efficient follicle formation is associated with particulate and high-molecular-weight antigens which are liable to be phagocytized, whereas soluble, poorly phagocytized antigens tend to be inefficient. Soluble proteins may be effective if given in precipitated form. Thymic dependency appears to be irrelevant. The present results point to a possible participation of macrophages in the mechanism of follicle formation. PMID- 3524503 TI - Immunohistochemical localization of urotensins I and II in the caudal neurosecretory neurons of the carp Cyprinus carpio and the sharks Heterodontus japonicus and Cephaloscyllium umbratile. AB - Using antisera to urotensins I and II (UI and UII), in the carp, Cyprinus carpio, three types of caudal neurosecretory neurons were identified: those with both UI- and UII-immunoreactivities, those with only UI-immunoreactivity and those with only UII-immunoreactivity. The last type of neurons exceeded the other types in number, while neurons immunoreactive with both UI and UII antisera were relatively few. The axons of neurons of these three types terminated around the capillaries in the urophysis. In the cat shark, Heterodontus japonicus and the swell shark, Cephaloscyllium umbratile, two types of neurons were identified: those with both UI- and UII-immunoreactivities and those with only UII immunoreactivity. Neurons of the former type were greater in number than the latter. The axons of neurons of both types terminated in the neurohemal areas. PMID- 3524504 TI - Microcirculation of the pancreas in the rat and rabbit with special reference to the insulo-acinar portal system and emissary vein of the islet. AB - Microcirculation of the pancreas in the rat and rabbit with special reference to the islets was studied by scanning electron microscopy (SEM) of vascular corrosion casts, light microscopy (LM) of India ink-injected/cleared tissues, and intravital microscopy of in situ organs. The following observations were made: Approximately 10-20% of the total terminal arterioles supplied the islets, while the remainder directly supplied the exocrine pancreas. The vas afferens of the islets divided into sinusoidal capillaries with frequent U-shaped turns in the cortical A and D cell area of the islets, and their secondary branches supplied the core B cell area. Intravital microscopy confirmed that blood irrigated the cortex of the islets first and the core portion second. All islets observed possessed insulo-acinar portal vessels. About 60% of the islets in the rat possessed emissary veins leading directly into the systemic circulation, while in the rabbit, less than 5% of islets possessed emissary venules of small diameter. Thus, the well-developed emissary veins of the islets seemed characteristic of the rat, as compared with the rabbit and several other mammals examined previously. The insulo-acinar portal system seems to represent a short vascular route through which islet secretions are transported in high concentrations to the exocrine pancreas, there to exert their actions. The emissary veins of the islet seem to serve for the quick conveyance of insular secretions into general circulation. It is suggested that the pancreatic lobule is made up of subdivisions or microcirculatory units, each of which is supplied centrally by the insulo-acinar portal system, while peripherally the unit also receives direct branches of intralobular arterioles. The veins run the periphery of the unit. The occurrence of sphincters in the vas afferens and the emissary veins of the islets is suggested as being involved in the regulation of the islet blood flow. PMID- 3524505 TI - Lipoproteins and apolipoproteins. Composition, metabolism, and association with coronary heart disease. AB - Apolipoproteins play major roles in regulating lipoprotein synthesis and catabolism. Apolipoprotein AI activates the lecithin cholesterol acyltransferase, apolipoprotein CII and CIII regulate the lipoprotein lipase, and apolipoprotein B 100, B-48, and E control the cholesterol uptake into hepatic and extrahepatic cells. Therefore, investigating the alterations of lipoprotein metabolism in disease states at the apolipoprotein level may give increased insight into the underlying mechanisms of lipoprotein changes and provide better understanding about the premature development of the atherogenic process. PMID- 3524506 TI - Lysozyme and alpha 1-antitrypsin in giant-cell tumor of bone and in other lesions that contain giant cells. AB - We performed an immunohistochemical study of 24 giant-cell tumors of bone and 30 other lesions (fibrous histiocytoma, nonossifying fibroma, and giant-cell tumor of the tendon sheath) using lysozyme and alpha 1-antitrypsin as markers for histiocytic cells. The presence of histiocytic cells in giant-cell tumors of bone is confirmed by the finding of a positive reaction for alpha 1-antitrypsin in both multinucleate giant cells and mononuclear stromal cells in some cases. It is not clear whether the positive cells are to be regarded as neoplastic or reactive and alpha 1-antitrypsin is not considered as a diagnostically useful marker for giant-cell tumor of bone. In malignant fibrous histiocytoma, too, histiocytic cells could be identified by their positive reaction for alpha 1-antitrypsin; some of these cells had the morphologic features of tumor cells. Cells with a positive reaction for lysozyme were rarely found, except in giant-cell tumors of the tendon sheath. PMID- 3524507 TI - Cardiac myxoma with glandlike structures. An immunohistochemical study. AB - We report the case of a 14-year-old girl with a left atrial myxoma associated with atrial septal defect. Histopathologically, glandular structures were found at the base of the tumor. Immunohistochemical examination of the tumor revealed positive staining of the glands with cytokeratin, epithelial membrane antigen, and carcinoembryonic antigen. The positive staining for epithelial markers suggests that these structures are epithelial and could represent either endodermal heterotopia or multipotential mesoderm retaining the capacity for epithelial expression. The glands should not be confused with metastatic mucin producing adenocarcinoma. PMID- 3524508 TI - Immunohistochemical localization of S100 protein in skin tumors. AB - We applied a peroxidase-antiperoxidase technique for S100 protein to 73 tumors of skin and skin adnexa. These included 15 eccrine tumors, 11 apocrine tumors, 18 tumors with differentiation toward hair, two sebaceous adenomas, one mixed tumor of the scalp, ten dermatofibromas, ten basal cell carcinomas, five squamous cell carcinomas, and one clear cell acanthoma. Consistent results were obtained. Occasional cells in eccrine tumors showed strong positive staining, as did the Langerhans' cells in the squamous cell carcinomas and the clear cell acanthoma. The cells of the apocrine tumors showed moderate to weak staining, and the tumors with differentiation toward hair, the sebaceous adenomas, and the mixed tumor of the scalp showed uniform negative staining, as did basal cell carcinomas and dermatofibromas. PMID- 3524510 TI - Heterosexual experience and isosexual behavior in laboratory-housed male stump tailed macaques (M. arctoides). AB - Three feral-born male stump-tailed macaques were housed together for 9 years from prepubertal age. The animals were then transferred to another laboratory and housed individually. They were pair-tested with each other (isosexual tests) and with females (heterosexual tests) for the first time in their adult lives. The study revealed that these males preferred females as sexual partners. They preferred each other as groom partner. The heterosexual experience did not drastically alter sociosexual behavior between the males. PMID- 3524509 TI - Analgesic effectiveness of D-phenylalanine in chronic pain patients. AB - Enkephalins are a biochemical pathway for endogenous analgesia. A number of compounds inhibit degradation of enkephalins within the body. One of these compounds, D-phenylalanine (DPA), has been shown to increase the pain threshold in animals. It is hypothesized that this naloxone reversible analgesia is induced by DPA blockage of enkephalin degradation by the enzyme carboxypeptidase A. Preliminary studies of chronic pain patients have shown a response rate to DPA from 32% to 75%. This study was a double-blind crossover evaluation of a randomized parallel design to determine the efficacy of DPA in 30 subjects with chronic pain from varied etiology which was unrelieved by multiple therapeutic interventions. Each patient received a stabilized therapeutic regimen during this study consisting of four weeks of either DPA 250 mg or lactose (placebo) orally four times a day. After four weeks the DPA and placebo groups were crossed over for an additional four weeks of treatment. Pain was quantified using a visual analog pain scale and a cold pressor test. Data from the pain questionnaires revealed more pain relief on DPA reported by 25% of the patients, more pain relief on placebo reported by 22% of the patients, and no difference in pain relief reported by 53% of the patients. Lowest pain level of the visual analog scale was reported by 47% of the patients on DPA and 53% on placebo. There appears to be no significant analgesic effect from D-phenylalanine in chronic pain patients when compared to placebo. PMID- 3524511 TI - Cefoxitin plus tobramycin and clindamycin plus tobramycin. A prospective randomized comparison in the therapy of mixed aerobic/anaerobic infections. AB - The efficacy of therapy with cefoxitin sodium plus tobramycin sulfate, with the tobramycin therapy discontinued if no cefoxitin-resistant pathogens grew from appropriate cultures, was compared with clindamycin phosphate plus tobramycin therapy in mixed aerobic/anaerobic intra-abdominal and female pelvic infections. Of 96 evaluable patients, 39 (76%) of 51 randomized to cefoxitin and 38 (84%) of 45 randomized to clindamycin were cured and an additional seven (14%) of 51 and three (6.7%) of 45, respectively, were improved. Bacteroides fragilis "group" was isolated from 44 (54%) of 82 patients with appropriate specimens. Duration of aminoglycoside therapy was significantly shorter in patients randomized to cefoxitin and tobramycin (mean, 4.1 +/- 1.8 days vs 7.0 +/- 3.2 days). There was a tendency to greater nephrotoxic reactions in patients randomized to clindamycin and tobramycin. We conclude that cefoxitin plus tobramycin with selective early discontinuation of aminoglycoside therapy is an acceptable regimen for the therapy of mixed aerobic/anaerobic infections. PMID- 3524512 TI - Use of egg-yolk antibody for detection of respiratory syncytial virus in nasal secretions by ELISA. AB - Egg-yolk immunoglobulins extracted from the eggs of hens immunized with respiratory syncytial virus (RSV) have been used as a reagent in double sandwich ELISA for detecting RSV in nasal secretions. The sensitivity of virus detection was the same in indirect ELISA, using rabbit anti chicken globulin conjugate, as when biotinylated yolk globulin and labeled avidin were used for detection. The specificity of ELISA for detecting RSV using yolk antibody was similar to that achieved by indirect immunofluorescence using commercial reagents of mammalian origin. Purified immunoglobulin was easily extracted from egg yolk; the amount of globulin present in a single preparation obtained from a batch of ten eggs was sufficient to carry out 10(6) ELISA tests for RSV detection. PMID- 3524513 TI - Comparison of clinic, home, and deferred language treatment for aphasia. A Veterans Administration Cooperative Study. AB - Aphasic patients who met stringent selection criteria were assigned randomly to three groups: clinic treatment by a speech pathologist for 12 weeks, followed by 12 weeks of no treatment; home treatment by a trained volunteer for 12 weeks, followed by 12 weeks of no treatment; or deferred treatment for 12 weeks, followed by 12 weeks of treatment by a speech pathologist. At 12 weeks after entry, language measures indicated that the clinic-treatment patients made significantly more improvement than did the deferred-treatment patients, and improvement in home-treatment patients did not differ significantly from either clinic- or deferred-treatment patients. At 24 weeks after entry, after deferred treatment patients had received clinic treatment, there were no significant differences among the groups. These results suggest that clinic treatment for aphasia is efficacious, and delaying treatment for 12 weeks does not compromise ultimate improvement. PMID- 3524514 TI - Muscarinic agonist therapy of Alzheimer's disease. A clinical trial of RS-86. AB - Cholinergic projections to the cerebral cortex from certain basal forebrain nuclei degenerate in Alzheimer's disease. Nevertheless, attempts to alleviate this disorder through the administration of drugs that increase the availability of acetylcholine to postsynaptic receptor sites have generally yielded disappointing results. In an attempt to evaluate the therapeutic efficacy of cholinomimetics that act independently of the presynaptic cholinergic terminals, a double-blind, placebo-controlled trial of the muscarinic agonist RS-86 (2-ethyl 8 methyl-2,8 diazospiro [4.5]-decane-1,3-dione hydrobromide) was undertaken. Eight patients with Alzheimer's disease with mild to moderately advanced dementia received RS-86 orally at maximum individually tolerated dose levels for eight days. Although some verbal and visuospatial tests showed slight alterations, no consistent overall change in cognitive performance could be discerned. These results lend further support to the view that short-term administration of cholinomimetic monotherapies may fail in the symptomatic treatment of Alzheimer's dementia. PMID- 3524516 TI - Intravenous digital subtraction angiography. PMID- 3524515 TI - Stroke in renal transplant recipients. PMID- 3524517 TI - Two-dimensional electrophoresis in the analysis of a mixture of human sublingual and submandibular salivary proteins. AB - Complex protein mixtures of unstimulated human sublingual and submandibular saliva were fractionated by two-dimensional (2-D) gel electrophoresis, visualized by silver staining and then analysed by immunostaining. Specific proteins were identified by incubation with specific antibody and peroxidase-conjugated second antibody (Western blot). Electrophoresis and silver staining revealed over 50 protein components in 2 microliter of unconcentrated mixture. The Western-blot technique allowed detection of protein spots of plasma origin when an antibody against whole serum was used, but only the albumin spot could be found. Albumin, secretory IgA, acid phosphatase and alpha-amylase were identified with specific antibodies. PMID- 3524518 TI - Immunohistochemistry and electron microscopy of cyclitic membrane. Report of a case. AB - An immunohistochemical study using various antibodies directed against antigens of inflammatory cells, neurons, and Muller cells, interstitial collagens (types I and III), basement membrane collagens (types IV and V), and basement membrane glycoproteins (laminin and fibronectin) was performed to characterize the components of two cyclitic membranes (in an enucleated eye and a surgical specimen) from a 15-year-old patient with an eight-year history of chronic bilateral uveitis. When specimens were obtained, no inflammation was seen clinically. Correlative light and electron microscopic examinations were also performed on one specimen. The preponderant cells in the cyclitic membrane were glial cells. The preponderant extracellular tissue within the cyclitic membrane consisted of basement membrane components. These observations suggest that cyclitic membranes could be formed mainly by the extension of proliferative glial elements from the retina, with a minor component derived from fibroblasts. PMID- 3524519 TI - Early detection of xerophthalmia by impression cytology. PMID- 3524520 TI - Genetic aspects of arteriosclerosis. AB - This review discusses the genetic factors in the development of arteriosclerosis and coronary heart disease (CHD). In several studies, multivariate analysis of prospective mortality/morbidity data and angiographic findings have indicated that a family history of CHD contributed to CHD risk independently of the established risk factors. In addition, ethnic groups that differ in the prevalence and incidence of CHD also markedly differ in blood groups and protein enzymatic markers. These or other genetic differences may affect CHD rates. Data from fraternal and identical twins, the source of some early genetic CHD findings, are reviewed. Genetic disorders of lipoprotein metabolism and transport, such as familial hypercholesterolemia, as well as other monogenic disorders are discussed. The role of apoprotein E polymorphism i other monogenic disorders are discussed. The role of apoprotein E polymorphism in determining plasma LDL variability among individuals is considered. Recombinant DNA technology, molecular cloning, and the identification of restriction fragment length polymorphisms are new tools for investigators who assess DNA polymorphism. Recent advances in that domain include: DNA polymorphisms affecting blood levels of apo A-I and A-II, association of a DNA insertion on chromosome 19 with severe premature atherosclerosis, and information concerning linkage of the genes for various apolipoproteins. In addition, the evidence for a major genetic component in diabetes mellitus and research into the genetic aspects of hypertension are reviewed. The male/female ratio in pathologically and epidemiologically assessed atherosclerosis may provide clues to the role of genetics. Early structural changes in the coronary artery intima are compatible with the ethnic and gender predilection. A key question in understanding underlying mechanisms in atherosclerosis is why coronary arteries are occluded in individuals whose other arterial systems are largely unaffected. The review concludes with a discussion of the directions and implications of future genetic research in arteriosclerosis with an emphasis on uncovering genetically determined differences in arterial wall response to blood flow. Subpopulations with different genetic risks may be identified, in which case universal preventive strategies might be replaced with specific ones. PMID- 3524522 TI - The 'lost' or 'unknown' IUD. PMID- 3524521 TI - Decreased arterial elasticity associated with cardiovascular disease risk factors in the young. Bogalusa Heart Study. AB - Noninvasive ultrasonic examinations were performed in 1984 on a biracial sample of 109 10- to 17-year-old adolescents to determine whether elastic properties of the carotid arteries are associated with cardiovascular disease risk factors in the young. The subjects examined were in either the upper (high risk) or lower (low risk) race-, sex-, and age-specific tertile for both serum total cholesterol (TC) and systolic blood pressure (SBP) during a 1981-82 community survey. The pressure-strain elastic modulus (Ep), a measure of stiffness, for the carotid arteries was calculated by dividing the pulse pressure by the fractional diameter increase in the carotid artery during the cardiac cycle, as measured by ultrasonic techniques. Repeat studies on 20 randomly selected subjects demonstrated high reproducibility of the elasticity measurements (intraclass correlation coefficient = 0.84). The mean Ep in the high risk group was 5.1 kPa higher than in the low risk group, after controlling for race, sex, and age (one sided p value = 0.03). Furthermore, a positive parental history of myocardial infarction was related to increased Ep levels (p less than 0.05), independently of race, sex, age, TC, and SBP. The results indicate that ultrasonic techniques can detect functional differences in the carotid arteries of children and adolescents that are associated with the risk of cardiovascular disease as adults. PMID- 3524523 TI - Diagnostic, percutaneous peritoneal lavage in blunt abdominal trauma: rationale, technique and results. AB - The records of 90 consecutive adult patients, who presented after blunt abdominal trauma and who underwent diagnostic, percutaneous peritoneal lavage over a 3 year period, were reviewed. Lavage effluents were considered positive, negative or equivocal. An equivocal result was one where the tubing contained blood stained fluid, but it was still possible to see newsprint through the tubing. Fifty-one lavages were positive, 24 negative and 15 equivocal. All 51 patients with a positive effluent and three of the patients with an equivocal effluent had a laparotomy and in all but one case a significant injury was found. There were no false negative results. In a single patient the transverse colon was perforated during the insertion of the lavage catheter. Diagnostic, percutaneous peritoneal lavage is a simple, safe, rapidly performed, accurate technique designed to detect intraperitoneal blood and the results of this review suggest that it has a role to play in the decision-making process when assessing adult patients who have suffered blunt abdominal trauma. PMID- 3524524 TI - Gallbladder emptying in man related to fasting duodenal migrating motor contractions. AB - Animal studies have shown that the gallbladder (GB) empties partially during fasting in relation to phase II of the interdigestive motor cycle (IDMC). It has been assumed that in man the GB remains inert during fasting, although there have been no studies in which repeated sequential measurements of gallbladder volume have been made and related to the IDMC. In this study the possibility of linkage between the IDMC and GB volume has been examined in nine fasting human volunteers (five males/four females). A multilumen constantly perfused manometry catheter was positioned in the duodenum and motor activity recorded continuously. Phase III of the IDMC was characterized by phasic contractions, with a frequency of 10 12/min for at least 2 min, which had a distal propagative pattern and were followed by a motor quiescence (Phase I). GB volume was calculated at 15 min intervals from ultrasound measurements of the maximal length and diameter of the GB by the summation of cylinders method, and related to the time of onset of each phase III of the IDMC. In all nine subjects GB volume decreased prior to the onset of phase III and increased following its passage (P less than 0.01). GB volume decrease ranged between 6 and 56% of maximal GB volume (median 18%) and subsequent filling ranged from 14 to 53% (median 27%). The maximal volume decrease occurred 30 min prior to the onset of phase III (P less than 0.02). These studies have demonstrated that the human GB empties partially during phase II of the IDMC.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3524525 TI - Sir James Officer Brown: his contribution to the development of thoracic and cardiac surgery. PMID- 3524526 TI - Hepatic peroperative echography. PMID- 3524527 TI - Spontaneous neonatal renal vein thrombosis. AB - A case of spontaneous neonatal renal vein thrombosis is presented. A 1 week old, 36 week gestation, male child presented with gross haematuria and a large right flank mass. Investigations including intravenous pyelogram, ultrasound and venacavogram indicated the diagnosis. The child was clinically well, with normal renal and clotting function. No predisposing cause could be found. A conservative approach to treatment was undertaken in view of the normal renal function, and no evidence of consumptive coagulopathy or pulmonary emboli. The child remains well, but may require nephrectomy in the future. PMID- 3524528 TI - An alternative approach to skin graft donor site dressing. PMID- 3524529 TI - Jaundice may herald an appendiceal abscess. PMID- 3524530 TI - Respiratory syncytial virus: a review of the virus, its epidemiology, immune response and laboratory diagnosis. PMID- 3524531 TI - Vitamin A status in children who are prone to respiratory tract infections. AB - The effect of Vitamin A supplementation on susceptibility to acute respiratory infections was investigated in a randomized controlled trial. One hundred and forty-seven preschool-age children with a history of frequent respiratory illness were randomized into Vitamin A supplemented (450 micrograms/day) and placebo groups. Respiratory symptoms were recorded on a daily basis over a period of 11 months. The children who received the supplement experienced 19% fewer episodes of respiratory symptomatology (P less than 0.05) than their placebo counterparts, despite the fact that their plasma retinol levels did not change. Children with a prior history of lower respiratory illness or of allergy benefited most from supplementation. The plausibility of a role for Vitamin A in the aetiology of respiratory proneness is reviewed. PMID- 3524532 TI - Immunodiagnosis of autoimmune skin disease in the dog, cat and horse. AB - Skin biopsies from 47 dogs, 6 cats and 5 horses with suspected autoimmune skin disease were submitted for immunofluorescence from 1978 to 1985. These cases were predominantly Western Australian in origin, although a number were also referred from Queensland and Victoria. In 5 dogs, 2 cats and 2 horses immunoglobulin binding to intercellular cement substance and/or basement membrane was demonstrated by direct immunofluorescence. Antinuclear antibody was also demonstrated in several of these cases. Immunofluorescence was used in combination with histopathological examination to confirm the clinical diagnosis of autoimmune disease in 19/47 dogs, 4/6 cats and 2/5 horses. There was no age, breed or sex predisposition amongst the 19 positive dogs, however there was a higher incidence of antinuclear antibody (54%) than the normal canine population (10%) and other autoantibodies (rheumatoid factor) were sometimes present. Abnormalities in serum protein electrophoresis and serum complement C4 levels were also recorded in this group. PMID- 3524533 TI - Obstruction of the third portion of the duodenum. PMID- 3524534 TI - The incidence of sub-hepatic collections after cholecystectomy. PMID- 3524535 TI - Primary common bile duct carcinoid demonstration by computerised tomography, ultrasonography and angiography. PMID- 3524536 TI - Imaging in neuroblastoma--a 12 year experience. PMID- 3524537 TI - Ultrasound guided removal of an intracranial bullet: case report. PMID- 3524538 TI - Turner's syndrome. PMID- 3524539 TI - Primary and secondary wattle swelling response to phytohemagglutinin as a measure of immunocompetence in chickens. AB - Wattle responses of 2-to-8-week-old chickens to phytohemagglutinins PHA-P and PHA M were studied. Dilutions of PHA-M that did not induce wattle swelling after one injection did cause readily detectable swelling when injected a second time 1 week later. These responses were absent in birds subjected to thymectomy and gamma-irradiation at hatching and in birds treated with cyclosporin A during the week of sensitization, indicating that these responses are T-cell-dependent. Chickens bearing transplantable fibrosarcomas failed to show responses. It is suggested that reactivity to a second injection of PHA-M may be used as a measure of immunocompetence at the T-cell level in very young chickens. PMID- 3524540 TI - Congo red medium to distinguish between invasive and non-invasive Escherichia coli pathogenic for poultry. AB - In the course of our molecular studies of virulence factors associated with invasive avian Escherichia coli infections, it was first necessary to distinguish between common E. coli and those that cause septicemia in poultry. We found a direct correlation between the ability of clinical isolates of E. coli to bind Congo red dye (CR) and their ability to cause septicemic infection in chickens. This finding was supported by bacteriological studies of 30 broiler flocks (26 sick and 4 healthy) and by virulence studies in chickens and mice. All 144 isolates of E. coli from internal tissues of diseased birds were determined to be CR-positive (red colonies). Congo-red-positive E. coli colonies were isolated from air sacs, pericardium, liver, lung, joint fluid, and heart blood of chickens with lesions of colisepticemia. In contrast, of 170 E. coli isolates from the poultry house environment and from the trachea and cloaca of healthy birds, more than half were CR-negative (white colonies). No CR-negative (white) E. coli colonies were found in internal organs from birds with typical lesions of colisepticemia. We feel that these preliminary findings suggest that the CR dye binding could be used as a phenotypic marker to distinguish between invasive and noninvasive isolates. PMID- 3524541 TI - Detection of Mycoplasma gallisepticum by direct immunofluorescence using a species-specific monoclonal antibody. AB - A monoclonal antibody against Mycoplasma gallisepticum (MG) (strain S6) was prepared in mice and identified as isotype IgG1 by standard procedures. Although it did react at high titers (1:100,000) in the enzyme-linked immunosorbent assay (the original method for its identification), it failed to react in the agglutination, hemagglutination-inhibition, and growth-inhibition tests. When conjugated to fluorescein isothiocyanate, the monoclonal antibody reacted with the homologous and eight "atypical" strains of MG but not with M. meleagridis or M. synoviae in the direct fluorescent-antibody test. This reagent may be useful for detecting field infections involving atypical strains of MG. PMID- 3524542 TI - Development of vaccines for bacterial diseases using recombinant DNA technology. AB - A vaccine was prepared using recombinant DNA techniques to prevent fatal enterotoxigenic Escherichia coli diarrhea in swine. The product, which is a subunit vaccine, was prepared by mechanical and chemical removal of pilus adhesins from the surface of genetically engineered strains of E. coli. The vaccine contains the pilus adhesins K88, K99, and 987P plus an adjuvant. The genes responsible for production of K88 and K99 were separately cloned into the multicopy vector pBR322. K88 was found to be encoded on a 7.6-kilobase HindIII EcoRI fragment, and K99 was found to be encoded on a 7.15-kilobase BamHI fragment. Strains containing the recombinant plasmid for K99 produced up to ten times more K99 than strains containing the wild-type plasmid. Vaccination of pregnant pigs with the vaccine led to production of pilus-adhesin-specific antibodies that were transferred to the piglets in colostrum and milk. Pilus adhesin-specific antibodies neutralized the adhesiveness of the pili on enterotoxigenic E. coli, thus preventing attachment, colonization, and disease. Mortality of pigs in litters from vaccinated pigs due to experimentally induced enterotoxigenic E. coli diarrhea was reduced 10-to-20-fold (depending upon the challenge strain), and the incidence, severity, and duration of diarrhea were also reduced. PMID- 3524543 TI - Morphopathology of the adenohypophysis of chickens in shock induced by Escherichia coli. AB - We studied modifications in the adenohypophysis of chickens subjected to experimental septic shock by repeated intraperitoneal inoculations with Escherichia coli 026 B6. We observed vascular modifications characterized by capillary dilation and endothelial defects, together with marked perivascular edema and collagen fibers in the groups receiving the most inoculations. Similarly, there was a proliferation of mononuclear cells, belonging mainly to the mononuclear phagocyte system, and plasma cells and lymphocytes. The lesions found in chickens receiving only one inoculation may be evidence of a morphopathological relationship between shock induced by E. coli and lesions that develop in the swollen-head syndrome. PMID- 3524544 TI - Effects of cage contamination with coccidia and salmonella on acute salmonellosis in young chickens. AB - The effects of concurrent cage contamination with Salmonella typhimurium and Eimeria tenella on the establishment of salmonella infection in day-old chickens were investigated. Chickens were divided into five groups: uninfected recipient birds placed in a cage contaminated by donor birds infected with E. tenella and S. typhimurium; E. tenella-infected recipients placed in a cage contaminated by S. typhimurium-infected donors; uninfected recipients placed in a cage contaminated by S. typhimurium-infected donors; E. tenella-infected recipients placed in a cage contaminated by uninfected donors; and uninfected recipients placed in a cage contaminated by uninfected donors. Three identical trials were conducted. Recipient birds were necropsied 4, 7, and 11 days after caging. In the cage where donor birds infected with both organisms had been reared, S. typhimurium counts in feces and number of feces positive for S. typhimurium were significantly (P less than 0.05) greater than those in the other cages on days 0, 4, and 7 after caging. Moreover, in this cage, more chicks died, counts of S. typhimurium in cecal contents were greater, and more birds were positive for S. typhimurium than in the other groups. This suggests that S. typhimurium infection in day-old chickens is enhanced in cages contaminated with E. tenella and S. typhimurium compared with infection in cages contaminated with S. typhimurium alone. PMID- 3524545 TI - Clearance of bacteria in turkeys with Bordetella avium-induced tracheitis. AB - Quantitative clearance of aerosolized Escherichia coli from the trachea, lung, and air sacs was measured in turkeys infected with Bordetella avium. Clearance of E. coli in turkeys with B. avium-induced tracheitis was minimally affected early in infection. Sixteen to 23 days after infection with B. avium, sporadic, mild depressions in clearance of E. coli were observed in the tracheas, which had large areas of deciliated tracheal epithelium or replacement of normal epithelium by immature hyperplastic epithelium or metaplastic squamous epithelium. Clearance of E. coli from the lung and air sacs was minimally affected in turkeys infected with B. avium. PMID- 3524546 TI - Gestational diabetes--infant malformations and subsequent maternal glucose tolerance. AB - The frequency of abnormal glucose tolerance in the first 12 months after gestational diabetes was found to be 33.3%, which is much higher than previously accepted. Women with gestational diabetes (Group 1 = 54 requiring insulin, Group 2 = 32 treated with diet alone) attending a metropolitan teaching hospital over a 3 1/2 year period were followed-up after delivery to determine their subsequent glucose tolerance. Of 86 seen 3 months after delivery, 2 had developed insulin dependent diabetes mellitus (IDDM) and 2 noninsulin dependent diabetes mellitus (NIDDM), diagnosed by glucose tolerance testing. Another 38 returned for follow up glucose tolerance testing at 12 months; of these 3 had impaired glucose tolerance (IGT), 7 had NIDDM, and one who had had NIDDM at 3 months now showed IGT after 9 months dietary treatment. Thus, 12 months after delivery, the cumulative prevalence of abnormal glucose tolerance was 14/42 (33.3%), 10 of the 42 being frankly diabetic (26%). Of the remaining 44 patients, 21 have not yet reached 12 months or were pregnant again, and 23 did not attend for glucose tolerance testing. Although the trend was for gestational diabetes mellitus (GDM) to recur earlier and more severely in subsequent pregnancies, in 3 instances the diabetes did not recur. Major congenital malformations occurred in 4 of the 86 babies (4.7%); minor malformations were found in a further 13 (15%) with no difference in frequency between Group 1 and Group 2. PMID- 3524547 TI - Gestational diabetes. PMID- 3524548 TI - Intravenous labetalol and intravenous diazoxide in severe hypertension complicating pregnancy. AB - The results of a prospective trial to evaluate the use of diazoxide and labetalol given intravenously in the management of severe hypertensive disease in pregnancy are presented. Both drugs had an efficient hypotensive action. The reduction in blood pressure in the labetalol group was better controlled and this may be a factor influencing perinatal outcome. Because of the freedom of maternal and fetal side-effects, labetalol given by intravenous infusion is a more appropriate drug for use in the management of hypertensive crises occurring in pregnancy and labour. PMID- 3524549 TI - Preparation for induction of labour of the unfavourable cervix with Foley catheter compared with vaginal prostaglandin. AB - Ripening of the unfavourable cervix prior to induction of labour using traction on a Foley catheter (32 patients) was compared with 40 mg of prostaglandin F2 alpha in Tylose gel applied to the external cervical os and held in place for 12 hours with a vaginal diaphragm (25 patients). Each patient in the above groups had a modified Bishop score of 0-3 and was randomly allocated to one or other group. Comparison was made with a further 25 patients in whom the cervical score was 4-6. Timing of amniotomy and commencement of Syntocinon infusion were equivalent for all patients. Prostaglandins conferred no advantage over Foley catheter in terms of amniotomy-delivery interval, operative delivery rate, and condition of the baby one minute after birth. The disadvantages of prostaglandins for cervical ripening are a longer preparation-delivery interval, and cost ($77 versus $4.75 for the Foley catheter). Currently, prostaglandins are not officially approved for use in Australia for induction of labour. It is suggested, therefore, that the Foley catheter is preferable for ripening the unfavourable cervix as a prelude to amniotomy. PMID- 3524550 TI - Preoperative cervical dilatation: a trial of laminaria tents and prostaglandin F2 alpha gel. AB - Surgical damage to the cervix in patients undergoing termination of pregnancy may be responsible for serious complications in subsequent pregnancies. Sixty nulliparous women undergoing first trimester termination of pregnancy were randomly allocated to 3 treatment groups, one using laminaria tents preoperatively, one using intracervical PGF2 alpha gel preoperatively and one using no pretreatment. Results showed clear benefits in the laminaria group, in terms of achieving preoperative cervical dilatation and ease of further operative dilatation. Laminaria tents were superior to PGF2 alpha gel which was, in turn, superior to no pretreatment. There were no differences in blood loss or postoperative complications among the 3 groups. Laminaria tents provide a cheap, effective and safe method of reducing the risk of cervical damage in women undergoing surgical termination of pregnancy. PMID- 3524551 TI - Timing of ovulation by determination of the urinary luteinizing hormone surge with an enzyme-linked monoclonal antibody dipstick (OvuStick). AB - An enzyme-linked double monoclonal antibody dipstick for measuring luteinizing hormone in urine was tested for timing ovulation in thrice daily urine samples collected for several days around mid-cycle in 24 women undergoing artificial insemination. The assay produced information comparable to single daily serum LH measurements. The dipsticks could be used by untrained people to test their own urine as an aid to the detection of ovulation for the timing of artificial insemination or of sexual intercourse to promote or avoid conception. PMID- 3524553 TI - Does telephone counselling have preventive value? AB - Major developments in health care frequently result not from careful planning by professional health care providers, but from social processes whereby a heightened awareness of need leads to new strategies and resources for community support. The development of a network of hospitals in eighteenth-century England was 'the outcome of individual initiative and of coordinated voluntary effort and subscription'. The evolution of mental health care in the United States was influenced greatly by the enthusiasm and advocacy of reformers such as Dorothea Dix and Clifford Beers. The development of telephone counselling services, now an integral part of community mental health care, resulted from a recognition that the psychosocial stresses of twentieth-century life could perhaps be alleviated through support offered by telephone. This recognition has led to the mobilising of many thousands of volunteers who serve in hundreds of telephone counselling services worldwide. For telephone counselling as for many other new developments, the initial period of growth has been followed by one of reflection and evaluation. That telephone counselling services have earned a place in the community mental health network and are here to stay is beyond doubt, though the ways in which they can be used to greatest advantage are still being clarified. At the level of primary prevention there is as yet no convincing evidence that telephone counselling services have reduced the incidence of psychological disorder. It must be added, however, that mental health professionals have also had relatively little success in reducing the occurrence of psychological disorder, and only with carefully designed programs directed toward specific at risk groups. The evidence is more encouraging at the level of secondary prevention.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3524552 TI - Cognitive deficit in the depressed elderly: a review of some basic unresolved issues. AB - Research relating to three interrelated issues concerning cognitive deficit in the depressed elderly is reviewed. The issues are: the role of ageing in cognitive deficit associated with depression; whether the cognitive deficit is intrinsic to depression in the elderly or a secondary motivational effect; and the possibility of qualitative differences between the cognitive deficits seen in the depressed elderly and in senile dementia. Despite their fundamental importance, only the most tentative conclusions can be drawn with respect to any of these issues because researchers have either failed to recognise them or failed to appreciate the methodological problems involved in researching them. PMID- 3524554 TI - Squibb academic lecture: Shakespeare and DSM-III. AB - Modern literary criticism generally rejects the idea of off-stage lives for Shakespeare's characters. All we have is behaviour--the visible behaviour of 'Shakespeare's talking animals'. But a review of that behaviour in the light of DSM-III suggests a high degree of clinical accuracy in some of it. The depictions of Ophelia, Lear and Caius Martius Coriolanus supply examples. PMID- 3524555 TI - D. H. Lawrence and self-psychology. AB - The work and life of D. H. Lawrence is examined as an example of Kohut's notion of the anticipatory function of art and as providing a rich source of material for examination of the respective importance in personality development of Oedipal conflict and the pre-Oedipal establishment of a sense of self. The importance of self-psychology as an expansion of psychoanalysis is noted and some of the ways Lawrence anticipated this development are described. It is also suggested that Lawrence provides convincing confirmation of a self-psychology view of creative drive, and a thesis is briefly expounded that in his major novels he was pursuing his own self-healing. PMID- 3524556 TI - A device for unobtrusive surveillance of home relaxation practice. PMID- 3524557 TI - Myogenic lineages and myofibrillogenesis. PMID- 3524558 TI - Muscle regeneration: fetal myogenesis in a new setting. PMID- 3524559 TI - Different immunofluorescence staining patterns of the thin filament revealed by use of three monoclonal antibodies specific to actin. PMID- 3524560 TI - Biochemical markers in rats: linkage relationships of aconitase (Acon-1), aldehyde dehydrogenases (Ahd-2 and Ahd-c), alkaline phosphatase (Akp-1), and hydroxyacid oxidase (Hao-1). AB - We have examined the linkage relationships between five biochemical markers, Acon 1, Ahd-2, Ahd-c, Akp-1, and Hao-1, and 19 other genetic loci in five breeding combinations. The genetic locus that codes for a recently described aldehyde dehydrogenase in the liver (Ahd-c) has been assigned to linkage group X (LG X). Hydroxyacid oxidase is coded for by a locus (Hao-1) that is linked to genes that encode agouti coat color and seminal vesicle proteins in linkage group IV. Alkaline phosphatase (Akp-1) was linked to the locus that encodes the C6 component of complement and this association provisionally defines a new linkage group (LG XI) in the rat. The locus Acon-1 could not be positively assigned to a specific linkage group but the results from one breeding combination suggest that this locus may be included in linkage group II. No linkage relationship could be detected for the aldehyde dehydrogenase coded for by Ahd-2. PMID- 3524561 TI - Human hepatocytes metabolizing ethanol generate a non-polar chemotactic factor for human neutrophils. AB - When human hepatocytes were incubated with low concentrations of ethanol they general chemotactic activity for human neutrophils. Generation of chemotactic activity was dependent upon duration of incubation and concentration of ethanol used. Production of chemotactic activity by ethanol-treated hepatocytes was inhibited completely in the presence of the alcohol dehydrogenase inhibitor 4 methylpyrazole. PMN isolated from rats, in contrast, do not respond chemotactically to the factor released by homologous cells. Preliminary studies indicated that the chemotactic factor is non-polar in nature (perhaps related to leukotriene B4). These results indicate that human hepatocytes, when exposed to ethanol, generate chemotactic factor(s) for human PMN. The occurrence of this phenomenon may explain, in part, the PMN infiltrates observed in human liver during the course of acute alcoholic hepatitis. PMID- 3524562 TI - A bacterial-induced lectin which triggers hemocyte coagulation in Manduca sexta. AB - An inducible hemagglutinin termed M13, was purified from M. sexta hemolymph. M13 is a glucose-specific lectin which in addition to erythrocyte agglutination, can activate dedifferentiation of various hemocytes into a filamentous coagulation network. When lectin activity was inhibited with glucose or antiserum, neither erythrocyte agglutination or hemocyte coagulation occurred. When M13 was boiled or trypsin treated, hemocyte activation was lost, but erythrocyte agglutination remained. Hence M13 activity appears to be bimodal, possessing both a lectin activity and a hemocyte-coagulating activity. PMID- 3524563 TI - Altered distribution of protein kinase C in dystrophic muscle cells and its modulation by liposome-delivered phospholipids. AB - The activity and subcellular distribution of the calcium-phospholipid dependent protein kinase (protein kinase C) were studied in normal and dystrophic muscle cells in vitro. Clonal strains of satellite cells, isolated from normal and dystrophic (C57BL/6J/dydy) mice, differentiate in vitro at a comparable level (over 80% of fusion). Differentiated myotubes were homogenized and separated into a soluble and a particulate fraction. The activity of protein kinase C was assayed in both fractions, and was found to be mainly in the cytosol of normal cells, whereas it was mainly associated to the membrane fraction of dystrophic cells. This altered distribution of the enzyme was likely consequent to alterations in the phospholipid composition of the dystrophic cell membrane, since it was possible to partially revert the situation by modifying the membranes with liposome-delivered phospholipids. Splenic lymphocytes from dystrophic mice showed an altered distribution of protein kinase C similar to that observed in muscle cells. The possible biochemical basis and the functional consequences of this altered distribution of the enzyme in the dystrophic cells are discussed. PMID- 3524564 TI - Characterization of monoclonal antibodies directed against pyruvate oxidase from Escherichia coli: modulation of antibody-induced inhibition by enzyme conformation. AB - Monoclonal antibodies have been prepared against pyruvate oxidase, a flavoprotein dehydrogenase isolated from Escherichia coli. Six monoclonals were obtained, but only one was found to bind to the native form of the enzyme. This monoclonal, 1I1, was a potent inhibitor. Although this antibody inhibited the unactivated and lipid-activated forms of the enzyme, it had much less of an inhibitory effect on the protease-activated form of the enzyme, although the antibody still bound to this form. Hence, the coupling between antibody binding and the conformation at the active site can itself be modulated by the conformation of the protein. PMID- 3524565 TI - Localization of insulin degradation products to an intracellular site in isolated rat hepatocytes. AB - In the present study, we have examined whether insulin degradation products are present on the surface of isolated rat hepatocytes and can be removed by an acid dissociation technique. Hepatocytes were incubated with [125I]insulin for 30 minutes, rapidly washed to remove unbound insulin, and then briefly exposed to acidic conditions (pH 5.0) to remove bound hormone from the cell surface. The radioactive material removed from the cell by acid dissociation and that remaining with the cells were separately analyzed by high performance liquid chromatography. The two primary degradation products of insulin present in control cell extracts were found only with the cell-associated material after acid dissociation. The insulin-sized radioactive material in the extract of acid dissociable material consisted of only intact [125I]insulin. These results show that the two primary degradation products of insulin in rat hepatocytes are found only intracellularly and suggest that the degradation of the hormone begins after it is internalized. PMID- 3524566 TI - Purification of cytoplasmic precursors of yeast mitochondrial phenylalanyl-tRNA synthetase subunits. AB - Two polypeptidic precursors of yeast mitochondrial phenylalanyl-tRNA synthetase subunits were purified from the cytoplasm by immunoprecipitation with an insolubilized glutaraldehyde-treated IgG fraction, followed by two chromatographies on Sephadex G-200 and on DEAE-cellulose. Methionine was found as the N-terminal residue in both precursors, which exhibited N-terminal extensions. PMID- 3524567 TI - Expression of type X collagen mRNA levels in embryonic chick sternum during development. AB - Embryonic chick sternum cartilage exhibits profound spatial and temporal changes in Type X collagen biosynthesis during development. Production of this collagen is confined to the presumptive calcification region and its expression is not acquired until stage 43. To examine the mechanisms responsible for regulation of developmental changes in biosynthetic expression of Type X collagen, we determined the levels of translatable Type X procollagen mRNA employing a cell free translation system. We found that mRNA capable of directing Type X collagen synthesis was present exclusively in cartilage destined to undergo calcification and that its levels were nearly equivalent at all stages of development. These findings suggest that expression of Type X collagen in embryonic chick sternum is determined at the translational level. PMID- 3524568 TI - C-ras expression decreases during in vitro senescence in human fibroblasts. AB - Expression of the c-ras oncogene was determined in growing early and late passage human (IMR-90) fibroblasts using northern blot analysis of total cellular RNA. It was found that late passage cells demonstrated lower levels of c-ras by about four fold when compared to levels found in early passage cells. Southern blot analysis of genomic DNA from early and late passage fibroblasts digested with either SacI or BamHI showed somewhat increased hybridization levels in early passage cells compared to late passage cells. Data is discussed in relation to a previous report of c-ras expression and gene amplification. PMID- 3524569 TI - Catalytic function of a tyrosyl residue in tryptophanase. AB - Tryptophanase has an essential tyrosyl residue/active site which can be modified by tetranitromethane. Pyridoxal 5'-phosphate can prevent this modification efficiently, whereas pyridoxal 5'-phosphate N-oxide cannot, indicating that the free pyridinium N is required for the interaction of the coenzyme with the tyrosyl residue, probably via a hydrogen bond. The weakened binding of the coenzyme to the modified enzyme was confirmed on gel filtration, the modified enzyme being dissociated from the coenzyme seven-fold faster than the native enzyme. Furthermore, absorption spectral analyses demonstrated that the modified enzyme can catalyze the transaldimination step, but fails to abstract the alpha-H of substrates. The tyrosyl residue, therefore, not only participates in coenzyme binding, but also contributes to alpha-H labilization. PMID- 3524570 TI - Molecular nature of human epidermal growth factor (hEGF)-like immunoreactivity in human plasma. AB - To investigate the molecular features of hEGF in the circulatory system, we analyzed hEGF-like immunoreactivity (hEGF-LI) in human serum and plasma by our two-site enzyme immunoassay (EIA), using an aliquot of each fraction obtained by gel filtration of human serum or plasma on Sephadex G-100. The results demonstrated that the majority of the hEGF-LI in the plasma (HMW X hEGF-LI) emerged in the void volume, while a small amount of hEGF-LI (LMW X hEGF-LI) eluted at a position similar with that of standard hEGF. After reduction of HMW X hEGF-LI with 2-mercaptoethanol, hEGF-LI emerged at the same elution position as that of standard hEGF, suggesting that the predominant form of hEGF may circulate as a complex with some macromolecule(s) in human blood. The biochemical properties of the plasma component(s) with high molecular weight which form the complex with hEGF and the physiological significance of this circulating complex still remain to be clarified. PMID- 3524571 TI - Glycerolipid metabolism in lung from ventilated and unventilated rabbits. AB - The incorporation of [14C]-glycerol 3-phosphate and [3H]-palmitate into phosphatidic acid, phosphatidylcholine, phosphatidylethanolamine and triacylglycerols by lung microsomes from ventilated and unventilated rabbits was measured. Unventilated lung microsomes showed an impairment of the "de novo" synthesis of phosphatidic acid and, therefore, a general decrease of glycerolipids synthesized from glycerol 3-phosphate. The incorporation of [3H] palmitate into phosphatidic acid was considerably lower than the incorporation of [14C]-glycerol 3-phosphate by lung microsomes from both ventilated and unventilated rabbits, and the 3H/14C molar ratio did not change during incubation time. These observations suggest the preferential utilization of endogenous fatty acids by acyltransferases involved in the formation of phosphatidic acid. The activities of the enzymes implicated in the synthesis of phosphatidylcholine from lysophosphatidylcholine remained unchanged in lung from both ventilated and unventilated rabbits. PMID- 3524572 TI - Regulation of fructose-2,6-bisphosphate and glycogen synthesis by dichloroacetate and phenazine methosulphate in rat adipose tissue. AB - The effects of dichloroacetate and phenazine methosulphate on the content of fructose-2,6-bisphosphate and glycogenesis in incubated epididymal adipose tissue were examined. Both agents stimulated the synthesis of fructose-2,6-bisphosphate in the presence of glucose, the effect being higher in tissue from fasted-refed rats than in normal fed rats. Additions of dichloroacetate to the incubation medium also increased the incorporation of [U-14C]glucose into glycogen and this effect was additive with that of insulin. However phenazine methosulphate strongly depressed the insulin-dependent glycogen synthesis. These data are considered in relation to the increased rate of glucose metabolism known to occur in the presence of dichloroacetate and the stimulation of pentose phosphate pathway with phenazine methosulphate. PMID- 3524573 TI - Characterization of the sulfonylurea-induced potentiation of the insulin response in cultured 3T3 adipocytes. AB - Studies were carried out to determine the role of sulfonylureas in the regulation of insulin-sensitive hexose uptake in cultured 3T3 adipocytes. Exposure (0-72 hr) of cells to the sulfonylurea-derivative tolbutamide (0.05-0.3 mg/ml) induced a time- and concentration-dependent potentiation of the stimulatory effect of insulin on hexose uptake (500 vs 340%). The effect was maximal within 24 hr and completely reversible. It was strictly limited to the presence of insulin. Basal hexose uptake and insulin binding were not affected by the drug. High concentrations of the agent (greater than 0.3 mg/ml) induced a decrease in insulin response, suggesting a concentration optimum. Lineweaver-Burk analysis of uptake data revealed that the potentiating effect of tolbutamide was due to enhancement of the insulin-induced increase in apparent Vmax, i.e. in the number or activity of hexose transporters. This enhancement was inhibited by cycloheximide (1 microgram/ml), indicating involvement of protein synthesis in the induction of the effect. It is concluded that sulfonylureas act by influencing synthesis of protein(s) which potentiate the effect of insulin on hexose uptake. PMID- 3524574 TI - Effects of alloxan on S-adenosylmethionine metabolism in the rat liver. PMID- 3524575 TI - Inhibition of the mutagenicity and metabolism of 6-methyl-benzo[a]pyrene and 6 hydroxymethyl-benzo[a]pyrene. AB - Previously reported inhibitors of benzo[a]pyrene (BaP) mutagenicity in Salmonella typhimurium strain TA98 were tested for their effectiveness against the mutagenicity of 6-methyl-benzo[a]pyrene (6-CH3-BaP), 6-hydroxymethyl benzo[a]pyrene (6-CH2OH-BaP) and 6-acetoxymethyl-benzo[a]pyrene (6-CH3COOCH2 BaP). Dose-response curves obtained for phenothiazine (PTH), 2 chlorophenothiazine (2Cl-PTH), phenylisothiocyanate (PHN), phenethylisothiocyanate (PNE), trans-retinol (TR) and disulfiram (TETD) showed a variety of degrees of inhibition of mutagenicity. Additionally, glutathione (GSH) was found to inhibit the mutagenicity of 6-CH3COOCH2-BaP, and the mutagenicity of 6-CH2OH-BaP was enhanced by the addition of supplemental ATP, Na2SO4 and EDTA. Only 2Cl-PTH was equally as good an inhibitor of 6-CH3-BaP and BaP, reducing revertant colonies to less than 50% of control at 10 X BaP concentration. To probe the mechanism of inhibition, the effect of 2Cl-PTH on the binding of BaP and the 6-substituted benzo[a]pyrenes to cytochrome P-450 was investigated by difference spectroscopy. Also, the effect of 2Cl-PTH on the subsequent metabolism of 6-CH3-BaP and 6-CH2OH-BaP was investigated by rapid scan difference spectroscopy and high-performance liquid chromatographic separation of products. The results are consistent with a major mechanism of inhibition for 2Cl-PTH involving a competition for the cytochrome P-450 binding site. PMID- 3524576 TI - Digestion of the host erythrocyte by malaria parasites is the primary target for quinoline-containing antimalarials. AB - Intraerythrocytic malaria parasites feed on their host cell cytosol. We show that human red blood cells infected with the malaria parasite Plasmodium falciparum, produce free amino acids the composition of which resembles that of globin, the most abundant red blood cell protein. The rate of amino acid production is almost equal to the rate of efflux of these acids from the infected cell. Production of amino acids increases with parasite age: the rates of production at the young ring and the mature trophozoite stages were 3.3 and 13.5 nmol/10(8) infected cells per min at 37 degrees, respectively, compared with 0.04 nmol/10(8) cells per min in uninfected cells. The quinoline-containing antimalarial drugs, chloroquine, quinine and mefloquine, inhibit amino acid production at the same concentrations at which they inhibit parasite growth, but have no effect on the endogenous parasite protein degradation. We suggest that parasite feeding on host cell cytosol is the primary target for the antimalarial action of these drugs. Chloroquine accumulation, the rate of amino acid production by infected cells and the inhibitory effect of the drug, were determined simultaneously at the different stages of parasite development. At all stages the rate of amino acid production and chloroquine accumulation were directly related and both were inversely related to the inhibitory efficiency of the drug. The lysosomotropic agents methylamine and NH4Cl at millimolar concentrations also inhibit amino acid production, suggesting that the process is pH dependent and localized in the vacuole. Host cytosol degradation and drug accumulation both take place in the parasite food vacuole. Our observations imply that the metabolically dependent acidification of this parasite organelle is involved in both processes. PMID- 3524577 TI - Production of drugs by microbial biosynthesis and biotransformation. Possibilities, limits and future developments (2nd communication). PMID- 3524578 TI - ASHA interviews: Perspectives on licensure. PMID- 3524579 TI - Harm to the public: is it real? PMID- 3524580 TI - Licensure in speech-language pathology and audiology. The questions/the answers. PMID- 3524581 TI - Characteristics of state licensure laws. PMID- 3524582 TI - Licensure activity in unlicensed states. PMID- 3524583 TI - Professional liability in speech-language pathology and audiology. PMID- 3524584 TI - Professional services programs accredited by the Professional Services Board and those in the accreditation process May 1, 1986. PMID- 3524585 TI - More than a billion in earnings. PMID- 3524586 TI - The effects of mevinolin and neomycin alone and in combination on plasma lipid and lipoprotein concentrations in type II hyperlipoproteinemia. AB - The reduction of elevated low density lipoprotein (LDL) cholesterol concentrations in patients with Type II hyperlipoproteinemia leads to improved cardiovascular morbidity and mortality. Two agents which may be of value in treating hypercholesterolemia are mevinolin and neomycin. Since these drugs lower cholesterol levels through complementary mechanisms, we evaluated the effects of mevinolin and combined mevinolin-neomycin treatment on plasma lipoprotein concentrations in 21 type II hyperlipoproteinemic patients. Mevinolin reduced total and LDL cholesterol concentrations by 24% and 31% respectively (P less than 0.001) and 81% of the patients reduced their LDL cholesterol levels to less than 200 mg/dl. Although the addition of neomycin to mevinolin treatment further lowered total (5%) and LDL (4%) cholesterol concentrations, it also reduced HDL cholesterol levels (19%) (P less than 0.05). Therefore mevinolin normalizes the plasma lipid concentrations in patients with type II hyperlipoproteinemia and combined mevinolin and neomycin treatment offers no advantage over mevinolin-only therapy. In addition, these findings emphasize the importance of determining the HDL cholesterol level to fully evaluate the effects of hypolipidemic therapy. PMID- 3524587 TI - Immunoelectron-microscopic localization of the terminal C5b-9 complement complex in human atherosclerotic fibrous plaque. AB - The assembly of the terminal C5b-9 complement complex is a prime mechanism of complement-induced membrane damage followed by inflammatory response mediation and subsequent extensive tissue damage. In the assembly process the terminal complement components expose neoantigenic determinants which can be recognized by specific antibodies. Using such a specific antibody, affinity-purified rabbit IgG and by means of immunoelectron microscopy, the C5b-9 neoantigens were localized on the structures of the human fibrous plaque from 3 iliac and 3 femoral arteries obtained at surgery. The immunoelectron-dense deposits were localized on the cell debris, enmeshed in the connective tissue matrix, consisting of irregular particles that frequently had the shape and size of intracellular organelles or vesicles with concentric osmiophilic lamellae. No deposits could be found on the intact cells, on the connective tissue matrix or on cholesterol and lipid deposits. The presence of C5b-9 neoantigens deposits in the fibrous plaques frequently associated with other immune-related proteins indicates that complement activation has occurred in situ and could be related to the chronic progression of the atherosclerotic lesion. PMID- 3524588 TI - The fibrinolytic system and coagulation during bezafibrate treatment of hypertriglyceridemia. AB - Bezafibrate was given to 23 hypertriglyceridemic but otherwise healthy middle aged men in a double-blind, cross-over study to evaluate its effect on the components of the fibrinolytic system as well as on ATIII, FVIIIR: Ag, FVIII: C and platelet aggregation. Fibrinogen dropped markedly (P less than 0.05) and there was a small but significant fall of ATIII. The second wave of platelet aggregation was found much less frequently than in controls (P less than 0.001). Bezafibrate seemed to decrease the rate of formation of the first wave platelet aggregation. PMID- 3524589 TI - Sex steroid receptors in normal and malignant endometrium. AB - Estradiol and progesterone receptor concentrations have been measured and their hormonal regulation extensively studied in normal human endometrium. However, in endometrial cancer, the biochemical assays presently used face the complex problem of tumor and tissue heterogeneity. This problem may be circumvented by immunocytochemistry on tissue sections proven to be histologically malignant. The in vivo experimental model developed in our laboratory is an ideal source of tissue necessary for purification of the progesterone receptor and antibody production. Hopefully, the physiology of the receptor may be studied under ideal conditions in this experimental system. PMID- 3524590 TI - Intracellular localization of steroid hormone receptors. A challenging problem. Autoradiographic and biochemical study. AB - The classical model for the mechanism of action of steroids holds that unbound receptors for steroids reside exclusively in the cytoplasmic compartment and that they undergo translocation to the nucleus when bound to steroids in a process which is temperature sensitive. In the present study we looked at the localization of the estradiol receptor using autoradiography and biochemical procedure. Uteri from ovariectomized and/or ovariectomized-adrenalectomized rats, as well as several cell lines (with estrogen receptor (ER+) were incubated with [3H]-estradiol or [3H]-R2858 (methoxy-17-ethinylestradiol) for 5 min to 2 h at different concentrations of ligands (0.1-10 nM) at 4 degrees C. When the tissue or cells were processed for autoradiography the localization of steroid was nuclear and cytoplasmic. In contrast when the tissue or cells were processed using the usual biochemical procedures, all binding activity appeared in the cytosolic fraction. In addition, when concentrated preparations of homogenized uteri as well as several nuclear preparations from cell lines were made, free receptor could be demonstrated in the crude nuclear preparations. In the present study, data are presented which suggest that there are unbound receptors for estrogen in nuclei of the smooth muscle cells of myometrium as well as in nuclei of the several cell lines (ER+). We propose a new model for the distribution of estrogen receptors in which unbound receptors are in equilibrium, partitioned between nucleus and cytoplasm according to the free water content of these intracellular compartments. PMID- 3524591 TI - [Spontaneous bone marrow micrometastasis of a cerebral glioma. Immunohistochemical diagnosis in a biopsy sample and review of the literature]. AB - A 55 year-old woman was admitted to hospital in January 1981 with transient expressive dysphasia. Past personal history was unremarkable except for a six month history of renal colic and thrombophlebitis in the veins of the right leg. Computed tomographic scan of the head and carotid angiogram revealed a left calcified temporoparietal tumor. Because of pulmonary embolism it was decided to refute a cerebral biopsy. The patient also declined radiotherapy. In May 1983, a thorough workup revealed an incomplete fracture of the first lumbar vertebra and a diffuse demineralization of the rachis and pelvis. Four weeks later she developed temporal epilepsy and pulmonary embolism. A whole brain irradiation (60 Gy) was performed in August 1983. The patient's condition remained clinically stable until December 1984 when she was readmitted to hospital with a severe weight loss, diffuse osseous pain and pancytopenia. A bone marrow biopsy from the iliac crest showed a diffuse tumor involvement. Peroxidase-antiperoxidase staining using monoclonal antiserum to glial fibrillary acidic protein was strongly positive in numerous tumors cells. The pathological diagnosis was bone marrow metastasis by glioma. She died in March 1985, 4 years and 3 months after the first admission to hospital. Autopsy was not performed. A literature search reveals only 9 cases of extraneural spreading of astrocytomas and glioblastomas in the absence of previous craniotomy with post-mortem examination. The authors also comment on the clinical, pathological and histogenic aspects of extraneural metastasis of gliomas. PMID- 3524592 TI - [Breast carcinoma with giant cell stromal reaction. First male case]. AB - We report here the first case, to our knowledge, of mammary carcinoma with giant cell stromal reaction occurring in a man. Review of literature allows to consider this carcinoma as a distinctive morphological entity. Ultrastructural cytochemical and immunohistochemical studies show that giant cells also present in metastases are non tumorous cells coming from mononuclear phagocytes cells system. This entity is peculiar by presence of inusually high titers of receptors to progesterone. Clinical evolution is still not well known. PMID- 3524593 TI - [Histological changes in the lymph nodes during immune stimulation reactions]. AB - The stimulation of the cellular and humoral immune reactions is described, as well as the different cellular types implicated (B and T lymphocytes, their subsets and derived cells, and mononuclear cells of the phagocytic system). The classification of these various cells, using immunolabeling the "back-up" cells and the so-called immune-accessory cells (dendritic and interdigital reticular cells) is also shown. The aspects of lymphatic circulation and intralymphatic blood circulation are then discussed. Findly, the various elementary modifications which appear during these immune reactions are studied: some result from the action of the humoral immunity (follicular hyperplasia, immunoblastic hyperplasia and plasmocytosis), and others from the stimulation of cellular immunity (hyperplasia of the deep cortex). These modifications may be variably associated with plasmacytoid cell hyperplasia, various sinusal reactions (chronic catarrh, macrophagic histiocytosis - some-times erythrophagocytic, and B lymphocytosis), and histiocytic, epithelioid, tuberculoid or abscessed granulomatous reactions. the diagnosis and classification of these elementary lesions allow the definition of the histopathological type, thus permitting the orientation towards a certain etiology. PMID- 3524595 TI - Influence smoking cessation with computer-assisted instruction. PMID- 3524594 TI - [Immunocytochemistry of steroid hormone receptors. New aspects of cellular and endocrine physiology]. AB - Recent immunohistochemical data challenge the concept of nuclear translocation of steroid hormone-receptor complexes proposed initially by Jensen et al. and Gorski et al. The detection of estrogen and progesterone receptors exclusively in the nucleus of target cells is at variance with the presence of the free receptor in the cytoplasm. In this review, we discuss how our concept of the mechanism of action of steroid hormone ought to be revised in the light of the new data. PMID- 3524596 TI - Methylprednisolone treatment in aplastic anaemia. AB - Twenty patients with aplastic anaemia were treated with a short term bolus of methylprednisolone. Seven patients were refractory to anabolic steroids and were observed in very long follow-up periods of 14-104 months. Thirteen patients had never been treated. The latter group also received anabolic steroids. Five out of 20 patients responded to the treatment while the remaining patients did not or died. Responders among patients refractory to anabolic steroids had shorter duration of disease compared to non-responders. No recurrence of aplasia was observed in all responders. PMID- 3524597 TI - Stone age nutrition: implications for today. PMID- 3524598 TI - Colorectal adenomas: identification and management. PMID- 3524599 TI - Plasma catecholamines in the acute phase of the response to myocardial infarction. AB - Plasma catecholamine (adrenaline, noradrenaline and dopamine) concentrations have been measured in 48 patients within 6 hours of the onset of symptoms of an acute myocardial infarction. The concentrations of all three catecholamines were elevated, and there were positive correlations between plasma noradrenaline concentrations and the severity of infarct as assessed by the coronary prognostic index and serum LDH levels. Plasma glucose, free fatty acid, lactate and cortisol levels were elevated while insulin levels were reduced. The site of infarction did not influence the pattern of hormonal and metabolic responses although heart rate was significantly lower in the inferior than in the anterior infarct group. Seven patients went into ventricular fibrillation shortly (less than 1.8 h) after blood sampling. Plasma catecholamine concentrations were markedly elevated in these patients with levels similar to those previously reported after cardiac arrest. PMID- 3524600 TI - Toward an open architecture for morphometric computing. AB - Prototype biomedical computing and graphics systems developed since the early 1970s for computer microscopy, architectonic or morphometric analysis and visual display have been marked by the highly local character of their designs. Such approaches, while often heroic and unusually creative in character, have limited the exportability of hardware or software products to the larger biomedical community. A general systems orientation, based on a shared, "open" architecture of hardware and software, with known and published standards, is proposed. The incremental nature and funding character of such a system is also discussed. PMID- 3524601 TI - Cellular logic implementation on a generalized image processor applied to biomedical image processing. AB - The implementation on a generalized image processor of a cellular logic package that performs non-recursive cellular-logic operations (CLOs) in real time is described. This system takes advantage of up to 20 512 X 512 X 8-bit memory planes within the image processor and can manipulate cells with up to 256 symbolic states. The flexibility of the image processor allows the use of an expanded cellular transition set, beyond bit-on or bit-off, as well as application-specific neighborhood configurations. The use of concurrent data dependent global calculations, including CLO iteration termination control, is described. The array processor implementation specifics are discussed. This general cellular logic package is applied to biomedical images in the Image Processing Laboratory, Department of Radiological Sciences, University of California at Los Angeles. Geometric information is acquired from the images using real-time operators on the image array processor. This information includes image segmentation, area calculation, object counting, centroid determination and shape analysis. Initial clinical results are presented, and possible future medical applications are discussed. PMID- 3524602 TI - [Derivatives of arachidonic acid. II. Medical perspectives]. PMID- 3524603 TI - Impairments in route negotiation through a maze after dorsolateral frontal, inferior parietal or premotor lesions in cynomolgus monkeys. AB - Ten cynomolgus monkeys were trained to follow a fixed route through a whole-body maze consisting of 3 X 3 matrix of 9 compartments, all with interconnecting doors. Two monkeys learned to use proprioceptive guidance such that they tended to produce the same sequence of movements even if they entered the maze by a different door. They were not impaired by bilateral lesions to inferior parietal cortex (Area 7a/PG). The rest used non-proprioceptive guidance relying on external cues in the environment, probably outside the maze. These were impaired by bilateral lesions of either dorsolateral frontal or posterior parietal cortex. At least 3 different strategies may be used for route negotiation. Postoperative comparisons of the frontal and parietal groups on the effects of rearranging the external cues and on learning a new route through the maze suggested that the groups were differentially impaired in the use of different strategies. In a subsequent study, bilateral lesions to premotor cortex (Area 6) resulted in an impaired ability to follow a route using either proprioceptive or external cues. PMID- 3524604 TI - Midbrain lesions, dopamine and male sexual behavior. AB - Destruction of the medial preoptic area (MPOA) eliminates mating in male rats and this region is believed to play a major role in the control of male sexual behavior. Efferents from the MPOA pass through and/or terminate in 4 midbrain regions: the dorsolateral tegmentum (DLT), the central gray, and the A9 and A10 areas. The present study reports the effects of bilateral destruction of each of these midbrain regions on brain catecholamines and sexual behavior in male rats. DLT lesions eliminated mating, reproducing the effect of bilateral preoptic lesions. The sexual activity of males with central gray lesions was accelerated in the sense that the mounting rate for these males was significantly faster than for controls and lesioned males ejaculated more frequently and with shorter latencies than did controls. A9 lesions impaired mating--lesioned males mounted at a slower rate and ejaculated less frequently than controls. Males with A10 lesions took longer to re-initiate mating after an ejaculation than controls, but copulation per se (as reflected in mount rate, ejaculation frequency and latency to ejaculate) was not affected by A10 damage. Brain catecholamine levels were not affected by either DLT or central gray lesions. A9 lesions produced a significant depletion in neostriatal dopamine which was highly correlated with mount latency, mount rate, ejaculation latency and ejaculation frequency. A10 lesions produced a significant depletion of dopamine in the nucleus accumbens and cingulate cortex, but these effects were not significantly correlated with any measure of sexual behavior. PMID- 3524605 TI - [Impressions for fixed dentures]. PMID- 3524606 TI - Immune abnormalities in renal failure and hemodialysis. AB - Considerable work needs to be done in order to understand the immunosuppressive effect of 'uremia' and the lymphocyte changes induced by hemodialysis. For example, the lymphocyte population dynamics can be further defined using monoclonal antibodies specific for lymphocyte subgroups. In vitro assays are available for lymphokine detection (i.e. IL-1, IL-2 which are important for T cell function) and may be correlated with both the clinical state and overall immunobiological status of hemodialyzed patients. The possibility of specifically delineating the extent of the immune system dysfunction in renal failure patients (on or off dialysis) is at hand. With this knowledge it will be possible to manipulate their management so as to minimize function alterations. PMID- 3524607 TI - Patient reactions and granulocyte degranulation during hemodialysis with cuprophane and polycarbonate membranes. A double-blind study. AB - During dialysis with cuprophane or polycarbonate filters, a fall in neutrophil and eosinophil cell counts is observed. Total complement remains unchanged, but C3a increases indicating complement activation. Release of granular granulocyte proteins is observed indicating granulocyte activation. Patient reactions or biochemical findings indicate no significant difference when polycarbonate or cuprophane membranes are used, except perhaps less complement activation with polycarbonate. The biochemical observations may be due to complement activation or cell contact with the membrane. PMID- 3524608 TI - Controlled trial of D-penicillamine to prevent retinopathy of prematurity. AB - 204 infants with birthweights between 751 and 2000 g and 26-35 weeks gestational age (100 treated and 104 control subjects) were enrolled in a prospective controlled trial of the effectiveness of D-penicillamine (DPA) in the prevention of retinopathy of prematurity (ROP). The two groups did not differ significantly in gestational age, birth weight, Apgar scores, the time of exposure to oxygen and in the incidence of PDA or in the number of exchange transfusions and RBTs. Of the treated infants 29, and of the control infants 34 died before the tenth week of life. These cases were not included in further analysis. Patients were subsequently examined and assessed by two ophthalmologists independently, who did not know which babies were receiving DPA. Six of the 70 surviving control infants and none of the 71 surviving treated infants had ROP stage II or graver. The results suggested that ROP may effectively be prevented with DPA in very low birth-weight-infants, and that the drug has no serious adverse effects during the neonatal period. PMID- 3524609 TI - [Ultrasonographic evaluation of the development of the brain sulcus]. PMID- 3524610 TI - [Ultrasound detection of CNS abnormalities in a fetus and its management]. PMID- 3524611 TI - Back to basics: an evolutionary odyssey with reflections on the nutrition research of tomorrow. PMID- 3524612 TI - Diet and human behavior: how much do they affect each other? PMID- 3524613 TI - Biochemical basis for the manifestations of iron deficiency. PMID- 3524614 TI - Nutrition and infection. PMID- 3524615 TI - Gastrointestinal microflora in mammalian nutrition. AB - A mammal is a complex organism consisting of eukaryotic animal cells and eukaryotic and prokaryotic microbial cells. Most of the microorganisms reside in communities in the gastrointestinal tract. These gastrointestinal microfloras are known to serve nutritional functions in ruminants, pseudoruminants, and monogastric mammals with only modest or no foregut fermentations but with extensive hindgut fermentations in blind cecal pouches. In adult animals, the microflora hydrolyzes exogenous (dietary) and endogenous polymers, and provides the adult with all or at least a significant proportion of its carbon, energy, vitamins, and macromolecular building blocks. The flora also functions as a conservator of nitrogen that would otherwise be excreted as urea. In exchange, the flora competes directly with the host tissues for nutrients ingested in the diet, and also competes indirectly by somewhat repressing the absorptive capacities of the animal tissues. When the synergism is in balance, the animal tissues and the microflora operate in harmony for the health and nutritional welfare of the host as a whole. The system may be unbalanced by antibacterial drugs that destroy the microflora and by diseases of the animal tissues that destroy the controls regulating where indigenous communities localize in the tract, their microbial composition, and their biochemical activities. At such times, the nutrition of the animal tissues can be adversely affected to the extreme. Humans living in developed and developing countries have extensive microfloras in their hindguts. Humans living in developing countries may also have extensive microfloras in their small bowels. Those floras may function in nutrition of the animal tissues of man much the same as do floras in similar locations in the gastrointestinal tracts of mammals other than man. However, animals of some species other than human gain much of the nutritional benefit from their microflora through the practice of coprophagy. Since adult humans do not normally practice coprophagy, any nutritional benefit from the microflora depends upon the capacity of the bowel mucosa, principally that of the large bowel, to absorb bacterial products, e.g. short-chain volatile fatty acids. Such absorption undoubtedly occurs, but is surely not a major source of carbon and energy for the animal tissues of man. PMID- 3524616 TI - Metabolism of sulfur-containing amino acids. AB - Met metabolism occurs primarily by activation of Met to AdoMet and further metabolism of AdoMet by either the transmethylation-transsulfuration pathway or the polyamine biosynthetic pathway. The catabolism of the methyl group and sulfur atom of Met ultimately appears to be dependent upon the transmethylation transsulfuration pathway because the MTA formed as the co-product of polyamine synthesis is efficiently recycled to Met. On the other hand, the fate of the four carbon chain of Met appears to depend upon the initial fate of the Met molecule. During transsulfuration, the carbon chain is released as alpha-ketobutyrate, which is further metabolized to CO2. In the polyamine pathway, the carboxyl carbon of Met is lost in the formation of dAdoMet, whereas the other three carbons are ultimately excreted as polyamine derivatives and degradation products. The role of the transamination pathway of Met metabolism is not firmly established. Cys (which may be formed from the sulfur of Met and the carbons of serine via the transsulfuration pathway) appears to be converted to taurine and CO2 primarily by the cysteinesulfinate pathway, and to sulfate and pyruvate primarily by desulfuration pathways in which a reduced form of sulfur with a relatively long biological half-life appears to be an intermediate. With the exception of the nitrogen of Met that is incorporated into polyamines, the nitrogen of Met or Cys is incorporated into urea after it is released as ammonium [in the reactions catalyzed by cystathionase with either cystathionine (from Met) or cystine (from Cys) as substrate] or it is transferred to a keto acid (in Cys or Met transamination). Many areas of sulfur-containing amino acid metabolism need further study. The magnitude of AdoMet flux through the polyamine pathway in the intact animal as well as details about the reactions involved in this pathway remain to be determined. Both the pathways and the possible physiological role of alternate (AdoMet-independent) Met metabolism, including the transamination pathway, must be elucidated. Despite the growing interest in taurine, investigation of Cys metabolism has been a relatively inactive area during the past two decades. Apparent discrepancies in the reported data on Cys metabolism need to be resolved. Future work should consider the role of extrahepatic tissues in amino acid metabolism as well as species differences in the relative roles of various pathways in the metabolism of Met and Cys. PMID- 3524617 TI - Monosaccharides in health and disease. AB - In healthy persons, glucose homeostasis maintains blood glucose levels between 70 and 130 mg/dl despite perturbations by meals, fasting, and exercise. Long-term follow-up of diabetic patients has suggested that "good control" of blood sugar levels minimizes the long-term complications of diabetes, such as retinopathy, nephropathy, and atherosclerosis. It now seems likely the products of insulin independent metabolic pathways in epithelial and endothelial cells leading to polyol formation and protein glycosylation may be factors in the genesis of retinopathy, neuropathy, nephropathy, and premature atherosclerosis of diabetic patients. Dietary complex carbohydrates of various type, including those rich in dietary fiber, which are the cell walls of fruits, vegetables, and cereals, may slow the rate of absorption of glucose from those diets and contribute to a lowering of the postprandial glucose peak. Glycemic responses to various foods compared to glucose have been studied and show a large variation, which is dependent upon gastric emptying, overall effects on rate of hydrolysis and absorption of glucose from food mixtures. Dietary sucrose seems to cause a degree of insulin resistance. The active part of the disaccharide is fructose, which does not elicit an acute insulin response, but appears indirectly to increase insulin levels in both animals and man. Sucrose in animals appears to promote obesity more than glucose because of its lack of stimulation of thermogenesis. Xylitol has been used as a sweetener and as a sugar substitute in total parenteral nutrition. It is a paradox that the most physiological of sugars (glucose) can be a menace at high concentrations. The use of nonphysiological sugars or their derivatives in diabetics and patients with special needs, such as TPN, requires much more investigation to develop a sound rationale in nutrition management. PMID- 3524618 TI - Regulation of cholesterol biosynthesis. PMID- 3524619 TI - Metabolism, nutrition, and function of carotenoids. PMID- 3524620 TI - The pathophysiology of anorexia nervosa and bulimia nervosa. PMID- 3524621 TI - The impact of culture on food-related behavior. AB - Some of the sociodemographic and psychosocial determinants of individuals' food related behaviors were examined in this chapter. The empirical research indicates that individuals do participate differentially in their culture. But, the reasons for why people eat what they eat are still incompletely understood, as evidenced by the inadequate predictive ability of the determinants examined. PMID- 3524622 TI - Carnitine metabolism and function in humans. AB - It is apparent from the foregoing discussion that carnitine plays an essential role in human intermediary metabolism. The question of a dietary requirement for carnitine, particularly for the human infant, is of significant theoretical and practical interest. Aberrant carnitine metabolism resulting from abnormal genetic or acquired conditions may have serious consequences for the affected individual. At present many of the treatment modalities for carnitine deficiency are empirical. Further clarification of the mechanisms by which carnitine depletion is manifest in these conditions is essential for designing treatment programs. Moreover, therapeutic use of carnitine in several human diseases not involving carnitine deficiency per se has been indicated. Before such treatment becomes generally accepted, we must determine precisely the role of this amino acid in the biochemical and physiological events that participate in the pathogenesis of each disease. PMID- 3524623 TI - Food likes and dislikes. PMID- 3524624 TI - Metabolic adaptation to low intakes of energy and protein. PMID- 3524625 TI - Mutagens and carcinogens in foods. PMID- 3524626 TI - Somatic nutrient requirements of ruminants. AB - On the basis of existing information it is, perhaps, useful to propose tentative preliminary figures for somatic nutrient requirements (Table 2). Such a proposal may serve as a focus for research to clarify more precisely the somatic requirements for a given production function in a given species. The requirements, therefore, are presented as interspecies generalizations and are calculated per kilogram of metabolic body size for the maintenance of adult animals. Only those nutrients for which there are some experimental data are included, so the absence of a given nutrient is an indication that it has not been studied. The figure for energy was derived by subtracting from the metabolizable energy for maintenance those heat losses associated with bacterial action and with prehension and transport of food. The resulting value was then increased by an amount representing the relative inefficiency of VFA, as compared with glucose metabolism. Amino acid values are essentially those obtained by intravenous administration. Water-soluble vitamin values except for thiamin were not listed because they were not expected to differ from whole-body requirements. Thiamin data were based on the work of Mueller & Asplund (51). The most obvious need is for definitive values for the amino acid requirements for productive functions and for water-soluble vitamin data. In the absence of such data, experiments with supplementation of these nutrients will continue to be haphazard and arbitrary. (Table: see text). PMID- 3524628 TI - The dentition of Lindow man. PMID- 3524627 TI - [Effect of bilateral common carotid artery ligation on prostaglandin levels (TXA2, PGI2) in spontaneously hypertensive rats (SHRSP, SHRSR) and normotensive rats (WKY)]. AB - Three different levels of global forebrain ischemia were induced in rats and their plasma levels of Thromboxane B2 (TXB2) and 6 Keto PGF1 alpha were determined to investigate the relation between severity of ischemia and eicosanoid production. Ischemia stimulates the activity of cellular lipase whose actions cause deacylation of brain phospholipids and release of free fatty acids. Arachidonic acid (A.A.) is one of the predominant fatty acids which is liberated in brain after ischemia. A.A. is the primary substrate for the synthesis of prostaglandins (PGs), Thromboxane A2 (TXA2) and Prostacyclin (PGI2), which play an important role in regulation of platelet aggregation and vasotonus. Thromboxane is a potent platelet aggregator and vasoconstrictor. On the other hand, PGI2 has the opposite nature. Therefore it can be considered that PGs and moreover, the balance of TXA2 and PGI2 may have an intimate relation to the development of cerebral ischemia. Three different levels of ischemia were produced by bilateral carotid artery ligation (BLCL) using three kinds of rats with different blood pressure ranges, namely, SHRSP (Stroke-prone spontaneously hypertensive rats), SHRSR (Stroke-resistant spontaneously hypertensive rats) and WKY (Wistar kyoto rats). It is known that higher pressure groups suffer severe ischemia by BLCL procedure. Hypertensive rats (SHRSP, SHRSR) were originally produced from WKY. The experimental animals used were about 300 gr and 16 weeks old male rats. The plasma and brain TXB2 and 6 Keto-PGF1 alpha, stable metabolites of TXA2 and PGI2 were measured by radioimmunoassay. The chronological changes of brain and plasma PGs levels after ischemia using SHRSR were also investigated.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3524630 TI - Porcelain laminates: a review. PMID- 3524629 TI - Acquired immune deficiency syndrome: review. PMID- 3524631 TI - Dental antiques in Mayfair. PMID- 3524632 TI - A case study for the provision of a full upper and partial lower denture for an adult patient with a cleft palate. PMID- 3524633 TI - The role of cross sectional echocardiography and pulsed Doppler ultrasound in the management of neonates in whom congenital heart disease is suspected. A prospective study. AB - The application of cross sectional echocardiography and pulsed Doppler ultrasound to the management of symptomatic neonates with suspected congenital heart disease was studied in 96 consecutive cases. The ability of echocardiography to establish a complete and accurate diagnosis and a correct management plan was evaluated. Sequential segmental analysis of data from cardiac catheterisation and necropsy identified 536 cardiovascular anomalies. Of the 536 anomalies 512 were correctly diagnosed by echocardiography (sensitivity 95.5%). Seven false positive echocardiographic diagnoses were made (specificity 98.6%). Nearly all the missing diagnoses and all the false positive diagnoses made by echocardiography were extracardiac vascular anomalies. Normal cardiovascular anatomy was at all times correctly identified by echocardiography. In 12 babies (12.5%) a management plan could not be established because of inconclusive echocardiographic findings. Of the 84 proposed plans based on the echocardiographic findings, eight were found to be inappropriate after catheterisation. Thus, 76 babies (79.2%) could have been correctly managed without cardiac catheterisation. The combination of cross sectional echocardiography and pulsed Doppler ultrasound not only allows diagnosis of congenital cardiac anomalies in most neonates but can facilitate appropriate clinical management. Only a minority of neonates with suspected congenital heart disease require cardiac catheterisation and angiography. PMID- 3524634 TI - Non-invasive assessment by Doppler ultrasound of 155 patients with bioprosthetic valves: a comparison of the Wessex porcine, low profile Ionescu-Shiley, and Hancock pericardial bioprostheses. AB - One hundred and fifty five patients with 167 bioprosthetic valves (68 Wessex porcine, 54 Hancock pericardial, and 45 low profile Ionescu-Shiley pericardial valves) were studied by Doppler ultrasound. Valve gradients were calculated from the mitral and aortic flow velocities by the modified Bernoulli equation. Mean mitral gradients were significantly smaller across the Ionescu-Shiley valves than across the Wessex porcine or Hancock pericardial valves. Mitral pressure half time was, however, significantly longer in the Hancock pericardial than in the Wessex porcine or Ionescu-Shiley valves. No significant differences were seen among the groups of aortic bioprostheses, though the comparable size of Wessex porcine valves showed significantly higher gradients. Bioprosthetic regurgitation was detected in 13 of 103 mitral and 11 of 59 aortic valves, though it was suspected clinically in only 12 mitral and six aortic bioprostheses. Doppler ultrasound is a repeatable non-invasive method of acquiring haemodynamic information in vivo from a variety of bioprostheses and it can detect bioprosthetic regurgitation at an early stage. PMID- 3524636 TI - John Hunter: on heart disease. PMID- 3524635 TI - Plasma catecholamine changes during cardiopulmonary bypass: a randomised double blind comparison of trimetaphan camsylate and sodium nitroprusside. AB - The effects of trimetaphan camsylate and sodium nitroprusside on the catecholamine response to cardiac surgery were compared in a randomised double blind study of twelve male patients undergoing elective myocardial revascularisation. The solutions were titrated to maintain a mean arterial pressure of 70-85 mm Hg before and after bypass and less than 70 mm Hg during bypass. The rise in plasma adrenaline during cardiopulmonary bypass in the sodium nitroprusside group was significantly greater than that in the trimetaphan camsylate group. There was a smaller rise in plasma noradrenaline in the sodium nitroprusside patients but this was significantly higher than in the patients receiving trimetaphan camsylate. Administration of trimetaphan camsylate provides a simple and effective way to reduce catecholamine release during cardiopulmonary bypass. PMID- 3524637 TI - Effects of captopril and a combination of hydralazine and isosorbide dinitrate on myocardial sympathetic tone in patients with severe congestive heart failure. AB - Changes in circulating catecholamines and transmyocardial catecholamine balance associated with improved left ventricular function were studied in patients with chronic heart failure after treatment with captopril (10 patients) and hydralazine in combination with isosorbide dinitrate (eight patients). Cardiac performance improved in response to both captopril and hydralazine-nitrate treatment. The systemic haemodynamic effects were also qualitatively similar, but the hydralazine-nitrate combination caused a greater increase in cardiac index and heart rate. Captopril did not change arterial adrenaline concentrations (0.63 to 0.60 nmol/l), arterial noradrenaline (4.2 to 3.9 nmol/l), or net transmyocardial noradrenaline release (390 to 317 pmol/min), while hydralazine nitrate increased arterial adrenaline (0.91 to 1.47 nmol/l) and transmyocardial noradrenaline release (225 to 554 pmol/min). Although both captopril and hydralazine-nitrate treatment improve left ventricular performance in patients with chronic heart failure, hydralazine-nitrate enhances cardiac sympathetic tone and captopril does not. The clinical relevance of these findings, however, is not known. PMID- 3524638 TI - Pharmacokinetics of local anaesthetics. PMID- 3524639 TI - Local anaesthetic techniques in obstetrics. PMID- 3524640 TI - Local anaesthetic techniques in paediatric surgery. PMID- 3524641 TI - Local anaesthesia for orthopaedic surgery. PMID- 3524642 TI - Local anaesthetic techniques for prevention of postoperative pain. PMID- 3524643 TI - Comparison of the use of domperidone, droperidol and metoclopramide in the prevention of nausea and vomiting following gynaecological surgery in day cases. AB - The efficacy of domperidone 20 mg, droperidol 2.5 mg, metoclopramide 10 mg or placebo (saline) administered i.v. before induction of anaesthesia, was studied in 199 women undergoing gynaecological surgery as day cases. Following a standardized general anaesthetic technique, droperidol or metoclopramide significantly reduced the incidence of nausea and vomiting; domperidone decreased the incidence of postoperative nausea alone. The occurrence of extrapyramidal reactions was similar in all groups. Patients treated with antiemetics were no more sedated than those given placebo. Those receiving droperidol complained of significantly less postoperative pain than those who had received domperidone or metoclopramide. PMID- 3524644 TI - A controlled comparative trial of Actisorb activated charcoal cloth dressings in the community. PMID- 3524646 TI - Clinical applications of bronchoalveolar lavage: an interim view. PMID- 3524645 TI - Effects of magnesium supplementation in testicular cancer patients receiving cis platin: a randomised trial. AB - The concentration of magnesium in serum has been shown to fall to potentially dangerously low levels after several courses of treatment with cis diamminedichloroplatinum II (cis-platin). The aims of this study were to examine the effects of magnesium supplementation on predicted outcome of treatment, rate of response to treatment and toxicity of treatment. Sixteen patients with testicular cancer were studied in detail over a 14 month period. One patient with an ovarian dysgerminoma was also included in the study. Eight patients were randomised to receive magnesium supplements both intravenous and oral; nine did not. The non-supplemented group showed significantly greater renal tubular damage as assessed by urine N-acetyl-B-D-glucosaminidase (NAG). There was a trend towards a reduction in treatment delays due to neutropenic episodes in the supplemented group, and serum magnesium concentrations remained significantly higher. Neither group showed differences in tumour growth rates or outcome. These results show that magnesium supplements are of considerable benefit and show no harmful effects in patients receiving cis-platin treatment. It is is suggested that magnesium supplements should be a routine part of the treatment regime, and that these should comprise both i.v. supplements during treatment and oral supplements between courses. PMID- 3524647 TI - Augmentin compared with oxytetracycline for chest infections in general practice. AB - Augmentin and oxytetracycline were compared in the treatment of chest infections in general practice in an investigator-blind study of 748 patients randomly allocated to 7 days' treatment with standard doses of either Augmentin or oxytetracycline. Significantly more patients treated with Augmentin had a good overall response to therapy both at day 7 (P less than 0.001) and at day 14 (P less than 0.01). The differences between treatments were less marked for individual signs and symptoms of lower respiratory tract infections, due to smaller numbers of patients with any particular symptom. Augmentin, however, was significantly more effective than oxytetracycline in the resolution of chest pain at day 7 (P less than 0.025) and cough at day 14 (P less than 0.005). Sputum purulence was also cleared more effectively by Augmentin by day 14 (P less than 0.001). Both treatments were well tolerated, with no significant difference between treatments in the small number of adverse events. Augmentin has been shown to be an effective, well tolerated treatment for chest infections, superior to oxytetracycline in efficacy and possibly in speed of resolution of clinical symptoms. PMID- 3524648 TI - The effect of zaprinast (M&B 22,948, an orally absorbed mast cell stabilizer) on exercise-induced asthma in children. AB - We conducted a placebo controlled, double-blind trial on the effect of a single dose of zaprinast (M&B 22,948, an orally active mast cell stabilizer) on exercise induced asthma in 15 children. We demonstrated no prophylactic effect on the whole group. A trend towards effectiveness was shown when the results for children whose asthma was not steroid dependent were analysed alone. PMID- 3524649 TI - Evaluating the effects of speech therapy for aphasics: developing the single case methodology. PMID- 3524650 TI - Microcomputer speech therapy for dysphasic adults: a comparison with two conventionally administered tasks. PMID- 3524651 TI - Aphasia with recurrent utterance: a review. PMID- 3524652 TI - Beyond randomised controlled trials: the case for effective case studies of the effects of treatment in aphasia. PMID- 3524653 TI - Subcorneal pustular dermatosis followed by pyoderma gangrenosum. PMID- 3524654 TI - Electrical field stimulation of isolated primate sweat glands. AB - An in vitro method is described for inducing secretion in isolated monkey eccrine sweat glands by means of electrical field stimulation (EFS). Ultrastructural analyses of these glands revealed unmyelinated nerve fibres surrounding the secretory coils. Numerous small clear vesicles, characteristic of cholinergic nerve terminals, were observed, along with a few which were large and dense cored. EFS elicited an immediate secretory response which ceased abruptly upon termination of the current. The response was inhibited in a dose-dependent manner by atropine (IC50 1.5 X 10(-9) mol/l). Although most glands were completely inhibited by atropine, a minor atropine insensitive component was operative in some preparations. Physostigmine (10(-6) mol/l) potentiated the response to subthreshold EFS. Lidocaine (3 X 10(-4) mol/l) completely and reversibly blocked EFS but had no effect on methacholine (10(-6) mol/l) induced secretion. These results confirm that eccrine sweat gland activation is predominantly via cholinergic pathways and that EFS of isolated glands may be a useful model to study the control of secretory function in normal and diseased states. PMID- 3524655 TI - Adult 'fetal-like' erythropoiesis characterizes recovery from bone marrow transplantation. AB - The transient fetal-like erythropoiesis which appears during recovery from bone marrow transplantation has now been examined at the level of erythroid progenitor cells. A 7-year-old boy with beta +-thalassaemia major was studied during engraftment from his beta-thalassaemia trait sister. Hb F and i antigen rose as expected. Macrocytosis never developed, but red cell size distribution became very heterogeneous. Bone marrow CFU-E and BFU-E were detected by 30 d, prior to the appearance of reticulocytes. Marrow erythroid progenitor cell numbers were normal by 146 d, while those in the blood became normal by 360 d. After transplantation globin synthesis ratios in erythroid colonies were diagnostic of thalassaemia trait, indicating engraftment. Individual erythroid colonies derived from both blood and marrow at all times during reconstitution showed no correlation of G gamma and gamma. Thus the fetal-like stress erythropoiesis of marrow expansion following transplantation was derived from adult and not fetal progenitor cells. PMID- 3524656 TI - Bone marrow transplantation in two multiply transfused patients with thalassaemia major. AB - Bone marrow transplantation has generally been unsuccessful when applied to patients with thalassaemia major over the age of 6 years. We report here two successful transplants for this disorder in a 7 1/2-year-old boy and an 11-year old girl following a pre-transplant cytoreductive/immunosuppressive regimen of total body irradiation and cyclophosphamide. Complete durable engraftment of donor haematopoietic and lymphoid populations was documented through several approaches, including cytogenetic analysis, haemoglobin electrophoresis, globin chain synthetic ratios, red cell typing and DNA restriction enzyme analysis. Both patients are surviving in good health, 28 and 9 months from transplantation. The successful outcome in these patients demonstrates the feasibility of marrow transplantation for the treatment of thalassaemia in multiply transfused and, presumably, highly sensitized patients. PMID- 3524657 TI - Autologous bone marrow transplantation (ABMT) for acute leukaemia in complete remission: a pilot study of 33 cases. AB - Thirty-three leukaemic patients in CR were treated by high-dose therapy followed by ABMT: 18 of them had acute non-lymphoblastic leukaemia (ANLL) in first remission (CR1) with a mean age of 23.7 years (3-44). All but one of them were conditioned with a polychemotherapy regimen including 6-thioguanine, Ara-C, CCNU, and cyclophosphamide. The marrow cells were purged by chemical means in 16 cases. Five transplant-related deaths were observed: three cardiac failures, one interstitial pneumonitis and one aspergillus pneumonia. At the time of analysis (October 1984), four patients had relapsed and eight were still in unmaintained CR1 (44+, 46+, 30+, and five between 2.5+ and 8+ months post transplant). Fifteen patients had acute lymphoblastic leukaemia: four were autografted in CR1 and 11 children were grafted in CR2; the conditioning regimen was fractionated total body irradiation followed by cyclophosphamide for all but one patient who was conditioned with BACT (Burkitt leukaemia); the marrow was purged by a chemical agent in 11 patients and by monoclonal antibodies and C' in four: four out of 15 patients relapsed (two grafted in CR1 and two grafted in CR2); 10 patients are still in unmaintained CR: two adults grafted in CR1 (26+; 12+ months) and eight children with a mean follow-up of 13.4 months post graft (2 + -45+ months). The clinical study leads to the following conclusions: in adult patients the marrow should be harvested during CR1 and at the time of minimal residual disease. The quality of previous chemotherapy and conditioning regimen prior to ABMT play a prominent role in the in vivo eradication of the leukaemic cells. The real impact of marrow purging is still unknown and a larger series of homogeneous patients, conditioned with the same protocols and the same transplant timing, is required before any conclusions can be drawn. PMID- 3524658 TI - Immunohistochemical study of basement membrane proteins and type III procollagen in myelofibrosis. AB - In this study the distribution of type IV collagen in the marrow is compared with that of laminin, another basement membrane protein. In addition, incompletely processed type III procollagen is identified with specific antibodies. In normal bone marrow the distribution of the type III procollagen antigen closely resembles that of reticulin staining. In all the myelofibrotic samples, representing both early and advanced disease, the fibrous tissue stains heavily for this antigen. Thus type III procollagen which has not completely lost its aminoterminal propeptide is a genuine component of the extracellular matrix fibres in human bone marrow. Laminin is found with type IV collagen in continuous basement membranes in arterial walls, whereas only discontinuous strips of staining are seen along the sinusoids in normal marrow. In myelofibrosis the dilated or obliterated sinusoids have thickened or continuous basement membranes, visible with both stainings. Neovascularization also increases the extent of basement membrane staining in fibrotic marrow. With respect of these antigens, there is no difference between primary and secondary myelofibrosis. These changes warrant the use of serum antigens related to type IV collagen and to type III procollagen as markers for developing myelofibrosis. PMID- 3524659 TI - Anti-granulocyte opsonic activity and autoimmune neutropenia. AB - Sera from patients with unexplained neutropenia have been assayed for anti granulocyte opsonic activity using a chemiluminescence technique which measures the metabolic response of human monocytes to antibody-coated granulocytes. This rapid and simple technique was more sensitive than indirect immunofluorescence in the detection of anti-granulocyte antibodies. Anti-granulocyte opsonic activity was detected in sera from 17 of 31 patients, suggesting that their neutropenia may have had an autoimmune basis. The opsonic activity of five of the 17 sera was increased when granulocytes were sensitized in the presence of fresh serum. Four of these sera bound IgM and C3b to granulocytes in the immunofluorescence test. Human IgG when added to the monocyte suspension medium inhibited monocyte response to IgG antibody-opsonized granulocytes. This inhibition was less when granulocytes were opsonized with sera containing IgM and complement granulocyte binding activity. This observation may be relevant to the selection of neutropenic patients for therapeutic use of intravenous immunoglobulin. PMID- 3524660 TI - Evolution of the myelodysplastic syndromes. PMID- 3524662 TI - Serum beta 2-microglobulin in multiple myeloma. PMID- 3524661 TI - A stimulator of murine haemopoietic stem cell proliferation produced by human fetal liver cells. AB - Normal murine bone marrow was incubated with medium conditioned by liver cells from human fetuses of 11-17 weeks gestational age. This treatment increased the proportion of murine haemopoietic stem cells (CFU-S) which were synthesizing DNA from less than 10% to more than 30%. The human fetal liver cell supernatants were fractionated using Amicon filters to obtain nominal molecular weight ranges of 10 30,000, 30-50,000 and 50-100,000 daltons. The stimulator was present only in the 30-50,000 dalton fraction. When human fetal liver cells were separated by adherence to plastic, medium conditioned by the adherent, but not the non adherent, cells produced the stimulator. A population of non-cycling GM-CFC was not switched into cycle during incubation with this CFU-S proliferation stimulator. Human fetal livers of all gestational ages tested contain a specific stimulator of CFU-S proliferation. This appears to have properties similar to that demonstrated in murine fetal liver and regenerating murine bone marrow. Human and murine haemopoietic stem cell proliferation may therefore be regulated by similar mechanisms. PMID- 3524663 TI - A new projective test: the Caine-Marteau-Dympna Test (CMD). AB - The Caine-Marteau-Dympna (CMD) Test, a new thematic apperception projective test, has acceptable inter-rater reliability. Validity was demonstrated by its ability to differentiate psychiatric in-patients from out-patients and non-patients, and by the relationships found between ratings derived from the test protocols and various questionnaires. These latter provide measures associated with either an inner or outer orientation towards the world. This has implications for many different areas of life, including occupational preference and adjustment, psychiatric symptom formation, psychological treatment expectancies and therapeutic outcome. Thus, the inner oriented individual, who is likely to be responsive to interpretative psychotherapy, tends to produce CMD responses displaying individualistic, abstract themes; a concern with intrapsychic conflict, deficiencies in social interaction and lack of structure; and internal control. PMID- 3524664 TI - Labetalol does not alter the placental and fetal blood flow or maternal prostanoids in pre-eclampsia. AB - The effect of intravenously administered labetalol (1 mg/kg) on placental and fetal blood flow was studied in 13 pre-eclamptic women. Although the maternal blood pressure decreased, no changes occurred in the blood flows in the intervillous space, the umbilical vein or the fetal descending aorta, nor did the indices of peripheral vascular resistance in the fetal aorta change, but the placental vascular resistance did decrease. Labetalol had no effect on prostacyclin or thromboxane A2 as measured by urinary 6-keto-prostaglandin F1 alpha and serum thromboxane B2 respectively. These findings are clinically relevant since they suggest that labetalol reduces maternal blood pressure without interfering with the placental or fetal blood flow. PMID- 3524665 TI - Oestriol with oestradiol verses oestradiol alone: a comparison of endometrial, symptomatic and psychological effects. AB - In a prospective, double-blind, randomized, cross-over trial, the effects of oral oestradiol, 2 mg daily, on the endometrial histology, frequency and severity of vaginal bleeding, and the symptomatic and psychological status of postmenopausal women were compared with those of oral oestradiol, 2 mg daily, plus oestriol, 1 mg daily. Both therapies were prescribed for 3 months on a cyclical basis. The addition of oestriol to oestradiol did not modify the endometrial response. The prevalence of proliferative/hyperplastic endometrium (64%: 9 of 14 biopsies) was similar after both treatments and there were no significant differences in either the frequency or heaviness of vaginal bleeding. Both therapies significantly reduced hot flushes, night sweats and vaginal dryness: no significant differences in effect on the symptomatic and psychological status were recorded. The addition of 1 mg of oestriol to 2 mg of oestradiol did not confer any benefit and the value of such an addition is challenged. PMID- 3524666 TI - Ultrasound study of ovarian cysts in pregnancy: prevalence and significance. AB - Previous surveys of the prevalence and natural history of ovarian cysts have been based on those ascertained by clinical examination. This study examines the fate of 137 adnexal cysts discovered during the course of 26 110 ultrasound scans in early pregnancy. Of these 10% were operated on in the first instance, and a further 2% required operation during pregnancy for painful complications. In 3% cysts were removed at caesarean section or in the puerperium. Half the removed cysts were neoplastic including one low grade carcinoma. Of the 120 cysts treated conservatively, 89% could not be detected on ultrasound examination later in pregnancy. All cysts greater than 8 cm should be removed, as should smaller cysts that are multilocular, thick-walled or semi-solid. PMID- 3524667 TI - Place of delivery: a review. AB - Policies about place of delivery have tended to be formulated without either looking at existing evidence or doing new research into the relative safety for women and babies of delivery in different settings. This article reviews published research on the subject, and finds that many of the data required have not been collected. Furthermore, many analyses fail to take account of selection biases or differences in the birthweight distribution and the incidence of congenital malformations among babies born in different settings. Nevertheless, some tentative conclusions can be drawn. The available evidence does not support claims that, for the baby, the iatrogenic risks of obstetric intervention outweigh the possible benefits. At the same time, there is no evidence to support the claim that the shift to hospital delivery is responsible for the decline in perinatal mortality in England and Wales nor the claim that the safest policy is for all women to be delivered in hospital. PMID- 3524668 TI - Pain relief in labour using transcutaneous electrical nerve stimulation (TENS). A TENS/TENS placebo controlled study in two parity groups. AB - The analgesic effects of transcutaneous electrical nerve stimulation (TENS) in labour and effects on outcome were investigated in a double-blind TENS/TENS placebo controlled trial in 100 primigravidae and 50 women in their third labour. There were no differences between the TENS and the TENS placebo users in terms of pain concept or relief, and only 12 and 13% of primigravidae and 48 and 39% of the para 2 women completed labour without requiring other analgesia in their respective groups. The primigravidae who used either TENS or TENS placebo alone had shorter labours than those who required further analgesia. Although the outcome of labour for mother and infant were similar in the two groups, there was a higher operative delivery rate in women who also had epidural analgesia. There were highly significant differences between the TENS and the TENS placebo users in terms of favourable and unfavourable comments by the mothers and the midwives at 1 and 24 h after delivery. The evident consumer satisfaction for TENS suggests TENS has a part to play in analgesia in labour but the equivocal findings in terms of factors associated with pain relief points to the need for apparatus more specifically designed to cope with the special characteristics of the pain of labour. PMID- 3524669 TI - The bonded mandibular lingual retainer. AB - The lower fixed retainer from cuspid to cuspid has been one of the commonly used methods of retention at the end of the orthodontic treatment. Orthodontists mostly use the lingual wire soldered to cuspid bands for the fixed lower retainer. With the advent of the new effective bonding materials many orthodontists prefer to use cuspid-to-cuspid/biscuspid-to-biscuspid bonded retainers to obtain optimal retention of lower anterior teeth both functionally and aesthetically. After experimenting with a variety of previous methods, such as the use of rubber bands, elastic threads, cotton pliers, ligature wires and silastic trays for the accurate placement and immobilization of a lower lingual retainer during the bonding, we have found that the use of two 1 to 1 1/2 inch pieces of 0.016 inch wires tack welded to lingual wire gives the best results. It is more accurate, simple, inexpensive and designed to save the orthodontist chair time. PMID- 3524670 TI - Selective radiolabeling and isolation of the hydrophobic membrane-binding domain of human erythrocyte acetylcholinesterase. AB - The hydrophobic, membrane-binding domain of purified human erythrocyte acetylcholinesterase was labeled with the photoactivated reagent 3 (trifluoromethyl)-3-(m-[125I]iodophenyl)diazirine. The radiolabel was incorporated when the enzyme was prepared in detergent-free aggregates, in detergent micelles, or in phospholipid liposomes, but the highest percentage of labeling occurred in the detergent-free aggregates. Papain digestion of the enzyme released the hydrophobic domain, and polyacrylamide gel electrophoresis in sodium dodecyl sulfate or gel exclusion chromatography demonstrated that the label was localized exclusively in the cleaved hydrophobic domain fragment. This fragment was purified in a three-step procedure. Digestion was conducted with papain attached to Sepharose CL-4B, and the supernatant was adsorbed to acridinium affinity resin to remove the hydrophilic enzyme fragment. The nonretained fragment associated with Triton X-100 micelles was then chromatographed on Sepharose CL-6B, and finally detergent was removed by chromatography on Sephadex LH-60 in an ethanol-formic acid solvent. The fragment exhibited an apparent molecular weight of 3100 on the Sephadex LH-60 column when compared with peptide standards. However, amino acid analysis of the purified fragment revealed only 1 mol each of histidine and glycine per mole of fragment in contrast to the 25-30 mole of amino acids expected on the basis of the molecular weight estimate. This result suggests a novel non-amino acid structure for the hydrophobic domain of human erythrocyte acetylcholinesterase. PMID- 3524671 TI - Identification of amine components in a glycolipid membrane-binding domain at the C-terminus of human erythrocyte acetylcholinesterase. AB - Purified human erythrocyte acetylcholinesterase was labeled by reductive radiomethylation with saturating amounts of [14C]formaldehyde and sodium cyanoborohydride. Acid hydrolysis and automated amino acid analysis permitted both identification of radiomethylated components by their coelution with radiomethylated standards and quantitation of these components. The methylated N terminal amino acids glutamate and arginine were observed at levels of 0.66 and 0.34 residues, respectively, per 70-kilodalton subunit, and lysine residues were methylated on their epsilon-amino groups to a level of 7.40 residues per subunit [Haas, R., & Rosenberry, T.L. (1985) Anal. Biochem. 148, 154-162]. In addition, each subunit contained 1.35 residues of methylated ethanolamine and 0.98 residue of methylated glucosamine. Papain digestion cleaved the intact enzyme into two fragments, an enzymatically active hydrophilic fragment and a small hydrophobic fragment that represented the membrane-binding domain. The radiomethylated amino acids were quantitatively retained in the hydrophilic fragment, while the methylated ethanolamine and glucosamine were confined exclusively to the hydrophobic domain fragment. This fragment included the C-terminal dipeptide of the subunit. Peptide sequencing by manual Edman methods was combined with radiomethylation to demonstrate the sequence His-Gly-ethanolamine-Z for the hydrophobic domain fragment. The ethanolamine residue in this sequence is in amide linkage to the C-terminal Gly and is clearly distinct from the ethanolamine residues in Z which are susceptible to radiomethylation in the intact enzyme. Since Z also includes glucosamine and 2 mol of fatty acids [Roberts, W.L. & Rosenberry, T.L. (1985) Biochem. Biophys. Res. Commun. 133, 621-627], we conclude that the membrane-binding domain of human erythrocyte acetylcholinesterase is a covalently linked glycolipid at the C-termini of the subunits.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3524672 TI - Identification of three sites of proteolytic cleavage in the hinge region between the two domains of the beta 2 subunit of tryptophan synthase of Escherichia coli or Salmonella typhimurium. AB - The beta 2 subunit of tryptophan synthase is composed of two independently folding domains connected by a hinge segment of the polypeptide that is particularly susceptible to limited proteolysis by trypsin [Hogberg-Raibaud, A., & Goldberg, M. (1977) Biochemistry 16, 4014-4019]. Since tryptic cleavage in the hinge region inactivates the beta 2 subunit, the spatial relationship between the two domains is important for enzyme activity. However, it was not previously known whether inactivation results from cleavage of the chain or from the loss of internal fragment(s) subsequent to cleavage at two or more sites. We now report comparative studies of limited proteolysis by three proteinases: trypsin and endoproteinases Lys-C and Arg-C. Our key finding that endoproteinase Arg-C inactivates the beta 2 subunit by cleavage at a single site (Arg-275) demonstrates the important role of the hinge peptide for enzymatic activity. We have also identified the sites of cleavage and the time course of proteolysis by trypsin at Arg-275, Lys-283, and Lys-272 and by endoproteinase Lys-C at Lys-283 and Lys-272. Sodium dodecyl sulfate gel electrophoresis, Edman degradation, and carboxypeptidases B and Y have been used to identify the several fragments and peptides produced. Our finding that the beta 2 subunit and F1 fragments have a heterogeneous amino terminus (Met-1 or Thr-2) indicates that the amino-terminal methionine is incompletely removed during posttranslational modification. Our results show that Edman degradation can be effectively used with a protein of known sequence to analyze proteolytic digests that have at least four different amino-terminal sequences.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3524673 TI - Amino acid sequence of human von Willebrand factor. AB - The complete amino acid sequence of human von Willebrand factor (vWF) is presented. Most of the sequence was determined by analysis of the S carboxymethylated protein. Some overlaps not provided by the protein sequence analysis were obtained from the sequence predicted by the nucleotide sequence of a cDNA clone [Sadler, J.E., Shelton-Inloes, B.B., Sorace, J., Harlan, M., Titani, K., & Davie, E.W. (1985) Proc. Natl. Acad. Sci. U.S.A. 82, 6391-6398]. The protein is composed of 2050 amino acid residues containing 12 Asn-linked and 10 Thr/Ser-linked oligosaccharide chains. One of the carbohydrate chains is linked to an Asn residue in the sequence Asn-Ser-Cys rather than the usual Asn-X-Ser/Thr sequence. The sequence of von Willebrand factor includes several regions bearing evidence of internal gene duplication of ancestral sequences. The protein also contains the tetrapeptide sequence Arg-Gly-Asp-Ser (at residues 1744-1747), which may be a cell attachment site, as in fibronectin. The amino- and carboxyl terminal regions of the molecule contain clusters of half-cystinyl residues. The sequence is unique except for some homology to human complement factor B. PMID- 3524674 TI - DNA fragmentation and cytotoxicity from increased cellular deoxyuridylate. AB - Previous results from this laboratory have shown that thymidylate deprivation results in dramatic elevation of intracellular dUTP and incorporation of dUMP into DNA. The goal of the present studies was to determine whether the latter changes may play a part in the associated cytotoxicity ("thymineless death"), which is ordinarily assumed to be a direct result of reduced intracellular dTTP. The approach used here was to increase intracellular dUTP without allowing dTTP to diminish and observe the effects on cell viability. dUMP pools were expanded by exposure of cells to deoxyuridine [in cell growth medium containing hypoxanthine, methotrexate, and thymidine (HAT medium)], resulting in accumulation of dUTP to levels that approached those of dTTP, which were at, or higher than, the levels in untreated cells. In conjunction with this the cells became nonviable, and newly synthesized DNA was fragmented, both of which occur with thymidylate depletion and, we assume, result from the active process of excision repair at the many uracil-containing sites in DNA. The results indicate that, although the relative importance of low dTTP remains unknown, elevated dUTP can account for the cytotoxicity caused by thymidine starvation. Most of the "dTTP" measured by the DNA polymerase assay in cells treated with methotrexate (MTX) (plus purine supplement) was, in fact, dUTP, which may explain some previous observations of only modest depression of dTTP in cells treated with MTX or similarly acting drugs. PMID- 3524675 TI - Affinities of tRNA binding sites of ribosomes from Escherichia coli. AB - The binding affinities of tRNAPhe, Phe-tRNAPhe, and N-AcPhe-tRNAPhe from either Escherichia coli or yeast to the P, A, and E sites of E. coli 70S ribosomes were determined at various ionic conditions. For the titrations, both equilibrium (fluorescence) and nonequilibrium (filtration) techniques were used. Site specific rather than stoichiometric binding constants were determined by taking advantage of the varying affinities, stabilities, and specificities of the three binding sites. The P site of poly(U)-programmed ribosomes binds tRNAPhe and N AcPhe-tRNAPhe with binding constants in the range of 10(8) M-1 and 5 X 10(9) M-1, respectively. Binding to the A site is 10-200 times weaker, depending on the Mg2+ concentration. Phe-tRNAPhe binds to the A site with a similar affinity. Coupling A site binding of Phe-tRNAPhe to GTP hydrolysis, by the addition of elongation factor Tu and GTP, leads to an apparent increase of the equilibrium constant by at least a factor of 10(4). Upon omission of poly(U), the affinity of the P site is lowered by 2-4 orders of magnitude, depending on the ionic conditions, while A site binding is not detectable anymore. The affinity of the E site, which specifically binds deacylated tRNAPhe, is comparable to that of the A site. In contrast to P and A sites, binding to the E site is labile and insensitive to changes of the ionic strength. Omission of the mRNA lowers the affinity at most by a factor of 4, suggesting that there is no efficient codon-anticodon interaction in the E site. On the basis of the equilibrium constants, the displacement step of translocation, to be exergonic, requires that the tRNA leaving the P site is bound to the E site. Under in vivo conditions, the functional role of transient binding of the leaving tRNA to the E site, or a related site, most likely is to enhance the rate of translocation. PMID- 3524676 TI - Biosynthetic alr alanine racemase from Salmonella typhimurium: DNA and protein sequence determination. AB - The nucleotide sequence of the alr gene encoding the biosynthetic alanine racemase in Salmonella typhimurium is reported. The sequence was determined by the dideoxy chain termination method of Sanger mostly from recombinants derived from shotgun and specific subcloning of a 2.6-kilobase region containing the alr gene. The final bridging of nonoverlapping contiguous sequences was accomplished with the use of synthetic site-specific primers. The alr gene was found to be 1077 base pairs in length encoding a protein of 359 amino acid residues. Comparison of alr with the dadB gene encoding the catabolic alanine racemase in S. typhimurium revealed almost identical size (1077 vs. 1068 base pairs) and 52% sequence identity. The respective gene products displayed 43% homology, which includes a decapeptide bearing the pyridoxal 5'-phosphate binding site. PMID- 3524677 TI - Biosynthetic alanine racemase of Salmonella typhimurium: purification and characterization of the enzyme encoded by the alr gene. AB - An alanine racemase, encoded by the alr (dal) gene and believed to be the biosynthetic source of D-alanine for cell wall formation, was purified to homogeneity from an overproducing strain of Salmonella typhimurium (dadB), and the enzymological properties of this enzyme were compared with those of the dadB alanine racemase that functions in the catabolism of L-alanine [Wasserman, S. A., Daub, E., Grisafi, P., Botstein, D., & Walsh, C. T. (1984) Biochemistry 23, 5182]. The alr-encoded enzyme has a monomeric structure with a molecular weight of about 40 000. One mole of pyridoxal 5'-phosphate is bound per mole of enzyme, which is essential for catalytic activity of the enzyme. After the internal Schiff base with pyridoxal 5'-phosphate was reduced with NaB3H4, followed by carboxamidomethylation and tryptic digestion of the enzyme, the amino acid sequence of the pyridoxal 5'-phosphate binding peptide was determined. The sequence of 10 amino acid residues around the lysine residue, to which pyridoxal 5'-phosphate is bound, was identical with that of the dadB racemase. No homology was found in the amino-terminal amino acid sequence between the two enzymes. The enzyme was inactivated with D- and L-beta-fluoroalanine, D- and L-beta chloroalanine, and D-O-acetylserine in a mechanism-based fashion with a common partition ratio of about 150. The enzyme was labeled with an equimolar amount of [14C]-D-beta-chloroalanine. The inactivator-pyridoxal 5'-phosphate adduct was isolated and shown to be the same structure formed in the dadB racemase inactivation [Roise, D., Soda, K., Yagi, T., & Walsh, C. (1984) Biochemistry 23, 5195]. PMID- 3524678 TI - Spectroscopic properties of the cobalt(II)-substituted alpha-fragment of rabbit liver metallothionein. AB - The C-terminal segment of rabbit liver metallothionein 1 (alpha-fragment) containing four paramagnetic Co(II) ions was obtained by stoichiometric replacement of the originally bound diamagnetic Cd(II) ions. The latter form was prepared by limited proteolysis with subtilisin as described previously [Winge, D. R., & Miklossy, K. A. (1982) J. Biol. Chem. 257, 3471-3476]. Electronic absorption, magnetic circular dichroism (MCD), and electron paramagnetic resonance (EPR) measurements were employed to monitor the stepwise incorporation of Co(II) ions into the metal-free fragment. Absorption and MCD spectra of the apofragment containing the first 3 Co(II) equiv show the typical features of tetrahedral tetrathiolate Co(II) coordination. However, in the d-d region only small changes in the visible and no apparent change in the near-infrared region are discernible when the fourth Co(II) is bound. This unusual spectral behavior was not seen in Co(II) substitution of native metallothionein [Vasak, M., & Kagi, J. H. R. (1981) Proc. Natl. Acad. Sci. U.S.A. 78, 6709-6713] and may indicate a different cluster geometry. In the charge-transfer region, the binding of all 4 Co(II) equiv is accompanied by characteristic increments of the thiolate S--- Co(II) bands. As in the formation of Co(II)7-metallothionein, the development of the charge-transfer and EPR spectral properties upon binding of the first 2 Co(II) equiv to the apofragment is indicative of isolated, noninteracting tetrahedral tetrathiolate Co(II) complexes. The binding of the additional Co(II) ion is accompanied by a red shift in the charge-transfer region and by the dramatic loss of paramagnetism in the EPR spectra, both diagnostic of the formation of metal-thiolate cluster structures.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3524679 TI - Chemical modification and cross-linking as probes of regions on ferredoxin involved in its interaction with ferredoxin: NADP reductase. AB - Ferredoxin which had been modified with glycine ethylester in the presence of a water-soluble carbodiimide to the extent of one carboxyl-group modified per ferredoxin was subjected to peptide mapping in an attempt to locate the site(s) of modification. The peptide mapping was done by HPLC and analysis of the resulting chromatogram allowed assignment of peaks to various segments in the amino acid sequences of the two isozymes of ferredoxin. The modified ferredoxin appeared to be a mixture of ferredoxin derivatives in which modification had occurred in three areas of the molecule. Although unable to identify the specific residues modified, it has been shown that modification is localized in the regions of residues 26-30, 65-70, and 92-94. The possibility that these regions of ferredoxin may define its binding site for ferredoxin: NADP reductase is discussed. Peptide mapping studies on a covalently linked adduct between ferredoxin and ferredoxin: NADP reductase also support these regions of ferredoxin as being important in the interaction between the two proteins. PMID- 3524680 TI - The induction of mitochondrial L-3-glycerophosphate dehydrogenase by thyroid hormone. AB - L-3-Glycerophosphate dehydrogenase was purified from porcine brain mitochondria by a shorter and simpler procedure than previously reported. Immunoblotting with antiserum to the porcine enzyme established that rat liver L-3-glycerophosphate dehydrogenase has the same Mr (76 000) by SDS-polyacrylamide gel electrophoresis. In liver mitochondria from normal and hyperthyroid rats, changes in L-3 glycerophosphate dehydrogenase activity were parallelled by changes in enzyme content assayed by immunoblotting. Similar changes were found in the amount of enzyme synthesised in vitro by reticulocyte lysate programmed with rat liver mRNA, suggesting that thyroid hormone causes specific induction of L-3 glycerophosphate dehydrogenase mRNA. PMID- 3524681 TI - Radical-pair energetics and decay mechanisms in reaction centers containing anthraquinones, naphthoquinones or benzoquinones in place of ubiquinone. AB - In reaction centers from Rhodobacter sphaeroides (formerly called Rhodopseudomonas sphaeroides), light causes an electron-transfer reaction that forms the radical pair state (P+I-, or PF) from the initial excited singlet state (P) of a bacteriochlorophyll dimer (P). Subsequent electron transfer to a quinone (Q) produces the state P+Q-. Back electron transfer can regenerate P from P+Q-, giving rise to 'delayed' fluorescence that decays with approximately the same lifetime as P+Q-. The free-energy difference between P+Q- and P can be determined from the initial amplitude of the delayed fluorescence. In the present work, we extracted the native quinone (ubiquinone) from Rps. sphaeroides reaction centers, and replaced it by various anthraquinones, naphthoquinones, and benzoquinones. We found a rough correlation between the halfwave reduction potential (E1/2) of the quinone used for reconstitution (as measured polarographically in dimethylformamide) and the apparent free energy of the state P+Q- relatively to P. As the E1/2 of the quinone becomes more negative, the standard free-energy gap between P+Q- and P decreases. However, the correlation is quantitatively weak. Apparently, the effective midpoint potentials (Em) of the quinones in situ depend subtly on interactions with the protein environment in the reaction center. Using the value of the Em for ubiquinone determined in native reaction centers as a reference, and the standard free energies determined for P+Q- in reaction centers reconstituted with other quinones, the effective Em values of 12 different quinones in situ are estimated. In native reaction centers, or in reaction centers reconstituted with quinones that give a standard free-energy gap of more than about 0.8 eV between P+Q- and P*, charge recombination from P+Q- to the ground state (PQ) occurs almost exclusively by a temperature-insensitive mechanism, presumably electron tunneling. When reaction centers are reconstituted with quinones that give a free-energy gap between P+Q- and P* of less than 0.8 with quinones that give a free-energy gap between P+Q- and P* of less than 0.8 eV, part or all of the decay proceeds through a thermally accessible intermediate. There is a linear relationship between the log of the rate constant for the decay of P+Q- via the intermediate state and the standard free energy of P+Q-. The higher the free energy, the faster the decay. The kinetic and thermodynamic properties of the intermediate appear not to depend strongly on the quinone used for reconstitution, indicating that the intermediate is probably not simply an activated form of P+Q-.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3524682 TI - Cholate-soluble and -insoluble iron binding components of rabbit duodenal brush border membrane. Relevance to Fe2+ uptake by brush-border membrane vesicles. AB - Fe2+ uptake by brush-border membrane vesicles from rabbit duodenum has been investigated and found to show similar qualitative properties to those previously demonstrated with mouse proximal intestine brush-border membrane vesicles (Simpson, R.J. and Peters, T.J. (1986) Biochim. Biophys. Acta 856, 109-114). In particular, a relatively low affinity (Km(app) approx. 83 microM), NaCl and pH sensitive transport component is present. The disruption of 59Fe2+-laden vesicles with sodium cholate, followed by gel filtration or centrifugal analysis reveals that cholate insoluble material (Mr greater than 10(6)) is the major destination for 59Fe2+ taken up by intact vesicles. Analysis of cholate extracts for Fe2+ binding ability reveals a single high-capacity (49.8 +/- 15.6 nmol/mg vesicle protein (S.E., n = 3)), high-affinity (Kd(app) less than 5 microM) binding component with an Mr equivalent to approx. 10(4) on gel filtration in the presence of cholate. This binding component is extracted into chloroform/methanol (2:1, v/v) is relatively heat and protease resistant and thus appears to be a lipid. PMID- 3524683 TI - Substrate specificity of the Escherichia coli maltodextrin transport system and its component proteins. AB - Maltooligosaccharides up to maltoheptaose are transported by the maltodextrin transport system of Escherichia coli. The overall substrate specificity of the transport system was investigated by using 15 maltodextrin analogues with various modifications at the reducing end of the oligosaccharides as competing substrates. The binding interaction of the analogues with maltoporin in the outer membrane and the periplasmic maltose-binding protein, the two protein components of the transport system with known specificity for maltodextrins, was also investigated. All analogues containing several alpha, 1----4-glucosyl linkages were bound with high affinity by maltoporin and maltose-binding protein, regardless of O-methyl, O-nitrophenyl, beta-glucosyl or beta-fructosyl substitutions at the reducing end of the dextrins. Introduction of a negative charge or lack of a ring structure at the reducing end were also ineffective in abolishing binding by these two proteins. These results suggest that the structure of the reducing glucose is not important in the binding specificity of maltoporin or maltose-binding protein. However, the high affinity of these proteins for analogues was not in itself sufficient for recognition by the transport system overall. Maltohexaitol, 4-nitrophenyl alpha-maltotetraoside and 4-beta-D-maltopentaosyl-D-glucopyranose were bound with the same affinity as comparable maltodextrins by both maltoporin and maltose-binding protein but were poorly recognized by the transport system. These results suggest that another, yet uninvestigated component of the transport system has a more restricted specificity towards changes at the reducing end of the maltodextrin molecule. PMID- 3524684 TI - Phenotype and functions of intratumoral macrophages. PMID- 3524685 TI - The cytolytic and regulatory role of natural killer cells in experimental neoplasia. AB - NK cells are defined here as cells, other than macrophages and polymorphonuclear leucocytes, from non-immunized animals (or humans) which are cytotoxic for neoplastic and non-neoplastic targets in the absence of specific antibody. Though not requiring antibody, they may function as K cells in ADCC. This definition includes cells activated nonspecifically by such agents as IFN and IL-2. Murine NK cells may be subdivided into two types by differences in the kinetics of target-cell lysis. Those we label Type 1 correspond roughly to what others have called NKA, NKL or simply NK cells; those of Type 2 to NKB, NKS and NC cells. Type 1 cells express various antigens, including NK-1, Thy-1 (50%), Ly-1 (25%), Qa-3, Qa-4, Qa-5, Ly-5, Ly-6, Ly-10, Ly-11 and asialo-GM1, not expressed by Type 2 cells, whereas Mac-1 may be expressed by both types. At least some NK cells appear to be pre-thymic cells which, in the presence of a thymus, can differentiate into T cells. The level of NK activity is influenced by the age and genetic background of the mouse, the organ from which the cells are obtained, and a variety of experimental manipulations. Type 1 activity is increased by IFN and IL-2; Type 2 activity by IL-3. IFN appears to be concerned in the development of spontaneous NK activity in young mice. Many experiments have shown that NK cells may inhibit the growth of tumours which are sensitive to NK cells of the same type in vitro. Inhibitory cells which suppress NK activity may play an important regulatory role in vivo. There is still uncertainty about how NK cells recognize their targets. Possibilities discussed are: (1) specific interacting molecules; (2) more diffuse properties of target cell membranes; (3) absence of MHC-coded self-recognition markers. Certainly, the presence of a Class 1 MHC molecule is not necessary. NK killing appears to be mediated by cytotoxins released by NK cells. In vivo, NK cells contribute to limiting the development of transplanted and primary tumours, and metastasis from established tumours. NK cells seem well qualified to act as a first-line defence against neoplasia, and may kill cells not killed by T cells. Transfer of NK cells may be of value in the treatment of cancer. PMID- 3524686 TI - Antiinflammatory proteins associated with human and murine neoplasms. AB - The immune mechanisms by which a host recognizes and destroys a growing tumor are undoubtedly complex and, as yet, incompletely understood. It is apparent, however, that mononuclear phagocytes play an important role in the defense against neoplastic disease and that the ability of monocytes and macrophages to accumulate at and within a growing tumor is a strict requirement for them to effect that role. Studies from our laboratory as well as those of other investigators have demonstrated that patients with a variety of neoplastic diseases have a specific defect in monocyte chemotactic responsiveness and that this defect is associated with the presence of the tumor. Furthermore, we and others have shown that a similar defect occurs in tumor-bearing rodents, thus allowing model systems to be developed for the study of the mechanisms involved. We have demonstrated that transplanted, spontaneous or carcinogen-induced murine tumors produce low molecular weight proteins which inhibit the accumulation of macrophages to inflammatory foci and that a significant portion, if not all, of these proteins are physicochemically and antigenically related to the retroviral envelope protein p15E. We have shown that p15E itself can inhibit the inflammatory accumulation of macrophages in normal mice. Studies on a wide variety of cancer patients have revealed that the fluids of such patients contain proteins which inhibit the responses of normal monocytes to various chemotaxins and, as in tumor-bearing mice, that these antiinflammatory proteins are antigenically related to retroviral p15E. Recent studies have demonstrated that human tumor cells can simultaneously release factors which are chemotactic for monocytes with those which are p15E-related inhibitors of chemotactic responsiveness, suggesting that the mononuclear phagocyte response to a growing tumor may be, in part, dictated by the balance obtained between various proteins produced by that tumor. The isolation and characterization of endogenous retroviral sequences within the human genome and the observation that the envelope genes of these endogenous sequences are partially homologous to p15E provide potential candidates for the p15E-related inhibitors of chemotactic responses which have been identified from human cancer cells and fluids. Studies now under way in a number of laboratories should provide more definitive answers regarding the nature and source of these p15E-related inhibitors.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3524687 TI - Molybdenum cofactor: a compound in the in vitro activation of both nitrate reductase and trimethylamine-N-oxide reductase activities in Escherichia coli K12. AB - Nitrate reductase (nitrite: (acceptor) oxidoreductase, EC 1.7.99.4) and trimethylamine N-oxide reductase (NADH : trimethylamine-N-oxide oxidoreductase, EC 1.6.6.9) activities were reconstituted by incubation of the association factor FA (the putative product of the chlB gene) with the soluble extract of the chlB mutant grown anaerobically in the presence of trimethylamine N-oxide. When soluble extracts of the chlB mutant grown on 10 mM sodium tungstate, a molybdenum competitor, were used in complementation systems, no enzymatic reactivation was observed. Heated extracts of the parental strain 541 were shown to contain a thermoresistant molybdenum cofactor by their ability to reactivate NADPH-nitrate reductase activity in the nit1 mutant of Neurospora crassa. By complementation of parental strain heated extract with association factor FA and soluble extract of the chlB mutant grown in the presence of sodium tungstate, we were able to show for the first time that the molybdenum cofactor is an activator common to the in vitro reconstitution of both nitrate reductase and trimethylamine-N-oxide reductase activities. PMID- 3524688 TI - Size and shape of the multicatalytic proteinase from rat skeletal muscle. AB - The multicatalytic proteinase from rat skeletal muscle, a non-lysosomal high molecular weight enzyme active at neutral to alkaline pH, has been examined in the electron microscope as well as by dynamic laser light scattering. Both methods reveal monodisperse particles. Electron micrographs show a cylinder shaped complex with a diameter of 11 nm and a length of 16 nm in negatively stained, and a diameter of 9.6 nm and a length of 14.3 nm in freeze-dried, heavy metal replicated specimens. The molecule is composed of four rings or disks. PMID- 3524689 TI - Intracellular transfer of phospholipids in the yeast, Saccharomyces cerevisiae. AB - In Saccharomyces cerevisiae, unlike in higher eukaryotic cells, most of the reactions involved in phospholipid biosynthesis occur both in mitochondria and in the endoplasmic reticulum. Some of the key enzymes involved, however, are restricted to one compartment. Thus, the formation of phosphatidylethanolamine by decarboxylation of phosphatidylserine occurs only in mitochondria, while phosphatidylcholine synthesis via methylation of phosphatidylethanolamine is restricted to microsomes. When yeast cells were pulse labelled with [3H]serine,[3H] phosphatidylethanolamine formed in mitochondria was found not only in the organelle but also, with even higher specific radioactivity, in the endoplasmic reticulum. Translocation of phosphatidylethanolamine between organelles was blocked immediately after poisoning cells with cyanide, azide and fluoride. Part of the [3H]phosphatidylcholine formed in the endoplasmic reticulum by methylation of [3H]phosphatidylethanolamine was transferred to mitochondria. This process continued in deenergized cells, although at a lower rate as compared to metabolizing cells. This result indicates rapid movement of both phosphatidylethanolamine and phosphatidylcholine requires metabolic energy, but that phosphatidylinositol-specific phospholipid transfer protein that has been found in saccharomyces cerevisiae (Daum, G. and Paltauf, F. (1984) Biochim. Biophys. Acta 784, 385-391). The mechanism of movement of phospholipids from internal membranes to the cell surface was studied with temperature-sensitive secretory mutants (Schekman, R. (1982) Trends Biochem. Sci. 7, 243-246) of Saccharomyces cerevisiae. A shift from the permissive to the restrictive temperature, which blocks the flow of vesicles involved in the secretion of proteins, had no effect on the transfer of phosphatidylinositol to the plasma membrane. PMID- 3524690 TI - Ingensin, a fatty acid-activated serine proteinase from rat liver cytosol. AB - The enzyme responsible for the succinylleucylleucylvalyltyrosine methylcoumarylamide- (SLLVT-) degrading activity was purified from the postmitochondrial supernatant of rat liver (Yamamoto, T., Nojima, M., Ishiura, S. and Sugita, H. (1986) Biochim. Biophys. Acta 882, 297-304). The enzyme, named ingensin, was activated by saturated fatty acids, especially myristic acid, as well as by unsaturated linoleic acid and arachidonic acid. Although 2 mercaptoethanol activated ingensin 2-fold and p-chloromercuribenzoate and HgCl2 completely inhibited its peptide-hydrolyzing activity, the enzyme is activated by the addition of a thiol-blocking reagent, monoiodoacetic acid. Ingensin was also inhibited by a specific serine proteinase inhibitor, diisopropyl fluorophosphate, but not by a specific cysteine proteinase inhibitor, E-64-c. These results suggest that the enzyme is a serine proteinase with an active thiol group(s) near the active site. We have found that the addition of glycerol and nordihydroguaiaretic acid lowered the extent of its activation by fatty acids as well as its intrinsic peptide-hydrolyzing activity. PMID- 3524691 TI - Assessment of in vivo protein synthesis in lamb tissues with [3H]valine flooding doses. AB - Week-old lambs received an intravenous injection of 4.3, 8.5, 12.8 or 17.1 mmol [3H]valine/5 kg body weight, i.e., 3.6-14.4-times the whole-body free valine content. To ensure that protein synthesis measurements in lambs are reliable within a 30-min period, these large amounts of valine must account for at least around 11-times the total free pool of valine. This amounted to 12.8 mmol valine/5 kg body weight. There were no significant variations in plasma insulin and plasma glucagon levels 5, 13 and 30 min after the injection of so much valine. The fractional rates of protein synthesis were determined in tissues of animals receiving either 12.8 or 17.1 mmol valine/5 kg body weight. The rates of protein synthesis in the jejunum (87.5%/day), liver (106.6%/day) and tensor fasciae latae muscle (18.8%/day) of lambs injected with the 12.8 mmol [3H]valine flooding dose, were in the range of data obtained in immature rats. Increasing the flooding amount of valine up to 17.1 mmol/5 kg body weight did not significantly alter protein synthesis rates in the jejunum, liver or skeletal muscle. This suggested that both the flooding-dose method in itself and valine had no effect on in vivo protein synthesis. PMID- 3524692 TI - Purification and characterization of the antisecretory factor: a protein in the central nervous system and in the gut which inhibits intestinal hypersecretion induced by cholera toxin. AB - The antisecretory factors (ASF) are hormone-like proteins which inhibit cholera toxin-induced intestinal hypersecretion. Although ASF concentrations in young control rats were low, those in old control rats and toxin-treated rats were high. Toxin-treated rats had 200 ED50 units/g wet weight of ASF in the pituitary gland, while their intestinal mucosa, bile and milk contained 3, 0.5 and 0.5 units/g. In adult man and in 8-9-month-old pig the pituitary level was about 20 units/g. The isoelectric points of ASF from pig and rat were 4.8 and 5.0, respectively, while the molecular size as determined by gel filtration on Bio-Gel P-150 was the same in both cases (Kav 0.43). The molecular weight as determined by SDS-polyacrylamide gel electrophoresis was 60,000 for ASF from porcine pituitary gland. One ED50 unit of the purified porcine ASF corresponded to about 10(-13) mol (1-5 ng) of protein. There were two different ASF from human pituitary gland: pI 5.2, Kav 0.43; and pI 4.5, Kav 0.6. Since antibodies against porcine ASF failed to neutralize the latter protein, it may be unrelated to porcine ASF; the human pI 5.2-protein and rat ASF were both neutralized, but less effectively than was porcine ASF. All the ASF molecules attached to agarose gel, from which they dissociated again in methyl alpha-D-glucose: porcine and rat ASF were eluted at 0.3-0.9 M methyl alpha-D-glucose, human pI 5.2-ASF at 0.1-0.9 M, and human pI 4.5-ASF at 0.1-1.5 M methyl alpha-D-glucose. PMID- 3524693 TI - Human pancreatic chymotrypsinogen A: a non-competitive enzyme immunoassay, and molecular forms in serum and amniotic fluid. AB - A sandwich enzyme immunoassay has been developed for human pancreatic chymotrypsin(ogen) using polystyrene balls coated with specific IgG as the first antibody and peroxidase-labelled IgG as the second antibody. The detection limit was 0.5 microgram/l. A good parallelism was observed with the curves obtained from standard chymotrypsinogen A and chymotrypsin(ogen) present in pancreatic juice; however, a slight discrepancy in parallelism with chymotrypsin(ogen) present in serum and amniotic fluid was noticed. Chymotrypsinogen concentration in pancreatic juice was evaluated to represent 9% of total proteins. Mean values of chymotrypsin(ogen) in human sera were 24.6 +/- 8.3 micrograms/l in adults and 20.9 +/- 8.8 micrograms/l in newborns. In amniotic fluid at the 18th week of pregnancy the values were scattered (5-70 micrograms/l). The molecular forms of immunoreactive chymotrypsin(ogen) in normal serum and amniotic fluid have been investigated by gel filtration on Sephadex G-100. Two peaks of immunoreactive chymotrypsin(ogen) were observed in normal serum; the first peak elutes in a position consistent with a complex of chymotrypsin with serum inhibitor (Mr 76,000), and the second peak elutes with a molecular weight of approx. 25,000 corresponding to the elution position of free chymotrypsin(ogen). In normal amniotic fluid three peaks of immunoreactive material were present; the first and second peaks elute in the same position as in serum, and the third peak with a molecular weight of about 14,500 may represent a degraded form of chymotrypsin. PMID- 3524694 TI - Phosphorylation of external cell-surface proteins by an endogenous ecto-protein kinase of goat epididymal intact spermatozoa. AB - Intact spermatozoa from goat cauda epididymides possess an ecto-(cyclic AMP independent protein kinase) activity that causes transfer of the terminal phosphate of exogenously added [gamma-32P]ATP to the serine and threonine residues of several endogenous plasma-membrane phosphoproteins located on the external cell surface. Cyclic AMP, cyclic GMP, calmodulin and muscle cyclic AMP dependent protein kinases I and II had no appreciable effect on the rate of phosphorylation of ecto-proteins by the intact cells. The ecto-enzyme is not derived from the catalytic subunit of a cyclic AMP-dependent kinase. Sperm ecto kinase activity is not due to contamination of broken cells or any possible cell damage during incubation and isolation of spermatozoa. The phosphorylation reaction was linear for approx. 1 min and there was no detectable uptake of ATP by these cells. The activity of the ecto-kinase was strongly inhibited by proteinases and by the membrane-nonpenetrating surface probes. The products of the reaction were associated with the intact cells and the 32P of the labelled cells was largely lost when treated with Triton X-100 or proteinases: trypsin and pronase. These data are consistent with the view that the observed protein kinase and the phosphoproteins are located on the external surface of spermatozoa. Vigorously forward-motile whole spermatozoa showed a relatively high capacity to phosphorylate ecto-proteins that undergo rapid turnover. The results suggest the occurrence of a novel coupled-enzyme system (ecto-protein kinase and phosphoprotein phosphatase) on the sperm external surface that may modulate sperm physiology by determining the phosphorylated states of the ecto-proteins. PMID- 3524695 TI - [Various physico-chemical properties of lytic proteinase L2 of the enzyme preparation lysoamidase isolated from bacteria of Pseudomonadaceae family]. AB - Some physico-chemical properties of lytic proteinase L2 isolated from the enzymatic microbial preparation of lysoamidase were studied. The molecular mass of the enzyme is 15 000 Da, pI is 5.3. The enzyme hydrolyzes casein as well as the cells and cell walls of Staphylococcus aureus 209-P. The pH optimum of casein hydrolysis lies at 9.5; that for cell wall hydrolysis at 8.0. The temperature optimum for casein hydrolysis and cell lysis lies at 55 degrees C and 65 degrees C, respectively. The enzyme proteolytic activity is inhibited by serine proteinase inhibitors in a greater degree than the lytic activity. 50% of the proteolytic and lytic activities is lost upon enzyme heating for 15 min at 65 degrees C. PMID- 3524696 TI - Immunological response to stress in agoraphobia and panic attacks. AB - The authors studied in vitro immune function as measured by lymphocytic proliferative response to mitogen stimulation in 36 patients with agoraphobia and panic attacks who were participating in a double-blind placebo-controlled psychopharmacological study of anxiety disorder. No significant difference in immune status was observed between panic patients and healthy controls. PMID- 3524697 TI - Ceftazidime pharmacokinetics in preterm newborns on the first day of life. AB - Ceftazidime pharmacokinetics were studied in 13 preterm newborns requiring antibiotic treatment, following intramuscular administration of a 50 mg/kg dose in the first 24 hours of life. The main pharmacokinetic parameters (peak concentration, time to reach peak, plasma half-life, area under the curve, elimination constant, distribution volume and plasma clearance) were determined directly from the serum concentrations observed. The clinical and bacteriological response to ceftazidime treatment was good; no side effects or alterations of biohumoral parameters were noted. PMID- 3524698 TI - Met-enkephalin-like immunoreactivity (MELI) and enkephalinase activity (EKA) in cord blood and newborns in the first hours of life. AB - Recently, the presence and the concomitant release with catecholamines of metenkephalin and other pro-enkephalin A deriving peptides have been demonstrated in the adrenal medulla of various mammals and man. As high amounts of catecholamines are released in the newborn at delivery, probably following the stress of parturition, a similar release of met-enkephalin and other pro enkephalin A deriving peptides from the newborn chromaffin tissue may be hypothesized. In the present study we investigate the occurrence of met enkephalin-like immunoreactivity and enkephalinase (quite a specific enkephalin degrading enzyme) in cord and newborn plasma at different hours after birth. Our results show the presence of high met-enkephalin-like immunoreactivity levels in cord and newborn plasma with respect to normal adult values. On the contrary, cord blood enkephalinase activity was lower than in adult subjects and further decreased during the first hours of life. A positive correlation was found between the two parameters. These data seem to indicate a release of met enkephalin-like peptides from the newborns' sympathoadrenal tissue following the stress of delivery and in the first hours of life. PMID- 3524699 TI - Incorporation of 3-deoxy-3-fluoro-D-glucose into glycogen and trehalose in fat body and flight muscle in Locusta migratoria. AB - Flight muscle and fat body extracts from Locusta migratoria were incubated with D [U-14C]-glucose or D-[3-3H]-3-deoxy-3-fluoroglucose and the products were analyzed. In the case of the latter compound, radio-chromatographic analysis yielded glycogen and trehalose fractions that were shown by 19F nuclear magnetic resonance to contain fluorine. Acid hydrolysis of these fractions liberated tritium labelled 3-deoxy-3-fluoro-D-glucose. In addition to the formation of "fluoroglycogen" and "fluorotrehalose" in these tissue extracts, there was an accumulation of tritium labelled fructose. PMID- 3524700 TI - [Induction of macrophage migration inhibition factor-producing cells in vitro]. AB - The in vitro induction of effector cells mediating delayed type hypersensitivity (DTH) responses was demonstrated during joint cultivation of plastic non-adherent spleen cells of intact CBA mice and adherent spleen cells pretreated with MBSA or OVA. The activity of these effector cells was studied by testing their ability to produce MIF after stimulation by a specific antigen. The formation of MIF producing cells was observed with the use of low antigen doses (about 50 micrograms/ml). High OVA doses (250 micrograms/ml) were found to suppress the development of MIF-producing cells. MIF-producing cells obtained after either in vitro or in vivo exposure to identical antigens did not differ in their activity. PMID- 3524701 TI - [Differentiation potentials of clonal strains of bone marrow fibroblasts]. AB - The clonal nature of CFUf-derived fibroblast colonies was proved by chromosomal analysis of individual colonies and single-colony-derived fibroblast strains using mixed cell cultures from male and female rabbits. CFUf progeny, forming colonies composed of more than 10(3) cells was capable of 20-30 cell doublings during subsequent passages. When transplanted in diffusion chambers, single colony-derived fibroblast strains formed bone and cartilage simultaneously. Thus, CFUf or part of them can be regarded as bone marrow osteogenic stem cells. PMID- 3524702 TI - [Effect of estrone on formation of the focus of heterotopic hematopoiesis]. AB - The effect of estrone injections on the heterotopic bone marrow organ formation was studied in (C57Bl X CBA)F1 mice by bone marrow shaft transplantation under the kidney capsule. Estrone injections resulted in femur marrow fibrosis, the increase in the weight of femur and heterotopic organ ossicle, drastic reduction in heterotopic organ cellularity. Depression of hemopoiesis in ectopic organ cannot be attributed to mechanical displacement of hemopoietic cells because a newly formed bone cavity under the kidney capsule was not closed. Thus, estrone had a detrimental effect on the creation of microenvironment in the heterotopic organ. PMID- 3524703 TI - [Structural changes in the kidneys during experimental infection caused by Yersinia pseudotuberculosis]. AB - A pronounced affinity of Yersinia pseudotuberculosis to the epithelium of renal tubules has been first stated. Microorganisms disseminate through blood into the renal tissue and enter the winding tubule lumen as part of glomerular filtrate. Due to invasion and intensive multiplication of Yersinia pseudotuberculosis within epitheliocytes the epithelium is damaged and necrotic nephrosis develops. Intensive microbial colonization was noted in the tubule lumen. Extra-capillary glomerulonephritis due to Yersinia pseudotuberculosis was detected for the first time. Our data can account for long-term renal disorders in patients with pseudotuberculosis. PMID- 3524704 TI - [Production in vivo of macrophage migration inhibition and stimulation factors in the inductive phase of the alloimmune response]. AB - Macrophage migration inhibition and stimulation factors were revealed in the serum of alloimmune mice by polyacrylamide gel electrophoresis. CBA mice were primed intravenously with 90 X 10(6) and challenged subsequently intravenously with 20 X 10(6) spleen cells of BALB/c mice. Macrophage migration inhibition and stimulation factors were revealed in pre- and post-albumin fractions, respectively, already on days 1 and 6 after alloimmunization. It is suggested that at an early phase of immune response the immunomediators with alternative functions whose local activity gradients predetermined the macrophage behaviour, are released into the serum of alloimmune animals. PMID- 3524705 TI - [Effect of nutrient medium perfusion on the secretory activity of rat hepatocytes and pancreatic islet cells]. AB - The data are reported on albumin secretion by rat hepatocytes and insulin secretion by pancreatic beta-cells of newborn rats during cell cultivation on flat synthetic membrane in conditions of continuous medium perfusion. Albumin and insulin secretion by the appropriate cultures was higher in continuous medium perfusion than in the control. Enhanced sensitivity of pancreatic beta-cells to glucose, as compared to the control was revealed. It is concluded that continuous medium perfusion of hepatocytes and pancreatic beta-cells in the primary culture had a favourable effect on albumin and insulin secretion by the appropriate cultures. PMID- 3524706 TI - Studies on the pathophysiology of posttransfusion purpura. AB - Posttransfusion purpura typically occurs in PLA1 negative blood recipients who have been previously immunized to the PLA1 antigen. Following transfusion, severe thrombocytopenia develops with the formation of anti-PLA1. Since the patients' platelets lack the PLA1 antigen, one would not expect this antibody to destroy autologous platelets. In this study we show that PLA1 antigen exists in stored blood and can absorb to PLA1 negative platelets making them PLA1 reactive. Incubating PLA1 (-) platelets with ultracentrifuged plasma from PLA1 (+) blood donors allowed anti-PLA1 to bind to PLA1 (-) platelets. Control plasma from PLA1 (-) blood donors did not lead to anti-PLA1 binding. Using an inhibition assay, we showed that stored blood contains PLA1 material that was not removed by ultracentrifugation. The material absorbing to PLA1 (-) platelets represented the PLA1 antigen, which was confirmed by Western blotting. After incubating plasma containing PLA1 antigen with PLA1 (-) platelets, reactivity at 95,000 D was observed. Native PLA1 (+) platelets showed a similar band. When PLA1 (-) platelets were incubated with plasma from a PLA1 (-) donor, this band was not present. These studies show that a soluble form of PLA1 antigen exists in stored blood that can absorb to PLA1 (-) platelets. Consequently, anti-PLA1 can bind to these platelets leading to thrombocytopenia. These observations may explain the autologous destruction of platelets in posttransfusion purpura. PMID- 3524707 TI - Increased infection mortality and decreased neutrophil migration due to a component of an artificial blood substitute. AB - We previously showed that an artificial blood substitute containing perfluorocarbons, Fluosol-DA, inhibited both neutrophil migration and adherence, due to its detergent component, Pluronic F-68. The purpose of the studies we report here was to determine if Fluosol or Pluronic might also reduce in vivo neutrophil migration and impair host resistance to bacterial infection. We studied in vivo PMN migration by injecting mice intraperitoneally (IP) with glycogen, followed by intravenous (IV) infusion of saline, Fluosol, or Pluronic. Peritoneal lavage after eight hours showed a significant decrease in the accumulation of PMN in lavage fluids of animals given either Fluosol or Pluronic (control--.19 +/- .03 X 10(6) PMN/mL, glycogen--1.35 +/- .14; glycogen/Fluosol- 0.63 +/- .12; glycogen/Pluronic--0.69 +/- .07). We ascertained the effect of Fluosol and Pluronic on infection mortality by injecting mice IV with saline, Fluosol, or Pluronic, followed by a quantity of E coli (0.6 X 10(7] IP shown in preliminary studies to kill 20% to 50% of the mice in 24 hours. The 24-hour mortality was 14/45-saline, 24/32-Fluosol (chi 2 = 17.1; P less than .001) and 17/23 - Pluronic (chi = 11.2; P less than .001). Neither Fluosol nor Pluronic caused mortality without E coli. The increase in infection mortality occurred when Fluosol was given either two hours before, or simultaneously with E coli, but only with the simultaneous administration of bacteria and Pluronic. Pluronic did not alter reticuloendothelial system (RES) clearance function. These studies indicate that, in an animal model, Fluosol-DA, due to its detergent component Pluronic F-68, impaired neutrophil delivery to an inflammatory locus, and resulted in an increased rate of infection mortality. Since Pluronic did not result in RES blockade, but did impair the delivery of PMN to an inflammatory locus, our results suggest that the latter effect is responsible for the increase in infection mortality. PMID- 3524708 TI - Use of highly polymorphic DNA probes for genotypic analysis following bone marrow transplantation. AB - The use of DNA markers known as restriction fragment length polymorphisms is a sensitive and informative method of distinguishing patient and allogeneic donor cells after bone marrow transplantation. To apply the test, it is necessary in each case to find DNA probes that display patient-specific and donor-specific bands in Southern transfer hybridization. We have isolated a set of 12 cloned DNAs from highly polymorphic loci by which siblings can usually be distinguished. With just four of these probes, we can expect to distinguish the genotypes of the recipient and a sibling donor in more than 99% of cases (except between identical twins). The availability of many highly polymorphic probes also allows selection of an optimal probe for each case, one that can detect both the patient and donor specific bands in a single hybridization with maximum resolution and sensitivity. We have applied these probes to the analysis of cells from peripheral blood and bone marrow after transplantation and demonstrated their usefulness in confirming engraftment of donor cells or graft rejection, and in detecting mixed lympho hematopoietic chimerism. PMID- 3524709 TI - Thrombin binding and response in platelets from patients with dyslipoproteinemias: increased stimulus-response coupling in type II hyperlipoproteinemia. AB - Platelets were obtained from patients with various hyperlipidemias [type II, type V, lecithin-cholesterol acyltransferase (LCAT) deficiency] and hypolipidemias (abetalipoproteinemia, Tangier disease) to ascertain relationships among plasma lipids, platelet lipids, thrombin binding and thrombin-induced platelet aggregation, and to compare these data with those previously obtained on stimulus response coupling in platelets following in vitro modification of membrane microviscosity. Washed platelets were studied for their ability to bind 125I thrombin in the range of 10(-10) to 10(-6) mol/L (10 mU/mL to 100 U/mL) and to aggregate with thrombin at concentrations less than 10(-9) mol/L (100 mU/mL). The values for binding and aggregation in eight patients from six kindred with familial hypercholesterolemia, taken as a group, fell in the low normal range. If divided into two groups, patients with overt cardiovascular disease bound normal amounts of thrombin but were more responsive to it, whereas patients without overt cardiovascular disease bound lower amounts of thrombin but gave an aggregation response in the normal range. These results suggest that platelet hyperresponsiveness in familial hypercholesterolemia arises from an alteration in the coupling mechanism between thrombin binding and response such that platelets from patients with familial hypercholesterolemia are able to respond with lower receptor occupancy than is the case with normal platelets. Thrombin binding and aggregation were within normal ranges for platelets from abetalipoproteinemia patients (N = 4) and type V hyperlipoproteinemia (N = 2), although in the latter case the response appeared to be less at very low thrombin concentrations (less than 30 mU/mL). Thrombin binding was elevated in Tangier disease (N = 3) but with lower responsiveness at lower thrombin concentrations. Thrombin binding was also elevated in LCAT deficiency (N = 2), and one patient showed increased and another showed decreased aggregation responses. In general, increased plasma cholesterol levels resulted in increased stimulus-response coupling (type II), whereas increased triglyceride levels resulted in decreased coupling (type V, Tangier), and there was no apparent alteration in the coupling mechanism with overall reduction in plasma lipid levels as in abetalipoproteinemia. PMID- 3524710 TI - Monocytes stimulate fibroblastoid bone marrow stromal cells to produce multilineage hematopoietic growth factors. AB - In previous studies we have found that monocytes produce soluble factors that stimulate human umbilical vein endothelial cells to produce granulocyte macrophage colony-stimulating activity (CSA), burst-promoting activity (BPA), and megakaryocyte colony-stimulating activity (Meg-CSA) as well as factors that stimulate T lymphocytes and neonatal fibroblasts to produce CSA. To test the hypothesis that monocytes would similarly stimulate the production of hematopoietic growth factors by autologous bone marrow stromal cells, multiply passaged adherent fibroblastoid cells derived from the bone marrow of normal volunteers were exposed to conditioned media prepared by incubating autologous peripheral blood monocytes in complete medium for three days. When conditioned media from stromal cells incubated in monocyte-conditioned medium were compared with those of stromal cells cultured in the absence of monocyte-conditioned medium, BPA was increased fourfold and CSA was increased more than 30-fold. We conclude that mononuclear phagocytes recruit stromal cells of the marrow to produce multilineage growth factors in vitro. We suggest that these monocyte derived recruiting activities may play an important role in orchestration of hematopoietic growth factor production by cells of the marrow microenvironment. PMID- 3524712 TI - Interview, diagnostic, and legal aspects in the forensic psychiatric assessments of deaf persons. AB - Forensic psychiatric assessments rely on many underlying presumptions concerning the language development and abilities of their subjects. Although these assumptions may apply across a culturally diverse group of hearing subjects, they probably do not apply to those who are prelingually deaf because such deaf persons never developed verbal language. In this article, a review of the range of literature focusing upon the unique aspects of interviews, diagnosis, and legal understanding of the deaf is conducted. An attempt to illuminate those features believed to be most relevant to forensic assessments of this unique population is made. The demands of interviews conducted in manual language are discussed and particular attention is paid to the impact of the interpreter upon confidentiality, privilege, agency, and the dynamics of the interview. It is also suggested that many of the baseline behaviors of the deaf may, at least partly, result from differences in communication style between the deaf and hearing. This article reports that many major mental disorders occur with the same frequency among the deaf and hearing and include many of the same symptoms. However, organic mental disorders may occur at a somewhat greater rate among the deaf because of the organic basis of deafness. Finally, the ways in which deafness and the use of an interpreter may influence the deaf person's ability to understand and relate to legal concepts and process are discussed. It is noted that many of these problems may arise from a deaf persons inexperience or undereducation about legal matters rather than psychopathology. PMID- 3524711 TI - Clinical relevance of protein C. AB - Protein C is, after activation by thrombin, a potent inhibitor of blood coagulation. An isolated deficiency of protein C increases the risk of thrombosis. The two forms of protein C deficiency, the heterozygous and the homozygous deficiency state, have different clinical features. Patients with heterozygous protein C deficiency are at a high risk to develop venous thrombosis and pulmonary embolism. In newborns with homozygous protein C deficiency with very low protein C levels (1%) a purpura fulminans like syndrome was observed. Heparin and coumarin derivatives are effective drugs in heterozygous protein C deficiency, homozygous patients may be treated either by replacement of protein C or coumarin derivatives. Decreased protein C levels were observed in various other diseases: Chronic and acute liver disease, disseminated intravascular coagulation, malignancy, postoperatively and during treatment with asparaginase. The role of protein C in these diseases to trigger thrombosis is not yet established. PMID- 3524713 TI - [Immunohistochemical study using monoclonal antibodies (H222 SP gamma) of estrogen receptors: correlation with biochemical analysis (by radioligand) of 115 breast carcinomas]. AB - Breast cancer specimens from 115 patients were assayed for the presence of estrogen receptors (ER) using a monoclonal antibody (H222 SP gamma) and an immuno histochemical method ER-ICA. The specific ER immuno-staining was observed in cell nuclei. The intensity of the immuno-staining level (ISL) and the percentage of positive cells (PC) variable within tumors tissue, were graded (from 0 to 3): intensity level (IL) and percentage of positive cells (PC). (IL + PC) were correlated to biochemical ER assay using radiolabeled ligands ER - RLA. Both ER - ICA and ER - RLA were correlated in 87.9% of the cases. Discrepancies between both assays appeared mainly due to heterogeneity of the tissue samples. From this study it is concluded that ER - ICA is a reliable histochemical method since well correlated with biochemical assay, easily and rapidly performable, and constitutes a new approach method for ER detection in tissue, particularly valuable in minimal breast cancer, and precancerous lesions. PMID- 3524714 TI - Pharyngeal and glottic changes following methacholine challenge in normal subjects. AB - Recent evidence indicates that some normal subjects exhibit glottic narrowing following experimentally induced bronchospasm. Similar findings have been observed during episodes of bronchospasm in asthmatics. The exact mechanism of this effect is unknown but it is thought to occur as part of a generalized reflex response associated with constriction of intrapulmonary airways. We tested the hypothesis that in addition to the glottic changes, coincident with intrapulmonary airway constriction which occurred after inhalation of methacholine, the pharynx would show similar changes. Pharyngeal and glottic cross-sectional areas were measured using the acoustic reflection technique in seven healthy subjects before and after inhalation of metacholine. Before methacholine, pharyngeal and glottic areas (mean +/- SE) were 5.0 +/- 0.2 cm2 and 2.4 +/- 0.3 cm2 respectively. After inhalation of methacholine, these areas were reduced to 4.6 +/- 0.3 cm2 and 1.9 +/- 0.3 cm2 respectively (p less than 0.05). We conclude that inhalation of methacholine induces similar reductions in glottic and pharyngeal areas. The role of local or reflex mechanisms accounting for this reduction remains unclear. PMID- 3524715 TI - Observations made by the replica technique on adhesion of visible light-cured composite resins to cavities. PMID- 3524716 TI - [Methods for replication of the mandible]. PMID- 3524717 TI - [Relation of indices of periodontal disease and the results of salivary occult bleeding tests]. PMID- 3524718 TI - An economical technique for a few-unit posterior interim restoration. PMID- 3524719 TI - [Mechanisms of maxillary expansion using laser holographic interferometry methods]. PMID- 3524720 TI - [Academic eulogy of Prof. Georges Leplat, titular member and former president]. PMID- 3524721 TI - Management of bleeding oesophageal varices. AB - Variceal haemorrhage has long been recognized as a serious complication of portal hypertension. The last few years have seen a considerable expansion in the techniques available for its control. This review examines these therapeutic options and their role in patient management. PMID- 3524722 TI - A brief history of the Plastic Surgery Unit based on Shotley Bridge General Hospital. PMID- 3524724 TI - A double-blind gluten-free/gluten-load controlled trial in a secure ward population. AB - A double-blind control trial of gluten-free versus a gluten-containing diet was carried out in a ward of maximum security hospital: 24 patients were studied for 14 weeks. Most suffered from psychotic disorders, particularly schizophrenia. Various dimensions of behaviour were rated on the Psychotic In-Patient profile (PIP) at different stages. There were beneficial changes in the whole group of patients between pre-trial and gluten-free period in five dimensions of the PIP, maintained during the gluten challenge period; these changes could be attributed to the attention the patients received. Two patients improved during the gluten free period and relapsed when the gluten diet was reintroduced. PMID- 3524723 TI - The dexamethasone suppression test. Fact and artefact. PMID- 3524725 TI - The AMDP-system in clinical psychopharmacology. AB - The AMDP-System has been developed in Europe by the Association for Methodology and Documentation in Psychiatry the standardised documentation of psychiatric files and for the measurement of change in drug trials. It is increasingly used in the French-speaking and German-speaking countries by clinical psychopharmacologists for teaching classical German psychopathological concepts to students and for the multicentre and multifactorial evaluation of drug changes. The AMDP-System consists of three anamnestic forms and of two comprehensive rating scales on present psychopathology (100 items + write-in items) and somatic complaints (40 items + write-in items). PMID- 3524726 TI - Milton Erickson's contribution to psychiatry. PMID- 3524727 TI - A controlled study of acupuncture in neck pain. AB - Twenty-five out-patients with chronic neck pain participated in a prospective, randomized trial of acupuncture versus placebo transcutaneous nerve stimulation. A single-blind, non-cross-over design incorporated several outcome measures in an attempt to determine any particular facet of pain that responded to acupuncture. No significant difference between the two treatments was found either post treatment or at follow-up. Whilst the small population studied limits the conclusions that may be drawn, these findings suggest that acupuncture may have no greater effect than that of a powerful placebo. PMID- 3524728 TI - Study of sulphamethoxazole in rheumatoid arthritis. AB - Twenty-three patients with rheumatoid arthritis (RA) entered a single-blind cross over study of sulphamethoxazole 2 g daily compared to placebo. Sulphamethoxazole was administered for 3 months during the 6-month study. Sulphamethoxazole exhibited properties commensurate with a second-line effect with a significant acute-phase reactant response and a parallel change in the clinical state. Adverse effects were common and resulted in nine drug-related withdrawals, mainly due to nausea and vomiting. There were also reversible abnormalities in liver function tests on the active drug. The role of sulphonamides in treatment of RA requires further exploration. PMID- 3524729 TI - The golden age: a shifting spectrum. British Institute of Radiology presidential address 1985. PMID- 3524730 TI - Radiotherapy and breast conservation. PMID- 3524731 TI - Thoracic neuroblastoma: antenatal demonstration in a case with unusual post-natal radiographic findings. PMID- 3524732 TI - A miserable child with an abdominal mass--and more. PMID- 3524733 TI - 90 years of X-rays. Proceedings of a joint meeting between the British Institute of Radiology, the National Radiological Protection Board and the British Association for the Advancement of Science. London, November 8, 1985. Abstracts. PMID- 3524734 TI - Proceedings of the British Medical Ultrasound Society. Seventeenth annual meeting. Southampton, December 17-19, 1985. Abstracts. PMID- 3524735 TI - Ultrasonography of the normal adrenal glands: a study using linear-array real time equipment. AB - The adrenal glands were evaluated in 70 normal volunteers using linear-array real time ultrasonography. All the scanning approaches described for manual B-scanning were used and, on the left side, longitudinal scans along the axillary lines were also performed. The right adrenal gland was imaged in 68 of the 70 volunteers and the left gland in 63. The dynamic capabilities of real-time equipment were of great help for proper localisation and identification of the glands. Changes in the scanning plane demonstrated variations in the adrenal morphology, because different portions of the gland were encountered by the scanning beam. PMID- 3524736 TI - Imaging of questionable and unusual pelvic masses. AB - Ultrasonography is usually the initial diagnostic examination performed for evaluating gynaecological conditions and pelvic masses. The authors' experience with 11 "problem cases" and a review of the literature of such enigmas has led to the following recommendations in the following order: a plain radiograph or repeat ultrasound study; ultrasound study with the water enema technique; gastrointestinal examination if the answer is still not apparent, followed by computed tomography or a real-time ultrasound study during a clinical pelvic examination. PMID- 3524737 TI - The man who hated hospitals. PMID- 3524738 TI - Proceedings of the British Institute of Radiology. Radiology '86: forty-fourth annual congress and scientific exhibition. Bristol, April 9-11, 1986. PMID- 3524739 TI - Local excision of subcutaneous fat in the management of insulin overdose. PMID- 3524740 TI - Diagnostic yield of endoscopic retrograde cholangiopancreatography in carcinoma of the pancreas. AB - The results of 117 consecutive endoscopic retrograde cholangiopancreatographic (ERCP) examinations in patients with adenocarcinoma carcinoma of the pancreas, performed over a six year period, are reported. The diagnostic accuracy of this procedure (80.3 per cent) was higher than that of computed tomography (63.6 per cent) and ultrasonography (54.0 per cent). Fewer false negative diagnoses were made by retrograde cholangiopancreatography (7.7 per cent) than with the other procedures (28 per cent each). Analysis of the total ERCP experience during the study period revealed a false positive rate for malignancy of 5.6 per cent. In situations where investigations are performed by individuals with a broad spectrum of expertise, ERCP is superior to other methods in diagnosing pancreatic carcinoma, even in areas with a high prevalence of chronic pancreatitis. PMID- 3524741 TI - Haemodynamic assessment of the femoropopliteal segment: comparison of pressure and Doppler methods using ROC curve analysis. AB - Combined aorto-iliac and femoropopliteal vascular disease remains a problem in vascular surgery. Arteriography does not provide information on the relative contributions of the two lesions to the presenting symptoms. Aorto-iliac haemodynamics may reveal occult aorto-iliac disease but does not show whether combined proximal and distal reconstruction will be required to provide symptomatic relief. Haemodynamic assessment of both segments may help in this respect. A haemodynamic assessment of the femoropopliteal segment of 72 limbs in 38 patients is reported. The segmental pressure drop between a common femoral arterial cannula and a below-knee occlusion cuff is compared with a non-invasive Doppler method combining both transit time and damping factor. Comparison is made using receiver operating characteristic (ROC) curve analysis. The measurement of segmental pressure drop is more accurate than the Doppler method in detection of femoropopliteal stenoses of greater than 50 per cent of the luminal diameter (P less than 0.05). PMID- 3524742 TI - De-functioning stomas: a prospective controlled trial comparing loop ileostomy with loop transverse colostomy. AB - Patients undergoing colorectal surgery who required a defunctioning stoma were randomly allocated to receive either a loop ileostomy (n = 23) or transverse loop colostomy (n = 24). Assessment was made during construction, immediately postoperatively, during the period of outpatient supervision and before and after stoma closure. The ileostomy was associated with significantly less odour than the colostomy (P less than 0.01) and required significantly less appliance changes (P less than 0.05). Furthermore eleven patients (58 per cent) with a colostomy experienced three or more problems with stoma management compared with only three patients (18 per cent) with an ileostomy (P less than 0.05). Wound infection was also significantly more common after closure of the colostomy compared with the ileostomy. Both types of stoma were demonstrated objectively to defunction the distal bowel almost completely. These results indicate that a loop ileostomy is the procedure of first choice when a stoma is needed to defunction the distal colorectum. PMID- 3524743 TI - Intramuscular loading dose of quinine for falciparum malaria: pharmacokinetics and toxicity. AB - In a study of intramuscular injection of quinine eight adults with moderately severe falciparum malaria resistant to chloroquine were treated with quinine dihydrochloride, being given a loading dose of 20 mg salt (16.7 mg base)/kg followed by three or four eight hourly maintenance doses of 10 mg salt (8.3 mg base)/kg injected into the anterior thigh. All patients responded to treatment. Fever and parasite clearance times (mean (SD) 60 (23) h and 53 (22) h respectively) were comparable with those obtained with intravenous quinine. The mean peak plasma quinine concentration of 11.0 mg/l (34.4 mu mol/l) [corrected] was reached a median of five hours after administration of the loading dose. In all patients plasma quinine concentrations exceeded the high minimum inhibitory concentration for Plasmodium falciparum malaria prevalent in Thailand within four hours of the start of treatment but did not cause toxicity other than mild cinchonism. When intravenous infusion is not possible an intramuscular quinine loading dose is an effective means of starting treatment in patients with moderately severe falciparum malaria who cannot swallow tablets. PMID- 3524744 TI - Divided dose intramuscular regimen and single dose subcutaneous regimen for chloroquine: plasma concentrations and toxicity in patients with malaria. AB - Adults with malaria in Sri Lanka were treated with parenteral chloroquine diphosphate, either 2.5 mg base/kg intramuscularly at 0, 1, 12, 13, 24, and 25 hours or 5 mg base/kg subcutaneously at 0, 12, and 24 hours. Both regimens were completed with oral chloroquine phosphate, 5 mg base/kg, at 36 and 48 hours. Mean peak chloroquine concentrations in the first 12 hours, which were 0.5 (range 0.3 0.6) mg/l (1.4 (0.9-1.7) mu mol/l) [corrected] with the intramuscular regimen and 0.3 (0.2-0.4) mg/l (1.0 (0.7-1.3) mu mol/l) [corrected] with the subcutaneous regimen (p less than 0.05), were reached in median times of 90 (65-90) minutes and 30 (30-60) minutes respectively (p less than 0.05) after the start of treatment. The mean area under the plasma concentration curve for the first 12 hours was 1.4 (0.9-2.1) mg/l.h (4.5 (2.8-6.4) mu mol/l.h) [corrected] after intramuscular administration and 1.8 (0.8-2.3) mg/l.h (5.7 (2.7-7.2) mu mol/l.h) [corrected] after subcutaneous administration (p greater than 0.1). Mean maximum plasma concentrations were higher after intramuscular administration (0.6 (0.4 0.8) mg/l (1.7 (1.3-2.5) mu mol/l)) [corrected] than after subcutaneous administration (0.4 (0.4-0.5) mg/l (1.3 (1.3-1.5) mu mol/l)) [corrected] (p less than 0.05), but both regimens produced satisfactory plasma profiles. Chloroquine resistance was found in the only case of Plasmodium falciparum malaria. Chloroquine is absorbed rapidly after divided dose intramuscular injection and single dose subcutaneous injection and does not cause hypotension or neurotoxicity in adults. Similar regimens should be evaluated in children before the parenteral use of this drug is abandoned. PMID- 3524745 TI - Extrahypothalamic vasopressin and oxytocin in the human brain; presence of vasopressin cells in the bed nucleus of the stria terminalis. AB - In the present study, the distribution of extrahypothalamic vasopressin (VP) and oxytocin (OXT) in the human brain was investigated by means of immunocytochemistry. In the septum verum, few VP fibers were found in the nucleus septalis lateralis and medialis (NSL and NSM), and in the bed nucleus of the anterior commissure. Very few VP and OXT fibers were present in the amygdala and in the hippocampus, mainly around the rostral tip of the lateral ventricle on the level of the pes hippocampi. The locus coeruleus (LC) contained dense networks of VP fibers and, although to a lesser extent, OXT fibers over its entire rostrocaudal extension. VP-immunoreactive neurons were present in the bed nucleus of the stria terminalis in a number of subjects, while no OXT cells were found in this structure. Thus, the VP innervation of limbic structures in the human brain, in particular of the NSL, was found to be clearly less pronounced than in the rat brain. The VP innervation of the LC, by contrast, was denser in the human brain than in the rat brain. No sex differences were found in the VP innervation of the human brain. These findings stress the need for caution in extrapolation of data concerning peptidergic innervation of the rat brain towards the human brain. PMID- 3524746 TI - Acetylcholinesterase generates enkephalin-like immunoreactivity when it degrades the soluble proteins (chromogranins) from adrenal chromaffin granules. AB - Acetylcholinesterase was purified by passage through 3 affinity columns. The enzyme so purified was found to be homogeneous by electrophoresis and the peptidase and AChE activities co-eluted from a high pressure liquid chromatography column. The purified AChE degraded the chromogranins, the soluble proteins from the adrenal chromaffin granules, at a rate of nearly 8 micrograms/microgram AChE/h. The rate was fastest with the largest chromogranins, but proteins across the whole molecular weight spectrum were hydrolyzed. Immunoassay of extracts after incubation with AChE showed that enkephalin-like material had been produced. Incubations were also done with chromogranins that had been fractionated by size exclusion chromatography. The AChE degraded protein in all fractions and generated enkephalin-like immunoreactive material in fractions where it was produced by sequential treatment with trypsin and carboxypeptidase B. It seems likely, therefore, that AChE can hydrolyze some of the enkephalin precursors that are sensitive to trypsin and carboxypeptidase B, but the one-step nature of its action suggests a mode of action with fewer restrictions. It is concluded that AChE can hydrolyze proteins of widely differing sizes and the data add to the evidence that AChE is able to hydrolyze enkephalin precursors resulting in the generation of immunoreactive peptide. PMID- 3524747 TI - Glycine neurons in the brain and spinal cord. Antibody production and immunocytochemical localization. AB - Antibodies were raised against glycine and they were specific for immunocytochemistry. Obtained from rabbits immunized with glycine conjugated to glutaryled protein-carriers, antisera were then purified by adsorption on the various glutaraldehyde-conjugated protein-carriers. Using a modified ELISA method, their specificity was determined in competition experiments between conjugated glycine and either non-conjugated glycine or other conjugated amino acids or derivatives, preincubated with anti-glycine antibodies. Calculated at half-displacement, the resulting cross-reactivity ratios showed conjugated glycine to be the best recognized compound. By revealing the presence of the majority of the glycine-containing cell bodies in the brainstem and spinal cord, immunocytochemical applications of glycine antibodies confirmed their use as specific tools for a better understanding of the role of glycine in the central nervous system. PMID- 3524748 TI - Augmented plasma renin levels in dehydrated sheep with periventricular lesions. AB - Ablation of tissue in the midline anterior wall of the third ventricle (AV3V) of sheep did not consistently alter baseline plasma renin concentration (PRC) in water replete animals, but caused a greatly augmented increase in PRC in response to water deprivation. PRC might increase in these sheep in order to maintain blood pressure, however it is possible that a central inhibitory influence on renal renin release, operative during dehydration, is disrupted by AV3V-lesions. PMID- 3524749 TI - Coexistence of calcitonin gene-related peptide and vasoactive intestinal peptide in cholinergic sympathetic innervation of rat sweat glands. AB - Immunoreactivity for calcitonin gene-related peptide (CGRP) has been localized with indirect immunofluorescence techniques in the cholinergic sympathetic fibers that innervate eccrine sweat glands in the rat. This innervation also contains vasoactive intestinal peptide-like immunoreactivity (VIP-IR). A small proportion of principal neurons in stellate and lumbar sympathetic ganglia which provide innervation to the sweat glands contain detectable CGRP-immunoreactivity. The CGRP-IR neurons are immunoreactive for VIP; however, many VIP-IR neurons in these ganglia do not contain detectable levels of CGRP-IR. PMID- 3524750 TI - Distribution and development of proenkephalin-like immunoreactivity in the lumbar spinal cord of the chicken. AB - Met5-enkephalin- (Met-ENK), Leu5-enkephalin-, Met5-enkephalin-Arg6-Phe7-, metorphamide- and BAM 22P-like peptides could be detected in the lumbar spinal cord of the chicken by immunocytochemistry and/or high performance liquid chromatography. However, a peptide identical to Met5-enkephalin-Arg6-Gly7-Leu8 could not be detected in the lumbar spinal cord of the chicken using an antiserum that was capable of detecting the octapeptide in mammalian tissues. Nerve fiber- and terminal-like processes containing proenkephalin-derived peptides were concentrated in the superficial laminae of the dorsal horn and along the midline rostral to the central canal. A lesser concentration of processes containing proenkephalin-derived peptides occurred in the medial and lateral motor columns of the ventral horn. The level of total radioimmunoassayable Met-ENK in the lumbar spinal cord of the chicken embryo increased more than 1000-fold between day 4.5 and day 18. A schedule of curare administration that had previously been shown to prevent naturally occurring somatic motoneuron death in the chicken lumbar spinal cord resulted in a two-fold increase in total radioimmunoassayable Met-ENK in the lumbar spinal cord. PMID- 3524751 TI - Extrahypophyseal distribution of alpha-melanocyte stimulating hormone (alpha-MSH) like immunoreactivity in postmortem brains from normal subjects and Alzheimer type dementia patients. AB - Using a sensitive double-antibody solid-phase enzyme immunoassay method alpha melanocyte stimulating hormone-like immunoreactivity (alpha-MSH-LI) was measured in 21 regions of postmortem brains from 8 normal subjects and 5 patients with Alzheimer-type dementia (ATD). In the brains from the normal subjects, the highest concentration of alpha-MSH-LI was found in the hypothalamus. Relatively high concentration were also measured in the locus coeruleus, substantia innominata, substantia nigra, amygdala and medial nucleus of thalamus. alpha-MSH LI in other regions was approximately 1/100 of the hypothalamic content. This data is consistent with the existence of alpha-MSH in extrahypophyseal regions and indicates its regional distribution in the human brain. In the Alzheimer brains, although the temporal cortex and hippocampus had normal concentrations of alpha-MSH-LI, the cingulate cortex, caudate and substantia nigra showed significantly lower concentrations of alpha-MSH-LI than those of the control brains. This data suggests that further studies of alpha-MSH content in a larger number of ATD brains would be useful. PMID- 3524752 TI - Immunocytochemical study of enkephalin-like cell bodies in the thalamus of the cat. AB - Using an indirect immunoperoxidase technique, the localization of enkephalin-like cell bodies in the thalamus of the cat was carried out. Enkephalin-like cell bodies are widely distributed in the cat thalamus. However, immunoreactive cells may be regrouped in 4 clusters which do not exactly correlate with the anatomical subdivisions of the thalamus. One is located in the dorsocaudal aspect of the thalamus, another in the midline area, and the others are formed by the nuclei geniculatum mediale and laterale. PMID- 3524753 TI - Corticotropin-releasing factor (CRF) inhibits gonadotropin-releasing hormone (GnRH) release from superfused rat hypothalami in vitro. AB - A dose-dependent suppression of basal gonadotropin-releasing hormone (GnRH) release was observed when rat hypothalamic slices were superfused with human/rat corticotropin-releasing factor (CRF) (10(-12) to 10(-8) M). CRF was also found to significantly reduce the amount of GnRH released in response to 56 mM KCl. These in vitro results demonstrate that the CRF inhibition of GnRH secretion observed in vivo occurs within the hypothalamus and independently of the CRF activation of the pituitary-adrenal-gonadal axis. PMID- 3524754 TI - Ontogenesis of microtubule-associated protein 2 (MAP2) in embryonic mouse cortex. AB - The developing neocortex in mice from embryonic day 13 (E13) until birth (E19) was immunoreacted with a monoclonal antibody for microtubule-associated protein 2 (MAP2) that is highly specific for neuronal somata and dendrites. In E13 neocortex there was no detectable MAP2 immunoreactivity on tissue sections or on gel blots. From E14 to birth the MAP2 immunoreactivity was present in both tissue sections and immunoblots of homogenized cortex. In the neocortex the staining pattern was lamina-specific. The molecular layer and the cortical subplate contained the most dense staining of dendrites and cell somata. The cortical plate showed weak to moderate staining at these ages while the intermediate and ventricular zones were not stained above background control levels. Gel blots correspondingly did not show detectable levels of MAP2 until E14. Ultrastructural data suggest that MAP2 is present in dendrites in each of the laminae. The laminar pattern of MAP2 immunoreactivity may be due to either the higher density of differentiating dendrites in the molecular and subplate layers or to compartmentalization of MAP2 within individual cortical neurons. PMID- 3524755 TI - Intrinsic 5HT-immunoreactive neurons in the spinal cord of the fetal non-human primate. AB - Serotonin (5HT) immunoreactive neurons were identified in the late-term fetal spinal cord of normal non-human primates. These neurons were distributed throughout the spinal cord, being concentrated in lamina X and the subjacent ventral median fissure, while their immunoreactive fibers and terminals innervated the zone surrounding the central canal and the ventral spinal artery. Even at this late fetal stage, the dorsal and ventral spinal gray matter was virtually devoid of any positive 5HT immunoreactivity, in contrast to that seen in the adult primate. These findings suggest that the intrinsic 5HT neurons of the primate during development may modulate CSF composition or provide cues for spinal cord differentiation rather than regulate sensorimotor functions as they do in the adult. PMID- 3524757 TI - Glial-like cells in sympathetic neural crest derivatives during human embryogenesis. Detection by S-100 immunohistochemistry. AB - The present study investigates at the light and electron microscopic levels the possible presence and distribution during human development of glial-like satellite cells in sympathetic neural crest derivatives by S-100 immunohistochemistry. From the earliest stages investigated, immunostained cells were detected inside sympathetic migrating masses and at their periphery, where they constituted a continuous layer isolating sympathetic elements from mesenchymal cells. The detection and peculiar distribution of these glial-like cells in developing sympathetic tissue could open new perspectives in the study of events linked to the migration and differentiation of some neural crest derivatives. PMID- 3524756 TI - The migration and neurochemical differentiation of gamma-aminobutyric acid (GABA) immunoreactive neurons in rat visual cortex as demonstrated by a combined immunocytochemical-autoradiographic technique. AB - The development of some cortical local circuit neurons was traced using a technique which combined immunocytochemistry to label gamma-aminobutyric acid immunoreactive (GABA+) neurons and [3H]thymidine autoradiography to identify cells with similar times of origin. Double-labeled neurons (GABA+ neurons with autoradiographic silver grains over their nuclei) are evident only after migration is complete. GABA+ neurons born on gestational day 16 are first identified in layer VIa on postnatal day 0 and those born on day 19 are in layer III on postnatal day 6. The frequency of double-labeled neurons increases during the week following their appearance. Therefore, the migration and the neurochemical differentiation of GABA+ neurons follow inside-to-outside sequences. PMID- 3524758 TI - Growth and development of intraocular fetal cortex cerebri grafts in rats of different ages. AB - Cortex cerebri pieces from fetal donors were homologously and bilaterally grafted to the anterior chamber of the eye of 1.5-, 3.0- and 7.5-month-old rats. Repeated stereoscopic in vivo measurements revealed that the grafts in the young group grew to a size twice as large as those in the older two groups. The degree of gliosis was studied immunohistochemically using antibodies against glial fibrillary acidic protein. Both grafts to young and to older hosts were clearly gliotic as compared to normal cerebral cortex. However, the gliosis was significantly more pronounced in grafts to 3.0- and 7.5-month-old hosts as compared to grafts to 1.5-month-old hosts. The vascular component was evaluated using antibodies against laminin. We found laminin immunofluorescence to be an excellent marker of brain tissue vascularization, particularly at the capillary level, revealing the entire capillary tree and endothelial budding. The density of the vascular plexus and the average thickness of the capillaries of cortex cerebri grafted to the youngest recipients was remarkably similar to normal cerebral cortex. In marked contrast, grafts to the older hosts had a clearly pathological vascular network characterized by few, thick-walled blood vessels and very few normal-looking capillaries. We conclude that host age factors profoundly influence development and growth of intraocular brain tissue grafts. PMID- 3524760 TI - [The diploma of surgeon from Trnava University. On the 350th anniversary of the opening of Trnava University]. PMID- 3524759 TI - [A forgotten Slovak physician and pioneer in genetics, Dr. Pavol Olexik (1801 1878)]. PMID- 3524761 TI - [The development of knowledge in endocrinology and a new definition of hormones]. PMID- 3524762 TI - Parasites: epidemiology and control. PMID- 3524763 TI - Control strategies for nematodiasis in cattle. PMID- 3524764 TI - Epidemiology and control of nematodes and cestodes in small ruminants. Northern United States. PMID- 3524765 TI - Host genetic factors in helminth control in sheep. PMID- 3524766 TI - Malpractice. A case for safety glasses. PMID- 3524767 TI - Oral biopsy technique. The pathologist's perspective. PMID- 3524768 TI - Polylactic acid surgical dressing material. Postoperative therapy for dental extraction wounds. PMID- 3524769 TI - Prosthetic tooth composition. PMID- 3524770 TI - Development of computer assisted instruction. Lessons for teaching nursing research. PMID- 3524771 TI - Measuring attitude toward computer assisted instruction. The development of a semantic differential tool. PMID- 3524772 TI - Two techniques for teaching interviewing--a comparative study. PMID- 3524773 TI - CAI enhances the medication dosage calculation competency of nursing students. PMID- 3524774 TI - Nursing education. Challenges of the computerized environment. PMID- 3524775 TI - Inauguration of the Canadian Ophthalmological Society, Societe canadienne d'ophtalmologie. PMID- 3524776 TI - Topographic studies of the effects of microinjections of muscimol on the hypothalamic control of feed intake in sheep. AB - Ten sheep were used to define the anatomical basis for the feeding systems sensitive to gamma-aminobutyric acid, by using intrahypothalamic microinjections of the gamma-aminobutyric acid agonist, muscimol. In satiated sheep, 1 microL of muscimol (0.5 nmol/microL) elicited feeding when injected into paraventricular, ventromedial, and anterior hypothalamic areas. Similar injections into 39 sites tested in 6-h fasted sheep failed to decrease feed intake. The data suggest that neurons sensitive to gamma-aminobutyric acid in medial hypothalamus may be involved in the initiation of feeding. PMID- 3524777 TI - Granule contents from rat polymorphonuclear leukocytes: antimicrobial properties and characterization. AB - The nonoxidative antibacterial properties of isolated rat polymorphonuclear leukocyte granule contents were examined using Salmonella typhimurium LT-2 and a series of progressively rough lipopolysaccharide mutants of this strain as target bacteria. The granule extract was most active at 37 degrees C, with a substantial decrease in activity observed at lower temperatures. Deep rough bacterial mutants were killed best within a pH range of 6-8, while killing of mutants with increased lipopolysaccharide content was most efficient at an acid pH of 5. The activity of the extract was dependent on incubation time but was independent of the number of bacterial cells present in the assay mixture. The killing action of the granule extract was inhibited by the cations Na+, K+, Mg2+, Ca2+, and Fe2+. The degree of inhibition was dependent on the type and concentration of ion used. Rough mutants grown with aeration to log phase were killed more efficiently than the same mutants grown to stationary phase under static conditions. Also, gram positive bacteria were more susceptible to the extract than were gram-negative organisms. PMID- 3524778 TI - Heart transplants likely to quadruple in Canada by 1990. PMID- 3524779 TI - Microvascular surgery as an adjunctive tool in renal transplantation. AB - There has been a serious shortage of suitable kidneys for transplantation since this procedure became the treatment of choice for many patients with end-stage renal failure. Some harvested kidneys are discarded due to complicated or injured renal vasculature and some potential living related donors are judged unsuitable because their kidneys have multiple vessels. The authors review the basic microsurgical techniques they have used in such situations to salvage kidneys for transplantation. They emphasize the ex-vivo, "bench", microsurgical method for protecting the kidney from prolonged warm ischemia time (as with multiple complicated in-situ anastomoses). Several illustrative case reports from their recent experience are presented. The authors conclude that microvascular surgery is an important adjunct to the armamentarium of the transplant surgeon. PMID- 3524781 TI - Ascites: ultrasound guidance or blind paracentesis? AB - The classic site for paracentesis in generalized ascites is in the left lower quadrant of the abdomen at a position equivalent to McBurney's point. Its use has an average success rate of 58%, depending on the amount of liquid. To assess the efficacy of paracentesis at this site and to establish the ideal site for blind puncture, we studied 27 consecutive patients with ascites detected by abdominal ultrasonography. The amount of ascites was graded from 1 to 4. Free fluid had accumulated mostly in the perihepatic region, then around the bladder and in the right paracolic gutter, and finally in the left flank. In six of the eight patients in whom fluid was found in the left or right flank, air-filled bowel loops were observed between the abdominal wall and the fluid, in the expected path of a blind puncture. These findings suggest that the safety and efficacy of paracentesis would be greatly improved by ultrasonographic guidance. PMID- 3524780 TI - Experience of a Canadian multi-organ transplant service. AB - Organ transplantation has become the treatment of choice for selected patients with end-stage failure of the heart, liver or kidneys. The expanding role for organ transplantation, however, has led to a corresponding increase in the complexity of patient management. In response to these changes, University Hospital, London, Ont., has established an interdisciplinary multi-organ transplant service (MOTS). MOTS coordinates donor organ procurement and patient management. Donor organs have been retrieved from as far south as Dalton, Georgia, as far west as Calgary and as far east as Halifax. As of Dec. 31, 1985, 485 transplants had been performed, including 387 kidney transplants, 51 heart transplants, 3 heart/lung transplants, 43 liver transplants (in adults and children) and 1 pancreas transplant. With current immunosuppressive protocols MOTS projects 1-year patient survival rates of 95% after kidney transplantation, 88% after heart transplantation and 81% after liver transplantation. Patient rehabilitation has been excellent. PMID- 3524782 TI - The economic situation in Saskatchewan. By Lillian A. Chase. CMAJ 1933. PMID- 3524783 TI - Drug storage: a cautionary note. PMID- 3524784 TI - Rifampin alone or with trimethoprim for contacts of children with Haemophilus influenzae type b infections. AB - We carried out a nonrandomized, unblinded study to compare the efficacy of rifampin alone with that of rifampin in combination with trimethoprim in the eradication of the Haemophilus influenzae type b (HIB) carrier state among contacts of patients with invasive HIB infection. The study population comprised 17 index patients admitted to hospital with severe HIB infections and 233 contacts, 43 of whom had nasopharyngeal colonization with HIB of the same biotype as that of the index patient. Rifampin in a daily dose of 20 mg/kg (maximum 600 mg) for 4 days eradicated the carrier state in 86% of cases, as did the combination of rifampin at the same dosage and trimethoprim in a daily dose of 5 mg/kg (maximum 160 mg) for 4 days. PMID- 3524785 TI - A conversation with Malcolm Muggeridge. Interview by David Woods. PMID- 3524786 TI - Depression in dialysis patients: a review of psychological factors. AB - A review of the literature reveals that the incidence and prevalence of depression among dialysis patients is unknown but that estimates may vary from 20 to 50 percent. Diagnostic and methodological problems related to the population are examined and the notion that depression in this population may represent a qualitatively different entity, is evaluated. Finally, several theoretical models of depression are described and their particular relevance to depression among dialysis patients is discussed. PMID- 3524787 TI - Pseudocyesis: an overview. AB - The author reviews the medical literature on pseudocyesis, the condition where a nonpregnant woman believes she is pregnant and has objective signs of pregnancy. The disorder involves both psychological and neuroendocrine mechanisms and is related to other conditions varying in severity from fleeting fears and wishes in healthy women to pathological changes in neuroendocrine functions in others. The notion that the condition is a heterogeneous one, closely related to other more common disorders, is emphasized. PMID- 3524788 TI - Cancers of the anogenital region in renal transplant recipients. Analysis of 65 cases. AB - There is a 100-fold increase in the incidence of carcinomas of the vulva and anus in renal transplant recipients compared with the general population. Anogenital (anus, perianal skin, and external genitalia of both sexes) carcinomas occurred in 65 of 2150 renal transplant recipients who presented with 2298 different types of malignancy. Two-thirds of the patients were female and one-third male. They were much younger than persons with similar tumors in the general population. The average age of the females at the time of diagnosis was 37 years (range, 20-64) and of the males, 45 years (range, 34-62). The neoplasms occurred late after transplantation, an average of 88 months (range, 9-215), compared with an average of 56 months (range, 1-225.5) for all other post-transplant malignancies. The lesions involved the vulva, penis, scrotum, anus, or perianal area. Two patients also had involvement of the urethral meatus. In several female patients, there was a "field effect" with multiple tumors of the squamous epithelium of the anogenital area, vagina, or uterine cervix. Lesions ranged from in situ carcinomas (in one-third of the cases) to those with invasion of adjacent organs and lymph node metastases. Treatment varied from local excisions to radical vulvectomy, abdominoperineal resection, or penile resection, sometimes combined with excision of the inguinal lymph nodes. In several patients, there was a previous history either of condyloma acuminatum or herpes genitalis, suggesting a possible viral etiology of these tumors. PMID- 3524789 TI - A randomized comparison of maintenance treatment with androgens, immunotherapy, and chemotherapy in adult acute myelogenous leukemia. A Leukemia-Lymphoma Group Trial of the EORTC. AB - Twenty-three European centers participated in a randomized clinical trial (AML-5) to study the effect of androgens and immunotherapy during maintenance in adult acute myelogenous leukemia. Induction treatment consisted of Adriamycin (doxorubicin) 50 mg/m2 day 1, vincristine VCR 1 mg/m2 day 2, and cytosine arabinoside 80 mg/m2 every 12 hours by push injection days 3-9. Patients in complete remission were randomized into four groups: (1) 6-mercaptopurine 70 mg/m2 days 1-14, methotrexate 15 mg/m2 twice weekly days 15-28, and reinduction with daunorubicin 35 mg/m2 and vincristine 1 mg/m2 day 29; (2) chemotherapy as in group 1 plus stanozolol 0.15 mg/kg/day; (3) 6-thioguanine 70 mg/m2 orally on 4 consecutive days and cytosine arabinoside 80 mg/m2 subcutaneously day 5 every week; and (4) chemotherapy as in Group 3 plus irradiated blast cells treated with neuraminidase. Three hundred forty-eight patients were eligible and 295 were evaluable. The median age was 45 yrs. A complete remission was achieved in 64% of the patients, with 158 complete remissions randomized. Patients not randomized and patients receiving bone marrow transplantation (BMT) were analyzed separately. There was no difference in disease-free survival (DFS) or survival in the four maintenance arms. For patients reaching complete remission, the median DFS was 40 weeks, and median survival was 22 months with 30% surviving at 4 years. The overall survival was 18% at 4 years. There was no beneficial effect for DFS or survival by adding either immunotherapy or androgens to chemotherapy during maintenance. However, patients receiving immunotherapy seemed to have a higher rate of responses to reinduction after relapse than those in the other treatment arms. PMID- 3524790 TI - Active immunotherapy of human solid tumor with autologous cells treated with cholesteryl hemisuccinate. A Phase I study. AB - A marked increase in specific immunogenicity of tumor cells is induced upon incorporation of cholesteryl hemisuccinate (CHS) into the cell membrane, which presumably promotes the expression of latent tumor-associated antigens. Immunotherapy with CHS-treated and irradiated tumor cells as vaccine was found to be very effective in various murine experimental tumors and in eliciting delayed type hypersensitivity in cancer patients. Based on these findings, we have carried out a Phase I study on 21 patients with solid tumor who had exhausted standard therapeutic options. All participating patients were examined by conventional physical and clinical tests prior and during the study. The immunotherapy regimen for most patients consisted of an intramuscular injection of 2 X 10(7) CHS treated and irradiated autologous tumor cells given at 2-week intervals. Variations on this regimen were mostly due to the lack of sufficient number of cells. None of the patients displayed evidence of toxicity or any other local or systemic adverse effects. In seven patients, regression of tumor mass was observed. In six of nine patients who were tested for delayed-type hypersensitivity against their CHS treated tumor cells, a significant increase in skin reaction was observed after immunotherapy. The lack of any adverse reaction in this treatment, in addition to the observed positive clinical and immunologic response in advanced cancer patients, indicate a safe therapeutic potency which is planned to be investigated in the subsequent clinical studies. PMID- 3524792 TI - Immunologic and cytogenetic studies improve prognosis prediction in chronic B lymphocytic leukemia. A multivariate analysis of 24 variables. AB - Sixty patients with chronic B-lymphocytic leukemia (CLL) were studied. The prognosis predictions achieved from clinical and hematologic status, cytogenetic karyotype, immune phenotype, and cellular proliferative responses in vitro were studied by Cox's multivariate analysis. Indicators of poor survival were high dextran sulphate (DxS)-induced CLL-cell proliferation in vitro (P less than 0.002), older age, low percentage T-cells of blood lymphocytes (P less than 0.01), low hemoglobin count, advanced Binet stage, male sex, and high lymphocyte count (P less than 0.05). A therapy-demanding disease was predicted by cytogenetic data (extra chromosome 12, and complex karyotypes [P less than 0.001]), high DxS-induced CLL-cell proliferation (P less than 0.001), high frequency of cytogenetically abnormal metaphases, and advanced Rai and Binet stages (P less than 0.01). The best combinations of parameters included the cytogenetic variables, the DxS-induced CLL-cell proliferation, the relative T cell number, and the Binet stage. Thus, results from immunologic and cytogenetic studies seem to be helpful in the prediction of prognosis. PMID- 3524791 TI - Chromosomal abnormalities in human retinoblastoma. A review. AB - In part because of an association between the tumor and the constitutional chromosome 13q deletion syndrome and the finding of 13q deletions or monosomy 13 in retinoblastoma cells from individuals with normal constitutional karyotypes, chromosome 13q is postulated to contain a gene responsible for tumorigenesis in retinoblastoma. A review of the cytogenetics of retinoblastoma (incorporating an analysis of five previously unpublished cases and 77 cases from the literature) revealed recurrent abnormalities (in addition to those involving number 13, 21% of cases) that included: additional copies of 1q material (44%), isochromosome (6p) (45%), monosomy 16 (18%), marker 1p+ (13%), and homogeneously staining regions and double minutes (9%). Possible roles for these chromosome abnormalities in tumor development are discussed. PMID- 3524793 TI - Determination of DNA synthesis, estrogen receptors, and carcinoembryonic antigen in isolated cellular subpopulations of human breast cancer. AB - Primary breast adenocarcinomas obtained from ten patients were enzymatically digested using collagenase (1 mg/ml), hyaluronidase (1 mg/ml), elastase (0.1 mg/ml) and DNAse (0.2 mg/ml). The tumor cells were labeled with 3H-thymidine and, in some cases, with 3H-estradiol. The isolated cells were submitted successively to a Ficoll-Hypaque and a bovine serum albumin gradient, from which 12 fractions were obtained. In each fraction, several characteristics were determined: carcinoembryonic antigen (CEA), thymidine (dThd) incorporation, and estrogen receptors (ER). Three main cellular subpopulations were characterized: An intermediate density subpopulation (1.046-1.054 g/ml), in which the proliferating cells are concentrated. In this subpopulation a small number of CEA-positive cells are present, but ER containing cells are virtually absent. A high-density, small cell subpopulation that concentrates most of the ER-containing cells. This subpopulation lacks proliferating cells, but CEA-containing cells are abundant. A low-density subpopulation, lacking proliferating cells and with scarce ER positive cells, although CEA-positive cells are frequent. These findings strongly suggest that proliferating cells lack ER. PMID- 3524794 TI - Intramuscular myxoma. A clinicopathologic, immunohistochemical, and electron microscopic study. AB - This clinicopathologic study concerns 17 cases of intramuscular myxoma, including an immunohistochemical survey of 10 cases and an electron microscopic examination of 4. There was a female preponderance in a ratio of 14:3. The most common sites of tumors were the large muscles of the thigh (seven cases), followed by those of the buttock (three) and the lower leg (three). The size of the tumor ranged from 1.5 to 20 cm (median, 6 cm) in the greatest diameter. Neither recurrence nor metastasis was seen in any of 15 patients for whom information was available. In addition to the conventional microscopic features, such as hypocellularity, absence of a plexiform capillary network, and no detection of typical glycogen rich lipoblasts, the following findings were regarded as helpful to differentiate an intramuscular myxoma from myxoid liposarcoma: hypovascularity of the tumor, demonstrated by angiography; a homogeneous computed tomography appearance with low density, absence of S-100 protein immunoreactive cells such as lipoblasts; and electron microscopically, the constituent cells were predominantly fibroblast like cells with a prominent secretory activity, together with a small number of primitive mesenchymal cells and histiocyte-like cells, but with no lipoblasts. After simple excision, the 15 patients who could be followed are well with no recurrence during various periods of follow-up. PMID- 3524795 TI - Renal failure due to lymphomatous infiltration of the kidneys. Report of three new cases and review of the literature. AB - Three new cases of renal failure due to lymphomatous infiltration of the kidneys are described and the clinical features of 14 similar patients in the literature are reviewed. The diagnosis of renal failure secondary to lymphomatous infiltration was made by ruling out other causes of renal failure and demonstrating prompt improvement in renal function after systemic chemotherapy or local irradiation of one or both kidneys. Histiocytic lymphoma was the most common underlying disease. In the setting of diffuse lymphoma with other causes of renal failure reasonably excluded, radiographic demonstration of enlarged kidneys without obstruction suggests the need for intensive combination chemotherapy in most cases. PMID- 3524796 TI - Primary mucinous carcinoid tumor of the ovary. AB - A case of primary mucinous carcinoid tumor of the ovary occurring in a 37-year old woman is described. The tumor, which replaced the left ovary, was accompanied by metastases in the contralateral ovary and para-aortic lymph nodes. Careful investigations excluded metastatic origin of the tumor. The tumor was solid, but contained an epidermoid cyst. There were no other teratomatous elements. The patient was treated with combination chemotherapy. A second-look operation 9 months following diagnosis revealed extensive microscopic involvement of the peritoneal cavity. The patient's condition deteriorated and she died 1 year after diagnosis. Detailed autopsy revealed peritoneal, pleural, lymphatic, and bone marrow carcinomatosis, but no evidence of a primary tumor elsewhere. Microscopic, ultrastructural, and immunocytochemical findings are described. It is considered that primary mucinous carcinoid tumor of the ovary represents a specific histopathologic entity. Unlike other types of primary ovarian carcinoid tumors, it behaves as an aggressive malignant neoplasm. PMID- 3524797 TI - Intermediate dose methotrexate in childhood acute lymphoblastic leukemia resulting in decreased incidence of testicular relapse. AB - Six hundred thirty-four children with acute lymphoblastic leukemia (ALL) were randomized to receive sanctuary therapy consisting of either cranial irradiation (CRT) plus intrathecal (IT) methotrexate (MTX) or three courses of intermediate dose methotrexate (IDM) plus intrathecal methotrexate. Two hundred sixty-six male patients achieved a complete response and were evaluable for the effects of prophylactic therapy on the duration of remission. There was one isolated testicular relapse (0.8%) in the IDM group compared with 14 (10%) in the CRT group. The incidence of testicular relapse was significantly lower in the patients treated with IDM (P less than 0.001). High plasma levels of MTX achieved during the 24-hour infusions may result in increased penetration of MTX into the interstitium of the testes, thus allowing for the eradication of sequestered leukemic cells and preventing the emergence of drug resistance resulting from exposure to sublethal concentration of MTX. PMID- 3524798 TI - Pulmonary complications occurring after allogeneic bone marrow transplantation. A study of 130 consecutive transplanted patients. AB - This report deals with 81 pulmonary episodes occurring in 130 consecutive patients who underwent allogeneic bone marrow transplantation for hematologic malignancy in the same unit over a 5-year period. These episodes observed in 69/130 patients (53%) were mostly of infectious origin, and were investigated by bronchoalveolar lavage (BAL). The main causes of pneumonia were: cytomegalovirus (CMV) (n = 25), bacterial pneumonia (n = 17), invasive aspergillosis (n = 11) and pulmonary hemorrhage (n = 9). The overall mortality due to or associated with pneumonia was 26/130 (20%). Graft-versus-host disease clearly increased the incidence of infectious pneumonia and the mortality due to or associated with pneumonia. Granulocyte transfusions did not influence the incidence of CMV pneumonitis. The main causes and risk factors for pneumonia are discussed. The role of BAL as a noninvasive procedure is stressed. PMID- 3524799 TI - Minimal deviation adenocarcinoma of the uterine cervix ("adenoma malignum"). An immunohistochemical comparison with microglandular endocervical hyperplasia and conventional endocervical adenocarcinoma. AB - In an effort to obtain objective information that would be useful in separating minimal deviation adenocarcinoma (MDA) or "adenoma malignum" of the endocervix from benign endocervical glandular proliferations, four cases of MDA were studied immunocytochemically, and compared with seven cases of microglandular endocervical hyperplasia (MEH) and six cases of conventional endocervical adenocarcinoma (ACA). Monoclonal antibodies to carcinoembryonic antigen (CEA) and blood group isoantigens A, B, and H (BGI) were used in these analyses. All MDA and ACA were CEA-positive, whereas none of the cases of MEH stained for the presence of this substance. Six of seven examples of MEH expressed appropriate BGI; the remaining case failed to stain for blood group substances. In contrast, six of ten cases of malignant endocervical glandular tumors manifested "inappropriate" expression of BGI, based on the patients' known blood types. These data suggest that immunostains for CEA may be helpful in the diagnostic separation of MDA and MEH. The close biochemical similarity between CEA and BGI is postulated as an explanation for "inappropriate" expression of blood group antigens by malignant endocervical lesions. PMID- 3524800 TI - Monoclonal antibodies against oncofetal mucin M1 antigens associated with precancerous colonic mucosae. AB - We obtained seven monoclonal antibodies (MAb) against a gastric mucin of an ALeb patient. By immunoperoxidase on normal gastric mucosae, two MAbs (3-3A and 2-25 LE) reacted exclusively with the A and Lewis-positive individuals, respectively; the five other MAbs (1-13 M1, 2-11 M1, 2-12 M1, 9-13 M1, and 58 M1) stained the mucus cells of surface gastric epithelium independently of ABO or Lewis status. They did not stain normal colonic mucosae, but did stain fetal and precancerous colonic mucosae. Using serial sections, each anti-M1 MAb stained the same goblet cells in fetal and precancerous colon. Extensive search of other normal tissues showed that M1 antigens were restricted to the epithelium embryologically derived from the foregut (gastric and bronchial epithelium) and from Mullerian ducts (mucus cells of endocervix and prostatic utriculus). Some differences in the reactivities of the various anti-M1 MAb were observed in subesophageal, subtracheal, and endocervical mucus cells, suggesting that each anti-M1 MAb characterized a different M1 epitope. A mixture of these five anti-M1 MAbs allowed the estimation of M1 mucus modification in the precancerous colonic mucosae with a sensitivity near to that obtained with polyclonal anti-M1 antibodies. Papain and mercaptoethanol treatments destroyed the M1 epitopes, at variance with the A- or Lewis-related antigens. Our results therefore suggest that the expression of M1 epitopes in precancerous colonic mucosae cannot be due exclusively to alterations in mucin glycosylation but may be related to the reexpression of antigens associated with native gastric mucin which is normally produced by the fetal colon during the sixth month of gestation. PMID- 3524801 TI - Inhibition of proteolytic enzymes in the in vitro amnion model for basement membrane invasion. AB - The ability of B16-F10 mouse melanoma cells to cross an amnion basement membrane was determined in the presence of strong inhibitors of both serine and cysteine proteases. The concentrations of inhibitors were at orders of magnitude higher than their Ki values to serine and cysteine proteases implicated in metastasis, thus ensuring a complete inhibition for tumor secreted proteases such as cathepsin B-like proteases, plasminogen activators, and plasmin. Under these conditions of high serine and cysteine protease inhibitor concentrations, no significant decrease in B16-F10 melanoma cell invasion through the amnion was observed. Separate experiments showed that the inhibitors were neither toxic to the cells nor degraded. The results show that neither tumor cell secreted cathepsin B-like proteases nor plasminogen activator have a controlling role in basement membrane crossing in this metastatic model. A possible role for tumor cell membrane proteases in basement membrane invasion, in which the substrates of the protease bind to receptor sites near a membrane associated proteolytic activity, is not eliminated. PMID- 3524802 TI - In vitro and in vivo effects of a monoclonal antibody-toxin conjugate for use in autologous bone marrow transplantation for patients with breast cancer. AB - We have devised a method utilizing a monoclonal antibody-toxin conjugate (LICR LON-Fib75/abrin A-chain) for ridding bone marrow of infiltrating breast cancer cells to rescue patients with autologous bone marrow following high dose therapy. Initially we examined the activity of this conjugate in vitro. Five of seven human breast cancer cell lines were killed following exposure at 10(-8) M for 2 h; this concentration only reduced bone marrow colony formation to 83% (range, 50 100%) of control bone marrow. We then examined the pattern of bone marrow recovery after high dose melphalan (200 mg/m2) in patients with advanced breast cancer who were in remission following combination chemotherapy. To do this we compared the time of recovery of the blood count in three patients who received treated marrow and seven who received untreated marrow. Mean time to recovery of the peripheral white count (greater than 1.5 X 10(9)/liter) was 16.7 days (treated) and 18.3 days (untreated), respectively. Mean time to recovery of peripheral platelet count (greater than 50 X 10(9)/liter) was 23.7 days (treated) and 18.9 days (untreated), respectively. Patients continued in remission for 1 greater than 14 mo after high dose melphalan, and remission duration was similar in patients who received treated (6.2 mo) and untreated (7.3 mo) bone marrow. These findings indicate that treatment of bone marrow with LICR-LON-Fib75/abrin A chain conjugate does not significantly impair bone marrow recovery, and it is, therefore, possible to rescue breast cancer patients with bone marrow that has been cleansed of infiltrating cancer cells. This may have an application in patients with poor-risk primary breast cancer who have micrometastases and who may benefit from intensive therapy, but it has minimal application in patients with more advanced disease. PMID- 3524803 TI - Immunohistochemical antigenic expression and in vivo tumor uptake of monoclonal antibodies with specificity for tumors of the gastrointestinal tract. AB - Two monoclonal antibodies with specificity for carcinoembryonic antigen and Ca 19 9 gastrointestinal tract tumor associated antigens were infused after iodination with 125I and 131I, respectively, in six patients 3 days and in one patient 4 days before radical surgery for colon or rectal carcinoma. Biopsy specimens from tumor, normal colon, fat, muscle, and skin along with a blood sample were excised at surgery and counting was performed for gamma emission. Fragments were then studied by two independent pathologists for immunohistochemical expression of corresponding antigens using the avidin-biotin peroxidase complex. A correlation study was thereafter performed between the amount of antibody bound in vivo, expressed as the percentage of injected dose per gram of tissue and the quantitative expression of tumor associated antigens, taking into account both the percentage of cells expressing the antigen and intensity of staining. For this limited number of patients a good correlation was found between amount of targeted antibodies and amount of expressed antigens. For carcinoembryonic antigen, r values were 0.69 and 0.90 for each pathologist (with an r value of interobserver correlation of 0.74); for Ca 19-9, values of 0.78 and 0.84 were obtained for each observer, with an interobserver r value of 0.97. Based on this limited study, it may be assumed that the possibility of imaging a given tumor is in part correlated to intensity of antigenic expression at the tumor site; other parameters, like tumor vascularization and blood flow for instance, are, however, to be considered for accessibility of antibodies to corresponding antigens. PMID- 3524804 TI - Determination of estrogen receptor in breast cancer using monoclonal antibody technology: results of a multicenter study in the United States. AB - Three laboratories compared their routine steroid binding assays with the Abbott estrogen receptor-enzyme immunoassay (ER-EIA) to determine ER in breast cancer cytosols. Each laboratory was first trained to use the ER-EIA kit and then performed routine proficiency panels to determine assay reproducibility. The frozen panels prepared from MCF-7 cytosol produced good intraassay results but the between assay coefficients of variation were frequently above 10%. Lyophilized MCF-7 cytosols produced better reproducibility upon repeated assay. One laboratory demonstrated that New England Nuclear steroid binding kits and the ER-EIA produced comparable results when MCF-7 lyophilized cytosols were used. The analysis of breast tumor samples demonstrated excellent linear correlation coefficients for each laboratory (greater than 0.92 N approx. 60 samples each) but different slopes. The comparison of the ER-EIA with the New England Nuclear steroid binding assay produced a slope of 1.13. The ER-EIA appears to produce comparable results to the conventional steroid binding assays for the determination of ER in breast tumor cytosols. PMID- 3524806 TI - Quality control requirements in estrogen receptor determination. AB - The clinical significance of estrogen receptor (ER) levels determined in breast cancer tissue depends on the quality of the ER assay procedure itself as well as on several critical factors beyond the direct responsibility of the receptor laboratory. A novel immunobiochemical assay (ER-EIA) has been made available by Abbott Laboratories. In comparison to the classical radioligand binding assay, the use of ER-EIA resulted in lower intra- and interassay as well as interlaboratory coefficients of variation. This may be explained by the complete standardization of ER-EIA as compared to ER radioligand binding assay. Considerable attention must be paid to the source of origin of quality control material if identical ER levels are to be obtained by both methods, as the monoclonal antibodies of ER-EIA bind less avidly to cytosolic ER of calf uterus and, in contrast to routine ER radioligand binding assay, are able to recognize occupied ER. PMID- 3524805 TI - Use of a monoclonal anti-estrogen receptor antibody in the immunohistochemical evaluation of human tumors. AB - A monoclonal antibody to human estrogen receptor protein (H222 Sp gamma), amplified via immunoperoxidase techniques, was used in the analysis of estrogen receptor in 452 breast carcinomas, 100 endometrial carcinomas, and 15 melanomas. Immunohistochemical evaluation incorporated both intensity and distribution of staining (HSCORE). Quantitative estrogen receptor content was determined by dextran-coated charcoal analysis and sucrose density gradient analysis. In all cases H222 Sp gamma localized in the nucleus of target cells. A semiquantitative correlation existed between HSCORE and biochemical assays for breast and endometrial tissues. The sensitivities and specificities for HSCORE as compared to the biochemical assays ranged from 80 to 95% and from 74 to 94%, respectively. HSCORE correlated with tumor grade for breast and endometrial carcinoma. Immunohistochemical evaluation showed no specific staining in melanomas. The data suggest that immunohistochemical receptor localization provides information complementary to standard biochemical assays in the tissues studied. PMID- 3524807 TI - Enzyme immunoassay of estrogen receptors in fine needle aspirates of breast tumors. AB - Enzyme immunoassay of estrogen receptors (ER-EIA) was compared to radioligand assay (ER-RLA) in fine needle aspirates of breast tumors. Fine needle aspiration is a relatively atraumatic means of harvesting malignant cells from breast tumors. Fine needle aspiration provides a homogeneous suspension (about 90% malignant cells) with a sufficient amount of cellular material (10 to 50 micrograms DNA per sample) for single point radioligand assays of extractable estrogen (ER) and/or progesterone receptor (PR) in about 85% of primary adenocarcinomas at the time of diagnosis. Sixty-one different samples of malignant mammary cells were obtained by fine needle aspiration from 43 adenocarcinomas, 11 metastatic axillary nodes or 7 cutaneous nodules. Thirteen patients were under antiestrogen therapy (tamoxifen). ER-EIA was performed with Abbott's reagents, following the manufacturer's protocol. ER-RLA was a single saturation (5 nM) dextran-charcoal assay with [3H]R2858 as the labeled estrogen. The sensitivity of ER-EIA allowed dilution of the sample up to 10 times (according to sample cellularity and ER level) with less than 20% deviation from undiluted samples. Three levels of dilution of the samples (1/1, 1/2, and 1/10) allowed them to fall at least once into the range of the ER-EIA standard curve. Quantitative correlation between ER-EIA and ER-RLA was high (r = 0.86), and highest (r = 0.97) when samples from patients undergoing tamoxifen treatment were excluded. Major discrepancies between ER-EIA and ER-RLA appeared in those patients undergoing tamoxifen therapy; much higher values were obtained by ER EIA. Eight of 13 of these patients were ER negative by ER-RLA but ER positive by ER-EIA. This preliminary observation indicates that in vivo ER modulation by hormones and antihormones should be reevaluated. PMID- 3524808 TI - Estrogen receptor immunocytochemical assay (ER-ICA): computerized image analysis system, immunoelectron microscopy, and comparisons with estradiol binding assays in 115 breast carcinomas. AB - An estrogen receptor (ER) immunocytochemical assay (ER-ICA) was applied to 115 malignant breast carcinomas and the results were compared to those of steroid binding assays performed on cytosol extracts of the same tumors. Immunoperoxidase (peroxidase-antiperoxidase) staining was performed on frozen sections using rat monoclonal antibody to estrogen receptor H222SP gamma. A preembedding method was used for the immunoelectron microscopy study. A semiquantitative analysis and a computerized image analysis system (SAMBA 200 TITN) were used to evaluate the positive ER immunostaining. Positive immunostaining (81 of 115) was always located in the nucleus of tumor cells and of normal cells in adjacent breast tissue. The immunostaining pattern differed from one tumor to another, due to variations in either the intensity or the percentage of positive cells. When immunohistochemical staining was correlated to biochemical assay, there was an 88% correlation, and staining intensity and percentage of positive cells significantly increased (P less than 0.01) with cytosolic ER levels and were independent of cellularity. These results indicated that ER-ICA is to date the most reliable histochemical method for ER detection and correlated in 88% of the cases with ER biochemical assay; ER-ICA constitutes a method particularly valuable to screen ER negative tumors on condition that tumor fragment quality (sampling and storage) is perfectly controlled; ER-ICA provides additional information for heterogeneous ER distribution within tumors; ER-ICA as a qualitative method is unable to replace the quantitative ER determination obtained with biochemical assay although the computerized system (SAMBA 200) for image analysis of microscopic preparations constitutes a valuable improvement of immunostaining analysis; and ER-ICA based on ER antigenic site detection is complementary to biochemical assay based on ER functional site determination. PMID- 3524809 TI - Comparison of immunochemical and radioligand binding assays for estrogen receptors in human breast tumors. AB - We have compared a new enzyme immunoassay (EIA) for estrogen receptors (ER) with our conventional radioligand binding assays (multipoint dextran-coated charcoal assay for cytoplasmic ER and hydroxylapatite exchange assay for nuclear ER). Cytoplasmic ERs were measured in 76 human breast cancer specimens by EIA and by five-point Scatchard analysis. The correlation between the two assays yielded a straight line with a slope of 0.92 (r = 0.95; P less than 0.001); conversely, in 31 nuclear salt extracts, linear regression analysis of hydroxylapatite exchange assay data with EIA showed a clear correlation (r = 0.93; P less than 0.001) but a slope of 1.7, demonstrating that EIA detects more ER sites. The binding of the antibody to the cytoplasmic ER molecules was investigated by sucrose density gradient analysis, which showed that EIA recognizes both cytoplasmic forms (9 and 3S), but does not distinguish between them. Advantages and drawbacks of this method are discussed with respect to its application for routine receptor determination for clinical management of breast cancer patients. PMID- 3524810 TI - Comparison of immunocytochemical estrogen receptor assay, estrogen receptor enzyme immunoassay, and radioligand-labeled estrogen receptor assay in human breast cancer and uterine tissue. AB - Determination of estrogen receptor content in 82 breast cancer specimens with immunocytochemical estrogen receptor assay (ER-EIA) (Abbott) was compared with our routinely used binding assay using 125I-estradiol as radioligand with Scatchard plot analysis of the binding data. Although the estrogen receptor content measured with the ER-EIA was approximately 2-fold higher compared with the binding assay, the immunochemical method proved to be a useful alternative for estrogen receptor determination. Furthermore, it is possible to detect estrogen receptors in FPLC Superose 12 (size exclusion column) eluates or in the fractions obtained after sucrose density centrifugation using the ER-EIA. Forty breast cancer samples were analyzed utilizing the immunocytochemical technique (ER-ICA) for visualization of the estrogen receptor content in frozen tumor tissues in relationship to the quantitative results obtained with the ER-EIA assay. Specific staining for estrogen receptor was confined only to the cell nucleus, was distributed irregularly among the tumor cells, and was variable in intensity. The staining intensity and the percentage of positively stained cells increased with increasing level of cytosolic estrogen receptor. In 27 of 40 cases the immunocytochemical results correlated well with the ER-EIA assay. Nine cases were ER-ICA negative with positive ER-EIA, and four were ER-ICA positive with negative ER-EIA. PMID- 3524811 TI - Evaluation of an enzyme immunoassay for estrogen receptors in human breast cancers. AB - An estrogen receptor enzyme immunoassay kit (ER-EIA) has been evaluated in 70 human breast carcinomas against a routine cytoplasmic [3H]estradiol binding assay (ERU). A linear correlation between the ER-EIA and the ERU was observed for binding values up to 400 fmol/mg of cytosol protein. Above this value, the ERU underestimates the concentration of receptor. The ERU gave a lower number of estrogen receptor-positive tumors (50 of 70) than did the ER-EIA assay (59 of 70). In the ERU-negative ER-EIA-positive tumors, receptor values as determined by the ER-EIA assay all fell below 50 fmol/mg of protein (mean, 19.9 +/- 4.2 fmol/mg of protein). Application of an exchange procedure which estimates the total steroid binding capacity of the cytosol gave positive results in 7 of 9 ERU negative ER-EIA-positive tumors (mean, 16.9 +/- 2.95 fmol/mg of protein). Subdivision of the binding data according to the menopausal status of the patient indicates low receptor values in premenopausal women by each assay. A correlation between the ER-EIA assay and the histological grade of tumors was observed; Grade I well-differentiated tumors were all positive, while Grade II and III tumors were 86% and 75% positive, respectively. No correlation between the ER-EIA assay and tumor lymph node stage or tumor size was observed. PMID- 3524812 TI - Quantitation of estrogen receptor in seventy-five specimens of breast cancer: comparison between an immunoassay (Abbott ER-EIA monoclonal) and a [3H]estradiol binding assay based on isoelectric focusing in polyacrylamide gel. AB - Quantitation of estrogen receptor has been performed in cytosol prepared from 75 specimens of breast cancer tissue from patients who had not received hormonal therapy. The study was performed in order to compare an immunoassay (Abbott Laboratories, North Chicago, IL) with our currently used method for estrogen receptor analysis based on isoelectric focusing of [3H]estradiol-receptor complex in polyacrylamide gels. Using linear regression analysis, a regression coefficient (slope) of 1.30 and a correlation coefficient of 0.75 were calculated. The differences in results between the two methods are probably partly explained by the fact that the ligand-based method only measures unoccupied receptor, whereas the immunoassay detects the total amount of receptor, resulting in generally slightly higher concentrations with the latter method. However, in five of 75 specimens the ligand-based method gave a considerably higher concentration of estrogen receptor. This was most probably explained by partial proteolysis resulting in the formation of receptor fragment(s), which was undetectable with the immunoassay but detectable with the ligand-based method. These observations underline the importance of careful handling of specimens during the whole immunoassay procedure. PMID- 3524813 TI - Alterations in hepatocyte insulin receptors in rats fed a choline-deficient diet. AB - Specific insulin binding and glycogen synthesis were studied in control hepatocytes, hepatocytes from rats fed a choline-deficient (CD) diet for 7 to 14 days, and hepatoma cells induced with a CD diet and DL-ethionine in culture. Both the binding affinity and the number of receptors were affected in hepatocytes by the CD diet. The number of receptor sites was 26,000/cell and the dissociation constant (Kd) for the high affinity binding site was 2.6 nM at 30 degrees C, in contrast to the control values of 205,000 sites/cell and 23.2 nM, respectively. In the hepatoma cells, receptor cell number and Kd were further diminished to 6,400 sites/cell and Kd = 1.1 nM. The basal level of glycogen synthesis in control hepatocytes and in CD hepatocytes was similar; however, the basal rate of glycogen synthesis in hepatoma cells was only 16% of that in the control cells. The glycogen synthesis in hepatoma cells was stimulated by insulin, but at a 3 log higher concentration compared to the control cells. This loss of sensitivity to insulin is consistent with the marked decrease in insulin receptors. CD hepatocytes had a decrease in insulin receptors with a concurrent decrease in Kd (increase in binding affinity), such that, sensitivity to insulin did not differ significantly from that of control hepatocytes. However, the maximal stimulation of glycogen synthesis was only 27% that of the control cells. The changes in receptor number and Kd of hepatocytes from rats fed a CD diet may be due to alterations in cell membrane lipid composition and this alteration may be responsible for the enhanced sensitivity of hepatocytes to chemical carcinogens and for the tumor promoting effect of the diet. PMID- 3524814 TI - Prediction of the optimal timing of bone marrow reinfusion after high dose chemotherapy. AB - Autologous bone marrow transplantation allows the use of high dose chemotherapy by obviating dose limiting myelosuppression. The pharmacology of high dose chemotherapy has been inadequately explored, yet this information is critical to determine the timing of marrow infusion and assure that engraftment is not compromised. We have used the Salmonella mutagenesis test (SMT) and colony forming unit-granulocyte, erythrocyte, monocyte, megakaryocyte assay to evaluate the optimal time for marrow infusion after therapy with high dose combinations of alkylating agents (Solid Tumor Autologous Marrow Support Program) in seven patients. The SMT is sensitive, rapidly performed, and has been used to detect mutagenic activity in urine following administration of cyclophosphamide, cisplatin, and 1,3-bis(2-chloroethyl)-1-nitrosourea. In parallel, determination of colony forming ability of the patients own bone marrow (colony forming unit granulocyte, erythrocyte, monocyte, megakaryocyte assay), when cocultured with autologous serum obtained before and after treatment, provided an assay for circulating marrow toxic drugs or metabolites. The onset of mutagenic activity in the SMT and the in vitro appearance of myelotoxicity by autologous serum in the colony forming unit-granulocyte, erythrocyte, monocyte, megakaryocyte assay were concurrent, and these activities returned to base line at the time of marrow infusion (72 h posttreatment). One patient of the seven was excreting mutagens (TA100 strain only) at the time of marrow reinfusion; he developed hepatic venoocclusive disease, and delayed engraftment. These observations suggest that as high dose regimens evolve the SMT may serve as a rapid, sensitive indicator of the circulation and excretion of toxic compounds, and thereby assist in predicting the optimum time of bone marrow reinfusion. PMID- 3524815 TI - Mutagenic and cell-transforming activities of triol-epoxides as compared to other chrysene metabolites. AB - The syn- and anti-isomers of the bay-region diol-epoxides of chrysene and of 3 hydroxychrysene and their metabolic precursors have been investigated for mutagenicity in Salmonella typhimurium (reversion to histidine prototrophy) and V79 Chinese hamster cells (acquirement of resistance to 6-thioguanine) and for transforming activity in M2 mouse prostate cells. Other known and potential chrysene metabolites have been included in mutagenicity experiments. Direct mutagenic activity in S. typhimurium TA 100 exhibited, in order of potency, anti triol-epoxide greater than syn-triol-epoxide greater than anti-diol-epoxide greater than syn-diol-epoxide greater than chrysene 5,6-oxide much greater than chrysene-1,2-quinone, chrysene-3,4-quinone, and chrysene 5,6-quinone. Chrysene, the six isomeric chrysenols, and the trans-dihydrodiols [trans-1,2-dihydroxy-1,2 dihydrochrysene (chrysene-1,2-diol), trans-3,4-dihydroxy-3,4-dihydrochrysene, trans-5,6-dihydroxy-5,6-dihydrochrysene, and 9-hydroxy-trans-1,2-dihydroxy-1,2 dihydrochrysene (9-hydroxychrysene-1,2-diol)] were inactive per se but were activated to mutagens in the presence of reduced nicotinamide adenine dinucleotide phosphate-fortified postmitochondrial fraction (S9 mix) of liver homogenate from Arochlor 1254-treated rats. Chrysene, 3-hydroxychrysene, chrysene 1,2-diol, and 9-hydroxychrysene-1,2-diol were activated efficiently; the other compounds were activated weakly. In S. typhimurium TA 98, the mutagenic activities of the chrysene derivatives were weak in comparison with those in the strain TA 100. trans-3,4-Dihydroxy-3,4-dihydrochrysene (in the presence of S9 mix) was the most efficacious mutagen in strain TA 98. The relative mutagenic potencies of the directly active compounds differed from the results obtained in strain TA 100, in that in strain TA 98 the anti-diol-epoxide was more mutagenic than the triol-epoxides and chrysene 5,6-oxide was more mutagenic than syn-diol epoxide and syn-triol-epoxide. In V79 cells, the order of mutagenic potency was: anti-triol-epoxide greater than anti-diol-epoxide greater than syn-triol-epoxide greater than syn-diol-epoxide greater than chyrsene 5,6-oxide greater than chrysene-1,2-diol (in the presence of S9 mix) greater than 9-hydroxychrysene-1,2 diol (in the presence of S9 mix) greater trans-3,4-dihydroxy-3,4-dihydrochrysene in the presence of S9 mix). Chrysene, 3-hydroxychrysene, 5-hydroxychrysene, and 6 hydroxychrysene showed no mutagenic effects in V79 cells, either in the presence or absence of S9 mix.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3524816 TI - Role of monocyte cytotoxic factor in cytolysis of actinomycin D-treated WEHI 164 cells mediated by freshly isolated human adherent mononuclear blood cells. AB - The role of the monocyte cytotoxic factor (CF) in cytolysis of untreated and actinomycin D (Act D)-treated WEHI 164 cells by freshly isolated human adherent mononuclear cells has been investigated in this study. Murine WEHI 164 cells were used as target cells because of their sensitivity to lysis mediated by monocytes and their resistance to natural killer cells. Monocytes as well as monocyte supernatants mediated cytolysis of WEHI 164 cells. Cytolysis was enhanced by Act D treatment of target cells. The addition of lipopolysaccharide to monocytes accelerated the progression of cytolysis of Act D-treated WEHI 164 cells mediated by monocytes. A polyclonal rabbit antiserum against CF inhibited the cytolytic activity of monocytes and monocyte supernatants against untreated as well as Act D-treated WEHI 164 cells. At low effector:target ratios, the cytolysis was totally abrogated by CF antiserum. Depletion of natural killer cells from adherent cells by the monoclonal antibody Leu 11b and rabbit complement did not reduce cytolysis of Act D-treated WEHI 164 cells. Immunofluorescence microscopy revealed that CF antiserum stained the plasma membrane of freshly isolated monocytes, suggesting that CF is a membrane-associated molecule. Our data indicate that CF is an important effector molecule in cytolysis mediated by freshly isolated monocytes against untreated and Act D-treated WEHI 164 cells. PMID- 3524817 TI - Evaluation of thioesterase II as a serum marker for rat mammary cancer. AB - Thioesterase II, the key enzyme which regulates the production of medium-chain fatty acids by the mammary fatty acid synthetase, is expressed specifically in epithelial cells of the rat mammary gland, regardless of their state of differentiation, and we consider the enzyme to be a reliable marker for this cell type. The objective of this study was to determine whether this enzyme is expressed universally in tumors originating from rat mammary epithelial cells and whether it might be shed into the serum of host animals. Immunoreactive thioesterase II was detected in all of the epithelial derived mammary tumors tested, being highest in tumors that exhibited obvious epithelial morphology. Two of the tumors, R3230AC and DMBA 1, were transplanted into Fischer 344 rats and the levels of thioesterase II in the tumor and serum were monitored by enzyme immunoassay. Thioesterase II content of the transplanted tumors fell to, and remained at, a low level during the first week following transplantation. During this period the transplanted tumor established a new network of blood vessels; no thioesterase II was detectable in the serum. Subsequently, thioesterase II levels in the tumors returned to the values observed before transplantation and thioesterase II was detectable in the serum. Of 51 rats transplanted with the R3230AC tumor, 37 showed elevated serum thioesterase II levels; of 40 transplanted with the DMBA 1 tumor, 35 showed elevated serum thioesterase II. Furthermore, there was a statistically significant correlation between serum thioesterase II and tumor burden in both tumor model systems. The identity of the serum antigen reacting with anti-thioesterase II antibodies was confirmed, by Western immunoblotting, to be full-length thioesterase II polypeptide. Parallel studies with fatty acid synthetase, an enzyme with an ubiquitous tissue distribution, indicated as expected that serum levels of this enzyme were unlikely to provide a reliable index of mammary tumor status. These results indicate that thioesterase II may be a useful serum marker for mammary cancer. PMID- 3524818 TI - Effect of growth state and heat shock on nucleolar localization of the 110,000-Da heat shock protein in mouse embryo fibroblasts. AB - We have shown previously that the mammalian 110,000-Da heat shock protein (hsp110) associates with nucleoli in several cell types and that in 2-day postconfluent mouse 10T1/2 cells, a segregation of the antigen from the nucleolar phase-dense body is seen (J.R. Subjeck, T. Shyy, J. Shen, and R.J. Johnson. J. Cell Biol. 97: 1389-1395, 1983). Here we further characterize the nucleolar segmentation of hsp110 in mouse 10T1/2 and 3T3 cells with respect to the formation of this structure in dense cultures and investigate the behavior of this protein following conditions (serum deprivation, actinomycin D, and heat shock) known to affect the functional and morphological integrity of the nucleolus. It is shown that in addition to its nucleolar locale, an affinity of hsp110 for the nonnucleolar, nuclear compartment in actively proliferating cells is also observed. When proliferating cells are treated with actinomycin D (1 microgram/ml) for 8 h, hsp110 separates from the nucleolar phase-dense body to form a fluorescent nucleolar cap which resembles that seen in confluent cultures. This drug also results in a disappearance of hsp110 from the nucleoplasm. Incubation of cells for 24 h in media without serum also results in the nucleolar segmentation of hsp110 and a reduction in nucleoplasmic staining. A moderate nonlethal heat treatment does not lead to segmentation of hsp110 in proliferating cells but conversely results in a transient reversal of segmentation in confluent cultures. Examination of segmented nucleoli of postconfluent cells by immunoelectron microscopy reveals that hsp110 is associated with the fibrillar component of these nucleoli, the site of ribosomal DNA. PMID- 3524819 TI - Loss of a c-H-ras-1 allele and aggressive human primary breast carcinomas. AB - The human H-ras protooncogene was shown to be expressed in 16 of 22 invasive ductal carcinomas of the breast. The K- and N-ras protooncogenes were either not expressed or expressed at low levels. No amplification or rearrangement of the three ras genes was detected among the 104 breast carcinoma DNAs tested. These results indicate that the overexpression of H-ras in human breast tumors is not correlated with alteration of the protooncogene. In addition, we did not find any point mutation at the codon 12 of the H-ras or K-ras protooncogenes in 32 and 64, respectively, tumor DNAs examined. However, in tumor DNAs from 14 of 51 patients, heterozygous for H-ras-1 related BamHI restriction fragments, one allele was lost. This allele loss did not alter ras Mr 21,000 protein expression. Correlation with clinicopathological data showed, however, that the loss of one H ras-1 allele in breast carcinoma DNAs is significantly linked to histological Grade III tumors, the lack of estrogen and/or progesterone receptors, and the subsequent occurrence of distal metastasis. Our results thus indicate that the loss of one H-ras-1 allele correlates with the most aggressive primary carcinomas of the breast. PMID- 3524820 TI - Recognition of serum alkaline phosphatase by murine monoclonal antibodies against human osteosarcoma cells. AB - Using OST6 and OST7 monoclonal antibodies against human osteosarcoma cells, a solid-phase radioimmunosandwich assay was developed to quantitate a human osterosarcoma-associated antigen in a total of 242 sera from healthy adults and patients with various diseases. The levels of the antigen in sera were high in patients with osteosarcoma and in children without tumorous diseases compared with healthy adults; however, the highest level of the antigen was found in patients with obstructive jaundice. The quantity of the antigen correlated with serum alkaline phosphatase (EC 3.1.3.1.) activity, and showed a strong correlation (correlation coefficient, 0.94) in 50 sera. Immunolocalization of enzyme activity assay using monoclonal antibodies was performed to ascertain whether the antigen had alkaline phosphatase activity. This assay proved that OST6, OST7, and OST15 monoclonal antibodies recognized serum alkaline phosphatase; furthermore, these monoclonal antibodies seemed to react with not only the bone isoenzyme but also the liver isoenzyme. PMID- 3524822 TI - Treatment of muscular dystrophies and inflammatory myopathies. PMID- 3524821 TI - Antidepressants and convulsive seizures: clinical, electroencephalographic, and pharmacological aspects. PMID- 3524823 TI - Comparative metabolism of daunorubicin and 4-demethoxydaunorubicin in mice and rabbits. AB - In the present study, the biodisposition of 4-demethoxydaunorubicin (4DDM) and its 13-dihydrometabolite was compared with daunorubicin (DM) and its metabolite in rabbit serum, and the results were considered in the light of this DM analog's pharmacokinetic behavior in mice. In rabbit serum, the levels of the 13-OH derivative of both DM and 4DDM (daunorubicinol and 4-demethoxydaunorubicinol) were higher than in mice. In vitro metabolic studies with mouse and rabbit cytosol indicated that the hepatic metabolism was quantitatively important for both analogs (70%-90% for DM and 4DDM was reduced to the 13-OH metabolite), but the rabbit had a much higher specific capacity to metabolize these compounds. DM seemed a better substrate for cytoplasmic aldoketoreductase, the enzyme affinity in rabbits being three times higher than for 4DDM. Cytotoxicity studies in vitro showed that 4-demethoxydaunorubicinol, unlike daunorubicinol, was as cytotoxic as the parent compound, and this suggests this metabolic step does not inactivate 4DDM but contributes to its high and long-lasting biological activity in vivo. PMID- 3524824 TI - Phase II study of lonidamine in patients with metastatic renal cell carcinoma: a National Cancer Institute of Canada Clinical Trials Group Study. AB - The National Cancer Institute of Canada Clinical Trials Group conducted a phase II study of lonidamine, given in an escalating oral daily schedule in patients with measurable advanced renal cell carcinoma. Two responses were seen in 25 evaluable patients. Toxicity was mild or moderate in most patients and included myalgia, nausea, vomiting, somnolence, and testicular pain. Lonidamine was not myelosuppressive. This agent had only minimal activity against renal cell carcinoma when given in this oral schedule. PMID- 3524825 TI - Phase II study of etoposide for carcinoma of the prostate. AB - The treatment of prostate carcinoma with the epipodophyllotoxin derivative etoposide was studied in a multi-institutional phase II trial. An iv dose schedule of 130 mg/m2 daily for 3 days every 3 weeks was utilized. A total of 36 patients were evaluable; the observed total response was 3%. Moderate toxicity (predominantly myelosuppression) was seen utilizing this treatment schedule. It is concluded that etoposide possesses little single-agent therapeutic activity for prostate carcinoma. PMID- 3524827 TI - Abbreviated phase I clinical trial of i.v. mitozolomide. PMID- 3524826 TI - Phase II trials of 5-FU, doxorubicin, and cisplatin in advanced, measurable adenocarcinoma of the lung and stomach. AB - A combination of 5-FU (600 mg/m2 on Days 1 and 8), doxorubicin (40 mg/m2 on Day 1), and cisplatin (75 mg/m2 on Day 1) has been used for treatment of 31 patients with advanced measurable adenocarcinoma of the lung and 35 with gastric cancer. The regimen was given every 4 weeks until disease progression to patients who had not received prior chemotherapy. One complete response occurred in the lung cancer group. Ten of the gastric cancer patients (29%) had partial responses. The median duration of response was 5.5 months and the median survival in responding patients was 10.8 months. Toxicity of the regimen was moderate. We conclude that this combination offers no particular advantages over previously described treatments for these diseases. PMID- 3524828 TI - Phase II trial of aclarubicin in epidermoid carcinoma of the head and neck. PMID- 3524829 TI - Phase II evaluation of etoposide in refractory multiple myeloma: a Southeastern Cancer Study Group Trial. PMID- 3524830 TI - Phase II study of vindesine in the treatment of pediatric patients with solid tumors: a report from the Childrens Cancer Study Group. PMID- 3524831 TI - Phase II trial of N-methylformamide in patients with advanced colorectal carcinoma. PMID- 3524832 TI - Simple method for the administration of high-dose etoposide during autologous bone marrow transplantation. PMID- 3524833 TI - Phase II evaluation of acivicin in lung cancer: a Southeastern Cancer Study Group Trial. PMID- 3524834 TI - Phase II trial of Baker's antifol in patients with recurrent or inoperable head and neck cancer. PMID- 3524835 TI - Phase II trial of mitoguazone in children with leukemia and lymphoma: a Pediatric Oncology Group Study. PMID- 3524836 TI - Phase II evaluation of mitoxantrone in advanced carcinoma of the stomach: a Southeastern Cancer Study Group Trial. PMID- 3524837 TI - Pulmonary toxicity of carmustine in patients treated for malignant glioma. AB - Carmustine (BCNU) was employed as the only chemotherapeutic agent in a Radiation Therapy Oncology Group multimodality study comparing misonidazole-radiosensitized radiation therapy to conventional radiation therapy in 318 patients with malignant glioma. In 289 patients evaluable for BCNU pulmonary toxicity, there were no clinical manifestations of toxicity in patients receiving less than 902 mg/m2 total BCNU dose. Ten of 107 patients receiving more than this dose developed detectable pulmonary toxicity. Results of a multivariate regression analysis of risk factors, which corrects for survival time bias, suggested increased risk of pulmonary toxicity when total dose exceeds 1400 mg/m2. The risk of pulmonary toxicity was not increased by the administration of misonidazole and does not appear to be related to age. PMID- 3524838 TI - Hexamethylene bisacetamide: a polar-planar compound entering clinical trials as a differentiating agent. PMID- 3524839 TI - Prognostic signs in fetal hydrocephalus. AB - An antenatal diagnosis of fetal hydrocephalus was made in 38 cases. Using certain criteria for the assessment of fetal prognosis, 23 cases were considered to be severely affected. Postnatal evaluation of these 23 cases established the extensive severity of fetal abnormality in all cases. The prognosis was estimated to be more favorable in 10 cases, of which 8 were delivered by elective cesarean section and 2 by spontaneous vaginal delivery. In 9 cases a ventriculoatrial shunting procedure was performed early in the neonatal period, while 1 case was treated conservatively. Follow-up of these 10 cases (at 7 months to 5 years of age) revealed normal or subnormal development in 6 cases and severe retardation in 4. Fetal hydrocephalus proved to have several etiological causes and was associated with other anomalies in 84% of cases. Severe forms of fetal hydrocephalus can, by means of modern ultrasound techniques, be detected before the 20th gestational week. Some cases of fetal hydrocephalus progress slowly during the fetal period. These can be followed until term by repeated ultrasound examinations and good or moderate prognosis can be expected with the use of early postnatal therapy. Only a minority of hydrocephalic fetuses seem to be potential objects for antenatal shunting. PMID- 3524840 TI - Preventative effect of etretinate therapy on multiple actinic keratoses. AB - Multiple actinic keratoses (MAK) are premalignant lesions that may produce a significant treatment problem not always controllable by destructive therapy. Etretinate therapy has been shown to produce both prophylactic and therapeutic effects on premalignant epithelial tumors of mice. Results are presented on an 8 month double blind crossover trial (4 months placebo/4 months etretinate, randomly assigned) in 15 patients with severe MAK. Fourteen patients improved significantly on etretinate, whereas five of six patients who had placebo in the first 4-month period became worse as measured by the number of lesions and diameter of larger lesions. However, eight of nine patients who had placebo in the second 4-month period (ie, following etretinate therapy) showed no significant increase in the number of actinic keratoses, suggesting that etretinate may prevent the appearance of new lesions during, and for some time after, its administration. Moderate dose-dependent mucocutaneous side effects were frequent. It is proposed that an annual 3-month course of etretinate may help control severe MAK patients, minimizing the need for destructive therapies. PMID- 3524841 TI - Effects of antihypertensive therapy on the hemodynamics of hypertension: clinical implications. AB - Early essential hypertension is characterized by high cardiac output and normal total peripheral resistance and renal blood flow; in chronic hypertension, total peripheral resistance is elevated, cardiac output is decreased from initial levels, and renal blood flow diminishes as the disease progresses. The various classes of antihypertensive drugs induce different hemodynamic effects to maintain blood pressure control. Long-term administration of all classes of antihypertensive drugs results in a decrease in mean arterial pressure, and most drugs reduce total peripheral resistance. Heart rate and cardiac output generally remain unchanged, but they are decreased after long-term therapy with beta blockers. Some beta-blockers also reduce renal blood flow. Drugs such as the selective alpha 1-adrenergic blocking agent prazosin, which normalizes the hemodynamic profile of hypertension, appear to be advantageous. In addition, prazosin maintains exercise tolerance at near-normal levels. PMID- 3524842 TI - A cost analysis of nalbuphine versus meperidine used in oral surgery procedures. AB - Cost control is of primary importance to the oral surgeon in private practice. Fifty-six patients, 26 receiving nalbuphine (10 mg IV) and 30 receiving meperidine (50 mg IV), were included in a comparative evaluation of recovery-room costs. The two treatment groups were comparable with respect to the surgical procedures performed, the quantity of ancillary sedation used, and the analgesic effectiveness of the two study medications. However, there were marked differences between treatment groups for two characteristics: length of time in the recovery room was more than 50% greater and the nursing time required per patient was 35.3% greater in the meperidine group than in the nalbuphine group. Cost analysis indicated that nalbuphine is more cost-effective than meperidine if recovery-room nursing staff salaries exceed $16,000 per year. PMID- 3524843 TI - Double-blind randomized trial of diclofenac sodium versus placebo in patients with rheumatoid arthritis. AB - In a six-week, double-blind, randomized, multicenter clinical trial, the efficacy and safety of 150 mg/day of diclofenac sodium and a placebo were compared in 182 patients with active definite or classical rheumatoid arthritis. Safety and tolerability were evaluated in all patients and efficacy was determined in a subset of 158 patients who met all criteria for eligibility. A significantly greater improvement in six of eight treatment variables was seen in the diclofenac-treated patients than in the placebo group after one week of therapy. Fewer diclofenac-treated patients than placebo-treated patients discontinued the study because of lack of therapeutic response. Adverse experiences were reported by 28% of the diclofenac group and 21% of the placebo group, not a statistically significant difference. Gastrointestinal complaints were the most frequently reported side effects in both treatment groups, but there was no significant difference between the treatment groups. Diclofenac was found to be effective, safe, and well tolerated for the treatment of patients with active rheumatoid arthritis. PMID- 3524844 TI - Rociverine for nocturia in the elderly: medium-term controlled clinical trial. AB - Forty patients, aged 51 to 79 years, with nocturia due to bladder instability, resorption of postural edema, or senile decay, were treated with rociverine or flavoxate to test the possibility of reducing or eliminating nocturnal voidings. After a two-day observation period, each patient received either 20 mg of rociverine or 200 mg of flavoxate in a single dose at 8 PM. The following were assessed before the trial and after 14 and 28 days of treatment: number of night voidings, interval between drug administration and first voiding, volume of first voiding, volume of urine voided during the night, volume of morning urine, and total volume of urine passed between 8 PM and 8 AM. Routine laboratory tests performed before and after the trial showed both drugs to be well tolerated. The results of the trial show that rociverine reduced the number of night voidings significantly more (P less than 0.05) than did flavoxate. PMID- 3524845 TI - [Graft versus host reaction after bone marrow transplantation and possibilities of its prevention]. PMID- 3524846 TI - [Vaclav Steffal. The first professor at the Czech Medical School and his relations with the Association of Czech Physicians]. PMID- 3524847 TI - [Jan Josef Antonin Scrinci (1697-1773). The beginnings of teaching experimental physics at the Prague Medical School]. PMID- 3524848 TI - [100 years' of the Ostrava City Hospital]. PMID- 3524849 TI - Immunohistochemical localization of thioredoxin and thioredoxin reductase in mouse exocrine and endocrine pancreas. AB - Thioredoxin and thioredoxin reductase (NADPH-oxidized thioredoxin oxidoreductase, E.C. 1.6.4.5) have been proposed to be involved in several thiol-dependent reduction-oxidation reactions in cells. Both proteins have been immunohistochemically demonstrated in the periphery of the cytoplasm and in cytoplasmic granules of acinar and islet cells in mouse pancreas. In animals fed ad libitum, the staining for thioredoxin was more intense in the exocrine acinar cells than in the islet cells, whereas that for thioredoxin reductase was more intense in the endocrine than in the exocrine pancreas. In the islets of fed mice all endocrine cell types showed about the same staining intensity for thioredoxin, while thioredoxin reductase was greatly enriched in the somatostatin containing D cells. Starvation overnight caused an increased staining for both proteins in the acinar cells as well as in the islets. Under conditions of starvation, thioredoxin reductase, in contrast to thioredoxin, appeared to increase preferentially in the islet B cells, as compared with the D cells. Cysteamine treatment reduced the staining for somatostatin and for thioredoxin reductase in the D cells without any obvious effect on the other pancreatic cells. The results are compatible with a role for thioredoxin and thioredoxin reductase in secretion. PMID- 3524850 TI - Mosquito trypsin: immunocytochemical localization in the midgut of blood-fed Aedes aegypti (L.). AB - A polyclonal antibody was raised against trypsin purified from the midgut of blood-fed Aedes aegypti. Using this antibody and our modification of the peroxidase-antiperoxidase immunocytochemical reaction, strong activity was found in the lumen of the midgut at the light-microscopical level. The activity was localized mainly in the posterior part of the distensible, abdominal midgut, along the periphery of the blood bolus and within the peritrophic membrane. Immunoreactivity appeared 8 h after the blood meal and was most prominent around 24 h, coinciding with our previous spectrophotometric determinations of trypsin. At the electron-microscopical level, secretory granules, immunocytochemically labelled with anti-trypsin antibody and protein A-colloidal gold, were first detected about 12 h after the blood meal. At 18 h, the secretory pathway could be followed immunocytochemically from the formation of granules in the Golgi complex until their release by exocytosis in the midgut lumen. By 24 h, there was a reduction in secretory granules, and large lysosomes appeared. The process of secretion described for this mosquito is comparable to similar events in vertebrate secretory systems and the presence of an intracellular trypsinogen is suggested. PMID- 3524851 TI - Measurement of cardiac output without right heart catheterization: reliability, advantages, and limitations of a left-sided indicator dilution technique. AB - This study was done to determine the accuracy and reliability of cardiac output measurements by the injection of indocyanine green into the left ventricle, with simultaneous sampling from a systemic artery. In 40 patients (18 men, 22 women, aged 34 to 74 years), cardiac output was measured in close temporal proximity by (a) standard indicator dilution (right atrium-to-pulmonary artery thermodilution in 11, pulmonary artery-to-systemic artery indocyanine green in 29) and (b) left ventricle-to-systemic artery indocyanine green. There was excellent agreement between the two techniques (r = 0.98, SEE = 0.12 liters/minute). In 28 of the patients, cardiac output also was measured by ascending aorta-to-systemic artery indocyanine green. In these individuals, this technique yielded results that were disparate from those obtained by standard indicator dilution (difference between standard indicator dilution and left ventricle-to-systemic artery indocyanine green = 0.18 +/- 0.13 [mean +/- SD] liters/minute; difference between standard indicator dilution and ascending aorta-to-systemic artery indocyanine green = 0.72 +/- 0.55 liters/minute; p less than 0.001), and in 22 of the 28, the ascending aorta-to-systemic artery indocyanine green cardiac outputs were greater than those obtained by standard indicator dilution. Thus, cardiac output can be measured accurately by injecting indocyanine green into the left ventricle, with simultaneous sampling from a systemic artery, but it cannot be quantified reliably by introducing indicator into the ascending aorta. The left ventricle-to systemic artery indocyanine green technique can be used in patients undergoing only left heart catheterization.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3524852 TI - Two yeast mutants defective in endocytosis are defective in pheromone response. AB - We have purified biosynthetically labeled alpha-factor secreted from transformed yeast alpha cells. This alpha-factor binds specifically to a cells and is internalized by a time-, temperature-, and energy-dependent process. alpha-factor is internalized in an intact form and then rapidly degraded. Two yeast mutants defective in the accumulation of an endocytotic marker, lucifer yellow CH, in the vacuole have been isolated. end1 accumulates invaginations of the plasma membrane, and end2, an internal membrane-bound organelle. One of these mutants, end1, is defective for internalization of alpha-factor. Both of these mutants are defective in pheromone response. PMID- 3524853 TI - The bacterial origin of replication, oriC. PMID- 3524854 TI - Host protein requirements for in vitro site-specific DNA inversion. AB - Flagellar phase variation is mediated by a recombination event that occurs at specific sites leading to inversion of a chromosomal segment of DNA. The presence of a 60 bp recombinational enhancer sequence on the DNA substrate molecule results in a 150-fold stimulation in the initial rate of inversion. The protein components required for inversion have been purified. They include the 21,000 dalton recombinase (Hin), a 12,000 dalton host protein (Factor II), and one of the major histone-like proteins of E. coli HU. The dependence of the initial rate of recombination on HU varies with respect to the location of the recombinational enhancer. The role of HU, Factor II, and the enhancer in facilitating site specific recombination is discussed. PMID- 3524855 TI - Site-specific recombination promotes plasmid amplification in yeast. AB - All stable, naturally occurring circular yeast DNA plasmids contain a pair of long, nontandem inverted repeats that undergo frequent reciprocal recombination. This yields two plasmid inversion isomers that exist in the cell in equal numbers. In the 2 mu circle plasmid of S. cerevisiae such inversion is catalyzed by a plasmid-encoded site-specific recombinase, FLP. We show that the site specific recombination system of 2 mu circle enables the plasmid to increase its mean intracellular copy number in yeast cells growing under nonselective conditions. This apparently occurs by a FLP-induced transient shift in the mode of replication from theta to double rolling circle as initially proposed by Futcher. This capability may ensure stable maintenance of the plasmid by enabling it to correct downward deviations in copy number that result from imprecision of the plasmid-encoded partitioning system. PMID- 3524856 TI - A genetic determinant required for continuous reinfection of adjacent cells on large plasmid in S. flexneri 2a. AB - We have identified a region (virG) on the 230 kb virulence plasmid of S. flexneri that is required for cell-to-cell spread of the bacterium. Tn5 insertions into this region result in avirulent mutants that can initially invade and multiply in epithelial cells, but tend to lose active movement and tend to localize within the cytoplasm, where they are gradually extinguished without infecting adjacent cells. The virG region was localized to within 4 kb and may contain a single cistron. Sequences hybridizing to this region were found in all intact virulence plasmids of Shigellae and enteroinvasive E. coli. PMID- 3524857 TI - Self-splicing of group II introns in vitro: mapping of the branch point and mutational inhibition of lariat formation. AB - Group II intron bl1 from yeast mitochondria can undergo self-splicing in vitro. Exons become correctly ligated, and the excised intron has a lariat structure similar to that of introns from nuclear mRNA. The branch point of the bl1 lariat is located eight or nine nucleotides upstream of the 3' end of the intron and is part of a hairpin structure that is well conserved among group II introns. Several mutations next to the branch point and in other parts of the core structure of group II introns are shown to affect lariat formation. One of them, carried by strain M4873, abolishes splicing in vivo and in vitro, apparently by changing the architecture of the hairpin structure containing the branch point. Similarities between group II introns and nuclear pre-mRNA introns are discussed in terms of evolutionary relatedness. PMID- 3524858 TI - Identification of a protein-binding site that mediates transcriptional response of the c-fos gene to serum factors. AB - Transient transcriptional activation of the c-fos gene following serum stimulation of susceptible cells requires a conserved DNA element located 300 bp 5' to the mRNA cap site. A DNA-binding gel electrophoresis assay was used to detect a protein(s) in HeLa cell nuclear extracts that specifically binds to the 5' activating element. The protein recognizes a region of dyad symmetry within the 5' activating element, defined by binding competition, dimethylsulphate (DMS) interference and DNAase I and DMS protection studies. A single 22 bp synthetic copy of the dyad symmetry element will both compete efficiently for protein binding and restore serum regulation to c-fosH genes that lack the 5' activating element. PMID- 3524860 TI - A novel glycosphingolipid that may participate in embryo inversion in Volvox carteri. AB - Mouse monoclonal antibody 4-I-244 detects a developmentally regulated antigen in embryos of Volvox carteri and inhibits specifically the morphogenetic process of inversion (the process by which the embryo turns inside out). Antigen 4-I-244 was chemically characterized as a complex phytosphingolipid containing the neutral sugars xylose, galactose, and glucose as well as inositol and phosphate. PMID- 3524859 TI - Polymeric immunoglobulin receptor expressed in MDCK cells transcytoses IgA. AB - We expressed cDNA for the rabbit polymeric immunoglobulin receptor in polarized Madin-Darby Canine Kidney epithelial cells, which normally do not produce this receptor. The receptor appeared to function as in vivo; dimeric IgA was transported from the basolateral to the apical surface and released into the apical medium, together with the cleaved fragment of the receptor, known as secretory component. This system enabled us, for the first time, to study quantitatively IgA transcytosis in vitro and thus make the following observations. First, greater than 90% of the newly made receptor that is ultimately cleaved to secretory component and released into the apical medium goes first to the basolateral surface. Second, transport of the receptor does not depend on ligand binding. Third, transcytosis of bound ligand has a t 1/2 of 30 min. PMID- 3524861 TI - Restoration of a non-vital tooth to allow reuse of a pre-existing cast crown. PMID- 3524862 TI - A technique for making impressions on patients requiring complete and removable partial dentures. PMID- 3524863 TI - The post-alongside-post magnetic keeper: a clinical report. PMID- 3524864 TI - Role of calmodulin in cadmium-induced microtubule disassembly. AB - Micromolar CdCl2 has been shown to cause disassembly of the cytoplasmic microtubule complex in cultured Swiss 3T3 cells. We show in this paper that Cd(II), an environmental and occupational health hazard, induces microtubule disassembly in an in situ cytoskeleton model system, and that the calmodulin inhibitors, trifluoperazine and Compound 48/80, prevent this Cd(II)-induced microtubule disassembly. Our results suggest that Cd(II) affects microtubules by activating calmodulin associated with the cytoskeleton. Furthermore, the fact that these two ions have very similar ionic radii (0.99A vs. 0.97A) supports our conclusion that Cd(II) acts similarly to Ca(II) in inducing microtubule disassembly. This may be relevant to the mechanism of Cd-mediated cellular injury. PMID- 3524865 TI - Ganglioside GM1 localization in cholinergic neurons visualized by use of a double avidin-biotin complex system. AB - Localization of ganglioside GM1 in cholinergic neurons from the septal area of a primary culture newborn rat brain was studied with a double avidin-biotin complex system. Cholinergic neurons were identified by double immunolabeling techniques that use choline acetyltransferase (ChAT) and neurofilament (NF) protein antibodies. ChAT-positive neurons also were stained for ganglioside GM1 by using an avidin-biotin complex technique. PMID- 3524866 TI - Distribution of fibronectin, microtubules and microfilaments in the melanophore of the medaka, Oryzias latipes. AB - Distributions of fibronectin, microtubules and microfilaments in the melanophore of the medaka, Oryzias latipes, were studied using immunofluorescence. We found fluorescent fibers of fibronectin running from the central region to the periphery of the melanophore, but patterns differed depending on whether melanophores had been treated with methanol. Fibrous structures were present in methanol-treated melanophores, whereas only diffuse fluorescence was seen in untreated ones. These fibrous structures, thought to be microtubules, were arranged radially. Actin fibers also showed a radial arrangement, but were not as well organized. In addition, granules with actin immunofluorescence were present. PMID- 3524867 TI - Considerations in designing acceptable neuromuscular stimulation systems for restoring function in paralyzed limbs. AB - Recent progress in the field of functional neuromuscular stimulation (FNS), that is, the restoration of purposeful movement to paralyzed limbs via stimulation, has enabled paraplegic individuals to stand up, walk, and even climb stairs (with assistance) and quadriplegics to hold and manipulate utensils and useful objects. A number of experimental and clinical FNS systems are considered, emphasizing the algorithms used to regulate movement under a variety of conditions (isometric, isotonic, dynamic load, reciprocal control) and the physiologic problems encountered. Further development of FNS systems is required to achieve patient acceptability in daily living. Three important factors will be use of implanted intramuscular or nerve stimulating electrodes, quantitative documentation of FNS produced movements, and incorporation of force, position, and other modes of feedback to both the controller and the patient. PMID- 3524868 TI - Physiologic aspects of spinal cord injury and functional neuromuscular stimulation. AB - Functional neuromuscular stimulation (FNS) has been demonstrated to restore purposeful movement to muscles paralyzed by spinal cord injury (SCI). It is hoped that this technique will ultimately improve rehabilitation by enabling skilled activities for paraplegics (e.g., walking) and quadriplegics (e.g., feeding oneself) to be accomplished regularly with safety and reliability. It is also expected that FNS exercise programs will lead to higher levels of health and fitness for SCI individuals. However, high fatigability of electrically stimulated paralyzed muscles may severely limit FNS applications. This fatigability is related to numerous factors, including the deteriorated condition of the paralyzed muscles and cardiopulmonary system, the nonphysiologic way in which these muscles are activated with FNS, and the probability that organ system adjustments that normally accompany voluntary exercise do not occur to the same extent with this peripherally induced exercise. More research is necessary to determine the mechanisms of fatigue for FNS exercise so that methods could be devised to increase resistance to fatigue. In addition, more research is necessary to substantiate the potential health and fitness benefits that have been stated for FNS exercise training. PMID- 3524869 TI - Aerobic capacity in spinal cord injured people. PMID- 3524871 TI - [25 years of the Psychiatric Research Institute]. PMID- 3524870 TI - [Comparison of nomifensine, maprotiline and imipramine in a double-blind study of patients with endogenous depression]. PMID- 3524872 TI - [40 years' of "Ceskoslovenske Pediatrie"]. PMID- 3524873 TI - [Correlation of miction cystourethrography with ultrasonic examination in children with urination disorders]. PMID- 3524874 TI - [60 years of immunobiologic production in Czechoslovakia]. PMID- 3524875 TI - Disulfide cleavage and insulin denaturation by active oxygen in the copper(II)/ascorbic acid system. PMID- 3524876 TI - Enzyme immunoassay for cinobufagin. PMID- 3524877 TI - [Histopathology of leprosy. Study of more than 2300 biopsies]. AB - 2,326 biopsies on Moroccan subjects suffering of leprosy had been studied in 4 years. After a critical study of histopathologic diagnosis and the classifications, the authors studied especially the lepromatous granuloma, its evolution during treatment and the lepromatous reactions. Defining histologically a reactional background, they make a certain generalisation among all the types of reactions observed in lepromatous patients. PMID- 3524878 TI - [Bacterial infections and early Plasmodium falciparum malaria]. AB - Two cases of Plasmodium falciparum malaria associated with bacterial infections- streptococcus A septicemia and Legionnaires' disease--are described. The association of these two infections is probably not incidental, and the hypothesis of Plasmodium falciparum induced immuno-deficiency is discussed. PMID- 3524879 TI - Imported cases of chloroquine-resistant falciparum malaria in Iran. AB - Six imported cases of chloroquine-resistant Falciparum malaria have been studied since October 1984. In five cases including two Iranian men, returned from India, two Afghan and one Bengalee immigrants came to Iran through Pakistan, recrudescence occurred following treatment with chloroquine. In these five cases resistance of P. falciparum to chloroquine was clinically (by the in vivo test) at R1 level in all patients. The resistance was also confirmed by the macro in vitro susceptibility test which was carried out in four of them. These five chloroquine-resistant cases were treated, one with Sulfadiazine-Pyrimethamine, three with Quinine-Sulfadiazine-Pyrimethamine and one with Sulfadoxine Pyrimethamine (Fansidar) successfully. In the sixth case who was a Pakistani tourist the parasites showed resistance in the macro in vitro test, but apparently responded to chloroquine treatment in three days. It seems the resistance in this case was also at R1 level as other cases. PMID- 3524880 TI - [Bancroft's filariasis in Anjouan (Comoro Islands)]. AB - A parasitological survey on Bancroftian filariasis has been carried out in Anjouan (Comoro Islands) in 1982. A fall in the microfilaria rate (17.66%) is noticeable comparatively to Prod'hon investigations in 1969 (41.25%). Prevalence is reduced in the main localities but is still high in remote villages, specially in the inner district of the island. PMID- 3524881 TI - [Malaria in Gabon. I. Study of 500 children with fever in Libreville]. AB - Among 500 febrile children who came for medical examination in the Pediatric Department at the Hopital General de Libreville, 29.2% were infected by malaria. P. falciparum was the most common (96.7%), P. malariae and P. ovale were sparsely present. Rarely detected in people consulting for fever, shivering and headache were the two symptoms directly related to paludism. There is a direct correlation between the size of the spleen and the rate of infestation. Screening among babies from 3 to 6 months' old, shows 13% already infected. The top of malaria incidence lies between 2 and 3 years of age (42% were infected). PMID- 3524882 TI - Periodontal maintenance: a review of the literature. PMID- 3524883 TI - Induction of delayed-type hypersensitivity in human volunteers immunized with a candidate leprosy vaccine consisting of killed Mycobacterium leprae. AB - A killed armadillo-derived Mycobacterium leprae vaccine was examined for its ability to induce a delayed-type hypersensitivity (DTH) response in purified protein derivative (PPD)-positive human volunteers living in a leprosy non endemic country. Four groups of individuals aged between 23 and 28 years were given 1.5 x 10(7), 5 x 10(7), 1.5 x 10(8) and 5 x 10(8)M. leprae intradermally. A marked increase in reactivity to the M. leprae-derived skin test antigen (MLSA) was observed in the vaccinated groups receiving the three highest doses of vaccine while there was very little change observed in their PPD reactivity. No unacceptable side-effects attributable to the vaccine were observed. The killed armadillo-derived M. leprae vaccine thus appears to be able to induce a DTH response in man at doses which do not cause unacceptable side-effects. PMID- 3524884 TI - A strategy for cancer prevention and control research. AB - Cancer is an important cause of morbidity and mortality in industrial countries. Recently changes in life-style and the environment in developing countries have coincided with increases in the incidence of certain cancers which might be related to these factors. A strategy for the prevention of all such cancers is presented, which involves research in a sequence of five phases to identify suitable interventions and to confirm their effectiveness in population studies, prior to their application on a nationwide scale. PMID- 3524885 TI - Secular trends in maternal mortality in Sweden from 1750 to 1980. AB - Mortality statistics have been kept continuously in Sweden since 1750 and reveal that the maternal mortality rate declined from 900 to 6 per 100 000 live births over the period 1750 to 1980. Two-thirds of this decrease occurred during the 19th century and the remainder in the 20th century. In the 18th century, 10% of deaths among women aged between 15 and 49 years were due to complications at parturition, but today this accounts for only 0.2% of deaths in women of this age group. Life-table analysis indicates that 1 out of 29 women in Sweden lost her life in parturition during the 18th century, while today only 1 out of 1000 women dies as a result of complications during pregnancy and parturition. PMID- 3524886 TI - Age and parity as determinants of maternal mortality--impact of their shifting distribution among parturients in Sweden from 1781 to 1980. AB - The reduction in maternal mortality in Sweden between 1781 and 1980 is analysed with respect to changes in the distribution of age and parity among parturients over this period. Changes in maternal age contributed to almost 3% of the reduction in mortality over the period 1781-1911 and to 5% between 1911 and 1980. From 1965 to 1980, however, about 50% of the reduction in mortality was caused by a decrease in maternal age. Changes in parity have had the opposite effect. Maternal deaths attributable to the risk factors of age and parity increased from 46% during the 19th century to 80% from 1951 to 1980. PMID- 3524887 TI - Exercise muscle metabolism measured by magnetic resonance spectroscopy. AB - Nuclear magnetic resonance imaging (MRI) is a technique which gives body images in much the same way as X-ray tomography. Most images are produced from signals of mobile hydrogen atoms in the tissues. Since bone contains few such atoms the images do not show bone material but allow marrow to be observed. Recently the technique has been extended to include spectroscopy of atoms of 31P, 13C and several others important in cell and tissue metabolism. The technique which uses a radiofrequency surface coil placed over the tissue of interest, is called topical magnetic resonance spectroscopy (MRS). Magnetic resonance spectroscopy which measures phosphorus nuclei can be used to study phosphorus in muscle. The same instrument can be used to study hydrogen density distribution. It can monitor muscle metabolism during exercise and muscle energetics can thus be evaluated. MRS gives a more accurate picture of the in vivo proportions of high energy phosphates than conventional biochemical analysis, which requires muscle biopsy, it can be used to monitor living tissue in a non-destructive way. PMID- 3524888 TI - Effects of tumor growth on host defenses. AB - Monocytes and macrophages play an important role in host defense against neoplasia. Studies from our and other laboratories have demonstrated that patients with a variety of cancers have a defect in monocyte chemotactic responses. Tumor-bearing mice are also inhibited in their ability to accumulate macrophages to inflammatory foci. We have shown that extracts prepared from murine tumors, as well as the plasma and urine of tumor-bearing mice, contain anti-inflammatory proteins which are antigenically and physicochemically related to the immunosuppressive retroviral envelope protein p15E. Similarly, proteins capable of inhibiting monocyte chemotactic responses are present in human cancerous effusions and can be specifically absorbed by monoclonal antibodies to p15E. Furthermore, we have demonstrated that human malignant and mitogen transformed cells contain p15E-related antigens. These findings led us to propose a two stage model of tumorigenesis: the first stage involves neoplastic transformation of a cell while the second stage involves activation of a gene coding for a p15E-like protein which allows the transformed cell to escape immune surveillance and go on to become a tumor. Support for this model has come from recent studies which have identified within the human genome an endogenous retrovirus sequence whose envelope gene is partially homologous to a highly conserved region of p15E. Using a synthetic peptide, termed CKS-17, we have shown that this region may be responsible for many of the biological activities of p15E and is capable of suppressing lymphocyte and natural killer cell immune functions as well as those of monocytes and macrophages. Thus tumors may be capable of evading host defense mechanisms by activation of a normal gene related to the immunosuppressive retroviral protein p15E. PMID- 3524890 TI - Genotoxic effects of ethylene oxide and their relevance to human cancer. PMID- 3524891 TI - Mutagenicity of 3,4-diphenyl-5-nitrofuran analogs in Salmonella typhimurium. AB - A new series of chemicals comprising eight different 3,4-diphenyl-substituted furan analogs, namely, methyl-3,4-diphenyl-2-furoate, methyl-3,4-diphenyl-5-nitro 2-furoate, 3,4-diphenyl-5-nitro-2-furoic acid, 3,4-diphenyl-5-nitro-2 acetylfuran, 3,4-diphenyl-5-nitro-2-bromoacetylfuran, 2-amino-4-(3,4-diphenyl-5 nitro-2-furyl)thiazole, 2-acetyl-amino-4-(3,4-diphenyl-5-nitro-2-furyl)thiazole and 2-formyl-amino-4-(3,4-diphenyl-5-nitro-2-furyl)thiazole were synthesized and their mutagenic activities tested in Salmonella typhimurium. The structure- activity relationship studies revealed that for mutagenic activity the nitro group is essential and that the potency of activity is greatly altered by the nature of the substituent at the 2-position of the furan ring. The mutagenic activities of these chemicals were generally much higher in TA100 compared to TA98. The relative order of activities for 2-substituted, 3,4-diphenyl-5 nitrofurans were COOCH3 greater than COCH2BR greater than COCH3 greater than COOH in S. typhimurium TA100. 3,4-Diphenyl-5-nitro-2-bromoacetylfuran was equally active in nitroreductase-proficient (TA98, TA100) and in nitroreductase-deficient (TA98NR, TA100NR) strains. In contrast, the acetyl and carboxymethyl ester analogs were relatively less active in nitroreductase-deficient strains. Mutagenic activities of 3,4-diphenyl-substituted furylthiazoles in comparison with the unsubstituted analogs of N-[4-(5-nitro-2-furyl)-2-thiazolyl]-formamide, N-[4-(5-nitro-2-furyl)-2-thiazolyl]-acetamide and 2-amino-4-(5-nitro-2 furyl)thiazole revealed that the phenyl groups drastically reduced their mutagenic activities. However, the relative order of activities formylamino greater than or equal to acetylamino greater than amino were the were the same between phenyl-substituted and unsubstituted analogs. PMID- 3524889 TI - Shaping future strategies for the pharmacological control of tumor cell metastases. AB - The eradication of established metastases in patients with malignant tumors is the single most important objective in clinical oncology. The current panel of antineoplastic agents discovered through random and semiempirical screening procedures has proven largely ineffective in treating disseminated disease and there is a clear and urgent need for more efficient antimetastatic drugs. Unfortunately, although progress has been made in examining the biology of metastatic spread, our understanding of the pharmacology, biochemistry and molecular genetics of this process is meager and insufficient to provide a rational foundation for the design of mechanism-based antineoplastic agents. Faced on the one hand with the failure of existing drugs to control metastatic spread and on the other with a dearth of alternative pharmacological approaches, the prospect of offering significantly improved therapy to the cancer patient of the 1990's is poor. The challenge of the coming decade lies in obtaining better insights into the molecular mechanisms of metastasis and using this information to identify pharmacological opportunities to curtail the proliferation of secondary tumor growths. As a first step toward this goal we need to define more rigorously what constitutes a therapeutic target in malignant disease and what steps in the pathogenesis of cancer metastasis represent the gravest risk to the patient and thus are most eligible for direct pharmacological intervention. In addressing these issues and developing future strategies for antimetastatic drugs, Paget's 100 year-old 'seed and soil' hypothesis continues to offer a useful conceptual framework for analysis of metastatic behavior. Although Paget's proposal has been validated by a century of clinical observation, efforts to define the 'seed and soil' theory in molecular terms have not been attempted. With the advent of more efficient methodologies for culturing human normal and neoplastic cells coupled with the availability of microanalytical technologies it now becomes possible to investigate and identify the complementary biochemical components of the tumor cell 'seed' and organ 'soil' that combine to encourage the proliferation of metastases. With this information the design of specific pharmacological strategies to uncouple the 'seed and soil' relationship may emerge as a potential therapeutic approach for antagonizing the growth of disseminated malignant tumors. PMID- 3524892 TI - Microbial filtrates activate granulocytes without complement or prostaglandins. AB - Cardiorespiratory dysfunction in sepsis may be mediated by circulating complement, activated leukocytes, prostaglandins, or by a direct effect of endotoxin. The purposes of this study were to determine if pathogenic microbes produce these substances and to evaluate the direct effects of substances released by micro-organisms on granulocyte aggregation (GA). Escherichia coli, (E. coli), Aeromonas hydrophila (Aeromonas h.), Staphylococcus aureus (S. aureus), and Candida albicans, (Candida a.) were incubated in broth to a concentration of 10(9)/ml. Broth was filtered and analyzed by radioimmunoassay for complement components C3a and C5a, thromboxane B2 (TxB), and prostaglandin 6 keto-F1 alpha (PGI) and by the limulus amebocyte lysate test (LAL) for endotoxin. GA, % of maximum zymosan activated aggregation (% max. T), was performed with broth, microbial filtrates, and endotoxin or normal purified human leukocytes in HBSS. Organisms were incubated in broth (B), broth + 0.0135 mg/ml arachidonic acid (BA), and broth + arachidonic acid + indomethacin (BAI). Broth alone was the control (C). RESULTS: C3a, C5a, TxB, and PGI were not detectable in C broth or in any microbian filtrate. LAL was positive in all filtrates, but negative in C broth. GA responses were significantly greater in E. coli (56 +/- 5% max T) and Aeromonas h. (57% +/- 8% max T) compared to S. aureus (10 +/- 5% max T), Candida a. (14 +/- 8% max T) and C broth (1 +/- 1% max T). GA with purified E. coli endotoxin at concentrations measured in the filtrates was not related to the GA responses the original filtrates.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3524893 TI - Changes of plasma gastrointestinal glucagon concentrations following lethal infusions of E. coli. AB - We have determined the effect of lethal E. coli infusions in dogs on plasma concentrations of pancreatic and gastrointestinal-derived glucagon and have explored the contributions of each source of glucagon during the early and recovery phases of shock. We examined 18 adult dogs in three protocols: group I received LD100 E. coli alone, group II received LD100 E. coli + tobramycin (TOB), and group III received LD100 E. coli + TOB + methylprednisolone sodium succinate (MPSS). E. coli organisms were infused intravenously during a 1-hour period and each animal was monitored for 6 hours and observed for a 7-day recovery period. Plasma concentrations of pancreatic and gastrointestinal glucagon were determined by specific RIAs. The survival percentages (greater than 7 days) were 0% in group I, 17% in group II, and 83% in group III. Early progressive increases in plasma concentrations of pancreatic and gastrointestinal-derived glucagon, reaching statistical significance by 6 hours following the onset of E. coli administration, were seen in the three groups. The increase in gastrointestinal derived glucagon was of a greater magnitude than that from the pancreas. Attenuation of the increase appeared to be achieved by corticosteroid infusion during its time of administration (6 hours). Recovery from shock was characterized by an exceptionally slow return (greater than or equal to 7 days) to control levels of glucagon in all recovering animals. PMID- 3524894 TI - Myocardial ischemia: platelet and thromboxane concentrations in cardiac lymph and the effects of ibuprofen and prostacyclin. AB - Blood platelets have been implicated in several mechanisms leading to and/or modifying myocardial ischemia. Cardiac lymph examination allows insight into the extracellular fluid that is in equilibrium with the capillary blood. In order to obtain an index of platelet activation during coronary artery events in the awake chronic animal, we wished to ascertain whether evaluation of cardiac lymph would detect changes in platelet activation resulting from a vascular occlusion. The study used conscious dogs in which cardiac lymph vessels had been previously cannulated by open-chest surgical protocol. The concentrations of immunoreactive thromboxane B2 and platelet counts were assessed in the cardiac lymph during the control period, the 10-60 minute occlusions, and the reperfusion periods. The same protocols were effected on another series of dogs after infusion of ibuprofen or prostacyclin. Initially, immunoreactive thromboxane B2 concentrations in the systemic blood and cardiac lymph were identical. A three fold increase in immunoreactive thromboxane B2 concentrations occurred in untreated animals and was accompanied by a fall in platelet count in the lymph. The infusion of ibuprofen or prostacyclin, which inhibit platelet aggregation by different mechanisms, prevented both the decrease in platelets and the increase in immunoreactive thromboxane B2. In this study, intravascular events resulting from coronary occlusion invoke a rapid rise of immunoreactive thromboxane B2 in the extravascular fluid. A decrease in platelet escape into the extravascular compartment is interpreted as a result of intravascular aggregation promoting decreased platelet numbers. Thus, examination of continuously flowing cardiac lymph allows rapid detection of intravascular activation of platelets in the awake animal in the absence of surgical trauma. PMID- 3524895 TI - T. Lauder Brunton and amyl nitrite: a Victorian vasodilator. PMID- 3524896 TI - Sensitive detection of the effects of reperfusion on myocardium by ultrasonic tissue characterization with integrated backscatter. AB - We have shown recently that tissue characterization of myocardium with ultrasound reflects changes associated with contractile function throughout the cardiac cycle. To determine whether ultrasonic tissue characterization can sensitively detect the impact of ischemic injury and reperfusion on contractile properties of the heart, we studied the time course of change of backscatter after 5, 20, and 60 min of coronary occlusion followed by reperfusion in 15 dogs. The time averaged integrated backscatter (IB) and the amplitude and phase of cyclic variation of IB (phase relative to the left ventricular pressure waveform) were measured. A novel ultrasonic index of acute injury was identified, the phase weighted amplitude of cyclic variation, and calculated by weighting the amplitude of cyclic variation of IB with respect to the phase. We hypothesized that backscatter variables would change dramatically after occlusion and that their restitution after reperfusion would sensitively reflect the extent and time course of reversibility of ischemic injury. After coronary occlusion, segmental wall thickening decreased from approximately 55% to 5% regardless of the duration of ischemia. Changes in backscatter associated with this decrease included an increase in time-averaged IB of approximately 5 dB, a 5 dB decrease in cyclic variation, an 80 degree phase shift, and a 7 dB decrease in phase-weighted amplitude. Wall thickening after reperfusion immediately after the 5, 20, or 60 min occlusions recovered to 45%, 27%, and 12% of baseline values, respectively. Within 3 hr it recovered to 53%, 44%, and 22%. Time-averaged IB recovered initially by 89%, 61%, and 44% (all p less than .05) and continued to recover subsequently although more slowly. Ultimate recovery was virtually complete. In contrast to the rapid recovery of time-averaged IB, phase-weighted amplitude recovered initially to only 72%, 41%, and -7% of baseline (all p less than .05) and manifested slower and incomplete recovery when ischemia had been present for 20 or 60 min. After reperfusion, the time course of both cyclic variation and phase were reflected by changes in the phase-weighted amplitude. The backscatter variables assessed appear to sensitively delineate the duration, time course of recovery, and reversibility of ischemic injury in response to reperfusion. The results suggest that early recovery of time-averaged IB corresponds in part to the restoration of tissue ultrastructural integrity.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3524897 TI - Recommendations for use of laboratory studies for pediatric patients with suspected or proven heart disease. A statement of the Committee on Congenital Cardiac Defects of the Council on Cardiovascular Disease in the Young of the American Heart Association. PMID- 3524898 TI - Cysteine proteinase inhibitor levels in semen. AB - New proteinase inhibitors have recently been found in seminal plasma which specifically inhibit cysteine proteinases such as ficin, papain, cathepsin H and cathepsin B. The inhibitors consist of two components, In-A and In-B, both of which are effective in native semen. In the present work, a method of assay is devised to determine activities of both components separately. Under conditions in which In-B is denatured completely while In-A is not, inhibitory activity of In-A alone is determined. The mean In-A inhibitory level is 1.52 +/- 0.28 inhibitor unit/mL and the level is independent of the number of spermatozoa. In-B level is calculated by subtracting In-A level from the total ficin inhibition level of the semen. The mean In-B level is 1.47 +/- 0.52 inhibitor unit/ml. In-B level has a tendency to increase with increasing number of spermatozoa. The correlation coefficient is 0.307 and statistical significance p less than 0.005. PMID- 3524899 TI - C-reactive protein as biochemical indicator of bacterial infection in neonates. AB - Serial quantitative measurements of C-reactive protein (CRP) were performed, using an automated enzyme immunoassay method, in 127 neonates (114 premature and 13 full-term) classified in three groups: neonates with a normal postnatal course (group 1, n = 69), neonates with clinical suspicion of bacterial infection but with negative cultures (group 2, n = 49), and neonates with proven bacterial infection (group 3, n = 9). A total of 545 serial serum CRP concentrations were determined. In group 1, CRP concentrations were below the detection limit of the method (10 mg/L) except in one neonate who suffered from neonatal anoxia but whose clinical course was uncomplicated (CRP: 31 mg/L within 24 h of life). Thirty-three neonates of group 2 had CRP values consistently below 10 mg/L while 16 had elevated CRP concentrations at least on one occasion ranging from 10 to 70 mg/L. Diagnoses other than bacterial infection could explain the raised CRP concentrations in neonates of group 2. CRP concentrations were found to be elevated (greater than 80 mg/L) during the course of infectious diseases in all neonates with proven bacterial infection (septicemia (4), pneumonia (1), multiple micro-abscesses (1), urinary tract infection (3]. Serial measurement of CRP concentrations are shown to be valuable in detecting bacterial infection in neonates as well as in following the efficacy of antimicrobial therapy. PMID- 3524900 TI - Measurement of ionized calcium in serum with ion-selective electrodes: a mature technology that can meet the daily service needs. AB - This article reviews key advances in ion-selective electrode technology that have made potentiometric measurements of ionized calcium (Ca2+) reliable and precise. Our use of two second-generation Ca2+ analyzers (Radiometer ICA1 and NOVA 8) made possible uninterrupted service as volume increased to 31 640 patient tests in 1985. The lower results on the NOVA 8 were adjusted upwards to match those of the ICA1 to give identical results. Both analyzers were evaluated under working conditions of high volumes and multiple operators to establish downtime, electrode life, and costs. We have classified all Ca2+ analyzers into first-, intermediate-, and second-generation instruments, the better to understand their differences. Results for large numbers of patients' sera were shown to be systematically different when any two analyzers were compared. These differences are the consequence of each manufacturer's unique choices of the following: (a) the matrix of the calcium calibration solutions, (b) the type and configuration of the reference electrode, and (c) the salt-bridge solution. Elimination of each analyzer's biases will require agreement on a reference system that defines the accuracy of Ca2+ measurements on serum, plasma, or whole blood. The sound analytical performance of today's second-generation Ca2+ analyzers has allowed us to exploit the inherent superiority of Ca2+ over total calcium (CaT) measurements in the daily care of patients. We report on the preference of Ca2+ over CaT by physicians at our hospital since the introduction of second-generation Ca2+ analyzers. Therefore, we state unequivocally from our very satisfactory experience over the past five years that Ca2+ is a clinical laboratory test whose time has come! PMID- 3524901 TI - Ion-selective membrane electrodes for clinical use. AB - We review ion-selective solvent polymeric membrane electrodes for clinical use. The particular requirements that the clinical application set on the membrane are discussed in terms of selectivity, stability, lifetime, and response time. The performance of currently available electrodes is reviewed, with consideration of actual problems that arise in clinical practice. PMID- 3524902 TI - Detection of anti-laminin antibodies in sera by latex agglutination. AB - We describe a latex particle agglutination assay for detecting circulating antibodies against laminin, a noncollagenous glycoprotein of basement membranes. Polystyrene latex particles on which laminin has been adsorbed are incubated with serum for about 25 min at 42-45 degrees C. The agglutination is then measured by counting residual unagglutinated particles. Polyethylene glycol 6000 enhances the agglutination. The assay is fully automated, yielding results in about 45 min, for 50 samples per hour. Addition of purified laminin abolishes the agglutination of laminin-coated particles in practically all positive sera. The anti-laminin antibody titers obtained by this latex immunoassay and by radioimmunoassay correlated well in 161 sera from patients with suspected or established renal diseases. The agglutination assay more frequently gave positive results for cases of glomerulonephritis with linear deposits (20/22 cases) than for glomerulonephritis with granular deposits (7/68) or glomerulonephritis with no glomerular deposits (2/13). The finding of low anti-laminin antibody titers in sera from about 15% (34/230) of the healthy subjects suggests that these autoantibodies are pathogenic only in certain circumstances. PMID- 3524903 TI - Two new monoclonal antibody-based enzyme-linked assays of apolipoprotein B. AB - We describe two new monoclonal antibody-based, solid-phase immunoenzymometric assays for the quantification of apolipoprotein (apo) B in plasma: a competitive assay and a direct assay. For both, we utilize 96-well microtiter plates and native low-density lipoprotein (LDL) for preparing the standard curve. A single monoclonal antibody, MB24, is used in the competitive assay. The direct assay involves use of two monoclonal antibodies, MB24 and MB47. These two antibodies bind to distinct, unrelated apo B epitopes expressed by all LDL particles, and both antibodies detect apo B in very low-density and intermediate-density lipoproteins as well as LDL. With the two-step competitive assay, which involves use of LDL-coated microtiter plates, the intra- and interassay reproducibility in plasma apo B measurements averaged 6% and 12%, respectively. In the one-step direct assay, which takes less than 2 h for completion, plasma samples and peroxidase-labeled MB24 are incubated simultaneously on MB47-coated microtiter wells. The amount of labeled MB24 bound to lipoproteins trapped by MB47 is proportional to apo B concentration. With the direct assay, intra- and interassay CVs averaged 7% and 12%, respectively. These assays are simple, reproducible, involve convenient incubation intervals, and do not require radioisotopes; thus they can be widely applied in clinical laboratories. PMID- 3524904 TI - Fully automated protocol for EMIT determination of serum digoxin with the Cobas FARA centrifugal analyzer. PMID- 3524905 TI - Elimination of the residual alveolar cleft by secondary bone grafting and subsequent orthodontic treatment. AB - A combined surgical/orthodontic procedure to eliminate the residual alveolar cleft by secondary bone grafting and subsequent orthodontic treatment is described. The operations have been carried out on 378 patients: 240 males and 138 females. Seventy-two patients had bilateral clefts, making a total of 450 grafted clefts. The optimal age for this secondary bone grafting has been found to be 9 to 11 years. In 292 of the cases, the canine had reached its final position in the arch, which allowed a four-group semiquantitative assessment of the newly obtained interdental septum on dental radiographs. The best results have been achieved in cases where the bone graft was carried out prior to the eruption of the canine. In this group, a normal (category I) interdental septal height was achieved in 64 percent and a slightly lower (category II) interdental septum in 32 percent. Interdental septa classified as type I and II are considered to be acceptable. The cleft space was closed in 90 percent of the cases. No significant difference between unilateral and bilateral cases was found. When the same procedure was carried out after eruption of the canine, the results were less favorable. PMID- 3524906 TI - Cervical vertebral anomalies in cleft lip and palate. AB - A survey was made of the upper cervical vertebrae in children with cleft lip and palate in order to determine the prevalence of cervical vertebral anomalies. The cleft sample consisted of 105 patients attending for orthodontic treatment. It was subdivided into cleft lip (CL), cleft palate (CP), unilateral cleft lip and palate (UCLP) and bilateral cleft lip and palate (BCLP) subgroups. A control was comprised of 120 orthodontic patients. The cervical vertebral anomalies were classified into two types, posterior arch deficiency (PAD) and fusion anomalies (FUS). The results confirmed that the cervical vertebral anomalies occurred significantly more often in the cleft sample (13%) than in the controls (0.8%), p less than 0.001. The total prevalence of cervical vertebral anomalies was similar in the four cleft sub-samples, but the occurrence of each of the two types of cervical vertebral anomalies showed a more differentiated pattern. Posterior arch deficiency occurred significantly more often in cleft palate (CP), (16%) than in controls p less than 0.001, but fusions did not occur more frequently in any cleft groups than in controls. PMID- 3524907 TI - Enzyme immunoassay of serum cortisol using a new transferable needle lid technique. AB - A simple enzyme immunoassay of serum cortisol using for the first time a transferable needle lid as solid phase has been developed. The needles coated with second antibody and dipped into the wells of a microtitre plate bind the specific antibody of a competitive enzyme immunoassay mixture. Bound enzyme activity is estimated in the wells of another microtitre plate. This technique provides further advantages on the frequently used microtitre plate version. Washes between the immunological and the enzymatic reaction take very short time and are less laborious. Due to the facility of simultaneous starting and stopping of all reactions, a better precision and sensitivity is achieved. In the present cortisol assay, horseradish peroxidase covalently coupled to cortisol-21 hemisuccinate was used as enzyme label and tetramethylbenzidine as the chromogen for measuring enzyme activity. No extraction or deproteinization steps are involved. The turn around time for 41 samples (in duplicate) is 2.5 h. The detection limit of the assay is 5 pg of cortisol per well. Results of the present method correlated well (r = 0.92) with those of a commercial radioimmunoassay using iodinated cortisol. PMID- 3524908 TI - Effects of calcium loading on blood pressure in spontaneously hypertensive rats: attenuation of the vascular reactivity. AB - The effects of oral calcium loading on the blood pressure of spontaneously hypertensive rats (SHR) (n = 20) and age-matched normotensive Wistar-Kyoto rats (WKY) (n = 16) were investigated. Calcium loading was performed by adding 1.5% CaCl2 (Calcium chloride) to the drinking water. Calcium loading attenuated the development of hypertension in the SHR but not in the WKY, and at the end of a 3 week experiment, systolic blood pressure was 171+2 vs 197+3 mmHg (P less than 0.01). In spite of this reduction of blood pressure, there were no significant changes in sodium-water balance, plasma levels of norepinephrine and epinephrine, plasma renin activity, plasma aldosterone concentration and serum electrolytes due to the calcium treatment. On this basis, the depressor mechanism of calcium loading in the SHR was studied by observing the pressor response to norepinephrine and the vascular reactivity to norepinephrine in hind limb perfusion. It was found that both the pressor response and the vascular reactivity were significantly attenuated by the calcium treatment in the SHR but not in the WKY. These results suggest that the antihypertensive effects of calcium treatment in SHR may depend mainly on attenuation of the vascular reactivity. PMID- 3524909 TI - Changes in aortic water and sodium contents associated with potassium supplement in DOCA-salt rats. AB - Since waterlogging, increased vascular water and sodium contents, could contribute to the development of deoxycorticosterone acetate (DOCA)-salt hypertension, we have examined the effect of dietary potassium supplementation on the water and sodium contents of abdominal aorta after short-term (one week) treatment with DOCA while receiving a 1% NaC1 solution to drink. Supplementation with 1% KC1 solution could counteract the blood-pressure rising action of DOCA salt, associated with the inhibition of sodium retention. In addition, treatment with DOCA-salt was associated with increases in water (83.1 +/- 3.0% wet weight) and sodium (118.7 +/- 2.8 microEq/g dry weight) contents of the aorta compared with those of the control rats (69.7 +/- 0.3% wet weight and 103.0 +/- 4.0 microEq/g dry weight, respectively). In contrast, 1% KC1 supplementation could attenuate the increase in water (73.2 +/- 1.5% wet weight) and sodium (110.3 +/- 2.3 microEq/g dry weight) contents of the aorta in DOCA-salt rats. Taken together, these results suggest that potassium supplement not only attenuates the sodium retention but also moderates the "waterlogging" in the vascular wall in DOCA-salt rats, thus leading to the antihypertensive action of potassium supplement in the early stage of DOCA-salt hypertension. PMID- 3524910 TI - The effectiveness of adenoidectomy in the treatment of glue ear: a randomized controlled trial. AB - One hundred children with glue ear, in whom surgical treatment was indicated, were randomly allocated to 1 of 4 treatment groups. Children in 2 of the groups underwent adenoidectomy plus various combinations of ear operations while in the other 2 groups surgery was confined to the ears. The effect of adenoidectomy was assessed 6 weeks, 6 months and 1 year after surgery by means of audiometry, impedance tympanometry and parental opinion. Improvements in hearing were greater in those children who underwent an adenoidectomy than in those who did not (4.0 dB at 6 weeks; 2.4 dB at 6 months; 0.7 dB at 1 year). However, these differences are of little clinical significance and were only statistically significant (P less than 0.05) 6 weeks after surgery. Middle ear function, measured by tympanometry, revealed a similar pattern of response to treatment. Despite this, 6 months after surgery a higher proportion of parents were satisfied with their child's condition if an adenoidectomy had been performed. Possible explanations of this discrepancy between clinical and parental assessments of outcome are discussed. PMID- 3524911 TI - Experimental and clinical aspects of carbon as a middle ear prosthesis. AB - The biocompatibility of vitreous carbon and carbon fibre reinforced carbon (CFRC) as middle ear implants was investigated. In separate animal model systems, vitreous carbon was implanted in the middle ear of 20 DA rats for up to 6 months, whilst 3 varieties of CFRC (basic or crude, ultrasonically cleaned, glazed) were implanted in 98 guinea-pig middle ears for up to 4 months. Tissue reactions to implantation were assessed by means of stereoscopic and standard light microscopy, and scanning electron microscopy with chemical analysis facilities (EDAX, WDAX). Vitreous carbon and glazed CFRC were considered suitable for human implantation and a trial of the latter was started in 23 patients (14 partial, 9 total ossicular implants). At 9 months, only 52% of the implants were still in situ; 40% had been extruded and 8% had elicited inflammatory responses which would undoubtedly result in extrusion. Carbon particle dissemination with carbon fibre destruction and exposure as a result of peroperative prosthesis drilling were considered the likely causes for the failure of this implant. PMID- 3524912 TI - Endoscopy in the diagnosis and therapy of pancreatic disorders. PMID- 3524913 TI - Endoscopic ultrasonography. AB - EUS has many advantages over x-ray and other endoscopic procedures for the detection of lesions located in the wall of the GI tract. In the oesophagus, invasion of cancer and spread to lymph nodes can be visualized by EUS before surgery. In the stomach, the invasion depth of cancer and the therapeutic effect of laser irradiation to early cancer can be studied. EUS may also be useful in the evaluation of chemotherapy in malignant lymphoma. In benign diseases of the GI tract, EUS can provide important information about submucosal tumours. It can improve the differential diagnosis of malignant and benign submucosal tumours. EUS will also contribute to the elucidation of the pathogenesis of giant folds developing in the stomach. In addition, EUS is beneficial in the diagnosis of chronic pancreatitis, pancreatic cyst, pancreatic cancer, cancer of the papilla Vateri and diseases of the biliary tract. In conclusion, we feel that endoscopic ultrasonography may prove to be a useful technique in the diagnosis of intra- and extramural lesions of the GI tract, but comparisons with conventional imaging procedures should be performed. PMID- 3524914 TI - Endoscopic haemostasis of the upper gastrointestinal tract. AB - The realm of endoscopy has gone from that of diagnosis to that of diagnosis and therapy. Therapeutic endoscopy is a rapidly advancing frontier in the field of gastroenterology. Its use in securing haemostasis has recently flourished. Considerable progress has been made. Various experimental techniques have been tried and found lacking, while others, such as laser photocoagulation, electrohydrocoagulation and endoscopic sclerotherapy, are proving to be very useful. The mortality for upper gastrointestinal bleeding has remained high for decades, despite recent advances in medicine. This may be related to the shift in the population toward the older age group. Recent advances in endoscopic haemostasis seem to be showing promise in improving survival rates. This is a result of improved recognition of risk factors, including the stigmata of recent haemorrhage, of early surgical intervention in the elderly, and of the ability to reliably secure haemostasis endoscopically. This chapter gives an account of the various techniques of endoscopic haemostasis and explains the numerous controversies through the discussion of selected experimental and clinical trials. PMID- 3524915 TI - Endoscopy as final arbiter in controlled clinical trials in peptic disorders. AB - Endoscopy should not be the sole final arbiter in controlled clinical trials of peptic disorders. Data on the response of symptoms to treatment and the occurrence of side-effects may be not as 'hard' as endoscopically assessed 'healing' and 'relapse', but may be clinically more meaningful. Furthermore, in most recent trials, 'healing' and 'relapse' were poorly defined; important information on residual mucosal lesions after healing was often neglected. PMID- 3524916 TI - Regulation of macrophage accessory cell activity by mycobacteria. I. Ia expression in normal and irradiated mice infected with Mycobacterium microti. AB - CBA/Ca mice were infected by either the intravenous or intraperitoneal route with Mycobacterium microti and the subsequent changes in local macrophage populations examined. Following infection, the number of macrophages increased and they showed greater expression of both MHC Class II molecules. This response was not dependent on viability of the mycobacteria, in contrast to reports with other microorganisms such as Listeria. Studies in sublethally irradiated mice indicated that persistent antigen could give rise to a response after a period of host recovery which was radiation dose dependent. This procedure also highlighted differences in the regulation of different murine class II antigens in vivo, as seen by delayed re-expression of I-E antigens. Macrophage accessory cell function, as assessed by an in vitro T cell proliferation assay, correlated with Ia expression after fixation, but not after indomethacin treatment; this highlights the diverse nature of regulatory molecules produced by these cells. PMID- 3524917 TI - Human follicular dendritic cells (FDC): a study with monoclonal antibodies (MoAb). AB - A collection of new and established FDC-reactive MoAb has been used in an immunohistological study designed to throw light on (a) the nature of FDC (which are of unknown lineage) as judged by their sharing of antigens with other cell types and (b) the reason for the strong expression of some B cell antigens on FDC. The MoAb were tested on: (1) sections of tonsil, (2) sections of lymph nodes from four cases of non-Hodgkin's lymphoma, (3) peripheral blood cells and (4) cells of cultured haemopoietic cell lines. Only one of the ten new MoAb bound to FDC and no other component of the tissues screened. It resembled R4/23, a MoAb known to be specific for FDC. The other nine antibodies showed a range of cross reactivity patterns involving one or more of the following: monocytes, macrophages, platelets, epithelium, endothelium and connective tissue fibres. Some of the MoAb reacted with B lymphocytes and cells of B lymphoblastoid lines but none showed the restricted FDC-staining pattern associated with MoAb which detect the CD23, P45 antigen. The findings are discussed in terms of the intrinsic or extrinsic nature of the antigens detected. PMID- 3524918 TI - The influence of killed Mycobacterium leprae and other mycobacteria on opsonized yeast phagocytosis. AB - The influence of killed mycobacteria on the metabolic burst associated with phagocytosis of opsonized zymosan by normal human polymorphonuclear leucocytes (PMNL) or monocytes was studied by chemiluminescence (CL) measurements. M. leprae reproducibly reduced the peak and total CL of both types of phagocyte to a small, but highly significant extent. Electron microscopy showed that M. leprae were phagocytosed: cells with ingested or adherent M. leprae phagocytosed fewer zymosan particles. M. leprae did not cause aggregation of the phagocytes or quenching of CL. M. lepraemurium did not influence the CL response to zymosan. Addition of M. tuberculosis caused an increased response with PMNL but not with monocytes. PMID- 3524919 TI - Effect of sodium intake and sodium delivery to the macula densa on renal renin content and juxtaglomerular apparatus morphology. AB - Active and inactive renin were measured in individual juxtaglomerular apparatus (JGA) and in whole kidney homogenates. The morphology of the JGA was examined in microbiopsy glomerular specimens and in kidneys fixed by arterial perfusion. In rats on high and normal salt intake the total renin content of a single JGA was 14 (s.e.m. = 3) and 29 (s.e.m. = 4) ng AI/h, respectively. The amount of cystoplasm occupied by renin granules was 20% and 27%. Crystalline cores were seen in 1.5% and 7% of the granules, respectively. Increased delivery of NaCl to the macula densa did not alter total renin, but decreased inactive renin from 30% to 0, crystalline core-containing cells from 33% to 14% and decreased the percentage of granules with crystalline cores from 12% to 2.2%. Increased sodium in the diet and increased delivery of NaCl to the macula densa decreased the proportion of renin present in the inactive form and decreased the proportion of crystalline cores. These coincidental alterations suggest that crystalline cores contain inactive renin and suggest that the delivery of sodium to the macula densa activates renin. PMID- 3524920 TI - The syndrome of hypertension and hyperkalaemia with normal GFR. A unique pathophysiological mechanism for hypertension? AB - Based on 28 reported patients, constant features of the syndrome of hypertension and hyperkalaemia are hyperkalaemia, hyperchloraemia, normal renal glomerular function and, in all adult patients, hypertension. Inconstant features include short stature, intellectual impairment and muscle weakness. Levels of renin and aldosterone are low, but respond to dietary salt restriction and diuretic therapy, both of which reverse the hypertension and hyperkalaemia. The basic abnormality is excessive renal sodium retention, leading to chronic suppression of renin and aldosterone; the latter is then hyporesponsive to the hyperkalaemic stimulus. Dietary salt loading or impaired production of any natriuretic or chloriuretic factor (for example atrial natriuretic peptide or renal natriuretic prostaglandins) would predispose to development of the syndrome. With normal GFR, this appears to be a unique mechanism for hypertension and hyperkalaemia. PMID- 3524921 TI - Effect of prostaglandin E1 in brown Norway rats with mercury-induced autoimmune disease. AB - The effect of prostaglandin E1 on mercury-induced autoimmune disease in brown Norway rats has been investigated. Daily doses of 6 to 24 micrograms prolonged survival and significantly decreased proteinuria, deposition of immune reactants in the glomeruli, circulating anti-glomerular membrane antibody production, total serum IgE, and circulating immune complex level. A dose of 3 micrograms was also effective but to a lesser degree. These results show the efficiency of prostaglandin E1 in yet another autoimmune disease, show that the beneficial effect of prostaglandin E1 in this model is related to its immunosuppressive effects, and suggest that modification of prostaglandin-mediated suppression induced by HgCl2 might play a role in the pathogenesis of this autoimmune disease. PMID- 3524922 TI - Phenotypic dissection of cord blood immunoregulatory T-cell subsets by using a two-color immunofluorescence study. AB - Expression of TQ1(Leu8) and 2H4 antigens on human cord blood T-cell subsets was evaluated by a double immunofluorescence analysis. In normal adult blood all of the helper function for B-cell differentiation is confined to the smaller OKT4+TQ1-(Leu8-) cell subset, while the OKT4+TQ1+(Leu8+) cell subpopulation includes a subset of suppressor inducer 2H4+(JRA+) cells. Our results indicated that the OKT4+TQ1-(Leu8-) cell subpopulation was decreased and the reciprocal OKT4+TQ1+(Leu8+) cell subset was markedly increased in cord blood E-rosetting OKT3+ cell population. A rise in the number of cord OKT4+2H4+ cells was also found. In addition, TQ1 antigen was present on OKT3+E-, a less mature, cord T cell subset, not present in adult blood. These findings may not only be of help in understanding lymphoid cell development during ontogeny, but also may agree with the reported strong-suppressor and weak-helper activities exerted by the T cell subsets circulating in human cord blood. PMID- 3524923 TI - Clinical and morphologic evolution of idiopathic membranous nephropathy. AB - Twenty-five adult patients with idiopathic membranous nephropathy (IMN) and nephrotic syndrome (NS) who had participated at a long-term randomized trial with steroid and chlorambucil for six months, underwent repeated renal biopsies. The mean interval between pretreatment and the second biopsy was 41 months. Five evolutionary morphologic changes were adopted. Extensive normalization of the basement membrane (stage V) was observed in 6 of the 9 patients with complete and sustained remission. Only patients in stages I or II at admission seemed to get to reparation stage V. Persistence of NS or a partial remission was usually associated to the progression of the capillary wall lesion to stage III or IV. Our treatment schedule significantly increased the likelihood of getting to the reparation stage V. PMID- 3524924 TI - Renal failure and dialysis therapy in children with hepatic failure in the perioperative period of orthotopic liver transplantation. AB - Severe renal failure (GFR less than or equal to 20 ml/min/1.73 m2) complicated the clinical course in 27 of 146 children (18.5%) admitted for orthotopic liver transplantation (OLT). Hepatorenal syndrome (HRS) was the cause of renal failure in 12 of 15 patients in whom renal failure preceded OLT while acute tubular necrosis, pre-renal factors and cyclosporine nephrotoxicity were the major causes of renal failure post-OLT. Eight patients died from hemorrhage, infection or other complications of hepatic failure before OLT could be performed. Survival in the remaining 19 patients undergoing OLT was significantly lower compared to 114 patients with OLT and no renal failure (53% vs 81%, p less than 0.025). Dialysis therapy in 13 of the 27 patients with renal failure (10 hemodialysis and 3 peritoneal dialysis) was frequently complicated by severe gastrointestinal hemorrhage and hypotension, and directly contributed to the death of two patients prior to OLT. Among the 19 patients with renal failure who were actually transplanted, the survival rate was similar whether dialysis was used or not (5/10 vs 5/9) even though the mean GFR was significantly lower in dialyzed patients (p less than 0.05). However, although small patient numbers precluded meaningful statistical analysis, dialysis appeared to be beneficial for the subgroup of 12 patients with HRS, 4 of whom had complete recovery of renal function after successful OLT. We conclude that, renal failure is common in children with advanced liver failure; dialysis in such patients may increase morbidity and does not improve overall mortality; and dialysis support may improve survival in the subgroup of patients with HRS. PMID- 3524925 TI - Urinary protein analysis in the early detection of acute rejection episodes after renal transplantation in children. AB - The purpose of the present longitudinal investigation was to assess the predictive value of urinary protein analysis in the early detection of rejection crisis after renal transplantation. Forty-one children were studied consecutively over a period of 6 months applying the following methods: creatinine clearance (Ccr); urinary total protein (UTP); and electrophoretic differentiation of urinary proteins according to their molecular size by microgradient-gel electrophoresis (MGGE) with a continuous concentration gradient of 4-40% of polyacrylamide. Protein fractions analyzed were albumin (69,000 d), low molecular weight proteins (LMW-proteins, less than 69,000 d), and high molecular weight proteins (HMW-proteins, greater than 69,000 d). No rejection was observed in 30 children (group A), a total of 18 rejection episodes occurred in 11 children (group B). UTP was significantly lower in group A as compared to group B (107 vs 376 mg/m2/24 h), but no differences in urinary protein pattern were observed between group A and group B prior to rejection. One to two days after rejection UTP increased to 938 mg/m2/24 h, and 3-7 days after rejection LMW-protein fraction increased from 9% to 23% with a corresponding decrease of albumin fraction from 71% to 56% of UTP. No qualitative changes were noted in respect to HMW-protein excretion. It is concluded that changes of UTP and urinary protein pattern occur during rejection episodes but are of no predictive value in detecting rejection before clinical symptoms appear. PMID- 3524926 TI - Immunophenotyping of mononuclear cell infiltrates associated with renal disease. AB - Twenty-eight frozen renal biopsy specimens with a marked mononuclear cell interstitial infiltrate (MCI) were analyzed with monoclonal antibodies and a biotin-avidin peroxidase technique to define the surface phenotype distribution of the infiltrating cells. Twelve cases were diagnosed as tubulointerstitial nephritis of acute and chronic presentation, of unknown cause in 5 cases or secondary to multiple myeloma or drug reactions. Sixteen cases occurred in primary and secondary glomerulonephritis, 3 cases being associated with lymphoproliferative disorders. The results showed a remarkable heterogeneity of the MCI composition, even in cases with similar clinical and pathological findings. Namely, the T cells accounted for the majority of the infiltrating cells in most cases but a variable predominance of the T cell subsets Leu3 and Leu2 was observed. B cells and monocytes were also prominent in some cases. Such differences in the MCI composition may indicate the activation of different mechanisms of tissue damage, or a different phase of the renal disease. In the three cases of glomerulonephritis associated with lymphoproliferative disorders, the malignant origin of the MCI was demonstrated in one case, while in the remaining cases it was excluded. PMID- 3524927 TI - Relationship of abnormal Tamm-Horsfall glycoprotein localization to renal morphology and function. AB - Tamm-Horsfall glycoprotein (TH) distribution was studied using a biotin-avidin immunoperoxidase technique in renal biopsies from 166 consecutive patients and 8 normal kidneys. Tubulointerstitial damage was independently assessed and graded. In 109 patients TH antibodies were measured by ELISA and in 30 of these urinary TH and beta 2-microglobulin excretions were measured by radioimmunoassay. In 124 biopsies only distal tubular epithelium and casts were stained. Glomerular space (8) or interstitial (34) deposits were seen in 42 biopsies; 16/68 with glomerulonephritis, 4/14 with systemic vasculitis, 12/33 with chronic interstitial nephritis, 1/8 with acute interstitial nephritis, 9/43 with other nephropathies. There was no correlation between TH distribution and the degree of tubulointerstitial damage (p greater than 0.5), urinary TH excretion (p greater than 0.05), urinary beta 2-microglobulin excretion (p greater than 0.05), glomerular filtration rate, urinary concentrating ability, or the incidence of pyuria. TH antibodies did not correlate with TH distribution (p greater than 0.5) or the degree of tubulointerstitial damage. Abnormal TH distribution showed no statistical relationship to the degree of tubulointerstitial damage, changes in renal function or levels of TH antibodies. PMID- 3524928 TI - Participation of the renin-angiotensin system in the captopril-induced worsening of anemia in chronic hemodialysis patients. AB - The study was aimed to show whether the renin-angiotensin system acts on erythropoiesis in chronic renal failure patients with hemodialysis, since captopril leads to the worsening of anemia in such patients. The average dose of captopril in 13 cases studied was 19.3 mg per day and duration of the administration was 48 days. Blood-pressure fall by captopril was accompanied with the worsening of anemia. There were significant decreases in hemoglobin (8.3%), hematocrit (7.3%), red blood cell count (7.6%) and reticulocyte count (43.7%). Angiotensin II was significantly decreased (15.7%) with significant reductions of plasma aldosterone concentration (15.2%) and angiotensin-I converting enzyme (45.7%), and with significant increases in plasma renin activity (158.6%) and in angiotensin I (238.3%). However, plasma erythropoietin concentration remained unchanged. Serum iron concentration was slightly but significantly increased after captopril. Reticulocyte count was significantly correlated with AII either before (r = 0.716, p less than 0.01) or after captopril (r = 0.658, p less than 0.05). There was significant correlation between angiotensin II and red blood cell count before captopril (r = 0.710, p less than 0.01). It is concluded from the present study that the reduction of angiotensin II by captopril might contribute to the worsening of anemia seen in chronic hemodialysis patients. PMID- 3524929 TI - Effect of chronic oral testosterone undecanoate administration on the pituitary testicular axes of hemodialyzed male patients. AB - Testosterone undecanoate (TU) or placebo was administered orally (for 12 weeks) in a double blind study, to 19 patients with chronic renal insufficiency on hemodialysis in a daily dose of 240 mg. Effect on plasma testosterone (T), dihydrotestosterone (DHT), androstenedione (A), 110H androstenedione (110A), FSH, LH and PRL concentration and the pituitary responsiveness to LH-RH/TRH stimulation was studied. These hormone levels were determined before the study and after 6 and 12 weeks of treatment. There was a rise in plasma androgen concentration in all treated patients. Mean plasma DHT, A and 110A increased at 12 weeks from 0.3, 0.85 and 1.13 ng/ml to 1.13 (p less than 0.05), 1.4 (p less than 0.05) and 1.44 (p less than 0.05) respectively. There was no change in plasma T or free testosterone. However, basal LH, FSH fell progressively from 5.51 and 5.51 ng/ml to 2.13 and 1.84 ng/ml (p less than 0.05). The level of significance of these changes was confirmed when the response to LH-RH was considered. Basal plasma PRL also decreased from 376 microU/nl to 306 (p less than 0.05), but PRL response to TRH remained unchanged. In contrast, none of these modifications were observed in placebo-treated patients. We conclude that oral TU restored to normal the pituitary-testicular axis. This form of treatment should be preferentially chosen instead of intramuscular injections in these frequently heparinized patients on hemodialysis. PMID- 3524930 TI - The multiple levels of endothelial cell-coagulation factor interactions. PMID- 3524931 TI - Fibrinogen, fibrin and fibrin degradation products in relation to atherosclerosis. AB - Many human atherosclerotic lesions, showing no evidence of fissure or ulceration, contain a large amount of fibrin which may be in the form of mural thrombus on the intact surface of the plaque, in layers within the fibrous cap, in the lipid rich centre, or diffusely distributed throughout the plaque. Small mural thrombi are invaded by SMCs and collagen is deposited in patterns closely resembling the early proliferative gelatinous lesions. In experimental animals, thrombi are converted into lesions with all the characteristics of fibrous plaques, and in saphenous-vein bypass grafts, fibrin deposition is the main cause of wall thickening and occlusion. There seems little doubt that fibrin deposition can both initiate atherogenesis and contribute to the growth of plaques. Epidemiological studies indicate that increased levels of fibrinogen and clotting activity are associated with accelerated atherosclerosis, and although blood fibrinolytic activity has given inconsistent results, in arterial intima both fibrinolytic activity and plasminogen concentration are decreased in cardiovascular disease. Fibrin may stimulate cell proliferation by providing a scaffold along which cells migrate, and by binding fibronectin, which stimulates cell migration and adhesion. Fibrin degradation products, which are present in the intima, may stimulate mitogenesis and collagen synthesis, attract leukocytes, and alter endothelial permeability and vascular tone. In the advanced plaque fibrin may be involved in the tight binding of LDL and accumulation of lipid. Thus there is extensive evidence that enhanced blood coagulation is a risk factor not only for thrombotic occlusion, but also for atherogenesis. Enhanced blood coagulation frequently coexists with hyperlipidaemia and, together, these may have a synergistic effect on atherogenesis. PMID- 3524932 TI - Thrombotic thrombocytopenic purpura and the haemolytic-uraemic syndrome: evolving concepts of pathogenesis and therapy. AB - Thrombotic thrombocytopenic purpura (TTP) and the haemolytic-uraemic syndrome (HUS) are caused by platelet thrombi in the microcirculation (i.e. arterioles and capillaries) throughout the body (TTP) or predominantly in the kidneys (HUS). Plasma factors that induce intravascular platelet agglutination have been a focus of investigation into the pathogenesis of these disorders. Von Willebrand factor (vWF) multimeric forms that are larger than those present in normal plasma are found in the plasma of patients with the chronic relapsing form of TTP. These unusually large vWF multimers are similar to those produced by normal human endothelial cells, but never allowed into the normal circulation. Unusually large vWF multimers in chronic relapsing TTP patients are most apparent in plasma during remission. They disappear, presumably in the process of attaching to platelets and inducing the formation of platelet thrombi, during relapses in chronic TTP. The disappearance of the largest plasma vWF multimeric forms during acute episodes of non-relapsing TTP and HUS has also been seen. These syndromes may be the result of damage to systemic or renal endothelial cells. A cofactor which induces the attachment of large vWF multimers to platelets during episodes of TTP has recently been detected, but not yet characterized biochemically. The cryosupernatant (i.e. vWF-depleted) fraction of normal plasma contains an activity that converts, or potentiates the conversion of, unusually large vWF multimers to the somewhat smaller circulating vWF forms as the bloodstream. There is clinical evidence that an autoantibody may prevent the effect of this 'unusually large vWF depolymerase' in some chronic relapsing TTP patients. Transfusions of normal plasma or cryosupernatant as prophylaxis against, or therapy for, episodes of TTP may transiently provide this missing unusually large vWF depolymerase activity, as well as additional plasma proteins to bind and eliminate the vWF cofactor proposed as the inciting agent of TTP episodes. In some patients, partial removal of unusually large vWF multimers (and possibly the inciting vWF cofactor) by plasmapheresis may be required along with the transfusion of normal plasma or cryosupernatant, in order to control in vivo platelet agglutination. Plasma manipulation has greatly improved the survival of patients with relapsing and non-relapsing forms of TTP. Corticosteroids may also be beneficial. The effectiveness of ancillary measures (splenectomy, vinca alkaloids or other immunosuppressive drugs) is not precisely defined. There is no convincing evidence that aspirin, dipyridamole or PGI2 are helpful in TTP.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3524934 TI - The use of antithrombotic drugs in artery disease. AB - Evaluating the use of antithrombotic drugs in artery disease has been a long and difficult process, which is far from complete. The aims of treatment have ranged from the primary prevention of myocardial infarction or stroke, through the restoration of blood flow to ischaemic organs in order to salvage threatened tissue, to the prevention of recurrent vascular occlusion. Drugs studied in depth by clinical trial include the oral anticoagulants, antiplatelet drugs (especially aspirin), and thrombolytic agents. Their results are considered under the headings of coronary artery disease, cerebral ischaemia, and peripheral vascular disease. Aspirin, with or without dipyridamole, prevents progression of unstable angina to myocardial infarction or death, probably reduces long-term mortality after myocardial infarction, and prevents aortocoronary bypass graft occlusion. It decreases the risks of stroke or death in patients with transient cerebral ischaemia, diminishes cardiovascular morbidity after a thrombotic stroke, and may improve the outcome after some kinds of surgery for peripheral vascular disease. The benefits of oral anticoagulant treatment to prevent artery occlusion remain poorly defined. Oral anticoagulants prevent systemic embolism in many groups of high-risk patients, and probably reduce the risk of recurrence after embolism has occurred. Whether their long-term use to prevent reinfarction in patients with a previous myocardial infarct can be justified remains uncertain. They are of little or no proven value in patients with transient cerebral ischaemia or thrombotic stroke. On the other hand, there is increasing support for early thrombolytic treatment after myocardial infarction, especially since two multicentre trials have now shown reduced mortality in patients treated with intracoronary streptokinase within 4-6 hours of infarction and a further large multicentre study also demonstrated reduced mortality in patients treated with early intravenous streptokinase. In addition, the local infusion of streptokinase leads to recanalization in a high proportion of patients with a recent peripheral artery occlusion who are poor candidates for surgery. PMID- 3524933 TI - Diabetes mellitus, vascular disease and thrombosis. PMID- 3524935 TI - Charles K. Friedberg. PMID- 3524936 TI - Acute and chronic pulmonary thromboembolism: current perspectives. Part I: Glossary of terms, historic evolution and prevalence. AB - Despite considerable medical as well as surgical advances, the problem of pulmonary thromboembolism, both acute and chronic, continues to plague clinicians of all medical disciplines. Approximately 650,000 to 700,000 patients per year suffer from acute pulmonary thromboembolism in the United States. Of these, approximately 60,000-70,000 die as a direct result of it. Our knowledge of the etiology, pathology, pathogenesis of pulmonary infarction, pathophysiology, accurate diagnosis, proper management (including both primary and secondary prophylaxis) of deep vein thrombi and pulmonary thromboemboli has advanced considerably during the past 15 years. These advances, which have now been adopted in the clinical practice, have already begun to indicate that not only more cases of acute and chronic pulmonary thromboembolism are being recognized than before, but also the morbidity and mortality of this disease process is declining. This is likely to improve further as our quest for safe, accurate, noninvasive and inexpensive diagnostic methods continues. Medical thromboembolectomy using thrombolytic therapy is fast replacing the surgical thromboembolectomy for patients with acute massive pulmonary thromboembolism. Better thrombolytic agents, such as tissue plasminogen activator, which selectively lyses the thromboemboli without producing significant systemic lytic state and now undergoing clinical investigation, is likely to revolutionize the management of both acute and chronic pulmonary thromboembolism because of its propensity to dissolve plasminogen-bound thrombi of any age. The majority of the patients who suffer from acute pulmonary thromboembolism recover most of their lost lung function unless cardiopulmonary reserve was compromised prior to the onset of the acute episode.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3524937 TI - Sir Dominic John Corrigan. PMID- 3524938 TI - Altered fibronectin distribution in cultured fibroblasts from patients with Ehlers-Danlos syndrome. AB - Using the immunofluorescence technique we have studied the distribution of fibronectin in cultured fibroblasts from patients affected by Ehlers-Danlos Syndrome (EDS) types I, II and VI. In these cells the amount of fibronectin production is reduced with respect to normal fibroblasts; moreover fibronectin fibers are shorter, thicker, mainly pericellular and show intracytoplasmic accumulation. The altered fibronectin distribution may be the result of altered interactions of fibronectin with extracellular matrix components, either due to abnormal fibronectin or to changes in other extracellular matrix molecules (e.g. collagens, hyaluronic acid). PMID- 3524940 TI - A theoretical analysis of the turnover of the hepatic insulin receptor in the rat. PMID- 3524939 TI - Anti-lymphocyte antibodies in the pathogenesis of SLE. PMID- 3524941 TI - Perthes' disease. The family tree. AB - The discovery and use of roentgenograms by Wilhelm Rontgen in 1895 was one of the most important turning points in the history of orthopedics. Within only a few years, immense advances were made in the recognition and definition of bone and joint disorders that, until then, had been thought to be different or unusual forms of musculoskeletal tuberculosis. Perthes' disease has become one of the Lieblingsthema of orthopedics. The study of the history of Perthes' disease is fascinating: the sources of many "original" thoughts can be traced back across the world, through the years. This review begins with the 19th century, traces the emergence of the definition of Perthes' disease and some related conditions, and follows the story of the disease in the first decade of its history as a separate entity. PMID- 3524942 TI - The classic. A typical disease of the upper femoral epiphysis. By Erwin Schwarz. PMID- 3524943 TI - Femoral anteversion in Perthes' disease with observations on irritable hips. Application of a new method using ultrasound. AB - A new ultrasound method was used to measure femoral anteversion (torsion) of both hips in children with unilateral Perthes' disease, children with previous irritable hips, and healthy children of a similar age. In children with Perthes' disease, the mean femoral anteversion of affected hips is significantly higher compared with normal controls. In the opposite hips, femoral anteversion for right and left hips separately is not significantly different from that of controls. The affected hips show a significantly greater scatter of anteversion than do normal hips, which could be secondary to the disease; but the opposite hips also show a significantly wider scatter of anteversion than do normal hips, which suggests a developmental abnormality of femoral torsion in the femur of the unaffected limb. In children with Perthes' disease, femoral anteversion asymmetry is characteristic, marked, and significantly different from that of normal hips, with the affected hips usually being the more anteverted (with two exceptions). Irritable hips show significantly greater femoral anteversion asymmetry than do normal hips, with the affected femur usually being less anteverted than the opposite femur. These observations may have relevance in Perthes' disease with respect to both etiology, femoral osteotomy, and prognosis. PMID- 3524944 TI - [An autopsy case of Creutzfeldt-Jakob disease with white matter lesion and amyloid plaques]. PMID- 3524945 TI - [A case report of a pregnant woman with severe bacterial meningitis caused by group A beta-hemolytic Streptococcus]. PMID- 3524946 TI - Hepatobiliary imaging in choledocholithiasis. A comparison with ultrasound. AB - A retrospective analysis of preoperative biliary imaging and ultrasound in 22 patients with surgically proven choledocholithiasis was performed. Ultrasound detected dilated ducts greater than 7 mm in 11 of 14 jaundiced patients (79%). Hepatobiliary imaging was able to detect either absent or delayed bowel visualization or prominent bile ducts in 13 of 14 jaundiced patients (93%). Of eight nonjaundiced patients, ultrasound showed dilated ducts in three (38%). Hepatobiliary imaging showed either absent bowel activity or prominent ducts in six of eight nonjaundiced patients (75%). Twenty of 22 patients had stones in the gallbladder that were detected by ultrasound, although only one patient had actual visualization of the common duct stone. Hepatobiliary imaging may show abnormalities in choledocholithiasis with normal ultrasound studies. PMID- 3524947 TI - Nuclear medicine evaluation of focal fatty infiltration of the liver. AB - Focal fatty infiltration of the liver (FFIL) occasionally may be mistaken as metastatic disease, primary liver malignancy, or other space-occupying lesions on CT or ultrasound studies, especially if there is significant mass effect. In these confusing cases, Xe-133 liver imaging has been advocated for confirmation of FFIL, since such studies have been reported to be sensitive and specific. The authors present results of four Xe-133 and four Tc-99m sulfur colloid scans in six patients with FFIL. Xe-133 imaging was found useful for diagnostic confirmation in only one patient and was misleading in the other three. Routine liver-spleen imaging was a more reliable method of confirmation, since no focal defects were found in any of the patients. PMID- 3524948 TI - Adverse effects of drugs in the first trimester of pregnancy. PMID- 3524949 TI - Prescribing in pregnancy. Mineral and vitamin supplements. PMID- 3524950 TI - The management of renal disease in pregnancy. PMID- 3524951 TI - The treatment of gastrointestinal disease in pregnancy. PMID- 3524952 TI - Prescribing in pregnancy. Epilepsy in pregnancy. AB - In women with epilepsy, seizure control during pregnancy can be improved by maintaining the serum anticonvulsant drug concentration within the therapeutic range. Treatment with one anticonvulsant drug plus folic acid supplementation 5 mg per day seems appropriate in most cases. This should be achieved before conception whenever possible. No anticonvulsant drug seems free of teratogenic risk. With the commonly used anticonvulsant drugs-phenytoin, phenobarbitone, carbamazepine and sodium valproate-the risk is relatively low and represents less potential harm to the fetus than might occur with uncontrolled seizures. PMID- 3524953 TI - Prescribing in pregnancy. Bacterial infections in pregnancy. AB - Certain infections, such as UTI, may have an increased incidence during pregnancy owing to physiological changes. Between 2 and 10% of pregnant women have covert or asymptomatic bacteriuria which is associated with an increased incidence of acute symptomatic UTI in later pregnancy if left untreated. Thus antenatal screening to detect the presence of bacteriuria is justified. Most women will remain abacteriuric throughout the remainder of pregnancy after a single course of antibiotic therapy but a small percentage will fail to respond or have recurrent UTIs. Maternal infection with certain organisms, namely those which resist phagocytosis, may result in transplacental infection of the fetus in utero. Congenital syphilis is preventable and antenatal serological screening is usually routinely performed. Listeriosis following maternal infection in pregnancy is less predictable and the epidemiology of L. monocytogenes remains unclear. Genital tract carriage of sexually transmitted organisms, such as N. gonorrhoeae or C. trachomatis, may also be detected during pregnancy and antibiotic therapy will be indicated to eradicate such organisms and prevent maternal and neonatal morbidity. Antibiotic therapy during pregnancy will not, however, eradicate carriage of GBS from the genital tract, although carriage status at term can now be reliably predicted by using enriched culture techniques and swabbing multiple sites on more than one occasion. Where carriage is confirmed, the administration of intrapartum antibiotics to the mother appears a useful approach in the prevention of early onset neonatal GBS disease. Broad spectrum intrapartum antibiotics may also be indicated when there are complications, such as prolonged labour or premature rupture of membranes, which are associated with a higher incidence of maternal postpartum endometritis and morbidity than in women following uncomplicated vaginal delivery. Serious postnatal sepsis and shock is fortunately now rare. The pharmacokinetics of antibiotics in late pregnancy and the puerperium are altered and maternal serum levels may be reduced by 10-50%. Most antibiotics cross the placenta and are excreted in breast milk. Some agents, such as the beta-lactams, are considered safe in pregnancy and breast-feeding women while other antibiotics are contraindicated owing to risk of toxicity (often rare) or teratogenicity (often theoretical). Caution is necessary with many agents which may cause side effects or toxicity although this does not necessarily contraindicate their use in pregnancy.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3524954 TI - Clinical pharmacokinetics and pharmacological effects of carbamazepine and carbamazepine-10,11-epoxide. An update. AB - Carbamazepine is a first-line drug in the treatment of most forms of epilepsy and also the drug of first choice in trigeminal neuralgia. Furthermore, it is now frequently used in bipolar depression. Most oral formulations of carbamazepine are well absorbed with high bioavailability. The drug is 75% bound to plasma proteins. The degree of protein binding shows little variation between different subjects, and there is no need to monitor free rather than total plasma concentrations. Carbamazepine is metabolised in the liver by oxidation before excretion in the urine. A major metabolite is carbamazepine-10,11-epoxide which is further metabolised by hydration before excretion. This epoxide-diol pathway is induced during long term treatment with carbamazepine. Co-medication with phenytoin or phenobarbitone further induces this metabolic pathway. Some but not all studies indicate an increased metabolism of carbamazepine during pregnancy. The drug crosses the placenta, and the newborns who are exposed to the drug during fetal life eliminate the drug readily after birth. There seems to be no problem to nurse children during treatment with carbamazepine. Metabolism of carbamazepine is comparable in children and adults. Several studies have tried to establish a relationship between plasma carbamazepine and clinical effect in epilepsy, but very few of these are controlled. The best anticonvulsant effect seems to be obtained at plasma concentrations of 15 to 40 mumol/L and a similar optimal plasma concentration range was found in a controlled study in trigeminal neuralgia. Side effects are more frequent at higher plasma concentrations but are also seen within that range. In some patients, with pronounced fluctuation of plasma concentrations during the dosage interval, side effects may be avoided by more frequent dosing. Carbamazepine-10,11-epoxide is a potent anticonvulsant in animal models. During treatment with carbamazepine the plasma concentrations of this metabolite are usually 10 to 50% of those of the parent drug. It has not been possible to establish the relative contribution of the two compounds to the pharmacological effects. The epoxide has therefore been given to humans with the aim of determining the relative potency of the parent drug and its metabolite. After single oral doses of carbamazepine-10,11-epoxide to healthy subjects, the compound was rapidly absorbed. As a mean of 90% of the given dose was recovered in urine as trans-10,11-dihydroxy-10,11-dihydro-carbamazepine, a complete absorption of unchanged epoxide was shown.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3524955 TI - Drug disposition in obese humans. An update. AB - Drug disposition for many drugs has now been studied in obese individuals and some general conclusions can be drawn. Absorption of drugs evaluated to date is unchanged due to obesity. Apparent volume of distribution is greatly increased for some drugs including most benzodiazepines, thiopentone, phenytoin, verapamil and lignocaine (lidocaine). Modest increases in volume of distribution have been noted for methylxanthines, aminoglycosides, vancomycin, ibuprofen, prednisolone and heparin. Distribution of digoxin, cimetidine and procainamide is unchanged in obesity. The mechanism for the increased distribution of some drugs and unchanged distribution of others in obesity is unclear at present. It may be in part due to the lipophilic character of the drug molecule; however, other complex and as yet poorly understood factors contribute to the variability in drug distribution in obese patients. Protein binding of drugs bound to albumin is not dramatically changed in obesity. In contrast, some studies report that drugs bound to alpha 1 acid glycoprotein (AAG) may have increased binding that is related to increased serum AAG concentration; however, this is not a consistent finding. Oxidative drug biotransformation is minimally changed in obesity with the exceptions of ibuprofen and prednisolone, for which clearance increases as a highly correlated function of total bodyweight. Drug conjugation uniformly increases as a function of bodyweight in obesity, with paracetamol (acetaminophen), lorazepam and oxazepam having been studied. Drug acetylation may be unchanged in obesity, with only procainamide evaluated at this time. High clearance drugs, including lignocaine, verapamil and midazolam, have no change in clearance in obese individuals compared to normal bodyweight controls. Renal clearance of drugs is little changed for some drugs evaluated (digoxin, cimetidine), and increased for others (aminoglycosides, unmetabolised procainamide). Characterisation of appropriate animal models of obesity is underway to clarify the mechanisms for these in vivo pharmacokinetic observations in obese man. Two models, the Zucker obese and the obese cafeteria-fed male Sprague-Dawley rat, have provided preliminary physiological pharmacokinetic data with evaluations of theophylline, phenobarbitone and verapamil.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3524956 TI - Clinical pharmacokinetics of disopyramide. AB - Disopyramide is an antiarrhythmic agent with proven efficacy in the management of atrial and ventricular arrhythmias. The drug is well absorbed and undergoes virtually no first-pass metabolism. Peak concentrations are achieved approximately 0.5 to 3.0 hours after a dose. Absorption is reduced and slightly slowed in patients with acute myocardial infarction. Disopyramide is excreted as unchanged drug (two-thirds) or as the metabolite mono-N-desisopropyldisopyramide, with elimination via both renal and biliary routes. Elimination half-life is approximately 7 hours in normal subjects and patients, but is prolonged in patients with renal insufficiency (creatinine clearance less than 60 ml/min). Disopyramide exhibits complex protein binding. It is bound to alpha 1-acid glycoprotein (AAG), an acute phase reactant, and binds in a concentration dependent (saturable) manner. The unbound fraction is reduced in the presence of elevated concentrations of AAG, as are found in acute myocardial infarction and in some chronic haemodialysis patients and renal transplant recipients. Free disopyramide concentrations are low relative to total concentration in these patients. Because the pharmacological effects of disopyramide are determined by unbound drug, changes in the unbound fraction could make total disopyramide concentrations misleading as a guide to therapy. Changes in protein binding do not, however, alter free disopyramide or metabolite concentrations, both of which are dependent only on dosage and intrinsic clearance. Free drug concentration measurement could potentially improve therapeutic monitoring, but is as yet of unproven clinical value. Disopyramide is cleared more rapidly in children than in adults, and therefore children require higher dosages to attain therapeutic concentrations. PMID- 3524958 TI - Value of rapid diagnosis of respiratory syncytial virus infection on management of small infants. AB - Respiratory syncytial virus (RSV) is a common cause of infection in infancy and early childhood. A presumptive diagnosis of RSV infection can frequently be made on clinical grounds. Confirmation can be made by viral culture, which may take 3 to 7 days. Immunofluorescent assay (IFA) is a specific and sensitive test that can provide laboratory confirmation of RSV infection the same day. Rapid diagnosis of RSV infection may have implications regarding prevention of nosocomial spread of RSV, early initiation of anti-viral therapy, use of antibiotics, and duration of hospital stay. Data are presented regarding the use of RSV-IFA and its effect on patient management. PMID- 3524959 TI - Retention of a light-cured fissure sealant (Helioseal) in a tropical environment after 12 months. PMID- 3524957 TI - Clinical pharmacokinetics of cholinesterase inhibitors. AB - This review deals mainly with the pharmacokinetics of the reversible quaternary cholinesterase inhibitors neostigmine, pyridostigmine and edrophonium, which are mainly used to antagonise non-depolarising neuromuscular blockade in general anaesthesia and in the symptomatic treatment of myasthenia gravis. Only in the last few years, since the introduction of highly sensitive and selective analytical procedures based on gas and liquid chromatography, have proper pharmacokinetic studies of these drugs become possible. Rapid cooling and addition of internal standard to samples before freezing are important precautions in view of the poor stability of the cholinesterase inhibitors in plasma and blood. Plasma clearances of the reversible quaternary cholinesterase inhibitors are in the range 0.5 to 1.0 L/h/kg and their apparent volumes of distribution range from 0.5 to 1.7 L/kg. Accordingly, the drugs have short plasma elimination half-lives, in the order of 30 to 90 minutes. One to two hours after oral administration of 60 mg pyridostigmine, peak plasma concentrations of 40 to 60 micrograms/L are observed, whereas the plasma concentrations of neostigmine after a 30 mg oral dose are only 1 to 5 micrograms/L. The oral bioavailability of these hydrophilic ionised compounds is low: that of pyridostigmine is approximately 10% and the value for neostigmine is even lower. In spite of the short elimination half-life of pyridostigmine, intraindividual variations in plasma concentration during a dose interval are small in myasthenic patients receiving oral maintenance therapy, probably as a result of slow absorption from the gastrointestinal tract. Severely impaired renal function has been shown to prolong the elimination of neostigmine and pyridostigmine, while methylcellulose has been reported to inhibit the absorption of the latter drug completely. Other pharmacokinetic drug interactions suggested so far do not seem to be of clinical significance. Although a positive correlation has been demonstrated between the plasma concentrations of these drugs and their pharmacological effects as measured by a decrement in muscle response to repetitive nerve stimulation in a single muscle, this relationship is less clear when a global evaluation of muscular function in myasthenia gravis is used. Pharmacokinetic studies of the tertiary reversible cholinesterase inhibitor physostigmine, an important tool in experimental cholinergic neuropharmacology, are still in their initial stages. This drug too is characterised by a short plasma elimination half-life of 20 to 30 minutes.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3524960 TI - Desensitizing agents. A review. PMID- 3524961 TI - Salvaging the broken porcelain fused to metal partial prosthesis. PMID- 3524962 TI - Application of immunochemistry to the diagnosis of human neoplasms in routine histologic sections. AB - The application of immunostaining techniques to the study of sections of formalin fixed, paraffin-embedded tissues has deeply influenced the practice of surgical pathology of tumors. We have favored in our laboratory the avidin-biotin complex immunoperoxidase method and have gradually substituted monoclonal antibodies for polyclonal sera. Better results are sometimes obtained with trypsinization prior to the application of the primary antibody. The more common primary antibodies used are directed against the following categories of cellular antigens: intermediate filaments, oncofetal products, hormones or hormone-related peptides, enzymes or enzyme-related peptides, cell- or tissue-"specific" products, lymphocyte-leukocyte antigens, and immunoglobulin chains. Controls are essential to every immunohistochemical reaction. Because of the pitfalls of immunohistochemical techniques, immunohistochemistry as applied to the study of tumors should be used with utmost care and as an extension of routine surgical pathology. PMID- 3524963 TI - [Is the PACS feasible for a large radiological department? Reflections on the image data volume of the Medical Radiation Institute of the University of Tubingen in 1983. Picture Archiving and Communication System]. AB - Picture Archiving and Communication Systems (PACS) are getting more and more important for departments of radiology with the increasing spread of digital imaging methods. To determine the demands made on such systems, we calculated the digital image data volume for all examinations carried out in 1983 at the Department of Medical Radiology of the University of Tubingen. 20.37% of all examinations were performed with digitalised equipment. Plain radiography takes the lion's share among the total number of image data. If digitalisation is based on a spatial resolution of 8 Lp/mm, the share is 98.4% of the total image data volume of 7 123 GByte. This figure is far in excess of the estimates stated in literature. The possibilities of image data reduction and feasibility of a major PACS are discussed. PMID- 3524964 TI - [Digital image intensifier radiography: imaging qualities and initial use in the gastrointestinal area]. AB - We determined the quality of digital radiographs delivered by a large image intensifier (diameter 54 cm) and by a conventional fluoroscopic unit with a 33 cm image intensifier, and compared them to that of 100 mm spot films obtained from the same units. A special image processor was available allowing 25 images/s using a 512/512 matrix or 7.5 images/s with a 1024 X 1024 matrix. The spatial resolution of digital radiographs was well below that of the spot films, while no difference was found in contrast resolution. Images of colon specimens and gastrointestinal studies demonstrate that digital radiography does not imply a loss in diagnostic information inspite of the lower spatial resolution. Gastrointestinal studies using digital radiographs will reduce the amount of irradiation exposure of the patient and could represent an additional use for an existing equipment for DSA. PMID- 3524965 TI - [Value of digital subtraction angiography compared to conventional angiography in diagnosing hypernephroma]. AB - The authors report on the application of intraarterial renal digital subtraction angiography in 82 patients and more than 122 conventional angiographies. The radiological criteria of renal carcinoma are discussed. The value of angiography in relation to other imaging methods is assessed and compared. PMID- 3524966 TI - [Realtime sonography of intrascrotal space-occupying lesions]. AB - In 848 examinations of the testes in 317 patients, including 253 follow-up and/or multiple follow-up examinations and 36 unilateral testicle examinations (e.g., orchidectomy, aplasia or nondescent) it was shown that sonography is a diagnostic method which is on the one hand capable of clearly differentiating cystic from solid space-occupying processes, and on the other hand also offers certain possibilities for evaluating the status of solid findings. Histologic identification of malignant tumors was only achieved with teratomas. The differential diagnostic problem was in differentiating scrotal tumors from focal orchitis, chronic epididymitis, testicular torsion and contusion, and in differentiation between paratesticular neoplasms and epididymitides. The testicular findings included testicular neoplasms, cicatrization and cysts of the tunic, sequelae of trauma, orchitis, cryptorchism, hypoplasia, aplasia, and testicular cysts. Paratesticular findings included hydroceles, spermatoceles, varicoceles, paratesticular neoplasms, epididymitides, paratesticular scars, and thickening of the testicular coat. PMID- 3524967 TI - How useful is computed tomography in the diagnosis and assessment of bronchiectasis? AB - A study was performed to determine the value of computed tomography (CT) in the diagnosis and assessment of cylindrical and mild varicose bronchiectasis. Fifteen patients, in whom bronchography had shown such bronchiectasis in 34 of 73 lobes that could be assessed, were examined by CT. A control group of 12 subjects in whom there was no clinical or plain radiographic suspicion of bronchiectasis was also studied. Computed tomography (CT) was considered to show bronchiectasis in 28 lobes, 27 of which were bronchiectatic as shown by bronchography. Of 45 lobes where CT was not thought to show bronchiectasis, bronchography demonstrated 38 normal and seven bronchiectatic lobes. All lobes in the control group were interpreted as normal. Using bronchography as the definitive investigation for cylindrical or mild varicose bronchiectasis, CT has a sensitivity of 79% and a specificity of 99% in the diagnosis of the disease. The high specificity indicates that a diagnosis of cylindrical or mild varicose bronchiectasis by CT is reliable but CT is too insensitive to be used as a screening test. PMID- 3524968 TI - Ultrasound and computed tomography of the infant brain: a clinical comparison. AB - The ultrasound and computed tomography examinations of the brain in 89 infants were correlated and compared. In 85% of cases both provided information of equal diagnostic accuracy. In the remaining 16% it was the combination of both examinations that provided the maximal information about anatomical localisation, extent of disease and tissue characterisation. PMID- 3524969 TI - Art, history and the antiquity of rheumatic diseases. PMID- 3524970 TI - A comparison of diflunisal and phenylbutazone in the treatment of ankylosing spondylitis. AB - A 12-week double-blind randomized drug trial followed by an open extension period of 36 weeks was carried out in 38 male patients with ankylosing spondylitis (AS) to compare the efficacy and safety of diflunisal (500 mg twice daily) and phenylbutazone (200 mg twice daily). Both drugs proved to be effective in improving the severity of symptoms associated with AS, and this improvement was maintained throughout the open extension period. Initially diflunisal had a more pronounced and rapid analgesic action, whereas phenylbutazone was more effective in increasing axial mobility. During the study 9 patients dropped out: 3 in each treatment group due to side effects and 1 in each group due to lack of efficacy; another patient was lost to follow-up. The two drugs were similarly safe as judged by the occurrence of adverse clinical effects, mainly gastrointestinal. This study again demonstrates the value of phenylbutazone in AS but, taking into account the possible haematological side effects, the use of other NSAIDs is stressed. Diflunisal is an alternative capable of improving the painful stiffness associated with AS. PMID- 3524971 TI - Naproxen and piroxicam in the treatment of osteoarthritis. PMID- 3524972 TI - International symposium. Art, history and antiquity of rheumatic diseases. Brussels, April 1986. Abstracts. PMID- 3524973 TI - [Captopril in the treatment of arterial hypertension in the elderly patient]. PMID- 3524974 TI - [Sulodexide in the therapy of vasculopathies]. PMID- 3524975 TI - [Ceftizoxime and its place in the context of modern cephalosporins]. PMID- 3524976 TI - [Coloring agents in the food industry]. PMID- 3524977 TI - Advances in diagnostic techniques in pulmonary medicine. PMID- 3524978 TI - The immunoperoxidase localization of type X collagen in chick cartilage and lung. AB - We have localized type X collagen in chick cartilage and lung by use of affinity purified antibodies raised against the purified protein. Examination of the centers of primary endochondral development in the embryonic sternum, developing cartilage in the embryonic tubular bones and growth plate cartilages demonstrated the specific association of type X collagen with regions of hypertrophic chondrocytes in these tissues. Furthermore these studies revealed a tendency for type X collagen to accumulate adjacent to regions of active vascular invasion and an apparent lag between the initial intracellular accumulation and the matrix deposition of type X collagen. A lag in the matrix accumulation of type X collagen was also shown biochemically and immunohistochemically in chondrocytes in culture. In chick lung type X collagen was localized to the smooth muscle of the blood vessels and to smooth muscle surrounding alveolar ducts. PMID- 3524979 TI - Identification of diabetic patients treated with insulin or oral hypoglycemics within a defined population. PMID- 3524980 TI - Depression of glutamine-stimulated uric acid production and blood glutamine accumulation by insulin in chickens. AB - This experiment was conducted to examine effects of insulin on glutamine accumulation in blood and uric acid production in the chicken infused with glutamine. Insulin pretreatment eliminated the stimulatory effect of glutamine infusion on urinary uric acid excretion in the chicken fed a 5% protein diet, which resulted in no increase in urinary total nitrogen excretion by the infusion. In the chicken fed a 20% protein diet the pretreatment with insulin did not have such clear depressive effects on the increases in urinary uric acid and total nitrogen excretion caused by the glutamine infusion. Insulin tended to depress the increases in plasma glutamine concentration caused by the infusion of glutamine at both levels of dietary protein intake. PMID- 3524981 TI - Degradation of newly-synthesised casein in mammary explants from pregnant and lactating goats. AB - Casein degradation was measured by a pulse-chase method in explants from freshly prepared from goat mammary tissue. An initial increase in L-[5-3H]proline radioactivity incorporated in casein during the chase period was followed in some conditions by a decrease resulting from intracellular degradation of the major casein polypeptides. Differences in the proportion of casein degraded in explants cultured with or without prolactin suggested that the process was under hormonal control. Greater degradation of casein by explants obtained in late pregnancy and early lactation suggested that the process may affect net casein production in vivo. PMID- 3524982 TI - A survey of polar and nonpolar lipids from epidermis and epidermal appendages of the chicken (Gallus domesticus). AB - Total lipid was extracted from chicken (Gallus domesticus) epidermis, leg scale, claws, feathers and preen glands and analyzed by quantitative thin-layer chromatography. All of the tissue lipids contained large proportions of wax diesters, triglycerides, and free sterols and variable proportions of phospholipids, steryl esters and free fatty acids. All of the keratinized tissues, but not the preen gland, contained ceramides, acylceramides and cholesteryl sulfate. Acylglucosylceramides were found only in full thickness epidermis. Glucosylsterols and acylglucosylsterols were found in the keratinized tissues, and may be of significance in the evolutionary history of the epidermal water barrier. PMID- 3524983 TI - Evaluation of scintigraphic data of renal transplants. AB - Scintigraphic data obtained during 594 examinations of renal transplants were evaluated by an experienced physician. Each examination included both the measurement of a radioiodine hippurate uptake curve, and a technetium 99m diethylenetriamine pentaacetic acid (DTPA) time-activity curve describing renal perfusion. Features were extracted from both curves. Discriminant analysis of the features resulted in a computer classification of the grafts. This classification was compared with the physician's diagnosis. Congruence between the computer classification and the diagnosis supported the diagnosis, and revealed those features which were able to lead to the correct diagnosis. The analysis was used to assess graft function, and to identify acute tubular necrosis and acute, as well as chronic, rejection. The computer classification was in agreement with the diagnosis in about 80% of the acute rejections, in 86% of all instances of acute tubular necrosis, and in 80% of chronic rejections. The procedure can be used to mutually improve the diagnosis of both physician and computer. PMID- 3524984 TI - Cox's regression model: computing a goodness of fit statistic. AB - A simple test for goodness of fit of the proportional hazards regression model has recently been proposed. This article indicates how a large number of programs in current use to fit this model can be easily adapted to incorporate this goodness of fit statistic. PMID- 3524985 TI - The effects of loneliness: a review of the literature. PMID- 3524986 TI - Training therapists to perform interpersonal psychotherapy in clinical trials. PMID- 3524987 TI - Establishing the vertical jaw relationship for the complete denture patient. PMID- 3524988 TI - In vitro radioisotopic labeling of the L-3 stage of Brugia malayi. AB - Ten radioisotopes (133Ba, 207Bi, 109Cd, 51Cr, 59Fe, 203Hg, 54Mn, 125Sb and 75Se) were used to label the L-3 stage of Brugia malayi. The in vitro uptake at 4 hours in a buffered salt solution was greatest for 207Bi and exceeded that of 203Hg, by a factor of 6 and the rest of the radionuclides by factors of 26 or more. Dimethylsulfoxide (DMSO) (1%) in the medium only slightly enhanced the uptake of 207Bi but increased 203Hg uptake by a factor of 2.5. After incubation in non radioactive medium only 2% of the 207Bi was retained; for 203Hg the retention was 70% or better. Increasing the labeling time increased total uptake and retention of the radionuclides. The retention of the 203Hg injected intraperitoneally into jirds (Meriones unguiculatus) in the form of labeled L-3s was followed over a 16 day period by counting the jirds in a whole animal NaI crystal detector. One L-4 stage of B malayi was recovered at the end of this period. PMID- 3524989 TI - Pharmacotherapy of sudden cardiac death due to acute myocardial ischaemia. Experimental and clinical experience. AB - A critical review of experimental studies aiming to determine the effect of drugs in the prevention of sudden cardiac death. They include antiischaemic drugs, the drugs influencing transmembrane ion transport, those altering the phospholipid structure of the myocardial membrane as well as the medicaments improving blood rheology, preventing thrombosis, cytoprotective drugs and thrombolytic therapy. PMID- 3524990 TI - Organization of extracellularly mineralized tissues: a comparative study of biological crystal growth. AB - Biological mineralization processes are extremely diverse and, to date, it is an act of faith rather than an established principle that organisms utilize common mechanisms for forming crystals. A systematic analysis of the structural organization, as far as possible at the molecular level, of five different extracellularly mineralized tissues is presented to demonstrate that at least these mineralization processes are all part of the same continuum. The degrees of control exercised over crystal nucleation and crystal growth modulation are the basic variables. The five tissues, extracellularly mineralizing algae, radial and granular foraminifera, mammalian bone, mammalian enamel, and mollusk shell nacre, probably span the entire spectrum. Their crystal shapes, sizes, and the relations between the mineral phase and the organic phase, are primarily used to assess probable degrees of control exercised over crystal nucleation and modulation. Three different types of nucleation processes can be recognized: nonspecific, stereochemical, and epitaxial. Modulation of crystal growth after nucleation is either absent, achieved by adsorption of macromolecules onto specific crystal faces, or occurs by the prepositioning of matrix surfaces which interrupt crystal growth. The tissues in which active control is exercised over crystal growth all contain similar types of acidic matrix macromolecules. Significantly, the framework matrix macromolecules are all quite different and hence probably perform some tissue-specific functions. The study shows that there is a common basis for understanding these mineralization processes which is reflected in the nature of the protein-crystal interactions which occur in each tissue. PMID- 3524991 TI - Molecular biology of terminal transferase. AB - Terminal transferase is an unusual deoxynucleotide polymerizing enzyme found only in prelymphocytes. The protein was purified to homogeneity from calf thymus glands in 1971 as a 32 kDa protein with a two peptide structure. Subsequent biochemical and immunological analyses of terminal transferase protein in crude extracts from a number of animal species showed a single peptide with a molecular weight of about 58,000. The two peptide structure found earlier was caused by proteolysis. Homogeneous 58 kDa terminal transferase has now been produced from human lymphoblastoid cells and calf thymus glands by immunoaffinity chromatography. In vitro phosphorylation studies showed that the terminal transferase protein contains one phosphorylation site near one end of the polypeptide chain, and the phosphorylation of the enzyme has been confirmed by in vivo labeling experiments. Unambiguous demonstration of the molecular weight of the human terminal transferase was obtained by translation of the cloned human terminal transferase DNA sequence to a 58,308 Da protein. The translated amino acid sequence also provided a possible phosphorylation site near the amino terminus of the protein. Preliminary analysis of the genomic structure shows a simple intron/exon pattern with the total human terminal transferase gene spanning at least 65 Kb. PMID- 3524992 TI - The mechanism of muscle contraction. AB - Knowledge of the mechanism of contraction has been obtained from studies of the interaction of actin and myosin in solution, from an elucidation of the structure of muscle fibers, and from measurements of the mechanics and energetics of fiber contraction. Many of the states and the transition rates between them have been established for the hydrolysis of ATP by actin and myosin subfragments in solution. A major goal is to now understand how the kinetics of this interaction are altered when it occurs in the organized array of the myofibril. Early work on the structure of muscle suggested that changes in the orientation of myosin cross bridges were responsible for the generation of force. More recently, fluorescent and paramagnetic probes attached to the cross-bridges have suggested that at least some domains of the cross-bridges do not change orientation during force generation. A number of properties of active cross-bridges have been defined by measurements of steady state contractions of fibers and by the transients which follow step changes in fiber length or tension. Taken together these studies have provided firm evidence that force is generated by a cyclic interaction in which a myosin cross-bridge attaches to actin, exerts force through a "powerstroke" of 12 nm, and is then released by the binding of ATP. The mechanism of this interaction at the molecular level remains unknown. PMID- 3524993 TI - Quantitative analysis of cardiac arrhythmias. AB - Quantitative analysis of cardiac arrhythmias has been the subject of intensive research during the last 10 years. Several systems have been designed to help in the processing of cardiac signals: single or multiple lead electrocardiograms (ECG), electrograms from intracardiac catheters, esophageal recordings, etc. The main objective of these developments was oriented toward positive identification of arrhythmias or rhythm-disturbance counts to imitate the cardiologist's interpretation in contexts such as routing ECG and ambulatory recordings. However, these systems were mainly measurement tools aimed at extracting auricular and ventricular depolarization timings plus gross morphology description. The domain of morphology analysis of beat-to-beat auricular depolarization on ECG has never been highly active due to poor signal conditions. For routine ECG, automatic interpretation was set as an objective to complement computer-assisted ECG interpretation of conduction problems (i.e., morphology analysis of a representative beat extracted or averaged from the dominant rhythm). The limitations of rhythm interpretation in this context are well known. In the ambulatory ECG context, the analysis procedures are relatively simple and are often summarized as trivial counts describing, most exclusively, the ventricular arrhythmic behavior of the heart over a relatively long duration. Waveform-detection and measurement have been the bottleneck of advancement in arrhythmia analysis since highly reliable detection of events on a beat-to-beat basis are necessary to perform a valid analysis. Rare approaches have proposed probabilistic definition of event detection. The present review puts emphasis on the potential of several methods which have been demonstrated as powerful in identifying short- or long-duration heartbeat patterns, mode of heartbeat initiation, mode of heartbeat coupling, etc. Globally, these methods are referred to as time series analysis, modeling of rhythm patterns, simulation, and pattern recognition. A delay in the advancement of the study of arrhythmogenesis and limiting the analysis of arrhythmias to textbook descriptions is not justified when put in perspective of the potential of implementing powerful techniques which have been more or less neglected or used in a narrow way. PMID- 3524994 TI - Lymph circulation: physiology, pharmacology, and biomechanics. AB - Lymph is the fluid in the lymphatic system. The lymphatic system, a complex network of vessels, is essentially a drainage system within the body which transports excess fluid and metabolic waste products from interstitial spaces into the blood circulatory system. Lymph flow is governed by extrinsic forces due to the movements of organs and skeletal muscles which exert external pressure on the lymphatic walls, and by the intrinsic forces due to rhythmic contractions of smooth muscle in the walls of the lymphatic vessels which play a major role in lymph circulation. Intensities of these lymphatic smooth-muscle contractions are modulated by several humoral mediators such as epinephrine, serotonin, and PGE1. These notions of lymphology, together with principles of mechanics, have been integrated into mathematical models of lymph circulation. Model analysis has revealed several interesting features of lymph circulation and lymphatic system design. Distention-induced enhancement of contractility is important in achieving significant increase in lymph flow during edema. PMID- 3524995 TI - Techniques for measuring red cell, platelet, and WBC survival. AB - Blood cell survival studies yield valuable information concerning production and destruction of cells circulating in the bloodstream. Methodologies for the measurement of red cell survival include nonisotopic methods such as differential agglutination and hemolysis. The isotopic label may be radioactive or, if not, will require availability of a mass spectrograph. These methods fall into two categories, one where red cells of all ages are labeled (51Cr, DFP32, etc.) and those employing a cohort label of newly formed cells (14C glycine, 75Se methionine, etc.). Interpretation of results for methodology employed and mechanism of destruction, random or by senescence, are discussed. A similar approach is presented for platelet and leukocyte survival studies. The inherent difficulties and complications of sequestration, storage, and margination of these cells are emphasized and discussed. PMID- 3524996 TI - Urinary calculi: microbiological and crystallographic studies. AB - Although referred to as "urinary calculus disease", the formation of stone in the urinary tract is not caused by a single etiological agent. As such, diverse clinical investigations to diagnose the cause of stone formation must be carried out and the course of management after diagnosis must inevitably be different in each case. This review will cover all aspects of calculus formation, but will give particular attention to calculi caused by infection of the urinary tract with urease-producing bacteria. This is a recurrent, potentially life-threatening disease which has led clinicians to refer to the condition as "stone cancer". Because the etiology of infection stones is so different from stones caused by metabolic disorders, the two disease patterns should be considered separately, a fact often overlooked in epidemiological studies of stone formation. The importance of analysis of calculi as an aid to management is thus emphasized; identification of stone type will help to indicate appropriate therapy. A review of methods of analysis will be covered, particularly crystallographic analysis. Inhibition of bacterial urease as a means of management of infection stones will be discussed together with problems encountered and brighter hopes for the future. PMID- 3524997 TI - Clinical and environmental aspects of arsenic toxicity. AB - Arsenic is widely distributed throughout the animal and plant kingdoms and our environment where sources can be natural or anthropogenic. Agricultural uses of arsenic have declined recently, but it still has well-defined roles in industry. Small amounts of arsenic are metabolized in a variety of ways and are largely rapidly methylated and excreted by man and animals. Poisoning can occur and may follow an acute or chronic course. Toxic manifestations in man occur at the cellular level and may appear in many organ systems. Specific effects can often be demonstrated in the skin and in the vascular and nervous systems. Other toxic effects appear to include carcinogenesis, mutagenesis, and teratogenesis. PMID- 3524998 TI - Antigen-specific B cell tumors of mice. AB - The topics covered in this review include: the origin and availability of murine B cell lymphomas bearing immunoglobulins of known antigen reactivity; their etiology and the role of antigen in lymphomagenesis; the extent to which such tumors are true analogs of normal B cells; and the knowledge of B cell differentiation which has been derived from the study of these cells. There is little or no evidence that B lymphomas with preselected antigen specificity can be induced at will. However, there is evidence that genetic factors influencing idiotype specific regulation can predispose particular subsets of B cells to neoplastic transformation, and thereby indirectly influence the antigen specificity of the resultant lymphomas. The bulk of evidence suggests that, except for growth control characteristics, recently derived B cell lymphomas retain many of the features of normal lymphocytes. Thus, mechanisms elucidated by study of lymphomas are probably reflective of normal B cell biology. PMID- 3525000 TI - Computer networks for image management in radiology: an overview. AB - Currently, images obtained from digital radiographic modalities are archived and managed as analog images recorded on radiographic film. An alternative for total image management is a computer-based digital network. General design considerations for a digital image network are reviewed, and estimates of important system parameters are determined. PMID- 3524999 TI - Placental immunoregulation. AB - Mammalian gestation is complex and varies widely among species, but the embryonic contribution to the maternal-fetal interface, the trophoblast, remains constant. Alloantigen and stage/tissue specific antigens are present on the trophoblast in low concentration and often in locations inaccessible to maternal immune effectors. Nonetheless, pregnancy does prime the mother for humoral immunity; cell-mediated responses are more difficult to demonstrate. The placenta appears to be an efficient block to cellular traffic into the fetus; the placental barrier to specific antibody has been established, but its efficiency is controversial. Nonspecific, local, active suppression mediated by lymphoid cells within the decidua is apparently an important concomitant of successful gestation. Yet there is evidence that an ongoing immune response is beneficial to pregnancy, allowing an increase in placental size in response to growth-promoting lymphokines while blocking graft-rejection mechanisms. Thus it appears that immunoregulation at the maternal-fetal interface is complex, and no single mechanism can account for the success of the "fetal allograft". PMID- 3525002 TI - Radiology of Meckel's diverticulum. AB - Meckel's diverticulum is the most common congenital anomaly of the gastrointestinal tract. Approximately 2 to 3% of all individuals have a Meckel's diverticulum and one third of them experience clinical symptoms. Until a decade ago, the correct diagnosis of the lesion was rarely established prior to abdominal surgery or autopsy. However, the introduction of modern imaging techniques and the refinement of gastrointestinal contrast studies have facilitated the preoperative recognition of this entity. This article reviews the radiographic pathology of Meckel's diverticulum and the spectrum of its associated complications. PMID- 3525001 TI - Computed tomography of the superior vena cava. AB - The superior vena cava (SVC) can be visualized and reliably evaluated by computed tomography (CT). Opacification of this vessel with iodinated contrast material and multiplanar reformations can provide information concerning the patency of the lumen and the relationship of the SVC with adjacent mediastinal and lung structures, both normal and abnormal. SVC obstruction leading to SVC syndrome is the most common condition affecting this vessel. It can be caused by both extrinsic compression and intraluminal thrombosis. Numerous collateral pathways have been described by conventional radiographic and anatomic studies with the azygos vein being the most important collateral vessel. From this aspect, five distinct grades of SVC obstruction can be identified. Grade 0: SVC narrowing without clinical evidence of SVC syndrome. Grade I: Moderate SVC narrowing without collaterals. Grade II: Severe SVC narrowing with the azygos vein serving as partial collateral. Grade III: SVC obstruction above the azygos arch. Grade IV: SVC obstruction at or below the level of the azygos arch. Patients with Grades I to IV have clinical evidence of SVC syndrome, and the CT grading roughly corresponds to the severity of clinical findings. CT accurately depicts both the site of SVC obstruction and important collateral pathways and clearly distinguishes between SVC thrombosis and external compression. In this regard, it provides unique information not available from other modalities such as conventional or radioisotope venography. Furthermore, in a number of patients with suspected SVC obstruction, this vessel may be patented, leading to clinical reassessment. The only disadvantage of CT as compared with radionuclide flow studies is the potential hazard from i.v. administration of iodinated contrast material. Less common abnormalities of the SVC include congenital or developmental conditions, such as persistent left SVC, aneurysms, dilation of the vessel due to heart failure, and variations (usually tortuosity) of the thoracic inlet vessels. We conclude that CT should be used as the procedure of choice for the diagnosis of SVC abnormalities, especially in patients with suspected SVC syndrome. PMID- 3525003 TI - The optimal radiographic technique for operative and T-tube cholangiography. AB - Optimal radiographic technique for T-tube and operative cholangiography requires an intimate knowledge of bile duct anatomy and the techniques that can be employed to demonstrate the biliary system. This article will review the anatomical considerations of the intra- and extrahepatic bile ducts that are important in direct cholangiography. The various radiographic techniques available for studying the biliary system will be reviewed. Based on several considerations, a high kVp and high-contrast agent concentration technique should produce better quality operative and T-tube cholangiograms than the currently recommended low kVp and low-contrast agent concentration technique. Results from our phantom and clinical studies will be presented to support this concept. The advantages and disadvantages of both types of techniques will be discussed, and recommendations will be made for performing the optimal radiographic evaluation for T-tube and operative cholangiography. PMID- 3525004 TI - Computed tomography in radiotherapy planning of the axillary region. AB - Computed tomography was used in the pretreatment evaluation of three patients with neoplasms involving the axillary region. Radiation therapy treatment fields were more accurately defined using the computed tomography data. Computed tomography has a valuable role in radiotherapy planning in patients with tumors involving the axillary region. PMID- 3525005 TI - Dilatation of the common bile duct secondary to a hydronephrotic kidney. AB - Obstruction of the common bile duct secondary to hydronephrosis is uncommon. We observed common bile duct dilatation secondary to marked right hydronephrosis. Following nephrectomy the common bile duct returned to normal size, confirming the suspicion that the dilatation was due to extrinsic compression. PMID- 3525006 TI - Ultrasound monitored hepatic cryosurgery: longevity study on an animal model. AB - Ultrasound imaging has been proposed to monitor the amount of frozen tissue during hepatic cryosurgery of primary and metastatic tumors. In this follow-up study, a cryolesion was produced in an adult pig under ultrasound monitoring. The animal was allowed to recuperate for 3 days before being sacrificed. Pathologic and histologic evaluation showed extremely close correlation with the ultrasound image. The necrotic region was clearly observable in the sonogram after 3 days. Ultrasonography can accurately represent the extent of the cryolesion both during as well as following cryosurgery. PMID- 3525007 TI - Mechanical ventilation strategies in adult respiratory distress syndrome. PMID- 3525008 TI - HLA antigens and their significance in the pathogenesis of anterior uveitis: a mini review. PMID- 3525009 TI - The safety of bromocriptine in hyperprolactinaemic female infertility: a literature review. AB - The dopamine agonist bromocriptine has been widely used to facilitate pregnancy in hyperprolactinaemic women, with a success rate of 80% in relevant cases. Neither the inappropriate hyperprolactinaemia consequent upon bromocriptine withdrawal after conception nor the relative hypoprolactinaemia caused by treatment throughout gestation appears to affect adversely the course and outcome of pregnancy or the endocrine status of the fetus. No teratogenic effect of bromocriptine has been evidenced in humans, and no disturbances in the physical, psychomotor, and intellectual development of the offspring have been observed. Pituitary-tumor enlargement during closely supervised pregnancies very rarely leads to severe and irreversible complications; both the re-institution of bromocriptine treatment in the event of tumor enlargement and its preventive use throughout pregnancy have been shown to be effective measures. It is interesting, moreover, that a reduction of hyperprolactinaemia, compared with pregestational levels, may be seen after bromocriptine-facilitated pregnancies. PMID- 3525010 TI - Malignant genital tract tumors in children. PMID- 3525011 TI - Exercise testing of patients recovering from myocardial infarction. PMID- 3525012 TI - Nosocomial infection: prevention by special clean-air, ultraviolet light, and barrier (isolator) techniques. PMID- 3525014 TI - Expression of the natural resistance gene (Lsh) in wild mice infected experimentally with Leishmania donovani or Salmonella typhimurium. PMID- 3525013 TI - Susceptibility of Mus musculus musculus (Czech I) mice to Salmonella typhimurium infection. PMID- 3525015 TI - Distributions of vimentin and desmin filaments in embryonic cardiac muscle cells in culture. AB - Immunofluorescence studies on the distributions of vimentin and desmin in embryonic rat cardiac muscle cells in culture were carried out, using antibodies against vimentin and desmin. The cell culture was continued for 5 days. Both vimentin and desmin increased in concentration as the cardiac myocytes matured in culture. Vimentin and desmin were mainly organized as filamentous structures and oriented in longitudinal and other directions within the cytoplasm of the cells. Cross-striated fluorescence of vimentin and desmin was rarely observed in cardiac myocytes, although cross-striated myofibrils were present during early and late periods of culture. Desmin did not show preferential adherence to the Z-line of the cultured myocytes. Vimentin was observed on the nuclei of cardiac myocytes in the form of complex network and beaded structures during culture period. Both vimentin and desmin were present in fibroblastic cells in culture. Our observations suggest that vimentin and desmin in cardiac myocytes in culture probably provide a skeletal framework, which facilitates the assembly of myofibrils. Also, these intermediate filaments are probably involved in the organization of cellular organelles in the cell cytoplasm. The role of the intermediate filaments found on the nucleus and its periphery is probably to maintain the position of the nucleus in the cytoplasm of the cell, providing an adherence between the nucleus and adjacent cytoplasmic sites. PMID- 3525017 TI - Unstable chromosome sites and evolutionary rearrangements in akodont rodents (Cricetidae). AB - Evolutionary rearrangements producing changes in chromosome 1 of Akodon molinae were traced by comparing the G banding patterns of the karyotypes from six species of akodont rodents. It was possible to subdivide chromosome 1 of A. molinae into unstable and stable regions. Most of the spontaneous rearrangements of chromosome 1 appearing in passages 116-128 of a continuous line of A. molinae cells (AKm line) occurred in the unstable regions which comprise repetitive DNA sequences favouring the setting up of heteroduplexes leading to rearrangements. When AKm cells were irradiated with UV light it was observed that unstable regions of chromosome 1 showed higher rates of unscheduled DNA synthesis (UD) than stable areas. A differential degree of condensation making certain regions of the chromatin fibril more accessible to repair enzymes or a better target for damage, is probably the cause of the variable response to UV light, and perhaps to most clastogenic agents (including those responsible for spontaneous rearrangements). Thus, the distribution of repetitive DNA sequences, the structure of the chromatin fibril and the efficiency of the DNA repair machinery may be important factors in the origin of spontaneous chromosomal rearrangements. PMID- 3525016 TI - Prostaglandin-induced storage and secretion of esteroproteases in the mouse submaxillary gland. AB - The submaxillary glands of adult C3H mice which received intraperitoneal injections of prostaglandins F2 alpha and E2 (PGF2 alpha and PGE2) were examined biochemically and ultrastructurally. Results indicated that the specific activity of esteroprotease in an homogenate of submaxillary glands was significantly increased when mice were treated with PGF2 alpha (96 or 480 micrograms/kg), and decreased when they were treated with PGE2 (96 or 480 micrograms/kg). Ultrastructural findings were correlated with these biochemical data. Thus, it appeared that PGF2 alpha stimulated the secretion and synthesis of bioactive proteins, and that PGE2 stimulated only the secretion. PMID- 3525018 TI - Pathophysiology and treatment of central sleep apnea. PMID- 3525019 TI - Transvenous endomyocardial biopsy. Clinical indications, potential complications, and future applications. PMID- 3525020 TI - Reversal of central sleep apnea using nasal CPAP. AB - Based on the theory that obstructive (OSA) and central (CSA) sleep apneas share common pathophysiologic mechanisms, we attempted to treat eight patients with predominantly CSA by continuous positive airway pressure (CPAP). All patients exhibited repetitive episodes of CSA and mixed sleep apneas (MSA) in the supine position with a mean duration of 23.7 +/- 0.7 s and 34.5 +/- 1.3 s, respectively. The pattern of apnea changed when the subject lay in the lateral position. Five patients were observed to develop OSA in the lateral position with a mean duration of 27.2 +/- 1.5 s, while the other three patients snored continuously. High levels of CPAP (range 9.0 to 16.5 cm H2O) prevented all CSA and MSA and resulted in quiet breathing in all eight patients. Intermediate levels of CPAP produced firstly MSA, then purely OSA and/or continuous snoring. Low levels of nasal CPAP also prevented OSA and snoring occurring in the lateral posture in all subjects (range 2.0 to 8.3 cm H2O). Three patients are currently on home CPAP therapy for a range of four to 36 months. We conclude that upper airway collapse in the supine posture has a key role in the induction of CSA. We suggest that a reflex inhibition of respiration through activation of supraglottic mucosal receptors during passive oropharyngeal airway closure caused CSA in these patients. PMID- 3525021 TI - Overnight nasal CPAP improves hypersomnolence in sleep apnea. AB - Eleven adult men with sleep apnea underwent nocturnal polysomnography on two successive nights. The first study, done without NCPAP, served as the control. The second (treatment) was done with the application of 7.5 to 15 cm H2O nasal continuous positive airway pressure (NCPAP). A subjective sleepiness index (SSI) was noted upon awakening from each night of polygraphic recording. During the control night, the mean frequency of apnea episodes/sleep hr was 35.95 +/- 4.5 SE, and the mean duration was 28.68 +/- 2.7 sec. Mean frequency of disorder of breathing (DOB) episodes/sleep hr was 19.25 +/- 6.2 and mean duration of DOB episodes was 23.1 +/- 2.8 sec. During the treatment night, all obstructive apnea episodes were abolished. During the control night, the mean decrease in arterial oxygen saturation during obstructive apnea episodes was 11.2 +/- 1.9 percent and the mean lowest saturation was 67.6 +/- 4.0 percent. NCPAP eliminated arterial oxygen desaturation. While 44.5 +/- 5.7 percent of total sleep time was spent in either apnea or disordered breathing during the control night, NCPAP decreased this to 0.73 +/- 0.3 percent. In addition to the improvement in respiration during sleep, SSI decreased from a mean of 3.73 +/- 0.49 after the control night to 1.64 +/- 0.24 after treatment, reflecting an improvement in daytime hypersomnolence. We conclude that nasal CPAP is effective in eliminating obstructive apnea episodes, and results in a marked decrease in daytime hypersomnolence after one treatment night. PMID- 3525022 TI - Addition of terbutaline to optimal theophylline therapy. Double blind crossover study in asthmatic patients. AB - The efficacy and side effects of oral or inhaled terbutaline were examined in 13 mild-to-moderate asthmatic patients (ages 12 to 71 years) on maintenance theophylline (levels 10 to 25 micrograms/ml). In a crossover design, each patient received for two weeks oral terbutaline, 5 mg qid, inhaled terbutaline, 400 micrograms qid, or identical placebo tablets or metered-dose inhalers. Prior to each double-blind period, terbutaline was given for two weeks to ensure development of beta-adrenergic subsensitivity. Home-monitored peak flows and need for supplementary bronchodilators were significantly improved with both oral and inhaled terbutaline, but only the inhaled drug significantly decreased symptoms. Long-term terbutaline, either oral or inhaled, added to maintenance theophylline improved the patients' pulmonary function. The inhaled drug also improved the patients' clinical status as reflected by asthma symptom scores and need for extra bronchodilator. Combining terbutaline with theophylline did not produce evidence of cardiotoxicity. PMID- 3525024 TI - Flow resistance of expiratory positive-pressure valve systems. AB - The flow-resistive characteristics of a variety of commercially available expiratory positive-pressure valve systems used to provide continuous positive airway pressure (CPAP) and positive end-expiratory pressure were evaluated. One flow-resistor and seven threshold-resistor expiratory pressure valve systems were set at 5, 10, 15, 20, and 25 cm H2O of expiratory pressure, and sinusoidal exhaled flows peaking at 50,100, and 200 L/min were directed through each valve at each level of expiratory pressure. The Siemens flow-resistor valve demonstrated the greatest deviation in pressure above set CPAP levels at peak flow rates of 100 and 200 L/min, which suggests high resistance to exhaled flow. The Vital Signs threshold-resistor valve demonstrated the least deviation in pressure from set CPAP levels at all rates of exhaled flow, which suggests low flow resistance. The Emerson and IMV Bird threshold-resistor systems resisted flow less than the BEAR-2 and the Puritan-Bennett MA-2 and 7200 inflatable balloon threshold-resistor-like valve systems. These data suggest that threshold resistors may be classified as low-resistance or high-resistance types. Using only low-resistance threshold resistors for CPAP may minimize the incidence of barotrauma and other deleterious effects related to airway pressure. PMID- 3525023 TI - Comparison of PY 108-068, a new calcium antagonist, with nifedipine in exercise induced asthma. AB - Several calcium antagonists, each with significantly different chemical structures, have demonstrated variable attenuation of exercise-induced asthma. Quantitative comparisons have been hampered by differences in the intensity of challenge and the severity of the underlying disease between groups of patients. In 12 asthmatic adults with relatively severe exercise-induced asthma, we compared the effect of a new calcium antagonist, PY 108-068, in doses of 75 mg and 150 mg with nifedipine (30 mg) and placebo on resting flow rates and flow rates after exercise. Over a three-week period, each patient completed a four day, randomized, double-blind Latin-square study. After receiving one of four oral drugs, spirometry was repeated every 30 minutes for two hours, followed by a six-minute treadmill exercise test breathing dry air. The exercise tests were well matched for work rate, ventilation, heart rate, and oxygen uptake. Spirometry was then repeated seven times over the next 30 minutes after exercise. Though both 150 mg of PY 108-068 and nifedipine were associated with mild bronchodilation before exercise, only the latter was significant (p less than 0.05). Exercise-induced asthma (expressed as maximal percent fall in the forced expiratory volume in one second from before baseline) was significantly attenuated only by 150 mg of PY 108-068 compared to placebo (24 +/- 13 vs 40 +/- 16; p less than 0.05). Headache, which occurred in six subjects after nifedipine, five after 150 mg of PY 108-068, one after 75 mg of PY 108-068, and none after placebo, was subjectively more severe after nifedipine. We conclude that in these patients, there was a tendency for mild bronchodilation before exercise with both 150 mg of PY 108-068 and nifedipine, but only the 150-mg dose provided significant protection against exercise-induced asthma two hours after the drug. PMID- 3525025 TI - Comparative in vitro susceptibility of Treponema pallidum to ceftizoxime, ceftriaxone and penicillin G. AB - A procedure dating back to the early penicillin era is adapted in order to determine the activity of the new cephalosporins ceftizoxime and ceftriaxone against Treponema pallidum in vitro. While the well-known activity of penicillin G is confirmed for the virulent Nichols strain (0.002 micrograms/ml lead to 50% immobilisation) the new cephalosporins turn out to be almost as efficacious. The concentration of ceftizoxime leading to 50% inhibition amounts to 0.004 micrograms/ml. The corresponding figure for ceftriaxone is 0.01 micrograms/ml. The potential importance of these findings for the treatment of syphilis in man are discussed. PMID- 3525026 TI - [Early and late management of anorectal injuries]. PMID- 3525027 TI - [Rectal prolapse]. PMID- 3525028 TI - [Complications in pancreatic duct occlusion: passage of the occlusant into the venous system]. AB - In two cases, occlusion of the residual pancreas remaining after a Whipple's procedure was associated with a "spillover" of the occlusant into the venous system of the pancreas, resulting in one of the cases in embolisation of intrahepatic branches of the portal vein. In both cases, the parenchyma of the residual pancreas was well preserved. The cause of the spillover into the venous system was the injection of a too large volume into the ductal system, with subsequent rupture of small side branches. To avoid this rare complication, the filling of the ductal system should be carried out under intraoperative radiological control. PMID- 3525029 TI - [Effectiveness of tetrachlorodecaoxide (TCDO) in the treatment of complicated disorders of wound healing. A controlled study: TCDO versus PVP-iodine complex]. AB - In a controlled study on the treatment of wound-healing impairments 29 patients underwent local treatment with TCDO (Oxoferin) while Beta-isodona was used in 31 cases. Regarding the criterion of reducing the wound area, i.e. epithelization, a highly significant superiority of Oxoferin could be demonstrated in the treatment of complicated wounds. The evaluation of the state of granulation, that was documented by a semiquantitative procedure, indicated that Oxoferin tends to be slightly superior. However, the following observations have to be emphasized: Oxoferin induces a development of granulation tissue on exposed tendons, bones, and fasciae and the granular tissue is of much better quality than after treatment with Betaisodona. Concerning its effect on the degree of contamination, Oxoferin proved to be at least as efficacious as the established and effective antiseptic Betaisodona. Both substances are tolerated well and the application is simple, they do not differ here. PMID- 3525030 TI - [Simplified method of transosseous suture fixation]. PMID- 3525031 TI - Onstage dental props gleam on Broadway. PMID- 3525032 TI - Bonding can serve as alternative during orthodontic corrections. PMID- 3525034 TI - [Primary small intestinal tumor: an analysis of 97 cases]. PMID- 3525033 TI - [A case of juxtaglomerular cell tumor (reninism): diagnostic methods and treatment]. PMID- 3525035 TI - [Hematologic changes in systemic lupus erythematosus]. PMID- 3525036 TI - The importance of the Mac-1, LFA-1 glycoprotein family in monocyte and granulocyte adherence, chemotaxis, and migration into inflammatory sites: insights from an experiment of nature. AB - The Mac-1, LFA-1 (lymphocyte function-associated 1), p150,95 family of glycoproteins, which share a common beta subunit of Mr 95 000, are of widespread importance in leucocyte adhesion reactions. This paper focuses on the role of this glycoprotein family in granulocyte and monocyte adhesion and chemotaxis in vitro, and in migration into inflammatory sites in vivo. Most findings have been made with granulocytes, but results with monocytes are similar. Some studies have used leucocytes from patients exhibiting a severe or moderate deficiency in expression of this glycoprotein family, which is secondary to a defect in the common beta subunit. Patients are susceptible to bacterial infections and have defective pus formation and Rebuck skin-window tests, despite chronic granulocytosis. Granulocytes from such patients exhibit defective adherence to serum albumin and fibronectin-coated glass or plastic, defective orientation and directed migration in response to chemoattractants, and are defective in chemoattractant-stimulated aggregation and hyperadherence. Antibodies to the common beta subunit, to the Mac-1 alpha subunit, and to a lesser extent to the LFA-1 and p150,95 alpha subunits, inhibit many of the same functional responses by normal cells. In normal granulocytes and monocytes chemoattractants stimulate a five-fold increase in Mac-1 and p150,95 surface expression, by mobilization of a latent, presumably intracellular, pool. Cells from patients are deficient in up regulation of these molecules but show normal up-regulation of other surface receptors, degranulation and oxidative burst. The hypothesis is presented that Mac-1 and p150,95 regulate or directly mediate the increase in granulocyte and monocyte adhesivity, which is essential for diapedesis, chemotaxis and migration into inflammatory sites. PMID- 3525037 TI - The cell and molecular biology of apolipoprotein E synthesis by macrophages. AB - Mononuclear phagocytes secrete over 50 different proteins that are regulated during differentiation and that are under the influence of various materials and factors in their extracellular milieu as part of the inflammatory response. The complex nature of the regulation of the expression of these molecules is displayed by apolipoprotein E (ApoE). ApoE mRNA first appears as monocytes differentiate into macrophages, and this expression is paralleled by the secretion of ApoE by the cells. In mature macrophages ApoE synthesis and secretion are decreased by activation of macrophages with endotoxin and interferon-gamma. Although these macrophages contain abundant translatable ApoE mRNA, little ApoE is synthesized, suggesting that this decrease occurs largely at the translational level. ApoE is also controlled at the level of secretion. ApoE is concentrated in the Golgi complex of macrophages and is also found in endoplasmic reticulum, secretion vesicles and coated vesicles. When macrophages come in contact with immune complexes the intracellular ApoE compartment degranulates rapidly. Therefore, ApoE is regulated at the levels of secretion, translation and transcription. PMID- 3525038 TI - Actin filament architecture and movements in macrophage cytoplasm. AB - Actin filaments are the predominant structural elements in macrophage cortical cytoplasm. These fibres form a unique orthogonal network that fills all lamellae extended from the cell and which, in the cell body, bifurcates to form layers 0.2 0.5 micron thick on the cell top and bottom. Single short filaments, 0.1 micron in length, intersect in space in either T-shaped or X-shaped overlaps to form this ultrastructure. Network assembly and pseudopod extension occur when actin filaments within the network elongate. This filament growth is driven by a large storage pool of actin bound to the sequestering protein, profilin. Elongation is regulated by acumentin, gelsolin and possibly severin, proteins that bind to the end of the filaments, preventing the addition of actin monomers to the filaments. The cytosolic concentration of calcium controls whether filaments assemble or disassemble. Filaments can assemble when the filament ends are not blocked by gelsolin, a condition predicted to occur when the calcium concentration is less than 0.1 micron. Orthogonality results when actin filaments are cross-linked by molecules of actin-binding protein. PMID- 3525039 TI - Localization and function of tissue macrophages. AB - The rat monoclonal antibody F4/80 defines a plasma membrane glycoprotein of about 160 kilodaltons that is expressed by mature mouse macrophages. The antigen has been used to define macrophage distribution within the mouse (normal adult, embryo, infection models) by cytochemistry and quantitative immunochemical analysis. Macrophages migrate into fetal and adult haemopoietic and other tissues in an ordered sequence. The surface properties of 'fixed' macrophages isolated from various organs (bone marrow, liver, spleen) are distinct from those of circulating monocytes or free cells (peritoneal and pleural cavities, alveolar) and may play a role in local adhesion and trophic interactions with other cells. PMID- 3525040 TI - Characterization of the human c-myc protein using antibodies prepared against synthetic peptides. AB - Synthetic peptides with amino acid sequences based on inferred sequences encoded by the human c-myc proto-oncogene have been used as immunogens to produce polyclonal and monoclonal antibodies. These peptide-specific antibodies have then been used to identify the intact human c-myc protein. By immunoprecipitation and immunoblotting analysis we have defined the human c-myc protein as a phosphoprotein with an apparent molecular mass of 62 kDa on a sodium dodecyl sulphate-polyacrylamide gel. The protein is present in both normal and transformed cells but the steady-state levels of p62c-myc are elevated in the transformed cells by comparison with normal ones. We have used our anti-c-myc peptide antibodies to study the subcellular localization of p62c-myc. We find the protein to be loosely associated with cell nuclei by an interaction which is highly sensitive to variations in ionic strength within the physiological range. In response to in vitro or in vivo heat-shock the protein becomes sequestered in an insoluble complex associated with the nucleus. This complex contains a discrete subset of nuclear proteins, of which p62c-myc is a member. Immunofluorescence microscopy of p62c-myc shows it to be localized in a defined and previously unobserved subnuclear structure. A role for p62c-myc as an intracellular messenger is suggested. PMID- 3525041 TI - Selection by site-directed antibodies of small regions of peptides which are ordered in water. AB - High resolution nuclear magnetic resonance has been used to study a short peptide which corresponds to the antigenic region of a larger peptide immunogen. This work shows that there is a strong conformational preference for a Type II beta turn in solution. This observation has implications for the nature of the immunogenicity and antigenicity of peptide antigens as well as for the more general question of protein-folding mechanisms. PMID- 3525042 TI - Rectosigmoid sphincter of O'Beirne. AB - In the early 19th century, James O'Beirne proposed that a physiologically important sphincter existed at the rectosigmoid junction. Interest in the rectosigmoid junction had been stirred by a common affliction of the time: spasmodic constriction of the rectum. It was believed that many patients suffered from chronic constipation because of rectosigmoid spasms. O'Beirne proposed that a sphincter at the rectosigmoid junction governed the passage of stool from the sigmoid into the rectum. Further, he maintained that spasmodic constriction of the rectum resulted from dysfunction of this rectosigmoid sphincter. His views, however, conflicted with those of such contemporaries as Houston, who emphasized the role of rectal valves in producing spasmodic constriction. Anatomic studies in the early 20th century found at least a rudimentary sphincter at the rectosigmoid junction in 40 percent of the normal population. Motility studies in the last 35 years have demonstrated unique intraluminal pressure patterns as well as the propagation of retroperistaltic waves in this area. The rectosigmoid in patients with constipation shows an increased activity, as if this area is causing a physiologic obstruction to the passage of stool into the rectum. In contrast, the rectosigmoid in patients with diarrhea demonstrates markedly decreased activity, thereby providing unobstructed access of the feces to the rectum. These studies support O'Beirne's hypothesis that a sphincter governs the passage of stool from the sigmoid colon into the rectum. PMID- 3525043 TI - Classic articles in colonic and rectal surgery. William Harrison Cripps 1850 1923. Cancer of the rectum: its pathology, diagnosis, and treatment. PMID- 3525044 TI - Primary adenocarcinoma of the bile ducts. Clinical characteristics and natural history. AB - Primary bile duct carcinoma is a malignancy with a poor prognosis, but recent diagnostic developments allow earlier detection and possibly improved chances for effective palliation or surgical cure. In order to increase the clinical understanding and awareness of this disorder, 43 patients with primary adenocarcinoma of the bile ducts were reviewed. The mean patient age was 63, and symptoms of nausea, abdominal pain, and pruritus were reported in a majority of patients. Documented weight loss, alcoholic stools, cutaneous icterus, and hepatomegaly were each present in a majority of patients. Serum bilirubin and alkaline phosphatase determinations were abnormal in 40 of 43 patients (93%), and cholangiography was the diagnostic study providing the most discriminating information. Locally invasive disease and biliary obstruction was the major cause of morbidity and mortality, and there was only one surgical cure. These data suggest that cholangiography and nonsurgical techniques for biliary drainage should be employed in most patients who are not optimal surgical candidates. PMID- 3525045 TI - Gastric protection by meciadanol. A new synthetic flavonoid inhibiting histidine decarboxylase. AB - Flavonoids reportedly inhibit histidine decarboxylase and reduce gastric mucosal histamine content. We studied the effects of acute and chronic intragastric administration to rats of meciadanol, a new synthetic flavonoid (Zyma S.A., Nyon, Switzerland). The action of meciadanol was compared to that of 16,16-dimethyl PGE2. Meciadanol did not affect acid or pepsin output at any dose used. High doses of 16,16-dimethyl PGE2 reduced both acid and pepsin output. Meciadanol partially prevented aspirin-induced lesions but the prevention required chronic administration of meciadanol. In contrast, a single dose of meciadanol completely prevented ethanol-induced lesions. Chronic administration of meciadanol also completely prevented ethanol-induced lesions. 16,16-Dimethyl PGE2 prevented both aspirin-induced and ethanol-induced lesions in doses that did not affect acid or pepsin output. Meciadanol did not influence the effect that either aspirin or ethanol had on endogenous mucosal PGI2. Thus, the dose range of meciadanol that protected against ulcerogens did not affect either gastric acid secretion or pepsin output. Therefore, we conclude that meciadanol's action represents true cytoprotection, which was previously attributed only to prostaglandins. PMID- 3525047 TI - Cryptosporidiosis in a patient receiving immunosuppressive therapy. Possible activation of latent infection. PMID- 3525046 TI - Control of human colonic motor function. AB - Human colonic motility is governed by control mechanisms involving the electrical activity of the smooth muscle cell membranes, the intrinsic and extrinsic nervous activity, and hormonal action. The structural bases for neural and myogenic control have not been demonstrated. However, gap junctions are lacking between muscle cells, and nerves are not close to smooth muscle cells. The myogenic control, as observed in vitro, is described and compared with results obtained from different in vivo techniques. In vitro and in vivo measurements are critically evaluated, and a reconciliation between them attempted. No appropriate animal model is available to help resolve different findings and interpretations. Neural control of colon motility is exerted probably through modulation of myogenic activity as well as directly. The activities of extrinsic nerves, intrinsic motor nerves and afferent nerves are integrated within the colon, at prevertebral ganglia and in the spinal cord in animals, but similar data are not available for the human. There is a lack of studies directly relating transit to motility and conventional beliefs need reexamination. PMID- 3525049 TI - Endoscopic sclerotherapy for esophageal varices. AB - Sclerotherapy for esophageal varices is now well established as a method of treatment for varices which have bled initially and then have been controlled by medical means. The long term outcome of such treatment is now under study. The value of sclerotherapy for acutely bleeding varices or as a prophylactic measure in patients with varices that have not bled is more controversial and its role awaits the outcome of additional controlled trials. PMID- 3525050 TI - Gastrointestinal motility disorders. AB - A classification of gastrointestinal motility disorders is offered based upon the type of disorder in transit (delay or acceleration), and the region of the gastrointestinal tract affected. Specific abnormalities of myoelectrical patterns are identified when possible and related to disturbances in transit in the stomach and small bowel. PMID- 3525048 TI - Lack of a direct effect of the autonomic nervous system on glucose-stimulated gastric inhibitory polypeptide (GIP) secretion in man. AB - To determine whether the autonomic nervous system has a direct effect on GIP secretion, six normal subjects received a 4-hr intraduodenal perfusion of glucose (225 mg/min) and polyethylene glycol on four successive days. During the latter 2 hr, either normal saline, propranolol, phentolamine, or atropine were infused intravenously. Glucose absorption was calculated by measuring glucose and polyethylene glycol following luminal aspiration distal to the perfusion site. Basal and peak or nadir values in the saline study of plasma glucose, insulin, glucagon, and GIP were similar to the other three studies prior to autonomic blockade. During the latter 2 hr of the glucose perfusion, the plasma glucose and glucagon responses to saline did not differ from responses to the three blocking agents. Phentolamine but not atropine or propranolol resulted in a greater insulin response compared to saline (3247 +/- 762 vs 1348 +/- 388 microU/ml/120 min, P less than 0.01). GIP was not significantly affected by phentolamine (18,146 +/- 4574), propranolol (7585 +/- 5854), or atropine (15,797 +/- 6297) compared to saline (11,717 +/- 5204 pg/ml/120 min). Glucose absorption was unaffected by infusions of saline, phentolamine, and propranolol, but was increased following atropine infusion (5841 +/- 1120 vs 1044 +/- 808 mg/120 min, P less than 0.02). There appears to be no direct effect of the autonomic nervous system on glucose-induced secretion of GIP. PMID- 3525051 TI - Etiopathogenesis and definition of chronic pancreatitis. AB - This is a critical review of papers published on definition, classification, etiology, and pathogenesis of chronic pancreatitis from 1981 to 1985. Articles published earlier will only be mentioned when they are necessary to the understanding of the present knowledge or when they are insufficiently known. The more ancient literature has been reviewed elsewhere. The etiology and pathogenesis section will be limited to calcifying pancreatitis which is the most frequent form of chronic pancreatitis. The etiology of chronic obstructive pancreatitis has been studied in another review. The simple fibrosis of the pancreas is excluded from this chapter. PMID- 3525052 TI - Hypoglycemia and counterregulation in insulin-dependent diabetic patients: a comparison of continuous subcutaneous insulin infusion and conventional insulin injection therapy. AB - Eleven insulin-dependent diabetic patients were treated in random order by 2-mo continuous subcutaneous insulin infusion (CSII) or 2-mo conventional injection treatment (CIT) with crossover to the alternative regimen. Mean plasma glucose concentrations throughout the day were significantly lower during CSII than during CIT, but the percentage of plasma glucose values less than 2.5 mmol/L, obtained from outpatient self-collected diurnal profiles, was similar for both treatments (CSII vs. CIT: 5.9 and 4.8%, respectively). Reported symptomatic hypoglycemia at home was not significantly different in the whole group of patients treated by CSII or CIT but was reduced by a mean of 57% (P less than .02) in the five patients on CSII who experienced frequent symptomatic hypoglycemic episodes (greater than 4/2 mo) during CIT. Neither the plasma glucose concentration at which the patients recognized induced hypoglycemia nor the glycemic or counterregulatory hormone responses for 60 min thereafter were changed by CSII treatment. PMID- 3525054 TI - Maintenance of basal insulin secretion in severe non-insulin-dependent diabetes. AB - It has been postulated that glucose regulation is secondary to maintenance of normal basal insulin secretion. Serum glucose, insulin, and C-peptide levels were measured at fasting in 209 consecutive non-insulin-dependent diabetic patients and after glucose stimulation in 193 patients. The basal serum insulin C-peptide levels were not significantly different in control subjects (mean 22 +/- 8.8 microU/ml) and in patients with varying severity of diabetes (mean 24 +/- 9.6 microU/ml) except in the most severely diabetic group [fasting serum glucose greater than 350 mg/dl (19.4 mmol/L), mean 19 +/- 7 microU/ml]. In 39 patients who developed ketonuria without acidosis during follow-up, the mean basal serum insulin was 22 microU/ml during the episode of ketonuria, 21 microU/ml during the glucose tolerance test, and 25 microU/ml after glucose stimulation (statistically nonsignificant differences). Our data suggest that hyperglycemia compensates for beta-cell impairment so that basal insulin secretion usually stays above the threshold for ketoacidosis unless there is marked beta-cell impairment. Patients who fail to increase insulin in response to nutrient challenge are at risk of developing ketosis. PMID- 3525055 TI - Comparison of plasma glucose, serum insulin, and C-peptide responses to three isocaloric breakfasts in non-insulin-dependent diabetic subjects. AB - While differences in glucose and insulin responses to specific carbohydrate foods have been reported, few data are available for mixed meals incorporating such foods. This study compared the plasma glucose (PG), serum insulin (SI), and C peptide (CP) responses to three different isocaloric test breakfasts given in random order to eight insulin-treated non-insulin-dependent diabetes mellitus (NIDDM) patients. The test meals were selected from a hospital food exchange list and contained similar quantities of carbohydrate, protein, fat, and dietary fiber. The postprandial PG, SI, and CP responses to two of the test breakfasts (meal A: eggs, toasted wholemeal bread, orange juice, margarine, and milk; meal B: wheatflake biscuits, toasted wholemeal bread, milk, and margarine) were similar (meal A: 104.3 +/- 23.0 mg X h X dl-1, 5996 +/- 1108 microU X min X ml-1, and 89.8 +/- 25.4 pmol X min X ml-1, respectively; meal B: 104.9 +/- 21.6 mg X h X dl-1, 6268 +/- 1161 microU X min X ml-1, and 99.8 +/- 26.4 pmol X min X ml-1, respectively). Meal C, consisting of toasted muesli and skim milk, produced smaller glycemic and insulin responses (46.8 +/- 8.8 mg X h X dl-1; P less than .02, and 4369 +/- 700 microU X min X ml-1; P less than .05, respectively) than meals A and B and less endogenous insulin secretion (CP response 62.8 +/- 19.9 pmol X min X ml-1; P less than .05 compared with meal A, NS compared with meal B).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3525053 TI - Prevalence of insulin deficiency among initially non-insulin-dependent middle aged diabetic individuals. AB - The endogenous insulin secretion capacity of 171 insulin-treated middle-aged persons with diabetes (81 men, 90 women) of the Kuopio University Central Hospital district (population 250,000), East Finland, was measured by the C peptide response to glucagon. The prevalence of insulin deficiency among initially non-insulin-dependent diabetic (NIDDM) individuals was calculated on the basis of those who were initially treated with diet or oral drugs and 3 yr or more after diagnosis had been treated with insulin and were insulin deficient in this study. The prevalence of complete insulin deficiency (postglucagon C-peptide undetectable) was among initially NIDDM individuals of the same region, 0.7% in men and 1.2% in women. Using the postglucagon C-peptide level of 0.20 nmol/L as a cut-off point, the prevalence of insulin deficiency was 2.0% in men and 1.9% in women and, on the basis of C-peptide level of 0.60 nmol/L, the prevalence of insulin deficiency was 3.5% in men and 2.7% in women. Our data suggest that the deterioration of insulin secretion capacity in NIDDM to the level that leads to insulin dependency occurs less often than has been previously suggested. PMID- 3525056 TI - Comparison of metabolic effects of white beans processed into two different physical forms. AB - In the present study eight control subjects and eight patients with non-insulin dependent diabetes mellitus (NIDDM) consumed single portions of processed beans equivalent to 50 g of carbohydrate. The beans were processed by different methods into two physical forms; one maintained the integrity of the bean cells (undamaged bean cells, UC) and the other ruptured the bean cells (damaged bean cells, DC). Incremental glucose response areas after ingestion of either UC or DC were not significantly different in control subjects, while incremental insulin response areas (49 +/- 7 vs. 26 +/- 4 microU X ml-1 X h-1, P less than .05) were significantly lower after eating UC-processed beans. In patients with NIDDM both incremental glucose (150 +/- 14 vs. 73 +/- 25 mg X dl-1 X h-1, P less than .001) and insulin (67 +/- 16 vs. 46 +/- 11 microU X ml-1 X h-1, P less than .05) response areas were significantly lower after UC administration. To test the effectiveness of the UC-processed bean when incorporated into mixed meals, nine patients with NIDDM consumed mixed meals containing either DC or UC on two separate mornings. The test meals represented a typical Mexican American use of pureed beans wrapped in a flour tortilla topped with melted cheese. Incremental glucose responses were significantly lower after the UC meal (171 +/- 42 mg X dl 1 X h-1, P less than .05) when compared with the DC meal (212 +/- 34 mg X dl-1 X h-1). Incremental insulin areas were also lower after the UC (91 +/- 19 microU X ml-1 X h-1) when compared with the DC meal (120 +/- 22 microU X ml-1 X h 1).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3525057 TI - Twice-daily mixed regular and NPH insulin injections with new jet injector versus conventional syringes: pharmacokinetics of insulin absorption. AB - The purpose of the present study was to evaluate the feasibility of using a jet injector in a split and mixed regular and NPH insulin regimen and to compare serum glucose and free-insulin profiles obtained with the injector and the conventional syringe and needle. Twelve insulin-dependent diabetic patients were hospitalized for 5 days. After a stabilization day, six patients received their insulin injection with the injector for 2 days and with the syringe and needle for the following 2 days; the regimen was reversed for the other six patients. Diet, exercise, and insulin dosage remained constant. The serum glucose levels with the injector were consistently lower than those obtained with the syringe at all times of the day except at 5:00 a.m. and 7:30 a.m., when mean values were similar for both treatments. Free-insulin levels were higher with the injector from 10:30 a.m. to 4:30 p.m. These findings suggest that insulin absorption is faster and possibly greater with the injector than with the syringe. When switching from a syringe to an injector insulin program, insulin dose adjustment may be necessary. PMID- 3525058 TI - Preprogrammed intravenous insulin infusion in diabetic humans: metabolic consequences of altering meal size. AB - New implantable, variable-rate, intravenous insulin infusion systems offer the possibility of increased dietary flexibility in the treatment of diabetes mellitus. However, the development of insulin infusion algorithms required to maintain near-normal glycemia in the presence of a nonconstant diet first requires information concerning the metabolic response to meals of varying size when the insulin dose is fixed. With this goal in mind, we studied five type I diabetics aged 16-40 yr who were treated for 3 wk with a portable intravenous insulin infusion system. Initially, the patient's usual prescribed diabetic diet was provided, and an individual waveform of insulin infusion resulting in diurnal normoglycemia was defined for each meal. Subsequently, small (12% of total daily calories) and large (36% of total daily calories) versions of the regular breakfast (24% of total daily calories) were provided without change in the insulin infusion waveforms, and the resulting metabolic profiles were studied. The overall mean fasting plasma glucose levels before the meals of varying size were not significantly different, but the incremental rises in plasma glucose with the small (31 +/- 5 mg/dl), regular (48 +/- 7 mg/dl), and large (64 +/- 5 mg/dl) breakfasts varied directly with the meal size. The subsequent mean plasma glucose levels before the regular lunch were significantly different (P less than .05) after the small (50 +/- 4 mg/dl) and large breakfasts (131 +/- 9 mg/dl), compared with the regular breakfast (81 +/- 7 mg/dl). Despite these differences, the plasma glucose levels before dinner were virtually identical. We conclude that large variations in meal size produce glycemic changes in keeping with the caloric content of the meal.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3525059 TI - Development of new jet injector for insulin therapy. AB - To improve diabetic patients' compliance to multiple injection protocols, we developed and tested a new insulin jet injector, the Preci-Jet 50. The prototype has the following features: small size (14 X 2 cm) and weight (160 g), capability of mixing two types of insulin, accuracy and reliability of the ejected volume (dose), ease of use and sterilization, simplicity of design, and capacity of adjusting jet pressure to individual skin resistance. The ejected volume, evaluated by gravimetry, was more accurate and more reliable with the injectors (N = 18) than with 0.5-cc disposable plastic syringes (N = 18). The dead space of the injectors (N = 16), as evaluated by isotopic recuperation of radioactive insulin, was minimal, allowing mixed insulin injections. The human-device interface evaluation demonstrated that diabetic patients (N = 13) learned easily to manipulate the injector and that their ability to use it properly improved after 1 mo of use. We conclude that this injector may be a practical tool for insulin-dependent diabetic patients. PMID- 3525060 TI - Insulin-dependent diabetes mellitus and child abuse: is there a relationship? AB - Many of the family psychosocial variables significantly related to child abuse are also significantly related to insulin-dependent diabetes mellitus (IDDM) control. These variables are reviewed, and an increased child abuse risk factor for children with IDDM is discussed. Behavioral indicators of families experiencing difficulty in coping with IDDM are provided. These indicators are associated with both diabetes control and child abuse and should be recognized by diabetes health-care professionals. PMID- 3525061 TI - Insulin syringe reuse. PMID- 3525062 TI - The use of systemic cyclosporin a in human corneal transplantation: a preliminary report. AB - Four patients (six eyes) underwent successful corneal transplantations while receiving systemic cyclosporin. The six eyes had marked corneal vascularization preoperatively and in four, previous grafts had rejected. These eyes were therefore at high risk with respect to the likelihood of rejection and subsequent graft failure. All six grafts have remained clear (mean follow up twelve months) and only one minor rejection episode has occurred: this was easily reversed. The patients were monitored by repeated serum creatinine and trough serum cyclosporin levels. No significant side effects were encountered. PMID- 3525063 TI - Electrophysiological and pathological studies on Creutzfeldt-Jakob disease with retinal involvement. AB - In a case of Creutzfeldt-Jakob disease in a 59-year-old female, multifocal degeneration from the cerebral cortex through the visual pathway to the retina was detected clinically, electrophysiologically, and pathologically. Visual evoked cortical potentials (VECPs) showed a peculiar huge negative wave in the early stage but the amplitude reduced gradually. The a- and b-waves of the ERG were detectable in the final stage. Dynamic topography of VECPs revealed a delay of excitation in the visual cortex in the early stage, but a complete defect of the cortical potential and diminished reactivity of the brain stem were apparent in the later stage. Pathological findings were the spongy degeneration of the cerebral cortex, demyelination of the white matter and the optic pathway, and the degeneration of the nerve fiber layer and ganglion cell layer of the retina. PMID- 3525064 TI - [Energy parameters of the membrane during protein secretion in gram-negative bacteria]. PMID- 3525065 TI - Proposals for ethical standards in therapeutic trials with humans. PMID- 3525066 TI - Clinical trials of myeloma treatment: a review. AB - Clinical trials of myeloma treatment are reviewed. 7618 patients are described in nine Tables (some patients appear in more than one). Most randomized trials and trials of non-staged myeloma yield no statistically significant differences between the combinations of alkylators, vinca alkaloids, nitrosoureas, anthracyclines, epipodophyllotoxins, procarbazine and/or steroids used. Intensive combination treatment induces response in an average of 3 months and seems superior to monotherapy in stage III, in which the early mortality is reduced from 45% to 10%. No studies were found showing any evidence for superiority of intensive treatment in stage I. Alternating chemotherapy combinations do not delay refractoriness. No evidence was found that maintenance treatment prolongs survival in responding patients. PMID- 3525067 TI - Breast tumours: a review of adjuvant chemotherapy trials. AB - Updated randomized trials using adjuvant chemotherapy for breast cancer have generally shown significantly improved disease-free survival in young women. Nevertheless, this improvement does not appear to be lasting in locally advanced disease. The effects on overall survival remain controversial and have been observed in only five trials. Except for three trials, results in postmenopausal women have also been disappointing. The best regimen of adjuvant chemotherapy and, more importantly, its timing are still not well defined, although early or perioperative treatments seem to have a fair chance of success. PMID- 3525068 TI - Adriamycin, vincristine, cyclophosphamide and 5-fluorouracil (AVCF) compared with cyclophosphamide, methotrexate and 5-fluorouracil (CMF) in premenopausal breast carcinoma. Personal results. AB - Adjuvant treatment of breast cancer with AVCF gave significantly longer disease free survival than CMF in the group of patients taken as a whole, in the subgroup with lymph node involvement and in the premenopausal subgroup. No significant difference was found regarding overall survival. PMID- 3525069 TI - Neoadjuvant chemotherapy of breast cancer. AB - About 80% of patients with breast cancer ultimately die of metastatic disease at 20 years. Distant metastases are more important as a cause of death than local or regional relapses. It is for this reason that adjuvant chemotherapy is necessary, especially in young patients and those with extensive disease. Initial chemotherapy preceding any local or regional treatment is justified on the grounds that both surgery and anaesthesia lead to immunodepression. Further, the value of initial chemotherapy has been demonstrated in many experimental and clinical trials by Nissen-Meyer, Bonadonna and Cooper (1-3). In the present study 145 patients, including 67 with inflammatory breast cancer (IBC), were treated with 4-6 weeks of Velbe, thiotepa, methotrexate, fluorouracil and prednisone, with Adriblastin added for patients with IBC, T greater than 7 cm, or N2, N3. Because of tumour regression of greater than 50% observed in 80% of the patients, the majority (123 patients) then received radiotherapy alone (cobalt + iridium), resulting in complete remission in all these cases. Maintenance treatment with the same drugs was prescribed for 6-18 months depending on the initial stage. Tumour regression appears to be an important prognostic factor. Median follow-up is only 17 months, the longest being 42 months. Overall survival at 2 years for IBC is 90%, with a disease-free survival of 80%. Cosmetic results are excellent. While these results are encouraging, longer follow-up is needed to confirm this improvement. PMID- 3525070 TI - The value of radiation therapy after excision of stage I breast cancer. AB - Most studies of the treatment of early breast cancer with conservative surgery and radiation therapy have had two major shortcomings: they have been based largely on short-term follow-up; and they have compared their short-term results only with long-term results after mastectomy. These methods greatly underestimate the actual incidence of local recurrence after breast preservation combined with radiation therapy because a significant portion (50% or more) of local recurrences after radiation treatment for early breast cancer are recognized more than five years after treatment. The effect of radiation is more accurately assessed by comparing results with conservative surgery without radiation therapy. This allows an estimate of the effect of the radiation therapy itself. Ten-year local recurrence rates after treatment of early breast cancer with mastectomy, conservative surgery with radiation therapy and conservative surgery without radiation therapy are 0-8%, 13-26% and 16-19% respectively. When breast preservation is combined with radiation therapy there is a lower incidence of local recurrence at five years, but at 10 years the results with and without radiation therapy are quite comparable. In both situations the recurrence rates are much higher than after mastectomy. The significance of this higher recurrence rate has not been fully evaluated. All reports of the treatment of early breast cancer should have at least 10 years of follow-up. Under no circumstances should any data be published which include patients followed for less than five years. PMID- 3525072 TI - Radiotherapy and chemotherapy of malignant brain gliomas. AB - At present radiation therapy appears to be the only effective adjuvant treatment in malignant supratentorial gliomas (MSG). Six thousand rads given over 6 weeks increase survival significantly, by about 50%, but the addition of a further 1000 rads to the conventional 6000 rad dose may not be beneficial. Radiosensitizers of anoxic cells such as mizonidazole are ineffective. Superfractionation could represent an improvement over conventional radiotherapy. Adjuvant chemotherapy has proved ineffective in the vast majority of trials, with a few exceptions, the most important being the increase of long-term survivors by BCNU. In the author's opinion chemotherapy should be restricted to patients with recurring signs of MSG. PMID- 3525071 TI - Breast tumours: adjuvant radiotherapy trials. AB - According to controlled trial results, adjuvant radiotherapy associated with radical surgery has significantly decreased local recurrences of breast tumours, but with no effects on survival. Nowadays, in controlled trials, the advantages of associating radiotherapy with surgery and adjuvant chemotherapy are not clear. A non-significant trend towards better control of local disease is observed in some trials, mainly in locally advanced disease. In most of the other trials no benefit has been found. Although some detrimental effects have been observed when adjuvant chemotherapy was delayed or reduced by radiotherapy, on the whole radiotherapy does not appear to have any harmful effects on final results. PMID- 3525073 TI - The choice of treatment in polycythaemia vera. AB - The current results of prospective protocols initiated by the Polycythaemia Vera Study Group are presented. These results help to define the best choice of treatment in accordance with the risk factors. PMID- 3525074 TI - Trials of adjuvant chemotherapy in colorectal cancer. AB - Chemotherapy has been extensively investigated in colorectal cancer. Evaluation in advanced disease has shown that only a limited number of drugs are active. This activity was assessed according to objective criteria for response of measurable lesions, but despite producing objective remissions, no agent has prolonged survival in advanced disease. Drugs showing activity in advanced disease have been evaluated subsequently as adjuvants to surgery. Single agents were evaluated first and 5-fluorouracil has been investigated most extensively. It has been administered by a variety of routes and in different regimens and in some trials it has produced results which border on statistical significance for both disease-free interval and survival. It is the drug of first choice in colorectal cancer, although in some trials no effect was seen. Razoxane (ICRF 159) has also been evaluated and has shown some promise, although also some toxicity. Trials of combinations of treatments have been performed and have used permutations of 5-fluorouracil, MeCCNU, BCG and radiotherapy. None of these trials has shown a definite advantage for chemotherapy and, in some, toxicity has been considerable. 5-Fluorouracil as a single agent has shown the best results to date, and is the treatment of first choice but no treatment has been shown to prolong survival unequivocally in colorectal cancer. Future trials should include a surgery-only control arm, against which any new treatment can be compared. PMID- 3525075 TI - Clinical studies with new anthracyclines: epirubicin, idarubicin, esorubicin. AB - Analogue development is one of the most intensively pursued anticancer drugs research projects. The rationale in anthracycline analogue development followed by Farmitalia Carlo Erba has been the selection of agents with improved therapeutic index with respect to the parent structures, different spectrum of activity, reduced toxicity to the myocardium and oral route of administration. The clinical development is based on Phase I, II and III studies. However, the best definition in terms of activity and toxicity of an anticancer agent is accomplished with Phase II clinical trials, especially if they are comparative in a randomized fashion with the parent compound. Esorubicin has just started Phase II clinical testing. Phase I studies have shown hints of activity in several malignant diseases. Idarubicin has already been shown to be an important antileukaemic agent in Phase II-III studies. Moreover this compound is the first oral anthracycline that has shown activity in breast cancer, lymphomas and leukaemias, together with potential for reduced cardiac toxicity. Epirubicin, which is now in Phase III clinical development, has been shown to possess a better therapeutic index than doxorubicin since it induces less acute toxicities (nausea and vomiting, mucositis, myelosuppression) and less cardiotoxicity than its parent compound, without loss of activity in responsive tumours. PMID- 3525076 TI - Aclacinomycin A: clinical development of a novel anthracycline antibiotic in the haematological cancers. AB - Aclacinomycin A (aclarubicin; ACM) is a new class II anthracycline antibiotic. Preclinical studies suggested that ACM had approximately equivalent antitumour activity but produced substantially less cardiotoxicity compared to other anthracyclines. Because of the recognized importance of these compounds in the treatment of haematological tumours, clinical trials of ACM were initiated in the late 1970s. ACM has been extensively evaluated in patients with relapsed leukaemia and advanced malignant lymphoma. Analysis of results compiled from Europe, Japan, and the United States shows that ACM is probably equivalent to doxorubicin for remission induction of patients with relapsed acute non lymphoblastic leukaemia. Initial studies using ACM alone and in combination with standard cytotoxic drugs in previously untreated patients compare favourably with the best standard treatment for this disease. The antitumour activity of ACM in patients with acute lymphoblastic leukaemia or malignant lymphoma who have previously received doxorubicin or daunorubicin is low, and the issue of whether ACM lacks clinical cross-resistance to other anthracyclines is unresolved. Acute cardiac arrhythmias have been observed following administration of ACM, but congestive cardiomyopathy has been uncommon. Results to date all indicate that ACM has fulfilled its early expectations of antileukaemic activity and reduced toxicity. These hypotheses should now be evaluated in prospective, randomized trials with conventional anthracyclines. PMID- 3525077 TI - Busulfan versus 32P in polycythaemia vera. AB - In 293 patients with previously untreated polycythaemia vera, two different treatment modalities were randomized: 32P (0.5-1 mCi/10 kg at diagnosis and for each overt relapse) versus busulfan (4-6 mg/day during 4-8 weeks, with re administration at relapse). Duration of remission was significantly longer after busulfan (median not equal to 4 years) than after 32P (median not equal to 2 years). Moreover, overall survival was slightly but significantly longer in patients treated with busulfan, with a trend towards increased mortality related to vascular complications or secondary cancers in the 32P group. PMID- 3525078 TI - Clinical trials of the treatment of minimal residual tumours. AB - It is well known that even after maximal surgical and/or cytostatic treatment, and even in patients with an apparently complete remission, what is known as minimal residual disease often remains. Adjuvant chemotherapy given for periods longer than six months after the induction of complete remission does not appear, in comparative trials with a five-year follow-up, to improve the final prognosis either in leukaemia or in solid tumours. It is suggested here that the reason may be that minimal residual tumours may consist of cells in the G-O phase. Breast cancer before the menopause may be an exception, since oestrogens present before, but not during, menopause are promotors. This could explain why premenopausal breast cancer seems to be the only tumour transitorily sensitive to adjuvant chemotherapy. Immunotherapy given during complete remission seems to result in longer remission duration and/or overall survival and/or survival after relapse in some but not in all properly conducted trials. It is well known that large tumour masses are not influenced by immunotherapy. In contrast, it is known that cells in G-O, refractory to chemotherapy, may be sensitive to immunotherapy. PMID- 3525079 TI - Carbamazepine in recurrent affective disorders? PMID- 3525080 TI - [Malaria prevention. Risk of infection in relation to preventive measures]. AB - Between 1980 and 1985 falciparum malaria was diagnosed in 28 and tertian malaria in 17 patients. Only three of the 35 non-immune patients complied with the appropriate chemoprophylaxis; these three patients nevertheless developed tertian malaria (recurrences caused by "dormant" merozoites). The main drawbacks of chemoprophylaxis were lack of patient compliance (26 out of 35 patients) and inappropriate medical advice (14 out of 35 patients). Initial symptoms developed within one month after the end of exposition in 21 out of 23 patients infected by Plasmodium falciparum, but only in three out of twelve cases of tertian malaria. Risk of infection by Plasmodium falciparum is highest in Africa, while most of the malaria cases in India are caused by Plasmodium vivax. Long-term prophylaxis using pyrimethamine-sulfadoxine (Fansidar) is not advisable as there is a risk of life-threatening side effects. PMID- 3525081 TI - [Cardiogenic shock. Etiology and diagnosis]. PMID- 3525082 TI - [Medullary thyroid carcinoma. Results of a family screening program]. AB - During a ten-year period (1975-85) 56 patients with medullary carcinoma of the thyroid were under treatment. A family screening programme discovered such a tumour in the offspring of a 47-year-old female patient and her 56-year-old sister. In four of seven offspring from three lines of this family ultrasonography revealed changes in the thyroid. Positive preoperative pentagastrin test with stimulation of calcitonin as tumour marker resulted in the histological diagnosis of thyroid carcinoma. PMID- 3525083 TI - [Therapy of Parkinson's syndrome]. PMID- 3525086 TI - Sara Elizabeth Branham (Matthews). A biographical sketch. PMID- 3525084 TI - Indoramin. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic efficacy in hypertension and related vascular, cardiovascular and airway diseases. AB - Indoramin is a postsynaptic selective alpha 1-adrenoceptor antagonist used in the treatment of hypertension. In contrast to some other alpha-blockers, animal studies suggest that its blood pressure lowering effect results from relaxation of peripheral arterioles as a consequence of blockade of postsynaptic alpha 1 adrenoceptors. Furthermore, unlike some other alpha-blockers, this lowering of blood pressure is rarely associated with reflex tachycardia or postural hypotension. Therapeutic trials have shown indoramin to be effective in lowering blood pressure in all grades of hypertension: mild and moderate hypertension when used alone, but generally in combination with a thiazide diuretic, and in moderate to moderately severe hypertension when used in combination with a beta blocker and diuretic. In a few small comparative studies, no significant difference was found in the blood pressure lowering effects between indoramin and methyldopa, propranolol and prazosin. Side effects were similar for indoramin, propranolol and methyldopa; however in the 1 comparative study with prazosin, prazosin produced a lower incidence of sedation. Indeed, the most common side effect with indoramin therapy has been sedation of a mild to moderate and/or transient nature, reported in about 19% of cases. Other side effects which have sometimes led to a withdrawal of indoramin treatment have been dry mouth, dizziness, and in males, failure of ejaculation; however, side effects may be reduced by starting therapy with smaller doses and titrating more gradually. PMID- 3525087 TI - Amoxycillin-clavulanic acid combination in bronchopulmonary infection due to beta lactamase-producing Branhamella catarrhalis. Preliminary report. AB - Since 1978 we have taken an interest in lower respiratory tract infections associated with Branhamella catarrhalis in Christchurch, New Zealand. In a preliminary trial, 20 patients with bronchopulmonary infection caused by beta lactamase-producing B. catarrhalis were treated with a combination tablet of amoxycillin 500 mg and clavulanic acid 125 mg ('Augmentin') 3 times daily for 5 days. Sputum cultures were negative for B. catarrhalis within 3 days in all patients. Two of 7 patients whose sputum cultures were positive for this organism at a review 2 to 4 weeks later were successfully treated with a further course of amoxycillin/clavulanic acid. PMID- 3525085 TI - Current issues in thrombosis prevention with antiplatelet drugs. AB - In this review, the major current problems related to the pharmacology and clinical use of antiplatelet drugs are discussed in relation to the physiopathology of the platelet-vessel wall interaction and arterial thrombus formation. Although platelet adhesion to injured vessels is a crucial step in thrombogenesis, none of the currently used antiaggregating drugs prevents this phenomenon. Why the normal endothelium does not react with platelets is not known. Thus we are unable to pharmacologically restore endothelial 'non thrombogenicity' when lost by single or repeated injury. In contrast, more information is available on the mechanisms controlling and amplifying platelet activation by physiological stimuli (such as collagen and thrombin), and on their pharmacological modulation. The 3 main amplification loops involve arachidonic acid metabolism, ADP release and possibly the availability of a phospholipid platelet activating factor. These pathways are in turn activated by the phosphatidylinositol cycle. The most widely used antiaggregating drug is aspirin. It prevents the formation of arachidonic acid metabolites both in platelets and in vascular cells. The use of low-dose aspirin, thromboxane-synthase inhibitors, thromboxane receptor antagonists, epoprostenol (prostacyclin) and its stable analogues, and ticlopidine all appear to be promising pharmacological approaches, but none has so far been tested in clinical trials for thrombosis prevention. On the other hand, aspirin (in relatively large doses of 300 to 1500 mg daily), sulphinpyrazone and dipyridamole have been tested alone or in combination in the secondary prevention of thromboembolic complications. Aspirin has significantly reduced both the occurrence of myocardial infarction and mortality rate in patients with unstable angina and/or previous myocardial infarction; it has also proved beneficial in cerebrovascular disease. The beneficial effect of aspirin was dose-independent. In some of these trials aspirin was combined with either dipyridamole or sulphinpyrazone. When used alone, the latter compound has reduced sudden death or thromboembolic complications in patients with myocardial infarction. It remains to be established whether antiplatelet therapy may prevent or stop the progression of atherosclerosis. PMID- 3525088 TI - The elderly patient. A special case for diuretic therapy. AB - Diuretics are among the most widely prescribed drugs, especially for the elderly with cardiac failure or hypertension. Progressive structural and functional changes occur in the kidneys after the fourth decade, leading to impairment of the ability of the kidneys to handle sodium, water and solutes. The renal reserves of the elderly are about half those of the young. In addition, the renin aldosterone system shows reduced activity in old age. The pharmacokinetics and pharmacodynamics of diuretics in the elderly are reviewed, and the influence of congestive cardiac failure is emphasised with regard to the kinetics of diuretics and the deleterious effect of diuretic-induced hypokalaemia and hypomagnesaemia on the pharmacology of digoxin. Guidelines are suggested for the use of diuretics in the elderly, including the avoidance of unnecessary use, the careful choice of diuretic used, the need for small initial doses, and the prevention of hypokalaemia. The place of potassium-sparing agents for the elderly and adverse effects of diuretics, either mechanical, metabolic or toxic are discussed. Mechanical problems are related to the rate and volume of urine produced, and the resulting effects on bladder function and on blood volume. Although toxic effects are relatively rare, metabolic effects include electrolyte changes, impairment of glucose tolerance, and increased serum uric acid and lipids. Most of these adverse effects are preventable by careful management; the consensus is that they are not of sufficient clinical significance to outweigh the long record of efficacy and safety of diuretic therapy in the elderly. Diuretics will, and should, continue to be used extensively in elderly patients with hypertension and/or cardiac failure. PMID- 3525089 TI - Diuretic drugs. Progress in clinical pharmacology. AB - Oral diuretics are amongst the most widely used drugs in clinical practice today. Their discovery close on thirty years ago remains a major milestone in therapeutic progress. Though originally designed for treating heart failure, diuretics are more commonly prescribed, worldwide, in hypertension than for relief of oedema. Since the introduction of chlorothiazide, diuretic development has passed through a series of distinct stages. The thiazide era was followed by the 'high-ceiling' diuretics, the antikaliuretics and, more recently, polyvalent agents that cause both saluresis and uricosuria. Alongside these synthetic achievements, major advances have occurred in the knowledge of nephron function and ion transport mechanisms. These have acted as stimulus to the design of novel categories of diuretics. The practising clinician thus has a wide range of available diuretics to choose from. The most appropriate choice of an agent aimed at the relief of symptoms with minimal adverse effects requires an understanding of where and how diuretics act within their primary target organ, the kidney. Whereas various procedures, ranging from micropuncture to the study of brush border membrane vesicles, have been utilised experimentally, investigation of the mode and sites of action of diuretics in man has largely depended on application of clearance methodology. Refinements in analytical chemistry have encouraged study of the pharmacokinetic and metabolic fate of diuretics. Taken together, available evidence shows that most diuretics exert their saluretic action from the intraluminal aspect of the renal tubules. The time-course of drug delivery, as well as total quantity of drug transported into the lumen determine the cumulative drug response. Exceptions are muzolimine and the aldosterone antagonists which act at the peritubular membrane. Distinctive stereospecific effects on luminal tubular ion transport occur with indacrinone and etozoline. The clinical use of diuretics often involves concurrent administration with other drugs. The mechanisms involved in a number of the resulting pharmacodynamic and pharmacokinetic interactions have considerable relevance in patient management. Notable examples of these interactions are the blunting of diuretic action by non steroidal anti-inflammatory agents and the diuretic-induced diminution in the renal clearance of lithium salts. PMID- 3525092 TI - [Ultrasound-guided follicle aspiration for in vitro fertilization]. PMID- 3525090 TI - The diuretic dilemma and the management of mild hypertension. AB - Diuretics are used in first-step antihypertensive monotherapy or in combination with adrenergic-inhibiting agents in the majority of hypertensive patients in the United States. A 30-year experience has demonstrated that blood pressure is lowered to as great or greater a degree with diuretics than when many of the presently available antihypertensive drugs, including converting enzyme inhibitors, calcium entry blockers, beta- or alpha-adrenergic inhibitors, or centrally acting sympatholytic agents, are used. Diuretics appear to be especially effective in the elderly and in black patients. All of the major hypertension clinical trials upon which we base our decisions for treatment have employed diuretics as step-1 therapy--with a reduction in morbidity and mortality. In addition, data suggest that more effective treatment of hypertension has contributed to the decrease of over 45% in deaths from cerebrovascular disease and the overall reduction of cardiovascular deaths over the past 15 to 20 years in the United States. The debate concerning the long term safety of diuretic therapy has focused on the USA Multiple Risk Factor Intervention Trial (MRFIT) results and several papers, suggesting that the lipid raising or potassium-lowering properties of diuretics may produce adverse effects. Suggestions have been made that the use of other drugs without metabolic side effects may result in greater benefit with less risk, especially in the management of mild hypertension where the risk of the disease is not immediate or great. A review of the MRFIT and lipid data from long term studies has failed to establish the 'toxicity' of diuretic agents. In addition, recent studies have not confirmed previous observations that diuretic-induced hypokalaemia increases ventricular ectopy or contributes to sudden death. Although hypokalaemia should be avoided and corrected if it occurs, especially in patients with ischaemic heart disease, in the elderly, in patients with pretreatment ectopy or in patients on low potassium diets, the fear of this metabolic side effect of diuretics should not deter the physician from continuing the use of these agents both as monotherapy in most patients and as second-step therapy with an adrenergic-inhibiting drug. PMID- 3525093 TI - General clinical considerations of nystagmus. PMID- 3525091 TI - Electrolyte abnormalities and ventricular arrhythmias. AB - Investigation of coronary heart disease manifesting as sudden death has highlighted the role of electrolyte disturbances in arrhythmogenesis. The identification of the 3 major cardiac risk factors--hyperlipidaemia, hypertension and smoking--does not fully explain sudden death in asymptomatic patients with an abnormal ECG. Sudden death is usually ascribed to cardiac arrhythmia whose pathogenesis has 3 possible mechanisms affecting the electrical properties of the heart. Thiazide diuretics are known to deplete potassium and magnesium in the body and while magnesium deficiency has been especially associated with cardiac rhythmicity, potassium levels modulate the cellular effects of calcium in the myocardium. In patients with ischaemic heart disease, both hypokalaemia and hypomagnesaemia correlate with the frequency of serious arrhythmias and even in ambulatory hypertensive patients on diuretics, it is important to preserve electrolyte homeostasis. There is, however evidence to suggest that some patients are more susceptible to diuretic-induced arrhythmias and in these patients even mild hypokalaemia can cause ventricular arrhythmias, and age may be a contributory factor. The risk of thiazide-induced arrhythmias has yet to be confirmed. PMID- 3525094 TI - Neurodevelopmental outcome of periventricular haemorrhage and leukomalacia in infants 1250 g or less at birth. AB - The brains of 50 consecutively admitted infants weighing 1250 g or less at birth were serially examined beyond the neonatal period for periventricular haemorrhage and for periventricular leukomalacia with real-time ultrasound. There was significant correlation between the presence or absence and the severity of haemorrhage with survival. A prospective neurodevelopmental assessment was completed at 2 years of age, corrected for prematurity, on all survivors. None of the 20 survivors with normal scans or germinal layer haemorrhages had evidence of major disability and all four survivors with intracerebral haemorrhage or periventricular leukomalacia had major disability. The mental performance on the Bayley scales of infant development was also significantly worse in the latter group. Six of the eight survivors with intraventricular haemorrhage had no major disability, including three who had post-haemorrhagic hydrocephalus. Our results showed that cerebral ultrasound detection of brain pathology is a good predictor of neurodevelopmental outcome in such extremely low birthweight infants. However, as the maximum extent of periventricular haemorrhage may develop beyond one week of age and cystic periventricular leukomalacia commonly develops after the neonatal period, serial scanning is mandatory to ensure diagnostic accuracy for both periventricular haemorrhage and leukomalacia. PMID- 3525095 TI - Role of asphyxia and slow intrauterine growth in morbidity among breech delivered infants. AB - The outcome of breech delivery was evaluated by a neonatal neurological score and a follow-up examination at 18 months of age. The subjects were 132 children identified by ultrasound to be in breech presentation in the 33rd gestational week. 62 were born in breech presentation, while 70 turned to vertex presentation. During the early neonatal period, a neurological score was obtained based on the results of 29 items concerning posture, muscle tone, reflexes and reactions. Although there was no difference, in neurological score or in general development when the entire breech and vertex groups were compared, the SGA (small-for-gestational age) infants and the infants with low Apgar scores of the breech group had the poorest neurological scores. The contribution of certain maternal and fetal factors to postnatal condition was evaluated by a multiple linear regression analysis. Within the breech group, relationships were found between the neurological score and the variables intrauterine growth, fetal sex, and low Apgar score. A major part (66%) of the variation in neurological score was explained by the combination of these variables. These factors should therefore be taken into consideration when deciding on the mode of delivery in breech presentation. PMID- 3525096 TI - Three-dimensional visualization of root canal in mandibular premolars. PMID- 3525097 TI - Comparative sealability of amalgam and polycarboxylate cements as retrograde fillings in vitro. PMID- 3525098 TI - [It is possible to reconstruct an existing cuspid guidance?]. PMID- 3525099 TI - [Elastase estimation in human periodontal pocket exudate and its importance as an inflammation parameter]. PMID- 3525101 TI - [Shortened dental arch]. PMID- 3525100 TI - [The effect of hemostatic threads on the gingival margin]. PMID- 3525102 TI - [3d molar extraction from the prosthetic point of view]. PMID- 3525103 TI - [Differential indications for fixed and removable prosthetics]. PMID- 3525104 TI - [Limits of maintenance for abutment and pontic teeth]. PMID- 3525105 TI - [Assessment of the connecting elements between the residual dentition and dentures]. PMID- 3525106 TI - [Prospective aspects in the construction and integration possibilities of dentures]. PMID- 3525107 TI - [Bondings in bonded bridge technics]. PMID- 3525108 TI - [Uprighting tipped molars as a pre-prosthetic and periodontitis-preventive measure]. PMID- 3525109 TI - [Questions on repair possibilities of plastic filling materials]. PMID- 3525110 TI - [Transcoronally pinned partial crown bridges]. PMID- 3525111 TI - [Removable bridges with Konus crowns]. PMID- 3525112 TI - [In vitro study of the dynamics of free-end saddle dentures with different supports]. PMID- 3525113 TI - [Free-end bridges--results of a follow-up study]. PMID- 3525114 TI - [The present status of bracket bonding technics]. PMID- 3525115 TI - [Dentin after various preparations in vivo]. PMID- 3525116 TI - [Pre-prosthetic orthodontics]. PMID- 3525117 TI - [Extraction therapy through the course of time]. PMID- 3525118 TI - Insulin-sensitive, serum-sensitive protein kinase activity that phosphorylates ribosomal protein S6 in cultured fibroblast-melanoma hybrid cells. AB - A protein kinase activity (S6PK) that phosphorylates ribosomal protein S6 has been detected in cytosolic extracts prepared from an insulin-sensitive mouse fibroblast-melanoma hybrid cell line. The activity of this enzyme is greatly increased in cells that have been stimulated with insulin or serum for 30 min before preparation of the extract. In the parental melanoma cells, which are insensitive to the growth-stimulatory action of insulin, the activity of the enzyme is lower than in the hybrid cells and is not increased in response to insulin. The insulin-sensitive, serum-sensitive S6PK from the hybrid cells is eluted as a single peak from diethylaminoethyl (DEAE)-cellulose between 0.15 and 0.2 M KCl. The apparent mol wt of the enzyme, as determined by gel permeation chromatography, is approximately 105,000. A second S6 kinase activity from the hybrid cells is trypsin dependent and elutes from DEAE-cellulose at a lower salt concentration than S6PK. In contrast to S6PK, the trypsin-dependent S6 kinase activity does not vary in a consistent manner in response to insulin or serum. Fractions obtained from DEAE-cellulose chromatography of extracts of the hybrid cells have also been assayed for ability to phosphorylate the synthetic octapeptide Arg-Arg-Leu-Ser-Ser-Leu-Arg-Ala (S6-1), the structure of which is based on a phosphorylated region of the S6 protein. Two trypsin-dependent peaks of protein kinase activity have been found to phosphorylate this peptide, one eluting at 0.05 M KCl and the other at 0.10-0.15 M KCl. The first peak elutes at the same salt concentration as the trypsin-dependent protein kinase(s) that phosphorylate ribosomal protein S6, while the second elutes slightly, but reproducibly ahead of S6PK. Several properties of the second peak of S6-1 phosphorylating activity suggest that it is not S6PK. PMID- 3525119 TI - Electrophoretic analysis of membrane proteases in the luteinized rat ovary. AB - Membrane fractions from fully luteinized rat ovaries contained proteolytic enzymes that were solubilized and reversibly inhibited by the anionic detergent sodium dodecyl sulfate. Electrophoretic analysis in substrate-containing sodium dodecyl sulfate-polyacrylamide slab gels revealed the presence of numerous protease bands in the mol wt range of 26,000 to more than 200,000. When casein served as protease substrate in the gels, enzyme bands of Mr 26,000, 28,000, 30,000, and 90,000 were produced by crude (2,000 X g pellet) ovarian membranes. Gels containing casein and plasminogen also revealed the presence of two plasminogen activators of Mr 63,000-65,000 and 42,000. Subcellular fractionation of luteinized ovaries by centrifugation in sucrose density gradients indicated that the Mr 90,000 protease and the two plasminogen activators were uniformly distributed among microvillous membranes, basolateral membranes (BLM), and the mitochondrial-lysosomal fraction (MLF). The Mr 26,000, 28,000, and 30,000 proteases were enriched in BLM and MLF. Analysis of crude membranes in slab gels which contained gelatin as the protease substrate revealed the presence of two additional enzymes of Mr 52,000 and more than 200,000. The Mr greater than 200,000 protease was present in microvillous membranes, BLM, and MLF. The Mr 52,000 protease was found exclusively in BLM. This enzyme was not consistently demonstrable in crude membranes but could be generated upon incubation of membranes at 30 C. This finding indicated that Mr 52,000 protease can exist in an inactive and/or zymogen form. The Mr 90,000 protease was inhibited by tosyl lysine chloromethyl ketone and dansyl-glutamyl-glycylarginine chloromethyl ketone. The gelatinase activity of the Mr 52,000 protease was blocked by tosyl lysine chloromethyl ketone, dansyl-glutamyl-glycylarginine chloromethyl ketone and tosylamide-2-phenyl chloromethyl ketone. The activity of the Mr 26,000, 28,000, and 30,000 proteases was not affected by any of the above mentioned inhibitors. These findings demonstrate that the proteolytic potential of ovarian membranes is not limited to plasminogen activators. Numerous plasminogen independent proteases are also present, and these may play a role in ovulation, luteolysis, and mediation of hormonal stimulation. PMID- 3525120 TI - Epidermal growth factor stimulates glycogen synthesis in fetal rat hepatocytes: comparison with the glycogenic effects of insulin-like growth factor I and insulin. AB - The effects of epidermal growth factor (EGF) on glycogen metabolism and the binding of [125I]iodo-EGF to receptors in fetal rat hepatocytes have been examined. The actions of EGF have been compared with those of insulin-like growth factor I (IGF-I) and insulin. EGF (0.1-45 nM) stimulated dose-dependent increases in [14C]glucose incorporation into glycogen (8.8-31.1%, P less than 0.01) and total cellular glycogen content (5.6-21.4%, P less than 0.05). The concentration of EGF causing half-maximal stimulation of glycogen synthesis was 2 ng/ml, and maximal stimulation occurred at 1 h of incubation. EGF had no effect on the uptake of the nonmetabolizable monosaccharide [14C]O-methyl-D-glucose, suggesting that the glycogenic effect of EGF was not mediated through stimulation of glucose transport. Although IGF-I (1-100 nM) and insulin (14 nM to 10 microM) also stimulated glycogen synthesis in fetal liver, the maximal effects of these hormones occurred at 2 h incubation, and the dose-response curves of IGF-I and insulin were not parallel to that of EGF. In addition, the maximal glycogenic effect of EGF was only 40% that of insulin or IGF-I, and the effects of EGF and insulin on [14C]glucose incorporation were additive. These findings suggest that EGF stimulates glycogen synthesis through a mechanism distinct from that of IGF-I or insulin. The binding of [125I]iodo-EGF to fetal hepatocytes was specific, saturable, and time- and temperature-dependent. Maximal specific binding occurred at 1 h of incubation at 37 C or at 24 h of incubation at 4 C. Unlabeled EGF (0.05 250 ng/ml) caused a dose-dependent inhibition of the binding of [125I]iodo-EGF to fetal hepatocytes, with half-maximal displacement of [125I]iodo-EGF by 1.7 ng unlabeled EGF/ml. The specific binding of [125I] iodo-EGF was not inhibited by high concentrations of insulin or IGF-I, suggesting that the differences in the mechanisms by which EGF, insulin, and IGF-I stimulate glycogenesis may be explained in part by differences in the binding of these hormones to fetal liver receptors. In addition to having mitogenic effects in fetal tissue, EGF or other EGF-like growth factors may have acute effects on fetal hepatic intermediary metabolism and may contribute to the accumulation of liver glycogen in the mammalian fetus during late gestation. PMID- 3525121 TI - Retroendocytosis of insulin in rat adipocytes. AB - A variety of ligands internalized by receptor-mediated endocytosis follow a short circuit pathway that does not lead to degradation but results in rapid exocytosis of intact ligand, a process termed retroendocytosis. We studied the time course of [125I]iodoinsulin processing and retroendocytosis after internalization in isolated rat adipocytes. After steady state binding and internalization, surface receptor-bound insulin was removed by exposing cells to a low pH at low temperatures. The cells containing internalized [125I]iodoinsulin were reincubated in fresh medium; subsequently, the radioactivity remaining within the cells and released into the medium were analyzed at various times by trichloroacetic acid (TCA) precipitation, Sephadex G-50 gel filtration, and reverse phase HPLC. Cell-associated radioactivity progressively decreased after reincubation in 37 C buffer, with 50% released in 9 min and 85% by 45 min. In the media, TCA-precipitable material appeared quickly, with a t1/2 of 2 min, and plateaued by 10 min. TCA-soluble material was released continually throughout the 45-min period. The release of both TCA-precipitable and TCA-soluble material was temperature and energy dependent. Sephadex G-50 chromatography demonstrated the loss of insulin from the intracellular pool and its appearance in the medium with a time course similar to that of TCA-precipitable material. Reverse phase HPLC demonstrated that the intracellular and medium radioactivity eluting in peak II (insulin peak) on Sephadex G-50 was composed of both intact insulin and intermediates. In conclusion, these studies demonstrated that after the internalization of insulin, rat adipocytes release not only small mol wt degradation products of insulin, but also insulin intermediates and intact insulin. The rate of retroendocytosis reported here is almost identical to the rate of insulin receptor recycling in rat adipocytes. Therefore, retroendocytosis may serve as an excellent in vitro reflection of the extent and rate of insulin receptor recycling. PMID- 3525122 TI - Rabbit placental relaxin: ultrastructural localization in secretory granules of the syncytiotrophoblast using rabbit placental relaxin antiserum. AB - Although relaxin has been isolated from the placenta of the human, rabbit, horse, and cat, this study represents the first ultrastructural localization of the hormone in placental tissue. Placentas were removed from rabbits on days 15, 23, and 30 of pregnancy, and the tissues were prepared for light and electron microscopies. The cytoplasm of the syncytiotrophoblast from all stages of pregnancy studied showed positive staining for the hormone at the light level using guinea pig antirabbit relaxin serum and the avidin-biotin technique. Ultrastructurally, the syncytiotrophoblast was found to contain membrane-bounded granules (150-400 nm in diameter) which formed at the Golgi and were seen in close association with the cell membrane. Exocytosis involving the incorporation of the granule membrane into the cell membrane was observed. These granules labeled positively for relaxin after treatment with guinea pig antirabbit relaxin serum and goat antiguinea pig immunoglobulin G-colloidal gold. Control sections in which the relaxin antiserum was absorbed with purified rabbit relaxin or substituted with normal guinea pig serum contained no gold-labeled granules. Cross-reactivity of the rabbit relaxin antiserum with porcine relaxin was demonstrated by labeling of the relaxin-containing granules in the pregnant pig corpus luteum with the rabbit relaxin antiserum and by inhibiting the labeling of rabbit placental and pig corpora luteal granules by absorbing the rabbit relaxin antiserum with porcine relaxin. We have previously described the labeling of rabbit placental relaxin with porcine relaxin antiserum. This study suggests that relaxin is synthesized and secreted from the syncytiotrophoblast of the rabbit placenta, with the subcellular site of storage being membrane-bounded granules. PMID- 3525123 TI - Influence of cholecystokinin on insulin output from isolated perifused pancreatic islets. AB - The C-terminal eight-amino acid derivative of CCK, sulfated on the tyrosine residue (CCK8S), stimulated a dose-dependent biphasic pattern of insulin secretion from isolated perifused islets in the presence of 7 mM glucose. It was without any effect if glucose were absent from the medium or maintained at 4 mM. The response to CCK8S was readily reversible and dependent on the presence of extracellular calcium. While CCK8S did not increase glucose usage rates above those noted with 7 mM glucose alone, inclusion of the metabolic inhibitor 2 deoxyglucose lowered glucose usage rates to values obtained with 3-5 mM glucose and abolished the influence of CCK8S on insulin output. Removal of the metabolic inhibitor restored the secretory response. N-Acetylglucosamine (15 mM) or glyceraldehyde (2.5 mM) substituted for glucose and permitted CCK8S to evoke secretion. The nonsulfated eight-amino acid derivative of CCK, CCK8, provoked insulin secretion in the presence of 7 mM glucose, but only at 10-100 times greater levels than CCK8S. CCK4 (1 microM) did not influence insulin output in the presence of 7 mM glucose. On an equimolar basis, CCK8S was significantly more effective than gastric inhibiting polypeptide in augmenting insulin output. The results support a role for CCK8S in the regulation of insulin levels in vivo. PMID- 3525124 TI - Hormonal control of a low Km (type II) iodothyronine 5'-deiodinase in cultured NB41A3 mouse neuroblastoma cells. AB - The central nervous system manifests complex homeostatic mechanisms for the maintenance of thyroid hormone economy. The present studies used the NB41A3 mouse neuroblastoma cell line as a model system to study the hormonal regulation of the enzymatic conversion of T4 to T3 in neural tissue. NB41A3 cells manifested a thiol-dependent 6-n-propyl-2-thiouracil-insensitive iodothyronine 5'-deiodinase (I5'D) with a Km for T4 of approximately 10 nM. I5'D activity was increased 2- to 4-fold in cells grown in thyroid hormone-depleted medium. Exposure of cells in situ to various thyroid hormones resulted in a rapid dose-dependent inhibition of enzyme activity with the following order of potency: rT3 = T4 greater than T3. The potent inhibitory effect of rT3 on I5'D activity could not be attributed to substrate competition with T4 in the reaction assay. The addition of dexamethasone (2 X 10(-7) M) to the culture medium also inhibited I5'D activity by 46 +/- 6% (+/- SE; n = 4 experiments; P less than 0.02), whereas insulin and epinephrine were without effect. In other experiments, saturation analysis using a purified preparation of isolated nuclei from NB41A3 cells demonstrated the presence of saturable, high affinity nuclear binding sites which had a Kd value for T3 of 0.13 +/- 0.05 nM and a maximum binding capacity of 0.13 +/- 0.01 pmol T3/mg DNA. These studies demonstrate that NB41A3 cells have a low Km (type II) I5'D process and nuclear T3-binding sites very similar to those previously described in the rat central nervous system. I5'D activity in this cell line appears to be regulated by multiple serum factors, including thyroid hormones and glucocorticoids. The potent regulatory effect of rT3 and T4 suggests that T3 formation by thyroid hormones in neural tissue is controlled by a unique cellular mechanism independent of the nuclear T3 receptor. Since tissue and plasma concentrations of T4 are considerably higher than those of rT3, the former hormone is likely to be the principal thyroid hormone regulating this enzymatic process. PMID- 3525125 TI - Calcitonin gene-related peptide: occurrence in pancreatic islets in the mouse and the rat and inhibition of insulin secretion in the mouse. AB - The intrapancreatic cellular distribution and effects on basal and stimulated insulin secretion of the 37-amino-acid polypeptide, calcitonin gene-related peptide (CGRP), were investigated in the mouse. The cellular localization of CGRP was also studied in the rat pancreas. In both species, CGRP was demonstrated in pancreatic islet cells and nerve fibers. Immunocytochemical double staining experiments revealed the CGRP-immunoreactive cells in the mouse to be identical with a majority population of the insulin cells. In the rat, on the other hand, CGRP-immunoreactive cells were identical with somatostatin cells. CGRP immunoreactive nerve fibers were observed, in both species, running in the exocrine parenchyma, particularly around blood vessels, and they were occasionally seen also within the islets. In in vivo experiments, CGRP was found to inhibit both basal and stimulated insulin secretion in the mouse. Thus, 6 min after the iv injection of CGRP (0.85 nmol/kg), plasma insulin levels were 13 +/- 2 (SE) microU/ml compared to 30 +/- 4 microU/ml in controls (P less than 0.01). At this dose level, CGRP inhibited the insulin secretory response to carbachol, leaving that to glucose unaffected. However, at a higher dose level (4.25 nmol/kg), CGRP inhibited glucose-induced insulin secretion as well. We conclude that CGRP occurs in islet cells and in intrapancreatic nerve fibers of both the mouse and the rat, and inhibits both basal and stimulated insulin secretion in vivo in the mouse. PMID- 3525126 TI - Capacity of individual somatotropes to release growth hormone varies according to sex: analysis by reverse hemolytic plaque assay. AB - A reverse hemolytic plaque assay was used to investigate the mechanism(s) underlying sexual differences in GH release which evolve at puberty in rats. The percentages of GH-secreting cells in 24-h pituitary cultures from each sex were similar for pituitary donors up to 30 days of age (range = 38.9% to 41.7% of all cells in culture, n = 3 separate experiments) but decreased by day 50. The decrease was more striking for females (to 24.1 +/- 0.3% mean +/- SE) than for males (to 33.2 +/- 1.1%). However, owing to the greater increase in total pituitary cell number exhibited by female rats at this time, the absolute numbers of somatotropes recovered from male and female pituitaries were almost identical on 50 and 100 days of age. To assess the secretory capacities of individual somatotropes, we measured the sizes of plaques formed. In prepubertal rats (days 10-30), the plaque areas under basal conditions were comparable for males and females at each age studied, and treatment with GH-releasing factor increased plaque sizes to approximately the same degree (10-fold) for both sexes at each age. However, by day 100, plaques that formed under both basal and stimulated conditions were consistently larger (P less than 0.01) for male than for female donors. Taken together, our results demonstrate that sexual differences in GH release are attributable to the secretory capacities of individual somatotropes rather than to differences in the numbers of GH cells in pituitaries of male and female rats. PMID- 3525127 TI - Bifunctional activity of epidermal growth factor on alpha- and kappa-casein gene expression in rodent mammary glands in vitro. AB - Explants from mammary glands of virgin rats and pregnant rats and mice were cultured under serum-free conditions in the presence of various combinations of the hormones insulin (I), aldosterone (A), corticosterone (C), PRL, and epidermal growth factor (EGF). Bifunctional activity of EGF was found on expression of the alpha- and kappa-casein genes. In the presence of I, A, and C, EGF increased the level of alpha-casein mRNA in pregnant mouse mammary gland explants, but not in rats. kappa-Casein mRNA sequences in mouse mammary gland explants were also significantly increased by EGF in the presence of I, A, and C, but in rat mammary gland explants, the increase was less. In contrast, in the presence of I, A, C, and PRL, EGF inhibited the induction of both alpha- and kappa-casein mRNA sequences in tissue from rats and mice. This bifunctionality of EGF in terminal differentiation of the rodent mammary gland was also reflected in the levels of synthesis of total casein and alpha-lactalbumin. PMID- 3525128 TI - Evidence that a short-lived effect of copper leads to amplification of prostaglandin E2 stimulation of the release of gonadotropin-releasing hormone from median eminence explants. AB - We have previously shown that copper (Cu) amplifies prostaglandin E2 (PGE2) stimulation of LHRH release from explants of the median eminence area (MEA) incubated under in vitro conditions. In this study, we have carried out an extensive comparative study of the kinetics of the process of PGE2 stimulation and C alpha-amplified PGE2 (Cu/PGE2) stimulation of LHRH release. MEA explains obtained from adult male rats were incubated under in vitro conditions, and LHRH released into the medium was assayed by RIA. Kinetic parameters were established by varying the time of exposure of the MEA to Cu or PGE2 and the dose of Cu or PGE2. Cu action requires a minimal 5-min period of exposure of the MEA, is rapidly manifested (less than 5 min after transfer of Cu-free medium), and is reversible (half-life, 10-15 min). Cu amplification of PGE2 action is a saturable function of the concentration of both Cu and PGE2; half-saturation and saturation were achieved with 120 and 200 microM copper, respectively, and with 0.6 and 10 microM PGE2, respectively. A 5-min exposure of Cu-treated MEA to PGE2 has the following time course of PGE2 action: the maximal rate of LHRH release is attained within 5 min; release is maintained at the maximal rate for another 5 min and then declines. Importantly, this decline is not prevented by a longer (15 min) exposure of the MEA to PGE2, indicating desensitization to PGE2 action. When MEA treated with Cu (5 min) and PGE2 (15 min) is allowed to recover for 45 min in buffer, the tissue regains its responsiveness to PGE2. All of the kinetic parameters of the process induced by PGE2 alone are similar to those described above for Cu/PGE2, except that the magnitude of the maximal rate of PGE2 stimulated release is 4- to 6-fold lower and that release is maintained at this rate for about 45 min. We also examined the PG structure specificity for stimulation of LHRH release and found that PGD2 by itself or after Cu pretreatment is much less effective than PGE2 in stimulating LHRH release. In summary, Cu amplification of PGE2 stimulation of LHRH release from LHRH neuronal terminals (i.e. MEA explants) involves rapid activation of a short-lived component.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3525129 TI - Cytochemical evidence for different routes of gonadotropin-releasing hormone processing by large gonadotropes and granulosa cells. AB - The route and rate of internalization of GnRH were compared in studies of dispersed ovarian granulosa cells and large pituitary gonadotropes from fractions enriched by centrifugal elutriation. GnRH receptors were localized with the use of a biotinylated [D-Lys6]GnRH analog, followed by avidin gold or avidin-biotin peroxidase complex stains. Both target cell types bound the [biotinyl-D-Lys6]GnRH (Bio-GnRH) in 1 min, and there were multiple patches of label on microvilli and coated or uncoated pits by 3 min. Quantification of the avidin-gold stains showed a significant increase in the number of labeled sites per cell profile at 3 min, followed by a decrease 15 min after exposure. No staining was seen in cells treated with medium only or with Bio-GnRH competing with a 100-fold excess of unlabeled [D-Lys6]GnRH. Internalization of the Bio-GnRH occurred during the first 3 min in both target cell types. However, the initial sites of processing appeared to be different. In granulosa cells, label was in vesicles and receptosomes (endosomes) and a few small multivesicular bodies. No stain was seen in the Golgi region for at least 15 min, at which time the stain was of low intensity. At later times (15-30 min), most of the label appeared in large multivesicular bodies. In contrast, gonadotropes exhibited labeling in Golgi complex cisternae, condensing vesicles, and immature granules as early as 3 min after exposure. Label was also seen on a subpopulation of granules in the cytoplasm and in a few multivesicular bodies. These comparative studies of two different target cells suggest that whereas the rates of internalization of GnRH are similar, the initial sites of processing may be different. Granulosa cells may degrade or separate the ligand from its receptor in multivesicular bodies. Large pituitary gonadotropes appear to use the Golgi complex route, and the processing may be associated with the formation of granules. The staining pattern correlates with early immunocytochemical studies that showed staining for GnRH on gonadotrope granules. We hypothesize that the granules may be sites for degradation of the ligand, separation of the ligand from its receptor, recycling of the receptor to the plasma membrane, or all three. PMID- 3525130 TI - Immunohistochemical localization of placental lactogen in binucleate cells of bovine placentomes. AB - Bovine placental lactogen (bPL) has been isolated from bovine trophoblast and characterized as a 32 K mol wt protein which exists in three different forms which differ in their isoelectric point values and their amino acid compositions. Two of the three forms have been shown to have both bovine GH (bGH)- and bovine PRL (bPRL)-like activities equal on a molar basis to bGH and BPRL in radioreceptor assays. It has been postulated that, in sheep, PL is delivered to the maternal circulation by the migration of fetal binucleate cells from the trophoblast across the fetal-maternal boundary into the uterine epithelium. To determine whether an analogous situation exists in the cow, antibodies to bPL were used to localize bPL in bovine placentomes and to measure its concentration in fetal and maternal sera. For cytology, bPL was localized on sections of placentomes from midgestation and term bovine placentas using an indirect immunoperoxidase technique. Stained binucleate cells were demonstrated throughout the trophoblast, often in close association with the microvillous boundary which separates the trophoblast from the maternal epithelium. In cross-sections of fetal villi, binucleate cells with cytoplasmic processes extending into and through the uterine epithelium were immunostained as well as cells within the plane of the uterine epithelium in close approximation or apposition to the maternal basement membrane. RIA demonstrated bPL to be present in maternal sera in concentrations of 1-2 ng/ml and in fetal sera at 5-12 ng/ml. These data are consistent with the hypothesis that binucleate cell migration accomplishes the delivery of bPL to the maternal circulation. PMID- 3525131 TI - Unexpected presence of estrogens in culture medium supplements: subsequent metabolism by the yeast Sacchromyces cerevisiae. AB - We have previously shown the presence of 17 beta-estradiol in extracts of commercially prepared Saccharomyces cerevisiae ss well as the production of estradiol by yeast grown in the laboratory. In our current study, yeast grown in a chemically defined medium synthesized estradiol in only small amounts, (less than 500 pg/liter). We have analyzed a variety of media commonly used for growing yeast and found that substantial estradiol production (greater than 5 ng/liter) was obtained when yeast were grown in medium supplemented with Bacto-peptone. The peptone was shown to contain significant amounts of estrone, and the results of the experiments establish a precursor-product relationship where estrone from the medium is metabolized to estradiol by S. cerevisiae. Studies with added [3H]estrone demonstrated rapid conversion into [3H]estradiol and a 3H-labeled nonpolar estrogen derivative. The commercially obtained yeast used previously had been grown in a molasses medium. We demonstrate here that the molasses medium contains substantial amounts of estrone and estradiol. We conclude that the conversion of estrone in a culture medium to estradiol in laboratory grown yeast and estrone and estradiol present in the commercially grown yeast medium account for the majority of estradiol found in yeast. PMID- 3525132 TI - Ovulation-inducing activity of synthetic luliberin (LH-RH). PMID- 3525133 TI - Initial experience with thrombin as injection agent for bleeding gastroduodenal lesions. PMID- 3525134 TI - Endoscopic ultrasonography of an arteriovenous malformation in a gastric polyp. AB - A case of arteriovenous malformation in a gastric polyp in a 60-year-old male complicated by profuse bleeding after endoscopic polypectomy, and treated successfully by emergency surgery, is presented. The vascular abnormality was clearly visualized by endoscopic ultrasonography (EUS) prior to endoscopic removal of the polyp. Although endoscopic coagulation of the pedicle proceeded slowly and with the utmost care causing apparently adequate coagulation of the stalk, the depth, of coagulation appeared insufficient to prevent major haemorrhage. From this experience we would be inclined to recommend EUS examination of the pedicle of large polypoid lesions to document the size of the vascular structure before endoscopic transection is carried out. PMID- 3525135 TI - Comparison of the structure of ribosomal 5S RNA from E. coli and from rat liver using X-ray scattering and dynamic light scattering. AB - The structure of eukaryotic ribosomal 5S RNA from rat liver and of prokaryotic 5S RNA from E. coli (A-conformer) have been investigated by scattering methods. For both molecules, a molar mass of 44,500 +/- 4,000 was determined from small angle X-ray scattering as well as from dynamic light scattering. The shape parameters of the two rRNAs, volume Vc, surface Oc, radius of gyration Rs, maximum dimension of the molecule L, thickness D, and cross section radius of gyration Rsq, agree within the experimental error limits. The mean values are Vc = 57 +/- 3 nm3, Oc = 165 +/- 10 nm2, Rs = 3.37 +/- 0.05 nm, L = 10.8 +/- 0.7 nm, D = 1.57 +/- 0.07 nm, Rsq = 0.92 +/- 0.01 nm. Identical structures for the E. coli 5S rRNA and the rat liver 5S rRNA at a resolution of 1 nm can be deduced from this agreement and from the comparison of experimental X-ray scattering curves and of experimental electron distance distribution functions. The flat shape model derived for prokaryotic and eukaryotic 5S rRNA shows a compact region and two protruding arms. Double helical stems are eleven-fold helices with a mean base pair distance of 0.28 nm. Combining the shape information obtained from X-ray scattering with the information about the frictional behaviour of the molecules, deduced from the diffusion coefficients D020, w = (5.9 +/- 0.2) X 10(-7) cm2 s-1 and (6.2 +/- 0.2) X 10(-7) cm2 s-1 for rat liver 5S rRNA and E. coli 5S rRNA, respectively.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3525136 TI - Induction of SOS genes of Escherichia coli by chromium compounds. AB - The induction of several SOS genes of Escherichia coli such as recA, umuC, and sfiA by hexavalent (K2Cr2O7, K2CrO4, and CrO3) and trivalent (CrCl3, Cr(NO3)3, and (CH3COO)3Cr) compounds of chromium was studied. Induction was measured as beta-galactosidase activity, using lacZ gene fusions under the control region of different SOS genes. The hexavalent chromium forms induced the genes responsible for massive synthesis of RecA protein, error-prone repair, and inhibition of cell division. On the other hand, the trivalent chromium compounds were unable to induce any of the SOS genes tested. Individual assay of hexavalent chromium compounds showed that K2Cr2O7 was a stronger inducing agent of those three SOS genes tested than K2CrO4, which, in turn, was stronger than CrO3. All this data led to the conclusion that hexavalent chromium compounds, but not trivalent, are proficient agents of induction of the SOS system and can produce indirect mutagenesis in Escherichia coli. PMID- 3525137 TI - Mutagenicity study on pyrazole, seven pyrazole derivatives, and two nitroimidazoles with the L-arabinose resistance test of Salmonella typhimurium. AB - The mutagenicity of pyrazole and seven pyrazole derivatives (4-nitropyrazole, 4 bromopyrazole, 1-methyl-4-nitropyrazole, 3,5-dimethyl-4-nitropyrazole, 1-methyl-4 bromopyrazole, 4,4'-dinitro-1, 1'-methylene-dipyrazole and 4,4'-dibromo-1,1' methylene-dipyrazole) has been investigated with the L-arabinose forward mutation assay of Salmonella typhimurium. Two nitroimidazoles (1-methyl-5-nitroimidazole and metronidazole) were included as reference drugs. The mutagenicity of each chemical was determined by both preincubation and liquid tests, in the presence or absence of S9 microsomal fraction. The mutagenic response was expressed as the absolute number of L-arabinose resistant mutants growing in selective plates, supplemented with traces of D-glucose. Strain BA13 with a wildtype lipopolysaccharide barrier was used as a comparison to the deep rough derivative BA9. No mutagenic effect was detected with pyrazole and two of its derivatives, 1 methyl-4-bromopyrazole and 4,4'-dibromo-1,1'-methylene-dipyrazole. The other five pyrazole derivatives were mutagenic to different degrees, although their mutagenic potencies were always considerably lower than those of the two nitroimidazoles. The results suggest that 4-nitropyrazoles, as well as 4,4' dinitro-1, 1'-methylene-dipyrazoles, should be investigated further as alternatives to, or even substitutes for, the currently used nitroimidazoles. PMID- 3525138 TI - NPPD (spy dust) is predicted to be a mutagen. AB - With the aid of CASE, the Computer Automated Structure Evaluation system, a new artificial intelligence procedure to study structure-activity relationships and a data base consisting of 233 monocyclic nitroarenes, it is predicted that 5-(4 nitrophenyl)-2,4-pentadienal will be mutagenic for Salmonella typhimurium but that the activity will be very low. PMID- 3525139 TI - Target sequences for mutagenesis in Salmonella histidine-requiring mutants. AB - Nucleotide target sequences involved in reversion to the wild type phenotype are diagrammed for Salmonella frameshift histidine-requiring mutants hisD3052, hisD3018, hisD6610, and hisD6580 and for base-substitution mutants hisG46 and hisG428. Frameshift strain hisC3076 probably reverts by nucleotide changes similar to those that occur during reversion of hisD3018 and hisD6610. Multiple modes of reversion characterize each strain. Each strain also has a particularly diagnostic mutagen-susceptible sequence. These highly mutagen-susceptible stretches are the hisD3052 GCGCGCGC sequence, the hisD6610 CCCCCC sequence, the hisD6580 AAAAA sequence, and the A/T containing codon of hisG428 and G/C containing codon of hisG46, respectively. Between them, hisG46 and hisG428 are reverted by all of the six possible base substitution transition and transversion mutations. PMID- 3525140 TI - A review of the symposium on aneuploidy: etiology and mechanism. AB - A symposium titled "Aneuploidy: Etiology and Mechanisms" was held in Washington, D.C., in March, 1985. The stimulus for convening it was the growing concern that environmental agents with the capacity to induce aneuploidy can have detrimental effects on human health. Major components of the symposium were devoted to an analysis of human aneuploidy, mechanisms by which aneuploidy originates, and tests for the symposium, its conclusions, and major uncertainties in the field. PMID- 3525141 TI - The demonstration of the migration of talc from the vagina and posterior uterus to the ovary in the rat. PMID- 3525142 TI - The effect of ultraviolet radiation on humoral immune responses to T-dependent antigens. AB - Multiple exposures to broadband ultraviolet (uv) radiation resulted in alterations in the ability of BALB/c mice to produce antibodies to the T dependent antigens ovalbumin and sheep erythrocytes following intraperitoneal, intradermal, and intravenous inoculation. A number of differences were observed in the influence of uv radiation on the specific cells producing antibody, as opposed to pure serological analyses. While both enhancement and reduction of the humoral response occurred, the experiments have suggested that the alterations in antibody responses following uv irradiation appear to be dependent on the nature of the antigen, the route of antigen administration, and the sometimes transient nature of the responses. The intradermal route of antigen inoculation was under the greatest influence of uv radiation. PMID- 3525143 TI - Risk analysis of multiple environmental factors: radiation, zinc, cadmium, and calcium. AB - Simultaneous effects of four risk factors, i.e., radiation exposure at a sublethal dose and excessive administration of zinc or cadmium and calcium deprivation, were examined by animal experiments. Deaths among 360 mice within 30 days after the whole body irradiation of 524-617 rad gamma rays were observed under 36 experimental conditions set by all possible combinations of varied levels of the four risk factors. A similar experiment was conducted a month later to check the reproducibility by using another 360 mice. The reproducibility of the experiment was confirmed and therefore the data from the two experiments were pooled. The analysis of data based on a multiple logistic model suggested that administration of zinc acts protectively against radiation. PMID- 3525145 TI - Quality-of-life measures: hospital interview versus home questionnaire. AB - Measures adapted from social survey research were used to assess the quality of life of 33 end-stage renal disease (ESRD) patients in a 2-week test-retest design that varied both location and format of administration (hospital interview vs. home self-administered questionnaire). The measures were found to have substantial consistency over time, location, and format. These results indicate that quality of life is a stable construct and support the usefulness of questionnaire quality-of-life measures for evaluating medical interventions. PMID- 3525144 TI - Effects of castanospermine on purified lysosomal alpha-1,4-glucosidase. AB - The indolizidine alkaloid castanospermine (1,6,7,8 tetrahydroxyoctahydroindolizine) inhibits hydrolysis of maltose, glycogen and isomaltose by purified lysosomal alpha-glucosidase yielding Ki values of 0.095, 0.10 and 0.30 mumol/l, respectively. Castanospermine exhibited high affinity for both the maltose and isomaltose sites. In distinct contrast, the alkaloid exhibited little or no affinity for the site catalyzing hydrolysis of glycogen as indicated by a noncompetitive mode of inhibition. Kinetic data presented in this report indicate castanospermine to be a very potent inhibitor of lysosomal alpha glucosidase. PMID- 3525146 TI - Two cases of abnormal equine pregnancy associated with excess foetal fluid. PMID- 3525147 TI - Professor Albert Messervy. PMID- 3525148 TI - Expression of murine and human granulocyte-macrophage colony-stimulating factors in S. cerevisiae: mutagenesis of the potential glycosylation sites. AB - Murine (m) and human (h) granulocyte--macrophage colony-stimulating factors (GM CSF) have been expressed in large quantities in Saccharomyces cerevisiae using a secretion vector containing the promoter and leader sequences of the mating pheromone alpha-factor. Functionally active mGM-CSF was identified by a proliferation assay with a factor-dependent cell line and by a granulocyte- macrophage colony formation assay using bone marrow cells. The activity of hGM CSF was confirmed by stimulation of granulocyte--macrophage colony formation using human cord blood cells. Murine GM-CSF with various apparent mol. wts (13, 18, 24, 34 and 40 kd, as well as a smear of higher mol. wts) was detected in yeast culture medium by protein blotting using a rat monoclonal antibody specific for the mGM-CSF N-terminal region peptide. Protein blotting using a rat monoclonal antibody specific for the hGM-CSF N-terminal region demonstrated that a 15.6-kd and higher mol. wt heterogeneous species were secreted. Mutations introduced at each of the two potential N-linked glycosylation sites in mGM-CSF showed that the 13-kd protein is not glycosylated and the major 18-kd protein is mainly glycosylated at the more C-terminal site, whereas the heterogeneous higher mol. wt species were not affected by the mutations. The N-terminal amino acid of the 13-kd protein was shown to be Ser which was four amino acids in the C terminal direction from the fusion point. PMID- 3525150 TI - The karyotype and ploidy of Trypanosoma cruzi. AB - Little is known of the number or organization of chromosomes in Trypanosoma cruzi, the protozoan parasite responsible for Chagas' disease in man in the New World. Straightforward cytogenetic analysis is precluded because trypanosome chromosomes fail to condense during the cell cycle. We have size-fractionated the chromosome-sized DNA molecules of representative T. cruzi strains by pulsed field gradient (PFG) gel electrophoresis and located several housekeeping genes by Southern blotting using cDNA probes from the related trypanosome T. brucei. We show that DNA molecules from homologous chromosomes of T. cruzi migrate differently in the PFG system and infer that T. cruzi epimastigotes are at minimum diploid. In contrast to T. brucei, mini-chromosomes are absent in T. cruzi. All the housekeeping genes studied hybridize to DNA molecules which can be resolved in the PFG system, suggesting that T. cruzi may have no chromosomes larger than a few megabase pairs. PMID- 3525149 TI - Modulation of the level of expression of cellular genes in adenovirus 12-infected and transformed human cells. AB - The level of expression of thymidine kinase (TK), heat shock protein 70 (HSP70), beta-tubulin and p53 was assessed in human embryo kidney cells (HEKs) infected with adenovirus type 12 (Ad 12) and Ad 12 early region 1 (E1) mutants. HSP70, beta-tubulin and p53 levels were unchanged but TK activity was dramatically increased following wild-type infection. The initial activation of TK required the expression of the product of the E1A 13S mRNA but sustained expression only occurred with those viruses expressing the E1B proteins as well. A number of human cell lines transformed with either Ad 12 or Ad 5 E1 DNA were also assessed for the level of expression of HSP70, beta-tubulin and p53. Both HSP70 and beta tubulin levels were greatly increased compared with primary human cells although there was considerable variation between lines. p53 was only expressed at high levels in Ad 12-transformed lines expressing E1A and E1B proteins. PMID- 3525151 TI - A temperature-sensitive mutant in the gene rplX for ribosomal protein L24 and its suppression by spontaneous mutations in a 23S rRNA gene of Escherichia coli. AB - A temperature-sensitive mutant with an altered ribosomal protein L24 was analysed. Revertant analysis showed that the temperature-sensitive growth was correlated with the altered protein. A DNA segment containing the mutant rplX gene was cloned and sequenced. The GGC codon for glycine at the amino acid position 84 of the protein was found to be altered to a GAC codon for aspartic acid. By transforming the rplX mutant with a plasmid carrying the rrnB operon and by selecting for temperature-resistant transformants we obtained two spontaneous suppressor mutants in the gene for 23S rRNA. DNA sequence analysis of the region corresponding to the 5' end of the 23S rRNA showed a C to T alteration at position 33 in both mutants and an additional A to G alteration at position 466 in one of them. The results suggest intimate interaction of protein L24 and the 5' end of 23S rRNA in vivo and support a secondary structure model of the 23S rRNA which brings these mutational points into a close contact. PMID- 3525152 TI - Growth hormone regulation in two types of aerobic exercise of equal oxygen uptake. AB - Five normal men, aged 23 to 35 years, participated in two bouts of continuous aerobic cycling separated by five days. The first type of exercise (EI) was cycling at a pedalling frequency of 50 rev X min-1 with a load which produced a steady state O2 uptake of approximately 40% of the subjects' VO2max. The second type of exercise (EII) was cycling at a pedalling frequency of 90 rev X min-1 with a load such that an equal steady state VO2 was reached and maintained. Both EI and EII lasted 40 min. GH levels increased in EI and EII, reaching their maximum at 8 min of recovery (245 and 300% of resting values, respectively). No significant differences were observed between EI and EII in GH, lactate, glucagon, insulin, cortisol and glucose levels between the two exercises. While it has been reported earlier that GH levels were frequently related to lactate levels and/or decreased O2 availability (Sutton 1977; Raynaud et al. 1981; Kozlowski et al. 1983; VanHelder et al. 1984a, b), this study suggests that the opposite is also valid, that is, different types of exercise of equal VO2, duration and lactate production do not produce significantly different GH responses. PMID- 3525154 TI - Increased glucagon secretion during hyperthermia in a sauna. AB - Plasma glucagon, adrenaline, noradrenaline, insulin and glucose concentrations were measured in 7 healthy young males during hyperthermia in a sauna bath: plasma glucagon levels increased from baseline values of 127.0 +/- 12.9 (SEM) pg X ml-1 to a maximum of 173.6 +/- 16.1 (SEM) pg X ml-1 at the 20th min of exposure. No change in plasma insulin and a slight increase in plasma glucose concentration were seen. Since a concomitant moderate increase in plasma catecholamine levels was also present, the adrenergic stimulus is believed to trigger glucagon release during hyperthermia. Diminished visceral blood flow, known to occur in sauna baths, may cause a decrease in the degradation of plasma glucagon and thus contribute to the elevated plasma glucagon levels. PMID- 3525155 TI - The isolation, purification and amino-acid sequence of insulin from the teleost fish Cottus scorpius (daddy sculpin). AB - Insulin from the principal islets of the teleost fish, Cottus scorpius (daddy sculpin), has been isolated and sequenced. Purification involved acid/alcohol extraction, gel filtration, and reverse-phase high-performance liquid chromatography to yield nearly 1 mg pure insulin/g wet weight islet tissue. Biological potency was estimated as 40% compared to porcine insulin. The sculpin insulin crystallised in the absence of zinc ions although zinc is known to be present in the islets in significant amounts. Two other hormones, glucagon and pancreatic polypeptide, were copurified with the insulin, and an N-terminal sequence for pancreatic polypeptide was determined. The primary structure of sculpin insulin shows a number of sequence changes unique so far amongst teleost fish. These changes occur at A14 (Arg), A15 (Val), and B2 (Asp). The B chain contains 29 amino acids and there is no N-terminal extension as seen with several other fish. Presumably as a result of the amino acid substitutions, sculpin insulin does not readily form crystals containing zinc-insulin hexamers, despite the presence of the coordinating B10 His. PMID- 3525153 TI - Metabolic and endocrine responses to graded exercise under acute hypoxia. AB - Eight male subjects (24 +/- 1 years old) performed graded ergocycle exercises in normoxic (N) and acute hypoxic (H) conditions (14.5% O2). VO2max decreased from 55.5 +/- 1.3 to 45.8 +/- 1.4 ml . kg-1 . min-1 in H condition. Plasma glucose and free fatty acid concentrations remained unchanged throughout exercise in both conditions. Increase in blood lactate concentration was associated with relative workload in both conditions. At VO2max lactate concentrations were similar in the two conditions, plasma insulin, glucagon, and LH concentrations did not significantly change in either. Plasma delta 4-androstenedione and testosterone increased in a similar manner in both conditions. Finally plasma norepinephrine concentration reached at VO2max was significantly lower in hypoxia. These results suggest that acute moderate hypoxia does not affect metabolic and hormonal responses to short exercise performed at similar relative workloads, i.e. when the reduction of VO2max due to hypoxia is taken into consideration. The lower catecholamine response to maximal exercise under acute hypoxia might suggest that the sympathetic response could be related to relative as well as absolute workloads. PMID- 3525156 TI - Insulin receptors of chicken liver and brain. Characterization of alpha and beta subunit properties. AB - Receptors on membranes of chicken liver and brain bound porcine 125I-insulin in a specific and temperature-dependent manner. Competition with unlabeled insulin derivatives exhibited typical insulin potency ratios, i.e. chicken greater than porcine insulin greater than human proinsulin (2.1/1/0.02). Apparent binding affinity was higher in brain with a 50% inhibition of tracer binding of 1.3 +/- 0.2 nM porcine insulin as compared to 2.8 +/- 0.3 nM in liver. The apparent molecular mass of the 125I-insulin cross-linked alpha subunit of the insulin receptor was 139 +/- 2 kDa for chicken liver and 127 +/- 2 kDa for chicken brain. These molecular masses were similar to those of rat liver and brain insulin receptors. Neuraminidase treatment of the cross-linked insulin receptor increased the mobility of the alpha subunit from liver but did not affect that from brain, suggesting a difference in the glycosylation of the chicken brain alpha subunit as previously described in the rat. Despite this change, both receptors could be purified on wheat germ agglutinin (WGA) chromatography after Triton solubilization. In the presence of CTP and vanadate (phosphatase inhibitors) insulin-stimulatable tyrosine-specific phosphorylation of exogenous substrates was demonstrated with chicken liver and brain receptors. The reaction was dependent on Mg2+ and Mn2+. As noted with other insulin receptors, the best artificial substrate for phosphorylation was poly(Glu,Tyr)4:1. In both chicken liver and brain the smallest effective insulin dose as well as maximal stimulation of phosphorylation of the substrate was similar to that seen with rat liver, and in all three tissues chicken insulin was more potent than porcine insulin. In chicken liver an active ATP hydrolytic activity copurified with the insulin receptors during WGA chromatography. Further purification using S-300 Sephacryl filtration or affinity (insulin-biotin-avidin) chromatography could dissociate the phosphorylation and the hydrolytic activities. Gel electrophoresis, under reducing conditions revealed beta subunits with apparent Mr of 97-99 kDa in chicken liver and brain, which were phosphorylated in the presence of insulin. Similar apparent molecular masses have been described for the beta subunit of rat liver receptors. These studies suggest that both chicken brain and liver insulin receptors exhibit coupling of alpha and beta subunits with fully active tyrosine kinase and that the structural difference of the brain insulin receptor is widespread and phylogenetically old. PMID- 3525157 TI - Transport and processing of endocytosed lysosomal alpha-glucosidase in cultured human skin fibroblasts. AB - In the present study we have characterised the molecular products that arise from processing of a precursor form of alpha-glucosidase isolated from urine after endocytosis at 37 degrees C by cultured human skin fibroblasts. The urinary precursor (Mr 110 000) was processed to forms with Mr of 100 000, 80 000 and 74 000. These forms were approximately 4000 Da larger than the corresponding forms of endogenously synthesized alpha-glucosidase. Digestion of the different forms of the enzyme with endoglycosidase F showed that the differences in apparent molecular mass between the exogenous and corresponding endogenous forms were due to difference in glycosylation. Intracellular transport of endocytosed alpha glucosidase was followed by incubating fibroblast homogenates with glycyl-L phenylalanine-beta-naphthylamide (Gly-Phe-NH-Nap), which leads to specific lysis of lysosomes. Transport to the lysosomes was a fast process: within 45 min after endocytosis more than 50% of the enzyme was present in the lysosome. The first step in the processing of endocytosed alpha-glucosidase started in a Gly-Phe-NH Nap-insensitive (prelysosomal) compartment, but further processing of the enzyme to lower-Mr forms was coupled to transport to the lysosomes. Processing of alpha glucosidase after uptake at 20 degrees C was also studied. At this temperature the enzyme accumulated in an organelle with a low buoyant density, presumably the endosome; this compartment appeared to be heterogeneous, ranging in density from 1.04 g/ml to 1.08 g/ml. Under these conditions only the first step in the processing of the enzyme occurred. It is concluded that endocytosed enzyme is processed more rapidly than endogenously synthesized enzyme owing to the fact that endocytosed enzyme is transported more rapidly to the lysosomes. Furthermore, processing may start in a prelysosomal organelle. PMID- 3525158 TI - Detection and partial characterization of the chromatin-associated proteases of yeast Saccharomyces cerevisiae. AB - The chromatin fraction was prepared from yeast Saccharomyces cerevisiae free from cytoplasmic contamination except for a trace of mitochondria. When the yeast chromatin was incubated with histones as a substrate it showed three peaks of proteolytic activity as approximately pH 4, pH 7 and pH 11. These activities were separated from each other by differential extractions from chromatin and successive gel filtration through Sephadex G-100. Proteases were partially characterized by affinity labeling with [3H]diisopropylfluorophosphate (iPr2P-F) and by various protease inhibitors. The neutral and the alkaline proteases were serine proteases with a molecular mass of 35 kDa and 25 kDa respectively. The acidic protease showed a molecular size larger than 100 kDa on the gel filtration, and was probably an aspartyl protease because it was most strongly inhibited by pepstatin. A iPr2P-F-binding protein with a molecular mass of 66 kDa, found in chromatin, was likely to be converted to the alkaline protease of 25 kDa when chromatin was incubated at pH 10 or in 6 M urea/0.1 M phosphoric acid at the extraction. The distribution of proteolytic activities and iPr2P-F-binding proteins were compared among chromatins from different strains and from cells in different growth phases and it was found that these three proteases were present in all of them but with different proportions. Considering that rat liver chromatin contains equivalents to these proteases [Tsurugi, K. and Ogata, K. (1982) J. Biochem. (Tokyo) 92, 1369-1381], the results suggested that they play some important roles in the function of eukaryotic chromatin. PMID- 3525159 TI - Limited proteolysis of lactose permease from Escherichia coli. AB - Escherichia coli lactose permease (also referred to as lactose carrier) is an integral protein of the cytoplasmic membrane. Using lactose permease either radiolabeled biosynthetically in plasmid-bearing E. coli minicells or radioalkylated post-synthetically by chemical modification, we have determined sites on the membrane-bound protein accessible to proteolytic attack and we have characterized several high-molecular-mass products. The most prominent polypeptide obtained from lactose permease radiolabeled biosynthetically is observed after digestion with different proteases. The fragment produced by thermolysin was shown to contain the intact N-terminus and to extend into the region around amino acid residue 140 which, according to secondary structure models, is presumed to be less tightly folded than the rest of the molecule. Evidence is presented that the corresponding fragments obtained after digestion with several other proteases also originate from the N-terminal part of the protein. This N-terminal segment of the lactose carrier is resistant to proteolytic digestion even in the presence of non-ionic detergents and it may represent a tightly folded domain. Additional proteolytic cleavage sites located C-terminal of the Cys148 residue can be inferred. PMID- 3525160 TI - Isolation and characterization of the 10-kDa and 22-kDa polypeptides of higher plant photosystem 2. AB - Two polypeptides of 10 kDa and 22 kDa, shown to be components of the higher plant photosystem 2, were purified and examined. A NaCl/Triton X-100 treatment was designed, which released these two polypeptides from the thylakoid membrane, in concert with the extrinsic 16-kDa and 23-kDa proteins, concomitant with a loss in oxygen-evolution activity. After this treatment the oxygen-evolving activity of the photosystem 2 membranes devoid of the 10-kDa and the 22-kDa polypeptides could be restored with CaCl2, but not by readdition of the purified 23-kDa protein. This deficiency was caused by an inability of the 23-kDa protein to rebind to the photosystem 2 membranes. In analogy, the oxygen-evolution activity of a highly purified photosystem 2 core preparation, devoid of the 10-kDa and 22 kDa polypeptides, was stimulated by CaCl2, but not by the 23-kDa protein. We, therefore, suggest that the 10-kDa or the 22-kDa polypeptides provide a binding site for the extrinsic 23-kDa protein to the thylakoid membrane. The 10-kDa and 22-kDa polypeptides were isolated through ion-exchange chromatography in the presence of detergents. They both displayed hydrophobic properties, verified by their low proportion of polar amino acid residues and their partition to the hydrophobic phase during Triton X-114 fractionation. The purified polypeptides did not contain metallic cofactors or substances with absorption in the visible region of the spectrum. PMID- 3525161 TI - Activation in vitro of respiratory nitrate reductase of Escherichia coli K12 grown in the presence of tungstate. Involvement of molybdenum cofactor. AB - The chlorate-resistant (chlR) mutants are pleiotropically defective in molybdoenzyme activity. The inactive derivative of the molybdoenzyme, respiratory nitrate reductase, present in the cell-free extract of a chlB mutant, can be activated by the addition of protein FA, the probable active product of the chlB locus. Protein FA addition, however, cannot bring about the activation if 10 mM sodium tungstate is included in the culture medium for the chlB strain. The inclusion of a heat-treated preparation of a wild-type or chlB strain prepared after growth in the absence of tungstate, restores the protein-FA-dependent activation of nitrate reductase. All attempts to activate nitrate reductase in extracts prepared from tungstate-grown wild-type Escherichia coli strains failed. It appears that during growth with tungstate, the possession of the active chlB gene product leads to the synthesis of a nitrate reductase derivative which is distinct from that present in the tungstate-grown chlB mutant. Heat-treated preparations from chlA and chlE mutants which do not possess molybdenum cofactor activity fail to restore the activation. Fractionation by gel filtration of the heat-treated preparation from a wild-type strain produced two active peaks in the eluate of approximate Mr 12000 and less than or equal to 1500. The active material in the heat-treated extract was resistant to exposure to proteinases, but after such treatment the active component, previously of approximate Mr 12000, eluted from the gel filtration column with the material of Mr less than or equal to 1500. The active material is therefore of low molecular mass and can exist either in a protein-bound form or in an apparently free state. Molybdenum cofactor activity, assayed by the complementation of the apoprotein of NADPH:nitrate oxidoreductase in an extract of the nit-1 mutant of Neurospora crassa, gave a profile following gel filtration similar to that of the ability to restore respiratory nitrate reductase activity to the tungstate-grown chlB mutant soluble fraction. This was the case even after proteinase treatment of the heat stable fraction. Analysis of the chlC (narC) mutant, defective in the structural gene for nitrate reductase, revealed that heat treatment is not necessary for the expression of the active component. Furthermore both the active component and molybdenum cofactor activity are present in corresponding bound and free fractions in the non-heat-treated soluble subcellular fraction.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3525162 TI - A transcription terminator in the 5' non-coding region of the tyrosyl tRNA synthetase gene from Bacillus stearothermophilus. AB - The 5' non-coding region of the tyrosyl-tRNA synthetase gene (tyrS) of Bacillus stearothermophilus is 324 nucleotides long. It contains a premature terminator and a strong promoter: these were identified in vitro by RNA run-off experiments and in Escherichia coli by construction of specific mutants. The terminator consists of a stem and loop structure followed by the string of T residues characteristic of rho-independent termination. This is preceded by another stem and loop structure which may permit the formation of an anti-terminator. Neither the promoter nor the premature terminator appears to be regulated by the tyrosyl tRNA synthetase in vitro or in E. coli. PMID- 3525164 TI - Visualization of intermediary transcription states in the complex between Escherichia coli DNA-dependent RNA polymerases and a promoter-carrying DNA fragment using the gel retardation method. AB - DNA-dependent RNA polymerase in complex with a DNA fragment was analyzed by electrophoresis in non-denaturing gels as core enzyme, holoenzyme, during initiation and elongation. The DNA fragment carried the promoter A1 of the phage T7. The stoichiometry between holoenzyme and promoter and between sigma and core enzyme in complex with DNA was determined. Holoenzyme bound as a monomer to the DNA, whereas core enzyme formed aggregates before binding to the DNA. If the molar ratio of holoenzyme to DNA exceeded 0.5:1 a second holoenzyme molecule interacted with the DNA fragment with diminished affinity. A large difference in the frictional coefficient of the holoenzyme-promoter and the core enzyme-DNA complex indicated a drastic conformational difference between the two types of complexes. The stability of the holoenzyme-promoter complex decreased with decreasing temperature, accompanied by at least partial dissociation of holoenzyme into core enzyme and sigma factor. Addition of nucleoside triphosphates did not change the electrophoretic mobility of the complex if abortive transcription only was allowed, but increased it after addition of all four nucleoside triphosphates owing to release of the sigma factor. PMID- 3525163 TI - Peptide uptake by Salmonella typhimurium. The periplasmic oligopeptide-binding protein. AB - The uptake of most peptides, including many peptide antibiotics, by the oligopeptide permeases of Escherichia coli and Salmonella typhimurium requires the function of a specific peptide-binding protein (the OppA protein) located within the periplasm. The OppA protein is the largest and most abundant periplasmic substrate-binding protein known and has an unusually broad substrate binding specificity. The OppA protein has been purified to homogeneity and anti OppA antibodies have been raised. The sequence of the OppA protein has been deduced from the nucleotide sequence of the oppA gene. This protein is unrelated to any other known periplasmic substrate-binding protein, either immunologically or in its amino acid sequence. The role of this protein in peptide transport is discussed. PMID- 3525165 TI - Nucleotide sequence of the pntA and pntB genes encoding the pyridine nucleotide transhydrogenase of Escherichia coli. AB - A 3240-base-pair DNA fragment spanning the pyridine nucleotide transhydrogenase (pnt) genes of Escherichia coli has been sequenced. The sequence contains two open-reading frames, pntA and pntB of 1506 and 1386 base pairs, coding for the transhydrogenase alpha and beta subunits, respectively. The coding sequences are preceded by a promoter-like structure and are most likely co-transcribed. Each coding sequence is preceded by a Shine-Dalgarno sequence. The amino-terminal amino acid sequences were determined from the purified alpha and beta subunits of the transhydrogenase. These sequences agree with those predicted from the nucleotide sequences of the pntA and pntB genes. The predicted relative molecular masses of 53906 (alpha) and 48667 (beta) are close to the values obtained by analysis of the subunits by sodium dodecyl sulfate/polyacrylamide gel electrophoresis. Several hydrophobic regions large enough to span the cytoplasmic membrane were observed in each subunit. These results indicate that transhydrogenase is an intrinsic membrane protein. PMID- 3525166 TI - Pathophysiological mechanisms and clinical significance of ventricular late potentials. PMID- 3525167 TI - Aspirin for the prevention of coronary thrombosis: current facts and perspectives. PMID- 3525168 TI - Two-dimensional echocardiographic assessment of anticoagulant therapy in left ventricular thrombosis early after acute myocardial infarction. AB - This study was designed to assess, by two-dimensional echocardiography, the effects of anticoagulant therapy on left ventricular thrombosis detected after acute myocardial infarction. Thirty-eight patients with left ventricular thrombi detected by two-dimensional echocardiology within 5 weeks (mean 4) of the onset of infarction were randomly assigned to the following groups: group A consisted of 19 patients who received oral anticoagulants (acenocoumarin 1-6 mg daily regulated to keep prothrombin time within the range of 25 to 35%) and group B which consisted of 19 non-treated control patients. Seventeen patients from both groups were restudied 15 days, 3 months and one year later to evaluate the changes in size of thrombi. Echocardiographic examinations were read blindly; a significant decrease in ventricular thrombus size was taken as a greater than or equal to 5 mm reduction of thickness in the apical views. In Group A, 9 patients showed a complete resolution of thrombus at the 15 day study; at one year, thrombus had resolved in 15 and persisted unchanged in size in 2 patients. The mean dimension of thrombi in patients of group A was 18 +/- 6.6 mm at the screening examination and decreased to 6.6 mm, 3.8 mm and 2.2 mm, respectively, at 15 days, 3 months and one year follow-up studies. Among 17 patients of group B at the 15 day study, two had resolution of thrombus and 15 were unchanged; at the one year examination thrombus was resolved in 4, decreased in size in 4 and persisted unchanged in 9 patients. Analysis of variance of the dimensional changes of thrombi in the two groups of patients confirmed a significant efficacy of anticoagulant therapy (P less than 0.001). On the basis of our results we conclude that full-dose anticoagulant therapy, started early (within 5 weeks) after acute myocardial infarction, is effective in the resolution of left ventricular thrombosis. PMID- 3525169 TI - Cineaortography in the assessment of aortic regurgitation: a comparison of different catheter types. AB - The accuracy in diagnosing aortic regurgitation was studied in 170 consecutive cineaortograms. In 85 patients (group A) cineaortograms were undertaken with Sones or Gensini catheters, which produce a jet of contrast material directed towards the aortic valve. The other 85 patients (group B) underwent cineaortography with pigtail catheters, which may cause more equal distribution of contrast material in the aortic root. In group A, 31 of 71 patients (44%) without clinically known aortic valve disease showed angiographic grade I-III/IV aortic regurgitation. In group B only 8 of 61 patients (13%) without clinical evidence of aortic valve disease had grade I-II/IV aortic regurgitation on cineaortography. This difference is statistically significant (P less than 0.001). We conclude that catheters which produce a jet of contrast medium directed straight at the aortic valve can cause artificial trivial to moderate aortic regurgitation. Angiographic evaluation of aortic regurgitation should be performed with a catheter such as a pigtail or closed-end multiple sidehole catheter in which the contrast medium is not directed straight at the aortic valve. PMID- 3525170 TI - Fibrinolytic therapy in bacterial endocarditis: experimental studies in dogs. AB - An investigation was undertaken to assess the value of adding streptokinase therapy to standard penicillin treatment of artificially induced infective endocarditis due to Streptococcus sanguis. In pigs a low-grade infection could be induced which closely simulated streptococcal endocarditis in man, but for technical reasons this model proved unsatisfactory for further experimentation. In dogs the induction of S. sanguis endocarditis produced a more severe illness with a short natural history. Dogs were divided into two groups, one treated with penicillin alone, the other with penicillin and streptokinase. A five-day course, in which twice daily injections of an acylated streptokinase-plasminogen complex were given, caused a substantial reduction in the size of vegetations and possibly a higher proportion of cures and less damage to the valves. Infarction of the brain, almost certainly due to embolism, was significantly greater in the streptokinase treated group, but the same was not true of the kidneys. The possible value of such treatment for certain kinds of bacterial endocarditis in man, especially in the right side of the heart, is discussed. PMID- 3525171 TI - Evaluation of allograft perfusion by radionuclide first-pass study in renal failure following renal transplantation. AB - To assess the diagnostic value of indices measured on a first-pass curve, we performed 72 radionuclide renal first-pass studies (RFP) in 21 patients during the early weeks following renal allograft transplantation. The diagnosis was based on standard clinical and biochemical data and on fine needle aspiration biopsy (FNAB) of the transplant. Aortic and renal first-pass curves were filtered using a true low-pass filter and five different indices of renal perfusion were computed, using formulae from the literature. Statistical analysis performed on the aortic and renal indices indicated excellent reproducibility of the isotopic study. Although renal indices presented a rather large scatter, they all discriminated well between normal and rejection. Three indices have a particularly good diagnostic value. In the discrimination between rejection and Acute Tubular Necrosis (ATN), only one index gave satisfying results. The indices, however, indicate that there are probably ATN with an alternation of renal perfusion and rejection episodes where perfusion is almost intact. We conclude that radionuclide first-pass study allows accurate and reproducible quantitation of renal allograft perfusion. The measured parameters are helpful to followup the course of a post-transplantation renal failure episode and to gain more insight into renal ischemia following transplantation. PMID- 3525172 TI - Thyroid abnormality secondary to tortuous carotid artery. AB - A 59-year-old man was referred to the nuclear medicine service for a thyroid scan, as his neck was thick and the thyroid was not palpable. In the past the patient had undergone head and neck irradiation for acne. A 123I-thyroid scan was interpreted as a "cold" nodule in the lower pole of the right lobe, but thyroid ultrasound showed no thyroid abnormality. Repeat ultrasound examination eventually showed a tortuous carotid artery behind the lower pole of the right lobe of the thyroid that corresponded to the "cold" defect. PMID- 3525173 TI - Symbolic reasoning about myocardial scintigrams in PROLOG. AB - PROLOG (PROgramming in LOGic) is the declarative programming language at the heart of the Japanese fifth-generation computer project. It is proposed that PROLOG is a suitable tool for symbolic image processing, once standard preprocessing has been done. In the present application, the problem of prediction of coronary anatomy from myocardial scintigrams is addressed. Uncertainty is dealt with by a combination of fuzzy-set theoretic and probabilistic reasoning. Heuristic classification rules are based on clinical experience and on a set of 247 myocardial scintigrams with their corresponding coronary angiograms. PMID- 3525174 TI - The renal washout parameter as an indicator of transplant rejection. AB - The accumulation of intravascular fibrin thrombosis in both acute and chronic renal rejection leads to a delay in the transit of perfusion. This study examines the renal washout parameter as an indicator of transit time. By mathematical simulation of renal time-activity curves various factors which can influence this parameter are investigated, a simple analysis is proposed and clinical results are correlated with biopsy findings. A washout parameter greater than 28 s is found to be consistent with histologically diagnosed rejection over a range of bolus qualities. PMID- 3525175 TI - Relationship between severity of clinical symptoms and delay in gastric emptying in chronic gastritis; studied with 99mTc-DTPA scintigraphy. AB - The gastric emptying time is studied with 99mTC-DTPA-labeled mixed meal in 18 patients with chronic gastritis, all confirmed by endoscopic examination and biopsy. Emptying was slow in all such patients, but the intensity of symptomatology showed no correlation with gastric emptying half time. PMID- 3525176 TI - Intermediate-dose methotrexate in the treatment of childhood acute lymphocytic leukaemia: lack of benefit during maintenance therapy following intensive induction therapy. AB - One hundred and fifty-one children with acute lymphocytic leukaemia (ALL) received multiple agent induction chemotherapy followed by intensive phase treatment. One hundred and thirty-seven patients were randomised for the first year of maintenance treatment to receive reinforcement therapy (pulses) with either intermediate-dose methotrexate (ID-MTX) and prednisone (PRED) or vincristine (VCR) and PRED. The probability of continuous complete remission (CCR) at 5.5 years is 0.80 for the ID-MTX group and 0.84 for the VCR group. Extramedullary relapses were not prevented either in the ID-MTX group nor in the VCR group. Since in previous studies VCR/PRED pulses did not increase CCR rates when given after intensive combination chemotherapy, it can be concluded from this study that neither did ID-MTX reinforcement therapy further improve treatment results in our patients with ALL when given after aggressive chemotherapy. PMID- 3525177 TI - "Inborn errors of metabolism" and "chemical individuality", two ideas of Sir Archibald Garrod briefly revisited 50 years after his death. AB - Two ideas of Sir A. Garrod, "chemical individuality" (1902) and "inborn errors of metabolism" (1908) have proved fundamental for the development of medical knowledge. The latter idea was more fortunate than the former which, however has been extremely heuristic. On the other hand the two ideas are not entirely independent of each other: in fact, a third Garrodian concept, "inborn factors in disease", represents a significant link between them. "Inborn errors of metabolism" revived the laws of genetics and opened the way to interpretation of the molecular diseases with all their inherent practical modern implications (neonatal screening, prenatal diagnosis, and in perspective, genetic engineering). "Chemical individuality" still constitutes a valid premise for knowledge of biological individuality (in other words, the "biological ego") fundamentally programmed for conservation of self and for continuous discrimination of self versus non-self. PMID- 3525178 TI - Overnight metabolic profiles in very young insulin-dependent diabetic children. AB - The magnitude of the disturbance of metabolic control in diabetes mellitus in very young children has been recognised, but seldom studied. Limitations to studies are set by the difficulty of obtaining control data and until recently the lack of alternative therapies. Recently "mini" pumps for continuous subcutaneous insulin delivery have become available and may offer an alternative therapeutic possibility. The present investigation has been undertaken to collect overnight metabolic data of very young diabetic children (less than 6 years) controlled by standard injection therapy. During one admission to hospital frequent blood samples were collected for free insulin, glucose, alanine, lactate, glycerol and 3-hydroxybutyrate determinations. In all children (n = 9) the profiles showed a steep rise in glucose from 04.30 h (6.2 +/- 1.3 mmol/l) to 09.30 h (17.8 +/- 2.4 mmol/l) (the so-called "dawn-phenomenon"). The nature of the changes in the intermediary metabolites suggested that rise in blood glucose was caused by insufficient insulin. We have attempted to explore the time relationship between the overnight drop in free insulin levels and the rises in blood glucose by a distribution-free statistical analysis, correlating successive changes in time between the two profiles. The analysis suggested a delay of 2-6 h between free insulin levels and their effects. IN CONCLUSION: a clear "dawn phenomenon" is seen in very young diabetic children, and contributes to their poor glycaemic control. More stable and higher insulin concentrations in the early morning, obtained perhaps by continuous subcutaneous insulin infusion, might ameliorate the overall glycaemic control in the very young diabetic child. PMID- 3525179 TI - Statistical analysis of statural growth following kidney transplantation. AB - Factors affecting the growth rates of 59 children and adolescents for the first 2 years following kidney transplantation were evaluated. The factors assessed were age at transplantation, renal function, prednisone dosage, donor source, and prior history of transplantation. The observed growth velocity was expressed as the percentage of the growth velocity predicted by bone age. Normal growth (greater than or equal to 80%) was exhibited by 37% of the patients and 22% had accelerated growth (greater than or equal to 100%). The chronological age at transplantation did not correlate significantly with growth when bone age was used as the reference for expected velocity. Males grew better than did females. There was a unique sex/race interaction with black males growing most rapidly. Better renal function, the ability to lower prednisone dosage, alternate day prednisone, and a decreasing diastolic blood pressure were positively correlated with better growth rates after transplantation. Donor source and prior history of transplantation did not significantly influence growth rate. PMID- 3525181 TI - Cerebrospinal fluid beta 2-microglobulin: a study in controls and patients with metastatic and non-metastatic neurological diseases. AB - We studied cerebrospinal fluid Beta 2-microglobulin (CSF B2-m) in 197 patients with a variety of neurological diseases to evaluate the usefulness of B2-m in the detection of meningeal dissemination of malignancy. In the control group we found a relationship between CSF log B2-m and age (P less than 10(-4)). Age standardized reference values were established as 0.65-2.2 mg/l. The results show that CSF B2-m was elevated in leptomeningeal metastases from solid and haematological tumors. We observed slight elevations of CSF B2-m in epidural and parenchyma metastases from solid tumors. Our study shows that B2-m in CSF is a sensitive marker for meningeal metastases especially from hemopoietic tumors. PMID- 3525180 TI - Some comments on the clinical use of evoked potentials. AB - In this survey we describe the uses of somatosensory, visual, and auditory evoked potentials (EPs), adding some critical comments on the values and pitfalls of these methods. It must be stressed that the application of EPs is most valuable when combined with a thorough neurological examination. There is general agreement that EP measurement is one of the best techniques for objective, noninvasive study of brain function in humans. PMID- 3525182 TI - Adenovirus replication as an in vitro probe for drug sensitivity in human tumors. AB - The feasibility of using adenovirus 5 as an in vitro probe for chemosensitivity in short-term cultures of human tumors was evaluated using human melanoma cell lines and primary cultures of melanoma biopsies. A convenient immunoperoxidase method was developed for quantitating viral replication 2 days after infection. Two different approaches were explored: the host cell reactivation assay (HCR) using drug-treated virus; and the viral capacity assay using drug-treated cells. The HCR assay detected sensitivity to 5-(3-methyl-1-triazeno)imidazole-4 carboxamide (MTIC) in Mer- (methyl excision repair deficient) cell lines as decreased ability of the cells to replicate MTIC-treated virus. This test should be applicable to DNA-damaging agents and repair-deficient tumors. Adenovirus replicated readily in nonproliferating primary cultures of melanoma biopsies; application of the HCR assays to this material identified one Mer- sample of 11 tested. Herpes viruses were not suitable for use in HCR because herpes simplex virus type 1 failed to distinguish Mer- from Mer+ melanoma cells; and nonproductive infection of MTIC-sensitive lymphoid cells with Epstein-Barr virus yielded an MTIC-resistant cell line. The second assay (viral capacity) involved determination of the inhibition of replication of untreated virus in treated cells. This approach correctly predicted sensitivity to hydroxyurea and deoxyadenosine in melanoma cell lines when compared with clonogenic survival assay. Viral capacity was also inhibited by cytosine arabinoside, fluorouracil, vincristine, adriamycin, 6-mercaptopurine and ionising radiation, and may therefore be useful for detecting sensitivity to a wide range of antitumor agents. PMID- 3525183 TI - Treatment of malignant lymphoma with high dose of chemo or chemoradiotherapy and bone marrow transplantation. AB - Twenty-eight patients with malignant lymphoma were treated with high dose chemo or chemoradiotherapy and allogeneic or autologous bone marrow transplantation. They can be divided in two groups: Group 1: (19 pts) consisted in patients in relapse or in n complete remission (n greater than 2) (high risk patients); Group 2 (9 pts) consisted in patients in first or second complete remission at time of bone marrow graft (standard risk patients). Complete remission was achieved in 11/17 patients evaluable for response (65%). Duration of response is very different for two groups: in group 1, all patients relapsed within a median of 2 months (range: 1-12) and died within a median of 7 months (range: 2.5-15). In group 2, 7/9 are alive and well in unmaintained CCR in a median of greater than 18 months (range: greater than 15- greater than 36) (P less than 0.01). This experience shows the feasibility of this approach, the obvious antitumoral activity of these conditioning regimens and invited us to use such therapy at an earlier stage of the disease. PMID- 3525184 TI - Protein as a fuel for endurance exercise. PMID- 3525185 TI - Physiology of upper body exercise. PMID- 3525186 TI - Sleep deprivation and exercise. PMID- 3525187 TI - Cardiovascular adaptation to exercise at high altitude. AB - To exercise at high altitude means working in an environment with reduced atmospheric pressure. The oxygen tension of the inspired air is therefore decreased, that is, there is atmospheric hypoxia. Exercise increases oxygen requirements which must now be met in the face of this decreased oxygen driving pressure. The initial handicap is less complete oxygenation of blood within the lung. In an effort to preserve oxygen delivery, a greater volume of blood is circulated, that is, cardiac output is increased. However, this pattern of compensation is only temporary. Within days, hemoconcentration increases the oxygen-carrying capacity of the blood, and as a consequence, less cardiac output is required to maintain oxygen delivery. In fact, cardiac output decreases to levels lower than existed prior to ascent. This reduction in cardiac output results primarily from a decrease in stroke volume due to less venous return secondary to the smaller blood volume produced by hemoconcentration. The hypoxia of high altitude produces sustained stimulation of the sympathetic nervous system. Initially, this increases heart rate, but, with time, the responsiveness of the heart decreases, so the initial tachycardia may not be sustained. Other consequences of sympathetic stimulation include an increase in resting metabolic rate, a shift away from glycogen toward free fatty acids as primary energy sources, and bone marrow stimulation to increase red cell production. The parasympathetic nervous system may also be stimulated at high altitude, which may explain the reduction in maximum heart rate. Upon arrival at high altitude, aerobic working capacity is reduced. Although this may or may not be attenuated following adaptation, endurance capacity does seem to improve. Several parallels therefore emerge between adaptation to the hypoxia of high altitude and adaptation to the struggle for oxygen created by exercise training at low altitude. Sympathetic stimulation is common to both forms of hypoxic stress, and similar responses, particularly metabolic, result. Not surprisingly, then, exercise training provides an advantage to adaptation to high altitude. PMID- 3525188 TI - Applicability of body composition techniques and constants for children and youths. AB - This review has focused on the chemical immaturity of children and the implications for body composition estimates. Prepubescent and pubescent children deviate considerably in fat-free body composition from the adult reference male, and this has lead investigators to overestimate body fatness in this population using conventional body composition formulas. The use of multicomponent approaches to body composition to obtain more accurate estimates of body fatness in children has provided new information on the body composition of this population. Sex- and age-specific constants, to replace those derived from the reference male, are suggested for further testing and verification as well as for use in the clinical setting. The chemical immaturity in children has its greatest effect on estimating the extent of obesity in children 6 to 11 years of age and in estimating body fatness in the lean, athletic, prepubescent population. Previous estimates of the growth rate of fat and fat-free body are also affected by chemical immaturity. Further research is needed to study the impact of physical activity and inactivity on the composition of the fat-free body during growth, to develop constants for more accurate estimates of fatness in physically active samples of all ages and to validate the constants presented in the less active populations. Future research with multicomponent body composition systems in all populations of children and youth is essential for progress in this area. Results will have an important contribution to the estimation of childhood obesity, prediction of minimal weight in the athletic population and estimates of growth rate of fat and fat-free body mass. The development of body composition methodologies which more accurately measure the growth of muscle and bone as well as fat is a major challenge ahead. PMID- 3525189 TI - Pediatric and adolescent sports injuries: recent trends. PMID- 3525190 TI - Biomechanical consequences of sport shoe design. PMID- 3525191 TI - The biomechanics of the long jump. AB - The preceding review has been based on over 200 publications in Czech, English, French, German, Japanese, Polish, and Russian. Even a cursory perusal of these materials is sufficient to show that much has been done to try and obtain a scientific understanding of long jump techniques. It is clear, too, that still more remains to be done. Much of the work to date has been focused on just a few aspects of long jump technique. Other important aspects have received relatively little attention. The latter include the accuracy of the approach, the techniques used during the final strides of the approach, the role of elastic energy in the takeoff, the initiation and control of the jumper's angular momentum, and the techniques used in the landing. Future research efforts might well be directed towards resolving major issues concerning these aspects of long jump technique. The methods used to gather data in the studies reviewed have been rather unimaginative. Two-dimensional cinematography has been used in the vast majority of the studies and force platforms in a few. Other data-gathering procedures like three-dimensional cinematography, electromyography and accelerometry have rarely, if ever, been used. In only one or two studies was anything remotely approaching experimental or technological innovation in evidence. The methods used to analyze data have also been very limited. With the notable exception of a study by Ballreich, few papers have involved anything more sophisticated than means, standard deviations, correlation coefficients and an occasional multiple regression equation. Given these facts, it is hard to avoid the conclusion that our knowledge of long jump techniques might be greatly improved if the full range of available and appropriate procedures were turned to the purpose. Finally, no review of the literature on long jump techniques would be complete without reference to the level of scholarship displayed in the works under consideration. With only a few exceptions, the level shown in the scientific papers reviewed here left much to be desired. Time and again, variables were not defined, crucial measurement techniques were not described and major results were not presented or discussed. In addition, much of the data presented in tables and graphs were patently in error. In light of all this, it is clear that unless the level of scholarship improves, future progress in this area of sports biomechanics is likely to be very slow. PMID- 3525192 TI - Isokinetic dynamometry: implications for muscle testing and rehabilitation. AB - Isokinetic exercise has become an increasingly popular modality in rehabilitative medicine during the past decade. The facility by which isokinetic dynamometers provide information about dynamic muscle contractions has, no doubt, been a major factor in this popularity. Isokinetic dynamometers are passive devices which resist applied forces and control the speed of exercise at a predetermined rate. Such dynamometers generally provide a record of applied force throughout a joint range of motion. Some of the postulated advantages of isokinetic exercise include safety, accommodating resistance and the facility for muscle force analysis. In spite of the advantages that isokinetic dynamometry provides, there are a number of considerations that are important in the interpretation of force recordings. While the term "isokinetics" generally denotes a type of muscular contraction which accompanies a constant rate of limb movement, periods of acceleration and deceleration exist in the context of isokinetic exercise. The acceleration and subsequent oscillatory and deceleration periods of "isokinetic" exercise limit the duration of the period of constant velocity in exercises with isokinetic dynamometry. Impact artifacts on torque records result from the compliance of the dynamometer system as it adjusts the accelerating limb to the present speed. The position at which peak torque occurs in a joint range varies with speed of motion. Therefore, analysis of maximal values at specific joint angles across speeds should be made in addition to the peak values generated throughout a joint range. The shape of the isokinetic force-velocity curve differs from the classic curve derived from prepared muscle specimens. As speed approaches zero, the isokinetic muscular force tends to rise much less steeply than that of the in vitro curve. Because measurements of absolute maximal force or velocity are subject to constraints in human studies, the direct comparison of in vivo to in vitro force-velocity curves is not justified. Neural inhibition of the force generated in intact muscle as tension rises has been postulated as a possible mechanism retarding the force curve at slow speeds. The reliability of specific types of isokinetic dynamometers appears to be quite high when test-retest analyses are performed with inert weights. Whether submaximal or maximal warm-ups are essential to ensure stable measures is still questionable at this time. It seems prudent to recommend submaximal warm-ups prior to maximal testing in order to reduce the possibility of muscle strain.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3525193 TI - Effect of a single dose of sublingual captopril in hypertensive patients. PMID- 3525194 TI - Cerebral renin-angiotensin mediation of isoproterenol-induced thirst in the dog. AB - Pretreatment of dogs with s.c. isoproterenol (10 micrograms/kg) caused a significant increase in drinking when 100 ng renin substrate was administered 3 min later to the lateral cerebral ventricles or subfornical organ. Isoproterenol itself was a potent peripheral (10 micrograms/kg), but unreliable central (0.01-1 microgram) dipsogen. The increased drinking after combined s.c. isoproterenol and intracerebroventricular (i.c.v.) renin substrate injections was significantly attenuated by i.c.v. captopril (20 micrograms), but was not influenced by s.c. captopril (500 micrograms/kg). However, combined i.c.v./s.c. pretreatment with captopril nearly abolished drinking to peripheral isoproterenol, or the combination of s.c. isoproterenol and i.c.v. renin substrate. Finally, single intracranial injections of the components of the renin-angiotensin system elicited dose-dependent and site-specific drinking. Renin substrate, angiotensin I and angiotensin III produced greater intakes at forebrain tissue sites than after i.c.v. or subfornical organ injections. Renin, on the other hand, was more potent i.c.v. than at forebrain loci. These results suggest that the cerebral renin-angiotensin system may participate in beta-adrenergic thirst mechanisms by increasing local angiotensin II biosynthesis in specific areas of the brain. PMID- 3525195 TI - The non-sulfonylurea moiety of gliquidone mimics the effects of the parent molecule on pancreatic B-cells. AB - Compound UL-DF 9 corresponds to the non-sulfonylurea moiety of gliquidone, a hypoglycaemic sulfonylurea of the second generation. Its effects on the B-cell function were studied in vitro with mouse islets. In the presence of a non stimulatory concentration of glucose (3 mM), UL-DF 9 decreased 86Rb+ efflux and accelerated 45Ca2+ efflux from islet cells, depolarized the B-cell membrane and induced an electrical activity similar to that triggered by stimulatory concentrations of glucose, and increased insulin release. The changes in 45Ca2+ efflux and insulin release, but not the inhibition of 86Rb+ efflux, were abolished in the absence of Ca2+. In the presence of 10 mM glucose, UL-DF 9 increased 86Rb+ and 45Ca2+ efflux from the islets, augmented the electrical activity in B-cells, and potentiated insulin release. These changes were suppressed by omission of extracellular Ca2+. Qualitatively similar effects were produced by lower concentrations of gliquidone itself. The data suggest that UL DF 9 and gliquidone decrease the K+ permeability of the B-cell membrane, thereby causing a depolarization which leads to activation of voltage-dependent Ca channels and Ca2+ influx, and thus eventually increase insulin release. Hypoglycaemic sulfonylureas of the second generation therefore seem to contain a second chemical group that interacts with K channels of B-cells as does the sulfonylurea group itself. PMID- 3525196 TI - Thiopental inhibits K+ permeability of rat and mouse pancreatic beta-cells. AB - The effects of thiopental on the insulin release and 86Rb efflux from isolated rat islets and on parameters of the electrical activity of single beta-cells of mice were studied. Thiopental 0.2 and 1.0 mM increased by 16.6 and 33.3%, respectively, the insulin release induced by 6.0 mM glucose. Thiopental reduced the 86Rb efflux rate in both 0 and 6.0 mM glucose, but had only a slight effect in 16.7 mM glucose. Menadione (20 microM) did not block the inhibitory effect of thiopental on 86Rb efflux. Thiopental induced a reversible membrane depolarization in a dose-dependent manner (0.2-1.0 mM). It also induced electrical activity at a subthreshold glucose concentration and continuous spiking in presence of 11.1 mM glucose. In the presence of 2,4-dinitrophenol (20 microM) this continuous spiking was changed to an oscillatory activity similar to that induced by 11.1 mM glucose. Thiopental (0.5 mM) induced an increase in input resistance of 12.7, 17.9 and 16.0% in 0, 5.6 and 11.1 mM glucose, respectively. The thiopental-induced changes in insulin secretion, 86Rb efflux and electrical parameters indicate that K+ permeability was affected in both rat and mouse beta cells. Our results suggest that thiopental is a direct inhibitor of the glucose sensitive K+ permeability in the beta-cell. PMID- 3525197 TI - SCH 23390 antagonizes apomorphine- and ergot-induced hypothermia. AB - The reportedly specific D-1 dopamine (DA) receptor antagonist SCH 23390 significantly reduced the hypothermia elicited by various DA receptor agonists like apomorphine, pergolide and lisuride. When tested against equihypothermic doses of each agonist, SCH 23390 significantly reduced the hypothermia elicited by apomorphine (0.2 mg/kg s.c.) and by pergolide (0.1 mg/kg i.p.) at doses of 0.025 mg/kg s.c. Doses of 0.050 mg/kg s.c. of SCH 23390 were necessary to reduce the hypothermia elicited by 0.012 mg/kg s.c. of lisuride. Pretreatment with the specific D-2 antagonist (-)sulpiride (50 mg/kg i.p.) completely prevented the hypothermia elicited by lisuride (0.012 mg/kg i.p.), pergolide (0.1 mg/kg i.p.) and apomorphine (0.2 mg/kg s.c.) and shifted to the right the dose-response curve for agonist-induced hypothermia. A study of the interaction between 0.05 mg/kg s.c. of SCH 23390 with various doses of the agonists showed that the effectiveness of SCH 23390 in antagonizing the hypothermia was maximal towards apomorphine and least towards lisuride for which significant antagonism was observed only against the lowest dose tested (0.012 mg/kg s.c.). The reportedly specific D-1 receptor agonist SKF 38393 given in doses up to 20 mg/kg i.p. or intracerebroventricularly up to 100 micrograms failed to influence body temperature while it evoked intense grooming and stimulated motility. PMID- 3525198 TI - Human small airway smooth muscle responses in vitro; actions and interactions of methacholine, histamine and leukotriene C4. AB - The in vitro contractile responses to methacholine, histamine and leukotriene C4 (LTC4) were measured in human bronchiolar strips obtained after surgery. LTC4 was approximately 100 times more potent than both methacholine and histamine (mean pD2 values were 8.01, 6.18 and 5.87 respectively). All three agonists produced the same maximum contractile response (Tmax) and no difference was found in the time course of methacholine-, histamine- and LTC4-induced responses. When methacholine, histamine and LTC4 were applied in succession on one airway preparation, no interactions between these agonists were demonstrated for pD2. However, interactions were found concerning Tmax. The sensitivity (pD2) could be measured accurately and reproducibly and showed a relatively small within patients variation (coefficients of variation 4-5%). In contrast, Tmax showed a considerable within-patients variation (coefficients of variation 47-91%), which limits its usefulness when small numbers of airway preparations are studied. PMID- 3525199 TI - The different effects of exogenous and neuronally released norepinephrine on renin release in rat kidney cortical slices. AB - The effects of veratrine on renin release from rat kidney cortical slices were compared with those of norepinephrine (NE). Veratrine (10-100 micrograms/ml) produced a concentration-dependent increase in renin release. This action was markedly attenuated by propranolol but not influenced by prazosin. On the other hand, relatively higher concentrations of NE produced an inhibition of renin release and the inhibitory action was reversed by prazosin. These results suggest that exogenous NE inhibits renin release by preferential activation of alpha 1 adrenoceptors while neuronally released NE stimulates renin release by exclusive activation of beta-adrenoceptors. PMID- 3525200 TI - Detection of lymphocytic choriomeningitis virus antibody in colonies of laboratory animals in Japan. AB - Indirect fluorescent antibody method was applied for a detection of lymphocytic choriomeningitis virus (LCMV) antibody in colonies of laboratory animals in Japan. The results showed that the antibody exist in SPF mice (3/152, 2.2%) and conventional mice (30/539, 5.6%) with the titers ranging from 1:10 to 1:160. The antibody was also detected in 2.2% (2/89) of Syrian hamsters, and 2.9% (2/68) of Apodemus agrarius, 21.4% (3/14) of Japanese harvest mice which have been maintained as laboratory colony for several years. However, the antibody was not demonstrated in Mongolian gerbils, Suncus murinus, guinea pigs and rats, thus far. These results indicate that LCMV infection is present in laboratory animals in Japan, and pointed out the importance of microbiological monitoring for LCMV. PMID- 3525202 TI - Etoposide as an in vitro purging agent for the treatment of acute leukemias and lymphomas in conjunction with autologous bone marrow transplantation. AB - We examined the effects of various concentrations of etoposide (20-125 microM, 2 h incubation) on normal bone marrow and seven malignant cell lines: HL-60, K562, Namalva, MOLT-3, CEM-7, and the Hodgkin's cell lines L428KS and L428KSA. Tumor cell log-kill was dose dependent and greater than 4 for all cell lines but L428KSA (log-kill, 3.73). Median recovery of CFU-GM after purging with 75, 100, and 125 microM etoposide was 3.6%, 1.3%, and 1% of the controls, respectively. After one week of long-term marrow culture (LTMC), recovery increased 10-20 times/10(5) cells plated, reaching median values of 33.6%, 23.5%, and 20.7% of the controls in samples purged with 75, 100, and 125 microM etoposide, respectively. Flow cytometry for cell-cycle analysis and RNA content, and chromosomal studies of one-week-old LTMC from healthy donors detected no significant abnormalities in purged as compared to control cultures. After 3-4 weeks of LTMC, both control and etoposide-treated cells formed confluent monolayers. Using a panel of seven monoclonal antibodies (S3.13, S16.144, S4.7, S8.6, RIB-19, anti-HLA-DR, and VIL-A1), we investigated the expression of early and late differentiation antigens on LTMC after various culture times (0, 1, 2, 3, and 4 weeks). None of the early antigens S3.13, S16.144, and S8.6 was significantly reduced following etoposide treatment, either in nonadherent cells collected from the supernatant or in the adherent cell population obtained from trypsinized monolayers. Etoposide treatment dose dependently delayed the expression of RIB-19 (a late myeloid antigen) and, to a lesser extent, of S4.7 (an "intermediate" myelomonocytic marker). VIL-A1 expression was not affected by etoposide treatment. We conclude that etoposide purging of bone marrow in the 75 125 microM range spares a sufficient number of functionally intact stem cells to allow adequate in vivo reconstitution following autologous transplantation. PMID- 3525201 TI - Facilitated glucose transport across the retinal pigment epithelium of the bullfrog (Rana catesbeiana). AB - Transport studies of glucose analogs [3H] 3-O-methyl-D-glucose (mD-glu) and L [14C]glucose (L-glu) across the isolated retinal pigment epithelium (RPE) of the bullfrog was undertaken to determine whether the glucose transport mechanism was dependent upon the postulated ion-transport scheme and/or whether glucose transport is insulin-mediated. In addition, metabolic inhibitors were tested to explore the energy requirements of glucose transport across the RPE. Flux studies of mD-glu and L-glu performed with mounted RPE tissues, with short circuit current (SCC) and potential difference (PD) monitored via automatic voltage clamp apparatus, indicate that transport is clearly stereospecific with D-glucose being transported at least 13 times faster than L-glucose. The system was found to be saturable with a Km of about 24 mM glucose and Vmax of 1400 nmol cm-2 hr-1. Unidirectional Michaelis-Menten constants indicate that the RPE glucose carrier is accessible for transport from either the choroid or retinal side and a bidirectional facilitated diffusion mechanism is suggested. Insulin had no effect on either ion transport (SCC) or glucose transport (passive or facilitated). Both aerobic and anaerobic energy inhibitors decreased ion transport to less than 25% of control, but had little effect, if any, on glucose transport across the isolated RPE. Sodium iodoacetate decreased ion transport by 90% of control, but a much slower decrease in facilitated glucose transport of 22% of control suggests that carrier energy requirements, if any, are not direct or immediate. Osmotic studies performed with sucrose and glucose suggest that elevations in osmolarity increase passive glucose movement and decrease facilitated glucose-transport rates. Glucose was found to be much more detrimental to glucose transport than sucrose, suggesting that at high concentrations molecular glucose decreases facilitated transport and increases passive glucose movement by a mechanism other than can be accounted for by osmotic considerations. A model for RPE glucose transport, consistent with current data, is proposed which translocates D glucose, via an alternating conformational change of the glucose carrier. This carrier does not require a direct supply of metabolic energy, nor a functioning ion-transport mechanism. At a given moment, a single binding site for D-glucose is postulated to be available on either side of the RPE membrane for glucose translocation, although binding site affinity for glucose could differ on each side. PMID- 3525203 TI - Autologous marrow transplantation for patients with chronic myeloid leukemia in accelerated or blastic phase: report of 14 cases. AB - Between June 1979 and October 1983, 14 autografts were performed in 13 patients with CML (ten blast crisis, four accelerated phase). Results were disappointing: four patients died during aplasia; seven returned to chronic phase, but three died of hemorrhage, four relapsed, and three did not reverse. The main problem was the very low rate of successful engraftment. Both the collection of bone marrow after treatment with busulfan and a particular sensitivity of CFU-GM to cryoinjury were responsible for the infusion of very low doses of CFU-GM. However, we observed some promising results: In one patient in acute blast crisis, the Ph 1 chromosome disappeared, as well as the cytogenetic marker of transformation; in another patient with acute pure cytogenetic acceleration, the abnormal clone disappeared for 27 months; a third patient was maintained in a second chronic phase for 20 months. Thus we suggest that the results of autografting in chronic myeloid leukemia would be improved by infusing the largest possible dose of stem cells collected before or long after treatment by busulfan, and freezing them following a careful program. PMID- 3525204 TI - Regulatory role of human bone marrow fibroblasts in proliferation by granulocyte and macrophage colony-forming cells. AB - Human bone marrow fibroblasts (BMF) regulate the proliferation of granulocyte and macrophage colony-forming cells (GM-CFC). The mechanism used by BMF to regulate the proliferation of GM-CFC was investigated. When target marrows contained few spontaneous colonies, BMF enhanced granulopoiesis, while BMF-conditioned medium (BMF-CM) failed to do so. When target marrows contained large numbers of spontaneous colonies and when colony-stimulating factor (CSF) was present in the cultures, BMF and BMF-CM inhibited granulopoiesis. Adherent cells were necessary for the stimulation of granulopoiesis by BMF, but not for the inhibition of granulopoiesis by BMF and BMF-CM. Interaction of BMF with GM-CFC in dishes for a short time inhibited colony formation by GM-CFC. From these data, it has been concluded that the BMF regulate granulopoiesis and maintain the homeostasis of granulopoiesis through cell-cell interaction and factors produced by the BMF. PMID- 3525205 TI - Does measurement of bronchial hyperreactivity help in the clinical diagnosis of asthma? PMID- 3525206 TI - Cystic fibrosis: protease activity in saliva evaluated with chromogenic substrates. AB - The protease activities in saliva from individuals with cystic fibrosis (CF) were studied using four different chromogenic substrates. In the CF-group a significantly decreased protease activity in the range 50-70% was found, compared to an age- and sex-matched control group, but with considerable overlap between the CF-patients and the control patients. The trypsin-like activity found in CF patients without chronic colonisation with Pseudomonas aeruginosa was significantly decreased and without overlap compared to the control patients. The results indicate that determination of salivary protease activity using chromogenic substrates may give additional information in patients with suspected cystic fibrosis, and indicate the possibility of an additional diagnostic test. PMID- 3525207 TI - Obstructive sleep apnea reversed by increased lung volume? PMID- 3525208 TI - Pleural plaques--asbestos--ill-health. PMID- 3525210 TI - The nature and development of steroid hormone receptors. PMID- 3525211 TI - DNA synthesis in exocrine and endocrine pancreas after partial hepatectomy in Syrian golden hamsters. AB - 3H-thymidine autoradiography showed an enhanced DNA synthesis in acinar and islet cells of pancreas after partial hepatectomy in syrian golden hamsters. A significant nuclear labeling index of acinar cells was observed between 48 and 84 h and reached control levels by 120 h. An increased labeling index of islet cells was also observed, however, this increase was not statistically significant. These results indicate growth factor(s) produced after partial hepatectomy is capable of inducing DNA synthesis in pancreas. PMID- 3525212 TI - Cadmium in foods and the diet. AB - Information on the sources of cadmium in food are presented and the effects of raised environmental levels of cadmium on the concentration of cadmium in plant based foods, fish and shellfish, meat and offals, and dairy produce are discussed. Information is also presented on normal dietary intakes of cadmium and how these intakes may be elevated by environmental pollution or atypical dietary habits. The estimation of dietary intakes of cadmium using data about extreme intakes of specific foods is described. PMID- 3525209 TI - Insulin receptors: structure and function. AB - The recent characterization of the human insulin receptor structure and its intrinsic tyrosine kinase activity represent major advances in our understanding of the mechanism of insulin action. It is reasonable to think that the insulin induced autophosphorylation and activation of its receptor kinase represent an important event in the action of insulin on cell metabolism and growth. The fundamental research reviewed may be followed by the discovery of molecular receptor defects in clinical syndromes of insulin resistance. PMID- 3525213 TI - Cadmium in human population. PMID- 3525214 TI - Biological indicators of cadmium exposure and toxicity. AB - The increasing environmental and occupational exposure of populations to cadmium creates the need for biological indicators of cadmium exposure and toxicity. The advantages and disadvantages of monitoring blood cadmium, urinary, fecal, hair, and tissue cadmium, serum creatine, beta 2-microglobulin, alpha 1-anti-trypsin and other proteins, and urinary amino acids, enzymes, total proteins, glucose, beta 2-microglobulin, retinol-binding protein, lysozyme, and metallothionein are discussed. It is concluded that urinary cadmium, metallothionein and beta 2 microglubulin may be used together to assess cadmium exposure and toxicity. PMID- 3525215 TI - Human health effects of exposure to cadmium. AB - The health effects of human exposure to cadmium are discussed with emphases on intake, absorption, body burden, and excretion; osteomalacia in Japan; hypertension; and proteinuria, emphysema, osteomalacia, and cancer in workers. Elevated blood pressure has not been observed as a result of excessive exposures to cadmium in Japan or the workplace. Renal tubular dysfunction and consequent proteinuria is generally accepted as the main effect following long-term, low level exposure to cadmium. Studies of workers show that proteinuria may develop after the first year of exposure or many years after the last exposure. Proteinuria and deterioration of renal function may continue even after cessation of exposure. The immediate health significance of low-level proteinuria is still under debate. However, there is evidence that long-term renal tubular dysfunction may lead to abnormalities of calcium metabolism and osteomalacia. The few autopsy and cross-sectional studies of workers do not permit conclusions to be drawn regarding the relationship between cadmium exposure and emphysema. Retrospective and historical-prospective studies are needed to settle this important question. No conclusive evidence has been published regarding cadmium-induced cancer in humans. However, there is sufficient evidence to regard cadmium as a suspect renal and prostate carcinogen. Because of equivocal results and the absence of dose-response relationships, the studies reviewed should be used with caution in making regulatory decisions and low-dose risk assessments. PMID- 3525216 TI - Cadmium, the environment and human health: an overview. PMID- 3525217 TI - Bioaccumulation of cadmium in marine organisms. AB - It has been established that, although Cd occurs in the marine environment in only trace concentrations, most marine organisms, especially molluscs and crustaceans, can accumulate it rapidly. Cadmium is not uniformly distributed in the body and selectively accumulates in specific organs like liver, kidney, gills, and exoskeleton. The concentrations in muscle tissues are several orders of magnitude lower. The disposition of Cd in the organisms in the laboratory studies generally parallels those in nature. A number of biotic factors like body size, maturity, sex, etc. influence bioaccumulation but extensive studies are still lacking. The chemical form of Cd in the environment is of prime importance in bioaccumulation by marine organisms. Salinity can affect the speciation of Cd, and bioaccumulation is affected by both temperature and salinity. The ultimate level of Cd in the organisms will depend not only on the biotic and abiotic factors but also on metabolism of the metal by the organisms. A few studies indicate depuration of Cd by some bivalves but other organisms show very effective retention of Cd. Metallothionein formation for detoxification and storage has been observed in a large variety of marine organisms. Recent reports indicate an alternate storage and excretion mechanism in the formation of membrane-limited vesicles or granules. There seems to be a common link between intracellular localisation of Cd in metal-binding proteins and Cd containing vesicles as detoxifying mechanisms in the marine organisms. Much of what is known about Cd bioaccumulation by marine organisms has come from laboratory studies and there are inherent dangers in trying to extrapolate the results to field situations. In spite of tremendous progress made over the years, the basic understanding of the bioaccumulation process is still very nebulous and will remain so until the uptake, storage, and elimination processes are fully understood. PMID- 3525218 TI - Cadmium contamination in agriculture and zootechnology. PMID- 3525219 TI - Pathways and distribution of cadmium in grasslands. PMID- 3525220 TI - Recognition of spectral patterns in the green treefrog: neurobiology and evolution. AB - The natural communication behavior of frogs has provided a framework for studying both the mechanisms and evolution of sound pattern recognition. In the green treefrog behavioral studies using synthetic stimuli have identified the pertinent acoustic properties of its complex but stereotyped vocal signals. There are two optimal frequency bands: the most effective signals have about the same amount of energy in the two bands. Neurophysiological studies revealed biases for these two frequency bands at the level of the peripheral auditory system. Furthermore, the neural response properties in an auditory thalamic area are especially well correlated with selective phonotaxis based on the appropriate combination of low- and high-frequency sound energy. Comparing the optimal frequency bands in terms of female preferences with the range of frequencies produced by males in natural populations suggests that intraspecific mate choice based on call frequency alone is unlikely. PMID- 3525221 TI - Acoustic adaptations for parent-offspring recognition in swallows. AB - We have used field and laboratory studies to investigate acoustic adaptations for parent-offspring recognition in two closely related pairs of swallows: (a) bank swallow (Riparia riparia) and northern rough-winged swallow (Stelgidopteryx serripennis), and (b) cliff swallow (Hirundo pyrrhonota) and barn swallow (Hirundo rustica). Cross-fostering and playback experiments show that bank swallow and cliff swallow parents recognize their offspring by voice while rough winged swallow and barn swallow parents do not. We argue that this species difference is due to an evolutionary history of strong selection for recognition in bank swallows and cliff swallows, which live in large, dense colonies, and of weak or no selection for recognition in rough-winged swallows and barn swallows, which live solitarily or in small groups. We consider two possible acoustic adaptations which may underlie the observed species difference. First, the "signature" calls of cliff swallow and bank swallow chicks appear to be more individually distinctive than the homologous calls of rough-winged swallows and barn swallows. This conclusion is supported by a sonographic analysis of among- and within-individual call variation: The information content of bank swallow and cliff swallow calls is considerably greater than that of rough-winged swallow or barn swallow calls. We also discuss our more recent work on the hypothesis that the colonial swallow species are better able to discriminate these sorts of auditory stimuli. We conclude with the caution that auditory specializations may be unnecessary given the signature call adaptation and the general capabilities of the avian ear. PMID- 3525222 TI - Theoretical contributions of tests on animals to the special-mechanisms debate in speech. AB - Many animal species demonstrate a keen sensitivity very early in life to stimuli that play a role in their survival. Theorists have taken this to mean that species-specific mechanisms evolved in animals that aid in the detection and recognition of important stimuli. Similar arguments have been made about the mechanisms that underlie the perception of speech in humans. Theories of speech perception present convincing arguments that even the phonetic level of language requires specially evolved mechanisms, because of the extreme complexity involved in the mapping between sound and percept. Phenomena such as categorical perception have been attributed to the workings of these mechanisms. This paper lays out an argument concerning the contribution of animal studies on categorical perception to the special-mechanisms debate. Animals provide a model of auditory level processing in the absence of phonetic-level processing, and test whether the existence of a phenomenon such as categorical perception necessitates specialized mechanisms. A review of the studies shows that animal demonstrate categorical perception of the voicing and place features. These data, as well as some recent findings on young human infants, are considered with regard to their impact on theories of infant speech perception and on the evolution of speech. PMID- 3525223 TI - The possible role of protein kinase C and phospholipids in the regulation of steroid production in rat Leydig cells. AB - We have studied the possible involvement of the activation of calcium-dependent phospholipid-activated protein kinase (PK-C) in the stimulatory action of LHRH on Leydig cells, using 4 beta-phorbol-12-myristate-13-acetate (PMA) and phospholipase C (PL-C). LHRH agonist (LHRH-A) and PL-C had a large synergistic effect on LH-stimulated steroid production, whereas PMA inhibited the effect of LH. However, PMA always caused an increase in steroid production stimulated by various doses of dibutyryl cAMP. LH and PMA stimulated the phosphorylation of 17 and 33 kDa proteins, whereas LHRH-A and PL-C had no effect. Of all effectors used, LH had the most pronounced effect on the synthesis of 14, 27 and 30 kDa proteins. The present results suggest that the mechanisms of action of LHRH-A and PL-C on steroid production in Leydig cells may be similar and different from PMA, and may involve stimulation of a specific type of PK-C or hydrolysis of a specific pool of phospholipids. PMID- 3525224 TI - Inhibition of fungal and mammalian sterol biosynthesis by 2-aza-2,3 dihydrosqualene. AB - 2-Aza-2,3-dihydrosqualene (I) and a quaternary ammonium derivative (II) inhibited ergosterol biosynthesis in cells and cell-free extracts of the pathogenic yeast Candida albicans as measured by incorporation of radiolabelled precursors. The compounds inhibited squalene epoxidase and 2,3-oxidosqualene cyclase to varying degrees in microsomes from C. albicans and from rat liver. The rat liver epoxidase was 50% inhibited by I at 2.4 microM. In C. albicans cells, but not in cell-free extracts, I also inhibited lanosterol demethylation and led to accumulation of an unidentified polar product. PMID- 3525225 TI - An infrequent generation of catenated network of pBR322 in Escherichia coli. AB - It was demonstrated that Escherichia coli infrequently generates the catenated network of pBR322. This complex pBR322 form was detected when DNA molecules could hardly enter the agarose gel during electrophoresis and was found to comprise monomers and dimers of the plasmid. PMID- 3525226 TI - Evolutionary conservation of the substrate-binding cleft of phosphoglycerate kinases. AB - The primary structures of six phosphoglycerate kinases (PGKs) are known: three from mammals, one from yeast, and two from trypanosomes. Comparison of the amino acid sequence of these enzymes reveals 154 invariant positions out of 392 positions in the aligned sequences. Most of the conserved positions fall into the twelve beta-sheets and adjacent peptide regions that form the inner loops surrounding the ATP and 3-phosphoglycerate-binding cleft. The homology between mammalian and yeast PGKs is greater than 94% for the inner-loop region, even though the overall homology is less than 65%. Trypanosome PGK has only 44% overall homology with the mammalian enzyme, but shows 74% homology in the inner loop region. Trypanosome PGK contains a polypeptide segment in its N-terminal domain that is transposed in comparison with the other species. PMID- 3525227 TI - The C-terminal, 23 kDa peptide of E. coli haemolysin 2001 contains all the information necessary for its secretion by the haemolysin (Hly) export machinery. AB - In this paper we show the construction of a plasmid pLG609 which carries the 3' end of the haemolysin structural gene, hlyA under tac promoter control. Expression of pLG609 in an E. coli strain carrying the haemolysin export genes hlyB and hlyD led to the efficient secretion of the C-terminal, 23 kDa peptide of haemolysin. The discovery of a C-terminal topogenic sequence, which appears to be all that is required for secretion of the whole toxin, is so far quite unique in protein export. PMID- 3525228 TI - Protein-chemical analysis of pertussis toxin reveals homology between the subunits S2 and S3, between S1 and the A chains of enterotoxins of Vibrio cholerae and Escherichia coli and identifies S2 as the haptoglobin-binding subunit. AB - The purified toxin of Bordetella pertussis was dissociated in 5 M urea in the presence of immobilized haptoglobin. The toxin was dissociated in free S1, free S5 and the free complexes S2-S4 and S3-S4, with S2-S4 as the only haptoglobin binding moiety, identifying S2 as the haptoglobin-binding protein. Partial NH2 terminal amino acid sequences were obtained from the dissimilar toxin subunits, after separation by SDS-polyacrylamide gel electrophoresis followed by electroblotting onto polybrene-coated glass-fiber sheets. The sequences reveal extensive homology of the N-terminal portions of the constitutive subunits S2 and S3 and between S1 and the enterotoxin A chains of Vibrio cholerae and Escherichia coli. PMID- 3525229 TI - Influence of space flight on red blood cells. AB - Losses of red blood cell mass (RCM) averaging 10-15% have been observed consistently in astronauts after space flight; postflight recovery of RCM requires 4-6 wk. Although apparently not harmful to the health and effectiveness of crews during uncomplicated flights, decreased RCM could compromise health and performance in the event of illness, injury, or partial malfunction of the life support system. Whether the loss of RCM would worsen or stabilize in missions longer than 7 months is unknown. As a biological response, it is a significant, predictable reaction whose etiology, biological mechanisms, and potential operational significance are inadequately defined. Weightlessness is probably the primary cause; however, contributory factors may include hypokinesia/hypodynamia, bone loss, muscle atrophy, altered hemodynamics, stress, and metabolic disturbances. Space medical specialists consider other possible influences such as hypoxia, hypobaria, radiation, toxic contaminants, and launch and reentry accelerations as less likely factors. Because the data base on loss of RCM is insufficient for the National Aeronautics and Space Administration's space medical responsibilities, the Life Sciences Research Office ad hoc Working Group on Space Anemia suggested research approaches ranging form fundamental topics such as utilization of erythropoietin and oxygen in target organs and cell-cell interactions, through possible splenic and vascular dysfunctions, metabolic disturbances, and inhibitors of erythropoiesis, to methodology and models. PMID- 3525230 TI - Intrinsic membrane properties of magnocellular neurosecretory neurons recorded in vitro. AB - Over the past 15 years, extracellular recordings from the rat supraoptic and paraventricular nuclei have revealed two populations of endocrine neurons that can be antidromically activated from neurosecretory axons in the neurohypophysis. Both the oxytocinergic and vasopressinergic populations of magnocellular neuroendocrine cells (MNCs) fire bursts of action potentials that facilitate hormone release from neurohypophyseal terminals. Moreover, both populations are osmosensitive, increasing their firing rate as osmolarity is elevated. Recently, slice and explant preparations of hypothalamus have enabled intracellular recording of these cells in normal and modified saline solutions. Spiking, bursting, and osmosensitivity can occur independently of synaptic input, enabling MNCs, for example, to transform an unpatterned depolarizing influence into the repetitive bursting pattern associated with vasopressin release. Current-clamp studies have started to characterize the repertoire of conductances across the MNC membrane that are responsible for action potential discharge, afterpotentials, bursting, and osmosensitivity. This provides a basis not only for further voltage-clamp studies, but for understanding transmitter effects that act by modulating intrinsic MNC currents. PMID- 3525231 TI - Plasticity in the hypothalamic magnocellular neurosecretory system. AB - Over the past decade or so, plasticity has emerged as an important, quantifiable property of the mammalian hypothalamic magnocellular neurosecretory system. This plasticity has turned out to be genuinely related to normal function in the sense that it is a set of responses to physiological stimulation rather than only the sequelae of insult or injury, and it is generally completely reversible. This latter property, of course, distinguishes it further from the plasticity observed after injury. Four features of this magnocellular system that have been shown to display predictable and reversible intercellular plasticity are reviewed: the relationships between neurons and their associated astrocytic glia at various levels (dendritic somatic and terminal) of the magnocellular elements; the extent of terminal and glial contact with the basement lamina in the neurohypophysis; the type and possible efficacy of synaptic input, and the extent of electrotonic coupling among the magnocellular neurons. PMID- 3525232 TI - Diet-mediated alteration of chromatin structure. AB - Higher-order chromatin structure and the process of transcription are related. The significance of a nutritional state's altering chromatin structure lies in the potential role of that nutritional state in the regulation of gene expression. In rats short-term feeding of semisynthetic diets varying in the proportion of carbohydrate, protein, or fat alters the configuration of liver chromatin as measured by sensitivity to micrococcal nuclease (EC 3.1.31.1). A carbohydrate-rich, fat-free diet increases the sensitivity of rat liver chromatin to micrococcal nuclease and decreases the nucleosome repeat length. In contrast, a protein-free diet or a diet deficient in magnesium or zinc decreases the sensitivity of liver nuclear chromatin to micrococcal nuclease. Diet-mediated mechanisms that alter chromatin structure are now unknown, but the continued study of nutritional interaction with the genome should identify the responsible features as well as their significance to gene function. PMID- 3525233 TI - Regulation of the gene for fatty acid synthase. AB - The activity of hepatic fatty acid synthase (EC 2.3.1.85) correlates positively with the rate of synthesis of long-chain fatty acids. Thus, in a starved chick, both the rate of fatty acid synthesis and the activity of fatty acid synthase are low. Feeding stimulates both processes. The increase in fatty acid synthase activity caused by feeding is due to an increase in the concentration of enzyme protein, which in turn is caused by an increase in the rate of synthesis of the enzyme. Using fatty acid synthase cDNA clones isolated in our laboratory, we showed that feeding causes a rapid increase in the level of fatty acid synthase mRNA. Increased transcription of the fatty acid synthase gene precedes the increase in fatty acid synthase mRNA level caused by feeding, which indicates regulation at the level of transcription. The feeding-induced stimulation of fatty acid synthase can be mimicked in culture by incubating chick embryo hepatocytes with insulin and thyroid hormone. Glucagon inhibits the increase caused by insulin and thyroid hormone. Enzyme synthesis is the regulated step. In hepatocytes in culture, thyroid hormone stimulates and glucagon inhibits the accumulation of fatty acid synthase mRNA. Insulin has only a small stimulatory effect on mRNA level despite a large stimulation of the synthesis of fatty acid synthase. Thus, thyroid hormone and glucagon regulate enzyme level at a pretranslational step, whereas insulin regulates the translation of fatty acid synthase mRNA. We conclude that complex hormonal regulation of the production and translation of fatty acid synthase mRNA underlies the dietary regulation of enzyme synthesis observed in intact animals. Future work will involve isolation of cloned genomic DNA for the fatty acid synthase gene and identification of nucleotide sequences involved in the regulation of this gene. PMID- 3525234 TI - Regulation of hepatic gene expression by lipogenic diet and thyroid hormone. AB - Adaptive hyperlipogenesis in the liver occurs after feeding rats a high carbohydrate, fat-free diet or after treatment with thyroid hormone. This phenomenon is accompanied by the induction of a family of enzymes and proteins involved in various aspects of lipogenesis, resulting largely from alterations in the rates of protein synthesis. The changes in protein production, in turn, are the result of increased or decreased cellular concentrations of specific mRNAs in response to carbohydrate feeding or hyperthyroidism. There is a large degree of overlap between the mRNA species induced by thyroid hormone and carbohydrate feeding in rat liver. One such mRNA species, spot 14, has several attractive features as a potential model for exploring the molecular mechanisms involved in the regulation of gene expression. Most importantly, the mRNA for spot 14 increases with a lag time of less than 20 min after treatment with thyroid hormone or sucrose gavage and thus may represent a primary response to the hormonal and dietary stimuli. Initial studies to elucidate the cellular site of action of thyroid hormone and dietary carbohydrate indicate that changes in both the rate of gene transcription and the stability of the nuclear RNA precursor are involved in spot 14 mRNA induction. PMID- 3525235 TI - The albumin gene: DNA-protein interaction. AB - A carbohydrate-rich, fat-free diet dramatically alters the higher-order chromatin structure of rat liver nuclei. In addition, the mRNA level of the phenotypic protein of liver, albumin, is reduced. Within 200 base pairs of the initiation site of the albumin mRNA, a histone H1-binding site has been mapped. Histone H1 is the higher-order architectural protein of chromosomes. The presence of H1 with nucleosomes that package albumin gene sequences implies the presence of H1 in template-active chromatin. The role histone H1 has on the architecture of active genes may be a fundamental level of gene regulation. PMID- 3525236 TI - Endometrial immunofluorescence associated with endometriosis and pelvic inflammatory disease. AB - Anti-immunoglobulin G (anti-IgG) staining in the endometrium by immunofluorescence has been associated with endometriosis. To investigate this phenomenon further, we took endometrial samples from 42 patients who underwent laparoscopy or laparotomy, which were tested for immunofluorescence. Fluorescein labeled anti-IgG was incubated with tissue samples. Of 18 patients with documented endometriosis, 16 had positive immunofluorescence (89% sensitivity). Of 24 patients with no evidence of endometriosis, 9 had false-positive immunofluorescence and 15 had negative immunofluorescence. Of the 9 false positive samples, 8 had evidence of old pelvic inflammatory disease. In the absence of this condition, there was only one false-positive study for immunofluorescence. The implications of these findings in terms of the pathophysiology of endometriosis-associated infertility is that it may be an immune-mediated process. With regard to diagnosis, the high predictive value of endometrial immunofluorescent IgG may be a useful tool in indicating early laparoscopic examination of the infertile period. PMID- 3525237 TI - Chronic testosterone cypionate therapy in men with secondary impotence. AB - There have not been studies assessing the effects of chronic testosterone cypionate (TC) therapy on circulating levels of testosterone (T), estradiol (E2), free T, bioavailable T (BAT), luteinizing hormone (LH), and sexual function in impotent men with low T levels. This study was a double-blind crossover using 200 mg of TC or placebo given intramuscularly every 14 days for six injections and the other medication given for six doses. Blood was drawn before each injection. Mean concentrations of T, E2, free T, and BAT were the same on TC or on placebo, but serum LH was significantly suppressed during intramuscular TC. With TC statistically significant improvements in libido and in potency were noted. Five of the men were able to have vaginal sex while taking TC. TC injections every 14 days do not appear to maintain increased T concentrations for 2 full weeks, and other dosage/injection schedules are being evaluated, but there were improvements in libido and potency. PMID- 3525238 TI - [Therapeutic results of patients with gingival tumors]. PMID- 3525239 TI - [Condition of the periodontium around the abutment teeth of silver-palladium bridges and on the contralateral side]. PMID- 3525240 TI - [Angiotensin II as a factor inhibiting the fear response]. AB - Angiotensin II being administered into the rabbit lateral cerebral ventricles (0.015-0.15 micrograms) suppressed the fear response to electrical stimulation of the hypothalamic ventromedial nucleus, and in doses 1-10 ng blocked the inherent behavioral fear responses in rats. Microiontophoretic application of the same drug to cortex and parafascicular thalamic complex induced mainly an activation. Prevalence of inhibitory neuronal responses to angiotensin II was observed in the hypothalamic structures as well as in the midbrain RF. Cortical and subcortical neuronal responses to angiotensin II were enhanced after stimulation of the hypothalamic "fear center". The suppression of the fear response after angiotensin II administration seems to be related to changes in the cortical subcortical interrelationships: diminishing of the midbrain RF ascending activation due to descending cortical effects. PMID- 3525241 TI - [Age and features of prostanoid biosynthesis in the rat kidney]. AB - The biosynthesis of PgF2, 6-keto-PgF1 alpha and TxB2 from endogenous precursor in vitro by the rat kidney cortex and medulla in ontogenesis was found to be highest at young age reducing from papillae to kidney cortex. The main product of the biosynthesis in kidney medulla of young and adult rats was PgE. PMID- 3525242 TI - [Effect of delta-sleep-peptide on the state of brain membranes during exposure to cold stress]. PMID- 3525243 TI - Glass ionomer: its emerging role as an intermediary dental base. PMID- 3525244 TI - Long-acting local anesthetics. PMID- 3525245 TI - [Clinical investigation on the mechanism of glucose intolerance in Cushing's syndrome]. AB - We investigated the mechanism of glucose intolerance in 51 patients with Cushing's syndrome. In an oral 100g glucose tolerance test, although prevalence of decreased glucose tolerance was very high as revealed in 36 of 47 patients (77%) studied, impairment was rather mild in the majority of patients and only 10 patients (21%) were judged as diabetic. Plasma insulin was measured in 12 patients and the mean values of these patients reached above normal levels after oral glucose load. When insulin secreting capacity was assessed by measuring the ratio of the incremental area of insulin above fasting level to the corresponding area of glucose during the test, Cushing's syndrome as a whole exhibited a normal ratio compared to 9 control subjects (113 +/- 115 vs. 144 +/- 78 microU/mg, M +/- SD, ns), but in 3 patients with severe impairment of glucose tolerance reaching the diabetic range, the ratio was lower than normal (27 +/- 20 vs. 144 +/- 78 microU/mg, M +/- SD, p less than 0.05). The hypoglycemic effect of iv insulin was studied in 23 patients and was demonstrated to have decreased. Thus, we confirmed the presence of decreased insulin sensitivity, i.e. insulin resistance in Cushing's syndrome. The age of patients showed positive correlation with the degree of impairment in glucose tolerance and insulin secreting capacity, but not with that of insulin sensitivity, that is, in patients with advanced age, glucose intolerance appeared to be severe with decreased insulin secreting capacity. 125I insulin binding to red blood cells in 8 patients was examined to elucidate the mechanism of insulin resistance in Cushing's syndrome. Percent specific binding at tracer concentration of insulin in Cushing's syndrome was not different from the value obtained in 19 normal subjects (8.2 +/- 3.0 vs. 7.7 +/- 1.0%, M +/- SD, ns). Receptor concentration and affinity were also normal. From these observations, it is likely that glucose intolerance in Cushing's syndrome is primarily due to the effects of chronic glucocorticoid excess on tissue metabolism of glucose as characterized by the presence of insulin resistance, which is not due to a defect in insulin-receptor binding but rather caused by the alteration in post-receptor mechanism, and increased secretion of insulin can be considered as a compensatory mechanism. In some patients, however, a decrease in insulin secreting capacity, the cause of which is not clear but at least related to the patient's age, is found and seems to lead to severe glucose intolerance. PMID- 3525246 TI - [Studies on estrogen receptor in normal and cancerous human uterine endometrium by immunological methods]. AB - The presence of cytosol estrogen receptor (ER) and the ER of nuclear extracts in normal uterine endometrium and endometrial adenocarcinoma tissues were determined by radioreceptor assay (RRA) and enzyme immunoassay (EIA). In addition the intracellular localization of ER and tissue distribution of ER positive cells was demonstrated by immunocytochemical assay (ICA). The levels of cytosol ER measured by EIA and RRA had a significant correlation in normal endometrium (r = 0.90) (P less than 0.01) and endometrial adenocarcinoma (r = 0.96) (P less than 0.01) as well as in breast cancer (r = 0.93) (P less than 0.01). The ER measured by immunocytochemical method using the monoclonal anti-ER antibody obtained from breast cancer cells was applicable to the detection of the ER in uterine endometrial tissues. In endometrial adenocarcinoma, the levels of cytosol ER in G1 (Highly differentiated adenomatous carcinoma) tissues (187.6 +/- 189.0 fmoles/mg protein) were significantly higher than those in G2 (Moderately differentiated adenomatous carcinoma with partly solid areas) tissues (15.0 +/- 31.9 fmoles/mg protein) (P less than 0.05). The levels of cytosol ER peaked in the late follicular phase (432.0 fmoles/mg protein) and remained low in the other phases. Epithelial cells in the normal endometrium were stained uniformly by ICA, in contrast, ICA stained and non-stained cells existed concurrently in the same endometrial adenocarcinoma tissues. A similar finding was also shown in breast cancer tissues and may be related to the efficacy of anti-estrogenic drugs on the growth of whole cancer tissues. PMID- 3525247 TI - [The evolution of caries: a histochemical study of enamel and dentin]. PMID- 3525248 TI - [S.E.M. analysis of the stages of preparation of a new composite for Class I and II restorations]. PMID- 3525249 TI - [Technics for cavity preparation of inlays]. PMID- 3525250 TI - [Prosthetic rehabilitation using neuromuscular guidance in a rare case of Christ Siemens-Weech syndrome]. PMID- 3525251 TI - [New technics in the morphometric analysis of free gingival grafts]. PMID- 3525252 TI - [Initial experience with Shademate. Form and color separately prepared]. PMID- 3525253 TI - [Basic supplies and aids for electro-erosion]. PMID- 3525254 TI - [Manufacture of the J.P. lock block. A simple attachment element]. PMID- 3525255 TI - [Adhesive+stone-method]. PMID- 3525256 TI - [Everything from one alloy? Cobalt-chromium-molybdenum-titanium-alloys]. PMID- 3525257 TI - [Retention comparison. Bonding systems for bonded bridges]. PMID- 3525258 TI - [Firing of ceramic materials on palladium-silver alloys]. PMID- 3525259 TI - [Jacket crown--an alternative? Turn back to original]. PMID- 3525260 TI - [Color polarity at the incisal edge]. PMID- 3525261 TI - [Team work in denture care]. PMID- 3525262 TI - [Dicor bridge system. Single crowns in practical combinations]. PMID- 3525263 TI - Drugs in dentistry. Agents for gingival retraction. PMID- 3525265 TI - Cutaneous immunofluorescence in hepatitis B virus infections. PMID- 3525264 TI - Response of solitary psoriatic plaques to experimental application of podophyllotoxin. AB - A 16-week double-blind study of parallel groups was carried out in the treatment of 152 patients suffering from stable psoriasis vulgaris. Podophyllotoxin was applied once daily at three different concentrations in an ointment base, namely 0.1, 0.25 and 0.5%. One stable psoriatic lesion was selected and monitored during the study course. All three concentrations of podophyllotoxin induced a statistically highly significant improvement (p less than 0.001) of the selected lesions. There was statistically highly significant difference between the treated and control lesions already after 2 weeks of treatment (p greater than 0.001), and this difference increased further during the study course. Eleven patients experienced adverse reactions - severe skin rash - spontaneously reported by the patients. PMID- 3525266 TI - Continuous subcutaneous insulin infusion versus intensive conventional insulin therapy in type I and type II diabetic pregnancy. AB - Two groups of pregnant diabetic women, fifteen with type I and fourteen with type II diabetes, were randomly assigned either to CSII or to ICT and the subgroups compared with respect to glycaemic control, insulin requirement and perinatal out come. Ten non-diabetic pregnant women served as controls for the variations in the metabolic parameters considered (24-hour mean blood glucose and glycosylated hemoglobin). Strict glycaemic control was achieved and maintained by both regimens before week 13 in all patients with type I and in 57.1% of patients with type II diabetes. The mean insulin requirements in the type I group increased up to week 34-36 and then stabilized to term in patients receiving CSII and rose progressively to term in those receiving ICT. In the type II group insulin requirements rose up to week 36 in patients receiving CSII and up to week 32 in those receiving ICT, stabilizing thereafter on both regimens. No significant differences in mean insulin requirement at the different stages of gestation were found between the patients receiving CSII and those receiving ICT of either group. Perinatal outcome was satisfactory in both groups, although control of foetal growth was better with ICT than with CSII. CSII is a practical, safe and effective method of maintaining maternal normoglycemia in pregnancy but for the present we cannot consider it superior to ICT in the treatment of pregnant diabetic women. PMID- 3525267 TI - [Seasonal cycles of adipocyte lipogenesis and blood insulin in the young rabbit]. AB - The young domestic rabbit (2.5 months old) shows seasonal variation in metabolism similar to wild mammal. During the annual seasonal cycle we observed variations in the intensity of lipogenesis in isolated perirenal adipocytes; fatty acid synthesis, which uses acetate as a precursor rather than glucose, reaches a maximum in winter and a minimum in spring. The magnitude of the glucose induced pancreatic insulin response varies during the annual seasonal cycle and it follows the variations in the lipogenesis cycle; thus, the plasma IRI increase is highest in winter when maximum lipogenesis occurs. PMID- 3525268 TI - Direct and indirect influences of a 14 days oestradiol-17 beta treatment on the endocrine pancreas of the female rat. AB - The relationship between the hyperinsulinism induced by 14-days oestradiol treatment and the trophic action of this hormone on the endocrine pancreas was studied. The possible interference of the adrenal glands in these effects of oestradiol was investigated using comparisons between adrenalectomized and/or ovariectomized rats. Oestradiol increased the dry weight of the islets of Langerhans and enhanced total incorporation of [3H] leucine into newly synthetized proteins during a glucose stimulation independently of the presence of the adrenal glands. Conversely, the presence of the adrenal glands was necessary for the expression of the enhancing actions of oestradiol such as the production of insulin hypersecretion, increased insulin biosynthesis and a higher proportion of light granules inside the B cells. These results were in favour of a direct trophic role of oestradiol on the endocrine pancreas, but also of an indirect role of this hormone in the stimulation of the insulin secretion and biosynthesis, mediated by glucocorticoids. PMID- 3525269 TI - Insulin and C-peptide responses to 75 g oral glucose load in the healthy man. AB - Plasma insulin and C-peptide levels in the fasting state and after a 2-h 75 g oral glucose tolerance test (OGTT) in a large number of healthy subjects are reported. 247 volunteers (134 males, 113 females), aged 13-69 years, who had a negative history of diabetes, no history of significant disease, normal physical examination, normal body weight, normal glucose tolerance, normal blood tests, and who were taking no drugs were studied. Results, mean +/- SEM (range): fasting glucose concentration = 4.64 +/- 0.03 mmol/l (3.10 - 6.10), 1-h glucose concentration = 5.23 +/- 0.10 mmol/l (2.20 - 9.90), 2-h glucose concentration = 4.11 +/- 0.06 mmol/l (2.00 - 6.80); fasting insulin level = 0.088 +/- 0.002 nmol/l (0.03 - 0.28), 1-h insulin level = 0.45 +/- 0.01 nmol/l (0.06 - 1.63), 2-h insulin level = 0.24 +/- 0.01 nmol/l (0.05 - 1.12); fasting C-peptide concentration = 0.60 +/- 0.01 nmol/l (0.14 - 1.34), 1-h C-peptide concentration = 2.17 +/- 0.05 (0.63 - 8.56), 2-h C-peptide concentration = 1.77 +/- 0.04 nmol/(0.35 - 5.74). Fasting insulin and fasting C-peptide concentrations correlated to post-glucose insulin and C-peptide concentrations, respectively. At each sampling-point insulin concentration correlated to C-peptide concentration. After glucose ingestion, both insulin and C-peptide plasma levels correlated significantly with the corresponding glucose levels. During fasting, C-peptide but no insulin level correlated to glucose level.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3525270 TI - The effects of sucrose meal on insulin requirement in IDDM and its modulation by acarbose. AB - The purpose of the present study was to evaluate the insulin requirement in response to sucrose meal in IDDM and its modulation by a disaccharidase inhibitor, Acarbose. After an overnight fast, the subjects (n = 9) were "hooked" to the artificial pancreas (Biostator) to maintain normoglycemia. Blood glucose and insulin requirement were recorded by the Biostator throughout the experiment. The patients were divided into two groups. In group I, five patients received increasing sucrose load (50, 75 and 100 g) with and without Acarbose 100 mg. After a 50 g sucrose meal with and without Acarbose, the peak postprandial (PP) blood glucose was 118 and 157 mg/dl and the insulin requirement was 3.9 and 7.8 units resulting in free plasma insulin peak of 34 and 59 microU/ml respectively. After a 75 g sucrose meal with and without Acarbose, the peak PC blood glucose was 134 and 166 mg/dl and the insulin requirement was 5.7 and 9.9 units resulting in free plasma insulin peak of 75 and 87 microU/ml. After a 100 g sucrose meal with and without Acarbose the peak PP blood glucose was 131 and 175 mg/dl and the insulin requirement was 6 and 12.8 units resulting in free plasma insulin peak of 50 and 69 microU/ml. In group II, four patients received increasing Acarbose dose with a fixed sucrose load (75 g). The PP blood glucose peaked at 161, 145, 120 and 102 mg/dl after 0, 50, 100, 200 mg of Acarbose respectively. The total insulin requirements were 12.9, 9.6, 4.3 and 3.1 units. The free plasma insulin was decreased by Acarbose treatment while plasma glucagon remained unaffected.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3525271 TI - Characteristics of children and adolescents with insulin-dependent diabetes mellitus participating in a summer camp educational program. AB - Clinical, biological and social characteristics were assessed in 456 children and adolescents participating in a summer camp for children with diabetes mellitus. In these subjects, aged from 7 to 18 years, the mean duration of the diabetes was five and a half years. They carried out their usual treatment under parental supervision, 31% of them being of rural origin. Mean glycosylated haemoglobin was approximately twice as high as a reference population (12.2% +/- 2.3, vs. 6.6% +/ 0.7) and was similar to that observed in various specialized hospitals. Factors which correlated with glycosylated haemoglobin included gender, school performance, vacation away from home, time spent watching television and practicing sport and eating patterns. This descriptive analysis gives some insight into the health status of the studied population. It represents the initial phase of a study to assess the efficacy of a diabetes educational programme for children and adolescents. PMID- 3525272 TI - [Allergy to insulin]. PMID- 3525273 TI - Double-blind comparison of 200-mg ketoconazole oral tablets and 1200-mg miconazole vaginal capsule in the treatment of vaginal candidosis. AB - In a double-blind, randomized study the efficacy of oral ketoconazole (400 mg for 5 days) was compared with that of topical miconazole (1200 mg a single dose) in the treatment of 42 patients with vaginal candidosis. One week after the start of therapy the mycological cure rate was 87% in the ketoconazole group and 95% in the miconazole group, indicating that both regimens are equally effective. No major side-effects were observed. PMID- 3525274 TI - The components of the plant fatty acid synthetase system. PMID- 3525275 TI - Molecular structure and expression of fatty acid synthetase genes in yeast. PMID- 3525276 TI - Developmentally regulated expression of the cell-cell adhesion glycoprotein cell CAM 120/80 in peri-implantation mouse embryos and extraembryonic membranes. AB - Peri-implantation mouse embryos and extraembryonic membranes were examined immunohistochemically for the expression of the cell-cell adhesion molecule (cell CAM) 120/80. Cell-CAM 120/80 was seen along the lateral borders of all cells in the blastocyst but became undetectable on trophoblastic giant cells, some mononuclear trophoblastic cells and parietal yolk sac cells when blastocysts were cultured in vitro. In postimplantation embryos in vivo, all parts of the early egg-cylinder reacted with the antibody to cell-CAM 120/80 except for the cells of the parietal endoderm and the primary trophoblastic giant cells. In the late stage egg-cylinder, no cell-CAM 120/80 was seen on the cells of the primitive mesoderm or on the primordial germ cells. The germ cells in genital ridges and fetal gonads remained cell-CAM 120/80-negative throughout the fetal stages of development. In the extraembryonic membranes, the visceral yolk sac, amnion, and the cells of the placental labyrinth were cell-CAM 120/80-positive, whereas, the parietal yolk sac cells and the spongiotrophoblast cells were negative. These data show that cell-CAM 120/80 is found on cells arranged into epithelial layers in the early embryo and extraembryonic tissues, but is not expressed in the dissociated cells differentiating from these epithelia. Thus, the expression of cell-CAM 120/80 appears to be developmentally regulated. PMID- 3525277 TI - Effect of serum on cell-to-cell associations during in vitro development of preimplantation mouse embryos. AB - We have identified an activity which alters the morphology and developmental timing of post-compaction mouse embryos. A 15-min exposure of 4- and 8-cell mouse embryos to sera containing this activity induced monolayer formation, changing the normal positions of blastomeres at the 16- to 64-cell stages. Recovered embryos form normal blastocysts, based on morphology and in vitro production of trophectoderm and inner cell mass derivatives. These results suggest that under certain circumstances blastomeres remain developmentally labile as late as the sixth or seventh cleavage cycle. PMID- 3525278 TI - Stage-specific insulin binding in mouse preimplantation embryos. AB - Stage-specific insulin binding in the developing mouse embryo was demonstrated by an indirect immunofluorescence technique using an antibody against insulin. Concentration-dependent fluorescence labeling was observed in the morula and blastocyst stages of development, whereas no reactivity was seen in unfertilized oocytes or in 2-, 4-, and 8-cell embryos. The possible significance of these observations is discussed. This represents the first report of stage-specific insulin binding during mammalian preimplantation development. PMID- 3525280 TI - Plasticity in the nervous system of adult hydra. I. The position-dependent expression of FMRFamide-like immunoreactivity. AB - The plasticity of nerve cells expressing the neuropeptide FMRFamide was examined in adult hydra. Using a whole-mount technique with indirect immunofluorescence, the spatial pattern of neurons showing FMRFamide-like immunoreactivity (FLI) was visualized. These neurons were located in the tentacles, hypostome, and peduncle, but not in the body column or basal disc. Since every neuron in the nerve net is continuously displaced toward an extremity and eventually sloughed, the constant pattern of FLI+ neurons could arise in one of two ways. When displaced into the appropriate region, FLI- neurons are converted to FLI+ neurons, or FLI+ neurons arise by differentiation from interstitial cells. To distinguish between these two possibilities, interstitial cells, the multipotent precursors of the nerve cells, were eliminated by treatment with hydroxyurea or nitrogen mustard. Following head, or foot and peduncle, removal from these animals, the missing structures regenerated. The spatial pattern of FLI+ neurons reappeared in the newly regenerated head or peduncle. This shows FLI- neurons in the body column were converted to FLI+ when their position was changed to the head or the peduncle. When the peduncle was grafted into the body column, it was converted to basal disc or body column tissue, and FLI disappeared. The appearance and loss of FLI was always position dependent. These results indicate that the neurons in the mature nerve net can change their neuropeptide phenotype in response to changes in their position. PMID- 3525279 TI - Presynaptic or postsynaptic origin of acetylcholinesterase at neuromuscular junctions? An immunological study in heterologous nerve-muscle cultures. AB - Numerous studies have shown that the acetylcholine receptor (AChR) is inserted in the plasma membrane of the muscle fiber, and that it is focalized at the site of neuromuscular junctions, as an effect of neural influence. In contrast, acetylcholinesterase (AChE) may be presynaptic or anchored in the basal lamina, as well as postsynaptic at neuromuscular junctions. We investigated the origin of the junctional enzyme, particularly the collagen-tailed asymmetric A12 forms, by studying the AChE contents of heterologous rat and chicken neuromuscular cocultures by immunohistochemical and biochemical methods. We found that the overall content of AChE, in the neuromuscular cocultures, including the A12 form, was essentially identical to the sum of the contents of separate myotube and motoneuron cultures. The sedimentation coefficients of the rat and chicken asymmetric forms are sufficiently different to clearly differentiate these enzymes in sucrose gradients: 16 S for rat, 20 S for chicken A12 AChE. Sedimentation analyses of AChE in cocultures thus showed that the A12 form was of muscular origin. In the case of aneural cultures of myotubes, histochemical staining of AChE activity or immunohistochemical staining with specific antibodies showed only very scarce, faint concentrations of enzyme. Some patches of acetylcholine receptor (AChR) were, however, visible in these cultures. Neuromuscular contacts are readily established in cocultures of myotubes with embryonic motoneurons from spinal cords. In the presence of motoneurons, the myotubes presented a larger number of AChR patches. The most remarkable feature of neuromuscular cocultures was the presence of numerous intense AChE patches which always coincided with AChR clusters. By specifically staining nerve terminals with tetanus toxin, we could show an excellent correlation between neuromuscular contacts and the presence of AChE-AChR patches. We found that the AChE patches in heterologous cocultures could be stained exclusively by the anti myotube AChE antiserum. The focalized enzyme is therefore exclusively, or very predominantly, provided by the myotube. PMID- 3525281 TI - Requirement of a neural tube signal for the differentiation of neural crest cells into dorsal root ganglia. AB - The influence of the neural tube on early development of neural crest cells into sensory ganglia was studied in the chick embryo. Silastic membranes were implanted between the neural tube and the somites in 30-somite-stage embryos at the level of somites 21-24, thus separating the early migrated population of neural crest cells from the neural tube. Neural crest cells and peripheral ganglia were visualized by immunofluorescence using the HNK-1 monoclonal antibody and several histochemical techniques. Separation of crest cells from the neural tube caused the selective death of the neural crest cells from which dorsal root ganglia (DRG) would have developed. Complete disappearance of HNK-1 positive cells was evident already 10 hr after silastic implantation, before early differentiation sensory neurons could have reached their peripheral targets. In older embryos, DRG were absent at the level of implantation. In contrast, the development of ventral roots, sympathetic ganglia and adrenal gland was normal, and so was somitic differentiation into cartilage and muscle, while morphogenesis of the vertebrae was perturbed. To overcome the experimentally induced crest cell death, the silastic membranes were impregnated with a 3-day-old embryonic chick neural tube extract. Under these conditions, crest cells which were separated from the tube survived for a period of 30 hr after operation, compared to less than 10 hr in respective controls. The extract of another tissue, the liver, did not protract survival of DRG progenitor cells. Among the cells which survived with neural tube extract, some even succeeded in extending neurites; nevertheless, in absence of normal connections with the central nervous system (CNS) they finally died. Treatment of silastic implanted embryos with nerve growth factor (NGF) did not prevent the experimentally induced crest cell death. These results demonstrate that DRG develop from a population of neural crest cells which depends for its survival and probably for its differentiation upon a signal arising from the CNS, needed as early as the first hours after initiation of migration. Recovery experiments suggest that the subpopulation of crest cells which will develop along the sensory pathway probably depends for its survival and/or differentiation upon a factor contained in the neural tube, which is different from NGF. PMID- 3525282 TI - Transient expression of collagen type II at epitheliomesenchymal interfaces during morphogenesis of the cartilaginous neurocranium. AB - In the avian embryo a matrix-mediated tissue interaction between retinal pigmented epithelium and neural crest-derived periocular mesenchyme leads to the differentiation of (scleral) cartilage. The composition of the extracellular matrix at the interface between these two tissues has been examined immunohistochemically, both during and after the interaction has taken place. Of the matrix components studied (fibronectin, laminin, and collagen types I, II, IV, and V) only collagen type II displayed a dramatic change in distribution between the two stages. During the interaction, at stage 15, type II was present in the extracellular compartment basal to the epithelium. After completion of the interaction, collagen type II was no longer detectable at the interface even though it was readily detectable in the vitreous humor, cornea, and perinotochordal sheath, and subsequently will be expressed by the chondrogenic tissue itself as overt differentiation commences. These results suggest that collagen type II might be causally involved in this particular epitheliomesenchymal interaction. Examination of the spatial and temporal patterns of collagen type II expression elsewhere in the developing craniofacial complex revealed a hitherto unreported pattern of distribution. In addition to its predictable locations (i.e., cornea, vitreous, and perinotochordal sheath) it was found to be present at certain other sites, for example, at the basal surfaces of some neuroepithelia. These additional locations are all known to be sites of chondrogenesis-promoting tissue interactions which result in the formation of the elements of the cartilaginous neurocranium (e.g., otic vesicle). Furthermore this spatial distribution exhibits a changing temporal pattern in that it is detectable at the time that the interactions are known to be taking place, but subsequently is no longer detectable by the immunohistochemical means employed. This definable pattern of transient collagen type II expression, occurring at very early stages of craniofacial development, is interpreted as reflecting one level of morphogenetic specification of chondrocranial/skull form in the developing vertebrate head. PMID- 3525283 TI - Induction of neural cell adhesion molecule (NCAM) in Xenopus embryos. AB - Using a classical neural induction protocol (H. Spemann and H. Mangold (1924). Roux' Arch. Entwicklungsmech. Org. 123, 389-517), it has been demonstrated that the sustained presence of NCAM in Xenopus embryos, as detected by immunohistochemistry, was confined to the experimentally induced nervous system and the primary host nervous system. Furthermore, in vitro NCAM expression by dorsal blastopore lip and animal pole tissue was detected only when the two tissues were cultured in contact. These and other results show that readily detected and sustained levels of NCAM expression in Xenopus can be used as a marker for neural tissue and an early positive indicator that neural induction has occurred. They suggest that the observed levels of NCAM are a consequence of and not a prerequisite for induction. Using NCAM expression in vitro to determine the minimum time necessary for this induction to occur in vivo, it was found that NCAM was first detected in cultured animal pole that had been removed at stage 10.75 or later. Thus, an inductive step necessary and sufficient for stimulation of NCAM expression in animal pole tissues had not occurred or was reversible prior to the first 2 to 2.5 hr of gastrulation. PMID- 3525284 TI - Transfer of autoimmune diabetes mellitus with splenocytes from nonobese diabetic (NOD) mice. AB - The nonobese diabetic (NOD) mouse, a model of human type I diabetes, develops insulitis beginning at 4-6 wk of age. By 30 wk of age, 72% of females and 39% of males develop spontaneous diabetes, apparently because of an overwhelming autoimmune response to the insulin-producing beta-cells within the islets. To identify the immune mechanism responsible for destruction of beta-cells in the NOD mouse, we developed an adoptive transfer protocol that induces diabetes in NOD mice at an age when spontaneous diabetes is rarely observed. Splenocytes from overtly diabetic NOD mice were unable to transfer diabetes to very young (less than or equal to 6 wk) irradiated NOD mice but effectively transferred diabetes to irradiated NOD mice greater than 6 wk of age. In such transfers, overt diabetes was induced within 12-22 days in greater than 95% (79/82) of the recipients. Thus, transfer of splenocytes to young mice induces them to become diabetic at a higher frequency and at a younger age than their untreated littermates. Equally successful transfers with as few as 5 X 10(6) spleen cells have been performed in male and female NOD mice, even though males display a lower spontaneous incidence of diabetes than females. Splenocytes obtained from diabetic mice maintained on insulin for up to 2 mo also transferred diabetes. Because NOD mice display increasing levels of insulitis with age, spleen cells obtained from nondiabetic NOD mice of different ages were tested for their ability to transfer diabetes.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3525285 TI - Islet secretory granules contain cytochrome b561. AB - A cytochrome has been detected in secretory granules prepared from anglerfish islets of Langerhans. The heme moiety was determined to be of the b type, and the dithionite-reduced cytochrome exhibited an alpha-band maximum at 561 nm with an extinction coefficient of 13.8 mM-1 X cm-1. The protein was present at a concentration of 40 +/- 4 pmol/mg of secretory granule protein. The cytochrome was found to be an integral membrane protein and to be reduced by ascorbic acid but not by NADH, NADPH, reduced glutathione (GSH), or succinate. Because of the similarity to previously characterized secretory granule cytochrome b561's from neuroendocrine tissues, this cytochrome is also referred to as cytochrome b561. Although its function has not yet been elucidated, the apparent specificity for ascorbate suggests that it may be a component of the ascorbate-dependent peptidyl glycine alpha-amidating monooxygenase system that functions in the amidation of islet hormones. PMID- 3525286 TI - Glucagon immunoreactivity and chromatographic profiles in pancreatectomized humans. Paradoxical response to oral glucose. AB - The nature and origin of plasma immunoreactive glucagon (IRG) after pancreatectomy in humans remains controversial. Low plasma IRG levels and heterogeneity hamper accurate assessment. We studied plasma IRG levels and profiles in 12 patients 2-57 mo after a total pancreatectomy (with antrectomy and duodenectomy) for cancer (N = 9) or chronic pancreatitis (N = 3). After oral glucose, plasma IRG (with the COOH-terminal-specific 30K glucagon antibody) rose from 59 +/- 7 to a peak of 113 +/- 17 pg/ml at 60-120 min. Chromatographic profiles revealed four distinct IRG fractions. In every patient a plasma IRG fraction of 9000-15,000 Mr, detectable basally, increased markedly after oral glucose and accounted for the rise in total IRG observed in plasma. Nine of the 12 pancreatectomized subjects had no detectable 3500-Mr glucagon and the remaining 3 had very low levels. For the group as a whole, 3500-Mr IRG comprised 1-2% of the total recovered IRG. Two patients were also studied before pancreatectomy: suppressibility of glucagon (Mr 3500) was evident. After surgery this paradoxical response to oral glucose was demonstrated. Reproducibility of these responses was confirmed in two patients studied twice over 2 yr. Diabetic controls without pancreatectomy did not show this response. The absence or marked reduction of pancreatic glucagon was confirmed in five of the pancreatectomized patients after intravenous arginine or oral protein. Normal basal plasma IRG and profiles, oral glucose suppressibility, and arginine stimulation were present in five control patients with unresectable pancreatic malignancies.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3525288 TI - Efficacy of pulsatile versus continuous insulin administration on hepatic glucose production and glucose utilization in type I diabetic humans. AB - To evaluate the role of pulsatile insulin administration, hepatic glucose production (HGP) and utilization were studied in type I diabetic patients in the fasting state and during a euglycemic insulin (1 mU X kg-1 X min-1 i.v.) clamp with continuous and pulsatile insulin administration. In the latter study, insulin was infused at twice the continuous rate with 3-min-on/7-min-off intervals, thereby reducing total insulin delivery by 40%. The restraining effect of pulsatile insulin on basal HGP (1.91 +/- 0.35 mg X kg-1 X min-1) was equipotent to continuous insulin exposure (1.80 +/- 0.17 mg X kg-1 X min-1). During the insulin-clamp studies, HGP was equally suppressed by pulsed (0.62 +/- 0.12 mg X kg-1 X min-1) as by continuous insulin infusion (0.63 +/- 0.12 mg X kg 1 X min-1). Insulin-stimulated glucose utilization was not significantly altered in either study (2.55 +/- 0.27 vs. 2.92 +/- 0.23 mg X kg-1 X min-1). When in further studies the total insulin dose given during the pulsatile study was infused continuously (0.6 mU X kg-1 X min-1), HGP in the basal state and residual HGP during the insulin-clamp study were 25-30% higher than in the pulsatile experiments, whereas glucose utilization was not significantly different. In conclusion, by reducing total hormone delivery by up to 40%, but given in a pulsatile fashion, insulin is equally potent in controlling HGP as continuous insulin administration. This greater efficacy of pulsatile exposure in suppressing HGP is accompanied by an equipotent effect on glucose utilization.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3525287 TI - Are insulin autoantibodies markers for insulin-dependent diabetes mellitus? AB - Recent studies have shown that insulin autoantibodies occur in patients with newly diagnosed insulin-dependent diabetes mellitus (IDDM) before exogenous insulin treatment. Our study was designed to test the hypothesis that insulin autoantibodies, like cytoplasmic islet cell antibodies (ICAs), can identify individuals with ongoing autoimmune beta-cell destruction and increased risk of IDDM development. Insulin autoantibodies detected by use of a radioligand-binding assay were found in 1.4% of normal controls, 4% of first-degree relatives of IDDM patients, and in 37% of newly diagnosed IDDM patients. A strong positive correlation between insulin autoantibodies and ICAs was observed. HLA typing of insulin-autoantibody-positive first-degree relatives of IDDM patients, as well as in the general population, revealed a strong association with HLA-DR3 and/or-DR4, suggesting that insulin autoantibodies are restricted to persons genetically susceptible to IDDM. In an ongoing study of beta-cell function in ICA-positive nondiabetic individuals, the additional presence of insulin autoantibodies significantly increased the likelihood of beta-cell dysfunction. After intravenous glucose stimulation, insulinopenia was present in 70% of ICA and insulin-autoantibody-positive individuals in contrast to only 23% of ICA positive, insulin-autoantibody-negative persons. These data document a significant association between insulin autoantibodies and ICAs and support the contention that insulin autoantibodies, like ICAs, are markers of ongoing beta cell destruction. PMID- 3525289 TI - In vivo evaluation of four posterior composites: quantitative wear measurements and clinical behavior. PMID- 3525290 TI - Effect of thermal cycling on fracture strength and microleakage in teeth restored with a bonded composite resin. PMID- 3525291 TI - Retention of dowels using Conclude composite resin as a luting medium. PMID- 3525292 TI - The retention of self-threading pins embedded in various restorative materials. PMID- 3525293 TI - Biocompatibility of mercury derivatives. PMID- 3525294 TI - Displacement amplitude as a measure of the acoustic output of ultrasonic scalers. PMID- 3525295 TI - Microinjection of glycosaminoglycan-degrading enzymes in the chicken blastoderm. An ultrastructural study. AB - The relationship between the presence of glycosaminoglycans (GAGs) and the morphology of the middle layer or mesoblast was examined by performing transmission electron microscopy of chicken blastoderms microinjected with GAG degrading enzymes. The controls included microinjections with saline or trypsin, as well as solid-phase assays for proteolytic activity in commercially available GAG-degrading preparations. The results indicate that, in normal as well as in saline-injected blastoderms, middle-layer cells are rounded or cuboidal in shape, and are linked to each other by small intercellular junctions in the primitive streak region. As they migrate laterally along the basal lamina, they appear as typical mesenchymal cells, being separated by large intercellular spaces and covered by cell processes. The removal of hyaluronate (by the microinjection of hyaluronidases) led to compaction of the middle-layer cells in the area lateral to the primitive streak. These cells lost their mesenchymal aspect and retracted their processes, and intercellular junctions were observed. The presence of proteolytic activity in the enzyme preparations did not interfere with the results. On the basis of the results obtained using this microinjection technique, we were able to confirm at the ultrastructural level that hyaluronate, due to its space-creating properties, promotes the detachment of ingressed primitive-streak cells and preserves the mesenchymal aspect of the middle layer during the lateral migration of single cells along the basal lamina. Whether the presence of hyaluronate is necessary to allow positioning of the mesoblast could not be inferred using our experimental procedure. We present evidence that this molecule, as well as having physicochemical properties, is also involved in the modulation of tissue interactions during gastrulation. PMID- 3525296 TI - Differential survival of cartilage and muscle cells in chick limb-bud cell cultures maintained in chemically defined and serum-containing media. AB - Chick limb buds at stages 22-23 largely consist of replicating presumptive chondroblasts and presumptive myoblasts. To study the influence that different medium compositions may have on the survival, replication, and terminal differentiation of these dissociated cells in vitro, micromass cultures were reared in either standard Dulbecco's modified Eagle's medium containing fetal calf serum (SC-DMEM) or in serum-free DMEM. By day 4, approximately 80% and 50% of the original cell inoculum had been lost in DMEM and SC-DMEM cultures, respectively, as estimated from the recovery of incorporated 3H-thymidine. Between days 1 and 4, the total-DNA content remained virtually constant in DMEM cultures, while it increased five- to sixfold in SC-DMEM cultures. In both media, definitive myoblasts and chondroblasts first emerged on day 1 and day 2, respectively, as determined by immunofluorescence staining using antibodies against muscle light meromyosin (LMM) or the major cartilage proteoglycan. In both media, the chondroblasts increased in number and, by day 4, had formed sizable chondroblast nodules. The number of chondroblasts in SC-DMEM cultures exceeded that observed in DMEM cultures. In DMEM, the LMM-positive myoblasts had an atypical morphology and failed to fuse into elongated myotubes; these cells began to degenerate on about day 4, being undetectable by day 8. In SC-DMEM, the numerous LMM-positive myoblasts located in the center of the micromasses also had an atypical morphology, failed to form multinucleated myotubes, and were absent by day 8.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3525297 TI - Regulatory implications of Ames' mutagenicity assay using Salmonella typhimurium. AB - Interpretive difficulties can be expected when molecular biology and modern genetics are applied to the safety evaluation of chemicals. Experience, in a regulatory setting, with evaluating the results of short term tests, such as Ames' mutagenicity assay using Salmonella typhimurium (Ames' assay), shows that the traditional toxicological paradigm for interpreting and evaluating the results of such tests is less than adequate. The considerable importance of a negative test outcome to the public health as well as to the course of the commercial development of a potentially useful chemical places special demands on both the investigator and the regulatory reviewer for an understanding of Ames' assay. The adequate design, conduct, interpretation, and evaluation of the outcomes of this assay require a knowledge of the chemical properties of the test agent, an understanding of the scientific basis of the test, and an appreciation of the extent to which modifications of the assay can alter the outcome. The investigator and the regulatory reviewer use the same considerations to determine the adequacy of the test design and of the test results. However, a fundamental difference exists between how they interpret results and how they view the outcome. Results from a study comparing activation systems from food animal and laboratory animal sources are used to illustrate the complexity of using safety data from a genetic test. A framework is developed to suggest how to accommodate the points of view of the investigator and the regulatory reviewer in evaluating these data. PMID- 3525298 TI - Removable partial denture variations for the elderly patient. PMID- 3525299 TI - Salivary gland function during aging. PMID- 3525300 TI - Restoration of the occlusal face height by removable partial dentures in elderly patients. PMID- 3525301 TI - Work of cardiology community results in approval of amiodarone. PMID- 3525302 TI - [The Roman Coronary Disease Prevention Project: effectiveness of intervention and reduction of mortality over a 10-year period]. AB - The study has been conducted in 6027 men aged 40-59 at entry, for a total of 3131 treated and 2896 controls, distributed in two pairs of occupational groups. The preventive intervention included actions against some classical coronary risk factor i.e. diet and exceptionally drugs on cholesterol, anti-hypertensive drugs in hypertensives, anti-smoking advice in smokers, diet and increase of leisure physical activity in men with overweight. The treatment has lasted 6 years and has been accompanied by a significant reduction of the estimated multivariate coronary risk in treatment groups reaching a peak after 4 years (-26.5%) and a final value of -20.5% after 6 years. Coronary mortality in 10 years (the last 4 without treatment and risk factors measurements) has shown a maximum difference between treated and controls after 6 years (-29.5%) whereas at the end of 10 years it was of -23.5% (p less than 0.1). The final rates of coronary mortality were 34.1 per 1000 in controls and 26.1 per 1000 in treated men (benefit 8 per 1000). All causes mortality after 10 years was 94.8 per 1000 in controls and 89.1 per 1000 in treated groups with a benefit of 5.7 per 1000. PMID- 3525303 TI - [Digitalis and sinus rhythm. An old question that is still current]. AB - To study the efficacy of chronic digitalis therapy in patients with congestive heart failure and sinus rhythm, a bibliographic search was fulfilled. 12 clinical trials were found and analyzed from a clinical and methodological point of view. These studies have shown a discrepancy between the clinical and haemodynamic efficacy of the drug. Usually patients' symptoms don't improve as it should be expected from the haemodynamic data. It is possible and advisable to withdraw a chronic treatment in many stable patients without worsening the clinical conditions. However some methodological bias (research strategies, patient selections, follow-up analysis and clinical and haemodynamic criteria) seem to reduce the results' reliability. The old question of digitalis efficacy in sinus rhythm is still controversial: new inotropic drugs are appearing. The lesson from the digitalis controversy should be seriously considered in the clinical evaluation of these new therapeutic agents. PMID- 3525305 TI - [Bibliographic review]. PMID- 3525304 TI - [Leopold Auenbrugger and chest percussion]. PMID- 3525306 TI - [Colonic electromyography in man: technics, results, clinical value]. PMID- 3525307 TI - [Post-stress nonlithiasic acute cholecystitis. Contribution of ultrasonics to the diagnosis and treatment in 50 cases]. AB - Fifty cases of post-stress acute acalculous cholecystitis were observed during the past 9 years, mainly after major surgery or trauma. The apparently increasing incidence over the last 4 years (42 cases) could probably be explained by a better diagnostic approach of this condition by routine use of ultrasonography. No specific etiological factor could be found; however total parenteral nutrition and/or sepsis and/or use of narcotics could possibly play a role in the appearance of this complication. Although diagnosis can occasionally be suspected in the basis of abdominal and infectious signs, diagnosis was made primarily on the following ultrasonographic signs: enlarged gallbladder with thickened wall, sludge, and occasionally a double-wall aspect and a pericholecystic collection. In this series, most of the patients were treated by cholecystectomy, but a new therapeutic approach was used in 10 cases: percutaneous transhepatic drainage under sonographic control. Outcome is still poor, with a 50 p. 100 mortality rate. PMID- 3525309 TI - [Echographic aspects of 2 cases of Vater's ampulloma]. PMID- 3525308 TI - [Delta hepatitis virus: 3rd identified hepatitis virus]. PMID- 3525310 TI - [Immunological diagnosis of human hydatidosis]. PMID- 3525311 TI - [The liver and aging]. PMID- 3525312 TI - Occurrence and neonatal development of N-terminal (1-15) immunoreactivity of big gastrin in the rat antrum. AB - G34N (1-15) immunoreactive cells and C-terminal tetrapeptide immunoreactive cells in the antrum of rats of various ages were studied immunocytochemically in both naturally weaned and non-weaned conditions. Some of the C-terminal immunoreactive cells were found to lack G34N (1-15) immunoreactivity while the remainder showed both types of immunoreactivity. G34N (1-15)/C-terminal immunoreactive cell rates increased with age and reached adult values at 3 weeks after birth. The rates in a non-weaned condition were, however, significantly lower than those in a naturally weaned rats. These findings suggest that the development of G34N (1-15) immunoreactivity in rat antral gastrin cells is closely related to maturation of the gastrin cells, and weaning may enhance the maturation process. PMID- 3525314 TI - Ventilatory function in chronic peptic ulcer. A controlled study of ventilatory function in patients with gastric and duodenal ulcer. AB - The aim of this study was to determine if a defect in ventilatory function is present in patients with chronic peptic ulcer and if so, is it present in both gastric and duodenal ulcer and is it related to smoking. Fifty-six patients with peptic ulceration (27 gastric ulcer, 29 duodenal ulcer), together with 56 healthy controls matched for age, sex, and smoking status, were studied. Ventilatory function was measured and the ABH blood group antigen secretor status was determined. Vital capacity and forced expiratory volume in 1 s were significantly reduced in both smokers and nonsmokers with gastric ulcer when compared with controls; total lung capacity was lower than controls only in smokers with gastric ulcer. In duodenal ulcer patients, a trend similar to that observed in gastric ulcer patients was present. It is concluded that a defect in ventilatory function is present in patients with chronic gastric ulcer; a lesser defect is present in patients with duodenal ulcer. PMID- 3525313 TI - Development of a monoclonal antibody identifying an antigen which is segregated to the sinusoidal and lateral plasma membranes of rat hepatocytes. AB - We developed a monoclonal antibody to the plasma membrane of rat hepatocytes. Immunoelectron microscopic characterization of an antigen identified by our antibody revealed that the antigen was present diffusely on the sinusoidal and lateral plasma membranes of hepatocytes but absent from the bile canalicular membrane. Sinusoidal lining cells (Kupffer cells and endothelial cells) were devoid of the antigen. Within hepatocytes, the antigen was present in the Golgi complexes, segments of endoplasmic reticulum and small vesicle-like structures. The development of the monoclonal antibody to the segregated membrane antigen of the hepatocyte in this study provides a reliable marker of specific membrane domains for use of isolation of plasma membrane surfaces and is a useful tool for investigation of the transferring mechanisms of membrane proteins to their destinations. PMID- 3525315 TI - Impaired transit of chyme in chronic intestinal pseudoobstruction. Correction by cisapride. AB - Chronic intestinal pseudoobstruction is a clinical syndrome whose pathophysiology, objective diagnosis, and treatment are poorly understood. We investigated 8 patients with this syndrome in whom intestinal dysmotility was established manometrically by two or more of the following criteria: abnormal configuration or propagation of interdigestive motor complexes, sustained incoordinate pressure activity, non-propagated bursts of phasic pressure activity, and failure of a solid-liquid meal to induce a fed pattern. To establish the functional impairment and region of the gut primarily affected by the disease, we quantified radio-scintigraphically the gastrointestinal transit of the solid (131I-fiber) and liquid (99 mTc-DTPA) components of a meal. Our techniques allowed us to quantify separately gastric emptying and pylorus-to cecum transit. Furthermore, we evaluated the effects of a new prokinetic agent, cisapride. Gastric emptying times in pseudoobstruction were not significantly delayed; however, transit times through the small bowel (t1/2) were markedly prolonged [solids, 235 +/- 43 min (mean +/- SEM) vs. 138 +/- 25 controls, p less than 0.05; liquids, 310 +/- 67 vs. 181 +/- 28 controls, p = 0.07]. Cisapride was effective in reducing the delayed intestinal transit time to within the normal range (delta solids = -115 +/- 25 min; delta liquids = -146 +/- 71 min; p less than 0.05 for both). These studies suggest that intestinal dysmotility in this group of patients with pseudoobstruction was associated with delayed small bowel transit of radiolabeled solid and liquid components of chyme. Cisapride can restore to normal the delayed transit, indicating that it may potentially correct the impaired propulsive activity in the small bowel of these patients. PMID- 3525316 TI - Chronobiological study of factors affecting plasma aldosterone concentration in cirrhosis. AB - We studied the mechanisms leading to derangement of aldosterone secretion in cirrhosis. The circadian patterns of plasma renin activity (PRA), aldosterone, cortisol, sodium, and potassium were studied in 16 nonazotemic cirrhotics (group 1 without ascites, 7 cases; group 2 with ascites, 9 cases) and 7 healthy controls. Group 1 did not differ from controls in aldosterone, sodium, and potassium mean daily levels (mesors), but had reduced PRA mesor (p less than 0.05). Moreover, minor derangements in circadian patterns of PRA, aldosterone, and potassium were also found. Group 2 not only showed an increased mesor of PRA (p less than 0.05), aldosterone (p less than 0.001), and reduced sodium (p less than 0.005), but also achronia in daily fluctuations of PRA, aldosterone, and potassium. In all groups the mesors of PRA and aldosterone were correlated (r greater than or equal to 0.82; p less than 0.01 or less), but the regression line slopes of patients were steeper than those of controls (group 1, p less than 0.05; group 2, p less than 0.01). Moreover, although in controls and some group 1 patients aldosterone paralleled cortisol rhythmicity, most group 2 patients had aldosterone daily patterns correlated with those of PRA. Finally, no relationships between plasma potassium and aldosterone concentrations were found in patients, whereas they were strictly related in controls. These results suggest that the renin-angiotensin system is the prevalent determinant of aldosterone secretion in cirrhosis. PMID- 3525317 TI - Levamisole therapy in chronic type B hepatitis. Results of a double-blind randomized trial. AB - A double-blind, randomized, controlled trial has been undertaken to evaluate treatment of chronic hepatitis type B with levamisole. Ten patients received levamisole (150 mg/day, 3 days/wk) and 10 received placebo until seroconversion to antibody to hepatitis B e antigen eventually occurred, or for a maximum of 18 mo. Final evaluation at 24 mo after starting treatment revealed that 60% of the patients in the levamisole group had become hepatitis B e antigen negative, 90% were hepatitis B virus-deoxyribonucleic acid negative in serum, and 8 of 9 (89%) patients had cleared hepatitis B core antigen from the liver. On the other hand, in the placebo group only 4 of the 10 subjects (40%) were hepatitis B e antigen and hepatitis B virus-deoxyribonucleic acid negative in serum and 3 of 8 (37.5%) of them became hepatitis B core antigen free in the liver. Moreover, in 8 patients of the treated group and in 4 of the control cases aminotransferase activities fell into the normal range. A liver biopsy specimen was obtained after treatment in 17 patients and 7 of 9 levamisole recipients showed marked improvement in hepatic histology, compared with 3 of 8 placebo recipients. These data show that patients treated with long-term levamisole therapy have a tendency toward normalization of aminotransferase activities and suppression of hepatitis B virus replication, suggesting that the drug may be of benefit in chronic hepatitis B e antigen-positive hepatitis. PMID- 3525318 TI - Biliary ascariasis: ultrasonography, endoscopic retrograde cholangiopancreatography, and biliary drainage. AB - Roundworms migrating into the biliary tract are a relatively common cause of biliary symptoms in areas where the parasite is endemic. Visualization of worms by conventional radiologic methods is often unsatisfactory, whereas ultrasonography offers a rapid, safe, and noninvasive approach to the diagnosis. Using real-time ultrasonographic scanning we demonstrated for the first time the characteristic morphology of the worms in a patient with biliary ascariasis. In addition, the motility of the worms in the biliary tract could be confirmed. Ultrasonography is also a convenient method for the follow-up of patients. Endoscopic biliary drainage and instillation of piperazine citrate through a nasobiliary drain is a logical therapy and was used successfully in this patient. PMID- 3525319 TI - [Origin of hematopoietic stromal cells in chimeras]. PMID- 3525320 TI - [Immunological diagnosis of acute lymphoblastic leukemia]. PMID- 3525321 TI - Precocious meiotic centromere separation of a novel yeast chromosome. AB - In Saccharomyces cerevisiae, a reciprocal translocation between chromosome II and a linear plasmid carrying a centromere (CEN6) has split chromosome II into two fragments: one, approximately 530 kilobase pairs (kbp) in size, has the left arm and part of the right arm of chromosome II; the other, a telocentric fragment approximately 350 kbp in size, has CEN6 and the rest of the right arm of chromosome II. A cross of this yeast strain with a strain containing a complete chromosome II exhibits a high frequency of precocious centromere separation (separation of sister chromatids during meiosis I) of the telocentric fragment. Precocious centromere separation is not due to the position of the centromere per se, since diploids that are homozygous for both fragments of chromosome II segregate the telocentric fragment with normal meiotic behavior. The precocious centromere separation described here differs from previously described examples in that pairing and synapsis of this telocentric chromosome seem to be normal. One model of how centromeres function in meiosis is that replication of the centromere is delayed until the second meiotic division. Data presented in this paper indicate that replication of the centromere is complete before the first meiotic division. The precocious separation of the centromere described here may be due to improper synapsis of sequences flanking the centromere. PMID- 3525323 TI - [The need for protein synthesis in UV-irradiated Escherichia coli cells for fixation of induced Str mutations]. AB - The kinetics of accumulation of fixed Str mutations was determined during incubation in nutritional medium of Escherichia coli WP2 irradiated with 6.8 J/m2 either at log growth phase or after completion of DNA replication. Those Str mutations which lost ability for photoreactivation (fixation I) or susceptibility to antimutagenic activity of mfd-type (fixation II) were considered as fixed mutations. It was shown that both fixations occurred synchronously, starting in about 10 min after irradiation and being over in 40-50 min. In cells irradiated after completion of replication, fixation depended on protein synthesis de novo: chloramphenicol added to irradiated culture blocked fixation. An attempt to study the effect of chloramphenicol on fixation in a culture irradiated at the log phase failed, because of high lethal action of the antibiotic on such cells. Fixation could proceed in the presence of acriflavine. Possible mechanisms for fixation of Str mutations are discussed in connection with the fact of its dependence on protein synthesis. PMID- 3525322 TI - Genetic differences among the A/J X C57BL/6J recombinant inbred mouse lines and their degree of association with glucocorticoid-induced cleft palate. AB - Hydrocortisone sodium phosphate was injected intramuscularly into A/J, C57BL/6J and recombinant inbred lines from these two parental lines to study the genetics of steroid-induced cleft palate in a situation of identical maternal and fetal genotypes. The strains were typed for H-2 (the major histocompatibility locus), beta-glucuronidase and beta 2-microglobulin, which served as markers on chromosomes 17, 5 and 2, respectively. Hepatic glucocorticoid binding capacity had been previously measured in Hepes buffer and Hepes buffer plus dithiothreitol (DTT). The level of glucocorticoid binding in Hepes buffer and in Hepes plus DTT, as well as their ratio, was compared to the incidence of steroid-induced cleft palate in the recombinant inbred lines. A correlation was found between the response of glucocorticoid binding to DTT (expressed as a ratio of binding in the presence of DTT to binding without DTT) and hydrocortisone-induced cleft palate. When analyzing the effect of the three chromosomal markers on hydrocortisone induced cleft palate, the b alleles of beta 2-microglobulin and of beta glucuronidase were associated with a higher incidence. Genetic analyses of the differences between these two inbred strains of mice in the incidence of steroid induced cleft palate show it not to be monogenic. PMID- 3525324 TI - [Isolation of Tyr- mutants of facultative methylotrophic Pseudomonas sp. M]. AB - A method for isolation of Tyr- mutants of facultative methylotrophic bacteria Pseudomonas sp. M which possess two tyrosine synthesis pathways is presented. The method is based on the two-step blocking of the tyrosine synthesis: the first step of the supplementary pathway of synthesis from phenylalanine, the second being the main pathway from 4-hydroxyphenylpyruvate. PMID- 3525325 TI - [Construction of the bacterial genome--the next goal of genetic engineering]. AB - The article deals primarily with literature data on the organization and evolution of bacterial genome. An account of the conception of "current" bacterial evolution consisting of periodical inclusions into a bacterial genome of genes having exogenous origin is given. A hypothesis is proposed that rare inversions going through the oriC or terC chromosomal regions could serve as reparative rearrangements providing balanced distribution of the DNA segments of different origin within the circular genome. It is asserted that the progress in the study of the model microorganism Escherichia coli K-12 as well as in genetical methods give rise to a new experimental challenge--the creation of a "rational" bacterial genome on the basis of E. coli cell. It is proposed that a "rational" bacterial genome could be devoid of many genes which provide the evolutionary formed ecological potential of the species and its capacity for rapid adaptation to new environment. PMID- 3525326 TI - Depression in the fifties. AB - 'Depression in the fifties' is assumed to signify 'involutional melancholia', a diagnosis which was once much used but is now disappearing. It has been proposed that this category arose from what was essentially a comparison between unipolar and bipolar depressions but which ignored the differences in the modal age of onset. PMID- 3525327 TI - Quantitative detection of cerebral arteriosclerosis by means of the Doppler ultrasonic technique. AB - A correlation between the continuity of the cerebral blood flow pattern and the cerebral vascular resistance (namely, cerebral arteriosclerosis) was investigated by the Doppler ultrasonic technique. The following facts were observed. Examination of the brachial blood flow pattern in circulatory stress, i.e., hand grasping, brachial-binding, cold- and warm-stimulating tests revealed that the more the peripheral vascular resistance was increased, the more was the discontinuity of brachial blood flow pattern increased. Investigation of the continuity of the cerebral blood flow pattern (internal carotid artery) in 18 young healthy persons and 46 elderly patients with cerebral vascular diseases revealed a continuous pattern in all of the young persons, while the discontinuous pattern was frequently observed in the elderly patients. These findings suggest that the cerebral vascular resistance is more increased in the elderly patients than in the young persons. The cerebral blood flow pattern was classified into the following three types according to the continuity of the cerebral blood flow pattern: continuous, intermediate and discontinuous type, and the relation to the Continuous Index (CI), which was devised as an objective parameter of the continuity, was examined. The following CI figures were obtained: 110-200% in the young persons; in the elderly patients: continuous type, 120-185%; intermediate type, 85-135%; discontinuous type, 50-85%. From the above findings it is postulated that the Doppler ultrasonic technique is useful for the quantitative detection of cerebral arteriosclerosis, i.e., anticipation of cerebral vascular accidents, and for the discrimination between arteriosclerotic dementia and Alzheimer's disease. PMID- 3525328 TI - [Prenatal cytogenetic diagnosis. The beginning of a new stage in cytogenetics in Mexico]. PMID- 3525329 TI - [Diabetes mellitus and pregnancy. I. Various considerations on diagnosis and treatment]. PMID- 3525330 TI - [Normal echographic anatomy of the brain of the newborn infant]. PMID- 3525331 TI - The scientific basis of osseointegrated implants. PMID- 3525332 TI - The clinical application of the osseointegrated prosthesis. Part II. PMID- 3525333 TI - [Mycotic lesions of the bronchopulmonary system (experimental study)]. PMID- 3525334 TI - [Current status of the problem of diagnosis and treatment of pulmonary echinococcosis]. PMID- 3525335 TI - Measuring the damage--ethanol and the liver. PMID- 3525336 TI - Short term treatment of gastric ulcer: a comparison of sucralfate and cimetidine. AB - A double blind randomised study was undertaken to compare sucralfate and cimetidine in short term treatment of gastric ulcer. The study included 149 patients with endoscopically confirmed gastric ulcerations. Patients with prepyloric ulcers 2 cm or less from the pyloric ring were not accepted for participation in the trial. Ulcer healing was assessed endoscopically at four week intervals. A total of 134 patients completed the study. The cumulative healing rates after 12 weeks were 98% for sucralfate and 94% for cimetidine treated patients. After four and eight weeks, the healing rates were 61% and 94% for sucralfate and 69% and 94% for the cimetidine-treated group respectively. No statistically significant differences in healing rates were seen. The 95% confidence interval was calculated for the difference between the ulcer healing rates of sucralfate and cimetidine. This interval was found to range between +11% and -2% after 12 weeks of treatment - that is, the healing efficacy of sucralfate was calculated to be at most 11% better or 2% worse than that of cimetidine. No significant differences in symptom relief, side effects or antacid intake were found. PMID- 3525337 TI - A single night time dose of ranitidine in the acute treatment of gastric ulcer: a European multicentre trial. AB - Four hundred and twenty eight patients with endoscopically diagnosed gastric ulcers, randomly allocated to treatment with ranitidine 300 mg at night or ranitidine 150 mg twice daily, were evaluated in a double blind multicentre trial conducted in 10 European countries. After four weeks, complete ulcer healing was observed in 138 of 211 patients (65%) treated with ranitidine 300 mg nocte and in 155 of 217 patients (71%) receiving 150 mg bd. Cumulative healing rates at eight weeks were 90% and 93%, respectively. There was no statistically significant difference between the healing rates at either four or eight weeks. The treatment regimens were equally effective at rapidly reducing the incidence of ulcer related symptoms. Adverse events reported were minor and equally distributed between the two groups. The results of this trial show that 300 mg of ranitidine administered at night is an effective and safe alternative to the current twice daily regimen for the short term treatment of gastric ulcer. PMID- 3525338 TI - Pernicious anaemia and mucosal endocrine cell proliferation of the non-antral stomach. AB - There is a recognised association between pernicious anaemia and the development of gastric carcinoma, endocrine cell hyperplasia, and carcinoid tumour. Multiple endoscopic biopsies from the body mucosa of seven patients with pernicious anaemia showed small intestinal metaplasia with varying degrees of inflammation, fibrosis, and expansion of the lamina propria. Using conventional silver and lead stains, endocrine cells were inconspicuous. Staining for the general neural and neuroendocrine markers NSE and PGP 9.5 revealed a proliferation of endocrine cells in the epithelium and isolated clumps of endocrine cells in the lamina propria. The clumps were composed of two cell types, either small or large. Some of these endocrine cells showed gastrin, 5HT, VIP and substance P immunoreactivity of varying intensity. Ultrastructurally nine morphologically distinct types of granules were found some of which correlated with the immunohistochemistry. Some separate islands were composed solely of endocrine cells while others had a definite neural component, suggesting that the former arise from 'budding off' of enteroendocrine cells and the latter originate from the neuroendocrine cells of the lamina propria plexus. Thus there may be a dual origin of carcinoid tumours. Carcinoid tumours associated with pernicious anaemia tend to be multifocal and are infrequent. Less than 50 such cases have hitherto been reported. Our findings of endocrine cells proliferations in seven cases of pernicious anaemia indicate that this may be an adaptive change that occurs frequently and provides the basis on which carcinoids, less frequently, develop. PMID- 3525339 TI - Gut endocrine cell population in coeliac disease estimated by immunocytochemistry using a monoclonal antibody to chromogranin. AB - Abnormalities of gut endocrine responses, as well as changes in the number of different endocrine cell types, have been reported convincingly in coeliac patients. Nevertheless, no estimation of total numbers of gut endocrine cells has yet been made in well defined groups of coeliacs. In this study, we have visualised all endocrine cell types in jejunal biopsies from coeliac patients with active and quiescent disease as well as in controls, using a monoclonal antibody to chromogranin. This protein was purified originally from bovine adrenal medulla and is known to be a reliable marker for all endocrine cells of the gut. The following groups were considered: (a) nine coeliacs with active illness, (b) 10 coeliacs under gluten-free diet, (c) eight coeliacs receiving gluten challenge, (d) five non-coeliacs (controls). Histological (haematoxylin and eosin) and immunocytochemical (peroxidase anti-peroxidase) stains were applied to 3 micron paraffin sections. Quantitative estimation of endocrine cell density was made using four different methods in order to evaluate the results fully (number of cells/mm2, number of cells/visual field, number of cells/8 crypts-villi, number of cells/unit of length of muscularis mucosae). In patient groups (a) and (c), coeliacs with active disease and coeliacs on gluten challenge diet respectively, a significantly higher number of endocrine cells was observed in comparison with normal controls (group d). In group (b) patients, coeliacs on gluten-free diet, no significant changes in the number of endocrine cells were observed in comparison with controls. Our results show that a significant increase in endocrine cell density exists in coeliacs with active illness (groups a and c), in comparison with controls. This condition is resolved in coeliacs receiving a gluten-free diet (group b). PMID- 3525340 TI - Where do all the tablets go in 1986? PMID- 3525342 TI - Transcutaneous Doppler ultrasound measurement of blood flow. PMID- 3525341 TI - Human intestinal intraepithelial lymphocytes. PMID- 3525343 TI - Therapy of stage III (optimal) epithelial carcinoma of the ovary with melphalan or melphalan plus Corynebacterium parvum (a Gynecologic Oncology Group Study). AB - A randomized prospective therapy trial in patients with stage III optimal epithelial carcinoma of the ovary was accomplished by the Gynecologic Oncology Group. Therapy with melphalan or melphalan plus immuno-adjuvant, Corynebacterium parvum (C. parvum), was utilized as adjuvant treatment following surgical therapy. One hundred eight-five patients were eligible for evaluation with 87 patients in the melphalan group and 98 patients in the melphalan plus C. parvum group. The comparison of the treatment regimens showed no differences with respect to either progression-free interval or survival. However, it should be noted that a 50% 3-year survival was obtained. A group was identified, using four prognostic factors that had 80% survival at 3 years. Maximum size of the residual tumor, as well as performance status, was not prognostically significant. This study demonstrates a lack of efficacy of the addition of C. parvum to melphalan for this patient population. PMID- 3525345 TI - [Hysterectomy. Methods of the Miami University Clinic]. PMID- 3525344 TI - [Treatment of mastopathy with cyclic mastodynia: clinical results and hormone profile]. PMID- 3525346 TI - [How radical should surgery in ovarian cancer be?]. PMID- 3525347 TI - [Ultrasound diagnosis of fetal malformations]. PMID- 3525348 TI - [Corticosteroid therapy in childhood asthma]. PMID- 3525349 TI - [The hyperkinetic syndrome and its relation to the syndrome of attention deficit disorder]. PMID- 3525350 TI - [Psychosomatic aspects of cancer]. PMID- 3525351 TI - [Endoscopic sclerotherapy for bleeding esophageal varices]. PMID- 3525352 TI - [Cyclosporin]. PMID- 3525353 TI - [Carotid sinus hypersensitivity--new aspects]. PMID- 3525354 TI - [Activity of proteolytic enzymes and their inhibitors in the granulocytes of infants with acute pneumonia]. PMID- 3525355 TI - On talc translocation from the vagina to the oviducts and beyond. AB - The objective of this study was to investigate whether multiple vaginal depositions of neutron-activated talc in the cynomolgus monkey result in the translocation of this material to the uterus and beyond. Within a 45-day period, six monkeys received 30 applications of 125 mg neutron-activated talc, suspended in 0.3 ml physiological saline solution containing 1% carboxymethyl cellulose as a suspending agent. The suspension was deposited in the posterior vaginal fornix of the sedated monkeys. Two days after the final talc application, the animals were anaesthetized. Abdominal lavage was performed and the lavage fluid collected for gamma-ray analysis. Also collected for gamma-ray analysis were the following tissues/organs: ovaries, oviducts, uterus, and vagina with cervix. Six untreated control monkeys underwent the same procedures. The radioisotopes 46Sc, 60Co, 59Fe and 51Cr in the activated talc served as tracers. Only the samples containing vagina and cervix from the dosed monkeys contained varying quantities of talc. This demonstrates that no measurable quantities of talc, deposited by multiple applications in the vaginal fornix of the cynomolgus monkey, translocated to the uterus or beyond. PMID- 3525356 TI - Unpredictability: an essay in toxicology. PMID- 3525358 TI - [Immune reactions caused by insulin]. PMID- 3525357 TI - The Chinese restaurant syndrome: an anecdote revisited. AB - The Chinese Restaurant Syndrome arose from an anecdote of discomfort experienced after eating Chinese cuisine. Monosodium glutamate has been implicated as the causative agent. Work over the past 17 years has consistently failed to reveal any objective sign accompanying the transient sensations that some individuals experience after the experimental ingestion of monosodium glutamate and it is questionable whether the term 'Chinese Restaurant Syndrome' has any validity. When some common food materials are used in the same experimental setting, similar symptoms can be produced in a limited number of people. Double-blind testing of individuals who identify themselves as suffering the 'syndrome' has failed to confirm the role of monosodium glutamate as the provocative agent. PMID- 3525359 TI - [Diclofenac in blunt traumatic ankle joint swelling. Volumetric monitoring in a placebo controlled double-blind trial]. PMID- 3525360 TI - Role of adrenal glands in the development of abnormal glucose and insulin homeostasis in genetically obese (ob/ob) mice. AB - This study evaluates the role of adrenal hormones in the development of hyperinsulinaemia and impaired glucose homeostasis in genetically obese hyperglycaemic C57BL/6J ob/ob mice. Lean (+/?) and obese mice were bilaterally adrenalectomised or sham operated at 5 weeks of age, and glucose tolerance was examined after 7 and 14 days. Adrenalectomy temporarily reduced food intake and body weight gain in lean mice, and improved glucose tolerance without a significant change in plasma insulin concentrations at both intervals studied. In obese mice adrenalectomy permanently reduced body weight gain and food intake to values comparable with lean mice. Glucose tolerance was improved in adrenalectomised obese mice at both intervals studied, resulting in plasma glucose concentrations similar to adrenalectomised lean mice. Plasma insulin concentrations during the tolerance tests were reduced in adrenalectomised obese mice, but remained higher than in lean mice. Adrenalectomy did not improve the poor insulin response to parenteral glucose in obese mice. The results indicate that adrenal hormones play an important role in the development of glucose intolerance and contribute to the hyperinsulinaemia in obese (ob/ob) mice, in part by promoting hyperphagia. PMID- 3525361 TI - Effects of parenteral palatinose on glucose metabolism in normal and streptozotocin diabetic rats. AB - The present experiment was carried out to investigate the metabolism of palatinose (6-O-alpha-D-glucopyranosyl-D-fructose) in the rat. The bolus injection of palatinose (0.5 g/kg) in the tail vein of normal and streptozotocin (STZ) diabetic rats caused significant increments in glucose and insulin concentrations. However, in severe STZ diabetic rats (greater than 300 mg/dl of fasting plasma glucose) no significant change in glucose and insulin concentrations was observed. In liver perfusion, the gradual decrease in glucose output from the normal and mild STZ diabetic rat livers perfused with 20 mM Krebs Ringer-Tris buffer pH 7.4 was prevented by the addition of 5.5 mM palatinose in the perfusate and fructose was detected in the effluent during the palatinose infusion. The results indicate that palatinose is metabolized to glucose and fructose in both normal and diabetic rat tissues, and this causes the increase in blood glucose concentration. On the other hand, the direct stimulatory effect of insulin release from pancreatic B-cell was not observed when the palatinose was infused into the isolated perfused rat pancreas. The study suggest that palatinose administered parenterally is metabolized by tissues and expected to be used as a source of fluid and energy supply. PMID- 3525362 TI - Beta cell function in long term NIDDM (type 2) patients and its relation to treatment. AB - Pancreatic beta cell function was assessed by estimation of fasting and post prandial plasma C-peptide in 183 non-insulin dependent diabetic patients, who were treated with oral hypoglycaemic drugs, for more than 10 years. One-hundred and-forty-one patients, continued to respond to oral hypoglycaemic agents (Group I) and in 42 the control was not satisfactory and had to be changed over to insulin (secondary failure, Group II). Significant beta cell reserve (PP CP greater than or equal to 0.6 pmol/ml) was present in 89 out of 183 patients (48%) and 83 (93%) of them responded to oral hypoglycaemic agents. Among the 94 patients with low beta cell reserve, 58 (62%) were on oral hypoglycaemic agents and the other 36 (38%) were on insulin. Of the 42 patients with secondary failure to the oral drugs, 36 (86%) had low C-peptide while 6 (14%) had significant C peptide values. Secondary failure to oral hypoglycaemic agents can also occur in spite of good beta cell reserve. Beta cell reserve was not correlated either to the duration of diabetes or the age at diagnosis of the patients. PMID- 3525363 TI - Mechanism and significance of insulin resistance in myotonic dystrophy. AB - In order to elucidate the mechanism of the glucose intolerance frequently associated with myotonic dystrophy (MD), glucose metabolism of 10 patients and 10 controls was investigated using the following tests: successive intravenous stimulation of insulin secretion by glucose and tolbutamide, detection of serum islet cell antibodies, measure of the specific insulin binding on erythrocytes and evaluation in vivo of insulin sensitivity by the euglycaemic glucose clamp method. Glucose tolerance was decreased in MD patients (K value: 1.51 +/- 0.15 vs 2.4 +/- 0.2 X 10(-2)) in spite of a basal (26 +/- 4 vs 11 +/- 2 microU/ml) and post-stimulative hyperinsulinism (area of the plasma insulin curve after glucose IG: 642 +/- 120 vs 315 +/- 28 microU/ml/min and area after tolbutamide IT: 740 +/ 166 vs 335 +/- 35 microU/ml/min). No islet cell antibody was detected in the serum of MD patients. These results suggest that decrease of glucose tolerance is secondary to peripheral insulin resistance. Specific binding of insulin on erythrocytes was slightly but not significantly reduced in MD patients (specific binding: 8.21 +/- 0.9 vs 9.64 +/- 0.9%, receptor number: 23 +/- 2 receptors/cell, concentration of unlabelled insulin displacing 50% of the bound radioactivity: 7.2 +/- 0.56 vs 6.6 +/- 0.6 ng/ml). There was a loss of normal down regulation of insulin receptors in MD. The results of the euglycaemic glucose clamp confirmed the insulin resistance especially for the highest insulin infusion rates. These data show that the insulin resistance of MD is due to both receptor- and post receptor-defect but that the main abnormality is an unresponsiveness located after the insulin signal on the receptor. PMID- 3525364 TI - Dosage effect of insulin in treating diabetic rats. PMID- 3525365 TI - Intrahepatic cholangiectases and large-duct obliteration in primary sclerosing cholangitis. AB - We studied intrahepatic bile ducts of five patients with chronic ulcerative colitis and primary sclerosing cholangitis. The livers had been obtained at the time of orthotopic liver transplantation. After specimen cholangiography and perfusion fixation, sequential blocks and sections from portal tracts were studied, combining light microscopy with scanning electron microscopy. In vivo cholangiograms were studied also. The specimens revealed: absence of normal bile ducts; presence of thin-walled tubular or saccular cholangiectases with semicircular and annular fibrous crests, without evidence of superinfection; cholangiectases with secondary acute or chronic-cellular cholangitis, with or without cholangitic abscesses; fibrous cholangitis without ductal dilatation; transformation of bile ducts into fibrous cords which were either solid or contained remnants of bile duct epithelium, and complete loss of bile ducts. The shape and distribution of the cholangiectases suggested that these lesions were manifestations of the disease process and not passively dilated normal ducts. Fibrous-obliterative cholangitis with formation of fibrous cords was found not only at the level of interlobular and adjacent septal bile ducts but also at the level of segmental bile ducts that normally would have been demonstrable in cholangiograms. The "pruned-tree" appearance in cholangiograms appears to result from the transition between patent and often cholangiectatic ducts, and duct obliteration. At present, intrahepatic cholangiectases in association with duct obliteration can be considered pathognomonic morphologic features of primary sclerosing cholangitis. PMID- 3525366 TI - Rat hepatic bile acid sulfotransferase: identification of the catalytic polypeptide and evidence for polymeric forms in female rats. AB - A monoclonal antibody, PK1B, directed against rat liver bile acid sulfotransferase was used for the purification and characterization of the enzyme. Incubation of rat liver supernatant with the antibody followed by immunoprecipitation with Staphylococcus aureus cells demonstrated that PK1B reacted with 90% of the enzymatic activity present in the liver supernatant from female rats and 40 to 50% of the activity in male liver preparations. Immunoadsorption chromatography with PK1B bound to Sepharose isolated active enzyme which was purified greater than 75-fold. Sodium dodecyl sulfate polyacrylamide gel electrophoretic analysis of this preparation in the presence of 2-mercaptoethanol demonstrated three polypeptides: Mr 29,500; 32,500, and 34,000. Western blot analysis indicated that PK1B recognized an epitope which was found only on the Mr 29,500 polypeptide. Two-dimensional gel electrophoresis associated the enzymatic activity with this Mr 29,500 band. High-pressure liquid chromatographic analysis of immunopurified enzyme defined three distinct, enzymatically active protein populations: I (Mr 400,000 to 170,000); II (Mr 130,000), and III (Mr 43,000). An Mr 29,500 polypeptide was the sole constituent of Peaks I and III and a major constituent of Peak II. Sodium dodecyl sulfate polyacrylamide gel electrophoresis in the presence and absence of 2 mercaptoethanol indicated that in Peak II, catalytically active Mr 29,500 protein is associated with the other two polypeptides by disulfide bonds. In contrast, Peak I consists of a polymer of Mr 29,500 polypeptide which is independent of disulfide interaction. PMID- 3525367 TI - Mechanisms of secretion of proteins into bile: studies in the perfused rat liver. AB - Employing the in situ perfused rat liver, we examined the origins and mechanisms of transport of proteins into bile. First, utilizing polyacrylamide gels, we noted that many biliary proteins co-migrated with dominant serum proteins. Upon liver perfusion with serum-free medium, most proteins disappeared from the biliary profile; one major biliary protein that was not present in serum, identified as secretory component, remained. Kinetic analysis of the disappearance half-lives of the biliary proteins suggested that some serum proteins enter bile by a slow (20 to 30 min; transcellular) route, while others utilize both slow and rapid (5 min; paracellular) routes. In biosynthetic labeling experiments, secretion of newly synthesized proteins into bile was delayed about 20 min when compared with secretion of proteins into the perfusion medium and comprised less than 1% of the total secreted proteins. When a new liver was inserted into the perfusion medium containing newly synthesized secreted proteins, only two proteins, hemopexin and an unidentified protein, were transported into the bile from the perfusion medium; other biliary proteins were presumed to come directly from the hepatocyte. This latter group included some proteins that were secreted into the perfusion medium as well as into bile, and others, e.g., secretory component, that were secreted only into bile. Based on our results we have defined six pathways for entry of proteins into bile. PMID- 3525368 TI - Natural course of delta superinfection in chronic hepatitis B virus-infected patients: histopathologic study with multiple liver biopsies. AB - We evaluated the natural course of delta superinfection in patients with chronic B viral hepatitis by examining serial liver biopsy specimens from 23 patients. The mean follow-up period was 2.5 years, and the average number of liver biopsies per patient was 2.8. The striking features were: (i) the prolonged acute hepatitis-like necroinflammatory activity (mean = 15 months) following acute delta hepatitis and (ii) rapid progression to severe forms of liver disease within a mean interval of 24 months from the onset of delta superinfection. Although there was a high frequency of stainable delta antigen (90%) in these liver biopsy specimens, there was no correlation between the degree of positivity and the histopathological changes. PMID- 3525369 TI - Use of propranolol to reduce the rebleeding rate during injection sclerotherapy prior to variceal obliteration. AB - In a prospective, randomized controlled trial, 53 patients with variceal hemorrhage from portal hypertension, including 44 with cirrhosis, were allocated, after initial control of the bleeding, to treatment by sclerotherapy alone, or by this together with oral propranolol in a dose sufficient to reduce resting pulse rate by 25% during the period up to the time when varices were obliterated. Eight of the 27 patients undergoing sclerotherapy alone rebled during this period as compared to 7 of the 26 patients in the additional propranolol group (p greater than 0.80), two patients from each group dying from uncontrollable variceal hemorrhage. Propranolol precipitated encephalopathy in one patient and complicated resuscitation following bleeding in a second, and as there was no evidence in this study that use of the drug reduced the frequency or severity of the variceal bleeding, its administration cannot be recommended during the period prior to obliteration of varices by sclerotherapy. PMID- 3525370 TI - Calcitonin gene-related peptide in the hepatic and splanchnic vascular systems of the rat. AB - The distribution and origin of calcitonin gene-related peptide immunoreactive structures in hepatic and splanchnic vasculature of the rat were investigated by the immunofluorescent technique. Calcitonin gene-related peptide immunoreactive fibers were dissociated from compact thick calcitonin gene-related peptide immunoreactive fiber bundles located around the hepatic and splanchnic vasculature, and reached the tunica adventitia of the vasculature. Some fibers penetrated further into the tunica media of the vasculature. In the tunica adventitia of the vasculature, calcitonin gene-related peptide immunoreactive fibers formed a fine meshwork which could be traced to the branches and arterioles. In the liver, calcitonin gene-related peptide immunoreactive innervation extended from porta hepatis to portal triads, running with branches of the hepatic artery and portal vein. Some calcitonin gene-related peptide immunoreactive fibers separated from thinner calcitonin gene-related peptide immunoreactive fiber bundles in portal triads and coursed into the immediately adjacent parenchyma. In the dorsal spinal ganglia (T8-10, L1), calcitonin gene related peptide immunoreactive cells accounted for about 60% of the total number of ganglion cells. Bilateral vagotomy just below the diaphragm or bilateral transection of the greater splanchnic nerve resulted in a marked decrease of the number of calcitonin gene-related peptide immunoreactive fibers in the vasculature, whereas a combined operation was followed by the complete depletion of calcitonin gene-related peptide immunoreactive fibers. These results indicate that calcitonin gene-related peptide immunoreactive innervation in hepatic and splanchnic vasculature may have a dual origin. In conclusion, the widespread distribution of calcitonin gene-related peptide immunoreactive fibers in the hepatic and splanchnic vasculature suggest that calcitonin gene-related peptide innervation may be involved in sensory transmission. PMID- 3525371 TI - Liver disease in pregnancy. AB - The diseases which affect the liver in pregnancy can be subdivided into those which occur simultaneously with gestation and those which occur in the context of and exclusively during pregnancy. This review deals with the latter group and describes the histopathological features of acute fatty liver of pregnancy and liver disease in toxaemia of pregnancy, hyperemesis gravidarum and intrahepatic cholestasis of pregnancy. PMID- 3525373 TI - HHS set to limit heart transplant center growth. PMID- 3525372 TI - Mediastinal large-cell lymphoma of B-type, with sclerosis: histopathological and immunohistochemical study of eight cases. AB - Eight cases of mediastinal non-lymphoblastic large-cell lymphoma have been studied by histopathological and immunohistochemical methods. A common clinical, morphological and immunophenotypic pattern was identified. Six of eight cases proved to be of B-cell origin by the expression of B-associated antigens detected by specific monoclonal antibodies. Cells of large size with nuclei of varying morphology and a peculiar type of fine compartmentalizing fibrosis were observed in all specimens. Clinically the disease was characterized by the young age of the patients, primary mediastinal involvement, aggressive behaviour and spread to unusual sites (kidneys in four cases). This seems to be a hitherto unrecognized entity in the field of non-Hodgkin's lymphomas, often misdiagnosed because of location and a morphology uncommon for B-cell malignancies. Immunohistochemical analysis on frozen tissue sections appears to be mandatory for a correct diagnosis. Nevertheless, this type of lymphoma could be suspected also on the basis of its peculiar clinicopathological characteristics. PMID- 3525374 TI - HCFA makes life precarious for referral centers. PMID- 3525375 TI - Killing PIP: another nail in the cash-flow coffin? PMID- 3525376 TI - Rural capitation? HCFA studies AR plan's success. PMID- 3525377 TI - HCFA links Medicare's future with capitation. Interview by Janet Firshein. PMID- 3525378 TI - Congress backs funding for antirejection drugs. PMID- 3525379 TI - Much-touted HHS study voided in labor/delivery case. PMID- 3525380 TI - Birth defects in blacks and whites in relation to prenatal development: a review and hypothesis. PMID- 3525381 TI - Tumors of skeletal muscle. AB - The most common tumors arising in muscle are soft tissue sarcomas, fibromatoses, and hemangiomas. Rhabdomyosarcoma is primarily a tumor of childhood and adolescence and arises most commonly in extramuscular sites. Most intramuscular rhabdomyosarcomas are alveolar. Increased diagnostic accuracy and the recognition of malignant fibrous histiocytoma have changed understanding of adult, intramuscular, pleomorphic rhabdomyosarcoma. Immunohistochemistry is playing an increasingly important role in the diagnosis of rhabdomyosarcoma, and the correlation between the histologic features and clinical behavior of rhabdomyosarcoma is under investigation. Because of their diversity and overlapping histologic features, muscle tumors are a challenge for the pathologist and require intensive study by current techniques. PMID- 3525382 TI - Immunohistochemical demonstration of chromogranin in endometrial carcinomas with argyrophil cells. AB - Forty-five endometrial carcinomas, 36 of which contained argyrophil cells and nine of which were nonargyrophilic by the Grimelius method, were examined immunohistochemically for chromogranin. Chromogranin immunoreactivity was present in 19 of the 36 tumors with argyrophil cells (53 per cent) and in none of the nine tumors lacking these cells. All six of the tumors that contained argyrophil cells resembling enterochromaffin cells were chromogranin-positive, with the staining corresponding to the argyrophilia. In contrast, only 13 of the 30 tumors in which argyrophilia was present in the apical region or throughout the cytoplasm of the cells showed chromogranin immunoreactivity. In seven of these tumors, an excellent correlation existed between the distribution of argyrophilia and chromogranin positivity, but in the other six tumors argyrophilia was more pronounced than chromogranin immunoreactivity. Adjacent to one tumor, unusual cells in which argyrophil granules were packed predominantly in the basal portion of the cytoplasm were encountered in a focus of atypical hyperplasia; these cells were also chromogranin-positive. The present observations suggest that endometrial carcinoma cells with diffuse or apical chromogranin immunoreactivity may represent an early stage in the development of cells resembling those of the enterochromaffin type. PMID- 3525383 TI - Pollen grain granuloma: a new clinicopathologic entity. AB - Chronic ulceration of the ankle developed in a woman who had been stepped on by a cow. Microscopic examination revealed a florid foreign body granulomatous reaction in which pollen grains were found both within giant cells and lying free in fibrous tissue. The grains resembled those of the Asteraceae, or Compositae, family. This is the first report of pollen grains associated with an invasive tissue process. The morphologic features of pollen grains and their differentiation from other foreign bodies are discussed. PMID- 3525384 TI - Resistance in Escherichia coli after single dose ampicillin to treat gonorrhoea. AB - Patients with uncomplicated gonorrhoea were treated with a single dose of either ampicillin 3 g orally or procaine penicillin 2.4 MIU by injection, both with probenecid 1 g orally. The proportion of faecal Escherichia coli resistant to ampicillin before and a week after treatment was assessed. Of 55 patients treated with ampicillin who initially possessed sensitive flora, 25 (45.5%) became colonised subsequently by resistant E coli. Resistance to ampicillin, together with resistance to some other antimicrobials, was transferable in vitro. Penicillin, however, selected resistant E coli in only four (14.3%) out of 28 patients with initially sensitive flora. There was no difference in therapeutic response between the two agents. Intramuscular penicillin appeared to offer appreciably greater microbiological benefits than oral ampicillin in treating gonorrhoea. PMID- 3525385 TI - Comparison of enzyme immunoassays and cell culture for detecting Chlamydia trachomatis. AB - Endourethral or endocervical swabs were taken from 403 patients to detect Chlamydia trachomatis by four different methods including standard tissue culture. Two immunoenzyme assays, Chlamydiazyme and IDEIA, were found to be satisfactory and could be valuable for large and busy sexually transmitted disease (STD) clinics. PMID- 3525386 TI - Efficacy of combined treatment with oral and topical acyclovir in first episode genital herpes. AB - Fifty patients presenting with first episode genital herpes were randomly allocated to seven day treatment with either oral acyclovir plus 5% acyclovir cream or oral acyclovir plus matching placebo cream. Combined treatment with oral and topical acyclovir was associated with a shorter duration of itching in women alone (p = 0.04) but gave no clinical relief of other symptoms, the time to healing of lesions, or the subsequent recurrence rate. Concomitant topical treatment with 5% acyclovir cream confers no advantages on patients who receive oral acyclovir. PMID- 3525387 TI - Prevalence of urinary tract infection in homosexual and heterosexual men. AB - Homosexual practices might be expected to result in an increase in urinary tract infection in adult men. Midstream urine specimens were collected from 200 homosexual and 205 heterosexual men attending a clinic for sexually transmitted diseases. Three specimens from each group yielded more than 10(5) Escherichia coli per ml. The prevalence of urinary tract infection among homosexuals was therefore similar to that in the heterosexual population. PMID- 3525388 TI - Conventional tissue culture compared with rapid immunofluorescence for identifying chlamydia trachomatis in specimens from patients attending a genitourinary clinic. PMID- 3525389 TI - Comparison of immunofluorescence and culture methods in the diagnosis of chlamydial infections. PMID- 3525390 TI - Quantitative tissue characterization based on pulsed-echo ultrasound scans. PMID- 3525391 TI - A new CT-aided stereotactic neurosurgery technique. PMID- 3525392 TI - Dynamics of early T cells: prothymocyte migration and proliferation in the adult mouse thymus. AB - The object of this review has been to consider precursor cell migration into the normal adult thymus, using the mouse model. We have presented a series of experiments and discussed them in the context of other relevant experiments in the literature. The conclusions, qualified in the text, can be summarized as follows: There is a continual input of precursor cells into the normal undepleted adult thymus. The daily input of precursors under normal circumstances is very low (e.g. several per day). Once a precursor enters the pool of proliferating cells inside the thymus, its proliferation is limited to only several weeks. There is no permanent endogenous stem cell. There are a number of different precursor microenvironments in the thymus with different controls, since the kinetics of early (bone marrow-derived) and late (thymus-derived) precursors is quite different. All of these points require further analysis, and we have presented a minimal model as a basis for further experiment. PMID- 3525393 TI - Postthymic T-cell development. PMID- 3525394 TI - Lymphocyte population kinetics in the mouse. AB - In a normal dynamic equilibrium, at least half of the peripheral T-cell pool is constituted by lymphocytes which have divided 24-48 h previously, and are therefore rapidly renewed. The renewal of peripheral T cells occurs partly by influx of cells from the thymus and, more importantly, by cell division at the periphery. The cyclic pattern of decay observed for T cells after HU treatment suggests the presence of progenitor-descendent relationships within the peripheral T-cell pool. Peripheral progenitors must contain both cycling and non cycling cells to account for cell recovery after HU administration in ATx mice. T cell production at the periphery involves both organized (spleen or lymph nodes) as well as non-organized lymphoid tissue (GALT). The latter may in fact provide the major contribution. Expansion of mature T lymphocytes contributes to clonal persistence at the periphery and to the choice of T-cell repertoires. The importance of post-thymic selection of T-cell repertoires is suggested by the considerable expansion potential revealed by peripheral T cells. PMID- 3525395 TI - Lymphocyte migration and differentiation in a large-animal model: the sheep. AB - The size and docility of the sheep permit various surgical interventions and repeated collections of biological samples. Development of lymphatic cannulation techniques in this species enabled the investigation of the kinetics of lymphocyte migration in single lymph nodes of not only postnatal animals but also of fetuses at various stages of gestation. It was first demonstrated in the sheep that lymphocyte recirculation commences in the fetus without any exogenous antigenic stimulus. Using these cannulation techniques, it is also possible to investigate humoral events such as the secretion of lymphokines taking place in single lymph nodes with regard to the regulation of lymphopoiesis and the immune response. An extracorporeal perfusion system has been used successfully to investigate the emigration of cells from various lymphoid organs in the sheep. This apparatus enables cells to be labelled in their normal microenvironment with radioisotopes and/or fluorescent probes without destroying the normal tissue architecture. In studies with outbred animals such as the sheep, an investigation in which an individual animal is studied as a case history over a long time often provides much more information than studies based on single-point examinations of many animals and is much closer to the clinical study of immunological problems in individual humans. The recent development of an array of monoclonal antibodies against lymphocyte surface antigens in sheep will help to further dissect the complexity of immunological phenomena. Therefore, the sheep is a useful animal model to study physiological events taking place in the lymphoid system, and in vivo studies in this species will continue to offer a great potential for research of biological relevance and supplement the research done on the in vitro manipulation of cells and biological products related to the immune system. PMID- 3525396 TI - Quantitative correlation between molar refractivity and the inhibition of dihydrofolate reductase by 2,4-diamino-5-benzylpyrimidines. PMID- 3525398 TI - Preferential secretion of a common anti-DNA idiotype (16/6 Id) and anti polynucleotide antibodies by normal mononuclear cells following stimulation with Klebsiella pneumoniae. AB - Peripheral blood mononuclear cells derived from 6 normal subjects were incubated with 5 polyclonal activators (pokeweed mitogen, Epstein-Barr virus, group-A Streptococcus, Staphylococcus aureus and Klebsiella pneumoniae. After 7 days of incubation, the supernatants were examined for immunoglobulin (IgG and IgM) production, the level of a common anti-DNA idiotype (16/6 Id) and autoantibody activity against ssDNA, dsDNA, poly(I), poly(dT) and cardiolipin. Significantly increased levels of the 16/6 Id were recorded only with the Klebsiella stimulated MNC. Increased immunoglobulin levels and autoantibody reactivity were noted with all 5 polyclonal activators. The Klebsiella cell membrane preparation induced the highest values. No correlation was found between the 16/6 levels, autoantibody activity and the absolute concentrations of IgG or IgM. This study, together with previous reports, suggests a role for Klebsiella in the etiology of autoimmune diseases. We suggest that Klebsiella can induce anti-DNA-like autoantibodies not only by polyclonal activation, but also by a more specific stimulus. PMID- 3525397 TI - Functional characteristics of the veiled cells in afferent lymph from the rat intestine. AB - Non-lymphoid veiled cells (VC) in the thoracic duct lymph from mesenteric lymphadenectomized rats have been studied by light microscopy, enzyme histochemistry and scanning electron microscopy. These cells arise in the afferent lymph from the intestine. They have been semi-purified and examined for expression of Ia antigens using an indirect immunoperoxidase technique and monoclonal antibodies. Accessory cell function necessary for mitogen-induced blastogenesis in the thoracic duct lymph from these animals has been correlated with the presence of VC by depletion and reconstitution experiments. Similar results were obtained with lymphocyte suspensions from other rat lymphoid organs and they are contrasted with those from studies on mouse lymphoid cells. Antigen presentation in a secondary in vitro lymphoproliferative assay was also depleted from immunized lymph node cells by removal of endogenous VC and can be reconstituted in a dose-dependent fashion with antigen-pulsed VC from afferent intestinal lymph. In contrast, reconstitution of both mitogen-induced blastogenesis and antigen-induced lymphoproliferation with peritoneal exudate cells was poor, while at high multiplicities of added macrophages, such cells were inhibitory. Afferent intestinal lymph VC were found to transport bacteria and bacterial antigen in rats infected with Salmonella typhimurium. The results are discussed in relation to the lineage of the VC in intestinal afferent lymph, their function as accessory cells and their possible physiological role in transporting antigens from the gut to its regional lymph nodes. PMID- 3525399 TI - R plasmids, KR61 and KR61-A, from Aerobacter aerogenes. PMID- 3525400 TI - Characterization and mapping of mutator genes (mut 1 and mut 4) in strain JC 355 of Escherichia coli K 12. PMID- 3525401 TI - Radiometric evaluation of antibacterial activity of bouvardin (NSC 259968) on Escherichia coli and Staphylococcus aureus. PMID- 3525402 TI - Relative superiority of Magnogel enzyme immunoassay for detection of human chorionic gonadotropin in urine. PMID- 3525403 TI - Lack of effect of nifedipine on counterregulatory mechanisms in essential hypertension. AB - The influence of long-term nifedipine treatment on body fluid compartments, renal function, the renin-angiotensin system, and the adrenergic system was studied in 18 patients with essential hypertension. A placebo period of 4 weeks was followed by a 6-week dose-titration period. Thereafter, the dose was kept constant for an additional 6 weeks (mean dose, 51 mg/day). As compared with placebo values, diastolic blood pressure decreased approximately 12% during nifedipine treatment. Plasma volume, extracellular fluid volume, and the ratio of plasma to interstitial fluid volume did not change significantly, either in the group as a whole or in a subgroup in which pedal edema developed. Plasma concentrations of epinephrine and norepinephrine increased slightly after 2 weeks of treatment, but they returned to control values after 6 weeks of therapy. Plasma concentrations of renin, angiotensin II, and aldosterone did not change significantly. Glomerular filtration rate and renal clearances of sodium and potassium were unchanged as well. These results indicate that long-term nifedipine treatment does not lead to activation of counterregulatory mechanisms, such as fluid retention or the renin-angiotensin or adrenergic systems. This may well be of importance for the antihypertensive efficacy of nifedipine treatment. PMID- 3525404 TI - Effects of long-term treatment with indomethacin on renal function. AB - The prolonged effects (42 days) of indomethacin treatment on the renin angiotensin-aldosterone axis, renal hemodynamics, and renal excretory function in humans were studied. Indomethacin produced a 41% sustained depression in the 24 hour excretion of prostaglandin E2 and a mild (7%) decrease in inulin clearance but did not affect the clearance of p-aminohippurate, the 24-hour excretion of sodium and potassium, or the basal values of plasma aldosterone; however, it decreased the basal values of renin and prevented the stimulated (3 hours of walking) responses of plasma renin activity and plasma aldosterone. Indomethacin also produced a decrease in both the diuretic and saluretic response to furosemide and in the renal ability to concentrate urine. The indomethacin induced hyporeninism and hypoaldosteronism were more pronounced when the subjects were receiving a sodium-restricted diet. This finding indicates that prolonged administration of anti-inflammatory drugs induces chronic hyporeninism and hypoaldosteronism. Prolonged treatment with indomethacin also produced some of the symptoms of a syndrome of hypoprostaglandinism, such as decreased plasma renin activity, plasma aldosterone, and urinary prostaglandin E2 in association with increases in plasma potassium levels and diastolic pressure. PMID- 3525405 TI - Effect of captopril on 99mTc-diethylenetriaminepentaacetic acid renograms in two kidney, one clip hypertension. AB - In an effort to improve on the noninvasive detection of renal artery stenosis, we investigated the effect of angiotensin converting enzyme inhibition on computer assisted 99mTc-diethylenetriaminepentaacetic acid (DTPA) renal flow studies in a canine model of two-kidney, one clip hypertension and compared these findings with clearances of inulin and p-aminohippuric acid in the stenotic and contralateral kidney before and after converting enzyme inhibition. The 99mTc DTPA renal flow study with the converting enzyme inhibitor captopril (1.5 mg/kg bolus with 1.5 mg/min infusion) showed an increased sensitivity in the detection of unilateral renal artery stenosis over the use of the 99mTc-DTPA study alone. Captopril induced striking alterations that were most evident in the 15-minute 99mTc-DTPA renal flow study, in which all nine curves exhibited severely blunted uptake and excretion of the radionuclide. These changes were reversed during a recovery study without converting enzyme inhibition and were not seen when blood pressure was lowered with nitroprusside to a level similar to that observed during converting enzyme inhibition. The changes shown by the 99mTc-DTPA study during converting enzyme inhibition correlated with a decrease in the glomerular filtration rate of the stenotic kidney. Captopril infusion significantly decreased the glomerular filtration rate of the stenotic kidney (16.0 +/- 3.1 vs 11.0 +/- 2.5 mg/min, p less than 0.03) but not of the contralateral kidney (32.4 +/- 2.6 vs 28.4 +/- 2.8 mg/min).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3525406 TI - The storage form of renin in renin granules from rat kidney cortex. AB - Renin granules were partially purified from rat kidney cortex, and a storage form of renin in the granules was examined. Renin granules were isolated by discontinuous Percoll density gradient centrifugation followed by continuous Percoll density gradient centrifugation. The partially purified fraction was free from mitochondria and microsomes, as judged by the absence of marker enzymes of these organelles, but contained some lysosomal enzyme activities. The specific renin activity was 0.58 mg angiotensin I/hr/mg protein, 500 times as active as the original homogenate. Immunochemical staining with specific antisera against rat kidney renin revealed that about 10% of the granules recovered in the partially purified fractions were stained strongly. The stored renin was not activated either by acidification or by trypsin treatment, indicating that stored renin was in the fully active form. By sodium dodecyl sulfate gel electrophoresis, the stored renin had two different molecular weights, 38,000 and 36,000, and these molecular weights were not reduced by dithiothreitol or 2 mercaptoethanol, suggesting that these renins are single-chain types as opposed to the two-chain type found in male mouse submaxillary gland. These results suggest that active renins with two different molecular weights may be released from renin granules of juxtaglomerular cells. PMID- 3525407 TI - Mechanisms involved in protection provided by immunization against core lipopolysaccharides of Escherichia coli J5 from lethal Haemophilus pleuropneumoniae infections in swine. AB - In an investigation of the potential protective effects of immunity against common lipopolysaccharide core antigens of gram-negative bacteria during a severe gram-negative infection in the natural host, we induced Haemophilus pleuropneumoniae infections in weanling pigs immunized with a vaccine of an Rc mutant of Escherichia coli (strain J5). To help define the mechanism involved in J5-mediated protection, we compared the clinical, hematologic, bacteriologic, and serologic responses following an H. pleuropneumoniae infection in J5-immunized pigs with those following an H. pleuropneumoniae infection in nonimmunized control animals. As a result of an intranasal inoculation, all of the control animals and the J5-immunized animals were infected with H. pleuropneumoniae. However, while 80% (4 of 5) of the nonimmunized pigs died within 24 h as a result of the infection, no deaths occurred in the J5-immunized animals. In the immunized group, J5 titers dropped during the acute stages of the infection and rebounded to well above the prechallenge levels during convalescence. The J5 titer also increased in the single surviving control animal. These findings suggest that antibodies against common subsurface components of gram-negative bacterial cell walls correlate with protection from an otherwise lethal challenge of H. pleuropneumoniae but do not prevent infection. Important growth-phase dependent antigenic changes have been recognized to occur during the growth of H. pleuropneumoniae in cultures (R. Nielson, Nord. Veterinaermed. 28:337-348, 1976). In a study of these changes and during an inquiry into the mechanism of J5 antibody-mediated protection, measured quantities of H. pleuropneumoniae were removed from a broth culture at hourly intervals and used to absorb hyperimmune equine J5 antiserum. Significantly greater amounts of J5-specific antibodies were absorbed during the log phase of bacterial growth than during the early or late phase. The availability of epitopes recognized by J5 antibodies appears to be closely related to the rate of bacterial multiplication. The results of these experiments suggest a mechanism of protection provided by increased immunity to E. coli J5 during gram-negative infections. PMID- 3525408 TI - Enhanced primary resistance to Treponema pallidum infection and increased susceptibility to toxoplasmosis in T-cell-depleted guinea pigs. AB - Strain 2 guinea pigs made T-cell deficient by thymectomy and irradiation and protected with syngeneic bone-marrow cells (TXB guinea pigs) have a surprisingly high level of resistance to cutaneous syphilis and to the dissemination of treponemes to the draining lymph node. Compared with normal euthymic controls infected with Treponema pallidum Nichols, syphilitic TXB guinea pigs developed fewer and less severe skin lesions and their lymph nodes contained lower numbers of treponemes. Associated with this evidence for enhanced innate resistance was the ability of the TXB host to produce, during each test interval of a primary infection, more antitreponemal antibodies than that of their euthymic counterparts. Similar levels of partial protection against cutaneous and disseminated syphilitic infection and elevated antibody levels occurred in challenged normal guinea pigs passively immunized with lymphocytes from T. pallidum-infected TXB donors. In contrast, the capacity of the TXB host to be protected against a lethal infection with the unrelated intracellular protozoan parasite Toxoplasma gondii was greatly impaired unless it received an intravenous infusion of normal syngeneic thymocytes. These seemingly paradoxical results are explained primarily in terms of a residual T-helper-cell population in the TXB guinea pig which is large and competent enough to generate antisyphilis, but not anti-Toxoplasma, immunity. PMID- 3525409 TI - Isolation and characteristics of collagenolytic enzyme produced by Candida albicans. AB - In media containing collagen as the nitrogen source, the pathogenic yeast Candida albicans secreted a collagenolytic enzyme. Purification of the enzyme from a culture filtrate was achieved by DEAE-Sephacel chromatography at pH 6.7. The molecular weight was found to be 46,000 by 10% sodium dodecyl sulfate polyacrylamide gel electrophoresis, and the isoelectric point was at pH 4.2. The pH optimum lay between 3.5 and 4.0, and above pH 6.0, the enzyme underwent alkaline denaturation. The enzyme was heat labile, and a decrease in activity was found above 55 degrees C. The enzyme activity was inhibited by the addition of urea, cysteine, and pepstatin. No other inhibitor among those tested had any effect. The C. albicans enzyme degraded both the native acid-soluble collagen and the insoluble dentinal collagen. PMID- 3525410 TI - Natural and experimental infection with an attaching and effacing strain of Escherichia coli in calves. AB - Gnotobiotic calves were inoculated with an O5:K4:H-, urease-positive strain of Escherichia coli isolated from a 2-day-old calf with diarrhea. The calves developed elevated temperatures and passed loose mucoid feces, with or without blood. The E. coli strain was negative for heat-stable and heat-labile enterotoxins but produced high levels of Shiga-like toxin. Bacteria attached diffusely to the epithelium of the large intestine and multifocally to the epithelium of the ileum. The duodenum and jejunum were not affected. At the sites of bacterial attachment, microvilli were effaced, enterocytes were degenerate, and necrosis and exfoliation had occurred. These results confirm a previous report from England that calves may naturally contract infections similar to those caused by enteropathogenic E. coli strains pathogenic to humans or rabbits. This suggests that the calf bacterial strains, like some enteropathogenic E. coli strains, produce high levels of Shiga-like toxin and cause attachment and effacement lesions in the colonic epithelium of the infected host. PMID- 3525411 TI - Pathogenesis of Campylobacter spp. in athymic and euthymic germfree mice. AB - Adult athymic (nu/nu) and euthymic (+/nu) germfree BALB/c mice were orally challenged with pure cultures of Campylobacter jejuni (human clinical fecal strains) and a human blood isolate of Campylobacter fetus subsp. fetus. After a period of adaptation to the mouse intestinal tract, all three C. jejuni strains caused disease in gnotobiotic mice. Mouse-adapted, weakly cytotoxic C. jejuni 45100 consistently induced disease symptoms (transient diarrhea, cecal shrinkage, and acute inflammatory changes with eosinophilia in the lower intestinal mucosa) in nu/nu mice 7 to 9 days after oral challenges. Conversely, no overt disease or histopathology was evident in +/nu mice challenged with the same strain (45100). After periods of adaptation in the murine alimentary tract, the two C. jejuni strains, 24 and INN 73-83, with greater cytotoxin-producing capacities, decreased cecal size and caused minor mucosal inflammatory changes in both nu/nu and +/nu BALB/c mice 1 to 2 weeks after intestinal colonization. A transient splenomegaly was also evident at 1 to 2 weeks after germfree nu/nu mice were colonized with each of the three C. jejuni strains used in this study. Occult blood was observed in a small percentage (approximately 11%) of nu/nu and +/nu BALB/c mice that were colonized with C. jejuni strains 45100 and INN 73-83. C. fetus subsp. fetus 255 colonized the alimentary tract of gnotobiotic mice, but neither morbidity nor mortality was evident. The disease we observed in the gnotobiotic mice, along with the histological changes in the intestinal tract after oral challenges, resembles symptoms of campylobacteriosis in humans. The gnotobiotic BALB/c mouse model of Campylobacter disease provides a unique opportunity to detail basic aspects of the acute and chronic pathogenesis of and immunity to this recently recognized disease. PMID- 3525412 TI - Levels of antibodies to Plasmodium falciparum sporozoite surface antigens reflect malaria transmission rates and are persistent in the absence of reinfection. AB - Antibodies reacting with Plasmodium falciparum sporozoite surface antigens were measured by an immunofluorescence assay using wet preparations of sporozoites attached to poly-L-lysine-treated glass slides, a procedure which was found to be more specific than one using glutaraldehyde-treated and dried preparations. Subjects recovering from a first attack were found to be negative. In two African villages which differed in the level at which mosquitoes transmit the disease (1 and 100 infective bites per year and per individual), both the prevalence by age group and the levels of anti-sporozoite antibodies differed markedly, as follows. In the low-transmission area, these antibodies were not detected in subjects aged 2 to 10 years; thereafter, prevalence increased gradually with the age of the subject and reached 90% in subjects aged 50 to 80 years. In the high-transmission area, all of the subjects studied, including the younger ones, were positive. Anti-sporozoite antibody levels were independent of the levels of antibodies directed against blood stages. On average, the mean antibody titers were equal to 1/16 in the first village and 1/1,650 in the second one. These results suggest that stage-specific antibodies reflect the cumulative number of sporozoites inoculated in humans by mosquitoes and may therefore have useful epidemiological applications. In addition, the presence of stage-specific antibodies in the sera of African adults collected at different times after departure from the endemic area indicates that they may last for several years. During the course of this study, we observed a heterogeneity of immunofluorescence labeling in parasite populations prepared from mosquito salivary glands. This raises the question of possible qualitative or quantitative antigenic differences or both between one sporozoite and the other. PMID- 3525414 TI - A surface glycoprotein of Trypanosoma lewisi binds immunoglobulin G from the serum of uninfected rats. AB - Detergent extracts of whole Trypanosoma lewisi were fractionated by polyacrylamide gel electrophoresis and transferred to nitrocellulose for immunoblotting analysis. Antibody probes to rat immunoglobulin G (IgG) and IgM detected intact gamma chains, mu chains, and light chains in extracts. The amount of immunoglobulin detected increased as the infection progressed. Transfers were also incubated in serum from conventionally reared (CRS), specific-pathogen-free (SPFS), or germ-free rats before being probed with anti-rat IgG or anti-rat IgM. Components of 200, 175, and 120 kilodaltons (kDa) bound IgM from all sera tested and were present in extracts of trypanosomes isolated from lethally irradiated or intact rats on different days during infection. No parasite components bound IgG from serum of germ-free rats. However, 145-, 175-, and 200-kDa components bound IgG from CRS and SPFS. A 74-kDa protein was the major IgG-binding component in extracts of reproducing parasites. This component bound much more IgG from CRS than it bound from SPFS. The 74-kDa protein was removed from parasites by mild trypsinization and corresponded to a major surface glycoprotein detected when intact cells were radioiodinated. These results indicate that natural antibodies to T. lewisi exist in rats or that these parasites have surface proteins that bind immunoglobulins without regard to antigenic specificity. PMID- 3525413 TI - Characterization of a secretory proteinase of Candida parapsilosis and evidence for the absence of the enzyme during infection in vitro. AB - The opportunistic yeastlike fungi of the genus Candida comprise three species which are proteolytic in vitro. Among them, C. albicans and C. tropicalis are of foremost medical importance. However, a strict correlation between extracellular proteolytic activity and virulence is opposed by the low virulence of the third proteolytic species, C. parapsilosis. We purified the secretory acid proteinase of C. parapsilosis (clinical isolate 265). The enzyme is a carboxyl proteinase (EC 3.4.23) like all other secretory Candida proteinases handled so far. Proteinase 265 is distinguished by a lower molecular weight (approximately 33,000); it has increased hydrophobicity, which accounts for inhibition of the enzyme by hemin, and required the presence of nonionic detergent in the initial steps of purification. The enzyme already undergoes alkaline denaturation at neutrality. Its activity is thus confined to the acid microenvironment of the fungal cell wall. Within this range, the enzyme may degrade immunoglobulins like immunoglobulin A1 (IgA1), IgA2, and secretory IgA. No indication was found for glycosylation of proteinase 265 and the related enzyme of C. albicans CBS 2730. However, the comparable proteinase of C. tropicalis 293 was identified as a manno protein. Antiserum against proteinase 265 cross-reacted strongly with corresponding enzymes from other Candida species. Antisera against proteinases of C. albicans and C. tropicalis reacted only weakly with proteinase 265. Thus, secretory Candida proteinases are likely to possess common and species-specific antigenic sites. In contrast to C. albicans, infection of phagocytes by C. parapsilosis 265 was not accompanied by secretion of fungal proteinase. This lack of induction of the enzyme under conditions of infection may account for the low virulence of most isolates of C. parapsilosis. PMID- 3525415 TI - Localization of the streptococcal C5a peptidase to the surface of group A streptococci. AB - Immunofluorescent staining was used to determine that the streptococcal C5a peptidase (SCP) exists as a cell surface antigen on group A streptococci. The ability of hyperimmune serum to neutralize cell-associated SCP activity provided further evidence for the location of SCP. Quantification of SCP during growth in vitro by indirect enzyme-linked immunosorbent assay showed that approximately 90% of the measurable antigen is cell bound. PMID- 3525416 TI - Composition of affinity-purified alpha-hemolysin of Escherichia coli. AB - Escherichia coli alpha-hemolysin was purified from culture supernatants by affinity chromatography, using a hemolysis-neutralizing monoclonal antibody ligand. Purified hemolysin contains several proteins and lipopolysaccharides. Thus, alpha-hemolysin exists as a macromolecular complex and may be exported from E. coli cells by outer membrane fragmentation. PMID- 3525418 TI - Surgical endodontic retreatment. PMID- 3525417 TI - Characterization of heat-stable enterotoxin from a hypertoxigenic Escherichia coli strain that is pathogenic for cattle. AB - An enterotoxigenic Escherichia coli (ETEC) strain isolated from a calf with clinical scours was found to produce over 17- to 60-fold more heat-stable enterotoxin (STa) than four laboratory-adapted bovine ETEC strains. The purified STa of this strain was identical to those produced by other ETEC strains. A severe form of scours was induced in 5- to 15-day-old colostrum-fed calves and in 1- to 2-week-old piglets by oral administration of the purified STa. This study demonstrates that STa is a mediator of diarrhea in newborn calves and piglets and that under identical growth conditions diverse strains of bovine ETEC may produce variable amounts of homologous STa's. PMID- 3525419 TI - Furosemide in renal transplantation. PMID- 3525420 TI - Evolution in the structure and distribution of 4F2-antigen from the oncofetal to the adult phenotype of human fibroblasts. AB - The monoclonal antibody (MAb) 4F2 defines an oncofetal antigen in human fibroblastic cells. Two-dimensional electrophoretic analysis reveals that tumor cell lines from mesenchymal tissues co-express two or more heavy-chain molecular variants of the antigen whereas the light subunit (41 kDa) is not affected. Among normal cells, only embryonic and newborn fibroblasts (from donors up to 20 days after birth) clearly co-express two distinct molecular forms of the heavy chain with MW of 85 and 75 kDa, respectively. Cells derived from 3-month-old donors express detectable amounts of the 85 kDA but only faint traces of the 75 kDa subunit, while fibroblastic cells derived from donors older than 3 months seem to express only the 85 kDa subunit. Immunofluorescence analysis performed on adherent living cells shows that, in the first months after birth, there is a gradual evolution from the oncofetal to the adult phenotype also in the cell distribution of the 4F2. This evolution is reflected by a progressive disappearance of the 4F2 antigen from the cell membrane becoming, in adult normal cells, inaccessible to anti-4F2 MAb. The existence of different molecular forms and different membrane positions of the 4F2 antigen could facilitate surveillance of morphological and structural changes in the evolution of human fibroblastic cells during the developmental process and neoplastic transformation. PMID- 3525421 TI - A symposium honouring Richard Langendorf. PMID- 3525422 TI - Richard Langendorf in perspective. PMID- 3525423 TI - Viminol R2 analgesic activity in patients with postoperative pain: comparison with pentazocine. AB - The analgesic activity of Viminol R2 was compared to that of Pentazocine and placebo in a double-blind, "between subjects" study involving 42 patients with postoperative pain randomly assigned to 3 groups of 14 patients each and treated with a single intravenous dose of Viminol R2 10 mg, Pentazocine 30 mg or placebo. Pain relief scores were recorded over a 2 h period after treatment. The analgesic activity of Viminol R2 and Pentazocine was significantly greater than that of placebo both in terms of time-course of action and frequency of classes of satisfactory analgesia. No statistically significant differences were found between Viminol R2 and Pentazocine. No side effects were observed in any patients treated with Viminol R2. PMID- 3525424 TI - Comparative effect of propranolol and labetalol on isometric exercise and cold stress induced increase in arterial blood pressure. AB - The effect of propranolol and labetalol on cold stress and isometric exercise induced rise of blood pressure was studied in 7 patients with essential hypertension and 14 normal volunteers in a controlled, double blind, randomized, cross-over trial design. The subjects received either propranolol (40 mg) or labetalol (100 mg) orally after breakfast. In patients of mild to moderate essential hypertension, labetalol reduced significantly both systolic as well as diastolic rise of blood pressure induced by both types of exercises. Propranolol only reduced the rise of systolic blood pressure significantly. In normotensive subjects, labetalol reduced significantly the rise in systolic as well as diastolic blood pressure induced by cold stress, but not by the isometric exercise, while propranolol only reduced significantly the rise in systolic blood pressure induced by both the tests. The rise in heart rate was more with isometric exercise than with cold stress both in hypertensive patients and control subjects. The heart rate rise was significantly reduced by propranolol in all the experiments except for the rise induced by cold stress in hypertensive patients. The changes in heart rate produced by labetalol were not significant. PMID- 3525425 TI - Regional and international comparison in utilization of antidiabetic drugs. AB - Data are expressed in the comparable manner through the method of defined daily doses (DDD), which has been adopted for drugs in our country according to the internationally agreed method of drug utilization [Stanulovic et al. 1981]. Together with Iceland, Novi Sad had the lowest insulin utilization in 1976, the rate being 1.7 DDD/1000 inhabitants per day. Insulin was used 7.2 times less than in Sweden. However, the utilization of biguanide of 6 DDD/1000 inhabitants per day was 10 times greater than in other European countries. Prescribing rate of preparations of sulfonylurea in Novi Sad was high (8.2 DDD/1000 inhabitants per day); only Sweden came closer to these values. Causes contributing to these differences could be found in the relation between juvenile diabetes and adult onset diabetes as well as in physicians' attitudes towards therapy, in nutritional status and degree of obesity in the population, age structure of population, number of dietitians in the diabetological service, etc. Diabetologists and clinical pharmacologists should explain causes leading to these differences and determine side effects of available antidiabetic drugs, either positive or negative, in order to enable their optimum utilization. PMID- 3525426 TI - Cimetidine kinetics in renal transplant recipients. AB - Single dose kinetics of cimetidine (Ci) were investigated in 10 patients with renal impairment of varying degrees after renal transplantation. Thirteen healthy subjects and 7 patients with stable renal insufficiency served for control. The studied groups showed no difference in the non-renal Ci-clearance (Clnr) and the volume of distribution at steady state (Vdss). The renal Ci-clearance (Clr) declined parallel to renal function, whereas the estimation of renal tubular transport capacity (Clr/endogenous creatinine-clearance) was independent of renal function in either group studied. The healthy subjects and the control-patients showed a significant correlation between the reduction of the total Ci-clearance (ClB) and the endogenous creatinine-clearance (Clcrea) (ClB = 192 +/- 3.8 Clcrea, p less than 0.001). The individual ClB-values of the patients after kidney transplantation were found within the 90% confidence intervals of this regression line. According to these findings, dosage adjustments of Ci on the basis of Clcrea measurements appear to be valid for renal transplant recipients. PMID- 3525427 TI - Low-dose captopril alone and in combination with hydrochlorothiazide in the treatment of mild to moderate essential hypertension. AB - In this open, titrated dose clinical trial, captopril, when used in small doses (up to 150 mg daily) for 8 weeks (n = 5) and 4 months (n = 13) in patients suffering from mild to moderate essential hypertension, produced a fall in blood pressure both systolic and diastolic. The end point viz. supine diastolic blood pressure of 90 mmHg or less was reached in 6 out of 18 patients with captopril alone and in another 4 patients after the addition of hydrochlorothiazide (25 mg to 50 mg daily). In 4 more patients, a good response was observed but the end point was not reached. The response was fair in 1 and poor in 3 remaining patients. The side effects produced were only mild in nature and did not require any change in dosage schedule. No significant changes were produced in serum electrolytes, creatinine and blood counts. PMID- 3525428 TI - Evaluation of encephalotropic and psychotropic properties of gabapentin in man by pharmaco-EEG and psychometry. AB - In a double-blind, placebo-controlled study the encephalotropic and psychotropic properties of gabapentin - a new gaba-analogue with anticonvulsant and antispastic properties penetrating the blood brain barrier easily - were studied in 10 normal subjects by means of quantitative pharmaco-EEG and psychometric analyses. They received randomized and in weekly intervals single oral doses of 50 mg, 100 mg, 200 mg and 400 mg gabapentin as well as placebo. EEG recordings and evaluation of pulse, blood pressure and side effects were carried out after 0, 1, 2, 4, 6 and 8 hours; psychometric tests were done at the same times except for the first hour. Computer-assisted spectral analysis of the EEG showed moderate though significant central effects of gabapentine in doses of 200-400 mg as compared with placebo, which were maximally pronounced in the 2nd hour post drug. These alterations were generally characterized by an attenuation of total power, augmentation of delta and theta activity and a decrease of alpha activity indicating CNS-inhibitory properties. Only at the late hours did the type of changes shift towards a vigilance-promoting one. Beta activity showed alternating changes. Psychometric and psychophysiological evaluations demonstrated subtle psychotropic effects as compared with placebo characterized mostly by an improvement in concentration, numerical memory, complex reaction and performance in the alphabetical reaction test while performance variability increased as well. Subjectively experienced well-being changed dose-dependently. CFF decreased after 100 mg as did pupil size after 50-200 mg. Evaluation of pulse, blood pressure and side effects demonstrated good tolerability of the drug. PMID- 3525429 TI - Effect of the blood glucose level on the metabolic response of intravenous salbutamol. AB - The effect of an intravenous salbutamol dose (2 micrograms/kg or 8 micrograms/kg) on serum insulin and blood glucose was studied in 8 healthy volunteers after different glucose loads. Administration of glucose significantly increased circulating blood glucose and serum insulin concentrations before the salbutamol injection. The acute insulin releasing capacity of 2 micrograms/kg salbutamol was intensified and its blood glucose elevating effect was diminished by preceding glucose loading. Elevation of salbutamol dose from 2 to 8 micrograms/kg caused a 3.4 fold elevation of insulin secretion and an even more pronounced increase in blood glucose response. PMID- 3525430 TI - Comparison between ranitidine 150 mg b.d. and ranitidine 300 mg nocte in the treatment of duodenal ulcer. AB - A multicenter trial was undertaken to assess the clinical usefulness of a single night-time dose of ranitidine in the short-term healing of duodenal ulcer. 384 patients with endoscopically diagnosed duodenal ulcer were randomly allocated to treatment with ranitidine either 150 mg b.d. or 300 mg as a single night-time dose for four weeks. The patients not healed after four weeks were again treated for four weeks. Of the 356 patients who completed the study, according to the protocol, 148 of 176 (84.1%) recovered on ranitidine 150 mg b.d. and 147 of 180 (81.7%) recovered on 300 mg nocte after four weeks. The healing rates increased to 95.8% and 94.8% respectively after four more weeks. Ulcer symptoms were rapidly reduced with no significant differences between the two treatment groups. There were no unwanted effects in either group and no significant abnormal biochemical or hematological changes. The results of this study support the hypothesis that ranitidine 300 mg given as one night-time dose and ranitidine 150 mg b.d. are equally effective. Ranitidine 300 mg once daily in a clinical practice may be advantageous to the patient. PMID- 3525431 TI - Effects of short-term treatment with coenzyme A or sulodexide on plasma lipids in patients with hypertriglyceridemia (type IV) or mixed hyperlipemia (type IIb). AB - Twenty-seven inpatients suffering from type II and IV dyslipidemia, randomly divided into two groups of 14 and 13 subjects, were treated with coenzyme A (2,000 Lipmann U daily) and sulodexide (300 Lipasemic U daily), respectively, in both cases administered intravenously for 20 days. The principial plasma lipid parameters (total and HDL-cholesterol, LDL-cholesterol in subjects with triglyceridemia less than 400 mg/dl, triglycerides, apoproteins and lipoproteins) were recorded before and after treatment. Tests on patients included an assessment, on a semiquantitative scale, of symptoms arising from modifications of blood flow to the various organs. Statistical analysis of data demonstrated that coenzyme A has a significant cholesterol-lowering action (with an increase in HDL-cholesterol) and a more pronounced hypotriglyceridemic effect in both types of dyslipidemia considered, results on both variables proving more satisfactory than with the control drug. PMID- 3525432 TI - A comparative evaluation of particulate and soluble glucan in an endotoxin model. AB - Particulate glucan (P) but not soluble glucan (F) has been shown to sensitize rats to endotoxins. This phenomenon is believed to be mediated by the reticuloendothelial system (RES). The effect of glucan-P and -F on the RES, and the response of glucan-treated rats to nonlethal doses of endotoxin were investigated. Rats were injected for 5 days with 10 mg/kg of glucan-P, -F or saline. Three days later rats were either (1) injected with colloidal carbon for clearance studies, (2) sacrificed for organ histology and determination of serum glucose, plasma thromboxane (Tx) B2, and plasma 6-keto-prostaglandin (PG) F1 alpha concentrations, or (3) challenged with a nonlethal dose of endotoxin. The latter were further subdivided into groups for either 30-day survival or for sacrifice at 30 min or 4 h post-endotoxin infusion to obtain blood samples for glucose, TxB2, and 6-keto-PGE1 alpha determinations. Glucan-P induced hepatosplenomegaly and granulomatous changes within the liver and spleen. The carbon clearance halftime was markedly decreased in these animals. In glucan-P treated rats challenged with endotoxin, elevated concentrations of both plasma prostanoids were observed as well as alterations in serum glucose levels. These changes were less pronounced in glucan-F- or saline- treated rats. Following endotoxin challenge, only 40% of glucan-P-treated rats survived 30 days whereas 100% of both the glucan-F and saline-treated rats survived. We conclude that glucan-P, in contrast to glucan-F, significantly heightens RES function and that this effect likely accounts for the endotoxin sensitivity. PMID- 3525433 TI - Recombinant human tumor necrosis factor--I. Cytotoxic activity in vitro. AB - Cytotoxic activity of recombinant human TNF (rHu-TNF) on various human cell lines was examined in vitro. rHu-TNF exerted a cytostatic effect on various types of human tumor cells such as carcinoma, sarcoma, leukemia, melanoma and other types. When the cytocidal effect was examined on the tumor cells which were cytostatically susceptible to rHu-TNF, the cytocidal effect of rHu-TNF was also noticed on many of these tumor cells. However, some tumor cells were affected cytostatically only. Human diploid cells were not affected cytostatically or cytocidally by rHu-TNF. WI-38 VA13 cells which are an SV-40-transformed derivative of WI-38 diploid cells, were affected both cytostatically and cytocidally by rHu-TNF. These results suggest that rHu-TNF exerts cytostatic and cytocidal effects against a broad spectrum of human tumor cells, and its cytotoxic activity is tumor-specific. PMID- 3525434 TI - Recombinant human tumor necrosis factor--II. Antitumor effect on murine and human tumors transplanted in mice. AB - Recombinant human tumor necrosis factor (rHu-TNF) was found to exhibit potent antitumor activities not only against murine tumors, i.e. Meth A sarcoma, B 16 melanoma, colon 26 adenocarcinoma, Lewis lung carcinoma and MH134 hepatoma, transplanted in syngeneic mice but also against human tumors, i.e. HMV-2 melanoma, PC-10 lung carcinoma and GOTO neuroblastoma, heterotransplanted in nude mice. rHu-TNF caused necrosis of all tumors tested and inhibited their growth in a dose dependent manner. Complete regression of tumors was observed in mice bearing Meth A, B16, colon 26, MH134, HMV-2 and PC-10 but not in mice bearing Lewis lung carcinoma and GOTO neuroblastoma. The prolongation of survival time was also observed in syngeneic mice transplanted with murine tumors except Lewis lung carcinoma. The antitumor effect of rHu-TNF was more evident when it was given intratumorally than when given intravenously. The feasibility of rHu-TNF as a drug for cancer therapy is discussed. PMID- 3525436 TI - Bhopal: a bibliography. PMID- 3525435 TI - Early colonial health developments in Mauritius. AB - The historical development of Mauritius and in particular the early developments in health care are crucial to an understanding of the contemporary health system. The introduction of major epidemic diseases through the movements of French soldiers to and from India and the immigration of indentured laborers from India account for the high mortality and morbidity rates in the 18th and 19th centuries and later. The colonial economy created and fortified the dependence on a single cash crop and on imported food. It also contributed toward the impoverization of large sections of the Mauritian population. The colonial era is also responsible for initiating a three tier system of health care. PMID- 3525437 TI - Blood flow in the extremities of athletes. PMID- 3525438 TI - X-ray analysis of renin substrates. Phenyloxyacetyl-leucyl-valyl-phenylalanine methyl ester: an analogue of angiotensinogen-(10-13) sequence. AB - The crystal structure of the title compound, an analogue of the angiotensinogen (10-13) peptide in which the N-terminal leucine and the C-terminal tyrosine are respectively replaced by the phenyloxy-acetic group and by phenylalanine, has been determined by X-ray diffraction. The peptide crystallizes in the space group P2(1)2(1)2(1) with a = 4.866(1), b = 22.311(3), c = 27.213(4) A and Z = 4. The crystal structure was solved by direct methods and refined to an R value of 0.056. The molecules adopt a pleated sheet conformation with the hydrophobic residues alternatively situated on the right and left of the main chain. In the crystallographic "a" direction, the molecules are linked by hydrogen bonds and form parallel pleated sheet-type structures. PMID- 3525439 TI - Enzymatic semisynthesis of porcine despentapeptide (B26-30) insulin using unprotected desoctapeptide (B23-30) insulin as a substrate. Model studies. AB - Unprotected porcine desoctapeptide(B23-30) insulin (DOPI) and the synthetic Gly Phe-Phe were used as substrates for the trypsin-catalyzed synthesis of despentapeptide(B26-30) insulin (DPPI). The DPPI synthesis was accompanied by a moderate oligomerization and by the formation of a side produce which was identified as a DOPI derivative having an extra peptide bond between the Gly(A1) and Arg(B22) and which was named des(23-63) proinsulin (1). Despite side reactions, the conditions were found where the overall DPPI yields were comparable to those obtained via di-Boc DOPI, and these procedures were faster and simpler since the Boc protection and deprotection steps were omitted. The reaction progress was directly monitored by HPLC. PMID- 3525440 TI - UV-type damage associated with ionizing radiation: a review. AB - The induction of UV-type damage by ionizing radiation in repair deficient strains of E. coli is reviewed. Both photoreactivable and non-photoreactivable types of damage can be observed. The induction of UV-type damage is largely independent of the presence of free-radical reactive agents (e.g. oxygen and thiols), but is dependent upon the energy of the photon--or electron--beam used, the radiation geometry and the optical absorbance of the extracellular medium. On the basis of calculations and experimental evidence, it is clear that one mechanism whereby such damage arises is through the generation of Cerenkov emission. However, small yields of UV-type damage can be produced using X-rays whose energy is below the threshold for production of Cerenkov emission. In this instance, the damage induction mechanism is thought to involve a direct excitation process. PMID- 3525441 TI - Instructional computing in American nursing programs. AB - This paper summarizes more than a decade of progress on computing in nursing education and reports the results of a two-phase study of instructional computing in American nursing programs. The study reveals an enormous range of activity in nursing education, the importance of various barriers to growth and use of computers and the perceptions of deans and directors of potential remedies and the feasibility of each. PMID- 3525442 TI - Fabrication of collarless porcelain fused to metal restorations without using a platinum matrix. PMID- 3525443 TI - Carbohydrate-induced thermogenesis in man. AB - The effect of thermogenesis due to carbohydrate depends upon the metabolic utilisation of the nutrient. With the glucose clamp technique, when infusing glucose and insulin simultaneously, one can study glucose metabolism under steady states glucose and insulin plasma levels. The amount of glucose needed to maintain euglycemia can be monitored. The increment of energy expenditure is continuously measured by open circuit indirect calorimetry. The combined technique of glucose clamp with continuous indirect calorimetry allows to determine the rate of glucose storage. The experimental value for glucose-induced thermogenesis measured over three hours following glucose ingestion in young adults is around 12 to 15% of the energy content of the glucose load. The results support the concept of two components in the thermogenic response to glucose infusion: an "obligatory thermogenesis" which accounts for the energy costs of storing the nutrient and a "facultative thermogenesis" which is an energy dissipative process. PMID- 3525444 TI - Gentamicin-resistance plasmids in an intensive care unit. AB - To better understand the role of plasmids and their importance in the endemic antibiotic resistance of Enterobacteriaceae, we began a prospective study of our combined medical intensive care/coronary care unit. An initial culture survey of the patients, ward staff, and environment was followed by a prospective sampling of 139 consecutive new admissions at the time of admission to the unit, and at regular intervals thereafter for the remainder of their stay. All cultures were planted on agar-containing gentamicin. Of the 147 patients studied, 12 (8.2%) were colonized with 20 strains of gentamicin-resistant gram-negative bacilli (GRGNB) at 29 sites. An additional four GRGNB were isolated from the environment. Of the 24 GRGNB strains, 7 (29%) Enterobacteriaceae carried plasmids shown to carry the gentamicin-resistance determinant. Plasmids were further characterized by restriction endonuclease digestion profiles of plasmid DNA purified from E. coli C600 transconjugants or transformants. A 93 kb plasmid introduced to the unit by a Serratia liquefaciens colonizing a patient transferred from another area in the hospital was identical to 93 kb plasmids carried by a C. amalonaticus and an E. aerogenes subsequently colonizing another patient on the unit. A 60 kb plasmid, first isolated from a S. marcescens colonizing a sink drain was later isolated from an E. cloacae colonizing a patient. Our results indicate that spread of specific R-plasmids may be one mechanism for dissemination of antibiotic resistance on our MICU/CCU. PMID- 3525445 TI - Veno-venous bypass without heparin in orthotopic liver allotransplantation in the pig. AB - It is now widely accepted that a veno-venous bypass is required to minimize the problems of the anhepatic phase in orthotopic liver transplantation. A technique that does not require systemic anticoagulation is needed to prevent damage by heparinization in hepatic patients. The use of heparin-bonded cannulas offers low risks of thromboembolic complication. Fourteen orthotopic liver transplantation were performed in pigs, including 7 with a roller pump and 7 with a centrifugal pump, without systemic anticoagulation and with heparin-bonded circuits except for the portal cannula, connectors, centrifugal pump head and the tract of the circuit on which the roller moves. All the circuits were previously utilized in clinical liver transplantation and repeatedly washed in saline solution and sterilized for each experiment. The haemodynamic control of the anhepatic state was excellent without hypotension and venous engorgement. In only one case a thromboembolic complication was noted. Arterial pressure, heart rate, urine flow, creatinine, arterial pH and thromboelastographic data did not change significantly while on bypass. No difference was found in the use of either a roller or a centrifugal pump even when the blood flow fell to less than 1000 ml/min to 500 ml/min. PMID- 3525446 TI - [Diuretic therapy in chronic heart failure]. PMID- 3525447 TI - [Heart transplantation. Indications--complications--hemodynamic results]. PMID- 3525448 TI - [Increased CK-MB activity in a 54-year-old patient with unstable angina pectoris]. PMID- 3525449 TI - A phase II study of carboplatin in advanced squamous cell carcinoma of the cervix (a Gynecologic Oncology Group Study). AB - The Gynecologic Oncology Group conducted a Phase II trial of carboplatin in patients with measurable advanced squamous cell carcinoma of cervix. No prior therapy with cytotoxic drugs was permitted in patients entered into this study. Patients entered were GOG performance status 2 or better. Carboplatin 400 mg/m2 (340 mg/m2 in patients who had had prior pelvic radiotherapy with subsequent escalation to 400 mg/m2 if bone marrow tolerance was good) was administered as a 15-minute IV infusion. Treatments were repeated every four weeks until disease progressed or until toxicity prohibited further therapy. Thirty-nine evaluable patients were treated. Two complete and nine partial responses were observed (response rate 28.2%). No neurotoxicity and only mild reversible nephrotoxicity was seen. Gastrointestinal toxicity was severe in three patients (7.7%). Dose limiting toxicity was myelosuppression. Carboplatin is active against squamous cell carcinoma of cervix and appears to be less nephrotoxic, neurotoxic, and nauseogenic than cisplatin. Randomized studies of this drug against cisplatin are indicated to determine the role of carboplatin in the therapy of squamous cell carcinoma of cervix. PMID- 3525450 TI - Sonography of the kidneys in hemolytic uremic syndrome. AB - The sonographic appearance of kidneys in patients presenting with acute renal failure due to hemolytic-uremic syndrome (HUS) was evaluated and compared with that in an age-matched control series. In nine patients with HUS, the renal cortex was typically hyperechogenic and the renal pyramids appeared sonolucent. The renal size was normal or enlarged compared with 35 normal controls. While not specific, the sonographic patterns described in this study support the diagnosis of HUS in the appropriate clinical setting. PMID- 3525451 TI - An algorithmic approach to accurate ultrasonic fetal weight estimation. AB - A flexible model is proposed for estimation of fetal weight from biparietal, occipitofrontal, and average abdominal diameters and femoral shaft length. Individual formulas are selected by gestational age-independent decision rules that reflect fetal body proportions. The correlation coefficient for observed and predicted weight was .994 in a series of 96 fetuses studied within 36 hours of delivery, with 20% of cases having error less than 10 g/kg and 90% with error less than 80 g/kg. PMID- 3525453 TI - Renal replacement therapy. PMID- 3525452 TI - Delayed homograft rejection following common bile duct ligation: in vivo evidence that obstructive jaundice is immunosuppressive. PMID- 3525454 TI - Reversible severe thrombocytopaenia associated with captopril therapy. PMID- 3525455 TI - Biographical sketches--61. Marie. PMID- 3525456 TI - Evidence of spina bifida in skeletal remains from Ireland. PMID- 3525457 TI - Convulsive therapy--a critical appraisal of its origins and value. PMID- 3525458 TI - Biographical sketches--65. Bruce. PMID- 3525460 TI - Ultrasonography in the diagnosis of soft tissue tumours. AB - The diagnosis of soft tissue tumours by the traditional instrumental methods often creates problems. Indeed, it is fairly difficult to make an accurate pre operative diagnosis of a neoplasm of the soft tissues. The authors therefore employed ultrasonography to investigate 29 soft tissue tumours. They consider that ultrasonic assessment can make a valuable contribution to diagnosis in this type of pathology and provide information about the benign or malignant character of the neoplasm. PMID- 3525459 TI - Is migraine due to a deficiency of pineal melatonin? AB - Recent clinical observations favor the theory that migraine is caused by a primary injury of cerebral neurons with secondary involvement of intracranial and extracranial blood vessels. The primary injury is attributed to disruption of cerebral neurotransmitters and particularly the neuroadrenergic and serotonergic systems. These theories have not explained the importance of environmental factors, which so frequently trigger migraine. The author suggests that the pineal gland, which is outside the CNS unprotected by blood brain barrier and sensitive to external stimuli, could act as the intermediate causative factor of migraine, via a derangement of melatonin. PMID- 3525461 TI - Ultrasonography in the early diagnosis of congenital dysplasia of the hip. AB - The authors discuss the feasibility of using ultrasonography in the early diagnosis of congenital dysplasia of the hip. Having used the methods of Graf and Harcke, they devised a new scan which always reveals the state of the limbus in neonatal congenital dysplasia. This has been used for two years as an additional technique in neonates with a positive Ortolani click to demonstrate the presence of an inverted limbus, which is not revealed in the Graf and Harcke scans although they give a very good overall picture of the femoral head and acetabulum. The disclosure of an inverted limbus at this early stage is of crucial importance in determining the correct treatment to be adopted. PMID- 3525462 TI - Scintigraphic study of the evolution of cortical homografts in the treatment of fractures. AB - Twelve patients who had undergone osteosynthesis with a metal plate combined with a frozen homoplastic bone graft for the treatment of fractures or pseudarthrosis were subjected to bone scintigraphy with 99 Tc MDP. This investigation showed the graft to be a site of early and specific accumulation of the tracer. This finding supports early colonization of the graft by vascular structures and osteoblastic cells. In view of the small number of cases studied and our incomplete knowledge of the metabolic processes involved these considerations must remain hypotheses but given the excellent clinical results obtained, the relationships between homoplastic bone and host bone merit further investigation. PMID- 3525463 TI - Ultrasonography in the investigation of loose hip prostheses. AB - Twenty-two patients with severe pain in the hip on weight-bearing after prosthetic replacement were investigated by radiography, arthrography, scintigraphy and ultrasonography to determine the accuracy of these diagnostic methods in detecting loosening of infective or mechanical origin. In two cases, ultrasonography revealed superficial infections that were resolved with antibiotic therapy. Of the remaining 20 cases, 12 involved a deep infection and in 8 the loosening was of mechanical origin. In the deep infections, standard radiography provided a diagnosis in 66% of cases, arthrography in 75% and scintigraphy in 83%, while ultrasonography detected the deep infection in all 12 cases. In the patients with mechanical mobilization, arthrography and ultrasonography were 100% accurate. Since ultrasonography is able to detect discrete or diffuse lesion of the soft tissues around a prosthesis it should be included among the methods used to screen patients with painful hips after prosthetic replacement. PMID- 3525464 TI - [Benjamin Lipschutz (1878-1931) and his significance in dermatology (dermatovirology)]. AB - The present study elaborates on the person of Benjamin Lipschutz, the jewish austrian dermatologist and microbiologist (virologist). His voluminous scientific oeuvre is appreciated, particularly with regard to his role as a pathfinder for the newly developing field of dermatovirology. PMID- 3525465 TI - [Initial manifestation of eruptive exanthematous psoriasis vulgaris caused by captopril medication]. AB - Angiotensin-converting enzyme (ACE) is identical to the dipeptidyl carboxypeptidase kininase II, which inactivates bradykinin. That is why captopril, an orally active ACE inhibitor, alters the kallikrein-kinin arachidonic acid system. It is suggested that this mechanism could be responsible for the dosage-dependent incidence of polymorph cutaneous eruptions during therapy with captopril. A 42-year-old female patient with no previous personal or family history of psoriasis developed an eruptive-exanthematous type of psoriasis vulgaris 1-2 weeks after the beginning of captopril therapy. It is suggested that the onset of the dermatosis was produced by a blockade of bradykinin inactivation. This might have increased the production of arachidonic acid and led to elevated concentrations of inflammatory mediators. PMID- 3525466 TI - An alternative technique for attaching thermoluminescent dosimeters to small mammals. PMID- 3525467 TI - Review of twenty years of research on medical care utilization. AB - A wide variety of issues in social distribution and system performance are approached through analysis of utilization, as shown by this review of twenty years of research. Utilization studies have been used to examine social norms with respect to dying and to geographical and class diffusion of access to the most useful diagnostic procedures. Prevention utilization is selected for special study but is difficult to analyze because both the boundary between prevention and treatment services and the unit of observation are ill defined. A series of studies of the class gradient in use of care under conditions of reduced barriers to care indicate that equity can be improved through program design even though deficits remain at this time. For health plans with social objectives, a stable low-user group presents a challenge to outreach rather than a source of financial comfort. Other work on utilization examines unnecessary care through study of interregional variation in surgical rates and the phenomenon of physician-induced demand; cost-sharing; the HMO model in its attempt theoretically to reconcile equity with cost-containment; the role of sex differences in utilization; and the influence of women's social roles and traditional/contemporary cultural relationships on access. PMID- 3525468 TI - Implications of the method of capital cost payment on the weighted average cost of capital. AB - The author develops a theoretical and mathematical model, based on published financial management literature, to describe the cost of capital structure for health care delivery entities. This model is then used to generate the implications of changing the capital cost reimbursement mechanism from a cost basis to a prospective basis. The implications are that the cost of capital is increased substantially, the use of debt must be restricted, interest rates for borrowed funds will increase, and, initially, firms utilizing debt efficiently under cost-basis reimbursement will be restricted to the generation of funds from equity only under a prospective system. PMID- 3525469 TI - Multiple hormone storage by 'polycrine' cells in the pancreas (from a case of nesidioblastosis). AB - Pancreatic tissue from a case of neonatal hypoglycaemia with nesidioblastosis has been studied by routine light and electron microscope techniques and by highly sensitive light and electron microscope immunolocalization methods. A hyperplastic nodule within the pancreas from this case contained enlarged distorted haemorrhagic islets, with a variable rim of exocrine tissue. Islet cells in these areas were shown to contain more than one hormone in separate granules. An immunoperoxidase system using hapten-labelled primary antibodies and photochemical amplification applied to serial semithin sections suggested a consistent overlap between insulin and glucagon immunoreactive cells. Serial ultrathin sections of tissue embedded in LR White showed that some heteromorphous cells with predominantly beta-granules also contained a minority population of granules which had either glucagon or glicentin immunoreactivity. In adjacent studies, the same techniques confirmed that the majority population of granules did indeed contain insulin, and immunocolloidal gold methods were used to show that glucagon and glicentin containing granules were present in the same cells. The significance of these findings is discussed, including the possibility that cells containing more than one granule type might represent a subpopulation of facultative cells in transit from producing one hormone to producing a second. The importance of sensitive immuno-electron microscopy in the investigation of endocrine lesions is stressed. PMID- 3525470 TI - Immunohistochemical localization of plasma retinol-binding protein and prealbumin in human pancreatic islets. AB - This study was undertaken, employing the immunoenzyme method, to confirm the presence of retinol-binding protein in human pancreatic islets, and to compare its distribution with that of prealbumin, insulin, glucagon, somatostatin and pancreatic polypeptide. It was found that most islet cells contained retinol binding protein, although centrally located cells showed stronger reactivity than those in the peripheral region. The distribution of each of the five polypeptides differed from that of retinol-binding protein, indicating that these peptides did not cross-react with anti-retinol-binding protein antibody. Islet cells which contained prealbumin, on the other hand, were mostly classified as A cells. Further studies are necessary to confirm whether the islet cells produce retinol binding protein or only store it. PMID- 3525471 TI - Immunocytochemical detection of ricin. II. Further studies using the immunoperoxidase method. AB - Radio-iodinated ricin was injected into rat muscle in vivo to establish the distribution of the toxin at various time intervals after injection. Injection site muscle and para-aortic lymph nodes were selected for localization of ricin by the immunoperoxidase technique. Sections of snap-frozen tissues were fixed using a variety of methods to establish the best protocol for the immunodetection method. This was found to be with an ether-ethanol mixture. Ricin was detected in tissue at the site of injection taken from rats sacrificed 1, 4, 8 and 24 h after injection and in tissue from animals dying from ricin intoxication after about 30 h. This method, however, failed to demonstrate unequivocally the presence of ricin in lymphoid tissue which had been indicated by the radiotracer study. The significance of these findings and their relevance to forensic diagnosis are discussed. PMID- 3525473 TI - Neuron-specific enolase and serotonin in the Merkel cells of conger-eel (Conger conger) epidermis. An immunohistochemical study. AB - Immunocytochemical techniques were used to investigate the distribution and co localization of neuron-specific enolase (NSE) and serotonin (5-HT) in the skin of the conger eel, Conger conger. NSE and 5-HT immunoreactivity were found in Merkel cells; these cells were also identified at the electron-microscope level by the presence of characteristic granules and their association with an intraepithelial nerve ending. For the first time, it was demonstrated that Merkel-cell granules of vertebrate skin exhibit an immunoreaction with 5-HT. The production of amines may indicate that the Merkel cells of C. conger have both secretory capabilities and transduction functions. However, immunocytochemical investigation of the synaptic zones at the electron microscope level will be necessary to confirm this hypothesis. The present histochemical results suggest that NSE and 5-HT may be marker substances for Merkel cells, and that immunocytochemistry is a useful tool for the light-microscopic localization of these cells. PMID- 3525472 TI - Chromogranin A, B and C immunoreactivities of mammalian endocrine cells. Distribution, distinction from costored hormones/prohormones and relationship with the argyrophil component of secretory granules. AB - Antibodies specific for chromogranin A, B or C have been used to detect immunohistochemically these three anionic proteins. Pancreatic A, B and PP cells, gut argentaffin EC, argyrophil ECL and gastrin G cells, thyroid C cells, parathyroid cells, adrenal medullary cells, pituitary TSH, FSH and LH cells as well as some axons of visceral nerves have been found to react with chromogranin A antibodies. Pancreatic A, gut EC and G, adrenal medullary and pituitary cells as well as some gut nerve fibers showed chromogranin B immunoreactivity. Chromogranin C immunoreactivity has been detected in pancreatic A, pyloric D1, intestinal L, thyroid C, adrenal medullary and pituitary cells, as well as in some gut neurons and nerve fibers. No crossreactivity has been found in immunohistochemical tests between chromogranins A, B or C and costored monoamines or peptide hormones/prohormones, from which chromogranins can be separated by selective extraction during fixation. On both morphological and chemical grounds a relationship seems to exist between chromogranin A and Grimelius' argyrophilia. Sialooligosaccharide chains of chromogranin A and, possibly, chromogranins' phosphoserine/phosphothreonine groups, seem to interact with guanidyl, amino, and/or imidazole groups of non-chromogranin components to form silver complexing sites accounting for granules' argyrophilia, which can be removed or blocked without affecting chromogranin immunoreactivities. The abundant anionic groups of the three proteins should contribute substantially to granules' basophilia, the partly "masked" pattern of which supports the existence of a close interaction of such groups with other components of secretory granules, including monoamines and peptide hormones or prohormones. Chromogranins could play a role in hormone postranslational biosynthesis and intragranular packaging. PMID- 3525474 TI - Morphological studies on cellular detachment induced by antibody reactions directed against membrane associated antigens. An ultrastructural study. AB - The skin explant model was used to determine the effect of antibody reactions against membrane associated antigens on normal human keratinocytes. Addition of specific allo-antibodies against HLA class I antigens induced characteristic changes in the cells on the outermost region of the explant-outgrowth. A disorganization of the filopodia of these cells occurred and the edges of the cellular border were lifted from the substratum. These signs of detachment were also found when pemphigus serum was added. In both experimental conditions the detachment of the cells was complement independent. After removing the antiserum a recovery took place, but the cells once lifted from the substratum remained recognizable as a ridge of cells. No changes were observed when the explants were incubated with antibodies against HLA class II antigens. Incubation with specific antibodies against HLA class I antigens not present on the explant had also no effect. We propose that antibody reactions against various membrane associated antigens can induce within a few hours characteristic changes of the cellular margins. PMID- 3525475 TI - Electron immunocytochemical localization of pepsinogen I (PgI) in chief cells, mucous-neck cells and transitional mucous-neck/chief cells of the human fundic mucosa. AB - Specific PgI antibodies devoid of PgII cross reactivity have been applied to aldehyde-osmium fixed human, fundic-type, gastric mucosa investigated with the protein A-immunogold technique. PgI immunoreactivity has been detected in the homogeneous secretory granules of glandular chief cells, in bipartite granules of mucous-neck cells, in the granules of cells showing intermediate patterns and topography in between chief and mucous-neck cells (transitional cells), as well as in the granules of a few cells in the foveolar/mucous-neck boundary zone showing mixed foveolar/mucous-neck granule populations. The findings support progressive transformation of mucous-neck cells into chief cells. PMID- 3525476 TI - Spontaneous cortical DC-potential shifts: modulation stereotypy; relationships to higher EEG-frequencies. AB - A description of scalp-recorded, spontaneous, cerebral DC-potential shifts is given independent of other variables (shift stereotypy), in relationship to higher frequencies (theta, alpha 1, alpha 2: 4-13 Hz) and as analyzed pairwise across the median sagittal line (Fz, Cz, Pz) separately according to frequency and condition (relaxation and moderate mental load). Spontaneous DC-shifts are shown to behave unpredictably. Whether measured jointly (up to triads) or as dyad and triad context entropy, the frontal DC-shifts are calculated as being random, whereby their definition as such within the context of the Principle Component Analysis is supported by the analysis of longitudinal registrations. Cross correlation analysis of the cerebral slow potential's relationship to each of the higher frequencies (theta, alpha 1, alpha 2) reveals it to be highly independent, the highest correlation accounting for merely 11% of the common variance, the average being 9% (R congruent to 0.3). By matching the conjoint activity of the DC-potential between Fz-Cz, Cz-Pz, and Fz-Pz to that of theta, alpha 1, alpha 2 at the same paired sites, the DC-activity is shown to be operating at higher levels of synchronous activity than the higher frequencies, regardless of pairing and/or condition, although the general level of synchronous activity (DC, theta, alpha 1, alpha 2) is remarkably high along the median sagittal line, 75% of the correlation averages of all analysis-pairings being above 0.60. PMID- 3525477 TI - The role of anger in the consciousness development of peace activists: where physiology and history intersect. AB - The focus of this paper concerns the role of anger in the development of consciousness in peace activists. By looking at this from 3 perspectives we can see an intersection of physiology and history. Looked at most closely, anger is a physiological event that recurs in the life of an individual. From a broader perspective, anger plays a critical role and a particular step in the development of consciousness. And from the broadest perspective, we may see how individual peace activists play a role in history by helping to resolve those contradictions (such as the present one between war and peace) by which history jerks its way forward. To put the proposition most carefully, it will be argued that anger is the personal fuel in the social motor that resolves the institutional contradictions that arise in the course of history. The materials on which this paper is based come from two sources. First is the study I have conducted in recent years on the development of consciousness in peace activists. Wishing to contribute my scientific skills to the peace movement, I have analyzed autobiographies of famous peace activists and oral histories of contemporary activists in Connecticut where I live. Since results from both the autobiographies and the oral histories are similar for present purposes, I will not make any distinction between them. The second source of material is the work that I and other researchers have conducted for many years on the brain mechanisms, behavioral complexities and evolutionary trends of aggressive behavior in rats, cats and monkeys. This material has been extensively published and is referred to in the bibliography (Adams, 1979, 1980). PMID- 3525478 TI - Clinical pharmacology of ivermectin. PMID- 3525479 TI - Diagnosis of equine monocytic ehrlichiosis (Potomac horse fever) by indirect immunofluorescence. AB - The recent establishment of a system for the continuous in vitro propagation of Ehrlichia risticii, the causative agent of equine monocytic ehrlichiosis (EME; synonym, Potomac horse fever), has facilitated the development of an indirect fluorescent antibody test for the diagnosis of this disease under laboratory and field conditions. The field diagnostic application of the test has aided in the recognition of the disease in 16 states of the United States and in 1 province of Canada. A limited epidemiologic study conducted between January and September 1985, in an area where the disease is known to be enzootic, revealed that conversion from seronegative to seropositive status is not always accompanied by clinical manifestations of the disease. Confirmatory findings in experimentally inoculated horses suggest the existence of clinically undetectable infections. PMID- 3525480 TI - Use of gray-scale ultrasonography in the diagnosis of reproductive disease in the bitch: 18 cases (1981-1984). AB - Gray-scale ultrasonography was utilized in addition to radiography in the diagnosis of reproductive disease in 18 bitches. In 72% of the cases, ultrasonography was considered diagnostic because it revealed information on organ architecture, relationships of radiographically silhouetting soft tissue structures, and fetal viability that was unobtainable by radiography alone. In the remainder of the cases, ultrasonography was contributory to the diagnostic process by supporting the clinical and radiographic diagnoses. The benefits of ultrasonography are discussed, as is the ultrasonographic appearance of a variety of reproductive tract diseases. PMID- 3525481 TI - Proceedings of Nobel Symposium 63. Cellular mechanisms in hearing (en hommage a Georg von Bekesy). Karlskoga, 2-6 September 1985. PMID- 3525483 TI - Georg von Bekesy and the Karolinska Institute. PMID- 3525482 TI - Functional structure of the organ of Corti: a review. AB - The mammalian auditory organs have a dual sensory system (inner vs. outer hair cells) with distinctly different cellular organizations and innervation patterns. However, the inner (IHCs) and outer (OHCs) hair cells are mechanoreceptors sharing similar general characteristics such as organization of stereocilia (including linkage system) and a gradation of stereociliary height along the length of the cochlea. This gradation of stereociliary height may be the single most important anatomic feature in the tuning capability of the sensory cell. Several lines of evidence suggest that the stereociliary stiffness may be modulated by the sensory cells themselves, most likely via the cuticular plate rootlet complex. The stereociliary bundles of both types of hair cell are organized in a 'W' formation with a steplike arrangement. In the OHCs, the 'W' formation is sharply angulated and slanted toward the apex, coinciding with the slanted fiber arrangement of the overlying tectorial membrane, which is firmly coupled to the tips of the tallest row of the stereociliary bundles. However, in the IHCs, the 'W' formation is wide and its long axis is linear and arranged at a right angle to the radial axis of the organ of Corti; also, the ciliary bundles are freestanding (with a few exceptions in the basal turn). This arrangement in the IHCs would be best suited for deflection by the radial flow of the endolymph. Present evidence suggests that the subtectorial fluid space exists, is filled with endolymph, and freely communicates with endolymph. Because of the discovery of the phenomenon of 'cochlear emission', the possible motility of the sensory cells, particularly of the OHCs, has drawn intense interest in recent years. Recent investigations with dissociated sensory cells (OHCs) indicate some motile capability under various experimental conditions, although it has not been established that this motility is present in vivo. For this reason, the specialized cellular organization for motility and localization of contractile and cytoskeletal proteins have been investigated. These results support the possibility that the OHCs may have cellular facilities for this function.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3525484 TI - Ionic environment of cochlear hair cells. AB - The scala media of the adult cochlea in mammals comprises a morphologically closed compartment sealed with tight junctions of the intermediate to tight types. The unique ionic composition of endolymph is maintained by the stria vascularis through active reabsorption of sodium and active secretion of potassium against ionic gradients. The subtectorial space is only a partially closed compartment which communicates with the endolymph via holes in the tectorial membrane at its outer insertion to the organ of Corti. Hardesty's membrane divides the subtectorial space into two compartments: one facing the surfaces of inner hair cells and one facing the surfaces of outer hair cells. In the study of comparative anatomy, hair cells, e.g. in the lizard, basilar papilla are of two types: those covered with a tectorial membrane and those being free standing lacking the tectorial membrane. The ionic environment of the hair cell surface seems to be the same, independent of whether covered with a tectorial membrane or not. The tectorial membrane itself is semipermeable to ions in the endolymphatic space. Only the surface structures of the hair cell with the sensory hairs facing the subtectorial space are exposed to the high concentration of potassium, whereas the remaining parts of the hair cell are surrounded by a fluid having a more normal extracellular type of ionic composition (cortilymph/perilymph). During embryonic development the ionic composition of endolymph develops in parallel with the morphologic maturation of the stria vascularis. A completely mature composition of endolymph is reached before any electrophysiological potentials in the cochlea can be elicited. The sensory hair surface of hair cells has reached a mature morphology prior to the maturation of endolymph. In several species the tectorial membrane is morphologically only partially mature when the increase of the potassium concentration of endolymph starts. Drugs primarily affecting the stria vascularis causing a transient change of the ionic composition of endolymph result in a transient dysfunction of inner ear potentials. If the ionic changes persist for longer time, morphological changes can occur in both the stria vascularis and the hair cells of the organ of Corti. Whether such changes are primarily caused by the ototoxic drug itself or by changes in the ionic composition of endolymph has to be explored further. PMID- 3525485 TI - Georg von Bekesy and his work. AB - Bekesy's scientific work is assessed, after presentation of a brief biographical sketch. Emphasis is less on his actual achievements (with which the reader is presumed to be generally familiar), and more on his approaches to given problems and the unique solutions he found for many of them. Bekesy was the first to study the function of the auditory organ experimentally, replacing theoretical considerations by empirical evidence. He devised novel experimental methods that were suitable for specific problems, often following up on them by an entirely different approach if the latter was more promising for the particular state of his investigation. He was an extremely keen observer, paying attention to seemingly trivial details that often formed starting points of new studies. When he occasionally became bogged down by what appeared to be insurmountable experimental difficulties, he shelved his subject temporarily, often for many years, simply to take it up again when he had found a new approach. It was only to be expected that some of his findings are now being corrected or modified. However, these new studies are conducted many decades after his original observations and measurements, and do not detract from his pioneering and towering achievements. PMID- 3525486 TI - Stimulation of lipogenesis by insulin in swine adipose tissue: antagonism by porcine growth hormone. AB - The effects of physiological (1, 10 ng/ml) and pharmacological (1,000 ng/ml) concentrations of insulin (INS) and porcine growth hormone (pGH) on lipid metabolism were determined in short-term (2 h) and long-term (26, 50 h) incubations of swine adipose tissue. The short-term effects of three different commercial sources of bovine serum albumin (BSA) on adipose tissue metabolism were also evaluated. Two of the three BSA preparations were found to be unsuitable for inclusion in the short-term incubation buffer because they caused a stimulation of lipid synthesis in adipose tissue and masked the stimulatory effects of insulin. Physiological concentrations of insulin stimulated glucose metabolism in 2-h incubations by 100% in adipose tissue from 80-kg swine. After a 26-h incubation period, INS maintained rates of glucose metabolism at levels comparable to maximally stimulated rates in fresh tissue. Insulin also enhanced glucose metabolism following 50-h incubations; however, rates were less than for 2- or 26-h incubations. Glucose metabolism was also stimulated in adipose tissue from 127-kg swine when incubated for 2 h with INS; however, INS responsiveness declined with increasing body weight. Lipogenesis and glucose oxidation were partially maintained by INS using tissue from the heavier swine. A pharmacological but not physiological concentration of pGH stimulated glucose metabolism in short-term incubations by 50% in adipose tissue from 80-kg swine, and by 10% in adipose tissue from 127-kg swine. Long-term culture of adipose tissue in the presence of pGH had no effect on glucose metabolism. Physiological levels of pGH directly antagonized the stimulation of glucose metabolism by INS in short- and long-term incubations. In summary, these results are the first to establish that swine adipose tissue is quite sensitive to insulin and that pGH directly antagonizes insulin action. PMID- 3525487 TI - Effects of restriction of dietary energy intake during the prepubertal period on secretion of luteinizing hormone and responsiveness of the pituitary to luteinizing hormone-releasing hormone in heifers. AB - The working hypothesis that a low plane of nutrition during the prepubertal period delays puberty in heifers by retarding the prepubertal increase in secretion of luteinizing hormone (LH) was investigated. Secretion of LH and the responsiveness of the pituitary to LH-releasing hormone (LHRH) were compared in heifers fed a growing diet (which allowed spontaneous occurrence of puberty; n = 12; control) or an energy deficient diet (which delayed puberty; n = 11; delayed) during the prepubertal period. The dietary treatments were initiated when the heifers were 299 +/- 14 (mean +/- SD) d of age (d 0 of the experiment) and continued until d 175 of the experiment (474 +/- 14 d of age). Weight gains were .79 +/- .05 (mean +/- SE) and .21 +/- .03 kg X head-1 X d-1 for control and delayed heifers, respectively. Puberty occurred on d 120 +/- 14 of the experiment (428 +/- 13 d of age) in control heifers, whereas none of the delayed heifers attained puberty during the feeding period. Serum concentration of LH and the frequency of LH pulses increased rapidly during the 175-d feeding period in control heifers. In delayed heifers, serum LH concentration increased less rapidly and no increase in pulse frequency was detected during the experimental period. Amplitude of LH pulses tended to be higher in control than delayed heifers. Responsiveness of LH secretion to LHRH was lower in delayed than control heifers. It is speculated that failure of secretion of LH to increase is the causative factor for delayed puberty when dietary energy is limited during the prepubertal period in heifers. PMID- 3525488 TI - Inositol and hepatic lipidosis. II. Effect of inositol supplementation and time from parturition on serum insulin, thyroxine and triiodothyronine and their relationship to serum and liver lipids in dairy cows. AB - Percutaneous liver biopsies and blood samples were obtained from 80 dairy cows in nine Michigan herds over the peripartum period. Thirty-nine cows were fed 17 g of supplemental inositol and 41 were fed a placebo. Liver biopsies were assayed for total myoinositol and triglyceride (TG) concentrations. Blood samples were assayed for serum dextran precipitable cholesterol, nonesterified fatty acids (NEFA), insulin, thyroxine (T4), free (FT4), triiodothyronine (T3) and free T3 (FT3) concentrations. Serum concentrations of insulin and the thyroid hormones decreased near parturition, with lowest concentrations occurring in the immediate postpartum period. Concentrations of T3 correlated well with T4, and the concentrations of free thyroid hormones reflected concentrations of total thyroid hormones. The percentage of hormone in the free fraction remained constant over time. Serum insulin, T3 and T4 were negatively correlated with serum NEFA and liver TG concentrations. Thyroid hormone concentrations were positively correlated with serum dextran precipitable cholesterol concentrations. Inositol supplementation was associated with reduced circulating T3 and FT3 concentrations, but not T4 and FT4 concentrations. Changes in hormone concentrations at parturition and their relationship to liver TG and serum NEFA concentrations were consistent with a metabolic adaptation by the dairy cow to the negative energy balance of early lactation. PMID- 3525489 TI - Recombinant DNA, gene transfer and the future of animal agriculture. AB - Recombinant deoxyribonucleic acid (DNA) technology and gene transfer are two areas of biotechnology that will have significant impact on animal agriculture. Applications to animal agriculture can be expected in animal health management, improved crops and feeds, manipulation of animal physiology, and genetic improvement of livestock species. Improved diagnostic reagents and vaccines that will improve herd health are currently under development. Yield of crop plants such as corn will be increased and the nutritional value of these feeds improved through applications of recombinant DNA technology. Administration of exogenous hormones synthesized by bacteria holds great promise for increasing the yield of milk and possibly meat. Research on the transfer of cloned genes into animals has progressed rapidly and has recently been accomplished in sheep and swine. Tissue specific and developmentally regulated expression of transferred genes now seems possible with defined gene promoter sequences. Several applications of these biotechnologies can be expected within 5 to 10 yr, whereas others may require longer periods of research. The 21st century will herald a new era in animal science research and applications, with recombinant DNA and gene transfer playing major roles. PMID- 3525490 TI - Behavioral, physiological and functional aspects of stereotyped behavior: a review and a re-interpretation. AB - Stereotypies are repetitive actions that are fixed in form and orientation and serve no obvious purpose. Their occurrence in farm animals submitted to intensive husbandry has been interpreted to indicate inadequate environmental design or welfare. Over recent years, detailed descriptive studies have led to a better understanding of the organization and development of stereotypies, particularly in pregnant sows housed in tether stalls. Stereotyped behaviors appear to emerge from elements of initial defensive reactions of animals to their environment. They develop via a progressive narrowing of the behavioral repertoire, until only self-directed behaviors are displayed. Pharmacological studies suggest that performance of stereotyped behavior depends on the brain dopamine systems that are involved in selection and initiation of motor movements. However, generalization of these data to natural stereotypies is doubtful. Recent evidence favors an involvement of brain opioid peptides in stereotyped behavior of sows, although the exact mechanisms remain unknown. Stereotypies are typically observed in situations of conflict or frustration. They have been claimed to have an adaptive function, either by providing self-generated sensory stimulation to compensate for the lack of environmental stimulation, or by allowing animals to discharge their tension or anxiety. However, there is little evidence in favor of either interpretation. On the basis of present knowledge, it is proposed that stereotyped activities gain strength because of the positive feedback effect of sensory stimulation on their underlying control systems, which leads to a progressive sensitization of these neural systems. Stereotypies would then be simply the outward expression of an activation of lower brain structures controlling motor behavior which occurs in the absence of normal inhibitory control by higher nervous functions. PMID- 3525491 TI - Structural analysis of myosin genes using recombinant DNA techniques. AB - Myosin, the major protein of the myofibril, consists of two heavy chains with a molecular weight (MW) of 200,000, complexed with four light chains of MW 17,000 to 21,000. Both the heavy and light chains exhibit polymorphisms that are tissue specific and developmental stage-specific. Myosin heavy chains and light chains appear to be represented in the genome as multigene families in various species, including chickens, cattle, humans, rats, rabbits and nematodes. Myosin heavy chain proteins have a high amino acid sequence homology among isoforms, and the genes for each isoform likewise exhibit a high degree of nucleotide sequence conservation. The myosin heavy-chain genes have a complex structure and contain up to 65% intervening sequence composed of up to 20 or more individual introns. Partial sequence data, transcriptional orientation and tissue of expression have been determined for several myosin heavy-chain genes. The use of recombinant DNA and associated techniques will eventually yield definitive information on the control of expression of each individual gene, as well as factors that regulate expression of closely related isoforms. PMID- 3525492 TI - Monoclonal antibodies: pragmatic application of immunology and cell biology. AB - Monoclonal antibodies represent a natural extension of research efforts directed at understanding the structure and function of antibody molecules. In this paper, essential concepts that led to development of monoclonal antibody technology are outlined, including a short discussion on antibody structure and genetics. An overview of the theory of monoclonal antibody production is presented, as well as a comparison of the properties of monoclonal antibodies and conventional antisera. The paper concludes with a discussion of recent innovations in monoclonal antibody technology and their current and potential applications in animal agriculture. PMID- 3525493 TI - Potential for manipulation of the rumen fermentation through the use of recombinant DNA techniques. AB - Recombinant DNA techniques offer a new approach to the study and eventual genetic manipulation of rumen bacteria to modify the rate and extent of nutrient digestion within the rumen. The foreign genes cloned into a rumen bacterium undoubtedly will have to enhance its ability to compete; otherwise, the new trait will be lost from the highly competitive environment within the rumen. As a general rule, the types of metabolic activities amenable to gene cloning may be those that enhance substrate versatility or eliminate a dependence of a specific rumen bacteria on cross-feeding by other rumen microorganisms. Enhanced substrate diversity and bypassing cross-feeding probably will become more important as the use of highly refined feeds and waste materials from the food and other industries are used in greater quantities to meet the dietary needs of ruminants. PMID- 3525494 TI - Plasma, rumen and urine pools in urea dilution determination of body composition in cattle. AB - To determine if urea diffuses into reticulo-ruminal water (RRW) during urea dilution estimation of body composition, four 450-kg heifers were infused intravenously with a solution containing 65.05 g urea plus .95 g 15N-urea, after a 20-h removal of feed. Blood, urine and rumen fluid were collected before infusion and at various times for 120 min after infusion. Plasma 15N clearance was described by a two-pool model. Plasma and urine 15N levels equilibrated within 12 min post-infusion and then declined at similar rates, suggesting that renal clearance is a major component of the second pool. Rumen fluid contained no urea and rumen NH3-N did not increase during the study. Rumen fluid and plasma 15N did not equilibrate over the time studied (rumen fluid 15N/plasma 15N = .07 and .17 at 12 and 120 min after infusion, respectively). Therefore, urea dilution at 12 min overestimates empty body water only by the volume of urine produced during this time; RRW influences urea dilution estimation of body composition only as a component of live weight. PMID- 3525495 TI - Domagk and the development of the sulphonamides. PMID- 3525496 TI - The sulphonamides: an early British perspective. PMID- 3525497 TI - In-vitro antibacterial activity of BO-1165, a new monobactam antibiotic. AB - BO-1165 has excellent antibacterial activity against Gram-negative bacteria but it is almost inactive against Gram-positive and anaerobic bacteria. BO-1165 was more active than the four reference drugs against Escherichia coli, Salmonella spp., Shigella spp., Klebsiella pneumoniae, Serratia marcescens, indole-positive and indole-negative Proteus. Also, BO-1165 exhibited high antibacterial activity against strains of Pseudomonas aeruginosa (MIC50, 3.12 mg/l) and P. cepacia (MIC50, 1.56 mg/l), but did not against Ps. maltophilia strains. BO-1165 had good stability to plasmid-mediated and chromosome-mediated beta-lactamases. However, the compound was slightly hydrolyzed by the beta-lactamases isolated from Proteus vulgaris, Ps. cepacia, Klebsiella oxytoca and Ps. maltophilia, which were capable of hydrolyzing aztreonam. PMID- 3525498 TI - The assay of chloramphenicol acetyltransferase activity by high performance liquid chromatography. AB - A high performance liquid chromatographic method is described for the assay of chloramphenicol acetyltransferase activity which detects the formation of both 3 acetoxy chloramphenicol and 1,3-diacetoxy chloramphenicol. In experiments performed at pH 6.8 only 3-acetoxy chloramphenicol was detected while in experiments performed at pH 7.8 both 3-acetoxy and 1,3-diacetoxy chloramphenicol were detected. PMID- 3525499 TI - Gentamicin assay in the presence of imipenem. PMID- 3525500 TI - Aldosterone response to angiotensin II during hypoxemia. AB - Exercise in humans causes increases in plasma renin activity (PRA) and plasma aldosterone concentrations (PAC) except when performed at high altitude or while the subjects breathe hypoxic gas. Under those conditions, PRA increases with exercise but PAC does not. We speculated that the PAC suppression during hypoxemic exercise was due to hypoxemia-induced release of a circulating inhibitor of angiotensin II-mediated aldosterone secretion. To test this hypothesis, we measured the PAC response to graded infusions of angiotensin II during hypoxemia and normoxemia. Eight normal volunteers were given increasing doses of angiotensin II (first 2 ng X kg-1 X min-1 and then 4, 8, and finally 12 ng X kg-1 X min-1, each for 20-min periods) on 2 separate days, once while breathing room air and the other day while breathing hypoxic gas adjusted to maintain the subjects' hemoglobin saturation at 90%. The PAC response to different doses of angiotensin II did not significantly differ during hypoxemia from normoxemia. We conclude that our model of hypoxemia does not cause release of an inhibitor of angiotensin II-mediated aldosterone release. PMID- 3525501 TI - Fetal breathing and behavior measured through a double-wall Plexiglas window in sheep. AB - The inability to see the fetus makes the assessment of fetal behavior difficult. To circumvent this problem we implanted a Plexiglas window in the left flank of the ewe. Fetuses were instrumented for measurements of sleep, breathing, and swallowing. Ten fetal sheep were studied on 32 occasions. Six fetuses were delivered through the window at term, and postnatal behavior was compared with intrauterine behavior. Fetuses observed during resting conditions alternated between periods of quiet sleep [high-voltage electrocortical activity (ECoG)] and active or rapid-eye-movement sleep (low-voltage ECoG). In quiet sleep, movements were absent except for periodic generalized electromyographic discharges. Eye and breathing movements were rare or absent. Swallowing was also absent. In active sleep, movements were increased with powerful breathing and swallowing activity. Fetal wakefulness defined by open eyes and purposeful movements of the head was never seen in utero but was clearly observed after delivery. We conclude that fetal wakefulness as defined postnatally was not able to be demonstrated in utero. PMID- 3525502 TI - Muscle glycogen utilization during prolonged strenuous exercise when fed carbohydrate. AB - The purpose of this study was to determine whether the postponement of fatigue in subjects fed carbohydrate during prolonged strenuous exercise is associated with a slowing of muscle glycogen depletion. Seven endurance-trained cyclists exercised at 71 +/- 1% of maximal O2 consumption (VO2max), to fatigue, while ingesting a flavored water solution (i.e., placebo) during one trial and while ingesting a glucose polymer solution (i.e., 2.0 g/kg at 20 min and 0.4 g/kg every 20 min thereafter) during another trial. Fatigue during the placebo trial occurred after 3.02 +/- 0.19 h of exercise and was preceded by a decline (P less than 0.01) in plasma glucose to 2.5 +/- 0.5 mM and by a decline in the respiratory exchange ratio (i.e., R; from 0.85 to 0.80; P less than 0.05). Glycogen within the vastus lateralis muscle declined at an average rate of 51.5 +/- 5.4 mmol glucosyl units (GU) X kg-1 X h-1 during the first 2 h of exercise and at a slower rate (P less than 0.01) of 23.0 +/- 14.3 mmol GU X kg-1 X h-1 during the third and final hour. When fed carbohydrate, which maintained plasma glucose concentration (4.2-5.2 mM), the subjects exercised for an additional hour before fatiguing (4.02 +/- 0.33 h; P less than 0.01) and maintained their initial R (i.e., 0.86) and rate of carbohydrate oxidation throughout exercise. The pattern of muscle glycogen utilization, however, was not different during the first 3 h of exercise with the placebo or the carbohydrate feedings. The additional hour of exercise performed when fed carbohydrate was accomplished with little reliance on muscle glycogen (i.e., 5 mmol GU X kg-1 X h-1; NS) and without compromising carbohydrate oxidation. We conclude that when they are fed carbohydrate, highly trained endurance athletes are capable of oxidizing carbohydrate at relatively high rates from sources other than muscle glycogen during the latter stages of prolonged strenuous exercise and that this postpones fatigue. PMID- 3525503 TI - Methylprednisolone on circulating eicosanoids and vasomotor tone after endotoxin. AB - Acute pulmonary and systemic vasomotor changes induced by endotoxin in dogs have been related, at least in part, to the production of eicosanoids such as the vasoconstrictor thromboxane and the vasodilator prostacyclin. Steroids in high doses, in vitro, inhibit activation of phospholipase A2 and prevent fatty acid release from cell membranes to enter the arachidonic acid cascade. We, therefore, administered methylprednisolone (40 mg/kg) to dogs to see if eicosanoid production and the ensuing vasomotor changes could be prevented after administration of 150 micrograms/kg of endotoxin. The stable metabolites of thromboxane B2 (TxB2) and 6-ketoprostaglandin F1 alpha (6-keto-PGF1 alpha) were measured by radioimmunoassay. Methylprednisolone by itself did not alter circulating eicosanoids but when given 2.5 h before endotoxin not only failed to inhibit endotoxin-induced eicosanoid production but actually resulted in higher circulating levels of 6-keto-PGF1 alpha (P less than 0.05) compared with animals receiving endotoxin alone. Indomethacin prevented the steroid-enhanced concentrations of 6-keto-PGF1 alpha after endotoxin and prevented the greater fall (P less than 0.05) in systemic blood pressure and systemic vascular resistance with steroid plus endotoxin than occurred with endotoxin alone. Administration of methylprednisolone immediately before endotoxin resulted in enhanced levels (P less than 0.05) of both TxB2 and 6-keto-PGF1 alpha but with a fall in systemic blood pressure and vascular resistance similar to the animals pretreated by 2.5 h. In contrast to the early steroid group in which all of the hypotensive effect was due to eicosanoids, in the latter group steroids had an additional nonspecific effect. Thus, in vivo, high-dose steroids did not prevent endotoxin-induced increases in eicosanoids but actually increased circulating levels of TxB2 and 6-keto-PGF1 alpha with a physiological effect favoring vasodilation. PMID- 3525504 TI - Contractile changes in opposing muscles of the human ankle joint with aging. AB - The effects of aging on maximal voluntary strength and on the isometric twitch were determined in the ankle dorsiflexor and plantarflexor muscles of 111 healthy men and women aged 20-100 yr. Men were found to be stronger than women at all ages. In both sexes, the average values for maximum voluntary strength of the dorsiflexors and plantarflexors began to decline in the 6th decade. Although the absolute loss of strength was greater for the plantarflexor muscles, the relative losses were similar in the two muscle groups. During maximum voluntary effort, stimulation of motor nerves produced no additional torque in the majority of elderly men and women, indicating that these subjects remained able to utilize their descending motor pathways for optimal muscle activation. Comparisons of muscle compound action potentials, twitch torques, and muscle cross-sectional areas suggested that a decrease in excitable muscle mass was entirely responsible for the lower strength of the elderly. An additional effect of aging was the gradual prolongation of twitch contraction and half-relaxation times throughout the adult life-span. PMID- 3525505 TI - Hemodynamic effects of synchronous high-frequency jet ventilation during acute hypovolemia. AB - We studied the effects of synchronous cardiac cycle-specific high-frequency jet ventilation (HFJV) in pentobarbital-anesthetized, splenectomized, closed-chest dogs to test the hypothesis that phasic inspiratory increases in intrathoracic pressure (ITP) selectively timed to specific periods of the cardiac cycle have different hemodynamic effects during both hypovolemia (acute hemorrhage, 20 ml/kg) and neurogenic vasomotor shock (hexamethonium, 10 mg/kg) than those observed during normovolemic control conditions. Ventricular stroke volumes (SV) were measured by electromagnetic flow probes. The influence of changes in venous return (VR) on the subsequent hemodynamic response to synchronous HFJV was analyzed using instantaneous VR curves (M. R. Pinsky, J. Appl. Physiol. 56:765 771, 1984). During hemorrhage the VR curve was shifted leftward with concomitant reductions in apneic SV (15.4 +/- 3.8 to 11.2 +/- 3.6 ml, mean +/- SD), (P less than 0.01) that were accentuated by HFJV (P less than 0.01), except when the phasic inspiratory increases in ITP during HFJV were timed to occur during late diastole (-4% apneic SV, NS). SV was greater with late diastolic pulses than with other timed synchronous ITP pulses during hypovolemia (P less than 0.01). During ganglionic blockade, arterial pressure decreased (139 +/- 14 to 76 +/- 18 Torr, P less than 0.001), but VR was preserved at control levels, and no significant cardiac cycle-specific HFJV effects occurred. We conclude that SV reductions associated with positive-pressure ventilation during acute hypovolemia are minimized by HFJV synchronized to late diastole but that this effect is preload dependent. PMID- 3525506 TI - Fluid conservation in athletes: responses to water intake, supine posture, and immersion. AB - The roles of antidiuretic hormone (ADH) and aldosterone in the elicited diuretic responses of trained and untrained men to seated, supine, and head-out water immersed conditions were studied. Volunteers were comprised of groups of six untrained individuals, six trained swimmers, and six trained runners. Each subject underwent three protocols, six hours in a seated position, supine position, or immersion (35 degrees C water). The last two protocols were preceded and followed by 1 h of seated position. After 10 h of fasting, 0.5% body wt of water was drunk. One hour later the trained groups had higher urine osmolalities (P less than 0.05) and urinary excretion rates of ADH (P less than 0.05) and lower urine flow rates (P less than 0.05) than untrained subjects. Throughout the sitting protocol, urinary ADH was also higher in both trained groups (P less than 0.05). Both supine posture and immersion resulted in significant decreases in urinary ADH in the untrained subjects (P less than 0.05) but no changes wer noted in swimmers and only during the second hour of immersion in the runners (P less than 0.05). The natriuresis and kaliuresis were greater during immersion than in the supine position but plasma renin activity, measured only in trained groups, and plasma aldosterone, measured in the untrained group, were decreased similarly with both protocols. The increases in urinary sodium excretion and urine flow rate were lower in trained than untrained subjects during the supine and immersion protocols (P less than 0.05). The data are compatible with an increased osmotic but decreased volume sensitivity of ADH control in trained men. PMID- 3525507 TI - A method for separating cultured preadipocytes according to their density: application to stromal cells from overfed suckling rats. AB - The stroma vascular fraction of adipose tissue consists of a heterogeneous cell population; not all the cells in this compartment undergo adipose conversion in primary culture. A density gradient centrifugation procedure was used to separate cultured cells on the basis of their triglyceride content. This method was applied to both stroma vascular cells from rat adipose tissue and to a 3T3 F442A preadipose cell line as a reference. Comparison of the results obtained from these two cell types suggests that this separation procedure can lead to a quantification of adipose differentiation in the heterogeneous stromal cell population. Separation procedures were applied to cultured stromal cells derived from young rats during the onset of nutritional obesity induced by overfeeding in early life. Results show that early overfeeding induced an increase in the stromal cell differentiation capacity which is expressed in vitro. PMID- 3525508 TI - Comparison of oral salbutamol with reproterol in reversible airway obstruction. PMID- 3525509 TI - Colon cleansing prior to roentgenologic examination. A double blind comparative study. PMID- 3525510 TI - [Cholecystoduodenal fistula complicating a primary gallbladder cancer diagnosed by ultrasonography and computed tomography]. PMID- 3525511 TI - The role of intravenous DSA in extracranial arterial injury. PMID- 3525512 TI - Characterization and purification of helveticin J and evidence for a chromosomally determined bacteriocin produced by Lactobacillus helveticus 481. AB - Lactobacillus helveticus 481 produced an antimicrobial agent active against five closely related species. The sensitive indicators included L. helveticus 1846 and 1244, L. bulgaricus 1373 and 1489, and L. lactis 970. The antimicrobial compound was active at neutral pH under aerobic or anaerobic conditions, was sensitive to proteolytic enzymes and heat (30 min at 100 degrees C), and demonstrated a bactericidal mode of action against sensitive indicators. These data confirmed that antimicrobial activity of L. helveticus 481 was mediated by a bacteriocin, designated helveticin J. Production of helveticin J was maximized in an anaerobic fermentor held at a constant pH of 5.5. Ultrafiltration experiments on culture supernatants containing the bacteriocin revealed that helveticin J was present as an aggregate with a molecular weight in excess of 300,000. Sodium dodecyl sulfate polyacrylamide gel electrophoresis of helveticin J purified through Sephadex chromatography resolved a 37,000-dalton protein band with bacteriocin activity. L. helveticus 481 was shown to harbor a single 8-megadalton plasmid (pMJ1008). Isolates cured of pMJ1008 were phenotypically identical to plasmid-bearing cells in fermentation patterns, helveticin J activity, and immunity spectra. The data provided evidence for a chromosomal location of helveticin J and host immunity determinants. PMID- 3525513 TI - Vector for regulated expression of cloned genes in a wide range of gram-negative bacteria. AB - A pKT231-based broad-host-range plasmid vector was constructed which enabled regulation of expression of cloned genes in a wide range of gram-negative bacteria. This vector, pNM185, contained upstream of its EcoRI, SstI, and SstII cloning sites the positively activated pm twin promoters of the TOL plasmid and xylS, the gene of the positive regulator of these promoters. Expression of cloned genes was induced with micromolar quantities of benzoate or m-toluate, the inexpensive coinducers of the pm promoters. Expression of a test gene, xylE, which specifies catechol 2,3-dioxygenase, cloned in this vector was tested in representative strains of a variety of gram-negative bacteria. Regulated expression of xylE was observed in most strains examined, and induced levels of enzyme representing up to 5% of total cellular protein and ratios of induced:noninduced levels of enzyme up to a factor of 600 were observed. The level of xylE gene expression in different bacteria tended to be correlated with their phylogenetic distance from Pseudomonas putida. PMID- 3525514 TI - Release of cell-free ice nuclei by Erwinia herbicola. AB - Several ice-nucleating bacterial strains, including Erwinia herbicola, Pseudomonas fluorescens, and Pseudomonas syringae isolates, were examined for their ability to shed ice nuclei into the growth medium. Only E. herbicola isolates shed cell-free ice nuclei active at -2 to -10 degrees C. These cell-free nuclei exhibited a freezing spectrum similar to that of ice nuclei found on whole cells, both above and below -5 degrees C. Partially purified cell-free nuclei were examined by density gradient centrifugation, chemical and enzymatic probes, and electron microscopy. Ice-nucleating activity in these cell-free preparations was associated with outer membrane vesicles shed by cells and was sensitive to protein-modifying reagents. PMID- 3525515 TI - Newly made enzymes determine ongoing cell wall synthesis and the antibacterial effects of cell wall synthesis inhibitors. AB - Cell wall synthesis can continue with less than the total complement of cell wall synthetic enzymes present in normal growing cells. A method was developed to investigate whether there exists an excess of cell wall-synthesizing enzymes (penicillin-binding proteins [PBPs]) which all remain functional or whether a mixed population of functional and nonfunctional enzymes characterize normal cells. Surprisingly, cells in which less than 10% of the PBPs were functional could grow at a normal rate, as evidenced by increases in viable counts, culture turbidity, and rates of peptidoglycan, protein, and RNA synthesis. This subset of functional enzymes was biosynthetically new. Penicillin-induced lysis occurred contingent on the acylation of this same small fraction of PBPs, the copy number and affinities of which were below the level of detection by current fluorographic assay techniques. We propose that PBPs have a short functional half life and that cell wall synthesis and bacterial lysis reflect the activity of newly synthesized PBPs. PMID- 3525516 TI - Molecular analysis of the promoter operator region of the Escherichia coli K-12 tyrP gene. AB - The nucleotide sequence of the tyrP promoter region from Escherichia coli has been determined. Two TYR R boxes have been identified, and one of these was shown to overlap the -35 region of a major tyrP promoter (p1). S1 nuclease mapping of in vivo transcripts revealed that transcription from p1 is stimulated by phenylalanine and to a lesser extent by leucine. The demonstration that mutants in which TyrR-tyrosine-mediated repression of tyrP has been abolished have single base changes in the TYR R box which overlaps p1 suggests that TyrR-tyrosine mediated repression of tyrP also involves p1. TyrR-independent stimulation of tyrP expression by Casamino Acids involves a second promoter 140 bases upstream of p1. There are no TYR R boxes in this region. The sequences of 10 TYR R boxes preceding the genes tyrP, tyrR, and aroG and the operons aroF tyrA and aroL aroM are compared and discussed. PMID- 3525517 TI - Eubacterial origin of chlamydiae. AB - The sequence of the 16S rRNA gene from Chlamydia psittaci was determined. Comparison of this sequence with other 16S rRNA sequences showed the organism to be eubacterial. The organism represents a hitherto unrecognized major eubacterial group. However, this group may be peripherally related to the planctomyces and relatives. Although these two groups seem to have very little in common phenotypically (they have been studied in very different ways), cell walls in both cases contain no peptidoglycan. PMID- 3525518 TI - crp genes of Shigella flexneri, Salmonella typhimurium, and Escherichia coli. AB - The complete nucleotide sequences of the Salmonella typhimurium LT2 and Shigella flexneri 2B crp genes were determined and compared with those of the Escherichia coli K-12 crp gene. The Shigella flexneri gene was almost like the E. coli crp gene, with only four silent base pair changes. The S. typhimurium and E. coli crp genes presented a higher degree of divergence in their nucleotide sequence with 77 changes, but the corresponding amino acid sequences presented only one amino acid difference. The nucleotide sequences of the crp genes diverged to the same extent as in the other genes, trp, ompA, metJ, and araC, which are structural or regulatory genes. An analysis of the amino acid divergence, however, revealed that the catabolite gene activator protein, the crp gene product, is the most conserved protein observed so far. Comparison of codon usage in S. typhimurium and E. coli for all genes sequenced in both organisms showed that their patterns were similar. Comparison of the regulatory regions of the S. typhimurium and E. coli crp genes showed that the most conserved sequences were those known to be essential for the expression of E. coli crp. PMID- 3525519 TI - Molecular cloning and nucleotide sequence of the Corynebacterium glutamicum pheA gene. AB - The pheA gene of Corynebacterium glutamicum encoding prephenate dehydratase was isolated from a gene bank constructed in C. glutamicum. The specific activity of prephenate dehydratase was increased six-fold in strains harboring the cloned gene. Genetic and structural evidence is presented which indicates that prephenate dehydratase and chorismate mutase were catalyzed by separate enzymes in this species. The C. glutamicum pheA gene, subcloned in both orientations with respect to the Escherichia coli vector pUC8, was able to complement an E. coli pheA auxotroph. The nucleotide sequence of the C. glutamicum pheA gene predicts a 315-residue protein product with a molecular weight of 33,740. The deduced protein product demonstrated sequence homology to the C-terminal two-thirds of the bifunctional E. coli enzyme chorismate mutase-P-prephenate dehydratase. PMID- 3525520 TI - Genetic organization of plasmid R1162 DNA involved in conjugative mobilization. AB - DNA involved in the mobilization of broad-host-range plasmid R1162 was localized to a region of 2.7 kilobases within coordinates 3.4 to 6.1 kilobases on the R1162 map. By examining the transfer properties of plasmids containing cloned fragments of DNA from within this region, we showed that at least four trans-active products and a cis-active site (oriT) were involved in mobilization. A cloned DNA fragment of 155 base pairs was capable of providing full oriT activity. This fragment was located within 600 base pairs of DNA containing the origin of replication of R1162, and its nucleotide sequence and that of neighboring DNA were determined. Activation of oriT required R1162-encoded, trans-acting products. Deletions which resulted in the loss of one or more of these had a variable effect on transfer efficiency and indicated the presence of both essential and nonessential Mob products. Regions encoding these products flanked oriT and in one case appeared to overlap a gene essential for plasmid replication. The implications of these findings with respect to the broad host range of R1162 are discussed. PMID- 3525521 TI - Putative signal peptide on the small subunit of the periplasmic hydrogenase from Desulfovibrio vulgaris. AB - We sequenced the NH2 terminus of the large and small subunits of the periplasmic hydrogenase from the sulfate-reducing bacterium Desulfovibrio vulgaris (Hildenborough) and found that the small subunit lacks a region of 34 NH4 terminal amino acids coded by the gene for the small subunit (G. Voordouw and S. Brenner, Eur. J. Biochem. 148:515-520, 1985). We suggest that this region constitutes a signal peptide based on comparison with known procaryotic signal peptides. PMID- 3525522 TI - Phenelzine treatment of melancholia. AB - Monoamine oxidase (MAO) inhibitor antidepressants are widely thought by clinicians and researchers to be ineffective in the treatment of endogenous depression. This study reports an open clinical trial in which seven of eight outpatients (88%) with melancholia responded to phenelzine treatment. This response rate is comparable to the response to tranylcypromine in a previous study at our clinic. These results suggest that MAO inhibitors are effective for outpatients with endogenous depressive syndromes. The use of MAO inhibitors may be an alternative treatment for patients who cannot tolerate or who have not responded to tricyclic antidepressants. PMID- 3525523 TI - Therapeutic effects of pindolol on behavioral disturbances associated with organic brain disease: a double-blind study. AB - A double-blind, placebo-controlled crossover study was conducted to examine the effects of pindolol for the treatment of 11 patients with impulsive, explosive behaviors and other emotional-behavioral abnormalities as a consequence of brain disease or injury. Pindolol treatment was associated with significant therapeutic benefits without sedation and without the use-limiting side effects that occur with propranolol. PMID- 3525524 TI - Some aspects of artificial caries lesion formation of human dental enamel in vitro. AB - Investigations of artificial carious lesion formation of human dental enamel showed great variability in caries susceptibility. Human specimens were demineralized in acid buffers with Ca and phosphate ions, undersaturated with respect to hydroxyapatite. Under nearly all conditions the results varied from no lesion formations to etching. This may be due to properties of the surface layer such as fluoride content and permeability. PMID- 3525525 TI - The inhibition of demineralization of human enamel after fluoride varnish application as a function of the fluoride content. An in vitro study under constant composition demineralizing conditions. AB - The inhibiting effect of a 24 hours application of a fluoridated varnish with various fluoride contents on demineralization of human sound enamel was evaluated in vitro. The varnishes used had the same polyurethane base (Fluor Protector) and contained 0.7; 0.1; 0.05 and 0 wt% fluoride, resp. A constant composition technique was used to demineralize varnished and non-varnished specimens at a pH of 5 for periods upto 2 weeks. Microhardness measurements were carried out after several time intervals to follow mineral loss in time longitudinally. At the end of each experimental run microradiography was carried out to investigate 1) lesion type, 2) lesion depth and 3) mineral loss. It is shown in this study that the fluoride releasing varnishes applied on the enamel for 24 hours can inhibit demineralization completely. No demineralization inhibition with the 0% fluoride varnish application was observed. PMID- 3525526 TI - [Dental amalgams and allergy]. AB - After a short description of the fundamental basis of allergy, particularly in relation to contact allergy, the authors review the 41 published cases of allergy to dental amalgam consisting of 30 female and 11 male patients. 20 of these patients recovered on removal of the dental amalgam. The most frequent symptoms were of the remote cutaneous type (38/41 cases) while local symptoms, particularly gingivitis and stomatitis, occurred in 17 cases. These probably underestimate the true prevalence of the condition for several reported cases have not been published. The authors then go on to describe the sensitizing property of amalgam in relation to the occupational environment and the length of time that the amalgam has been in the mouth. Mercury is the most common sensitizing agent, but other metals, particularly cooper, zinc or silver could also be implicated. The authors attempted to explain the physio-pathological mechanism of sensitization via the cutaneous as well as the oral, digestive and respiratory tracts by describing the chelating properties of metals with cellular or tissue constituents. In the last chapter, the prevention and clinical treatment of sensitization to dental amalgams is described. PMID- 3525527 TI - Human preproapolipoprotein C-II. Analysis of major plasma isoforms. AB - Apolipoprotein C-II plays a major role in lipid metabolism as a cofactor for lipoprotein lipase, the enzyme involved in the hydrolysis of triglyceride-rich lipoproteins. Apo-C-II is initially synthesized as a 101 amino acid protein that undergoes subsequent cotranslational cleavage of a signal peptide. Post translational processing of apo-C-II has not been previously described. In this manuscript we identify four major plasma isoforms of apo-C-II by two-dimensional gel electrophoresis and immunoblot analysis that result from post-translational modification of apo-C-II. Neuraminidase studies have shown that two of these isoforms are early secreted sialic acid containing glycoproteins. Amino acid compositional and amino-terminal analysis have established that the major plasma isoform of apo-C-II is proapo-C-II. Proapo-C-II undergoes proteolytic cleavage of its amino-terminal hexapeptide to generate the mature form of apo-C-II. Thus, apo C-II appears to be secreted as a carbohydrate containing proprotein that then undergoes deglycosylation and proteolytic cleavage to generate mature apo-C-II, a minor isoform in plasma. An improved understanding of the structural relationship of the various plasma isoforms of apo-C-II will help to elucidate the mechanisms involved in normal, as well as defective, processing of apo-C-II. PMID- 3525528 TI - Effects of insulin on lipoprotein secretion in rat hepatocyte cultures. The role of the insulin receptor. AB - Insulin inhibits the secretion of lipoprotein components such as triglyceride, phospholipid, and apolipoproteins B and E in primary rat hepatocyte cultures. The aim of this study was to determine whether these hormonal effects are related to the interaction of insulin with its receptor on the surface of cultured hepatocytes. Half-maximal inhibition of secretion of apolipoprotein E and triglyceride occurred at 6 ng/ml porcine insulin, equivalent to a 20% receptor occupancy. When compared to porcine insulin, both guinea pig insulin and desoctapeptide insulin were 60 times less inhibitory on triglyceride and apolipoprotein secretion. These analogs were also 60 times less effective in competing with porcine 125I-insulin for receptor binding. Anti-insulin receptor IgG inhibited binding of porcine insulin to cells in a dose-dependent fashion. However, similar to the hormone itself, it reduced the secretion of triglyceride and apolipoproteins E and B. Preincubation of cells with 200 ng/ml porcine insulin for 15 h caused a 2.5-fold reduction of surface receptor number. These cells were less sensitive to the inhibitory effect of porcine insulin on secretion of triglyceride and apolipoproteins B and E. We conclude that the effects of insulin on lipoprotein processing by hepatocytes in culture are receptor-mediated, can be imitated by antibodies, to the insulin receptor, and are subject to control by receptor down-regulation. PMID- 3525529 TI - The DNA scanning mechanism of T4 endonuclease V. Effect of NaCl concentration on processive nicking activity. AB - T4 endonuclease V is a pyrimidine dimer-specific endonuclease which generates incisions in DNA at the sites of pyrimidine dimers by a processive reaction mechanism. A model is presented in which the degree of processivity is directly related to the efficacy of the one-dimensional diffusion of endonuclease V on DNA by which the enzyme locates pyrimidine dimers. The modulation of the processive nicking activity of T4 endonuclease V on superhelical covalently closed circular DNA (form I) which contains pyrimidine dimers has been investigated as a function of the ionic strength of the reaction. Agarose gel electrophoresis was used to separate the three topological forms of the DNA which were generated in time course reactions of endonuclease V with dimer-containing form I DNA in the absence of NaCl, and in 25, 50, and 100 mM NaCl. The degree of processivity was evaluated in terms of the mass fraction of form III (linear) DNA which was produced as a function of the fraction of form I DNA remaining. Processivity is maximal in the absence of NaCl and decreases as the NaCl concentration is increased. At 100 mM NaCl, processivity is abolished and endonuclease V generates incisions in DNA at the site of dimers by a distributive reaction mechanism. The change from the distributive to a processive reaction mechanism occurs at NaCl concentrations slightly below 50 mM. The high degree of processivity which is observed in the absence of NaCl is reversible to the distributive mechanism, as demonstrated by experiments in which the NaCl concentration was increased during the time course reaction. In addition, unirradiated DNA inhibited the incision of irradiated DNA only at NaCl concentrations at which processivity was observed. PMID- 3525530 TI - Cell-specific post-translational processing of preproglucagon expressed from a metallothionein-glucagon fusion gene. AB - Glucagon is a peptide hormone of 29 amino acids encoded by a preprohormone which contains in tandem the sequences of glucagon and two additional glucagon-like peptides (GLPs) structurally related to glucagon and separated by intervening peptides. Glucagon arises by cleavage from the prohormone within the A cells of the pancreatic islets but in the intestine remains as part of a partially processed precursor (glicentin). To determine whether additional glucagon-like peptides are processed from preproglucagon and to analyze for potential cellular specificity in the processing of preproglucagon, we introduced and expressed a metallothionein-glucagon fusion gene in a fibroblast and two endocrine (pituitary and pancreatic islet) cell lines. Chromatographic analyses of cell extracts utilizing specific radioimmunoassays to chemically synthesized peptides demonstrate the liberation of intact glucagon, glicentin, GLP-I(1-37), GLP-I(7 37), GLP-II, and an intervening peptide amidated at its carboxyl terminus. The peptides were present in distinct yet different patterns in the two endocrine but not the fibroblast cell lines. The cell-specific liberation of the glucagon-like and intervening peptides suggests their potential as new bioactive peptides. The cellular specificity in the processing of preproglucagon indicates that the genetic determinants of the processing activity are complex and are expressed in a cell-specific manner. PMID- 3525531 TI - Serum amyloid A-containing human high density lipoprotein 3. Density, size, and apolipoprotein composition. AB - Serum amyloid A protein (apo-SAA), an acute phase reactant, is an apolipoprotein of high density lipoproteins (HDL), in particular the denser subpopulation HDL3. The structure of HDL3 isolated from humans affected by a variety of severe disease states was investigated with respect to density, size, and apolipoprotein composition, using density gradient ultracentrifugation, gradient gel electrophoresis, gel filtration, and solid phase immunoadsorption. Apo-SAA was present in HDL particles in increasing amounts as particle density increased. Apo SAA-containing HDL3 had bigger radii than normal HDL3 of comparable density. Purified apo-SAA associated readily with normal HDL3 in vitro, giving rise to particles containing up to 80% of their apoproteins as apo-SAA. The addition of apo-SAA resulted in a displacement of apo-A-I and an increase in particle size. Acute phase HDL3 represented a mixture of particles, polydisperse with respect to apolipoprotein content; for example, some particles were isolated that contained apo-A-I, apo-A-II, and apo-SAA, whereas others contained apo-A-I and apo-SAA but no apo-A-II. We conclude that apo-SAA probably associates in the circulation of acute phase patients with existing HDL particles, causing the remodeling of the HDL shell to yield particles of bigger size and higher density that are relatively depleted of apo-A-I. PMID- 3525532 TI - Isolation of an active-site peptide of lipoprotein lipase from bovine milk and determination of its amino acid sequence. AB - Lipoprotein lipase from bovine milk reacted stoichiometrically with diisopropylphosphorofluoridate (DFP), an inactivator of serine esterases, resulting in the loss of enzymatic activity against triacylglycerols. The reaction obeyed first-order kinetics with a rate constant of 0.69 h-1. In order to isolate the peptide containing the diisopropylphosphoryl moiety (DIP), partially purified lipoprotein lipase was covalently labeled with [3H]DFP, and the labeled protein was reduced, carboxymethylated, and further purified to about 90% homogeneity. Cyanogen bromide cleavage followed by gel filtration yielded a radioactive peptide of 6-8 kDa. This peptide was succinylated and then digested with Staphylococcus aureus V8 proteinase. From this digest, a peptide containing 0.95 mol of [3H] DIP/mol of peptide was isolated by gel-permeation chromatography followed by reverse-phase high performance liquid chromatography. Automated Edman degradation provided the following sequence: Ala-Ile-Gly-Ile-His-Trp-Gly-Gly- (DIP)Ser-Pro-Asn-Gln-Lys-Asn-Gly-Ala-Val-Phe-Ile-Asn-(Ser, Leu)-Glu. Analysis of the sequence for secondary structure suggests that the reactive serine of lipoprotein lipase is in a beta-turn, a structure similar to those of the active sites of most other serine proteinases. Lipoprotein lipase appears to share this secondary structure with other serine hydrolases despite significant differences in the primary structure of this domain. PMID- 3525533 TI - Complete amino acid sequences of bovine and human endozepines. Homology with rat diazepam binding inhibitor. AB - The complete amino acid sequences of bovine and human brain endozepines have been determined. The amino-terminal serine of both endozepines is acylated. Assignment of the first 7 residues was achieved through Edman degradation after acid-induced rearrangement and subsequent acid hydrolysis of the amino-terminal blocking group. Cleavage of endozepine by chemical and enzymatic techniques established all the fragments in an unambiguous sequence. Bovine and human endozepines are single-chain polypeptides of 86 residues, with calculated molecular weights of 9913, displaying 93% homology. A comparison between the sequences of bovine and human endozepines with the partial sequences of the functionally related diazepam binding inhibitor from rat brain reveals significant sequence homology. The reported results suggest that bovine and human endozepines as well as rat diazepam binding inhibitor belong to a new family of polypeptides which presumably take part in the modulation of gamma-aminobutyric acid-ergic transmission. PMID- 3525534 TI - Structure of yeast external invertase Man8-14GlcNAc processing intermediates by 500-megahertz 1H NMR spectroscopy. AB - A series of high mannose oligosaccharides with the size range Man8-14GlcNAc was purified from Saccharomyces cerevisiae invertase, and the composition of each was determined by chemical analysis. Purity and composition were verified by 1H NMR spectroscopy at 500 MHz, and structures were assigned on the basis of chemical shifts in C1-H and C2-H protons of similarly substituted compounds of known structure. Such analyses showed that these invertase oligosaccharides were a homologous series of homogeneous compounds, each related to the next member by addition of 1 mol of mannose in a specific alpha-linked configuration. Man8GlcNAc purified from the total glycoprotein fraction of disrupted yeast was the smallest species found and had the same homogeneous structure as that previously reported for the Man8GlcNAc from invertase (Byrd, J. C., Tarentino, A. L., Maley, F., Atkinson, P. H., and Trimble, R. B. (1982) J. Biol. Chem. 257, 14657-14666). Digestion of Man8-13GlcNAc species from invertase with Aspergillus satoi alpha 1,2-mannosidase provided products that were consistent with the structures assigned by 1H NMR as did fast atom bombardment-mass spectroscopy fragmentation analysis of the Man9,10GlcNAc oligosaccharides. These results lead to the proposal that Man8GlcNAc is the only trimming intermediate in Saccharomyces sp., and the remaining Man9-14GlcNAc oligosaccharides are biosynthetic intermediates which define the principal pathway of single-step mannose addition in the formation of the inner core of yeast mannan. PMID- 3525535 TI - O6-methylguanine mutation and repair is nonuniform. Selection for DNA most interactive with O6-methylguanine. AB - Mutations were induced in the ampicillinase gene of a bacteriophage f1/pBR322 chimera both by incorporation of O6-methyl-dGTP opposite T during DNA replication in vitro and by site-directed mutagenesis using O6-methylguanine-containing oligonucleotides. After passage of the DNA through Escherichia coli, analysis of 151 O6-methyl-dGTP-induced mutations indicated a significantly greater number of unmutated mutation sites than expected, whereas the mutated sites generally fit a Poisson distribution. The unmutated sites are assumed to be caused by the inability of some sequences to tolerate the presence of a tetrahedral methyl group within the confines of a Watson-Crick helix (Toorchen, D., and Topal, M.D. (1983) Carcinogenesis 4, 1591-1597). A consensus of the DNA sequences surrounding unmutated mutation sites was derived. The consensus sequence had significant similarity to the region of the rat Harvey ras oncogene containing the N-methyl-N nitrosourea activated site for transformation (Zarbl, H., Sukumar, S., Arthur, A. V., Dionisio, M.-Z., and Barbacid, M. (1985) Nature 315, 382-385). We propose that direct alkylation at O6 of a guanine present within the consensus sequence may produce a DNA conformation less subject to repair. Mutation by O6 methylguanine-containing oligonucleotides demonstrated that repair of the O6 methylguanine lesions varied at least 3-4-fold with position of the lesion. PMID- 3525536 TI - Isolation and characterization of a new 40-kilodalton protein from bovine cardiac muscle. AB - A new protein having a subunit weight of 40,000 has been purified from myosin extracted bovine cardiac myofibrils. Its amino acid composition and isoelectric point are distinct from actin, eu-actinin, and a variety of sarcoplasmic proteins of similar size. Affinity-purified antibodies made to this protein only react with a single 40-kDa protein band from cardiac myofibrils on immunoblots. The anti-40-kDa protein also shows cross-reactivities with cardiac myofibrils from rabbits, rats, and chickens. Immunofluorescence studies demonstrate that the 40 kDa protein is localized at the Z-bands of cardiac myofibrils and at the intercalated discs. The antibody did not react with skeletal muscle myofibrils by immunofluorescence or immunoblotting. It appears that the 40-kDa protein may play a role in the strong attachments between adjacent myofibrils in cardiac muscle. PMID- 3525537 TI - Crystalline arrays of the Escherichia coli sn-glycerol-3-phosphate acyltransferase, an integral membrane protein. AB - The gene encoding the Escherichia coli sn-glycerol-3-phosphate acyltransferase, plsB, was inserted into hybrid plasmids under transcriptional control of the lambda PL and tac promoters. Enzymatic activities 35-50-fold above wild type and a large increase in glycerol-P acyltransferase polypeptide were obtained. Thin section electron microscopy of the cells overproducing the glycerol-P acyltransferase revealed 235-245-A diameter tubular structures associated with the cytoplasmic membrane. These structures were released from the cell by osmotic lysis and purified on Matrex Gel Green A. Subsequent sodium dodecyl sulfate polyacrylamide gel electrophoresis demonstrated that the dominant protein constituent of the tubules was the glycerol-P acyltransferase. Analysis of tubule enriched fractions isolated by differential centrifugation revealed a decreased phospholipid to protein ratio as compared to total and cytoplasmic membrane fractions. At high magnification, negative stained tubules displayed ordered arrays of stain-excluding components projecting 50-60 A from the cytoplasmic surface. Optical diffraction patterns from the micrographs contained intense layer lines at (1/78 A) and (1/39 A) along the tubule axis and a prominent spot at (1/62 A) near the equator. From compositional and structural data, 18-37% of the polypeptide volume is estimated to lie within the hydrophobic domain of the tubule membrane. PMID- 3525538 TI - Structural analysis of the ileR locus of Escherichia coli K12. AB - The Ile repressor protein negatively controls expression from the ilv and thr promoters of Escherichia coli K12. Its existence was inferred from an analysis of the phenotypes of the ileR mutant avr-16 (Johnson, D. I., and Somerville, R. L. (1983) J. Bacteriol. 155, 49-55). The nucleotide sequence of ileR, the structural gene for Ile repressor, has been determined. A DNA segment of 300 base pairs constitutes the ileR gene. The predicted gene product, a protein of 100 amino acids (molecular weight 11,823) has primary structural features reminiscent of other double-stranded DNA-binding regulatory proteins. S1 nuclease mapping of the 5' terminus of ileR mRNA revealed two discrete species whose startpoints differed by approximately 47 nucleotides. The ileR gene, like other repressors for amino acid biosynthetic systems, is autogenously regulated at the transcriptional level. Within the ileR promoter region lie two 18-base pair segments of DNA bearing significant homology to putative operator targets also found within the thr and ilv promoters. A second open reading frame capable of specifying a protein of 83 amino acids, designated orf83, is transcribed divergently from the ileR gene. There are 202 base pairs separating the first codons of the two genes. S1 nuclease mapping of the 5' terminus of orf83 mRNA revealed two discrete species whose startpoints differed by approximately 27 nucleotides. The upstream promoters for ileR and orf83 overlap in their -35 regions. PMID- 3525539 TI - Insulin-stimulated glucose transport in rat adipose cells. Modulation of transporter intrinsic activity by isoproterenol and adenosine. AB - The mechanism of modulation of insulin-stimulated glucose transport activity in isolated rat adipose cells by lipolytic and antilipolytic agents has been examined. We have measured glucose transport activity in intact cells with 3-O methylglucose and in plasma membranes with D-glucose, and the concentration of glucose transporters in plasma membranes using a cytochalasin B binding assay. In intact cells, isoproterenol reduced insulin-stimulated transport activity by 60%. This effect was lost after cooling and washing the cells with homogenization buffer, and neither the concentration of glucose transporters nor transport activity in the plasma membranes differed from control. However, treatment of cells with KCN prior to homogenization preserved the isoproterenol effect through the fractionation procedure. Plasma membranes from these cells contained an unchanged number of transporters (31 +/- 7, mean +/- S.E., versus 31 +/- 4 pmol/mg of protein in controls) but transported glucose at a reduced rate (19 +/- 6 versus 48 +/- 9 pmol/mg of protein/s). Conversely, incubation of intact cells in the presence of adenosine stimulated plasma membrane glucose transport activity compared to that in the absence of adenosine (44 +/- 6 versus 36 +/- 6 pmol/mg of protein/s). Kinetic studies of isoproterenol-inhibited glucose transport in plasma membranes revealed a 60% decrease in Vmax (2900 +/- 350 versus 7200 +/- 1000 pmol/mg of protein/s) and a small increase in Km (15.1 +/- 1 versus 13.0 +/- 0.6 mM). These data indicate that modifications of glucose transport activity produced by lipolytic and antilipolytic agents in intact adipose cells can be fully retained in plasma membranes isolated under appropriate conditions. Furthermore, the effects of these agents occur through a modification of the glucose transporter intrinsic activity. PMID- 3525540 TI - The heme and Fe4S4 cluster in the crystallographic structure of Escherichia coli sulfite reductase. AB - Isolated hemoprotein subunits of Escherichia coli NADPH:sulfite reductase catalyze the 6-electron reduction of SO2-3 to S2-. The prosthetic groups of the hemoprotein, a siroheme and a Fe4S4 cluster, have been shown by spectroscopy to be tightly coupled. We have crystallized the isolated hemoprotein subunits and produced a 3-A electron density map by x-ray crystallography. A single heavy atom derivative and the native anomalous scattering (from the protein's 5 Fe and several S) were used to calculate the phases. In the electron density map, the cluster has a geometry similar to other Fe4S4 clusters. Both the cluster and the siroheme are found near the surface of the protein. The siroheme and the Fe4S4 cluster pack next to each other in the structure, apparently with a common ligand, consistent with a cysteine S gamma, shared by the siroheme Fe and one of the cluster Fe. The distance from the siroheme Fe to the center of the cluster is 5.5 A and the distance from the siroheme Fe to the nearest cluster Fe is 4.4 A. The edge of the siroheme macrocycle appears to be in Van der Waals contact with a cubane S atom of the cluster. The sixth coordination position of the siroheme Fe appears unoccupied and is quite exposed to the solvent. Some possible implications of the proposed structure on the role of the bridged siroheme-Fe4S4 cluster in catalysis are discussed. PMID- 3525541 TI - Characterization of a unique glycoprotein antigen expressed on the surface of human neuroblastoma cells. AB - In order to develop a molecular probe to delineate chemical and biological characteristics of human neuroblastoma cells, a murine monoclonal antibody (Mab 5G3) was produced that is directed to a glycoprotein, preferentially expressed on the surface of such cells. This antibody is of IgG2a isotype, has an association constant of 8 X 10(9) M-1, and reacts preferentially with human neuroblastoma cell lines and fresh frozen tissue sections in enzyme-linked immunosorbent assay and immunoperoxidase assays, respectively. Minimal reactivity is observed with a variety of lymphoblastoid cell lines and normal fetal and adult tissues. Mab 5G3 specifically recognizes a neuroblastoma target glycoprotein antigen of 215 kDa that is derived from a 200-kDa precursor, as evident from pulse-chase biosynthetic studies. Treatment with tunicamycin revealed that both molecules contain N-asparagine-linked oligosaccharides; however, only the 215-kDa species is resistant to treatment with endo-beta-N-acetylglucosaminidase H and sensitive to neuraminidase, indicating that it contains trimmed and terminally sialylated oligosaccharides of the "complex" type. In contrast, the 200-kDa precursor is sensitive to endo-beta-N-acetylglucosaminidase H and resistant to neuraminidase treatment indicating that it contains high-mannose non-processed oligosaccharides. The 215-kDa molecule is sulfated, phosphorylated at serine residues, and expressed on the cell surface. A molecule of 200 kDa is detected by Mab 5G3 in spent culture medium of human neuroblastoma cells which is neither sulfated nor phosphorylated. PMID- 3525542 TI - The acute and chronic effects of glucocorticoids on insulin receptor and insulin responsiveness. Transient fluctuations in intracellular receptor level parallel transient fluctuations in responsiveness. AB - The treatment of confluent embryonic Swiss mouse fibroblasts (3T3-C2 cells) with glucocorticoids has been shown to result in a time- and dose-dependent increase in the number of cellular insulin receptors (Knutson, V. P., Ronnett, G. V., and Lane, M. D. (1982) Proc. Natl. Acad. Sci. U.S.A. 79, 2822-2826). Cellular events relating to the insulin receptor and insulin responsiveness which occur over the time course of the transition to the "up-regulated" steady state are described. Over the 48-h transition from the basal to the up-regulated steady state, a transient increase in the level of intracellular receptor was detected with a 3-5 fold increase in intracellular receptor found 12 h after steroid administration. Through the use of the heavy isotope density shift, this increase in the intracellular receptor population was preceded by a decrease in the rate of receptor inactivation, with no change in receptor synthesis. Insulin-induced receptor down-regulation was abolished after 12 h of dexamethasone treatment, when the intracellular receptor level was elevated. Nevertheless, the cells maintained the ability to internalize receptor in response to insulin binding. The hormonal responsiveness of the cells over the glucocorticoid-induced transition was assessed by the ability of insulin to stimulate the cellular uptake of 2-deoxyglucose and aminoisobutyric acid. Glucose transport was transiently increased at a time when the intracellular population of receptor was transiently elevated. Glucocorticoid treatment ultimately led to a loss of insulin-sensitive glucose transport. Insulin-stimulated amino acid transport was transiently abolished when the intracellular population of receptor was high. With chronic steroid treatment, the sensitivity of the amino acid transporter was increased above control levels. These data would indicate that glucocorticoids have no short- or long-term effect on insulin receptor synthesis; the insulin induced internalization of insulin receptor alone is not sufficient to induce a cellular response to insulin; and the cellular events leading to the transient accumulation of intracellular receptor are coupled to the cellular responsiveness of the cells to insulin. PMID- 3525543 TI - Yeast mitochondrial RNA polymerase. Purification and properties of the catalytic subunit. AB - An RNA polymerase was purified 6500-fold to near homogeneity from a whole cell extract of Saccharomyces cerevisiae. The purified enzyme consists of a single 145,000-dalton polypeptide. By subcellular fractionation, the enzyme was localized to the mitochondria. The RNA polymerase activity is alpha-amanitin- and rifampicin-resistant. With single-stranded DNA templates, the enzyme catalyzes the synthesis of polyribonucleotide chains with lengths ranging from less than 10 to greater than 100 residues. It is inactive with double-stranded DNA. Specific antisera inhibit the RNA polymerase activity and recognize the 145,000-dalton polypeptide. The antisera relate this enzyme to previously described yeast mitochondrial RNA polymerase preparations capable of initiation of transcription at mitochondrial promoter sequences (Winkley, C. S., Keller, M. J., and Jaehning, J. A. (1985) J. Biol. Chem. 260, 14214-14223). It therefore appears that the enzyme is a subunit of the yeast mitochondrial RNA polymerase. PMID- 3525544 TI - Recombinant DNA-derived forms of human alpha 1-proteinase inhibitor. Studies on the alanine 358 and cysteine 358 substituted mutants. AB - The specificity and reactivity of human alpha 1-proteinase inhibitor has been investigated by in vitro mutagenesis of the reactive site P1 methionine 358 residue to alanine 358 and cysteine 358. A comparison of the second-order association rates of both uncharged mutants with 9 serine proteinases indicated that each reacted similarly to either the normal plasma inhibitor or to a mutant containing valine in this position (Travis, J., Owen, M., George, P., Carrell, R., Rosenberg, S., Hallewell, R. A., and Barr, P. J. (1985) J. Biol. Chem. 260, 4384-4389) when tested against either neutrophil or pancreatic elastase. However, oxidation, carboxymethylation, or aminoethylation of the cysteine mutant to yield a charged P1 residue resulted in a significant decrease in association rates with both elastolytic enzymes, and aminoethylation created an excellent trypsin and plasmin inhibitor. These results indicate that the specificity of alpha 1 proteinase inhibitor is determined in a general manner by the class of amino acid residue in the P1 position. Substitution within the same category, such as from valine to alanine or cysteine among the aliphatic hydrophobic residues, has little effect on association rates with the elastolytic enzymes tested. However, alteration from an uncharged to a charged residue may cause considerable changes in both inhibitor specificity and reactivity as noted here with the cysteine derivatives and also previously with a natural variant in which methionine 358 to arginine 358 conversion resulted in the production of a potent thrombin inhibitor (Owen, M. C., Brennan, S. O., Lewis, J. H., and Carrell, R. W. (1983) N. Engl. J. Med. 309, 694-698). PMID- 3525545 TI - The insulin receptor and calmodulin. Calmodulin enhances insulin-mediated receptor kinase activity and insulin stimulates phosphorylation of calmodulin. AB - Despite intensive research efforts, the functional role and regulation of the insulin receptor kinase remain enigmatic. In this investigation, we demonstrate that calmodulin enhances insulin-stimulated phosphorylation of the beta subunit of the insulin receptor and histone H2b and that insulin also stimulates phosphorylation of calmodulin. Using wheat germ lectin-enriched insulin receptor preparations obtained from rat adipocyte plasma membranes, calmodulin stimulated the rate and increased the amount of 32P incorporated predominantly into tyrosine residues of the beta subunit of the receptor when assayed in the presence of insulin. The stimulatory effect of calmodulin was both dose-dependent and saturable with half-maximal and maximal phosphorylation of the beta subunit occurring at 0.4 and 2.0 microM calmodulin, respectively. Ca2+ enhanced the ability of calmodulin to stimulate insulin-mediated phosphorylation of the beta subunit with an apparent K0.5 of approximately 0.6 microM. Calmodulin also induced an approximately 2-fold increase in both the rate and amount of insulin mediated incorporation of 32P into histone H2b. The stimulatory effect of calmodulin was only observed in the presence of insulin and was concentration dependent (K0.5 approximately 3.0 microM calmodulin), saturable (at 5 microM calmodulin), and Ca2+-dependent (K0.5 = 0.2 microM free Ca2+). Insulin also induced phosphorylation of a 17-kDa protein. On the basis of its molecular weight and purification via immunoadsorption with protein A-Sepharose-bound anti calmodulin IgG, this phosphoprotein was identified as a phosphorylated form of calmodulin. Phosphorylation of calmodulin was only observed in the presence of insulin and was both Ca2+- and insulin concentration-dependent with half-maximal effects observed at 0.1 microM free Ca2+ and 350 microunits/ml insulin. Collectively, these results support the hypothesis that Ca2+ and calmodulin participate in the molecular mechanism whereby binding of insulin to its receptor is coupled to changes in cellular metabolism. PMID- 3525546 TI - The translational efficiency of tRNA is a property of the anticodon arm. AB - We have reciprocally transplanted the anticodon arm sequences of a set of amber suppressor tRNA genes, using recombinant DNA techniques. By this means, a very efficient suppressor may be converted to a poor one, and the poorest tRNA to the efficiency of the best one. In tRNA molecules of normal 2 degrees and 3 degrees structure, the suppressor efficiencies of different composite tRNAs having the same anticodon arm sequence are approximately the same. Large numbers of simultaneous changes throughout the rest of the molecule do not affect the efficiency. Selective nucleotide modification as a result of varied anticodon arm sequences cannot explain these efficiencies. Efficiencies are also unlikely to differ because of selective aminoacylation. Measurement of in vivo tRNA shows, however, that tRNA levels do vary if the anticodon arm sequence is changed. If tRNA levels are normalized, the anticodon arm effect on the translational efficiency remains. Therefore, different anticodon arms, all of normal secondary structure, are not equivalent in translation. The most efficient sequences in this series resemble those found in natural tRNAs associated with similar anticodons, as is proposed in the extended anticodon theory (Yarus, M. (1982) Science 218, 646-652). These molecules also provide some information on the specificity of nucleotide modification enzymes and on determinants of the steady state tRNA level. PMID- 3525547 TI - Development of an in vitro bacteriophage N4 DNA replication system. AB - An in vitro DNA replication system from bacteriophage N4-infected Escherichia coli has been developed. It requires MgCl2, all four deoxyribonucleoside triphosphates, and exogenously added N4 phage DNA; other DNAs are used inefficiently or not at all. Ribonucleoside triphosphates are not required, although they stimulate DNA synthesis. In vitro replication starts at the ends of the N4 genome and moves progressively inward. Initiation occurs through hairpin priming at the 3' ends of the genome, but shows a strong preference for the right end. Three N4 gene products (dnp, dbp, and exo) required in vivo for N4 DNA synthesis are absolutely required in the in vitro system. These findings are discussed with respect to the mode of N4 DNA replication. PMID- 3525548 TI - The structure of hemocyanin II from the horseshoe crab, Limulus polyphemus. The amino acid sequences of the smaller cyanogen bromide fragments. AB - Fourteen fragments have been isolated from hemocyanin component II of Limulus polyphemus by cleavage with CNBr. The amino acid sequences of the two largest fragments, CNBr Ia and Ib, have been determined (Yokota, E., and Riggs, A. F. (1984) J. Biol. Chem. 259, 4739-4749; Behrens, P. Q., Nakashima, H., Yokota, E., and Riggs, A. F. (1986) J. Biol. Chem. 261, 10520-10525). We have determined the amino acid sequence of the remaining 12 smaller fragments. PMID- 3525549 TI - The structure of hemocyanin II from the horseshoe crab, Limulus polyphemus. The amino acid sequence of the second largest cyanogen bromide fragment. AB - Fourteen fragments have been isolated from hemocyanin component II of Limulus polyphemus by cleavage with CNBr. The amino acid sequence of the largest fragment, CNBr Ia has been reported (Yokota, E., and Riggs, A. F. (1984) J. Biol. Chem. 259, 4739-4749). The amino acid sequence of the 12 smaller fragments is reported in an accompanying paper (Moore, M. D., Behrens, P. Q., and Riggs, A. F. (1985) J. Biol. Chem. 261, 10511-10519). We have determined the amino acid sequence of the second largest fragment, CNBr Ib. The fragment contains 142 residues and has a molecular weight of 16,095. PMID- 3525550 TI - Structure of hemocyanin II from the horseshoe crab, Limulus polyphemus. Sequences of the overlapping peptides, ordering the CNBr fragments, and the complete amino acid sequence. AB - The amino acid sequence of the largest fragment, CNBr Ia (203 residues) has been reported (Yokota, E., and Riggs, A. F. (1984) J. Biol. Chem. 259, 4739-4749). The amino acid sequences of the second largest fragment, CNBr Ib (142 residues), and of the 12 smaller fragments are reported in accompanying papers (Moore, M. D., Behrens, P. Q., and Riggs, A. F. (1986) J. Biol. Chem. 261, 10511-10519; Behrens, P. Q., Nakashima, H., and Riggs, A. F. (1986) J. Biol. Chem. 261, 10520-10525). The complete amino acid sequence of hemocyanin component II has been established by isolation and analysis of 13 methionine-containing peptides from either a tryptic digest or a Staphylococcus aureus strain V8 protease digest of whole carboxamidomethylated hemocyanin II. Hemocyanin II is composed of 628 residues and has a molecular weight with two copper atoms of 72,946. PMID- 3525551 TI - Independent refolding of domains in the pancreatic serine proteinases. AB - Ser-neotrypsinogen and Val-neotrypsinogen are two-chain modifications of bovine trypsinogen produced on limited proteolysis with trypsin. Ser-neotrypsinogen has Lys131-Ser132 cleaved in the connecting peptide (the autolysis loop) linking the amino- and carboxyl-terminal domains. Val-neotrypsinogen has Arg105-Val106 cleaved which is located within the amino-terminal domain. The mixed disulfide derivative of Ser-neotrypsinogen was successfully refolded. A functional molecule was regenerated from the polypeptide fragments with the correct molecular weight of neotrypsinogen in an overall yield of 7%. Val-Neotrypsinogen could not be refolded. The first-order rate constants for the regeneration of Ser neotrypsinogen were determined from the formation of active enzyme molecules as a function of time and from the regain of the correct molecular weight. Both kinetic values were the same indicating that refolding of the polypeptide chains first forms globular domain structures. The two domains then associate and the disulfide bonds between the domains and the correct geometry of the active site residues are formed last. The same kinetic results were also found in refolding Thr-neochymotrypsinogen (Duda, C. T., and Light, A. (1982) J. Biol. Chem. 257, 9866-9871) where peptide bond cleavage also occurred in the connecting peptide. These observations support the hypothesis that the pathway of folding of serine proteinases proceeds with the independent refolding of domains. PMID- 3525552 TI - Reversible inactivation of the O2-labile hydrogenases from Azotobacter vinelandii and Rhizobium japonicum. AB - Hydrogenases catalyze the reversible activation of dihydrogen. The hydrogenases from the aerobic, N2-fixing microorganisms Azotobacter vinelandii and Rhizobium japonicum are nickel- and iron-containing dimers that belong to the group of O2 labile enzymes. Exposure of these hydrogenases to O2 results in an irreversible inactivation; therefore, these enzymes are purified anaerobically in a fully active state. We describe in this paper an electron acceptor-requiring and pH dependent, reversible inactivation of these hydrogenases. These results are the first example of an anaerobic, reversible inactivation of the O2-labile hydrogenases. The reversible inactivation required the presence of an electron acceptor. The rate of inactivation was first-order, with similar rates observed for methylene blue, benzyl viologen, and phenazine-methosulfate. The rate of inactivation was also dependent on the pH. However, increasing the pH of the enzyme in the absence of an electron acceptor did not result in inactivation. Thus, the reversible inactivation was not a result of high pH alone. The inactive enzyme could not be reactivated by H2 or other reductants at high pH. Titration of enzyme inactivated at high pH back to low pH was also ineffective at reactivating the enzyme. However, if reductants were present during this titration, the enzyme could be fully reactivated. The temperature dependence of inactivation yielded an activation energy of 44 kJ X mol-1. Gel filtration chromatography of active and inactive hydrogenase indicated that neither dissociation nor aggregation of the dimer hydrogenase was responsible for this reversible inactivation. We propose a four-state model to describe this reversible inactivation. PMID- 3525553 TI - Bacteriophage N4-coded 5'----3' exonuclease. Purification and characterization. AB - Bacteriophage N4 DNA replication requires the activity of a phage-induced exonuclease. We show here that the activity is phage coded. We have purified this enzyme to apparent homogeneity. It has a denatured molecular weight of 45,000 and exists in solution as a dimer. Duplex DNA is the preferred substrate which it degrades in a 5'----3' direction to 5' mononucleotides by a distributive mechanism. The enzyme does not act at a nick or a gap; indeed, it requires an end for activity. A possible role for this exonuclease in N4 replication is discussed. PMID- 3525554 TI - Relationship between the affinity and proteolysis of the insulin receptor. Evidence that higher affinity receptors are preferentially degraded. AB - 125I-Insulin binding to rat liver plasma membranes initiated two processes that occurred with similar time courses: an increase of receptor affinity for hormone and degradation of the Mr 135,000 alpha subunit of the insulin receptor to a fragment of Mr 120,000. Inhibitors of serine proteinases prevented alpha subunit degradation without affecting the affinity change. This shows that the change of affinity is not produced by receptor proteolysis and that the intact alpha subunit of the insulin receptor can exist as a higher or lower affinity species. Hormone binding was much more rapid than receptor proteolysis and the initial rate of alpha subunit degradation was independent of the concentration of occupied lower affinity receptors. Only persistent hormone binding and the accumulation of higher affinity insulin-receptor complexes led to significant receptor proteolysis. As the incubation time between 125I-insulin and membranes increased, the rate at which hormone dissociated from Mr 135,000 complexes diminished, whereas hormone dissociated from Mr 120,000 complexes slowly after brief or extended incubations. These observations suggest that 125I-insulin binds to membranes to form low affinity complexes that are not substrates for proteolysis. A slow conformational change produces higher affinity hormone receptor complexes that are selectively degraded. Thus, the conversion between states of affinity may play a role in the regulation of receptor proteolysis and, consequently, insulin action in cells. PMID- 3525555 TI - A novel serine protease (IRCM-serine protease 1) from porcine neurointermediate and anterior pituitary lobes. Isolation, polypeptide chain structure, inhibitor sensitivity, and substrate specificity with fluorogenic peptide substrates. AB - A novel serine protease, which we have called IRCM-serine protease 1, was purified from both porcine neurointermediate and anterior pituitary lobes. The enzyme was inhibited by soybean trypsin inhibitor, pancreatic trypsin inhibitor, benzamidine, phenylmethyl-sulfonyl fluoride, and thiol reagents including HgCl2, p-chloromercuribenzoate, and 5,5'-dithiobis-(2-nitrobenzoic acid) and was resistant to lima bean trypsin inhibitor, alpha 2-macroglobulin, alpha 1 antitrypsin, and C1-esterase inhibitor. IRCM-serine protease 1 displayed "trypsin like" specificity toward a number of tripeptide coumarin-containing substrates, with kcat/km values ranging from 10(4) to 10(6) M-1 S-1. The best substrate was benzyloxycarbonyl-L-Ala-L-Lys-L-Arg-4-methylcoumarin-7-amide with a kcat/Km value of 2.27 X 10(6) M-1 S-1. IRCM-serine protease 1, Mr = 169,000-190,000 determined by gradient gel electrophoresis and gel filtration, respectively, appears to be a homologous dimer. The monomeric subunits of the enzyme are composed of an Mr = 38,000 polypeptide chain which is modifiable by 125I-D-Tyr-Glu-Phe-Lys-Arg-CH2Cl, disulfide-linked to another polypeptide resulting in a subunit molecular weight of 88,000. PMID- 3525556 TI - A pH-induced increase in hydrophobicity as a possible step in the penetration of colicin E3 through bacterial membranes. AB - Exposure to low pH triggers an increase in the hydrophobicity of the colicin E3 molecule. Using a [3H] Triton X-100 binding assay we have shown that the amount of detergent (at supramicellar concentrations) associated with colicin E3 increased dramatically at pH 3.8 and below. Interaction of colicin E3 with asolectin vesicles was monitored by following its cross-linking with two different photoactivatable radioactive phospholipid analogues. At neutral pH colicin E3 was cross-linked with the phospholipid probing the membrane surface whereas at pH 4.5 and below, the bacteriocin reacted with the phospholipid probing the hydrophobic core of the bilayer. With the use of phase partitioning of proteins in Triton X-114 it was shown that at acidic pH whole colicin E3 and its immunity protein segregated in the detergent phase. After trypsin digestion of the colicin-immunity complex, the N-terminal portion of E3 (T1) and the immunity partitioned in the detergent phase at low pH. In contrast, the enzymic domain of the colicin (T2) remained in the aqueous phase and was recovered in a highly active form as a consequence of its dissociation from the immunity protein. These results are discussed in relation to the mechanism of entry of colicin E3 into bacterial cells. PMID- 3525557 TI - The effect of Mg2+ on the guanine nucleotide exchange rate of p21N-ras. AB - There is growing evidence that the protein products of the ras gene family, p21ras, can couple growth factor receptors to intracellular second messenger production and in particular to phosphoinositol lipid turnover. So far, however, there has been no direct proof that the ras proteins function as typical regulatory G proteins. We show here that the human p21N-ras protein, isolated from an Escherichia coli expression system, can exist as a stable GDP complex which exchanges very slowly with exogenous GTP, the half-life of the p21N-ras X GDP complex being around 20 min. However, in low Mg2+ (0.5 microM) the exchange rate is dramatically increased and the half-life of the p21N-ras X GDP complex is less than 30 s. Furthermore, in low Mg2+, the relative binding affinity of the protein for GTP as compared to GDP is increased 10-fold. The effect of low Mg2+ on the exchange rate of both normal and oncogenic mutant p21ras molecules is identical. We propose that removal of Mg2+ in vitro induces a similar conformational change to stimulation in vivo. The properties described here are consistent with a G protein-like activity for p21N-ras. PMID- 3525558 TI - Structural requirement at the cleavage site for efficient processing of the lipoprotein secretory precursor of Escherichia coli. AB - A phenotypically silent mutation in the signal peptide of the Escherichia coli outer membrane prolipoprotein was combined with other mutations in the mature lipoprotein structure. Under conditions where the individual mutations permit normal lipoprotein secretion, the prolipoprotein with both mutations was unable to be normally modified or processed. These results demonstrate that a given signal peptide is fully functional only if it is structurally compatible with the protein to be secreted. This structural compatibility between the signal peptide and the secretory protein is considered to be dependent on the secondary structure formed at or near the signal peptide cleavage site. PMID- 3525559 TI - Efficiency of reconstitution of the membrane-associated sn-glycerol 3-phosphate acyltransferase of Escherichia coli. AB - Membrane-associated enzymes are often solubilized with detergents, purified, and then reconstituted with phospholipid cofactors to regain function. Insofar as most purification and reconstitution procedures are not quantitative, the final reconstituted preparations could reflect a population of molecules ranging from fully functional to completely inactive. Quantitative studies on the efficiency of reconstitution of the Triton X-100-solubilized sn-glycerol 3-phosphate (glycerol-P) acyltransferase of Escherichia coli cytoplasmic membrane were undertaken at each step of purification. Physical recovery of the 83,000 Mr polypeptide was quantitated in polyacrylamide gels using membranes from cells labeled with [3H]leucine. The 83,000 Mr polypeptide in such gels was demonstrated to consist exclusively of the glycerol-P acyltransferase peptide by V8 peptide mapping. Comparison between physical recovery of 83,000 Mr polypeptide and reconstituted activity allowed the efficiency of reconstitution to be determined. Unexpectedly, disproportionalities occurred during the purification. However, the final purification of reconstituted enzyme activity matched that of the 83,000 Mr polypeptide. This method also allowed measurement of the specific activities of the glycerol-P acyltransferase in membranes from a wild type E. coli strain and from plasmid-containing strains which express the plsB gene product to different extents. The physical amounts of the 83,000 Mr polypeptide and glycerol-P acyltransferase activity measured in membranes were not strictly proportional. In strains where the amount of 83,000 Mr polypeptide was enhanced, a larger proportion of latent activity was observed following solubilization and reconstitution. The results establish the suitability of the reconstituted preparations of glycerol-P acyltransferase for detailed kinetic analysis and permit inferences pertaining to regulation. PMID- 3525560 TI - Expression of the type I regulatory subunit of cAMP-dependent protein kinase in Escherichia coli. AB - An expression vector has been constructed for the type I regulatory subunit of cAMP-dependent protein kinase. A cDNA clone for the bovine RI-subunit has been inserted into pUC7. When Escherichia coli JM105 was transformed with this plasmid, R-subunit was expressed in amounts that approached 4 mg/liter. The expressed protein was visualized in total cell extracts by photolabeling with 8 azidoadenosine 3':5'-mono[32P]phosphate following transfer from sodium dodecyl sulfate-polyacrylamide gels to nitrocellulose. Expression of R-subunit was independent of isopropyl-beta-D-thiogalactopyranoside. R-subunit accumulated in large amounts only in the stationary phase of growth, and the addition of isopropyl-beta-D-thiogalactopyranoside during the log phase of growth actually blocked the accumulation of R-subunit. Maximum expression (20 mg/liter) was achieved when E. coli 222 was transformed with the RI-containing plasmid. E. coli 222 is a strain that contains two mutations; it is cya- and also has a mutation in the catabolite gene activator protein (crp) that enables the protein to bind to DNA in the absence of cAMP. The expressed RI-subunit was a soluble, dimeric protein, and no significant proteolysis was apparent in the cell extract. The purified RI-subunit bound 2 mol of cAMP/mol of R monomer, reassociated with C subunit to form holoenzyme, and migrated as a dimer on sodium dodecyl sulfate polyacrylamide gels in the absence of reducing agents. The expressed protein was also susceptible to limited proteolysis, yielding a monomeric cAMP-binding fragment having a molecular weight of 35,000. In all of these properties, the expressed protein was indistinguishable from RI purified from bovine tissue even though the R-subunit expressed in E. coli represents a fusion protein that contains 10 additional amino acids at the amino terminus that are provided by the lac Z' gene of the vector. This NH2-terminal sequence was confirmed by amino acid sequencing. PMID- 3525561 TI - Conformation-specific monoclonal antibodies to the calcium-induced structure of protein C. AB - Monoclonal antibodies to various domains of human protein C were characterized, and the cross-reactivity of these antibodies with other vitamin K-dependent proteins was explored. Three antibodies, JTC-1, -2, and -3 reacted with protein C only in the presence of Ca2+ and were shown to bind to the light chain of protein C. It is suggested that these antibodies recognize a gamma-carboxyglutamic acid domain-related conformational change induced by metal ions, evidenced by the fact that half-maximal binding was observed at calcium concentration of 0.5, 0.6, and 0.7 mM, respectively, by the fact that these antibodies, even in the presence of Ca2+, do not react with gamma-carboxyglutamic acid domainless protein C, and by the fact that Zn2+ and Tb3+ support binding in essentially the same way. Each cell line was stabilized by recloning five times. In addition each antibody had a single isoelectric point and was of the IgG1 kappa class. The interaction of antibodies JTC-1, -2; and -3 with protein C-Ca2+ was characterized by a single class of binding sites with Kd of 3.98 X 10(-9) M, 4.01 X 10(-9) M, and 6.76 X 10(-9) M, respectively. However, antibodies JTC-1, -2, and -3 bound to prothrombin-Ca2+ with Kd of 7.81 X 10(-9) M, 2.0 X 10(-7) M, and higher than 1.0 X 10(-5) M, respectively. In addition they had weak affinity for factor X in the presence of Ca2+. The results indicate that the antibodies JTC-1, -2, and -3 are conformation-specific monoclonal antibodies directed against an at least partially common metal ion-induced three-dimensional structure in protein C, prothrombin, and factor X. PMID- 3525562 TI - Purification and characterization of the major constitutive form of testicular heme oxygenase. The noninducible isoform. AB - Recently we reported on the presence of two isoforms of heme oxygenase in rat liver microsomes, referred to as HO-1 and HO-2, and that only HO-1 is inducible (Maines, M. D., Trakshel, G. M., and Kutty, R. K. (1986) J. Biol. Chem. 261, 411 419). Presently we report on the detection of two isoforms of the enzyme in rat testis and purification to near homogeneity of the noninducible isoform, HO-2. A comparative characterization of the liver HO-1 and the testicular HO-2 is also provided. The relative abundance of the isoforms in the two organs was dissimilar. In the testis, the predominant form was HO-2, and only minute amounts of HO-1 were detected. In the liver, however, a 1:2 ratio of HO-1 to HO-2 was noted. The activity of HO-2 in both organs was refractory to cadmium, an inducer of the hepatic HO-1. Under nondenaturing electrophoresis conditions, HO-2 showed a higher mobility than HO-1; on a sodium dodecyl sulfate-polyacrylamide gel, HO-2 displayed a higher monomeric Mr. The apparent Mr values for HO-2 and HO-1 were 36,000 and 30,000, respectively. The isoforms differed in immunochemical properties. Antiserum to the liver HO-1 did not recognize the testicular HO-2 when examined by double immunodiffusion or by Western immunoblotting. HO-2 was more sensitive to heat inactivation than HO-1. When exposed at 65 degrees C (10 min), 70% of HO-1 activity was retained; however, nearly 80% of HO-2 activity was lost. The apparent Km values for heme for HO-1 and HO-2 were 0.24 and 0.40 microM, respectively. HO-1 and HO-2 had similar requirements for cofactor and flavoprotein reductase and were inhibited by heme-ligands (CO, KCN, NaN3). HO-2 utilized as substrate, Fe-protoporphyrin, Fe-hematoporphyrin, and Fe hematoporphyrin acetate; it did not degrade intact purified rat liver cytochromes b5 and P-450 LM2, catalase, cytochrome c, hemoglobin, or myoglobin. PMID- 3525563 TI - Regulation of chloroplast-encoded chlorophyll-binding protein translation during higher plant chloroplast biogenesis. AB - Etioplasts of 5-day-old dark-grown barley seedlings synthesize most of the soluble and membrane proteins found in chloroplasts of illuminated plants. Prominent among these proteins are the large subunit of ribulose bisphosphate carboxylase and the alpha- and beta-subunits of the chloroplast ATPase. However, etioplasts do not synthesize four chloroplast-encoded proteins which are major constituents of the chloroplast thylakoid membrane: two chlorophyll apoproteins of photosystem I (68 and 65 kDa) and two chlorophyll apoproteins of photosystem II (47 and 43 kDa). Pulse-labeling experiments show that the lack of radiolabel accumulation in the chlorophyll apoproteins in etioplasts is due to inhibition of synthesis rather than apoprotein instability. Illumination of 5-day-old dark grown barley selectively induces synthesis of the plastid-encoded chlorophyll apoproteins and proteins of 32, 23, and 21 kDa. Synthesis of the chlorophyll apoproteins was significant in plants illuminated for 15 min and was near maximum by 1 h. The induction of photosystem I chlorophyll apoprotein synthesis was not accompanied by an increase in mRNA for these proteins. These results demonstrate that the synthesis of the plastid-encoded photosystem I chlorophyll apoproteins is blocked at the translational level in dark-grown barley. Translation of the chlorophyll apoproteins is induced rapidly by light with a time course which is similar to the light-dependent formation of chlorophyll from protochlorophyllide. PMID- 3525564 TI - Purification and characterization of a novel neurotensin-degrading peptidase from rat brain synaptic membranes. AB - A peptidase that cleaved neurotensin at the Pro10-Tyr11 peptide bond, leading to the formation of neurotensin-(1-10) and neurotensin-(11-13), was purified nearly to homogeneity from rat brain synaptic membranes. The enzyme appeared to be monomeric with a molecular weight of about 70,000-75,000 as determined by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and high pressure liquid chromatography filtration. Isoelectrofocusing indicated a pI of 5.9-6. The purified peptidase could be classified as a neutral metallopeptidase with respect to its sensitivity to pH and metal chelators. Thiol-blocking agents and acidic and serine protease inhibitors had no effect. Studies with specific peptidase inhibitors clearly indicated that the purified enzyme was distinct from enzymes capable of cleaving neurotensin at the Pro10-Tyr11 bond such as proline endopeptidase and endopeptidase 24-11. The enzyme was also distinct from other neurotensin-degrading peptidases such as angiotensin-converting enzyme and a recently purified rat brain soluble metalloendopeptidase. The peptidase displayed a high affinity for neurotensin (Km = 2.6 microM). Studies on its specificity revealed that neurotensin-(9-13) was the shortest neurotensin partial sequence that was able to fully inhibit [3H]neurotensin degradation. Shortening the C terminal end of the neurotensin molecule as well as substitutions in positions 8, 9, and 11 by D-amino acids strongly decreased the inhibitory potency of neurotensin. Among 20 natural peptides, only angiotensin I and the neurotensin related peptides (xenopsin and neuromedin N) were found as potent as unlabeled neurotensin. PMID- 3525565 TI - Catalytic domains of carbamyl phosphate synthetase. Glutamine-hydrolyzing site of Escherichia coli carbamyl phosphate synthetase. AB - We present evidence that cysteine 269 of the small subunit of Escherichia coli carbamyl phosphate synthetase is essential for the hydrolysis of glutamine. When cysteine 269 is replaced with glycine or with serine by site-directed mutagenesis of the carA gene, the resulting enzymes are unable to catalyze carbamyl phosphate synthesis with glutamine as nitrogen donor. Even though the glycine 269, and particularly the serine 269 enzyme bind significant amounts of glutamine, neither glycine 269 nor serine 269 can hydrolyze glutamine. The mutations at cysteine 269 do not affect carbamyl phosphate synthesis with NH3 as substrate. The NH3 dependent activity of the mutant enzymes was equal to that of wild-type. Measurements of Km indicate that the enzyme uses unionized NH3 rather than ammonium ion as substrate. The apparent Km for NH3 of the wild-type enzyme is calculated to be about 5 mM, independent of pH. The substitution of cysteine 269 with glycine or with serine results in a decrease of the apparent Km value for NH3 from 5 mM with the wild-type to 3.9 mM with the glycine, and 2.9 mM with the serine enzyme. Neither the glycine nor the serine mutation at position 269 affects the ability of the enzyme to catalyze ATP synthesis from ADP and carbamyl phosphate. Allosteric properties of the large subunit are also unaffected. However, substitution of cysteine 269 with glycine or with serine causes an 8- and 18-fold stimulation of HCO-3 -dependent ATPase activity, respectively. The increase in ATPase activity and the decrease in apparent Km for NH3 provide additional evidence for an interaction of the glutamine binding domain of the small subunit with one of the two known ATP sites of the large subunit. PMID- 3525566 TI - Transfer of fatty acids from the 1-position of phosphatidylethanolamine to the major outer membrane lipoprotein of Escherichia coli. AB - The utilization of exogenous fatty acids for phospholipid synthesis via the sn glycerol-3-phosphate acyltransferase was blocked in Escherichia coli mutants lacking acyl-CoA synthetase activity (fadD) resulting in the selective esterification of the 1-position of phosphatidylethanolamine by extracellular fatty acids (Rock, C. O., and Jackowski, S. (1985) J. Biol. Chem. 260, 12720 12724). The incorporation of exogenous [1-14C]palmitate into phosphatidylethanolamine in fadD mutants was inhibited by chloramphenicol and was depressed by preventing the acylation of the amino terminus of the lipoproteins with the antibiotic globomycin. Lipoprotein acylation was directly examined in fadD mutants harboring hybrid plasmids containing either the major outer membrane lipoprotein gene or a lipoprotein-beta-lactamase gene fusion transcriptionally regulated by the lacUV5 promoter-operator region. Induction of lipoprotein synthesis in the presence of extracellular [1-14C]palmitate increased the amount of radioactivity entering the 1-position of phosphatidylethanolamine and efficiently labeled lipoprotein acyl moieties. Labeling of the 1-position of phosphatidylethanolamine prior to the induction of lipoprotein biosynthesis resulted in the transfer of fatty acid from phosphatidylethanolamine to the lipoprotein. Lipoprotein fatty acids derived from the 1-position of phosphatidylethanolamine were resistant to hydroxylamine hydrolysis, and globomycin reduced the incorporation of exogenous [1-14C]palmitate into lipoproteins by 80% suggesting that this fatty acid is primarily attached to the amino terminus of the lipoprotein. These data illustrate that fatty acid turnover in phosphatidylethanolamine is initiated by the transfer of 1-position acyl moieties to the major outer membrane lipoprotein. PMID- 3525567 TI - Comparisons of antibody reactivity and enzyme sensitivity between small proteoglycans from bovine tendon, bone, and cartilage. AB - Preparations of small proteoglycans from bovine tendon, bone, and cartilage have been compared for sensitivity to various enzymes and reactivity with different polyclonal antibodies. Chondroitinase ABC digestion of all proteoglycans generated a core protein preparation that migrated similarly in sodium dodecyl sulfate-polyacrylamide electrophoresis as a doublet band with Mr approximately equal to 45,000. The small proteoglycans of cartilage were divided into two populations based upon electrophoretic migration of the intact molecules (Rosenberg, L. C., Choi, H. U., Tank, L-H., Johnson, T. L., Pal, S., Webber, C., Reiner, A., and Poole, A. R. (1985) J. Biol. Chem. 260, 6304-6313). The core preparations of tendon, bone, and the faster-migrating (PG II) proteoglycans of cartilage all interacted in Western blot/enzyme-linked immunosorbent assay analysis with polyclonal antibody raised against either the tendon or bone proteoglycans. The slower-migrating (PG I) proteoglycans of cartilage did not react with these antibodies. Digestion of the tendon small proteoglycan with Staphylococcus aureus V8 protease released glycosaminoglycan chains from the molecule and generated a 40-kDa protein fragment that was resistant to further rapid degradation by the enzyme. This large digestion fragment was also prominent following V8 protease digestion of the faster-migrating (PG II) population of small cartilage proteoglycans, but not the small proteoglycan of bone. The N terminal amino acid sequence of the tendon (PG II) proteoglycan was determined. These observations provide additional evidence for heterogeneity among the chemically similar small proteoglycans from different tissues. PMID- 3525568 TI - Magnetic resonance imaging in planning limb-salvage surgery for primary malignant tumors of bone. AB - In defining the linear extent of a malignant tumor in a long bone, radiographs, computerized tomography, and scintigraphy are routinely employed, especially when non-ablative surgery is being considered. The drawbacks of these modalities in defining the true intracompartmental extent of disease within a bone can largely be overcome with the use of magnetic resonance imaging. We did a prospective analysis of magnetic resonance imaging in sixteen consecutive patients with a primary malignant tumor of a long bone, and it showed that this modality has clinical promise of being more precise than the other modalities in defining the true proximal and distal extent of a tumor in a long bone. Coronal images permit easier planning of surgical techniques for salvage of a limb using an allograft than do a multiplicity of transverse images. PMID- 3525569 TI - Localized osteolysis in stable, non-septic total hip replacement. AB - We are reporting four cases of extensive, localized bone resorption adjacent to a rigidly anchored, cemented total hip replacement. None of these hips showed evidence of infection on clinical, bacteriological, or pathological evaluation. The tissue from the regions of osteolysis showed sheets of macrophages and foreign-body giant cells invading the femoral cortices. Abundant methylmethacrylate particulate debris was present in the tissues, but polyethylene wear debris was absent. The histological appearance of this tissue resembled that reported about loosened total hip implants with the exception of the synovial-like layer at the cement surface. The cases reported here show that aggressive bone lysis may occur around stable cemented total hip arthroplasties without the presence of sepsis or malignant disease. PMID- 3525570 TI - Ultrasonographic evaluation of the rotator cuff and biceps tendon. PMID- 3525571 TI - Early avascular necrosis of the femoral head. Report of a case and review of the literature. AB - The clinical and pathological findings in a case of early avascular necrosis of the femoral head following renal transplantation are described. Regions of subchondral bone distant from the principal lesions showed increased numbers of empty osteocytic lacunae. This has been quantified and it is suggested that a loss of osteocytes is perhaps one of the earliest lesions leading to established avascular necrosis. PMID- 3525572 TI - A safe and effective low pressure tourniquet. A prospective evaluation. AB - An unusually wide pneumatic tourniquet has recently become available; we provide a simple formula for its use with a low but effective inflation pressure. A prospective, randomised and controlled trial in 600 lower limb and 150 upper limb operations is reported. The wide tourniquet (12.5 cm) was as effective at low pressure as was a conventional tourniquet (9 cm) inflated to significantly higher pressures. Fewer patients suffered from painful paraesthesiae after operation using the broad, low-pressure tourniquet. PMID- 3525573 TI - The effect of mixed-function oxidase and amine oxidase inhibitors on the activation of dialkylnitrosamines and 1,2-dimethylhydrazine to bacterial mutagens in mice. AB - The effect of the mixed-function oxidase inhibitor phenylimidazole (PI) and the amine oxidase inhibitors iproniazid (IPRO) and aminoacetonitrile (AAN) on the mutagenic activity of various carcinogens was determined in intrasanguineous host mediated assays, using mice as hosts and E. coli 343/113 as an indicator of mutagenic activity. The carcinogenic compounds dimethyl-, diethyl-, methylethyl-, and diethanolnitrosamine (DMNA, DENA, MENA, and DELNA respectively) and 1,2 dimethylhydrazine (SDMH) were administered i.p. to mice pretreated or not with one of the inhibitors. After 4 h exposure to each of the carcinogens, E. coli cells recovered from the liver of non-pretreated mice showed considerable induction of VALr mutations; after pretreatment of the hosts with the three inhibitors, significant reduction of the amounts of induced mutants in vivo was observed. Particularly, PI proved a very efficient inhibitor of DENA, MENA, DELNA, and SDMH mutagenicity (93%-97% reduction), suggesting that these carcinogens are mainly activated by cytochrome P-450-dependent enzymes. However, since PI might also inhibit the NAD-mediated activation of DELNA by alcohol dehydrogenase (ADH), the present experiments do not rule out an additional role of ADH in the in vivo mutagenic activation of DELNA. AAN and IPRO were less and much less effective, respectively, in reducing the mutagenic activity of all compounds. Surprisingly, PI showed less inhibition of the mutagenic activity of DMNA (60% reduction), as compared to the other carcinogens; this indicates that metabolic routes other than the cytochrome P-450-dependent enzyme system may be important for the activation of DMNA. PMID- 3525574 TI - Synthesis, antitumor activity, distribution and toxicity of 4-[4-[bis(2 chloroethyl)amino]phenyl]-1-hydroxybutane-1 1-bisphosphonic acid (BAD), a new lost derivative with increased accumulation in rat osteosarcoma. AB - The aim of this study was to investigate whether the newly synthesized bisphosphonic acid-linked N-Lost derivative BAD retains bone-seeking and cytostatic properties. The paper describes experiments on mutagenicity in vitro and on toxicity in vivo. BAD is characterized by very low mutagenic activity toward histidine auxotrophic Salmonella typhimurium strains. Cytotoxic effects were tested in rat osteosarcoma and in Walker carcinosarcoma 256B. The LD50 of i.v. injected BAD was 146 mg/kg. Acute toxicity is probably caused by calcium complexing of the bisphosphonate part of the molecule. Labeling experiments showed moderate accumulation in bone and osteosarcoma, as well as in lung metastases. BAD effected high tumor growth inhibition in osteosarcoma and Walker carcinosarcoma-bearing rats and marked prolongation of survival; histologic and radiographic examination revealed rapid calcification of osteosarcoma and lung metastases. BAD-pretreatment produced protective effects against osteolysis induced by intratibially implanted Walker carcinosarcoma ascites cells. The cytostatic efficacy of equitoxic doses of BAD in rat osteosarcoma is comparable to that of dacarbazine and in Walker carcinosarcoma to that of melphalan. PMID- 3525575 TI - Type VI collagen in extracellular, 100-nm periodic filaments and fibrils: identification by immunoelectron microscopy. AB - Filaments and fibrils that exhibit a 100-nm axial periodicity and occur in the medium and in the deposited extracellular matrix of chicken embryo and human fibroblast cultures have been tentatively identified with type VI collagen on the basis of their similar structural characteristics (Bruns, R. R., 1984, J. Ultrastruct. Res., 89:136-145). Using indirect immunoelectron microscopy and specific monoclonal and polyclonal antibodies, we now report their positive identification with collagen VI and their distribution in fibroblast cultures and in tendon. Primary human foreskin fibroblast cultures, labeled with anti-type VI antibody and studied by fluorescence microscopy, showed a progressive increase in labeling and changes in distribution with time up to 8 d in culture. With immunoelectron microscopy and monoclonal antibodies to human type VI collagen followed by goat anti-mouse IgG coupled to colloidal gold, they showed in thin sections specific 100-nm periodic labeling on extracellular filaments and fibrils: one monoclonal antibody (3C4) attached to the band region and another (4B10) to the interband region of the filaments and fibrils. Rabbit antiserum to type VI collagen also localized on the band region, but the staining was less well defined. Control experiments with antibodies to fibronectin and to procollagen types I and III labeled other filaments and fibrils, but not those with a 100-nm period. Heavy metal-stained fibrils with the same periodic and structural characteristics also have been found in both adult rat tail tendon and embryonic chicken tendon subjected to prolonged incubation in culture medium or treatment with adenosine 5'-triphosphate at pH 4.6. We conclude that the 100-nm periodic filaments and fibrils represent the native aggregate form of type VI collagen. It is likely that banded fibrils of the same periodicity and appearance, reported by many observers over the years in a wide range of normal and pathological tissues, are at least in part, type VI collagen. PMID- 3525576 TI - Abundant expression of ras proteins in Aplysia neurons. AB - We have cloned a DNA fragment from the marine mollusc Aplysia californica, which contains sequences homologous to mammalian ras genes, by screening a genomic library with a viral Ha-ras oncogene probe under conditions of low stringency hybridization. Nucleotide sequencing revealed a putative exon that encodes amino acids sharing 68% homology with residues 5 to 54 of mammalian p21ras polypeptides, and which therefore is likely to encode a ras-like Aplysia protein. The cloned locus, designated Apl-ras, is distinct from the Aplysia rho (ras homologue) gene and appears to be more closely related to mammalian ras. We used a panel of monoclonal antibodies raised against v-Ha-ras p21 to precipitate an Mr 21,000 protein from extracts of Aplysia nervous tissue, ovotestis, and, to a much lesser degree, buccal muscle. Fluorescence immunocytochemistry revealed that ras like protein is most abundant in neuronal cell bodies and axon processes, with staining most prominent at plasma membranes. Much less was present in other tissues. The prominence of ras protein in neurons, which are terminally differentiated and non-proliferating, indicates that the control of cell division is not the sole function of this proto-oncogene. The large identified neurons of Aplysia offer the opportunity to examine how ras protein might function in mature nerve cells. PMID- 3525577 TI - Myosin at the apical pole of ciliated epithelial cells as revealed by a monoclonal antibody. AB - A monoclonal antibody (CC-212), obtained in a fusion experiment in which basal bodies from quail oviduct were used as immunogen, has been shown to label the apical pole of ciliated cells and to react with a 200-kD protein. This monoclonal antibody was demonstrated to be an anti-myosin from smooth muscle or from nonmuscular cells using the following criteria: On Western blots it reacted with the myosin heavy chains from gizzard and platelet extracts and from cultured cell line extracts, but did not react with striated muscle myosin heavy chains. By immunofluorescence it decorated the stress fibers of well-spread cells with a characteristic striated pattern, while it did not react with myotubes containing organized myofibrils. On native ciliated cells as well as on Triton-extracted ciliated cortices from quail oviduct, this monoclonal antibody decorated the apical pole with a stronger labeling of the periphery of the apical area. Ultrastructural localization was attempted using the immunogold technique on the same preparation. Myosin was associated with a filamentous material present between striated rootlets and the proximal extremities of the basal bodies. No labeling of the basal body itself or of axoneme was observed. PMID- 3525580 TI - Dynamic rearrangements of erythrocyte membrane internal architecture induced by infection with Plasmodium falciparum. AB - Cultured human erythrocytes infected with Plasmodium falciparum were studied by freeze-fracture electron microscopy. Special emphasis was placed upon the formation of the membrane surface excrescences ('knobs') found on red cells containing mature parasites. Knobs were visualized as conoid projections of the protoplasmic fracture face (PF) and depressions of the exoplasmic fracture face (EF). Knob formation was correlated with parasite growth and, on the basis of the organization of intramembranous particles (IMP) in the PF leaflet, a series of changes associated with parasite maturation was discerned: (1) a focal IMP cluster with minimal erythrocyte membrane elevation; (2) an elevated central IMP cluster surrounded by an IMP-free zone and concentric IMP ring; (3) maximal erythrocyte membrane deformation, concomitant with a loss of obvious IMP organization. Subtle changes in PF IMP organization were seen with knob formation and parasite maturation, including an apparent lateral partitioning of endogenous red cell membrane proteins between knobby or knob-free membrane areas in trophozoite-infected cells. IMP size distributions of the PF were shifted toward smaller particles in schizont-infected cells. Parasite development did not affect IMP densities in the PF; however, a decrease from 464 +/- 106 micron-2 to 374 +/- 94 micron-2 was seen in the EF of schizont-infected cells. IMP densities were similar over knobs and knob-free areas of either membrane leaflet, and there was no apparent EF IMP reorganization associated with the presence of knobs. These findings indicate that dynamic membrane changes are associated with knob formation and parasite maturation. PMID- 3525579 TI - Assembly and dynamics of the actin filament system in nonmuscle cells. AB - Kinetic analysis has provided a detailed quantitative description of the mechanism of actin polymerization as well as the methods to analyze the mechanisms of action of actin-binding proteins. In Acanthamoeba, five different proteins regulate the pool of monomers available for polymerization, cap the end of filaments, sever filaments, and cross-link filaments. Remarkably, many of these interactions involve very-low-affinity bonds between the protein molecules. PMID- 3525578 TI - Intracellular localization of the 55-kD actin-bundling protein in cultured cells: spatial relationships with actin, alpha-actinin, tropomyosin, and fimbrin. AB - The 55-kD protein is a new actin-bundling protein purified from HeLa cells (Yamashiro-Matsumura, S., and F. Matsumura, 1985, J. Biol. Chem., 260:5087-5097). We have prepared monoclonal antibodies against the 55-kD protein and examined its intracellular localization, as well as its spatial relationships with other components of microfilaments in cultured cells by double-label immunofluorescence. The localization of the 55-kD protein is similar to that of actin. The antibody to the 55-kD protein stained strongly both microspikes and stress fibers. The 55-kD protein was found from the basal portions to the extremities of microspikes while alpha-actinin was localized only in the basal portions. In stress fibers, the 55-kD protein was found rather continuously in comparison to the periodic localizations of alpha-actinin and tropomyosin. Although fimbrin is located in microspikes and ruffling membranes, fimbrin is hardly found in stress fibers unlike the 55-kD protein. These observations coupled with the actin-bundling activity of the 55-kD protein imply that the 55 kD protein is involved in the formation of microfilament bundles in both microspikes and stress fibers. PMID- 3525581 TI - Immunochemical and ultrastructural mapping of the gelatin-binding and cell attachment regions of human plasma fibronectin with monoclonal antibodies. AB - Monoclonal antibodies against fibronectin were used to locate the gelatin-binding and cell-attachment regions of plasma fibronectin at an ultrastructural level. A total of 23 hybridomas were generated using mice immunized with either intact fibronectin or a 40 000 Mr gelatin-binding fibronectin fragment. One of these antibodies (D9b) strongly inhibited the interaction of radio-labelled fibronectin with gelatin. Another antibody (IB10) inhibited the attachment of Chinese hamster ovary (CHO) cells to a fibronectin substratum by 99%. Both of these antibodies were purified by affinity chromatography on columns of fibronectin-Sepharose and were then incubated with soluble fibronectin to form antigen-antibody complexes. The complexes were separated from free antibody on a column of Sephadex G-200 and were prepared for electron-microscopic examination by spraying on mica discs and rotary shadowing with platinum. As determined by this method, the fibronectin molecules measured 124 +/- 1.7 nm in length. Monoclonal antibody IB10 was visualized as a globular projection 40 +/- 1.4 nm from one end of the fibronectin filament. Monoclonal antibody D9b, on the other hand, was visualized as a globular projection at or near one or both ends of the molecule. These data provide the first morphological localization of the gelatin-binding and cell attachment regions of fibronectin and indicate that further studies using monoclonal antibodies directed toward other epitopes should shed light not only on function but also on the tertiary and quaternary structure of the fibronectin molecule. PMID- 3525582 TI - Size uniformity of ribonucleoprotein matrix particles in loops of Pleurodeles waltlii lampbrush chromosomes visualized by electron microscopy. AB - The different kinds of loops of lampbrush chromosomes were identified in phase contrast, then analysed by electron microscopy on thin sections. Examination at high magnification showed that the basic structure of the ribonucleoprotein (RNP) matrix of all kinds of loops is a 30 nm RNP particle. Furthermore, this study suggests that the morphological differences between the loops are due to the extent of aggregation of these particles. PMID- 3525583 TI - Anti-tubulin antibodies locate the blepharoplast during spermatogenesis in the fern Platyzoma microphyllum R.Br.: a correlated immunofluorescence and electron microscopic study. AB - The discovery that the monoclonal anti-tubulin antibody YOL 1/34 recognizes a microtubule organizing centre, the blepharoplast (which arises de novo during the latter stages of spermatogenesis in the fern, Platyzoma microphyllum), has enabled us to follow it and associated microtubules throughout most of its ontogeny. By correlating electron-microscopic and immunofluorescence observations, YOL 1/34 is seen to stain the blepharoplast uniformly at a time when no microtubules are present within the organelle. Later, staining becomes intense at the surface, concomitant with the re-location of cylindrical channels to the periphery of the blepharoplast. During anaphase of the ultimate division of the spermatid mother cell the blepharoplast moves to the spindle poles and sharpens the otherwise barrel-shaped mitotic apparatus. Prior to this stage the blepharoplast is, however, off-centre and at variable positions around the poles. Later still, in the differentiating spermatids, the blepharoplast is the focus for radiating cytoplasmic microtubules that abut directly onto the electron-dense organelle, penetrating the ribosome-free halo. The three main conclusions are: that tubulin in a pre-microtubular form is associated with the cylindrical channels that arise de novo within the previously amorphous blepharoplast and act as a template in basal body formation; that the late appearance of the blepharoplast as a focus for the spindle poles during the final mitosis provides strong argument against its functioning during spindle pole initiation (despite its ability to sharpen the poles at anaphase); that the blepharoplast does seem to act as a microtubule organizing centre in the mitotically quiescent spermatid. PMID- 3525584 TI - Responsiveness of isolated versus rejected children to social skills training. AB - Fifty children aged from 7 to 12 yr were identified as either isolated or rejected by peers on the basis of sociometric nomination. Subjects were randomly assigned to either social skills training (SST), attention placebo control (APC) or no-treatment control (NTC). Social skills training was not found to produce beneficial effects for either isolates or rejects over and above any changes within the APC or NTC groups. Rejected children in all experimental conditions showed minimal improvement over time whereas isolated children in all groups tended to show improvements in social competence. PMID- 3525585 TI - Interaction of estrogen receptor isoforms with immobilized monoclonal antibodies. AB - High-performance liquid chromatography was performed to separate the various isoforms of estrogen receptor from human breast cancer, based on size (high performance size-exclusion chromatography) and surface charge (high-performance ion-exchange chromatography) properties. The ability of these isoforms to interact with the monoclonal antibodies was assessed. All isoforms exhibited similar immunodeterminant sites, but when they are bound to [125I]iodoestradiol 17 beta (IE), only 30% binding of the radioactive complex to the immobilized monoclonal antibodies was observed. However, the mass of the receptor recognized by the antibody bead, via the estrogen receptor-enzyme immunoassay (ER-EIA), was always significantly higher. This was true for both fractionated and non fractionated cytosols, suggesting that non-ligand binding forms, such as precursors and products of the estrogen receptor, were also recognized; or the ligand was only selecting for a particular conformer(s); or the monoclonal antibody on the bead recognized other proteins associated with estrogen receptor. Ion-exchange fractionation of unlabeled receptor showed loss of immunodeterminant sites. However, size-exclusion fractionation did not show this effect. Diethylstilbestrol, a competitor of IE binding, showed marked stability of receptor recognized by ER-EIA during both size-exclusion and ion-exchange chromatography. Limited trypsin treatment of the receptor caused the loss of immunodeterminant sites without altering the ligand binding sites. Thus, proteolysis of estrogen receptors in cytosols of human breast cancer could easily lead to underestimation by ER-EIA. Although the components with immunodeterminant sites recognized by ER-EIA were always eluted with the ligand-binding isoforms of the estrogen receptor, our data suggest that the concentration of the protein having the epitope associated with the monoclonal antibody is unequal to that recognized by the steroid ligand. We conclude that application of ER-EIA to clinical assays of estrogen receptors clearly needs further clarification. PMID- 3525586 TI - Reversed-phase high-performance liquid chromatography of insulin. Resolution and recovery in relation to column geometry and buffer components. PMID- 3525587 TI - A14-[125I]monoiodoinsulin purified by different high-performance liquid chromatographic procedures and by polyacrylamide gel electrophoresis: preparation, immunochemical properties and receptor binding affinity. AB - Reversed-phase high-performance liquid chromatography (RP-HPLC) allows the rapid separation of A14-[125I]monoiodoinsulin directly from the iodination mixtures. It remains to be clarified, however, whether the RP-HPLC chromatographic conditions affect the properties of the purified tracer. In this study we prepared A14 [125I]insulin purified by polyacrylamide gel electrophoresis (PAGE) and by three different RP-HPLC mobile phases containing, respectively, ammonium acetate, sodium perchlorate and trifluoroacetic acid. The binding characteristics of all these tracers were examined using an insulin antiserum and insulin cell receptors. The specific radioactivity corresponded to the theoretical maximum for the RP-HPLC-purified tracers and was significantly lower for the PAGE-purified tracers. Significant differences were found in the binding of different tracers to the insulin antiserum: maximum binding ranged from 94 to 99% and was significantly lower for tracers purified by RP-HPLC eluents B and C; antiserum dilution giving 50% tracer binding was lower for tracers purified by RP-HPLC eluent B. The four insulin derivatives showed no difference in non-specific precipitation and in the affinity constant values calculated from the Scatchard analysis. No significant difference was found in the binding of the four insulin derivatives to the human-cultured IM-9 lymphocytes and to the human circulating monocytes. In conclusion, the present work demonstrates that the immunological properties of the A14-[125I]monoiodoinsulin purified by RP-HPLC may be partially affected by the composition of the mobile phase. In order to obtain a fully potent A14-[125I]insulin derivative and to have the possibility of comparing data from different laboratories, the chromatographic conditions must be taken into account. PMID- 3525588 TI - Polyamines. AB - Putrescine, spermidine, spermine and their derivatives are considered to be potential markers of certain diseases. Routine methods have, therefore, been developed in the course of the last decade. Several automated liquid chromatographic and gas chromatographic methods are presently at our disposal, which meet the practical requirements of sensitivity and specificity. They make the routine application of gas chromatographic-mass spectrometric methods dispensable. Very recently the amino acids deriving from polyamines have also been taken into consideration as tumour markers. Their separation by capillary gas chromatography has been reported. Separation of ion pairs on reversed-phase columns may also prove useful in the establishment of complete concentration profiles of polyamines and their derivatives in tissues and body fluids. PMID- 3525589 TI - Profiling of amino acids in body fluids and tissues by means of liquid chromatography. AB - The needs of urgent diagnoses and the needs emerging from acute forms of diseases have directed progress in amino acid profiling to modern, rapid, automated analyses that can be done at reasonable cost. The first step in this direction was the short programmes of classical ion-exchange chromatography. At the beginning of this review we attempted to survey methods of sample preparation and sample treatment, as these are frequently neglected stages where artefacts or erroneous results may arise. There are basically the following approaches in amino acid profiling by liquid chromatographic techniques. For preliminary screening of a large number of samples in clinical routine planar procedures are the methods of choice, as they allow large numbers of samples to be handled with minimum effort and at very reasonable cost. For more precise profiling, particularly where quantitative data are essential, one can choose between some of the modern procedures for separating underivatized amino acids using modern equipment for cation-exchange chromatography, by making use of a stepped series of lithium citrate buffers with ninhydrin, o-phthalaldehyde or 4-fluoro-7 nitrobenzo-2,1,3-oxadiazole detection. Ninhydrin detection is preferred in those situations where the demands on sensitivity are not high. Where, however, only small amounts of samples are available or high sensitivity is required, one of the latter two methods is preferred. The o-phthalaldehyde procedure is not suitable for the detection of secondary amines and, if these are of interest, then diazole derivatization is to be preferred. At present, however, the ninhydrin and o-phthalaldehyde detection procedures are the most popular. The other choice is to use one of the sophisticated HPLC systems equipped with fluorescence detection and to separate amino acids as derivatives. Here o phthalaldehyde and 4-fluoro-7-nitrobenzo-2,1,3-oxadiazole derivatives offer the most versatile possibilities. Automation and computerization have penetrated both categories of liquid column separation and are applied to automated sample delivery, automated and computerized gradient formation and quantitation of the data obtained. The tables of metabolic disorders of amino acids and the roles of different amino acids in these disorders should provide preliminary information for clinical chemists. PMID- 3525590 TI - Profiling of neuropeptides using gradient reversed-phase high-performance liquid chromatography with novel detection methodologies. AB - Biological tissues and fluids are subjected to gradient reversed-phase high performance liquid chromatography (RP-HPLC) separation and the neuropeptide profile of the collected fractions is obtained by radioreceptor assay (RRA) using a broad-based competing ligand. Radioimmunoassay (RIA) is also used to detect specific neuropeptides in the HPLC-purified fractions. Further confirmation of the identity of the peptides present in the tissue is obtained by mass spectrometry (MS) in the fast atom bombardment (FAB) mode. FAB-MS produces the protonated molecular ion of the peptide and allows direct measurement of underivatized peptides at the nanogram level, with increased molecular specificity. FAB-MS-MS identifies a unique amino acid sequence-determining ion in the mass spectrum of a peptide and offers maximum molecular specificity. This analytical chromatography methodology is applied to the study of the molecular basis of several disease states by monitoring several peptidergic pathways and individual peptides and their metabolic relationships. Molecular mechanisms involved in pain, stress, tumor formation, and neurological studies are studied. PMID- 3525591 TI - High-performance liquid chromatographic profiling of nucleic acid components in physiological samples. AB - The papers reviewed represent recent progress in HPLC profiling of nucleic acid components in physiological samples. Each method was designed for a particular application and possesses certain inherent advantages and/or disadvantages. Many methods are simply modifications of previous procedures. Although some methodologies appear to be superior to others, there is no "best" method for universal usage. The analyst must use the procedure which is best suited for the particular application at hand. This review is meant to be a starting point for the chromatographer who is comparing and evaluating HPLC methods for a given application. PMID- 3525592 TI - Profiling of carbohydrates, glycoproteins and glycolipids. AB - Current chromatographic methods for the analysis of a variety of carbohydrate materials in body fluids and tissues have been reviewed, from the viewpoints of clean-up of samples, separation modes, methods for detection and quantification, and degree of convenience. This review also contains several tables, listing names of samples, methods of analysis, analytical conditions, and normal as well as pathological levels reported, from representative publications. PMID- 3525593 TI - Advanced instrumentation and strategies for metabolic profiling. AB - This review summarizes the instrumental techniques applicable for metabolic profiling analysis. Since its origin with the work of Roger Williams, use has been made of planar chromatography, column liquid chromatography, electrophoresis, gas-liquid chromatography, and mass spectrometry to obtain analyte patterns. Strategies for the analysis of various metabolites including organic acids, steroids, drugs, bile acids, carbohydrates, and proteins are discussed. PMID- 3525594 TI - Metabolic profiling with gas chromatography-mass spectrometry and its application to clinical medicine. AB - Nowadays, metabolic profiling is widely applied in clinical medicine for the diagnosis and study of human diseases. The number of these applications and their diversity have increased rapidly in the past few years. This review summarizes recent advances in the methods for sample pretreatment and the clinical application of GC-MS to the study of uraemia, diabetes mellitus, dicarboxylic aciduria and other organic acidurias. High-resolution GC-MS is well suited to the profile analysis of metabolic disorders. PMID- 3525595 TI - Lipids and their constituents. AB - Many tissues, cells and body fluids possess characteristic lipid composition that can be readily recognized without full resolution and quantitation of individual molecular species. Various chromatographic methods have been adopted for this purpose and are extensively employed in biomedical research. Although lipid profiles are known to change with disease and lipid profiling holds considerable potential for clinical diagnosis, few routines have been established for this purpose. This is partly due to the laborious nature of the simpler methods and the high cost of automated systems. A combination of thin-layer or liquid chromatography with universal detection systems promises to provide more attractive analytical routines for clinical application in the future. At present thin-layer chromatography is the simplest and most rapid qualitative assay for both neutral and polar lipids. Low-temperature gas chromatography is still the method of choice for fatty acid analyses, while high-temperature gas chromatography is eminently suited for quantitative analysis of intact neutral lipids. The availability of the flame ionization and mass detectors now makes high-performance liquid chromatography more useful for profiling both neutral and polar lipids. Combinations of gas or liquid chromatography with mass spectrometry must remain of specialized interest only because of the prohibitive costs of operation. PMID- 3525596 TI - Profiling steroid hormones and urinary steroids. AB - This paper reviews techniques utilized in the profiling of steroids in body fluids and tissues. Methods for profiling plasma unconjugated steroids and urinary steroid metabolites are focused on. Concentrations or levels of excretion of a variety of steroids have been documented and reviewed. The importance of profiling techniques in the study of normal and pathophysiology of hormonal steroids is discussed. PMID- 3525597 TI - The Markov process as a general method for nonparametric analysis of right censored medical data. AB - The product limit method of Kaplan and Meier for estimating survival functions and the logrank test of Mantel are widely employed for analysis of longitudinal medical data. Developed for analysis of one-time events such as death, survival analysis is also commonly adapted to more complex states such as loss of vision or cancer remission by restricting analysis to first occurrences. The nonparametric discrete time nonhomogeneous Markov process is proposed as a better model for any applications of the latter type. This simple stochastic model allows for an arbitrary number of possible states and for transitions in any direction. Maximum likelihood estimators are easily computed for the stochastic model and are identical to the product-limit estimates in the special case represented by the Kaplan-Meier model. The logrank test extends to evaluation of differences between populations with respect to any specified transition. PMID- 3525598 TI - The relationship of physical activity to high density lipoprotein cholesterol in postmenopausal women. AB - The relationships of physical activity to total HDL, HDL-2 and HDL-3 cholesterol were examined in 255 white postmenopausal women, mean age, 57.6 years. Physical activity was measured by the Paffenbarger Index (a composite index of walking, stair climbing and sports in the past week); by a modified Paffenbarger which included only sport activities; and by an objective activity monitor (LSI). Depending on which activity measure was used, different univariate relationships between physical activity and the HDL-cholesterol subfractions were noted. Physical activity, as measured by sport kcal/week or by objective monitors was related to HDL-2 cholesterol [r = 0.22 (p less than 0.01)] and [r = 0.19 (p less than 0.01)], respectively, but not to HDL-3 cholesterol. Physical activity, as measured by the Paffenbarger kcal/week was only related to HDL-3 [r = 0.15 (p less than 0.05)]. Multiple regression analyses revealed that sport activity was significantly related to total HDL and HDL-2 cholesterol. Activity as measured by objective monitors was not independently related to either HDL-total or HDL-2. Activity as measured by the Paffenbarger kcal/week was an independent determinant of HDL-3, after controlling for body fatness. Insulin, caloric intake and liver function were analyzed as possible underlying mechanisms, but we could not demonstrate any mediating or interacting effect on any of these mechanisms for the association of HDL-cholesterol to physical activity. PMID- 3525599 TI - Psychosocial consequences of childhood and adolescent cancer survival. AB - A Connecticut Addendum to a multi-center National Cancer Institute study was developed to investigate psychosocial effects of long-term childhood and adolescent cancer survival. Cases (450), drawn from the files of the Connecticut Tumor Registry and 587 of their siblings were located and interviewed. Overall response rate was 84%. The frequency of lifetime major depression in survivors (males, 15%; females, 22%) did not appear to differ from that of their siblings (males, 12%; females, 24%) and was similar to those reported in the literature for the general population. The usual correlates of depression (sex, marital status, perception of health) were observed, independent of a history of a childhood malignancy. There were no differences in the reported frequencies of suicide attempts, running away or psychiatric hospitalizations for either sex. Eighty percent of the male survivors were rejected from the armed forces, 13% from college and 32% from employment. These values were significantly higher than those of the male siblings. Female survivors were significantly more likely than their sisters to be denied entrance into the military (p less than 0.05), but no differences were observed between females with respect to college or employment. Both sexes had more difficulty obtaining health and life insurance than their siblings (p less than 0.0001). Although survivors of childhood and adolescent cancer do not seem to be at excess risk for major depression, they do appear to have difficulty attaining certain major socioeconomic goals. PMID- 3525600 TI - The pharmacokinetics of subcutaneous regular insulin in type I diabetic patients: assessment using a glucose clamp technique. AB - We recently reported that the peak effect and duration of action of regular insulin injected sc were prolonged in diabetic patients and were not related to the presence of insulin antibodies. The results suggested that the ambient level of plasma glucose might be an important factor in determining the pharmacokinetics of regular insulin. In the present study we used a glucose clamp technique, which minimizes interference by counterregulatory phenomena, to study the pharmacokinetics of regular insulin injected sc at 2 different blood glucose concentrations [276 +/- 7 (+/- SEM) and 130 +/- 5 mg/dl] in 10 insulin-dependent diabetic patients. The patient's blood glucose concentration was maintained constant by means of a variable rate iv infusion of 20% dextrose in water after sc injection of regular insulin (0.2 U/kg) in the deltoid region of the arm. The onset of insulin action occurred at similar times at both glucose concentrations (0.6 +/- 0.1 h at 276 mg/dl vs. 0.5 +/- 0.1 h at 130 mg/dl; P greater than 0.05). Peak insulin action (determined from the time of the maximal glucose infusion rate) was delayed in the studies done at 276 mg/dl (4.7 +/- 0.2 h) compared to that in studies done at mean glucose concentrations of 130 mg/dl (4.3 +/- 0.2 h; P less than 0.05). The duration of insulin action was also significantly prolonged in the studies done at the higher glucose concentrations (9.1 +/- 0.3 h at 276 mg/dl vs. 7.7 +/- 0.2 h at 130 mg/dl; P less than 0.01). These results confirm previous reports of prolonged insulin action in diabetic patients, especially in the presence of hyperglycemia. PMID- 3525601 TI - Growth hormone (GH) provocative testing frequently does not reflect endogenous GH secretion. AB - GH secretion was studied in 73 children with classical GH deficiency or GH neurosecretory dysfunction (GHND), intrinsic short stature, or normal stature. The GH-deficient group was defined by a peak GH secretory response below 10 ng/ml to all provocative tests (arginine, L-dopa, insulin hypoglycemia, and clonidine). GHND was defined by a mean serum 24-h GH concentration below 3 ng/ml, with a normal response (greater than or equal to 10 ng/ml) to provocative testing. Twenty-one GH-deficient children, 21 children with GHND, and 18 short control children underwent provocative GH testing and a 24-h study with GH sampling every 20 min. A group of 13 normal stature control children also underwent 24-h GH sampling. The mean stimulated peak serum GH level [4.7 +/- 0.6 (+/- SEM) ng/ml] in the GH-deficient group was significantly below that in the GHND (19.5 +/- 1.7 ng/ml) and short control groups (24.0 +/- 3.5 ng/ml; P less than 0.01). The mean 24-h serum GH concentration was reduced in GH-deficient (1.5 +/- 0.2 ng/ml) and GHND (2.0 +/- 0.1 ng/ml) children compared to those in short (5.6 +/- 0.5 ng/ml) and normal stature (5.8 +/- 0.8 ng/ml) control children (P less than 0.01). Peak GH concentrations after provocative testing correlated poorly with 24-h mean concentrations in GH-deficient, GHND, and short control children (r = 0.38, 0.23, and 0.41, respectively; P = NS for all groups). Mean serum GH concentrations from blood sampling intervals of 12 h (day/night; 0800-2000/2000-0800 h, respectively) or even 6 h (day; 0900-1500 h) were statistically different in GHND or GH deficient groups compared to those in control children; however, there was significantly more overlap for individual children using the 6- and 12-h daytime intervals than for the 24-h data. Plasma somatomedin-C/insulin-like growth factor I correlated with mean 24-h GH concentration endogenous secretion (r = 0.7; P less than 0.001). These data suggest that provocative GH testing frequently does not correlate with endogenous GH secretion. PMID- 3525602 TI - Production of pituitary protein 7B2 immunoreactivity by endocrine tumors and its possible diagnostic value. AB - 7B2 is a protein originally isolated from pituitary, which has been shown to be present in the central nervous system and in certain peripheral tissues, with very high concentrations in pancreatic islets. Endocrine and nonendocrine tumors from 185 patients were investigated by RIA for the presence of immunoreactive pituitary protein 7B2. The highest mean concentration of 7B2 immunoreactivity was found in insulinomas [452 +/- 174 (+/- SEM) pmol/g wet wt tissue; n = 16], which was significantly higher than the concentration in normal adult pancreatic tissue (28.3 +/- 4.4 pmol/g; n = 7). High concentrations of 7B2 immunoreactivity also were found in other endocrine tumors. The cellular localization of 7B2 was studied in normal pancreas, pancreas with hyperplastic islets, and endocrine tumors. 7B2 immunoreactivity was localized to B-cells in the normal pancreas and to variable proportions of cells in islet cell hyperplasias, B-cell tumors, and pheochromocytomas. Plasma concentrations of 7B2 immunoreactivity also were determined in 255 patients with established diagnoses of endocrine or nonendocrine tumors. The proportion of patients with elevated plasma concentrations (arbitrarily set at more than 4 SD above the mean) were 42 of 72 with pancreatic islet cell tumors, 7 of 11 with midgut carcinoid tumors, and 5 of 13 with medullary carcinomas of the thyroid. Especially high values were found in patients with glucagonomas (14 of 20), vipomas (12 of 13), and pancreatic polypeptide-producing tumors (5 of 6). Thus, 7B2 immunoreactivity is produced by a variety of different tumors and may serve as a tumor marker, especially in patients with certain pancreatic islet tumors. PMID- 3525604 TI - Bonding first molars. PMID- 3525603 TI - Cushing's syndrome secondary to ectopic corticotropin-releasing hormone adrenocorticotropin secretion. AB - A 47-yr-old woman with severe Cushing's syndrome had a bronchial carcinoid secreting ACTH and corticotropin-releasing hormone (CRH) and associated pituitary corticotroph hyperplasia. While the clinical picture was consistent with the ectopic ACTH syndrome, the biochemical pattern was that of pituitary ACTH dependent hypercortisolism. Both plasma ACTH and CRH levels were high. However, while plasma ACTH increased during metyrapone administration and decreased during administration of high dose of dexamethasone, plasma CRH levels did not change, suggesting a direct pituitary response to these testing maneuvers. Immunoperoxidase staining of the tumor tissue confirmed the presence of ACTH and CRH, and the finding of an ACTH and a CRH concentration gradient across the tumor bed indicated that the tumor was actively secreting these two hormones. Cytochemical heterogeneity was seen in the tumor, in which two distinct populations of cells, one secreting ACTH and beta-endorphin and the other secreting CRH, were identified. This patient, thus, had an unusual syndrome of ectopic ACTH and ectopic CRH secretion. PMID- 3525605 TI - Bonding for enhanced retention of removable appliances. PMID- 3525606 TI - Bonded composite button for removable appliances. PMID- 3525607 TI - Correlation of anatomy and ultrasonographic images in the infant hip: an experimental cadaver study. AB - An experimental study was performed to correlate images of the infant hip obtained by ultrasonography with documented anatomic relationships. Two term stillborn neonatal cadavers were studied by imaging approaches used clinically. Specific anatomic structures were marked with echo-dense metal. The dissected cadaver hip joint was imaged in located and dislocated positions while immersed in a water bath. The results of the studies confirm the accuracy of ultrasonography in visualizing the cartilaginous structures of the infant hip joint. The experimentally obtained images correlate well with images obtained clinically. PMID- 3525608 TI - Peptide growth factors and inflammation, tissue repair, and cancer. PMID- 3525609 TI - In vivo kinetics of insulin action on peripheral glucose disposal and hepatic glucose output in normal and obese subjects. AB - To determine whether abnormal kinetics of insulin's biologic actions contribute to the overall insulin resistance in obesity, we compared the rate of activation and deactivation of insulin's effects to stimulate glucose disposal rate (Rd) and inhibit hepatic glucose output (HGO) in 12 nonobese and 10 obese subjects using the euglycemic clamp technique at insulin infusion rates of 15, 40, 120, and 1,200 mU/M2 per min. In both groups, stimulation of Rd was faster the higher the insulin infusion rate and the time to reach half maximal stimulation (A50 value) in normals was 52 +/- 4, 44 +/- 2, 29 +/- 3, and 21 +/- 2 min at infusion rates of 15, 40, 120, and 1,200 mU/M2 per min, respectively. In the obese subjects, the rate of activation was slower (higher A50 values) with A50 values of 74 +/- 6, P less than 0.001 (compared to normal), 64 +/- 8 min, P less than 0.001, and 28 +/- 3 min, P less than 0.01, at the 40, 120, and 1,200 mU/M2 per min insulin infusions. Deactivation of the insulin effect to stimulate glucose disposal rate (Rd) was faster in the obese group compared with normal individuals after all comparable insulin infusions. In summary: for both groups, the higher the insulin infusion rate, the higher the steady state Rd value, the faster the rate of activation and the slower the subsequent rate of deactivation. In insulin resistant obese subjects, the rate of activation of insulin action was slower and the rate of deactivation faster at comparable insulin infusion rates. The rate of suppression of HGO was comparable in normal and obese subjects, but the rate of recovery of HGO back to basal values was faster in the obese group. And in view of the phasic manner in which insulin is normally secreted following meals, steady state insulin action is not normally achieved. Therefore, the abnormal kinetics of insulin action in insulin-resistant obese individuals may represent functionally important manifestations of the insulin resistance in this condition. PMID- 3525610 TI - Immunolocalization of elastase in human emphysematous lungs. AB - The current working hypothesis concerning the pathogenesis of human pulmonary emphysema proposes that neutrophils migrate through the alveolar interstitium and degranulate, releasing proteolytic enzymes into the interstitium. These enzymes, in particular elastase, can bind to and degrade interstitial elastin. This report describes an immunohistochemical, ultrastructural technique that utilizes polyclonal antibodies to localize neutrophil elastase in human lungs. Using both the immunoperoxidase and the immunogold methods on thin, embedded sections of surgically resected human emphysematous lung tissue, elastase was localized in neutrophils in the lung interstitium and extracellularly in association with interstitial elastic fibers in human lungs that showed local emphysema of varying severity. Quantitative morphometric data were obtained from the lungs of eight patients undergoing lobectomy for removal of pulmonary carcinomas. Patients had preoperative forced expiratory volume (FEV1)% levels ranging from 55 to 77. There was a correlation between a quantitative measure of the local distribution of neutrophil elastase in contact with alveolar interstitial elastin and the local presence of emphysematous change as determined by mean linear intercept of the various histologic sections. These data support the validity of the "protease protease inhibitor balance hypothesis" as an explanation of the pathogenesis of human pulmonary emphysema. PMID- 3525611 TI - Development of enzyme immunoassay for Platonin (NK 19). AB - A sensitive and specific enzyme immunoassay for an immunomodulator PLATONIN (NK 19) has been developed and applied to the evaluation of pharmacokinetics in human and rats. NK 19 analog, succinyl NK 19 has been synthesized and coupled to bovine serum albumin. This conjugate is immunogenic and when injected into rabbits antibodies of high affinity for NK 19 were obtained. Some light decomposed products of Platonin were of lower cross-reactivity with these antibodies. For competitive reactions, these antibodies were incubated with a mixture of succinyl NK 2900-beta-D-galactosidase conjugate and standard NK 19 or sample. Then, antibody-bound enzyme-hapten were separated from free one using anti-rabbit IgG immobilized on polystyrene balls. Activity of the enzyme on the solid phase was fluorometrically determined. The present immunoassay allows detection of as low as 10 pg of NK 19 in the biological fluids using 50 microliters of the samples. The accuracy and reproducibility were also quite satisfactory. By use of this assay, plasma levels of NK 19 after a single oral administration of 5 mg or 10 mg/body to human volunteers or intravenous injection of 2 micrograms/kg to rats could be determined. PMID- 3525613 TI - Mass spectrometry: calculations. PMID- 3525612 TI - Pancreatic endoproteases and pancreatic secretory trypsin inhibitor immunoreactivity in human Paneth cells. AB - Normal and metaplastic gastrointestinal mucosa obtained at surgical resection were studied by light microscopy, using the unlabelled antibody enzyme method for immunohistochemical staining of lysozyme, pancreatic endoproteases, and pancreatic secretory trypsin inhibitor (PSTI). Paneth cells in the mucosa of normal small intestine, gastric mucosa with intestinal metaplasia, and colonic metaplastic mucosa were found to contain anionic trypsin, cationic trypsin, lysozyme, and PSTI immunoreactivity, but not chymotrypsin and elastase immunoreactivity. Normal gastric and colonic mucosa and some goblet cells in the small intestine showed positive PSTI immunoreactivity but no endoprotease immunoreactivity. The presence of immunoreactive trypsin and immunoreactive PSTI in the Paneth cells, which are of secretory type, probably indicates an important extrapancreatic source of these proteins rather than a storage of endocytosed material. PMID- 3525614 TI - Stable isotopes in pharmacology studies: present and future. AB - Stable-isotope techniques offer advantages over older methods in safety, sensitivity, specificity, and reduction in numbers of subjects required and analytic determinations for some types of pharmacology studies. In addition to their use as internal standards in gas chromatography-mass spectrometry analytic methods, stable isotopes have been successfully employed in studies of absorption, bioavailability, distribution, biotransformation, excretion, metabolite identification, time-dependent and dose-dependent pharmacokinetic changes, drug interactions, pharmacologic changes during pregnancy, mutagenicity, and teratogenicity. PMID- 3525615 TI - Development of melancholia during carbamazepine treatment in borderline personality disorder. AB - Carbamazepine, an anticonvulsant, has shown efficacy in the treatment of a wide range of psychiatric disorders, including classical affective disorders. Because patients with borderline personality disorder show prominent affective symptomatology on the one hand and symptoms suggestive of an epileptoid disorder on the other, carbamazepine was included in a multidrug, placebo-controlled, double-blind study. During carbamazepine treatment, three of 17 (18%) patients developed melancholia, which remitted on discontinuation of carbamazepine. While carbamazepine may prove to be an effective medication for some patients with borderline personality disorder, careful attention to change in depressive symptoms is suggested. PMID- 3525616 TI - VIP terminals, axons, and neurons: distribution throughout the length of monkey and cat spinal cord. AB - The distribution of vasoactive intestinal polypeptide (VIP) was mapped by peroxidase immunocytochemistry in the spinal cords of seven Macaca fascicularis monkeys and two cats. The animals were perfusion fixed with different chemicals. Those that were perfused with either a Zamboni fixative or 5% acrolein had significantly greater immunoreactivity outside the sacral cords; those fixed with 4% paraformaldehyde had little in nonsacral regions. VIP-like immunoreactive (VIP) axons and terminals were found in the superficial dorsal horn, reticular nucleus of lamina V, intermediomedial nucleus, and lamina X at all levels from C2 to S4; a few axons and terminals were also seen in the ventral horn. Axons were found in Lissauer's tract at all levels, and axons appeared in the dorsolateral and ventrolateral white matter at midthoracic levels; in the lumbosacral cord the number and extent of axons in the lateral and ventral white matter increased progressively in a caudal direction. VIP neurons were identified in thoracic intermediate gray lateral to the central canal and in the intercalatus (IC) and intermediolateral (IML) nuclei. Electron microscopy of the VIP terminals in laminae I and II of the cervical cord revealed they contain small round vesicles and many large granular vesicles; some are glomerular terminals and most form asymmetrical synaptic contacts onto dendrites. These results indicate VIP is much more widely distributed in the spinal cord than previously thought; VIP may be associated with both visceral thoracic and lumbosacral afferents, and with other afferents in the cervical cord; VIP neurons are present in the thoracic intermediate gray; and VIP axons in the ventral and lateral white matter indicate that the spinal cord is supplied in part by VIP sources other than primary afferents. PMID- 3525617 TI - Immunohistochemical localization of urotensin I/corticotropin-releasing factor, urotensin II, and serotonin immunoreactivities in the caudal spinal cord of nonteleost fishes. AB - Neurosecretory cells in the caudal spinal cord of fishes were first discovered in elasmobranches. However, most of the subsequent work on the caudal neurosecretory system has emphasized its morphology and function in teleosts. Two major peptides, urotensins I and II (UI and UII), have been isolated from this system in teleosts and their amino acid sequences have been determined. We have used immunohistochemical techniques to confirm and expand previous morphological and pharmacological findings regarding the phylogenetic occurrence and the anatomical organization of the caudal neurosecretory system and to localize putative neurohormonal products within its structural elements. UII-immunoreactive neuronal structures were found in the holocephalan, Hydrolagus collei; the elasmobranches, Squalus acanthias, Dasyatis sabina, and Raja binoculata; the dipnoan, Protopterus annectens; the brachiopterygian, Erpetoichthys calabaricus; the chondrostean, Polyodon spathula; and the holosteans Lepisosteus platyrhinchus and Amia calva. UI/corticotropin-releasing-factor immunoreactive elements were detected in the caudal spinal cords of Petromyzon marinus, Raja binoculata, Polydon spathula, Lepisosteus platyrhinchus, L. osseus, L. platostomus, and Amia calva. In addition, in several of these species, immunohistochemical techniques have provided evidence for serotoninergic input to the caudal neurosecretory system. PMID- 3525618 TI - Three-dimensional structure of astrocytes in the rat dentate gyrus. AB - Structural features of astrocytes in the rat dentate gyrus were studied by means of light and high-voltage electron microscopy of Golgi-impregnated materials, conventional electron microscopy, combined Golgi-electron microscopy, and immunohistochemistry for glial fibrillar acidic protein. Astrocytes in the dentate gyrus were of the protoplasmic type and were classified into six subtypes based on the location of their somata; i.e., astrocytes in the polymorph layer, in the subgranular zone, in the granular cell layer, at the border of the granular cell layer and the molecular layer, in the molecular layer, and subjacent to the pia surface. Stereoscopic observations of 5-micron-thick sections of Golgi-impregnated materials revealed three-dimensional structural details of astroglial processes not apparent in either the light microscope or in conventional thin-section electron microscopy. Most of them were basically thin sheets, varying in shape and size in accordance with their sites. In the granule cell layer, thin veillike sheets or lamellae, originating from three kinds of astrocytes (subtypes 2, 3, and 4), intervened between granule cell somata, whereas in the plexiform and molecular layers small leafletlike appendages originating from astrocytes (subtypes 1, 2, 4, and 5) intermingled with one another, making spongelike conglomerates. Thus astrocytes in the subgranular zone and those at the border of the granule cell layer and the molecular layer showed prominent regional differentiation of their processes among layers. In addition to these sheetlike processes, thin threadlike processes were also common. PMID- 3525619 TI - Ultrastructural characterization of identified cholinergic neurons transplanted to the hippocampal formation of the rat. AB - The ultrastructural features of cholinergic neurons transplanted to the rat hippocampal formation were studied by using a monoclonal antibody to choline acetyltransferase (ChAT). Septal cell suspensions were prepared from E-18 rat embryos and injected into the hippocampus of host rats that had been previously subjected to a bilateral transection of the fimbria-fornix. Rats with fimbria fornix lesions alone and unoperated rats served as controls and were examined to characterize the native hippocampal cholinergic system. Both unoperated controls and rats with fimbria-fornix lesions showed a sparse population of intrinsic ChAT immunoreactive neurons that were most numerous in the subgranular zone, the hilus fascia dentata, and near the hippocampal fissure. ChAT-positive terminals from controls formed synapses on dendritic structures that were primarily symmetrical. ChAT-positive dendrites in controls received synaptic input from nonimmunoreactive axon terminals. In rats with septal transplants, ChAT immunoreactive transplant neurons were found that were either bipolar or multipolar. Axons of transplanted neurons were unmyelinated and arose either from the cell body or a primary dendritic process where they gave off numerous collaterals. Terminals from transplant neurons formed synapses with many nonimmunoreactive neurons. In transplant animals, two main targets of ChAT immunoreactive terminals were identified: The great majority of synapses were symmetrical junctions with dendritic spines and shafts. A number of terminals were found that appeared to be juxtaposed to nonimmunoreactive axon terminals, possibly forming symmetrical axo-axonic connections. In contrast, such axo-axonic contacts were not observed in the controls. It is concluded that transplanted cholinergic neurons may reinnervate the host hippocampus; however, this reinnervation is different from what is seen in the intact hippocampal formation. PMID- 3525620 TI - Immunological and ultrastructural observations on swine thymic lymphoma. AB - A case of swine thymic lymphoma is described. A young pig had a mediastinal mass and bone marrow involvement and the microscopic findings showed peripheral blood involvement. The tumour was composed of small to medium sized lymphoid cells which formed rosettes with sheep erythrocytes and were characterized by narrow cytoplasmic bands, nuclear convolution and clustered dense bodies. Such structural and immunological features resembled those of human thymic lymphomas derived from thymic T-cells. PMID- 3525622 TI - Vasopressin-induced bullous disease and cutaneous necrosis. AB - Intravenous vasopressin is a commonly used modality for control of bleeding esophageal varices. The development of ischemic cutaneous complications is a recently described entity. In previous reports, cutaneous necrosis has occurred at sites of extravasation, at or proximal to intravenous catheter sites, or at isolated pressure points. We review the literature on vasopressin-induced cutaneous reactions and report a case of cutaneous necrosis and bulla formation in which multiple bullae formed during vasopressin therapy at sites distant from direct intravenous flow. PMID- 3525621 TI - Bullous systemic lupus erythematosus: an unusual clinical course and detectable circulating autoantibodies to the epidermolysis bullosa acquisita antigen. AB - Bullous systemic lupus erythematosus is a newly recognized form of systemic lupus erythematosus characterized by a skin eruption clinically and histologically resembling dermatitis herpetiformis and responsive to dapsone. We report on a patient with bullous systemic lupus erythematosus who initially presented with lesions clinically resembling erythema multiforme, experienced exacerbation of her disease with dapsone, and had detectable circulating autoantibodies to the epidermolysis bullosa acquisita antigen. PMID- 3525624 TI - Occurrence of basement membranes in pigment cell tumors of the skin, relation to cell type and clinical behavior. AB - The occurrence, location and intensity of the basement membrane (BM) components collagen IV and laminin in benign and malignant pigment cell tumors was studied by immunohistochemical methods. The results seemed to establish the following findings: junctional nevi display varying continuity of BM; nevus cells in the dermis display more continuous and thicker BM superficially (associated with epithelial type nevus cells); superficial spreading melanoma displays discontinuity of BM, and nodular melanoma and metastatic melanoma display variable BM around tumor aggregates. The variable expression of BM components in this study showed an apparent relationship to tumor cell type and laminin and collagen IV production, partly related to clinical behaviour. PMID- 3525623 TI - Artifacts in MR imaging after surgical intervention. AB - Artifacts are encountered repeatedly in magnetic resonance (MR) imaging after neurological orthopedic surgery, although there is no evidence of metallic foreign bodies on radiography and CT. Experiments demonstrated that surgical filling materials, such as bone cement and bone transplants are not the cause of the artifacts. On the other hand, we have been able to show that short-term contact between a diamond drill and untempered operating instruments can cause abrasions and set free minute metallic fragments. Those particles are missed by X ray procedures including CT but cause MR artifacts by local disturbance of the homogeneity of the magnetic field. Therefore, MR represents a highly sensitive method to trace extremely small amounts of magnetic substances. Postsurgical MR, however, may be of limited value because of the disturbing artifacts. PMID- 3525625 TI - Immunohistochemical markers of sweat gland tumors. AB - Using immunoperoxidase methods, normal sweat glands, 44 benign and 4 malignant sweat gland tumors were tested for the presence of carcinoembryonic antigen (CEA), pregnancy-specific-B1-glycoprotein (SP1) and actin (ACT). CEA and SP1 stained the secretory and duct-lining cells of normal eccrine glands. Among benign tumors, 74% were positive for CEA and 44% for SP1. The staining reaction was found mainly in luminal secretions and surrounding cells. Staining by SP1 was reduced, but not suppressed, after absorption with the purified antigen. ACT was found in myoepithelial cells of the secretory tract of normal glands and in basal cells of all cases of hidradenoma papilliferum. Only 3 sweat gland carcinomas reacted for CEA. In a malignant chondroid syringoma, no ACT-positive cells were seen in the myxochondroid stroma. The potential value of CEA, SP1 and ACT in the diagnosis of sweat gland tumors is discussed. PMID- 3525626 TI - Stone age nutrition: implications for today. AB - The nutritional elements appropriate for contemporary humans reflect genetically determined biochemical and physiological factors, which have evolved over hundreds of millions of years. Stone Age humans, however, derived nearly all of their nutrients from just two of the four major food groups we select from today. PMID- 3525627 TI - A histological assessment of the initial healing response adjacent to porous surfaced, titanium alloy dental implants in dogs. AB - We report here the results of a histological assessment of the initial healing response following implantation into the dog mandible of a porous-surfaced, titanium alloy endosseous dental implant. Two implants were placed in edentulous areas on each side of the mandible of each dog and covered with a full-thickness mucoperiosteal flap. The implant sites on one side of the mandible were allowed to head for four weeks, while those on the other side were allowed to head for eight weeks before the animals were killed. Histological specimens were obtained and assessed both qualitatively and by computer-assisted morphometry. All but one of the 24 implants were well-tolerated and healed with a variable ingrowth of bone into the porous-surface geometry. The histomorphometric measurements revealed that bone ingrowth had reached a plateau by four weeks of initial healing. PMID- 3525629 TI - Humoral responses and cross-reactivity to viridans streptococci in recurrent aphthous ulceration. AB - It has been proposed that recurrent aphthous ulceration (RAU) is caused by hypersensitivity to oral streptococci. This hypothesis is based on reports that RAU patients have increased levels of circulating IgG antibodies against oral streptococci, and that rabbit antisera prepared against oral streptococci are cross-reactive with oral mucosa. Using indirect immunofluorescence, we have investigated both of these reported phenomena. End-point titers of serum antibodies against three different strains of oral streptococci were assayed from nine RAU subjects with active ulcers and compared with those of nine control subjects. Titers ranged from 1:2 to 1:64 in both groups and do not appear to have any clinical or immunopathogenic significance. Cross-reactivity was studied using hyperimmune rabbit antisera raised against five different strains of oral streptococci. Homologous bacterial titers ranged from 1:1024 to 1:8192, but none of these anti-streptococcal sera produced heterologous titers greater than 1:32 with oral mucosa. This apparent low level of cross-reactivity with oral mucosal antigens appears to be non-specific and clinically insignificant. In previous reports, we have used both leucocyte migration and lymphocyte blast transformation to study cell-mediated immunity to viridans streptococci in RAU (Gadol et al., 1985; Greenspan et al., 1985). None of our results supports an immunopathogenic role for oral streptococci in RAU. PMID- 3525628 TI - A clinical and radiographic assessment of a porous-surfaced, titanium alloy dental implant system in dogs. AB - A new endosseous dental implant system incorporating a porous-surface geometry with a tapered, truncated-cone shape was placed bilaterally in edentulous areas of dog mandibles in a two-stage procedure. All implants had been stabilized by bone ingrowth by the time of the second procedure (insertion of a transgingival collar and implant-supported bridge). The transgingival collar had a porous surface geometry on its apical one-third, and was meant to encourage gingival connective tissue ingrowth and attachment, but in fact provided an excellent milieu for bacterial contamination. As a consequence, many of the implants showed clinical and radiographic signs of impending failure by eight months. Only those implants for which the porous coat, including that of the transgingival collar, was completely submerged in bone were observed to be successful. This study reports on the radiographic and clinical assessment of this implant system in dogs during the period of function. PMID- 3525630 TI - Influence of metal thickness on stress distribution in metal-ceramic crowns. AB - The objective of this study was to calculate the stress distribution induced in anterior metal-ceramic crowns fabricated with either gold-alloy or nickel-alloy copings of reduced thickness using plane stress analyses. Two-dimensional finite element models of three crown designs were subjected to a simulated biting force of 200 N which was distributed over porcelain near the lingual metal-ceramic junction. Based on plane stress analyses, the maximum tensile and compressive stresses in porcelain for the three cases were 29.5 MPa and 123.1 MPa, respectively. The highest tensile strains in porcelain for veneered Ni-Cr and Au Pd copings with conventional dimensions were 0.016% and 0.014%, respectively. The maximum stresses and strains in porcelain for the crowns with a conventional coping thickness (0.3 mm) and a reduced coping thickness (0.1 mm) were not significantly different. All values were below the critical failure values of porcelain. PMID- 3525631 TI - [Nonmonotonous increase in the content of sulfhydryl groups during the growth of a synchronous Escherichia coli culture]. PMID- 3525632 TI - pH-dependent bactericidal barrier to gram-negative aerobes: its relevance to airway colonisation and prophylaxis of acid aspiration and stress ulcer syndromes -study in vitro. AB - pH-Dependent bactericidal activity on four gram-negative bacilli that are mainly responsible for gastric to airway colonisation has been investigated. Organisms studied were Escherichia coli, Enterobacter cloacae, Klebsiella pneumoniae and Serratia marcescens. At pH of the medium adjusted to 2.7 or lower all four organisms were killed in 1.5 h. At pH 3.1 or greater, no reduction in viable bacterial number was noted over 2 h. Even when pH of the medium was adjusted to 6.8, no increase in bacterial count was observed in 4 h. Relevance of these findings in relation to airway colonisation and prophylaxis of acid aspiration and stress ulcer syndromes is discussed. It is suggested to maintain pH of the gastric contents above 4.0 by H2 antagonists and prevent growth of gram-negative organisms in the stomach by keeping it empty. PMID- 3525633 TI - Morphological response to positive end expiratory pressure in acute respiratory failure. Computerized tomography study. AB - Ten patients with acute respiratory failure (ARF), (4 pneumonia, 4 sepsis, 2 polytrauma), underwent computerized tomography (CT) of the lungs, (apex, hilum, base), at 5, 10, 15 cm H2O positive end expiratory pressure (PEEP). The ARF lungs, on CT scan, appeared as a patchwork of normal and dense areas with generally well defined boundaries. Most of the densities were found in the dependent regions. The areas of density were correlated with PaO2 (r = 0.51). The PEEP increase resulted in a significant expansion of total cross-sectional lung surface area. The dense areas decreased significantly at the hilum and base when increasing PEEP while the changes at the apex were not significant. The changes of density with PEEP were highly correlated with the changes in oxygenation (r = 0.91). In the individual patient, however, the modifications of gas exchange can not be entirely predicted from morphological changes, possibly due to a diversion of pulmonary blood flow. PMID- 3525634 TI - Cardiac afferents and the renal response to positive pressure ventilation in the dog. AB - The effects of cardiac denervation on renal function during spontaneous breathing (SB) and controlled mechanical ventilation (CMV) were investigated in six mongrel dogs. Selective and reversible blockade of cardiac afferents was achieved by instillation of procaine 2% into the pericardium. Application of procaine 2% into the pericardium during SB caused a statistically significant depression of urine flow (-55%), of sodium (-64%) and potassium excretion (-42%), and of inulin ( 21%) and PAH-clearance (-30%). After institution of CMV with a positive end expiratory pressure (PEEP) of 10 cm H2O a further, statistically significant decrease in urine flow (-42%) and sodium excretion (-70%) and of the inulin ( 15%) and PAH-clearance (-38%) was observed. Global hemodynamics, mean arterial pressure (MAP), central venous pressure (CVP), mean pulmonary artery pressure (MPAP) and cardiac index (CI) did not change significantly after installing procaine 2% into the pericardium during SB. After institution of CMV an increase in CVP and MPAP occurred whereas MAP and CI remained unchanged. During the following periods of spontaneous breathing first with blockade of cardiac afferents and later after washing out the procaine with NaCl 0.9% all parameters of renal function approached control levels as measured in the first period of spontaneous breathing without cardiac denervation. PMID- 3525635 TI - Pop-off system for the high flow IMV reservoir bag. AB - A pop-off valve system for use with intermittent mandatory ventilation that employs high flow and a reservoir bag is described. It ensures constancy of the mechanical tidal volume regardless of the flow rate of fresh gases into the reservoir bag of the spontaneous breathing circuit. PMID- 3525636 TI - Wandering central venous catheter. PMID- 3525637 TI - Academic nursing centers: a demographic profile. PMID- 3525638 TI - Endowed chairs in nursing: an update. PMID- 3525639 TI - Joseph Francis Volker. Alabama's most distinguished adopted son. Part I--The pre Alabama years. PMID- 3525641 TI - A treasury of dentistry. PMID- 3525640 TI - Celebrating a centennial: a retrospective view. PMID- 3525642 TI - H.H.--hallmark of excellence (Harold Hillenbrand). PMID- 3525643 TI - The presidents. Leslie Maurice FitzGerald 1953-1954. PMID- 3525644 TI - Contours of the edentulous palate. AB - Diagnostic casts were made of the palates of 123 patients who had complete dentures. Categorization of all cross-arch palatal forms yielded a distribution in which 93% showed some variation of a U-shaped palatal form, be it angular or mildly curved. Along the midline, 12% had steep anterior inclines, curved midpalatal regions, and curved posterior palates; 69% had moderate anterior inclinations, curved midpalates, and curved posterior palates; 12% had palates that were moderately inclined anteriorly, flat in the midpalatal section, and flat posteriorly. The remaining palates were predominantly flat in two of the three regions measured. PMID- 3525645 TI - Dentistry on stamps (Henri Moissan). PMID- 3525647 TI - Dentistry on stamps. PMID- 3525646 TI - Management of the isolated deformed dentinoalveolar complex by subepithelial graft and resin-bonded fixed partial denture. AB - Two cases in which subepithelial connective tissue grafts were used as adjuncts to definitive prosthetic reconstruction have been presented. The method for managing the deformed dentinoalveolar complex in the anterior portion of the mouth was discussed. The improved appearance coupled with the resin-bonded fixed partial denture warrant the consideration of the subepithelial graft in selected cases. PMID- 3525648 TI - Cardiac transplantation in patients over 50 years of age. AB - Sixty-two patients underwent cardiac transplantation at the University of Arizona from March 1979 to March 1985. Thirteen patients (11 men and 2 women) were over 50 years of age at the time of transplantation and 49 were under the age of 50. The mean age (+/- SEM) of the patients over 50 was 53 +/- 1 years. Eight of these patients were treated with conventional immunosuppressive therapy (azathioprine, prednisone and rabbit antithymocyte globulin) and five, beginning in January 1983, were treated with cyclosporine, prednisone and rabbit antithymocyte globulin. Early mortality (0 to 90 days) was 16% in the group over 50 versus 18% for those under 50. The late mortality (greater than 90 days) was 36 and 33%, respectively. In both groups, rejection and infection were the principal causes of death. The incidence of infection was 1.9 +/- 0.5 episodes per patient in those patients over 50 and 1.9 +/- 0.4 in those under 50. The incidence of rejection was 1.3 episodes per patient-year in patients over 50 and 1.7 episodes per patient-year in those under 50. Actuarial survival at 1 year was 72 +/- 14% in the group over 50 and 66 +/- 7% in the group under 50 years of age. These data indicate that the results of cardiac transplantation for patients over 50 do not differ significantly from those for patients under 50. Therefore, it is concluded that a rigidly defined age criterion for cardiac transplant recipients is not acceptable. Each potential recipient must be evaluated in terms of individual risk and benefit from the procedure. PMID- 3525649 TI - Left ventricular filling in endurance-trained subjects. AB - Whether exercise-induced increases in left ventricular mass can alter left ventricular diastolic function was evaluated by measuring transmitral flow velocities at rest by Doppler echocardiography in 15 amateur endurance-trained runners and 15 age- and sex-matched sedentary control subjects. Ventricular mass index, end-diastolic volume index and stroke volume index were derived from measurements of M-mode echocardiograms recorded under two-dimensional guidance. All three variables were increased in the runners (p less than 0.01). These findings, plus the lower heart rate at rest (p less than 0.001), were consistent with endurance training. Although the runners had an almost twofold greater myocardial mass index, their peak early diastolic filling velocity and time to peak filling velocity did not differ from those of the sedentary subjects. In runners, the peak filling velocity with atrial systole tended to be lower (p = 0.12), the ratio of peak filling velocity with atrial systole to that of early diastole was less (p less than 0.05) and the percent of stroke volume contributed by atrial systole was less (p less than 0.001). These differences in atrial filling may be related to the lower heart rates at rest in runners. In summary, significant increases in left ventricular mass, when associated with endurance training, do not alter the early diastolic filling of the left ventricle. PMID- 3525650 TI - Cardiovascular teaching techniques: planning and presenting effective instruction -alternative technologies of teaching in cardiovascular medicine. October 10-11, 1985. PMID- 3525652 TI - Unproven procedures for diagnosis and treatment of allergic and immunologic diseases. American Academy of Allergy and Immunology. PMID- 3525651 TI - Malnutrition at the cellular level in uremia: a new frontier for research. AB - Previously reported studies showed that protein-calorie malnutrition (PCM) in children is associated with significant alterations in muscle cell composition, characterized by increased cell water and Na, with decreased concentrations of K, Mg, and some glycolytic and citric acid cycle metabolites. In PCM, the i.c. H2O and levels of Na and K were significantly related, by multiple regression analysis, to the combined set of simultaneously measured levels of cell metabolites, phosphoenolpyruvate, pyruvate, alpha-ketoglutarate, and oxaloacetate. Cell bioactivities also were affected by PCM. Activities of the enzymes pyruvate kinase and malic and isocitric dehydrogenases were significantly reduced in muscle homogenates of PCM children. Kinetic analysis of pyruvate kinase indicated an 8-10-fold reduction in maximal velocity of the enzyme, consistent with a reduction in enzyme protein. Additionally, reduced levels of ATP and the equilibrium constant of the adenylate kinase system were observed in leukocytes of PCM children. Alterations in the activity of the energy-dependent Na pump have been noted by others in association with the accumulation of i.c. Na in severe malnutrition. Neither protein synthesis nor amino acid pools was measured in these previously reported studies. Recent data from several laboratories show that the "profiles" of i.c. and plasma amino acids are very different, both in uremics and in control subjects. In control subjects, with leukocytes as the cell model, the level of protein synthesis can be predicted by multiple regression analyses from simultaneously measured levels of plasma or i.c. amino acids. Intracellular amino acids are better predictors. Of 19 intracellular amino acids, a combination of five accounted for 54% of the variance in protein synthesis in normal, healthy adults. Levels of these predictor cell amino acids can, in turn, be predicted by different combinations of apparently unrelated plasma amino acids. In adult uremic patients stabilized by hemodialysis, with leukocytes as the cell model, levels of ATP, energy charge, adenylate kinase and pyruvic kinase activities were reduced. Others have reported increased i.c. water and Na contents, and impaired Na pump activity. Cell levels of methionine and the branched-chain amino acids, valine, leucine, and isoleucine, and protein synthesis also were significantly reduced. By multiple regression analysis, the observed levels of protein synthesis and energy charge in the hemodialyzed uremic patients were largely accounted for by different combinations of intracellular amino acid than in healthy subjects.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3525653 TI - Research and application of current topics in sports nutrition. AB - The increased focus on fitness and subsequent research in the exercise field has expanded the role of nutrition as it relates to sports medicine. A literature review and application are presented for the anatomical, physiological, and biochemical mechanisms of caffeine in endurance events; iron status and physical performance; regulation of fluid and electrolyte balance during exercise; and stress fractures, calcium, and diet. The goal is to provide dietitians with information that is needed to formulate and rationalize recommendations regarding sports nutrition. An expanded role is offered to dietitians who wish to communicate sports medicine information to other health professionals and to consumers who engage in exercise. Nutrition and sports medicine information could benefit consumers and other health professionals in employee wellness programs in medical centers and organizations, fitness centers, sports medicine clinics, schools, and athletic teams. PMID- 3525654 TI - Dietary tyramine and other pressor amines in MAOI regimens: a review. AB - A critical review of the literature on amine composition and relevant case reports provides rational guidelines for diet planning and counseling of patients on monoamine oxidase inhibitor (MAOI) drug regimens. Small amounts of normally harmless pressor amines in foods can lead to a hypertensive crisis, which is often termed the "cheese reaction." Initial recognition of the problem led to reduced usage of MAOIs and overzealous food restrictions. Recently, confidence in handling such reactions and in MAOI usage has increased. MAOIs treat anxiety and depression by supposedly inhibiting the inactivation of neurotransmitters. A side effect is the concurrent failure to inactivate the potent vasopressor amine, tyramine. Consumption of 6 mg of tyramine may produce a mild crisis whereas 10 to 25 mg may produce severe headaches with intracranial hemorrhage and its sequelae. Any food rich in aromatic amino acids can become high in tyramine if aging, contamination, prolonged storage, or spoilage occurs. Tables are presented listing the current MAOI drugs; the pressor amines; the tyramine content of various cheeses; and foods to avoid, foods to use with caution, and foods that are not restricted. Rational guidelines for dietary counseling in MAOI usage include: keep tyramine intake below 5 mg, begin diet counseling before drug therapy, monitor patient compliance, recommend preparation and consumption of only fresh foods, and continue the diet four weeks beyond drug therapy. PMID- 3525655 TI - The use of naproxen in controlling postoperative pain in podiatric surgery. AB - The study was conducted with 110 patients admitted to Sheridan Park Hospital to determine the efficacy of the nonsteroidal anti-inflammatory drug, naproxen, in relieving postoperative pain. Aspirin, as well as compounds classified as nonsteroidal, anti-inflammatory drugs (NSAID), such as naproxen, are known to inhibit synthesis of certain prostaglandins that are involved in the inflammation process. This is the cause of a significant percentage of postoperative pain. PMID- 3525656 TI - Recognizing unusual tendon pathology at the ankle. AB - It is difficult to recognize tendon pathology in the ankle area when there is no open wound. This manuscript was written to indicate subtle characteristics associated with tendon trauma around the ankle. Failure to recognize these problems will result in improper treatment or lack of treatment and the results may be disastrous to the patient. Diagnostic aids, such as radiographs, ultrasound, or tenography, may be valuable; however, a careful physical examination should make it possible to diagnose correctly and to treat tendon pathology surrounding the ankle. PMID- 3525657 TI - [Triploidy and mole. Apropos of 2 cases continuing to the second trimester]. AB - Triploidy in a common chromosomal abnormality that gives rise to early abortion in most cases. Rarely triploidies carry on past the end of the first trimester. When they do they are always accompanied by severe intra-uterine growth retardation with occasionally molar changes in the placenta. These changes are different from hydatidiform moles but they can become malignant. The formal diagnosis of triploidy depends on the fetal caryotype. PMID- 3525658 TI - Measuring liver span. Bedside examination versus ultrasound and scintiscan. AB - In 75 hospital patients an estimation of liver span was made independently by students (I), fellows (II), and consultants (III). These bedside estimates were made three times at full inspiration in a right parasagittal line one third of the sternal length from the midline by palpation, direct, and indirect percussion. These bedside estimates were compared to each other and to ultrasound in full inspiration in the supine position and to scintiscan in quiet respiration. We found that bedside estimate of liver span by direct percussion was accurate as ultrasound, but that indirect percussion estimate of liver span was inaccurate. Scintiscanning during quiet respiration over-estimates the liver span in comparison to ultrasound. Previous suggestions that clinical estimates of liver span should be abandoned may be in error. PMID- 3525659 TI - Pseudomyxoma peritonei. Radiologic features. AB - Diagnostic radiologic features of pseudomyxoma peritonei consist of diffusely scattered plaques of calcifications in the abdomen, poorly defined soft tissue masses and ascites on plain abdominal radiographs, characteristic scalloping of the hepatic margin, numerous multilocular cystic masses with rims of curvilinear calcifications and compression of abdominal viscera without evidence of invasion at computed tomography, and an echogenic mantle with ascitic septations at ultrasonography. In an appropriate clinical setting, this spectrum of radiologic features is highly specific for the diagnosis of pseudomyxoma peritonei. PMID- 3525660 TI - Social networking, hardiness and immigrant's mental health. PMID- 3525662 TI - The acute abdomen and Murphy's signs. AB - The history of the acute abdomen describes a shift from emphasis on prognosis to treatment through correlation of clinical and pathological findings. John B. Murphy was an acclaimed leader of American surgery whose name is associated with several diagnostic maneuvers used in the evaluation of the acute abdomen. These include deep-grip palpation used in examination for suspected biliary disease. PMID- 3525661 TI - Septic shock (Part 2). PMID- 3525663 TI - The genetic associate: a career option in genetic counseling. AB - Eleven training programs designed to prepare genetic associates (genetic counselors) at the master's degree level are compared and contrasted. Sarah Lawrence College developed the first such program in 1969; currently, most genetic associate programs are housed in medical schools in major universities across the nation. The newest program (at the University of South Carolina) accepted its first class in the fall of 1985. Data provided herein will enable college and university faculty to advise interested students about this viable career option. PMID- 3525664 TI - Dominant mutations regulating i-antigen expression in Tetrahymena thermophila. AB - Two dominant mutations at the RseD locus regulating the differential expression of alternative cell surface immobilization antigens of the ciliate Tetrahymena thermophila are described. RseD1 and RseD2 express I to the exclusion of H (28 degrees C) and are leaky for I when expressing either L (15 degrees C) or T (40 degrees C). Complementation was not observed in RseD1/RseD2 heterozygotes, and in 326 testcross progeny no wild-type (micronuclear) recombinants were observed. Macronuclear recombination also was not observed. RseD is located on chromosome 5, at least 50 map units from rseB, which also regulates antigen expression. This brings to four the number of loci known to regulate antigen expression. PMID- 3525665 TI - Association of elastin with oxytalan fibers of the dermis and with extracellular microfibrils of cultured skin fibroblasts. AB - The formation of a mature elastic fiber is thought to proceed by the deposition of elastin on pre-existing microfibrils (10-12 nm in diameter). Immunohistochemical evidence has suggested that in developing tissues such as aorta and ligamentum nuchae, small amounts of elastin are associated with microfibrils but are not detected at the light microscopic and ultrastructural levels. Dermal tissue contains a complex elastic fiber system consisting of three types of fibers--oxytalan, elaunin, and elastic--which are believed to differ in their relative contents of microfibrils and elastin. According to ultrastructural analysis, oxytalan fibers contain only microfibrils, elaunin fibers contain small quantities of amorphous elastin, and elastic fibers are predominantly elastin. Using indirect immunofluorescence techniques, we demonstrate in this study that nonamorphous elastin is associated with the oxytalan fibers. Frozen sections of normal skin were incubated with antibodies directed against human aortic alpha elastin and against microfibrillar proteins isolated from cultured calf aortic smooth muscle cells. The antibodies to the microfibrillar proteins and elastin reacted strongly with the oxytalan fibers of the upper dermis. Oxytalan fibers therefore are composed of both microfibrils and small amounts of elastin. Elastin was demonstrated extracellularly in human skin fibroblasts in vitro by indirect immunofluorescence. The extracellular association of nonamorphous elastin and microfibrils on similar fibrils was visualized by immunoelectron microscopy. Treatment of these cultures with sodium dodecyl sulfate/mercaptoethanol (SDS/ME) solubilized tropoelastin and other proteins that reacted with the antibodies to the microfibrillar proteins. It was concluded that the association of the microfibrils with nonamorphous elastin in intact dermis and cultured human skin fibroblasts may represent the initial step in elastogenesis. PMID- 3525666 TI - Glycoprotein hormone alpha-subunit in human stomach. AB - To demonstrate the immunoreactive alpha-subunit of human chorionic gonadotropin (hCG) or glycoprotein hormones in non-neoplastic gastric mucosa, and to clarify the nature and significance of alpha-subunit-immunoreactive cells, immunohistochemical studies were performed on gastric mucosa using polyclonal antibodies for hCG alpha and beta, hLH beta, hFSH beta, hTSH beta, and gastrin, and a monoclonal antibody for hCG alpha. Surgically resected stomachs were classified as follows: nearly normal (Group A); antral gastritis (Group B); fundic gastritis with pseudopyloric glands (Group C); and intestinal metaplasia (Group D). Cells immunoreactive for the alpha-subunit were present in the pyloric glands and to a lesser extent in the fundic glands (Groups A and B). Almost all alpha-subunit-immunoreactive cells were nonreactive for the beta-subunits of the four glycoprotein hormones. alpha-subunit-immunoreactive cells corresponded to gastrin-containing cells in the pyloric glands, but were unrelated to gastrin in the fundic glands. In fundic gastritis, alpha-subunit-immunoreactive cells appeared to increase (Group C), and many hyperplastic foci were observed in atrophic glands with hyperplasia of the argyrophilic cells (Groups C and D). Isolated hCG alpha or the alpha-subunit of glycoprotein hormones may be present in the endocrine cells of gastric mucosa, and alpha-subunit-immunoreactive cells in the fundic glands seem to proliferate in fundic gastritis. PMID- 3525667 TI - Quantitative morphometric studies of pancreatic islets obtained from tolbutamide treated rats. AB - We have developed a computerized system for quantitative morphometric analysis of the number and position of secretory granules and organelles in pancreatic islet beta cells following tolbutamide treatment. Data from animals injected with tolbutamide for 1, 2, and 3 days were compared to tissues obtained from untreated control animals. Pancreatic islets removed by a collagenase technique were perfused with an appropriate medium to restore a basal state. After fixation and embedding, thick sections of beta cells were viewed by electron microscopy. Morphometric studies of randomly selected or serially cut cells were performed with computer programs for digitization, quantify, rotational, and perspective display. Tolbutamide treatment resulted in graded granule depletion which was maximal at 72 hr relative to control animals. Reduced granule density was associated with significant reduction in total cell area or cytoplasmic area, but was without effect on nuclear size. Since granule depletion improved visualization of subcellular structures, this will enable us to pursue studies of exocytosis under a variety of physiological conditions. PMID- 3525668 TI - Synchronized synthesis and intracellular transport of serum albumin and apolipoprotein B in cultured rat hepatocytes as studied by double immunofluorescence. AB - Synthesis and intracellular transport of two secretory proteins, serum albumin (SA) and apolipoprotein B (apo B) have been synchronized in primary cultures of normal rat hepatocytes to make possible immunocytochemical study of the transport pathway. Under appropriate conditions of cycloheximide treatment, synthesis of new protein was inhibited and, by double immunofluorescent labeling, the cells were found to be largely depleted of the SA and apo B previously synthesized. Re initiation of protein synthesis led to sequential appearance of SA and apo B, first in the endoplasmic reticulum, then in the Golgi complex, and finally at the cell surface. These results indicate that it should be feasible to use this cell system for high-resolution investigation of the sequence of structures involved in intracellular transport of SA and apo B by corresponding immunolabeling experiments as observed by electron microscopy. PMID- 3525669 TI - On the presence of proteolytic activity in glycosaminoglycan-degrading enzyme preparations. AB - A solid-phase protease assay has been used to screen different commercial preparations of glycosaminoglycan-degrading enzymes for the presence of proteolytic activity. Proteases cannot be detected in preparations of testicular hyaluronidase and of chondroitinase at the concentration used for histochemical purposes. Commercial Streptomyces hyaluronidase contains proteolytic contaminants detectable at the concentration used for histochemistry. At higher concentrations, all preparations appear to be contaminated with proteases. The results obtained using this assay suggest that addition of a mixture of proteinase inhibitors containing N-ethylmaleimide, EDTA, pepstatin, and phenylmethanesulfonylfluoride or soybean trypsin inhibitor has little effect on the proteolytic activity of the glycosaminoglycan-degrading enzyme preparations, irrespective of the pH used. Moreover, the use of EDTA in this mixture is questionable. This study also describes two testicular hyaluronidase preparations that may be particularly useful in functional studies of the living organism, as they are only slightly contaminated. PMID- 3525670 TI - Tuberculosis in East Sussex. II. Aspects of badger ecology and surveillance for tuberculosis in badger populations (1976-1984). AB - Following the disclosure of Mycobacterium bovis infection in badgers in East Sussex in 1976, badgers have been examined from and around farms on which cattle have become infected, but with no other attributable source of infection. These farms are confined to the downland of the south-west of the county and M. bovis has been confirmed in badger populations utilising their land. The available evidence indicates that M. bovis infection in badgers is also confined to this area. A detailed study in one area on the South Downs suggested that M. bovis is endemic in the badger population and therefore presents a continued risk for cattle occupying the area. PMID- 3525671 TI - Evaluation of a two-minute strep A direct swab test (SADST) on patients with pharyngitis at a primary care clinic. AB - A two-minute strep A direct swab test (SADST) was used to detect the presence of Lancefield group A streptococci (GAS) from the throats of 207 patients with pharyngitis at a primary-care clinic. The results were compared with a standard culture method. Fifty-one specimens were positive and 156 specimens were negative for GAS by culture. The SADST had a sensitivity of 96% (49 of 51) and specificity of 98.7% (154 of 156). The predictive values of a positive and negative SADST, for GAS, were 96% and 98.7% respectively. The SADST showed negative reactions with five specimens containing beta-haemolytic streptococci other than GAS and 34 known stock cultures other than GAS. Our results indicate that SADST is a rapid, simple, convenient and reliable test to use for diagnosis of GAS pharyngitis at primary care clinics, physicians' offices and clinical laboratories. PMID- 3525672 TI - Tuberculosis in East Sussex. III. Comparison of post-mortem and clinical methods for the diagnosis of tuberculosis in badgers. AB - Following epidemiological and ecological studies of a defined badger population in an area of East Sussex, removal of all badgers by cage trapping was attempted. Trapping was incomplete due to the activities of protesters. Forty-seven badgers were caught from the eight social groups. All badgers were examined clinically and samples of faeces, urine and tracheal aspirate were taken, together with swabs from any bite wounds, for bacteriological examinations. Forty-five animals were skin tested using whole killed cells of Mycobacterium bovis strain AN5, bovine PPD Weybridge and new human tuberculin. Skin test results were recorded after 24 and 72 h. All badgers were killed and subjected to a post-mortem and bacteriological examination. M. bovis was detected in 10 (21.3%) badgers at post mortem and in 2 badgers from clinical samples. Four social groups were infected. Positive skin test results were recorded at 72 h with bovine PPD (2 micrograms and 20 micrograms/ml), strain AN5 (1 mg/ml) and human tuberculin (2 micrograms/ml), but not with human tuberculin at 20 micrograms/ml. Histological sections of the skin test reactions showed the cellular types typical of delayed type hypersensitivity. The skin test reactions observed were neither sensitive nor specific enough to be of practical value. PMID- 3525673 TI - Tuberculosis in East Sussex. IV. A systematic examination of wild mammals other than badgers for tuberculosis. AB - A detailed investigation of the possible role of wild mammals, other than badgers, in the maintenance of Mycobacterium bovis in an area on the South Downs of East Sussex was carried out over 3 years. Estimates of population sizes were made where possible and minimum sample sizes were selected to be 95% certain of including at least one infected animal if the prevalence was at least 5%. Samples of wild mammals were taken from populations which had the highest potential direct or indirect contact rate with known infected badgers. M. bovis was not isolated from any of the 15 species of wild mammals. It was concluded that badgers are able to maintain M. bovis in an area independently of other species, and that in the area studied other species were not a source of infection for the cattle herds. PMID- 3525674 TI - Blood pressure and heart rate variability. PMID- 3525675 TI - A human intercellular adhesion molecule (ICAM-1) distinct from LFA-1. AB - Homotypic adhesion by phorbol ester-stimulated lymphocytes requires LFA-1 and Mg+2 and does not involve like-like interactions between LFA-1 molecules on adjacent cells. The latter finding suggested that a second molecule, distinct from LFA-1, also participates in LFA-1-dependent adhesion. The identification of such a molecule was the object of this investigation. After immunization with LFA 1-deficient EBV-transformed lymphoblastoid cells, a MAb was obtained that inhibits phorbol ester-stimulated aggregation of LFA-1+ EBV lines. This MAb defines a novel cell surface molecule, which is designated intercellular adhesion molecule 1 (ICAM-1). ICAM-1 is distinct from LFA-1 in both cell distribution and structure. In SDS-PAGE, ICAM-1 isolated from JY cells is a single chain of Mr = 90,000. As shown by MAb inhibition, ICAM-1 participates in phorbol ester stimulated adhesion reactions of B lymphocyte and myeloid cell lines and T lymphocyte blasts. However, aggregation of one T lymphocyte cell line (SKW-3) was inhibited by LFA-1 but not ICAM-1 MAb. It is proposed that ICAM-1 may be a ligand in many, but not all, LFA-1-dependent adhesion reactions. PMID- 3525676 TI - The interaction of Escherichia coli with normal human serum: the kinetics of serum-mediated lipopolysaccharide release and its dissociation from bacterial killing. AB - We have examined the killing of E. coli and kinetics of lipopolysaccharide (LPS) release after the exposure of the bacteria to normal human serum (NHS) and sera deficient in complement components, or with inactivated complement components. LPS of the galactose epimerase-deficient strain E. coli J5 were specifically radiolabeled by growing the bacteria in a medium containing [3H]galactose. Exposure of the washed bacteria to NHS resulted in a significant reduction (greater than 99%) in viability within 15 min and the concomitant release of radiolabeled LPS. However, maximal release of LPS was consistently 30% of the total radiolabel incorporated into the LPS molecules. The amount of tritium labeled LPS released was shown to be directly proportional to the concentration of bacteria exposed to NHS, suggesting that release of LPS was not limited by the availability of some critical serum component(s). The consumption of complement in NHS by incubation with E. coli was demonstrated by decreased alternative and classical pathway-specific hemolytic activity. The use of Factor D-depleted and VEM-treated human sera demonstrated that, with these bacteria, both the alternative and classical pathways of complement contribute to bacterial killing and release of LPS. It is noteworthy that, in VEM-treated and Factor D-depleted sera, the rate of killing and the kinetics of LPS release were somewhat slower as compared to control serum. Bacterial killing in C7-depleted and C9-deficient human sera was minimal. Neither killing nor LPS release occurred in heat inactivated (56 degrees C, 30 min) human serum. The amount of [3H]LPS released by C9-deficient serum was qualitatively similar to the amount released by the action of NHS. Tritium-labeled LPS was not released in C7-depleted serum. These data indicate that bacterial killing can be dissociated from LPS release, and suggest that, whereas LPS release may be necessary for the bactericidal effects of serum complement, it is probably not sufficient to effect killing. Furthermore, a significant fraction of LPS can be removed from the outer membrane of the bacteria without an apparent affect on viability. PMID- 3525678 TI - Tumor dormancy. I. Regression of BCL1 tumor and induction of a dormant tumor state in mice chimeric at the major histocompatibility complex. AB - The growth of the BCL1 tumor in murine H-2 chimeras was studied. Lethally x irradiated BALB/c mice were reconstituted with C57BL/6 bone marrow that had been depleted of T cells. When chimerism was established 90 to 120 days later, large doses of BCL1 cells were injected. The tumor grew progressively, reaching a peak level of as many as 10(9) tumor cells per animal by 40 days after inoculation. After that time, the tumor regressed in all the chimeric animals, and by 100 days after inoculation, virtually all the animals appeared disease free as judged by an absence of BCL1-idiotype-positive cells in the spleen and peripheral blood, a normal spleen size, and absence of an elevated white blood cell count. Such animals were followed for as long as 8 mo after tumor inoculation and remained disease free. However, transfer of graded numbers of splenocytes from these animals into normal BALB/c recipients resulted in development of tumor in recipients receiving 100 or more spleen cells. These results indicate a large tumor burden in the spleen of each donor, namely, 10(6) to 10(7) BCL1 cells. The present model should facilitate characterization of the mechanisms underlying tumor dormancy. PMID- 3525677 TI - Activity of recombinant tumor necrosis factor on Toxoplasma gondii and Trypanosoma cruzi. AB - Activated macrophages produce tumor necrosis factor (TNF), a cytokine with anti tumor and anti-plasmodia activities. This study revealed that recombinant TNF (rTNF) inhibits intracellular multiplication of blood trypomastigotes of Trypanosoma cruzi in murine peritoneal macrophages. rTNF did not have any apparent direct effect on the survival of extracellular T. cruzi or on its ability to infect mammalian cells. The degree of inhibition of the intracellular multiplication of T. cruzi was found to be a function of the time of exposure of the infected cells to rTNF. rTNF induced a comparable effect when different strains of the parasite were used. In contrast to its activity on T. cruzi, rTNF did not affect intracellular multiplication of Toxoplasma gondii tachyzoites or bradyzoites in normal murine peritoneal macrophages or in human fibroblasts. Killing of Toxoplasma tachyzoites by activated macrophages was not enhanced by rTNF. PMID- 3525679 TI - Quantitative Western blot assay for measurement of the murine acute phase reactant, serum amyloid P component. AB - Quantitation of the murine acute-phase reactant, serum amyloid P component (SAP), by Western blot is described. The assay is sensitive, reliable and inexpensive. Electrophoresis in standard SDS-polyacrylamide gels (SDS-PAGE) effectively separates SAP from other serum proteins. Electrophoretic blotting of SAP from the SDS-PAGE onto nitrocellulose (NC) paper is followed by a bovine serum albumin 'blocking' wash and exposure to anti-SAP antibody. Subsequent incubation with radioiodinated protein A was followed by autoradiography, and SAP bands were cut from the NC paper and counted in a gamma counter. The utility of this method for quantitation of SAP in biological fluids was verified using sera from normal mice and mice undergoing an acute inflammatory response. The results confirm the elevation of SAP associated with acute inflammation. The sensitivity of this technique coupled with the minute volumes of biological sample required renders it of potential utility for SAP quantitation in a variety of inflammatory disease states. PMID- 3525680 TI - Immunoassay for the detection of E. coli proteins in recombinant DNA derived human growth hormone. AB - An enzyme-linked immunosorbent assay (ELISA) has been developed for the quantitation of part-per-million levels of the most probable E. coli polypeptide (ECP) contaminants of E. coli produced biosynthetic human growth hormone (hGH). The antibody preparation, used for both coat and conjugate in this ELISA, was demonstrated to be reactive with the reference ECPs (a collection of the most probable protein contaminants) by both affinity chromatography and immunoblot analysis. Affinity purification of this antibody preparation using immobilized reference ECPs resulted in an assay with a higher signal-to-noise ratio and also 'normalized' the antibody population to approach stoichiometric equivalence with the immobilized ECPs. Reference ECPs, size fractionated by gel filtration, were quantitated in agreement with their absorbance at 280 nm. The assay was demonstrated to be specific for ECPs obtained from the hGH purification process. Since the purification of each recombinant DNA derived protein from E. coli requires its own unique process, this means that no generic ECP assay can be developed. It is felt that the criteria established for this assay provide a comprehensive approach to the development of quantitative multiple antigen immunoassays. PMID- 3525681 TI - Antinuclear antibody. Precise and accurate quantitation without serial dilution. AB - A new method for measuring homogeneous pattern antinuclear antibody by immunofluorescence has been validated. This method exploits the differential sensitivity of rat heart muscle, kidney tubules and liver parenchyma as substrates for ANA, and employs calibrating sera. It provides quantitative measurement in the range 2.5-10 WHO IU/ml and semi-quantitative measurement up to 30 WHO IU/ml, without the need for serial dilution. The routine use of standards together with this method improves precision and provides conversion of measurements to IU/ml. These modifications make ANA a precise screening test for the exclusion of SLE. PMID- 3525682 TI - Detection of chicken antibody to the protozoan parasite Eimeria tenella by antigen-coated microspheres. AB - A sensitive immunoassay for detecting antibodies to the protozoan parasite of poultry Eimeria tenella, has been developed. Microspheres coated with parasite antigen are reacted with antibody-containing chicken serum followed by a fluorescent labeled second antibody and analyzed by flow cytometry. The assay was used to demonstrate that chickens, vaccinated with E. tenella sporozoite antigen, showed significant elevations in serum antibody levels after exposure to infection compared to non-vaccinates. The assay is reproducible and because antigen-coated microspheres are stable for up to 4 weeks at 4 degrees C, a single batch can be used to analyze multiple serum samples. PMID- 3525683 TI - Serious problems with antimalarial drugs. PMID- 3525684 TI - The value of adjuvant systemic antibiotic therapy in localised wound infections among hospital patients: a comparative study. AB - In a prospective randomised double-blind controlled trial that involved 73 patients with non-invasive wound infections receiving local wound treatment, the effect of adjuvant systemic antibiotic therapy was compared with that of a placebo. On inspection, more wounds were assessed as clinically clean after administration of an antibiotic than after the placebo was given although this difference was not statistically significant. Microbiological evaluation, however, showed a significantly higher cure of sepsis and elimination of individual organisms (P less than 0.05) after antibiotic therapy. Furthermore, eradication of antibiotic-susceptible organisms was significantly greater than that of resistant organisms (P less than 0.005), indicating adequate penetration of antibiotic into the septic wound exudate. The results suggest that appropriate adjuvant systemic antibiotic therapy in the management of infected wounds promotes bacterial clearance and this may enhance healing of wounds. PMID- 3525685 TI - Identification of a 37 kilodalton protein at the epidermal basement membrane by an antiserum to human amnion. AB - A protein which is recognized by an antibody to human amniotic epithelial basement membrane was identified at the basal lamina of human epidermis by immunohistology. This protein was localized at the lamina lucida of human epidermal basement membrane by immunoelectron microscopy. Studies of normal human keratinocyte cultures and epidermal wound healing suggested that the protein was probably produced by keratinocytes. By immunoblotting, a basic apparent isoelectric pH (pHiapp = 7.3) protein band of 37 kD was seen. These data indicate that this 37 kD protein, clearly different from other known basement membrane components, is present in simple and stratified epithelia of ectodermal origin, and is associated with hemidesmosomes. PMID- 3525686 TI - Antigenic specificity of fogo selvagem autoantibodies is similar to North American pemphigus foliaceus and distinct from pemphigus vulgaris autoantibodies. AB - Fogo selvagem (FS) is clinically, histologically, and immunopathologically similar to sporadic pemphigus foliaceus (PF, as seen in North America and Europe), although the epidemiology of these 2 diseases differs markedly. It has been proposed that FS is identical to PF but, for some reason, occurs in an endemic focus in central Brazil. If this hypothesis is correct, the autoantibodies in FS and PF should have similar antigenic specificities. We studied sera from 13 patients with FS from central Brazil, and compared them with 20 sera from patients with PF from the United States. All these sera had circulating antibodies that bound the cell surface of epithelial cells in identical patterns by indirect immunofluorescence on monkey esophagus or normal human skin. In immunoprecipitation studies none of the 13 FS sera precipitated the pemphigus vulgaris (PV) antigen from radiolabeled extracts of cultured human keratinocytes. This is similar to the findings with PF sera of which 19 of 20 sera did not react with PV antigen, but in sharp contrast to the results with PV sera which, as previously reported, all immunoprecipitate the PV antigen. Immunoblotting performed on extracts of normal human epidermis demonstrated that 7 of 20 PF sera specifically and intensely bound an approximately 160 kD polypeptide, previously identified as desmoglein I, a desmosomal glycoprotein. Similarly, 3 of 13 FS sera specifically bound a 160 kD polypeptide. Thirteen normal sera from North America, 8 normal and disease control sera from central Brazil, 11 PV sera, and 12 bullous pemphigoid sera did not specifically bind this polypeptide. Two-dimensional gel electrophoresis confirmed that the 160 kD polypeptides identified by the subgroup of PF and FS sera were identical. These studies demonstrate that, although the exact molecular specificities of the majority of PF and FS sera remain to be determined, FS autoantibodies do not bind the PV antigen and a subgroup of FS autoantibodies have molecular specificity identical to that of a subgroup of PF autoantibodies. PMID- 3525687 TI - Modulation of collagen type synthesis in organ and cell cultures of fibroblasts. AB - Fibroblast cultures are widely used to study abnormalities of collagen metabolism in both inborn and acquired diseases. However, there is reason to question the extent to which the experimental information obtained from in vitro culture systems in fact reflects the in vivo situation. In the present study we analyzed the proportions of collagens I and III synthesized by human and mouse skin fibroblasts maintained under various culture conditions. The amount of type III collagen extracted from skin specimens was lower than that which was newly synthesized in organ culture. Cells obtained by enzymatic disintegration of skin specimens synthesized more type III collagen than fibroblasts grown from explants. However, subcultivation of the enzymatically liberated cells resulted in a continuous decline of type III collagen production which eventually reached levels similar to those observed in explant cultures. PMID- 3525688 TI - Two species of dermatan sulfate proteoglycans with different molecular sizes from newborn calf skin. AB - Two species of dermatan sulfate-proteoglycans (DS-PGs) were isolated from calf skin. The first species, PDS-H (high-molecular-weight proteodermatan sulfate), contains the core protein with a molecular weight of either about 55,000 or 53,000. Both the core proteins are capable of binding to concanavalin A (Con A). The second species, PGs-L (low-molecular-weight proteoglycan containing dermatan sulfate and/or chondroitin sulfate), contains a core protein of Mr = 20,000 that did not bind to Con A. Tryptic peptide mappings revealed that Mr = 55,000 core protein and Mr = 53,000 core protein were of the same origin. However, the tryptic peptides and the amino acid composition of PGs-L core protein were completely different from those of PDS-H core proteins. The polyclonal antibodies against Mr = 55,000 core protein reacted with both the core proteins of Mr = 55,000 and Mr = 53,000 but not with the core protein from PGs-L. The DS was found to be the only glycosaminoglycan component of PDS-H. That is, the glycosaminoglycan from PDS-H was composed of 46% iduronosylhexosamine units and 54% glucuronosylhexosamine units, while the glycosaminoglycan of PGs-L was composed of 30% iduronosylhexosamine units and 70% glucuronosylhexosamine units. PMID- 3525689 TI - Epidermolysis bullosa acquisita antigen, a major cutaneous basement membrane component, is synthesized by human dermal fibroblasts and other cutaneous tissues. AB - The epidermolysis bullosa acquisita (EBA) antigen is identified as 2 chains: a 290,000-dalton protein and a less prominent 145,000-dalton protein. The 290,000 dalton chain is synthesized by human keratinocytes in culture. In this study, we show that the 290,000-dalton chain is synthesized by human skin fibroblasts and cutaneous human tumors. In contrast, HT1080 cells, a human sarcoma cell line known to produce matrix molecules (such as laminin and type IV collagen), does not synthesize the EBA antigen. Further, the EBA antigen is absent from serum and blood components, placenta, amnion, lung, and the EHS tumor, a murine sarcoma that produces large amounts of laminin, type IV collagen, nidogen, entactin, and basement membrane proteoglycan but is present in cutaneous tumors of adnexal and epithelial origin. These data suggest that while the EBA antigen is synthesized by both human skin keratinocytes and fibroblasts and is therefore not specific for a primordial germ layer, it does appear to be specific for tissue containing a stratified squamous epithelium. PMID- 3525690 TI - Increase in antigenicity of basement membrane zone antigens in bullous pemphigoid. PMID- 3525691 TI - A mouse model for vitiligo. AB - As the result of a long search for a depigmenting mouse that could serve as a model for the study of vitiligo, we have located a strain that arose from the C57BL/6J. Its provisional genetic designation is C57BL/6J Ler-vit/vit. This vitiligo mouse has congenital dorsal and ventral white spots (piebaldism) as well as progressive replacement of pigmented hairs by white hairs with each spontaneous molt or after plucking. The lack of pigment is due to the absence of melanocytes from the amelanotic hair follicles and epidermis. As in human beings and the Smyth chicken model, there is also diminution of ocular pigment. Reciprocal skin transplants between C57BL/6J and vitiligo mice, and transplants into nude mice, suggest a programmed pigment cell death in the vitiligo mice. Like human beings with vitiligo, maximally depigmented vitiligo mice have a decreased contact sensitivity response in comparison to age-matched C57BL/6J controls. The resistance to injected B16 melanomas is lowered. Vitiligo mice show no signs of premature aging. Already at this early stage in the study of this new animal model, there are findings that open a range of new approaches to the study and treatment of patients with vitiligo and melanomas. PMID- 3525692 TI - Immunochemistry of elastotic material in sun-damaged skin. AB - The nature of elastotic material in sun-damaged human skin was investigated by indirect immunofluorescence. Antibodies were used against the following components of the dermis: type I and type VI collagens, aminopropeptide of type I and type III procollagens, fibronectin, elastin, microfibrillar proteins, and basement membrane represented by the 7S domain of type IV collagen, laminin, and nidogen. The elastotic material exhibited marked fluorescence for elastin and microfibrillar proteins which codistributed with fibronectin. The presence of type I and VI collagens and procollagen type III were demonstrated to a lesser extent within the elastotic material. These results suggest that solar elastosis is primarily derived from elastic fibers and not from preexisting or newly synthesized collagens. PMID- 3525693 TI - Monoclonal antibodies cross-reactive with group A streptococci and normal and psoriatic human skin. AB - Infection with group A streptococci has been implicated as a factor capable of exacerbating psoriasis. In order to explore the possibility of cross-reactivity between streptococcal antigens and human skin in this phenomenon, skin from psoriatic patients and control subjects was reacted with 3 monoclonal antibodies against group A streptococci and antibody binding was estimated by the indirect immunofluorescence technique. Monoclonal antibody 54.2.8 stained the nuclei and cytoplasm of cells within the epidermis and epidermal appendages, as well as cells scattered throughout the dermis. In contrast, monoclonal antibodies 49.8.2 and 36.2.2 labeled the cytoplasm of epidermal cells and epidermal appendages but did not react with nuclei. No difference in the staining patterns of control skin and uninvolved skin from patients with psoriasis was observed. However, skin from psoriatic lesions contained large amounts of cross-reactive skin component(s). Sera from patients with guttate psoriasis did not react differently with normal or psoriatic skin when compared with normal sera. Western immunoblots of skin extracts demonstrated that monoclonal antibody 54.2.8 reacted with a family of proteins in the molecular weight range of 60-70K. The results indicate that component(s) in human skin share cross-reactive epitopes with group A streptococci. Immunologic cross-reactions between group A streptococci and human skin may play an important role in the exacerbation of certain skin disorders following streptococcal infections. PMID- 3525694 TI - 2'-Fluoro-5-iodoarabinosylcytosine, a new potent antiviral agent: efficacy in immunosuppressed individuals with herpes zoster. AB - 2'-Fluoro-5-iodoarabinosylcytosine (FIAC) has potent antiviral activity in vivo against herpes simplex virus types 1 and 2 and cytomegalovirus. For examination of the clinical efficacy of FIAC, a randomized, double-blind study of FIAC versus adenine arabinoside (ara-A) was conducted in 34 immunosuppressed individuals with varicella-zoster virus infections. The median time to the appearance of the last new lesion was shorter in patients who received FIAC relative to those who received ara-A (two versus five days, respectively; P less than .001) FIAC also reduced pain and accelerated initial crusting within 72 hr in a significantly greater proportion of patients when compared with ara-A (P = .004 and P = .0009, respectively). FIAC caused few toxic reactions (mild nausea and transient elevation in activity of serum aspartate aminotransferase). Thus FIAC is therapeutically superior to ara-A for the treatment of varicella-zoster virus infections in immunosuppressed subjects. PMID- 3525695 TI - Suppression of recurrent genital herpes simplex virus infection with recombinant alpha 2 interferon. AB - This double-blind, placebo-controlled study evaluated the efficacy and safety of sc administered recombinant alpha 2 interferon (IFN-alpha 2) in the suppression of frequently recurrent genital herpes simplex virus (HSV) infection. Seventy-six otherwise healthy subjects who had eight or more recurrences during the preceding year received 1 X 10(6) IU of IFN-alpha 2, 3 X 10(6) IU of IFN-alpha 2, or placebo three times per week for 12 weeks. Recipients of the higher dose of IFN alpha 2, had fewer outbreaks during the study (2 vs. 3), a shorter period of viral shedding (2 vs. 4 days), less itching (1 vs. 3 days), and a faster healing time (6 vs. 8 days). The lower dose of IFN-alpha 2 was not effective. Significant side effects (fever, malaise, myalgia, fatigue, and arthralgia) occurred after the first injection of 3 X 10(6) IU of IFN-alpha 2 in 91% of the subjects, but subsequent injections produced only mild and intermittent side effects that were well tolerated. Mild leukopenia was noted in subjects treated with IFN-alpha 2. Treatment with IFN-alpha 2 resulted in moderate suppression and decreased duration of recurrent genital HSV infection in patients with frequent recurrences. PMID- 3525696 TI - In vitro killing of spores and hyphae of Aspergillus fumigatus and Rhizopus oryzae by rabbit neutrophil cationic peptides and bronchoalveolar macrophages. AB - The fungicidal activity of six rabbit neutrophil cationic peptides (NP) against resting (dormant) spores, preincubated (swollen) spores, and hyphae of Aspergillus fumigatus and Rhizopus oryzae was examined. Whereas resting spores of both fungi were totally resistant to killing by up to 500 micrograms of NP/ml, preincubated spores and hyphae were sensitive, under optimal conditions, to less than 1 microgram /ml. NP-1 and NP-2, also found in rabbit bronchoalveolar macrophages, were the most active of the peptides. Activity was inhibited with increasing ionic strength, calcium but not magnesium, incubation at 4 C, and the chitin fragments chitobiose and chitotriose. 125I-labeled NP-1 bound to all three forms of A. fumigatus. Finally, killing of A. fumigatus conidia by rabbit bronchoalveolar macrophages was faster and greater if the conidia were first preincubated in RPMI 1640 medium. Thus, although NP did not kill the resting A. fumigatus conidia, a role for cationic peptides in macrophage-mediated killing is not precluded, as fungicidal activity of both isolated cationic peptides and intact bronchoalveolar macrophages appeared to occur only after the conidia became activated. PMID- 3525697 TI - Role of lipopolysaccharide and capsule in the serum resistance of bacteremic strains of Escherichia coli. AB - To define the relative roles of capsule and lipopolysaccharide in the virulence of Escherichia coli obtained from blood, we compared the behavior of K1- and K5 encapsulated strains in serum bactericidal and rat virulence assays. Unencapsulated isogenic mutants selected from five parent strains of E. coli O12:K1, but not of O18:K1 or O7:K1 (all rough-specific phage insensitive), were lysed by normal human sera. In contrast, isogenic mutants from strains of serotypes O6:K5 and O18:K5 retained the serum resistance of the parent strains. There was a greater than 10(5) difference in LD50 in newborn rats between K1 positive and K1-negative pairs of E. coli serotypes O18 and O7 and a greater than 1 log difference between isogenic pairs of serotype O12; however, the K5 isogenic pairs had a similar LD50. Some non-O6 O serotypes, however, required the K5 capsule for serum resistance. We conclude that some O serotypes require encapsulation for optimal virulence but that other O serotypes may not. PMID- 3525698 TI - Further evidence associating hemolytic uremic syndrome with infection by Verotoxin-producing Escherichia coli O157:H7. PMID- 3525699 TI - Pathogenicity of enteroadherent Escherichia coli in adult volunteers. PMID- 3525700 TI - Cross-reactivity of antibodies to lipopolysaccharides from Escherichia coli J5. PMID- 3525701 TI - Probing of Campylobacter jejuni with DNA coding for Escherichia coli heat-labile enterotoxin. PMID- 3525702 TI - [The advantage of omental wrapping around the bronchial anastomosis in canine allotransplantation of the lung]. PMID- 3525703 TI - [Subcutaneous long-term pulsatile administration of LH-RH to patients with hypothalamic amenorrhea]. AB - The effects of pulsatile LH-RH administration on ovulation induction and luteal phase activity were studied in 8 women with hypothalamic amenorrhea (2, with primary amenorrhea and 6 with secondary). Ten to 20 micrograms of LH-RH was subcutaneously injected by autoinfusion pump every 2 hours for more than 56 days. Six out of 8 women responded to the treatment and showed a total of 18 ovulatory cycles. The mean length of the follicular and luteal phases was 25.9 +/- 6.37 days and 11.9 +/- 0.43 days, respectively. The serum progesterone level in mid luteal phase was 12.0 +/- 2.35 ng/ml and was in the normal range for naturally cycling women. Two patients with secondary amenorrhea conceived in the 2nd and 3rd ovulatory cycle, respectively. In two patients who showed no response to LH RH pulsatile administration for 56 days of treatment, serum LH and FSH levels were gradually lowered and the response to 100 micrograms of LH-RH iv injection was remarkably attenuated, suggesting that the pituitary gland was desensitized by the treatment. PMID- 3525704 TI - [A high peptidase activity specific for hydrolysis of Z-Phe-Arg-MCA from human serum during pregnancy]. PMID- 3525705 TI - [Operation of functional maintenance in myoma uteri]. PMID- 3525706 TI - VP-16: phase specific cytocidal activity and preliminary trials in acute monocytic leukemias. PMID- 3525707 TI - [A case of hemangiopericytoma afflicted with hypoglycemia due to insulin like activity]. PMID- 3525708 TI - [Movements and pressures of the mouth floor at the lower lingual denture border]. PMID- 3525709 TI - [Adhesion between a new self-curing resin and denture base alloys]. PMID- 3525710 TI - [Occlusal contact of complete dentures during mastication]. PMID- 3525711 TI - [Histological study of facial development in rat embryos by indirect immunofluorescence and autoradiography]. PMID- 3525712 TI - [Study of the movements of soft tissues surrounding a denture (teeth)--trial construction of 3-D transducer]. PMID- 3525713 TI - Use of bioprosthetic tendon in digital pulley reconstruction--an experimental study. AB - The potential clinical application of Glutaraldehyde treated bioprosthetic material in the hand as implants to substitute for damaged pulley, tendon or ligament has not been fully explored. This study tries to evaluate the efficacy and safety of the proposed bioprosthetic pulley in an experimental model. One of the digital flexor pulleys of the rabbit's foot was excised and replaced by a bioprosthetic pulley using a standardized technique. Autogenous tendon graft was used as the control on the opposite foot. Altogether twenty rabbits (40 feet) were included in the study and they were sacrificed at different time intervals up to one year. The retrievals were analysed for flexor tendon adhesions and rupture of the pulley macroscopically. Histological and Electron Microscopy study of the 'pulley' and 'pulley-bone' junction were also carried out. Results show consistently the progressive creeping substitution of the bioprosthetic material by the rabbit's own tissue without significant inflammatory reactions. Neither adhesions nor breakage of the pulley were detected, the results comparing favourably with the control group using autografts except for the longer time taken for the substitution process. PMID- 3525714 TI - A comparative controlled trial of a new perforated splint and a traditional splint in the treatment of mallet finger. AB - A perforated mallet finger splint is described and the results of a controlled trial comparing its use with a conventional splint are presented. The perforated splint gives superior results by virtue of the fact that it does not require to be removed for purposes of hygiene and can thus produce a satisfactory result even in those patients who fail to grasp the technique of removal and replacement of the splint. PMID- 3525715 TI - [Bond strength of etched porcelain laminates with 3 different bonding agents]. PMID- 3525716 TI - [An experimental study on the apical marginal leakage of several canal sealing materials]. PMID- 3525717 TI - Synergistic toxicity of endotoxin and hemoglobin. AB - Stroma-free hemoglobin (SFH) is advocated as an oxygen-transporting resuscitation solution. Hemoglobin has been shown to enhance endotoxin lethality when given intraperitoneally. It is possible that SFH could interact with endotoxin when used as an oxygen-transporting resuscitation system for trauma victims with contaminating wounds. To assess the effects of these two agents when given intravascularly, rabbits were infused with SFH (1.75 gm/kg) or albumin (controls; 1.75 gm/kg) with and without endotoxin. Two doses of endotoxin were used. At 14.5 ng/kg of Salmonella enteritidis endotoxin, no effect was seen in the albumin group. However, 50% of the hemoglobin group died. At 14.5 micrograms/kg, the albumin group showed hematologic alterations, but all animals lived. All SFH treated animals died at the higher endotoxin dose. SFH alone caused cardiac abnormalities (bradycardia in 100%, sinus arrhythmias in 30%, and ventricular arrhythmias in 20%), liver abnormalities (necrosis in 40% and 240% increase in alanine aminotransferase activity by 6 hours), and intravascular thrombi (30%). The only hemoglobin-induced abnormality that was more frequent in the presence of endotoxin was ventricular arrhythmias (up to 75% of animals). Thrombin times were approximately 20% larger in all SFH groups compared with the albumin groups. By 6 hours after infusion, endotoxin prolonged the thrombin time even further, despite the lack of fibrinogen consumption. This study shows that endotoxin and SFH exert synergistic toxicity when SFH is given in a clinically relevant dose for an oxygen-transporting resuscitation system. Only minute quantities of endotoxin are needed to produce this phenomenon. We hypothesize that this synergism is endotoxin enhancement of hemoglobin toxicity. PMID- 3525718 TI - Heart transplantation at the Humana Heart Institute International. PMID- 3525719 TI - Computer-assisted instruction for students with attentional difficulties. PMID- 3525720 TI - Low density lipoproteins in atherosclerosis. PMID- 3525721 TI - Rates of sterol synthesis in the liver and extrahepatic tissues of the SHR/N corpulent rat, an animal with hyperlipidemia and insulin-independent diabetes. AB - The SHR/N-corpulent rat is a new genetically obese strain that exhibits both insulin-independent diabetes and hyperlipidemia. The present studies were undertaken to characterize various parameters of cholesterol metabolism in this model. At 11 weeks of age, the obese animals had markedly elevated plasma cholesterol, triglyceride, glucose, and insulin concentrations and elevated hepatic triglyceride concentrations compared to their lean littermates. The additional cholesterol in plasma was carried in the fractions of density less than 1.006, 1.020-1.055, 1.055-1.095, and 1.095-1.21 g/ml. In the obese rats the level of free cholesterol in the liver was decreased significantly while that of cholesteryl ester showed little change. Hepatic sterol synthesis was markedly suppressed in the obese animals. However, the rate of sterol synthesis in the small intestine and other extrahepatic tissues generally remained unchanged. Although hepatic synthesis was suppressed, whole animal sterol synthesis in the obese rats was similar to that in the lean controls. This resulted because, in the obese animals, not only was the reduced rate of hepatic synthesis partly balanced by a greater than 70% increase in liver mass, but the mass of the small intestine and adipose tissue was also increased more than 30% and 4-fold, respectively, thereby making these tissues quantitatively more important sites of sterol synthesis. When obese rats were pair-fed to the intake of their lean littermates for 10 weeks, there was only a modest reduction in body weight and plasma cholesterol concentration, and the rate of hepatic sterol synthesis remained very low. The suppression of synthesis in the liver also persisted when the obese rats were fed surfomer, a drug that specifically blocks cholesterol absorption. In contrast, feeding cholestyramine restored the rate of hepatic sterol synthesis to that found in lean animals. Bile acid pool size in the obese males and females was 2.5-fold greater than in their lean controls. The suppression of hepatic sterol synthesis in this model may be due to a change in the entero-hepatic circulation of bile acids arising from an expanded pool or, alternatively, it may represent a compensatory response to overproduction of sterol and its precursors in the intestinal and adipose compartments. PMID- 3525722 TI - Light microscopic immunocytochemical localization of hepatic and intestinal types of fatty acid-binding proteins in rat small intestine. AB - Monospecific antisera to purified hepatic fatty acid-binding protein (hFABP) and gut fatty acid-binding protein (gFABP) have been used to localize these two proteins in the small intestine of fed rats at the light microscopic level. Pieces of duodenum, jejunum, and ileum were removed from 4-, 10-, 20-, 22-, and 60-day-old Sprague-Dawley rats. Both cryostat and paraffin sections were studied for the presence of hFABP or gFABP by the avidin-biotin immunoperoxidase method. Slides were graded blind for the intensity of staining. Despite the structural and immunological differences between these two proteins, we showed no major differences between their staining patterns or their staining intensity throughout the intestine during postnatal development. The staining for both fatty acid-binding proteins was cytoplasmic. No brush border staining was found. Staining was more intense in the proximal rather than distal intestine, in the villus rather than crypt cells, and in the apex rather than the base of intestinal cells. Shifts in staining patterns, and staining intensity occurring during development may be related to variations in dietary fat intake, rates of cell proliferation, intestinal anatomy, and mechanisms for fat absorption. PMID- 3525723 TI - Chondro-osseous iliac crest graft for one stage reconstruction of the ankylosed TMJ in children. AB - In 6 children, an ankylosed temporo-mandibular joint was replaced by a chondro osseous graft from the iliac crest. The technique is described. The long term results show that this procedure is technically successful. It is also demonstrated that the graft has the possibility to react to functional stimuli. This enables it to grow in a multidirectional manner. PMID- 3525724 TI - Free autologous nerve grafting--comparison of suture materials. AB - The inferior alveolar nerve was reconstructed by grafting the sural nerve in 16 rabbits. Suturing was performed using the non-absorbable suture material Ethilon and absorbable Vicryl. The postoperative results were evaluated by measuring the following parameters: electrical stimulus threshold, conduction velocity, area of myelin sheaths, area of nerve fibres, number of nerve fibres, histogram of the diameter of nerve fibres. All these values are discussed, to give an idea of the healing process and to examine the influence of absorbable suture material. PMID- 3525726 TI - Multiple baseline across subjects design: proposed use in research. PMID- 3525727 TI - Reimbursement for primary and cognitive physician services. PMID- 3525725 TI - Horse-shoe sandwich osteotomy of the edentulous maxilla as a preprosthetic procedure. AB - A preprosthetic procedure for treatment of severe atrophy of the maxilla is reported. By means of the horse-shoe sandwich osteotomy of the edentulous maxilla with interposition of iliac crest or ribs in combination with a modified submucous vestibuloplasty there is the possibility of increasing the vestibular and palatal height and improving the mucosal contour in one surgical session. The method, which is described in details, avoids the disadvantages of the earlier operation methods of direct osseous augmentation and the Le Fort-I-osteotomy of the edentulous maxilla. The satisfactory results of 15 operated cases in the observation period of 3 to 15 months are reported. There is only little bone resorption. The horse-shoe sandwich osteotomy might therefore be the method of choice in cases of extreme atrophy of the maxilla. PMID- 3525728 TI - Rational diagnosis and treatment. AB - Clinical decisionmaking includes reasoning from prescientific or scientific theories, reasoning from uncontrolled or controlled experience, and reasoning based on empathic understanding and moral beliefs. The development of contemporary clinical thinking is discussed, and it is found that successive generations of medical practitioners have had different views of the rationality and relative importance of these modes of reasoning: that which is considered rational by one generation of doctors is sometimes denounced by the next. The author's book, Rational Diagnosis and Treatment, which is an example of clinical thinking in the 1960s and early 70s, is used to illustrate one particular view of clinical decisionmaking. PMID- 3525729 TI - Central inhibition of oxytocin release in the rabbit: role of the midbrain. AB - Transection of the ventral central grey and surrounding midbrain tegmentum in anaesthetized lactating rabbits caused repeated milk ejections which, on comparison with the effects of i.v. infusions of synthetic oxytocin, synthetic arginine-vasopressin or a mixture of the two, were attributed to continuous release of 1.25-2.5 mu. oxytocin/min, although it is not known whether lesser amounts of vasopressin might also have been released. It is suggested that the ascending midbrain reticular formation, which is known to project rostrally through this region, controls the central inhibition of oxytocin release via the previously described septo-hippocampo-subicular route to the hypothalamus. PMID- 3525730 TI - Relationship between human chorionic gonadotrophin-induced changes in testicular microcirculation and the formation of testicular interstitial fluid. AB - The relationship between testicular vascular permeability and testicular microcirculation as measured by laser Doppler flowmetry was studied in adult rats. In untreated control animals there was an oscillatory testicular blood-flow pattern with a frequency of 10.6 +/- 0.8 pulses/min and the amount of testicular interstitial fluid (IF) collected was 61.5 +/- 2.2 microliter/g testis. Treatment of the rats with 25-200 i.u. human chorionic gonadotrophin (hCG) s.c. 8 h before the experiment resulted in a change in the testicular flow pattern from pulsatile to continuous and an increase in IF volume. Treatment with hCG (50 i.u., s.c.) changed the testicular blood-flow pattern from oscillatory to continuous 4, 8 and 16 h after treatment. The flow pattern returned to being pulsatile 32 h after treatment with hCG. The IF information was increased at those times when the blood-flow pattern was continuous. No effects on blood flow or IF formation were observed with 12.5 i.u. hCG s.c. The present study shows a dose- and time dependent covariation between the increase in testicular IF volume and the disappearance of the pulsatile flow in testicular microcirculation. It appears that a continuous flow pattern favours the transport of fluid from blood vessels to the interstitium. PMID- 3525731 TI - Gonadotrophin-releasing hormone (GnRH) overcomes GnRH antagonist-induced suppression of LH secretion in primates. AB - If the suppressive effects of gonadotrophin-releasing hormone (GnRH) antagonists on gonadotrophin secretion are mediated through GnRH-receptor occupancy alone, it should be possible to restore serum gonadotrophin levels by displacing the antagonist with exogenous GnRH. To test this hypothesis, eight adult crab-eating macaques (Macaca fascicularis), weight 4.7-7.6 kg, were subjected to the following treatment regimens. A GnRH-stimulation test was performed before and 4, 12 and 24 h after a single s.c. injection of the GnRH antagonist (N-Ac-D-p-Cl Phe1,2, D-Trp3, D-Arg6, D-Ala10)-GnRH (ORG 30276). The stimulation tests were performed with 0.5, 5.0 or 50 micrograms GnRH given as a single i.v. bolus. Blood was taken before and 15, 30 and 60 min after each bolus for analysis of bioactive LH and testosterone. The GnRH-challenging doses were given as follows: 0.5 microgram GnRH was injected at 0 and 4 h, followed by 5.0 micrograms after 12 h and 50 micrograms after 24 h. One week later, 5.0 micrograms GnRH were given at 0 and 4 h, followed by 50 micrograms after 12 h and 0.5 microgram after 24 h. Finally, after another week, the GnRH challenges began with 50 micrograms at 0 and 4 h, followed by 0.5 microgram at 12 h and 5.0 micrograms at 24 h. This design permitted comparison of the LH and testosterone responses with respect to the dose of GnRH and the time after administration of GnRH antagonist.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3525732 TI - Effect of graded doses of gonadotrophin-releasing hormone on serum LH concentrations in mares in various reproductive states: comparison with endogenously generated LH pulses. AB - Luteinizing hormone release induced by a range of small (3.3-33 micrograms) and large (300-500 micrograms) i.v. doses of gonadotrophin-releasing hormone (GnRH) was measured in acyclic (n = 4), luteal phase (n = 3) and follicular phase (n = 5) mares and compared with endogenously generated LH pulses in the same reproductive states. Extrapolation from log-linear dose-response curves showed that an LH pulse comparable to an endogenous one would be simulated by i.v. injection of 7.0 (n = 4) and 4.1 (n = 6) micrograms GnRH in luteal and follicular phase mares respectively; a much smaller dose than the 500 micrograms usually given clinically or experimentally. In acyclic mares (n = 4), LH pulses occurred too infrequently to be characterized. At small doses of GnRH the amount of LH released by the same dose was similar in all three reproductive states, although the steroid hormone milieu differed markedly. This implies that observed differences between states in mean (+/- S.E.M.) serum LH concentrations (0.7 +/- 0.01, 1.2 +/- 0.03 and 11.6 +/- 0.33 (microgram/l) in acyclic, luteal and follicular phase mares respectively) were produced by differences in GnRH pulse frequency and/or amplitude and not by steroid-mediated changes in pituitary response to GnRH. In acyclic, luteal and follicular phase mares, LH pulse frequency was: immeasurably low, 0.09 and 1.14 pulses/h respectively, which supports the important contribution of pulse frequency to determining mean LH concentration.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3525733 TI - Effects on growth and body composition of androgen deprivation by castration or autoimmunization to LH-releasing hormone in the male rat under conditions of controlled food intake. AB - The effects of endogenous gonadal hormones on the regulation of body composition and energy retention have been investigated under conditions of controlled food intake. Male and female rats were fed the same amount from weaning to 82 days of age. The carcases of males contained more protein, less lipid and yielded more ash than females, but they had the same amount of total energy in their carcases as females. In a second experiment, male rats were sham-operated or castrated at 19 days and then fed equal amounts from weaning. At 40 days, intact and castrated rats did not differ in total carcase energy content nor in carcase composition. At 82 days the carcases of intact rats had more protein but had retained the same amount of energy as castrated rats. By 131 days, the difference in protein content was larger and intact rats had less carcase lipid, less carcase energy and gave less ash than castrated rats. At the same age and with a similar food intake, the differences in carcase composition between intact males and females were considerably larger than between intact and castrated males. In a third experiment, male rats were sham-operated or castrated at 1 day post partum and fed the same amount as in the second experiment from weaning to 82 days. Both sham-castrated and castrated rats grew less well than rats operated on at 19 days. The differences in carcase composition between intact and castrated rats were in the same direction but of greater magnitude than in rats operated at the later age.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3525734 TI - Reversible and irreversible effects of retinol upon the phenotypic properties of embryonal carcinoma cells. AB - We have generated an embryonal carcinoma cell line, NR1, which is not growth inhibited in response to retinol. Although the retinol-treated cells undergo morphological change, show reduced levels of the surface antigen SSEA-1 and possess increased surface reactivity with antifibronectin serum, the extent of phenotypic change of NR1 cells in response to retinol is not so great as that following treatment with retinoic acid. Furthermore, unlike cells from lines such as F9, the retinol-promoted morphological alterations appear to be reversible. The increased adherence of NR1 cells to glass coverslips in the presence of retinol suggests that stronger interaction with the substratum is responsible for the observed alteration in appearance of the cells. It is possible that NR1 cells exposed to retinol progress no further than a reversible, early stage of differentiation. Alternatively, retinol-treated cells might express a group of markers normally associated with, or accompanying, an irreversible, differentiated phenotype even though the cells are not, in fact, undergoing differentiation. PMID- 3525735 TI - The preliminary characterization of mitogens secreted by embryonic chick wing bud tissues in vitro. AB - Embryonic chick wing bud tissues secrete diffusible mitogens when cultured in vitro (Bell & McLachlan, 1985). These molecules may play an important role in limb development since media conditioned by morphogenetically active regions of the wing bud possess greater mitogenic activity than media conditioned by non morphogenetic regions. These studies show that while the chick-derived growth factors were mitogenic for mouse-derived NIH 3T3, 10T1/2 and NR6 cells and chick limb bud cells, they did not stimulate DNA synthesis in 3B11, PC13 END, normal rat kidney or bovine endothelial cells. Furthermore, the effects of chick-derived mitogens were synergistically enhanced by insulin and PGF 2 alpha but remained unaffected by ECDGF, EGF, FGF and MSA. These findings indicate that embryonic chick limb bud cells synthesize and secrete growth factors which resemble in function other well-characterized growth factors and in particular PDGF. PMID- 3525736 TI - Erythromycin in the treatment of acute bronchitis in a community practice. AB - To assess the efficacy of erythromycin in treating acute bronchitis, 52 adults were enrolled in a randomized trial comparing a one-week course of erythromycin with placebo. Among smokers, no difference in outcome was noted. Among nonsmokers, trends favored more rapid resolution of key symptoms in the erythromycin group, but these trends did not generally achieve statistical significance. These results suggest a trial with a larger sample size. PMID- 3525737 TI - Otolaryngologic manifestations of pregnancy. AB - A unique group of ear, nose, and throat disorders are associated with pregnancy. While most are benign and reverse after parturition, some do not. These disorders may be classified categorically by site into cutaneous, otologic, rhinologic, oral, pharyngeal, and laryngeal manifestations. The etiology and pathogenesis of these disorders are discussed, making every attempt to separate fact from conjecture. Therapeutic recommendations are made based on available information. PMID- 3525738 TI - Unilateral failure of lactation after breast biopsy. PMID- 3525739 TI - [Studies in diabetic retinopathy--an investigation of 203 diabetics]. PMID- 3525740 TI - Immunoelectrophoretic analysis of Streptococcus agalactiae serotype Ia antigens. AB - Rabbit antibodies to heat-killed whole cells of Streptococcus agalactiae serotype Ia were used to establish an antigen map using Triton X-100 sonicates of homologous cells and crossed immunoelectrophoresis. A total of 11 antigens were identified but the density of immunoprecipitates was varied and only seven could be reliably detected, one of which dominated the immunoprecipitate pattern by its intensity. The antigens were partially characterized by immunological, chemical and cell-location methods. Five of the antigens contained carbohydrate and two of those were sensitive to trypsin and probably represent cell-wall compounds. Of the three most prominent antigens, one was surface located and represented the type and shared type antigens (Iabc), one was a cell-wall carbohydrate and very sensitive to periodate, and one was a protein/carbohydrate complex which was heat labile and trypsin sensitive. Group B epitopes were detected in three immunoprecipitates. Cross-reactions between type Ia and other serotypes and streptococci were recorded. PMID- 3525741 TI - Lack of effect of leader peptidase overproduction on the processing in vivo of exported proteins in Escherichia coli. AB - The kinetics of maturation of certain exported proteins were analysed in Escherichia coli strains that also concomitantly overproduce either a periplasmic protein or the leader peptidase. The results led to three conclusions. Overproduction of leader peptidase has no effect on the rate of maturation of at least two exported proteins, one periplasmic (TEM beta-lactamase), one outer membrane (PhoE); therefore, the quantity of leader peptidase is not rate-limiting for normal export. Overproduction of PhoS reduces the rate of maturation of two other periplasmic proteins (beta-lactamase and PhoA) and itself, presumably by competing for the rate-limiting component of the export apparatus. Overproduction of leader peptidase in a strain overproducing PhoS has no effect on the retarded maturation of PhoS. Therefore even in these conditions, leader peptidase is not rate limiting. PMID- 3525742 TI - A DNA sequence containing the control sites for the uxaB gene of Escherichia coli. AB - The nucleotide sequence of a 286 bp fragment containing the uxaB control region of Escherichia coli has been determined. The transcriptional start of the uxaB gene has been located and the promoter signals identified. Various fragments of the uxaB promoter-proximal region were fused in vitro with the lacZ gene. Results obtained with these fusions indicate that the operator-promoter sites are located on a 110 bp restriction fragment. The determination of the amino acid sequence of the NH2-terminus of the uxaB gene product revealed that the uxaB gene is not initiated with the AUG codon but with the unusual GTG codon. CRP, the cyclic AMP receptor protein, does not bind to the uxaB control region DNA even though expression of the uxaB gene is sensitive to catabolite repression. PMID- 3525743 TI - Pyruvate metabolism and the phosphorylation state of isocitrate dehydrogenase in Escherichia coli. AB - During growth of Escherichia coli on acetate, isocitrate dehydrogenase (ICDH) is partially inactivated by phosphorylation and is thus rendered rate-limiting in the Krebs cycle so that the intracellular concentration of isocitrate rises which, in turn, permits an increased flux of carbon through the anaplerotic sequence of the glyoxylate bypass. A large number of metabolites stimulate ICDH phosphatase and inhibit ICDH kinase in the wild-type (E. coli ML308) and thus regulate the utilization of isocitrate by the two competing enzymes, ICDH and isocitrate lyase. Addition of pyruvate to acetate grown cultures triggers a rapid dephosphorylation and threefold activation of ICDH, both in the wild-type (ML308) and in mutants lacking pyruvate dehydrogenase (ML308/Pdh-), PEP synthase (ML308/Pps-) or both enzymes (ML308/Pdh-Pps-). Pyruvate stimulates the growth on acetate of those strains with an active PEP synthase but inhibits the growth of those strains that lack this enzyme. When pyruvate is exhausted, ICDH is again inactivated and the growth rate reverts to that characteristic of growth on acetate. Because pyruvate stimulates dephosphorylation of ICDH in strains with differing capabilities for pyruvate metabolism, it seems likely that pyruvate itself is a sufficient signal to activate the dephosphorylation mechanism, but this does not discount the importance of other signals under other circumstances. PMID- 3525744 TI - Polyhedrin structure. AB - Polyhedrin has evolved two highly specialized functions. Firstly, it forms a protective crystal around the virus and secondly it resists solubilization except under strongly alkaline conditions similar to those found in the insect midgut. Both of these properties allow the virus to remain viable for many years outside the insect host. Although polyhedrin and granulin can vary by about 50% in amino acid sequence, many of their structural features are highly conserved, reflecting the similar function and biochemical properties of these proteins. By comparing the sequences, domains within the gene which evolve rapidly have been identified and molecular phylogenies have been proposed. Information on predicted secondary structure has also been obtained and some insight into the possible role of codon usage in baculovirus function has also been gained from the sequence information. In addition to the conserved structural properties of the polyhedrin protein, there is a conserved regulatory process which results in the synthesis of massive amounts of polyhedrin. This process is probably governed by a virus-specific RNA polymerase. A potential regulatory signal shared by all these genes has been identified upstream from the polyhedrin gene. A number of additional granulin and lepidopteran polyhedrin sequences will certainly be forthcoming because of the ease with which these genes are identified by cross-hybridization with available related probes. However, of special interest will be sequences from dipteran and hymenopteran polyhedrins which will add greatly to our understanding of the constraints governing polyhedrin structure and diversity. Another logical step in their study will be to examine polyhedrin quaternary structure utilizing X-ray crystallography. Additional areas of future emphasis will probably focus on the regulation of polyhedrin synthesis. Elucidation of the regulatory signals governing transcription of these genes are of prime interest as are complementary studies on the characterization of the RNA polymerase which transcribes these genes. PMID- 3525745 TI - Expression of the S-coded genes of lymphocytic choriomeningitis arenavirus using a baculovirus vector. AB - A DNA copy of the lymphocytic choriomeningitis virus (LCMV, WE strain)S RNA species has been inserted in both orientations into plasmids containing a 7.1 kb DNA sequence of the baculovirus Autographa californica nuclear polyhedrosis virus (AcNPV). The inserts were placed behind the polyhedrin gene promoter of AcNPV and in the place of the nucleotide sequences including and flanking the polyhedrin gene translation initiation codon. The derived plasmids were used to obtain recombinant AcNPV viruses after transfection of Spodoptera frugiperda cells in the presence of infectious AcNPV DNA and the selection of polyhedrin-negative viruses. The expression of the two LCMV S-coded genes, the nucleoprotein and glycoprotein precursor, in S. frugiperda cells by the recombinant baculoviruses is described. Based on the results obtained with three different expression vectors, the site of insertion of the foreign genes in the 5' non-coding region of the polyhedrin gene appears to be an important determinant of the level of expression obtained. PMID- 3525746 TI - The characterization of a set of amber mutants of bacteriophage T5. AB - A collection of amber mutants of bacteriophage T5 was analysed using an in vivo complementation test and assigned to 21 complementation groups. The incomplete phage structures produced by T5 amber mutant infection of the non-permissive host were examined. The mutants were allocated to four phenotypic types, as defined by an in vitro complementation test: those which produced functional heads, H; those which produced functional tails, T; those which produced inactive heads and functional tails, HI + T; and those which did not synthesize either heads or tails, 0. Functional heads and inactive heads were indistinguishable in shape and size in the electron microscope. Four different patterns of DNA metabolism were observed when different amber mutants were grown under non-permissive conditions. They were the wild-type pattern (D+) in which host DNA degradation was followed by synthesis of phage DNA, host DNA degradation without phage DNA synthesis (D0), neither host DNA degradation nor phage DNA synthesis (DD0) and host DNA degradation with slight DNA synthesis (DS). Upon infection of the non-permissive host with representatives of different complementation groups of mutants either normal lysis occurred or bacterial growth ceased without subsequent lysis. The phenotypic characteristics of the amber mutants were used for partial elucidation of the functions of the affected genes. PMID- 3525747 TI - Occurrence of respiratory syncytial virus subtypes A and B strains in Sweden. AB - The subtype characteristics of 22 strains of respiratory syncytial (RS) virus isolated in Sweden were determined by the use of monoclonal antibodies. Eleven antibodies specific for distinct epitopes on five different structural proteins were used in immunofluorescence and radioimmune precipitation assays. One group of 12 isolates were derived from a three-month epidemic during 1984, whereas the other ten virus isolates were recovered during a time period of 13 years (1971 1983). All isolates could be allocated to the previously defined groups of subtype A and B strains of RS virus. During the single epidemic season, five subtype A and seven subtype B strains were found. During the 13-year period a randomly alternating appearance of six subtype A and four subtype B strains was observed. Thus RS virus strains of different subtype characteristics may occur alternately or concomitantly. The possible significance of consecutive infections with RS virus subtypes for immunopathological events deserves further studies. PMID- 3525748 TI - Role of radiation therapy in cancer of the breast. PMID- 3525749 TI - Psychopharmacology of temper outbursts. A review. AB - Recent studies suggest that several drugs, specifically carbamazepine, propranolol, and lithium, may alleviate rage outbursts. This literature is reviewed and possible mechanisms of action are discussed. PMID- 3525750 TI - Effects of exposure of DNA to methyl mercury on its activity as a template-primer for DNA polymerases. AB - A previous publication [Frenkel, Cain, and Chao, Biochem. Biophys. Res. Commun. 127, 849-856 (1985)] described the observation that double-stranded DNA which was briefly exposed to methyl mercury (MeHg) and purified to remove free methyl mercury was transcribed at a higher rate by RNA polymerase II from wheat germ. The specificity of this phenomenon has now been investigated by examining the activity of this MeHg-exposed DNA as a template-primer for DNA polymerases. DNA synthesis by the bacteriophage T4-induced DNA polymerase was higher with the MeHg exposed DNA as a template-primer than with control DNA. In contrast, the rate of DNA synthesis by E. coli DNA polymerase I was lower with the MeHg-exposed DNA as template-primer. With both enzymes (as well as with RNA polymerase II), after denaturation of the MeHg-exposed and control DNAs the differences in template activity were either eliminated or markedly reduced. The enzymes are thus able to detect a MeHg-induced alteration in DNA. In contrast, circular dichroism, a physical method that is sensitive to conformational changes in DNA, did not detect any difference between the MeHg-exposed and control DNAs. PMID- 3525751 TI - Insulin binding to the blood-brain barrier in the streptozotocin diabetic rat. AB - 125I-Insulin binding to isolated brain microvessels from control, streptozotocin diabetic, and insulin-treated diabetic rats was measured. The binding was highest in the control (21.1 +/- 1.8%/mg capillary protein) and lowest in the diabetic (14.8 +/- 1.9%, p less than 0.01) animals. Administration of 2 U of protamine zinc insulin per day increased the maximum binding in the diabetic rats to 17.2 +/- 2.1%. Scatchard analyses of the binding showed that the major difference between the diabetic and the control animals was a decrease in the number of both high- and low-affinity sites in the diabetic animals. To test whether the failure of up-regulation in the hypoinsulinemic diabetic animal was related to an inherent defect in the endothelial cell or resulted from the diabetic milieu, cultured brain endothelial cells were tested for their capacity to up- and down regulate their insulin receptors in vitro. In response to 100 ng/ml insulin for 12 h, these cells down-regulated their insulin receptors. When the insulin was removed, the insulin receptors returned to control levels. These studies showed that in vitro brain capillary endothelial cells have the capacity to increase their insulin receptors in response to a low-insulin environment, whereas in vivo the microvessels decrease their insulin receptors in response to diabetes.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3525752 TI - Presence of vasoactive intestinal polypeptide-like immunoreactivity in the cholinergic electromotor system of Torpedo marmorata. AB - Vasoactive intestinal polypeptide (VIP)-like immunoreactivity was detected in the cholinergic electro-motor system of Torpedo marmorata using a combination of immunohistochemical assays, radioimmunoassay, and HPLC. The immunohistochemical assays revealed that the distribution of VIP-like immunoreactivity in the electric lobes, electromotor nerves, and electric organ is comparable to that of the stable cholinergic synaptic vesicle marker vesicle-specific proteoglycan. Ligation of the electromotor nerves caused a marked accumulation of VIP-like immunoreactivity in the lobes (180%) and the proximal portions of the electromotor nerves (130%) and a decrease in the electric organ (-50%), when measured by radioimmunoassay using synthetic VIP (porcine sequence) as the standard. VIP-like immunoreactivity in extracts of electric lobes electromotor nerves, and electric organ was eluted from a semipreparative reverse-phase HPLC column as a single peak with a retention time similar to that of porcine VIP. Rechromatography at higher resolution on an analytical column indicated diversity between the molecular forms of VIP-like immunoreactivity extracted from electric lobe and electric organ, suggesting the possibility of posttranslational processing. PMID- 3525753 TI - Immunochemical characterization of peripheral nervous system myelin 170,000-Mr glycoprotein. AB - A recently described 170,000-Mr glycoprotein, specific to peripheral nervous system (PNS) myelin, was purified from rat PNS myelin by preparative sodium dodecyl sulfate-polyacrylamide gel electrophoresis and used to immunize guinea pigs and rabbits. The resultant antisera proved specific for 170,000-Mr glycoprotein by enzyme-linked immunosorbent assay, by immunoprecipitation of the appropriate peptide from solubilized PNS myelin, and by immunoblot analysis of rat PNS myelin. The anti-rat 170,000-Mr glycoprotein antisera cross-reacted with proteins of similar molecular weight in human and bovine PNS myelin, but such proteins were not detected in human or rat CNS myelin or other rat tissues. The 170,000-Mr glycoprotein was also detected by this immunoblot procedure in recently isolated rat Schwann cells but not in those kept in culture for greater than or equal to 3 days. By indirect immunofluorescent microscopy, anti-rat 170,000-Mr glycoprotein antibody bound to rat PNS myelin sheaths but not to other rat tissues. Together, these studies indicate the 170,000-Mr glycoprotein is specific to PNS myelin of several species and that a neuronal influence may be required for its expression by Schwann cells. PMID- 3525754 TI - Insulin is released from rat brain neuronal cells in culture. AB - Depolarization of neuronal cells in primary culture from the rat brain by potassium ions in the presence of calcium or by veratridine caused a greater than three-fold stimulation of release of immunoreactive insulin. HPLC of the released insulin immunoreactivity from the neuronal cultures comigrated with the two rat insulins. The depolarization-induced release of insulin was inhibited by cycloheximide and was specific for neuronal cultures since potassium ions failed to cause the release in comparably prepared astrocytic glial cells from the rat brain. Prelabelling of neuronal cultures with [3H]leucine followed by depolarization resulted in the release of radioactivity that immunoprecipitated with insulin antibody. The release of [3H]insulin was biphasic. These observations suggest that neuronal cells from the brain have the capacity to synthesize insulin that could be released under depolarization conditions. PMID- 3525755 TI - Changes in insulin binding to developing embryonic chick neural retina cells. AB - Specific cell surface insulin binding to embryonic chick neural retina cells has been demonstrated in vivo. Kinetics of insulin binding as well as hormonal specificity were similar to those reported for other vertebrate cells and tissues, both neural and nonneural. When surface insulin binding to retinal cells was studied as a function of embryonic age, a developmental relationship was observed. Scatchard analysis revealed that the number of cell surface insulin receptors decreased approximately 75% between days 10 and 16 of embryonic development. Receptor affinities remained fairly constant for this period. PMID- 3525756 TI - Viscero-somatic and viscero-visceral reflexes in brain death. AB - Little is known about spinal visceral reflexes in brain-dead man, although they have been described in experimental animals. In 1983, 25 brain-dead individuals were observed during donor nephrectomy. It was confirmed that some of these donors, without higher centre modulation and not under significant pharmacological influence, had viscero-somatic motor reflexes and viscero visceral cardiovascular reflexes. PMID- 3525757 TI - Increased nerve conduction in diabetics after a year of improved glucoregulation. AB - We studied median, ulnar and peroneal motor nerve conduction velocity (NCV) and median sensory action potential (SAP) latency and amplitude in 18 insulin dependent diabetic patients who were begun on a continuous subcutaneous insulin infusion (CSII) program. With institution of this therapy, significant decreases in mean blood glucose and glycosylated hemoglobin occurred. After 12 months of CSII treatment, median, peroneal, and ulnar motor NCVs all increased significantly. The average NCV increase was 2.5 m/s. Median SAP amplitude and latency did not significantly change. In a second group of 12 diabetic patients with the same mean age and comparable initial NCV and SAP measures, no significant changes in motor NCVs or SAPs occurred after 12 months of conventional insulin treatment. These results indicated the need for further long term studies of the role of strict glucose control in the prevention of diabetic neuropathy. PMID- 3525758 TI - Increased thromboxane level in experimental spinal cord injury. AB - An increased accumulation of tissue thromboxane A2 occurred shortly after spinal cord injury. Prostacyclin formation was not affected. The magnitude of the increase in thromboxane and the extent of post-traumatic vascular damage as determined by extravasation of 125I-labeled human serum albumin were both dependent on the degree of injury. These findings raise the possibility that activation of arachidonic acid metabolism with a preponderance in thromboxane formation may contribute to microvascular injury in experimental spinal cord contusion. PMID- 3525759 TI - Nerve conduction studies in the Twitcher mouse (murine globoid cell leukodystrophy). AB - Progression of the neuropathy in the Twitcher mouse (twi-C57BL/6J), an animal model of globoid cell leukodystrophy, was assessed with serial motor nerve conduction studies from just after birth until near death (day 45) and after hematopoietic cell transplantation (HCT). Under ether anesthesia, the tibial nerve was stimulated percutaneously at the sacral notch and at the ankle, and recordings were made from plantar foot muscles. Motor conduction velocity (MCV), distal latency, amplitude, duration and number of phases of compound muscle action potentials on proximal (pCMAP) and distal (dCMAP) stimulation were measured. In 15-19 day-old Twitcher, despite the absence of motor signs, MCV was significantly reduced, 12.8 +/- 2.8 (10) m/s (M +/- SD, No. of recordings), compared with unaffected siblings, 18.1 +/- 2.6 (21) m/s (P less than 0.01). The ratio of pCMAP to dCMAP amplitudes was reduced in the Twitcher, 0.39 +/- 0.13 (10), compared with controls 0.72 +/- 0.17 (21) and the ratio of pCMAP to dCMAP phases was increased (2.8 +/- 0.8 (10) vs 1.0 +/- 0.2 (21), P less than 0.01 for all). As neurologic signs progressed by 35-39 days, MCV became slower, 5.8 +/- 1.0 (11) m/s, pCMAP and dCMAP became smaller, but the ratio of pCMAP to dCMAP amplitudes in the Twitcher (0.55 +/- 0.36, 11) was similar to controls (0.71 +/- 1.0, 20) as was the ratio of pCMAP to dCMAP phases (1.0 +/- 0.4 vs 1.0 +/- 0.1). These results suggest that there is diffuse non-uniform slowing of nerve conduction with block especially in proximal nerve fibers initially. With HCT, mean MCV remained slow (6.7 +/- 1.2 (18) m/s, vs 34.5 +/- 3.9 (12) m/s) but motor function persisted. PMID- 3525760 TI - Endogenous production of TNF in mice long after BCG sensitization. AB - The effect of tuberculin-antigen protein (PPD: purified protein derivatives) on the priming of tumor necrosis factor (TNF) a long time after sensitization with bacillus Calmette-Guerin (BCG) was investigated in mice. Mice were infected intravenously (i.v.) with 4 X 10(7) colony-forming units (CFU) of BCG per mouse, and the TNF activity triggered by 15 micrograms lipopolysaccharide (LPS) was assayed with time using L-929 cells. The activity was maximal 4 weeks after sensitization and decreased to the control level after 10 weeks. The i.v. injection of 10 micrograms of PPD per mouse enhanced the TNF production triggered by LPS in mice even 10-20 weeks after sensitization. This enhancement was unexpectedly quite transient, being maximal 3 h after PPD treatment. The activity was comparable to that in mice 4 weeks after sensitization of BCG (without PPD). The enhancing effect of PPD was observed in the dose range of 0.1-10 micrograms/mouse, and 10 micrograms of PPD significantly enhanced the TNF activity triggered by even 0.6 microgram LPS. These findings indicate that priming of sensitized animals with some antigens followed by triggering with LPS induces a significant endogenous production of TNF even a long time after antigen sensitization. The possible application of these findings for inducing endogenous production of TNF in human patients by use of tuberculin allergy is discussed. PMID- 3525761 TI - Phase I clinical trial of an MAF-containing lymphoblastoid cell line supernatant. AB - A preliminary Phase I evaluation of macrophage activating factor (MAF) derived from the partially purified supernatant of human RPMI-1788 lymphoblastoid cell line was performed in 4 parts in 39 patients with advanced cancer. The first two parts used subcutaneous routes of administration and the second two parts used a 4-h intravenous infusion method. Individual doses ranged from 0.1 ml (1.7 mg protein) to 100 ml (1,700 mg protein). Subcutaneous dose was limited by the volume of administered material, and an attempt to use a concentrate of the supernatant resulted in severe local skin reactions. Larger doses given intravenously were well tolerated. Resultant toxicity was mild and consisted of transient fever and chills. One patient with malignant melanoma had a complete response of a 3-cm skin metastasis; one patient with breast cancer had disappearance of a skin nodule while visceral disease progressed; and one patient with histiocytic lymphoma had resolution of a conjunctival lesion. Treatment in many patients was associated with an increase in absolute peripheral lymphocytes. In the high-dose intravenous group, a statistically significant increase in the phagocytic index of peripheral blood leukocytes was noted. Lymphoblastoid MAF appears to be relatively safe to administer and has promise both as an antitumor agent and in the treatment of other altered immune conditions. PMID- 3525762 TI - Immunomodulatory effect of synthetic branched polypeptides. II. AB - A comparative investigation of various polypeptides was carried out in order to elucidate structure-activity correlations. The immunoadjuvant properties of the chemically well-characterized branched polypeptides, poly[Lys-(DL-Alam)] (Lys:Ala = 1:2.95) (AK), poly[Lys-(D-Leui-DL-Alam)] (Lys:Ala:Leu = 1:3.0:0.95) (D-LAK), and poly[Lys-Hisi-DL-Alam)] (Lys:Ala:His = 1:2.95:0.85) (HAK), were investigated. D-LAK and HAK were able to augment the antibody response of BDF inbred mice to immunization with sheep red blood cells (SRBC), as assessed by the hemolytic plaque-forming cell assay, whereas AK had no similar effect. The stimulating effect of D-LAK and HAK was dependent on dose and timing of treatment relative to SRBC immunization. However, the optimal dose levels were lower and the effective dose interval more restricted as compared to the previously described poly[Lys (Leui-DL-Alam)] (LAK). Like LAK, both HAK and D-LAK were able to compensate for the immunosuppressive effect of the cytotoxic drugs dianhydrogalactitol, vincristine, and 5-fluorouracil, which all have different mechanisms of action, provided that combined treatment by polypeptide and drug was applied repeatedly before the SRBC immunization. PMID- 3525763 TI - Induction by heterologous fibrinogen of release of TNF-like cytotoxic factor from murine macrophages. AB - In an attempt to find nontoxic triggering agents to release cytotoxin from primed macrophages of mice, the abilities of eight plasma components to induce release of cytotoxin from J-774.1, a murine macrophage-like cell line, were examined. Heterologous, but not homologous, fibrinogen and fibrin were found to enhance the release of cytotoxin. The fibrinogen and fibrin did not contain any lipopolysaccharide (LPS) as tested with polymyxin B. Thus, heterologous fibrinogen and fibrin could be useful as nontoxic triggering agents. PMID- 3525764 TI - Dose-response is alive and well. PMID- 3525766 TI - The clinical and biological correlates of coagulopathy in children with acute leukemia. AB - We determined the clinical and biological correlates of coagulopathy in a large series of patients with untreated childhood acute leukemia. Twenty-five of 805 children with acute lymphoblastic leukemia (ALL) (3.1%) and 27 of 195 with acute myeloid leukemia (AML) (13.8%) met any two of three requirements for a coagulation disorder: fibrinogen level less than 150 mg/dL; fibrin degradation products greater than 10 micrograms/mL; and prolongation of prothrombin time (PT) greater than 12 seconds, activated partial thromboplastin time (PTT) greater than 45 seconds, or thrombin time (TT) greater than 18 seconds. Patients with ALL complicated by abnormal coagulation were more likely to be boys and to have a T cell immunophenotype, a high leukocyte count, a mediastinal mass, leukemic involvement of the CNS, hepatosplenomegaly, and L2 blast cell morphology. These features were highly interrelated, with only T-cell markers and CNS involvement achieving independent significance in a multivariate logistic regression model. Hepatomegaly, blast cell morphological subtype (French-American-British [FAB] M3, M4, and M5) and age less than 2 years were each associated with coagulopathy in patients with AML, although age failed to retain importance after logistic regression analysis. The presence of coagulopathy at diagnosis of ALL did not influence the rate of remission induction (P = .55). By contrast, only 14 of 27 children with coagulopathy at diagnosis of AML achieved a complete remission (CR), compared with 129 of 168 other patients who lacked this complication (P = .003). After multivariate analysis, coagulopathy remained independently associated with failure to attain remission in AML (P = .02). Fatal hemorrhagic complications arising in the CNS or lungs accounted for nine of the 13 induction failures in this group. The presence or absence of coagulopathy had no discernible influence on treatment outcome among patients with either ALL or AML who attained a CR. Laboratory evidence of a coagulation defect may be useful in identifying patients with AML who have a greater risk of induction failure and, hence, require close surveillance and intensive replacement therapy to prevent fatal hemorrhagic complications. PMID- 3525765 TI - Analysis of dose intensity for adjuvant chemotherapy trials in stage II breast cancer. AB - We have analyzed the relationship between dose intensity of cyclophosphamide, methotrexate, and fluorouracil (CMF)-containing adjuvant chemotherapy of stage II breast cancer and 3-year relapse-free survival. Studies using only one or two drugs of CMF or melphalan instead of cyclophosphamide were included in the analysis by using simple techniques developed for this purpose. There was a clear cut relationship between relapse-free survival and dose intensity in trials containing all four prognostic groups: less than 50 years, one to three and more than three positive nodes; and greater than or equal to 50 years, one to three and more than three positive nodes (P less than 10(-5)). Relapse-free survival also correlated with dose intensity for each of the four prognostic groups analyzed separately (P less than .005). Dose intensity was an independently significant correlate of relapse-free survival in multivariate analysis (P less than 10(-5)). This is a retrospective study, and the hypothesis that dose intensity contributes to outcome independently of other variables should be tested prospectively. Methods of increasing dose intensity also require testing in randomized trials before they can be applied to routine clinical practice. PMID- 3525767 TI - Improved survival rate in children with stage III and IV B cell non-Hodgkin's lymphoma and leukemia using multi-agent chemotherapy: results of a study of 114 children from the French Pediatric Oncology Society. AB - Children with B cell non-Hodgkin's lymphoma who have not relapsed 1 year after diagnosis and treatment are generally cured. We report here the results of treatment in 114 children who all had a minimum follow-up of 20 months. The protocol LMB 0281 from the French Pediatric Oncology Society was used. This nine drug intensive-pulsed chemotherapy was based on high-dose cyclophosphamide, high dose methotrexate (HD MTX), and cytosine arabinoside (ara-C) in continuous infusion. CNS prophylaxis was with chemotherapy only. No local irradiation was performed. No debulking surgery was recommended. There were 72 patients with stage III lymphoma and 42 patients with stage IV lymphoma or B cell acute lymphocytic leukemia (B-ALL). Among those 42 patients, seven had CNS involvement alone, 21 had bone marrow alone, and 14 had both; 26 had greater than 25% blast cells in bone marrow, 14 of whom had blast cells in blood. The primary site of involvement was the abdomen in 90 patients, the Waldeyer Ring in nine, and various sites in eight; seven patients presented without tumor. Seventy-seven patients are alive with a median follow-up of 2 years and 8 months. Seven patients died due to initial treatment failure, 11 died from toxicity, and 19 died after relapse. Among the 93 patients without initial CNS involvement, only one isolated relapse in CNS occurred. Survival and disease-free survival rates reached 67% and 64%, respectively, for all patients, 75% and 73% for stage III patients and 54% and 48% for stage IV and B-ALL patients. Bone marrow involvement was not an adverse prognostic factor. Contrary initial CNS involvement indicated a bad prognosis with a disease-free survival rate of 19% compared with 76% without CNS disease. This study showed that CNS prophylaxis and local control of the primary tumor can be achieved by intensive chemotherapy alone, without radiotherapy or debulking surgery. PMID- 3525768 TI - Improved survival duration with combination chemotherapy induction for multiple myeloma: a Southwest Oncology Group Study. AB - Four hundred forty previously untreated patients with active multiple myeloma were entered into a randomized trial (Southwest Oncology Group [SWOG] study 7927/28) comparing vincristine, melphalan, Cytoxan (Mead Johnson & Company, Evansville, Ind), and prednisone (VMCP) alternating with vincristine, BCNU, Adriamycin (Adria Laboratories, Columbus, Ohio) and prednisone (VBAP) with or without levamisole with vincristine, Cytoxan, and prednisone (VCP) with or without levamisole for induction therapy. The treatment groups were well balanced for all of the known major prognostic factors. Patients receiving VMCP-VBAP responded (greater than or equal to 75% regression) more frequently to induction therapy, both without (54%) and with (44%) levamisole v VCP without (28%) or with (28%) levamisole (P less than .001). In addition, patients receiving VMCP-VBAP (+/- levamisole) had a survival duration determined to be significantly increased by all forms of analysis: 48 and 33 months for VMCP-VBAP without and with levamisole v 29 and 26 months for VCP without and with levamisole (P = .011 overall). Levamisole did not improve response rates or survival duration (P greater than or equal to .1), nor did it prolong remission in the maintenance phase (P = .85). Analysis of SWOG study 7704/05 (updated April 1985) confirmed improved survival for combination therapy v MP, but no benefit for levamisole. The overall findings support the use of VMCP-VBAP as an excellent treatment option for remission induction in patients with active myeloma of all stages and prognostic categories. PMID- 3525769 TI - Hypersensitivity reactions to teniposide (VM-26): an analysis. AB - An analysis of hypersensitivity reactions to teniposide was approached using three methods: investigator survey, adverse drug reaction analysis, and literature search. By the survey method, hypersensitivity incidence was 6.5% with the majority of the reactions (82%) occurring in brain tumor or neuroblastoma patients. By the second method, 43 cases of hypersensitivity that were reported to the National Cancer Institute (NCI) between January 1983 and October 1985 were analyzed in detail. Reaction onset was unpredictable according to the number of drug doses. The majority of the patients (65%) experiencing the reaction had neuroblastoma or brain tumors, and these patients also tended to react earlier in the course of drug administration than those with hematologic malignancies. Clinical presentation was not correlated with the patient's diagnosis. All patients recovered. However, only six of 13 were successfully rechallenged with the drug. The third approach, the literature search, provided information on 82 hypersensitivity reactions among 2,250 patients (3.6% incidence). Forty-five percent of these reactions were linked to neuroblastoma or brain tumor patients. The analysis of hypersensitivity to teniposide by these three methods provides insight into the true incidence of hypersensitivity reactions in the general patient population. The frequency of the reactions is substantially higher in patients with neuroblastoma and brain tumors. This population should be considered for future trials of aggressive prophylactic therapy. PMID- 3525770 TI - A phase I trial of spirohydantoin mustard (NSC 172112) in patients with advanced cancer. AB - Spirohydantoin mustard (spiromustine, NSC 172112) is a classical bifunctional alkylating agent synthesized in an effort to develop antitumor agents effective against CNS tumors. The rationale was to combine the reactive moiety of an active antitumor agent with the hydantoin part of the molecule, which might serve as a carrier to cross the blood brain barrier. Thirty-eight patients with refractory solid tumors received spiromustine as part of a phase I trial at the Johns Hopkins Oncology Center. Three schedules were investigated: intravenously (IV) daily for three consecutive days, IV every other day for 3 days, and IV on a weekly basis for three doses, all cycled every 28 days. Hematologic toxicity was infrequently seen. Mild to moderate nausea and vomiting occurred on all schedules. The dose limiting toxicity was CNS toxicity characterized by mydriasis, xerostomia, lethargy, confusion, and hallucinations. This CNS toxicity was dose related, cumulative, and reversible. IV physostigmine appeared to diminish the neurotoxicity if administered before spiromustine and at frequent intervals following the drug. The maximum tolerated dose of spiromustine (without concomitant physostigmine) on the three times a week schedule is 6 mg/m2. With physostigmine pretreatment, 8 mg/m2 can be administered. The three times daily and every other day for three days schedules are not recommended for further study due to the severity of neurotoxicity. It is recommended that 6 mg/m2 be used as the starting dose for any phase II studies using the three times weekly schedule, and that physostigmine be used as needed to minimize neurotoxicity. Dose escalation above this level can be considered when individual tolerance has been established. Phase II trials to investigate the activity of this agent against primary and metastatic CNS malignancies appear indicated on the basis of three transient radiographic responses in refractory malignancies metastatic to the CNS. PMID- 3525771 TI - Sequential methotrexate-fluorouracil: the role of leucovorin in improving tumor response. PMID- 3525772 TI - 13-cis-retinoic acid in myelodysplastic syndromes. PMID- 3525773 TI - Development of homoharringtonine. PMID- 3525774 TI - An in vitro model of proliferation and differentiation of the chick retina: coaggregates of retinal and pigment epithelial cells. AB - Pigment epithelial (PE) cells exert a pronounced organizing effect when added to embryonic day (E) 5-6 chick retinal cells in a reaggregation system such that after a period of 14-21 d of culture, the main layers of an intact E10-E14 retina are reconstructed (Vollmer et al., 1984). In the present study we investigated the time course of the formation of retina-like structures in retinal-pigment epithelial aggregates, in particular, the fate of the PE cells and their influence on processes of differentiation within the aggregates. PE cells first form a core in the center of the aggregates and migrate to the periphery at later stages. The PE core affects the organization of proliferation and differentiation, phenomena that were monitored using 3H-thymidine autoradiography and AChE histochemistry, respectively. A double-staining procedure combining both techniques on the same section is described. Soon after aggregation, a matrix zone and a zone of differentiated cells are formed. At later steps, proliferation becomes gradually restricted to a narrow band within the aggregates comparable to the in vivo situation. The spatiotemporal pattern of withdrawal from mitosis resembles that of the in vivo retina. Proliferation in aggregates is sustained over a longer period with PE, as compared with aggregates formed by retinal cells alone. AChE staining in aggregates in the presence of PE shows a layered appearance, while there is only crude sorting-out of labeled and unlabeled cells in aggregates composed of retinal cells only. The basis of PE cell action as well as the relevance of this in vitro system for understanding normal eye development are briefly discussed. PMID- 3525775 TI - The response of chick sensory neurons to brain-derived neurotrophic factor. AB - To determine the spectrum of activity of brain-derived neurotrophic factor (BDNF) among first-order sensory neurons, explants of the nine distinct populations of sensory neurons from embryonic chicks of 3-14 d incubation (E3-E14) were grown in collagen gels with and without BDNF in the culture medium. The explants responded to BDNF with profuse neurite outgrowth and comprised those in which neurons are derived from neural crest (the dorsomedial part of the trigeminal ganglion, rostromedial part of the trigeminal mesencephalic nucleus, jugular ganglion, and lumbosacral dorsal root ganglia) and from epibranchial placodes (the ventrolateral part of the trigeminal ganglion and the geniculate, petrosal, and nodose ganglia). This response was first clearly observed in the ventrolateral trigeminal and nodose ganglia as early as E4, but did not appear until later in other explants. The dorsomedial trigeminal, jugular, and geniculate ganglia were the latest to develop a response, which was not apparent until E8. In all explants the response was maximal between E10 and E12, and there was a decline in the magnitude of the response from E12 to E14. Although explants of the vestibular ganglion failed to respond to BDNF, the survival and growth of vestibular neurons in dissociated neuron-enriched cultures were promoted by BDNF. To investigate whether all first-order sensory neurons respond to BDNF or whether BDNF-responsive neurons comprise a distinct subset, we studied the influence of BDNF and NGF on the survival and growth of the placode-derived and the neural crest-derived neurons of the trigeminal ganglion in dissociated neuron-enriched culture.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3525776 TI - A partially purified preparation of isolated chemosensory cilia from the olfactory epithelium of the bullfrog, Rana catesbeiana. AB - Cilia at the tips of dendritic processes of olfactory receptor cells are the sites of initial recognition and transduction events in olfactory reception. We have detached cilia from the olfactory epithelium of the bullfrog, Rana catesbeiana, via a calcium shock and partially purified them in high yield (226 +/- 19 micrograms protein/frog, n = 14) by sucrose gradient centrifugation. The cilia appear to undergo osmotic lysis during the isolation procedure, forming isolated axonemal structures and ciliary plasma membrane vesicles with diameters of 100-500 nm and an internal volume of 2.3 +/- 0.5 microliter/mg protein. PAGE in SDS reveals approximately 30 protein bands, among which cytoskeletal components, such as tubulin and actin, are readily identifiable by immunoblotting. Approximately 15 glycoprotein bands reactive with concanavalin A are discernible with major glycopeptides at apparent molecular weights of 56-65, 95, and 116 kDa. In contrast to olfactory cilia, respiratory cilia, isolated from the palate of the frog, do not contain the prominent glycopeptides observed for olfactory cilia. The 56-65 kDa glycopeptide region reacts with antiserum against chick kidney, Na+/K+-ATPase, and contains the beta subunit of this enzyme. In addition, we have identified the alpha and beta subunits of a guanine nucleotide binding protein (G-protein) in the olfactory cilia preparation. This preparation of isolated olfactory cilia from Rana catesbeiana represents a readily accessible model system for studies of initial events in chemosensory recognition and signal transduction in the olfactory system. PMID- 3525777 TI - Ultrastructure of gonadotropin-releasing hormone neuronal structures derived from normal fetal preoptic area and transplanted into hypogonadal mutant (hpg) mice. AB - The hpg mutant mouse lacks the neurohormone gonadotropin-releasing hormone (GnRH) and hence has a reproductive deficit. This deficit can be corrected by placement of normal fetal preoptic area into the third ventricle (see Krieger et al., 1985). We have now used ultrastructural immunocytochemistry to investigate the morphology of GnRH neurons in such intraventricular grafts, the routes that their axons take as they exit into the host, and the neurosecretory terminations that they make in the host median eminence. The GnRH cells in the transplant were similar in morphology to that reported for such cells in the preoptic area of other rodents. There was a large central nucleus, frequently indented and containing 1 or 2 nucleoli. The thin rim of cytoplasm was filled with rough endoplasmic reticulum, Golgi stacks, and mitochondria. Both dendritic and axonal profiles were identified, and a modest synaptic input to the former was found. Between the host and the implant a complex multilayered ependymal zone developed, and it was through this region that GnRH axons exited into the host arcuate nucleus and median eminence, usually surrounded by ependymal or glial elements. Within the median eminence, GnRH terminals were in close association with fenestrated blood vessels forming a normal neurosecretory terminus. PMID- 3525778 TI - Functional temporary crowns simplified. PMID- 3525779 TI - Evaluation of cerebral AVM's using transcranial Doppler ultrasound. AB - Blood flow velocities in basal cerebral arteries were recorded noninvasively in 28 patients with cerebral arteriovenous malformations (AVM's) and were correlated with the angiographic findings. In normal arteries remote from the AVM, flow velocities ranged from 44 to 94 cm/sec (median 65 cm/sec) with pulsatility indexes from 0.65 to 1.10 (median 0.87). This is consistent with findings in normal individuals. Arteries feeding the AVM's were identified by the high flow velocities (ranging from 75 to 237 cm/sec, median 124 cm/sec). The pulsatility index ranged from 0.22 to 0.74 (median 0.48). The difference of these results from findings in normal remote arteries was highly significant (p less than 0.001). Hyperventilation tests illustrated the hemodynamic difference between an AVM and normal cerebrovascular beds. Flow velocity measurements permitted noninvasive diagnosis of AVM's in 26 of the 28 patients. Furthermore, the identification of individual feeding arteries permitted good definition of the anatomical localization of individual AVM's. Flow velocity measurements combined with computerized tomography scans are useful in the diagnosis of AVM's. With the feeding artery's configuration identified on angiography, flow velocity measurements permit a new insight into the "hemodynamic dimension" of an AVM and its possible effects on adjacent normal brain-tissue perfusion in the individual patient. PMID- 3525780 TI - Early diagnosis of acute postoperative renal transplant rejection by indium-111 labeled platelet scintigraphy. AB - A prospective evaluation of 111In-labeled platelet scintigraphy (IPS) for the early diagnosis of acute postoperative renal transplant rejection (TR) was undertaken. The results of IPS were compared with in vitro biochemical tests, the clinical finding of graft tenderness, and combined [99mTc]DTPA and [131I]orthoiodohippurate scintigraphy. With a sensitivity of 0.93 and a specificity of 0.95, IPS provided otherwise unavailable diagnostic information. Furthermore, postoperative IPS was a good predictor of long-term allograft survival. PMID- 3525781 TI - Aerosol penetration ratio: a new index of ventilation. AB - Superimposition of nuclear medicine scintigrams and standard radiographs provides a unique opportunity for merging functional information intrinsic to nuclear medicine images with the high resolution anatomic detail of radiographs. A newly developed image processing system allows the merging of two separate films of greatly varying sizes to form a single composite image. Subsequent quantitative analysis of the composite image may be performed. Using the superimposition technique, [99mTc]DTPA aerosol ventilation scans (4.5 X 4.5 cm) were superimposed upon chest radiographs (35.6 X 43.2 cm) in 17 cystic fibrosis (CF) patients. Subsequent quantification of the area of nuclear scan ventilation and the radiographic lung area was then performed. A new quantitative radiologic index of ventilation, the aerosol penetration ratio (APR), was defined. Linear correlation of aerosol penetration ratio with residual volume (RV) as percent of total lung capacity (TLC) measured by body plethysmography was good. We conclude that the APR has validity as a physiologic parameter which localized regional excessive residual volume and correlates well with RV/TLC, the "gold standard" pulmonary function index of obstructive airway disease. PMID- 3525782 TI - Indium-111 white blood cell scan for infectious complications of polycystic renal disease. PMID- 3525783 TI - JONA's Semiannual Directory of Consultants to Nursing Administration. PMID- 3525784 TI - Variations in respiratory disease morbidity among pulp and paper mill town residents. AB - This study investigated whether occupational exposure in pulp and paper mills or geographic proximity to mills was associated with an increase in risk for respiratory disease hospitalizations. Three years (1980 to 1982) of 100% age- and sex-adjusted hospital admission rates for selected respiratory diagnoses were calculated for 66 Maine towns located between 0 and 15 miles for seven Kraft mills and four groundwood pulp and paper mills. Additional data collected for each town included the number of production workers at each mill, mill proximity, insurance coverage, hospital distance, bed size, full-time equivalent physicians, unemployment and income rates. Regression results provide evidence that occupational exposure may be a significant factor in hospitalizations for respiratory infections, bronchitis and asthma, and respiratory signs and symptoms, although potential confounders (smoking, commercial health insurance) need to be examined. PMID- 3525785 TI - Infantile cortical hyperostosis: report of two cases. PMID- 3525786 TI - Mandibular reconstruction with a microvascular free groin osteocutaneous graft based on the deep circumflex iliac vessels. AB - Two cases in which mandibular reconstruction was accomplished by a free groin osteocutaneous composite graft with microvascular anastomosis of its feeding deep circumflex iliac vessels are presented. The immediate and long-term postoperative results were found to be very satisfactory. PMID- 3525787 TI - Immunofluorescent localization of structural collagen types in endochondral fracture repair. AB - A nonimmobilized rat tibial fracture model of endochondral osseous repair was examined for the unique localizations of specific collagen genetic types. At various stages of the healing process, the demineralized callus was reacted with immunofluorescent antibodies directed against the type specific forms of matrix collagen. Type III collagen rapidly appeared (day 8-10) and remained in the primitive mesenchymal callus until remodeled. It was particularly prominent in the highly vasoformative regions and the pericallus encapsulation but not present in preexisting cortical and neoformed lamellar bone. The type II collagen, a marker of cartilage, was uniquely located only in areas of chondroid differentiation and calcification. Type II collagen was absent from all bone and was not identified beneath the repairing intact periosteum. The differentiating chondrocytes synthesized type II collagen on an underlayer of type III collagen already within the mesenchymal matrix. From these studies of genetically unique collagen markers, it appears that only in areas of motion or anoxia does an intermediate of chondroid tissue appear. The utilization of specific type II and type III collagen immunofluorescent antibodies has facilitated the understanding of the fracture repair process and has acted as an indicator for unique matrix components. PMID- 3525789 TI - The occurrence and clinicopathological significance of serotonin immunoreactive cells in large bowel carcinoma. AB - We studied the incidence, clinicopathological relevance and prognostic significance of serotonin immunoreactive cells in a clinically well-documented series of 300 large bowel cancer patients. Serotonin immunoreactive cells were detected in 8 per cent of the carcinomas, occurring either as focal clusters (4.7 per cent) or as occasional single cells (3.3 per cent). Both types frequently displayed presence of mucin and/or immunoreactivity for secretory component as well. In respect of localization, stage or tumour extension and histological grade tumours with serotonin immunoreactivity showed no significant differences in comparison with carcinomas lacking this feature. In terms of survival, however, the tumours with serotonin immunoreactivity demonstrated a more aggressive clinical course in comparison with tumours without these cells. This phenomenon reached borderline statistical significance. It is therefore concluded that the study of serotonin immunoreactivity in large bowel carcinomas enables the identification of a subpopulation of colorectal carcinomas with a relatively poor prognosis. PMID- 3525788 TI - Ion concentration effects on the zeta potential of bone. AB - Stressed bone generates an electrical potential, the sign of which reverses in the presence of specific concentrations of sodium, potassium, or calcium ions. A study was designed to test the hypotheses, drawn from stress-generated potential (SGP) studies, that the reversal in polarity of the zeta potential of bone is the cause of this SGP polarity reversal. The zeta potential of bone particles, prepared from fresh bovine metatarsals as homogeneous 5 microns dispersions, was measured by free-fluid electrophoresis in different concentrations of sodium chloride. The zeta potential of bone particles reversed sign at a sodium ion concentration that was the same as that found to reverse measured SGPs, namely 0.74 molar. This finding is consistent with the hypothesis that streaming potentials are the cause of SGPs in fluid-saturated bone. It was possible to obtain electrophoretic mobility histograms, and hence zeta-potential histograms, of bone particles by using a Pen Kem, Inc. (Bedford Hills, NY, U.S.A.) "3000" Automated Electrokinetic Analyzer. At sodium ion concentrations at which bone particles were nearly neutral, the zeta-potential histograms indicated a broad distribution of particle charge, with some particles being negative, some positive, and some neutral. In addition, it was found that particles prepared from Formalin-fixed bone produced the same electrokinetic results as those prepared from fresh bone, and that the addition of MOPS buffer caused the zeta potential to invert sign from negative to positive values at ion concentrations exceeding 3.0 molar. PMID- 3525790 TI - The narcotics we indulge in. Part II. By James F. W. Johnston. 1853. PMID- 3525791 TI - Hemolytic uremic syndrome and diarrhea associated with Escherichia coli O157:H7 in a day care center. AB - Three cases of hemolytic uremic syndrome with bloody diarrhea occurred during an outbreak of diarrheal illness in children aged 4 months to 9 years who attended a day care center. Thirty-six (34%) of 107 had diarrhea (three or more loose or watery stools in 24 hours) lasting greater than or equal to 3 days. Thirty-one (48%) of 64 children younger than 4 years of age but only (12%) of 43 in the older classes became ill (relative risk 4.0, P less than 0.001). Eleven (31%) of the 36 children with diarrhea had blood in their stools. Sequential movement of illness from class to class was consistent with person-to-person spread. Ten (18%) of 56 family members of ill children but only one of 45 family members of well children younger than 4 years of age developed a diarrheal illness (P less than 0.05). Escherichia coli O157:H7 was detected in two of eight stool specimens from children who had bloody diarrhea (one with hemolytic uremic syndrome), two of seven with nonbloody diarrhea, and none of nine who remained well. All three stool specimens obtained at less than or equal to 6 days compared with one of nine obtained at greater than 6 days after onset yielded this organism (P less than 0.02). E. coli O157:H7 can cause hemolytic uremic syndrome and both nonbloody and bloody diarrhea, and can spread within families and through modes other than foodborne transmission. PMID- 3525792 TI - Research advances in pediatric rheumatic diseases: of mice, stress, and data sets. PMID- 3525793 TI - Indomethacin for prevention of intraventricular hemorrhage. PMID- 3525794 TI - Systematics of species referred to the genus Angiostrongylus. AB - Based on morphological criteria of the male bursa, angiostrongylid nematodes often placed in the genus Angiostrongylus Kamensky (1905) were found to be heterogeneous, comprising species which are relegated to 5 distinct genera: Angiostrongylus Kamensky, 1905 (syn. Haemostrongylus Railliet and Henry, 1907); Parastrongylus Baylis, 1928 (syn. Pulmonema Chen, 1935, Rattostrongylus Schulz, 1951, Morerastrongylus Chabaud, 1972, Chabaudistrongylus Kontrimavichus and Delyamure, 1979); Angiocaulus Schulz, Orlov and Kutass, 1933; Gallegostrongylus Mas-Coma, 1977 (syn. Thaistrongylus Ohbayashi, Kamiya and Bhaibulaya, 1979 n. syn); and Stefanskostrongylus Drozdz, 1970. These genera all contain species located primarily in specific host groups: Angiostrongylus in carnivores; Parastrongylus in rodents (Muridae), Angiocaulus in mustelids; Rodentocaulus in rodents (Cricetinae), Gallegostrongylus in rodents (Muridae), and Stefanskostrongylus in insectivores. Species in each genus include: Angiostrongylus (A. vasorum, A. raillieti, A. chabaudi); Parastrongylus (P. tateronae, P. cantonensis, P. mackerrasae, P. sandarsae, P. sciuri, P. petrowi n. comb., P. dujardini, P. schmidti, P. costaricensis n. comb., P. malaysiensis n. comb., P. ryjikovi n. comb., P. siamensis n. comb.); Angiocaulus (A. gubernaculatus, A. ten n. comb., A. sp. Caballero, 1951); Rodentocaulus (R. ondatrae) and Gallegostrongylus (G. ibicensis, G. andersoni, G. harinasutai n. comb.). Angiostrongylus pulmonalis is likely similar to Stefanskostrongylus soricis and is transferred to this genus. Angiostrongylus minutus is removed to Stefanskostrongylus. PMID- 3525795 TI - Purification and characterization of a neutrophil chemotactic factor from Dirofilaria immitis. AB - A neutrophil chemotactic factor (NCF-Di) was purified from a crude extract of Dirofilaria immitis adult worm by a combination of anion-exchange chromatography on DE52 and gel filtration on Sephacryl S-200. NCF-Di showed a single protein band by both polyacrylamide gel electrophoresis (PAGE) and sodium dodecyl sulfate (SDS) PAGE. The molecular weight of NCF-Di was estimated to be 17,000 by gel filtration on Sephadex G-150, and 14,000 by SDS-PAGE. NCF-Di was an acidic protein with isoelectric point of 4.5. NCF-Di was absorbed neither to lentil lectin-Sepharose nor to concanavalin A-Sepharose. The chemotactic activity of NCF Di was heat labile (56 C, 1 hr), but was resistant to periodate oxidation. These results suggest that NCF-Di is a simple peptide which has few or no sugar chains. These physicochemical properties of NCF-Di were compared to previously reported parasite-derived chemoattractants or purified allergen of D. immitis. PMID- 3525796 TI - Toxoplasma gondii antibodies in cats: detection by indirect hemagglutination and indirect fluorescent antibody tests. PMID- 3525797 TI - A method for the study of sporocyst demography during schistosome development. PMID- 3525798 TI - Development of digestive motor patterns during perinatal life: mechanism and significance. PMID- 3525800 TI - Fetal sacrococcygeal teratoma. AB - Sacrococcygeal teratoma (SCT) is being diagnosed before birth with increasing frequency. We were recently consulted about management of a 22-week fetus with SCT and reviewed our experience (6 cases) and the literature. We found that most fetal SCT present from 22 to 34 weeks gestation with a uterus enlarged by the tumor and/or associated polyhydramnios; although the American Academy of Pediatrics Surgical Section clinical classification is an important prognostic indicator in neonatal SCT, it does not appear to predict outcome in fetal SCT; associated chromosomal abnormalities or life threatening anomalies are rare; presentation after 30-weeks gestation is a relatively good prognostic sign with fetal survival, after planned cesarean delivery, in 6 of 8 cases; and hydrops and/or placentomegaly in association with fetal SCT predicts fetal demise soon after diagnosis with 7 of 7 cases dying in utero. PMID- 3525799 TI - Bethanechol for pediatric gastroesophageal reflux: a prospective, blind, controlled study. AB - To investigate the effect of bethanechol on postprandial gastroesophageal reflux in children, and the relationship between its effect on the lower esophageal sphincter pressure and its effect on reflux, we studied 31 consecutive children with pathologic reflux, using manometry and pH probe, both before and after administration of bethanechol. The initial sphincter pressure was subnormal in only 35% of the patients. The bethanechol-treated sphincter pressure was increased in 97% of the patients (from 13.4 +/- 1.3 to 34.1 +/- 2.6 mm Hg) and was normal in 97% of the patients, yet bethanechol did not improve any measure of postprandial reflux in the patient group as a whole. Furthermore, the 20 patients with normal sphincter pressures had significant worsening of their percent of postprandial time with reflux (from 21.8 +/- 5.3 to 33.8 +/- 6.0%, p = 0.009). Thus, this study demonstrates a failure of the acute administration of bethanechol to improve postprandial gastroesophageal reflux and raises the issue of whether the widespread use of bethanechol to treat reflux in children is appropriate. PMID- 3525801 TI - Cholelithiasis in infancy: resolution of gallstones in three of four infants. AB - Cholelithiasis in infancy is believed to be a rare finding. It is also held that all cholelithiasis in infancy has a predisposing factor such as hemolysis, prolonged fasting, congenital abnormality of the biliary tree, or the administration of TPN and is associated with severe morbidity and mortality. In the last three years, four infants at our hospital have been found on real-time ultrasonography to have gallstones. Their ages ranged from 3 weeks to 6 months. One patient had a hemolytic disease but the finding of cholelithiasis in the other three patients was incidental. A repeat sonogram in the infant with hemolysis three months after initial recognition and one day before scheduled cholecystectomy revealed spontaneous resolution of the gallstones. This led us to a conservative approach in the other three patients. Two more infants had spontaneous resolution of their gallstones and one child, now aged 16 months, is thriving with a persistent asymptomatic gallstone visible on sonogram. PMID- 3525802 TI - Can fetal and newborn allografts survive in an immunocompetent host? AB - This study explores methods of prolonging allograft survival by varying the ontogeny of the donor tissue (fetal, newborn, and adult), and the recipient (newborn and adult) in a series of outbred Sprague-Dawley rats. Allografts of renal or adrenal tissue (1 mm2) were implanted under the renal capsule of the recipient animal. Six experimental groups were constructed with the adult as the recipient in the first three, and four-to six-day-old newborn rat pups in the last three groups. A total of 212 animals were grafted and the animals were killed between 7 and 83 days later, and we carried out morphometric and histologic analyses of all grafts. In Group I (adult donor----adult host), all 17 grafts implanted for ten days or longer were completely rejected. In Group II, newborn tissue was implanted into 23 adults. By nine days after implantation, 17 grafts were fully rejected and the average graft had decreased in size by 68% +/- 78.7% (P less than .05 compared with their initial size). In contrast, when fetal renal or adrenal grafts were implanted into 93 adults (Group III) we saw a 17.6 +/- 9.7 fold increase in graft size when recipients were killed at least 7 days after implantation (P less than .05 compared with their initial size). When we used the newborn as a recipient, we found that all 20 adult grafts (Group IV) were rejected within 10 days. When newborn tissue was implanted into 15 newborns (Group V) all 15 animals rejected their grafts within ten days.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3525804 TI - Eikenella corrodens infections in children. AB - Techniques for obtaining, transporting, and culturing bacteriologic specimens have improved in recent years. The laboratory is now identifying rare fastidious organisms in surgical infections, which were previously unknown to clinicians. One of these organisms, Eikenella corrodens, was found in 28 children over 5 years. It was most commonly found in patients with perforated appendices or in wounds with oral contamination. Eikenella most often occurs in multibacterial infections but has also been grown in pure culture. When this bacteria is found in a patient with a serious surgical infection the wound must be widely opened and debrided of necrotic tissue. Prolonged antibiotic therapy based on culture and sensitivity is necessary to prevent prolonged or recurrent infection. PMID- 3525803 TI - Major duodenal injuries in children: diagnosis, operative management, and outcome. AB - The diagnosis, treatment, and outcome of ten children less than 13 years old operated on for major duodenal injuries is reviewed. Three had gun shot wounds with perforation and seven had blunt trauma resulting in duodenal disruption. Of those with blunt trauma, three had massive injuries requiring immediate operation, and four had what appeared to be lesser injuries. The symptoms of those children with lesser injuries were initially vague and delayed in onset, resulting in a delay of 24 hours to 7 days from time of injury to admission. At the time of admission, all four had tenderness localized to the right lower quadrant and an unclear preoperative diagnosis. Eight had associated injuries, most commonly to the pancreas. The single death occurred within 48 hours of injury and was the result of an associated head injury. The surviving nine patients left the hospital between the 11th and 22nd postoperative day doing well. One patient with a transected pancreas and extensive duodenal injury underwent a pancreaticoduodenectomy with a Whipple type reconstruction. Two patients with an extensive blowout injury to the duodenum and one with a crush injury to the pancreas underwent a pyloric exclusion and gastrojejunostomy. These patients did well with no fistula formation. The remaining seven children underwent debridement and primary closure of the duodenal injury. Four developed fistulae; however, two were pancreatic, one was jejunal, and only one was duodenal. All drained less than 250 mL per 24 hours and all except the jejunal fistula were closed by the 17th postoperative day. All were supported nutritionally either intravenously or more recently with a jejunal catheter placed at operation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3525805 TI - Results of levatorplasty for anal incontinence. AB - Since the introduction of the levatorplasty, 44 patients were operated upon for anal incontinence on our service. In 31 patients, a levatorplasty was performed. The selection of the levatorplasty as operative procedure was based on the availability of a functional levator as demonstrated by physical examination, anorectal manometry, and defecography. The 31 patients ranged from infancy to 76 years of age and 30 of them were followed up to 7 years with an average of 3 years. In 18 patients with fecal incontinence following operative procedures for anorectal malformations, satisfactory continence was restored in 8, improvement was found in 6, and 4 patients remain incontinent. In 13 patients with incontinence following operative procedures or trauma, the postoperative results were satisfactory in 9 patients, 2 improved, and 2 failed. The review showed that the levatorplasty was most successful in patients in whom the revised but normally innervated levator replaces a destroyed external sphincter in the presence of an intact internal sphincter. Only one half of all patients with major incontinence following an operative procedure for anorectal malformations had an adequate levator that allowed successful restoration of function. The review showed that the levatorplasty can improve or restore anal continence in a variety of conditions in properly selected patients. PMID- 3525806 TI - Accuracy of an average ultrasonic laboratory in measurements of fetal biparietal diameter, head circumference and abdominal circumference. AB - Twenty patients between 14 and 28 gestational weeks were scanned on three occasions during a single day by six operators with different ultrasonic experience (three use a compound scanner and three a real-time equipment). On each occasion every operator had to measure in a "blind" manner the fetal biparietal diameter (BPD), head circumference and abdominal circumference (HC and AC); a coded copy of head and abdominal circumference was subsequently measured by one of the members of the staff. Statistical analysis was carried out on the 1800 measurements, and it was concluded that the accuracy was not dissimilar from that reported by pilot studies. The reproducibility of the parameters studied did not change throughout pregnancy and real-time and compound scanner yielded homogeneous results. PMID- 3525807 TI - Neonatal jitteriness of unknown origin and circulating catecholamines. AB - Jitteriness is a common problem affecting neonates. Although the cause can sometimes be determined by history or conventional laboratory evaluations, nevertheless, in many instances the cause of the jitteriness is unknown. To determine if either intracranial hemorrhage (ICH) or elevated catecholamines are responsible for jitteriness in neonates, we studied 34 healthy term neonates with normal hematocrits, serum glucose, Ca, Mg, Na, K and P. Thirteen of the infants had jitteriness as their only clinical problem. There were no differences in Apgar scores, birthweight, or gestational age in the two groups. Norepinephrine levels were significantly elevated in the jittery group as compared to the control group: 1276 +/- 574 vs. 914 +/- 338, p less than 0.05. Epinephrine levels were not different in the two groups. Intracranial hemorrhage was not found in any of the patients. Jittery neonates have increased sympathetic activity. What influence the increased levels have on other metabolic and hormonal systems is yet to be determined. PMID- 3525808 TI - Hydrops fetalis. PMID- 3525809 TI - Antenatal prevention of the neonatal respiratory distress syndrome: benefits and potential risks for the mother and the infant. PMID- 3525810 TI - Localization of fibronectin in gingival connective tissue of the beagle dog. Ultrastructural detection with ferritin and peroxidase-conjugated antibodies. AB - Ferritin and peroxidase-conjugated antibodies were used in an indirect antibody method to localize fibronectin in gingival connective tissues. Fibronectin was found in the basal lamina beneath the epithelium and endothelium. Collagen fibrils associated with the basement membranes were also heavily coated by fibronectin. Amorphous patches of fibronectin were found adjacent to the plasma membrane of epithelial cells as well as free in the interepithelial spaces. Fibronectin was present throughout the connective tissue in close association with individual collagen fibrils, apparently serving as an interfibrillar cementing substance. Patches of fibronectin were located at the cell surface of fibroblasts, plasma cells, lymphocytes, endothelial cells, smooth muscle cells, and neutrophils. These amorphous patches were observed to connect adjacent cells across narrow spaces and to connect cells to collagen fibrils. The heavy labeling for fibronectin visualized by fluorescent microscopy around gingival blood vessels (Cho et al., 1985) can be accounted for by a heavy coating of fibronectin on the collagen fibrils and basal laminas associated with endothelial cells, as well as by the presence of abundant deposits of fibronectin along the cell membranes of endothelial cells and in the intercellular spaces of the vessel wall. PMID- 3525811 TI - [Studies on the constituents in the roots of Cassia obtusifolia L. and the antimicrobial activities of constituents of the roots and the seeds]. PMID- 3525812 TI - [Application of the sandwich enzyme immunoassay for determination of batroxobin in various animal plasma]. PMID- 3525813 TI - [Metabolic fate of batroxobin in human]. PMID- 3525814 TI - Oxidation of naphthalene by Saccharomyces cerevisiae and Candida utilis. AB - The yeasts Saccharomyces cerevisiae 118 and Candida utilis 128 were examined for their ability to metabolize the polycyclic aromatic hydrocarbons naphthalene and anthracene. The two yeasts tested oxidized these aromatics. Metabolites were extracted and analyzed by thin layer chromatography and gas chromatography. The predominant oxidation product of naphthalene found in the culture medium was 1 naphthol. PMID- 3525815 TI - Polymerized phospholipid vesicles containing amphotericin B: evaluation of toxic and antifungal activities in vitro. AB - We have prepared lipid vesicles (liposomes) composed of polymerized bis[12 (methacryloyloxy)dodecanoyl]-L-alpha-phosphatidylcholine (DPL) which contain the antifungal polyene antibiotic amphotericin B (AMB). It was necessary to devise a novel method for incorporating AMB into the liposomes subsequent to polymerization. The polymer liposome AMB was as effective as AMB in "conventional" liposomes in terms of inhibiting fungal growth in vitro. However, in contrast to "conventional" liposomes, the polymerized DPL vesicles did not protect mammalian cells against AMB induced toxicity. PMID- 3525817 TI - Hypnosis for children and adolescents with cancer: an annotated bibliography 1960 1985. PMID- 3525818 TI - Influence of insulin on urinary eicosanoid excretion in rats with experimental diabetes mellitus. AB - Urinary prostaglandin (PG) and thromboxane (Tx) excretion, measured by radioimmunoassay, were examined in two groups of male Wistar rats made diabetic with streptozotocin, 70 mg/kg, one of which received daily insulin beginning on the 7th day after administration of streptozotocin. In addition, urinary kallikrein excretion and blood pressure were monitored. After the induction of diabetes the profile of urinary eicosanoid excretion was altered. 6-keto-PGF1 alpha and TxB2 excretion increased markedly within 24 to 48 hr and remained elevated for the duration of the study, up to 58 days. PGF2 alpha excretion also increased, the change being apparent after 6 days whereas PGE2 excretion was reduced at this time. Urinary kallikrein excretion was unchanged but blood pressure became elevated above control levels 2 weeks after the induction of diabetes. Insulin treatment, to maintain mean blood glucose levels below 200 mg/dl, resulted in decreased excretion of TxB2, PGF2 alpha and 6-keto-PGF1 alpha. However, excretion of PGE2 and kallikrein were increased after insulin treatment which also prevented the elevation in blood pressure. These studies indicate that insulin treatment of experimental diabetes corrects alterations in renal arachidonic acid metabolism and prevents the associated increase in blood pressure. PMID- 3525819 TI - The biology of folate in depression: implications for nutritional hypotheses of the psychoses. AB - Folate deficiency is a common occurrence in psychiatric disorders, whether organic or functional, particularly in depressive illness. We have shown that folate deficiency is a common association of depressive symptoms in a variety of settings including primary endogenous or non-endogenous depression, and in alcoholic, lithium-treated and anorexic patients. Possible pathogenetic mediating mechanisms for this association are methylation and hydroxylation and the implications for nutritional hypotheses of the psychoses are discussed. We suggest that folate deficiency, with or without deficiencies of other nutritional factors such as monoamine precursors, vitamins B6, B12 and C, may predispose to or aggravate psychiatric disturbances, particularly depression and a model for these interactions is proposed. PMID- 3525816 TI - A guide to ultrasonic pachymeters. AB - An ongoing study of ultrasonic pachymeters has been carried out to determine the accuracy, reproducibility, and ease of operation of currently available ultrasonic pachymeters. Side-by-side evaluation was done to determine interobserver variation and a number of other factors. The results to date are summarized as a guide. PMID- 3525820 TI - Flow cytometric analysis of immunoglobulin and complement component C3 on the surface of Trypanosoma lewisi. AB - We have reinvestigated whether surface immunoglobulin (sIg) on Trypanosoma lewisi is antibody directed toward parasite antigen by using flow cytometry to analyze parasites stained with fluoresceinated F(ab')2 fragments of antibodies to rat IgG and IgM. We have confirmed that IgG antibody to the parasites is present both in the serum of rats and on the surface of parasites between the fourth and twentieth days of infection, that the amount of sIg per cell increases as the infection progresses, and that considerably more IgG is present on parasites harvested from intact rats than on those from rats that had been immunosuppressed by whole body gamma-irradiation. In addition sIgM was detected on trypanosomes from intact, but not on parasites from irradiated rats. We have also made two observations suggesting that not all sIg is specific antibody made in response to T. lewisi. First, a low but significant amount of sIgG was detected on parasites throughout infection in irradiated rats; no sIgM was detected on these parasite. Second, when parasites harvested from immunosuppressed rats were incubated in normal rat serum, the amount of both sIgG and sIgM detected by flow immunofluorescence increased. Parasites harvested from intact animals bound IgM but not IgG from normal rat serum. These results suggest either that natural antibody to the trypanosomes is present in the serum of uninfected rats or that some rat immunoglobulins bind to structures on the trypanosome surface in ways that do not depend on usual antigen-antibody interactions. Finally, flow immunofluorescence was also used to detect complement component C3 on the surface of both intact and trypsinized bloodstream forms harvested from intact or immunosuppressed rats. The amount of sC3 per cell did not increase until late in the infection and consequently did not correlate with the increase of sIgG. Therefore, T. lewisi avoids destruction by the immune system although immune effector molecules, IgG, IgM, and C3, are on its surface. PMID- 3525821 TI - Modern methods of diagnosis in liver disease. PMID- 3525822 TI - Aspergillus lung disease. PMID- 3525823 TI - Mayerne and his successors: some Huguenot physicians under the Stuarts. PMID- 3525824 TI - The Haslar crosslink: new within old. PMID- 3525825 TI - Devon Glorious Devon. PMID- 3525826 TI - Surgeon Lieutenant on leave--a day in Bath. PMID- 3525827 TI - The Hong Kong experience: management of locally entered personnel. PMID- 3525828 TI - Primary closure of maxillo-facial wounds. AB - In maxillo-facial wounds with soft tissue involvement, the most important object in the initial treatment is to secure primary closure without deformity, or, if that is not possible, primary epithelialisation of the raw surfaces. In addition to the early healing with minimal scar tissue which results, this allows further operative procedures to be carried out much earlier and under much simpler conditions than if healing had occurred by granulation and scarring. The operative technique adopted in a series of 304 patients in a maxillo-facial surgical unit in the BLA included meticulous toilet and excision of wound surfaces before closure by several different methods: when soft tissue loss was minimal, direct closure in layers was affected; when the soft tissue defect was too large for direct closure the wound was closed by either local flaps or skin to mucous membrane suture or skin grafting of the raw surface. Examples of these methods are shown. In a series of 165 cases in whom the immediate results have been personally observed or on whom reports have been received, 153 cases (93 per cent) have been completely successful, 10 cases (6 per cent) have had a partial breakdown of the wound, and two cases (1.2 per cent) have been complete failures. PMID- 3525829 TI - Stress self-help packages in primary care: a controlled trial evaluation. AB - A controlled trial study which examined the clinical effectiveness of a stress self-help package administered by general practitioners to patients presenting with psychological problems which were potentially stress-related is described. Patients were randomly allocated to one of two groups: existing general practitioner treatment with or without the use of the package. Significant advantages were found for patients who received the package compared with controls in both their level of symptoms at three-month follow-up and their rate of consulting for psychological problems in the three-month post-treatment period compared with the three-month pre-treatment period. The potential use of such packages in the treatment of psychological problems in primary care is discussed. PMID- 3525830 TI - The morphological and molecular susceptibility of sheep and mouse zona pellucida to acrosin. AB - The effect of acrosin on the gross morphology and macromolecular constituents of the mouse and sheep zona pellucida has been examined by light microscopy and SDS PAGE following labelling of the zona with 125I. Ram and boar acrosin had similar effects on the sheep zona in that while there was no discernible alteration in the gross morphology of the investment it was proteolysed to the same limited extent by both enzymes; during 1 h major polypeptides of Mr 180,000 (present on the zona pellucida of eggs but absent from that of oocytes) and 80,000 were hydrolysed, giving rise to polypeptides of Mr 68,000, 54,000 and 46,000, of which the last accumulated and represented the lowest molecular weight hydrolysis product. By contrast, the mouse zona pellucida was completely dissolved from the egg by ram acrosin and the investment's macromolecules were extensively hydrolysed. PMID- 3525831 TI - Preparation of a plasma membrane-rich fraction from rat spermatozoa. AB - Monoclonal antibodies to antigens located on surface and intracellular membranes of spermatozoa from the rat cauda epididymidis have been used as probes to assess the purity of putative plasma membrane fractions. Spermatozoa were demembranated by shearing forces generated on a vortex-mixer. Immunofluorescence and ultrastructural analysis of vortex-mixed spermatozoa showed that they were denuded of approximately 90% of surface membrane. Areas of acrosomal membranes were also removed. Crude plasma membranes were recovered in low-speed wash fluids and fractionated on a 13-23% Nycodenz density gradient. Three bands containing membrane vesicles were resolved. Absorption curves and direct binding assays using monoclonal antibodies specific for acrosomal membranes, mitochondrial membranes and fibrous sheath showed relatively strong binding to bands 1 and 2 but weak binding to band 3. Conversely a monoclonal antibody specific for a surface membrane antigen bound strongly to band 3 and weakly to bands 1 and 2. Identification on immunoblots of the antigens recognized by the monoclonal antibodies revealed that band 3 was positive for surface membrane antigens but gave no reaction for intracellular antigens. However, bands 1 and 2 were strongly positive for intracellular components. The results suggest that vortex-mixing is a simple and efficient means of removing the plasma membrane from spermatozoa and that a membrane fraction can be recovered from a Nycodenz density gradient that is enriched 40- to 50-fold in surface antigens. PMID- 3525832 TI - Culture of epithelial and stromal cells of guinea-pig endometrium and the effect of oestradiol-17 beta on the epithelial cells. AB - Epithelial and stromal cells of guinea-pig endometrium were separated by enzymic digestion, isolated by successive centrifugation, and maintained in culture as pure cell types for 5 days on growth medium. On Day 5, ultrastructural studies were performed on the two cell types, demonstrating that epithelial cells can grow as a monolayer composed of cohesive groups of polygonal cells (1.3 X 10(5) cells/cm2), while stromal cells were mostly fibroblastic. The effect of hormones was studied on the epithelial cells in culture. The monolayer was cultured into harvest medium for 3 days to ensure the complete removal of endogenous steroids, then these cells were incubated with 2 X 10(-9) M-oestradiol-17 beta for 3 days. There was a rise in the progesterone receptor level, varying from 1.3 to 10.8 times. The three enzymes known to interfere with oestradiol-17 beta metabolism were present in the epithelial cells grown in our culture conditions. By incubation with oestrone sulphate for 3 days it was demonstrated that, in cultured epithelial cells, oestrone sulphate is converted into oestradiol-17 beta sulphate, and oestrogen sulphates are hydrolysed to active oestrogens. PMID- 3525833 TI - Effect of porcine relaxin on the human umbilical artery. AB - Relaxin decreases human myometrial contractions in vitro; that effect is synergized by progesterone. We examined the effects of porcine relaxin on the contractility of isolated perfused human umbilical arterial strips in vitro. One experimental group received relaxin (1.5 micrograms/mL), the second received progesterone (500 ng/mL) plus relaxin, and the control strips received neither. Both resting and agonist-stimulated (KCl or serotonin) isometric tension were compared with profile analysis for all groups. Relaxin had no effect on either resting or agonist-stimulated tension either with or without progesterone. Neither higher concentrations of relaxin nor longer exposures altered contractility. Therefore, the human umbilical artery, unlike the cervix and myometrium, is not sensitive to porcine relaxin. Porcine relaxin could be used as a tocolytic or cervical ripening agent without adversely affecting fetal placental circulation. PMID- 3525834 TI - Detection of Chlamydia trachomatis using consecutive endocervical swabs. Prevalence in asymptomatic female adolescents and women attending a sexually transmitted disease clinic. AB - Chlamydia trachomatis is an organism commonly transmitted through sexual intercourse. In women it is associated with cervicitis, salpingitis, perihepatitis and infertility. Neonates born to infected women may have inclusion conjunctivitis and pneumonia due to this organism. Screening in obstetrics and in gynecology clinics is not usually performed routinely because of the cost and time involved in culturing the organism. A rapid enzyme immunoassay (EIA) kit (Chlamydiazyme, Abbott Laboratories) that can detect C. trachomatis was developed recently. Women belonging to two different cohorts were studied to determine whether multiple endocervical samples increased the likelihood of a positive result from this EIA kit. One cohort consisted of 70 asymptomatic, sexually active female adolescents from a local family planning clinic. The second cohort included 80 women who were seen at a sexually transmitted disease (STD) clinic. Both groups were assayed for Chlamydia infections using the rapid EIA kit. Positive test results were found in 7 of the 70 asymptomatic teenagers (10%) and 12 of the 80 women from the STD clinic (15%). No significant differences were noted in the order of the positive swabs in either group, although more of the earlier swabs tended to be positive. PMID- 3525835 TI - Antepartum ultrasonographic evaluation and management of placental chorioangioma. A case report. AB - Chorioangiomas are usually small and found by careful sectioning of the placenta. In recent years ultrasonography has been used in antenatal diagnosis. Multiple and large tumors (greater than 5 cm) are associated with increases in fetal morbidity and mortality. We treated a woman who had severe polyhydramnios and a large chorioangioma with vascular channels in the tumor confirmed by Doppler studies. Daily fetal breathing was used to monitor fetal well-being. PMID- 3525836 TI - B-mode ultrasound evaluation of skin thickness in progressive systemic sclerosis. AB - B-mode ultrasound scanning was studied as a noninvasive means of determining skin thickness in the extremities of patients with progressive systemic sclerosis. Skin thickness determined by ultrasonic scanning was compared with skin thickness determined by an established radiographic technique. A high degree of correlation was observed between measurements made by these techniques. Our studies suggest a potential application of B-mode ultrasound in the diagnosis and serial evaluation of patients with progressive systemic sclerosis. PMID- 3525837 TI - Gout of the rich and famous. AB - A number of sources on the subject of gout, and particularly its role in history, were consulted. Highlights are presented to illustrate popular conceptions of the social implications of gout. It is indicated that the consequences of this affliction may be disastrous to empires, yet are not always viewed as entirely negative for individual sufferers. PMID- 3525838 TI - The efficacy of diflunisal in osteoarthritis of the knee: an extended study. PMID- 3525839 TI - Streptonigrin. 1. Structure-activity relationships among simple bicyclic analogues. Rate dependence of DNA degradation on quinone reduction potential. AB - A series of simple aza and diaza bicyclic quinones related to the AB ring system of streptonigrin (1) have been synthesized and tested in vitro for their ability to degrade DNA under conditions similar to those used with the parent drug. The results obtained from a study of 22 quinones indicate that there is a quantitative linear relationship between their reduction potentials and the rate at which they degrade DNA under identical conditions in vitro. Almost all of the synthetic substances were superior to 1 in their DNA-degrading ability. PMID- 3525840 TI - Biochemical studies on tick embryogenesis: lipovitellin and protease activity in Dermacentor andersoni (Acari: Ixodidae). PMID- 3525842 TI - Increased detection of polymicrobial septicaemia by repeat subculture. AB - Repeated subcultures were performed on 572 blood cultures that had yielded single significant organisms and 55 from which contaminants had grown. This yielded 83 more isolates from 71 patients. Only one of the contaminated blood cultures yielded a further significant isolate. Additional antibiotic therapy was indicated in only six patients. Although repeated subculture increased the detection of additional isolates, it did not help in the management of most patients. PMID- 3525841 TI - The nature and role of mucosal damage in relation to Salmonella typhimurium induced fluid secretion in the rabbit ileum. AB - The time course and nature of mucosal damage induced in rabbit ileal loops by two strains of Salmonella typhimurium (TML and W118) isolated from human infections was assessed by immunofluorescence microscopy and by scanning and transmission electronmicroscopy. Salmonella-induced fluid secretion occurred in the presence or absence of gross mucosal architectural damage. Neither strain caused mucosal ulceration. When damage did occur, the villi were shortened by loss of their tip regions with concomitant reforming of an intact mucosal surface. Immediately preceding the onset of fluid secretion, marked infiltration of the mucosa with polymorphonuclear leukocytes and occasional macrophages was seen. This revives an earlier suggestion that interaction between invading salmonellae and acute inflammatory cells may be an important factor in initiation of fluid secretion. Brush-border invasion by salmonellae cannot per se be the immediate cause of fluid secretion, because the latter occurred several hours after initial invasion. PMID- 3525843 TI - A case of nonimmune hydrops fetalis with a rare cardiac anomaly in a rhesus monkey. AB - A case of nonimmune hydrops fetalis in a rhesus monkey was identified by ultrasound. The 68-day fetus exhibited generalized edema, pleural effusion, and mild ascites. Intrauterine fetal demise occurred between 75 and 80 days gestation. Necropsy revealed marked anasarca and a rare cardiac anomaly characterized by aortic and left atrioventricular valve atresia, hypoplasia of the ascending aorta and arch, and absence of the left ventricle. PMID- 3525844 TI - Mississippi physician participation in Medicaid. PMID- 3525845 TI - Morphogenesis of f1 filamentous bacteriophage. Increased expression of gene I inhibits bacterial growth. AB - We have cloned the gene I sequence of the filamentous bacteriophage f1 downstream from the lambda leftward promoter on a plasmid that also contains the temperature sensitive lambda repressor, cI857. Temperature induction of gene I protein (pI) resulted in rapid cessation of growth. This inhibition appears to involve a rapid decrease in synthesis of host protein and RNA. The ability of pI to cause this inhibition is not dependent on thioredoxin, a host factor that is necessary for phage morphogenesis and has been shown by genetic data to interact with pI. The inhibition does not appear to be mediated by the amino half of the protein, as induction of an identical plasmid construction of an amber mutant positioned two thirds along gene I, does not affect cell growth. Analysis of the transcription products from the cloned gene I confirmed previous suggestions that a transcription terminator exists in the amino-terminal portion of the gene. In addition, there is no detectable promoter activity in the 152 bases immediately upstream from the gene. These data and the inability to overproduce pI argue for down-regulation of pI production. Radioactive labeling of proteins in maxi-cells and normal Escherichia coli cells identifies pI as a protein of about 39,000 Mr that partitions with the cell envelope. Pulse-chase experiments suggest that pI is not processed to any appreciable extent. PMID- 3525846 TI - Information content of binding sites on nucleotide sequences. AB - Repressors, polymerases, ribosomes and other macromolecules bind to specific nucleic acid sequences. They can find a binding site only if the sequence has a recognizable pattern. We define a measure of the information (R sequence) in the sequence patterns at binding sites. It allows one to investigate how information is distributed across the sites and to compare one site to another. One can also calculate the amount of information (R frequency) that would be required to locate the sites, given that they occur with some frequency in the genome. Several Escherichia coli binding sites were analyzed using these two independent empirical measurements. The two amounts of information are similar for most of the sites we analyzed. In contrast, bacteriophage T7 RNA polymerase binding sites contain about twice as much information as is necessary for recognition by the T7 polymerase, suggesting that a second protein may bind at T7 promoters. The extra information can be accounted for by a strong symmetry element found at the T7 promoters. This element may be an operator. If this model is correct, these promoters and operators do not share much information. The comparisons between R sequence and R frequency suggest that the information at binding sites is just sufficient for the sites to be distinguished from the rest of the genome. PMID- 3525847 TI - Cell surface exposure of the outer membrane protein OmpA of Escherichia coli K 12. AB - The 325-residue OmpA protein is one of the major outer membrane proteins of Escherichia coli K-12. A model, in which this protein crosses the membrane eight times in an antiparallel beta-sheet conformation and in which regions around amino acids 25, 70, 110 and 154 are exposed at the cell surface, had been proposed. Linkers were inserted into the ompA gene with the result that OmpA proteins, carrying non-OmpA sequences between residues 153 and 154 or 160 and 162, were synthesized. Intact cells possessing these proteins were treated with proteases. Insertion of 15 residues between residues 153 and 154 made the protein sensitive to proteinase K and the sizes of the two cleavage products were those expected following proteolysis at the area of the insertion. Addition of at least 17 residues between residues 160 and 162 left the protein completely refractory to protease action. Thus, the former area is cell surface exposed while the latter area appears not to be. The insertions did not cause a decrease in the concentration of the hybrid proteins as compared to that of the OmpA protein, and in neither case was synthesis of the protein deleterious to cell growth. It is suggested that this method may serve to carry peptides of practical interest to the cell surface and that it can be used to probe surface-located regions of other membrane proteins. PMID- 3525848 TI - Constraints on codon context in Escherichia coli genes. Their possible role in modulating the efficiency of translation. AB - The constraints on nucleotide sequences of highly and weakly expressed genes from Escherichia coli have been analysed and compared. Differences in synonymous codon spectra in highly and weakly expressed genes lead to different frequencies of nucleotides (in the first and third codon positions) and dinucleotides in the two groups of genes. It has been found that the choice of synonymous codons in highly expressed genes depends on the nucleotides adjacent to the codon. For example, lysine is preferably encoded by the AAA codon if guanosine is 3' to the lysine codon (AAA-G, P less than 10(-9)). And, on the contrary, AAG is used more often than AAA (P less than 0.001) if cytidine is 3' adjacent to lysine. Guanosine occurs more frequently than adenosine 5' to all the lysine codons (AAR, P less than 10(-5), i.e. NNG codons are preferred over the synonymous NNA codons 5' to the positions of lysine in the genes. The context effect was observed in nonsense and missense suppression experiments. Therefore, a hypothesis has been suggested that the efficiency of translation of some codons (for which the constraints on the adjacent nucleotides were found) can be modulated by the codon context. The rules for preferable synonymous codon choice in highly expressed genes depending on the nucleotides surrounding the codon are presented. These rules can be used in the chemical synthesis of genes designed for expression in E. coli. PMID- 3525849 TI - H4 histone messenger RNA decay in cell-free extracts initiates at or near the 3' terminus and proceeds 3' to 5'. AB - The relative decay of four human messenger RNAs, gamma globin, delta globin, c myc and H4 histone, were compared in a cell-free system. Under appropriate conditions, they are degraded in vitro in approximately the same relative order as in vivo: histone faster than c-myc and delta globin faster than gamma globin. Degradation of polysome-associated H4 histone mRNA and of deproteinized histone mRNA begins at or near the 3' terminus. At least a portion of the mRNA then continues to be degraded in a 3' to 5' direction. Discrete 3'-terminal degradation hold-up points are observed, suggesting that 3' to 5' degradation occurs non-uniformly. Cycloheximide and puromycin inhibit protein synthesis but do not affect the rate or directionality of histone mRNA decay in vitro. We conclude that the rate-limiting step in H4 histone mRNA decay occurs at or near the 3' terminus and that at least a portion of the mRNA molecule is subsequently degraded 3' to 5', probably via a processive exonuclease. PMID- 3525850 TI - Alterations in the baroreceptor reflex control of heart rate in streptozotocin diabetic rats. AB - Baroreflex control of heart rate was studied in conscious diabetic rats at 12, 24 and 48 weeks after the induction of diabetes with streptozotocin. Baseline blood pressure (mean arterial blood pressure) of diabetic rats was significantly lower at 12 weeks after the induction of diabetes when compared to age-matched control rats. However, at 24 and 48 weeks of diabetes, no difference in blood pressure was observed between diabetic and age-matched control rats. In contrast, bradycardia (prolongation of pulse interval) was a consistent feature of diabetic rats at all time points (12, 24, and 48 weeks). To assess parasympathetic control of heart rate, baroreceptor sensitivity was determined by infusing phenylephrine. Baroreflexes in diabetic rats were changed from an increased sensitivity at 12 and 24 weeks to decreased sensitivity at 48 weeks after the induction of diabetes. This suggests that alterations in baroreflex sensitivity might depend upon the length of time the animals were exposed to the diabetes. Insulin treatment in diabetic animals reversed hypotension, bradycardia and altered baroreflex sensitivity observed in 12-week diabetic rats. Non-diabetic rats, in which the development of diabetes was prevented by pretreatment with 3-0 methylglucose before streptozotocin injection, or rats which did not develop diabetes after streptozotocin injection showed a similar baseline blood pressure, heart rate and baroreflex sensitivity to those of age-matched control rats (12, 24 and 48 weeks). This data suggests that changes in blood pressure, heart rate and baroreflex sensitivity are due to the diabetic state, not to streptozotocin toxicity. PMID- 3525852 TI - Review of the biodistribution and toxicity of the insect repellent N,N-diethyl-m toluamide (DEET). AB - A review of the biodistribution and toxicity of the insect repellent N,N-diethyl m-toluamide (DEET) is presented. Workers using repellent containing this compound may be exposed to greater than 442 g in 6 mo. In human studies, variable penetration into the skin of from 9 to 56% of a topically applied dose and absorption into the circulatory system of approximately 17% have been reported. Excretion of DEET by humans was initially rapid but not as complete as in animal models. Only about one-half of the absorbed DEET was excreted by humans over 5 d. Depot storage of DEET in the skin was also documented. Skin irritant effects, including scarring bullous dermatitis in humans, were reported. One animal study that reported embryotoxicity could not be confirmed by other investigators. The limited testing for mutagenicity and carcinogenicity provided negative results. Neurotoxic effects were observed in workers exposed to 4 g or more per week. Six young girls developed encephalopathies after exposure to unspecified amounts of DEET ranging from small to massive doses. Three of these girls later died. The cause of their death has not been resolved. Because of the lack of information, further research into the absorption, carcinogenicity, and neurotoxic effects is needed. PMID- 3525851 TI - Update in cancer chemotherapy: gastrointestinal cancer, cancer of the pancreas. AB - An update of the state of the art of cancer chemotherapeutic treatment of gastrointestinal tract cancer is described in this multiple-part series. A review of cancers of the colon, rectum, and anus was published in the April and May issues of the Journal. In this section, cancer of the pancreas and its treatment with surgery, radiation therapy, chemotherapy, and adjuvant chemotherapy are discussed. PMID- 3525853 TI - The child and exercise: an overview. AB - In this paper the complex topic of 'the child and exercise' is approached from a multidisciplinary angle. Research concerned with effects of exercise on growth and development is reviewed. In spite of traditional beliefs, there is not enough evidence to support the view that regular and intense physical training promotes an increase in body size, nor is there any physiological evidence that severe training has any harmful effect on the body. Exercise capacity and aerobic power increase gradually throughout childhood. Investigations have shown that children aged 10 years or younger do not react with an increased VO2 max as one would expect from endurance activities. The trainability of endurance seems to depend on the biological maturity level of growing children. After puberty the effects of endurance training are similar to those reported for adults. Just how much physical activity is necessary or optimal during the growing years is not known because individual variation is great. Even fewer results are available on the trainability of anaerobic capacity. The trainability of other factors such as strength, speed, flexibility and coordination is amply discussed. Finally some thoughts are given to young female athletes, both early and late maturers, with respect to their sport performance and expectancies. PMID- 3525854 TI - The amino-terminal domain of the v-fms oncogene product includes a functional signal peptide that directs synthesis of a transforming glycoprotein in the absence of feline leukemia virus gag sequences. AB - The nucleotide sequence of a 5' segment of the human genomic c-fms proto-oncogene suggested that recombination between feline leukemia virus and feline c-fms sequences might have occurred in a region encoding the 5' untranslated portion of c-fms mRNA. The polyprotein precursor gP180gag-fms encoded by the McDonough strain of feline sarcoma virus was therefore predicted to contain 34 v-fms-coded amino acids derived from sequences of the c-fms gene that are not ordinarily translated from the proto-oncogene mRNA. The (gP180gag-fms) polyprotein was cotranslationally cleaved near the gag-fms junction to remove its gag gene-coded portion. Determination of the amino-terminal sequence of the resulting v-fms coded glycoprotein, gp120v-fms, showed that the site of proteolysis corresponded to a predicted signal peptidase cleavage site within the c-fms gene product. Together, these analyses suggested that the linked gag sequences may not be necessary for expression of a biologically active v-fms gene product. The gag-fms sequences of feline sarcoma virus strain McDonough and the v-fms sequences alone were inserted into a murine retroviral vector containing a neomycin resistance gene. Both constructs were biologically active when transfected into NIH 3T3 cells and produced morphologically transformed foci at equivalent efficiencies. When transfected into a cell line (psi 2) expressing complementary viral gene functions, G418-resistant (Neor) cells containing either of these vector DNAs produced high titers of transforming viruses. Analysis of proteins produced in cells containing the vector lacking gag gene sequences showed that gP180gag-fms was not synthesized, whereas normal levels of both immature gp120v-fms and mature gp140v-fms were detected. The glycoprotein was efficiently transported to the cell surface, and it retained wild-type tyrosine kinase activity. We conclude that a cryptic hydrophobic signal peptide sequence in v-fms was unmasked by gag deletion, thereby allowing the correct orientation and transport of the v-fms gene product within membranous organelles. It seems likely that the proteolytic cleavage of gP180gag-fms is mediated by signal peptidase and that the amino termini of gp140v-fms and the c-fms gene product are identical. PMID- 3525855 TI - Deletions in the N-terminal coding region of the v-sis gene: determination of the minimal transforming region. AB - The gene product of the v-sis gene is closely related to the B chain of platelet derived growth factor (PDGF). However, v-sis also encodes additional amino acids at its N and C termini, which are not represented in the sequence data of PDGF. We have constructed a series of N-terminal deletion mutants in the v-sis gene to define the minimum region required for transformation. These mutants were assayed for biological activity by using retroviral expression vectors which donate a signal sequence, required for translocation across the rough endoplasmic reticulum, to the mutant gene product. The minimal transforming region of the v sis gene product defined by this analysis has 15 residues missing at the N terminus when compared with the PDGF-B chain. There are only two residues separating the closest transforming and nontransforming gene products. Mutant gene products lacking both the basic dipeptide processing site and the N-linked glycosylation site were found to be biologically active, indicating the dispensability of those processing steps. These results delimit the minimal transforming region of the v-sis gene product to residues 127 through 214, a total of 21 residues smaller than the PDGF-B chain. PMID- 3525856 TI - Pyelovesicostomy as a form of urinary reconstruction in renal transplantation. AB - The development of ureteral obstruction or ureteral fistula formation in the renal transplant recipient usually requires surgical repair. This involves reconnecting the donor ureter to either the recipient ureter (ureteroureterostomy) or bladder (ureteroneocystostomy), or creating an anastomosis between the renal pelvis and recipient native ureter (pyeloureterostomy). Occasionally, the donor or recipient ureter is absent, necrotic or diseased so that a ureteroureterostomy, ureteroneocystostomy or pyeloureteral anastomosis cannot be performed. In 8 such cases we have performed a direct anastomosis between the donor renal pelvis and recipient bladder (pyelovesicostomy) with a followup of between 2 months and 11 years. In all 8 patients there has been no deterioration in renal function attributed to obstruction at the anastomotic site or to the free reflux between the bladder and renal pelvis. Because of the excellent short-term and long-term results of pyelovesicostomy, this procedure should be considered as an excellent alternative to pyeloureterostomy, ureteroureterostomy and ureteroneocystostomy in the reconstruction of the upper urinary tract of the renal transplant patient. PMID- 3525858 TI - Free graft patch 1-stage procedure to repair penile hypospadias unsuitable for the flip-flap procedure: indications and experience. AB - From January 1983 to December 1985, 14 procedures were performed in which a free graft of skin from either the foreskin or elsewhere was substituted for the flipped flap in the repair of hypospadias. This obviates the problem of thin skin below the urethral meatus, since a flipped flap in such a case will result in devascularization of the flap. Moderate chordee was not necessarily a contraindication to the use of this procedure, provided the chordee could be corrected without moving the meatus proximally. Cosmetic and functional results have been good, and there was only 1 urethral fistula. Nevertheless, because of the need for a scrotal flap of fat to prevent fistula formation and to ensure vascularization of the graft, and because of the availability of a vascularized flap from the foreskin in most cases, the free graft patch procedure is best reserved for cases in which the foreskin is either absent or deficient. PMID- 3525857 TI - A 20-year experience with vasovasostomy. AB - A total of 624 of 699 vasovasostomy patients was followed during the last 20 years. Better results were obtained when there was shorter duration of obstruction, bilateral straight vas-to-straight was anastomosis and bilateral presence of sperm in the vas fluid during vasovasostomy. Results of end-to-end and side-to-side macrosurgical anastomosis, as well as of 1-layer and 2-layer microsurgical anastomosis were similar. Macrosurgical success rates were 84 per cent for patency and 35 per cent for pregnancy in the 300 cases. Microsurgical success rates were 90 per cent for patency and 51 per cent for pregnancy in 324 cases. Failure of patency was caused mainly by anastomotic scar formation with sperm and suture granulomas. Failure of pregnancy was owing mainly to inadequate postoperative semen quality. PMID- 3525859 TI - Preputial calculus: a case report. AB - A preputial calculus developed postoperatively in a child with epispadias. Analysis of the pathophysiological development of this lesion and a review of the literature are presented. The inert subpreputial space may become calculogenic in the presence of phimosis and urinary stasis. PMID- 3525860 TI - Re: Preoperative evaluation of localized prostatic carcinoma by transrectal ultrasonography. PMID- 3525861 TI - The mechanism of human bladder tumor implantation in an in vitro model. AB - Implantation of tumor cells in the bladder following transurethral resection of superficial bladder tumors is believed to be one factor in the etiology of bladder tumor recurrences. Using an in vitro model system we have studied the initial interaction between bladder carcinoma cells and a naturally produced basement membrane-like substrate. Minced explants of superficial low grade human bladder tumors from 10 patients were plated into culture dishes coated with a naturally produced extracellular matrix (ECM). This ECM has been shown to resemble the human urothelial basement membrane and submucosa in its macromolecular composition and ultrastructural appearance. It was found that a firm attachment of the human bladder tumor cells occurred within one hour, reached a maximal value within 24 hours and was followed by flattening and proliferation of the plated cells. These results indicate that prevention of tumor implantation should be initiated in the first hour after transurethral resection of the bladder tumors. This assay can be used for the investigation of various treatments to prevent tumor implantation. PMID- 3525862 TI - Current status of chemotherapy sensitivity testing for urological malignancies. PMID- 3525863 TI - Magnetic resonance imaging of the renal mass. AB - To compare the effectiveness of magnetic resonance imaging with that of excretory urography, retrograde pyelography, ultrasound, computerized tomography, angiography and venography 34 patients with renal masses, including 25 renal cell carcinomas, were examined on a 0.15 Tesla Picker 1100 magnetic resonance imager with multiple pulse sequences. Pathological proof was available for all cases except renal cysts, for which ultrasound or computerized tomographic findings were accepted. Differentiation of solid from cystic lesions was seen with magnetic resonance imaging, ultrasound and computerized tomography but not excretory urography. Tumor invasion of the renal vein and inferior vena cava was visualized in 7 patients by magnetic resonance imaging, ultrasound, computerized tomography and venography but not by excretory urography. Magnetic resonance T1 contrast scans best characterized renal masses, with good resolution of metastatic lymphadenopathy and renal cysts. Scans showing T2 contrast were best for identification of pseudocapsules in renal carcinoma, venous invasion by tumors and papillary adenocarcinoma. Advantages of magnetic resonance imaging include differentiation of solid masses from benign cystic lesions, and identification of major blood vessels and vascular invasion without administration of contrast medium. Disadvantages of magnetic resonance imaging are long imaging times and motion artifacts. Advances by the manufacturer in solving these problems will strengthen the role of magnetic resonance imaging in renal evaluation. PMID- 3525864 TI - Immunological assessment of renal cancer patients as evaluated by the lymphocyte adherence inhibition test. AB - The lymphocyte adherence inhibition test was used to evaluate tumor immunity toward 2 types of soluble renal cancer antigens extracted from 3 different renal cancer specimens. These extractions were accomplished with either 3 molar potassium chloride or 2.5 per cent butanol, and were tested in 23 patients with renal cancer, 8 with benign renal disease and 9 with bladder cancer. In 62 tests of lymphocyte adherence inhibition reactivities toward 3 molar potassium chloride in renal cancer patients the mean value of lymphocyte adherence inhibition reactivity (32.7 +/- 15.4 per cent) was significantly greater compared to that observed in 20 examinations in patients with benign renal disease (17.6 +/- 9.4 per cent, p less than 0.001) and 24 tests in bladder cancer patients (15.4 +/- 4.4 per cent, p less than 0.001). With a lymphocyte adherence inhibition index of greater than 20 per cent as a positive response, there were 50 true positive findings (81 per cent) in the renal cancer group, while the combined benign renal disease and bladder tumor groups had 34 true negative responses (77 per cent). With the butanol extract the mean lymphocyte adherence inhibition reactivity of the 62 tests done on renal cancer patients (38.9 +/- 10.8 per cent) was significantly greater than either control group (7.1 +/- 6.2 per cent, p less than 0.001 for benign renal disease and 5.9 +/- 2.6 per cent, p less than 0.001 for bladder tumor). Moreover, of 62 tests done on renal cancer patients 59 (95 per cent) had true positive responses, while 43 of the 44 tests (98 per cent) in the combined control group showed true negative findings. These results suggest that immune responses in renal cancer can be assessed with the lymphocyte adherence inhibition test, and they may be useful in the diagnosis and management of renal cancer patients. PMID- 3525865 TI - A new technique for creation of a cavernoglandular shunt in the treatment of priapism. AB - A new cavernoglandular shunt technique for the treatment of priapism is described. The shunt is created by use of a skin biopsy punch, which establishes a large and effective communication between the glans and corpus cavernosum, and provides efficient means of venous drainage from the corpora cavernosa. Since free communication exists between the corpora cavernosa through the median septum, the shunt is performed only on 1 side. However, if this method fails to resolve the problem the procedure is performed on the other side as well. This technique was performed successfully in 4 patients with satisfactory results. PMID- 3525866 TI - A comparison of the effect of diethylstilbestrol with low dose estramustine phosphate in the treatment of advanced prostatic cancer: final analysis of a phase III trial of the European Organization for Research on Treatment of Cancer. AB - In a randomized phase III trial performed by the Urological Group of the European Organization for Research on Treatment of Cancer low dose estramustine phosphate (280 mg. twice daily for 8 weeks and 140 mg. twice daily thereafter) was compared to diethylstilbestrol (1 mg. 3 times daily) in patients with stages T3 to T4, M0 or M1 prostatic cancer. Of 248 patients entered 227 were evaluable for analysis: 115 received estramustine phosphate and 112 received diethylstilbestrol. The best response of the local tumor as assessed by palpation was seen in patients receiving diethylstilbestrol. There was no significant difference between treatments for response rate of metastases, interval to local progression, distant progression, over-all survival and death of carcinoma of the prostate. Duration of survival was correlated with the assessment of local response as determined by palpation. The response of distant lesions also was correlated closely with survival. Diethylstilbestrol (1 mg. 3 times daily) was associated with a significantly worse degree of cardiovascular toxicity than estramustine phosphate. This finding was especially obvious in patients who had no history of cardiovascular disease. Gastrointestinal toxicity occurred in 25 patients treated with estramustine phosphate, including 6 in whom cessation of treatment was necessary. Further studies are required to determine the optimum dose of diethylstilbestrol and estramustine phosphate, and to establish the best form of hormonal treatment for prostatic carcinoma. PMID- 3525867 TI - Adrenal myelolipoma: report of diagnosis by fine needle aspiration. AB - We report 2 cases of adrenal myelolipoma. The diagnosis was suspected preoperatively in the first case on the basis of radiographic findings, ultrasonography and computerized tomography, and was confirmed by an operation. In the second case the diagnosis was established by fine needle biopsy. Computerized tomography and ultrasonography help in the preoperative diagnosis of myelolipoma but only fine needle biopsy can differentiate this lesion from a malignant neoplasm and avoid an operation. PMID- 3525868 TI - Routine prostatitis? A case report of long-term foreign body in the prostatic urethra. AB - We report a case of intermittent chronic prostatitis for 13 years. Evaluation revealed a foreign body of the prostatic urethra as the etiology of the symptoms. PMID- 3525869 TI - Re: Delayed diagnosis of voiding dysfunction: occult spinal dysrhaphism. PMID- 3525870 TI - Evaluation of the rat renal allograft model in comparison to man: a physiological perspective. AB - Fabre has previously questioned the rat kidney allograft model from an immunologic perspective and raised some important considerations. The present study addresses further the fidelity of the rat renal allograft model from a physiologic rather than immunologic perspective. We reviewed several rat renal allograft studies from several laboratories, including our own, that followed BUN or urea levels during renal failure. Also examined were several studies from the literature concerning patient survival and uremia. The percentage of patient and rat survival was plotted against maximal BUNs attained. The frequency of survival was significantly (p less than 0.05) increased in the rats by comparison to the patient population over a range of median BUNmax values. Additional human data that were utilized for analysis included a group of 16 patients who experienced renal failure and subsequently chose not to undergo dialysis. Comparing the mean BUN at death in rats from our laboratory to this patient population, we found that there was a significant difference (p less than 0.001, 292 +/- 142 mg./dl. versus 127 +/- 51 mg./dl., respectively). When all of the rat data was combined, including results from the literature, and compared to the patients, a significant (p less than 0.001) increase in BUN at death was confirmed (204 +/- 95 versus 127 +/- 51, respectively). We also found that 82% of the rats that died with uremia possessed BUNs greater than 200 mg./dl. at some time during their course. In contrast, only one of the 16 patients (6%) that died with uremia demonstrated BUN levels as great as this. Although the rats frequently (13%) went on to indefinite survival after experiencing high levels of uremia, the vast majority did not. We conclude that the rats exhibit superior ability to tolerate high concentrations of urea in comparison to man. However, as a group, they demonstrated little ability to sustain their uremic condition for prolonged periods. This latter consideration is of utmost importance, since most renal transplant studies base their conclusions on length of animal survival following organ allograft failure due to rejection. We feel this is a salient feature of the rat renal allograft model. PMID- 3525871 TI - The role of intravenous digital subtraction angiography in the evaluation of extracranial carotid artery disease. Can the decision for carotid artery surgery be made solely on the basis of its findings? AB - This retrospective study compared intravenous digital subtraction angiography (IV DSA) with conventional catheter angiography (CA) performed on 105 patients with suspected cerebrovascular disease. Comparisons were made considering CA as the "gold standard." Factors reviewed for correlation included carotid artery stenosis, ulceration, fibromuscular disease, vessel occlusion, and subclavian and intracranial lesions. Each IV-DSA was judged as to its quality. Eighty-seven patients (83%) had interpretable IV-DSA studies. IV-DSA differed from CA regarding stenosis on 46 carotid arteries (26%). Of 47 excellent quality IV-DSA studies, 18 (38%) were in disagreement with CA regarding stenosis. For the subcategory of patients having hemodynamically significant stenosis (greater than 50% luminal narrowing) according to CA, the sensitivity of IV-DSA was 85%. Specificity was 94% with an overall accuracy rate of 92%. The authors believe these high values are somewhat misleading. The IV-DSA interpretation of stenosis differed from CA in 32 of 48 patients (67%) in this group with a mean difference of 30%. IV-DSA identified 3 of 11 intracranial lesions (27%). Surgical therapy was modified in 13 of 87 patients (15%) on the basis of angiographic interpretation of carotid artery stenosis compared with IV-DSA. We conclude that IV-DSA should be used as a screening tool and the decision for carotid artery surgery made solely on its findings should be reached with the knowledge of its limitations and that any patient with hemispheric cerebral symptoms warrants CA as the first diagnostic examination. PMID- 3525872 TI - Intra-arterial digital subtraction angiography as a method to study peripheral vascular disease. AB - In many patients with peripheral vascular disease, conventional arteriograms are not adequate to make proper preoperative decisions. In the past, these inadequate studies led to surgical exploration of vessels and intraoperative angiography to determine operability. Such efforts prolonged operating time and potentially had adverse effects on amputation levels. Recently, intra-arterial digital subtraction angiography (IDSA) has provided an excellent means to further evaluate these patients preoperatively. We presently have 30 patients in whom IDSA supplemented routine aortography and runoff studies. When standard angiographic studies were considered inadequate, the catheter was positioned appropriately and IDSA was obtained. Inadequate lower extremity distal runoff in 23 patients and no proximal or distal runoff in seven patients prompted the IDSA. The IDSA study yielded further information on all patients, and 26 of 30 patients underwent successful bypass operation. In all 17 patients having femoropopliteal or femorotibial bypass, the IDSA was confirmed by an intraoperative (after bypass) angiogram. Nine patients had inflow procedures, and operative findings corroborated the IDSA. Two patients refused surgery and two patients were not candidates for revascularization. The IDSA study provided an accurate "road map," eliminated unnecessary vessel exploration, saved vital operative time, and prevented compromise of potential amputation levels. PMID- 3525873 TI - Serologic study on the prevalence of murine viruses in a population of wild meadow voles (Microtus pennsylvanicus). AB - The demography and serology of a population of wild meadow voles (Microtus pennsylvanicus) were monitored from 1982 to 1984 near Pinawa, Manitoba, Canada. Serologic tests were performed on 486 samples to detect the presence of viral antibodies to 11 common murine viruses. Meadow voles showed evidence of infection with Theiler's encephalomyelitis, reovirus-type-3, ectromelia, lymphocytic choriomeningitis, adenovirus, and mouse hepatitis viruses. At times of good survival and breeding performance the population was nearly free of evidence of viral infection. During a period of severe mortality in the winter of 1982-1983, evidence of infection by Theiler's encephalomyelitis virus and reovirus-type-3 was obtained. A high prevalence of antibodies and high titers to these two viruses were characteristic of voles that were captured late in the decline in density in the spring of 1983. This association of mortality with a viral outbreak is consistent with the hypothesis that vole population declines are sometimes related to opportunistic pathogens present in the voles' biotic and social environment. PMID- 3525874 TI - Salmonella spp. in nestling common barn-owls (Tyto alba) from southwestern New Jersey. AB - The prevalence of Salmonella spp. in nestling common barn-owls was investigated in southwestern New Jersey during the summer of 1985. Of 94 owls sampled by swabbing the cloaca, eight (8.5%) were found to harbor Salmonella spp. Three serotypes--S. thompson, S. tuindorp, and S. typhimurium--were identified. Five (20%) of the 25 nest sites examined (all of them in or near farm buildings or dwellings) contained Salmonella-positive owls. PMID- 3525875 TI - Starting insulin treatment as an outpatient. Report of 100 consecutive patients followed up for at least one year. AB - Most textbooks advise that newly diagnosed insulin-dependent diabetics be admitted to the hospital. Nevertheless, if they are not acutely ill, we start insulin treatment on an outpatient basis. We report herein the logistics, efficacy, and safety of our system. Over two years, 115 newly diagnosed insulin dependent diabetics were seen in our hospital. Fifteen (66% of them ketoacidotic) were admitted. The other 100 were treated as outpatients by a nurse specialist with a starting dosage of 6 to 10 units of intermediate-acting insulin twice daily. Hemoglobin A1 concentration at diagnosis was 15.2% +/- 2.7% (mean +/- SD); at six months, 10.9% +/- 2.9%; and at one year, 10.6% +/- 2.8%. Only three outpatient starters were hospitalized in the first year, one for hypoglycemia and two with respiratory tract infections. Our findings suggest that outpatient stabilization is both safe and cost-effective. PMID- 3525876 TI - Diagnostic imaging in pediatric renal inflammatory disease. PMID- 3525877 TI - Lasers in medicine and surgery. Council on Scientific Affairs. AB - Clinical applications have been found for lasers in a number of medical and surgical specialties. New applications in current areas of use and extension of laser technology to other medical and surgical specialties will continue to occur as investigational uses are pursued. Lasers produce medical and surgical effects in target tissues by heating them to the point of coagulation or vaporization, by ionizing molecular tissue, and by inducing photochemical effects through a mediating photosensitizer. Increased ability to transmit certain laser beams via fiber optics further extends areas of clinical application. Laser safety programs are essential to safeguard physician operators, ancillary personnel, and patients. Federal regulation, under two laws, deals with the laser radiation safety of devices and controls to ensure that devices reaching the market are reasonably safe and effective for their intended use. PMID- 3525878 TI - Medical control. Quality assurance in prehospital care. AB - Medical control is an essential component of a prehospital care system. It is a method of ensuring quality and accountability of the care provided and thus provides a method of risk management for the system. Politicians, fire departments, ambulance companies, physicians, and others are struggling for control of prehospital emergency care. Unless physicians are willing to become involved and provide leadership for prehospital care, it will be impossible to establish quality care. Physician input must be involved throughout planning, implementation, and evaluation of an EMS system. It is mandatory that physicians experienced in emergency care of the acutely ill or injured patient direct all medical aspects of the prehospital care system and provide ongoing review of the system. Medical control includes three phases: prospective, immediate, and retrospective. The incorporation of medical control in a specific EMS system will be dependent on that system's characteristics; nevertheless, proper medical control is essential to ensure a high quality of prehospital care. Further studies will be necessary to evaluate medical control and determine the best mechanism for providing quality assurance in prehospital care. PMID- 3525879 TI - From the National Institutes of Health. PMID- 3525880 TI - Adjuvant chemotherapy for breast cancer. A pooled estimate based on published randomized control trials. AB - The use of adjuvant chemotherapy for treating patients with operable breast cancer remains a worldwide controversy. Using the data from published randomized control trials with a minimum two-year follow-up, pooled estimates of relapse free survival rates and overall survival rates were calculated. Relapse-free survival rates were improved by 12.5% (95% confidence interval [CI] +/- 4.5%) at three years and by 8% (CI +/- 6%) at five years, with studies using multiple agents showing a greater effect. A significant advantage was also present in overall survival rates at three years, but only for studies involving multiple agents (4% +/- 3.5%). Results from combining data for other types of trials were inconclusive. The use of this method is presented to illustrate its value as an explicit and systematic one for combining data from several randomized control trials in assessing a therapeutic controversy. PMID- 3525881 TI - Enhanced responses to pressor stimuli by intracerebroventricular infusions of angiotensin II in conscious rats. AB - Effects of the intracerebroventricular (IVT) infusion of a subpressor dose (3 ng/kg/min) of angiotensin II (ang II) on the pressor responses to intravenous (IV) infusions of ang II and to IV bolus injections of norepinephrine (NE) were studied in conscious rats. This study was undertaken to determine whether activations of the brain renin-angiotensin system alter pressor responsiveness to IV infusions of ang II and IV injections of NE in the conscious state. Pressor responses to IV infusions of ang II and IV injections of NE were potentiated by the concurrent IVT infusion of the subpressor dose of ang II. Plasma renin activity (PRA), plasma corticosterone (B), and plasma prolactin concentration (PRL) were also measured before and during the IVT infusion of the subpressor (3 ng/kg/min) or the pressor (50 ng/kg/min) dose of ang II in order to determine the mechanisms for this pressor hyperresponsiveness to vasoconstrictor substances. The IVT subpressor dose of ang II increased PRA, but did not significantly change B and PRL. The IVT pressor dose of ang II decreased PRA and increased B, but did not significantly change PRL. These results suggest that the brain renin angiotensin system plays an important role in pressor responsiveness to IV ang II and NE. Although the mechanisms are not fully understood, pressor hyperresponsiveness to IV ang II and NE by an intracerebroventricularly administered subpressor dose of ang II may be related to increased sympathetic outflow, because of the increment in PRA. PMID- 3525883 TI - [A double blind comparative study on the efficacy of S6472, cefaclor and amoxicillin, in the treatment of bacterial pneumonia]. AB - The S6472 is a 4:6 mixture of 2 types of granules of cefaclor (CCL) coated with different films; one type of granules is soluble at low pH's and absorbed in the stomach while the other type is soluble at high pH's and absorbed in the intestine. The difference in absorption sites makes it possible to maintain blood concentrations of the drug at clinically efficient levels for a longer period of time compared with ordinary CCL. The efficacy, safety and usefulness of S6472 in the treatment of bacterial pneumonia was compared with those of ordinary CCL and of amoxicillin (AMPC) by the blind method. The patients entered in this trial were those who had bacterial pneumonia or lung abscess and were 16 years or above of age. The S6472 was given orally for 14 days at a daily dose of 1,500 mg (750 mg each after breakfast and supper), CCL was given at a daily dose of 1,500 mg (500 mg each after every meal), and AMPC at 2,000 mg (500 mg each after every meal and at the bedtime). To make the study blind, placeboes were matched with the test drug so that patients in every treatment group took 4 doses per day. Out of a total of 195 patients thus treated, 179 patients (55 in S6472 group, 62 in CCL group and 62 in AMPC group) were adopted for the evaluation by committee members while 185 patients (58 in S6472 group, 63 in CCL group and 64 in AMPC group) by controllers. When clinical results of the 3 treatment groups were compared, no statistically significant differences were observed in efficacy rates (cure rates), incidences of side effects nor abnormal findings of laboratory tests. From these results of this trial, it is concluded that oral administration of 750 mg of S6472 twice a day (1,500 mg per day) is as effective and useful as that of 500 mg of ordinary CCL 3 times a day (1,500 mg per day) or 500 mg of AMPC 4 times a day (2,000 mg per day) in the treatment of bacterial pneumonia or lung abscess. PMID- 3525882 TI - [Augmentation by serrapeptase of tissue permeation by cefotiam]. AB - Cefotiam (CTM) is a new cephalosporin with a broad spectrum of activity against both Gram-positive and Gram-negative microorganisms. Cephalosporins are widely used for prophylaxis of infections in patients undergoing thoracotomy. Augmentation by serrapeptase on tissue permeation of CTM was examined in 35 thoracotomy patients with lung cancer. The subjects were divided into two groups according to the method of the administration of CTM. Group I consisted of 17 subjects, each of whom received a single dose of 2 g of CTM alone by an instillation for 30 minutes. Group II consisted of 18 subjects, each of whom received a combination of CTM and serrapeptase; serrapeptase was given 2 tablets (10 mg) each time for three times/day until the day before surgery, and then CTM was administered by the same procedure. The following results were obtained: Individual difference was observed for the permeation of CTM into tissues. Pathologic differences also affected the permeation. Nevertheless, the CTM levels in pulmonary tissues reached about a half of those in the blood in both the single dose group and the combination group, hence sufficient concentrations exceeding MIC80 for main microorganisms that caused infections in the lung were obtained. The concentrations of CTM in inflammatory tissues have showed lower levels than those of normal tissues in both CTM single dose and the combination groups. Decrease of blood flow volume may have contributed to the reduction in levels of CTM in the inflammatory tissues. The ratio of the concentration of the drug in pulmonary tissues to that in the blood was 29.1 +/- 2.5% in the single dose group, and 44.2 +/- 6.0% in the combination group, the latter showing quite a significant increase (P less than 0.05). Combined administrations of CTM and serrapeptase deserves more trials in the case when surgical treatments of the lung are performed. An antiinflammatory effect of serrapeptase in the respiratory system is expected, and in addition, the combined use of CTM and serrapeptase should stimulate permeation of the antibiotic into tissues. PMID- 3525884 TI - [Total number of bacteria and fungi as an index for human pollution at Syowa Station in Antarctica. 1. Special reference to the specimen collected by 18th Japanese Antarctic Research Expedition]. PMID- 3525885 TI - [Clinico-pathological study of thyroid carcinomas detected by mass screening]. AB - Ultrasound examination is a useful diagnostic procedure in mass screening for thyroid tumors. Between September 1983 and September 1985, we found many cases of nodular lesions in the thyroid, in which we frequently detected small carcinomas by echo-guided aspiration cytology. Nineteen thousand eight hundred twenty-four samples were examined, and echo-guided aspiration cytology was carried out in 1,169 persons, from which 115 positive cases were obtained. Seventy-four patients were operated upon, and 71 of them (96%) were found to have carcinomas, including 40 cases of small papillary carcinomas less than 10 mm in largest diameter. These small carcinomas were classified into four types histologically. Echogram patterns were different from each other and corresponded to histological types. Cytological figures of the small papillary carcinomas were also varied. PMID- 3525886 TI - [Hemostatic derangement in bone marrow transplantation]. PMID- 3525887 TI - [Bone marrow transplantation in the treatment of monosomy 7]. PMID- 3525888 TI - [Long-term survival in unmaintained remission after allogeneic bone marrow transplantation in the treatment of acute lymphoblastic leukemia. Report of a case]. PMID- 3525889 TI - [A successful case of Burkitt's lymphoma treated with allogeneic bone marrow transplantation]. PMID- 3525890 TI - [Genes on pituitary hormones]. PMID- 3525891 TI - [Chemical structure, biosynthesis and body distribution of the corticotropin releasing factor]. PMID- 3525892 TI - [Methods for the analysis of the corticotropin releasing factor]. PMID- 3525893 TI - [Gene organization and processing of pituitary growth hormone and prolactin]. PMID- 3525894 TI - [Biosynthesis of pituitary hormones--gene organization and processing- gonadotropins]. PMID- 3525895 TI - [Biosynthesis of pituitary hormones--gene organization and processing--posterior pituitary hormones]. PMID- 3525896 TI - [Progress in the synthesis of pituitary hormones--with special reference to genetic engineering]. PMID- 3525897 TI - [Morphology of pituitary neoplasms]. PMID- 3525898 TI - [Progress in diagnostic imaging of pituitary tumors]. PMID- 3525899 TI - [Hypopituitarism]. PMID- 3525900 TI - [Radioimmunodetection of cancer]. PMID- 3525902 TI - [Ultrasonic imaging of mammary gland diseases]. PMID- 3525901 TI - [High-frequency hyperthermia therapy of cancer]. PMID- 3525903 TI - [CT scan and ultrasonic evaluation of traumatic duodenal intramural hematoma in childhood]. PMID- 3525904 TI - [An attempt at endoscopic retrograde pancreatography by the digital subtraction technic]. PMID- 3525905 TI - [Immunohistochemical demonstration of desmin and vimentin in an arrector pili nevus]. PMID- 3525906 TI - Characteristics of fresh isolates of wild measles virus. AB - Characteristics of fresh isolates of wild measles virus were studied by immunofluorescence using monoclonal antibodies, SDS-polyacrylamide gel electrophoresis, and electron microscopy. By the immunofluorescence test, hemagglutinin, nucleocapsid-associated phosphorylated, and fusion proteins were found only in the cytoplasm of cells infected with the virus at a low passage level. Nucleocapsid (NP) and membrane (M) proteins were found in both the cytoplasm and nuclei. Since the M protein is present only in the cytoplasm of cells infected with the laboratory strain of measles virus, this intranuclear M protein may be specific to the wild virus. At an increased passage level, the intranuclear M protein became undetectable, but the NP protein was still present in the nuclei. SDS-polyacrylamide and electron microscopy showed that wild measles viruses were shown to have characteristics similar to those of laboratory strains. PMID- 3525907 TI - Density and distribution of Clostridium tetani in the soil. AB - Clostridium tetani or its toxin was recovered from a minute amount of soil samples collected on the surface of the ground of various places. C. tetani was recovered from 10% and tetanus toxin alone from another 1% of soil samples employing 1 mg of the soil. C. tetani or its toxin alone was recovered, employing 1 mg or more of soil, from the wet shores of ponds and rivers, fields and rice fields (85%), the yards of farmers and non-farmers (53%), school and hospital grounds (30%) and on the roadside (20%). Two tetanus patients were injured in their yards where 1 mg soil samples yielded C. tetani. 12 of 13 soil samples collected at the yard of one of these patients at 3 different times yielded C. tetani. C. tetani did not remain at the same place in the same quantity. It was isolated more readily from the soil samples collected on the surface of than deep in the ground. PMID- 3525908 TI - A case of donor-specific transfusion (DST) rejection with morphological similarity to acute glomerulonephritis. PMID- 3525909 TI - [Age and efficacy of calcium entry blocker in essential hypertension--double blind trial using nicardipine]. PMID- 3525910 TI - [CAI (Computer Assisted Instruction) system for arrhythmia using a simulation model of impulse formation and conduction system of the heart]. PMID- 3525911 TI - [Adhesive resins for dental use]. PMID- 3525912 TI - [Endoscopic laser holography]. PMID- 3525913 TI - [Transitions in midwifery functions. 13. Dr. Mitsuo Segi and maternal and child health care]. PMID- 3525914 TI - [The effects of PGI2 and PGI2 analogue (OP41483) on acute renal ischemia in rabbits]. PMID- 3525915 TI - [Studies on glucose intolerance in chronic renal failure--estimation of insulin sensitivity before and after introduction of hemodialysis]. PMID- 3525916 TI - [Exercise renography with two-time injection of 99mTc-DTPA at a short interval- deconvolution analysis in normal subjects and patients with essential hypertension]. PMID- 3525917 TI - [Trends in the progress of Japanese nuclear medicine and comparison with the European trends--with special reference to number of oral presentations at the annual meetings of the Japanese Society of Nuclear Medicine]. PMID- 3525918 TI - [Enzyme immunoassay (EIA)]. PMID- 3525919 TI - [Ultrasonic diagnosis of esophageal cancer]. PMID- 3525920 TI - [Nursing of a patient with esophageal cancer and postoperative pulmonary complications]. PMID- 3525921 TI - [History of the Industrial College and the problems in the school management]. PMID- 3525922 TI - [Planning of group practice in clinical training in public health nursing education: a study on the need of and possibilities in clinical training]. PMID- 3525923 TI - [History of the nursing school attached to Sakurai High School for Girls described in the records of U.S. Presbyterian Missions. 1. Founding of Sakurai High School for Girls and the lives of Maria T. True and Kajiko Yajima]. PMID- 3525924 TI - Baroreflex participation of cardiovascular response to E. coli endotoxin. AB - The purpose of this experiment was to evaluate the effects of the arterial baroreceptor buffering capacity on cardiovascular parameters during hypotension caused by E. coli endotoxin in anesthetized dogs. In the control group, mean blood pressure and cardiac output fell significantly from 104 +/- 10 mmHg to 63 +/- 7 mmHg and 1.17 +/- 0.16 l/min to 0.67 +/- 0.08 l/min, respectively, 60 min after intravenous injection of endotoxin (1 mg/kg). Central venous pressure also decreased significantly after the injection. Total peripheral resistance and portal vein pressure increased significantly immediately after the injection, and then returned toward baseline levels. The time course of changes in these five cardiovascular parameters after the injection of endotoxin was the same as that in dogs with sino-aortic denervation. Following the injection of endotoxin, stroke volume and left ventricular dP/dt fell significantly in both control and denervated dogs; however, these decreases in the denervated group were significantly greater. These findings suggest that the arterial baroreceptors may play a role in the poor compensatory response to hypotension induced by endotoxin, at least, in the cases of mean blood pressure, cardiac output, total peripheral resistance, central venous pressure, and portal vein pressure. PMID- 3525926 TI - [History of public health nursing under the National Health Insurance system: legislative measures and changes in nursing activities]. PMID- 3525925 TI - Dopamine release and presynaptic dopaminergic regulation in guinea pig spinal cord. AB - Using pharmacological approaches, we obtained evidence for the release of dopamine (DA) and its dopaminergic regulation in the guinea pig spinal cord. Electrical stimulation of the cord pieces increased the endogenous DA release and the efflux of [3H]dopamine [( 3H]DA) from tissues preloaded with [3H]DA. The evoked release of [3H]DA was current- and frequency-dependent and was prevented by tetrodotoxin (10(-6) M) or Ca2+-free medium containing EGTA (10(-4) M), while benztropine allowed a recovery of a more extensive amount of [3H]DA in the superfusing medium by inhibiting the reuptake process. The stimulated [3H]DA release was reduced by LY-171555, but not by SKF-38393 and 8-Br-cAMP. ( )Sulpiride enhanced the stimulated endogenous DA and [3H]DA release. (-)Sulpiride reversed the inhibition of evoked [3H]DA release induced by LY-171555, while SKF 38393 and 8-Br-cAMP did not affect LY-171555-induced inhibition of evoked [3H]DA release. These findings provide additional evidence for the neurotransmitter role of DA in the spinal cord of the guinea pig, and they strongly suggest the presence of presynaptic regulation of DA release via the dopamine receptor which is the D2 type. PMID- 3525927 TI - [Public health nurses under the National Health Insurance system: at the conclusion of their historical mission]. PMID- 3525928 TI - Improved outcome of renal transplantation with cyclosporine compared with azathioprine--experience in 33 recipients followed for over one year. AB - Long-term clinical aspects after kidney transplantation using cyclosporine (CsA) were studied in 33 patients who received kidney grafts from one haplotype identical living related donor and who were followed for at least one year. Both actual graft and patient survival rates were 97 per cent at one year. Incidence and severity of acute rejection were reduced to a greater extent in patients treated with CsA than in patients treated with azathioprine (AZ). The incidence of infections was low, and no serious bacterial infection occurred in these 33 patients. In 17 of 33 patients with a deteriorative graft function caused by intractable nephrotoxicity, CsA was converted to AZ. The mean serum creatinine level of converted patients was significantly higher than that of patients maintained with CsA at each time when a dose of CsA was stepwise reduced from 14 mg/kg/day to 6 mg/kg/day. Conversion to AZ improved graft function dramatically, although it resulted in reversible acute rejections in 4 patients. CsA induced hepatotoxicity occurred in 10 patients, but in all normal liver function was restored with decrease in the dose. The potent immunosuppressive effect of CsA compensates for its side effects. However, CsA should be converted to AZ when the chronic nephrotoxicity persists at a late stage of post-transplantation. PMID- 3525929 TI - Enhanced endotoxin clearance in reversed Eck fistula rats during a tolerant stage. AB - The effects of tolerance to Escherichia coli endotoxin on the clearance activity of the hepatic reticuloendothelial system was examined using the experimental animal model of the reversed Eck fistula (REF). Compared with clearance rate of 51Cr-labeled endotoxin in the normal REF-rat, in the tolerant reversed Eck fistula animals, there was three fold increase in the clearance of endotoxin in the liver. The enhanced endotoxin uptake of the hepatic reticuloendothelial system was observed when the medium containing serum from tolerant animals was infused into the non-tolerant liver with a Harvard pump before the clearance studies, using 51Cr-labeled endotoxin administered via the femoral vein. Heat treatment of tolerant serum at 56 degrees C for 45 min destroyed the enhancing effect. These results suggest that during endotoxin tolerance, humoral factors, particularly complement, play an important role in the uptake of endotoxin from portal vein blood. A direct stimulation of the hepatic reticuloendothelial system may also occur. PMID- 3525930 TI - [Characteristics of Candida albicans antigen in patients with bronchial asthma- statistical analysis]. PMID- 3525931 TI - [The role of prostaglandins on hypoxic pulmonary vasoconstriction in dogs- especially the role of PGI2]. PMID- 3525932 TI - [Serum lactic dehydrogenase activity and isoenzyme patterns following nephrolithotomy using one-layer interrupted parenchymal suture]. PMID- 3525933 TI - [Urological complications and management of congenital neurogenic bladder without meningomyelocele]. PMID- 3525934 TI - [Full-thickness skin graft urethroplasty]. PMID- 3525935 TI - [Immunological monitoring in renal transplantation. I. Fundamental study on lymphocyte electrophoresis]. PMID- 3525936 TI - [Immunological monitoring in renal transplantation. II. Lymphocyte electrophoretic test and lymphocyte subset analysis]. PMID- 3525937 TI - Combined ultrastructural and immunohistochemical studies on a mouse rhabdomyosarcoma. PMID- 3525938 TI - Use of echography in guinea pigs for pregnancy diagnosis. PMID- 3525939 TI - Meet a transplant coordinator. Interview by Gail Pisarcik Lenehan. PMID- 3525940 TI - The gift of life: organ donation and the emergency nurse. PMID- 3525941 TI - Injury: is it a health problem? PMID- 3525942 TI - A case for organ donation. PMID- 3525944 TI - Organ donation: an emergency nurse makes a difference. PMID- 3525943 TI - Organ donation: the challenge for emergency nursing. PMID- 3525945 TI - Recognition and nursing care of organ donors. PMID- 3525946 TI - Helping the family of the potential organ donor: crisis intervention and decision making. PMID- 3525947 TI - Jump-starting the heart: a current review of defibrillation techniques and equipment. PMID- 3525948 TI - Nursing diagnosis: an overview and application to emergency nursing. PMID- 3525949 TI - Prehospital tape reviews: improving attendance and quality. PMID- 3525950 TI - Cyclosporine. PMID- 3525951 TI - The patient's legal responsibility. PMID- 3525952 TI - Air transport guidelines for the neurologically impaired patient. PMID- 3525954 TI - How to report problems with medical products. PMID- 3525953 TI - Assessment of a child with asthma. PMID- 3525955 TI - Measuring ED patient satisfaction with a questionnaire. PMID- 3525956 TI - Basement membrane and the invasive activity of metastatic tumor cells. AB - Many, but not all, metastatic tumor cells have a similar phenotype. These are transformed cells with a high affinity for basement membranes and the ability to produce basement membrane degrading enzymes. Such characteristics help the cells traverse this critical barrier. Traversal may be a rather rare event unless the cells respond to local factors that amplify the numbers of cells recruited to the site and induce the cells to invade. These factors may include tissue-specific attractants and matrix molecules such as laminin. Understanding the specific steps involved in the invasion process should allow development of antimetastatic regimens directed at those activities specific to metastatic tumor cells. Due to the heterogeneity of tumor cells, other mechanisms for metastasis undoubtably exist. PMID- 3525957 TI - Histologic demonstration of antigens reactive with anti-p21 ras monoclonal antibody (RAP-5) in human stomach cancers. AB - The immunohistochemical reactivity of RAP-5, a monoclonal antibody (MoAb) raised against a synthetic peptide corresponding to positions 10-17 of the ras gene product from T24 bladder carcinoma, was studied in 96 surgically resected stomach cancers of humans. The cytoplasm of cancer cells in 65 cases (68%) was positively stained with MoAb RAP-5, although the staining was heterogeneous among cancer cells. There was no definite correlation between depth of tumor invasion and reactivity to MoAb RAP-5. Cancer cells of poorly differentiated tumors showed a tendency to react less frequently and less intensely to MoAb RAP-5. In nontumorous gastric mucosa, parietal cells and some portions of intestinal metaplasia were stained with MoAb RAP-5. These findings suggest an increased expression of the ras gene product (p21) in about two-thirds of gastric adenocarcinomas and in some nonneoplastic gastric epithelial cells. PMID- 3525958 TI - Reversal of tumor-induced biochemical abnormalities by insulin treatment in rats. AB - In F344 rats bearing transplantable 3-methylcholanthrene (CAS: 56-49-5)-induced sarcomas, plasma concentrations of immunoreactive insulin were decreased following the development of mild or severe anorexia. Plasma levels of immunoreactive glucagon and lactate were elevated in severely anorectic tumor bearing (TB) rats, while plasma glucose concentrations remained normal. Both groups of TB rats exhibited decreased plasma levels of serine, glutamine, citrulline, and tryptophan and increased concentrations of alanine. Plasma levels of proline and phenylalanine were also elevated in the severely anorectic TB rats. In a second experiment, 7 daily treatments with insulin corrected the anorexia for 6 days and increased body weights of TB rats. Plasma concentrations of lactate and immunoreactive glucagon were decreased, and the abnormal plasma concentrations of glutamine, proline, analine, and phenylalanine were altered toward normal following the insulin treatments. Therefore, these data are consistent with insulin treatments benefiting the TB host by increasing feeding, increasing body weight, reducing tumor glycolysis and metabolism, reducing gluconeogenesis, and reducing host catabolism, while not stimulating tumor growth. Thus insulin therapy may have potential benefits in cancer treatment by shifting glucose metabolism toward the host and away from the tumor. PMID- 3525959 TI - Hyperthermia in cancer therapy. PMID- 3525960 TI - [Actual condition and chemotherapy of extrapulmonary tuberculosis in national sanatoria. (An observation in intestinal tuberculosis and tuberculous peritonitis)--report of the B series of 26th controlled trials of chemotherapy. Cooperative Study Unit of Chemotherapy of Tuberculosis of National Sanatoria in Japan (CSUCTNS)]. PMID- 3525961 TI - [Studies on bactericidal effects of NaOH on mycobacteria. 2. Survival rates mycobacteria in sputum and in saline after pretreatment with NaOH solution]. PMID- 3525962 TI - [Basic lipoprotein metabolism reactions in the plasma]. PMID- 3525963 TI - [Experiences in determining C-reactive protein in neonatal infections]. PMID- 3525964 TI - [B streptococcal infection of the newborn infant]. PMID- 3525965 TI - [The role of N.I. Pirogov in the reorganization of the medical school clinics of Kiev University (on the centenary of the construction of the clinics)]. PMID- 3525966 TI - [Use of physical methods in the combined treatment of the residual pleural cavities following destructive pneumonias in children]. PMID- 3525967 TI - [Surgical treatment of external intestinal fistulae in children]. PMID- 3525968 TI - [Surgical treatment of Hirschsprung's disease by 1-stage resection of the colon with the application of a primary anastomosis]. PMID- 3525969 TI - [Perforated duodenal ulcer in a child with acute dysentery]. PMID- 3525970 TI - [Intraoperative echographic control over the radical extent of transurethral resection in bladder tumors]. PMID- 3525971 TI - [Echography and computed axial tomography in the diagnosis of bladder tumors]. PMID- 3525972 TI - [New developments in the immunosuppressive treatment of patients following a kidney transplant]. PMID- 3525973 TI - [Current aspects of the surgical treatment of peptic ulcer]. PMID- 3525974 TI - [Choice of the skin suture in abdominal operations]. PMID- 3525975 TI - [Factors interfering with the dexamethasone suppression test]. AB - The interpretation of the dexamethasone suppression test in endocrinology and psychiatry depends on several variables. False-positive results can be caused by stress, weight loss, alcohol withdrawal, treatment with diphenylhydantoin, phenobarbital, rifampicin, carbamazepine and lithium. Therapy with spironolactone, naloxone, alpha 1-mimetic agents and estrogen can be responsible for an increase in plasma-cortisol concentration. False-negative results are seen in patients with liver disease and can also result from therapy with benzodiazepines at high dosages, indomethacin and possibly methadone and ketoconazole. PMID- 3525976 TI - Antazoline as an adjuvant in immunosuppressive therapy in renal transplant patients. AB - The survival of transplanted cadaver kidneys was compared in a group of 33 first transplant patients treated with antazoline (Antistine) in addition to conventional immunosuppressive therapy (group A) and a group of 36 patients receiving immunosuppressive therapy only (group B). After 1 year, the transplant survival rate was 79% in group A as compared to 56% in group B (P less than 0.05). The difference which was still present after 2 and 5 years could not be attributed to any other factors that might have influenced the survival rate. Antazoline appears above all to diminish the intensity of moderately severe rejection episodes, which often lead to graft loss inducing a chronic type of rejection reaction. However, the frequency of rejection crises during the first 4 months and the percentages of patients without rejection or with primary irreversible rejection crises were practically the same in the two groups. The mechanism of action underlying this potentially important immunosuppressive effect of antazoline is as yet not clarified. PMID- 3525977 TI - [Immune complexes in allergies: evidence of IgE-containing immune complexes in Churg-Strauss vasculitis]. AB - In five patients with vasculitis, hypereosinophilia and elevated serum-IgE levels, the diagnosis of Churg-Strauss syndrome was established. To identify a possible role of IgE in pathogenic mechanisms leading to vasculitis, a sequential precipitation of patients' sera was performed using various concentrations of polyethylene glycol 6000 (PEG). Using a radioimmunosorbent test, the precipitates obtained were tested for their IgE contents. Considerable amounts of IgE were found in the serum precipitates of all patients. In parallel studies, no IgE containing precipitates were detected in sera from patients with different allergic diseases and high IgE serum levels. The demonstration of IgE-containing PEG precipitable material in all patients suffering from Churg-Strauss syndrome, together with the finding of an elevated C3d and C4 level and a decreased C3 level in one patient and an increased C3d level in a second patient, suggests that IgE-containing immune complexes play a pathogenic role in the Churg-Strauss syndrome. PMID- 3525978 TI - [Stages in the development of flight safety in aerospace medicine]. PMID- 3525979 TI - [Interlabyrinthine asymmetry, vestibular dysfunction and space motion sickness]. AB - The data available suggest that a disorder in the labyrinthine paired function can be regarded as a factor responsible for the initiation and development of space motion sickness. This concept is based on the assumption that in the norm the vestibular function is to a certain extent asymmetric which is made for by a compensatory center in the central nervous system. Exposure to an unusual space environment leads to a disorder of this compensation and development of a "new" vestibular asymmetry. This exposure involves: elimination of the difference in the weight of otolith membranes, disorder of the canal-otolith interaction, asymmetric blood-CSF changes, distinct interhemispheric asymmetry, general stress. Vestibular asymmetry that develops in the weightless state may become sufficient for the generalization of afferent impulsation to normal stimuli and development of a strong reaction. Adaptation to weightlessness occurs due to rearrangements of the compensatory center which are responsible for lower vestibular asymmetry. The compensatory mechanisms that have evolved in weightlessness continue to function during a certain time interval after recovery. They facilitate a re-initiation of vestibular asymmetry and motion sickness that is mainly provoked by head movements, as in the weightless state. PMID- 3525980 TI - [Space biology and medicine (on the 25th anniversary of the first space flight of Iuri Alekseevich Gagarin)]. PMID- 3525981 TI - [Interpretation of the kinetocardiogram of the right heart]. AB - On the basis of ultrasonic Doppler valvulocardiography of 20 healthy men and catheterization of the right heart of 15 patients with acute large-focal myocardial infarction, the development of elements of the right kinetocardiograms (KCGr) is explored. Comparison of kinetocardiograms of the right heart with ultrasonic and catheterization data has demonstrated that KCGr can be used to examine right heart contractions of cosmonauts and pilots in flight and on the ground as well as of patients to diagnose pathologies of the right compartments of the heart. PMID- 3525982 TI - Repeated Escherichia coli endotoxin-induced pulmonary inflammation causes chronic pulmonary hypertension in sheep. Structural and functional changes. AB - Chronic pulmonary hypertension occurs in several human diseases in which there is evidence of chronic or repeated bouts of pulmonary inflammation. To determine whether prolonged lung inflammation causes persistent pulmonary hypertension Escherichia coli endotoxin was given to seven chronically instrumented awake sheep three times a week for 10 to 14 weeks. Pulmonary artery, left atrial and systemic arterial pressures, cardiac output, arterial blood gases and pH were monitored before starting endotoxin treatment and twice weekly, immediately before endotoxin infusion. Three sheep receiving saline over a similar time period served as controls. Pulmonary vasoreactivity to breathing 12% oxygen and a bolus infusion of an analog of prostaglandin H2 was also assessed. Peripheral lung biopsy tissue was taken at baseline and at periods throughout the experiment to assess pulmonary inflammation. Repeated endotoxin infusions resulted in a significant increase in mean pulmonary artery pressure from the 8th week of treatment and more than a 50% increase from week 10 (baseline = 18.4 cm H2O +/- 1.0 (mean +/- SE); 10 weeks endotoxin = 27.8 +/- 4.3; p less than 0.05). Pulmonary vasoreactivity to both an analog of prostaglandin H2 and 12% oxygen decreased in the period from 4 to 8 weeks of endotoxin treatment. Light microscopic assessment of lung biopsy tissue showed a persistent four-fold increase above baseline in number of peripheral lung granulocytes. Electron microscopy revealed that granulocytes, lymphocytes, and monocytes sequestered in the lungs of these animals, and that structural damage to the endothelium was minimal. Morphometry of lungs obtained at autopsy in which the pulmonary arteries had been distended with barium-gelatin showed extension of muscle into the walls of smaller intra-acinar arteries (than normal) and a reduction in number of filled peripheral arteries. We conclude that repeated infusions of endotoxin into sheep cause persistent lung inflammation, altered pulmonary vasoreactivity, sustained pulmonary hypertension, and some of the structural changes characteristic of this disease. Chronic inflammation may play a role in the pathogenesis of chronic pulmonary hypertension. PMID- 3525983 TI - Paucity of beta 2-microglobulin expression on small cell lung cancer, bronchial carcinoids and certain other neuroendocrine tumors. AB - Cell lines established from small cell lung cancer (SCLC), a neuroendocrine tumor, have low or absent expression of class I major histocompatibility complex antigens. To determine whether this phenomenon occurs also in vivo, 244 routine paraffin-embedded tumors including 32 SCLC and 79 non-SCLC (NSCLC) lung cancers were studied for expression of beta 2-microglobulin (beta 2m) by an avidin-biotin coupled immunoperoxidase technique. The majority of SCLC tumors lacked beta 2m expression, while some had weak, focal expression. In contrast, most NSCLC expressed beta 2m, often strongly. The difference between SCLC and NSCLC was highly significant statistically, suggesting that beta 2m can be used as a clinical immunodiagnostic marker for distinguishing NSCLC from SCLC. In addition, certain other neuroendocrine tumors (neuroblastoma, bronchial and midgut carcinoid tumors) lacked beta 2m expression, whereas some (pheochromocytoma, medullary thyroid carcinoma, and peripheral neuroectodermal tumors) usually stained positively. Such non-neuroendocrine tumors as colon, breast, and prostate carcinomas showed moderate to high expression of beta 2m. Selective absence of beta 2m expression by certain neuroendocrine tumors appears to be a phenomenon of biological and diagnostic importance. PMID- 3525984 TI - Immune electron microscopy of hepatitis delta-antigen in hepatocytes. AB - Immune electron microscopic examination of hepatitis delta delta-antigen (HDAg) was carried out on liver biopsies from seven patients with chronic type B hepatitis and delta-infection. HDAg was mainly found in the nucleus, but in some scattered hepatocytes it was found in the cytoplasm also, either in association with ribosomes or in the hyaloplasm. The association of HDAg with ribosomes may be the result of translation from delta-messenger RNA on the same ribosomes. In the nucleus, delta-antigen was present in the chromatin area as irregular granular structures, and there was staining of aggregates of 20 to 30-nm particulate structures, similar to those first described in non-A, non-B hepatitis. However, similar particulate structures were also present in HDAg negative nuclei. The delta-particles which have been described in blood could not be identified in hepatocytes. PMID- 3525985 TI - The multitumor (sausage) tissue block: novel method for immunohistochemical antibody testing. AB - We describe a method of embedding 100 or more different tissue samples in a normal-sized paraffin block, the multitumor tissue block (MTTB). MTTBs allow the simultaneous immunohistologic testing of numerous tissue samples on a single slide with one drop of antibody. Because all of the tissue samples are treated equally during immunostaining, most sources of variation are removed and comparative studies are facilitated. MTTBs containing miscellaneous neoplasms are suitable for screening of hybridoma supernatants during the early phases of monoclonal antibody production. This permits economical and rapid screening for tissue-specific monoclonal antibodies and simultaneous selection of those that perform well in tissue sections. MTTBs are also useful for the routine monitoring of sensitivity in immunohistochemistry because they can be prepared to include tissues with a broad spectrum of antigen densities. Because a large number of nearly identical sections can be obtained from a single MTTB, these sections could be useful for large scale interlaboratory quality control studies. PMID- 3525986 TI - Flexibility of single-subject experimental designs. Part I: Review of the basics of single-subject designs. AB - The discussion in this article is directed at a brief review of the basic components of single-subject experimental designs. It sets out to present some of the technical and practical advantages in developing single-subject designs to evaluate potential treatment variables and treatments. The point is made that the designs are specifically structured for applied, intervention research. In addition to explaining how the basic AB components function to allow for a controlled evaluation, a short review is included of other factors important to the scientific method such as operational definitions, reliability, repeated measures, and internal and external validity. The article serves as a foundation for the following two articles that are directed at demonstrating the flexibility of single-subject experimental studies. PMID- 3525987 TI - Flexibility of single-subject experimental designs. Part II: Design selection and arrangement of experimental phases. AB - The purpose of this paper is to present a taxonomy of single-subject experimental designs and discuss relevant examples that underscore the versatility and flexibility of this approach to clinical research. The proposed taxonomy serves as a heuristic model that may facilitate an understanding of single-subject experimental designs. Four general evaluation strategies employed in applied research--treatment-no treatment comparison, component assessment, treatment treatment comparison, and successive level analysis--are discussed within this schema. Each of these evaluation strategies is related to commonly posed clinical research questions, and published examples of design options that address these questions are presented. Throughout the discussion basic considerations relating to appropriate design selection are reviewed. PMID- 3525988 TI - Flexibility of single-subject experimental designs. Part III: Using flexibility to design or modify experiments. AB - The purpose of this paper is to present clinical researchers with viable alternatives to basic, prototypical single-subject experimental designs. The availability of these alternatives is a product of the flexibility inherent in the application of these designs. Two general types of flexibility are discussed: a priori flexibility, as in combining designs in one study and ad hoc flexibility in which a design is modified during the course of a study. The flexibility afforded by the designs provides the opportunity to fashion individual experimental designs for specific research problems addressed. A review of the clinical research literature published during the last 10 years revealed that the flexibility of these designs has been underutilized. The benefits that can derive from using the potential flexibility of the designs are described, and specific suggestions are made for incorporating flexibility into clinical research. PMID- 3525989 TI - The academic surgeon as a clinical investigator. PMID- 3525990 TI - Elimination of mechanical failure of the Hickman right atrial catheter. AB - The double lumen Hickman right atrial catheter (Evermed Co., Palo Alto, Calif.) is usually inserted through an open venous cutdown into the internal jugular or cephalic vein. It is difficult to mechanically secure. Tight ligatures around the vein opening and catheter occlude the lumen of the Silastic rubber catheter while loose ligatures allow slippage. Migration of the tip into the vena cava or innominate vein causes fibrin sleeve formation and occlusion. Because of problems during the initial use of this catheter, we modified a subsequent series by placing a Silastic rubber bead on the catheter. The catheter is carefully trimmed so that the tip will lie in the right atrium and the bead is placed into the vein proximal to the securing ligature. Comparison of the two series of primarily leukemic patients revealed complete elimination of mechanical problems in patients with beaded catheters (0/18), and significant mechanical failure in unbeaded catheters (7/23). These data indicate that adequate fixation of the Hickman catheter at the level of the venotomy and placement of the tip in the right atrium eliminates mechanical failure and markedly improves catheter function. PMID- 3525991 TI - Mitochondrial death in sepsis: a failed concept. AB - The concept of early selective mitochondrial injury has been proposed to explain the global metabolic dysfunction observed in the septic state. A two phase study was undertaken to test the validity of this hypothesis. In the initial phase, an endotoxin shock model was employed in the rat to delineate the function of skeletal muscle mitochondria. Mitochondrial function was determined polarimetrically, comparing state three and state four rates, respiratory control index (RCI) and ADP:O ratios. No significant alteration in these parameters was observed in the endotoxic state. Phase II of the study was designed to investigate mitochondrial function in a bacterial peritonitis rat model. Both liver and skeletal muscle mitochondrial function were determined to control for possible alterations in liver metabolism. Neither muscle nor liver mitochondria exhibited functional impairment during sepsis. We conclude from this study that neither endotoxemia nor peritonitis selectively "kills" mitochondria as previously suggested. PMID- 3525992 TI - The syndrome of inappropriate antidiuretic hormone secretion associated with induction chemotherapy for squamous cell carcinoma of the head and neck. AB - Two patients with squamous cell carcinoma of the head and neck are reported in whom the syndrome of inappropriate antidiuretic hormone (SIADH) secretion occurred transiently during the rapid cytolytic phase of tumor destruction after chemotherapy with cis-platinum diamminedichloride and bleomycin. Immunoperoxidase staining for ADH of the original biopsy specimens from both patients was negative. Possible mechanisms for and the implications of the production of SIADH in this setting are discussed. PMID- 3525993 TI - Copy number amplification of the 2 micron circle plasmid of Saccharomyces cerevisiae. AB - The 2 micron circle is a small double stranded DNA plasmid that occurs at about 60 copies per cell in the nuclei of virtually all strains of Saccharomyces cerevisiae. The plasmid has no apparent phenotypic effect on host cells, and is the basis of many useful vectors for the transformation of yeast. Under certain circumstances, the plasmid is apparently able to replicate more than once per cell cycle; this over-replication allows the maintenance of the plasmid at high copy number. The plasmid has two inverted repeat sequences, and encodes a product that catalyses intra-molecular recombination between these two repeats. Models are proposed whereby recombination leads to copy number amplification. In particular, it is proposed that intra-molecular recombination during replication flips the orientation of one replication fork with respect to the other, so that both forks travel in the same direction around a circular monomer template, generating a large multimer from a monomer and a single initiation of replication. PMID- 3525994 TI - New York--a bellwether for thoracic surgery. PMID- 3525995 TI - Myocardial function after preservation for 24 hours. AB - The orthotopically transplanted heart undergoes several steps between harvest from the donor and reperfusion in the recipient: cardioplegic arrest and cooling, ischemia during the operation, in most cases a preservation or storage period of varying duration, and reperfusion. Each of these steps represents a period during which damage to the heart can occur. In this study we have quantified the degree of damage sustained by a donor heart during each of these steps. This objective was achieved by evaluating the function of rabbit hearts via Langendorff procedures following (Group 1) cooling and reperfusion; (Group 2) cardioplegic arrest, cooling, and reperfusion; (Group 3) arrest, cooling, 1 hour of ischemia (5 degrees or 25 degrees C), and reperfusion; (Group 4) arrest, cooling, 24 hours of preservation, and reperfusion; and (Group 5) arrest, cooling, 24 hours of preservation, 1 hour of ischemia (25 degrees C), and reperfusion. Comparisons were made between groups and to control hearts. Cooling and reperfusing the heart (Group 1) led to no loss of function, although recovery to precooling function levels required approximately 25 minutes. Hearts that were arrested before cooling (Group 2) regained full function without the slow recovery time. Hearts that were arrested, cooled, and made ischemic at 5 degrees C (Group 3) recovered 95% of preischemic contractile function: maximum systolic pressure and the maximum positive derivative of the systolic pressure curve. No change in diastolic compliance was detected. Hearts that were arrested, cooled, and made ischemic at 25 degrees C (Group 3) recovered 89% of preischemic contractile function (maximum systolic pressure and the maximum positive derivative of the systolic pressure curve). Again, no change in diastolic compliance was detected. Hearts that were arrested, cooled, preserved for 24 hours, and reperfused (Group 4) recovered 84% of control contractile function (maximum systolic pressure and the maximum positive derivative of the systolic pressure curve), whereas hearts that had the additional hour of ischemia at 25 degrees C (Group 5) recovered only 75% of control contractile function. In the latter two groups diastolic compliance was also compromised. Group 4 had a 20% decrease in the volume required to reach 10 mm Hg, and Group 5 had a 26% decrease. Pressure-volume curves suggest a loss of contractility and a loss of compliance in these hearts. These data indicate that while significant damage occurred as a result of ischemia and reperfusion, this damage was masked by the larger decrease in function occurring as a result of the preservation period. PMID- 3525996 TI - A synopsis of Chinese ancient therapeutic methods. PMID- 3525997 TI - Wang Shuhe, compiler of pulse classic. PMID- 3525998 TI - A monograph on acupuncture and moxibustion. PMID- 3525999 TI - Effects of codonopsis pilosula-astragalus injection on platelet aggregation and activity of PGI2-like substance. PMID- 3526000 TI - [Burnout phenomenon in the nursing profession and bibliography on factors responsible for its development]. PMID- 3526001 TI - The psychiatrist-patient privilege and third-party payers: Commonwealth v. Kobrin. PMID- 3526002 TI - The College I know. PMID- 3526003 TI - Has modern technology changed our concept of lymph formation? PMID- 3526004 TI - Effect of leukotrienes C4 and D4 on prostaglandin I2-liberation from human lymphatics. AB - Whereas prostaglandin I2 (PGI2), a major metabolite of human lymphatics, does not itself affect lymphatic contractility significantly, it is able to counterbalance the contractile response to thromboxane and leukotrienes. We now demonstrate that leukotrienes C4 and D4 evoke a dose-dependent increased production of PGI2 from human lymphatics. It is likely that leukotrienes either exert a contractile rhythmic effect on human lymphatics or, alternatively, evoke increased PGI2 formation which relaxes human lymphatics. These mechanisms may be of local importance in regulating lymphatic "tone" at sites of inflammation as leukotrienes are liberated from activated white blood cells. PMID- 3526006 TI - The effect of Medicaid on access to ambulatory mental health care for the poor and near-poor under 65. AB - Analysis of the National Medical Care Utilization and Expenditure Survey indicates that the poor/near-poor with continuous Medicaid coverage had almost double the probability of use of ambulatory mental health care compared with the poor/near-poor not enrolled in Medicaid. The higher probability of use reflects the impact of increased financial accessibility to needed mental health services and may also be influenced by an associated demand for social services provided by organized mental health settings in addition to clinical services. Intensity of use per user was not significantly different between Medicaid- and non Medicaid-enrolled poor/near-poor, but the percent paid out of pocket was substantially lower for those continuously in Medicaid. PMID- 3526005 TI - Evidence for the lack of lysosomal involvement in the age-related slowing of protein breakdown in Turbatrix aceti. AB - Lysosomal proteinase activity increases, whereas the rate of protein degradation decreases in the aged free-living nematode, Turbatrix aceti. The lysosomotropic agents, chloroquine and ammonium chloride have no effect on the rate of protein degradation in either young or old organisms. These findings lend strong support to the idea of a non-lysosomal site of endogenous protein degradation under basal metabolic conditions. PMID- 3526007 TI - Medicaid families under managed care. Anticipated behavior. AB - This study reports the results of a household survey of 495 Medicaid clients eligible under the Aid to Families with Dependent Children program in Monroe County, New York. The purpose of the study has been to examine the views and to anticipate the health care choices/decisions of Medicaid clients prior to their enrollment in a new, county-wide Medicaid-managed care program. The findings indicate significant ethnic differentials among the Medicaid poor, both in the choice of care source and in the reasons offered for that choice. Forty percent of those interviewed would like to change to a new source of care, but less than 13% can actually be expected to change. Private practice arrangements were the preferred source of care, yet distance to such sources appears to represent a major stumbling block to access. This study suggests that the managed-care approach being offered in Monroe County may offer the Medicaid eligibles a new stigma-free way of affiliating with a health care provider. This is being recognized by those surveyed as an important element. The study demonstrates that the choices made by the Medicaid recipients are perfectly rational given the recipients' knowledge of Medicaid and the health care system, and the general conditions in which they find themselves. These findings have important implications for the move of Medicaid programs from the fee-for-service to the managed-care/HMO system. PMID- 3526008 TI - Recent trends in pediatrician participation in Medicaid. AB - Many Medicaid policy changes occurred in recent years including those resulting from the Omnibus Budget Reconciliation Act of 1981 and the Tax Equity and Fiscal Responsibility Act of 1982. At the same time, the supply of providers increased and the health care market became more competitive. This paper presents evidence about how these developments are affecting pediatricians' participation in state Medicaid programs. Surveys conducted in 1978 (N = 814) and 1983 (N = 791) indicate that the proportion participating declined only slightly from 85.1% to 82.0%. The average Medicaid case load of participants remained at 15%, although extent of participation of individual pediatricians fluctuated. Previous research demonstrates that physicians' Medicaid participation is affected by reimbursement level, administrative complexity, and generosity of eligibility and benefits. Our data confirm these influences. However, the longitudinal design of the analyses reported here also captures shifts in the relative influence of these factors. The influence of policy factors has diminished over time, while the influence of changes in physician supply has increased. Increased physician supply, however, is associated with decreased Medicaid participation. Thus, diminished access to pediatric care for low-income children may result from recent changes in Medicaid and in the broader health care environment. PMID- 3526009 TI - [Salmonella enteritidis arteritis]. PMID- 3526010 TI - [Treatment of systemic lupus erythematosus (II)]. PMID- 3526011 TI - [DNA polymorphism and genetic diseases]. PMID- 3526012 TI - [Immediate recurrence of segmental and focal hyalinosis postrenal transplant]. PMID- 3526013 TI - [Legionella pneumophila cavitation pneumonia in a patient with renal transplant]. PMID- 3526014 TI - [Tropical splenomegaly syndrome or hyperreactive malarial splenomegaly]. PMID- 3526015 TI - [Cough induced by captopril]. PMID- 3526017 TI - [Magnesium metabolism and its disorders]. PMID- 3526016 TI - [Comparative study of beta 2-microglobulin and carcinoembryonic antigen in 93 cancer patients. Usefulness of the combined determination of both markers]. PMID- 3526018 TI - [Respiratory diseases and sterility]. PMID- 3526019 TI - [Continuing medical education today]. PMID- 3526020 TI - [Optimum time of insulin therapy in type I diabetes mellitus]. PMID- 3526021 TI - [Pulmonary toxicity caused by amiodarone]. PMID- 3526022 TI - [Chronic necrotizing pulmonary aspergillosis]. PMID- 3526023 TI - [Renal transplants and blood transfusions. Mechanisms of alloimmune enhancement]. PMID- 3526024 TI - [Importance of pregnancy and parturition in the psychomotor development of the child]. PMID- 3526025 TI - Acute gastrointestinal bleeding. AB - Acute gastrointestinal bleeding remains a major cause of morbidity and mortality. Recent diagnostic and therapeutic advances may play a significant role in the care of the bleeding patient. PMID- 3526027 TI - The advantage of modular software design in computerized ECG analysis. AB - In the early 1970s, modular software design was advocated as a means to obtain better structured and more reliable software systems. Such a modular approach was also introduced for computerized ECG processing in 1972. The TNO Modular ECG/VCG interpretation system was developed along these lines. During the last decade, the algorithms of this system were thoroughly improved and evaluated. This resulted in 1983 in a new version of this system named MEANS (Modular ECG ANalysis System). This paper outlines the ideas of the modular approach as they were originally defined in 1972 and developed over the years. The usefulness and advantages of these ideas will be discussed based on 12 years of experience. It appeared that modularity is the ideal approach to the development and maintenance of complex systems such as for ECG/VCG interpretation. PMID- 3526026 TI - Hematologic emergencies. AB - Hematologic emergencies require thorough but prompt evaluation of the patient, availability of relatively routine laboratory tests, and immediate decisions. This article discusses the emergencies associated with red blood cell disorders, white blood cell disorders, hemostatic disorders, and transfusion reactions. PMID- 3526028 TI - Historical and methodological aspects of computer-assisted medical history taking. AB - The purpose is to draw, in a historical perspective, the main outlines of a theoretical and methodological approach of computer-assisted anamnesis (CAA). At the University of Liege (Belgium), studies on CAA were started in 1966, as an extension of previous works in the field of computer-assisted instruction (CAI). A short retrospect of the SIAM-DOCEO Project is given. Various factors contribute to reducing the place physicians effectively assign to history-taking, in spite of its essential role. Non-interactive self-administered questionnaires cope only very partially with that situation. For about 20 years, a number of CAA projects have been set up in many countries. Four basic questions dealing with the diffusion of CAA techniques are examined. (a) It is crucial not to put man machine interaction and human dialogue on the same footing. A computer is quite unable to understand anything, but it can help health professionals in gathering medical history data. (b) As a rule, a CAA program should intervene in a limited and well defined pathological field, i.e. not too far from the diagnostic stage. (c) Acceptance by patients is very encouraging. (d) In contrast, reactions are mixed among physicians, essentially because of subjective factors. Accuracy and reliability, completeness and relevancy are, as a whole, undeniable qualities of CAA data, but the computer is--hopefully only for a short time--still often perceived more as a competitor than as a tool. The bibliography comprises 84 references. PMID- 3526029 TI - Consultation system for diagnosis of headache and facial pain: RHINOS. AB - How does a doctor make a diagnosis based on his medical knowledge? A hypothesis is proposed concerning the diagnostic method of specialized doctors. The knowledge provided by an authority is used to establish a diagnostic system for headache and facial pain named RHINOS. RHINOS is based on the above hypothesis as represented by the programming language Prolog, which is operative on an NEC PC 9801 microcomputer with reasonable CPU time. This implementation form benefited greatly from RHINOS's portability and availability. RHINOS has four types of rules, two levels, acting as a forward link from manifestations to diseases. It also has disease images as a backward link from diseases to manifestations. With this knowledge, RHINOS makes not only a single diagnosis but also differential diagnosis, and diagnosis for complicated cases of two or more diseases. The disease-image link made this possible. RHINOS was applied for diagnoses of 50 patients: 82% of its answers were equivalent to those made by a specialist, and a further 16% were close to the right answers. PMID- 3526031 TI - Practical use of a free-text computer system in pathology. AB - Free-text is a natural and effective means of communication of clinically valuable information in subjects such as morbid anatomy. Due to recent developments in hardware and software, it is becoming possible for a greater number of pathologists and others to consider the computer as a possible means of storing, retrieving and analysing findings which have been expressed in words. This paper describes some experiments which have been carried out in this area; these suggest that computer-held free-text can yield useful and hitherto unavailable information, but that coded input may be required for some applications. PMID- 3526030 TI - [Teaching medical diagnosis by computer simulation]. AB - A program of computer-assisted teaching, called AEDM, has been developed to simulate, with a conversational type terminal, the natural process of medical decision making. This system rests on two softwares, 'teaching' and 'inquiring', with 10 000 PASCAL instructions and the database of a computer-assisted diagnostic system (about 100 MO). The study describes the objectives and the characteristics of a system based on a simulation program; using natural procedures and non-specialized software is useful to develop computer-assisted teaching concerning different fields of pathology. PMID- 3526032 TI - [Illig-Fanconi disease. First case described in Ecuador]. AB - We are presenting here one case of Illig-Fanconi disease, in one month old baby otherwise in good health. The clinical evolution was characterized by flares of lesions every fifteen days more or less; these lesions were papules of one to two centimeters of diameter, some of them having a central depression, and leaving a white patches when they cleared up. The disease disappeared completely when the child was six months old, and there were not any recurrence until today. No systemic involvement was detected. PMID- 3526033 TI - [Recessive dystrophic epidermolysis bullosa (with esophageal involvement)]. AB - We are presenting a young man with Epidermolysis Bullosa (Dystrophica recessive type) who had lesions in hands, feet and face; some plaques of alopecia were noted on the scalp. Three years ago the patient showed marked dysphagia due to some esophagus erosions, which have been appearing regularly. One year ago it was necessary to take the patient to the Hospital where a esophagectomy was performed replacing the esophagus by a piece of colon. PMID- 3526034 TI - [Association between HLA and disease. Current status and perspectives]. PMID- 3526035 TI - [Contact dermatitis caused by Septopal]. AB - A man affected of a femur osteomyelitis was treated with Septopal (Merck) and presented an allergic contact dermatitis on the left thigh, thorax, abdomen with bilateral oedema of eyelids and generalized pruritus. The cause was a co-polymer of methyl-methacrylate-methacrylate of the material of the small balls of Septopal, which liberates gentamycin contained inside through little pores. PMID- 3526036 TI - [Botryomycosis]. AB - Four cases of botryomycosis are presented. All patients had fistulous and ulcerated lesions of the lower limbs. Diagnosis was based on the clinical and laboratory findings (presence of grains on direct microscopy examination and positive bacterial cultures). All patients had osteomyelitis. Three were treated with antibiotics or sulfonamides (orientated by the antimicrobial susceptibility test) and were cured. PMID- 3526037 TI - [Carcinoma cuniculatum of the hand]. AB - We've made a brief account of Carcinoma Cuniculatum and after reviewing the references, we found four cases which didn't appear on the foot as usual. We've reported a 68-year-old man, with a lesion on the back of his left hand; it had been present six years and had recurred after a surgical excision. On the clinical point of view, the lesion is a roughly oval 7 X 5 cm., plaque formed by the junction of small violaceous nodules. The surface is keratotic and it presents multiple sinuses from where a white, greasy material oozed out. Concerning the pathological findings we can observe that the papillomatous surface squamous epithelium penetrated into the underlying tissue. The epithelium contained sinuses which were filled with keratin. Occasionally the epithelium showed individual cell keratinization. The squamous epithelium was well differentiated and a feature seen was intra-cellular oedema, with sheets of uniform, pale, staining epithelium. Mitotic activity was low and confined to the basal layers. The tumour was accompanied by a fibrous stroma which was somewhere heavily infiltrated by chronic inflammatory cells. The treatment consisted of a wide excision and graft. As to the aetiology of the tumour the different authors suggest several possibilities, since the enduring trauma, chronic inflammation, burn scars, radiation, arsenic ingestion until the viral aetiology. McKee and Wilkinson suggest that it's a multifactorial process, playing the wart virus the main part in the breaking out of the tumour. PMID- 3526038 TI - [Aphthous ulcers and their syndromes]. AB - With the object to clarify the different aphthous syndromes, their clinical manifestations, histopathological and radiological patterns and their evolution, the authors report three patients (26 year old woman with a bipolar aphthosis, Neumann type; 47 year old man with a Behcet's syndrome, and a 53 year old woman with a recurrent necrotic mucous periadenitis), pointing out that these entities are as important for dermatologists as for the other specialists. PMID- 3526039 TI - [X-ray microanalysis of epitheliomas and melanomas: is the Cu/Zn index a prognostic parameter? Preliminary note]. AB - The authors comment the interest of the X Ray microanalysis in Dermatology and, especially, the Cu/Zn index determination in cutaneous tumors. PMID- 3526040 TI - [Mycosis: a therapeutic breviary, 1985]. AB - A short, up to date review of the therapy of the mycoses makes it clear that almost every case of almost every mycoses can be treated until eradication. On the other hand, the diagnostic facilities and the therapeutic expertise of the physicians and the socio-economic and mental capacity of most patients are insufficient for a substantial change to be attained. PMID- 3526041 TI - [Epidemiology and pathogenesis of donovanosis]. AB - Thirty three cases of donovanosis have been observed at the Dermatology Department of Cayenne's Hospital between 1970 and 1982, only in black people. The high frequency of rectal lesions of passive homosexual patients and the vagina contamination in women without sexual intercourse postulate for the intestinal reservoir of the bacteria, and the possibility of auto-inoculation. There is probably a cellular immune deficit. Donovanosis is often associated with other diseases, and in our practice in French Guyana, with leprosy. The skin of the genitalia is the most frequently infected, the mucosa generally resistant. The intracellular life of the "Donovan bodies" "Calymmatobacterium granulomatosis"- in the cytoplasm of large mononuclear cells seems an argument for an anergic disease. PMID- 3526042 TI - [Analysis of circulating T-lymphocyte subpopulations with monoclonal antibodies in psoriasis]. AB - Subsets of peripheral blood lymphocytes were studied by surface markers in 21 patients with psoriasis. 12 had active lesions and 9 had stable lesions. The number of T cells was estimated by indirect immunofluorescence with the monoclonal antibody OKT3. The number of T inducer cells was estimated with the monoclonal antibody OKT4. The number of the activated cell was estimated with the monoclonal antibody Edu I. The patients with psoriasis had decreased T cell number, decreased T inducer cell number and increased T activated cell number. The patients with active lesions had the most pronounced alterations of T cells subsets. In these patients was observed also a decreased inducer/T suppressor cell ratio. The results, that show alterations in T cell number and it ratio are not able to establish or clarify an inducer or suppressor T cell activity in the course of psoriasis. The number of T suppressor cells was estimated with the monoclonal antibody OKT8. PMID- 3526043 TI - [Lymphocyte subpopulations in alopecia areata]. AB - Subsets of peripheral blood lymphocytes were studied in 19 patients with alopecia areata. The results shows: a decreased Tm/Tg ratio, decreased number of OKT4+ cells, increased OKT8+ cells, decreased OKT4+/OKT8+ cell ratio. Total lymphocytes, T cells, Tm cells, Tg cells, T DR+ cells and B lymphocytes were normal. The results are similar to those founded in autoimmune diseases and suggest the existence of an immunopathogenic mechanism in these disease. PMID- 3526044 TI - [Congenital hemihypertrophy]. AB - A case of congenital hemihypertrophy, which affects the right part hemi-tongue and the homolateral superior member, is reported in a just born of feminine sex, this patient has been observed until the age of one year and five months, at this age she was not controlled any more. Then the clinic history is reviewed and the clinic, associate congenital defects, are commented, also the existence of embryonal tumours, possible etiopathogenic hypothesis, treatment and prognostic. PMID- 3526045 TI - [Childhood acropustulosis. A study of 10 cases]. AB - Ten cases of infantile acropustulosis were studied clinically, in laboratory and histopathologically. There was no racial predominance. In most of the cases the lesions started in the first 6 months of life and were located mainly on the feet severe itching. Was a constant symptom. Laboratory studies were negative for fungus, bacteria and acarus. Atopy was found in 20% of the cases and 30% of the families. Blood eosinophiles was found in 70% of the lesions. PMID- 3526047 TI - [Aplasia cutis congenita. Report of 2 cases]. AB - In 1983, we had two cases of pediatric patients, which were observed in the Regional Hospital "Victor Lazarte Echegaray" of the Peruvian Institute of Social Security in Trujillo, these cases correspond to the syndrome of aplasia cutis congenita. In the first case, the defect was localized as a of ulcer in the right inferior member, which was affected from the third part distal of the thigh to the back part of the foot. In the second one, the lesion was in the middle line of the hairy skin, and it had the particularity of being associate to others congenital malformations. These cases are mentioned because of their rarity of presentation at a world level as well as their unknown occurrence in our country. Then we comment the clinic, histological characteristics, associate congenital defects, possible etiopathogenic mechanisms, differential diagnostic and its evolution and treatment. PMID- 3526046 TI - [Darier-Ferrand progressive recurrent dermatofibroma]. AB - Dermatofibroma progressive and recurrent, described by Darier and Ferrand in 1924 is a tumour that grows slowly, and can invade the whole dermis, sectors of the conjunctival interlobular hypodermic tracts, superficial muscular fascia and invade striated muscular fibers, lymphatic ganglia and bones. The most frequent localization is the back and abdomen although it an be seen in other sits of the skin. Ulceration is not frequent. Usually it is most resistant to therapy and recidives frequently. As it is not radio sensible the treatment of first choice is surgery. The evolution is very slow, from months to twenty or more years. We communicate a case of dermatofibroma recurrent of Darier and Ferrand localized in the left supra spinal region, that ulcerated when patient was irradiated with cobalt because she had a lung adenocarcinoma. Possibility radiotherapy produced an alteration in the immunological state of the patient producing by this mechanism the ulceration of the DF. PMID- 3526048 TI - [Cutaneous Crohn disease]. AB - The term "metastatic" Crohn's disease is used to define the cutaneous lesions, distant from the gastrointestinal tract and separated from other ulcerations by normal skin, showing granulomatous histology. A case of Crohn's disease with metastatic ulcerations of the vulva, perineum, submammary folds, groins and abdominal fold is presented. In the literature only 26 similar cases were found. Cutaneous manifestations associated to Crohn's disease, its classification and treatment are commented. The excellent response of our case to metronidazole is stressed. PMID- 3526049 TI - [What is your diagnosis? Localized neurofibroma]. PMID- 3526050 TI - [Comparison of serological types of E. coli occurring in the urine and feces of patients with urinary tract infection]. PMID- 3526051 TI - Natural and synthetic trehalose diesters as immunomodulators. PMID- 3526053 TI - Calmodulin. PMID- 3526052 TI - Polyfunctional DNA intercalating agents. PMID- 3526055 TI - [Insulin treatment of type I diabetes--a review]. PMID- 3526054 TI - Activities of cefoxitin in vitro and in vivo: a study in patients with biliary tract infection undergoing percutaneous transhepatic biliary drainage. AB - Activities of cefoxitin and the effect on killing of bacteria in bile from six patients undergoing percutaneous transhepatic biliary drainage were analyzed in relation to in vitro activities of the drug, with particular reference to the incubation time. The bacteriostatic and bactericidal activities of cefoxitin with short term (6 hr) incubation correlated well with the duration of the effective cefoxitin concentration and the decrease of viable bacteria in bile juice from the patients. These timed in vitro activities can be used as well as the conventional MIC and MBC with the prolonged incubation of 24 hr, in the deductive analysis of bacterial response in vivo. PMID- 3526056 TI - [The man behind the syndrome: Thomas G Morton. He cured the patients --but failed to find an explanation for the pain]. PMID- 3526057 TI - [Mechanisms of tumor invasion in the laryngeal structure. A study of undecalcified thin sections]. AB - Mechanisms of invasion of squamous cell carcinoma into the framework of the larynx were studied in nondecalcified acrylic embedded tissue. Destruction was always an indirect process mediated by giant cells or proteases. Two different stages of tissue specific response were seen. Bone was reacting with osteoneogenesis in the interface and with apposition of bone at the tumour non attached side. Hyaline cartilage was responding with new formation of bone distant to the tumour and with production of protease inhibiting cartilage substance, whenever the tumour was attached to cartilage directly. Macrophages resorbed the product of these local tumour-host-interactions. There were plasma cells indicating a local immunological activity. In cases of irradiated carcinomatous larynxes this local immunological process seemed to be not in action. Here tumour invaded the skeleton of the larynx directly and microphages were seen removing the waste of destruction showing sequesters of cartilage and bone. These findings confirm the therapeutic principle that in carcinomas infiltrating the framework of the larynx irradiation is insufficient. Irradiation disarranges the specific local mechanism of defence and advances destruction and metastases by the tumour. Therefore, if operative treatment is not possible, it must be discussed, whether an alternative palliative proceeding--for example endolaryngeal reduction of tumour masses by laser surgery conservating the laryngeal framework--is a more adequate solution. PMID- 3526058 TI - [Treatment possibilities of keloid in the ENT area with special reference to anthelixplasty]. PMID- 3526059 TI - Surgical treatment of stenosis of the external auditory canal. AB - Analysis of the outcomes of reconstruction for stenosis of the ear canal in 20 patients revealed that the key step in the procedure after the stenotic meatus and ear canal skin have been removed (in the process accomplishing a wide meatoplasty) is widening the posterior bony canal wall until some mastoid cells are encountered. After the tympanic membrane has been deepithelialized, the bony canal should be lined with two separate pieces of split-thickness skin grafts and protected with Silastic sheeting and packing. Average follow-up of 3 1/3 years revealed that 2 ear canals have restenosed, 2 have partially restenosed, and 18 have healed. Of the 22 ears, 15 have had hearing improved to within 25 dB SRT or better, 5 have moderate hearing improvement, and 2 have no improvement. There were no complications. PMID- 3526060 TI - [Sonographic diagnosis of focal lesions of the liver]. PMID- 3526061 TI - [A comparative multicenter clinical study of ranitidine and cimetidine in the treatment of duodenal ulcer]. PMID- 3526062 TI - [Diagnosis and follow-up of acute gallbladder inflammation using ultrasound]. PMID- 3526063 TI - [Structure and organization of the major histocompatibility gene complex]. PMID- 3526064 TI - [History of the Internal Medicine Department in relation to the Internal Medicine Clinic of the Kucic General Hospital in Rijeka 1935-1980]. PMID- 3526065 TI - Molecular analysis of urinary AT III related antigen in liver cirrhosis. AB - Urinary antithrombin III (AT III) related antigen was analyzed by SDS polyacrylamide gel electrophoresis and Western blotting, and the nitrocellulose membrane was scanned with a 2-wavelength TLC scanner. The urinary AT III related antigen was found to be located in three different molecular weight regions: the AT III region, and molecular weight regions higher and lower than that of AT III. The ratio of the higher molecular weight region to the AT III region divided by the urinary creatinine, was taken as an "index" and was analyzed in liver cirrhosis patients as well as in normal controls. The "index" in liver cirrhosis was higher than that in the controls. Further, the "index" revealed a significant proportional correlation with the total bilirubin and direct bilirubin, and also a significant inversely proportional correlation with the plasma AT III, suggesting that the "index" tends to become higher as liver function decreases. The pathophysiological significance of the "index" is briefly discussed. PMID- 3526066 TI - 3H-SCH 23390 binding sites in the rat substantia nigra: evidence for a presynaptic localization and innervation by dopamine. AB - Chronic treatment with SCH 23390, a selective D-1 dopamine receptor antagonist, elicited a 32% increase in the density of 3H-SCH 23390 binding sites in nigral membrane preparations but failed to change the apparent KD of the ligand for its binding sites. Haloperidol, a D-2 dopamine receptor antagonist which blocks the dopamine-sensitive adenylate cyclase and (-) sulpiride, a selective D-2 dopamine receptor blocker, which does not block the dopamine-sensitive adenylate cyclase, failed to change both the Bmax and KD of 3H-SCH 23390 binding. Finally, the intrastriatal injection of kainic acid produced a marked decrease of both GAD activity and GABA content and 3H-SCH 23390 binding sites (65%) in the homolateral substantia nigra. The results show that in the rat substantia nigra most of the 3H-SCH 23390 binding sites have a presynaptic localization on the striato-nigral GABAergic afferent terminals and suggest that dopamine released from nigral dendrites exerts a tonic influence on these presynaptic D-1 dopamine receptors. PMID- 3526067 TI - Prevention of the toxicity of erythromycin estolate in the perfused rat liver by endotoxin. AB - The possibility that endotoxin pretreatment could prevent the hepatotoxic effects of erythromycin estolate (EE) was investigated using the isolated perfused rat liver. The addition of E. coli endotoxin (25 micrograms/ml) to the perfusate, 30 min prior to EE administration at 150 or 200 microM, significantly ameliorated the decreases in bile and perfusate flow caused by either concentrations of the drug in control liver preparations. This phenomenon was also studied using liver isolated from rats pretreated in vivo with endotoxin for three days. In these preparations, EE at both concentrations did not alter bile flow and caused reductions of perfusate flow which were far less than those observed in untreated control livers. Furthermore, in livers from endotoxin-treated rats EE induced less reduction of bile acid excretion and, at 150 microM, it did not increase the bile to perfusate ratio of sucrose seen in control preparations after the drug, which may be an expression of altered hepatocytic membrane permeability. Since it is known that both endotoxin and EE interact with membranes, it is suggested that the "protective" effects of endotoxin may occur at the membrane level. PMID- 3526068 TI - Learning deficits occur in young mice following transfer of immunity from senescent mice. AB - The extent to which immune processes contribute to senescence-related neurological/behavioral impairment was examined using an adoptive transfer procedure. C57BL/6 mice aged 22 to 24 months showed impaired ability for acquisition of an active avoidance response when compared with younger mice aged 3 months. An immunofluorescence assay of the sera of these mice indicated that only sera from the senescent mice reacted with brain antigen. When tested three months following irradiation and receipt of bone marrow/spleen cell suspensions from senescent mice, young mice showed senescence-like serum-brain reactivity and declines in their abilities to acquire learning. Young control mice receiving cell suspensions from age-matched donors showed no evidence of serum-brain reactivity or learning deficits, suggesting that impaired learning was related to acquisition of aged immunity and not a nonspecific effect of the transfer procedure. These findings indicate that immune processes may be involved in the etiology of senescence-related neurological/behavioral dysfunctions. PMID- 3526069 TI - Direct opioid regulation of pituitary release of bovine luteinizing hormone. AB - Although endogenous opioid peptides (EOP) are thought to alter pituitary release of luteinizing hormone (LH) by modifying the release of gonadotropin-releasing hormone (GnRH) from the brain, EOP may also directly affect the release of LH from pituitary cells. This hypothesis was tested using dispersed cells from the bovine anterior pituitary gland. Pituitaries were enzymatically dissociated, preincubated for 18 h and then cultured for either 2 or 24 h with GnRH, naloxone, methionine-enkephalin (Met-enk) or their combinations. Basal release of LH into media was 18.2 and 38.4 ng/100,000 cells after culture for 2 or 24 h, respectively. When cultured for 2 or 24 h with 10 nM GnRH, LH release was 296% and 131% of the basal release for each culture period. Cellular viability (75% vs 68%) and total (cells + medium) LH (128 vs 134 ng/100,000 cells) did not differ (P greater than .05) between cells cultured for 2 or 24 h. Naloxone (1 microM) increased (P less than .01) basal release of LH by 57% after 2 h of culture but not after 24 h of culture. Naloxone did not augment the amount of LH released in response to 10 nM GnRH. Addition of Met-enk (1 nM to 1 microM) suppressed (P less than .05) basal release of LH (23% to 62%) after 2 h of culture. Similar suppressive effects (8% to 49%) occurred in a dose-dependent manner (0.1 nM to 1 microM) after 24 h of culture. Met-enk (1 and 100 nM) antagonized (P less than .05) the stimulatory effect of naloxone and reduced (P less than .05) the amount of LH released in response to GnRH after 2 h of culture. In summary, the stimulatory effect of naloxone on the basal release of LH suggests that EOP may directly regulate pituitary cell function; the inhibitory effect of physiological concentrations of Met-enk on the basal in vitro release of LH suggests that EOP may directly affect the release of LH in vivo; the antagonism between the stimulatory effect of naloxone and the inhibitory effect of Met-enk is consistent with effects exerted through opioid receptors; and the stimulatory effect of GnRH may be partially reduced by Met-enk. These results are consistent with the hypothesis that opioids may directly modulate the release of LH at the pituitary level. PMID- 3526070 TI - Effects of hypersecretion of growth hormone and prolactin on plasma levels of glucagon and insulin in GH3-cell-tumor-bearing rats, and the influence of bromocriptine treatment. AB - Plasma levels of prolactin, growth hormone, glucagon insulin and glucose were measured in non-treated control rats, bromocriptine-treated control rats and GH3 cell-tumor-bearing rats with and without bromocriptine treatment. Bromocriptine treatment increased plasma levels of glucagon, insulin and glucose in control rats. Tumor-bearing rats had increased body weight and increased plasma levels of prolactin, growth hormone, glucagon, insulin and glucose. Bromocriptine treatment reduced body weight and decreased the plasma levels of prolactin, glucagon and insulin, as compared to non-treated tumor-bearing rats. The drug had no effect on plasma levels of growth hormone and glucose. These results indicate that, in GH3 cell-tumor-bearing rats, prolactin, glucagon and insulin are more sensitive to the action of bromocriptine than growth hormone. PMID- 3526071 TI - Use of indirect immunofluorescence to show changes in liver actin microfilament staining in inbred mice strains exposed to the mycotoxin sporidesmin. AB - The distribution of microfilaments in cryostat sections of liver from BALB/c and C57BL/6 mice was compared using the F-actin binding probe rhodaminyl phalloidin and indirect immunofluorescence using a human serum containing antiactin autoantibodies. The immunological reactivity of this serum was established by its capacity to immunoprecipitate purified skeletal muscle actin and by its ability to immunoprecipitate a protein which migrated electrophoretically with actin from 35S-labeled liver cells. Oral administration of the liver toxin sporidesmin did not substantially alter the binding of rhodaminyl phalloidin to microfilaments but the reactivity of the anti-actin serum with the liver cytoskeleton was diminished 3 h after, and enhanced within 24 h of toxin ingestion. Amounts of actin measured by DNAse inhibition were not altered. The results are assessed in terms of their significance for understanding the way in which sporidesmin causes liver damage. PMID- 3526072 TI - The effect of fixation upon monoclonal cryostat immunohistochemistry. PMID- 3526073 TI - The Gerbich blood group antigens: a review. PMID- 3526074 TI - Thermonuclease testing: the rapid identification of Staphylococcus aureus in blood culture. PMID- 3526075 TI - [Ultrasound diagnosis of the involvement of retroperitoneal and abdominal lymph nodes in Hodgkin's disease]. AB - Ultrasonography and lymphography have been carried out in 238 patients with Hodgkin's disease to define the stage, recurrences and evaluate the efficiency of treatment. In 35 cases the results have been verified by morphologic study of lymph nodes removed during laparotomies. The results of ultrasonic study demonstrate involvement of lymph nodes of the spleen hilum, liver and other abdominal nodes found in 14 out of 115 untreated patients. The involvement of the nodes below the diaphragm has been found in 39 patients out of 123, subjected to different treatments. The significance of the technique in evaluating treatment efficiency, diagnosing recurrences and progression of the process has been shown. PMID- 3526076 TI - [Ultrasonic tomography in the diagnosis of non-discrete retroperitoneal tumors]. AB - The ultrasonic tomography has been used among other methods to diagnose nonorganic extraperitoneal tumours in 114 patients. The results have shown the ultrasonic tomography to be an efficient method permitting one to diagnose the tumours in 91.4% of cases studied. The high diagnostic accuracy of the method (87.7%), the absence of irradiation load noninvasiveness and economy of ultrasonic tomography make it a useful method for screening extraperitoneal nonorganic tumours at early stages of patients observation. PMID- 3526077 TI - [Metronidazole in the radiotherapy of malignant neoplasms]. PMID- 3526078 TI - [Current state and approaches to increasing the effectiveness of combined radiotherapy of uterine cancer]. PMID- 3526079 TI - [Radiation pathomorphosis of human tumors]. PMID- 3526080 TI - Molecular genetics of insulin-dependent diabetes mellitus. AB - Insulin-dependent diabetes mellitus is an autoimmune disease the development of which is influenced by genetic factors (Cahill & McDevitt, 1981). As concordance for IDD is less than 50% in identical twins, environmental factors are also required for the development of IDD. Although viral agents have been implicated in the past, the specific environmental components leading to IDD remain unknown. This paper reviews current research focused on the genetic factors that influence susceptibility to IDD. PMID- 3526081 TI - Immunoreactivity to a 64,000 Mr human islet cell antigen in sera from insulin dependent diabetes mellitus patients and individuals with abnormal glucose tolerance. AB - Autoantibodies in sera from newly diagnosed insulin-dependent diabetes mellitus (IDDM) patients recognize a 64,000 Mr human islet cell antigen. The incidence of these antibodies was 86% in 28 insulin-dependent diabetes mellitus patients, 100% in seven first-degree relatives with abnormal glucose tolerance, 6% in 34 healthy individuals, 17% in 29 patients with Hashimoto's or Graves' disease, and 0% in five systemic lupus erythematosis patients. It is suggested that the 64,000 Mr human islet cell protein is the major target antigen of islet cell autoantibodies in insulin-dependent diabetes mellitus. PMID- 3526082 TI - The genetic epidemiology of type I diabetes mellitus and autoimmune thyroid disease. Molecular interactions at the population level. AB - Liability to type I diabetes and autoimmune thyroid disease is familial but not monogenic. Associations of each disorder with several genetic polymorphisms suggest complex interactions in genetic liability, as do associations with aberrant immune function in patients and their unaffected relatives. Each disorder may be genetically heterogeneous, and epidemiological studies suggest that environmental influences on liability to type I diabetes are complex. Familial aggregation of these and other autoimmune endocrine disorders is observed. Genetic analyses have not taken full account of these complexities, due to limitations in data, analytical methods, or both. Evaluating interactions of influences on liability to these disorders will require comprehensive investigations in which all relevant immunological and genetic indicators of liability are assessed for patients, affected and unaffected relatives, and healthy controls. These should aim to determine the influence of allelic variation of participating molecules on normal and aberrant immune function, liability to autoimmunity, and liability to individual diseases. Such efforts would facilitate rational immunological manipulation of liability to these disorders. PMID- 3526083 TI - The etched porcelain inlay/onlay restoration. PMID- 3526084 TI - Gastric inhibitory polypeptide and insulin response to increasing doses of oral glucose: dependency on glucose amount and volume of the test drink. AB - The plasma levels of glucose, immunoreactive insulin (IRI), and immunoreactive GIP (IR-GIP) of eight healthy normal-weight subjects were compared following administration of oral glucose load of 10, 30, 60, 90, and 120 g, each given in a volume of 300 and 600 mL of water. By increasing the glucose load from 30 to 60 g, the integrated glucose response was more than doubled, irrespective of the volume. If more than 60 g glucose was given, the venous blood glucose levels did not significantly increase further. The IRI concentrations peaked between 30 and 40 minutes, irrespective of the size and volume of the glucose load. The peak values were significantly higher if 30, 60, and 90 g glucose was given in 600 mL than in 300 mL water. The integrated IRI output increased gradually if the glucose concentration of the 300 mL load was increased, whereas a maximal IRI response occurred already with 60 g glucose if dissolved in 600 mL water. At identical amounts of glucose (60 g) the integrated IRI response was doubled by increasing the ingested volume of the drink from 300 to 600 mL. Also the peak and integrated IR-GIP response increased in a dose-dependent manner by increasing the size of the glucose load. Larger amounts of glucose mainly prolong the GIP response. Significantly greater amounts of IR-GIP were released with 60 and 90 g glucose when given in 600 mL instead of 300 mL water. The parallel increment of IR-GIP and IRI is compatible with an important role of GIP as an insulinotropic gut factor.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3526085 TI - Treatment of gynecomastia with tamoxifen: a double-blind crossover study. AB - Benign asymptomatic or painful enlargement of the male breast is a common problem, postulated to be due to an increased estrogen/testosterone ration or due to increased estrogenic or decreased androgenic stimulation via estrogen or androgen receptor interactions. Treatment at present consists of analgesic medication or surgery. However, treatment directed against the preponderance of estrogenic stimulation would seem to represent a more specific form of therapy. In the present double-blind crossover study, one-month courses of a placebo or the antiestrogen tamoxifen (10 mg given orally bid) were compared in random order. Seven of ten patients experienced a decrease in the size of their gynecomastia due to tamoxifen (P less than 0.005). Overall, the decrease for gynecomastia for the whole group was significant (P less than 0.01). There was no beneficial effect of placebo (P greater than 0.1). Additionally, all four patients with painful gynecomastia experienced symptomatic relief. There was no toxicity. The reduction of breast size was partial and may indicate the need for a longer course of therapy. A followup examination was performed in eight out of ten patients nine months to one year after discontinuing placebo and tamoxifen. There were no significant changes from the end of the initial study period except for one tamoxifen responder who developed a recurrence of breast tenderness after six months, and one nonresponder who demonstrated an increase in breast size and a new onset of tenderness after ten months. Therefore, antiestrogenic treatment with tamoxifen may represent a safe and effective mode of treatment for selected cases of cosmetically disturbing or painful gynecomastia. PMID- 3526086 TI - Correlation between insulin clearance and insulin responsiveness: studies in normal, obese, hyperthyroid, and Cushing's syndrome patients. AB - Insulin clearance and secretion determine the plasma insulin concentration. To elucidate the significance of these parameters in man, we employed the euglycemic insulin clamp technique to measure insulin sensitivity, insulin responsiveness, and insulin clearance, and we calculated the basal insulin delivery rate. In 27 patients (six normal, six obese, ten hyperthyroid, and five with Cushing's syndrome), insulin was infused at rates of 0.3, 1, 3, or 10 mU/Kg/min, and insulin concentration and glucose utilization were measured. C-peptide concentrations were measured before and during insulin infusion and decreased significantly, indicating a reduction of endogenous insulin secretion to 62% of basal in normals and a similar reduction in the other groups. Maximal responsiveness to insulin was a glucose utilization rate of 450 +/- 20 mg/min/m2 in normals, unchanged in obese, 42% increased in hyperthyroid, and 34% decreased in Cushing's syndrome patients. Sensitivity to insulin was decreased in all three abnormal groups. Insulin clearance rates were 1,050 +/- 80 mL/min/m2 for normals, not significantly changed in obese, 45% increased in hyperthyroid, and 33% decreased in Cushing's syndrome patients. All three abnormal groups showed hyperinsulinemia compared to normal. The basal insulin delivery rates were calculated as 7.0 +/- 0.3 mU/min/m2, with a threefold increase in obese and in hyperthyroid and no significant change in Cushing's syndrome patients. Insulin clearance correlated well with insulin responsiveness (r = .65, P less than 0.001), but poorly with insulin sensitivity (r = .36).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3526087 TI - Burn-induced stimulation of lysosomal enzyme activity in skeletal muscle. AB - A localized burn injury to a rat hindlimb was used to investigate the proteolytic enzymes responsible for the burn-induced increase in muscle protein breakdown. In 10,000 x g pellets of muscle homogenates, burn stimulated (50% to 100%) protease activities with pH optima of 3, 5.5, and 7.8. Burn also stimulated acid protease activity in 27,000 x g supernatants derived from triton X100 treated extracts of muscle. Pretreatment of rats with compound 48/80 (to eliminate contaminating mast cells) eliminated 95% of the neutral protease activity in the particulate fraction. The Ca++-sensitive neutral protease was not affected by either burn or 48/80 treatment. However, muscle extracts from the burned leg always showed a 40% to 70% increase in acid protease activity. All of the acid protease activity could be inhibited by a combination of cathepsin inhibitors pepstatin (0.01 microgram/mL) and leupeptin (1 mumol/L) and leupeptin (1 mumol/L) or Ep475 (1 microgram/mL). Leupeptin and the lysosomotropic agent leucine methyl ester also inhibited the burn-induced proteolysis in intact muscle. A time course shows parallel increases in whole muscle proteolysis and acid protease activity of muscle homogenates. These findings support the conclusion that the increase in lysosomal cathepsins are sufficient to account for the burn-induced increase in protein breakdown in muscles from the injured leg. PMID- 3526088 TI - Methods for the determination of membrane potential in bioenergetic systems. PMID- 3526089 TI - Data dictionaries--a way forward to write meaning and terminology into medical information systems. PMID- 3526090 TI - Inhibition of F plasmid replication in htpR mutants of Escherichia coli deficient in sigma 32 protein. AB - The Escherichia coli htpR (= hin, rpoH) mutants are defective in the induction of heat-shock proteins due to a deficiency in sigma 32 and are unable to grow at high temperature. We found that these mutants are also defective in supporting replication of certain plasmids including F and mini-F. When a htpR mutation is introduced into an F' strain, the F' plasmid is effectively excluded. Similarly, when an F' or mini-F plasmid is introduced into htpR mutant cells, transconjugant or transformant clones are obtained at low frequencies and the plasmid is rapidly lost upon subsequent growth in a non-selective medium. In htpR amber mutants carrying a temperature-sensitive suppressor, mini-F replication occurs normally at 30 degrees C, but is inhibited upon transfer to 40 degrees C where the suppressor tRNA is inactivated. A temperature-resistant "pseudo-revertant" of the htpR6 (amber) mutant, that exhibits apparently normal induction of the major heat shock proteins in the absence of functional sigma 32, fails to support mini-F replication at 40 degrees C, suggesting that inhibition of mini-F replication is not a secondary consequence of the defective induction of the major heat-shock proteins. It is proposed that the function of the sigma 32 protein is directly required for F plasmid replication. PMID- 3526091 TI - Assembly analysis of ribosomes from a mutant lacking the assembly-initiator protein L24: lack of L24 induces temperature sensitivity. AB - Previously, we have shown that the ribosomal protein L24 is one of two assembly initiator proteins. L24 is essential for early steps of the assembly of the 50S ribosomal subunit but it is not involved in both the late assembly and the ribosomal functions. Surprisingly, an E. coli mutant (TA109-130) exists which lacks L24. This apparent paradox is analyzed and resolved in this paper. The phenotypic is analyzed and resolved in this paper. The phenotypic features of the mutant lacking L24, are a temperature sensitivity (growth severely reduced beyond 34 degrees C), a very low growth rate already at permissive temperatures (at least six-fold slower than wild type) and an underproduction of 50S subunits (molar ratio of 30S to 50S about 1:0.5). The S value of the mutant large subunits is 47S, and they are normally active in poly(Phe) synthesis. The total protein of the mutant large subunits show negligible activity in the total reconstitution assay using the standard two-step procedure. Number analysis of the assembly initiator proteins revealed that only one initiator protein is effective, as expected. The activity is restored upon addition of wild-type L24. However, when the temperature of the first step is lowered from 44 degrees to 36 degrees C, reconstitution of active particles occurs with a 50% efficiency in the absence of L24. The recovery of activity is accompanied by the appearance of again two initiator proteins, when the mutant TP50 lacking L24 is used in the reconstitution assay at the 'permissive' temperature of 36 degrees C during the first step.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3526092 TI - Immunologically related proteins in cytoplasmic and mitochondrial ribosomes of yeast Saccharomyces cerevisiae. AB - Ribosomal proteins from the cytoplasm and mitochondria of the yeast Saccharomyces cerevisiae were compared by immunoblotting techniques. Antibodies raised against cytoplasmic ribosomal proteins cross-react with five mitochondrial ribosomal proteins, four of which are located in the large and one in the small mitochondrial subunits. The possible existence of common ribosomal proteins for cytoplasmic and mitochondrial ribosomes is discussed. PMID- 3526094 TI - Cd2+ accommodation by Saccharomyces cerevisiae. AB - The Cd2+ accommodation mechanism of S. cerevisiae has been examined. In a synthetic medium containing 1 microM CdSO4, cell proliferation was observed following a time lag period of approximately 18 h. During the time lag period, the cell number and viable cell count did not change and the cells did not excrete organic acid as a Cd-chelator, neither did they produce inorganic sulphide in the form of CdS. Whereas approximately 30% of Cd2+ taken up by Cd accommodated cells was distributed in the cytosol, only a small percentage of Cd2+ was found in the cytosol of unaccommodated cells following 1 h incubation in 1 microM Cd-medium. Furthermore, some Cd2+ in the soluble fraction from Cd accommodated cells was bound to low molecular weight (less than 30,000) protein(s), while unaccommodated cells only contained small amounts of these proteins. Therefore, it is proposed that Cd2+ binds to the low molecular weight protein(s) present in the cytosol, resulting in a decrease of Cd-toxicity, although the exact mechanism of accommodation is not clear. PMID- 3526093 TI - Streptococcal pyrogenic exotoxin type A (scarlet fever toxin) is related to Staphylococcus aureus enterotoxin B. AB - The nucleotide sequence of the gene encoding group A streptococcal pyrogenic exotoxin type A (SPE A) was determined by the dideoxy chain termination method. The first 30 residues of the translation product represented a hydrophobic signal peptide. The mature protein was 220 amino acids in length and had a molecular weight of 25,805. It has significant protein sequence homology with Staphylococcus aureus enterotoxin B but not with other proteins in the Dayhoff library. PMID- 3526095 TI - Production of colicin E5 by epidemic strains of Salmonella typhimurium var. Copenhagen. AB - Sixty eight strains of Salmonella typhimurium were isolated during an outbreak of salmonellosis in the paediatric ward of Saadi hospital in Shiraz, Iran. Eleven of the strains were shown to produce a single type of colicin of group E. This colicin was identified as colicin E5. Most of the colicinogenic strains exhibited similar drug sensitivity and phage typing patterns and all were of the serotype S. typhimurium var. Copenhagen. PMID- 3526096 TI - Properties of mutacin b, an antibacterial substance produced by Streptococcus mutans strain BHT. AB - An antibacterial substance produced by strain BHT of Streptococcus mutans (mutacin b) was found to be a small molecule (MW 3,500-6,000) with remarkable resistance to temperature, alkali and various solvents. Enzyme sensitivity tests of partially purified preparations indicated that mutacin b is a peptide. It is sensitive to several proteolytic enzymes and its lethal effects on sensitive cells can be prevented by adding trypsin to cells exposed to mutacin b. High concentrations of mutacin b inhibited the growth of producer cells, indicating that strain BHT is only partially immune to this substance. PMID- 3526097 TI - Effect of growth rate and aeration on the production of microcin by Escherichia coli growing in continuous culture. AB - The production of microcin 15, a low molecular weight antibiotic, resistant to proteases and antagonized by methionine, was measured in batch and continuous cultures of E. coli LP 136. The highest yield per cell was obtained in conditions (anaerobiosis, low glucose concentration, low growth rate) similar to those found in the intestinal tract. It is postulated that microcin production may be an important factor in growth competition between enterobacteria in the intestinal tract. PMID- 3526098 TI - Surface hydrophobicity and adherence of Candida to acrylic surfaces. AB - The relationship between cell surface hydrophobicities and adherence capacities to acrylic surfaces was investigated with seven laboratory strains and eighteen clinical isolates of Candida species. C. albicans was less adherent to acrylic surfaces than were other species and hardly adhered to hexadecane, whereas other strains, which had a high affinity to hexadecane, were more adherent to acrylic surfaces. A correlation was observed between the adherence capacities of Candida species to acrylic surfaces and their cell hydrophobicities. When acrylic plates were coated with human whole saliva, the contact angle of the plate became smaller than that of the nontreated plate and adherence of hydrophobic strains decreased, whereas the adherence of C. albicans was not affected. PMID- 3526099 TI - Insulin potentiation therapy: a new concept in the management of chronic degenerative disease. AB - In insulin potentiation therapy the hormone insulin is used as an adjunct in the medical management of the chronic degenerative diseases including malignant neoplasia. In this, the recognized physiological action of insulin--that of increasing cell membrane permeability--is taken advantage of to potentiate the pharmacological actions of medications administered concurrently in the therapy. This potentiation occurs because of the heretofore unrecognized applicability of this membrane permeabilizing effect of insulin to a much wider range of tissues than is classicly accepted, and further the observed effect of this permeabilizing phenomenon as it relates to drug molecules, most importantly the antineoplastic agents. The historical context of insulin potentiation therapy is described, and scientific corroboration for its novel hypotheses is given. Insulin potentiation therapy represents a potentially revolutionary concept in the medical management of diseases and is, in the authors' opinion, deserving of intensive scientific investigation through in vitro and in vivo experimentation and properly conducted human clinical trials in a university teaching hospital setting. PMID- 3526100 TI - Immunoblot confirmation of immune response to Campylobacter pyloridis in patients with duodenal ulcers. AB - The specificity of serum immune responses to Campylobacter pyloridis that were found in the sera of patients with duodenal ulcers has been confirmed by means of the Western blot method. The presence of the same immune response to the organism in apparently healthy individuals, especially older people, suggests a repeated exposure throughout life to this organism, the source of which remains unknown. PMID- 3526101 TI - Cyclosporin A in organ transplantation. AB - Cyclosporin A is a novel, powerful immunosuppressive agent. It is a cyclic polypeptide and is one of several metabolites of a number of soil fungi. Its main effect is directed against the helper T lymphocyte. Thus, cyclosporin A represents the first of a new generation of immunosuppressive agents that are capable of selective rather than broad spectrum activity. The immunosuppressive properties of cyclosporin A have been applied successfully to prevent the rejection of transplanted organs both in animals and humans. Clinically, it has been used in the management of transplanted kidneys, hearts, lungs, livers and, to some degree, pancreases and bone marrow. It is also finding some application in the control of various autoimmune conditions. The clinical use of cyclosporin A is still in an early phase and several aspects have not been defined optimally. The most common and troublesome side-effect is nephrotoxicity. Other adverse effects include hirsutism, gum hypertrophy and mild psychiatric disturbances as well as involvement of the gastrointestinal tract, liver and central nervous system. PMID- 3526102 TI - The unsuitability of minoxidil for the treatment of moderate hypertension. AB - Minoxidil is very effective in the treatment of severe or resistant hypertension but fluid retention and hypertrichosis have been side-effects. This study examines the suggestion that the use of small doses of minoxidil may be effective in the treatment of moderate hypertension without causing these adverse effects. Sixteen patients with an elevated blood pressure level that was suboptimally controlled by combination therapy with diuretic and beta-adrenoreceptor blocking agents entered a randomized open trial to compare the efficacy and acceptability of minoxidil and prazosin as supplementary therapy to bendrofluazide and metoprolol. Blood pressure control was similar in the two groups. However, relatively large doses of minoxidil were required and over-all tolerance to the drug was poor; five of eight patients who were receiving minoxidil experienced marked fluid retention that necessitated a change in diuretic agent to substantial doses of frusemide. Low doses of minoxidil do not appear to be effective in the treatment of moderate hypertension, and the drug cannot be recommended for this indication. PMID- 3526103 TI - Parathyroid localization. PMID- 3526104 TI - Treatment of LD100 Escherichia coli septic shock with netilmicin and methylprednisolone in baboons. AB - Treatment efficacy with netilmicin sulphate/methylprednisolone sodium succinate in a severe septic shock baboon model, using an LD100 of live Escherichia coli, was evaluated. All the animals treated with both netilmicin and methylprednisolone were permanent (greater than or equal to 7 days) survivors, whereas none of the untreated baboons lived more than 24 hours. These results indicate that, in a baboon model, netilmicin is an effective alternative to gentamicin (with methylprednisolone) in the treatment of severe septic shock. PMID- 3526106 TI - Serodiagnosis of human G and M immunoglobulins to Toxoplasma gondii by ELISA using whole tachyzoites as antigens: a comparative study with the indirect haemagglutination (IHA) and immunofluorescence (IFA) tests. AB - An indirect ELISA using whole tachyzoites of Toxoplasma gondii fixed onto the bottom of microtiter plate wells is described for detection of specific G and M anti-toxoplasma antibodies. ELISA results were compared with those of IFA and IHA tests. Similarity of antigens (cell surface) involved in ELISA and IFA permits high correlation between the two tests (r = 0.84-0.93, P less than 0.001) and results in good accordance for negative sera. As ELISA offers several advantages over the classical IFA test, it may be considered an alternative method for screening of G and M anti-toxoplasma antibodies. PMID- 3526105 TI - Indirect haemagglutination test for the detection of thermolabile (LT) enterotoxin from Escherichia coli. AB - An indirect haemagglutination test (IH) for the detection of enterotoxigenic E. coli (LT) was developed. Twenty-five enterotoxigenic E. coli (ETEC) from human and porcine diarrhoea and from river water were examined. The described IH test was more specific and sensitive than the passive immune haemolysis test (PIH). PMID- 3526107 TI - [Joint pain in childhood. A proposal of guidelines for differential diagnosis of juvenile rheumatoid arthritis]. PMID- 3526108 TI - [Acute appendicitis in childhood. Evaluation of a computerized diagnostic model]. PMID- 3526109 TI - [Influence of HDV infection on the course of HBsAg-positive chronic hepatitis in a pediatric case series]. PMID- 3526110 TI - [Clinical evaluation of a new antibacterial agent, xibornol, in the treatment of bacterial infections of the upper respiratory tract in childhood. Comparison with erythromycin]. PMID- 3526111 TI - Hog Lane surgery (Ophthalmic Hospital, Canton, China). PMID- 3526112 TI - [Central giant-cell reparative granuloma. Etiological problems--histological aspects. Natural history--diagnosis and therapy. Review of the literature and comments on clinical cases]. PMID- 3526113 TI - [Indications for extraction of the impacted 3d molar in an orthodontic treatment program. A review of the literature]. PMID- 3526114 TI - [New type of partial denture with magnetic retention]. PMID- 3526115 TI - [Use of diflunisal in postoperative pain of the oral cavity]. PMID- 3526116 TI - [Evaluation of the results of a study of the anti-inflammatory and analgesic activity of zidometacin vs. indomethacin following outpatient surgery on the oral cavity]. PMID- 3526117 TI - [Clinico-pharmacological comparison between between enzyme-type anti-inflammatory agents postoperatively in oral surgery]. PMID- 3526119 TI - [The diagnosis of the depth of gastric cancer invasion by the ultrasonic method]. AB - To establish the diagnosis of the depth of gastric cancer invasion by ultrasonic method scanned from the body surface preoperatively, 51 resected specimens of gastric cancer and 61 in-patients with gastric cancer were examined by Toshiba electro-linear-scanner (SAL-50A). Experiments of inserting a needle into the wall of resected stomach and removing some layers of specimens were done to determine the origin of the ultrasonic five layers structure. The tomographies, which were obtained from 51 specimens scanned in the water and 61 patients scanned from the body surface, were compared with their microscopic findings. The lesions which were limited in the anterior or posterior wall and located distal to the middle part of stomach body were able to be diagnosed accurately. It was difficult to diagnose the depth when there was a deep benign ulcer formation associated with an early cancer lesion or deformity of gastric wall due to compression of massive tumor. The depth diagnosed by ultrasonic method was sometimes deeper than final pathological one but rarely shallower than it. In this study, most advanced gastric cancer could be diagnosed correctly by this ultrasonic method preoperatively. This fact serves useful reference to determine the operative procedure. PMID- 3526118 TI - [Ileus--with emphasis on pathophysiology]. PMID- 3526120 TI - [Selective arterial secretin injection test for localization of gastrinoma]. AB - We have already shown that gastrinomas release gastrin when stimulated with secretin in vitro. In order to ascertain whether this is true in vivo and whether the reaction is clinically useful in the localization of gastrinomas, secretin was injected into a feeding artery of the gastrinoma in four patients, and blood samples were taken from a peripheral artery (PA) and the hepatic vein (HV) for determination of immunoreactive gastrin (IRG) and immunoreactive insulin (IRI) levels. When secretin was injected into a feeding artery of the gastrinoma, IRG rose within 40 seconds in the HV and within 60 seconds in the PA. When secretin was injected into a nonfeeder, IRG did not rise for 2 min in the PA. This test was performed to two of the postgastrectomized patients and a patient with hypergastrinemia due to atrophic gastritis. In these patients, IRG in the hepatic vein did not rise for two minutes. It was concluded that secretin directly stimulates gastrinomas to release gastrin in vivo and that the selective arterial secretin injection test is helpful in determining the location of the gastrinoma. PMID- 3526121 TI - [A new technic for filling the posterior teeth]. PMID- 3526122 TI - Digital subtraction angiography in cerebral and peripheral vascular diseases. PMID- 3526123 TI - Cholestanol and fatty acids of serum lipids as risk factors of stroke. PMID- 3526124 TI - Effects of several lipid-lowering drugs on skin total and esterified cholesterol. PMID- 3526125 TI - Hypolipidemic effects of bezafibrate: studies in Italy. PMID- 3526126 TI - Aspirin and the prevention of stroke after transient ischaemic attack. PMID- 3526127 TI - Treatment of claudication with dipyridamole and aspirin. PMID- 3526128 TI - Early and late results of carotid endarterectomy. High-resolution echotomography and Doppler spectral analysis evaluation. PMID- 3526129 TI - Preliminary results of sulodexide treatment in patients with peripheral arteriosclerosis and hyperlipidemia. A multicentre trial. PMID- 3526131 TI - The evaluation of the cerebral circulation by non-invasive methods. PMID- 3526130 TI - Cochleovestibular disorders and hyperlipidemia. A controlled trial with fenofibrate. PMID- 3526132 TI - Extracranial cerebrovascular Doppler examination with additional transcranial Doppler and Duplex scanning of the carotid artery in the stroke-prone patient. PMID- 3526133 TI - The CNR program of preventive medicine--SP4 Objective 44. Non-invasive techniques for the evaluation of atherosclerotic plaque progression or regression. PMID- 3526134 TI - Echotomographic extracranial carotid evaluation in amaurosis fugax, hemispheric TIA and stroke patients. PMID- 3526135 TI - Theoretical studies on sex ratio evolution. PMID- 3526136 TI - [Scanning electron microscopic study of tissue reactions around implanted gentamycin-polymethylacrylate pellets]. PMID- 3526137 TI - [Detection of glial fibrillary acid protein in brain tumors by the immunoperoxidase method]. PMID- 3526138 TI - Application of modified Salmonella/microsome prescreen to petroleum-derived complex mixtures and polynuclear aromatic hydrocarbons (PAH) AB - In some cases, the Salmonella mutagenicity assay may fail to predict the carcinogenic potential of PAH (and of complex mixtures containing PAH) because of nonoptimal in vitro metabolic activation parameters. In this study, 7 petroleum derived complex mixtures, as well as a number of individual PAH which were representative constituents of such mixtures, were tested in a Salmonella prescreen using quadrant plates with rat or hamster S9 at concentrations approximately 2-8 times those used in the standard assay. Some PAH (perylene, quinoline, benzo[b]chrysene, phenanthrene, anthracene) were optimally activated to mutagens by S9 at 400 microliters/plate. Rat S9 was similar to hamster S9 for most tested PAH, but anthracene and quinoline mutagenicity was enhanced by hamster S9. All 7 complex mixtures were more mutagenic with 200-400 microliters/plate S9; rat was generally slightly more efficient than hamster. Modifying this assay to include a prescreen using a range of S9 concentrations (and perhaps from species other than rat) may improve prediction of the potential carcinogenicity of complex petroleum-derived mixtures. PMID- 3526139 TI - Mutagenicity of soy sauce treated with a physiologically feasible concentration of nitrite. AB - Soy sauce treated with nitrite was found to be more mutagenic to Escherichia coli WP2 uvrA/pKM101 than Salmonella typhimurium TA100 without S9 mix. The mutagenicity of soy sauce treated with nitrite was affected by the concentration of soy sauce in the nitrosation mixture, and a concentration of 5% resulted in the highest specific activity (revertants/ml soy sauce equivalent). By incubating soy sauce at a concentration of 5% in a solution of 1 mM nitrite at pH 3 for 1 h at 37 degrees C, the equivalent of 1 ml of soy sauce induced 2790 revertants of E. coli WP2 uvrA/pKM101 without S9 mix. PMID- 3526140 TI - An internal survival standard for Salmonella typhimurium forward mutation assays. AB - A novel S. typhimurium forward mutation assay which avoids plating density artifacts is described. The new method uses a pair of multiply drug-resistant substrains of TM677, a bacterial strain used in previous forward mutation studies. This technique permits the measurement of cell survival following mutagen treatment by plating the culture on specially supplemented plates at the same cell concentration used to measure mutant yield. Thus this method is both technically easier and theoretically superior to our previous method. PMID- 3526141 TI - Escherichia coli xthA mutant is not hypersensitive to ascorbic acid/copper treatment--an H2O2 generating reaction. AB - Ascorbate (vitamin C) in the presence of copper yields H2O2, which seems to be responsible for its toxic effects in bacteria. However, we found that the Escherichia coli xthA mutant strain, which is hypersensitive to H2O2, has almost the same sensitivity as the wild-type strain to ascorbate and copper treatment. Our results suggest that the DNA damage induced in E. coli by H2O2 generated in oxidized ascorbate solutions is different from that induced by direct H2O2 treatment. PMID- 3526142 TI - Inducibility of gene conversion in Saccharomyces cerevisiae treated with MMS. AB - At high survival levels (85%), point mutation and gene conversion frequencies were determined in strain D7 of Saccharomyces cerevisiae after treatment with methyl methanesulfonate (MMS) either after cells were incubated in complete medium before plating or following a split-dose protocol. It is shown that induction of gene conversion by MMS post-incubation leads to an additional enhancement in frequency. This increase is not observed for point mutation. By fractionation of the MMS dose (1 mM + 1 mM) with incubation in complete medium between the 2 doses the frequency of gene conversion is twice as high as with a single equal total dose (2 mM). This treatment does not modify the frequencies of point mutation. These data support the notion that an inducible recombinogenic function exists in wild-type yeast. PMID- 3526143 TI - Ganglioside therapy in diabetic neuropathy. AB - Cronassial, a combination of four different cerebral gangliosides, was administered intramuscularly (40 mg daily) in a double-blind controlled study of 28 patients with moderate to severe diabetic neuropathy. Clinical neurologic and near-nerve electrophysiologic studies were performed. The 14 patients receiving gangliosides experienced statistically significant improvement in their clinical scores due to an increase in lower extremity sensory perception. No other clinical or electrophysiologic changes were present. No side effects were noted. Further studies employing greater numbers of patients and higher doses are required to confirm the efficacy of gangliosides in diabetic neuropathy. PMID- 3526144 TI - Identification and isolation of Trypanosoma cruzi trypomastigote cell surface protein with properties expected of a fibronectin receptor. AB - The fibronectin receptor of Trypanosoma cruzi trypomastigotes was identified using immunoprecipitation procedure. Parasite radioiodinated surface material was incubated with fibronectin followed by rabbit IgG anti-fibronectin and protein A Sepharose. The precipitates were analyzed by sodium dodecyl sulfate polyacrylamide gel electrophoresis. Two radioactive bands were seen. One of 220 kDa corresponded to a subunit of fibronectin molecule present on the parasite surface at the time of isolation. The major radioactive band of 85 kDa corresponded to the fibronectin receptor. Fibronectin receptor was purified using affinity chromatography on human fibronectin coupled to Sepharose. Analysis of fibronectin receptor by sodium dodecyl sulfate-polyacrylamide gels demonstrated one major band of 85 kDa. The purified fibronectin receptor was active since 40 60% of labeled receptor could rebind to fibronectin-Sepharose. In addition, fibronectin receptor could interact with cells bearing fibronectin molecules as shown by the binding of 125I-labeled fibronectin receptor to human monocytes and neutrophils as well as cloned 3T3 fibroblasts. The binding could be inhibited by treatment of cells with anti-fibronectin antibodies. Finally, we showed that the affinity-purified fibronectin receptor and antibodies to the receptor exerted an inhibitory effect on the infection of 3T3 fibroblasts by T. cruzi trypomastigotes in an in vitro culture system. PMID- 3526145 TI - Monoclonal anti-gametocyte antibodies identify an antigen present in all blood stages of Plasmodium falciparum. AB - Two polypeptides of 150 and 130 kDa present in all asexual and sexual blood stages of Plasmodium falciparum have been identified with anti-gametocyte monoclonal antibodies. The apparent molecular mass of these antigens is identical in different developmental stages of the parasite and in different isolates. These antigens are released in the culture supernatant during the process of schizogony and are also detected in the sera of patients undergoing a primary P. falciparum infection. Antibodies against these antigens occur in sera of a large percentage of children and most adults living in malaria-endemic areas, suggesting that they are highly immunogenic. The anti-gametocyte monoclonal antibodies react with a synthetic peptide (Glu-Glu-Asn-Val)4, present in antigen Pf155 [Perlmann, H. et al. (1984) J. Exp. Med. 159, 1686-1704] and in the ring infected erythrocyte surface antigen [Coppel, R.L. et al. (1984) Nature 310, 789 792], indicating that these polypeptides are closely related. In contrast, two glycophorin-binding proteins of similar molecular mass [Perkins, M.E. (1984) J. Exp. Med. 160, 788-798] appear to be entirely distinct from the presently described antigens. We failed to observe any in vitro inhibitory activity of the monoclonal antibodies on merozoite invasion and on gametocyte infectivity. PMID- 3526146 TI - In vivo time course of synthesis and processing of major schizont membrane polypeptides in Plasmodium falciparum. AB - A rapid method of separating membrane co-sedimentable and soluble components of Plasmodium infected erythrocytes is presented. We propose a nomenclature for major P. falciparum polypeptides, applicable to different isolates and based on their cellular location and stage specificity. For four of these polypeptides (185 kDa = Mp1; 120 kDa = Mp3; 76 kDa = Mp5; 90 kDa= Sp2) supposed to play a role in protective immunity, monospecific antibodies were available. We have studied their fate at the time of merozoite release and reinvasion, and the possible correlations between these polypeptides, by pulse-chase experiments. PMID- 3526147 TI - Identification of a Plasmodium chabaudi antigen present in the membrane of ring stage infected erythrocytes. AB - A novel antigen of asexual blood stages of the rodent malaria parasite Plasmodium chabaudi, was detected by means of a modified indirect immunofluorescence assay (IFA), using glutaraldehyde fixed and air dried monolayers of P. chabaudi infected erythrocytes. P. chabaudi hyperimmune sera gave a distinct surface immunofluorescence of erythrocytes infected with early stages of the parasite. Fixation and drying of the erythrocytes was necessary for the antigenic activity to be exposed. The antigens were species specific as P. chabaudi hyperimmune serum only stained P. chabaudi but not P. yoelii or P. falciparum infected erythrocytes. The antigenic activity involved in the IFA was resistant to trypsin, phospholipases and neuraminidase but not to pronase, suggesting that the antigens were polypeptides. The surface immunofluorescence was inhibited by an extract of parasitized erythrocytes, but not by similar extracts of normal erythrocytes. The inhibitory antigens were soluble and heat stable (100 degrees C, 5 min). For identification and characterization of the antigens, antibodies were isolated by acid elution from monolayers of infected erythrocytes and monoclonal antibodies were produced. Probing in immunoblotting of extracts of parasitized erythrocytes separated by sodium dodecyl sulfate polyacrylamide gel electrophoresis with the eluted antibodies, showed that they reacted consistently with a polypeptide of Mr 105 000 (Pch105). The Pch105 antigen shares many characteristics with Pf155, a P. falciparum antigen considered as a candidate for a vaccine against that parasite. PMID- 3526148 TI - Immunity to malaria and naturally acquired antibodies to the circumsporozoite protein of Plasmodium falciparum. AB - A candidate Plasmodium falciparum sporozoite vaccine, R32tet32, which includes 32 tetrapeptide repeats derived from the circumsporozoite protein of P. falciparum, has been developed on the basis of the hypothesis that antibodies to the repeat region of this protein will protect against sporozoite infection. The results of two in vitro assays, the circumsporozoite precipitation reaction and the inhibition of sporozoite invasion into hepatoma cells, are thought to indicate protective immunity. We therefore tested serum samples from persons living in a hyperendemic malarious area of Indonesia for antibodies against R32tet32 and for their ability to produce circumsporozoite precipitation and to inhibit sporozoite invasion of hepatoma cells. The prevalence and mean titer of antibody against R32tet32 increased with the age of the subjects, whereas the prevalence of P. falciparum infection in the community decreased. Only serum samples with IgG or IgM R32tet32 antibody titers greater than or equal to 1/800 had precipitation activity and invasion-inhibiting activity of more than 75 percent. When the serum samples were fractionated by affinity chromatography, only the fractions containing purified human antibody to R32tet32 were found to contain this activity. These data support the hypotheses that antibodies to the circumsporozoite protein are important in reducing the prevalence of malaria with increasing age among persons in areas in which malaria is endemic and that vaccine-elicited antibody to the circumsporozoite repeat region will protect against infection with P. falciparum sporozoites. PMID- 3526149 TI - Research in malaria vaccines. PMID- 3526150 TI - In vitro and in vivo results suggesting that anti-sporozoite antibodies do not totally block Plasmodium falciparum sporozoite infectivity. PMID- 3526151 TI - Diltiazem and reinfarction in patients with non-Q-wave myocardial infarction. Results of a double-blind, randomized, multicenter trial. AB - We performed a multicenter, double-blind, randomized study to evaluate the effect of diltiazem on reinfarction after a non-Q-wave myocardial infarction. Nine centers enrolled 576 patients: 287 received diltiazem (90 mg every six hours) and 289 received placebo. Treatment was initiated 24 to 72 hours after the onset of infarction and continued for up to 14 days. The primary end point, reinfarction, was defined as an abnormal reelevation of MB creatine kinase in plasma within 14 days. Reinfarction occurred in 27 patients in the placebo group (9.3 percent) and in 15 in the diltiazem group (5.2 percent)--a 51.2 percent reduction in cumulative life-table incidence (P = 0.0297; 90 percent confidence interval, 7 to 67 percent). Diltiazem reduced the frequency of refractory postinfarction angina (a secondary end point) by 49.7 percent (P = 0.0345; 90 percent confidence interval, 6 to 73 percent). Mortality was similar in the two groups (3.1 and 3.8 percent, respectively, in the placebo and diltiazem groups), but adverse drug reactions (most of which were mild) were more common in the diltiazem group. Nevertheless, the drug was well tolerated, despite concurrent treatment with beta blockers in 61 percent of the patients. We conclude that diltiazem was effective in preventing early reinfarction and severe angina after non-Q-wave infarction and that it was also safe and generally well tolerated. PMID- 3526152 TI - Electrocardiography 100 years ago. Origins, pioneers, and contributors. PMID- 3526153 TI - Airway responsiveness to leukotrienes C4 and D4 and to methacholine in patients with asthma and normal controls. AB - Leukotrienes C4 and D4 may serve as chemical mediators in asthma. Although patients with asthma are known to be hyperresponsive to the bronchoconstrictive effects of histamine and methacholine, whether the same is true for the leukotrienes is controversial. We compared the airway responses to methacholine and to leukotrienes C4 and D4 in 12 asthmatic patients and 6 controls. We found that the patients were more responsive to the leukotrienes than the controls, and we observed a linear correlation between airway response to methacholine and that to leukotriene C4 (r = 0.68, P less than 0.01) and D4 (r = 0.79, P less than 0.001). However, relative to the airway response to methacholine, the response to the leukotrienes was much greater in the controls than in the patients. Furthermore, the asthmatic subjects who were most responsive to methacholine had the lowest relative airway response to both leukotrienes. Thus, the patients with the greatest airway responsiveness to methacholine paradoxically showed the lowest relative airway response to the leukotrienes. In contrast, this difference in relative airway responses has not been observed between methacholine and other bronchoconstrictor mediators, such as histamine. Although no adequate explanation for these observations has yet emerged, our data suggest that leukotrienes C4 and D4 are unique bronchoconstrictors with a possible role in the pathogenesis of asthma. PMID- 3526154 TI - Effect of captopril on diabetic proteinuria. PMID- 3526156 TI - Empirical antimicrobial therapy in the neutropenic host. PMID- 3526157 TI - The future of Medicare. PMID- 3526155 TI - A randomized trial comparing ceftazidime alone with combination antibiotic therapy in cancer patients with fever and neutropenia. AB - To assess the efficacy of single-agent therapy relative to standard combination antibiotic therapy for the initial management of fever and neutropenia in cancer patients, we conducted a randomized trial comparing ceftazidime alone with a combination of cephalothin, gentamicin, and carbenicillin. Of 550 evaluable episodes of fever and neutropenia, 282 were treated with ceftazidime alone and 268 with the combination. All episodes were evaluated for responses at 72 hours after the start of treatment and at resolution of the neutropenia. Of the patients with unexplained fever who were given ceftazidime alone, 99 percent were alive at 72 hours and 98 percent were alive when the neutropenia resolved, as compared with 100 percent and 98 percent, respectively, of those given combination therapy. Of the patients with documented infection who were given ceftazidime alone, 98 percent were alive at 72 hours and 89 percent when the neutropenia resolved, as compared with 98 percent and 91 percent, respectively, of those given combination therapy. The majority of episodes of documented infection in both treatment groups necessitated additional antimicrobial treatment or other modifications of the initial regimen, as compared with only 22 percent of the episodes of unexplained fever. We conclude that initial single agent therapy with certain beta-lactam antibiotics is a safe alternative to standard combination antibiotic therapy, although patients with documented infection or protracted neutropenia are likely to require additional or modified treatment. PMID- 3526158 TI - Cell biology. An unfolding story of protein translocation. PMID- 3526159 TI - Dame Honor Fell FRS (1900-1986) PMID- 3526160 TI - The cytoplasmic carboxy terminus of M13 procoat is required for the membrane insertion of its central domain. AB - The M13 coat protein spans the Escherichia coli plasma membrane with its amino terminus facing the periplasm. It is made as a precursor--the procoat--with a typical leader peptide. Mutations which destroy the basic character of the carboxy-terminal domain of procoat, a domain which is oriented towards the cytoplasm, block membrane assembly, while insertion of three lysyl residues near the carboxy terminus partially restores assembly. Thus the information specifying membrane insertion of M13 procoat protein is found in its mature region as well as the leader and is not simply decoded in an amino to carboxy direction. PMID- 3526161 TI - [Transplantation of autologous skin biopsies: an effective clinical treatment of leg ulcer]. PMID- 3526162 TI - Omaha: the polio years. PMID- 3526163 TI - Monitoring of effects of cis-diamminedichloroplatinum (II). Part III. Effect of platinum complexes on PHA-stimulated proliferation of human peripheral blood mononuclear cells in vitro. AB - The effect of the platinum complexes cis-DDP and CBDCA on the functions of human peripheral blood mononuclear cells (PBMC)--viability, proliferating activity after polyclonal stimulation with phytohemagglutinin is followed in an in vitro study. Both the platinum complexes (at concentrations 10(-5) up to 10(-9) mol/l) inhibit significantly the proliferating activity of PBMC without affecting its viability, i.e. integrity and permeability of the cell membrane structures. As to effectivity, cis-DDP has shown itself a more effective inhibitor of cellular proliferation than CBDCA of which 10-100 times higher concentrations are required to achieve the same inhibitory effect in dependence on the temporal relation to the application of phytohemagglutinin. The highest inhibitory effect is noted when cis-DDP is applied either simultaneously with, or 48 h after PHA, i.e. at the stage of maximum proliferating activity. The results bring support to the assumed mechanism of action of the above platinum complexes--intervention into DNA synthesis. Since the test of blastic transformation of PBMC is held to be an image primarily of the function of T lymphocytes, it may be inferred that platinum cytostatics can affect cell-mediated immunity also in patients. PMID- 3526164 TI - Morphological and immunohistochemical study in Hodgkin's disease. AB - Histogenesis of different microscopical types of Hodgkin's disease was investigated in a series of 19 patients by morphological and immunohistochemical methods. The main changes affecting the lymphatic system occur in perivascular areas, which contain a great amount of thymic factor. The Hodgkin's and Reed Sternberg cells appear to arise from the perivascular mesenchyme and some of them have cross-striated cytoplasm. PMID- 3526165 TI - [The extreme gagging reflex in dental situations: a literature review]. PMID- 3526166 TI - [Cuspid guidance and acid etch technics in the restoration of cuspid protected occlusion]. PMID- 3526167 TI - [Kidney transplantation in a case of amyloidosis]. AB - Renal transplantation was performed in five patients with various forms of amyloidosis (familial amyloidosis, Mediterranean fever and Crohn's disease). All grafts were functioning one year after the operation. Only one patient died of cardiac shock more than 10 years after transplantation; the other recipients are alive with a functioning graft from 12 to 67 (mean, 41) months after transplantation. No early severe infection was observed in any patient. Graft biopsy obtained in three patients disclosed amyloid deposits in only one: deposits initially (72 months post-transplantation) mild and perivascular, became more prominent in the vessels and extended into the mesangium 4 1/2 years later. Extrarenal amyloid involvement observed in four cases did not lead to serious clinical consequences during the follow-up period. Renal transplantation thus provides an effective treatment of terminal renal failure due to amyloidosis whatever its cause. PMID- 3526168 TI - The centenary of Friederich H. Lewy 1885-1950. PMID- 3526169 TI - Formation of behaviorally active estrogen in the dove brain: induction of preoptic aromatase by intracranial testosterone. AB - The preoptic area (POA) of the male ring dove is a target for specific behavioral effects of estrogen that are separable from those of androgen. Activity of the aromatase system in the POA, which converts testosterone to 17 beta-estradiol (E2), is increased by systemic androgen. Using crystalline steroid implants positioned stereotaxically in the brain, we examined whether aromatase induction is a result of direct steroid action on the POA, which can occur independently of the behavioral effects of androgen. Implants of testosterone propionate (TP) greater than 1.0 mm from POA nuclei were ineffective in increasing preoptic aromatase activity irrespective of whether the implants were unilateral, or bilateral with twice the potential output of testosterone. Within the 1.0-mm range, distance of implant from the POA nuclei was negatively correlated with induced aromatase activity in POA samples, indicating a direct effect of testosterone or its metabolites on enzyme activity. Induction of aromatase activity was higher in the right side of the POA than the left, suggesting asymmetry in inducible aromatase. Inactive 5 beta-reduced androstanes, 5 alpha dihydrotestosterone and 17 beta-estradiol were formed from intracranial 3H testosterone in POA. Since estradiol benzoate implants did not induce aromatase activity, this metabolite does not appear to act directly on the POA, although it is effective if administered systemically. Implants of TP in the region of the POA caused vocal behavior (perch calling) to be shown by some males. There was no correlation between the behavioral effectiveness of implants and induced POA aromatase activity. Since increase in E2 formation occurred in the absence of vocal behavior, activation of androgen-dependent behavior is not an absolute requirement for the induction effect. We conclude that testosterone can influence aromatase activity required for local production of E2 in the brain by direct action on POA cells. PMID- 3526170 TI - Computed tomography-based stereotactic third ventriculostomy: technical note. AB - This report describes a computed tomography-based computer-assisted stereotactic technique for performing 3rd ventriculostomy. The procedure has been performed on seven patients with acquired obstructive hydrocephalus of various etiologies. None of these patients have yet required shunting. PMID- 3526171 TI - Attempts at prevention or treatment of intracranial arterial spasm: an update. AB - Numerous approaches to the prevention and treatment of intracranial arterial spasm have been made during the past three decades. In the present article, the author has assembled data about such attempts that were not included in a similar compilation published in 1980. Since 1980, there has been some progress toward the satisfactory management of this detrimental condition, but much remains to be done. PMID- 3526172 TI - Pathogenic mechanisms of depressive states. PMID- 3526173 TI - Reversible and irreversible neuronal damage caused by excitatory amino acid analogues in rat cerebellar slices. AB - Slice preparations of the developing rat cerebellum were used to investigate the light and electron microscopic correlates of reversible and irreversible neuronal injury caused by the neurotoxic excitatory amino acid receptor agonists, kainate and N-methyl-D-aspartate. The slices were examined after various periods of exposure to the agonists (up to 30 min) with or without a 90 min recovery period in agonist-free medium. N-Methyl-D-aspartate (100 microM) caused necrosis of deep nuclear neurons and differentiating granule cells, the exposure times necessary to induce non-recoverable damage (leading to necrosis), being, respectively, 10 min and 20-30 min. Exposure periods of only 2-4 min with kainate (100 microM) were needed for Golgi cells to subsequently undergo necrosis. Other cell types (Purkinje, granule and deep nuclear neurons) were altered histologically by kainate but most recovered fully from 30 min exposures. Before the recovery period, the worst affected of these cells (deep nuclear neurons) displayed increased cytoplasmic and nuclear electron density and microvacuolation due to swelling of Golgi cisterns but little or no chromatin clumping or mitochondrial expansion. The neurons which were injured irreversibly by the agonists within 30 min displayed, near the time of lethal injury, increased cytoplasmic and nuclear electron lucency, marked focal aggregation of chromatin and swelling of Golgi apparatus. Mitochondrial swelling did not appear to precede lethal injury and even after exposure times sufficient, or more than sufficient, to lead to necrosis, large numbers of mitochondria remained in a condensed configuration. The significance of the histological changes is discussed and they are compared with those occurring in other pathological conditions. The time scales required for the receptor agonists to induce irreversible cellular lesions would be consistent with this being a process which is responsible for acute neuronal necrosis in the brain. PMID- 3526174 TI - Ionic requirements for neurotoxic effects of excitatory amino acid analogues in rat cerebellar slices. AB - The ionic requirements for the neurotoxic effects of N-methyl-D-aspartate and kainate in incubated slices of developing rat cerebellum were studied using light and electron microscopy. Under normal conditions, 30 min exposure to 100 microM N methyl-D-aspartate followed by a 90 min recovery period in agonist-free medium resulted in the necrosis of differentiating granule cells and deep nuclear neurons, while the corresponding effect of 100 microM kainate was the death of Golgi cells. Substitution of 96% of the Cl- in the medium with isethionate did not prevent the toxicity of either agonist. However, all the ordinarily vulnerable cells survived and exhibited normal ultrastructure if the slices were exposed to the excitants in a Ca2+-free medium and were subsequently allowed to recover in a Ca2+-containing solution. Prior to this recovery period, granule, Golgi and deep nuclear neurons exposed to N-methyl-D-aspartate were markedly swollen but their mitochondria were hypercontracted and there was no clumping of chromatin or obvious swelling of the rough endoplasmic reticulum or Golgi apparatus, in contrast to observations made on slices exposed to this agonist in normal medium. Substitution of all the Na+ in the medium with a mixture of choline (118 mM) and Tris (25 mM) itself caused necrosis of granule cells and deep nuclear neurons and an intense microvacuolation of Purkinje cells, due, in large part, to high amplitude mitochondrial swelling. A low (25 mM) Na+ medium was well tolerated under control conditions. This medium protected granule cells but not deep nuclear neurons from the toxicity of N-methyl-D-aspartate and failed to prevent kainate-induced death of Golgi cells. It is concluded that the acute neurotoxic effects of the two excitatory amino acid receptor agonists in the slices are dependent on extracellular Ca2+ and are independent of extracellular Cl-. Where apparent, the protective effect of reducing extracellular Na+ on the toxicity of N-methyl-D-aspartate is likely to reflect the involvement of this ion in the primary depolarizing mechanism. PMID- 3526175 TI - Amino acid neurotoxicity: relationship to neuronal depolarization in rat cerebellar slices. AB - It has long been proposed that the excitatory and toxic properties of acidic amino acid receptor agonists are linked. To test this hypothesis, the depolarizing effects of quisqualate, kainate and N-methyl-D-aspartate in adult and immature rat cerebellar slices have been studied in relation to their neurotoxic effects in the same tissues (reported separately). A "grease-gap" method was used to measure the depolarizing responses of Purkinje cells and granule cells in lobule VI to the agonists. The depolarizing potencies of kainate and quisqualate were apparently similar on both cell types and at both ages studied although maximal responses to kainate were always larger. N-Methyl-D aspartate was a very weak agonist in the adult slices but was much more effective in the immature tissues, apparently on both Purkinje cells and granule cells. Comparison of the depolarizing effects of the agonists with their neurotoxic effects on Purkinje cells and granule cells suggested that: (a) the ability to depolarize is a required condition for an agonist to be neurotoxic, (b) the magnitude of depolarization, rather than depolarizing potency, is the more pertinent determinant of neurotoxic potency and (c) resistance to the neurotoxicity of an agonist is not necessarily associated with resistance to its depolarizing actions. Histological studies indicated that the neurotoxicity of N methyl-D-aspartate and kainate in immature cerebellar slices could largely not be replicated by veratridine (50 microM) or high extracellular K+ (124 mM) indicating that receptor-mediated ionic fluxes may be needed in addition to those caused by depolarization. Exposure of the slices to anoxia in the absence of glucose partially reproduced the toxicity of the receptor agonists. Application of ouabain for 30 min caused necrosis of all the cells which are vulnerable to the agonists but spared the cells which are not vulnerable. Profound ionic imbalance thus appears to be a sufficient explanation for amino acid neurotoxicity. PMID- 3526176 TI - [Met]- and [Leu]enkephalin-like immunoreactive cell bodies and nerve fibres in the coeliac ganglion of the cat. AB - The occurrence and distribution of methionine- and leucine-enkephalin-like immunoreactivity were investigated in the cat coeliac ganglion using either the indirect immunoperoxidase method or the peroxidase-antiperoxidase technique. Several antisera raised to methionine- and leucine-enkephalin were used. Their specificity was assessed by incubating sections of the coeliac ganglion with increasing dilutions of antisera and with antisera saturated with their respective antigen. The present study was performed both in untreated and in colchicine-treated cats. Immunoreactive methionine- and leucine-enkephalin-like cell bodies were only visualized in colchicine-treated cats. Two types of labeled cells were observed. The first type had a size similar to that of unlabeled principal ganglion cells. These labeled cells were numerous and scattered throughout the ganglion; they probably represented enkephalin-containing ganglion cells. The second type of immunoreactive cells were of a much smaller size. They were always gathered in small clusters of about 5-15 cells and were not numerous; they presumably represented enkephalin-containing small intensely fluorescent cells. Immunoreactive nerve fibres were mainly observed in untreated cats and accessorily in colchicine-treated cats. In untreated animals dense networks of methionine- and leucine-enkephalin-like immunoreactive fibres were found in the coeliac ganglion. These fibres had numerous varicosities which often closely surrounded unlabeled principal ganglion cells. In colchicine-treated cats some immunoreactive fibres surrounded labeled principal ganglion cell bodies. The present results establish for the first time the presence of enkephalin-like immunoreactive principal ganglion cells in a mammalian sympathetic prevertebral ganglion. The presence of enkephalin-containing principal ganglion cells, small intensely fluorescent cells and nerve terminals, supports an important role of enkephalins in the integrative synaptic activities of cat coeliac ganglion cells. PMID- 3526177 TI - Brainstem auditory hallucinosis. AB - We studied three patients with findings suggesting that auditory hallucinations may occur with lesions of the tegmentum of the pons and lower midbrain. The evidence was clinical (indicating location of the lesion), radiologic (CT), pathologic in one case, and physiologic (affirming integrity of the cochleas and auditory nerves). The condition is comparable with the Lhermitte peduncular diencephalic visual hallucinosis. PMID- 3526178 TI - Myasthenia gravis after allogeneic bone marrow transplantation: relationship to chronic graft-versus-host disease. AB - Three patients with chronic graft-versus-host disease (GVHD) developed myasthenia gravis (MG) 762 to 1,180 days after allogeneic bone marrow transplantation. Symptoms of MG were observed after taper or discontinuation of immunosuppressive treatment of chronic GVHD. All patients developed antibodies to acetylcholine receptor, and one had antibody formation to striated muscle. One patient died of complications of treatment of MG. The severity of disease underscores the importance of the differential diagnosis and the need for prompt therapy of this late complication after human bone marrow transplantation. PMID- 3526179 TI - Inflammatory myopathy associated with chronic graft-versus-host disease. AB - Damage of skeletal muscle in association with graft-versus-host disease (GvHD) has been referenced exceptionally. Eighteen months after bone marrow transplantation, a 22-year-old man developed polymyositis associated with manifestations of chronic GvHD, such as peripheral eosinophilia and localized morphea. Diagnosis of polymyositis was established by clinical, electromyographic, and histopathologic findings. His clinical condition improved with immunosuppressive therapy. At electronmicroscopy, some close and broad contacts between lymphocytes with activated appearance and degenerated muscle fibers were observed, suggesting a lymphocytotoxic mechanism. The findings support the idea that polymyositis can be considered a manifestation of chronic GvHD. PMID- 3526180 TI - Intrathecal administration of natural human interferon alpha in amyotrophic lateral sclerosis. AB - Ten patients with amyotrophic lateral sclerosis were given intrathecal injections of natural interferon alpha, 1 million units weekly for 7 to 24 weeks. Six patients completed the trial. Four voluntarily withdrew after 7 to 13 injections. The slopes of deterioration for 40 quantitative tests of neuromuscular function for the control and treatment periods were compared by paired t test in the six patients who completed the trial and in the patient who withdrew after 13 injections. No significant differences were found. The patients tolerated treatment well. The CSF reaction was modest and spontaneously reversible. Indomethacin and ibuprofen blocked interferon side effects. PMID- 3526181 TI - Sciatica--management by chemonucleolysis versus surgical discectomy. AB - Two therapeutic approaches designed specifically to relieve the symptoms of sciatica and resolve the signs of lumbar radiculopathy brought about by herniation of the nucleus pulposus have evolved. The surgical removal of the lumbar disc is an operation which has undergone miniaturization in recent years. Treatment of disc hernia by chemical hydrolysis of the nucleus pulposus (chemonucleolysis) has, over the past 20 years, become an alternative to open surgical treatment. These two forms of therapy are compared as to their efficacy and safety. Neurosurgeons now have the data to decide on the suitability of employing one or the other (or both) of these forms of treatment in the care of patients with intractable sciatica. PMID- 3526182 TI - [Methods for preventing complications of central venous catheterization]. PMID- 3526183 TI - [Ceftazidime in the treatment of infections in intensive care. Experience with 20 clinical cases]. PMID- 3526184 TI - [Short-term ceftazidime administration in surgical prophylaxis]. PMID- 3526185 TI - [Role of echography in the diagnostic approach to abdominal injuries]. PMID- 3526186 TI - [Veno-venous extracorporeal circulation in orthotopic transplant of the liver. Experimental study]. PMID- 3526187 TI - [Primary closure in the treatment of pilonidal sinus. Evaluation of immediate and remote results]. PMID- 3526188 TI - [Short-term systemic prophylaxis in elective colorectal surgery. Comparison between the clindamycin-tobramycin combination and ceftazidime]. PMID- 3526189 TI - [Ceftazidime (Glazidim) in pediatric surgery]. PMID- 3526190 TI - [Endogenous opioids in the regulation of exocrine and endocrine pancreatic function (review)]. PMID- 3526191 TI - [Echotomographic, colonoscopic and clinical evaluation of syntropium bromide]. PMID- 3526192 TI - [Instrumental and clinical evaluation of syntropium bromide (VAL 480), a new synthetic spasmolytic]. PMID- 3526193 TI - [Surgical and postsurgical therapy of differentiated carcinomas of the thyroid]. AB - Surgical removal of the gland has been for a long time an essential tool in the therapy of differentiated thyroid carcinomas. Radical or conservative operation is discussed in the surgical management of thyroid carcinoma. In all cases main risk factors must be considered: age, sex and tumour extension. I131 therapy is prescribed in the treatment of functioning metastasis of patients after total thyroidectomy. Substitutive hormonotherapy must also suppress TSH secretion. PMID- 3526194 TI - [Diabetes and surgical interventions]. AB - Due to the ways their disease develops diabetics are more likely to require surgery than the rest of the population and operations constitute a stress factor with high rates of morbidity and post-operative mortality due essentially to cardiovascular and infectious complications. In normal subjects the stimulation of the hypothalamohypophyseal axis and the suprarenal marrow induced by surgical stress mobilizes energy substrates that provoke the secretion of insulin that prevents their accumulation and improves their utilization. In diabetics the inadequacy or lack of insulin secretion unbalances these mechanisms to the great danger of the patients themselves. For this reason patients' pre-operative conditions must be very carefully assessed and treatment designed to prevent the increase of catabolic ways due to the lack of insulin must be given. Some of the many treatment protocols proposed are described and discussed, a distinction being made between diet, non insulin and insulin dependent diabetics. The post operative risk constituted by the onset of non-ketoacidotic hyperosmolar coma, as occurs in other severe stress situations should also be remembered. PMID- 3526195 TI - [Obstetric psychoprophylaxis with the RAT method. Analysis of attendance and evaluation of the efficacy of the method]. PMID- 3526196 TI - [Early recognition of twin-to-twin transfusion syndrome. Differential diagnosis and therapeutic hypothesis]. PMID- 3526197 TI - [Echographic images of fetal visceral atony: limits between dysmorphism and dysfunction]. PMID- 3526198 TI - [Echographic monitoring of the ovarian follicle]. PMID- 3526199 TI - [Echotomographic diagnosis in a case of a rare genital malformation: uterus communicating with a double vagina one of which was atretic]. PMID- 3526200 TI - Biological methods for studying the biosynthesis of natural products. PMID- 3526201 TI - Tropane alkaloids. PMID- 3526202 TI - Avermectins and milbemycins. PMID- 3526203 TI - Behavioral consequences of antidepressant treatment in rodents. AB - This review discusses the effects of antidepressant drugs on behaviors that are changed during the clinical treatment of depression. We first consider whether there is a similar subjective state produced by antidepressant drugs that might be akin to the mood changes caused clinically by these drugs. We thus review the evidence that antidepressant drugs can produce a distinctive enough subjective state to serve as a discriminative stimulus, and then discuss the nature of the cue produced. Secondly, we discuss whether there is any evidence that antidepressants enhance the rewarding aspects of stimuli since this aspect of behavior is reported to change during the successful treatment of depression. In this section we review the effects on electrical brain stimulation, water and food intake, exploratory and social behaviors. Finally, because of the proposed role of stress in the aetiology of depression, we review the effects of antidepressants on the responses to acute and chronic stress. PMID- 3526204 TI - Agricultural strategies, food and nutrition: issues and opportunities. AB - Agricultural development in developing countries has not lead to significant improvements in the consumption and nutrition of poor people. One reason is that, in the design of policy and projects, consumption objectives have not been incorporated explicitly. Far greater understanding is required of the way rural people plan their strategies for obtaining household food; external assistance should build on these activities rather than undermine them. This has often occurred in the past. Five aspects of agricultural policy are considered which, if incorporated into planning and implemented, should lead to improvements in food consumption and nutrition. These are: first, a review of the way in which export crops should be introduced and promoted so that food security is not adversely affected; second, a discussion of the need to give greater attention to what are known as "minor" crops; third, a discussion of the importance of incorporating seasonality into planning; fourth, a review of the importance of women; and fifth, an examination of the ways in which crop breeding research should involve nutritional concerns. The paper concludes with some observations from Kenya whereby agricultural sector planning could incorporate nutritional objectives. PMID- 3526205 TI - Dentistry aids anthropology. PMID- 3526206 TI - The proteins of dental enamel. PMID- 3526207 TI - The rational management of oral candidosis associated with dentures. PMID- 3526208 TI - Comparison of netilmicin with ceftriaxone for the treatment of severe or complicated urinary tract infections. AB - A randomised trial was undertaken to compare the efficacy of netilmicin and ceftriaxone for the treatment of severe or complicated urinary tract infections. Forty-seven patients completed the study. Twenty-three of 24 patients treated with netilmicin and 21 of 23 treated with ceftriaxone were cured. One patient treated with netilmicin had a mild, reversible disturbance of renal function. Six patients developed diarrhoea after ceftriaxone treatment. PMID- 3526209 TI - Multiple dose insulin regime using the NovoPen. PMID- 3526210 TI - Peritonsillar infection in Christchurch 1981-1984. AB - Retrospective review of the notes of 83 peritonsillar infection sufferers over three years at Christchurch Hospital reveals that the typical sufferer is a young adult male who is most likely to present in winter or summer. Only a quarter of the patients had a significant recent history of tonsillitis but four had had a previous quinsy and six had had a previous tonsillectomy in childhood. Length of symptoms does not appear helpful in differentiating an abscess from a cellulitis. Anaerobic organisms were found in 49% of aspirates and streptococci were the most important aerobic organism. Potential beta lactamase producing organisms, H influenzae, Staph aureus and Bacteroides sp were infrequent and penicillin remains the drug of choice. Appropriate antibiotics and drainage are the essentials of management and tonsillectomy may be indicated. PMID- 3526211 TI - Serendipity and the discovery of penicillin. PMID- 3526212 TI - 99mTc-DTPA uptake in malignant and inflammatory bowel disease: experience from gastrointestinal bleeding studies. AB - During the evaluation of 99Tcm-DTPA for localization of acute gastrointestinal bleeding in 81 studies (78 patients), it was observed that there was an increased 99Tcm-DTPA at sites of inflammatory and malignant lesions of the GI tract in 18 studies. Active bleeding was detected only in 10 and no bleeding was detected in the remaining eight studies. In all the increased DTPA uptake helped to localize the site of bleeding. Image subtraction of early from delayed images according to a predefined acquisition and processing protocol helped to differentiate bleeding from non bleeding lesions. We conclude that increased 99Tcm-DTPA uptake in malignant and inflammatory lesions of the bowel is an additional advantage for its use in localizing the site of acute GI bleeding. Technetium-99m diethylenetriamine pentaacetic acid (99Tcm-DTPA) has been widely used for imaging the brain and kidneys since it was introduced by Hauser in 1970. Kadir and Strauss in 1979 reported that 99Tcm-DTPA localizes in segments of bowel with inflammation due to ulcerative colitis, regional enteritis and other forms of enterocolitis. Recently we reported the advantages of 99Tcm-DTPA in localizing the site of acute gastrointestinal bleeding. Inflammatory bowel diseases are among the causes of gastrointestinal bleeding. One of the problems in localizing the site of the bleeding by radionuclide procedures is the intermittent nature of the bleeding. We have reviewed all gastrointestinal bleeding studies in our department using 99Tcm-DTPA from January 1984 till September 1985 in order to find out whether increased uptake of 99Tcm-DTPA was helpful in localizing the bleeding lesion due to malignancy and/or inflammation. PMID- 3526213 TI - Work and pregnancy. Review of the literature and policy discussion. AB - An increasing proportion of obstetric patients are working women. This widens the world of concern for the obstetrician, who must now become familiar with the consequences of workplace exposures and conditions for both maternal and fetal health. This review briefly explores interactions between chemical and physical hazards on the job and the physiologic changes of pregnancy in order to propose ways in which the obstetrician can intervene on behalf of the individual patient, as well as on the public level. Through discussion of the Pregnancy Discrimination Act, job transfer and modification, disability, breastfeeding, etc., emphasis is placed on the social and policy factors that affect reproductive outcome for the working pregnant woman. PMID- 3526214 TI - Neoplastic pericarditis and gynecologic malignancies--a review of the literature. AB - Neoplastic involvement of the heart/pericardium is not a common complication of gynecologic malignancies. However, as its occurrence can represent a substantial risk for the patient, it is important for the clinician to understand the pathophysiology, diagnosis, and treatment of this complication. An attempt, therefore, is made to review the pertinent clinical aspects of this condition with emphasis on the treatment options available. PMID- 3526215 TI - Role of amniocentesis in ultrasound-detected fetal malformations. AB - Sixty-three patients with antenatally diagnosed fetal malformations over the period of 14 months were prospectively offered genetic amniocentesis, irrespective of gestational age. An additional 15 patients were excluded from the study because of a known lethal malformation (13 anencephaly, two amniotic bands). Twenty patients accepted amniocentesis, and seven chromosomal disorders were found. Obstetric management was altered in some of these patients as a result of the anomalies. PMID- 3526216 TI - Mathematic modeling of fetal growth: development of individual growth curve standards. AB - To provide a more precise means for monitoring individual fetal growth and to improve the detection of growth abnormalities, the Rossavik growth model [P = c(t)k + s(t)] has been used to establish individual growth curve standards. A longitudinal study of the growth of one-dimensional (biparietal diameter, head, and abdominal circumferences), two-dimensional (head and abdominal profile areas), and three-dimensional (head and abdominal volumes) parameters in 18 normal fetuses has revealed that the growth of all parameters can be well described by the Rossavik model (R2: 97.2 to 99.5%). Strong statistical evidence was obtained indicating that the coefficient k is principally a geometric coefficient having a value determined primarily by the dimension of the parameter being studied. It was also found that the coefficients c and s can be estimated from the data obtained before 28 weeks' conceptual age. Individual growth curve models derived from data obtained before 28 weeks were capable of predicting growth beyond 28 weeks. These models provide growth curve standards for evaluating individual fetal growth beyond 28 weeks. PMID- 3526217 TI - Ultrasound cystourethrography by perineal scanning for the assessment of female stress urinary incontinence. AB - Perineal scanning using linear array ultrasound was used as an alternative to radiologic cystourethrography in the investigation of female urinary incontinence. The technique provides similar information to that obtained by fluoroscopy without exposing the patient and the physician to radiation. The bladder neck and urethra as well as the urodynamic catheter are readily visualized. Familiarity with the unusual configuration of the sonogram needs to be attained. PMID- 3526219 TI - Diagnosis of ectopic pregnancy. PMID- 3526218 TI - Mefenamic acid in the treatment of premenstrual syndrome. AB - The use of mefenamic acid in the treatment of premenstrual syndrome (PMS) was investigated in 15 women over six menstrual cycles. A randomized, double-blind, cross-over, placebo-controlled design was used to overcome the methodologic criticisms of other medication trials in this condition. Mefenamic acid significantly improved many of the physical, mood, and performance symptoms associated with PMS. The physical symptoms that showed marked improvement were fatigue, headache, and general aches and pains (P less than .001). Most mood symptoms were improved, the most significant being freedom from mood swings (P less than .005). PMID- 3526220 TI - Intrauterine aspiration of a large fetal ovarian cyst. AB - Most large series of neonatal ovarian cysts are limited to those diagnosed in the newborn period. Eight cases of fetal ovarian cysts diagnosed prenatally by ultrasound have been reported, only one of which was aspirated in utero. Reported is the youngest fetus to undergo in utero aspiration of an ovarian cyst to reduce the risk of secondary pulmonary hypoplasia. PMID- 3526221 TI - Genital tract reconstruction in a patient with congenital absence of the vagina and hypoplasia of the cervix. AB - A 15-year-old female presented with congenital absence of the vagina and a blind ending hypoplastic cervix. The uterine cavity appeared normal by ultrasound examination, and the patient experienced molimina. Cognizant of risks and failures of described attempts at correction, reconstruction was performed using a series of stents covered with skin grafts. At 21 months postoperatively, the patient now has a functioning vagina and menstruates regularly. The desire to avoid a hysterectomy coupled with new alternatives in the management of the infertile patient resulted in the approach described. PMID- 3526222 TI - Are you IO or ID? PMID- 3526223 TI - [Newly developed polishing system for conical inner crowns and its equipment]. PMID- 3526224 TI - Optical problems following refractive surgery. AB - All of the refractive surgical procedures share the common optical complications of glare and photophobia, undercorrection and overcorrection, regular and irregular astigmatism, loss of best corrected acuity, fluctuation in visual acuity, loss of progression of effect, and monocular diplopia. This review presents the different clinical settings under which these various complications can occur. Many of the complications are associated with technical problems at the time of surgery and abnormalities in the resurfacing of the cornea after surgery. Many of these complications can be corrected by glasses, contact lenses, or repeat refractive surgical procedures. PMID- 3526225 TI - Indirect immunofluorescent antibody diagnosis of herpes simplex with upper tarsal and corneal scrapings. AB - Indirect immunofluorescent techniques were used to diagnose active herpes simplex virus ocular infections in 84 patient observations (41 with ocular lesions suspicious clinically for herpes simplex and 43 with lesions suspicious clinically for other ocular inflammatory conditions). We found indirect immunofluorescent antibody techniques to have a high sensitivity (97%) and specificity (73%) when compared to herpes simplex virus cultures. Similarly, we found the sensitivity (98%) and specificity (77%) of indirect immunofluorescent antibody techniques to be high when compared to the clinical diagnosis of herpes simplex viral infection. Significantly, there were no false negative tests by indirect immunofluorescent techniques. Both corneal and upper tarsal scrapings by indirect immunofluorescence were used and the upper tarsal scrapings were an excellent source of cells exhibiting herpes simplex virus antigens. All cases in which corneal scrapings were positive by indirect immunofluorescence for herpes simplex ere also positive by upper tarsal scrapings, although the converse was not true. PMID- 3526227 TI - Fuchs' corneal dystrophy. A clinicopathologic study of the variation in corneal edema. AB - Corneal buttons from six patients with Fuchs' dystrophy had varying degrees of clinical edema measured in most cases by preoperative optical or ultrasonic pachymetry. These were sectioned in the operating room so that histologic correlations could be made. Histologically, marked thickening of Descemet's membrane and abnormal corneal endothelium corresponded to areas of severe clinical edema and were usually located in the central and paracentral regions. Descemet's membrane displayed multiple prominent guttata of varying size and shape, either facing the anterior chamber, or buried within multilaminar Descemet's membrane. In some corneas, aggregates of 10 nm fibrils were seen at the edges of guttata, corresponding to areas that stained for oxytalan fibrils. The endothelium was attenuated underlying the guttata. Clinical edema was not present unless accompanied by marked thickening of Descemet's membrane with multiple guttata and attenuation of corneal endothelium. The peripheral cornea was relatively clear clinically and showed minimal histologic changes. PMID- 3526226 TI - Drug-induced cicatricial pemphigoid affecting the conjunctiva. Light and electron microscopic features. AB - Cicatricial pemphigoid (CP) is a chronic inflammatory disease which can affect the conjunctiva. It is a slowly progressive disorder of unknown but presumed autoimmune etiology. Pseudopemphigoid, or CP associated with ocular drug administration, has also been described. These cases, which appear clinically indistinguishable from unilateral idiopathic CP affecting the conjunctiva, have been related to the use of echothiophate iodide, pilocarpine, idoxuridine, and epinephrine. We report the histopathologic and ultrastructural characteristics of 22 biopsies from ten patients with iatrogenic CP following the use of various ocular drugs. All patients presented with clinically obvious, active CP affecting the conjunctiva. Light microscopy and electron microscopy revealed findings identical to those previously reported for idiopathic CP of the conjunctiva: squamous metaplasia, increased numbers of desmosomes, basal lamina modifications suggestive of damage and attempted repair, subepithelial inflammatory cell infiltration, and diminished intravascular space within the stroma. These patients responded to immunosuppressive therapy. The authors wonder if it is possible that these patients were destined to develop CP, but that with topical ocular drug use, a more rapid emergence of the chronic cicatrizing feature of CP developed. PMID- 3526228 TI - The triple procedure. Analysis of outcome, refraction, and intraocular lens power calculation. AB - Presented are the results of 66 consecutive, elective, combined procedures of penetrating keratoplasty, extracapsular cataract extraction, and intraocular lens insertion (triple procedure) performed by three surgeons between January 1981 and January 1984. After a mean postoperative followup of 15.8 months, over 90% of the eyes had clear grafts, and of the 56 eyes with good preoperative visual potential, 77% achieved a best corrected visual acuity of 20/40 or better. The postoperative mean refractive deviation from emmetropia was 2.17 diopters, with a range of +6.62 D to -5.50 D, 62% falling between -2.00 and +2.00 diopters. Using multiple regression analysis of preoperative and postoperative variables, an attempt was made to derive a predictive formula for the power of the intraocular lens to be implanted during the triple procedure. In contrast to cataract surgery, where axial length and corneal power remain fairly constant preoperatively and postoperatively, penetrating keratoplasty produces marked changes in corneal curvature and power. Therefore, a single formula could not be derived to predict accurately the intraocular lens power for the patients. However, using the results for an individual surgeon, a formula was derived that could improve the predictability of intraocular lens power. PMID- 3526229 TI - Treatment of glaucoma with high-intensity focused ultrasound. AB - This report is a summary of results for 170 eyes of patients with refractory glaucoma treated with high-intensity focused ultrasound. The results are analyzed in terms of the effectiveness of various treatment regimens, complications, and classifications of the patient population according to such factors as age and etiology. The mean pretreatment intraocular pressure (IOP) for the ensemble of patients treated with optimal intensity levels was 38.6 mmHg. Whereas only 10% of these patients had an IOP of 25 mmHg or less prior to treatment, 90% had an IOP of 25 mmHg or less within 3 months of treatment. At 1 year after a single treatment, 65% of patients still maintained intraocular pressures of 25 mmHg or less, and 56% had pressures of 22 mmHg or less. The effectiveness of retreatment of failed or unresponsive cases was also investigated and found to have a degree of success comparable to that of initial treatments. PMID- 3526230 TI - Anterior optic nerve blood flow decreases in clinical neurogenic optic atrophy. AB - Anterior optic nerve blood flow was studied in nine patients with unilateral neurogenic optic atrophy using noninvasive techniques. Disk reflectometry measurements from temporal sites demonstrated a significant reduction in the index of blood volume in atrophic optic nerves as compared with the contralateral optic nerves (P less than 0.00001). Laser Doppler measurements from the same temporal sites detected a significant reduction in the speed of blood (P less than 0.002). On average, blood volume was decreased by 49% +/- 11% and blood speed by 30% +/- 17%. Combining the results of these two techniques yielded a relative index of blood flow that showed a significant reduction in the atrophic nerves (P less than 0.0001), averaging 64% +/- 14% temporally. Nasally there was less reduction in blood flow. The results correlated well with clinical assessment of the degree of optic nerve damage (rho = 0.92, P less than 0.002). This study demonstrates that clinical neurogenic optic atrophy induces significant reductions in overall anterior optic nerve blood flow that are detected by these noninvasive techniques. PMID- 3526231 TI - Electrical stimulation applied to bone and nerve injuries in the upper extremity. AB - In conclusion, electrical stimulation of bone has advanced from the laboratory to clinical reality. Despite the lack of good double-blind clinical studies, it is impossible to ignore the excellent results reported from numerous multicenter trials. Doubts and controversies will and should continue. Electrical stimulation has a definite place in the treatment of scaphoid nonunion as well as other failures of osteogenic biology in the upper extremity. The future may realize the enormous potential of electrical stimulation in areas of nerve repair, wound healings, or osteoporosis. The hand surgeon may soon be operating in the age of biophysics where he or she can charge by the kilowatt hour. Yet one should not become a mere technician, but understand the basic science of what one is doing and, above all, maintain a balanced and critical approach. PMID- 3526232 TI - Free tissue transfers to the upper extremity. AB - With the expanded surgical options provided by free tissue transfers, upper extremity reconstruction has progressed to a level of greater finesse. Recognizing the ideal tissue for restoration of function and aesthetics, thin skin dorsally and sensate glabrous skin volarly, is the first step to effective application of microsurgery in the hand. With complex deformities, all missing components must be considered and the patient's goals realistically defined. An in-depth understanding of hand function is combined with an exhaustive knowledge of free tissue donor sites and a reconstructive plan is formulated. Staged reconstruction may be necessary, depending on the complexity of the problem. Ideal donor tissues are not always available, but it is expected that advances in immunology will soon make "spare part surgery" a viable alternative. PMID- 3526233 TI - Kienbock's disease. AB - Kienbock's disease is an isolated disorder of the lunate resulting from vascular compromise to the bone. The symptoms include wrist pain, limited range of motion, and decreased grip strength. The diagnosis is made from characteristic changes seen in the lunate on radiograms of the wrist. The severity of the disease can be categorized by staging the degree of involvement. This is helpful in guiding the practitioner through the maze of treatment options. Initial treatment of Kienbock's disease is conservative and includes immobilization, analgesics, and/or anti-inflammatory medication. If symptoms are not relieved, then based on the degree of involvement, several surgical options exist that will provide a successful result. These include autogenous tendon replacement arthroplasty, revascularization, radial shortening, ulnar lengthening, limited intercarpal arthrodesis, and silicone replacement arthroplasty. Salvage procedures for Kienbock's disease include wrist denervation, wrist arthrodesis, and proximal-row carpectomy. Currently, we prefer immobilization for treatment of stage I Kienbock's disease. For stage II, a revascularization procedure may be attempted or ulnar lengthening/radial shortening done, particularly if there is significant negative ulnar variance. In stage III, replacement arthroplasty and/or limited intercarpal arthrodesis is our treatment of choice, and for stage IV, one of the salvage procedures is indicated. PMID- 3526234 TI - Basal joint arthritis. Fusion, implant, or soft tissue reconstruction? AB - The basal joint of the thumb is often afflicted with arthritis with significant resultant disability. Many reconstructive procedures are available. Many factors must be considered to choose the best procedure for the individual patient. PMID- 3526235 TI - [Primary dermatoplasty in open injuries of the hand and fingers in ambulatory conditions]. PMID- 3526236 TI - [Timing of surgical treatment of hand deformities in sequelae of injuries of the median and ulnar nerves]. PMID- 3526237 TI - [Achievements of Soviet military surgery]. PMID- 3526238 TI - [Restoration of work capacity of patients injured in traffic accidents (report II -disability)]. PMID- 3526239 TI - [Treatment of injuries of the flexor tendons of the fingers in children]. PMID- 3526240 TI - [Discovery of the lesser circulation]. PMID- 3526241 TI - [The Hungarian medical press between 1919 and 1944]. PMID- 3526242 TI - [Enthesopathic hyperostosis of the pterygoid fossa: an early roentgenologic finding in temporomandibular dysfunction syndrome]. PMID- 3526243 TI - [Treatment of severe combined immune deficiency with fetal thymus and bone marrow transplantation, as well as with thymosin]. PMID- 3526244 TI - [Urinary fistula after the use of adhesives on the renal parenchyma]. PMID- 3526245 TI - [First traces of resuscitation attempts in ancient Egypt]. PMID- 3526246 TI - [In memory of the National Society for Public Health]. PMID- 3526247 TI - [Significance of the determination of prostacyclin metabolism in the management of hemolytic uremic syndrome and thrombotic thrombocytopenic purpura]. PMID- 3526248 TI - [Simultaneous occurrence of SLE-associated autoimmune hemolytic anemia and hemolytic crisis caused by E coli]. PMID- 3526249 TI - [Exfoliative cytological examination of the urinary tract using a membrane filter]. PMID- 3526250 TI - [S. S. Korsakov (1854-1900)]. PMID- 3526251 TI - [Johann Peter Frank and the founding of public health policy]. PMID- 3526252 TI - [The possibility of knowing the objective truth]. PMID- 3526253 TI - History of hazards associated with asbestos. PMID- 3526254 TI - Directory, 1986. PMID- 3526255 TI - Chronic pain and the family: a review. AB - This paper reviews the literature on chronic pain patients and their families. The review focuses on family and marital variables correlated with pain, conceptualizations of the family's role in maintaining pain, reports of family treatment and follow-up studies of the family's impact on treatment. Although research in this field is generally weak methodologically, and the mechanisms whereby the family affects chronic pain are still little understood, the authors conclude that family characteristics and behaviors contribute strongly to a chronic pain problem and they have a significant influence on treatment outcome. PMID- 3526256 TI - Deafferentation and chronic pain in animals: an evaluation of evidence suggesting autotomy is related to pain. AB - This paper examines evidence which suggests that the self-mutilation of deafferented limbs exhibited by laboratory animals is a response to pain or dysesthesia and is therefore an adequate model of chronic pain. Evidence from studies using physiological, pharmacological and behavioral methods provides strong support that autotomy reflects chronic pain. New evidence presented in this paper demonstrates that specific treatments can be used to manipulate the extent of autotomy, causing increases or decreases, as well as restricting it to specific parts of a denervated foot. This evidence argues that autotomy scores are an appropriate measure of the degree of pain or dysesthesia which results from the deafferentation of a limb. PMID- 3526257 TI - [Development of the theory of natural foci and ecological parasitology in the works of V. V. Kucheruk]. PMID- 3526258 TI - Gwendolen Rees FRS--fifty-six years (1930 to date) in research. PMID- 3526260 TI - Sialic acid analysis and tritium-labelling of sialoglycoproteins of mouse erythrocytes infected with Plasmodium berghei. AB - Schizont-infected red blood cells (SI-RBC) from Plasmodium berghei-infected mice contain between 2 and 10 times as much sialic acid as uninfected RBC from the same blood (99-550 micrograms/10(10) RBC versus 33-65 micrograms/10(10) RBC). Total RBC samples from infected animals containing up to 63% ring- and trophozoite-infected cells had identical sialic acid contents to purified RBC samples (of less than 3% parasitaemia) from the same blood (52-64 micrograms/10(10) RBC). We conclude that RBC containing immature parasites have the same sialic acid content as uninfected RBC from infected blood and that total cellular sialic acid increases during maturation to the schizont stage. Uninfected RBC from infected blood had 25-50% as much sialic acid as normal mouse RBC (33-65 micrograms/10(10) RBC versus 126 micrograms/10(10) RBC). There were no qualitative changes in RBC sialic acids, all RBC samples having 60-70% N acetylneuraminic acid, 30-40% N-acetyl-9-O-acetylneuraminic acid and 5-10% N glycolylneuraminic acid. The quantitative changes we observed during infection must reflect changes in murine sialoglycoconjugates, as we have shown elsewhere that Plasmodia do not synthesize or contain sialic acids. Since the sialic acid composition of mouse serum glycoconjugates is quite different to that of the RBC fractions studied here, the quantitative data suggest that part of the sialic acids of the uninfected RBC has been transferred to SI-RBC. With higher molar ratios of periodate to substrate than generally used, we were able to radio isotopically label normal murine sialoglycoproteins on SI-RBC and purified uninfected RBC from infected blood by the periodate/NaB3H4 method. Several new proteins were then tritiated with SI-RBC but these proteins may be intracellular and could even lack sialic acid. PMID- 3526259 TI - Identification of isolate-specific proteins on sorbitol-enriched Plasmodium falciparum infected erythrocytes from Gambian patients. AB - We have compared the surface radio-iodinated proteins of uninfected and Plasmodium falciparum-infected erythrocytes from natural infections of human patients. Cryopreserved infected blood from Gambian children with falciparum malaria was thawed, cultured to the middle trophozoite stage, and surface radio iodinated. Trophozoite-infected cells were enriched about 10-fold on a Percoll gradient newly designed to separate cells based on their differential permeability to sorbitol. Infected blood was radio-iodinated and erythrocytes from the fraction enriched in parasitized cells and uninfected erythrocytes from the same sample obtained from the gradient and compared by SDS-PAGE and autoradiography. In each sample, parasitized erythrocytes contained one or more polypeptides of very high molecular weight (Mr 250 000-300 000) that were not found on uninfected erythrocytes from the same patient. These proteins were isolate-specific in size and number, suggesting that natural isolates contain a variable number of different P. falciparum phenotypes for this surface protein. In addition, these radio-iodinated surface proteins could not be extracted from the host cell membrane by the non-ionic detergent Triton X-100, but were extracted by SDS. The properties of these proteins suggest they are the equivalent for natural infections of the strain-dependent antigen previously described (Leech, Barnwell, Miller & Howard, 1984) on the surface of P. falciparum-infected Aotus erythrocytes. In addition, we observed a second parasite-dependent modification of labelled proteins on infected erythrocytes with the appearance of a new band of Mr 30 000. There were also variations in the pattern of radio-isotope labelled proteins on uninfected erythrocytes from different patients. PMID- 3526261 TI - Damage to malaria-infected erythrocytes following exposure to oxidant-generating systems. AB - A study has been made of the damage incurred by normal and Plasmodium falciparum infected human erythrocytes following exposure to a variety of oxidant-generating systems. Hydrogen peroxide, produced by the glucose-glucose oxidase system, increased methaemoglobin formation within normal erythrocytes while normal levels of oxyhaemoglobin were maintained. Exposure to products of the xanthine-xanthine oxidase interaction did not have the same effect. Malondialdehyde measurements indicated that the host cell membranes of parasitized cells had undergone lipid peroxidation even before exposure to the oxidant-generating systems. Lipid peroxidation of normal and parasitized cell membranes was increased upon exposure to reagent-grade hydrogen peroxide and alloxan: this increase was not observed following exposure to the two enzyme-substrate systems that generated reactive oxygen intermediates. In addition, the effects of parasitism on intracellular levels of catalase and superoxide dismutase were assessed. Normal and parasitized erythrocytes were found to possess similar levels of these enzymes, which protect against oxidant-induced damage. It was therefore concluded that the increased susceptibility of infected cells to oxidant damage was probably not related to any decrease in the function of these enzymes. PMID- 3526262 TI - A study on antigen recognition by onchocerciasis patients with different clinical forms of disease. AB - Sera from 40 onchocerciasis patients from the Yemen Arab Republic with either mild localized forms of onchocerciasis, intermediate or severe localized forms of the disease or generalized forms of infection were studied with respect to their IgG and IgM response against Onchocerca volvulus antigens. Immunoblotting, performed with SDS-PAGE-separated proteins of female O. volvulus and quantified by densitometric scanning, revealed IgG and IgM antibodies against worm components in sera of all patients. Persons with intermediate or severe localized forms of onchocerciasis had a stronger IgG response against more proteins than individuals of the other groups. However, some antigens (Mr 21, 23, 30, 33 kDa) induced comparable quantities of IgG in all groups. The IgM response of patients with mild localized forms of onchocerciasis was more intensive and directed against more antigens than in the other groups. No antigens were detected that were recognized only by individuals with low levels of microfilaridermia. In all groups, varying concentrations of antibodies against cuticle, muscle/hypodermis layer and/or uterus of female O. volvulus were detected by the indirect immunofluorescence test using frozen worm sections as antigen. The highest mean antibody titres were found in patients with intermediate and severe localized forms of disease. PMID- 3526263 TI - Further studies of cyclical transmission and antigenic variation of the ILDar 1 serodeme of Trypanosoma vivax. AB - Antigenic variation in the ILDar 1 serodeme of the naturally rodent-infective stock of West African Trypanosoma vivax has been investigated following cyclical transmission. The immunofluorescent and immune lysis tests were employed with a panel of 39 variant-specific mouse antisera. When antigenically homogeneous, or mixed, populations were transmitted by tsetse flies to goats, the first peak parasitaemias arising in the goats were antigenic mixtures (up to 9 major, and several minor variants being recognized in some cases) from which the ingested variant was absent. Although first peak parasitaemias in similarly infected goats showed some variants in common, there was no obvious relationship between the VAT profiles in different goats. When these populations were expanded in irradiated mice, VAT heterogeneity was maintained with a tendency towards the development of predominant variants in some, but not all, instances. Six additional variants, derived following the growth of bloodstream form ILDat 1.9 in 37 degrees C culture, were also represented in goat and mouse populations. Two further variants, isolated after cyclical development of ILDat 1.9-derived trypanosomes in vitro, were not present in the early parasitaemias in goats and mice. PMID- 3526264 TI - Insulinotropic activity in the serum of obese and nonobese infants and children. AB - The ability of a serum fraction, mol wt 1000-5000, to stimulate insulin release in vitro was studied in 123 obese and normal weight children aged 0-17 yr. The sera were fractionated by serial molecular filtration after treatment with urea. Stimulation of insulin release was determined with a bioassay using isolated rat islets in perifusion. The islet-stimulating activity was found in all obese children less than the age of 10 yr and in the majority of the obese children older than 10 yr of age. In normal weight children the activity was also found in the majority of infants, but was infrequent in older children. The serum islet stimulating activity was positively correlated with the duration and degree of obesity and with linear growth rate. The molecular structure and origin of the insulinogenic activity in the serum is still unknown. In high-performance liquid chromatography it has the same elution characteristics as the hypothalamic insulin-glucagon liberin. The present results suggest a role for the serum islet stimulating activity in the pathogenesis of obesity. PMID- 3526265 TI - Immunologic identification of a pulmonary surfactant-associated protein of molecular weight = 6000 daltons. AB - Hydrophobic, small molecular weight, surfactant-associated protein of Mr = 6000 (SAP-6) was isolated from bovine, canine, and human alveolar lavage and identified by silver staining after sodium dodecyl sulfate polyacrylamide gel electrophoresis gels. Lesser amounts of protein of Mr = 14,000, 20,000, and 26,000 daltons also copurified with SAP-6, likely representing oligomers of the Mr = 6,000 dalton protein. In the absence of sulfhydryl-reducing agents, increased amounts of the larger forms of the protein were observed. Antisera generated against bovine SAP-6 were used to further characterize the protein and distinguish it from the more abundant surfactant-associated glycoprotein of Mr = 35,000 (SAP-35) present in mammalian surfactants. Rabbit antisera generated against the bovine hydrophobic protein recognized SAP-6 and lesser amounts of the proteins of Mr = 14,000, 20,000, and 26, 000 daltons. The SAP-6 antisera were reactive against the hydrophobic proteins from human, bovine, and canine surfactants as assessed by immunoblot analysis after sodium dodecyl sulfate polyacrylamide gel electrophoresis. SAP-6 antisera did not detect bovine SAP-35 the abundant surfactant-associated glycoprotein, by immunoblot analysis; however, some reactivity of the anti-SAP-6 was detected against purified bovine SAP-35 by a sensitive enzyme-linked immune-adsorbant assay. Anti-SAP-6-did not react with bovine serum components either by immunoblot or by enzyme-linked immune-adsorbant assay. Monospecific antisera generated against bovine SAP-35 did not detect SAP-6 by immunoblot analysis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3526266 TI - A quantitative assay for a Clara cell-specific protein and its application in the study of development of pulmonary airways in the rat. AB - Rat lung lavage contains a 10 kDa protein that has been shown by immunocytochemistry to be specific for Clara cells. An inhibition enzyme-linked immunosorbent assay was established for this protein using rabbit antibody to the 10 kDa Clara cell protein. The assay has a sensitivity of about 3.0 ng/ml and a working range of about 5 to 50 ng/ml. Quantitation of the 10 kDa protein in amniotic fluid revealed an increase of about 4-fold at day 20 of gestation. The 10 kDa protein content of lung homogenate increased steadily from day 18 of gestation to 1 wk after birth, after which a decline was observed. Nearly 60-fold increase in the concentration of the 10 kDa Clara cell protein in lungs was noted from day 18 of gestation to birth and a further about 7-fold increase was noted from the day of birth to 1 wk of age. A progressive increase in the 10 kDa protein, with increasing age, was also noted on immunoblot analysis of lung homogenates. As judged from the immunoblots of lung homogenates, stained with rabbit antirat 10 kDa protein antiserum, the content of an antigenically similar 200 kDa Clara cell protein was negligible. The quantitative results for 10 kDa Clara cell protein parallel the results of immunocytochemistry and quantitation of the volume density of Clara cell granules indicating that quantitation for the 10 kDa protein could be used to monitor the development of Clara cells and that of the pulmonary airways. PMID- 3526267 TI - Early physical therapy effects on the high-risk infant: a randomized controlled trial. AB - A prospective, randomized, controlled trial was conducted to assess the effects of early physical therapy on infants at risk for neurologic sequelae and to evaluate the impact of such early treatment on the prevention or minimization of future handicaps. A cohort of 134 infants who had received care in two Montreal inborn neonatal intensive care units was identified prospectively. Infants were stratified according to prognosis and birth weight and were randomly assigned to either an experimental or control group. Babies assigned to the experimental group received early physical therapy, whereas those allocated to the control group received conventional follow-up care. Outcome measures were administered by independent evaluators at 12 months and included measures of neurologic status, motor and overall development, and physical growth. No statistically significant differences on any of the measured outcomes at 12 months were found between the experimental and control groups. Infants weighing less than 750 g at birth, regardless of group assignment, consistently demonstrated significant delays in their growth and development when compared with their heavier peers. The early physical therapy program investigated in this study was not efficacious in altering the pattern of motor development in those high-risk infants participating in the trial. PMID- 3526268 TI - Fungal colonization in the very low birth weight infant. AB - In the neonate, fungal infections result in significant morbidity and mortality. For very low birth weight (less than 1,500 g) infants, we prospectively determined the fungal colonization rate to be 26.7%. In one third of infants with fungal colonies, mucocutaneous candidiasis developed, and in 7.7%, systemic disease developed. Two thirds of the infants had colonies in the first week of life. This colonization was probably acquired during labor and delivery, because those infants who had colonization were more often delivered vaginally than by cesarean section. Early colonization, commonly from the gastrointestinal or respiratory tract, featured Candida albicans and Candida tropicalis. Late colonization, occurring after 2 weeks of life (15.0% of patients), was more likely to be cutaneous and was associated with either Candida parapsilosis or such poor growth that the organism could not be identified. Infants with colonization only rarely had budding yeasts (6.1%), whereas more than half of the infants with either a urinalysis showing budding yeasts or a urine culture growing fungi had invasive disease. Fungal contamination was not found on either thoracotomy tubes or catheter tips. In the low birth weight infant, fungal colonization represents a significant risk factor for cutaneous or systemic candidiasis in these infants. PMID- 3526269 TI - Southeast Asian children in America: the impact of change. AB - This is a review of the psychiatric literature on acculturation and child development in Southeast Asian refugees. Each age group suffers somewhat differently from refugee experience, and these differences are described further. In addition, to aid the acculturation and developmental processes, treatment approaches are suggested. This article should be useful to pediatricians who care for refugee children and are unfamiliar with the psychiatric literature about refugees. PMID- 3526270 TI - Safety and efficacy of long-term diet and diet plus bile acid-binding resin cholesterol-lowering therapy in 73 children heterozygous for familial hypercholesterolemia. AB - Our specific aim was to examine the efficacy and safety of long-term cholesterol lowering diet and bile acid-binding resin therapy in 73 children heterozygous for familial hypercholesterolemia (FH). We prospectively followed accretion of height and weight in 40 FH children for 5.8 years on diet alone and in 33 FH children for 4.3 years on diet and bile acid-binding resins (8 to 20 g/d). In 67 of these 73 children, sequential data on plasma cholesterol lowering was obtained, including 32 children on diet plus bile acid-binding resins and 35 on diet alone. For all 73 children, median age, sex, and race-specific percentiles for height and weight at entry were 50 and 50, respectively, and 5.7 years later, were unchanged at 50 and 50. Initial and final percentiles for height (r = .76, P less than .001) and weight (r = .70, P less than .001) were closely correlated. Percentile distributions for height and weight at entry into the study did not differ from those at the end of follow-up (P greater than .1), in both the 40 FH children on diet alone and the 33 on diet plus bile acid-binding resins. Tracking of height and weight did not differ in the 40 children on diet alone v the 33 on diet plus bile acid-binding resins (P greater than .1). During 6 years of follow up there were no significant differences in the percentage of serial, postbaseline measurements for height which were either less than or greater than or equal to baseline percentiles, comparing 40 FH children on diet alone, 33 FH children on diet plus resin, and 39 normal children (on ad libitum diet). FH children on diet or plus resin had a smaller percentage of weight measurements equal to or more than baseline percentiles than normals on follow-up (P less than .01), probably reflecting restriction of total fat intake to less than 35% of calories. On diet alone, 32 FH children had total plasma cholesterol of 307 +/- 8 mg/dL (mean +/- SE); bile acid-binding resins were added to diet in these children at an average age of 11.5 years, with this regimen maintained for 4.6 +/ 0.4 years, leading to a mean reduction in total plasma cholesterol of 12.5% +/- 2% beyond the effects of diet alone (P less than .01).(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3526271 TI - The child is father of the man. PMID- 3526272 TI - [Pathogenetic substantiation of the use of immunomodulating preparations in the treatment of chronic viral hepatitis B in children]. PMID- 3526273 TI - [Echography of the pancreas in children with diabetes mellitus]. PMID- 3526274 TI - [Salmonellosis--a current problem of infectious pathology in childhood]. PMID- 3526275 TI - [Hypertrophic cardiomyopathy in children]. PMID- 3526276 TI - [Hypocalcemia in childhood]. PMID- 3526277 TI - Synthetic hydrogels as drug delivery systems. AB - Hydrogels are widely studied materials for the preparation of sustained release drug dosage forms. Their soft, tissue-like consistency and their high biocompatibility in a number of applications make them promising candidates for this purpose. The water and the polymer in the gel form intricate structures and much research has been devoted to the elucidation of these structures, and of the interactions involved in their formation. Simple, drug-loaded hydrogels normally give a matrix-type delivery profile, in which the release rate is proportional to the square root of time; a number of approaches has been used to change this profile to other types of delivery, for instance to zero-order release. A number of in vivo tests using hydrogel delivery systems has given favourable results. PMID- 3526278 TI - Episodic release of renin from single isolated superfused rat afferent arterioles. AB - Doubts have been raised about the involvement of an exocytotic event in the renin release process. This motivated the development of a technique which permitted the study of renin release from one single superfused rat afferent arteriole with a time resolution of 20 seconds. By using this technique it is shown in 43 experiments that the undisturbed renin release is episodic with a renin discharge of 45.2 +/- 3.3 (SEM) nano Goldblatt units per episode (n = 114) and a frequency of one episode per 5 min. The total renin content of one arteriole was about 30 microGU. The renin discharge and frequency correspond to calculated values for the renin content of single juxtaglomerular cell granules and the release rates in vivo, respectively. Release activity could be stimulated by an acute decrease in the osmolality of the superfusion medium (-20 mOsm sucrose, n = 14) indicating that an osmotic water movement is involved in the secretory process. This study provides functional evidence that renin release is exocytotic. In addition it reports what appears to be the first direct measurement of release of secretory material compatible with secretion of single granules from any secretory system. PMID- 3526279 TI - State-approved schools of nursing R.N. 1986. PMID- 3526281 TI - Regular distribution of length heterogeneities within non-transcribed spacer regions of cloned and genomic rDNA of Saccharomyces cerevisiae. AB - A length difference of about 50 bp in the EcoRI fragment B of the rDNA from two different strains of Saccharomyces cerevisiae has been mapped in detail by sequencing of cloned fragments. This 2.4 kb EcoRI fragment contains the start of the 35S rRNA gene at one end and the 5S rRNA gene in the middle flanked by non transcribed spacers, NTS1 and NTS2. The difference appeared as short deletions or insertions in five regularly spaced regions within the 1 kb NTS1, 3' to the 5S rRNA gene. The same regions of heterogeneities were displayed when all available sequence data of the NTS1 were compared. Four of the variable regions are located 160-170 bp apart, indicating that they might represent linker sequences between phased nucleosomes. Two variant clones, differing in the length of one subfragment of NTS1, were isolated for each strain. In both cases these represented the major variants among chromosomal NTS1 as revealed by sequencing of genomic fragments. PMID- 3526282 TI - Yeast omnipotent supressor SUP1 (SUP45): nucleotide sequence of the wildtype and a mutant gene. AB - The primary structures of the yeast recessive omnipotent suppressor gene SUP1 (SUP45) and one of its mutant alleles (sup1-ts36) was determined. The gene codes for a protein of 49 kD. The mutant protein differs from the wildtype form in one amino acid residue (Ser instead of Leu) in the N-terminal part. The codon usage differs significantly from that of yeast ribosomal protein genes. However, an upstream element resembling a conserved oligonucleotide in the region 5' to ribosomal protein genes in S. cerevisiae has been found. A DNA probe internal to the SUP1 gene does not exhibit detectable homology to genomic DNA neither from higher eucaryotes nor from eu- or archaebacteria. The hypothetical function of this protein in control of translational fidelity is discussed. PMID- 3526280 TI - Codon usage in yeast: cluster analysis clearly differentiates highly and lowly expressed genes. AB - Codon usage data has been compiled for 110 yeast genes. Cluster analysis on relative synonymous codon usage revealed two distinct groups of genes. One group corresponds to highly expressed genes, and has much more extreme synonymous codon preference. The pattern of codon usage observed is consistent with that expected if a need to match abundant tRNAs, and intermediacy of tRNA-mRNA interaction energies are important selective constraints. Thus codon usage in the highly expressed group shows a higher correlation with tRNA abundance, a greater degree of third base pyrimidine bias, and a lesser tendency to the A+T richness which is characteristic of the yeast genome. The cluster analysis can be used to predict the likely level of gene expression of any gene, and identifies the pattern of codon usage likely to yield optimal gene expression in yeast. PMID- 3526283 TI - Secondary structure as primary determinant of the efficiency of ribosomal binding sites in Escherichia coli. AB - Using a previously described vector (pKL203) we fused several heterologous ribosomal binding sites (RBSs) to the lacZ gene of E. coli and then studied the variation in expression of the fusions. The RBSs originated from bacteriophage Q beta and MS2 genes and the E. coli genes for elongation factor EF-Tu A and B and ribosomal protein L11 (rplK). The synthesis of the lacZ fusion proteins was measured by an immuno precipitation method and found to vary at least 100-fold. Lac-specific mRNA synthesis follows the variation in protein production. It appears that there is a correlation between the efficiency of an RBS to function in the expression of the fused gene and the lack of secondary structure, involving the Shine and Dalgarno nucleotides (SDnts) and/or the initiation codon. This efficiency is context dependent. The sequence of the SD nts and the length and sequence of the spacer region up to the initiation codon alone are not able to explain our results. Deletion mutations, created in the phage Q beta replicase RBS, reveal a complex pattern of control of expression, probably involving the use of a "false" initiation site. PMID- 3526284 TI - Mutant Escherichia coli Ada proteins simultaneously defective in the repair of O6 methylguanine and in gene activation. AB - The activated Ada protein triggers expression of DNA repair genes in Escherichia coli in response to alkylation damage. Ada also possesses two distinct suicide alkyltransferase activities, for O6-alkylguanines and for alkyl phosphotriesters in DNA. The mutant Ada3 and Ada5 transferases repair O6-methylguanine in DNA 20 and 3000 times more slowly, respectively, than the wild-type Ada protein, but both exhibit normal DNA phosphotriester repair. These same proteins also exhibit delayed and sluggish induction of the ada and alkA genes. Since the C-terminal O6 methylguanine methyltransferase domain of Ada is not implicated in the direct binding of specific DNA sequences, this part of the Ada protein is likely to play an alternative mechanistic role in gene activation, either by promoting Ada dimerization, or via direct contacts with RNA polymerase. PMID- 3526286 TI - Nucleotide sequence analysis of the trimethoprim resistant dihydrofolate reductase encoded by R plasmid R751. PMID- 3526285 TI - Translational regulation of expression of the bacteriophage T4 lysozyme gene. AB - The bacteriophage T4 lysozyme gene is transcribed at early and late times after infection of E. coli, but the early mRNA is not translated. DNA sequence analysis and mapping of the 5' ends of the lysozyme transcripts produced at different times after T4 infection show that the early mRNA is initiated some distance upstream from the gene. The early mRNA is not translated because of a stable secondary structure which blocks the translational initiation site. The stable RNA structure has been demonstrated by nuclease protection in vivo. After DNA replication begins, two late promoters are activated; the late transcripts are initiated at sites such that the secondary structure can not form, and translation of the late messages occurs. PMID- 3526287 TI - Preparation of capped RNA transcripts using T7 RNA polymerase. PMID- 3526288 TI - Nucleotide sequence of pheW; a third gene for E. coli tRNAPhe. PMID- 3526289 TI - Reis-Buckler's corneal dystrophy. PMID- 3526290 TI - RCM Supplement. Still laughing after all these years. Interview by Laurence Dopson. PMID- 3526291 TI - Nonmutagenicity of curcumin and its antimutagenic action versus chili and capsaicin. AB - Turmeric, which is one of the commonly used spices in Indian cooking, was tested for mutagenicity using the Ames test. The alcoholic extract of fresh or dried turmeric, its principal components, and pyrolyzed turmeric powder and curcumin were tested for mutagenicity in Salmonella typhimurium strains with and without metabolic activation. None of these were mutagenic in all the tester strains. Chilies (which are used with turmeric powder) and their principal alkaloid capsaicin were mutagenic in the TA 98 with S9 mixture. We tested curcumin, which is the principal component of turmeric, for its antimutagenic effect. It showed dose-dependent decreases in mutagenicity of chili extract and capsaicin. Also, we compared the antimutagenicity of curcumin with other known antioxidants, including BHA, vitamins E and C, and vegetable oils. These all showed dose dependent decreases in mutagenicity of chili extract and capsaicin. These studies show that although there are few mutagenic principles in Indian food, there is still quite a large number of antimutagenic principles in the Indian diet that will modulate the activity of environmental mutagens. PMID- 3526292 TI - [Breathing disturbances during sleep]. PMID- 3526293 TI - [Methods of breaking the cigarette smoking habit]. PMID- 3526294 TI - Attachment of anterior tooth fragments. PMID- 3526295 TI - A comparison of two dentin bonding agents in primary and permanent teeth. PMID- 3526296 TI - Adaptation of composite resin restorative materials to retentive grooves of Class I cavity preparations. PMID- 3526297 TI - Adrenal corticosteroids as antiemetics during cancer chemotherapy. AB - Adrenal corticosteroids were first reported in 1979 to have antiemetic effects during cancer chemotherapy. Since then considerable numbers of trials have been conducted to evaluate their activity alone and in combination with other agents. The majority of the research has centered on dexamethasone, although other corticosteroids have been studied. Dexamethasone as a single agent is superior to placebo and appears to be more effective than standard doses of prochlorperazine when administered with highly emetic agents. Dexamethasone is comparable to metoclopramide against moderately emetogenic agents and low-dose cisplatin, but less effective than metoclopramide against highly emetic agents or high-dose cisplatin. Dexamethasone improves the activity of prochlorperazine and metoclopramide and may reduce some of the side effects associated with the latter. Current trials continue to explore the role of corticosteroids alone and in combination with antiemetics. PMID- 3526298 TI - Ketoprofen: a review of its pharmacologic and clinical properties. AB - Ketoprofen (Orudis), a highly potent and safe nonsteroidal antiinflammatory drug of the propionic acid derivative group, was synthesized in France by Rhone Poulenc chemists in 1967, 3 years after the prototype ibuprofen. Ketoprofen was introduced in 1973 in France and the United Kingdom for antiinflammatory use. Today the drug is available in about 80 countries and has recently been approved in the United States for treatment of rheumatoid arthritis and osteoarthritis. The therapeutic experience with ketoprofen is estimated to have exceeded 3 million patient-years. Double-blind trials have established its therapeutic equivalence with aspirin, indomethacin, and ibuprofen in rheumatoid arthritis and with aspirin in osteoarthritis. Ketoprofen has a short half-life, a simple metabolism, and a broad therapeutic window, and does not accumulate with multiple doses. These features contribute to a rapid onset of action, flexible dosing, and a reliable tolerance profile. PMID- 3526299 TI - Peptidases involved in the catabolism of neurotensin: inhibitor studies using superfused rat hypothalamic slices. AB - In order to identify which peptidases are involved in the catabolism of neurotensin in the CNS, [3H-Tyr3,11]-neurotensin was superfused over rat hypothalamic slices in the presence and absence of peptidase inhibitors. The degree of degradation of the peptide was determined by reverse phase HPLC separation of 3H-labelled neurotensin from 3H-labelled products. Very little degrading activity was released from the slice into the medium during the superfusion. In the absence of inhibitors, 20 to 50% of 3H-neurotensin was degraded giving mainly 3H-Tyr along with other unidentified 3H-labelled products. Inhibitors of endopeptidase 24.11 (phosphoramidon) and proline endopeptidase (antibody) had no effect on the degradation. Captopril, an inhibitor of angiotensin converting enzyme, had a small inhibitory effect. In contrast, dynorphin(1-13), an inhibitor of a soluble, thiol dependent metallopeptidase which hydrolyses neurotensin at Arg8-Arg9, gave greater than 80% inhibition of 3H neurotensin degradation in the slice preparation. 1,10-Phenanthroline, an inhibitor of metallopeptidases, was also an effective inhibitor. The dynorphin sequence responsible for the inhibition contains the Arg6-Arg7 bond. Other peptides (bradykinin and angiotensin) which are substrates of the soluble metallopeptidase also inhibited neurotensin breakdown by the slice. This evidence suggests that this thiol dependent metalloendopeptidase is the major neurotensin catabolizing enzyme in hypothalamic slices. PMID- 3526300 TI - Immunohistochemical and chromatographic studies of peptides with tachykinin-like immunoreactivity in the central nervous system of the lamprey. AB - The distribution and chemical properties of compounds with tachykinin-like immunoreactivity (TK-LI) in the spinal cord and brain of lampreys (Lampetra fluviatilis and Ichthyomyzon unicuspis) were investigated by means of immunohistochemistry and various chromatographic methods combined with radioimmunoassay. The distribution of TK immunoreactive fibers in the lamprey spinal cord was investigated with 13 different TK antisera which gave positive staining in pilot experiments. The antisera were raised against substance P (SP) (n = 6), physalaemin (PHY) (n = 1), neurokinin A (NKA) (n = 2), kassinin (KAS) (n = 2) or eledoisin (ELE) (n = 2). Pre-incubation of these antisera with their corresponding TKs abolished or reduced the immunostaining. Four different patterns of distribution were found with the 13 antisera, and they did not seem to be related to the TKs against which the antisera were raised. The different patterns could be explained by assuming the presence of the three different TKs. Six different antisera, raised against SP (n = 2), KAS (n = 2) or ELE (n = 2), were used for radioimmunoassay. The TK-LI material eluted as several separate components in various chromatographic systems. The central nervous system (CNS) of the lamprey did not contain measurable amounts of SP, NKA, neurokinin B (NKB), KAS or ELE. The present data imply that the lamprey CNS contains at least three different TKs probably different from SP, PHY, NKA, NKB, KAS or ELE; these are possibly new, not earlier described TKs. The three hypothetical TKs differ in their distribution. PMID- 3526301 TI - Specific glucagon-related peptides isolated from anglerfish islets are metabolic cleavage products of (pre)proglucagon-II. AB - Sequence analyses of cDNAs prepared from anglerfish islet mRNA have demonstrated the presence of mRNAs coding for two different preproglucagons, aPPG-I and aPPG II. Each of these precursors was predicted to contain 29 residue and 34 residue glucagon-related peptides as potential cleavage products. Recently, several glucagon-related peptides found in extracts of anglerfish islets have been isolated and characterized. In order to determine whether any of these peptides could be identified as metabolic cleavage products in anglerfish islets, differentially radiolabeled Mr 2,500-8,000 peptides from islet extracts were subjected to reverse phase HPLC under varying conditions. The potential cleavage products aPPG-II[52-80] and aPPG-II[89-122] could be readily identified among the extract peptides. Both peptides became labeled appropriately (as predicted from their sequences) with 13 different amino acids and demonstrated glucagon-like immunoreactivity in a radioimmunoassay. Conversely, a third peptide (aPPG-II[89 119]) could be found among the labeled products in small amounts only. These results demonstrate that glucagon-II[52-80] and aGLP-II[89-112] are primary cleavage products of aPPG-II and suggest that aGLP-IIc[89-119] may be a peptide generated more slowly by post-translational modification of aGLP-II. PMID- 3526302 TI - [Clinical and metabolic aspects of vitamin B6 deficiency]. PMID- 3526303 TI - Nesidioblastosis associated with congenital malformations of the heart. Morphological and immunohistochemical study of 5 necropsy cases. AB - Pancreatic tissue from 5 children with congenital heart disease (CHD) with morphological alterations of the endocrine components at autopsy were compared in a double-blind semiquantitative study, which included light microscopy and immunocytochemistry, to pancreatic tissue of 5 children of similar age but without CHD. Hyperplasia and hypertrophy of islets of Langerhans, scattered endocrine cells within the exocrinic acini, cluster of endocrine cells budding from ductular epithelium or within interlobular connective tissue, and hyperplasia of ductular epithelium were found to be present in the patients with congenital cardiac defects. The observed findings resembled those present in a surgically resected pancreas from a child with clinically overt nesidioblastosis. Although this study suggests a higher incidence of endocrine pancreas disturbances in certain types of CHD, the clinical significance of these morphological alterations will require further studies. PMID- 3526304 TI - DNA flow cytometry of cells obtained from old paraffin-embedded specimens. A comparison with results of scanning absorption cytometry (a methodological study). AB - Suspensions of single cell nuclei were obtained from 31 different samples of 7-9 years old paraffin-embedded bladder cancer biopsies. The DNA content of the ethidium-bromide-stained nuclei was analyzed by flow cytometry (FCM). The tumour stemline ploidy, as determined by FCM, was compared with that obtained by Feulgen scanning absorption cytometry (SACM) in imprints obtained from the same biopsy before it was fixed. Fifteen tumours that were diploid by FCM were also diploid by SACM. All of the 16 tumours with non-diploid DNA-stemlines by FCM were non diploid by SACM, though minor differences between the ploidy values were occasionally seen when the results of the two methods were compared. The background activity due to cell debris was considerable and resulted in a mean variation coefficient (CV) of 5.1% for human spleen cells fixed and embedded before preparation for FCM in the same way as the tumour samples. In the tumour samples there was a large and unpredictable variation of the ratio between the DNA values of chicken erythrocytes (internal standard) and diploid cells. In some specimens this ratio would have resulted in incorrect evaluation of the FCM DNA histogram. The following method for evaluation of FCM histograms is therefore proposed: Single peak histograms obtained from paraffin embedded tissue should always be interpreted as representative for a diploid cell population. In FCM histograms from paraffin-embedded tissue with more than one peak, the first peak should be considered as representing diploid cells. PMID- 3526305 TI - DNA-measurements on formalin-fixed, paraffin-embedded squamous cell carcinomas from different ENT-regions. AB - DNA measurements were performed on formalin-fixed, paraffin-embedded squamous cell carcinomas, using the method of Hedley et al. Ultrasonication was sometimes necessary after enzymatic disintegration to dispose of residual cytoplasm. The isolated nuclei were stained with Hoechst 33258. DNA measurements were performed using a rapid system for static fluorometry (FLUORA-programme). The method proved to be highly accurate. The mean CV of the stem cell peaks from different tumours was 5.3. There was no difference between material less or more than 5 years old (mean CVs 5.2 and 5.5 respectively). RNase treatment had no effect and was therefore not considered necessary. The proliferative activity was calculated by computer assuming a rectilinear distribution of S-phase cells. Because routinely paraffin-embedded material can be used, DNA analysis can be performed on tumour material where the clinical outcome is known, in order to evaluate certain DNA variables. PMID- 3526306 TI - The seronegative spondyloarthropathies. A graduated approach to management. AB - The seronegative spondyloarthropathies can create multiple and complex therapeutic problems. Consequently, the primary care physician needs to offer continuous encouragement and support to the patient, who must maintain a lifelong regimen of antiinflammatory drug therapy, daily exercise, and other supportive measures to retain mobility. With comprehensive care, the vast majority of patients can lead full, productive lives. However, management can succeed only with active participation of patients who have been adequately educated about their disease. PMID- 3526307 TI - Thyroid function tests. Selective use for cost containment. AB - Clinicians often obtain a variety of thyroid function tests in patients suspected of having thyroid disease when only a few are necessary to adequately establish a diagnosis and do follow-up. For hyperthyroidism and hypothyroidism, measurement of serum T4 is the best screening test. The serum T3 resin uptake test should be added with women suspected of being hyperthyroid because of the changes produced by pregnancy or estrogen-containing contraceptives. Various imaging techniques, including RAI, ultrasound, CT, and MRI, are often used for differentiating benign or cystic thyroid nodules from malignant or solid ones. Each of the available techniques has a different cost, and each is most suitable for a particular disorder. Special tests (eg, TRH testing and measurement of serum TBG) should be added to the basic screening tests only for questionable cases to differentiate diagnostic possibilities or confirm an uncertain diagnosis. PMID- 3526308 TI - Oral cancer detection. The importance of routine screening for prolongation of survival. AB - The incidence of oral cancer has increased in the past ten years. Early diagnosis and treatment are essential to long-term survival; however, patients at highest risk visit the dentist infrequently. The reddish, velvety or erythroplakial lesion at the base of the tongue or floor of the mouth is highly suspicious in any patient and requires further evaluation. High-risk patients with less suspicious appearing lesions must be reevaluated on close recall. Prognosis improves vastly when the lesion is detected and treated early. One study demonstrated a 64% five-year survival rate for patients with oral cancer that was diagnosed before regional lymph node involvement versus a 15% five-year survival for patients whose lesions were diagnosed after regional lymph node involvement. By including an oral cancer examination in routine physical examination of patients, the physician and public health nurse can increase the likelihood of early detection of oral cancer. PMID- 3526309 TI - Urinary incontinence in the elderly. Ways to relieve it without surgery. AB - Few studies of incontinence have been done on the elderly as a specific population, although epidemiologic reports reveal that incontinence is a debilitating condition that affects 15% to 30% of the elderly population of the United States. In diagnosing the problem, we use the simplest procedure that can supply the required information. However, if the diagnosis is uncertain or the treatment being considered is risky, urodynamic testing is necessary. Several nonsurgical treatments are available and have varying degrees of success in reestablishing continence. Some, such as pharmacotherapy and intermittent self catheterization, are effective for some patients and are replacing bladder drill and bladder distention in popularity. Less conventional techniques (electrotherapy, biofeedback, and periurethral injection) are useful only in select cases and have had fewer clinical trials. Clamps and external devices for men and pessaries for women are prone to complications and generally are avoided in our practice. Long-term use of indwelling catheters is a last resort, to be considered only when all other alternatives have been exhausted. Further clinical research that considers the particular problems of the elderly is needed so that practical, humane, and effective treatment becomes possible. PMID- 3526310 TI - Pharmacotherapy for chronic obstructive pulmonary disease. PMID- 3526311 TI - [Therapeutic procedures in temporomandibular joint diseases]. PMID- 3526312 TI - [Pathogenesis of skin bullae formation]. PMID- 3526313 TI - Identification of cytotrophoblast colonies in cultures of human placental cells using monoclonal antibodies. AB - The morphological appearance of four distinctive types of colony in human placental cultures is described. Using a panel of monoclonal antibodies, one of these colonies is found to comprise cells with the phenotypic characteristics which allow them to be defined as cytotrophoblast with a reasonable degree of certainty. A second type of colony also contains cells of epithelial origin, but the trophoblast lineage of these cells is more difficult to ascertain. The remaining two types of colony are derived from mesenchymal elements representing either macrophages or fibroblasts. It is hoped that the precise identification of cytotrophoblast colonies will provide a useful yardstick to assess the efficiency of any future techniques which are devised for the selective growth and propagation of human trophoblast in vitro. PMID- 3526314 TI - Characterization of a sheep trophoblast-derived antigen first appearing at implantation. AB - A monoclonal antibody designated SBU-3 was produced by the fusion of mouse NS-1 myeloma cells with spleen cells from a BALB/c mouse immunized with sheep trophoblast microvilli. Lee et al (1985) have reported the immunohistological staining of sheep trophoblast with SBU-3 showing that, as early as 21 days of gestation, the monoclonal antibody recognizes an antigen restricted to the binucleate cells of the trophoblast which are located only at sites of invasion of the underlying uterine tissue. Subsequently the antigen appears in the maternal syncytial layer. Immunoprecipitation of 125I-labelled microvilli by SBU 3, characterization of the antigen on immunoblots, and biochemical analysis all suggest that this monoclonal antibody specifically recognizes a carbohydrate epitope on a series of glycoproteins of molecular weights between 30 000 and 200 000. SBU-3 antigen is present in allantoic fluid but is not detectable in any fetal or adult tissue studied, including maternal and fetal sera. It is suggested that this antigen may have a role in the placentation process. PMID- 3526315 TI - The effect of aminophylline on renin release from human chorio-decidua. AB - The effect of aminophylline on renin release from human chorion was investigated by perfusing the tissue with various concentrations of the drug. Buffer containing aminophylline (2 X 10(-6) mol/l) doubled the rate of active and total renin secretion, but a more concentrated solution (10(-5) mol/l) released proportionately less active and total renin although the result was statistically significant. Renin secretion was not altered by aminophylline (5 X 10(-5) mol/l). The pattern of renin release was modulated by concentrations of aminophylline which were at least a 100-fold lower than those required to inhibit cyclic adenosine 3',5'-monophosphate phosphodiesterase. However, as the methylxanthines are potent adenosine receptor antagonists, we suggest that in the human chorion adenosine is a mediator of renin release. PMID- 3526316 TI - [Islet cell surface autoantibodies: their immunoenzyme analysis using rat target cells]. AB - A hard phase immunoenzymatic system for primary screening and subsequent quantitative determination of autoimmunobodies to the surface of islet cells (ASIC) was worked out using rat target cells. ASIC organ-specificity was confirmed by the absence of crossreactions with rat hepatocytes and splenocytes. The determination of the upper normal bound with 99% confidence interval combined with a high sensitivity of the method allowed an objective and significant assertainment of ASIC-positive sera even with a low level of antibodies. ASIC quantitative characteristic is their titer determined with the help of the intersection of a titration curve with the upper normal bound. ASIC were detected approximately in half of the patients with insulin-dependent diabetes of a duration of maximum 5 years and were not detected in the patients with insulin dependent diabetes compensated with diet and sugar lowering drugs using the above method. PMID- 3526317 TI - [Causes of hyperinsulinemia and decreased sensitivity to insulin in liver damage]. AB - Chronic contamination of rats with heliotrin causing the development of hepatitis or hepatocirrhosis and partial hepatectomy to decrease the amount of liver cellular elements resulted in intolerance to glucose, a decrease in the sensitivity of the body to insulin, hyperinsulinemia after a glucose-tolerance test. The content of glycogen in the liver of the heliotrin contaminated rats was much lower than that in the controls and after glucose-tolerance an absolute increment of glycogen in the controls was 8.8-fold higher than in the heliotrin contaminated rats. It was concluded that a decrease in glucose-tolerance and hyperinsulinemia in patients with chronic hepatitis and hepatocirrhosis were determined by a decrease in the amount of functionally active liver cellular elements and the development of insulin resistance. PMID- 3526318 TI - [Binding properties of insulin receptors in adipose tissue and hepatic plasma membranes in rats during fasting and in alloxan diabetes]. AB - The affinity and number of receptors were determined using Scatchard's, Meytes' and Rose's graphic analyses in the hepatic and fat plasmatic membranes of rats in various duration of hunger (2 and 7 days) and alloxan diabetes (3 and 7 days after alloxan administration) to test a hypothesis that increased affinity of insulin receptors was the first phase of their activation preceding an increase in the number of insulin binding sites. Irrespective of hunger duration an increase in the number and affinity of receptors was detected in the hepatic membranes and an increase in their affinity in the fat membranes. In diabetes of various duration the number of receptors in the membranes of both tissues increased. With an increase in the period of exposure the degree of expression of receptor changes decreased in the fat but not in the hepatic membranes. PMID- 3526319 TI - [Role of insulin in the regulation of the tubular reabsorption of glucose in the kidneys]. AB - Glucose tubular transport in the kidneys in changes of insulin concentration in the blood was studied in acute and chronic experiments on dogs. Maximum glucose reabsorption in the kidneys was shown to remain unchanged in the stimulation of insulin secretion or depletion of insular function (alloxan diabetes). Neither did the administration of insulin into the renal artery at doses of 0.02-0.04 U/min for 30 min. influence glucose reabsorption which rose during hormone infusion at doses of 0.4-0.5 U/min only. PMID- 3526320 TI - [Alloxan cytotoxicity: a new aspect of the problem]. AB - The effect of alloxan on human intact erythrocytes (in the suspension and whole blood) was studied using an original potentiometric apparatus permitting continuous registration of the flow rate of reducing equivalents ('RE) through a plasmatic membrane. Acceleration of RE flow from erythrocytes due to the activation of hexosomonophosphate shunt (HMPS) was established. This effect was inhibited by P-chlormercury benzoate proving the involvement of the SH-groups of erythrocyte membrane proteins in the interaction of alloxan with erythrocytes. Oxygen consumption after adding alloxan was recorded by polarography that indicated the "start" of the alloxan----dialuric acid (A in equilibrium with DA) cycle. Enhanced RE production in erythrocytes may be caused by H2O2 and free radicals forming in this cycle. It was shown that HMPS activation i.e. transition to a more intense stationary regimen was maintained for a period exceeding the calculated period of alloxan "halt--life". This residual effect of alloxan "depleted" erythrocyte protective mechanisms that was expressed in a decrease in maximum capacity of HMPS of rat whole blood after receiving by the animals a diabetogenic dose of alloxan (150 mg/kg body mass). Thus a specific cumulation of the effect of alloxan expressed in the transition of the RE generation system to a more intense stationary regimen, was revealed. In investigating the mechanism of alloxan cytotoxicity one should take into account this peculiarity of alloxan along with the factor of affinity and conditions for initiation of the A in equilibrium with DA cycle. PMID- 3526321 TI - [Autoimmune aspects of insulin-dependent diabetes mellitus. Insulitis and pancreatic beta-cell destruction]. PMID- 3526322 TI - [Results of different programs of chemotherapy using rifampicin in patients with newly detected destructive pulmonary tuberculosis]. PMID- 3526323 TI - [Remote results of chemotherapy of patients with chronic destructive pulmonary tuberculosis]. PMID- 3526324 TI - [Use of semipermeable cellophane membranes for obtaining Mycobacterium biomass]. PMID- 3526325 TI - [Academician F.G. Ianovskii and his contribution to the development of Russian phthisiatry (on the 25th anniversary of his birth)]. PMID- 3526326 TI - [Wilhelm Konrad Roentgen (1845-1923) (on the 90th anniversary of discovery of roentgen rays)]. PMID- 3526327 TI - Structure, corrosion and biocompatibility of dental Ag-Pd-Cu-(Au)-(Zn) alloys. PMID- 3526328 TI - Potential proteolytic activity of human plasma fibronectin. AB - Evidence is presented that fibronectin (FN) polypeptide chain contains a latent proteinase. Human plasma FN was cleaved with cathepsin D into three main fragments: 140-kDa and 70-kDa single-chain and 140-kDa double-chain polypeptides. Their separation was achieved according to their affinity for heparin-Sepharose. A single-chain 140-kDa fragment (H-1) was eluted in the first peak. This peptide corresponds to the already described fragment that originates from the central part of FN; it contains a low-affinity heparin-binding site, one free SH group, and a cell-binding site. After reduction and further purification by preparative polyacrylamide gel electrophoresis, this fragment revealed a spontaneous decomposition, which could be attributed to proteolytic degradation. The subfragments, ranging from 25 to 95 kDa, yielded the same proteolytically active doublet of 28-30 kDa when tested by NaDodSO4/polyacrylamide gel electrophoresis in a gel containing copolymerized gelatin or fibrinogen. The proteolytic activity was inhibited by specific SH proteinase inhibitors. The proteinase forms a labeled complex after its incubation with 125I-labeled cystatin. Neither FN, cathepsin D, nor any products from previous purification steps were proteolytically active under the conditions of the assay. It was suggested that the same fragment may also yield an inhibitor, since structural analogies were found between the cell-binding region of FN and SH proteinase inhibitors. PMID- 3526329 TI - Inducible overproduction of the mouse c-myc protein in mammalian cells. AB - We have made Chinese hamster ovary (CHO) cell lines that contain up to 2000 copies of the coding region of the mouse c-myc gene fused to the promoter of the Drosophila gene (hsp70) encoding a Mr 70,000 heat shock protein. Incubation of these cells at 43 degrees C results in an estimated 100-fold induction of c-myc mRNA. Translation of this mRNA occurs when the cells are returned to 37 degrees C, and during the first 3 hr of recovery at 37 degrees C, the c-myc protein is one of the most abundantly synthesized proteins in the cells. The products of the induced c-myc gene are phosphoproteins of apparent Mr 64,000, 66,000, and 75,000. Induced cells die, suggesting that elevated levels of c-myc are cytotoxic. Amplification of genes placed under control of the Drosophila hsp70 promoter may provide a general method for inducibly over expressing proteins in mammalian cells. PMID- 3526330 TI - yes-related protooncogene, syn, belongs to the protein-tyrosine kinase family. AB - An src/yes-related novel gene named syn (SYN in human gene nomenclature) has been identified in the human genome on chromosome 6 and characterized by molecular cloning. Nucleotide sequence analysis of cDNA clones showed that the c-syn gene could encode a protein-tyrosine kinase that is very similar in primary structure to the v-yes and human c-src proteins. A 2.8-kilobase transcript of the c-syn gene, which differs in size from those of the c-yes, c-src, and c-fgr genes, was observed in various cell types. These results show that syn is a new member of the tyrosine kinase oncogene family. PMID- 3526331 TI - Yeast gene required for spindle pole body duplication: homology of its product with Ca2+-binding proteins. AB - Saccharomyces cerevisiae strains bearing temperature-sensitive alleles of the cell division cycle gene CDC31 are specifically defective in duplication of the spindle pole body, the microtubule-organizing center of yeast. To define the function encoded by CDC31 more fully, we have isolated genomic clones of the gene by selection for complementation of a temperature-sensitive allele. The locus from which the clone was derived was marked by integration of a nutritional marker and found by meiotic mapping to cosegregate with CDC31. The polypeptide sequence of the open reading frame in the CDC31 gene was determined and compared with the sequences of other known proteins. This revealed significant homology with the calmodulins and other members of the Ca2+-binding protein family. On the basis of comparison with these related proteins, it is evident that the CDC31 gene product has at least two binding sites for Ca2+ and is also homologous with other regions of the calmodulin sequence. We propose that Ca2+ fluxes within the yeast cell play a key role in spindle pole body duplication and consequently in the organization of the microtubule arrays. PMID- 3526332 TI - Human leukemia cells synthesize and secrete proteins related to platelet-derived growth factor. AB - Human leukemia cells in culture (HL-60) synthesize and secrete proteins that are recognized by antiserum to human platelet-derived growth factor (PDGF). The molecular mass of the intracellular proteins immunoprecipitated by PDGF antiserum ranged from 34 kDa to 240 kDa. PDGF-related proteins were also identified in the conditioned medium of the cells. Several of these immunoprecipitated proteins were glycosylated. A single protein of 46 kDa was immunoprecipitated from the cell-free translation products of mRNA obtained from the leukemia cells. Antiserum to the C but not to the N terminus of the predicted amino acid sequence of the transforming protein p28sis/PDGF-2 also immunoprecipitated proteins secreted by the HL-60 cells. These findings provide a direct demonstration for the synthesis and secretion of PDGF-like proteins by leukemia cells in culture. These proteins do not appear to be coded by the known c-sis/PDGF-2 locus since no sis mRNA was detectable in the HL-60 cells. PMID- 3526333 TI - Decreased c-myc expression is an early event in retinoic acid-induced differentiation of F9 teratocarcinoma cells. AB - Retinoic acid-induced differentiation of mouse F9 teratocarcinoma cells is known to be accompanied by changes in gene expression. We examined the expression of the c-myc gene during retinoic acid-induced differentiation of F9 cells. Retinoic acid caused a 50% reduction in the level of c-myc mRNA after 3 hr of treatment and a 90% reduction after 12 hr. We have also examined several features of c-myc genomic structure in F9 cells, PYS2 (differentiated parietal yolk sac) cells, and liver--namely, methylation, amplification, and gross organization. Comparison of Hpa II and Msp I digests of DNAs from F9, PYS2, and liver showed that the c-myc gene in F9 cells is hypomethylated relative to that in PYS2 cells and in liver. The Hpa II sites that undergo methylation during differentiation were found to be in the second intron. Gross structural changes of the c-myc gene have not occurred in F9 or PYS2, and the c-myc gene is not amplified. PMID- 3526334 TI - Spatial pattern of catalase (Cat2) gene activation in scutella during postgerminative development in maize. AB - The scutellum of maize is a fully differentiated, nondividing, diploid embryonic tissue. Two distinct structural genes (Cat1 and Cat2) encoding the enzyme catalase (CAT) are differentially expressed in this tissue during postgerminative development. As development proceeds, the expression of Cat1 diminishes, while that of Cat2 is enhanced, leading to the disappearance of the CAT-1 protein and the gradual accumulation of the CAT-2 protein. The present investigation was undertaken to determine whether all scutellar cells may be genetically programmed to activate expression of Cat2 synchronously or whether there is an asynchronous spatial gradient of Cat2 activation. By using immunofluorescence microscopy and anti-CAT-2 IgG, we have found that a gradient of Cat2 activation occurs within the scutellar cell mass during postgerminative development. The gradient of Cat2 activation occurs from the outer perimeter of the tissue inward toward the embryonic axis. To determine a potential site of origin for any putative "triggering signal" for Cat2 activation, we demonstrated that Cat2 is expressed in the single layer of aleurone cells prior to its expression in any other tissue during kernel development. To our knowledge, this is the first observation of a gradient-type spatial pattern of a eukaryote gene activation occurring in a stable, virtually nondividing tissue such as the maize scutellum. The significance of these results with respect to developmental gene regulation is discussed. PMID- 3526335 TI - recD: the gene for an essential third subunit of exonuclease V. AB - Exonuclease V (EC 3.1.11.5) of Escherichia coli, an enzyme with multiple activities promoting genetic recombination, has previously been shown to contain two polypeptides, the products of the recB and recC genes. We report here that the enzyme contains in addition a third polypeptide (alpha) with a molecular mass of about 58 kDa. The alpha polypeptide is not synthesized by a class of mutants (previously designated recB) lacking the nuclease activity of exonuclease V but retaining recombination proficiency. The gene, recD, coding for the alpha polypeptide is located near recB in the order thyA-recC-ptr-recB-recD-argA on the E. coli chromosome. The recB and recD genes appear to be governed by a common promoter to the left of recB; a weaker promoter appears to govern recD alone. In the light of these results we discuss the relation between the structure and function of the three polypeptides of exonuclease V, hereby alternatively designated RecBCD enzyme. PMID- 3526336 TI - Saccharomyces cerevisiae contains two functional genes encoding 3-hydroxy-3 methylglutaryl-coenzyme A reductase. AB - We have isolated two genes from yeast encoding 3-hydroxy-3-methylglutaryl coenzyme A reductase [hydroxymethylglutaryl-coenzyme A reductase (NADPH); HMG-CoA reductase; EC 1.1.1.34], the rate-limiting enzyme of sterol biosynthesis. These genes, HMG1 and HMG2, were identified by hybridization to a cDNA clone encoding hamster HMG-CoA reductase. DNA sequence analysis reveals homology between the amino acid sequence of the proteins encoded by the two yeast genes and the carboxyl-terminal half of the hamster protein. Cells containing mutant alleles of both HMG1 and HMG2 are unable to undergo spore germination and vegetative growth. However, cells containing a mutant allele of either HMG1 or HMG2 are viable but are more sensitive to compactin, a competitive inhibitor of HMG-CoA reductase, than are wild-type cells. Assays of HMG-CoA reductase activity in extracts from hmg1- and hmg2- mutants indicate that HMG1 contributes at least 83% of the activity found in wild-type cells. PMID- 3526337 TI - Suppression of human DNA alkylation-repair defects by Escherichia coli DNA-repair genes. AB - The ada-alkB operon protects Escherichia coli against the effects of many alkylating agents. We have subcloned it into the pSV2 mammalian expression vector to yield pSV2ada-alkB, and this plasmid has been introduced into Mer- HeLa S3 cells, which are extremely sensitive to killing and induction of sister chromatid exchange by alkylating agents. One transformant (the S3-9 cell line) has several integrated copies of pSV2ada-alkB and was found to express a very high level of the ada gene product, the 39-kDa O6-methylguanine-DNA methyltransferase. S3-9 cells were found to have become resistant to killing and induction of sister chromatid exchange by two alkylating agents, N-methyl-N'-nitro-N-nitrosoguanidine and N,N'-bis(2-chloroethyl)-N-nitro-sourea. This shows that bacterial DNA alkylation-repair genes are able to suppress the alkylation-repair defects in human Mer- cells. PMID- 3526338 TI - An inhibitor of SOS induction, specified by a plasmid locus in Escherichia coli. AB - Plasmid R6-5 contains a locus whose product inhibits induction of sfiA and prophage lambda in a recA441 mutant at 42 degrees C and in a recA+ host after treatment with nalidixic acid. This plasmidic SOS-inhibition locus (psi) is situated on an 8.1-kilobase DNA fragment near oriT, the origin of plasmid R6-5 conjugational transfer. Loss of the Psi function, resulting from the insertion of Tn3 into psi+, greatly reduced the synthesis of two proteins, designated PsiA (Mr 24,500) and PsiB (Mr 12,500). Using host cells in which there was an inactive LexA repressor, we found that Psi function does not act by interfering with the expression of the SOS pathway. The Psi function may affect the generation of an SOS signal. We postulate that during the course of evolution, the Psi function has been selected in some conjugative plasmids so as to permit them to transfer single-stranded DNA without generating an SOS signal. PMID- 3526339 TI - Protein kinase C directly phosphorylates the insulin receptor in vitro and reduces its protein-tyrosine kinase activity. AB - The beta subunit of purified insulin receptor is phosphorylated on a serine residue by purified preparations of protein kinase C (ATP: protein phosphotransferase, EC 2.7.1.37). This phosphorylation is inhibited by antibodies to protein kinase C and stimulated by phospholipids, diacylglycerol, and Ca2+. The phosphorylation of the receptor by protein kinase C does not affect its insulin-binding activity but does inhibit by 65% the receptor's intrinsic tyrosine-specific protein kinase activity (ATP: protein-tyrosine O phosphotransferase, EC 2.7.1.112). These results indicate that activators of protein kinase C, such as phorbol esters, desensitize cells to insulin by direct protein kinase C action on the insulin receptor. PMID- 3526341 TI - Autogenous regulation of splicing of the transcript of a yeast ribosomal protein gene. AB - The gene for a yeast ribosomal protein, RPL32, contains a single intron. The product of this gene appears to participate in feedback control of the splicing of the intron from the transcript. This autogenous regulation of splicing provides a striking analogy to the autogenous regulation of translation of ribosomal proteins in Escherichia coli. PMID- 3526340 TI - Covalent linkage of ribonuclease S-peptide to microinjected proteins causes their intracellular degradation to be enhanced during serum withdrawal. AB - The amino-terminal 20 amino acids are required for microinjected ribonuclease A (RNase A) to be taken up by lysosomes and degraded at an enhanced rate during serum withdrawal. We used water-soluble carbodiimides to covalently attach the RNase S-peptide (residues 1-20) to [3H]RNase S-protein (residues 21-124) at unspecified locations. We then measured catabolism of the [3H]S-protein-S-peptide conjugate after its microinjection into human diploid fibroblasts. The attached S peptide caused the degradation of S-protein to be enhanced 2-fold in the absence of serum. Control experiments showed that degradation of [3H]RNase S-protein remained unresponsive to serum after conjugation with the inactive fragment, RNase S-peptide (residues 1-10). Covalent attachment of RNase S-peptide had a similar effect on the catabolism of two other proteins. Degradation rates of microinjected 125I-labeled lysozyme and 125I-labeled insulin A chain are normally unresponsive to serum withdrawal. However, breakdown rates of microinjected 125I labeled lysozyme-S-peptide and 125I-labeled insulin A chain-S-peptide conjugates were increased 2-fold during serum deprivation. We suggest that RNase S-peptide acts as a "single sequence" that directs cytosolic proteins to lysosomes through a pathway that is activated by deprivation conditions. PMID- 3526342 TI - Importance of the loop at residues 230-245 in the allosteric interactions of Escherichia coli aspartate carbamoyltransferase. AB - Site-directed mutagenesis has been used to replace tyrosine-240 with phenylalanine in each of the catalytic chains of aspartate carbamoyltransferase. Tyrosine-240 is part of a loop in the structure of the enzyme, between residues 230 and 245, which undergoes a substantial conformation change as the enzyme becomes ligated [Krause, K. L., Volz, K. W. & Lipscomb, W. N. (1985) Proc. Natl. Acad. Sci. USA 82, 1643-1647]. The mutant enzyme with phenylalanine at position 240 has substantially reduced homotropic interactions and an increased affinity for the substrate aspartate but displays no alteration in maximal observed specific activity. The Hill coefficient decreases from 2.4 for the wild-type enzyme to 1.8 for the mutant, and the aspartate concentration at half the maximal observed velocity decreases from 11.9 mM to 4.7 mM at pH 8.3. Heterotropic interactions of the mutant enzyme are altered to a lesser extent. The catalytic subunit derived from the mutant enzyme exhibits kinetics identical to that of the wild-type catalytic subunit. Reactivity of the mutant enzyme with p hydroxymercuribenzoate suggests that the unligated enzyme exists in an altered conformation. The properties of the mutant enzyme are explained in terms of the structure of the wild-type enzyme, and a model is proposed to account for the allosteric interactions of the wild-type enzyme in terms of specific interactions involving the 230-245 loop of the enzyme. PMID- 3526343 TI - Processing of phage T4 td-encoded RNA is analogous to the eukaryotic group I splicing pathway. AB - Several features of the split td gene of phage T4 suggest an RNA processing mechanism analogous to that of the self-splicing rRNA of Tetrahymena and other group I eukaryotic introns. Previous work has revealed conserved sequence elements and the ability of td-encoded RNA to self-splice in vitro. We show here that a noncoded guanosine residue is covalently joined to the 5' end of the intron during processing. Further, we demonstrate the existence of linear and circular intron forms in RNA extracted from T4-infected cells and from uninfected Escherichia coli expressing the cloned td gene. Sequence analysis of the intron cyclization junction indicates that the noncoded guanosine and one additional nucleotide are lost from the 5' end of the intron upon cyclization. This analysis places a uridine residue upstream of the cyclization site, in analogy to three other group I cyclization junctions. These striking similarities to the splicing intermediates of eukaryotic group I introns point not only to an analogous processing pathway and conserved features of cyclization site recognition but also to a common ancestry between this prokaryotic intervening sequence and the group I eukaryotic introns. PMID- 3526344 TI - Affinity chromatography with an immobilized RNA enzyme. AB - M1 RNA, the catalytic subunit of Escherichia coli RNase P, has been covalently linked at its 3' terminus to agarose beads. Unlike M1 RNA, which is active in solution in the absence of the protein component (C5) of RNase P, the RNA linked to the beads is active only in the presence of C5 protein. Affinity chromatography of crude extracts of E. coli on a column prepared from the beads to which the RNA has been crosslinked results in the purification of C5 protein in a single step. The protein has been purified in this manner from cells that contain a plasmid, pINIIIR20, which includes the gene that codes for C5 protein. A 6-fold amplification of the expression of C5 protein is found in these cells after induction as compared to cells that do not harbor the plasmid. PMID- 3526345 TI - Effect of amino acid substitutions on the catalytic and regulatory properties of aspartate transcarbamoylase. AB - Although intensive investigations have been conducted on the allosteric enzyme, aspartate transcarbamoylase, which catalyzes the first committed reaction in the biosynthesis of pyrimidines in Escherichia coli, little is known about the role of individual amino acid residues in catalysis or regulation. Two inactive enzymes produced by random mutagenesis have been characterized previously but the loss of activity is probably attributable to changes in the folding of the chains stemming from the introduction of charged and bulky residues (Asp for Gly-128 and Phe for Ser-52). Site-directed mutagenesis of pyrB, which encodes the catalytic chains of the enzyme, was used to probe the functional roles of several amino acids by making more conservative substitutions. Replacement of Lys-84 by either Gln or Arg leads to virtually inactive enzymes, confirming chemical studies indicating that Lys-84 is essential for catalysis. In contrast, substitution of Gln for Lys-83 has only a slight effect on enzyme activity, whereas chemical modification causes considerable inactivation. Gln-133, which has been shown by x ray crystallography to reside near the contact region between the catalytic and regulatory chains, was replaced by Ala. This substitution has little effect on catalytic activity but leads to a marked increase in cooperativity. The Gln-83 mutant, in contrast, exhibits much less cooperativity. Since a histidine residue may be involved in catalysis and His-134 has been shown by x-ray diffraction studies to be in close proximity to the site of binding of a bisubstrate analog, His-134 was replaced by Ala, yielding a mutant with only 5% wild-type activity, considerable cooperativity, and lower affinity for aspartate and carbamoylphosphate. All of the mutants, unlike those in which charged or bulky residues replaced small side chains, bind the bisubstrate analog, which promotes the characteristic "swelling" of the enzymes indicative of the allosteric transition. PMID- 3526346 TI - Identification of phosphoproteins correlated with proliferation and cell cycle arrest in Saccharomyces cerevisiae: positive and negative regulation by cAMP dependent protein kinase. AB - Recent genetic and biochemical studies of two mutants of the cAMP pathway in yeast, cyr1 and bcy1, have demonstrated that cAMP-dependent protein phosphorylation plays a major regulatory role in the control of proliferation and differentiation. As a first step in examining this regulatory system in more detail and in identifying the protein substrates of cAMP-dependent protein kinase, we have analyzed phosphoprotein patterns in the mutants cyr1-2(ts) and bcy1 by two-dimensional polyacrylamide gel electrophoresis. Our analysis has revealed several proteins whose phosphorylation is controlled positively or negatively by the cAMP pathway in yeast. The presence of some of these phosphoproteins was directly associated with proliferation (positive regulation), while that of others was correlated with cell cycle arrest (negative regulation). The phosphoprotein patterns of cyr1-2(ts) temperature-arrested cells, and nitrogen (NH+4)-starved cells, were strikingly similar, suggesting that response to NH+4 is mediated in part by adenylate cyclase. Phosphoproteins whose presence correlated with cell cycle arrest were found to be phosphorylated on serine and threonine residues, while the major phosphoproteins present predominantly in proliferating cells were phosphorylated only on serine residues. None of the greater than 20 phosphoproteins we examined contained phosphotyrosine under either growth condition. PMID- 3526347 TI - Meiotic disjunction of circular minichromosomes in yeast does not require DNA homology. AB - Circular plasmids containing an autonomously replicating sequence (ARS) and a centromeric DNA sequence (CEN) segregate as independent linkage groups during meiosis in Saccharomyces cerevisiae. If two genetically marked plasmids are present in the same diploid cell, their segregation during meiosis may be determined relative to each other. It has been observed that for centromere plasmids containing some DNA sequences in common, these plasmids tend to segregate away from each other at the first meiotic division [Clarke, L. & Carbon, J. (1980) Nature (London) 287, 504-509; Clarke, L., Fitzgerald-Hayes, M., Buhler, J.-M. & Carbon, J. (1981) Stadler Genet. Symp. 13, 9-23]. Here we show that nonhomologous plasmids, having no detectable DNA sequence cross hybridization, also tend to disjoin from each other at the first meiotic division. Therefore, this nonrandom segregation to opposite poles can occur by mechanisms that do not involve DNA sequence homology. This process may be an active nonhomologous pairing system or it may reflect unknown physical restraints on the meiotic segregation of the two plasmids. In either case, this process cannot be used as a possible assay for homologous meiotic pairing. PMID- 3526348 TI - Spermidine synthase of Escherichia coli: localization of the speE gene. AB - We have obtained Escherichia coli mutants lacking spermidine synthase (putrescine aminopropyltransferase) and have found that the mutated gene (speE) is located immediately upstream from the gene coding for S-adenosylmethionine decarboxylase (speD); these genes are located at 2.7 minutes on the E. coli chromosome. Both genes are present in a 1795-base-pair fragment of E. coli DNA that was cloned into pBR322. Deletion of 105 bases upstream of speE caused a coordinate loss of both activities, indicating that speE and speD constitute a single operon. speE and speD have also been cloned separately in a high-expression vector; strains carrying these plasmids overproduce the respective enzymes. PMID- 3526349 TI - Molecular analysis of the DNA sequences involved in the transcriptional regulation of the phosphate-repressible acid phosphatase gene (PHO5) of Saccharomyces cerevisiae. AB - The expression of the PHO5 gene of Saccharomyces cerevisiae is transcriptionally regulated in response to the level of inorganic phosphate present in the growth medium. We have identified, by DNA deletion analysis, the sequences (upstream activator sequences) that mediate this response. The sequence 5' CTGCACAAATG 3' is present in two copies located within a 60-base-pair region. The presence of a single copy of the sequence is sufficient for the phosphate-mediated transcriptional response. In addition, a DNA fragment that contains two copies of this sequence will act to repress transcription of a CYC1-lacZ fusion when placed either upstream or downstream of the CYC1 activator sequence. PMID- 3526350 TI - The specific direct interaction of helper T cells and antigen-presenting B cells. AB - Cell couples have been formed by mixing an antigen- and Ia-specific cloned helper T-cell line with a B-cell hybridoma presenting the antigen. By immunofluorescence observations, we have shown that the microtubule-organizing center (MTOC) inside the helper T cell, but not in the bound antigen-presenting cell, becomes oriented to face the area of specific cell-cell contact. This MTOC orientation is antigen- and Ia-specific, and thus provides direct evidence for the specific interaction of a helper T cell with a B cell. It is presumed that the function served by this MTOC orientation, which is accompanied by the coordinate reorientation of the Golgi apparatus, is to target Golgi apparatus-derived secretory vesicles, containing putative lymphokines and/or growth factors, from the helper T cell directly to the antigen-presenting cell. PMID- 3526351 TI - Plasmodium falciparum polypeptides associated with the infected erythrocyte plasma membrane. AB - Plasmodium falciparum proteins associated with plasma membranes of infected erythrocytes were identified by using three techniques: isolated plasma membranes from infected and uninfected erythrocytes were compared by gel electrophoresis and silver staining; isolated plasma membranes from cells metabolically labeled with [35S]methionine were assayed by gel electrophoresis; and uninfected and infected intact erythrocytes were surface-labeled by lactoperoxidase iodination, and the labeled polypeptides were compared by gel electrophoresis. The results from these experiments indicate that at least six parasite-derived polypeptides (Mr = greater than 240,000, 150,000, 55,000, 45,000, 35,000, and 20,000) are associated with the infected erythrocyte plasma membrane. At least four of these peptides (Mr = 55,000, 45,000, 35,000, and 20,000) may be exposed on the surface of the infected erythrocytes. PMID- 3526352 TI - Human parathyroid antigen: characterization and localization with monoclonal antibodies. AB - A cell surface antigen on human parathyroid cells was identified by monoclonal antibodies. The antigen, called parathyroid antigen (PTA), is found on both of two major polypeptides (190 kDa and 160 kDa) apparently associated exclusively with parathyroid cells. To determine whether PTA was a suitable target for in vivo imaging, 125I-labeled anti-PTA was injected into nude mice bearing human parathyroid xenografts. IgG1 anti-PTA antibody showed excellent radiolocalization of the grafts, whereas IgM anti-PTA, containing the same variable domains as the IgG1 antibody, showed little specific binding. These results suggest that antibody isotype is an important parameter for the in vivo immunoscintigraphy of specific cellular antigens. PMID- 3526353 TI - In vitro reconstitution of flagellar filaments onto hooks of filamentless mutants of Salmonella typhimurium by addition of hook-associated proteins. AB - An in vitro system for reconstituting flagellar filaments onto hooks of filamentless mutants of Salmonella typhimurium was used to investigate the role played in filament formation by the three hook-associated proteins (HAPs, products of the flaW, flaU, and flaV genes). These proteins--FlaW, FlaU, and FlaV -are believed to be assembled in this order at the distal end of the hook. When the recipient hooks were provided by flaU mutants, whose hook tips contained FlaW only, exogenous FlaU was essential for polymerization of both exogenous and endogenous flagellin, whereas exogenous FlaV inhibited such polymerization. When the recipients were flaV-mutant hooks, whose tips contained FlaW and FlaU but not FlaV, exogenous FlaV inhibited polymerization of exogenous flagellin. FlaV also inhibited polymerization of exogenous flagellin at the tips of filament fragments. In contrast, FlaV was essential for polymerization of endogenous flagellin onto flaV-mutant hooks, and onto short filaments that had been made (in the absence of FlaV) by polymerization of exogenous flagellin on the tips of flaV mutant hooks. These results suggest that FlaV acts not only at the tip of the hook to initiate growth of the filament, but also at the tip of the growing filament, and that FlaV is essential for polymerization of endogenous flagellin- i.e., for the normal process of filament assembly in vivo. PMID- 3526354 TI - Steady-state level and turnover rate of the tripeptide Tyr-Gly-Gly as indexes of striatal enkephalin release in vivo and their reduction during pentobarbital anesthesia. AB - Tyr-Gly-Gly (YGG) was recently shown to be an extraneuronal metabolite of opioid peptides derived from proenkephalin A, formed in brain by the action of "enkephalinase" (membrane metalloendopeptidase, EC 3.4.24.11) and degraded by aminopeptidases. The dynamic state of YGG in mouse striatum was studied by evaluating the changes in its level elicited by inhibitors of these peptidases. Inhibition of YGG synthesis by Thiorphan or acetorphan reduced YGG levels with a t1/2 (mean +/- SEM) of 12 +/- 2 min, indicating an apparent turnover rate (mean +/- SEM) of 18 +/- 2 pmol/mg of protein per hr. An apparent turnover rate of 18 +/- 2 pmol/mg of protein per hr was derived from the rate of YGG accumulation elicited by the aminopeptidase inhibitor bestatin. In addition, accumulation of Tyr-Gly-Gly-Phe-Met (YGGFM) in an extrasynaptosomal fraction after blockade of its degradation by Thiorphan and bestatin occurred at a rate of 18 +/- 3 pmol/mg of protein per hr, which is likely to reflect the rate of enkephalin release in vivo. Hence, the three series of data suggest that striatal enkephalins rapidly turn over--e.g., with a t1/2 in the 1-hr range. Pentobarbital anesthesia reduced by about 60% the rate of YGG accumulation elicited by bestatin and the extrasynaptosomal YGGFM accumulation elicited by Thiorphan and bestatin. This suggests that the activity of striatal enkephalin neurons is depressed during anesthesia. Pentobarbital (and chloral hydrate) did not affect the steady-state level of YGGFM but rapidly reduced that of YGG. Hence, the steady-state levels of YGG seem a reliable index of changes in enkephalin release, and measuring levels of characteristic fragments might therefore provide a general means of evaluating neuropeptide release in vivo. PMID- 3526355 TI - Pneumococcal vaccine immunization of patients with renal impairment. AB - The immunogenicity of the polyvalent pneumococcal vaccine was studied in renal allograft recipients and dialysis patients. There was no significant overall difference in the antibody response of the allograft recipients compared to control subjects at 1 month following immunization. Chronic hemodialysis patients had significantly lower postvaccination antibody levels for 6 of 12 serotypes. Better graft function in the allograft recipients correlated positively with higher antibody levels. Azathioprine and prednisone in dosages employed had no consistent effect on antibody response. No deterioration of renal function ascribable to the vaccine was observed. Patients were sampled at 1, 2, and 3 1/2 years following immunization. Geometric mean titers (GMT) were calculated for all the serotypes per group for each time of sampling. There was a significant decrease with time in antibody GMTs for all the groups (P less than 0.01). Chronic hemodialysis patients had significantly lower GMTs than control subjects and allograft recipients at 1, 2, and 3 1/2 years postimmunization (P less than 0.05). The 3 1/2 years postimmunization antibody levels were very low in dialysis patients, suggesting that reimmunization of these patients may be required. PMID- 3526356 TI - Effect of bombesin and gastrin-releasing peptide on the release of gastric inhibitory polypeptide and insulin in rats. AB - The objective of this study was to determine whether bombesin- or gastrin releasing peptide-induced release of insulin occurs before or after the release of gastric inhibitory polypeptide (GIP) in rats. The present results demonstrate that GIP release occurs before insulin release and suggest that bombesin-like peptides and GIP interact to stimulate insulin secretion. PMID- 3526357 TI - Attenuation by prostacyclin of adrenaline-stimulated lipid peroxidation in the myocardium. AB - The study aimed to investigate the effect of adrenaline upon lipid peroxidation processes in the myocardium and to evaluate the effect of prostacyclin upon the content of lipid peroxidation products in adrenaline-treated hearts. Anaesthetized rabbits were infused for 2 hours with adrenaline /1 microgram/kg/min/, adrenaline and prostacyclin /2 ng/kg/min/ and prostacyclin alone; controls received saline. After termination of infusion lipid peroxidation products /conjugated double bonds CDB, malondialdehyde MDA, lipid-soluble fluorescent material, FM/ and SH groups were measured in the myocardial tissue. Adrenaline significantly increased the content of all three indices of lipid peroxidation and decreased the concentration of soluble SH groups. PGI2 infused simultaneously significantly decreased the concentration of final metabolites of peroxidation /MDA, FM/ and prevented decrease of SH groups. The content of intermediate products of peroxidation, CDB was elevated. In conclusion, enhanced free radical activity, resulting in increased peroxidation of myocardial lipids may contribute to known injurious effect of adrenaline upon myocardium. The finding that PGI2 prevents increased formation of final peroxidation products gives support for the hypothesis that anti-free radical activity may be a component of cytoprotective action of prostacyclin. PMID- 3526358 TI - Insulin-potentiating action of gliclazide (diamicron). AB - Normal rats were given a daily dose of gliclazide (8 mg/kg) for a period of 6 days. Twenty-four hours after the treatment period, the treated animals had a significant increase in the initial rate of glucose utilization during intravenous glucose tolerance tests when compared to the controls. Insulin stimulated 3-0-Methylglucose transport and glucose oxidation were potentiated in adipocytes prepared from gliclazide-treated rats, indicating that improved glycemic control can, at least partly, be attributed to extrapancreatic effects. The drug treatment did not induce any changes in total insulin binding, implicating that the extrapancreatic effects of this hypoglycemic drug are mediated through a post-binding site. PMID- 3526359 TI - Mutagenic activity of the dacarbazine analog p-(3,3-dimethyl-1-triazeno)benzoic acid potassium salt in bacterial cells. AB - The mutagenic activity of the antimetastatic agent p-(3,3-dimethyl-1 triazeno)benzoic acid potassium salt (DM-COOK) was studied in procaryotic cells and compared with that of dacarbazine (DTIC) which is clinically used in the management of human neoplasms. The results indicated that DM-COOK has a very low mutagenic activity on the Salmonella typhimurium strains tested, while it is more effective in inducing trp+ revertants in E. coli B strains. The magnitude of these effects was always less pronounced than that displayed by DTIC. The mutagenic activity of DM-COOK appeared to be independent from the addition of a metabolic activating system and had a different pattern from that displayed by MM COOK. It is therefore unlikely that DM-COOK acts through conversion into the monomethyl derivative. PMID- 3526360 TI - [The evolution of "Martindale" and the "British National Formulary" and their role in providing information on drugs in the United Kingdom]. PMID- 3526361 TI - The physics of photodynamic therapy. PMID- 3526362 TI - Predictors of outcome of low birth weight infants. A review of the literature and methodological issues. AB - This article provides a summary of the attempts of various researchers to establish predictive relationships between certain perinatal risk factors and the neurologic outcome in the very low birth weight population and outlines some of the methodological problems inherent in developmental research. Information gathered through current assessment methods has limited prognostic value and should be used judiciously in decision making about diagnosis or intervention. PMID- 3526363 TI - Reduced repair of non-dimer photoproducts in a gene transfected into xeroderma pigmentosum cells. PMID- 3526365 TI - Pulmonary arterial impedance and right ventricular function. PMID- 3526364 TI - Physiological aspects of pineal functions in mammals. PMID- 3526366 TI - Meal-induced increases in parasympathetic and sympathetic activity elicit simultaneous rises in plasma insulin and free fatty acids. AB - The aim of this study was to investigate sympathetic and parasympathetic activity during food intake in rats by measuring plasma norepinephrine (NE), epinephrine (E), insulin, free fatty acids. (FFA), glycerol and blood glucose. Therefore male Wistar rats were implanted with silastic jugular vein cannulas so that blood could be withdrawn from freely moving animals. Blood samples were frequently taken before, during and after intake of a test meal. The effects of the blood sampling procedure on above mentioned blood compounds was also determined. Insulin increased considerably within the first minutes of food intake before a rise in blood glucose which is mediated by a vagal mechanism. An increase in plasma NE could be observed during the whole period of ingestive behavior whereas E increased considerably only in the first minute. Plasma FFA level was augmented sharply during food intake and a few minutes afterwards, whereas plasma glycerol levels did not change. After termination of food intake sympathetic activation disappeared and both plasma FFA and glycerol levels declined significantly below levels as observed in control rats. In contrast, plasma insulin and blood glucose increased considerably. It is concluded that food intake in rats causes a simultaneous increase in both sympathetic and parasympathetic activity and because of that a rise in plasma FFA and insulin respectively. It is argued that augmented sympathetic activity elicits a rise in plasma FFA levels, which is not mediated by increased lipolysis but by either decreased FFA utilization or reduced reesterification. PMID- 3526367 TI - Exercise reduces gonadal atrophy caused by short photoperiod or blinding of hamsters. AB - The effect of voluntary exercise upon several reproductive parameters was assessed in male Syrian hamsters. Forty-two animals were caged in five groups and then blinded: Ten housed five per plastic cage; eight housed individually in plastic cages; six housed individually in plastic cages with 15 cm exercise wheels in the cage; eight housed in Wahmann steel activity cages with 36 cm wheels locked to prevent rotation; ten housed in functional Wahmann running wheel cages. At 16 weeks after blinding, animals with access to functional running wheels had significantly larger testes (3.7 +/- 1.0 g) than those with no wheels or locked wheels (1.86 +/- 0.6 g; mean +/- SD; p less than 0.001). These results suggested that voluntary exercise reduces testicular atrophy caused by blinding. A second experiment was run in which the animals were subjected to a short photoperiod (LD 6:18) for 12 weeks instead of blinding. Similar results were obtained except that access to the small exercise wheels did not affect testicular atrophy: Mean testicular mass of animals in individual cages = 0.79 +/ 0.3 g, small wheels = 0.74 +/- 0.4 g, functional Wahmann wheels, 2.56 +/- 1.0 g, locked Wahmann wheels 0.52 +/- 0.1 g (p less than 0.01). PMID- 3526368 TI - Female discrimination of male dominance by urine odor cues in hamsters. AB - Female hamsters have been found to differentially respond to the odors of dominant as opposed to subordinate males. This study reexamined these responses in an olfactometer allowing the females to choose between urinary odors obtained from males differing in dominance status and clean air source. The behavior of the estrous females was consistent with previous research which indicated that such females exhibit a preference for stimuli obtained from dominant males. Contrary to previous findings in a two-choice apparatus, diestrous females failed to prefer the odors of subordinates. These females spent significantly more time in the area infused with unscented air. These data emphasize the importance of odor cues as they relate to male attractivity and possibly mate choice. They also underscore the need to allow animals to avoid conspecific odors in order to reduce the possibility of forcing animals into an unrealistic choice situation. PMID- 3526369 TI - Changes in insulin, glucose and GH concentrations in fed chickens. AB - The concentrations of insulin, glucose and growth hormone were examined in chickens during the fed and fasted states. In broiler chickens between 5 and 7 weeks of age, blood samples were drawn at intervals which reflected fed (-4 hr), fasted (+0 min) and post meal states (+15 min, immediately after a 15 min meal (and +30 min). Plasma was assayed using a chicken insulin standard in a heterologous RIA. Overall insulin averages, reflecting averaged values for 10 birds/day and 5 replications revealed a decrease with fasting and an increase post-meal. Insulin levels returned to pre-fasted concentrations within 15 min of meal termination. Changes in glucose concentrations correlated with those of insulin with the exception of the +30 min period. When insulin levels were observed in chickens where no food was consumed, insulin levels at +0 and +15 min were not different. No difference in GH concentration occurred at -4 hr, +0 or +15 min but the +30 min value increased (p less than 0.05). PMID- 3526370 TI - Evaluation of fibrin glue in rat sciatic nerve repairs. AB - Using the rat sciatic nerve model, we evaluated the merits of homologous fibrin glue in the repair of peripheral nerve transections as compared to standard epineural suture repairs. A total of four study groups were used, with 10 animals assigned to each group. In group I, the transected sciatic nerve was repaired with six interrupted 10-0 nylon sutures; in group II, only two interrupted sutures were used; in group III, a two-suture repair was reinforced with fibrin glue; and in group IV, only fibrin glue was used. All animals were sacrificed at 8 weeks, and histologic sections evaluated. When fibrin alone was used, dehiscence occurred in 80 percent of the animals, and as reinforcement of a two suture repair, it only increased the inflammatory reaction. PMID- 3526371 TI - A new surgical technique for phalloplasty in patients with exstrophy of the bladder. AB - Posterior pelvic osteotomy has not been a satisfactory operation to provide penile length in the repair of defects associated with bladder exstrophy. The authors are proposing a new technique based on the movement of the halves of the symphysis and pubic rami (en bloc with the attached corpora cavernosa) to the midline. This is accomplished by osteotomies of the superior and inferior rami and bone grafting of the resulting defects in the superior rami only. The hip joints are not disturbed, risk of complications appears to be reduced, and increased effective penile length is obtained. Cadaver dissections confirmed the practicality of this operation and a successful case is reported. The anatomy and physiology of penile function that is important to surgeons is reviewed. PMID- 3526372 TI - Double-tipped center-threading suture needle for subcuticular suturing. PMID- 3526373 TI - Jacques Joseph and the upper lateral nasal cartilages. PMID- 3526374 TI - Hyponatremic coma and elevated serum creatine phosphokinase following excessive caffeine intake. PMID- 3526375 TI - Sex differences in human motor activity level. PMID- 3526376 TI - Perceiving character in faces: the impact of age-related craniofacial changes on social perception. PMID- 3526377 TI - Gaze and eye contact: a research review. PMID- 3526378 TI - Treatment plans across psychologists assessing the same case of insomnia. PMID- 3526379 TI - [Long-term effect and prognostic criteria of a behavior therapy program in essential hypertension]. PMID- 3526380 TI - ["Rajneeshism" or "psychology of the Buddhas" as psychotherapeutic alternatives for academic dropouts?]. PMID- 3526381 TI - Treatment of the psychotic pregnant patient. PMID- 3526382 TI - Pica: current perspectives. PMID- 3526383 TI - Cumulative index volumes 66-70 (1981-1985). PMID- 3526384 TI - Malignant effusions. AB - Recurrent malignant effusions present a difficult management problem and are a major cause of morbidity. This article reviews the pathophysiology of serosal effusions, with particular reference to those occurring in malignant diseases. A detailed review of the investigations available and the characteristic findings in malignant effusions is presented. The influence of serosal cavity fluid dynamics on the pharmacology of intracavitary chemotherapy is discussed, and a rational approach to intracavitary treatment is presented. The treatment options for patients with malignant effusions are described and the present status of medical treatment is discussed. PMID- 3526385 TI - The importance of anaemia in cerebral and uncomplicated falciparum malaria: role of complications, dyserythropoiesis and iron sequestration. AB - Ninety-four per cent of 169 patients with cerebral malaria developed anaemia (haematocrit less than 35 per cent) and 30 per cent required blood transfusion to maintain the haematocrit at more than 21 per cent. Anaemia was at its worst on admission in 58 patients (34 per cent); in the rest the haematocrit fell further, reaching its nadir one to 17 days later (mean 2.3 days). The mean lowest haematocrit was 24.3 +/- 7.2 per cent (+/- 1 SD) and the mean maximum fall was 7.9 +/- 5.6 per cent. Anaemia was more severe in patients with bacterial infection, retinal haemorrhages, schizontaemia and in pregnancy. The lowest haematocrit correlated with admission parasitaemia (r = -0.33, p less than 0.001), total serum bilirubin (r = -0.25, p less than 0.01) and serum creatinine (r = -0.22, p less than 0.01). In 23 patients with uncomplicated falciparum malaria the mean serum iron on admission was 53 micrograms/dl (range 16-157) and the mean serum ferritin 1773 ng/ml (range 170-10 000). There was a significant (p less than 0.001) rise in serum iron 96 h after starting antimalarial treatment; the serum ferritin declined slowly over several weeks. Stainable iron was present in all marrows examined and in eight patients the characteristic pattern of the anaemia of chronic disorders was seen. Seventy-three per cent of patients had dyserythropoiesis which was moderate to gross in 36 per cent. Dyserythropoiesis and erythrophagocytosis were often present on admission but sometimes appeared after the parasitaemia had cleared and persisted for at least three weeks into convalescence. These disturbances in iron metabolism and haemopoiesis are not completely explicable by red blood cell parasitisation. They may contribute more to the anaemia than has previously been recognised. PMID- 3526386 TI - What is life?: Schrodinger's influence on biology. PMID- 3526387 TI - DNA conformation of Chinese hamster V79 cells and sensitivity to ionizing radiation. AB - Chinese hamster V79 cells grown for 20 h in suspension culture form small clusters of cells (spheroids) which are more resistant to killing by ionizing radiation than V79 cells grown as monolayers. This resistance appears to be due to the greater capacity of cells grown in contact to repair radiation damage. Attempts to relate this "contact effect" to differences in DNA susceptibility or DNA repair capacity have provided conflicting results. Two techniques, alkaline sucrose gradient sedimentation and alkaline elution, show no difference in the amounts of radiation-induced DNA single-strand breakage or its repair between suspension or monolayer cells. However, using the alkali-unwinding assay, the rate of DNA unwinding is much slower for suspension cells than for monolayer cells. Interestingly, a decrease in salt concentration or in pH of the unwinding solution eliminates these differences in DNA unwinding kinetics. A fourth assay, sedimentation of nucleoids on neutral sucrose gradients, also shows a significant decrease in radiation damage produced in suspension compared to monolayer cultures. It is believed that this assay measures differences in DNA conformation (supercoiling) as well as differences in DNA strand breakage. We conclude from these four assays that the same number of DNA strand breaks/Gy is produced in monolayer and spheroid cells. However, changes in DNA conformation or packaging occur when cells are grown as spheroids, and these changes are responsible for reducing DNA damage by ionizing radiation. PMID- 3526388 TI - Radioprotective effect of polyethylene glycol. AB - Polyethylene glycol of molecular weight 400 (PEG-400) had a radioprotective effect of about 20% against lethality when given ip 20 min prior to single or fractionated X-ray doses to the head and neck. Dose modification factors (DMF) based on LD50/15 values ranged from 1.14 to 1.24. A similar DMF of 1.12 based on LD50/30 values was obtained using single doses of whole-body X irradiation. Mice given head and neck irradiation had significantly reduced rectal temperatures (31.3 +/- 3.0 degrees C) 9 days post irradiation compared with unirradiated controls (35.4 +/- 0.6 degrees C). No such reduction was observed when PEG-400 was given with radiation (36.3 +/- 0.9 degrees C). PEG-400 also lessened, but not significantly, the frequency of shivering in irradiated animals. Histopathologic examination of the oral structures demonstrated only marginal protection by PEG 400. Estimation of the alpha/beta ratio from LD50 data on head and neck irradiated mice yielded values of 4.4 +/- 1.9 (95% confidence limits) Gy without PEG-400 and 7.9 +/- 1.4 Gy with PEG-400. Since it is a non-thiol radioprotector, PEG-400 may be more useful when combined with more conventional thiol-containing radioprotectors. PMID- 3526389 TI - The relative biological effectiveness of 14.5-MeV neutrons for the induction of gene conversion and mutation in yeast. AB - The relative biological effectiveness (RBE) and oxygen enhancement ratio (OER) were determined in the yeast Saccharomyces cerevisiae for the induction of gene conversion (the product of recombinational repair) and mutation (the product of error prone repair) by 14.5-MeV neutrons in comparison with 60Co gamma rays and 150 KVp X rays. Neutron irradiation in oxic or anoxic conditions induced significantly higher yields of convertants and mutants than sparsely ionizing radiations under the same conditions. RBEs for both gene conversion and mutation under anoxia were significantly higher than under oxic conditions. RBEs for mutant induction under anoxia were lower than the RBEs for gene conversion under the same conditions. The data support the hypothesis that the production of lesions leading to the genetic consequences of gene conversion and mutation differ in their dependence upon LET and the presence of oxygen during irradiation, and therefore the two DNA repair processes which produce these end points recognize, at least in part, different classes of damage. PMID- 3526390 TI - Quantitation of the involvement of the recA, recB, recC, recF, recJ, recN, lexA, radA, radB, uvrD, and umuC genes in the repair of X-ray-induced DNA double-strand breaks in Escherichia coli. AB - Isogenic Escherichia coli strains carrying single DNA-repair mutations were compared for their capacity for (i) the repair of X-ray-induced DNA double-strand breaks (DSB) as measured using neutral sucrose gradients; (ii) medium-dependent resistance, i.e., a recA-dependent X-ray survival phenomenon that correlates closely with the capacity for repairing DSB; and (iii) the growth medium dependent, recA-dependent repair of X-ray-induced DNA single-strand breaks (SSB) as measured using alkaline sucrose gradients (about 80% of these SSB are actually parts of DSB). These three capacities were measured to quantitate more accurately the involvement of the various genes in the repair of DSB over a wide dose range. The mutations tested were grouped into five classes according to their effect on the repair of X-ray-induced DSB: (I) the recA, recB, recC, and lexA mutants were completely deficient; (II) the radB and recN mutants were about 90% deficient; (III) the recF and recJ mutants were about 70% deficient; (IV) the radA and uvrD mutants were about 30% deficient; and (V) the umuC mutant resembled the wild-type strains in its capacity for the repair of DSB. PMID- 3526391 TI - [Natural background radiation: problem of radionuclide migration and biological effects]. AB - Natural radiation background is the main contributor to radiation dose delivered to plants, animals, and man. That is why its effects are of increasing interest in radiobiology, radioecology, and radiation hygiene. The following problems are discussed: migration of main natural radionuclides in biosphere, dose formation, biological role of natural radiation background on the Earth, standards for natural radiation background, and problems of natural radiation background and biosphere evolution. The tasks of further radiobiological research in evaluating the role of natural radiation background are outlined. PMID- 3526392 TI - [Bone marrow autotransplantation as a factor modifying the process of hematopoietic tissue recovery in irradiated guinea pigs]. AB - Guinea pigs were subjected to myeloexfusion 30-90 min before gamma-irradiation with a superlethal dose of 8 Gy. Immediately after irradiation, the bone marrow (4 X 10(7) cells) was autotransplanted. The automyelotransplantation provided a pronounced stimulation of haemopoiesis and substantially shortened the time of its regeneration. The myeloexfusion in some of the exposed control animals had a beneficial effect in their resistance and blood system recovery. PMID- 3526393 TI - [Oxygen effect in the radioresistant Escherichia coli Gamr444 strain]. AB - In experiments on E. coli Gamr 444 the oxygen effect has been studied. Cells were exposed to gamma-rays with constant bubbling of oxygen or nitrogen through the suspension or without bubbling. In the latter case the dose-effect curve was distorted due to radiochemical absorption of oxygen. The dose curve parameters were determined in the anoxic and oxygenating conditions, they are: lin n(N2) = 3.6; D0(N2) = 371 Gy; In n(O2) = 3.6; D0(O2) = 112 Gy. The oxygen effect for E. coli Gamr 444 was 3.3 as determined by D0. In studying the radiosensitivity and its modification in radioresistant strains one should eliminate the influence of radiochemical absorption of oxygen by aeration of the medium during exposure. PMID- 3526394 TI - [Modification of the damaging effect of alpha-particles on Escherichia coli K-12 by low-intensity laser irradiation]. AB - A study was made of the combined effect of laser (helium-neon laser, lambda = 633 nm) and alpha-radiation on survival of Escherichia coli K-12 cells of different genotypes. Pre- and post-irradiation exposures to laser-radiation diminished the damaging effect of alpha-particles. In the latter case, modification of survival was more pronounced. PMID- 3526395 TI - [Effect of insulin and glucagon on superoxide dismutase degradation in the liver of irradiated rats]. AB - A study was made of the effect of insulin and glucagon on the time of functioning and degradation of superoxidedismutase in the liver of rats irradiated with a dose of 8 Gy. The hormones were shown to enhance the effect of radiation. PMID- 3526396 TI - [Objective criteria for determining the degree of radiation injury of nerve cells in a cerebral syndrome]. AB - The automatized morphometric technique was used to estimate the degree of injury to spinal nervous cells of rats exposed to 360 Gy radiation. It was shown that the compression coefficient and the volume of neuron nuclei considerably diminished as the CNS-syndrome developed, and the geometrical dimensions of the nervous cells themselves underwent phase changes. PMID- 3526397 TI - Myocardial perfusion studies: lessons from a decade of clinical use. PMID- 3526398 TI - Simulated pulmonary nodules: detection with dual-energy digital versus conventional radiography. AB - Performance of a prototype dual-energy digital chest radiography unit in detecting calcified and noncalcified simulated pulmonary nodules was compared with that of a highly optimized, conventional system. Nodules ranging in size (0.5, 1.0, and 1.6 cm), in number (five to 11), and in calcium content (0-25 mg) were superimposed over the lungs of a frozen, unembalmed, human chest phantom. For each technique, six observers examined 50 posteroanterior projections with different randomized nodule locations. Detection consisted of locating and assigning a level of confidence to each perceived nodular opacity. The resulting plots of the true-positive fraction versus the mean number of false-positive calls per projection indicate that for both calcified and noncalcified nodules, the digital unit performed significantly better (P less than .01). PMID- 3526399 TI - Calcification in pulmonary nodules: detection with dual-energy digital radiography. AB - The authors undertook a clinical study to determine the accuracy of dual-energy digital radiography in revealing nodule calcification because calcification in a pulmonary nodule almost excludes the possibility of malignancy. Over a 6-month period, 61 patients with pulmonary nodules (less than or equal to 3 cm) or masses (greater than 3 cm) were examined on a prototype scanned projection unit using a dual-energy detector. In 49 of 61 patients, nodules were noncalcified, and in 12, they were calcified. In 57 patients, the benignancy or malignancy of nodules was established beyond reasonable doubt by pathologic confirmation in 38 and by strong inference in 19 (four patients with noncalcified solitary pulmonary nodules either refused further investigation or surgery or their follow-up was too short to permit exclusion of malignancy). Dual-energy radiography was found to be highly accurate in assessing the presence or absence of calcification in pulmonary nodules and thus in determining their benignancy or possible malignancy. PMID- 3526400 TI - Gaucher disease: sonographic appearance of the spleen. AB - Ultrasonographic (US) examinations of the upper abdomen were performed in 80 patients with Gaucher disease. Of the 49 patients that had not undergone splenectomy, 47 had splenic enlargement. Sixteen patients had multiple lesions in the spleen. Most patients had discrete hypoechoic lesions that corresponded pathologically to focal homogeneous clusters of Gaucher cells. Several patients had similar lesions that were hyperechoic and were composed of Gaucher cells and fibrosis or infarction. A few patients had a geographic pattern of irregular areas of involvement of Gaucher cells among normal splenic parenchyma. The liver was often enlarged but otherwise sonographically unremarkable. Patients with Gaucher disease often have US examinations of the left upper quadrant for abdominal pain. A variety of US findings in the spleen typical for Gaucher disease should be recognized and not interpreted as acute changes. PMID- 3526401 TI - Neonatal uterine morphology as seen on real-time US. AB - The uterus in the neonate is prominent and readily identified on ultrasonography (US). The neonatal uterus is larger than the prepubertal uterus as a result of residual stimulation from maternal hormones. The uterus was visualized in 31 of 35 (89%) infant girls examined with real-time US. Mean uterine length was 3.4 cm. The majority of the uteri were tubular or spade-shaped, with the anteroposterior diameter of the cervix equal to or greater than the anteroposterior diameter of the fundus. The endometrial cavity was visualized in 30 (97%), a myometrial halo in nine (29%), and a small amount of endometrial fluid in seven (23%) of the uteri. PMID- 3526402 TI - Urinary tract dilatation in utero: classification and clinical applications. AB - A morphologic classification of in utero urinary tract dilatation is presented. Ninety-two hydronephrotic fetal kidneys diagnosed with ultrasound were graded according to the proposed classification. The findings suggest that grade I dilatation (anteroposterior diameter of the renal pelvis less than 10 mm) should be considered normal. Grades II and III constitute an intermediate hydronephrosis, requiring postnatal urologic surgery in nearly half the cases. Grade IV (moderate dilatation of the calyces, with easily identified residual renal cortex) and grade V (severe dilatation of the calyces with atrophic cortex) are clearly pathologic and require neonatal corrective surgery. It is hoped that use of this simple and practical classification will facilitate communication and comparison of results in the literature. PMID- 3526403 TI - Ureteropelvic junction stenosis: antenatal ultrasonographic diagnosis, postnatal investigation, and follow-up. AB - Between January 1981 and October 1984, the diagnosis of ureteropelvic junction (UPJ) stenosis was suspected in 39 fetuses after routine obstetrical ultrasound (US) examination. Postnatal investigation revealed that the initial diagnosis had been accurate in 30 cases (77%). There were 35 UPJ stenoses in 30 patients. The degree of dilatation of the renal pelvis (grades III, IV, or V) observed postnatally with sonography as well as the obstructive excretory pattern noted by renal isotope scanning were used as criteria to determine the need for early postnatal pyeloplasty (performed in 25 patients), which relieved the obstruction and, in the majority of patients, improved renal structure and function. PMID- 3526404 TI - Nondilated obstructive uropathy: percutaneous nephrostomy performed to reverse renal failure. AB - Ureteral obstruction can lead to renal failure without involving detectable dilatation of the calyces, renal pelvis, or ureter proximal to the obstruction. This phenomenon was noted in seven patients who had clinical obstruction that we were not able to diagnose using computed tomography (CT) or ultrasonography (US). These patients underwent percutaneous nephrostomy (PCN), which resulted in brisk diuresis and improved renal function. We obtained an accompanying antegrade urogram in these cases, which demonstrated the level of obstruction and indicated that dilatation of the collecting system was minimal or not present. When obstructive uropathy is suspected, we believe it is essential to consider performing PCN to evaluate and potentially reverse renal failure, even when CT and US scanning do not demonstrate obstruction. PMID- 3526405 TI - Nondilated obstructive acute renal failure: diagnostic procedures and therapeutic management. AB - We examined 80 patients with acute obstructive anuria by ultrasound (US). Four of the 80 patients did not have dilatation of the urinary tract. In all four cases, antegrade pyelography guided by real-time US demonstrated urinary tract obstruction after the four patients had experienced 4, 5, 8, and 34 days of anuria, respectively. Diuresis occurred as a result of percutaneous nephrostomy in all four cases. Three of the patients were successfully treated by percutaneous techniques alone. Our findings demonstrate that even a complete and long-term obstruction of the urinary tract does not necessarily induce dilatation in the upper part of the tract. In such cases, only the direct opacification of the urinary tract can help confirm that the obstruction is present. Even in the absence of dilatation, antegrade pyelography guided by real-time US is a possible diagnostic method and can be the first step in the performance of percutaneous nephrostomy. PMID- 3526406 TI - Renal artery stenosis: evaluation with intravenous digital subtraction angiography. AB - The ability of diagnostic intravenous digital subtraction angiography (IVDSA) to demonstrate the degree of renal artery stenosis was compared with that of intraarterial angiography in 45 patients with 92 arteries. Stenotic lesions on both IVDSA and intraarterial studies were classified as normal (0% stenosis), minor (less than 50%), low grade (50%-80%), and high grade (80%-99%). There was agreement about the degree of stenosis in 90% of the cases. IVDSA grading was correct in 94% of atheromatous lesions and in 56% of the fibromuscular dysplastic lesions. In the high-grade atheromatous lesions, the degree of stenosis was slightly overestimated on IVDSA studies in 22.5% of the cases. In fibromuscular dysplasia, stenosis was underestimated in 33% of the cases. PMID- 3526407 TI - Time-of-flight MR flow imaging: selective saturation recovery with gradient refocusing. AB - A novel magnetic resonance flow-imaging technique is presented and its suitability evaluated for both qualitative and quantitative imaging of flow. The method is derived from a selective saturation-recovery scheme consisting of a tagging and detection pulse followed by a bipolar read gradient. The detrimental phase effects causing signal loss at fast flow are shown to be greatly reduced because of the absence of a 180 degrees pulse and its associated section selection gradient. The second loss mechanism intrinsic to 180 degrees spin echoes, the washout of excited spins between excitation and detection pulse, likewise is not present with the discussed technique. Assuming a parabolic flow profile, the authors calculated the signal evolution curve and found it to be in agreement with the experimental washout curve. The technique is shown to provide high-intensity signals for arteries such as carotid and vertebral arteries. Arteries and veins can be differentiated by judiciously choosing interpulse intervals or by alternating selective and nonselective tagging pulses. PMID- 3526408 TI - Superior vena cava obstruction: evaluation with digital subtraction angiography. AB - Superior vena cava (SVC) obstruction is an uncommon but dramatic clinical presentation that often requires immediate treatment. We present a technique for evaluation of SVC syndrome using small-gauge butterfly needles and intravenous digital subtraction angiography, and we report our results in ten patients. We find this technique superior to conventional venography since it is rapid, easy, safe, and more cost-effective to perform. PMID- 3526409 TI - Plastic wrap for US transducer sterility or sanitization. AB - Commercially available plastic wrap can be used to encase an ultrasound transducer for sanitization purposes. If sterility is required, an individual piece of plastic wrap can be gas sterilized before the transducer is covered with it. This technique does not degrade or temporally limit the use of the transducer, it is easy to perform, and the materials are readily available. PMID- 3526410 TI - Ultrasound examination of the hand. PMID- 3526411 TI - Supraspinal contributions to the initiation and control of locomotion in the cat. PMID- 3526412 TI - Kindling mechanisms: current progress on an experimental epilepsy model. PMID- 3526413 TI - Neurobiology of an anorectic drug: fenfluramine. PMID- 3526414 TI - [Tooth molding using an additive technic]. PMID- 3526415 TI - [Current status and prospects of the laboratory diagnosis of arterial hypertension]. PMID- 3526417 TI - Using the twin-stage occluder with a functionally generated pathway record. PMID- 3526416 TI - [Effect of noise on the hematopoietic and immune systems. II. Erythrocytes, neutrophils, lymphocytes, immunoglobulins, biochemical changes in the blood and the hemostatic system]. PMID- 3526418 TI - Set up of removable partial denture anterior teeth prior to frame fabrication. PMID- 3526419 TI - Tooth morphology: practical considerations to aid correct occlusal anatomy and axial wall profile. PMID- 3526420 TI - Clasp repair using a light-cured acrylic resin. PMID- 3526421 TI - Buprenorphine versus domperidone in chemotherapy-induced emesis: a pilot study. AB - A randomized double-blind cross-over study was performed to evaluate the possible anti-emetic effect of the partial opiate antagonist buprenorphine in comparison to domperidone in chemotherapy-induced nausea and vomiting. Emesis was of significantly shorter duration on domperidone treatment. Most patients preferred domperidone, mainly due to adverse side-effects of buprenorphine. Nevertheless, emesis in buprenorphine treatment was less disabling. Therefore, it might be useful to search for new alternatives in this group of drugs or to use them in a combination regimen of anti-emetic agents. PMID- 3526422 TI - Tumour invasion and metastasis: therapeutic implications? AB - Invasion and metastasis is the hallmark of tumour malignancy. Some aspects of invasion and metastasis with potential implications for tumour therapy are reviewed: the value of laboratory models; the acquisition of invasiveness and metastatic capability during carcinogenesis; the relationship between growth and invasion; clinical and experimental anti-invasive and antimetastatic agents. The value of joint experimental and clinical research is underscored. PMID- 3526423 TI - Regional outcome in oropharyngeal and pharyngolaryngeal cancer treated with high dose per fraction radiotherapy. Analysis of neck disease response in 1646 cases. AB - Out of a series of 1666 consecutive patients with squamous cell carcinoma of oropharynx and pharyngolarynx, 1646 were evaluable at a 3-year interval following radical radiation therapy. The actuarial 3-year nodal control rate using the AJC classification was: N0 98%, N1 90%, N2 88%, N3 71% when the primary was controlled. The regional outcome is influenced by clinical features such as nodal size, multiplicity and fixity. Cervical recurrence frequency is higher for pharyngolaryngeal carcinoma than for oropharyngeal cancer. The impact of the treatment planning on regional control is discussed. Due to the of concomitant boosting of nodes, cervical metastases were treated according to a type of accelerated fractionation schedule with weekly doses of 12-15 Gy for a total of 70-85 Gy in 75% of the cases. Clear-cut dose control relationships are demonstrated for nodes larger than 3 cm in diameter. Overboosting residual cervical disease fails to yield a better nodal control. Comparative analysis is established between results obtained with this high dose per fraction radiotherapy schedule, conventional regimens of irradiation and other new approaches, combining chemical and physical agents. Therapeutic implications are also derived to define adequate field coverage. PMID- 3526425 TI - [The Hickman catheter in patients subjected to a bone marrow transplant or intensive chemotherapy. Analysis of 45 cases]. PMID- 3526424 TI - [Echographic diagnosis of gas in the excretory ducts of a transplanted kidney]. PMID- 3526426 TI - [An integrated overview of the pathology of the hematopoietic pluripotential germ cell]. PMID- 3526427 TI - [Sclerosis of varices: a therapeutic option in portal hypertension]. PMID- 3526428 TI - [The harmful biopsies of Kaiser Frederick III]. PMID- 3526429 TI - [Empyema caused by Aspergillus. Apropos of 3 cases]. PMID- 3526430 TI - [Renal insufficiency induced by captopril in a patient with bilateral renal artery stenosis]. PMID- 3526431 TI - [Insulin-receptor interaction in Cushing's syndrome]. PMID- 3526432 TI - [Comparative study between the subcutaneous continuous insulin infusion pump and optimized conventional treatment. Effects at 6 months]. PMID- 3526433 TI - [Value of ultrasonography in the diagnosis of infanto-juvenile renal polycystosis]. PMID- 3526434 TI - [Diffuse large-cell non-Hodgkin's lymphoma. Historical development of polychemotherapy protocols]. PMID- 3526435 TI - [Endocrinology of osteoporosis]. PMID- 3526436 TI - [Anesthesia in liver transplants]. PMID- 3526437 TI - [Current treatment of the pulmonary aspiration of gastric contents]. PMID- 3526438 TI - [Adverse reactions of the allergic type in anesthesia]. PMID- 3526439 TI - [Anesthesia in liver transplantation (II)]. PMID- 3526440 TI - [Malignant hyperthermia during heterotopic orthotopic liver transplantation]. PMID- 3526441 TI - [Orthotopic cardiac transplant in a patient with terminal ischemic cardiopathy. Presentation of a case]. PMID- 3526442 TI - [Surgical technics in an experimental transplant of the liver. II. Orthotopic transplant]. PMID- 3526443 TI - [Meckel's diverticulum and its complications. A review of the Spanish literature apropos of 35 cases]. PMID- 3526445 TI - [Single stenosis of an extrahepatic bile duct. Value of endoscopic retrograde cholangiopancreatography and other imaging technics]. PMID- 3526444 TI - [Panendoscopy and renal transplant. Endoscopic and histologic findings]. PMID- 3526446 TI - [Technics of vascular microsurgery in pancreas autotransplantation in the dog]. PMID- 3526447 TI - [Dissolution of biliary calculi with ursodeoxycholic acid: spectrographic study of undissolved calculi]. PMID- 3526448 TI - [An unusual case: the "traveling root"]. PMID- 3526449 TI - [French Language Society of Pneumology. List of members (1986)]. PMID- 3526450 TI - Insulin regulates expression of the phosphoenolpyruvate carboxykinase gene. PMID- 3526452 TI - Evolution of a model of estrogen action. PMID- 3526451 TI - Molecular characterization of fibroblast growth factor: distribution and biological activities in various tissues. PMID- 3526453 TI - Determinants of puberty in a seasonal breeder. PMID- 3526454 TI - Pubertal growth: physiology and pathophysiology. PMID- 3526455 TI - Seasonal breeding in a marsupial: opportunities of a new species for an old problem. PMID- 3526456 TI - Structure and expression of the human parathyroid hormone gene. PMID- 3526457 TI - Regulation of gene expression by androgens in murine kidney. PMID- 3526458 TI - [Secretion and hepatic extraction of insulin in obesity with normal glucose tolerance]. PMID- 3526459 TI - [Organ-specific autoantibodies in type I diabetic patients and their relatives]. PMID- 3526460 TI - [New prospects for insulin therapy in type 1 diabetes]. PMID- 3526461 TI - [Does the current knowledge on the pathogenesis of type 1 diabetes justify immunotherapeutic intervention?]. PMID- 3526462 TI - [Optimized conventional insulin therapy]. PMID- 3526463 TI - [Glycosylated hemoglobin and diabetes mellitus]. PMID- 3526464 TI - [Insulin receptors: their nature and regulation]. PMID- 3526465 TI - Application and results of different chemotherapy regimens in primary liver malignancies. PMID- 3526466 TI - Systemic therapies for patients with liver tumors: prospects for the future. PMID- 3526467 TI - Typical and atypical resection techniques of hepatic metastases. PMID- 3526468 TI - Hepatic arterial ligation and portal vein infusion: a clinical trial by the Gastrointestinal Tract Cancer Group of the European Organization for Research and Treatment of Cancer. PMID- 3526469 TI - Therapeutic strategies in primary and metastatic liver cancer: indication and results of external radiation therapy. PMID- 3526471 TI - Significance and limitations for diagnostics and follow-up. PMID- 3526470 TI - Monoclonal antibody infusion in gastrointestinal cancer patients. PMID- 3526472 TI - Perioperative and conventionally timed chemotherapy in operable breast cancer: the Ludwig Breast Cancer Study V. PMID- 3526473 TI - Neoadjuvant chemotherapy in the conservative management of breast cancers: study of 143 patients. PMID- 3526474 TI - Impact of primary site of stage III and IV squamous cell carcinomas of the head and neck on 7-year survival figures following initial non-cisplatin-containing combination chemotherapy. PMID- 3526475 TI - Implications of certain cell kinetic and biological parameters for preoperative chemotherapy. PMID- 3526476 TI - Adjuvant therapy for breast cancer: a brief overview of the NSABP experience and some thoughts on neoadjuvant chemotherapy. PMID- 3526477 TI - Preoperative (neoadjuvant) chemotherapy for breast cancer: outline of the British Columbia Trial. PMID- 3526478 TI - Perioperative adjuvant chemotherapy of breast cancer: the Scandinavian experience. PMID- 3526479 TI - Lack of response of rat chondrosarcoma chondrocytes to interleukin-1 to produce proteoglycan- and collagen-degrading enzymes. AB - Chondrocytes obtained from rat articular cartilage and Swarm rat chondrosarcoma were maintained in culture. Human interleukin-1 (IL-1) was added at confluency, and three days later the spent media was evaluated for proteoglycan- and collagen degrading enzymes. Unlike chondrocytes from articular cartilage from several species, chondrocytes from Swarm rat chondrosarcoma did not respond to IL-1 stimulation. This lack of sensitivity to IL-1 may be a useful biochemical marker to classify various types of chondrosarcomas. However, it appears that the use of chondrosarcoma chondrocyte cultures are not useful as a source for metalloproteinases. PMID- 3526480 TI - Effects of glucose, insulin and epinephrine on lactate metabolism by isolated adipocytes. AB - Epididymal fat cells were incubated in vitro with either 2 mM or 6 mM [U 14C]lactate, and where appropriate, 6 mM glucose, 10 mU/ml insulin or 2 micrograms/ml epinephrine. Increasing lactate concentration promoted lactate carbon incorporation into specific products, and the presence of glucose significantly enhanced this effect. Significant lipogenic or lipolytic hormonal effects upon lactate metabolism were observed only in the presence of glucose, as insulin primarily increased lactate conversion to fatty acids while epinephrine promoted lactate oxidation. These data emphasize the importance of lactate as an alternative substrate for intermediary metabolism in adipocytes, and indicate that hormonal modulation of lactate metabolism is modest, but distinct, and requires the presence of physiological glucose concentrations. PMID- 3526481 TI - The initial blood retention properties of arterial prostheses. AB - The initial contact between blood and vascular grafts may be a determinant of the fate of the implants. They behave in different ways depending upon their nature: the processed human umbilical vein and the bovine heterograft just lead to minimal thrombotic retention; the expanded PTFE is even more antithrombogenic; the porous polyesters which are porous textiles, should be totally impregnated with a thrombotic matrix to make the wall impervious. These observations were clearly determined by exposing the grafts to blood, incorporating either labeled platelets or labeled fibrinogen, and they were correlated by SEM examination. PMID- 3526482 TI - Glucagon-like polypeptide and insulin contents in the brain from acute hepatic failure dogs. AB - Insulin contents in the thalamus-hypothalamus were significantly increased in acute hepatic failure dogs treated with dimethylnitrosamine. Glucagon immunoreactivity (GI) contents also tended to increase in the same portion of the brain. However, insulin and GI contents in the cerebral cortex and midbrain did not rise. Glucagon-like immunoreactivity (GLI) contents were much higher than GI in all the brain regions tested, but the levels were not significantly altered in hepatic failure dogs. A simultaneous infusion of insulin and glucagon to hepatic failure dogs failed to produce an elevation of insulin, GI and GLI contents even in the thalamus-hypothalamus. PMID- 3526483 TI - The role of the spleen and splenic autotransplants in clearing experimental bacteremia caused by the gram-negative bacterium Escherichia coli. AB - Several clinical and laboratory studies have demonstrated the risk of sepsis in connection with encapsulated bacteria. The importance of clearing these organisms by the spleen is now well accepted. In contrast, the present work deals with the clearance of non-encapsulated gram-negative bacteria (Escherichia coli). The animals used for the experiments (a heterogeneous population of rabbits) were divided into a control group, a splenectomized group, and an autotransplanted group. The histological examination of the splenic transplants revealed typical splenic tissue including lymphatic follicles with germinal activity 42 days after transplantation. For estimation of the clearance capacity different amounts of bacteria were injected i.v. into the rabbits, and colony-forming bacterial cells in the blood were counted at certain intervals. In the control group no bacteria could be detected in the blood after 7 min. All animals of the splenectomized and autotransplanted groups showed a remarkable decrease in clearance efficiency (no bacteria in the blood after 19 min). No difference in the clearance kinetics could be shown between splenectomized and autotransplanted animals. Measuring the uptake of bacterial cells into different organs elicited low incorporation in the spleen as compared to non-immunocompetent organs, but no difference between normal spleen and splenic replants. However, saturation with E. coli cells reached higher limits in the normal spleen than in autotransplants. The immunologic capacity with respect to IgM-producing lymphocytes was measured by the hemolytic plaque assay. The results showed a severe malfunction of the autotransplants as compared to the normal spleen (only 2% of the activity of the control group). Vaccination against E. coli increased the clearance efficiency in all three groups. The data presented in this paper point out that several functions of the spleen cannot be carried out by autotransplants. The reasons, therefore, may be limited transplant mass and/or decreased specific functions. PMID- 3526485 TI - Effect of fasting and dexamethasone on binding characteristics of canine erythrocyte insulin receptors. AB - Insulin binding characteristics of canine erythrocyte insulin receptors were studied before and after a 72-hour fast, and one and three days following glucocorticoid (dexamethasone) administration. The 72-hour fast tended to increase maximum insulin binding, but no significant differences were found. The administration of dexamethasone resulted in an increased maximum binding of insulin to its receptors which, at day 1, was due to an increase in receptor concentration, and at day 3, to an increased insulin binding affinity of the receptor. These data suggest that the erythrocyte insulin receptor may be useful in clinical and experimental studies in the dog. PMID- 3526484 TI - Plasma hormone concentrations in newborn Scottish blackface lambs during basal and summit metabolism. AB - The plasma concentrations of adrenaline, noradrenaline, dopamine, thyroxine, tri iodothyronine, cortisol, insulin and glucose were estimated in lambs aged one to five hours during basal metabolism and then during summit metabolism (the maximum thermogenic response to cold stress). The increase in metabolic rate from basal metabolism to summit metabolism was associated with marked increases in the plasma levels of adrenaline, noradrenaline, cortisol and glucose and a decrease in the plasma level of insulin. There were no quantitative relationships between summit metabolic rate and the plasma levels of any of the hormones measured. These findings suggest that the marked lamb-to-lamb variation in heat production capacity found here and elsewhere cannot be directly attributed to variation in the activities of the sympathetic nervous system, the thyroid, the adrenal cortex or the pancreas. Concurrent estimations of respiratory quotient suggested that the newborn lamb has a marked dependence on carbohydrate as an energy substrate at high rates of heat production. PMID- 3526486 TI - A micromethod for measuring swine fever antibody by neutralisation and immunofluorescence. AB - A micromethod employing the neutralisation and direct immunofluorescence technique for the detection of antibodies against swine fever in pig serum samples is described. The micromethod is simple and reproducible when compared with the macromethod. A total of 80 blood samples were randomly collected for comparison. The results are promising and reveal a 100 per cent correlation with the macrotechnique. PMID- 3526487 TI - [Fundamental aspects on MRI]. PMID- 3526488 TI - [MRI diagnosis of myocardial infarction--comparison with Xray CT]. PMID- 3526489 TI - [MRI of aortic aneurysms--comparison with CT]. PMID- 3526490 TI - [Blood flow images by MRI]. PMID- 3526491 TI - [Maimonides: the philosopher as physician]. PMID- 3526492 TI - [Abdominal packing as management of massive postoperative bleeding. Report of a case]. PMID- 3526493 TI - [Congenital adrenal hyperplasia as a cause of female pseudo- hermaphroditism]. PMID- 3526494 TI - [Adhesion factors in enterotoxigenic Escherichia coli]. PMID- 3526495 TI - [Effect of the polysaccharide from Klebsiella pneumoniae K8 on the LD50 of Salmonella typhi]. PMID- 3526496 TI - [Pit and fissure sealants. The effect of etching depends on the differences in tooth surface cleaning methods, and the method of cleaning pits and fissures]. PMID- 3526497 TI - [A case of thrombasthenia in a child with gingival bleeding]. PMID- 3526498 TI - [Clinical planning and design of removable bridges (1). The splinting effect of abutments]. PMID- 3526499 TI - A proposal for interpreting and reporting negative studies. AB - An issue of continuing interest is the interpretation and reporting of 'negative' studies, namely studies that do not find statistically significant differences. The most common approach is the design-power method which determines, irrespective of the observed difference, what differences the study could have been expected to detect. We propose an alternative approach, the application of equivalence testing methods, where we define equivalence to mean that the actual difference lies within some specified limits. This approach, in contrast to the design-power approach, provides a way of quantifying (with p-values) what was actually determined from the study instead of saying what the study may or may not have accomplished with some degree of certainty (power). For example, a possible outcome of the equivalence testing approach is the conclusion at the 5 per cent level that two means (or proportions) do not differ by more than some specified amount. The equivalence testing approach applies to any study design. We illustrate the method with a cancer clinical trial and an epidemiologic case control study. In addition, for those studies in which one cannot specify limits a priori, we propose the use of equivalence curves to summarize and present the study results. PMID- 3526501 TI - [Surgical treatment of pressure sores of the heel]. PMID- 3526500 TI - The use of an extended baseline period in the evaluation of treatment in a longitudinal Duchenne muscular dystrophy trial. AB - A trial of Duchenne muscular dystrophy involved tracking boys of all ages through a one-year baseline period, followed by a one-year trial of leucine versus placebo treatment. In this paper we develop a model for a total-muscle-strength score that uses the data of the extended baseline period in the evaluation of the leucine treatment. The model is based on a polynomial growth curve in age whose coefficients can vary according to treatment or phase. Maximum likelihood estimates of the parameters of the model are obtained from use of the EM algorithm. We propose tests for the adequacy of the model as well as for treatment effects. A quadratic model appears the most parsimonious fit to the data and there is no evidence of any leucine effect on scores. We examine the asymptotic power of the test for treatment effect and compare it with that of a simpler analysis. PMID- 3526502 TI - [Treatment of endometriosis by agonist analogs of gonadoliberin (LHRH)]. PMID- 3526503 TI - [Use of analogs of LHRH in the treatment of precocious puberty]. PMID- 3526504 TI - [Therapeutic update]. PMID- 3526505 TI - [Bronchodilators and ciliary clearance]. PMID- 3526509 TI - [Lyophilized skin grafts. A clinical evaluation]. PMID- 3526506 TI - Optimal use of fluids of varying formulations to minimise exercise-induced disturbances in homeostasis. AB - The rationale underlying the development of various formulations of beverages for consumption before, during, and/or after physical exercise is that such formulations should minimise some of the disturbances in physiological homeostasis that occur during exercise and thereby prevent injury and/or enhance performance. Exercise- and dehydration-induced increases in core temperature, body fluid osmolality, heart rate, losses of plasma and other body fluid volumes, and carbohydrate depletion are probably the most important homeostatic disturbances that can be ameliorated by fluid consumption. With the exception of athletes subject to hyponatraemia after consumption of ordinary water during prolonged activity, changes in electrolyte concentrations in the body fluids of most athletes do not justify the inclusion of electrolytes in fluid replacement beverages to be consumed during exercise. However, small amounts of sodium added to water does speed gastric emptying and fluid absorption from the intestine. Recent evidence suggests that a precompetition meal high in easily digested carbohydrates should be consumed not later than 5 to 6 hours before competition. There is little published research on the optimal composition of this meal. Water ingestion 30 to 60 minutes before exercise seems to be of benefit to temperature regulation and cardiovascular homeostasis if the exercise is of moderate intensity (50 to 65% VO2max), but probably has little effect at the higher intensities of athletic performance. There is no systematic evidence to support the inclusion of calcium or sodium chloride in drinks consumed an hour or 2 before exercise. Furthermore, if glucose solutions are fed 15 to 45 minutes before prolonged exercise, they will probably cause a fall in blood glucose during exercise and may adversely affect performance. These adverse effects are not present when fructose is consumed before exercise. Contrary to the adverse effects of glucose feedings 15 to 60 minutes before exercise, the consumption of 18 to 50% solutions of glucose or glucose polymers 5 minutes before prolonged exercise seems to have potential for improving endurance performance. Similarly, the inclusion of caffeine in beverages consumed 60 minutes before prolonged exercise improves athletic performance for many subjects. Others may be hypersensitive to the effects of caffeine and are adversely affected by its use. For exercise leading to exhaustion in less than 30 minutes, neither caffeine nor carbohydrate ingestion is effective in minimising homeostatic perturbations or improving exercise performance.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3526510 TI - [Dysmenorrhea in the female adolescent. Clinical, biological and therapeutic data]. AB - The physiology and pathology of dysmenorrhea in adolescent girls has become clear in the past 5 years. Although the prime cause of the disorder has not been identified, the obvious rise in PGF2 alpha prostaglandins is an objective biologic sign. As a result, more specific treatment has become possible with more definite and established care of this "condition" which is often distressing to the teenage girl affected. PMID- 3526511 TI - [Spaniomenorrhea and hypermenorrhea in the female adolescent. Aspects and management]. AB - Ninety percent of cases of metrorrhagia during puberty are of functional origin and related to short, monophasic cycles. Emergency care may sometimes necessitate rapid administration of estrogens. Treatment of the underlying condition involves the administration of progestogens 10 days per cycle or, less frequently, artificial cycles. Spaniomenorrhea during puberty may, less commonly, be due to ovarian dystrophy. Functional forms should be treated only if they are accompanied by mastopathy. PMID- 3526507 TI - Diabetes, insulin and exercise. AB - The metabolic and hormonal adaptations to single exercise sessions and to exercise training in normal man and in patients with insulin-dependent as well as non-insulin-dependent diabetes mellitus are reviewed. In insulin-dependent (type I) diabetes good metabolic control is best obtained by a regular pattern of life which will lead to a fairly constant demand for insulin from day to day. Exercise is by nature a perturbation that makes treatment of diabetes difficult: Muscle contractions per se tend to decrease the plasma glucose concentration whereas the exercise-induced response of the so-called counter-regulatory hormones tend to increase plasma glucose by increasing hepatic glucose production and adipose tissue lipolysis. If the pre-exercise plasma insulin level is high, hypoglycaemia may develop during exercise whereas hyperglycaemia and ketosis may develop if pre exercise plasma insulin levels are low. Physical activity is often difficult to carry out on a precise schedule and the exercise-induced changes in demand for insulin and calories vary according to the intensity and duration of exercise, time of day, and differ within and between individuals. Thus, physical training can not be recommended as a means of improving metabolic control in insulin dependent diabetes. However, our present knowledge and technology allows the well informed and cooperative patient to exercise and even to reach the elite level. To achieve this, pre-exercise metabolic control should be optimal and knowledge of the patient's reaction to exercise is desirable, which necessitates frequent self-monitoring of plasma glucose. It may often be necessary to diminish the insulin dose before exercise, and/or to ingest additional carbohydrate during or after exercise. In non-insulin-dependent (type II) diabetes, exercise is associated with less risk of metabolic derangement, and in genetically disposed individuals physical training may prevent development of overt diabetes possibly by diminishing the strain on the pancreatic beta cell. The latter, however, is only achieved if exercise is not accompanied by increased caloric intake. Whether physical training in diabetes can reduce cardiovascular morbidity and mortality is at present unknown, but training has in diabetic patients been shown to lessen some risk factors for development of arteriosclerosis. However, training of diabetics (especially in the less well-regulated patient) may not lessen coronary risk factors to the same extent as in healthy subjects. PMID- 3526508 TI - Viral illnesses and sports performance. AB - Viruses are ubiquitous and cause numerous infections in humans. These may vary from asymptomatic infection to severe debilitating illness. Viruses enter the host cells to replicate, using host synthetic mechanisms, and, thus, are resistant to conventional antibiotics. The human body responds to viral infection by synthesising specific antibody which can be used to aid diagnosis. Infectious mononucleosis (glandular fever) commonly affects the 15 to 30 years age group. It may produce severe debility which may last a month or more. Coxsackie virus infection can produce symptoms of the common cold but may also invade heart muscle and produce myocarditis, a potentially serious disease. Other viruses also produce a wide spectrum of disease. Recent evidence has shown that people undergoing severe mental or physical stress may have reduced immunity to viral infections. There are risks associated with strenuous physical activity during the acute phase of viral infection, and there are reports of sudden death and serious complications occurring in previously fit young adults who undertake vigorous exercise when in the acute phase of a viral illness. Abnormalities of skeletal muscle have been demonstrated in patients with viral infection and this may explain the loss of performance experienced by athletes after upper respiratory tract infection. As a general rule, for all but mild common colds, it is advised that the athlete avoids hard training for the first month after infection. PMID- 3526512 TI - [Utero-ovarian echography during normal development and in sexual precocity]. AB - Utero-ovarian ultrasonography provides biometric data concerning internal female sexual organs. The length of the uterus provides the best indication of estrogen impregnation. This low-cost, non-invasive examination is suitable for an initial investigation of whether the uterus is stimulated at the normal age or prematurely. The method can be used to monitor the advance of puberty as well as the effects of therapy, surgery, slowing by LH-RH analogs, puncture under ultrasound of a secreting follicular cyst. Follicular cysts of this type are now found to be very common, thanks to the possibilities offered by ultrasonography. PMID- 3526514 TI - [Identification of a selective immobilization process and its use in isolating Vibrionaceae]. PMID- 3526513 TI - [Chemiluminescence of the human neutrophil granulocyte. III. Variation induced by the type of microorganism. Dependence on the bacterial strain]. PMID- 3526515 TI - [Rapid positive bacteriological diagnosis in toxic food poisoning]. PMID- 3526516 TI - [New methods and technics in epidemiological research (molecular epidemiology)]. PMID- 3526517 TI - [Where are we with renal transplantation?]. PMID- 3526518 TI - An understanding definition of esthetics variations as found in nature as opposed to symmetry. PMID- 3526519 TI - Kulzer's Silicoater: a new technique for bonding methacrylates to metal. PMID- 3526520 TI - Accurate duplication of the natural incisal guidance and its significance in fabrication of dental restoration. PMID- 3526521 TI - Dental implants: a proven success. PMID- 3526523 TI - [The baker's wife: a nursing predecessor]. PMID- 3526524 TI - [Searching for the lost image]. PMID- 3526522 TI - Clinical study on beclomethasone dipropionate powder preparation (TL-102) in perennial nasal allergy. AB - The efficacy, safety and optimal dose of TL-102, a powder mixture of beclomethasone dipropionate (BDP) and hydroxypropylcellulose (HCP) were studied in 250 patients with perennial nasal allergy in an intergroup comparative double blind manner. Four different capsules containing respectively 30 micrograms of HCP and 1.5 micrograms, 12.5 micrograms, 25 micrograms and 50 micrograms of BDP, were prepared and the drug was applied intranasally evenly between both nostrils at a dose of 2 cap./day b.i.d. for one week. The degrees of overall improvement, usefulness, improvement of nasal symptoms (sneezing, nasal discharge, nasal blockage) and improvement of rhinoscopical findings (mucosal swelling and nasal secretion) were found to be dose-dependent. Antigen provocation reaction and nasal eosinophil count were both inhibited as compared with the TL 1.5 g group. The incidence of side effects was 4.5%, but all side effects observed were mild. Using TL-102 resulted in a therapeutic effect comparable to the conventional BDP preparations using a dose 1/4th of the normal dose of these BDP preparations. The incidence of side effects was 1/3th in comparison with conventional BDP. It was suitable to administer BDP 50 micrograms capsule containing 30 mg of HCP twice a day. PMID- 3526525 TI - [Comments on the therapeutic approach in myeloma]. PMID- 3526526 TI - The phagocytosis function and the antibody reactivity in the thymectomized and thymectomized-irradiated adult rats. AB - The authors have investigated the influence of the thymus on peritoneal macrophages phagocytosis and antiflagellar agglutinin serum antibodies to "H" Salmonella typhi in the adult rat with diminished immunologic potential. The results show that the immune reactions diminish in intensity in the thymectomized animal. The immune reactions are also diminished in the thymectomized animal exposed to radiation as compared to control irradiated but non-thymectomized. PMID- 3526527 TI - [The leukocyte adherence inhibition test. II. The number of adherent cells in relation to the method of their separation and incubation]. PMID- 3526528 TI - Clinical and scanning electron microscopic study of surface changes of incipient caries lesions after debonding. AB - The surface features of incipient caries lesions around bonded orthodontic brackets were assessed longitudinally. In standardized periods after debonding and clean-up, color slides were made and silicone impressions were taken of two maxillary incisors on each of six adolescent patients. These teeth were characterized by varying degrees of macroscopically visible demineralized white areas around the bonded brackets. The color slides were studied in a dark room. The positive surface replicas were studied in SEM. At the time of debonding heavy accumulations of dental plaque were observed in all areas corresponding to the white, demineralized areas. During the experimental period there was a reduction in these plaque deposits. The appearance of the lesions changed from chalky-white at the time of debonding to a more diffuse opacity, particularly in the peripheral parts of the lesion. Examination of the surface replicas in the SEM revealed a general tendency toward leveling of the surface of the lesion indicating a loss of porous tissue. At higher magnification the lesions showed signs of wear. Four teeth were presented to illustrate typical examples of the time-related changes at the surface. The present study confirmed that removal of cariogenic challenge results in arrest of further demineralization. The gradual regression of the lesion at the clinical level was believed to be primarily a result of surface abrasion with some redeposition of minerals. PMID- 3526529 TI - Production of beta 2-microglobulin by chronic lymphocytic leukaemia cells in vitro. AB - The in vitro production of beta 2-microglobulin (beta 2m) by leukaemic cells was studied in 22 patients with chronic B-lymphocytic leukaemia (CLL). In addition, the concentration of beta 2m in serum (S-beta 2m) was determined and expressed as percent of the upper normal limit, after a correction for elevated S-Creatinine values. Patients with progressive disease usually had CLL cells with a high rate of in vitro synthesis and an increased S-beta 2m. This was not found in patients with non-progressive disease. The in vitro synthesis of beta 2m X the lymphocyte count correlated with S-beta 2m in the total material (r = 0.65). The increased S beta 2m frequently observed in CLL may therefore originate from the tumour cells. Hence, S-beta 2m is promising as a clinically useful tumour cell-associated marker in CLL. PMID- 3526530 TI - Fungal infections in patients with AIDS and AIDS-related complex. PMID- 3526531 TI - Erythema chronicum migrans in Sweden: clinical manifestations and antibodies to Ixodes ricinus spirochete measured by indirect immunofluorescence and enzyme linked immunosorbent assay. AB - 26 Swedish patients with erythema chronicum migrans (ECM) were studied regarding associated clinical symptoms and antibodies to Swedish Ixodes ricinus spirochete. 11/26 (42%) of the patients had associated symptoms, compared to more than 90% of 314 American patients with ECM, as described by Steere et al. Only 2/26 (8%) had multiple skin lesions, compared to 48% of the American patients. Elevated erythrocyte sedimentation rate and circulating immune complexes were demonstrated in 6/25 (24%) and 8/25 patients (32%), respectively, as against in 53% and 84%, respectively, of the American patients. The antibody response to Ixodes ricinus spirochete was measured by indirect immunofluorescence (IFA) and enzyme-linked immunosorbent assay (ELISA). Compared to the 95% percentile of controls, significantly high antibody titers were demonstrated in 3/25 (12%) by IFA, and 7/25 (28%) by ELISA. The ELISA antibody titers differed significantly (p less than 0.05) between ECM-patients and controls. The spirochetal antibody response in ECM was also compared with that in spirochete-associated disease of the central nervous system. PMID- 3526532 TI - A comparative study of amoxycillin and pivampicillin in persistent Haemophilus influenzae infection of the lower respiratory tract in children with chronic lung disease. AB - A double-blind cross-over study was undertaken to compare the efficacy of amoxycillin and pivampicillin on Haemophilus influenzae infection of the lower respiratory tract in children. 20 patients with cystic fibrosis (CF) or chronic obstructive pulmonary disease (COPD) due to other causes were included in the study. All patients had a history of regularly harbouring H. influenzae in sputum and repeated treatment failures with pivampicillin. 18 completed two 14-day courses in random order with equimolar doses of pivampicillin (80 mg/kg/day) and amoxycillin (62 mg/kg/day). Both drugs were well tolerated with no serious side effects, but pivampicillin was associated with more pronounced nausea. In steady state the mean serum concentrations of antibiotics 2 and 4 h after medication were 9.7 and 3.7 micrograms/ml for pivampicillin and 19.1 and 7.9 micrograms/ml for amoxycillin (p less than 0.01). Eradication of H. influenzae and clinical improvement was seen in one-third of the courses with both drugs. Betalactamase producing ampicillin-resistant strains emerged during 58% of the amoxycillin courses, but only in 16% of the pivampicillin courses (p less than 0.001). The high number of treatment failures and the development of resistant strains indicate that betalactamase inhibitors may possibly improve the efficacy of these drugs, especially of amoxycillin, in these patients. PMID- 3526533 TI - [Impact of atmospheric pollution on the lung]. AB - Longitudinal studies on the effects of atmospheric pollutants on the respiratory system have yielded conflicting conclusions. Socio-economic situation, cigarette smoking and chronic diseases must be taken in account in this multifactorial problem. Nevertheless, evidence has been accumulating that exposure brings a consistent rise in the frequency of chest conditions. Although current levels of pollution are apparently tolerable, unusual weather variations may result in a disquieting situation with ultimately increasing morbidity and mortality rates. Limit levels of pollutant concentration have to be respected since air quality standards adequately protect against adverse health effects, at least in high risk populations. PMID- 3526534 TI - [Cyclosporin A and hyperlipidemia after kidney transplantation. Prospective study]. AB - Hyperlipidemia is common after renal transplantation and has been attributed, at least in part, to corticosteroid therapy. We therefore studied serum lipids in a group of nondiabetic transplant recipients on conventional immunosuppression with azathioprin and prednisone (Aza/P), in comparison with a transplanted group on cyclosporin A monotherapy (CyA) without steroids. Frequency and degree of hyperlipidemia in the two groups showed no significant difference. Atherogenic hypercholesteremia was found as frequently in patients on CyA as in those on Aza/P. Possible factors preventing normalization are discussed. PMID- 3526535 TI - [Clinical and microbiological effects of a 10-day oral administration of ornidazole (Tiberal) following the mechanical treatment of marginal periodontitis]. PMID- 3526536 TI - [Drug regulation of the opioid gene expression transcriptional level and its methodology]. PMID- 3526537 TI - [Synthetic immunologically active peptides]. PMID- 3526538 TI - [Mechanism and significance of cardiovascular changes during the defense-alerting response]. PMID- 3526539 TI - [Advances in studying the cardiovascular neurons of the brain stem]. PMID- 3526540 TI - [Research on the plasticity of the nervous system]. PMID- 3526541 TI - [On specializations in the visual system]. PMID- 3526542 TI - [Serotoninergic and non-serotoninergic neurons in the raphe nuclei of the brain stem]. PMID- 3526543 TI - [Gastrins levels in both sexes]. PMID- 3526544 TI - [Phospholipases A and acute pancreatitis]. PMID- 3526545 TI - [Photoaffinity labeling--a new technic of molecular pharmacology]. PMID- 3526547 TI - Glasgow Royal Infirmary and the Cathedral. PMID- 3526546 TI - A diagnosis in retrospect: the case of Angus MacKay. AB - A review of the casenotes on Angus MacKay, first piper to Queen Victoria, lead to a diagnosis in retrospect of manic-depressive illness. PMID- 3526548 TI - Effect of a blood transfusion protocol and low dose steroid regime on renal transplant survival. AB - The effects of introduction of a low steroid regime and pre-transplant blood transfusion were evaluated. The kidney and patient survival rates for the period before such a policy was adopted were compared with the period after this policy. There has been a highly significant rise in patient survival rates to the present level of 95 per cent at three years. There was a similar rise in three year graft survival rates from less than 40 per cent to 66 per cent. PMID- 3526549 TI - The management of TIAs in 1986. PMID- 3526550 TI - Infectious diarrhea: an update. PMID- 3526551 TI - Mutagenicity and polycyclic aromatic hydrocarbons analysis of ambient airborne particles collected in Athens, Greece. AB - Samples of airborne particulates from the Athens atmosphere were examined for mutagenicity and various polycyclic aromatic hydrocarbons (PAH). Extracts induced linear, dose-related increases in TA98 His+ revertants in the Ames/Salmonella assay and contained average benzo[a]pyrene (BaP) levels of 3.9 ng/m3 of air. The levels of revertants/m3 of the samples showed a linear relation to their BaP and benzo[b]-(BbF) + benzo[k]-fluoranthene (BkF) concentrations and were higher in areas with dense traffic than in industrial areas. It is suggested that the atmosphere of Athens favours the formation of secondary direct-acting mutagens due to the oxidation and nitration of PAH by ozone and nitrogen oxides, which are more abundant in the late spring months. PMID- 3526552 TI - Active human-yeast chimeric phosphoglycerate kinases engineered by domain interchange. AB - Phosphoglycerate kinase (PGK) is a monomeric protein composed of two domains of approximately equal size, connected by a hinge. Substrate-induced conformational change results in the closure of the active site cleft, which is situated between these two domains. In a study of the relations between structure and function of this enzyme, two interspecies hybrids were constructed, each composed of one domain from the human enzyme and one domain from the yeast enzyme. Despite a 35% difference in the amino acid composition between human and yeast PGK, catalytic properties of the hybrid enzymes are very similar to those of the parental proteins. This result demonstrates that the evolutionary substitutions within these two distantly related molecules do not significantly affect formation of the active site cleft, mechanism of domain closure, or enzyme activity itself. PMID- 3526553 TI - A new approach to the oral administration of insulin and other peptide drugs. AB - The oral administration of peptide drugs is well known to be precluded by their digestion in the stomach and small intestine. As a new approach to oral delivery, peptide drugs were coated with polymers cross-linked with azoaromatic groups to form an impervious film to protect orally administered drugs from digestion in the stomach and small intestine. When the azopolymer-coated drug reached the large intestine, the indigenous microflora reduced the azo bonds, broke the cross links, and degraded the polymer film, thereby releasing the drug into the lumen of the colon for local action or for absorption. The ability of the azopolymer coating to protect and deliver orally administered peptide drugs was demonstrated in rats with the peptide hormones vasopressin and insulin. PMID- 3526554 TI - A yeast gene that is essential for release from glucose repression encodes a protein kinase. AB - The SNF1 gene plays a central role in carbon catabolite repression in the yeast Saccharomyces cerevisiae, namely that SNF1 function is required for expression of glucose-repressible genes. The nucleotide sequence of the cloned SNF1 gene was determined, and the predicted amino acid sequence shows that SNF1 encodes a 72,040-dalton polypeptide that has significant homology to the conserved catalytic domain of mammalian protein kinases. Specific antisera were prepared and used to identify the SNF1 protein. The protein was shown to transfer phosphate from adenosine triphosphate to serine and threonine residues in an in vitro autophosphorylation reaction. These findings indicate that SNF1 encodes a protein kinase and suggest that protein phosphorylation plays a critical role in regulation by carbon catabolite repression in eukaryotic cells. PMID- 3526555 TI - Detection of prethrombotic states in patients with atherosclerotic lesions. PMID- 3526557 TI - Introductory historical remarks on atherosclerosis and hemostasis. PMID- 3526556 TI - Atherosclerosis and hemostasis. PMID- 3526558 TI - Monocyte-macrophage participation in atherogenesis: inflammatory components of pathogenesis. AB - This article has addressed the roles of the monocyte-macrophage in atherogenesis and factors influencing monocyte recruitment to the intima. The diversity of the secretory products of the macrophage and their putative participatory roles in pathogenesis have been reviewed and discussed. Additionally, we have presented summary data on the monocyte chemoattractant peptide SMC-CF and on the differentiation of the monocyte-derived foam cell. Discussion has centered on the concept of atherosclerosis as an inflammatory process. PMID- 3526559 TI - Management of chronic myelogenous leukemia. PMID- 3526561 TI - [Experimental studies on grafting in the mandible of rats--comparative studies between autogenous iliac bone and rib]. PMID- 3526560 TI - Hairy-cell leukemia: biology and treatment. PMID- 3526562 TI - [Clinical evaluation of scaling under stimulation anesthesia (acupuncture) using the "Pointer" finger]. PMID- 3526564 TI - Selective primary health care: a critical review of methods and results. AB - In the aftermath of the Alma Ata conference, three types of Primary Health Care (PHC), have been identified. Comprehensive PHC (CPHC) and Basic PHC (BPHC) both have a wide scope of activities, BPHC however does not include water and sanitation activities. Only one year after the Alma Ata conference, CPHC was attacked as not 'feasible' and selective PHC (SPHC) was offered as an interim alternative. SPHC only addresses 5 to 8 diseases, almost all of them falling within the realm of pediatrics. Our article critically analyses the methods and results of SPHC. It contrasts the lack of supportive data for SPHC and its methodological deficiencies with the extent of its adoption by bilateral cooperation agencies, foundations, academic and research institutions, and international agencies. We suggest that rather than health factors, the major determinants of this adoption have been political and economical constraints acting upon decision makers exposed to a similar training in public health. PMID- 3526563 TI - Case report 363: Infantile cortical hyperostosis (Caffey disease ICH) iliac bones, femora, tibiae and left fibula. PMID- 3526565 TI - Limits to medical dominance: the case of chiropractic. AB - This paper describes and analyzes the social history of chiropractic in Canada to partially test a thesis regarding changes in the dominance of the medical profession. We earlier sketched the rise of medicine to dominance by World War I, its consolidation until after World War II, and signs of the start of a decline in dominance signalled by the 1962 doctors' strike in Saskatchewan. One test of the historical sequence described, and particularly the recent signs of decline in medical power, is to examine one of orthodox medicine's major competitors, chiropractic. To what degree has medicine been successful in its opposition to chiropractic? The development of chiropractic in Canada shows its early survival and latterly, in the 1960s and 1970s its increasing popular use and official recognition. Particularly important in its recent success was the establishment of a college in Canada in 1945 and partial inclusion of chiropractic under government health insurance in the 1970s. While chiropractic has gained in acceptance and recognition it has sacrificed many of its earlier claims to be an alternative healing art and to some degree chiropractic has become 'medicalized'. But medicine has also been forced to make concessions. Despite total medical opposition, chiropractic survives. The recent successes of chiropractic tend to confirm our earlier thesis of the beginnings of the decline of medical dominance and to show that medicine, while dominant, was never hegemenous. However, chiropractic did not produce medicine's current difficulties. Rather medicine is being challenged directly by state power and pressures to rationalize health care and indirectly is affected by the class struggle. Chiropractic itself owes much of its own early success to support by the working class and working class organizations such as unions. In this sense both medicine and chiropractic can only be adequately viewed both in relationship to one another and as part of the changing Canadian social structure as a whole. PMID- 3526566 TI - Increasing kidney transplantation in Britain: the importance of donor cards, public opinion and medical practice. AB - The Department of Health and Social Security has recently spent over three quarters of a million pounds advertising the merits of kidney donor cards. The advertising campaign stresses that carrying signed cards requesting the removal of kidneys and other organs after death both increases the number of kidneys available and increases the number of kidney transplants that actually take place. This paper examines the relative success of the kidney donor card campaign in Britain and the nature of the relationship between a more widespread distribution of donor cards and the frequency of kidney transplantation. This is done in two main ways: Through a review of the evidence detailing public support expressed in the media and from social surveys (including original empirical work conducted at Bath University). By an analysis of previously unpublished statistical evidence made available by the Department of Health and Social Security. The paper concludes that the battle for public sympathy towards kidney donation has largely been won and the kidney donor card campaign has been a success. However these success perhaps deflect attention away from more important issues in the transplant equation, as the link between card carrying and increased transplantation is neither direct nor simple. PMID- 3526567 TI - Stroke: health care on the periphery. AB - A study of decision-making among health providers who work with stroke patients provided information concerning stroke rehabilitation ideology and practice. Data collected from 32 professionals on the meaning of rehabilitation in relation to stroke revealed that stroke rehabilitation is considered to be on the periphery of American health care. Three factors contribute to the peripheral status of stroke rehabilitation: the health care system devalues rehabilitation; stroke rehabilitation differs from acute care medicine; and stroke is viewed as a geriatric problem. PMID- 3526568 TI - "Pseudogallbladder" appearance in partial afferent loop obstruction in a patient with cholecystectomy. AB - We have described a patient who was admitted to the hospital for evaluation of RUQ abdominal pain 40 years after a Billroth II gastrectomy, as well as a cholecystectomy of which the patient was unaware. Gray-scale abdominal ultrasonography and Tc 99m-IDA hepatobiliary imaging were interpreted as revealing an enlarged gallbladder and cholelithiasis. An obstructed afferent loop of the Billroth II anastomosis had mimicked a gallbladder on ultrasonography and hepatobiliary imaging. PMID- 3526569 TI - Shigellosis complicated by acute appendicitis. AB - Acute appendicitis developed in a 23-year-old Mexican-American man with acute bacillary dysentery (shigellosis). This is the first such case reported in the English literature. PMID- 3526570 TI - Chronic osteomyelitis caused by Staphylococcus aureus: controlled clinical trial of nafcillin therapy and nafcillin-rifampin therapy. AB - A controlled trial of treatment of chronic osteomyelitis caused by Staphylococcus aureus compared nafcillin alone with nafcillin plus rifampin for a six-week period. Treatment was well tolerated, the only adverse effect being mild neutropenia in four of 18 patients; no toxicity was observed from rifampin. Eight of ten patients in the combined treatment group had a favorable clinical response (with follow-up of two to four years) as compared to four of eight in the nafcillin group (P = .2). Despite the failure to show a statistically significant advantage of rifampin plus nafcillin, we conclude that the combination, along with appropriate surgery, should be considered for patients with chronic staphylococcal osteomyelitis. PMID- 3526571 TI - Group F streptococci in the pharynx: pathogens or innocent bystanders? AB - beta-Hemolytic streptococci (BHS) of Lancefield group F were isolated in moderate to heavy growth from throat cultures taken from 46 children and adolescents with symptomatic pharyngitis. In most instances, oxygen deprivation by means of an anaerobe jar was required for these beta-hemolytic organisms to grow. In relation to a comparison group of children with throat cultures positive for group A BHS, children with group F isolates were more likely to be adolescents and less likely to have fever and cervical adenopathy. It appears that group F BHS are not a major cause of nonepidemic pharyngitis in the pediatric age group. More precise determination of how commonly these organisms cause pharyngitis will require either comparison of isolation rates of group F BHS from the throats of both sick and well children, or further elucidation of the serologic response to these organisms so as to distinguish invasive infection from asymptomatic carriage. PMID- 3526572 TI - Expectant management of rupture of membranes at term. AB - We conducted a prospective randomized study involving 317 patients with term gestations (greater than 36 weeks) and premature rupture of membranes (PROM). Eighty-five percent of the 167 patients managed conservatively began labor within 48 hours. The cesarean section rate in this group was 7% as opposed to 21% in the group managed by oxytocin induction. There were no neonatal infections, and the maternal intrauterine infection rate was lower in the group managed expectantly, 4% vs 12%. There was no difference in the average time of hospitalization for the two groups. Conservative management of patients with PROM at term will significantly reduce the incidence of cesarean section without placing the mother or infant at a higher risk of infection. PMID- 3526573 TI - Pregnancy outcome in renal transplant recipients: experience at the Medical College of Georgia and review of the literature. AB - Between 1970 and 1982, 13 renal transplant recipients had 17 pregnancies with follow-up at the Medical College of Georgia (MCG). Nine patients received related donor grafts and four received cadaver kidneys; 11 mothers survived their pregnancies. Preeclampsia, urinary tract infections, and preterm labor were frequent complications. complications. Perinatal complications were rare, and 12 of 13 continuing pregnancies produced surviving infants. Only one infant had congenital abnormalities (premature closure of the fontanelles and umbilical hernia). We present maternal and neonatal details, with prognostic considerations for pregnancy in such patients. PMID- 3526574 TI - Prevention of acute tubular necrosis after transplantation: effect of pretransplantation volume expansion. AB - We reviewed our experience with 100 consecutive cadaveric transplants of kidneys from satisfactory donors with respect to immediate function after transplantation. The management was the same in all patients except that 66 of them received 1,000 ml of 0.9 N saline IV preoperatively. The overall incidence of acute tubular necrosis (ATN) was 23.2%, but the incidence of ATN in the group of patients who received saline was 7.6%, as compared to 53% in those that did not (P less than .001). There was no other significant difference between the two groups. We conclude that when cadaver kidneys are harvested and preserved under satisfactory conditions, preoperative volume expansion markedly lowers the incidence of posttransplantation ATN, suggesting that the recipient volume status is an important consideration. PMID- 3526576 TI - Epidemiology of emergence and spread of drug-resistant falciparum malaria in Southeast Asia. AB - In Southeast Asia the medicated salt project of Pailin, on the Kampuchea-Thai border, demonstrated that drug resistance, especially chloroquine resistance, can develop when a large population of P. falciparum parasites is exposed to intense transmission under intense drug pressure. The selection of resistant parasites being activated by the introduction of non-immune groups. Emergence of drug resistance was the result of continuous and prolonged mass exposure of P. falciparum to pyrimethamine and chloroquine resulting in the selection of resistant mutants. This selection was associated with multiple exposures of the parasites to much higher drug doses, during repeated passages through the non immune hosts, increasing the degree of resistance. Resistances spread to the receptive areas of Kampuchea and other neighbouring countries through the movements of the temporary migrants who, by then, had become carriers infected with drug resistant falciparum parasites. The rapid and early spread of chloroquine resistance in A. balabacensis areas was not a coincidence but the result of the biological advantages of this species complex in relation to malaria transmission. In Australasia the medicated salt project carried out in Irian Jaya, on the border with Papua New Guinea, also resulted in the development of drug resistance in P. falciparum. PMID- 3526575 TI - Essential hypertension: new insights and controversies in treatment with diuretics. PMID- 3526577 TI - Seroepidemiology of malaria in northern Thailand: II. Focal and temporal variations in endemicity. AB - Four population groups from regions of Northern Thailand were surveyed for the presence of antibodies to Plasmodium falciparum using the indirect immunofluorescent antibody (IFA) test. Each of the four populations was selected from areas known to represent different patterns of malaria transmission. Group 1 was from an area where there had been no malaria transmission for approximately 30 years. Individuals in this group below age 40 showed an extremely low prevalence of malaria antibodies. Group 2 was chosen from an area where low levels of transmission have continued despite more than 30 years of DDT spraying. In this group the age related pattern of malaria antibodies varied from village to village but in all villages there was a sharp increase in the prevalence of IFA positive tests in individuals over 30. The third group has had continuously high levels of transmission. Although there are differences in the age related prevalence of IFA positives when individual villages are compared, there is a greater prevalence at all ages than in the first two groups. The fourth group was selected from an area where transmission had recently resumed after freedom from indigenous cases for approximately six years. There was little difference in the prevalence of IFA positive individuals below the age of 25 but above that there was a steady increase in prevalence with age. The correlation of IFA antibody positives with known patterns of malaria transmission in these four areas demonstrates the usefulness of this serological technique in assessing malaria endemicity and the effectiveness of control measures as well as in the interpretation of other malaria statistics. PMID- 3526578 TI - The efficacy of artemether (qinghaosu) in Plasmodium falciparum and P. vivax in Burma. AB - Seven sulfadoxine-pyrimethamine resistant Plasmodium falciparum infected patients and 2 patients with mixed (P. falciparum and P. vivax) infection were given Artemether. The results showed that Artemether is effective in sulfadoxine pyrimethamine resistant malaria. The mean fever clearance time and parasite clearance time of patients treated with Artemether is shorter than those treated with chloroquine, quinine or sulfadoxine/pyrimethamine. In one patient with mixed infection all parasites disappeared but P. vivax reappeared on day 11 and on day 14 after two consecutive courses. In another P. vivax reappeared on day 21. PMID- 3526579 TI - Salmonella aortitis at Ramathibodi Hospital, Bangkok, Thailand. AB - Two cases of Salmonella aortitis were diagnosed by positive culture from the wall of aortic aneurysm. Common features in both cases included fever, abdominal/back pain and pulsatile abdominal mass with underlying severe atherosclerosis. The fatal outcome of both cases despite surgical and medical treatment was discussed and guideline of management was proposed. PMID- 3526580 TI - Catalase activity in red cell and liver of mice infected with Plasmodium berghei. AB - Hydrogen peroxide (H2O2) has been incriminated to have an oxidative killing malaria parasite. As P. berghei-infected mouse red cells generated H2O2 in vivo, this would result in the alteration of catalase status of the host. The present study was undertaken to determine catalase activity in red cells and liver of mice infected with P. berghei. The studies were performed in 17 samples of infected red cells as well as 20 samples of the normal red cells. Results showed that the catalase activity in red cells of the infected group was significantly lower (p less than 0.01) than that of the normal group. There was a reverse relationship between catalase activity and parasitemia. Crude parasite lysates possessed no catalase activity. Liver catalase content in the infected group was also found to be significantly lower (p less than 0.05) than that of the control group. All these findings indicated that P. berghei-infected mice caused a depressed catalase activity in red cells and liver which was possibly due to the catalatic function in detoxifying the increased H2O2 to water and free oxygen. PMID- 3526581 TI - [Specialization of therapeutic polyclinic services and problems in the training of staff physicians (scientific review)]. PMID- 3526582 TI - [Medical services of partisan units]. PMID- 3526583 TI - [History of military medical education in Russia during the 19th century]. PMID- 3526584 TI - [I. F. Bush--founder of the 1st Russian school of surgery]. PMID- 3526585 TI - [Naval physician K. S. Morkotun (on the 125th anniversary of his birth)]. PMID- 3526586 TI - [Development and introduction of an integrated automated system into the process of mass screening of cardiology patients]. PMID- 3526587 TI - [Imaging diagnosis of prostatic cancer]. PMID- 3526588 TI - [Abdominal aortic aneurysm: diagnostic importance of transvenous DSA]. PMID- 3526589 TI - Surgery in patients with heart transplants. Anaesthetic and operative considerations. AB - As cardiac transplantation becomes more common, so an increasing number of patients with functioning heart transplants may require surgery for related or unrelated non-cardiac conditions. Fifteen patients who have undergone a total of 39 operations (excluding retransplantation) since heart transplantation were reviewed; 36% were for infective conditions and 23% each for gastro-intestinal and vascular lesions. There was one postoperative death in a patient undergoing leg amputation for overwhelming Clostridium welchii infection. There were no major non-fatal complications. The conditions for which operation may be necessary, the specific problems of anaesthesia and surgery in such patients, and the prophylactic measures which may be undertaken to ensure an uncomplicated clinical course are discussed. A clear understanding of the physiology and pharmacology of the denervated heart is essential if these patients are successfully to undergo major operations requiring general anaesthesia. PMID- 3526590 TI - Premenstrual syndrome in Cape Town. Part II. A double-blind placebo-controlled study of the efficacy of mefenamic acid. AB - Thirty patients suffering from the premenstrual syndrome were studied for five consecutive menstrual cycles. An untreated baseline cycle without medication was followed by four treatment cycles. Mefenamic acid or placebo was taken on days 11 26 of the cycle in a prospectively randomized double-blind cross-over manner, with each patient acting as her own control. On subjective assessment, there was a significant overall improvement on mefenamic acid compared with placebo. With the exception of gastro-intestinal symptoms, mefenamic acid was not significantly better than placebo for any of the individual symptoms assessed on the patients daily symptom checklists. PMID- 3526591 TI - Fast facts and figures about Social Security. PMID- 3526593 TI - An aid in the construction of a stapled anterior rectal anastomosis. PMID- 3526592 TI - A comparison of piperacillin and clindamycin plus gentamicin in women with pelvic infections. AB - The efficacy and safety of piperacillin were compared with those of clindamycin plus gentamicin in 74 women with obstetric or gynecologic infections (such as endometritis, salpingitis and septic abortion). Thirty-five of the patients in the group treated with piperacillin and 33 of the patients in the group treated with clindamycin plus gentamicin were clinically cured. Clinical failure occurred in two patients in the group treated with piperacillin (salpingitis in one and endometritis in the other patient) and relapse of salpingitis occurred in one. Three patients who were given clindamycin plus gentamicin (all with salpingitis) did not respond to therapy. The most frequently isolated organisms were Neisseria gonorrhea and Bacteroides species. Adverse clinical experiences and the results of laboratory tests were fewer in the group treated with piperacillin than in the patients who received the combination regimen; in neither instance was treatment discontinued because of these effects. Thus, piperacillin was as safe and effective as a combination of clindamycin plus gentamicin. PMID- 3526594 TI - Sydney Ringer and the origins of cardioplegia. PMID- 3526595 TI - Perspective on staging approaches in the malignant lymphomas. AB - The value of staging in malignant lymphomas is underscored by the advances made in therapeutic options. Through the years, it has become clear that combined modality therapy should be avoided if possible because of the increased risk of second malignant diseases. Thus, it is crucial to define those patients who are potentially cured by limited therapy, such as radiotherapy alone, or combination chemotherapy. This means that careful clinical staging with the best roentgenographic techniques currently available is necessary. At institutions, such as the University of Chicago and Stanford University, it is important to determine nodal disease that is potentially cured with radiotherapy (I through III, III1, at the University of Chicago). In non-Hodgkin's lymphoma, such as poorly differentiated lymphoma and diffuse histiocytic lymphoma, only a small percentage of patients in certain centers who have truly localized Stage I disease may benefit from radiotherapy alone. It is these groups of patients who may need surgical staging. Thus, in 1986, only a small percentage of patients with non-Hodgkin's lymphoma will actually benefit in terms of therapeutic options from the staging laparotomy. Perhaps as newer imaging techniques, such as magnetic resonance imaging, become available, the staging laparotomy may become obsolete. PMID- 3526596 TI - Edwin Barkley Boldrey. PMID- 3526597 TI - Critique of the extracranial-intracranial bypass study. AB - The potential benefit of extracranial-intracranial anastomosis was evaluated by a multicenter international cooperative study headed by the group in London, Ontario, Canada. The final conclusion of the study was that the extracranial intracranial anastomosis did not provide any benefit over the treatment with aspirin. Several objections and shortcomings have been identified in this study. In our evaluation it cannot be concluded that EC-IC bypass surgery is not effective in reducing stroke in all patient populations. PMID- 3526598 TI - The extracranial-intracranial bypass study. PMID- 3526599 TI - Further conclusions from the extracranial-intracranial bypass trial. PMID- 3526600 TI - Risk factors associated with interstitial pneumonia following allogeneic bone marrow transplantation for acute leukemia in Japanese experience. AB - Records of 101 patients with acute leukemia who received allogeneic bone marrow transplantation (BMT) with preparation using cyclophosphamide and total body irradiation (TBI) from September 1975 through July 1984 were collected into Japanese Bone Marrow Transplant Registry from 15 of the participating hospitals. These patients were divided into two groups by year of BMT. Group I included nine acute lymphocytic leukemia (ALL) and nine acute non-lymphocytic leukemia (ANL) patients who received BMT before 1980. Group II consisted 39 ALL and 44 ANL patients who were treated after 1981. One-year survivals were 11% and 58% in groups I and II, respectively (p less than 0.001). Probabilities of developing interstitial pneumonia at one year were 93% and 37% in groups I and II, respectively (p less than 0.001). Of 14 patients who developed interstitial pneumonia in group I, twelve (86%) died of interstitial pneumonia. Fifteen of 22 (68%) were fatal in group II. Using proportional hazard regression model, year of BMT (p = 0.0001) and selection of platelet donor with negative cytomegalovirus (CMV) titer (p = 0.0215) were found to be significant risk factors associated with interstitial pneumonia. The present analysis indicated that change in the selection of patients, e.g., in remission without infection at the time of BMT, as well as treatment modality, e.g., fractionated TBI, and selection of platelet donor with negative CMV titer, resulted in the significant improvement in the survival and decreased incidence of interstitial pneumonia. PMID- 3526601 TI - Modification of survival and hematopoiesis in mice by tocopherol injection following irradiation. AB - The LD50/30 of CD-1 female mice increased from 6.6 Gy to 7.0 Gy when 2.5 mg of dl alpha-tocopherol was injected immediately post irradiation. Increased survival was associated with increased numbers of hematopoietic colony forming units (CFU). Endogenous spleen colonies were found in greater numbers in the tocopherol treated mice after irradiation. The vitamin, however, must be injected within five hours following irradiation to have this effect. The increased numbers of CFU in tocopherol-treated mice may be due to a stimulation of recovery or repair processes. Split-dose studies suggest that most repair of sublethal damage in hematopoietic stem cells take place within seven and nine hours following irradiation. Tocopherol injection appears to enhance the recovery manifested in the split-dose assay. There is also evidence that tocopherol-treatment caused an earlier onset of mitotic activity in CFU after irradiation. The increased number of spleen colonies in tocopherol-injected mice is not due to an altered CFU seeding efficiency associated with an altered spleen microenvironment. Tocopherol injection did not affect the shoulder of the stem cell survival curve using exogenous spleen colony assays of bone marrow-derived or spleen-derived hematopoietic stem cells. There appears to be a decrease in Do in the higher dose region (4.3 Gy) of the bone marrow exogenous SCA survival curves for the vehicle injected and the non-injected groups; however, the tocopherol-injected group showed no evidence of change in radiosensitivity up to the highest dose used (5.0 Gy). Data may be interpreted to suggest that the therapeutic effect of tocopherol may involve repair of hematopoietic stem cell damage in the higher dose range of bone marrow syndrome. PMID- 3526602 TI - [Radiologic diagnosis of recurrences and sequelae to therapy of cervical cancer]. AB - A collaboration between gynecologist, radiologist, and gynecologic radiotherapist is necessary in order to diagnose relapses and therapy effects in uterine cervix carcinoma. New imaging methods such as computed tomography, ultrasonography including endo-sonographic procedures and multiple spin echo imaging have to be applied for clinical check-up which is based on the fundamental investigation performed after primary therapy. These methods allow a very precise demonstration of lymph node relapses greater than 2 cm in the wall of the small pelvis as well as of remote metastases. The problem remains to reveal lymph node metastases below 2 cm and beginning recurrences in the cervical and parametrial region after irradiation. PMID- 3526603 TI - Thromboxane A2 mediates hemodynamic and respiratory dysfunction in graded bacteremia. AB - Thromboxane A2 has been implicated as a mediator of cardiorespiratory dysfunction in sepsis. This study evaluated whether or not thromboxane A2 was necessary or sufficient for these adverse effects to occur during bacteremia. Fourteen adult swine under barbiturate anesthesia and breathing room air were monitored with arterial and pulmonary artery catheters. Animals were studied for 4 hours in three groups: group I, graded infusion of 10(9)/ml Aeromonas hydrophila; group II, Aeromonas hydrophila infusion plus SQ 29,548 (thromboxane A2 antagonist); and group III, U46619 (thromboxane A2 agonist) infusion in normal swine to pulmonary artery pressures observed in group I. Hemodynamic parameters, arterial and mixed venous blood gases, and plasma thromboxane B2 and prostaglandin 6-keto-F1 were measured. At sacrifice after 4 hours, wet-to-dry lung weights were calculated. Results indicated that thromboxane A2 was necessary and sufficient for the development of pulmonary hypertension and impaired alveolar-capillary oxygen diffusion in graded bacteremia. It was necessary but not sufficient for increased lung water to occur and sufficient but not necessary for decreased cardiac index and stroke volume index. Thromboxane A2 was neither sufficient nor necessary to the pathophysiology of systemic hypotension during graded bacteremia. Plasma prostaglandin 6-keto-F1 levels were increased in hypotensive animals with sepsis, suggesting its involvement in hypotension during sepsis. PMID- 3526604 TI - A new approach to the therapy of cancer based on the systemic administration of autologous lymphokine-activated killer cells and recombinant interleukin-2. AB - A new approach to cancer therapy has been developed based on the adoptive transfer of autologous lymphokine-activated killer (LAK) cells and recombinant interleukin-2 (IL-2). Forty-one patients with advanced cancer who have failed all standard treatments were treated in this experimental protocol. Fourteen patients experienced an objective regression of cancer, including one patient with metastatic melanoma who underwent a complete regression. Objective responses were seen in patients with colorectal cancer, renal cell cancer, melanoma, and lung adenocarcinoma. The sites of tumor regression included subcutaneous tissue, lung, and liver. The major side effect of therapy resulted from the administration of high-dose IL-2 and was manifested primarily as fluid retention, resulting in a generalized capillary permeability leak syndrome. This approach to adoptive immunotherapy represents a promising approach to the therapy of patients with metastatic cancer. Attempts to increase the potency and decrease the toxicity of therapy and extend this treatment to patients with smaller tumor burdens are in progress. PMID- 3526605 TI - Resection of the liver for colorectal carcinoma metastases: a multi-institutional study of patterns of recurrence. AB - The Registry of Hepatic Metastases has collected data on consecutive patients from 24 institutions who have undergone hepatic resection for colorectal carcinoma metastases. Patterns of recurrence were examined in a subgroup of 607 patients who had undergone curative resection of isolated hepatic metastases. Forty-three percent of these patient have had recurrences in the liver and 31% have had recurrences in the lung (either alone or in combination with other organs). A multivariate analysis showed that patients with positive pathologic margins or bilobar metastases were at an increased risk of having a recurrence in the liver (68% and 64%, respectively). We conclude that: hepatic resection effectively controls hepatic tumor in a substantial number of patients, adjuvant therapy after hepatic resection should be directed at both the lung and liver to significantly increase survival, and patients with positive pathologic margins or bilobar metastases are at an increased risk for hepatic recurrence. PMID- 3526606 TI - Identification and treatment of cyclosporine-associated allograft thrombosis. AB - Endothelial injury associated with cyclosporine (CSA) therapy in the absence of rejection has resulted in irreversible intrarenal allograft thrombosis and transplant loss. Indium 111 (111In)-labeled platelet scanning is an effective way to identify those transplants that are at risk for acute loss. Two hundred prospective 111In scans were obtained (100 on allografts with normal function and 100 with transplant dysfunction of all causes). 111In scans in patients with dose dependent CSA nephrotoxicity (N = 58) and biopsy proved acute rejection (N = 22) were negative. Grossly abnormal scans (three to eight times greater than hepatic uptake) were noted in nine recipients identified as having a hemolytic uremic like syndrome associated with CSA use. Accelerated allograft functional loss was irreversible in six patients despite stopping CSA, systemic anticoagulation, increased steroids and antilymphocyte globulin, and infusion of fresh-frozen plasma. Three patients with grossly positive 111In scans and clinical and laboratory parameters consistent with this syndrome were treated with cessation of CSA and intra-arterial infusion of streptokinase into the renal allograft followed by systemic heparinization. Normal transplant function was regained and continues at 1, 7, and 8 months after transplant. 111In-labeled platelet scanning can noninvasively identify this syndrome of CSA-associated arteriopathy and allow for early therapy to reverse it. Intrarenal arterial streptokinase therapy is a successful way to treat acute CSA-associated arteriopathy. PMID- 3526607 TI - Liver transplantation across ABO blood groups. AB - Six hundred seventy-one first, second, and third orthotopic liver allografts in 520 patients were reviewed to determine the effect of donor-recipient mismatches or incompatibilities for the ABO blood groups on graft survival. A significant advantage for ABO donor-recipient identity was found, especially in adults and for first grafts. However, a surprisingly large number of ABO incompatible grafts were successful. We recommend that nonidentical or incompatible grafts be limited to patients such as small children for whom the supply of available donors is severely limited or for patients in urgent need of transplantation or retransplantation. PMID- 3526608 TI - Impaired metabolic response to endotoxin in obstructive jaundice. AB - Surgical management of extrahepatic cholestasis is frequently complicated by sepsis, which can be explained in part by diminished function of the reticuloendothelial system. We have explored the possibility that the metabolic response to infection may also be abnormal. Fischer 344 rats underwent either bile duct ligation (BDL) or sham operation and were studied 3 days after operation. Hepatic amino acid uptake measured in vivo by the accumulation of 14C alpha-aminoisobutyric acid or in vitro by the rate of transport of 14C-alanine by isolated hepatocytes was unaltered in the BDL animals, while gluconeogenesis from alanine by viable hepatocytes from BDL rats was actually enhanced. However, the expected increase in hepatic amino acid uptake in response to endotoxin was diminished in the BDL animals. In addition, we observed impaired responses of the jaundiced animals to glucagon and interleukin-1, two mediators of the hepatic acute phase response to endotoxin. These data suggest that while hepatic amino acid transport is normal in the basal state, the rat with extrahepatic biliary obstruction does not respond appropriately to stress and that this defect cannot be explained solely on the basis of altered handling of endotoxin by the reticuloendothelial system. PMID- 3526609 TI - Prostacyclin treatment of ischemic ulcers and rest pain in unreconstructible peripheral arterial occlusive disease. AB - The efficacy of prostacyclin (PGI2) treatment was assessed in 26 patients with surgically unreconstructible atherosclerotic arterial occlusive disease of the lower extremity manifested by nonhealing ulcers and rest pain. Patients were randomized to receive a 72-hour intravenous infusion of PGI2 (6 ng/kg/min, n = 13) or placebo (n = 13). Ulcer size was measured by photographic planimetry, and rest pain was graded by blinded objective scoring at monthly intervals for 6 months. Ulcer size increased 64% in PGI2-treated patients and 22% in placebo treated patients by 1 month after infusion. Rest pain decreased slightly in both PGI2 and placebo groups. At the conclusion of the study, 54% of placebo-treated patients and 31% of PGI2-treated patients had a positive treatment response, indicated by at least a 20% decrease in ulcer size and a 33% decrease in rest pain. PGI2 infusion did not improve the high-placebo response rate seen in these patients with severely ischemic extremities. These results emphasize the importance of placebo-controlled studies, even in patients with unreconstructible arterial disease. PMID- 3526610 TI - Prospective, randomized trial of nasogastric suction in patients with acute pancreatitis. AB - The efficacy of nasogastric (NG) suction was evaluated in a prospective, randomized trial in 60 patients with acute pancreatitis of mild to moderate severity. Group I, NG (29 patients) was treated with NG suction, and group II, no NG (31 patients) was treated without NG suction. The presentation, cause of pancreatitis, and clinical parameters at the time of admission of the two groups were similar. The use of NG suction had no discernible benefit during hospitalization. There were no differences in duration of abdominal pain, the interval until bowel sounds returned, the need for narcotic administration, or the length of time intravenous fluid therapy was needed. When compared with group II, no NG, patients in group I, NG tended to resume oral intake later (5.0 +/- 0.3 versus 3.9 +/- 0.5 days) and remain hospitalized longer (13.1 +/- 2.6 versus 10.7 +/- 2.0 days). The incidence of serious complications, such as pancreatic abscess, pseudocyst, biliary obstruction, or pulmonary failure, was no different between the groups. This study demonstrates that the routine use of NG suction in patients with acute pancreatitis of mild to moderate severity is of no benefit in altering the clinical course. PMID- 3526611 TI - The letters of William Stewart Halsted and William Williams Keen. AB - William Halsted and William Keen were two of the most distinguished surgeons in U.S. medicine. Although their personalities were completely opposite, they enjoyed a long and devoted friendship. An extensive correspondence was maintained throughout their relationship. This article examines their friendship by analyzing these letters, which are being published for the first time. PMID- 3526612 TI - [Ingrid Wyller's 90th birthday: a youngster from the previous century. Interview by Bjorn Arild Ostby]. PMID- 3526614 TI - [Amnesty International--an anniversary for which there is no ground to celebrate]. PMID- 3526613 TI - [Israel. Always room for the parents in the pediatric ward]. PMID- 3526615 TI - [Effect of graded physical exertion on the levels of glucose and insulin in the blood of patients with ischemic heart disease]. AB - The paper is concerned with the data on changes in the levels of glucose and insulin in the blood of 15 healthy males and 75 CHD patients as a result of bicycle ergometric testing. Hypoglycemia without changes in the insulin content developed in the CHD patients with low exercise tolerance in response to bicycle ergometric testing. In patients with better functional indices a short-term hypoglycemic shift was combined with a decrease in the insulin level in the blood. The glucose level and insulin content decreased in response to exercise in patients with myocardial infarction (on the 28th-33rd days), in the patients with chronic CHD the glucose level and insulin content were not considerably changed during exercise. PMID- 3526616 TI - [Predicting the effectiveness of nitrosorbide with regard to increasing tolerance to physical loads]. AB - A study of the indices of spiroergometry, tetrapolar rheography, echocardiography at rest and during bicycle ergometry in 50 patients after myocardial infarction prior to and after the use of nitrosorbide showed that the use of this drug to raise exercise tolerance was recommended to patients after myocardial infarction with a considerable enlargement of the left ventricle. The invariability of heart rate after taking the drug at rest served as a prognostic criterion for the use of nitrosorbide to raise exercise tolerance. Increased cardiac rhythm at rest by 11% and upwards after the use of the drug was a sign of its inefficacy for the above purpose. PMID- 3526617 TI - [Effect of corinfar on hemodynamics in ischemic heart disease]. AB - During examination on the basis of a double blind test corinfar administered sublingually at a dose of 10-30 mg decreases significantly in 1 hour systolic and diastolic arterial pressure, general peripheral resistance, increases the heart rate, the blood stroke and minute volumes and a medium rate of the circular contraction of the muscular fibers in CHD patients. An increase in systolic discharge is associated with lowered arteriole tension. PMID- 3526618 TI - Advances in rehabilitation for the head and neck cancer patient. PMID- 3526619 TI - Scalp neoplasm associated with cranium bifidum in a 24-week human fetus. AB - Prenatal ultrasonography at 24 weeks disclosed a fetus with a large mass protruding from the occiput. The mass was an invasive, undifferentiated mesenchymal neoplasm of the scalp associated with a defect in the occipital bone (cranium bifidum). The tumor may have derived from neural crest at the site of rhombencephalic closure. The tumor itself would seem to be a sporadic event, but the cranium bifidum may imply a recurrence risk of 2-3% for future pregnancies. PMID- 3526620 TI - Risk factors in the prevalence of anencephalus and spina bifida in New Zealand. AB - This paper presents results from an epidemiological study on the 51 anencephalus and 53 spina bifida cases in the 1978 New Zealand birth cohort. Multiple sources were used in the ascertainment, and the prevalence rates were 0.98 and 1.02 per 1,000 total births, respectively. No association was found with the traditional indicators of the effect of environmental factors: maternal age, social class, nuptiality, month of birth, or estimated month of conception. Males comprised 41% of anencephalus and 36% of spina bifida cases; the prevalence was higher in the non-Maori than in the Maori population. New Zealand-born mothers appear to have a much lower risk of spina bifida, but not anencephaly, than those born in England/Scotland. The rate for the latter population was within the range of a number of UK-based studies. As the bloodstock of New Zealand whites has been predominantly derived from the UK population, and as New Zealand is a low prevalence area, this suggests that the higher risk for these women is likely to be attributable to factors present in their birthplace but absent in New Zealand. These findings provide further evidence that the epidemiologic patterns of anencephalus and spina bifida in low-prevalence areas are at variance with those in high-prevalence areas, such as the United Kingdom. They also support the hypothesis that the contrast in rates between high- and low-prevalence areas is a reflection of the impact of environmental factors in high-prevalence areas on the "background" or baseline frequency of anencephalus and spina bifida found in low prevalence areas. PMID- 3526621 TI - Major limb malformations following intrauterine exposure to ethanol: two additional cases and literature review. AB - Two children are reported in whom major limb malformations were identified and whose mothers had consumed large quantities of alcohol in the first trimester of pregnancy. In one there was complete amelia of the upper limbs, while the other had preaxial polydactyly of both hands. These cases, taken together with previously reported instances of major limb anomalies following intrauterine ethanol exposure, as well as animal investigations that have demonstrated virtually identical limb malformations following ethanol administration, suggest that maternal ethanol abuse may be casually related to these limb malformations. We suggest that interruption of blood supply to the developing limb may be caused by ethanol exposure and may result in all of the various limb malformations described. PMID- 3526623 TI - Teratogen update: fetal hydantoin effects. PMID- 3526622 TI - Pulmonary hypoplasia in chondrodystrophic mice. AB - Lungs of day-18 fetal mice with hereditary chondrodysplasia (cho) were examined histologically and biochemically for pulmonary hypoplasia. Compared with normal littermate controls, the mutant's lungs were smaller by 37 (wet weight) and 22% (dry weight). Total DNA and protein per whole lung were decreased by 13 and 19%, respectively. The significantly smaller-than-normal terminal sacs observed in histological sections of the mutant's lungs corresponded with the greater difference (37%) in lung wet weight. The developmental mechanism for this disorder was further explored by examining the volumes of thoracic cavity and amniotic fluid. The volume of the thoracic cavity of newborn mutants was less than half that of controls, suggesting that the pathogenetic mechanism for the hypoplastic lungs in chondrodysplastic mice includes thoracic dystrophy. Measurement of the amniotic fluid volume revealed polyhydramnios in the mutant, thereby ruling out oligohydramnios as a mechanism. The relevance of this study to human pulmonary hypoplasia in short-limb chondrodystrophy is discussed. PMID- 3526625 TI - The Galveston quarantine stations, 1853-1950. PMID- 3526624 TI - Teratogen update: hyperthermia. PMID- 3526626 TI - The physician's influence on informed consent for bone marrow transplantation. PMID- 3526627 TI - Effect of selective and non-selective beta blockade on pulmonary function and tracheobronchial mucociliary clearance in healthy subjects. AB - A controlled, double blind, crossover study was carried out to ascertain the effect of single doses of selective (100 mg atenolol) and non-selective (160 mg propranolol) beta blocker on pulmonary function and tracheobronchial mucociliary clearance. The study group comprised 12 healthy, young subjects. Adequate and comparable blockade was achieved with both drugs, the administration of which resulted in significantly lower pulse rates (at least up to eight hours after administration of the drug) and systolic blood pressures (three hours after drug administration) than were found with placebo. Small (of the order of 5%) but nevertheless statistically significant falls in FEV1 and forced vital capacity accompanied the administration of both beta blockers (but not the placebo) and were measurable up to eight hours after administration of the drug. Indices of pulmonary function had returned to normal by the next day. Peak expiratory flow and indices of small airways function remained unaltered after beta blockade. Mean tracheobronchial mucociliary clearance was depressed after administration of both beta blocking drugs, although the reduction was significant (p less than 0.05) only when propranolol was compared with placebo. PMID- 3526628 TI - Trequinsin analogues as modulators of the thrombin-mediated reactions in haemostasis. PMID- 3526629 TI - Fast functional protein C assay using Protac, a novel protein C activator. AB - A simple and rapid clotting method for the quantitative determination of protein C (PC) in plasma consists of the conversion of PC into activated PC (APC) by means of Protac, an activator protein isolated from Agkistrodon contortrix contortrix venom, of the subsequent degradation of factors V and VIII in PC immuno-depleted plasma by the generated APC and of the measurement of the prolongation of the activated partial thromboplastin time (APTT) which is proportional to the amount of PC in the sample. In 33 normal individuals a mean PC level of 97.1% of a normal pooled plasma was found. Comparison with an enzyme immunoassay for PC in 33 patients with liver disease revealed a good correlation (r = 0.986). Patients under warfarin therapy (n = 34) had a mean PC level of 19.8%; a comparison with the immunological assay (mean value = 55.3%) in the same population suggested that the assay did not co-estimate acarboxy forms of PC. The assay proved to be insensitive to heparin concentration lower than 1 U/ml. Due to its simplicity, it should be suitable for diagnostic routine and monitoring of patients with abnormal PC level, even if under anticoagulation. PMID- 3526630 TI - The dentist who made the West famous. PMID- 3526631 TI - The ancestors we never knew. PMID- 3526632 TI - [Ultrasound in the diagnosis of gallbladder stones]. PMID- 3526633 TI - [Preparation for coloscopy]. PMID- 3526634 TI - [Botulism]. AB - In view of large-scale outbreaks of botulism among waterfowl and farm animals in the Netherlands, studies were done designed to estimate the risks incurred by man. The presence of C. botulinum in the environment as well as contamination cycles and the potential for multiplication were studied. Raw materials used in the production of food were frequently found to be contaminated with types of C. botulinum pathogenic for man. The growth of C. botulinum in foods and meat preservatives other than nitrite were examined. To reduce the use of laboratory animals in research on botulism, immunological methods to detect botulinum toxins were developed. PMID- 3526635 TI - [Helminths of carnivores relevant to veterinary practice]. AB - Especially in an urban environment man and carnivores live closely together, whereby one has to pay attention not only to animal parasites, but also to human pathogenic connections regarding these parasites. Because of the infection risk the animal owner has to be competently informed by his veterinarian. While some cestodes make great demands on hygiene, with others the cycle can be interrupted by consequent diet restrictions. Of all nematodes the stomach worm of the cat is of greater importance as it is easily overlooked because of its small size, is difficult to diagnose and is occurring in our regions with an infestation rate of about 40%. "Larva migrans visceralis" and "Larva migrans cutanea" caused by ascaride and hookworm larvae are important in human medicine and demand therapeutic measures. The contamination of parks, playgrounds and beaches with these parasites caused by carnivores requires a critical evaluation of the human pathogen interests. PMID- 3526636 TI - A monoclonal antibody against human colon cancers. AB - A monoclonal antibody was prepared by hybridizing mouse myeloma cells with spleen cells from the mouse which was immunized with human colon cancer transplanted in nude mice. The reactivity of the monoclonal antibody, named A7, was tested by immunoperoxidase method. A7 reacted strongly with human adenocarcinoma cell lines and carcinoembryonic antigen (CEA). In surgical specimens, A7 reacted with 10 cancer tissues and 2 normal colon mucosa from 19 colorectal cancer patients. A7 did not react with other cancers. It was thought that A7 reacted with colon- or colon cancer-specific CEA. The reactivity of A7 with colorectal cancers was markedly reduced by preoperative irradiation. PMID- 3526638 TI - The size and number of Langerhans islets correlated with their endocrine function: a morphometry on immunostained serial sections of adult human pancreases. AB - Surgical and autopsy specimens of normal pancreas from three human adults were submitted to morphometry of Langerhans islets and so-called extra insular islet cells, by measuring the islet radii on serial sections immunostained for either insulin or glucagon. All the islets contained in a test volume were measured including single cells, and the distribution of their radial sizes was studied. It was found that the distribution of islets was strongly skewed and continuous, with the majority of islets having radial values near to the minimum. From the fact that only one peak was found in the distribution curve, it is concluded that in spite of the distinction previously made between islets of Langerhans and so called extra-islet cells, they are in fact both part of a continuous distribution. Moreover, the Weibull function, assumed as the theoretical distribution, fit well with the empirical histograms, giving support for the contention of continuous distribution with a single peak. Although the small islets account for a majority of the number of islets, they account for only a very small percentage of the islet volume. This is thought to indicate that the bulk of the endocrine functions of the pancreas are carried out by large islets, whereas the so-called extra-islet cells are likely to be their precursors. With regard to the cellular structure of the islets, it was found that the smaller the islet, the smaller the percentage of islets containing A cells, with the vast majority of cells in the smallest islets (often single cells) being B cells. PMID- 3526637 TI - Vacuolated plasma cells in multiple myeloma. AB - Practically all myeloma cells had prominent vacuoles, around and within which the end product of acid phosphatase (AP) reaction was demonstrated. These vacuoles were considered to be autophagic. In remission, only a few myeloma cells were vacuolated. Serial determinations showed transition from an initial high AP score (3.86) to a low score (1.32) in remission. Moreover, there was a trend towards a lower average percentage of positive cells in remission (72%) as compared to the preinduction phase (100%). Intracellular Bence Jones proteins of the present case may be toxic and capable of causing vacuolation with activation of lysosomal enzymes. PMID- 3526639 TI - Pronounced damage of intestinal tract mucosa by the combination of 1-methyl-1 nitrosourea plus 1,3-bis-(2-chloroethyl)-1-nitrosourea. Effect of drug sequence and time interval of administration. AB - The combination of 1-methyl-1-nitrosourea (MNU) and 1,3-bis(2-chloroethyl)-1 nitrosourea (BCNU) has an overadditive toxicity in rats. This overadditive effect is dependent on drug sequence and time interval between the administration of both compounds. Application of MNU within 2 h prior to BCNU or simultaneous application of both compounds displayed the highest toxicity. The dose-limiting toxicity appears to be a severe damage of the intestinal mucosa. PMID- 3526641 TI - [The acid etching technic in prosthetic bridges]. PMID- 3526640 TI - [Direct bonding in cases of crowding]. PMID- 3526642 TI - [100 years in dental local anesthesia]. PMID- 3526643 TI - Intracerebral hemorrhage: non-hypertensive causes. PMID- 3526644 TI - Thrombolytic therapy in stroke: possibilities and hazards. PMID- 3526646 TI - Progress review: hypoglycemic brain damage. AB - The central question to be addressed in this review can be stated as "How does hypoglycemia kill neurons?" Initial research on hypoglycemic brain damage in the 1930s was aimed at demonstrating the existence of any brain damage whatsoever due to insulin. Recent results indicate that uncomplicated hypoglycemia is capable of killing neurons in the brain. However, the mechanism does not appear to be simply glucose starvation of the neuron resulting in neuronal breakdown. Rather than such an "internal catabolic death" current evidence suggests that in hypoglycemia, neurons are killed from without, i.e. from the extracellular space. Around the time the EEG becomes isoelectric, an endogenous neurotoxin is produced, and is released by the brain into tissue and cerebrospinal fluid. The distribution of necrotic neurons is unlike that in ischemia, being related to white matter and cerebrospinal fluid pathways. The toxin acts by first disrupting dendritic trees, sparing intermediate axons, indicating it to be an excitotoxin. Exact mechanisms of excitotoxic neuronal necrosis are not yet clear, but neuronal death involves hyperexcitation, and culminates in cell membrane rupture. Endogenous excitotoxins produced during hypoglycemia may explain the tendency toward seizure activity often seen clinically. The recent research results on which these findings are based are reviewed, and clinical implications are discussed. PMID- 3526645 TI - Race, sex and occlusive cerebrovascular disease: a review. PMID- 3526647 TI - Spontaneous history of asymptomatic internal carotid occlusion. AB - Forty-nine patients with ICA occlusion, who presented without any neurological signs or symptoms, were prospectively followed for an average of 31.2 months. Eight patients (16%) suffered a stroke during follow-up, of which five were within the vascular territory of the occluded artery--5 patients (10%) developed TIAs 4 of which were ipsilateral to the occluded artery. Non-invasive vascular follow-up did not reveal a progression of extracranial arterial disease in the majority of later symptomatic patients. Twenty-three patients (46.9%) died during follow-up, coexisting coronary artery disease being the major cause of death. PMID- 3526648 TI - Progression and regression of carotid stenosis. PMID- 3526649 TI - Prediction of function after stroke: a critical review. AB - A review of 33 studies identifies the factors of prior stroke, older age, urinary and bowel incontinence, and visuo-spatial deficits as adverse prognostic indicators of function. No relationship is shown between sex, hemisphere of stroke, and functional outcome. Functional admission score is a strong predictor of discharge functional status, but its relationship with improvement in function is unclear. Findings regarding the prognostic value of severity of paralysis and onset-admission delay are ambiguous. Comparison among studies is hindered by differences in patient samples, timing of assessments, criteria by which outcome is measured and measuring instrument used. Future studies should measure function at set times post-stroke, use functional scales whose reliability and validity is well established, and be conducted in several treatment centres to ensure that the sample is representative of the population to which the predictor measure is to be applied. PMID- 3526650 TI - Expression of class I transplantation antigens. PMID- 3526651 TI - Preservation damage in liver transplantation. Influence of rapid cooling. AB - Liver preservation and transplantation was performed in pigs. For flush perfusion cold (2 degrees C) and warm (15 degrees C) lactated Ringer's solution were compared. Administration of cold Ringer's resulted in a severe endothelial damage of sinusoids that was aggravated after recirculation, as shown by electron microscopic examination. Using warm Ringer's solution this alteration was limited. Liver parenchymal cells are impaired mainly during reflow as a consequence of microcirculatory disturbance. After cold flushing animals died within a few hours, whereas after flushing with warm Ringer's solution pigs survived definitively. PMID- 3526652 TI - Hepatocyte transplantation for enzyme deficiency disease in congenic rats. AB - Long-term effects of hepatocyte transplantation (HTX) in the treatment of enzyme deficiency disease were studied. Congenic enzyme-deficient (R/APfd-j/j) and non enzyme-deficient (R/APfd) rats were used as recipients and donors, respectively. The R/APfd-j/j rat strain is congenitally deficient of bilirubin uridyldiphosphate (UDP)-glucuronyl transferase. R/APfd-j/j rats underwent HTX by intrasplenic injection of 10(7) isolated R/APfd hepatocytes (group 1A). Another group of R/APfd-j/j rats was treated similarly, but underwent splenectomy after 11 weeks (group 1B). Controls consisted of R/APfd-j/j rats grafted with 10(7) R/APfd-j/j hepatocytes (group 2), and R/APfd-j/j rats that underwent a sham operation (group 3). Total plasma bilirubin (TB) levels were significantly reduced in groups 1A and 1B during the experiment (both P less than 0.01). In the control groups TB reduction was not observed. Bile analyses at 30 weeks after HTX showed that in group 1A 13.7 +/- 2.7% of total biliary bilirubin was conjugated. In group 1B a significantly lower fraction was conjugated: 6.6 +/- 1.1% (P less than 0.05). Conjugated bilirubin was not found in bile of groups 2 and 3. Histology showed survival of hepatocytes in all spleens of rats of groups 1A, 1B and 2. It is concluded that congenic hepatocytes from R/APfd donors are not rejected after transplantation into the R/APfd-j/j rat, and maintain long-term function. Splenectomy does not abolish, but does reduce, the therapeutic effect significantly, indicating that part of the transplanted hepatocytes maintains function in the enzyme-deficient host liver. The congenic R/APfd-j/j and R/APfd rat strains represent a new animal model for research in metabolic deficiency disease. PMID- 3526653 TI - The chyloesophageal fistula. A new approach to thoracic duct drainage. AB - The main reason for the virtual abandonment of external thoracic duct drainage as an immunosuppressive measure is not its lack of efficacy, but the time-consuming technical problems of maintaining cannula patency and replacing the large obligatory losses of fluid and protein. In an effort to overcome these problems we have devised a method of diverting thoracic duct lymph internally into the esophagus of the sheep, our hypothesis being that fluid and protein should be resorbed, but lymphocytes and antibodies destroyed. By isolating that part of the venous system into which the thoracic duct drains and anastomosing this conduit to the cervical esophagus a chyloesophageal fistula was created. A mean patency of 19 days was demonstrated radiologically and there was a reproducible peripheral blood lymphopenia of over 50% of preoperative values at 4 weeks. Although plasma albumin levels fell from 37 g/L to 29 g/L at 1 week, they remained stable thereafter. No parenteral fluid or protein was administered, yet the animals remained well with no significant weight loss or overt signs of dehydration or hypoproteinemia. Skin allograft mean survival time was prolonged from 9 to 11.8 days (P less than 0.01). PMID- 3526654 TI - Sequential analysis of HLA-class II antigen expression in human renal allografts. Induction of tubular class II antigens and correlation with clinical parameters. AB - The expression of HLA-class II antigens was assessed in 142 biopsies from 29 recipients of cadaveric renal allografts who received either short-term cyclosporine (n = 12) or azathioprine and low-dose prednisolone (n = 17). Biopsies were obtained before transplantation, routinely at days 7, 21, 90, and 365 after transplantation, and at other times as clinically indicated. Cryostat sections were labeled with monoclonal antibodies using an indirect immunoperoxidase technique. In all biopsies HLA-class II antigens were expressed on glomeruli and intertubular structures. In pretransplant biopsies proximal tubules expressed class II antigens, whereas distal tubules were always negative. After transplantation three patterns of class II expression were recognized based on renal tubular class II staining: normal, focal increased, and generalized increased expression. Sequential biopsy analysis showed fluctuating levels of expression in individual patients, which correlated with cellular infiltration and was associated with allograft rejection. 71% of biopsies obtained at day 90 from patients on conventional therapy showed increased class II expression compared with only 9% of biopsies from patients on cyclosporine immunosuppression. All patients with normal class II antigen expression in day 90 biopsies had well-functioning grafts two years after transplantation, whereas 3 of 9 with increased class II antigen expression had failed. Furthermore, all grafts failing from irreversible rejection before 90 days showed marked increase of class II antigen expression. The increased class II antigen expression in renal allografts may be merely a marker of rejection or may have a role in the augmentation of the response, either in its induction or as a target for the effector arm of the reaction. PMID- 3526655 TI - Detrimental effect of cyclosporine on initial function of cadaver renal allografts following extended preservation. Results of a randomized prospective study. AB - We report herein the results of a randomized prospective trial comparing maintenance cyclosporine (CsA)-prednisone immunosuppression to a regimen of azathioprine-prednisone-antilymphocyte globulin (ALG) in cadaver renal transplant recipients. Fifty-six patients were entered into this study with 31 assigned to the ALG group and 25 to the CsA group. These two groups were well matched for most major determinants of graft outcome and the mean renal preservation time was 37 hr in each group. The incidence of acute tubular necrosis (ATN) was high in both groups (58% ALG, 72% CsA, NS). There were five cases of primary nonfunction in the CsA group and only one in the ALG group (P = .05). Of the kidneys that functioned, the mean serum creatinine nadir (1.5 vs. 2.2 mg/dl, P = .06) and the mean number of days to reach the serum creatinine nadir (24.2 vs. 43.3 days, P = .03) were both less in the ALG group. The actuarial one-year graft survival rate in the ALG and CsA groups is 78% and 48%, respectively (P less than .05). This difference is mainly due to the large number of primary nonfunctioning grafts in the latter group, which we attribute to the effect of CsA's nephrotoxicity superimposed on renal ischemia incurred prior to transplantation. These data emphasize that, in order to realize the full benefit of CsA in cadaver transplantation, renewed emphasis must be placed on minimizing ischemic renal damage. PMID- 3526656 TI - Characteristics and clinical relevance of autolymphocytotoxins in patients with aplastic anemia. AB - Serum of 68 patients with aplastic anemia was tested for the presence of autolymphocytotoxins (auto-LTs). Prior to specific disease treatment, 16 patients (24%) displayed antibodies cytotoxic to their own lymphocytes. These antibodies had the characteristics of cold-reactive lymphocytotoxins. Their detection in patients' sera was found unrelated to a viral or toxic cause of the disease or the patients' HLA genotype. Broadly reactive anti-HLA antibodies were less frequent in pretreatment sera containing auto-LTs, suggesting that these autoantibodies could modulate alloantibody production. However, after specific disease treatment, the alloantibody frequency was comparable in patients with or without auto-LTs. We found no significant difference in response to antilymphocyte serum or bone marrow graft outcome in the patients in relation to the presence or absence of pretreatment auto-LTs. This observation suggests that the detection of these autoantibodies in aplastic anemia has no clinical relevance. PMID- 3526657 TI - Expression of donor class I major histocompatibility antigens on the vascular endothelium of mouse skin allografts. AB - The expression of a class I MHC antigen on the vascular endothelium of mouse skin allografts was assessed by in vivo uptake of radiolabeled monoclonal anti-class-I antibody in the grafts after i.v. injection into the recipients. Endothelial localization of the bound antibodies was demonstrated via double-labeling immunofluorescence microscopy using factor-VIII-related antigen as a marker for endothelial cells. Treatment of recipients with cyclosporine was accompanied by low levels of class I antigen expression in the grafts, and similarly low levels were measured in grafts carried by nude recipients in the complete absence of rejection. Withdrawal of immunosuppressive therapy was followed by an increased class I antigen expression in the donor skin. An increase was also observed in skin grafts undergoing first-set rejection. We conclude that the expression of class I antigens on the capillary endothelium of mouse skin allografts in vivo is variable and is under influence of the immune status of the recipient. PMID- 3526658 TI - Prolonged skin allograft survival through enhancement effects on donor tissue. AB - A skin allograft retransplantation model was utilized to study the mechanism of immunological enhancement in a murine system. Enhancement was accomplished by treating allografted recipients with host antidonor serum (B6AF1 anti-B10.D2 alloantiserum). Grafts from enhanced or untreated hosts were retransplanted after seven days onto a second recipient. Enhanced retransplanted grafts had significantly prolonged survival as compared with unenhanced grafts. The survival of enhanced retransplanted grafts was as prolonged as that of primary skin grafts on antiserum-treated hosts. Splenocytes harvested from recipients of enhanced retransplanted allografts showed delayed and diminished development of T cell responses to graft alloantigens. Sensitization of the second recipient abrogated prolonged survival of enhanced retransplanted grafts. Also, enhancement prevented sensitization of allografted recipients. One interpretation of these studies suggests that a sensitization block is a sufficient mechanism of skin allograft enhancement. The site of action of antisera is within the graft itself. Decreased T cell responses in the host are indirect effects of diminished antigenicity of enhanced grafts. Further studies of immunological enhancement should be directed to the graft, not toward the graft recipient. PMID- 3526659 TI - Severe nephrotoxicity caused by the combined use of gentamicin and cyclosporine in renal allograft recipients. PMID- 3526660 TI - Allogeneic bone marrow transplantation for X-linked lymphoproliferative syndrome. PMID- 3526661 TI - Pretransplant antibody screening using lymphocytes frozen in microtest trays. PMID- 3526662 TI - Assessment of primarily vascularized cardiac allografts in mice. PMID- 3526663 TI - Transmission of malaria by bone marrow transplantation. PMID- 3526664 TI - Proceedings of an international symposium on monitoring and manipulation in autoimmune disease and organ transplantation. July 28-31, 1985, Chateau Montebello, Canada. PMID- 3526665 TI - Proceedings of an international symposium on monoclonal antibody therapy with orthoclone OKT3 in renal transplantation. PMID- 3526666 TI - Staghorn calculus in a renal allograft. AB - A case of staghorn calculus in a transplanted kidney associated with tertiary hyperparathyroidism in the presence of infection has been described. Possible mechanisms of pathophysiology have been discussed. PMID- 3526667 TI - Radionuclide scans and needle biopsies in the diagnosis and treatment of renal allograft pyelonephritis and rejection developing in the course of postoperative acute tubular necrosis. PMID- 3526668 TI - Contrasting results of immunological monitoring in cyclosporine- and azathioprine treated renal allograft recipients. PMID- 3526669 TI - Management of a postbiopsy arterial pseudoaneurysm in a transplanted kidney: utilization of epsilon aminocaproic acid and controlled hypotension. PMID- 3526670 TI - Indications for organ transplantation. Proceedings of a pre-congress conference held in association with the second congress of the European Society for Organ Transplantation. November 26, 1986, Munich, FR Germany. PMID- 3526671 TI - Renal biopsy in Saudi children with nephrotic syndrome not responsive to corticosteroid: a preliminary report. AB - Percutaneous renal biopsy was done in 25 Saudi children whose nephrotic syndrome did not respond to prednisolone. The histologic diagnosis was mesangial proliferative glomerulonephritis in 11 cases; an additional two biopsies had features of both mesangial proliferative glomerulonephritis and focal segmental glomerulosclerosis. Immunofluorescence was abnormal in 16 out of 21 patients, with IgM as the most frequently detected immunogen. PMID- 3526672 TI - [Monoclonal antibodies to the antigens of human HeLa tumor cells]. AB - A panel of 6 hybridomas "XEJIMA" producing monoclonal antibodies specific to HeLa cells is prepared. Monoclonal antibodies do not bind to antigens of human diploid fibroblasts, human continuous B- and T-lymphocytes and animal cell lines. The specificity of monoclonal antibodies to cellular antigens of 5 HeLa-like cell lines and 6 human tumour cells lines, not contaminated with HeLa cells, is determined. Antibody containing ascitic fluid and culture media of hybridomas XEJIMA-3, -12, -13, and -22 significantly decrease the attachment of HeLa cells to the surface of culture flasks. Monoclonal antibodies XEJIMA-11, -12 and -13 block the multiplication of HeLa cells. The effect depends on serum concentration in the nutrient medium. PMID- 3526673 TI - [Cell cultivation on polyimide film to obtain preparations for light optical and electron microscopic research]. AB - Upon cultivation of the brain tissue and skin-muscle tissues of human embryos, a polyimide film was used as a lining. The optimal conditions of the preliminary processing of the lining (sterilization, washing) are described. An easy separation of the polyimide film from the media (in the process of tissue treatment for electron microscope studies) facilitates the use of the material for light and electron microscopy without damaging the culture. PMID- 3526674 TI - [Neutral red is not suitable for measuring the pH lysosomes of the intact cell]. PMID- 3526675 TI - [Intensified conventional insulin therapy in the diabetic pregnant woman]. PMID- 3526676 TI - [Loss of cutaneous tissue of the face and its repair. Apropos of 35 cases]. PMID- 3526677 TI - [The turning points in Tunisian medicine: from the 18th century to the beginning of the 20th century]. PMID- 3526678 TI - [Purification, identification and properties of cysteine cathepsins from animal tissues]. AB - The paper deals with the modern methods of purification of cathepsins B, H, L, N, S. The ways to control their separation in the course of purification are discussed. The multiplicity of molecular forms of these enzymes is analyzed. PMID- 3526679 TI - [Effect of glutathione on the proteolytic degradation of tissue proteins in young and old rats]. AB - The proteolysis rate of the total liver, brain and testicle homogenates from young and old rats was studied by proteolytic enzymes. The level of autolytic destruction of brain and liver proteins decreases with aging. The total liver, brain and testicle proteins of young animals are splitted by pronase faster than the proteins of the old ones. Addition of reduced glutathione to the reaction mixture causes an increase in the rate of liver and brain proteins splitting by pronase in old rats up to the level determined for the young animals. At the same time the effect of glutathione on the testicle tissue of old animals was not observed. PMID- 3526680 TI - [High molecular weight multienzyme complexes of aminoacyl-tRNA-synthetases in eukaryotic cells]. AB - The data available in literature on the possibility of the aminoacyl-tRNA synthetases to function in different eukaryote cells in the composition of high molecular-weight complexes are generalized. Interactions in complexes formed by synthetases and other components as well as the physiological significance of such universal multi-enzymic complexes in cells of higher organisms are discussed. PMID- 3526681 TI - Gaston Dupouy, 7 August 1900-22 October 1985. PMID- 3526682 TI - Delineation of adrenal in controls and nontumorous adrenal disorders by real-time ultrasonic-scanner. AB - In 90 control subjects, 90% of the right adrenal and 38% of the left were delineated by sector US scanner. A longitudinal scan from an intercostal space in the mid-axillary line and a right-anterior-transverse scan from the intercostal space were useful in displaying the right adrenal, and an anterior-transverse scan from the epigastrium was also useful in showing the left adrenal. The latter was not as clear as the right. Moreover, a transverse scan from the left flank did not fully display the whole image of the left adrenal. The sizes of both adrenal images were somewhat smaller than those made by computerized tomography (CT), as shown in our previous study. Although the left adrenal in one case of congenital adrenogenital syndrome and those in three cases of Cushing's disease could not be delineated, all of the enlarged right adrenals in these cases were demonstrated by ultrasonic scanning (US). These results suggest the clinical usefulness of US for the detection of affected, nontumorous right adrenals. PMID- 3526683 TI - Tissue characterization from ultrasound B-scan data. AB - An approach to ultrasonic tissue characterization, using textural features of the B-scan image, is described. Portions of a B-scan image, 64 X 64 pixels spatially by 8 bits deep, are acquired from regions of interest and subjected to computer analysis. A systematic approach to defining a set of 93 textural features of a B scan is described and methods and criteria for selecting optimum combinations of these are discussed. As a test of its power, the approach has been applied to the discrimination between the B-scan textures corresponding to livers and spleens of normal humans and various measures of "success" have been quantified both on a "training set only" and on a "training set plus test set" basis. The overall test probability of success of 82% on a single image and 94% on a subject yielding multiple images indicates the potential of the techniques for conditions where a subtle but uniform change in parenchymal texture may be present. PMID- 3526684 TI - Bibliography of biomedical ultrasound. No. 53. PMID- 3526685 TI - Real-time ultrasound evaluation of renal transplant failure during the early postoperative period. AB - In a prospective clinical trial 385 ultrasound (US) examinations were performed on 50 renal allograft patients. Baseline sonograms were obtained within 24 hrs of transplantation, and serial US examinations were performed in two to three days intervals during hospital recovery. 24 out of 28 cases of acute rejections (85.7%) were detected by US with an 8% false positive rate. Using statistical analysis, enlarged and sonolucent pyramids, areas of decreased parenchymal echogenicity and an increase in anterior-posterior diameter of the organ, proved to be the best US-rejection criteria. Fine needle aspiration cytology revealed a high rate of false positive rejection diagnosis (23.8%). The results demonstrate that US is a valuable diagnostic aid in the evaluation of postoperative renal transplant failure. PMID- 3526686 TI - [Monoclonal antibodies. Production and clinical use]. PMID- 3526687 TI - Dialysis and transplantation: problems for the future. PMID- 3526688 TI - The last of the fifty--a time of change. PMID- 3526689 TI - Andrew Malcolm and CD Purdon. Pioneers of occupational medicine in Belfast. PMID- 3526690 TI - Malone Place Hospital (1860-1981) (the Belfast Midnight Mission). PMID- 3526691 TI - Malaria in Northern Ireland. AB - The clinical features, parasitology and prophylactic history of 67 patients who imported malaria to Northern Ireland between 1974 and 1983 are reported. P. falciparum infections were encountered more frequently than anticipated from current United Kingdom experience. The clinical implications of these findings are discussed. PMID- 3526692 TI - [Clinico-immunomorphologic parallels in kidney allotransplantation]. PMID- 3526693 TI - [Combined injuries of the abdominal organs with ureteral damage]. PMID- 3526694 TI - [Significance and problems of Chlamydia detection in urologic patients]. AB - Chlamydiae represent the aetiological agent in non-gonococcal urethritis in about 50% of the cases, but it is also increasingly recognized that Chlamydia trachomatis can cause prostatitis or epididymitis. The introduction of methods for the direct detection of chlamydia in clinical materials allows early diagnosis and therefore effective antibiotic therapy. The new tests however give both false positive and false negative results. PMID- 3526695 TI - Testicular torsion after orchiopexy with nonabsorbable sutures. AB - Testicular torsion occurring three years after bilateral orchiopexy is described. The antecedent orchiopexy was accomplished using 2-0 proline sutures and transseptal fixation of the contralateral testicle. A history of bilateral orchiopexy should not interfere with diagnosing torsion in the acute scrotum. Doppler ultrasound and nuclear imaging scan are auxiliary tools that should be used when available, but should not preclude expeditious surgical treatment of suspected torsion. PMID- 3526696 TI - Forces for change. PMID- 3526697 TI - Distinguished physician award presented to Francis A.L. Mathewson, M.D., former Medical Director, Great-West Life Assurance Company, Winnipeg, Manitoba, Canada. PMID- 3526698 TI - Clinical trial of parvaquone for the treatment of East Coast fever in Kenya. PMID- 3526699 TI - A farm investigation into swayback in a herd of goats and the result of administration of copper needles. AB - Clinical, biochemical and pathological findings led to a diagnosis of swayback in a herd of goats. Trace element values in soil, pasture and supplementary feed were measured, and copper oxide needles administered to the adult goats. This form of treatment had a more limited effect in these goats than is reported in sheep. PMID- 3526700 TI - Use of a new and rapid milk progesterone assay to monitor reproductive activity in the cow. AB - A new and rapid enzyme-amplified immunoassay (AELIA) has been developed for the measurement of progesterone in milk. The AELIA system is a non-isotopic method that gives results within 35 minutes. Milk progesterone concentrations measured in 10 cows sampled daily at various stages of the reproductive cycle were very similar to those recorded by a validated radioimmunoassay. The results show that the speed and sensitivity of the AELIA system would make it possible to diagnose pregnancy rapidly at about 24 days after insemination, to predict the onset of behavioural oestrus from decreasing progesterone values during the third week after a preceding oestrus, and to obtain a daily record of milk progesterone levels in animals treated for infertility of ovarian origin. PMID- 3526701 TI - Teat factors in E coli mastitis. PMID- 3526702 TI - Pulmonary lesions and Mycobacterium bovis excretion from the respiratory tract of tuberculin reacting cattle. AB - Although it is generally recognised that tuberculous lesions are present in lymph nodes associated with the respiratory tract in approximately 90 per cent of reactors with confirmed infection, lung lesions are found in only 1 to 2 per cent of such cases during abattoir examination. When lung lesions are not detected, it has been claimed that such cattle are non-excretors and thus unimportant in the epidemiology of the disease. In this study the lungs of 55 reactor cattle were sliced into sections approximately 0.5 cm thick. Tuberculous lesions were evident in over 70 per cent of lungs from reactors with concurrent lesions in lymph nodes of the respiratory system. Further, M bovis was isolated from single samples of nasal and, or, tracheal mucus taken at slaughter in 19 per cent of confirmed cases. Several of these reactors had a clear tuberculin test less than six months previously indicating recent infection. This study confirms the continued importance of the infected bovine in the epidemiology and current eradication of bovine tuberculosis. It is suggested that all tuberculous cattle with lesions in respiratory lymph nodes, rather than being regarded as non-excretors, should be considered as possible excretors and thus important sources of infection for other cattle both within and between herds. PMID- 3526703 TI - Colonization antigens, antibiotic resistance and plasmid content of enterotoxigenic Escherichia coli isolated from piglets with diarrhoea in Galicia (north-western Spain). AB - Escherichia coli colonies isolated from 50 diarrhoeic and 29 healthy piglets were investigated for several properties related to pathogenicity, such as production of heat-labile (LT) and heat-stable (STa) enterotoxins, presence of K88 and K99 colonization antigens, mannose-resistant haemagglutinating activity (MRHA), beta haemolysis and antibiotic resistance. The objective was to establish the toxic and adhesive abilities of E. coli strains that cause porcine diarrhoea in Galician farms. Fifty-seven colonies from 14 diarrhoeic piglets formed STa, while no STa+ colony was detected from healthy piglets. Thirty-four of the 57 STa+ colonies were resistant to gentamicin. Sixteen representative STa+ strains isolated from the 14 infected piglets were serotyped, investigated for plasmid content and examined by electron microscopy. Of these STa+ strains, 15 belonged to serotype 0141:K85ab and carried on their surface the fimbrial antigen P987. The remaining representative STa+ strain belonged to serotype 0101:K30 and was K99+, being the only STa+ strain with MRHA activity. All 15 STa+ P987+ strains possessed a similar plasmid pattern, with three plasmids ranging in molecular weight from 33 X 10(6) to 74 X 10(6); nine of the gentamicin-resistant strains possessed an additional plasmid of molecular weight 16 X 10(6), which was absent in the six gentamicin-sensitive strains. Strains producing LT or K88 antigen were not detected. Forty-one MRHA+ colonies were isolated at similar rates from both diarrhoeic and healthy piglets. Twelve of the 19 non-enterotoxigenic MRHA+ strains of which the O-group was established, belonged to serogroups (01, 02, 07, 08, 09 and 075) typical of the human E. coli strains that cause extraintestinal infections. Finally, a statistically significant association between haemolytic and MRHA activities in porcine E. coli was found. In conclusion, it was found that STa+ E. coli strains belonging to serotype 0141:K85ab:P987 are associated with porcine diarrhoea in Galicia. Additionally, no correlation between the isolation of non-ETEC MRHA+ strains and diarrhoea was observed. PMID- 3526704 TI - Bovine leptospirosis: experimental serovar hardjo infection. AB - Almost the full range of clinical signs observed in pregnant cattle naturally infected with Leptospira interrogans serovar hardjo was observed in this experimental study in which 22 heifers were infected by intraplacentome inoculation with serovar hardjo strains. These features included abortion, mummification, stillbirth, premature and term birth of weak calves and full-term birth of live apparently healthy calves. Leptospires were demonstrated in all but three calves by culture and or immunofluorescence. PMID- 3526705 TI - The role of vibrissae in behavior: a status review. AB - Vibrissae or tactile hairs are an important part of the tactile sensory apparatus of many mammals. A wide range of suggested functions found in the literature include food acquisition, prey attack, aggression and attack behavior, facial expression in intraspecies communications, dispersion of pheromones, maintaining head position in swimming, and a wide range of environmental monitoring (e.g., current detection in water, wind direction on land). There is little work done specifically on domestic animals or their feral relatives. Work on the tactile senses in general and vibrissae in particular is an open field of study. A set of general questions for study of vibrissa function in domestic animals is presented. PMID- 3526707 TI - [Isolation of Escherichia coli O 157 from pigs with diarrhea]. AB - Biochemical and serologic studies were carried out with Escherichia coli strains isolated from pigs affected with diarrhea. A total of 161 were investigated, 13 (8.01 per cent) of which were found to belong to serogroup O 157. Almost all strains proved beta-hemolytic, enterotoxigenic, and K 88-positive. The strains of this serogroup were found for the first time in this country in swine colibacteriosis. PMID- 3526708 TI - Expression of reovirus p14 in bacteria and identification in the cytoplasm of infected mouse L cells. AB - Reovirus genome segment S1 is transcribed by the virion-associated polymerase to form a single mRNA species that codes for two polypeptides: the 49-kDa cell attachment protein, sigma 1, starting from the first A-U-G in the S1 transcript, and a 14-kDa nonstructural, basic protein initiated from the second A-U-G in a different reading frame (Ernst and Shatkin, 1985; Jacobs et al., 1985; Shatkin, 1985). To confirm that p14 is made in reovirus-infected cells, determine its intracellular location, and generate sufficient amounts of the polypeptide to begin an analysis of its presumptive role in the virus life cycle, the p14 coding sequence of an S1 cDNA clone was subcloned into the EcoRI site downstream of the lambda PL promoter in the bacterial expression vector, pEV-vrf1. The vector was modified to align the ribosome binding site with the p14 initiator codon, and transcription was placed under control of lambda cIts in a compatible plasmid. Transformed Escherichia coli RRI incubated at 42 degrees produced a new polypeptide of approximately 14 kDa as determined by SDS-PAGE. This polypeptide reacted specifically with rabbit antisera made against synthetic peptides corresponding to exposed regions of authentic p14 as predicted from the S1 cDNA sequence. Antipeptide sera also precipitated a approximately 14-kDa polypeptide in lysates of reovirus-infected mouse L cells, demonstrating the synthesis of p14 in vivo. Immunofluorescence experiments indicate that p14 accumulates in the cytoplasm of infected L cells. PMID- 3526706 TI - Characterisation of an antiserum and development of an ELISA for glutathione peroxidase. AB - Sheep red blood cells were fractionated by ion exchange and gel filtration chromatography to yield glutathione peroxidase approximately 99% pure. An antiserum against glutathione peroxidase was raised in the rabbit. The antiserum has been shown to cross-react with both bovine and human glutathione peroxidase by double diffusion. An enzyme linked immunosorbent assay has been developed for glutathione peroxidase which detected 6.15 X 10(-5) IU of the enzyme. The antiserum has also been shown to be effective in the detection of glutathione peroxidase immobolised on strips of nitrocellulose, subsequent to sodium dodecyl sulphate polyacrylamide gel electrophoresis, by second antibody conjugate. Avidin biotin was also used to detect nitrocellulose immobolised enzyme. These techniques provide an alternative highly sensitive and specific means of assaying glutathione peroxidase which is not dependent on the lability of enzymatic activity nor the chemical specificity of the assay. PMID- 3526710 TI - The nucleotide sequence of the polyhedrin gene region from the multicapsid baculovirus of Orgyia pseudotsugata. AB - The nucleotide sequence was determined of a 1.6-kb restriction fragment containing the polyhedrin gene of the multicapsid nuclear polyhedrosis virus of Orgyia pseudotsugata (OpMNPV). In addition, both the 5' and 3' termini of the polyhedrin mRNA were located in the flanking sequences using S1 mapping procedures. 5' Leader, 3' flanking, and open reading frame sequences of 50-52, 145-167, and 735 nucleotides, respectively, were determined, for a total mRNA length of about 935 nucleotides. A potential 5' regulatory sequence which included the mRNA initiation site was identified and an open reading frame upstream of the polyhedrin gene was located. In addition to the polyhedrin mRNA, two major transcripts upstream of the polyhedrin gene were identified by transcriptional mapping. PMID- 3526709 TI - Nucleotide sequencing and transcriptional mapping of the Orgyia pseudotsugata multicapsid nuclear polyhedrosis virus p10 gene. AB - A 32P-labeled cloned DNA fragment (AcMNPV HindIII-Q) containing one of the repeated sequences and a portion of the p10 gene from Autographa californica multicapsid nuclear polyhedrosis virus (AcMNPV) was used to probe Southern blots containing restriction endonuclease digests of Orgyia pseudotsugata muticapsid nuclear polyhedrosis virus (OpMNPV) DNA. A single 3.6-kb fragment, OpMNPV HindIII Q, was hybridized. The OpMNPV HindIII-Q fragment was cloned into pUC-18, mapped with restriction endonucleases, and reprobed with the AcMNPV HindIII-Q fragment. A small region of ca. 700 bp, near the left end of the cloned fragment, was cross hybridized. DNA sequencing in this region revealed an open reading frame of 279 bp which shares detectable homology with the p10 gene of AcMNPV. The sequences downstream from the p10 gene in both viruses also contain long open reading frames which share homology. Northern blot analysis of RNA from OpMNPV infected O. leucostigma cells was used to define the temporal and spatial organization of transcripts from this region. S1 analysis of both termini of the major p10 mRNA indicates nontranslated regions of 52-53 bases at the 5' end and 175 bases at the 3' end. The 5'-mRNA start site was located within a 12-nucleotide sequence which is conserved in all late hyperexpressed baculovirus genes. PMID- 3526711 TI - [Biological values of preserved human fetal liver cells to be used for transplantation]. PMID- 3526713 TI - [The significance of doppler sonography in the diagnosis of extracranial occlusive disease of the carotid arteries]. PMID- 3526712 TI - [Personal experience with the administration of sulfinpyrazone to patients with kidney failure]. PMID- 3526714 TI - [Various problems in organizing the medico-chemical protection of the troops during World War II (from the experience of the work of an army toxicologist)]. PMID- 3526715 TI - [Role of the Central Military Medical Commission in improving military medical examinations during World War II]. PMID- 3526716 TI - [A prominent surgeon (80th anniversary of the birth of A. A. Vishnevskii)]. PMID- 3526717 TI - [Creation and use of medical supply inventories in the prewar years and during World War II]. PMID- 3526718 TI - [Study of phenotypic characteristics, the R and Ent plasmids of enterotoxigenic Escherichia coli]. PMID- 3526719 TI - [The first Soviet laboratory of experimental cancer therapy (40th anniversary of the creation of the laboratory)]. PMID- 3526721 TI - [Carcinogenic activity of various naturally occurring hydrazine derivatives]. PMID- 3526720 TI - [Stimulation of the immunological reactivity of cancer patients by Eleutherococcus extract]. AB - In vitro treatment of lymphocytes with eleutherococcal preparation produced an immune-boosting effect both in cancer patients and healthy controls. The results of a randomized study pointed to eleutherococcus' capability of stimulating general non-specific resistance and immunologic vigor in the course of cytostatic and radiation treatment for breast cancer. Since eleutherococcus is free of toxicity and allergenicity in prolonged treatment, it is indicated in patients receiving intensive antitumor therapy. Drug concentration should be tailored individually. PMID- 3526722 TI - [Morphology and histological classification of heart neoplasms]. PMID- 3526723 TI - [Content, antioxidant activity and stability of tocopherols in dietary lipids]. PMID- 3526724 TI - [Nutrition and allergic reactivity]. PMID- 3526725 TI - Current issues in neonatal transfusions. AB - Two controversial issues of neonatal transfusion practices, erythrocyte 'booster' transfusions and granulocyte transfusions, are critically reviewed, and current recommendations for transfusion practices are made. Infants should receive erythrocyte transfusions to treat congestive heart failure caused primarily by anemia. It is customary to maintain the hematocrit at greater than 40% in neonates with severe respiratory disease, although the efficacy of this practice has not been firmly established. Erythrocyte transfusions seem to be indicated for infants with anemia plus recurrent apnea, poor weight gain or the syndrome of tachycardia, tachypnea, dyspnea and poor feeding for which no other cause can be found. Granulocyte transfusions are likely to benefit seriously ill neonates exhibiting all three of the following: strong evidence of bacterial sepsis, neutropenia (compared to age-related normal values) and a diminished marrow neutrophil storage pool. Granulocyte transfusions for septic infants expressing only one or two of these features should be considered to be experimental therapy. PMID- 3526726 TI - Intravenous immunoglobulins: pharmacological aspects and therapeutic use. AB - The requirements for a present-day IVIG preparation are outlined. These are mainly: fully preserved activities of the recognition and effector functions of the IgG molecule, a normal subclass distribution, and a normal half-life after infusion. The therapeutic uses of IVIG preparations are discussed as follows: Antibody substitution in cases of generalized or partial antibody deficiency in immune-compromised patients. These include the following diseases: hypogammaglobulinemia (congenital and acquired, including the neonates); drug induced and viral immunosuppression. Antibody substitution in cases of selective antibody deficiency in otherwise immune-competent patients. These include acute cases of consumptive antibody deficiencies of the Jarisch-Herxheimer reaction type; in particular, chronic inflammations which apparently involve ineffective immune responses in which the organism is unable to build up sufficient amounts of antibodies with the required partial specificity, which is indispensable for overcoming the disease. Modulation of the immune system by Ig-Ig interactions (mainly idiotype-anti-idiotype interactions) and Ig-Fc-receptor interactions, as it is known from the RES blockade during IVIG treatment of idiopathic thrombocytopenic purpura. PMID- 3526727 TI - Genetic polymorphism of the seventh component of complement: a new variant. AB - Genetic polymorphism of the seventh component of complement (C7) was studied by the methods of agarose gel isoelectric focusing and immunoblotting. Serum or plasma samples were treated with neuraminidase prior to isoelectric focusing. A cathodal variant, named C7 5, was recognized in the treated samples. Family study indicates that the C7 5 component is genetically determined. The allele frequencies calculated from 183 healthy Japanese individuals were C7*1 = 0.809, C7*2 = 0.104, C7*4 = 0.038, and C7*5 = 0.049. An association between C7 and C6 alleles was not found. PMID- 3526728 TI - [Jules Rene Guerin--on the 100th anniversary of his death]. PMID- 3526730 TI - Ob/gyn on the rise: the evolution of professional ideology in the twentieth century--Part I. AB - Medical practice is based upon a combination of knowledge, skill, and belief. This paper traces the development of the belief system or ideology in obstetrics and gynecology from 1920 to the present. Using Presidential addresses and other important articles from the two most prestigious obstetrics and gynecology journals, we look at what these doctors say about themselves and about women. The first period, from 1920-1944, marks the formal alliance of obstetrics and gynecology in the United States and the formation of its ideology. Part II of this article, to be published in the next issue, will begin with the expansive War and post-War years and extend to 1980 when obstetrics and gynecology finds itself under attack from all sides. PMID- 3526729 TI - [Campylobacter-like bacteria (C. pylori) in the healthy stomach?]. AB - Some authors recently published reports on the findings of unidentified S-shaped spiral bacteria, so called "Campylobacter pylori", in the gastric epithelium and the significant connection between these strains and gastric diseases. 24 fasting gastric juice samples of young healthy volunteers were now analysed bacteriologically using the campylobacter isolation techniques. RESULTS: It was not possible to find the so called "C. pylori" in the healthy stomach. PMID- 3526731 TI - [Therapy of pemphigus and pemphigoid]. AB - Severe cases of pemphigus vulgaris should be treated with prednisone in high dosage (180-360 mg daily). In milder cases, we prefer the combined therapy with prednisone 40 mg every other day and an immunosuppressive drug, i.e. azathioprin, cyclophosphamide, or methotrexate. For treatment of bullous pemphigoid, the combined therapy is usually sufficient. PMID- 3526732 TI - [Intravenous DSA of the heart: functional studies of the left ventricle in coronary heart disease at rest and following stress]. AB - Intravenous digital subtraction angiography (i.v. DSA) of the heart is performed for demonstration of the morphologic and functional peculiarities of the left heart chamber, especially the ejection fraction and regional wall motion abnormalities. Employment of both geometric and video densitometric computation techniques resulted in a good correlation with direct ventriculography (r = 0.945), video densitometry, however, with a tendency to values up to 10% higher. Comparative DSA studies during rest and following exercise in 25 patients with coronary heart disease were suitable to discover pathologic strain reactions of the myocardium in 4 cases, typically depending on angiographic findings of the coronary arteries. In this way a simple method for better estimation of a deficit in coronary blood supply and its functional impact on myocardial performance may become useful. PMID- 3526733 TI - [Effect of captopril in chronic aortic insufficiency]. AB - In 16 patients with chronic aortic regurgitation, we studied the acute hormonal and hemodynamic effects of 12.5 to 25 mg captopril; in 12 patients the changes after a 4 to 8 week treatment period (mean 6.3 +/- 2 weeks; doses: 3 times 12.5 to 3 times 25 mg/day) were investigated. The following baseline variables were evaluated: the radionuclide left ventricular ejection fraction (EF) at rest and during exercise, left ventricular end-diastolic volume (EDV), regurgitant blood volume (RBV); and plasma renin activity (PRA). Repeated determinations of EF, EDV and RPA were carried out 90 minutes after application of the drug. In patients with chronic therapy, EF at rest and during exercise, EDV, RBV and PRA were reinvestigated at the end of the study. Acute administration of captopril was followed by an increase of EF (from 49 +/- 12 to 55 +/- 12%, p less than 0.001) and a slight decrease of EDV (from 389 +/- 160 to 376 +/- 146 ml, p less than 0.05). PRA significantly increased (from 1.6 to 3.1 ng/ml/h, p less than 0.05). Chronic therapy resulted in a moderate decrease of systolic and diastolic blood pressure (from 156/70 +/- 31/15 to 140/63 +/- 23/15 mm Hg, p less than 0.01). However, no significant changes were observed in EF at rest and during exercise (51 +/- 9 vs. 53 +/- 10% and 45 +/- 14 vs. 47 +/- 14%), EDV (433 +/- 179 vs. 422 +/- 179 ml) and RBV (136 +/- 81 vs. 129 +/- 77 ml). PRA was significantly increased (6.3 ng/ml/h, p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3526735 TI - [Sex differences in child skeletons. Current knowledge and diagnostic significance]. PMID- 3526734 TI - [The diameter of arterial and venous abdominal vessels during acute and chronic administration of nitrates. A sonographic study]. AB - Fourteen male patients with coronary heart disease were randomly assigned to treatment periods with isosorbide dinitrate (ISDN) 120 mg/day (6 X 20 mg) and placebo for 4 weeks each, according to a double-blind protocol with intraindividual cross-over. The luminal diameters of the superior mesenteric artery, the hepatic artery, the superior mesenteric vein and the portal vein were determined sonographically in the supine position on days 1, 14 and 28 of both treatment periods 90 min after drug intake. The measurements were repeated after 1.6 mg sublingual nitroglycerin. On day 1 of drug intake the vessel diameters increased significantly after ISDN as compared to placebo: superior mesenteric artery: +11%; hepatic artery: +26%; superior mesenteric vein: +17%; portal vein: +11% (p less than 0.05). No differences in luminal diameters between both drug regimens were found on days 14 and 28. Additional nitroglycerin caused a marked diameter increase during the placebo period (14-21%; p less than 0.001) and on days 14 and 28 of ISDN therapy, while the drug effects were absent after maximal ISDN-induced vasodilatation on day 1. Thus, nitroglycerin and isosorbide dinitrate administered acutely caused a comparable vasodilatation of arterial and venous vessels in the splanchnic region. During sustained therapy with isosorbide dinitrate the vasodilatory effects of the drug were lost. It is supposed that a decrease of blood pooling in the splanchnic region occurs during sustained ISDN therapy. Despite this tolerance development to the circulatory effects of isosorbide dinitrate, nitroglycerin remained effective with regard to arterial and venous vasodilatation. PMID- 3526736 TI - [Happy 100-year anniversary for Midwifery Association]. PMID- 3526737 TI - ["Don't tear down Konradsberg". Interview by Viveka Holmertz]. PMID- 3526738 TI - [Innovations in ultrasound require reliable education. Interview by Anita Widen]. PMID- 3526739 TI - Surgical treatment of congenital fronto-orbitomalar asymmetries. AB - Congenital fronto-orbital asymmetries can be of various origin. Correction of these malformations, whether due to maldevelopment of the foetus or to a congenital tumour, generally require a combined intracranial and extracranial approach. In recent years, a working group of plastic surgeons and neurosurgeons in the French-speaking part of Switzerland have been particularly interested in these problems. Some of their results are presented here. PMID- 3526740 TI - [Ureterocystoneostomy using the psoas hitch technic--outside variant]. AB - This paper presents the "outside" variant of the standard psoas hitch procedure. Two basic principles of the procedure are: lateralisation and fixation of the bladder at the psoas muscle; the long and straight reimplantation of the ureter on the posterior, lateral or anterolateral bladder wall using the extravesical approach. The main indications were the extensive changes of the ureter in case of neurogenic bladder dysfunction and the reduced bladder capacity with the changes of the mucous membrane. The procedure was also applied in those cases where the standard procedure would have been indicated. The advantages and disadvantages of the procedure in relation to the standard psoas hitch procedure are discussed. During 1982 to 1985 this procedure was applied in 67 cases. The age ranged from 2 months to 14 years. With 9 patients the operation was performed bilaterally. The time interval between the operations was from 3 to 6 months. Tailoring of the ureter was undertaken in 3 cases. The complications were: One ureter stenosis that was solved by means of the same technique, and three parahiatal diverticula formations without clinical manifestations. PMID- 3526741 TI - The clinical applications of demineralised bone powder (DBP)-induced osteoneogenesis. AB - New bone tissue can be induced anywhere in the animal organism, i.e. even at a site distant from actual bone, by the implantation of demineralised bone powder (DBP). Basic implantation experiments were first carried out and tested in the rat (Bettex-Galland 1985). The results led us to use the experience gained to treat four patients with bone defects with DBP (one bone cyst, and 3 chronic skull defects). The DBP used was prepared aseptically from fresh cadaver bone. The results were assessed by means of x-ray films and/or CT-scan, and the preliminary evaluation is encouraging. PMID- 3526742 TI - [Delivery planning and interdisciplinary management of large coccygeal teratomas]. AB - Prenatal sonographic screening and a growing experience of examiners with regard to possible congenital malformations such as large coccygeal teratomas have induced the request for an early interdisciplinary consultation between obstetrician, human geneticist, paediatric surgeon, neonatologist and psychologist. It should aim at a careful information and counselling of the parents with regard to the mode of delivery and possibilities of operative management. The prerequisites for far sighted planning and performance of delivery are demonstrated by the example of large coccygeal teratomas. The availability of equipment, facilities and manpower at the time of delivery guarantees a course of delivery at reduced risk and is, together with the psychological guidance of the parents, a basic element of optimal care for the newborn. PMID- 3526743 TI - [Hermann Emminghaus. Founder of scientific child and adolescent psychiatry]. AB - The discipline of child and adolescent psychiatry regards Hermann Emminghaus as one of those responsible for its becoming established as a separate branch of science. The monograph by Emminghaus entitled Die psychischen Storungen des Kindesalters (Mental Disorders of Childhood), which appeared in 1887 in the Handbuch der Kinderkrankheiten, was the first overview in German of the emotional problems occurring during this phase of life. It represents, in the words of the American child psychiatrist HARMS (1967), the "cradle of child psychiatry." In 1984, to commemorate this pioneer in our specialty, the Hermann Emminghaus Prize was established. It is to be awarded every two years in recognition of outstanding contributions to scientific research in child and adolescent psychiatry. PMID- 3526744 TI - [Cellular immunity in dialysis patients using the lymphocyte transformation test (LTT) in comparison to conservatively treated patients with chronic terminal renal failure]. AB - By means of the lymphocyte transformation test (LTT), using the mitogens phytohemagglutinin (PHA), concanavalin A (ConA), lipopolysaccharide (LPS) E. coli and the antigens tuberculin (PPD) and O-streptolysin, a contribution should be made for the judgment of the functional capacity of the immune system--in particular of the cellular immunity--in uraemia patients with and without dialysis therapy. In 33 patients with different duration of the dialysis (0.5 to 130 months) and 15 retention patients who were not yet treated by means of dialysis the LTT was controlled with stimulant agents mentioned above. In these cases was shown that dialysis patients managed metabolically regularly did not show a significant restriction of the cellular immunity in the LTT (PHA stimulation over 0.55 transformed cells, con-A-stimulation over 0.37 transformed cells). The not dialysed patients with chronic uraemia showed a distinct diminution of the unspecific T-cell transformation by PHA and ConA, whereas the antigen-induced stimulation (PPD, O-streptolysin) was not disturbed in this case as well. In the two cases the B-cell transformation (on LPS) was not significantly disturbed. There was a good concordance with the clinical findings: scarcely general infects, no shunt infections, relatively many organ losses by rejection after transplantation in the dialysis patients. The not yet dialysed retention patients revealed clinically a higher inclination to an infect. There were no own experiences about the course after transplantation without preceding dialysis. It is discussed in how far also immunological investigations may play a role in the establishment of the optimum management of the dialysis, the moment of the beginning with the dialysis and for the "more individual preparation of the transplantation". PMID- 3526745 TI - [Crusader's tomb contains only a tooth]. PMID- 3526746 TI - [Experiences in treatments using bonded bridges]. PMID- 3526747 TI - [Experimental diabetic neuropathy. Morphometric studies on the rat N. suralis in short-term streptozotocin-induced diabetes]. AB - Morphometric studies of sural nerves were performed in diabetic rats 35 or 44 d, respectively, after the administration of 60 mg/kg b.w. streptozotocin. Morphometry of photographed semithin sections was performed after whole-body glutaraldehyde perfusion both with the semiautomatic MOP Videoplan and the MOP AM 02 (Kontron, Munich, F.R.G.). The following parameters were registered: Area of nerves and fibers, perimeter of fibers, diameter of axons, thickness of myelin sheaths, form factor. No decrease of the total nerve area or of the myelinated area were found. Parameters area of fibers, thickness of myelin sheath and form factor decreased in diabetic animals. Axon diameter, ratio axon diameter-myelin sheath thickness and perimeter of fibers increased in the diabetic nerves. It is suggested that primary Schwann cell lesion is responsible for the observed myelin reduction. PMID- 3526748 TI - [Significance of a theoretical pathology for the scientific cognitive process in medicine]. AB - A critical examination of current trends in medicine demonstrates the need for a deepened theoretical foundation. Of particular importance is the development of theoretical pathology. The goals, methods and content of theoretical pathology are discussed and contrasted with those of general and special pathology. Although general pathology incorporates some elements of theoretical pathology, the latter is based on the theory of cognition rather than empirical science. Dialectic materialism is an essential element of this discipline. The development of theoretical pathology demands an interdisciplinary approach on the part of physicians, natural and social scientists and must be based on a broad concept of human disease. PMID- 3526749 TI - [Long-term results of dentures with various connector elements]. PMID- 3526750 TI - [Changes in the retentive bases of individually fabricated bonded brackets]. PMID- 3526751 TI - [The mantel cast--a method to improve the friction of superstructures in dental prosthetics]. PMID- 3526752 TI - [Ease in dental technical casting procedures with the use of dental prosthetic casting forceps (PAZ)]. PMID- 3526753 TI - [Echinococcosis of the liver. Its surgical treatment based on 178 personal cases]. AB - Reported in this paper are 178 patients who had received surgical treatment for echinococciasis of the liver, among them 144 at the Surgical Hospital of Madrid University, between 1962 and 1970, and another 34 at the Surgical Hospital of Granada University, between 1971 and 1982. All of them had been carriers of Echinococcus cysticus. Echinococciasis of the liver usually is not diagnosed until the hydatid cyst begins to cause conspicuous symptoms or complications on account of its own growth. Diagnostic clues are obtainable from laboratory findings (eosinophilia in excess of four per cent), immune reaction, complement fixation reaction according to Weinberg, and intracutaneous test according to Casoni. Diagnosis of the authors' cases had been preceded by scintiscanning. Surgical removal of echinococcus cysts from the liver calls for an undogmatic approach. From among all surgical methods applicable to cyst removal the authors have most frequently used closed marsupialisation, according to Posadas-Dew (65.8 per cent of all cases). Drainage marsupialisation was applied to 25.8 per cent of all cases. The postoperative lethality amounted to 2.3 per cent. Morbidity was low. PMID- 3526754 TI - [Diagnosis and surgical therapy of primary retroperitoneal tumors]. PMID- 3526755 TI - [Immunodiagnostic studies in ovarian cancer using the leukocyte adherence inhibition test (LAI test). 1. Detection of cellular sensitization of peripheral blood lymphocytes using the LAI test]. AB - 34 patients with histological assured ovarian cancer were investigated with the direct chamber LAI-assay according to Halliday and Miller. As antigens we used KCl-extracts of ovarian cancer, fetal tissue and four other tumor associated antigens, A sensitivity of lymphocytes to ovarian cancer antigens (OCA) and fetal antigens (FA) was detected in the malignant group with significant differences p less than 0.0005 to the control group. The accuracy for OCA was 86% respectively 82% for FA. The LAI-assay has additional value for diagnosing of ovarian cancer. Difficulties in interpreting the individual LAI-assays results as well as false positive tests in the control group are discussed. PMID- 3526756 TI - [Immunodiagnostic studies in ovarian cancer using the leukocyte adherence inhibition test (LAI test). 2. Preoperative studies and follow-up]. AB - Preoperative investigations in ovarian cancer have shown that early diagnostic or screening is impossible by means of the leucocyte adherence inhibition test (LAI test = LAI). However, this test is important for follow-up studies. The LAI can be an additional parameter for individual decision. It in the clinical supervision of patients has been shown that metastasizing and local recurrent tumors can be detected by this test approximately 4-8 weeks before clinical evidence. PMID- 3526757 TI - Isolation and characterization of a peptidase from an oral strain of Corynebacterium matruchotii. AB - From the cell extract of Corynebacterium matruchotii strain ATCC 14266, a peptidase could be isolated and purified, increasing the specific activity 267 times. This enzyme with a molecular weight of 60,000 was completely inactivated by heating at 50 degrees C for 20 min, its optimum pH was found to be pH 7.5 and the isoelectric point was 4.1. The peptidase was inhibited by diisopropylfluorophosphate, phenylmethanesulfonyl fluoride, tosyl-L-lysine chloromethyl ketone, chymostatin and urea. Among various synthetic substrates tested, only benzoyl-L-arginine-p-nitroanilide and benzoyl-L-arginine ethylester were found to be hydrolyzed by this enzyme. Several proteins investigated were not hydrolyzed, but the enzyme inactivated a peptidic staphylococcal bacteriocin. PMID- 3526758 TI - [Who discovered Campylobacter jejuni/coli? A review of hitherto disregarded literature]. AB - Non culturable spiral form bacteria were noted in 1886 by Theodor Escherich. He found them in stool specimens and large intestinal mucous associated with diarrhoea in neonates as well as in kittens. In the following years till the end of the century a number of mainly german language publications appeared, describing the occurrence of such "spirilla" in cases of "cholera-like" and "dysenteric" disease. These organisms were found mainly in the colon or associated with mucous in diarrheal stool specimens. Growth on solid medium was unsuccessful, although living bacteria could be kept in liquid culture medium for a few days. The following points suggest that the microorganisms described were probably Campylobacter ssp: typical morphology association with enteritis in neonates, infants and kittens failure to grow on solid medium despite microscopic detection and the fact that to date no other bacteria with comparable morphology have been associated with human enteric infections. PMID- 3526759 TI - [Automated technics in microbiological diagnosis compared with conventional methods]. AB - Two different tools for automation in medical microbiological diagnosis were tested. The results of biochemical identification of bacteria and antimicrobial susceptibility testing were compared with conventional methods--biochemical identification with Minitek and API 20 E and susceptibility testing wih the nutrient agar diffusion test. Sceptor from Becton Dickinson is usable because of a good accordance with conventional methods and the good quality of the associated computer program (different types of statistical evaluation). The 'fully automated' MS 2 from Abbott has more limitations and is more expensive in material, but is able to give a diagnosis in few hours, if a pure culture is available. Differences to conventional methods are greater. PMID- 3526760 TI - Proteus penneri showing a green colour reaction with Kovacs' indole reagent. AB - All 33 investigated strains of Proteus penneri gave a green colour reaction with Kovacs' indole reagent after an incubation of about three days at 36 degrees C. Furthermore, 26% of the 51 strains of Proteus mirabilis studied also showed the green colour reaction but somewhat more weakly. The initial compound of this reaction seems to be a product of tryptophan metabolism which is formed only under aerobic conditions. PMID- 3526761 TI - Determination of asymptomatic carrier rate of beta-haemolytic group B Streptococcus in vaginas of pregnant women in Ibadan, Nigeria. AB - Bacteriological studies of 500 vaginal swabs from pregnant women in second and third trimester from 4 government hospitals in Ibadan showed that 8 (1.6 per cent) were found to be culture-positive for Group B Streptococcus. Five (1.0 per cent) were found to harbour group D streptococci. All the 8 group B Streptococcus isolates were sensitive to erythromycin, methicillin, penicillin G, ampicillin and chloramphenicol in decreasing order. They were resistant to tetracycline, sulphafurazole and streptomycin. PMID- 3526762 TI - Commemoration of the publication 100 years ago of the papers by Dr. Th. Escherich in which are described for the first time the organisms that bear his name. AB - The centenary of the publication by Dr. Th. Escherich of his papers on the colonization of the intestines of neonates by bacteria is commemorated. His papers are reviewed and discussed from the point of view of current knowledge. The organisms described by him as Bacterium coli commune and now known as Escherichia coli are particularly discussed and their role as enteropathogens assessed. Current work on these organisms is contrasted with studies on them over the last 100 years. PMID- 3526763 TI - Characterization of hemolytic strains of Escherichia coli belonging to classical enteropathogenic O-serogroups. AB - 147 isolates of enteropathogenic E. coli (EPEC) belonging to eleven different O serogroups were examined for hemolysin-synthesis. Hemolysin-producing (Hly+) strains were found at high frequency in O-serogroups 26 and 114 and at low frequency in O-serogroup 126. The hemolytic activities of EPEC strains of different serogroups were found to be low when compared to Hly+ non-EPEC E. coli strains of different origins. Similarities between the hly determinants of EPEC strains and the hly region of an uropathogenic strain were detected by DNA hybridization. By this method hly genes of EPEC strains belonging to O-serogroups 114 and 126 were localized on the bacterial chromosome. The hly determinants of O26 strains were localized on 100 +/- 5 MD size conjugative plasmids. The hly plasmid pEO5 of the O26 strain C4115 was transferred by conjugation into an E. coli K12 recipient and found to be stable inherited. The hemolytic activity of the transconjugant was comparable to the wildtype O26 donor. The plasmid pEO5 was found to be different in size, compatibility and hemolysin expression from a number of described hemolysin-plasmids. PMID- 3526764 TI - Prevalence of Pneumocystis carinii in wild rodents in Japan. AB - During the period from November 1980 to April 1984, 292 small wild rodents were captured in 6 localities in Japan. Eleven out of 142 Apodemus speciosus, 1 out of 11 A. argenteus, 4 out of 40 Microtus montebelli and 2 out of 3 Mus musculus were positive for Pneumocystis carinii. The intensity of infection was generally low and the infection rate did not show any significant difference between sexes of the host animals. The seasonal prevalence of infection in A. speciosus was not remarkable, but was somewhat higher in winter to spring than in summer to autumn. Also, the infection rate in A. speciosus was higher in relatively heavy body weights than in the lighter or the heaviest weight groups. This is the first report of P. carinii infection in wild rodents in Japan. We propose A. speciosus, A. argenteus and M. montebelli as the new natural hosts for P. carinii. No morphological difference was found between P. carinii in wild rodents, in rats and in man as far as the present light microscopic examination is concerned. PMID- 3526765 TI - [The problem of catharsis in the scientific legacy of N. Krestnikov]. PMID- 3526766 TI - [Psychiatric aspect of the study of comatose states in craniocerebral injuries (review)]. PMID- 3526767 TI - [Traumatic cerebral arachnoiditis: various features of its development (review of the literature)]. PMID- 3526768 TI - [Spinal endoscopy]. PMID- 3526769 TI - [Carotid body tumor. Presentation of a familial case]. AB - Report of a bilateral carotid body tumor in a female. Six members of her family also present the same disease. Epidemiology and surgical tactics are discussed. Special attention is focused on the pathogenetic mechanisms. PMID- 3526770 TI - [Sacral chordoma, a rare tumor]. AB - One case of chordoma is described. A review of literature shows that this condition is rare. This malignant tumor grows slowly. The symptoms owing to the surrounding structures compression appear insidiously. Standard radiography, tomography, echography and computed tomography are an aid to diagnosis confirmed by biopsy. Surgical removal of the tumor is the primary modality of treatment. Surgical resection is carried out using a combined abdominal and trans-sacral approach. Complete tumoral resection is limited by preservation of sacral stability and urinary and fecal continence. Many patients are referred for radiation therapy after subtotal resection. Local recurrence is frequent. Metastasis is rare. 90 per cent of patients are dead in ten years. PMID- 3526771 TI - [40 years' of the Orthopedic Clinic of Palacky University in Olomouc]. PMID- 3526772 TI - [Total hip joint endoprosthesis and reconstruction of the acetabulum using a bone graft]. PMID- 3526773 TI - Antibiotics in acute abdominal surgery. A clinical trial comparing the combination of ampicillin, mecillinam and metronidazole with cefoxitin alone. AB - 168 patients undergoing acute abdominal surgery for suspected peritoneal contamination were randomized consecutively to receive either a combination of ampicillin, mecillinam and metronidazole (group I) or cefoxitin (group II). Seventy-nine patients were evaluable in group I and 69 in group II. Postoperative surgical infections were seen in a total of 17 patients, 6 in group I (7.6%) and 11 in group II (15.9%). Evaluation of potential resistance development, side effects and a trend towards better efficacy, together with a positive cost benefit analysis, have led us to adopt the combination of ampicillin, mecillinam and metronidazole as the standard treatment in cases of acute abdominal surgery. In the 18 months following the conclusion of the study, 263 patients undergoing acute abdominal surgery were treated with the triple combination. The infection rate in this material was 4.6%. PMID- 3526774 TI - Surgical strategy in thyroid carcinoma: a clinical review. PMID- 3526776 TI - George L. Wied, 65. PMID- 3526775 TI - The low T3 state. An experimental study. PMID- 3526777 TI - Multiple myeloma. The diagnostic role and prognostic significance of exfoliative cytology. AB - The clinical significance and diverse cytomorphologic spectrum of exfoliative cytology in multiple myeloma are presented from our 20-year retrospective and continuing prospective studies and from an extensive review of the literature. Of 370 myeloma patients studied retrospectively, 126 had at least one exfoliative cytologic specimen but only 6 had one or more specimens positive for myeloma. These included six pleural and two ascitic fluids and one sputum. In Papanicolaou stained smears, myeoloma cells varied from essentially normal-appearing plasma cells to dispersed large malignant cells with little or no plasmacytoid features. Whereas all 203 cervical or vaginal, cerebrospinal, urine and bronchial specimens were negative for myeloma, 40% and 50% of the pleural and ascitic fluids, respectively, were positive. Four prospectively studied patients produced a total of seven positive serous fluid specimens. Follow-up data was available for eight patients with cytology positive for myeoloma. Six were dead within three months of the first positive specimen. PMID- 3526778 TI - Cystoscopic biopsy supernate. A new cytologic approach for diagnosing urothelial carcinoma in situ. AB - The examination of cystoscopic biopsy supernates is a new cytologic procedure that can aid the urologist in the differential diagnosis of urothelial carcinoma in situ (CIS) and cystitis. Within the past two years, the Cytodiagnostic Urinalysis Laboratory has received 79 cystoscopic biopsy supernate specimens from 29 patients; these were prepared using a membrane filtration technique and stained with a modified Papanicolaou method. Positive diagnoses were rendered on 17 (21.5%) specimens, including 7 (41%) CIS and 10 (59%) papillary neoplasms. An 87% cytohistologic correlation was seen. Of the 17 cases with biopsy specimens that were denuded and thus nondiagnostic, 11 had negative supernate cytologies and 6 had positive cytologic diagnoses. Half of these positive specimens were diagnosed as CIS. Because urothelial CIS is often a friable lesion that yields denuded bladder biopsies, the cytologic examination of cystoscopic biopsy supernates offers a valuable adjunctive method for diagnosing urothelial CIS on otherwise lost cellular material. PMID- 3526779 TI - Actinomyces in cervical smears of women using intrauterine contraceptive devices. AB - Cervical smears from 1,784 women who attended the family planning clinics of the Institute for Research in Reproduction were examined for the presence of Actinomyces-like organisms. Among 815 intrauterine contraceptive device (IUD) users, the repeat smears from 57 women were positive for Actinomyces-like organisms, giving a prevalence rate of 6.99%. Immunofluorescent staining using specific antisera confirmed the presence of A. israelii in all 57 women. Forty IUD users whose smears were positive for Actinomyces-like organisms underwent bacteriologic culture studies; A. israelii was isolated in 23 of these cases. The clinical findings at the time of smear collection in the 57 IUD users were within normal limits. The initial cervical smears of all IUD users and both the initial and repeat smears of all nonusers were negative for Actinomyces-like organisms. The data indicate that prolonged use (greater than 2 years) of an inert or copper intrauterine device promotes the overgrowth of Actinomyces in the vagina and that this can be detected by routine cervical cytology. PMID- 3526780 TI - Fine needle aspiration minibiopsies. AB - During a five-and-one-half-year period, cell buttons were prepared from 393 (29%) of 1,375 fine needle aspirates. Of these, 237 were diagnostically helpful and confirmatory in conjunction with the smears. In 103 (7% of all cases), the tissue fragments in the cell button allowed a definite diagnosis or classification of the tumor that otherwise would not have been possible. The architecture that is often preserved in these minibiopsies is identical to that seen in larger tissue samples. The specimens lend themselves well to special histochemical and electron microscopic studies. Wider use of this established and simple procedure is encouraged. PMID- 3526781 TI - Processing of aspiration cytology samples. An alternative method. AB - Cytotechnologists usually assist in smear preparation during radiologic fine needle aspiration (FNA) procedures. An alternative technique is presented that requires neither cytotechnologist participation nor immediate processing. In 111 consecutive patients undergoing FNA procedures, the aspirate was immediately fixed in 50% ethanol. The specimen was refrigerated and later processed in the laboratory as cell block preparations, which often maintained the original histologic architecture, and smears, which demonstrated good nuclear detail without air-drying artifacts. In our patients, this technique was 95% sensitive and 100% specific for the diagnosis of malignancy. PMID- 3526782 TI - Application of Diatex compound in cytology: use in preparing multiple slides from a single routine smear. PMID- 3526783 TI - Cytocentrifugal disc plate for preparation of cytologic samples. PMID- 3526784 TI - Immunoreactive gastric inhibitory polypeptide and K cell hyperplasia in obese hyperglycaemic (ob/ob) mice fed high fat and high carbohydrate cafeteria diets. AB - The effect of diet composition on plasma and intestinal concentrations of immunoreactive gastric inhibitory polypeptide (GIP) and intestinal K cell density was examined in obese hyperglycaemic (ob/ob) mice. The mice were reared from 3 to 11 weeks of age on either stock diet, a high fat (HF) cafeteria diet or a high carbohydrate (HC) cafeteria diet. The HF cafeteria diet increased the concentration of GIP in plasma (75%) and in the intestine (118%) and increased the density (54%) of GIP-secreting K cells in the upper jejunum compared with the stock diet. Plasma and intestinal GIP concentrations were not significantly altered by the HC cafeteria diet, although the density of K cells in the upper jejunum was increased (45%). The extent of hyperglycaemia and hyperinsulinaemia in ob/ob mice was not significantly altered by the HF and HC cafeteria diets. The results indicate that an increased amount of dietary fat chronically stimulates the production and secretion of GIP, and enhances intestinal K cell density in ob/ob mice. PMID- 3526785 TI - Glucose tolerance in early pregnancy. AB - The effect of pregnancy on oral glucose tolerance (50 g of glucose) and plasma insulin and glucagon responses to oral glucose was studied in weeks 10 and 32 of pregnancy and again 1 year post partum in 12 normal women. Already in week 10, fasting plasma glucose was decreased and the glucose-induced insulin secretion increased as compared with post partum. However, glucose tolerance was not affected at this time. In week 32, glucose tolerance had deteriorated, although the levels of both fasting and glucose-induced insulin were higher than those found in early pregnancy and post partum. At all investigations fasting plasma glucagon and the suppression of plasma glucagon after oral glucose were similar, indicating that glucagon is not implicated in the changes in glucose homeostasis seen in pregnancy. It is concluded that glucose tolerance is unaltered by pregnancy in week 10. Pregnancy has, however, at this very early stage already affected glucose homeostasis as seen by the decrease in fasting plasma glucose and the increase in the insulin response to glucose. PMID- 3526786 TI - Human decidua synthesizes placental protein 14 (PP14) in vitro. AB - Human decidua was found to synthesize and secrete placental protein 14 (PP14). The presence of PP14 in tissue explants of decidua, foetal membranes and placenta from term pregnancy was demonstrated by radioimmunoassay. The PP14 content in decidua (1300 +/- 410 ng/100 mg tissue) was higher than in chorion (570 +/- 120 ng/100 mg; P less than 0.01), amnion (240 +/- 100 ng/100 mg; P less than 0.001) or placenta (300 +/- 130 ng/100 mg; P less than 0.001). Three to 36 times more PP14 was released into culture medium by decidual explants compared with the other tissues, and cycloheximide decreased this release by 39%. Placental tissues released hardly any PP14. Decidual synthesis of PP14 was demonstrated by incorporation of [35S]methionine into immunoprecipitable PP14 in tissue culture. PMID- 3526787 TI - The classification of endometriosis: historical evolution, critical review and present state of the art. AB - The surprising disagreement in treatment results obtained by the various authors treating endometriosis is in large part due to differences in the severity of the disease. Only the adoption of a satisfactory staging system allows valid comparison between homogeneous groups of patients. This paper reviews and analyzes the various classifications proposed with the aim of showing the original aspects and the defects that led to the development of new systems including the most recent one published by the American Fertility Society. Devising a classification system presents unexpectedly great problems, but it is essential to be able to compare treatment results. PMID- 3526788 TI - Relationship between local and systemic autoantibodies to sperm, and evaluation of immunobead test for sperm surface antibodies. AB - Immunobead test (IBT), mixed antiglobulin reaction test for IgG (IgG-MART) and tray agglutination test (TAT) were used to study sperm antibodies in semen and serum of 200 men in infertile partnerships. The value of the IBT was also assessed. Semen from 22 men had insufficient number of motile sperm and were unsuitable for IBT and IgG-MART. Twenty-four men (of 178 that had all tests done) had significant serum antibody titres; sperm surface IgG and IgA were detected by IBT in 23 of them. IgG-MART was also positive in all but 4 of these 23; these 4 had positive TAT in seminal plasma and serum, but the titres were never above 64. Semen from 3 men was found to have only IgA sperm antibodies; 2 of these 3 had negative serum TAT. All tests were negative in 30 fertile men used as controls. We conclude that IBT is a useful test and is more sensitive than IgG-MART at low antibody titres, local autoimmune response to sperm can occur without a systemic counterpart, IgA sperm antibodies can occur alone (i.e. without IgG) in semen. PMID- 3526789 TI - Central haemodynamics and oxygen transport during CPPV with frequencies of 16 and 8 times per minute. AB - During the weaning period after 18 h of mechanical ventilation following open heart surgery, central haemodynamics, systemic oxygen transport and total oxygen consumption were assessed in a total of 11 patients receiving continuous positive pressure ventilation. Mechanical ventilatory rates of 16 and 8 times per minute were studied. Systemic arterial pressure, cardiac index, stroke volume index, left ventricular stroke work index, rate-pressure-product, and systemic oxygen transport were observed to be higher during the lower ventilatory rate. Because transmural right atrial and pulmonary capillary wedge pressures were also higher during ventilation with a frequency of eight times per minute, the lower frequency may impede venous return less. This might explain the difference found in central haemodynamics between the two ventilation frequencies. PMID- 3526790 TI - A double-blind trial of the analgesic properties of physostigmine in postoperative patients. AB - A double-blind clinical trial of the analgesic and antisedative effects of physostigmine was carried out on surgical patients (n = 60) during the first hours postoperatively. Pethidine and placebo were included for comparison in the double-blind study. The degree of pain and sedation was estimated when the patient demanded analgesics and immediately before the administration of the test drug. The dosage administered i.v. was: physostigmine salicylate 2 mg, placebo = saline, or pethidine chloride 50 mg. After this, the same parameters were recorded at regular intervals. In addition, ventilatory rate, pulse rate, systolic blood pressure and side effects, if any, were noted. The results showed that physostigmine caused analgesia that was of the same magnitude as pethidine during the first 15 min, after which it decreased to the level of the placebo at 30 min. An antisedative or arousal effect was recorded over a somewhat longer time period; after this, there was no difference between placebo and physostigmine. In contrast to pethidine, physostigmine caused no decrease in the ventilatory rate. The pulse rate and systolic blood pressure did not change in any of the groups. Although the durations of the analgesic and antisedative effects of physostigmine were short, the use of this drug may well be preferable to the use of e.g. naloxone when immediate alertness of the patient is wanted without causing an increase in postoperative pain. PMID- 3526791 TI - Sonoanatomy of the shoulder. AB - With the aid of ultrasound we tried to visualize the muscles of the shoulder region, the collum scapulae, the axillary artery and vein and the brachial plexus. We were successful with exception of the vessels and the nerves. Knowledge of the anatomical landmarks is essential in ultrasound image reading. PMID- 3526793 TI - [A survey for school screening in Senegal: considerations on the usefulness of this screening method and on the importance of endemicity among the youthful population of leprosy villages]. AB - A mass case-finding survey has been carried out among the pupils as a test measure: in an ordinary rural village: 2204 examined children; prevalence rate of leprosy: 0.90 per 1000; in two leper villages: 333 examined children; prevalence rate of leprosy: 125 per 1000. The authors have emphasized: the difficulty of school survey and the necessity to entrust a skilled staff with this job. The general low prevalence of leprosy cases with children in Senegal: 0.96 per 1000, inferior to the threshold of 4 per 1000 above which school survey is advised to be carried out. The high prevalence rate of leprosy with the children of the leper villages (140 times as much as general prevalence rate). This situation could be the result of: the inefficiency of the chemoprophylaxis by DDS; the existence of primary resistance cases to DDS (some of them clinically proved), consequence of the numerous secondary resistance cases which have already been witnessed in these villages. PMID- 3526792 TI - [A trial of polychemotherapy of leprosy in the Dakar region. Initial observations on the acceptability of the protocols used]. AB - Since 1982, in Dakar, a controlled essay tests the suitability of several short protocols of multidrug therapy (MDT), some of them being close to those advised by the WHO, others showing a starter stage of a two month daily MDT. In three years, 198 paucibacillary and 123 multibacillary patients have been treated. The short duration of these treatments leads to an important decrease in the load of the Department. The total rate of those who have not attended for the treatment is of 15.2% whereas it was of 52% with DDS monotherapy for a similar treatment duration. Those who gave up don't seem to live in Dakar. To judge by the diligence of the patients, the compliance seems excellent even for the protocols requiring a daily dose of ethionamide: 95% of paucibacillary, 76% of multibacillary patients have maximal attendance. The authors think that any MDT program: must be preceded by a retraining of staffs; must give a priority to the health education of the patients; must involve a home patient search for system. PMID- 3526794 TI - [The value of electromyographic studies in leprosy]. AB - In Dakar, during a definite period of time, all the new leprosy cases have been subjected to an electromyographic examination before treatment: a total of 37 patients and 518 examined nerves including all clinical forms: NCV: 33% of the examined nerves are found to be affected. The sensory nerves are frequently and early involved. In frequency order: sural (54%), posterior tibial (50%), sensory ulnar (35%), sensory median (29%), motor ulnar (28%), lateral popliteal (17%) and motor median (12%). The study of the SCV seems relatively more reliable than the sensory testing in the case of the ulnar and the median (75 comparisons): concordance in 69% of the cases; SCV only abnormal in 19%; sensory testing only abnormal in 12%. The EMG detection is superior to the motor testing and to the motor nerve conduction for the lateral popliteal (32 comparisons): 41% of concordant examination; 59% of differences among which 44% of anomalies revealed only by detection. PMID- 3526795 TI - [The patient with Hansen's disease confronts his distress]. AB - This article is about the effect of Hansen's disease on the personality of 29 patients of the Institute of Applied Leprology of Dakar, Foundation of the Order of Malta. This approach to the distress of these patients was done by an inquiry based on sociocultural and clinical variables and compared to a study composed of tubercular and psychiatric patients. This study reports four distress levels (loss of identity, loss of object, forlornness, culpability) which are distinguished by sex and age. The actual analysis of the experience of this distress shows the importance of support of the traditional representation of these leprous patients' psychology. PMID- 3526796 TI - [Correction of the Hansen claw hand using direct Zancolli lasso procedures and 2 of its variations]. AB - The procedure of the Zancolli "Lasso" or V direct Zancolli uses a flexor superficialis tendon which after a distal section is turned inside out and is fixed on itself after forming a loop around the proximal pulley of the sheath of the flexor. The mode of distal fixation being the same, the authors also study two different methods which resort either to one tendon for two, three or four fingers, or only to one strip of the flexor tendon for one finger. 45 cases of this kind of operation are reported. In the most important series in which the principle procedure has been used, the results are good in 80% of the mobile claws and average in 70% of the stiffened claws. The cases operated according to the two different methods, less numerous, give approximately the same results. The suggested indications are in favour of the changes in the procedure. PMID- 3526797 TI - [Prevention of perforating plantar ulcers: trial directed by a mobile team]. AB - AIMS: to prevent the appearance of plantar ulcerations and then mutilations, by going in the field in order to: make suitable footwear, educate the patients, train the paramedical staff. Means: 1 fitted lorry, 1 physiotherapist, 1 shoemaker, and 1 educator. RESULTS: In one year, 206 patients have been provided with shoes and followed up. Advice have been taken exactly in the leper villages in which the attendance rate is of 98%; this rate varies between 47 to 70% in the all-purpose dispensaries. Paramedical workers of all-purpose Health Centers did not take great interest in this action. After 6-12 months under observation: 84% of good results for the feet without deformity or slightly deformed; 51% for the deformed feet. The results are quite satisfactory for the feet without plantar ulcer at the beginning, and that whatever the food deformity stage. But for the feet wounded by plantar ulcer at the beginning, 33% of recovery have been reported after wearing these shoes. PMID- 3526798 TI - [HLA and leprosy in Dakar: distribution of histocompatibility antigens in leprous patients and their relationship to ENL reactions]. AB - 50 lepromatous patients among whom 34 shared repeating ENL reactions and a reference group of 150 blood donors were typed for HLA antigens. In the comparison of the lepromatous group to the reference group, the HLA-B 8 was the only antigen which turned out to be significantly increased within the lepromatous patients. Some changes reported by other authors have also been pointed out (decrease in HLA-A2 and HLA-A3, increase in HLA-AW 23 within the lepromatous patients) but those are not significant in this study. In the lepromatous group itself, not any significant change has been pointed out between the patients sharing ENL and those who did not show any. Nevertheless a non significant increase in HLA-BW 35 in the patients with ENL is to be pointed out. PMID- 3526800 TI - Evaluation of the castability of four different alternative alloys by measuring the marginal sharpness. AB - The castability of two low-gold and two silver-palladium alloys was evaluated, using a Type III gold alloy as reference. Six castings from each alloy were subjected to a castability test, in which the marginal sharpness of simulated crowns--that is, the edge diameter--was used to assess the castability. The mean crown edge diameters of the silver-palladium alloys were three to four times the corresponding diameters of the gold-based alloys. The differences between these two groups were statistically significant. It is concluded that the castability of the low-gold alloys studied was comparable to that of the Type III alloy, whereas the silver-palladium alloys studied had a castability that may result in technical and clinical problems. PMID- 3526799 TI - Cytochemical localization of acid phosphatase in the hindbrain of dysraphic mice. AB - The cytochemical localization of acid phosphatase (AP) was studied at the ultrastructural level in the abnormal neuroepithelium of dysraphic loop-tail (Lp/Lp) embryos between 9 and 12 days of gestation. At 9-11 days, normal and abnormal embryos showed a positive AP reaction throughout the thickness of the neuroepithelium, i.e., in apical, intermediate, and basal zones, although many cells were unreactive. The reaction is sensitive to sodium fluoride and occurs in saccules and vesicles associated with the Golgi complex, as well as in vacuoles of varying size containing flocculent and particulate material. Gap-junctional vesicles, which are known to occur in increased numbers in abnormal brains, were AP-negative. By 12 days of gestation, the reaction in normal embryos was localized in the midventral marginal layer, where some cell processes were filled with reaction product; in abnormal embryos, these AP-positive processes were not observed. The results indicate that perturbations in lysosomal activity may not be fundamentally involved in the etiology of dysraphism in this mutant. PMID- 3526801 TI - In situ characterization of the inflammatory cell infiltrates of hyperplastic denture stomatitis. AB - Cryostat sections from 14 surgical specimens were examined to determine whether selected factors of the immune response related to histopathological reactions are present in the palatal mucosa affected by hyperplastic denture stomatitis. By means of various immunological techniques the presence of IgG, IgA, IgM, complement factor C3c, receptors for the Fc region of IgG (FcR) and for complement factor C3b (C3bR), T lymphocytes, and macrophages were studied. The inflammatory infiltrate was mainly located in the papillary part of the lamina propria. IgG, IgA, and IgM appeared both in plasma cells and intercellularly. FcR, C3bR, and T lymphocytes were present in the areas with inflammatory cell infiltrate. Macrophages were found in the papillary part of the lamina propria and within the epithelium. The immunological response in the mucosa affected by denture stomatitis was in many respects similar to that of marginal and apical periodontitis. We conclude that hyperplastic denture stomatitis is a complex inflammatory lesion showing elements of both humoral and cellular immune responses. PMID- 3526802 TI - Ultrasonic assessment of cervix in normal pregnancy. AB - We studied 30 normal pregnant women from the first trimester to 36 weeks. This group of women had had no previous miscarriage, termination of pregnancy, operations on the cervix, or premature labor. Fifteen were primigravidae and the remainder were multigravidae. There was no significant difference in the length of the cervix from 10 to 36 weeks of gestation (p greater than 0.05). The mean width of the cervix gradually increased from 10 to 36 weeks of gestation (p less than 0.01). The mean width of the cervical canal showed no significant change from 10 to 36 weeks of gestation (p greater than 0.05). PMID- 3526803 TI - Catheter-associated bacteriuria. A controlled trial with the Bardex Urinary Drainage System. AB - In a randomized trial, the Bardex Urinary Drainage System was tested against a routine system consisting of a silicone-coated 16F Latex Foley catheter and exchangeable 1 500 ml collecting bags. The Bardex system consists of an all silicone balloon catheter preconnected and sealed to the drainage tube with tape. The tube is united with a 2,000 ml collecting bag via a vented drip chamber. It has an extremely hydrophilic coating (BN-74) resembling the natural glycosaminoglycans lining the urothelium. This coating is intended to minimize urethral irritation and bacterial migration and also to cause slow release of water-soluble antiseptics applied to the surface. In the present study, isobetadine 10% was applied prior to the insertion and reapplied daily after pulling gently on the catheter. Forty female patients aged 31 to 85 years completed the study. In the Bardex group of patients, bacteriuria developed in none by the third day of catheterization and in 5% by the fourth day. In the Foley group, the bacteriuria rate was significantly higher, with 35% on the third day (p less than 0.01) and 45% on the fourth day (p less than 0.02). No difference between the two drainage systems was found concerning incontinence beside the catheter, urethral pain or burning, meatal reddishness or urethral discharge. No conclusion regarding the advantages or disadvantages of the BN-74 coating and the isobetadine application can be drawn from the present study. PMID- 3526804 TI - Single-dose intravenous tinidazole prophylaxis in abdominal hysterectomy. AB - In 100 patients undergoing abdominal hysterectomy, a double-blind study was undertaken to evaluate the efficacy of prophylactic tinidazole treatment in diminishing the postoperative infection rate. The patients treated received a single dose of 1,600 mg tinidazole i.v. during 2 h preoperatively. One patient each from the placebo and treatment groups was excluded since the operations was ultimately not hysterectomy. The two groups of women, 49 in each, were comparable with regard to age, previous obstetrical and gynecological history, and reason for hysterectomy. Significant infectious complications (pelvic cellulitis, vaginal cuff abscess, pelvic abscess) were observed in 9 (18.4%) of the 49 placebo patients, but in only 3 (6.1%) of the 49 tinidazole-treated patients. Mild or mode rate wound infections were found in 2 patients of each group (4%). Urinary tract infections were found in 10 placebo (20.4%) and 12 tinidazole treated patients (24.5%). Among patients developing cuff abscesses, Bacteroides was the most frequently isolated anaerobic genus, B. bivius being the predominant species, while bacteria of enteric origin such as Escherichia coli and Streptococcus faecalis were the most common aerobic isolates. The results of the present study indicate that an intravenous preoperative single-dose tinidazole prophylaxis might reduce the risk of major pelvic infection following hysterectomy, the causative microorganisms usually being a mixture of aerobic and anaerobic bacteria. PMID- 3526805 TI - Vaginitis emphysematosa in a renal transplant patient. AB - Transplant surgery is now a widely established practice and the associated immunosuppressive treatment is followed by various complications. The present report on vaginitis emphysematosa in a woman with renal transplantation indicates that even this benign condition may have a connection with immunosuppressive therapy. PMID- 3526806 TI - Computed tomography and ultrasonography for diagnosis of hip joint effusion in children. AB - Nineteen consecutive children with transient synovitis of the hip were examined for intracapsular joint effusion using computed tomography (CT) and ultrasonography (US). The two techniques were highly correlated in measurements of the anterior displacement of the joint capsule, indicating both to be reliable diagnostic tools. Such an effusion is clinically important because of the increase in intracapsular pressure with ensuing disturbance in the vascular supply to the proximal femoral epiphysis, as demonstrated experimentally and clinically in transient synovitis. PMID- 3526807 TI - Suture of achilles tendon rupture under local anesthesia. AB - We operated on a consecutive series of 30 closed Achilles tendon ruptures under local anesthesia and without the use of a tourniquet. We had no reruptures or major complications, and the results were comparable to other series of operatively treated achilles tendon ruptures. PMID- 3526808 TI - Mast cell degranulation in nasal polyps. AB - Light- and electronmicroscopic observations as well as immunohistochemical studies were made on nasal polyps from 15 patients. The patients included 2 cases of aspirin intolerance (AA), 6 cases of allergic rhinitis (NA) and 7 cases of chronic rhinitis (CS) with negative skin tests against major inhalant allergens. Nasal polyps commonly contained many inflammatory cells such as neutrophils (PMN), eosinophils, plasma cells, mast cells, lymphocytes and macrophages. Two morphological features were conspicuous in our study: 1) PMN migration and attachment to the basal lamina, 2) accelerated degranulation of mast cells. Mean values of degranulated granules were 0.532473/micron2 in AA, 0.492615/micron2 in NA and 0.253591/micron2 in CS. These results indicate that mast cell degranulation in CS is much less than that in AA and NA. Immunohistochemical investigations revealed very few IgE-positive cells in both AA and NA, and none in CS. On the other hand IgG and IgA were frequently observed in all cases of nasal polyps. The present study suggests that mast cell degranulation plays an important role in the formation of nasal polyps, but it may not only be an IgE dependent mechanism. To elucidate other possibilities, more extensive immunological studies will be required. PMID- 3526809 TI - [Reliability of echotomography in the study of latero-cervical masses]. PMID- 3526810 TI - A clinicopathological study of 15 autopsy cases with allogeneic bone marrow transplantation in special reference to graft versus host disease (GVHD). AB - A clinicopathological investigation was made on 15 autopsy cases with allogeneic bone marrow transplantation. Engraftment was recognized in 11 patients, 6 out of which survived more than 100 days postgrafting, and 5 terminated within 100 days. The other patients succumbed to sepsis before engraftment. In 8 evaluated cases with clinical acute graft versus host disease (GVHD), involvement of acute GVHD was histologically confirmed in the skin, liver, and/or intestine. Atypical ductal changes similar to those of interlobular bile ducts were noted in the pancreas and esophageal gland in a patient with severe acute GVHD. Although 6 long-term patients showed neither definite lichenoid papulae nor sicca syndrome diagnostic for clinical chronic GVHD, 4 patients exhibited prolonged hepatic dysfunction and/or abnormal serological tests suggestive of autoimmunity, and they had some degree of basal vacuolar degeneration with or without lymphocytic infiltrates in the dermis, and atypical degeneration of small bile ducts at the same level as seen in acute GVHD ranging 20 to 50 micron in diameter. Chronic sialoadenitis with atypical epithelial degeneration was evident in two of them. A major cause of death was interstitial pneumonia of viral or fungal etiology due to persistent immunodeficiency. PMID- 3526811 TI - Immunohistochemical study of malignant melanoma. AB - Fifty-two malignant melanoma cases were divided morphologically into round, spindle and mixed-cell types and were studied immunohistochemically on the localization and staining intensity of S-100 protein and neuron specific enolase (NSE). Most of malignant melanomas were positively stained for S-100 protein and NSE. There were no correlation between the localization of S-100 protein and three cell types. However S-100 protein and degree of melanin production seemed to have an inverse relationship. On the other hand, for NSE, there were some differences on immunostaining intensity among the three cell types. Especially, deeply invasive melanomas showed strong reactivities for NSE and it may clinicopathologically indicate their poorer prognosis. PMID- 3526812 TI - Curved rods related to Mobiluncus--phenotypes as defined by monoclonal antibodies. AB - 51 strains, including clinical isolates, type and reference strains of Mobiluncus, were studied as to phenotype and reactivity with a set of monoclonal antibodies to defined Mobiluncus antigens. Numerical analysis of phenotypic data and the reactivity with monoclonal antibodies showed that the bacteria are clustered to form the two main species, M. mulieris and M. curtisii, although some atypical variants occur. In indirect immunofluorescence assay, the unique antigens were fully exposed on the cell surface and could therefore be used as markers for specific microscopic identification of Mobiluncus in mixed vaginal samples from women attending an STD clinic. The monoclonal antibodies identified M. mulieris and M. curtisii, showing a high correlation with the detection of motile curved rods in wet smears and curved rods in Gram-stained preparations. 70% of the samples harbouring Mobiluncus as seen by direct identification with monoclonal antibodies were culture-positive when an elaborate dilution technique for culture was used. PMID- 3526813 TI - Influence of polysaccaride capsule and ionic strength on buoyant density of group B streptococci. AB - Density fluctuation during the cell cycle was investigated with group B streptococcus (GBS), type Ia, in isotonic medium. Maximum density occurred at late lag-phase, with a minimum at the middle of logarithmic growth. During the stationary phase the density remained stable. The buoyant density of serotypes Ia, Ib, II, III and a rough variant was determined by means of gradient centrifugation. In an isotonic milieu at the early stationary phase, the density of the strains varied in the range between 1.06 and 1.11 g/ml. Low ionic strength reduced the density of all strains. Neuraminidase-treatment increased the buoyant density of types Ia, Ib and III. The same pattern was seen in isotonic and hypotonic medium, although low ionic strength markedly augmented these differences. The influence of tonicity and neuraminidase-treatment was most prominent with types Ia and III, which may be due to relatively thicker polysaccaride capsules in these types. PMID- 3526814 TI - The indirect leucocyte migration inhibition assay--an endotoxin-sensitive chemokinetic assay. Part II. AB - Depletion of agarose for endotoxins resulted in a low spontaneous migration of polymorphnuclear cells (PMNC). Re-addition of endotoxin, in casu lipopolysaccharide from E. coli 026:B6 (LPS), enhanced the spontaneous PMNC migration in a two-phased dose-response pattern, reaching maximum migration with LPS 1 x 10(-7) g/ml. Thus, the migration of PMNC under agarose seems to be a chemokinesis. Leucocyte migration inhibition factor (LIF), induced by PPD 50 micrograms/ml at endotoxin-free conditions, significantly reduced the PMNC migration compared to supernatants from control cultures, however not compared to the conventional limit of significance, MI = 0.80. With increasing PMNC migration there was an insignificant decrease in the MI. Addition of LPS, 1 x 10(-9) g/ml, during LIF induction caused a significant increase in LIF production, an effect which overshadowed the effect of PPD. Thus, the application of the conventional limit of significance, MI = 0.80, may result in false-negative or false-positive conclusions, depending upon the endotoxin contamination. A standardization of the endotoxin content in both steps of the indirect leucocyte migration inhibition assay seems mandatory in order to obtain a reliable and reproducible bioassay. PMID- 3526815 TI - Data on the mutagenic and cell toxic examinations of different pharmaceutical additives II. PMID- 3526816 TI - Further data on the origin of gonadotropin releasing hormone in the median eminence of the rat hypothalamus. AB - Gonadotropin releasing hormone (GnRH) content of the two halves of the median eminence of the rat hypothalamus was determined by radioimmunoassay three weeks after three different unilateral knife cuts around the preoptic area. A unilateral cut in front or above the area caused a more than 25% decrease in the GnRH content of the two halves of the median eminence. A cut lateral to the preoptic region had only a slight effect similar to that observed after sham operations. The data suggest that probably more than 50% of the rat median eminence GnRH derives from outside the preoptic-suprachiasmatic region. The GnRH fibres projecting to the median eminence but arising from outside the preoptic region, probably mainly from GnRH perikarya in the limbs of the diagonal band of Broca and septum, enter this area partly from rostral and partly from above, but not from lateral direction. partly from rostral and partly from above, but not from lateral direction. Several of these fibres probably cross before terminating in the median eminence. PMID- 3526818 TI - Bone marrow transplantation in multiple melanoma. PMID- 3526817 TI - Follow-up study of cartilaginous bone tumors. AB - A series of clinical and pathological studies were performed on 74 cartilaginous bone tumors including osteochondromas, multiple cartilaginous exostoses, chondromas, chondromatoses, benign chondroblastomas and chondrosarcomas. Resection was adequate for the osteochondromas, and no recurrence was observed. Out of 14 multiple cartilaginous exostoses, three, all in flat bones showed malignant change. The predominant sites of chondroma were the finger and toe bones, and curettage and bone graft was adequate treatment. Neither recurrence nor malignant change was observed. Two cases of chondromatosis, one of Ollier's disease and one of Maffucci's syndrome, were included in our series. Leg length discrepancy and pathologic fracture were common problems in chondromatosis. Moreover, malignant change was suspected in a hemangioma of the Maffucci's syndrome patient. Benign chondroblastoma was treated by curettage and bone graft, with no recurrence. In our series, 4 primary and 3 secondary chondrosarcomas were observed. Metastasis was seen in only one case. Because of the discrepancy between the biological behavior and histological findings of cartilaginous bone tumors, the malignancy of tumors should be evaluated by clinical signs and symptoms as well as by histological findings. PMID- 3526819 TI - Hemodynamic effects at rest and during exercise in long-term treatment with prazosin in chronic congestive heart failure. AB - The long-term effects of prazosin in chronic congestive heart failure were studied in 10 patients (New York Heart Association class III-IV) in a double blind cross-over study. Patients with systolic blood pressure greater than 120 mmHg and left ventricular filling pressure greater than 15 mmHg were included. Prazosin lowered the arteriovenous oxygen difference both at rest and during exercise (p less than 0.05), increased cardiac index (p less than 0.01) and reduced right atrial pressure and systemic vascular resistance (p less than 0.05) during exercise. Left ventricular filling pressure was also reduced, but not significantly, during exercise. Our data show that prazosin has beneficial long term effects during exercise in patients with chronic congestive heart failure. PMID- 3526820 TI - Bone marrow transplantation in three patients with multiple myeloma. AB - Three patients with multiple myeloma received bone marrow grafts from HLA identical sibling donors. One of the patients, with IgA kappa myeloma, refractory to alkeran-prednisone therapy, is well and still without sign of disease 26 months post transplantation. A second patient with Bence-Jones kappa myeloma is well, and skeletal pain and Bence-Jones proteinuria has disappeared 2 months after transplantation. A third patient with IgG-lambda myeloma died of effusive pericarditis shortly after transplantation. Bone marrow transplantation may be indicated in a selective group of patients with multiple myeloma. PMID- 3526821 TI - Cardiovascular prostaglandins: some comments on their involvement in circulatory physiology and pathophysiology. AB - There is little, if any, good evidence in the literature to indicate a role for cardiovascular PG in congestive heart failure, either in its pathogenesis or as a consequence of and defense against its manifestations. Usually congestive heart failure is considered to develop as a vicious cycle in which impaired cardiac output, increased peripheral resistance, decreased renal blood flow, increased renin release and further increased peripheral resistance and decreased cardiac output are important constituents. Increased sympathetic activity may promote cardiovascular PG formation through the sympathetic neurotransmitter noradrenaline; such an action has, however, not been documented hitherto. Furthermore, increased plasma renin activity may promote PG formation via increased circulating levels of angiotensin; even such an action remains, however, to be demonstrated. If the heart failure leads to local tissue ischemia the hypoxia as such, or the subsequent increase in adenosine production, may also facilitate cardiovascular PG formation. All these mechanisms, if operative, would counteract the increased peripheral resistance, by promoting the formation of vasodilator PG. On the other hand PGI2 stimulates renal formation of renin, which would act to elevate the peripheral resistance. These contradictory effects of endogenously formed PG focus on the need for more careful studies on their involvement in the hemodynamic consequences of congestive heart failure: until more data are available it is impossible to know whether an activated synthesis of PG should be regarded as advantageous and worth therapeutical support, or negative and subject to inhibition.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3526822 TI - Aspects on "traditional" vasodilators in the treatment of chronic heart failure. AB - Vasodilator therapy of heart failure has through the last 5-10 years become a well established treatment. Traditionally these drugs have been classified after their primary site of action on the vascular beds. Thus drugs primarily acting on the arteriolar bed are called afterload-reducing agents and are exemplified by hydralazine. Drugs primarily acting on the venous bed have been called preload reducing reducing agents and the typical example is nitroglycerin. Other drugs, like prazosin, act on both the arteriolar and venous vascular beds. The classification is, however, not as sharp as originally believed since preload- and afterload-reducing activities mix with each other. Treatment with vasodilators for chronic heart failure has mainly been advocated in patients with valvular regurgitation, ischemic heart disease and various types of dilated cardiomyopathies. It seems appropriate today to put some questions concerning vasodilator therapy for heart failure. Among such questions are: When in the natural history of congestive heart failure should vasodilator therapy be commenced? How effective is long-term administration of vasodilating drugs? May vasodilator therapy decrease mortality in congestive heart failure? What about the efficacy of new vasodilating drugs compared to more traditional ones? In the review of vasodilating drugs besides ACE inhibitors, these questions will be addressed. PMID- 3526824 TI - Lifestyle modification with heavy alcohol drinkers: effects of aerobic exercise and meditation. AB - To assess the effects of exercise and meditation on alcohol consumption in social drinkers, 60 male students, between the ages of 21 and 30, all classified as heavy social drinkers, were randomly assigned to one of three conditions: exercise (running), meditation, and a no-treatment control group. The study consisted of three distinct phases: pretreatment baseline (2 weeks), treatment intervention (8 weeks), and a follow-up period (6 weeks). Subjects in the running and meditation conditions met as a group during the treatment intervention phase, and all subjects self-monitored their daily consumption of alcohol throughout the study. The results showed that subjects in the exercise condition significantly reduced their alcohol consumption compared to the no-treatment control condition. The implications of these findings for treatment intervention, and the importance of subject compliance are discussed. PMID- 3526823 TI - [Changes in the hypothalamo-pituitary-adrenal axis and the metabolism of serotonin in affective disorders. Therapeutic use of serotonin precursors (review)]. PMID- 3526826 TI - William Vere Cruess 1886-1968. PMID- 3526825 TI - Biofeedback, cognitive training and relaxation techniques as multimodal adjunct therapy for hospitalized adolescents: a pilot study. AB - Modifications and adjuncts to traditional therapy techniques appear to be necessary for successfully treating hospitalized adolescents with impaired social and verbal skills, and a history of acting-out behavior. Modified therapy groups were combined with a structured biofeedback and cognitive training program to help these adolescents control anger and modify their behavior. Used in conjunction with training and practice in relaxation techniques, this multimodal treatment approach appeared to be helpful in both reducing incidents of acting out on residential units, and in reaching individualized therapeutic goals. The present paper describes use of this multimodal approach within selected residential settings, and outlines the structured materials developed by the authors. PMID- 3526827 TI - Sulfites in foods: uses, analytical methods, residues, fate, exposure assessment, metabolism, toxicity, and hypersensitivity. PMID- 3526828 TI - Soy sauce biochemistry. PMID- 3526829 TI - New protein foods: a study of a treatise. PMID- 3526830 TI - Maillard reactions: nonenzymatic browning in food systems with special reference to the development of flavor. PMID- 3526831 TI - An approach to the late effects of oral commissure injuries. AB - This article describes the treatment of the late effects of oral commissure scarring, especially after electrical cord injuries. The combination of mucosal advancement flaps plus split vermilion grafts and full-thickness preauricular skin grafts are used and illustrated in two patients. These methods have yielded satisfactory results in six patients. PMID- 3526832 TI - Correction of true periorbital fat herniation in cosmetic lower lid blepharoplasty. AB - The presence of puffy, baggy lower eyelids is one of the first signs of the aging face. Baggy eyelids can result from excessive eyelid skin, hypertrophied orbicularis muscle, and/or periorbital fat herniation. An exact diagnosis of which components are contributing to the problem must be made in the preoperative period so that proper correction can be made during surgery. The concept of true periorbital fat herniation in the causation of baggy lower eyelids is presented. The surgical correction of this anatomic defect involves identification and approximation of the dehiscent orbital septum to the capsulopalpebral ligament. Thirty-five patients who presented with true lower eyelid fat herniation and who underwent direct suture repair are reviewed. PMID- 3526833 TI - John Orlando Roe--not Jacques Joseph--the father of aesthetic rhinoplasty. AB - By a careful analysis of numerous medical articles, this article emphasizes that John Orlando Roe (1848-1915), an otolaryngologist from Rochester, New York, was the true father of aesthetic rhinoplasty--in contrast to the claims that incorrectly assign this role to Jacques Joseph of Berlin. PMID- 3526834 TI - A classic reprint: The deformity termed "pug-nose" and its correction, by a simple operation. By John O. Roe.1887. PMID- 3526835 TI - Direction of suture lines in Z-plasty scar revision. AB - Conventional methods of Z-plasty, a basic technique of plastic surgery, are incorrect since they are based on the assumption that the suture lines as designed prior to Z-plasty and those that actually result will coincide. For Z plasty to be satisfactorily applied in scar revision, sufficient thought must be given to the actual directions in which the suture lines will lie in comparison with those envisioned. PMID- 3526836 TI - Antihypertensive treatment as a possible cause of stroke in the elderly. AB - There have been a few reports on stroke as a side-effect of antihypertensive treatment. To study the occurrence of this side-effect, a questionnaire was sent to all Dutch nursing homes (n = 322). Thirty patients were reported with signs of cerebral ischaemia shortly after starting antihypertensive and diuretic drugs. Nine of these cases were well documented with full data on blood pressure, measured immediately after the event and compared with pretreatment levels. A review of cases reported in the literature is presented. It is concluded that, especially in elderly patients, an abrupt fall in blood pressure may induce cerebral ischaemia, sometimes resulting in stroke. Antihypertensive treatment in the elderly should therefore start with a small dose, the aim being to reduce blood pressure gradually. PMID- 3526837 TI - [Non-Hodgkin lymphoma of the gingiva]. PMID- 3526838 TI - [A case of soft vesical calculi]. AB - A case of soft vesical calculi is reported. A 72-year-old male, visited our clinic complaining of discharge of white muddy substance. KUB film revealed calcification in the vesical region. Urinalysis showed UTI, and culture of urine was positive for Proteus mirabilis. Thereafter, the patient suffered from discharges of similar calculi several times. Two of three infrared spectroscopic charts showed mixture of calcium phosphate and ammonium hydrogen urate and that of the remaining disclosed magnesium ammonium phosphate. An alcian blue-PAS double staining of this calculus revealed the presence of acid and neutral glycosaminoglycans, and bacterial colonies. These calculi were thought to be different from the so called 'matrix calculi'. PMID- 3526839 TI - Real-time breast sonography: application in 300 consecutive patients. AB - Sonography, disappointing as a primary screening method, has emerged as the single most helpful adjunct to mammography in evaluation of the clinically and/or mammographically abnormal breast. Sonography can reliably diagnose simple cysts presenting as palpable masses or as indeterminate, nonpalpable lesions on mammography. However, differentiation of benign from malignant solid masses cannot be reliably accomplished by sonography. The expense of an automated breast sonographic scanner has deterred many radiologists from the purchase of such a unit. The authors have used both an automated breast scanner and a real-time 10 MHz hand-held unit. This paper describes their experience with the real-time unit, demonstrating both normal and pathologic anatomy. Special emphasis has been placed on the sonographic diagnosis of a simple cyst because this lesion was the cause of one-quarter of all palpable masses and nonpalpable, mammographically dominant masses. Cysts are sharply marginated and anechoic. Posterior enhancement visible in 78 of 80 cysts was not demonstrable on all images in 25% of cysts. PMID- 3526840 TI - The V-shaped artifact of the gallbladder wall. AB - Among 20,000 patients who had undergone abdominal or gallbladder sonographic examinations, 36 had a short V-shaped artifact originating from an hyperechoic focus in the gallbladder wall. Associated symptoms were varied and nonspecific. The 10 gallbladders excised because of associated cholelithiasis showed a thickened wall, and seven patients had diverticulosis of the wall with impacted stones. In vitro sonographic examination of five gallbladders reproduced the "V" artifact and showed that it originated from a small intramural cholesterol stone. The V artifact should be distinguished from the larger comet-tail and ring-down artifacts, which arise from metal or gas. PMID- 3526841 TI - CT appearance of impaired lymphatic drainage in liver transplants. AB - Early postoperative CT scans of three patients who had undergone liver transplantation show hypodense areas surrounding the portal venous system and to a lesser extent the intrahepatic inferior vena cava. These changes were considered to represent dilated lymphatic vessels caused by impaired lymphatic drainage of the transplant after total interruption of the lymphatic vessels at surgery. This hypothesis was tested in three piglets after complete surgical interruption of the lymphatic vessels of the liver. Results of histologic examinations and an additional long-term follow-up CT study in one patient suggest that hypodense periportal and pericaval areas are a reversible CT finding in liver transplants caused by lymph stasis. PMID- 3526842 TI - Nonparasitic splenic cysts: a report of 52 cases with radiologic-pathologic correlation. AB - We reviewed 52 cases of splenic cysts on file at the Armed Forces Institute of Pathology. There were 24 true (epidermoid) and 28 false (posttraumatic) cysts. The history and clinical presentations, including pain, splenomegaly, or mass, were similar in both groups. Radiologic manifestations included splenomegaly and the occasional identification of a distinct mass by conventional radiography even in the absence of calcification. The lesions produced a photopenic defect on nuclear scintigraphy and were avascular on angiography. Sonography and CT demonstrated a cystic lesion with occasional septations, wall trabeculation, and low-level internal echoes. Three false cysts demonstrated solid and cystic components on sonography and CT, corresponding to organizing hematoma within the cyst. Splenomegaly or a splenic mass of a predominantly cystic nature with no clinical evidence of echinococcus suggests the diagnosis of splenic cyst. Reliable radiologic distinction between true or false splenic cyst does not seem possible. Complex mass may represent a "transition" between hematoma and false splenic cyst. PMID- 3526843 TI - The shoulder impingement syndrome: prevalence of radiographic findings and correlation with response to therapy. AB - The shoulder impingement syndrome is believed to be caused by compression of the rotator cuff tendons and subacromial bursa between the humeral head and structures that make up the coracoacromial arch. Plain film findings were tabulated for 36 patients, 22-81 years old, who had signs and symptoms of an acute impingement syndrome. The most common radiographic abnormalities were subacromial bony proliferation in 68%, degenerative changes in the greater tuberosity of the humerus in 66%, and degenerative joint disease in the acromioclavicular joint in 66%. There was evidence of calcium deposition in the rotator cuff in 37%, inferiorly oriented acromioclavicular osteophytes in 32%, and degenerative changes of the lesser humeral tuberosity in 29%. The acromiohumeral space was narrowed in only 21%. The radiographic findings were scored blindly and compared to the treatment outcome of 6 weeks of medical therapy. There was no statistically significant correlation between any of the radiographic findings and the response to medical therapy. The results suggest that radiographic findings are extremely common in patients with the acute impingement syndrome, but that they are not useful as prognostic indicators of the short-term response to medical treatment. PMID- 3526844 TI - Digital wrist arthrography: precision in determining the site of radiocarpal midcarpal communication. AB - Wrist arthrography is used for precise determination of posttraumatic interosseous ligament tears. Digital subtraction arthrography adds to the precision in diagnosis of the site of radiocarpal-midcarpal communication. Using the technique for digital subtraction wrist arthrography outlined in this paper, the classic scapho-lunate and lunate-triquetral perforations were delineated. Scaphotrapezium and triquetral-hamate interosseous ligament perforations were also delineated. The added diagnostic precision of digital subtraction at the first injection was useful in planning the correct surgical procedure. PMID- 3526845 TI - Sonographic diagnosis of foreign bodies of the distal extremities. PMID- 3526846 TI - The air bronchogram: sonographic demonstration. AB - A new sonographic pattern of pulmonary consolidation associated with air-filled bronchi in children is presented. The consolidated area of the lung is usually hypoechoic, poorly defined, and wedge-shaped. The air-filled bronchi produce linear, high-amplitude branching echoes that converge toward the lung root. Posterior acoustic shadowing and reverberation artifacts are seen accompanying the proximal large bronchi. A comparative study is presented in which 30 pediatric patients with clinical and radiographic evidence of pneumonia were sonographically evaluated. Twenty-eight patients were successfully examined with sonography. The cases were divided into three groups: (1) consolidated lung without pleural effusion (19 patients); (2) consolidated lung with small pleural effusion (five patients); and (3) consolidated lung with partial compression atelectasis due to large pleural effusion (four patients). PMID- 3526847 TI - Ischemic hepatic necrosis: a cause of fetal liver calcification. PMID- 3526849 TI - Computerized reference management: searching the literature. PMID- 3526848 TI - I.v. and intraarterial hybrid digital subtraction angiography: clinical evaluation. AB - Temporal/energy (hybrid) subtraction is a technique for removing soft-tissue motion artifact from digital subtraction angiograms. The diagnostic utility of hybrid subtraction for i.v. and intraarterial angiography was assessed in the first 9 months of operation of a dedicated production system. In i.v. carotid arteriography (N = 127), hybrid subtraction (H) provided a double-profile projection of the carotid bifurcation in an additional 14% of studies, compared with temporal subtraction (T) alone (H79:T48, p less than 0.001). However, a change in estimated percent stenosis or additional diagnostic information occurred in only 2% of studies. In i.v. abdominal arteriography (N = 23), hybrid subtraction, compared with temporal subtraction, provided a diagnostic examination in an additional 14% of studies (H20:T17); however, this difference is not statistically significant. An additional three i.v. abdominal angiograms were nondiagnostic. In intraarterial abdominal (N = 98) and pelvic (N = 60) angiography, hybrid subtraction provided a diagnostic examination in an additional 5% of studies (abdomen H94:T90, pelvis H58:T56); this difference was not statistically significant. An additional 5% of all intraarterial abdominal and pelvic digital subtraction angiographic studies were considered nondiagnostic. Hybrid subtraction provides a double-profile view of the carotid bifurcation in a significant number of patients. However, apart from some potential for improved i.v. abdominal arteriography, hybrid subtraction does not result in significant improvement in comparison to conventional temporal subtraction techniques. PMID- 3526850 TI - Sonographic and arthrographic assessment of the shoulder after operative repair of a torn rotator cuff. PMID- 3526851 TI - Systemic lupus erythematosus following total body irradiation for malignant lymphoma. AB - A case of a 63-year old man, who developed systemic lupus erythematosus three years after an initial diagnosis of small-cleaved centrofollicular lymphoma is described. The diagnosis of SLE was made on the basis of the accepted "1982 revised criteria for the classification of SLE". The autoimmune disease arose after a cycle of total body irradiation, despite the treatment with combination chemotherapeutic doses such a CVP or COAP or Cyclophosphamide, Vincristine, VM-26 and Prednisone. Genetic, immunological and exogenous environmental factors may co exist and might equally be implicated in the pathogenesis of SLE and malignant lymphoma. However, the onset of SLE after total body irradiation could have been caused by the inactivation of suppressor T lymphocytes, which are known to be sensitive to radiations in vitro. PMID- 3526852 TI - Ethmozine: electrophysiology, hemodynamics, and antiarrhythmic efficacy in patients with life-threatening ventricular arrhythmias. AB - Thirteen patients with drug-resistant, life-threatening ventricular arrhythmias and inducible sustained ventricular tachycardia (VT) at electrophysiologic study received moricizine HC1 (ethmozine), 10 mg/kg/day orally. Eight patients underwent electrophysiologic study before and after drug administration; the arrhythmia became noninducible in one. In five other patients, spontaneous sustained VT occurred after 1 to 5 days of drug therapy, and one patient had a worsening of arrhythmias on ethmozine. Ethmozine prolonged infranodal conduction time (HV interval) (51.4 +/- 13.8 msec to 69.3 +/- 17.7 msec [mean +/- SD]), PR interval (201 +/- 28.1 msec to 244 +/- 62.2 msec), and QRS interval (123 +/- 27 msec to 147 +/- 32 msec). Ventricular refractory periods were not consistently affected, and only the one patient who became noninducible had an increase in effective ventricular refractory period (280 to 310 msec). The drug had no significant effect on sinus cycle length or sinus node recovery time, atrial conduction or refractoriness, or atrioventricular nodal refractoriness. Ethmozine had no effect on radionuclide ejection fraction (25.5 +/- 12.7% to 28.2 +/- 13.8%) or cardiac index (2.4 +/- 0.7 to 3.0 +/- 0.6 ml/min/m2) and caused no significant changes in mean aortic, right atrial, pulmonary arterial, or pulmonary capillary wedge pressures. Although the drug is well tolerated and produces no untoward hemodynamic effects, ethmozine is relatively ineffective in patients with sustained VT refractory to conventional antiarrhythmic agents. PMID- 3526853 TI - Electrophysiologic effects of cibenzoline in humans related to dose and plasma concentration. AB - The electrophysiologic effects of a new antiarrhythmic agent, cibenzoline, were investigated in 25 patients with an average age of 62 years. The compound was administered intravenously, as a bolus given over 2 minutes, then as a slow infusion over 40 minutes. Each subject was randomly allocated to receive one of the following four doses: 1.55 mg/kg (six patients), 1.8 mg/kg (six patients), 2.2 mg/kg (six patients), or 2.6 mg/kg (seven patients). Plasma cibenzoline concentrations at these doses were 378 +/- 80,525 +/- 194, 618 +/- 72, and 731 +/ 196 ng/ml, respectively. Administration of 1.55 mg/kg cibenzoline significantly shortened the sinus cycle (60 msec on average; p less than 0.025) and increased intraatrial (+8 msec; p less than 0.05) and His-Purkinje conduction times (HV interval + 13 msec; p less than 0.001). At 1.80 mg/kg, prolongation occurred in the HV interval (+9 msec; p less than 0.02), the duration of the QRS complex (+20 msec; p greater than 0.05), and the QT interval (+18 msec; p less than 0.025). At the higher doses these changes became more marked (maximum increase: HV = +16 msec, p less than 0.001; QRS + 25 msec; p less than 0.001; QT + 26 msec, p less than 0.05), and additional effects on atrioventricular nodal conduction time (AH interval + 17 msec; p less than 0.05) and atrial (+20 msec; p less than 0.05) and ventricular (+10 msec; p greater than 0.05) effective refractory periods were observed. Prolongation of the QRS duration was the effect that correlated best with plasma cibenzoline levels (r = 0.47; p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3526855 TI - The pharmacodynamic and pharmacokinetic differences of the D- and L-isomers of verapamil: implications in the treatment of paroxysmal supraventricular tachycardia. AB - There is increasing interest in defining the pharmacodynamic and pharmacokinetic characteristics of drugs that are marketed as racemic mixtures. Verapamil is one such drug that is commercially available as a mixture of D- and L-isomers. The L isomer of verapamil has a greater-negative inotropic, negative chronotropic, and negative dromotropic potency than the D-isomer. The values for fraction unbound in serum, distribution volume, and systemic clearance are substantially greater for the L-isomer after intravenous dosing. After oral dosing, the D-isomer achieves peak plasma concentrations five times greater than the L-isomer. The pharmacodynamic and pharmacokinetic characteristics of each isomer are reviewed. The differences in the concentrations of the D- and L-isomers after oral vs intravenous dosing may contribute to the relatively lower efficacy of orally administered verapamil in the treatment of PSVT. PMID- 3526854 TI - Is single oral administration of captopril beneficial in screening for primary aldosteronism? AB - Plasma renin activity (PRA) and plasma aldosterone concentration (PAC) were measured in 19 cases with primary aldosteronism (PA) and in 72 with essential hypertension (EHT) to differentiate the two disorders during the following conditions on normal salt diet: after overnight recumbency (basal state) and 2 hours after oral administration of 25 mg of captopril. Screening criteria were determined so that all PA patients were diagnosed as positive, and their specificities were compared with those of other conventional screening methods for PA. After captopril administration, the specificity of a criterion based on a combination of PAC and PAC/PRA ratio was 93% and positive predictive value was 79%. This criterion was superior to blood pressure response to angiotension II analog infusion, PRA on salt depletion, and to PAC on salt loading. However, higher specificity (97%) and positive predictive value (90%) were obtained from a criterion based on a combination of basal PAC and PAC/PRA ratio. Therefore, the use of a combination criterion based on PAC and PAC/PRA ratio at basal state rather than after captopril administration may give a satisfactory result in the screening for PA. PMID- 3526856 TI - Lipid regulation: a clinician's view of patient management. AB - Practicing physicians now have the capability as well as the responsibility to treat hyperlipidemia. Recent conclusive trials have demonstrated the link between lipid elevations and coronary heart disease, as well as the likelihood of reducing coronary heart disease risk by lowering blood lipids via diet and/or drug intervention. Screening criteria for hyperlipidemia in normal patients and in special patient subgroups are described, and recommendations for treatment are proposed. The diet recommended by the American Heart Association--which limits fat intake to 25% to 30% of all calories in a 1:1:1 ratio of saturated, monounsaturated and polyunsaturated fats, and limits cholesterol to less than 300 mg/day--is discussed. Guidelines are suggested for drug therapy with lipid lowering agents to reduce abnormal lipid levels when diet alone proves insufficient after 2- to 3-month trial. PMID- 3526857 TI - Vasopressin, renin and norepinephrine levels before and after captopril administration in patients with congestive heart failure due to idiopathic dilated cardiomyopathy. AB - The effects of 4 weeks of captopril treatment were studied in 10 patients with chronic congestive heart failure (CHF). Acute administration of 50 mg of captopril resulted in an increase in cardiac index and significant decreases in arterial pressure, peripheral vascular resistance and pulmonary capillary wedge pressure. Before treatment, all patients had elevated vasopressin levels (17 +/- 4 pg/ml) relative to decreased plasma osmolality (274 +/- 15 mOsm/kg H2O), and these values were not initially affected by captopril administration (22 +/- 7 pg/ml). However, the relation between arginine vasopressin and plasma osmolality was restored to normal by long-term therapy with captopril (50 mg 3 times daily) (3.0 +/- 1.3 pg/ml; 283 +/- 166 mOsm/kg H2O), which also resulted in sustained improvement of cardiac function. Long-term captopril therapy increased plasma renin concentration from already elevated levels (11 +/- 4 to 32 +/- 8 ng AI/ml X hour) and decreased plasma norepinephrine from 1,054 +/- 244 to 488 +/- 101 pg/ml. Thus, nonosmolar stimulation of vasopressin secretion in CHF can be restored to normal by chronic converting enzyme blockade. The acute vasodilator effects of converting enzyme blockade are not mediated by a reduction of possible vasoconstrictor effects of vasopressin. PMID- 3526858 TI - Effect of oral neomycin treatment of hyperlipoproteinemia on antibiotic susceptibilities of stool enteric flora. PMID- 3526859 TI - Relation and influence. PMID- 3526860 TI - The reconstruction of traumatic memories. PMID- 3526861 TI - Differentiation of Cryptococcus neoformans serotypes by isoenzyme electrophoresis. AB - Cryptococcus neoformans has been divided into four serotypes by specific agglutination in immune rabbit sera. Based on mating characteristics of the perfect state and epidemiologic and biochemical differences, the serotypes have been divided into two major pairs. In an attempt to characterize the serotypes further, the authors studied 22 strains of C. neoformans by the technic of horizontal starch-gel isoenzyme electrophoresis. The glucose-phosphate isomerase and phosphoglucomutase of serotypes A, C, D, and a subset of the serotype B strains migrated to distinguishable locations in this system. The activities of the remainder of the serotype B strains co-migrated with the serotype C strains. Thus, this technic distinguishes all the serotypes of C. neoformans except for a subset of serotype B and should be a useful adjunct for further elucidation of the epidemiologic and biochemical differences among serotypes. PMID- 3526862 TI - A case report of mantle zone lymphoma progressing into follicular lymphoma. AB - The authors report a case of mantle zone lymphoma (MZL) progressing into follicular lymphoma (FL) with macroglobulinemia (IgM, lambda). At a first lymph node biopsy, a diagnosis of MZL was made on the basis of the presence of vague neoplastic nodules, consisting of small lymphoid cells and small cleaved cells. At a second lymph node biopsy, nodules of follicular lymphoma were observed in the central zones of the vague neoplastic nodules. At a third biopsy, the central zones were found to expand, revealing FL dominant pattern. The progress of FL from MZL also was suggested by sIg, AIPase, anti-CALLA (common acute lymphoblastic leukemia antigen) antibody, and anti-DRC (dendritic reticulum cell) antibody findings. Consequently, this is suggested to be a neoplasm of B lymphocytes differentiating from small lymphocytes in the primary follicle or the mantle zone of secondary follicle into germinal center cells. The anti-DRC antibody findings suggest the neoplastic cells of FL induce DRC as the neoplastic stroma. PMID- 3526863 TI - Fatal Aspergillus pneumonia in chronic granulomatous disease. AB - A 20-year-old man died from Aspergillus pneumonia three weeks after heavy exposure to grain dust. Lung biopsy and autopsy demonstrated a distinctive form of suppurating granulomatous bronchopneumonia caused by Aspergillus fumigatus, which was the sole agent cultured from the tissue. The liver and lymph nodes contained pigmented lipid histiocytes characteristic of chronic granulomatous disease, and subsequently both of the patient's brothers were found to have X linked chronic granulomatous disease. The authors suggest that this morphologic expression of Aspergillus pneumonia should raise a suspicion of neutrophil dysfunction or chronic granulomatous disease. PMID- 3526864 TI - Easy, cheap, and reliable identification of ganglion cells. PMID- 3526865 TI - Putting rapid group A strep throat screening tests into perspective. PMID- 3526866 TI - Diphtheria, tetanus, and pertussis vaccine. A comparison of the immune response and adverse reactions to conventional and acellular pertussis components. AB - Although the conventional Bordetella pertussis vaccine, which consists of killed whole organisms, has been shown to be effective in preventing disease, it has been associated with transient local and systemic reactions and may produce encephalopathy, though rarely. A new acellular pertussis vaccine containing partially purified protein antigens, filamentous hemagglutinin, and lymphocytosis promoting factor hemagglutinin has been developed for use in Japan. We compared the immunogenicity and reactogenicity of conventional and acellular pertussis vaccine. Forty children aged 4 to 6 years and 40 children aged 18 to 24 months, all previously immunized at appropriate times with conventional diphtheria and tetanus toxoids and pertussis vaccine, were enrolled. We randomly assigned children to receive either conventional pertussis vaccine or acellular pertussis vaccine in a double-blind fashion. The diphtheria and tetanus components in both preparations were identical. Equivalent rises in pertussis agglutinin titers and antibodies to filamentous hemagglutinin and lymphocytosis-promoting factor hemagglutinin were measured in both vaccine groups at both ages that we studied. However, reaction rates to the two vaccines in both age groups were strikingly different. Acellular pertussis vaccine was significantly less reactogenic for fever, pain, fretfulness, abnormal gait, and local reactions at the vaccine administration site. If studies in progressively younger children confirm its reduced reactogenicity and equal immunogenicity, and if large-scale trials indicate its efficacy, the acellular pertussis vaccine may be a more appropriate candidate than the current vaccine. PMID- 3526867 TI - Clinical utility of magnetic resonance imaging in pediatrics. AB - A review of over 100 articles and our own experience of scanning nearly 500 children with magnetic resonance (MR) imaging indicate that MR is well tolerated by children. Magnetic resonance is already proving to be the imaging modality of choice for the central nervous system. It should soon prove its utility for the study of most tumors, vascular problems, and infections of the musculoskeletal system. In other regions of the body, MR can identify abnormality well, but many of these abnormalities can be identified well with other modalities, and the precise role of MR is yet to be defined. We anticipate that the number of indications for the use of MR will grow rapidly. PMID- 3526868 TI - Francesco Luigi Fanzago and the first Chair of Forensic Medicine of the University of Padua--1806. PMID- 3526869 TI - Impaired contractile motility of the gallbladder after gastrectomy. AB - Contractile motility of the gallbladder was compared using a real-time ultrasonography in 13 patients with gastric ulcer and 31 patients with gastric cancer who had undergone either subtotal or total gastrectomy within 1 month previously. Contractile motility of the gallbladder after oral administration of dried egg yolk (Daiyan, Maruishi, Osaka), which was slightly but not significantly reduced in patients with gastric ulcer, was remarkedly impaired in patients with gastric cancer who had either subtotal or total gastrectomy including radical lymph node dissection. Especially, maximum contractile rate after Daiyan in Billroth II patients was significantly reduced than that of Billroth I patients. Intramuscular injection of naloxone (0.4 mg), which had no effects on contractions after Daiyan in healthy subjects, significantly improved the hypomotility in response to Daiyan in these gastric cancer patients. It was suggested, therefore, that the possible roles of various anatomical and mechanical changes resulting from gastrectomy including vagotomy and sympathectomy, and in particular exclusion of duodenum from digestive circuits and relative or absolute excess of endogenous opioids, were involved in the control of the gallbladder motility within 1 month after gastrectomy including lymphadenectomy. PMID- 3526870 TI - The Mirizzi syndrome: preoperative diagnosis by sonography and transhepatic cholangiography. AB - Common hepatic duct obstruction from an impacted calculus in the cystic duct is an uncommon cause of jaundice. The complimentary role of both transhepatic cholangiography and sonography can facilitate and assist the physician in making a preoperative diagnosis of Mirizzi syndrome and prevent an unnecessary choledochotomy and exploration of the common bile duct. PMID- 3526871 TI - Primary gastrointestinal lymphoma complicated by common bile duct obstruction: report of two cases. AB - This report describes two cases, a case of primary small intestinal lymphoma and a case of gastroduodenal lymphoma both producing obstructive jaundice due to invasion of the common bile duct. Oesophagogastroduodenoscopy revealed the lesions and the endoscopic biopsies confirmed the diagnosis of lymphoma in both the cases. Ultrasound examination of the biliary system, followed by percutaneous transhepatic cholangiography, delineated the dilated biliary tree with distal obstruction of the common bile ducts. While radiotherapy alone was sufficient in the case of primary small intestinal lymphoma; drainage procedures were required in the case of gastroduodenal lymphoma to relieve the obstruction of the common bile duct. PMID- 3526872 TI - Aneurysmal malformation of the extrahepatic portal vein. AB - Malformations of the extrahepatic portal vein are quite rare. A 6-cm aneurysmal malformation of the extrahepatic portal vein, thought to be congenital in origin, is described. An English language literature review yielded only six similar cases, each of which was associated with portal hypertension, primary hepatocellular disease, or both. The patient reported herein had cholelithiasis with chronic cholecystitis, but no primary liver disease or vascular disease. We believe this is the first report of such an anomaly. PMID- 3526873 TI - Coexpression of p165 myeloid surface antigen and terminal deoxynucleotidyl transferase: a comparison of acute myeloid leukaemia and normal bone marrow cells. AB - A double immunofluorescence technique, using antibodies to terminal transferase (TdT) and a 165-kilodalton myeloid differentiation antigen (p165), has been used to investigate the phenomenon of TdT expression in cases of acute myeloid leukaemia (AML). Five cases of AML were shown to have significant (18-90%) numbers of leukaemic cells that concurrently expressed both TdT and p165 myeloid surface antigen. Examination of nonleukaemic bone marrow cells showed that the vast majority of normal TdT+ cells are p165 negative. However, in 5 of the 11 samples analyzed, rare cells staining for both p165 and TdT were found. These results suggest that some cases of TdT+ AML may arise from the clonal expansion of rare "biphenotypic" precursor cells existing in normal bone marrow. PMID- 3526874 TI - Vancomycin and the kidney. PMID- 3526875 TI - Role of glomerular filtration rate in the impaired sodium and water excretion of patients with the nephrotic syndrome. AB - Hemodynamic and hormonal factors were monitored in nine patients with nephrotic syndrome who were evaluated relative to their capacity to excrete a 20-mL/kg water load (normal greater than 80%). In five "nonexcretor" patients (37% of water load excreted in five hours), as compared to four normal excretors (105% of water load excreted in five hours; P less than .01 v nonexcretors), neither BP (131/88 v 119/79 mm Hg), pulse (74 v 77 beats/min), cardiac index (3.7 v 3.1 L/min/m2), pulmonary wedge pressure (9.3 v 7.3 mm Hg), systemic vascular resistance (1537 v 1254 dynes-sec-cm-5), nor plasma volume (41.3 v 40.1 mL/kg) were different. Similarly, plasma renin activity (2.6 v 3.7 ng/mL/h), plasma aldosterone (12 v 10.9 ng/dL), and plasma norepinephrine (403 v 312 pg/mL) were not different between nonexcretor v excretor patients with nephrotic syndrome. Plasma vasopressin concentrations were also similar both before (3.1 +/- 0.8 v 2.4 +/- 1.2 pg/mL) and during the water load (0.9 +/- 0.3 v 1.0 +/- 0.4 pg/mL). Inulin clearances, however, were lower in the nonexcretor v the excretor nephrotic patients (37 v 78 mL/min/1.73 m2; P less than .02) and correlated with water excretion (r = .68; P less than .05). Head-out water immersion increased sodium (40 to 110 microEq/min; P less than .01) and water excretion (37% to 82%; P less than .025) in the nonexcretors; the improvement correlated with the increase in inulin clearance during immersion (r = .70; P less than .05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3526876 TI - Airborne particles, their use in the respiratory system to measure air flow, function, and clearance. AB - Nonhygroscopic monodisperse particles can be used to estimate airway dimensions within chosen regions of the respiratory tract. These dimensions correspond well with those measured in inflation-fixed lungs. The dispersion of a bolus of airborne particles on inhalation and exhalation is very sensitive to the dimensions of the airways through which the bolus passes, yielding indices of dispersion that provide sensitive indicators of changes in airway dimensions, eg, with smoking. The rates of clearance of particles from the lungs are determined using gamma-labelled particles whose lung retention is determined by external measurements. There are major differences between the deep lung and the ciliated airways. Changes in clearance rates are caused by disease or inhaled intoxicants such as cigarette smoke. At lower levels of irritant exposure, an acceleration of clearance rate is observed, while higher doses and longer periods of exposure produce decreased rates. It is suggested that aerosol techniques may have useful clinical applications; approaches are suggested for such applications. PMID- 3526877 TI - Infection in cancer patients. A continuing association. AB - Infection remains a major complication in patients with malignant disease. There are many factors predisposing to infection in this patient population, including local factors due to the tumor, specific deficiencies in host defense mechanisms due to certain malignant processes, and deficiencies in host defense mechanisms secondary to cancer chemotherapy. Neutropenia is probably the most important factor predisposing to infection in cancer patients. These patients require prompt broad-spectrum antibiotic therapy when fever develops. The majority of infections occurring in this patient population are caused by gram-negative bacilli and cure rates usually are between 65 and 75 percent. The most important prognostic factor is whether or not the neutrophil count recovers during the course of infection. Fungal infections have increased in frequency in neutropenic patients and often present as fevers of unknown origin. Increasingly, neutropenic patients are receiving antifungal agents as empiric therapy for persistent fever that fails to respond to antibacterial antibiotics. The most critical factor in recovery from fungal infection is remission of the underlying malignant disease. PMID- 3526878 TI - Infection in postoperative patients. AB - The majority of surgical infections are due to multiple bacterial pathogens, usually represented by mixtures of both aerobic and anaerobic species. Contamination from endogenous sources accounts for the majority of these infections. The most virulent of all such sepsis appears to arise from a symbiosis between aerobic gram-negative rods and various anaerobes. Antibiotics have proved efficacy in both the treatment as well as the prevention of surgical infection. The choice of antimicrobial agent(s) should be based upon the drug's spectrum of activity against known or anticipated pathogens, the biologic half life of the agent, which serves as a guide to the frequency of administration, and the drug's safety. The third-generation cephalosporins have been shown to be especially useful because of their broad spectrum of activity, prolonged half life, and limited toxicity. Sepsis that persists or is uncontrolled despite antibiotic administration often leads to failure of multiple organ systems. Only energetic surgical measures offer any real chance for patient survival when such a stage has been reached. PMID- 3526879 TI - Infections in the elderly. AB - Elderly patients appear to be predisposed to serious infections because of coexisting chronic or acute diseases that disrupt integumental barriers, impair clearance mechanisms, or compromise cellular responses to infection. The severely disabled elderly are particularly at high risk, because they are often unable to care for their personal hygiene and are malnourished, immobile, incontinent, or institutionalized. Senescence of the immune system per se does not appear to be a major predisposing factor for infection in this population. Infections in the elderly frequently present with non-specific signs and symptoms. Clues of focal infection are often absent or obscured by underlying chronic conditions. Once a site of infection is identified, clinicians should initiate therapy with broad spectrum antibiotics to treat the array of most likely potential pathogens. Strategies to prevent infection include programs to help the elderly maintain active, non-institutionalized life-styles and the appropriate use of available vaccines. PMID- 3526880 TI - Management of infectious complications in acquired immunodeficiency syndrome. AB - Infectious complications are the most common cause of death in patients with acquired immunodeficiency syndrome (AIDS). Opportunistic infections associated with defects in both T and B lymphocyte function have been observed. Invasive infections, including those secondary to procedures both in and out of the hospital, must also be considered. Reliance on serologic antibody tests is ill advised since antibody response is often not effective. Since simultaneous infections frequently develop in patients with AIDS, attempts to identify pathogens by culture and histopathology should be aggressive and thorough. With rapid diagnosis and therapy, many of the infections will respond. Prolonged treatment is indicated as recrudescence is common. PMID- 3526881 TI - Infection in patients with cystic fibrosis. AB - Cystic fibrosis is the most common lethal genetic disease of Caucasians. The disease affects the exocrine gland secretions throughout the body, and as a result, major pathologic changes develop in the pancreas and in the bronchi. Obstruction of the respiratory airways results in chronic infection, and in time, this leads to progressive deterioration of lung function. In the initial stages of the disease, usually during infancy, infection with Staphylococcus aureus plays an important role. Hemophilus influenzae infections are also common. As the disease progresses, infection with Pseudomonas aeruginosa develops. Exacerbation of bronchopulmonary infection is often initiated by respiratory viral or mycoplasmal infection, with superimposed S. aureus and P. aeruginosa infections contributing to the severity of the infection. Frequent courses of antibiotic therapy are usually required, and some patients may have to receive antibiotics continuously. Oral cephalosporins, ampicillin, and the combination of trimethoprim/sulfamethoxazole are commonly used for relatively mild infections. In the treatment of exacerbation of infection, intravenous penicillinase resistant penicillins and anti-Pseudomonas antibiotics are the drugs of choice. For Pseudomonas infections, ticarcillin, carbenicillin, the ureidopenicillins, and the aminoglycosides are indicated. The combination of an anti-Pseudomonas penicillin and an aminoglycoside are most commonly used. Of the third-generation cephalosporins, ceftazidime appears to be the most efficacious. The quinolones (such as ciprofloxacin) are also active against P. aeruginosa, and preliminary studies of these drugs in patients with cystic fibrosis appear to indicate that they are as efficacious as the already available antibiotics. In many centers, Pseudomonas cepacia has emerged as a serious problem in patients with cystic fibrosis. This organism tends to develop resistance to multiple antibiotics. In some centers, infection with P. cepacia has been associated with a severe, frequently fatal, pneumonia. PMID- 3526882 TI - Infections and prosthetic devices. AB - Hundreds of thousands of people have temporary or permanent prosthetic devices inserted each year in the United States. Infection rates associated with these devices vary depending upon numerous factors; however, overall, several percent of these devices become associated with infection. Diagnosis of these infections can be complicated by underlying disease, surgery, or the prosthesis itself, making it difficult to ascertain whether abnormalities of routine diagnostic studies are caused by infection. Specific diagnostic tests are usually required to confirm the presence of infection and identify the causative organism. The frequent isolation of skin organisms (such as Staphylococcus epidermidis) as the pathogen can also cause confusion as to whether the culture was contaminated. Fortunately, treatment of these infections is usually successful, although removal of the prosthetic device is often necessary. Recent laboratory and clinical studies that demonstrate various steps in the development of these infections and their response to treatment will help to better determine the optimal prevention, diagnosis, and treatment of these infections. PMID- 3526883 TI - Escherichia coli bacteremia in cancer patients. AB - During a 10-year period, 621 episodes of Escherichia coli bacteremia occurred in 575 cancer patients. The infection was most common in patients with acute leukemia and genitourinary and gastrointestinal malignancies. Most of the patients acquired their infection while in the hospital, and 38 percent had received antibiotics during the preceding 10 days. Fever occurred in 96 percent of patients, and afebrile patients had an especially poor prognosis. Only 4.5 percent of the patients had disseminated intravascular coagulation, although hemorrhage contributed to the death of 15 percent of the patients. The overall response rate was 66 percent, but it increased from 48 percent in 1972 to 76 percent in 1981. Patients without pulmonary infection had a response rate of 78 percent, whereas patients with pulmonary infection had a response rate of only 41 percent. Patients who had positive blood culture results while receiving appropriate antibiotic therapy had a poor prognosis. There was no correlation between the patients' initial neutrophil counts and response, but patients whose neutrophil count increased during therapy had a response rate of 75 percent, compared with a 47 percent response rate for patients whose neutrophil count decreased. The response rate was 71 percent for patients who received appropriate antibiotics, 38 percent for patients who received inappropriate antibiotics, and 8 percent for patients who received no antibiotics. A single appropriate antibiotic was as effective as a combination. PMID- 3526884 TI - Empiric use of vancomycin during prolonged treatment-induced granulocytopenia. Randomized, double-blind, placebo-controlled clinical trial in patients with acute leukemia. AB - Because gram-positive infections cause morbidity following intensive antileukemic chemotherapy, the effects of vancomycin versus placebo were evaluated in a randomized, double-blind, placebo-controlled trial in 60 adult patients with acute leukemia and first infectious fever during prolonged (mean of 32 days) granulocytopenia. Gram-positive sepsis was associated with first fever in 17 (28 percent) of the 60 patients. None of 31 patients randomly assigned to receive vancomycin demonstrated gram-positive infection, whereas 16 of 22 patients randomly assigned to receive placebo subsequently had gram-positive infection (seven had sepsis, and nine had local infections; p less than 0.005). All patients with gram-positive infection were then given vancomycin, and all showed prompt clinical responses. The predominant gram-positive organism causing infection was beta-lactam-resistant Staphylococcus epidermis (19 of 44 isolates). Patients randomly assigned to receive vancomycin had more rapid resolution of first infectious fever and fewer total febrile days during the granulocytopenic course than did patients randomly assigned to receive placebo. Although vancomycin had no effect on the presence or absence of documented fungal infection, patients treated with vancomycin received empiric amphotericin B for recurrent or persistent fever later (mean of 14 days after initial antibiotic coverage was begun) than did patients receiving placebo (mean of 9.9 days; p less than 0.005), and thus received fewer total days of empiric amphotericin B therapy (mean of 16.3 days) than did patients given placebo (mean of 24.6 days; p less than 0.01). These data demonstrate that empiric use of vancomycin reduces the morbidity of gram-positive infections following intensive antileukemic therapy and decreases the need for empiric use of toxic amphotericin B. PMID- 3526886 TI - Should calcium be used in cardiac arrest? AB - Calcium salts have been recommended for and used in the treatment of various forms of cardiac arrest for many years. Although calcium plays a major role in excitation-contraction coupling, it can have a deleterious effect in some processes of cellular injury. Clinical trials suggest that calcium salts are not effective in ventricular fibrillation and asystole, but that some patients with electromechanical dissociation may have a favorable hemodynamic response. Because of the potential risks of calcium salts, their use should be limited to specific subsets of patients with cardiac arrest. PMID- 3526885 TI - Aztreonam therapy in neutropenic patients with cancer. AB - Combinations of aztreonam/vancomycin, aztreonam/vancomycin/amikacin, and moxalactam/ticarcillin were compared in a prospective randomized trial as empiric therapy for febrile neutropenic cancer patients. Vancomycin was added to aztreonam to provide coverage against gram-positive organisms. Of 535 febrile episodes included in the study, 455 were evaluable. The aztreonam/vancomycin and aztreonam/vancomycin/amikacin combinations were both more effective than the moxalactam/ticarcillin combination in a total of 244 episodes of documented infection. The difference was due to the fact that both aztreonam-containing combinations were more effective than the moxalactam/ticarcillin combination in documented gram-positive infections. The three regimens were equally effective in 67 documented infections due to a single gram-negative bacterial species. (The response rates were 87, 86 and 94 percent for the aztreonam/vancomycin, aztreonam/vancomycin/amikacin, and moxalactam/ticarcillin combinations, respectively.) Aztreonam was effective as the single active antibiotic in the treatment of gram-negative infections in neutropenic patients; however, it must be used in combination with another antibiotic to provide gram-positive coverage. PMID- 3526887 TI - Hepatic veno-occlusive disease. AB - Hepatic veno-occlusive disease is a nonthrombotic obliteration of small intrahepatic veins by loose connective tissue. The venous occlusion may be progressive and lead to massive hepatocellular necrosis. Although originally described as a result of intoxication with plant alkaloids, it is now seen as a complication of high-dose antineoplastic chemotherapy, especially in the setting of bone marrow transplantation. The incidence of hepatic veno-occlusive disease after bone marrow transplantation approaches 20 percent, with mortality ranging from 7 to 50 percent. The clinical diagnosis may be quite accurate (as confirmed by biopsy or autopsy) and is based on the triad of jaundice, hepatomegaly and/or right upper quadrant pain, and ascites or unexplained weight gain. The pathogenesis is obscure but most likely relates to drug-induced venous endothelial damage. At the present time, therapy for veno-occlusive disease of the liver remains supportive. As intensive chemotherapy regimens (with or without bone marrow support) become more widely applied, it is expected that this disease will be encountered more frequently. PMID- 3526888 TI - Hemodynamic effects of positive end-expiratory pressure. Historical perspective. AB - Mechanical ventilation with positive end-expiratory pressure has been known to increase arterial oxygen content for approximately 40 years. Early experiments demonstrated a diminution of cardiac output with the application of positive end expiratory pressure, and it was not favored as a therapeutic modality until the 1960s, when it was found to be effective in the treatment of adult respiratory distress syndrome. In recent years, physiologists have methodically scrutinized the effects of positive end-expiratory pressure on each of the major determinants of cardiac output. Review of the progression of thought on this subject reinforces for today's clinician basic principles of cardiac performance and heart-lung interaction. PMID- 3526889 TI - Angioneurotic edema, agranulocytosis, and fatal septicemia following captopril therapy. AB - Captopril, an angiotensin converting enzyme inhibitor used in the treatment of hypertension, has been associated with hematologic as well as dermatologic side effects. Two patients with captopril-induced angioneurotic edema, one of whom had fatal granulocytopenia and overwhelming polymicrobial sepsis, are presented. PMID- 3526890 TI - The prenatal growth of the human body determined by the measurement of bones and organs by ultrasonography. AB - This paper presents the ultrasonographic analysis of the growth of two groups of human fetuses, one longitudinal and the other cross-sectional. Measurements of all the long bones were taken, as well as measurements of the following diameters: Biparietal, occipitofrontal, thoracic and abdominal anterior/posterior and transverse, spinal canal width, arm, forearm, thigh and leg transverse. The bladder and the stomach were also measured. The pregnancies analyzed covered the period between the 8th and 38th week of gestation. Centiles (3rd-97th) were calculated for each structure and week. All pregnancies known or suspected to be abnormal were removed from the study. The values obtained were tested in 102 pregnancies (test group); the expected values (from the graphs) did not deviate from the values obtained from this group of fetuses, demonstrating the reliability of the values presented in these graphs. All structures measured showed linear growth. There was no significant difference between the longitudinal and cross-sectional groups. PMID- 3526891 TI - Homeostasis. VII. A conspectus. AB - The characteristics and properties of physiological homeostasis are broadly reviewed in terms that should pave the way for definitive genetic analysis. The ideas are illustrated by common physiological and pathophysiological examples with special reference to type II diabetes mellitus. PMID- 3526892 TI - Effect of immunoglobulin depositions of glomerular sialic acids in patients with IgA nephropathy. AB - A study of double immunofluorescence-staining of immunoglobulins and sialic acids in the glomeruli from patients with IgA nephropathy is described. Renal biopsy specimens from patients with IgA nephropathy were stained with rhodamine-labeled antihuman IgA, IgG or IgM antisera and then stained with FITC-labeled Limulus polyphemus (LPA), Tricum vulgaris (WGA) or antihuman C3 antisera. Marked positive stainings of IgA and C3 and positive binding of LPA or WGA were observed in the glomerular mesangial areas from patients with IgA nephropathy. LPA or WGA were not bound with glomerular capillary walls from patients with moderate and advanced stages of IgA nephropathy, although depositions of IgA and C3 were markedly observed in such walls. There was a significant inverse correlation between the deposition of IgA and the binding of LPA or WGA in glomerular capillary walls obtained from these patients with IgA nephropathy. The levels of proteinuria from patients with moderate and advanced stages of IgA nephropathy were significantly higher than those with minimal and slight stages of such disease. It is suggested that the decrease of sialic acids in glomerular capillary walls might be due to a deposition of IgA in some patients with IgA nephropathy. It is concluded that high levels of proteinuria might be due to the decrease of sialic acids in glomerular capillary walls from patients with moderate and advanced stages of IgA nephropathy. PMID- 3526893 TI - Glomerular disease in cirrhosis of the liver: low frequency of IgA deposits. AB - Twelve HBsAg-negative patients with histologically documented cirrhosis of the liver of either alcoholic (8 of 12) or cryptogenic (4 of 12) origin underwent renal biopsy to investigate proteinuria, hematuria and/or renal failure. Immunofluorescence was positive for IgA in 2 patients with mesangiocapillary glomerulonephritis (MCGN) and could not be performed in 2 additional patients with the same diagnosis. However, in the remaining 8 patients, immunofluorescence was negative for IgA and frequently positive for C3, IgG, IgM and/or fibrinogen. These 8 patients without IgA were classified as follows: MCGN with subendothelial electron-dense deposits (2 cases), IgM-IgG cryoglobulinemia with diffuse endocapillary glomerulonephritis (1 case), membranous nephropathy (1 case), diffuse endocapillary proliferative glomerulonephritis (1 case), vasculitis with focal segmental necrotizing glomerulitis and crescentic glomerulonephritis (2 cases). These results show that cirrhosis of the liver can be associated with a wide variety of glomerular disorders. Contrary to previous belief, IgA is absent in two thirds of patients with cirrhosis and glomerulopathy. Therefore, the pathogenetic importance of IgA in the development of glomerular disease in such patients is doubtful. PMID- 3526894 TI - Fever and renal dysfunction in a renal transplant patient. PMID- 3526895 TI - Private practice. Out on a limb and loving it. PMID- 3526896 TI - Maternal ingestion of acetylsalicylic acid inhibits fetal and neonatal prostacyclin and thromboxane in humans. AB - Small doses of maternal acetylsalicylic acid have proved to prevent preeclampsia. To study the mechanism of this action of acetylsalicylic acid, healthy women ingested 100 mg (n = 13) or 500 mg (n = 14) of acetylsalicylic acid during labor at term. The fetal prostacyclin synthesis, as assessed by the production of 6 ketoprostaglandin F1 alpha (a metabolite of prostacyclin) by the umbilical artery, was reduced from 21.3 +/- 1.6 ng/gm/min of dry weight in the controls (n = 25, mean +/- SE) to 7.8 +/- 1.1 ng/ml/min (p less than 0.001) in infants of mothers receiving 500 mg of acetylsalicylic acid, but it was unchanged in infants with mothers receiving 100 mg of acetylsalicylic acid (19.5 +/- 2.3 ng/gm/min). Maternal ingestion of 500 mg of acetylsalicylic acid also was accompanied by reduced (p less than 0.10) urinary excretion of 6-ketoprostaglandin F1 alpha in neonates during the first 3 days of life. The fetal platelet thromboxane A2 synthesis, as assessed by the release of thromboxane B2 (a metabolite of thromboxane A2) during spontaneous clotting of the umbilical blood (63.4 +/- 4.2 pg/10(5) platelets, n = 22), was inhibited in infants born to mothers given 100 mg (14.0 +/- 3.7 pg/10(5) platelets, p less than 0.001) or 500 mg of acetylsalicylic acid (6.1 +/- 3.5 pg/10(5) platelets, p less than 0.001). The thromboxane B2 release by the umbilical artery (1.1 +/- 0.1 ng/gm/min, n = 13) also was decreased in infants of mothers receiving 500 mg of acetylsalicylic acid (0.57 +/- 0.1 ng/gm/min, n = 7, p less than 0.01). Thus a small dose of maternal acetylsalicylic acid (100 mg) inhibits only the fetoplacental thromboxane A2 but leaves prostacyclin production unaffected. PMID- 3526897 TI - Diagnosis and management of fetal facial clefts. AB - Fetal facial clefts were identified sonographically in 12 cases, 10 (83%) of which had other structural anomalies. When a facial cleft is diagnosed prenatally a careful search of the fetus for associated anomalies is indicated. With the finding of an autosomal trisomy in four of the 10 cases (40%) with associated anomalies, cytogenetic amniocentesis is desirable to aid in diagnosis and subsequent obstetric management of these patients. PMID- 3526898 TI - Lymph node metastasis in cancer of the cervix: a preliminary report. AB - Accurate assessment of lymph node metastasis in cervical cancer is imperative to treatment plan. A histologic sampling method is suggested in which surgically excised lymph nodes are dissected at multiple levels before paraffin embedding. This approach proves to be a more sensitive procedure than the current bisection method in detecting metastasis. PMID- 3526899 TI - Successful midtrimester thoracentesis with analysis of the lymphocyte population in the pleural effusion. AB - A case of successful midtrimester fetal thoracentesis is reported. Several chest taps were performed in a fetus between 20 and 23 weeks' gestation to relieve the large and progressing pleural effusion. Analysis of the lymphocyte subpopulations in the pleural fluid showed differences in cell mix when compared with that of our previous, equally successful reported case. PMID- 3526900 TI - Failure of ibuprofen in treatment of herpes genitalis. AB - Motrin (ibuprofen), a potent inhibitor of prostaglandin synthetase, was tested in women and men for treatment of recurrences of genital herpes. In a double-blind trial, no statistically significant differences were observed between treated and placebo groups in any of the measured parameters. PMID- 3526901 TI - The placental bed biopsy: review from three European centers. AB - This review derives from extensive experience with the placental bed biopsy technique in three centers over the last 30 years. A placental bed biopsy, usually taken at cesarean section, must include basal decidua and subjacent myometrium from the central zone of the placental site. Attention is drawn specifically to the sampling errors and to the pitfalls in morphologic interpretation of tissues, both maternal and fetal, that are continuously changing throughout the course of pregnancy. The features of the normal placental bed and of vascular lesions in pathologic pregnancies are briefly reviewed. Extension and elaboration of the technique and its more widespread use could contribute to the elucidation of many of the unresolved problems in human pregnancy. PMID- 3526902 TI - Nonstress and contraction stress testing of baboon fetuses. AB - This study of six pregnant baboons at 133 to 175 days of gestation indicates that all of 26 nonstress tests (two to seven per animal) and all of eight contraction stress tests (one or two per animal) were successfully performed despite the need for sedation of the dam with ketamine. PMID- 3526903 TI - Predictive value of ultrasonic targeted imaging for fetal anomalies. PMID- 3526904 TI - Precarved lyophilized tissue for lamellar keratoplasty in recurrent pterygium. AB - Thirteen eyes with recurrent pterygia were treated with excision and lamellar keratoplasty using precarved, lyophilized donor cornea. After an average follow up of 23 months, only one eye (7.7%) required repeat excision. Two eyes (15.4%) had minor recurrences that were asymptomatic and did not progress. Minimal vascularization at the interface between donor and recipient cornea was frequent, but this completely regressed after suture removal and topical corticosteroid treatment. Limitation of movement, when present preoperatively, was improved or eliminated. Best corrected visual acuity was unchanged in eight eyes (61.5%), decreased by one line in two eyes (15.4%), and improved by one or two lines in three eyes (23.1%). Postoperative astigmatism was within 0.5 diopter of the preoperative value in 11 eyes (84.6%); one eye (7.7%) had a postoperative increase of 1 diopter and another eye (7.7%) of 2 diopters. PMID- 3526905 TI - Dermis-fat graft for orbital reconstruction after subtotal exenteration. AB - A surgical technique for reconstruction after subtotal orbital exenteration uses an autogenous dermis-fat graft. A musculocutaneous flap is advanced over the graft to provide the anterior vascular supply for the free dermis-fat graft. The periorbita and remaining orbital tissue provide the vascular supply posteriorly. This technique eliminates extensive skin grafting and delayed spontaneous healing. Wound healing is rapid and surgical morbidity is minimized. We have used this procedure in three patients with sebaceous gland adenocarcinoma, two patients with severe posttraumatic contracted sockets, and as a palliative procedure in one patient with a fungating choroidal melanoma and widespread metastasis. PMID- 3526906 TI - Effect of intravenous fluorescein on fluorescent treponemal antibody testing. PMID- 3526907 TI - An assessment of the impact of the Medicare Prospective Payment System on level II fieldwork. AB - The health care industry has undergone radical change because of the implementation of the Medicare Prospective Payment System (MPPS). This study is an assessment of the effect of MPPS on Level II fieldwork. Six factors that have the potential to influence fieldwork delivery patterns formed the basis of a questionnaire that was mailed to 23 occupational therapy directors in acute care Wisconsin hospitals. The 21 returned questionnaires were tallied by frequency of response and analyzed to ascertain current practice and changes resulting from MPPS. Findings indicate a strong commitment to professional and technical Level II fieldwork education. Departments reporting a decrease in staff were able to deflect the impact of the reductions by modifying their clinical education programs. Although changes were noted in all of the six identified categories, there was only minimal evidence that they were directly related to MPPS. Monitoring change during the 3rd and 4th year of the transition was recommended. PMID- 3526908 TI - Questioning our classical understanding of accommodation and presbyopia. AB - The development of precise instrumentation, electron microscopy, and enhanced analytical capabilities have renewed interest in understanding the mechanisms of accommodation and presbyopia. The properties of the ciliary muscle, the zonule, the lens capsule, and the crystalline lens are being reevaluated, suggesting, for example, that these components' elasticities change significantly with age and that the biochemical properties of the crystalline lens may be altered as the lens ages. The recent findings, mainly during the past decade, are contrasted with or incorporated into our classical understanding of the accommodative mechanism and presbyopia as stated originally by Helmholtz and Fincham. PMID- 3526909 TI - Endotoxin and tumor necrosis factor induce interleukin-1 gene expression in adult human vascular endothelial cells. AB - Interleukin 1 (IL-1) can induce potentially pathogenic functions of vascular endothelial cells. This mediator was formerly thought to be produced primarily by activated macrophages. We report here that bacterial endotoxin and recombinant human tumor necrosis factor cause accumulation of IL-1 beta mRNA in adult human vascular endothelial cells. IL-1 alpha mRNA was also detected when endothelial cells were exposed to endotoxin under "superinduction" conditions in the presence of cycloheximide. Metabolic labeling of these cells during endotoxin stimulation demonstrated increased synthesis and secretion of immunoprecipitable IL-1 protein that comigrated electrophoretically with the predominant monocyte species. In parallel with increased IL-1 mRNA and protein, endothelial cells exposed to endotoxin also release biologically active IL-1 that was neutralized by anti-IL-1 antibody. Because bloodborne agents must traverse the endothelium before entering tissues, endothelial IL-1 production induced by microbial products or other injurious stimuli could initiate local responses to invasion. Endothelial cells are both a source of and target for IL-1; accordingly, this novel autocrine mechanism might play an early role in the pathogenesis of vasculitis, allograft rejection, and arteriosclerosis. PMID- 3526910 TI - Distinct histologic patterns of acute, prolonged, and chronic rejection in vascularized rat pancreas allografts. AB - In a model of pancreas whole organ transplantation in streptozotocin diabetic rats distinct histologic patterns of acute, prolonged and chronic rejection were defined by light microscopy. Allotransplantation between major histocompatibility complex (MHC) congenic and recombinant rat strains allowed an immunogenetic analysis of the effect of defined histocompatibility antigens on graft morphology. The impact of surgical techniques with preserved and suppressed exocrine secretion on graft histology was sequentially assessed in pancreas isograft recipients. MHC incompatibility was associated with acute rejection, non MHC disparity with prolonged rejection and RT1.C mismatch with chronic rejection. PMID- 3526911 TI - Expression of a granule membrane marker on the surface of neutrophils permeabilized with digitonin. Correlations with Ca2+-induced degranulation. AB - The authors have previously shown that human neutrophils can be permeabilized with the cholesterol-complexing agent digitonin and that these cells can be induced to secrete granule contents by increasing free Ca2+ concentrations. In the studies reported here, the authors wished to determine whether secretion of granule constituents correlated with the appearance of an immunologic marker for granule membranes on the surface of the permeabilized neutrophils. For this purpose, we used flow cytometry and two fluorometrically identifiable markers, Mo1 (a granule membrane marker) and beta 2-microglobulin (beta 2m) (a plasma membrane marker). It was found that the ratio of Mo1/beta 2m increased for permeabilized neutrophils which were exposed to micromolar concentrations of free Ca2+. This increase in the detectable surface concentration of Mo1 was accompanied by the release of lysozyme, vitamin B12 binding protein, and beta glucuronidase into the medium. Statistical analysis showed a very strong correlation between granule secretion and the Mo1/beta 2m ratio. These data thus suggest that granule membrane components were being introduced into the plasma membrane during Ca2+-induced granule discharge; this in turn suggests that secretion by permeabilized neutrophils represents true degranulation. PMID- 3526912 TI - Congenital malformations of the ear. AB - Two hundred and two operations on patients with a congenital ear malformation are presented. Special emphasis is placed on those patients seen in the past three years. The goal of surgery is normal, or near normal, hearing in the operated ear. The surgical approach is direct to the middle ear, and the mastoid air cell system is not opened. Temporalis fascia is used for the new tympanic membrane and a center hole split-thickness skin graft is used to line the new ear canal. In the uncomplicated atresia patient, the postoperative speech reception threshold is routinely 15 to 25 dB. PMID- 3526913 TI - Comparative study of the clinical results obtained by means of Plastipore and ceramic ossicular prosthesis and bone allografts. AB - We present a comparative study of the clinical and audiologic results obtained by means of Plastipore and ceramic ossicular prostheses and bone allografts in reconstructive middle ear surgery. We stress the excellent tolerance for ceramic and bone allografts in comparison to Plastipore. Functionally, the best results were obtained with partial prostheses using bone allografts and with total ceramic ossicular prostheses. Air-bone gaps less than 10 dB (37%) and 20 dB (69%) were achieved in patients with partial prostheses; in patients with total prostheses, 38% had an air-bone gap of less than 10 dB and 62% of less than 20 dB. PMID- 3526914 TI - Prospere Meniere: a glimpse at his personality and time from his introduction of Kramer's book, "Diseases of the Ear". PMID- 3526915 TI - EMG feedback and the restoration of motor control. A controlled group study of 12 hemiparetic patients. AB - A controlled group study involving 12 patients was performed with the purpose of comparing the effects of EMG feedback in the (re-)learning of motor control to the effects of a conventional physical therapy procedure (NDT). The therapy was focussed on the improvement of the dorsiflexion function of the foot. Special attention was given to the measurement and evaluation of functional parameters (range of motion and gait). The results indicated no significant differences between the two methods. The implications of the results for the employment of EMG feedback and other therapeutic procedures in motor rehabilitation are discussed. PMID- 3526916 TI - Glucose alters configuration of gap junctions between pancreatic islet cells. AB - In rat pancreatic islets, gap junctional subunits (GJS) occur under two different configurations, namely in linear single strands and in polygonal particle aggregates. The present freeze-fracture study demonstrates that GJS can rapidly (dis)assemble into one of these membrane specializations without changes in their total number. Isolation of the pancreatic gland and its perfusion at 2.8 mM glucose is accompanied by a decrease in polygonally packed GJS from 46 to 16%. A rise in medium glucose concentration is followed, within 10 min, by a dose dependent increase in the percent polygonal particles. This glucose effect on gap junction configuration is calcium dependent and reversible upon glucose removal; it is still entirely detectable when protein synthesis is blocked by cycloheximide. These results indicate that islet gap junctions are dynamic structures that rapidly adjust their configuration to extracellular regulators of beta-cell function. In the light of previous observations, it is suggested that this rapid (dis)assembly of gap junctional structures be considered as a component in the ionic and metabolic coupling between insulin-containing beta cells of the pancreas. PMID- 3526917 TI - Induction of mitochondrial metabolism and pH-modulated ammoniagenesis by rocking LLC-PK1 cells. AB - In an effort to find a model system in which the regulation of renal ammoniagenesis could be delineated, the LLC-PK1 line of cultured pig kidney epithelial cells was examined. Ammonia production by normally cultured LLC-PK1 cells (monolayers on 75-cm2 flasks, under 6 ml still serum-containing medium) was found to be neither modulated by direct (3 h) nor adapted by chronic (3 day) manipulation of medium pH (production at pH 7.05, 7.40, or 7.60 not significantly different). Considering that the mitochondrial glutamine to alpha-ketoglutarate pathway is the major regulatory site of ammoniagenesis, and that mitochondrial metabolism might be restricted under the normal lactate-generating or hypoxic culture conditions, we examined ammonia production by rocked flasks of LLC-PK1 cells. Flask were rocked continually at a rate of 2.5 oscillations/min, thereby exposing the cells to the atmosphere 40-50% of the time and also maximizing medium O2 tension and nutrient-waste exchange. Mitochondrial enzyme activities in rocked LLC-PK1 cells were shown to be consistently 1.5-fold greater than those in normally cultured cells. Ammonia production by rocked cells was not only directly modulated by short incubations with low and high pH media (production at pH 7.05 greater than 7.40 greater than 7.60) but was adapted by chronic (3 day) manipulations of medium pH (16 h after return to pH 7.40 medium production by pH 7.05- greater than 7.40- greater than 7.60-adapted cells). Thus rocker culture of the LLC-PK1 cell line both induces mitochondrial metabolism and converts cellular ammoniagenesis to a pH-sensitive phenomenon.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3526918 TI - Inhibition by proinsulin of endogenous C-peptide release in healthy man. AB - To determine the role of proinsulin on endogenous insulin release, splanchnic output and arterial concentrations of C-peptide were measured in healthy subjects before and during infusion of human (HPI) and porcine (PPI) proinsulin at increasing rates for 70 min each (HPI, 328 and 656 micrograms X m-2 X h-1; PPI, 54, 134, and 268 micrograms/m-2 X h-1), while euglycemia was maintained by variable glucose infusion. By using this approach splanchnic C-peptide output was reduced by human proinsulin infusion from 143 +/- 16 (mean +/- SE) pmol/min to 111 +/- 18 and 75 +/- 11 pmol/min (P = 0.01). Simultaneously, arterial concentrations of C-peptide decreased from 716 +/- 40 pmol/l by 23 and 32%. Similar inhibition was induced by porcine PPI of splanchnic C-peptide output at an infusion rate of 268 micrograms X m-2 X h-1. Mean metabolic clearance rate was 2.7 and 3.7 ml X kg-1 X min-1 for HPI and PPI, respectively. Splanchnic glucose output was almost completely suppressed by human and porcine proinsulin at maximal infusion rates. This effect preceded both inhibition by proinsulin of splanchnic C-peptide output and stimulation of peripheral glucose utilization. We conclude that human and porcine proinsulin suppress endogenous insulin secretion at pharmacological concentrations. The observed constancy of the metabolic clearance rate of HPI demonstrates that its clearance remains a nonsaturable process up to supraphysiological HPI concentrations, while clearance of PPI appears to be subject to saturation. Furthermore, it appears that splanchnic glucose output responds earlier to proinsulin exposure than suppression of C peptide release or stimulation of peripheral glucose utilization. PMID- 3526919 TI - Maternal ethanol ingestion: effect on maternal and neonatal glucose balance. AB - Liver glycogen availability in the newborn is of major importance for the maintenance of postnatal blood glucose levels. This study examined the effect of maternal ethanol ingestion on maternal and neonatal glucose balance in the rat. Female rats were placed on the Lieber-DeCarli liquid ethanol diet, an isocaloric liquid pair-fed diet, or an ad libitum rat chow diet at 3 wk before mating and throughout gestation. Blood and livers were obtained from dams and rat pups on gestational days 21 and 22. The pups were studied up to 6 h in the fasted state and up to 24 h in the fed state. Maternal ethanol ingestion significantly decreased litter size, birth weight, and growth. A significantly higher mortality during the early postnatal period was seen in the prenatal ethanol exposed pups. Ethanol significantly decreased fed maternal liver glycogen stores but not maternal plasma glucose levels. The newborn rats from ethanol ingesting dams also had significantly decreased liver glycogen stores. Despite mobilizing their available glycogen, these prenatal ethanol exposed pups became hypoglycemic by 6 h postnatal. This was more marked in the fasted pups. Ethanol did not affect maternal nor neonatal plasma insulin levels. Thus maternal ethanol ingestion reduces maternal and neonatal liver glycogen stores and leads to postnatal hypoglycemia in the newborn rat. PMID- 3526920 TI - A dual-isotope technique for determination of in vivo ketone body kinetics. AB - "Total ketone body specific activity" has been widely used in studies of ketone body metabolism to circumvent so-called "isotope disequilibrium" between the two major ketone body pools, acetoacetate and beta-hydroxybutyrate. Recently, this approach has been criticized on theoretical grounds. In the present studies, [13C]acetoacetate and beta-[14C]hydroxybutyrate were simultaneously infused in nine mongrel dogs before and during an infusion of either unlabeled sodium acetoacetate or unlabeled sodium beta-hydroxybutyrate. Ketone body turnover was determined using total ketone body specific activity, total ketone body moles % enrichment, and an open two-pool model, both before and during the exogenous infusion of unlabeled ketone bodies. Basal ketone body turnover rates were significantly higher using [13C]acetoacetate than with either beta [14C]hydroxybutyrate alone or the dual-isotope model (3.6 +/- 0.5 vs. 2.2 +/- 0.2 and 2.7 +/- 0.2 mumol X kg-1 X min-1, respectively, P less than 0.05). During exogenous infusion of unlabeled sodium acetoacetate, the dual-isotope model provided the best estimate of ketone body inflow, whereas 14C specific activity underestimated the known rate of acetoacetate infusion by 55% (P less than 0.02). During sodium beta-hydroxybutyrate infusion, [13C]-acetoacetate overestimated ketone body inflow by 55% (P = NS), while better results were obtained with 14C beta-hydroxybutyrate alone and the two-pool model. Ketone body interconversion as estimated by the dual-isotope technique increased markedly during exogenous ketone body infusion. In conclusion, significant errors in estimation of ketone body inflow were made using single-isotope techniques, whereas a dual-isotope model provided reasonably accurate estimates of ketone body inflow during infusion of exogenous acetoacetate and beta-hydroxybutyrate.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3526921 TI - Chronic exercise increases insulin binding in muscles but not liver. AB - It has been postulated that the improved glucose tolerance provoked by chronic exercise is primarily attributable to increased insulin binding in skeletal muscle. Therefore, we investigated the effects of progressively increased training (6 wk) on insulin binding by five hindlimb skeletal muscles and in liver. In the trained animals serum insulin levels at rest were lower either in a fed (P less than 0.05) or fasted (P less than 0.05) state and after an oral glucose tolerance test (n = 8) (P less than 0.05). Twenty-four hours after the last exercise bout sections of the liver, soleus (S), plantaris (P), extensor digitorum longus (EDL), and red (RG) and white gastrocnemius (WG) muscles were pooled from four to six rats. From control animals, killed at the same time of day, muscles and liver were also obtained. Insulin binding to plasma membranes increased in S, P, and EDL (P less than 0.05) but not in WG (P = 0.07), RG (P greater than 0.1), or in liver (P greater than 0.1). There were insulin binding differences among muscles (P less than 0.05). Comparison of rank orders of insulin binding data with published glucose transport data for the same muscles revealed that these parameters do not correspond well. In conclusion, insulin binding to muscle is shown to be heterogeneous and training can increase insulin binding to selected muscles but not liver. PMID- 3526922 TI - Glucose turnover in response to exercise during high- and low-FIO2 breathing in man. AB - The purpose of this study was to assess whether breathing high or low concentrations of O2 could affect glucose turnover during exercise in man. Ten healthy subjects performed two constant work-rate exercise tests, one when the fraction of inspired O2 (FIO2) was 0.15 and the other at the same work rate but when the FIO2 was 0.80. The work rate for each subject was chosen so that blood lactate would be elevated during hypoxia, but would be lower during hyperoxia. Glucose appearance (Ra) and disappearance (Rd) were measured using the primed, constant infusion of [3-3H]glucose. Although the work rate was the same during hypoxia and hyperoxia in each subject, hypoxic exercise was accompanied by a significantly larger rest to exercise increase in Rd (delta Rd) compared with hyperoxia by 265%. Similarly, delta Ra was greater during hypoxia than during hyperoxia by 188%. Lactate to pyruvate ratios were significantly higher during hypoxic exercise suggesting a shift in the cell redox to a more reduced state. Insulin and glucagon were not affected by the FIO2, but both epinephrine and norepinephrine were increased during hypoxic exercise, which may explain the increase in Ra. The regulation of blood glucose during exercise in vivo appears to be dependent on the availability of oxygen to the working muscle cells. PMID- 3526923 TI - On linearity of insulin kinetics. PMID- 3526924 TI - Autoregulation of renal blood flow in two-kidney, one-clip hypertensive rats. AB - Renal blood flow (RBF) autoregulation was examined in the clipped and nonclipped kidneys in two groups of two-kidney, one-clip (2K-1C) hypertensive rats 10 wk after clipping. The arterial pressure distal to the clip and the renin secretion rate (RSR) were also examined. The blood pressure (BP) was 149 +/- 4 and 162 +/- 6 mmHg in the two hypertensive groups vs. 114 +/- 3 mmHg in the controls (P less than 0.02). The RBF (in ml X min-1 X kidney-1) was 4.27 +/- 0.41 in the nonclipped and 2.18 +/- 0.23 in the clipped kidneys (P less than 0.001). The pressure distal to the clip was 104 +/- 7 mmHg. The renal vascular resistance (RVR) (in mmHg X ml-1 X min-1 X g-1) was 25.0 +/- 1.4 in the control kidneys vs. 58.4 +/- 4.5 in the nonclipped (P less than 0.001) and 39.9 +/- 6.6 in the clipped kidneys (P less than 0.01). The RBF autoregulation was well preserved in the nonclipped kidneys but reset to a higher lower pressure limit of autoregulation of 106 +/- 4 mmHg, which was significantly higher than in the normotensive controls (84 +/- 6 mmHg) (P less than 0.01). In the clipped kidneys there was complete loss of RBF autoregulation. RSR decreased with reduction of the perfusion pressure in the clipped kidneys. The increased RVR might have been due to a combination of structural and functional changes in both kidneys. PMID- 3526925 TI - Mechanism of skeletal muscle underperfusion in a dog model of low-output heart failure. AB - To investigate the mechanism responsible for underperfusion of working skeletal muscle in heart failure, we measured systemic and femoral bed hemodynamics during treadmill exercise and gracilis muscle resistance during contraction frequencies of 1-9 Hz in 8 dogs ventricularly paced at 260 beats/min for 3 wk to induce heart failure (HF) and in 9 control dogs. At peak treadmill exercise (4 mph, 10%), HF dogs had reduced cardiac outputs (control: 297 +/- 42 vs. HF: 212 +/- 16 ml X min 1 X kg-1) and femoral bed flows (control: 352 +/- 112 vs. HF: 229 +/- 95 ml/min) and elevated arterial lactates [control: 1.7 +/- 0.7 vs. HF: 4.1 +/- 0.7 mM (all P less than 0.04)], consistent with skeletal muscle underperfusion. This muscle underperfusion was associated with reduced mean arteriovenous pressure gradients [control: 119 +/- 12 vs. HF: 91 +/- 9 mmHg (P less than 0.001)] but with normal systemic vascular [control: 21 +/- 6 vs. HF: 23 +/- 5 U (P = NS)] and femoral bed resistances [control: 3.5 +/- 1.6 vs. HF: 4.4 +/- 2.3 X 10(2) U (P = NS)]. Both groups also had similar gracilis muscle minimal resistance during exercise (control: 2.0 +/- 1.1 vs. HF: 1.9 +/- 0.9 X 10(3) U/100 g) and following maximal vasodilation (control: 2.0 +/- 1.0 vs. HF: 2.1 +/- 1.0 X 10(3) U/100 g). These results suggest that 1) short-term rapid ventricular pacing in the dog produces a model of low output HF resembling HF in humans, and 2) skeletal muscle underperfusion in this model is due to a reduced muscle arteriovenous pressure gradient and not to impaired skeletal muscle arteriolar vasodilation. PMID- 3526926 TI - Succinyl trialanine p-nitroanilide hydrolytic activity in blood vessels of the rat. AB - Succinyl trialanine p-nitroanilide [Suc-(Ala)3-pNA] hydrolytic activity, an enzymatic activity related to elastase, in vascular wall was detected and partially characterized. Subcellular distribution of this activity closely paralleled that of plasma membrane marker enzymes, 5'-nucleotidase, and phosphodiesterase I, suggesting its association with the vascular muscle plasma membranes. The same distribution of elastolytic activity was observed. Hydrolytic activity toward Suc-(Ala)3-pNA was inhibited by EDTA, ethyleneglycol-bis(beta aminoethylether)-N,N'-tetraacetic acid but not by trypsin inhibitor. Enzyme activities were different not only between aortic muscle extracts from young and mature rats, but also among the extracts from elastic and muscular arteries, specific activity being higher in the aortas of young animals or in elastic arteries, respectively. The activity studied [Suc-(Ala)3-pNAase] in vascular wall may play a role in vascular connective tissue metabolism as well as function. PMID- 3526927 TI - Central renin-angiotensin system and the pathogenesis of DOCA-salt hypertension in rats. AB - The antihypertensive effect of blockade of the brain renin-angiotensin system (brain RAS) was investigated in DOCA (deoxycorticosterone acetate)-salt hypertensive rats. Continuous intracerebroventricular (ICV) administration of SQ14225 (SQ; 1.25 micrograms X 0.5 microliter-1 X h-1) for 7 days attenuated the increase in blood pressure (99 +/- 5 vs. 116 +/- 4 mmHg on the 7th day) and also reduced the elevation of blood pressure (157 +/- 7 vs. 138 +/- 6 mmHg) in these hypertensive rats. Attenuation of increasing blood pressure in the developing phase following ICV SQ treatment was accompanied by decrease of fluid intake and prevention of elevation of the plasma vasopressin. In the established phase, in addition to reduction of the plasma vasopressin and decrease of fluid intake, restoration of the impaired baroreceptor reflexes was brought about by ICV SQ treatment. These results indicate that the brain RAS strongly influences the regulation of blood pressure in DOCA-salt hypertensive rats and that its mechanism of action is closely related to changes in sodium excretion, vasopressin, and the baroreceptor reflexes. PMID- 3526928 TI - Left ventricular function during lethal and sublethal endotoxemia in swine. AB - Our previous studies suggested that after a median lethal dose (LD50) of endotoxin, cardiac contractility was depressed in nonsurviving dogs. The canine cardiovascular system is unlike humans in that dogs have a hepatic vein sphincter that is susceptible to adrenergic stimulation capable of raising hepatic and splanchnic venous pressures. We retested the hypothesis that lethality after endotoxin administration is associated with cardiac contractile depression in pigs, because the hepatic circulation in this species is similar to that of humans. We compared cardiac mechanical function of pigs administered a high dose (250 micrograms/kg) or a low dose (100 micrograms/kg) endotoxin by use of the slope of the end-systolic pressure-diameter relationship (ESPDR) as well as other measurements of cardiac performance. In all the pigs administered a high dose, ESPDR demonstrated a marked, time-dependent depression, whereas we observed no significant ESPDR changes after low endotoxin doses. The other cardiodynamic variables were uninterpretable, due to the significant changes in heart rate, end diastolic diameter (preload), and aortic diastolic pressure (afterload). Plasma myocardial depressant factor activity accumulated in all endotoxin-administered animals, tending to be greater in the high-dose group. In this group, both subendocardial blood flow and global function were depressed, whereas pigs administered the low dose of endotoxin demonstrated slight, but nonsignificant, increases in flow and function. These observations indicate that myocardial contractile depression is associated with a lethal outcome to high doses of endotoxin. One possible mechanism for this loss of contractile function may be a relative hypoperfusion of the subendocardium. PMID- 3526929 TI - Tribute to Alexander Reid Martin 1896-1983. PMID- 3526930 TI - The effect of maternal antigenic stimulation upon the active immune responsiveness of their offspring: suppression induced by soluble protein antigen, ovalbumin, in mice. AB - The active immune responsiveness of the offspring of pregnant mice stimulated with heterologous protein antigen was investigated by measuring the plaque forming cells (PFC). Mice (C57BL/10;B10) immunized once in pregnancy with ovalbumin (OVA) in the form of Al(OH)3 gel (in alum) or in a soluble form (in saline) developed no anti-OVA PFC response. The anti-OVA PFC response suppression induced in the offspring was high in the offspring of alum-treated mothers and low in those of saline-treated mothers. The optimal dose of OVA in alum that induces the highest immunological memory in pregnant mice caused the complete suppression of PFC development in their offspring. The same dose of OVA in saline induced a negative immunological memory in pregnant mice and partial suppression in the offspring. On the other hand, mice primed prior to conception and boosted during pregnancy developed anti-OVA PFC in significant numbers, and only a partial suppression was established in their young. Based on these data, we discussed the possible mechanisms concerned with the specific suppression induced in the young B10 mice stimulated by OVA. PMID- 3526931 TI - Localized primary (AL) amyloid tumor of the breast. Cytologic, histologic, immunocytochemical and ultrastructural observations. AB - Two examples of localized primary amyloid tumor of the breast are presented, including one patient with metachronous bilateral lesions. Our findings and review of the literature indicate that this rare lesion occurs predominantly in elderly females and can be mammographically and clinically confused with carcinoma. Fine-needle aspiration biopsy can be a useful procedure to make a preliminary diagnosis. Congo red staining with prior potassium permanganate incubation confirmed the AL type of amyloid in our two cases; this might be the predominant type in the localized form involving the breast. Immunofluorescence studies demonstrated IgA, with kappa and lambda light-chain deposition within the amyloid foci in one case, and intracytoplasmic IgG with both light chains within plasma cells and amyloid deposits of the second case. Ultrastructural examination of one of the cases showed characteristic findings of straight, nonbranching fibrils of 4-9 nm, diagnostic of amyloid. From our findings and a review of the literature, we conclude that amyloid tumors of the breast can occur in three separate settings: secondary amyloidosis, systemic or multiple myeloma associated amyloidosis, and as a localized primary type having a benign course. PMID- 3526932 TI - The 1985 Fred W. Stewart Award. PMID- 3526933 TI - Carotid endarterectomy for amaurosis fugax without angiography. AB - Angiography has associated morbidity and mortality, but it is the road map for the vascular surgeon. Can blood vessels be safely operated on without first obtaining an angiogram? It was the purpose of this retrospective analysis to ascertain the need for and value of carotid angiography in patients with amaurosis fugax. Twenty-eight patients (18 men and 10 women) with an average age of 66.4 years (range 58 to 71 years) had histories consistent with amaurosis fugax and were operated on for it. They did not have a history of transient ischemic attacks or stroke. Histories were reviewed for cardiac disease, smoking, hypertension, and diabetes. All patients were studied by noninvasive methods (bidirectional Doppler analysis, oculoplethysmography, carotid phonoangiography, and real-time B-mode ultrasonography), cerebral computerized tomographic scan, and angiography. Nineteen of the 28 patients (11 men and 8 women) had fluorescein angiography. All preoperative computerized tomographic scans were negative. Findings on real-time B-mode ultrasonography suggested significant ulcerated plaque in all of the patients. Angiography could only confirm ulcerated areas in 17 of the 28 patients. Of the patients studied by fluorescein angiography, 17 of 19 (10 men and 7 women) had confirmed embolic lesions. Surgery confirmed ulcerative lesions in all of the 28 patients. Results of this study indicate that if a patient has a history consistent with amaurosis fugax, a negative computerized tomographic scan, and a positive real-time B-mode ultrasonogram, an angiogram may not be necessary. PMID- 3526934 TI - Effect of quantitated stenoses on arterial sound spectrum analysis. AB - Spectral analysis of carotid Doppler signals has been shown to be accurate in determining the degree of carotid artery stenosis when compared with arteriography. Since the Doppler angle and the amount of gain used during measurement may affect results, an in vitro study was performed measuring peak frequency, mode frequency, and percent window at various Doppler angles and gains to determine if these latter factors could affect results of the test. A spectrum analyzer with an 8 MHz continuous-wave Doppler probe was utilized. Seven cross sectional area stenoses (0 to 100 percent) were applied to an undiseased bifurcated cadaver artery which was suspended in a saline bath and placed in a pulsatile circulatory system. At each stenosis, peak frequency, mode frequency, and percent window were measured at three Doppler angles (45 degrees, 60 degrees, and 75 degrees) at a constant gain and at three different gains (low, medium, and high) at a constant Doppler angle of 60 degrees. Arterial pressure was measured distal to the stenoses. Critical stenoses were present at greater than 82 percent area reduction. At a Doppler angle of 60 degrees and medium gain, correlation coefficients between percentage of stenosis and peak frequency, mode frequency, and percent window were 0.9520, 0.8369, and -0.9861, respectively. However, peak frequency and mode frequency actually decreased at stenotic areas of more than 82 percent and were similar to frequencies seen at stenotic areas of 61 percent. Peak frequency significantly decreased as Doppler angle increased, so there was an even greater overlap of peak frequency values at larger angles. Percent window did not appear to be affected by Doppler angle. At an angle of 60 degrees and different gains, there appeared to be very little overlap of percent window values between any stenoses. Peak frequency and mode frequency did not appear to be affected by gain. This study demonstrates an excellent correlation between percentage of stenosis and peak frequency and percent window. However, peak frequency was significantly affected by changes in Doppler angle and did not differentiate subcritical (61 percent) from critical (96 percent) stenoses. Percent window, however, was not significantly affected by Doppler angle or gain and was able to differentiate between all degrees of stenosis. PMID- 3526935 TI - Initial experience comparing B-mode imaging and venography of the saphenous vein before in situ bypass. AB - Preoperative saphenous vein assessment was performed using both venography and B mode scanning. Fifty patients underwent preoperative assessment, and the results were compared with the intraoperative findings. Both venography and B-mode imaging were equally accurate at determining the dominant saphenous system, but B mode imaging missed five thigh double systems that were shown on venography. Neither venography nor B-mode imaging were good predictors of actual vein size at most sites in the leg, with the exception of B-mode assessment below the knee, where there was a positive correlation with intraoperative vein size (r = 0.80; p less than 0.01). In our study, B-mode scanning was consistently more reliable in determining vein presence and continuity than venography, which gave nine false negative results. Finally, B-mode imaging allows the marking of a saphenous vein map on the patient's leg preoperatively as a guide to bypass surgery. PMID- 3526936 TI - Infrapopliteal bypasses to heavily calcified rock-like arteries. Management and results. AB - Of the 355 consecutive infrapopliteal bypasses for limb salvage performed over a 5 year period at our institution, 116 (Group I) were to noncalcified vessels, 203 (Group II) were to vessels of varying degrees of calcification (mild to moderate), and 36 (Group III) were to heavily and circumferentially calcified arteries. A new intraoperative fracture technique was used to overcome the rigidity of the arterial wall in the latter group. Three year cumulative patency rates for Groups I, II, and III were 45 percent, 58 percent, and 47 percent, respectively. Comparable limb salvage rates for Groups I, II, and III were 66 percent, 73 percent, and 75 percent. No significant difference in patency or limb salvage results could be elicited between the three groups by the log-rank test. These findings suggest that arterial calcification is an invalid predictor of failure in small vessel bypasses. Even circumferentially calcified arteries, which are generally thought to be surgically unapproachable, should not be a deterrent to limb salvage attempts. PMID- 3526937 TI - High-dose steroids in childhood acute idiopathic thrombocytopenia purpura. AB - Nine newly diagnosed, previously untreated children (mean age: 4.2 years, range: 1-9 years) with severe acute idiopathic thrombocytopenia purpura (mean platelet count: 5.8 X 10(9)/L, range: 1-12 X 10(9)/L) were treated with high-dose steroids (prednisone 4-8 mg/kg/day). Steroid dose was based on platelet count at presentation: Group I (platelets less than 5 X 10(9)/L) was started on 8 mg/kg/day; Group II (platelets 5-15 X 10(9)/L) received 6 mg/kg/day. All patients had serologic and histologic evidence of acute idiopathic thrombocytopenia purpura. On this protocol, it took a mean number of 1.9 days (1-3 days) to reach a platelet count of at least 20 X 10(9)/L and 9.2 days (3-26 days) to reach a normal platelet count. No significant toxicity was observed except for weight gain ranging from 3-10% and mild behavioral problems. Both groups were on high dose steroids (4-8 mg/kg/day) for 7.3 +/- 2.1 days. Only one patient had a brief relapse to a platelet count of 18 X 10(9)/L while on therapy (day 14), but responded promptly to an increase in prednisone dose. Presently, all nine patients are in remission and have not required maintenance medication. PMID- 3526938 TI - The evolution of clinical molecular genetics. Neuroblastoma as a model tumor. AB - The use of cytogenetics and molecular genetics to elucidate mechanisms underlying the pathogenesis of human cancer has led to important advances in our understanding of cancer etiology. The identification of a reciprocal (11;22) translocation in peripheral neuroectodermal tumors and N-myc amplification in classical childhood neuroblastoma provides new guidelines for the diagnostic evaluation of peripheral nervous system tumors. New approaches to the staging of these tumors are likely to include the evaluation of genetic alterations associated with tumor progression. Also, new therapeutic approaches will be focused on the modification of specific molecular targets responsible for neoplastic growth. PMID- 3526939 TI - Antibody response to Escherichia coli L-asparaginase. Prognostic significance and clinical utility of antibody measurement. AB - By using a modification of the microtiter solid-phase radioimmunoassay, we have measured Escherichia coli L-asparaginase (L-ASP) specific IgG, IgG4, and IgE antibodies in children who received L-ASP as part of their chemotherapy for leukemia and lymphoma. In 13 children with acute lymphoblastic leukemia induced with vincristine, prednisone, and L-ASP (10,000 IU/M2 i.v. each week for 3 weeks), seven developed high titer specific IgG antibodies. Four of the seven relapsed at the time of their peaking IgG response (6-10 months). None of the six with low or absent L-ASP antibody response have relapsed (followed for 20-35 months). In six children with allergic reactions to L-ASP reinduction, all had high titers of L-ASP specific IgG4 (greater than or equal to 20 U/ml) at the time of their reaction. In 16 other children with low L-ASP IgG4 (less than 13 U/ml), none demonstrated allergic reactions to rechallenge. Specific IgE was not consistently detectable in either group. In 21 patients with leukemia or lymphoma on L-ASP with cyclophosphamide-containing regimens, none developed significant IgG antibody response, compared with seven of 13 not receiving cyclophosphamide (p less than 0.001). We conclude: (a) development of L-ASP antibodies may have prognostic significance; (b) the detection of specific IgG4 can predict L-ASP allergy; and (c) cyclophosphamide-containing regimens reduce antibody formation to L-ASP and may allow repetitive (without anaphylaxis) and more effective (avoiding neutralizing antibodies) use of L-ASP. PMID- 3526940 TI - Symposium on imaging research in alcoholism. Introduction to the symposium. PMID- 3526941 TI - Computerized tomographic scan assessment of alcoholic brain damage and its potential reversibility. AB - The assessment of alcoholic brain damage by computerized tomographic (CT) scanning is reviewed and discussed. Alcoholics showed greater cerebral atrophy than aged-matched neurological controls. Supratentorial atrophy measurements correlated significantly with some neurobehavioral assessment measures. The cerebral atrophy reversed in some subjects with maintained abstinence. Computerized assessment of cerebral spinal fluid volume (cerebral atrophy) and mean cerebral density showed decreased cerebral spinal fluid volume and increased cerebral density with maintained abstinence over 4 weeks in a group of 20 alcoholics. CT cerebellar measurements demonstrated atrophy in many subjects, but these measurements did not correlate with measures of ataxia, cognitive impairment, supratentorial atrophy measurements, or age. An example of a magnetic resonance imaging scan of an alcoholic is given. Its advantages in avoiding bony artifact for posterior fossa atrophy estimations and its potential for in vivo description and localization of central nervous system metabolic abnormalities in alcoholism are discussed. PMID- 3526942 TI - Glucose uptake in brain during withdrawal from ethanol, phenobarbital, and diazepam. PMID- 3526943 TI - Assessment of alcoholism-related organic brain syndromes with positron emission tomography. PMID- 3526944 TI - Nuclear magnetic resonance spectroscopy and imaging in the study of experimental liver diseases. AB - We are investigating potential noninvasive new strategies for the assessment of liver injury, steatosis, and hepatic tumor development. These techniques employ nuclear magnetic resonance (NMR) imaging and spectroscopy. Accordingly, several experimental animal models of liver injury and steatosis produced in rats by ethanol, azaserine, L-ethionine, carbon tetrachloride, and D-galactosamine. Ethanol and L-ethionine induce acute steatosis without necrosis, whereas azaserine, carbon tetrachloride, and D-galactosamine are known to produce steatosis with varying degrees of hepatic necrosis. Triglyceride content and protein spin relaxation times were measured. T1 values were analyzed by using an inversion recovery technique at eight different tau values (20 msec to 2.50 sec) and T2 by Carr-Purcell-Meibloom-Gill pulse sequences with 10 spin echoes (4-40 msec). We also performed NMR imaging studies on controls and ethanol-induced steatosis using a 60-MHz Technicare 8-cm bore superconducting system. Results of these experiments indicate that varying degrees of steatosis produce striking changes in T2 without inducing changes in T1, whereas necrosis superimposed on steatosis produces T1 changes as well. Thus, these NMR spectroscopy and imaging studies demonstrated that steatosis may be clearly defined in vitro and in vivo. PMID- 3526945 TI - Use of nuclear magnetic resonance spectroscopy to study the effects of ethanol consumption on liver metabolism and pathology. AB - The application of NMR spectroscopy to studies of intact organs represents a powerful technology applicable for investigations of alcohol-induced liver disease in animal models. NMR-assisted studies of ethanol metabolism and its related pathology are now possible utilizing the 13C and 31P nuclei primarily. The major advantage of the technology includes the capacity to investigate biochemical processes at the level of the intact organ which is analyzed as a perfused preparation or in situ in an anesthetized animal model. Quantitative measurements of compounds containing either 31P or 13C nuclei are possible, and the kinetics of precursor incorporation into compounds associated with carbohydrate, lipid, and amino acid metabolism are readily followed. The concentrations of free Mg2+ and the pH of the intact liver can be monitored as a function of external perturbation and/or metabolic disturbances. PMID- 3526946 TI - Image analysis and computer graphics: emerging applications in ethanol research. PMID- 3526947 TI - Effects of age, sex, and cimetidine on acute ethanol-induced inhibition of the hepatic monooxygenase systems. AB - Our aim was to investigate the possible interaction of acute ethanol (E) with the metabolism of other drugs by microsomes isolated from immature and mature rat livers and placenta. The effects of acute in vitro E exposure on the N demethylation of [14C]aminopyrine and [1-14C]methylcaffeine by these tissues were determined. In addition, the effects of ethanol on these two enzyme systems from male and female livers were compared along with an analysis of ethanol and cimetidine inhibitory interactions. The degree (percentage) of inhibition by acute E (1-3 mg/ml) varied with both age and sex. Aminopyrine demethylase activity was inhibited by E to a greater degree (p less than 0.05) in the adult female than the male. However, when inhibition was expressed in absolute terms (control minus inhibited activity), these inhibitory values varied in direct proportion to initial (control) enzyme activity. Thus, E reduced aminopyrine demethylase from adult male microsomes by 4 times that in the female and in excess of 1000 times the absolute inhibition observed in fetal liver regardless of E concentration. A similar pattern of sex and age differences in caffeine demethylase response to E was observed except that absolute differences in inhibition were less due to smaller variation in control values. In addition, placental caffeine demethylase was highly sensitive to E inhibition (51% at 3 mg/nl) but not to the extent of caffeine demethylase from fetal liver (75% at 3 mg/nl). Finally, it was demonstrated that E interacts with cimetidine in a manner that may be additive. PMID- 3526949 TI - Dietary factors and alcoholic cirrhosis. AB - Mortality from cirrhosis in many countries deviates markedly from that expected for a given per capita alcohol intake. We investigated the possibility that dietary factors might explain the deviation expected and actual mortality rates in different countries. Deviations from expected cirrhosis mortality was calculated as a percentage for 17 different countries, all of whom had carrier rates for hepatitis B virus of less than 2%. The percentage of deviation was correlated with dietary intake of saturated fat, polyunsaturated fat, cholesterol, and also with mortality from ischemic heart disease. The percentage of deviation correlated inversely with dietary cholesterol (r = -0.86, p 0.001) and saturated fat (r = -0.80, p 0.001) and positively with polyunsaturated fats (r = -0.55 p 0.05). This suggests that both saturated fat and cholesterol protect against alcoholic cirrhosis while polyunsaturated fats promote cirrhosis. The correlation between percentage of deviation and ischemic heart disease (r = 0.78, p 0.002) suggests that those factors that promote ischemic heart disease protect against alcoholic cirrhosis. PMID- 3526948 TI - Human aldehyde dehydrogenase: kinetic identification of the isozyme for which biogenic aldehydes and acetaldehyde compete. AB - Michaelis constants and maximal velocities for phenylacetaldehyde (a metabolite of phenylethylamine), 3,4-dihydroxyphenylacetaldehyde (a metabolite of dopamine), 5-hydroxyindole acetaldehyde (a metabolite of serotonin), and 3,4 dihydroxyphenylglycolaldehyde (a metabolite of epinephrine and norepinephrine) have been determined for both cytoplasmic (E1) and mitochondrial (E2) isozymes of human liver aldehyde dehydrogenase (EC 1.2.1.3). Kinetic constants with biogenic aldehydes have never been previously determined for individual homogeneous isozymes of aldehyde dehydrogenase from any species. Mathematical treatment of these constants suggests that competition with acetaldehyde during alcohol metabolism would severely inhibit dehydrogenation of biogenic aldehydes with the mitochondrial and not the cytoplasmic isozyme of human liver aldehyde dehydrogenase. PMID- 3526950 TI - Alcohol use by adolescents in disrupted families. AB - Alcohol use increases among adults in response to marital disruption and divorce, but data that are available regarding adolescent alcohol use are inconsistent in the light of whether or not families are intact. To explore this question we obtained measures of frequency and quantity of alcohol use from 2595 junior and senior high school students, together with information about family intactness and parental alcohol use. Adolescents in single and stepparent families reported more alcohol use than adolescents from intact families, for both frequency and quantity of use. This was the case for boys and for girls, as well as for junior high school and for senior high school students. Parents in nonintact families also were reported to be using more alcohol than parents in intact families. Adolescent alcohol use was significantly correlated with parental alcohol use. After adjusting adolescent alcohol use for parental alcohol use as a covariate, the finding of greater alcohol use by adolescents in non-intact families remained. PMID- 3526951 TI - The ferret: a new model of oral ethanol injury involving the liver, bone marrow, and peripheral blood lymphocytes. AB - We have developed a model of oral ethanol ingestion in the ferret by providing a complete liquid diet in which 21% of the total caloric intake is given as ethanol. After 3 weeks of ethanol treatment, migration inhibitory factor activity from ferret lymphocytes was significantly decreased when compared to animals fed a dextrose-substituted, identical liquid diet. Lymphocyte blastogenesis in response to the mitogen, phytohemagglutinin, was also decreased after 6 weeks of ethanol ingestion. Histopathologically, hepatic cell degeneration, fat deposition, and "Mallory body-like" material were present after 11 weeks of therapy. Bone marrow aspirate cells from the iliac crest of ethanol-fed animals showed vacuolization in both erythroid and myeloid elements after 6 weeks of ethanol ingestion. Mean ferret weights were not significantly different between the ethanol and dextrose control groups; serum ethanol and acetaldehyde concentrations were somewhat higher over the study period compared to those seen in human alcoholics. Therefore, we have designed a small animal model of the toxic effects of alcohol in which multiple organ systems exhibited evidence of ethanol-related disease. PMID- 3526952 TI - Mandatory supervised antabuse therapy in an outpatient alcoholism program: a pilot study. AB - We instituted a program of mandatory supervised antabuse therapy in an outpatient alcoholism clinic for patients who wish to remain connected to the clinic but who have continued to drink repeatedly. Almost 60% of 68 patients who agreed to this regimen achieved significant periods of sobriety. These preliminary findings suggest that a controlled trial of this approach is warranted. PMID- 3526953 TI - Equilibration, distribution, and elimination of a single dose of intravenous ethanol in dogs with intact renal function or anuria. AB - We infused 11 mmol/kg of intravenous ethanol into dogs with either intact renal function (n = 5) or ureteral ligation (n = 7), and studied by frequent blood sampling and by urine collection the time and mode of ethanol equilibration, the elimination parameters, and the comparison of observed equilibrated plasma ethanol levels to levels predicted either by linear or by nonlinear kinetics. Equilibration time was 25 min or less, renal fraction of elimination was less than 5% of total elimination, and both linear (elimination rate) and nonlinear (Vmax and Km) elimination parameters were not different between dogs with intact renal function and dogs with anuria. Serum sodium concentration did not change throughout the experiments, eliminating the hypothesis that acute ethanol load creates clinically significant temporary osmotic water transfer from the intracellular into the extracellular compartment. Distribution volumes of ethanol from linear kinetics were slightly, but not statistically, greater than volumes from nonlinear kinetics. Equilibrated plasma ethanol levels predicted by linear kinetics agreed closely with observed levels greater than 4 mmol/liter, but underestimated observed levels less than 4 mmol/liter. Equilibrated plasma ethanol levels predicted by nonlinear kinetics agreed with observed levels throughout the range of observed concentrations. The use of linear kinetics to predict blood ethanol levels should be limited to the pseudolinear portion of the blood alcohol curve. PMID- 3526955 TI - Drinking behavior of high risk college men: contradictory preliminary findings. AB - Seventeen high risk and seventeen low risk college-aged men were compared with respect to drinking behavior/problems and certain implicated personality characteristics. The low risk subjects were, surprisingly, found to drink and become intoxicated more frequently than high risk subjects. They also reported significantly higher sensation seeking scores. This latter variable accounted for the greatest amount of variance in both risk status and frequency of drinking. By contrast, high risk subjects reported somewhat more lifetime alcohol-related symptomatology and significantly more preadult antisocial symptoms. Preadult antisocial symptoms, alone, explained 39% and 29%, respectively, of the variance in alcohol-related symptoms and the amount consumed on a typical drinking day. The implications and limitations of the findings with respect to the development of alcoholism are discussed. PMID- 3526954 TI - Alcohol intake and withdrawal: effects on branched chain amino acids and alanine. AB - The effects of chronic alcohol consumption on plasma branched chain amino acids and alanine concentrations were evaluated, and basal blood concentrations of these amino acids were determined after chronic ethanol intake and following a withdrawal period in 30 admitted alcoholics. After ethanol intake, alcoholics showed increased branched chain amino acid concentrations; the blood alanine concentrations were depressed after the withdrawal period. To evaluate the effect of ethanol on diurnal variations of these amino acids in the blood, a group of these patients underwent two isocaloric diets with and without wine. The diet with alcohol induced a sustained increase of branched chain amino acids persisting even after the postprandial phase with a decrease of alanine as compared to the diet without. PMID- 3526956 TI - Application of isoelectric focusing in immobilized pH gradients to the study of acetaldehyde-modified hemoglobin. AB - We applied the technique of isoelectric focusing (IEF) on immobilized pH gradients (LKB) to determine whether acetaldehyde-modified hemoglobins (Hb) prepared in vitro with unphysiological acetaldehyde concentrations have clinical relevance. This technique separates proteins with pl less than 0.01 and provides detail about hemoglobins not otherwise separable. We performed two kinds of studies. In one kind of study, we incubated red cells from control subjects with acetaldehyde. Products of these incubations were applied to IEF gels either directly or after reduction with sodium cyanoborohydride. Incubation of red cells with acetaldehyde in 1-150 mM concentration without cyanoborohydride reduction yielded hemoglobin bands of decreasing pl the appearance of which coincided with the disappearance of Hb A and Hb A1c. When the products of incubation were reduced with cyanoborohydride before IEF, an additional acidic Hb band appeared which we call the "anodal CNBH band." In a second kind of study, we compared IEF patterns of hemolysates from control subjects and alcoholism detoxification patients, without adding acetaldehyde. Again, samples were applied to IEF gels either directly or after reduction with cyanoborohydride. When samples were run on IEF without reduction, no differences were seen between patients and controls. When samples were reduced before IEF, an anodal CNBH band appeared having the same mobility as the band seen after in vitro incubations with acetaldehyde. These bands were often stronger in samples from patients, but not consistently so. Several experiments, including the use of glycolysis inhibitors, indicated that the anodal CNBH band is an adduct of fructose 1,6-diphosphate with hemoglobin. We suggest that in millimolar concentrations, acetaldehyde may function as an inhibitor of glycolysis at or below the aldolase step. PMID- 3526957 TI - Relationship between serum cortisol, liver function, and depression in detoxified alcoholics. AB - High levels of serum cortisol or abnormal dexamethasone suppression tests may be helpful in diagnosing major depressive disorder. However, a controversy exists as to whether abnormal liver function associated with alcohol abuse may negate the diagnostic value of the dexamethasone suppression test in alcoholics. We investigated the value of the dexamethasone suppression test in alcoholics by analyzing the liver function, cortisol levels, and psychiatric status of inpatients from an alcohol detoxification treatment center. The subjects met the DSM III criteria for alcohol dependence but took no chronic medication and had negative screening for substance abuse. They had routine blood screening to evaluate liver function, the afternoon cortisol test and dexamethasone suppression test to study glucocorticoid activity, and a structured evaluation to determine psychiatric diagnoses. The blood chemistry findings demonstrated a lack of significant liver synthetic dysfunction in this group, although 43% of the subjects had some elevation of their liver enzymes. We did not find differences in the liver function between patients with normal and abnormal cortisol levels. However, subjects with endogenous depression did have significantly elevated afternoon cortisol levels, and they tended to have more normal liver tests. These results indicate that modest liver dysfunction does not contaminate the validity of the plasma cortisol tests or the dexamethasone suppression test as diagnostic tools for assessing depression in this group of detoxified alcoholics. In addition, they demonstrate an association between depression and plasma cortisol levels and suggest a correlation between depression and better liver function in alcoholics who seek detoxification. PMID- 3526958 TI - Identification and selective precipitation of human aldehyde dehydrogenase isozymes using antibodies raised to horse liver aldehyde dehydrogenase isozymes. AB - Aldehyde dehydrogenase (ALDH) enzymes from human liver homogenates were recognized in immunoblotting experiments and precipitated in Ouchterlony double diffusion gels by antibodies raised to the horse liver mitochondrial and cytosolic ALDH isozymes. The antibody raised to the cytosolic horse liver ALDH (alpha HC) has been shown to be specific for cytosolic ALDH isozymes, while the antibody raised to the horse liver mitochondrial ALDH (alpha HM) precipitated both mitochondrial and cytosolic ALDH isozymes. It was possible to selectively remove the cytosolic ALDH from a homogenate of a liver sample from a Caucasian by preincubation with alpha HC; the remaining mitochondrial enzyme was then precipitated by alpha HM in double diffusion gels. The experiments were repeated with a liver sample from an Oriental, presumed to have been alcohol sensitive since no active mitochondrial ALDH was found. The precipitation of a relatively inactive mitochondrial enzyme by alpha HM from a cytosolic ALDH-free sample confirmed previous reports of the existence of a mitochondrial ALDH in tissue from an alcohol-sensitive Oriental. The results of immunoblotting experiments confirm the co-migration, in electrophoresis, of the cytosolic and mitochondrial ALDHs from the liver of an alcohol-sensitive Oriental. The results reported here, together with previous observations, indicate that the antibodies raised to horse liver ALDH isozymes can be used to determine the subcellular location of ALDH isozymes in various human tissues, including frozen tissue samples which are not amenable to subcellular fractionation. PMID- 3526959 TI - Disposition of ethanol and activity of hepatic and placental alcohol dehydrogenase and aldehyde dehydrogenases in the third-trimester pregnant guinea pig for single and short-term oral ethanol administration. AB - The disposition of ethanol and its metabolite, acetaldehyde, and the activity of alcohol dehydrogenase (ADH) and aldehyde dehydrogenases (ALDH) were determined in the third-trimester pregnant guinea pig following single and 7-day oral administration of ethanol (0.5 g X kg maternal body weight-1 X day-1). Animals were killed at each of selected times after the single and seventh ethanol dose. For both ethanol dosage regimens, the maternal and fetal blood and brain ethanol concentrations were virtually identical during the elimination phase of the time course study. There was initial slow transfer of ethanol into amniotic fluid, followed by significantly higher ethanol concentration in amniotic fluid relative to maternal and fetal blood during the elimination phase. Acetaldehyde was measurable in maternal blood, maternal brain, and fetal brain at concentrations that were low and variable. For both ethanol dosage regimens, ADH activity was measurable only in maternal liver. Low Km ALDH activity was measurable only in maternal liver and fetal liver. High Km ALDH was measurable in maternal liver, fetal liver, and placenta and was significantly greater in maternal liver. The data indicate that there is bidirectional placental transfer of ethanol in the maternal-fetal unit; the elimination of ethanol from the maternal and fetal compartments is regulated by maternal hepatic biotransformation involving ADH; the amniotic fluid is a reservoir for ethanol in utero; the low Km ALDH in fetal liver protects the fetus from ethanol-derived acetaldehyde in the maternal circulation; and short-term maternal administration of once-daily, low-dose ethanol does not produce major changes in ethanol disposition and the activity of the enzymes involved in ethanol biotransformation. PMID- 3526961 TI - Use of regression residuals to quantify individual differences in acute sensitivity and tolerance to alcohol. AB - Due to the problem of correlation of errors inherent in the difference or ratio scores typically used to quantify individual differences in acute sensitivity and tolerance to alcohol, it is recommended that residual scores from regression analyses be used instead for such quantification. Conceptualizations of acute sensitivity and tolerance and problems with the reliability of change scores are also discussed. PMID- 3526960 TI - Membrane fluidity and alcohol dependence. AB - Rats were chronically intoxicated with alcohol by exposing them to increasing concentrations of ethanol vapor over a 4-week period. They were tested for alcohol consumption in a free choice situation of water and 10% (v/v) alcohol. On the basis of their intakes they were divided into alcohol-dependent and nondependent groups. Synaptosome membrane fluidity evaluated by fluorescence polarization was compared between the two groups and against nonintoxicated controls. The intoxicated animals had a lower membrane fluidity than controls, mainly because of a highly significant increase of rigidity in the alcohol dependent group. Furthermore, membrane fluidity was found to be correlated with the degree of behavioral dependence (i.e., alcohol intake during the free choice period). PMID- 3526962 TI - Acetaldehyde causes a prolongation of the doubling time and an increase in the modal volume of cells in culture. AB - The effects of culturing four human cell lines--Raji, MOLT-4, WI-L2, and K562--in the presence of 10-360 microM acetaldehyde for 3-18 days have been investigated. Concentrations of 45-360 microM caused a prolongation of the cell doubling time, and those of 90-360 microM caused an increase in the modal cell volume and in the protein content per cell. The results indicate that relatively low concentrations of acetaldehyde cause an impairment of cell proliferation and an abnormality of cell growth in vitro and support the possibility that ethanol-derived acetaldehyde may be responsible for some aspects of tissue damage in chronic alcoholics, including the increase in the mean cell volume of erythrocytes. Three of the four cell lines studied showed a reduction and the fourth showed no change in modal cell volume after culture with 100 mM ethanol, suggesting that the macrocytosis of red cells induced by chronic alcoholism is not caused via some direct effect of ethanol on the erythron. PMID- 3526964 TI - Handedness and alcoholism: a family history of left-handedness. PMID- 3526963 TI - Alcohol consumption: effect of gender and psychopathology. AB - Alcohol consumption, when corrected for body weight, was not related to age and did not differ from male and female alcoholics, when compared within subtype of alcoholism. Regardless of gender, alcoholics with antisocial personality diagnosis drank significantly more alcohol than non-antisocial personality alcoholics. PMID- 3526965 TI - [Nasal polyps and cellular immunity]. PMID- 3526967 TI - [In memory of His Excellency Benigno Lorenzo Velazquez]. PMID- 3526966 TI - [Opioids and reproduction]. PMID- 3526968 TI - Braving new frontiers. ANA's economic and general welfare program, 1946-1986. PMID- 3526969 TI - [The history of tracheotomy. I]. AB - Tracheotomy is one of the oldest operations. Indications for and methods of the operative technique are reported already from the ancient times. The following outline - subdivided in three parts - tries to give a comprehensive survey of the development of tracheotomy throughout the centuries. The first part is concerned with the role of tracheotomy in antiquity, in Greek and Roman medicine and in the medicine of the Arabians at the turn of the millennium according to our time. The first tracheotomy is said to have been performed by Asklepiades of Bythinien, who lived in Rome during the last century before the Christian era. The question whether tracheotomy would be of use or not was highly controversal in the following centuries. There were advocates of the operation (for example Antyllus, Paulus von Aegina), but there were strict antagonists, too (for example Aretaeus). In Arabian medicine finally, tracheotomy had an important rank in theory, but probably it had never been performed in humans. The second part of this paper is occupied with the establishment of tracheotomy in the medicine of the European middle ages. Despite many ethical reservations, it became generally accepted as the last live-saving method in certain syndromes. Protagonists of the method included Ambroise Pare, Thomas Fienus, Hieronymus Fabricius ab Aquapendente, Julius Casserius, and Johannes Scultetus. A new method of performing tracheotomy, the opening of the trachea with the use of a trocar, was first described by Sanctorius Sanctorius (1561-1636). The third part of this outline describes the development of the method of tracheotomy in the last 400 years.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3526970 TI - Surgery without pain--Part II: 1800-1847. AB - This paper was commissioned to cover the beginning of anaesthesia: the transition from surgical operations with pain to those without. It reviews some previous pre anaesthetic histories (Part I): it focuses upon attitudes to pain; and it seeks evidence from the one hundred years before the discovery of anaesthesia. Finally (Part II) it outlines the introduction of nitrous oxide and of ether anaesthesia. PMID- 3526971 TI - Visualization of bilin-linked peptides and proteins in polyacrylamide gels. AB - Biliproteins and bilipeptides subjected to discontinuous sodium dodecyl sulfate polyacrylamide gel electrophoresis in the presence of zinc acetate form a complex which fluoresces an orange color when viewed under ultraviolet light. The complex between the bilin chromophore and the zinc ion fluoresces at wavelengths which can be selectively visualized in gels by using a red filter. For the biliproteins phytochrome and C-phycocyanin the minimum detectable quantities are 100 and 50 ng, respectively. This is comparable to the sensitivity of Coomassie blue staining. The technique has been used for selective detection of phytochrome in plant extracts and to distinguish chromophore-bearing peptides from those not containing chromophore in proteolytic digests of phytochrome. PMID- 3526972 TI - Theoretical models for predicting the effect of bridging group recognition and conjugate substitution on hapten enzyme immunoassay dose-response curves. AB - Models for predicting the effect of immunological recognition of the bridge group on the dose-response curves obtained with heterogeneous hapten enzyme immunoassays are presented. Appropriate theoretical treatment shows that the greater affinity of antibodies toward the enzyme-labeled species than for the unlabeled hapten analyte results in assays with limited detection capabilities. This problem is compounded when enzyme conjugates possessing multiple haptens are used. In equilibrium type competitive arrangements, the concentrations of binder and labeled hapten may be optimized to some extent to improve assay performance. However, the results presented show that only when assays are performed in a sequential binding mode using carefully controlled timing of reagent incubations can the detection capabilities of the assays be fully maximized for analyte measurements. Unfortunately, it is also shown that such sequential binding approaches render the assays essentially nonselective. The effect of decreasing the affinity of the binder to the enzyme-labeled hapten relative to the unlabeled analyte by using heterologous conjugates in equilibrium arrangements is shown to improve detection capabilities but also at the expense of reduced selectivity. Suggestions for reagent concentrations and conjugate substitution (degree of conjugation), which provide optimized dose-response curves at a given ED50 value, are also presented as are proposals for using different binders which do not exhibit bridging group recognition. PMID- 3526973 TI - A rapid nonchromatographic assay for aminopropyltransferases. AB - Aminopropyltransferases are key enzymes in the biosynthesis of the polyamines spermidine and spermine. A procedure is described for assaying these enzymes by differential charcoal adsorption of 14C-labeled decarboxylated adenosylmethionine substrate from the labeled polyamine product. This assay is linear with time and enzyme concentration, and is suitable for use with a variety of amine acceptors. This procedure has the advantage, over those previously used, that it is extremely rapid yet very sensitive. PMID- 3526974 TI - Correlation between fluorescent polarisation immunoassay and enzyme immunoassay of anticonvulsant drugs, and stability of calibration graphs. PMID- 3526975 TI - Sonography of the tongue and floor of mouth. AB - The study about the sonoanatomy of the tongue and the floor of the mouth was undertaken with 20 volunteers. A description of the examination technique is given in comparison with computerized tomography. It is pointed out that it is easier to adjust the section planes optimally to the anatomical situation with ultrasound. This examination technique is noninvasive and easy to do. It is comfortable for the patient and can be repeated frequently, for example it allows a follow-up of cancer patients. Finally--this technique is cheap and can be performed at any given place. PMID- 3526976 TI - A method for a quantitative determination of changes in tissue volume as a result of perfusion fixation. AB - A method for quantifying changes in volume of tissue as a result of perfusion fixation is described. This is achieved by setting standards into the tissue in vivo and in situ by applying dyes to the intact tissue at known distances. Immediately after perfusion the distances of the dyes are macroscopically measured and the comparison between the corresponding distances before and after perfusion enables a quantification of the alteration of the tissue. The total error of this method is approximately 0.5-0.8% (linear). PMID- 3526977 TI - The differentiation of repeated epilation (Er/Er) mouse mutant skin in organ culture and in grafts. AB - The homozygous repeated epilation (Er/Er) mouse mutant dies at birth and shows a variety of malformations, one of which is a skin defect. The developmental abilities of skin fragments from these Er/Er mouse embryos were studied in organ culture and in grafts performed either under the renal capsule of young mouse hosts or under the skin of mouse fetuses. In organ culture, the skin fragments differentiated in accordance with their genetic origin. The most characteristic feature was the abnormally thickened spinous layer and the formation of numerous epidermal nodules in Er/Er skin pieces removed from 13- to 16-day-old embryos, and cultured for 4 to 6 days, whereas the normal skin showed a constant layered organization. As in normal skin, keratin fibers developed within 4 to 6 days of culture. However, in contrast to normal skin, where keratin sheaths developed all over the surface of the epidermis, the Er/Er skin exhibited keratin masses inside the nodules. Combinations of mutant Er/Er epidermis with normal dermis resulted in abnormal skin differentiation, with formation of nodules similar to those observed for unseparated Er/Er skin fragments, whereas the reciprocal combination (normal epidermis with Er/Er dermis) produced normal skin differentiation. Cornified layers developed in both types of explants. Grafts of Er/Er and, for comparison, of normal skin fragments under the renal capsule or under a fetus's skin showed that the development of Er/Er skin in a normal or Er/+ host was similar to that of a normal skin. Thus, if isolated from the mutant organism, and inserted into a normal environment, the skin recovered within 6 to 7 days after transplantation and then developed normally. Our experiments suggest that the abnormal skin development of the Er/Er mutant might be caused by environmental influences. PMID- 3526978 TI - Antigenic phenotyping of isolated and in situ rodent follicular dendritic cells (FDC) with emphasis on the ultrastructural demonstration of Ia antigens. AB - The antigenic phenotype of mouse lymph node follicular dendritic cells (FDCs) was studied by immunocytochemical techniques. Indirect fluorescence was used in conjunction with monoclonal antibodies to localize FDC surface antigens on FDC enriched cell preparations and in cryostat sections. Lymph nodes from rats and mice were also labeled directly for Ia antigens with fluorescein- or peroxidase conjugated Ia-specific monoclonal antibodies (i.e., MRC Ox4 and 10-2.16, respectively). Lymphoid tissue was also prepared for electron microscopy to allow clear distinction between Ia antigens of B lymphocytes and FDCs in situ. In these experiments, gold-labeled antigen was used to clearly identify FDCs and their processes among the Ia-positive cells of lymph node follicles. The labeling observed by light and electron microscopy showed that FDCs expressed Ia in situ and in vitro. Additional surface determinants shown to be expressed by FDCs included H2-K, common leukocyte antigen, and the receptor for the Fc portion of IgG1 and IgG2b. Neither macrophage antigens, such as Mac-1, Mac-2, Mac-3, and F4/80, nor the lymphocyte markers Ly-1, Ly-2, and Thy-1 were expressed by FDCs. Thus, the antigenic phenotype of FDCs, along with their distinctive dendritic morphology, their nonphagocytic and nonadherent nature, and their ability to trap and retain immune complexes on their plasma membrane, identifies them as a unique cell population. PMID- 3526979 TI - Lectin binding sites on human endocervix: a comparison with secretory and proliferative endometrium. AB - Endocervix and corresponding endometrium of women of reproductive age were studied histochemically with 13 fluorescein isothiocyanate-labeled lectins to delineate the differences between the epithelial cells in two anatomical sites. Lectin from Maclura pomifera (MPA), Ulex europaeus (UEA-I), Glycine max (SBA), and Vicia villosa (VVA) bound only to endocervical epithelium and were the only four lectins that distinguished endocervical from endometrial epithelium. These differences were independent of menstrual cyclic changes and blood group antigen secretion. These data show that lectins can be used to histochemically distinguish endocervical from endometrial glands. PMID- 3526980 TI - Distribution of actin in Sertoli cell ectoplasmic specializations and associated spermatids in the ground squirrel testis. AB - We have investigated the possibility that the complex patterns of fluorescence associated with spermatids of the ground squirrel labeled with 7-nitrobenz-2-oxa 1,3-diazole-phallacidin (NBD-phallacidin) are due to the presence of filamentous actin within the spermatids themselves rather than to actin in attached Sertoli cell ectoplasmic specializations, as previously reported (J. Cell Biol., 100:814 825). Enzymatic treatments (trypsin, DNAase 1) freed Sertoli cell ectoplasmic specializations from spermatids and resulted in a loss, from the spermatids, of the complex fluorescence patterns, suggesting that the latter were generated by labeled actin in ectoplasmic specializations. Moreover, ectoplasmic specializations that were detached enzymatically from spermatids demonstrated the same fluorescence patterns as those emitted from spermatids in the intact or mechanically fragmented seminiferous epithelium. Most spermatids, however, do display a weak and diffuse pattern of fluorescence that changes during spermatogenesis and that is localized between the acrosomal cap and nucleus. S-1 decoration confirmed this subacrosomal localization and further demonstrated that the actin in adjacent Sertoli cell ectoplasmic specializations is arranged in a unipolar fashion. We conclude that the complex patterns of actin fluorescence associated with mechanically isolated spermatids are a superimposition of both Sertoli cell and germ cell actin; however, the latter is either poorly detected or not detected at all when Sertoli cell ectoplasmic specializations overlie the germ cells. PMID- 3526981 TI - Pituitary lactotroph sedimentation profiles and in vitro secretory activity after ablation of the medial basal hypothalamus. AB - Pituitary cells from adult male rats subjected to chronic (6 and 10 weeks) medial hypothalamic ablation (MHA) were analyzed by unit gravity sedimentation to assess distribution of size and density of lactotrophs, and for subsequent in vitro prolactin (PRL) release in primary culture. Tinctorial staining (Herlant's tetrachrome) showed that initial preparations of cells from MHA rats were small and relatively undifferentiated. MHA cells did not sediment as far into the gradient as did cells from intact control pituitaries. Intracellular PRL content was lower in all gradient fractions of MHA cells. At 6 weeks after surgery, peak recovery of PRL was also in the upper portions of the gradient. In the 10-weeks group, however, peak PRL recovery from MHA cells was in a population that sedimented further, but more restrictedly, in comparison with control cells. At both postsurgical intervals, the majority of tinctorially or immunocytochemically identified lactotrophs from lesioned rats were lower in the gradient, indicating enlarged and denser cells. Relative numbers of lactotrophs (per pituitary) were increased 10 weeks after MHA. In vitro PRL release, over a maximum of 21 days culture, was comparable for cells from MHA rats and intact controls, according to daily per cell secretion rates and "production index" (hormone released/initial hormone content). By comparison, luteinizing hormone (LH) release was suppressed in culture compared to intact controls, and LH was recovered from gradient fractions of smaller cells. The results indicate that chronic removal of hypothalamic influence results in gradual prolactin cell hypertrophy and decreased hormone retention and in relative increase in numbers.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3526982 TI - The sperm acrosome: immunological analysis using specific polyclonal and monoclonal antibodies directed against the outer acrosomal membrane of boar spermatozoa. AB - An antiserum to the purified porcine outer acrosomal membrane (OAM) was raised in female Balb/c mice and was characterized by means of an indirect ELISA. The hyperimmune serum reacted selectively with the acrosomal cap of the sperm head and showed an extremely good cross reactivity with bull and human spermatozoa when assayed by indirect immunofluorescence. Immunoelectron microscopy using the protein A-gold method further confirmed the specificity of the anti-OAM-antiserum for the OAM. In an effort to identify the OAM antigens recognized by the hyperimmune serum and to analyse the extent of cross reactivity on a molecular level, the SDS-extractable proteins were separated by SDS-PAGE, transblotted and immunoprinted using an 125J-conjugated anti-mouse-antibody. To facilitate functional and structural analysis of distinct OAM-proteins monoclonal antibodies were generated by hybridization of mouse myeloma cells with the splenocytes of female Balb/c mice immunized with the purified OAM. One fusion resulted in about 100 anti-OAM-antibodies secreting hybridoma cultures, of which about 30% showed cross reaction with human and bull spermatozoa. Four stable cell lines were selected for this study secreting antibodies directed against the outer acrosomal membrane of boar spermatozoa. Whereas the polyclonal immune mouse serum stained the entire acrosomal cap, the four hybridoma antibodies generated a patch-work like immunofluorescence pattern over the acrosome. HPLC-ELISA of the solubilized OAM revealed first information on the nature of the corresponding membrane antigen. PMID- 3526983 TI - Cardiopulmonary effects of oleic acid-induced pulmonary edema and mechanical ventilation. AB - In order to define the mechanisms whereby cardiac output and arterial oxygen transport are reduced by acute permeability pulmonary edema and by positive end expiratory pressure (PEEP), hemodynamic, respiratory, and lung water changes were measured in 12 mechanically ventilated dogs prior to the injection of oleic acid and at 1, 2.5, and 4 hr after the injection. Measurements were performed at each interval before and after the addition of 20 cm H2O PEEP. Positive end-expiratory pressure was not continued between measurements. One hour after the oleic acid injection, the lung water content and the pulmonary vascular resistance had increased more than 100% while the right ventricular (RV) volume, RV stroke volume, and PaO2 had decreased more than 35%. Each application of PEEP increased the PaO2 to control levels. However, PEEP also significantly increased the lung water content and pulmonary vascular resistance, and decreased the RV volume and stroke volume by 33%. The extravasation of fluid from the intravascular to the interstitial and alveolar spaces of the lung with oleic acid pulmonary edema is associated with substantial decreases in right ventricular volume and stroke volume and significant increases in the pulmonary vascular resistance. Treatment with 20 cm H2O PEEP further increases the lung water content and pulmonary vascular resistance and substantially reduces the right ventricular volume and stroke volume. PMID- 3526984 TI - The safety and efficacy of esmolol during myocardial revascularization. AB - The safety and efficacy of esmolol during high-dose fentanyl anesthesia were studied in 37 patients undergoing coronary artery bypass grafting (CABG). The anesthetic management consisted of fentanyl 75 micrograms/kg, pancuronium 0.15 mg/kg, and O2. To assess the safety of esmolol, it was administered in a double blind manner to 17 anesthetized patients prior to surgical incision. Infusion of the drug was increased in stepwise fashion to obtain administration rates between 100 and 300 micrograms X kg-1 X min-1. Esmolol produced small but significant increases in pulmonary capillary wedge pressure (PCWP) (8.3 +/- 1.7 to 13.2 +/- 2.0 mmHg) when compared with placebo (10.9 +/- 1.0 to 12.1 +/- 0.6 mmHg) (P less than 0.05). For the other studied parameters (heart rate, mean arterial pressure, central venous pressure, cardiac index, stroke index, left ventricular stroke work index, systemic vascular resistance, and peripheral vascular resistance), no significant differences were observed between esmolol and placebo. To evaluate the efficacy of esmolol, 20 patients were randomly assigned to an esmolol group (n = 11) or a placebo group (n = 9). The study medication was infused from 5 min before induction through initiation of cardiopulmonary bypass. Infusion of esmolol at 200 micrograms X kg-1 X min-1 prevented tachycardia in response to intubation. In the esmolol group the heart rate increased from 63.4 +/- 2.7 to 67.6 +/- 2.9 beats/min after intubation, while in the placebo group it increased from 61.4 +/- 4.3 to 72.4 +/- 3.4 beats/min (P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3526985 TI - [Vascular surgical aspects of renal transplants]. PMID- 3526986 TI - A study of isoetharine mesylate in patients with chronic bronchial asthma. AB - We performed a double-blind, random crossover study to investigate the respiratory effects of a single dose isoetharine mesylate (IM), administered by a metered aerosol canister in 19 subjects with mild, stable asthma. In addition, we studied the influence of the dose (number of actuations) and the mode of administration (delay between actuations) on these respiratory effects. The protocol consisted of a screening day and four test days: (1) one inhalation IM (2) two inhalations IM (3) one inhalation placebo (P), and (4) two inhalations P. In addition, the first nine asthmatics paused one minute between inhalations whereas the last ten paused five minutes between inhalations. Lung function was assessed using maximal and partial expiratory flow volume curves. Measurements were taken prior to aerosol delivery and for six hours after aerosol. Significant differences between IM and P were seen for up to two hours. The maximum effect was observed at 15 minutes, corresponding to a 23% and 25% increase in FEV1 from baseline with one and two puffs, respectively (P less than .001). The differences between one and two actuations were, in general, not significant. No significant differences were observed between individuals who waited one versus five minutes between inhalations. We conclude that IM aerosol results in significant improvement compared with placebo for two hours. Differences between one and two inhalations and the interval between two inhalations did not, in general, lead to enhanced effectiveness of this drug in the group of asthmatics studied. PMID- 3526988 TI - Evaluation of determination of theophylline concentrations by Seralyzer. AB - Determination of theophylline concentrations by Seralyzer in 28 paired serum and plasma samples disclosed almost identical results. Comparison of determinations by Seralyzer and enzyme-multiplied immunoassay in 31 paired serum samples disclosed significant underestimation by Seralyzer when recalibrated whenever results of analysis of a 15-micrograms/mL control exceeded limits of +/- 3 micrograms/mL. Determinations by Seralyzer did not differ significantly from enzyme-multiplied immunoassay with narrower limits of 15 +/- 2 micrograms/mL for Seralyzer calibration for 18 paired samples. Seralyzer results are sufficiently reliable for clinical use if the instrument is recalibrated whenever analysis of the 15-micrograms/mL control falls outside limits of +/- 2 micrograms/mL. PMID- 3526989 TI - Alcohol tolerance. PMID- 3526987 TI - Immune responses to ingested antigens in relation to feeding pattern in childhood. PMID- 3526991 TI - The role of endogenous peptides in the action of opioid analgesics. AB - The observation that the narcotic antagonist naloxone could inhibit analgesia produced by electrical stimulation of the brain indicated the involvement of an endogenous chemical in the relief of pain. Multiple endogenous opioid peptides have been identified that have similar pharmacological properties to known narcotic analgesics. The biosynthesis, release, and degradation of opioid peptides have been studied in order to better understand how the manipulation of endogenous opioid systems can be used to produce or augment analgesia. The results of our studies reveal that various conditions and manipulations, such as electrical brain stimulation, acupuncture, stress, and the administration of opioid analgesics, can cause the release of endogenous opioid peptides and possibly endogenous nonpeptide substances. It has also been discovered that nonopioid peptides, such as cholecystokinin, calcitonin, and angiotensin II, can alter the action of opioid analgesics by antagonizing or potentiating their effects. An understanding of the role of endogenous peptides in endogenous opioid mechanisms is necessary for the development of new ways to treat pain and such other disorders as sleep apnea in children (sudden infant death syndrome), head injury, and opioid addiction that involve the activation or alteration of endogenous opioid systems. PMID- 3526990 TI - Effect of alcohol on cellular membranes. AB - Ethanol disrupts the physical structure of cell membranes. The most fluid membranes, including those that are low in cholesterol, are the most easily disordered by ethanol. Although the membrane-disordering effect is small, there is pharmacological, temporal, and genetic evidence that it is important. Animals that are resistant to ethanol intoxication because of their genetic background or because of previous exposure to ethanol are found to have brain membranes that are not easily disordered in vitro. An exception is the increased behavioral sensitivity in aging animals, which is not matched by changes in their membranes. When animals are treated chronically with ethanol, their membranes become stiffer, a response that can be regarded as adaptive. Ethanol may favor the uptake of cholesterol or saturated fatty acids into membranes, thus reducing its own effect. PMID- 3526992 TI - Management of poisoning associated with "newer" antidepressant agents. AB - Overdose of tricyclic antidepressants remains one of the most difficult poisonings to manage optimally in the emergency department, primarily due to the extremely rapid onset of life-threatening symptomatology. The continued high incidence of such overdoses has ensured that morbidity and mortality rates also remain unacceptably high. The development of the "second-generation antidepressants," with apparently different pharmacology and toxicity after overdose, has been an attempt to address this serious medical problem. This report reviews the published literature on the overdose toxicology of the newer cyclic antidepressants currently available in the United States--amoxapine, maprotiline, and trazodone. Nomifensine, released by the FDA in 1984, recently has been voluntarily withdrawn from the world market. Bupropion, released in 1985, also has been voluntarily withdrawn by the manufacturer three months after its release. PMID- 3526993 TI - Immunological approach to poisoning. AB - The use of antibodies in the diagnosis and treatment of drug poisoning is becoming an important aspect of emergency medicine. Digoxin-specific antibodies selectively inhibit the pharmacologic and toxic effects of the digitalis glycosides. Digoxin-specific Fab fragments rapidly reverse digitalis toxicity in animals and man. Furthermore, these Fab fragments are eliminated in the urine and are less immunogenic than whole antibodies. Anti-digoxin Fab fragments have been approved by the Food and Drug Administration for the treatment of digitalis intoxication. Alternative ways of using antidrug antibodies in the treatment of poisoning are being explored. Studies that demonstrate that antidrug antibodies immobilized on solid matrices remain functional have been conducted. Such immobilized antidrug antibodies are being evaluated for their ability to remove drugs from the circulation by extracorporeal perfusion. These areas of research promise to provide significant advances in the treatment of poisoning. PMID- 3526994 TI - Radiation accidents. AB - It is essential that emergency physicians understand ways to manage patients contaminated by radioactive materials and/or exposed to external radiation sources. Contamination accidents require careful surveys to identify the metabolic pathway of the radionuclides to guide prognosis and treatment. The level of treatment required will depend on careful surveys and meticulous decontamination. There is no specific therapy for the acute radiation syndrome. Prophylactic antibodies are desirable. For severely exposed patients treatment is similar to the supportive care given to patients undergoing organ transplantation. For high-dose extremity injury, no methods have been developed to reverse the fibrosing endarteritis that eventually leads to tissue death so frequently found with this type of injury. Although the Three Mile Island episode of March 1979 created tremendous public concern, there were no radiation injuries. The contamination outside the reactor building and the release of radioiodine were negligible. The accidental fuel element meltdown at Chernobyl, USSR, resulted in many cases of acute radiation syndrome. More than 100,000 people were exposed to high levels of radioactive fallout. The general principles outlined here are applicable to accidents of that degree of severity. PMID- 3526995 TI - Clinical toxicology of cyanide. AB - Cyanide poisoning causes a high incidence of severe symptomatology and fatality. There are numerous sources of potential cyanide exposure. Without the history of cyanide exposure, diagnosis is often difficult. Treatment with supportive measures and available specific and efficacious antidotes frequently allows survival. The toxicology of cyanide, including sources, clinical features, diagnosis, and treatment, is reviewed. PMID- 3526996 TI - Free radicals and environmental toxins. AB - Some chemicals that contaminate our environment exert their toxic effects by virtue of their ability to form free radicals. In the absence of sufficient quenching reactions, these reactive radicals can attack biomolecules, resulting in their oxidative degradation. Biological membranes which contain polyunsaturated fatty acids are most susceptible to oxidative degradation (lipid peroxidation), although oxidation of DNA may have more severe biological consequences. Free radicals species can be generated by at least two mechanisms in vivo. The first, of which carbon tetrachloride (CCl4) is the classic example, is the biotransformation of the chemical to a free radical species. Metabolism of CCl4 to the trichloromethyl radical by the hepatic mixed-function oxidase system results in the initiation of lipid peroxidation, protein-lipid cross linkages, and trichloromethyl adducts with DNA, protein, and lipid. The second mechanism for forming free radicals involves their reduction to less stable free radical intermediates which are oxidized by molecular oxygen to give superoxide (O2-.). In the presence of transition metals, such as iron, O2-. can be converted to other oxygen radical species, such as the hydroxyl radical (.OH), an extremely powerful oxidant capable of cleaving DNA, oxidizing protein, and initiating lipid peroxidation. Under many conditions, lipid peroxidation appears not to be initiated by .OH, but rather by an iron-oxygen complex. Regardless of the identity of the initiating species, transition metals are required for most of the deleterious reactions of oxygen. Superoxide and certain organic radicals have been found to release iron from ferritin. PMID- 3526997 TI - Genetic aspects of alcoholism. AB - The importance of genetic factors in alcoholism is supported by family, twin, and adoption studies. The four-fold increased risk for this disorder in adopted-away sons of alcoholics supports the need for studies attempting to identify biologic and genetic factors that influence the future risk for alcoholism. Some methodological issues inherent in the search for markers of a predisposition toward alcoholism are reviewed and the results of studies of children of alcoholics are presented. Two potentially important findings include the decreased intensity of reaction to alcohol challenges in these high-risk young men, and the possibility that they demonstrate small amplitudes of the P300 brain wave. Some clinical and research implications of these findings are discussed. PMID- 3526998 TI - Genetic variability of enzymes of alcohol metabolism in human beings. AB - Alcohol is eliminated from the body almost entirely by hepatic metabolism, first to acetaldehyde, then to acetate, and finally to carbon dioxide and water. The time course of elimination is best described by Michaelis-Menten kinetics, and rates of elimination following standard doses of ethanol vary among subjects as much as three-fold. Studies comparing rates of elimination in identical and fraternal twins have shown that about half of the variability is attributable to genetic factors. The principal enzymes responsible for ethanol metabolism are alcohol dehydrogenase and aldehyde dehydrogenase. The reaction catalyzed by alcohol dehydrogenase is the rate-limiting step of the pathway. Human livers contain multiple isoenzymes of alcohol dehydrogenase, which are dimeric molecules arising from the association of two subunits encoded by five different structural genes. Genetic polymorphism at two of these gene loci has been described, and all known homo- and heterodimeric forms of the isoenzymes have now been isolated and characterized. Notably, some of them differ quite strikingly in reactivity toward ethanol. Thus a basis for the genetic variability in alcohol metabolic rate can be found in the kinetic properties of the alcohol dehydrogenase isoenzymes. The efficient oxidation of acetaldehyde by hepatic aldehyde dehydrogenase is essential for ethanol oxidation to continue over time, because the equilibrium of the alcohol dehydrogenase reaction favors the conversion of acetaldehyde to ethanol. Acetaldehyde is a very toxic substance the removal of which makes possible the consumption of large quantities of ethanol frequently imbibed by alcoholics. There are also multiple molecular forms of aldehyde dehydrogenase in liver, and the mitochondrial form is the one principally responsible for acetaldehyde oxidation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3527000 TI - Bovine chlamydial abortion: serodiagnosis by modified complement-fixation and indirect inclusion fluorescence tests and enzyme-linked immunosorbent assay. AB - Sequential serum samples from 11 cows experimentally inoculated with different abortigenic strains of Chlamydia psittaci were tested by a modified complement fixation (MoCF) test, an indirect inclusion fluorescence antibody (IIFA) test, and an enzyme-linked immunosorbent assay (ELISA). One of these cows was not pregnant, another gave birth at term to a healthy calf, and all the others prematurely delivered infected dead calves or weak live calves. The results achieved with these tests on sera of 3 of the cows were compared with those from the previously used standard complement-fixation (CF) test. Six of 11 cows had detectable preinoculation titers between 1:8 and 1:16 when tested by the MoCF test, yet preinoculation titers were not detected by CF. In contrast, 9 of 11 and 10 of 11 preinoculation samples had detectable chlamydia-specific antibodies when examined by the IIFA test and the ELISA, respectively. The preinoculation IIFA titers ranged from 1:8 to 1:64, and the ELISA optical density values varied from 0.150 to 0.450. All cows responded with significant increases in antibody levels detected by the MoCF test, the IIFA test, and ELISA after they were experimentally inoculated and after they aborted or delivered infected calves. Overall, the dynamics of the antibody responses were found to be similar with the 3 different serologic techniques. When cows aborted later than 36 days after they were inoculated, the antibody response was biphasic, whereby the more pronounced responses occurred after the abortion occurred. The nonpregnant cow and the cow that delivered a healthy calf at term had only one phase of increasing and decreasing titers directly after they were inoculated. PMID- 3526999 TI - Use of monoclonal antibodies to identify outer membrane antigens of Actinobacillus species. AB - Three monoclonal antibodies (LG17, LG30, and LG33) were used to identify outer membrane antigens of Actinobacillus sp (As8C isolate) cultured from the epididymides of an infected ram lamb. Specificity of the 3 antibodies to As8C antigens was determined by use of bacterial agglutination, the enzyme-linked immunosorbent assay, and the indirect fluorescent antibody test. Results of immunoelectron microscopy confirmed that each antibody was specific for epitopes on As8C outer membrane antigens. Evaluation by use of enzyme-linked immunoelectrotransfer blot indicated that target antigens for LG17 and LG33 antibodies had molecular weights of 10 kilodaltons and 43 kilodaltons, respectively. Multiple-band staining was observed with the LG33 antibody. The target antigen for the LG30 antibody could not be discerned by use of enzyme linked immunoelectrotransfer blot. For each of the 3 monoclonal antibodies, enzyme-linked immunosorbent assay titers were obtained for Actinobacillus seminis, A actinomycetemcomitans, and 10 field isolates of Actinobacillus spp. Target antigens for LG17 and LG30 antibodies occurred infrequently or were absent on these bacteria. However, the target antigen for the LG33 antibody was shared by Actinobacillus seminis, A actinomycetemcomitans, and the 10 field isolates of Actinobacillus spp, indicating some diversity of outer membrane antigens between isolates. PMID- 3527001 TI - Effects of microbial and host variables on the interaction of rotavirus and Escherichia coli infections in gnotobiotic calves. AB - Naturally occurring mixed infections with Escherichia coli and rotavirus have been associated with fatal diarrhea of calves about 1 week old. Experiments were designed to reproduce this syndrome in gnotobiotic calves. Clinical, microbiological, and pathologic data were used to assess severity of disease and mechanisms of the interaction between the 2 infections. An initial study involved 5- to 8-day-old gnotobiotic calves inoculated with a strain of enterotoxigenic E coli (ETEC) and a strain of rotavirus. Calves were observed for 2 days after they were inoculated; fatal diarrhea was not produced. In later studies, variables were tested to identify those that might contribute to fatal diarrhea. Variables which did not result in fatal or severe diarrhea or which did not cause disease that was more severe in dually inoculated calves than that in monoinoculated calves were increasing feed to 2 times base line, increasing dose of ETEC to 10 times base line, inoculating calves when they were 2 days old, using a strain of E coli that causes colisepticemia, and using a different strain of rotavirus. When the observation period was extended from 2 days to 6 days after calves were inoculated, severe, watery, fatal diarrhea occurred in 6 of 12 calves by 32 to 72 hours after dual inoculation was given. Fatal diarrhea was associated with intensive colonization by the ETEC in the caudal half of the small intestine. Microscopic lesions were similar between dually inoculated and rotavirus monoinoculated calves, except there was more severe atrophy of ileal villi of dually inoculated calves.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3527002 TI - The powers of John Barleycorn. Beliefs about the effects of alcohol on social behavior. PMID- 3527003 TI - Understanding and preventing relapse. PMID- 3527004 TI - Etiology of alcoholism reconsidered. The case for a biopsychosocial process. PMID- 3527005 TI - Effects of common therapeutic concentrations of oxygen on lung clearance of 99mTc DTPA and bronchoalveolar lavage albumin concentration. AB - We studied the effects of oxygen concentrations (21 to 50%) considered clinically "safe" on clearance of inhaled technetium-labeled diethylene triamine pentaacetate (99mTc DTPA) and the concentration of albumin in bronchoalveolar lavage (BAL) fluid of normal subjects. We also measured several markers of cell injury and inflammation in the BAL fluid including total and differential cell counts, lactate dehydrogenase, alkaline phosphatase, extracellular potassium, and several eicosanoids. Subjects inhaled oxygen (50, 40, 30, or 21%) for a mean of 45 h; there were no symptoms or bronchoscopic signs of oxygen toxicity. The concentration of albumin in BAL fluid was increased compared with baseline measurements in a dose-dependent manner in subjects exposed to 30% oxygen and above. Clearance of 99mTc DTPA was increased only in subjects who inhaled 50% oxygen. There were no significant changes in BAL fluid volume or total and differential cell counts after oxygen exposure. A trend towards an increased percentage of polymorphonuclear leukocytes was noted in the 50% oxygen group. We found no evidence of cell injury or inflammation in the BAL fluid. Supplemental humidity did not appear to influence the findings in the 50% oxygen group. Thus, oxygen in concentrations considered clinically "safe" increases clearance of 99mTc DTPA and BAL albumin concentration in normal subjects after a relatively short time of exposure. PMID- 3527006 TI - Granulomatous pneumonitis induced by bacille Calmette-Guerin in the mouse and its treatment with cyclosporin A. AB - Granulomatous pneumonitis was induced intravenously by an injection of BCG, and changes in the population of cells from bronchoalveolar lavage (BAL) fluid were examined. Increased lymphocytes in BAL fluid, especially Lyt-1 positive T lymphocytes, were observed after the development of granulomatous pneumonitis. Cyclosporin A (Cy A) administered for 5 days before and for 5 days after BCG injection clearly suppressed development of the granuloma. The BAL cell count and cell population became almost the same as those in naive animals. The increase in the number of Lyt-1 positive T cells was abrogated by Cy A treatment. These results suggested the important role of Lyt-1 positive T cells in the development of granulomas and the possible beneficial effect of Cy A in human granulomatous lung diseases. PMID- 3527007 TI - The soft palate and breathing. PMID- 3527008 TI - Pulmonary arteriovenous malformations: a critical update. AB - Although first reported 90 yr ago, the natural history of pulmonary arteriovenous malformations (PAVM) is still incompletely understood. We review historical perspectives and pathologic classification of this rare disease and identify etiologic factors and clinical features in the 450 reported cases. The many different diagnostic modalities currently available are described, and a logical sequence of investigations is suggested. Pulmonary angiography remains mandatory prior to definitive treatment. The available evidence strongly suggests that morbidity and mortality in untreated PAVM exceeds that associated with either surgical resection or embolic occlusion. Thus, definitive treatment should be offered in all cases, with the possible exception of asymptomatic patients with small lesions who have no evidence of Osler-Weber-Rendu disease. Embolotherapy is now the treatment of choice in institutions with the necessary expertise and facilities, notwithstanding the absence of long-term follow-up for patients treated this way. It is suggested that increased documentation of long-term morbidity and mortality in both treated and untreated patients with PAVM will lead to greater understanding and more effective management of this enigmatic condition. PMID- 3527009 TI - Problems in prescribing and supplying oxygen for Medicare patients. PMID- 3527010 TI - American Thoracic Society. Medical Section of the American Lung Association: Treatment of tuberculosis and tuberculosis infection in adults and children. AB - Treatment of tuberculosis: A 6-month regimen consisting of isoniazid, rifampin, and pyrazinamide given for 2 months followed by isoniazid and rifampin for 4 months is effective treatment in patients with fully susceptible organisms who comply with the treatment regimen. It may be advisable to include ethambutol in the initial phase when isoniazid resistance is suspected. A 9-month regimen consisting of isoniazid and rifampin is also highly successful. The need for an additional drug in the initial phase is not certain unless isoniazid resistance is suspected, in which case ethambutol should be included until susceptibility tests have been reported. In the presence of documented resistance to isoniazid, rifampin and ethambutol, perhaps supplemented initially by pyrazinamide, should be given for minimum of 12 months. Children should be treated in essentially the same ways as adults using appropriately adjusted doses of the drugs. However, consideration must be given to the important differences in the approach to management in children. Extrapulmonary tuberculosis should be managed according to the principles and with the drug regimens outlined to pulmonary tuberculosis. The major determinant of the outcome of treatment is patient compliance. Careful attention should be paid to measures designed to foster compliance and to ensure that patients take the drugs as prescribed. Treatment of tuberculous infection: Preventive therapy with isoniazid given for 6 to 12 months is effective in decreasing the risk of future tuberculosis. (ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3527012 TI - Positional effects on distribution of ventilation in chronic obstructive pulmonary disease. AB - Ventilation is distributed predominantly to the dependent lung in normal persons in the decubitus position. We evaluated the distribution of ventilation in four patients with mild-to-moderate chronic obstructive pulmonary disease using 81mKr gas. Patients were tested in the sitting and right and left decubitus positions with and without the application of positive end expiratory pressure (PEEP). In contrast to findings in controls, ventilation was predominantly distributed to the nondependent lung in patients in the decubitus position. Mean ventilation in the right lung decreased from 51% of the total in the sitting position to 31% in the right decubitus position; it increased with the application of 10 cm PEEP. Reduced ventilation in the dependent lung most likely is caused by closure of the airways after a decrease in volume. Application of PEEP resulted in increased lung volume and preferential distribution of ventilation to the dependent lung. PMID- 3527011 TI - The effect of almitrine bismesylate on hypoxemia in chronic obstructive pulmonary disease. AB - Almitrine bismesylate was studied for its effects on hypoxemia in 67 patients with chronic obstructive lung disease in a placebo-controlled, double-blind study. Arterial Po2 rose by 11.2 mm Hg (p less than 0.05) in 21 patients receiving 100 mg twice daily and by 6.0 mm Hg (p less than 0.05) in 22 patients receiving 50 mg twice daily. Arterial Pco2 decreased by 3.8 mm Hg (p less than 0.05) in the group receiving 100 mg twice daily but was unchanged in patients receiving 50 mg twice daily. Lung function was unaltered except for a slight increase in forced mid-expiratory flow in both dosage groups (p less than 0.05). The major side effect was the unexplained worsening of dyspnea, which occurred in 4 patients (19%) receiving 100 mg twice daily, 2 (9%) receiving 50 mg twice daily group, and 1 (4%) receiving placebo. Almitrine bismesylate improves arterial blood gas values in patients with chronic obstructive lung disease, apparently by reducing intrapulmonary ventilation-perfusion mismatching, and appears to be useful in the long-term management of these patients. PMID- 3527013 TI - Ultrasonography in acute fatty liver of pregnancy. PMID- 3527015 TI - Home health care. Health and Public Policy Committee, American College of Physicians. PMID- 3527014 TI - One hundred years of American internal medicine. A view from the inside. AB - The term internal medicine began to be used by German writers in the late 19th century to designate a branch of practice incorporating the growing understanding of morbid anatomy, microbiology, physiology, and biochemistry. American practitioners of internal medicine began to take a respected place in world medicine toward the close of the 19th century. Noteworthy changes followed World War II, owing to allocation of large sums of money for biomedical research by governments, philanthropic organizations, and the pharmaceutical industry. Clinical problems in this period shifted in preponderance from acute infections to the chronic diseases that accompany aging. Complex diagnostic procedures, together with a diversity of therapeutic choices, created need for full-time teachers and clinical investigators in medical schools, as well as for subspecialists in practice. The pendulum may have swung too far toward specialization, and in the future a substantial proportion of practitioners of internal medicine will still continue to serve as generalist physicians. PMID- 3527016 TI - Searching the medical literature. PMID- 3527017 TI - How to keep up with the medical literature: III. Expanding the number of journals you read regularly. AB - Clinicians can derive immense satisfaction from keeping abreast of new developments in patient care by regularly scanning the medical journal literature. Combined with good reading habits and self-discipline, this scanning generally can be accomplished within the time that most practitioners allot to attempting to keep up to date. We describe tactics for formulating a personalized journal-reading list and ensuring access to the key articles in one's field at a reasonable cost. These tactics begin with deleting low-yield journals from regular reading and adding journals more relevant to one's interests. The cost of multiple journal subscriptions can be reduced by circulating different journals among colleagues or by regular visits to the library. These tactics can be supplemented or replaced by using Current Contents or the Selective Dissemination of Information service of the National Library of Medicine and other database vendors. PMID- 3527019 TI - [Gastroesophageal reflux and acute and chronic respiratory disorders in infants and children]. PMID- 3527018 TI - Infantile subglottic hemangiomas. An update. AB - Between 1913 and 1985, 323 cases of infantile subglottic hemangiomas have been reported in the English language literature. The purpose of this study is to review these cases, to report The Johns Hopkins Hospital experience with ten additional cases, and to compare the various methods of treatment in an attempt to identify the regimens associated with the best outcome. The majority of the patients presented before the age of 6 months with respiratory distress, most commonly inspiratory stridor. There was a 2:1 female to male preponderance. The diagnosis was established by endoscopy in the majority and confirmed by biopsy in one third, without serious bleeding complications. A plethora of treatment methods have been described, including the following: corticosteroids, tracheotomy, radiation therapy, radioactive implant therapy, surgical excision, cryotherapy, and carbon dioxide laser. These methods were reviewed and their results compared to our own. We conclude that several methods are effective, each having its advantages and disadvantages. We believe that immediate tracheotomy should be performed in cases with severe airway obstruction. Smaller lesions may be vaporized with the carbon dioxide laser without tracheotomy if postoperative care is provided in a pediatric intensive care unit. Corticosteroids may be used alone or in combination with other modalities. External radiation therapy and injection of sclerosing agents are not advised. PMID- 3527020 TI - [Congenital cutaneous candidiasis. Review of the literature apropos of a case]. PMID- 3527021 TI - [Hematologic onset of progressive visceral malaria in a 10-year-old girl]. PMID- 3527022 TI - Digital subtraction angiography (DSA) of the heart and coronary arteries. PMID- 3527023 TI - Diagnosis in phlebothrombosis. Phlebofluorography versus Doppler sonography. PMID- 3527024 TI - Importance of ECG-gating in pulsed-mode DSA of the pulmonary arteries. PMID- 3527025 TI - Usefulness of digital subtraction angiography in ischemic cerebral vascular disease: relationship to age and gender. PMID- 3527027 TI - Cortical bone pegs in the treatment of osteochondral fracture of the knee. AB - Cortical bone pegs have been used in osteochondritis dissecans to fix the loosened or loose fragment. In osteochondral fractures of the knee the fragment has either been removed or reattached usually with headless pins or ASIF screws and only occasionally with cortical bone pegs. We report on four patients with osteochondral fractures of the knee, where cortical bone pegs were used as the means of fixation, with good results. PMID- 3527026 TI - [Heart transplantation 1985. Experience of the Pitie]. AB - Heart transplant surgery has come of age over the last four years, after 17 years of clinical application: indications have been specified, techniques systematized and treatment and post-operative follow-ups have been clarified. The results are remarkable: survival at four years is more than 80 per cent, with normal socio familial and often professional reintegration for almost all heart transplant patients. Increased application of heart transplant surgery in the months to come will transform prognosis in patients presenting irreversible cardiac lesions, but will raise the problem of the supply of donor organs. PMID- 3527028 TI - Invagination versus simple ligation of the caecal tip with reference to the strength of the caecal closure. An experimental study in the rat. AB - In an experimental model using the rat, the role of invagination and double invagination for efficient closure of the caecum was studied. A standardized opening of the tip of the caecum was closed in three different ways, thus placing the animals in three groups. I: Closed with simple ligation. II: Closed with simple ligation and a purse-string suture invagination. III: Closed with simple ligation and a purse-string suture and a Z-suture causing double invagination. The caecum was filled with methylene blue and obstructed by a balloon catheter introduced via a caecostomy. Pressure inside the obstructed caecum was measured through a channel opening at the tip of the catheter. The pressure was increased with 4 cm of water every 10 minutes. The maximal pressure reached before leakage of methylene blue from the caecal closure or a drop in pressure in the lumen, was seen to be significantly higher in the groups with invagination and double invagination of the caecal closure, respectively, when compared with those with simple ligation only. The experimental data suggest that the invagination is important for secure closure of the caecal wall. PMID- 3527029 TI - Comparison of iohexol and meglumine iothalamate in single contrast knee arthrography. A double-blind investigation. AB - A prospective double-blind study was performed to assess the side effects and visualization quality of 2 contrast media, iohexol and meglumine iothalamate in single contrast arthrography. There were very few adverse reactions during the examination. During the 2 days after arthrography pain occurred in about 29% of each group. Iohexol caused somewhat less delayed pain on movement and fewer sensations of swelling than iothalamate. The quality of the arthrograms was significantly better with iohexol both in films taken immediately after injection as well as after 20 minutes. PMID- 3527030 TI - Hapten-specific unresponsiveness in mice. IV.--Significance of anti-hapten antibody responses elicited by E. coli lipopolysaccharides in tolerant mice. AB - The antibody response to lipopolysaccharide (LPS) and trinitrophenol-LPS (TNP LPS) was investigated in mice after tolerance induction to chemically reactive hapten 2-4-6-trinitrobenzene sulphonic acid. The depression of the anti-TNP IgM response elicided by LPS was moderate and lasted 1 week. Depression of the response to TNP-LPS was severe and lasted 5 weeks. Tolerant mice given LPS 7 days after tolerance induction, at a time when it elicited a normal response, and challenged with TNP-LPS 2 weeks later, exhibited the same depression of their anti-TNP response as tolerant mice not given LPS. Furthermore, the anti-TNP IgM elicided by TNP-LPS in normal mice was of higher avidity than that observed with LPS. These results suggest that the anti-TNP response elicided by LPS cannot account for the overall immune status of tolerant mice. PMID- 3527031 TI - Murine primary in vivo response to TNP-Ficoll: multigenic control involving H-2. AB - Since the primary PFC response to TNP-Ficoll, a thymus-independent type 2 antigen, displays an important variability in vivo among diverse inbred mouse strains, we used, in the present report, H-2 congenic strains possessing different genetic backgrounds to show that the amplitude of this response is governed by MHC genes, with one regulating locus situated in or near the centromeric part of the I-A subregion. In addition, this H-2 control was largely modulated by gene(s) located outside MHC and IgH haplotypes, as evidenced by the response of recombinant inbred strains (BXH) between the high responder C3H/HeJ and the low responder C57BL/6J. Our results are discussed in terms of humoral regulations and the requirement for self-recognition in cellular interactions which lead to activation of B lymphocytes in the in vivo primary response towards TI-2 antigens. PMID- 3527032 TI - Lymphocyte disappearance and reappearance after a single whole-body irradiation dose of 5 Gy. AB - The effects of a single exposure to 5 Grays of caesium gamma rays administered at a high-dose rate were investigated in rat lymphocyte populations. Such a dose completely depleted the B-cell population but never totally depleted the T-cell population. T and B lymphocytes reappeared in the spleen after 10-15 days and somewhat later in the mesenteric lymph nodes and Peyer's patches. In the spleen, non-circulating B lymphocytes of the marginal zone reappeared after a few days, as did the B lymphocytes of the follicles. Lymphoid tissues were observed to have recovered their normal aspect between days 50 and 60 after irradiation; however, even at that time, the germinal centres had not yet returned to normal. PMID- 3527033 TI - The structure and function of eukaryotic enhancer elements and their role in oncogenesis. AB - Transcriptional enhancers have now been identified near or within a large number of viral and cellular genes. They are cis-acting regulatory sequences generally capable of elevating transcription from a linked gene in a distance and orientation independent manner. More recent evidence suggests that this activity may be modulated in a host-cell-specific manner. Enhancer function in some cases at least appears to be controlled by the operation of trans-acting factors within the host cell. Occasionally enhancers may also be responsible for repression of gene transcription. It has now become clear that the development of some cancers may be linked with the activity of enhancer sequences. It is likely that this process involves subversion of the normal regulatory mechanisms which control expression of proto-oncogenes through the interposition of exogenous, cis-acting enhancer sequences. The evidence comes from two sources, firstly a strong association between the action of enhancer sequences and some forms of naturally occurring cancers, and secondly, the induction of neoplastic transformation in susceptible cells by genetically manipulated oncogenes under the transcriptional control of enhancer elements. PMID- 3527034 TI - Mechanisms of lymphocyte traffic in neoplasia. AB - The composition of tumor infiltrating lymphocyte populations is often reported to be different from that of the lymphocyte pool of peripheral blood. This suggests that infiltration-regulating mechanisms reside in or near the tumor microenvironment. Available evidence indicates that these mechanisms exert their effects on lymphocyte traffic. Two models of regulation are proposed. In the selective immigration model, different lymphocyte types display different tendencies to extravasate into the tumor. Selective immigration could reflect heterogeneity of such lymphocyte properties as binding to vascular endothelium, response to chemotactic factors, or spontaneous locomotion. In the other model, selective entrapment, different types of lymphocytes exit from the tumor microenvironment at different rates. Entrapment could be regulated by selectively acting adhesive, locomotion-inhibiting, or negatively chemotactic factors. Available information supporting each model is presented. The composition of infiltrate may also be influenced by the composition of the circulating lymphocyte pool. Evidence is presented that this pool in turn may be influenced by tumor-induced systemic changes in lymphocyte traffic. Deliberate manipulation of lymphocyte traffic should improve the effectiveness of immunotherapeutic regimes. One promising method of traffic manipulation is the modulation of spontaneous motility. A collagen gel assay for spontaneous lymphocyte motility is described. PMID- 3527036 TI - [Echography and fetal urinary malformations]. AB - A great number of malformations of the foetal urinary tract can now be discovered during the antenatal period, due to the technological development of ultrasound in the light of foetal physiology: firstly the case of a severe oligohydramnios indicating a bilateral renal malformation and underlining its seriousness which is lethal in most cases: early severe oligohydramnios leads to very serious pulmonary hypoplasia of which the child will die at birth even if he only presents a surgically curable malformation such as lower urinary tract valves. This severe oligohydramnios is seen in bilateral renal agenesis, infantile polycystic kidney disease, multicystic bilateral dysplasia, lower urinary tract obstructions. Absence of oligohydramnios: unilateral malformation (it must be taken into consideration that normality of the contralateral kidney is not always easy to confirm by ultrasound). This is the case of unilateral hydronephrosis, unilateral renal agenesis, unilateral multicystic dysplasia, solid renal dysplasia, unilateral primary megaureter. Finally, complex malformations, where the diagnosis and management are problematic because the intensity of the effects is difficult to evaluate, the complexity of the malformation makes the diagnosis uncertain and lastly there exists an oligohydramnios which is more or less severe which makes for a difficult examination. This is the case of bilateral hydronephrosis, lower urinary tract obstructions, Prune Belly syndrome, bilateral primary megaureters, and megabladders. PMID- 3527035 TI - Oncogenes and autoimmunity. AB - Vertebrate cells harbor genes (proto-oncogenes) which carry the potential to become dominant transforming genes or oncogenes. Evolutionary conservation is the hallmark of these genes which implies that they have a major role in the growth and differentiation of the cells. In vitro activation of various cell types (immune cells, fibroblasts, etc.) leads to increased expression of various oncogenes in a certain temporal sequential order. Lymphoid cells from mice with autoimmune disorders have been shown to exhibit increased oncogene expression. Mononuclear cells from patients with angioimmunoblastic lymphadenopathy and certain autoimmune disorders (systemic lupus erythematosus and rheumatoid arthritis) express increased quantities of certain oncogenes. In this review, we discuss the role of oncogenes in the activation of immune cells and the pathogenesis of human autoimmunity. PMID- 3527037 TI - [Use of a resorbable mesh in the conservative treatment of a ruptured human kidney allograft]. AB - A new surgical technique is proposed to preserve severe ruptured renal allografts requiring surgical exploration. Renal corsetage using an absorbable mesh provided a continuous external compression for these friable and fragile kidneys. Two cases treated successfully with this method are reported. PMID- 3527038 TI - Carotid surgery, cognitive function, and cerebral blood flow in patients with transient ischemic attacks. AB - Psychological testing, cerebral blood flow (CBF) measurement, and computed tomographic scan were performed before and 3 months after operation in 31 patients subjected to endarterectomy of the internal carotid artery (ICA) because of transient ischemic attacks and in 11 control patients operated on for atherosclerosis of the lower extremities. In preoperative psychological testing both carotid surgery patients and controls performed somewhat below the normal level for their age group. Postoperatively, cognitive functions improved in the carotid surgery group but not in the control group. The improvement was related to the laterality of the operation, being more marked in verbal tests in patients with left ICA operation and in visuospatial tests in patients with right ICA operation. Postoperatively regional CBF improved in 2 patients only. Hence the intellectual improvement could not be related to changes in CBF. Intellectual deterioration in patients with internal carotid atherosclerosis may be delayed or terminated by surgical abolition of the source of multiple cerebral embolizations. PMID- 3527039 TI - Membrane defects in Duchenne dystrophy: protease affecting sarcoplasmic reticulum. AB - Human muscle sarcoplasmic reticulum (SR) yields three major protein bands. The percent distribution of the mean values of the bands from 15 normal human muscles was 55.4, 14.6, and 30.0 for the 100, 55, and 45-kDa mass proteins, respectively. A mean distribution similar to that in normal muscle SR was found in preparations from 7 patients with polymyositis and from 7 patients with myotonic dystrophy. In 12 preparations from patients with Duchenne dystrophy, the protein distribution differed from that of preparations from normal muscle. The 100-kDa mass protein band was decreased, whereas the 55- and 45-kDa mass bands were increased. Protease inhibitors pepstatin A, antipain, and leupeptin, as well as ethyleneglycol-bis(aminoethyl ether)-N,N,N',N'-tetraacetic acid or ethylenediaminetetraacetic acid, significantly reduced this change. However, some of the changes cannot be prevented by the addition of inhibitors and must be expressed in vivo. Neither protease inhibitors nor chelators affected SR preparations from normal muscle. We found a five- to ten-fold increase in calcium activated neutral protease activity in Duchenne dystrophic muscles that degraded the calcium-adenosinetriphosphatase of SR. The active protease was identified as the cytoplasmic calpain II. The increased activity in Duchenne muscles may explain many reported abnormalities. PMID- 3527040 TI - Single-stranded DNA binding proteins required for DNA replication. PMID- 3527041 TI - Hormonal regulation of mammalian glucose transport. PMID- 3527042 TI - Transmembrane transport of diphtheria toxin, related toxins, and colicins. PMID- 3527043 TI - Molecular aspects of sugar:ion cotransport. PMID- 3527044 TI - Carbohydrate-binding proteins: tertiary structures and protein-sugar interactions. PMID- 3527045 TI - Transcription termination and the regulation of gene expression. PMID- 3527046 TI - Lectins as molecules and as tools. PMID- 3527047 TI - Double-stranded RNA replication in yeast: the killer system. PMID- 3527048 TI - Bacterial periplasmic transport systems: structure, mechanism, and evolution. PMID- 3527049 TI - Taurine: biological update. PMID- 3527050 TI - Structural aspects of the red cell anion exchange protein. PMID- 3527051 TI - Proteoglycan core protein families. PMID- 3527052 TI - Transcription of cloned eukaryotic ribosomal RNA genes. PMID- 3527053 TI - The transport of proteins into chloroplasts. PMID- 3527054 TI - Metallothionein. PMID- 3527055 TI - Actin and actin-binding proteins. A critical evaluation of mechanisms and functions. PMID- 3527056 TI - [History of methods for estimating body height by skeletal findings. Recommendations for estimating body height by skeletal findings up to the middle of the 20th century]. AB - Up to now no historical review concerning the methods to estimate body height from skeletons has been given. As well no collection of the formulae relevant to this subject, which would save laborious search in the wide-scattered literature, is available hitherto. This study tries to fill this gap. The anthropological and statistical treatment of the populations under study will not be discussed in this connection, because this has to be left to a separate study. PMID- 3527057 TI - [Disordered bacitracin synthesis and sporulation in mutant Bacillus licheniformis with decreased proteolytic activity]. AB - The vegetative cells of B. licheniformis, producing bacitracin, a feed grade peptide antibiotic were exposed to nitroso guanidine and six mutants with lowered activity of serine exoprotease in the culture fluid were isolated. It was found that synthesis of bacitracin and sporulation of the mutants were impaired. The cause of the impairment is not known. The results are discussed from two viewpoints: serine exoprotease is responsible for positive regulation of bacitracin biosynthesis and sporulation at the account of forming an amino acid pool in the medium, simultaneous changing of the three features in the mutants may be due either to a single pleiotropic mutation or to multiple mutations independently induced by nitroso guanidine. PMID- 3527058 TI - [Optimizing the composition of the medium for the biosynthesis of antibiotic, proteases and pigments by the mycophilic fungus Hypomyces rosellus using a mathematical experimental design method]. AB - Regulation of protease and pigment production in Hypomyces rosellus by the medium components was easier than that of antibiotic production. Medium was developed. The activity of exoproteases and pigment with the use of this medium increased up to 385-800 PU/ml and 0.68-0.83 arbitrary units, respectively. The level of the antibiotic biosynthesis was insignificant. PMID- 3527059 TI - [Role of levorin and lytic enzymes in the interrelations of yeasts and actinomycete in a mixed culture]. AB - Interrelation of yeasts and the actinomycete producing levorin, Streptomyces levoris in mixed cultures was studied. It was found that death of the accompanying microorganisms during fermentation with the two cultures was mainly due to the effect of the actinomycete lytic enzymes. The level of the enzymatic lysis depended on the genus and species characteristics of the organisms used in mixed cultures. By the end of the fermentation process the culture fluid contained no organisms with respect to which the lysoenzymes of S. levoris were highly active. In this case mixed cultivation of the actinomycete and yeasts resulted in increasing antibiotic synthesis by 45-48 per cent as compared to the control. The yeasts hydrolyzed by the S. levoris yeastlytic enzymes with difficulty or slightly remained viable up to the end of mixed cultivation and lowered the level of the antibiotic activity. PMID- 3527060 TI - [Effect of cationic polymers and surface-active substances on bacterial resistance to kanamycin]. AB - The effect of cationic polymers and surface active substances (SAS) on sensitivity of Klebsiella aerogenes 600, Escherichia coli 154 and Proteus vulgaris 7470 to kanamycin was studied. A decrease in the resistance of the above organisms to kanamycin on its use in combination with cationic polymers and SAS was observed. It was shown that such substances inhibited the activity of the enzymes inactivating kanamycin. Their effect was suggested to be due to changes in the lipid surrounding of the enzymes. PMID- 3527061 TI - Serotonin manipulations and the structure of feeding behaviour. AB - Experimental manipulations of 5-HT by central or peripheral procedures produce clear effects on food intake. Interpretation of these effects can be improved by monitoring changes in the behavioural structure of feeding and by designing experiments which adjust the contextual and temporal dimensions of feeding. Experimental techniques include micro-analysis of behaviour, macro-analysis of meal patterns, dietary self-selection of macro-nutrients, analysis of appetite and satiety sequences, appetitive and consummatory aspects of instrumental performance and dietary-induced hyperphagia. Using these procedures in conjunction with various pharmacological treatments including the administration of tryptophan, 5-hydroxy-tryptophan, 5-HT, re-uptake blockers, synaptic releasers, synthesis blockers, receptor blockers and others it has been demonstrated that 5-HT manipulations give rise to a specific constellation of changes in feeding parameters. The most prominent changes following peripheral or central (paraventricular nucleus) injections are a reduction in meal size and a curtailment of eating rate. These changes can be distinguished from those induced by other pharmacological treatments and are consistent with a modulation of the process of satiation and the state of satiety. Changes in feeding induced by 5-HT manipulations are not secondary to non-specific behavioural alterations. PMID- 3527062 TI - Gastromotor mechanism of fenfluramine anorexia. AB - A gastric slowing effect of fenfluramine accounts for most of the drug's suppressant effect on food intake in freely feeding rats. It is conceivable on the evidence to date that this gastromotor action of fenfluramine explains all its effects on appetite and metabolism, but additional peripheral and central effects--such as motor inhibition--are likely. Rate of gastric emptying is quantitatively the dominant physiological control of appetite: it determines the duration for which absorption of a meal sustains metabolic satiety; it also influences gastric distension, which can be a source of innate satiation and of learned carbohydrate-specific satiation. Since most of the neurotransmitter serotonin (5HT) resides in the gastrointestinal wall, not the brain, gastromotor suppression of appetite should be the first working hypothesis for a serotoninergic drug such as fenfluramine. The largest effect on food intake that arises from gastric slowing by fenfluramine and active metabolites is a lengthening of the period of satiety after a meal of a given size. The residue of this extended satiety could reduce appetite at a subsequent fixed mealtime and hence the size of such a meal. Fenfluramine appears not to intensify satiation processes generated by a meal. Rather, it affects eating processes from the start. Also, fenfluramine disrupts learned carbohydrate-specific satiation operative within a meal. This negates the claim that fenfluramine reduces carbohydrate-specific appetite--which in any case (like other claims that drugs modulate nutrient selection) is not based on adequately designed dietary selection tests. PMID- 3527063 TI - Carbohydrate craving, obesity and brain serotonin. AB - One mechanism through which the brain obtains information about the composition of the diet involves food-induced changes in the plasma amino acid pattern (principally the "plasma tryptophan ratio"), which then cause increases or decreases in brain tryptophan levels, and in the synthesis of a neurotransmitter, serotonin, which is formed from the tryptophan. A carbohydrate-rich, protein-poor meal stimulates insulin secretion; this diminishes plasma levels of the amino acids which compete with tryptophan for transport into the brain (e.g., leucine, isoleucine and valine), thus increasing tryptophan's flux across the blood-brain barrier and its brain levels. In contrast, a high-protein meal contributes so much more of these latter amino acids to the blood stream than of the relatively scarce tryptophan that it diminishes tryptophan's entry into the brain. This article reviews evidence that the brain actually utilizes the food-induced changes in brain serotonin in order to make choices about what to eat at the next meal. It also discusses the likelihood that a disturbance in this mechanism is involved in producing the "carbohydrate-craving" that is frequently associated with obesity. (This behavior which has been studied by allowing hospitalized subjects to choose freely among isocaloric meals and snacks of varying protein/carbohydrate ratios, typically manifests itself as a propensity to consume 30 per cent or more of the total daily calorie intake in the form of sweet or starchy snacks, usually at a characteristic time of day.) D Fenfluramine, a drug that selectively enhances serotonin-mediated neurotransmission, also selectively suppresses "carbohydrate-craving" in these subjects.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3527064 TI - Effect of the peroxisomal proliferator di(2-ethylhexyl)phthalate on component reactions of the rat hepatic microsomal fatty acid chain elongation system and on other hepatic lipogenic enzymes. AB - The feeding of 2% di(2-ethylhexyl)phthalate (DEHP) to rats increased the hepatic microsomal elongation of palmitoyl-CoA by about twofold, while those of palmitoleoyl-CoA and gamma-linolenoyl-CoA decreased to 83 and 63%, respectively, of the control values. When component reactions of the elongation pathway were measured, it was observed that only the activity of condensing enzyme was increased by twofold, while those of beta-ketostearoyl-CoA reductase, beta hydroxypalmitoyl-CoA dehydrase, and trans-2-hexadecenoyl-CoA reductases were not affected. Furthermore, the time course for induction of both condensation and elongation of palmitoyl-CoA was similar. In vitro addition of DEHP had no effect on either condensation or elongation. Thus, these results indicate that the peroxisomal proliferator induces only the condensing enzyme which is the regulatory and rate-limiting step of elongation sequence. The DEHP treatment also markedly enhanced the cytosolic NADPH-generating activities of glucose-6-PO4 dehydrogenase (2.2-fold) and malic enzyme (7.3-fold). Unexpectedly, the activities of fatty acid synthetase and citrate cleavage enzyme were unaffected. These results are discussed in light of the fact that these lipogenic enzymes are coordinately induced by diet or hormones. PMID- 3527065 TI - Glucose-induced phospholipid-dependent protein phosphorylation in neonatal rat islets. AB - The participation of calcium-activated, phospholipid-dependent protein kinase in the phosphorylation of endogenous islet proteins following the exposure of cultured, neonatal pancreatic islets to stimulatory glucose concentrations was investigated by two techniques. In the first technique, islets were prelabeled with 32Pi. The major endogenous substrates for glucose-induced phosphorylation had apparent molecular masses of 130,100 +/- 1010, 100,000 +/- 700, 80,400 +/- 890, 58,100 +/- 1200, 39,800 +/- 700, and 29,400 +/- 700 Da. In the presence of 12-O-tetradecanoylphorbol 13-acetate (2 microM), an activator of calcium activated phospholipid-dependent kinase, there was enhanced phosphorylation of proteins of 80,000, 40,000, and 29,000 Da. In the second technique, exogenous phosphorylation by [gamma-32P]ATP of proteins in a postnuclear particulate fraction was studied in the presence and absence of cofactors for Ca2+-activated, phospholipid-dependent protein kinase (Ca2+, phosphatidylserine, and unsaturated diolein). These studies were performed in islets preexposed to low (1.7 mM) or high (16.7 mM) glucose concentration prior to preparation of the postnuclear particulate fraction. Following exposure of islets to low glucose concentration, three substrates (apparent molecular masses 40,500 +/- 600, 57,100 +/- 700, and 79,400 +/- 600 Da) in the postnuclear particulate fraction exhibited enhanced phosphorylation in the presence of calcium ions, phosphatidylserine, and unsaturated diolein. In preparations of islets preexposed to 16.7 mM glucose, the phosphorylation of the protein of molecular mass about 40,000 Da was significantly reduced, indicating prior phosphorylation of the acceptor sites on this substrate in response to glucose exposure. It is concluded that stimulation of neonatal cultured islets by glucose induces the acute changes in calcium ion, phospholipid, and diacylglycerol concentration required to activate the calcium activated phospholipid-dependent protein kinase and that the islet postnuclear particulate fraction contains at least one specific substrate for this kinase. PMID- 3527066 TI - The role of magnesium and potassium ions in the molecular mechanism of ribosome assembly: hydrodynamic, conformational, and thermal stability studies of 16 S RNA from Escherichia coli ribosomes. AB - In an attempt to understand the role of magnesium ion in ribosome assembly in vitro, the hydrodynamic shape, conformation, and thermal stability of ribosomal 16 S RNA were studied systematically as a function of Mg2+ concentration by sedimentation velocity, intrinsic viscosity, circular dichroism, and difference ultraviolet absorption spectroscopy. These results were then compared with the corresponding parameters obtained for 16 S RNA under the optimal conditions of reconstitution, i.e., at 37 degrees C, 20 mM Mg2+, an ionic strength equal to 0.37, and pH 7.8 [S. H. Allen, and K.-P. Wong (1978) J. Biol. Chem. 253, 8759 8766]. When the 360 mM KCl required for reconstitution of 30 S ribosomes is added to the medium, only subtle conformational changes are observed, consistent with the destabilization of the conformation, thus making the RNA molecule more "open" and accessible to protein binding. However, when the concentration of Mg2+ is lowered from 20 to 1 mM, the hydrodynamic parameters indicate that the 16 S RNA is partially unfolded, while thermal denaturation studies suggest that the amount of base-stacking and base-pairing is not concomitantly altered. Further removal of the Mg2+ by dialysis against a pH 7.8 buffer containing no Mg2+ results in a drastic decrease of secondary structure and indicates that the Mg2+ is required for maintenance of the pairing, stacking, and stability of the nucleotide bases, in addition to the long range interactions which result in a compact structure. The results suggest that the 20 mM Mg2+ is required for the 16 S RNA molecules to assume the proper secondary and tertiary structure containing the protein-binding sites, while the high K+ concentration (360 mM KCl) is needed for "loosening up" the RNA, making the protein binding sites more accessible to the ribosomal proteins for molecular recognition and binding as well as for the conformational changes that occur during ribosome assembly. PMID- 3527068 TI - A new ganglioside in human meconium detected with antiserum against human milk sialyltetrasaccharide a. AB - Antiserum directed against the alditol derivative of the human milk monosialyloligosaccharide sialyltetrasaccharide a [D. F. Smith, P. A. Prieto, and B. V. Torres (1985) Arch. Biochem. Biophys. 241, 298-303] is used to detect a new ganglioside in human meconium by direct binding on nitrocellulose filters of the sialyl[3H]oligosaccharide alditol obtained from gangliosides after ozonolysis and alkali fragmentation. The sialyl[3H]oligosaccharide is purified by affinity chromatography on a column containing anti-sialyltetrasaccharide a antibodies. The affinity-purified sialyl[3H]oligosaccharide cochromatographs with the 3H labeled alditol derivative of authentic sialyltetrasaccharide a from human milk. Results of sequential enzyme degradation of the pure sialyl[3H]oligosaccharide and cochromatography of the digestion products with standards are consistent with the presence in meconium of a monosialylganglioside with the structure NeuAc alpha 2-3Gal beta 1-3GlcNAc beta 1-3Gal beta 1-4Glc-ceramide. This ganglioside is presumably the biosynthetic precursor of the sialyl-Lea ganglioside [G. C. Hansson and D. Zopf (1985) J. Biol. Chem. 260, 9388-9392], which is also a component of human meconium. PMID- 3527067 TI - Isolation of multiple forms of indanol dehydrogenase associated with 17 beta hydroxysteroid dehydrogenase activity from male rabbit liver. AB - Seven multiforms of indanol dehydrogenase were isolated in a highly purified state from male rabbit liver cytosol. The enzymes were monomeric proteins with similar molecular weights of 30,000-37,000 but with distinct electrophoretic mobilities. All the enzymes oxidized alicyclic alcohols including benzene dihydrodiol and hydroxysteroids at different optimal pH, but showed clear differences in cofactor specificity, steroid specificity, and reversibility of the reaction. Two NADP+-dependent enzymes exhibited both 17 beta-hydroxysteroid dehydrogenase activity for 5 alpha-androstanes and 3 alpha-hydroxysteroid dehydrogenase activity for 5 beta-androstan-3 alpha-ol-17-one. Three of the other enzymes with dual cofactor specificity catalyzed predominantly 5 beta-androstane 3 alpha,17 beta-diol dehydrogenation. The reverse reaction rates of these five enzymes were low, whereas the other two enzymes, which had 3 alpha-hydroxysteroid dehydrogenase activity for 5 alpha-androstanes or 3(17)beta-hydroxysteroid dehydrogenase activity for 5 alpha-androstanes, highly reduced 3-ketosteroids and nonsteroidal aromatic carbonyl compounds with NADPH as a cofactor. All the enzymes exhibited Km values lower for the hydroxysteroids than for the alicyclic alcohols. The results of kinetic analyses with a mixture of 1-indanol and hydroxysteroids, pH and heat stability, and inhibitor sensitivity suggested strongly that, in the seven enzymes, both alicyclic alcohol dehydrogenase and hydroxysteroid dehydrogenase activities reside on a single enzyme protein. On the basis of these data, we suggest that indanol dehydrogenase exists in multiple forms in rabbit liver cytosol and may function in in vivo androgen metabolism. PMID- 3527069 TI - [Recent progress in studies of the drug-metabolizing enzyme cytochrome P-450]. AB - More than a dozen nearly full-length cDNA clones for cytochromes P-450 were isolated from various sources. From their nucleotide sequences, the primary structures of the corresponding proteins were deduced. All the P-450s determined showed statistically significant sequence homology among them. On the basis of this homology, the molecular evolution of the P-450 super gene family was discussed, and the functional domains of the proteins including the heme-binding site were estimated. Chromosomal DNAs for methylcholanthrene- and phenobarbital inducible P-450s, the two inducible forms of P-450 which diverged approximately 400 million years ago, were cloned, and their gene structures were analyzed. It was interesting that all the exon-intron boundaries between the two subgene families were found not to be conserved. The mechanism of inductive expression of the methylcholanthrene-inducible P-450 c that catalyzes detrimental reactions of chemical carcinogens and mutagens such as benzo[a]pyrene were investigated by the method of DNA transfection. Several cis-acting DNA elements responsible for the regulation were located in the 5' flanking region of the P-450 c gene. PMID- 3527071 TI - Epidermolysis bullosa acquisita with negative direct immunofluorescence. PMID- 3527070 TI - [Randomized crossover trial of the antiemetic effects obtained with metoclopramide and droperidol versus those obtained with metoclopramide, droperidol and methylprednisolone in patients receiving cis-platinum chemotherapy]. AB - Twenty-four patients with lung cancer receiving cis-platinum chemotherapy were entered in an antiemetic randomized crossover trial. The effects of high-dose metoclopramide and droperidol (regimen I) were compared with those obtained with a combination of high-dose metoclopramide, droperidol and methylprednisolone (regimen II). Three patients (12.5%) treated with regimen I and 10 (43.5%) treated with regimen II had no vomiting at all (p less than 0.05). Patient preference was significantly in favor of regimen II (p less than 0.05). No Severe side effects were observed. A further trial is necessary to determine the optimal dosage and scheduling of the available agents. PMID- 3527072 TI - The physician and the medical literature. From Index Medicus to MEDLARS to GRATEFUL MED and beyond. PMID- 3527073 TI - Autosomal recessive pachyonychia congenita. AB - We report the second and third cases of pachyonychia congenita inherited as an autosomal recessive disorder. Our cases were unusual, with the fingernails showing a striking leukonychia and appearing clinically as Terry's nails. These patients were originally diagnosed as having epidermolysis bullosa simplex because of a history of a life-long blistering disorder. The clinical features and inheritance of pachyonychia congenita, as well as the reasons for the long delay in diagnosis of our cases, are discussed. PMID- 3527074 TI - Systemic absorption of topical steroids. Metabolic effects as an index of mild hypercortisolism. AB - This study was undertaken to determine whether the commonly used treatment of psoriasis with potent topical glucocorticoids results in hypercortisolism and whether metabolic changes might provide a means for monitoring pharmacologic effects of excessive systemic absorption of glucocorticoids. Plasma cortisol, glucose, and insulin and circulating polymorphonuclear leukocytes were assessed under controlled conditions in five otherwise healthy patients with psoriasis (40% to 85% involvement) treated with topical desoximetasone, without occlusion. In all patients, there were rapid and sustained suppression of endogenous cortisol production, twofold to threefold increases in fasting insulin levels indicating insulin resistance, and elevated levels of polymorphonuclear leukocytes. Two patients also experienced reduced glucose tolerance. These findings suggest that application of potent corticosteroids to large areas of diseased skin results in sufficient systemic absorption to cause not only adrenal suppression but some degree of hypercortisolism with greater frequency and rapidity than has been suggested. Prospective monitoring of insulin-glucose relationships as a sensitive index of the metabolic effects of glucocorticoids may provide a means of assessing excess systemic absorption that is not predictable on the basis of adrenal suppression or circulating levels of the drug. Such prediction could have particular relevance in anticipating adverse clinical effects in the treatment of chronic skin disorders with potent topical glucocorticoids. PMID- 3527075 TI - Chemotherapy-induced acral erythema in patients receiving bone marrow transplantation. AB - Chemotherapy-induced acral erythema is an uncommon and distinctive syndrome of intense macular erythema of the palms and fingers seen in patients treated with high-dose chemotherapy. It is painful, may form bullae, and heals uneventfully with desquamation. The incidence (35%) of this complication in patients receiving bone marrow transplantation at our institution is quite high and probably reflects the exceptional doses of chemotherapy and concomitant total body irradiation these patients receive. Biopsy specimens showed vacuolar change, spongiosis, necrotic keratinocytes, and epidermal atypia. These findings probably result from direct toxic effect and mimic those of acute graft-vs-host disease. Awareness of chemotherapy-induced acral erythema is important to avoid its misdiagnosis as a cutaneous sign of acute graft-vs-host disease. This distinction can usually be made on clinical grounds. If necessary, serial skin biopsy specimens are helpful. PMID- 3527076 TI - Dermatologic applications of cyclosporine. AB - It is evident that cyclosporine A is a potent immunosuppressive agent and may become immensely valuable in the treatment of cutaneous disease. The extent of its application and efficacy is speculative, as neither the pathogenesis of many of the diseases, nor the mechanism of action of cyclosporine is fully understood. Well-designed clinical and laboratory studies are necessary to delineate its therapeutic value in a particular disorder. It must be emphasized that the systemic use of the drug is associated with several serious side effects, including nephrotoxicity and lymphoproliferative disease. Local topical application may reduce these concerns, and make treatment of benign diseases a possibility. Therefore, until these well-designed prospective studies are performed, cyclosporine's use should be limited and closely monitored. PMID- 3527077 TI - Cutaneous insulin reaction resembling acanthosis nigricans. AB - We describe a patient who developed hyperkeratotic, verrucous plaques at sites of repeated insulin injections. One similar case has previously been reported. This phenomenon may be an unusual manifestation of the trophic actions of insulin. PMID- 3527078 TI - Epidermolysis bullosa acquisita with negative direct immunofluorescence. PMID- 3527079 TI - Transient acantholytic dermatosis: an immunohistochemical study. PMID- 3527080 TI - James Spence medallist, 1986. Sir Peter Tizard. PMID- 3527081 TI - Synchronizing breathing and positive pressure ventilation. PMID- 3527082 TI - Fetal and neonatal prostacyclin and thromboxane in relation to mode of delivery. AB - To study whether prostacyclin and thromboxane A2 might play a role in neonatal adaption pieces of the umbilical arteries of infants born vaginally (n = 18) or by elective caesarean section (n = 11) were superfused in vitro and the release of 6-keto-PGF1a (hydration product of prostacyclin) and thromboxane B2 (metabolite of thromboxane A2) measured by radioimmunoassay. In addition, the capacity of fetal platelets to produce thromboxane A2 and the neonatal urinary concentrations of 6-keto-PGF1a were measured. Infants born by caesarean section had lower diastolic blood pressure, higher heart rate, and smaller differences between rectal and skin temperature compared with infants born vaginally during the first two hours of life. The only difference encountered in the prostanoids between the groups was reduced urinary excretion of 6-keto-PGF1a in infants born by caesarean section, whose release of 6-keto-PGF1a by the umbilical artery was positively correlated with heart rate, respiration frequency, and dermal temperature. Thus prostacyclin may be a regulatory determinant, particularly in infants born by caesarean section. PMID- 3527083 TI - Endosonographic staging of carcinoma of the uterine cervix. AB - The advantages of a new endosonic technique for staging carcinoma of the cervix are demonstrated. Using this method virtually all palpable findings can be objectified, and in most cases, assessing the size of the tumor inside the cervix seems to allow further differentiation in stage Ib. By imaging the parametrium, rectal sonography provides an important diagnostic aid for making the differentiation between stages Ib, IIb and IIIb. For assessment of the extent of vaginal infiltration, rectal ultrasound diagnosis and in particular vaginosonography can be used. Rectal and especially transurethral sonography are useful for detecting an infiltration of the bladder wall and for further evaluation of cystoscopically visible vesiculated oedema. PMID- 3527084 TI - [Renal abscess caused by gram-negative bacteria]. PMID- 3527085 TI - Significance of non-pathogenic cross reactive bowel flora in patients with ankylosing spondylitis. AB - We have previously shown that antisera raised in rabbits to certain enteric cross reactive strains of bacteria are capable of specifically lysing the peripheral blood lymphocytes of HLA-B27 positive patients with ankylosing spondylitis (B27+ AS+). We now report that bacteria with cross reactive antigenic determinants are found in the bowel flora of all of 52 B27+ AS+ patients but in only one of 50 HLA B27 positive normal controls (B27+ AS-). These organisms are functionally similar to the cross reactive enteric bacteria originally reported. They are not confined to a particular genus or species and their cross reactive serological nature appears to be a property shared by all enteric organisms isolated from B27+ AS+ patients. Organisms with these properties have been shown to persist in the bowel flora of 14 B27+ AS+ patients followed up for more than one year. PMID- 3527086 TI - A placebo controlled, crossover study of azathioprine in Reiter's syndrome. AB - Eight patients with intractable Reiter's disease were entered into a double blind, placebo controlled, crossover study of azathioprine versus placebo--each patient serving as his own control. Drug therapy was administered for 16 weeks, patients receiving azathioprine (eight weeks) or placebo (eight weeks) in random order. Azathioprine was given as 1 mg/kg body weight for the first month and 2 mg/kg body weight for the second month. Six individuals completed both arms of the crossover. One withdrew because of nausea during the first week (azathioprine), and a second subject withdrew at four weeks because of lack of efficacy (placebo). At the end of the 16 weeks five out of six preferred azathioprine and one placebo. The mean unweighted joint score decreased from 19.8 to 2.7 during the azathioprine medication but increased from 13.4 to 19.9 during the placebo period. Patients were unable to reduce their analgesic or non steroidal anti-inflammatory drug requirements during the placebo period, but four out of six were able to do so during azathioprine therapy. There were no drug related laboratory abnormalities. The data suggest that azathioprine may work rapidly in Reiter's disease. If these essentially anecdotal findings of efficacy are confirmed, long term toxicity may not be an over-riding factor since for some patients therapy can be rapidly tapered at eight weeks--either because of adequate improvement or failure to respond. PMID- 3527087 TI - HLA-DR expression by labial minor salivary gland tissues in Sjogren's syndrome. AB - Minor salivary gland biopsy specimens from patients with Sjogren's syndrome (primary and secondary) and from normal controls were examined with the four step biotin-avidin-immunoperoxidase assay. The composition of the infiltrating cells was similar in patients with both primary and secondary Sjogren's syndrome, consisting primarily of T lymphocytes with predominance of T helper/inducer cells. B lymphocytes (Leu-14) were approximately 20-35% of the infiltrating lymphocytes, while only a few OKM1 (monocytes/macrophages) cells and Leu-7+ (natural killer; NK) cells were observed. The majority of infiltrating lymphocytes expressed HLA-DR antigens. In the biopsy specimens of the controls there were no infiltrates; the scattered lymphocytes, however, were also predominantly T lymphocytes. Finally, the glandular epithelial cells (ducts and acini) were inappropriately expressing HLA-DR antigens, in contrast with controls where minimal HLA-DR expression was found. PMID- 3527088 TI - Surgical versus nonoperative treatment of symptomatic carotid stenosis. 211 patients documented by intravenous angiography. AB - From 1980 through 1982, intravenous extracranial digital subtraction angiography (DSA) was performed in 6684 patients at the Cleveland Clinic. Of these, 211 previously unoperated patients had prior transient ischemic attacks (TIA) or strokes in conjunction with greater than 50% carotid stenosis on unequivocal DSA studies. Nonoperative management was employed in 126 patients, including 120 (84%) who received antiplatelet therapy or formal anticoagulation. The remaining 85 patients underwent carotid endarterectomy. During a mean follow-up interval of 36 months, there was no overall difference in survival, late TIA, or stroke between the nonoperated and surgical cohorts. However, parity was maintained in these groups only because of the prevalence of intermediate (50-69%) stenotic lesions and stable internal carotid occlusions in the nonoperated group. Carotid endarterectomy provided superior stroke prevention for patients with greater than 70% unilateral stenosis (p = 0.04), for those with greater than 50% bilateral stenosis (p = 0.004), and for those with internal carotid occlusions associated with greater than 50% contralateral stenosis (p = 0.03). The special risk of such discrete subsets should be recognized in order to plan appropriate treatment at the present time, as well as to conduct safe clinical trials in the future. PMID- 3527089 TI - Surgical versus nonoperative treatment of asymptomatic carotid stenosis. 290 patients documented by intravenous angiography. AB - From 1980 through 1982, intravenous extracranial digital subtraction angiography (DSA) was performed in 6684 patients at the Cleveland Clinic. Of these, 290 previously unoperated patients had asymptomatic carotid stenosis exceeding 50% of lumen diameter on unequivocal DSA studies. Either the presence or the absence of carotid bruits substantially misrepresented the severity of angiographic stenosis on approximately 30% of sides. Nonoperative management was employed in 195 patients, including 104 (53%) who received antiplatelet therapy, while another group of 95 patients underwent prophylactic carotid endarterectomy. During mean follow-up intervals of 33-38 months, surgical treatment significantly reduced the cumulative incidence of subsequent neurologic events in men (p = 0.05). Statistically unconfirmed trends also suggested that carotid endarterectomy tended to prevent late strokes in subsets of patients with greater than 70% stenosis or bilateral carotid lesions. The overall stroke rate for women was higher in the surgical group (p = 0.03), in part because of their unusual risk for perioperative complications (9%) in this particular series. PMID- 3527091 TI - The thoracic surgical industrial complex. AB - The thoracic surgical industrial complex is an industry worth $2 billion per year and is shaped by six dominant forces, three positive and three negative. The three positive forces are technological innovation, entrepreneurial activity, and the flow of capital and the three opposing forces, government regulation, cost containment, and the excessive costs of product liability insurance. We are now at a critical time in the evolution of this industry, with growth being enhanced in areas of lesser risk, namely, nonimplantable devices, at the expense of high risk implantable devices. The future of the artificial heart hinges on the balance between the six forces, and this analysis examines the possibilities for timely development of this ultimate implantable device. PMID- 3527090 TI - Transplantation of pediatric donor kidneys to adult recipients. Is there a critical donor age? AB - Cadaver kidneys remain a scarce resource, yet single pediatric donor kidneys are underutilized at some centers. Between 1967 and 1984, 133 single pediatric and 318 adult donor cadaver transplants were performed. Patient and graft survival, renal function, and complications in adult recipients grouped by donor age were compared. Recipient age for all groups was similar (34-36 years). Life table analysis revealed no difference in graft survival in recipients of kidneys from donors aged 2, 3, 4, 5-10, and 11-15 when compared with adult donors. Graft survival in these groups improved over time with current 1-year survival over 75%. Recipients from donors less than 24 months of age demonstrated significantly poorer results, with no kidney surviving greater than 2 months. Serum creatinine of grafts functioning greater than 6 months was similar in all groups. It is concluded that single pediatric kidneys from donors greater than 2 years of age can be successfully transplanted to adults with good long-term results. PMID- 3527092 TI - Cardiac surgery in patients with chronic renal disease. AB - The combination of chronic renal failure and cardiovascular disease is identified frequently and results in high morbidity and mortality without appropriate medical and surgical therapy. Experience during the last eighteen years has shown that cardiac operations can be undertaken in this high-risk group with acceptable morbidity and mortality and with reasonable expectation of symptomatic improvement. In a six-year period, 17 patients with chronic renal disease underwent cardiac procedures at the Vanderbilt University Affiliated Hospitals. Ten patients were on long-term hemodialysis, and 7 had a functioning renal transplant. Thirteen patients had a coronary artery bypass procedure alone, 1 had a bypass procedure plus aortic valve replacement, 1 had a bypass procedure plus repair of the mitral valve, 1 had a bypass procedure and resection of a left ventricular aneurysm, and 1 had aortic valve and mitral valve replacement for endocarditis. Sixteen patients survived and were discharged. The hospital stay was shorter for patients with a renal transplant than for those on hemodialysis (mean, 11 days versus 22 days, respectively), and perioperative complications were less frequent in the transplant group. There has been 1 late death unrelated to the operative procedure. Fifteen long-term survivors have been followed a mean of 26 months (range 7 to 108 months). All have achieved symptomatic improvement and are in New York Heart Association Functional Class I or II. These results in this high-risk patient group provide a basis for cautious optimism and for a continued aggressive approach in patients with chronic renal disease who require cardiac operation. PMID- 3527093 TI - Platelet damage by protamine and the protective effect of prostacyclin: an experimental study in dogs. AB - Protamine is given after cardiopulmonary bypass to reverse the effect of heparin. However, the adverse effects of an overdose have not been fully evaluated. In this canine study, a standard dose of one bolus of heparin (300 IU per kilogram of body weight) was neutralized by an infusion of protamine hydrochloride in a 1:2 ratio. Platelet number and function were severely reduced by this overdose of protamine, and this finding correlated with a prolongation of the bleeding time. Giving a titrated dose of protamine hydrochloride to reverse heparin activity, measured by the activated clotting time, affected neither platelet number nor function. When prostacyclin (0.5 microgram/kg/min) was infused during administration of an overdose of protamine, platelets again were not affected by the excess of protamine. PMID- 3527094 TI - Role played by oxygen in myocardial protection with crystalloid cardioplegic solution. AB - To evaluate the importance of the oxygen dissolved in crystalloid cardioplegic solution, the protective effects of oxygenated glucose-insulin-potassium cardioplegic solution (O2-GIK) (oxygen tension greater than 600 mm Hg) on the isolated working guinea pig heart were compared with those of deoxygenated (N2 GIK) (oxygen tension less than 10 mm Hg) and aerated GIK solution (GIK) (oxygen tension = 140 to 160 mm Hg). Hearts were subjected to 180 minutes of ischemia with intermittent infusions (every 30 minutes) of cold cardioplegic solution, followed by 30 minutes of normothermic reperfusion. The O2-GIK solution tended to maintain high-energy phosphates at higher levels during ischemia, and resulted in the best recovery of cardiac function. Though not as effective as O2-GIK, GIK solution produced protective effects; N2-GIK solution failed to exert such effects. These results strongly suggest that the protective effects of crystalloid cardioplegic solution are due primarily to the oxygen dissolved in it; anaerobic metabolism or washout of the metabolites plays a minor part. PMID- 3527095 TI - Acute isolated pulmonary rejection following transplantation of the heart and both lungs: experimental and clinical observations. AB - Early observations following transplantation of the heart and both lungs have suggested that acute rejection occurs simultaneously in both organs. Endomyocardial biopsy could, therefore, be used to monitor rejection in both heart and lungs. We present here our experience with heart-lung transplantation in the baboon, and in two recently observed human patients. The evidence we provide suggests that acute rejection may occur earlier in the lungs than in the heart, and that monitoring the heart alone may prove inadequate. Of 12 baboons that survived heart and lung transplantation, 11 died from acute isolated pulmonary rejection; 10 of these 11 animals showed no features of cardiac rejection. In 2 of 6 human patients who have undergone this operation, an episode of acute pulmonary rejection is believed to have occurred in the absence of cardiac rejection. There is no easy method of confirming pulmonary rejection directly (other than open-lung biopsy, which is clearly contraindicated as a routine procedure). We suggest that more attention be directed toward developing tests that indicate acute rejection but are not organ specific, rather than relying on techniques that diagnose cardiac rejection only. PMID- 3527096 TI - "Tire patch" angioplasty: a new method of arterial repair. AB - A method of controlling a problematic aortotomy suture line using an onlay patch of polytetrafluoroethylene (Gore-Tex) is described. This method has been used successfully in several instances with good control of bleeding and no complications. PMID- 3527097 TI - Ascending aortic IABP complications. PMID- 3527098 TI - Nuclear chromatin decondensation of human sperm: a review. AB - The decondensation of the nucleus of human spermatozoa normally occurs in the oocyte and allows the formation of a male pronucleus. This phenomenon must occur rapidly at this stage but is excluded during all the preceding stages of maturation of the sperm and during travel through the female genital tract, as otherwise it would loose its genome. The compactness of the sperm nucleus has been studied in an attempt to understand the biochemical substratum involved in the condensation/decondensation processes. This review is limited to human sperm, as the decondensation process seems, up to a point, rather different from that described in animals because of different susceptibilities to decondensing reagents and different protein ratios. PMID- 3527099 TI - [Specific relaxation technics]. PMID- 3527100 TI - [Stress and one of its remedies: relaxation]. PMID- 3527101 TI - [Studies on changes in endocrine function and microvascular structure in experimental chronic pancreatic injuries]. PMID- 3527102 TI - Effects of an artificial intestinal valve on massive bowel resection. PMID- 3527103 TI - [A clinical study of an artificial intestinal valve]. PMID- 3527104 TI - [A clinical study of risk factors associated with direct interruption surgery of esophageal varices. A comparative study between transthoracoabdominal esophageal transection with hand suture and transabdominal esophageal transection with the EEA stapler]. PMID- 3527105 TI - [Identification of the cadaveric 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 in order 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 in all details to the exhumed skull. PMID- 3527106 TI - [Antonio Vallejo Nagera (1889-1960)]. PMID- 3527107 TI - Effects of acetylsalicylic acid on heterotopic bone resorption and formation in rats. AB - The effects of acetylsalicylic acid (ASA) on bone metabolism have been studied in a bone transplantation model using radioisotopic and biochemical parameters. Isografts (femora) from infant inbred rats, extensively prelabeled with collagen and mineral-tracing radioisotopes, were transplanted to muscle pouches in young male rats. Bones from the opposite side of the donor rats served as nonimplanted reference bones. The recipients were given 150 mg/kg/12 h of ASA by gavage for 18 days. The serum concentrations obtained were comparable with the recommended anti inflammatory levels in humans. Twenty-four hours before being killed the animals were labeled again with other collagen and mineral radioisotopes. After 18 days of medication the resorption of the transplanted bone was inhibited by about 15% in the ASA treated rats compared with controls, as measured by the losses of collagen (14C-hydroxyproline) and mineral (strontium-85). Also, the net gains of mineral and collagen in the ASA-treated transplants were reduced by about 15% and 11% respectively compared with controls during the medication period. During the last 24 h of the study the rates of mineral incorporation (calcium-47 uptake) and collagen synthesis (3H-hydroxyproline) were reduced to an even greater degree in the ASA-treated transplants. These results indicate an inhibitory effect of ASA on bone metabolism. PMID- 3527108 TI - External fixation of tibial shaft fractures with severe soft tissue injuries by Hoffmann-Vidal-Adrey osteotaxis. AB - The operative results in 65 patients with 66 tibial shaft fractures and severe soft tissue injuries, stabilized by an external fixation frame according to Hoffmann or Vidal-Adrey, are reviewed and the treatment principles are discussed. Four patients required secondary amputations. Fifty-three patients could be followed up for an average of 23.2 months. The infection rate was 9.2% and nonunion was found in 11.1% of cases. Two patients had a refracture after removal of the fixation device. Twenty-three patients (42.6%) required one or more secondary operations. Of the 65 patients, 70.4% had very good or good end results, 16.7% acceptable, and 12.9% poor. External fixation according to Hoffmann or Vidal-Adrey affords excellent definitive stabilization in simple fractures of the lower leg with soft tissue injuries. In comminuted fractures of the lower leg with loss of bone fragments and severe tissue damage, external fixation is better used as a means of temporary stabilization until soft tissues permit definitive rigid stabilization. PMID- 3527109 TI - Scopolamine effects in vestibular defensiveness. AB - Disturbed vestibular function secondary to brain stem injury may result in postural gravitational insecurity, and aversion reactions or intolerance to movement. The Transderm scopolamine disc was applied in a double-blind, placebo controlled study of five post-head-injury patients who underwent provocative vestibular stimulation such as turning in a wheelchair, head shaking, and the log roll. Four of the patients showed improvement in exquisite sensitivity to rotational movement. A surprise finding of improved truncal stability in two of the more severely injured patients indicates a potential usefulness of the scopolamine patch for patients with truncal ataxia. PMID- 3527110 TI - The kinetics of peritoneal clearance of Escherichia coli and Bacteroides fragilis and participating defense mechanisms. AB - In a study using pigs, we delineated the dynamic character and the interplay of defense mechanisms that operate in the peritoneal cavity and their effectiveness against Escherichia coli and Bacteroides fragilis. The bacteria were extensively cleared during the first three hours. The concentration of both organisms in the peritoneal fluid decreased by up to 300,000-fold, and the final concentration was a function of the inoculum given. Clearance efficiency did not differ between a bolus dose and prolonged bacterial administration. Peritoneal absorption was a major eliminating mechanism during the first three hours but was limited to bacterial concentrations exceeding approximately 10(9) colony-forming units per milliliter of peritoneal fluid. Intraperitoneal elimination started immediately and continued for approximately six hours. Thereafter, residual bacteria were not eliminated, even though the defense capacity was intact. Prolonged bacterial administration, however, protracted the period for active bacterial destruction. PMID- 3527111 TI - Pulmonary infections. The Minnesota randomized prospective trial of cyclosporine vs azathioprine-antilymphocyte globulin for immunosuppression in renal allograft recipients. AB - Nineteen of 224 renal allograft recipients who were prospectively randomized to receive either cyclosporine (n = 117) or azathioprine sodium-antilymphocyte globulin (n = 107) for immunosuppression suffered from one period of pneumonia (14 azathioprine and five cyclosporine recipients); two recipients of azathioprine had two episodes. Four patients in the azathioprine group and one in the cyclosporine group died, for mortalities of 3.7% and 0.85%, respectively. The percentage of pneumonia-free patients at one year was 96.3% in the cyclosporine group while it was 90.8% in the azathioprine group. Nondiabetics, women, and recipients of grafts from living related donors were at a statistically lower risk of developing pneumonia when treated with cyclosporine. Viral (cytomegalovirus), fungal (Candida, Aspergillus), and multibacterial causes of pneumonia each occurred with a similar incidence. PMID- 3527112 TI - Nathan Zuntz and 100 years non-protein-nitrogen research in Berlin. PMID- 3527113 TI - [Reference values of the total serum IgE levels by RIST, RIA-PRIST, and EIA PRIST]. PMID- 3527115 TI - [Amyloidosis of the pancreatic islets and diabetes mellitus]. AB - Pancreas was examined in 136 patients who died at the age of 7 to 89 years of various diseases including 22 with diabetes mellitus. Amyloidosis of its islands was observed in 9 patients (aged 49 and over); 6 out of them suffered from diabetes mellitus. Number of islands with amyloidosis and amyloid quantity were determined morphometrically. Glucagon-producing A-cells and insulin-producing B cells in the islands not involved in amyloidosis were counted in sections impregnated by Grimelius. It is found that the development of diabetes is determined not only by the islands amyloidosis but by the quantitative domination of A-cells over B-cells in the islands without amyloidosis as well being the manifestation of aging processes. PMID- 3527114 TI - Failure of nifedipine to reduce atherogenesis in cholesterol-fed rabbits. AB - The purpose of this study was to determine if therapeutic dosages of nifedipine, a drug that reduces intracellular calcium concentrations, suppresses atherogenesis in normotensive, cholesterol-fed rabbits. Control groups were fed either normal chow (Group I), or normal chow supplemented with 0.10 and 0.25% cholesterol (wt/wt) (Group II). Group III animals were fed the same diets as Group II animals and received nifedipine (0.625 and 1.250 mg/kg/d). During the course of the study (3 months) no systematic quantitative difference (P greater than 0.05) was observed between Groups II and III with regard to mean arterial blood pressure, serum cholesterol, serum electrolytes (sodium and potassium), plasma renin activity, or serum lipoprotein classes. At necropsy, there likewise was no difference in affected aortic surface area, aortic cholesterol content, or renal renin content. We conclude that nifedipine, at human therapeutic dosages, has no effect on either atherogenesis or the renin-angiotensin system in normotensive rabbits fed a moderately cholesterol-rich diet. PMID- 3527116 TI - [Pathogenesis and morphologic features of candidal colpitis]. AB - Pathomorphogenesis of candidal colpitis was studied using the murine model with induced oestrus. After intravaginal inoculation, the adherence of pathogen to the mucosal surface of vagina is noted which is followed by its invasion into superficial and deep epithelial layers with the formation of germ tubes and pseudomycelium. The fungal cells are eliminated by the epithelial desquamation and by leukocytes migrating into the epithelium and forming intraepithelial abscesses. The sanation of mucosa is achieved by the sequestration of infected epithelium from the non-infected one. Tissue reactions appear to be in close correlation with the activity of pathogen during all the phases of mycotic process. PMID- 3527117 TI - [Transplantation angiopathies and vasculitis after allogeneic grafting of cadaver kidney to humans]. AB - The material of 560 allogenic corpse kidney transplantations was studied and the conclusion drawn on the possibility of the development in the kidney graft of two types of vascular lesions. The first type is referred to as a genuine angiopathy the causes and structure of which change depending on the time of donor kidney persistence in the recipient. The second type is regarded as immune vasculitis. The role of some immune and non-immune factors in the development of transplant vascular bed changes is discussed. PMID- 3527118 TI - Ultrastructure of developing human muscle: the problem of multinucleation of striated muscle cells. AB - The authors studied by electron microscopy the muscle of 27 human foetuses ranging from 9 weeks to 9 months development. It was possible to observe that disintegration of the plasma membranes of adjacent myoblasts and myotubes which share a common basement membrane tube appears to occur in longitudinally disposed cells of those categories. This may help to explain how further nuclei may be incorporated into well developed myotubes and how the striated muscle cells become multinucleated during embryonic myogenesis and regeneration in vivo. PMID- 3527119 TI - [Heidenhain's form of Creutzfeldt-Jakob disease: report of a case]. AB - A case of Creutzfeldt-Jakob disease, Heidenhain's form is reported. The first clinical manifestations were cortical blindness and visual agnosia. The patient here concerned, a woman aged sixty three, during the clinical course of the disease showed mental deterioration and pyramido-extrapyramidal manifestations. She died after five months. The electroencephalographic findings showed periodic activity. The anatomopathological examination showed neuronal degeneration, status spongiosus and proliferation of astroglial cells. The clinical, electroencephalographic, pathological and etiopathogenical aspects are discussed. PMID- 3527120 TI - Artificial liver: present and future. AB - Early in 1956, the first model of a biological artificial liver, using a live dog's liver incorporated in a cross-hemodialyzer, was placed in an experimental animal with portocaval encephalopathy. This "biological artificial liver," a hybrid artificial liver in the present terminology, was the first in the world. In October 1958, the first human patient, a young male patient in hepatic coma due to liver cirrhosis, was placed on the laboratory-made biological artificial liver composed of four parabiotic cross-hemodialyzers connected with four live dogs' livers to which the "hepatic reactors" for ammonium adsorption and acid base balance were additionally equipped. This first case was very successful, resulting in the patient's recovery from coma. This article introduces the past history of the artificial liver, research of which has mainly been conducted in Japan since the early 1950s by the author, M. Mito, and Y. Nose. Until recently, little progress has been made in this field through the application of blood purification principles such as hemoadsorption, plasmapheresis, and other modifications and combinations. Accumulation of clinical experiences with such conventional methods has stimulated the third generation of the artificial liver to a return to a hybrid organ applying modern science and technology. A concept of hybrid organs in comparison with organ transplants is introduced. The Japanese national project of developing a new artificial liver system, as conducted by the author as the chairman and his associates, is introduced. PMID- 3527121 TI - Comparison of alternative outcome measures for antiepileptic drug trials. AB - Studies to determine the efficacy of antiepileptic drugs often use seizure frequency as an outcome measure. Time to kth seizure (k up to 12) was investigated as an alternative endpoint. Monte Carlo simulations, based on seizure behavior in previous clinical trials, were used to evaluate crossover studies with these endpoints. exhibited the highest power. However, tests on time to the 12th seizure, for a sample size of 50, approached the power of tests on seizure frequency with a sample size of 20. Including patients with less severe epilepsy (two vs four seizures per month) did not change the power of tests on time to the kth seizure and lowered it only moderately for tests on seizure frequency. The simulation methodology presented can be adapted to evaluate other design variations. PMID- 3527122 TI - Embryonal rhabdomyosarcoma of the conjunctiva. A clinicopathologic and immunohistochemical study. AB - Rhabdomyosarcoma of the conjunctiva is a rare lesion, with few previously reported cases. We have observed such a tumor occurring in a 16-year-old girl. The clinical and pathologic entities to be considered in differential diagnosis in such cases are several; in this circumstance, immunohistologic reactivity for desmin and myoglobin (two muscle-related proteins) allows a definitive interpretation of rhabdomyosarcoma to be made. This article documents the clinicopathologic features of the epibulbar rhabdomyosarcoma seen in our patient and discusses the immunocytochemical characteristics of myogenic tumors in general, in the context of ocular neoplasia. PMID- 3527123 TI - The immediate maxillary full denture. II. The dento-alveolar complex. PMID- 3527124 TI - Fifty years of dental education in Queensland. PMID- 3527125 TI - Contact dermatitis. PMID- 3527126 TI - Primary cutaneous malignant melanoma: diagnosis and management. PMID- 3527127 TI - Common hair disorders. PMID- 3527128 TI - Immunological consequences of intestinal helminth infections. Cellular and anamnestic responses to ovalbumin. AB - Depressed IgG responses to ovalbumin administered with the inflammatory adjuvant, Al(OH)3, have previously been demonstrated in mice immunized 5 to 13 days after infection with Nematospiroides dubius, when the parasite is encysted in the intestinal mucosa or becoming established in the lumen. This report extends these findings to show that primary IgE and delayed-type hypersensitivity (DTH) responses, the generation of antigen-primed cells detectable in syngeneic irradiated recipients or in vitro and the recall of immunological memory are correspondingly impaired. Co-transfer experiments using irradiated recipients demonstrated weak suppressor activity in spleen cells from infected mice which was not attributable to T cells. The results suggest that N. dubius administered before immunization can impair the development of many classes of antigen-primed lymphocytes. The implications of this finding with respect to parasite survival are discussed. PMID- 3527129 TI - Import of carbamylphosphate synthetase and ornithine transcarbamylase into mitochondria of rat liver: detection of aggregates of enzyme in cytoplasm and mitochondria using immunoelectron microscopy with the protein A-gold method. AB - We investigated the distribution of the nuclear encoded mitochondrial enzymes, carbamylphosphate synthetase (CPS; EC 6.3.4.16) and ornithine transcarbamylase (OTC; EC 2.1.3.3) in liver by immunocytochemistry on ultrathin sections using the protein A-gold technique. Both enzymes were found to be present as aggregates in the cytoplasm of hepatocytes, in association with ER membranes adjacent to mitochondria. Clusters of the enzymes were also found inside the mitochondria. The aggregation of these enzymes was found only with antibodies to CPS and OTC and not with antibodies against albumin or with IgG from unimmunized serum, nor were aggregates found in cells other than hepatocytes. The results are suggestive of localized uptake of clusters of enzyme or co-translational uptake of enzyme at discrete localizations and that endoplasmic reticulum (ER) associations may be necessary for uptake of the percursor forms of CPS and OTC. The possible involvement is discussed of micropinosomes which are seen associated with inner membrane, intermembrane space and outer membrane in mitochondria obtained from a perinuclear pellet where ER and mitochondria are frequently found in close association. PMID- 3527130 TI - Bleeding ulcer: timing and technique in surgical management. AB - The individual surgeon's training, experience and flexibility are decisive factors in the successful recovery of patients after surgery for acute bleeding peptic ulcer. With planned management, careful preparation for surgery should be considered as of equal importance to surgical skill. Early diagnosis and exact resuscitation are the two most important aspects of a plan of treatment which anticipates the need for early surgery. In the past, patients were often referred late for surgery after significant blood loss and transfusion. Surgeons have endeavoured to define the cases that are likely to rebleed and prepare them promptly for surgery. Probably the best indications for early surgery are severe haemorrhage, reflected by shock on admission, an age of over 50 and active bleeding from the ulcer seen at diagnostic endoscopy. Prospective studies have shown a reduction in mortality from bleeding ulcer where policy requires early endoscopic diagnosis, exact resuscitation in the intensive care unit and early surgery in high risk cases. PMID- 3527131 TI - A brief history of eponyms in endocrinology. AB - Many of the disorders of the endocrine glands are known by the names of the person credited with their description. The origins of commonly used eponyms and the original descriptions are reviewed. PMID- 3527132 TI - Farquhar McCrae MD--portrait of a surgeon. AB - Born in Scotland in 1807 of a well to do family, Farquhar McCrae received his medical training in Edinburgh and Paris. He was commissioned as Assistant Surgeon in the British Army and in 1839 migrated with his family to become a pioneer grazier, businessman and doctor in the settlement at Port Phillip. He later transferred to Sydney where he was one of the first surgeons elected to the staff of Sydney Infirmary in 1845. Farquhar McCrae died in 1850 after a short but eventful career. PMID- 3527133 TI - Invasive melanoma in the donor and recipient sites of a Hutchinson's freckle transplanted in a split skin graft. AB - An extraordinary case of synchronous development of invasive melanoma in the donor and recipient sites of a split skin graft is reported. The histological features suggest transplantation of a Hutchinson's melanotic freckle (lentigo maligna) at operation 10 years previously as the probable cause. The case is particularly interesting in that the invasive melanoma at both sites was at a similar stage despite a considerable difference in exposure to sunlight in the long postoperative period, perhaps discounting this factor as a precipitating cause of melanoma in Hutchinson's melanotic freckle (lentigo maligna melanoma). PMID- 3527134 TI - Lord Lister--the great Victorian. PMID- 3527135 TI - The prevalence of Eperythrozoon ovis infection in weaner and adult sheep in north eastern Victoria. AB - A survey of weaner (6 to 12 months) and adult sheep for the presence of Eperythrozoon ovis antibodies using an immunofluorescent antibody assay was carried out. In 22 shires in north eastern Victoria over 2 years infection was demonstrated in 10% and 51% of weaner and adult sheep respectively. PMID- 3527136 TI - The early days of space medicine in Germany. An almost forgotten chapter of German-American history of science. PMID- 3527137 TI - The possible involvement of PGI2 in the PEEP-induced changes in cardiac output and blood pressure. AB - Ventilation with positive end-expiratory pressure (PEEP) is employed in clinical and aviation medicine. The widespread application of PEEP, however, is limited principally because of its adverse effect on cardiac output (CO) and systemic arterial blood pressure (BP). Recently, it has been suggested that this PEEP induced cardiovascular depression may be mediated by vasoactive agents, possibly prostaglandin in nature. This study examined the possible involvement of PGI2 in the PEEP-induced decreases in CO and BP. Chloralose-anesthetized mechanically ventilated dogs were subjected to brief intervals (75 s) of PEEP 10 or 20 mm Hg. Arterial levels of 6-keto-PGF1 alpha (stable metabolite of PGI2) were monitored by radioimmunoassay. These parameters were compared before and during PEEP application. During PEEP, tracheal pressure-related decreases in both CO and BP were noted. Application of either PEEP 10 or 20 mm Hg resulted in an increase in circulating 6-keto-PGF1 alpha levels in three animals while a decrease was noted in two others. Overall, application of PEEP did not result in a significant change from baseline levels. Furthermore, there was no correlation between changes in either CO or BP with changes in arterial 6-keto-PGF1 alpha levels. These results do not support the hypothesis that the short term PEEP-induced changes in CO or BP are mediated by endogenously released PGI2. PMID- 3527138 TI - Subjective and cognitive effects of relaxation. PMID- 3527139 TI - Analysis of fibronectin expression during human muscle differentiation. AB - Fibronectin expression during human muscle differentiation was investigated by determining its distribution in foetal, normal adult and dystrophic muscle and in foetal, normal adult and dystrophic muscle cultures during myogenesis. Muscle sections and muscle cultures were studied by indirect immunofluorescence staining using polyclonal and monoclonal anti-human antibodies. Mass and clonal muscle cultures were prepared from foetal, adult and dystrophic muscle tissue. Immunofluorescence staining detected fibronectin on the epimysium, perimysium and endomysium of transverse sections of normal adult muscle, while sarcoplasm was devoid of this glycoprotein. In foetal muscle, some fibers showed a prominent ring of fibronectin. In mass and clonal cultures, myoblasts were found to synthesize and accumulate fibronectin while myotubes did not. No difference in fibronectin distribution was observed between Duchenne Muscular Dystrophy (DMD) and control myotubes. An enzyme-linked immunoassay (ELISA), performed on homogenated muscle, sonicated fibroblasts and muscle cells, showed a high fibronectin level in fibroblasts when compared with the other samples tested. PMID- 3527140 TI - Cell kinetics of gliomas by serial stereotactic biopsy. AB - The potential proliferative activity of glial tumors has been investigate by serial stereotactic biopsies and by "in vitro" 3H-thymidine incorporation procedure (labeling index, LI). The methodology of this combined approach and the preliminary results in 33 patients are reported. Cell kinetic data have been matched with the histological classification (W.H.O.). PMID- 3527141 TI - Comparison of mechanisms for DNA strand break formation by the direct and indirect effect of radiation. PMID- 3527142 TI - Mutagenic DNA repair in bacteria: the role of UmuDC and MucAB. PMID- 3527143 TI - The involvement of an E. coli multiprotein complex in the complete repair of UV damaged DNA. AB - The bimodal nature of the E. coli uvrABC catalyzed incision reaction of UV irradiated DNA leads to potential excision of a 12-13 base long damaged fragment. However, the oligonucleotide fragment containing the UV-induced pyrimidine dimer is not released under non-denaturing in vitro reaction conditions. The uvrABC proteins, also, are stably bound to the incised DNA and do not turn over following the incision event. In this communication it is shown that damaged fragment release from the parental uvrABC incised DNA is dependent on either chelating conditions or upon the simultaneous addition of the uvrD gene product (helicase II) and the polA gene product (DNA polymerase I) when catalyzing concommitant polymerization of deoxynucleoside triphosphate substrates. The product of this multiprotein catalyzed series of reactions serves as a substrate for polynucleotide ligase which results in the restoration of the integrity of the strands of DNA. The addition of the uvrD protein to the incised DNA-uvrABC complex also results in turnover of only the uvrC protein. It is suggested that the repair processes of incision, excision, resynthesis and ligation are coordinately catalyzed by a protective complex of proteins in a 'repairosome' type of configuration. PMID- 3527144 TI - Molecular approaches to the study of nucleotide excision repair in eukaryotes. AB - Very little is known about the molecular mechanism of nucleotide excision repair in eukaryotes. Studies on human cells have been stimulated by the availability of excision repair-defective cell lines from patients suffering from the autosomal recessive disease xeroderma pigmentosum (XP). Such studies have contributed significantly to an understanding of the genetic complexity of excision repair in human cells. However, to date, no human excision repair genes or gene products known to complement the repair defect in XP cells have been isolated. The yeast Saccharomyces cerevisiae is an interesting model for exploring the molecular mechanism of nucleotide excision repair in eukaryotic cells. As is true in human cells, multiple yeast genes are involved and at least five genes are required for the specific incision of UV-irradiated DNA in vivo. These five genes have been isolated by molecular cloning and the nucleotide sequences of four of them have been determined. Each of these cloned genes is being used for overexpression of protein. PMID- 3527145 TI - The adaptive response of mammalian cells to alkylating agents. PMID- 3527146 TI - DNA glycosylases in DNA repair. PMID- 3527147 TI - DNA damage, DNA repair and induced mutagenesis: some enzymological and structural considerations. PMID- 3527148 TI - Salmonella tester strains: mutational targets and correlation with animal carcinogenicity and teratogenicity. PMID- 3527149 TI - Use of gradient denaturing gels to determine mutational spectrum in human cells. AB - Based on the fact that mutagens induce specific patterns of gene mutations, this paper outlines a method to allow discrimination among mutagen-treated populations. The technique should allow direct screening of human tissue for genetic change, using human peripheral blood lymphocytes deficient in the enzyme hypoxanthine guanine phosphoribosyl transferase. The method is based on gradient denaturing gel electrophoresis, which separates short DNA molecules according to their melting properties. The melting behavior of DNA fragments is extremely sequence-dependent, and DNAs with single basepair substitutions often migrate differently. Even DNA fragments with the same basepair substitutions at different locations in the molecule have been resolved. Gradient-denaturing gel electrophoresis has the capacity to separate mutant DNA on the basis of the nature and position of the mutation. PMID- 3527150 TI - [Tendon rupture of the biceps muscle of the arm and its treatment with special reference to the key hole operation]. PMID- 3527151 TI - [Flexor tendon suture of the hand--Kleinert primary suture and early secondary suture]. PMID- 3527152 TI - Monoclonal antibodies to monoamine oxidase B and another mitochondrial protein from human liver. AB - A monoclonal antibody has been generated to human liver monoamine oxidase (MAO) B by fusion of mouse myeloma cells with spleen cells from a mouse immunized with a mixture of semi-purified MAO A and MAO B. The antibody, 3F12/G10, an immunoglobulin G1, reacts with its antigen in cryostat sections of human liver, showing an intracellular particulate distribution as demonstrated by immunoperoxidase staining. The antibody indirectly precipitates [3H]pargyline labelled human MAO B both from liver and platelet extracts but fails to precipitate MAO A from liver extracts. The antibody does not recognise rat liver MAO B, showing that the determinant is not universally expressed on MAO B. The antibody has no effect on the catalytic activity of MAO B. Other monoclonal antibodies were generated but they are directed to a protein with a subunit Mr of 54 000, a contaminant of the MAO preparation. One of these antibodies, A8/C2, an IgG2a, reacts with the same protein in both rat and human liver extracts. PMID- 3527154 TI - Investigation of the arylnitroso reductase activity of pig liver aldehyde reductase. AB - The reduction of p-nitroso-N-dimethylaniline, p-nitroso-N-diethylaniline, p nitrosophenol and p-nitroso-N-phenylaniline with NADPH in the presence of aldehyde reductases 1 and 2 is described. The reactivity of these nitroso substrates is increased by hydrophobic substituents and those promoting OH- elimination from the molecule of the reduced substrate. NN-Dimethylbenzoquinonedi iminium cation was proved to be the reaction product formed from p-nitroso-N dimethylaniline. The kinetics of the reduction of p-nitroso-N-dimethylaniline catalysed with aldehyde reductase 1 are rather complex at pH 7, and the preferred pathway mechanism is probably involved. The reaction sequence approaches the ordered pattern at pH 8.5. It was shown that NADPH in equilibrium NADP+ recyclization proceeds in the presence of NADP+, p-nitroso-N-dimethylaniline, cyclohexanol and aldehyde reductase 1, the alcohol oxidation being the slowest step in this reaction. However, the rate of cyclohexanol oxidation surpasses that of the dissociation of NADPH from the enzyme. PMID- 3527153 TI - The effects of endotoxaemia on protein metabolism in skeletal muscle and liver of fed and fasted rats. AB - The response of muscle and liver protein metabolism to either a single or three successive daily injections of an endotoxin (Escherichia coli lipopolysaccharide, serotype 0127 B8; 1 mg/ml, 0.3 mg/100 g body wt.) was studied in vivo in the fed rat, and at 24 and 30 h after endotoxin treatment during fasting. In the fed rats there was a catabolic response in muscle, owing to a 60-100% increase in muscle protein degradation rate, and a 52% fall in the synthesis rate. Although there was a 20% decrease in food intake, the decrease in protein synthesis was to some extent independent of this, since rats treated with endotoxin and fasted also showed a lower rate of muscle protein synthesis, which was in excess of the decrease caused by fasting alone. The mechanism of this decreased protein synthesis involved decreased translational activity, since in both fed and fasted rats there was a decreased rate of synthesis per unit of RNA. This occurred despite the fact that insulin concentrations were either maintained or increased, in the fasted rats, to those observed in fed rats. In the liver total protein mass was increased in the fed rats by 16% at 24 h, and the fractional synthesis rate at that time was increased by 35%. In rats fasted after endotoxin treatment the liver protein mass was not decreased as it was in the control fasted rats, and the fractional synthesis rate was increased by 22%. In both cases the increased synthesis rate reflected an elevated hepatic RNA concentration. The extent of this increase in hepatic protein synthesis was sufficient at one point to compensate for the fall in estimated muscle protein synthesis, so that the sum total in the two tissues was maintained. PMID- 3527155 TI - The 52-kDa estrogen-induced protein secreted by MCF7 cells is a lysosomal acidic protease. AB - An estrogen-induced 52-kDa glycoprotein secreted by human breast cancer cells and able to autostimulate the growth of MCF7 cells has been purified, using monoclonal antibodies, and characterized. The protein contains mannose 6 phosphate signals on its N-linked high-mannose chains, suggesting that it is a lysosomal enzyme. Both the secreted 52-kDa protein and its processed cellular forms (52-, 48- and 34-kDa) were identified as carboxyl proteinases having an optimal activity at pH 3.5 and being specifically inhibited by pepstatin. This protease is characterized by its inducibility by estrogens and its high concentration in proliferative benign and malignant mammary tissue, when detected by immunohistochemistry. The estrogen-induced secretion of this protease may help to understand how estrogens stimulate mammary tumor growth and/or invasion. PMID- 3527156 TI - Amino acid composition of the 9 kDa phosphoprotein of pea thylakoids. AB - The 9 kDa phosphoprotein of pea thylakoids was isolated by electroelution from SDS-polyacrylamide gels and its amino acid composition determined. The result is at variance with the amino acid compositions predicted from published nucleotide sequences of the genes for apocytochrome b-559 and for CFo subunit III. The amino acid composition of the 9 kDa phosphoprotein resembles that of the 25 kDa light harvesting chlorophyll a/b protein (LHC-II). We propose that the 9 kDa polypeptide is a chlorophyll-binding protein of photosystem II, that it functions as a link in excitation energy transfer between LHC-II and the reaction centre, and that its phosphorylation regulates excitation energy distribution by means of mutual electrostatic repulsion between itself and phosphorylated LHC-II. PMID- 3527157 TI - Vanadate stimulation of IGF binding to rat adipocytes. AB - Preincubation of adipocytes with insulin (10 ng/ml) stimulated binding of IGF-II to maximal levels of 160% above controls. Vanadate also augmented IGF-II binding with an increase of 126% above controls at a concentration of 1 mM. Coincubation of vanadate (1 mM) with a maximal stimulatory dose of insulin (10 ng/ml) produced no additive effect. However, at submaximal doses of insulin (0.1 ng/ml) the effect of vanadate was additive. Amiloride, a potent inhibitor of the insulin receptor kinase, inhibited the effects of both vanadate and insulin. The data are consistent with an effect of vanadate via a similar sequence of steps to that of insulin; perhaps involving activation of the insulin receptor kinase. PMID- 3527158 TI - The 20,000 dalton structural variant of recombinant DNA-derived methionyl human growth hormone has early insulin-like effects in hypophysectomized rats. AB - The 20,000 dalton variant of recombinant DNA-derived methionyl human growth hormone (20K-Met-hGH) induced decreases in blood glucose and free fatty acid concentrations one hour after intraperitoneal injection into fasted, hypophysectomized rats. Similar results were obtained using the 22,000 dalton form of recombinant DNA-derived methionyl human growth hormone (22K-Met-hGH). The data reported show that 20K-Met-hGH induces early insulin-like effects similar to the responses produced by 22K-Met-hGH in fasted hypophysectomized rats. PMID- 3527159 TI - Quantitation of a src-like tyrosine protein kinase during fertilization of the sea urchin egg. AB - Fertilization of the sea urchin egg is known to involve an increase in overall protein tyrosine kinase activity which precede the first cell division. In order to determine the types of tyrosine kinases that are involved in fertilization, we have used immunological and other criteria to identify a c-src related protein kinase in eggs of the sea urchin L. variegatus. Using an immune complex assay, we have measured the level of this c-src related protein kinase during fertilization and early embryonic development. Fertilization results in a decrease in the c-src kinase detectable by this technique suggesting that c-src does not contribute to the fertilization induced increase in protein tyrosine kinase activity. PMID- 3527160 TI - A putative opioid-peptide processing activity in enriched Golgi fraction from rat brain. AB - A Golgi enriched fraction from rat brain was prepared. The preparation has no carboxypeptidase activity and is not contaminated with cytosol, mitochondria and lysosomes as judged by marker enzyme activities for these constituents. Associated with the Golgi membranes a putative opioid peptide processing activity was demonstrated, which acts on Dynorphin 1-13, alpha- and beta-Neoendorphin. The enzyme cleaves the bond between the paired basic residues, releasing Leucine enkephalin-Arg6. The activity has a pH-optimum around 9 and is inhibited by serine-protease inhibitors. Intracellular location and substrate specificity suggest that this endopeptidase activity may be involved in proenkephalin processing. PMID- 3527161 TI - Specific detection of Plasmodium falciparum malaria by a molecularly cloned DNA probe. AB - A highly repeated DNA sequence from Plasmodium falciparum was cloned and used as a probe in molecular hybridization to detect malaria. Our results indicate that the probe is specific to P. falciparum but not to other species of Plasmodium and is extremely sensitive. As little as a 20 pg parasite DNA, which is equivalent to about 1000 parasites can be detected. The cloned DNA can be used as a diagnostic tool to follow the course of infection of falciparum malaria. PMID- 3527162 TI - Effect of streptozotocin-induced diabetes and insulin treatment on the degradation of hexokinase II in the skeletal muscle of the rat. AB - The rate of degradation of hexokinase II and the general pool of cytosolic proteins was measured in the skeletal muscle of normal, streptozotocin-diabetic, and insulin-treated streptozotocin-diabetic rats. The rate constant for hexokinase II degradation increases by a factor of 3 in the diabetic as compared with the normal animal. There were analogous alterations observed for the general pool of cytosolic proteins; however, the changes were much more subtle. Insulin treatment restores the increased degradative rate to normal levels in both classes of muscle proteins. PMID- 3527163 TI - Sphingolipids inhibit insulin and phorbol ester stimulated uptake of 2 deoxyglucose. AB - Studies are presented demonstrating inhibition of both insulin and phorbol myristate acetate stimulated uptake of 2-deoxyglucose uptake by 3T3-L1 fibroblasts. Greatest inhibition of uptake was seen with sphinganine while sphingosine was also potent in this regard. Ceramide inhibited phorbol myristate acetate but not insulin stimulation of uptake. It is suggested that sphingolipid inhibition of glucose transport relates to the previously demonstrated effect of corticosteroids to increase membrane sphingomyelin and inhibit glucose transport. PMID- 3527164 TI - Expression of the phosphoenolpyruvate carboxykinase gene and its insulin regulation during differentiation of preadipose cell lines. AB - The adipose conversion of Ob1771 and 3T3-F442A preadipose cells is accompanied by the expression of the phosphoenolpyruvate carboxykinase (PEPCK) gene. The PEPCK mRNA is absent from growing, undifferentiated Ob1771 and 3T3-F442A cells as well as from non-differentiating 3T3-C2 cells. It is present in differentiated Ob1771 and 3T3-F442A cells as well as in liver, kidney and white adipose tissue from mouse. Transcriptional run-off measurements in nuclei isolated from undifferentiated and differentiated Ob1771 and 3T3-F442A cells reveal that the PEPCK gene transcription is activated during differentiation. Studies of the time course of changes indicate that the emergence of PEPCK mRNA takes place in parallel to mRNA encoding for a 28 kDa protein (28 K mRNA) but later than that encoding for glycerol-3-phosphate dehydrogenase (GPDH mRNA). Insulin leads to an increase in the content of PEPCK and GPDH mRNAs with half-maximally effective concentrations of 0.5 and 5 nM for GPDH mRNA and PEPCK mRNA, respectively. Thus, in contrast to rat hepatoma cells, insulin exerts in adipose cells a positive regulation on the expression of the PEPCK gene. PMID- 3527165 TI - An Escherichia coli mutant exhibiting temperature-sensitive ATP synthesis. AB - A mutant strain SM434 (ttr-3) of Escherichia coli that exhibits a temperature sensitive Unc(succinate-nonutilizing) phenotype was characterized. The mutant allele ttr-3 was not linked to the ilvA gene, but was complemented by Fill carrying 81 min-91 min of the E. coli chromosome. The mutant strain SM434 exhibited resistance to N,N'-dicyclohexylcarbodiimide (DCCD) and a temperature sensitive phenotype at the level of ATP synthesis, compatible with that of cell growth. These findings indicate that the mutant strain SM434 could carry a mutation (ttr-3) in an unknown gene responsible for the energy-transduction system. PMID- 3527166 TI - Frameshift mutagenesis in Salmonella typhimurium by reversible DNA intercalators: effect of a UVR B mutation. AB - The simple reversible intercalating agents isopropyl-oxazolopyridocarbazole and 9 aminoacridine have been found to induce frameshift -1 mutations at a much lower level in Salmonella typhimurium delta uvrB TA 1537 than in the uvr+ wild type TA 1977 strain. This phenomenon can neither be explained by differential cytotoxicity of the drug nor by selective permeation and accessibility to intercalating sites to bacterial DNA. These finding indicate that the lower mutagenicity of intercalating agents in the delta uvrB strains does not result from nonspecific phenotypic modifications of parameters which control the mutagenesis. That leads to the hypothesis that in agreement with the Streisinger's model, the excision repair system could be directly involved in the appearance of frameshift mutations. PMID- 3527167 TI - The complete amino acid sequence of human brain-derived acidic fibroblast growth factor. AB - Acidic fibroblast growth factor is a potent mitogen for a variety of cells in culture, including vascular endothelial cells, and is angiogenic in vivo. The complete amino acid sequence of human brain-derived acidic fibroblast growth factor has been determined from amino terminal sequence analysis and carboxypeptidase A digestion of the whole protein and sequence analyses of peptides generated by tryptic, Staphylococcus aureus V8 protease and cyanogen bromide cleavages. A potential Asn-Gly-Ser glycosylation sequence is present in the human protein. The complete amino acid sequence is compared to that of the equivalent protein purified from bovine brain. PMID- 3527168 TI - Induction of polypeptides in Saccharomyces cerevisiae after ultraviolet irradiation. AB - Alterations in the synthesis of proteins following exposure of Saccharomyces cerevisiae to UV light were investigated using radioactive labelling and two dimensional electrophoresis. UV-irradiation induced the synthesis of various proteins. Among them the analogue of the RecA protein of Escherichia coli (Angulo et al. 1985) and two other polypeptides (34 Kd and 35 Kd, pI 5.8) were observed in all four strains analyzed namely two DNA-repair deficient (rad-) strains: (rad6-1 and pso2-1) and their isogenic wild type RAD+ strains. PMID- 3527169 TI - Lysophosphatidylinositol, but not lysophosphatidic acid, stimulates insulin release. A possible role for phospholipase A2 but not de novo synthesis of lysophospholipid in pancreatic islet function. AB - In the current study, lysophosphatidylinositol is shown to promote insulin release in a manner having characteristics of physiologic exocytosis--that is, it is dose-dependent, saturable, reversible, inhibitable and unassociated with detrimental effects on subsequent islet functioning. Lysophosphatidylglycerol had similar insulinotropic effects. However, lysophosphatidic acid was ineffective over a wide range of concentrations. These studies provide further support for the postulated role of phospholipase A-generated lysophospholipids in signal transduction in the pancreatic islet but suggest that any de novo synthesis of lysophosphatidic acid from metabolites of glucose (M. Dunlop and R. Larkins, Biochem. Biophys. Res. Comm. 132:467, 1985) is unlikely to contribute directly to the insulin secretion induced by that fuel. PMID- 3527170 TI - Calcium-dependent activation of glycogen phosphorylase in rat pheochromocytoma PC12 cells by nerve growth factor. AB - Glycogen phosphorylase in PC12 cells exists in two forms analogous to those found in brain and muscle. The active phosphorylated form of the enzyme, phosphorylase a, represents about 20-30% of total glycogen phosphorylase in these cells. Incubation of PC12 cells with 100 ng 7S nerve growth factor/ml increased phosphorylase-a within minutes. In contrast to nerve growth factor, insulin (6 ng/ml) and epidermal growth factor (6 ng/ml) decreased phosphorylase-a. Activation of phosphorylase-a by nerve growth factor was not accompanied by increases in cyclic AMP; however, removal of extracellular Ca2+ or incubation of cells with calcium channel blockers inhibited activation of glycogen phosphorylase by nerve growth factor. PMID- 3527171 TI - Purification and properties of RNA polymerase of phage KB1. AB - Bacteriophage KB1 belongs to group C of Bradely's classification After infection a bacteriophage specific RNA polymerase is induced in infected cells. KB1 RNA polymerase is a stable enzyme and is easily purified to homogeneity in good overall yield. The activity resides in a single polypeptide chain of molecular weight about 90,000. Synthesis of RNA by KB1 RNA polymerase requires a DNA template and Mg++ and like SP6 RNA polymerase, is strongly stimulated by either bovine serum albumin or spermidine. Thiol reactive reagents inhibit the enzyme, suggesting the presence of essential sulfhydryl residues. The enzyme possess a stringent promoter specificity. The KB1 RNA polymerase is also highly active in synthesis of poly(rG) with poly(dI).(dC) as template. My experiments suggest that the catalytic portion of the polymerase can be separated from the RNA polymerase holoenzyme. PMID- 3527172 TI - Amino acid sequences of two tryptic peptides from D(-)-beta-hydroxybutyrate dehydrogenase radiolabeled at essential carboxyl and sulfhydryl groups. AB - D(-)beta-hydroxybutyrate dehydrogenase (BDH) purified from bovine heart mitochondria contains essential thiol and carboxyl groups. A tryptic BDH peptide labeled at an essential thiol with [3H]N-ethylmaleimide (NEM), and another tryptic peptide labeled at an essential carboxyl with N,N'-dicyclohexyl [14C]carbodiimide (DCCD), were isolated and sequenced. The peptide labeled with [3H]NEM had the sequence Met.Glu.Ser.Tyr.Cys*.Thr.Ser. Gly.Ser.Thr.Asp.Thr.Ser.Pro.Val.Ile.Lys. The label was at Cys. The same peptide was isolated from tryptic digests of BDH labeled at its nucleotide-binding site with the photoaffinity labeling reagent, arylazido- -[3-3H] alanyl-NAD. These results suggest that the essential thiol of BDH is located at its nucleotide binding site, and agree with our previous observation that NAD and NADH protect BDH against inhibition by thiol modifiers. The [14C]DCCD-labeled peptide had the sequence Glu.Val.Ala.Glu*.Val. Asn. Leu.Trp.Gly.Thr.Val.Arg. DCCD appeared to modify the glutamic acid residue marked by an asterisk. Sequence analogies between these peptides and other proteins have been discussed. PMID- 3527173 TI - Characterization of hamster liver nicotine metabolism. I. Relative rates of microsomal C and N oxidation. AB - A high pressure liquid chromatographic procedure has been developed for the determination of the two principal N- and C-oxidation products of nicotine in hamster liver subcellular fractions. Advantage was taken of the fact that cyanide ion forms a stable adduct with the microsomal metabolite that is the precursor of cotinine. The rate and extent as well as the sensitivity of inhibition were similar for cotinine, the 5'-cyanonicotine adduct, and an as yet unidentified microsomal metabolite which is presumed to be the initial microsomal metabolite on the pathway to cotinine formation. The rates of nicotine-N'-oxidase and nicotine-5'-hydroxylase activities exhibited differential response to inhibitors as well as differential susceptibility to proteolytic digestion. Data are presented which indicate that low levels of nornicotine contamination in stock nicotine resulted in the artifactual formation of methylcyanonornicotine adduct. No evidence consistent with the formation of nornicotine by isolated microsomes was obtained. PMID- 3527175 TI - Dipyridamole and vascular prostacyclin production. AB - The action of dipyridamole on the vascular production of prostacyclin (PGI2) has been investigated. Dipyridamole (1-100 microM) did not induce a significant stimulation of PGI2 release in any of the following experimental models: rings of rabbit aorta, cultured endothelial cells from bovine aorta or human umbilical vein, cultured explants of bovine aortic smooth muscle. The activity of known stimuli of PGI2 release (ADP, suloctidil, serotonin) and the capacity of dipyridamole to inhibit adenosine uptake into endothelial cells were carefully checked. Pretreatment of the rabbit aorta with dipyridamole (10-100 microM) prolonged the transient stimulation of PGI2 release induced by mechanical deendothelialization: this effect was probably due to a partial protection of the cyclooxygenase against oxidative self-inactivation. Our largely negative results are consistent with the current theory that the antiplatelet action of dipyridamole is mediated by adenosine and not by PGI2. PMID- 3527174 TI - Biochemical pharmacology of N-acetyl-N-(methylcarbamoyloxy)-N'-methylurea (caracemide; NSC-253272). AB - Preclinical pharmacologic studies of caracemide [N-acetyl-N-(methylcarbamoyloxy) N'-methylurea; CAR] have demonstrated a marked instability of this compound in the presence of either phosphate buffer (pH 7.4) or human plasma. Using [1-14C acetyl]CAR and [3H-methylcarbamoyloxy]CAR, three CAR degradation products were identified: product A, N-(methylcarbamoyloxy)acetamide; product B: N (methylcarbamoyloxy)-N'-methylurea; and product C: N-hydroxy-N'-methylurea. CAR degradation in human plasma was demonstrated by high-performance liquid chromatography (HPLC) to occur in a time- and temperature-dependent manner. A 30 min incubation (37 degrees) of CAR (10(-4) M) with human plasma resulted in degradation of more than 55% of parent compound; at 1 hr, more than 75% of original CAR was degraded. Incubation of [1-14C-acetyl]CAR with rat brain homogenate resulted in the formation of 14CO2. This reaction was partially inhibited by coincubation with physostigmine (10(-3) M). CAR inhibited acetylcholinesterase activity in neuroblastoma cells with an IC50 of 14 microM. In mechanism of action studies, CAR was found to inhibit ribonucleotide reductase activity but only at nine times the IC50 of hydroxyurea. In contrast to hydroxyurea, CAR was found to be non-cell-cycle phase-specific and non-cross resistant with two CHO cell lines resistant to hydroxyurea. These data demonstrate the instability of CAR; moreover, they suggest that its mechanism of cytotoxicity is distinctly different from that of hydroxyurea and that the neurotoxicity associated with CAR administration may be caused in part by inhibition of acetylcholinesterase activity. PMID- 3527176 TI - Herman P. Schwan. 1985 recipient of the d'Arsonval Medal. PMID- 3527177 TI - Research on biological effects of nonionizing radiations: contributions on biological properties, field interactions, and dosimetry. PMID- 3527178 TI - Idiopathic familial acroosteolysis: histomorphometric study of bone and literature review of the Hajdu-Cheney syndrome. AB - We describe a 27-year-old man with familial acroosteolysis involving 9 fingers. Bone biopsy of an affected digit showed osteolysis with no tetracycline deposition, rare osteoclasts, increased vascularity, and numerous mast cells. In contrast, the iliac crest bone showed active bone remodeling and normal double tetracycline labeling. We believe mast cells deserve further study as possible factors in this form of localized osteolysis. PMID- 3527179 TI - Effects of diltiazem versus nifedipine on lower esophageal sphincter pressure in patients with progressive systemic sclerosis. PMID- 3527180 TI - Clinical and serologic associations of the antiribosomal P protein antibody. AB - Antibodies to the ribosomal P proteins (anti-P) were detected, by Western blot analysis, in the sera of 20 of 114 patients with various autoimmune disorders. Eighty-five percent of the patients with anti-P had systemic lupus erythematosus (SLE). Of 93 randomly selected patients, the frequency of anti-P was 7 of 59 SLE patients (12%) and 0 of 34 non-SLE patients. Approximately one-third of the patients with anti-P antibodies were male; approximately half were black. In contrast to the findings of some previous studies which used isolated ribosomes as antigen, an increased frequency of renal disease was not observed. Although the overall frequency of central nervous system lupus was similar in SLE patients with and those without anti-P, 6 of 6 patients with psychosis had anti-P antibodies. Western blotting was the most sensitive and specific method for the detection of anti-P antibodies; counter-immunoelectrophoresis and cytoplasmic indirect immunofluorescence were positive in only 47% and 65% of the anti-P positive patients, respectively. Although 53% of the SLE patients with anti-P had concomitant anti-Ro antibodies, none had anti-La (as detected by counterimmunoelectrophoresis). Anti-P antibodies, therefore, appear to be relatively specific serologic markers for SLE and may be detected in the serum even when antibodies to double-stranded DNA are not found. PMID- 3527181 TI - Clinical experience and results of treatment with suprofen in pediatrics. 5th communication: a single-blind study on antipyretic effect and tolerability of suprofen syrup versus metamizole drops in pediatric patients. AB - In a single-blind study, 60 children in two age groups (30 patients: 6 months to 3 years; 30 patients: 3 years to 12 years), were orally treated with either alpha methyl-4-(2-thienyl-carbonyl)phenylacetic acid (suprofen, Suprol), syrup 10 mg/ml or metamizole drops 50% for a maximum period of 4 days, up to 4 times a day. The children presented with high fever due to bacterial or virus infections. Body temperature, pulse rate, and respiratory rate were evaluated at the beginning and then 30 min, 1, 1 1/2, 2, 3, 4, 5, and 6 h after the first administration of the respective drug. Significant differences between the drugs were found for all variables; this demonstrated that with suprofen the antipyretic effect set in more rapidly than with the reference drug. No side-effects were observed in children treated with suprofen syrup. Two patients showed adverse effects, i.e. sweating and hypotension, during the treatment with metamizole. Due to its good antipyretic effect and good tolerability, suprofen appears to be particularly useful for symptomatic treatment of pediatric patients with fever caused by bacterial or virus infections. PMID- 3527182 TI - Controlled double-blind study of the therapeutic effect of pirenzepine dihydrochloride in duodenal ulcer. Phase III study. AB - A controlled double-blind study was performed in 17 institutes using gefarnate as a control drug in order to investigate the therapeutic effect and safety of pirenzepine dihydrochloride (LS 519) in duodenal ulcer. A total of 233 subjects were studied, 110 in the pirenzepine group (LS group) and 123 in the gefarnate group (GF group). Final improvement rate of ulcer lesions (8 weeks) of LS group showed the highly significant superiority over the GF group. Cumulative healing rates based on endoscopic findings of 17.9, 49.4, 67.0, 84.2 and 91.2% were found for the LS group at the 2nd, 4th, 6th, 8th, 10th and 12th weeks, respectively; the respective values for the GF group being 14.7, 33.0, 51.5, 66.7, 70.5 and 72.4%. Thus, the LS group showed a significantly superior acceleration of healing to that of the GF group on all occasions but the 2nd week. The improvement rate of subjective symptoms for moderately and markedly improved cases together totalled 98.9% for the LS group and 81.2% for the GF group, indicating the significant superiority of the former. These results proved the excellent therapeutic effect of pirenzepine. No significant difference in safety was found between the two drug groups. Gastric analysis was carried out before the start of drug administration and of its termination. In the healed subjects treated with pirenzepine there were a significant decrease in the secretion volume and acid output, and also a tendency to decrease in the acidity in basal secretion; and further a tendency to decrease in the acidity in maximally stimulated secretion. PMID- 3527183 TI - Previous alcohol intake and residual cognitive deficits in detoxified alcoholics and animals. AB - A common assumption is that protracted alcohol consumption is causally related to the intellectual impairment seen in sober recovering alcoholics. However, attempts to demonstrate consistent and significant relationships between alcohol intake and cognitive-perceptual functioning in such alcoholics have been inconclusive. A review of the human studies indicates that the inconsistent results cannot be accounted for by potentially confounding variables such as age, education, sex, days abstinent, years of abuse, type of hospital and number of tests used. In detoxified mice and rats there is clear evidence for a causal relationship between duration of alcohol intake and learning and memory tasks, although limited mainly to studies of relatively high levels of alcohol intake and performance on a few types of tasks. These studies suggest a duration threshold for impairment before which impairment does not occur and after which there is a systematic inverse relationship between duration and quality of performance. Finally there is an asymptote effect where, with increase in duration and increase in age, there is no corresponding decrement in performance. A number of promising areas to be investigated using the rodent model are discussed. Findings from such investigations should have heuristic value for human studies. Reasons for the inconsistent results in humans are detailed and suggestions offered to facilitate further research in this area. PMID- 3527185 TI - A study of alcoholism treatment units. PMID- 3527184 TI - Alcohol and dilated cardiomyopathy. AB - Alcohol has been considered a cardiotoxin for over a century, but the pathogenesis and natural history of alcohol-related heart disease remains obscure. The diagnosis still rests on the coincidence of alcoholism and a dilated hypocontractile heart in the absence of any other cause of dilated cardiomyopathy. Advances have been made in our understanding of the effects of acute and chronic alcohol administration both at a haemodynamic and cellular level, and recent studies have indicated that preclinical changes in LV dimensions and function are common in alcoholics. It is not known whether clinical cardiomyopathy, which develops in only 1-2% of heavy drinkers, occurs because of genetic predisposition, or the presence of synergistic cardiovascular risk factors. Abstinence remains the mainstay of treatment, but the prognosis is poor after development of frank heart failure. PMID- 3527186 TI - Diabetes update. PMID- 3527187 TI - Performance of aeromedical crewmembers: training or experience? AB - In a clinical trial testing delivery of cardiopulmonary resuscitation (CPR) and emergency cardiac care (ECC) in a medical helicopter, 40-45% of physicians, nurses, and paramedics certified in advanced cardiac life support (ACLS) performed below standard as compared with full-time flight nurses and paramedics. Personnel regularly engaged in aeromedical activities perform far better than those similarly qualified but less familiar with the aviation environment. Because regular ACLS techniques apply during air transport, training, comfort, experience, and confidence are critical factors in crew performance and may affect outcome. The ideal crew should include regular partners who train and work together. The temptation to assign personnel to aeromedical duties without adequate preparation, testing, and commitment must be resisted. Those responsible for the medical direction of hospital-based helicopter services should insist on full-time crew members and provide them with liberal training opportunities and opportunities for skill maintenance. PMID- 3527188 TI - Critical care medicine: an annotated bibliography of the recent literature. PMID- 3527189 TI - Data sources for accident modelling. AB - The value of modelling for the study of accidents and for devising and assessing methods of prevention depends on the reliability of data sources. Police statistics are commonly used for accidents which cause death or injury. Several studies, however, show their deficiencies particularly for injury accidents of pedestrians and pedal cyclists. Hospital records give better information on injuries and diagnostic classification by the ICD code can be usefully improved by inclusion of the "E" (circumstance) detail. Insurance data can provide another source which is likely to be best for accidents involving multiple vehicles and damage to the property of third parties. The special "no fault" compensation system in New Zealand gives an unusually full source of data suitable for statistical analysis of accidents. PMID- 3527190 TI - Taking account of system interactions in modelling road accidents. AB - This paper argues that modelling of accidents and injuries not based on the broadest possible conceptualization of the accident generation process is likely to suffer from unintended biases. Further, careful consideration must be given to the objectives for which the modelling is designed. The analysis recognizes that the form modelling can take is constrained by data availability. Alternative modelling techniques are discussed along with the advantages and weaknesses of each. Finally, it is recommended that, when possible, a battery of techniques be used, to guarantee needed information is obtained while assuring the results are not simply a biased product of the technique used. PMID- 3527191 TI - Regression analysis of aggregate accident data: some methodological considerations and practical experiences. AB - In empirical traffic safety studies regression analysis is perhaps the most widely used statistical technique. In the great majority of cases the regression model is applied in its standard form. If, however, highly aggregate accident data are analyzed, usually most of the assumptions of the standard model are violated. Referring to a practical study it is demonstrated how it may become difficult to decide whether or not a certain variable can be regarded as truly "explanatory." It appears that even in seemingly unproblematic situations contradictory results are obtained from only slightly different model specifications. It is recommended that the use of highly aggregate accident data be avoided whenever possible. Some hints are given concerning the use of appropriate extensions of the classical linear regression model in road accident studies. PMID- 3527192 TI - Enhanced sodium appetite in rats with lesions centered on nucleus medianus. AB - Recent experiments have demonstrated that rats with lesions of the ventral portion of nucleus medianus (vNM) frequently exhibit a chronic and robust hyperdipsia, which occurs only at night. This study indicates that the same brain damage may produce a nocturnal appetite for sodium that is similarly pronounced and persistent. Of 68 rats with vNM lesions, 33 were observed to drink at least 15 ml of 0.51 M NaCl solution per day, and 11 of them consumed more than 30 ml daily. The basis for this impressive consumption of saline is uncertain; the brain-damaged rats had normal sodium concentrations, renin activities, and aldosterone levels in plasma during basal maintenance conditions, and they conserved sodium in urine when maintained on a sodium-deficient diet. Nevertheless, the present results indicate that vNM and/or local fibers of passage may play an important role in the control of sodium appetite, as it does in the control of thirst. PMID- 3527193 TI - [The upper dentition completely remade]. PMID- 3527194 TI - [All the secrets of the R.P.I. clasp]. PMID- 3527195 TI - [3 surgical procedures in a single stroke]. PMID- 3527196 TI - [The sound "S" shows the class]. PMID- 3527198 TI - [Blade implants simplified]. PMID- 3527197 TI - [With veneers less harm to the sulcus]. PMID- 3527199 TI - [Silicone masks for metallo-ceramic restorations]. PMID- 3527200 TI - [Controlled polymerization of composite materials. Everything is easier with the laser]. PMID- 3527201 TI - [A simple and less traumatic method for complete edentulousness. Fibrous tissue also aids in retention]. PMID- 3527202 TI - [It is possible to avoid cheek biting]. PMID- 3527203 TI - [Precision is the only difficulty]. PMID- 3527204 TI - [The architecture of the mouth]. PMID- 3527205 TI - [Clinical trial of a Cavex Clearfil core]. PMID- 3527206 TI - [Overdentures: pros and cons]. PMID- 3527207 TI - [The "other" teeth determine the work]. PMID- 3527208 TI - [Partial crowns and non-rigid connectors]. PMID- 3527209 TI - [The "F" and "V" seal]. PMID- 3527210 TI - [The "S" phoneme in the lower teeth]. PMID- 3527211 TI - [Reinvestment instead of plaster]. PMID- 3527212 TI - [The larger the diameter the better the finish]. PMID- 3527213 TI - [Dentures on top of implants]. PMID- 3527214 TI - [Amalgam reconstruction of posterior destruction]. PMID- 3527215 TI - [Screw implants simplified]. PMID- 3527216 TI - [The conquest of space]. PMID- 3527217 TI - [Prosthetic reconstruction with a ceramic jacket crown. Office procedures. Phases of shoulder preparation using impressions tested in the mouth]. PMID- 3527218 TI - [Prosthetic reconstruction with a ceramic jacket crown. Laboratory procedures]. PMID- 3527219 TI - [The sealant restoration]. PMID- 3527220 TI - [Fluid resin: penetration into the enamel]. PMID- 3527221 TI - [Away with those ugly "black holes"]. PMID- 3527222 TI - Self-association of des-(B26-B30)-insulin. The effect of Ca2+ and some other divalent cations. AB - It has been confirmed by sedimentation equilibrium and sedimentation velocity experiments that des-(B26-B30)-insulin does not self-associate at neutral pH. Sedimentation equilibrium experiments at pH 7, 25 degrees C were conducted to investigate the effects of the structurally and physiologically important divalent cations Zn2+, Cd2+, Pb2+ and Ca2+ on the aggregation state of des-(B26 B30)-insulin (pig) in solution. It was found that all of these ions bring about association of this insulin analogue; Zn2+ and Cd2+ to a more marked degree than Pb2+ and Ca2+. The predominant species in solutions containing Zn2+ appear to be hexamers and hexameric aggregates, in those containing Cd2+, species up to and including tetramers, and in those containing Pb2+ and Ca2+, monomers and dimers of des-(B26-B30)-insulin appear to be the only species present. The possible significance of these findings, especially in relation to a role for Ca2+ in the action of insulin, is discussed. PMID- 3527223 TI - The effect of catalase and methionine-S-oxide reductase on oxidised alpha 1 proteinase inhibitor. AB - Oxidative damage to alpha 1-proteinase inhibitor (alpha 1-PI) may be important in the pathogenesis of emphysema. We have studied the ability of 2 enzymes (catalase and methionine-S-oxide reductase) to prevent and reverse oxidation of alpha 1-PI by hydrogen peroxide. Pre-incubation of catalase with H2O2 protected alpha 1-PI from oxidation, but the enzyme could not reverse prior oxidation of alpha 1-PI. In contrast, methionine-S-oxide reductase fully restored activity to H2O2 oxidised alpha 1-PI. Sputum sol-phase from smokers and non-smokers contained alpha 1-PI that was only about 30% active. Functional activity increased in both smokers (p less than 0.025) and non-smokers (p less than 0.05) approximately 2 fold following incubation with the reductase. Western blotting of the samples showed that about 20% of the alpha 1-PI was present as an enzyme-inhibitor complex and 20% was proteolytically cleaved. These observations suggest proteolysis, complexing with enzyme and oxidation are mechanisms of inactivation of alpha 1-PI in lung secretions. PMID- 3527224 TI - Temperature dependency of the anomeric specificity of yeast and bovine hexokinases. AB - The phosphorylation of alpha- and beta-D-glucose by either yeast hexokinase or beef heart hexokinase was measured at both 10 and 30 degrees C. At 30 degrees C, the anomeric specificity of yeast hexokinase represented a mirror image of that of bovine hexokinase, in terms of both maximal velocity and affinity. A decrease in temperature apparently accentuated the anomeric difference in both maximal velocity and affinity of bovine hexokinase. Such a difference consisted in a higher maximal velocity with beta- than alpha-D-glucose, but a greater affinity for the alpha- than beta-anomer. In yeast hexokinase, however, the decrease in temperature suppressed the anomeric difference in maximal velocity and inversed the anomeric difference in affinity. In the case of both enzymes, the fall in temperature decreased more the maximal velocity recorded with alpha-D-glucose than that measured with beta-D-glucose, and severely lowered the Km for alpha-D glucose, whilst failing to affect significantly the Km for beta-D-glucose. These findings, which allow to reconcile prior apparently conflicting data, reveal that the anomeric behaviour of hexokinase is affected by the ambient temperature. Our data also support the view that hexokinase underwent a phylogenic evolution in terms of its anomeric specificity. PMID- 3527225 TI - Isolation purification and properties of a site-specific proteolytic enzyme "valyl-proteinase" from Candida tropicalis. AB - A highly specific proteolytic enzyme cleaving at the carboxyl group of valine has been isolated from Candida tropicalis. Its specificity has been determined by digesting beta-lactoglobulin and a number of synthetic peptides. The enzyme a glycoprotein, has a molecular mass of 40 +/- 7 kDa on the basis of sodium dodecyl sulphate polyacrylamide gel electrophoresis. Its optimum activity occurs at 37 degrees C at a pH between 8-9. It has been named "Valyl-proteinase" because of its selective cleavage. PMID- 3527226 TI - Isolation and amino-acid sequence analysis of human sperm protamines P1 and P2. Occurrence of two forms of protamine P2. AB - The two protamines of human sperm cell nuclei, P1 and P2, were isolated in pure form after extraction with 6M guanidine/5% mercaptoethanol and alkylation with vinyl pyridine by reversed-phase high-performance liquid chromatography. The amino-acid sequence of protamine P1 was determined by analysing the intact protein and the fragments obtained by cyanogen bromide cleavage. Out of the 50 amino-acid residues 24 are arginines and 6 are cysteines. The sequence of protamine P2 was determined by analysing the intact protein and the fragments resulting from cleavage with endoproteinase Lys-C and thermolysin. Protamine P2 was found to occur in two forms which only differ in their N-terminal regions. The form P2' is three amino-acid residues longer at the N-terminus than the form P2''. Out of the 57 amino-acid residues in the longer form 27 are arginines and 5 are cysteines. Human protamine P1 is highly homologous with the protamines isolated from bull, boar, ram and mouse sperm cells, but human protamine P2 shows a novel type of structure, although also here the dominant amino acids are arginine and cysteine. PMID- 3527227 TI - IgM-IFA, IgM-ELISA, DS-IgM-ELISA, IgM-ISAGA, performed on whole serum and IgM fractions, for detection of IgM anti-toxoplasma antibodies during pregnancy. AB - The traditional IgM-ELISA has a better sensibility and specificity than IgM-IFA when these two tests are performed on whole sera, but in many cases (sera titer values of greater than 200 I.U./ml) the presence of IgM antitoxoplasma antibodies can be detected only after purification of IgM fractions. The separations of IgM fractions avoids either false positive results due to the rheumatoid factors or antinuclear antibodies, and false negative results due to the competition between IgG and IgM antibodies. The present investigation has shown that antibody titers obtained by IgM-IFA and traditional IgM-ELISA correlate well with DS-IgM-ELISA and IgM-ISAGA performed on whole serum. The false negative results that frequently occur with IgM-IFA and traditional IgM-ELISA performed on whole sera having sera titer values of greater than 200 I.U./ml in IgG IFA are avoided when the same sera were tested by DS-IgM-ELISA and IgM-ISAGA. All the sera which gave positive results by DS-IgM-ELISA were also positive when tested with IgM-ISAGA. Our researches demonstrate the high specificity and sensitivity of IgM-ISAGA and DS-IgM-ELISA performed on whole serum. PMID- 3527228 TI - [The significance of antipolysaccharide C antibodies from Streptococcus group A. Their importance in the diagnosis of streptococcal infections]. AB - Here is underlined the role of quantitative determination of streptococcus A polysaccharide C antibody for the diagnosis of streptococcal infection. The Authors suggest to associate this determination with antistreptolysin titer and/or bacterial esoenzyme antibody titer, in order to achieve a wider spectrum of streptococcus induced antibodies for therapeutic and prophylactic applications. PMID- 3527229 TI - Prevalence of antibodies to Legionella pneumophila and micdadei in hospitalized children. AB - 217 children were studied by IFA technique to assess the incidence and prevalence of infections due to L. pneumophila and micdadei. The study was completed by a bacteriological environmental research. No acute infection was detected. Nevertheless 10.1% of all patients showed positive antibody titers. This percentage was 0 in children aged less than 1 year and reached 17.7% in children after 3. Most positive sera were due to a pooled antigen containing L. pneumophila serotypes 1, 2, 3. All environmental samples were negative. Our results demonstrate that our area has probably a low endemicity and that children are a low risk population. Nevertheless the absence of acute pulmonary pathology either during the period of investigation or at the anamnestic report seems to strengthen the reported possibility of infection without major pulmonary signs, with a course as an influenza-like syndrome or as an inapparent infection. PMID- 3527230 TI - The amino acid sequence encompassing the active-site histidine residue of lipoamide dehydrogenase from Escherichia coli labelled with a bifunctional arsenoxide. AB - Pyruvate dehydrogenase multienzyme complex (PD complex) in the presence of pyruvate, thiamine pyrophosphate, coenzyme A, and Mg2+ (or NADH) was irreversibly inhibited with the radiolabelled bifunctional aresenoxide p [(bromoacetyl)amino]phenyl arsenoxide (BrCH2 14CONHPhAsO). The initial reaction of the reagent was with a reduced lipoyl group of the lipoamide acetyltransferase component to form a dithioarsinite complex. Following the normal catalytic reactions, the anchored reagent was delivered into the active site of the lipoamide dehydrogenase (E3) component where an irreversible alkylation ensued via the bromoacetamidyl moiety. Treatment with 2,3-dithiopropanol (to break dithioarsinite bonds) caused the radiolabelled reagent to reside with E3. E3 was isolated from the inhibited PD complex and CNBr cleavage of the inhibited enzyme yielded a single radiolabelled peptide that was purified on a cyanopropyl silica column using high performance liquid chromatography. The radiolabelled amino acid was identified (after acid hydrolysis) as N3-[14C]carboxymethyl histidine in agreement with earlier studies. The radiolabel was located in residue 14 of the peptide for which the sequence was determined as GCDAEDIALTIHAHPTL-EIVGLAAEVFEG. This sequence agrees with the amino acid sequence determined from the gene sequence of E3. The histidine alkylated in the E3 component of the PD complex by BrCH2 14CONHPhAsO is residue-444 and further establishes its active site role. PMID- 3527231 TI - A chronological review--1960-1985 of the changing concepts related to modifications, treatment, preservation and augmentation of the complete denture basal seat. PMID- 3527232 TI - Porcelain-alloy compatibility--a necessity for durable and aesthetic restorations. PMID- 3527233 TI - Stress-breaking in partial dentures. PMID- 3527234 TI - Partial denture design--a group project. PMID- 3527235 TI - Effect of dietary carbohydrate type on lipoprotein lipase, hepatic lipase, and lecithin:cholesterol acyltransferase activities in cynomolgus monkeys. AB - The effects of dietary sucrose and starch with and without exogenous cholesterol on postheparin plasma lipoprotein lipase (PHLA) and hepatic lipase (HLA) were studied in cynomolgus monkeys. Serum triglyceride levels were higher in sucrose fed animals than starch and exogenous cholesterol lowered serum triglyceride levels when added to sucrose diet but not starch diets. Sucrose markedly increased insulin levels, more so than starch; however, dietary cholesterol lowered insulin levels in sucrose diet but increased the levels in starch diet. PHLA activity was increased two- to threefold greater in sucrose than in starch diets. Exogenous cholesterol lowered PHLA activity in sucrose diet but increased PHLA activity in starch diet. HLA activity was increased with sucrose more than starch. Lecithin:cholesterol acyltransferase (LCAT) activity was significantly higher in sucrose diets than in the starch diet. Addition of cholesterol to either of these diets lowered the LCAT activity. These results indicate that PHLA, HLA, and LCAT activities not only are affected by the nature of carbohydrates, but also are related to triglyceride metabolism. The interaction of carbohydrates and cholesterol in the diet by influencing these selected enzymes plays an integrated role in lipoprotein particle interconversion processes. PMID- 3527236 TI - Renin substrate and the renin-angiotensin system in hog tissues. AB - The individual components of the renin-angiotensin system has been identified in numerous tissues. In this study we have examined whether a functional renin angiotensin system is operative in several hog tissues including brain, aorta, and liver. The contribution of tissue renin substrate to the rate of local angiotensin generation was also assessed. Electrophoretic differences in plasma and tissue renin substrates, indicating structural differences, were employed as an index of independence of the tissue system from that of the peripheral circulation. Our results indicate that all tissues studied had the potential to locally generate angiotensin and that renin substrate limited to rate of the renin reaction in these tissues. Electrophoretic parameters, polyacrylamide gel electrophoresis, and isoelectric focusing suggest that the tissue renin systems are of local origin. The potential magnitude of local angiotensin production is such that tissue renin-angiotensin systems may significantly contribute to the control and regulation of blood pressure and other regulatory mechanisms influenced by angiotensin. PMID- 3527237 TI - [Neuronal specificity in retinotectal projection]. PMID- 3527238 TI - [Formation of the spinal reflex arc]. PMID- 3527239 TI - The efficacy of overdentures in clinical practice. PMID- 3527240 TI - Uptake of General Dental Service treatment in Great Britain 1965-1983 with special reference to radiography, prosthetics and the care of children. PMID- 3527241 TI - Abrasivity of denture cleaning pastes in vitro and in situ. PMID- 3527242 TI - The effect of 8 weeks treatment with the calcium antagonist felodipine on blood pressure, heart rate, working capacity, plasma renin activity, plasma angiotensin II, urinary catecholamines and aldosterone in patients with essential hypertension. AB - The effect of 8 weeks treatment with the calcium antagonist felodipine--a new long-acting dihydropyridine derivative--in a dose of 10 mg twice daily was studied in 10 male patients with essential hypertension, WHO grade I-II, aged 25 62 years. Diastolic blood pressure was reduced in supine and upright position. Systolic blood pressure was reduced only in the upright position. Heart rate was unchanged in the supine and decreased in the upright position. During dynamic exercise blood pressure was reduced. The maximal working capacity decreased, whereas the maximal heart rate attained was unchanged. Twenty-four hour urinary noradrenaline excretion, plasma renin activity and 24 h urinary aldosterone excretion were increased. Plasma angiotensin II and 24 h urinary adrenaline excretion were unchanged. In conclusion, felodipine is an effective long-acting blood pressure lowering drug with minor side effects. After 8 weeks on felodipine treatment heart rate was not increased, although the activity of the sympathetic nervous system and the renin-aldosterone system seemed enhanced. PMID- 3527243 TI - Quinine pharmacokinetics and toxicity in pregnant and lactating women with falciparum malaria. AB - Quinine dihydrochloride (10 mg or, in two patients, a loading dose of 20 mg kg-1) was infused intravenously over 4 h in ten severely ill but conscious women with falciparum malaria complicating the third trimester of pregnancy. Plasma quinine concentrations, measured spectrophotofluorimetrically after benzene extraction, fitted closely a single exponential decline after the intravenous infusion. These data were therefore fitted to a one compartment model: total apparent volume of distribution, V, 0.96 +/- 0.27 l kg-1 (+/- s.d.), elimination half-time (t1/2,z), 11.3 +/- 4.3 h, total clearance, 1.22 +/- 0.77 ml min-1 kg-1. There was no relationship between arterial blood pressure and plasma quinine concentrations. Eight women delivered of live infants while taking quinine, had placental cord plasma quinine concentrations from 1.0 to 4.6 mg l-1 (mean 2.4) which correlated significantly with maternal plasma quinine concentrations (r = 0.78, t = 3.06, P less than 0.05). The mean (+/- s.d.) ratio of cord plasma to maternal plasma quinine concentration was 0.32 +/- 0.14. Heart blood from a foetus aborted at term had a plasma quinine concentration of 2.8 mg l-1; simultaneous maternal plasma quinine was 7.1 mg l-1 (ratio 0.39). Breast milk quinine concentrations and milk to plasma ratios were 0.5-3.6 mg l-1 (mean 2.6) and 0.11-0.53 (mean 0.31) in twenty-five women who were breast-feeding and had taken oral quinine sulphate for 1-10 days (mean 4.0). Five women with more serious infections received intravenous quinine; breast milk quinine concentrations ranged between 0.5 and 8.0 mg l-1 (mean 3.4).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3527244 TI - Enhancement by sodium salicylate of the blood glucose lowering effect of chlorpropamide-drug interaction or summation of similar effects? AB - The ability of sodium salicylate (3 g) to enhance the blood glucose lowering action of chlorpropamide (200 mg) has been confirmed in healthy male volunteers who received an oral test dose of 50 g glucose. Salicylate raised the plasma concentration of insulin and lowered that of cortisol but did not alter the concentration of chlorpropamide. The area under the blood glucose concentration time curve was used as the measure of drug response and the significance of drug effects was assessed by analysis of variance. In one study on five volunteers the effect of combining salicylate and chlorpropamide was additive. In a second study on six volunteers 200 mg chlorpropamide, 3 g sodium salicylate and 100 mg chlorpropamide + 1.5 g salicylate were equi-effective. The enhancement of chlorpropamide action by salicylate in this single dose study is consistent with the summation of similar effects. It is not necessary to postulate an interaction. PMID- 3527245 TI - In vitro activity of chloroquine, the two enantiomers of chloroquine, desethylchloroquine and pyronaridine against Plasmodium falciparum. AB - A 48 h in vitro test was conducted to compare the susceptibility of two strains of Plasmodium falciparum to chloroquine, the two enantiomers of chloroquine, desethylchloroquine and the new antimalarial drug pyronaridine. The five compounds similarly inhibited the chloroquine sensitive strain. However, desethylchloroquine was less active and pyronaridine was much more active than chloroquine and its enantiomers against the chloroquine resistant strain. PMID- 3527246 TI - Placebo controlled double-blind randomised cross-over trial of atenolol, hydrochlorothiazide and amiloride, and the combination (Kalten) in patients over 60 years of age. PMID- 3527247 TI - A general practice study to compare alverine citrate with mebeverine hydrochloride in the treatment of irritable bowel syndrome. PMID- 3527248 TI - Peppermint oil does not relieve the pain of irritable bowel syndrome. PMID- 3527249 TI - A double-blind controlled trial of danazol and bromocriptine in the management of severe cyclical breast pain. PMID- 3527250 TI - Pulmonary damage caused by a protease from Legionella pneumophila. AB - Intranasal (or intratracheal) administration of a tissue-destructive protease from Legionella pneumophila to guinea-pigs produced areas of haemorrhagic pneumonia in the lungs after 1/2 h. By 24 h there was confluent consolidation in all lobes. Histological and ultrastructural studies showed alveolar haemorrhage, vesiculation and necrosis of type I alveolar epithelium and endothelium, followed by progressive exudation of oedema fluid, fibrin, PMN and macrophages. Damage to type II cell lamellated bodies and discharge of lamellar material were significant features of the lesion. Collagenase activity was indicated by morphological degradation of collagen fibres in severely affected interalveolar septa. The pathological changes of Legionnaires' disease pneumonia can thus be reproduced experimentally by the administration of a L. pneumophila tissue destructive protease, suggesting that production of this protease in vivo during L. pneumophila infection may play an important role in causing the pneumonia. PMID- 3527251 TI - Identification of an epidermal basement membrane defect in recessive forms of dystrophic epidermolysis bullosa by LH 7:2 monoclonal antibody: use in diagnosis. AB - LH 7:2 is a monoclonal antibody that was raised against an extract of human epidermal cells and identifies an epitope within the lamina densa of the basement membrane of stratified squamous epithelia. Using indirect immunofluorescence we found intense labelling with LH 7:2 at the epidermal basement membrane (EBM) of normal skin, and in skin samples from patients with simplex, junctional, dominantly inherited dystrophic and acquired forms of epidermolysis bullosa (EB), as well as bullous pemphigoid. Staining was absent or only very faint in generalized recessive dystrophic EB (RDEB), and patchily reduced in the localized form of RDEB. We conclude that LH 7:2 recognizes an EBM antigen which may be important in the pathogenesis of RDEB. Moreover, the antibody provides a useful probe for the rapid diagnosis of RDEB and is of special value in helping to discriminate between localized RDEB and typical dominant dystrophic EB- conditions which closely resemble each other clinically and which cannot be distinguished by means of transmission electron microscopy. PMID- 3527252 TI - Immunohistochemical study of lysozyme in lupus miliaris disseminatus faciei. AB - The lysozyme activity in tissue samples from patients with lupus miliaris disseminatus faciei (LMDF), sarcoidosis and foreign body granuloma was investigated using the immunoperoxidase technique. The majority of epithelioid cells and giant cells in LMDF and sarcoidosis showed strong lysozyme staining in their cytoplasm. However, most macrophages and giant cells in foreign body granulomas, including granulomatous reactions to epidermal cysts and other foreign materials, stained weakly for lysozyme or were negative. These results suggest that LMDF is different from the foreign body reaction to inert substances, and may be induced by an immunological mechanism associated with cell mediated immunity. PMID- 3527253 TI - Immunohistological characterization of endometrial gland epithelium and extravillous fetal trophoblast in third trimester human placental bed tissues. AB - The distribution, morphology and antigen expression of endometrial glands, uterine vessels and fetal trophoblast have been studied in third trimester placental bed tissues with a panel of monoclonal antibodies in immunohistochemical techniques. Residual endometrial glands were numerous but often were attenuated or compressed and could only be identified clearly with epithelial cell markers. These glands must be clearly distinguished from vessels and trophoblast in immunological studies of cells in the placental bed. The changing pattern of antigen expression of both maternal glands and fetal trophoblast in placental bed tissues may indicate a form of local regulation of gene expression. PMID- 3527254 TI - In vivo function of Escherichia coli pyruvate oxidase specifically requires a functional lipid binding site. AB - The pyruvate oxidase of Escherichia coli is a peripheral membrane flavoprotein that is dramatically activated by lipids. The enzyme strongly binds to phospholipid vesicles in vitro. In vivo, in addition to enzyme activation, binding is thought to be important to provide access of the enzyme to ubiquinone dissolved in the lipid bilayer. It was unclear if both or either of these attributes is needed for enzyme function in vivo. To differentiate between activation and lipid binding, we have constructed, using recombinant DNA techniques, a mutant gene that produces a truncated protein. The truncated protein lacks the last 24 amino acids of the C-terminus of the oxidase (due to introduction of a translation termination codon) and thus is closely analogous to the activated species produced in vitro by limited chymotrypsin cleavage [Recny, M.A., Grabau, C., Cronan, J.E., Jr., & Hager, L.P. (1985) J. Biol. Chem. 260, 14287-14291]. The truncated protein (like the protease-derived species) is fully active in vitro in the absence of lipid, and its activity is not further increased by addition of lipid activators. Moreover, the truncated enzyme fails to bind Triton X-114, a detergent that binds to and activates the wild-type oxidase. Strains producing the truncated protein were devoid of oxidase activity in vivo. This result indicates that binding to membrane lipids is specifically required for function of the oxidase in vivo; activation alone does not suffice. PMID- 3527255 TI - Inhibition of serine proteases by peptidyl fluoromethyl ketones. AB - We have synthesized peptidyl fluoromethyl ketones that are specific inhibitors of the serine proteases alpha-chymotrypsin and porcine pancreatic elastase. By analogy with the corresponding aldehydes it is assumed that the fluoromethyl ketones react with the gamma-OH group of the active site serine to form a stable hemiacetal [Lowe, G., & Nurse, D. (1977) J. Chem. Soc., Chem. Commun., 815; Chen, R., Gorenstein, D.G., Kennedy, W.P., Lowe, G., Nurse, D., & Schultz, R.M. (1979) Biochemistry 18, 921; Shah, D.O., Lai, K., & Gorenstein, D.G. (1984) J. Am. Chem. Soc. 106, 4272]. 19F NMR studies of the chymotrypsin-bound trifluoromethyl ketone inhibitors Ac-Leu-ambo-Phe-CF3 and Ac-ambo-Phe-CF3 clearly indicate that the carbonyl carbon is tetrahedral at the active site of the enzyme. The inhibitor is bound as either the stable hydrate or the hemiacetal, involving the active site serine. The effect of varying the number of amino acid residues in the peptidyl portion of the inhibitor and the number of fluorines in the fluoromethyl ketone moiety is examined. In the series of trifluoromethyl ketone elastase inhibitors, the lowering of Ki concomitant with the change from a dipeptide analogue to a tetrapeptide analogue (Ac-Pro-ambo-Ala-CF3, Ki = 3 X 10(-3) M; Ac-Ala-Ala-Pro ambo-Ala-CF3, Ki = 0.34 X 10(-6) M) correlates well with the variation in V/K for hydrolysis of the corresponding amide substrates. This trend is indicative of the inhibitors acting as transition-state analogues [Bartlett, P.A., & Marlowe, C.K. (1983) Biochemistry 22, 4618; Thompson, R.C. (1973) Biochemistry 12, 47].(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3527256 TI - Photochemically induced dynamic nuclear polarization NMR study of yeast and horse muscle phosphoglycerate kinase. AB - A photochemically induced dynamic nuclear polarization (photo-CIDNP) study of yeast and horse muscle phosphoglycerate kinase with flavin dyes was undertaken to identify the histidine, tryptophan, and tyrosine resonances in the aromatic region of the simplified 1H NMR spectra of these enzymes and to investigate the effect of substrates on the resonances observable by CIDNP. Identification of the CIDNP-enhanced resonances with respect to the type of amino acid residue has been achieved since only tyrosine yields emission peaks and the dye 8-aminoriboflavin enhances tryptophan but not histidine. By use of the known amino acid sequences and structures derived from X-ray crystallographic studies of the enzymes from the two species, assignment of the specific residues in the protein sequences giving rise to the CIDNP spectra was partially achieved. In addition, flavin dye accessibility was used to probe any changes in enzyme structure induced by substrate binding. The nine resonance peaks observed in the CIDNP spectrum of yeast phosphoglycerate kinase have been assigned tentatively to five residues: histidines-53 and -151, tryptophan-310, and tyrosines-48 and -195. The accessibility of a tyrosine to photoexcited flavin is reduced in the presence of MgATP. Since the tyrosine residues are located some distance from the MgATP binding site of the catalytic center, it is proposed either that this change is due to a distant conformational change or that a second metal-ATP site inferred from other studies lies close to one of the tyrosines. Horse muscle phosphoglycerate kinase exhibits seven resonances by CIDNP NMR.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3527257 TI - Dissociation of the lactose repressor-operator DNA complex: effects of size and sequence context of operator-containing DNA. AB - The dissociation kinetics for repressor-32P-labeled operator DNA have been examined by adding unlabeled operator DNA to trap released repressor or by adding a small volume of concentrated salt solution to shift the Kd of repressor operator interaction. The dissociation rate constant for pLA 322-8, an operator containing derivative of pBR 322, was 2.4 X 10(-3) s-1 in 0.15 M KCl. The dissociation rate constant at 0.15 M KCl for both lambda plac and pIQ, each of which contain two pseudooperator sequences, was approximately 6 X 10(-4) s-1. Elimination of flanking nonspecific DNA sequences by use of a 40 base pair operator-containing DNA fragment yielded a dissociation rate constant of 9.3 X 10(-3) s-1. The size and salt dependences of the rate constants suggest that dissociation occurs as a multistep process. The data for all the DNAs examined are consistent with a sliding mechanism of facilitated diffusion to/from the operator site. The ability to form a ternary complex of two operators per repressor, determined by stoichiometry measurements, and the diminished dissociation rates in the presence of intramolecular nonspecific and pseudooperator DNA sites suggest the formation of an intramolecular ternary complex. The salt dependence of the dissociation rate constant for pLA 322-8 at high salt concentrations converges with that for a 40 base pair operator. The similarity in dissociation rate constants for pLA 322-8 and a 40 base pair operator fragment under these conditions indicates a common dissociation mechanism from a primary operator site on the repressor. PMID- 3527258 TI - Thermodynamic analysis of the lactose repressor-operator DNA interaction. AB - Kinetic and equilibrium constants for lactose repressor-operator DNA interaction have been examined as a function of salt concentration, size and sequence context of the operator DNA, and temperature. Significant salt effects were observed on kinetic and equilibrium parameters for pLA 322-8, an operator-containing derivative of pBR 322, and pIQ, an operator and pseudooperator-containing derivative of pBR 322. The association rate constant and equilibrium constant for the 40 base pair operator fragment were also salt dependent. Data for all the DNAs were consistent with a sliding mechanism for repressor-operator association/dissociation [Berg, O. G., & Blomberg, C. (1978) Biophys. Chem. 8, 271-280]. Calculation of the number of ionic interactions based on salt dependence yielded a value of approximately 8 for repressor binding to pIQ and pLA 322-8 vs. approximately 6 for the repressor-40 base pair fragment. These data and the differences in binding parameters for the plasmids vs. the 40 base pair operator are consistent with the formation of an intramolecular ternary complex in the plasmid DNAs. Unusual biphasic temperature dependence was observed in the equilibrium and dissociation rate constants for pLA 322-8, pIQ, and the 40 base pair fragment. These observations coupled with a discontinuity found in the inducer association rate constant as a function of temperature suggest a structural change in the protein. The large positive entropy contributions associated with repressor binding to all the DNAs examined provide the significant driving force for the reaction and are consistent with involvement of ionic and apolar interactions in complex formation. PMID- 3527259 TI - Type VIII collagen from bovine Descemet's membrane: structural characterization of a triple-helical domain. AB - Bovine corneal Descemet's membrane (DM) was subjected to limited pepsin digestion. Soluble native collagens were fractionated by differential salt precipitation, and a mixture of type V collagen and collagenous fragments with a chain Mr of 50,000 (50K) was obtained at a concentration of 1.5 M NaCl. Further purification of the 50K collagen by molecular sieve and high-performance liquid chromatography resulted in the isolation of two-non-disulfide-bonded polypeptides, 50K-A and 50K-B, which were susceptible to several neutral proteases, including bacterial collagenase. By the criteria of peptide mapping, amino acid composition, and N-terminal sequence analysis, 50K-A and 50K-B were structurally dissimilar, although both chains contained Gly-X-Y repeats. 50K-A and 50K-B were immunologically and structurally distinct from collagen type I, III, IV, V, and VI. Immunohistochemical studies of bovine ocular tissue showed preferential distribution of the collagen containing the 50K fragment in the DM, with a more disperse arrangement of apparently interconnecting fibrils in the corneal stroma. Type VIII collagen isolated from the culture medium of metabolically radiolabeled bovine corneal endothelial (BCE) cells and its pepsin resistant Mr 50 000 domain(s) both cross-reacted with antisera to 50K polypeptides from the corneal DM. Additionally, the CNBr peptide maps of pepsin resistant Mr 50 000 polypeptides of type VIII collagen isolated from BCE cells and bovine corneal DM were highly similar.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3527260 TI - Dipeptide metalloendoprotease substrates are glucose transport inhibitors and membrane structure perturbants. AB - Dipeptide substrates for metalloendoproteases have previously been shown to block biological processes requiring membrane fusion. Thus, we employed such compounds as potential inhibitors of the insulin-dependent activation of glucose transport in fat cells. This event is thought to involve vesicle movement from an intracellular site to the cell surface and would therefore require membrane fusion during the activation step. We find that synthetic dipeptides which are metalloendoprotease substrates rapidly and reversibly inhibit insulin-activated glucose oxidation in a dose-dependent manner but exhibit essentially no effect on basal levels. A similar result is obtained when glucose transport is measured directly in intact fat cells, in metabolically poisoned cells, and in isolated membrane vesicles derived from insulin-activated or untreated fat cells. That is, the dipeptide substrates inhibit insulin-activated glucose uptake to a greater extent than basal transport, and they do so even when vesicle translocation and fusion have already taken place as in ATP-depleted cells and isolated vesicles. Onset of transport inhibition after dipeptide addition is rapid, but not instantaneous, with a t 1/2 of 15-30 s. The metalloendoprotease substrates also inhibit glucose uptake and cytochalasin B binding in human erythrocytes but not in human placental microsomes. Finally, light microscopic examination of substrate-treated red cells reveals marked cupping and/or echinolation of the cell membrane. We conclude the following from these observations: Metalloendoprotease substrates are inhibitors of adipocyte glucose transport.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3527261 TI - Factor VII binding to tissue factor in reconstituted phospholipid vesicles: induction of cooperativity by phosphatidylserine. AB - The binding of factor VII and tissue factor produces a membrane-associated proteolytic complex which may be the primary biological initiator of coagulation. Homogeneous tissue factor, a glycoprotein purified from bovine brain, was reconstituted into phospholipid vesicles ranging from neutral (100% phosphatidylcholine) to highly charged (40% phosphatidylserine) with octyl glucoside. The vesicles were characterized with respect to size and tissue factor content and orientation. Employing data from protease digestion, we deduced that tissue factor is randomly oriented; thus, its effective concentration in these vesicles was half its total concentration. In all binding experiments, 1 mol of enzyme was bound per mole of available activator at saturation. This stoichiometry was not affected by the form of the enzyme employed or the phospholipid composition of the vesicles. With tissue factor incorporated into phosphatidylcholine vesicles, the Kd was 13.2 +/- 0.72 nM for factor VII and 4.54 +/- 1.37 nM for factor VIIa. Thus, the one-chain zymogen binds to the activator with only slightly less affinity than the more active two-chain enzyme. Active site modification of factor VII and factor VIIa with diisopropyl fluorophosphate resulted in tighter binding of the derivatized molecules. Inclusion of phosphatidylserine in the vesicles altered the binding both quantitatively and qualitatively. With increasing acidic phospholipid, the concentration of enzyme required to occupy half the activator sites was decreased. In addition, positive cooperativity was observed, the degree of which depended on the vesicle charge and the form of the enzyme. An explicit two-site cooperative binding model is presented which fits these complex data. In this model, tissue factor is at least a dimer with two interacting enzyme binding sites. PMID- 3527262 TI - Purification and characterization of recombinant single-chain urokinase produced in Escherichia coli. AB - Recombinant single-chain urokinase (rUK1) has been purified from Escherichia coli. The purification utilizes a refractile body purification, followed by batch DE-52 cellulose extraction, hydroxylapatite chromatography, and S-200 chromatography. Two-chain rUK (rUK2) is separated from rUK1 on benzamidine- Sepharose. The purification eliminates proteases early in the procedure so the rUK1 will not be cleaved to rUK2. The rUK1 has been characterized by amino terminal analysis as well as carboxy-terminal analysis after cleavage by plasmin. PMID- 3527263 TI - Subunit interactions of the Escherichia coli mannitol permease: correlation with enzymic activities. AB - A fraction of the phosphorylated form of the Escherichia coli mannitol permease (enzyme IIMtl) of the sugar phosphotransferase system can be extracted from the membrane in a dimeric form [Roossien, F.F., & Robillard, G.T. (1984) Biochemistry 23, 5682-5685]. Using E. coli minicells in which this protein can be specifically labeled with [35S]methionine, we show in this paper that part of the unphosphorylated form of enzyme IIMtl can also be extracted from the membrane as a dimer. We further demonstrate that both phosphoenolpyruvate-dependent phosphorylation of the permease and conditions promoting turnover of the enzyme decrease the amount of extractable dimer. Thus, the dimer of these forms of the enzyme appears to be less stable than that of the unmodified form, at least in detergent solution. In contrast, inorganic phosphate, which activates the permease-catalyzed phospho exchange between mannitol 1-phosphate and mannitol ("transphosphorylation"), stabilizes the dimer. These results support the hypothesis that the mannitol permease dimer is more active in transphosphorylation than the monomer. Treatment of minicell membranes with oxidizing agents produced heat-stable, high molecular weight aggregates of the permease on dodecyl sulfate gels, but no heat-stable dimer could be detected. The nonionic detergent Lubrol PX decreased the amount of dimer extractable at 30 degrees C with a concomitant increase in the monomeric form. These results suggest that the dimer depends predominantly on hydrophobic interactions for its stability and is not covalently cross-linked in that form by oxidizing agents. PMID- 3527264 TI - Enzyme I of the phosphoenolpyruvate: sugar phosphotransferase system has two sites of phosphorylation per dimer. AB - Enzyme I of the phosphoenolpyruvate: sugar phosphotransferase system of Escherichia coli has been reported to contain one phosphorylation site per dimer and thus operates by either a half of the sites or a flip-flop mechanism [Misset, O., & Robillard, G. T. (1982) Biochemistry 21, 3136-3142; Hoving, T., ten Hoeve Duurkens, R., & Robillard, G. T. (1984) Biochemistry 23, 4335-4340]. In this paper, the determination of two phosphorylation sites per dimer of enzyme I was made by using a number of different methods. In some experiments, less than two sites per dimer were found, but a concomitant loss in enzyme I activity was also found. The phosphorylated residue in enzyme I was shown to have the properties expected for a N3-phosphohistidinyl residue. PMID- 3527265 TI - Energetic consequences of multiple K+ uptake systems in Escherichia coli. AB - The energetics of growth of Escherichia coli FRAG 1 under potassium-limited growth conditions and with glucose as sole carbon and energy source were studied in the chemostat and compared with those of a mutant, FRAG 5, defective in the high-affinity potassium uptake system. The steady-state concentration of biomass decreased with increasing growth rate and was the same in both parent and mutant. For each growth rate, the rate of production of ATP was higher in the parent than the mutant strain. Under potassium-limited conditions, FRAG 1 has at least two potassium uptake systems, an inducible high-affinity uptake system and a constitutive low-affinity uptake system (Rhoads, D.B., Waters, F.B. and Epstein, W. (1976) J. Gen. Physiol. 67, 325-341). Apparently, the presence of the high affinity uptake system in the parent leads to an energy drain. We suggest that this energy drain is due to futile cycling of potassium ions. On the basis of a mosaic non-equilibrium thermodynamic description of bacterial growth, it is concluded that the growth behaviour under potassium limitation corresponds to that expected for a catabolite limitation. PMID- 3527266 TI - Na+-dependent p-aminohippurate transport at the basolateral side of the isolated perfused rat kidney. AB - The uptake of p-amino[3H]hippurate by isolated perfused rat kidney was studied to characterize the mechanism which was responsible for organic anion transport process. A rapid injection multiple indicator dilution technique and the distributed two-compartment model of Sawada et al. (Computer Methods Programs Biomed., 20 (1985) 51) were employed. Some characteristics of a carrier-mediated transport from the antiluminal space to the intracellular space for p aminohippurate at the basolateral side were demonstrated: the uptake was stimulated by the countertransport effect and showed Na+ dependency. These findings are consistent with p-amino[3H]hippurate's being taken up into the isolated rat basolateral membrane vesicle by Na+-dependent carrier-mediated transport (J. Pharmacol. Exp. Ther. 227 (1983) 122). It is suggested that the multiple indicator dilution technique is a sensitive new method to study the mechanisms of renal tubular transport in the living kidney as an organ. PMID- 3527267 TI - Cross-linking analysis of yeast mitochondrial outer membrane. AB - By enrichment of contact sites between the two mitochondrial boundary membranes it has been shown that this fraction contained a high activity of glutathione transferase and hexokinase which was bound to the outer membrane pore protein (Ohlendieck, K. et al. (1986) Biochim. Biophys. Acta 860, 672-689). Therefore, an interaction between the three proteins in the contact sites has been suggested. Cross-linking experiments with isolated outer membrane of yeast mitochondria show that glutathione transferase and the pore protein are already associated in the free outer membrane. Porin appeared to adopt four different oligomeric complexes in the membrane, including interactions with a 14 kDa polypeptide, which has glutathione transferase activity. The latter polypeptide could be phosphorylated by intrinsic or extrinsic protein kinases, while the porin itself was not phosphorylated. Yeast hexokinase, when bound to the outer membrane, was able to cross-link to the pore protein. PMID- 3527268 TI - Erythrocyte anion transport: the kinetics of a single-site obligatory exchange system. PMID- 3527269 TI - Transport of sugar nucleotides and adenosine 3'-phosphate 5'-phosphosulfate into vesicles derived from the Golgi apparatus. PMID- 3527270 TI - Inactivation of transforming activity of plasmid DNA by lipid peroxidation. AB - DNA damage due to NADPH-dependent lipid peroxidation of liposomes was examined using liposomes prepared from lipids, NADPH-cytochrome P-450 reductase and cytochrome P-450 isolated from rat liver microsomes. Plasmid pBR322 DNA was incubated in the reaction mixture for liposomal lipid peroxidation and introduced to Escherichia coli CSR603 (uvrArecA). More of the transforming activity of the DNA was lost as the lipid peroxidation progressed, and this inactivation was dependent on the extent of lipid peroxidation. Single strand breaks occurred in the plasmid DNA. Hydroxyl radical scavengers could not prevent most of the strand breaks or the lipid peroxidation reaction. Chloroform extracts from the reaction mixture of peroxidized microsomes also inactivated the transforming activity of pBR322 DNA but did not cause strand breaks. The 105 000 X g supernatant of the reaction mixture, which contained more than 85% of the thiobarbituric acid reactive substances, did not inactivate the plasmid DNA. The degradative products of [U-14C]arachidonic acid in the liposomes did not bind to DNA. These results led to the conclusion that at least two types of DNA damaging agent are produced during NADPH-dependent microsomal lipid peroxidation. One induces single strand breaks of DNA and another inactivates the plasmid-transforming activity without inducing strand breaks. PMID- 3527271 TI - Use of an antibody to characterize and determine the role of the major Met-tRNAf deacylase from rabbit reticulocyte ribosomes. AB - Inhibition of polypeptide chain initiation in rabbit reticulocyte lysate by phosphorylation of eukaryotic initiation factor-2(alpha) results, secondarily, in the enzymatic deacylation of Met-tRNAf on the 48 S initiation complexes that accumulate. We have prepared an antibody to a highly purified preparation of the major Met-tRNAf deacylase activity on rabbit reticulocyte ribosomes, termed deacylase II. Antibody, but not similarly purified normal IgG, completely neutralizes the activity of Met-tRNAf deacylase II and has no effect on Met-tRNAf deacylase I, a separate, minor, reticulocyte activity with the same substrate specificity but very different physical and enzymatic properties, strongly suggesting that deacylase I and II are distinct proteins. We partially purified Met-tRNAf deacylase activities from rabbit liver, myocardium and bone marrow ribosomes and found them to be similar to each other and to reticulocyte deacylase I in their enzymatic properties and insensitivity to anti-deacylase II, suggesting that deacylase I may be a general form of this enzyme, present in many cells, while deacylase II may be induced specifically during erythroid differentiation. Addition of the antibody to reticulocyte lysate incubated in the absence of hemin or presence of hemin plus 0.1 microgram/ml poly(I X C) did not reverse the inhibition of protein synthesis but did reduce the rate of turnover/utilization of Met-tRNAf and increase the level of Met-tRNAf bound to 48 S initiation complexes, demonstrating that the deacylase does not directly inhibit protein synthesis under these conditions but does mediate the deacylation, loss, and thus greater than expected turnover of Met-tRNAf in the 48 S complexes that accumulate. PMID- 3527272 TI - A biochemical comparison of glucosephosphate isomerase isozymes from Trypanosoma cruzi. AB - The glucosephosphate isomerase (D-glucose-6-phosphate Ketol-isomerase, EC 5.3.1.9) isozymes of Trypanosoma cruzi were characterized with respect to their native and subunit molecular size, isoelectric point and in vitro thermostability. The molecular weight data are consistent with a dimeric enzyme structure. The apparent native and subunit size homogeneity and differences in pI values imply that the electrophoretic mobility differences of isozymes in native gels are determined by their molecular charge. Minor differences in peptide maps indicate the existence of some heterogeneity in the primary structure of the isozymes. The stability of triple-banded glucosephosphate isomerase electrophoretic profiles was confirmed, supporting the view that these phenotypes represent non-interconvertible enzyme species. PMID- 3527273 TI - alpha 1-Antitrypsin Christchurch, 363 Glu----Lys: mutation at the P'5 position does not affect inhibitory activity. AB - alpha 1-Antitrypsin Christchurch was isolated from the plasma of a Cambodian woman who was heterozygous for this variant and for the normal M protein. Tryptic peptide maps revealed that the inhibitory-site peptide, 359-365 Ser-Ile-Pro-Pro Glu,Val,Lys, was missing and replaced by two new peptides Ser-Ile-Pro-Pro,Lys and Val-Lys, indicating a mutation of 363 Glu----Lys. There was no obvious clinical condition associated with this new antitrypsin. Competition experiments showed that antitrypsin Christchurch reacted at the same rate as normal antitrypsin in the presence of limiting amounts of trypsin, chymotrypsin, thrombin and neutrophil elastase. Both inhibitors were inactivated by catalytic amounts of papain. This inactivation was due to cleavage at the phenylalanine residue at the P7 position, seven residues towards the N-terminal of the inhibitory site. A one step ethanol extraction procedure is described for isolating the papain cleavage products. PMID- 3527274 TI - Purification of human plasma inactive renin by immunoaffinity chromatography on profragment-specific IgG. AB - Inactive renin was purified to apparent homogeneity from human plasma by ion exchange, gel filtration, Affi-Gel blue, immunoaffinity chromatography on profragment-specific IgG coupled to Sepharose, and preparative HPLC. By this method, a 460000-fold purification was obtained. The purified renin was totally inactive and was activated by trypsin. PMID- 3527275 TI - Effect of N-alkyl and C-alkylputrescines on the activity of ornithine decarboxylase from rat liver and E. coli. AB - N-Methyl-, N-ethyl-, N-propyl-, N-butyl-, N,N-dimethyl- and N,N' dimethylputrescines were assayed as inhibitors of ornithine decarboxylase (EC 4.1.1.17) from rat liver and from Escherichia coli. They were found to be poor inhibitors, with the exception of N-propylputrescine and N,N-dimethylputrescine, which were inhibitory at 25 mM. A homologous series of 1-alkylputrescines ranging from 1-methylputrescine (1,4-diaminopentane) to 1-heptylputrescine (1,4 diaminoundecane) was assayed for effect on the activity of ornithine decarboxylase from the same sources. 1-Methylputrescine (5 mM) inhibited the mammalian enzyme, while the higher homologues showed significantly less inhibitory activity. When assayed on the bacterial enzyme, 1-methylputrescine (5 mM) was not inhibitory, while the higher homologues showed inhibitory effects. At higher concentrations, 1-methylputrescine and 1-heptylputrescine were the best inhibitors of these series of rat liver ornithine decarboxylase. When 1 methylputrescine, 2-methylputrescine, 1,2-dimethylputrescine, 1,3 dimethylputrescine and 1,4-dimethylputrescine were assayed as inhibitors of the decarboxylase, 2-methylputrescine was found to be the best inhibitor of the rat liver enzyme, while 1,3-dimethylputrescine was the best inhibitor of the bacterial enzyme. 1,4-Dimethylputrescine (2,5-diaminohexane) did not inhibit the enzyme from either source. Both, 2-methylputrescine and 1-methylputrescine, as well as the 1,2- and 1,3-dimethylputrescines were competitive inhibitors of the enzyme, and a Ki of 1 mM was obtained for 2-methylputrescine when the rat liver decarboxylase was used. N-Methyl, 1-methyl and 2-methylputrescines were found to inhibit in vivo the activity of rat liver ornithine decarboxylase which had been previously induced by thioacetamide treatment. 2-Methylputrescine (50 mumol/100 g body weight) was found to be the best in vivo inhibitor (93% inhibition), while putrescine under similar conditions inhibited 56% of the enzymatic activity. PMID- 3527276 TI - Interaction of hepatic asialoglycoprotein receptor with asialoorosomucoid and galactolyzed lysosomal alpha-glucosidase. AB - An asialoglycoprotein receptor was isolated from murine liver and purified more than 1600-fold using 2-fold affinity chromatography on asialoorosomucoid Sepharose. The purified receptor did not interact with 125I-orosomucoid, but bound to 125I-asialoorosomucoid. The binding of the receptor to asialoorosomucoid was saturable. The dissociation constant of the receptor-asialoorosomucoid complex was 0.4 X 10(-9) M. The molecular mass of the receptor, as determined with the use of specific antibodies by the immunoblotting method, was 43 kDa. High concentrations of unlabeled asialoorosomucoid and of n-aminophenyl-beta-D galactosyl derivatives of bovine serum albumin, ovalbumin and acid alpha glucosidase from human liver inhibited the binding of the receptor to 125I asialoorosomucoid almost completely. The binding of the receptor to 125I galactolyzed alpha-glucosidase was pH-dependent, with the pH optimum at 8.0-9.0. It was shown that, as in the case of 125I-asialoorosomucoid, the binding of the 125I-galactosyl derivative of alpha-glucosidase occurred in the presence of Ca2+ and was inhibited by N-acetylgalactosamine. Glycoproteins containing galactose as a terminal residue inhibited the interaction of the receptor with 125I galactolyzed alpha-glucosidase. The possibility of directed transport of the galactolyzed alpha-glucosidase derivative into parenchymous liver cells using receptor-mediated endocytosis is discussed. PMID- 3527278 TI - Purification of rat adrenocortical actin and its use in an immunoprecipitation assay to quantitate cellular actin. AB - In an earlier study on the long-term effects of the pituitary hormone corticotropin (adrenocorticotropin, ACTH), we reported that ACTH promotes the loss of 20-25% of the total actin in isolated rat adrenocortical cells. In a continuation of this work, we report here the purification to near homogeneity of rat adrenal actin. We demonstrate that the protein purified is adrenal actin, and use this actin in the DNAase immunoprecipitation assay of Snabes et al. to confirm our earlier observation of the effect of ACTH on adrenocortical actin. Finally, we describe several changes made in the original protocol of this immunoassay which we believe significantly improve the accuracy of the assay in estimating actin contents in tissue and cell samples. PMID- 3527277 TI - Isolation and characterization of differentiated alveolar type II cells from fetal human lung. AB - A method has been developed for isolating differentiated type II cells from human lung of 18-24-week gestation. The procedure involves an initial 4-day culture of lung explants in the presence of dexamethasone (10 nM) and triiodothyronine (2 nM). Type II cells (and fibroblasts) are isolated by trypsin digestion of the explants, two differential adherence steps and incubation overnight in primary culture. This method provides a high yield of type II cells ((50 +/- 15) X 10(6) cells/g wet weight of explant) with a purity of 85 +/- 5% in 16 experiments. The type II cells contain numerous perinuclear granules which stain darkly with toluidine blue and Papanicolaou stain; electron microscopy showed these inclusions to be lamellar bodies with tightly stacked, well defined lamellae. Type II cells, but not fibroblasts, were positive by immunofluorescence histology for surfactant apoprotein and binding of Maclura pomifera lectin which binds to the surface of type II but not type I cells in vivo. The rate of both [3H]acetate and [3H]choline incorporation into phosphatidylcholine (PC) was several-fold greater in type II cells than fibroblasts; the saturation of PC was 36.2 and 25.9%, respectively. Release of saturated PC was stimulated by terbutaline, the ionophore A23187, and tetradecanoyl phorbol acetate in type II cells but not fibroblasts. We conclude that differentiated type II cells can be isolated in relatively high yield and purity from hormone-treated explants of fetal human lung. PMID- 3527279 TI - Effect of down-regulation and return of insulin receptors on glycogen synthesis in cultured rat hepatocytes. AB - The dependence of the regulation of insulin receptors by insulin on the time hepatocytes were maintained in culture and the relationship between the return of down-regulated receptors and glycogen synthesis from labelled glucose were investigated in primary cultures of adult rat hepatocytes. Insulin receptor numbers, but not ligand affinity, decreased significantly within the first 24 h of culture, even in the absence of insulin, and then returned to the immediate 'post-attachment' level during 24-48 h. Therefore, down-regulation of insulin receptors by 10 nmol/l insulin was only minor during the 1st day in culture, but amounted to 50% of control levels after the 2nd day, whereas the rate of insulin degradation remained unaltered throughout the entire period of culture. When down regulated monolayers were switched to insulin-free medium, receptors returned to control levels within 5-10 h. The reduced basal rate of glycogenesis as well as insulin-sensitivity and insulin responsiveness of this metabolic pathway also gradually increased to control levels. However, the time-dependent receptor return was dissociated from the increase in insulin-sensitivity, emphasising the importance of postbinding events. Since the changes both in basal rates and in insulin responsiveness of glycogenesis during the period of receptor return were inversely related to differences in the actual glycogen content between control and down-regulated cells, cellular glycogen content might participate in the regulation of glycogenesis as a 'feedback inhibitor'. PMID- 3527280 TI - Trace elements and antibacterial activity in amniotic fluid. AB - Antibacterial activity and trace element concentrations in amniotic fluid (AF) were determined in a population of 39 pregnant women in the second half of gestation. Antibacterial activity in each AF was measured by a spectrophotometric micromethod after 18 h incubation at 37 degrees C using Escherichia coli K 12 as a reference bacterium. Concentrations of zinc, iron, copper, calcium, potassium and bromine were measured by particle-induced X-ray emission method and the zinc concentration was also measured by atomic absorption spectrophotometry. Phosphate concentration was determined by direct albumin adding method. In AFs with good antibacterial activity significantly lower concentrations of potassium and bromine were found when compared to AFs with lower antibacterial activity. Concentrations of zinc, iron, copper, calcium or phosphate did not correlate with antibacterial activity in AF. PMID- 3527281 TI - The medieval garden. PMID- 3527282 TI - Genetics of schizophrenia: I. Familial patterns and mode of inheritance. AB - The purpose of this article is to review and condense the available literature on genetic modeling in schizophrenia research. The principles underlying genetic models and the various applications of these models to family data are reviewed. It is concluded that despite the advances in statistical genetics, the mode of inheritance of schizophrenia remains elusive. The conflicting results are attributed to variation in methods for data collection and analysis and to the heterogeneous nature of the disorder. The possibility is also raised that most previous genetic analyses of schizophrenia may have been compromised by methodological drawbacks. Although the use of advanced genetic models in conjunction with adequate data may shed more light on the genetic contribution to schizophrenia, the limitations of this approach in genetically heterogeneous disorders must be recognized. Alternative methods, such as studies with biological susceptibility traits and genetic markers, may be more useful in unraveling the specific genetic components that underlie the transmission of schizophrenia. PMID- 3527283 TI - Hammond and lithium: historical update. PMID- 3527284 TI - Expression of acrosin during mouse spermatogenesis: a biochemical and immunocytochemical analysis by a monoclonal antibody C 11 H. AB - A monoclonal antibody C 11 H was produced against human acrosomal antigen. It also cross-reacted with acrosomes of the boar and the mouse. In boar spermatozoa the antibody reacted, in immunoblotting analysis, with polypeptides of Mr 55,000 and 53,000. The proteolytic activity was detected by zymographic casein overlay assay. Partially purified boar sperm acrosin was bound by the C 11 H affinity column, and acrosin activity was detected in the eluate. These experiments indicate that C 11 H antibody recognizes sperm acrosin. The acrosin expression during spermatogenesis was studied with C 11 H antibody, using mouse testis as a model. Immunocytochemical analysis revealed that step 9 spermatids were the first cells to react with C 11 H antibody. During step 14, the perinuclear pattern of C 11 H-binding disintegrated into small particles around the spermatid nuclei for the period of close association between spermatid bundles and Sertoli cells. During late step 15, the antigen became located at the site in the acrosome typical for step 16 spermatids and spermatozoa. These results indicate that monoclonal C 11 H antibody recognizes acrosin that is first expressed in haploid cells coincident with the onset of nuclear elongation and cessation of RNA transcription. The changes in the distribution pattern suggest that acrosin may be modified by Sertoli cells. In addition to studies on acrosin, this antibody may be useful in investigations of transcription and translation and their regulation during spermatogenesis in general. PMID- 3527285 TI - The biology of puberty. PMID- 3527286 TI - The cortical magnification factor and photopic vision. PMID- 3527287 TI - A review of estimating animal abundance. AB - During the past 5 years there have been a number of important developments in the estimation of animal abundance and related parameters such as survival rates. Many of the new techniques need to be more widely publicized as they supplant previous methods. The aim of this paper is to review this literature and suggest further avenues for research. PMID- 3527289 TI - Hemopoietic stem cells "age" structure revealed by the exogenous colony forming method. AB - The number of colony forming units in mice following the transplantation of cells of bone marrow, spleen and embryonal liver, forming exogenous spleen colonies on 5, 8 and 11 days has been determined. It has been shown that stem cell subpopulation forming colonies on 5 day (CFUs-5) was notable for lower capacity for self maintenance, and contained predominantly by erythroid colonies, these CFUs-5 were mainly in embryonal liver and less in reduced in the hemopoietic populations in mice. PMID- 3527290 TI - Epidemiology and etiology of malignant melanoma. AB - According to recent cancer epidemiology reports malignant melanoma in both sexes and lung carcinoma in females, are the only cancers of which the incidence continuously increases. In Australia, Northern Europe and Canada the incidence doubling time of malignant melanoma has been 10 to 20 years only. The highest incidence has been found in the State of Queensland, Australia, with an incidence of 32/100,000 inhabitants per year in males and 33.4/100,000 in females. Moreover 1 of 3 persons is likely to develop skin cancer during life span in Queensland. The new habit of Whites to sun-bath in sunny regions of the world seems to be in close relationship with the increased incidence of malignant melanoma. In addition, the hazard of skin cancer is higher in the south of U.S.A. as compared with the north, where the UVB radiations is lower. Genetic factors seem to play a role in malignant melanoma. Patients having this tumour report sunburn and freckling in a 4 fold higher frequency than non melanoma patients. Chemicals such as psoralens; used as photosensitizers, synthetic steroids and probably some cosmetics, may act as error prone carcinogenic agents in the presence of hv from UV light. This field of skin toxicology and carcinogenesis leads into to the way of new developments in cosmetics, including the design of efficient skin protectors. Therefore, future efforts in preventing further increase of malignant melanoma incidence should take into account the following: UV irradiation is a causative factor of malignant melanoma; the evidence of genetic propensity at developing malignant melanoma.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3527291 TI - The alpha 2 cDNA sequence of human haptoglobin carries a bacterial promoter functional in vivo. AB - Various constructions of human haptoglobin (Hp) cDNA coding either for the complete alpha 2FS beta precursor protein or only for the beta subunit have been placed under the control of the lambda PR promoter in the bacterial expression vector pCQV2 (Queen, 1983). In addition to the expected 45,000 dalton polypeptide synthesized after induction of the PR promoter, the complete alpha 2FS beta constructions constitutively express a smaller polypeptide of approximately 30,000 dalton corresponding to a truncated Hp protein. Computer analysis of the HpcDNA revealed the presence of two strong potential bacterial promoters (alpha 2 PF and alpha 2 PS) located in the duplicated alpha 2FS sequence. Both Hp promoter signals are followed by potential mRNA start sites and ribosome binding sites at a compatible distance from initiation codons. In addition, the Hp alpha 2 cDNA sequence, when fused upstream to the cDNA coding for alpha 1-antitrypsin, constitutively promotes in vivo the efficient expression of an hybrid protein specifically recognized by antibodies raised against alpha 1-antitrypsin or haptoglobin. PMID- 3527288 TI - Bifilar enzyme-sensitive sites in ultraviolet-irradiated DNA are indicative of closely opposed cyclobutyl pyrimidine dimers. AB - Incubation of UV-irradiated DNA with pyrimidine dimer-DNA glycosylase in cell free lysates prepared from Micrococcus luteus results in the appearance of double strand breaks. It has previously been assumed that such double-strand breaks result from cleavage at closely opposed dimers. We have used hybrid molecules of bacteriophage T7 DNA comprised of two unirradiated strands, two UV-irradiated strands, or one unirradiated and one UV-irradiated strand to test this hypothesis. Bifilar cleavage was observed only with molecules consisting of two irradiated strands and no bifilar cleavage was observed after the monomerization of pyrimidine dimers by enzymatic photoreactivation. Our results indicate that at least 80% of the double-strand breaks result from cleavage at closely opposed dimers and that the induction of dimers in one strand does not influence the induction of dimers at closely opposed positions in the complementary strand of a DNA double helix. PMID- 3527292 TI - A radioimmunocytological quantitative method for the rapid detection of ras oncogene p21 protein in mammalian cells. AB - In order to provide a sensitive and quantitative detection method of ras p21 at the cytological level, the monoclonal antibody Y13 259 and iodinated protein A were used to locate the ras protein in various mammalian cell lines. The subsequent autoradiograph can be analysed by a computer-assisted system which showed in these reported experiments that the relative levels of p21 detected in these cells corresponded to results obtained earlier using conventional biochemical methods. PMID- 3527293 TI - DNA cytosine methylation and heat-induced deamination. AB - The heat-induced conversion of 5-methylcytosine (m5C) residues to thymine residues and of cytosine to uracil residues in single-stranded DNA was studied. The calculated rates for deamination at 37 degrees C and pH 7.4 were approximately 9.5 X 10(-10) and 2.1 X 10(-10) sec-1, respectively. N4 Methyldeoxycytidine, which is in the DNA of certain thermophilic bacteria, was more heat-resistant than was deoxycytidine and much more than was 5 methyldeoxycytidine. Thermophilic bacteria which contain N4-methylcytosine rather than m5C in their genomes may thereby largely avoid heat-induced mutation due to deamination, which is incurred by the many organisms that contain m5C in their DNA. PMID- 3527294 TI - Glycogen: a metabolic viewpoint. PMID- 3527295 TI - Insulin binding to rat intestinal epithelial cells following partial small-bowel resection. AB - Partial (60%) resection of rat small bowel was performed in order to obtain a model of intestinal mucosal hyperplasia for studying specific insulin binding. The affinity, but not the binding capacity, of insulin receptors in the adaptive mucosa decreased three and seven days following enterectomy. This modification took place only in crypt cells but not in mature villous cells. Since plasma insulin levels were not altered by the surgical manipulation, the observed decrease of insulin binding could not be related to regulation by insulin concentration. These results do not support a trophic role of insulin on intestinal mucosa and appear to be more a consequence of the hyperactive status of proliferation and differentiation at the mucosal level. PMID- 3527296 TI - Time dependent effect of indomethacin on the stimulation of protein synthesis in isolated rabbit muscle by insulin. AB - Insulin (100 microU/ml) stimulated protein synthesis and PGF2 alpha release in isolated rabbit muscle, but had little effect on the rate of protein degradation. The effect of insulin persisted for at least 5 h after removal of the hormone. Indomethacin, added at the start of the incubation, inhibited the stimulatory effect of insulin on protein synthesis and PGF2 alpha release, but did not block the binding of iodinated insulin. When added 2 h after insulin, indomethacin did not inhibit the stimulation of protein synthesis but completely inhibited the increase in PGF2 alpha release. The results suggest that the stimulation of protein synthesis by insulin is mediated by metabolites of membrane phospholipids but that these changes are involved during the phase of response that immediately follows the binding of insulin to its receptor. PMID- 3527297 TI - [Regulation of human respiration during excessive intrapulmonary pressure]. PMID- 3527299 TI - [Monoclonal antibodies to different antigens of skin epithelium obtained by immunizing mice with streptococcus group A antigens]. AB - Monoclonal antibodies (MCA) were obtained by immunization of BALB/c mice with streptococcal group A protein antigens of the cellular wall, or with whole microbial cells. In immunofluorescence test, MCA react with different skin epithelial structures (basal, suprabasal or all the epidermal layers). The majority of MCA belong to autoantibodies. The same MCA revealed no cross reactions with streptococcal antigens in immunoenzyme and inhibition tests. MCA reacting with epithelial cells are, apparently, obtained as a result of polyclonal activation of the autoreactive clones by streptococcal antigens. PMID- 3527298 TI - [Effect of the proteolysis of low-density serum lipoproteins on their interaction with macrophages]. AB - 125I-labelled human serum low density lipoproteins (LDL) were incubated with cultured mouse peritoneal macrophages at 37 degrees C, with the following study of cellular uptake and 125I-LDL degradation by measuring the content of TCA soluble products of LDL hydrolysis in the cultural medium. It was shown that limited pepsin proteolysis of LDL (10%) led to a more effective LDL uptake and degradation by macrophages. The data suggest that enzyme-induced modification of LDL may increase their atherogenicity. PMID- 3527300 TI - [Stimulation of phagocytic function by factors inhibiting leukocyte and macrophage migration in humans]. AB - Fractions containing macrophage migration inhibition factor (MIF) and leucocyte migration inhibition factor (LIF) were obtained using Sephadex G-200 filtration from supernatant fluids of human lymphocyte cultures stimulated by PHA. The fractions were tested for the ability to affect migration and phagocytic activity of target cells. Peripheral blood leucocyte migration capacity was inhibited by the fraction with the molecular mass of 60,000-70,000 D (LIF), while migration activity of mouse peritoneal exudate cells was suppressed by the fraction with the molecular mass of 20,000-30,000 D (MIF). MIF- and LIF-containing fractions increased almost three-fold Fc-receptor-mediated phagocytic activity of neutrophils. PMID- 3527301 TI - [Immunostimulant properties of aspartic acid]. AB - The experiments on mice have shown that aspartic acid and aspartic acid containing functionally different agents (panangin, thymopentin, pentagastrin) promoted the in vitro differentiation of bone marrow T-precursors into T lymphocytes and stimulated the in vivo immune response to SRBC. At the same time aspartic acid and panangin had no effect on the immune response to thymus independent Vi-antigen. PMID- 3527302 TI - Clonable T lymphocytes in T cell-depleted bone marrow transplants correlate with development of graft-v-host disease. AB - Early clinical trials using T lymphocyte-depleted human marrow for transplantation have reported that such grafts reduce, to varying degrees, both the incidence and the severity of graft-v-host disease (GVHD). However, to date, no clear estimates have been made as to what degree of T cell depletion is necessary to prevent GVHD in every case. To address this problem, we used a limiting dilution assay (LDA) to quantitate residual clonable T lymphocytes in human T cell-depleted bone marrow in 31 HLA-identical transplants for leukemia. The number of phytohemagglutinin -interleukin 2-responsive T lymphocytes determined by LDA and expressed as T cell per kilogram recipient weight was found to correlate with the subsequent development of GVHD: no patients who received less than 1 X 10(5) T cell per kilogram developed GVHD (N = 24). Of the seven patients who received 1 X 10(5) to 4.4 X 10(5) T cell per kilogram, four patients developed grade I or II skin GVHD. This study thus provides a quantitative estimate of the number of T lymphocytes necessary to initiate clinically detectable GVHD in an HLA-identical host. PMID- 3527303 TI - Absence of tubular structures and immunolabeling for von Willebrand factor in the platelet alpha-granules from porcine von Willebrand disease. AB - The electron microscopic localization of von Willebrand factor (vWF) was studied in platelets from normal and von Willebrand disease (vWD) pigs. In normal pig platelets, immunolabeling for vWF was far more intense and extensive than in human platelets and was either localized at one pole of the alpha-granule or all along its periphery or long axis. As in human platelets, this immunolabeling coincided with the presence of tubules about 200 nm in diameter. These structures were more numerous than in human platelets, with up to 30 tubules per alpha granule. They were easily identified either in transverse sections, usually grouped in a less electron-dense part of the matrix at one pole of the alpha granule, or in longitudinal sections parallel to the long axis of the elongated granules, or coiled around the alpha-granule core. They closely resemble those structures found in Weibel-Palade bodies. In platelets from pigs with severe vWD, these structures were absent, as was the immunolabeling for vWF; however, cytoplasmic microtubules were normally present in these platelets. Thus, the granule-associated tubules can be distinguished from the microtubules, which are larger in diameter (250 nm), are present in both normal and vWD platelets, and do not stain for vWF. These results strongly suggest that the tubular structures present in the alpha-granules of normal porcine platelets correspond to the vWF molecule itself. PMID- 3527304 TI - Aromatase inhibitors for treatment of breast cancer: current concepts and new perspectives. AB - Estrogens provide the major hormonal support for endocrine-dependent human mammary neoplasms. In postmenopausal women, the extraglandular aromatization of the adrenal prehormone, androstenedione to estrone is the major pathway for estrogen biosynthesis. Estrone can then be converted into estradiol or into an inactive conjugate, estrone sulfate. Recent data suggest that the estrogens may also be synthesized in situ by human breast tumors, either from androstenedione via aromatase, or from estrone sulfate via the enzyme, sulfatase. Our enzyme kinetic studies support the predominance of the sulfatase pathway for in situ estrogen biosynthesis. The ability of estrone sulfate to stimulate colony formation of the nitrosomethylurea-induced rat mammary tumor in the clonogenic assay, suggests that this in situ pathway has biologic relevance. Aromatase inhibitors can be used to suppress the levels of circulating estrone, estrone sulfate, and estradiol in postmenopausal women. Aminoglutethimide, the major inhibitor currently used clinically, acts in a competitive fashion and blocks cholesterol side chain cleavage and 11 beta-hydroxylase as well as aromatase. Clinical studies indicate that the combination of aminoglutethimide plus replacement glucocorticoid causes breast tumor regression with the same frequency and for the same duration as surgical ablative therapies such as adrenalectomy or hypophysectomy. Aminoglutethimide also induces a similar rate of tumor regression as achieved with the antiestrogen, tamoxifen. However, because tamoxifen is associated with fewer side effects, this antiestrogen is to be preferred over use of aminoglutethimide as first-line hormonal treatment for women with breast cancer. Several specific suicide inhibitors of aminoglutethimide such as 4 hydroxy-androstenedione are being developed and have proven effective in early clinical trials with breast cancer patients. Further development of active aromatase inhibitors should allow precise control of estradiol levels in women with breast cancer. This ability to perform an 'estrogen clamp' may allow new strategies to be developed in which hormone depletion followed by repletion can produce a synchronization of tumor cell DNA synthesis. If achievable, such manipulations may allow potentiation of the effects of cytotoxic chemotherapy. This latter concept is currently being rigorously tested in basic and in clinical investigative studies. PMID- 3527305 TI - A double blind randomised clinical trial of adjuvant aminoglutethimide versus placebo given to post menopausal patients with histologically confirmed stage II breast cancer. AB - A multicentre double blind trial is underway to evaluate aminoglutethimide (AG) (Orimeten, Ciba) 1.000 mg/day with hydrocortisone (HC) 20-40 mg/day versus placebo for adjuvant treatment of post menopausal patients with histologically confirmed stage II breast cancer. An interim analysis in February 1985 indicates that of 338 patients randomised 165 received AG + HC and 173 received placebo. At this time 143 AG + HC patients and 141 placebo patients were eligible and assessible for analysis. Of those who received AG + HC 41 have developed metastases and 27 died compared to placebo patients, 53 of whom have developed metastases (p = 0.04) and 34 have died (p = 0.21). These results are similar to the reported advantages for adjuvant tamoxifen given for stage II breast cancer. PMID- 3527306 TI - Combined endocrine treatment of postmenopausal patients with advanced breast cancer. A randomized trial of tamoxifen vs. tamoxifen plus aminoglutethimide and hydrocortisone. AB - The therapeutic efficacy of combined endocrine therapy with tamoxifen, aminoglutethimide and hydrocortisone (T+AG+H) was evaluated against treatment with tamoxifen (T) alone in 210 patients above 65 years of age with metastatic breast cancer. The treatment results have been assessed for the 166 fully evaluable patients and were the following for the T and T+AG+H groups, respectively: PD: 31 and 35%; NC: 35 and 37%; PR: 13 and 16%; and CR: 21 and 12%. The overall treatment results are not statistically different (p = 0.35) and the 95% C.L. of the difference of the response rates are -8% to +20%. The median duration of remission was approximately 24 months in both treatment groups (p = 0.31). The time to treatment failure was comparable with median values of 10 and 8 months in the T and the T+AG+H groups respectively (p = 0.17). Toxicity was more frequent and severe in the combined treatment group and could in most instances be attributed to treatment with AG+H. In conclusion, the simultaneous use of T and AG and H does not seem to improve the therapeutic results in postmenopausal patients with advanced breast cancer. PMID- 3527307 TI - Steroid hormone receptors as prognostic indicators in primary breast cancer. AB - Recurrence-free survival (RFS) has been evaluated with regard to estrogen and progesterone receptor (ER and PgR) status for 145 postmenopausal women with primary breast cancer at high risk for recurrent disease. All patients received only local-regional therapy as an adjuvant therapy (DBCG protocol 77-c patients). ER+ patients had a significantly longer RFS than ER-patients. This difference was apparent using a cut-off level of 10 fmol/mg cytosol protein to distinguish between ER+ and ER-patients. There was no apparent difference in patients with high (greater than = 100 fmol/mg cytosol protein) ER levels vs. those with intermediate (10-99 fmol/mg cytosol protein) levels, indicating that the prognostic value of ER determinations in the natural course of the disease resides in a qualitative rather than a quantitative distinction among patients. No difference in RFS was found patients when patient were subdivided according to PgR status. The clinical applicability of the ER-ICA assay method for ER determinations is demonstrated in a subset of patients, some of whom received adjuvant endocrine therapy. PMID- 3527308 TI - Sub-chronic effect of DDT on humoral immune response in mice. PMID- 3527310 TI - IAIMS and the library at the University of Utah. AB - The formal creation of an Integrated Academic Information Management System (IAIMS) at the University of Utah began in the fall of 1983. The keystone of the IAIMS effort is the HELP hospital information system. IAIMS at the University of Utah is a broad-based program extending across the Health Sciences Center and beyond to health professionals throughout the inter-mountain area. This paper describes the background that led to IAIMS, the IAIMS planning process, and the library's participation in this effort. PMID- 3527309 TI - The bright thread: the Bulletin's 75th anniversary. AB - This chronological review of the Bulletin of the Medical Library Association deals with the years 1911 through 1985. The Bulletin has had nineteen editors, from Marcia C. Noyes and John Ruhrah, M.D. (1911-26), through Susan Crawford, Ph.D. (1983-1986). This paper describes the Bulletin's gradual expansion in size and contents, the initiation of various departments and sections, and some of the pioneering articles. Major steps in expenses, income, and subscription price are given. Important changes in the format and the growth of the administrative and advisory structures are covered. PMID- 3527311 TI - IAIMS at Columbia: a strategic plan and model project. AB - This report describes the Integrated Academic Information Management System (IAIMS) prototype project at the Columbia-Presbyterian Medical Center, the factors that led to the selection of this particular project, and the planning for its implementation. The lessons learned to date and implications for the library are summarized. PMID- 3527312 TI - Beyond the library: IAIMS at Georgetown University. AB - The strategic planning process and the pilot phase projects undertaken by Georgetown University for an Integrated Academic Information Management System (IAIMS) are described. Emphasis is placed on core services such as a local area network, an academic information management center in the library, and expansion of health sciences databases for improved access to biomedical information. Special applications in education and clinical care are highlighted. The library, a key to IAIMS activities, has emerged in a leadership role at Georgetown. PMID- 3527313 TI - The IAIMS initiative at the University of Maryland at Baltimore. AB - With support from the National Library of Medicine, the University of Maryland at Baltimore is creating an Integrated Academic Information Management System (IAIMS) that will serve as a prototype for academic health centers. A campus-wide undertaking, the IAIMS initiative at Maryland is characterized by its functional comprehensiveness and its planning model. The resulting strategic plan is serving as a guide in the ongoing model development within an interdisciplinary Hypertension Center. PMID- 3527314 TI - Judith R. Messerle. President, Medical Library Association 1986-1987. PMID- 3527315 TI - Carcinoid syndrome. Radiology. AB - The carcinoid syndrome is usually produced by an ileal carcinoid tumour that has metastasized to the liver but can also be caused by similar tumours in many other organs. These neoplasms create a variety of radiological appearances which are often characteristic. In recent years percutaneous embolization of hepatic carcinoid metastases has been successfully employed as part of the treatment of the syndrome. PMID- 3527316 TI - Developments in dialysis for acute renal failure. AB - Although the complication of acute renal failure may occur in all types of medical and surgical patients, many clinicians still treat it using the conservative methods of management first described over 30 years ago. Active management, with early dialysis and adequate nutrition, keeps the patient in the best possible condition so that sufficient time for recovery of renal function is allowed. Many refinements in dialysis technique have occurred and some of these are described below. PMID- 3527317 TI - Radiology of inflammatory bowel disease. AB - Plain radiographs and barium studies remain the primary imaging procedures in patients with known or suspected Crohn's disease or ulcerative colitis. The newer imaging modalities such as radionuclide studies, ultrasound and angiography have an important role in selected cases. PMID- 3527318 TI - Aspirin and ischaemic heart disease. PMID- 3527320 TI - Breast scintigraphy with 99mTc-diethylene triamine penta-acetic acid for the detection of malignant disease. AB - A single-blind prospective study of 99mTc-diethylene triamine penta-acetic acid (DTPA) breast scintigraphy was performed on 160 women who presented at the outpatient clinic with suspected breast tumour. The sensitivity of scintigraphy in establishing the diagnosis of breast cancer was 75 per cent. The specificity of scintigraphy in excluding the presence of breast cancer was 91 per cent. The diagnostic value of DTPA breast scintigraphy is at present too low in comparison with mammography to be clinically useful. PMID- 3527319 TI - Isolation and contractile responses of single pregnant rat myometrial cells in short-term primary culture and the effects of pharmacological and electrical stimuli. AB - A modified method for enzymatically isolating myometrial cells from the pregnant rat has been developed and the mechanical properties of single cells in short term primary culture have been studied in response to various stimuli. The dissociation method produced a high proportion of fully relaxed cells and these cells shortened and subsequently relaxed completely in response to successive applications of acetylcholine, angiotensin II, high K+ solution or depolarizing current. In single cells, the contractions induced by acetylcholine and high K+ solution were concentration-dependent. Maximal contractions were obtained with 135.6 mM K+ and 5 X 10(-4)M acetylcholine. In single myometrial cells, the time course of contractions induced by acetylcholine, high K+ solution or depolarizing current was similar, suggesting that the rate of shortening was determined by limits of the contractile mechanism. Scanning electron microscopy revealed a smooth surface to the relaxed cells which contrasted with the numerous evaginations present on fully contracted cells. These results demonstrate the retention of structural integrity, acetylcholine and angiotensin II receptors, and potential-dependent Ca channels in myometrial single cells in short-term primary culture. Cells produced by this technique may provide a useful model for detailed electrophysiological studies. PMID- 3527321 TI - A randomized clinical trial of oral ursodeoxycholic acid in obstructive jaundice. AB - Forty patients with obstructive jaundice (bilirubin greater than 100 mumol/l) were entered into a randomized trial of oral ursodeoxycholic acid for 48 h before surgery versus no additional therapy. Pre-operative venous and operative portal total bile salt concentrations were higher in the bile salt treated patients (P less than 0.001). Portal endotoxaemia during operation was reduced in ursodeoxycholic acid treated patients (P less than 0.05). There was no significant difference in systemic venous endotoxaemia, renal function or postoperative morbidity or mortality. This study suggests pre-operative oral bile salt therapy may be of no clinical benefit in patients with obstructive jaundice. PMID- 3527322 TI - Knotting in continuous mass closure of the abdomen. PMID- 3527323 TI - Childhood epidemiology. Perspective and patterns. PMID- 3527324 TI - Current epidemiology of childhood infections. PMID- 3527325 TI - Childhood epidemiology. Physical development. PMID- 3527326 TI - Vision in childhood. PMID- 3527327 TI - Respiratory disease in the neonatal period. PMID- 3527328 TI - Respiratory disease in childhood. PMID- 3527329 TI - The epidemiology of hypertension in children. PMID- 3527330 TI - Childhood epidemiology. Gastro-intestinal tract. PMID- 3527331 TI - Urogenital malformations and disease. PMID- 3527332 TI - Endocrine disorders: diabetes mellitus, congenital hypothyroidism, and congenital adrenal hyperplasia. PMID- 3527333 TI - The haemopoietic system in childhood. PMID- 3527334 TI - Musculo-skeletal disorders in childhood. PMID- 3527335 TI - The epidemiology of adolescent behaviour problems. PMID- 3527336 TI - Child health and the environment. PMID- 3527337 TI - Childhood epidemiology. Prevention and health promotion. PMID- 3527338 TI - Enhanced long-term potentiation induced in rat dentate gyrus by coactivation of septal and entorhinal inputs: temporal constraints. AB - High-frequency activation of the entorhinal cortical (perforant path) inputs to the rat dentate gyrus can produce a long-term potentiation (LTP) of perforant path-dentate evoked responses. In this paper we examined the enhanced LTP effects produced by coactivation of septal and entorhinal inputs to the dentate gyrus. Trains of electrical stimulation applied to the two inputs were found to increase the magnitude of LTP to a level above that produced by trains applied to the perforant path alone. The largest LTP increments were observed when the septal trains were applied less than 100 ms prior to the perforant path trains. If the septal trains followed the perforant path trains there was no additional increment in LTP magnitude, regardless of the intertrain interval. The relationship of this cooperativity effect to mechanisms of associative learning is discussed. PMID- 3527339 TI - The effects of L-DOPA on regional cerebral glucose utilization in rats with unilateral lesions of the substantia nigra. AB - Using [14C]2-deoxyglucose autoradiography, we have studied the effects of systemically administered L-DOPA (10, 25 and 50 mg/kg s.c.) on regional cerebral glucose utilization (RCGU) in rats with unilateral substantia nigra lesions. In comparison with lesioned rats treated with saline, the lesioned-DOPA treated rats demonstrated contralateral turning and RCGU changes in both ipsilateral and contralateral brain regions. L-DOPA treatment markedly increased RCGU in the ipsilateral entopeduncular nucleus (EP) and substantia nigra pars reticulata (SNr), cell groups that receive direct striatal input and function as major outflow pathways of corpus striatal activity. In contrast, L-DOPA did not alter RCGU in the globus pallidus (GP), supporting the thesis that dopamine (DA) has different effects on striatal outflow to the GP compared with outflow to both the EP and SNr. Moderate RCGU increases were observed in the ipsilateral subthalamic nucleus (STN), lateral midbrain reticular formation (LMRF), and deep layers of the superior colliculus (DLSC), all regions which receive direct projections from the GP, EP or SNr. L-DOPA decreased RCGU in the ipsilateral lateral habenular nucleus (LHN) and increased RCGU in the contralateral LHN, changes that we suggest are mediated via altered neuronal activity in the striatum and EP. The results suggest that systemically administered L-DOPA, after conversion to DA in the brain, interacts with supersensitive DA receptors in the DA-depleted striatum to selectively activate efferent pathways. Furthermore, the data suggest that the LMRF and DLSC are functionally activated during L-DOPA induced turning and support the hypothesis that nigroreticular and nigrocollicular projections are of physiologic significance in the expression of striatal activity. PMID- 3527340 TI - Coexistence of enkephalin- and serotonin-like substances in single small intensely fluorescent cells of the guinea pig superior cervical ganglion. PMID- 3527342 TI - Hypothalamic circuits and circadian rhythms: effects of knife cuts vary with their placement within the suprachiasmatic area. AB - The suprachiasmatic nucleus (SCN) of the hypothalamus and its efferent projections are necessary for the generation of circadian rhythms. To further investigate the role of SCN connections in the generation of behavioral rhythms, intact and blinded-castrated male rats housed in constant conditions were given horizontal knife cuts aimed dorsal to the SCN, or sham surgery. Rhythms of locomotor activity and drinking behavior were monitored using a microcomputer. Cuts that spared the SCN failed to abolish rhythms. Effects of cuts that damaged the SCN ranged from changes in period length of the rhythms to abolition of drinking rhythms. These and previous results indicate that connections between the SCN and the paraventricular nucleus of the hypothalamus are not necessary for the expression of behavioral rhythms. PMID- 3527341 TI - Enduring changes in brain and behavior produced by chronic amphetamine administration: a review and evaluation of animal models of amphetamine psychosis. AB - Some people who repeatedly use stimulant drugs, such as amphetamine (AMPH), develop an AMPH-induced psychosis that is similar to paranoid schizophrenia. There has been, therefore, considerable interest in characterizing the effects of chronic stimulant drug treatment on brain and behavior in non-human animals, and in developing an animal model of AMPH psychosis. A review of this literature shows that in non-human animals chronic AMPH treatment can produce at least two different syndromes, and both of these have been proposed as animal models of AMPH psychosis. The first syndrome is called 'AMPH neurotoxicity', and is produced by maintaining elevated brain concentrations of AMPH for prolonged periods of time. AMPH neurotoxicity is characterized by what has been termed 'hallucinatory-like' behavior, which occurs in association with brain damage resulting in the depletion of striatal DA and other brain monoamines. The second syndrome is called 'behavioral sensitization', and is produced by the repeated intermittent administration of lower doses of AMPH. Behavioral sensitization is characterized by a progressive and enduring enhancement in many AMPH-induced behaviors, and is not accompanied by brain damage or monoamine depletion. It is argued that the changes in the brain and behavior associated with the phenomenon of behavioral sensitization provide a better 'model' of AMPH psychosis than those associated with AMPH neurotoxicity. Much of the review involves a critical analysis of hypotheses regarding the biological basis of behavioral sensitization. Research on this question has focused on mesotelencephalic DA systems, and suggestions that behavioral sensitization is accompanied by: an increase in postsynaptic DA receptors; an increase in DA synthesis; an increase in DA utilization and/or release; and a decrease in DA autoreceptors, are evaluated. It is concluded that there is not convincing evidence for an increase in postsynaptic DA receptors or in DA synthesis in animals sensitized to AMPH. In contrast, there is strong evidence to support the notion that behavioral sensitization is due to enhanced mesotelencephalic DA release, especially upon re exposure to the drug. The evidence that this enhancement in DA release is due to autoreceptor subsensitivity was found to be equivocal, and therefore other hypotheses should be entertained. Lastly, evidence is discussed in support of the idea that behavioral sensitization is not unique to the psychopharmacology of stimulant drugs, but may be produced by many environmental stimuli that directly or indirectly activate brain catecholamine systems.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3527343 TI - Dr. Robert Levet: an obscure practiser in physic. PMID- 3527344 TI - Gun money--owning a piece of history. PMID- 3527345 TI - [Obituary of Rene Sauvage (1896-1985)]. PMID- 3527346 TI - [Analphalipoproteinemia and cardiovascular risk. Case of Tangier disease]. PMID- 3527348 TI - [Lung, mirror of iatrogenic diseases. Example of amiodarone]. PMID- 3527347 TI - [Senegalese experience with the efficacy of ivermectin (MK 933) in the treatment of human onchocerciasis (double-blind comparative study with diethylcarbamazine citrate) (DEC.C)]. PMID- 3527349 TI - [Idiopathic habitual abortions (role of immunity)]. PMID- 3527350 TI - [Hemodynamic consequences caused by the vascular short-circuit in arteriovenous malformations of the brain in man]. PMID- 3527351 TI - [Quantitative measurement of postprandial exchanges of urea and ammonia nitrogen between the digestive tract and portal blood in the pig]. PMID- 3527352 TI - [Future prospects for the diagnosis and treatment of adenocarcinoma of the pancreas]. PMID- 3527353 TI - [Recent changes in obstetric outcome and modification of maternal age]. PMID- 3527354 TI - [Obituary of Paul Padovani 1903-1985]. PMID- 3527355 TI - [National opinion poll on cerebrovascular accidents. Paul Padovani survey]. PMID- 3527356 TI - [The fibroblast and its differentiations]. PMID- 3527357 TI - [Distribution of cigarette consumption in 15 to 65-year-old men and women in 1984]. PMID- 3527358 TI - [Effects of ethanol on the neural regulation of pancreatic secretion in the dog]. PMID- 3527359 TI - [Clinical evaluation of hospital activity]. PMID- 3527360 TI - [Value and limits of bronchial biopsy in asthmatics]. PMID- 3527361 TI - [Detection of atherogenic hyperlipoproteinemias in childhood: key step in the prevention of premature atherosclerosis (study of 752 children from 312 families)]. PMID- 3527362 TI - [Malignancy of villous tumors of the large intestine]. PMID- 3527363 TI - [Mode of expression of coronary cardiopathies and personality profile]. PMID- 3527364 TI - [Restricted diet and diabetes mellitus]. PMID- 3527365 TI - [The law will no longer protect medical secrets in a few years]. PMID- 3527366 TI - [Introductory remark (50th anniversary of the death of Charles Nicolle 1866 1936)]. PMID- 3527368 TI - [Thoughts and personality of Charles Nicolle]. PMID- 3527367 TI - [Charles Nicolle and the results of his scientific thoughts]. PMID- 3527369 TI - [Human vaccination against brucellosis (Charles Nicolle)]. PMID- 3527370 TI - [The work of Charles Nicolle in protozoology]. PMID- 3527371 TI - [Dobutamine in vascular surgery]. AB - The hemodynamic parameters of 12 patients operated on not a coronary vascular disease have been controlled by means of not invasive technic. The aortic output was measured by means of an oesophageal probe that associates echography and Doppler effect. A double blinded study was done by dividing the patients into two groups. The group 1 was subjected to a perfusion of dobutamine and the group 2 to a perfusion of a placebo during the operation. The group 1 showed a mean aortic output similar-level than before anesthesia one (3.40 +/- 0.61 l/min; 3.35 +/- 0.5 l/min) and 37% greater than group 2 (p less than 0.01), during operation period. The average systolic volume of group 1 was nearly similar at the initial one (46.5 +/- 12.92 ml; 40.8 +/- 8.2 ml) and 35% higher than group 2 (p less than 0.01). The cardiac frequency was higher (average 14 beats per minute) in the group 1 (p less than 0.01). The total systemic vascular resistance of group 1 were maintained in equilibrium and did not show any significative change. In opposition, group 2 showed a 207% increase in their vascular resistance, in relation to the initial values (p less than 0.01). These values were significatively higher that those of the group 1 (p less than 0.00). Mean diuresis was of 144 +/- 41.5 ml/h for group 1 and 43.6 +/- 10.9 ml/h for group 2 (p less than 0.001). In group 2 the H+ concentration increased from 33 to 39 nmol/l (p less than 0.01) and it was higher (p less than 0.01) than group 1.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3527372 TI - [Anesthesia for keratoplasty]. PMID- 3527373 TI - Large strongyles. Recent advances. AB - This review cites recent advances in the knowledge pertaining to infections of large strongyles in equids. Emphasis is placed on Strongylus vulgaris and attention is focused on pathogenesis of clinical manifestations of infections and treatment and control, including chemotherapy of migrating larvae and drug resistance. PMID- 3527374 TI - Small strongyles. Recent advances. AB - The recent increased interest in cyathostomes can be traced to simplification of their taxonomy, improved knowledge of pathogenicity, and failures of practical control due to anthelmintic resistance. Cyathostome ova develop to infective third-stage larvae (L3) at a rate that is directly proportional to environmental temperature. Equine feces serve as a reservoir for L3, which are liberated by moderate amounts of rainfall. Third-stage larvae persist for longer periods at low temperatures, easily surviving over-winter on pastures to provide a source of infection during the following grazing season. Third-stage larvae exsheath within the host and enter the mucosa and submucosa of the cecum and large colon. Larvae develop within mucosal cysts, molt to the fourth stage, and may persist within the tissues for up to 2 1/2 years. Larvae ultimately emerge from the mucosa to become adults in the lumen. Adult populations are replenished by recently ingested larvae and by immature worms newly emerged from arrested development. The magnitude of larval and adult populations within the host displays seasonal variations, with peak numbers occurring in early spring and autumn in the United States. In typical natural infections, a small number of species comprise the majority of the cyathostome populations. Cyathostome infection may result in anorexia, weight loss, diarrhea, colic, and death. Cyathostome ova are easily detected in feces, but ova may not be present during larval cyathostomiasis. Increased concentrations of beta-globulins, hypoalbuminemia, anemia, and leukocytosis occur inconsistently. Two major problems in the treatment of cyathostome infections are anthelmintic resistance and the insusceptibility of encysted larvae to recommended dosages of most anthelmintics. The major goal of cyathostome control is prevention of environmental contamination with nematode ova. Host resistance appears to protect against cyathostome disease rather than cyathostome infection, and one manifestation of this resistance appears to be prolongation of the prepatent period. PMID- 3527376 TI - Epidemiology and control of parasites in northern temperate regions. AB - The serious and widespread problem of drug resistance has forced a re-thinking of basic philosophy regarding control of equine parasites. It has illustrated the dangers of total reliance on chemical control and stimulated the use of alternate strategies. Two new approaches are described. Prophylactic treatments in the spring and summer provide effective strongyle and colic control with less selection pressure for drug resistance. A nonchemical approach of pasture cleaning twice a week offers the same advantages with the added bonus of a 50 per cent increase in grazing area. PMID- 3527375 TI - Ascarids. Recent advances. AB - P. equorum is a common and ubiquitous parasite that persists for many years in stables and on pasture in spite of good hygiene and anthelmintic control programs. Foals are usually infected early in life. During the migratory phase of the infection, clinical signs include coughing and a nasal discharge followed by depression and unthriftiness as the worms mature in the gut. Some foals die as a result of intestinal impaction or rupture. Patency is established around 3 months of age, and fecal egg counts may rise to very high levels. From 6 months of age onwards, the ascarid burden diminishes as the foals become immune. Patent infections are seldom found in mature horses and, when present, they tend to be of low magnitude. Preventive measures are aimed at treating foals frequently enough to prevent the development of a large mass of ascarids in the intestine. This is achieved by a 6-weekly dosing regimen using an anthelmintic with proven and reliable efficacy against P. equorum. PMID- 3527377 TI - Epidemiology and control of parasites in warm climates. AB - The kind of parasites a horse acquires depends upon its environment. Because patterns of transmission vary greatly with climate and management, no one worming program has universal applications. This article discusses epidemiology and control of equine parasites in the southern United States, where climates vary from warm temperate to subtropical and from humid in the southeast to arid in the southwest. PMID- 3527378 TI - Anthelmintics and drug resistance. AB - Equine anthelmintics and the resistance of nematode parasites to anthelmintics are reviewed. Recommendations are made for effective treatment of these parasites and for procedures that can be performed to minimize the problem in the future. PMID- 3527380 TI - Disposable Check-Bite Trays. PMID- 3527379 TI - Immunity and potential of vaccination. AB - This article will focus on current information available on the equine immune response to helminth parasites as it relates to acquired resistance, hypersensitivity reactions, and vaccine development. PMID- 3527381 TI - Current status of group dental practice in Canada. PMID- 3527382 TI - So you want to do some research? Or how to make estimations using approximate numbers and uncertain statistics. PMID- 3527383 TI - Prelicensure as an instrument for maintenance of standards. PMID- 3527384 TI - Examinations and procedures for licensure (competency assurance). PMID- 3527385 TI - Oral hygiene skills assessment. PMID- 3527386 TI - R-plasmid transfer in soil and water. AB - R-plasmid transfer in Escherichia coli was investigated in nutrient broth, sterile soil, and sterile stream water. Plasmid transfer occurred in broth cultures at 30 and 22 degrees C, but not at 15 degrees C. R-plasmid transfer was not observed at 30, 22, and 15 degrees C in nonamended sterile soil and stream water. The addition of nutrients to sterile stream water and soil allowed plasmid transfer to occur at temperatures ranging from 15 to 30 degrees C. R-plasmid transfer was also observed in soil adjusted from 20 to 100% of its water-holding capacity. PMID- 3527387 TI - The treatment of the restless legs syndrome with clonazepam: a prospective controlled study. AB - The effect of clonazepam on the restless legs syndrome was studied in a group of 6 patients. Following a drug-free period, 3 patients received clonazepam for 4 weeks followed by placebo for 4 weeks thereafter and 3 patients received the same medication and for the same length of time but in reverse order. The effectiveness of the medication was evaluated by means of a self-rating system in which patients assigned a score daily to the degree of discomfort experienced in the previous 24 hours. Three patients improved on clonazepam but 2 of these also improved on placebo. Clonazepam was not shown to be significantly more effective than placebo in the treatment of RLS. PMID- 3527388 TI - Comparison of the API Staph-Ident and DMS Staph Trac micromethods for the identification of coagulase-negative staphylococci. AB - Two rapid identification micromethods, the API Staph-Ident and the DMS Staph Trac, were compared for the identification of coagulase-negative staphylococci. Seventy-five isolates, mainly of bovine origin, were used as the test organisms. Species identification and profile numbers assigned to isolates by each system were compared. However, no clear correlation patterns emerged, indicating the two methods were not comparable. PMID- 3527389 TI - Preliminary observations on the use of latex agglutination test for the detection of mastitis due to Streptococcus agalactiae in cows. AB - A commercial latex agglutination test for the detection of Group B streptococcal antigens was used to detect infection due to Streptococcus agalactiae in whey of bovine milk samples. Fifteen out of 17 known infections were detected, but it was necessary to incubate the wheys at 37 degrees C for 18 hours in nine of the samples. It was found that the latex agglutination test could detect Group streptococcal carbohydrate antigens in whey samples from artificially infected quarters from one to four days after failure to detect the organism on culture or after antibiotic therapy of the affected quarter. PMID- 3527391 TI - Time course changes in blood metabolites during endotoxin fever in sheep. AB - Time course changes in the concentration of plasma amino acids, glucose, insulin, and creatinine were measured in seven mature sheep during fever induced by Escherichia coli (serotype 055:B5) endotoxin. Rectal temperature was increased above that recorded in control animals from 0.75 to 6.25 h postinjection with a maximum rise of 2.3 degrees C. Total amino acid concentrations decreased (P less than 0.05) 4.5 h postinjection and remained depressed (P less than 0.05) until 19 h postinjection. The plasma concentration of each individual amino acid decreased (P less than 0.05) at some point during the experiment with the exception of tryptophan and tyrosine. Glucose concentration decreased (P less than 0.05) and remained depressed until at least 55 h postinjection. Plasma insulin concentration was elevated (P less than 0.05) from 4.5 to 13 h postinjection. Plasma creatinine concentration increased during fever (P less than 0.05) and returned to normal by 31 h postinjection. PMID- 3527392 TI - Application of a modified indirect fluorescent antibody test to the detection of antibodies to bovine respiratory syncytial virus in Ontario cattle. AB - A modified indirect fluorescent antibody test for the detection of serum antibodies to bovine respiratory syncytial virus was developed. The test made use of Terasaki plastic microtiter plates in which bovine respiratory syncytial virus (Saskatchewan strain) infected Georgia bovine kidney cells were grown and fixed in situ by a modified acetone fixation procedure. Evans blue dye was used as a counterstain to reduce nonspecific fluorescence. In a study of 986 field sera from a geographically broad cross-section of mature Ontario cattle, 95% of the samples were found to be positive at or above a 1:2 dilution. No seronegative regions, counties or herds were identified. When representative samples covering a range of indirect fluorescent antibody titers were further examined by a microtiter virus neutralization assay, a significant agreement was found between the two tests. Up to a fourfold decrease in titer was observed when antigen coated plates were stored at -70 degrees C for four months. The modified indirect fluorescent antibody test for bovine respiratory syncytial virus antibody detection proved to be a rapid, practical procedure for use in the diagnostic laboratory. This study confirms that bovine respiratory syncytial virus is widespread in the Ontario cattle population and that most mature cattle can be assumed to have been exposed to this virus. PMID- 3527390 TI - The two faces of selenium-deficiency and toxicity--are similar in animals and man. AB - The purpose of this review article is to demonstrate the close parallelism of daily requirements, biological activity and minimum and maximum tolerable levels of selenium for animals and man. In addition, the carcinogenic/anticarcinogenic properties of selenium are discussed and a postulate of how these dichotomous effects may occur in accordance with selenium-induced immunomodulation is presented. A review of pertinent literature pertaining to the biological action of selenium in animals and man, including deficiency, toxicity, carcinogenicity and effects on immunity, is included to support these concepts. The predominant biochemical action of selenium in both animals and man is to serve as an antioxidant via the selenium-dependent enzyme, glutathione peroxidase, and thus protect cellular membranes and organelles from peroxidative damage. The signs and symptoms of selenium deficiency closely simulate each other for animals and man. Severe deficiency is characterized by cardiomyopathy while moderate deficiency results in less severe, myodegenerative syndromes such as muscular weakness and pain as well as a variety of other selenium-associated diseases. Clinical manifestations of many of these disorders require contributory factors, such as stress, to precipitate symptoms which are documented for animals and implicated for humans. Current evidence suggests that a daily selenium consumption for man of approximately 30 micrograms is necessary to prevent the selenium-deficient syndrome, Keshan disease, while approximately 90 micrograms/day/adult should be the minimum daily requirement for optimum biological performance. Recognizing that humans in several countries do not meet the proposed minimum daily requirement of 90 micrograms, several compelling reasons are presented in deriving this minimal daily nutritional intake. Selenosis can occur in laboratory animals, livestock, and humans following long-term exposure to selenium concentrations as low as 5 mg selenium/kg of diet (5 ppm). The selenium-induced lesions for all species are similar, which once again illustrates a positive corollary for selenium effects in both animals and man. From compilation of available data, the maximum tolerable level for selenium in man could be considered in the range of 1000 to 1500 micrograms/day. This is in contrast to the currently recommended maximum human tolerable level of 500 micrograms/day. The amount of selenium that can be tolerated, however, is dependent upon individual biological variation, nutritional status and general state of health.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3527394 TI - Biotyping of clinical isolates of Escherichia coli of animal origin, using the Analytab API 20E system. AB - Using the Analytab (API 20E) Enterobacteriaceae system of biochemical identification, a total of 506 Escherichia coli isolates from different animal species were coded numerically or biotyped. Fifty-four different biotypes were identified, 11 accounting for 83.1% of the isolates examined. Three of these profiles accounted for 65.3% of the isolates and were found in almost all animal species. Some of the biotypes were found in only one animal species: six in cattle, five in horses, 15 in pigs, two in sheep, two in birds, one in dogs and one in a porpoise. Biotypes, as determined here, could not be related to a particular pathology and more work is needed to assess the extent and significance of this relative biotype specificity among animal species. The use of other, more sophisticated, typing systems, i.e. plasmid "fingerprinting", or restriction endonuclease analysis of chromosomal DNA, would have to be investigated. PMID- 3527393 TI - Relationships between metabolic changes and clinical signs in pregnant sheep given endotoxin. AB - Groups of four pregnant ewes were allocated to the following feeding and intravenous endotoxin treatments: fed, Escherichia coli endotoxin (50 micrograms/kg X 75), fed, saline, fasted, E. coli endotoxin (50 micrograms/kg X 75) and fasted, saline. Endotoxin administration resulted in depression, fever, hypoglycemia, hypocalcemia and a reduction in nonesterified fatty acid and ketone body concentrations. Depression correlated best with body temperature (r = 0.76), fasted sheep showed smaller increases in body temperature and were less depressed following endotoxin. Three of eight endotoxin treated sheep died, mortality was not related to rectal temperature but was associated with lactic acidosis. Hypoglycemia was not associated with either death or depression. Fed sheep that were unable to stand had lower serum calcium concentrations than standing sheep. PMID- 3527395 TI - Perivascular eosinophilic droplets in swine brain induced by Escherichia coli toxin. AB - Pigs inoculated intravenously with the culture supernatant and extract of Escherichia coli were investigated histologically. Perivascular eosinophilic droplets and slight vascular degeneration were observed in the medulla oblongata, mid-brain and pons. These droplets were negative for periodic acid-Schiff staining. PMID- 3527396 TI - Domperidone, a new dopamine antagonist. AB - Domperidone is a dopamine antagonist that has recently been released in Canada. Unlike metoclopramide hydrochloride, the other available dopamine antagonist, it does not readily enter the central nervous system. Domperidone acts as both an antiemetic and an upper gastrointestinal tract prokinetic agent. It is rapidly absorbed after oral administration, and few side effects have been reported. Domperidone has been approved for use in Canada for the symptomatic management of upper gastrointestinal tract motility disorders and to prevent gastrointestinal symptoms associated with the use of dopamine agonist agents in Parkinson's disease. The pharmacologic features, indications and side effects of domperidone are reviewed. PMID- 3527397 TI - The heart of the matter: Ottawa surgeons make history and create a controversy. PMID- 3527398 TI - The Ischemic Heart Disease Life Stress Monitoring Program: 18-month mortality results. PMID- 3527399 TI - The practical aspects of clinical trials of contraceptive methods. AB - Although setting up a clinical trial to test the efficacy of a method of contraception may appear to be a simple exercise, in practice, unless the aim is well delineated, the trial carefully designed, and the staff participating in the trial carefully briefed, problems will arise which prevent a successful outcome. Possible areas of bias such as selection of participants and staff prejudices must be eliminated, otherwise the value of the results may be diminished. Ethical considerations must be addressed regarding voluntary participation, information for participants, delineation of risk to participants and informed consent. PMID- 3527400 TI - Occupation-related male infertility: a review. AB - Male infertility is a significant health problem for which few aetiological factors have been identified. The role of occupational exposure is largely unknown but certain substances such as 1,2-dibromo-3-chloropropane, oestrogen, heat, lead and microwaves have been reported to impair spermatogenesis in workers. Other agents which interfere with reproductive performance in experimental animals such as cadmium, manganese, organophosphates and some solvents have not been studied sufficiently for their occupational risks to be fully known. Some occupational exposures, extensively studied, appear to convey little or no risk to male fertility including radiological exposure, anaesthetic gases and Agent Orange. It is clear that the range of substances potentially hazardous to male reproduction is great but the number of agents for which the evidence is unequivocal is very small. PMID- 3527401 TI - Brain death and persistent vegetative states. AB - Patients who suffer severe brain damage may be brain dead, even though their cardiorespiratory function is supported by mechanical ventilation. According to criteria established in the United Kingdom and the United States, if these patients meet the preconditions of apneic coma that is attributable to diagnosed irreversible cause, and the presence of drug intoxication, hypothermia, or metabolic coma is excluded, then documentation of absent brainstem reflexes and apnea despite a PaCO2 of 50 mm Hg or greater will confirm the presence of brain death. If the brain is dead, the patient is dead, regardless of the state of his circulation, and he should be declared dead and removed from the ventilator. If the patient has lost higher cortical function but brainstem function is preserved, he may be in the persistent vegetative state and live for years with apparent sleep-wake cycles but no awareness of any external or internal stimuli. As the prognosis for recovery from the persistent vegetative state is absent, there is no ethical responsibility to continue treatment other than to provide basic nursing care to maintain the dignity of the patient. PMID- 3527402 TI - Treatment of chronic lymphocytic leukemia using chlorambucil and prednisone with or without cycle-active consolidation chemotherapy. A Southeastern Cancer Study Group Trial. AB - Patients with untreated chronic lymphocytic leukemia (CLL) received protocol treatment with 6 months of chlorambucil (CB) (30 mg/M2) and prednisone (P) (80 mg/d X 5) every 2 weeks. Complete and partial responders (CR, PR) were then randomized to consolidation with six more courses of CB and P or to four courses of cytosine arabinoside (25 mg/M2 every 12 hours X 8, subcutaneously) and cyclophosphamide (25 mg/M2 every 12 hours X 8, orally) every three weeks. Of the 178 eligible patients entered, 138 (78%) were evaluable for induction therapy which produced a 22% hematologic CR and an overall response rate (CR + PR) of 74%. Eighty-two patients received adequate consolidation, at the end of which 43 were in CR. No difference was seen in response or survival between the two consolidation treatments. Responders had longer survival than nonresponders (P = 0.0001) even when a 6-month "guarantee time" was excluded, but there was no survival difference between CR and PR. Thus, intermittent CB and P is a well tolerated, useful therapy for CLL but the addition of cyclophosphamide and cytosine arabinoside does not improve results. PMID- 3527403 TI - Malignant schwannoma with a rhabdomyoblastic component, a so-called triton tumor. A clinicopathologic study. AB - Triton tumors, malignant schwannomas with a rhabdomyoblastic component, are rare. This article reports the clinical course, therapeutic approach, and histopathologic aspects of three cases. Immunoperoxidase staining for the Schwann's cell marker S-100 protein and for the skeletal muscle proteins desmin, myosin, and myoglobin proved to be useful for diagnosis. The clinical histories of 24 previously reported cases are analyzed, and the therapeutic possibilities are discussed. PMID- 3527404 TI - Acute gastrointestinal bleeding as the presenting manifestation of prostate cancer. AB - Gastrointestinal bleeding was the presenting manifestation in four patients without readily apparent prostate cancer. Three of these patients had laboratory evidence of acute disseminated intravascular coagulation (DIC) and one patient had a friable rectal mass. The diagnosis of prostate cancer was made in three patients by employing an immunoperoxidase technique for prostatic acid phosphatase in metastatic foci. Dramatic resolution of DIC occurred in two patients following hormone therapy. Radiation therapy was effective in controlling bleeding in another patient. Two patients are alive with no further bleeding episodes at 8 and 18 months follow-up, respectively. In patients who present with a bleeding diathesis and adenocarcinoma of unknown primary, it is important to consider prostate cancer because of its frequent and prolonged responsiveness to hormonal therapy. PMID- 3527405 TI - Insulin receptor regulation in minimal deviation hepatoma cell line. AB - Treatment of H4 hepatoma cells with the lectin wheat germ agglutinin (WGA) in the concentration range of 10-25 micrograms/ml increased 125I-insulin binding fivefold as compared to control binding in untreated cells. The increased insulin binding was rapid, readily reversible, and correlated with a 10-fold increase in the binding affinity of the receptor for insulin. Kinetic studies indicate that this increased affinity resulted from a decrease in the dissociation rate. The effect was specifically mediated by the lectin since it was reversed by simultaneous incubation with the monosaccharide N-acetyl-D-glucosamine (50 mM) or the disaccharide N,N'-diacetylchitobiose (1 mM). The WGA-mediated increase in insulin binding was not caused by inhibited insulin degradation. While WGA (5 micrograms/ml) mimicked insulin to induce stimulated uptake of [3H]aminoisobutyrate, the lectin failed to enhance the biological sensitivity of H4 hepatoma cells to insulin. At higher concentrations of WGA (125 micrograms/ml), interference with the insulin-mediated response was observed. Trypsin treatment of H4 hepatoma cells prior to measuring binding of 125I-insulin in the presence of increasing concentrations of native insulin, led to a leftward shift of the competition curve, indicating an increased affinity of the receptor. No further increase was observed when the trypsin-treated cells were subsequently exposed to WGA. These results suggest that trypsin treatment and WGA exposure may increase the affinity of the receptor by a similar mechanism. The results are consistent with the concept that WGA and trypsin decrease interaction between insulin binding and receptor affinity regulating components in the plasma membrane, leading to an increase in the affinity of the receptor for insulin. PMID- 3527406 TI - Follicular lymphoma--do no harm. PMID- 3527407 TI - Ineffectiveness of levamisole in prolonging remission or survival of women treated with cyclophosphamide, doxorubicin, and 5-fluorouracil for good-risk metastatic breast carcinoma: a Southeastern Cancer Study Group Trial. AB - A total of 97 women with good-risk metastatic breast cancer received therapy with cyclophosphamide, doxorubicin, and 5-FU; half of these patients were randomly allocated to receive levamisole, 2.5 mg/kg, 2 days of each week in addition to chemotherapy, while the other half received an identical placebo. Good-risk patients consisted of those with bone-only metastasis, or local chest wall recurrence with or without bone metastasis. No significant difference in response rate, duration of disease control, or survival was observed between the groups. No major toxicity was associated with levamisole. PMID- 3527408 TI - Trial of the combination of mitomycin, vindesine, and cisplatin in patients with advanced non-small cell lung cancer. AB - In prior trials, mitomycin, vindesine, and cisplatin have each been shown to have reproducible antitumor activity as single agents when used in the treatment of patients with non-small cell lung cancer. The two-drug combinations of vindesine plus high-dose cisplatin or mitomycin have shown an improved major response rate and manageable toxicity in prior trials. In this report, 90 patients with stage III non-small cell lung cancer were treated with the three-drug combination of mitomycin (8 mg/m2), vindesine (3 mg/m2), and high-dose cisplatin (120 mg/m2). Eighty-seven patients (97%) were adequate for both response and toxicity. Major objective responses occurred in 60% of the patients. The toxicity of this regimen was predictable and manageable when established supportive care measures were employed. Based on the response rate observed, the combination of these three agents merits further study in randomized trials against other chemotherapeutic regimens and consideration of its use in adjuvant and preoperative settings. PMID- 3527409 TI - Extensive non-small cell lung cancer treated with mitomycin, cisplatin, and vindesine (MiPE): a Southwest Oncology Group Study. AB - Ninety-seven previously untreated patients with metastatic non-small cell lung cancer were treated with combination chemotherapy consisting of mitomycin (10 mg/m2) on Day 1, cisplatin (50 mg/m2) on Days 1 and 22, and vindesine (3 mg/m2) on Days 1 and 22 (MiPE). MiPE was repeated at 6-week intervals until disease progression or unacceptable toxicity. The overall response rate was 33%. There were seven complete responses (7%) and 25 partial responses (26%). The median progression-free interval for responding patients was 7 months. Median survival for all patients was 5 months, with 16% surviving 1 year. One patient died from sepsis while neutropenic. The results with MiPE treatment for patients with non small cell lung cancer compare favorably to other mitomycin-vinca combinations previously tested in the Southwest Oncology Group. PMID- 3527410 TI - Therapeutic response in phase I trials of antineoplastic agents. AB - We analyzed the therapeutic effect reported in 187 phase I trials of 54 anticancer drugs introduced into National Cancer Institute-sponsored clinical trial from 1974 to 1982. An additional 12 drugs entering clinical trial prior to 1974 were also examined. Objective responses (partial and complete) were reported in 271 of the 6447 patients (4.2%). Thirty-nine percent of the patients were treated at an initial dose level greater than or equal to the dose ultimately recommended for phase II trials. Patients in phase I trials generally had adequate performance status (Karnofsky scale greater than 80% or Eastern Cooperative Oncology Group 0, 1, or 2). More than 90% of the patients had received prior chemotherapy. We next examined the therapeutic effect observed in phase II trials for each of the drugs. Thirty-eight of the 54 drugs had completed at least one phase II trial. Twenty-one drugs were rated active, and nine were rated inactive. For the drugs entering clinical trial since 1974, the median phase I response rate for those active in phase II was 4.3%, compared to 2.7% for the drugs not found active in phase II. This difference was not statistically significant. The tabulated response rate in phase I trials reported here should be interpreted cautiously. There are many factors which may contribute to significant variability in the reported response rates, including the heterogeneity of patient population with respect to prior therapy and tumor type, lack of requirement for measurable/evaluable disease on entry into many studies, and variations in the rigor with which tumor sites are followed for response. These factors may lead to either an overestimate or underestimate of the true response rate in phase I. Although little therapeutic effect is produced in phase I, we discuss several measures which might increase patient benefit during these trials. PMID- 3527411 TI - Central nervous system prophylactic treatment for childhood leukemia: neuropsychological outcome studies. AB - The cognitive sequelae of central nervous system treatments for leukemia have become a major concern as more leukemic children survive the initial consequences of the disease. A review of 28 neuropsychological outcome studies published in the past nine years shows that the preponderance of evidence from the better designed studies suggests that leukemic children who do not suffer overt Central Nervous System (CNS) complications, such as CNS relapse, do not experience significant cognitive deficits as a consequence of their treatment. Also, these studies do not unequivocally suggest that cranial irradiation as a treatment technique results in greater cognitive impairment than treatment without irradiation. Many studies are consistent in finding that leukemic children younger than 8 years of age have a worse outcome than older ones although both groups perform in the average to bright normal range. It is currently difficult to conclude that such differences in intellectual outcome were caused by the CNS treatment alone or other psychosocial aspects of acquiring leukemia. The confusion present in the literature could be greatly reduced by combining the research efforts on the psychosocial aspects of acquiring leukemia with the studies examining neuropsychological outcome. PMID- 3527412 TI - Concomitant illness in patients treated for Hodgkin's disease. PMID- 3527413 TI - Geographic cancer risk and intracellular potassium/sodium ratios. AB - Geopathological, dietary, gerontological, and geophysiological data, data on electrolyte concentrations in healthy cells and in the corresponding tumor cells, and data on the potassium status of patients with different diseases and the associations of these diseases with cancer revealed a common denominator in the potassium-sodium-cancer relationship. A number of independent studies showed that the concentration of intracellular potassium was negatively correlated to cancer rates, whereas the concentration of intracellular sodium was positively correlated to cancer rates. The ratio between the concentrations of intracellular potassium and sodium was negatively correlated to cancer rates and was of greater importance in this respect than the two elements individually. The relations between these concentrations and cancer rates are hyperbolic rather than linear, which explains the fact that two independent carcinogenic agents are synergistic rather than additive. PMID- 3527414 TI - Modulation of carbohydrate metabolism during carcinogenesis. AB - Investigations in a number of experimental models and some observations in humans have indicated that changes in carbohydrate metabolism precede the development of many tumor types and appear to be closely associated, if not causally related, to neoplastic cell transformation. Thus, a decrease or increase of many enzymes (including those of the carbohydrate metabolism) and/or a transient excessive storage of polysaccharides (glycogenosis, mucopolysaccharidosis) or lipids (lipidosis) was demonstrated by cytochemical and biochemical methods during carcinogenesis induced by chemicals in liver, pancreas, colon, kidney, and brain. The results suggest that an ordered pattern of metabolic and morphologic changes occurs during neoplastic cell transformation. Apparently, an increase in the flux of certain metabolic pathways such as the hexose-monophosphate shunt and glycolysis develops during transformation of many cell types. This metabolic aberration is conventionally explained as a consequence of a higher metabolic requirement. However, it is conceivable that during neoplastic cell transformation certain metabolites are accumulated in unphysiologically high concentrations (especially intermediates of glucose metabolism) and thereby force the cell to activate alternative metabolic pathways. PMID- 3527415 TI - Induction of neoplastic lesions in the livers of C57BL x C3HF1 mice by chloral hydrate. AB - Chloral hydrate is a compound of environmental significance. The current investigation was undertaken to evaluate the carcinogenic effect of chloral hydrate, because it is present in drinking water and it is also used as a sedative. Fifteen-day-old C57BL x C3HF1 male mice were given a single dose of chloral hydrate in distilled water at two dose levels: group 1, 5 micrograms/g BW; group 2, 10 mu/g BW (20-25 mice per group). Thirty-five mice given distilled water only served as controls. Animals were sacrificed at 24 hr and thereafter at various intervals up to 92 weeks. The entire liver was fixed and examined histologically. Mice sacrificed between 48 and 92 weeks showed hepatic lesions ranging from hyperplastic to trabecular carcinomas. The tumor incidence in mice given 10 micrograms/g chloral hydrate (six of eight) was significantly higher (P less than 0.05) than the incidence in the controls (two of 19). These findings indicate that chloral hydrate should be more thoroughly studied for potential carcinogenicity. PMID- 3527416 TI - Distribution of surface nonspecific cross-reacting antigen and influence of proteolytic enzymes on this antigen in myeloid cell series. AB - Discontinuous density-gradient centrifugation was used to separate myeloid cells of different myelocytic leukemias [acute myelocytic leukemia (AML), chronic granulocytic leukemia (CGL), and chronic granulocytic leukemia in blast crisis (CGL-BC)] into fractions containing granulocytes in individual stages of maturation. The distribution of surface nonspecific cross reacting antigen (sNCA), and cytoplasmic NCA (cNCA) in each cell fraction was estimated by immunofluorescence (IF), and the influence of proteolytic enzymes and neuraminidase on sNCA presence was analyzed. It was found that the percentage of sNCA- and cNCA-positive cells increased in more mature granulocyte fractions; only in the morphologically oldest granulocytes did the number of sNCA-positive cells decrease, probably as a result of the rise of NCA secretion into body fluids; proteolytic enzymes caused an increasing number of sNCA-expressing cells; and neuraminidase treatment usually reduced the percentage of sNCA-positive cells. PMID- 3527417 TI - Cancer in renal transplant recipients. AB - The incidence of cutaneous malignancies and non-Hodgkin lymphomas is higher in transplant recipients than in the general population. From 1968 to 1984, 200 kidney grafts were transplanted to 180 patients with end-stage renal disease. All patients were on azathioprine (Aza) and prednisolone. In selected cases ALG and/or small doses of CsA were added. Six patients developed malignant tumors (two Kaposi sarcoma, one squamous cell and one squamous plus basal cell skin cancers, one reticulosarcoma, and one glioma). Mean age of patients was 43 years (range 35-53 years), and mean time of appearance of the tumor after transplantation was 62 months (range 24-98 months). Treatment consisted of reduction of the dosage of Aza, surgical removal or local irradiation of the tumor, and chemotherapy in case of systemic involvement (two cases). Three patients died (one Kaposi sarcoma, one reticulosarcoma, and one glioma) 3 to 6 months after diagnosis, and all three had previously been on high doses of Aza. The remaining three cases (one Kaposi) were cured by stopping or decreasing Aza, by excision, and/or local irradiation of the tumor. It seems that late diagnosis and Aza in high dosage are the main factors leading to the rapid dissemination of the initially localized tumor. PMID- 3527418 TI - Basic principles for utilizing combination differentiation agents. AB - The induction of differentiation in several tumor lines serves as a basis for a new approach to cancer treatment. In vitro studies in the mouse erythroleukemia (MEL) cell system have identified about 300 agents capable of inducing differentiation by mechanisms that remain to be elucidated. The design of differentiation therapy will depend on the specific tumor cell type, an effective time course, and the synergistic interaction among combinations of two or more inducers. The induction of differentiation may be followed by terminal cell division (TCD) or programmed cell death in several tumor cell systems. This mechanism for the destruction of tumor cells is one goal of differentiation therapy and differs from nonspecific cytotoxic therapy. To evaluate the effect of differentiation therapy, a clear distinction must be made between nonspecific cytotoxicity and the programmed TCD of induced cytodifferentiation. One possible parameter for assessing the commitment to TCD in the MEL cell system is a selective decrease in DNA ligase activity, which does not appear to occur following treatment with nonspecific cytotoxic agents. These biological and biochemical parameters should be helpful in designing agents capable of inducing TCD in vivo. PMID- 3527419 TI - [Sudden death: what's new after Lancisi? 1. Sudden death in an apparently healthy population]. PMID- 3527420 TI - Tricuspid valve surgery: indications, methods, and results. PMID- 3527421 TI - Correlative immuno-electron-microscopic and immunofluorescent localization of actin in sensory and supporting cells of the inner ear by use of a low temperature embedding resin. AB - The cochleas from chinchilla inner ears were processed in the cold through Lowicryl K4M, and cured by UV light. Thick (2 microns) sections were reacted with primary antibodies raised against actin, and anti-actin antibodies localized by FITC epifluorescence. On thin sections from the same blocks anti-actin antibodies were localized ultrastructurally with secondary antibodies coupled to colloidal gold. In the hair cells, actin was present in the stereocilia and cuticular plate, regions where thin filaments were observed by electron microscopy. Colloidal gold was uniformly distributed over these regions and over the stereocilia rootlets demonstrating that actin was present in this region although previously in permeabilized cells, the rootlet was not decorated with myosin subfragment S-1. Actin was present in the pillar and Deiters supporting cells at the reticular lamina and at the basilar membrane, where a meshwork of thin filaments was seen by electron microscopy. Colloidal gold particles were also localized over the thin processes of the pillar and Deiters cells, and over the region of the Deiters cell which envelops the base of the outer hair cell. In these regions actin co-localized with microtubules along the entire length of the supporting cells. PMID- 3527422 TI - Regional specificity of anuran larval skin during metamorphosis: dermal specificity in development and histolysis of recombined skin grafts. AB - Skins from back and tail were dissected from tadpoles of Rana japonica prior to resorption of the tail and separated into epidermis and dermis by treatment with neutral protease. Homotypically and heterotypically recombined skins were constructed from the separated epidermis and dermis and transplanted into the tail of the original tadpole. Skin grafts using dermis from tail region degenerated simultaneously with resorption of the tail. However, skin grafts containing dermis from back region survived on the posterior part of the juvenile frog beyond metamorphosis. Furthermore, all epidermis underlaid with dermis from back region formed secretory glands and became flattened epithelia characteristic of adult back skin, regardless of region from which the epidermis came. Even when epidermis isolated from tail skin was cultured inside a back skin graft, the tail epidermis survived forming an epithelial cyst and developed secretory glands. These results suggest that regional specificities of anuran larval skin, i.e., development of back skin and even histolysis of tail skin, are determined by regionally specific dermis. The results also suggest that some of epidermal cells of tail skin are able to differentiate into epithelial cells similar to back skin of the adult under the influence of back dermis. PMID- 3527423 TI - Evidence for the presence of Calbindin-D 28K (CaBP-28K) in the tibial growth cartilages of rats. AB - The distribution of the vitamin-D dependent calcium-binding protein (Calbindin-D 28K) (CaBP-28K) in the tibial growth plate cartilage of the rat has been studied immunohistochemically using an antibody raised against rat renal CaBP-28K. The protein was detected mainly in the nuclei of chondrocytes and occasionally in the juxtanuclear cytoplasm. The distribution was not uniform throughout the growth plate, but concentrated in the proliferatively active chondrocytes of the resting and proliferative zones. These findings raise the possibility that CaBP-28K may be involved in the mitotic activity of the chondrocytes, acting as a regulator of the proliferative process, perhaps via intranuclear calcium. PMID- 3527425 TI - A comparative in vitro study on LHRH responsiveness of LH cells of the pars tuberalis and pars distalis. AB - The aim of the present study was to test whether the luteinizing-hormone (LH) cells in the pars tuberalis (PT) of the rat and mouse respond to LH-releasing hormone (LHRH) as do those of the pars distalis. A part of the basal hypothalamus containing the pituitary stalk, median eminence and the pars tuberalis (H-PT), was dissected out and incubated in vitro. The LH-secreting capacity of the PT was investigated after removal of the "pituitary body" (i.e., partes distalis, intermedia and nervosa). First, some rat and mouse H-PT tissues were treated with synthetic LHRH (100 ng/ml), while others were incubated without LHRH. After 24 h of incubation, variable amounts of LH release were detected in the medium. This LH discharge, however, was not LHRH-dependent but proportional to the number of PT LH cells that were immunohistochemically detected in each incubated tissue. Since there was marked individual variation in the number of LH cells in the PT, the LH levels in the incubation medium were next compared before and after LHRH treatment using the same H-PT of the rat. An effect of LHRH could not clearly be shown in this experiment. Finally, the cytological response of the PT to LHRH was investigated by incubating both the H-PT and pituitary body connected to the intact pituitary stalk. Immunohistochemical examination of LHRH-treated tissues after 24 h revealed that, in females of both rats and mice, hormone depletion occurred in LH cells of the pars distalis but not in those of the PT.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3527424 TI - Calcitonin gene-related peptide-immunoreactive nerve fibres in the small intestine of the guinea-pig: electron-microscopic immunocytochemistry. AB - Calcitonin gene-related peptide (CGRP)-containing nerve fibres were identified by pre- and post-embedding electron-microscopic immunocytochemistry in the guinea pig small intestine. Immunoreactive nerve processes were numerous in the mucosa and submucosa, especially in the connective tissue among the crypts of Lieberkuhn. In some cases they were found in close apposition to epithelial cells. Many of the labelled nerve fibres were observed around blood vessels, especially arterioles. In the inner circular muscle layer, the immunoreactive nerve processes were found in close association (sometimes less than 40 nm) to smooth muscle cells. CGRP-positive terminals contained a predominance of electron lucent synaptic vesicles (35-40 nm in diameter) together with a few large granular vesicles (80-120 nm in diameter). Post-embedding immunostaining, using the immunogold procedure, localized CGRP-immunoreactivity in large granular vesicles, 80-92 nm in diameter. These ultrastructural observations confirm that CGRP-containing nerve fibres exist in the small intestine and suggest that they may participate in the regulation of the smooth muscle activity, mucosal cell secretion and blood flow and, by analogy with other systems, a sensory role also seems likely. PMID- 3527426 TI - Immunological demonstration of intestinal absorption and digestion of protein macromolecules in the trout (Salmo gairdneri). AB - An immunofluorescence technique using antibodies against the Fc and Fab fragments of human IgG (IgGH) was used to study the absorption of proteins by the intestinal epithelial cells of rainbow trout after oral or anal administration. Cellular absorption of a high molecular weight protein, hepatitis-B surface antigen (HBsAg), was also studied by using two monoclonal antibodies, one specific for the confirmation of the antigen (implying disulfide bridges), and the other that reacts with the constituent polypeptides. Both absorbed IgGH and HBsAg were seen to be segregated in the apical vacuolar system, a characteristic feature of intestinal epithelial cells. The same antibodies were used with an everted sac technique in conjunction with immunofluorescence, to show the intravacuolar degradation of IgGH and HBsAg following absorption. By using an antibody against cathepsin D, it was possible to demonstrate, by immunofluorescence, the localization of this enzyme in the same vacuolar system. After coupling the antibody to peroxidase or to the protein A/colloidalgold complex, the ultrastructural antigenic sites of cathepsin D could be seen to be localized in the interior of the vacuoles. The vacuolar localization of a cathepsin B activity was determined by incubating sections of intestinal mucosa, or isolated epithelial cells, with a specific synthetic substrate (Z-Ala-Arg-Arg methoxynaphthylamide). The supranuclear hyaloplasmic vacuoles of intestinal epithelial cells may be considered to be phagolysosomes that assure the degradation of absorbed proteins. This function may be of fundamental importance in the in the nutritional processes of this species. PMID- 3527429 TI - Characteristic pattern of monoaminergic nerve fibers in the pineal organ of the monkey, Macaca fuscata. AB - Monoaminergic nerve fibers were studied in the pineal organ of the monkey. Macaca fuscata, by use of fluorescence and immunohistochemical procedures. Abundant formations of noradrenergic nerve fibers were observed in the pineal organ. They entered the parenchyma in the form of several coarse bundles via the capsule in the distal portion of the organ and spread throughout the organ after branching into smaller units. The density of the autonomic innervation decreased gradually toward the proximal portion of the organ. In the distal portion, numerous nerve fibers formed perivascular plexuses around the blood vessels and some fibers ran as bundles unrelated to the blood vessels in the stroma. Fine varicose fibers and bundles derived from these plexuses penetrated among the pinealocytes. However, only a few intraparenchymal fluorescent fibers were detected in the proximal third of the gland. With the use of serotonin antiserum serotonin-immunoreactive nerve fibers were clearly restricted to the ventroproximal part of the pineal organ. Although the somata of the pinealocytes showed intense immunoreactivity, their processes were not stained. In one exceptional case, clusters of pinealocytes displaying very intense immunoreactivity were found in an area extending from the distal margin of the ventral portion of the pineal stalk to the proximal portion of the pineal organ proper: these cells were bipolar or multipolar and endowed with well-stained processes. PMID- 3527427 TI - Surface-associated vesicles in retinal arterioles and venules. AB - The surface-associated vesicles in retinal arterioles and venules were studied after fixation in glutaraldehyde-tannic acid or after intravitreal injection of peroxidase or lactoperoxidase. The vesicles were concentrated along the abluminal (basal) surface of the endothelial cells and along the plasma membranes of smooth muscle cells in arterioles and of pericytes in post-capillary venules. They were rarely encountered in the deeper regions of these cells. In perpendicular sections through the cell surface the majority of vesicles were in continuity with the plasma membrane whereas in tangential sections, they appeared to lie "free" in the cytoplasm. All such vesicles were labeled after exposure to tannic acid or to the heme-proteins. Peroxidase-reaction product was never seen in the lumen of the vessels. These observations suggest that the surface vesicles in endothelial cells, smooth muscle cells and pericytes are invaginations of the plasma membrane and are thus not involved in the transcytosis or endocytosis of proteins. The vesicles in the latter two cell types may be involved in some aspect of contractility rather than pinocytosis. PMID- 3527428 TI - Changes occurring in the epithelium covering the bronchus-associated lymphoid tissue of rats after intratracheal challenge with horseradish peroxidase. AB - Changes occurring in the epithelium covering bronchus-associated lymphoid tissue (BALT) in the rat after several intratracheal administrations of horseradish peroxidase (HRP) were studied using morphological and ultrastructural methods. The epithelium is invaded by W3/25-positive (T-helper) lymphocytes, the BALT epithelial cells become Ia-positive and develop microvilli; there is an apparent loss of cilia. The number of non-ciliated cells in stimulated BALT increases. The non-ciliated cells can be subdivided into two cell types, one with electron-dense cytoplasm and cytoplasmic granules and the other without granules. The electron density of the latter cell type is intermediate between that of the ciliated cells and that of the granule-containing non-ciliated cells. The granule containing cell types may be responsible for the uptake of antigens, while the other non-ciliated cell may be involved in the production of the secretory component and the passage of secretory IgA. PMID- 3527431 TI - [Vaginal microbial flora of healthy Chinese women in Nanchang, Jiangxi Province]. PMID- 3527430 TI - Somatotrophs and lactotrophs in the anterior pituitary of fetal and neonatal rats. Electron-microscopic immunocytochemical identification. AB - The ultrastructure of immunoreactive somatotrophs and lactotrophs in pituitaries of fetal rats at 19, 20 and 21 days of gestation and on the day of birth was studied. Somatotrophs, first detectable at 19 days of gestation, undergo only minor modifications before reaching the structure described for adults. In particular there is an increase in the endoplasmic reticulum and Golgi apparatus. Lactotrophs, first identifiable in newborn rats, are very different in ultrastructure from adult cells, because the secretory granules are generally small, but variable in shape and size and the Golgi complex is prominent. PMID- 3527432 TI - [Susceptibility of Anopheles jeyporiensis candidiensis to Plasmodium vivax]. PMID- 3527433 TI - [Hares (Leporidae) and their parasitic ticks (Ixodidae) in relation to tick-borne diseases]. PMID- 3527434 TI - [Dr Wu Lian-de: pioneer in China's epidemiology]. PMID- 3527435 TI - [Geographical distribution of chloroquine-resistant strains of malignant malaria in Yunnan Province]. PMID- 3527436 TI - [Chloroquine-resistant malignant malaria in Hainan Island: report of 10 years' study]. PMID- 3527437 TI - [An outbreak of food poisoning due to entero-invasive E. coli]. PMID- 3527438 TI - [Sero-epidemiological studies on Mycoplasma pneumoniae infections in pneumonia in children]. PMID- 3527439 TI - [LT gene-probe for epidemiologic surveys on enterotoxin-producing E. coli: its preparation and characterization]. PMID- 3527440 TI - [Advances in the research of Legionnaires' disease during the past 3 years in China]. PMID- 3527441 TI - [Group B streptococcal infections]. PMID- 3527442 TI - Segregation analysis of migraine in 128 families. AB - To test the existence of inherited liability to migraine, formal segregation analysis of family data collected from 128 patients has been performed. Patients were subdivided into three groups in accordance with the presence or absence of migraine in their parents. The results obtained in each group were then compared with those expected on the basis of two different modes of simple Mendelian inheritance, namely autosomal dominant and autosomal recessive transmission. Our data show that neither of the two hypotheses can be accepted, thus suggesting the existence of a possible genetic heterogeneity of liability to migraine. PMID- 3527443 TI - Double-strand breaks can initiate meiotic recombination in S. cerevisiae. AB - We investigated the effects of double-strand breaks on meiotic recombination in yeast. A double-strand break was introduced at the MATa locus by sporulation of a MAT alpha inc/MATa diploid under inducing conditions for the HO-encoded endonuclease; 14% of the resulting tetrads had undergone 4 alpha:0a conversion. Conversion at MAT was associated with co-conversion of a closely linked marker and an increased recombination frequency for flanking markers. We also studied the sporulation products of a diploid heterozygous at the HIS4 locus for an insertion of a 100 bp fragment of MATa containing the HO endonuclease cut site. Under inducing conditions, a significant number of tetrads were formed that had undergone gene conversions in favor of the HIS4+ allele. Although double-strand breaks can initiate meiotic recombination in yeast, the data suggest that they do not normally do so. PMID- 3527444 TI - Systemic natural killer activity following cardiac engraftment in the rat: lack of correlation with graft survival. AB - The systemic NK activity was studied both in untreated rats which acutely reject allogeneic heterotopic heart grafts and in cyclosporine-treated rats which tolerate their transplants. The trend and magnitude of changes in NK activity were similar at all time points for the two animal groups. Compared to naive rats, peak NK activity was noted 7-8 days after engraftment in untreated rats and 7-12 days after engraftment in cyclosporine-treated hosts. In both groups, NK activity returned to normal levels by 3 weeks. No evidence could be found for inactivation of NK cells or their precursors in vivo in ungrafted rats undergoing cyclosporine treatment alone. These data are consistent with prior studies and suggest that non-specific cytotoxic activity does not represent a crucial force contributing to acute rejection of vascularized organ grafts. PMID- 3527445 TI - Characterization of natural killer cells and their precursors in the murine bone marrow. AB - We have fractionated murine bone marrow cells according to their density on bovine serum albumin (BSA) gradient and studied (a) the NK activity against YAC-1 targets, (b) the proportion of asialo GM1+ lymphocytes, (c) and the presence of large granular lymphocytes (LGL) in the different fractions (A, B, C, D). The NK activity was found mainly in the C fraction, but the proportion of asialo GM1+ cells was the same in every fraction. No LGLs were found in the bone marrow. Cells from the various fractions were also transplanted into irradiated recipients. Seven days later the highest NK activity was found in the spleens of mice injected with cells from the A + B fractions indicating that the immediate precursors for NK cells reside in the low density fractions of the BSA gradient. Mice transplanted with C or D fractions needed longer time to develop normal NK levels. The treatment of bone marrow cells before transplantation with anti asialo GM1+ complement did not inhibit the development of NK activity, so it can be concluded that the precursor for NK is asialo GM1-. PMID- 3527446 TI - Natural cytolytic activity in mice with natural or induced cellular defects. I. Differential ability of in vitro interleukin-2 addition to augment natural cytolytic function. AB - The ability of in vitro addition of recombinant interleukin 2 (rIL-2) to differentially enhance natural cytotoxicity was assessed using cells from mice with natural and induced cellular defects. In vivo treatment with most immunosuppressive or cytoreductive agents, anti-asialo-GM1 antibody, or gamma irradiation dramatically reduced in vitro cytotoxicity against natural killer (NK) sensitive targets by direct reduction in either percentage specific lysis or lytic units per spleen. In most cases, in vitro addition of rIL-2 (at concentrations causing augmented NK function in cells from naive Balb/C mice) enhanced cytotoxic activity of cells from treatment groups to a normal value but not within the rIL-2-enhanced range of nontreated animals. Additionally, cytotoxic activity of cells from animals treated with certain drugs or gamma irradiation could be augmented by rIL-2 when measured by percentage lysis but not lytic units per spleen. In vivo treatment with cyclosporin A did not affect natural cytotoxic activity and addition of rIL-2 augmented the NK activity in a similar fashion to the profile of naive cells. In experiments using cells from beige (C57Bl/6-bg) mice which have a natural defect in NK activity against YAC-1 targets, addition of rIL-2 (at concentrations causing augmented natural cytotoxic function in cells from C57Bl/6 mice) could not effectively enhance in vitro natural cytotoxic function. PMID- 3527447 TI - The Donath-Landsteiner autoantibody: the incommensurable languages of early immunologic dispute. PMID- 3527448 TI - Macrophage suppression by a low-molecular-weight fraction of murine spleen cell culture supernatant. AB - Macrophage suppression has been reported to be mediated by a component of murine serum. The present investigation involves in vitro production of this macrophage modulator (suppressor) by concanavalin A-stimulated murine spleen cells. Spleen cell culture supernatant containing this suppressor, which has been called macrophage suppressor factor (MSF), caused a significant decrease in in vitro phagocytosis of Listeria monocytogenes by resident murine peritoneal macrophages. The molecular weight of MSF was determined by ultrafiltration to be less than 10,000, and the suppressor activity of MSF was not altered by heating at 100 degrees C for 30 min or storage at -70 degrees C for 6 months. MSF is resistant to treatment with Pronase E, but is, however, sensitive to acid hydrolysis. Activity of MSF in spleen cell culture supernatants from normal mice does not differ from that in supernatants from mice immunized with L. monocytogenes. It was determined that MSF is not affected by antigenic stimulation and is apparently produced constitutively. PMID- 3527449 TI - Proliferative responses of T cells from SJL----F1 and F1----SJL bone marrow chimeras to SJL lymphoma cells. AB - RCS tumor cells induce marked proliferation of syngeneic SJL T cells in vivo and in vitro. Certain F1 hybrids of SJL mice give high proliferative responses to gamma-RCS, while other F1 hybrids give low responses. SJL----"non-responder" F1 and "non-responder" F1----SJL semiallogeneic bone marrow chimeras were prepared to study how the host environment affects the ability of T cells to give a proliferative response to gamma-RCS. The results indicate that T cells educated in an SJL host become responsive to RCS cells, while T cells educated in an (SJL X BALB/c)F1 host become unresponsive. This finding applies to both thymus and lymph node T cells. The unresponsiveness in F1 mice is not due to suppressor cells, since added F1 cells do not affect the proliferative response of SJL cells to gamma-RCS. Instead, it appears that RCS-specific T cells are either deleted in (SJL X BALB/c)F1 mice, or expanded in SJL mice as they develop. These findings are discussed in relation to the specificity of the responding T cells, for LPS activated syngeneic B cell blasts as well as RCS cells, and to the presence of a "leaky" thymus barrier in SJL mice for B cells. PMID- 3527450 TI - Demonstration of hapten augmentable plaques in the bromelain treated anti-mouse red blood cell system: putative evidence for anti-idiotypic regulation of autoantibody secretion. AB - Spleen cells from normal, nonautoimmune mice (C3H/HeN) spontaneously produce hemolytic plaques against autologous bromelain-treated red blood cells (BrMRBC). The number of anti-BrMRBC plaques detectable can be increased by including either a 3 M KCl extracted antigen from BrMRBCs or the hapten phosphorylcholine chloride (PC) as an antigenic analog in the plaque assay. Optimal PC concentration for augmenting the number of plaque forming cells (PFCs) was between 10(-7) and 10( 8) M. Incubation of spleen cells with an equal volume of 10(-7) M PC one, two, or three times resulted in the preparation of populations of cells which yielded increased numbers of PFCs. In addition, the number of anti-BrMRBC plaques of cells incubated three times could not be further increased by adding PC to the plaquing mixture. The eluate produced by the initial incubation of spleen cells with 10(-7) M PC specifically suppressed the anti-BrMRBC PFC response of these nonhapten augmentable cell populations (3 X eluted). These studies indicate that a naturally occurring autoantibody response is normally regulated by the presence of a molecule bound to the cell surface of autoantibody forming cells. PMID- 3527451 TI - Localization of AT-rich sequences at the nuclear matrix. AB - After culture with 3H-thymidine murine erythroleukemia cells with more sites of DNA attached to the nuclear matrix have more labeled thymidine in their matrix bound DNA than in their total DNA than do cells with fewer attachment sites. This indicates that the average attachment site sequence is enriched in A + T base pairs. PMID- 3527452 TI - Monoclonal antibodies against nuclear matrix detect nuclear antigens in mammalian, insect and plant cells: an immunofluorescence study. AB - We have applied monoclonal antibodies generated against nuclear matrix in an immunofluorescence study of a variety of plant and animal species. Antibodies P1 and I1 detected antigens in all species examined, including higher and lower plants. Antibodies PI1 and PI2 stained only animal cells, and showed some tissue and/or species-specific variability in staining pattern. The presence of similar nuclear matrix components in such diverse species suggests that nuclear order may be maintained by similar mechanisms in all eukaryotes. PMID- 3527453 TI - Robert Day Allen (1927-1986): an appreciation. PMID- 3527454 TI - Rearrangement of tubulin, actin, and myosin in cultured ventricular cardiomyocytes of the adult rat. AB - Antitubulin, phalloidin, and antimyosin were used to study the distribution of microtubules, microfilaments, and myofibrils in cultured adult cardiomyocytes. These cells undergo a stereotypic sequence of morphological change in which myotypic features are lost and then reconstructed during a period of polymorphic growth. Microtubules, though rearranged during these events in culture, are always present in an organized network. Myosin and actin structures, on the other hand, initially degenerate. This initial degeneration is reversed when a cell attaches to the culture substratum. Upon attachment, new microtubules are laid down as a cortical network adjacent to the sarcolemma and, subsequently, as a network in the basal part of the cell. Actin and then myosin filament bundles appear next, in a pattern corresponding to the pattern of the microtubules. Finally, striated myofibrils are formed, first in the central part of the cell, and subsequently in the outgrowing processes of the cell. A mechanism is suggested by which the eventual polymorphic shape of a cell is related to the shape of its initial area of contact with the culture substratum. Finally, a model of myofibrillogenesis is proposed in which microtubules participate in the insertion of myosin among previously formed actin filament bundles to produce myofibrils. PMID- 3527455 TI - Mutagenicity of benzylic acetates, sulfates and bromides of polycyclic aromatic hydrocarbons. AB - Studies were performed to determine the direct mutagenicity of the acetates and some bromides and sulfates of hydroxymethyl polycyclic aromatic hydrocarbons in S. typhimurium strains TA98 and TA100. Benzylic acetates, bromides and sulfates were synthesized and characterized. The compounds tested were benzyl alcohol, 5 hydroxymethylchrysene, 1-hydroxymethylpyrene, 6-hydroxymethylbenzo[a]pyrene, 6-(2 hydroxyethyl)benzo[a]pyrene, 6-hydroxymethylanthanthrene, 9 hydroxymethylanthracene, 9-hydroxymethyl-10-methylanthracene, 7 hydroxymethylbenz[a]anthracene, 7-(2-hydroxyethyl)benz[a]anthracene, 12 hydroxymethylbenz[a]anthracene, 7-hydroxymethyl-12-methylbenz[a]anthracene, 12 hydroxymethyl-7-methylbenz[a]anthracene, 1-hydroxy-3-methylcholanthrene, 2 hydroxy-3-methylcholanthrene, 3-hydroxy-3, 4-dihydrocyclopental[cd]pyrene and 4 hydroxy-3, 4-dihydrocyclopental[cd]pyrene. The benzylic sulfate esters of 6 hydroxymethylbenzo[a]pyrene and 7-hydroxymethylbenz[a]anthracene were the most mutagenic compounds, whereas the aliphatic sulfate ester of 7 hydroxyethylbenz[a]anthracene did not cause an increase in mutations above background. All meso-anthracenic benzylic acetate esters were mutagenic in both strains with various degrees of activity, whereas the corresponding non-benzylic esters were inactive, as expected. Of the non-meso-benzylic acetate esters, only the 3-acetoxy-3, 4-dihydrocyclopenta[cd]pyrene was mutagenic. In the benzylic bromide series, only the eight mesoanthracenic were mutagenic, whereas benzyl bromide and 5-bromomethylchrysene were inactive. The aliphatic bromides, 6-(2 bromoethyl)benzo[a]pyrene and 7-(2-bromoethyl)benz[a]anthracene did not display significant activity. The potencies of the acetate esters more accurately reflect the mutagenicity because the rate of solvolysis did not compete with the reactivity of the esters with bacterial DNA. In the case of benzylic sulfates and bromides, the rate of solvolysis was very rapid and could have diminished the level of mutagenicity, depending on the assay conditions. These results demonstrate that meso-anthracenic benzylic acetates, sulfates and bromides are mutagenic, whereas benzylic acetate esters attached to other carbon atoms are inactive. PMID- 3527456 TI - Bridging phenomena in steroid immunoassays. The effect of bridge length on sensitivity in enzyme immunoassay. PMID- 3527458 TI - [Historical perspectives of the American Nurses' Association]. PMID- 3527457 TI - [Nursing care in the treatment of Parkinson's disease by encephalon-stereotactic surgery]. PMID- 3527459 TI - [Notes on the "Treatise on febrile diseases caused by cold" (Shang han lun)]. PMID- 3527461 TI - [Surgical therapy of hallux valgus: technics, cases, results (communication of the 8th Congress of the Italian Society for Medicine and Surgery of the Foot, Rome 1978)]. AB - After a careful description of the surgical method according to Regnauld for the bloody treatment of valgus big toe, followed by them since 1974, the Authors show their casuistry. The results are considered from the aesthetic and functional standpoint; the single patients' opinion is also reported. The Authors, as a conclusion, declare themselves satisfied pith this method, which not only gives excellent aesthetic and functional results, but also caused no relapses. PMID- 3527460 TI - Liposome-cell interactions: in vitro discrimination of uptake mechanism and in vivo targeting strategies to mononuclear phagocytes. AB - The interactions of liposomes with cells have been extensively studied to determine their potential use as vehicles for the delivery of drugs in vivo. Since intravenously administered liposomes are, for the most part, cleared by cells of the reticuloendothelial system (RES), considerable effort has been made to take advantage of this phenomenon rather than view it as an obstacle. Indeed, cells of the RES, in particular macrophages, have been shown to play a vital role in homeostasis and in host defence mechanisms against infection and neoplasia. In this article, we present an overview of liposome-cell interactions, with particular emphasis on the techniques used to monitor the interaction of liposomes with macrophages. Specifically, we discuss methodologies which can be used to differentiate between liposome-cell fusion, adsorption and endocytosis in vitro. In addition, we outline the various strategies that have been employed for both actively and passively targeting liposomes to macrophages in vivo. We also review the rationale and various techniques for designing liposomes for enhanced macrophage uptake, which, in certain cases, results in the selective release of liposome-entrapped compounds in situ. PMID- 3527462 TI - [Value of ultrasonics in painful hip in children]. AB - The authors report their experience concerning echography in 40 children. They emphasize its importance in the painful hip. All patients suffered with a painful limping with normal standard front and profile X-Rays. Echography appears to be a test both simple and reliable to discern synovial extravasation (no false positive). Yet, it is not able to predict the kind of effusion. More especially, echography is not limited to the very diagnosis of extravasation: in acute transient synovitis, it shows an enlargement of the joint cavity, with no effusion, giving evidence of the inflammatory synovial reaction, in arthritis, it allows a good survey, pointing out healing under treatment, persistent extravasation commanding iterative succions, and the coming out of an articular septation. PMID- 3527463 TI - [Measurement of femoral anteversion in children by ultrasonics]. AB - After reviewing the anatomy of the frontal geometry of femur and values for femoral anteversion during growth, an ultrasound method is described for measurement of femoral anteversion. The principle underlying the technique is the use of a spirit level fixed to a bar probe and an effective contention in rotation of lower limbs, this ensuring validity of results even in infants. Analysis of findings in a preliminary series of 10 infants (20 hips), age range 2 to 16 years, with torsion anomalies of lower limbs, showed values obtained to be totally superimposable on those provided by a CT scan. PMID- 3527464 TI - The pathophysiology of murine retrovirus-induced leukemias. AB - Murine leukemia viruses (MuLVs) are retroviruses which induce a broad spectrum of hematopoietic malignancies. In contrast to the acutely transforming retroviruses, MuLVs do not contain transduced cellular genes, or oncogenes. Nonetheless, MuLVs can cause leukemias quickly (4 to 6 weeks) and efficiently (up to 100% incidence) in susceptible strains of mice. The molecular basis of MuLV-induced leukemia is not clear. However, the contribution of individual viral genes to leukemogenesis can be assayed by creating novel viruses in vitro using recombinant DNA techniques. These genetically engineered viruses are tested in vivo for their ability to cause leukemia. Leukemogenic MuLVs possess genetic sequences which are not found in nonleukemogenic viruses. These sequences control the histologic type, incidence, and latency of disease induced by individual MuL Vs. PMID- 3527465 TI - Production of monoclonal antibodies to lymphocytes surface antigens. PMID- 3527467 TI - Utilization of 1,N6-etheno-2'-deoxyadenosine 5'-triphosphate during DNA synthesis on natural templates, catalyzed by DNA polymerase I of Escherichia coli. AB - To test whether vinyl chloride-induced mutagenesis might involve ambiguous base pairing of 1,N6-etheno-adenine (epsilon A) during DNA synthesis, we examined the base pairing potential of epsilon dATP during DNA synthesis catalyzed by Escherichia coli DNA polymerase I (Klenow fragment). An electrophoretic assay of chain elongation was used to assess the degree to which epsilon dATP could substitute for each of the normal dNTPs during elongation of a primer annealed to a bacteriophage template. Despite the fact that the etheno bridge completely blocks normal Watson-Crick pairing of epsilon A with T, we observed that epsilon dATP could substitute for dATP during primer elongation (although inefficiently). In addition, detectable substitution of epsilon dATP for dGTP and dCTP occurred, indicating that epsilon A exhibits ambiguous base pairing properties. The relative ease of epsilon dAMP incorporation (opposite template T, C and G) appeared to vary considerably at different positions along the template. The major form of epsilon A incorporation (replacement of A) was confirmed by measurements of epsilon dATP----epsilon dAMP turnover (a commonly used method for detecting misincorporation), and also by the demonstration that epsilon A was present in enzymatic hydrolysates prepared from DNA that was synthesized with epsilon dATP replacing dATP. A model for ambiguous base pairing of epsilon dATP is proposed, in which incorporation occurs via the protonated, syn form of epsilon dATP. PMID- 3527468 TI - Early and late hemodynamic consequences of group B beta streptococcal sepsis in piglets: effects on systemic, pulmonary, and mesenteric circulations. AB - We have modified our previously described experimental model of neonatal sepsis using group B beta hemolytic streptococci (GBS) in piglets and report here early and late hemodynamic responses to GBS infusion in the systemic, pulmonary, and mesenteric circulations. Piglets were anesthetized, intubated, and ventilated. Aortic blood pressure (AOP), pulmonary artery pressure (PAP), central venous pressure (CVP), left atrial pressure (LAP), cardiac index (CI), mesenteric blood flow index (MBFI), and heart rate (HR) were measured directly. Systemic vascular resistance index (SVRI), pulmonary vascular resistance index (PVRI), mesenteric vascular resistance index (MVRI), and stroke volume index (SVI) were calculated. Sepsis was induced by continuous IV infusion of live GBS beginning at 0.5 X 10(7) organisms/kg/min. LAP was held constant throughout the sepsis protocol. PAP and PVRI were the most sensitive hemodynamic indices of early GBS sepsis, rising to greater than two times baseline levels within 11 min of the onset of bacteremia (approximately 1.0 X 10(8) cumulative organisms/kg). In contrast, AOP was unaffected during the first 83 min of GBS sepsis (approximately 25 X 10(8) organisms/kg) but fell from 84 to 47 mmHg in the final 31 min of the experiment. Both CI and MBFI fell monotonically as a function of cumulative GBS dose, reaching 72% and 64% of baseline at 55 min (approximately 12.5 X 10(8) organisms/kg) and 40% and 34% of baseline by 3 hr of sepsis (approximately 125 X 10(8) organisms/kg), respectively. At every GBS dose, the fall in CI was entirely accounted for by a reduction in SVI. SVRI, MVRI, and PVRI were elevated at all times during GBS sepsis. Despite a 34% reduction in systemic oxygen delivery during the first 83 min of GBS infusion (approximately 25 X 10(8) organisms/kg), arterial pH and base excess did not change significantly. Thereafter, pH fell monotonically reflecting the progressive development of metabolic acidosis. PMID- 3527469 TI - The pulmonary microvascular response to infusion of live Escherichia coli in sheep with acutely or chronically prepared lung lymph fistula. AB - The effects of infusion of live Escherichia coli bacteria in awake sheep with a chronic lung lymph fistula (n = 15) were compared to anesthetized animals (n = 7) receiving the same septic insult after surgical trauma including bilateral thoracotomies for lung lymph cannulation (acute group). During preseptic baseline conditions, pulmonary arterial pressure (Ppa) and central venous pressure (Pcv) were increased and leukocytes decreased in the newly operated animals compared to the sheep with a chronic lung lymph fistula. After i.v. infusion of live E. coli 10(9) X kg-1 b.w. over 20 min, arterial pressure (Psa), cardiac output (Qt), leukocytes, and partial pressure of arterial oxygen (PaO2) decreased in both groups. Ppa peaked after 15 min at 37.2 +/- 2.5 in the chronic and 33.4 +/- 3.3 mm Hg in the acute group. In the chronic group, Ppa remained elevated but not in the acute group during the rest of experiment. Lung lymph flow (QL) increased significantly in both groups during the initial high Ppa, but it increased to a higher level in the chronic group. After 150 min, QL did not differ between the groups but remained elevated over baseline. Lymph-to-plasma concentration ratio (L/P) for total protein decreased in the chronic group during the initial high QL. This decrease was not seen in the acute group that had a significantly higher L/P between 30 and 120 min after sepsis. The high QL with unchanged L/P compared to baseline indicated increased permeability in the pulmonary microvessels in both groups but the changes in permeability, hemodynamics, or respiratory parameters after sepsis were not aggravated by the surgical trauma. PMID- 3527470 TI - Surgery for coarctation of the aorta in the neonate. AB - Between 1972 and 1984, 100 consecutive neonates (less than or equal to 30 days old) underwent repair of coarctation of the aorta. Mean (+/- SD) age at operation was 12.0 +/- 8.0 days; mean weight was 3.1 +/- 0.5 kg. Simple coarctation was present in 29 patients (group I), 32 patients had additional ventricular septal defects (group II) and 39 patients had additional complex heart disease (group III). An associated patent ductus arteriosus was present in a total of 81 patients. Subclavian flap angioplasty (SFA) was performed in 70 patients, resection and end-to-end anastomosis (E-E) in 24 patients, and miscellaneous procedures in six patients. All SFA procedures were performed after 1977, and 87.5% of E-Es were done before 1977. The early mortality was 33.3% for patients undergoing E-E and 11.4% for those undergoing SFA. Freedom from reintervention for recoarctation after 5 years was 92.9% for patients who underwent E-E and 75.2% for those who underwent SFA. Actuarial survival at 4 years was 85.5% for group I, 79.9% for group II, and 42.9% for group III. Follow-up was 97.7% for a mean (+/- SD) of 41.9 +/- 37.1 months. It is likely that some of the differences between patients undergoing SFA and E-E with respect to early mortality and freedom from reintervention are due to the different time frames during which the procedures were done. However, neonatal ductal tissue after SFA may contract and fibrose causing recoarctation, while disadvantages related to the circumferential suture line after E-E may have been overemphasized in the past. A prospective randomized trial of these two techniques is warranted. PMID- 3527471 TI - Extended aortic arch anastomosis for repair of coarctation in infancy. AB - Surgical repair of coarctation of the aorta was performed in 17 infants, median age 14 days, median weight 3.5 kg. Extended end-to-end aortic arch anastomosis was used. A long incision was made in the inferior aspect of the aortic isthmus and arch, which was then anastomosed to the obliquely trimmed distal aorta. The aortic arch was hypoplastic in eight patients. Mean cross-clamp time was 17.1 min. Pulmonary artery bands were placed in five patients. Follow-up two dimensional echocardiographic and Doppler studies on 13 patients 1 to 56 months after surgery demonstrated normal distal aortic flow in 10, slightly decreased flow in two, and diminished flow in one. Patients with abnormal Doppler flow showed no gradient in one case and a 30 mm Hg gradient in two. Extended aortic arch anastomosis is safe in infancy, leaves no native coarctation shelf tissue in the repaired segment, does not sacrifice the subclavian artery, is useful in hypoplastic isthmus, and is at low risk to develop aneurysm or recoarctation. PMID- 3527466 TI - Antibody-mediated targeting in the treatment and diagnosis of cancer: an overview. AB - Enhancing the discrimination between tumour and host has been an underlying goal of efforts to improve the diagnosis and treatment of cancer. Over the past 15 years considerable interest has focussed upon targeting systems designed to permit selective delivery of a variety of agents, including drugs, radioisotopes and toxins, to tumours, for both diagnosis and therapy. A vast body of information has accumulated on this subject, and considerable emphasis has been placed on the use of antibodies as carriers, as at present they offer the greatest clinical potential. Many targeting systems have been evaluated in vitro and in pre-clinical models, but few, with the exception of antibody-radioisotope conjugates, have been evaluated in patients. However, systematic evaluation of the therapeutic potential of immunoconjugates in the clinic is planned or already under way. While reviews of some individual aspects of antibody targeting do exist, there are none that encompass this entire field. Our objective is to fill this gap with a concise overview of antibody-mediated targeting for diagnostic and therapeutic applications. PMID- 3527472 TI - Prognostic factors and surgical treatment of partial atrioventricular canal. AB - In this study we sought to determine the prognostic factors that influence early and late survival after repair of partial atrioventricular canal and the need for reoperation. From January 1962 to January 1984, 199 patients underwent correction of partial atrioventricular canal. There were 73 male and 126 female patients, ranging in age from 5 months to 71 years (mean 11.2 years). Total 30 day operative mortality was 5.5%. Since 1980, the mortality has declined to 3%. Significant determinants of operative mortality were congestive heart failure, cyanosis, failure to thrive, age less than 4 years, and moderate-to-severe mitral valve insufficiency (p less than .01). Sex, cardiomegaly, radiographically increased pulmonary vasculature, intraoperative postrepair right ventricular-to left ventricular pressure ratio, and pulmonary-to-systemic flow ratio were not significant in determining early mortality. Follow-up ranged from 1 to 21.4 years (mean 15.2). There were seven late deaths, primarily in older patients from atherosclerotic disease or malignancy. Late survival was 98% at 1 year and 96% at 20 years. Reoperation was performed on 18 patients, 15 for mitral incompetence, and three for subaortic stenosis. The need for reoperation correlated with severity of postrepair mitral insufficiency. Longterm survival is excellent after repair of the partial form of atrioventricular canal. PMID- 3527473 TI - Development of a sandwich ELISA to detect IgG and IgG sub-class antibodies specific for a major antigen (Ag 7) of Aspergillus fumigatus. AB - A sandwich ELISA has been developed, using an affinity purified monospecific antiserum as a capture antibody, to detect specific IgG and IgG sub-classes to a major antigen (Ag 7) of Aspergillus fumigatus in the sera of patients with allergic bronchopulmonary aspergillosis (ABPA). Significantly elevated levels of specific IgG to Ag 7 were detected in 97% of ABPA sera tested, as compared to control sera and to sera from A. fumigatus skin-prick test positive individuals. IgG sub-class antibody levels to Ag 7 were also determined in a similar sandwich ELISA, but using specific monoclonal antisera instead of the polyclonal anti-IgG. Both Ag 7 specific IgG1 and IgG4 levels were found to be significantly raised in the ABPA sera compared to controls. It is proposed that this antigen-specific ELISA may provide a more specific diagnostic test for IgG antibody detection in sera of ABPA patients. PMID- 3527474 TI - Homogeneous, micelle quenching fluoroimmunoassay for detecting amphetamines in urine. AB - We developed a homogeneous fluoroimmunoassay for detecting amphetamines in urine. Only fluorescence intensity need be measured because the emission of non-protein bound fluorescein-labeled amphetamine is preferentially quenched by detergent micelles. In a previous reported prototype assay system for measuring gentamicin in serum we used fluorescein and dodecyl sulfate (Anal Chem 1985; 57:1928-30). We have found that favorable hydrophobic and (or) ionic character of the analyte and unfavorable polar and (or) ionic character of the fluor are important determinants of the desired interactions. An anionic detergent and fluorescein, therefore, should be appropriate for apolar of cationic analytes, such as gentamicin and amphetamines. A greater [H+] at the anionic micelle surface is important for quenching emission from the fluor moiety. Millimolar concentrations of dodecyl sulfate rapidly denature immunoglobulin unless hapten is bound with sufficiently high affinity. Affinity was sufficiently high for the antibody used in the prototype gentamicin assay but not for the amphetamine antibody. Thus for the amphetamine assay, we used a non-denaturing detergent, dodecyl(oxyethylene)12 sulfate. The assay requires 30 microL of specimen in 2 mL of total assay volume. Amphetamine(d-,dl-, and meth-), at a concentration of 1 mg per liter of urine, is readily detected. PMID- 3527475 TI - Use of a reversed-phase evaporation vesicle formulation for a homogeneous liposome immunoassay. AB - Complement-mediated release of enzyme molecules from reversed-phase evaporation vesicles serves as the basis of the sensitive homogeneous immunoassay reported here. We found it necessary to co-entrap the substrate glucose 6-phosphate with the bacterial enzyme glucose-6-phosphate dehydrogenase (EC 1.1.1.49) to protect enzyme activity during liposome preparation. Enzyme can be released specifically from these liposomes by incubation with antibody and complement. the enzyme is not merely available to substrate but is actually physically free of the liposomes. Inhibition of this complement-mediated lysis by theophylline is the basis for the homogeneous liposome immunoassay described. The assay results vary linearly with theophylline concentrations in plasma in the clinically relevant range, and serum components do not interfere. The reagents in the assay kit are stable for at least seven months when stored at 5 degrees C. No nontheophylline compounds reacted significantly with the antiserum used. The assay can be run in a kinetic format, with either ultraviolet or colorimetric detection. PMID- 3527476 TI - Chemometrics: an overview. AB - Chemometrics is broadly defined as the application of mathematical and statistical methods to chemistry. Because the mathematical and statistical aspects of chemistry require measured values, analytical chemists have been at the forefront of the "chemometric revolution." Using the analysis of variance as a paradigm, I present an overview of chemometrics as it is practiced today. Receiving special emphasis are: the design of experiments to acquire information from the relevant universe of possible measurements; the establishment of relationships among independent and dependent variables; the importance of minimizing purely experimental uncertainty; sequential simplex optimization; analysis of principal components; and cluster analysis. PMID- 3527477 TI - The computer as a diagnostic consultant, with emphasis on use of laboratory data. AB - In this preliminary study concerning the applicability of expert computer systems, such as INTERNIST-I, to providing advice to clinical pathologists regarding patients' diagnoses and the pertinence of performing further laboratory tests, 32 complex cases, drawn from Case Records of the Massachusetts General Hospital, were analyzed diagnostically by computer, on the basis of clinical laboratory data only. Half (16 cases) were diagnosed correctly, but in 15 of the rest no diagnostic conclusion could be reached. However, no diagnostic errors were made. The study provides preliminary evidence that expert computer systems can be useful to clinical pathologists and clinical internists in guiding the laboratory workup of patients toward correct diagnosis. PMID- 3527478 TI - Application of the EXPERT consultation system to accelerated laboratory testing and interpretation. AB - The EXPERT consultation system-building tool, a knowledge-based artificial intelligence program developed at Rutgers University, has been applied to the development of a laboratory consultation system facilitating sequential laboratory testing and interpretation. Depending on the results of a basic panel of laboratory tests, the system requests that specific secondary tests be performed. Input of these secondary findings can result in requests for tertiary testing, to complete the database necessary for interpretation. Interpretation of all results is based upon final inferences from the collected findings through a series of rules, a hierarchical network that yields an efficient production system not easily obtained through conventional programming. The rules included in this model are based upon initial results for total protein, calcium, glucose, total bilirubin, alkaline phosphatase, lactate dehydrogenase, aspartate aminotransferase, thyroxin, hemoglobin, mean corpuscular volume, and the concentrations of four drugs. Pertinent clinical history items included are jaundice, diabetes, thyroid disease, medications, and ethanol. Implementing this system in a laboratory-based accelerated testing program involving outpatients maximized the effective use of laboratory resources, eliminated useless testing, and provided the patient with low-cost laboratory information. PMID- 3527479 TI - Perspectives on the use of chemometrics in laboratory medicine. AB - Today's automated laboratory instruments are capable of generating prodigious volumes of high-quality measurements. Increasingly, the powerful mathematical and statistical methods of chemometrics are being called upon to help reduce these measurements to useful information. Chemometric methods have been important in automating various data-intensive functions of the clinical laboratory, including analysis of cellular images, identification of bacteria and fungi on the basis of their metabolic and chemical properties, and identification of drugs and toxic substances from their mass spectra. These methods also appear promising in aiding both the selection and interpretation of laboratory tests for diagnosis, monitoring, and prognosis. In spite of the demonstrated potential of these methods, significant problems remain to be solved in the areas of measurement standardization, data-base collection, and user familiarity with these approaches before chemometric methods can be used most fully by the clinical laboratory. PMID- 3527480 TI - Immunoenzymometric determination of trypsin/alpha 1-protease inhibitor complex in plasma of rats with experimental pancreatitis. AB - The currently available radioimmunoassays of trypsin measure total immunoreactive trypsin (EC 3.1.1.7), which includes both trypsinogen and alpha 1-protease inhibitor-bound trypsin. Hitherto, the only way to differentiate these two forms of trypsin has been to fractionate them on a gel-filtration column. We describe here a solid-phase immunoenzymometric assay that rapidly measures the amount of cationic trypsin bound to alpha 1-protease inhibitor in the plasma of rats with experimental pancreatitis. The assay specifically measures this complex within the range from 0.2 to 5.0 ng without interference by high concentrations of free alpha 1-protease inhibitor. The high correlation (r = 0.985) of the values obtained by size fractionation and by this assay demonstrates the accuracy of the assay, which is the first single-tube method for determining this form of activated cationic trypsin in plasma. PMID- 3527481 TI - Solid-phase immunoassay of digoxin by measuring time-resolved fluorescence. AB - We describe a time-resolved fluoroimmunoassay for the cardiac glycoside digoxin. The assay depends on the competitive distribution of Eu3+-labeled anti-digoxin antibodies between solid-phase-bound digoxin and the digoxin in the sample or standard. After this immunoreaction, the bound fraction of the Eu3+-label is dissociated from the solid phase, converted into a highly fluorescent beta diketone chelate, and measured in a fluorometer with time-resolution (1230 Arcus, LKB-Wallac). Sample volume is 20 microL, the incubation lasts 30 min, and the concentration range of the assay for digoxin is from 0.25 to 4.0 ng/mL (0.32-5.1 nmol of digoxin per liter). Correlation with an in-house RIA was good (r = 0.97, n = 43). The sensitivity was equivalent to that of most RIAs: 0.2 ng/mL (0.25 nmol/L). PMID- 3527482 TI - The lability of estrogen receptor: correlation of estrogen binding and immunoreactivity. AB - We compared the Abbott enzyme immunoassay method for estrogen receptor with a standard dextran-coated charcoal method, and studied the effects of treatments causing denaturation. Estrogen receptor values were slightly higher by the Abbott method, but the methods agreed with regard to receptors being present or absent in 94-98% of 50 cases. Heat lability of immunoreactivity by the Abbott enzyme immunoassay is comparable to the lability of estrogen binding by the estrogen receptor. Estrogen and molybdate substantially stabilized estrogen receptor during the assay, but improper handling of tissue before the assay may cause similar, substantial decreases in estrogen receptor by either method. The Abbott method is easier to use than the dextrancoated charcoal method, requires less tissue, and measures receptor with or without endogenously bound estrogen, but reagent cost is high. PMID- 3527483 TI - Fluorescence polarization immunoassay for ethosuximide evaluated and compared with two other immunoassay techniques. AB - We evaluated a new fluorescence polarization immunoassay (FPIA) for ethosuximide in the Abbott TDx and compared results with those by two other ethosuximide immunoassays, EMIT (Syva Co.) and aca (DuPont). The FPIA assay produced within- and between-day CVs of less than 5% at the low, medium, and high ranges of the standard curve. For the ethosuximide FPIA assay the standard curve was stable during the 47 days of the study. By all three methods, we analyzed 100 serum and plasma samples from patients who were receiving ethosuximide. The coefficient of determination (r2) for TDx versus EMIT was 0.973 (slope, 0.96; intercept, -0.80); for TDx vs aca it was 0.985 (slope, 1.00; intercept, -2.44); both relationships were statistically significant (p less than 0.05). Values for patient's specimens were significantly lower by the TDx than by the aca or EMIT methods (p less than 0.05). PMID- 3527484 TI - In memoriam F. Mason Sones, Jr., M.D. (1918-1985): the man and his work. PMID- 3527485 TI - Intravenous digital subtraction angiography for evaluation of the renal arteries in pediatric patients. PMID- 3527486 TI - Lymphocytosis in the cerebrospinal fluid of a patient with chronic lymphocytic leukemia: the value of immunologic analysis. PMID- 3527487 TI - Normal human serum contains two forms of acetylcholinesterase. AB - We have produced antibodies (polyclonal and monoclonal) against acetylcholinesterase, and used them for immuno-chemical demonstration and quantification of the enzyme in serum. The concentration was 1.2 IU/l. The antibodies were shown not to cross-react with human butyrylcholinesterase, using pure preparations of the enzymes. The serum acetylcholinesterase could be purified using affinity chromatography. The resulting preparation was analyzed using sucrose density gradient centrifugation. Two forms of the enzyme with sedimentation constants of 10.9S and 7.6S were observed, both reacted equally well with monoclonal antibodies towards acetylcholinesterase indicating a common epitope. PMID- 3527488 TI - Physiological concentrations of human epidermal growth factor in biological fluids: use of a sensitive enzyme immunoassay. AB - A sandwich enzyme immunoassay for epidermal growth factor (EGF) has been developed which measures EGF concentrations in serum, urine, saliva, gastric and pancreatic juices without pretreatment. Sensitivity for human EGF is 500 fg/tube. Serum EGF concentration in normal males and females is 780 and 604 pg/ml, respectively. Urinary human EGF is 51.3 ng/mg creatinine for males, and 68.3 ng/mg creatinine for females. The difference is not significant, and no correlation between serum and urinary concentrations exists, but serum concentration changes with age. The highest concentration is seen up to 9 years of age, suggesting that EGF promotes cell proliferation during growth. PMID- 3527489 TI - Highly sensitive enzyme immunoassay for human creatine kinase MM and MB isozymes. AB - A sensitive enzyme immunoassay system for measurement of MM and MB forms of human creatine kinase (CK) was developed using purified monospecific antibodies to the M subunit and to the B subunit of CK. The CK-MM assay system consisted of polystyrene balls with immobilized F(ab')2 fragments of anti-M and the same antibody Fab' fragments labeled with beta-D-galactosidase from Escherichia coli. The CK-MB was assayed with the polystyrene balls with either antibody (anti-M or anti-B) F(ab')2 fragments and the other antibody (anti-B and anti-M, respectively) Fab' fragments labeled with galactosidase. The assays were highly sensitive and 3 pg of CK-MM and CK-MB were measurable. The CK-MM assay was specific to the M subunit of creatine kinase, and it cross-reacted about 15% with CK-MB, but not with CK-BB. The CK-MB assay did not cross-react with CK-MM nor CK BB. Therefore, concentrations of CK-MM could be estimated by subtracting the cross-reacting values of CK-MB. Coefficients of variation in within-run and between-run precision studies for serum CK-MM and CK-MB were less than 9%. Serum levels in healthy adults of various ages (16-59 yr old) were ranged from 35.2-132 ng/ml for CK-MM and from 0.40-1.77 ng/ml for CK-MB. There was apparently no statistical significance among the sex- and age-related differences. Concentrations of CK-MM and CK-MB in various human tissues were also determined. The CK-MM was present abundantly in the heart and the tissues composed of striated muscles (skeletal muscle, diaphragm and proximal esophagus). The CK-MB was distributed not only in the heart but also in the striated muscle tissues at a relatively high level. PMID- 3527490 TI - Determination of urinary estradiol using an enzymatic method during the menstrual cycle. Comparison with an method using isotope dilution-mass spectrometry (ID MS). AB - Results for measurements of urinary estradiol were compared with results from a method using isotope dilution-mass fragmentography. Urine samples were collected from women during the menstrual cycle. The results obtained differed in absolute values, but showed good correlation. PMID- 3527491 TI - Changing practice of medicine. PMID- 3527492 TI - Mechanistic basis of alterations in mucosal water and electrolyte transport. AB - Diarrhoea can, in principle, result from the stimulation of secretion, the inhibition of absorption, or both. In practice, it is the simultaneous stimulation of secretion and inhibition of absorption that has most frequently been observed. The majority of substances affecting the intestine fall into two categories, those stimulating secretion and inhibiting absorption and those having the opposite effects. It is therefore important to understand both the mechanisms of secretion and the mechanisms of absorption. In this chapter, the basic cellular mechanisms by which water and electrolytes are actively absorbed and secreted in the small and large intestine have been presented. The steps at which these mechanisms are thought to be regulated by one or all of the three potential intracellular mediators, cAMP, cGMP and Ca++, have been indicated. It is hoped that an understanding of these basic cellular mechanisms will aid in understanding the pathophysiological conditions of diarrhoea described in the following chapters. PMID- 3527494 TI - Bacterial toxins and diarrhoea. AB - Bacteria and their toxins are responsible for an enormous burden of diarrhoeal disease. Knowledge about the toxins and their mechanisms of action is limited. Thus, although considerable information is available about the mechanism of action of cholera toxin and a small number of heat-stable enterotoxins, information on the role and action of many others is incomplete. The demonstration of a toxic effect in a test system does not necessarily imply that that activity is relevant to the pathogenesis of the diarrhoea. On the other hand, the absence of a toxic effect in experimental systems does not eliminate the possibility that a toxin is responsible for a particular organism's clinical effects. This is a field of active research and much more work is clearly required. PMID- 3527493 TI - Cholera. PMID- 3527495 TI - Eicosanoids and their role in the pathogenesis of diarrhoeal diseases. AB - Eicosanoids are unsaturated fatty acid compounds derived from 20-carbon 'essential' fatty acids, the most important being arachidonate. Both cyclooxygenase and lipoxygenase products of arachidonate are abundant in the human gut and their biological effects include modulation of fluid and electrolyte secretion, motor activity, mucosal blood flow, and cytoprotection, in addition to chemotaxis and immune response in inflammation. In health, these lipid mediators reinforce or synergize normal homeostatic mechanisms that could proceed in their absence. Receptors for control of intestinal secretion can be divided into two major classes, one of which triggers the production of cyclic AMP and another, which initiates phospholipid breakdown and arachidonate release. An intimate connection appears to exist between phospholipid metabolism, cytosolic Ca2+ levels, electrogenic anion secretion, Na+ pump rate, electroneutral Na+/H+ exchange activity, and intracellular pH. Ca2+-dependent secretagogues affect fluid and electrolyte transport in the small and the large bowel by increasing Ca2+ entry and Ca2+ mobilization through stimulation of eicosanoid formation, prostaglandins of the E type being the most important. Secretory diarrhoea may be thought of, therefore, as cellular Ca2+ intoxication. Uncontrolled formation of eicosanoids, perhaps with a changed spectrum of arachidonate metabolites, may not only be the source of diarrhoea associated with mucosal inflammation, but may also be critical for cell proliferation resulting in abnormal cell differentiation, which seems to be the link between long standing inflammatory bowel disease and the increased risk of colonic neoplasia. A better understanding of the pathophysiological role of eicosanoids in diarrhoeal disease has allowed reinterpretation of the rationale behind current therapy. PMID- 3527497 TI - Diarrhee motrice. AB - The gut is a long convoluted tube, in which food is processed and nutrients, salt and water are absorbed. The degree of absorption depends to a large extent on the degree of contact between the luminal contents and the absorptive epithelium. Motor activity can influence the degree of absorption because it regulates the degree of contact with the epithelium and it may also induce secretion by a reflex mechanism. Many factors that induce diarrhoea are associated with 'abnormal' and highly propagative forms of motor activity that can clear material through the gut, allowing insufficient epithelial contact for absorption. These propulsive motor patterns may be provoked by distension of the gut with fluid, but they can also occur in response to diarrhoeogenic factors when there is minimal distension. Patients who complain of increased frequency, urgency and incontinence but pass normal stool volumes often have an abnormality in the motor activity of the anorectum. Thus, the generation of abnormal or propagated forms of motor activity must be regarded as an important component of the pathogenesis of all types of diarrhoea and an increased stool volume can be regarded as the end result of a vicious spiral (Figure 12) that may start with a primary abnormality in either motor activity or epithelial transport. PMID- 3527496 TI - Congenital chloride diarrhoea. AB - Congenital chloride diarrhoea is an autosomal recessive disease characterized by life-long watery diarrhoea of prenatal onset with high faecal Cl- concentration. Seventy-nine patients have so far been reported. The basic defect involves the active Cl-/HCO3- exchange mechanism of the distal ileum and colon. The defect causes impaired absorption of Cl-, acidity of intestinal contents because of impaired excretion of HCO3-, and, secondarily, impaired Na+ absorption. Intra uterine diarrhoea leads to hydramnios and often to premature birth. Unless adequately treated, most patients will die of hypo-electrolytaemic dehydration within the 1st few months of life. Some infants will survive in such a state, with severe alkalosis, hypochloraemia, hypokalaemia, and retarded growth and development. Their plasma renin and aldosterone concentrations will become grossly elevated, and pathological changes will develop in the kidneys. The diagnosis is established when faecal Cl- concentration exceeds 90 mmol/l after water and electrolyte deficits have been corrected. Congenital chloride diarrhoea should be treated with full oral replacement of the faecal losses of Cl-, Na+, K+, and water. This therapy will abolish all the secondary disorders, provide for normal growth and development, and prevent renal disease. Though this therapy does not abolish the diarrhoea, most children will become toilet trained at a normal age, their social adjustment will be unimpaired, and they will live a perfectly normal life. PMID- 3527498 TI - Faecal incontinence. PMID- 3527499 TI - Ileostomy diarrhoea. AB - Proctocolectomy renders patients more prone to significant fluid and electrolyte disturbance due not only to the loss of the normal absorptive capacity of the colon, but also due to unique complications of the postoperative state. Other than causes of diarrhoea unrelated to ileostomy, ileal resection, partial small bowel obstruction, and regional enteritis represent the most common causes of ileostomy diarrhoea following conventional ileostomy. In addition, patients with intra-abdominal reservoirs are prone to develop a bacterial overgrowth syndrome. With reservoirs placed in a pelvic location, as part of an ileoanal procedure, defecatory frequency (with or without high faecal outputs) can also result from ineffective pouch evacuation, decreased pouch capacity or poor sphincteric function. PMID- 3527500 TI - Factitious diarrhoea. AB - Gastroenterologists often have to deal with patients with chronic diarrhoea. The vast majority will suffer from functional bowel syndrome. A few will present with a clear-cut organic disease. If chronic diarrhoea remains unexplained after extensive testing, if daily stool volume is high (greater than 500 g/24 h) and if the patient is female, factitious diarrhoea should be considered. Melanosis coli on sigmoidoscopy, cathartic colon on barium enema examination, a positive room search and chemical detection of the presence of specific laxatives in urine or stool may lead to the correct diagnosis. Treatment and management of such patients is difficult. Denial is the usual response to confrontation. Counselling and guidance by psychiatrists or psychologists is often not accepted by the patient. In many cases the role of the physician may be limited to preventing further potentially dangerous diagnostic and therapeutic interventions. PMID- 3527501 TI - Fetal mortality in sibships of cases with neural tube defects. AB - Rates of fetal mortality in sibships of probands with neural tube defects (NTDs) may reflect liability to NTDs. Expectations from the multifactorial model predict that fetal loss should be higher in sibships of male probands; in multiplex sibships; and sibships where the proband had no additional malformations. This was analysed for 715 pregnancies from 398 sibships. In general, the results did not support the expectations of the multifactorial model. PMID- 3527502 TI - Class II MHC antigen expression in the atherosclerotic plaque: smooth muscle cells express HLA-DR, HLA-DQ and the invariant gamma chain. AB - Class II antigens of the major histocompatibility complex (MHC) are normally expressed only by cells of the immune system. They may, however, also appear on other cells, both in vivo and in vitro. We have studied class II MHC antigen expression on human arterial smooth muscle cells using immunocytochemical analysis of surgical biopsies. The class II antigens, HLA-DQ and HLA-DR are virtually absent from cells of normal arteries, but appear in atherosclerotically transformed tissue, where the majority of cells express HLA-DR, and one-third of the cells express HLA-DQ. These atherosclerotic plaques are composed of a heterogeneous population of cells, which includes smooth muscle cells, macrophages, and T cells. Among smooth muscle cells containing the muscle specific intermediate filament protein desmin, one-third of the cells express HLA DR and almost as many express HLA-DQ. These cells also contain the invariant gamma chain, which is associated with class II antigens during intracellular transport. Plaque macrophages, in contrast, are usually of the DQ-DR+ phenotype. The patterns of class II antigen expression are discussed in relation to cell differentiation and pathogenesis of disease. PMID- 3527503 TI - Association of circulating immune complexes containing bovine proteins and graft versus-host disease. AB - Chronic graft-versus-host disease (GVHD) is a complex immunological disease which can appear in up to 30% of survivors of allogeneic bone marrow transplantation. Target organs include skin, mucous membranes and liver; eventual mucosal defects, specifically involving secretory IgA, have been observed. In these studies we show that transplant recipients who develop GVHD are more likely to have higher serum antibody titres to bovine casein and circulating immune complexes containing casein than patients who do not develop this complication. The stage of GVHD may be related to the level of antibody to casein. The biological role of immune complexes in relationship to the evolution of this disease is unknown. PMID- 3527504 TI - The simultaneous presence of Langerhans' cell and interdigitating cell antigenic markers on inflammatory dendritic cells. AB - Immunohistological studies have been performed on tissues from various dermatological conditions using two monoclonal antibodies, RFD1 and NA1/34. These reagents were used to determine whether antigen expression restricted to interdigitating cells (RFD1+) and Langerhans' cells (NA1/34+) in normal tissues might occur together on dendritic cells involved in cutaneous inflammatory reactions. The results presented demonstrate that in psoriasis, allergic contact dermatitis and atopic dermatitis a proportion of the inflammatory dendritic cells express both antigens. PMID- 3527505 TI - Characterization of two distinct antigens expressed on either resting or activated human B cells as defined by monoclonal antibodies. AB - Two antigen systems (L29 & L30) expressed on two distinct human B cell subpopulations were identified by using BL1-4D6 and TB3-7D5 monoclonal antibodies, respectively. L29 was expressed on approximately one-third of B cells in human lymphoid tissues. These B cells associated with L29 were large activated B cells located in the germinal centres of lymphoid follicles. L30, on the other hand, existed on approximately two-thirds of B cells mainly located in the mantle zone of lymphoid follicles, most of which also expressed IgM and IgD on their cell membrane. In addition, L30 was shared on mature granulocytes. With the use of polyclonal activators such as pokeweek mitogen (PWM) and protein A-bearing staphylococci (SAC), L29 antigen was inducible on PWM- or SAC-stimulated B cells in correspondence with the emergence of Tac and T10 antigens of these B cells. In contrast, L30 antigen on the B cells stimulated by the polyclonal activators was decreased in its expression and was finally lost from these B cells. Although none of L29 and L30 was expressed on normal, non-activated human thymus and peripheral T cells, L29 but not L30 was expressed on concanavalin A-activated T cells. Immunochemical studies showed that L30 consist of a single polypeptide with mol. wt of 40,000. L29 antigen is presently under study. PMID- 3527506 TI - Inhibition of murine bladder tumor growth by bacille Calmette-Guerin: lack of a role of natural killer cells. AB - Intravesical instillation of bacille Calmette Guerin (BCG) currently is considered the most effective treatment for recurrent superficial bladder cancer, but little is known about the mechanism of action. We have adapted a model in which the mouse bladder tumor, MBT-2, is implanted directly into the bladder to examine the mechanism by which BCG inhibits tumor growth. The intravesical administration of BCG inhibited MBT-2 implantation in a dose-dependent manner. Concomitantly, natural killer (NK) activity was augmented in a dose-dependent manner. Conversely, BCG doses which did not augment NK activity lacked antitumor activity. Linear regression analysis showed a significant correlation between the antitumor activity of BCG and modulation of NK activity (correlation coefficient, 0.991). Additional studies were performed in which NK activity was abrogated by administration of anti-asialo-GM1 serum. NK activity was depressed in spleens and lymph nodes of both normal and BCG-treated mice. Abrogation of NK activity did not alter the efficacy of BCG therapy suggesting that NK cells are not a major contributor to the antitumor activity of BCG. PMID- 3527507 TI - Spleen cell factor inhibits lymphoproliferation, abnormal Ia expression and overt autoimmunity in MRL-lpr mice. AB - Autoimmune MRL-lpr have an abnormal pattern of lymphokine production. In our attempt to repair this defect, MRL-lpr mice were prophylactically treated daily with a lectin stimulated rat spleen cell product rich in interleukin-2. Therapy inhibited the lymphoid hyperplasia of the unique lymphocytes regulated by the lpr gene, suppressed the enhanced supranormal expression of Ia on peritoneal macrophages and protected this strain from autoimmune renal injury. Purified recombinant interleukin-2 alone did not prevent autoimmune disease expression. Thus, a spleen cell product other than interleukin-2 can ameliorate the aggressive course of lymphoproliferation and autoimmunity in MRL-lpr mice. PMID- 3527508 TI - Bleaching of root canal treated teeth and cervical external resorption: review of the literature. PMID- 3527509 TI - Abnormal lung and liver uptake of gallium-67 and technetium-99m MDP in hypercalcemia of lymphoma with metastatic pulmonary calcification. AB - Abnormal pulmonary uptake of Ga-67 citrate and Tc-99m MDP and reversible liver uptake of Tc-99m MDP was seen in a patient with hypercalcemia of lymphoma and biopsy-proven metastatic pulmonary calcification. Abnormal lung uptake of Tc-99m MDP may confirm the diagnosis of pulmonary calcification, lessening the need for invasive procedures to evaluate pathologic lung uptake of Ga-67 citrate. PMID- 3527510 TI - Technetium-99m sulfur colloid imaging of vascular thrombosis in pancreaticosplenic transplant. PMID- 3527511 TI - Detection of urinary extravasation by delayed technetium-99m DTPA renal imaging. AB - Delayed imaging with Tc-99m DTPA renal scintigraphy demonstrated urinary extravasation in a patient with acute anuria in whom early sequential imaging showed no abnormal extrarenal radionuclide accumulation. PMID- 3527512 TI - Virilization of a female infant due to an adrenal tumor. AB - We report here the case of a 22-month-old girl with virilization due to a potentially malignant adrenal tumor. She presented with clitoromegaly and growth of pubic hair, first noticed at birth. The clinical picture, hormonal profile, and pathologic findings are described. The practical aspects of the differential diagnosis and treatment are illustrated. PMID- 3527513 TI - Brotizolam, a triazolothienodiazepine, in insomnia. AB - Sixty-three outpatients with chronic insomnia were treated for 3 weeks under double-blind conditions with either brotizolam (n = 29) at a dose of 0.25 mg or 0.5 mg or placebo (n = 34). A 3-day placebo period preceded and followed the double-blind treatment phase. Brotizolam consistently produced significantly more sleep improvement than placebo but also more adverse effects. In those patients switched abruptly from brotizolam to placebo, rebound insomnia was observed, being most marked at the first post-brotizolam placebo night. PMID- 3527514 TI - Antihypertensive and biochemical dose-response study of tripamide. AB - Tripamide is an experimental sulfonamide-derived diuretic antihypertensive agent. Twenty-four hospitalized patients with essential hypertension received placebo followed by 10, 25, 50, or 100 mg of tripamide daily in a randomized, double blind design. All doses of tripamide significantly lowered standing arterial pressure. Changes in blood pressure, heart rate, and weight were not dose related, but the decrease in mean arterial pressure was significantly related to both age (P less than 0.02) and pretreatment blood pressure (P less than 0.05). Serum potassium levels were lowered significantly by the 25 and 100 mg daily doses of tripamide, whereas all doses of tripamide significantly reduced serum chloride levels and produced an increase in serum uric acid levels. Disparate time courses of antihypertensive and diuretic effects and the lack of a relationship between the increase in urine volume and the change in blood pressure suggest an additional antihypertensive action of tripamide or a delayed physiologic adaptation to volume depletion. Equal antihypertensive effects over the range of 10 to 100 mg/day, but greater hypokalemia at higher doses, suggest that future studies should employ the lower doses of tripamide. PMID- 3527515 TI - Physiological and morphological changes in islet B cells following treatment of the guinea pig with alloxan. AB - Alloxan injections (200 mg/kg i.v.) into guinea pigs led to a significant decline of serum insulin levels and a marked inhibition of normal weight gain during the first 96 hr following treatment. Both of these parameters tended to normalize between 96 and 120 hr after treatment. However, neither hyperglycemia nor glycosuria occurred at any time. Volume densities of islet B cells (= volume density of islet cells immunostained for insulin per islet volume density) decreased and pyknotic nuclei appeared in the islets during the initial 48 hr after alloxan treatment. Islet B-cell volume density then returned to normal over the ensuing 24 hr, and remained normal up to 120 hr following administration of alloxan. In summary, after high doses of alloxan were given guinea pigs, serum insulin levels were reduced below control levels within 24 hr; this was associated with changes in body weight which paralleled changes in insulin levels more closely than did levels of blood or urine glucose; the volume density of immunostained B cells initially decreased and then returned to control levels by 72 hr following alloxan injection. The alloxan-treated guinea pig may represent a unique model for studying the restoration of insulinogenic capacity in insulinopenic diabetes. PMID- 3527516 TI - The metabolic response to insulin deprivation in idiopathic brittle diabetes. AB - To test the hypothesis that frequent episodes of ketoacidosis and severe hyperglycaemia in brittle diabetes result from an exaggerated response to insulin withdrawal, the metabolic response to insulin deprivation in 16 severely brittle female diabetics has been compared with that in 6 C-peptide negative stable female diabetic patients of similar age and body weight. 4 hr after stopping insulin infusion, blood glucose was significantly higher in the brittle diabetics (22.8 vs 17.0 mmol/l, p less than 0.001) but blood 3-hydroxybutyrate was not different (1.8 vs 1.6 mmol/l). Concentrations of free insulin and counter regulatory hormones were similar, basally and during the deprivation. Insulin antibody levels were significantly elevated in the brittle patients (11.2 vs 5.2 mmol/l, p less than 0.05) and there was no relationship between glucose or ketone body response and antibody level. Blood lactate, pyruvate, alanine and glycerol were significantly elevated basally in the brittle diabetic patients, but did not respond differently to insulin deprivation. Basal lactate and pyruvate concentrations were significantly correlated with overnight insulin requirements (lactate, rs 0.62, p less than 0.05; pyruvate, rs 0.70, p less than 0.05) suggesting that the elevated basal concentrations resulted from the higher peripheral insulin delivery rates required to maintain overnight normoglycaemia in the brittle patients. We conclude that although there are demonstrable abnormalities of intermediary metabolism in brittle diabetics, neither elevated levels of counter-regulatory hormones, nor an exaggerated response to insulin withdrawal explains the frequent episodes of ketoacidosis in these patients. PMID- 3527517 TI - Influence of acute experimental hypercalcemia on peripheral insulin sensitivity in healthy subjects. AB - Since hypercalcemia is thought to have a modifying effect on glucose metabolism, the possible influence of experimental hypercalcemia on peripheral insulin reaction was investigated in 6 healthy control subjects by the euglycemic clamp technique. Each of these subjects was randomly tested twice, in the normocalcemic as well as in the hypercalcemic state (infusion of calcium gluconate 15 mg/kg body wt. over a period of 180 min). Infusion of calcium gluconate caused a 27% increase in plasma calcium levels, whereas the plasma phosphate levels were not significantly changed during the eucalcemic and hypercalcemic clamp protocol. Steady state plasma insulin levels and plasma glucose levels were nearly identical between the 2 clamp protocols. Exogenous hypercalcemia had no significant influence on peripheral glucose utilization measured by the M-value (M = 4.83 +/- 0.6 mg/kg body wt./min in the eucalcemic state, 4.77 +/- 0.7 mg/kg body wt./min in the hypercalcemic state, n.s.). The present data indicate that at least acute experimental hypercalcemia has no significant influence on peripheral glucose utilization. PMID- 3527518 TI - Effects of retinoic acid on growth, insulin secretion, and hexose incorporation into macromolecules of a continuously growing, insulin-secreting cell line (RINm5F). AB - The continuously growing, insulin-secreting cell line RINm5F does not respond to glucose with increased rates of insulin secretion and cell proliferation. The possibility that retinoic acid, which acts as a differentiating agent in several cell systems, could induce such responses to glucose has been investigated. Retinoic acid (10(-6)-10(-5) mol/l) failed to affect the cell viability, cell proliferation, 3H-thymidine incorporation or the DNA contents of the cultured RINm5F cells, irrespective of the glucose concentration of the culture medium. The insulin release was not affected either by glucose or by retinoic acid. Higher concentrations of the drug (10(-4) mol/l) proved toxic to the cells. The incorporation of 3H-mannose and 3H-glucosamine into TCA precipitable material of the RINm5F cells was strongly decreased by an increased glucose concentration of the medium. The incorporation of 3H-mannose, but not that of 3H-glucosamine, into macromolecules which could be precipitated with Concanavalin A or wheat germ lectin was diminished by retinoic acid (10(-5) mol/l). PMID- 3527519 TI - Sodium retention in response to saline infusion in uncomplicated diabetes mellitus. AB - The response to a 21 infusion of physiological saline infusion was studied in 7 male uncomplicated insulin-dependent diabetics and in 7 non-diabetic male controls. The urinary sodium excretion in the diabetics in each of the 4 hr following the infusion was approximately half that of the controls. The total induced sodium excretion in controls was 34 +/- 4 mmols (mean +/- SEM) but only 14 +/- 4 mmols in the diabetics (p less than 0.005). The hourly creatinine clearance rate was higher in diabetics than in controls indicating a mechanism of reduced sodium excretion via enhanced tubular reabsorption rather than impaired filtration. This propensity to sodium retention in diabetics may play a role in the tendency to cardiovascular and renal complications. PMID- 3527520 TI - The importance of diabetes heredity in lean subjects on insulin secretion, blood lipids and oxygen uptake in the pathogenesis of glucose intolerance. AB - Insulin secretion, work capacity and plasma lipids were evaluated in 52 middle aged men with impaired glucose tolerance (IGT), and the values were compared with those of 23 normoglycemic subjects with family histories of Type 2 diabetes and of 22 non-hereditary normoglycemic controls. All subjects were non-obese males of comparable age. Estimated maximal oxygen uptake was significantly lower (p less than 0.01) and triglyceride concentrations significantly higher (p less than 0.01) in IGT individuals than in subjects of the non-hereditary normoglycemic group, while no significant differences were noted in comparison with the hereditary group. IGT individuals showed an impaired insulin response to glucose with significantly lower absolute values of insulin and C-peptide during the early phase of the oral glucose tolerance test (OGTT) than in non-hereditary normoglycemic subjects, but not significantly lower than in the hereditary group. Similarly, at most time points of the OGTT the ratios of insulin and C-peptide to glucose were significantly lower in the IGT group than in the non-hereditary group, while these differences were less pronounced in comparison with the hereditary group. These findings suggest some similarities of metabolic disturbances in lean normoglycemics with positive family histories of Type 2 diabetes and in lean IGT individuals. Family history of diabetes (both first degree and second degree only) was significantly more prevalent among IGT individuals than among normals. PMID- 3527521 TI - Subclinical diabetes mellitus in the BB rat. AB - The spontaneously diabetic BB Wistar rat is a well recognized animal model for the study of insulin-dependent diabetes mellitus (IDDM). Previously we have noted hyperglycemia and insulitis in BB rats without clinical diabetes. 121 rats were studied prospectively. 43 (36%) were normal and 64 (52%) developed IDDM suspected by the presence of glycosuria and acute weight loss, and confirmed with pancreatic histology. In the remaining 14 (12%) animals, pancreatic histology was also abnormal, varying from mild insulitis only to moderate insulitis and beta cell degranulation. Since these rats gained weight normally, had no glycosuria, or hyperglycemia they were designated as having subclinical diabetes. At death, their plasma-insulin concentrations and the amount of extracted pancreatic insulin was intermediate between that of the normal and diabetic group (p less than 0.001). We have identified a group of rats with pancreatic features of diabetes but no clinical expression. Further investigation of this syndrome may reveal clinical, immunological or histological features which protect these animals from the development of overt disease. PMID- 3527522 TI - Pumped intravenous insulin in experimental diabetes. AB - We infused experimentally diabetic animals continuously with exogenous insulin for periods of up to 324 days. Direct intravenous infusions from a prototype of an implantable device were used to explore whether this route can achieve repetitive control of fasting glycaemia within normal limits, here defined as being between 60 and 120 mg/dl. Fasting plasma glucose levels were controlled by simply adjusting the rate of exogenous insulin delivery when the observed level was outside the range of 100-120 mg/dl. An analysis of the results obtained indicated that 73% (427/591) of the fasting plasma glucose levels were within these normal limits. Remarkably, only 1% (6/591) of them were below 60 mg/dl, the lowest being 42 mg/dl. Hyperglycaemia above 150 mg/dl was seen in 11% (67/591) of the observations. However, all (6/6) of the hypoglycaemic episodes and most, 87% (58/67), of the hyperglycaemic episodes were of an accountable nature secondary to mechanical failures, electrical failures, methodologic or other problems encountered episodically during the long course of these studies. Two parallel control groups of experimentally diabetic animals received the same diet and were treated prospectively by daily subcutaneous injections for periods up to 224 days. The goal of this treatment was to attain metabolic control by either "conventional" or "intensified" injection methods. To these ends, fasting plasma glucose levels were measured on a daily basis (5 days/week) in both groups, and also at intervals postprandially in the intensively controlled group. These data were used to adjust insulin dosages. An analysis of the results indicated that only 24% (148/617) of the fasting plasma glucose levels were within the normal limits.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3527523 TI - Human ultralente insulin: a comparison with porcine lente insulin as a twice daily insulin in insulin-dependent diabetic patients with fasting hyperglycaemia. AB - Six C-peptide-deficient diabetic patients, selected because of raised fasting blood glucose concentrations, participated in a randomised cross-over trial comparing twice-daily porcine soluble plus human ultralente with porcine soluble plus porcine lente insulins. As out-patients, overall mean blood glucose concentrations before and after breakfast were significantly lower during human ultralente therapy (7.2 +/- 0.8 vs 12.0 +/- 1.3, 11.1 +/- 1.0 vs 14.3 +/- 1.0 mmol/l, p less than 0.05), but were unchanged for the rest of the day. During overnight in-patient metabolic profiles a nadir in blood glucose occurred between 2-4 am with both insulin regimens (5.2 +/- 0.9 mmol/l ultralente, 6.5 +/- 1.3 mmol/l lente). Mean fasting and post-breakfast blood glucose levels were significantly lower with human ultralente as were fasting concentrations of glycerol and non-esterified fatty acids (p less than 0.05). Patients with poor overnight metabolic control and raised fasting blood glucose concentrations may benefit from human ultralente insulin, used as part of their twice-daily insulin regimen. PMID- 3527525 TI - Urolithiasis. PMID- 3527524 TI - The effect of short term intensive insulin therapy in non-insulin-dependent diabetics who had failed on sulphonylurea therapy. AB - To determine the effect of short term intensive insulin therapy in non-insulin dependent diabetes mellitus (NIDDM) we studied 10 patients who had been on maximal doses of sulphonylurea therapy, with a glycosylated haemoglobin value persistently above the normal range. All patients were non-ketonuric, had negative islet cell antibodies, and had been on sulphonylureas for a mean duration of 5.6 yr. Patients were maintained at euglycaemia (plasma glucose 4-7 mmol/l) for 24 hr using an open-loop intravenous insulin regimen, and then underwent a standard 75 g oral glucose tolerance test (OGTT). This was repeated after 3 months of treatment with insulin. Mean fasting plasma glucose and glycosylated haemoglobin were 10.1 mmol/l and 12.2% respectively before, and 7.1 mmol/l (p less than 0.001) and 8.4% (p less than 0.001) after treatment. There was no significant change in body weight. Plasma insulin and C-peptide responses to 75 g OGTT did not change significantly, but the total amount of intravenously infused insulin required for 24-hr euglycaemia fell from a mean value of 138 u before treatment to 87 u (p less than 0.001) at the end of insulin therapy. Remission, with glycosylated haemoglobin in the normal range for more than 3 months after stopping insulin, was observed in 5 out of the 10 patients. All 5 who failed to achieve remission had markedly blunted maximal insulin responses of less than 10 mu/l on both OGTT's. Our study shows that insulin treatment in NIDDM appears to exercise a beneficial effect by lowering insulin resistance. We suggest that this may be of advantage early on in patients with NIDDM in preserving B-cell reserve. PMID- 3527526 TI - Current concepts in clinical therapeutics: acute myocardial infarction. AB - The epidemiology and etiology, pathophysiology, diagnosis, clinical presentation, complications, and treatment of acute myocardial infarction (AMI) are reviewed. Major risk factors for AMI include age, sex (men greater than women), family history, race, hyperlipidemia, hypertension, cigarette smoking, diabetes mellitus, and diet. AMI occurs when there is a prolonged decrease in oxygen supply to the myocardium caused by coronary thrombosis or coronary vascular spasm. Traditional drug treatment of uncomplicated AMI includes oxygen, laxatives, and analgesics. For analgesia, narcotic agonists are generally preferred, although intravenous nitroglycerin is of value for both reducing infarct size and relieving pain. Fibrinolytic therapy is also indicated in these patients. Low-dose heparin should be initiated on admission to the hospital. Beta adrenergic blocking agents have proven useful in reducing the incidence of ventricular fibrillation and sudden death. Antiplatelet agents may also be used to decrease long-term mortality. Recent studies have focused on reduction of infarct size using agents such as beta blockers, calcium-channel blockers, nitroglycerin, and thrombolytics. Revascularization procedures are required in some patients to re-establish adequate coronary perfusion. Most patients who survive AMI initially have a relatively uncomplicated clinical course. An increasing number of therapeutic interventions are available for acute and chronic treatment of AMI. PMID- 3527527 TI - Endotracheal drug therapy in cardiopulmonary resuscitation. AB - Use of endotracheal drug therapy during cardiopulmonary resuscitation (CPR) is reviewed. Endotracheal drug therapy--instillation of a drug solution directly into an endotracheal tube for absorption into the circulation via the alveoli- may be used during CPR when venous access is limited. Administration of drugs via a central vein is the most efficient route, but a central i.v. line may not be present and peripheral venous administration may not be possible because of vasoconstriction, trauma, other patient-related factors, or absence of personnel trained to insert i.v. catheters. An endotracheal tube is usually inserted during CPR; in most cases, this procedure can be performed outside the hospital by emergency medical personnel. Basic life-support measures are not interrupted during endotracheal administration as they are in intracardiac drug administration. Drugs that may be administered by the endotracheal route include epinephrine, atropine sulfate, lidocaine hydrochloride, naloxone hydrochloride, and metaraminol bitartrate. Endotracheal delivery of calcium salts, sodium bicarbonate, and bretylium tosylate is not recommended. Pharmacokinetic data for drugs administered endotracheally are lacking; therefore, dosage recommendations are empirical. Usually, the same dose is administered endotracheally as by the i.v. route. Little is known about choice and volume of diluent and the best anatomic site of application. Endotracheal drug administration may replace intracardiac injection as the second-line alternative to intravenous drug injection during CPR. PMID- 3527528 TI - Pathogenesis and management of primary osteoporosis. AB - The pathophysiology of primary osteoporosis and the various therapeutic regimens that have been used are reviewed. Osteoporosis is a major public health problem because the incidence of hip, wrist, and vertebral fractures associated with bone loss is high. Postmenopausal women are at increased risk for developing osteoporosis because bone mineral content is lower in women than in men, dietary calcium intake is frequently insufficient, intestinal absorption of calcium decreases with age, and the rate of bone loss accelerates at menopause. The efficacy of many single and combination therapies in preventing or treating osteoporosis has been studied. Differences in study design and diagnostic techniques and the heterogeneous nature of osteoporosis make evaluation of clinical trials difficult. Exercise helps to maintain skeletal mass, but amenorrhea caused by vigorous activity may be harmful. The efficacy of estrogen replacement therapy is documented best; many studies have shown that estrogens slow the rate of bone loss and reduce the incidence of fractures, but the association of estrogen use with endometrial cancer and breast cancer is of concern. Progesterones may protect against endometrial cancer, but undesirable effects of oral contraceptives have resulted in a hesitancy to use combination hormonal therapy. All adults should meet daily nutritional requirements for calcium, but this intake may be insufficient for elderly persons and is below recommended doses for treating osteoporosis. A daily intake of at least 1000-1500 mg of elemental calcium has been shown to slow the rate of bone loss. Nutritional requirements for vitamin D should be met, but benefits from pharmacologic doses have not been demonstrated. The role of fluoride, calcitonin, anabolic steroids, and vitamin D metabolites is unclear. Fluoride has the potential to increase bone mass, but effects on bone histology and fracture rates require further study. The major goals for the management of osteoporosis are maintenance of bone mass and prevention of fractures. An adequate intake of calcium and regular weight-bearing exercise are important preventive measures. Despite the documented effectiveness of estrogens, risks associated with long-term use are of concern. PMID- 3527529 TI - Current concepts in clinical therapeutics: pressure sores. AB - The etiology, pathophysiology, clinical presentation, prevention, management, and complications of pressure sores are reviewed. Three specific patient populations are at high risk of developing pressure sores: spinal-cord-injury, geriatric long term-care, and orthopedic patients. Pressure sores usually develop at bony prominences on the body as a result of four etiologic elements: pressure, shearing forces, friction, and moisture. Excessive pressure causes poor tissue perfusion, which is normally compensated for by shifts in body position. However, in these patient populations, various abnormalities prevent patients from recognizing or compensating for this pressure. Once a lesion forms, it may progress through four stages marked by worsening necrosis, infection, and tissue loss. The best treatment of pressure sores is prevention. Various mechanical devices may assist the patient in decreasing or distributing pressure, but quality nursing care is essential for debilitated or disabled patients. If a pressure sore develops, treatment should focus on (1) eliminating local pressure, (2) cleaning and removing necrotic tissue, (3) creating a tissue-growth environment, and (4) treating factors that retard wound healing. Drug therapy includes agents for chemical cleansing and debridement of pressure sores and systemic antibiotics for complications such as septicemia or osteomyelitis. Despite efforts to improve treatment of pressure sores, prevention remains the best treatment. PMID- 3527530 TI - Insulin resistance, insulin deficiency and the pathogenesis of diabetes mellitus. PMID- 3527531 TI - Spectral analysis with digital presentation of C-W Doppler signals in the evaluation of carotid stenosis. AB - Using a continuous-wave ultrasound Doppler system with spectral analysis (FFT) and digital processing and presentation, the Doppler shift characteristics of the carotid arteries were studied in 40 healthy subjects (20 men and 20 women; average age 69 years). The reference values, thus obtained, were applied to the analysis of sonograms from 46 carotid arteries, which were also studied angiographically. Stenoses which reduced the diameter of the internal carotid artery by more than 30% could be identified with a sensitivity of 97% and a specificity of 100%. The results extend previous experience that spectral analysis improves the usefulness of the ultrasound Doppler system in the evaluation of carotid artery disease. The addition of digital processing and presentation of the Doppler shift characteristics increases the diagnostic precision and provides a permanent record. The importance of well-trained sonographers and adequate reference values is emphasized. PMID- 3527532 TI - A laser Doppler technique for measuring distal blood-pressure: a comparison with conventional strain-gauge technique. AB - Twenty-five patients with peripheral circulatory disorders were examined by laser Doppler and strain-gauge techniques to compare these methods of measuring distal systolic blood-pressure. The correlation coefficients for simultaneous measurement of toe and ankle systolic blood-pressures were high, 0.98 and 0.99 respectively. The correlation coefficient for successive measurements of toe pressure was lower, 0.83, probably because of a variation in blood-pressure with time. The laser Doppler method seems to be more sensitive than the strain-gauge method in the low-pressure range. The laser Doppler probe is easy to attach to most skin surfaces and the laser Doppler technique may be, therefore, an alternative and a complement to the strain-gauge method when the strain-gauge is difficult to use on damaged or ulcerous toes and feet. PMID- 3527533 TI - Effect of local warming on forearm reactive hyperaemia. AB - Measurement of minimal vascular resistance has proved useful in quantifying structural changes in regional circulations. Accurate measurement of minimal vascular resistance requires full relaxation of all resistance vessels within the region under examination. The usual procedure in humans involves the measurement of maximal forearm blood-flow following 6-10 min of forearm ischaemia. We conducted this study to find whether forearm skin was fully vasodilated by this procedure. Peak forearm blood-flow was measured by plethysmography in six healthy subjects following 10 min of ischaemia while the arm was at a neutral temperature (33 degrees C) and while the arm was locally warmed to 42 degrees C. Peak reactive hyperaemia blood-flow was significantly elevated by local heating (P less than 0.001) to 79.6 ml 100 ml-1 min-1 from a value of 50.2 ml 100 ml-1 min-1 during normothermia. Peak reactive hyperaemia blood-flow in the contralateral unheated forearm showed no significant change between the two periods of ischaemia (P greater than 0.05). These findings were confirmed in four subjects by laser Doppler velocimetry, which gives a linear index of skin blood-flow. In normothermic conditions, this index rose to 0.89 V following 10 min of ischaemia and to 1.26 V with local warming to 42 degrees C (P less than 0.001). Ischaemia plus local warming did not cause a further significant rise in this index of skin blood-flow (1.35 V, P greater than 0.05). These data suggest that 10 min of ischaemia during normothermia is insufficient to relax fully cutaneous resistance vessels and that maximal forearm blood-flow is underestimated by this procedure. PMID- 3527534 TI - [Current status of osteosarcoma therapy]. PMID- 3527535 TI - [A new pharmacologic treatment of primary dysmenorrhea]. PMID- 3527536 TI - [Clinical experience and instrumental evaluation of buflomedil hydrochloride in the therapy of chronic obliterative arteriopathies of the legs]. PMID- 3527537 TI - [Recent findings on lithium salts. Biochemical, neurophysiologic and clinico therapeutic aspects]. PMID- 3527538 TI - [Long-term efficacy and tolerability of captopril in the therapy of arterial hypertension]. PMID- 3527539 TI - [Behavior of blood ammonia, insulin, glucagon, renin and prolactin during propranolol therapy in cirrhosis patients with portal hypertension]. PMID- 3527540 TI - [Clinico-functional study of the activity of a new xanthine derivative: bamifylline]. PMID- 3527541 TI - Electrophoretic techniques in today's clinical laboratory. AB - The clinical laboratory today is being asked to do more tests faster than ever before. The field of electrophoresis is no different than any other part of the clinical laboratory. With these demands comes the need to get more information in a more timely fashion. Agarose gives the clinical electrophoresis laboratory a tool for resolving proteins in a more meaningful manner. These patterns, when confirmed with specific protein analysis and immunofixation electrophoresis, can lead to earlier diagnosis and treatment. Those who say they have no time to run electrophoresis probably have not run electrophoresis lately and are missing out on a very valuable and cost-effective tool. PMID- 3527542 TI - The clinical use of alkaline phosphatase enzymes. AB - The enzyme alkaline phosphatase is an important serum analyte and its elevation in serum is correlated with the pressure of bone, liver, and other diseases. The analysis of the isoenzymes of alkaline phosphatase is an aid in diagnosing liver and/or bone disease, especially the high molecular weight isoenzymes that appear in cholestatic liver disease. PMID- 3527543 TI - Creatine kinase isoenzymes. AB - Creatine kinase (CK), a widely distributed enzyme in the body, has its highest activities in skeletal muscle and myocardium; when serum CK activities are abnormally increased, injury to these organs must be part of the differential diagnosis. The isoenzyme CK-MB is the most important biochemical test in the diagnosis of acute myocardial infarction. PMID- 3527544 TI - Electrophoretic assays of amylase isoenzymes and isoforms. AB - Electrophoretic methods provide an effective means for analysis of amylase isoenzymes and isoforms. A wide variety of such techniques have been developed and reflect different applications and analytic objectives of different investigators. Virtually all of the available clinical data on amylase isoenzymes and isoforms has resulted from application of these methods. Recent identification of selective amylase inhibitors and of monoclonal antibodies to amylase isoenzymes holds promise of development of rapid routine clinical assays for amylase isoenzymes. Electrophoretic methods will have an important role in validating these new assays. Furthermore, at the present time, electrophoretic methods provide the best approach for analyzing isoforms of the pancreatic and salivary isoenzymes. This may be clinically important in patients with tumors, pancreatic pseudocysts, or macroamylasemia. Further clinical experience is needed to define the roles of the various assays that are now available for the estimation of amylase isoenzymes and isoforms in human samples. PMID- 3527545 TI - Panic disorder: a review. PMID- 3527546 TI - Impact of oral hygiene and use of fluorides on caries increment in children during one year. AB - The aim of this study was to assess the modifying effect of oral hygiene, and the use of fluorides on caries increment in children when frequency of meals, intake of sugars and prevalence of lactobacilli and S. mutans in the saliva were known. In 8- and 13-yr-olds it was possible to show that children with a low caries increment (0-2 surfaces) had lower mean values for frequency of meals, daily sucrose consumption and prevalence of lactobacilli and S. mutans in the saliva than children with a high caries increment (greater than or equal to 3 surfaces). There were higher mean values in the low caries-increment groups for toothbrushing frequency, use of fluoridated toothpaste and NaF-mouthrinse. Gingival bleeding index (GBI %) was used as an objective measure of oral hygiene and revealed statistically significant differences between the two groups in both age groups (P less than 0.05, P less than 0.01) with the highest scores recorded in the high caries-increment groups. Using as discriminating variables number of meals/day, daily consumption of sucrose and other sugars and number of lactobacilli and S. mutans in the saliva, 77% of the 8-yr-olds and 70% of the 13 yr-olds were correctly classified with regard to net caries increment. If GBJ %, tooth-brushing frequency, use of fluoridated toothpaste and NaF-mouthrinse were included in the analysis another 4% of the 8-yr-olds and 11% of the 13-yr-olds could be correctly classified. PMID- 3527547 TI - Community mental health centers and insurance reimbursements. AB - This study represents the first of a two-stage project. The first phase of the study examined the funding sources for the 40 Community Services Boards in Virginia. Data provided from the Department of Mental Health and Mental Retardation in Virginia examined fee collections which are comprised of direct client, commercial insurance, Medicaid and Medicare. An analysis of quarterly reports from 1982 to 1984 revealed that Medicaid collections have decreased significantly, while commercial insurance reimbursements have increased significantly. These results, although limited to data from Virginia, point to the need to examine if these shifts are occurring nationwide, and to determine if the shift toward commercial insurance is impacting upon the delivery of services in Community Mental Health Centers. PMID- 3527548 TI - Pneumococcal vaccine in aboriginal children--a randomized controlled trial involving 60 children. PMID- 3527549 TI - Comparative aspects of the apparent Michaelis constant for neutral amino acid transport in several animal tissues. AB - The apparent Michaelis constant, Km, for transport of a number of neutral amino acids has been compared between intestine, heart, brain and erythrocytes among a variety of animals using values available in the literature. Neutral amino acids with side chains containing 3, 4, 7 and 9 carbon atoms had approximately equal mean Km values when tested for intestinal transport among a variety of species; alanine appeared to have a mean Km value that was larger than those found for the first group, and glycine had a significantly greater mean Km than all of the other compounds tested. Km values for phenylalanine and tryptophan measured in rat heart were found to be close to the means measured for these substrates in intestine. The mean Km values measured in mammalian brain for each of the neutral amino acid substrates were found not be significantly different from each other. When the means of Km values for the neutral amino acids tested were compared between intestine and brain, only the glycine means were shown to differ significantly between the organs. Based on data for several mammalian species, brain appears to have a greater average apparent affinity for glycine than does intestine. In the human erythrocytes and in a few other mammalian species, Km values for all neutral amino acids tested with exception of glycine were found to be similar in magnitude to each other and to the Km averages of neutral amino acids found in intestine for the series containing 3-9 carbon atoms. The Km value for glycine in the human erythrocyte was noted to be substantially lower in value than the averages for glycine in brain or intestine. Avian red blood cells appear to have high apparent affinity for neutral amino acid transport when compared with red cells of several mammalian species. PMID- 3527551 TI - RHINOS: a consultation system for diagnosis of headache and facial pain. AB - This paper is intended to describe the expert system RHINOS for diagnosing patients whose chief complaints are headache and facial pain. RHINOS assists physicians in diagnosing the above-mentioned disease. For this purpose the authors surveyed diagnosing processes used by physicians to determine what advice physicians want. As a result, the author reached the conclusion that knowledge for diagnosing the above-mentioned disease should be categorized according to four types of rules: exclusive rules (if the patient has disease D, he must have symptoms S1, S2,....,Sn), inclusive rules (if the patient has symptoms S1, S2,...,Sn, he has disease D with a probability X (0 less than X less than 1)), associate rules (if the patient has symptoms S1, S2,...,Sn the probability that he has the disease D increases) and disease image (if the patient has disease D, he may have symptoms S1, S2,...,Sn). Through harmonious use of these four types of rules, RHINOS gives the advise that physicians want. RHINOS is widely available because it is implemented by Prolog-KABA which is operative on personal computers such as NEC PC9801 and IBM-PC. PMID- 3527550 TI - Imbalance between polymorphonuclear leukocyte proteases and antiproteases in chronic pyogenic infections and its relation to the proteolysis of complement component C3. PMID- 3527552 TI - Nickel allergy to dental prostheses. PMID- 3527553 TI - Cardiac transplantation: first year experience at Hartford Hospital. PMID- 3527554 TI - Abortion 1986: state constitutional perspectives. II. PMID- 3527555 TI - Improvement of aortocoronary bypass patency by antiplatelet drug administration. Preliminary communication. AB - Patients with aortocoronary bypass whose peroperatively measured blood flow amounted to 40 ml/min or less were divided into two groups. The treated group was from postoperative day 0 given 2 X 500 mg acetylsalicylic acid and 3 X 75 mg dipyridamole per day; the control group was without this medication. One month and one year after surgery the patients were examined by coronarography. The first follow-up examination revealed in the treated group 34 patent and 7 occluded bypasses, in the control group 17 patent and 20 occluded bypasses. On late follow-up examination there were in the treated group 24 patent and 13 occluded and in the control group 8 patent and 30 occluded bypasses (p less than 0.001). PMID- 3527556 TI - Nonlinear analysis: mathematical theory and biological applications. AB - Wiener's method of a nonlinear system analysis and its application to neurophysiology are surveyed. His theory is explained on the orthogonal functional series expansion of a nonlinear noise with respect to the Brownian motion whose formal derivative is understood as the white Gaussian noise. Then, efforts made for applying the method to practice are discussed. Special attention is paid on relationship between the internal structure of a given nonlinear system and its kernels of the functionals. This serves to explain a meaning of the kernels. Finally, following the works of one of the authors (K-I.N.) and his colleagues, the analysis of the catfish retinal neuron system is introduced as a typical and successful example of the applications in neurophysiology. PMID- 3527557 TI - Cerebral magnetic fields. AB - A critical presentation is given about the state-of-the-art of neuromagnetism, the study of neural functions by the measurement of magnetic fields. First, an introduction is given about the neural origin of electromagnetic fields. The forward and inverse problems are then studied. The forward problem can be stated as follows: given electrical currents in the brain, calculate the magnetic field. Correspondingly, the inverse problem is to calculate currents in the brain from the magnetic field measured outside the head. The instrumentation necessary for successful neuromagnetic measurements is discussed, and the emphasis is on new developments. The review of experimental neuromagnetic results discusses studies on spontaneous cerebral magnetic fields in normal subjects and in epileptic patients. Furthermore, evoked-field studies of the various sensory modalities as well as studies of event-related fields are reviewed. The relevance of various efforts in neuromagnetism and prospects for the future are discussed. PMID- 3527558 TI - Effects of Escherichia coli endotoxin on pulmonary vascular resistance in intact dogs. AB - The effects of endotoxin on pulmonary hemodynamics were studied in seven intact dogs. The distribution of pulmonary vascular resistance was estimated by the effective pulmonary capillary pressure, which was derived from the pressure transient recorded while the pulmonary artery catheter was rapidly wedged. After the injection of endotoxin, cardiac output and aortic pressure consistently fell. Pulmonary artery occlusion (wedge) pressure also decreased, but not significantly. Although pulmonary artery pressure did not necessarily rise, total pulmonary vascular resistance increased in every dog. The absolute increase in pulmonary artery resistance was greater (142 mm Hg/L X min/kg); than in venous resistance (111 mm Hg/L X min/kg); however, the relative increase in venous resistance was higher (410% for venous resistance vs. 220% for pulmonary artery resistance). As a result of venoconstriction, there was a consistent increase in effective pulmonary capillary pressure (from 2.5 to 6.3 mm Hg). Our data indicate that the pulmonary vascular response to endotoxin injection is characterized by constriction of both pulmonary arteries and pulmonary veins. The capillary wedge pressure did not reflect the pulmonary microvascular pressure, since it varied in the opposite direction to the effective capillary pressure. PMID- 3527559 TI - Acquired immunodeficiency syndrome in the United States: a selective review. AB - The acquired immunodeficiency syndrome (AIDS) epidemic shows no sign of waning. Recent calculations suggest that several hundred thousand asymptomatic people may have been infected with the putative AIDS agent, HTLV-III/LAV. This review includes an analysis of immunologic data, means of preventing transmission of the syndrome, and a discussion of the psychosocial and ethical impact of the disorder. Also summarized are epidemiologic and clinical parameters of AIDS in the US. PMID- 3527560 TI - In memoriam S. Cooper, 1922-1985. PMID- 3527561 TI - A technical bias: differences in cooling rates prevent ampoules from being a reliable index of stem cell cryopreservation in large volumes. AB - Ampoule tests are commonly used as an index of the cryopreservation efficiency of marrow stem cells in bags. We have studied the recovery of hematopoietic progenitor cells (CFU-GM, BFUe) in 52 ampoules and compared it to the recovery in 83 standard bags. Our data showed significantly deficient CFU-GM and BFUe recoveries (respectively 47 +/- 31% and 31 +/- 30%) in ampoules when compared to bags (respectively 72 +/- 22% and 64 +/- 19%; P less than 0.001). Moreover, a good progenitor cell recovery (greater than or equal to 50%) was observed in only 46% of frozen ampoules versus 100% observed in frozen bags (P less than 0.05). We were able to relate this nonoptimal recovery to an excessively rapid freezing rate of -9 degrees C/min following the release of fusion heat which occurred in ampoules, while the freezing rate was constantly maintained at -2 degrees C/min in the corresponding bags. We therefore conclude that the cooling conditions have to be carefully controlled to ensure that the bags and ampoules are both cooled under the same conditions. Otherwise, ampoules would not be a reliable index of the true progenitor cells' cryopreservation efficiency in bags. PMID- 3527562 TI - Clinical cryobiology of tissues: preservation of corneas. AB - It is well recognized that the clarity of the cornea is a function of its hydration, and that this hydration is controlled by a "pump-and-leak" mechanism operating across the posterior monolayer of cells called the endothelium. A breakdown of the endothelium through disease or injury causes a marked increase in corneal thickness as the stroma imbibes fluid from the aqueous humor in the anterior chamber of the eye. This thickened, edematous condition of the stroma results in a cloudy cornea with an associated marked decrease in visual acuity. Treatment for this condition is usually by full-thickness corneal transplantation (penetrating keratoplasty), the success of which is dependent upon the donor cornea having an intact and healthy endothelium. It is essential, therefore, that any method of corneal storage for penetrating keratoplasty should protect and preserve the endothelium in a viable state. Current clinical practice relies upon short-term methods of preservation by two principal methods. Moist Chamber Storage is the time-honored corneal preservation method; it consists of keeping enucleated eyes at 0-4 degrees C in a sealed jar containing a pad of cotton gauze soaked in saline to provide a humid environment. The time limit placed upon this method of storage is 24-48 hr after which the viability of the endothelium deteriorates rapidly. Storage in M-K (McCarey-Kaufman) Medium involves excision of the corneoscleral segment from the donor eye and immersing it, endothelial side uppermost, in a medium consisting of tissue culture medium, 5% Dextran 40, and antibiotics. Laboratory and clinical studies indicate that storage in M-K medium at 4 degrees C preserves human endothelial cells for up to 4 days when the eye has been removed from the cadaver in less than 10 hr postmortem. Long-term preservation of corneas by freezing has long been a major goal in eye banking because indefinite storage by cryopreservation offers significant advantages for the quality and the quantity of material for use in keratoplasty, as well as for its distribution. However, procedures that have been developed for the cryopreservation of corneas have not been widely used, and a number of studies have shown that these procedures are inadequate for maintaining the integrity of the corneal endothelium. Not surprisingly, clinicians are now reluctant to accept corneas that have been frozen by these methods, though the clinical need is now greater than ever.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3527563 TI - Meat flavor volatiles: a review of the composition, techniques of analysis, and sensory evaluation. AB - Flavor is an important quality attribute which relates to the organoleptic characteristics of meat. Although perception of flavor is a complex phenomenon, odor is the most important single factor contributing to the overall characteristics of flavor. A large number of compounds have been identified in the volatile fraction of red meats and poultry. An overview of the chemical constituents present in the volatiles of beef, pork, mutton, and chicken is presented according to species and arranged by chemical class--hydrocarbons, alcohols, acids, aldehydes, ketones, sulfides, heterocyclic compounds, etc. The volatile components of cured and uncured pork are compared. The field of meat flavor is assessed in terms of what has been accomplished and the direction in which it may proceed. Techniques for analysis of these volatiles are briefly described. PMID- 3527564 TI - Water sorption by proteins: milk and whey proteins. AB - The content and physical state of water in foods influence their physical, chemical, quality, safety, and functional behavior. Information concerning the sorption behavior of dairy proteins, in the water activity (Aw) range 0 to 0.9, is collated in this paper. The sorption behavior of proteins in general, the kinetics of absorption, factors affecting water binding, the phenomenon of desorption hysteresis, and the chemical and physical nature of water/protein interactions are reviewed in general terms. This is followed by a discussion of thermodynamic aspects of sorption phenomena and the adequacy of the various equations for describing sorption isotherms of proteins. After a discussion of the methods available for measuring sorption by milk proteins, the sorption behavior of various milk protein preparations, i.e., nonfat dry milk, whey proteins, caseins, and milk powders is summarized. Finally, the water activity of cheese and its relationship to solute mobility and solvent water are discussed. Some of the unique features of protein behavior, i.e., conformational changes, swelling, and solubilization are cited as possible sources of disparities between various reports. PMID- 3527565 TI - Capsicum--production, technology, chemistry, and quality. Part III. Chemistry of the color, aroma, and pungency stimuli. AB - The spice capsicum, the fruits of the genus Capsicum (Family Solanaceae), is a very popular food additive in many parts of the world, valued for the important sensory attributes of color, pungency, and aroma. A large number of varieties are widely cultivated and traded. The characteristic carotenoids of the bright red paprika and cayenne-type chillies, the high character impact aroma stimuli, the methoxy pyrazine of green bell capsicum, the esters of ripe tabasco and the highly potent pungency stimuli, and the capsaicinoids of African and other Asian varieties of chillies, have been of great interest to chemists and biochemists. Research workers in other disciplines such as genetics and breeding, agriculture, and technology have been interested in this spice to develop new varieties with combinations of different optimal levels of the stimuli for the sensory attributes and to maximize production of storable products for specific end uses. Physiologists have been intensely studying the action of the highly potent pungency stimuli and social psychologists the curious aspect of growing acceptance and preference for the initially unacceptable pungency sensation. In the sequential review of all these aspects of the fruit spice Capsicum, the earlier two parts covered history, botany, cultivation and primary processing, and processed products, standards, world production, and trade. In Part III, the chemistry, the compositional variations, synthesis and biosynthesis of the functional components, the carotenoids, the volatiles, and the capsaicinoids are comprehensively reviewed. PMID- 3527566 TI - Carcinogenic principles isolated from bracken fern. AB - The carcinogenicity of bracken fern, Pteridium aquilinum, was demonstrated most clearly by the experiment of Evans and Mason in 1965. We have performed fractionation of the aqueous extract by means of the assay based on carcinogenicity and isolated an unstable norsesquiterpene glucoside of illudane type named ptaquiloside (PT). It was proved that PT is the carcinogenic principle present in bracken fern, inducing mammary cancer and multiple ileal tumors in high incidences when given orally to female Sprague-Dawley rats. The present review article deals with the explanation of carcinogenicity of bracken fern, progress in separation of carcinogenic fraction, isolation of PT, and its carcinogenic activity in rats. PMID- 3527567 TI - Models of hepatocarcinogenesis in the rat--contrasts and comparisons. AB - A variety of approaches for the induction of altered hepatic foci, hyperplastic nodules, and hepatocellular carcinomas in rat liver have been developed. These protocols, aided by the appearance of preneoplastic lesions during the carcinogenic process, have proven to be very useful for examining many of the characteristics of events involved in rat hepatocarcinogenesis. A number of models have demonstrated distinct steps or stages in the progression of the carcinogenic process. These protocols are currently employed in the classification and distinction of agents effecting hepatocarcinogenesis at one or more of its stages. This review presents an overview of the present-day multistage hepatocarcinogenesis model systems in the rat, with contrasts and comparisons of these systems. The potential uses of the model systems in the identification of complete carcinogens, initiating agents, and promoting agents devoid of initiating action are discussed. PMID- 3527568 TI - Relationship between proteases and descemetocele formation in experimental Pseudomonas keratitis. AB - Proteases are involved in the pathogenesis of Pseudomonas aeruginosa infections of the cornea. Although there are many potential roles for these enzymes, involvement in corneal stroma destruction with subsequent descemetocele formation and/or corneal perforation is an important example. This study examined the relationship of elastase and alkaline protease to corneal destruction as indicated by descemetocele formation. The protease content of the overnight Mueller-Hinton broth cultures of various strains of P. aeruginosa correlated with the production of descemetoceles both in the rabbit trauma model of Pseudomonas keratitis and upon intrastromal injection of filtrates of the overnight culture media. The levels of alkaline protease correlated better with descemetocele formation than those of elastase. The influx of inflammatory cells was not correlated with descemetocele formation within 24 to 48 hrs. PMID- 3527569 TI - Diabetes mellitus in the child and adolescent: Part I. PMID- 3527570 TI - Suppurative diseases of the lung and pleural space. Part II: Bronchiectasis. PMID- 3527571 TI - Funding of graduate medical education: perspective of a surgical educator. PMID- 3527572 TI - Financing graduate medical education. PMID- 3527573 TI - An in vivo test of viability for cryopreserved human skin. PMID- 3527574 TI - Direct cardiac effects of supramaximal insulin. PMID- 3527575 TI - Hyperacute rejection of liver transplants in rats. PMID- 3527576 TI - Biogenesis of lipoproteins in bacteria. PMID- 3527577 TI - Production and release of cloacin DF13 and related colicins. PMID- 3527578 TI - In vitro analysis of the bacterial protein export. PMID- 3527580 TI - Lymphedema tarda. AB - Lymphedema tarda is a rare form of primary lymphedema. Its cause is unknown; an autoimmune destruction of lymphatic channels can be hypothesized. A case of lymphedema tarda in which direct immunofluorescent studies of involved tissue showed no immune deposits is presented. The differential diagnosis of this condition is also discussed. PMID- 3527579 TI - Signal peptidases. PMID- 3527581 TI - A sequential study of hepatic structural damage following the intravenous injection of Corynebacterium parvum. AB - Sequential histological and fine structural changes were studied in liver from 4.5 min to 21 days after a single intravenous injection of Corynebacterium parvum in the rat. A previously unreported effect of the micro-organism, the formation of eosinophilic inclusion bodies within hepatocytes, was observed between 15 min and 24 h of injection. These structures were most common in periportal hepatocytes at 2 h. The structural, enzyme- and immunohistochemical features of these bodies suggest that they represent a consequence of sub-lethal cell injury, affecting the endoplasmic reticulum or Golgi apparatus; resolution occurred within 24 h. The ingestion of C. parvum by phagocytes and the deposition of fibrin within sinusoids preceded the development of acute and chronic parenchymal and portal tract inflammation, leading to self-limiting granulomatous hepatitis. Lethal cell injury was represented by the presence of single-cell and confluent hepatocyte necrosis. Intravenous C. parvum causes sublethal and lethal hepatocyte damage, seen as the formation of cytoplasmic bodies and hepatocyte necrosis, respectively. Disseminated intravascular coagulation may mediate these changes via local hypoxia. This model could prove useful in the study of granulomatous hepatitis and in the evaluation of anti-inflammatory agents. PMID- 3527583 TI - Patient compliance with nasal CPAP therapy for sleep apnea. AB - Continuous positive airway pressure via the nasal route (nasal CPAP) is effective in reducing the frequency of occlusive and mixed patterns of sleep apnea. Little is known about long-term patient compliance with this therapeutic modality, however. In order to evaluate this, questionnaires were mailed to 24 sleep apnea patients who had received a nasal CPAP system for nightly use. Patients were requested not to sign the questionnaire. At the time of mailing, the patients had possessed their nasal CPAP equipment for 10.3 +/- 8 months (mean +/- SD). Twenty patients (83 percent) responded to the questionnaire. Sixteen responders used nasal CPAP during all nightly sleep time, and two used it for all but one and 2.5 hours of nightly sleep time, respectively. One individual used it on alternate nights, and one patient did not use it all. Thus, 17 of 20 (85 percent) responders were compliant. Including information about the four nonresponders, obtained by means other than questionnaire, 18 of 24 (75 percent) patients were compliant with therapy. All but two patients were obese at the time sleep apnea was diagnosed. Only 50 percent of questionnaire responders reported weight loss after receiving nasal CPAP, and these individuals were frequent nasal CPAP users. The most common complaints were mask discomfort (14 responders) and nasal dryness and congestion (13 responders). We conclude that long-term home nasal CPAP is a viable therapy that is conscientiously applied and well-tolerated by most sleep apnea patients. PMID- 3527582 TI - An ultrasound examination of tongue movement during swallowing. PMID- 3527584 TI - Tracheostomy in the intensive care unit. Part 2: Complications. PMID- 3527585 TI - Use of fables in clinical assessment of contested child custody. PMID- 3527587 TI - [Suction technics]. PMID- 3527586 TI - [Treatment of scorbutic disease in the XVIIth and XVIIIth centuries]. PMID- 3527588 TI - [Atraumatic grinding and polishing. Economical rotation speed. (Maintenance of dental tissues, management of the pulp)]. PMID- 3527589 TI - [The smear layer. Current data on this iatrogenic endodontic residue]. PMID- 3527590 TI - [Elective surgery of stomach ulcer]. PMID- 3527591 TI - [Hemorrhage in peptic gastroduodenal ulcer: data as a deciding aid in the concept of surgical therapy]. PMID- 3527593 TI - [Atypical resection and anastomosis technics in ulcer surgery]. PMID- 3527592 TI - [Antimicrobial chemoprevention in colorectal interventions: a single parenteral dose at the start of surgery is adequate]. AB - The effectivity in reducing septic complications after colorectal operations of oral 1 g Neomycin plus 0.25 g Metronidazol t.i.d. on the last preoperative day vs. intravenous single dose 5 g Mezlocillin plus 0.5 g Metronidazole was tested by sequential medical plan. There was no statistically significant difference between both chemoprophylaxis groups (p = 0.10). It is concluded that the intravenous chemoprophylaxis should be preferred because of the lowest dosage and therefore the fewest side-effects. PMID- 3527594 TI - [Interventions on the pylorus--indications and technical variants]. PMID- 3527595 TI - [Anastomotic stoma. A variation of the Mikulicz procedure]. PMID- 3527596 TI - [Effects of an analog of LRH on luteal function in normal women; report of 18 cases]. PMID- 3527597 TI - [Computer-aided prediction of the outcome of cephalic labor presentation]. PMID- 3527598 TI - [The value of renal immunofluorescence examinations in the diagnosis of lupus nephritis--an analysis of 25 cases as compared with idiopathic glomerulonephritis]. PMID- 3527599 TI - [An approach to early diagnosis of pancreatic cancer: a clinical analysis of 261 cases]. PMID- 3527600 TI - [Immunological aspects of cerebrovascular disease]. PMID- 3527601 TI - [Spongiform encephalopathy--clinical and pathological report of 1 case]. PMID- 3527602 TI - [Ultrasonic diagnosis of cardiac carcinoma]. PMID- 3527603 TI - [Clinical and immunopathologic study on 100 cases of rheumatoid arthritis]. PMID- 3527604 TI - [The significance of measurement of beta 2 microglobulin in pleural effusion and serum in the differential diagnosis of pleural effusion]. PMID- 3527605 TI - [Current clinical study of pulmonary disease due to Mycobacterium kansasii or M. avium intracellulare in the United States]. PMID- 3527606 TI - [Identification of atypical mycobacterium infections by PPD-B skin tests]. PMID- 3527607 TI - [Pneumonia caused by Staphylococcus aureus]. PMID- 3527608 TI - [A review of congenital tuberculosis]. PMID- 3527609 TI - [Advances in the study of anti-silicotic agents]. PMID- 3527610 TI - Human chorionic gonadotrophin expression in colorectal adenocarcinoma. AB - The presence of human chorionic gonadotrophin (HCG) in colorectal adenocarcinoma was studied histologically in 45 tumors using immunoperoxidase technique. Ten neoplasms (22.2 percent) contained HCG-positive tumor cells. These cells were present mostly at the periphery of the tumors. Many formed parts of glands, while some were arranged in syncytial clumps or columns, or singularly. Thus, these tumor cells resembled trophoblastic tissue not only in being HCG-positive but also in their peripheral distribution and occasionally in morphologic appearance. HCG-positive tumors were seen more commonly in the rectosigmoid region (90 percent) and were more aggressive than HCG-negative tumors. In this study, lymph node or liver metastases were present in 70 percent of HCG-positive tumors compared with 29 percent of negative tumors--a difference which is statistically significant. PMID- 3527611 TI - Classic articles in colonic and rectal surgery. Sir Charles Gordon-Watson 1874 1949. The radium problem. The treatment of carcinoma of the rectum with radium. PMID- 3527612 TI - Simple solution to problem of biostator-induced insulin aggregation. AB - It has recently been reported that there is a significant loss of insulin immunoreactivity and bioavailability secondary to heat-induced insulin aggregation during prolonged insulin delivery by the Biostator. This artifact of Biostator insulin delivery system makes data generated by studies that use prolonged, continuous insulin infusions performed with the Biostator uninterpretable. We report the prevention of this problem by the addition of 20 ml heparinized whole blood to a 500-ml reservoir containing the insulin to be infused. The proposed solution is simple, economical, and without risk to the subject since his or her own blood can be used. PMID- 3527613 TI - Impaired cardiac adjustment to pregnancy in type I diabetes. AB - To assess the adaptation of the heart of diabetic subjects in the natural volume overload state of pregnancy, echocardiography was performed during each trimester and postpartum in 17 women with insulin-dependent diabetes mellitus (IDDM) and in 11 healthy women. The mean duration of diabetes was 14 yr and signs of microvascular complications were detected in 6 patients. The diabetic women had slightly smaller left ventricles than the control women already in the basal state (postpartum), and the pregnancy-induced increase in left ventricular size and stroke volume was less in the diabetic than in the control women. The heart rate rise also tended to be less in the diabetic women, resulting in a markedly smaller increase in cardiac output in this group (1.3 vs. 3.4 L/min, P less than .01). Left ventricular systolic function, wall thicknesses, or left atrial size did not differ between the groups at any point in the study. Minor collections of pericardial fluid were observed in 14 (76%) diabetic women and in 5 (45%) control women during the second and/or third trimester, but only 2 diabetic women had classic pericardial effusions. In conclusion, the normal hemodynamic adjustments to pregnancy seem to be impaired in women with IDDM. Preclinical diabetic cardiomyopathy and autonomic neuropathy may be involved in the observed alterations. PMID- 3527614 TI - Current therapeutic concepts in diabetic hypertension. AB - Diabetes mellitus and hypertension are both prevalent in the adult population. The development of hypertension in the diabetic patient is likely to increase the morbidity and mortality in a subgroup already at high risk for atherosclerosis and deserves special consideration. Several studies have confirmed the beneficial effects of antihypertensive therapy on complications such as diabetic nephropathy. This emphasizes the importance of normalizing blood pressure in the diabetic population. It has been suggested that the threshold for initiating antihypertensive therapy should be lower in diabetic patients. All antihypertensive agents have potential disadvantages in patients with diabetes. The commonly encountered effects include deterioration of diabetic control, sexual dysfunction, electrolyte imbalance, and lipid disorders. The adverse effects of these agents on serum lipids have been implicated in the less-than expected reduction in coronary heart disease noted in some studies. The recent Lipid Research Council study has emphasized the importance of elevated lipid levels and increased cardiovascular mortality. Antihypertensive therapy has advanced rapidly in the last 5 yr. The special problems in the treatment of hypertension within the diabetic population are now receiving greater attention. Undesirable biochemical side effects of drugs used to treat hypertension have become publicized, and the long-term consequences of these abnormalities are under critical scrutiny. The new antihypertensive medications offer exciting alternative approaches to the more traditional agents with less chance of significant metabolic side effects. PMID- 3527615 TI - Fat atrophy in human insulin therapy. PMID- 3527616 TI - Acute radiation syndrome. PMID- 3527617 TI - Clinical aspects of islet B-cell function in non-insulin-dependent diabetes mellitus. PMID- 3527618 TI - Current approaches to measurement of insulin secretion. AB - The studies reviewed in this article have indicated that C-peptide and insulin are cosecreted from the beta cell in equimolar concentration, that C-peptide does not undergo significant hepatic extraction, and that its MCR remains constant over the physiologic range of concentrations. Furthermore, the peripheral kinetics of distribution of C-peptide can be described by a two-compartment mathematical model. If model parameters are derived in individual subjects by analysis of C-peptide decay curves, this information can subsequently be used to derive insulin secretion rates with a great degree of accuracy from endogenously secreted C-peptide concentrations. The application of this approach to clinical research studies should greatly enhance our understanding of insulin secretion. PMID- 3527619 TI - C-peptide: an index of insulin secretion. AB - Insight into the natural history of beta cell function in IDDM patients obtained by C-peptide measurements is reviewed. It is argued that residual insulin secretion of metabolic importance is present in all IDDM patients during the initial course of the disease. After some months, beta cell function reaches its maximum; thereafter it declines at different rates dependent on the age at onset of diabetes and, possibly, on the presence of ICA and HLA-antigens. As many as 15% of IDDM patients retain life-long beta cell function that persists at approximately 10% of that observed in nondiabetic individuals. The residual endogenous insulin secretion is characterized by reduced capacity, as well as abnormal insulin secretory kinetics; these defects in residual insulin secretion can be modulated by changes in metabolic regulation as well as by immunosuppression during the initial course of the disease. PMID- 3527620 TI - Heterogeneity of insulin secretion in type II diabetes. PMID- 3527621 TI - Oligodeoxynucleotide-directed mutagenesis of Escherichia coli and yeast by simple cotransformation of the primer and template. AB - A method of oligodeoxynucleotide-directed mutagenesis is presented which requires no in vitro DNA synthesis. Cotransformation of the synthetic primer and single stranded template into competent spheroplasts of Escherichia coli or Saccharomyces cerevisiae generates the directed mutation. The desired event is detected genetically or by hybridization screening using the mutagenic oligodeoxynucleotide as a probe. The targeted mutation arises at a frequency of approximately 0.1%. In one extensively studied case in E. coli, involving creation of a 99-bp deletion, this procedure produced many fewer untargeted mutation events than did conventional protocols. PMID- 3527622 TI - Congenital anomalies in offspring of insulin-dependent diabetic mothers. PMID- 3527623 TI - Effect of ammonia on glucagon secretion from the perfused pancreas of cirrhotic rats. AB - Effects of ammonia on glucagon and insulin secretion from the perfused pancreas of cirrhotic rats were investigated to clarify the occurring mechanism of hypersecretion of pancreatic glucagon in liver cirrhotics. The results were as follows: During ammonia loading, insulin secretion was inhibited in a dose related manner, whereas glucagon secretion was gradually increased at high concentrations of ammonia (2 mM) in control rats; this tendency was augmented in the presence of alpha-ketoglutarate in cirrhotic rats. On cessation of ammonia loading, a transient but definite increase in glucagon and insulin secretion was observed. Basal plasma glucagon and ammonia levels as well as basal glucagon secretion from the perfused pancreas of cirrhotic rats were significantly higher than in control rats. Basal insulin secretion from the perfused pancreas of cirrhotic rats was not different in spite of high levels of plasma insulin. Glucagon secretory response to glucose and arginine from the perfused pancreas of cirrhotic rats was higher than in the control pancreas, whereas insulin secretion was lower. In these cirrhotic rats, an increase in the number of islet cells, particularly A cells, was observed. These data suggested that hypersecretion of pancreatic glucagon which was responsible for hyperglucagonemia in cirrhotic rats might be attributed to high levels of ammonia and alpha-ketoglutarate in blood as well as to the fluctuation of abnormal ammonia concentration in blood and to the hypertrophy of islets, particularly of the A cell group due to hypersecretion. PMID- 3527624 TI - Osteopenia in mice with genetic diabetes. AB - Bone mass and growth were studied in mice with genetic diabetes (db/db) characterized by obesity, hyperinsulinemia and hyperglycemia, in their lean litter mates (db/+) and in non-diabetic mice of the same strain (+/+). No significant difference was observed between db/+ and +/+ mice. The length, bone mass, bone mineral mass, bone mineral density and content of moisture of the tibia of the db/db mice were significantly decreased compared with the db/+ and +/+ mice. Microradiographs of the distal femur diaphysis of the db/db mice showed a significant reduction of the spongious bone area and of the number and thickness of bone trabeculae with a normal mineralization. The amount of osteoid was significantly increased in the db/db mice. The area of cortical bone of the tibia epiphysis of the db/db mice was significantly decreased compared with the db/+ and +/+ mice. The data suggest the occurrence of osteopenia due to decreased mineralization in mice with genetic diabetes. PMID- 3527625 TI - Sustained improvement in diabetic control on long-term self-monitoring of blood glucose. AB - The benefits of self-monitoring of blood glucose (SMBG) were assessed in 38 Chinese adults on conventional insulin regimens who had been performing SMBG for a mean duration of 26 months (range 15-40). For analysis patients were divided into 2 groups. Group A consisted of 27 insulin-requiring patients who were referred for SMBG because of poor control or young age (less than or equal to 35 years). Group B consisted of 11 IDDM patients who were on SMBG from diagnosis. Mean age and duration of SMBG were similar in the 2 groups though group A had longer duration of disease. In group A, mean haemoglobin A1 (HbA1) decreased from 12.4 +/- 0.5% before SMBG to 10.9 +/- 0.5% at 6 months (P less than 0.005), 10.7 +/- 0.5% at 12 months (P less than 0.005) and 10.3 +/- 0.4% after long-term SMBG. This was accompanied by a significant reduction in insulin requirement from 0.82 +/- 0.07 U/kg/day to 0.72 +/- 0.07 U/kg/day (P less than 0.05). In group B, insulin requirement progressively decreased in the first 6 months. At 12 months, mean HbA1 was 9.0 +/- 0.5% and insulin requirement was 0.58 +/- 0.08 U/kg/day. No significant change in HbA1 or insulin requirement was observed beyond the first year. After long-term SMBG, 82% of patients in group B had good control (HbA1 less than or equal to 10%) compared to 45% only in group A (P less than 0.05). Long-term SMBG is associated with sustained improvement in diabetic control and is particularly beneficial if introduced to diabetic patients right from diagnosis. PMID- 3527627 TI - [Induction in the pBR322 plasmid of deletions predetermined by primary DNA structure]. PMID- 3527626 TI - Significance of impaired glucose tolerance in an Asian Indian population: a follow-up study. AB - A prospective study was undertaken in 107 Indians with impaired glucose tolerance (IGT) for a period ranging from 2 to 10 years. On follow-up, 32% still had an impaired glucose tolerance, 32% reverted to normal glucose tolerance and 36% developed diabetes. Careful dietary adherence and weight reduction were found to favour normalisation of glucose tolerance. Poor dietary adherence, persistent obesity and weight gain were found to precipitate diabetes. The study stresses the need for intensive diet therapy in individuals with IGT. Insulin responses were heterogeneous in IGT and non-predictive of the follow-up changes in glucose tolerance. PMID- 3527628 TI - New developments in the field of synthetic muramyl peptides, especially as adjuvants for synthetic vaccines. AB - MDP (N-acetylmuramyl-L-alanyl-D-isoglutamine), the first synthetic peptidoglycan derivative capable of replacing whole mycobacteria in Freund's complete adjuvant, is highly active in stimulating antibody production. It also produces delayed hypersensitivity and stimulates non-specific resistance. MDP itself is pyrogenic but murabutide (N-acetyl-muramyl-L-alanyl-D-glutamine-n-butyl ester) is not pyrogenic and is undergoing clinical trials. MDP and its derivatives will prove useful as adjuvants, especially for the "new generation" of synthetic vaccines, which will be discussed in detail. They are also interesting for increasing host resistance against various bacterial and parasitic infections and in experimental tumour immunotherapy. MDP and its derivatives, such as murabutide, will also prove useful in combination with chemotherapy, especially for immunodepressed and elderly patients. Some muramyl peptides are also active in prolonging slow wave sleep in rabbits, cats and monkeys. Muramyl peptides are typical bacterial metabolites, which are apparently essential for establishing a normal immune status and slow wave sleep; they thus represent a new category of vitamins. PMID- 3527629 TI - Present aspects concerning the molecular mechanisms of photochemotherapy with psoralens. AB - The various photophysical and photochemical events that can be produced by psoralens after their excitation by UV-A radiation are reviewed, with particular reference to their possible significance for induction of photobiological effects. A close correlation has been found between the covalent photoaddition of furocoumarins to the pyrimidine bases of DNA and the inhibition of DNA synthesis inside living cells; this fact underlines the importance of this photoaddition for the antiproliferative effects exerted by furocoumarins. A good correlation has also been found between the formation of cross-linkages in DNA and the induction of erythema on skin; monofunctional furocoumarins, like methyl angelicin derivatives, are unable to induce erythema, although they have very strong antiproliferative properties. PMID- 3527630 TI - Anticapsin: an active site directed inhibitor of glucosamine-6-phosphate synthetase from Candida albicans. AB - L-beta-(2,3-epoxycyclohexanono-4)-alanine, an active fragment of the antibiotic tetaine, identical to the antimetabolite anticapsin, is a powerful inhibitor of partially purified glucosamine-6-phosphate synthetase (2-amino-2-deoxy-D-glucose 6-phosphate ketol isomerase, aminotransferring, EC 5.3.1.19) from pathogenic fungus Candida albicans. Anticapsin was demonstrated to be a competitive inhibitor of this enzyme with respect to L-glutamine and uncompetitive with respect to D-fructose-6-phosphate. Incubation of anticapsin with glucosamine-6 phosphate synthetase in the absence of glutamine led to the formation of an inactive enzyme, irreversibly modified. The inactivation obeyed saturation kinetics; the determined Kinact was 9.5 X 10(-6) M. Addition of glutamine protected the enzyme against inactivation by anticapsin. Reaction of anticapsin with the enzyme exhibited characteristics of affinity labelling of the glutamine binding site. Probably the inactivation proceeds via an alkylation of cysteine residue at the glutamine binding site. PMID- 3527631 TI - Drug delivery systems: optimising the structure of peptide carriers for synthetic antimicrobial drugs. AB - This paper discusses the concept of smugglins, i.e., molecules that are formed by attaching to, or incorporating into, normal cell nutrients varied moieties as a means of transporting otherwise impermeant substances into cells. Examples of antimicrobial smugglins that use this principle in Nature are described. The rationally designed antibiotic smugglins investigated to date are critically reviewed. Criteria for the design of optimal peptide carriers for antimicrobial smugglins are considered. A computer-linked, continuous-flow system for rapid measurement of the kinetic parameters for substrate transport via peptide permeases is described which, together with current molecular, genetic and biochemical techniques, now provides the means to obtain the information on which rational design should be based; examples are given for Escherichia coli and Candida albicans. After an uncertain commercial start, it now seems likely that increasing understanding of the uptake processes and other relevant features will make drug targeting using peptide carriers an achievable goal. Certainly their widespread occurrence in Nature should provide added incentive for the design of synthetic smugglins. PMID- 3527632 TI - Interaction of polyene antibiotics with membrane lipids: physicochemical studies of the molecular basis of selectivity. AB - From various studies on the interaction of amphotericin B with unilamellar lipid vesicles, it appears that the strength of the binding does not depend only on the presence of sterol molecules in the membranes; and that several bound amphotericin B species are in competition, their relative amounts depending on the nature and percentage of sterol in the lipid bilayer. Bound amphotericin B molecules exchange rapidly between the membranes. It is therefore possible to add the antibiotic by transfer from amphotericin B-preloaded vesicles of dipalmitoylphosphatidylcholine, instead of direct addition. In these conditions the selectivity in the sensitivity to H+ leakage induced by amphotericin B between ergosterol- and cholesterol-containing vesicles is greatly enhanced. In the case of Mycoplasma laidlawii cells, a preliminary increase of K+ cellular content is observed when low doses of amphotericin B are added by transfer, an effect which is not observed with direct addition of the antibiotic. PMID- 3527633 TI - Cell wall of pathogenic yeasts and implications for antimycotic therapy. AB - Yeast cell wall is a complex, multilayered structure where amorphous, granular and fibrillar components interact with each other to confer both the specific cell shape and osmotic protection against lysis. Thus it is widely recognized that as is the case with bacteria, yeast cell wall is a major potential target for selective chemotherapeutic drugs. Despite intensive research, very few such drugs have been discovered and none has found substantial application in human diseases to date. Among the different cell wall components, beta-glucan and chitin are the fibrillar materials playing a fundamental role in the overall rigidity and resistance of the wall. Inhibition of the metabolism of these polymers, therefore, should promptly lead to lysis. This indeed occurs and aculeacin, echinocandin and polyoxins are examples of agents producing such an action. Particular attention should be focused on chitin synthesis. Although quantitatively a minor cell wall component, chitin is important in the mechanism of dimorphic transition, especially in Candida albicans, a major human opportunistic pathogen. This transition is associated with increased invasiveness and general virulence of the fungus. Yeast cell wall may also limit the effect of antifungals which owe their action to disturbance of the cytoplasmic membrane or of cell metabolism. Indeed, the cell wall may hinder access to the cell interior both under growing conditions and, particularly, during cell ageing in the stationary phase, when important structural changes occur in the cell wall due to unbalanced wall growth (phenotypic drug resistance). PMID- 3527634 TI - Antineoplastons: history of the research (I). AB - Antineoplastons are naturally-occurring peptides and amino acid derivatives which control neoplastic growth. The theory of antineoplastons was conceived through the application of the cybernetic theory of autonomous systems to studies of peptides in human blood. The original research began in 1967, when it was noticed that there were significant differences in the peptide content in the serum of cancer patients as compared with the control group. Since similar peptide fractions were isolated from urine, a research programme was established for the identification of antineoplastic peptides from urine. Medicinal use of urine and urine extracts has been known for centuries in ancient Egypt, Greece, Rome, India and North and Central America. In modern times, the first study of growth inhibiting substances in urine was conducted in 1937. The research on urinary peptides has a long history and was initiated by a Polish researcher, S. Bondzynski, in 1897. Antineoplastons were found to be completely different from peptides and amino acid derivatives isolated from urine by other authors. Research on antineoplastons led to the isolation of different peptide fractions from urine, named Antineoplaston A1, A2, A3, A4 and A5, which possessed high anticancer activity and low toxicity. The first active component was identified as 3-phenylacetylamino-2,6-piperidinedione and was named Antineoplaston A10. Two synthetic derivatives of Antineoplaston A10 were named Antineoplaston AS2-1 and AS2-5. All antineoplaston formulations were submitted for Phase I clinical studies in advanced cancer patients. The treatment was free from significant side effects and resulted in objective response in a number of advanced cancer cases.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3527636 TI - Clinical use of appetite suppressants. PMID- 3527635 TI - [Attenuation of the development of hypertension in young stroke-prone spontaneously hypertensive rats by long-term intracerebroventricularly administered captopril]. PMID- 3527638 TI - Lithium dosing in renal allograft recipients with changing renal function. PMID- 3527637 TI - Antimicrobial update. AB - New and soon-to-be introduced antimicrobials are reviewed and compared with agents already in use to determine possible therapeutic and/or cost advantages. Drugs discussed are amdinocillin, ticarcillin/clavulanic acid, ceftriaxone, ceftazidime, imipenem/cilastatin, aztreonam, and quinolones. PMID- 3527639 TI - [Quality of sonography in internal medicine]. PMID- 3527640 TI - [Malignant melanoma: which examinations are useful in staging and follow-up?]. AB - Data on 378 patients with histologically proven malignant melanoma were analysed. Metastases were demonstrated within a few months to maximally 11 years postoperatively in 41 patients by clinical or biochemical examinations, computed tomography, ultrasound or radiology. At the time of the first postoperative staging examination metastases were found by clinical examination in five, by computed tomography in a further two patients. Later follow-up examinations discovered metastases by clinical examination in 32 patients, by chest X-ray in two. It is concluded that postoperative staging does not require elaborate routinely performed tests. Specific studies, admittedly undertaken only after the occurrence of symptoms, should be aimed at determining metastases and their extent so that indications for operation can be established if isolated organ metastases have been demonstrated. PMID- 3527641 TI - [Diagnosis of inflammatory and tumorous changes of the large intestine using colonic sonography]. AB - By water instillation into the large intestine, sonographic visualization of the whole length of the colon from the recto-sigmoid to the caecum can be achieved. Detailed evaluation of the lumen, the wall and the surrounding connective tissue may be carried out. Diagnostic sonography of the colon in 41 patients with pathological changes confirmed by colonoscopy showed that colonic polyps and carcinomas can be detected by this method. In Crohn's disease, typical changes can be seen, which allow the degree of inflammatory infiltration to be assessed. Thus, sonography of the colon is a diagnostic procedure which gives discriminating evidence in diseases of the large intestine. PMID- 3527642 TI - [Factors interfering with and influencing the measurement of direct and indirect parameters of free thyroxine]. PMID- 3527644 TI - [Conservative principles in the therapy of subarachnoid hemorrhage]. PMID- 3527643 TI - [Effects of horse-chestnut seed extract on transcapillary filtration in chronic venous insufficiency]. AB - The effect of horse-chestnut seed extract (standardized on aescin; Venostasin retard) was assessed in a randomized placebo-controlled crossover double-blind trial of 22 patients with proven chronic venous insufficiency by measuring the capillary filtration coefficient and the intravascular volume of the lower leg by venous-occlusion plethysmography. Three hours after taking two capsules of Venostasin (600 mg; each capsule containing 50 mg aescin) the capillary filtration coefficient had decreased by 22%, whereas after administration of an identical-looking placebo capsule it rose but slightly over three hours. The difference in the effect of Venostasin and placebo is statistically significant (P = 0.006). The intravascular volume was reduced 5% more after Venostasin than the placebo, but this is not statistically significant. It is concluded that Venostasin has an inhibitory effect on oedema formation via a decrease in transcapillary filtration and thus improves oedema-related symptoms in venous diseases of the legs. PMID- 3527645 TI - [Protective effect of the calcium antagonist diltiazem on acute kidney failure following kidney transplantation. The results of a prospective randomized study]. AB - In a prospective randomised study the effect of the calcium antagonist diltiazem on primary transplant failure following cadaver kidney transplantation was studied. The transplants were perfused with a solution containing 20 mg/l diltiazem, the graft recipient received diltiazem as a bolus injection of 0.28 mg/kg pre-operatively, followed by a continuous infusion of 0.0022 mg/kg X min for 48 hours. Thereafter diltiazem was applied orally (twice 60 mg/d). Glomerular filtration rate and renal blood flow were measured by single-shot techniques (inulin, PAH). For immunosuppression ciclosporin A and low-dose methylprednisolone were given. Nine patients (41%) in the control group (n = 22) but only two (10%) in the diltiazem group (n = 20) developed primary transplant failure (P less than 0.05). Glomerular filtration rate in transplants with primary function was significantly higher in the diltiazem group (day 4: 29 +/- 0.8 vs. 20 +/- 0.8; day 7: 39 +/- 1.4 vs. 24.9 +/- 0.7 ml/min, P less than 0.05) although ciclosporin blood levels were significantly higher in this group (week 1: 1150 vs. 728 ng/ml, P less than 0.01). The rate of rejection episodes was significantly higher in controls than in patients on diltiazem (0.5 +/- 0.05 vs. 0.1 +/- 0.02 rejection episodes per patient in the first postoperative month, P less than 0.05). CONCLUSION: Diltiazem has a protective effect against primary transplant failure following cadaver kidney transplantation. Furthermore, it might reduce the nephrotoxicity of ciclosporin A. PMID- 3527646 TI - [Modern diagnosis and therapy in stroke]. PMID- 3527647 TI - [Which factors are increasing the nephrotoxicity of aminoglucoside antibiotics?]. PMID- 3527648 TI - [Endoscopic sonography of the upper gastrointestinal tract]. PMID- 3527649 TI - [Progesterone concentration in uterine flushings from the ipsi- and contralateral uterine horn in relation to the corpus luteum periodicum and in blood serum in cattle]. PMID- 3527650 TI - [From the reptilian scale to feathers and hair--evolution of skin appendages]. PMID- 3527651 TI - [Sternal organ--sternal gland--in small ruminants]. PMID- 3527652 TI - [Roentgenologic and macroscopically prepared findings in lumbar vertebrae of the New Zealand White rabbit (Oryctolagus cuniculus f. domestica) during postnatal development]. PMID- 3527653 TI - [Current indications for fetotomy in cattle]. PMID- 3527654 TI - [Occurrence of aseptic necrosis of the palmar and plantar ligament in the horse- a contribution to the differentiation of sesamoid bone diseases]. PMID- 3527655 TI - [Tolerance and immunization trials with a commercial vaccine against Chlamydia psittaci and Coxiella burnetii]. PMID- 3527656 TI - [Detection of antibodies to bovine brucellosis in farm bulk milk samples with an ELISA system]. PMID- 3527657 TI - Newer concepts in the pathogenesis of myocardial ischaemia. Implications for the evaluation of antianginal therapy. PMID- 3527658 TI - Omeprazole. A preliminary review of its pharmacodynamic and pharmacokinetic properties, and therapeutic potential in peptic ulcer disease and Zollinger Ellison syndrome. AB - Omeprazole is a substituted benzimidazole derivative which markedly inhibits basal and stimulated gastric acid secretion. It has a unique mode of action, irreversibly blocking the so-called proton pump of the parietal cell which is supposedly the terminal step in the acid secretory pathway. In animals, on a weight basis, omeprazole is 2 to 10 times more potent than cimetidine in inhibiting gastric acid secretion. Toxicological studies in rats have shown that very high doses of omeprazole administered for 2 years produce hyperplasia of gastric enterochromaffin-like cells and carcinoids, a few with proliferations into the submucosa. The significance of such findings to the clinical situation is wholly speculative and requires further research. Preliminary studies in patients with duodenal ulcers or Zollinger-Ellison syndrome have found no mucosal changes which would suggest that the drug represents a risk for development of carcinoid tumours at therapeutic dosages. In patients with duodenal ulcers omeprazole, at dosages of at least 20mg once daily, produced ulcer healing rates of between 60 and 100% after 2 weeks and between 90 and 100% after 4 weeks, even in patients resistant to treatment with H2-receptor antagonists. Comparative trials clearly demonstrated that omeprazole 20 to 40 mg administered once daily was significantly more effective than usual dosage regimens of cimetidine and ranitidine in healing duodenal ulcers during 2 to 4 weeks of treatment. At present no data are available evaluating omeprazole as maintenance therapy once ulcers have healed. Other clinical trials have also shown that omeprazole is effective for treating gastric ulcers, ulcerative peptic oesophagitis, and Zollinger-Ellison syndrome. In patients with Zollinger-Ellison syndrome the profound and long lasting antisecretory activity of omeprazole may make it the drug of choice for treating the massive acid hypersecretion associated with the disease, especially when H2-receptor antagonists are ineffective. During clinical trials reported to date omeprazole has been very well tolerated but further clinical experience is essential to fully evaluate its safety profile. Thus, omeprazole represents a pharmacologically unique antisecretory drug which is very effective for rapidly healing peptic ulcers and peptic oesophagitis, and for reducing gastric acid hypersecretion in patients with Zollinger-Ellison syndrome. If the apparent absence of undesirable mucosal morphological changes during treatment with usual doses in patients with peptic ulcer disease is confirmed, it may be a major advance in the treatment of these diseases. PMID- 3527661 TI - A developmental study of glycerol oxidation by rat brain. AB - The rates of oxidation of several concentrations of [1,3-14C]glycerol to 14CO2 were measured in whole homogenates of brain from rats of different ages. The rates of oxidation of glycerol at concentrations from 0.1 to 20 mM were significantly lower with brains of neonatal animals than with adult rats, and increased to adult levels during the second to third week of life. The addition of unlabelled glucose decreased the rate of [1,3-14C]glycerol oxidation by about 40% at all ages and glycerol concentrations. Increasing the initial concentration of glycerol 200-fold from 0.1 to 20 mM resulted in more than a 100-fold increase in the rate of glycerol oxidation. This pattern of an increased rate of oxidation with increasing substrate concentration was in marked contrast to that previously found with other brain energy substrates which levelled off with increasing concentration. The data suggest that glycerol could be an important energy substrate in certain areas or cell types in adult rat brain, or that the ability to oxidize high concentrations of glycerol is a detoxification mechanism to prevent accumulation of excess free glycerol. PMID- 3527660 TI - Drugs in the treatment of female infertility. Recent advances. AB - Involuntary infertility is an increasing problem in this era of delayed childbearing. Fortunately, many advances have been made recently in the medical and surgical treatment of infertility. This article reviews the principal aetiologies of infertility and their treatments, and focuses on the current and future uses of ovulation-inducing drugs and other infertility treatments. Proper diagnosis of anovulation and luteal phase dysfunction is discussed together with a description of conventional treatments with clomiphene and human menopausal gonadotrophins (hMG). Recent advances including the use of synthetic gonadotrophin hormone-releasing hormone (GnRH), purified human follicle stimulating hormone and a combination of GnRH and hMG are described, along with the application of the same agents for enhanced follicular recruitment for in vitro fertilisation. In addition, several promising future developments for pharmacological induction of normal ovulation are also discussed. PMID- 3527662 TI - Cleft palate. PMID- 3527663 TI - Diagnosis of human hydatidosis in Kenya. II. An enzyme-linked immunosorbent assay (ELISA) based on a thermo-stable antigen. PMID- 3527664 TI - [Brazilian biomedical publications in the international scientific literature. Endemic communicable diseases]. AB - The number of Brazilian periodicals listed in the Index Medicus dropped from 70 in 1964 to 15 in 1983, or 78%, while the total number of listed periodicals from other countries fell only 11%. The total number of articles published in Brazil on Chagas' disease, schistosomiasis, leishmaniasis, leprosy, malaria, and filariasis, and listed in the Index Medicus did not change significantly between 1965 and 1982, because, with the exception of the journal O Hospital, the Brazilian periodicals that published 74% of all articles on those diseases remained listed throughout the period considered. The predominant subjects in articles on endemic diseases were Chagas' disease and schistosomiasis, and in the later years there was a tendency to index more articles on basic than on applied research. The number of articles on Chagas' disease published by Brazilian authors directly in foreign journals increased considerably during the latter decade. Analysis of all the data together suggests that the developed countries select a specific portion of the Brazilian output of biomedical literature--which is kept listed in secondary and international publications or published directly in foreign journals--while another portion of the same output gradually loses visibility on the international scene. PMID- 3527659 TI - Dantrolene. A review of its pharmacodynamic and pharmacokinetic properties and therapeutic use in malignant hyperthermia, the neuroleptic malignant syndrome and an update of its use in muscle spasticity. AB - Dantrolene sodium acts primarily by affecting calcium flux across the sarcoplasmic reticulum of skeletal muscle. Recently, dantrolene has been used very successfully in the treatment of several rare hypercatabolic syndromes which have previously been associated with high mortality rates. In malignant hyperthermia, where early diagnosis and treatment usually with intravenous dantrolene in association with other supportive measures (and often subsequent dantrolene therapy) is performed, recovery is seen in virtually 100% of patients. There is a rapid resolution of hyperthermia, dysrhythmias, muscle rigidity, tachycardia, hypercapnia, mottled or cyanotic skin, and metabolic acidosis, and a slower normalisation of myoglobinuria and elevated serum creatine phosphokinase levels. In patients with family history or previous episodes of malignant hyperthermia, prophylactic treatment with dantrolene prior to anaesthesia prevents the syndrome occurring in most cases. Where malignant hyperthermia has developed patients have been successfully treated with further dantrolene therapy. Dantrolene has also been used successfully in the treatment of a few cases of heat stroke and the neuroleptic malignant syndrome--both of which have many similarities to malignant hyperthermia. Dantrolene is well established in the treatment of patients with muscle spasticity where it generally improves at least some of the components of spasticity (i.e. hyper/hypotonia, clonus, muscle cramps and spasms, resistance to stretch and flexor reflexes, articular movement, neurological and motor functions and urinary control). However, in some patients, particularly those with multiple sclerosis, dantrolene may not be effective, and in many cases muscular strength may diminish. Long term dantrolene therapy has been associated with hepatic toxicity and may cause problems in patients treated for disorders of muscle spasticity. Thus, dantrolene offers a unique advance in the therapy available for the treatment of hypercatabolic disorders and is also useful in the treatment of muscle spasticity of various aetiology. PMID- 3527666 TI - [The use of palladium-gold alloys in bonded bridges]. PMID- 3527665 TI - [Development of medical education in medical schools, Argentina, 1900-1982]. PMID- 3527667 TI - [Intensive monitoring of patients with removable partial dentures]. PMID- 3527668 TI - [Testing the API-20-a-System for the analysis of anaerobic bacterial populations from periodontal pockets]. PMID- 3527669 TI - [Dental surgical procedures in thrombocytopenic risk patients]. PMID- 3527670 TI - [Pyogenic granuloma in a patient with erythroleukemia after bone marrow transplantation]. PMID- 3527671 TI - [Comparative study of 20 different bonding resins for acid-etch bonded bridges]. PMID- 3527672 TI - [The wedge test--a simple testing procedure for the fatigue strength of bonded joints]. PMID- 3527673 TI - [Vibrations of burns in modern drive systems]. PMID- 3527674 TI - [A new rinsing method for the collection of granulocytes in marginal periodontitis]. PMID- 3527675 TI - [Production of a metal shell crown from solid material using electro-erosion]. PMID- 3527676 TI - [What is conservative, what is surgical periodontal treatment understood to be?]. PMID- 3527677 TI - [Microbial colonization of periodontal pockets around artificial titanium abutments]. PMID- 3527678 TI - [Systemic metronidazole therapy and/or subgingival scaling with root planing. I. Clinical results]. PMID- 3527679 TI - [Systemic metronidazole therapy and/or subgingival scaling and root planing. II. Development of clinical parameters in relation to the changes in the composition of the associated subgingival microflora]. PMID- 3527680 TI - [New surgical technics for transplantation and implantation in periodontal bone surgery (full papillary flaps)]. PMID- 3527681 TI - [Materials science properties of glass ionomer cements in comparison with conventional materials. II. Studies on the bond strength in bovine teeth]. PMID- 3527682 TI - [Clinical effect in relation to a one-time subgingival tooth cleaning and root planning procedure in advanced adult periodontitis]. PMID- 3527683 TI - [Effect of serotonin (5-hydroxytryptamine) on the islets of Langerhans of the pancreas in the golden hamster]. PMID- 3527684 TI - [New concepts of the mechanism of action of insulin]. PMID- 3527685 TI - [Endorphins. Physiological and pharmacological aspects, and research in psychiatry]. AB - This article gives an overview of the biochemistry, physiology and pharmacology of endogenous opioid peptides. The role of endorphins in psychiatric pathology in the last ten years, has mainly been studied through two clinical research strategies: Pharmacological, administration of opiate agonists or antagonists, or substances altering endorphins metabolism. Biological, static or dynamic dosage of opioid activity in peripheral liquids, trying to correlate those measures either with a syndrome, or with a clinical trait. These methods applied to schizophrenia, affective disorders, anxiety, addiction, anorexia, and tardive dyskinesia are being reviewed. Results are very heterogeneous but support the involvement of the endogenous opioid system in some psychiatric pathology. Furthermore, this paper should help to underline some of the present day development of biological psychiatry. PMID- 3527686 TI - [Neurological aspects of infantile autism]. AB - Childhood autism is not usually considered as a neurological disease although frequent antecedents of ante, peri and postnatal injuries are found in its antecedents. Several symptoms of autism particularly in the early development, resemble the signs observed in frontal, temporal, striatal and brainstem dysfunctioning. These cerebral structures are connected with the central dopaminergic system which may be disturbed in autistic children. Such hypotheses suggest the necessary elaboration of an infant and child "behavioral neurology". PMID- 3527687 TI - The neuroendocrinology of stress and aging: the glucocorticoid cascade hypothesis. PMID- 3527688 TI - Genetics of adrenal steroid 21-hydroxylase deficiency. AB - Impairment of 21-hydroxylation is the most common enzymatic deficiency resulting in the syndrome of CAH, which may present either in the classical form in infants or in the nonclassical form in older individuals. Variable signs and symptoms of androgen excess are common to both types of the disorder, which are transmitted as autosomal recessive traits linked to HLA. Virilization begins in the second month of gestational life in classical 21-OHD, but postnatally in the nonclassical form. Salt wasting is a feature of the disease in a large number of classical patients; in the simple virilizing form aldosterone biosynthesis, a function of the adrenal zona glomerulosa, is intact. Additionally, no patient with nonclassical 21-OHD has been found to have salt wasting. Levels of precursor hormones are less markedly elevated in nonclassical 21-OHD, reflecting a less severe enzyme deficiency; coordinates of basal and stimulated 17-OHP are plotted on a nomogram to ascertain diagnostic category within a family. Confirmatory evidence of heterozygosity within the family of an affected proband is found by performing HLA typing. Specific linkage disequilibria exist for the classical and nonclassical forms of 21-OHD. Frequency of the classical disease is 1/5,000 1/15,000 in Caucasians, whereas the nonclassical disease is found in approximately 1/100 individuals in the Caucasian population, placing the latter disorder among the most common autosomal recessive disorders in man. A deletion of the active 21-hydroxylase gene has been detected in some classical patients; further investigations are in progress to elucidate the molecular genetics of this disease. PMID- 3527689 TI - Current status of the 1,4- and 1,5-benzodiazepines in the treatment of epilepsy: the place of clobazam. AB - The 1,4-benzodiazepines have a recognised place in the treatment of epilepsy. Thus, diazepam, clonazepam, and, more recently, lorazepam are used intravenously for status epilepticus. Oral clonazepam has proved useful as adjunctive therapy in generalised absence seizures, myoclonic seizures, and partial seizures. Oral nitrazepam is well known for its use in the treatment of infantile spasms with hypsarrhythmia and in the myoclonic epilepsies of childhood. Clobazam, a 1,5 benzodiazepine, has been shown in controlled studies to be superior to placebo, and in open studies it has produced an overall reduction in seizure frequency of 65%. The main indication for its use is as oral adjunctive therapy in refractory epilepsy. It has a rapid onset of action, is well tolerated, and many studies indicate it has a psychotropic action and produces minimal or no cognitive impairment. The most common side-effect reported was sedation, while the overall incidence of side-effects in the open studies was 38%. In all studies reviewed, 4% of patients had to be withdrawn because of adverse reactions. In general, there are no significant interactions with other anticonvulsants, although changes in a few have been described. Withdrawal seizures can occur and require gradual termination of clobazam. The main disadvantage of clobazam is the development of tolerance, which develops in approximately 36% of patients, and there is no way of predicting in which patients or when the phenomenon is likely to occur. A dose of 20 to 30 mg at night is recommended, possibly commencing at 10 mg. PMID- 3527690 TI - Putnam, Merritt, and the discovery of Dilantin. AB - In the first part of this essay, the "common wisdom" about Putnam and Merritt's contributions to the treatment of epilepsy was summarized (Rowland, 1982). Based on the history that has been presented here, how true are these "wisdoms"? Putnam and Merritt did devise "a simple and reliable method to test drugs of anticonvulsant effect" and they did show "that anticonvulsant effects in cats accurately predicted effects in humans," but others before them had done these same things. Dilantin, contrary to common wisdom, was not the first anticonvulsant drug to be tested in animals before it was given to human subjects; at least a year before, Cobb and his co-workers had done the same thing using vital dyes. However, Dilantin did represent the first time an anticonvulsant tested in animals was subsequently studied in a large series of patients. Nor were Putnam and Merritt the first to show that "anticonvulsant and sedative effects of drugs could be separated." Potassium borotartrate, ketogenic diet, ketone bodies, and vital dyes were anticonvulsive without necessarily being sedative. However, Putnam and Merritt were probably the first to make so explicit a statement to this effect. It may well have been this particular statement--and the fact that it was so well heard by other researchers--that represented their greatest achievement. In Kuhn's theory of scientific revolutions, the great step forward may not be so much the accumulation of evidence that the existing paradigm is not a feasible one, but rather the use of this evidence to form a new model or paradigm which is then accepted by normal science in such a fashion that the results prove to be productive. This, it would seem, is what Putnam and Merritt did. From it came their own major discovery, Dilantin, which, in Rowland's words, remains "a mainstay of treatment" for epilepsy up to the present time, and which "opened the way to the development of other anticonvulsant drugs." PMID- 3527691 TI - Coping skills training for children: effects on distress before, during, and after hospitalization for surgery. AB - Thirty-three parent-child dyads (children's mean age = 7.2 years, SD = 1.2) were randomly assigned to information, anxiety reduction, or coping skills presurgical preparatory interventions. All groups received the "information" procedure that described typical hospitalization and surgery experiences via a puppetry film viewed 1 week prior to hospital admission. In the anxiety reduction group, parents also learned procedures (e.g., relaxation) to help them reduce their own distress. Parents in the coping skills group learned how to help their children use coping self-talk and related techniques. The coping skills intervention was expected to assist children most effectively, although the anxiety reduction procedure was also expected to improve adaptation relative to the information condition. These hypotheses were generally supported. Anxiety reduction and coping skills groups, compared to the information group, reduced children's self reported fearfulness and parents' reported distress. Furthermore, only the coping skills group, compared to the information group, exhibited fewer maladaptive behaviors during hospitalization (ratings by observers) and less problematic behavior in the preadmission week and second postdischarge week (daily parental diaries). Theoretical explanations for these results are discussed in light of the similar findings obtained by Peterson and Shigetomi (1981). PMID- 3527692 TI - Preparing children for medical examinations: the importance of previous medical experience. AB - The relationship between past medical experience and children's response to preparation for medical examinations was investigated in 79 pediatric outpatients aged 3 to 12 years. Children were randomly assigned to one of five preparation conditions prior to receiving a medical examination and a throat culture: sensory information about the exam, training in coping skills (deep breathing and positive self-talk), combined sensory information and coping skills training, attention control, and no-treatment control. The results indicated that children with previous negative medical experiences demonstrated more behavioral distress during a throat culture examination that did children with previous positive or neutral medical experiences. In addition, the attention control condition appeared to increase the distress of children with previous negative medical experiences. Amount of past exposure to the specific medical procedure was not related to observed distress. The implications of these findings for the preparation of children for medical procedures are discussed. PMID- 3527693 TI - Predicting medical compliance among adolescents with cystic fibrosis. AB - This investigation evaluated the utility of a new assessment tool based on a competency/coping skills model in predicting medical compliance of adolescents with cystic fibrosis. The Medical Compliance Incomplete Stories Test (M-CIST) was administered to 40 adolescent and young adult inpatients aged 13 to 23. These data were compared to objective measures of the patient's medical compliance. The M-CIST was positively correlated with compliance (multiple R = .72, p less than .001) and discriminated compliant from noncompliant patients. Data derived from patients' responses on the assessment tool could also be used projectively to provide information useful to clinicians treating adolescents with cystic fibrosis. PMID- 3527694 TI - Periodic transcription as a means of regulating gene expression during the cell cycle: contrasting modes of expression of DNA ligase genes in budding and fission yeast. AB - Using cultures synchronised by three independent procedures, we have shown that the CDC9 gene, coding for DNA ligase, is periodically expressed in the Saccharomyces cerevisiae cell cycle. The level of CDC9 transcript increases many fold in late G1 reaching a peak at about the G1/S phase boundary and preceding the peak in histone message by some 20 min. The level of DNA ligase itself also fluctuates, showing the expected pattern for a stable enzyme synthesised periodically. In contrast, the transcript from the DNA ligase gene (CDC17) of Schizosaccharomyces pombe is present at a constant level throughout the cell cycle, and no fluctuation in amount was detected, although the histone H2A showed the expected periodic synthesis. Furthermore, DNA ligase activity remains at a constant level during the S. pombe cell cycle showing that there is unlikely to be any form of translational control. These contrasting modes of expression of the DNA ligase genes in the two organisms suggests that when periodic transcription is observed from an essential cell cycle gene, it may have no particular significance for regulating progress through the cell cycle. Also, regulatory circuits may be less well conserved between organisms than the processes they control and thus different organisms may utilise quite different modes of control to achieve the same ends. PMID- 3527695 TI - Timing of initiation of chromosome replication in individual Escherichia coli cells. AB - The synchrony of initiation of chromosome replication at multiple origins within individual Escherichia coli cells was studied by a novel method. Initiation of replication was inhibited with rifampicin or chloramphenicol and after completion of ongoing rounds of replication the numbers of fully replicated chromosomes in individual cells were measured by flow cytometry. In rapidly growing cultures, with parallel replication of several chromosomes, cells will end up with 2n (n = 1, 2, 3) chromosomes if initiation occurs simultaneously at all origins. A culture with asynchronous initiation may in addition contain cells with irregular numbers (not equal to 2n) of chromosomes. The frequency of cells with irregular numbers of chromosomes is a measure of the degree of asynchrony of initiation. After inhibition of initiation and run-out of replication in rapidly growing B/r A and K-12 cultures, a small fraction of the cells (2-7%) contained 3, 5, 6 or 7 chromosomes. From these measurements it was calculated that initiation at four origins in a single cell occurred within a small fraction, 0.1, of the doubling time (tau). A dnaA(Ts) mutant strain grown at permissive temperature exhibited a very large fraction of cells with irregular numbers of chromosomes after drug treatment demonstrating virtually random timing of initiation. A similar pattern of chromosome number per cell was found after treatment of a recA strain. PMID- 3527696 TI - A chromatin core particle obtained by selective cleavage of histones by clostripain. AB - Rat liver chromatin core particles digested with clostripain yield a structurally well-defined nucleoprotein particle with an octameric core made up of fragmented histone species (designated H'2A, H'2B, H'3 and H'4, respectively) after selective loss of a sequence segment located in the N-terminal region of each core histone. Sequential Edman degradation and carboxypeptidase digestion unambiguously establish that histones H2A, H2B, H3 and H4 are selectively cleaved at the carboxyl side of Arg 11, Lys 20, Arg 26 and Arg 19 respectively and that the C-terminal sequences remain unaffected. Despite the loss of the highly basic N-terminal regions, including approximately 17% of the total amino acids, the characteristic structural organization of the nucleosome core particle appears to be fully retained in the proteolyzed core particle, as judged by physicochemical and biochemical evidence. Binding of spermidine to native and proteolyzed core particles shows that DNA accessibility differs markedly in both structures. As expected the proteolyzed particle, which has lost all the in vivo acetylation sites, is not enzymatically acetylated, in contrast to the native particle. However, proteolyzed histones act as substrates of the acetyltransferase in the absence of DNA, as a consequence of the occurrence of potential acetylation sites in the core histones thus rendered accessible. The possible role of the histone N terminal regions on chromatin structure and function is discussed in the light of the present observations with the new core particle obtained by clostripain proteolysis. PMID- 3527697 TI - Anaerobic meningitis in children. PMID- 3527698 TI - Current problems of chemotherapy of infections with coagulase-negative staphylococci. AB - A review is given of current problems in the chemotherapy of infections caused by coagulase-negative staphylococci. Along with the recent increase in the number of these infections has come the realisation that such infections may be difficult to treat. The sites of infection caused by coagulase-negative staphylococci are considered and recent advances in the understanding of the molecular biology of these organisms reviewed. Appropriate antibiotic therapy for individual infections is discussed, likewise the contribution the laboratory can make to ensure that the most effective antibiotics are used. PMID- 3527699 TI - High-level trimethoprim resistance in urinary bacteria. AB - The results of a three year evaluation of the incidence and type of trimethoprim resistance in pathogens responsible for significant bacteriuria in a general hospital in Edinburgh UK, are presented and compared to results of a previous study. In the present study, trimethoprim resistance was 50% more frequent in bacteria isolated from men and nearly twice as frequent in bacteria from elderly patients. However, the proportion of trimethoprim resistant strains fell annually when resistance was measured at trimethoprim concentrations of both 10 mg/l and 1000 mg/l. The proportion of strains able to transfer trimethoprim resistance also fell by half, and there was some movement of trimethoprim resistance transposons into the bacterial chromosome. These results suggest that migration of high-level trimethoprim resistance genes into the permanent location of the bacterial chromosome is occurring. PMID- 3527700 TI - Rapid coagglutination test for the direct detection of group A streptococci from throat swabs. AB - A one-minute antigen detection test was compared with a conventional culture method for detecting group A beta-hemolytic streptococci. The test detects coagglutination between protein A and streptococcal antigen extracted directly from throat swabs. Of the 307 specimens tested, 66 (21.5%) were positive for group A streptococci by culture and 16 specimens (5.2%) were positive for other beta-hemolytic streptococci. The direct test agreed with the culture in 274 of 307 specimens (accuracy 89.3%). The sensitivity of the test was 86.4% (57/66), the specificity 90% (217/241), the positive predictive value 70.4% and the negative predictive value 96%. If only throat cultures with more than 100 colonies of group A streptococci per plate were considered, the sensitivity of the direct test rose to 96%. If only a strong agglutination was considered positive, the specificity of the direct test rose to 98%. Further studies are needed to determine whether this test could be used alone or in addition to culture. PMID- 3527701 TI - Adherence of Trichomonas vaginalis to cell culture monolayers. AB - The in vitro adherence to WISH cells of a pathogenic Trichomonas vaginalis strain was studied with a method utilizing thymidine-labeled protozoa. A marked dose related adherence was observed. Glutaraldehyde fixed trichomonads were not adherent. The presence of fetal calf serum during the assay did not influence attachment. Concanavalin A inhibited adherence of protozoa. Complete or partial inhibition of adherence was achieved by preincubating WISH cells with Lactobacillus fermentum or Streptococcus agalactiae. Finally, pretreatment of cells with alpha-estradiol, beta-estradiol, progesterone and estrone influenced attachment of protozoa, whereas estriol was ineffective. These results suggest that adherence of Trichomonas vaginalis is dependent on different factors, whose manipulation may have clinical relevance in preventing recurrence of trichomonad vaginitis. PMID- 3527702 TI - Effect of Bacteroides fragilis grown in the presence of clindamycin, metronidazole and fusidic acid on opsonization and killing of Escherichia coli. AB - Bactericidal action of human polymorphonuclear leucocytes on Escherichia coli in the presence of Bacteroides fragilis grown in subinhibitory concentrations of clindamycin, metronidazole and fusidic acid was studied. Bacteroides fragilis grown in the absence of drugs significantly inhibited the killing of Escherichia coli. Bacteroides fragilis grown in the presence of the drugs had a reduced inhibitory effect on the killing of Escherichia coli but this reduction was only significant for Bacteroides fragilis grown in 1/2 MIC of clindamycin. The phagocytosis of Bacteroides fragilis grown with and without clindamycin, as measured by killing, was the same. Complement consumption of Bacteroides fragilis grown with and without clindamycin did not differ. Clindamycin-treated Bacteroides fragilis fixed C3 to a significantly lower degree than did untreated bacteria. The chemiluminescence of Escherichia coli opsonized with serum preincubated with clindamycin-treated Bacteroides fragilis was significantly higher than with serum preincubated with untreated bacteria. These results suggested that in killing experiments of mixed Escherichia coli and Bacteroides fragilis, the mechanism underlying the reduced inhibitory capacity of clindamycin exposed Bacteroides fragilis is related to greater availability of C3 in serum for opsonization of Escherichia coli. PMID- 3527703 TI - Use of monoclonal antibodies for rapid detection of influenza A virus in nasopharyngeal secretions. AB - Two monoclonal antibodies against influenza A virus were assessed for use as diagnostic reagents in an indirect immunofluorescence assay (IFA) of nasopharyngeal secretions. Monoclonal antibody IA-52, directed at an internal antigen, reacted with all influenza A tested. The high stability of this epitope permitted its use in a rapid IFA test, which gave results comparable to those obtained with polyclonal antibodies and viral isolation. The second monoclonal antibody, IA-279 was directed at a surface epitope (hemagglutinin); it reacted with almost all H3 subtype strains. Positive IFA using these monoclonal antibodies permitted rapid preliminary differentiation between the current two major subtypes of influenza A virus (H1N1, H3N2). PMID- 3527704 TI - Photosystem I reaction centers from maize bundle-sheath and mesophyll chloroplasts lack subunit III. AB - Photosystem I reaction centers were isolated from mesophyll and bundle-sheath chloroplasts of the C4 maize plant. Both preparations were found to be free of chlorophyll b and to have the same spectral properties and chlorophyll/P700 ratio as photosystem I reaction centers isolated from C3 plants. Photosystem I reaction centers from both mesophyll and bundle sheath were found to consist of six subunits with apparent molecular masses of about 70 kDa, 20 kDa, 17 kDa, 16 kDa, 10 kDa and 8 kDa, corresponding to photosystem I reaction center subunits I, II, IV, V, VI and VII of spinach, as tested by their immunological cross-reactivity with antibody raised against the respective spinach subunits. No cross-reactivity was found with antibodies raised against subunit III of spinach, either in whole thylakoids or purified reaction centers of both bundle-sheath and mesophyll chloroplasts. It is concluded that photosystem I reaction centers of bundle sheath and mesophyll thylakoids of maize are identical and lack the polypeptide corresponding to subunit III present in all C3 plants so far tested. PMID- 3527705 TI - Structure and properties of casein kinase-2 from Saccharomyces cerevisiae. A comparison with the liver enzyme. AB - A type-2 casein kinase (YCK-2), lacking the 25-kDa autophosphorylatable beta subunit characteristic of animal casein kinases-2, has been obtained in a nearly pure form from Saccharomyces cerevisiae and was compared with liver casein kinase 2 (LCK-2). A 22-kDa phosphorylatable protein, copurifying with YCK-2, can be removed by ultracentrifugation at low ionic strength and is shown by several criteria to be unrelated to the beta subunit of LCK-2. The native Mr of YCK-2, deprived of the 22-kDa phosphoprotein, is about 150 000. Limited proteolysis experiments show that YCK-2 included 37-kDa catalytic subunits, which can be converted into still active 35-kDa proteolytic derivatives. These data are consistent with a homotetrameric quaternary structure as opposed to the heterotetrameric subunit composition alpha 2 beta 2 of LCK-2 and other animal casein kinases-2. Although many properties of YCK-2 and LCK-2, including substrate specificity, inhibition by heparin, polyglutamic acid and quercetin and stimulation by polyamines, are similar; their stability under denaturing and dissociating conditions and their response to polybasic peptides are quite different. In particular YCK-2 is more readily denatured than LCK-2 by heating and exposure to urea, sodium dodecylsulphate and deoxycholate while its activity is inhibited by 100-150 mM NaCl, which conversely stimulates LCK-2 activity 2-3 fold. The Km value of the synthetic peptide substrate Ser-(Glu)5 for YCK-2 is not significantly changed by the addition of polylysine. On the contrary the Km value of the same peptide substrate for LCK-2 decreases approximately tenfold upon addition of polylysine, which also prevents the fast autophosphorylation of the kinase at its beta subunit. These data suggest that the beta subunit of animal CK 2 may play a role in determining both the stability of the enzyme and its regulation and that, consequently, the different properties of YCK-2 may be at least in part accounted for by its lack of beta subunits. PMID- 3527707 TI - A psychiatrist's remarks on the significance of basic research in neurobiology for psychiatry. The work of Detlev Ploog. PMID- 3527706 TI - Amitriptyline and oxaprotiline in the treatment of hospitalized depressive patients. Clinical aspects, psychophysiology, and drug plasma levels. AB - Amitriptyline (AT) and the noradrenaline reuptake inhibiting antidepressant oxaprotiline (OT = hydroxymaprotiline) were compared in 59 primary depressive inpatients in a 4-week double blind parallel group design. In the Hamilton Depression Rating Scale and 2 self-rating scales AT proved to be more efficient than OT, mainly with respect to disturbances of appetite and sleep. Agitated patients receiving OT needed more additional tranquilizing medication. The number of side-effects did not differ. Both drugs increased heart rate and skin resistance level (SRL) to about the same degree and did not influence the number of spontaneous fluctuations of SRL, habituation of SRL orienting responses (OR), frequencies of respiration and blinking. Salivation was temporarily more impaired by AT. All physiological variables differed between patients and 30 healthy controls during the whole 4-week trial. Clinical outcome showed a linear relation to OT plasma levels. For AT a therapeutic window was confirmed for concentrations of AT and its metabolite nortriptyline between 125 and 200 ng/ml. Patients whose SRL-OR habituated rapidly had a better outcome than slow habituators. Urinary excretion of 3-methoxy-4-hydroxyphenylglycol was lower in patients than in controls but could not predict outcome with either drug. PMID- 3527708 TI - Structure and dynamics of human communication at the beginning of life. AB - Although the beginning of postpartum social integration and communication has been long viewed as relevant to psychiatric theories, early parent-infant communication has become a matter of scientific investigation only recently. The present survey explains the significance of an approach based upon the general systems theory and explores to what extent the early parent-infant interaction can function as a didactic system to support the development of thought and speech. Evidence of this function has been found in those forms of parental behavior that escape the parent's conscious awareness and control, as exemplified in the vocal communication with presyllabic infants. Parents unknowingly adjust the structure and dynamics of speech to the constraints of infant capacities, detach prosodic musicality from lexical structure, and use it in particularly expressive forms for the delivery of the first prototypical messages. In this and other similar ways, parents offer an abundance of learning situations in which infants can try out various integrative operations. A biological rather than cultural provenience of the support of communicative development indicates a potential relevance for the interpretation of speech evolution. In addition to qualities of the vocal tract and to complex symbolic capacities in humans, the early intuitive support of communicative development and its playful character are suggested as species-specific determinants of speech evolution. Implications for clinical research are suggested. PMID- 3527710 TI - Differential diagnosis and therapy of rare testicular tumors. AB - The origin, differential diagnosis and therapy of rare testicular tumors are reviewed. 5% of all testicular tumors are rare tumors. Most of these rare tumors are of non-germ cell origin. PMID- 3527709 TI - The brain as a self-organizing system. AB - Clinical evidence and numerous results from animal experimentation indicate that cognitive functions have to be learned. Brain structures subserving these functions require sensory experience for their maturation. Genetic instructions are in principle not sufficient to specify neuronal connections with sufficient precision. Self-organization processes are implemented in addition which allow to optimize genetically determined blue prints of connectivity by making use of functional criteria. Thus, neuronal activity becomes an important shaping factor in the development of the structural and functional architecture of the forebrain. To the extent that this neuronal activity is modulated by sensory signals, environmental factors can influence the development of neuronal networks. Recent experiments indicate that these shaping processes are additionally controlled by modulatory systems. Both, the noradrenergic projection from the locus coeruleus and the cholinergic projection from the basal forebrain facilitate activity-dependent long-term changes of neuronal connections during development. The activity of these modulatory systems in turn depends on central states such as arousal, attention, and perhaps also motivation. It is inferred from this evidence that experience-dependent self-organization should not be considered as a passive imprinting process but rather as an active dialogue between the brain and its environment. The hypothesis is discussed that many developmental disturbances which are commonly attributed to deprivation are in fact due to defaults of the CNS which either lead to the formulation of wrong questions or to the reduction of exploratory drive. PMID- 3527711 TI - Treatment of neonatal hydronephrosis by malformation of the ureteropelvic junction: interest of percutaneous nephrostomy. AB - The authors have studied 42 children less than 1 month of age, who had hydronephrosis due to ureteropelvic junction obstruction. Most of them were detected by antenatal ultrasound. Bilateral forms were found in 13 patients. Thus a total of 55 kidneys were involved. Three forms were distinguished. The benign forms (n = 15) were operated. The mild forms (n = 29) must be operated, but not in emergency. Immediate complications (n = 5) and failures (n = 4) are more frequent than in older children. The severe forms (n = 11) are characterized by renal mutation on IVU. In these forms, percutaneous nephrostomy confirms the diagnosis and shows the functional value of the kidney. Only 5 of these 11 children underwent nephrectomy. PMID- 3527712 TI - Hemodynamics of the legs and clinical symptoms following regional blocks for transurethral surgery. AB - In a prospective clinical study we compared the hemodynamics and clinical symptoms following regional blocks and general anesthesia. 115 patients undergoing transurethral resection of the prostate were randomized to spinal (n = 62) and epidural (n = 53) blocks. An additional 10 patients received general anesthesia. Calf arterial flow, determined by strain gauge plethysmography (SGP), was similar pre- and postoperatively in the regional block groups but decreased in the general anesthesia group (p less than 0.05) on the 5th postoperative day compared to the preoperative day. On the 2nd and 5th postoperative days, venous capacity was lower (p less than 0.05) after general anesthesia compared to regional blocks. Antiembolism stockings offered no hemodynamic or clinical advantages. During the hospital stay (screening by Doppler and SGP) and 3 months of follow-up, no deep vein thrombosis or pulmonary embolism was diagnosed. 3 months after the operation, unspecific pain and/or weakness in the legs were reported by 12 patients in the spinal group, while the epidural group remained asymptomatic (p less than 0.01). We conclude that the predictive value of negative Doppler and SGP findings is good and that spinal and epidural blocks are hemodynamically advantageous as compared to general anesthesia. PMID- 3527713 TI - Atraumatic partial nephrectomy. Experience with 112 consecutive patients. AB - The aim of the described method of partial nephrectomy is to minimize injury to the kidney, if possible without causing unnecessary loss of blood, and without interrupting the arterial or venous blood flow during surgery. Use of a pedicle clamp, compressing forceps for the renal parenchyma or hypothermia is superfluous. Following pre- and intraoperative estimation of the dimensions of the area of the renal parenchyma to be removed, virtual hemostasis is achieved by applying a continuous U-shaped suture distal to the portion of the kidney to be resected, using an atraumatic chromic catgut suture. Total hemostasis in the area to be excised is attained with the aid of a second U-shaped suture, running parallel to the first but entering on the opposite renal margin. Following excision, the raw surfaces are then reapproximated by means of a continuous suture and thus sealed. To conclude the operation a temporary nephrostomy is inserted. The immediate and later follow-up results and the advantages and potential complications of the new technique are described in 112 consecutive patients presenting for treatment during a period of 12 years. PMID- 3527715 TI - High-dose melphalan and total body irradiation with bone marrow transplantation for refractory malignancies. AB - We investigated if high dose melphalan and total body irradiation could be administered to adult patients with acceptable toxicity. Nineteen adult patients with relapsed disease, 15 of them having hematologic malignancies, were treated with high-dose melphalan (100 mg/m2-140 mg/m2) divided over 2 consecutive days followed by a rest period of 4 days before receiving total body irradiation, 850 rad administered in five fractionated doses over 3 days. Subsequently 11 patients received autologous, seven allogeneic and one syngeneic, bone marrow transplantation. All patients had severe myelosuppression and the major extramedullary toxicity was mucositis. There were three early deaths, two related to septicemia and one to graft-versus-host disease with associated cytomegalovirus pneumonitis. All patients were heavily pretreated, and 16 were demonstrating progressive disease on alternative salvage therapies at the time of bone marrow transplantation. Two of the 16 evaluable patients (12.5%) achieved complete remissions, and 10 (63%) achieved partial remissions for a total response rate of 75%. One patient is a long-term disease-free survivor (over 1 yr). An occasional patient may be cured by this approach. The combination of melphalan, an alternative alkylating agent to cyclophosphamide and total body irradiation are associated with moderate gastrointestinal toxicity in heavily pretreated adult patients. The combination warrants further investigation in a less heavily pretreated population to determine more accurately the complete response rate. PMID- 3527714 TI - A preliminary analysis of the effects of elliptinium on immune reactivities in mice. AB - The immune effects of Elliptinium (2-methyl-9-hydroxyellipticinium, 9-HME), a chemical recently shown to possess clinical antineoplastic activity, were investigated in mice. Primary antibody responses to T-dependent and T-independent antigens, DTH reactivity and responsiveness to mitogens were significantly depressed only by post treatment with single drug doses of at least 5 mg/kg i.v., i.e. doses clearly above those known to exert full antitumoral effectiveness and to induce lymphoid cell depletion in the same species. Only drug doses in the LD50 range (i.e. 10 mg/kg) reduced the capacity of NK cells and of activated macrophages to express non-specific cytotoxicity towards tumor target cells. When repeated dose regimens were used, significant immune depression was again seen at doses above those displaying chemotherapeutic activity. Data obtained suggest that at chemotherapeutically effective dosages 9-HME possesses in mice a comparatively low immunodepressive potential and that immune cells mediating natural host defence mechanisms appear especially resistant to this drug. PMID- 3527716 TI - Direct instruction: a research-based approach to curriculum design and teaching. PMID- 3527717 TI - Research on teaching: opening the door to special education classrooms. PMID- 3527718 TI - Learning disabilities: the social construction of a special education category. PMID- 3527719 TI - Future directions in deinstitutionalization and education: a Delphi investigation. PMID- 3527720 TI - Effects of the alpha-glucosidase inhibitor 1 desoxynojirimycin (Bay m 1099) on postprandial blood glucose, serum insulin and C-peptide levels in type II diabetic patients. AB - Bay m 1099 is a newly developed inhibitor of intestinal alpha-glucosidase. Its ability to lower postprandial plasma glucose, serum insulin and C-peptide levels in Type II diabetics has been investigated. Fifteen obese Type II diabetic patients with inadequate metabolic control during sulphonylurea treatment received a standardized diet and were treated either with Bay m 1099, b.d. (100 mg before breakfast and dinner) or placebo for 3 days, according to a double blind cross-over design. The postprandial blood glucose level was significantly lower during Bay m 1099 treatment compared to placebo after breakfast and dinner (AUC after breakfast p less than 0.001). The reduced postprandial hyperglycaemia was associated with a decrease in meal stimulated serum insulin and C-peptide levels. Thus, Bay m 1099 may be a useful addition in the treatment of Type II diabetic patients. PMID- 3527721 TI - Inhibition of lipopolysaccharide-induced monocyte interleukin 1 secretion by gangliosides. AB - Gangliosides known to be potent immunosuppressors are shown to inhibit the secretion of interleukin 1 (IL 1) by human monocytes stimulated with lipopolysaccharide (LPS). The inhibitory activity was observed either with mono-, di- or trisialogangliosides. The inhibition of LPS-induced IL 1 secretion was obtained in the presence of indomethacin, indicating that the ganglioside inhibitory capacity was not due to prostaglandin induction. Indeed the inhibitory activity seems to be mediated by an interaction with LPS molecules, preventing their ability to deliver a signal to monocytes for IL 1 secretion. PMID- 3527722 TI - Fine specificity of antibodies produced in rhesus monkeys following in vivo treatment with anti-T cell murine monoclonal antibodies. AB - The immune response of 23 rhesus monkeys against different murine monoclonal antibodies (mAb) administered in vivo as immunosuppressive agents has been analyzed. Seven mAb specific for either helper-inducer (CD4 molecules) or cytotoxic/suppressor (CD8 molecules) T cells, that cross-react with monkey lymphocytes, were administered i.v. for 10 consecutive days in rhesus monkeys. Nineteen of the animals were recipients of a skin or renal allotransplant. Nineteen out of the 23 monkeys developed a significant immune response against the injected monoclonal. This response was restricted in its specificity since unrelated murine monoclonals were not recognized by the monkeys' anti-monoclonal immunoglobulins. Fine analysis of the monkeys' sera revealed that the antibodies produced against the xenogeneic proteins selectively exhibited two major specificities i.e., anti-isotypic and anti-idiotypic. On a practical basis, these results suggest that an animal already immunized against a given mAb should still be sensitive to the therapeutic effect of another monoclonal sharing the same specificity but different idiotype. PMID- 3527723 TI - Differential protracted effects of morphine and ethylketocyclazocine challenges on EEG and behavior in the rat. AB - One group of six adult female Sprague-Dawley rats was given a series of automatically administered i.v. morphine injections over eight days. Similarly, a second group of six rats was given ethylketocyclazocine (EKC). Control rats received chronic i.v. saline injections. Tolerance to EEG and behavioral effects of morphine and EKC was demonstrated. At 15 days morphine post-withdrawal, morphine challenges produced EEG and behavioral stupor for a mean of 5 min, followed by EEG and behavioral arousal for a mean of 131 min. In contrast, morphine challenges in saline control rats produced a biphasic EEG and behavioral response consisting of a mean of 85 min of stupor, followed by a mean of 88 min of arousal. However, at 15 days EKC post-withdrawal, EKC challenges produced a biphasic EEG and behavioral response consisting of a mean of 57 min of depression followed by a mean of 55 min of arousal; control saline rats demonstrated similar responses to EKC challenges. Similar results were obtained at one month post withdrawal for all groups. Thus, protracted effects on EEG and behavior were evident in rats chronically treated with morphine, but not in rats chronically treated with EKC. PMID- 3527724 TI - Hormonal factors influencing fractional excretion of filtered sodium in normal children. AB - Fractional excretion of filtered sodium (FENa), plasma renin activity (PRA), urinary kallikrein excretion and main urinary metabolite of prostaglandin F2 alpha (PGF MUM) excretion were measured to evaluate the relationship between FENa and these hormonal factors in 33 healthy children aged 8 to 15 years. FENa showed a significant negative correlation with PRA and PGF MUM excretion (P less than 0.001, P less than 0.01, respectively), suggesting that PRA and PGF MUM are useful investigations in evaluating FENa. Especially PRA is often measured routinely and should be measured first, which may provide useful pathophysiological information on the genesis of abnormal FENa. PMID- 3527725 TI - The action of cyclosporin A on the endocrine pancreas in vitro--functional and morphological studies. AB - We investigated the effect of Cyclosporin A (100 ng/ml - 12000 ng/ml) on functional parameters of the endocrine pancreas in vitro. The insulin secretion of isolated islets in response to a variety of secretory stimulators is characterized by minimal alteration occasionally observed in the presence of very high Cyclosporin A concentrations. Cyclosporin A did not alter the glucose induced biphasic insulin secretion, nor the arginine-stimulated glucagon secretion of the perfused rat pancreas. Exposure of isolated islets to 2000 ng Cyclosporin A/ml for 3 weeks resulted in a minimal decrease of insulin content and a marked reduction of glucagon content, which were not accompanied by drastic alterations of insulin secretion. Scanning electron micrographs of these Cyclosporin A-treated islets did not differ from cultured control islets. The results let us assume that Cyclosporin A exerts no toxic effects on the endocrine pancreas in vitro, when exposed to concentrations greater than or equal to 2000 ng/ml. PMID- 3527726 TI - The role of insulin antibodies in insulin treatment of type I diabetes. AB - We investigated equilibrium plasma binding patterns of insulin in 45 juvenile diabetics treated with conventional insulin preparations. Insulin binding parameters were evaluated by Scatchard analysis of the binding data. Stable diabetics had significantly lower equilibrium dissociation constants than labile, thus suggesting an enhanced insulin depot effect due to stronger insulin binding. Correlation of insulin binding data with a glycemic control index yielded a positive relationship between insulin antibody binding and the degree of glycemic control. Insulin neutralization as detected by a relationship between maximum binding capacity of high affinity antibodies and insulin requirement could only be found if patients with poor diabetes control were excluded. Similarly, the well-known promoting influence of residual beta-cell functional capacity (assessed by C-peptide levels) on diabetic stability was observed only after exclusion of patients with higher insulin antibody binding. These data suggest that insulin antibodies are influencing insulin treatment of diabetics in a dual way. They may neutralize therapeutic insulin but at the same time they exert an insulin-sparing action by improvement of diabetes control. Occasionally the latter effect may abolish the correlation between diabetes control and beta-cell functional capacity. PMID- 3527728 TI - Normal and malignant cells, including neurons, deposit plasminogen activator on the growth substrata. AB - The results of four different assay methods showed that both normal and malignant plasminogen activator-secreting cells deposited substantial amounts of this protease on tissue-culture substrata, including collagen coatings. The cells studied were Rous sarcoma virus (RSV)-transformed vole fibroblasts, a malignant neural cell line (NG108-15) capable of neurite formation, and normal mouse regenerating sensory neurons. Deposited plasminogen activator was detected by a fibrin overlay assay at sites from which cells growing on coverslips had been gently dislodged, showing that active enzyme is left beneath cells and in the immediate pericellular area. For neuronal cells, fibrinolytic zones were detected not only at the previous positions of cell bodies but also along the terrain conditioned by neurite extension, suggesting that a trail of plasminogen activator is left behind during growth cone movement. Substratum-bound enzyme could be solubilized in buffers containing sodium dodecyl sulfate (SDS) or Triton X-100 and demonstrated by zymography following electrophoresis or assayed for amidolytic activity with a chromogenic substrate (Kabi S-2251). The results suggest that plasminogen activator may be considered a component of substrate adhesion material. Secretory proteases deposited directly on matrix molecules would seem strategically positioned to participate in local degradation of components of the extracellular environment. PMID- 3527727 TI - Human hepatocyte growth factor in plasma from patients with fulminant hepatic failure. AB - Plasma from patients with fulminant hepatic failure obtained during plasma exchange therapy, like their serum, demonstrated marked stimulatory activity on DNA synthesis in cultured rat hepatocytes. Heat treatment at 56 degrees C for 30 min did not affect this activity of the plasma, but reduced that of the serum. This growth-promoting activity was confirmed by showing that the patients' serum and plasma increased the labeling index with [3H]thymidine and the total number of nuclei in hepatocyte cultures. The activity of pooled active fractions obtained by gel filtration of the heated plasma was lost completely on heat treatment at 80 degrees C for 10 min or on treatment with trypsin or chymotrypsin, which suggests that it was due to a protein. The human hepatocyte growth factor was purified about 600-fold from heated plasma of a patient by ammonium sulfate precipitation and chromatographies on Affi-Gel Blue and hydroxylapatite. The maximum effect of this partially purified factor on DNA synthesis in cultured hepatocytes was greater than that of epidermal growth factor. The molecular weight of the hepatocyte growth factor was about 85,000 as determined by SDS-PAGE. PMID- 3527729 TI - Redistribution of the nuclear mitotic apparatus protein (NuMA) during mitosis and nuclear assembly. Properties of purified NuMA protein. AB - Monoclonal antibodies and human autoimmune sera specific for the nuclear mitotic apparatus protein (NuMA protein) were applied to study the structure of this protein and its intracellular distribution. The NuMA protein was purified using immuno-affinity columns. Studies on this large (250 kD) nuclear protein indicated that it is a highly asymmetric phosphoprotein. It is present in all mammalian cells examined and in those of some non-mammals. Immunofluorescence studies on fixed cells demonstrated that its intracellular distribution is essentially the same in all species at all stages of the cell cycle. Immunoblot (western blot) analysis showed that the size of the NuMA protein varies slightly in different species. At the onset of mitosis the NuMA protein redistributes from the nucleus to two centrosomal structures that later will become part of the mitotic spindle pole. This occurs at the time of nuclear breakdown and eventually leads to an accumulation of the NuMA protein at the polar region of the mitotic spindle. After anaphase the protein redistributes from the spindle polar region into the reforming nucleus and concentrates initially at the site where nuclear lamins and perichomatin have been reported to assemble. Living cells microinjected with fluorescent anti-NuMA antibodies were studied to examine parameters that effect the redistribution of the NuMA protein in vivo. These experiments indicate that microtubule assembly is essential for the NuMA protein to accumulate in the polar region. PMID- 3527730 TI - The age-related decline in antibody response is transferred by old to young bone marrow transplantation. AB - The immune response declines with age. This decline correlates with thymic involution and involves primarily a loss in T-cell function, whereas humoral immunity is more variably affected. In the current experiments we have measured immunoglobulin synthesis in vitro after mitogen stimulation, and specific antibody response after vaccination. We found that the response to pokeweed mitogen by non-specific immunoglobulin production, and the response to vaccine was shown to be transferred to lethally irradiated young mice by old to young bone marrow transplantation. Both pokeweed mitogen and tetanus toxoid require T cell help for optimal response, and, therefore, our observations are in accordance with the age-associated decline in T-cell immunity. The finding that young hosts transplanted with old bone marrow produce less antibody than young hosts transplanted with young bone marrow highlights the importance of the decline in cellular function with age. PMID- 3527731 TI - Development of spleen CFU-S colonies from day 8 to day 11: relationship to self renewal capacity. AB - To investigate the persistence of spleen colonies from day 8 to day 11 of their development, we injected low numbers of marrow cells in order to obtain single colonies on the spleens of irradiated mice. Colonies were isolated on either half of the spleen on the eighth day. The position of day-11 colonies, determined relative to the ligature, indicated where novel colonies appear between those times. The results showed no evidence of the persistence of colonies from day 8 to day 11. The self-reproduction capacity of CFU-S that survive various cytotoxic drugs depends on the specific subpopulations that are affected by the drug. Using cyclophosphamide, busulphan, or BCNU, the self-renewal capacity of surviving CFU S was manipulated. The results show that after cytotoxic treatments, a high day 11-day-8 ratio is not necessarily a reflection of a high self-renewal capacity of the CFU-S population that forms the day-11 colonies. PMID- 3527732 TI - Persisting radiation effect on murine 7-day and 12-day CFU-S. AB - If radiation-induced reduction in the proliferative ability of bone marrow cells is due to a change in the age structure of stem cells, it might be measurable by an increase in the ratio of 7- to 12-day spleen colonies. This increase has not been detected at either three weeks or one year after 5 Gy gamma-irradiation. It was found, however, that diameters of colonies and weights of hemopoietic tissue per colony were reduced after both periods of recovery. Thus, slow colony growth may have masked a change in the stem cell age structure. It is concluded that injury persists in a proportion of stem cells that continues the production of progeny and may contribute to late effects. Persisting cellular injury, in modified form, may affect all mitotically active tissues. PMID- 3527733 TI - Bronchial challenge: interpretation of readings. AB - Bronchial reactivity as tested in vivo reflects to some extent the responsiveness of smooth muscle in the lower airways. The in vivo reactivity is often presented in terms of PC20 (provocation concentration leading to a 20% fall of FEV1), an index that is supposed to provide condensed information of the general dose/response relationship by a continuous variable. However, expressing the fall in relative terms is not strictly logical, as the random experimental error of FEV1 shows a homoschedastic distribution. Furthermore, PC20 becomes mathematically unstable in cases with a slight response and can be determined with reasonable precision only when the observed fall is close to 20% or more. When a small number of highly differing dose levels are used in clinical challenge testing, the results should rather be presented as the maximum, absolute change of FEV1 obtained at a specified dosage. PMID- 3527734 TI - Flow-volume response to inhaled methacholine in asthmatics; comparison of area under the curve (AFV) with conventional parameters. AB - The sensitivity and reliability of a new index of flow volume spirometry, area under the expiratory flow-volume curve (AFV), was tested in metacholine challenges in 42 patients with bronchial hyperreactivity. The responses of AFV were compared with those of VC, FVC, FEV1, PEF and MEF50. After inhaled metacholine AFV showed the greatest decrease (36.0%) from the baseline; the corresponding changes of VC, FVC, FEV1, PEF and MEF50 were 12.9%, 15.9%, 20.9%, 20.3%, and 33.3%, respectively. The changes expressed in units of coefficient of variation (variation between two successive curves) were: VC 2.9, FVC 3.7, FEV1 3.7, PEF 2.9, MEF50 2.9 and AVF 6.7. Thus, AFV seemed to be the most sensitive indicator of bronchoconstriction in metacholine challenges tests. In addition, the changes of AFV correlated well with those of FEV1 (r = 0.939, p less than 0.001). PMID- 3527735 TI - The neural reflexes in the airways. PMID- 3527736 TI - Airway inflammation and non allergic bronchial responsiveness. PMID- 3527737 TI - Inflammatory mediators of asthma. PMID- 3527738 TI - Plasmodium berghei: histology, immunocytochemistry, and ultrastructure of the placenta in rodent malaria. AB - The pathological changes associated with malarial infection in pregnancy were studied in rats and mice infected with Plasmodium berghei at different stages of gestation. Histopathological and ultrastructural studies of infected placentae near term in both species revealed disruption of architecture with gross thickening and necrosis of cells in the labyrinthine zone and fibrosis of the trilaminar trophoblast separating the maternal and fetal circulations. In the mouse, the extent of histopathological alterations in infected placentae ranged from the presence of immature erythrocytes in the fetal circulation in low grade maternal infection, to the marked deposition of fibrinoid material on the trilaminar trophoblast and inflammatory masses in severely infected placentae. In the rat, histopathological aberrations in the placentae were marked by placental stroma edema, fibrosis, and cellular infiltration. Immunohistological studies of cryostat sections of placentae from infected animals showed more parasites and pigment in infected mouse placentae than in the corresponding rat organ, but in both species parasites and pigment were largely confined to the maternal blood spaces and were only occasionally found in necrotic areas of trophoblast. No clear differences were observed between infected and control placentae in terms of the amount of IgG, IgM, or IgA which were each present in various amounts. These observations and the rarity of congenital malaria in the animals indicate that the placenta constitutes a major barrier to infection of the fetus. However, the pathological aberrations in the infected placentae may impose a biochemical stress upon the fetus which may account for the low birthweight, the increased frequency of abortion, and the greatly increased maternal and fetal death rates observed in malaria. PMID- 3527739 TI - Schistosoma japonicum: ultrastructural localization of a hemoglobinase using mercury labeled pepstatin. AB - Mercury labeled pepstatin was used to demonstrate the site of a pepstatin sensitive hemoglobinase in paraformaldehyde fixed adult Schistosoma japonicum. Pepstatin was covalently attached to glutathione using dicyclohexylcarbodiimide followed by addition to methyl mercury chloride. Deposition of mercury was observed in lipid-like globules and autophagic vacuoles in the gastrodermis. Control studies were negative in all instances. These results complement previous cytochemical studies on the distribution of other acid hydrolases in the gastrodermis of schistosomes. It is hypothesized that this pepstatin sensitive enzyme probably belongs to the carboxyl class of proteinases. PMID- 3527740 TI - Schistosoma mansoni: surface membrane stability in vitro and in vivo. AB - The human complement component C3b is known to bind in vitro to the surfaces of all developmental stages of schistosomes as a consequence of complement activation by the alternative pathway. C3b bound to Schistosoma mansoni parasites has now been used in combination with fluorescent labeled antibodies against C3b to label the surfaces of living schistosomes. Binding of complement components and labeled antibodies to adult schistosomes rendered their surface membrane homogeneously fluorescent. At the ultrastructural level, the label was seen as a dense deposit lying on the tegumental membrane. Surface damage was not observed in labeled adults by electron microscopy. Fluorescent schistosomes were cultured in vitro for periods of up to 2 weeks, during which time the parasites remained fully viable and their surface membrane was still fluorescent. The electron dense deposit persisted, and tegumental damage at the electron microscope level was minimal or absent. Consequently, adult schistosomes would seem able to survive in vitro in the absence of rapid and general turnover of their surface membrane. Loss of fluorescence was observed consistently only at the anterior end of the parasite, including the suckers, a finding which indicates that membrane turnover may occur at different rates on different parts of the body. Fluorescent 3-week old juveniles and 6-day-old lung stage parasites were cultured under the same conditions with similar results: they remained viable and fluorescent for at least 2 weeks. Results with skin schistosomula were different in the sense that many worms died during culture, and those which survived lost large parts of their fluorescent surface. A few of the surviving and fluorescent schistosomula developed the elongate shape typical of lung stage parasites. Fluorescent viable skin schistosomula were injected intravenously into mice and subsequently recovered from the lungs after varying periods. Fluorescence was lost in a patchy way within a few minutes from some individuals and within several hours from most of the worms. These data permit the following conclusions: C3b is a suitable tracer for membrane renewal in all developmental stages of schistosomes. Very slow membrane renewal in vitro and very rapid renewal in vivo are both compatible with parasite survival. PMID- 3527741 TI - Adherence of gram-positive and gram-negative bacterial strains to human lung fibroblasts in vitro. AB - The adherence to eukaryotic cells of Escherichia coli, Neisseria gonorrhoeae, Pseudomonas aeruginosa, Staphylococcus aureus, Staphylococcus epidermidis and the yeast Candida albicans was studied by light microscopy with an in vitro micromethod involving different cell lines. The method is inexpensive, consumes little time and material, and is reproducible. It was used to show that the gram positive Cowan I strain of S. aureus, which naturally forms protein A on its surface, adheres in much larger numbers to human lung fibroblasts than the protein A-free Wood 46 strain, the strain of S. epidermidis, and the encapsulated Smith strain. The presence of a capsule on the latter strain apparently prevented its attachment to the fibroblasts. Among the gram-negative species studied, a piliated clinical isolate of N. gonorrhoeae, displaying the opaque colonial phenotype, adhered in larger numbers than another isolate lacking pili and displaying the transparent phenotype. E. coli K12 attached slightly to the cell line, whereas P. aeruginosa adhered to it moderately. One strain of C. albicans tested did not attach in any detectable numbers. No clear correlation between bacterial cell surface hydrophobicity, as evaluated by the hexadecane assay, and adherence to eukaryotic cells could be demonstrated for these microorganisms. With our method, bacterial attachment proceeded best at 37 degrees C and did not require more than 1 h of contact with the cell monolayer. The method described revealed differences in the adherence to eukaryotic cells, not only among species, but also between strains of the same species. PMID- 3527742 TI - Aromatic tetra-amidines: antiproteolytic and antiesterolytic activities towards serine proteinases involved in blood coagulation and clot lysis. AB - The inhibitory effect of 1,3-di-(p-amidinophenoxy)-2,2-bis-(p amidinophenoxymethyl)propane (TAPP-H), TAPP-halo derivatives (with Cl, Br or I) and benzamidine on the Ancrod, bovine Factor Xa, and human plasmin catalyzed hydrolysis of esters and anilides of amino acids was investigated, at pH 8.1 and 37 degrees, and compared with that shown from these compounds on bovine thrombin and porcine pancreatic kallikrein catalysis. The inhibitory effect of TAPP-H and TAPP-halo derivatives on the proteinases considered, involved, to different extents, in blood coagulation and clot lysis, is higher by at least 10-fold, than that of benzamidine, which binds at the primary specificity subsite (S1) of serine endopeptidases and is commonly taken as a molecular inhibitor model. The high inhibitory effect of aromatic tetra-amidines has been interpreted taking into account an additional productive binding for a second benzamidine or halo benzamidine moiety to the enzyme surface. Moreover, the data reported here allowed us to clarify the inhibition mechanism (in vitro) of TAPP-H on blood coagulation, induced by the "cancer coagulation factor" produced by the Walker carcinoma in Wistar rats and on the fibrinogen-to-fibrin conversion, and to identify some serine proteinases which act as targets for aromatic tetra amidines. PMID- 3527743 TI - Expression, secretion and folding of human growth hormone in Escherichia coli. Purification and characterization. AB - An efficient secretion vector containing a gene coding for an E. coli signal peptide fused to human growth hormone (hGH) was cloned into E. coli. The recombinant fusion protein was expressed and correctly processed hGH was secreted into the periplasmic space at a yield of 10-15 micrograms hGH/A600. Purification of hGH from the periplasmic fraction by anion exchange and size exclusion gave hGH of greater than 90% purity. Characterization by SDS-PAGE, amino terminal analysis, trypsin mapping, and circular dichroism demonstrated that the fusion protein was correctly processed to authentic hGH and that the E. coli periplasm provided an appropriate environment for proper folding of hGH and disulfide bond formation. PMID- 3527744 TI - Regions of SV40 large T antigen necessary for oligomerization and complex formation with the cellular oncoprotein p53. AB - The simian virus 40 (SV40) T antigen is composed of 708 amino acids and forms monomers and various oligomers and, in small amounts, heterologous complexes with the cellular oncoprotein p53 (T-p53). Using SV40 mutants coding for T antigen fragments which are either deleted in the N-terminal half or truncated by various lengths at the C-terminal end, we found that a region between amino acids 114 and 152 and a C-terminal region up to amino acid 669 are essential for the formation of high Mr oligomers of T antigen. Furthermore, only the C-terminal end up to amino acid 669 is essential for T-p53 complex formation but not the N-terminus up to amino acid 152. PMID- 3527745 TI - The importance of individual nucleotides for the structure and function of rRNA molecules in E. coli. A mutagenesis study. AB - Methods of in vitro mutagenesis were employed to determine the importance of individual nucleotides within the ribosomal RNAs for the structure and function of E. coli ribosomes. A series of defined nucleotides in the genes for the 5 S and 16 S RNA were altered by transition and transversion mutations using either oligonucleotide-directed or bisulfite-catalyzed mutation procedures. Plasmids harbouring the mutated rRNA genes were expressed and the ribosomes containing such altered RNAs were investigated for impairments in RNA-protein interaction assembly and mRNA-coded tRNA binding. PMID- 3527746 TI - Adjacent codon-anticodon interactions of both tRNAs present at the ribosomal A and P or P and E sites. AB - A labeled tRNA present at the A, P or E site can be partially chased from the ribosome, a cognate nonlabeled tRNA as chasing substrate being 3-12-times more efficient than non-cognate tRNA at a molar ratio tRNA: 70 S = 10:1. These findings indicate that a tRNA bound to a programmed ribosome undergoes codon anticodon interaction at all three sites (A, P and E site). Furthermore, both labeled tRNA present on the ribosome can be chased more effectively with cognate than with non-cognate substrate at the same time. This finding provides strong evidence that both tRNAs present on the ribosome exhibit simultaneous codon anticodon interaction. This is valid for both the pretranslocational state (Ac[3H]Lys-tRNALys in the A and [14C]tRNALys in the P site) as well as the posttranslocational state (Ac[3H]Lys-tRNALys in the P and [14C]tRNALys in the E site). PMID- 3527747 TI - Identification of c-myb (chicken), c-myb (mouse) and v-myb (AMV) protein products by immunoprecipitation with antibodies directed against a synthetic peptide. AB - A synthetic nonadecapeptide (IL 19) derived from a sequence of v-myb was covalently bound to haemocyanin and used for immunization. Anti-IL 19 serum immunoprecipitated a 75 kDa protein in the lysate of metabolically labelled chicken and murine thymus cells. Presaturation of the serum with IL 19 abolished this immunoprecipitation, thus indicating that the product of c-myb in both chicken and murine thymuses is the 75 kDa protein (p75c-myb). Anti IL 19 serum also precipitated p48v-myb in the lysate of nonproducer myeloblasts. PMID- 3527748 TI - Insulin stimulation of glucose uptake and the transmembrane potential of muscle cells in culture. AB - The membrane potential of L6 muscle cells was measured with the fluorescent dye bis-oxonol. Hyperpolarizations of up to 15 mV were caused by gramicidin (in N methyl-D-glucamine+ medium), or by monensin or ionomycin. Depolarization was achieved with gramicidin (in Na+ medium), or with K+. Insulin did not change the resting membrane potential of -70 mV, yet it effectively stimulated 2-deoxy-D glucose uptake. Conditions that hyperpolarize the cells did not alter the basal rate of hexose uptake. Moreover, insulin was still capable of stimulating hexose uptake in depolarized cells. It is concluded that modulation of the membrane potential is probably not a signalling event in insulin stimulation of hexose uptake. PMID- 3527749 TI - Structure of Rhodopseudomonas sphaeroides R-26 reaction center. AB - The molecular replacement method has been successfully used to provide a structure for the photosynthetic reaction center of Rhodopseudomonas sphaeroides at 3.7 A resolution. Atomic coordinates derived from the R. viridis reaction center were used in the search structure. The crystallographic R-factor is 0.39 for reflections between 8 and 3.7 A. Validity of the resulting model is further suggested by the visualization of amino acid side chains not included in the R. viridis search structure, and by the arrangements of the reaction centers in the unit cell. In the initial calculations quinones or pigments were not included; nevertheless, in the resulting electron density map, electron density for both quinones QA and QB appears along with the bacteriochlorophylls and bacteriopheophytins. Kinetic analysis of the charge recombination shows that the secondary quinone is fully functional in the R. sphaeroides crystal. PMID- 3527750 TI - Novel specificity of an endoribonuclease of yeast. AB - Investigations of the cleavage specificity of a cyclizing endoribonuclease of yeast show that it hydrolyzes Y-A bonds of single-stranded regions of RNA and that oligonucleotides are hydrolyzed poorly. The stringent specificity of the enzyme suggests that it may be useful for generating specific fragments of polyribonucleotides. An isolation technique employing ethanol extraction has now been used to isolate the enzyme free of other RNases, and the studies show that it is a small protein, 10 kDa or less in molecular mass. PMID- 3527751 TI - Evidence that TraT interacts with OmpA of Escherichia coli. AB - The OmpA protein is one of the major outer membrane proteins of Escherichia coli. Among other functions the protein serves as a receptor for several phages and increases the efficiency of F-mediated conjugation when present in recipient cells. TraT is an F-factor-coded outer membrane lipoprotein involved in surface exclusion, the mechanism by which E. coli strains carrying F-factors become poor recipients in conjugation. To determine a possible interaction of TraT with OmpA, the influence of TraT on phage binding to cells was measured. Because TraT inhibits inactivation of OmpA-specific phages it is suggested that TraT interacts directly with OmpA. Sequence homology of TraT with proteins 38, the phage proteins recognizing outer membrane proteins, supports this finding. A model of protein interactions is discussed. PMID- 3527752 TI - Radiation inactivation analysis of kidney microvillar peptidases. AB - Five membrane peptidases were studied by radiation inactivation analysis of pig kidney microvillar membranes. One heterodimeric enzyme, gamma-glutamyl transferase, presented a target size corresponding to the dimeric Mr. The other enzymes are known to be homodimers. Three of these, aminopeptidase A. aminopeptidase N and dipeptidyl peptidase IV, gave results clearly indicating the monomer to be the target and, hence, in this group the association of the subunits was not essential for activity. The target size for endopeptidase-24.11 was intermediate between those for monomer and dimer and its functional state was not resolved by the experiments. PMID- 3527753 TI - Induction of cell surface insulin antigenicity in fibroblasts transfected with islet genomic DNA. AB - Ltk- cells were transfected with total genomic DNA obtained from rat islets or from insulinoma cells mixed with DNA tagged with fluorescent dye. Fluorescence activated cell sorter (FACS) was used for initial selection of successful transfectants, monitoring fluorescent DNA incorporated into the cell. For subsequent selections the cells were treated with anti-insulin antiserum labeled with fluorescent dye and selected by FACS. Beta-cell DNA, but not DNA from murine leukemic cells, induced the appearance of cell surface insulin antigenicity in fibroblasts. This phenotypic expression was transient. Together with our previous demonstration of the induction of insulin secretion in Ltk- cells [(1986) Biochem. Biophys. Res. Commun. 136, 638-644], these results indicate that beta cell-specific characteristics can be transfected to non-endocrine cells by genomic DNA transfection. PMID- 3527754 TI - Protection of mice against Plasmodium berghei infection by a tuftsin derivative. AB - In Plasmodium berghei infections, the mortality rate and parasitaemias were significantly reduced and the mean survival time was considerably enhanced by pretreating the animals with a tuftsin derivative, Thr-Lys-Pro-ARg-NH-(CH2)2 NHCOC15H31. This effect of the modified tuftsin was further increased upon its incorporation in the liposome bilayer. These results indicate that tuftsin and its derivatives may prove useful in enhancing nonspecific host resistance against protozoan infections. PMID- 3527755 TI - Prediction and prevention of famine. AB - In general, famines have become less frequent and of decreasing magnitude in recent decades, a generalization to which sub-Saharan Africa is the striking exception. The underlying factors preventing famine continue to weaken in sub Saharan Africa, while they grow stronger elsewhere. The basic elements of famine prevention are: a substantial surplus of agricultural production beyond the subsistence needs of the rural population; highly developed transportation systems within rural areas, between rural and related urban areas, and with the rest of the world; and a democratic form of government. The first makes a shortage of food and income to buy food less likely, the second makes it possible to deal with food and income shortages if they do occur, and the third ensures that necessary and feasible actions will be taken. In a democratic framework a free press brings attention to famine even in isolated areas, and public opinion refuses to countenance inaction by the bureaucracy. Once conditions of famine arise, market mechanisms concentrate food where the purchasing power exists, drawing food from the rural to the urban areas and from the poor to the rich. In such circumstances governments must take direct action to prevent starvation. Famine is predicted by successive years of poor crops, a rapid rise in food prices, a decline in the prices of goods that the poor sell (particularly including the livestock of pastoralists), and a decline in employment. PMID- 3527756 TI - New technology and its role in enhancing global food production. AB - The transfer in the past 3 decades of modern agricultural technology to countries of the Third World has led to a steady improvement in global food production. The results have not been evenly distributed, however, and serious problems remain. Modern biotechnology may contribute to solving some of the problems of high input costs and may also contribute to decreasing the risks associated with agriculture in developing economies. Several problems must be overcome, however. Among these are finding ways to bring the advanced technological capabilities of private companies, both large and small, to the international agricultural research network where commercial incentives are not strong or are inappropriate. Also, unless and until severe countervailing forces, such as population growth rates and deterioration of the environment, are brought under control the spread of new agricultural technology will be of little consequence in the most difficult famine-prone situations. PMID- 3527757 TI - Role of the placenta in ensuring fetal nutrition. PMID- 3527758 TI - Fetal nutrition: supply, combustion, interconversion, and deposition. AB - The study of placental transport is confounded by species differences, gestational differences, and a permanent non-steady state. The histology of the interhemal membrane, the degree of steric hindrance to diffusional exchange, the discrimination of electric charge, the flow pattern, and the transfer of intact gamma globulins are all species specific. We suggest the creation of order based on the ultrastructure of the placental barrier. The gas diffusion capacity of the membrane changes during gestation. This change is initially due to an increase in placental mass, but the gas diffusion capacity continues to increase after placental growth has ceased, because of changes in surface area and thickness of the membrane. The non-steady state of fetal weight is accompanied by an uptake of nutrients far in excess of what is necessary to satisfy oxygen consumption. Measurements of venous and arterial cord blood chemistry are sufficient to distinguish the fraction of nutrient uptake that is dedicated to catabolism from the fraction that is dedicated to fetal growth. PMID- 3527759 TI - Placental transport and utilization of amino acids and carbohydrates. AB - Uteroplacental tissues have been shown to have a high rate of metabolism under in vivo steady-state conditions. Fully two-thirds of the glucose and one-half of the oxygen consumed by the uterus are utilized by these tissues rather than by the fetus. Its high metabolic rate must be borne in mind in any analysis of tracer kinetics, which prohibits the exclusion of these tissues and the use of a two compartment model for analysis of carbohydrate and amino acid metabolism. Current techniques permit determination of utilization rates of nutrients in all three compartments (fetal, uteroplacental, and maternal) with considerable precision. Using tracer amino acids one can determine rates of protein synthesis and protein breakdown as well as rates of amino acid oxidation. These techniques should prove useful in investigating the role of various trophic factors in fetal life and in assessing the impact of changes in placental function or maternal nutritional state on fetal growth and metabolism. PMID- 3527760 TI - Role of uteroferrin in transplacental iron transport in the pig. AB - The pig possesses a noninvasive, diffuse type of epitheliochorial placentation in which the blood supply of the mother is well separated from the absorptive surface of the chorion, a feature that must complicate the movement of nutrient molecules across the placenta. Evidence is presented that a protein synthesized and secreted by the glandular epithelial cells of the maternal uterus of the pig is involved in iron transport to the fetus. This protein, uteroferrin, is induced by progesterone; is purple, which results from an unusual iron center; and possesses acid phosphatase activity. Secreted uteroferrin is taken up by specialized chorionic epithelial cells located in domed structures, called areolae, overlying the mouth of each uterine gland. Uteroferrin then enters the placental venous drainage and its iron is efficiently incorporated into fetal hemoglobin. It is taken up by the fetal liver or cleared by the kidney. The liver is the main site of erythropoiesis in the fetus. From the kidney uteroferrin enters the allantoic sac where it exchanges its iron with fetal transferrin. The rate of uteroferrin biosynthesis in the uterus and its rate of metabolism in the fetus can theoretically provide sufficient iron for the needs of pregnancy, at least until around day 70 of the 115-day gestation. Uteroferrin and transferrin, the iron transport protein of plasma, appear to be unrelated proteins. PMID- 3527762 TI - [Method of colpoperineorrhaphy]. PMID- 3527761 TI - Placental metabolism and transport of lipid. AB - Both the developing fetus and the placenta require fatty acids for the synthesis of complex lipids necessary for the biogenesis of plasma membranes, intracellular membranes, and organelles; triacylglycerol stores; and secreted products such as lipoproteins, bile, and pulmonary surfactant. Although fetal tissues can readily synthesize fatty acids, considerable evidence exists in nonruminants that as much as 50% of the fatty acid requirements of the fetus are maternally derived. The placenta may be even more dependent than the fetus on the maternal contribution because the placenta synthesizes fatty acids poorly. The major sources of fatty acid provided to the fetus and placenta have not been identified with certainty. Maternal free fatty acids readily cross the placenta and the fatty acid moieties of maternal serum lipoproteins may also be transferred. The mechanism of transport of maternal free fatty acids and lipoprotein-carried lipid has not been investigated on a molecular level. Future studies with cultured trophoblasts should be useful in providing answers to many questions concerning placental lipid metabolism and the role of the placenta in transporting lipid to the fetus. PMID- 3527763 TI - [Outstanding social activist, humanist (Nikolai Ivanovich Pirogov)]. PMID- 3527764 TI - [Medieval scholasticism, education and medicine]. PMID- 3527765 TI - [Outstanding Russian pediatrician N. P. Gundobin (1860-1908)]. PMID- 3527766 TI - Screening therapeutic insemination donors for sexually transmitted diseases: overview and recommendations. PMID- 3527767 TI - Effect of estradiol on the pituitary response to intravenous stimulation with luteinizing hormone-releasing hormone in menopausal women. AB - Five menopausal patients were submitted to stimulation with 100-micrograms doses of luteinizing hormone-releasing hormone (LH-RH) administered 120 minutes apart under three different types of conditions: (1) in a hypoestrogenic state (test 1); (2) in a hyperestrogenic state after acute intravenous bolus injection of 400 micrograms 17 beta-estradiol (E2) (test 2); (3) in a hyperestrogenic state after daily oral administration of 50 micrograms ethinyl E2 for 3 to 4 weeks (test 3). The results of the three tests showed that (1) the time needed to reach maximum LH values after LH-RH injection was longest in test 3; (2) the hormonal production rate (HPR) in test 1 was greatest after the first stimulus with LH-RH. In test 2, the two stimulations with LH-RH induced an equivalent HPR, whereas in test 3, the HPR was greatest after the second stimulation; (3) the correlation between basal LH values before LH-RH injection and the maximal values of the responses obtained after each injection changed throughout the experiment. In all three tests, the slope of the line (significant positive correlation) was always greater after the second stimulation. When the three tests were compared, the slope in test 3 was greater than in test 2, and the slope in test 2 greater than in test 1. These results clearly suggest the important role of estrogens in the regulation of LH release in women by acting not only at the hypothalamus but also at the pituitary level, and demonstrate a correlation between basal LH levels and the maximum response to LH-RH stimulation. This correlation is more marked during estrogen treatment and depends on the time of exposure to estrogen. PMID- 3527768 TI - Effect of sperm antibodies in females on human in vitro fertilization. AB - The effect of sperm antibodies derived from the female partner's serum on fertilization and embryo cleavage was evaluated by analyzing the Royal Women's Hospital in vitro fertilization (IVF) data. The results suggest that antispermatozoal isoantibodies detected by the immunobead test (IBT) can interfere with IVF. Thus, in a group of patients with IBT-IgG and IBT-IgA sperm antibody titers of greater than or equal to 10 in serum, a low fertilization rate (15%) was obtained when the wife's serum was used as serum supplement in the IVF culture medium. Where replacement (antibody-negative donor or cord) serum was used in the culture medium, a higher fertilization rate (69%) was obtained (P less than 0.01). These results underline the importance of using replacement serum in cases where the wife has significant sperm antibody levels in her serum. Six pregnancies were obtained in the antibody-positive group (n = 20), five of which occurred in patients with IBT-IgG and IBT-IgA-titers less than 10, for a pregnancy rate of 5/9 in this subgroup. Four of these patients delivered (4/9). Analysis of larger groups of antibody-positive patients is required for further evaluation of these results and ascertainment of the likelihood of occurrence of posttransfer effects of sperm antibodies on the embryo. PMID- 3527769 TI - An antisperm monoclonal antibody inhibits sperm fusion with zona-free hamster eggs but not homologous eggs. AB - The zona-free hamster egg penetration assay (HEPA) was evaluated as a test for identifying fertilization-blocking antibodies. A monoclonal antibody, AH-20, that binds to the surface of guinea pig sperm was used to test antibody inhibition of sperm-egg fusion. AH-20 strongly inhibited guinea pig sperm fusion with zona-free hamster eggs but had no effect on guinea pig sperm fusion with zona-free guinea pig eggs. No inhibition by AH-20 was found in the homologous fusion assay over a wide range of sperm concentration, fertilization rate, and fertilization index. The results suggest that although guinea pig sperm can fuse with both hamster and guinea pig eggs, some aspect of the fusion mechanism is different in the two cases. The findings also indicate that HEPA, which is frequently used to assess the fertility potential of human sperm, can identify as blockers of sperm-egg fusion antibodies that have no effect on homologous sperm-egg fusion. PMID- 3527770 TI - Monoclonal antibodies to hepatitis B surface antigen: production and characterization. AB - Hybridomas secreting anti-HBsAg antibodies were produced by fusion of the mouse myeloma cell line SP2/0 with lymphocytes from mice immunized with purified HBsAg. All clones produced antibodies of the IgG1 idiotype that react with the subtype a determinant of HBsAg. An enzyme immunoassay for detection of HBsAg in human sera using monoclonal antibodies was developed and compared with commercial Sevatest ELISA HBsAg/micro I kit for detection of HBsAg in clinical serum samples. PMID- 3527771 TI - A basis for estimation of consumption: literature values for selected food volatiles. Part I. AB - This paper is a compilation of quantitative data available on volatile compounds reported so far in 18 food items including some legume, cereals, grapes and cheeses as well as crab, lobster, cocoa and chocolate. No publications reporting quantitative data were found for five of these 18 food products, i.e. sultana grape, broad beans, cassava, oat and rye. About 440 volatile compounds have been assayed globally in the other 13 food products and more than 50% of them were found in grape or in grape juice. Levels of these volatile compounds in the selected foods were generally in the ppb range and less often in the low ppm range. Very high levels were found for some carboxylic acids in cheeses and cocoa and for some alcohols and acids as well as for ethyl acetate in grape juice. PMID- 3527772 TI - [Form and color]. PMID- 3527773 TI - [Effective possibilities for dental technicians. A concrete case and its solution]. PMID- 3527774 TI - [Anatomic occlusal surfaces designed with silicone molds]. PMID- 3527775 TI - [Grooved shoulder-clasp attachment]. PMID- 3527776 TI - [Modified indirect post design technic]. PMID- 3527777 TI - [Training dental technicians. 30. Control baseplate]. PMID- 3527778 TI - [Imitation of nature in form and color]. PMID- 3527779 TI - [The Al-Khadra spring-lock activator bar and its problem-free construction]. PMID- 3527780 TI - [A combined telescopic and Konus crown in one]. PMID- 3527781 TI - [Free-end prostheses in the mandible. Possibilities and chances]. PMID- 3527782 TI - [Modelling and systematic completion of true-to-nature gold occlusal surfaces]. PMID- 3527783 TI - [New standards in metal-ceramics. The porcelain bevel with shoulder margins]. PMID- 3527784 TI - [Attachments in comparison. Loss of retention is not failure]. PMID- 3527785 TI - [Renaissance of resin jacket crowns? New methods using light-curing resins]. PMID- 3527786 TI - [Individualization of artificial teeth. The Mass complete denture]. PMID- 3527787 TI - [Periodontal preventive designs of reconstructions with pressure button anchors]. PMID- 3527788 TI - [Abutment preparation made easy. Initial experiences with Visio-Bloc]. PMID- 3527790 TI - [Evaluation of crown margins. Ideal position is not obtainable]. PMID- 3527789 TI - [Pd-based alloy as an alternative? The cost question is in the middle]. PMID- 3527791 TI - [Experiences with a resin of the Bowen generation]. PMID- 3527792 TI - [Restorations for all ages--wear is function of time]. PMID- 3527793 TI - [Communication aid in colored materials. The color-palette system]. PMID- 3527794 TI - [Kalotax-Setup-Kalotte, a transparent subject]. PMID- 3527795 TI - [Alloy situation after zero hour. Thoughts on the new denture guidelines]. PMID- 3527796 TI - [Error-free model preparation. Air inclusion is avoidable]. PMID- 3527797 TI - [Dual education--the future of hand work]. PMID- 3527798 TI - Soft tissue curettage. Literature review. PMID- 3527799 TI - A critical look at recent dentifrice claims. PMID- 3527800 TI - [Pseudo-T cell defect in bullous pemphigoid]. PMID- 3527801 TI - Partial denture design: modern concepts. 2. Design: (i) a sequential approach, plague accumulation and lateral stresses. PMID- 3527802 TI - Lytic activities in coelomic fluid of Eisenia foetida and Lumbricus terrestris. AB - Coelomic fluids of the two earthworm species E.foetida (E.F.) and L.terrestris (L.T.) have not only the ability to lyse various vertebrate erythrocytes but also to digest vertebrate serum proteins. Both activities are carried by different molecules since hemolysis but not proteolysis was inhibited by simple sugars. In contrary, proteolysis was blocked by PMSF which did not influence hemolysis. Coelomic fluids of E.F. digest effectively vertebrate serum proteins (PIgG, HSA) but not the proteins of L.T. coelomic fluids. The proteolytic activity was detected in approximately 40 000 mol. wt. fraction. After digestion proteolytic fragments were analyzed by immunoelectrophoresis, SDS-PAGE and TCA precipitation. Two of the fragments reacting with PIgG antisera remained intact even after 120 h digestion. PMID- 3527803 TI - Effect of hydrocortisone on immune system of the lizard, Chalcides ocellatus. III. Effect on cellular and humoral immune responses. AB - Administration of a single injection of 1.0 mg/g body weight hydrocortisone acetate (HC) to adult lizards, Chalcides ocellatus in summer elicited a high and lasting rise in serum corticosterone and cortisol, peak levels being, however, in the physiologic ranges of 10 micrograms % (2 X 10(-7) M) and 40 micrograms % (1 X 10(-6) M), respectively. Elevation of serum corticosteroid (CS) concentrations by exogenous HC impaired the proliferative capacity of spleen cells in mixed leukocyte reaction (MLR) and significantly delayed skin allograft rejection. In vivo HC also abrogated the primary in vivo and in vitro immune responses of lizards to rat erythrocytes (RRBC). Reactivity to allogeneic cells in MLR, and antibody production against RRBC were, however, recovered when serum CS levels resumed normal, basal values i.e. at three weeks post-HC injection. These data indicate that rise in circulating CS induces severe immunosuppression in lizards. PMID- 3527804 TI - A stereotaxic device for the closed exchange of intramedullary rods, using image intensified X-rays, in children with osteogenesis imperfecta. PMID- 3527805 TI - Evaluating treatments for preterm labor: possible solutions for some methodological problems. AB - The usual evaluation procedures for labor-inhibiting therapies are criticized and a new measure is proposed. This measure (rate of pregnancy prolongation) is shown to fulfil the criteria of high sensitivity to treatment effects and of unbiasedness for the gestational age of patients. The use of analysis of covariance is proposed as a solution for the problem of confounding background variables. The advantages of the new evaluation procedure are illustrated by the analysis of a clinical trial of labor inhibition by hypnotic relaxation. PMID- 3527806 TI - Modified distribution of epidermal glycoproteins in the nude mouse. AB - The nude mouse is an athymic mutant whose immunological deficiency has been exploited for transplantation of normal and diseased xenogeneic tissue. Histologically, its skin has no unusual features apart from the absence of hair. We report here a biochemical study of its epidermis, with comparison to the hairless mouse (which is devoid of hair but otherwise functionally normal). The epidermal glycoproteins were probed with the lectin, concanavalin A (Con A). Fluorescein isothiocyanate (FITC)-Con A overlays of cryostat skin sections gave a similar fluorescent pattern for both mouse strains: all the viable epidermal cell layers were labeled but not the stratum corneum. In contrast, when different populations of keratinocytes that were separated on Percoll gradients were analyzed by gel electrophoresis, and the gels then overlaid with iodinated Con A, all the epidermal layers, including the stratum corneum, were labeled. For all the epidermal cell layers there are substantial differences between the two mouse strains. We observe changes in the glycoprotein distribution with the stage of differentiation. Comparison with our earlier data for human epidermis indicates that the discrepancies between the nude mouse and the hairless mouse are much greater than those between the latter and man. The most striking difference is the absence in the stratum corneum of the nude mouse of a 40 K glycoprotein which is the dominant feature for the hairless mouse and for man. The gel patterns point to functional discrepancies in the epidermis of the nude mouse, particularly in the stratum corneum, not evident histologically or with FITC-Con A. PMID- 3527807 TI - Comparative utilization of glycerol and alanine as liver gluconeogenic substrates in the fed late pregnant rat. AB - The appearance of plasma [14C]glucose in the inferior cava vein after a pulse of 0.2 mmol of [U-14C]L-alanine or [U-14C]glycerol/200 g body wt given through the portal vein was studied in fed 21 day pregnant rats and virgin controls under pentobarbital anesthesia. In both groups values were much higher when [U 14C]glycerol was the administered tracer than when [U-14C]L-alanine, and they were augmented in pregnant versus virgin animals at 1 min when receiving [U 14C]glycerol and at 2 min when receiving [U-14C]L-alanine. 20 min after the tracers rats receiving [U-14C]glycerol showed much higher liver [14C]glycogen and [14C]glyceride glycerol than those receiving [U-14C]L-alanine. Radioactivity present in liver as [14C]glyceride glycerol was greater in pregnant than in virgin rats receiving [U-14C]glycerol whereas radioactivity corresponding to [14C]fatty acids was lower in the former group receiving either tracer. At 20 min after maternal treatments fetuses showed lower plasma [14C]glycerol than [14C]alanine values but plasma [14C]glucose and liver [14C]glycogen values were much greater in fetuses from mothers receiving [U-14C]glycerol than [U-14C]L amine. Besides showing the higher gluconeogenic efficiency in pregnant than in virgin rats, results indicate that at late gestation glycerol is used as a preferential substrate for both glucose and glyceride glycerol synthesis in liver. PMID- 3527808 TI - Effect of insulin on pyruvate dehydrogenase in a mixture of plasma membranes and mitochondria from normal and alloxan treated rat brains. AB - In a mixture of plasma membranes/mitochondria from normal rat brain, pyruvate dehydrogenase (PDH) is present in the active (PDHa) and the inactive (PDHi) form; the latter is converted into the former by preincubation with Ca2+ and Mg2+ and represents about 40% of total PDH (PDHt = PDHa + PDHi). Incubation with increasing insulin concentrations activates PDHa and PDHt, the maximum being reached at 25 microU/ml insulin; inhibition appears with further insulin increase. In a mixture of plasma membranes and mitochondria from alloxan rat brain PDHa activity markedly decreases; no activation is achieved by preincubation with Ca2+ and Mg2+. However an activating effect of Ca2+ and Mg2+ appears when the mixture is added and incubated with increasing insulin concentrations. PDHa and PDHt activity reaches a maximum of stimulation at 25 microU/ml insulin; the activation is reduced at higher concentrations of insulin though no inhibition appears. ATP partially inhibits PDHa in normal and alloxan rat brain plasma membrane/mitochondria mixtures; this effect is completely cancelled by 25 microU/ml insulin. PMID- 3527809 TI - Significance of infarct site and methylprednisolone on survival following acute myocardial infarction. AB - Eight hundred and forty-nine patients with confirmed myocardial infarction were enrolled in a double-blind, placebo-controlled clinical trial of the efficacy of methylprednisolone sodium succinate (MPSS, Solu-Medrol Sterile Powder, The Upjohn Company) for reduction of morbidity and mortality following an acute myocardial infarction complicated by left ventricular failure. Two study groups were prospectively defined based on time from onset of chest pain to administration of investigational therapy. Study Group 1 received investigational therapy before 6 hours had elapsed while Study Group 2 was treated 6 to 12 hours from the onset of chest pain. Both study groups were randomized to receive either a 30 mg/kg i.v. dose of MPSS (3 g maximum) or a matching placebo at the time of study admission, to be followed by an identical dose three hours later. Definitive electrocardiograms were available for 814 patients at admission. The mortality rates at 28 days and 6 months for the anterior transmural and nontransmural infarctions did not differ significantly with regard to time to treatment or investigational therapy. For the inferior/posterior transmural infarctions, however, there was a 92% relative reduction in mortality at 28 days in the MPSS treatment arm of Study Group 2 (1/83 [1.2%] for patients given MPSS versus 15/97 [15.5%] for those given placebo; p less than 0.001). This significant difference persisted at the 6 month follow-up evaluation (3/82 [3.6%] for patients on MPSS versus 17/96 [16.6%] for those on placebo, P less than 0.01). Site-specific efficacy has been reported for the anterior infarction groups of the major beta blocker trials.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3527810 TI - Positive synergism between diuretics and methylprednisolone following acute myocardial infarction. AB - In studies of patients with cardiac failure following an acute myocardial infarction, 1114 patients were followed for 7-day mortality. In the 45% of patients receiving diuretics on day 1, the death rate was twice that of patients not receiving diuretics. In patients treated 6 to 12 hours following the onset of chest pain, mortality was 2.8 times that of patients treated within 6 hours of the onset of chest pain. Randomization to methylprednisolone sodium succinate (MPSS, Solu-Medrol Sterile Powder, The Upjohn Company) did not improve the low mortality rates of those patients who did not need diuretics nor who were treated early. However, patients who were treated late and who needed diuretics and who were randomized to MPSS had a death rate half that of those who received placebo. PMID- 3527811 TI - Post-acute myocardial infarction symptomatic pericarditis (PAMISP): report on a large series and the effect of methylprednisolone therapy. AB - One thousand one hundred and fifty-eight patients sustained a presumed myocardial infarction. Ninety-six per cent of the cases were complicated by ventricular failure. Five hundred and eighty-nine patients were randomized to receive methylprednisolone sodium succinate (MPSS, Solu-Medrol Sterile Powder, The Upjohn Company) (two doses of 2 to 3 g i.v. three hours apart within 12 hours of the onset of chest pain) and 569 to placebo. 7.5% of patients receiving MPSS and 18.5% of the patients on placebo had post-acute myocardial infarction symptomatic pericarditis (PAMISP) (p less than 0.001). The MPSS-treated patients needed less therapy for their PAMISP, and MPSS pre-treatment attenuated and limited the PAMISP. Patients who suffered PAMISP did not differ in age or sex from patients without PAMISP, but had a 3.4-fold greater incidence of anterior acute myocardial infarctions (AMIs). The literature is also reviewed to show that MPSS is a beneficial intervention in PAMISP and other pericarditides. PMID- 3527812 TI - Metal: ATP characteristics of insulin- and epidermal growth factor-stimulated phosphorylation in detergent extracts of rat liver plasma membranes. AB - The metal: ATP characteristics of insulin- and epidermal growth factor-(EGF) stimulated protein kinase activities were examined in Nonidet P40 extracts of rat liver plasma membranes. The two kinase activities were capable of utilizing either manganese or magnesium, although differences were observed. Insulin stimulated 32P incorporation into an Mr 95 000 protein exhibited a higher affinity for ATP in the presence of manganese compared to magnesium. At 200 microM ATP, insulin stimulated 32P incorporation into the Mr 95 000 protein 3- to 5-fold after 5 min in the presence of either metal. At 1 mM ATP, insulin stimulated 32P incorporation was significantly greater in the presence of magnesium. In contrast, EGF-stimulated 32P incorporation into an Mr 170 000 protein exhibited similar ATP dependencies in the presence of magnesium or manganese. Basal phosphorylation of the Mr 170 000 protein was 2- to 3-fold higher in the presence of manganese, however. Since the higher basal phosphorylation persisted after chromatography on wheat germ lectin-Sepharose, it may represent an inherent activity of the receptor kinase. In the presence of magnesium: ATP, low concentrations of manganese enhanced both insulin- and EGF stimulated phosphorylation of angiotensin II suggesting involvement of a second metal binding site which regulates the kinase activity. The results presented show major differences in the metal: ATP properties of the two major hormonally regulated protein kinase activities observed in detergent-extracted liver membranes. PMID- 3527814 TI - Changes in the activity of the maturation-promoting factor during meiotic maturation and following activation of amphibian and starfish oocytes: their correlations with protein phosphorylation. AB - Changes in the extent of protein phosphorylation and their possible correlation with changes in the activity of maturation-promoting (MPF) factor were investigated throughout meiotic maturation and following activation of amphibian and starfish oocytes. Despite several exceptions in the pattern of phosphorylation of individual proteins, high and low levels of protein phosphorylation were found to be correlated with high and low levels of MPF activity. Both the extent of protein phosphorylation and MPF activity were found to drop upon parthenogenetic activation and to cycle synchronously thereafter in the amphibian. In contrast no drop in MPF activity or in the extent of protein phosphorylation was observed following activation of starfish oocytes with ionophore A23187. This suggests that changes of protein phosphorylation and of MPF activity are rather related to the progression of the cell cycle than directly to Ca2+-dependent activation reaction. In amphibians global protein kinase activity in homogenates was found to drop with MPF activity following activation. Changes in the ratio of threonine vs serine phosphorylation were also investigated during the course of meiotic maturation and activation in both amphibian and starfish oocytes: changes in the activity of MPF were found to be better correlated with changes in threonine than serine phosphorylation. PMID- 3527813 TI - Paraphysectomy-induced stimulation of parathyroid glands in mature frogs (Rana catesbeiana): evidence for telencephalic regulation of parathyroid gland function. AB - The relationship of the paraphyseal-choroid plexus complex to parathyroid gland function was investigated in adult frogs. Light microscopy and morphometric analysis indicated that total parathyroid gland volume, cell volume and vascular volume doubled by 7-28 days after surgical removal of the paraphyseal-choroid plexus complex (paraphysectomy). This increase correlated with the appearance of large Golgi-associated vesicles, an increase in the apparent number of cytoplasmic dense-core granules, and PTH within the parenchymal cells as monitored by immunofluorescence. Twelve months after paraphysectomy, parathyroid glands became cystic with a central fluid-filled cavity surrounded by a stratified cuboidal cell layer. The parenchymal cells of cystic glands contained numerous cytoplasmic dense-core granules and were also positive for PTH. Radioimmunoassay of cystic parathyroid fluid indicated a PTH concentration of 2 micrograms/microliter; however, analysis by SDS-PAGE indicated a wide range of proteins in cystic fluid. The results of this study indicate that paraphysectomy induces stimulation of the parathyroid glands and suggest a role for the paraphyseal-choroid plexus complex in the regulation of amphibian parathyroid gland function. PMID- 3527815 TI - Differentiation of lens and neural cells in chicken embryos is accompanied by simultaneous decay of DNA replication machinery. AB - DNA polymerase alpha was detected in cells of developing chicken embryos by an immunofluorescent method using a monoclonal antibody specific for the high molecular weight polypeptide of chicken DNA polymerase alpha, and DNA polymerase beta was detected using a rabbit anti-chicken DNA polymerase beta antibody. In lens tissue of the 3- to 4-day chicken embryo, fluorescence with anti-DNA polymerase alpha antibody was detected in nuclei of lens epithelial cells but not in nuclei of lens fiber cells which had differentiated from epithelial cells. The localization of cells containing DNA polymerase alpha coincided with the distribution of cells capable of DNA replication as detected by [3H]thymidine autoradiography. Similar results were obtained during the differentiation of neural matrix cells to neuroblasts in the developing neural tube. In contrast to DNA polymerase alpha, DNA polymerase beta was detected in nuclei of both undifferentiated and differentiated cells of these tissues. Since the disappearance of DNA polymerase alpha was very rapid after the onset of differentiation, the DNA replication machinery in which DNA polymerase alpha plays a central role is thought to decay almost simultaneously with the onset of cellular differentiation in these tissues. PMID- 3527817 TI - Environmental regulation of type X collagen production by cultures of limb mesenchyme, mesectoderm, and sternal chondrocytes. AB - We have examined whether the production of hypertrophic cartilage matrix reflecting a late stage in the development of chondrocytes which participate in endochondral bone formation, is the result of cell lineage, environmental influence, or both. We have compared the ability of cultured limb mesenchyme and mesectoderm to synthesize type X collagen, a marker highly selective for hypertrophic cartilage. High density cultures of limb mesenchyme from stage 23 and 24 chick embryos contain many cells that react positively for type II collagen by immunohistochemistry, but only a few of these initiate type X collagen synthesis. When limb mesenchyme cells are cultured in or on hydrated collagen gels or in agarose (conditions previously shown to promote chondrogenesis in low density cultures), almost all initiate synthesis of both collagen types. Similarly, collagen gel cultures of limb mesenchyme from stage 17 embryos synthesize type II collagen and with some additional delay type X collagen. However, cytochalasin D treatment of subconfluent cultures on plastic substrates, another treatment known to promote chondrogenesis, induces the production of type II collagen, but not type X collagen. These results demonstrate that the appearance of type X collagen in limb cartilage is environmentally regulated. Mesectodermal cells from the maxillary process of stages 24 and 28 chick embryos were cultured in or on hydrated collagen gels. Such cells initiate synthesis of type II collagen, and eventually type X collagen. Some cells contain only type II collagen and some contain both types II and X collagen. On the other hand, cultures of mandibular processes from stage 29 embryos contain chondrocytes with both collagen types and a larger overall number of chondrogenic foci than the maxillary process cultures. Since the maxillary process does not produce cartilage in situ and the mandibular process forms Meckel's cartilage which does not hypertrophy in situ, environmental influences, probably inhibitory in nature, must regulate chondrogenesis in mesectodermal derivatives. (ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3527816 TI - An early developmental phase of pp60c-src expression in the neural ectoderm. AB - The expression of the normal cellular src protein (pp60c-src) was investigated in the early chick embryo during gastrulation and neurulation by immunoperoxidase staining using antisera, raised against bacterially expressed pp60v-src, that recognizes pp60c-src specifically in normal cells. During gastrulation pp60c-src immunoreactivity appeared primarily in the neural ectoderm and was much less prominent in the mesoderm, endoderm, and nonneural ectoderm. During neurulation pp60c-src immunoreactivity began to disappear from the wall of the closing neural tube so that by the completion of neural tube closure no specific pp60c-src immunoreactivity appeared in any of the neuroepithelial cells composing the neural tube. These studies reveal a developmental phase of pp60c-src expression even earlier than reported previously, when neuroepithelial cells of later embryos undergo terminal neuronal differentiation. These findings raise the possibility that pp60c-src may mediate two different differentiation signals in the neuronal lineage. PMID- 3527818 TI - Role of muramyl peptides for the enhancement of synthetic vaccines. AB - Adjuvants are largely used in human and veterinary medicine with conventional vaccines. Vaccines of the future could be synthetic immunogens which would require the addition of more immunomodulators. Muramyl peptides (MDP) are synthetic glycopeptides which can substitute mycobacteria in FCA and are also adjuvant-active in saline. A derivative, Murabutide, is currently undergoing clinical trials and has been found efficient in several experimental models of conventional and synthetic vaccines. For example, when a Plasmodium knowlesi sporozoite peptide conjugated to tetanus toxoid was administered in saline with Murabutide higher titers of biologically active antibodies were obtained than when the same conjugate was given in FCA. Coupling of MDP or derivatives to the immunogens enhanced their activity and allowed the use of carriers to be diminished or even avoided. In the same malarial model the linkage of a Murabutide derivative to the conjugate stimulated the response to the peptide and decreased the response to the carrier. Promising results were obtained when several peptides copying structures of different pathogens were associated in the same molecule by covalent linkage and administered with Murabutide in saline: biologically active antibodies were demonstrated to three of the corresponding pathogens. PMID- 3527820 TI - Vaccinology in practical perspective. AB - The nearly two centuries of success and failure in vaccinology have been superceded by an era of new opportunity employing hybridoma, recombinant, directed genetic alteration, and synthetic chemical technologies. Vaccines against a large number of infectious disease agents are now possible and they may be made practically useful by incorporating many relevant epitopes in complex "polytopic" vaccines. Though the technologies are well laid, hurdles still remain and these involve the need for understanding immunity in molecular terms. Developed countries typically underutilize vaccines even though resources are adequate. In Third World countries, where the need is greatest, there is least use because of the lack of resources. In pursuing vaccinology for Third World application, a balance needs to be sought, in the practical sense, between the amount of funds allocated to research and development and the amount allocated to utilization, lest vaccines be wastefully created that can never be used. Inclusion of the greatest possible number of needed immunodeterminants in the fewest number of vaccines is critical to practical application in developed as well as in developing countries. PMID- 3527819 TI - Cell activation and immunogenicity. AB - There is presently great interest in the production of synthetic vaccines which utilize as immunogens peptides representing portions of protein antigens, either free or conjugated to protein carriers. The use of such immunogens raises questions regarding the cells which are activated an the characteristics of the resulting immune response. Using the tobacco mosaic virus protein (TMVP) as a model antigen, immune induction by the protein and by synthetic vaccines related to this protein was investigated. Specifically we have compared immune induction by the parent protein, an unconjugated eicosapeptide representing residues 93-112 of the protein, and an immunogen consisting of the C-terminal decapeptide of the above eicosapeptide conjugated to the protein carrier KLH. The comparison led to the following conclusions: Immunization with the free eicosapeptide but not with its C-terminal decapeptide leads to the activation of T and B lymphocytes. Immunization with the free eicosapeptide or with its C-terminal decapeptide-KLH conjugate induces antibodies capable of reacting with the parent protein. The isotype composition of the antibodies induced by these immunogens is similar to that induced by immunization with the whole protein. The fine specificity of the antibodies induced by all three immunogens is similar. However, the antibody populations induced by the synthetic immunogens may be devoid of one or more clonotypes depending upon constraints imposed by cellular interaction. Antigen specific T helper cells do not seem to influence the fine specificity of antibodies induced to a given epitope. Comparison of the induction of memory responses by the three immunogens led to the conclusion that immunization with the peptide hapten conjugated to the heterologous carrier KLH does not lead to an anamnestic antibody response upon encounter with the native protein. Immunization with an immunogenic peptide representing a portion of the protein recognized by T and B lymphocytes leads to an anamnestic antibody response upon encounter with the native protein. PMID- 3527821 TI - Recombinant yeast hepatitis B vaccine. PMID- 3527822 TI - Synthesis and antigenic activity of E. coli ST and its analogues. AB - Several enterotoxigenic E. coli (ETEC) are common causes of diarrhea in man and animals. These strains of E. coli produce two types of enterotoxins: heat-stable (ST) and heat-labile (LT). These toxins are peptides of molecular weight 2000 and 90,000 daltons, respectively. It is proposed that the synthetic analogues of these toxins could be effectively used as the vaccines against enterotoxigenic activity of E. coli. In this paper we report the isolation and chemical characterization of a heat-stable toxin STa. We also report the synthesis of this toxin and its analogues and their biochemical and immunological characterization. PMID- 3527824 TI - Insulin-receptor development in normal and diabetic pregnancies. Role of membrane fluidity. AB - In the hyperinsulinemic offspring of the diabetic mother, both significant macrosomia and postnatal hypoglycemia are thought to be due to increased insulin sensitivity. The purpose of this study is to characterize changes in insulin receptor development in fetal offspring of an experimental model of diabetic pregnancy. Two groups of Sprague-Dawley female rats were studied after timed mating. Both groups received injections of either vehicle (controls) or streptozocin (diabetic), 40 mg/100 g body wt, on day 7 of pregnancy and were killed at either 17, 20, or 21 days of gestation. Maternal and fetal blood were assayed for glucose and insulin, and fetal liver membranes were prepared for 125I labeled insulin binding, lipid composition, and fluorescence polarization studies with the probe 1,6-diphenyl-1,3,5-hexatriene (DPH). Maternal and pooled fetal glucose levels were elevated in streptozocin-treated rats; however, pooled fetal insulin values were not elevated in the offspring of diabetic animals compared with controls (33 +/- 1 vs. 50 +/- 5 microU/ml). 125I-insulin binding was greater in fetal offspring of diabetic (FD) rat membranes at each gestational age studied [P less than .001 by analysis of variance (ANOVA)] due to significantly greater numbers of both high- and low-affinity receptors. The highest insulin-binding capacity was seen on membranes obtained from FD rats at day 21 (9.92 M X L-1 X 100 micrograms membranes-1 vs. 6.38 M X L-1 X 100 micrograms protein-1 in fetal control (FC) rats. At each gestational age, membranes from FDs had lower values for fluorescence polarization (using the probe DPH) than did gestational-age- matched controls.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3527823 TI - Cyclosporin-induced inhibition of insulin secretion in isolated rat islets and HIT cells. AB - The effects of cyclosporin, an immunosuppressive agent used in diabetic and nondiabetic patients, on in vitro glucose-induced insulin secretion were evaluated in isolated islets and in a glucose-responsive clonal beta-cell line (HIT cells). Cyclosporin inhibited glucose-induced insulin secretion in a dose response manner at concentrations commonly found in human blood. With isolated islets, four time periods (0-5, 5-15, 15-30, and 30-60 min) were examined after stimulation with 300 mg/dl glucose. Inhibition of insulin secretion by cyclosporin was evident by 5-15 min as well as during later times with progressively smaller drug concentrations. With HIT cells, longer-term effects were examined after 16 h of incubation with various drug concentrations. Inhibition of insulin secretion was again observed, and these inhibitory effects were not reversed by drug washout. A cyclosporin concentration of 0.1 microgram/ml, which is a therapeutic blood level in humans, was sufficient to inhibit insulin secretion in both in vitro models. Patients using this drug should be carefully monitored for signs of deficient insulin secretion. PMID- 3527825 TI - Direct effects of cyclosporin A on human pancreatic beta-cells. AB - Cyclosporin A (CyA) may induce clinical remission in newly diagnosed insulin dependent diabetes mellitus patients. Recently, however, adverse effects of high doses of CyA on rodent islets have been reported in vivo and in vitro. The possible direct effects of CyA on the human endocrine pancreas were therefore evaluated. Islets isolated from eight necrokidney donors were cultured in the presence of a therapeutically relevant dose of CyA, i.e., 100 ng/ml. During a 5 day culture period the release of insulin was reduced by 36% (range 7-61%), whereas the islets' content of insulin was increased by 59% (range 3-268%). The glucagon content was not affected. Cyclosporin G inhibited the insulin release, whereas dihydrocyclosporin D had no consistent effects. Glucose-stimulated insulin release from perifused islets was markedly depressed in CyA-treated islets. This effect was not fully reversed 48 h after removal of the drug. We concluded that CyA has a direct inhibitory effect on insulin release from human pancreatic islets with a concomitant increase in the residual insulin content. If applicable to the in vivo condition, CyA may therefore, in addition to its immunosuppressive effect, have direct effects on the endocrine pancreas, which may be relevant for clinical application of the drug. PMID- 3527827 TI - Growth-promoting effects of diabetes and insulin on arteries. An in vivo study of rat aorta. AB - Proliferation of arterial smooth muscle cells is regarded as an important event in atherogenesis, which according to in vitro culture studies is influenced by diabetes and insulin. To assess whether this holds true in vivo, we studied the cellular kinetics of thoracic aorta in normal and streptozocin-induced diabetic rats with and without insulin treatment. We measured the incorporation of [3H]thymidine into intima-media, as well as its DNA content, 2 and 14 days after endothelial denudation. We found that the mitotic response of an injured artery is not modified by diabetes but is depressed by insulin treatment in nondiabetic rats, probably due to hypoglycemia. Our data in insulin-treated diabetic rats support but do not definitely settle the view that insulin is mitogenic as long as the treatment does not cause sustained hypoglycemia. PMID- 3527826 TI - Further evidence implicating diacylglycerol generation and protein kinase C activation in agonist-induced increases in glucose uptake. Insulin-like effects of phenylephrine in BC3H-1 myocytes. AB - We have previously suggested that insulin effects on 2-deoxyglucose (2-DOG) uptake in BC3H-1 myocytes are due to increases in de novo phospholipid synthesis, diacylglycerol generation, and protein kinase C activation. To test this hypothesis further, we examined the effects of phenylephrine, an agonist that increases diacylglycerol and protein kinase C activity through phospholipase C activation. As evidence for phospholipase activation in BC3H-1 myocytes, we found that phenylephrine increased acute 32PO4 incorporation into phosphatidic acid and phosphatidylinositol, generation of [3H]inositol phosphates from prelabeled [3H]inositol phospholipids, cytosolic Ca2+, and membrane-bound protein kinase C. Phenylephrine also provoked dose-related increases in [3H]2-DOG uptake that were similar in magnitude and time course to those induced by insulin. As with insulin, phenylephrine effects on 2-DOG uptake were not apparent in myocytes that were maximally stimulated with 12-O-tetradecanoylphorbol-13-acetate, a diacylglycerol analogue that activates protein kinase C. These findings support our hypothesis that diacylglycerol generation and protein kinase C activation may be important in the stimulation of glucose uptake by agents such as phenylephrine and insulin that activate the phosphoinositide cycle. PMID- 3527828 TI - Impaired glucose homeostasis in adult rats from hyperglycemic mothers. AB - The purpose of our study was to investigate whether nondiabetic gestational hyperglycemia during fetal life could have additional effects on glucose homeostasis and insulin secretion in the adult rat. Hyperglycemia without the main other metabolic disorders and vascular injuries associated with diabetes was produced in unrestrained pregnant rats by continuous glucose infusion during the last week of pregnancy. Control rats were infused with distilled water. Compared with controls, the newborns from hyperglycemic rats were hyperglycemic and hyperinsulinemic. When studied longitudinally up to 3 mo, they showed slightly but significantly increased basal plasma glucose levels and normal basal insulin concentrations compared with controls. Glucose tolerance and insulin secretion in response to a glucose load (0.5 mg/kg, i.v.) were altered: Plasma glucose values were more increased at 5 min and remained higher 90 min after glucose injection; incremental plasma insulin values and the insulinogenic indexes (delta IRI/delta G) were always lower in rats from hyperglycemic mothers than in controls. These alterations were more and more marked with advancing age (1-3 mo). These data show that gestational hyperglycemia may lead to persistent impairment of glucose homeostasis and insulin secretion in the adult rat. PMID- 3527830 TI - The effects of mechanical loading on marginal integrity of composite restorations. PMID- 3527829 TI - Effects of weight loss on mechanisms of hyperglycemia in obese non-insulin dependent diabetes mellitus. AB - To quantitate the effects of weight loss on the mechanisms responsible for hyperglycemia in non-insulin-dependent diabetes mellitus (NIDDM), eight obese subjects with NIDDM were studied before and after weight reduction with posttreatment assessment after 3 wks of isocaloric (weight maintenance) refeeding. After weight loss of 16.8 +/- 2.7 kg (mean +/- SE), the fasting plasma glucose level decreased 55% from 277 +/- 21 to 123 +/- 8 mg/dl. The individual fasting glucose levels were highly correlated with the elevated basal rates of hepatic glucose output (HGO) (r = 0.91, P less than .001), which fell from 138 +/ 11 to 87 +/- 5 mg X m-2 X min-1 after weight loss. The change in fasting plasma glucose also correlated significantly with the change in the basal rates of HGO (r = 0.74, P less than .05). This was associated with reduced fasting serum levels of glucagon (from 229 +/- 15 to 141 +/- 12 pg/ml), reduced free fatty acids (from 791 +/- 87 to 379 +/- 35 mu eq/L), and unchanged basal insulin levels (17 +/- 4 to 15 +/- 2 microU/ml).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3527831 TI - Pulp response to a dentin bonding system in miniature swine. PMID- 3527832 TI - "Model investing" method of FPD construction: its accuracy. PMID- 3527833 TI - Enzymatic and transport studies in cholesterol-fed guinea pigs using intestinal brush border membrane vesicles. AB - The intestinal absorptive and digestive functions using the brush border membrane (BBM) vesicles were evaluated in guinea pigs receiving cholesterol-supplemented diet for 12 weeks. The Na+-gradient-dependent transport of D-glucose (p less than 0.001), L-alanine and L-phenylalanine (p less than 0.01) was decreased significantly the BBM of cholesterol-fed animals. The maximal velocity (Vmax) value of the sucrase and leucine aminopeptidase was decreased without any change in the affinity constant (Km) value, demonstrating that the enzyme contents were reduced in response to cholesterol-rich diet. However, both the Km and Vmax values of the alkaline phosphatase decreased markedly, suggesting that a new enzyme of increased substrate affinity had been formed due to intestinal adaptation of cholesterol load in diet. The present study demonstrated that cholesterol feeding caused a significant alteration in nutrients absorption, membrane enzymes and chemical composition of the small intestine. PMID- 3527834 TI - Evidence of an accelerated B-cell destruction in HLA-Dw3/Dw4 heterozygous children with type 1 (insulin-dependent) diabetes. AB - The possible association between residual B-cell function and specific HLA antigens in Type 1 (insulin-dependent) diabetes was studied in a cross-sectional series of 144 diabetic children and adolescents, as well as in a prospective series of 44 newly diagnosed diabetic subjects who were observed for the initial 2 years of their diabetes. In the cross-sectional study, the HLA-Dw3/Dw4 heterozygotes had a lower mean serum C-peptide concentration during 1980, 0.03 +/ 0.01 nmol/l (mean +/- SEM) vs. 0.09 +/- 0.01 nmol/l (p less than 0.02), as well as a lower 24-h urinary C-peptide excretion, 0.27 +/- 0.06 nmol/m2 vs. 1.34 +/- 0.19 nmol/m2 (p less than 0.05), than the other subjects. In addition, the Dw3/Dw4 heterozygotes had a clinical remission of shorter duration, 113 +/- 47 days vs. 203 +/- 22 days (p less than 0.05), and a higher mean glycosylated haemoglobin level during 1980, 14.8 +/- 0.05% vs. 13.7 +/- 0.2% (p less than 0.05), than those without the Dw3/Dw4 combination. In the prospective study the serum C-peptide concentrations were of the same magnitude in the Dw3/Dw4 heterozygotes and the other subjects during the first month. Subsequently the C peptide concentrations in the subjects with the Dw3/Dw4 combination started to decrease 2 months earlier than in the other subjects. The Dw3/Dw4 children had a significantly lower serum C-peptide concentration at 21 months, 0.01 +/- 0.01 nmol/l vs. 0.13 +/- 0.02 nmol/l (p less than 0.01), and at 24 months, 0.03 +/- 0.01 nmol/l vs. 0.12 +/- 0.02 nmol/l (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3527835 TI - Natural killer cell and islet killer cell activities in type 1 (insulin dependent) diabetes. AB - Peripheral blood mononuclear cells from 20 Type 1 (insulin-dependent) diabetic patients were examined for natural killer cell activity using the K562 cell line as 51Cr labeled targets. Mean natural killer cell cytotoxicity mediated by enriched non-T cells from patients (37 +/- 4.0%) was lower (p less than 0.03) than in controls (56 +/- 3.7%). Specificity was evaluated by examining other patient subgroups. Mean non-T cell mediated natural killer cell activity in Type 2 (non-insulin-dependent) diabetic patients and Type 1 patients with long term disease was 65 +/- 5.4% and 62 +/- 4.8% respectively (p less than 0.003 vs new onset Type 1 patients). Longitudinal studies of new onset Type 1 patients during the remission (honeymoon) phase revealed persistently impaired natural killer cell activity in 3 of 4 patients. In 30 new onset and 11 remission Type 1 diabetic patients, mean non-T cell-mediated cytotoxicity was also measured using dispersed 51Cr labeled islet target cells. Mean islet cytotoxicity mediated by cells from new onset patients was 34 +/- 2.4%, whereas in non-diabetic control subjects mean cytotoxicity was 25 +/- 1.8% (p less than 0.005). During remission, islet cytotoxicity remained at similar or elevated levels in most patients. In patients evaluated simultaneously for K562 and islet cell cytotoxicity, natural killer cell activity was decreased, whereas islet killing was increased. These results suggest a dichotomy in natural killer cell and islet killer cell activities in new onset Type 1 diabetes that could have an important role in the pathogenesis of Type diabetes. PMID- 3527836 TI - Differential glycaemic effects of potato, rice and spaghetti in type 1 (insulin dependent) diabetic patients at constant insulinaemia. AB - The blood glucose responses to cooked potato, rice and spaghetti were studied in six Type 1 (insulin-dependent) diabetic patients who had attained euglycaemia by the artificial pancreas prior to the meal intake. The amount of potato (raw weight 200 g), parboiled rice (raw weight 50 g), and spaghetti (raw weight 50 g) had approximately identical caloric content (range 203-225 kcal) and amount of available carbohydrate (range 39.4-43.4 g). The postprandial blood glucose response areas after cooked potato and cooked parboiled rice were similar (180 min values: cooked potato: 1190 +/- 110 mmol/l X min, cooked rice: 1160 +/- 140 mmol/l X min and 240 min values: cooked potato: 1690 +/- 140 mmol/l X min, cooked rice: 1740 +/- 210 mmol/l X min). In contrast, the response after cooked spaghetti was slower and less pronounced (180 min value: 830 +/- 80 mmol/l X min and 240 min value: 1320 +/- 120 mmol/l X min), and was significantly smaller than those of cooked potato (180 min: 2p less than 0.01 and 240 min: 2p less than 0.01) as well as cooked rice (180 min: 2p less than 0.01 and 240 min: 2p less than 0.02). Our study emphasizes the importance of determining the glycaemic response of foodstuffs under conditions of isoinsulinaemia. PMID- 3527837 TI - A new method of detection of islet cell antibodies (ICA) using peroxidase-labeled protein A, and incidence of ICA in type 1 (insulin-dependent) diabetes. AB - We have developed a new method of detecting islet cell antibodies using peroxidase-labeled protein A, and have determined the incidence of ICA in Type 1 (insulin-dependent) diabetes in Japan. In our method, fresh frozen sections of human pancreas and serum samples were incubated and then treated with peroxidase labeled protein A at room temperature. Conjugates of peroxidase and protein A were subjected to Sephadex G-200 column chromatography, and only the 80,000 dalton peak was employed. The treated sections were allowed to react with haematoxylin and eosin (HE) to confirm the localization of islet cells. With this method, human pancreatic tissues can be used regardless of age and blood type, and the stained sections can be stored for more than 5 years. Serum samples obtained from 52 patients with Type 1 diabetes, 54 with Type 2 (non-insulin dependent) diabetes and 100 control subjects were examined. In patients with Type 1 diabetes, islet cell antibodies were detected in 14 of 14 (0.5 years after onset), 3 of 6 (0.5-1 years after onset), 7 of 16 (1-5 years after onset) and 2 of 16 (more than 5 years after onset). In contrast, only 4 of 54 patients with Type 2 diabetes and none of the controls were ICA positive. It is concluded that, with our newly developed method using peroxidase-labeled protein A, ICA is present in all Japanese Type 1 diabetic patients whose diabetic manifestations are less than 0.5 years duration from onset. PMID- 3527838 TI - An estimate of the effect of acute exsanguination on catecholamine and glucoregulatory hormone concentrations in the newborn rat. AB - We have determined the effect of acute exsanguination on plasma concentrations of glucose, insulin, glucagon, dopamine, epinephrine and norepinephrine in neonatal Sprague-Dawley rats. This was done by comparing concentrations of these substances in aliquots of blood obtained within 10 s of the initial bleeding to those in blood obtained over the next 50 s of the blood drawing process. Concentrations of glucose and insulin showed no change between early and late samples. Glucagon concentrations showed variable responses dependent upon the age of the animal. Concentrations were unchanged at birth, but increased 22% and 58% at 1 and 6 h of age respectively. Catecholamine concentrations increased greatly (57 to 215%) between blood aliquots regardless of age at the time of sampling. These findings indicate that hormonal responses occur during the relatively brief period of blood drawing in Sprague-Dawley rats, pointing out further limitations inherent in the use of small animals for acute metabolic and hormonal studies. PMID- 3527839 TI - Effect of glicentin-related peptides on glucagon secretion in anaesthetized dogs. AB - Recent studies have demonstrated that glicentin is released during nutrient ingestion. However, the biological function of glicentin remains unclear. In order to clarify the role of glicentin in the enteroinsular axis, the effect of glicentin-related peptides was investigated using in vivo local circulation of canine pancreas. Peaks I and II of gut glucagon-like immunoreactivity, partially purified from porcine intestinal extract by affinity chromatography and gel filtration, synthesized hexadecapeptide of N-terminal glicentin (1-16) and synthesized octapeptide of C-terminal glicentin (62-69) were administered for 10 min into the pancreaticoduodenal artery of canine pancreas. Blood samples were then drawn from the pancreaticoduodenal vein. The administration of peak I of glucagon-like immunoreactivity during arginine infusion in a dosage of 20 ng reduced the glucagon secretion by 42 pmol/l (p less than 0.05), whereas peak II of glucagon-like immunoreactivity (20 ng) slightly increased the plasma level of insulin, although not significantly. The administration of glicentin (1-16) in a dosage of 400 ng during saline infusion did not alter the plasma insulin level, but reduced the plasma glucagon level in the pancreaticoduodenal vein by 29 pmol/l (p less than 0.05). In addition, glicentin [62-69] in a dosage of 400 ng exerted a decrease in both the plasma insulin (40 mU/l, p less than 0.05) and glucagon level (27 pmol/l, p less than 0.05). The present study demonstrates the suppression of pancreatic glucagon release during the infusion of peak I glucagon like immunoreactivity and N- or C-terminal glicentin-related peptide. Therefore, it is suggested that glicentin released during nutrient intake might inhibit the secretion of glucagon. PMID- 3527840 TI - Islet cell antibodies, mumps infection and mumps vaccination. PMID- 3527842 TI - Gestational hyperglycaemia and insulin release by the fetal rat pancreas in vitro: effect of amino acids and glyceraldehyde. AB - Unrestrained pregnant rats were infused with glucose during the last week of pregnancy to produce slight or high gestational hyperglycaemia. Control rats were infused with distilled water. Insulin secretion of the fetuses at term was studied in vitro using a perifusion system. Compared with controls, perifused pancreases of slightly hyperglycaemic fetuses showed a similar pattern of insulin secretion in response to 10 mmol/l leucine. Arginine-induced insulin secretion at 20 mmol/l was higher than in controls. In both groups, 10 mmol/l alpha ketoisocaproate had a poor stimulatory effect on insulin release, and 5 mmol/l D glyceraldehyde was ineffective in eliciting insulin secretion. In highly hyperglycaemic fetuses all the secretagogues, with the exception of arginine, which induced a sustained monophasic insulin secretory response, had no effect on insulin release. These data show that long-term exposure of fetal B cells to high plasma glucose levels in utero suppresses or alters further insulin secretory response not only to glucose but also to other nutrient secretagogues. The partially spared insulin secretory response to arginine suggests that the defect may concern stimulus-secretion coupling rather than insulin releasing machinery. PMID- 3527841 TI - Correction by insulin added in vitro of abnormal membrane fluidity of the erythrocytes from type 1 (insulin-dependent) diabetic patients. AB - Filtrability of erythrocytes obtained from uncontrolled Type 1 (insulin dependent) diabetic patients is abnormal, but is corrected by insulin added in vivo or in vitro. As erythrocyte filtrability depends on several determinants, we chose to study a membrane property of erythrocytes from diabetic subjects. Membrane fluidity was studied by fluorescence polarization using a lipophilic probe, the diphenyl-hexatriene and the Coulter Epics V together with a laser Spectra-physics 2000. Fluorescence polarization values obtained for 31 normal subjects (0.253 +/- 0.043 SD) and 31 uncontrolled Type 1 diabetic patients (0.231 +/- 0.043 SD) were significantly different (p less than 0.01). Insulin (2.5.10( 9) mol/l) added in vitro increased the fluorescence polarization values of red cell membranes from diabetic patients (without insulin, fluorescence polarization values = 0.210 +/- 0.032 SD; with insulin, fluorescence polarization values = 0.253 +/- 0.024 SD, p less than 0.001, n = 15), but had no effect on normal membranes (without insulin fluorescence polarization values = 0.255 +/- 0.037 SD, with insulin, fluorescence polarization values = 0.251 +/- 0.026 SD; n = 12). Given a relationship between the lipid bilayer and membrane cytoskeleton proteins, this insulin-correctable abnormality of erythrocyte membrane fluidity may be an important determinant of the rheological behaviour of erythrocytes from diabetic patients. PMID- 3527843 TI - The measurement and validation of the nonsteady-state rates of C-peptide appearance in the dog. AB - In order to verify the calculation of nonsteady rates of secretion of C-peptide, dog C-peptide was infused into 5 normal conscious dogs at varying rates. Using the decay curve obtained following a preliminary injection of C-peptide in each animal, concentrations during the infusion, and mathematical deconvolution, the rate of appearance of the C-peptide was calculated. This rate was within 12% of the infusion rates, with 94% of the C-peptide infused recovered in the calculation. The metabolic clearance of C-peptide was calculated to be 10.1 +/- 1.0 ml/min following both its injection and constant infusion. In conclusion, within the limits of the errors determined, C-peptide and therefore insulin secretion can be calculated on a continuous basis under nonsteady-state conditions. PMID- 3527844 TI - Effects of anti-insulin antibody on insulin binding to liver membranes: evidence against antibody-induced enhancement of insulin binding to the insulin receptor. AB - In the presence of anti-insulin antibody, 2-to 3-fold enhancement of 125I-insulin binding to liver membranes was observed when binding was estimated by the radioactivity of 125I-insulin bound to the membrane pellets. However, after 125I insulin was covalently cross-linked to liver membranes using disuccinimidyl suberate in the presence of anti-insulin antibody, sodium dodecyl sulfate polyacrylamide gel electrophoresis and autoradiography showed that 125I-insulin bound to the alpha-subunit of the insulin receptor was inhibited by anti-insulin insulin antibody in an dose-dependent manner. More importantly, at an anti insulin antibody dilution range between 1:50 and 1:5,000, sodium dodecyl sulfate polyacrylamide gel electrophoresis revealed two 125I-labelled bands of mol wt 62,000 and 27,000, while only one band of mol wt 130,000 was revealed in the absence of anti-insulin antibody. These Mr = 62,000 and Mr = 27,000 bands were found to be the heavy and the light chain of anti-insulin IgG molecules respectively. Pepsin digested anti-insulin serum had only an inhibitory effect on 125I-insulin binding to liver membranes. Non-immunized guinea pig serum or IgG completely abolished the enhanced effect of anti-insulin antibody. Further, this enhanced effect was inhibited by Fc fragment-specific anti-IgG serum or H&L-chain specific anti-IgG serum in a dose-dependent manner. Protein A also inhibited the effect of anti-insulin antibody. In IM-9 lymphocytes and human red blood cell ghosts, which have no Fc gamma receptors, enhancement of insulin binding was not observed in the presence of anti-insulin antibody.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3527845 TI - Human plasma fractions inhibit the action of insulin on adipocytes and somatomedin on cartilage. AB - Since human immunoglobulins exert an insulin-like stimulatory effect on adipocyte lipogenesis at concentrations markedly lower than those found in vivo, and since human serum or plasma are only midly stimulatory, we predicted that human serum probably contains an inhibitor of adipocyte lipogenesis. Supernatant preparations, obtained from the precipitation of immunoglobulins from plasma in 2.5 mol/l ammonium sulphate, were extensively dialysed and tested for their activity on bioassay systems commonly used for measuring insulin. The supernatants produced a marked inhibition of basal and insulin- or IgG-stimulated lipogenesis and glucose oxidation by adipocytes at protein concentrations of 10 mg/l. The supernatants were further purified through ultrafiltration to demonstrate two main inhibitory fractions, 10 to 30 K and 30 to 50 K, which again produced marked inhibition of basal and insulin- or IgG-stimulated adipocyte lipogenesis and glucose oxidation. These fractions were then tested for basal and serum somatomedin-stimulated 35S sulphate uptake by porcine cartilage: both basal and serum somatomedin-stimulated 35S uptake were significantly inhibited (p less than 0.01). Therefore, normal human serum contains at least two peptides which are markedly inhibitory to glucose metabolism and insulin action on adipocytes and 35S transport and somatomedin action on cartilage. PMID- 3527846 TI - Lack of a lipoprotein-induced insulin resistance in hepatoma cells in culture. AB - A lipoprotein-induced resistance to the action of insulin has been postulated. To test this hypothesis, cultured rat-derived hepatoma cells, designated FAO, and human-derived hepatoma cells, designated HEP-G2, were incubated for 20 h in the presence or absence of lipoprotein; specific 125I-insulin receptor binding and labeled glucose incorporation into glycogen were then measured. Very low density lipoproteins (d less than 1.006 g/ml) in physiologic (0.5 mg/ml) or pathophysiologic (5 mg/ml) concentrations did not modify insulin receptor binding of FAO or HEP-G2 cells. This was true for very low density lipoproteins derived from normal human, diabetic human, and streptozotocin-diabetic rat plasma. Low density lipoproteins (d = 1.019 - 1.063 g/ml) isolated from normal human plasma similarly failed to modify insulin receptor binding. Concerning insulin action, the different very low density lipoprotein preparations did not modulate either basal or insulin-stimulated glucose incorporation into glycogen of the cells. Thus, very low density lipoproteins and low density lipoproteins did not induce insulin resistance in cultured hepatoma cells either at the insulin receptor level or at the post-receptor level. PMID- 3527847 TI - Vitamin D deficiency and the endocrine pancrease. PMID- 3527848 TI - Prepaid dental care for the elderly in an HMO Medicare demonstration. PMID- 3527849 TI - Ratios of basal seat area of maxillary and mandibular edentulous ridges and how they affect the practicing dentist. PMID- 3527850 TI - [Protocol of the heart transplant: a lesson for the physician]. PMID- 3527852 TI - Variceal bleeding: which shunt? PMID- 3527851 TI - Effect of ursodeoxycholic acid and chenodeoxycholic acid on cholesterol and bile acid metabolism. AB - Orally administered UDCA dramatically reduces the secretion of cholesterol into the bile. During UDCA therapy cholesterol balance is maintained by a reduction in both the relative and absolute absorption of cholesterol and, perhaps, by a combined moderate enhancement of bile acid synthesis and a suppression of cholesterol production. The percentage of UDCA in the bile is limited by the inability of UDCA to suppress bile acid synthesis from cholesterol and by the conversion of UDCA to CDCA by the intestinal bacteria. PMID- 3527853 TI - Results of a randomized trial of end-to-side portacaval shunt and distal splenorenal shunt in alcoholic liver disease and variceal bleeding. AB - Since 1976, we have compared the end-to-side portacaval shunt (PCS) with the distal splenorenal shunt (DSRS) in patients with alcoholic liver disease and recurrent variceal bleeding. Fifty-four patients were randomly assigned to receive either shunt procedure. There were 27 patients in each group and both groups were highly comparable in clinical and laboratory characteristics. Median follow-up was 31 mo in each group. Postoperative complications and operative mortality (7% after PCS, 12% after DSRS) were comparable. Spontaneous portasystemic encephalopathy developed in 32% of the patients at risk after PCS and in 39% after DSRS. Rebleeding from varices occurred in 4% of the patients after PCS and in 27% after DSRS. Cumulative survival was not significantly different between groups (5-yr survival: 31% after PCS, 43% after DSRS). We have failed to demonstrate superiority of DSRS in our patients with alcoholic liver disease with respect to postoperative encephalopathy or survival, and have experienced an unusually high rate of variceal rebleeding after DSRS. PMID- 3527854 TI - Gastric mucosal protection against ulcerogenic factors in the rat mediated by capsaicin-sensitive afferent neurons. AB - Treatment of newborn rats with capsaicin (0.16 mmol/kg) is known to cause a permanent degeneration of certain, primarily unmyelinated, afferent neurons. In this study, experimentally induced gastric ulceration was investigated in adult rats treated with capsaicin as neonates. It was found that in capsaicin-treated animals the formation of gastric mucosal lesions in response to indomethacin, ethanol, or cysteamine was significantly enhanced as compared with vehicle treated controls. The duodenal ulceration caused by cysteamine was not altered after capsaicin treatment. In further experiments the possible pathways involved in the effect of capsaicin treatment on gastric mucosal protection were explored. It was found that the capacity of gastric tissue to release prostaglandins E2 and I2 was unchanged after capsaicin treatment. Atropine, hexamethonium, cimetidine, or terbutaline all reduced gastric ulceration in response to indomethacin in both solvent- and capsaicin-treated rats but did not counteract the enhancement of the ulcerogenic effect of indomethacin in capsaicin-treated rats. Guanethidine enhanced the ulcerogenic effect of indomethacin in solvent-treated but not in capsaicin-treated animals. Ethanol-induced formation of gastric lesions remained unaltered by guanethidine in both solvent- and capsaicin-treated rats. These results indicate that capsaicin-sensitive afferent neurons are involved in gastric mucosal protection against ulcerogenic factors. The data further suggest that this type of gastric defense is primarily due to a local mechanism initiated by sensory nerve endings in the gastric mucosa. PMID- 3527855 TI - Spontaneous bacterial peritonitis after endoscopic variceal sclerotherapy. PMID- 3527856 TI - It was 20 years ago... PMID- 3527857 TI - [Vaginosonographic pelvimetry as a new method of the sonographic determination of internal pelvic measurements]. AB - Up to now sonographical pelvimetry has been performed by employing compound scanners. The development of a new vaginal scanner (panorama scanner) offers the possibility of using modern real-time ultrasound equipment for pelvimetry. Measurements were performed by vaginal scanner, compound scanner and after delivery by x-ray examination in 48 patients. Evaluation of our data showed a good correlation of all three methods. In contrary to the compound scanner vaginosonographical pelvimetry is not affected by the gestational week. Furthermore this method allows also the measurement of the transversal pelvic diameter. PMID- 3527858 TI - [Prenatal diagnosis and postnatal course in abnormalities of the kidneys and urinary tract]. AB - The authors' own experiences concerning the prenatal diagnosis and postnatal course in 26 foetuses with anomalies of the urinary tract are reported. The malformations observed can be separated into five groups which can also be distinguished sonographically: Urinary tract malformations of poor prognosis, Unilateral cystic kidneys. Hydronephroses, Urinary tract malformations with ascites, Urinary tract malformations in combination with other anomalies of poor prognosis. Sonographic differentiation of the multicystic kidney (Potter type IIA) from the hydronephrosis is usually possible. The recognition of cystic renal dysplasia in urinary tract obstructions (Potter type IV) and the differentiation of renal hypoplasia from renal agenesis is difficult. The dilatation of the urinary system has to be generally regarded as an unspecific symptom, the cause of which can be finally clarified only in the postnatal period. Prenatal invasive diagnostic procedures were carried out only in two foetuses. A concomitant anhydramnios was always associated with a poor prognosis. In the case of unilateral of bilateral dilatation of the urinary tract with normal or slightly diminished amniotic fluid volume, induction of labour or prenatal intervention for drainage in utero was not indicated. The prognosis was infaust in 15 foetuses. One infant died of an unknown cause. Out of 10 surviving infants, six were successfully operated on, in three the dilatation of the urinary tract resolved spontaneously, and one child with prune belly-syndrome has to be catheterised daily. PMID- 3527859 TI - [Immunological variants and treatment of lymphoblastic leukemia]. PMID- 3527861 TI - Extrusion of an impacted third molar for use as a fixed partial denture abutment. PMID- 3527862 TI - Orthodontic root extrusion: its rationale and uses. PMID- 3527863 TI - Bond strength of composite to composite and bond strength of composite to glass ionomer lining cements. PMID- 3527860 TI - [Trip to U.S.A.--March 1985]. PMID- 3527864 TI - Rinsing times for a gel etchant related to enamel/composite bond strength. PMID- 3527865 TI - Insertion stresses associated with a prefabricated, threaded, parallel endodontic dowel system. PMID- 3527866 TI - Free gingival graft using surgical site tissue as donor material. PMID- 3527867 TI - Interaction of genetics and epidemiology in the literature. AB - To evaluate the extent of interaction between genetics and epidemiology in studies reported in the literature, we reviewed all the "familial/genetic" papers published in a standard epidemiology journal (American Journal of Epidemiology, AJE) and all the "epidemiology" papers published in a standard human genetics journal (American Journal of Human Genetics, AJHG) between 1966 and 1984. A variety of medline subject headings were used in this search. Computerized listings of titles, subject headings, and abstracts were reviewed. It could be shown that familial/genetic papers constituted 4.3% of all papers published in AJE and epidemiology papers constituted 16.4% of papers published in AJHG. Over time, familial/genetic studies published in AJE increased both in number and in proportion of all papers, and more family studies are using complex statistical genetic techniques. On the other hand, epidemiology papers published in AJHG did not increase in number over time, and actually decreased in relation to all papers. These papers were mostly either descriptive (eg, defining frequencies of Mendelian traits in populations) or analytical (eg, defining risk factors for chromosomal abnormalities, and other reproductive outcomes). This analysis suggests that epidemiologic methods have been widely used in the genetic literature, and that genetic methods are gaining more access to the recent epidemiology literature. Because of increasing recognition of the role of genetic factors in disease, there is a growing need to incorporate both genetic and epidemiologic methods in etiologic studies of complex disorders. PMID- 3527868 TI - DNA sequence analysis of mutagenicity and site specificity of ethyl methanesulfonate in Uvr+ and UvrB- strains of Escherichia coli. AB - EMS-induced mutations within a 180 base pair region of the lacI gene of E. coli were cloned and sequenced. In total, 105 and 79 EMS-induced mutations from a Uvr+ and a UvrB- strain, respectively, were sequenced. The specificity of EMS-induced mutagenesis was very similar in the two strains; G:C----A:T transitions accounted for all but three of the mutants. The overall frequency of induced mutation was fivefold higher in the UvrB- strain compared to the Uvr+ strain. This demonstrates, at the DNA sequence level, that the presumed premutagenic lesion, O6-ethylguanine, is subject to repair by the uvrABC excision repair system of E. coli. An analysis of mutation frequencies with respect to neighboring base sequence, in the two strains, shows that O6-ethylguanine lesions adjacent to A:T base pairs present better targets for the excision repair machinery than those not adjacent to A:T base pairs. PMID- 3527869 TI - Insulin-induced factitious hypoglycemic coma. AB - Hypoglycemia due to the ingestion of oral hypoglycemic agents or injection of insulin is a common way for chronic factitious disorder to present to physicians. Despite this fact, factitious hypoglycemic coma is rare. Because hypoglycemia is potentially fatal, with numerous sequelae, physicians need to be aware of its occurrence and method of detection. A case of chronic factitious disorder presenting as hypoglycemic coma is presented and its implications discussed. PMID- 3527870 TI - [Isolation and characteristics of Saccharomyces cerevisiae strains with increased sensitivity to detergents]. AB - The yeast mutants possessing enhanced sensitivity to detergents were obtained after treatment with ethyl methanesulfonate. The whole set of mutants may be divided into three groups, according to sensitivity to: cetylthreemethylammonium chloride detergents and dyes of the ethidium bromide type, detergents, dyes and antibiotics (gramycidin C and actinomycin D). The genetic analysis performed indicated that more than one gene are responsible for sensitivity. On the basis of the test for allelism mutants were distributed into three groups. It was shown that ethidium bromide is far more potent inducer of cytoplasmic petites in detergent-sensitive than in wild-type strains. PMID- 3527871 TI - Overlapping arrangement of the recF and dnaN operons of Escherichia coli; positive and negative control sequences. AB - The recF gene of Escherichia coli controls one of the recombination pathways and UV sensitivity, but its precise function and expression pattern are still largely unknown. We have characterized the promoter region of the recF gene by mapping for E. coli RNA polymerase binding sites, in vitro transcription experiments, cloning, and S1 mapping of in vivo mRNAs. It contains three overlapping promoters, two initiating transcription towards recF and one in the opposite direction. The recF promoter region is located about 600 bp upstream from the start codon of the recF structural gene and resides entirely within the translated region of the preceding gene, dnaN, which encodes for the beta subunit of DNA polymerase III. This unusual arrangement might provide discoordinate regulation of the recF and dnaN genes, thus controlling the level of DNA polymerase III holoenzyme. Expression of recF is also negatively controlled by sequences located upstream as well as inside the recF coding frame. Such negative regulation may serve to prevent toxic effects due to accumulation of an excessive number of copies of the recF gene product. PMID- 3527872 TI - Expression of synthetic human-lysozyme gene in Saccharomyces cerevisiae: use of a synthetic chicken-lysozyme signal sequence for secretion and processing. AB - A multicopy plasmid was constructed to direct the synthesis and secretion of human lysozyme (HLY) in Saccharomyces cerevisiae. This plasmid contains a synthetic chicken-lysozyme signal sequence (SIG) and a synthetic HLY structural gene, both inserted between the yeast GAL10 promoter and 2 mu plasmid FLP (flip flop recombination gene) terminator. The resulting plasmid directed the expression of the hybrid pre-lysozyme, with most of the HLY activity secreted into the culture medium and extracellular periplasmic space. The HLY activity in the culture medium increased with cell growth. The yeast accurately processed the hybrid precursor at the junction between the chicken SIG and the coding sequence downstream, yielding mature HLY. HLY purified from the culture medium was homogeneous and displayed specific activity identical to that of authentic HLY. PMID- 3527873 TI - Nucleotide sequence and deduced amino acid sequence of Escherichia coli adenine phosphoribosyltransferase and comparison with other analogous enzymes. AB - The Escherichia coli apt gene has been analyzed and its nucleotide (nt) sequence and the deduced amino acid (aa) sequence compared to those of other phosphoribosyltransferases (PRTs). The apt mRNA has a 102-nt leader sequence which may form alternate secondary structures. The RNA transcript may also form several 3' hairpin structures, which, however, do not appear to act as Rho independent terminators. All PRTs, including E. coli adenine PRT (APRT), have a strongly conserved 13-aa sequence, as well as other regions of aa sequence or structural similarity. E. coli APRT is remarkably similar to the mouse enzyme. PMID- 3527874 TI - Synthesis of fused glycoprotein D of herpes simplex virus type 1 but not type 2 inhibits Escherichia coli hosts. AB - Glycoprotein D from either Herpes simplex virus type 1 (gD-1) or type 2 (gD-2) has been expressed in Escherichia coli as a series of chimeric proteins. The expression vector used in this study, pJS413, was derived from pBR322 and contains several cloning sites between the lacZ promoter-operator and the phage lambda cro gene. Plasmids containing fusions between the cro gene, gD-related sequences and lacZ was constructed and shown to direct the synthesis of 160-kDa proteins. The accumulation of fusion protein could be visualized as inclusion bodies when the cells were examined by dark phase-contrast or transmission electron microscopy. None of the plasmids that encoded cro::gD gene fusions yielded significant amounts of material upon induction with isopropyl-beta-D thiogalactopyranoside. In addition, certain plasmids produced a form of Cro-gD-1 fusion protein which resulted in severe growth inhibition of E. coli. These inhibitory effects were attributed to the presence of specific gD-1 sequences, i.e., the transmembrane and cytoplasmic anchor region of the protein. PMID- 3527875 TI - [Retrospective determination of the infectiveness of raw milk arriving at a dairy plant]. PMID- 3527876 TI - [Comparative study of the T delta IUD and the copper T 220 in Costa Rica]. PMID- 3527877 TI - [Significance of the liquid-crystal state of biogenic structures in the pathogenesis of vibration disease (review of the literature)]. PMID- 3527878 TI - [Informative value of immunological methods in hygienic studies]. PMID- 3527879 TI - [Occupational noise and arterial hypertension (review of the literature)]. PMID- 3527880 TI - [Hematological indicators after exposure to acrylonitrile (review of the literature)]. PMID- 3527881 TI - [Current status of the clinical usefulness of the nuclear magnetic resonance technic]. PMID- 3527882 TI - [Surgical treatment of high extensive rectovaginal fistulas in our modification]. PMID- 3527884 TI - Osseointegration. Clinical results. Part III. PMID- 3527883 TI - [Psychophysical training in the "childbirth school" and acid-base equilibrium in parturients]. PMID- 3527885 TI - Lectin binding to normal human endometrium. AB - Avidin-biotin-peroxidase labelling technique was used to localize the binding sites of peanut agglutinin (PNA), Ulex europaeus (UEA-I), wheat germ agglutinin (WGA), concanavalin A (Con A), and Ricinus communis (RCA-I) in 30 samples of endometrium at different stages of the menstrual cycle and in early pregnancy. PNA and UEA-I exhibit weak binding to the apical portions of epithelial cells in proliferative and secretory phases, but become strongly positive in pregnancy. WGA and RCA-I show weak binding to glandular epithelium in the proliferative phase, but increase their affinity in the secretory phase. Con A demonstrates strong affinity to decidual cells. PMID- 3527886 TI - Subcutaneous heparin treatment of deep venous thrombosis: a comparison of unfractionated and low molecular weight heparin. AB - In a double-blind study, patients with phlebographically proven deep venous thrombosis (DVT) were treated with subcutaneous injections twice a day of either unfractionated heparin (UH; n = 27) or low molecular weight heparin (LH; n = 29) for 7 days, and the dose was adjusted until therapeutic range was reached, according to a chromogenic substrate anti-Xa assay. Forty-eight percent of the LH group did not need dose adjustment as compared to 24% of the UH group. During the course of heparin administration, deviation from initial heparin activity was frequent in both groups, but mean activity did not indicate a cumulative effect in either group. There was 1 incidence of pulmonary embolism (LH) and only 1 minor bleeding episode (UH). Half of the patients in both groups were phlebographically improved. We conclude that subcutaneous heparin treatment with UH or LH appears safe and convenient. PMID- 3527887 TI - Thrombosis prophylaxis in visceral surgery with the low molecular weight heparin fragment Kabi 2165 (7,500 and 2,500 anti-Xa IU/day). PMID- 3527888 TI - [A fundamental study on RISPI (2)--Mounted on the SONIC AIR handpiece--an anti abrasion experiment]. PMID- 3527889 TI - [Is sonography useful in the diagnosis of hand surgery?]. AB - In five cases in which sonography was used the value of the results was later assessed by surgery and histology. With adequate equipment and experience in handling, sonography is effective but not absolutely necessary in routine diagnosis. For obscure cases the method is of objective diagnostic help. PMID- 3527890 TI - [Surgical treatment of decubitus ulcers]. AB - In spite of the improved quality of medical care for paraplegic patients, patients with multiple sclerosis or spinal injuries after severe trauma, the incidence of pressure sores has not diminished. Whilst superficial ulcers usually heal with conservative treatment, deep established pressure sores rarely heal satisfactorily without surgical intervention. The various surgical procedures for closure of decubitus ulcers with their classical localisation, i. e. sacral, trochanteric and ischial ulcers, are critically discussed. The myocutaneous flaps offer a wide range of choices for coverage. Sometimes, however, it may be difficult to provide a good quality myocutaneous flap at one operation. In this paper 400 patients with extensive bed sores operated upon during the last 20 years in the Clinic for Plastic Surgery in Cologne, applying the "slide-swing plasty" are reported. Some principles of the slide-swing plasty are to be respected: The flap should be tailored to the size and the shape of the skin defect. Three basic forms of the method can be applied. The flap is placed to exploit the skin reserves surrounding the defect. The flap thickness should extend as far as the muscles. The advantages of this method are as follows: Extensive bed sores can be closed. Sometimes two or three ulcers can be dealt within a single operation. Subsequent recurrences can be closed again using slide swing plasty. PMID- 3527891 TI - [Interferon therapy in hematological malignancies]. PMID- 3527892 TI - [Gastrointestinal peptide hormones]. PMID- 3527893 TI - [Genetic aspects in obsessive-compulsive disorder]. PMID- 3527894 TI - [Pregnancy and the skin: physiological and pathologic changes]. PMID- 3527895 TI - [Antihypertensive action of dl-alpha-tocopherol 5-n-butyl-2-pyridinecarboxylate (TF-80)]. AB - Antihypertensive action of TF-80, an alpha-tocopheryl ester of fusaric acid (FA), was studied in normotensive and hypertensive rats. Oral doses of TF-80 up to 100 mg/kg did not affect systolic blood pressure in Wistar rats, whereas 50 and 100 mg/kg doses produced a significant reduction in systolic blood pressure in both spontaneously hypertensive rats (SHR) and DOCA-salt hypertensive rats (DSR) without significant changes in heart rate. Although maximal reduction in systolic blood pressure at single oral dosing of TF-80 (50, 100 mg/kg) and FA (15, 30 mg/kg) was approximately the same extent, respectively, the antihypertensive action of TF-80 was longer-lasting than that of FA. TF-80 at a chronic administration of 1 to 100 mg/kg/day for 6-9 weeks was preventive to the generation of hypertension in young SHR and DSR, but FA did not prevent the generation of hypertension. Hypotensive doses of TF-80 did not interfere in the rise in blood pressure produced by vasoactive substances such as norepinephrine, prostaglandin F2 alpha and angiotensin II in SHR, and it also failed to inhibit plasma renin. TF-80 was also found not to have a diuretic effect. These results show that TF-80 has a mild and long-lasting antihypertensive action that is different from FA. However, the antihypertensive mechanism of TF-80 remains to be solved. PMID- 3527896 TI - Histochemistry of esterase and esterprotease activities of brain tanycytes. PMID- 3527897 TI - Velopharyngeal insufficiency. PMID- 3527898 TI - Pathophysiology of motor speech disorders (dysarthria). PMID- 3527899 TI - Stuttering: a contemporary perspective. PMID- 3527900 TI - Studies on ABH antigen grouping of ammoniacal extracts of bloodstains by absorption-elution. AB - The effects of absorption time, titer of antiserum or lectin in the absorption stage, and elution temperature on relative antibody or lectin yield in elutes in the absorption-elution procedure were studied in bloodstains and ammoniacal extracts of bloodstains using conventional grouping reagents. In addition, monoclonal anti-A and anti-B and affinity-purified Ulex europaeus agglutinin I (UEA I) reagents were employed for comparison in these processes. Ammoniacal extracts of bloodstains and dried bloodstains on cotton substrata behaved comparably with respect to the parameters studied. The monoclonal anti-A and anti B and UEA I reagents studied yielded satisfactory results, comparable in some cases to conventional reagents, with respect to the parameters studied. PMID- 3527901 TI - [Echographic findings of orbital vascular anomalies in conjunctival congestion as a key symptom]. PMID- 3527902 TI - [Cavernous sinus fistula with special reference to spontaneous cavernous sinus fistula]. PMID- 3527903 TI - [Treatment of posterior uveitis with cyclosporin or prednisolone--one-year report of a randomized prospective study]. PMID- 3527904 TI - [Sonography in the diagnosis of pleuropulmonary disease]. PMID- 3527905 TI - [An anniversary: the controversy concerning cleft lip and palate. The beginning of the dispute 100 years ago in the "Fortschritte der Medizin"--still an open question]. PMID- 3527906 TI - [Does the magnetic field displace incorporated metallic parts? Problems of nuclear magnetic resonance tomography--physical effects]. PMID- 3527907 TI - [B-scan ultrasound in dermatology]. PMID- 3527908 TI - [Diltiazem protects transplants]. PMID- 3527910 TI - [Treatment of irritated stomach with cisapride. A placebo-controlled double-blind study]. PMID- 3527909 TI - [Rheumatherapy--then and now. From bloodletting to cortisone--I]. PMID- 3527911 TI - [Benign nerve sheath tumor of the stomach. A histopathologic and immunohistochemical analysis of 18 cases]. PMID- 3527912 TI - Noninvasive diagnosis of pulmonary hypertension: a World Health Organization study. AB - In the detection of pulmonary hypertension, especially that of only moderate extent usually associated with chronic obstructive lung disease, noninvasive methods, applied individually, are usually of insufficient accuracy. Accordingly, the World Health Organization undertook a prospective study in which several noninvasive methods were employed together in order to improve the diagnostic accuracy. The examinations analyzed encompassed chest roentgenography, electrocardiography, vectorcardiography, mechanocardiography, echocardiography, myocardial scintigraphy and ventriculography and pulmonary scintigraphy. From the chest X-ray, the size of the main pulmonary artery, the transpulmonary artery distance and the size of the right descending pulmonary artery were analyzed; correct identification of patients with or without pulmonary hypertension was achieved in only 40%. With respect to the electrocardiogram, the number of false negative and false positive findings renders this method of negligible usefulness. Mechanocardiography proved technically difficult and incurred inconsistencies in interpretation such that this method was only rarely useful in the diagnosis of pulmonary hypertension. The same held true for the use of echocardiography since it is technically difficult to obtain adequate imaging in patients with overinflated lungs and the pulmonic valve can only be visualized in about 50% of the patients. Right ventricular systolic time intervals would be interest but their measurement can only be accomplished in a small number of patients. Myocardial scintigraphy with thallium-201 may render indirect evidence of pulmonary hypertension if the right ventricular wall can be visualized; this is the case in 80% of patients in whom mean pulmonary artery pressure exceeds 30 mm Hg but only in 56% of those with mean pulmonary artery pressures between 21 and 30 mm Hg.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3527913 TI - Was refusal of care in Arizona overestimated? PMID- 3527914 TI - AHCCCS: a remarkable success? PMID- 3527915 TI - Defending Arizona refusal of care study. PMID- 3527916 TI - Cost containment and incentives for technology. PMID- 3527917 TI - Care of the elder veteran: new directions for change. PMID- 3527918 TI - Human and experimental anisakiasis in the United States. AB - In the past 13 years, 24 cases of anisakiasis have been reported in the United States. Of these, 14 were infections by Phocanema sp. and found in California and Alaska, and most were of the tissue non-invasive type. The remaining 10 cases were infections by larvae of anisakis type I (L3 and L4). Of these 10 cases, 4 were found on the west coast, 5 were on the east coast and one was in Hawaii. In 3 of the 10 cases, the parasite invaded the digestive tract. A characteristic symptom of the throat named "tingling throat" was manifested in 16 of the 24 cases, and this symptom was found to be due to larvae of Phocanema in most cases. As a method for immunological diagnosis of anisakiasis, the radioallergosorbent test (RAST) is being investigated as a cooperative study with Ishikura. As a result, IgE obtained from the sera of 4 patients who had been parasitologically diagnosed as having the disease and one patient in whom the parasite had not been confirmed but was clinically diagnosed as having the disease reacted strongly with anisakis larva antigens, and this reaction was able to be distinguished from the immune response to antigens of other Ascaris. On the other hand, when RAST was applied to child bronchial asthma patients in Hawaii, they showed a strong response to the anisakis larva antigens. Because the causative factors of child bronchial asthma in Hawaii are few and the environmental conditions are also good (i.e., do not cause asthma), their asthma is surmised to be helminth-associated asthma. In view of this background, as well, the results of RAST are interesting. When anisakis larva antigens were analyzed, a strong immunosuppressive effect was confirmed in the high molecular weight fraction (MW: greater than 10,000), while the presence of a substance having mutagenicity was confirmed in the low molecular weight fraction (MW: less than 10,000). In addition, in the sea near Hawaii, we discovered a novel species of Phocanema, which were named Terranova HA. PMID- 3527919 TI - [The development of a convenient enzyme-immunoassay method to detect human serum ferritin]. AB - We have developed an enzyme-immunoassay (EIA) method which is easily and conveniently handled to detect human serum ferritin instead of using the radioisotopes. Rabbit anti human liver ferritin antiserum was adsorbed to a 96 well microplate. Then, sera from patients were put into each well following the addition of peroxidase-labelled rabbit anti human liver ferritin antiserum. Therefore, this is composed of so-called "sandwich" method. One of the beneficial characteristics in this method is to be able to examine many samples at once and easily. Based on this principle, this is clinically useful for screening the abnormal level of serum ferritin from various patients. PMID- 3527920 TI - [Studies on endogenous LHRH]. AB - There has been increasing the evidence on the significances of the measurements of LHRH, one of the hypothalamic hormones, but there are no report on endogenous LHRH levels in patients with internal diseases associated with gonadal dysfunction or intracranial diseases. In this report, the radioimmunoassay of LHRH was established, and plasma LHRH levels in chronic renal failure before and during haemodialysis, and the levels in cerebrospinal fluid (CSF) and plasma in patients with acute intracranial diseases were determined. Plasma levels of immunoreactive LHRH in healthy adults were less than 7 pg/ml for men (n = 17) and less than 8 pg/ml for women (n = 25). The levels were increased in women in menstrual midcycle, postmenopausal period or in patients with hypergonadotropic hypogonadism. CSF LHRH levels were less than 6.1 pg/ml in control subjects, and there were no difference between postmenopausal subjects and the others. The immunoreactivities of CSF and plasma extracts were eluted in identical fractions with synthetic LHRH on Sephadex G-25 chromatography, and these dilutions gave a displacement curve parallel to that with the standard. Plasma LHRH levels were increased in patients with chronic renal failure before haemodialysis (11.1 +/- 1.4 pg/ml, mean +/- SE), and the levels were declined after the dialysis to 4.8 +/- 0.5 pg/ml. These suggest that elevated plasma LHRH reflects the decreased feedback inhibition by primary gonadal failure, and might in turn be responsible at least in part for high concentrations of plasma LH in this condition, and that plasma LHRH is mainly not bound to plasma proteins. LHRH levels of CSF and plasma in patients with acute intracranial diseases, e.g. cerebral bleeding, cerebral thrombosis and meningitis were often elevated abnormally, and these levels were decreased following the abatement of the diseases. These elevations are supposed to be the non-specific changes of this brain peptide suggesting the leakage from the damaged brain, but further studies are needed to clarify these potential significances. PMID- 3527922 TI - Absence of vasoactive intestinal peptide (VIP) innervation of adipose tissues. AB - Occurrence of vasoactive intestinal peptide (VIP) in the white and brown adipose tissues was examined in the rats using the immunofluorescence method. VIPergic innervation was observed in the jejunum, while it was not observed in the adipose tissues. The similar findings were obtained in the cold-acclimated and heat acclimated animals. PMID- 3527921 TI - Cell surface markers of acute non-lymphocytic leukemias: leukemia type and its expression of C3 and Fc receptors. AB - Seventeen untreated human acute non-lymphocytic leukemias (ANLL) were classified into four groups according to the presence or the absence of complement receptor and Fc receptor for IgG and IgM: Group I having neither C3 nor Fc receptors, Group II having either C3 or Fc receptor and Group III having both C3 and Fc receptors. ANLL of Group II was further subdivided into two groups: Group IIa having only Fc receptor and Group IIb having only C3 receptor. The morphologic and cytochemical analysis of ANLL in these groups revealed that the most immature type with regard to their myeloid-monocyte lineage was Group IIb followed by Groups I, IIa and III. Two cases of Group IIb were regarded as M1 type by French American-British (FAB) group classification and one of them had a Ph1-chromosome. The survival rate of patients in each group was investigated and Group IIb patients showed the tendency for the longest period of survival. PMID- 3527924 TI - Hepatic glucagon clearance during insulin induced hypoglycemia. AB - Studies concerning the importance of glucagon secretion in hypoglycemic counterregulation have assumed that peripheral levels of glucagon are representative of rates of pancreatic glucagon secretion. The measurement of peripheral levels of this hormone, however, may be a poor reflection of secretion rates because of glucagon's metabolism by the liver. Therefore, in order to understand the relationship between pancreatic glucagon secretion and levels of glucagon in the peripheral blood during hypoglycemia, we evaluated hepatic glucagon metabolism during insulin induced hypoglycemia. Four dogs received an insulin infusion to produce glucose levels less than 50 mg/dl for 45 minutes. In response to this, the delivery of glucagon to the liver increased from 36.7 +/- 5.9 ng/min in the baseline to 322.6 +/- 6.3 ng/min during hypoglycemia. Hepatic glucagon uptake increased proportionally from 13.6 +/- 7.2 ng/min to 103.1 +/- 28.3 ng/min and the percentage of delivered hormone that was extracted did not change (30.8 +/- 13.8% vs 32.9 +/- 11.6%). The absolute amount of glucagon metabolized by the liver was dependent on the rate of delivery and was not directly affected by plasma glucose level per se. To directly study the effect of hypoglycemia on hepatic glucagon metabolism, five dogs were given an exogenous infusion of somatostatin followed by an infusion of glucagon and then administered insulin to produce hypoglycemia. The percent of glucagon extracted by the liver (19.5 +/- 4.9% and 21.3 +/- 6.4%) was not affected by a fall in the plasma glucose level.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3527923 TI - Gestational diabetes mellitus: a syndrome with phenotypic and genotypic heterogeneity. AB - One hundred ninety-nine gravida with gestational diabetes mellitus (GDM) defined as "carbohydrate intolerance of varying severity with onset or first recognition during pregnancy" have been stratified into subgroups on the basis of fasting plasma glucose and evaluated for further phenotypic and genotypic heterogeneity. A significantly greater proportion of the women in all our groups were older and heavier than in a "control" population of 148 consecutive gravida with documented normal oral glucose tolerance. After correction for age and weight by covariate analysis, absolute insulinopenia in response to oral glucose could be demonstrated in all GDM groups, although exceptions were present in each. The incidence of diabetes in the mothers of our patients with GDM was 8-fold greater than in controls; the incidence in fathers did not deviate from control patterns. HLA-DR3 and DR4 antigens were more frequently present in GDM and the increase was statistically significant in blacks. At the time of diagnosis, cytoplasmic islet cell antibodies (ICA) were significantly more common in GDM associated with elevated fasting plasma glucose than in controls; the frequency of ICA was 18.4% (7/38) in women with fasting plasma glucose greater than or equal to 130 mg/dl. Our findings indicate that GDM entails genotypic as well as phenotypic diversity and may include patients with slowly-evolving Type I diabetes mellitus, as well as patients with Type II diabetes mellitus, and women with asymptomatic diabetes which antedated the pregnancy (i.e. pregestational diabetes mellitus). Appreciation of this heterogeneity should be incorporated into any evaluation of intervention strategies for women with GDM or into prognoses concerning their postpartum metabolic status. PMID- 3527925 TI - Increased placental growth and raised plasma glucocorticoid concentrations in fetal rabbits injected with insulin in utero. AB - Individual rabbit fetuses in utero were injected intramuscularly with either 2.0 Units protamine zinc insulin or saline at 23 days gestation after surgical reduction of litter size to 4 fetuses at 9 days gestation. Insulin-treated fetuses were still hyperinsulinaemic compared with littermate controls at 28 days gestation. Neither fetal body weight nor carcase composition were affected by insulin injection, but placental weight and RNA content were increased. Placental weight was highly correlated with plasma insulin concentration in control fetuses, but not in insulin-injected fetuses. Twenty-four hours after injection of insulin into individual fetal rabbits from normal litters at 23 or 27 days gestation insulin-injected fetuses were hyperinsulinaemic and euglycaemic, but had significantly higher plasma glucocorticoid concentrations than saline injected littermates. Stimulation of placental growth by fetal insulin may be an important component of the fetal growth stimulatory effect of endogenous insulin. Growth stimulatory effects of exogenous insulin may be antagonised by raised plasma glucocorticoid concentrations. PMID- 3527926 TI - Immunoreactive LHRH in chronic starved rats. AB - The effects of chronic starvation (1/4 of ad libitum food intake) for 21 or 30 days were studied on the hypothalamic and serum concentrations of LHRH, the pituitary and serum concentrations of LH, and the weights of the anterior pituitary, ovary and uterus in adult female Wistar rats (chronic starved group, CSG). Control female rats were fed ad lib. for the same periods (control group, CG). On day 22 or 31, half of the rats of each group were weighed and sacrificed by decapitation. Since there were no difference on above parameters between the experiments on 22nd and 31st day, the results were combined for each parameters. At the time of sacrifice, the body weight of CSG was on the average 44% lower than that of CG rats, and also marked reduction in anterior pituitary (44%), ovarian (61%) and uterine weights (69%) was observed. Serum LH concentrations (mean +/- SE; 5.67 +/- 0.67 versus 33.30 +/- 6.00 ng/ml, P less than 0.001) and pituitary LH content (286.7 +/- 19.4 vs 451.0 +/- 32.8 micrograms, P less than 0.001) were significantly decreased in CSG than in CG rats. However, pituitary LH concentration was not reduced because of the proportional reduction to the pituitary weight of CSG rats. Hypothalamic immunoreactive LHRH (IR-LHRH) content in CSG showed a significant increase as compared to CG rats (5.77 +/- 0.52 vs 4.41 +/- 0.27 ng/hypothalamic extract, P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3527927 TI - The erythrocyte insulin receptor response to insulin induced hypoglycaemia. AB - The response of the erythrocyte insulin receptor to a prolonged intravenous infusion of insulin has been measured in normal individuals during hypoglycaemia and when hypoglycaemia was prevented by the concurrent infusion of glucose. When euglycaemia was maintained, mean (+/- S.D.) specific insulin binding following the 5 hour insulin infusion was unchanged (6.9 +/- 2.1 to 6.65 +/- 2.2% bound per 2.25 X 10(9) erythrocytes). In the presence of mild hypoglycaemia, mean (+/- SD) specific insulin binding rose from 6.6 +/- 2.3 to 7.6 +/- 2.5% bound per 2.25 X 10(9) erythrocytes (P less than 0.01), after 5 hours. This increase was due to increased receptor affinity. It was not correlated with the increase in the concentration of any individual counter-regulatory hormone. Initial insulin receptor binding correlated strongly with the subsequent decline in plasma glucose concentration (r = 0.9527; P less than 0.01). Thus, acute hyperinsulinaemia, when associated with hypoglycaemia, does not result in downregulation of insulin receptors on erythrocytes but rather results in increased receptor binding. Consequently, the insulin receptor may not play an active role in protecting the individual against acute hypoglycaemia. PMID- 3527929 TI - Cephalic phase of insulin secretion in obese women. AB - The cephalic phase of reflex insulin secretion was studied in normoglycemic and normoinsulinemic female patients, obese (more than 30% over IBW) and normal subjects. After an overnight fasting, at the sight of breakfast food, the obese group did not present a cephalic response. Their glycemia and insulinemia levels remained at base levels. One minute after visual and olfactory stimulation, a statistically significant rise in immunoreactive insulin levels which was maintained throughout the test, was observed in the control group. PMID- 3527928 TI - Fasting and feeding variations of insulin requirements and insulin binding to erythrocytes at different times of the day in insulin dependent diabetics- assessed under the condition of glucose-controlled insulin infusion. AB - Nine insulin-dependent diabetic patients were examined for insulin requirement, counterregulatory hormones, and receptor binding during their connection to glucose-controlled insulin infusion system. They were of 103% ideal body weight. A diet of 45% carbohydrate, 20% protein and 35% fat was divided into three meals and three snacks averaging the daily calorie intake of 1859 kcal. Following an equilibrating phase of 14 hours after the connection to the glucose-controlled insulin infusion system the blood samples were taken at 0800, 1200 and 1800. The insulin infusion rate increased at 0300 in the early morning from 0.128 mU/kg/min to 0.221 mU/kg/min (P less than 0.02). The postprandial insulin infusion rate jumped from 0.7 U/h (0700-0800) to 7.5 U/h (0800-0900). The calorie related and carbohydrate related insulin demands after breakfast were also highest and declined after lunch respectively (1.16 uU/kg/min kj vs. 0.61 uU/kg/min kj, P less than 0.05 and 236 mU/g CHO vs. 129 mU/g CHO and 143 mU/g CHO). Of the counterregulatory hormones the cortisol showed a significant diurnal rhythm to insulin demands. The insulin tracer binding was higher at 0800 before breakfast than that at 1200 before lunch (P less than 0.05). The increased binding could be better attributed to receptor concentration change than to affinity change. The cause of insulin relative insensitivity in the morning could be due to altered liver response to the cortisol peak in type 1 diabetics. The preserved variation of insulin binding in our patients might be referred to feeding. PMID- 3527930 TI - Changes in tissue insulin sensitivity in previously "brittle" diabetics. PMID- 3527931 TI - Reduced insulin sensitivity of tenotomized muscle: a possible role of adenosine. PMID- 3527932 TI - Tricyclic antidepressants in prepubertal depressed children: review of the literature. AB - Other studies have reported the use of TCA antidepressants in the treatment of depressed children (Frommer 1967; Ossofsky 1974; Stack 1972; Polvan and Cebiroglu 1972). However, these studies did not meet criteria for inclusion in this review. In studies, other medicines were given concurrently with TCAs. Several did not specify the number of subjects and/or the number who responded. Sometimes subjects who were not diagnosed as depressed were included. Also studies of childhood depression tend to include adolescents; thus many samples were a mixture of adolescents and prepubertal children with the adolescents frequently predominating. As the purpose of this review was depression in prepubertal children, only studies comprised predominantly of prepubertal children were included. Although not included in this review, many such studies reported TCAs were useful in treating depression in children. After reviewing these studies, it is obvious that their sophistication has improved dramatically in recent years. Standard diagnostic criteria such as Feighner's Research Diagnostic Criteria, the Research Diagnostic Criteria, and more recently DSM-III (all of which are similar) have permitted a more objective and standardized diagnosis of depression. Likewise, the development of the Children's Depression Inventory and the Childhood Depression Rating Scale have allowed more objective measurement of severity of depression and of improvement in depression in children. Plasma drug level monitoring has allowed for pharmacokinetic studies of TCAs, more precise dose adjustment and equivalent drug treatment of subjects involved in clinical research studies. Studies to date indicate TCAs were helpful in treating depressed prepubertal children. However, double-blind placebo/control studies of tricyclic antidepressants in depressed prepubertal school-aged children have not been published. Ideally a study of antidepressants in children should include: objective standardized diagnostic criteria for diagnosing depression; objective rating of severity of depression; explicit exclusion criteria; steady-state plasma blood level monitoring; assured compliance; adequate duration of treatment so sufficient time is allowed for response to occur; a double-blind study design. Unfortunately the ideal study has not been done. TCAs may be an effective treatment for prepubertal major depressive disorder. However, further study is necessary to clearly establish their efficacy. PMID- 3527933 TI - An immunohistochemical and clinicopathological study of granulocytic sarcoma ('chloroma'). AB - A small series of granulocytic sarcomas (GS) or 'chloromas' has been studied by means of conventional histology and immunohistochemistry. The latter was found to be most useful in the diagnosis and characterization of these neoplasms, which are rare in Great Britain. Polytypic antisera to leukocyte elastase and cathepsin G have proved to be most useful, giving intense staining in all cases. These two markers are more specific than muramidase (lysozyme) and alpha 1-antitrypsin, since, unlike the latter two, they do not stain histiocytic cells. The results of staining with two monoclonal antisera, AGF 4.48 and AGF 4.36, are also described. In addition, the clinicopathological details of the seven cases are summarized and the literature is briefly surveyed. PMID- 3527935 TI - HHS trying to patch up holes in PRO program. PMID- 3527934 TI - Nodular fibrous proliferation (fibrous pseudotumour) of the tunica vaginalis testis. A light, electron microscopic and immunocytochemical study of a case and review of the literature. AB - A case of nodular fibrous proliferation of the tunica vaginalis testis occurring in a 25-year-old male is described. Electron microscopy and immunocytochemical analysis confirm a fibroblastic origin. The histogenesis of the lesion is considered in the light of the findings and a review of the literature. It is concluded that the lesions known variously as 'fibrous pseudotumour' and 'reactive periorchitis' represent a fibroblastic overgrowth of the genito-urinary tract in response to trauma or infection. Nodular or diffuse fibrous proliferation of the testicular tunica vaginalis is suggested as a unifying terminology for this group of lesions. PMID- 3527936 TI - PIP elimination puts strain on small hospitals. PMID- 3527937 TI - Court decisions streamline appeals process. PMID- 3527938 TI - Debate brews on home health payment. PMID- 3527939 TI - Panel narrows gaps in catastrophic coverage. PMID- 3527940 TI - Hospitals suffer from insufficient IBD payment rates. PMID- 3527941 TI - HMO suit sparks concern over Medicare reimbursement. PMID- 3527942 TI - Waxman champions expansion of Medicaid. Interview by Jeffrey Finn. PMID- 3527943 TI - Medicare group spreads the word: appeal. PMID- 3527944 TI - Endogenous neuropeptides in regulation of motor functions of the normal and pathological brain. PMID- 3527945 TI - Monoclonal antibodies specific immunotherapy of gastrointestinal tumors. AB - Monoclonal antibody 17-1A showing cytotoxic properties to GI tract adenocarcinoma cells in vitro and mediating tumor growth inhibition in nude mice, was used as immunotherapeutic agent in 95 patients with various metastatic gastrointestinal adenocarcinomas. Several clinical trials were performed in patients with metastatic disease unaccessible to more conventional therapy of proven efficacy. Results of the different trials are reported here. Tolerance to monoclonal antibody infusion was excellent with minor side effects, except when combinations of several monoclonal antibodies were used. Three complete responses, five partial responses inferior to 50% and 24 stable diseases were noticed. A randomized trial is presently performed in high risk cancer patients with B2 or C colorectal carcinomas with 17-1A as adjuvant immunotherapeutic agent after surgery. PMID- 3527946 TI - Treatment of advanced measurable or evaluable pancreatic carcinoma with 17-1A murine monoclonal antibody alone or in combination with 5-fluorouracil, adriamycin and mitomycin (FAM). AB - Between 1/85 and 3/86, 16 patients with advanced measurable or evaluable pancreatic carcinoma were treated with mouse monoclonal antibody consisting of a single dose of 400 mg 17-1A immunoglobulin given intravenously. None of the eight patients who received monoclonal antibody alone had any subjective or objective benefit. Two of the eight patients who received a combination of monoclonal antibody and 5-fluorouracil, adriamycin and mitomycin (F.A.M.) chemotherapy had clinically useful partial responses lasting 11 months and 7 months respectively. One of these patients, whose initial treatment consisted of an 8-week cycle of F.A.M. chemotherapy, had progressive deterioration as evidenced by weight loss and persistent abnormality of his CT scan, and then achieved a partial response following a single injection of monoclonal antibody while chemotherapy was continued. His response lasted 11 months. There was no toxicity associated with the administration of monoclonal antibody, and the F.A.M. chemotherapy was well tolerated with moderate and acceptable hematologic toxicity and mild gastrointestinal side effects. There were no treatment-related deaths. PMID- 3527947 TI - Clinical trial of Wistar Institute 17-1A monoclonal antibody in patients with advanced gastrointestinal adenocarcinoma: a preliminary report. AB - Immunotherapy using monoclonal antibody 17-1A has been performed on 22 patients with metastatic gastrointestinal cancer. Criteria for treatment included objective evidence of advanced colon, gastric, or pancreatic cancer (positive CAT scan or x-rays, elevated tumor markers, and/or abnormal liver function tests). The tumor tissue was antigenically positive in all cases. Performance status ranged from 50 to 100%. No adverse reactions were noted. Of the 22 cases treated, 4 (18%) have died, none have rapidly progressive disease, 4 (18%) have slowly progressive disease, 10 (45%) are considered stable with disease, and none are considered partial or complete responses. It is too early to classify the response in 4 cases. In 6 of 8 patients where anti-idiotypic data was available, death or progressive disease was correlated to negative anti-idiotypic response, and clinical stability to a positive anti-idiotypic response. In the patients considered to be stable, the percent change from pre-treatment serum 19-9 concentrations to current values ranged from -10% to +353%. In the patients who have died or have been classified as slowly progressive the serum 19-9 changes ranged from +13% to +707%. PMID- 3527948 TI - Detection of murine immunoglobulin in human tissues following therapeutic infusion of monoclonal antibody. AB - A class switch variant of hybridoma CO19-9 secreting IgG2a antibodies was shown to have the same immunoperoxidase binding pattern in human tissue as the IgG1 antibody secreted by the parental hybridoma. The IP tissue binding of GA73.3 and 17-1A monoclonal antibodies which have been suggested to bind to structurally related antigens were compared; although quite similar in distribution, some differences were noted. GA73.3 bound to 12/12 colon carcinomas compared to 17-1A which reacted with 11/12 tumors. In several cases, the percentage of cells reactive with GA73.3 (90-100%) exceeded those reactive with 17-1A (10-25%). Additionally, the intensity of reactivity for GA73.3 was consistently greater than that seen with 17-1A. The detection of murine antibody bound to human tissues following therapeutic infusion of 19-9 IgG2a or GA73.3 differed. Detection of antibody-antigen complexes was seen less often in patients who had received 19-9 IgG2a (2/6) than in patients who had received GA73.3 (5/5). Additionally, the presence of murine immunoglobulin was seen only in the extracellular mucin of the patients receiving 19-9 IgG2a, whereas strong cellular binding of murine immunoglobulin was noted following infusion with GA73.3. PMID- 3527949 TI - A perinatal monitoring display based on the fetal topogram. PMID- 3527950 TI - Evaluation of a step care approach in medical management of stable angina. PMID- 3527951 TI - Production of tumor necrosis factor in unprimed mice: mechanism of endotoxin mediated tumor necrosis. AB - Tumor necrosis factor (TNF) was detected in the sera of normal mice, unprimed by reticuloendothelial system (RES) stimulators, when such mice were injected with lipopolysaccharide (LPS). Amounts of TNF were approximately 200-fold less than those found in Corynebacterium parvum-primed mice. No TNF activity was detected in the sera of mice not administered LPS. TNF induction in unprimed mice was refractory to repeated administration of endotoxin, thus exhibiting a tolerance phenomenon. TNF produced in unprimed mice eluted similarly to Mycobacterium bovis, strain BCG-primed TNF on Sephacryl S-200 and DEAE Sephacel columns and was neutralized by rabbit antisera raised to partially purified BCG-primed TNF. When BALB/c mice having 7-day old subcutaneous Meth A tumor implants were administered TNF antiserum, endotoxin-induced hemorrhagic necrosis was largely prevented. These findings strongly suggest that endotoxin-induced hemorrhagic necrosis of tumors is mediated through TNF production and action. PMID- 3527952 TI - Stimulation of human lymphocytes by phytohemagglutinin (PHA) in a new ultra microtest plate. AB - The requirements for monocytes in lymphocyte proliferation were studied in ultra microcultures. For this purpose, an ultra-microtest plate was developed which comprises 121 wells, each having 0.23 microliter volume and 0.28 mm2 culture area. Human peripheral lymphocytes were seeded in the wells in numbers ranging from 1-57 cells/well and subsequently stimulated with phytohemagglutinin (PHA). Proliferation, assessed by microscopy in situ, was established in 46% of the wells where adherent non-specific, esterase-positive cells were present and in 6% where such cells were absent. The results indicate that PHA-stimulated human lymphocytes can proliferate in the absence of monocytes. The new microplate should be a valuable tool for dissecting the early events in T cell activation, especially if combined with various analytical methods such as time-lapse video, autoradiography and surface-marker techniques. PMID- 3527953 TI - Generation and characterization of a monoclonal antibody (1C5) to human migration inhibitory factor (MIF). AB - A monoclonal antibody was raised in mice against human MIF of the Mr 14,000 kd, produced by Concanavalin A-stimulated peripheral blood mononuclear cells. A hybridoma (1C5) secreting an IgG 1 antibody was selected which binds, yet does not neutralize MIF in the macrophage migration assay. MIF activity may be released from immobilized antibodies by acidic buffer elution. The eluate consists of three major bands at Mr 8,000, 14,000 and 28,000 as revealed by SDS polyacrylamide gel electrophoresis and molecular sieve chromatography (HPLC). By radioimmunoassay and enzyme-linked immunoassay, it could be shown that the antibody binds material with isoelectric points of 4.5 to 5.0 and of 3.0, which coincides precisely with the biological activities. Similar congruencies between the distribution of biologically reactive and binding material were found in molecular sieve and ion exchange chromatography. It is concluded that the antibody 1C5 reacts with most molecular weight entities of MIF which seem to be structurally related and which display similar characteristics as described for guinea pig and mouse MIF. PMID- 3527954 TI - [Dermatologic lesions in renal transplant patients treated with low doses of steroids]. PMID- 3527955 TI - The long-term efficacy of currently used dental implants: a review and proposed criteria of success. PMID- 3527956 TI - An improved method for preparing histological sections of metallic implants. PMID- 3527957 TI - Prosthetic considerations for the utilization of osseointegrated fixtures in the partially edentulous arch. PMID- 3527958 TI - A comparison of computer-assisted tomography and data-gathering modalities in prosthodontics. PMID- 3527959 TI - Steroids in cerebral malaria. PMID- 3527960 TI - The Medical Research Council Trial. PMID- 3527961 TI - Insulin as a potential factor influencing blood pressure in amputees. AB - War-injured, bilateral above-knee amputees are known to be at increased risk for cardiovascular mortality. To evaluate possible risk factors, we compared blood pressures and plasma glucose and insulin responses to orally administered glucose in 19 above-knee amputees from the Vietnam War (mean age, 36 +/- 1 years) with those of 12 age-matched unilateral below-elbow amputees. Body composition by densitometry and maximal oxygen consumption during arm or leg exercise were also determined. Nine of 19 leg amputees were hypertensive compared with one of 12 arm amputees. Their 3-hour average insulin responses were markedly increased (260 +/- 60 microU/ml) compared with those of normotensive leg (125 +/- 24 microU/ml) and arm amputees (101 +/- 20 microU/ml), and their mean body fat content (37.2%) also was elevated compared with that in both of these groups (23.2 and 22.6%, respectively). A unique finding was that both insulin response and body fat content were strongly and independently correlated with diastolic blood pressure (r = 0.55, p less than 0.01, and r = 0.62, p less than 0.01, respectively). We conclude that insulin may be a major factor in blood pressure regulation in the maturity-onset obesity that develops following traumatic leg amputation in young, healthy men. PMID- 3527962 TI - Requirement for cell-bound proteases in the mechanism of human neutrophil activation with various stimuli. AB - A cell membrane-associated protease/esterase has been implicated in the mechanism of "stimulus-secretion coupling" described for human neutrophil degranulation. In this regard, a broad spectrum of protease inhibitors were evaluated for their effects on granule enzyme release from neutrophils exposed to soluble, surface active stimuli. The serine protease inhibitors, L-1-tosylamide-2-phenylethyl chloromethyl ketone (TPCK) and N-alpha-p-tosyl-L-lysine-chloromethyl ketone (TLCK) and a thiol protease inhibitor, p-hydroxymercuribenzoate (PHMB), caused a concentration-related suppression of neutrophil degranulation elicited with 1-O hexadecyl/octadecyl-2-O-acetyl-sn-glyceryl-3-phosphorylcholine (AGEPC), ionophore A23187, phorbol myristate acetate (PMA), and 5(S), 12(R)-dihydroxy-6,14-cis-8,10 trans-eicosatetraenoic acid (LTB4). However, other inhibitors, such as aprotinin and p-hydroxyphenylpyruvic acid, were inactive. The maximum inhibitory effect with TPCK, TLCK, and PHMB was observed when neutrophils were exposed to these inhibitors prior to contact with the respective stimuli. In addition, the magnitude of inhibition increased in proportion to the preincubation time of protease inhibitor with stimulus. The results of these studies implicate proteases in the sequence of events underlying activation of the human neutrophil secretory process in response to structurally and chemically dissimilar stimuli. PMID- 3527964 TI - Serum complement levels in cerebral malaria. PMID- 3527963 TI - Peripheral blood and intrarenal phagocytic chemiluminescence during acute kidney graft rejection. AB - During organ graft rejection, soluble mediators of inflammation are released into the polymorphs (PMNs) and monocytes recruited from the blood. One functional capacity of polymorphs and monocytes/macrophages is the production of cytotoxic activated oxygen species upon stimulation, which may contribute to the rejection process. Nothing is known about the influence of allograft rejection on this inflammatory cell property. Chemiluminescence (CL) allows measurement of respiratory burst capacity in small cell samples. Zymosan-induced and luminol amplified CL of diluted whole blood, separated PMNs, and mononuclear cells from peripheral venous blood, as well as of intragraft phagocytes was measured after allogeneic and autologous kidney transplantation in untreated dogs. CL of separated PMNs, mononuclear cells, and intragraft phagocytes was significantly elevated during allograft rejection. In autologous kidneys transplanted to recipients of allografts, CL was also increased in the autologous grafts during rejection of the allogeneic ones, indicating a systemic alteration in phagocyte function. PMID- 3527965 TI - Beta cell nesidioblastosis. PMID- 3527966 TI - Urinary tract infection and recurrent gastroenteritis. PMID- 3527967 TI - Real time ultrasonography in the evaluation of hydrocephalus and associated abnormalities. PMID- 3527969 TI - Serratia marcescens infection in newborns. PMID- 3527968 TI - Diaphragmatic hernias in infants and children. PMID- 3527970 TI - Chemotherapy of malaria. PMID- 3527971 TI - Recombinant DNA and the pediatrician. PMID- 3527972 TI - [Glass ionomer cements in dentistry. Most recent data]. PMID- 3527973 TI - [The use of gutta percha in endodontics]. PMID- 3527974 TI - [The effect of the smear layer on the impenetrability of the root canal obturation]. PMID- 3527975 TI - [Atraumatic low-wear rotary-speed grinding and polishing. Maintenance of dental tissue and management of the pulp]. PMID- 3527976 TI - [Physiological and mechanical requirements for design of a new implant (the Bicortex implant)]. PMID- 3527977 TI - [Bonded bridges. Clinical application of the Maryland bridge for the restoration of posterior edentulousness]. PMID- 3527979 TI - [Zeitschrift fur Stomatologie, Volume XXXI, 1933: The crisis in orthodontics. By Albin Oppenheim]. PMID- 3527978 TI - [Flasking and heat polymerization of complete dentures: a pressure and depressurization-associated system]. PMID- 3527980 TI - [Zeitschrift fur Stomatologie, Volume XXXI, 1933: Does the use of continuous force guarantee optimal biological and clinical results? By Albin Oppenheim]. PMID- 3527981 TI - [Cementation of brackets with glass ionomer cements. Clinical study with statistical data]. PMID- 3527982 TI - Binding of Streptococcus pyogenes to soluble and insoluble fibronectin. AB - The interaction of soluble and insoluble fibronectin with Streptococcus pyogenes was investigated. Soluble fibronectin bound to S. pyogenes in a dose-dependent and irreversible manner. Lipoteichoic acid competitively inhibited the binding of fibronectin to S. pyogenes but had little effect on the binding of fibronectin to staphylococci or pneumococci. The phase of growth of the streptococci had a slight effect on binding of fibronectin, with optimal binding occurring in the late log phase. S. pyogenes cells bound to fibronectin immobilized on microtiter plates in a dose-dependent and saturable manner. Both soluble fibronectin and lipoteichoic acid inhibited the binding of streptococci to immobilized fibronectin, suggesting that streptococci interact with soluble and insoluble fibronectin in a similar manner. Antibodies to fibronectin blocked the attachment of streptococci to immobilized fibronectin, whereas normal serum had no effect. Adherence of streptococci to buccal epithelial cells was inhibited by antibodies to fibronectin, but not by normal sera or by antibodies to buccal epithelial cells. The data suggest that lipoteichoic acid on the surface of S. pyogenes binds to fibronectin exposed on the host cell and that such binding mediates the attachment of streptococci to host cells. PMID- 3527983 TI - Resistance of C3H/HeJ mice to the effects of Haemophilus pleuropneumoniae. AB - Comparisons were made in the mortality associated with an inhaled dose of viable Haemophilus pleuropneumoniae type 5, strain J45, between adult C3H/HeN and C3H/HeJ mice. Mice of both strains were also challenged with Escherichia coli strains O111:B4 and J5. The 50% lethal dose (LD50) of H. pleuropneumoniae in C3H/HeN mice was calculated to be 10(6.5) CFU. At a mean dose of 10(6.7) CFU a 46% mortality rate occurred in C3H/HeN mice, whereas only 10% of the C3H/HeJ mice died (P less than 0.01). Deaths occurred significantly earlier in C3H/HeN mice (P less than 0.01). No deaths occurred later than 12 h postinfection in either group. Pulmonary lesions in the mice that died were similar to those in pigs that die during the acute phase of H. pleuropneumoniae infection. In surviving mice of both strains, a mild resolving interstitial and bronchopneumonia was present which was not typical of subacute H. pleuropneumoniae infections in swine. Quantitative bacterial isolations from the lungs, liver, and spleen indicate that H. pleuropneumoniae did not multiply in the lungs, was rapidly cleared, and did not become systemic. No deaths occurred in the mice inoculated with E. coli J5 or O111:B4 at mean doses of 10(6.3), 10(7.2), and 10(8.5) CFU, and 10(6.4), 10(7.5), and 10(8.2) CFU, respectively. The difference in the mortality rate between the C3H/HeN and C3H/HeJ mice suggests that endotoxin may be involved in acute deaths in pigs infected with H. pleuropneumonia. As indicated by the E. coli challenge, however, other factors are also likely to be involved. Because of the differences in the pathology and microbiology following H. pleuropneumoniae pulmonary infections in mice and pigs, mice do not appear to be an accurate model of the overall disease in swine. PMID- 3527984 TI - Hormonal factors in vaginal candidiasis in rats. AB - The hormonal status of rats affected vaginal infection with Candida albicans. Four hours after infection viable counts were higher and germ tubes were longer in those animals in estrous than in other animals. However, the infection was not maintained with the change in epithelial cell type which occurred as part of the estrous cycle. Estrogen dosing following ovariectomy predisposed toward infection, while progesterone dosing did not. In rats injected with progesterone, germ tube clumping was seen, leukocytes were present, and elimination occurred before hyphal growth was evident. In rats injected with estrogen, however, infection was maintained, with hyphal growth extending throughout the cornified epithelial layer. Vaginal washings from rats dosed with estrogen promoted elongation of germ tubes in vitro to a greater extent than washings from other rats. Preincubation of blastospores in progesterone and subsequent infection of rats in pseudoestrous promoted clumping of germ tubes in the vagina. Strains of C. albicans varied in their virulence, which correlated with their ability to produce germ tubes in vitro. Loss of virulence occurred on subculture of a clinical isolate. PMID- 3527985 TI - Cloning of a serotype-specific antigen from Pasteurella haemolytica A1. AB - Recombinant plasmids coding for a soluble (or surface) antigen of Pasteurella haemolytica A1 were identified. Two plasmids, both containing the same 5.4 kilobase pairs of insert DNA, were recovered independently by screening a clone band of P. haemolytica A1 genomic DNA in Escherichia coli for the expression of P. haemolytica A1 soluble antigens (R. Y. C. Lo and L.A. Cameron, Can. J. Biochem. Cell Biol. 64:73-76, 1986). E. coli cells carrying the plasmids were found to be agglutinated by an antiserum raised against the P. haemolytica A1 soluble antigens. Analysis of the E. coli clones by electron microscopy revealed patches of amorphous material on the surface of the cells which were not present on the controls. Further characterization with protein A-colloidal gold labeled both these patches and the outer membranes of these cloned cells pretreated with the specific antiserum. These results indicated that the cloned antigen was expressed on the surface of the E. coli cells. The cloned antigen was found to be specific for serotype 1 when tested by slide agglutination against a collection of P. haemolytica typing antisera. Southern blot hybridization, using the cloned DNA as a probe, labeled the genomic DNA from P. haemolytica serotype 1 as well as the cross-agglutinating serotypes 2 and 7, but not DNA from the non-cross agglutinating serotypes 3 and 4 and Pasteurella multocida. These results demonstrated that serotype specificity could be attributed to the particular antigenic determinants in the genome of the organism. PMID- 3527986 TI - Analysis of cell wall extracts of Candida albicans by sodium dodecyl sulfate polyacrylamide gel electrophoresis and Western blot techniques. AB - Cell walls of intact yeast- and mycelial-phase Candida albicans B311 were extracted with different compounds: dithiothreitol, dithiothreitol with protease, dithiothreitol with lyticase, and dithiothreitol with protease followed by beta glucuronidase with chitinase. Extracts were analyzed by sodium dodecyl sulfate polyacrylamide gel electrophoresis and Western blot techniques. Dithiothreitol extracts contained the most satisfactory array of components for study. Analysis of these extracts demonstrated that the outer cell wall layers of Candida blastoconidia and germ tubes contained a complex array of polysaccharides, glycoproteins, and proteins. The proteins contributed to a latticework stabilized by covalent bonds that was important in determining the porosity of the outer cell wall layers. When equivalent weights were analyzed, mycelial-phase extract contained a more varied array of proteins than did yeast-phase extract. Only a portion of proteins in mycelial-phase extract elicited antibody responses in hyperimmunized rabbits or infected humans. A polysaccharide-rich, high-molecular weight component (migrating at a position that would correspond to proteins having molecular weights of 235,000 to 250,000) and a protein component (molecular weight, 19,000) were readily demonstrable in the mycelial-phase extract but could not be identified in the yeast-phase extract. PMID- 3527987 TI - Late intraphagosomal hydrogen ion concentration favors the in vitro antimicrobial capacity of a 37-kilodalton cationic granule protein of human neutrophil granulocytes. AB - We described previously (W.M. Shafer, L.E. Martin, and J.K. Spitznagel, Infect. Immun. 45:29-35, 1984) the presence of a 37-kilodalton cationic antimicrobial protein (37K CAP) in extracts of granules prepared from human polymorphonuclear granulocytes (PMN). In this investigation, we prepared 37K CAP from PMN granule extracts by sequential ion-exchange and molecular-sieve chromatography and examined its antimicrobial activity against a number of gram-negative and gram positive bacteria. At concentrations of 5 micrograms/ml or lower, 37K CAP exerted selective antimicrobial activity against gram-negative bacteria. These bacteria included Acinetobacter lwoffii, Escherichia coli, Neisseria gonorrhoeae, Pseudomonas aeruginosa, Pseudomonas cepacia, Salmonella typhi, Salmonella typhimurium, and Shigella sonnei. However, at 5 micrograms of 37K CAP per ml, Proteus mirabilis, Proteus vulgaris, and Serratia marcescens resisted this antimicrobial activity. The bactericidal activity of 37K CAP was greatest in acidic (pH 5.5) as opposed to alkaline (pH 7.5) media. The level of S. typhimurium resistance to 37K CAP correlated with the presence of O antigen in the lipopolysaccharide. In the absence of O antigen repeat units, resistance was proportional to the length of the core oligosaccharide. These results suggest that 37K CAP may contribute significantly to the ability of PMN to kill gram negative bacteria by nonoxidative means, particularly as the maturing phagolysosome becomes acidified. PMID- 3527988 TI - Regulation of staphylococcal toxic shock syndrome toxin-1 and total exoprotein production by magnesium ion. AB - The effect of Mg2+ on in vitro production of extracellular proteins and, specifically, of toxic shock syndrome toxin-1 (TSST-1), by Staphylococcus aureus in a chemically defined medium was examined. As previously observed, the organisms did not proliferate in the absence of divalent cations. Low levels of Mg2+ (0.02 to 0.04 mM) permitted submaximal proliferation and elevated production of exoproteins. When the Mg2+ concentration was raised to 0.4 mM, multiplication was optimal and exoprotein levels were depressed. Ca2+ and Mn2+ diminished the effect of limiting Mg2+. The increased levels of exoproteins were not due to cell lysis or leakage since intracellular TSST-1 levels were not high enough to account for the increase in extracellular TSST-1 and since the intracellular enzyme, lactate dehydrogenase, was not found in culture supernatants. Cells cultured in low levels of Mg2+ remained in logarithmic growth longer than did those cultured in high concentrations of Mg2+ and, unlike the latter, produced exoproteins throughout the logarithmic growth phase. Low Mg2+ had no effect on cultures in the stationary phase, and organisms cultured in low Mg2+ recovered fully when transferred to high Mg2+. We conclude that, when cultured in medium deficient in Mg2+, S. aureus responds early in the growth cycle by increasing production of many extracellular proteins, including TSST-1. PMID- 3527990 TI - Comparative sealing ability of temporary filling materials evaluated by leakage of radiosodium. PMID- 3527989 TI - Oral immunization of mice with attenuated Salmonella enteritidis containing a recombinant plasmid which codes for production of the B subunit of heat-labile Escherichia coli enterotoxin. AB - We used Salmonella enteritidis serotype dublin strain SL1438, a nonreverting, aromatic-dependent, histidine-requiring mutant, as a recipient for a recombinant plasmid coding for production of the nontoxic B subunit of the heat-labile Escherichia coli enterotoxin. The S. enteritidis derivative EL23 produced heat labile enterotoxin subunit B that was indistinguishable from heat-labile enterotoxin subunit B produced by strains of E. coli or Salmonella typhi harboring the same plasmid. Mice immunized orally with strain EL23 developed progressively increasing mucosal and serum antibody responses to both heat-labile enterotoxin subunit B and to the lipopolysaccharide of the vaccine strain. The mucosal antibody response was shown to be immunoglobulin A specific and to be capable of neutralizing the biological activities of both E. coli heat-labile enterotoxin and cholera enterotoxin in vitro. PMID- 3527991 TI - Genetic control of delayed-type hypersensitivity in mice to Salmonella antigen. AB - Genetic restriction on the expression of delayed-type hypersensitivity (DTH) to Salmonella typhimurium in mice transferred passively with immune spleen cells was studied. After the intravenous transfer of immune C3H/HeJ (H-2Ik) cells into A.TL (H-2Ik) or A.TH (H-2Is) mice, footpad DTH responses could be evoked in the A.TL recipients, but not in the A.TH mice. When the immune cells of BALB/c or C3H/He mice were intravenously-transferred into F1 hybrids produced by mating BALB/c and C57BL/6 or C3H/He and C57BL/6, respectively, no DTH response could be evoked in these F1 hybrids that received immune parental cells. Local transfer as well as systemic intravenous transfer of immune parental cells to F1 haplotype recipients did not cause any DTH. Previous treatment of the F1 hybrid recipients with cyclophosphamide did not result in the expression of the DTH response. Transfer of immune F1 spleen cells into parental strains also did not induce DTH. When the immune cells of parental strains were transferred into F2 mice and into back cross mice, examination of the DTH response in these mice showed that some of them did not have any obvious footpad swelling, while others revealed various magnitudes of swelling. The resistance of F1 hybrids to transfer of DTH is discussed. PMID- 3527992 TI - Leukemia serum reactive with retrovirus-related antigen in normal human placenta. AB - Serum antibody reactive with a retrovirus-related p30 antigen in human normal term placenta was investigated and characterized by immunohistologic and immunoblotting methods. Sera obtained from patients with acute leukemia and malignant lymphoma were used as first antibody, and cryostat sections of placenta were the target antigen. An IgM antibody that reacted mainly with the basal aspect of syncytiotrophoblast of chorionic villi, where a putative human endogenous retrovirus p30 antigen is located, was directed by indirect immunofluorescence. This antibody activity, termed anti-basal aspect of syncytiotrophoblast (anti-BAST), was detected in the sera of many patients with acute leukemia (AML, ALL) and malignant lymphoma, and less frequently in sera of pregnant women and normal controls. As shown by immunoblotting analysis, the main reactive antigen recognized by anti-BAST was a non-glycosylated 32-kDa placental protein which was antigenically related to SSAV p30. A non-glycosylated 19-kDa protein was also considered to be one of the anti-BAST-corresponding antigens. This suggests the presence of a new antigen-antibody system of human retrovirus(es) revealed by subinfectious antigenic expression and by specific antibody activity in conditions of human health and disease, particularly, acute leukemias and malignant lymphomas of common types. PMID- 3527993 TI - S-phase fraction of human brain tumors in situ measured by uptake of bromodeoxyuridine. AB - One hundred fifty-four patients with brain tumors of various types were given an intravenous infusion of the thymidine analogue bromodeoxyuridine (BUdR), 200 mg/m2, at the time of surgery but before biopsy of the tumor to label S-phase cells. Excised tumor specimens were fixed, sectioned, and stained by immunoperoxidase methods to detect BUdR. The labelling index (LI), or percentage of BUdR-labelled cells, was calculated for each tumor specimen. The LIs of glioblastomas, medulloblastomas, and most highly anaplastic astrocytomas were 5% to 20%. The majority of moderately anaplastic astrocytomas showed LIs of less than 1%, but 30% of them had LIs similar to those of highly malignant gliomas. Most pituitary adenomas and neurinomas showed LIs of less than 1%. Nonmalignant meningiomas had LIs of less than 1%, whereas malignant meningiomas had LIs higher than 2.7%. This is an important observation, because malignant meningiomas are not well-defined histopathologically and their growth rate and rate of recurrence cannot be predicted by current diagnostic procedures. By estimating the proliferative potential of individual tumors more precisely, the BUdR LI supplements histopathological diagnosis, allowing a more accurate estimate of prognosis and facilitating the design of treatment regimens for individual patients. PMID- 3527994 TI - Density distributions of human squamous carcinoma cells: influence of growth conditions, proliferative status and DNA content. AB - Human squamous carcinoma cells (A431, CaSki) were grown in vitro as multicellular spheroids or as exponential and plateau-phase monolayer cultures. Single-cell suspensions were obtained by disaggregating the spheroids and monolayer cultures with trypsin-EDTA. Their buoyant density distributions were then compared by centrifuging the suspensions for 30 min at about 800gave and 4 degrees C in linear, continuous Percoll gradients. We found differences in buoyant density related to the growth condition (i.e. cells grown as spheroids or plateau-phase cultures were more dense than those from exponential cultures) and to the cell line (i.e. CaSki cells were more dense than the A431 cells). Cells isolated from the inner layers of the spheroids appeared to be less dense than those from the outer layers. In addition, quiescent cells separated from the A431 spheroids by centrifugal elutriation, a technique based on cell size, were more dispersed in buoyant density than the corresponding proliferating cells recovered from the same spheroids. Flow cytometric analysis with mithramycin was performed to measure the DNA content of the cells. We found that the CaSki cells contained relatively more DNA than the A431 cells whereas, for the same cell line, growth as monolayer cultures or as multicellular spheroids did not influence their relative DNA content. We conclude that the growth conditions, the proliferative status of the cells and possibly their relative DNA content may influence the density distribution of these cells. PMID- 3527995 TI - Double left innominate vein: an unusual cross-sectional echocardiographic appearance. AB - A patient is described with ventricular septal defects and two innominate veins which gave rise to an unusual cross-sectional echocardiographic finding thought to be due to a left superior caval vein without connexion to the coronary sinus. PMID- 3527996 TI - The chronic cerebral effects of cannabis use. II. Psychological findings and conclusions. AB - This paper examines the research evidence on the question of whether sustained use of marijuana may produce chronic cerebral impairment as measured by neuropsychological measures. Evidence from both American and cross-cultural studies suggests that marijuana probably does not produce chronic cerebral impairment, although subtle impairment cannot be ruled out. Several suggestions for new lines of research are discussed including prospective studies, effects of cannabis use on later aging processes, and true experimental studies. PMID- 3527997 TI - Clinical trial with arginine tidiacicate in symptomatic chronic persistent hepatitis. AB - In a double-blind study, 50 patients with chronic persistent hepatitis were assigned at random to two treatment groups. One group was given arginine tidiacicate (ATCA) at the dose of 400 mg tablets three times a day and the other given a placebo, both for 30 days. The group of patients receiving ATCA showed a clear-cut improvement of subjective symptoms and of the most important cytolysis and cholestasis parameters studied, such modifications being greater than in the placebo group. Drug tolerance was excellent, since no side-effects were observed. PMID- 3527998 TI - Current topics in sports medicine. International Symposium of the German Federation of Sports Medicine on the occasion of the 60th birthday of Prof. Wildor Hollmann, M.D., D.h.c. Cologne, February 2, 1985. PMID- 3527999 TI - Development of sports medicine in the Federal Republic of Germany from 1950 to the present. PMID- 3528000 TI - 2nd Symposium on Handling of Environmental and Biological Samples in Chromatography. October 24-25, 1985, Freiburg, West Germany. Issue dedicated to Professor J.F.K. Huber on the occasion of his sixtieth birthday. PMID- 3528001 TI - Automatic headspace sampling for determination of ethylene dibromide residues in cereals. AB - The possibility was investigated to apply a commercially available automatic head space sampler in trace analysis of ethylene dibromide (EDB, 1,2-dibromoethane), in cereals. Samples of rice and wheat flour were thermostatted in closed vials at 70 degrees C for 30 min. The top gas was then automatically introduced into a gas chromatograph equipped with an electron capture detector. Quantitation was performed using external standards (untreated samples spiked with solutions of EDB in N,N'-dimethylacetamide). The relative standard deviation of the method was 3.4% for rice and 4.5% for wheat flour, at a residue level of 0.008 mg/kg. The detection limit was 0.001 mg/kg (the official EC residue tolerance is 0.01 mg/kg). Preliminary experiments with other fumigants were carried out as well. The headspace technique in question has the following advantages over other methods for determining EDB residues in cereals: 1. No sample pre-treatment like extraction, steam distillation, purge and trap etc.; 2. Automated sample handling; 3. "Clean" chromatograms. PMID- 3528002 TI - President of the Sixth International Congress of Parasitology: the life and work of William Percy Rogers, with an appreciation of his contribution to parasitology. PMID- 3528003 TI - The periparturient rise in fecal egg counts in three strains of Florida Native ewes and its value in predicting resistance of lambs to Haemonchus contortus. PMID- 3528004 TI - Parasitology in Brisbane. PMID- 3528005 TI - Immunization against Taenia taeniaeformis in mice: identification of oncospheral antigens in polyacrylamide gels by Western blotting and enzyme immunoassay. PMID- 3528006 TI - Excretion of Trypanosoma cruzi by various stages of Rhodnius prolixus. PMID- 3528007 TI - Neuropsychiatric assessment of liver transplantation candidates: delirium and other psychiatric disorders. AB - Forty consecutive liver transplantation candidates underwent a standard psychiatric evaluation as part of a multidisciplinary preoperative examination. Psychiatric diagnoses were determined using DSM-III criteria and correlations between the psychiatric diagnoses and the results of bedside cognitive examinations, biochemical measures of hepatic function, and EEG's were made. Half of the patients could not be given a specific psychiatric diagnosis despite the fact of their being in terminal stages of a severe medical illness and being stressed by the uncertainty of whether they would be accepted for possible liver transplantation. Of the twenty patients given a psychiatric diagnosis, 60 percent were found to be delirious and 35 percent had an adjustment disorder. Delirium was associated with a serum albumin less than 3.0 g/dl, grades 1 through 3 EEG dysrhythmias, a Mini Mental State score less than 24 or impairment on Trailmaking Tests. In addition, discriminant analyses were performed to determine which batteries of tests best differentiated the delirious patients. A unique pattern of psychosocial stressors was noted in these patients where the severity of overall stress and of occupational dysfunction was high in most, yet family and social relationships were reported as less affected. PMID- 3528008 TI - Denial as a defense against depression in end-stage renal disease: an empirical test. AB - End-stage renal disease (ESRD) is recognized as imposing severe psychosocial stresses upon patients with the result that depression is believed to be highly prevalent. A number of studies have reported low levels of depression, however, and this contradictory finding has been explained via the construct of defensive denial-i.e., patients may minimize the impact of illness-related experiences upon their overall experiences of life. The present study tested this hypothesis in a sample of seventy ESRD patients. Participants rated a series of twelve life dimensions (e.g., work, family and martial relations, recreation) in terms of perceived intrusiveness and control as well as indicating their perceived similarity using a card sort task. Standard measures of depression, positive and negative moods, somatic symptoms of distress, self-esteem, and life happiness were also obtained via structured interviews. A multidimensional scaling analysis applied to the card sort data indicated that ESRD patients do, indeed, perceive illness-related and nonillness aspects of life as independent. However, an analysis of partial variance-controlling for age and nonrenal health-failed to provide evidence of defensive denial. The suggestion is forwarded that previous findings of a high prevalence of depression in ESRD may be in error due to the misidentification of uremic symptoms as symptoms of depression. PMID- 3528009 TI - Measurement of chronic pain in pain-depression literature during the 1980s: a review. AB - Measurement of pain is a new area of study. This review is based on a survey of pain-depression literature of the 80s. In general terms, measurement of pain is a neglected field. In most of the studies reviewed here pain is either not measured or measured somewhat crudely. Only in a minority of studies is there evidence of recognition that pain-measurement is a critical part of the overall clinical evaluation of chronic pain patients. PMID- 3528010 TI - Reflections on Sigmund Freud's relationship to the German language and to some German-speaking authors of the enlightenment. AB - The discussion of the papers of Anzieu and Ticho on 'The Influence of the German Language Culture on Freud's Thought' concentrates on two aspects of the theme. Firstly, the question is considered in how far specific individual words (e.g. 'Trieb'), as well as specific basic grammatical structures of the German language (e.g. certain forms of the passive voice; the flexibility in changing between the parts of speech) made the verbal grasp of unconscious and preconscious phenomena easier for Freud, i.e. facilitated the conceptualization of psychoanalysis. The second aspect deals with the young reader Freud's predilection for those German speaking authors--from Lessing to Heine--writing in the Enlightenment tradition. identification with these critical, rebellious thinkers contributed to the consolidation of Freud's personality. He himself stressed again and again the overriding importance of his steadfastness of character and his disbelief in authority for his life's achievement: the discovery of the unconscious in spite of inner and outer resistance. PMID- 3528011 TI - Eugenio Gaddini (1916-1985). PMID- 3528012 TI - The biological effects of radiofrequency radiation: a critical review and recommendations. AB - Exposure of the general public and in particular certain occupational groups to radiofrequency radiation (RFR) is ubiquitous and of growing concern. No clear and widely accepted understanding of the biological effects and health implications of such RFR exposure has emerged. This paper reviews the data available, including reports of RFR effects on single cells or cell components, on genetic composition or development, on developed organs, tissues, or cell systems, and on integrative and regulatory biological systems. Reports of RFR effects on the immunological system, with consideration of the influence of neuroendocrine responses, are critically reviewed in greater detail to illustrate important points regarding data acquisition and assessment, and understanding and application of the RFR bioeffects literature in general. Factors affecting RFR bioeffects research are reviewed, and recommendations for future studies are provided. PMID- 3528013 TI - Radiation chemical and physical mechanisms of radiosensitization of single cell systems by iothalamate. AB - The radiosensitizing effect of iothalamate (ITA) has been investigated in bacterial and mammalian cells in order to obtain a better understanding of the physical and radiation chemical mechanisms of sensitization displayed by the drug. In order to distinguish between the two, Escherichia coli B/r cells were irradiated with 9 MeV electrons, which allow only the radiation chemical mechanism to operate, and V79 cells with 250 KVp X-rays, which instead make possible the occurrence of both mechanisms. It has been shown that: Maximum sensitization already occurs in bacteria with 10(-2) mol dm-3 ITA (enhancement ratio (ER) 11.2 in oxygen, 2.7 in nitrogen), while in mammalian cells a concentration higher by a factor of 10 is required (ER 2.2 both in air and nitrogen). ITA sensitization is inhibited when bacteria are irradiated in growth medium instead of buffer. Such inhibition does not occur with V79 cells. Cysteine and glycerol completely cancel the sensitizing effect of ITA on bacterial cells in both gas phases. Dimethylsulphoxide (DMSO) does the same in nitrogen, while in oxygen it only reduces ITA sensitization to about 50 per cent of the level observed in control conditions. With mammalian cells, all the three scavengers do not modify significantly the enhancement produced by ITA, either in air or in nitrogen. The experimental results are consistent with both postulated mechanisms of sensitization. PMID- 3528015 TI - Expectancy and response to meditation. PMID- 3528014 TI - Helping deaf children acquire language: lessons from the past. PMID- 3528016 TI - The function of teleost fish lymphocytes in relation to inflammation. AB - Teleost fish exhibit inflammatory reactions which closely resemble those of mammals, but little is known about the mechanisms of inflammation in fish. While the leucocytes associated with inflammatory responses of fish bear close morphological similarity to those of mammals, it is not yet clear how comparable they are in function. Recently much work has been done to investigate the presence of lymphocyte subpopulations in fish, and while much of the data suggest the presence of mammalian T- and B-like lymphocytes the situation is still not clear and important differences appear to exist. Less information is available on the function of other inflammatory cell types, the neutrophils and macrophages, but once again differences between these cells in fish and mammals are apparent. The largest group of fish (the teleosts) comprises over 16,000 species which are widely evolved and differences between species should be expected and are indeed evident. Generalization concerning physiological responses of fish should therefore be made with caution. PMID- 3528017 TI - Nosocomial infections in 15 rural Wisconsin hospitals--results and conclusions from 6 months of comprehensive surveillance. AB - Fifteen rural Wisconsin acute care community hospitals with an average approved bed size of 55 and an average daily census of 28 patients participated in a nosocomial infection control project. Each hospital Infection Control Practitioner (ICP) was trained and conducted prospective nosocomial infection surveillance on all patients admitted to the hospital for 6 consecutive months between May 1, 1984 and April 30, 1985. Two hundred twenty nosocomial infections were reported among 13,420 discharged patients for an incidence rate of 1.64 infections per 100 discharged patients. One hundred sixty-four patients had one nosocomial infection. Twenty-three patients had two or more. Infection rates were highest among gynecology--4.9% and general surgery patients--4.0%, and lowest among newborns--0.3% and pediatric patients--0%. 39.7% of the infections were of the urinary tract, 27.9% of surgical wounds, 16% pneumonia, and 1.4% primary bacteremia. The other infections were in seven additional sites. Risk factors associated with acquisition of infections included old age, urinary catheterization, and/or a surgical procedure. The overall nosocomial surgical wound infection incidence for inpatient procedures was 1.9%, with incidences of 0.4% for hernia repair, 1.3% for cholecystectomy, 3.3% for appendectomy, 4.0% for total abdominal hysterectomy, and 3.9% for cesarean sections. The incidence of nosocomial infections was 2.7 infections per 100 discharged patients age 65 years or over and 0.9 infections per 100 discharged patients less than 65 years.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3528018 TI - When should we use urine cultures? PMID- 3528019 TI - Organization of biological systems: some principles and models. PMID- 3528020 TI - Control of the expression of genes for DNA ligase in eukaryotes. PMID- 3528021 TI - Conversion of malignant cells into normal ones. PMID- 3528022 TI - The migration of neural crest cells. PMID- 3528023 TI - [Allergic and pseudoallergic reactions to drugs]. PMID- 3528024 TI - [Atopic syndrome. Clinical aspects, prevention, therapy]. PMID- 3528025 TI - [Visceral larva migrans infection caused by Toxocara with bilateral exudative pleurisy]. PMID- 3528026 TI - [Acute thoracic pain: caused by a bronchial carcinoid]. PMID- 3528027 TI - [Tumor-like pneumonia--case report of clinical aspects and diagnosis of legionellosis]. PMID- 3528028 TI - [Psychology of the pain experience]. PMID- 3528029 TI - [Pharmacology of peripherally acting analgesics]. PMID- 3528030 TI - [Local pain management]. PMID- 3528031 TI - [Clinicopsychologic pain management]. PMID- 3528032 TI - [Organized treatment of pain. Determination of status]. PMID- 3528033 TI - Investigations of cytoskeletal elements in cultured bovine meshwork cells. AB - An ultrastructural, immunohistochemical, and functional study was conducted on cultured bovine meshwork cells. Particular emphasis was placed on the organization of the cytoskeleton, and the cells were viewed either as whole cells or following detergent extraction. For ultrastructural examination, several modes of viewing were adopted, including a detector situated above the specimens collecting secondary electrons (SE), a detector situated beneath the specimen collecting transmitted electrons (STEM), and conventional transmission electron microscopy at 100 KV (TEM). In whole cell mounts, information was obtained about the organization of the cytoskeleton and its relationship to other cytoplasmic organelles. Extraction procedures removed much of the plasma membrane and most organelles. The nucleus and cytoskeleton remained and stress fibers were prominent. Immunohistochemistry showed that the actin content of the cytoskeleton could be preserved after detergent extraction. Detergent-extracted cells decreased their surface area when exposed to MgATP in a dose-dependent manner. The decrease in surface area was associated with disassembly of cytoskeletal stress fibers and was optimal with 1 mM MgATP. Whether or not the change in surface area could be considered a "contractile event" was discussed. PMID- 3528034 TI - Distribution of the regulatory subunit of type II cAMP-dependent protein kinase in Y-79 retinoblastoma cells. Effect of butyrate. AB - An indirect immunofluorescence technique was employed to determine the intracellular distribution of the regulatory subunit of type II cyclic adenosine 3':5'-monophosphate-dependent protein kinase (RII) in Y-79 human retinoblastoma cells growing in monolayer culture. During the initial phases of growth (6 hr-6 days after seeding), RII was confined to the cytoplasmic areas of the Y-79 cells, seemingly, the Golgi apparatus. Treatment of cells for 3-5 days with 4 mM butyrate resulted in translocation of RII from cytoplasm to nuclei (mainly nucleoli) of cells. In a later stage of growth (24-day-old cultures), RII immunofluorescence was significantly decreased in all compartments within the untreated cells. In contrast, about 70% of the butyrate-treated cells yet showed nucleoli and/or cytoplasmic localization of RII at this stage. The nucleolar appearance of RII was parallel to the growth arrest and differentiation induced by butyrate. PMID- 3528035 TI - Radioisotope labeled platelets in medical diagnosis. AB - The myriad of applications of indium-111 labeled platelets (111In-P), both in biomedical research and clinical diagnostic imaging, in recent years is an index of the potential of this technology. Because many diseases involve the vascular system, a nontoxic platelet label suitable for imaging has immense potential for diagnosis. Presently confined to research centers, this technique is currently used in three main diagnostic situations: deep vein thrombosis, cardiac thrombi, and organ (renal) transplantation rejection. Future applications will proliferate when difficulties in achieving rapid labeling are overcome, and the period between study initiation and final diagnosis is diminished. This review emphasizes current clinical applications and the potential role of this technology in diagnostic imaging. PMID- 3528037 TI - Quantitative assessment of burn injury in porcine skin with high-frequency ultrasonic imaging. AB - Early excision and grafting of full thickness burns has been shown to decrease morbidity and mortality. Errors made in assessing acute burn depth are common and result in prolonged hospitalization in expectant healing of full-thickness burns and in unnecessary excision and grafting of potentially regenerative partial thickness burns. High-frequency ultrasonic imaging may be a noninvasive, convenient means of quantitating burn depth. A depth analysis system for imaging burned skin was developed using a high-frequency 18.5 MHz (nominal 25 MHz) pulse echo ultrasound system with a longitudinal resolution of 86 mu. Five adult mini swine (15 kg) were burned with a temperature-(190 degrees C) and pressure controlled (236 g/cm2) burning iron. A series of burn durations (1-45 seconds) was used to inflict partial- and full-thickness burns of various depths. Ultrasonic scans of the acutely excised burns were performed across the lateral margin of the burn, including adjacent normal skin to serve as control. Direct histologic comparison was made with each scan plane. Average burn and normal skin depth measurements were made by independent observers for 34 scans and corresponding histologic sections. A significant correlation was achieved between burn depth and percent burn (burn depth/adjacent normal skin depth) as measured by ultrasound and histology (R = 0.90, t = 11.2, P less than .001). PMID- 3528036 TI - Cross-sectional area measurements by digital subtraction videodensitometry. AB - A method for measurement of absolute cross-section areas in digital images of iodine-opacified vessels was tested in phantoms containing "normal" segments of circular cross-section and either circular or noncircular "stenoses" over a wide range of iodine concentrations. Accuracy varied with iodine concentration, with a slight tendency to overestimate the area at high concentration (185 mg I/ml) and to underestimate at low concentration (23 mg I/ml). Reproducibility was improved at the higher concentrations, with standard deviation ranging from 2% to 7% of the measured value, compared with 7% to 27% at the lowest concentration. Accuracy and reproducibility of area measurements on either normal or stenotic segments were unchanged by rotation of the vessel by up to 25 degrees out of the plane of the image. This method is easily implemented using computerized image processing techniques and has advantages over either manual or automated edge detection because it eliminates the need for an edge criterion and is independent of the viewing projection. PMID- 3528038 TI - Right upper quadrant pain and tenderness in a young man. PMID- 3528039 TI - Pet associated illness in Ireland: a review. PMID- 3528040 TI - Biographical sketches--66. Eijkman. PMID- 3528041 TI - Planning and implementation of large clinical trials. AB - The large-scale collaborative clinical trial has become an important activity in the biomedical research spectrum. It is the clinical trial that determines most precisely the efficacy of treatment of preventive regimens. These large studies, which usually cost tens of millions of dollars and use large numbers of research facilities, have a major impact on research and medical practice. Consequently, it is required that a number of factors be carefully assessed before any such study is undertaken. A formalized decision process has been developed by the National Heart, Lung and Blood Institute to aid in the formulation, design, conduct, analysis and dissemination of the results of clinical trials. This decision process, which provides a planning framework for the trial, is described here. The framework is constructed around three major decision points at which resources are committed: to plan the trial, to conduct the trial, and to terminate and disseminate the results of the trial. PMID- 3528042 TI - Evidence used for approval of new drugs. AB - New drugs in the United States are studied under investigational new drug exemptions. Commercial sponsors then gather the accrued data into a new drug application to support safety and effectiveness for marketing. The Food, Drug and Cosmetic Act of 1938, as amended in 1962, requires that effectiveness of a drug for its intended use be demonstrated by substantial evidence, consisting of adequate and well-controlled investigations, including clinical investigations, by experts qualified by training and experience to evaluate the drug. Safety must be demonstrated by appropriate methods. Although a certain nucleus of information is essential for all drugs, flexibility in testing is desirable in many areas. For each drug, the design and number of clinical studies vary. The number of patients, the type of patient population, and the kind of special studies to elucidate the mechanism of action or explore particular pharmacologic properties are chosen by the sponsoring pharmaceutical company. Data on effectiveness or on adverse reactions may be generated in the U.S. or in other countries. PMID- 3528043 TI - Evaluation of new diagnostic imaging technologies. AB - New imaging technologies have to be evaluated for safety and for utility taking into account the uniqueness of the biological feature examined, the quality of the anatomical visualization, and accuracy of diagnosis. Comparative studies establish whether the new technology complements or replaces older methods, and what contribution it makes to therapeutic strategies. Historically, there were three phases: that of the great lone innovators, from whose efforts new techniques diffused; that of the large cooperative studies by academic clinicians and, recently, with the advent of MRI (magnetic resonance imaging), the phase of publicly appointed assessors, such as the FDA (Food and Drug Administration, USA). The methods of the latter two are detailed and critically compared. Evaluation in the clinical setting is more comprehensive. Therapeutic benefit, and not just image quality, has to be the ultimate consideration. PMID- 3528044 TI - Prenatal diagnosis of genetic diseases. AB - The prenatal diagnosis of genetic disorders has become one of the most important tools in medical genetics and has changed the face of genetic counseling. Over 100 inherited metabolic diseases, all chromosomal abnormalities and a number of major congenital malformations can already be diagnosed at relatively early stages of fetal development. Various techniques at different stages of pregnancy are presently available. The earliest procedure, using chorionic villus biopsies, can be performed at approximately 8 weeks of gestation; however, the safety and efficacy of this method are not clear. Amniocentesis is performed at 16 weeks of gestation, and analyses of amniotic fluid and amniocytes are still the most commonly used diagnostic procedures to detect genetic disorders in the fetus. Moreover, real-time ultrasonography and fetoscopy permit the detection of a large number of fetal structural abnormalities in the second trimester of pregnancy through fetal blood samples, fetal skin biopsies, and observation of the fetal external anatomy. PMID- 3528045 TI - Clinical trials of bone marrow transplantation. AB - Bone marrow transplantation is increasingly used to treat a spectrum of diseases in man, including immune and genetic disorders, hematological diseases, and cancer. Approximately 11,000 transplants have been performed worldwide since 1970. About two-thirds of these transplants have involved donors, including related and unrelated individuals, and in the remaining third the patient's bone marrow has been used in the form of an autotransplant. In some disorders and under carefully defined circumstances, bone marrow transplantation appears to be the preferred therapy; these diseases include aplastic anemia, acute myelogenous leukemia, acute lymphoblastic leukemia, chronic myelogenous leukemia, and selected immune and genetic disorders. In other circumstances, the value of bone marrow transplantation is less well defined. Diseases in which bone marrow transplantation may be of benefit include Hodgkin's and non-Hodgkin's lymphoma, other cancers, thalassemia, hemoglobinopathies, genetic disorders, and possibly multiple myeloma. It has been difficult to precisely identify the role of bone marrow transplantation in many of these diseases. Prospective randomized controlled clinical trials have sometimes shown an advantage for bone marrow transplantation, but in most circumstances a benefit is as yet unproven. In the U.S. the annual incidence of individuals with diseases in which bone marrow transplantation is thought to be of proven benefit is approximately 5,400, and an additional 15,000 individuals annually have diseases in which bone marrow transplantation is thought to be of possible benefit. This study reviews data available from both controlled and uncontrolled clinical trials indicating the potential role of bone marrow transplantation in the treatment of human diseases. PMID- 3528046 TI - New approaches for the prevention of rejection and graft-vs.-host disease in clinical bone marrow transplantation. AB - The two major barriers to successful allogeneic bone marrow transplantation (BMT) in animals and man are graft-vs.-host disease (GVHD) and the risk of graft rejection. GVHD is the result of alloreactivity of mature donor T-lymphocytes present in the graft-vs.-host tissues and can be completely prevented by pregraft depletion of T-lymphocytes. Graft rejection results from residual host immunocompetent lymphocytes that survive heavy chemoradiotherapy prior to allogeneic BMT. Host resistance to allograft cannot be eradicated even by conventional conditioning with high-dose cyclophosphamide (120 mg/kg) and lethal whole body irradiation (1,200 rad). In the present report we have utilized two new techniques to overcome GVHD and graft rejection following allogeneic BMT. GVHD can be prevented by a new monoclonal rat antihuman lymphocyte antibody, CAMPATH-1, which binds human complement, enabling donor serum to serve as the source of complement. Prevention of rejection of T-lymphocyte-depleted marrow allografts can be achieved by the application of total lymphoid irradiation (TLI) in addition to conventional chemoradiotherapy, prior to allogeneic BMT. TLI causes potent immunosuppression with minimal side effects. A combination of TLI for overcoming host resistance to allograft, and CAMPATH-1 for overcoming GVHD, leads to a relatively smooth posttransplant outcome with no evidence of GVHD and with no need for posttransplant immunosuppression. PMID- 3528047 TI - Development and approval of vaccines in the United States. AB - In the United States, vaccines and the establishments in which they are manufactured are required to be licensed by the Food and Drug Administration (FDA) before the vaccine can be marketed. This licensing process, as well as the development and investigation of vaccines, is regulated by the FDA's Office of Biologics Research and Review. An application for licensing must contain information supporting the safety, effectiveness, purity and potency of the product. These are data obtained during the investigational phase and then submitted by a commercial sponsor for review and approval. Inspections, surveillance and laboratory testing are performed by the FDA before and after issuance of a license for marketing. The procedures and policies in the investigational and licensing phases of vaccine development are described. PMID- 3528048 TI - Prenatal ultrasonic diagnosis of fetal thoracic and intrathoracic abnormalities. AB - Seventeen cases of different types of fetal thoracic and intrathoracic abnormalities were diagnosed prenatally by ultrasound: nonimmune hydrops (5 cases), diaphragmatic hernia (3), Potter's syndrome (3), chylothorax (1), exstrophy of the cloaca (1), the extreme form of prune-belly syndrome (2), cystic hygroma (1) and short rib polydactyly syndrome (Majevski type) (1 case). The ultrasonic features of nonimmune hydrops, diaphragmatic hernia, Potter's syndrome and cystic hygroma are well recognized by most experienced sonographers. The ultrasonic prenatal diagnosis of exstrophy of the cloaca, a very rare entity, has not been reported previously. The condition consists of a large infraumbilical anterior abdominal wall defect, lumbosacral myelomeningocele, and fetal ascites. The extreme form of prune-belly syndrome is associated with the absence of the abdominal wall musculature and marked dilatation of the urinary tract, presented ultrasonically as multiple large cysts occupying the distended fetal abdominal cavity. In exstrophy of the cloaca, prune-belly syndrome, Potter's syndrome and short rib polydactyly syndrome the chest abnormality is similar-extreme shortening of the thoracic cage, which has various causes. The differential diagnosis of all these entities and guidelines for their correct prenatal ultrasonic diagnosis are presented. PMID- 3528049 TI - Treatment of congenital immune deficiencies with a thymic hormone--thymic humoral factor. AB - Five infants with congenital immune defects are presented. Three had various combined immune deficiencies (CID) and two had thymic deficiencies only. As bone marrow or thymus transplantations were not feasible in these patients, we attempted treatment with thymic humoral factor (THF), a thymic hormone, by daily i.m. injections during biweekly courses. In one CID patient, a partial improvement in immune indices and temporary clinical improvement were achieved. In the other two, THF did not arrest the patients' demise. The two patients with thymic dysplasia benefitted repeatedly from THF treatment, as exemplified by the disappearance of wasting, diarrhea and infections and by reconstitution of T cell parameters. Nevertheless, the patients relapsed after prolonged periods without THF administration. We therefore propose the administration of long-term, continuous or intermittent thymic hormone replacement therapy in infants with congenital thymic defects. Early diagnosis and immediate institution of treatment will probably improve prognosis. PMID- 3528050 TI - Primary pulmonary aspergilloma: case report and review of the literature. AB - We describe a patient with acute leukemia who developed a primary aspergilloma. A combination of surgical resection and parenteral amphotericin B cured the lesion. The pathophysiology, diagnosis and treatment of primary pulmonary aspergilloma are reviewed. PMID- 3528051 TI - Health care for veterans: the limits of obligation. AB - The federal government has a generally unquestioned obligation to provide health care to veterans for diseases or disabilities acquired during military service. Much argued, however, is the government's obligation to offer care for nonservice connected disorders. The Reagan administration has sharpened the debate recently by attempting to impose a means test on veterans over sixty-five who are seeking such care. But the controversy focuses on the wrong issue. Society has a moral obligation to provide adequate health care to all citizens but has no special obligation to care for nonservice-connected health problems of veterans. PMID- 3528052 TI - Once a soldier, always a dependent. AB - Why are veterans entitled to special benefits, such as free medical care? Not because such a benefit is an inducement to military service, or because a soldier accepts risk. Rather, the relationship of the Army, to use one service as an example, to a soldier is like that of a parent to a child. The right to health care, even carried beyond the term of service, is an extension of this quasi familial relationship. PMID- 3528053 TI - Setting the record straight on organ sales. PMID- 3528054 TI - Epidemiological evaluation of radiation risk using populations exposed at high doses. AB - Reasons are discussed for basing cancer risk estimates of low-dose radiation effects on extrapolations from populations exposed to high doses, rather than directly on studies of low-dose effects. Some of the major studies used for this purpose are described, together with difficulties encountered in extrapolating from them. Some recent statistical work to aid the evaluation of radiation risk from these studies is reviewed. PMID- 3528056 TI - Complications following laryngectomy. AB - The complications following 100 consecutive laryngectomies performed at our hospital during a recent 18-month period are reviewed. The complication rates for total laryngectomy (63 patients) and extended laryngectomy (37 patients) were 19% and 49%, respectively, while the fistula rates were 8% and 27%, respectively. These rates were influenced primarily by the extent of surgery and the type of reconstruction, which during this interval included primary closure, pectoralis major myocutaneous flap, or gastric transposition. In comparison to our previous study, when the deltopectoral flap was used for patching the pharynx, the fistula rate for extended laryngectomy has decreased as a result of our use of myocutaneous flaps and greater experience with gastric transposition. Currently, we use the pectoralis major myocutaneous flap for pharyngeal repair if the mucosa would otherwise be closed under tension. All circumferential defects are repaired with a gastric transposition. PMID- 3528057 TI - Identification and management of the patient at high risk for wound infection. AB - Despite the use of perioperative antibiotics, wound infection remains a major source of morbidity after contaminated head and neck cancer surgery. Most adjunctive methods designed to control wound infection include techniques to reduce bacterial wound contamination. Additional methods include predicting the high risk patient and the bacteriology of subsequent wound infection, which allows antibiotic prophylaxis to be used on a selective basis. This article reviews relevant experimental and clinical data that evaluated these methods. Based on these results, as well as personal observations, guidelines are suggested for controlling wound infection in patients undergoing contaminated head and neck surgery. PMID- 3528055 TI - Survival results from a phase III study of simultaneous versus 1-hour sequential methotrexate-5-fluorouracil chemotherapy in head and neck cancer. AB - There were 79 patients with squamous cell head and neck cancer randomized to receive simultaneous or 1 hour sequential methotrexate-5 fluorouracil (MTX--5-FU) chemotherapy: 47 patients were previously untreated and 32 patients had recurrent disease. The treatment groups were comparable for important prognostic features. The median survival for the 47 newly presenting patients was 22 months and for recurrent disease patients was 14 months. No difference could be detected in the survival of patients who received simultaneous versus sequential chemotherapy. When only chemotherapy responders were compared, no difference in survival was detected for those who received sequential versus simultaneous therapy. Subsequently, 19 chemotherapy responders received radical radiation therapy, and 15 were rendered disease-free whereas only 4 of 17 chemotherapy nonresponders were rendered disease-free by subsequent radiation (P = .002). The survival of the 19 chemotherapy responders was 34 months compared with 16 months for the 17 chemotherapy nonresponders treated with radiation. We conclude that there is no therapeutic advantage for 1 hour sequential MTX-5 FU chemotherapy compared with simultaneous use of these drugs in squamous cell head and neck cancer. Chemotherapy responders are more likely to respond to radiation therapy. PMID- 3528058 TI - Basal cell adenoma with myoepithelial cell-derived "stroma": a new major salivary gland tumor entity. AB - The light microscopic, immunohistochemical, and ultrastructural features of a unique variant of tubular-trabecular basal cell adenoma are described. The unusual feature of the six examples reported is the richly cellular "stroma" composed of spindle cells coursing between the anastomosing cords of epithelial tumor cells. Immunohistochemistry of all six cases and electron microscopy of two examples illustrated the biphasic differentiation of the epithelial portion of this form of basal cell adenoma, with a central core of duct luminal cells bordered on either side by one or more layers of modified myoepithelial cells. By light microscopy, the features and arrangement of cells in "stromal" regions of this tumor convey a fibroblastic derivation. However, this population of cells stains strongly for S-100 protein, ultrastructurally displays excessive external lamina production, intercellular junctions, and a growth pattern unlike fibroblasts, and is involved in the formation of extracellular mucinous materials. Such aspects indicate a second population of neoplastic myoepithelial cells in this tumor. Thus, this form of tubular-trabecular basal cell adenoma displays tricellular differentiation and, perhaps, may be considered either a hybrid basal cell adenoma and myoepithelioma or a cellular pleomorphic adenoma. PMID- 3528059 TI - [Transplantation of cold-preserved hepatocytes in the therapy of acute liver failure in rats]. PMID- 3528060 TI - [Ambroise Pare's "reigles chirurgiques" (1510-1590)]. PMID- 3528062 TI - Frequency and distribution of Candida species from denture wearers. PMID- 3528061 TI - Reverse phase high-performance liquid chromatography and secondary ion mass spectrometry. A strategy for identification of ten human hemoglobin variants. AB - Ten abnormal hemoglobins were detected and characterized in individual cases referred to our laboratory for evaluation of hematological problems. Six of these variants were electrophoretically silent and could be detected by reverse phase high-performance liquid chromatography (HPLC) analysis. HPLC was also used to analyze the tryptic peptides of each individual variant. In most of these variants, secondary ion mass spectra of the mixture of the tryptic peptides could reveal the aberrant peptide and predict possible substitution through the mass difference between the normal and abnormal peptide. The mass spectra of the isolated abnormal peptide generally contained sufficient fragment ions to define the position of the amino acid substitution, obviating the need for lengthy sequencing procedures. Combination of the two techniques. PMID- 3528063 TI - Attenuated Mycobacterium lepraemurium vaccine non-protective against Mycobacterium intracellulare infection in mice. PMID- 3528064 TI - Immunohistochemistry in the analysis of mouse aggregation chimaeras. AB - We have used cellular mosaicism in chimaeric mice to study the clonal organization of normal tissues. The mosaicism has been demonstrated in sections and in whole mounts of intestinal epithelium, aortic endothelium and retinal pigment epithelium using H2 antigens and a carbohydrate polymorphism recognized by Dolichos biflorus lectin as strain-specific markers. The results show that the epithelium of each adult intestinal crypt is derived from a single progenitor cell. Because crypts of differing genotype may contribute cells to the same villus, the pathways of cell migration up the villi can be demonstrated. The ability to stain mosaic patches in two dimensions in large intact sheets of epithelium has permitted a more satisfactory analysis in terms of clonal development than was previously possible with data from tissue sections. We have adapted statistical procedures from plant ecology to examine the scale of clustering of patches of like genotype, and thence to recognize 'descendent' clones, i.e. groups of cells which are not contiguous, but are related by descent from a common ancestor in embryogenesis. PMID- 3528065 TI - The effects of mechanical stability on the macromolecules of the connective tissue matrices produced during fracture healing. I. The collagens. AB - The distribution of types I, II, III, V and IX collagens in healing fractures of the rabbit tibia has been demonstrated by immunofluorescent techniques. It has also been shown that the mechanical stability of the healing fracture affects both the distribution and types of the collagens present. The initial fibrous matrix contains types III and V collagens; type I collagen was only located in this matrix if unfixed tissue was used. In mechanically stable fractures, cancellous bone forms over the entire periosteal surface by 5-7 days; type I collagen is laid down within the previous fibrous matrix. The trabeculae are heterogeneous in their collagen content. The cavities contain a matrix of types III and V collagens. Small nodules of cartilage may be present between 7 and 14 days; these contain types II and IX collagens. In mechanically unstable fractures, cancellous bone is initially formed away from the fracture gap. The fibrous tissue over the gap is replaced by cartilage; types II and IX collagens are laid down on the pre-existing fibrous matrix. The cartilage is replaced by endochondral ossification. At the ossification front, type I collagen is found around the chondrocyte lacunae of the spicules of cartilage. The new trabeculae contain a core of cartilage which is surrounded by a bone matrix of types I and V collagens. The fracture gaps are invaded by fibrous tissue, which contain types III and V collagens. this is later replaced by cancellous bone. PMID- 3528066 TI - Chromosomal localization of genes by scanning electron microscopy using in situ hybridization with biotinylated probes: Y chromosome repetitive sequences. AB - The feasibility of using scanning electron microscopy (SEM) to identify the position of specific DNA sequences was examined using a Y chromosome 'specific' probe (pHY2.1). Tests were carried out on chromosome spreads hybridized in situ with biotinylated pHY2.1. Chromosomal sites of hybridization of the probe were localized by an indirect immunohistochemical procedure which resulted in a gold product which could be amplified by silver precipitation. In the SEM, the specific location of the probe was easily identified due to the enhanced signal produced by the gold-silver complex. The probe was localized both on the long arm of the Y chromosome and within interphase nuclei. It was found that SEM was more sensitive than light microscopy since the probe could be identified without silver amplification. With refinements to the technique, SEM could provide a useful method for high resolution localizing of unique DNA sequences (i.e. single copy genes). PMID- 3528067 TI - Polyamine cytochemistry: comparisons between cytochemical, autoradiographic, immunocytochemical and chemical results in the prostate. AB - Results obtained with two newly developed fluorescence cytochemical methods for detecting the polyamines spermidine and spermine have been compared to autoradiographic localization of biosynthetically labelled polyamines, to immunocytochemical results obtained with antibodies directed against spermidine and spermine, and to chemical polyamine determinations using the rat prostate as a model tissue. Complete agreement between all five methods was obtained. Application of perchloric acid to formaldehyde-fixed sections of rat prostate strongly reduced the o-phthalaldehyde inducible and formaldehyde-fluorescamine inducible fluorescence characteristic of spermidine and spermine. Perchloric acid extracted 40% of tissue-bound polyamines from formaldehyde-fixed tissue sections, and molecules with the physicochemical characteristics of polyamines constituted 80-90% of all fluorescamine reactive molecules extracted. Our results therefore confirm the specificity of the o-phthalaldehyde and formaldehyde-fluorescamine methods for polyamine cytochemistry. As polyamines are strongly implicated in cellular growth regulation and cancer, simple and inexpensive techniques for polyamine histochemistry may be useful for interpreting the biological and pathophysiological roles of these molecules. PMID- 3528068 TI - Immunohistochemical detection of glycogen phosphorylase isoenzymes in rat and human tissues. AB - Glycogen phosphorylase has at least three isoenzymes, i.e. muscle-, liver-, and brain-types. Antibodies have been raised against highly purified isoenzymes from rat muscle, liver and brain and found to react specifically to extracts from human muscle, liver and brain, respectively. Using these antibodies and the unlabelled antibody-enzyme method, each of the three isoenzymes has been localized in both rat and human tissues. PMID- 3528069 TI - Maternal nutrition and breast feeding. AB - In this short review we will first summarize current theories relating to maternal nutritional needs during human lactation, then deal with dietary situations where theory and experimental findings differ. In fact such a divergence occurs most of the time, both in affluent countries and especially in the Third World. We will then consider the various hypotheses which are currently being tested in an attempt to rationalize this complex but crucially important enigma. These hypotheses suggest that the mother can 'adapt' both physiologically and behaviourally in order to protect the adequate nutrition of her baby. Finally we will discuss the health significance of what happens when the mother's ability to accommodate the nutritional stresses of pregnancy and lactation fails. Although we have been asked to deal just with lactation, from time to time it will also become necessary to consider events occurring during pregnancy in order to place the nutritional stresses of lactation within a rational biological perspective. Whilst in the medical world, parturition tends to be a watershed event which divides one clinical specialty from another, in nutritional terms its main significance is merely that the mother switches feeding her baby from one part of her anatomy to another. In so far as her nutritional requirements are concerned pregnancy and lactation are part of the same continuum. PMID- 3528070 TI - Prospects for further approximation of infant formulas to human milk. AB - In this study: breast-fed babies developed a flora rich in bifidobacteria with lower counts of enterobacteria; bacteroides and clostridia, if detected were usually present in low numbers; formula-fed babies usually had high counts of bifidobacteria and enterobacteria; bacteroides plus clostridia were isolated with higher counts and from a larger percentage of babies than in the breast-fed group; and conalbumin did not appear to bring the gut flora of formula-fed babies nearer to that observed in breast-fed infants. PMID- 3528071 TI - Nutritional management of acute gastroenteritis--rehydration and realimentation. PMID- 3528072 TI - Allergenicity of feeds and gastrointestinal immunoregulation in man and experimental animals. PMID- 3528073 TI - Coeliac disease: ecology, life history and management. PMID- 3528074 TI - Review of current practices in management of inherited disorders of amino acid metabolism in Western Europe. AB - Phenylketonuria is still a brilliant example that early diagnosis, immediate onset of treatment and carefully controlled diet enable the patient to grow up normally. There are, however, other inherited disorders of amino acid metabolism in which the prognosis of the affected patients--despite some progress in the recent past--is still very poor. PMID- 3528075 TI - Renin activation in juvenile secretory granules? Immunocytochemical experiments with an antiserum directed against the prosegment of human renin. AB - In immunocytochemical experiments on human kidney tissue with an antiserum directed against the prosegment of renin, only juvenile granules were clearly labeled. As the concentration of renin increases from protogranules to more mature granules, while the concentration of its prosegment decreases to subthreshold levels, it is assumed that the cleavage of the prosegment, i.e. the activation of renin, takes place in juvenile granules parallel to the condensation of the enzyme. PMID- 3528076 TI - Co-localization of xenopsin and gastrin immunoreactivity in gastric antral G cells. AB - Studies indicating evidence for the presence of the amphibian octapeptide xenopsin in gastric mucosa of mammals prompted us to investigate the cellular localization of this peptide. Using the peroxidase-antiperoxidase method and a specific antiserum to xenopsin (Xen-7) on paraffin and adjacent semithin sections of gastric antral mucosa from man, dog, and Tupaia belangeri, we found numerous epithelial cells showing a specific positive immunoreaction. These cells were of typical pyramidal shape and could be classified as of the "open" type. Cell quantification in serial sections processed for xenopsin and gastrin immunoreactivity, respectively, revealed an identical number of cells per section and an identical distribution of these cells in the middle zone of the antral mucosa. Furthermore, adjacent semithin sections demonstrated the colocalization of xenopsin and gastrin immunoreactivity within the same G-cell. The xenopsin antiserum could be completely absorbed with synthetic xenopsin but not with gastrin. Preabsorption tests with neurotensin, a xenopsin related peptide, or with somatostatin, glucagon, and enkephalins gave no evidence for crossreactivity of the xenopsin antiserum with these peptides. It is concluded that gastric antral G-cells in addition to gastrin also contain the amphibian peptide xenopsin. PMID- 3528077 TI - Immunohistochemical demonstration of DNA-incorporated 5-bromodeoxyuridine in frozen and plastic embedded sections. AB - The application of an immunohistochemical method in the detection of replicating cells, that have incorporated 5-bromodeoxyuridine (BrdUrd), was studied on frozen and plastic embedded sections of different rat tissues. Hydrolysis conditions employed in the Feulgen procedure are essential in making the incorporated BrdUrd accessible to the monoclonal anti-BrdUrd antibodies. To demonstrate the incorporated BrdUrd in plastic embedded sections a subsequent etching with xylene and digestion with protease is necessary. Data obtained with this method are completely comparable with those found by the tritiated thymidine method. In comparison with the thymidine method, the BrdUrd method is much less time consuming and does not require precautions in working with radioactivity. The BrdUrd-method enables a more precise localization as is especially shown in the plastic embedded sections. PMID- 3528078 TI - Immunohistochemical detection of bromodeoxyuridine in formalin-fixed tissues. AB - Bromodeoxyuridine (BrdUrd) immunohistochemistry has recently been introduced for the visualization of DNA-synthesizing nuclei. In order to detect the BrdUrd incorporated into nuclear DNA in formalin-fixed, paraffin-embedded tissues, we tested several different pretreatment procedures including digestion with proteinase and hydrolysis with HCl, prior to immunoperoxidase staining. In order to determine the optimal conditions for detecting nuclear BrdUrd, mice were given BrdUrd and 3H-thymidine simultaneously, and the autoradiographic and immunohistochemical results obtained in BrdUrd-stained sections were compared. It was found that digestion with 0.05% proteinase at 37 degrees C for 20 min and hydrolysis with 1N HCl at 37 degrees C for 20 min was sufficient to detect BrdUrd immunoreactivity in 3H-thymidine-labelled nuclei, the results being virtually unaffected by the orders in which the two pretreatments were performed. Our method extends the range of application for BrdUrd immunohistochemistry in cell kinetic studies. PMID- 3528079 TI - Immunohistochemical observations of immunoglobulin A in the Paneth cells of germ free and formerly-germ-free rats. AB - The localization of secretory immunoglobulin A (IgA) in Paneth cells was immunohistochemically studied in germ-free (Gf) and ex-Gf rats that had been injected with feces obtained from specific-pathogen-free (SPF) rats. In Gf as well as SPF rats, the secretory granules of Paneth cells and the brush borders of crypt cells exhibited IgA immunoreactivity. At 12 and 24 h after inoculation, it was found that, concomitant with the occurrence of considerable degranulation, the IgA immunoreactivity in Paneth cells disappeared, except of the margin of supranuclear vacuoles. In contrast, the IgA immunoreactivity of the crypt-cell brush borders was unchanged. Four days after inoculation, secretory granules exhibiting IgA immunoreactivity reaccumulated in Paneth cells. The present study suggests that Paneth cells regulate the bacterial milieu in the intestine by releasing secretory granules containing IgA into the crypt lumen. PMID- 3528081 TI - Comparison of serotonin and 5-methoxytryptamine immunoreactivity in rat raphe nuclei. AB - We studied the immunoreactivity of 5-methoxytryptamine (MT) and 5 hydroxytryptamine (HT) in the raphe region of rats using specific polyclonal antibodies and the peroxidase/anti-peroxidase (PAP) technique. Overall, the patterns of the specific staining for these two antibodies were found to be the same in this region of the rat brain. The staining reaction was considerably less intense for MT than for HT. Specificity tests were performed using HT, MT and tryptamine (T) conjugates at concentrations of 5 X 10(-8) M for antibodies to HT and 2.5 X 10(-9) M for antibodies to MT. Although the distribution of HT-like and MT-like immunoreactivity broadly overlapped, the results obtained from adsorption specificity tests confirmed the presence of specific MT staining in the rat raphe. PMID- 3528080 TI - Colour development of immunogold-labelled antibodies for light microscopy. AB - We describe an improvement of the immunogold technique, which is based on the colour development of silver-intensified immunogold signals. This method (referred to as the coloured-SIG technique) was found to be as sensitive as the silver-intensified immunogold method and more sensitive (in two of the three tested systems) than immunoenzymatic procedures, such as the peroxidase/antiperoxidase technique or the avidin-biotin system. The coloured SIG method results in either a magenta-red or a cyan-blue final reaction product. Therefore, this new improvement of the immunogold technique should be useful in double-staining methods, immunoblot methods and conventional immunostaining methods. PMID- 3528082 TI - Fractionation of human bone-marrow mononuclear cells with peanut agglutinin: phenotypic characterization with monoclonal antibodies. AB - Bone marrow mononuclear cells were fractionated by affinity chromatography on immobilized peanut agglutinin (PNA). The resulting PNA+ fraction represented 10% of the total cell number. Twenty percent of the cells within the PNA+ compartment coexpressed the T6, Ia, Mo1, and My4 differentiation antigens and possessed Fc and C3 receptors. The similarity in cell surface antigen phenotype led us to hypothesize that this subset may be a cellular precursor of dendritic cells found in the skin (Langerhans cells) or in the parenchimal organs of the body (D cells). PMID- 3528083 TI - Pulmonary alveolar proteinosis complicated by cerebral abscess: report of a case. PMID- 3528084 TI - Autobiographical scrapbooks: a coping tool for hospitalized school children. PMID- 3528085 TI - Mechanisms of DNA repair and their potential modification for radiotherapy. AB - The potentiation of radiation damage, which can be accomplished by the inhibition of repair, is estimated from published studies of repair deficient mutants. Sensitization factors as high as 10 have been achieved. Because it has previously been suggested that the most probable lethal lesion is a DNA double strand break (DSB), it is not surprising that cells deficient in repairing this type of damage are the most radiosensitive. The structures of DNA DSBs and other Locally Multiply Damaged Sites (LMDS) (involving both single strand breaks (SSB) and base damage sites) are reviewed, together with the processes by which cells may attempt to repair these lesions. Repair processes occur in competition with damage fixation, again, mechanisms of damage fixation are predicted from studies in model systems. A strategy for inhibiting the repair processes is devised that consists of holding the first SSB constituent of the LMDS open by repairing in the presence of deoxynucleoside analogues, such as ara-C, so that there is a higher probability of the formation of a DSB upon cleavage of the second site (on the other strand) by hydrolysis of a labile bond or by endonuclease cleavage of a base damaged site. To achieve preferential sensitization of tumor vs. normal tissue it may be possible to take advantage of the deficiency in alkaline phosphatase in tumor vs. normal vasculature, that is, in analogy with treatment with WR-2721. The deoxynucleoside analogue would be delivered together with the phosphate ester (deoxynucleotide) of the correct deoxynucleoside, for example, ara-C, in the presence of deoxycytidine monophosphate (dCMP). Higher alkaline phosphatase levels in normal tissue capillaries would hydrolyse the dCMP to deoxycytidine, which competes effectively with ara-C in repair replication. PMID- 3528086 TI - Potential of NMR and PET for determining tumor metabolism. AB - The basic principles underlying nuclear magnetic resonance spectroscopy (MRS) and positron emission tomography (PET) are explained. Examples of work relating to tumor metabolism are given and some of the important findings of clinical interest are presented. The future prospects of both systems are explored. PMID- 3528087 TI - Effect of misonidazole dose on survival in patients with stage IIIB-IVA squamous cell carcinoma of the uterine cervix: an RTOG randomized trial. AB - Between August 1980 and November 1984, 120 patients with FIGO Stage IIIB or IVA squamous cell carcinoma of the uterine cervix were randomized to receive radiation therapy (RT) (46 Gy pelvis + 10 Gy parametrial boost) followed by intracavitary or external boost to the primary +/- misonidazole (MISO) (400 mg/M2 2-4 hours prior to RT daily, maximum 12 gm/M2). The median at 24-28 hr misonidazole plasma level was 20 micrograms/ml 2-6 hr and 3.5 micrograms/ml. Approximately 60% of the patients on RT + MISO received 100% of expected total Misonidazole dose; peripheral neurologic toxicity was reported for nine patients receiving misonidazole (8 with mild and 1 with moderate paresthesia or pain). Time-dependent regression analyses found that actual cumulative misonidazole dose was not related to duration of survival from start of treatment (p = 0.5). MISO dose expressed as a percent of expected dose was marginally related to increased survival measured from 14 weeks on on study (p = 0.1). No improvement in survival was observed with the addition of misonidazole to RT (64% of the patients on RT alone were alive at 18 months versus 54% of those on RT + MISO). PMID- 3528088 TI - Thiol-induced biochemical modification of chemo- and radioresponses. AB - There is considerable interest in the role of thiols and redox enzymes as modulators of chemo- and radioresponses from both therapeutic and theoretical perspectives. The metabolism of GSH and the functioning of the GSH redox cycle can have a significant impact on the response of cells to both chemical and radiation stresses. From this rapidly developing research area, attention has been focused on recent progress in several areas: the use of GSH-depletion to reverse chemo-induced resistance to further chemical treatment; the significance of GSH transferase activity in chemoresistant cells; the effectiveness of GSH depletion in sensitizing radioresistant cells; and the evidence for an alternative GSH-linked recovery pathway. From an examination of these areas, it seems warranted to conclude the following: First, manipulation of the redox state is effective in enhancing the cytotoxic effect of radiation and some chemotherapeutic agents in radio- and chemoresistant cells; second, additional possibilities for a therapeutic advantage may be gained as new redox modifiers are developed; and last, membrane domains may provide important sites for redox alterations by naturally occurring substrates or by drugs specifically designed to alter this interaction. PMID- 3528089 TI - Misonidazole and other hypoxia markers: metabolism and applications. AB - A substantial effort is being devoted to developing markers for hypoxia in tumors. Most of the work to date has been performed on misonidazole (MISO), which is selectively metabolized by hypoxic cells to reactive products that bind covalently to cellular constituents. This paper attempts to review the metabolism of MISO as it relates to binding, to summarize several of the properties of the binding of MISO to cells and tissues which appear to be directly relevant to the characteristics of the reactive species involved, and to evaluate the potential of MISO and other nitroheterocycles as markers for hypoxia. Four roles for a hypoxic marker are considered. MISO labeled with 3H or 14C is a good marker for local radiobiological hypoxia in autoradiograms of tumor sections, but more work is required to investigate factors other than oxygen concentration that conceivably might affect the binding process. In quantitating hypoxic fraction in tumors using non-destructive techniques, which has been modelled by correlating surviving fraction with 14C-misonidazole uptake, non-specific binding to aerobic and necrotic tissue limits the accuracy of the estimate, but useful clinical applications can still be envisaged. For quantitation of a change in the hypoxic fraction of an individual tumor using serial assays, preliminary data suggest that MISO binding should be a sensitive assay. Fluorescent nitroheterocycles have a great deal of potential as markers to enable the sorting of tumor cell suspensions into portions derived from the hypoxic and aerobic regions, but better compounds are needed. PMID- 3528090 TI - DNA damage induced by reductively activated nitroimidazoles--pH effects. AB - The effect of pH on E. coli DNA damage measured viscometrically and induced by electrolytically reduced metronidazole and misonidazole has been studied, together with the effect on the statistical average number of electrons required for reduction, measured by high-resolution coulometry, and nitrite production measured colorimetrically. In general, nitroimidazole-induced DNA damage is greatest at acid pH and decreased at alkaline pH, but whereas metronidazole exhibits a linear relationship between DNA damage and increased pH, misonidazole shows a plateau between pH 6 and 8. The electron requirements for complete reduction (n) vary with pH. For misonidazole n increases with an increase in pH both in the absence and presence of DNA with a shallow plateau between pH 6 and 8. In contrast, for metronidazole, n decreases with increased pH and exhibits breakpoints between pH 6 and 8. Nitrite (NO2-) production is linear with increased pH for misonidazole but for metronidazole (NO2-) production shows a sudden increase at 7.5 yielding ca. 35% on a molar basis. The results may reflect differences in the relative stability and reactivity of the nitro radical anion. PMID- 3528091 TI - [Sister Hanna--this is how I remember it...]. PMID- 3528092 TI - [To the Swedish Midwifery Association]. PMID- 3528093 TI - [Anniversary report]. PMID- 3528094 TI - Therapy of endometritis in mares. PMID- 3528095 TI - Comparison of radiography and ultrasonography in the evaluation of renal lesions in the dog. AB - Survey abdominal radiographs, excretory urograms, and nephrosonograms were obtained from 14 dogs with renal lesions. Renal enlargement was suspected on survey radiographs and confirmed by excretory urography in 13 dogs. Radiographic differentiation between a solid and cystic renal lesion was not possible in 9 dogs. Ultrasonography determined the presence of solid masses in 12 dogs, established the presence of a renal cyst in the opposite kidney in 1 dog, and revealed hydronephrosis in 2 dogs. Ultrasonography appeared to be more sensitive than radiography in differentiating the internal characteristics of renal lesions. PMID- 3528096 TI - Rebound hyperglycemia following overdosing of insulin in cats with diabetes mellitus. AB - Posthypoglycemic hyperglycemia (rebound hyperglycemia) after overdosing of insulin was diagnosed in 6 cats with diabetes mellitus. Administration of excessive insulin induced hypoglycemia within 4 to 8 hours, followed by rebound hyperglycemia. Diagnosis was made by serial blood glucose determinations during a 20- to 24-hour period after insulin administration. Four cats had a history of difficulty in regulating the diabetic state. In 2 cats, rebound hyperglycemia was diagnosed on routine serial blood glucose determinations. All of the cats were hyperglycemic for most of the day. Rebound hyperglycemia was observed with both intermediate (neutral protamine hagedorn) and long-acting (protamine zinc iletin) insulins, and the range of insulin doses at which the disorder developed overlapped previously determined therapeutic doses for these insulins in the cat. Urine glucose and single afternoon blood glucose determinations were inadequate and potentially misleading in monitoring diabetic cats receiving excessive amounts of insulin. PMID- 3528097 TI - Continuous positive airway pressure therapy for aspiration pneumonia in a dog. AB - A 14-year-old mixed-breed dog aspirated a large amount of liquid barium sulfate. Calculation of the alveolar arterial oxygen tension difference (34 mm of Hg; normal, less than 7.5 mm of Hg) from the alveolar gas equation and the arterial blood gas analysis indicated impaired pulmonary gas exchange. The dog was treated for 5 days with continuous positive airway pressure and supplemental oxygen administered by a simple apparatus connected to a tracheostomy tube. Continuous positive airway pressure was believed to improve gas exchange and to increase pulmonary compliance by decreasing alveolar collapse in this dog. PMID- 3528098 TI - Toxoplasmosis. PMID- 3528099 TI - Questions vaccine efficacy trial. PMID- 3528100 TI - Cryptococcosis involving the eye and central nervous system of a dog. AB - Cryptococcus neoformans meningoencephalitis was diagnosed as the cause of stupor and generalized seizures in a 2-year-old Cocker Spaniel. Unilateral granulomatous chorioretinitis was observed ophthalmoscopically, and isolation of C neoformans from CSF confirmed the antemortem diagnosis. The dog was euthanatized and necropsied. Multifocal lesions were seen throughout the lungs, nasal turbinates, cerebral cortex, and the optic nerve of each eye. Microscopically, the multifocal lesions were granulomas consisting of lymphocytes, macrophages, plasma cells, and cryptococcal organisms. Infection may have originated in the nasal passages and extended directly through the ethmoid plate into the meninges of the CNS and optic nerves. Although the prognosis is poor in dogs with CNS involvement, various chemotherapeutic agents are available for use by clinicians. PMID- 3528101 TI - Michael Fordham re-viewed. PMID- 3528102 TI - The Child Analytic Training, 1960-1985: the first quarter century. PMID- 3528103 TI - Fordham the clinician as seen in his writings. PMID- 3528104 TI - Frieda Fordham's influence on Michael. PMID- 3528105 TI - A bibliography of the writings of Michael Fordham. PMID- 3528107 TI - GABA immunoreactivity in the primary nuclei of the auditory central nervous system. AB - Structures containing gamma-amino butyric acid (GABA) were investigated in the guinea pig cochlear nuclei and superior olivary complexes by means of an immunohistochemical procedure using an antibody directed against GABA. Immunoreactivity was observed in cell bodies of the superficial layers of the ventral and dorsal cochlear nuclei, in lateral superior olive, in some neurons of the medial superior olive, in lateral preolivary nuclei and in the lateral nucleus of the trapezoid body. Fibers and profiles exhibiting GABA immunoreactivity were found in almost all regions of the lower auditory pathways. The abundance of GABA in these regions indicates an important role of this inhibitory amino-acid in the auditory brainstem. PMID- 3528106 TI - Heterogeneity of sperm density profiles following 16-week therapy with continuous infusion of high-dose LHRH analog plus testosterone. AB - LHRH agonist analogs have been investigated as potential male contraceptives. It has been shown that the LHRH agonistic analog [D-Trp6,Pro9-NEt] LHRH (LHRHA) given to men in single doses up to 500 micrograms daily for up to 20 weeks with the coadministration of testosterone enanthate produces reversible oligozoospermia. Individual responses to the treatment, however, were variable. In this study, we gave the same analog to eight normal male volunteers as a continuous infusion of 500 micrograms daily for 16 weeks. Testosterone enanthate, 100 mg, was given by injection every second week. Six of the subjects became oligozoospermic but the other two retained sperm counts that were greater than 20 million/ml, although their treatment continued for 20 weeks. The reasons for this variability of response are not clear. Serum immunoreactive LH values increased during the infusion period whereas testosterone declined. FSH values fell during treatment in all subjects except the two non-responders. The acute pituitary response to LHRHA during the treatment or shortly thereafter (48 h) was completely abolished, and bioactive LH values were suppressed totally. FSH, LH, testosterone and sperm counts returned to normal in all subjects following discontinuation of LHRHA infusion. Continuous infusion of 500 micrograms of LHRHA daily for 16 weeks with 100 mg of testosterone enanthate every 2 weeks induced desensitization of the pituitary, loss of LH bioactivity, and decreases of FSH and testosterone. This mode of administration, however, did not improve sperm density results obtained earlier by single daily injections of the analog. Heterogeneity of sperm density profiles still persists for reasons that are not yet clear. PMID- 3528108 TI - Esthetic porcelain veneers, part I. PMID- 3528109 TI - Osseointegration for restorative dentists. Part I. Mandibular rehabilitation. PMID- 3528110 TI - Identification and grouping of Clostridium botulinum strains by numerical analysis of their electrophoretic protein patterns. AB - Strains of Clostridium botulinum type A, type E and both non-proteolytic and proteolytic types B and F were characterized by their electrophoretic protein patterns. As the protein pattern changes during sporulation, special attention was paid to the prevention of sporulation by selecting an appropriate medium (Strasdine's medium plus 1% w/v glucose) and a scheme of repeated subculturing. Ribosomal proteins, evolutionarily conservative and hence relatively similar in all types of bacteria, were removed to optimize the resolving power of the electrophoretic technique. Protein patterns were compared by computing correlation coefficients of normalized densitometric tracings. The method is highly reproducible and its resolving power is high: all protein patterns found were specific. The strains tested fall into two main groups: the proteolytic and the non-proteolytic cluster. Type A strains form a separate subgroup within the proteolytic cluster, the same applies to type E strains within the non proteolytic group. Although time-consuming for spore-forming bacteria, this method is, to our knowledge, the only technique that recognizes individual strains of Cl. botulinum. For non-spore-forming micro-organisms the method is certainly much simpler and hence even more valuable. PMID- 3528111 TI - The adherence of Staphylococcus aureus, Staphylococcus epidermidis and Escherichia coli on cotton, polyester and their blends. AB - The adherent behaviour of the Gram-positive Staphylococcus aureus and Staphylococcus epidermidis and the Gram-negative Escherichia coli on cotton, polyester and their blends through contact in aqueous suspensions was studied. Staphylococcus epidermidis was found to adhere to fabrics much more so than Staph. aureus. The adherence of both Staph. epidermidis and Staph. aureus to fabrics increased as the content of polyester fibres in the fabrics increased. The attachment of E. coli to all fabrics was very low and was not affected by the fibre contents. Total numbers of adherent bacteria on cotton and polyester fabrics were related directly to the concentrations of the bacterial suspensions. The extents of adherence, expressed by the percentage of adherent bacteria from the suspension, however, were independent of the concentration. The length of contact with bacteria was also found to affect the adherence of bacteria on fabrics studied. PMID- 3528112 TI - The carrier state: group B streptococcus. PMID- 3528113 TI - The pathophysiology of McArdle's disease: clues to regulation in exercise and fatigue. AB - Muscle phosphorylase deficiency (McArdle's disease) has conventionally been considered a disorder of glycogenolysis, and the associated impairment in oxidative metabolism has been largely overlooked. Muscle glycogen normally is the primary oxidative fuel at exercise work loads requiring more than 75-80% of maximal O2 uptake (VO2max). Evidence is presented to support the hypothesis that a limited flux through the Embden-Myerhof pathway in McArdle's disease reduces the capacity to generate NADH required to support a normal VO2max. The extent of the oxidative defect is substrate dependent; i.e., it can be partially corrected by increasing the availability of alternative oxidative substrates (e.g., glucose, free fatty acids) to working muscle. Experiments employing modification of substrate availability closely link the hyperkinetic circulatory response to exercise (i.e., an abnormally large increase in O2 transport to skeletal muscle) and the premature muscle fatigue and cramping of McArdle patients with their oxidative impairment and suggest that a metabolic common denominator in these abnormal responses may be a pronounced decline in the muscle phosphorylation potential ([ATP]/[ADP][Pi]). The hyperkinetic circulation likely is mediated by the local effects on metabolically sensitive skeletal muscle afferents and vascular smooth muscle of K+, Pi, or adenosine or a combination of these substances released excessively from working skeletal muscle. The premature muscle fatigue and cramping of McArdle patients does not appear to be due to depletion of ATP but is associated with an increased accumulation of Pi and probably ADP in skeletal muscle. Accumulations of Pi and ADP are known to inhibit the myofibrillar, Ca2+, and Na+-K+-ATPase reactions. PMID- 3528114 TI - A new photometric method for oxygen consumption measurements in cell suspensions. AB - A new technique is described for measuring O2 consumption rates and O2 concentrations in suspensions of respiring cells. Aliquots of a cell suspension kept in a special thermostated precision syringe are injected into the measuring system in defined time intervals. The O2 content of these samples is determined photometrically, as reported previously. The O2 consumption per cellular wet weight and/or per single cell can be calculated from the cell volume fraction, the physical density, the cell concentration in the suspension, and the time dependent decline of the O2 concentration in the precision syringe. The minimum detectable amount of O2 is 0.1 microliter O2, which corresponds to 0.001 (vol/vol) of O2 if a 100-microliters sample of suspended cells is analyzed. Reproducibility of the O2 consumption measurement is 9% of the measured value. The advantages offered by this method are the straightforward calibration in absolute terms, the short time required for one analysis (2-6 min), a high sensitivity, the simultaneous determination of overall O2 concentration and O2 consumption rates in cell suspensions, and the great variability in the application. PMID- 3528115 TI - Effect of antigravity suit inflation on cardiovascular, PRA, and PVP responses in humans. AB - Blood pressure, pulse rate (PR), serum osmolality and electrolytes, as well as plasma vasopressin (PVP) and plasma renin activity (PRA), were measured in five men and two women [mean age 38.6 +/- 3.9 (SE) yr] before, during, and after inflation of an antigravity suit that covered the legs and abdomen. After 24 h of fluid deprivation the subjects stood quietly for 3 h: the 1st h without inflation, the 2nd with inflation to 60 Torr, and the 3rd without inflation. A similar control noninflation experiment was conducted 10 mo after the inflation experiment using five of the seven subjects except that the suit was not inflated during the 3-h period. Mean arterial pressure increased by 14 +/- 4 (SE) Torr (P less than 0.05) with inflation and decreased by 15 +/- 5 Torr (P less than 0.05) after deflation. Pulse pressure (PP) increased by 7 +/- 2 Torr (P less than 0.05) with inflation and PR decreased by 11 +/- 5 beats/min (P less than 0.05); PP and PR returned to preinflation levels after deflation. Plasma volume decreased by 6.1 +/- 1.5% and 5.3 +/- 1.6% (P less than 0.05) during hours 1 and 3, respectively, and returned to base line during inflation. Inflation decreased PVP from 6.8 +/- 1.1 to 5.6 +/- 1.4 pg/ml (P less than 0.05) and abolished the significant rise in PRA during hour 1. Both PVP and PRA increased significantly after deflation: delta = 18.0 +/- 5.1 pg/ml and 4.34 +/- 1.71 ng angiotensin I X ml-1 X h-1, respectively. Serum osmolality and Na+ and K+ concentrations were unchanged during the 3 h of standing.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3528116 TI - Simultaneous analysis of grain and grain-based products for ethylene dibromide, carbon tetrachloride, and ethylene dichloride. AB - A method is described for the simultaneous measurement of parts per billion levels of the fumigants ethylene dibromide, carbon tetrachloride, and ethylene dichloride in grain and grain-based products. The fumigants are isolated by hexane co-distillation, separated by capillary gas chromatography, and detected with a mass spectrometer in the selected ion monitoring mode. Recoveries are greater than 90% and standard deviations are approximately 10% of the quantity measured. The method is free of interferences and its precision and accuracy are enhanced by the use of tetradeuterated ethylene dibromide and ethylene dichloride as internal standards. PMID- 3528117 TI - Hydrophobic grid membrane filter method for aerobic plate count in foods: collaborative study. AB - Twenty-one laboratories participated in a collaborative study to validate a hydrophobic grid membrane filter (HGMF) method for aerobic plate count by comparing its performance against the AOAC/APHA pour plate method. Raw milk, raw poultry, whole egg powder, flours, and spices were included in the study. Counts obtained by the HGMF and pour plate methods did not differ significantly, except in the case of whole egg powder, for which the HGMF method produced significantly higher counts. The hydrophobic grid membrane filter method for aerobic plate count in foods has been adopted official first action. PMID- 3528118 TI - Anaphylaxis caused by the sodium succinate ester of hydrocortisone and methylprednisolone. PMID- 3528120 TI - Evaluation of aerosolized triamcinolone acetonide as a replacement for aerosolized beclomethasone dipropionate. AB - Substitution of aerosolized triamcinolone acetonide for aerosolized beclomethasone dipropionate in treatment of 30 chronic asthmatics resulted in subjective improvement in all patients. There was reduction in requirement of systemic steroids and inhaled beta adrenergics. No adrenal suppression or oropharyngeal candidiasis occurred after replacing beclomethasone dipropionate with triamcinolone acetonide. PMID- 3528119 TI - Bioavailability and pharmacological effects of two slow-release theophylline preparations: intrasubject tablet-to-tablet variability. AB - The bioavailability and pharmacological effects of slow-release preparations oxtriphylline (Choledyl SA) and anhydrous theophylline (Theo-Dur) were compared in a single-blind, randomized, crossover study in 10 normal men. Subjects were administered three doses from the same lot of each preparation at weekly intervals. Plasma concentration of theophylline was measured at timed intervals for 33 hr by high-pressure liquid chromatography. Pharmacokinetic analysis showed that Choledyl SA peaked earlier (4.7 +/- 1.0 hr) than did Theo-Dur (9.6 +/- 8.2 hr), with higher peak concentrations, 6.4 +/- 0.7 micrograms/ml versus 4.1 +/- 0.5 micrograms/ml for Theo-Dur, and greater are under the curve, 102.4 +/- 15.7 micrograms/ml X hr versus 75.3 +/- 9.1 micrograms/ml X hr for Theo-Dur. 88% absorption was achieved in 6 hr with Choledyl SA versus 10 hr with Theo-Dur. Wide intra- and intersubject variations were observed with both preparations. Likewise, variable effects on systolic and diastolic blood pressure and pulse were observed with both preparations. The effects of both theophylline preparations on urine flow, osmolar clearance, and glomerular filtration rate were compared. Osmotic diuresis without detectable changes in the glomerular filtration rate was observed in subjects who received Choledyl SA versus Theo Dur. Differences in the bioavailability and renal effects were observed between Choledyl SA and Theo-Dur. Wide intra- and intersubject tablet-to-tablet variability were observed with both preparations. PMID- 3528121 TI - Bronchial asthma according to Byzantine medicine. PMID- 3528122 TI - The literary genius and the many maladies of Marcel Proust. Selections and notes. PMID- 3528123 TI - Molecular cloning, expression, and characterization of the gene for the surface (HPI)-layer protein of Deinococcus radiodurans in Escherichia coli. AB - The HPI protein of Deinococcus radiodurans belongs to the class of surface layer proteins which form crystalline two-dimensional arrays on bacterial cell envelopes. We have cloned and expressed the gene for this protein of Mr about 100,000 by using plasmid pUC8 in Escherichia coli. As judged by immunoreaction with monospecific antibodies, apparent Mr, and limited proteolysis, a single clone contained the gene encoding the complete polypeptide on an 8.9-kilobase (kb) insert. The insert was reduced to a 5.7-kb HindIII fragment, cloned in pUC18 in both orientations, and subjected to unilateral processive deletion with exonuclease III. The library of deletion derivatives was mapped and, in conjunction with protein immunoblotting of expressed polypeptides, was used to locate the positions of the structural gene and the Deinococcus promoter region that was responsible for expression of the HPI polypeptide. The HPI gene was confined to a stretch 2.95 kb in length. PMID- 3528124 TI - ATP hydrolysis during SOS induction in Escherichia coli. AB - Changes in cellular ATP concentration during SOS induction in strains of Escherichia coli with different levels of RecA and LexA proteins were studied. UV irradiation of RecA+ strains induced a twofold increase in the ATP concentration around the first 20 min, followed by a decrease to the values of nonirradiated cells. On the other hand, mutants defective in RecA protein or with either deficient RecA protease activity or cleavage-resistant LexA repressor did not show any decrease, suggesting that ATP consumption is related to LexA repressor hydrolysis. Furthermore, strains presenting a constitutive synthesis of RecA protein showed the same changes in ATP concentration as the wild-type strain. Likewise, the presence in a RecA+ strain of a LexA(Def) protein, which is defective in its capacity for binding specifically to SOS operators, did not disturb the changes in ATP when compared with the LexA+ RecA+ strain. Moreover, after UV irradiation, a LexA(Def) RecA- double mutant showed an important increase in ATP concentration, which remained elevated for at least 120 min after UV treatment. PMID- 3528125 TI - Induction of autolysis in nongrowing Escherichia coli. AB - Unless relaxation of the stringent response is achieved, all nongrowing bacteria rapidly develop resistance to autolysis induced by a variety of agents, including all classes of cell wall synthesis inhibitors. We now describe inhibitors of cell wall synthesis which were unusual in that they could continue to effectively induce autolysis in relA+ Escherichia coli even after prolonged amino acid starvation. The process of cell wall degradation seems to be catalyzed by similar hydrolytic enzymes in nongrowing and growing cells, yet the activity of these new agents capable of inducing autolysis in the nongrowing relA+ cells did not involve relaxation of RNA or peptidoglycan synthesis. We propose that the suppression of autolysis characteristic of nongrowing cells can be bypassed by a novel mechanism of autolytic triggering which is independent of the relA locus. PMID- 3528126 TI - Further evidence for overlapping transcriptional units in an Escherichia coli cell envelope-cell division gene cluster: DNA sequence and transcriptional organization of the ddl ftsQ region. AB - A 1.2-kilobase-pair BamHI fragment from a cell envelope-cell division gene cluster of Escherichia coli containing ddl and part of ftsQ was cloned and sequenced, and the sequence was interpreted with the aid of genetic complementation and promoter fusion data for the region. Both ddl and ftsQ were transcribed in the same direction (clockwise on the genetic map). ddl was shown to be capable of independent expression from a promoter of its own, and a promoter was identified within the ddl structural gene. The structural gene of ddl consisted of 918 nucleotides, encoding a 306-residue polypeptide of molecular weight 32,840; the synthesis of a protein of this molecular weight was shown to be directed from the 1.2-kilobase-pair BamHI fragment in minicells. Analysis of the DNA sequence further showed that the termination codon of ddl is separated from the initiation codon of ftsQ by one base, which suggests that these two genes may be translationally coupled when transcription is initiated upstream of ddl. This represents a second instance of potential translational coupling within this gene cluster and also indicates that the ddl and ftsQ transcriptional units must overlap (as has been reported earlier for ftsQ and ftsA and for ftsA and ftsZ). PMID- 3528127 TI - Immediate entrance to the export pathway after synthesis as a requirement for export of the sak gene product in Escherichia coli. AB - Export through the cytoplasmic membrane and processing of the sak product in Escherichia coli cells were investigated with E. coli strains carrying pTS301, which produce large amounts of staphylokinase at 42 degrees C. High-level synthesis of the sak product caused transient accumulation not only of the staphylokinase precursor (pSAK) but also of the maltose-binding protein and outer membrane protein A precursors. Thus it was concluded that the sak product shares the export pathway with E. coli secreted proteins at least at a certain step. During high-level synthesis of the sak product, a significant amount of the newly synthesized pSAK remained unprocessed after a chase period, possibly causing the observed accumulation of pSAK. Accumulating pSAK did not mature for a long period, whereas the newly synthesized sak product was exclusively detected in the mature form. These results suggest that it is necessary for the sak product to enter the export pathway during or immediately after synthesis to be exported and processed normally. PMID- 3528128 TI - Identification of the btuCED polypeptides and evidence for their role in vitamin B12 transport in Escherichia coli. AB - Passage of vitamin B12 across the outer and cytoplasmic membranes of Escherichia coli occurs in two steps, each involving independent transport systems. Since the vitamin accumulated in btuC or btuD mutants is readily released from the cell by chase or osmotic shock and does not undergo the usual metabolic conversions, the products of these genes might participate in transport across the cytoplasmic membrane. Mutations in btuC and btuD are complemented by recombinant plasmids carrying a 3,410-base-pair HindIII-HincII DNA fragment. Transposon Tn1000 mutagenesis and subcloning defined the location of these two genes and showed that they are separated by approximately 800 base pairs. The polypeptides elicited by this fragment and its derivatives were identified by using a maxicell system. The apparent molecular weight of the btuC product was approximately 26,000, that of the btuD product was 29,000. Both polypeptides were associated with the cell membrane. Transposon insertions in the region between btuC and btuD, as well as those in the two genes, conferred a deficiency in vitamin B12 utilization and transport when they were crossed onto the chromosome. This region, termed btuE, encoded a 22,000-Mr polypeptide and lesser amounts of a 20,000-Mr species. A portion of the BtuE protein was released from maxicells by osmotic shock or spheroplast formation. The relative production of BtuE and BtuD in response to plasmids carrying transposon insertions suggested that the three genes are arranged in an operon in the order btuC-btuE-btuD and that internal promoters exist since polarity was incomplete. Substantial elevation of transport activity was engendered by plasmids carrying the intact btu region, but not when any of the btu genes was disrupted. The btuCED region thus may encode a transport system for passage of vitamin B12 across the cytoplasmic membrane. This system bears similarities to periplasmic binding protein-dependent transport systems, although the putative periplasmic component is not required for its function. PMID- 3528129 TI - Nucleotide sequence of the btuCED genes involved in vitamin B12 transport in Escherichia coli and homology with components of periplasmic-binding-protein dependent transport systems. AB - The products of the btuCED region of the Escherichia coli chromosome participate in the transport of vitamin B12 across the cytoplasmic membrane. The nucleotide sequence of the 3,410-base-pair HindIII-HincII DNA fragment carrying a portion of the himA gene and the entire btuCED region was determined. Comparison of the location of the open reading frames with the gene boundaries defined by transposon insertions allowed the assignment of polypeptide products to gene sequences. The btuC product is a highly nonpolar integral membrane protein of molecular weight 31,683. The distribution of hydrophobic regions suggests the presence of numerous membrane-spanning domains. The btuD product is a relatively polar but membrane-associated polypeptide of Mr 27,088 and contains segments bearing extensive homology to the ATP-binding peripheral membrane constituents of periplasmic binding protein-dependent transport systems. Other regions of this protein are similar to portions of the outer membrane vitamin B12 receptor. The btuE product (Mr 20,474) appears to have a periplasmic location. It has the mean hydropathy of a soluble protein but lacks an obvious signal sequence. The cellular locations and structural and sequence homologies of the Btu polypeptides point to the similarity of these three proteins to components of binding protein dependent transport systems. However, the dependence on a periplasmic vitamin B12 binding protein has not yet been demonstrated. PMID- 3528130 TI - Electron probe analysis, X-ray mapping, and electron energy-loss spectroscopy of calcium, magnesium, and monovalent ions in log-phase and in dividing Escherichia coli B cells. AB - The elemental composition of individual cells of rapidly frozen and cryosectioned Escherichia coli B was measured with electron optical microanalytic methods. The Ca content was high (26.2 mmol/kg) in a 10-nm-wide region of the cell envelope. Amounts of cytoplasmic Ca in actively dividing cells were significantly higher (32.6 mmol/kg [dry weight]) than in the log-phase (1.5 mmol/kg) cells. Cellular Mg was 205 mmol/kg (dry weight) and it was uniformly distributed throughout the cell. Cells washed in distilled water before freezing lost monovalent ions (Na, Cl, and K), but the membrane-bound Ca and cellular Mg were not reduced, indicating that cellular Mg and membrane Ca are more tightly bound. PMID- 3528131 TI - Characteristics of sterol uptake in Saccharomyces cerevisiae. AB - A Saccharomyces cerevisiae sterol auxotroph, FY3 (alpha hem1 erg7 ura), was used to probe the characteristics of sterol uptake in S. cerevisiae. The steady-state cellular concentration of free sterol at the late exponential phase of growth could be adjusted within a 10-fold range by varying the concentration of exogenously supplied sterol. When cultured on 1 microgram of sterol ml-1, the cells contained a minimal cellular free-cholesterol concentration of 0.85 nmol/mg (dry weight) and were termed sterol depleted. When cultured on 11 micrograms of sterol ml-1 or more, the cells contained a maximal cellular free-cholesterol concentration of 6.8 nmol/mg (dry weight) and were termed free sterol saturated. Cells with free-sterol concentrations below the maximal level were capable of accumulating free sterol from the medium. The capacity of the cells for cholesterol uptake was inversely proportional to the initial intracellular concentration. The uptake of sterol was shown to be a nonactive process that is independent of cellular energy sources or viability. The intracellular transport of sterol for esterification is not sensitive to anti-microtubule agents. PMID- 3528132 TI - The significance of pharmacodynamic measurements in the assessment of bioavailability and bioequivalence of psychotropic drugs using CEEG and dynamic brain mapping. AB - There are a variety of problems in evaluating the bioavailability of psychotropic drugs. Psychotropics have many metabolites; there are discrepancies between peripheral plasma levels and therapeutic effects, and psychotropics must penetrate the blood-brain barrier to have an effect on their target organ. Therefore, "classical" pharmacokinetic evaluation may not be sufficient to determine the bioavailability and bioequivalence of these drugs. Additional and more precise information may be obtained by adding pharmacodynamic procedures to these evaluations. Quantitative pharmaco-EEG (QPEEG), which uses the computer analyzed electroencephalogram (CEEG), may be the method of choice for determining the pharmacodynamic profiles of psychotropic drugs at the central nervous system (CNS) level. The difficulties in evaluating the bioavailability of psychotropics, as well as the results of several studies that confirm the significance of CEEG as a pharmacodynamic measure, are discussed. PMID- 3528133 TI - Clinical relevance of the bioavailability/bioequivalence controversy. AB - A generic drug containing the same active ingredient as a brand name drug may not show identical clinical efficacy. There is increasing evidence that substitution of a generic for a brand name (or vice versa) drug with the expectation of similar results is problematic and that improper treatment may result. Clinical trials are needed to test generic psychoactive drugs. This paper provides guidelines for clinical situations in which problems relating to bioavailability and bioequivalence may arise, for example, in patients taking concomitant medication(s) or in chronically ill or elderly patients. In addition, the importance of knowing which assay methods are used to measure psychoactive drug blood levels in considering drug efficacy is stressed. PMID- 3528134 TI - Bioavailability of psychotropic drugs: historical perspective and pharmacokinetic overview. AB - The evolution of the federal government's role in the regulation and evaluation of generic psychotropic medications is described. To place many of the methodologic bioequivalence issues for antipsychotic agents into perspective, the pharmacokinetics of these drugs are reviewed. Appropriate methodologies for studying the pharmacokinetics and pharmacodynamics of psychotropic drugs are in early developmental stages. Many of the issues relating to bioequivalence of generic products will not be resolved until a better understanding of these factors is developed. PMID- 3528135 TI - Purification and characterization of a high-molecular-weight protease, ingensin, from human placenta. AB - We purified a high-molecular-weight protease, ingensin, from extract of human placenta by successive DEAE-cellulose, hydroxyapatite, and high performance liquid chromatographies. The activity of ingensin was determined by using a synthetic substrate, succinyl-leucyl-leucyl-valyl-tyrosine-methylcoumarinamide (MCA). The purified ingensin, which gave a single band in 6.5% nondenaturing polyacrylamide gel electrophoresis, was activated by linoleic acid and sodium dodecyl sulfate (SDS). Maximum activity was observed at pH 9.5 in the presence of 0.06% SDS, but at pH 8.0 in the presence of linoleic acid. A subcellular fractionation study showed that a large amount of ingensin activity was present in the cytosol or microsome fraction rather than in the precipitate of low-speed centrifugation. The effect of protease inhibitors on the activated ingensin was also investigated. PMID- 3528136 TI - Action of the protease from Streptomyces cellulosae on L-Leu-Gly. AB - The protease from Streptomyces cellulosae preferentially catalyzed the formation of (L-Leu-Gly)2 (P1) and (L-Leu-Gly)3 (P2) in highly concentrated solutions of L Leu-Gly, although it weakly hydrolyzed the substrate at the same time. The formation of P1, P2, L-Leu, and Gly was studied at various pH values, temperatures, and substrate concentrations. The initial velocities (v1, v2, and vH) of formation of P1, P2, and L-Leu (or Gly) and the sum (v1T) of v1 and v2 were determined. The effects of pH and temperature on v1, v2, vH, and v1T were examined at a fixed substrate concentration. The optimum pH and optimum temperature for each of the processes forming P1, P2, L-Leu, and Gly were 8.0 and 65 degrees C, respectively. In the study on the effect of substrate concentration, the plots of the initial velocities versus substrate concentrations were sigmoidal at lower substrate concentrations. The dependence of v1T on the substrate concentration could be explained by a mechanism involving a single active center forming the peptide bonds and two substrate-binding sites located on the left sites (S1 and S2) and the right sites (S1' and S2') of the active center of this enzyme. PMID- 3528137 TI - Isolation and expression in Escherichia coli of a cDNA clone encoding porcine pancreatic elastase. AB - We have cloned a DNA that is complementary to the messenger RNA that encodes porcine pancreatic elastase 1 from pancreas using rat pancreatic elastase 1 cDNA as a probe. This complementary DNA contains the entire protein coding region of 798 nucleotides which encodes an elastase of 266 amino acids, and 22 and 136 nucleotides of the 5' and 3'-untranslated sequences. When this deduced amino acid sequence was compared with known amino acid sequences, a carboxy-terminal 240 amino acids long peptide was found to be identical with a mature form of porcine pancreatic elastase 1, except for two amino acids. The porcine enzyme contains the same number of amino acid residues as the rat enzyme, and their amino acid sequences are 85% homologous. Taking the above findings together, we conclude that the cloned cDNA encodes a mature enzyme of 240 amino acids including a leader and activation peptide of 26 amino acids. We expressed the cloned porcine pancreatic elastase 1 cDNA in E. coli as a lac-fused protein. The resulting fused protein showed enzymatic activity and immunoreactivity toward anti-elastase serum. PMID- 3528138 TI - Characterization of the fatty acid synthetase system of Curtobacterium pusillum. AB - Curtobacterium pusillum contains 11-cyclohexylundecanoic acid as a major component of cellular fatty acids. A trace amount of 13-cyclohexyltridecanoic acid is also present. Fatty acids other than omega-cyclohexyl fatty acids present are 13-methyltetradecanoic, 12-methyltetradecanoic, n-pentadecanoic, 14 methylpentadecanoic, 13-methylpentadecanoic, n-hexadecanoic, 15 methylhexadecanoic, 14-methylhexadecanoic, and n-heptadecanoic acids. The fatty acid synthetase system of this bacterium was studied. Various 14C-labeled precursors were added to the growth medium and the incorporation of radioactivity into cellular fatty acids was analyzed. Sodium [14C]acetate and [14C]glucose were incorporated into almost all species of cellular fatty acids, the incorporation into 11-cyclohexylundecanoic acid being predominant. [14C]Isoleucine was incorporated into 12-methyltetradecanoic and 14-methylhexadecanoic acids: [14C]leucine into 13-methyltetradecanoic and 15-methylhexadecanoic acids; and [14C]valine into 14-methylpentadecanoic acid. [14C]-Shikimic acid was incorporated almost exclusively into omega-cyclohexyl fatty acids. The fatty acid synthetase activity of the crude enzyme preparation of C. pusillum was reconstituted on the addition of acyl carrier protein. This synthetase system required NADPH and preferentially utilized cyclohexanecarbonyl-CoA as a primer. The system was also able to use branched- and straight-chain acyl-CoAs with 4 to 6 carbon atoms effectively as primers but was unable to use acetyl-CoA. However, if acetyl acyl carrier protein was used as the priming substrate, the system produced straight-chain fatty acids. The results imply that the specificity of the initial acyl-CoA:acyl carrier protein acyltransferase dictates the structure of fatty acids synthesized and that the enzymes catalyzing the subsequent chain elongation reactions do not have the same specificity restriction. PMID- 3528139 TI - Further characterization of trimethylamine N-oxide reductase from Escherichia coli, a molybdoprotein. AB - Escherichia coli trimethylamine N-oxide (TMAO) reductase I, the major enzyme among inducible TMAO reductases, was purified to homogeneity by an improved method including heat treatment, ammonium sulfate precipitation, and chromatographies on Bio-Gel A-1.5m, DEAE-cellulose, and Reactive blue-agarose. The molecular weight was estimated by gel filtration to be approximately 200,000. A single subunit peptide with a molecular weight of 95,000 was found by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. This enzyme contained 1.96 atoms of molybdenum, 0.96 atoms of iron, 1.52 atoms of zinc, and less than 0.4 atoms of acid-labile sulfur per molecular weight of 200,000. The absorption spectrum of the enzyme showed a peak at 278 nm and a shoulder at 288 nm, but no characteristic absorption was found from 350 to 700 nm. A fluorescent derivative of molybdenum cofactor was found when the enzyme was boiled with iodine in acidic solution; its fluorescence spectra were almost the same as those of the form A derivative of molybdopterin found in sulfite oxidase. The molybdenum cofactor released from heated TMAO reductase I reconstituted nitrate reductase in the extracts of Neurospora crassa mutant strain nit-1 lacking molybdenum cofactor. Thus, TMAO reductase I contains molybdopterin, which is a common constituent of some molybdenum-containing enzymes. Some kinetic properties were also determined. PMID- 3528140 TI - Use of the interactive videodisc to teach pathology: a preliminary report. AB - Although use of computers in education dates to the early 1960s,1-3 it is only with the arrival of the "microcomputer revolution" that computers have become economically feasible in medical education. The advent of inexpensive and relatively powerful microcomputers initiated something of a chain reaction; microcomputers became available for educational purposes, thus creating a market for educational software. This accelerated development of educational software in turn made microcomputers more useable. While synergistic hardware and software development has occurred repeatedly in the microcomputer industry, it is only in the beginning stages in medical education. This paper presents a discussion of the development of one computer-assisted instructional program that utilizes an interactive videodisc format. PMID- 3528141 TI - ATP induces the release of a neutral serine proteinase and enhances the production of superoxide anion in membranes from phorbol ester-activated neutrophils. AB - Plasma membranes isolated from human neutrophils after brief exposure to phorbol 12-myristate 13-acetate contain a large portion (30-40%) of the total cellular protein kinase C (Melloni, E., Pontremoli, S., Michetti, M., Sacco, O., Sparatore, B., Salamino, F., and Horecker, B. L. (1986) Biochem. Biophys. Res. Commun. 136, 228-234) and also retain almost 90% of their content of neutral serine proteinase (Pontremoli, S., Melloni, E., Michetti, M., Sacco, O., Sparatore, B., Salamino, F., Damiani, G., and Horecker, B. L. (1986) Proc. Natl. Acad. Sci. U.S.A. 83, 1685-1689). When ATP is added to the isolated membranes, a substantial amount (approximately 25%) of the intrinsic proteinase is released into the incubation medium. The addition of ATP in the presence of NADPH also caused a significant enhancement of the production of O2 radicals. These effects of ATP were not observed with membranes isolated from untreated neutrophils. The release of the serine proteinase is almost fully dependent on the addition of ATP and is correlated with the phosphorylation of membrane proteins. It is also markedly inhibited by the addition of retinal or trifluoperazine inhibitors of native protein kinase C. The results represent the first direct demonstration of a role for membrane-bound protein kinase C activity in the release of neutral proteinase and the production of O2 radicals, responses related to the cytotoxic effects of activated neutrophils. PMID- 3528142 TI - A mitochondrial presequence can transport a chloroplast-encoded protein into yeast mitochondria. AB - Ribulose-1,5-bisphosphate carboxylase/oxygenase of chloroplasts contains eight large and eight small subunits. The small subunit is encoded by nuclear DNA, synthesized in the cytoplasm, and imported into chloroplasts. The large subunit is encoded by chloroplast DNA and synthesized within chloroplasts. We show in this communication that the large subunit of Chlamydomonas chloroplasts could be efficiently imported into isolated yeast mitochondria if it was attached to the presequence of a protein transported into the yeast mitochondrial matrix. Thus, synthesis of the large subunit within chloroplasts does not reflect the inability of this subunit to cross membranes. The same mitochondrial presequence could also transport the nuclear-encoded small subunit into yeast mitochondria. However, when the two types of subunits were coimported into mitochondria, they did not assemble with each other inside the heterologous organelle. PMID- 3528143 TI - Chemical characterization and purification of the beta subunit of the DNA polymerase III holoenzyme from an overproducing strain. AB - We have purified the beta subunit of the DNA polymerase III holoenzyme to homogeneity from an overproducing strain (Blanar, M., Sandler, S., Armengod, M., Ream, L., and Clark, A. (1984) Proc. Natl. Acad. Sci. U.S.A. 81, 4622-4626). From this procedure we can obtain 100 mg quantities of protein. The beta isolated from the overproducer is indistinguishable from that isolated from wild-type cells in terms of its activity and molecular weight. Partial amino acid sequence analysis has confirmed the DNA sequence of the dnaN gene (Ohmori, H., Kimura, M., Nagata, T., and Sakakibara, Y. (1984) Gene (Amst.) 28, 159-170) and established the sites for initiation and termination of translation. No processing that removes amino acid residues from beta occurs since the active protein begins with the initiating methionine and terminates at the position predicted from the DNA sequence. Our knowledge of the precise amino acid composition has been used to determine the extinction coefficient of beta to be 17,900 and 18,700 cm-1 M-1 at 280 and 277 nm, respectively. The extinction coefficient at 280 nm is reduced to 14,700 cm-1 M-1 under denaturing conditions in guanidine HCl. Conditions have been optimized so that 1 N-ethylmaleimide residue can be incorporated per beta monomer with full preservation of activity. PMID- 3528144 TI - Assembly of a yeast 5 S RNA gene transcription complex. AB - The assembly of the yeast transcription factors IIIA, IIIB, and IIIC, represented by crude chromatographic fractions, into a stable complex on the 5 S RNA gene has been assessed using a template competition assay (Bogenhagen, D. F., Wormington, W. M., and Brown, D. D. (1982) Cell 28, 413-421). The yeast factor A can interact transiently with the yeast 5 S RNA gene, but both factors A and C are required for the formation of a stable complex. Factor A, but not factor C, is sequestered into this complex. Both factors A and C, however, are required for the sequestration of factor B into the 5 S RNA gene transcription complex. During this study, it was noted that an amount of factor C which was insufficient to lead to significant transcription of the 5 S RNA gene could nonetheless efficiently stabilize factor A on the template. This suggests that factor C may initially act catalytically to stabilize a transient interaction of factor A with the 5 S RNA gene before assuming a stoichiometric role in the assembly of the complete transcription complex. Alternative interpretations of this observation are discussed. PMID- 3528145 TI - Transcriptional regulation of the mitochondrial genome of yeast Saccharomyces cerevisiae. AB - The relative rates of transcription of several classes of the mitochondrial genes of the yeast Saccharomyces cerevisiae have been determined. The rates were measured by pulse labeling whole yeast with [32P]O4, isolating the total RNA, hybridization to single-stranded M13 DNA probes containing segments of the gene of interest, digestion with RNase A or T1, and separation of the protected fragment by gel electrophoresis. This analysis indicated that, among the genes analyzed, transcriptional promoters varied in strength by 20-fold while the rates of transcription varied by more than 50-fold. The strengths of the promoters of the genes were ordered: tRNAMetf greater than tRNAPhe greater than 14 S rRNA greater than 21 S rRNA greater than tRNAGlu greater than Oli-1 much greater than tRNACys. In addition, transcription rates were measured within polygenic transcription units. This analysis indicated that there was transcriptional attenuation within all the polygenic transcription units with the greatest attenuation factor being as much as 17-fold, occurring after the tRNAGlu and tRNAMetf genes. This analysis indicated that regulation of the rates of transcription in the yeast mitochondrial genome occurs by two distinct mechanisms, modulation of the rate of transcriptional initiation and attenuation of transcriptional elongation. PMID- 3528146 TI - Site-specific alteration of cysteine 176 and cysteine 234 in the lactose carrier of Escherichia coli. AB - In the present study, Cys-176 and Cys-234 in the lactose carrier have been modified to serine residues via site-specific mutagenesis. The resultant mutants have been characterized with regard to galactoside transport activity and sulfhydryl reagent sensitivity. The mutant proteins (in which Cys-176 or Cys-234 had been replaced with serine) are able to effectively transport galactosides, although the transport rates for lactose and methyl-beta-D-galactopyranoside are slightly reduced compared to the normal lactose carrier. In addition, both mutants are less sensitive than the wild-type to high concentrations of two different sulfhydryl reagents, N-ethylmaleimide and p-hydroxymercuribenzoate. Overall, the data are consistent with the idea that Cys-176 and Cys-234 are close to the substrate recognition site. However, neither residue appears to be essential for galactoside transport by providing an ionizable group near the active site or by forming a disulfide bond. PMID- 3528147 TI - Specific contacts between the FLP protein of the yeast 2-micron plasmid and its recombination site. AB - Contact points between the FLP protein of the yeast 2-micron plasmid and its recombination site have been defined. Important features of the region previously defined as the minimal recombination site in vitro include a pair of 13-base pair inverted repeats separated by an 8-base pair spacer. The two FLP protein-binding sites within this region are 12 base pairs in length. In each case they include the internal 11 base pairs of one of the 13-base pair repeats, as well as the adjacent base pair within the spacer. The internal 6 base pairs within the spacer are not involved in binding or recognition by FLP protein. When the size of the spacer is increased or decreased by one base pair, the distance between the cleavage points is also increased or decreased correspondingly by one base pair. Points of cleavage are unaffected by changes in the spacer sequence. Specific contact points involving purine residues, identified by methylation protection and recombination interference experiments, are located in both the major and minor grooves of the DNA. Additional contact points between FLP protein and phosphate groups in the phosphate-deoxyribose backbone are clustered near the cleavage sites. PMID- 3528148 TI - Preproglucagon gene expression in pancreas and intestine diversifies at the level of post-translational processing. AB - Glucagon is a pancreatic hormone of 29 amino acids that regulates carbohydrate metabolism and glicentin is an intestinal peptide of 69 amino acids that contains the sequence of glucagon flanked by peptide extensions at the amino and carboxy termini. The glucagon gene encodes a precursor containing glucagon and two additional, structurally related, glucagon-like peptides separated by an intervening peptide. These peptides are encoded in separate exons. To determine whether the pancreatic and intestinal forms of glucagon arise by alternative RNA and/or protein processing, we used antisera to synthetic glucagon-like peptides and exon-specific, complementary oligonucleotides for analyses of proteins and mRNAs in pancreatic and intestinal extracts. Preproglucagon mRNAs are identical, but different and highly specific peptides are liberated in the two tissues. Immunocytochemistry shows colocalization of glucagon and the two glucagon-like peptides in identical cells. We conclude that diversification of preproglucagon gene expression occurs at the level of cell-specific post-translational processing. PMID- 3528149 TI - Binding of the glucocorticoid receptor to the rat liver nuclear matrix. The role of disulfide bond formation. AB - The nuclear matrix is a putative skeletal structure which has been implicated in many nuclear functions. To assess a possible role of the nuclear matrix in glucocorticoid action, purified rat liver nuclei containing glucocorticoid receptor complexes were treated with DNase I +/- RNase A followed by 1.6 M NaCl, thus yielding salt-extractable and salt-resistant (nuclear matrix) fractions. The subnuclear distribution of hormone-receptor complexes was determined by following the fate of unmetabolized radiolabel after injection of labeled triamcinolone acetonide into adrenalectomized animals and subjecting various subfractions to immunoblotting using a monoclonal antibody which recognizes the glucocorticoid receptor. Both techniques indicated that 50-70% of the total nuclear hormone receptor complexes were recovered in the nuclear matrix fraction. Previous results (Kaufmann, S. H., and Shaper, J. H. (1984) Exp. Cell Res. 155, 477-495) suggest that a variety of nuclear polypeptides become nuclease- and salt resistant as a result of the formation of intermolecular disulfide bonds. The following evidence suggests that disulfide bonds mediate the association between the glucocorticoid receptor and the nuclear matrix. When nuclei were isolated in the absence of sulfhydryl-blocking and -cross-linking reagents, sodium dodecyl sulfate-polyacrylamide gel electrophoresis under nonreducing conditions revealed that the receptor was present as a high molecular weight disulfide-cross-linked complex. When nuclei were isolated in the presence of the irreversible sulfhydryl blocking reagent iodoacetamide, the disulfide bonds which cross-linked the receptor into high molecular weight complexes were absent; and 85-100% of the hormone-receptor complexes were salt-extractable. When nuclei (isolated in the absence of iodoacetamide) were treated with the sulfhydryl-cross-linking reagent sodium tetrathionate, greater than 95% of the nuclear hormone-receptor complexes became resistant to extraction with nucleases and 1.6 M NaCl. The implications of these results for other matrix-associated nuclear functions are discussed. PMID- 3528150 TI - Topology of outer membrane pore protein PhoE of Escherichia coli. Identification of cell surface-exposed amino acids with the aid of monoclonal antibodies. AB - Monoclonal antibodies which recognize the cell surface-exposed part of outer membrane protein PhoE of Escherichia coli were used to select for antigenic mutants producing an altered PhoE protein. The selection procedure was based on the antibody-dependent bactericidal action of the complement system. Using two distinct PhoE-specific monoclonal antibodies, seven independent mutants with an altered PhoE protein were isolated. Among these seven mutants, five distinct binding patterns were observed with a panel of 10 monoclonal antibodies. DNA sequence analysis revealed the following substitutions in the 330-residue-long PhoE protein: Arg-201----His (three isolates), Arg-201----Cys, Gly-238----Ser, Gly-275----Ser and Gly-275----Asp. It is argued that amino acid residues 201, 238, and 275 are most likely directly involved in antibody binding and, therefore, exposed at the cell surface. Together with Arg-158, which was previously shown to be cell surface exposed as it is changed in phage TC45 resistant phoE mutants, these four positions show a remarkably regular spacing, being approximately 40 residues apart. A model is suggested in which the PhoE polypeptide repeatedly traverses the outer membrane in an antiparallel beta pleated sheet structure, exposing eight areas to the outside which are all separated by approximately 40 residues. PMID- 3528151 TI - 3-Hydroxyacyl-CoA epimerases of rat liver peroxisomes and Escherichia coli function as auxiliary enzymes in the beta-oxidation of polyunsaturated fatty acids. AB - The beta-oxidation of 2-trans,4-cis-decadienoyl-CoA, an assumed metabolite of linoleic acid, by purified enzymes from mitochondria, peroxisomes, and Escherichia coli was studied. 2-trans,4-cis-Decadienoyl-CoA is an extremely poor substrate of the beta-oxidation system reconstituted from mitochondrial enzymes. The results of a kinetic evaluation lead to the conclusion that in mitochondria 2 trans,4-cis-decadienoyl-CoA is not directly beta-oxidized, but instead is reduced by NADPH-dependent 2,4-dienoyl-CoA reductase prior to its beta-oxidation. Hence, the mitochondrial beta-oxidation of 2-trans,4-cis-decadienoyl-CoA does not require 3-hydroxyacyl-CoA epimerase, a conclusion which agrees with the finding that 3-hydroxyacyl-CoA epimerase is absent from mitochondria (Chu, C.-H., and Schulz, H. (1985) FEBS Lett. 185, 129-134). However, 2-trans,4-cis-decadienoyl CoA can be slowly oxidized by the bifunctional beta-oxidation enzyme from rat liver peroxisomes, as well as by the fatty acid oxidation complex from E. coli. The observed rates of 2-trans,4-cis-decadienoyl-CoA degradation by these two multi-functional proteins were significantly higher than the values calculated according to steady-state velocity equations derived for coupled enzyme reactions. This is attributed to the direct transfer of L-3-hydroxy-4-cis decenoyl-CoA from the active site of enoyl-CoA hydratase to that of 3-hydroxyacyl CoA dehydrogenase on the same protein molecule. All observations together lead to the suggestion that the chain shortening of 2-trans,4-cis-decadienoyl-CoA in peroxisomes and in E. coli occurs simultaneously by two different pathways. The major pathway involves the NADPH-dependent 2,4-dienoyl-CoA reductase, whereas 3 hydroxyacyl-CoA epimerase functions in the metabolism of D-3-hydroxyoctanoyl-CoA which is formed via the minor pathway. PMID- 3528152 TI - Cell-type-specific fibronectin subunits generated by alternative splicing. AB - Multiple fibronectin mRNAs arise by alternative splicing of the primary transcript of a single gene. We describe analyses of the contribution of this alternative splicing to fibronectin subunit heterogeneity in three different cell types using antisera directed against specific segments of fibronectin. beta galactosidase-fibronectin fusion proteins produced with the lambda gt11 bacterial expression vector were used as immunogens. One region of alternative splicing accounts for differences in subunit size, while a second contributes to differences between the fibronectins present in blood plasma and in fibroblastic cells. We also show, however, that these two regions of alternative splicing do not account for all detectable subunits. We have also used these segment-specific antisera to show that blood platelets contain a spectrum of fibronectin subunits distinct from that found in blood plasma. PMID- 3528153 TI - Purification and characterization of a mitochondrial isozyme of C1 tetrahydrofolate synthase from Saccharomyces cerevisiae. AB - C1-Tetrahydrofolate synthase is a trifunctional polypeptide found in eukaryotic organisms that catalyzes 10-formyltetrahydrofolate synthetase (EC 6.3.4.3), 5,10 methenyltetrahydrofolate cyclohydrolase (EC 3.5.4.9), and 5,10 methylenetetrahydrofolate dehydrogenase (EC 1.5.1.5) activities. In Saccharomyces cerevisiae, C1-tetrahydrofolate synthase is encoded by the ADE3 locus, yet ade3 mutants have low but detectable levels of these enzyme activities. Synthetase, cyclohydrolase, and dehydrogenase activities in an ade3 deletion strain co-purify 4,000-fold to yield a single protein species as seen on sodium dodecyl sulfate polyacrylamide gels. The native molecular weight of the isozyme (Mr = 200,000 by gel exclusion chromatography) and the size of its subunits (Mr = 100,000 by sodium dodecyl sulfate-polyacrylamide gel electrophoresis) are similar to those of C1-tetrahydrofolate synthase. Cell fractionation experiments show that the isozyme, but not C1-tetrahydrofolate synthase, is localized in the mitochondria. Genetic studies indicate that the isozyme is encoded in the nuclear genome. Peptide mapping experiments show that C1-tetrahydrofolate synthase and the isozyme are not structurally identical. However, immunotitration experiments and amino acid sequence analysis suggest that C1-tetrahydrofolate synthase and the isozyme are structurally related. We propose to call the isozyme "mitochondrial C1-tetrahydrofolate synthase." PMID- 3528154 TI - Insulin-dependent phosphorylation of the insulin receptor-protein kinase and activation of glucose transport in 3T3-L1 adipocytes. AB - Insulin stimulates hexose transport and phosphorylation of the insulin receptor in monolayer cultures of intact 3T3-L1 adipocytes. To assess the phosphorylation state of the receptor in situ, cells were equilibrated with [32P]orthophosphate and then disrupted under denaturing conditions which preserved the phosphorylation state of the receptor established in the cell. The insulin receptor, isolated by lectin adsorption and two-dimensional nonreducing/reducing polyacrylamide gel electrophoresis, occurred as a single oligomeric species with an apparent alpha 2 beta 2 subunit composition. This oligomeric structure was not altered by treating cells with insulin. Only the beta-subunit of the receptor was phosphorylated; [32P]phosphoserine and [32P] phosphotyrosine were both identified in the beta-subunit from cells in the unstimulated state, but only [32P] phosphotyrosine increased in cells stimulated with insulin. Neither insulin-like growth factors I nor II stimulated insulin receptor beta-subunit phosphorylation, although both activated hexose transport. Upon the addition of insulin, [32P]orthophosphate incorporated into the beta-subunit increased 4.5-fold (7-fold with respect to [32P]tyrosine) and was complete within 1 min (t1/2 = 8 s). Following the removal of insulin from the monolayers, [32P]beta-subunit fell to the basal level (t1/2 = 2.5 min); there was no lag phase before either transition. The tyrosine protein kinase activity, measured in vitro with a model substrate, was higher with immunoaffinity-purified insulin receptor from insulin stimulated cells than from cells in the basal state. Hexose transport rate, measured using 3-O-[methyl-14C]glucose, was half-maximally stimulated at 2 nM insulin. A 1-min latency period followed insulin addition, after which a 7-fold increase in the steady-state rate of hexose uptake was achieved within 5 min. Upon the removal of insulin, hexose transport continued at the stimulated steady state rate for 2.5 min and then declined to the basal rate with a half-time of 8 min. These kinetic experiments in situ and protein kinase activity measurements in vitro support the hypothesis that beta-subunit phosphorylation is an intermediate step linking insulin binding to the increased glucose transport rate. PMID- 3528155 TI - Pig intestinal microvillar maltase-glucoamylase. Structure and membrane insertion. AB - The NH2-terminal sequence (25 residues) of amphiphilic single polypeptide chain maltase-glucoamylase (EC 3.2.1.20) was determined by gas-phase sequencing. The result indicates that the NH2-terminal segment anchors the enzyme to the microvillar membrane. The single-chain form and the proteolytically processed two chain form have two distinct active sites differing in heat stability. However, both sites are sensitive to chonduritol B-epoxide and have similar substrate specificity. The amphiphilic single-chain maltase-glucoamylase and the amphiphilic proteolytically processed form were inserted into liposomes and studied by electron microscopy. The results showed that the enzyme is predominantly present as a homodimeric complex in the membrane. PMID- 3528156 TI - Functional assembly in vitro of phycobilisomes with isolated photosystem II particles of eukaryotic chloroplasts. AB - Phycobiliproteins obtained by dissociation of phycobilisomes were reassociated in vitro with intact thylakoids or isolated photosystems I and II preparations obtained from cyanophytes (prokaryotes) or green algae (eukaryotes) to form bound phycobilisome complexes. Energy transfer from Fremyella diplosiphon phycobiliproteins to chlorophyll a of reaction centers I and II was measured in: complexes containing intact thylakoids of the cyanophytes F. diplosiphon or Anacystis nidulans and the eukaryotic algae Euglena gracilis and mutants of Chlamydomonas reinhardtii; complexes containing isolated photosystem II particles of A. nidulans or C. reinhardtii; and complexes containing reaction center I of F. diplosiphon or C. reinhardtii. Energy transfer from phycoerythrin to chlorophyll a of photosystem II could be demonstrated in complexes containing phycobilisomes bound to cyanophyte thylakoids or isolated photosystem II particles of A. nidulans or C. reinhardtii. Bound phycobilisomes did not transfer energy to photosystem II within green algae thylakoids containing altered forms of light-harvesting chlorophyll a/b-protein complex (LHC) II antenna, reduced amounts of LHC II, or chlorophyll b, or chlorophyll b-less mutants, nor to chlorophyll a of photosystem I of intact thylakoids or isolated reaction centers. We conclude that phycobilisomes can form a specific and functional association with photosystem II particles of both cyanophytes and eukaryotic thylakoids. This interaction appears to be hindered by the presence of LHC II antenna in the eukaryotic thylakoids. PMID- 3528157 TI - Antibodies to the N-terminal portion of cartilage-inducing factor A and transforming growth factor beta. Immunohistochemical localization and association with differentiating cells. AB - Two apparently homologous proteins, designated CIF-A and CIF-B, were previously isolated from bovine bone on the basis of their cartilage-inducing activity in culture. CIF-A has been shown to probably be identical to transforming growth factor beta (TGF-beta). To address the question of tissue localization, antibodies to CIF-A were produced using a synthetic polypeptide identical to N terminal residues 1-30. The antibodies were immunoreactive with bovine CIF-A and human TGF-beta, did not recognize CIF-B, and did not recognize other molecular weight species in crude bovine bone extracts. The antibodies were used to immunohistochemically localize CIF-A/TGF-beta in fetal bovine bone and other tissues. There was abundant staining of osteocytes throughout cancellous and cortical bone as well as chondrocytes within the articular cartilage, although growth plate-associated chondrocytes were not labeled. In addition, immunoreactive cells were detected in bone marrow (megakaryocytes and some mononuclear cells), fetal liver (hematopoietic stems cells), and the thymus (Hassall's corpuscle and some medullary thymocytes). In the kidney, the antibodies labeled a population of epithelial cells lining the calyces. Tissues which did not have detectable amounts of CIF-A/TGF-beta included the thyroid, adrenal, salivary gland, and aorta. Results presented here suggest that the factor may function in vivo as a general development and repair factor and may play a significant role in the differentiation of many cell types including chondrocytes, osteocytes, T-lymphocytes, and red blood cells. PMID- 3528158 TI - Hormonal regulation of lipogenic enzymes in chick embryo hepatocytes in culture. Thyroid hormone and glucagon regulate malic enzyme mRNA level at post transcriptional steps. AB - Mechanisms involved in stimulation of the synthesis of malic enzyme by insulin and triiodothyronine and in inhibition of synthesis by glucagon have been investigated by assessing levels and rates of synthesis of malic enzyme mRNA in chick embryo hepatocytes in culture. Insulin alone had no effect on the level of malic enzyme mRNA, whereas triiodothyronine by itself caused a 7-fold increase. Insulin plus triiodothyronine caused an 11-fold increase. Glucagon caused a 93% decrease in the accumulation of malic enzyme mRNA caused by insulin plus triiodothyronine. Although the relative changes in mRNA level are smaller in magnitude, they are qualitatively similar to the effects of these hormones on synthesis of malic enzyme, suggesting that control is exerted primarily at pretranslational steps. After addition of triiodothyronine, malic enzyme mRNA accumulated with sigmoidal kinetics, approaching a new steady state at 36-48 h after adding hormone. Puromycin, an inhibitor of protein synthesis, blocked the effect of triiodothyronine if added 30 min prior to the hormone and inhibited further accumulation of malic enzyme mRNA if added 24 h after triiodothyronine. However, puromycin had no effect on the level of beta-tubulin mRNA (t1/2 = 3-5 h), suggesting that the effect of triiodothyronine on malic enzyme mRNA required synthesis of a peptide. Triiodothyronine increased transcription of the malic enzyme gene by 2-fold and level of its mRNA by 11-14-fold, indicating regulation is primarily at a post-transcriptional step. Glucagon caused malic enzyme mRNA to decay with a half-life of 1.5 h, whereas alpha-amanitin or actinomycin D, inhibitors of transcription, caused the mRNA to decay with a half-life of 8-11 h. The effect of glucagon was entirely post-transcriptional because the hormone had no effect on transcription. Taken together, these results suggest a model in which triiodothyronine regulates production of a peptide that stabilizes malic enzyme transcripts in the cytoplasm and/or nucleus. Glucagon may inhibit activity of the peptide induced by triiodothyronine. PMID- 3528159 TI - Protein synthesis in yeast. Identification of an altered elongation factor in thermolabile mutants of the yeast Saccharomyces cerevisiae. AB - Cell-free extracts from the wild type yeast strain (A364A) and from a group of noncomplementing mutants that are conditionally defective in translation were preincubated at a restrictive temperature prior to incubation at a permissive temperature for protein synthesis. Results of these experiments showed that upon exposure to the restrictive temperature (39 degrees C), all five of the noncomplementing mutants lost ability to incorporate amino acid into protein. The wild type parent strain retained better than 80% of the activity under identical conditions of heat treatment. Mutant extracts could be revived to incorporate amino acid by the addition of the purified yeast elongation factor 3. Factors 1 and 2 had no effect. The heat-treated extract from one mutant did not supplement the activity of the other mutant. Although all five of the mutants were inactivated by preincubation at 39 degrees C, each showed a variable rate and extent of thermolability. Heat-treated mutant extracts were fully active in polyphenylalanine synthesis with liver ribosomes but not with the yeast ribosomes. Since liver ribosomes do not require factor 3, this assay then confirms that factor 3 is the thermolabile component in this group of noncomplementing mutants. PMID- 3528160 TI - Protein synthesis in yeast. Isolation of variant forms of elongation factor 1 from the yeast Saccharomyces cerevisiae. AB - Two species of the elongation factor 1 (EF-1) differing in molecular weight, subunit composition, and isoelectric point have been isolated from cell-free extracts of the yeast Saccharomyces cerevisiae. The ratio of these two forms of EF-1 activity (EF-1 alpha and EF-1H) seem to vary in different strains and upon the growth phase from which the cells have been isolated. The log phase cells of a protease negative yeast strain EJ101 show a distribution of EF-1 alpha and EF 1H in the ratio of 3:1. Another laboratory yeast strain, D-587-4B, shows a distribution pattern of 4:1. The two forms of EF-1 are completely separable by ion exchange, gel permeation, and hydrophobic and affinity chromatography. Yeast EF-1 alpha is a single polypeptide of molecular weight 50,000 and has an isoelectric point of 8.9. The newly identified form of the yeast EF-1 (EF-1H) has a molecular weight of 200,000. The isoelectric point of this protein is around 5.5. Electrophoresis of the partially purified EF-1H in polyacrylamide gel containing sodium dodecyl sulfate indicates the presence of three nonidentical polypeptides having molecular weights of 50,000, 47,000, and 33,000. The three polypeptides are present in the ratio of 2:1:1. EF-1H is readily converted to EF 1 alpha and EF-1 beta gamma on anion exchange columns. The 50,000 dalton component of EF-1H immunologically cross-reacts with the antibody to EF-1 alpha. The other two polypeptides do not. On the basis of molecular weight, EF-1H is 2-3 fold more active than EF-1 alpha in poly(U)-dependent polyphenylalanine synthesis. EF-1H exchanges nucleotide (GDP----GTP) at a faster rate than EF-1 alpha. Both EF-1 alpha and EF-1H exhibit similar binding constants for GDP and GTP although the affinity of EF-1 alpha for guanine nucleotides is several-fold higher than that of EF-1H. The 33,000-dalton component of EF-1H appears to be functionally analogous to EF-1 beta (Ts) isolated from other eukaryotic sources. The function of EF-1 gamma is unknown. PMID- 3528161 TI - Thermodynamics of the hydrolysis of adenosine 5'-triphosphate to adenosine 5' diphosphate. AB - The enthalpy of hydrolysis of the enzyme-catalyzed (heavy meromyosin) conversion of adenosine 5'-triphosphate (ATP) to adenosine 5'-diphosphate (ADP) and inorganic phosphate has been investigated using heat-conduction microcalorimetry. Enthalpies of reaction were measured as a function of ionic strength (0.05-0.66 mol kg-1), pH (6.4-8.8), and temperature (25-37 degrees C) in Tris/HCl buffer. The measured enthalpies were adjusted for the effects of proton ionization and metal ion binding, protonation and interaction with the Tris buffer, and ionic strength effects to obtain a value of delta H0 = -20.5 +/- 0.4 kJ mol-1 at 25 degrees C for the process, ATP4-(aq) + H2O(l) = ADP3-(aq) + HPO2-4(aq) + H+(aq) where aq is aqueous and l is liquid. Heat measurements carried out at different temperatures lead to a value of delta C0p = -237 +/- 30 J mol-1 K-1 for the above process. PMID- 3528162 TI - Protein phosphorylation and protein kinase activities in BC3H-1 myocytes. Differences between the effects of insulin and phorbol esters. AB - To determine whether insulin activates protein kinase C in BC3H-1 myocytes, we evaluated changes in protein phosphorylation, protein kinase activities, and the intracellular translocation of protein kinase C activity in response to insulin and phorbol esters. Phorbol 12-myristate 13-acetate (PMA), but not insulin, stimulated the phosphorylation of an acidic Mr 80,000 protein which has been shown to be an apparently specific marker for protein kinase C activation. In addition, PMA, but not insulin, stimulated the rapid association of protein kinase C activity with a cellular particulate fraction. In contrast to these differences, both insulin and PMA stimulated the phosphorylation of ribosomal protein S6 and activated a ribosomal protein S6 kinase in cell-free extracts from cells exposed to these agents. In cells exposed to high concentrations of PMA for 16 h, protein kinase C activity and immunoreactivity were abolished, without changes in cellular morphology. Under these conditions, insulin, but not PMA, stimulated phosphorylation of the ribosomal protein S6 in intact cells and activated the S6 kinase in cell-free extracts derived from insulin-treated intact cells. We conclude that: insulin does not appear to activate protein kinase C in BC3H-1 myocytes, at least as assessed by phosphorylation of the Mr 80,000 protein; both insulin and PMA activate an S6 protein kinase in these cells; and insulin can promote S6 phosphorylation and activate the S6 kinase normally in protein kinase C-deficient cells. Activation of the S6 kinase by insulin and PMA, although apparently proceeding through different mechanisms, may explain some of the similar biological actions of these compounds in BC3H-1 myocytes. PMID- 3528163 TI - The quaternary structure of ornithine transcarbamoylase and arginase from Saccharomyces cerevisiae. AB - Electron microscopic studies employing negative staining, rotary shadowing, and unidirectional shadowing have revealed the subunit architecture of ornithine transcarbamoylase and arginase from Saccharomyces cerevisiae. These techniques have confirmed the quaternary structure of these enzymes, and have permitted an estimate of the shape and dimensions of each of the individual enzymes as well as those of the corresponding subunits to be determined. Both enzymes are trimers exhibiting 3-fold rotational symmetry with subunits which are oblate ellipsoids of revolution. The overall dimensions determined for ornithine transcarbamoylase are a height of 39 A and a width of 102 A. The consequent subunit dimensions are 59 X 59 X 39 A, yielding a subunit axial ratio of 1.51. Arginase has a height of 42 A and a width of 97 A. The subunit dimensions are 56 X 56 X 42 A, yielding a subunit axial ratio of 1.33. The hydrodynamic behavior of the two enzymes is fully consistent with this molecular architecture, suggesting that the structures proposed here are similar to those of the proteins in aqueous solution. PMID- 3528164 TI - Regulation of arginine metabolism in Saccharomyces cerevisiae. Association of arginase and ornithine transcarbamoylase. AB - Association of arginase and ornithine transcarbamoylase (OTCase) has been proposed to play an essential role in the regulation of arginine metabolism in Saccharomyces cerevisiae (Wiame, J.-M. (1971) Curr. Top. Cell. Reg. 4, 1-39). In this report multienzyme complex formation is directly demonstrated in the presence of the active-site ligands for OTCase and arginase. Using equilibrium sedimentation, a dissociation constant for complex formation was determined to be 2.3 X 10(-8) M in the presence of ornithine and agmatine, active-site ligands for OTCase and arginase, respectively. A molecular stoichiometry in the complex of one molecule of OTCase to one molecule of arginase was verified using transmission electron microscopy. The dimensions of the complex were determined by negative staining and rotary and unidirectional shadowing techniques to be 102 A wide by 81 A high. These dimensions are quantitively consistent with dimensions of the individual enzymes (Duong, L. T., Eisenstein, E., Green, S. M., Ornberg, R. L., and Hensley, P. (1986) J. Biol. Chem. 261, 12807-12813). The enzymatic activity of OTCase is virtually completely inhibited when associated with arginase, reflecting the dramatic modulation of enzyme activity as a consequence of the acquisition of quaternary structure in this multienzyme complex. PMID- 3528165 TI - Seasonality of conception in Hutterite colonies of Europe (1758-1881) and North America (1858-1964). PMID- 3528166 TI - A radiolabeled monoclonal antibody binding assay for cytoskeletal tubulin in cultured cells. AB - To detect changes in the extent of tubulin polymerization in cultured cells, we have developed a radioactive antibody binding assay that can be used to quantitate total cytoskeletal tubulin or specific antigenic subsets of polymerized tubulin. Fibroblastic cells, grown to confluence in multiwell plates, were permeabilized and extracted with 0.5% Triton X-100 in a microtubule stabilizing buffer. These extracted cytoskeletons were then fixed and incubated with translationally radiolabeled monoclonal antitubulin antibody (Ab 1-1.1), an IgM antibody specific for the beta subunit of tubulin. Specific binding of Ab 1 1.1 to the cytoskeletons was saturable and of a single apparent affinity. All specific binding was blocked by preincubation of the radiolabeled antibody with excess purified brain tubulin. Specific Ab 1-1.1 binding appeared to represent binding to cytoskeletal tubulin inasmuch as: pretreatment of cells with colchicine decreased Ab 1-1.1 binding in a dose-dependent manner which correlated with the amount of polymerized tubulin visualized in parallel cultures by indirect immunofluorescence, taxol pretreatment alone caused an increase in Ab 1 1.1 binding and prevented in a dose-dependent manner the colchicine-induced decrease in antibody binding, in cells pretreated with colcemid and returned to fresh medium, Ab 1-1.1 binding decreased and recovered in parallel with the depolymerization and regrowth of microtubules in these cells, and comparison of maximal antibody binding per cell between primary mouse embryo, 3T3, and human foreskin fibroblasts correlated with immunofluorescence visualization of microtubules in these cells. Thus, this assay can be used to measure relative changes in the level of polymerized cytoskeletal tubulin. Moreover, by Scatchard type analysis of the binding data it is possible to estimate the total number of antibody binding sites per cell. Therefore, depending on the stoichiometry of antibody binding, this type of assay may be used for quantitating total cytoskeletal tubulin, specific antigenic subsets of cytoskeletal tubulin, or other cytoskeletal proteins. PMID- 3528167 TI - Endogenous lectins from cultured soybean cells: isolation of a protein immunologically cross-reactive with seed soybean agglutinin and analysis of its role in binding of Rhizobium japonicum. AB - Incubation of Rhizobium japonicum with the cultured soybean cell line SB-1, originally derived from the roots of Glycine max, resulted in specific adhesion of the bacteria to the plant cells. This binding interaction appears to be mediated via carbohydrate recognition, since galactose can inhibit the heterotypic adhesion but glucose cannot. Affinity chromatography, on a Sepharose column derivatized with N-caproyl-galactosamine, of the supernatant fraction of a SB-1 cell suspension after enzymatic removal of cell wall yielded a single polypeptide (Mr approximately 30,000) on immunoblotting analysis with rabbit antibodies directed against seed soybean agglutinin. Fluorescently labeled rabbit anti-seed soybean agglutinin also yielded specific immunofluorescent staining on the cell wall and plasma membrane of the SB-1 cells. These results suggest that one likely candidate that may mediate the recognition between the Rhizobium and the soybean cells is the endogenously produced SB-1 lectin. This notion is supported by the observation that rabbit anti-seed soybean agglutinin blocked the Rhizobium-soybean cell adhesion, whereas control antibodies did not. PMID- 3528168 TI - Coupled expression and colocalization of 140K cell adhesion molecules, fibronectin, and laminin during morphogenesis and cytodifferentiation of chick lung cells. AB - We have analyzed the expression and distribution of fibronectin, laminin, and the 140K cell adhesion molecules (140K complex) in embryonic chick lung cells by a combination of biochemical and immunofluorescent approaches. The 140K complex was identified by monoclonal antibody JG22E as a complex of glycoproteins averaging 140,000 Mr and has been implicated in vitro as a receptor for fibronectin and laminin. Our studies provide the first description that the 140K complex is developmentally regulated, and that the 140K complex appears to be involved in adhesion of epithelial and endothelial cells during morphogenesis. We have shown that the 140K complex is expressed in high quantity in embryonic lung cell types, but is markedly reduced in all of the differentiated cell types except smooth muscle. Embryonic lung cells are enriched in 140K complex on portions of cells in close proximity to areas rich in fibronectin. For example, during the formation of airways and alveolar tissues, 140K complex is concentrated at the basal surfaces of epithelial cells adjacent to fibronectin. Likewise, during the angiogenic invasion of capillaries into lung mesenchyme, the 140K complex becomes localized at sites on the basal surfaces of endothelial cells in close contact with fibronectin. Finally, cytodifferentiating lung smooth muscle cells show unusually high levels of 140K complex, fibronectin, and laminin that persist into the adult. In contrast to fibronectin, laminin is found to be uniformly distributed in the basement membranes of differentiating epithelial cells. It becomes prominent in adult alveolar epithelium and airway epithelium concomitant with a reduction or loss of 140K complex and fibronectin at cell-basement membrane attachment sites. Surprisingly, laminin is also present in a punctate pattern in the mesenchyme of early lung buds, however, laminin, fibronectin, and 140K complex are greatly reduced or lost during mesenchymal maturation. Our results are consistent with the active participation of the 140K complex in cell to-matrix adhesion during morphogenesis of alveolar walls and cytodifferentiation of mesenchymal and smooth muscle cells. PMID- 3528169 TI - Sertoli cell binding to isolated testicular basement membrane. AB - We have examined the adhesion of primary Sertoli cells to a seminiferous tubule basement membrane (STBM) preparation in vitro. The STBM isolation procedure (Watanabe, T.K., L.J. Hansen, N.K. Reddy, Y.S. Kanwar, and J.K. Reddy, 1984, Cancer Res., 44:5361-5368) yields segments of STBM that retain their histotypic form in both three-dimensional tubular geometry and ultrastructural appearance. The STBM sleeves contain two laminae: a thick, inner basal lamina that was formed in vivo between Sertoli cells and peritubular myoid cells; and a thinner, outer basal lamina that was formed between myoid cells and sinusoidal endothelial cells. Characterization by immunofluorescence and SDS PAGE revealed that the isolated STBM retained fibronectin, laminin, and putative type IV collagen among its many components. When the STBM sleeves were gently shaken with an enriched fraction of primary Sertoli cells, the Sertoli cells bound preferentially to the lumenal basal lamina at the ends of the STBM sleeves. Few Sertoli cells bound to either the outer basal lamina of the STBM sleeves or to vascular extracellular matrix material which contaminated the STBM preparation. 3T3 cells, in contrast, bound to all surfaces of the STBM sleeves. Pretreatment of the STBM sleeves with proteases, 0.1 M Na metaperiodate, 4 M guanidine HCl, or heating to 80 degrees-90 degrees C inhibited lumenal Sertoli cell binding, but binding was not inhibited by chondroitinase ABC, heparinase, hyaluronidase, or 4 M NaCl. The lumenal Sertoli cell binding occurred in the presence or absence of added soluble laminin, but not fibronectin. The addition of soluble laminin, but not fibronectin, restored random binding of Sertoli cells to trypsinized STBM sleeves. Our in vitro model system indicates that Sertoli cells recognize differences in two basal laminae produced in vivo on either side of myoid cells. PMID- 3528170 TI - Evidence for two-step processing of nuclear-encoded chloroplast proteins during membrane assembly. AB - A plastome (chloroplast genome) mutant of tobacco, lutescens-1, displays abnormal degradation of the chloroplast-encoded polypeptides which form the core complex of photosystem II (PSII). Two nuclear-encoded proteins (present in polymorphic forms), which normally function in the water oxidation process of PSII, accumulate as larger size-class polypeptides in mutant thylakoid membranes. These accumulated proteins are intermediate in size between the full-length primary protein synthesized in the cytoplasm and the proteolytically processed mature polypeptides. Trypsin treatment of unstacked mutant thylakoids and of inside-out vesicle (PSII-enriched) preparations indicated that the intermediate size forms were correctly localized on the inner surface of the thylakoid membrane, but not surface-exposed in the same way as the mature proteins. Only one of the intermediate size-class proteins could be extracted by salt washes. We interpret these data to be consistent with the idea that the two imported proteins that function in the water oxidation step of photosynthesis and are localized in the loculus (the space within the thylakoid vesicles) undergo two-step processing. The second step in proteolytic processing may be related to transport through a second membrane (the first transport step through the chloroplast envelope having been completed); this step may be arrested in the mutant due to the absence of the PSII core complex. PMID- 3528171 TI - Monoclonal antibodies to the light-harvesting chlorophyll a/b protein complex of photosystem II. AB - A collection of 17 monoclonal antibodies elicited against the light-harvesting chlorophyll a/b protein complex which serves photosystem II (LHC-II) of Pisum sativum shows six classes of binding specificity. Antibodies of two of the classes recognize a single polypeptide (the 28- or the 26- kD polypeptides), thereby suggesting that the two proteins are not derived from a common precursor. Other classes of antibodies cross-react with several polypeptides of LHC-II or with polypeptides of both LHC-II and the light-harvesting chlorophyll a/b polypeptides of photosystem I (LHC-I), indicating that there are structural similarities among the polypeptides of LHC-II and LHC-I. The evidence for protein processing by which the 26-, 25.5-, and 24.5-kD polypeptides are derived from a common precursor polypeptide is discussed. Binding studies using antibodies specific for individual LHC-II polypeptides were used to quantify the number of antigenic polypeptides in the thylakoid membrane. 27 copies of the 26-kD polypeptide and two copies of the 28-kD polypeptide were found per 400 chlorophylls. In the chlorina f2 mutant of barley, and in intermittent light treated barley seedlings, the amount of the 26-kD polypeptide in the thylakoid membranes was greatly reduced, while the amount of 28-kD polypeptide was apparently not affected. We propose that stable insertion and assembly of the 28 kD polypeptide, unlike the 26-kD polypeptide, is not regulated by the presence of chlorophyll b. PMID- 3528172 TI - Identification of ZO-1: a high molecular weight polypeptide associated with the tight junction (zonula occludens) in a variety of epithelia. AB - A tight junction-enriched membrane fraction has been used as immunogen to generate a monoclonal antiserum specific for this intercellular junction. Hybridomas were screened for their ability to both react on an immunoblot and localize to the junctional complex region on frozen sections of unfixed mouse liver. A stable hybridoma line has been isolated that secretes an antibody (R26.4C) that localizes in thin section images of isolated mouse liver plasma membranes to the points of membrane contact at the tight junction. This antibody recognizes a polypeptide of approximately 225,000 D, detectable in whole liver homogenates as well as in the tight junction-enriched membrane fraction. R26.4C localizes to the junctional complex region of a number of other epithelia, including colon, kidney, and testis, and to arterial endothelium, as assayed by immunofluorescent staining of cryostat sections of whole tissue. This antibody also stains the junctional complex region in confluent monolayers of the Madin Darby canine kidney epithelial cell line. Immunoblot analysis of Madin-Darby canine kidney cells demonstrates the presence of a polypeptide similar in molecular weight to that detected in liver, suggesting that this protein is potentially a ubiquitous component of all mammalian tight junctions. The 225-kD tight junction-associated polypeptide is termed "ZO-1." PMID- 3528173 TI - Toxoplasma modifies macrophage phagosomes by secretion of a vesicular network rich in surface proteins. AB - Modification of macrophage phagosomes begins shortly after formation as Toxoplasma cells secrete membranous vesicles that form a reticulate network within the vacuole. The Toxoplasma-modified compartments then resist normal endocytic processing and digestion. We have used the pronounced Ca++-dependent stability of the intraphagosomal membrane (IPM) network to purify and characterize the structural proteins of this assembly. In addition to the structural matrix, Toxoplasma secretes a discrete set of soluble proteins, including a newly described 22-kD calcium-binding protein. The IPM network adheres to intact Toxoplasma cells after host cell lysis in the presence of 1 mM Ca++; however, the network readily disperses in calcium-free buffer and was purified as vesicles that sedimented at 100,000 g. Purified IPM vesicles were specifically recognized by immune sera from mice with chronic Toxoplasma infection and consisted primarily of a 30-kD protein when analyzed by SDS PAGE. IPM network proteins share a major antigenic component located on the surface of extracellular Toxoplasma cells as shown by immunoperoxidase electron microscopy using a polyclonal antibody prepared against the IPM vesicles. Moreover, in Toxoplasma-infected macrophages, anti-IMP antibody confirmed that the extensive IPM array contains proteins also found on the Toxoplasma cell surface. Our results indicate the IMP network represents a unique structural modification of the phagosome comprised in part of Toxoplasma surface proteins. PMID- 3528174 TI - The expression of myosin heavy chain isoforms in normal and hypertrophied chicken slow muscle. AB - Hypertrophy was produced in the anterior latissimus dorsi (ALD) muscle of 5-wk old chickens by application of a load to the humerus. After 4 wk, hypertrophied ALD muscles were greater than 2.5 times heavier than contralateral control ALD muscles. Two isomyosins are distinguishable in normal ALD muscles by their different electrophoretic mobilities. It is shown here that the faster migrating SM-1 isomyosin decreases in abundance with age and that the application of an overload enhances both the rate and extent of this process. Monoclonal antibodies were selected by an immunotransfer technique that were specific for the heavy chains associated with either SM-1 or SM-2, or cross-reacted with both isoforms. The cellular distribution of the SM-1 and SM-2 isomyosins was analyzed by immunofluorescent technique using these antibodies. Anti-SM-1 and anti-SM-2 antibodies reacted with separate populations of cells, whereas the third antibody reacted with all myocytes in the normal ALD muscle. These data suggest that there is an exclusive cellular distribution of myosin heavy chains associated with SM-1 and SM-2 proteins. Immunofluorescent analysis of hypertrophied muscle showed the anti-SM-2-specific antibody reacting with all myocytes, whereas the anti-SM-1 specific antibody reacted with none. This is consistent with the elimination of the SM-1 isoform in hypertrophied muscles. PMID- 3528175 TI - Selective increase of c-myc mRNA levels by methylglyoxal-bis (guanylhydrazone) and novobiocin in serum-stimulated fibroblasts. AB - We have studied the effect of methylglyoxal-bis (guanylhydrazone) (MGBG) and novobiocin on the accumulation of specific mRNAs in serum-stimulated ts13 cells (a temperature-sensitive mutant of the BHK cell line). The RNAs studied included: c-myc, v-ras, ornithine decarboxylase, beta-actin, histone H3, and those represented by clones p2F1 and p1B6 (Hirschhorn et al., Proc. Natl, Acad. Sci. USA, 81:6004, 1984) All these RNAs accumulated at higher levels when quiescent cells were serum stimulated for 16 h. Both MGBG (25 micronM and 100 micronM) and novobiocin (200 micrograms/ml) effectively prevented the transition from G0 to S phase. We found that 100 microM MGBG induced an overaccumulation of c-myc RNA while H3 RNA was decreased, and the steady-state levels of all other RNAs were the same as in cells stimulated without the drug. Novobiocin prevented the serum induced increase in the amount of all RNAs, which remained at the same levels as in quiescent cells, with the exception of c-myc, which again accumulated at a higher level in drug-treated cells than in serum-stimulated untreated cells. The possible significance of these results is discussed. PMID- 3528177 TI - Heparin protects basic and acidic FGF from inactivation. AB - The ability of heparin or that of hexuronyl hexosaminoglycan sulfate (HHS-4) to protect basic or acidic fibroblast growth factor (FGF) from acid or heat inactivation has been analyzed. Both freshly prepared basic and acidic FGF stimulate the growth of baby hamster kidney (BHK-21) cells exposed to medium supplemented with transferrin and insulin. Freshly prepared basic FGF was 10 fold more potent than acidic FGF. The addition of heparin to the medium decreased the potency of basic FGF while it potentiated that of acidic FGF. Upon storage of FGF at -80 degrees C, a decline in potency of both basic and acidic FGF was observed. Heparin, when added to the medium, potentiated their activities, which became similar to that of freshly prepared basic FGF. In order to test whether heparin could protect basic or acidic FGF from inactivation, both mitogens were exposed to acid conditions (1% trifluoroacetic acid, pH 1.08, 2 h) or heat (65 degrees C, 5 min) which inactivate basic or acidic FGF. When exposed to such treatment in the presence of heparin or HHS-4, basic and acidic FGF retained their potency. The effect of heparin and HHS-4 on the bioactivity of basic and acidic FGF is truly of a protective nature, since they had no effect when added after inactivation of the mitogens. Potentiation of the bioactivity of the protected mitogens or of the inactivated one could only be observed when cells were exposed to high heparin or HHS-4 concentrations. This indicates that heparin and HHS-4, in addition to protecting FGF from inactivation, also acts at another locus, as yet unidentified. PMID- 3528176 TI - In vitro actions on hemopoietic cells of recombinant murine GM-CSF purified after production in Escherichia coli: comparison with purified native GM-CSF. AB - Recombinant murine GM-CSF produced in Escherichia coli was purified to homogeneity and tested in parallel with purified native GM-CSF. Both recombinant and native GM-CSF stimulated granulocyte and/or macrophage colony formation by adult and fetal mouse progenitor cells, and with adult marrow cells the specific activity of the recombinant GM-CSF (25 X 10(8) U/mg) was similar to that of the native form (15 X 10(8) U/mg). At high concentrations (greater than 200 U/ml), both forms of GM-CSF also stimulated eosinophil colony formation by adult marrow cells and, at very high concentrations (greater than 800 U/ml), megakaryocyte and some erythroid and mixed-erythroid colony formation. Recombinant GM-CSF was as effective in stimulating the proliferation of the GM-CSF-dependent cell line FD as the native molecule. Both recombinant and native GM-CSF were able to induce partial differentiation in colonies of WEHI-3B myeloid leukemic cells. Recombinant GM-CSF competed effectively for the binding of 125I-labeled native GM CSF to hemopoietic cells, and antiserum to recombinant GM-CSF also neutralized the biological activity of native GM-CSF. The bacterially synthesized GM-CSF was a slightly more effective stimulus for megakaryocyte colony formation than the native molecule. The demonstration that purified bacterially synthesized GM-CSF is biologically active in vitro now permits studies to be undertaken on the in vivo effects of this material. PMID- 3528179 TI - Regulatory mechanisms affecting the blast stem cells of acute myeloblastic leukemia. AB - Recent studies have indicated the existence of a novel regulatory system governing cell growth and differentiation. The system is based on the cellular homologues of the transforming genes (oncogenes) of retroviruses. Cellular oncogene products include regulators of the cell generation cycle, cell-surface receptors, and growth factors. Preliminary evidence is available that this regulatory system is important in hemopoiesis. In this paper, the biology of the blast cells of acute myeloblastic leukemia is reviewed. Data is presented indicating that genetic control may be exercised in the nucleus to affect self renewal, at the cell surface, to mediate cell-to-cell interactions and through the environment by the production of growth factors. These findings support the suggestion that the blast population is a suitable model for studying oncogene based regulation. Blasts have the further advantage that laboratory observations made with their use can be correlated with the clinical course of the disease. PMID- 3528178 TI - Oncogenes and proto-oncogenes. PMID- 3528180 TI - Thermic effects on the expression of human lymphocyte genes. PMID- 3528181 TI - Genes encoding the alpha and beta chains of the human T cell antigen receptor. PMID- 3528182 TI - What chemicals are responsible for colon cancer? PMID- 3528183 TI - Relevance of N-nitrosamines to esophageal cancer in China. AB - Studies on the relevance of the N-nitrosamines to esophageal cancer in China are reviewed. Esophageal cancer is a complex and multifactorial problem. Although a causal association between nitrosamines exposure and esophageal cancer in China has not yet been rigorously established, exposure of Lin-Xian subjects to nitrosamines either directly or as a result of their in vivo formation has been detected in our study. Several N-nitrosamines (NDMA, NDEA, NMBzA, NPyr, NPip, and NSAR) in gastric juice collected from Lin-Xian inhabitants have been detected. A correlation was found between the lesions of esophageal epithelium and the amount of nitrosamines present. In addition, the amounts of N-nitrosamino acids (N nitrosoproline, N-nitrosothiazolidine 4-carboxylic acid, NSAR, and nitrates) excreted in 24-hr urine of subjects in Lin-Xian were significantly higher than those in Fan-Xian, indicating a higher exposure to N-nitroso compound and their precursors of the inhabitants in the high-risk area. The effect of nitrosamines on human esophagus has been investigated at the cellular levels. The amounts of O6-MedG in DNA of esophageal or stomach mucosa of patients from Lin-Xian were higher than that from Europe (Lyon and Essen). The presence of O6-MedG in the human fetal esophagus cultured with NMBzA was also detected. These findings indicate that the elevated levels of O6-MedG in esophageal DNA could be the result of a recent exposure to N-nitroso compounds or a genetically determined reduced cellular capacity for repair of O6-MedG from DNA. The hyperplasia was induced in the esophagus of human fetus that cultured with NMBzA for 2 weeks to 2 months. The intervention studies of esophageal cancer in Lin-Xian have been pursued. Intake of moderate doses of ascorbic acids by Lin-Xian subjects effectively reduced the urinary levels of N-nitrosamino acids to those found in un-dosed subjects in the low-risk area. If N-nitroso compounds are formed in vivo and are among the causative factors of esophageal cancer in Lin-Xian, ascorbic acid appears to be effective in lowering the body burden of these carcinogenic compounds. Thus, the plan of chemoprevention is carried out in Lin-Xian. PMID- 3528184 TI - Genetics of human cancer. PMID- 3528185 TI - Growth and differentiation of normal and transformed human bronchial epithelial cells. PMID- 3528186 TI - Philosophy of hand rehabilitation. AB - This article is an introduction to the history and philosophy of hand surgery and hand therapy. Case histories illustrate the basic principles and goals of hand rehabilitation. The importance of the team approach in the successful management of hand injuries is emphasized. PMID- 3528187 TI - Prospects for reassembling the cell nucleus. PMID- 3528188 TI - Future directions for studies of mechanisms for generating flagellar bending waves. PMID- 3528189 TI - Molecular and cell biology of plant cells. PMID- 3528190 TI - Cell cycle regulation in yeast. PMID- 3528191 TI - Regulation of cell proliferation at the onset of DNA synthesis. PMID- 3528192 TI - Cellular aspects of circadian rhythms. PMID- 3528193 TI - Desmosomes, cell adhesion molecules and the adhesive properties of cells in tissues. PMID- 3528195 TI - Biology of the macrophage. PMID- 3528194 TI - The gap junction. PMID- 3528197 TI - Meiosis: some considerations. PMID- 3528196 TI - Nuclear transplantation in eggs and oocytes. PMID- 3528198 TI - Cell mingling during mammalian embryogenesis. PMID- 3528199 TI - DNA maintenance and its relation to human pathology. PMID- 3528200 TI - The genetic analysis of malignancy. PMID- 3528201 TI - Cell surface carbohydrates: molecules in search of a function? PMID- 3528202 TI - The membrane-associated 'cortex' of animal cells: its structure and mechanical properties. PMID- 3528203 TI - [Contusions of the abdomen in children]. AB - Marked progress in the treatment of abdominal contusions in children over the last few years is due to the development of conservative surgery to the spleen and even possible abstention from operation following splenic injuries. The reliability of paraclinical exploratory procedures has increased, and ultrasound and CT scan imaging have reduced the need for peritoneal puncture-lavage. However, and unresolved problem concerns associated visceral lesions, and although treatment of isolated splenic injuries is fairly well detailed that of hepatic lesions raises difficulties because of lack of data on exact location of lesions and the anatomical damage produced. Injuries provoked and treatment instituted are described in relation to children admitted for severe abdominal contusions between 1970 and 1985. Since 1984, 52 children have undergone initial ultrasound imaging and only 6 (8%) peritoneal puncture-lavage procedures were necessary. Ultrasound is of value for diagnosis of a hemoperitoneum but of very limited use for defining sites of lesions, a more refined diagnosis being established by computed tomography. Finally, routine simplified emergency intravenous urography is performed in any child with severe abdominal contusion with even microscopic hematuria to detect possible subadventitial rupture of renal artery. PMID- 3528204 TI - Chemotaxonomy of selected species of the Actinobacillus-Haemophilus-Pasteurella group by means of gas chromatography, gas chromatography-mass spectrometry and bioenzymatic methods. AB - Instrumental analytical and bioenzymatic methods were used to differentiate between species of the Actinobacillus-Haemophilus-Pasteurella group. Long-chain fatty acids were analysed directly with gas chromatography (GC) without derivatization. GC of trifluoroacetylated whole-cell methanolysates was a rapid method for differentiation. Cellular sugars were more suitable for differentiation than fatty acids. D-Glycero-D-mannoheptose, the major localization of which was lipopolysaccharide, distinguished H. aphrophilus from A. actinomycetemcomitans, H. paraphrophilus, H. influenzae type b, P. haemolytica, P. multocida, and P. ureae. GC of single colonies, which is a new chemotaxonomic method, was preferable to GC of liquid-grown cells. Lysozyme-and EDTA-induced bacteriolysis and reduction of methylene blue by cellular hydrogenase served as additional criteria for differentiation. PMID- 3528205 TI - Detection of double-stranded RNA by immunoblot electrophoresis. AB - A procedure is described which permits the serological detection of double stranded RNA (dsRNA) which has been electrophoretically transferred from agarose gels to Zeta-Probe blotting membranes. Cucumber mosaic virus replicative forms of RNAs 1-3 and cassava (Manihot esculenta) clone 'Secundina' dsRNAs can be routinely detected from 1 g of leaf tissue. This procedure allows for the detection and size estimation of dsRNAs in crude nucleic acid preparations. PMID- 3528206 TI - Isolation of measles virus polypeptides from infected brain tissue by affinity chromatography. AB - A method has been developed to isolate measles virus proteins from infected hamster brain tissue. Suckling hamsters inoculated intracerebrally with the HBS strain of measles virus were used in these studies. Viral proteins were isolated from infected brain lysates by affinity chromatography on Sepharose beads coupled with IgG from rabbit hyperimmune anti-measles serum. The eluted proteins were separated by SDS-polyacrylamide gel electrophoresis (SDS-PAGE), electrophoretically transferred onto blotting matrix, and immunolabelled with anti-measles antibodies. Individual viral proteins were identified by labelling with monoclonal or monospecific antibodies. All viral proteins except the fusion (F1) protein were identifiable on the immunoblots in relative amounts comparable to purified virions. In addition, a second phosphoprotein (P) band not found in purified virions was present in infected brains and cell cultures infected with HBS or LEC strains of virus. This method should be useful for isolating small quantities of viral proteins from large amounts of tissue, and should make possible the characterization of measles virus proteins in persistently infected CNS tissue. PMID- 3528207 TI - Immunological cross-reactivity of adenovirus structural proteins. AB - The interserotypic cross-reactivity of adenovirus-specific antisera was examined on Western blots of virion proteins. The pattern of cross-reactivity was very complex. Virion polypeptides III, VI and the core VII were the major reactants. Generally, the degree of reactivity correlated with type and subgroup specificity. PMID- 3528208 TI - Immunoreactive renin, prorenin, and enzymatically active renin in plasma during pregnancy and in women taking oral contraceptives. AB - Direct RIA of renin with monoclonal renin antibodies and indirect RIA with angiotensin I antibodies were performed in plasma of 44 pregnant women, 44 women taking an oral contraceptive (OC), and 54 normal women. The following parameters were measured: immunoreactive renin, naturally occurring enzymatically active renin (active renin), trypsin-activatable inactive renin (prorenin), PRA, and renin substrate. Immunoreactive renin (mean, 95% confidence interval) was significantly higher in pregnant women (1090; 420-2800 pg/ml; third trimester) than in normal women (248; 101-562 pg/ml; P less than 0.001) and was lower in OC treated women (131; 41-415 pg/ml; P less than 0.001). Prorenin and active renin also were increased in pregnant women and decreased in OC-treated women. The fraction of renin that was in the active form was lower in pregnant women (4.8; 1.4-18%) than in OC-treated women (8.8; 3.0-25%; P less than 0.001) and normal women (9.1; 2.9-29%; P less than 0.001). Renin substrate was increased to comparable levels in pregnant women and OC-treated women, but PRA was increased in pregnant women and normal in OC-treated women. The maximum velocity per unit weight of renin was the same for active renal renin as for active plasma renin and trypsin-activated plasma prorenin. Maximum velocity and Km values measured in mixtures of purified active renin and renin substrate and the concentrations of active renin and renin substrate measured in whole plasma were entered into the Michaelis-Menten equation for calculating PRA. The calculated values were similar to the measured results in all three groups, indicating that PRA was determined by the molar concentrations of enzyme and substrate. Thus, we found no evidence of unknown substances in plasma interfering with the enzyme-substrate reaction. The percentage of circulating renin in the active form was much lower during pregnancy than in other conditions where the renal release of active renin is stimulated and prorenin is as high as during pregnancy. This suggests that a smaller fraction of prorenin is intrarenally converted into active renin before its release into the circulation or that a larger fraction of circulating prorenin is of extrarenal origin. The finding that PRA is normal during OC treatment suggests that the estrogen-induced increase in renin substrate is compensated for by suppressed renal release of active renin. PMID- 3528209 TI - Feedback inhibition of insulin secretion is altered in cirrhosis. AB - Hyperinsulinemia in human cirrhosis is generally considered an expression of reduced hepatic insulin degradation. To determine whether hyperinsulinemia may also depend on an altered feedback inhibition of insulin secretion, we performed euglycemic hyperinsulinemic clamp studies, infusing 40, 372, or 1280 mU/m2 X min biosynthetic human insulin in 30 compensated cirrhotic patients with portal hypertension and impaired glucose tolerance and 25 normal subjects, matched for age, sex, and weight. Mean fasting plasma insulin was significantly higher in cirrhotic patients [26.1 +/- 2.3 vs. 12.4 +/- 0.6 (+/- SE) microU/ml; P less than 0.001], while fasting plasma glucose levels were similar in the 2 groups. The mean plasma C-peptide level was significantly higher in cirrhotic patients, both basally (2.7 +/- 0.1 vs. 1.7 +/- 0.1 ng/ml; P less than 0.001) and during the clamp studies. Suppression of C-peptide at 120 min of the clamp was significantly less in cirrhotic patients (37 +/- 7% vs. 79 +/- 4%, 52 +/- 9% vs. approximately 100%, and 54 +/- 4% vs. approximately 100% during the 40, 372, and 1280 mU/m2 X min insulin infusions, respectively). The fasting C-peptide to insulin molar ratio was significantly lower in cirrhotic patients (5.4 +/- 0.3 vs. 6.4 +/- 0.3; P less than 0.005). The MCR of insulin at the three steady states was not significantly different between the 2 groups, whereas the basal systemic delivery rate of insulin was significantly higher in cirrhotic patients (14.7 +/- 1.7 vs. 6.5 +/- 0.4 mU/m2 X min; P less than 0.001). These results suggest that reduced feedback inhibition of insulin secretion may contribute to the hyperinsulinemia associated with cirrhosis. PMID- 3528210 TI - Insulin receptor proliferation: a mechanism for tumor-associated hypoglycemia. AB - A 30-yr-old man was found to have intractable hypoglycemia associated with colon carcinoma metastatic to the liver. Analysis of glucose requirements before death revealed a level of glucose turnover in excess of 12.9 mg/kg X min, consistent with maximally stimulated whole body glucose utilization. This high level of glucose turnover was present at a time when plasma immunoreactive insulin was very low. Insulin binding was measured in freshly isolated circulating mononuclear cells before death and in plasma membranes prepared from several tissues obtained at autopsy. A 3- to 5-fold increase in insulin receptor number was found in the mononuclear cells and liver and muscle plasma membranes. In contrast, skin fibroblasts maintained in tissue culture demonstrated no increase in insulin binding, thus suggesting that the increase in insulin receptors in freshly isolated tissues was acquired rather than intrinsic. Antibodies directed against the insulin receptor were not present. The patient's serum concentration of insulin-like growth factor I was low, but the serum level of nonsuppressible insulin-like protein was elevated. Serum bioassayable insulin-like activity was decreased. Based on tumor bulk at autopsy and in vitro analysis of glucose transport by his tumor cells maintained in monolayer tissue culture, it was estimated that his tumor could directly account for less than one third of the whole body glucose requirement. These data suggest that the increased tissue utilization of glucose in this hypoglycemic patient was caused by proliferation of insulin receptors in liver and muscle induced by his nonislet cell tumor through an unknown humoral mechanism(s). PMID- 3528211 TI - Saliva, breast milk, and serum antibody responses as indirect measures of intestinal immunity after oral cholera vaccination or natural disease. AB - The possibility that antibody responses in serum, saliva, or breast milk samples to oral vaccines or enteric infections may reflect the intestinal immune response was evaluated in Bangladeshi volunteers orally immunized with a cholera B subunit whole-cell vaccine (B + WCV) and in patients convalescing from enterotoxin induced diarrheal disease. Two peroral doses of B + WCV induced antitoxin and antibacterial antibody responses in the intestinal fluids of 76 and 92%, respectively, of the volunteers and in serum samples in 90 and 69% of those tested. These responses were comparable to those obtained after cholera or enterotoxigenic Escherichia coli disease. Whereas immunoglobulin A (IgA) antitoxin titer increases in saliva (44%) and breast milk (29%) specimens after vaccination were less frequent than in intestinal fluid (76%), antitoxin responses in saliva and breast milk occurred in 80 to 90% of the patients after disease. Also, antilipopolysaccharide (anti-LPS) titer increases in extraintestinal body fluids were found more frequently after disease than after vaccination. A comparison of the frequency and magnitude of antibody response in different body fluids with those in intestinal lavage fluid revealed no extraintestinal antibody that directly reflected the intestinal immunity. However, comparison of vibriocidal and IgG antitoxin antibodies in serum specimens with antitoxin and anti-LPS IgA responses in intestinal fluids after the vaccination of volunteers showed a sensitivity of 70 to 90% and a predictive accuracy of about 80% for the serum analyses reflecting the intestinal immune responses. Furthermore, antitoxin and anti-LPS antibody responses in saliva and breast milk samples seemed to be useful proxy indicators of a gut mucosal response of these antibodies after enterotoxin-induced diarrheal disease showing sensitivity vales of 70 to 90% and predictive accuracy vales of 70 to 100%. PMID- 3528212 TI - Use of the Bac-T-Screen to predict bacteriuria from urine specimens held at room temperature. AB - Results from the Bac-T-Screen (BTS) of fresh urine specimens were compared with the BTS results obtained when the same urine specimens had been held at room temperature for 24 h. Of the 246 specimens studied, 43 were initially BTS positive, 11 were false-negative, and 39 had greater than or equal to 10(5) CFU/ml. After 24 h at room temperature an additional 60 specimens had greater than or equal to 10(5) CFU/ml, of which only 16 were BTS positive; 10 specimens still gave false-negative results, and the number of false-positive specimens increased by only 6.5% of all specimens. For significant specimens (containing greater than or equal to 10(5) CFU of probable pathogens per ml), the predictive value of a negative test changed by only 0.1% (99.5 to 99.4%), whereas the sensitivity of the test remained at 96.4% for incubated specimens. Of those specimens that developed greater than or equal to 10(5) CFU/ml in vitro, 85% contained gram-negative bacilli. Neither bacteria grown in vitro nor urine specimens from normal females containing greater than or equal to 10(5) CFU/ml were positive with the BTS. For reasons not entirely understood, the BTS system may be unique in its ability to discriminate between bacteria which represent true bacteriuria and those which are present because of contamination, possibly due to other cellular elements present in infection-related bacteriuria, namely leukocytes and sloughed bladder epithelial cells. PMID- 3528213 TI - Influence of culture medium on susceptibility testing with BAY n 7133 and ketoconazole. AB - The effect of four culture media (two complex and undefined [Sabouraud glucose and Kimmig] and two synthetic and defined [synthetic amino acid medium, fungal, and modified yeast nitrogen base]) on the activity in vitro of two newer azole compounds (BAY n 7133 and ketoconazole) was assessed with five strains each of Candida albicans, Candida parapsilosis, and Cryptococcus neoformans. Also, the nutritional adequacy of the four media was evaluated with the same 15 strains of yeastlike fungi. While the MICs of BAY n 7133 were higher in the complex media, the activity of ketoconazole was little affected. The Candida spp. grew least well and the C. neoformans grew best in yeast nitrogen base. PMID- 3528214 TI - Evaluation of spot CAMP test for identification of group B streptococci. AB - The CAMP (Christie-Atkins-Munch-Petersen) test is commonly used for the presumptive identification of Streptococcus agalactiae (Lancefield group B). Using 350 clinical isolates of beta-hemolytic streptococci, we compared a 30-min spot CAMP test with the standard overnight CAMP test and the Lancefield precipitin test. We found 99% agreement among all three tests for all streptococci tested. The spot CAMP test is a rapid, inexpensive, and accurate method for identifying group B streptococci. PMID- 3528216 TI - Stability of immunofluorescence reactions produced by polyclonal and monoclonal antibody conjugates for rabies virus. AB - We investigated two consumer complaints that described fading of immunofluorescence reactions associated with the use of a commercial antirabies, fluorescein-labeled, monoclonal antibody conjugate. We compared the performance of this product with that of two polyclonal antibody antirabies conjugates and observed significant diminution of fluorescence with the monoclonal antibody conjugate only. Furthermore, the fading occurred only on tissue impressions that had been mounted but not exposed to UV light excitation, thereby essentially eliminating the photobleaching associated with fluorescence microscopy as a causative factor. Our observations suggest that mounting medium pH and the holding temperature of stained slides may be critical factors in maintaining optimal immunofluorescence reactions with this monoclonal antibody conjugate. We discuss some probable mechanisms that could produce the type of fading observed and also suggest certain precautionary measures for use with this monoclonal antibody conjugate. PMID- 3528217 TI - Serodiagnosis of visceral leishmaniasis in an American Peace Corps volunteer. AB - A case of visceral leishmaniasis in a young American Peace Corps volunteer is reported. Both clinical and epidemiologic evidence strongly supported the diagnosis; however, hepatic and splenic aspirates for the causative organism were negative. The diagnosis was eventually confirmed through serology, employing indirect immunofluorescence and complement fixation testing of serum. The patient clinically responded dramatically to sodium stibogluconate, the drug of choice for the treatment of visceral leishmaniasis. This case is significant because it alerts the physician to an unusual cause of fever of unknown origin in residents of the Western nations and demonstrates the potential usefulness of serology in diagnosing visceral leishmaniasis when the infecting organism cannot be isolated. PMID- 3528215 TI - Competitive enzyme-linked immunosorbent assay for cholera-related enterotoxins in Salmonella typhimurium. AB - We report a rapid competitive enzyme-linked immunosorbent assay to screen Salmonella typhimurium strains for cholera-related enterotoxin antigens. Polymyxin B extracts of bacterial cells from syncase-glucose broth cultures of 7 of 15 strains gave positive results. The specificity of the test was confirmed with known heat-labile-enterotoxin-positive and -negative Escherichia coli strains which gave significantly different values. PMID- 3528218 TI - Bone deficit in ovariectomized rats. Functional contribution of the marrow stromal cell population and the effect of oral dihydrotachysterol treatment. AB - This study investigates the proliferative and osteogenic role of marrow stromal/osteoprogenitor cells in the development of the cortical bone deficit in ovariectomized (OVX) female rats. In vitro, clonal growth of marrow stromal cells from OVX rats was significantly impaired (vs. sham-operated controls). Yet in vivo, cells from sham-operated and OVX rats had equal osteogenic potential in several in vivo experimental situations, such as in intraperitoneally implanted millipore diffusion chambers and in intramuscular implants of marrow plus osteoinductive bone matrix (composite grafts). Long-term (6 mo) dihydrotachysterol (DHT) treatment of OVX rats enhanced their in vitro proliferative potential and clonal growth, as well as their osteogenic expression in composite grafts. The observation that the in vivo osteogenic performance of OVX rat marrow stromal cells was normal at extraosseous sites suggests that the mechanisms leading to osteopenia may involve an abnormality in cell-matrix interactions. PMID- 3528219 TI - Embryotoxic effects of brief maternal insulin-hypoglycemia during organogenesis in the rat. AB - To test whether maternal hypoglycemia can impair organogenesis, we induced brief glucopenia with insulin in conscious pregnant rats during either the headfold stage or the early neural tube closure stage of embryogenesis. At each time, 10 pairs of animals received identical insulin infusions for 1 h. Half the animals were maintained at euglycemia during the infusions, while the others were allowed to become hypoglycemic. Euglycemia was maintained or restored in all animals immediately after the insulin was stopped. Spontaneous activity was diminished during the hypoglycemia but consciousness was preserved. Embryos were removed from mothers and examined 2 d later. This examination revealed that embryos from the hypoglycemic mothers were growth-retarded and displayed a small but significant incidence of gross developmental anomalies compared with embryos from the insulin-infused euglycemic mothers. Thus, brief, mild maternal hypoglycemia during early organogenesis can disrupt normal embryo development in the rat. The effect is due to the hypoglycemia per se rather than to the insulin employed for its induction. PMID- 3528220 TI - Vasoconstrictor role for vasopressin in experimental heart failure in the rabbit. AB - Vasopressin's role as a vasoconstrictor in chronic heart failure, was examined in rabbits with adriamycin cardiomyopathic congestive heart failure. Chronic adriamycin treatment resulted in a decrease in cardiac output (829 +/- 38-610 +/- 36 ml/min, P less than 0.005) and blood pressure (83 +/- 2-76 +/- 3 mmHg, P less than 0.01), and an increase in peripheral resistance (8,377 +/- 381-10,170 +/- 657 dyn-s-cm-5, P less than 0.05). Plasma renin activity (4.7 +/- 0.6-10.9 +/- 2.8 ng angiotensin I/ml X h) and norepinephrine (0.7 +/- 0.1-1.3 +/- 0.2 pmol/ml, P less than 0.05) increased while plasma vasopressin levels did not change. Vasopressin infusion, however, produced significantly greater increases in peripheral resistance in animals with heart failure than in controls. Moreover, a specific vasopressin vascular antagonist reduced blood pressure (7 +/- 3%) and peripheral resistance (14 +/- 4%) and increased cardiac output (10 +/- 3%) in animals with heart failure but had no cardiovascular effects in normal rabbits. These results suggest that vascular sensitivity to vasopressin is increased in heart failure, and that it contributes significantly to the increased afterload in heart failure despite normal plasma levels. In this model of severe, chronic heart failure the sympathetic, renin-angiotensin, and vasopressin systems all appear to be activated. PMID- 3528221 TI - On the origin and prevention of PAIDS (Paralyzed Academic Investigator's Disease Syndrome). PMID- 3528222 TI - An enzyme immunoassay for quantitation of a type 2 pneumocyte-specific surfactant associated antigen in bronchoalveolar lavage fluid. AB - A sensitive, specific and reproducible assay for quantitation of a surfactant associated antigen in mouse bronchoalveolar lavage fluid is described. The procedure employed was a non-equilibrium competitive enzyme immunoassay in which detection of unreacted antibody was significantly enhanced by the use of a second antibody and peroxidase-antiperoxidase as the reporter label. The sensitivity of the assay was such that bronchoalveolar lavage fluid had to be diluted 15 to 30 fold prior to assay. No interference by serum proteins or soluble tissue proteins was observed. This assay may provide in vitro quantitative assessment of the functional status of type 2 pneumocytes. PMID- 3528223 TI - A controlled study of folic acid treatment in three fragile X syndrome males. AB - Three fragile X syndrome males were given 10 mg folic acid daily in a multiple baseline, placebo study. Objective measures of memory skills, compliance, and behavioral appropriateness were taken during baseline, placebo, and treatment conditions. No change was evident in these variables during the drug trial. Thus, the findings shed doubt on the effectiveness of folic acid in increasing intellectual functioning or reducing behavior problems in individuals with fragile X syndrome. These results underscore the importance of operationally defined variables, double-blind observation and placebo treatment in elucidating the effects of folic acid. PMID- 3528224 TI - Medical applications of cognitive-behavioral interventions with children. PMID- 3528225 TI - Factor structure of the Hansburg Separation Anxiety Test. AB - This study examines two questions related to Hansburg's Separation Anxiety Test: To what extent can Hansburg's (1980a) matrix of correlations between theoretical factors be replicated in an independent sample? How closely do empirically derived factors from a factor analysis of test scales resemble the composition of Hansburg's theoretically based factors? A total of 135 New Zealand university students were given the Hansburg Separation Anxiety Test. Results provide minimal empirical support for Hansburg's theoretically based psychological systems factors. Additional factor replication studies with larger samples are needed to clarify the underlying empirical structure of the Separation Anxiety Test. PMID- 3528226 TI - Differences between human figure drawings of child molesters and control groups. AB - The present research attempted to identify differences between human figure drawings of adult and juvenile child molesters and adult and juvenile control groups, based on ratings obtained for various psychodiagnostic signs (N = 75). Eleven reliable signs were identified. Results of significance tests on each of the 11 signs revealed that adult molesters drew the female larger than the male. Also, molesters as a group produced drawings of poorer gender differentiation than did the controls as a group and drew the male figures with blank or missing eyes. The overall quality of the molesters' drawings was rated as significantly poorer than that of the control's drawings. Results of a factor analysis for the 11 signs revealed, for the molesters, a first factor of overall quality with a component of gender identity confusion, a second factor of figure-size only, a third factor of fingers only, and a fourth factor of hidden eyes/hidden hands. PMID- 3528227 TI - Calcium antagonism--with special reference to diltiazem. PMID- 3528228 TI - Calcium antagonists and glycaemic control. PMID- 3528229 TI - An assessment of the fungicidal activity of antimicrobial agents used for hard surface and skin disinfection. AB - Trichophyton mentagrophytes and Aspergillus niger conidia and Candida albicans blastospores were employed to assess the fungicidal activity of a range of antimicrobial agents used for hard-surface and skin disinfection in hospitals in the U.K. The antimicrobials were tested at in-use concentrations. The time taken to give greater than 99.99% kill was determined by estimating the number of survivors (cfu/ml) at a variety of time intervals after exposure of washed suspensions of spores to the disinfectants. At equivalent times the recovery in the broth was investigated. An alcoholic solution of chlorhexidine gluconate (0.02%) (Hibitane), iodine in Industrial Methylated Spirit (IMS) and a phenolic (0.36% phenols, Stericol) produced a 99.99% kill of all species within 2 min, alcoholic and aqueous solutions (10%) of povidone-iodine (Betadine) and hypochlorite (0.2%) required 10 min to give a 99.99% kill of all species tested. The preparations which contained cetrimide (Cetavlon), aqueous solutions of chlorhexidine gluconate (Hibitane) and combinations of these (Savloclens and Savlodil) were only slowly fungicidal, particularly against T. mentagrophytes spores, which was the most resistant of the three fungal species to disinfection. PMID- 3528230 TI - Local immune response to gastric Campylobacter in non-ulcer dyspepsia. AB - Colonising Campylobacter pyloridis were identified histologically in gastric biopsy specimens from 89% of 83 patients with non-ulcer dyspepsia and chronic gastritis, but not in 58 dyspeptic patients with normal mucosa. The presence and population density of organisms was associated with the presence of intraepithelial neutrophils. In vivo coating of the organisms by host immunoglobulin was investigated by immunoperoxidase staining of IgA, IgG, and IgM in 54 biopsy specimens. IgA coated bacteria were seen in all cases of active gastritis, and in 60% of biopsy specimens without intraepithelial neutrophils. Coating with IgG or IgM, or both, was correlated with activity of gastritis and was rarely seen in the absence of a neutrophil infiltrate. PMID- 3528231 TI - Immunoperoxidase labelled antibody staining in differential diagnosis of central nervous system haemangioblastomas and central nervous system metastases of renal carcinomas. AB - The problem of the differential diagnosis both of central nervous system haemangioblastomas and metastases of renal clear cell carcinomas was investigated by immunoperoxidase labelled antibody staining of five cases each of haemangioblastoma and metastatic renal carcinoma. Staining using anticarcinoembryonic antigen (CEA), antikeratin, antifactor VIII related antigen, and antibrush border was unhelpful. All five of the haemangioblastomas were negative and all five of the metastases were positive for epithelial membrane antigen (EMA), as defined by immunoperoxidase staining. This shows that commercially available anti-EMA monoclonal antibody is useful in distinguishing the two pathological entities. PMID- 3528232 TI - Effect of formalin pigment removal on peroxidase-antiperoxidase immunoperoxidase technique. PMID- 3528233 TI - Laboratory diagnosis of peritonitis in continuous ambulatory peritoneal dialysis by lysis and centrifugation. PMID- 3528234 TI - Bacteria on blood films. PMID- 3528235 TI - The condition of the soft tissues at tooth and fixture abutments supporting fixed bridges. A microbiological and histological study. AB - In 10 partially edentulous patients provided with fixed bridgework supported by the combination of tooth and titanium fixture abutments, the condition of the soft tissues surrounding the abutments was examined. Sampling of supra- and subgingival plaque was performed from both teeth and fixtures. The samples were analyzed regarding the total bacterial counts, the relative distribution of bacterial morphotypes and the cultivable microflora. From each patient, soft tissue biopsies were obtained from 1 tooth and 1 fixture abutment, and the specimens were analyzed for the presence and extension of inflammatory cell infiltrates. The microbiological examination showed that the distribution of bacterial morphotypes in the supra- and subgingival plaque both at teeth and fixtures were similar, irrespective of localization and type of abutment. Nonmotile rods dominated the microflora, whereas spirochetes were either not detected or occurred in very low proportions. From the histological analysis, it was found that a majority of the soft tissue biopsies (75-80%) from both tooth and fixture sites contained only very small inflammatory cell infiltrates. PMID- 3528236 TI - Topographical distribution of dorsal and median raphe neurons projecting to motor, sensorimotor, and visual cortical areas in the rat. AB - The present study was conducted to examine the spatial organization of dorsal (DR) and median (MR) raphe neurons that project to rostrocaudally aligned areas of the rat cerebral cortex. An additional goal was to determine if individual DR cells that send efferents to forelimb sensorimotor or visual regions of the neocortex also send axon collaterals to forelimb (crus II) or visual (paraflocculus) areas of the cerebellum. Long-Evans hooded rats received unilateral pressure injections of horseradish peroxidase (HRP) in either motor (n = 4) or sensorimotor (n = 5) or visual (n = 4) cortex to determine the intranuclear location of DR and MR neurons that project to specific neocortical regions. Coronal sections (40-100 microns) through the pons and midbrain were examined by light microscopy after the tetramethyl benzidine reaction and neutral red counterstaining were carried out. The locations of retrogradely labeled cells were recorded relative to a three-dimensional biological coordinate system maintained by a computer linked to the light microscope. For double labeling studies, unilateral injections of fast blue and nuclear yellow were made in paired motor (sensorimotor cortex and crus II of the lateral cerebellum) or visual (cortical area 17 and paraflocculus) areas of the CNS. Coronal tissue sections (35 microns) were collected on coverslips and examined on a Leitz fluorescence microscope (wavelength = 365 nm). DR neurons labeled from cerebrocortical injections of HRP were concentrated in the rostral two-thirds of the nucleus. HRP-filled neurons were distributed such that individual groups of neurons projecting to motor, sensorimotor, or visual cortex were aligned in a partially overlapping, rostral to caudal array. In the dorsoventral dimension, retrogradely labeled cells were clustered in three distinct groupings such that neurons projecting to the motor, sensorimotor, and visual areas were concentrated in dorsal, intermediate, and ventral portions of the DR nucleus, respectively. For all cases, the majority of HRP-filled cells were positioned along the midline or displaced to the side of the nucleus that was ipsilateral to the cortical injection site. A small number of retrogradely labeled neurons were observed in the MR following injections in the motor cortex. Computer-assisted reconstruction of the neuroanatomical data facilitated the visualization of spatial relationships between groups of DR neocortical projection neurons.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3528237 TI - GABAergic input to cholinergic forebrain neurons: an ultrastructural study using retrograde tracing of HRP and double immunolabeling. AB - Amygdalopetal cholinergic neurons in the ventral pallidum were identified by combining choline acetyltransferase (ChAT) immunohistochemistry with retrograde tracing of horseradish peroxidase (HRP) following injections of the tracer in the basolateral amygdaloid nucleus. Although ChAT-positive terminals were identified in the ventral pallidum, they were never seen in contact with either immunonegative or ChAT-positive amygdalopetal neurons. In material, in which immunostaining against glutamic acid decarboxylase (GAD), the synthesizing enzyme for GABA was combined with retrograde tracing of HRP from the basolateral amygdaloid nucleus, GAD-positive terminals were seen to contact immunonegative amygdalopetal neurons. In addition, when sections of the rostral forebrain were processed, first to preserve and identify the transported HRP, and then were sequentially tested for both ChAT and GAD immunohistochemistry with the immunoperoxidase reaction for both tissue antigens, GAD-immunopositive terminals were seen to make synaptic contacts with cholinergic amygdalopetal neurons. These results suggest that amygdalopetal, presumably cholinergic, neurons receive GAD positive terminals. In separate experiments using immunoperoxidase for ChAT and ferritin-avidin for GAD labeling, we confirmed the presence of GAD-containing terminals on cholinergic neurons. In addition, cholinergic terminals were seen in synaptic contact with GAD-positive cell bodies. These morphological studies suggest that direct GABAergic-cholinergic and cholinergic-GABAergic interactions take place in the rostral forebrain. PMID- 3528238 TI - Cholinergic innervation of the cat striate cortex: a choline acetyltransferase immunocytochemical analysis. AB - In area 17 of adult cats the morphology, distribution, and synaptology of cholinergic elements were examined by immunocytochemical methods with a monoclonal antibody against choline acetyltransferase (ChAT). ChAT(+) fibers are present throughout the entire depth of the cortex but are particularly dense in layer I. Typically these fibers are very thin and possess numerous irregularly spaced varicosities. Except in layer I and deep layer VI, where the fibers tend to run parallel to the pial surface, they appear to be randomly oriented. At the electron microscope level, immunolabeling was present in unmyelinated fibers of irregular contour and diameter. Most of the ChAT(+) varicose profiles contained mitochondria and round vesicles. Synaptic complexes were relatively infrequent and tended to be of the symmetrical type. They were located mostly on dendritic shafts and only rarely on cell bodies and dendritic spines. Both pyramidal and nonpyramidal cells were found to be innervated by cholinergic afferents. These anatomical data are consistent with the known physiology of acetylcholine in the visual cortex, which indicates that it acts as a modulator of cortical excitability. PMID- 3528239 TI - Pityriasis rosea update: 1986. AB - Pityriasis rosea is a common self-limited dermatologic disorder. It appears to be a nonspecific cutaneous reaction pattern with a large number of causes. Current evidence indicates that a cell-mediated immune mechanism may be important in its pathogenesis. PMID- 3528240 TI - Systemic administration of antibiotics in the management of venous ulcers. A randomized clinical trial. AB - Forty-seven patients with chronic venous leg ulcers were included in a randomized clinical trial to evaluate the efficacy of systemically administered antibiotics in healing with condition. One group was treated by means of elastic support bandages only, whereas the other one received the same local treatment plus systemic antibiotics. No statistically relevant difference was noted between the two groups in healing rates of ulcers or in changes of the microbiologic flora. The results of our study do not support the routine administration of systemic antibiotics in the management of chronic venous leg ulcers. PMID- 3528241 TI - Therapies versus placebo in the treatment of patchy alopecia areata. AB - We report the results of a controlled trial on 119 patients affected by patchy alopecia areata involving less than 40% of the scalp. The statistical analysis showed no differences between the results obtained using squaric acid dibutylester, diphencyprone, minoxidil, and placebo in the treatment of this form of alopecia. PMID- 3528242 TI - Mycosis fungoides: evaluation of immunohistochemical criteria for the early diagnosis of the disease and differentiation between stages. AB - Lesional skin specimens from twenty-eight patients with mycosis fungoides were studied by evaluating immunohistochemical criteria, primarily with monoclonal antibodies. It was demonstrated that significant differences exist between the control and the premycotic-stage group in regard to the monoclonal antibodies BE1, BE2, and OKT9. The detection of specific antigenic determinants on the surface of cell populations early in the course of the disease seems to be of considerable value for the early diagnosis of the disease. Statistically significant differences were found between the premycotic stage and the plaque stage in regard to T lymphocytes, macrophages, OKT6+, OKT4+, OKT8+, and BE2+ cells in the dermal infiltrate. Significant differences were also shown between the plaque and tumorous groups, concerning macrophages, T cells, and OKT9+ cells in the dermis, as well as epidermal dendritic cells. Differences between stages may supplement histologic data for the follow-up of the disease with or without treatment. PMID- 3528243 TI - Topical clobetasol-17-propionate: review of its clinical efficacy and safety. AB - Clobetasol-17-propionate, the most potent of currently available topical steroids as predicted by the vasoconstrictor assay, has just been approved in the United States. In psoriasis, it has proved significantly more effective than class II steroids and as or more effective than the only marketed class I steroid. In the more steroid-responsive eczemas, the superior efficacy of clobetasol is also apparent, but less striking. Clobetasol prolongs remission rates, making intermittent treatment schedules feasible and minimizing inherent potential steroid side effects. Clobetasol may also be useful in the treatment of a myriad of other skin conditions. A review of the pharmacology, efficacy, and side effects of this addition to our dermatologic armamentarium is presented here. PMID- 3528244 TI - The usefulness of immunodiagnostic tests in the diagnosis of a case of Lyme disease. PMID- 3528245 TI - Blood flow imaging by cine magnetic resonance. AB - A technique for measuring blood flow by whole body nuclear magnetic resonance is described. This method uses imaging gradient profiles that combine even echo rephasing with a field echo sequence to overcome the problem of signal loss from flowing blood. The flow velocity component in any desired direction may be measured by appropriate gradient profile modifications, producing velocity dependent phase shifts that can be displayed by phase mapping. The sequence allows for fast repetition so that flow information may be acquired rapidly from many points in the cardiac cycle and has been used in this mode to observe and measure blood flow in the heart chambers and great vessels. Flow measurements in the femoral artery were also carried out using the same technique; these were compared with similar measurements obtained by Doppler ultrasound. The technique can readily be applied using standard imaging equipment and should prove useful in the clinical assessment of many diseases of the cardiovascular system. PMID- 3528246 TI - Effect of changes in inflation and blood volume on regional lung density--a PET study: 2. AB - Data obtained during positron emission tomographic (PET) imaging of the lung are expressed in terms of lung volume, not lung weight. Therefore changes in PET data may simply reflect changes in regional lung inflation. Normalizing PET data with regional measurements of lung density (rLD) made with positron transmission tomography may be useful, but how rLD is altered by changes in either regional inflation or blood volume has not been evaluated. In 12 supine dogs the mean rLD was 0.32 +/- 0.06 g/ml lung and was not significantly changed by doubling the tidal volume. The mean LD decreased with increasing levels of positive end expiratory pressure (PEEP) (5-20 cm H2O, but regional changes were consistently present only at levels greater than 5 cm H2O. After sufficient hemorrhage to reduce cardiac output by half, mean rLD only decreased from 0.33 +/- 0.07 to 0.30 +/- 0.06 g/ml lung, while regional extravascular density remained unchanged. Thus, large changes in tidal volume, modest amounts of PEEP, and significant decreases in blood volume produced small, although measurable, decreases in rLD. Therefore, normalization of emission data with transmission derived measurements of LD should not be necessary for interventions that cause rLD to decrease. PMID- 3528248 TI - Effective use of dairy herd improvement somatic cell counts in mastitis control. AB - The single most important factor affecting somatic cell count in milk is mammary gland infection status. In comparison, all other factors are minor. Consideration needs to be given to diurnal effects on Dairy Herd Improvement a.m.-p.m. sampling schemes. Somatic cell count linear score of 5 (283,000) appears to be a good choice of threshold for mastitis control applications. A greater understanding of the nonbacteriological factors affecting somatic cell count is needed so that relative thresholds could be used to improve the clarity of somatic cell count interpretation. Linear score loss estimates are effective educational tools providing motivation for mastitis control implementation. Infection status or milk loss estimates based on single somatic cell count tests on individual cows are weak. A lactational average linear score on individual cows or linear score compilations across a herd provide credible estimates. Treatment of subclinical mastitis based on somatic cell count levels is not economically beneficial and is not recommended. Usefulness of Dairy Herd Improvement somatic cell count data as a mastitis management tool requires measures of mastitis level, new infection rate, and mastitis pattern within the herd over time. PMID- 3528247 TI - Portosystemic collaterals on MR imaging. AB - Fourteen patients with various portosystemic collaterals (seven esophageal varices, three paraumbilical veins, two splenorenal shunts, and two mesenteric varices) were imaged with magnetic resonance (MR) imaging using a superconducting imager. Collateral pathways were demonstrated as tortuous structures of no or low signal intensity on spin-echo image, and flow related enhancement did not cause any difficulty in evaluation. Direct sagittal images are especially useful for paraumbilical vein and coronal images for esophageal and mesenteric varix. The clinical role of MR in the assessment of portosystemic collaterals is discussed also in comparison with CT and ultrasound. PMID- 3528249 TI - Management of dry cows to reduce mastitis. AB - The objective of mastitis control during the dry period is to have as few infected quarters as possible at calving. This depends on enhancing elimination of infections present at drying off and on reducing the new infection rate during the dry period; prevention of new infection appears to offer greater long-term benefits. Incidence of new infection is high in the dry period with periods of high susceptibility shortly after dry off and again prepartum. Pathogens of both contagious and environmental origin cause new dry period infections; however, exposure to contagious pathogens probably decreases with cessation of regular milking, whereas exposure to environmental pathogens continues throughout the dry period. Varying susceptibility over the dry period may be affected by bacterial loads on the teat skin, characteristics of the teat canal, and internal protective mechanisms. At present, antibiotic therapy at the end of lactation is the most effective means of eliminating existing infections and preventing new infections. Although there are reasons to prefer selective therapy, present evidence favors a recommendation for treatment of all cows at the time of drying off. A shortcoming of present therapy regimens for the dry period is that they provide little or no protective effect against new infection prepartum. Other mastitis control methods and management practices have not been shown conclusively to reduce new dry period infections. However, it appears that reduction of exposure to environmental pathogens during dry period should be recommended. More effective means to reduce new infections in the prepartum period are needed. PMID- 3528250 TI - Luteinizing hormone response to pulsatile luteinizing hormone-releasing hormone in prepubertal heifers. AB - The effects of 12 hourly 5-micrograms injections of luteinizing hormone-releasing hormone on luteinizing hormone release, were examined in 18 prepubertal Holstein heifers at 4, 7, or 10 mo of age. During a 6-h pretreatment period, mean serum luteinizing hormone concentrations and mean number of endogenous luteinizing hormone episodes per hour were not influenced by age. The 12-h treatment regimen induced a pulsatile release of luteinizing hormone in all heifers. The magnitude, pattern, and total amount of luteinizing hormone released were not influenced by age. However, in the 4 and 10-mo-old age groups, magnitude of luteinizing hormone response to the 3rd hourly injection of luteinizing hormone-releasing hormone was greater than the response to the second injection. Magnitudes of luteinizing hormone responses decreased with time after the 4th hourly injection through the 12th injection and patterns of decline appeared similar among the three age groups. The pituitary of the prepubertal dairy heifer is able to respond to an hourly pulsatile administration of luteinizing hormone-releasing hormone and this treatment regimen appears to produce a self-priming effect on luteinizing hormone release. PMID- 3528251 TI - Growth of environmental mastitis pathogens in various bedding materials. AB - The objective of the study was to determine whether, under controlled conditions, bedding materials vary in their ability to support growth of different environmental pathogens independent of the presence of feces, urine, or other contamination. Five sterilized bedding materials (fine hardwood chips, recycled dried manure, chopped newspaper, softwood sawdust, and chopped straw) and three bacterial species (Escherichia coli, Klebsiella pneumoniae, and Streptococcus uberis) were used for a total of 15 bedding/bacteria combinations, replicated in three trials. Samples were incubated at 37 degrees C, and bacterial counts were determined over 5 d. Rapid growth was seen in straw and recycled manure, some growth occurred in hardwood chips, and a rapid decline in bacterial counts was observed in paper and softwood sawdust. In general, K. pneumoniae and E. coli showed more rapid growth or less rapid decline than did S. uberis. These results demonstrate that clean, damp bedding may support bacterial growth and suggest that high bacterial counts under barn conditions are influenced by factors more complex than type of bedding used. PMID- 3528252 TI - Controlled trial of very low calorie diet, behavior therapy, and their combination in the treatment of obesity. PMID- 3528253 TI - [History of local anesthesia]. PMID- 3528254 TI - Teaching debonding in dental hygiene programs. PMID- 3528255 TI - A comparison of methods for reducing stress among dental students. PMID- 3528256 TI - Reinforcement of surgical adhesive strips. AB - Surgical adhesive strips are often used for closure of some wounds or to minimize tension on sutures after closures. The package insert of the type most commonly used (Steri-Strip), indicates that the application of compound tincture of benzoin, U.S.P. (CTB) increases strip adhesion. The increase in adhesive power by CTB was compared with a preparation containing gum mastic (Mastisol). The study clearly demonstrated that the latter preparation provided a markedly more adhesive strength than that obtained with CTB. PMID- 3528257 TI - Use caution with mesh dressing. PMID- 3528258 TI - [Organelles--regulators of neutralohydrolasosomes and peroxidasosomes]. PMID- 3528259 TI - The scattering of ultrasound by cylinders: implications for diffraction tomography. AB - The validity of wave equations employed as system models in acoustical diffraction tomography is investigated using simulations and measurements of the scattering of plane ultrasound waves by cylinders. It is demonstrated by simulation and experiment that it can be appropriate to neglect density fluctuations and shear waves, implying that the commonly used form of the wave equation suitably describes scattering by fluctuations of acoustic speed and absorption. Diffraction tomographic reconstructions of simulated data reveal the importance of absorption, the behavior of the real and imaginary parts of the reconstructed refractive index, and the relative advantages and limitations of the Born and Rytov approximate transformations. PMID- 3528260 TI - Sleep in hospital. AB - Although sleep has been identified as an activity generally considered necessary for normal functioning, the nursing literature on the subject is relatively scanty. This paper is an attempt to review sleep and its relationship to nursing practice. A discussion of nursing interventions that are likely to ensure that adequate sleep is maintained is included. PMID- 3528262 TI - The presidents. Daniel Francis Lynch 1954-1955. PMID- 3528261 TI - Changing opportunities: an overview of the history of college health education. PMID- 3528263 TI - Hand asepsis: the efficacy of different soaps in the removal of bacteria from sterile, gloved hands. AB - The study showed that washing a gloved hand removed significant amounts of bacteria. If the proper soap or scrub is used, the gloved hand will be free of bacteria. It is suggested that all dental personnel wear gloves to protect themselves and to prevent cross-contamination of other patients. PMID- 3528264 TI - Diagnosis and treatment of localized juvenile periodontitis. AB - An actinomycetemcomitans can cause localized juvenile periodontitis and certain types of adult periodontitis. Optimal treatment of periodontal disease caused by this microorganism requires systemic antibiotic therapy in addition to mechanical debridement of the infected gingival tissues. Laboratory techniques are available to assist the practitioner in identifying this microorganism in dental plaque samples. PMID- 3528265 TI - Quantification of aortic regurgitation utilizing continuous wave Doppler ultrasound. AB - Aortic regurgitation and mitral stenosis are hemodynamically similar, insofar as both result in passive ventricular filling across a narrow orifice driven by a declining pressure gradient. Because mitral stenosis is successfully characterized by Doppler ultrasound determination of the velocity half-time, or time constant, aortic regurgitation might be quantified in an analogous fashion. Eighty-six patients with diverse causes of aortic regurgitation underwent continuous wave Doppler examination before cardiac catheterization or urgent aortic valve replacement. The Doppler velocity half-time was defined as the time required for the diastolic aortic regurgitation velocity profile to decay by 29%, whereas catheterization pressure half-time was calculated as the time required for transvalvular pressure to decay by 50%. Doppler velocity and catheterization pressure half-times were linearly related (r = 0.91). Doppler velocity half-times were inversely related to regurgitant fraction (r = -0.88). Angiographic severity (1+ = mild to 4+ = severe) was also inversely related to pressure and velocity half-time; a Doppler half-time threshold of 400 ms separated mild (1+, 2+) from significant (3+, 4+) aortic regurgitation with high specificity (0.92) and predictive value (0.90). The Doppler velocity half-time was independent of pulse pressure, mean arterial pressure, ejection fraction and left ventricular end diastolic pressure. Estimation of transvalvular aortic pressure half-time utilizing continuous wave Doppler ultrasound is a reliable and accurate method for the noninvasive evaluation of the severity of aortic regurgitation. PMID- 3528266 TI - Amino acid supplementation as therapy for attention deficit disorder. PMID- 3528267 TI - Child care and child abuse in early medieval Europe. PMID- 3528268 TI - Hermine Hug-Hellmuth--a neglected pioneer in child psychoanalysis. PMID- 3528269 TI - Refractive surgery: keratomileusis and keratophakia. AB - This paper reviews the non-radial keratotomy surgeries that are being performed. The author reviews the literature and suggests an approach toward counseling patients who may be considering these approaches. The paucity of reported studies makes the choice of these alternate procedures somewhat risky, particularly in their refractive predictability. PMID- 3528270 TI - The history of medical illustration. PMID- 3528271 TI - Evaluation of beta-naphthoxyacetic acid for mutagenic activity in the Salmonella/mammalian microsome assay. AB - Beta-naphthoxyacetic acid (BNOA) is used as a plant growth regulator on tomatoes and strawberries. It is the active ingredient in Blossom-Set and Berry-Set, two plant hormone sprays for fruit-set. The mutagenic activity of BNOA was evaluated in four strains of Salmonella typhimurium (TA97, TA98, TA100 and TA1535) in the presence and absence of liver microsomal and cytosolic enzymes derived from Aroclor induced rats. BNOA did not produce any significant increase (p less than 0.05) in the reversion of any of the four tester strains in the standard plate incorporation assay. Results of the agar overlay toxicity tests indicates that the chemical shows toxic effects at concentrations above 500 micrograms/plate. It was concluded that under the conditions of these tests, BNOA did not exhibit any mutagenic activity. PMID- 3528272 TI - Non-steroidal anti-inflammatory drugs in podiatric medicine and surgery. AB - This paper presents a review of nonsteroidal anti-inflammatory drugs (NSAIDs) in podiatric medicine and surgery. Although these agents possess a high degree of safety and efficacy, proper patient selection, monitoring, and early detection of side effects are emphasized. A discussion of prostaglandin biochemistry and physiology is included. PMID- 3528273 TI - The effect of touch on nutritional intake of chronic organic brain syndrome patients. AB - Inadequate nutrition, a major cause of illness and complications among elderly adults, is of particular import for those who cannot provide for themselves. We evaluated the effect of gentle touch during eating on nutritional intake (NI) of 42 institutionalized chronic organic brain syndrome (COBS) patients. Patients were randomly assigned to experimental or control groups. NI was evaluated for 3 consecutive weeks. During Weeks 1 and 3 all patients were encouraged verbally to eat. In the treatment week experimental group members were touched gently during this verbal encouragement. Repeated measures analyses of variance were used to evaluate the effect of touch on NI. In the first week NI for the groups did not differ. NI was significantly greater in the experimental than in the control group (p less than .01) during the other 2 weeks. Tactile stimulation, a simple intervention, may be an important adjunct to verbal encouragement to improve NI in COBS patients. PMID- 3528274 TI - Ultrasound demonstration of bile duct thickening in primary sclerosing cholangitis. PMID- 3528275 TI - Sandfly vector competence for transmission of Leishmania parasite in tropical Asia. PMID- 3528276 TI - Relative effect of mass survey and selective survey in mass diethylcarbamazine treatment. PMID- 3528277 TI - Comparative evaluation of Plasmodium knowlesi and P. cynomolgi antigens for the detection of human malaria antibody by immunofluoresence test. PMID- 3528278 TI - Biliary lavage with corticosteroids in primary sclerosing cholangitis. A clinical, cholangiographic and bacteriological study. AB - Bile duct perfusion with corticosteroids is reported to improve the cholangiographic and biochemical abnormalities in some patients with primary sclerosing cholangitis. In a randomised placebo controlled trial, thirteen consecutive patients received continuous bile duct irrigation with either normal saline (1 l/day) or normal saline plus hydrocortisone (100 mg daily) via a nasobiliary tube placed in a hepatic duct at endoscopic retrograde cholangio pancreatography. Eleven patients completed lavage for 2 weeks but no cholangiographic changes were observed in either group. Liver function tests deteriorated during lavage, but later returned to pre-treatment levels. Although bile was sterile at start of lavage, a wide range of bacteria was isolated from bile in all patients during treatment, and cholangitis with septicaemia occurred in 2 patients. We conclude that nasobiliary lavage is not beneficial in treating primary sclerosing cholangitis. PMID- 3528279 TI - Occupational toxic liver damage. PMID- 3528280 TI - Exercises for spiritual growth. PMID- 3528281 TI - The Indiana Peer Review Organization. A look at the sensitive and difficult mission of IPRO. PMID- 3528282 TI - Navy medicine comes ashore: establishing the first permanent U.S. naval hospitals. PMID- 3528283 TI - Public health and public healthiness, Sao Paulo, Brazil, 1876-1893. PMID- 3528284 TI - The thermal baths of traditional Ethiopia. PMID- 3528285 TI - Influence of cell fixatives and incubation schedule on PAP labeling of fibronectin in cultivated fibroblasts. AB - A simple combined method for differential PAP labeling of fibronectin (FN) in mouse embryo fibroblast cultures was developed. Methanol-5% glacial acetic acid in dry ice-fixed cell monolayers showed mainly intracellular FN staining. Fixation with neutral paraformaldehyde before labeling, developed membrane- and extracellular matrix-associated FN. A combination of both procedures, which required incubation with primary antibody, fixation with paraformaldehyde followed by chilled acid methanol, and re-incubation with primary antibody, yielded sharp intracellular and extracellular FN labeling. The outlined methods can be readily employed in association with other staining techniques. PMID- 3528286 TI - Immune deposits formed in situ by a monoclonal antibody recognizing a new intrinsic rat mesangial matrix antigen. AB - We describe a unique mesangial matrix component of the rat glomerulus identified by a murine monoclonal antibody. The antigen is present exclusively in the glomerular mesangium and cannot be detected in other rat tissues by indirect immunofluorescence techniques or following pretreatment of tissue sections with acid urea or other nonionic detergents. Specific immunoprecipitation of the solubilized antigen yields a single peptide with an apparent m.w. of 81,000 when analyzed by discontinuous SDS-PAGE. This mesangial matrix component is collagenase resistant and trypsin sensitive. Perfusion of an isolated kidney preparation with this antibody results in direct binding of the mouse immunoglobulin to its mesangial antigen. Passive administration of the monoclonal antibody to Lewis rats results in characteristic electron dense deposits within the mesangial matrix that can be visualized ultrastructurally as early as 3 days. The immune deposits form without the activation of rat complement and persist for longer periods than those that develop after the planting of aggregated proteins or preformed immune complexes. Experimental animals that received either a monoclonal antibody specific for laminin or a non-kidney binding preparation did not develop such immune deposits at any time during the course of the autologous phase of the immune process. The results obtained in this study indicate that electron dense immune deposits can develop in the mesangium with the participation of a unique intrinsic matrix component and specific circulating monoclonal antibodies by an in situ mechanism of immune complex formation. PMID- 3528287 TI - The genetic deficiency of leukocyte surface glycoprotein Mac-1, LFA-1, p150,95 in humans is associated with defective antibody-dependent cellular cytotoxicity in vitro and defective protection against herpes simplex virus infection in vivo. AB - The role of the Mac-1, LFA-1, p150,95 leukocyte glycoprotein family in mediating antiviral host defense was investigated by utilizing mononuclear cells (MC) obtained from eight patients with a genetic deficiency of Mac-1, LFA-1, and p150,95, and normal MC incubated with subunit-specific monoclonal antibodies (MAb) directed against these glycoproteins. As shown with an in vitro chromium release cytotoxicity assay to herpes simplex virus (HSV)-infected Chang liver target cells, MC of these patients with the severe phenotype or normal MC preincubated with a combination of MAb against Mac-1 glycoprotein subunits were deficient in antibody-dependent cellular cytotoxicity (ADCC). When used individually, MAb directed at LFA-1-alpha or -beta also inhibited ADCC and natural killer cytotoxicity (NKC). In a single cell agarose assay, MC of Mac-1 deficient patients formed fewer effector-target cell conjugates in the presence of specific anti-HSV antibody. To investigate the in vitro contributions of these glycoproteins to cytotoxic host defense mechanisms, two in vivo adoptive transfer models were explored in which neonatal mice are protected against a lethal HSV challenge by normal human MC plus anti-HSV antibody (in vivo ADCC) or human interferon-alpha (NKC stimulated in vivo). In each model, MC from patients with "severe" or "moderate" phenotypes of Mac-1 deficiency, or normal MC incubated with a combination of anti-LFA-alpha, Mac-1-alpha, p150,95-alpha plus -beta MAb failed to protect neonatal mice against lethal HSV infection. These studies further indicate requirements for adhesion-dependent mechanisms in the mediation of MC-ADCC, and suggest that Mac-1-dependent cellular adhesive properties are necessary for normal cytotoxic functions in vivo in experimental models of human ADCC or interferon-stimulated NKC. These findings, in addition to the recognized occurrence of severe or even lethal viral infections in some Mac-1-deficient patients, suggest that glycoproteins of the Mac-1 family may be important determinants of antiviral host defense. PMID- 3528288 TI - Effects of human colony-stimulating factor on the uptake and destruction of a pathogenic parasite (Trypanosoma cruzi) by human neutrophils. AB - The ability of granulocyte-macrophage colony-stimulating factor (CSF-H) to modulate human neutrophil functions was studied by using an in vitro system in which this cell type interacted with intracellular (amastigote [AMA]) forms of Trypanosoma cruzi. The presence of CSF-H during the 30-min period of neutrophil incubation with the AMA markedly enhanced parasite internalization. This effect was evidenced by significant increases in both the percentage of neutrophils incorporating AMA and the average number of AMA per 100 neutrophils with respect to mock-treated neutrophils. Pretreatment of the neutrophils with CSF-H reproduced the enhancement effect, whereas pretreatment of the AMA had no detectable consequence. The minimal neutrophil CSF-H pretreatment period required to significantly increase the number of AMA per 100 neutrophils was 20 min- suggesting that CSF-H induced time-dependent events ultimately leading to the manifestation of the noted effect--but neutrophil treatment with CSF-H for longer periods of time (up to 60 min) caused a much greater enhancement. Consistent with the notion of a regulatory action of CSF-H on neutrophils was the fact that the enhancing effect subsided gradually after removal of the factor and was no longer detectable after 16 hr. When 3H-labeled AMA were used, CSF-H-treated neutrophils released greater amounts of radiolabeled substances than mock-treated cells, indicating a stimulatory effect of CSF-H on the killing capacity of neutrophils. This was confirmed by the fact that untreated neutrophils that had internalized 3H-AMA killed the parasites at a faster rate when subsequently incubated with CSF H. Catalase, but not superoxide dismutase, mannitol, benzoate, or histidine, inhibited neutrophil killing of the 3H-AMA whether the granulocytes had been exposed to CSF-H or not. This indicated that the cytotoxic mechanism involved the production of hydrogen peroxide in both cases, but possibly at a higher rate in the CSF-H-treated neutrophils. These results point to a regulatory effect of CSF H on neutrophils that promotes cellular activities that might be relevant to the mechanisms of clearance of T. cruzi in vivo. PMID- 3528289 TI - Extravasation of intravascular fluid mediated by the systemic administration of recombinant interleukin 2. AB - Adoptive immunotherapy with lymphokine-activated killer cells and recombinant interleukin 2 (IL 2) can produce significant reduction of visceral metastases in tumor-bearing mice and, as shown recently, in humans with disseminated cancer. Because further dose escalations of IL 2 have been prevented by the development of a vascular leak syndrome (VLS) in both mice and humans, we investigated this VLS in mice undergoing the systemic administration of high-dose IL 2. A model for quantitating capillary permeability was used in which 125I-bovine serum albumin was injected i.v., and 2 hr later, tissues were counted in a gamma analyzer. A permeability index (PI) was calculated by dividing the mean counts per minute (cpm) of tissues from IL 2-treated mice by those from control animals. The injection of IL 2 produced increases in vascular permeability that were most pronounced in the thymus, spleen, lungs, liver, and kidneys (PI = 18.0, 10.0, 9.7, 6.7, and 6.3, respectively, on day 6). The development of the VLS was highly dependent on the number of days of IL 2 treatment (for example, the lungs contained 638, 1382, 3350, and 6187 cpm after 0, 1, 3, and 6 days of IL 2, respectively). Moreover, the degree of the VLS was directly related to the dose of IL 2 administered. Measurement of the wet and dry weights of lungs from IL 2 treated mice demonstrated that IL 2 produced a dramatic increase in their water weight (from 0.10 g at base line to 0.22 g after 200,000 U of IL 2 for 6 days). The injection of the IL 2 excipient failed to induce capillary leakage in tissues. Immunosuppression of mice by pretreatment irradiation (500 rad) or by injection of cyclophosphamide or by concurrent use of cortisone acetate markedly reduced or eliminated the development of the VLS. Similarly, the VLS was not observed in nude mice receiving IL 2. Thus, the administration of IL 2 produces a dose-limiting VLS that may be mediated, directly or indirectly, by host lymphoid elements. PMID- 3528290 TI - Identification and characterization of mitochondria autoantigens in progressive systemic sclerosis: identity with the 72,000 dalton autoantigen in primary biliary cirrhosis. AB - Sera from eight out of 62 (14.5%) patients with progressive systemic sclerosis (PSS) reacted by immunoblotting with a 72,000 dalton antigen and one, a patient with concomitant primary biliary cirrhosis (PBC), reacted with the 72,000 dalton and a 47,000 dalton antigen. Reactivity with these antigens was not seen with any of 111 control sera. The antigens with minor variations in m.w. were present in a variety of cultured cells and tissue homogenates from different species. Subcellular fractionation studies localized the antigens to the mitochondria. Of 19 sera from patients with other diseases selected for immunofluorescence staining for anti-mitochondria autoantibody, nine reacted with the 72,000 dalton antigen, seven reacted with both the 72,000 and 47,000 dalton antigens, and three reacted with the 47,000 dalton antigen. These results show that serum reactivity with the 72,000 dalton and 47,000 dalton mitochondria autoantigens is found with some patients with PSS. Because mitochondria autoantibodies that are reactive with the 72,000 dalton and 47,000 dalton polypeptides are also found in patients with PBC, the present finding provides additional support for the association of PSS with PBC. Prior absorption of rat liver homogenate with PBC sera removed PSS serum reactivity with a 63,000 dalton antigen, the equivalent 72,000 dalton antigen in rodents, and vice versa, showing that both PBC and PSS sera recognize the same antigen. PMID- 3528291 TI - Deposition of the terminal C5b-9 complement complex in infarcted areas of human myocardium. AB - Poly- and monoclonal antibodies to neoantigens of the human C5b-9 complement complex, as well as polyclonal antibodies to C5, C8, and C9, were used to detect and identify C5b-9 deposits in human myocardial tissue. Immunocytochemical studies were performed on fresh-frozen autopsy material derived from patients with myocardial infarctions; in addition, in 17 of these patients, paraffin sections of formalin-fixed tissue were investigated. Sixteen autopsies from patients with noncardiac diseases were analyzed as controls. Without exception, C5b-9 positivity was registered selectively and exclusively on and in myocardial cells located within the zones of infarction. The selectivity of staining was confirmed by control reactions for succinic dehydrogenase activity performed in adjacent, respective double-stained sections. Most intensive staining with anti neoantigen antibodies was observed in the peripheral areas of the infarctions. Weak staining for C3d, rather strong staining for C5 and C9, and intermediate staining with anti-C8 antibodies were observed in the same localizations. Stainings for C4 and IgA were negative, whereas immunocytochemical reactions for IgG and IgM revealed an irregular and very weak staining. Only very weak staining was also observed with a monoclonal antibody to complement S-protein, indicating that the terminal complement components were deposited mainly in the form of membrane-damaging C5b-9 complexes. Immunocytochemical staining for C5b-9 was found to represent a most sensitive tool for detection of ischemic myocardial lesions, permitting easy detection even of single cell necroses. As a working hypothesis, we suggest that initial ischemia may cause loss of the ability of the heart muscle cells to regulate complement turnover at the membrane level. The resulting deposition of C5b-9 on the cell membranes may contribute to functional disturbance and irreversible damage of myocardial cells during the infarction process. PMID- 3528292 TI - Correlation of treponemicidal activity in normal human serum with the presence of IgG antibody directed against polypeptides of Treponema phagedenis biotype Reiter and Treponema pallidum, Nichols strain. AB - Normal human serum (NHS) was shown to have complement-dependent treponemicidal activity against both Treponema pallidum and Treponema phagedenis biotype Reiter (TPR) by employing in vitro-in vivo neutralization and TPR plaque assays, respectively. The molecular basis of NHS treponemicidal activity was studied by immunoblot analysis in conjunction with treponemicidal assays. Five major T. pallidum polypeptide bands (47kDa, 35kDa, 33kDa doublet, and 30 kDa) and three major TPR polypeptide bands (47kDa and 33kDa doublet) bound IgG present in NHS. Absorption of NHS with TPR completely removed both TPR and T. pallidum treponemicidal activity; corresponding immunoblots demonstrated a significant removal of IgG antibody against all three TPR polypeptide bands as well as four T. pallidum polypeptide bands (30kDa, 33kDa doublet, and 35kDa). In contrast, T. pallidum absorption of NHS was found to remove treponemicidal activity against T. pallidum but not TPR; corresponding Western blots showed the complete removal of IgG antibody against all but one T. pallidum polypeptide band (47kDa) but no detectable loss in IgG antibody against the TPR polypeptides. These results suggest that antibody in NHS generated against nonpathogenic, indigenous treponemes is responsible for the T. pallidum treponemicidal activity. Furthermore, the treponemicidal activity against T. pallidum correlated with the presence of IgG antibody against T. pallidum polypeptides of 30kDa, 35kDa, and a 33kDa doublet. PMID- 3528293 TI - Characterization of an immunosuppressive factor from malignant ascites that resembles a factor induced in vitro by carcinoembryonic antigen. AB - Oncodevelopmental antigens may cause immunologic suppression in the host through release of suppressor molecules from the host's own immunoregulatory cells. This concept has been difficult to study until recently when carcinoembryonic antigen was shown to induce the release of such molecules from normal circulating human mononuclear cells in vitro. However, the amount of the suppressor moiety generated was too small to adequately characterize, and its presence in vivo, i.e., in the cancer-bearing host, was unknown. Therefore, we sought to isolate and characterize a similar or identical macromolecule from ascites having an elevated CEA level in patients with cancer. A single malignant ascites, when precipitated at 0 to 35% ammonium sulfate saturation, was the source of suppressive factor for purposes of isolation and standardization. Suppression was quantitated by reduction of [3H]thymidine incorporation by phytohemagglutinin stimulated normal human peripheral blood mononuclear cells. Sephadex G-200 chromatography revealed probable aggregation of the factor in isotonic buffers; aggregation was reduced in the presence of 8 M urea. Purification was achieved by precipitation with 5% trichloroacetic acid (TCA). The suppressor factor remained soluble in TCA and demonstrated a 95-fold increase in specific activity. Analytical sodium dodecyl sulfate polyacrylamide gel electrophoresis demonstrated a single protein band of 50,000 daltons. Ascites from three additional cancer patients gave identical results. Physicochemical characterization of the suppressor moiety revealed stability at 70 degrees C for 30 min and at pH 2 and pH 10 for 24 hr. Delipidation by chloroform-methanol extraction, proteolytic enzyme digestion, and protamine sulfate precipitation did not affect activity, suggesting that lipid, simple peptides, and nucleic acids were not crucial. However, periodate oxidation irreversibly destroyed suppressor activity, suggesting the importance of carbohydrate to the molecule and offering one explanation for protease resistance. Similarities in m.w. (50,000 daltons), isoelectric point (pI = 3.4), physical properties (heat and acid stability and resistance to proteases), and immunologic activity of this factor with that released from lymphocytes after in vitro exposure to carcinoembryonic antigen indicates they may be identical. Our results suggest that early aberrant events induced in the immunoregulatory network by tumor-associated antigens may be relevant and may lead to better understanding of immunosuppression in the cancer bearing host. PMID- 3528294 TI - The use of phycobiliproteins as fluorescent labels in immunoassay. PMID- 3528295 TI - Immunofluorescent screening of monoclonal antibodies to surface antigens of animal and plant cells bound to polycarbonate membranes. AB - We have developed an immunofluorescent screening method in which animal or plant cells are immobilized without fixation on polycarbonate (Nuclepore) membranes. The technique does not involve centrifugation, and virtually no cells are lost during processing. Direct microscopic analysis of antibody binding provides an extremely sensitive and reproducible screening system for hybridoma supernatants. PMID- 3528296 TI - Immunofluorescence staining of agarose-embedded cells. A new technique developed for immunological characterization of markers on a small number of cells. AB - A simple new method for the immunofluorescence staining of small numbers of cells is described: cell suspensions are mixed with low-temperature-gelling agarose at 37 degrees C and 2 microliter samples of agarose containing cells are dispensed onto multitest microslides precoated with agarose. The cells are subsequently stained by immunofluorescence techniques. Alternatively, the cell slides can be stored in liquid nitrogen until immunofluorescence staining is carried out. Since cells are entrapped within the agarose matrix, cell loss is prevented during staining and washing procedures. The method permits staining of as few as 250 cells for each marker, thus enabling simultaneous characterization of several separate cell markers in cerebrospinal fluid or other body compartments from which comparatively few cells are obtainable. PMID- 3528297 TI - A sensitive and reproducible method for the determination of subnanogram quantities of immunoglobulin E (IgE). AB - An immunoradiometric assay for immunoglobulin E (IgE) using high adsorption polystyrene test tubes as the solid phase (the 'Maxisorp' assay) is described. The sensitivity of the method was found to be 50 pg IgE/ml and the within-assay reproducibility was 3-7%. The accuracy was estimated by means of a comparison between the Maxisorp assay and paper radioimmunosorbent test (PRIST) and a correlation coefficient of 0.98 (P less than 0.001) was obtained. We conclude that the Maxisorp assay is a fast and reliable assay for IgE determination in cord blood, cell culture supernatants and other highly diluted IgE preparations. PMID- 3528298 TI - Hapten-protein conjugates prepared by the mixed anhydride method. Cross-reactive antibodies in heterologous antisera. AB - Poly-L-lysine conjugates of three structurally unrelated mycotoxins were made by either a mixed anhydride intermediate (MA) or an activated N-hydroxysuccinimide ester intermediate (AE). Control conjugates, with no mycotoxin, were also prepared by each method. Antisera elicited by mycotoxin-albumin conjugates produced by the MA method bound to the three poly-L-lysine-MA mycotoxin conjugates and the MA control conjugate , but bound only to the poly-L-lysine-AE conjugates of the homologous mycotoxin. Binding of antisera to homologous poly-L lysine conjugates was always inhibited by free hapten when the conjugate was prepared by the AE method but not by the MA method. The specific inhibition of antibody binding by various synthetic haptens indicated that the cross-reactions associated with the MA method were due to the undesired conjugation of isobutylformate during the mixed anhydride procedure. PMID- 3528299 TI - A sandwich enzyme immunoassay for wheat gliadin. AB - A sandwich double antibody solid-phase enzyme immunoassay (EIA) that can detect and quantitate gliadin is described. Quantitative analysis could be carried out in the range of 5-400 ng/ml and the assay was more sensitive than inhibition EIA. Gliadin possessed weak cross-reactivity with oats, maize and rice prolamines. In the presence of anti-gliadin antibody (serum from a patient with active coeliac disease) gliadin could not be detected, but the sensitivity of the assay was restored by heat treatment of the serum. This EIA can therefore be employed to assess the gliadin content of biological fluids where specific antibody may coexist. PMID- 3528300 TI - Immunochemical detection of proteins biotinylated on nitrocellulose replicas. AB - A sensitive method for staining proteins after transfer from polyacrylamide gels to nitrocellulose paper is described. Transferred proteins are first derivatized by reaction of the nitrocellulose replica with sulfosuccinimidobiotin and are then reacted sequentially with streptavidin, rabbit anti-streptavidin, and horseradish peroxidase-conjugated goat anti-rabbit IgG antibody. Application of the enzyme substrate, alpha-chloronaphthol, produces dark protein bands against a white background. The binding of streptavidin to the proteins is dependent on biotin derivatization and is inhibited by biotinylated bovine serum albumin or 10 nM biotin. The procedure permits detection of less than 5 ng of transferred protein in a single band and is thus 5-10 times more sensitive than horseradish peroxidase-conjugated avidin alone. For bovine serum albumin, the method is comparable in sensitivity to silver staining of protein in polyacrylamide gels. PMID- 3528301 TI - A rapid [3H]glucose incorporation assay for determination of lymphoid cell mediated inhibition of Candida albicans growth. AB - [3H]glucose uptake by Candida albicans after interaction with lymphoid effector cells was used to provide a quick, accurate and objective assessment of the growth inhibitory potential of lymphoid cells on candida. After 18 h coincubation of effector cells with candida, [3H]glucose was added for 3 h and the amount of radiolabel incorporated into residual candida was measured. The results showed that [3H]glucose uptake was proportional to the number of candida organisms left in the microwell and is dose dependent on the effector/target (E/T) ratio. At an E/T ratio of 300/1, complete inhibition of candida was seen, with significant inhibition still present at 30/1. In addition, monocytes and polymorphonuclear cells were found to be the primary cells responsible for eliminating candida. PMID- 3528302 TI - A plaque assay for cells making antibody against HLA antigens. AB - A plaque assay has been devised, for detecting cells making antibodies to HLA antigens, using intact nucleated cells as targets. The principle is to use a green fluorescent dye to stain living cells and a red fluorescent dye to stain the cells in a plaque that have been lysed by antibody and complement. Plaques are counted under a fluorescence microscope and the preparations can be made permanent and virtually non-quenchable by drying. PMID- 3528303 TI - Rodney Porter 1917-1985. PMID- 3528304 TI - Subclass distribution of IgG autoantibodies in bullous pemphigoid. AB - The distribution of IgG subclasses in the antibasement membrane zone autoantibody of pemphigoid in skin and serum was analyzed by use of monoclonal antibodies to human IgG subclasses. The predominant subclass was IgG4 which was present in 23 of 24 skin biopsies, IgG1 was next and IgG3 was found only occasionally. In 3 of 24 biopsies IgG4 was the only IgG subclass detected, C3 was absent in 2 of these, the third contained IgM and C3. Serum autoantibodies were similarly analyzed by indirect immunofluorescence (IIF) when again IgG4 autoantibody was the dominant subclass. No IgE autoantibody was detected by IIF. PMID- 3528305 TI - Elastase and neutral cathepsin production by human fibroblasts: effect of culture conditions on synthesis and secretion. AB - Fibroblasts from normal adult forearm skin and neonatal foreskin were cultured and examined for their ability to synthesize and secrete elastase and neutral cathepsin. All of the cultures examined produced detectable amounts of elastase using insoluble elastin as substrate. An enzyme was also found that hydrolyzed the synthetic elastin substrate, N-succinyl-(Ala)3-p-nitroanilide, but did not degrade insoluble elastin. In addition, activity against the synthetic cathepsin substrate N-benzoyl-DL-phenylalanine-naphthyl ester was found. Inhibitor profiles indicate that the elastin and N-succinyl-(Ala)3-p-nitroanilide degrading activities are due to metalloproteinases. Degradation of N-benzoyl-DL phenylalanine-naphthyl ester can be inhibited by phenylmethylsulfonyl fluoride. These proteinases were usually found associated with the cell layer. Although activities of the measured proteinases were detected in all cultures, increased or decreased enzyme activities were not predictably related to passage number or length of serum starvation. Degree of confluence also affected proteinase activities. Separation of the dermal-epidermal junction can be produced by the injection of these proteinases into intact mouse skin. PMID- 3528306 TI - Enrichment of human epidermal Langerhans cells by attachment to erythrocyte monolayers. AB - The present investigation introduces a method for purification of human epidermal Langerhans cells (LC). The method is based on the attachment of LC to IgG-coated sheep erythrocyte monolayers via their Fc receptors. To optimize the enrichment assay, several variables were tested. The best results were obtained when epidermal cells were centrifuged against erythrocyte monolayers; the purification procedure was performed at 4 degrees C in the presence of 5% fetal calf serum, using about 6 X 10(6) epidermal cells per erythrocyte plate (diameter 5 cm). The average purity of the recovered LC was 80.9% and LC-depleted fractions contained an average of 0.5% DR-positive cells. LC were able to enhance significantly leukoagglutinin- and purified protein derivative-induced T lymphocyte proliferation and leukocyte migration inhibitory factor production. PMID- 3528307 TI - Immunologic differentiation of the Sezary syndrome due to cutaneous T-cell lymphoma and chronic actinic dermatitis. AB - Peripheral blood mononuclear cells from two well-defined groups of patients with the Sezary syndrome have been studied employing indirect immunofluorescent and indirect immunogold techniques in light and electron microscopy, using monoclonal antibodies against T-cell subpopulations. Four patients had chronic actinic dermatitis (CAD) of the actinic reticuloid variant, with erythroderma. Eight patients had cutaneous T-cell lymphoma. All patients showed the clinical features of the Sezary syndrome, including erythroderma, palmoplantar hyperkeratosis, and peripheral lymphadenopathy, and in all patients significant numbers (0.5-30.5 X 10(9) cells/liter) of circulating mononuclear cells were observed with Sezary cell morphology on light-microscopic examination of blood films. Major differences were observed in the circulating T-cell subpopulations in the two groups. In the erythrodermic CAD patients, there was a moderately elevated T-cell count (1.6 +/- 0.6 X 10(9) cells/liter; normal, 1.0 +/- 0.3 X 10(9) cells/liter) of which the majority of the cells was suppressor T cells (OKT8+) giving a very low helper:suppressor T-cell ratio of 0.1:1-0.36:1 (normal, 1.7:1-3.5:1). In cutaneous T-cell lymphoma, there was also an elevation of the T-cell count (9.5 +/- 12.9 X 10(9) cells/liter), but in these patients the predominant cell was the helper T cell (OKT4+) with a high helper:suppressor T-cell ratio of 3.7:1-98:1. PMID- 3528308 TI - Human monoclonal antibodies that distinguish cutaneous malignant melanomas from benign nevi in fixed tissue sections. AB - Human monoclonal antibodies were generated by fusing a nonsecretory variant of murine myeloma cells with lymphocytes obtained from the lymph nodes of patients with metastatic cutaneous malignant melanoma. Two human IgG monoclonal antibodies, designated 2-139-1 and 6-26-3, were extensively studied for their patterns of binding to cells in 64 specimens of formalin-fixed, paraffin-embedded tissue sections. These comprised: 23 cutaneous and 2 ocular melanomas; 4 specimens of lentigo maligna; 27 benign nevi; 2 basal and 2 squamous cell neoplasms of the skin; and 4 specimens of normal skin. A direct avidin-biotin immunoperoxidase staining method was used. Under these conditions, the antibodies reacted with variable intensity to all 18 primary cutaneous malignant melanomas, 5 metastatic cutaneous melanomas, and both ocular melanomas. Antibody 2-139-1 reacted with 1 of 4 specimens and 6-26-3 with 3 of 4 specimens of lentigo maligna. Two of 5 dysplastic nevi reacted with both antibodies, each with a smaller proportion of cells than with melanomas. There was no reactivity with the 22 other nevi representing a spectrum of histologic types or with normal melanocytes. Basal cell and squamous cell carcinomas of the skin also were not stained. These human monoclonal antibodies appear to be useful in distinguishing malignant melanomas from benign nevi, with the exception of dysplastic nevi, and from basal and squamous cancers of the skin in routinely prepared tissue sections. They may also help to identify the cytoplasmic antigens that are immunogenic in humans. PMID- 3528309 TI - Cutaneous acute graft-versus-host disease to minor histocompatibility antigens in a murine model: histologic analysis and correlation to clinical disease. AB - Graft-versus-host disease (GVHD) can occur in bone marrow-transplant recipients even when donor and host are identically matched at the major histocompatibility complex. GVHD in this context presumably arises because of differences in minor histocompatibility antigens. Murine GVHD to minor histocompatibility antigens has been studied in an effort to determine whether skin is a target of the immune response in this model system. T cell-depleted marrow cells (10(7)) from B10.BR (H-2k) mice were supplemented with varying numbers of nylon wool-enriched splenic B10.BR T cells and transplanted intravenously into irradiated (1100 R) CBA (H-2k) mice. Sequential biopsies of ear skin were obtained at weekly intervals over a 7 week period. Histopathologic evaluation revealed basal cell layer vacuolization, exocytosis, and satellitosis of mononuclear cells in the epidermis. Dyskeratosis was observed only in animals receiving T cells, and proved to be the most reliable histologic parameter of disease with the number of dyskeratotic cells per linear millimeter of epidermis correlating both with severity of clinical disease and with the number of transplanted T cells. Ultrastructural examination revealed exocytosis of mononuclear cells into the epidermis where they were frequently apposed to degenerating and necrotic keratinocytes. These data indicate that the skin is an informative target organ for study of experimental GVHD to minor histocompatibility antigens. PMID- 3528310 TI - Prostaglandin E2 and D2 but not MSH stimulate the proliferation of pigment cells in the pinnal epidermis of the DBA/2 mouse. AB - Epidermal melanocytes proliferate following a variety of physical stimuli, for example, mechanical injury to the skin or exposure to UV radiation. We suggest that some transducer in the epidermis converts the physical modality into a biochemical signal which is responsible for initiation of mitosis. Melanocyte stimulating hormone, both alpha and beta variants, administered parenterally for periods up to 4 weeks do not alter the number of melanocytes per mm2 in several strains of neonatal or adult mice. Ultraviolet B and arachidonic acid both stimulate proliferation of pigment cells. Indomethacin which inhibits cyclooxygenase and the formation of prostaglandins (PGs) blocks the proliferation induced by both agents. We tested a wide variety of PGs. We observed that PGD2 applied daily to the skin of a mouse causes a small increase in melanocyte density (cells/mm2). PGE2 in similar doses applied topically caused a large increase. PGE2 caused an increase in the uptake of tritiated thymidine by dopa positive dendritic cells. This indicates that PGE2 stimulated some melanocytes to proliferate. Histologic studies indicate that PGE2 also enhances melanogenesis. PGE2 is synthesized in the skin and affects keratinocytes and Langerhans cells as well as pigment cells. We postulate that it is one compound that can modulate the interaction of these 3 main cells of the epidermis. PMID- 3528311 TI - Granulocyte-activating mediators (GRAM): I. Generation by lipopolysaccharide stimulated mononuclear cells. AB - We undertook a study to determine whether cytokines exist which are responsible for the activation of polymorphonuclear neutrophilic granulocytes (PMN) besides the already well-known stimuli. Lucigenin-dependent chemiluminescence was used to measure human PMN activation. Addition of supernatants from mononuclear cells stimulated with bacterial lipopolysaccharide produced a long-lasting activation of granulocytes. Induction of chemiluminescence was dose-dependent and inhibitable by superoxide dismutase. Fractionation of mononuclear cells by adherence to plastic dishes or counterflow elutriation proved that monocytes were able to generate granulocyte-activating mediators (GRAM). Production of GRAM was dependent on the dose of the stimulus and appeared to be maximal after 24 h of incubation. Addition of cycloheximide resulted in significantly decreased release of GRAM. Partial characterization of the activity showed GRAM to be heat-labile and sensitive to trypsin, indicating a protein nature of GRAM. The activity fractionated into 2 distinct peaks, one corresponding to 60 kD and another below 10 kD. The interleukin 1 activity did not appear to co-fractionate with GRAM. Evidence presented suggests that the activity corresponds to factors unlikely to have been described previously. PMID- 3528312 TI - IgM and IgG antibodies to phenolic glycolipid I from Mycobacterium leprae in leprosy: insight into patient monitoring, erythema nodosum leprosum, and bacillary persistence. AB - Serum IgM and IgG antibodies against Mycobacterium leprae-derived phenolic glycolipid I (PG) were determined in leprosy patients, contacts, and controls by enzyme-linked immunosorbent assay (ELISA). Anti-PG IgM levels increased from the tuberculoid (TT) to the lepromatous (LL) pole of the disease spectrum. There was a positive linear correlation between anti-PG IgM and bacillary index (BI). Patients with erythema nodosum leprosum (ENL) had lower levels of serum anti-PG IgM than non-ENL patients of comparable BI, suggesting that anti-PG IgM is involved in the pathogenesis of ENL. Initial observations indicate that high anti PG IgM levels in bacillary-negative patients might reflect bacillary persistence. A study of 2 different substrate reagents in the ELISA [2,2'-azino-di(3 ethylbenzthiazoline-6-sulfonic acid) (ABTS), 0.1 mM H2O2, serum diluted 1:20, and o-phenylenediamine (OPD), 5 mM H2O2, serum diluted 1:300] showed generally good correlation in detection of anti-PG IgM. However the OPD system detected more paucibacillary disease (BT), while the ABTS system detected the significant effect of ENL on the relationship between BI and anti-PG IgM. Anti-PG IgM was clearly dominant over anti-PG IgG. However, certain patients, including several patients who had upgraded from LL and borderline lepromatous leprosy (BL), showed high levels of anti-PG IgG. Since studies have shown that LL patients are selectively deficient in cell-mediated immunity, T-cell products may be required for the IgM to IgG isotype switch. We conclude that anti-PG IgM is useful for monitoring the bacillary load in individual patients and should prove useful for leprosy control strategies. PMID- 3528313 TI - Rapid prenatal diagnosis and exclusion of epidermolysis bullosa using novel antibody probes. AB - Prenatal diagnosis of recessive dystrophic epidermolysis bullosa was successfully achieved at 19 weeks' gestation by indirect immunofluorescence examination of a fetal skin biopsy sample using the monoclonal antibody LH 7:2. The abortus displayed marked blistering and the diagnosis was confirmed by transmission electron microscopy (TEM). In 3 further pregnancies at risk for lethal junctional epidermolysis bullosa the diagnosis was excluded using the polyclonal antibody AA3. In all these studies the results were available within 4 h of receiving the samples. These new techniques offer a quick and simple alternative to TEM for midtrimester prenatal diagnosis of 2 severe recessive forms of epidermolysis bullosa. PMID- 3528314 TI - Indirect immunofluorescence in vesiculobullous eruption of systemic lupus erythematosus. PMID- 3528315 TI - Titers of antibody to pneumococci in allogeneic bone marrow transplant recipients before and after vaccination with pneumococcal vaccine. AB - To understand the susceptibility of allogeneic bone marrow transplant recipients to pneumococcal infection, we measured the level of type-specific antibodies to pneumococcal capsular polysaccharide in serum from ten marrow recipients. Seven recipients received marrow from matched sibling donors who had recently been vaccinated with polyvalent pneumococcal vaccine. Titers of IgG antibodies to two pneumococcal serotypes (7F and 14) declined significantly during the first year after transplantation. IgM antibodies remained low or declined after transplantation, but IgM antibodies to type 7F increased during the latter half of the first year. Pneumococcal vaccine was administered to seven marrow recipients approximately two years after transplantation. Vaccinated recipients had lower postvaccination titers of type-specific IgG antibody than did vaccinated normal adults and vaccinated sibling donors, and the recipients had normal levels of type-specific IgM antibodies. Thus, the susceptibility of marrow graft recipients to pneumococcal disease may be related to lowered concentrations of antibody to pneumococci after engraftment. PMID- 3528317 TI - Analysis of Toxoplasma gondii antigens recognized by human sera obtained before and after acute infection. AB - The antibody response to Toxoplasma gondii was studied in human serum samples obtained before and during acute infection with T. gondii. Analysis was by the Sabin-Feldman dye test, double-sandwich IgM ELISA, agglutination test, and protein blots of toxoplasma antigens. Seventeen patients were studied: 12 pregnant women, 2 heart transplant recipients, and 3 symptomatic but immunologically normal individuals. Both IgM and IgG protein blots of the first serologically positive serum sample from each patient revealed new bands, as well as intensified staining of bands noted with the serologically negative serum samples. In each patient, bands corresponding to antigens of approximately 4 kilodaltons (kDa; IgM blots) and of approximately 35 kDa (IgG) were the most intensely stained. In one patient, IgM antibodies to the 4-kDa antigen(s) were demonstrable by protein blots before they were demonstrable by IgM ELISA. IgG protein blots of sera from individuals with chronic infection with T. gondii revealed weakly reactive antibodies to both the 4-kDa and 35-kDa antigens; these bands were not demonstrable in the IgM blots. PMID- 3528316 TI - Escherichia coli O157:H7 diarrhea in a nursing home: clinical, epidemiological, and pathological findings. AB - In September 1984, an outbreak of Escherichia coli O157:H7 infection occurred in a nursing home. It was the first recognized outbreak of this organism in the United States since 1982, when two outbreaks led to its recognition as a pathogen. Thirty-four of 101 residents developed a diarrheal illness; 14 were hospitalized with a severe illness characterized by crampy abdominal pain, marked abdominal distention, and grossly bloody diarrhea, and four died. The spectrum of illness associated with the infection was broad and included the following: asymptomatic infection, nonbloody diarrhea, hemorrhagic colitis, hemolytic uremic syndrome, and death. Clinical, radiographic, and postmortem pathological findings suggested involvement of the cecum and right colon. No evidence of response to antimicrobial agents could be documented, and antidiarrheal agents may have aggravated the disease. This investigation implicated hamburger as the vehicle transmission. Seventeen of 19 residents with hemorrhagic colitis, but only 28 of 67 healthy residents, had eaten hamburger on 13 September (P less than .001, Fisher's two-tailed exact test; relative risk [RR] = 7.7). Infection with E. coli O157:H7 can cause a wide range of manifestations. In the elderly these can be particularly severe and may resemble ischemic colitis. PMID- 3528318 TI - Use of D-lactic acid measurements in the diagnosis of bacterial infections. AB - This study explored the use of D-lactic acid as a marker for bacterial infections. D-Lactic was produced by frequently encountered human bacterial pathogens under anaerobic growth conditions; Bacteroides fragilis produced the largest amount. Orally administered D-lactic acid was absorbed from the intestines of rats and later found in measurable quantities in the blood and urine. Eunephric and anephric rats that received D-lactic acid intravenously showed similar quantities of this metabolite in the blood. These quantities are consistent with the distribution of D-lactic acid to total body water. Isolated liver and lung tissues from rats did not metabolize or produce D-lactic acid. Rats with experimentally induced, sublethal klebsiella peritonitis had D-lactic acidemia of 0.2 mM and 25.6 mM at 0 and 6 hr of infection, respectively. In a normal human, D-lactic acid was detected in the urine and blood after a subcutaneous injection of D-lactic acid, and pharmacokinetics of elimination similar to those of rats were found. PMID- 3528319 TI - Effects of sublethal concentrations of amphotericin B on Candida albicans. AB - Because sublethal concentrations of antibodies can have important effects on bacteria and may aid host defenses, even in the absence of direct microbial killing, the effect of brief sublethal exposures to amphotericin B on Candida albicans blastoconidia was evaluated. Amphotericin B (0.01-1.0 micrograms/ml for 60 min) inhibited germ tube formation and yeast adherence to both serum-coated plastic surfaces and fibrin matrices. These effects were not reversed by cation (K+ or Mg++) supplementation. Amphotericin B pretreatment accelerated clearance of C. albicans from the peritoneal surfaces of mice and reduced the inflammatory stimulus associated with this clearance, at least as measured by neutrophil influx. However, pretreatment did not facilitate killing of C. albicans by either neutrophils or monocytes in vitro. Thus sublethal concentrations of amphotericin B inhibit two activities of C. albicans that probably contribute to surface colonization and tissue invasion. These results provide one explanation for the clinical benefits observed with short courses of amphotericin B therapy for surface-limited candidal infections (e.g., esophagitis). PMID- 3528320 TI - Correlation of antibiotic synergy in vitro and in vivo: use of an animal model of neutropenic gram-negative sepsis. AB - The predictive value of in vitro studies of antibiotic interaction for clinical drug interactions is unclear. Five clinical isolates (two Klebsiella, two Pseudomonas aeruginosa, and one Serratia marcescens) were evaluated by the time kill curve method for in vitro synergy between amikacin and imipenem. When we used the stringent definition of synergy of Hallander et al., no synergy was present for any study strain; however, when we used a more-conventional definition of synergy, these drugs interacted synergistically against all study strains. The results of these in vitro studies were correlated with in vivo interactions by using neutropenic infant rats injected ip with study organisms and given various treatment regimens. For 80% of the study strains, treatment of rats with amikacin and imipenem resulted in significantly greater survival than did therapy with either drug alone or than could be predicted by addition of survival rates achieved with either agent alone (P less than .005). In vitro studies predicted this in vivo synergy in 80% of the cases when the more conventional definition of synergy was used, whereas they were not predictive when the more-stringent definition of synergy was used. This rat model of neutropenia and gram-negative sepsis may provide more insight into in vivo drug interactions than do current methods. PMID- 3528321 TI - Failures of combined chloroquine and Fansidar prophylaxis in American travelers to East Africa. PMID- 3528322 TI - Use of immunofluorescence examination to detect rabies virus antigen in the skin of humans with clinical encephalitis. PMID- 3528323 TI - The pathogenesis of hemorrhagic colitis caused by Escherichia coli O157:H7 in gnotobiotic piglets. PMID- 3528324 TI - Electrophoretic mobility of an esterase from Escherichia coli isolated from extraintestinal infections. PMID- 3528325 TI - Multiply drug-resistant Shigella dysenteriae type 1 and travelers' diarrhea. PMID- 3528326 TI - HLA compatibility for patients with thalassemia: implications for bone marrow transplantation. AB - In order to evaluate the possibility of a patient with thalassemia finding an HLA identical sibling donor, we performed an analysis of HLA antigens in families of thalassemic patients. The pattern distribution was not significantly different from the expected ratio 25:50:25. When the siblings were subdivided according to the age of the patients (under or over 5 years), the above pattern remained unmodified for both the age groups. The average size of the 129 thalassemic families was 2.4. Thus, taking into account that thalassemic patients have an average of 1.4 siblings and that the HLA genotype distribution is expected as such, HLA-matched siblings are available for 33% of the patients. Because an additional 8.5% of the patients were found HLA-phenotypically identical to one parent, the chance for a patient with thalassemia to find a suitable donor for bone marrow transplantation would be increased to 41.5%. Our preliminary data cannot be extrapolated to the overall Italian thalassemic population; however, it can be inferred that for a patient with thalassemia, the chance of finding a suitable donor for bone marrow transplantation is not reduced. PMID- 3528327 TI - Proceedings of the Canadian Conference on Bone Marrow Transplantation. Toronto, October 7-8, 1985. PMID- 3528328 TI - Hemopoietic precursors in human bone marrow transplantation. PMID- 3528329 TI - Manipulation of T cells in the transplant inoculum. PMID- 3528330 TI - Enterovirus studies in bone marrow transplantation. PMID- 3528331 TI - Immune reconstitution post-bone marrow transplantation. PMID- 3528332 TI - A review of bone marrow transplantation. PMID- 3528333 TI - Selection of patients with Hodgkin's disease and non-Hodgkin's lymphoma for bone marrow transplantation. AB - Despite substantial progress in curative therapy of malignant lymphomas, some patients fail current treatment and die of refractory disease. Although Although high-dose chemotherapy and supralethal total body irradiation followed by bone marrow transplantation may salvage and cure a proportion of these refractory patients, treatment of such end-stage patients with marrow grafting often fails because of resistant disease or transplant-related complications. Using the analogy of transplantation in the early phases of acute and chronic leukemias, results of marrow transplant in Hodgkin's disease and non-Hodgkin's lymphoma might be improved if performed earlier in the course of the malignancy. The following collaborative report by the Seattle and Stanford groups examines current results of conventional lymphoma therapy to define subgroups of patients with "high-risk" lymphoma for whom early marrow transplant might be offered to control otherwise incurable disease. PMID- 3528334 TI - On difficulties in reporting and interpreting SFG index. PMID- 3528336 TI - Draining lymph node enlargement produced by immunogenic strains of cultivable mycobacteria. AB - Lymphnode enlargement produced by strains of mycobacteria have a direct bearing on the immunogenicity characteristics. Two strains of mycobacteria namely M. habana TMC 5135 and M. marinum (SATO) have been studied for their property to produce enlargement of draining lymphnodes besides other cell-mediated immune responses. Both the strains are capable of producing the enlargements of inguinal and popliteal lymphnodes which is very significant. The enlargements of lymphnodes have been produced by these strains both in the live as well as killed state. Possibility of developing these strains as vaccine against leprosy has been discussed. PMID- 3528335 TI - Presence of "difficult to isolate" mycobacteria in armadillos. AB - Contrary to the findings with armadillos from Louisiana and Texas, armadillos from Florida are free of natural leprosy-like infection. Examination of ear clip, nasal, blood buffy coat, liver and spleen of inoculated armadillos from Florida did not reveal the presence of any acid fast bacteria. However, using massive inocula, 6 out of 77 armadillo tissues were found to contain very negligible proportions of cultivable mycobacteria. The significance of these isolates in relation to M. leprae and also to leprosy research is discussed. PMID- 3528337 TI - Study of amplitude frequency spectra of the compound action potentials recorded from normal and M. leprae infected mice using Fourier series analysis. AB - Compound action potentials recorded from normal and M. leprae infected mice sciatic nerves were analysed in frequency domain using Fourier Series Analysis. Changes in myelinated fibre potentials were detected as early as 2nd post inoculation month. This technique could be further developed to aid in early diagnosis of leprosy. PMID- 3528338 TI - Supervised administration of multidrug therapy in leprosy colonies through volunteers--a bacteriological assessment. PMID- 3528339 TI - [Recycling of membrane proteins and the regulation of membrane functions]. PMID- 3528340 TI - [Clinical role of urinary trehalase in proximal tubular damages]. PMID- 3528341 TI - [Two cases of tuberculous peritonitis with preoperative suspicious diagnosis of malignant ovarian tumors]. PMID- 3528342 TI - [The developmental characteristics of postterm fetuses assessed using both the physical parameters and real-time ultrasound]. AB - To evaluate how the physical profile differs between term and postterm fetuses, a statistical and an allometric analyses were made on 6658 cases delivered at 20 weeks of gestation or more in our hospital for last 40 years from 1940s to 1970s, by using the physical parameters such as the weight, the height and so on. Consequently, it was evident that there were two types of the postterm infants which were most markedly manifested on the body weight. One continued to grow and another remained less increasing in body weight. Unrelated to the weight at birth, the postterm infants were also found to have the transverse diameters (e.g. biparietal diameter) of the head which became more disproportionally enlarged than were those at term. This finding explains, in part, why the postterm fetus is susceptible to dystocia, and also implicates that the fetus will follow the brain development at 42 weeks of gestation onwards, as if it would run on such the same extrauterine course that the neonate given birth at term does so. A study was further extended to assess the functional aspect of the fetal development in association with the pathogenesis of the postterm fetuses, where three parameters including fetal urine production rate, fetal eye movement and resistance index (RI) at the umbilical arteries were used: The first and the second were observed using real-time ultrasound, and the third by means of pulse Doppler method.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3528343 TI - [Recent management of postterm pregnancy from a survey of 422 institutions]. AB - A survey of the management of postterm pregnancy was conducted among the institutions of Japan Society of Obstetrics and Gynecology. Results were as follows. The incidence of postterm pregnancy has been reduced as compared with that in 10 years ago. An ultrasound examination used to ascertain the expected date of confinement (EDC) has highly contributed to the reduction of postterm pregnancy. Estriol determination, non-stress test and ultrasonography are commonly used to assess the fetal well-being of postterm pregnancy. Intervention has been mainly performed by use of uterine contractive drugs (prostaglandins, oxytocin). For the management of postterm pregnancy, proper assessment of EDC must be recommended by BBT and ultrasonography. Induction of labor may take place if the cervix is favorable or fetal compromise is evident by biophysical and biochemical testing. PMID- 3528344 TI - Immunity to leprosy. IV. Murine T-cell proliferative responses to mycobacteria. AB - The nature of antigens shared between Mycobacterium leprae and other species of mycobacteria has been examined using a murine T-cell proliferation assay. Mice were immunized with different mycobacteria, and lymph node cultures were prepared one week later and challenged with M. leprae antigen. The 13 species of mycobacteria tested as antigens in this assay revealed that several species shared antigens in common with M. leprae as recognized by T-cell responses. C57BL/10J mice and congenic strains exhibit differences in T-cell responsiveness to M. leprae. B10.M and B10.Q mice are high responders and C57BL/10J are low responders, while F1 (C57BL/10J X B10.M) and (C57BL/10J X B10.Q) hybrid progeny are also low responders. These genetic differences were not observed when six other mycobacterial species were used as T-cell antigens. An unexpected finding was that the genetic pattern of T-cell responsiveness to M. marinum was identical to that observed for M. leprae using these strains of mice. Helper T cells may recognize antigenic determinants shared by M. leprae and M. marinum. These antigens may initiate the induction of T-cell responses to these two species of mycobacteria. PMID- 3528345 TI - Combined clofazimine- and dapsone-resistant leprosy. A case report. AB - A preliminary report is presented on the finding in a patient with lepromatous leprosy relapsing after maintaining clinical inactivity and bacterial negativity with dapsone monotherapy for a period of 23 years. Interestingly, Mycobacterium leprae from the fresh skin lesions revealed resistance to both clofazimine and dapsone by standard mouse foot pad testing. PMID- 3528346 TI - Adoptive transfer of tolerance induced by ICRC bacilli against Mycobacterium leprae in mice. AB - ICRC bacilli, the cultivable leprosy-derived mycobacteria, isolated from lepromatous nodules of leprosy patients were found to be immunogenic in BALB/c mice at a dose of 2 X 10(7) acid-fast bacilli when injected by the intradermal (i.d.) route. The sensitization to lepromin and ICRC antigens was measured by the foot pad enlargement (FPE) method. The same dose of bacilli when injected by intravenous (i.v.), intraperitoneal, and subcutaneous routes induced immune tolerance in mice as indicated by reduction in the FPE to the test antigens. The spleen cells obtained after i.v. injection of ICRC bacilli/Mycobacterium leprae after adoptive transfer brought about suppression of delayed-type hypersensitivity in sensitized as well as nonsensitized recipients, indicating production of suppressor cells after i.v. injection. Similarly, the tolerance induced by i.v. injection of M. leprae in mice could be partially converted to immunity by i.d. sensitization with live BCG and two strains of ICRC bacilli (C 44 and C-75). PMID- 3528347 TI - Restored pathogenicity of attenuated Mycobacterium lepraemurium in mice. AB - The ability of Mycobacterium lepraemurium (Mlm) to adhere to A31 cells in culture decreased with the number of passages of the bacilli on Ogawa egg-yolk medium. Pathogenic Mlm consistently grew in tissue culture cells but growth was not seen with attenuated Mlm isolated from a smooth colony. After prolonged incubation, attenuated Mlm became adapted to tissue culture growth. The pathogenicity of the attenuated bacilli was restored partially by the adaptation to tissue culture cells and restored almost completely by passage in mice. After restoration of pathogenicity by these methods, the Mlm formed rough-type colonies on Ogawa egg yolk medium although the colonies were not completely of the rough type. Attenuated Mlm did not interfere with the growth of in vivo-derived Mlm in tissue culture or in mice. PMID- 3528348 TI - A random survey of leprosy in wild nine-banded armadillos in Louisiana. AB - On the basis of the finding that lepromatous granulomas were almost always seen in the ears of armadillos with disseminated leprosy, a random survey of the prevalence of the disease among wild armadillos in the state of Louisiana, U.S.A., was conducted by examining histopathologically both ears of armadillos killed on the roads by automobiles. Ten (2%) of the 494 animals examined had disseminated leprosy. If a killed lepromatous armadillo releases up to 10 Mycobacterium leprae into the environment, the importance of the event to the epidemiology of leprosy must be considered. PMID- 3528349 TI - Purification of M. leprae isolated from human skin biopsies. PMID- 3528351 TI - Percutaneous transplantation of pulverized bone in rabbits. AB - The effects of percutaneous injection of the pulverized bone on osteogenesis at the site of bone defect were investigated in rabbits. Although the ceramic bone mixed with blood coagula showed the osteogenic capacity in fresh bone defects, it did not show this capacity in old bone defect. Injection of pulverized bone mixed with blood coagula resulted in greater bone formation than did pulverized bone mixed with saline. Three types of pulverized bone were used: ceramic bone, Kiel bone and autologous corticocancellous bone. Ceramic bone showed the greatest capacity in osteogenesis. These results suggest that the percutaneous injection of pulverized ceramic bone is effective in the treatment of fresh bone defects. PMID- 3528350 TI - Enzyme activation in peritoneal cells from mice infected with Mycobacterium lepraemurium. PMID- 3528352 TI - [Therapeutic plasmapheresis--history, present status and future prospect]. PMID- 3528353 TI - [Therapeutic apheresis in hematologic disorders; its indication and evaluation]. PMID- 3528354 TI - [A woman with a paroxysmal general hyperhidrosis in the climacteric period]. PMID- 3528355 TI - [A case of normotensive hypokalemia similar to Liddle's syndrome with episodic and paroxysmal hyperkalemia]. PMID- 3528356 TI - [A case of acute terminal ileitis caused by Yersinia pseudotuberculosis]. PMID- 3528357 TI - [Renal vein plasma renin activity in patients with essential hypertension and renovascular hypertension]. PMID- 3528358 TI - [A case of solitary renal cyst causing hyperreninemic hypertension]. PMID- 3528359 TI - [Moebius syndrome associated with obesity, dwarfism, endocrinological abnormalities and various minor anomalies]. PMID- 3528360 TI - Encore! PMID- 3528361 TI - A genetic and cell biologic mechanism for atherosclerosis: a decade later. PMID- 3528362 TI - Hyperlipidemia in coronary heart disease: a biochemical genetic approach. By Joseph L. Goldstein and Michael S. Brown. 1975. PMID- 3528363 TI - Urinary proteinase activity in patients with multiple traumatic injuries, sepsis, or acute renal failure. AB - Urinary proteinase activity was measured and partly characterized in 29 patients, most of whom had multiple traumatic injuries and 14 of whom had sepsis. Seven of these 29 patients also had acute renal failure. When they were compared with healthy controls, a significant increase of urinary proteinase activity measured with azocasein as a substrate could be found 1 day after admission (15.3 +/- 4.8 vs. 4.8 +/- 1.0 U/ml; P less than 0.05). In urine fractions of patients with sepsis, significantly higher proteolytic activities were measured than in patients without septicemia (20.5 +/- 4.2 vs. 12.3 +/- 2.2 U/ml; P less than 0.05). Patients with sepsis and acute renal failure showed higher urinary proteinase activity than patients with sepsis and normal kidney function (37.7 +/ 4.9 vs. 20.5 +/- 4.2 U/ml; P less than 0.05). During recovery from sepsis urinary proteinase activity decreased to normal values. Phosphorylase kinase was used to characterize the type of urinary proteinase(s). A predominant splitting of the alpha and gamma subunits of the enzyme was observed after trauma and sepsis. However all three subunits, alpha, beta, and gamma, were rapidly digested in the case of posttraumatic acute renal failure and sepsis, indicating the presence of different urinary proteinases. We conclude that proteolytic enzymes are present in urine fractions after traumatic injuries. Sepsis, acute renal failure, or both induce a further increase in urinary proteolytic activity caused by different proteinases. PMID- 3528364 TI - Differential recovery of antibody production potential after sublethal, whole body irradiation of mice. AB - Mice were given single injections of sheep erythrocytes (SE) or polyvinylpyrrolidone (PVP) at various times after sublethal, whole-body irradiation (550 rad 60CO) and direct, antigen-specific, plaque-forming cell (PFC) responses were quantified. Irradiated mice did not respond to SE or PVP when immunized 15 d postirradiation (PI); by day 30 PI, the responses by irradiated mice were 40-126% of normal to SE and 3-38% of normal to PVP. The impaired recovery after irradiation of immune responses to PVP was not due to altered antigen dose requirements or altered time of peak PFC response and occurred after irradiation of mice by doses as low as 200 rad. Both athymic and euthymic mice had impaired responses to PVP after whole-body irradiation. The impaired response of irradiated mice to PVP was repaired by adoptive transfer of normal bone marrow, fetal liver, or spleen cells and also by spleen cell preparations enriched in Ig+ cells but not by spleen cell preparations enriched in Thy.1+ or Ig- cells. With the aid of additional antigens it was observed that by day 30 PI, mice had recovered ability to respond to the T-cell-dependent antigen SE and the T-cell-independent type-1 antigens 2,4,6-trinitrophenyl Brucella abortus and butanol-extracted bacterial lipopolysaccharide, but at that time they gave impaired responses to the T-cell-independent type-2 antigens PVP, type III pneumococcal polysaccharide, and phenol-extracted bacterial lipopolysaccharide; they had an immune response pattern similar to that of CBA/N mice having an X-linked immunodeficiency. PMID- 3528365 TI - Fc receptor function on sheep alveolar macrophages. AB - We have examined the binding to sheep alveolar macrophages (AM) and peripheral blood polymorphonuclear leukocytes (PMN) of sheep immunoglobulin G subclasses or rabbit IgG immune complexes formed between rabbit anti-DNP IgG and DNP-bovine serum albumin. Binding studies using 125I-rabbit IgG immune complexes demonstrated 6.6 +/- 3.5 X 10(4) receptors per alveolar macrophage; these receptors bound immune complexes with an average association constant of 3.3 X 10(7) M-1. Saturation binding was achieved by 90 minutes at 4 degrees C with 6 X 10(-8) M IgG. Binding of subclasses of sheep IgG was examined by immunofluorescence. Only 10% of alveolar macrophages bound monomeric IgG1 and no binding of sheep IgG2 monomer could be demonstrated. In contrast, most peripheral blood PMN (93.0 +/- 9.5%) bound IgG2, but not IgG1. No binding to adult peripheral blood PMN of rabbit IgG immune complexes could be demonstrated. To study further the development of pulmonary host defense, we examined the expression of receptors for IgG immune complexes (Fc gamma R) on alveolar macrophages obtained from animals aged 8 through 180 days. At 8 and 21 days of age, the number of Fc gamma R varied considerably (75,000-192,000 sites per cell) and equalled or even exceeded that of adult sheep. Fc gamma R number declined by 42 and 90 days of age, where a nadir was reached (37,000 +/- 6,000 and 25,000 +/- 6,000 sites, respectively). By 180 days of age, the number of receptors had approached those of normal adult sheep (70,000 +/- 20,000 sites per cell). These studies parallel previous observations that revealed age-related differences in the phagocytic capacity of ovine alveolar macrophages. PMID- 3528366 TI - Isolation of pure LpB from human serum. AB - Low density lipoproteins (LDL), even after isolation from a narrow density cut and after several washes by preparative ultracentrifugation, are contaminated by 3-5% non-apoB proteins. Incubation of these LDL with artificial triglyceride-rich lipid emulsions (TGRP) removed all contaminating apoC and also, under certain conditions, apoA proteins. TGRP treatment did not, however, change the lipid composition and the flotation behavior of LDL. Residual apoE and albumin, amounting up to 0.5% of the apoB mass, were resistant to removal by TGRP treatment as well as by heparin-Sepharose column chromatography. ApoE and albumin could only be removed by immunoabsorption. PMID- 3528367 TI - 19th Hawaii International Conference on System Sciences-- Computer-assisted instruction (CAI) on nursing. Honolulu, Hawaii, January 1986. PMID- 3528368 TI - Preparing faculty to use and develop computer-based instructional materials in nursing. AB - This paper identifies the need for more specific guidelines in preparing faculty to use and develop computer-based instructional materials. Cory's model for faculty development is described and planning considerations are outlined. Finally, components of this multifaceted approach to faculty development- identifying available resources, emphasizing the current uses of computers, providing computer literacy/faculty awareness sessions, focusing on the instructional use of microcomputers, collaboration, and communication--are discussed. PMID- 3528369 TI - A regression model to identify successful learner traits with CAI. AB - This descriptive study examined the personality traits and instructional time factors of successful and nonsuccessful students who utilized computer-assisted instruction (CAI) to learn psychopharmacological nursing. Data from this study support the contention that there is beginning evidence to imply that there are certain individual traits that can be utilized to predict successful learning with CAI. The stepwise multiple regression analysis utilized in this study identified 17 variables that contributed to successful learning. Specific academic, cognitive, demographic, and philosophical indicators emerged as the most consistent predictors of learning associated with these psychopharmacological lessons presented on the PLATO system. These results and others are explored in terms of their educational implications, and suggestions are made for future research that can be used to plan more effective and efficient use of computers in nursing education. PMID- 3528370 TI - Developing computer simulations for staff nurse education. AB - Computer-assisted instruction holds promise for individualizing continuing education programs. This article describes how staff nurse educators are taught how to use the principles of instructional design to write clinical nursing simulations. At the conclusion of a 15-hour workshop participants have written, programmed, and begun the process of field testing their simulation. PMID- 3528371 TI - The impact of microcomputers on program excellence. AB - The following criteria were used to document program enhancement after the implementation of a microcomputer laboratory: faculty and student attitudes toward computer-assisted instruction (CAI); student anxiety scores toward state board examinations; increased visibility of the college (number of authored CAI modules, CAI grants, computer committee memberships, faculty attendance at computer courses); and relationship involving learning style, attitude, and student learning. Ninety-two of 112 students and 39 of 55 faculty responded to the request for data collection. Postimplementation, both faculty and students showed mean increases in their attitude toward CAI, although not statistically significant. Senior students had significantly decreased anxiety scores toward the state RN licensure examination after using Mosby's NURSESTAR for review (p less than .001). Increased visibility was also documented, but data collection continues regarding the relationship involving learning style, attitude, and student learning. It was concluded that the innovation of computers in an established nursing curriculum served to enhance program excellence. PMID- 3528372 TI - Computer-assisted instruction. An overview. AB - The development of computer-assisted instruction (CAI) is discussed and definition of major concepts is presented. The three major types of CAI (drill and practice, tutorials, and simulations) are defined and examples given for each. The impact of CAI in nursing is discussed and several CAI systems are described. PMID- 3528373 TI - The POSCH data processing experience. The problem of metadata. AB - Metadata, the term, may be new but metadata, the concept, is not new. For purposes of this paper, the term metadata is defined as the data used to define, store, retrieve, combine, analyze, and present the data values (the "real" data, so to speak). As clinical research studies get larger, it becomes desirable to use automated managers of the metadata. The Program on the Surgical Control of the Hyperlipidemias (POSCH), a national multiclinic clinical trial, manages most of its metadata manually but has been experimenting with ways to more fully automate them. Its Information Management System (IMS) is described with special emphasis on how it manages the metadata. The case is presented for further automation and standardization of metadata in large clinical research studies so that costs can be contained and smaller increments of "progress" can be measured. The concept of a Metadatabase Management System (MDBMS) is developed and illustrated using POSCH. PMID- 3528374 TI - Medical diagnostic support for spacecraft. The NASA project. PMID- 3528375 TI - Effects of pancreatectomy on the growth and metabolite concentrations of the sheep fetus. AB - The effects of fetal pancreatectomy on the growth and metabolism of the fetal sheep were investigated in chronically catheterized animals during the last third of gestation. Fetal pancreatectomy reduced body weight and crown-rump length at delivery near term (term 145 days). Body weight was affected more than body length so the ratio of weight to length was significantly less after pancreatectomy than in intact animals (P less than 0.05). Pancreatectomized fetuses appeared to maintain a normal growth rate for 5-10 days after surgery but thereafter showed no further significant increase in body weight. When all the data from the intact and pancreatectomized fetuses were combined, there was a significant positive correlation between the plasma insulin concentration in utero and the body weight at delivery near term. The majority of organs studied were reduced in absolute weight after pancreatectomy but only the spleen and thymus were proportionally lighter when the weights were expressed as a percentage of body weight. Brain and placental weights were similar in intact and pancreatectomized fetuses. Over the range of values observed in utero, there were significant inverse correlations between the log plasma insulin level and the mean plasma concentrations of glucose, lactate, fructose and alpha-amino-nitrogen in individual intact and pancreatectomized fetuses. Insulin infusion into pancreatectomized fetuses restored the metabolite concentrations to their normal values within 48 h of infusion. The results demonstrate that insulin has a vital role in regulating fetal growth and metabolism in utero. PMID- 3528376 TI - Effects of long- and short-term gonadectomy on the hypothalamo-hypophysial (LH releasing hormone-LH) system in oestrogen-treated male and female rats. AB - Considerable differences have previously been found in the hypothalamo hypophysial responsiveness to oestrogen, depending upon the time between gonad removal and exposure to oestrogen. In the present study a detailed analysis was made of some of the differences which may exist in pituitary LH-releasing hormone (LHRH) receptors and the amount of LH released in response to electrochemical depolarization of the medial preoptic area after 2 or 7 days of oestradiol treatment of long- and short-term gonadectomized male and female rats. The pituitary glands of long-term gonadectomized males and females secreted more LH in response to two pulse injections of LHRH than did short-term gonadectomized rats. The amount of LH released on day 2, however, was equivalent to that secreted after 7 days of oestradiol treatment. Moreover, long-term gonadectomized males and females had equivalent LHRH receptor concentrations, which were greater than those of short-term gonadectomized animals. Peak serum LH concentrations observed after preoptic stimulation were equivalent in short- and long-term castrated rats after 2 days of oestrogen exposure. Serum LH concentrations following preoptic stimulation in short-term gonadectomized males and females were significantly greater on day 7 than on day 2 of oestradiol treatment, whereas in long-term gonadectomized animals the stimulated release of LH was equivalent both in magnitude and time of peak release on both days.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3528377 TI - Immunoreactivity of a 70 kD protein purified from Mycobacterium bovis Bacillus Calmette-Guerin by monoclonal antibody affinity chromatography. AB - The protein antigens from Mycobacterium bovis (BCG), M. tuberculosis, and M. leprae share a number of common determinants. We have used a murine mAb (L7) recognizing such a determinant on a protein of Mr 70,000 to purify this antigen from M. bovis sonicate by affinity chromatography. Enrichment of the protein in column eluates was confirmed by immunoblotting and in antigen inhibition assays. After radiolabelling with 125I, the protein could be immunoprecipitated with human lepromatous leprosy sera. Stimulation of peripheral blood mononuclear cells from BCG-vaccinated and naturally mantoux-positive individuals induced proliferation and IFN-gamma secretion, while intradermal injection of purified antigen into the same subjects resulted in a delayed-type hypersensitivity reaction. Thus, the 70,000 molecule carried epitopes capable of reacting with B cells, and eliciting a potentially protective T cell response. The first 15 N terminal residues were sequenced using a gas-phase sequenator. PMID- 3528378 TI - LFA-1 immunodeficiency disease. Definition of the genetic defect and chromosomal mapping of alpha and beta subunits of the lymphocyte function-associated antigen 1 (LFA-1) by complementation in hybrid cells. AB - Lymphocyte function associated antigen 1 (LFA-1) is a leukocyte cell adhesion protein. We have studied a novel human immunodeficiency disease in which LFA-1 and two other proteins which share the same beta subunit are lacking from the surface of leukocytes. The basis of the inherited defect in cell surface expression of both the alpha and beta subunits of LFA-1 was determined by somatic cell fusion of patient or normal human cells with an LFA-1+ mouse T cell line. Human LFA-1 alpha and beta subunits from normal cells could associate with mouse LFA-1 subunits to form interspecies hybrid alpha beta complexes. Surface expression of the alpha but not the beta subunit of patient cells was rescued by the formation of interspecies complexes. The findings show that the LFA-1 alpha subunit in genetically deficient cells is competent for surface expression in the presence of an appropriate beta subunit, and suggest that the genetic lesion affects the beta subunit. The human LFA-1 alpha and beta subunits were mapped to chromosomes 16 and 21, respectively. The genetic defect is inferred to be on chromosome 21. PMID- 3528379 TI - Cytotoxic T lymphocytes against disease-associated determinant(s) in ankylosing spondylitis. AB - Cytotoxic T lymphocytes, induced by stimulating the PBMC of an HLA-B27+ normal individual (B27+, AS-) with the PBMC of an HLA-identical sibling suffering from ankylosing spondylitis (AS) (B27+, AS+), specifically lyse B27+, AS+ PBMC but not PBMC from HLA-27+ or B27-, AS- normal controls, or from HLA-B27- AS patients (B27 ,AS+). CTL of similar specificity can also be raised by immunizing in vitro B27+,AS- cells with autologous cells modified by cross-reactive bacterial antigens. These results suggest that CTL can recognize certain bacterial antigens in association with HLA-B27 and that this interaction may lead to an inflammatory episode during the initial stages of the disease. PMID- 3528380 TI - N-acetylalanine aminopeptidase activity in normal and tumour cells. AB - The catalytic concentration of N-acetylalanine aminopeptidase was determined in erythrocytes, polymorphonuclear leukocytes, lymphocytes, alveolar macrophages, human lung fibroblasts, human lung cancer cells, human umbilical vein endothelial cells, mice Leydig cells, rat tumour cells, and endothelial cells from hog and bovine lung. The catalytic concentration ranged from 0.5 +/- 0.1 nU/cell (erythrocytes) to 35 nU/cell (rat tumour cell line B Sp 73 ASML). Almost all tumour cells showed higher activity levels. No activity was found in human plasma. PMID- 3528381 TI - Effect of a rapid diagnostic method on prescribing patterns and ordering of throat cultures for streptococcal pharyngitis. AB - The sensitivity and specificity of a rapid identification test for group A beta hemolytic streptococcus and its impact on prescribing antibiotics and ordering throat cultures were evaluated in a primary care office setting. The calculated sensitivity, specificity, positive predictive value, and negative predictive value were 82 percent, 92 percent, 76 percent, and 94 percent, respectively. Throat cultures were ordered for 98 percent of patients with acute pharyngitis regardless of the method of testing available. After use of the rapid identification test within the office, a reduction was observed in physician prescribing of antibiotics before the throat culture results were known. Physicians were more likely to initiate antibiotics immediately when rapid test results for streptococcal infection were positive and provide patient education regarding symptomatic treatment when the results were negative. The rapid identification test is an acceptable alternative to the standard culture technique in the family practice office. The rapid test was apparently responsible for the observed reduction in antibiotic prescribing and should reduce unnecessary cost and antibiotic exposure in the ambulatory setting. PMID- 3528382 TI - Interactive computer-assisted instruction on cancer screening guidelines. PMID- 3528383 TI - Immunocytochemical demonstration of steroid hormones in the granulosa cells of the medaka, Oryzias latipes. AB - Immunocytochemical identification of steroid hormones was performed in granulosa cells isolated from large ovarian follicles of the medaka. The granulosa cells recovered from daily spawning females, 8.5 h after the onset of light, reacted with anti-progesterone and anti-17 alpha-hydroxyprogesterone antibody, while the granulosa cells treated 2.5 h after the onset of light did not. After 6 h stimulation with gonadotropin (PMS) in vitro, the isolated granulosa cells reacted with anti-progesterone antibody. The granulosa cells examined 8.5 h after the onset of light did not react with anti-estradiol or anti-estriol antibody. These results demonstrate that, in Oryzias latipes, progestins (progesterone and 17 alpha-hydroxyprogesterone) are synthesized in the granulosa cells which are directly stimulated by gonadotropin. PMID- 3528384 TI - Regenerate epithelium and skin glands of the adult newt react to the same monoclonal antibody. AB - A search for specific proteins involved in newt limb regeneration, using monoclonal antibodies against forelimb blastemas, led to the detection of an antigen in the regenerate epithelium. Fluorescent-antibody-labeled cells first appeared just prior to blastema outgrowth. From bud through early digit stages this antibody reacted with nearly all of the regenerate epithelial cells. Other tissues also reacted, including nerve, blood vessels, and gastrointestinal tract. The behavior of the reactive cells in the regenerate epithelium, and their close association with immediately adjacent skin glands, raises several new possibilities for the origin of the regenerate epithelium. PMID- 3528385 TI - Detection of tissue carcinoembryonic antigen in lung cancer with monoclonal antibody. PMID- 3528386 TI - Autologous bone marrow transplantation after supralethal dose of total body irradiation in a case of mycosis fungoides. PMID- 3528387 TI - Renal prostaglandin E in sustained severe hypertension. PMID- 3528388 TI - Serum beta-2 microglobulin in liver diseases. PMID- 3528389 TI - Detection of IgM antibodies against rubella virus: comparison of two indirect ELISAs and an anti-IgM capture immunoassay. AB - A commercial antibody capture enzyme immunoassay (Rubenz M) was compared to two commercial indirect enzyme immunoassays (Enzygnost IgM, Rubazyme-M) for the detection of rubella-specific IgM. Five hundred and fifty-two sera collected between the day of onset and 272 days after the onset of the exanthem of primary rubella were tested. Rubenz M was more sensitive early and late after the onset of the exanthem than the two indirect ELISAs. Rubenz M also appeared more sensitive when 240 sera were examined from patients with possible rubella in pregnancy, reinfection in pregnancy, suspected intrauterine infection, and recent vaccination. However, 5.5% of 968 pregnant women with no history of rubellalike symptoms or recent vaccination, the majority with elevated HAI titers, gave a low positive or borderline result with Rubenz M. None of these women delivered a congenitally infected child. Therefore, borderline and low-positive results must be interpreted with caution, as for any assay for rubella-specific IgM. PMID- 3528390 TI - Development of drugs to modify the actions of melatonin. AB - One of the best documented effects of melatonin in mammals is its antigonadotrophic effect. Melatonin has been shown to inhibit LH release and ovulation in rats and we chose this model to investigate the effects of new melatonin analogs. The analogs studied include 6-chloromelatonin, 6 fluoromelatonin, and 2-methyl-6,7-dichloromelatonin. All derivatives were more potent than melatonin and appeared to act on the brain and not on the pituitary to inhibit LH release. An exceptionally long duration of activity was found for 2 methyl-6,7-dichloromelatonin. The greatly increased stability of this derivative may provide a valuable tool in search for the role(s) of melatonin in mammals. PMID- 3528391 TI - Serotonin immunoreactivity in the nervous system of the dragonfly nymph. AB - Serotonin-like immunoreactivity was mapped using an antiserotonin antibody in wholemounts of the ventral nerve cord from dragonfly nymphs (Epitheca sp. and Pachydiplax longipennis). In both species, an immunoreactive cell ventral to each connective tract and an immunoreactive median cell cluster on the ganglion ventral surface were found in the unfused abdominal ganglia. Axon(s) from the median cell cluster branch in the anterior unpaired median nerve. Posterolaterally, in all of the ganglia examined, two or more intensely immunoreactive, bilaterally symmetric pairs of neurons were seen. Comparison of these posterolateral neurons, which appear to be serially homologous, with similar antiserotonin immunoreactive neurons described in other insects suggests that these neuron pairs may have cross-species homology as well. PMID- 3528392 TI - Immunohistochemical localization of intermediate filament proteins of neuronal and nonneuronal origin in the goldfish optic nerve: specific molecular markers for optic nerve structures. AB - The predominant proteins (58K) of the intermediate filament complex in the goldfish visual pathway consist of a series of isoelectric variants. Previous biochemical studies have shown that proteins ON1 and ON2 are of neuronal origin, whereas ON3 and ON4 are of nonneuronal origin. Polyclonal antibodies, purified by affinity chromatography, that are specific for ON1 and ON2 or ON3 and ON4 have been used to localize histologically the ON proteins within the normal and crushed optic nerve. Anti-ON1/ON2 antiserum presented a pattern consistent with intraaxonal staining. A nonneuronal staining pattern was observed with anti ON3/ON4 antiserum. The two patterns were distinct from and complementary to each other. The data suggest that ON3 and ON4 represent a novel glial fibrillary acidic protein. The results are discussed in terms of the function of these proteins in development, plasticity, and regeneration. PMID- 3528393 TI - Expression of microtubule-associated proteins during the early stages of neurite extension by brain neurons cultured in a defined medium. AB - Immunoblotting analysis was used to identify the microtubule-associated proteins (MAPs) present in cultures of mouse brain neurons. Polyclonal antibodies were raised against the two main adult brain MAPs, i.e., MAP2 (300 kDa) and tau (60-70 kDa). Whatever the stage of the culture, which was performed in a defined medium (3 or 6 days), the anti-MAP2 serum detected several high-molecular-weight components (including MAP2) and an entity with 62-65 kDa. Anti-tau revealed essentially a major peak of 48 kDa (young tau) but also slightly cross-reacted with the 62-65 kDa entity. During the culture period (0-6 days) the cells developed progressively a dense neuritic network; the concentration of the different MAPs increased in parallel but at different rates depending on the different species. The increase in concentration of the high-molecular-weight components occurred before that of 48-kDa tau. This suggests that high-molecular weight MAPs and 48-kDa tau might be involved respectively in the initiation and elongation of neurites. In contrast, and since the main developmental changes in tau composition seen in vivo did not occur during the time course of the culture, this transition might be related to later events of neuronal differentiation. PMID- 3528394 TI - A retrospective study of Creutzfeldt-Jakob disease in England and Wales 1970 1979. II: Epidemiology. AB - A comprehensive search yielded 121 confirmed cases of Creutzfeldt-Jakob disease who died in England and Wales in the decade 1970-1979, 31 probable cases and 10 possible cases. Descriptive epidemiological data are presented. The average annual incidence was 0.3 cases/million. An unexpected female excess was found. There was no evidence of space-time clustering of cases and no associations with occupation or past medical treatment were apparent. There was statistically significant variation in incidence rates in different parts of the country but no relationship was discovered between incidence and population density. PMID- 3528395 TI - The ominous discoloration of the spinal cord due to thoracic disk protrusions: a historical note. PMID- 3528396 TI - In vitro transformation elicited by Creutzfeldt-Jakob-infected brain material. AB - Previous studies indicated that tissue culture cells derived from Creutzfeldt Jakob disease (CJD) brains possess neoplastic properties. In order to see if CJD brain material could itself transform cells in vitro, BALB/C-3T3 and normal hamster brain monolayer cultures were exposed to whole brain homogenate or synaptosomal-mitochondrial fractions derived from CJD or control brains. Cells were exposed for seven days to CJD or control brain material, washed, and then passaged at weekly intervals. Transformation was evaluated by loss of contact inhibition, replication of cells with absent or low serum content of the medium and significant colony formation in soft agar. Seven parallel experiments were done, and six were viable. All cultures exposed to CJD material containing greater than or equal to 10(4) LD50 infectious units were positive for transformation (five of six studies); the single negative experiment contained only 2 X 10(3) infectious units. Definitive transformation could be observed at 12-16 weeks after application of both mouse and hamster CJD material. BALB/C-3T3 cells exposed to control hamster or mouse brain material were studied for greater than 120 passages in vitro and showed no comparable changes or evidence of spontaneous transformation, i.e. they required serum for replication and produced essentially no colonies in soft agar. Similarly, a normal adult hamster brain culture exposed to control brain material showed no evidence of transformation, whereas the identically passaged normal brain culture exposed to CJD material not only became a permanent line, able to grow in soft agar, but also was capable of producing tumors in nude mice. Thus CJD transformation was not confined to special potentials of "permanent" BALB/C-3T3 cells. These experiments suggest that a genomic alteration can be effected by CJD material. PMID- 3528397 TI - Olfactory neuroblastoma: an immuno-electron microscopic study of S-100 protein positive cells. AB - An immuno-electron microscopic study performed by a pre-embedding peroxidase antiperoxidase (PAP) technique revealed S-100 protein reactivity in the cytoplasm and connecting processes of marginal cells of olfactory neuroblastomas. The overlapping cytoplasmic processes of S-100 immunoreactive cells completely surrounded the main membrane-bound granule-bearing tumor cells forming a continuous interface between those tumor cells and fibrous connective tissue. The S-100 immunoreactivity was also observed in the cytoplasm and processes on non membrane-bound granule-bearing tumor cells within the tumor nodule. The tumor cell nodules and isolated tumor cells were completely surrounded by basement membrane material stainable with anti-laminin antiserum. It appears that the membrane-bound granule-bearing tumor cells of olfactory neuroblastoma are partitioned by basement membrane of S-100 protein-reactive cells and their processes. No S-100 protein-reactive cells were observed within the olfactory epithelium of the two patients with olfactory neuroblastoma. To determine a possible origin of S-100 protein-positive cells, normal olfactory epithelium from six adult patients at autopsy was studied for S-100 reactivity. There were no S 100 protein-positive cells within the normal olfactory epithelium. We discuss the evidence for considering olfactory neuroblastoma a variant of paraganglioma. PMID- 3528398 TI - Gliogenesis in organotypic tissue culture of the spinal cord of the embryonic mouse. I. Immunocytochemical and ultrastructural studies. AB - The technique of organotypic tissue culture offers an opportunity to observe in vitro complex interactions among glial cells and neurons, leading to the formation of myelin. In the present and accompanying work a combined ultrastructural, immunocytochemical and autoradiographic approach was used in a detailed study of the process of gliogenesis. Using immunocytochemical and ultrastructural criteria, differentiation along the oligodendroglia cell line is seen to be initiated a few days later than along the astroglial line. The sequence and timing of oligodendroglial differentiation both ultrastructurally and chemically follow those described in vivo. Formation of myelin has been demonstrated only by oligodendrocytes in which there is continuity between the perikaryal plasmalemma and myelin membranes. Oligodendroglial maturation culminated with the formation of light, medium and dark oligodendrocytes. The periodic acid Schiff-positive, glial fibrillary acidic protein (GFAP)-negative process of radial glial cells at explantation become GFAP-positive within 3 days, as described in vivo. Many of the astrocytes appear to have been derived from radial glial cells. Large numbers of dark glial cells, similar to the so-called 'intermediate glial cells', were seen. These were found to be astrocytes whose appearance probably reflected reaction to explantation-induced injury. PMID- 3528400 TI - Twenty years of MOPP therapy for Hodgkin's disease. AB - The results of treatment of 198 patients with MOPP (mechlorethamine, vincristine, procarbazine, and prednisone) for Hodgkin's disease were analyzed after a median of 14 years of follow-up. Throughout the period of follow-up, 103 patients have remained continuously free of disease. Review of biopsy specimens of 43 patients originally classified as Hodgkin's disease, lymphocyte-depleted type, revealed that ten of these patients actually had diffuse immunoblastic or large cell non Hodgkin's lymphomas. Of the 188 patients with Hodgkin's disease, 157 achieved a complete response (CR) (84%), and 66% of them (101 patients) have remained disease-free more than 10 years from the end of treatment. Absence of B symptoms and receiving higher doses of vincristine were factors associated with a higher CR rate and longer survival. Patients entering complete remission in five cycles or less had significantly longer remissions than those requiring six or more cycles. Forty-eight percent of the Hodgkin's disease patients have survived between 9 and 21 years (median, 14 years) from the end of treatment. Nineteen percent of the CRs have died of intercurrent illnesses, free of Hodgkin's disease. PMID- 3528401 TI - Elevated ras oncogene expression correlates with lymph node metastases in breast cancer patients. AB - The protein product of the ras cellular oncogene(s) (p21) was assayed in primary breast carcinomas from two groups of patients who had different axillary lymph node status. Using an immunohistochemical assay, the intensity and percent of neoplastic cells demonstrating ras p21 antigen staining were significantly higher in the primary tumors from patients with lymph nodes positive (LN+) for malignancy (20 patients) compared with the lymph node negative (LNO) group (21 patients). The expression of p21 also correlated with tumor size. Age and estrogen receptor status did not influence p21 staining. The antigen expression of p21 was similar in intensity and distribution in the primary tumor and regional lymph node metastases. Enhanced expression of p21 in primary breast cancers that metastasize to regional nodes indicates that ras p21 may be a determinant of the malignant potential of breast cancer cells and may represent a new class of more biologically relevant tumor markers. PMID- 3528399 TI - History of blood gas analysis. V. Oxygen measurement. AB - The first biologic use of a platinum cathode for oxygen monitoring was reported in 1938 by Blinks and Skow, who was studying photosynthesis. Their report led to the tissue oxygen studies of Davies, Brink, and Bronk. Clark, by covering cathode and anode with a polyethylene membrane, changed the polarographic cathode from a sensor of oxygen availability by diffusion to a measure of oxygen tension (PO2) in the solution and thereby facilitated an enormous expansion of the study of the respiratory physiology of blood oxygen after 1956. Clark's electrode led to the development of the present commercial blood gas systems that measure pH, carbon dioxide tension (PCO2), and PO2 and calculate many derived variables. Variations on Clark's electrode were designed for in vivo catheter-tip recording; gas phase oxygen monitoring; determining oxygen content of blood by releasing hemoglobin bound oxygen and measuring PO2; and determining oxygen consumption in cell cultures (thus replacing Warburg manometry). By reducing the cathode diameter, Staub and others eliminated the need for stirring the blood samples. Concurrent research with amperometric or polarographic oxygen measurement led Hersch to develop the means of determining oxygen content by coulometry in large cells that consumed all the injected oxygen. Methods of applying noninsulating, but protein impermeable, membranes to cathodes and of recessing cathodes into glass permitted measurement of PO2 in tissues and fluids with microelectrodes. PMID- 3528402 TI - A randomized comparison of tamoxifen with surgical oophorectomy in premenopausal patients with advanced breast cancer. AB - We randomized 122 premenopausal women to receive tamoxifen or to undergo a surgical oophorectomy. Of 54 evaluable women treated with tamoxifen, 24% had an objective response, as compared with 21% of 53 women having an oophorectomy. The median duration of response for tamoxifen (20 months) was longer than that for surgical oophorectomy (7 months), but this did not achieve statistical significance (P = .056). Overall median survival was 15 months for 58 patients receiving tamoxifen and 25 months for 53 patients undergoing oophorectomy (P = .18). Toxicity was greater in those undergoing oophorectomy, though both treatments were well tolerated. In those premenopausal women for whom hormonal therapy is indicated, tamoxifen is a suitable alternative to surgical oophorectomy. PMID- 3528403 TI - Single, sequential, and multiple alkylating agent therapy for multiple myeloma: a CALGB Study. AB - Four intravenous (IV) alkylating agent regimens were tested in 615 previously untreated patients with multiple myeloma. Patients were randomized to receive melphalan, cyclophosphamide, and carmustine in combination (MCBP), sequentially (Seq-MCBP), or in combination with doxorubicin (MCBPA). The fourth group received IV melphalan (MP) as the only alkylating agent. All groups received a tapering dose of prednisone. Toxicity was similar for all regimens although the nadir of cytopenia was reached more quickly for the regime including melphalan only. Response as measured by reduction in myeloma protein or other parameters were similar for the four treatments. Survival was significantly poorer for the group receiving the alkylating agents in sequence. The survival of high tumor cell load patients who were azotemic was better in the groups treated with IV MP or with the combination of IV MCBP. In view of the simplicity and probable cost savings attached to single-agent treatment, a melphalan/prednisone regimen should be considered as initial therapy for all patients with myeloma. PMID- 3528404 TI - Analysis of a prospectively randomized comparison of doxorubicin versus 5 fluorouracil, doxorubicin, and BCNU in advanced gastric cancer: implications for future studies. AB - A multi-institutional cooperative study of patients with locally advanced, recurrent, or metastatic gastric adenocarcinoma who had not previously received chemotherapy was conducted, prospectively randomizing patients to receive either doxorubicin or the three-drug combination, 5-fluorouracil (5-FU), doxorubicin (Adriamycin; Adria Laboratories, Columbus, Ohio), and BCNU (FAB). The 187 evaluable patients were initially stratified according to the presence of measurable or evaluable disease and performance status. There was a significantly higher response rate observed for FAB (40%) compared with doxorubicin (13%) among the 145 measurable-disease patients. Duration of response and survival were significantly longer for FAB in the measurable-disease group, but for the total patient population an early advantage for FAB in time to disease progression and survival was lost with continued follow-up. Median survival was 33 weeks for patients receiving FAB and 19 weeks for those receiving doxorubicin. Significant pretreatment factors adversely affecting survival included poor performance status, weight loss of greater than 10%, and more than two sites of metastases. Toxicity was not severe in either treatment arm, and only thrombocytopenia occurred significantly more often with FAB. It is contended that in the treatment of advanced gastric cancer, chemotherapy only exerts a relatively short-term and modest beneficial effect, most apparent in patients with intermediate tumor bulk. 5-FU remains the most active single agent, and combination chemotherapy has not yet proven its overall worth. Further studies are indicated comparing the most active combinations with 5-FU using optimal doses and schedules, and consideration must be given to the incorporation of no-treatment controls. PMID- 3528405 TI - Vascular toxicity associated with antineoplastic agents. AB - Vascular complications associated with antineoplastic agents are being reported with increasing frequency. Such vascular toxicity is clinically heterogeneous, ranging from asymptomatic arterial lesions to a fatal thrombotic microangiopathic syndrome. Mitomycin is most commonly implicated in the thrombotic microangiopathic syndrome, while bleomycin, either alone or in combination with a vinca alkaloid or cisplatin, appears to be an important cause of Raynaud's phenomenon. Acute arterial ischemic events, ie, myocardial infarction and cerebrovascular accidents, occur most frequently after cisplatin-based combination chemotherapy. Putative mechanisms for such toxicity include drug induced endovascular damage, perturbation of the clotting system, platelet activation, an abnormality of thromboxane-prostacyclin homeostasis, autonomic dysfunction, vasculitis, and stimulation of fibroblasts. More than one mechanism may be operative in an individual patient. Better documentation of the incidence and types of vascular toxicity and studies to help elucidate the pathogenesis and management of such toxicity are needed. PMID- 3528406 TI - ASCO--as a young adult. PMID- 3528407 TI - Clinical trial of pyridoxine to reduce vincristine neurotoxicity. AB - In a murine model system, pyridoxine has demonstrated protective properties during administration of lethal doses of vincristine (VCR). Subsequently, pyridoxine has been evaluated in patients receiving VCR during an adjuvant chemotherapy program for stage II carcinoma of the breast. The toxicities, cumulative VCR dosage, and percentage of ideal dosage observed in 24 patients receiving pyridoxine have been compared to those observed in 88 patients who previously received VCR without pyridoxine in the same chemotherapy program. All patients ideally were to receive VCR 1.0 mg/m2 weekly for 6-weeks with dose modification for neurotoxicity. Treatment patients received pyridoxine 1.5 grams p.o. daily in three divided doses during the 6-week course. The degree of neurotoxic manifestations of VCR was similar in the treatment and comparison patients. Absent to mild neurotoxicity was observed in approximately 70% of patients in both groups; moderate or greater neurotoxicity occurred in about 30% of patients in both groups. Full dosage (6.0 mg/m2) was attained in 8 (33%) treatment patients and 18 (24%) comparison patients (p = 0.28). The mean percentage of ideal dosage of VCR was 84.6 +/- 10.8 in patients receiving pyridoxine and 81.9 +/- 21.6 in those given only VCR (p = 0.59). Gastrointestinal and hematologic toxicities were similar in both groups. Pyridoxine in this dose and schedule afforded no protection from the neurotoxic side effects of VCR. PMID- 3528408 TI - D-1 dopamine receptors in the rat brain: a quantitative autoradiographic analysis. AB - The distribution of dopamine D-1 receptors has been determined in the rat brain by a quantitative in vitro light-microscopic autoradiographic method. The binding of [N-methyl-3H]-SCH 23390 to slide-mounted tissue sections takes place with characteristics expected of a substance that recognizes D-1 receptors. The binding is saturable, has high affinity, and exhibits an appropriate pharmacology and stereospecificity in several discrete microscopic brain regions as determined by quantitative autoradiography. The highest density of D-1 receptors occurs in the caudate-putamen, accumbens nucleus, olfactory tubercle, and the substantia nigra pars reticulata. High concentrations of D-1 receptors were associated with the intercalated and medial nuclei of the amygdala, entopeduncular nucleus, and major island of Calleja. Furthermore, moderate to low concentrations were observed in several other structures, such as the frontal cortex, subthalamic nucleus, and several thalamic, hypothalamic, and hippocampal areas. The distribution of D-1 receptors correlates very well with projection areas of dopaminergic pathways. This technique furnishes a powerful assay for the accumulation of detailed pharmacologic and anatomical data about D-1 receptors, and the results suggest possible CNS sites of action of D-1 dopamine receptor selective compounds. PMID- 3528409 TI - Dopamine enhances terminal excitability of hippocampal-accumbens neurons via D2 receptor: role of dopamine in presynaptic inhibition. AB - The effects of dopamine on the axonal terminals of hippocampal-nucleus accumbens (HIPP-ACC) neurons were investigated in urethane-anesthetized rats using extracellular single-unit recording techniques. Antidromic responses recorded in the ventral subiculum of the hippocampus were evoked by stimulation of the medial accumbens. Baseline terminal excitability of these neurons, established by threshold stimulation of the accumbens, was markedly enhanced by conditioning stimulation (10 Hz) of the ventral tegmental area (VTA), the origin of the mesolimbic dopaminergic neurons. Iontophoretic application of sulpiride, a selective D2 antagonist, onto the HIPP-ACC terminals attenuated the increased terminal excitability of these neurons produced by conditioning VTA stimulation, while intraperitoneal injection of SCH23390, a selective D1 antagonist, failed to attenuate this effect. Iontophoretic application of dopamine or its selective D2 agonist, LY171555, onto the terminals of the HIPP-ACC neurons mimicked the prolonged enhancement of the terminal excitability produced by VTA stimulation, whereas SKF38393, a D1 agonist, had no effect. The effects of VTA stimulation, dopamine and LY171555 application were similar after the accumbens had been pretreated with ibotenic acid, suggesting a direct action of dopamine on the axonal terminals of HIPP-ACC neurons, and that changes in terminal excitability were not mediated via interneurons or feedback pathways from the accumbens to the hippocampus. Since iontophoretic application of potassium, a depolarizing agent, also enhanced the terminal excitability of the HIPP-ACC neurons, it appears that dopamine depolarized, via D2 receptors, the axonal terminals of HIPP-ACC neurons.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3528410 TI - Developmental potential of quail dorsal root ganglion cells analyzed in vitro and in vivo. AB - The cell types present in quail dorsal root ganglia during early development were identified using markers for neurons, glial cells, and fibroblasts (Rohrer et al., 1985). Using the quail-chick transplantation technique, the potential of quail dorsal root ganglion cells to differentiate to adrenergic chromaffin cells, as identified by tyrosine hydroxylase immunostaining, was analyzed. A population of undifferentiated cells, which is present in quail dorsal root ganglia at embryonic day 5, was separated from neurons and glial cells. We show that this population contains cells that differentiate to adrenergic chromaffin cells after back-transplantation into 2-d-old chick embryos. A large proportion of these undifferentiated cells also differentiates to neurons in vitro. Precursors for adrenal chromaffin cells and for neurons are present in dorsal root ganglia in significant numbers only during early development. PMID- 3528411 TI - Weaver mouse cerebellar granule neurons fail to migrate on wild-type astroglial processes in vitro. AB - To study the regulation of glial-guided neuronal migration, we have analyzed the behavior of cerebellar granule neurons purified from the homozygous weaver (wv/wv) B6CBA-w mouse, an autosomal recessive genetic mutation that suffers a failure of granule cell migration along Bergmann glial processes (Rakic and Sidman, 1973a, b; Rezai and Yoon, 1972), on the processes of astroglia purified from homozygous normal B6CBA-Aw-J-wv (+/+) mouse cerebella. When co-cultured with normal astroglia, weaver granule neurons failed to form neuron-glia contacts characteristic of migrating neurons and impaired normal astroglial morphological differentiation. Normal astroglial cells co-cultured with weaver granule cells had enlarged cell somata with stunted processes and enlarged endfeet compared to normal astroglia co-cultured with normal granule cells. In contrast, normal neurons associated with weaver astroglia, forming tight appositions seen for migrating neurons in vivo, and enhanced weaver astroglial morphological differentiation. Weaver astroglia co-cultured with normal granule cells contained a more normal complement of glial filaments and had a smaller perikaryon with longer, more tapered processes than their counterparts co-cultured with weaver neurons. These results suggest, in agreement with the study of Goldowitz and Mullen (1982) on heterozygous mutant chimeras, that the granule neuron is a primary site of action of the weaver gene, and further support our previous findings that neuron-glia interactions regulate astroglial morphological differentiation (Hatten, 1985). PMID- 3528412 TI - Regional comparison of technetium-99m DTPA aerosol and radioactive gas ventilation (xenon and krypton) studies in patients with suspected pulmonary embolism. AB - The regional distribution of [99mTc]DTPA aerosol was compared with that of 133Xe (n = 30) and krypton (n = 24) in a group of patients with suspected pulmonary embolism. All patients had an aerosol study using a recently available commercial generator system, a ventilation study with one of the gases, and perfusion imaging. Regional information was assessed visually on xenon, krypton, and aerosol studies independently by considering each lung as three equal-sized zones. In addition, gas ventilation findings peripheral to regions of aerosol turbulence ("hot spots") were evaluated. Only 64% of the zones were in complete agreement on xenon and aerosol. Most of the discordance between xenon and aerosol was accounted for by minor degrees of 133Xe washout retention in zones that appeared normal in the aerosol study. An agreement rate of 85% was noted between 81mKr and aerosol regionally. The regions of discordance between aerosol and gas studies, however, usually were associated with unimpressive perfusion defects that did not change the scintigraphic probability for pulmonary embolism in any patient. Regarding zones of aerosol hyperdeposition, 76% had associated washout abnormalities on xenon; however, there was no correlation between the presence of these abnormalities or perfusion abnormalities. The results confirm the high sensitivity of 133Xe washout imaging, but suggest that radioaerosol imaging will detect most parenchymal abnormalities associated with perfusion defects of significance. PMID- 3528413 TI - Accurate demonstration of hepatic infarction in liver transplant recipients. AB - Serial HIDA scanning has proven to be a valuable tool in the postoperative management of liver transplant patients. Previous reports have documented its efficacy in detecting biliary leakage, abscess, and rejection. We have also found HIDA scanning to be a sensitive method for detecting early hepatic infarction before ultrasonographic changes occur. Two cases are presented to demonstrate the characteristic findings seen with hepatic infarctions. PMID- 3528414 TI - Determination of the volume of the thyroid gland by a high resolutional ultrasonic scanner. AB - We developed a new ultrasonic scanner for the thyroid and, in this study, the estimated volumes of the thyroids by this scanner were compared with the weights of those obtained at operation. In this ultrasonic scanner, an annular array transducer was employed instead of the conventional single element concave transducer. The distance of the focused area by this transducer was as long as 5 cm compared to 1 cm by the conventional transducer; therefore, the image obtained by the new scanner was so clear that it was not difficult to draw accurately the outlines of the thyroids. The volumes of the thyroids were calculated by a computerized digitizer. The estimated volumes of the thyroids by the ultrasonic scanner were closely correlated with their weights calculated by adding the actual weights of the thyroids removed to the estimates of the thyroids left at operation. Their correlation coefficients were as high as 0.99. This suggests that this new ultrasonic scanner is very useful in the determination of the volumes of the thyroids, since the measurement is very accurate, simple, and reproducible. PMID- 3528415 TI - Background correction in first-pass radionuclide angiography: comparison of several approaches. AB - This study was designed to test the comparative accuracy of several commonly used background correction techniques in first-pass radionuclide angiography (FPRNA). Thirty patients underwent FPRNA and single plane contrast angiography (CA) within 1 hr of each other. The left ventricular ejection fractions (LVEF) calculated from the different background subtraction approaches to FPRNA were compared to the CA LVEF. When applied to a representative cycle, a horseshoe-shaped background region of interest (BKROI) underestimated LVEF (p less than 0.005, r = 0.91, s.e.e. = 0.06) while a ring shaped BKROI adjusted at end-systole for aortic valve motion insignificantly overestimated LVEF (p = NS, r = 0.91, s.e.e. = 0.07). A lung background approach applied to a representative cycle gave the best correlation with CA (p = NS, r = 0.96, s.e.e. = 0.04). Without using a representative cycle, time-activity curves from a horseshoe-shaped BKROI and the LV ROI were created and the LV curve was normalized to the peak counts in the BKROI curve. LVEF calculated from the normalized curve correlated favorably with CA LVEF (p = NS, r = 0.91, s.e.e. = 0.08). The influence of some recently described improvements in representative cycle generation are also documented. PMID- 3528416 TI - Radionuclide-anesthetic flow study: a new technique for the study of regional anesthesia. AB - A new technique to study the dynamics of in vivo distribution of regional anesthetics is described. Five hundred microcuries of technetium-99m diethylenetriaminepentaacetic acid (DTPA) added to the anesthetic in a syringe prior to injection allows both dynamic and static imaging to assess the initial distribution of the injected anesthetic. Superimposed bone scans or transmission scans help delineate anatomy. The radionuclide-anesthetic flow study is a simple, safe technique to investigate both the spread of regional anesthetics and the factors that affect it. PMID- 3528417 TI - Dosimetric aspects of radiolabeled antibodies for tumor therapy. AB - Radioimmunotherapy (RIT) is rapidly attracting interest as a potential new weapon in the arsenal for cancer therapy. This article concentrates on some of the dosimetric aspects affecting the potential success of RIT, and examines factors which influence the choice of a radiolabel for RIT. No radionuclide is likely to give an optimum tumor/nontumor insult for all tumor types; therefore, the concept of matching the source to tumor morphology is introduced. Lists of candidate radionuclides are given, classified according to the type of decay, range, and energy of the emission. The article examines how the choice of radionuclide for radiolabeling the antibody affects the local energy deposition in the tumor. Both the effect of tumor size on the energy absorbed fraction and the problem of antibody binding heterogeneity are discussed. The approach to RIT is to relate the choice of radionuclide to the physical properties of the tumor. PMID- 3528418 TI - Delivery efficiency of technetium-99m DTPA aerosol. PMID- 3528419 TI - Immunohistochemical study of ovarian tumors using the OC 125 monoclonal antibody as a basis for potential in vivo and in vitro applications. PMID- 3528420 TI - Diminished hepatic insulin removal in obesity: role of basal insulin levels. PMID- 3528421 TI - Lobbying for registration laws: letters from the past. PMID- 3528422 TI - Glimpses of Mary Eliza Mahoney (7 May 1845-4 January 1926). PMID- 3528423 TI - Nineteenth-century philosophic influences on Nightingale's concept of the person. PMID- 3528424 TI - Ladies' Aid Societies and the nurses of Lincoln's army. PMID- 3528425 TI - Early nursing textbooks. PMID- 3528426 TI - Looking at the world through LDL-cholesterol-colored glasses. PMID- 3528427 TI - Comparison of dietary casein or soy protein effects on plasma lipids and hormone concentrations in the gerbil (Meriones unguiculatus). AB - The effects of dietary animal protein (casein) or soy protein (soy isolate) on plasma lipids and hormones were investigated in the gerbil. Diets, fed to male gerbils (initial weight, 60 g) for 4 wk, contained either 18% casein or soy isolate as the protein source. The dietary fat sources were lard (16%) and safflower oil (1%). The cholesterol content of the diet was 0.1%. Plasma total cholesterol concentrations were lower in gerbils fed the soy protein diet (159 mg/dl) than in the gerbils fed the casein diet (190 mg/dl). Absolute HDL cholesterol concentrations were unaffected by the protein source, but LDL cholesterol concentrations were lower in the soy-fed gerbils. Thus, the ratio of LDL to HDL cholesterol was lower in the soy-fed gerbils (0.42) compared with the casein-fed gerbils (0.70). Plasma insulin levels were higher in the soy-fed gerbils as were plasma thyroxine and thyroid-stimulating hormone levels. The results indicate that the gerbils can be used to study dietary effects on cholesterol parameters. These data also suggest that changes in plasma thyroxine levels may in part account for the hypocholesterolemic effect of soy protein. PMID- 3528428 TI - Insulin and glucose responses to glucose injection in fed and fasted obese and lean sheep. AB - Effects of short-term fasting on the insulin and glucose responses to injected glucose were determined in obese (n = 6) and lean (n = 6) Dorset ewes that were fed a maintenance level of energy intake. Sheep were assigned by Latin-square design to be fasted for 0 (fed), 12 or 24 h before glucose (350 mg/kg) was injected via jugular cannula at 2000 h with at least 7 d between successive tests. Insulin and glucose were quantified in jugular plasma samples. Pretreatment concentrations of insulin were affected (P less than 0.005) only by body condition with higher mean values in obese (23.5 +/- 3.3 microU/ml) than in lean (9.4 +/- 1.0 microU/ml) sheep. Pretreatment concentrations of glucose (53.6 +/- 1.8 mg/dl) were unaffected by body condition and fasting. The insulin responses to glucose, whether determined as absolute levels or response areas above base-line levels, were greater (P less than 0.005) in obese than in lean sheep regardless of fasting period. Insulin and glucose concentrations after glucose injection in lean sheep were unaffected by fasting. In contrast, the insulin response to glucose was greater (P less than 0.005) in fed obese than 12- or 24-h fasted obese sheep while glucose levels in the fed sheep were similar to those in the fasted obese sheep. Thus, factors associated with feeding enhanced the insulin response to glucose in obese sheep. In addition, obesity in sheep was associated with insulin resistance because basal hyperinsulinemia coexisted with euglycemia and because fractional removal rates of injected glucose were similar in obese and lean sheep despite much greater concentrations of insulin in obese sheep. PMID- 3528430 TI - Historical perspectives on the use of herbal preparations to promote health. AB - Herbal products continue to be popular among the American public for the treatment or prevention of a number of ailments. The medicinal use of herbs is deeply rooted in human history and folklore, and has been incorporated into the traditional medicine of virtually all human cultures. Strong religious and mystical beliefs have been associated with the healing properties of many herbs. These beliefs, together with the definite physiological and pharmacological effects of various herbs, as well as their economic potential, have been instrumental in the development of human medicine. Despite advances in our understanding of the medicinal and toxic properties of many herbs, the consumer today is confronted with misinformation concerning the efficacy of herbs that rivals the heyday of the patent medicine era. The discussion that follows examines the development of certain concepts throughout history concerning the use of herbs, and how these concepts may help account for the continued popularity of two highly promoted herbs, ginseng and garlic. PMID- 3528429 TI - Endogenous corticosterone rather than dietary sucrose as a modulator for intestinal sucrase activity in artificially reared rat pups. AB - The effects of sucrose and corticosterone on the expression of intestinal sucrase activity in preweanling rat pups were studied using an artificial rearing (AR) technique. When AR rat pups were isocalorically fed diets containing lactose or sucrose, or a carbohydrate-free diet from d 12-16, jejunal and ileal sucrase and maltase activities were induced to similar levels in all AR rats, whereas ileal lactase activity was precociously decreased. In separate experiments, enzyme activities were measured in ileal isografts subcutaneously implanted in littermates at birth. In AR rats fed the lactose diet, these isografts showed sucrase and maltase activities comparable with those of host ileum and also to isografts from AR rats fed the sucrose diet. In contrast, lactase activity was significantly higher in isografts than host ileum in all AR rats. Serum corticosterone levels were significantly elevated in AR rats for 24 h after intragastric cannular implantation. Precocious expression of ileal sucrase activity occurred in corticosterone treated, but not in untreated, adrenalectomized AR rats. In conclusion, dietary sucrose has no specific role in enhancing intestinal sucrase activity, and endogenous corticosterone is responsible for the induction of sucrase activity in AR rats. PMID- 3528431 TI - History of promotion of vegetable cereal diets. AB - Vegetarian regimes have been advocated since the eighteenth century by men and women in search of physical and spiritual health. Vegetarian theorists who professed to follow the tenets of the ancient philosopher Pythagoras believed that the diet should be part of an ascetic lifestyle. Others who promoted vegetarianism did so to symbolize their commitment to health and social reform. In the 1830s vegetarians in the United States, particularly Sylvester Graham and his followers, preached that special foods, mainly coarse whole meal breads, had particular virtues and were indeed the earliest health foods. Nutritional ideas and products that are the outcomes of the early vegetarian movement include a commitment to high fiber diets, the popularity of breakfast cereals, and the graham cracker. PMID- 3528432 TI - The history of enthusiasm for protein. AB - In the 1890s the USDA recommended over 110 g dietary protein per day for working men. This was based on Liebig's idea that protein was the source of muscular energy and the observation that protein consumption was higher in the more successful (i.e., affluent) social groups or nations than elsewhere. Chittenden's demonstration of physical energy being maintained on one-half this level of intake then led to reassessment of these standards, and attention was transferred to the discovery of trace nutrients and their practical significance. In the 1950s and 1960s protein again received priority attention. The "World Protein Gap" was considered the major cause of infant mortality and retarded development in the Third World but a problem that could be solved by the application of sophisticated technology. It then appeared that such technology was in general inapplicable to the real-life situation of more primitive communities. It was also found that a more equitable supply of ordinary foods could supply adequate protein, provided that, in the case of infants, attention was paid to their not being too bulky to allow adequate energy intake. PMID- 3528433 TI - The promotion of vitamin E. AB - Investigations that have influenced the promotion of vitamin E supplementation are reviewed. The various forms of vitamin E found in foods and the composition of synthetic vitamin E in common use are described with note of a frequent error of identification made in reports of studies on vitamin E. Recent communications on the use of antioxidants to delay carcinogenesis in animals and in humans are discussed. The publicity given the reports of cancer prevention by antioxidants will probably increase self-supplementations. It is therefore necessary to understand the pharmacological limits of such supplementation with vitamin E. Daily supplementation of adults with about 200 mg of d-alpha-tocopherol equivalents per day has not been proven to be harmful, but the effects of ingestion of more than 800 mg a day have not been studied sufficiently. Special precautions should be taken in administering emulsified vitamin E preparations intravenously to premature infants. PMID- 3528434 TI - Immunoassay as a screening tool for industrial toxicants. AB - Immunoassay techniques may represent useful screening tools to assist analysts interested in the presence and amounts of organic toxicants in biological fluids. The widespread application of immunoassay methods in medicinal and forensic (drugs of abuse) chemistry has resulted in such screening methodologies. Four methodologies of potential benefit are considered: the free radical assay technique, the enzyme-mediated immunoassay technique, radioimmunoassay, and hemagglutination. Each of these immunoassays is based on the competitive displacement of the labeled drug (or toxicant) from the antibody complex by the unlabeled drug-toxicant in the sample. PMID- 3528435 TI - Approaches to assessing pulmonary dysfunction and susceptibility in workers. AB - Indices of the maximal forced expiration are the most widely adopted method of screening for occupational lung disease because of their ease of measurement, employee acceptability, and reproducibility. However, these indices may lack sensitivity, specificity, or validity in detecting cases of some occupational lung diseases at asymptomatic stages when intervention may affect outcome. In populations at increased risk for occupational asthma, pneumoconiosis, or hypersensitivity pneumonitis, three other types of screening are being evaluated in field settings: tests for bronchial hyperreactivity, barriers to diffusion, and abnormalities in gas distribution in the lung. The potential methods of screening--cold air challenge, methacholine challenge, peak flow logs, diffusing capacity, and single breath nitrogen tests--await clinical trials in industrial settings to evaluate whether early case finding of susceptible subjects can result in prevention of morbidity. PMID- 3528436 TI - Lung cancer screening: the Mayo program. AB - The National Cancer Institute has sponsored three randomized controlled trials of screening for early lung cancer in large, high-risk populations to determine whether lung cancer detection can be improved by adding sputum cytological screening every 4 months to chest roentgenography done either yearly or every 4 months; and lung cancer mortality can be significantly reduced by this type of screening program, followed by appropriate treatment. Results of the three trials suggest that sputum cytology alone detects 15% to 20% of lung cancers, almost all of which are squamous cancers with a favorable prognosis; and chest roentgenography may be a more effective test for early-stage lung cancer than previous reports have suggested. Nevertheless, results of the randomized trial conducted at the Mayo Clinic showed that offering both procedures to high-risk outpatients every 4 months conferred no mortality advantage over standard medical practice that included recommended annual testing. PMID- 3528437 TI - Loss control and its place in the insurance industry. AB - The historical development of the insurance industry's role in efforts to prevent industrial accidents and occupational disease will be discussed. The various approaches that have evolved include fire insurance, casuality insurance, and compensation for occupational diseases. The basic approach used in insurance programs involved with occupational disease is to identify the toxic material to which employees are exposed, recommend engineering controls to reduce the exposure, and suggest a medical surveillance program. The insurance industry's efforts in industrial hygiene are also described. PMID- 3528438 TI - Bilateral microvascular free iliac grafts for mandibular reconstruction in intractable osteomyelitis: report of case. PMID- 3528439 TI - Neodymium-YAG laser in the treatment of urinary bladder carcinoma and localized prostatic carcinoma. PMID- 3528440 TI - [Immunohistologic study of the olfactory tissues]. PMID- 3528441 TI - [A clinical examination of ITI hollow cylinder implant]. PMID- 3528442 TI - [Evaluation of the speech of maxillectomy patients following obturator prosthetic treatment]. PMID- 3528443 TI - Determination of steroid hormone-dependency of tumours utilizing tissue sections. Survey of histochemical techniques and their application in surgical pathology. AB - The growth of neoplasms originating from steroid hormone target tissues may be hormone-dependent. It has been clearly demonstrated that the oestrogen and/or progestagen receptor status predicts the response to endocrine treatment and the prognosis of breast cancer. However steroid receptor determination in tumour cytosols has several limitations, which can partly be resolved by (immuno) histochemical detection of steroid hormone-responsive tumour cells. A variety of histochemical techniques including autoradiography of tritiated steroids, immunohistochemistry with antibodies to steroid hormones, histochemistry with fluorescent ligands of low molecular weight and fluorochrome- or enzyme-labelled macromolecular probes are discussed. It is concluded that there is as yet no substantial evidence that these methods visualize steroid receptors or detect steroid hormone-responsiveness of tumour cells. On the other hand, immunohistochemical demonstration of oestrogen receptors with monospecific antibodies seems validated and indications have been obtained that this information is clinically relevant. Recent developments suggest that immunocytochemistry of receptors and specific hormone-induced proteins, flow cytometric analysis and probably hybridocytochemistry in the future will help to improve management of steroid hormone-dependent tumours. PMID- 3528444 TI - Conduction tissue in the transplanted human heart. AB - Eleven orthotopically transplanted human hearts have been examined at retransplantation or necropsy. They were selected to cover the period up to 3 years after transplantation. The recipient SA node was examined in six, the donor SA node in eight and the AV conduction tissue in all eleven. Each of these areas has been examined by serial sectioning. All the conduction tissue is discretely involved in rejection and this involvement is no more severe than in the adjacent myocardium. In the AV tissue there is a tendency for the peripheral parts to be more frequently involved than the proximal. There is little evidence of permanent structural damage to the AV tissues by recurrent episodes of mild to moderate rejection. In the atrial nodes there is about a 50 per cent chance of surgical or procurement damage to both the recipient and the donor tissue. PMID- 3528445 TI - Hyporeninemic hypoaldosteronism in children with chronic renal failure. AB - The syndrome of hyporeninemic hypoaldosteronism (SHH) is not infrequent in adults with chronic renal failure caused by chronic tubulointerstitial nephritis, but it has been reported rarely in children. We present a systematic study of the interrelation between renal excretion of potassium and the renin-aldosterone axis in 23 children with CRF of different and unselected causes. Twenty children with chronic renal failure never had hyperkalemia, and both renin and aldosterone were normally stimulated by intravenous administration of furosemide, whereas three patients had moderate hyperkalemia (serum potassium concentration between 5.3 and 5.6 mEq/L) and failed to raise plasma renin activity and aldosterone values in response to furosemide. There three patients with SHH had lower basal and stimulated values of fractional potassium excretion than did patients with normokalemic chronic renal failure. Fractional potassium excretion was curvilinearly related to glomerular filtration rate (GFR), but in all three patients with SHH it was lower than expected for the level of GFR present. Fractional sodium excretion was also related to GFR, but no abnormalities were found. Two patients had hyperchloremic metabolic acidosis. After furosemide administration, they excreted an acid urine with low ammonium content, features characteristic of type 4 or hyperkalemic renal tubular acidosis. Prostaglandin E2 excretion was also significantly related to GFR, and appeared appropriate in two patients with SHH. The identification of three patients with SHH among 23 with chronic renal failure of unselected causes suggests that this entity is not rare in childhood. PMID- 3528446 TI - Trypanosoma cruzi morphogenesis: preliminary purification of an active fraction from hemolymph and intestinal homogenate of Triatoma infestans. PMID- 3528447 TI - Antigenemia in rabbits infected with Candida albicans serotype B: detection by enzyme immunoassay and preliminary characterization of the antigen. AB - Peroxidase-labeled IgG against Candida albicans serotype A cell walls failed to detect antigenemia in rabbits infected with C. albicans type B. Therefore type B antisera were produced in rabbits immunized with either type B cell walls; whole blastoconidia heated and killed at 60 degrees C (HK); a sublethal intravenous dosage of 10(6) colony forming units (c.f.u.); or a normally lethal dose of 10(7) c.f.u. injected into subcutaneously implanted plastic chambers. The four antisera were conjugated to peroxidase for a double antibody sandwich enzyme immunoassay. Sixteen rabbits, immunosuppressed with cortisone, received 10(7) type B blastoconidia intravenously. On day 4 their kidneys contained between 3.4 X 10(8) and 1.4 X 10(11) c.f.u. Antigenemia was detected only with the conjugated anti-HK IgG. A mean concentration of 246 ng ml-1 of circulating antigen was detected only when serum-antigen complexes were dissociated by boiling in EDTA. The properties of the circulating antigen were as follows: relative molecular weight between 50 000 and 100 000 da; stable to boiling and proteinases, labile to sodium periodate oxidation, and bound by concanavalin A. These properties are consistent with a polysaccharide or glycoprotein, probably the mannoprotein of the cell wall. Antigenic specificity was probed further using IgG produced against heat-killed C. albicans serotype A. Antigenemia resulting from infection with serotype B was detected in 5 of 5 rabbits tested with the anti-HK-serotype B IgG but only with 3 of 5 tested with the anti-HK-serotype A IgG. In addition, the concentrations detected with serotype B reagents were 31 times higher. PMID- 3528448 TI - Accumulation of 14-methyl sterols and defective hyphal growth in Candida albicans. AB - Polyene-resistant mutants of Candida albicans accumulating 14-methyl sterols in place of ergosterol and defective in hyphal growth were isolated after ultraviolet mutagenesis. Analysis of revertants showed that the alteration in sterol composition, the inability to grow as hyphae, and the antibiotic resistance had returned to normal simultaneously. In addition, clotrimazole, which caused accumulation of 14-methyl sterols at a subfungistatic concentration, also inhibited hyphal formation but had little effect on yeast propagation. It is concluded that there is an intrinsic rather than a fortuitous relationship between sterol composition and morphogenesis. PMID- 3528449 TI - Binding of human fibrinogen to Candida albicans in vitro: a preliminary study. AB - The binding of human fibrinogen to different morphological forms of Candida albicans (blastoconidia, germ tubes and hyphae) was investigated by immunofluorescence and electron microscopy. Fibrinogen appeared to bind more strongly to hyphae than to yeast forms, and was detected on the cell wall coat. These observations suggest a possible role for fibrinogen in fungal colonization processes in vivo. PMID- 3528450 TI - Glucose homeostasis during anesthesia and surgery in infants. AB - Baseline, preinduction, postinduction, and postsurgical plasma samples were collected for glucose, insulin, and cortisol in 16 neonates and infants. Glucose infusion rate was maintained constant (mean +/- SD 4.1 +/- 1.2 mg/kg/min) prior to and during surgery; additional fluid losses during surgery were replaced by fluids without dextrose. The weight at the time of surgery was 3,038 +/- 1,397 g. Postnatal age at the time of study ranged from one day to 40 weeks and the duration of surgery was 83 +/- 35 minutes. Plasma glucose values were higher than baseline values soon after induction of anesthesia (88 +/- 11 v 130 +/- 36 mg/dL; P less than .05); postsurgical glucose values were significantly higher than postinduction values (210 +/- 109 mg/dL v 130 +/- 36 mg/dL, P less than .01). Postsurgical plasma glucose had a negative correlation with weight of infants at the time of study (P less than .01; r = .61). Insulin changes were minimal and variable. Cortisol values did not change significantly from baseline values until the end of surgery (11.9 +/- 8.3 v 22.2 +/- 10.6 micrograms/dL; P less than .05). Hyperglycemia (greater than 150 mg/dL) was noted in 10/16 infants. This study indicates that glucose levels should be monitored and that additional fluid losses should be replaced by fluids without dextrose in neonates undergoing surgical procedures since hyperglycemia is a common occurrence. PMID- 3528451 TI - Comparison of manual and pressure-controlled periodontal probing. AB - Over 25,000 sites around natural teeth in three stages of periodontal therapy (prior to instrumentation, following closed subgingival instrumentation and following surgical therapy) were independently probed by two examiners. Examiner A used a conventional periodontal probe with uncontrolled pressure. Examiner B used an identical probe tip mounted in a handle which controlled vertical probing force at 50 g. The pressure-controlled technique produced significantly deeper clinical probing measurements on the direct facial and lingual aspects of teeth regardless of the stage of periodontal therapy that had been completed. Manual probing obtained deeper measurements on the distal-lingual aspects of teeth in the posterior regions which had not received surgical therapy. The percentage match between probing depths obtained by the two methods declined as the probing depths increased. Control of vertical force during probing may provide a more objective method of monitoring periodontal status during longitudinal trials. PMID- 3528452 TI - Atypical localized juvenile periodontitis. A case report and review of current treatment considerations. AB - An atypical case of localized juvenile periodontitis is presented. The case exhibits a unique distribution of osseous defects, an unusually high dental lesion incidence, and an atypical Gram-staining and morphologic subgingival microflora. Past and current treatment regimens are reviewed. Based on our current understanding of the pathogenesis of juvenile periodontitis and the therapeutic effects of antibiotic and surgical treatment, a temporal treatment regimen is proposed which would overlap instead of superimpose effective stages of therapy. PMID- 3528453 TI - Opiate withdrawal-induced hyposensitivity to naloxone's effects on serum luteinizing hormone in the male rat. AB - In previous studies, it was demonstrated that morphine pellet implantation markedly sensitized adult male rats to the subsequent elevations in serum luteinizing hormone (LH) levels produced by the opiate antagonist, naloxone. The present studies were carried out to examine the persistence of this phenomenon upon pellet removal and to characterize the relationship between naloxone-induced alterations in serum LH and the development and dissipation of precipitated withdrawal behavior. We found an excellent correlation between both the development and dissipation of naloxone-precipitated withdrawal behavior and hypersensitivity to naloxone's effects on serum LH. However, although there was no evidence of protracted effects of chronic morphine administration upon pellet removal as assessed by withdrawal behavior, the effects of naloxone on serum LH levels did not return to normal for nearly a week postwithdrawal. The markedly enhanced sensitivity to naloxone normally observed in the pellet-implanted animal dissipated immediately after pellet removal (6-24 hr), but, rather than exhibiting normal levels of responding, morphine-withdrawn animals were markedly hypo-sensitive to naloxone. The antagonist did not increase LH at all in pellet withdrawn animals and, in fact, appeared to depress them at many doses in the acutely withdrawn animal; normal responses did not return until 4 to 7 days after pellet removal. The mechanisms underlying the striking withdrawal-induced reversal of naloxone's effects on serum LH levels are presently unclear, but our data are consistent with the hypothesis that chronic morphine administration induces a fundamental change in the sensitivity of the endogenous opioid-mediated control of LH, which takes some time to revert to normal upon abrupt termination of opiate administration. PMID- 3528455 TI - Etched-metal resin-bonded intracoronal cast restorations. Part I: The attachment mechanism. AB - Numerous attempts have been made to increase the adhesive qualities of the luting medium. Investigators have attempted to modify the metal surface, the tooth surface, the luting material, or combinations. Although investigations have achieved limited success, the adhesive cement remains an elusive goal of restorative dentistry. This article described the etched-metal attachment mechanism as an intermediate phase between luting medium and adhesive medium. However the bond of the resin to the etched enamel and etched metal is not adhesion. Nevertheless, the continuity and microscopic dimension of the mechanical bond mimics the adhesion desired. Until that adhesive material is developed, the bonding mechanism will serve as an effective substitute. The attachment mechanism described is the basis for an improved restoration. Resin bonded retention can compensate for insufficient frictional retention or may completely substitute for frictional retention prescribed in a resin-bonded retainer prosthesis. Etched-metal procedures for intracoronal restorations permits conservative tooth preparation, greater retention, and improved support of remaining cusps. PMID- 3528456 TI - A review of methods and techniques to improve the fit of cast restorations. AB - Many factors that can affect the overall adaptation of cast restoration margins have been studied. Many methods and techniques have been advocated to improve casting accuracy. Some are time-consuming procedures and others are simple and economical. An acceptable cast restoration depends primarily on the dentist's ability to interpret and evaluate the restoration clinically and radiographically. PMID- 3528454 TI - Renal electrolyte excretion and renin release during calcium and parathormone infusions in conscious rabbits. AB - Following a random block experimental design in each case, three repeated measurement studies were carried out in three different groups of conscious rabbits, to investigate the renal effects of increasing doses of intravenous calcium chloride (CaCl2) and bovine parathyroid hormone (PTH). In the first study, each rabbit received either CaCl2 (0.15, 0.3, 0.5 or 1.0 mg kg-1 min-1) or vehicle alone (control) for 160 min. In the second study, rabbits were given either PTH (0.15 microgram kg-1 min-1), CaCl2 (1.0 mg kg-1 min-1), PTH plus CaCl2 (0.15 microgram kg-1 min-1 and 1.0 mg kg-1 min-1, respectively) or vehicle alone; PTH was infused for just over 60 min. In the third study, a much smaller dose (0.05 mg kg-1 min-1) of CaCl2 was infused for 100 min. CaCl2 infusion produced a striking fall in fractional excretion of sodium of at least 50% (P less than 0.01), but this was not dose related, being almost maximal at the smaller doses infused. Although this effect was evident in the absence of any changes in total plasma calcium concentration at the lower doses of CaCl2, renal calcium excretion was increased between 2- and 20-fold (P less than 0.01) at all doses infused. Fractional excretion of chloride doubled at the two higher doses of CaCl2 (P less than 0.01), but potassium excretion was unchanged. There were no consistent alterations in mean arterial blood pressure, effective renal plasma flow, glomerular filtration rate or plasma renin activity (PRA); total plasma calcium concentration was consistently elevated only during infusion of the high dose by just under 1 mmol l-1. PTH infusion had no measured effect on fractional excretion of sodium or renal calcium excretion, but doubled fractional potassium excretion (P less than 0.05). Heart rate and PRA increased (P less than 0.01 and less than 0.05, respectively), the latter by 50%, but systemic pressure and renal haemodynamics were not significantly affected. By contrast, PTH infused with CaCl2 produced a 4-fold rise in fractional sodium excretion and although renal calcium excretion remained increased, it was reduced by ca. 80% when compared with renal calcium excretion during infusion of CaCl2 alone. Infusion of PTH alone increased PRA, but when PTH and CaCl2 were infused together, PRA did not change.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3528457 TI - Effect of preparation finish on retention and fit of complete crowns. PMID- 3528458 TI - An analysis of margin adaptation of all-porcelain facial margin ceramometal crowns. PMID- 3528459 TI - The contribution of a pinhole to the retention and resistance form of veneer crowns. AB - This research quantitatively compared the retention and resistance of various designs of maxillary premolar partial veneer crown preparations. Crowns were evaluated with and without proximal boxes and occlusal pins. In the absence of boxes or grooves, pins markedly enhanced both retention and resistance. In the presence of proximal boxes, pins contributed only to retention and had no significant effect on resistance. If pins are used, the cement should be spiralled into the pin hole. As resistance is usually the more crucial parameter in preparation designs, it seems that wherever efficient axial modifications can be incorporated, the pinhole modification may be of little advantage. PMID- 3528460 TI - A clinical comparison of three types of resin-retained cast metal prostheses. AB - A preliminary clinical trial comparing three types of resin-retained cast metal FPDs was conducted. Micromechanical retainers were found to be more retentive than macromechanical retainers. The retention values in this investigation were in agreement with similar studies, but longitudinal studies are still desirable. PMID- 3528461 TI - Hypersensitive teeth. Part II: Treatment. AB - If the hydrodynamic theory for pain transmission were accepted, occlusion of the patent dentinal tubules would appear to be essential for treatment efficacy. There are many compounds with seemingly varied chemical forms that have been shown to be effective. Their exact mode of action however, is not clearly defined because well-designed, nonbiased, and controlled comparison studies between agents are lacking. The various toothpastes may have ingredients that actually occlude patent tubules or they may cause secondary desensitization by irrational or abrasive action. In any pain study, the nature of the placebo effect and other psychogenic factors play a significant role. Fluoride preparation with and without iontophoresis has been shown to alter tubule structure and form microprecipitates. The natural desensitization process, although slow, is nature's protection, allowing dentinal sclerosis of secondary dentin formation. Although the resin-adhesive systems, especially the new light-cured dentin bonding agents, appear immediately to be effective, the effect on the pulp remains unknown. Perhaps a combination of iontophoresis with sodium fluoride and light-cured dentin bonding material may yield protection and desensitization at a high level of predictability. With the population trends toward a more geriatric society, further research, knowledge, and understanding of dentinal hypersensitivity is of paramount importance. The expected increase in longevity of the dentition suggests that dentin exposure and sensitivity will increase as a clinical problem. There is a clear time-age relationship involved in gingival recession, erosion and attrition of the teeth, and the need for periodontal surgical therapy. For total comprehensive care, patient comfort is important and should be provided along with sound periodontal health and ideal restorative function. PMID- 3528463 TI - Changes in pH of irreversible hydrocolloid impression materials during setting. AB - Two ophthalmic and four dental irreversible hydrocolloid materials were tested in vitro to determine the initial pH and changes in pH to completion of set over 4 minutes. The ophthalmic Moldite material became more basic during its setting whereas the ophthalmic Moldeye material remained stable throughout the setting. The other materials tested decreased in pH with time. PMID- 3528462 TI - Evaluation of load transmission by distal-extension removable partial dentures by using reflection photoelasticity. PMID- 3528464 TI - Comparative analysis of personality characteristics of dental patients in relation to their natural and artificial dentitions. PMID- 3528465 TI - A metal-ceramic restoration with a porcelain labial margin: a modified direct lift method. PMID- 3528466 TI - Esthetic placement of bar-clasp direct retainers. AB - A technique has been described that will allow for the esthetic placement of artificial teeth by precisely controlling the location of the approach arm of the l-bar clasp. PMID- 3528467 TI - Characterization and antibiotic sensitivity patterns of yeast-like organisms. PMID- 3528468 TI - Sensory inputs to the nucleus basalis prosencephali, a feeding-pecking centre in the pigeon. AB - Evoked potentials were recorded from the nucleus basalis prosencephali (Bas) of the pigeon through chronically implanted electrodes. The auditory sensitivity of the Bas was assessed by the amplitude of the potentials. Audiograms thus obtained were comparable to those similarly measured from stations of the orthodox auditory pathway and resembled those obtained by others with behavioural techniques from the same species. The sensitivity to vibration applied to the beak was also measured. The vibrogram revealed two separate optima, one located in the lower frequency and another in the higher frequency region. These were shown to be due to trigeminal mechanoreceptive sensitivity and to bone/cochlea mediated sound sensitivity, respectively. Evoked potentials of the Bas in response to vestibular stimulation are described for the first time. The possibility that they were artefacts was excluded with several control procedures. These findings confirm recent anatomical evidence of a direct pathway from the vestibular nucleus to the nucleus basalis prosencephali. All afferents to the Bas are discussed in conjunction with the probable function of the nucleus as a sensorimotor coordinator of the pigeon's pecking/feeding behaviour. PMID- 3528470 TI - The diagnosis and treatment of scurvy: an historical perspective. PMID- 3528469 TI - Ranitidine or aluminium hydroxide as prophylaxis against gastrointestinal complications after renal transplantation. PMID- 3528471 TI - The modernisation of Haslar. PMID- 3528472 TI - A review of thallium toxicology. PMID- 3528473 TI - A comparison of oral cholecystography and real time ultrasonography in the diagnosis of non-acute disease of the gall bladder. PMID- 3528474 TI - [Synovial cysts of unusual localization. 2 cases and review of the literature]. AB - Two patients with true synovial cysts in atypical sites (internal compartment of knee and inguinal hollow) were investigated by radioarthrography, ultrasound and computed tomography imaging. The cyst in the hip region originated from a dilated serous bursa of the iliopsoas muscle that did not communicate or was no longer in communication with the joint. In contrast, the cyst of the knee appeared to be a lateral synovial capsule hernia. Positive diagnosis in both cases was dependent on combined ultrasound-CT scan imaging, this eliminating a tumor (sarcoma) of soft tissues. However, affirmation of the synovial origin (mesothelial covering of the wall) of the lesion was obtained by histology only, this allowing differentiation from a "capsular" (fibrous wall) cyst, which probably provokes similar ultrasound and CT scan images. PMID- 3528475 TI - [Muscular metastases. Uncommon manifestation of cystadenocarcinoma of the pancreas]. AB - The authors report the detection of a cystadenocarcinoma of the caudal pancreas developed by muscular metastasis. They insist on the rarity of that type of localization to distinguish from the lesions of steatonecrosis. In the check-up of the developing metastasis, this observation bears out the interest of the C.T. of first meaning which allows an approach of lesional characterization owing to the analogies of structure existing between the causal pancreatic lesion and its muscular and hepatic metastasis. PMID- 3528476 TI - [Small intestine transit anomalies in a patient with chronic abdominal pain and treated for Hansen's disease]. AB - This new case of enteropathy due to Clofazimine provided demonstration of the diagnostic value of small bowel follow-through examination in this complication. Various small intestine anomalies have been reported: ileal or partial jejunal lesions; variations in caliber; loss of physiologic folds; irregularly outlined surface and border lacunae and persistence of suppleness of pathologic loops. Knowledge of these anomalies should avoid exploratory laparotomy, Clofazimine induced enteropathy regressing after discontinuation of treatment. Repeat small bowel follow up examinations can be performed to review course of this regression. PMID- 3528477 TI - [Cavernous hemangioma of the spleen]. AB - A cavernous hemangioma of spleen in a clinically asymptomatic patient presented in the form of a hyperechogenic mass on ultrasound imaging, becoming progressively hyperdense on the CT scan with contrast. This appearance, similar in all respects to that seen with cavernous hemangioma of liver, is rarely reported in the literature. PMID- 3528478 TI - The rat placenta expresses paternal class I major histocompatibility antigens. AB - The expression of paternally inherited class I MHC antigens on the placental trophoblast of the rat has been investigated using a mouse anti-rat monoclonal antibody (MN4-91-6) in an indirect immunoperoxidase labelling assay on cryostat sections. Strong specific staining was obtained on the spongy zone trophoblast of the mature placenta from DA male (RT1a) X PVG female (RT1c) matings. In marked contrast, no staining was observed on the labyrinthine trophoblast nor on the trophoblastic giant cells at any stage of gestation from 8 to 19 days post coitum. None of the trophoblastic cell populations at any stage of gestation were reactive with an anti-class II monoclonal antibody. Class I positive endovascular cytotrophoblast cells were present in the maternal arterial sinusoids of the decidua. These findings imply that maternal immunoregulatory mechanisms must be essential for the survival of the placenta and fetus. PMID- 3528479 TI - Gordon W. Douglas, M.D. A Festschrift. PMID- 3528480 TI - Ratio of gestational sac volume to crown-rump length in early pregnancy. AB - The sine qua non of fetal well-being in the first trimester is considered to be the presence of fetal cardiac activity. Despite fetal viability, some pregnancies might have a sac that is too large or small for the gestational age, even in the first trimester. As a first step in evaluating this hypothesis, a nomogram was constructed for the ratio of normal sac volume to crown-rump length. PMID- 3528481 TI - The vanishing sac syndrome. Ultrasound evidence of pregnancy failure in multiple gestations, induced and spontaneous. AB - During a five-year period an ultrasound diagnosis of multiple gestations was made in 162 women. Four cases evidenced an empty gestational sac or sacs associated with viable, normal-appearing gestations. Three of the four patients had ovulation-induced pregnancies. Resorption of these empty sacs was documented. First- and early-second-trimester vaginal bleeding occurred frequently in these pregnancies and was a warning of the possible loss of one or more of the sacs. PMID- 3528482 TI - Embryonic heart rates before the seventh week of pregnancy. AB - Previous studies of normal human embryonic heart rates showed an increase in the rates between the 7th and 9th gestational weeks; the rates gradually declined thereafter until the 15th week. The present study added new information about embryonic heart rates before the seventh week. The heart rates are slower than those reported to occur after the seventh week. These observations are connected with morphologic and physiologic changes during this period of embryonic life. PMID- 3528483 TI - Ultrasonographic diagnosis of unruptured interstitial pregnancy. A case report. AB - Ultrasonography is frequently useful in the differential diagnosis of ectopic pregnancy. It proved to be valuable in the diagnosis of an interstitial ectopic pregnancy. PMID- 3528484 TI - Significance of sperm bacteriology for the in vitro fertilization of human and mouse oocytes. AB - The mouse oocyte was used to determine whether T-mycoplasma or Escherichia coli affects the fertilization and embryonal development of oocytes. Ureaplasma urealyticum (T-mycoplasma) in the mouse oocyte system had little influence on the fertilization rates achieved in vitro; however, in all the experiments there was a marked reduction of embryonal development after in vitro fertilization (IVF) of spermatozoa infected with Ureaplasma. Even in oocytes incubated with Ureaplasma only after having reached the two-cell stage, there was reduced development into blastocysts. Changes in the Ureaplasma concentration and incubation time had no major influence on the development into blastocysts. During IVF of mouse oocytes with spermatozoa infected with E. coli concentrations of 10(3)/mL, there were no changes in the fertilization or culture rate as compared to the control group. However, after insemination with 10(6) bacteria/milliliter there was no change in the IVF rates in the mouse oocyte; however, the culture rates were considerably reduced (19.5% as compared to 64.4% in the control group). Whether there are additional changes in the pregnancy rate after the transfer of blastocysts obtained after insemination of oocytes with infected spermatozoa remains a matter for future investigation. PMID- 3528485 TI - Dr John Radcliffe, the benefactor and his benefactions. PMID- 3528486 TI - Treatment of giant cell tumour of the femoral head and neck. AB - Giant cell tumours of the femoral head and neck treated at the Nuffield Orthopaedic Centre between 1970 and 1982 were reviewed to evaluate the effectiveness of primary treatment by curettage and bone grafting. All 4 cases recurred within two years, necessitating the likelihood of recurrence following curettage and bone grafting, particularly at this anatomical site, is stressed, and the possibility that hip replacement arthroplasty be considered the primary treatment of choice is discussed. PMID- 3528487 TI - Andrewes versus influenza: discussion paper. PMID- 3528488 TI - Aetiological role of viruses in multiple sclerosis: a review. PMID- 3528489 TI - Whither therapeutics? An enquiry into drug use from historical principles: Part II. PMID- 3528490 TI - Synthesis and renal vasodilator activity of 2-chlorodopamine and N-substituted derivatives. AB - A four-step synthesis of 2-chlorodopamine (2b) is presented as well as methods for the syntheses of the N-methyl, ethyl, and n-propyl analogues (2c-e). Compounds 2b and 2c were essentially equipotent to dopamine for increasing renal blood flow in anesthetized dogs that had been treated with the alpha-adrenergic antagonist phenoxybenzamine. The increases in renal blood flow were blocked by the DA1 antagonist (R)-(+)-8-chloro-2,3,4,5-tetrahydro-3-methyl-5-phenyl-1H-3 benzazepine. Compounds 2d and 2e were significantly less potent than dopamine in the same model; the increases in renal blood flow were attenuated by propranolol and blocked by a combination of propranolol and (R)-(+)-8-chloro-2,3,4,5 tetrahydro-3-methyl-5-phenyl-1H-3-benzazepine. The significance of an o-chloro substituent on dopamine analogues for the activation of the DA1 receptor is briefly discussed. PMID- 3528491 TI - Carrier-linked primaquine in the chemotherapy of malaria. AB - The antimalarial effect of intravenously administered primaquine (PQ) can be improved and its toxicity diminished by linking it to a macromolecular carrier protein. A thiol-containing primaquine derivative 8-[[4-(2-amino-3 mercaptopropionamido)-1-methylbutyl]amino]-6- methoxyquinoline was synthesized. This compound could readily be linked via a disulfide bond to a carrier protein containing (pyridyldithio)propionate groups. The derivative was coupled to serum albumin as well as to serum albumin that contained covalently linked lactose residues. The protein-drug conjugates were tested for their antimalarial activity in mice inoculated with Plasmodium berghei. The causal prophylactic activity of the conjugate with the lactosaminated serum albumin was 2 times higher than that of the free drug; the mean causal prophylactic doses (CPD50) were 6 and 13 mg of primaquine base/kg, respectively. Moreover, its acute lethal toxicity had decreased at least 6.5-fold (mean lethal dose (LD50) greater than 85 mg of primaquine base/kg). The therapeutic index of this conjugate was at least 12 times higher than that of the free drug. This allowed the administration of a dose that cured 100% of the animals (17.5 mg of primaquine base/kg), in a single injection. With unmodified serum albumin the conjugate showed an increased therapeutic efficacy (the CPD50 was approximately 10 mg of primaquine base/kg) and a strongly reduced lethal toxicity. PMID- 3528492 TI - Biologically active derivatives of gossypol: synthesis and antimalarial activities of peri-acylated gossylic nitriles. AB - A series of peri-acylated gossylic nitriles were synthesized from gossypol dioxime by treatment of the dioxime with the appropriate acid anhydride and its salt. The reaction pathway was elucidated by isolation and characterization of intermediates. Peri-acylated gossylic nitriles (acyl = acetyl, propionyl, butyryl, and valeryl) were compared with gossypol for activity against both chloroquine-sensitive and chloroquine-resistant strains of Plasmodium falciparum. The gossylic nitriles all retain activity, with activity increasing with the length of the peri-acyl group. Gossylic nitrile 1,1'-divalerate shows antimalarial activity comparable to gossypol itself. The peri-acylated gossylic nitriles are strong inhibitors of parasite lactate dehydrogenase. PMID- 3528493 TI - The impact of competitive health care systems on professional education. AB - The development of competitive markets for health services as a cost containment strategy and the attendant shift to the provision of services through large-scale organizations are having a profound effect on academic health sciences centers. At the University of Minnesota, where this transition is firmly in place, the teaching programs based at the University of Minnesota Hospital and Clinic are threatened as health maintenance organizations and similar provider systems restrict referrals to these institutions and limit lengths of stay. Moreover, large-scale provider organizations are becoming more influential in determining the content of the training programs. The University of Minnesota Health Sciences Center is attempting to improve its competitive position in health care delivery and reshape its teaching programs to reflect this new environment through strategic planning. PMID- 3528494 TI - Using structured medical information to improve students' problem-solving performance. AB - In the study reported here, the authors assessed the use of efficient organization of knowledge and of problem-solving strategies to enhance medical students' clinical problem-solving skills. Thirty-five preclinical medical students were randomly assigned to a experimental or control group and given a knowledge base containing information on eight congenital heart diseases to learn. Information for the experimental group emphasized disease groupings (based on their similar clinical presentation), symptom-disease associations, and clinical problem-solving heuristics. The same information for the control group was presented in a textbook format that emphasized the pathophysiology of the diseases. The students then diagnosed three computerized diagnostic problems of varying difficulty while verbalizing their problem-solving strategies. The results showed that the experimental group acquired a higher ratio of diagnostic to nondiagnostic cues, mentioned the correct diagnosis sooner in their workups, and correctly diagnosed the most difficult case more often than the control group. These results provide support for revisions in the organization and presentation of information that are aimed at improving clinical problem-solving skills. PMID- 3528495 TI - Introducing community-oriented primary care to first-year medical students. PMID- 3528496 TI - A search for new group-B streptococcal serotypes. AB - New serotypes were sought among 165 clinical isolates of group-B streptococci that were untypable by antisera for the conventional types Ia, Ib, II and III. The strains were tested for sialic acid, an integral component of the group-B streptococcal type-polysaccharides; trypsin-treated bacteria were tested by slide agglutination with the sialic-acid-specific lectin from the snail Cepaea hortensis. Sialic acid was detected in 96 of the strains; in 95 of these, new type antigens were identified serologically (type IV, 52; provisional type V, 34; candidate type NT6, seven; provisional type V and candidate type NT6, one; candidate type 7271, one); the remaining strain was found to possess a small amount of Ia antigen. Sialic acid was not detected in 69 strains, and none of these possessed a polysaccharide type-antigen. Chemical measurement of the sialic acid content of cultures by Aminoff's method gave results in conformity with the lectin-agglutination test and the presence of polysaccharide type-antigens. PMID- 3528497 TI - Spontaneous deletions of drug-resistance determinants from Salmonella typhimurium in Escherichia coli. AB - Plasmids isolated from two different clinical isolates of Salmonella typhimurium, both resistant to the antibiotics ampicillin, tetracycline, streptomycin and chloramphenicol, were used to transform Escherichia coli. Segregation of antibiotic-resistance determinants occurred in both cases. Analysis of plasmids from one set of segregants by DNA-DNA hybridisation indicated that the segregation was due to precise deletions in the transforming plasmid. PMID- 3528498 TI - Bactericidal, bacteriolytic and opsonic activity of human serum against Escherichia coli. AB - The effect of human serum on Escherichia coli was studied with serum-sensitive and serum-resistant strains. The bactericidal effect of human serum on serum sensitive strains of E. coli depended on the activation of the classical complement pathway. The role of activation of the alternative pathway was less important. After incubation in sub-bactericidal concentrations of serum these strains were also easily phagocytosed by polymorphonuclear leukocytes (PMNL). Strains of E. coli of certain O-types required not only an intact classical pathway but also the presence of specific antibodies for effective killing by serum and effective phagocytosis by PMNL, despite rapid activation of complement and rapid deposition of C3 on the bacterial surface in the absence of antibody. Capsulate strains O1K1 and O78K80 resisted the bactericidal effect of serum even in the presence of specific antibodies; phagocytosis by PMNL only occurred after opsonisation with specific antibodies. PMID- 3528500 TI - A simplified system for the identification of staphylococci by multipoint inoculation of test media. AB - Most hospital bacteriologists have divided staphylococci into two groups: Staphylococcus aureus and the coagulase-negative staphylococci of which the novobiocin-resistant varieties are termed S. saprophyticus. The identification of S. aureus has been easy but that of the other staphylococci has provided some difficulties and most currently available methods are expensive or time consuming. Multipoint inoculation of a set of test media provides a convenient way of identifying large numbers of staphylococcal isolates. In tests with 118 isolates, mainly clinical but including some environmental isolates and some from the National Collection of Type Cultures, there was 90.7% agreement between identifications by the API-Staph system and by the multipoint system. The remaining 9.3% of strains was identified by the multipoint system but could not be identified by use of the data supplied in the API-Staph kit. PMID- 3528499 TI - A survey of potential virulence factors in clinical and environmental isolates of Serratia marcescens. AB - One hundred and forty seven isolates of Serratia marcescens were collected from diverse clinical and environmental sources in south-east Texas. Natural isolates were compared with hospital strains for the occurrence of 12 potential virulence determinants. Their overall frequency was as follows: haemolytic activity 48%; lecithinase 95%; lipase 95%; motility 99%; pigmentation 24%; plasmid carriage 46%; proteolytic activity 98%; siderophore activity 99%; urease activity 5%; mannose-sensitive haemagglutination 96%; mannose-resistant haemagglutination 61%; and mannose-resistant type-K haemagglutination (MR/K-HA) 68%. Clinical strains demonstrated a significantly higher occurrence of MR/K-HA (p less than 0.001) and non-pigmentation (p less than 0.01) than environmental isolates. PMID- 3528501 TI - A review of the use of primates in studying human schistosomiasis. AB - Rodents, useful models for studies of human schistosomiasis not ethically possible in man, are not satisfactory in every respect. Primates, in many ways better models than rodents, though too expensive for general use, remain invaluable for testing the relevance of rodent findings to man. Higher primates such as chimpanzees are ideal models but, as endangered species, should only be used for critical studies for which lower, nonhuman primates are unsuitable. PMID- 3528502 TI - Albert Lester Lehninger 1917-1986. PMID- 3528504 TI - Festschrift in honour of Professor Hatsujiro Hashimoto. PMID- 3528503 TI - A genetic approach to the study of neutral amino acid transport in mammalian cells in culture. PMID- 3528505 TI - Development of extracellular matrix in chick paravertebral sympathetic ganglia. AB - Alcian blue staining coupled with enzyme digestion or critical electrolyte staining revealed differences in the development of extracellular matrix (ECM) within sympathetic ganglia compared with the surrounding capsule. On day 5 of chick development (Hamburger-Hamilton stage 26) only hyaluronic acid (HA) could be detected in the ECM surrounding condensing primary ganglia. By day 7 (st 30) the ganglionic capsule contained HA, as well as sulfated glycosaminoglycans (GAGs), and this pattern continued into the adult stage. During the later stages of embryonic life (st 41-45) satellite cells appear, showing fine structural characteristics that point to their role in the secretion of intraganglionic ECM. Only during these stages could ECM be detected histochemically within ganglia, the same stages (days 15-19) when routine electron microscopic methods reveal collagen fibrils embedded in a granular ground substance. Thus, the intraganglionic environment appears as a separate compartment free of detectable amounts of GAG until late embryonic stages when ECM is secreted around satellite cells. This developmental pattern could represent a role of ECM in the histological stabilization of ganglia during the late stages of differentiation, since the appearance of intraganglionic ECM is correlated with the appearance of small dense-cored vesicles characteristic of adult neurons. The developmental pattern of ECM in differentiating sympathetic ganglia is compared with that of other tissues that undergo condensation and morphogenesis. PMID- 3528506 TI - Cell cultures of adult cardiomyocytes as models of the myocardium. PMID- 3528507 TI - Could the absence or malfunction of vascular endothelium precipitate the occurrence of vasospasm? AB - The obligatory role of the endothelium in relaxations of isolated coronary arteries to acetylcholine is explained by the release by endothelial cells of a labile vasodilator substance(s), endothelium-derived relaxing factor(s). Other neurohumoral mediators can evoke endothelium-dependent relaxations of coronary arteries. Of particular importance from the clinical point of view are thrombin, serotonin and adenine nucleotides. The latter are chiefly responsible for the endothelium-dependent relaxations evoked by aggregating platelets. The absence or the dysfunction of the endothelium may favour the occurrence of vasospasm. PMID- 3528508 TI - Update in cancer chemotherapy: gastrointestinal cancer, cancer of the stomach and carcinoid tumors. AB - Cancer chemotherapy in the treatment of advanced gastric cancer provides only palliation with perhaps increased survival time in some patients. The primary treatment of gastric carcinomas is surgical, as this is the only hope for cure. It is estimated that 80 to 85 percent of patients with newly diagnosed cases of stomach cancer will be dead of their disease within five years. Radiation therapy alone is seldom employed, except as a palliative measure to control hemorrhage or pain. There are no data to suggest that postoperative radiation increases survival rates.Single-agent chemotherapy is of temporary palliative value in 20 to 30 percent of cases with a duration of response from three to five months. Combination chemotherapy has shown a somewhat higher response rate than single agent therapy. In advanced gastric cancer, there is no evidence of improved long term disease-free survival rates with any combination yet reported.The treatment of carcinoid cancer of the intestinal tract is surgical removal, as this offers the only hope of cure. Radiation therapy is of little benefit, except for moderate palliation in cases of extensive liver metasasis. Carcinoid cancers are moderately sensitive to chemotherapy.While some adjuvant chemotherapy trials suggest improvement, major survival gains remain to be demonstrated. Uncertainty as to the role of chemotherapy in the treatment of gastrointestinal cancers is probably due to lack of data. PMID- 3528509 TI - The health insurance plight of patients with sickle cell disease. AB - Despite chronic illness that requires routine medical follow-up as well as occasional acute care and hospitalizations, many persons with sickle cell disease (SCD) are not getting the care that they need. The primary reason for lack of proper care is due to the patients' lack of health insurance coverage. This paper will examine the problem of health insurance coverage among persons with chronic illnesses using SCD as a model. It is speculated by the author that persons who suffer from other chronic illnesses may also experience similar problems in obtaining health coverage. Supporting data for this report are derived from a survey on the health insurance status of a randomly selected group of SCD patients treated at the Howard University Center for Sickle Cell Disease. This survey revealed that 20 percent of 70 adult and pediatric patient respondents had no form of health insurance coverage. PMID- 3528510 TI - The extraordinary career of Juliano Moreira: Afro-Brazilian psychiatrist. PMID- 3528511 TI - Gene expression in hypothalamic neurons: luteinizing hormone releasing hormone. AB - In situ hybridization allows the detection and measurement of specific messenger RNAs in individual hypothalamic neurons, and has shown, among magnocellular neurons, not only which cells express the genes for oxytocin and vasopressin but also how they change with physiological stimulation. With this technique, neurons expressing a gene for luteinizing hormone releasing hormone-like messenger RNA have been discovered in the preoptic area and diagonal bands of the rat forebrain. Seven days of estrogen treatment of ovariectomized female rats increases the LHRH-like messenger RNA in this neuronal system. PMID- 3528512 TI - A model for the acetylcholine binding site of the nicotinic acetylcholine receptor. AB - A detailed model for the acetylcholine binding site on the nicotinic acetylcholine receptor is proposed. It is derived from assumptions based on existing biochemical, structural, and pharmacological data, combined with molecular modeling and principles of protein evolution and architecture. Acetylcholine is proposed to fit into a pocket on one face of an antiparallel beta-pleated sheet formed by residues 128-142 on the alpha-subunit. This sheet is flexible yet stable, in part because of a double cystine bridge at its end. Asp138, Thr133, and Gln140 provide a ring of negative charges around the quaternary ammonium group of acetylcholine, Ile131 and alkane segments of the other residues in the binding site provide hydrophobic interactions, and Gln140 provides a hydrogen bond for acetylcholine's carbonyl group; Glu129 would form part of the second anionic subsite for the bis-quaternary ammonium compounds and curares. The model is compatible with the available evidence pertaining to the binding site and with structure-activity relationship studies. It is precise and detailed, thereby making clear predictions, which are directly testable by affinity labeling and site-directed mutagenesis. It should prove useful in the design of such experiments. PMID- 3528513 TI - Cytoskeletal remodeling of rat aortic smooth muscle cells in vitro: relationships to culture conditions and analogies to in vivo situations. AB - Cytoskeletal features of arterial smooth muscle cells (SMC) vary characteristically during development and during atheromatous plaque formation (Gabbiani et al., 1984; Kocher et al., 1985). We have analyzed the cytoskeletal features of rat aortic SMC placed in culture in the presence of 10% foetal calf serum (thus containing growth factors probably playing a role in SMC development and atheroma formation), as compared to SMC freshly isolated from the rat aortic media. Under these conditions, SMC show a typical cytoskeletal remodeling characterized by: 1) increased content of vimentin per cell, increased number of cells containing only vimentin, and decreased number of vimentin plus desmin containing cells; 2) decreased contents of actin, tropomyosin and myosin; 3) a switch in the pattern of actin isoforms with the appearance of a beta-type predominance. Some of these changes (e.g. increase of vimentin and decrease of alpha-type actin) are seen already in cells entering for the first time in S phase after plating. Pulse-chase experiments with 3H-thymidine (3H-TdR) indicate that vimentin containing SMC possess a higher replicative activity than vimentin plus desmin containing SMC, thus explaining the selection of vimentin containing cells during culture. Our results indicate that during culture SMC develop features similar to those observed in normal foetal SMC or in SMC present in atheromatous plaques; this model may be useful for the understanding of mechanisms leading to SMC differentiation and to atheroma formation. PMID- 3528514 TI - [Effect of Dichroa febrifuga L. on chloroquinsensible and chloroquinresistant malaria parasites]. PMID- 3528515 TI - Longitudinal cell mediated immune responses and cross reactivity of lymphocytes from rabbits infected with Candida albicans. PMID- 3528516 TI - Carbamazepine toxicity: comparison of measurement of drug levels by HPLC and EMIT and model of carbamazepine kinetics. AB - A 23-month-old boy accidently ingested 2000 mg (148 mg/kg) of carbamazepine. The delayed onset of convulsions coincided with the peak serum level of total parent drug and an active metabolite (carbamazepine 10,11-epoxide). Comparisons of homogeneous enzyme multiplied immunoassay technique (EMIT) and high pressure liquid chromatography (HPLC) revealed that the EMIT slightly over-estimated plasma carbamazepine levels due to immunochemical cross reactivity with the epoxide metabolite. The peak plasma levels of the parent drug plus the active metabolite were more accurately determined by HPLC. These results emphasize the need to understand both the presence of active metabolites and characteristics of the assay being used in managing clinical intoxication with carbamazepine. PMID- 3528517 TI - Propylthiouracil-induced cholestatic jaundice. AB - The typical propylthiouracil (PTU)-linked hepatotoxicity, is known to manifest itself by hepatocellular injury with greatly increased serum transaminase values and evidence of hepatic necrosis on liver biopsy. Herewith presented is a 33-year old, thyrotoxic woman who developed cholestatic jaundice two weeks after initiation of PTU therapy. The diagnosis was confirmed by liver biopsy. A causal link between PTU treatment and the cholestatic jaundice was suggested by: the time of onset, typical skin rash and a positive migration inhibition factor (MIF) test to PTU. Awareness of this rare complication of PTU treatment may prevent the performance of unnecessary, expensive and possibly harmful diagnostic procedures. PMID- 3528518 TI - Asymptomatic bacteriuria in Nigerian diabetics. AB - One hundred and ninety diabetic patients and an equal number of non-diabetic patients, age- and sex-matched, were screened for occurrence of asymptomatic bacteriuria. Of the diabetics 6.3% were found to have covert bacteriuria as were 5.3% of the control group. Asymptomatic bacteriuria was found to occur more commonly in females than males and in the patients who were over 40 years old. The incidence of bacteriuria was not found to be related to the degree of control in the diabetic patients. The most common organism cultured was E. coli. PMID- 3528519 TI - Early diagnosis and intrauterine therapy of meconium plug syndrome in the fetus: risks and benefits. AB - Two cases are reported of patients in the third trimester of pregnancy in whom routine ultrasound examination revealed progressive dilatation of the fetal intestines. Intestinal obstruction was suspected and amniocentesis as well as amniography with Urografin were done. In both cases a regression in dilatation of bowel was noted on ultrasonography. The Urografin swallowed by the fetus was deemed to have relieved the obstruction of the fetal intestine. The babies were delivered in good condition and passed large amounts of watery meconium per rectum. In spite of the risks inherent in the use of Urografin amniography, as well as of amniocentesis, there appear to be a great number of advantages to the treatment of meconium obstruction of the fetus in utero. PMID- 3528521 TI - Yolk sac sign: sonographic appearance of the fetal yolk sac in missed abortion. AB - With improving technology, the fetal yolk sac can be routinely visualized sonographically in all living gestations of six to ten weeks. The minimal growth of the yolk sac during this interval and its subsequent obscuration by the growing amniotic sac are verified in this study. An important new sign of missed abortion has been inferred by Bernard and Cooperberg (AJR 144:597, 1985), and is titled in this article the "yolk sac sign." A gestational sac of 25 mm or more in mean diameter and empty except for the yolk sac is highly suspicious for nonviable gestation. This one-year prospective study adds nine such cases. To enhance specificity of this sign, additional criteria specify a yolk sac measuring 4 mm, a free-floating position within the gestational sac, and evacuation of the yolk sac on follow-up scan. However, when a ring-like structure measures 3 mm or less and lies peripherally in the gestational sac, this must be presumed to be a potential fetal pole. PMID- 3528520 TI - Intraoperative abdominal ultrasonography: initial experience with a dedicated high-resolution operative transducer. AB - A dedicated 8-MHz intraoperative scanning probe was used in 42 patients who underwent exploratory abdominal surgery. A variety of pathologic processes involving the liver, pancreas, bowel, and biliary and genitourinary systems were evaluated. Sonographic studies were evaluated to determine if they added new information (20 patients, 47.6 per cent), confirmed known information (20 patients, 47.6 per cent), or provided false information (two patients, 4.8 per cent). Preliminary experience with a specially developed transducer suggests that its design avoids many of the difficulties encountered with other transducers employed for this technique. Intraoperative sonography has, in many instances, the potential to simplify surgery, shorten operating time, and modify the type of surgical procedure performed. PMID- 3528522 TI - Further observations in the ultrasound evaluation of renal allograft rejection. AB - In order to determine whether sonographic parenchymal changes and volume changes are reliable predictors of acute transplant rejection, 36 recipients of renal allografts were studied. The significance of graft volume changes was evaluated, since most previous studies have not utilized routine immediate postoperative baseline scans for comparison to follow-up scans. All patients had baseline scans within 24 hours of the transplant. All 24 acute rejection patients had biopsy proof of rejection within three days of the follow-up scans. Seven clinically normal and five clinically designated acute tubular necrosis (ATN) patients were studied for comparison. A retrospective blind review utilizing three sonologists and previously described criteria combined with calculated volume changes demonstrated an overall sensitivity of 85 per cent and specificity of 94 per cent for the detection of acute rejection. The kidneys with acute rejection had an average volume increase of 73 per cent vs. 27 per cent for ATN patients and 24 per cent for normal patients, a statistically significant difference. PMID- 3528523 TI - Sonographic depiction of normal and abnormal endometrium with histopathologic correlation. AB - The sonographic appearance of the endometrium was correlated to histopathologic findings in 38 patients who underwent hysterectomy. The thickness was accurately assessed by sonography (within +/- 1 mm) in 33 of 38 patients. The hypoechoic halo which surrounds the endometrium was found to represent the inner third of the myometrium which is relatively vascular and compact. In postmenopausal patients who are not receiving hormonal replacement, an endometrium of greater than 5 mm should be considered abnormal. Several causes of abnormally thick endometrium were encountered in this study, including endometrial carcinoma, hyperplasia, adenomyosis, hematometria, mucometria, and pyometria. Sonography was found to be accurate in determining the depth of myometrial invasion in adenocarcinoma. PMID- 3528524 TI - An evaluation of fetal weight prediction using a simple equation containing the fetal femur length. AB - The accuracy of sonographic fetal weight estimation based on five published regression equations and two new equations generated from data at the authors' institution was evaluated on 41 small-for-gestational age (SGA) fetuses and 57 appropriate-for-gestational age (AGA) fetuses. Equations which contained the fetal femur length (FL) in addition to the biparietal diameter (BPD) and abdominal circumference (AC) yielded lower systematic and random errors in the SGA group but not in the AGA group. These findings support the contention that consideration of the FL is important in sonographic estimation of fetal weight in the growth-retarded fetus as head and limb growth may be affected to different degrees in different fetuses. A new equation, where birthweight in grams = 1.4 X (BPD(cm) X AC(cm) X FL(cm)) - 200, was developed which had a standard deviation of 98 g/kg in SGA fetuses and 68 g/kg in AGA fetuses. This equation yielded significantly lower random errors in the SGA but not in the AGA fetuses when compared with another linear equation without the FL. The new model is simple and practical to use, which makes it a viable alternative to more elaborate models containing three parameters. PMID- 3528525 TI - The sonographic appearance of the pancreatic duct following transampullary septectomy. PMID- 3528526 TI - Prenatal sonographic diagnosis of hemifacial microsomia (Goldenhar-Gorlin syndrome). PMID- 3528527 TI - Identification of an amino acid essential to the normal assembly of Autographa californica nuclear polyhedrosis virus polyhedra. AB - We compared the DNA sequence of the Autographa californica nuclear polyhedrosis virus polyhedrin gene with that of the polyhedrin gene from a morphology mutant called M5. A single point mutation was found at the BamHI restriction site within the polyhedrin coding sequence. This point mutation caused a substitution of leucine for proline at amino acid 58 in the M5 polyhedrin. This point mutation was shown to be responsible for both the appearance of cubic polyhedra and the altered mobility of the polypeptide on sodium dodecyl sulfate-polyacrylamide gels by transferring the M5 polyhedrin gene to the wild-type virus by cotransfection. Recombinants were found which assembled cubic polyhedra in infected cells, had the BamHI restriction site missing, and had an altered mobility of their polyhedrin polypeptide. Computed-predicted secondary-structure analysis indicated that the amino acid at position 58 could be critical to the proper folding of polyhedrin. PMID- 3528528 TI - Temperate coliphage HK253: attachment site and restricted transduction of proAB mutants of Escherichia coli K-12. AB - Temperate coliphage HK253 integrates near the proAB locus on the Escherichia coli K-12 chromosome. It can bring about specialized transduction of proAB and phoE mutants of E. coli, but it is incapable of general transduction. One of the proline-transducing particles was found to be nondefective. PMID- 3528530 TI - Comparison of myointimal hyperplasia in laser-assisted and suture anastomosed arteries. A preliminary report. AB - Use of the milliwatt CO2 laser to perform microvascular anastomoses is associated with characteristic histologic changes, including intimal hyperplasia and medial necrosis. The extent of myointimal proliferation after both suture and laser assisted vascular anastomosis was assessed in the rat femoral artery model. At 2 weeks the average intimal height of the laser-anastomosed vessels was 11.7 +/- 2.2 microns (mean +/- standard error of the mean) vs. 21.3 +/- 3.2 microns for sutured arteries (p less than 0.05). By 6 weeks the groups were equivalent (laser, 25.6 +/- 4.6 microns; suture, 17.3 +/- 1.2 microns; p, not significant). The medial changes associated with the laser-assisted method appear to inhibit the proliferative response at 2 weeks but are reversed by 6 weeks. PMID- 3528529 TI - Identification of attenuating mutations on the reovirus type 3 S1 double-stranded RNA segment with a rapid sequencing technique. AB - Reovirus type 3 variants with mutations in the major neutralization domain of the sigma 1 protein have attenuated neurovirulence and restricted neurotropism. We devised a variation of the rapid RNA sequencing technique to facilitate the analysis of double-stranded RNA. We sequenced the S1 double-stranded RNA segment, which encodes the sigma 1 protein, of five attenuated reovirus type 3 variants. Four of the variants have changes in codon 419, and a fifth variant has a change at codon 340, all of which resulted in amino acid substitutions in the sigma 1 protein. We identified two sites on the reovirus type 3 sigma 1 protein that play a critical role in neurovirulence. PMID- 3528531 TI - Duplex scanning in the assessment of deep venous incompetence. AB - A noninvasive method to evaluate deep venous incompetence by duplex scanning is presented. For this test, it was decided to have the patient standing so as to make the test less dependent on the need for patient cooperation and to allow gravity to produce reflux. Results were validated against ambulatory venous pressure measurements. The method described had a sensitivity of 84% and specificity of 88%. Duplex scanning is a useful screening test for detecting the presence and site of incompetence in patients with deep venous disease. PMID- 3528532 TI - Predictive power of penile/brachial index in diagnosing male sexual impotence. AB - To evaluate the diagnostic power of penile/brachial index (PBI) in patients studied for male sexual impotence, we prospectively interviewed 503 patients referred to our vascular laboratory for PBI measurements. Since the predictive values of diagnostic tests are affected by the prevalence of the disease in the population studied, we calculated the independent likelihood ratio for various PBI levels obtained. For the purpose of this analysis, "organic" impotence was defined as occurring in patients who had no nocturnal erections, whereas "clinical" impotence was defined as occurring in those patients who could not achieve penetration during intercourse. The patients were divided into four groups by the presence or absence of risk factors, including peripheral vascular disease (PVD) and diabetes mellitus. Patients taking medications that may affect potency (n = 175) were excluded from this analysis. The results show that the predictive power of PBI is less in diabetic patients with PVD and least in those without either PVD, diabetes, or drugs. In patients with PVD but no other risk factors, PBI is highly diagnostic with a sharp cut-off point at 0.6. Thus, the diagnostic power of PBI can be improved by considering the risk factors in the patients studied. PMID- 3528533 TI - Endothelial cell harvest for seeding vascular prostheses: the influence of technique on cell function, viability, and number. AB - Direct seeding of endothelial cells onto synthetic vascular prostheses has become the subject of increasing surgical research during the last 5 to 7 years. The currently employed cell harvest techniques are inefficient, resulting in cell counts far below the number of cells calculated to be present on the original donor vein. We have compared two methods of enzymatic endothelial cell harvest: cannulation with flushing and eversion over a stainless steel rod. Harvested cells were plated onto tissue culture plastic and counted after 24 hours of incubation. The methods ensured that only those cells viable and functional enough to adhere to the plastic were being considered. Cells were identified as endothelial by immunohistochemical techniques applying antisera to factor VIII related antigen. Segments of normal vein and of veins treated by each technique were viewed with a scanning electron microscope. Cannulation was the superior method, providing greater numbers of viable, functional cells. The eversion technique was unreliable and probably injurious to endothelial cells. PMID- 3528534 TI - How vascular surgeons use noninvasive testing. AB - A questionnaire was used to determine the patterns of use of noninvasive testing by vascular surgeons. The 494 respondents had been in practice an average of 18 years. Many of the examinations were done outside the office; 85% of laboratories used were hospital facilities. In the area of cerebrovascular testing the ocular pneumoplethysmographic techniques and the periorbital Doppler test continued to be used extensively; however, the acceptance of new technology was confirmed by the finding that 71% used some form of imaging. Arterial insufficiency of the legs was most commonly evaluated with segmental Doppler pressures and stress testing was used only in selected cases. Noninvasive tests were widely used postoperatively for the follow-up of patients. Most venous testing was aimed at the detection of acute deep venous thrombosis, and venous Doppler examination and impedance phlebography were the most widely used techniques. The data from this study document the patterns of use of the vascular laboratory. Unexpected findings included the widespread use of imaging (especially duplex scanning) and the frequent use of multiple tests for cerebrovascular evaluation. PMID- 3528535 TI - Atraumatic extracranial vertebral artery aneurysm: case report and review of the literature. AB - A case of atherosclerotic aneurysm of the extracranial vertebral artery in a 31 year-old woman is reported. The lesion was excised after distal and proximal ligation of the vessel. Review of the literature showed that atraumatic extracranial vertebral artery aneurysm unrelated to systemic illness is rare. Analysis of the reported cases of such lesions disclosed only one comparable case in a 73-year-old man. PMID- 3528536 TI - Earlier therapies for urinary stones. PMID- 3528538 TI - Rift Valley fever caused the fifth plague of Egypt and that of 1977. PMID- 3528537 TI - Cardiac transplantation in an 8-month-old female infant with subendocardial fibroelastosis. AB - On Nov 1, 1984, an orthotopic cardiac transplantation was performed in an 8-month old female infant with subendocardial fibroelastosis. Because of the advanced state of cardiac failure, the operation was done despite a positive tissue crossmatch for antitoxic donor-specific antibodies. Immunosuppression consisted of high doses of cyclosporine (up to 550 mg/m2 or 30 mg/kg) and steroids. Hypertension and tremor of the extremities, which were attributed to cyclosporine, occurred during the first week but resolved after seven days. No signs of nephrotoxic effects have been noted; however, a severe episode of allograft rejection was detected by endomyocardial biopsy on the seventh postoperative day, and a moderate rejection episode was noted on the 22nd postoperative day. Histologic improvement was seen after treatment with conventional steroid pulses. The patient was discharged on Nov 29, 1984. Complications consisted of four episodes of otitis media caused by Staphylococcus aureus and one rejection episode that was treated on an outpatient basis with an intravenous methylprednisolone sodium succinate pulse. Our experience emphasizes both the feasibility and importance of performing endomyocardial biopsies in infant recipients. Through biopsy, episodes of rejection can be discovered when clinical signs are not yet apparent. Eighteen months after transplantation, the child was developing and growing normally. PMID- 3528539 TI - Early use of X-ray machines and electrocardiographs at the Pennsylvania Hospital. PMID- 3528540 TI - The Dukes classification of colorectal cancer. PMID- 3528541 TI - Disulfiram treatment of alcoholism. A Veterans Administration cooperative study. AB - We conducted a controlled, blinded, multicenter study of disulfiram treatment of alcoholism in 605 men randomly assigned to 250 mg of disulfiram (202 men); 1 mg of disulfiram (204 men), a control for the threat of the disulfiram-ethanol reaction; or no disulfiram (199 men), a control for the counseling that all received. Bimonthly treatment assessments were done for one year. Relative/friend interviews and blood and urine ethanol analyses were used to corroborate patients' reports. There were no significant differences among the groups in total abstinence, time to first drink, employment, or social stability. Among the patients who drank and had a complete set of assessment interviews, those in the 250-mg disulfiram group reported significantly fewer drinking days (49.0 +/- 8.4) than those in the 1-mg (75.4 +/- 11.9) or the no-disulfiram (86.5 +/- 13.6) groups. There was a significant relationship between adherence to drug regimen and complete abstinence in all groups. We conclude that disulfiram may help reduce drinking frequency after relapse, but does not enhance counseling in aiding alcoholic patients to sustain continuous abstinence or delay the resumption of drinking. PMID- 3528542 TI - Women and alcohol. A review. PMID- 3528543 TI - Management of the patient with hemorrhaging esophageal varices. AB - Bleeding from esophageal varices remains a difficult clinical problem, carrying a high likelihood both of rebleeding and of mortality. The initial approach requires adequate but not overly vigorous volume replacement with blood and other fluids. Once the patient is resuscitated, upper gastrointestinal endoscopy should be performed to establish the source of bleeding. Both endoscopic variceal sclerotherapy and balloon tamponade appear to be effective in achieving temporary control of acute ongoing hemorrhage from esophageal varices. The value of intravenous vasopressin remains controversial. Rebleeding can be prevented in most patients by shunt surgery. However, surgery carries both considerable early morbidity and mortality (related mainly to the severity of the underlying liver disease) and substantial longer-term morbidity and mortality from hepatic encephalopathy and liver failure. The role of pharmacologic agents (eg, propranolol) intended to prevent variceal hemorrhage by reducing portal pressure remains to be established. At present, we recommend use of endoscopic variceal sclerotherapy for the control of active variceal bleeding, with employment of balloon tamponade and intravenous vasopressin if sclerotherapy is successful. Emergency shunt surgery should be reserved only for those patients whose bleeding cannot be controlled by these other means. For prevention of rebleeding in Child class C patients, we attempt to obliterate the varices by repeated endoscopic sclerotherapy. Patients who have two to three episodes of rebleeding despite this approach are considered for shunt surgery. For better-risk patients who do not have ascites, which is difficult to control, we are currently recommending a distal splenorenal shunt. Alternatively, repeated endoscopic variceal sclerotherapy is used for these better-risk patients (Child class A or B) in some centers, with shunt surgery reserved for patients who continue to rebleed. Which approach to preventing rebleeding in the better-risk patient is more effective, as well as the role of pharmacologic therapy with propranolol or other agents, remains to be settled by well-controlled randomized clinical trials. PMID- 3528544 TI - Leonardo da Vinci, Vitruvian Man. PMID- 3528545 TI - Medical education programs sponsored by government agencies. PMID- 3528546 TI - Regulation of glucose metabolism by altered pyruvate dehydrogenase activity. I. Potential site of insulin resistance in sepsis. AB - Regulation of the pyruvate dehydrogenase (PDH) complex has been demonstrated to be a key mechanism in the control of carbohydrate oxidation and conservation of glucose carbon. The effect of sterile inflammation and chronic sepsis (small and large abscess) on the activity of the PDH complex was examined in liver and skeletal muscle. Sepsis altered the proportion of PDH in the active, dephosphorylated form. In hepatic tissue, sterile inflammation leads to a 2.5 fold increase in the proportion of active PDH complex compared to fed control. The same increase in the proportion of active PDH complex was observed in rats with a small septic abscess. However, when the severity of septic episode was increased, the proportion of active PDH complex decreased relative to sterile inflammation or small septic abscess animals. A different pattern in the response to sterile inflammation and sepsis on the proportion of active PDH complex was observed in skeletal muscle compared to liver. In contrast to liver, sterile inflammation did not alter the proportion of active PDH in skeletal muscle. In addition, sepsis (either small or large septic abscess) resulted in a 3-fold decrease in the proportion of active PDH relative to fed control or sterile inflammatory animals. The decrease in the proportion of active PDH complex in sepsis was associated with a corresponding increase in the skeletal muscle acetyl CoA/CoA ratio. The mechanism responsible for lowered PDH complex activity may have been due to increased PDH kinase activity, secondary to increased skeletal muscle acetyl-CoA/CoA ratios. PMID- 3528547 TI - Development of cultured cardiac cells and difference of their structures in vivo. AB - Some interesting features in the morphological study of rat cardiac cells were obtained by use of the light and phase-contrast microscopy. The histological approach and comparison of the ultrastructures of the cultured cardiac cells with uncultured cells were included in the studies as a control. Four main points are discussed: the process of single beating cells that eventually constitutes the cell cluster and network, the function and histological content of the network, the mechanisms of synchronized beating cells, the substance of the cell surface coat and intercellular connection. PMID- 3528548 TI - Effects of positive end-expiratory pressure ventilation and extracorporeal ultrafiltration method in patients with refractory heart failure. AB - We studied the effects of positive end-expiratory pressure (PEEP) ventilation in ten patients with acute myocardial infarction (nine in Killip class III, one in Killip class IV; pulmonary capillary wedge pressure greater than 24 mmHg) and of extracorporeal ultrafiltration method (ECUM) in seven patients with refractory heart failure due to acute myocardial infarction and others. Application of PEEP resulted in significant increases in PaO2 and SaO2 and decrease in PaCO2. Significant reduction in mean pulmonary arterial and pulmonary capillary wedge pressures and heart rate was observed, while stroke work index increased significantly. There was a significant correlation between changes in stroke work index and PaO2 after the application of PEEP. The use of ECUM removed fluid of 1416 +/- 662 ml (680-2800 ml) with the ultrafiltration flux rate being 478 +/- 223 ml/hour. Significant decreases in mean pulmonary arterial, pulmonary capillary wedge and central venous pressures were observed, while PaO2 increased significantly. BUN and serum creatinine levels increased significantly, and total protein and serum albumin tended to increase. There was a significant correlation between fluid removed and change in PaO2 after the use of ECUM. Thus, PEEP and ECUM are beneficial for patients with refractory heart failure. The mechanism(s) are: reduction in preload due to an increased intrathoracic pressure and a decreased systemic venous return with PEEP, or due to removal of excess fluid with ECUM, and improvement of the oxygenation of the blood. PMID- 3528549 TI - Dialysis therapy in patients with renal insufficiency and cardiac dysfunction. PMID- 3528550 TI - [Antihypertensive effects of nicardipine hydrochloride (YC-93) on patients with hypertension during neuroleptanesthesia]. PMID- 3528551 TI - [A comparison between nicardipine hydrochloride (YC-93) and trimethaphan camsylate for treatment of acute hypertension during surgery. A double blind study in 12 institutions]. PMID- 3528552 TI - [Result of randomized comparative clinical study of nicardipine hydrochloride and trimethaphan camsylate on control of blood pressure during surgery]. PMID- 3528553 TI - [Anesthetic management of multiple endocrine neoplasia type 1]. PMID- 3528554 TI - [Changes in airway pressure during HFPPV (HFJ superimposed on IPPV)]. PMID- 3528555 TI - [Aminoglycoside antibodies: mechanism of action and resistance]. PMID- 3528556 TI - [Pathogenic factors in mixed infection due to Bacteroides fragilis and other species of bacteria in mice]. PMID- 3528557 TI - [Method for quantifying live bacteria in murine peritoneal macrophages by solubilizing with Triton X-100]. PMID- 3528558 TI - [Hemangiopericytoma of the breast]. AB - A rare case of hemangiopericytoma of the breast is reported with an electron microscopic study. The differential diagnosis is discussed. Ultrastructural study confirmed the diagnosis by revealing that the tumor cells were separated from the endothelial cells of the capillary and had abundant cytoplasmic filaments that formed dense plaques along the plasma membrane. The patient has remained free of tumor for four years after tumorectomy. A review of the literature on reported cases is also presented. Microscopically, benign and malignant forms could not be distinguished easily. It is necessary to followup behavior for more than five years if the tumor does not seem malignant. PMID- 3528560 TI - [CA 19-9 enzyme immunoassay]. AB - The carbohydrate antigenic determinant (CA 19-9) EIA kit (FUJIREVIO INC) was examined both experimentally and clinically. In the basic study, the standard curve showed linearity from to 240 U/ml, and the intra-and interassay reproducibility was good. Serum levels of CA 19-9 were determined by EIA in 246 cancer patients and 180 patients with benign diseases, and CA 19-9 levels by EIA were compared with those by RIA in concurrent measurement. There was an excellent correlation between the two. The positive of CA 19-9 EIA was almost the same as that of CA 19-9 RIA in cancer patients. False-positive cases by CA 19-9 EIA were somewhat more numerous than those by CA 19-9 RIA in patients with benign diseases, especially liver diseases. However, CA 19-9 assay by EIA is simple and has an excellent reproducibility and accuracy, as does that by RIA. Thus, the CA 19-9 EIA is a very useful assay. PMID- 3528559 TI - [Burkitt's lymphoma of the bilateral breasts presenting during lactation]. AB - A 34-year-old postpartum woman with Burkitt's lymphoma is reported. Lymphoma involved the bilateral breasts chiefly, as well as the brain, ileocecal region and supraclavicular lymph nodes. Fourteen days after bilateral mastectomy, the patient suddenly went into a coma due to rapid progress of brain involvement. However, the coma improved the day after VEPA chemotherapy and radiation were undertaken, and the tumor-involved brain decreased significantly in size following chemoradiotherapy. Chemoradiotherapy produced the almost complete disappearance of the remaining tumor. The patient is now being treated by a maintenance dose of Endoxan and is doing well. Burkitt's lymphoma of the breast in the present case had the clinical characteristics of bilateral involvement with rapid growth arising during lactation and pregnancy. PMID- 3528561 TI - [Studies of leukemic blast progenitors from acute myeloblastic leukemia patients in viscid methylcellulose culture and liquid suspension culture]. PMID- 3528562 TI - [Pathology of thrombosis]. PMID- 3528563 TI - [Clinical studies of thrombosis]. PMID- 3528564 TI - [Physiopathology of thrombosis: prostaglandins]. PMID- 3528565 TI - [Physiopathology of thrombosis: its relation to blood circulation]. PMID- 3528566 TI - [Physiopathology of thrombosis: blood vessel wall]. PMID- 3528567 TI - [Image diagnosis of thrombosis]. PMID- 3528568 TI - [Therapy of thrombosis: anticoagulant-fibrinolytic therapy]. PMID- 3528569 TI - [Antiplatelet therapy of thrombosis]. PMID- 3528571 TI - [Thrombosis in various diseases: diabetes mellitus]. PMID- 3528570 TI - [Thrombosis in various diseases: kidney diseases and blood coagulation]. PMID- 3528572 TI - [Thrombosis in various diseases: cerebral infarction]. PMID- 3528573 TI - [Thrombosis in various diseases: hyperlipidemia]. PMID- 3528575 TI - [Thrombosis in various diseases: neoplasms]. PMID- 3528574 TI - [Thrombosis in various diseases: arteriosclerosis and thrombosis]. PMID- 3528576 TI - [Thrombosis in various diseases; aging]. PMID- 3528577 TI - [Thrombosis in various disease: obstetric and gynecological diseases]. PMID- 3528578 TI - [Thrombosis in various diseases: vascular surgery]. PMID- 3528579 TI - [Thrombosis in various diseases: urologic diseases]. PMID- 3528580 TI - [Artificial organs and thrombosis: cardiopulmonary bypass]. PMID- 3528581 TI - [Artificial organs and thrombosis: CAPD and thrombosis]. PMID- 3528582 TI - [Artificial organs and thrombosis: kidney transplantation and thrombosis]. PMID- 3528583 TI - [Treatment of essential hypertension--excluding chemotherapy]. PMID- 3528584 TI - [Preparation of factor IX deficient plasma by immunoadsorption using monoclonal antibody (3A6) to factor IX and its application]. PMID- 3528585 TI - [Computer-assisted laboratory interpreting and reporting system for evaluation of acid-base dynamics by new acid-base terminology]. PMID- 3528586 TI - [Detection of cell surface antigen by immunocytochemistry on air-dried smears]. PMID- 3528587 TI - [Clinical evaluation of a pancreatic cancer-associated glycoprotein antigen, DU PAN-2. I. Enzymeimmunoassay and distribution of serum values in healthy persons]. PMID- 3528588 TI - [Scintigraphy of renal failure]. PMID- 3528589 TI - [Evaluation of renal function by ultrasonography]. PMID- 3528590 TI - [Interventional radiology in the diagnosis and management of renal failure]. PMID- 3528591 TI - [Case of the month: Acute focal bacterial nephritis]. PMID- 3528592 TI - [Ultrasonography of nodular goiter]. PMID- 3528593 TI - [Spinal sonography]. PMID- 3528594 TI - [Ultrasonographic evaluation of gallbladder dynamics in normal subjects and cholecystolithiasis]. PMID- 3528595 TI - [Changes in portal hemodynamics after portosystemic shunt surgery. Intraoperative and follow-up study using Doppler ultrasound]. PMID- 3528596 TI - [Clinical study concerning the maintenance of blood pressure during hemodialysis- the effect of humoral factors and cardiac performance]. PMID- 3528597 TI - [Mechanism of the acute antihypertensive effect of captopril in patients on hemodialysis]. PMID- 3528598 TI - [Hemolytic uremic syndrome: abnormalities of prostacyclin in the recurrent form]. PMID- 3528599 TI - Immunosuppression by captopril in vitro: inhibition of human natural killer activity by copper-dependent generation of hydrogen peroxide. AB - The effect of captopril and a mixture of captopril and copper on natural killer (NK) activity of normal human peripheral blood mononuclear cells (PBMC) was examined. Preincubation of PBMC with captopril alone did not affect their NK activity at concentrations of 5-50 micrograms/ml. However, in the presence of copper sulfate, captopril inhibited the NK activity in a dose-response fashion. Similar inhibition was observed when adherent depleted fraction was treated with captopril and copper. In the time course study, significant inhibition of NK activity by captopril and copper was already observed at 3 hr preincubation. The inhibition of NK activity by captopril and copper was completely abolished by the addition of catalase, but not by superoxide dismutase, interleukin-2, or indomethacin. Preincubation of PBMC with captopril and copper for 18 hr decreased its viability. This decrease was also reversed in the presence of catalase. These results suggest that immunosuppression by captopril in the presence of copper was mediated by hydrogen peroxide. PMID- 3528600 TI - [A case of Salmonella enteritidis hemopyrothorax]. PMID- 3528601 TI - [Immunohistochemical study of nonspecific granulomatous prostatitis]. PMID- 3528602 TI - [Human renal cell carcinoma: establishment of a new cell line (YCR-1) using soft agar culture technic]. PMID- 3528603 TI - [Observation of antibody-coated bacteria in the urine and infected kidney in murine experimental ascending pyelonephritis]. PMID- 3528604 TI - [Ultrasound-guided renal cyst puncture--experience with absolute ethanol instillation]. PMID- 3528605 TI - Gastrointestinal carcinoma-associated antigen defined by a murine monoclonal antibody. AB - A murine monoclonal antibody, CHIP, has been prepared against a human pancreatic carcinoma cell line, SHAW. With the use of the avidin-biotin immunoperoxidase technique, the CHIP antibody detected an antigen found in 11 of 20 fixed tissue sections of tumors obtained from patients with pancreatic carcinoma. The antibody also detected the antigen in 25 of 26 colon carcinoma specimens, 4 of 6 gastric carcinoma specimens, and 1 of 2 esophageal adenocarcinoma specimens. The antigen was also found in normal proximal jejunum and colon and in small amounts in pancreatic islets and parathyroid. There was no reactivity with normal pancreatic ductal or acinar cells or with mesenchymal tissues. PMID- 3528606 TI - The diagnosis of hyperinsulinism in a child in the absence of hyperinsulinemia. PMID- 3528607 TI - Clinical effect of diode laser to improve fair take of the grafted skin. PMID- 3528608 TI - Kansas pioneer nurse. PMID- 3528609 TI - The regulation of renal acid secretion: new observations from studies of distal nephron segments. AB - In this review we have attempted to present for the general reader the new information on renal acidification that has emerged from the study of discrete segments of the distal nephron. We have structured our presentation in the context of the cation exchange hypothesis which has strongly influenced modern thinking of acid-base regulation. We have shown that distal nephron acidification is active and can proceed even in the absence of sodium. We have also shown beyond doubt, that pH or the determinants of pH can influence the rate of proton secretion in probably all of the distal nephron segments. We have drawn attention to an exciting new means by which chloride (or its substitution) could alter the rate of net bicarbonate transport. A possible role for bicarbonate secretory activity in the mammalian distal nephron has been discussed as has the influence of mineralocorticoids on acid secretion. There is no question that all of this new information has created the need for a reassessment of the validity of the cation exchange hypothesis. After all, this is a view which specifically denies that renal acid excretion is modulated by pH of the blood, and affirms that it is intrarenal sodium handling that is the "driving force", so to speak, behind acidification responses. However, it seems inappropriate at this time to insist that current data do not allow for a component of sodium transport by the distal nephron to modulate the rate of acid secretion. It is also possible, as we have suggested, that an important effect of chloride gradients, independent of blood pH, could alter bicarbonate retrieval. Most importantly, we wish to stress that much of the in vitro perfusion data does not derive from animals subjected to the chronic acid-base derangements which were precisely those situations to which the cation exchange hypothesis was directed. Simply put, the whole animal studies of Schwartz and his colleagues provided no experimental observations on intrarenal sodium handling or acidification mechanisms, just as the microperfusion studies, both in vivo and in vitro, provide insufficient data that can be applied to whole animals subjected to chronic disturbances.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3528610 TI - Humoral control of water and electrolyte excretion during water restriction. AB - The goals of the present study were twofold: first, to assess the renal excretory and hormonal responses to chronic water restriction in dogs whose sodium retaining mechanisms had been stimulated through dietary sodium (Na+) deprivation; second, to determine the mediator(s) of the natriuresis which was observed with water restriction in these sodium deprived dogs. Three groups of dogs maintained on a low Na+ diet (5 mEq/day) for two weeks underwent a three day period of water restriction. In normal, intact dogs Group 1 (N = 5), water restriction resulted in a significant increase in Na+ excretion with a net cumulative loss of 26.3 +/- 2.6 mEq over three days. The natriuresis was associated with a significant increase in plasma vasopressin (PAVP) (1.7 to 10.2 pg/mliter) and a significant fall in plasma aldosterone (PALDO) from the levels observed with Na+ restriction alone (24.9 to 12.4 ng/dliter). The natriuresis could not be explained by decreases in food intake as determined by control studies in four dogs. Group 2 (N = 6) dogs had a decrease in PALDO with water restriction that was prevented by means of continuous i.v. aldosterone infusion (6.0 micrograms/kg/day). Dogs in this group failed to demonstrate a natriuresis during three days of water restriction, despite the fact that PAVP rose from 3.3 +/- 0.8 to a peak level of 14.95 +/- 1.9 pg/mliter. Group 3 (N = 6) dogs underwent selective neurohypophysectomy, thus preventing the rise in PAVP during three days of water restriction. In this group, PALDO also remained unchanged from the Na+ deprived level during water restriction, and no natriuresis was observed. We conclude: 1) that the natriuresis which occurs with water restriction is a potent physiological response that occurs even in the Na+ restricted state; and 2) this natriuresis can be explained by a fall in PALDO and not the rise in PAVP. PMID- 3528611 TI - Side effects of cyclosporin A treatment in patients with rheumatoid arthritis. AB - Cyclosporin A (CyA) and azathioprine (Aza) were compared with respect to renal side effects in an open controlled, randomized study of patients with rheumatoid arthritis. Twelve patients were treated with CyA (mean dose 7.8 +/- 1.2 mg/kg/day) and 12 with azathioprine for 26 weeks. All patients also received prednisolone 5 mg/day. The patients had normal serum creatinine (less than 120 mumoles/liter) and protein-free urine before the trial. CyA increased serum creatinine in nine out of the 11 patients followed for 26 weeks, the mean increase was approximately 50%. Creatinine clearance was reduced by 31%. Mean arterial pressure (MAP) and serum potassium were significantly increased by CyA. Urinary beta 2-microglobulin excretion was significantly increased by CyA, in five of the patients more than ten times. Urinary kallikrein excretion was reduced by more than 50% and urinary albumin excretion was doubled. All these parameters remained normal and unchanged in the azathioprine group. CyA was withdrawn in seven patients after 26 weeks. Urinary beta 2-microglobulin was still increased by 85% nine months after CyA treatment. The other parameters were gradually normalized after three to nine months except for one patient who developed renal failure. Urinary beta 2-microglobulin excretion was a very sensitive parameter for renal tubular damage in this study. PMID- 3528612 TI - Modulation of plasma and platelet vasopressin by cardiac function in patients with heart failure. AB - Two groups of patients with congestive heart failure were studied, one with elevated (Group I) and another (Group II) with suppressed plasma concentrations of vasopressin. The mean plasma arginine vasopressin (AVP) concentration in the 17 patients in group I was 3.1 +/- 0.4 pg/mliter whereas the eight patients in group II had plasma concentration less than 0.5 pg/mliter. Platelet AVP concentrations were also higher in the Group I than Group II patients (7.8 +/- 1.5 vs. 2.2 +/- 0.7 pg/mliter, P less than 0.001). Plasma effective osmolality (262 vs. 268 mOsm/kg H2O, P less than 0.05) and plasma sodium concentration (134 vs. 137 mEq/liter, P less than 0.05) were lower in Group I. The Group I patients had a lower cardiac index (CI, 1.9 vs. 2.5 liter/min/m2, P less than 0.05) and higher pulmonary capillary wedge pressure (PCWP, 30 vs. 22 mm Hg, P less than 0.02), plasma renin activity (4.4 vs. 2.0 ng/mliter/hr, P less than 0.01), and plasma aldosterone (74 vs. 10 ng/dliter, P less than 0.001) than the Group II patients. The Group I patients also excreted a smaller percentage of a 15 mliter/kg waterload (31 vs. 57%, P less than 0.005). Group I patients then were treated with agents to decrease cardiac afterload, either captopril or prazosin. CI increased (1.9 to 2.1 liter/min/m2, P less than 0.001) and PCWP decreased (30 to 27 mm Hg, P less than 0.001). This improved cardiac performance was associated with enhanced water excretion (31 vs. 52%, P less than 0.001) and decreased minimal urinary osmolality (375 vs. 208 mOsm/kg H2O, P less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3528613 TI - Guanabenz: a centrally acting, natriuretic antihypertensive drug. AB - Guanabenz is acutely natriuretic and diuretic in saline expanded animals. In man, guanabenz has not resulted in sodium retention as seen with other comparable antihypertensives. To directly define the action of guanabenz on sodium and water excretion in man, we performed clearance studies during water diuresis on eight hypertensive subjects under metabolic balance conditions. Each subject underwent three studies: 1) baseline study: no drug, a water diuresis study; this was followed by a saline load (= 2% BW); 2) acute study (24 hr after baseline): 16 mg guanabenz PO; and 3) chronic study: after one week of guanabenz 8 mg PO BID. In the acute guanabenz studies there were: 1) no changes in GFR or ERPF; 2) an increase in both sodium excretion and fractional sodium excretion; 3) a rise in free H2O clearance (CH2O) and (CH2O/GFR) X 100%. These findings were not sustained in the chronic guanabenz studies. We conclude that in man (preconditioned with prior saline loading) guanabenz is acutely natriuretic and water diuretic. These effects are due to decreased tubular sodium and water reabsorption, probably related to inhibition of alpha adrenergic activity. The data are consistent with selectively reduced renal sympathetic activity affecting sodium transport and provide a basis for the absence of edema and sodium retention associated with guanabenz therapy. PMID- 3528614 TI - Renin-containing cells in kidney transplants into the anterior eye chamber. PMID- 3528615 TI - The Goodpasture antigen in Alport's syndrome: studies with a monoclonal antibody. AB - A mouse monoclonal antibody (MCA-P1), which recognizes an antigenic determinant in human glomerular basement membrane against which autoantibodies are directed in Goodpasture's syndrome, was used in indirect immunofluorescence studies to investigate glomerular basement membrane structure in Alport's syndrome. We found reduced or absent binding of MCA-P1 to glomerular and distal tubular basement membranes in renal biopsy tissue from ten patients with Alport's syndrome. Antiglomerular basement membrane antibody eluted from the kidneys of a patient who had died from Goodpasture's syndrome was used to confirm these findings. In contrast, there was bright linear fluorescence of MCA-P1 on glomerular and tubular basement membranes of normal renal material and renal biopsy tissue obtained from patients with a variety of glomerulonephritides. These results suggest an abnormality or a variable quantity of the immunoreactive autoantigen in the glomerular basement membrane of patients with Alport's syndrome. Furthermore, MCA-P1 may be of value in the diagnostic interpretation of renal biopsies from patients with familial nephritis. PMID- 3528616 TI - Extrarenal potassium homeostasis. PMID- 3528617 TI - Bilateral native nephrectomy improves renal isograft function in rats. AB - Bilateral native nephrectomy has been suggested to improve renal allograft survival in man. This effect may be most prominent in patients experiencing acute tubular necrosis following transplantation. Thus, native kidneys may alter the course of ischemic acute tubular necrosis in the transplanted kidney. In the present studies, we utilized an experimental model of syngeneic transplantation in which rejection does not occur. We studied Lewis rat renal isografts transplanted into littermates following sham, unilateral or bilateral native nephrectomy. In a fourth group of rats, we evaluated the importance of native kidney excretory function by studying isografts transplanted into littermates with bilaterally obstructed native kidneys. Renal blood flow and excretory function were measured in vivo, eight days following transplantation. Renal excretory function of isografts transplanted into animals following bilateral native nephrectomy was similar to normal nontransplanted Lewis kidneys. The presence of either one or both functioning native kidneys significantly reduced isograft inulin clearance, PAH clearance, and blood flow. However, when isografts were transplanted into Lewis rats with bilaterally obstructed native kidneys, renal isograft inulin clearance and blood flow were not significantly impaired. Nontransplanted kidneys demonstrated "functional hypertrophy" following contralateral nephrectomy, with glomerular filtration rate and renal blood flow increasing by approximately 50%. In contrast, isograft glomerular filtration rate in animals following bilateral native nephrectomy was equivalent to that of single kidneys from normal animals with both kidneys in situ. However, renal blood flow of isografts from these animals increased to the same level as nontransplanted Lewis kidneys following contralateral nephrectomy.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3528618 TI - Use of beta 2 microglobulin to diagnose tubulo-interstitial renal lesions in children. AB - Fractional excretion (FE) of beta 2 microglobulin (beta 2M) was studied in children with glomerular (N = 114), tubular (N = 50) or other (N = 18) renal diseases. FE-beta 2M (normal less than 0.36%) was significantly (P less than 0.001) lower in glomerular diseases (mean 0.104%) than in tubular lesions (mean 4.27%). Unexpectedly, several patients with glomerular disease were found to have increased values for FE-beta 2M. To determine whether this was due to a tubular component in a primary glomerular disease process, FE-beta 2M was measured in 30 children with various glomerulopathies who underwent renal biopsy. Thirteen of these patients had tubulo-interstitial lesions in addition to their glomerular disease. FE-beta 2M in these patients averaged 3.76% (range 0.14 to 44.6%); only two results were normal. Mean FE-beta 2M in the 17 patients without biopsy evidence of tubulo-interstitial disease was 0.063% (range 0.02 to 0.34%); all values were in the normal range. The types of glomerular diseases in the two groups of patients were similar. Patients with a glomerular lesion complicated by tubulo-interstitial lesions had a poorer prognosis than did those with a pure glomerular disease. The high incidence of tubulo-interstitial lesions in patients with glomerular diseases was unexpected. Our data demonstrates that FE-beta 2M represents a reliable non-invasive method to diagnose such involvement. Measurements of beta 2M also provide a convenient method to follow the course and response to treatment of renal tubular injury. PMID- 3528619 TI - Proceedings of the 3rd Annual Downstate Pediatric Nephrology Symposium. April 1985, New York, New York, USA. PMID- 3528620 TI - The current state of renal transplantation. PMID- 3528621 TI - Current results in pediatric renal transplantation at the University of Minnesota. PMID- 3528622 TI - Nutrition therapy in renal disease. AB - Dietary therapy in chronic renal insufficiency has as its principle aim preservation of residual renal function and to a lesser extent addresses metabolic abnormalities--notably relating to calcium, phosphorus, and vitamin D. Assuring an adequate calorie intake and determining a safe low level of protein and phosphorus are therapeutic goals. Dietary therapy in chronic renal failure emphasizes the goal of avoiding the metabolic problems--particularly those relating to excess dietary protein and phosphorus. Lowering protein and phosphorus to levels at or below the recommended level for normal adults has beneficial effects. However the issue of what level of intake is adequate or safe has not been fully addressed. While comparable studies in infants and children are more difficult, the effects of lower intakes upon growth are a rigorous test of adequacy or safety for this therapy. PMID- 3528623 TI - Pediatric renal transplants: a Canadian perspective. PMID- 3528624 TI - Cyclosporine experience in renal transplantation in children. PMID- 3528625 TI - Recurrence of focal segmental sclerosis in children following renal transplantation. PMID- 3528626 TI - Recurrence of hemolytic uremic syndrome in renal transplant recipients. PMID- 3528627 TI - Pathophysiology of growth failure in chronic renal insufficiency. PMID- 3528628 TI - [Therapy of enuresis with a pediatric tablet of propiverin (Mictonettes)]. PMID- 3528629 TI - [A method of temporary exclusion of the duodenum after its injury]. PMID- 3528630 TI - [Immunology in surgery (review of the literature)]. PMID- 3528631 TI - [Effect of splenectomy on immunologic reactivity (review of the literature)]. PMID- 3528632 TI - [Current problems of heart transplantation in humans (review of the literature)]. PMID- 3528633 TI - [Nikolai Vasil'evich Sklifosovskii (on the 150th anniversary of his birth)]. PMID- 3528634 TI - [Effect of the species of the causative agent on immunologic reactions in patients with suppurative surgical infections]. PMID- 3528636 TI - [Changes in the proteolytic activity of blood in the pathogenesis of postphlebitic ulcers]. PMID- 3528635 TI - [Significance of the initial immunological status of surgical patients for the prognosis of complications]. PMID- 3528637 TI - [Microsurgery of injuries of the extremities]. PMID- 3528638 TI - [Assessment of the functional suitability of the isolated neonatal liver for transplantation]. PMID- 3528639 TI - [Posttraumatic cholecystitis (a review of the literature)]. PMID- 3528640 TI - [Percutaneous transhepatic cholangiography and drainage of the bile ducts in the diagnosis and treatment of mechanical jaundice (a review of the literature)]. PMID- 3528641 TI - [Transplantation of the parathyroid glands in experiments and in the clinic (a review of the literature)]. PMID- 3528642 TI - [Nikolai Ivanovich Pirogov in Bulgaria]. PMID- 3528643 TI - [Vladimir Afanas'evich Karavaev (on the 175th anniversary of his birth]. PMID- 3528644 TI - [Ultrasonic percutaneous drainage]. PMID- 3528645 TI - [Diagnosis and treatment of acute cholangitis]. PMID- 3528646 TI - [Ultrasonic diagnosis of mechanical jaundice]. PMID- 3528647 TI - [Ultrasonic study combined with direct methods of biliary tract contrast in the diagnosis of the causes of mechanical jaundice]. PMID- 3528648 TI - [Experimental validation of a nonabsorbable blunt precision suture of the hepato choledochus]. PMID- 3528649 TI - [Surgical procedure in liver injuries]. PMID- 3528651 TI - [History of Polish pediatric ophthalmology]. PMID- 3528652 TI - [Results of surgical treatment of congenital blepharoptosis]. PMID- 3528650 TI - [Autopericardium as material for the plastic repair of the arteries]. PMID- 3528654 TI - [Alcoholism and the digestive tract]. PMID- 3528655 TI - [Biological markers in alcohol users]. PMID- 3528656 TI - [Mechanism of albuminuria and its clinical significance]. PMID- 3528653 TI - Lung diseases after bone marrow transplantation. Results of a clinical, radiological, histological, immunological and lung function study. AB - The case histories of 72 subsequently treated patients - 44 with acute leukemia, 10 with chronic myeloid leukemia, 16 with severe aplastic anemia and 2 with neuroblastoma - were analyzed after bone marrow transplantation (BMT) with respect to pulmonary diseases. Thirty-eight patients suffered from a total of 51 pulmonary complications, which led to death in 20. Of 13 patients, 3 died of bacterial pneumonia, all of them during granulocytopenia; 2 of 6 patients died of fungal pneumonia and 2 out of 3 of a mixed bacterial-mycotic infection. Adult respiratory distress syndrome (ARDS) led to death in 2 patients. A granulocyte count under 500/microliter correlated significantly (P less than 0.002) with the fatal outcome of bacterial, fungal and ARDS pneumonia as well as with bronchitis. Viral pneumonia led to death in 8 of 9 patients; in each there was a significant correlation (P less than 0.05) with graft-versus-host disease (GvHD). Patients with repeated episodes of pulmonary illness had significantly more chronic GvHD (P less than 0.05); several of these patients displayed a reduction in helper T cells and an increase in suppressor T cells in the peripheral blood. The natural killer (NK) cells were reduced and the percentage of activated NK cell level lay between 6% and 69%. B-cells were absent or deficient. These findings explain in part the absence of specific antibody reactivity. Five of these patients also contracted GvHD-associated obstructive bronchiolitis, which did not respond to therapy. Pulmonary infiltrates of unknown origin (including idiopathic interstitial pneumonia) occurred in 8 of the patients (11.1%), with a fatal outcome in 3 patients. Significant changes (P less than 0.05) in lung function after BMT appeared in the form of reduced vital capacity (VC) increased residual volume (RV) and an increase in RV expressed as the percentage of total lung capacity. Pulmonary diseases were the most common complication and cause of death in our patients after BMT. PMID- 3528657 TI - [Use of lasers in therapeutic clinical practice]. PMID- 3528659 TI - [Ultrasonic diagnosis of liver cirrhosis]. PMID- 3528658 TI - [Comparative evaluation of ultrasonic and thermographic methods of diagnosis of diseases of the gallbladder and biliary tract]. PMID- 3528660 TI - Aspects of endothelial malfunction and function in cerebral microvessels. PMID- 3528661 TI - Globular domain of basement membrane collagen induces autoimmune pulmonary lesions in mice resembling human Goodpasture disease. AB - A distinct circulating antibody response could be evoked in C57BL mice after immunization with the globular domain NC1 of basement membrane collagen IV obtained from the mouse Engelbreth-Holm-Swarm tumor when injected together with complete Freund's adjuvant. The antibodies reacted with various subunits of NC1, did not cross-react with other basement membrane proteins, and exhibited a tissue reactivity restricted to certain basement membranes. Tissue-bound antibodies could be detected by direct immunofluorescence and were distributed together with C3 in a linear pattern along glomerular and alveolar basement membranes. Pathological changes were mainly observed in lung and kidney and consisted of inflammatory infiltrates and massive hemorrhages with strong granulomatous fibrotic development in the lung. Kidney alterations were comparably weaker and of focal nature. A nephrotoxic serum model showed rapid binding of rabbit antibodies against mouse NC1 to lung, liver, and kidney basement membranes which was followed several weeks later by an autologous phase with anti-rabbit IgG antibodies bound to basement membranes as immune complexes. There was no fibrotic response but hemorrhagic and inflammatory lung and kidney changes similar to those after active immunization were observed after passive transfer. The experimental NC1 autoimmune model has several features such as anti-NC1 response, tissue restriction, lung hemorrhages, and glomerulonephritis in common with patients suffering from Goodpasture disease. The development of lung fibrosis appears to be unique for the animal model. PMID- 3528662 TI - Analysis of murine hepatitis virus (JHM strain) tropism toward Lewis rat glial cells in vitro. Type I astrocytes and brain macrophages (microglia) as primary glial cell targets. AB - The murine hepatitis virus, JHM strain, causes a relapsing subacute demyelinating encephalomyelitis in Lewis rats after intracranial infection. The disease process involves both virus persistence within glial cells and the induction of autoimmunological attack of myelin, however, the relative importance of these features involved in chronic relapsing demyelination remains to be determined. In this report, we analyze the tropism of JHM virus to various neural cell types present within primary Lewis rat central nervous system cultures. Infection of primary cultures with JHM virus revealed that type I astrocytes and brain macrophages are the initial target cells of infection and that the myelin-forming oligodendrocytes are comparatively resistant, becoming infected only rarely through virus mediated cell fusion with previously infected cells. In addition, infection of cultures after removal of oligodendrocytes by various means had no effect on the tropism of JHM virus for the cultures. Cytopathic effects of JHM virus proceed rapidly by cell fusion within the astrocyte-macrophage monolayer, leaving the oligodendrocyte population largely unaffected. Therefore, the highly selective infection of type I astrocytes and macrophages appears to form the basis of JHM virus neurotropism in Lewis rats. These results indicate that JHM virus infection of astrocytes and brain macrophages may be more important in inducing chronic relapsing demyelinating processes than direct infection of the myelin-forming oligodendrocytes. Other possible pathways leading to chronic demyelination in rats involving type I astrocytes and brain macrophages are discussed. PMID- 3528663 TI - Ultrastructural localization and quantitation of nephritogenic antibodies in experimental glomerulonephritis. AB - The recently developed postembedding immunoelectron microscopic technique using low temperature embedding in Lowicryl K4M has been applied for the localization and relative quantitation of nephritogenic antibodies in rats with nephrotoxic serum nephritis. Nephrotoxic serum nephritis with different degrees of severity was induced by intravenous administration of increasing doses of rabbit anti-rat glomerular basement membrane antiserum to male Wistar rats. Twenty-four hours after administration, renal tissue was processed for immunoelectron microscopy using Lowicryl embedding after fixation in paraformaldehyde. Thin sections were stained with colloidal gold-labeled antibodies to rabbit IgG. By morphometric analysis the amount of gold label per nanometer of glomerular basement membrane was counted and a strong correlation was found with the amount of administered antiserum. These data show that postembedding immunoelectron microscopy using low temperature embedding in Lowicryl K4M and immunogold staining can be applied to study the localization and relative quantitation of tissue-bound immunoglobulins. PMID- 3528664 TI - Spatial distribution and accumulation of low density lipoproteins in the abdominal aorta of swine: determination by a novel electrotransfer procedure. AB - An immunotransfer procedure has been developed which can determine both the spatial distribution of low density lipoproteins (LDL) along the intima-media of large blood vessels such as the aorta, and can quantify LDL accumulation along its length. Aortas which were opened longitudinally along their ventral aspect were positioned so that their intimal side abutted against a gel containing glyoxyl agarose to which anti-LDL had been covalently coupled. LDL was electrophoresed out of the agarose gel where it was immunofixed. This distribution was then visualized first by incubating the gel with 125I-anti-LDL which bound to free epitopes on the immunofixed LDL, and second by subjecting the washed and dried gel to autoradiography. Plasma LDL was applied to wells of different shapes and sizes in an agarose gel substituting for aortic tissue, and the transfer procedure was performed as described. The resultant patterns matched those of the original wells, suggesting that the spatial distribution of LDL in the autoradiogram probably mimicked that in the aortic tissue. The transfer procedure appeared to be specific for the antigen under study since minimal silver grains were observed in autoradiograms when an IgG fraction of nonimmune serum was used in place of anti-LDL. Application of increasing concentrations of LDL to wells in a gel substituting for tissue, resulted in a dose-dependent increase in autoradiographic grain density. If such standards were applied to gels adjacent to tissue samples, the amounts of LDL in the tissue could be quantified from the standard curve of grain density versus LDL concentration. The distribution of LDL along the abdominal aortas of 10- and 31-week-old swine was determined by converting autoradiographic grain densities to isopleths of LDL concentrations by computer assisted image analysis. These distributions were focal and were found to range between 10 and 225 ng of apoB/mm2 of intimal surface area. This procedure lends itself not only to studies relating lipoprotein accumulation to atherogenesis, but also to any studies dealing with tissue accumulation of macromolecules. PMID- 3528665 TI - Prediction of streptococcal pharyngitis: an option for school nurses? AB - In this article the authors address the dilemma confronting school nurses in determining whether or not to counsel parents about seeking medical care for a child with a sore throat. The use of a clinical scorecard in the school setting as an aid in predicting streptococcal pharyngitis is investigated. The authors conclude that the only valid solution to the dilemma is the availability of the throat culture to schools. Using the culture as an additional assessment tool augments those already proven over time--the stethoscope, scoliosis and vision screening, and the otoscope. PMID- 3528666 TI - Right-sided cardiac transplantation: importance of functional valves. AB - An original surgical procedure had been developed entailing the implantation of a right-sided heterotrophic cardiac graft in 14 dogs. The benchwork preparation included creation of both atrial and ventricular septal defects which allowed transplantation with the avoidance of extracorporeal circulation and the utilization of all transplanted myocardium and parts. The structure and function of this graft were sequentially evaluated using rapid cine-computed tomograms which permitted assessment of forward graft flow, ventricular wall contraction, and diastolic thickness for both the native and grafted hearts. These parameters were followed during the early (E) (less than 3 days), intermediate (I) (4-21 days), and late (L) (greater than 21 days) postoperative periods. Forward flow (E: 3.0, I: 1.5, L: 2.6) through the transplant was maintained by the competence of the implanted valves despite a progressive decrease in the contraction (E: 3.0, I: 1.3, L: 1.0) and associated decrease in the wall thickness (E: 3.0, I: 2.6, L: 2.4). These findings were consistent with severe cardiac graft rejection without immunosuppression. In summary, long-term structural and functional forward flow of this configurated right-sided transplantation had been maintained by the competent valves on both sides of the graft despite severe rejection without immunosuppression as documented by rapid cine-computed tomograms. PMID- 3528667 TI - Pancreatic insulin secretion in exocrine pancreatic cancer. AB - Adenocarcinoma of the exocrine pancreas in man is associated with a high incidence of diabetes mellitus. Hyperglycemia in humans with pancreatic cancer is presumed to be caused by destruction of islets of Langerhans with a resultant impairment in pancreatic insulin secretion. This hypothesis was tested in an animal model of exocrine pancreatic cancer. Carcinoma of the pancreas was induced in male Syrian golden hamsters by weekly injection of N-nitrosobis(2 oxopropyl)amine. Using an ex vivo isolated perfused pancreas preparation, the capacity of cancer-bearing pancreata to secrete insulin in response to glucose and arginine was compared to normal animals of the same age. Animals with pancreatic cancer demonstrated a normal insulin secretory response to both glucose and arginine. Thus the hypothesis that exocrine pancreatic cancer causes diabetes by directly impairing insulin release must be questioned and alternative explanations for the association of diabetes and pancreatic cancer should be sought. PMID- 3528668 TI - A comparison of porcine orthotopic liver transplantation using a venous-venous bypass with and without a nonpulsatile perfusion pump. PMID- 3528669 TI - Cancer quackery: a continuing problem. PMID- 3528670 TI - Rapid and inexpensive enzyme inhibition assay of methotrexate. AB - A rapid and inexpensive enzyme inhibition procedure has been developed for the assay of methotrexate in biological fluids. The method achieves a high degree of sensitivity, reproducibility, and specificity. No prior separation procedures are required, and there is no cross-reaction with metabolites of methotrexate or other substances such as folinic acid, which is often given concurrently with methotrexate. Results are in good agreement with those given by the more expensive enzyme multiplied immunoassay technique. The new method is 30 times more sensitive than the enzyme multiplied immunoassay technique, being capable of determining concentrations as low as 1.0 X 10(-8) M (4.5 ng/ml), a distinct advantage over the enzyme multiplied immunoassay technique, since it may be successfully employed in conducting clinical pharmacokinetic studies. PMID- 3528671 TI - Effect of distribution of unfavourable codons on the maximum rate of gene expression by an heterologous organism. AB - We have analysed theoretically the effect of the relative position of unfavourable codons on the maximum level of synthesis of foreign proteins in E. coli. We predict that the occurrence of such codons scattered in the corresponding genes has little effect. In contrast, clustering (in our terminology indicating directly adjacent codons) of unfavourable codons is predicted to dramatically reduce the maximum level of protein synthesis. The context effect would explain the reduction of expression level for a chloramphenicol acetyl transferase gene modified by Robinson et al. (1984), which contains 4 contiguous unfavourable codons. As an example, we predict that due to the different downstream contexts of unfavourable codons in the alpha 1 and beta interferon genes, the maximum level of synthesis in E. coli for these proteins will be different. PMID- 3528672 TI - A double-blind, placebo-controlled clinical study on the effect of a standardized ginseng extract on psychomotor performance in healthy volunteers. AB - Various tests of psychomotor performance were carried out in a group of 16 healthy male volunteers given a standardized preparation of Korean ginseng (G 115; 100 mg twice a day for 12 weeks) and in a similar group given identical placebo capsules under double-blind conditions. A favourable effect of G 115 relative to baseline performance was observed in attention (cancellation test), processing (mental arithmetic, logical deduction), integrated sensory-motor function (choice reaction time) and auditory reaction time. However, end performance of the G 115 group was superior statistically to the placebo group only in mental arithmetic. No difference between G 115 and placebo was found in tests of pure motor function (tapping test), recognition (digit symbol substitution) and visual reaction time. No adverse effects were reported. It is concluded that G 115 may be superior to placebo in improving certain psychomotor functions in healthy subjects. PMID- 3528673 TI - The Aloe vera phenomenon: a review of the properties and modern uses of the leaf parenchyma gel. AB - The mucilaginous gel from the parenchymatous cells in the leaf pulp of Aloe vera has been used since early times for a host of curative purposes. This gel should be distinguished clearly from the bitter yellow exudate originating from the bundle sheath cells, which is used for its purgative effects. Aloe vera gel has come to play a prominent role as a contemporary folk remedy, and numerous optimistic, and in some cases extravagant, claims have been made for its medicinal properties. Modern clinical use of the gel began in the 1930s, with reports of successful treatment of X-ray and radium burns, which led to further experimental studies using laboratory animals in the following decades. The reports of these experiments and the numerous favourable case histories did not give conclusive evidence, since although positive results were usually described, much of the work suffered from poor experimental design and insufficiently large test samples. In addition some conflicting or inconsistent results were obtained. With the recent resurgence of interest in Aloe vera gel, however, new experimental work has indicated the possibility of distinct physiological effects. Chemical analysis has shown the gel to contain various carbohydrate polymers, notably either glucomannans or pectic acid, along with a range of other organic and inorganic components. Although many physiological properties of the gel have been described, there is no certain correlation between these and the identified gel components. PMID- 3528674 TI - A multidisciplinary approach to ritual enema scenes on ancient Maya pottery. AB - There are various enema scenes on classic Maya pottery, which undoubtedly represent rituals and may very well indicate that the ancient Maya took intoxicating enemas in a ritual context. This idea is quite contrary to the traditional view that the ancient Maya were a contemplative people, who did not indulge in ritual ecstasy. The occasional display of vomiting actors would seem to provide a plausible reason why the Maya opted for rectal application. Some scenes present a fair amount of evidence that an alcoholic beverage may have been taken rectally. Anecdotal experimental evidence suggests that an alcoholic liquid may certainly induce or intensify a state of inebriation, when it is administered via the rectal route. Other scenes open up the possibility that tobacco and the water lily or some other flowering plant may have served as an enema ingredient. The phytochemistry and psychopharmacology of tobacco are well documented and there can be little doubt that this herb may produce toxic effects, when it is taken in the form of a clyster. Unfortunately, little is still known about the constituents and pharmacological activity of the water lily. It is sometimes speculated that this plant is hallucinogenic, but experimental confirmation of this view is still awaited. PMID- 3528675 TI - Hypotensive effect of Rhamnus lycioides extracts. AB - Intravenous administration of a lyophilized hot water extract and various organic solvent extracts of Rhamnus lycioides to normotensive anesthetized Wistar rats produced a lowering of systemic arterial blood pressure. Acute toxicity of the lyophilized extract was studied in mice by intraperitoneal injection. The phytochemical analyses revealed the presence of steroids-triterpenes, catechin tannins, flavonoids, sugars and resins. PMID- 3528676 TI - Constrictive perivenous mesh prosthesis for preservation of vein integrity. Experimental results and application for coronary bypass grafting. AB - Saphenous veins undergo dramatic morphologic changes when used as coronary bypass grafts, and careful preparation of the graft alone is inadequate in preventing these changes. In this study, the use of a constrictive mesh for vein graft was evaluated. Fourteen sheep were subjected to a 5 cm resection of the carotid artery. Six sheep (Group A) received a jugular vein interposition graft, and the other eight sheep (Group B) received a jugular vein graft on which the constrictive mesh had been applied. The diameter of grafts in Group A was 14 +/- 1 mm compared with 7 +/- 0.5 mm for Group B (p = 0.05). The animals were put to death 4 months later. Scanning electron microscopy showed a disruption of the endothelial lining in Group A and a normal endothelium in Group B. Microscopy showed a statistical difference between Groups A and B regarding regularity and thickness of the intimal hyperplasia. Group B showed a moderate and regular intimal thickening and increased vasa vasorum. This indicates that distention and subsequent damage of the vein graft may be minimized by use of a constrictive mesh. Saphenous grafts surrounded by this constrictive mesh were inserted in four patients. Vein diameters were, respectively, 5, 4.3, 3.5, and 3.5 mm before meshing. After insertion in the mesh, vein diameters were 4.3, 3.5, 2.8, and 2.5 mm, respectively. Angiography performed 2 months later showed patent grafts of regular caliber. PMID- 3528677 TI - Aortoventriculoplasty in children. AB - Aortoventriculoplasty was performed in 16 children between July, 1980, and July, 1984. Indications for the procedure were 1) aortic stenosis or insufficiency, or both, necessitating replacement of an aortic valve whose anulus would not accept a 19 mm diameter valve, (2) replacement of a small valve prosthesis, or (3) recurrent tunnel subaortic stenosis. Patients were 5 months to 17 years old at operation, 14 had previous repairs, and four had prior aortic valve replacement. There were 13 long-term survivors followed up for 14 to 38 months; 12 are asymptomatic with normal exercise tolerance. Three had residual ventricular septal defects, two requiring repair. All patients were given warfarin with or without antiplatelet agents. There have been no thromboembolic episodes and no hemorrhagic complications. Aortoventriculoplasty is well tolerated in children and appears to be a viable surgical option in the management of young patients with a hypoplastic left ventricular outflow tract. PMID- 3528678 TI - Surgical ablation of posterior septal accessory pathways in the Wolff-Parkinson White syndrome by a closed heart technique. AB - The conventional technique for surgical ablation of posterior septal accessory pathways in the Wolff-Parkinson-White syndrome has been associated with a significant incidence of inadvertent permanent atrioventricular block. We report our experience with the ablation of posterior septal accessory pathways by a closed heart technique that combines mobilization of the posterior septal atrioventricular fat pad and exposure and cryoablation of the atrioventricular junction. The operation is performed on the normothermic beating heart. Consequently, atrioventricular node-His bundle conduction and accessory pathway conduction can be continuously monitored to avoid inadvertent injury to the atrioventricular node-His bundle system. This technique for ablation of posterior septal accessory pathways was used in 13 patients (four female and nine male patients, aged 14 to 59 years). The heart was exposed via a median sternotomy. Epicardial mapping was used to determine the insertion of the accessory pathway either to the left ventricular process or the immediately adjacent right or left ventricular free wall. Normothermic cardiopulmonary bypass was used in nine patients and omitted in four. Accessory pathway conduction disappeared in the course of dissecting the fat pad from the atrial wall and atrioventricular sulcus in all patients. Cryosurgical lesions were then applied to the atrioventricular sulcus in the area of interest (while monitoring atrioventricular conduction) to ensure transmural fibrosis of the atrioventricular ring. All patients tolerated the procedure well. There were no complications and, specifically, not a single instance of atrioventricular block. All patients remain arrhythmia free after a follow-up period of 10 months. This closed heart approach allows the ablation of posterior septal accessory pathways while the electrocardiogram is being monitored. It obviates the need for aortic cross-clamping and minimize the risk of inadvertent heart block. PMID- 3528679 TI - Perigraft seroma: long-term complications. AB - A 5 1/2-year-old child is described in whom a perigraft seroma complicating a polytetrafluoroethylene tubular graft was managed conservatively for 4 years without disruption of the function of the graft or progressive distortion of the pulmonary arteries. PMID- 3528680 TI - Long-term culture of infant leukemia cells: dependence upon stromal cells from the bone marrow and bilineage differentiation. AB - Infant leukemia cells with 46XY,t(11; 17)(q23; p13) karyotype and a hybrid pre B myeloid phenotype (HLA-DR, (Ia), B4 and My7-positive and CALLA and T11-negative) and immunoglobulin heavy chain gene rearrangement were maintained in long-term culture for over 10 months. The in-vitro survival and growth of the leukemia cells were strictly dependent upon the presence of their autologous marrow stromal cells. The latter could be replaced by the 14F1.1 clone of preadipocytes derived from mouse bone marrow. Neither heterologous human marrow or foreskin fibroblasts nor fibroblast or endothelial like cell lines from mouse stroma could mimic the effect of autologous stroma or 14F1.1 adipocytes. The leukemia cells maintained their original phenotype throughout the 10-month culture period with either their autologous stroma or the 14F1.1 adipocytes. They could be induced to differentiate in two distinct directions. Phorbol myristate acetate induced adherence of the leukemia cells and development of macrophage properties. In contrast, conditioned medium from a hybridoma producing B-cell growth factor caused aggregation of the leukemia cells and expression of CALLA antigen and surface IgM. This bipotency of the leukemia cells and their dependence upon marrow stroma are properties in common with stem cells. PMID- 3528681 TI - The stem cell concept revisited: self-renewal capacity is a dynamic property of hemopoietic cells. AB - A rigid developmental program of stem cell division and progressive maturation into blood cells is challenged. It is proposed that the capacity for self-renewal is not limited to pluripotent stem cells but is shared by committed progenitors and even cells of later compartments. The relative probability of self replication vs maturation in mitotic cells is controlled by extracellular influences. At the cell population level, the balance between proliferation and maturation and between compartments is regulated by feedback interactions. Inducibility of maturation in response to regulatory signals is smaller at earlier stages; consequently, at steady state primitive cells self-renew while their more differentiated progeny are forced to be transitory. The proposed dynamic linkage between compartments can be destabilized in a number of ways, resulting in defective hemopoiesis or leukemia. At all stages hemopoietic cells are able to change their patterns of gene expression, in an inheritable manner, in response to changes in their microenvironment. In particular, the capacity for self-renewal itself can vary even within a conventionally-defined compartment. On this basis of adaptive differentiation and self-renewal it is possible to account for the progression of chronic myelocytic leukemia and its "blastic conversion"; to analyse the hemopoietic system's response to various physiological and experimental perturbations; and to re-interpret the excessive phenotypic plasticity and apparent "lineage infidelity" manifested by leukemic cells and cell lines. PMID- 3528682 TI - Adherent cells in cultures of blast progenitors in acute myeloblastic leukemia. AB - Blast cells from patients with acute myelogenous leukemia (AML) grow exponentially in suspension culture and form colonies in cultures "stiffened" with methylcellulose; under both culture conditions, cells are generated which have the ability to adhere to plastic or glass. These adherent cells lack the capacity to form colonies, to proliferate in liquid culture or to support growth. Adherent cells are generated in parallel with changes in the frequency of clonogenic cells and express surface markers of AML blasts but with a higher frequency of an antigen recognized by the monoclonal MO1, a late stage marker associated with the macrophage differentiation lineage. While the appearance of adherent cells provides further evidence that blast cells follow differentiation programs in culture, the generation of adherent cells does not indicate that normal differentiation is occurring; rather the data is consistent with the view that components of normal monocytic differentiation programs are assembled abnormally in the programs of some blast progenitors. PMID- 3528683 TI - In vivo voltammetry: some methodological considerations. PMID- 3528684 TI - A threedimensional reconstruction program for personal computers. AB - A reconstruction program is described for personal computers, permitting threedimensional image reconstructions from serial sections. This program also makes it possible to calculate the volume of structures from their twodimensional images in histological sections. In this paper we show a program written in BASIC and debugged on a Sharp MZ-700 personal computer, equipped with the Sharp MZ-1P01 plotter. The program is explained in detail and is easily adapted to run on any personal computer. PMID- 3528685 TI - Abstracts. XIII annual meeting, European Society for Artificial Organs in conjunction with the Societe Francaise d'Hemapherese and Societe de Chirurgie Vasculaire, Avignon, France, September 1986. PMID- 3528686 TI - Lung injury following cardiopulmonary bypass; the potential role of oxidant-free radicals. PMID- 3528687 TI - Clinical experiences with the treatment of peripheral vascular diseases. PMID- 3528688 TI - Pathogenesis and treatment of infantile osteopetrosis. PMID- 3528689 TI - The Warsaw Society of the Friends of Sciences (WTPN). PMID- 3528690 TI - Doctor Karol Jonscher's hospital in Lodz (1884-1984). PMID- 3528691 TI - Insulin-dependent diabetes mellitus: pathophysiology. AB - Diabetes mellitus is a heterogeneous disorder. About 80% of the patients with this disease are categorized as having non-insulin-dependent diabetes mellitus, a disorder resulting from varied degrees of insulin resistance and impaired insulin secretion; the causes for these abnormalities are unknown. The remaining 15 to 20% of patients have insulin-dependent diabetes mellitus, a disorder caused by the destruction of insulin-producing endocrine cells within the pancreas and currently considered to be the result of an autoimmune process. During the course of both types of diabetes mellitus, the so-called long-term complications of diabetes invariably occur to some extent in all patients. These complications include retinopathy, nephropathy, neuropathy, and premature atherosclerosis. The molecular basis for these complications is not completely understood, but recent evidence obtained from both experiments in animals and prospective clinical studies indicates that metabolic derangements associated with poor glycemic control are a major determinant of the frequency and severity of these complications. Such evidence is the rationale for current attempts to maintain near-normal glycemia in patients with diabetes mellitus. PMID- 3528692 TI - What is "tight control" of diabetes? Goals, limitations, and evaluation of therapy. AB - Complete normalization of the blood glucose concentration is the ideal goal in patients with diabetes. Because of deficiencies in therapeutic modalities for diabetes, achievement of approximation of normoglycemia is usually a satisfactory result. Generally, blood glucose ranges of 70 to 120 mg/dl preprandially and less than 160 to 180 mg/dl 90 minutes postprandially in nonpregnant patients with diabetes are considered appropriate. Diurnal variations in glycemia can be caused by the size and composition of meals, the time of day a meal is eaten, stress, and exercise. Self-monitoring of blood glucose by the patient and measurement of glycosylated hemoglobin have been useful in achieving control of diabetes. PMID- 3528693 TI - Practical aspects of intensive insulin therapy. AB - Application of the principles of intensive insulin therapy in an attempt to achieve near-normal glycemia necessitates making many practical decisions for each patient. Often these decisions must be based on experience and opinion because the questions have not been studied adequately enough to be answered definitively. One approach to selection of patients, initiation of therapy, insulin management, blood glucose monitoring, and patient follow-up is reviewed. PMID- 3528694 TI - Complications of insulin-dependent diabetes mellitus: management of insulin reactions and acute illness. AB - Occasional mild hypoglycemia is an unavoidable and usually acceptable side effect of intensive insulin therapy. Patients with insulin-dependent diabetes mellitus may have impaired glucose counterregulation, which may increase the risk of hypoglycemia and justify less ambitious glycemic goals. A conservative but flexible approach to the treatment of insulin reactions is appropriate in order to avoid hyperglycemia. Insulin requirements are often increased during acute illness, and frequent self-monitoring of blood glucose concentrations is necessary to determine the need for supplementation with regular insulin. Frequent supplementation, together with modification of diet and maintenance of fluid intake, should not only minimize the need for hospitalization but also prevent severe deterioration in glycemic control. PMID- 3528696 TI - Cultured autologous skin for burns. PMID- 3528695 TI - Diabetes and pregnancy: control can make a difference. AB - In pregnant patients who have diabetes mellitus, metabolic control has been demonstrated to improve neonatal outcome considerably. All pregnant patients should be screened for gestational diabetes at 24 to 28 weeks of gestation with use of a glucose challenge test. Dietary therapy, and insulin therapy when appropriate, reduces the neonatal mortality associated with gestational diabetes to that of normal pregnancy. Macrosomia remains a problem, but aggressive use of insulin therapy may minimize this complication. Intensive control of insulin dependent diabetes both before conception and during pregnancy is essential. The risk of congenital malformations can be reduced to that associated with normal pregnancy if diabetes is well controlled during the first 8 weeks of pregnancy. Neonatal survival, macrosomia, and hypoglycemia also are directly related to the degree of control of maternal diabetes during the pregnancy. PMID- 3528697 TI - Fencing master early advocate of physical education. PMID- 3528698 TI - Malignant lymphoma in Olmsted County, Minnesota, 1970 through 1977. AB - A study of the incidence of malignant lymphoma in Olmsted County, Minnesota, revealed 91 new cases during the period 1970 through 1977. On the basis of the analyzed data, the overall average annual incidence rate per 100,000 population was 12.2 for males and 14.2 for females. The rates for both sexes combined (unadjusted for age) were 1.5 for Hodgkin's disease, 6.2 for lymphosarcoma, and 5.5 for reticulum cell sarcoma. The incidence rate for Hodgkin's disease decreased insignificantly, whereas that for both lymphosarcoma and reticulum cell sarcoma increased significantly during the period 1970 through 1977 in comparison with rates from the period 1945 through 1969. The largest increase was for rural males, for whom the rates for all three histologic types of lymphoma were substantially higher than those for urban males. PMID- 3528699 TI - Serum beta 2-microglobulin. PMID- 3528700 TI - French diplomat proclaims the medicinal properties of tobacco. PMID- 3528702 TI - Measurement and characterisation of the acoustic output of medical ultrasonic equipment. Part 2. PMID- 3528701 TI - Comparative histochemical distribution of nerve fibres storing noradrenaline and neuropeptide Y (NPY) in human ovary, fallopian tube, and uterus. AB - Nerves containing noradrenaline were studied by formaldehyde-induced fluorescence and neuropeptide Y (NPY) was visualised by immunohistochemistry in the human ovary, Fallopian tube and uterus. All structures were richly supplied with noradrenergic fibres closely associated with the vascular and non-vascular smooth musculature. NPY-containing nerve terminals were consistently fewer, particularly in the ovary. The best developed nerve supply was found in the tubal isthmus and uterine cervix. Vessels were usually innervated by plexuses of nerves, containing NPY as well as noradrenaline. The discrepancy between the number of the two types of histochemically distinguishable nerves suggests that, if noradrenaline and NPY are co-localised in one and the same nerve, this is not a constant phenomenon in the human female reproductive tract. PMID- 3528703 TI - Evaluation of the attenuation coefficients in normal and pathological breast tissue. PMID- 3528704 TI - Online measurement of mechanical parameters in ventilated neonates with rejection of unrepresentative cycles. PMID- 3528705 TI - [Cruorifilaria tuberocauda (Nematoda: Filarioidea) in Venezuelan capybaras]. AB - Four filariae are known to parasitize the capybara "Hydrochoerus hydrochaeris" namely the "Cruorifilaria tuberocauda", Eberhard, Morales & Orihel (1976). The "Dipetalonema (Alafilaria) hydrochoerus", Yates (1983), and two "mansonella" recently described by Eberhard, Campo-Aasen & Orihel (1983), "Mansonella longicapita" and "Mansonella rotundicapita". In this study we describe the adult parasites and the microfilaria of the "Cruorifilaria tuberocauda" (Nematoda, Filarioidea), Eberhard, Morales & Orihel (1976) obtained from the arteries of the kidney of two capybaras from Apure and Barinas states of Venezuela. The pathology produced by the presence of the filariae in kidney and lungs of the animals is described as well as the blood harboring microfilaria. PMID- 3528706 TI - [Dipetalonema (Alafilaria) hydrochoerus Yates (1983)]. AB - Four filariae are known to parasitize the capybara "Hydrochoerus hydrochaeris" namely the "Cruorifilaria tuberocauda", Eberhard, Morales & Orihel, 1976; the "Dipetalonema (Alafilaria) hydrochoerus", Yates & Jorgenson, 1983, and "Mansonella longicapita" and "Mansonella rotundicapita [corrected]", Eberhard, Campo-Aasen & Orihel, 1983. In this study we describe briefly the adult parasites and, the microfilaria of the species "Dipetalonema (Alafilaria) hydrochoerus" which were isolated from skin nips and we have found that the capybara "Hydrochoerus hydrochaeris" is parasitized in a proportion of 80% in the 16 animals studied. PMID- 3528707 TI - [Reactive perforating collagenosis. Apropos of a case and review of the literature]. AB - We present the case of a patient with the clinical and histopathological diagnosis of Reactive Perforating Collagenosis, the first case described in the Venezuelan Dermatological literature. The most frequent histopathological and differential clinical diagnoses are reviewed with regard to Kyrle's disease, Elastosis Perforans Serpiginosa and Perforating Folliculitis. Clinically our patient presented with a papular eruption over an erythematous base on the right forearm and the dorsum of the right hand. On the lower third on its ventral aspect these papules adopted a linear distribution suggesting an isomorphic reaction. Histopathologically, the phenomena of transepithelial elimination was observed. Finally we reviewed the multiple treatment modalities described in the literature for this disease. We treated our patient with topical retinoic acid at a 0.05% concentration nightly for seven nights with excellent results. At the present time she is free of cutaneous lesions. PMID- 3528708 TI - [Surgical treatment of baldness. 20 years' experience]. AB - After giving an introduction on the surgical treatment of alopecia in the last years, we talk about our experience with more than 2,500 patients. We discussed in individual chapters each one of the four major methods for the surgical management of male pattern alopecia: punch grafts, strip grafts, scalp reduction, flaps and combined techniques. In general more than the half of those patients have been seen and controlled for long time, because the most of them have continued with the clinic treatment in correspondence with the skin-hair pathology. PMID- 3528709 TI - [Clinical trial of a topical preparation containing urea, sunflower oil, evening primrose oil, wheat germ oil and sodium pyruvate, in several hyperkeratotic skin conditions]. AB - A topical clinical trial with preparations containing urea and sodium pyruvate has been made. It was used for diverse hyperkeratotic skin conditions (psoriasis, xerosis, pityriasis rubra pilaris, stuccokeratosis, seborrheic dermatitis, stasis dermatitis, pityriasis lichenoides chronica). A month later a clinical improvement was evident in all cases except in pityriasis lichenoides. PMID- 3528711 TI - [Kyrle's disease. Synonym: hyperkeratosis follicularis et parafollicularis in cutem penetrans. Report of a case]. AB - In El Salvador is observed the first case of Kyrle's disease. It's clinic pathologic study is conclusive for such a dermatologic entity. PMID- 3528710 TI - [Autoantibodies in vitiligo. Clinical significance]. AB - The occurrence of circulating autoantibodies was determined by indirect immunofluorescence in patients with vitiligo. In addition we determined the existence of anti-melanocytic antibodies by an immunofluorescence complement fixation technique, immunoglobulins in achromic and perilesional skin, complement (C3 and C4) and immunoglobulins in serum by immunoelectrophoresis. The results only indicate that a significant occurrence of circulating autoantibodies exists, especially antithyroid autoantibodies, which, moreover, are related to the vitiligos which affect important areas of the cutaneous surface (generalized vitiligo). PMID- 3528712 TI - [Skeletal changes caused by etretinate]. AB - A patient of 4 years of age, male is presented, that suffered from generalized pustulous psoriasis. The small response to prednisone and the aggravation of the symptomatology motivated the use of etretinate, in the dose of 1 mg/kg/day during six months obtaining the remission. Two years later he was seen again having minimal lesions of periumbilical psoriasis, observing delay in the growth, and in the radiological exam: periostic separation in the inferior part of femur, modeling alteration of the metaphysis, diffuse demineralization, slender bone, and a bone age of one and a half year. The authors advise over the necessity of controlling children that must receive etretinate, with clinic and periodic radiological exams. PMID- 3528713 TI - [Lupoid syndrome in "BCG-itis." Report of a case]. AB - It is presented the first case of lupoid syndrome of "BCG-itis" found in El Salvador. Its clinic-pathological study is conclusive for such dermatological entity. The complications of vaccination with BCG are rare. It must be treated as an active tuberculosis, but with a greater control of the patient. PMID- 3528714 TI - [Autochthonous cutaneous leishmaniasis in El Salvador. Report of 5 cases]. AB - It has been done a bibliographic review of Salvadorean scientific works on leishmaniasis cutaneous from January 1900 to June 1984. The skin manifestation is not an epidemiologic problem up to now. It is possible that insecticides, used on cotton and coffee crops, as well as in the fight against malaria, etc., play a definite role. Instead of antimony components, it is suggested the use of phosphate of chloroquine inter-lesional. PMID- 3528715 TI - [Ashy dermatitis. Comments on 2 clinical forms]. AB - The typical clinical characteristic of the ashy dermatitis is the fact that in case of light colored skin, the grey colour remains invariable. There is a new clinical form which is called the Brown Cinder Dermatitis which is characterized by a disciplined localization in the center of the face, trunk or upper extremities together with an inexorable change of the grey colour at the beginning to a brown colour at the end on the other it, has be enhanced the existence of the nummular form which is characterized by the existence of many greyish independent spots of circular or oval form mainly at the level of the trunk. PMID- 3528716 TI - [The man behind the syndrome: Douglas Argyll Robertson. He started the debate on the Argyll Robertson pupil--a peculiar ocular condition, not yet completely clarified]. PMID- 3528717 TI - [Structure and function of growth cartilage--a review]. PMID- 3528718 TI - [Indications for postoperative human albumin therapy in the intensive care unit- a prospective randomized study]. AB - In a prospectively randomised study (n = 161) we examined whether postoperative human albumin administration is justified in intensive care patients whenever the colloid osmotic pressure (COP) decreases below 26 cm H2O. Postoperative complication rates did not increase in the control group, although only 22% of these patients received albumin as compared to 100% in the therapy group. A decline of the COP below extreme values (even under 20 cm H2O) was compatible with survival. This study established only one indication for postoperative human albumin therapy: acute volume substitution in patients on dialysis. Consequently, in the second half year of this study only 3 of 49 patients of the control group received human albumin therapy. PMID- 3528719 TI - [Surgical treatment of bile duct cysts in childhood]. AB - Nine cases of cystic and cylindric bile duct dilatation are discussed. They were treated at the Children's Surgical Hospital of the University of Munich from 1970 to 1984. The patients' mean age was 4.2 years. Upper abdominal sonography in combination with hepatobiliary functional scintigraphy or computer tomography has been proven the best diagnostic procedure. The operating procedure of choice is a total cyst excision followed by an end-to-end anastomosis or a hepatojejunostomy according to the Roux-Y-technique. There were no immediate postoperative complications such as cholangitis. In one case we found a stenosis of the anastomosis after primary hepatocholedochostomy. PMID- 3528721 TI - [Use of imaging procedures in the diagnosis of jugular vein thrombosis]. AB - Based on ten patients suffering from internal jugular vein thrombosis the use of modern radiological procedures is discussed. The clinical examination should be followed by high-resolution ultrasonography. In most cases ultrasonography is able to reveal the correct diagnosis. Complementary computed tomography is recommended, if ultrasonography cannot establish the diagnosis of jugular vein thrombosis or if the thrombosis involves the v. cava superior, respectively the mediastinum. Retrograde catheter venography of the internal jugular vein is unnecessary, phlebography of one or both upper extremities should be completed, if the internal jugular vein thrombosis continues to the v. subclavia or v. cava superior and surgical intervention is discussed. PMID- 3528722 TI - [Initial results of digital video image analysis procedures in the evaluation of endoscopic ENT findings]. AB - Recent developments in data processing allow transformation of video frames into digital information. This makes it possible to perform computerised analysis of endoscopic ENT-videos. Two simple pilot systems ("Genlock Computer with Superimposer" and "Videodigitizer") are shown to discuss the advantages and drawbacks of these methods. PMID- 3528720 TI - [Polyglactin 910 (Vicryl) net in myringoplasty. An animal experiment and clinical study]. AB - According to studies by Dociu (1978), the resorption of Vicryl sutures causes only a slight foreign-body reaction in the back musculature of rats. Similarly, in experimental studies by Bowald et al. (1978) Vicryl mesh is reported to be an excellent material for use in the reconstruction of arteries; the chief virtue attributed to it is that it promotes cell proliferation during the healing process, and so promotes the growth of new arterial walls. Stimulated by Dociu's and Bowald's favourable results, we decided to study the influence of an impregnated, and hence stiffer, Vicryl mesh on the outcome of myringoplasties. Myringoplasties were performed on both ears of 15 cats. One ear drum of each cat was reconstructed with fascia and Vicryl mesh, the other (= control) ear drum with fascia only. In addition, myringoplasties with autologous fascia and Vicryl mesh were performed on 18 patients. The absorption of Vicryl mesh results in a temporary but pronounced foreign-body reaction. In consequence, the tympanic membrane temporarily thickens and is thoroughly vasculated. According to our findings Vicryl mesh does not promote the growth of a new tympanic membrane. In our patients we noticed pulpy swelling of the fascia after myringoplastic surgery with fascia and Vicryl mesh. From the above we conclude that Vicryl mesh is not suitable for splintage in myringoplastic surgery. PMID- 3528723 TI - [Extracranial aneurysms of the internal carotid artery--an otorhinolaryngologic problem?]. AB - The problem of high cervical internal carotid aneurysms is demonstrated in two patients. One patient presented with a massive intermittent bleeding in the nasopharynx, the second with a sudden paralysis of the cranial nerves 9-12. 2/3 of these extracranial internal carotid aneurysms are situated at the bifurcation of the common carotid artery and 1/3 are located proximal the skull base. These aneurysms can be "congenital" or traumatic in origin or may arise as a complication of otitis media or tonsillitis. Diagnosis should be established by arteriography. Even for asymptomatic aneurysms the present therapeutic concept consists of a multidisciplinary surgical approach with attempted vascular reconstruction, since spontaneous rupture may occur at any moment. PMID- 3528724 TI - [Adverse effects of drugs on the hearing organ]. AB - Many different classes of drugs are known to produce ototoxicity. They include such commonly used agents as salicylates and diuretics but the most important of them are the ototoxic antibiotics, particularly those of the aminoglycoside group. The toxic effects result from an initial selective damaging to the organ of Corti (hair cells) or the secretory cells of the stria vascularis. Both damaging mechanisms are dose-dependent. The ototoxic risk of the different drugs is described. PMID- 3528725 TI - [Efficacy of naftidrofurylhydrogenoxalate (Dusodril) as adjunctive therapy of patients with acute acoustic trauma. A controlled double-blind study]. AB - A study was carried out on 60 patients who had suffered an acute acoustic trauma. The aim of the study was to examine the effect of using naphtidrofurylhydrogen oxalate (Dusodril Pi. i.v. or Dusodril ret.) as an adjunctive measure alongside dextran-40 infusions (Thomaedex 40). After spontaneous remissions had been largely excluded, the patients were randomly assigned to two therapy groups. Very similar results were obtained in the naphtidrofurylhydrogen oxalate group and in the control group (30 patients each), showing that the use of this drug as an adjunctive therapeutic measure in the treatment of high-frequency hearing loss or alleviated tinnitus does not produce a significant improvement of results. PMID- 3528726 TI - Testing ciliary activity in patients with chronic and recurrent infections of the upper airways: experiences in 68 cases. AB - The clinical use of various tests of ciliary activity is uncertain and the purpose of this study is to assess the practical significance of the most current methods. Therefore, biopsy specimens of the nasal mucosa were investigated by means of phase contrast microscopy in 68 patients with chronic and recurrent infections of the upper airways. In 19 cases an absent or extremely weak ciliary activity could be demonstrated. Ultrastructurally, a characteristic pattern of defective dynein arms as observed in primary ciliary dyskinesia, was evident in only 3 out of these 19 patients. Measurements of the mucociliary transport velocity by means of intranasal Tc 99m labeled particles appeared to be unreliable in cases of severe nasal obstruction. In this study, phase contrast microscopy of biopsy material from the nasal respiratory epithelium appeared to have the most advantages: It is a practical and rather simple screening test in the assessment of ciliary activity. PMID- 3528728 TI - Drugs and nutrition in old age. AB - Drug effects are influenced by physiologic and pathologic changes that occur as a consequence of aging. The elderly may be more disposed to drug-induced nutrient depletion because of chronic illness, inadequate diet and long-term drug use. Digoxin, isoniazid, corticosteroids, diuretics and psychoactive agents pose special hazards to the nutritional status of elderly patients. On the other hand, dietary factors, such as protein levels or vitamin deficiencies, may be important determinants of age-related changes in drug disposition or toxicity. PMID- 3528727 TI - Vestibular morphological analysis of the effects of cisplatin vs. platinum analogs, CBDCA (JM-8) and CHIP (JM-9). AB - Synthetic second generation chemotherapeutic platinum analogs are presently being tested to identify an analog with greater antitumor activity, but less ototoxicity and nephrotoxicity than cisplatin. The objective of this study was to analyze potential vestibular effects of cisplatin and of the two platinum analogs, CBDCA (cis-diammine 1,1-cyclobutane dicarboxylato [2]-0,0(1) platinum or JM-8) and CHIP (cis-dichlorotrans-dihydroxy-bis(isopropylamine) platinum [IV] or JM-9) using scanning and transmission electron microscopy of vestibular neuroepithelium from the albino guinea pig. Vestibular neuroepithelial damage was not demonstrated in either cisplatin- or the analog-treated animals when administered at equitoxic doses. PMID- 3528729 TI - Charles Frick: Professor of Materia Medica 1823-1860. PMID- 3528730 TI - Donald Theodore Lewers MD, Med-Chi's 126th president. PMID- 3528731 TI - [Changes in hemodynamics and ECG in dogs following whole-body external gamma irradiation]. AB - Experiments were made on dogs of both sexes aged 2 to 4 with the body mass of 15.3 +/- +/- 1.1 kg. The animals were exposed to single external whole-body gamma beam irradiation with 60Co at a dose rate of 1.03-1.3 mA/kg. The exposure dose was 51.6 mC/kg. It was shown that the irradiated dogs developed hemodynamic shifts indicating the formation of conditions first for the overstrain of the left cardiac region (arterial hypertension and a decrease in the vascular coefficient indicating an increase in the precapillary tension of the greater circulation) and then for that of the right cardiac region (an increase in the vascular coefficient, concomitant weakening of the precapillary tension of the greater circulation and an elevated influx of the venous blood to the right cardiac region). According to the ECG results, gamma-beam irradiation at a dose of 51.6 mC/kg resulted in noticeable stabilization of cardiac rhythm as compared to the initial one in the course of one month. Later on the irradiated animals developed more marked tachycardia as compared to the control animals of the same age. In most cases tachycardia was combined with bradycardia. After 3.5-4,5 years 75% of the dogs showed signs of the left ventricular overstrain which 6.5-7 yrs later were supplemented in 50% of the animals by the "P-pulmonale" complex typical of the overstrain of the right atrium. In most dogs the formation of the signs of the overstrain of the left and right cardiac regions over time was accompanied by clear-cut changes in the position of the heart. A significant disorder of myocardial function in the irradiated animals showed evidence for the appearance of the coronary T wave in leads II and III and aVF lead. PMID- 3528732 TI - [Tolerance of the brain and spinal cord to fractionated irradiation]. PMID- 3528733 TI - [Ultrasonic device for studying respiratory movements of the fetus]. AB - A simple ultrasonic doppler device based on the Soviet models of echotachocardiographs is proposed. It is designed for recording fetal respiratory motions. With the device, the method will find more wide applications in detecting fetal conditions. PMID- 3528734 TI - [Echo-oculometer EOM-23]. PMID- 3528735 TI - [Device for producing latticed grafts from dermatome flaps]. AB - In a newly developed device for producing reticular transplants from dermatome grafts a spiral knife is used as a cutting tool. Due to such design it became possible to change smoothly the incision step when cutting the dermatome graft. PMID- 3528736 TI - [Neurobiologic effects of light and depressive pathology]. PMID- 3528737 TI - Present and future clinical position of magnetic resonance imaging. AB - Following the appearance of the first clinical reports on magnetic resonance imaging (MRI) five years ago, stock is now taken of the clinical value of this new imaging technique and its future potential is assessed. Contrast and spatial resolution as well as specificity of CT and MRI are compared and the multiplicity of sequences, multiplanar facility, and flexibility of MRI over CT are analyzed. The dominant role of MRI over CT in the study of some disorders of the central nervous system is assessed and so are the limitations. In this context the usefulness of paramagnetic contrast media is also evaluated. The difficulties of body imaging are discussed. The solutions of overcoming cardiac and respiratory motions artifacts are evaluated and areas where MRI has already achieved a high level of clinical application are identified. Mention is made of additional information obtainable by MRI as, for example, sodium imaging, blood flow measurements, and the combination of imaging with spectroscopy. Possible future prospects are analyzed, for example, high-resolution imaging, alternative sequences to those commonly used in particular the short TI IR sequence (STIR), chemical shift imaging, and the possibility of utilizing susceptibility for imaging purposes. The problem of radiofrequency receiver coil design is approached and so is the choice of magnetic fields. The future relationship of MRI with established noninvasive techniques is stressed. PMID- 3528738 TI - Fungemia due to Coccidioides immitis. An analysis of 16 episodes in 15 patients and a review of the literature. AB - Sixteen episodes of fungemia due to Coccidioides immitis were identified in 15 patients over a 7-year period at 2 hospital associated with the University of Arizona in Tucson. Fourteen of the 15 patients were male and 13 had an underlying condition, including malignancy in 6 and AIDS in 3. Ten of the patients were receiving corticosteroids at the time of fungemia. TP antibodies were present in 5 of 9 episodes and some titer of CF antibody was present in 7 of 11 instances. None of the 10 patients tested had a positive 1:100 coccidioidin skin test. In 11 of 15 episodes, a miliary chest roentgenographic pattern was apparent at the time of fungemia. Eleven of the 16 episodes ended in death within 1 month of the positive blood culture. Fungemic patients were compared to patients with culture proven coccidioidomycosis without fungemia and differed from them significantly in 3 respects. First, fungemic patients were more likely to have a diffuse miliary pattern on chest radiograph. Second, all fungemic patients had, by definition, disseminated coccidioidomycosis and this was more likely among fungemic patients than among non-fungemic patients. Finally, fungemic patients were more likely to die within 1 month of the positive culture for C. immitis. Fungemia occurred in greater than 30% of patients with culture-proven coccidioidomycosis who had a blood culture performed. These results suggest that coccidioidal fungemia is a marker for a severe, acute form of disseminated coccidioidomycosis associated with a high mortality. PMID- 3528739 TI - [Urinary excretion of beta 2 microglobulin in workers chronically exposed to various heavy metals]. AB - Increased urinary excretion of beta-2-microglobulin (b2m) is regarded as one of the earliest indices of the lesion of renal tubules. A great usefulness of the determination of this protein has been demonstrated in workers chronically exposed to heavy metals. The investigations have been carried out in 79 workers chronically exposed to cadmium, 39 workers chronically exposed to mercury and 31 non-exposed subjects. The urinary b2m concentration in all subjects was determined using the radioimmunoassay technique. In their own investigations the authors found, in 27.8% of the cadmium-exposed subjects, an increased excretion of b2m, a correlation being found between the urinary concentration of this protein and cadmium r = 0.696. Mercury-exposed workers did not exhibit an increased urinary excretion of b2m. PMID- 3528740 TI - [Problems related to studies on the mortality of industrial workers exemplified by observations of persons exposed to asbestos dust]. AB - The most significant problems strictly connected with studies of mortality in industrial cohorts are: selection of reference population, obtention of data for cohorts in historically prospective studies (completeners and reliability of sources of information on employment and death), determination of exposure in retrospective cohorts, disturbing factors, methods of statistical analyses. Basing on literature and their own experience the authoresses thoroughly analysed the first three methodological issues related to studies of mortality rates in industrial cohorts. PMID- 3528741 TI - Fasting- and meal-stimulated peptide hormone concentrations before and after gastric surgery for morbid obesity. AB - The influence of morbid obesity and of gastric surgery operation in circulating peptide hormone concentrations was studied in 26 patients. Plasma hormone levels were determined in the fasting state and after a standardized test meal before and six to nine months after gastric surgery. Before surgery fasting and postprandial blood glucose and hormone levels did not significantly differ in morbidly obese subjects from those in obese or normal subjects, except that in morbidly obese subjects, postprandial gastrin concentration remained at peak levels and did not return to fasting levels 120 minutes after the test meal. An average weight loss of 92 lb following the gastric surgery operation was accompanied by a decrease of fasting glucose and insulin levels and a decreased postprandial insulin response. There were no significant differences in plasma levels of pancreatic glucagon, of pancreatic polypeptide in the basal state, or of pancreatic glucagon after the test meal between the preoperative and postoperative groups. As compared to preoperative values, fasting gastrin levels decreased after surgery, the postprandial release of gastrin was virtually absent, and that of pancreatic polypeptide reduced. The significance of altered postprandial pancreatic polypeptide response and of the reversal of prolonged postprandial hypergastrinemia to a state of low circulating gastrin levels following gastric surgery on gastrointestinal secretion and mucosa remain to be determined. PMID- 3528742 TI - Acanthosis nigricans and obesity: acquired and intrinsic defects in insulin action. AB - Six obese, severely acanthotic females were evaluated for insulin resistance by an oral glucose tolerance test, intravenous insulin tolerance test, and insulin binding to freshly isolated monocytes, as well as studies of cultured skin fibroblasts. After baseline studies were obtained, the acanthotic subjects were maintained for 14 days on a 500 calorie diet, and the evaluations were repeated. Initial evaluation demonstrated normal glucose tolerance, but marked fasting hyperinsulinemia (57 +/- 5 microU/mL) and dramatically blunted response to exogenous insulin (KITT, 2.0%/min) when compared with five nonacanthotic weight matched controls (insulin, 15 +/- 2 microU/mL; KITT, 5.2%/min). Monocyte insulin binding for the acanthotic group (0.251 +/- 0.050%/10(6) cells) was only 56% of the binding seen in the obese controls (0.447 +/- 0.108%). After the acanthotic females dieted for 14 days, their hyperinsulinemia and monocyte insulin binding improved, but failed to normalize. The response to exogenous insulin was unchanged and remained drastically blunted. In contrast to the normal insulin binding found in the cultured fibroblasts from the nonacanthotic obese controls, insulin binding to fibroblasts from the acanthotic group was decreased by 40%, suggesting that an intrinsic defect in insulin binding was present. Thus, we conclude that this cohort of acanthotic obese females are considerably more insulin-resistant than nonacanthotic weight-matched females. Furthermore, these studies suggest that the severe insulin resistance results from a combination of an acquired defect related to obesity and an inherent cellular defect in insulin action at, or beyond, the receptor. PMID- 3528743 TI - C-peptide secretion in calcific tropical pancreatic diabetes. AB - Serum C-peptide levels were measured during a glucagon stimulation test in ten normal nonobese controls and 54 diabetic patients with recent onset of diabetes under 30 years of age. Diabetic patients were comprised of 13 CTPD, 23 IDDM, and 18 NIDDM. As similar to IDDM patients, serum C-peptide concentrations did not rise significantly (P greater than 0.05) in response to glucagon administration in CTPD-patients. Mean baseline and peak serum C-peptide concentrations in CTPD patients were significantly lower (P less than 0.001) than the values in normal controls and NIDDM patients, but were significantly higher (P less than 0.05) than those in IDDM patients. We conclude that CTPD patients have partial C peptide reserve, which may protect against ketosis and contribute to ketosis resistance in CTPD. Our results also suggest that CTPD patients require insulin treatment. Neither baseline nor peak C-peptide levels after glucagon could discriminate CTPD from IDDM and CTPD from NIDDM. PMID- 3528744 TI - Insulin-stimulated fluid-phase pinocytosis and internalization of the insulin receptor: differences between the U-937 monocyte and rat adipocyte. AB - U-937 monocytes, a human cell line, respond acutely to insulin by internalization of the insulin receptor and acceleration of fluid-phase pinocytosis. In the present studies, both processes were shown to require energy and both were dependent on the number of insulin receptors. Monocytes with a reduced number of insulin receptors, ie, down-regulated by a 16-hour insulin treatment, had a markedly reduced response to insulin-stimulation of pinocytosis and a decrease in the amount of insulin receptors internalized. This latter feature resulted, however, from the reduction in the cellular content of insulin receptors. The proportion of receptor internalized during a 30-minute acute treatment with insulin (eg, 59% of the cell surface receptors) was slightly greater than the proportion internalized in control cells. Therefore, down-regulation does not selectively destroy receptors that cycle, leaving only a subpopulation of receptors anchored in the membrane. Apparently, there is only one population of insulin receptors, all of which are equally competent with respect to internalization. Although these results suggest a close relationship between pinocytosis and receptor internalization, it was possible to separate the two systems. The addition of poly-L-lysine produced a marked stimulation of fluid phase pinocytosis in the absence of any increase in insulin receptor internalization. Thus, movement of the receptor into the internal pool requires more than an increase in the rate of pinocytosis. Rat adipocytes were also studied, and the results differed in several aspects from those of U-937 monocytes.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3528745 TI - Smoking and insulin sensitivity in type I diabetic patients. AB - Smoking increases counterregulatory hormone secretion and reduces capillary flow, both of which could reduce insulin mediated glucose disposal. To evaluate whether smoking has any effect on body sensitivity to insulin, we measured insulin mediated glucose disposal (1 mU euglycemic insulin clamp) during acute smoking in seven male type I diabetic patients. In addition, we performed a cross-sectional study to compare insulin sensitivity in 12 habitually smoking and 22 nonsmoking diabetic patients matched for age, relative body weight, sex, diabetes duration, HbA1, C-peptide, and insulin dose. In the acute study, baseline counterregulatory hormone levels were comparable in the smoking and control experiment. During smoking (9 to 12 cigarettes), carboxyhemoglobin level rose by 57% (P less than 0.01). Circulating adrenaline, cortisol, growth hormone, and glucagon levels were 40% to 100% higher during smoking than during the control clamp study (P less than 0.05-0.01). During acute smoking the rate of insulin-mediated glucose uptake (7.3 +/- 1.0 mg/kg/min) was not significantly different from that without cigarettes (6.8 +/- 0.7 mg/kg/min). In the cross-sectional study, the rate of glucose uptake was comparable in habitually smoking (5.0 +/- 0.5 mg/kg/min) and nonsmoking patients (4.8 +/- 0.3 mg/kg/min). Thus, inspite of a significant rise in counterregulatory hormones, neither acute nor habitual smoking causes substantial changes in insulin sensitivity in type I diabetics. PMID- 3528746 TI - Primary and secondary structural homologies between the HIS4 gene product of Saccharomyces cerevisiae and the hisIE and hisD gene products of Escherichia coli and Salmonella typhimurium. AB - A detailed comparative analysis of the Escherichia coli and Salmonella typhimurium hisIE and hisD gene products and the functionally equivalent, single, HIS4 gene product of Saccharomyces cerevisiae permitted several insights concerning the relationship between these genes. Our analysis supports the idea that HIS4 results from the fusion of his IE and hisD. The comparison permitted a more precise definition of the functional domains of hisI/HIS4A and hisE/HIS4B as well as the two functional domains of hisD/HIS4C. The homologies between the bacterial and yeast sequences suggest a region of the hisD/HIS4C protein that may constitute one of the active centres. A large fragment at the amino terminal region of the yeast protein is missing from the bacterial hisIE gene product and is probably not needed for catalytic activity. Another region of non-homology in the yeast protein is probably a peptide bridge connecting the HIS4AB domain to HIS4C. Although the overall homology at the level of amino acid sequence is modest (about 38%) there is a striking similarity when the hydropathic patterns and predicted secondary structural configurations of these proteins are compared. PMID- 3528747 TI - Accumulation of single strand interruptions within the yeast 2 microns DNA plasmid during replication in a DNA ligase mutant. AB - We have investigated the fate of the yeast 2 micron DNA plasmid in strains with a temperature sensitive mutation of DNA ligase. At the restrictive temperature the plasmid DNA collects as an open circular form with single strand interruptions. Both alpha factor pheromone, which arrests cells before the start of S phase, and hydroxyurea, which blocks progression through S phase, prevent the appearance of the open circular form. Thus, interrupted plasmid DNA does not accumulate in the absence of DNA replication. On average the interrupted molecules contain four to five interruptions per newly replicated strand. Most of the interruptions are nicks (breaks in a single phosphate ester bond) rather than gaps (absence of one or more nucleotides in a strand) as judged by the in vitro conversion of the interrupted molecules into a covalently closed form by DNA ligase. Mapping of the position of the interruptions reveals no predominate sites. PMID- 3528749 TI - Regulation of the plasmid state of the genetic element P4. AB - After infection of sensitive cells in the absence of a helper phage, the satellite bacteriophage P4 enters a temporary phase of uncommitted replication followed by commitment to either the repressed-integrated condition or the derepressed-high copy number mode of replication. The transient phase and the stable plasmid condition differ from each other in the pattern of protein synthesis, in the rate of P4 DNA replication and in the expression of some gene functions. The regulatory condition characteristic of the P4 plasmid state affects a superinfecting genome, preventing the establishment of the P4 immune condition. PMID- 3528748 TI - Relationship between pseudo-HPr and the PEP: fructose phosphotransferase system in Salmonella typhimurium and Escherichia coli. AB - We have studied in Salmonella typhimurium and Escherichia coli the properties of pseudo-HPr suppressor mutations. These mutations suppressed the defects in a ptsH mutant which lacks HPr, one of the enzymes of the phosphoenolpyruvate: carbohydrate phosphotransferase system. The suppressor mutation was mapped in S. typhimurium at 3 min, closely linked to leu. The corresponding chromosomal fragment of 1.7 kb from S. typhimurium and E. coli (extending clockwise from ilvH) was cloned. In a maxicell system a protein with an approximate molecular weight of 36,000 was synthesized. Pseudo-HPr suppressor mutations (fruR) and a deletion extending clockwise from leu resulted in the constitutive expression of the fru operon containing the genes for IIFru (fruA), IIIFru (fruB), fructose 1 phosphate kinase (fruK) and pseudo-HPr (fruF). fruR probably codes for a repressor of the fru operon. Tn10 mutagenesis revealed the following order of genes in the fru operon: fruB-(fruK, fruF)-fruA. Pseudo-HPr activity could replace HPr in PEP-dependent phosphorylation of PTS carbohydrates. IIIFru could be phosphorylated both via HPr and pseudo-HPr, since mutants lacking pseudo-HPr activity were still able to phosphorylate fructose in the presence of added HPr. Both the pseudo-HPr suppressor mutations at 3 min and the deletion extending from leu had an additional phenotype. Introduction of these mutations or deletions was always accompanied by disappearance of PEP synthase activity. Complementation of such a mutant with the cloned fragments reversed both phenotypes at the same time. Possibly, the fruR gene product acts as an activator of the gene coding for PEP synthase. PMID- 3528750 TI - The pentafunctional FAS1 gene of yeast: its nucleotide sequence and order of the catalytic domains. AB - FAS1, the structural gene of the pentafunctional fatty acid synthetase subunit beta in Saccharomyces cerevisiae has been sequenced. Its reading frame represents an intron-free nucleotide sequence of 5,535 base pairs, corresponding to a protein of 1,845 amino acids with a molecular weight of 205,130 daltons. In addition to the coding sequence, 1,468 base pairs of its 5'-flanking region were determined. S1 nuclease mapping revealed two transcriptional initiation sites; 5 and 36 base pairs upstream of the translational start codon. Within the flanking sequences two TATATAAA boxes, several A-rich and T-rich blocks and a TAG...TATGTT...TATGTT...TTT sequence were found and are discussed as transcriptional initiation and termination signals, respectively. The order of catalytic domains in the cluster gene was established by complementation of defined fas1 mutants with overlapping FAS1 subclones. Acetyl transferase (amino acids 1-468) is located proximal to the N-terminus of subunit beta, followed by the enoyl reductase (amino acids 480-858), the dehydratase (amino acids 1,134 1,615) and the malonyl/palmityl transferase (amino acids 1,616-1,845) domains. One major inter-domain region of about 276 amino acids with so far unknown function was found between the enoyl reductase and dehydratase domains. The substrate-binding serine residues of acetyl, malonyl and palmityl transferases were identified within the corresponding domains. Significant sequence homologies exist between the acyl transferase active sites of yeast and animal fatty acid synthetases. Similarly, a putative sequence of the enoyl reductase active site was identified. PMID- 3528751 TI - Genetic studies on the beta subunit of Escherichia coli RNA polymerase. VIII. Localisation of a region involved in promoter selectivity. AB - We have previously isolated an E. coli derivative carrying a small internal deletion (delta(rpoB)1570-1) of the beta structural gene. This RNA polymerase deletion mutant has no noticeable phenotype other than a slightly increased generation time in minimal medium. The deletion, which removes about 165 bp, has been localised to between codons 965 and 1,083, indicating it excises part of a tandem repeat structure present in the C-terminal region of beta. Analysis in vitro of purified RNA polymerase from the deletion mutant indicates that this enzyme has an altered promoter selectivity. These observations allow localisation of a site on the beta polypeptide of E. coli RNA polymerase involved in transcriptional initiation. PMID- 3528752 TI - Genetic studies on the beta subunit of Escherichia coli RNA polymerase. IX. The role of the carboxy-terminus in enzyme assembly. AB - The assembly of RNA polymerase was studied in Escherichia coli mutants encoding large N-terminal amber fragments of the beta subunit. Whereas the removal of up to 20% of the carboxy-terminus does not prevent the formation of premature core enzyme, the amber fragments seem to interfere with holoenzyme production. These studies permit, therefore, the localization of a region on the beta polypeptide involved in sigma binding. PMID- 3528753 TI - In vivo cloning ad characterization of mutations of the regulatory locus ompR of Escherichia coli K12. AB - The product of the ompR gene of E. coli K12 is a positive regulatory protein, which is needed for the expression of the major outer membrane proteins OmpC and OmpF in E. coli K12. A simple in vivo technique was used to transfer three ompR mutations (ompR101, ompR472, ompR4) onto a multicopy plasmid carrying the wild type ompR gene. The resulting clones were transformed into wild type and corresponding mutant backgrounds to analyze their effects on ompC and ompF expression. All of the cloned ompR mutant alleles exhibited a dominant OmpC- phenotype in an ompR+ background. In addition negative complementation of ompF expression was observed between chromosomal ompR4 and multicopy ompR101 alleles. The results suggest an interaction between different OmpR molecules and thereby support the idea that OmpR can exist as a multimeric protein. PMID- 3528754 TI - Regulation of the RAD6 gene of Saccharomyces cerevisiae in the mitotic cell cycle and in meiosis. AB - The regulation of the RAD6 gene at the mRNA level was investigated. The level of steady state RAD6 mRNA increases once every cell cycle, at late S/early G2. This stage is the one at which rad6 mutants arrest, as do wild-type cells exposed to hydroxyurea (HU) or methyl methanesulfonate (MMS), or cdc40 cells exposed to the restrictive temperature. This appears to be a repair-specific stage in the cell cycle. RAD6 mRNA levels increase when cells are treated with MMS, but this increase seems to be due to the arrest of the cells by MMS at the repair-specific stage; cells arrested at the same stage by HU or by the cdc40 lesion also show high levels of RAD6 mRNA. A much smaller increase in the level of RAD6 transcripts is seen following UV irradiation. During meiosis, RAD6 mRNA is more abundant before commitment to recombination. The differential increase of RAD6 mRNA during the S/G2 repair-specific stage of the cell cycle relates the RAD6 function to the normally occurring radioresistance found at this stage. PMID- 3528755 TI - A mutation affecting lipoamide dehydrogenase, pyruvate dehydrogenase and 2 oxoglutarate dehydrogenase activities in Saccharomyces cerevisiae. AB - In Saccharomyces cerevisiae a nuclear recessive mutation, lpd1, which simultaneously abolishes the activities of lipoamide dehydrogenase, 2 oxoglutarate dehydrogenase and pyruvate dehydrogenase has been identified. Strains carrying this mutation can grow on glucose or poorly on ethanol, but are unable to grow on media with glycerol or acetate as carbon source. The mutation does not prevent the formation of other tricarboxylic acid cycle enzymes such as fumarase, NAD+-linked isocitrate dehydrogenase or succinate-cytochrome c oxidoreductase, but these are produced at about 50%-70% of the wild-type levels. The mutation probably affects the structural gene for lipoamide dehydrogenase since the amount of this enzyme in the cell is subject to a gene dosage effect; heterozygous lpd1 diploids produce half the amount of a homozygous wild-type strain. Moreover, a yeast sequence complementing this mutation when present in the cell on a multicopy plasmid leads to marked overproduction of lipoamide dehydrogenase. Homozygous lpd1 diploids were unable to sporulate indicating that some lipoamide dehydrogenase activity is essential for sporulation to occur on acetate. PMID- 3528756 TI - The nucleotide sequence of an Escherichia coli chromosomal region containing the genes for ribosomal proteins S6, S18, L9 and an open reading frame. AB - The DNA sequence of a cluster of genes for ribosomal proteins S6 (rpsF), S18 (rpsR) and L9 (rplI), and of their surrounding regions was determined. The order of the genes was established as promoter-rpsF-rpsR-rplI. There is a 315 bp open reading frame that begins seven nucleotides after the end of rpsF and ends immediately before rpsR. Based on the data of insertional mutagenesis experiments with transposon gamma delta, we concluded that these genes probably form an operon. The amino acid sequence deduced from the nucleotide sequence of the genes agrees completely with the published amino acid sequence data for protein S6, but there are discrepancies in the case of proteins S18 and L9. The C-terminus of protein S6 was deduced to end with two Glu residues, suggesting that the other Glu residues previously found in this protein are added post-translationally as has been predicted (Reeh and Pedersen 1979). A possible secondary structure in the leader sequence as well as a possible transcriptional terminator after rplI were noticed in the sequence. PMID- 3528757 TI - Mu-induced rifamycin-resistant mutations not located in the rpoB gene of Escherichia coli. AB - A new class of rifamycin-resistant mutants of Escherichia coli was obtained by lysogenic insertions of bacteriophage Mu Amp DNA. Rifamycin resistance is closely linked to the ampicillin resistance conferred by the prophage. Mapping by conjugation with auxotrophic markers revealed that the rifamycin-resistant mutations are located between 28 and 37 min on the E. coli chromosome standard map, some distance from the rpoB gene at 89.5 min. The DNA-dependent RNA polymerase of these mutants is highly sensitive to rifampicin. PMID- 3528758 TI - Replication of pSC101: effects of mutations in the E. coli DNA binding protein IHF. AB - We have shown that the plasmid pSC101 is unable to be maintained in strains of E. coli carrying deletions in the genes himA and hip which specify the pleitropic heterodimeric DNA binding protein, IHF. We show that this effect is not due to a modulation of the expression of the pSC101 RepA protein, required for replication of the plasmid. Inspection of the DNA sequence of the essential replication region of pSC101 reveals the presence of a site, located between the DnaA binding site and that of RepA, which shows extensive homology with the consensus IHF binding site. The proximity of the sites suggests that these three proteins, IHF, DnaA, and RepA may interact in generating a specific DNA structure required for initiation of pSC101 replication. PMID- 3528759 TI - The isolation and characterization of ngm2, a mutation that affects nitrosoguanidine mutagenesis in yeast. AB - We have isolated and characterized a new mutant of Saccharomyces cerevisiae, carrying a single mutant allele that we designate ngm2-1, which is defective with respect to induced mutagenesis. This mutant was isolated by screening mutagenized clones for reduced frequencies of reversion of the his1-7 allele, induced by N methyl-N-nitro-N-nitrosoguanidine. As judged by the reversion of his1-7 and ilv1 92, ngm2-1 mutant strains are also deficient with respect to mutability induced by methyl methane sulfonate, ethyl methane sulfonate and, at least partially, by UV. UV-induced reversion of the ochre mutation arg4-17 and the frameshift mutation his4-38 was not much affected by ngm2-1, however. Like rev3 and rev7 mutations, ngm2-1 also has little influence on the reversion of the proline missense allele, cyc1-115. Ngm2-1 mutants are only at best very slightly more sensitive to the toxicity of the four mutagens used, and homozygous diploids sporulate normally. PMID- 3528761 TI - Progestogens have been defined as hormones whose function is to ensure the maintenance of pregnancy. PMID- 3528760 TI - Progestogens and lipid metabolism. PMID- 3528762 TI - Progestogen treatment in post-menopausal women. PMID- 3528763 TI - Coaggregation between Actinomyces viscosus with Streptococcus pyogenes and Streptococcus agalactiae. AB - Interbacterial coaggregation between Actinomyces viscosus indigenous to the human mouth and Streptococcus pyogenes and Streptococcus agalactiae was studied. Fifteen of twenty-six strains of Streptococcus pyogenes and thirteen of thirty one Streptococcus agalactiae showed a coaggregation with Actinomyces viscosus strain. The results show that the coaggregation mechanism required calcium and was dependent on pH. Some coaggregations were inhibited by 0.06 M. lactose and by 1 M. NaCl. PMID- 3528764 TI - Partial purification of polypeptides activating catalase in Saccharomyces cerevisiae. AB - In a previous paper the existence of an activating factor for catalase biosynthesis in Saccharomyces cerevisiae was reported. The partial purification of this factor by ammonium sulphate precipitation and chromatography is described. Several fractions with different molecular weights manifesting catalase activity in repressed cultures of S. cerevisiae were obtained, and are discussed. PMID- 3528765 TI - Nitrate-reducing bacteria in Kuwait domestic sewage. AB - Domestic sewage in Kuwait is mainly treated by an activated-sludge process, where different effluents and sludges are separated. Nitrate reduction in the raw sewage, effluent-1 and effluent-2 were studied. Various enrichments of these sewage samples were effected using 0.2 mg/ml of nitrogen as potassium nitrate and/or 0.5% carbon as glucose. Addition of 0.2 mg/ml nitrate-nitrogen enhanced more ammonia production (117.6 micrograms/ml) in comparison with other enrichments to sewage samples. Nitrate-reducing bacteria were also at a maximum with nitrate enriched sewage samples, especially with effluent-1 (109 X 10(6)/ml). Escherichia coli and Klebsiella pneumoniae were the only two nitrate reducing bacteria found in all sewage samples tested. Nitrite was unstable during the 7 days incubation period under anaerobic conditions which suggests that nitrates are reduced to ammonia. PMID- 3528766 TI - Ecological studies of Legionella species. I. Viable counts of Legionella pneumophila in cooling tower water. AB - The occurrence and viable counts of Legionella pneumophila in acid-treated water samples of 62 cooling towers on the main island of Japan were determined by inoculating them onto plates of Wadowsky-Yee-Okuda (WYO) agar medium. WYO plate cultures of 39 (63%) of the samples yielded L. pneumophila with viable counts ranging from 10 to 10(4) colony-forming units per 100 ml. Of the L. pneumophila isolates, 157 were serologically identified as serogroup 1, and the remaining 21 were agglutinated by serogroup 3 (2 strains) and serogroup 6 (19 strains) antisera. In each culture-positive water sample, the pH and the number of other bacteria were found not be statistically significantly correlated with the viable counts of L. pneumophila. However, a higher rate of recovery of L. pneumophila was obtained with the water samples with a smaller number of other bacteria. Practical use of commercially available antialgal or antimicrobial agents was found not to be significantly effective for controlling the occurrence and growth of L. pneumophila in cooling tower water. PMID- 3528767 TI - Increased resistance to Salmonella infection of hypoferremic mice fed a low protein diet. AB - BALB/c and CBA/CA mice fed a protein-deficient diet developed a plasma hypoferremia corresponding to a 30 percent lowering of serum iron concentration. This hypoferremia persisted as long as the diet was maintained. Hypoferremic CBA/CA mice had increased resistance to Salmonella typhimurium C5 infection, as shown by the reduced lethal activity and the decreased growth of the bacteria in the spleen and in the peritoneal exudate of the deficient animals. This induced resistance was abolished after injection of iron or Desferal into the restricted animals. Such resistance was not observed with BALB/c mice fed a protein deficient diet, in spite of the plasma hypoferremia. The growth of S. typhimurium C5 in the spleen and in the peritoneal exudate of these animals did not differ from the growth observed in control animals fed a protein-sufficient diet. This study suggests that hypoferremia induced by a protein-deficient diet is probably involved in the enhancement of resistance of CBA/CA mice to Salmonella infection, and that the phenomenon is host-strain dependent. PMID- 3528768 TI - Mechanisms of plasmid-mediated antibiotic resistances in Vibrio parahaemolyticus. AB - The mechanisms of drug resistance of clinical isolate, Vibrio (V.) parahaemolyticus ST550, resistant to chloramphenicol (CP), aminoglycoside antibiotics (AGs) and beta-lactam antibiotics were investigated. The mechanisms of resistance to CP, AGs and beta-lactam antibiotics were dependent on chloramphenicol acetyltransferase (CAT), aminoglycoside-3"-adenylyltransferase AAD(3") and aminoglycoside-3'-phosphotransferase APH(3') and TEM type penicillinase, respectively. PMID- 3528769 TI - Survey of modifying enzymes and plasmids in amikacin-resistant Serratia marcescens. AB - Forty amikacin-resistant strains of Serratia marcescens isolated from four different hospitals (A, B, C, and D) were examined for modifying enzymes and plasmids. Twenty-one of the isolates produced acetyltransferase that modified amikacin. Eighteen of the 21 acetyltransferase-bearing isolates were from different inpatients in hospital A and the other three were from hospital C. Amikacin resistance was mediated by conjugative plasmid of 24 megadaltons in 15 of the 18 acetyltransferase-bearing isolates of hospital A and by nonconjugative plasmids, derivatives of the 24-megadalton plasmids, in the remaining three isolates of the same hospital. The 24-megadalton plasmid determined aminoglycoside acetyltransferase (6') IV. This plasmid-borne enzyme conferred amikacin resistance on S. marcescens but not on Escherichia coli K12. The frequency of transfer of the 24-megadalton plasmid from the S. marcescens isolate to E. coli K12 by conjugation was approximately 10(-7) (transconjugants/donors) and was 0.1% of that between E. coli strains. In acetyltransferase-bearing isolates from hospital C, the enzyme was mediated by a nonconjugative plasmid in one case and could not be associated with a plasmid in the remaining two cases. Neither enzymes nor plasmids could be associated with amikacin resistance of the isolates of the other two hospitals. PMID- 3528770 TI - [Succinate dehydrogenase activity of Escherichia coli cells after heat stress and during the reparative process]. AB - The resting cells of different E. coli cells remained viable after their heating at 48 degrees C for 30 min. The activity of their succinate dehydrogenase (SDH) (EC 1.3.99.1) was not more than 50% of the control one. When the cells were inoculated after a heat stress into a peptone medium, they started to grow at a high rate. However, their maximal specific growth rate mu and the overall biomass yield were less than in the control. The SDH activity of the cells reached the original level by the end of the logarithmic growth phase. This did not happen when the cells were incubated in 0.14 M NaCl for a time necessary for the culture to reach the end of the logarithmic growth phase. The SDH activity (in absolute values) of cell-free extracts was not greater than 35% of the cell SDH activity. The SDH activity of the cell-free extracts did not change after their heating at 48 degrees C. The SDH activity of E. coli cells is recommended to be used as a parameter indicative of their stress state. PMID- 3528771 TI - [Selective method of isolating mutants sensitive to ultraviolet radiation from a culture of Rhodopseudomonas sphaeroides]. AB - The method of penicillin selection used after UV-irradiation (lambda = 254 nm) allows one to select UV-sensitive mutants (uvs-mutants) of the phototrophous bacterium Rhodopseudomonas sphaeroides induced by nitrosomethylurea with an effectiveness greater by an order of magnitude. Over 30% of the uvs-mutants obtained using this method had an elevated sensitivity not only to far-UV (F-UV, lambda = 254 nm) but also to near-UV (N-UV, lambda greater than 280 nm) UV irradiation. No correlation was found in the degree of sensitivity to F-UV and N UV-irradiation of the uvs-mutants. Mutants highly sensitive to the lethal action of N-UV were isolated. PMID- 3528772 TI - [Ability of bacteria living in the sea for the biosynthesis of fibrinolytic enzymes]. AB - Biosynthesis of fibrinolytic enzymes was studied in bacteria isolated from sea water (the Black Sea, the Balearic Sea, the Caribbean Sea) and from different habitats (water, detritus, fish intestines). Strains with the highest fibrinolytic activity belonged to the Bacillus genus and were isolated from mineral detritus and ruff intestines in the Black Sea. A procedure was developed for the isolation of enzyme preparations with a high specific fibrinolytic activity and a low caseinolytic activity. PMID- 3528773 TI - [Role of cell wall components in yeasts of the genus Candida in the morphology of the cell]. AB - The object of this work was to study the function of the mannan and glucan layers in the cell wall of Candida yeasts. When the outer mannan layer was removed with proteinases, the cells became round and their volume increased by a factor of 2.2. The contribution of the above layers into the elastic properties of the cell wall was estimated in qualitative terms. Apparently, mannans play a more important role in cell morphogenesis than it was supposed earlier. PMID- 3528774 TI - [Clinical and theoretical aspects of tooth reimplantation]. PMID- 3528775 TI - [Dentistry yesterday, today and tomorrow ... The Swiss Dental Society (SSO) commemorates the 100th anniversary of its founding (Bale, May 28-31, 1986)]. PMID- 3528776 TI - Ginger: inhibition of thromboxane synthetase and stimulation of prostacyclin: relevance for medicine and psychiatry. AB - Ginger, the common spice, has recently been found to act as a potent inhibitor of thromboxane synthetase, raising levels of prostacyclin, without a concomitant rise in PGE2 or PGF2 alpha. Indications for use of ginger to replace either thromboxane inhibitors having serious side effects or prostacyclin are given. PMID- 3528777 TI - The promise of enzymes in therapy of hyperlipidemia. AB - Treatment of hyperlipidemias must be commenced in that intestinal segment where alimentary lipoprotein aggregate generation is initiated postprandially and the aggregates are still in nascent form. This is to prevent the formation of potentially pathological units that do not equilibrate with the blood colloid. The colloid chemical state of the alimentary lipoprotein entities in the systemic circulation is decisive for maintenance of their stability and for their disposal from the blood. The causes of impaired, "unripe," lipoprotein aggregate formation include: (a) the action of human pancreatic lipase is even normally a restricted and vulnerable process, (b) inadequate ratio of protein to fat to stabilize the aggregates, (c) defective proteolysis in the small intestine, and (d) the dual behavior of the surface tension-lowering agent, the lecithin antagonist cholesterol. On the one hand, cholesterol represents physicochemically the weakest link in the lipoprotein interfaces. On the other hand, an excess of cholesterol in lipoprotein interfaces decreases the stability of the surface film. This leads to changes in the decay of the entities and the cell surface active lipid constituents of the "unripe" plasma lipoprotein colloid complexes can easily be adsorbed to the endothelial cell surface plasma membrane: the excess aggregate-cholesterol molecules simply join, or dissolve in, the cell membrane-cholesterol which thus acts as its own receptor or solvent: cholesterol dimers occur. This causes rigidity of the endothelial cell surface membrane and leads to impaired cell metabolism. The intima recognizes the impairment as a foreign body and initiates a physiological defense reaction including phagocytosis. The event may be still more dangerous if the adrenergic receptors of the autonomous nervous system involved in lipolysis with subsequent plasma efflux are simultaneously stimulated. The therapeutic measure indicated is production of balanced alimentary lipoprotein aggregates. This can be achieved by oral administration of (a) protease, and (b) non-specific micellar lipase. The lipase functions without restriction and can perform all the activities that human pancreatic lipase cannot. The enzymes utilized are of mold origin and generally available. PMID- 3528779 TI - The Institute of Medical and Veterinary Science. PMID- 3528778 TI - Recurrent "flare" of dermatitis herpetiformis after cytotoxic therapy for malignant lymphoma. PMID- 3528780 TI - Transvaginal ultrasonically-guided oocyte pick-up. PMID- 3528781 TI - Munchhausen versus Munchausen. PMID- 3528782 TI - [Local anesthetics. Properties, actions, pharmacokinetics]. PMID- 3528783 TI - The Steve Biko affair. PMID- 3528784 TI - Drugs that cause psychiatric symptoms. PMID- 3528785 TI - Permethrin for head lice. PMID- 3528786 TI - Statistical evaluation of prognostic factors in ALL and treatment results. AB - Prognostic factor evaluation is a frequent and desirable investigative activity in clinical trials. Nevertheless, a number of errors in the evaluation of such factors occur quite commonly. Many of these problems are due to inappropriate statistical interpretation of the analyses that are conducted. A detailed discussion of several problem areas is given. In the area of childhood ALL trials, issues related to the appropriate choice of disease end-points for analysis of prognostic factors are discussed. PMID- 3528788 TI - Report and recommendations of the Rome workshop concerning poor-prognosis acute lymphoblastic leukemia in children: biologic bases for staging, stratification, and treatment. PMID- 3528787 TI - United Kingdom Medical Research Council Acute Lymphoblastic Leukaemia (UKALL) Trials I-VIII: clinical features and results of treatment in four groups of children with adverse prognostic features. AB - Four groups of children with poor-prognosis disease were selected for study from the Medical Research Council childhood ALL trials. Each group was reviewed for distinguishing clinical features and response to therapy. The four comprised those with a diagnostic white cell count over 50 X 10(9)/l, those with a mediastinal mass, those less than a year old at diagnosis, and those presenting with meningeal involvement. They accounted for 17, 5.3, 2.6, and 3%, respectively, of unselected children with ALL. As expected, all four categories showed significantly inferior relapse-free survival to the rest, but only in patients with a mediastinal mass and in the under-1-year-olds did a recognisable syndrome emerge clearly associated with other clinical features. These two syndromes, high-count T-ALL and high-count infant null-ALL, are logical candidates for alternative therapy. Established meningeal disease also continues to present a major therapeutic challenge. PMID- 3528789 TI - [Synthesis and use of immunosorbents for the biospecific sorption of antibodies to the antigens of Echinococcus granulosus, E. multilocularis and their hosts]. PMID- 3528790 TI - [The epidemic process in echinococcosis foci in the Yakutsk ASSR studied by immunoenzyme analysis]. PMID- 3528791 TI - [Incidence of deep mycoses in the territory of the USSR (a review of the literature)]. PMID- 3528792 TI - [Use of mixed antigens for the immunofluorescence reaction in seroepidemiological research]. PMID- 3528793 TI - New nuclear medical technologies for pediatrics. AB - Nuclear medicine is very helpful for pediatric diagnostics because it provides noninvasive methods for the evaluation of physiologic functions and for the imaging of tumours, metastases and inflammatory diseases. These examinations can be done with very low risk and with low radiation burden for the children. New technologies help us to get more detailed diagnostic information and to reduce further the radiation. The most important developments in this field allow the clinical use of radioisotopes with extremely short lifetimes combined with a very low radiation exposure, imaging of tumours by new radioactive labelled tumour markers, the measurement of heart functions and blood flow through the use of computerized gammacameras with digital imaging processing capabilities and the three-dimensional imaging of radioactive tracers within the body. PMID- 3528794 TI - Concepts in spinal anesthesia. PMID- 3528795 TI - Transtracheal jet ventilation for the difficult airway. PMID- 3528796 TI - Oculocardiac reflex and the anesthesiologist. AB - Oculocardiac reflex is one of the trigemino-vagal reflexes, and is frequently observed during anesthesia for pediatric strabismus surgery. The reflex is greatly exaggerated in the presence of hypoventilation, hypoxemia and acidosis. The reflex is important as a cause of cardiac arrest during eye surgery. Several related reflexes are known, such as blepharocardiac reflex, oculorespiratory reflex, and the sudden infant death syndrome. Although the reflex can be prevented by a retrobulbar block or the administration of parasympatholytic drugs, well conducted anesthesia and cooperation with the surgeon is much more important. PMID- 3528797 TI - [Analysis of the nutritional behavior of the normal and diabetic population in childhood]. PMID- 3528798 TI - [Trace elements today. A synthetic review of the 10 essential elements with nutritional aspects and pathological pictures]. PMID- 3528800 TI - [Application of deconvolution analysis to the measurement of pancreatic and post hepatic secretion of insulin]. PMID- 3528799 TI - [Etiopathogenic and therapeutic aspects of chronic respiratory infection in cystic fibrosis]. PMID- 3528801 TI - [Mechanisms of damage to the islands of Langerhans in type I diabetes]. PMID- 3528802 TI - [Physical exercise and diabetes. Physiopathologic and clinical aspects]. PMID- 3528803 TI - [Giant-cell epulis. I. The nosological picture. Etiopathogenic, clinical and therapeutic aspects]. PMID- 3528804 TI - [Full-thickness onlay grafts in the correction of the deformity of partially edentulous ridges]. PMID- 3528805 TI - [Clinical evaluation of the efficacy of suprofen as an analgesic compared to acetylsalicylic acid in toothache]. PMID- 3528806 TI - Passing on the flame. The early years: history of MNA 1900-1920. PMID- 3528807 TI - Use of anterior composites--a clinical challenge. PMID- 3528808 TI - Posterior composites--the great advance. PMID- 3528809 TI - Pseudoseizures. AB - The history of hysteria, with special reference to pseudoseizures, is reviewed. The distinguishing features between nonepileptic and epileptic convulsions are then considered, prior to discussion of management and prognosis. The various psychopathologies associated with the diagnosis are noted, as are psychiatric conditions that may be confused with epilepsy. It is concluded that pseudoseizures represent a complex clinical problem, often requiring multidisciplinary evaluation, that can be rewarding to diagnose and treat. PMID- 3528810 TI - Cardiogenic syncope. Seizure versus syncope. AB - Our recommendations for the evaluation of the patient with suspected cardiogenic syncope are as follows: An initial thorough history and physical examination of the patient will suggest the diagnosis of cardiogenic syncope in at least 50 per cent of patients. A sudden occurrence of syncope, or "drop attack", is most suggestive of an arrhythmic cause for syncope. If there is no evidence of neurologic, metabolic, or obvious cardiac (for example, aortic stenosis) cause for syncope, a 24-hour ambulatory ECG should be performed. If the patient has had repeated syncopal episodes or if the patient has had seizures that are difficult to control with anticonvulsant therapy, ambulatory ECG monitoring may reveal an arrhythmia in these preselected patients. If the initial 24-hour ambulatory ECG is negative and if the patient has had multiple episodes of syncope, multiple days of recording will be necessary before typical symptoms occur that correlate with arrhythmias. Seventy-two hours of ambulatory ECG monitoring should be sufficient in most instances to establish an arrhythmic cause for syncope. Echocardiography and exercise stress testing are not routinely indicated in the evaluation of syncope unless the clinical history and examination suggest valvular or coronary disease. Rarely, an atrial myxoma will be visualized by echocardiography that is not apparent clinically. Those patients who still have unexplained recurrent syncopal episodes, despite all noninvasive studies, can benefit from invasive electrophysiologic studies, although the expected yield from electrophysiologic testing is low. PMID- 3528812 TI - Surgical options for uncontrolled epilepsy. AB - Surgical management of refractory epilepsy has undergone many modifications since it was instituted for the treatment of post-traumatic seizures many decades ago. Localization of onset of all seizures to a single resectable area of brain by various noninvasive and invasive recording methods is a complicated and controversial area, but guidelines are available. Success is correlated with accurate location and complete resection of the focus. When this is accomplished, resective surgery for epilepsy can provide cure or over 95 per cent reduction in seizure frequency in 60 to 90 per cent of patients undergoing these procedures. Although most often applied to temporal lobe foci, resections may be done in any cerebral lobe in the dominant or nondominant hemisphere with appropriate modifications of the evaluation and surgical procedure. When patients have unlocalizable or unresectable foci, depending on their exact pattern of seizures, electrical abnormalities, and neurologic status, other procedures may be used for surgical control of seizures. These include hemispherectomy, corpus callosum section, or stereotaxic procedures. The risks of all evaluation and surgical approaches are well balanced by the benefits obtained in a large proportion of patients. PMID- 3528811 TI - Use of barbiturates and benzodiazepines in treatment of epilepsy. AB - Barbiturates and benzodiazepines may be very effective in controlling seizures, especially status epilepticus. However, their chronic use may be associated with serious sedative-hypnotic effects that interfere with cognitive function and behavior. When utilized, patients must be carefully monitored to be certain that these side effects are not occurring. PMID- 3528813 TI - [Systemic hyperdynamic circulation and serum hormone concentrations in portal hypertension]. AB - In order to evaluate the pathogenesis of the systemic hyperdynamic circulation in portal hypertension, serum concentration of eight kinds of hormones including glucagon (Glu), aldosterone (Ald), renin (Ren), and epinephrine (Adr), and the hemodynamic parameters were measured in a series of 30 patients, of whom 23 were patients with liver cirrhosis, 3 were with Banti's disease, 2 with chronic active hepatitis, and 2 with pre-cirrhotic change. The average cardiac index was 4.6l/min, m2, with normal PCWP of 6.7 mmHg. CI. and SVR. showed significant inverse correlation of r = -0.767 (p less than 0.01), however, PCWP and CI did not have any significant correlation. Average serum concentrations of Glu, Ald, and Ren were 160 pg/ml, 139 pg/ml, and 5.4 ng/ml, respectively, all of which were increased up to 2.5 times above the normal values. Adr, norepinephrine, cortisol, estrone and estradiol were within normal limits. Of the eight hormones being measured, only Glu had significant correlation with both liver function tests and the cardiac index (r = 0.479, p less than 0.05). Neither Ald nor Adr had significant correlation with hemodynamic parameters. PMID- 3528814 TI - [Surgery of incisional hernia and its prognosis--statistical analysis in 657 patients]. AB - In order to study the problems of surgery for incisional hernia and its prognosis, 657 patients who had undergone surgery for incisional hernia between January 1974 and December 1983 in 27 hospitals were analyzed statistically by questionnaire survey. These patients consisted of 571 in whom surgery was performed for the first time and 86 in whom surgery was carried out for recurrent hernia. The ratio of male to female patients with initial surgery was 1:2.4, showing a higher frequency in females than in males. Initial surgery was most frequently carried out in the patients' 50s and 60s. The most common procedure which caused hernia was a median incision in 299 (51.6%), followed by an incision of the right hypogastrium for appendectomy in 211 (36.4%). There were many patients with systemic complications such as obesity, diabetes and asthma. The recurrence rate after radical surgery for incisional hernia was 9.1%. There was a tendency for the recurrence rate to be high in elderly patients and those who had had systemic complications (obesity, diabetes and asthma) preoperatively. The rate was very high, 33.3%, in patients with postoperative wound infection. The recurrence rate in patients with surgery for recurrent hernia was about three times as high as the 7.3% for patients with initial surgery. When the rate was determined by procedure, it was 2.4% for patients treated by a mesh prosthesis, 9.4% for those treated by celiorrhaphy and closure, and 16.7% for those treated by the overlap method. Mesh prosthesis was considered the best procedure, particularly for recurrent hernia. PMID- 3528815 TI - [Two cases of intussusception of appendiceal mucocele: diagnostic value of preoperative ultrasonography]. AB - Mucocele of the appendix was first described and named "Hydrops processus vermiformis" by Rokitansky in 1866. Intussusception of a appendiceal mucocele is very rare and we have been able to find only 14 previously reported cases. We present two cases with preoperative ultrasonography which is valuable for its diagnosis. Case 1: A 5-year-old male was admitted to Kahoku Hospital because of right lateral colic abdominal pain and tumor. Ba-enema examination revealed intussusception to the colon and ultrasonography showed the cystic mass of the appendix. Case 2: A 51-year-old female was admitted because of right lower abdominal pain. Ultrasonography was helpful showing the cystic tumor at the base of the appendix. Recent reports say that ultrasonography is valuable examination for its diagnosis. Also in our two cases preoperative ultrasonography was performed and gave us valid information for its qualitative diagnosis. PMID- 3528816 TI - [A case of inferior vena cava thrombosis associated with cholelithiasis demonstrated by ultrasonic examination]. AB - A case of a 44 year old female with inferior vena cava thrombosis associated with cholelithiasis was reported. The patient had chest and back pain due to pulmonary embolism. Ultrasonic examination showed stone echoes in the gallbladder and thrombus echoes in the inferior vena cava (IVC) at the height from renal veins to bifurcation of iliac veins, but iliofemoral thrombosis was not found by RI angiography and venography. Anticoagulant and urokinase were administered, then pulmonary embolus disappeared and IVC thrombus reduced. IVC thrombus was removed by incision of IVC. Thrombus was white thrombus. Etiology of thrombus was not clear. IVC ligation or plication for prevention of pulmonary emboli was not carried out. Etiology, diagnosis and treatment of IVC thrombosis were also discussed. PMID- 3528817 TI - [Study on hemostatic efficacy and safety of a hollow balloon catheter used in traumatic abdominal bleeding]. PMID- 3528818 TI - [Current trends in periodontology. Diagnosis]. PMID- 3528819 TI - [Current trends in periodontology. Therapy]. PMID- 3528820 TI - [Imaging procedures and follow-up in pediatric surgical diseases]. AB - The most important modern imaging diagnostics are the ultrasound, scintigraphy, computed tomography and recently the nuclear magnetic resonance (NMR). The diagnostic tools should be used one after another, always starting with the easiest to perform, with low risk and no harm to the patient, at low costs. In routine diagnostic procedures (e.g. blunt abdominal trauma) this will be the sonography. The result of the ultrasound may give rise to other, but more invasive methods. Computed tomography, e.g. may give more detailed information about position, size and operability of a tumor whereas scintigraphy has its strong point in disclosing functional organ disorders (e.g. kidney, liver and especially in splenic transplants). PMID- 3528821 TI - [Angiography and digital subtraction angiography]. AB - In pediatrics angiography is a method that is used relatively rarely. During the last few years the introduction of nonionic contrast media has led to considerable progress in the field of conventional angiography since these contrast media are tolerated much better than the ionic ones. Also in the field of catheter techniques the introduction of new catheters has led to considerable progress. The new catheters are characterized by very thin walls and wide lumina which allow a high flow of contrast media. Their use in children has considerably reduced local complications at the puncture site. The introduction of digital subtraction techniques on the one hand made intravenous angiography in pediatric patients possible and on the other hand led to considerable reduction of contrast media as compared to conventional angiography. Motion artifacts, however, cause problems. In interventional radiology, as far as blood vessels are concerned, technical possibilities are the same for children as for adults. Dilatations of blood vessels are the main indications. For embolizations the indications are mainly tumor embolizations and bleeding embolizations. PMID- 3528822 TI - [Ultrasound diagnosis: principles of application]. AB - Continuous technical development, more and more users of ultrasound and increasing experience in investigating various organs and regions of the human body have contributed to the fact that diagnostic ultrasound even in children today is a method of choice in many cases. The purpose of this report is to show the various indications and possibilities of ultrasound and to discuss the significance and value in comparison with other imaging modalities. PMID- 3528823 TI - [New aspects on the pathogenesis of patent ductus arteriosus in premature infants]. AB - It is generally accepted that vasodilator prostaglandins are involved in the pathogenesis of persistent ductus arteriosus (PDA) in preterm infants suffering from respiratory distress syndrome (RDS). When studying the prostaglandin metabolism it became apparent that in about 80% of these infants the activity of PGI2 and/or PGE2 was increased. In parallel to weaning infants from the respirator a decrease in prostaglandin activity was observed which was associated with ductal closure. The inhibition of prostaglandin synthesis with indomethacin had the same effect. Considering the various lines of evidence that an artificially ventilated lung is releasing vasodilatory prostaglandins into the circulation we postulated the following sequence of events in the pathogenesis of PDA in preterm infants: development of RDS or other pulmonary lesions which require artificial ventilation; this mechanical intervention causes permanent shear stress and barotrauma on the pulmonary tissue; this stress causes release of arachidonic acid from phospholipids; subsequently vasodilatory prostanoids, such as PGI2 and PGE2 are released and reach the pulmonary circulation and the ductus arteriosus. As a consequence the left-to-right shunt causes pulmonary hypercirculation with further need to continue artificial ventilation. A vicious circle is established. This circle can be broken by ductus ligation, by indomethacin treatment, by less traumatic artificial ventilation or by early weaning from the respirator with theophylline. PMID- 3528824 TI - Prevention of venous thrombosis and pulmonary embolism. PMID- 3528825 TI - Acute pancreatitis: update 1986. PMID- 3528826 TI - [The labio-lingual contour of the upper central incisor clinical crown]. PMID- 3528827 TI - Effects of norharman on the mutagenicity of chlorophenylhydroxylamine and its metabolism with rat liver S9. AB - o,p-Chlorophenylhydroxylamines (CPHAs) (10468-16-3, 823-86-9) only demonstrated mutagenicity in the presence of S9 mix and norharman (NOH) (244-63-3), as well as chloronitrobenzenes. The mutagenic activity of o-CPHA was 30 times higher than that of p-CPHA. When o-CPHA was preincubated with S9 mix without NOH, the mutagenic activity disappeared rapidly. The decrease in activity during the preincubation was suppressed by addition of NOH. HPLC analysis revealed that o CPHA was metabolized to o-chloroaniline (o-CA) (95-51-2) and that the metabolic reduction was inhibited by NOH. When microsomes containing NADPH were used instead of S9 mix, o-CPHA exhibited only very weak mutagenicity. The activity in the microsome system, however, was greatly enhanced by adding cytosol or ascorbic acid (50-81-7). These phenomena were only observed in the conventional plate incorporation method. In the case of the liquid incubation assay, in which test compound metabolism and tester strain mutation only occur in the liquid incubation medium, the mutagenic activity of o-CPHA in the microsome system with NOH was comparable to that in the S9 system, indicating that o-CPHA was activated by an enzyme in microsomes in the presence of NOH. Consequently, it was concluded that NOH not only affects the metabolic inactivation of o-CPHA to o-CA by S9, but also the metabolic activation of o-CPHA by microsomes. No appreciable enhancing effects of cytosol and ascorbic acid were observed in the liquid incubation assay, suggesting that these factors affect the stability of CPHA or an active metabolite. The microsome activation of o-CPHA was dependent on NADPH and oxygen; SKF-525A (62-68-0), metyrapone (54-36-4) and alpha-naphthoflavone (604-59-1) inhibited the mutagenic activity by about 50%, suggesting that cytochrome P-450 was involved in the metabolic activation. PMID- 3528828 TI - The effect of quercetin, a mutagenicity-enhancing agent, on the metabolism of 2 acetylaminofluorene with mammalian metabolic activation systems. AB - The effect of quercetin as the comutagen on 2-acetylaminofluorene (AAF) was investigated. AAF was metabolized with mammalian metabolic systems (S9 mix) in the presence or absence of quercetin in vitro, and its metabolites were determined by high-performance liquid chromatography. In the presence of quercetin, the total metabolic rate of AAF decreased compared with that in the absence of quercetin, whereas the formation of N-hydroxy-AAF (N-OH-AAF) and 2 aminofluorene (AF) increased. Since the main metabolic pathway of AAF is aryl hydroxylation, it is suggested that the decrease of total metabolic rate of AAF is due to the inhibition of aryl-hydroxylation by quercetin. From these results, it seems probable that the comutagenic effect of quercetin on AAF is due to the inhibition of aryl-hydroxylation (the detoxifying pathway) and the promotion of N hydroxylation and deacetylation (the activating pathway) in the AAF metabolism with S9 mix. PMID- 3528829 TI - Nickel(II) genotoxicity: potentiation of mutagenesis of simple alkylating agents. AB - Many metals have been shown to alter the function of a wide range of enzyme systems, including those involved in DNA repair and replication. To assess the impact in vivo of such metal actions a "Microtitre" fluctuation assay was used to examine the ability of Ni(II) to act as a comutagen with simple alkylating agents. In E. coli, Ni(II) chloride potentiated the mutagenicity of methyl methanesulfonate (MMS) in polymerase-proficient strains (WP2+ and WP2-), but not in polA- strains (WP6 and WP67) or in lexA- (CM561) or recA- (CM571) strains. The absence of UV excision repair (WP2- and WP67) had little, if any, effect. An extended lag phase was seen at 2-4 h in the polA- strains following treatment with Ni(II) chloride and MMS, but normal growth resumed thereafter. Results suggested that mutations induced by MMS were fixed during log phase growth and that more than 2 h of exposure were necessary for potentiation by Ni(II) to be observed. Thus, the extended lag phase probably cannot explain the lack of potentiation. RecA-dependence of the comutagenic effect was corroborated with S. typhimurium TA1535 and TA100. Only in the pKM101 containing strain, TA100, was potentiation of ethyl methanesulfonate (EMS) and MMS by Ni(II) chloride evident. The mucAB genes carried on pKM101 increase the sensitivity of TA100 to a variety of mutagens, providing there is a functional recA gene product. Taken together, the data suggest that Ni(II) acts indirectly, as a comutagen, in bacterial systems, possibly affecting processes involving recA- and/or polA-dependent function(s). PMID- 3528830 TI - Genetic and anti-tubulin effects induced by pyridine derivatives. AB - A series of pyridine derivatives, 2-methyl-, 2-chloro-, 2-acetyl-, 3-acetyl-, 4 acetyl, 2-phenyl-, 2,4-dimethyl-, 2,6-dimethyl- and 2-methyl-5-ethyl-pyridine, were shown to induce mitotic aneuploidy in strain D61.M of Saccharomyces cerevisiae. Induction of mitotic recombination was also observed with 3- and 4 acetylpyridine and 2-phenylpyridine in strain D61.M. 4-Acetylpyridine and 2 phenylpyridine were found to induce mitotic gene conversion and 2-phenyl-pyridine also induced reverse mutation in strain D7 of Saccharomyces cerevisiae. These two agents also inhibited the GTP-mediated assembly of porcine brain tubulin in vitro. PMID- 3528831 TI - The Salmonella typhimurium/mammalian microsomal assay. A report of the U.S. Environmental Protection Agency Gene-Tox Program. AB - The Salmonella assay has been in use for almost 15 years and can be defined as a routine test for mutagenicity and for predicting potential carcinogenicity. It detects the majority of animal carcinogens and consequently plays an important role in safety assessment. The test is also routinely used as the frontline screen for environmental samples (complex mixtures) isolated from air, water and food. This role will continue to remain an area of growth as or because sample volumes associated with these testing areas are generally very limited and more extensive testing is generally impossible. While this test, like all others, has some limitations, it is recommended that it be regularly included in all genetic testing batteries. PMID- 3528832 TI - Detection of 1-nitropyrene in yakitori (grilled chicken). AB - Pieces of raw chicken with or without a marinating sauce were grilled over a city gas flame, extracted with benzene-ethanol (4:1) by ultrasonication and fractionated into diethyl ether-soluble neutral, acidic and basic fractions. The mutagenicity of these fractions was measured with Salmonella typhimurium strains TA100, TA98, TA98NR and TA98/1,8-DNP6 in the presence and absence of a 9000 X g post-mitochondrial supernatant from Aroclor 1254-treated Sprague-Dawley rat liver (S9 mix). The basic fraction of yakitori without the sauce was more mutagenic than the other fractions for S. typhimurium strain TA98 in the presence of S9 mix. This is probably due to the presence of amino acid or protein pyrolysates. However, when the chicken was grilled with the sauce, the basic fraction showed lower mutagenicity for strain TA98 in the presence of S9 mix than did the same fraction without the sauce. The neutral fraction of yakitori with sauce showed high mutagenicity for strain TA98 in the absence of S9 mix, but low mutagenicity for strains TA98NR and TA98/1,8-DNP6, suggesting that this fraction might contain nitropyrenes (NPs). The neutral fraction of yakitori was analyzed by high performance liquid chromatography (HPLC). The neutral fraction of the chicken grilled with the sauce for 3, 5 and 7 min contained 3.8, 19 and 43 ng, respectively, of 1-NP per gram of yakitori accounting for 3.0, 2.7 and 1.3%, respectively, of the total mutagenicity.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3528833 TI - Influence of frying fat on mutagenic activity in lean pork meat. AB - Mutagenic activity in lean pork meat fried at two different pan temperatures, 200 degrees C and 250 degrees C, with or without the addition of fat, was measured in Ames' Salmonella test on strain TA98. 9 different fats with varying chemical composition were tested. All fried meat samples were shown to be mutagenic. At the frying temperature of 200 degrees C differences between meat samples fried in different fats or without fat, respectively, were small. All meat samples fried at 250 degrees C were considerably more mutagenic than the samples fried at 200 degrees C. At 250 degrees C, the addition of fat caused a significant rise in mutagenic activity. We believe this is mainly an effect of more efficient heat transfer from the bottom of the frying-pan to the meat samples, although other factors may also contribute. PMID- 3528834 TI - Hepatocyte-mediated mutagenicity of mononitrobenzo[a]pyrenes in Salmonella typhimurium strains. AB - The mononitro-substituted isomers of benzo[a]pyrene (B[a]P), 1-, 3- and 6 nitrobenzo[a]pyrene (NB[a]P), are environmental pollutants and are metabolized to mutagens in Salmonella by rat-liver homogenate postmitochondrial supernatant (S9) fractions. In this study, activation of these compounds to mutagens was investigated using the hepatocyte-mediated Salmonella mutagenicity assay. Hepatocytes from rats treated with Aroclor 1254 activated both 3-NB[a]P and 1 NB[a]P to mutagens, while 6-NB[a]P was not mutagenic. The positive mutagenicity responses were functions of both the chemical dose and the hepatocyte concentration. By using a nitroreductase-deficient strain (TA98NR) and a transesterificase-deficient strain (TA98/1,8-DNP6), it was verified that the direct-acting mutagenicities of 1- and 3-NB[a]P primarily were due to metabolic processes involving nitroreduction while the S9- and hepatocyte-mediated mutagenicity responses were also dependent on transesterification. When compared with the mutagenic responses produced with S9, the mutations induced by 1- and 3 NB[a]P in the presence of hepatocytes were relatively more dependent upon nitroreductase metabolism and less on transesterification. Thus, intact hepatocytes were capable of activating 1- and 3-NB[a]P to mutagenic metabolites and some of these metabolites appeared to be different from those produced by S9. PMID- 3528835 TI - Evaluation of Thimet 10-G for mutagenicity by 4 different genetic systems. AB - The insecticide Thimet 10-G was tested for mutagenic activity by 4 different genetic systems. It was unable to induce gene mutation in Salmonella, transfection inhibition in Mycobacterium, micronuclei formation in mice, and sister-chromatid exchange (SCE) in human lymphocytes were evaluated. It caused in mice an increase in the ratio of normochromatic to polychromatic erythrocytes and in human lymphocytes a decrease in mitotic index and delay in cell cycle. The results indicate that the insecticide is not mutagenic in the 4 test systems used at present. PMID- 3528836 TI - Comparative in vivo and in vitro genotoxicity studies of airborne particle extract in mice. AB - The genotoxicity of an acetone extract of locally collected airborne particles was evaluated both in vitro and in vivo using the sister-chromatid exchange (SCE) assay in mice. At the highest concentration (5.36 mg/5 ml culture), the extract caused approximately a 3-fold increase in SCEs over controls in mouse bone marrow and spleen primary cells in vitro. However, the same airborne particle extract did not induce a significant increase in the SCE level over controls in vivo in mouse bone marrow and spleen cells when administered intraperitoneally or through oral gavage. This indicates that bone marrow and spleen primary cell cultures can be used in in vitro genotoxicity studies of complex mixtures, and that the genotoxicity of airborne particles detected in the in vitro system cannot always be detected in vivo with the same cell types. In addition, the same acetone extract of airborne particles caused dose-related his+ revertants in the strain TA98 of Salmonella typhimurium, both with and without S9 activation. The significant finding of this study is that the in vitro genotoxicity results of airborne particle extract may not be very meaningful in an in vivo situation. PMID- 3528837 TI - Mutagenicity of para-substituted alpha-methylstyrene oxide derivatives with Salmonella. AB - A series of 5 para-substituted alpha-methylstyrene oxide derivatives have been synthesized and together with alpha-methylstyrene oxide as well as styrene oxide have been studied as to their mutagenicity with the TA100 and TA1535 strains of Salmonella typhimurium. A multiple regression analysis model has been developed which describes the mutagenicity of the alpha-methylstyrene oxides in TA100. An increase in van der Waals volume was the most important variable in the model with greater improvement occurring with inclusion of the Hammett values for the para substituents on the compounds. The alpha-methylstyrene oxides were less active alkylating agents with 4-(p-nitrobenzyl)pyridine than styrene oxide and with pyridine all reactivity was at the beta-epoxide carbon. However all the alpha-methylstyrene oxide derivatives, except for the bromo compound where toxicity was evident, showed mutagenicity values either greater or comparable to that of styrene oxide. These studies would indicate that reactivity at the beta carbon should also be a factor in describing the mutagenicity of the parent styrene oxide series. PMID- 3528838 TI - Mutagenic effect of amniotic fluid from smoking women at term. AB - Concentrated term amniotic fluid samples from 44 women smokers and 44 controls were investigated with respect to mutagenic effect in the Salmonella/mammalian microsome mutagenicity test, using tester strains TA98 and TA100. Tests with freeze-dried specimens of term amniotic fluid showed increases in the number of revertant colonies over background values, regardless of smoking status. However, samples from heavy smokers produced a higher number of revertants than did samples from nonsmokers in several experiments with tester strain TA98. The increase was statistically significant, using either total tar content or number of cigarettes smoked to identify heavy smokers. Experimental series with tester strain TA100 also resulted in higher group means for heavy smokers than for nonsmokers, but the difference was not statistically significant with the concentrations used in this assay. We conclude that heavy smokers may expose their unborn children to mutagenic substances. PMID- 3528839 TI - Contribution of wood stoves and fire places to mutagenic activity of airborne particulate matter inside homes. AB - Wood combustion produces compounds that are mutagenic in the Salmonella/microsome assay. As combustion products can be emitted in the home and the use of wood as a residential energy source is growing, an impact on human health might be of concern. In this study experiments were carried out to determine the contribution of wood combustion in stoves and fire places to indoor mutagenic activity under normal living conditions. Airborne particles from living rooms which were heated by stoves, or by fire places, and from outdoors were collected simultaneously. In each room two samples were collected during two consecutive weeks: one week the room was heated by central heating, the other week by wood combustion. Sampling took place in a total of 24 homes. Methanol extracts of the samples were tested in the Salmonella/mammalian microsome assay. Results show that mutagenic activity of outdoor air exceeds indoor mutagenicity. At the same time a correlation is found between in- and out-door mutagenicity, both with and without S9. However, a large difference is found between the ratio -S9/+S9 of in- and out-door mutagenic activity. Systematic differences in the ratio -S9/+S9 between control and experimental conditions are not observed. The use of wood stoves caused an increase of indoor mutagenicity in 8 out of 12 homes. It could be concluded that the use of an open fire consistently leads to an increase of mutagenic activity. This increase was caused by wood combustion products. PMID- 3528840 TI - Airplane emissions: a source of mutagenic nitrated polycyclic aromatic hydrocarbons. AB - Organic solvent extracts from airplane emission particulates are mutagenic for Salmonella typhimurium strain TA98. Using Salmonella tester strains deficient in enzymes required for the bioactivation of various nitroarenes, the mutagenicity present in these emissions was ascribed to the presence of nitrated polycyclic aromatic hydrocarbons. Based on the known aircraft particulate emission rates at U.S. airports, and using 1-nitropyrene (1-NP) and 1,8-dinitropyrene (1,8-DNP) as surrogates, it is calculated that at a minimum 7 kg 1-NP and 20 g, 1,8-DNP are emitted daily at a typical U.S. airport. PMID- 3528841 TI - Mutagenic activation of the benzidine-based dye direct black 38 by human intestinal microflora. PMID- 3528842 TI - SOS induction of the gene sulA is partly inhibited in Escherichia coli K12 cells overproducing the RecA protein. AB - A study was made of the SOS induction of the gene sulA of Escherichia coli K12 in relation to the gene dosage of the gene recA. In experiments the sulA::lacZ fusion strain PQ37 and derivatives of PQ37 with the multi-copy plasmids pDR1453 or pBR322 were used. The SOS response was induced with nitrofurantoin, SOS induction of the gene sulA was determined on the basis of the amount of beta galactosidase synthesized, i.e. by the SOS chromotest (Quillardet et al., 1982a). It was found in this work that cells with the plasmid pDR1453, which contain the gene recA of E. coli K12 (Sancar and Rupp, 1979), have a decreased SOS induction of the gene sulA. Cells with the plasmid pBR322 do not exhibit this decrease. Inactivation of the gene recA in the plasmid pDR1453 with preservation of the functional gene recA in the chromosome leads to a restoration of 'standard' SOS induction of the gene sulA. The results show that the amount of the gene product of the gene recA affects the SOS induction of the gene sulA. PMID- 3528843 TI - N-acetyl derivative as the major active metabolite of 2-amino-6 methyldipyrido[1,2-a:3',2'-d]imidazole in rat bile. AB - 2-Amino-6-methyldipyrido[1,2-a:3',2'-d]imidazole (Glu-P-1) is a mutagen and carcinogen isolated from a glutamic acid pyrolysate. When this 14C-labeled compound was administered to male F344 rats at a dose of 0.3 mCi (20.8 mg)/kg b.w., 70% of the radioactivity was excreted into the bile in 24 h. On HPLC analysis of this bile, several metabolites of Glu-P-1 were found with unmetabolized Glu-P-1. One of the mutagenic metabolites was identified as N acetyl-Glu-P-1. This metabolite had a specific mutagenic activity of about one quarter of that of Glu-P-1 and its amount in the bile corresponded to a few percent of the dose of Glu-P-1 administered. PMID- 3528845 TI - Isolation of Cryptococcus neoformans var. neoformans in the aviaries of the Antwerp Zoological Gardens. PMID- 3528844 TI - Effect of hydrogen sulfide on the mutagenicity of hydrogen peroxide in Salmonella typhimurium strain TA102. PMID- 3528846 TI - [Antimicrobial effects of in vitro-simulated ketoconazole-cantharidin blister fluid levels on candida albicans]. PMID- 3528847 TI - Multiple brain abscesses caused by Torulopsis glabrata in an immunocompromised patient. PMID- 3528848 TI - Characterization of Plasmodium falciparum sexual stage antigens and their biosynthesis in synchronised gametocyte cultures. AB - Synchronised gametocyte cultures were used to study the biosynthesis of the sexual stage target antigens (Mr 230 000, 48 000 and 25 000) for anti gamete/zygote antibodies. These antigens were shown to be synthesized during gametocyte development from day 2-3 onwards until gametogenesis occurred. After gametogenesis a 25 kDa protein was predominantly synthesized, whereas synthesis of the other target proteins was hardly detectable. The 48, 45, and 25 kDa proteins appeared to be glycosylated, in addition the 25 kDa was also acylated in that it bound [3H]palmitic acid covalently. The iso-electric point (pI) of these proteins was assessed as being 6.0 +/- 0.1 (for both 48 and 45 kDa) and 5.6 +/- 0.1 (for 25 kDa). PMID- 3528849 TI - A study of the membrane attachment site of the membrane-form variant surface glycoprotein from Trypanosoma brucei brucei using lipid vesicles as a model of the plasma membrane. AB - The incorporation of the membrane form and the soluble form of variant surface glycoprotein (mfVSG and sVSG) from Trypanosoma brucei brucei into liposomes has been investigated. It was found that selective incorporation of mfVSG into liposomes was possible in the presence of 8 M urea as a denaturing agent; sVSG, by contrast, was incorporated only poorly into liposomes. After proteolysis of mfVSG incorporated into liposomes, a compound was isolated from the liposomes which carries with it constituents of the glyophospholipid membrane anchor: ethanolamine, di-14:0-diglyceride and phosphatidylinositol were identified by electron impact and fast atom bombardment mass spectrometry, thus providing direct confirmation of the earlier findings of Holder [Holder, A.A. (1983) Biochem. J. 209, 261-262] and Ferguson et al. [Ferguson, M.A.J., Haldar, K. and Cross, G.A.M. (1985) J. Biol. Chem. 260, 4963-4968; Ferguson, M.A.J., Low, M.G. and Cross, G.A.M. (1985) J. Biol. Chem. 260, 14547-14555]. PMID- 3528850 TI - Kidney transplantation from unrelated living donors. PMID- 3528851 TI - The destabilization of health care. PMID- 3528852 TI - Absence of therapeutic benefit from antacids or cimetidine in non-ulcer dyspepsia. PMID- 3528854 TI - Is the teaching hospital an endangered species? PMID- 3528853 TI - Prophylactic treatment of very premature infants with human surfactant. AB - We undertook a randomized, controlled trial to determine whether human surfactant administered endotracheally at birth to very premature infants (gestational age, 24 to 29 weeks) would prevent the respiratory distress syndrome or reduce its severity. Thirty-one treated infants (birth weight, 938 +/- 286 g) were compared in a blinded fashion with 29 control infants (birth weight, 964 +/- 174 g). The lecithin/sphingomyelin ratio was less than 2 in all infants, and phosphatidylglycerol was not present in amniotic fluid or tracheal fluids at birth, indicating a deficiency of surfactant in the lungs. The principal dependent variables were neonatal death, the incidence of bronchopulmonary dysplasia, and the infant's requirement for respiratory support (and its complications). The surfactant-treated group had significantly fewer deaths than the control group (16 percent vs. 52 percent, P less than 0.001), fewer cases of bronchopulmonary dysplasia (16 percent vs. 31 percent), and significantly fewer cases of pulmonary interstitial emphysema (P less than 0.001) and pneumothorax (P less than 0.02). Prophylactic treatment with human surfactant also substantially reduced the period of neonatal intensive care. We conclude that treatment with human surfactant offers promise for improving the survival of very premature infants with a surfactant deficiency and for reducing the pulmonary sequelae of the respiratory distress syndrome. PMID- 3528855 TI - Outcome in patients with asymptomatic neck bruits. AB - Five hundred asymptomatic patients with cervical bruits were followed prospectively by clinical and Doppler examination for up to four years (mean, 23.2 months) to identify the variables predicting outcome. Thirty-six patients had strokes or transient ischemic attacks, 51 had cardiac ischemic events, and 45 died. At one year the incidence of cerebral ischemic events (transient ischemic attacks and strokes) was 6 percent, that of cardiac ischemic events was 7 percent, and that of death was 4 percent. The overall incidence of stroke at one year was 1.7 percent (1 percent in patients without previous transient ischemic attacks), but the incidence was 5.5 percent in patients with severe carotid artery stenosis (greater than 75 percent). Cerebral ischemic events were most frequent in patients with severe carotid-artery stenosis (P less than 0.0001), progressing carotid-artery stenosis (P less than 0.0005), or heart disease (P less than 0.0005) and in men (P less than 0.025). The degree of carotid-artery stenosis on initial presentation was a powerful predictor of neurologic sequelae. Patients with asymptomatic cervical bruits have a higher risk of a cardiac ischemic event than of a stroke. Although the risk of cerebral ischemic events is highest in patients with severe carotid-artery stenosis, in most instances even these patients do not have strokes without some warning. PMID- 3528856 TI - Carotid-artery disease. PMID- 3528857 TI - Failure of high-dose tocopherol to prevent alopecia induced by doxorubicin. PMID- 3528858 TI - Kinetic description of proteolysis. Part 1. Peptic hydrolysis of proteins isolated from chicken heart: optimization in terms of time and substrate concentration. AB - Simple equation for the total rate of proteolysis is proposed. The equation, based on the renal mechanism of proteolysis includes the substrate concentration and some functions of the degree of hydrolysis. These functions are experimentally determined in the case of peptic hydrolysis of chicken heart proteins. The integration of differential equation made it possible to describe the kinetics of the proteolysis in terms of substrate concentration, degree of proteolysis and reaction time. The kinetics of proteolysis does not obey the Michaelis-Menten law. The proposed way for mathematical modelling permits the optimization by productivity. PMID- 3528859 TI - Substances with biological activity of vitamin B12 formed during cultivation of Propionibacterium freudenreichii in the presence of precursors (short communications). AB - The papers of Kolhouse et al. and Cooper et al. described the occurrence of vitamin B12 analogues of unknown origin in blood serum. Some of these analogues may be derived from slaughter cattle raised on feed supplemented with vitamins and minerals, as was observed by Allen. Herbert et al. found vitamin B12 analogues in multivitamin preparations produced in U.S.A., and Kanazawa et al. in human liver, red cells and brain. It is not clear so far, if and how do vitamin B12 analogues interfere with vitamin B12 metabolism. When P. freudenreichii was cultivated in the presence of o-phenylenediamine and 5,6-dimethylbenzimidazole, which may be considered precursors as well as antimetabolites of vitamin B12, the stimulation of biosynthesis of substances with biological activity of vitamin B12 took place. Various signs show that these substances are probably vitamin B12 analogues. During stimulated and nonstimulated production of vitamin B12 by P. freudenreichii, two substances with vitamin B12 biological activity have always been obtained. Their relation was not stable and differed according to the conditions of cultivation. Every attempt to stimulate the biosynthesis of vitamin B12 resulted in the suppression of production of the substance with higher molecular weight, even if the biosynthesis of cobalamin (lower molecular weight) was increased. In our note we want to pay attention to the character of substances arising in the stimulated biosynthesis. PMID- 3528860 TI - Immune system. Complement-like cytotoxicity? PMID- 3528861 TI - Expression of a transfected human c-myc oncogene inhibits differentiation of a mouse erythroleukaemia cell line. AB - The Friend-virus-derived mouse erythroleukaemia (MEL) cell lines represent transformed early erythroid precursors that can be induced to differentiate into more mature erythroid cells by a variety of agents including dimethyl sulphoxide (DMSO). There is a latent period of 12 hours after inducer is added, when 80-90% of the cells become irreversibly committed to the differentiation programme, undergoing several rounds of cell division before permanently ceasing to replicate. After DMSO induction, a biphasic decline in steady-state levels of c myc and c-myb messenger RNAs occurs. Following the initial decrease in c-myc mRNA expression, the subsequent increase occurs in, and is restricted to, the G1 phase of the cell cycle. We sought to determine whether the down-regulation is a necessary step in chemically induced differentiation. Experiments reported here indicate that expression in MEL cells of a transfected human c-myc gene inhibits the terminal differentiation process. PMID- 3528863 TI - Deregulated expression of c-myc by murine erythroleukaemia cells prevents differentiation. AB - Friend murine erythroleukaemia (F-MEL) cells are a permanent line of primitive erythroid precursors originally derived from the spleens of mice infected with the Friend strain of murine leukaemia virus. F-MEL cells differentiate in vitro in response to various chemical inducers. Concomitantly with induction, a biphasic regulation of c-myc oncogene transcripts is observed. Within one hour of the addition of dimethyl sulphoxide (DMSO) or hypoxanthine (Hyp), the levels of c myc transcripts fall dramatically and remain virtually undetectable for the next few hours. Between 8 and 24 hours after induction, c-myc transcripts return to pre-induction levels and then decline again between 3 and 5 days as most of the cells undergo terminal differentiation. To explore the potential relationship between c-myc expression and F-MEL terminal differentiation, we have investigated here whether reversing the early fluctuations in c-myc transcript levels affects the ability of F-MEL cells to differentiate. We therefore constructed an amplifiable plasmid vector containing a full-length mouse c-myc complementary DNA and introduced it stably into recipient F-MEL cells. The exogenous c-myc sequences are transcribed in F-MEL cells and the transcript levels do not change significantly in response to inducing agents. The net result is continued c-myc expression following DMSO or Hyp induction and a complete or partial inhibition of F-MEL differentiation. PMID- 3528862 TI - Analysis of T-cell subsets in rejection of Kb mutant skin allografts differing at class I MHC. AB - The T-cell subpopulations which initiate and mediate tissue allograft rejection remain controversial. In the present study we attempted to identify the phenotype and function of the T-cell subset(s) primarily responsible for the rejection of skin allografts differing at a single class I locus in the major histocompatibility complex (MHC). We found that the rejection rates by B6 mice (H 2b) of four different class I mutant (Kbm) skin allografts form a distinct hierarchy. This hierarchy correlates strikingly and uniquely with the relative precursor frequencies of Lyt2+ interleukin-2-secreting T-helper cells reactive against the various Kbm mutants. To investigate the role of Lyt2+ T cells in the rejection of class I-disparate skin allografts directly, H-2b nude mice were engrafted with Kbm skin allografts and then reconstituted with L3T4+ or Lyt2+ T cell subpopulations from syngeneic H-2b mice. Lyt2+ T cells were observed to be both necessary and sufficient for the rejection of class I-disparate Kbm skin allografts, whereas L3T4+ T cells were neither necessary nor sufficient. These results identify the Lyt2+ interleukin-2-secreting T-cell subset as the critical cell type determining the rejection rate of class I-disparate Kbm skin allografts. PMID- 3528864 TI - Bone marrow grafts and tolerance. PMID- 3528865 TI - Similarity of mas and rhodopsin gene products. PMID- 3528866 TI - Monoclonal antibodies to promote marrow engraftment and tissue graft tolerance. AB - Allogeneic reactions are the major limitation to organ transplantation. These are manifested as rejection of the grafted tissue, and also, in the case of bone marrow transplantation (BMT), graft-versus-host disease (GVHD). Recent methods of avoiding GVHD, by depleting T cells from donor marrow, have led to an increased incidence of marrow graft rejection. Current recipient conditioning protocols involving drugs or irradiation cannot safely be increased, so alternatives must be found. Monoclonal antibodies can be used to control immune responses in vivo, and would be useful in this context if we could define and deplete the cells responsible for marrow rejection. We show here that elimination of residual L3T4+ and Lyt-2+ cells from mice receiving fully mismatched bone marrow abrogates rejection and promotes tolerance to donor-type skin grafts, even in sub-lethally irradiated recipients. PMID- 3528867 TI - Growth restoration of insulin-deficient diabetic rats by recombinant human insulin-like growth factor I. AB - Insulin-like growth factor I (IGF-I) and insulin stem from a common precursor, are structural homologues, act through similar receptors and elicit insulin-like and growth-promoting effects in vitro and in vivo. Serum IGF-I levels are controlled by growth hormone, insulin and nutrition. Insulin-deficient growth arrested diabetic animals have reduced serum IGF-I levels which are restored towards normal by insulin but not by growth-hormone treatment. Here we show that normal growth of diabetic rate is restored by infusion of recombinant human (rh)IGF-I without normalization of the blood sugar level and that insulin acts via an increase of IGF-I synthesis on growth of diabetic rats. We describe a new mechanism of endocrine control of growth in which IGF-I is the major stimulator at the cellular level. Growth hormone and insulin act mainly by modulating the hepatic synthesis of IGF-I. PMID- 3528868 TI - Selective proteolysis defines two DNA binding domains in yeast transcription factor tau. AB - Transcription of eukaryotic transfer RNA genes involves, as a primary event, the stable binding of a protein factor to the intragenic promoter. The internal control region is composed of two non-contiguous conserved sequence elements, the A and B blocks. These are variably spaced depending on the genes. tau, a large transcription factor purified from yeast cells, interacts with these two control elements as shown by DNase I footprinting, exonuclease digestion, dimethyl sulphate protection experiments and by analysis of point mutations. Here we used a limited proteolysis treatment to obtain a smaller form of tau with drastically altered DNA binding properties. A protease-resistant domain interacts solely with the B block region of tRNA genes. PMID- 3528869 TI - Roster. North Carolina Medical Society. 1986-1987. PMID- 3528870 TI - [Prevention of graft-vs-host disease following allogeneic bone marrow transplantation]. PMID- 3528871 TI - [C-reactive protein; an expensive sedimentation?]. PMID- 3528872 TI - [The extreme gag reflex in dental situations: a review of the literature]. PMID- 3528873 TI - [Dental prostheses in the Dutch population (1950-) 1981-1984]. PMID- 3528874 TI - [Nomen est omen: disease nomenclature and concept of disease as exemplified by epilepsy]. PMID- 3528875 TI - Volume homoeostasis in cirrhosis of the liver. Pathogenetic and therapeutic implications. PMID- 3528876 TI - Central nervous system involvement in systemic lupus erythematosus. A review of clinical observations, pathophysiology, diagnosis, disease course, prognosis and therapy. PMID- 3528877 TI - Magnesium and bone disease. PMID- 3528878 TI - Cellular infiltrate in renal graft rejection: T lymphocyte subsets detected by monoclonal antibodies. AB - We have examined the interstitial cellular infiltrate using monoclonal antibodies against T cells (Cris 1), helper/inducer T cells (OKT4) and suppressor/cytotoxic T cells (OKT8) by indirect immunofluorescence in renal biopsies taken from 14 transplanted patients during clinical episodes suggestive of acute (n = 9), chronic (n = 2) and no rejection (n = 3). Infiltrating T cells and T cell subsets were found to be significantly increased during all types of rejection (n = 11) as compared to no rejection (n = 3). Two types of biopsies could be distinguished according to the predominance of T cell subsets. In some biopsies (n = 6), OKT8+ cells were significantly more numerous that OKT4+ cells. In the remaining biopsies (n = 5), OKT4+ cells were more common that OKT8+ cells, the OKT4/OKT8 ratio being significantly higher. No association was observed between HLA mismatch and predominating T cell subset, neither for type nor outcome of graft rejection. Our results suggest that the OKT4+ cells may play a more important role than previously reported in renal graft rejection. PMID- 3528879 TI - Cyclosporin A in pediatric kidney transplantation and its effect on posttransplantation growth. AB - Results of cyclosporin A (CyA) treatment following kidney transplantation in 28 children were compared with those of conventional immunosuppression with azathioprine (Aza) in 34 children. CyA was given in combination with low-dose prednisolone. Under CyA the 2-year survival rate of patients and grafts was 96%, under Aza the 2-year survival rate of patients was 94% and of grafts 68% (p less than 0.01). Graft function was slightly lower in the CyA than in the Aza group. Growth after kidney transplantation was evaluated in those patients with a first graft and a function of longer than 1 year. Annual growth velocity for bone age was normal or even accelerated in all children treated with CyA and significantly better than in the children treated with Aza. It is concluded that CyA treatment combined with low-dose prednisolone yields excellent results and allows normal growth rates after kidney transplantation. PMID- 3528880 TI - Acute and chronic effects of captopril on bicyclo-PGEm, the stable bicyclic end product of prostaglandin E2 in essential hypertension. AB - Hemodynamic and hormonal actions of acute (50 mg) and chronic (150 mg/day) captopril were tested in 10 patients with essential hypertension. Under short term conditions blood pressure was reduced, heart rate and plasma adrenaline did not change, plasma angiotensin II and plasma aldosterone decreased. Plasma renin activity, basal plasma noradrenaline and bicyclo-PGEm, a novel stable metabolite of prostaglandin E2, increased after captopril. With chronic captopril treatment blood pressure was reduced after 4 weeks before readministration of captopril, heart rate did not change, plasma renin activity and bicyclo-PGEm remained elevated for 12 h after the last captopril dose. Angiotensin II remained suppressed, aldosterone and plasma catecholamines did not change between doses. Readministration of captopril led to a further reduction in blood pressure. Angiotensin II and aldosterone were further suppressed, bicyclo-PGEm levels increased from a higher baseline. Heart rate and plasma catecholamines did not change. Taken together, the results suggest that prostaglandin E2 is involved in the acute and chronic hypotensive response of captopril in patients with essential hypertension. PMID- 3528881 TI - Elevated plasma renin activity associated with renal dysfunction. AB - Elevated plasma renin activity (PRA) has been documented in patients with established acute renal failure. To study the association of PRA and renal dysfunction, 53 patients who were at risk of developing acute renal failure had serial measurements of PRA, renal function, and urinary beta 2-microglobulin. Those entered for study had pneumonia, septicaemia, volume loss with hypotension, or major surgical procedures with complications. Patients were divided into groups of abnormal or normal renal function. Abnormal renal function was defined by an elevated plasma urea and/or creatinine level with a submaximal urine urea to plasma urea ratio. The mean values of PRA for the abnormal and normal renal function groups, respectively, were 29 and 5.2 ng/ml/h (p less than 0.0001) and for beta 2-microglobulin 16.2 and 6.4 micrograms/l X 10(3) (p less than 0.0005). A linear regression of the logs of PRA to beta 2-microglobulin for the total group of patients gave an r value of 0.526 (p less than 0.001). These data show an association of PRA to renal dysfunction and tubular injury/dysfunction in the prerenal phase of renal failure, suggesting an effect of the renin-angiotensin system at this phase. It is not possible, however, to conclude from our study that the renin-angiotensin system has a direct role in the development of established acute tubular necrosis, since only 3 patients fell within this category. PMID- 3528882 TI - Surgical versus medical treatment in renovascular hypertension. Retrospective study of 166 cases. AB - A retrospective study of 166 cases of renovascular hypertension was performed. Before 1979, 114 patients were treated for renovascular hypertension. Forty underwent surgery. In this group, therapy resulted in cure or improvement in 45% of the patients. Seventy-four patients underwent medical therapy: 88% of these patients had improvement of blood pressure when beta-blockers were used, but only 41% when they were not. More recently (from 1979 to 1983), 52 patients were treated for renovascular hypertension, of which 31 patients have been operated for fibromuscular renal artery stenosis (62%) or atherosclerotic renal artery stenosis (32%). In this group, 90% of the patients were considered to be cured or improved with a mean follow-up of 36 months. Eighteen of thirty-one patients underwent autotransplantation with satisfactory results on blood pressure control. Twenty-one patients were treated by antihypertensive drugs: 86% of the patients were improved or cured (71.5% of the patients had atherosclerotic lesions) with a mean follow-up of 46.8 months. PMID- 3528883 TI - Unstimulated renal venous renin ratio predicts improvement in hypertension following nephrectomy for unilateral renal disease. AB - The ability of renal venous renin ratio (RVRR) to predict the blood pressure response to nephrectomy was studied in 45 hypertensive patients followed for at least 1 year after nephrectomy. Twenty patients had unilateral chronic parenchymal renal disease (UCPR) and 25 patients had unilateral renal artery stenosis (RAS). The RVRR procedure was performed according to a strict protocol which included sodium restricted diet (40 mmol daily) and hospital admission, with one set of unstimulated samples collected after overnight recumbency, and at least one further set collected after sympathetic nervous system stimulation induced by tilting or i.v. diazoxide. In only 3 of 12 patients with serum creatinine 0.15 mmol/l or higher and presumed bilateral renal disease was hypertension improved. If these 12 patients are excluded, RVRR was a good predictor of outcome, but only if the question of unstimulated and stimulated ratios was considered. Whereas inclusion of stimulated ratios increased the predictive accuracy to 81% in RAS, and avoided two false-negatives, in UCPR the stimulated ratio created four false-positives. Since there were no false negatives and six true-negatives in UCPR, overnight recumbent RVRR was a perfect predictor of outcome in this sub-group. It appears that RVRR without sympathetic stimulation is most reliable in UCPR, and RVRR during sympathetic stimulation in RAS, raising the question that renin regulation may be different in these two conditions. PMID- 3528884 TI - Renovascular hypertension. Ability to renal vein ratio to predict the blood pressure level 18-24 months after surgery. AB - Fourteen patients with severe hypertension and renal artery stenosis were treated surgically. One patient died 4 days after surgery due to a cerebral thrombosis. The other 13 patients were followed for 18-24 months. Five were considered cured since the diastolic blood pressure (DBP) was less than or equal to 90 mm Hg without therapy. Five were improved since DBP was less than or equal to 100 mm Hg during treatment with only one or two antihypertensive agents. There were unchanged. Renal vein renin ratio (RVRR) was greater than or equal to 1.5 either before or after furosemide in all patients who were cured or improved and less than or equal to 1.5 in 2 of 3 who were unchanged. It can be concluded that surgical treatment cured or improved 77% of the patients, and that a RVRR greater than or equal to 1.5 is a good predictor of the blood pressure lowering effect of surgery. PMID- 3528885 TI - Surgical management of branch renal artery disease. Value of in situ and extracorporeal technique. AB - Vascular reconstruction of the kidney is technically difficult in patients with branch renal artery disease. Formerly, many patients in this category were considered either inoperable or candidates for total or partial nephrectomy. However, advances in vascular reconstructive techniques during the past decade have improved this outlook and successful revascularization is now possible in most cases. This evolution has been primarily due to the incorporation of microvascular and extracorporeal techniques into the armamentarium of the renovascular surgeon. These techniques, their respective indications, and the merits of in situ versus extracorporeal repair are reviewed herein. PMID- 3528886 TI - Captopril and kidney function in renovascular and essential hypertension. AB - In the present study 25 patients with various forms of severe hypertension (essential hypertension: n = 12; renovascular hypertension: n = 11; unilateral small kidney: n = 2), which were treated with captopril for a mean control period of 34.9 months, were investigated. Reduction of mean blood pressure under captopril was comparable in all subgroups. However, patients with renovascular hypertension showed a significant increase in serum creatinine from 117 to 162 mumol/l (p less than 0.05) after 34.9 months, whereas in essential hypertensives even a slight decrease could be observed (113 vs. 111 mumol/l). Serum creatinine of the 2 patients with unilateral small kidney remained within the normal range. Changes in creatinine were markedly higher in cases with bilateral renal artery stenosis and/or in those with a very high initial plasma renin activity (greater than 15 ng/ml X 3 h). Our findings underline the necessity of cautious application of captopril in patients with renovascular hypertension. PMID- 3528887 TI - Cerebrovascular diseases: a review of the Indian experience in the last 35 years. AB - The relevant literature on cerebrovascular diseases from the Indian subcontinent in the last 35 years has been reviewed. Most of the data available are from retrospective studies carried out in various large urban hospitals. The incidence of stroke reported is less when compared with western figures, which may be a reflection of the population at risk. The incidence of stroke in the young Indians below the age of 40 years is higher compared to other countries, which again may be a statistical aberration or may be due to local aetiological factors. Ischaemic cerebrovascular complications of pregnancy and puerperium occur frequently, but the total picture is probably the same as elsewhere in the world. PMID- 3528888 TI - Luteinizing hormone releasing hormone (LHRH) neurons in aging female rhesus macaques. AB - Luteinizing hormone releasing hormone (LHRH) elements were demonstrated immunocytochemically in coronal sections of a portion of the left hypothalamus in twenty female rhesus macaques ranging in age from just over two years to over 21 years. This time period includes the juvenile preovulatory phase. The region studied included the retrochiasmatic region as far dorsally as the superior extent of the optic tract and as far posteriorly as the mammillary body. There was a range in total LHRH neurons per animal from 55 to 470. No trends in cell number as a function of age was observed. The range in cell number among the youngest animals (two year olds) was about the same as that in adult (6-15 year olds) and older (20+ year olds) animals. These results suggest that there is no age-related decline in the potential for manufacture of LHRH, at least into the pre-menopausal period, in the female rhesus macaque. PMID- 3528889 TI - Piracetam combined with lecithin in the treatment of Alzheimer's disease. AB - Nootropics, a new class of drugs believed to activate mental functions, have been proposed as a treatment for clinical disorders in which cognition is impaired. We therefore administered the nootropic drug piracetam, alone and in combination with phosphatidylcholine (PC), to 18 patients with Alzheimer's disease (AD), and measured the effects of treatment on a broad range of cognitive functions. Piracetam was administered according to three double-blind crossover protocols and a replication study that differed in piracetam dose (2.4 to 9.9 g/day) and whether PC (18 g/day) was administered concurrently. The drug was well tolerated, and there were not toxic side effects. Plasma choline levels rose significantly during piracetam and PC administration; monoamine metabolites in cerebrospinal fluid were unaffected by treatment. Piracetam, either alone or in combination with PC, did not significantly affect cognition in the AD group as a whole, nor did it improve test performance in any single patient. PMID- 3528890 TI - Medial septal and nucleus basalis magnocellularis lesions produce order memory deficits in rats which mimic symptomatology of Alzheimer's disease. AB - Rats with electrolytic lesions of the medial septum or ibotenic acid lesions of the nucleus basalis magnocellularis (NBM) were tested in an order memory task for an 8-item list of varying spatial locations within an 8-arm radial maze. Results indicated that rats with small medial septal lesions resulting in small AchE depletion of dorsal hippocampal formation were impaired only for the first, but not the last choice orders of the list. Animals with large medial septal lesions resulting in large AchE depletion of the dorsal hippocampal formation displayed an order memory deficit for all the choice orders of the list. In contrast, rats with small NBM lesions resulting in small AchE depletion of parietal and part of frontal cortex were impaired only for the last, but not the first choice orders of the list. Animals with large NBM lesions resulting in large AchE depletion of parietal and part of frontal cortex displayed an order memory deficit for all the choice orders of the list. The relationship between these findings and mnemonic symptomatology of Alzheimer's disease was discussed, as was the possible meaning of these results in providing an animal model for studying certain aspects of the disease. PMID- 3528891 TI - Desamino-D-arginine-vasopressin (DDAVP) in Alzheimer's disease. AB - Fourteen Alzheimer subjects participated in a parallel group study of desamino-D arginine-vasopressin (DDAVP, desmopressin). All subjects received one week of single-blind placebo. Then on a double-blind basis, the active group received DDAVP intranasally in doses starting at 30 micrograms per day and increasing over a 3 week period to 180 micrograms per day; the control group received an identical placebo. Using a repeated measures ANOVA, three measures out of thirty one were found to be statistically significant for DDAVP treatment: the Hamilton depression scale and the affect and interpersonal subscales of the SCAG. However, the magnitude of these changes was probably too small to be clinically significant. Except for one subject who transiently became hyponatremic (Na of 120) and confused while receiving 180 micrograms of DDAVP, there were no adverse effects. There were no significant group changes in sodium, potassium, plasma osmolality, blood pressure, and weight. PMID- 3528892 TI - A new case for a presynaptic role of dendrites: an immunocytochemical study of the n. raphe dorsalis. AB - The distribution of serotonin (5-HT) was determined by the application of the preembedding peroxidase-anti-peroxidase (PAP) technique in vibratome and ultrathin sections of the brain stem. The antiserum stained the neuronal groups B1 to B9. Somata, dendrites and axons of multipolar and bipolar neurons were recognized in the usual locations. The most commonly found profiles in the area of the n. raphe dorsalis were dendrites. The search for axon terminals was unsuccessful. The labeled dendrites appear in synaptic contact with unlabeled endings containing round or pleomorphic vesicles, and occasionally some large dense core vesicles. Contacts between two labeled dendrites or processes were not found. Occasionally a dendrodendritic junction between a 5-HT labeled dendrite and an unlabeled dendrite has been found. There are areas of the dendritic membrane free of synaptic junctions and free of glial insulation. Results are discussed in relation with the previously proposed presynaptic role of the dendrites in the neuronal circuitry of the n. raphe dorsalis. PMID- 3528893 TI - [A new treatment of hypertensive intracerebral hematoma--a follow-up study on 46 patients with hematoma treated by CT guided stereotactic method]. AB - During the last 2 years, 46 cases of hypertensive intracerebral hemorrhage in the basal ganglia were treated by CT guided stereotactic aspiration and their outcome was evaluated in terms of the rate of hematoma removal, the change of consciousness level and the recovery of motor and sensory functions. They are aged from 45 to 79 years old, the average 56, and aspirated 1 to 24 days after the onset, two third of them being within 1 week. The whole procedure was done in the CT room under direct CT guidance and by one trial. In putaminal type hemorrhage, the removed hematoma volumes ranged from 9 to 48 ml, average being 23.7 ml, in thalamic type from 5 to 29 ml, average being 15.5 ml. The average rate of removal was 81.1% in 30 cases within 1 week. In most cases, preoperative consciousness was not severely disturbed, in putaminal type, 19 were alert or confused, 4 somnolent, 5 stuperous and in thalamic type, 6, 6, 3 respectively and 2 were semicomatous, one of them had herniation sign. In putaminal type all but 2 cases recovered to alert or confused state, the first one had postoperative bleeding and the other was already apallic preoperatively. In thalamic type, we lost 3 cases, 2 by gastrointestinal bleeding and 1 DIC, by rehemorrhage 2 months after the operation. All but one who was semicomatous preoperatively recovered to alertness. In motor function, some cases of the putaminal bleeding with intact internal capsule remained hemiplegic. On the other hand, most of the cases with partial destruction of the internal capsule on CT recovered well in both types of hematoma.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3528894 TI - [Immunohistochemical study of subependymal giant cell tumor associated with tuberous sclerosis]. AB - Subependymal giant cell tumors from four patients associated with tuberous sclerosis were examined by peroxidase antiperoxidase (PAP) immunohistochemistry for neuron specific enolase (NSE), glial fibrillary acidic protein (GFAP) and S 100 protein. The tumor cells were grouped into three morphological types: ganglion-like pyramidal cells, swollen gemistocytic cells and fibrillated spindle cells. There was little difference in immunohistochemical property between these cell types in each case, suggesting that the tumor cells of different cell types have a same origin. The majority of the tumor cells was intensely stained for NSE in every case. On the other hand, for GFAP none of the tumor cells was stained in two cases, and the minority was weakly stained in the other two cases. The intensity of staining of the tumor cells for S-100 protein varied from case to case. Our findings together with those of others show the definite immunohistochemical characteristics of subependymal giant cell tumors with tuberous sclerosis, i.e., strong positivity for NSE in contrast to their negativity or weak positivity for GFAP. However, these findings do not necessarily suggest that the tumor is of neuronal origin, because in the case of neoplasms the significance of the presence of NSE as indicative of neuronal origin is open to question. PMID- 3528895 TI - In vivo LH-RH output of ovariectomized rats following estrogen treatment. AB - In the present experiment we examined the effect of estrogen upon in vivo luteinizing hormone releasing hormone (LH-RH) release from the medial basal hypothalamus of freely moving ovariectomized female rats during the period of the LH surge. Ovariectomized females (10-20 day) received two subcutaneous injections of oil or estradiol benzoate (EB; 25 micrograms/rat) at 48 and 24 h prior to push pull perfusion and were perfused between 10:00 and 18:00 h on the 3rd, day. Unexpectedly, the activity of the LH-RH pulse generator in ovariectomized rats was characterized by a very low mean LH-RH output. Administration of EB increased the activity of the LH-RH pulse generator as indicated by a significant increase in overall mean LH-RH release of EB- versus oil-treated females. In addition, EB treated females demonstrated a diurnal variation in LH-RH release with marginal, but significant, increases in LH-RH release during the period of the LH surge (14:10-18:00 h) as compared with levels obtained between 10:00 and 14:00 h. This increase in the overall mean release during the period between 14:10 and 18:00 h appears to be attributable to an EB-induced increase in the frequency of LH-RH release, since the amplitude did not change between the two 4-hour sampling periods.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3528896 TI - Reproductive failure due to experimentally induced constant estrus does not alter the LH-RH fiber density in the median eminence of the rat. AB - The effects of anterior hypothalamic deafferentation on luteinizing hormone releasing hormone (LH-RH) fiber density in the mediobasal hypothalamus (MBH) were compared to those of a number of nonsurgical treatments which give rise to anovulatory sterility (injections of estradiol valerate, exposure to constant light, or neonatal androgen administration) in the female rat. All of the treatments used (surgical and nonsurgical) disrupted the normal 4-day pattern of estrous cyclicity. Bilateral anterior hypothalamic deafferentation markedly reduced the packing density of LH-RH fibers in the MBH. Unilateral deafferentation reduced the number of fibers on the ipsilateral side of the MBH by 31-64% and on the contralateral side by 15-40%. In contrast, none of the three nonsurgical treatments had any significant effect on the LH-RH fiber density. Electron microscopic examination revealed no morphologic, or distribution differences in MBH LH-RH fibers between control females and animals rendered anovulatory by the nonsurgical experimental procedures. These results demonstrate that estrogen, androgen, and constant light induced anovulatory sterility are not associated with any overt change in the number or morphology of LH-RH immunoreactive fibers in the MBH, suggesting that the primary lesion responsible for the failure of normal estrous cyclicity in such animals resides in the systems responsible for regulating the activity of the LH-RH neurons rather than in the LH-RH neurons themselves. PMID- 3528897 TI - Ontogenesis of growth hormone-releasing hormone neurons in the rat hypothalamus. AB - The ontogenesis of growth hormone releasing hormone (GH-RH) containing neurons in the rat hypothalamus has been studied by immunohistochemistry, using a specific anti-rat GH-RH serum. Immunoreactive fibers were first detected in the prospective median eminence on day 18 of gestation. During the subsequent 3 days, they rapidly increased in distribution and intensity of staining within this structure. On day 21, positive fibers were also visible in a plexus within the arcuate nucleus. In 1-day-old rats treated with colchicine, positive perikarya were distributed in several hypothalamic nuclei, including the arcuate nucleus, dorsomedial nucleus, basal lateral hypothalamus, and perifornical region. The distribution was similar to that previously described in adult rats. The intensity of staining in the various hypothalamic regions increased during early postnatal life to levels nearly comparable to those in adult rats by 30 days. These findings showing the early appearance of GH-RH-positive terminals in the median eminence and the wide distribution of the perikarya at an early stage of postnatal life support the view that hypothalamic GH-RH serves an important role in the regulation of growth hormone secretion during late prenatal and early neonatal periods. PMID- 3528898 TI - Luteinizing hormone-releasing hormone neuronal system during the estrous cycle of the female rat: effects of surgically induced persistent estrus. AB - The effects of discrete lesions of the suprachiasmatic and medial preoptic nucleus on luteinizing hormone-releasing hormone (LHRH) neurons of the female rat were examined. The lesions disrupted the estrous cycle and prevented the preovulatory surge of luteinizing hormone and prolactin. Two to three months following the lesions, control and lesioned animals were perfused, the brains were sectioned, and the tissue processed for LHRH immunocytochemistry using the peroxidase antiperoxidase method and a high-titer, conformational antiserum to LHRH. Faintly stained LHRH cells were observed in the preoptic area and the basal hypothalamus at all stages of the estrous cycle. The number of immunoreactive cell bodies varied from a high of 583 cells on proestrus, to a low of 35 cells on estrus (mean +/- SEM = 323 +/- 59; n = 11). In contrast, the constant estrous animals with lesions showed increased intensity and number of LHRH neurons rostral, lateral and caudal to the lesion. The total number of cells ranged from 625 to 954 cells per animal (mean +/- SEM = 784 +/- 44; n = 8; p less than 0.001 vs. controls). Moreover, all lesioned animals exhibited intense fiber stain in the median eminence region. In conclusion, these data support the hypothesis that persistent estrus is caused by destruction of neurons which directly or indirectly control LHRH neurons. PMID- 3528899 TI - Anterior pituitary cells from Brattleboro (di/di), Long-Evans and Sprague-Dawley rats contain immunoreactive arginine vasopressin. AB - A radioimmunoassay specific for arginine-vasopressin (AVP) was used to establish the presence of immunoreactive (ir)-AVP in extracts of anterior pituitary glands from Sprague-Dawley (SD) and Long-Evans (LE) rats (3.05 +/- 1.0 and 1.66 +/- 0.9 ng/gland, respectively). Lower levels of ir-AVP (0.56 +/- 0.26 ng/gland) were detected in anterior pituitary gland extracts from rats with hereditary diabetes insipidus (Brattleboro; di/di). The anterior pituitary gland ir-AVP from each rat strain was further characterized by reverse-phase high-performance liquid chromatography (RP-HPLC). In each case the major peak of immunoreactivity co migrated with synthetic AVP. By peroxidase-antiperoxidase immunocytochemistry, sparsely distributed cells containing ir-AVP were localized in anterior pituitary sections. Levels of ir-AVP in primary cultures of anterior pituitary cells (from SD rats) increased from 52 +/- 5 pg/10(6) cells at 2 days in vitro to 152 +/- 17 pg/10(6) cells at 3 days; during this period 56 +/- 6 pg/ml ir-AVP was secreted into the culture medium. Fewer than 1% of the cells in these cultures were immunostainable for AVP. These data indicate that the anterior pituitary gland of the Brattleboro, Long-Evans and Sprague-Dawley rat contains ir-AVP, and that there is synthesis and secretion of this peptide in primary cultures of anterior pituitary cells in vitro. PMID- 3528900 TI - Hyperprolactinemia induced by pituitary isografts suppresses the priming effect of LH-releasing hormone in normal and hypogonadal mice. AB - We have investigated the effects of hyperprolactinemia, produced by pituitary isografts under the kidney capsule (16-20 days), on the LH releasing action and priming effect of LH-releasing hormone (LHRH) in normal and hypogonadal (hpg) female mice. The pituitary grafts increased the plasma prolactin concentrations about 3-fold in normal intact mice and 4-fold in hpg mice. The extent of the graft-induced hyperprolactinemia was reduced by ovariectomy in normal mice, but was the same in grafted hpg compared with intact normal mice despite the absence in the hpg mice of functioning ovaries. The priming effect of LHRH could be elicited in both types of mice by giving two injections of LHRH separated by an interval of 60 min. Hyperprolactinemia did not reduce the amount of LH released in response to a first injection of LHRH, but did reduce significantly the amount of LH released (primed) in response to a second injection of LHRH. Ovariectomy significantly increased the magnitude of the releasing action of LHRH in normal mice and prevented the graft-induced reduction of LHRH priming. These results show that hyperprolactinemia in normal and hpg mice suppresses the magnitude of the priming effect of LHRH. This may be an important mechanism by which prolactin reduces gonadotropin secretion. PMID- 3528901 TI - Concentration of striatal tyramine and dopamine metabolism in diabetic rats and effect of insulin administration. AB - Earlier work has shown that diabetic rats possess lower concentrations of brain p tyrosine; these animals also show a decrease in the rate of accumulation of striatal DOPA after decarboxylase inhibition and an increase in striatal binding sites for dopamine. These findings suggested that diabetic rats show a reduction in the metabolism of brain dopamine. This is an investigation of the effects of streptozotocin-induced (65 mg/kg, intracardially) diabetes on rat striatal concentrations of p-tyrosine, p-tyramine, m-tyramine, dopamine, 3,4 dihydroxyphenylacetic acid and homovanillic acid. Also, the effects of insulin administration (0.5-4 IU/kg, intraperitoneally) to normal and diabetic rats were studied. The onset of diabetes or effect of insulin treatment was determined by the changes produced in blood glucose. Streptozotocin produced a significant reduction in the striatal concentration of p-tyrosine, 3,4-dihydroxyphenylacetic acid and homovanillic acid observed 7 or 14 days after injection. The treatment produced a reduction in p-tyramine and an increase in m-tyramine. Insulin administration significantly increased rat striatal p-tyrosine, p-tyramine, 3,4 dihydroxyphenylacetic acid and homovanillic acid while m-tyramine was decreased. The concentrations of p-tyrosine, dopamine, 3,4-dihydroxyphenylacetic acid and homovanillic acid in the striatum of insulin-treated diabetic rats were within the range of control values. The results indicate that streptozotocin-diabetic rats possess a reduced striatal dopamine metabolism and that this is counteracted by insulin administration. These changes are probably the consequence of changes in the availability of some amino acid precursors and in tyrosine hydroxylase activity. PMID- 3528902 TI - Analysis of changes in intracranial pressure and pressure-volume index at different locations in the craniospinal axis during supratentorial epidural balloon inflation. AB - During experimental supratentorial epidural compression of the brain, cerebrospinal fluid (CSF) pressure and pressure-volume index (PVI) were measured in the supra- and infratentorial compartments of the craniospinal axis in anesthetized ventilated cats. A transtentorial gradient of CSF pressure developed when CSF pressure in the lateral ventricle exceeded 20 mm Hg at balloon volumes of 0.4 to 1.2 ml. The shapes of both the pressure vs. volume and the pressure gradient vs. volume curves were exponential. PVI in the supratentorial compartment was lowered more rapidly as brain compression advanced than PVI in the infratentorial compartment. An index was calculated to represent the relative resistance to the flow of CSF across the tentorial hiatus during supratentorial brain compression. This revealed different resistances to the flow of CSF in the cephalic and caudal directions. A hypothesis concerning the hydrodynamic aspects of the development of tentorial herniation is presented. PMID- 3528904 TI - Neurosurgery in Egypt. PMID- 3528903 TI - Brain abscess due to Haemophilus aphrophilus: possible canine transmission. AB - A 58-year-old patient developed progressive right hemiparesis and a hemisensory loss. Computed tomography demonstrated a lesion in the left frontoparietal region with ring enhancement. A craniotomy was performed and an abscess was removed, which on culture grew Haemophilus aphrophilus. The same organism was isolated from the patient's poodle dog but not from three other poodles of family members. This, along with previous reports, suggests that the poodle may be a vector in the transmission of this organism, which rarely may cause a brain abscess. PMID- 3528905 TI - Neurosurgery in Israel. PMID- 3528906 TI - Intraoperative ultrasonography with a cystoscope for the biopsy of a deep-seated brain lesion: case study. AB - An intraoperative technique for deep brain biopsy is described. It features the use of an integrated surgical support system for the instruments and a rod that provides external topographical maintenance of the coordinates established ultrasonographically. A cystoscope, when supported mechanically by this system, permits multiple entries of the biopsy forceps to the lesion without further disturbance of the brain, as well as irrigation, coagulation, and visualization, if desired. When used in conjunction with real time intraoperative ultrasonography, the surgeon may view the entire procedure and be certain that the biopsy sample has been obtained from the lesion, major deep blood vessels have been avoided, and the biopsy site is stable after the procedure. The advantages of this technique include simplicity, low cost, accuracy, stability, and availability to every neurosurgeon in every hospital. PMID- 3528907 TI - Use of intraoperative ultrasound in decision making during spinal operations. AB - The use of intraoperative spinal ultrasonography in 14 cases and its effect on decision making during laminectomy procedures is discussed. The advantages of the technique in operations for syringomyelia, trauma, spondylosis, intramedullary tumors, and neuroablative procedures of the spinal cord are elaborated. PMID- 3528908 TI - Rigid head fixation for intraoperative computed tomography. AB - A C-ring radiolucent head holder was designed to facilitate intraoperative computed tomography (CT) during resection of various intracerebral lesions. Important features of the procedure include rigid skull and CT table fixation, cranial access, and low artifact CT imaging performed during and after operation. A case of CT-assisted resection of an arteriovenous malformation is described. PMID- 3528909 TI - Aneurysmal bone cyst of the cervicothoracic spine: computed tomographic evaluation of the value of preoperative embolization. Case report. AB - In this report, the management of an aneurysmal bone cyst in the cervicothoracic region of an 8-year-old girl is described. Aneurysmal bone cyst is a histologically benign lesion that is often extremely vascular. In the spine, it can cause extensive bone destruction and compress neural structures. Because this lesion may involve all parts of a vertebra, full delineation of the lesion before its excision is important in planning the surgical approach. The value of preoperative embolization to reduce tumor vascularity, allowing total excision, and the improved radiological evaluation of this lesion with computed tomographic scanning are demonstrated. PMID- 3528910 TI - Neurogenic pulmonary edema associated with ruptured intracranial aneurysm: case report. AB - A case of ruptured distal anterior cerebral artery aneurysm associated with neurogenic pulmonary edema is presented. It is suggested that this association should not be accepted as a "taboo" for radical intervention followed by a proper management of ventilation with positive end-expiratory pressure to maintain the anesthetic condition. Cardiorespiratory control is essential in cases of pulmonary edema with ruptured aneurysm. Decompression and evacuation of blood clot surrounding the hypothalamus could subdue the hyperadrenosympathetic discharge that may cause neurogenic pulmonary edema. PMID- 3528911 TI - Incorporation of labeled sex hormones into the ependyma of the mediobasal hypothalamus after intraperitoneal and intraventricular injection into rats. PMID- 3528912 TI - Influence of luliberin and chorionic gonadotropin on luteinizing hormone and testosterone in the blood of monkeys under conditions of acute stress. PMID- 3528913 TI - Influence of "central" and "peripheral" estrogen injection on several parameters of immune homeostasis. PMID- 3528914 TI - Long-term results of stereotactic operations in parkinsonism. PMID- 3528915 TI - Distribution of neurons in the main cuneate nucleus projecting to the inferior olive in the cat. Evidence that they differ from those directly projecting to the cerebellum. AB - The distribution in the main cuneate nucleus of cells projecting to the inferior olive and the intermediate zone of the cerebellar anterior lobe were compared by means of double retrograde labeling methods in the cat. The tracer combinations were either Fast Blue and Diamidino Yellow Dihydrochloride; or horseradish peroxidase conjugated to wheat germ agglutinin and Diamidino Yellow Dihydrochloride. Neurons in the caudal, middle and rostral subdivisions of the main cuneate nucleus project to the inferior olive. Differences exist, however, in its number and location along the rostrocaudal extent of the nucleus. Cells projecting to the inferior olive predominate in the caudal and middle subdivisions, where they concentrate ventrally. No cells in the "clusters region" project to the inferior olive. Main cuneate nucleus neurons projecting to the cerebellum concentrate rostral to the obex, bordering the external cuneate nucleus and partially intermixing with the rostrally located cells projecting to the inferior olive. However, no double-labeled cells were found. The results indicate that the main cuneate nucleus projections to the inferior olive and cerebellar anterior lobe originate from different populations of neurons with high specific locations within the nucleus. This finding is in agreement with previous studies suggesting that each of the main cuneate nucleus targets receives its input from a distinct population of neurons within the nucleus. PMID- 3528916 TI - Neuropathology of heart transplantation: 23 cases. AB - We reviewed the clinical histories, operative results, and neuropathologic findings of 23 consecutive patients who had heart transplants. Prolonged preoperative hypotension and failure of cerebral autoregulation of blood flow, followed by postoperative elevation of blood pressure beyond the limits of cerebral autoregulation, may account for the high incidence of neurologic complications (70%); 60% were vascular. Immunosuppressive therapy may have been responsible for the high incidence (20%) of opportunistic intracranial infections. Lymphoproliferative disorders occurred in three patients (13%). PMID- 3528917 TI - Partial characterization of the Purkinje cell antigens in paraneoplastic cerebellar degeneration. AB - Serum from seven patients with paraneoplastic cerebellar degeneration contained anti-Purkinje cell antibodies. The samples were examined by immunoblotting to determine whether they recognized common antigens in isolated human Purkinje cell neurons. Two groups of antigens were detected by all seven sera with Mr 62/64 kd and 34 to 38 kd, both of which contributed to the Purkinje cell antigens detected immunohistochemically. These reactivities were absent from all controls tested. These antibodies may play a role in the pathogenesis of paraneoplastic cerebellar degeneration. PMID- 3528919 TI - Jumping Frenchmen of Maine. AB - The "Jumping Frenchmen of Maine" were described by George Beard in 1878. They had an excessive startle response, sometimes with echolalia, echopraxia, or forced obedience. In 1885, Gilles de la Tourette concluded that "jumping" was similar to the syndrome that now bears his name. Direct observations of jumpers have been scarce. We studied eight jumpers from the Because region of Quebec. In our opinion, this phenomenon is not a neurologic disease, but can be explained in psychological terms as operant conditioned behavior. Our cases were related to specific conditions in lumber camps in the 19th and the beginning of the 20th century. PMID- 3528918 TI - Trial of octacosanol in amyotrophic lateral sclerosis. AB - Octacosanol was tried in amyotrophic lateral sclerosis in a double-blind, placebo controlled, crossover design. Neurologic and pulmonary function evaluations showed no benefit. PMID- 3528920 TI - Diagnostic criteria for neurosyphilis. PMID- 3528921 TI - [Prophylaxis and treatment of pulmonary thromboembolism]. PMID- 3528922 TI - [Heterogeneity in cystic hygroma: its implications in genetic counseling]. PMID- 3528923 TI - [Endometrial stromal sarcoma. Description of a clinical case and review of the literature]. PMID- 3528924 TI - [Randomized multicenter study on the use of diclofenac in the treatment of primary dysmenorrhea. An analysis of the data relative to 878 patients]. PMID- 3528925 TI - [Medical therapy of cystic mastopathy. A critical review of the literature from 1980 to 1985]. PMID- 3528926 TI - [Adjuvant hormone therapy of breast neoplasms. A critical review of the literature and perspectives]. PMID- 3528927 TI - External quality assessment for clinical microbiology in Norway 1985. AB - During 1985 four external quality assessment tests for clinical microbiology were performed, each consisting of four simulated clinical specimens. The results are reported, evaluated and some problem areas discussed. PMID- 3528928 TI - Antibody response in patients infected with one common strain of Campylobacter jejuni. Evidence for production of antibodies against thermostable soluble antigens. AB - Antibody production was investigated for ten patients from a group of 20 who had contracted infections with a strain of Campylobacter jejuni of serotype PEN 6,7. Production of antibody was determined by titrating ten sets of paired sera for agglutination of formalin-treated and heat-treated cell suspensions and by passive hemagglutination using both sheep and human O Rh-red blood cells sensitized with extracted soluble thermostable antigens. All patients had demonstrable antibodies against the formalin-treated cells, six had a four-fold or greater increase in antibody levels. Nine patients showed antibodies against the heat-inactivated cells of whom five showed a fourfold or greater rise in antibody levels. Three patients developed antibodies against the extracted thermostable antigens. Sera from 100 blood donors served as controls. Six paired sera from patients that had antibodies against the heated suspension were analyzed by an immunofluorescence technique for determining IgM, IgA and IgG antibodies against live and heat-inactivated bacteria. Each of the six sera displayed antibody response primarily of the IgM and IgA class with highest levels against live cell suspensions. PMID- 3528929 TI - Insulin-like immunoreactivity in human retinoblastoma Y79 cell line. AB - Cells from the Y79 human retinoblastoma cell line were examined by immunofluorescence immunocytochemistry using an antiserum against insulin. All the cells showed intense staining, indicating the presence of insulin-like immunoreactivity in these cells. Our observations suggest that insulin may play an important role in the metabolism of retinoblastoma cells and that it may be possible to use this cell line as an in vitro model for studies on the action of insulin in the metabolism of human retinal cells. PMID- 3528930 TI - O-phosphohomoserine, a naturally occurring analogue of phosphonate amino acid antagonists, is an N-methyl-D-aspartate (NMDA) antagonist in rat hippocampus. AB - O-Phosphohomoserine, an analogue of the excitatory amino acid antagonist 2-amino phosphonovalerate, has been synthesized and tested for activity as an excitatory amino acid antagonist. The tests were carried out on 500 micron thick slices of rat hippocampus superfused in vitro at 30 degrees C. Antidromic and orthodromic potentials were studied in the CA1 region, recording from the pyramidal cell layer. At concentrations of 0.5 and 1 mM the compound produced a weak but significant antagonism of the depression of evoked potentials produced by N methyl-D-aspartate with no effect on the responses produced by kainic or quisqualic acids. O-Phosphohomoserine was not metabolised by brain homogenates or by alkaline phosphatases. Since O-phosphohomoserine is known to occur naturally in lower organisms, it would be of interest to seek its existence in the animal nervous system. PMID- 3528931 TI - New candidates for GABAergic neurons in the rat cerebellum: an immunocytochemical study with anti-GABA antibody. AB - Cerebellar cortical neurons immunoreactive to anti-gamma-aminobutyric acid (GABA) antibody were examined in the rat. In addition to the Purkinje, Golgi, basket and stellate cells, spindle-shaped cells lying just below the Purkinje cell layer were found to be strongly immunoreactive to the antibody. By the combination of immunofluorescence and hematoxylin stainings, these GABA-positive cells were shown to be the Lugaro cells. Unlike the immunopositive small Golgi cell, the pale cell was not immunoreactive to the antibody. PMID- 3528932 TI - Does cholecystokinin-like immunoreactivity in rat primary sensory neurons represent calcitonin gene-related peptide? AB - Using immunohistochemistry, calcitonin gene-related peptide (CGRP)- and cholecystokinin (CCK)-like immunoreactivity (LI) were found in many of the same spinal and trigeminal ganglion cells and motoneurons in the spinal cord and hypoglossal nucleus, as well as in fibers with an overlapping distribution in the spinal cord (dorsal horn, bundle ventral to the central canal) and in the spinal trigeminal nucleus. CCK-LI in all these structures disappeared after preadsorption of CCK antisera with CGRP at 10(-4) M and almost completely at 10( 5) M. CCK peptide in concentrations up to 10(-4) M, on the other hand, did not influence CGRP staining. The present findings raise the possibility that some CCK LI in primary sensory neurons in rat may represent CGRP or a similar peptide. PMID- 3528933 TI - Neurotoxic lesions of the paraventriculo-spinal projection block the nocturnal rise in pineal melatonin synthesis in the Syrian hamster. AB - The paraventriculo-spinal projection of the Syrian hamster was characterized by retrograde labelling of neuronal perikarya in the paraventricular nucleus of the hypothalamus (PVN) following injection of True blue tracer into the intermediolateral cell column of the thoracic spinal cord. Injection of the excitatory neurotoxin, N-methyl-D,L-aspartic acid into the region of the PVN spared magnocellular neurones and fibres of passage but destroyed parvocellular neurones of the paraventriculo-spinal pathway. Hamsters bearing complete bilateral lesions of the parvocellular PVN failed to show the typical nocturnal increase in pineal melatonin content. These data indicate the importance of the paraventriculo-spinal projection in the central control of pineal melatonin synthesis. PMID- 3528934 TI - CGRP-immunoreactive nerves in the genitalia of the female rat originate from dorsal root ganglia T11-L3 and L6-S1: a combined immunocytochemical and retrograde tracing study. AB - The origin of the calcitonin gene-related peptide (CGRP)-immunoreactive nerve fibres in the genital organs of the female rat was investigated by immunocytochemistry and retrograde tracing with the fluorescent dye True blue. The tracing results revealed that these tissues receive an afferent nerve supply from two separate groups of dorsal root ganglia: T11-L3 and L6-S1. In T11-L3 ganglia 66-86% of True blue-labelled neurones displayed CGRP immunoreactivity whilst 45-63% of labelled cells in L6-S1 ganglia contained the peptide. The results indicate that CGRP-containing dorsal root ganglion neurones form a major part of the afferent sensory nerve supply to the female rat genitalia. PMID- 3528935 TI - Growth of human oligodendrocytes in vitro on extracellular matrix. AB - Based on the successful use of a basement membrane-like extracellular matrix (ECM) as a physiological substrate for the growth of adult rat oligodendrocytes, we have applied the system to oligodendroglia of human origin. ECM is excreted and deposited on a culture dish by endothelia cells. Glial cells isolated from fresh human brains by a Percoll density gradient were maintained on ECM for several weeks in vitro. Cells identified as oligodendrocytes by anti galactocerebroside (GalC) could be transferred and replated on ECM-coated plates. In one case, GalC-positive cells isolated from a biopsy of an 8-year old girl were able to incorporate [3H]thymidine as revealed by autoradiography. ECM can be used successfully for the growth and in vitro maintenance of human oligodendrocytes. PMID- 3528936 TI - Immunocytochemical localization of gamma-aminobutyric acid in the rat hippocampal formation. AB - gamma-Aminobutyric acid (GABA) was detected immunocytochemically in the rat hippocampal formation utilizing a new antiserum made against GABA conjugated to bovine serum albumin. GABA immunoreactivity was found to be concentrated in pericellular networks of fibers around both dentate granule and hippocampal pyramidal neurons. Ultrastructural analysis indicated that GABA-immunoreactive (IR) terminals most often contained small clear vesicles and made symmetrical contacts with somata and dendritic shafts of hippocampal neurons. In addition, numerous GABA-IR neurons resembled basket interneurons that have been described in previous reports. PMID- 3528937 TI - The role of dopamine in the control of neuropeptide Y neurons in the rat arcuate nucleus. AB - In order to determine the role of dopamine (DA) on neuropeptide Y (NPY) neurons in the arcuate nucleus of the rat hypothalamus, we evaluated the effects of alpha methylparatyrosine (alpha-MPT), an inhibitor of catecholamines biosynthesis, and haloperidol, a dopaminergic antagonist, on NPY immunoreactive neurons. The two drugs used produced in the arcuate nucleus the appearance of a large number of NPY-containing neuronal bodies which are normally absent in control animals. The density of stained fibers were not significantly modified. These results suggest that DA can exert some negative regulation of NPY neurons activity in the arcuate nucleus. PMID- 3528938 TI - Opening the door on nursing's cost advantage. PMID- 3528939 TI - Nursing: on the cutting edge of opportunity. PMID- 3528940 TI - Prolactinoma and bromocriptine therapy. PMID- 3528942 TI - Dietary calcium and colonic epithelial cell proliferation. PMID- 3528941 TI - Luteinizing hormone-releasing hormone inhibits nicotinic transmission in bullfrog sympathetic ganglia. AB - Intracellular and voltage-clamp recordings were made from neurons in bullfrog sympathetic ganglia to investigate the effects of luteinizing hormone-releasing hormone (LH-RH) on nicotinic transmission. LH-RH (50 nM-4 microM) decreased the amplitude of the fast excitatory postsynaptic potential (fast EPSP) in a dose dependent manner. LH-RH (1-4 microM) reduced the quantal content of the fast EPSP by 60-85%. LH-RH did not change the frequency of the miniature (m) EPSP, but it slightly depressed the mEPSP amplitude. LH-RH (1-4 microM) caused a 22-32% decrease in the amplitude of the acetylcholine-induced synaptic responses due to the iontophoretic application of acetylcholine (ACh) to neurons in the presence of atropine (1 microM). These results suggested that LH-RH decreased nicotinic transmission in the bullfrog sympathetic ganglion, primarily by reducing the release of ACh from the preganglionic nerve terminals. PMID- 3528943 TI - Infant growth and obesity in Samoa. PMID- 3528944 TI - Vitamin E deficiency and neurologic dysfunction. PMID- 3528945 TI - Nutrition classics. The Biochemical Journal, Volume XXI 1927: XXIII. Chemistry of thyroxine. III. Constitution and synthesis of thyroxine. By Charles Robert Harington and George Barger. PMID- 3528946 TI - Carnitine derivatives are antiketogenic and hypoglycemic agents. PMID- 3528947 TI - Dietary methyl groups and cancer. PMID- 3528948 TI - Species variations in response to parenteral fluoride. PMID- 3528949 TI - Insomnia. PMID- 3528950 TI - Relaxation techniques. PMID- 3528951 TI - The history of medical malpractice in New York State. A perspective from the publications of the Medical Society of the State of New York. PMID- 3528952 TI - Alfred Nobel--the man and the prize. PMID- 3528953 TI - Streptokinase and acute myocardial infarction. PMID- 3528954 TI - Ultrasound prediction of pulmonary hypoplasia. AB - Normograms for ultrasound-measured fetal chest and heart circumferences were constructed from 83 normal pregnancies of 24 to 39 weeks' duration. Of six cases at risk for pulmonary hypoplasia, all of whom ultimately proved to have the condition, four fell below the fifth percentile for chest circumferences. Both cases in which the chest circumference was within the normal range had pleural effusions. PMID- 3528955 TI - Placental thromboxane and prostacyclin in the regulation of placental blood flow. AB - To study the significance of placental thromboxane A2 and prostacyclin in the regulation of placental blood flow, intervillous blood flow was measured using a 133Xenon method from 39 women zero to two days before delivery and compared it with the placental production of thromboxane A2 and prostacyclin as measured with a superfusion method postpartum. The placental production of thromboxane B2 (a metabolite of thromboxane A2; 4.5 +/- 1.3 ng/minute per gram dry weight of tissue; mean +/- SD) and that of 6-keto-prostaglandin F1 alpha (a metabolite of prostacyclin; 0.64 +/- 0.27 ng/minute per gram) did not correlate significantly with intervillous blood flow (153.1 +/- 108.0 mL/minute per 100 mL; r = -0.308 and 0.245, respectively), whereas the thromboxane B2/6-keto-prostaglandin F1 alpha ratio (8.53 +/- 4.3) was inversely related to intervillous blood flow (r = 0.419; P less than .01). In the women with intervillous blood flow below the normal mean (less than 130 mL/minute per 100 mL; N = 20) placental thromboxane B2 production (5.1 + 1.2 ng/minute per gram) was higher (P less than .005) and that of 6-keto-prostaglandin F1 alpha (0.54 +/- 0.23 ng/minute per gram) lower (P less than .02) than those in women with intervillous blood flow above 130 mL/minute per 100 mL (thromboxane B2 4.01 +/- 1.0 and 6-keto-prostaglandin F1 alpha 0.75 +/ 0.27 ng/minute per gram; N = 19). These results suggest that placental thromboxane A2 and prostacyclin may be factors in the regulation of intervillous blood flow and that their balance of production is more important than the presence of either agent alone.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3528956 TI - Perimortem cesarean delivery. AB - Postmortem cesarean delivery is an operation that has been practiced since antiquity. In previous centuries low infant survival rates led to negative opinions regarding the operation's usefulness. A review of the past centuries' cases and a review of fetal physiology suggest that to obtain optimum infant survival, cesarean delivery should be initiated within four minutes of maternal cardiac arrest. The physiology of cardiopulmonary resuscitation during pregnancy is analyzed, and recent cases of maternal cardiac arrest with successful maternal resuscitation are reviewed. This data suggests that perimortem cesarean delivery initiated within four minutes of maternal cardiac arrest will yield the highest rates of maternal survival. Legal liability from the operation is minimal. PMID- 3528957 TI - Results of treatment of severe fetal hydrothorax with bilateral pleuroamniotic catheters. AB - Unusual antenatal treatment of a case of severe fetal hydrothorax with secondary polyhydramnios and preterm labor is presented and illustrated. Bilateral pleural drainage catheters were placed antenatally to decompress the fetal chest in an effort to prolong pregnancy because of immature pulmonary studies and poor prognosis. Catheter migration occurred and effective drainage ceased after three days, but with tocolysis and bilateral thoracentesis, delivery was delayed another 48 hours to allow steroid therapy. With ventilatory therapy and chest drainage the infant survived and is doing well at one year of age. PMID- 3528958 TI - TAD-induction therapy for 175 adults with acute myeloid leukemia, followed by consolidation and maintenance therapy. The joint study of Ulm and Tubingen. AB - 175 patients with acute myeloid leukemia were treated between February 1980 and March 1985 with a TAD-induction therapy, three intensified consolidation cycles (COAP, COAP, AD), and a two-year mild maintenance therapy. The median age of the patients was 44 years, range 15-68 years. 62.3% of all patients attained complete remission and 13.7% partial remission. The median duration of remission was 10 months and the median survival time of patients in complete remission was 20 months. Patients older than 50 years had a higher early death rate (17.6) than younger patients (8.9%), but no difference was found in remission rates or in the median duration of remission and of survival. These results are in line with those of comparable studies. PMID- 3528959 TI - Age adapted induction and intensified consolidation therapy in acute myelogenous leukemia. AB - 52 patients entered a study for remission induction and intensified consolidation in AML. Group I (age less than or equal to 50 years) received a combination of DNR, ara-C and VP16-213 for induction and early consolidation and HDara-C/DNR for late consolidation. Of 34 evaluable patients (25 first diagnosis, 9 first relapse), 27 achieved CR. 13 patients received 1-2 courses of HDara-C/DNR. Toxic symptoms of HDara-C/DNR were severe myelosuppression, infections, skin reactions, diarrhea and hepatotoxicity. CNS toxicity was not observed. 2 patients died from infection. The duration of granulocytopenia (less than 500/microliter) was 7-43 days (range) and of thrombocytopenia (less than 25,000/microliter) 5-34 days (range). Patients of group II (age greater than 50 years) received a modified regimen with reduced toxicity. Their number is too small for evaluation as yet. PMID- 3528960 TI - High-dose cytosine-arabinoside and mitoxantrone in refractory acute myeloid leukemia: a clinical phase I/II-study. AB - In a multi-institutional study 26 patients with refractory acute myeloid leukemia were entered into a phase I/II study of HD-ara-C and mitox. HD-ara-C 3 g/m2 q 12h was given by 3h infusion on days 1-4. Mitox was started at 12 mg/m2/d on days 3, 4 and 5, and escalated to 4 and 5 doses of 10 mg/m2/d on days 2-5 and 2-6, respectively. From 24 patients presently evaluable for response, 12 achieved a CR and 2 a PR. 7 patients died of infectious complications within the first 4 weeks of treatment while persistent AML was found in 3 cases. Except for one death, possibly related to acute cardiomyopathy, toxicity was mild to moderate consisting of nausea and vomiting, mucositis and diarrhea. These data indicate a high anti-leukemic activity of HD-ara-C/mitox in AML refractory against conventional chemotherapy. PMID- 3528962 TI - Idarubicin in refractory acute leukemia. AB - 10 patients with resistant or relapsed acute leukemia (9 AML, 1 ALL) were treated with idarubicin (4-demethoxydaunorubicin) in combination with cytosine arabinoside +/- etoposide. All patients had been heavily pretreated. 9 AML patients had previously received 2-4 cycles of TAD-9 regimen. 2 complete and 1 partial remission were achieved. 1 patient died from septicemia in bone marrow aplasia without leukemic cells. 6 patients did not respond to idarubicin-based salvage treatment. The median survival from start of therapy was 4 months. Idarubicin-based combination chemotherapy is effective in relapsed acute leukemia, even in patients intensively pretreated with anthracyclines. PMID- 3528961 TI - Mitoxantrone and VP-16 in refractory acute myelogenous leukemia. AB - Phase I/II-studies suggested that mitoxantrone is effective in the treatment of acute leukemia. In this study we have investigated its efficacy in combination with VP-16 in patients with refractory acute myelogenous leukemia. The regimen consists of: mitoxantrone 10 mg/m2/day i.v. from days 1 to 5, VP-16 100 mg/m2/day as short infusion from days 1 to 3. A dosis escalation of VP-16 was attempted. As of August 1985, 27 patients have been enrolled in the study and 21 patients are now evaluable. Of these 21 patients, 6 (28.6%) have achieved complete remission including 3 with primary refractory disease, 2 with early relapse (less than 6 months after CR), and 1 with relapse under maintenance therapy. Two other patients have attained a partial remission. Toxicity was mild and, except one case of early death, no life threatening complications were observed. This combination seems to be an active regimen in refractory acute myelogenous leukemia and its incorporation in front line therapy seems warranted. PMID- 3528963 TI - Aclacinomycin-A in the induction treatment of childhood AML. AB - In the cooperative study AML-IGCI-84 27 children with AML (FAB M1 7X, M2 4X, M3 1X, M4 6X and M5 8X; 1 megakaryocytic leukemia) have been treated. The median initial white blood cell count was 18.0 G/l (range 1.8-1,350.0 G/l). 1 or 2 courses of induction therapy were used: I1 (aclacinomycin-A (ACLA-A), VP-16 and ARA-C) and I2 (daunorubicin (DNR), VP-16, and ARA-C). I2 was used only if bone marrow contained greater than 5% blast cells on day 21. I2 and consolidation treatment were identical with the current AML-BFM-83 protocol. 3 deaths before day 21 occurred (2 cerebral hemorrhages, 1 septicemia). 24 patients were evaluable for response, 20 (83.3%) achieved CR, 16 (66.7%) by I1, 4 after I2. 4 patients never reached CR, 3 of them had a PR after I1. M5 patients did badly (2 early deaths, 2 PR, 4 CR). All patients without CR after I1 received the whole AML-BFM-83 protocol. Comparison of the results of the 2 studies revealed a similar CR rate for I1 (our patients) and I2 (BFM data): 80.0% vs. 82.2% (calculated for patients who ever reached CR). CR was reached before consolidation in all our CR patients compared to 82.2% of BFM patients. Early CR may be of long term prognostic significance. Cardiotoxicity of induction may be reduced by substitution of DNR by ACLA-A. PMID- 3528964 TI - Current results of a multicenter trial in multiple myeloma. AB - 257 untreated myeloma patients (stage II and III) were studied in a multicenter trial. The patients were randomized and received MP or VCMP therapy. No differences in remission rate could be found in both therapy arms. After successful remission induction those patients without maintenance therapy relapsed significantly earlier than those patients receiving maintenance therapy. In pilot studies an etoposide therapy was found ineffective and a multidrug therapy (VBAMDex) could induce high remission rates in high risk and pretreated patients. PMID- 3528965 TI - [Quality of life of cancer patients under chemo- and radiotherapy. Prospective study of patients with gastrointestinal and bronchial cancers]. AB - In a prospective study, 156 patients with advanced lung and gastrointestinal carcinomas, receiving palliative chemotherapy or radiotherapy, were examined for changes in their quality of life during therapy. A questionnaire (68 questions), a linear analogue scale, and the Karnofsky performance scale were used three times in the course of therapy. The most important result seen during the evaluation of the questionnaire was the improvement in the psychical state in patients with tumor remission, even with increasing side-effects. In patients with progressive disease, a deteriorated psychosocial state and an increased burden due to the toxic side effects were observed. These results were also confirmed in progressive patients by the linear analogue scale. The Karnofsky performance scale showed a high correlation for the judgement of disease-related contents and the activity of the patient. In this study the relationship of treatment results and well-being is shown. It would seem important to include methods for the measurement of quality of life for the evaluation of oncological therapies. PMID- 3528966 TI - [Epirubicin in combination chemotherapy of metastasized breast cancer (VEC) and advanced ovarian cancer (PEC)]. AB - Epirubicin was applied in combination with vincristine and cyclophosphamide (VEC) against metastatic cancer of the breast in 14 patients, against advanced cancer of the ovaries. Epirubicin was applied in combination with cisplatin and cyclophosphamide (PEC) in 12 patients. Treatment of metastatic cancer of the breast achieved retrogression in 64%, the tumor was brought to a standstill in 12%. Treatment of cancer of the ovaries achieved complete retrogression in 75%, the tumor was brought to a standstill in 8.3%. There was no incidence of considerable myelo- or cardiotoxic side effects resulting in a necessary interruption of treatment. The achieved results of this treatment correspond to those with doxorubicin combinations, the toxicity, however, is less. PMID- 3528968 TI - [Epirubicin--results in breast cancer]. AB - Patients with metastasized breast cancer are incurable. Remissions with longer survival can be induced by chemotherapy in 50 to 80%, with 10 to 20% complete remissions, however, recurrence is unavoidable. Therefore the strategy of therapy in breast cancer must include two aspects: first prolongation of overall survival by multiple remissions with regimes that are not cross-resistant and secondly conservation of quality of life by minimization of therapy conditioned side effects. Epirubicin, the new anthracycline derivate and analogue of doxorubicin (probably the most active chemotherapeutic agent against breast cancer) exhibits the same high activity but lower side-effects compared with the parent compound. Complete and partial remissions in 33% of 313 breast cancer patients could be achieved with epirubicin. In three other studies the efficacy and side-effects of epirubicin were compared with the established drug doxorubicin. The remission rate was nearly the same but the side-effects such as nausea, vomiting, stomatitis, bone marrow toxicity and congestive heart failure were lower. Five different studies with epirubicin in combination with other cytostatics have shown comparable results as adriamycin combinations. In a randomized multicenter study, 520 patients were treated with epirubicin or doxorubicin in combination with cyclophosphamide and fluorouracil. The remission rates were 52 vs. 54%, respectively, but the toxicity of the epirubicin combination group was significantly lower. PMID- 3528967 TI - [Polychemotherapy of advanced soft tissue sarcomas with 4'-epi-doxorubicin (4' Epi-DX) and cisplatin (DDP)]. AB - 34 patients with locally advanced or metastatic soft tissue sarcoma were treated with 4'-epi-adriamycin (4'-Epi-DX: 45 mg/m2 day 1 + 2) and cisplatinum (DDP: 90 mg/m2 day 2). If leukocyte- or plateletnadirs during the previous interval were above 2,000/mm3 or 70,000/mm3 the dose of 4'-Epi-DX was escalated for 5 mg/m2 per treatment day. One patient died tumor-related soon after the first treatment cycle. In 33 evaluable patients 4 (12%) complete remissions, 10 (30%) partial remissions and 15 (46%) no changes were observed. 4 patients (12%) had primary progressive disease under treatment. In 6 patients treatment was stopped because of side effects: 4 intractable nausea and vomiting, 1 ototoxicity, 1 supposed cardiomyopathy. Hematotoxicity was not a limiting factor in this treatment regimen. PMID- 3528969 TI - [French FAC vs FEC study in advanced breast cancer]. AB - 239 patients were evaluable: 116 in the FAC arm, 123 in the FEC arm. There is no significant difference in the therapeutic responses between 2 regimens: 52 +/- 9% vs 49 +/- 9%. Duration of responses (273 vs 303 d) and overall survival were also similar. FEC appears less myelotoxic, less toxic also in terms nausea, vomiting and grade 3 alopecia than the adriamycin combination. 9 patients required treatment cessation due to grade 2 cardiac dysfunction with 3 CHF, against no case in the epirubicin regimen. PMID- 3528970 TI - Why resin-retained bridges fail. PMID- 3528971 TI - [Parthenogenesis in mammals]. AB - A review of studies dealing with spontaneous and induced parthenogenesis in mammals. The main methods of artificial egg activation, ways of their development and causes of mortality of the parthenogenetic mouse embryos are considered. The possibilities of using parthenogenesis for solving urgent problems of mammalian developmental biology are estimated and prospects of further studies in this field are outlined. PMID- 3528973 TI - Double running suture in penetrating keratoplasty. PMID- 3528972 TI - Current concepts of malignant glaucoma. PMID- 3528974 TI - Decreased fibronectin levels in aqueous humor after corneal injury. AB - Fibronectin plays an important role in wound healing and cell differentiation. The present study measures fibronectin levels in aqueous humor from injured corneas. In response to transcorneal freezing treatments, a thickened scar-like matrix is deposited on the posterior surface of rabbit corneas. This posterior collagenous layer (PCL) is visible grossly and has a uniform diameter. Aqueous humor from eyes with established posterior corneal scarring has significantly less fibronectin compared with control eye aqueous humor. Tissue culture experiments show that corneal endothelial cells from control eyes and PCL associated cells from injured eyes produce similar amounts of fibronectin. The marked decline in fibronectin levels in aqueous humor in scarred corneas supports the hypothesis that fibronectin plays a role in the pathological events which result from corneal injury. PMID- 3528975 TI - Corneal brush cytology: an experimental study. AB - A total of 48 corneal smears from rabbits were obtained by means of brush, cotton swab and spatula techniques. The cytomorphologic features in those methods are compared. In the smears prepared by brush, numerous corneal epithelial cells were found. The cells were well spread in a single layer and overlapping was uncommon. The morphology of the corneal cells was satisfactory for cytologic evaluation. In contrast, the other two methods lacked adequate numbers of cells and cell preservation. We feel that corneal epithelial cells are readily obtainable by the brush method, compared with the cotton swab and spatula methods, and the material is also ideally suited for cytologic evaluation. It can be easily used for corneal cytology in clinical situations. PMID- 3528976 TI - Composite resin. Its use in gold crown veneering. PMID- 3528977 TI - A simplified technique for closure of surgical sites following intraoral open reduction of mandibular fractures. AB - A technique is described in which intraoral open reductions can be performed with direct access to the bony fracture sites and still achieve a tight wound closure while the patient is maintained in maxillomandibular fixation following fracture reduction. PMID- 3528978 TI - Benzydamine hydrochloride in prevention and management of pain in oral mucositis associated with radiation therapy. AB - Benzydamine hydrochloride rinse reduced pain associated with radiation mucositis when it was used during the course of radiation therapy. Fewer patients using benzydamine rinse required systemic analgesics. All patients using benzydamine tolerated the rinse well and continued with regular rinsing throughout the course of radiation therapy. Benzydamine hydrochloride is currently undergoing clinical trials in the United States for application for approval from the Food and Drug Administration. PMID- 3528979 TI - Management of posttreatment endodontic pain with oral dexamethasone: a double blind study. AB - In a double-blind study, twenty-five subjects who received oral dexamethasone and twenty-five placebo subjects rated their postoperative pain 8 and 24 hours following initial endodontic treatment. The subjects who received dexamethasone reported statistically significantly less postoperative pain than the subjects who received the placebos. The question is raised as to whether oral corticosteroids are appropriate for routine management of posttreatment endodontic pain. PMID- 3528980 TI - The Golden Jubilee of the Department of Optometry, Uwist, Cardiff. PMID- 3528981 TI - In search of the spectrum's elusive yellow. PMID- 3528982 TI - [Development of dentistry in Austria (4). Adolph and Otto Zsigmondy]. PMID- 3528983 TI - [Esthetic dentistry. The shell technic and the repair of broken VMK appliances]. PMID- 3528984 TI - [Development of dentistry in Austria (5). Establishment of K.K. Dental Institute of University of Vienna]. PMID- 3528985 TI - [Development of dentistry in Austria (6). Rudolf Weiser and Hans Pichler]. PMID- 3528986 TI - Melanoma of the head and neck. Update and perspective. AB - The diagnosis and appropriate treatment of melanoma remains a controversial subject. A review of the literature as well as evaluation of our experience allows for a better understanding of this challenging problem and the development of some up-to-date guidelines in the treatment of this disease. PMID- 3528987 TI - The history of policy formation on cigarette use. PMID- 3528988 TI - A comparative study of the efficacy and pharmacokinetics of oral methadone and morphine in the treatment of severe pain in patients with cancer. AB - Eighteen patients suffering from cancer were entered into a study of the pharmacokinetics and efficacy of methadone and morphine in pain control. All patients had both clinical and radiological evidence of metastatic spread of their cancer and there were no significant differences in age, weight and sites of the primary cancer between the methadone (n = 9) and morphine (n = 9) groups. Blood opioid concentration, visual analogue pain scores (VAPS) and end-tidal percent carbon dioxide were measured before and after both an intravenous and oral dose of either methadone or morphine. Terminal half-lives (mean +/- S.D.) were 30.4 +/- 16.3 h and 2.7 +/- 1.2 h respectively for methadone and morphine while the clearance values (mean +/- S.D.) were 0.19 +/- 0.13 l/min and 1.16 +/- 0.47 l/min. The long half-life of methadone was associated with prolonged pain relief. However, the large variation in the half-life of methadone necessitated careful adjustment of the dosing interval in individual patients. There were pronounced differences in oral bioavailability between the two opioids: methadone, 79 +/- 11.7%, compared to morphine, 26 +/- 13% (mean +/- S.D.). Of greater clinical significance was the variability in these bioavailability estimates with a coefficient of variation of 15% for methadone compared to 50% for morphine. The combined effects of low and variable oral bioavailability for morphine may result in sub-therapeutic doses being administered as practitioners may be inhibited by the size of the effective oral morphine dose and may be confused by the variability in this dose compared to intramuscular doses. The initial oral dose of morphine varied from 15 mg 4 hourly to 150 mg 3 hourly, while the initial dose for methadone varied from 15 mg on alternate nights to 20 mg twice daily. There was no rapid escalation of daily opioid dose for either methadone or morphine when adequate pain control was provided rapidly at the start of treatment by the technique described in this study. PMID- 3528989 TI - Chronic headaches in adolescents: treatment in a school setting with relaxation training as compared with information-contact and self-registration. AB - An experimental study was conducted on 33 adolescent students with various types of chronic headaches (tension and combined tension and migraine headaches), all treated in a school setting. After a 4-week baseline period during which the subjects rated their headache activity, they were randomly assigned to a 9 session relaxation training programme or to an information-contact condition, both contrasted with an untreated self-registration group. Relaxation therapy alone led to significant improvement in headache activity, particularly in reduction of the frequency of complaints which still was significantly reduced at a 6-month follow-up evaluation. The effects obtained in the information-contact condition were comparable to those in the self-registration group, both achieving only minor improvements after treatment or at the follow-up assessment. The majority of students in the relaxation treatment, however, was much improved, attaining more than 50% reduction in headache activity. The findings in the present study are consistent with results from similar treatment outcome studies, reported on adult populations with chronic headaches, and demonstrate that relaxation training programmes can be of substantial help in a school setting. PMID- 3528990 TI - Brugia pahangi infections in cats: antibody responses which correlate with the change from the microfilaraemic to the amicrofilaraemic state. AB - The humoral responses of eight cats infected with Brugia pahangi to somatic antigens from all life-cycle stages were examined quantitatively by ELISA and qualitatively by immunoblotting for almost a year post infection. Six cats spontaneously became amicrofilaraemic: their production of IgG antibodies against somatic antigens of microfilariae, adults, and infective larvae was not statistically higher than that of the two cats which remained microfilaraemic. However, immunoblotting revealed that those cats which spontaneously became amicrofilaraemic selectively recognized certain microfilarial, adult and infective larval somatic antigens prior to disappearance of microfilariae from the peripheral circulation. The data suggest that selective recognition of antigens by some cats is responsible for the production of antibodies which may then promote microfilarial death. PMID- 3528991 TI - [External structure of cuticle injuries and larval mouth parts of the chiggers Euschoengastia rotundata and Neotrombicula vulgaris (Trombiculidae)]. AB - When E. rotundata larvae parasitize the abdominal part of the body of their host (Clethrionomys glareolus), capsules with round terminal opening are formed from which hind part of the mite's body projects forwards. Organization of the capsules shows that their walls are formed by a substance (probably by larval saliva) which differs from host's tissues. At the bottom of the capsules there are larval adhesive sites with openings in the proximal parts of stylostomes which resemble in their structure these of N. vulgaris larvae. The latter do not form capsules when feeding on their natural hosts, Microtus arvalis. Proximal part of stylostome is formed in both cases by amorphous glutinous substance bearing imprints of mite's mobile digits of chelicerae and hypostome. Mouth parts of hungry mites and satiated larvae of both species differ only in relative sizes of constituent parts. Soft apical part of hypostome turns backwards during the feeding and forms a sucker. The feeding of larvae of trombiculids in capsules, which is formally regarded as ectoparasitism, can apparently be considered as a special type of parasitism. PMID- 3528992 TI - [Intermediate host of the trematode Quinqueserialis quinqueserialis (Trematoda, Notocotylidae) in the USSR and the morphology of its parthenitae and larvae]. AB - A high infection rate of muskrat with the trematode Q. quinqueserialis was recorded in Pribaikalje. Its intermediate host is the mollusc Gyraulus (Anisus) stroemi. Morphology and biology of parthenites and larval phases of the development are studied and characters of the biology of this trematode are found out. PMID- 3528993 TI - Lipid metabolism in golden hamsters infected with plerocercoids of Spirometra erinacei (Cestoda: Pseudophyllidea). AB - Golden hamsters infected with Spirometra erinacei plerocercoids develop a hypertriglyceridaemia characterized by an increase in very low-density lipoprotein. Acyl-CoA synthetase activity, the rate of fatty acid synthesis in the liver and triglyceride production studies showed that the activation and synthesis of fatty acid and production of triglyceride in plerocercoid-infected hamsters were not significantly different from the controls. Lipase activity in post-heparin plasma was found to be suppressed in plerocercoid-infected golden hamsters. The presence of plerocercoids also resulted in a significant reduction in serum thyroxine, but the hypertriglyceridaemia associated with plerocercoid infection was not reversed by injecting the infected hamsters with 2 micrograms/day doses of L-thyroxine. The levels of serum immunoreactive insulin in plerocercoid-infected hamsters were not significantly different from the controls. We conclude that the hypertriglyceridaemia, associated with plerocercoid infection in hamsters, results predominantly from a suppression of triglyceride degradation, and that the suppression of lipase activity is probably not the result of hypothyroidism or the lack of insulin, but the result of secretion of growth hormone-like substances. PMID- 3528995 TI - Analysis of trypanosome variable antigen types in cultures of metacyclic and mammalian forms of Trypanosoma congolense. AB - Cultured metacyclic forms of Trypanosoma congolense display a characteristic repertoire of metacyclic variable antigen types (M-VATs) similar to that exhibited in vitro in the tsetse fly. There appeared to be no change in expression of M-VATs in cultures of two stocks of T. congolense even after several passages, cryopreservation or long-term cultivation in vitro. Metacyclic forms transformed into mammalian forms when transferred to cultures of bovine aorta endothelial cells and whilst one stock retained expression of M-VATs without change even after 4 months, the other stock underwent antigenic variation within 14 days of transfer. Analysis of the M-VAT composition of mammalian forms of this stock using monoclonal antibodies showed that although the proportion of mammalian forms expressing certain M-VATs declined considerably, trypanosomes expressing one M-VAT increased proportionally to comprise 50% of the population. In contrast, only small changes were seen in antigen expression in cultures of metacyclic trypanosomes from which mammalian-form cultures were derived. It was possible to produce in vitro, loss and reacquisition of variable antigen surface coat, similar to the differentiation process occurring when bloodstream trypanosomes are ingested by the tsetse fly and eventually develop into metacyclic forms. PMID- 3528994 TI - Plasmodium falciparum: regional differences in lectin and cationized ferritin binding to the surface of the malaria-infected human erythrocyte. AB - The distribution of anionic residues on the surface of erythrocytes infected with Plasmodium falciparum was studied using cationized ferritin (CF) and transmission electron microscopy. CF staining of uninfected erythrocytes or erythrocytes infected with a knobless variant resulted in a dense and uniform distribution of ferritin particles; however, when red cells infected with a knob-inducing variant were exposed to CF, aggregates of ferritin particles were observed in the region of membrane elevation. Lectin binding to the erythrocyte surface was visualized by transmission electron microscopy using ferritin-conjugated lectins and lectin fetuin-gold. No differences were observed in the lectin-binding patterns of malaria-infected or uninfected erythrocytes using WGA (wheat-germ agglutinin), RCA (ricin), and Limax flavus lectin. In distinct contrast to the uniform distribution of ferritin particles seen with these lectins was the appearance of clusters of ferritin-ConA over the knobby regions. Localized aggregates of ConA were not seen in knob-free areas or on the surface of red cells infected with a knobless variant. No significant differences were found in the agglutination reactions of normal and infected cells with the Cancer antennarius lectin specific for O-acylated sialic acids. PMID- 3528996 TI - [Determination of serum proline iminopeptidase activity using a fluorescent substrate in patients with Paget's disease and prostatic bone metastases. Preliminary results]. AB - Assessment of proline iminopeptidase activity in serum has been performed in 80 control subjects, 14 Paget's diseases and 10 patients with prostatic and osteoblastic bone metastases. In normal subjects, the PIP activity rises with age, mainly (+63%) in women after menopause. In benign or malignant osteoblastic bone diseases PIP activity is elevated and slightly related to urinary hydroxyproline excretion (r = 0.76) which evolution is close to. It is concluded that PIP activity dosage in serum may provide with urinary hydroxyproline, further information for the study of collagen metabolism in osteoblastic bone diseases during treatment. PMID- 3528997 TI - [Incidence of Mycoplasma pneumoniae infection in a population of hospitalized patients during an epidemic]. AB - During an outbreak with Mycoplasma pneumoniae, a serological survey was performed with 3,165 sera from 1,900 hospitalized patients over a 33 months period. Four hundred and eleven patients exhibit serological pattern suggestive for a recent infection. The main points are the following: the infection was more frequently (21.6%) detected in females than males, in the patients 5 to 19 years than in the other age groups; the incidence of the infection is the same in the group of patients hospitalized for extra-respiratory syndromes compared to respiratory infections; children and teen-agers exhibit the higher antibody titers; no modification of the type of infection was found in relation with age groups; the antibody titers are higher when patients are hospitalized with respiratory diseases, whatever their age group may be; there is no relation between sex and the type of infection, pulmonary or extra-pulmonary; a surprisingly high incidence of infections was detected in patients hospitalized with renal failure. PMID- 3528998 TI - [In vitro activity of the combination ticarcillin-clavulanic acid on bacterial isolates in surgery]. AB - The in vitro activity of ticarcillin in combination with clavulanic acid was tested, by disc diffusion, against 1,380 clinical bacterial isolates and was compared with that of ticarcillin alone. 83.8% of the isolates were susceptible to ticarcillin + clavulanic acid, whereas 56.6% were susceptible to ticarcillin alone. Minimal inhibitory concentrations (MIC) of ticarcillin in the presence of 4 micrograms/ml of clavulanic acid were determined against 157 ticarcillin resistant (MIC greater than 128 micrograms/ml) but ticarcillin + clavulanic acid susceptible strains of Gram negative bacilli and against 20 strains of beta lactamase producing Staphylococcus aureus. With the addition of clavulanic acid, MICs of ticarcillin were respectively less than or equal to 16 micrograms/ml and less than or equal to 64 micrograms/ml for 50 and 90% of the Gram negative bacilli. All the Staphylococcus aureus were inhibited by concentrations of ticarcillin less than or equal to 1 microgram/ml. PMID- 3528999 TI - [Pharmacokinetic, biochemical and histological study of the carbamazepine josamycin interaction in the rat following chronic administration]. AB - The determination of possible modifications of pharmacokinetic parameters of carbamazepine by josamycin in an experimental study after chronic administration of the drugs in the rat was undertaken to assay, or not, the enzymatic inhibition hypothesis which is supported in human clinical studies. Our data do not show any alteration in the Cmax, Tmax and AUC parameters of carbamazepine (total and unbound fraction) in case of conjunction with josamycin, but an earlier increase of plasmatic concentrations. The biochemical parameters are not modified, but a significant decrease of total bilirubin compared with controls and carbamazepine alone. The histological study does not show any liver lesion. PMID- 3529000 TI - [Effect on lipids, lipoproteins and apoproteins of labetalol prescribed in doses of 400 mg/day in hypertensive patients. Double-blind versus placebo study]. AB - The effects of labetalol on plasma lipoprotein metabolism were evaluated in a 3 month double-blind drug versus placebo study conducted on 30 consenting hypertensive patients, 15 of whom had normal plasma lipid levels and 15, minor type II hyperlipoproteinaemia; 20 patients received labetalol 400 mg/day and 10 the placebo. All patients remained in stable nutritional status throughout the study. Full clinical examination and blood sampling were carried out 30 days before, and on days 0, 30 and 90 of treatment. Whole blood was collected after 12 hours' fasting and immediately centrifuged prior to determination of plasma lipids (total cholesterol and triglycerides, by enzymatic assay), lipoprotein lipids (HDL, HDL2, HDL3, LDL, VLDL separated by ultracentrifugation in density gradient), apoproteins A1 and B (by laser immunonephelometry) and post-heparin lipoprotein lipase activity (PHLA). Significant changes in heart rate and systolic and diastolic blood pressures were noted in patients under labetalol but not in patients under placebo. Lipid and apolipoprotein levels were similar in both groups on day 0, and no significant variation in lipids, lipoprotein lipids and apolipoproteins were observed after 30 and 90 days of treatment with either labetalol or the placebo. At the end of treatment PHLA was unmodified in the group under placebo and raised in the group under labetalol (p = 0.05). The absence of changes in blood lipid values was found both in patients with normal lipidemia and in those with hyperlipidaemia. This study confirms that labetalol in doses of 400 mg/day has notable anti-hypertensive activity and, as previously reported and in contrast with other beta-blocking agents, is devoid of any adverse effect on lipid metabolism. PMID- 3529001 TI - [The Langerhans system. Definition. Physiologic and pathologic modifications]. AB - The Langerhans cell system including the Langerhans cell (LC), the indeterminate epidermal cell, the lymphoid interdigitating cell, and the lymph veiled cell is nowadays considered as a very peculiar subpopulation of the mononuclear phagocyte system. The authors have tried in this review to point out the main salient features, the qualitative and quantitative variations of these cells during physiological, experimental and pathological processes. PMID- 3529002 TI - [Lithium]. AB - Lithium salts are used in psychiatry, for their sedative properties in states of agitation and, above all, for their ability to prevent recurring manic and depressive episodes in manic-depressive psychosis. In addition to manic depressive psychosis, lithium is used as an antidepressant and the treatment of aggressive behaviors. Pharmacologic characteristics of lithium are incompletely elucidated; a few sedative and antiaggressive properties have been demonstrated in animals, but lithium fits into none of the known classes of psychoactive agents. Following absorption into the body, lithium does not bind to proteins. Penetration through the blood-brain barrier is poor. Elimination is mainly through the kidneys. Penetration of lithium into cells seems to vary across individuals. Lithium has a number of neurochemical effects, including stabilization of the number and sensitivity of monoaminergic receptors, which may be the mechanism for the drug's therapeutic properties. The main rule of lithium treatment is to achieve serum levels between 0.6 and 1 nM/l. Before starting a patient on lithium, tests are needed, especially to assess renal function: patients with renal failure are at risk for accumulation of lithium with toxic side effects. Most of the side effects are minor. The only serious risk is hyperlithemic intoxication that may cause mental confusion, coma and death. Lithium may induce malformations if given during the first trimester of pregnancy. The only true contraindications to lithium are renal failure, treatment by thiazide diuretics, and organic brain disease. PMID- 3529003 TI - [Micromethod of leukocyte typing using monoclonal antibodies and indirect immunofluorescence: cell adsorption on support slides treated with poly-L lysine]. AB - A micromethod of indirect immunofluorescence with monoclonal antibodies to study surface markers of leukocytes and precursors, is described. This method consists of attaching non specifically living cells on a slide, previously treated with a high molecular weight polymer (L-lysin). The advantage of this method consists of using only 1.10(4) cells by typage, and low amounts monoclonal antibodies (twenty to forty less). In addition, this common method can be used in most biology laboratories. PMID- 3529004 TI - [Spinal hydatidosis. Failure of albendazole]. AB - A recession of eighteen months is not enough to evaluate efficacy of albendazole therapy on spine hydatic cyst in spite of a negative specific serology by HAI and electrophoresis. Specific IgE and precipitates system number 5 seem not good tests for the following of evolution. Inoculation of mouse with bone biopsy is an interesting test to evaluate the viability of the cyst. PMID- 3529005 TI - Surgical pathology of the vermiform appendix. PMID- 3529006 TI - Nonatherosclerotic sudden coronary death. PMID- 3529007 TI - Basement membranes in human cancer. PMID- 3529008 TI - Patterns of pulmonary fibrosis. PMID- 3529009 TI - Clinical and pathological considerations in the evaluation of major head and neck specimens resected for cancer. Part II. PMID- 3529010 TI - [Effect of pancreozymin on insulin secretion in experimental chronic pancreatitis]. PMID- 3529011 TI - [The "cost" of adaptation]. PMID- 3529012 TI - Proflex, schizokinesis and the internal universe. PMID- 3529013 TI - Cervical cancer in the adolescent patient. PMID- 3529014 TI - Vulvar disorders in the prepubertal female. AB - Inspection of the vulva should be a routine part of well child care. Detection of poor perineal hygiene permits the establishment of good hygiene practices, which may prevent development of vulvovaginitis. Condylomata acuminata, molluscum contagiosum, herpetic vulvitis, and vulvovaginitis secondary to Neisseria gonorrhoeae, Gardnerella vaginalis, Chlamydia trachomatis, and Trichomonas vaginalis arouse suspicion of child sexual abuse, which must be addressed. Atopic dermatitis, psoriasis, lichen planus, and lichen sclerosis et atrophicus are often chronic and early diagnosis with appropriate treatment and follow-up contributes to the acceptance of the disease by parent and child. Early detection of the rare neoplasms of the vulva is essential to improved survival. PMID- 3529015 TI - Ultrasonography in the pediatric gyn patient. PMID- 3529016 TI - A review of the ultrasonic appearances of posterior urethral valve and ureteroceles. AB - Ultrasonographic studies of patients with posterior urethral valve and ectopic ureterocele vary in relation to the severity of obstruction and changes in the upper tracts. A broad review of these conditions, stressing sonography (including use of the perineal approach to the upper urethra) shows the great value of sonography but emphasizes the need to correlate with other imaging modalities (urography, cystourethrography, nuclear imaging). PMID- 3529017 TI - The sonographic evaluation of the great vessels' interspace in the pediatric retroperitoneum. AB - The great vessels' interspace, in the pediatric retroperitoneum, deserves special attention during abdominal sonographic examination. By rotating the child into the right anterior oblique position, the full length of this interspace is demonstrated. Normally, it has a uniform appearance. When invaded by disease, the sonographic pathology can be identified and differentiated from the surrounding structures. The studies were gathered from experience with 1658 retroperitoneal sonographic examinations. Fourteen children were found with disease involving the great vessels' interspace: 4 patients with lymphoma, 3 patients with sympathetic ganglioneuroblastoma, 2 patients with retroperitoneal rhabdomyosarcoma, and one case each, respectively, of adrenal neuroblastoma, Wilms' tumour, clear cell carcinoma of the kidney, retroperitoneal teratoma and Toxocara canis. PMID- 3529018 TI - Ultrasonographic features of glomerulocystic disease in infancy: similarity to infantile polycystic kidney disease. AB - Glomerulocystic kidney disease (GCD) is an unusual condition characterized pathologically by cystic dilatation of Bowman's space and the first portion of the proximal convoluted tubule. We report the serial ultrasound findings in an asymptomatic infant with GCD which were initially confused with infantile polycystic kidney disease. We emphasize the nonspecificity of ultrasonographic findings in cystic renal disease in early infancy and suggest a protocol for the diagnostic work-up of bilateral renal cystic disease in children. PMID- 3529019 TI - Magnetic resonance imaging in occult spinal dysraphism. AB - The value of magnetic resonance imaging (MRI), compared to myelography and computerized tomography, is illustrated in six patients with occult spinal dysraphism. MRI proved to be the diagnostic tool of choice. PMID- 3529020 TI - Hemorrhage in cavum septi pellucidi. AB - One case of hemorrhage in the cavum septi pellucidi (CSP) is presented. This unusual location of intracranial hemorrhage was demonstrated by cranial sonography in a premature neonate. PMID- 3529021 TI - Diagnostic value of ultrasonography in neonatal liver rupture. AB - A case of neonatal liver rupture is described. The capability of ultrasonography in revealing both the parenchymal lesions and the subcapsular hematoma is emphasised. PMID- 3529022 TI - Congenital absence of the portal vein in oculoauriculovertebral dysplasia (Goldenhar syndrome). AB - Absence of the portal vein with systemic visceral venous return was demonstrated in an 8-year old girl with oculoauriculovertebral dysplasia (Goldenhar syndrome) during preoperative evaluation of a liver mass. Congenital absence of the portal vein is a rare malformation of potential clinical significance. PMID- 3529023 TI - Association of changes in bombesin immunoreactive neuroendocrine cells in lungs of newborn infants with persistent fetal circulation and brainstem damage due to birth asphyxia. AB - The pulmonary neuroendocrine (NE) cells, from 16 term infants dying at 1-4 days of age from birth asphyxia, were immuno stained for bombesin-like immunoreactivity by the immunoperoxidase method. The distribution and frequency of bombesin-immunoreactive NE cells were quantified morphometrically and correlated with the presence or absence of brainstem function and persistent fetal circulation (PFC). In infants with loss of brainstem function, the frequency of bombesin immunoreactive NE cells was significantly increased compared to infants with intact brainstem function, i.e. meconium aspiration with PFC. Infants with brainstem injury, with one exception, failed to develop PFC. Pathological changes in the tegmentum of the brainstem, i.e. containing the respiratory center, correlated in nine of 10 cases with loss of brainstem function. These data suggest an inverse relationship between brainstem function, release of bombesin-like peptide from the pulmonary NE cells and the functional state of the pulmonary vasculature. Intact brainstem function appears to be essential for both the release of bombesin-like peptide from the NE cells and for pulmonary vasoconstriction leading to PFC; absence of brainstem function is, on the other hand, associated with failure to release bombesin-like peptide and loss of PFC type reactivity in the pulmonary vasculature. However, it appears unlikely that bombesin itself is a direct mediator of pulmonary vasoconstriction. PMID- 3529024 TI - [Monoclonal antibodies and their clinical use]. PMID- 3529025 TI - [Urethral injuries in boys and their treatment]. PMID- 3529026 TI - Prospective diagnosis of pseudohypoaldosteronism. PMID- 3529027 TI - [Effectiveness of the treatment of juvenile rheumatoid arthritis with dimethyl sulfoxide gel]. PMID- 3529028 TI - Maestro Francesco da Roma: portrait of a Renaissance public health officer. PMID- 3529029 TI - Frederick Banting's misinterpretations of the work of Ernest L. Scott as found in secondary sources. PMID- 3529030 TI - [Image diagnosis of parathyroid glands in patients with secondary hyperparathyroidism]. PMID- 3529031 TI - State-approved schools of nursing L.P.N./L.V.N. 1986. PMID- 3529033 TI - [Information on the incidence of tooth loss and use of dentures in 4 hospitals in Ostland]. PMID- 3529032 TI - Contact dermatitis in the dog. A review and a clinical study. AB - Allergic, irritative and photosensitive contact dermatitides make up a group of dermatoses which have traditionally been associated with some difficulties in diagnostication. The reason for this is the problems encountered in setting up, keeping in place, and reading the patch test which is the diagnostic tool relevant to veterinary practice. In the present study, a review of the disease complex is given, and a clinical study, dealing with allergic contact dermatitis, performed with materials and methods available to the small animal practitioner, is discussed with regards to symptomatology, diagnostic work, and therapy. With appropriate management, consisting in an attempt to eliminate the offending item(s), and glucocorticoid therapy adjusted to the clinical response, the disease carries a good prognosis. PMID- 3529034 TI - Simultaneous synthesis of human-, mouse- and chimeric epidermal growth factor genes via 'hybrid gene synthesis' approach. AB - Simultaneous synthesis of two DNA duplexes encoding human and mouse epidermal growth factors (EGF) was accomplished in a single step. A 174 b.p. DNA heteroduplex, with 16 single and double base pair mismatches, was designed. One strand encoded the human EGF, and the opposite strand indirectly encoded the mouse EGF. The heteroduplex DNA was synthesized by ligation of seven overlapping oligodeoxyribonucleotides with a linearized plasmid. After transformation in E. coli HB101 (recA 13), the resulting heteroduplex plasmid served as the template in plasmid replication. Two different plasmid progenies bearing either the human or mouse EGF-coding sequence were identified by colony hybridization using the appropriate probes. However, in E. coli JM103, the same process yielded plasmid progenies encoding different chimeric EGF molecules, presumably due to crossover of human and mouse EGF gene sequences. PMID- 3529035 TI - Nucleotide sequence of the hemC locus encoding porphobilinogen deaminase of Escherichia coli K12. AB - Porphobilinogen deaminase, the product of the hemC locus in Escherichia coli K12, catalyses the tetrapolymerisation of porphobilinogen (PBG) into the hydroxymethylbilane, preuroporphyrinogen. The hemC locus has been subcloned from the Clarke and Carbon plasmid pLC41-4. The sequence of the hemC structural gene and flanking DNA was determined by the dideoxy chain termination method of Sanger. The structural gene for hemC is located within a 942bp sequence encoding the monomeric PBG deaminase, molecular weight 33,857. The extent of the coding region was confirmed by sequencing the N-terminus of the purified enzyme and by determination of the molecular weight. The hemC locus is closely linked to the cyaA locus, the genes being transcribed in a divergent manner. Upstream of the hemC coding region, a possible promoter and three repeated GGATG sequences were identified. This is the first report of a complete DNA sequence for a structural gene specifying an enzyme of the heme biosynthetic pathway in prokaryotes. PMID- 3529037 TI - Guanine and adenine analogues as tools in the investigation of the mechanisms of mismatch repair in E. coli. AB - The efficiency of in vivo correction of five "mismatch analogues", incorporated into M13mp9 DNA, was studied in an attempt to elucidate the structural determinants required for mismatch recognition by the repair machinery of E. coli. Inosine was efficiently removed from an I/T mismatch, presumably by the action of hypoxanthine glycosylase. The mismatch analogues DI/T (DI = 7 deazainosine), Tu/C (Tu = tubercidin), N/C (N = nebularine) and DN/C (DN = 7 deazanebularine) were left largely unrepaired, giving rise to high yields of mutant phenotype. The efficiency of correction of these mismatch analogues could be correlated with their structure within the base-pair. PMID- 3529036 TI - DNA sequence analysis of ARS elements from chromosome III of Saccharomyces cerevisiae: identification of a new conserved sequence. AB - Four fragments of Saccharomyces cerevisiae chromosome III DNA which carry ARS elements have been sequenced. Each fragment contains multiple copies of sequences that have at least 10 out of 11 bases of homology to a previously reported 11 bp core consensus sequence. A survey of these new ARS sequences and previously reported sequences revealed the presence of an additional 11 bp conserved element located on the 3' side of the T-rich strand of the core consensus. Subcloning analysis as well as deletion and transposon insertion mutagenesis of ARS fragments support a role for 3' conserved sequence in promoting ARS activity. PMID- 3529039 TI - Photoalkylated DNA and ultraviolet-irradiated DNA are incised at cytosines by endonuclease III. AB - Photoalkylation, the ultraviolet irradiation of DNA with isopropanol and di-tert butylperoxide, causes a variety of base alterations. These include 8-(2-hydroxy-2 propyl)guanines, 8-(2-hydroxy-2-propyl)adenines and thymine dimers. An E. coli endonuclease against photoalkylated DNA was assayed by conversion of superhelical PM2 phage DNA to the nicked form. Enzyme activities were compared between extracts of strain BW9109 (xth-), lacking exonuclease III activity, and strain BW434 (xth-,nth-), deficient in both exonuclease III and endonuclease III. The endonuclease level in the double mutant against substrate photoalkylated DNA was under 20% of the activity in the mutant lacking only exonuclease III. Irradiation of the DNA substrate in the absence of isopropanol did not affect the activity in either strain. Analysis by polyacrylamide gel electrophoresis identified the sites of DNA cleavage by purified E. coli endonuclease III as cytosines, both in DNA irradiated at biologically significant wavelengths and in photoalkylated DNA. Neither 8-(2-hydroxy-2-propyl)purines, pyrimidine dimers, uracils nor 6-4' (pyrimidin-2'-one)pyrimidines were substrates for the enzyme. PMID- 3529038 TI - Interaction of the tight-binding I12-X86 lac repressor with non operator DNA: salt dependence of complex formation. AB - The interaction of the wild-type lac repressor and its tight binding double mutant I12-X86 with a non operator-210 base pair-DNA fragment has been investigated using the nitrocellulose filter binding assay. While the affinity of the double mutant for this non specific DNA is increased as compared to that of the wild-type repressor, the number of ions released from the vicinity of the DNA upon complex formation is less important for the mutant than for the wild-type. These results demonstrate that the adaptation in the recognition surface of the repressor recently proposed by Mossing et al (J. Mol. Biol., 1985, 186, 295-305) in the case of an Oc mutant may be a more general phenomenon. PMID- 3529041 TI - An experimental model for the detection and localisation of gastrointestinal bleeding using 99mTc-DTPA. AB - 99mTc-DTPA was successfully used to detect simultaneously gastrointestinal bleeding sites in experimentally created mucosal ulcers in the colon and stomach of rabbits. Unlike the other radiopharmaceuticals that are currently used, 99mTc DTPA was rapidly cleared from the vascular, hepatic and splenic circulation. The overall background radioactivity was low. 99mTc-DTPA appears to be an ideal agent for detection and localisation of gastrointestinal bleeding sites. PMID- 3529040 TI - C4-methyldeoxythymidine replacing deoxythymidine in poly[d(A-T)] renders the polymer resistant to the 3'----5' exonuclease activity of the Klenow and T4 DNA polymerases. AB - We previously reported that O4-alkyl dTTPs could replace, for short times, dTTP in polymer synthesis [Singer et al., PNAS 83, 26-32, 1986]. The reasons for such early termination of synthesis could be either proofreading or the eventual formation of weakly paired primer termini. Utilizing the known 3'----5' exonucleolytic activity of polymerases, in the absence of dNTPs, enabled us to conclude that, in contrast to the digestibility of poly[d(A-T)] which yielded the expected 3'-mononucleotides, the polymerizing enzymes did not digest O4-methyl dT or its neighbors. The presence of the resistant alpha-phosphorothionate linkage did not prevent measurable digestion of poly[d(A-T)] by the Klenow fragment. This, together with evidence that polymerization of O4-methyl dTTP is favored at low temperatures, supports the model proposed by Ollis et al. [Nature 313, 762 766, 1985] showing independent domains for the two activities in the Klenow fragment. PMID- 3529042 TI - Margaret Sanger: nurse and feminist. PMID- 3529043 TI - Covergowns and the control of operating room contamination. AB - This study assessed the effectiveness of cotton/polyester covergowns in protecting scrubsuits against bacterial contamination when operating room (OR) personnel are outside the clean environment of the operating suite. Rodac impression plates were used to measure bacterial contamination. The subjects were nurses working a normal daily OR routine. Bacterial colony counts on the right shoulder decreased when covergowns were worn over scrubsuits during the lunch period outside the OR and when fresh scrubsuits were put on following the lunch period. Colony counts rose over the lunch period when scrubsuits were worn unprotected outside the OR and when scrubsuits were removed before and put on again following lunch. Left thigh samples showed no significant effects of experimental treatments and yielded a mean colony count 2.8 times higher than right shoulder samples. Fifty-three percent of subjects were positive for Staphylococcus aureus and 16% yielded positive plates on 3 or more study days. The incidence of S. aureus contamination was affected by experimental treatments in a way similar to overall bacterial contamination. The results indicated that wearing covergowns protects against above-waist bacterial contamination of scrubsuits. PMID- 3529044 TI - Heart transplant. A second chance. PMID- 3529045 TI - Heart transplant. Harefield's choice. PMID- 3529046 TI - Psychiatric/mental health nursing. AB - From a historical perspective, psychiatric/mental health nursing as a specialized area of practice is in its early developmental stages. Within the discipline of nursing and on the interdisciplinary scene, the range and scope of actions of the psychiatric/mental health specialists is still being debated. Professional roles and responsibilities are somewhat blurred. But the role is expanding. Contemporary psychiatric nursing practice has moved to a position of collegial support among the disciplines with shared responsibility. The attitudes of society, of the nursing profession, and of the health care providers will continue to influence the maturation process of the psychiatric/mental health nursing specialty. PMID- 3529047 TI - Stereotaxic surgery of brain. PMID- 3529048 TI - Pulmonary toxicity secondary to cancer treatment. PMID- 3529049 TI - Iatrogenic fracture of roots reinforced with a cervical collar. PMID- 3529050 TI - [Use of calcium antagonists in the treatment of bronchial asthma]. PMID- 3529051 TI - A VIP/PHI-containing pathway links urinary bladder and sacral spinal cord. AB - Nerve fibres containing VIP and the co-produced PHI are found in the dorsal horn and autonomic centres of the sacral spinal cord and in pelvic organs. We have investigated the origin of these nerve fibres and a possible peptide-containing pathway linking pelvic viscera with the spinal cord of the cat and rat using neurochemical and neurosurgical procedures, retrograde tracing and immunocytochemistry. Cell bodies were located in the dorsal root ganglia (after colchicine injection), pelvic ganglia and bladder wall. Capsaicin treatment induced a loss of VIP/PHI from the dorsal horn. Retrograde tracing from the bladder revealed True Blue labelled cells in the dorsal root ganglia (L6, S1), parasympathetic nuclei and pelvic ganglia. Labelled cells were sequentially immunostained for VIP/PHI which were numerous in pelvic ganglia and scattered and weak in dorsal root ganglia. Pelvic nerve section induced a decrease of VIP/PHI immunoreactivity from the spinal cord and no change or a minimal increase in immunoreactive nerve fibers of the bladder. Thus pelvic visceral afferents with cell bodies in the dorsal root ganglia are a significant source of VIP/PHI containing fibres in the sacral dorsal horn. PMID- 3529052 TI - Vasoactive intestinal peptide as a bronchodilator in severe asthma. AB - In two studies vasoactive intestinal peptide (VIP) was administered intravenously to two groups of eight in-patient volunteers recovering from severe acute asthma. VIP (6 pmol/kg/min) infusion caused significant (p less than 0.01) increase in peak expiratory flow rate (PEFR) of 26 +/- 9 (SEM) l/min after 30 minutes infusion compared with a bronchodilation of 39 +/- 19 l/min seen with salbutamol (5 mcg/min). Following pretreatment with nebulized ipratropium bromide, VIP infusion caused a significant (p less than 0.02) bronchodilation of 25 l/min. VIP is a bronchodilator in severe asthma, although its effects are less than conventional medication. Reflex mechanisms are unlikely to explain the bronchodilatory effect of intravenous VIP. PMID- 3529053 TI - The biological significance of "enteroglucagon." Present status. AB - "Enteroglucagon" refers to glucagon-like peptides present in intestine that cross react with N-terminally directed antiglucagon antisera but not with C-terminally directed antisera. Two peptides having these features have been isolated from the lower small intestine: glicentin (69 amino acids) and oxyntomodulin (37 amino acids). The sequence of the pancreatic preproglucagon gene suggests that glucagon, glicentin and oxyntomodulin derive from the same translational pathway, each individual peptide being produced by different posttranslational processing. Both glicentin and oxyntomodulin contain the glucagon sequence that bears the N terminal epitope and are C-terminally extended by the same octapeptide masking the C-terminal epitope. The N-terminal 32 amino acid extension of glicentin renders the molecule unable to bind to hepatic glucagon receptors, unlike glucagon and oxyntomodulin. An original tissue specificity of oxyntomodulin, mediated by a novel type of receptor, has been observed in acid secreting gastric oxyntic glands. Oxyntomodulin and glicentin containing the C-terminal octapeptide, as well as the octapeptide itself, are able to inhibit gastric acid secretion. This biological activity is likely to represent the main physiological regulatory pattern in which "Enteroglucagon" is involved. PMID- 3529054 TI - PHI structural requirements for potentiation of glucose-induced insulin release. AB - Immunoreactive PHI was detected in rat pancreas. The potentiating effect of 10( 9) M PHI upon insulin release from the isolated perfused rat pancreas was significant and most consistent when 250 mg% glucose was present in the perfusion medium. PHI(1-15) retained a substantial potentiating effect on insulin release, while PHI(14-27) was essentially inactive. Replacement of amino-terminal decapeptide portion of the PHI molecule with the corresponding part of VIP resulted in a drastic decrease of the potentiating effect of PHI on insulin release. 10(-8) M PHI(14-27) substantially diminished the potentiation by 10(-9) M PHI while PHI(1-15) was without an inhibitory effect. The present results indicate that the PHI active site for potentiation of glucose-induced insulin release resides in the amino-terminal segment of the molecule but requires the carboxyl terminal segment primarily for binding to exhibit full biological activity. PMID- 3529055 TI - Molecular and cellular mechanisms of porphyrin photosensitization. AB - Mechanisms of porphyrin-sensitized photochemistry involving biomolecular substrates have been studied in a diverse array of in vitro and in vivo experimental protocols. Porphyrin-sensitized, singlet oxygen-mediated photooxidative damage has been implicated in peroxidation of cell membrane lipids; cross-linking of cell membrane and intracellular proteins; inhibition of cell membrane associated, cytosolic, mitochondrial and microsomal enzymes; disruption of intracellular organelles with release of inflammatory mediators and hydrolases; damage to DNA with retarded protein synthesis and delay in cell cycle; and activation of complement-generated inflammatory events leading to cell injury or death. PMID- 3529056 TI - Hemodialysis-related porphyria cutanea tarda--treatment failure with charcoal hemoperfusion. AB - A 56-yr-old man presented with a photosensitive bullous dermatosis 1 yr after commencing hemodialysis. Urinary porphyrin levels were normal and fecal porphyrin levels only minimally increased, but the plasma uroporphyrin concentration was markedly elevated, being higher than that normally occurring in porphyria cutanea tarda. The high plasma uroporphyrin level was thought to result from the combined effects of increased porphyrin production and failure of adequate clearance by hemodialysis. Chronic alcohol ingestion, methyldopa therapy and elevated iron and aluminum levels may have contributed to the porphyrin overproduction. Charcoal hemoperfusion proved unhelpful in lowering the plasma uroporphyrin concentration. PMID- 3529057 TI - [Isotope ventriculography, ultrasonography and polycardiography in the evaluation of left-ventricular function in patients with coronary disease]. PMID- 3529058 TI - [Contribution of Adam Wrzosek to the development of the history and philosophy of Polish medicine]. PMID- 3529059 TI - [Diurnal changes in serum noradrenaline levels and plasma renin activity in elderly persons with arterial hypertension]. PMID- 3529060 TI - [Functioning of the aging heart]. PMID- 3529061 TI - [Free radicals and antioxidants. Role of lipid peroxides in the development of arteriosclerosis]. PMID- 3529062 TI - [Transplantation of the spleen and splenic tissue]. PMID- 3529063 TI - [Role of blood platelets in the pathogenesis of diabetic angiopathy]. PMID- 3529064 TI - Cerebral toxoplasmosis after renal transplantation. Case report. AB - A 19-year-old immunosuppressed male patient, after renal transplantation, developed at the 10th postoperative day (p.d.) fever, anemia hepatosplenomegaly and plaquetopenia; this condition deteriorated progressively and was complicated by drowsiness and generalized convulsions which persisted until the death at the 29th p.d. Autopsy revealed acute encephalitis characterized by multiple disseminated small lesions in the brain, containing cysts and trophozoites of Toxoplasma gondii. The diagnosis was not done during life, as occurred with most of previously reported cases, a fact that points to the necessity of preventive controlling measures of these patients before the institution of immunosuppressive measures. PMID- 3529065 TI - Lymphoma of the colon and rectum. PMID- 3529066 TI - Severe renal sepsis in the very elderly. PMID- 3529067 TI - Tuberculous meningitis due to Mycobacterium bovis: a report of two cases. AB - Two Caucasian patients with bovine tuberculous meningitis are described. Classical Mycobacterium bovis was isolated from the cerebrospinal fluid on both occasions. Despite the elimination of cattle tuberculosis in this country, reactivated primary disease due to the bovine tubercle bacillus may still occur. PMID- 3529068 TI - Insulin oedema. AB - A 35 year old markedly underweight woman presented with uncontrolled diabetes. Following insulin therapy she developed gross fluid retention with extensive peripheral oedema, bilateral pleural effusions and weight gain of 18.8 kg in 22 days, accompanied by a fall in plasma albumin. She responded well to treatment with diuretics and salt-poor albumin, losing 10.3 kg in 6 days without recurrence of oedema. Severe insulin oedema is an uncommon complication of insulin therapy and may be due to effects of insulin on both vascular permeability and the renal tubule. PMID- 3529069 TI - Nocardia asteroides osteomyelitis. AB - Nocardia asteroides osteomyelitis has previously been described only in acutely ill patients. It may occur as an isolated event or part of the disease spectrum of disseminated nocardiosis. An 84 year old immune competent man with N. asteroides right tibial osteomyelitis had an unusual presentation, presumed mechanism of disease and outcome. His course affords an opportunity to review the literature on N. asteroides osteomyelitis and to discuss the unique features of his case. PMID- 3529070 TI - Age-related changes in tissue metabolic rates and sensitivity to insulin in the chicken. AB - In vitro metabolic studies were conducted with tissues from broiler pullets at 4, 8, and 12 weeks of age. In order to accurately assess plasma insulin at each of these ages, blood samples were withdrawn via indwelling venous catheters at 30 min intervals for 6 hr, and plasma was assayed by a homologous chicken insulin (cIns) radioimmunoassay. Birds (n = 6) were sacrificed 24 hr following blood sampling and livers, hearts, and abdominal fat pads removed for metabolic studies. Tissue slices of removed organs were incubated in Krebs-Ringer Bicarbonate buffer containing 13.9 mM glucose, .25 mM leucine, and .35 mM palmitate with either 0.0, 0.1, 1.0, or 100 ng/ml cIns. Carbon-14 labelled substrates were added to appropriate slice incubations and oxidation and incorporation into endproducts assessed. Plasma insulin decreased with age from 4 to 12 weeks (area under 6-hr concentration curve = 172.0 vs 56.9 ng X min X ml-1) to a degree approaching significance (P less than .10), in conjunction with decreased feed intake per unit of body weight. Palmitate oxidation and incorporation into cell lipid by adipose tissue, glucose oxidation and incorporation into lipid by liver and incorporation of leucine into trichloroacetic acid (TCA)-precipitable protein by cardiac muscle decreased substantially with age from 4 to 8 weeks (P less than .05). Oxidation of the branched-chain amino acid by cardiac muscle did not change significantly with age. Insulin enhanced the rate of leucine oxidation by cardiac muscle approximately 100% at 12 weeks but had no significant effect at earlier ages.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3529071 TI - Anxiety and panic disorders. PMID- 3529072 TI - Antidepressants in elderly arthritics. PMID- 3529073 TI - [Imbalance of proteases in smokers: references for the important role of alveolar macrophages and cysteine proteases]. PMID- 3529074 TI - Prenatal ultrasonic diagnosis of familial asymmetric septal hypertrophy. AB - Hypertrophic cardiomyopathy usually manifests clinically in the second or third decade of life. Two dimensional echocardiography is a reliable indicator of the presence of the disease. This technique is of use in the screening of fetuses at risk for familial cardiomyopathy. This report describes the prenatal echocardiographic detection of hypertrophic cardiomyopathy in the fetus of a mother with hypertrophic cardiomyopathy localized to the apical region of the left ventricle. PMID- 3529075 TI - Prenatal diagnosis of familial tuberous sclerosis following detection of cardiac rhabdomyoma by ultrasound. AB - The authors report a case of tuberous sclerosis (TS), diagnosed by prenatal ultrasound, which was suspected by the detection of intracardiac tumours and confirmed by the family investigation. Cardiac rhabdomyomata can be visualized early on echography and must suggest this diagnosis. The place of genetic counselling and prenatal diagnosis in TS is examined. PMID- 3529076 TI - Smoking intervention in the workplace: review and recommendations. AB - Growing interest has been expressed by the business community concerning intervention against smoking in the workplace. As most adult smokers are unlikely to have access to smokers' clinics or other treatment facilities outside the workplace, the workplace itself could be an ideal location for the provision of treatment programs. If the interest of the business community can be translated into action, large populations of smokers would become accessible to workplace treatment programs. Despite this possibility, the potential of the workplace for smoking intervention remains largely unexplored. In this review, the main reasons for workplace smoking intervention are discussed, and the available evidence for the main strategies (prohibition, incentives, treatment, and multicomponent) is reviewed and critically evaluated. The current emphasis in treatment studies is still on physician counseling, and the quality of reported work uneven. Many published studies not intended as evaluations, and many of those which are, have severe procedural or methodological flaws. The particular problems of evaluating workplace studies are discussed and the current research position is summarized. Because the number of evaluative studies is small, the recommendations that can be based on them are fairly limited. In conclusion, it is argued that a body of well-controlled evaluations is needed before the unique characteristics of the workplace can be assessed and exploited in smoking interventions. PMID- 3529077 TI - Smoking in Italy, 1949-1983. AB - Trends in the prevalence of cigarette smoking and the number of cigarettes smoked per day in Italy were derived from six national probability sample surveys conducted between 1949 and 1983. There was a steady and substantial decrease in reported smoking prevalence among adult men (from 71.4% of current smokers in 1949 to 45.6% in 1983), although the estimated average number of cigarettes smoked per day increased, at least up to 1980. Among women, large increases in smoking prevalence have occurred since the mid-1960s (up to 17.7% among women age 14 or over in 1983) and in average number of cigarettes smoked per day (10.9 in 1980). Both the reported decreasing prevalence among men and the increasing prevalence among women were concentrated mostly in the younger age groups. Data on national surveys of tobacco use may give interesting indications for the analysis of different trends in sex or age groups. They should, however, be interpreted critically, since large discrepancies between interview-based data and information on legal sales of manufactured cigarettes have emerged over the last years, indicating that interview data are largely biased in the sense of systematic underreporting. It seems, therefore, that more than any real changes in smoking habits taking place, it is the attitudes toward reporting smoking that have changed in Italy over the last three decades: in fact, in 1983 cigarette sales reached a maximum both in absolute terms and in average levels per adult. PMID- 3529078 TI - [Artificial pulmonary ventilation with positive end-expiratory pressure in patients after surgical treatment of pulmonary tuberculosis]. PMID- 3529079 TI - [Role of peripheral vasodilators in the complex treatment of chronic pulmonary heart disease]. PMID- 3529080 TI - Reduction of the toxicity and mutagenicity of alkylating agents in mammalian cells harboring the Escherichia coli alkyltransferase gene. AB - The toxic, mutagenic, and carcinogenic effects of alkylating agents have been attributed to their ability to damage DNA. Reaction at the O6 position of guanine results in miscoding during DNA replication, has been shown to be mutagenic in both bacteriophage and bacteria, and may be responsible for malignant transformation. In common with many other prokaryotes and eukaryotes the Escherichia coli B strain contains a protein that repairs O6-alkylation damage in DNA by transferring the alkyl group to one of its own cysteine residues. We have recently cloned the E. coli O6-alkylguanine alkyltransferase gene and shown it to encode a 37-kDa protein containing an additional activity that removes alkyl groups from alkylphosphotriesters in DNA. To examine the biological effects of this gene in mammalian cells, we have now inserted the coding sequence into a retrovirus-based selectable expression vector and transfected it into Chinese hamster V79 cells that lack endogenous alkyltransferase activity. A clone expressing high levels of the bacterial protein was selected and shown to produce a 37-kDa alkyltransferase protein and to rapidly repair O6-methylguanine produced in the host genome following exposure to N-methyl-N-nitrosourea. In comparison with a control population, this clone is considerably more resistant to the toxic and mutagenic effects of alkylating agents that react extensively with oxygen atoms in DNA. The usefulness of these clones in examining the role of DNA alkylation and other biological effects of alkylating agents is discussed. PMID- 3529081 TI - Regulatory mechanisms for induction of synthesis of repair enzymes in response to alkylating agents: ada protein acts as a transcriptional regulator. AB - Expression of the ada and alkA genes, both of which are involved in the adaptive response of Escherichia coli to alkylating agents, is positively controlled by Ada protein, the product of the ada gene. Large amounts of ada- and alkA-specific RNA were formed in cells treated with a methylating agent, whereas little such RNA was produced in untreated cells. The in vivo transcription-initiation sites for the two genes were determined by primer-extension cDNA synthesis. In an in vitro reconstituted system, both ada and alkA transcripts were formed in an Ada protein-dependent manner. However, responses of the two transcription reactions to methylating agents differed; ada transcription was stimulated by methylnitrosourea, while alkA transcription was suppressed. We prepared a methylated form of Ada protein by an in vitro reaction and compared the activity with that of the normal, unmethylated form. The methylated form was more effective in promoting ada transcription than was the unmethylated form, but the effects of both forms were much the same with regard to alkA transcription. Based on these findings, we propose a model for the molecular mechanism of adaptive response. PMID- 3529082 TI - Pks, a raf-related sequence in humans. AB - A human fetal liver cDNA library was screened at reduced hybridization stringency for v-raf-related sequences. In addition to the expected c-raf-1 cDNA, a second sequence was isolated. Comparison of the second gene (pks) to the other raf related sequences revealed nucleotide homologies of 71%. The predicted amino acid sequence of the kinase domain is sufficiently similar to that of v-raf to suggest that pks may encode a polypeptide that exhibits serine/threonine kinase activity. The expression of pks mRNA (2.7 kilobases long) is elevated in peripheral blood mononuclear cells isolated from two patients with angioimmunoblastic lymphadenopathy with dysproteinemia, a disease in which autoantibodies are produced following the lymphoproliferative activation of B cells. Analysis of somatic cell hybrids for segregation of the pks locus revealed the presence of an additional locus closely related to the pks sequence. PMID- 3529084 TI - Induction of c-sis gene expression and synthesis of platelet-derived growth factor in human myeloid leukemia cells during monocytic differentiation. AB - Phorbol esters induce the differentiation of human myeloid leukemia cells HL-60 and U-937 along the monocytic-macrophage lineage. This process has been associated with the induction of several cellular protooncogenes, including the c fos and c-fms genes. We now report that phorbol ester-induced differentiation of the HL-60 and U-937 cells results in the induction of the expression of the c-sis platelet-derived growth factor 2 (PDGF-2) protooncogene. sis mRNA transcripts were not detectable in the uninduced cells but were detectable within 12 hr of phorbol ester induction. Concomitantly, the induced cells were shown to synthesize and secrete biologically active PDGF-like proteins, identified in the conditioned medium of the phorbol ester-treated cells by direct immunoprecipitation with PDGF antiserum. Addition of cycloheximide to phorbol ester-treated HL-60 cells superinduced sis mRNA transcripts. c-sis gene transcripts were also detected in freshly isolated human monocytes but not in human granulocytes or in HL-60 cells induced to differentiate along the granulocytic lineage. Activation of the c-sis/PDGF-2 gene in human hematopoietic cells during monocytic differentiation may serve in the mediation of physiologic functions of the differentiated cells by means of the secretion of potent PDGF like mitogen. PMID- 3529083 TI - Isolation of a cDNA clone encoding the leader peptide of prion protein and expression of the homologous gene in various tissues. AB - We have isolated a hamster cDNA clone representing the coding sequences for the entire precursor of prion protein (PrP) 27-30. This clone encodes a protein of 254 residues and contains an in-frame ATG codon 42 bases upstream from the one previously reported. Analysis of the predicted amino acid sequence suggests that the PrP precursor protein contains an amino-terminal signal sequence, and a membrane-spanning domain in the carboxyl terminus. Cleavage of the signal peptide would produce a mature protein of 232 amino acids. Sequences homologous to the hamster PrP cDNA were detected in hamster, mouse, sheep, human, and rabbit genomes. A related 2.5-kilobase transcript was present in the brain of normal and scrapie-infected rodents. Two homologous transcripts, 2.5 and 1.1 kilobases, were detected in the lung and heart of normal animals. No PrP mRNA was detected in spleen stroma, a tissue known to contain high titers of scrapie. Antisera raised to the 27- to 30-kDa polypeptide detected the PrP in both normal and infected brains but failed to detect this protein in either normal or infected spleens. Homologous mRNA species were detected in human, sheep, and rabbit brain, even though the latter is resistant to scrapie infection. Our data suggest that PrP is not a necessary component of the infectious agent. PMID- 3529085 TI - Transfection of mouse erythroleukemia cells with myc sequences changes the rate of induced commitment to differentiate. AB - We have examined the role of the c-myc protooncogene in chemically induced differentiation of mouse erythroleukemia (MEL) cells by transfecting the cells with recombinant plasmids in which c-myc coding sequences were cloned downstream from the mouse metallothionein I promoter in sense and antisense orientations. We previously showed that treatment of MEL cells with inducers of differentiation leads to a rapid (less than 2 hr) decrease in the level of c-myc mRNA. c-myc mRNA is then transiently restored to pretreatment levels approximately 12-18 hr later. These events occur prior to the detection of cells that are irreversibly committed to erythroid differentiation. MEL cell transfectants containing the plasmid with myc in the sense orientation express a chimeric MT-myc mRNA, which also decreases shortly after addition of inducer. However, these clones reexpress myc RNA more rapidly than the parental line and they also differentiate more rapidly. On the other hand, transfectants containing the plasmid with myc in the antisense orientation exhibited a delay in the reexpression of c-myc mRNA and were found to differentiate more slowly than parental cells. Thus, we find a correlation between the time at which myc RNA is reexpressed following inducer treatment and the rate of entry of cells into the terminal differentiation program. PMID- 3529086 TI - Purification and characterization of a growth factor from rat platelets for mature parenchymal hepatocytes in primary cultures. AB - A growth factor (HGF) stimulating DNA synthesis of adult rat hepatocytes in primary culture was found in rat platelets. HGF was purified from rat platelets to homogeneity by a three-step procedure: stimulation of its release from platelets by thrombin, cation-exchanger fast protein liquid chromatography on a Mono S column, and heparin-Sepharose chromatography. HGF was clearly distinguishable from the platelet-derived growth factor (PDGF) by fast protein liquid chromatography. HGF was a heat- and acid-labile cationic protein that was inactivated by reduction with dithiothreitol. Its molecular mass was estimated to be 27 kDa by NaDodSO4/PAGE and its amino acid composition was very different from that of PDGF. The purified HGF stimulated DNA synthesis in adult rat hepatocytes at 2 ng/ml and was maximally effective at 20 ng/ml; its effect was additive or synergistic with those of insulin and EGF, depending on their combinations. HGF did not stimulate DNA synthesis of Swiss 3T3 cells, while PDGF did not stimulate that of hepatocytes. Thus, HGF showed clearly different cell specificity from PDGF in its growth-promoting activities. These findings indicate that HGF is a growth factor in platelets for mature hepatocytes. PMID- 3529087 TI - Construction of two Escherichia coli amber suppressor genes: tRNAPheCUA and tRNACysCUA. AB - Amber suppressor genes corresponding to Escherichia coli tRNAPhe and tRNACys have been constructed for use in amino acid substitution studies as well as protein engineering. The genes for either tRNAPheGAA or tRNACysGCA both with the anticodon 5' CTA 3' were assembled from four to six oligonucleotides, which were annealed and ligated into a vector. The suppressor genes are expressed constitutively from a synthetic promoter, derived from the promoter sequence of the E. coli lipoprotein gene. The tRNAPhe suppressor (tRNAPheCUA) is 54-100% efficient in vivo, while the tRNACys suppressor (tRNACysCUA) is 17-50% efficient. To verify that the suppressors insert the predicted amino acids, both genes were used to suppress an amber mutation in a protein coding sequence. NH2-terminal sequence analysis of the resultant proteins revealed that tRNAPheCUA and tRNACysCUA insert phenylalanine and cysteine, respectively. To demonstrate the potential of these suppressors, tRNAPheCUA and tRNACysCUA have been used to effect amino acid substitutions at specific sites in the E. coli lac repressor. PMID- 3529088 TI - The human c-ros gene (ROS) is located at chromosome region 6q16----6q22. AB - The human homolog, c-ros, of the transforming gene, v-ros, of the avian sarcoma virus, UR2, has been isolated from a human genomic library. A single-copy fragment from the human c-ros genomic clone has been used to map the human c-ros homolog (ROS) to human chromosome region 6q16----6q22 by somatic cell hybrid analysis and chromosomal in situ hybridization. Thus, the c-ros gene joins the c myb oncogene, which is distal to the c-ros gene on the long arm of human chromosome 6, as a candidate for involvement in chromosome 6q deletions and rearrangements seen in various malignancies. PMID- 3529089 TI - Molecular cloning of the breakpoint junction of a human chromosomal 8;14 translocation involving the T-cell receptor alpha-chain gene and sequences on the 3' side of MYC. AB - The MOLT-16 cell line, which was established from the malignant cells of a patient with T-cell acute lymphoblastic leukemia, is characterized by a translocation involving chromosome 8 (band q24) and chromosome 14 (band q11) [t(8;14)(q24;q11)]. To determine the position of the gene encoding the alpha chain of the T-cell receptor and of the protooncogene MYC (formerly c-myc) in relation to the breakpoint junction and to evaluate their possible role in the pathogenesis of T-cell neoplasia, we applied the techniques of in situ chromosomal hybridization, Southern blot analysis, and molecular cloning to MOLT 16 cells. Our results indicate that the breakpoint on chromosome 14 at band q11 occurs close to a joining sequence of the gene encoding the alpha chain of the T cell receptor. The constant region and part of the joining region of this gene are translocated to the 3' side of the MYC exons. The breakpoints on chromosomes 8 and 14 are close to, but distinct from, those found in SKW-3, another T-cell leukemia cell line, which has a t(8;14). The identification of a breakpoint to the 3' side of MYC suggests that this recurring translocation is analogous to the variant t(2;8) and t(8;22) translocations observed in the B-cell malignancies. PMID- 3529090 TI - Molecular cloning and nucleotide sequence of a full-length cDNA for human alpha enolase. AB - We previously purified a 48-kDa protein (p48) that specifically reacts with an antiserum directed against the 12 carboxyl-terminal amino acids of the c-myc gene product. Using an antiserum directed against the purified p48, we have cloned a cDNA from a human expression library. This cDNA hybrid-selects an mRNA that translates to a 48-kDa protein that specifically reacts with anti-p48 serum. We have isolated a full-length cDNA that encodes p48 and spans 1755 bases. The coding region is 1299 bases long; 94 bases are 5' noncoding and 359 bases are 3' noncoding. The cDNA encodes a 433 amino acid protein that is 67% homologous to yeast enolase and 94% homologous to the rat non-neuronal enolase. The purified protein has been shown to have enolase activity and has been identified to be of the alpha type by isoenzyme analysis. The transcriptional regulation of enolase expression in response to mitogenic stimulation of peripheral blood lymphocytes and in response to heat shock is also discussed. PMID- 3529091 TI - Secretion and processing of insulin precursors in yeast. AB - A series of dibasic insulin precursors including proinsulin was expressed and secreted from Saccharomyces cerevisiae. Recombinant plasmids were constructed to encode fusion proteins consisting of a modified mating factor alpha 1 leader sequence and an insulin precursor. The leader sequence serves to direct the fusion protein into the secretory pathway of the cell and to expose it to the Lys Arg processing enzyme system. The secreted peptides were purified from the fermentation broth and characterized by sequencing and amino acid analysis. Processing at one or both dibasic sequences was shown in proinsulin and in other insulin precursors containing a short spacer peptide in place of the C peptide. In contrast, no processing was observed in the absence of a spacer peptide in the insulin precursor molecule, e.g., B-Lys-Arg-A (where A and B are the A and B chain of human proinsulin, respectively). This type of single-chain insulin precursors isolated from such constructions could be enzymatically converted into insulin by treatment with trypsin and carboxypeptidase B. The above results suggest that the C-peptide region of proinsulin serves to direct the trypsin-like converting enzyme to process at the two dibasic sequences. We propose that in hormone precursors in general the spacer peptides serve to expose dibasic sequences for processing. PMID- 3529092 TI - Homologous ribosomal proteins in bacteria, yeast, and humans. AB - We describe sequences of two human ribosomal proteins, S14 and S17, and messenger RNAs that encode them. cDNAs were used as molecular hybridization probes to recognize complementary genes in rodent, Drosophila, and yeast chromosomal DNAs. Human ribosomal protein sequences are compared to analogous Chinese hamster, yeast, and bacterial genes. Our observations suggest that some ribosomal protein genes have been conserved stringently in the several phylogenetic lines examined. These genes apparently were established early in evolution and encode products that are fundamental to the translational apparatus. Other ribosomal protein genes examined, although similar enough to heterologous DNA sequences to indicate their structural relationships, appear to have diverged substantially during evolution, probably reflecting adaptations to different genetic environments. PMID- 3529093 TI - The C-C (6-4) UV photoproduct is mutagenic in Escherichia coli. AB - Mutation induced by ultraviolet light is predominantly targeted by UV photoproducts. Two primary candidates for the premutagenic lesion are the cyclobutane pyrimidine dimer and the less frequent (by a factor of 10) pyrimidine pyrimidone (6-4) photoproduct. Methylation of the 3'-cytosine in the sequence 5' CCAGG 3' reduces the yield of (6-4) lesions, but not of cyclobutane dimers, at these sites. By taking advantage of mutants deficient in cytosine methylation, we show here that at the three sites in the lacI gene of Escherichia coli having this sequence, the specific increase in the formation of the (6-4) photoproducts is accompanied by a concomitant increase in mutation. At each site, a G X C to A X T transition results in an amber mutation. In the unmethylated state, these sites become among the most frequent nonsense mutations recovered. We conclude that the (6-4) photoproduct constitutes a major premutagenic lesion in E. coli. PMID- 3529094 TI - Heat shock response in Escherichia coli influences cell division. AB - Analysis of a mutant in fam, a pleiotropic gene affecting cell division in Escherichia coli, revealed that this gene is probably identical to the heat shock regulatory gene htpR. The fam-715 mutant and different htpR mutants were found to share the following three characteristics: temperature-sensitive growth, faulty cell division, and inability to induce the normal cellular heat shock response. These defects were all corrected in fam and htpR mutants by complementation with plasmids carrying intact htpR+ or by recombination between these mutant alleles and a plasmid carrying only a portion of htpR. These results implicate the E. coli heat shock system in the regulation of cell division and raise the question of a similar role in other organisms. PMID- 3529095 TI - Phospholipase treatment of accessory cells that have been exposed to antigen selectively inhibits antigen-specific Ia-restricted, but not allospecific, stimulation of T lymphocytes. AB - The corecognition of antigen and class II major histocompatibility complex (MHC) molecules (Ia molecules) by the T-cell receptor is a cell surface event. Before antigen is recognized, it must be taken up, processed, and displayed on the surface of an Ia-bearing accessory cell (antigen-presenting cell, APC). The exact nature of antigen processing and the subsequent associations of antigen with the APC plasma membrane, Ia molecules, and/or the T-cell receptor are not well defined. To further analyze these events, we have characterized the processing and presentation of the soluble polypeptide antigen bovine insulin. We found that this antigen requires APC-dependent processing, as evidenced by the inability of metabolically inactivated APCs to present native antigen to antigen plus Ia specific T-T hybridomas. The ability of the same APCs to present antigen after uptake and processing showed that this antigen subsequently becomes stably associated with the APC plasma membrane. To characterize the basis for this association, we analyzed its sensitivity to enzymatic digestion. APCs exposed to antigen, treated with phospholipase A2, and then immediately fixed lost the ability to stimulate bovine insulin plus I-Ad-specific hybridomas. In contrast, the ability of these same APCs to stimulate I-Ad allospecific hybridomas was unaffected. This effect of phospholipase is not mimicked by the broadly active protease Pronase, nor is there evidence for contaminating proteases in the phospholipase preparation. These results suggest that one consequence of antigen processing may be an antigen-lipid association that contributes to the anchoring of antigen to the APC membrane. The implications of this model are discussed. PMID- 3529096 TI - The anticonvulsant MK-801 is a potent N-methyl-D-aspartate antagonist. AB - The compound MK-801 [(+)-5-methyl-10,11-dihydro-5H-dibenzo[a,d] cyclohepten-5,10 imine maleate)] is a potent anticonvulsant that is active after oral administration and whose mechanism of action is unknown. We have detected high affinity (Kd = 37.2 +/- 2.7 nM) binding sites for [3H]MK-801 in rat brain membranes. These sites are heat-labile, stereoselective, and regionally specific, with the hippocampus showing the highest density of sites, followed by cerebral cortex, corpus striatum, and medulla-pons. There was no detectable binding in the cerebellum. MK-801 binding sites exhibited a novel pharmacological profile, since none of the major neurotransmitter candidates were active at these sites. The only compounds that were able to compete for [3H]MK-801 binding sites were substances known to block the responses of excitatory amino acids mediated by the N-methyl-D-aspartate (N-Me-D-Asp) receptor subtype. These comprised the dissociative anesthetics phencyclidine and ketamine and the sigma-type opioid N allylnormetazocine (SKF 10,047). Neurophysiological studies in vitro, using a rat cortical-slice preparation, demonstrated a potent, selective, and noncompetitive antagonistic action of MK-801 on depolarizing responses to N-Me-D-Asp but not to kainate or quisqualate. The potencies of phencyclidine, ketamine, SKF 10,047, and the enantiomers of MK-801 as N-Me-D-Asp antagonists correlated closely (r = 0.99) with their potencies as inhibitors of [3H]MK-801 binding. This suggests that the MK-801 binding sites are associated with N-Me-D-Asp receptors and provides an explanation for the mechanism of action of MK-801 as an anticonvulsant. PMID- 3529097 TI - Tenth Boyd Orr memorial lecture. Food policy, nutrition and government. PMID- 3529098 TI - An historical perspective: the development of methods for assessing nutrient requirements. PMID- 3529099 TI - The physiological bases of nutrient responses during lactation. PMID- 3529100 TI - Light therapy and psychiatry. PMID- 3529101 TI - Monoclonal antibodies reactive with chicken peritoneal macrophages: identification of macrophage heterogeneity. AB - Mouse monoclonal antibodies (MCAs) were prepared against chicken inflammatory macrophages for the purpose of analyzing macrophage heterogeneity. Macrophage rich adherent peritoneal exudate cells harvested from Cornell K-strain chickens 42 hr after stimulation with Sephadex were used as immunogens in the production of the monoclonal antibodies. Eight hybridoma clones producing antibodies reactive with chicken peritoneal macrophages were subjected to characterization. While six of the monoclonal antibodies cross-reacted with various hematopoietic cell types, two MCAs (CMTD-1 and -2) were restricted in reactivity to macrophages. CMTD-1 was found to react with activated peritoneal macrophages generated by several irritants. In contrast, CMTD-2 identified a subpopulation of macrophages elicited by specific carbohydrate-based stimulants. This presumably was based on the cross-reaction of this MCA with specific carbohydrate linkages. Analysis using flow cytometry revealed the time-dependent appearance of CMTD-2 positive peritoneal macrophages between 24 and 52 hr after ip Sephadex injection. This subpopulation of peritoneal macrophages was found to be heterogeneous for the ability to undergo in vitro phagocytosis of sheep erythrocytes. CMTD-2 positive cells were also detected in the thyroids of 2-week-old Obese strain chickens with spontaneous autoimmune thyroiditis and at a low incidence in the spleens of normal chickens. PMID- 3529102 TI - Rapid separation and quantitation of mixed microorganisms by filtration and bioluminescence. AB - A membrane filtration/bioluminescence system was developed for the differentiation and quantitation of mixed populations of microorganisms. Samples containing microorganisms were filtered through two membrane filters of descending pore size. The microorganisms retained on the filter contain ATP that can be extracted and measured on the filter via the firefly luciferase-luciferin bioluminescence assay. Results, obtained in less than 20 min, show a good correlation (r greater than or equal to 0.95) between the light produced and the number of organisms in the sample. Using these techniques, Escherichia coli can be separated from yeast or mold and measured in samples containing both microorganisms. When lysostaphin is used to selectively lyse Staphylococci on the filter, the specific quantification of these bacteria among other microorganisms can also be accomplished. The filtration/bioluminescence technique offers the potential of being a rapid and sensitive method to differentiate and detect microorganisms, by selective sizing or lysing, in a variety of samples. PMID- 3529103 TI - What is the role of environmental mutagens for human cancer development? PMID- 3529104 TI - In vitro models for mutagenesis: a role for lesion, polymerase and sequence. PMID- 3529105 TI - Detection of natural bio-antimutagens and in vivo and in vitro analysis of their action. PMID- 3529106 TI - Comutagens in E. coli and Chinese hamster cells with special attention to arsenite. PMID- 3529107 TI - Genetic toxicology of O6 methylguanine. PMID- 3529108 TI - Base sequence alterations induced by ultraviolet radiation in the URA3 locus in yeast. PMID- 3529109 TI - Acetyl-CoA dependent O-acetylation of N-hydroxyarylamines in bacterial and mammalian cells--the significance for mutagenesis and carcinogenesis. PMID- 3529110 TI - Enhanced mutagenicity of low doses of alkylating agents and UV-light by inhibition of ribonucleotide reductase. PMID- 3529111 TI - Mutagens, carcinogens, and computers. PMID- 3529112 TI - Mutagenicity and chemical structure relations of naturally occurring mutagens from plants. PMID- 3529113 TI - Structure-activity relationship of nitroalkane-induced mutagenicity in the Ames Salmonella assay. PMID- 3529114 TI - The mutagenicity and chemical structure of certain chloroderivatives of polynuclear aromatic hydrocarbons. PMID- 3529115 TI - Determination of somatic mutations in human erythrocytes by flow cytometry. PMID- 3529116 TI - Mutagenicity of the particulates in smoke sauna air during heating and bathing: physiological properties, and comparison to other sources of mutagenic respiratory doses. PMID- 3529117 TI - Mutagenesis, clastogenesis, carcinogenesis: expectations, correlations and relations. AB - The expectations of the ability of in vitro mutagenesis and clastogenesis assays to unambiguously detect chemical carcinogens have not been fulfilled. The results of this study show a constant error rate in the identification of noncarcinogens with mutagenic potential. Also, different chemical carcinogen classes showed different correlations with mutagenicity. The relationship is further complicated by differential patterns of tumor induction in rodents. Therefore, while in vitro mutagenicity and clastogenicity define important properties of chemicals, additional information is required in order to clearly relate such results to potential carcinogenicity. PMID- 3529118 TI - Geoffroy and the homeobox. PMID- 3529119 TI - Collagen binding proteins associated with the chicken embryonic cell surface. PMID- 3529120 TI - Regulation of tissue patterning in the developing heart by fibronectin. PMID- 3529121 TI - Status of basic external human fertilization. PMID- 3529123 TI - Cytoskeleton in odontoblasts of rat incisors. PMID- 3529122 TI - Affinity-recognition, adhesion and contact-interactions of embryonic cells. PMID- 3529124 TI - Cell-cell interactions in the mediation of hormone dependent differentiation of mammary epithelium. PMID- 3529125 TI - Patterning of myogenic cells in the early chick limb bud. PMID- 3529126 TI - Locomotor behaviors in response to new selective D-1 and D-2 dopamine receptor agonists, and the influence of selective antagonists. AB - With the introduction of the selective D-1 dopamine receptor agonist and antagonist benzazepines, especially as enantiomeric pairs, there is now a range of D-1 compounds to complement the previously available selective D-2 agents. These have been used to investigate whether sub-types of dopamine receptors might be differentially involved in locomotor behavior. Stereotyped locomotion induced by the non-selective D-2 agonist apomorphine and by the selective D-2 agonist RU 24213 were blocked by the selective D-2 antagonists metoclopramide and Ro 22-2586 [-)-piquindone). Responses to either D-2 agonist were also blocked by the selective D-1 antagonists SCH 23390 and R-(but not S-) SK&F 83566. Non stereotyped locomotion was induced by R- but not S-SK&F 38393, a stereoselective D-1 agonist, and was blocked by SCH 23390. Responses to the D-1 agonist were also antagonised by metoclopramide. Such results suggest concerted D-1:D-2 interplay in the regulation of at least some dopaminergic behaviors, such as locomotion. PMID- 3529127 TI - The protective value of piroxicam on the enhanced inflammatory response after whole body irradiation. AB - The anti-inflammatory activity of piroxicam was assessed after whole body irradiation in rats. Two models of inflammation, the carrageenan-induced oedema and the adjuvant-induced arthritis in rats have been utilised. Piroxicam at doses of 1, 5 & 10 mg kg-1 i.p. was effective in inhibiting the paw oedema produced in both models of inflammation. The inflammatory response in irradiated was significantly higher than that produced in normal animals and was dependent on the radiation dose level used (0.5-2 Gy). The effect of piroxicam on the late inflammatory response produced by exposure to 2 Gy was studied by measuring the carrageenan-induced oedema 4 h after irradiation and on the third and seventh day thereafter. The increase in paw volume was significantly suppressed in animals receiving the drug. Administration of piroxicam (5 mg kg-1) one hour before irradiation of animals at 0.5 Gy, produced inhibition to the exaggerated inflammatory response in irradiated animals. This suggests that piroxicam possibly owes its protective value to prevention of the increase in cellular permeability induced by radiation. Alternatively, the drug may exert this effect by inhibiting PG synthesis, thereby reducing their potentiating influence on the other mediators of inflammation. Furthermore, the inhibition of lysosomal enzyme release possibly induced by the drug may contribute to the probable reduction in the release of inflammatory mediators. PMID- 3529128 TI - Cannabinoid pharmacology. AB - The pharmacology of the cannabinoids is characterized by at least two very provocative phenomena. First, the multiplicity of effects. As I have mentioned throughout this review, most of these effects are due to actions on the central nervous system. The major problem in the search for a therapeutic agent in this series has been due to the inability to find a cannabinoid with the therapeutic action at doses below those that produce side effects. The high lipid solubility of the cannabinoids allows them to be distributed throughout the brain at reasonable doses. The second aspect of their pharmacology worthy of special mention is their low toxicity. Throughout this review, I have indicated that the minimal effective dose of delta 9-THC for a particular pharmacological effect in animals was higher than that usually consumed by man. Yet, in almost all cases, it was much lower than the dose which produced toxic effects in the same species. These two characteristics of the animal pharmacology of cannabinoids carry over to humans. For instance, each of the cannabinoids tested in man causes many side effects at active doses and lethal effects of overdose by humans are nonexistent or rare. Toxicity following chronic use may be a different issue. A great deal of work has been carried out in an attempt to characterize the pharmacological effects of cannabinoids. It is clear from the material reviewed in this article that most if not all of the predominant effects of cannabinoids in whole animals are due to the direct effects of these compounds on the central nervous system. Our state of knowledge is too limited to rule out the possibility that they also produce effects on certain peripheral organs. It is expected that the majority of these effects will be shown to be due to the interaction of the cannabinoids with the neuronal innervation of the organ rather than directly with the organ tissue itself. Very high doses of cannabinoids just like all active drugs have an effect on many organ systems. These are toxicologic not pharmacologic and are nonspecific. The effects of cannabinoids at the molecular level have been reviewed by Martin (182a) in this series. This type of research is expected to elucidate the mechanism of action of cannabinoids at the cellular level. It is clear that the cannabinoids produce a unique behavioral syndrome in laboratory animals and in man.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3529129 TI - A one-sided education. PMID- 3529131 TI - Are physicians professionals? PMID- 3529130 TI - Science, information systems, and the future of medical practice. PMID- 3529132 TI - Growing old, growing aged. PMID- 3529133 TI - Perceptual studies on ultrasonic B-scan textures. AB - A pilot study of the perceptual characteristics of ultrasonic textured images is described. Scans of four models performed on four real-time machines optimised for display of a normal liver were used. A trial with 22 observers indicated that the model that gave images closest to the liver image varied between machines. A second, paired similarity test with five observers using all the model images was performed, with a cluster analysis of a multidimensional scaling procedure. This suggested that the prominent features of the textural images are often more closely related to the machines than to the models. Considerable further work is needed to confirm these pilot results and to identify the visual cues that are most significant in textured images. PMID- 3529134 TI - [Phlebology consultation services open to physicians]. PMID- 3529135 TI - [Ulcers]. PMID- 3529136 TI - [Deep venous thrombosis of inferior limbs]. PMID- 3529137 TI - [Importance of Doppler ultrasound tomography in medical treatment of external saphenous veins]. AB - Basing his study on his experience of the Doppler and of echotomography in everyday phlebological practice, the author examines the sclerosant treatment of symptomatic short saphenous veins, by measuring the reflux and morphology of this saphenofemoral junction. It would appear that the ectasia frequently encountered in the popliteus provide an ideal injection point which greatly reduces the risks associated with this injection. The results of this study are based on 100 short saphenous veins, and confirm the effectiveness of this method of treatment (95% success rate, whatever the calibre of the saphenous vein). PMID- 3529138 TI - [Ambulatory dermo-epidermal patch graft. Its advantages to the phlebologist in his office]. AB - By way of analysing the leg ulcers treated at his consulting rooms during six months, the author introduces the dermo-epidermal graft, simplified in a way that makes it practicable in the framework of an ambulatory treatment, with maximum ease for both practitioner and patient. The results, altogether satisfactory, prompt him to suggest that this technique be used in the context of routine treatment of leg ulcers of all aetiologies and sizes. The time gain is considerably more significant than the simplicity of the technique would lead one to suppose. The incidence of the method is quite high as it has been used in 15% of cases, but this frequency could easily be increased further with more daring. To all accounts there are no significant accidents to be feared and the author, describing the technique, urges those of his colleagues who have not yet tried the ambulatory dermo-epidermal patch graft to familiarize themselves with it. PMID- 3529139 TI - Sensitivity of hemA mutant Escherichia coli cells to inactivation by near-UV light depends on the level of supplementation with delta-aminolevulinic acid. PMID- 3529140 TI - Photoacoustic and photothermal methods applied to the study of radiationless deactivation processes in biological systems and in substances of biological interest. PMID- 3529141 TI - Hypericin and its photodynamic action. PMID- 3529142 TI - UVA effects on mammalian skin and cells. PMID- 3529143 TI - Repair in Escherichia coli of a psoralen-DNA interstrand crosslink site specifically introduced into T410A411 of the plasmid pUC 19. PMID- 3529144 TI - Reduced insulin secretion after short-term food deprivation in rats plays a key role in the adaptive interaction of glucose and free fatty acid utilization. AB - The present study was undertaken to investigate the effects of short-term fasting periods up to 24 hr on insulin secretory responses of the B-cell to glucose and the consequences for FFA and glucose availability in the circulation. Conscious male rats provided with permanently implanted heart catheters received glucose infusions at midday, lasting for 20 min, in the nearly ad lib condition (i.e., 6 hr of non feeding during daytime) and after extending the fasting period to 12, 18 and 24 hr. Basal preinfusion insulin levels and insulin responses to glucose decreased gradually during these fasting periods. Basal blood glucose dropped only significantly after 24 hr of fasting whereas basal FFA levels increased gradually from 6 hr of fasting onwards. After prolonged fasting insulin released during glucose infusion became more effective in suppressing plasma FFA levels. While our data suggest that the sensitivity to the antilipolytic action of insulin is increased, the decreased responsiveness of the B-cell after moderate fasting periods may result in a drop of basal insulin levels. This facilitates the switch from glucose to FFA metabolism for most tissues already, when the first meals are missed. The results suggest that this physiological process is important to save the glycogen stores as long as possible as fuel for the central nervous system, and also to support basic energy requiring processes adequately. PMID- 3529145 TI - A technique for repeated sampling of CSF from the anesthetized rat. AB - A method for repeatedly sampling cerebrospinal fluid (CSF) from anesthetized rats is described. The technique reliably and quickly yields blood-free samples of CSF and requires supplies that are commonly available. Samples as large as 250 microliter can be collected in a few minutes. There is no apparent malaise even when CSF is withdrawn once every three days for two weeks. This technique offers an alternative to surgical cannulation for sampling of CSF from the rat. PMID- 3529146 TI - Effects on growth and endocrine status of maintaining obese and lean Zucker rats at 22 degrees C and 30 degrees C from weaning. AB - Lean and genetically obese Zucker rats were maintained from 21 to 34 days of age at an ambient temperature of 22 degrees C or 30 degrees C. Maintenance at 30 degrees C normalised the lower rectal temperature of obese rats. At 30 degrees C obese rats reduced their food intake compared with obese animals at 22 degrees C but they were still hyperphagic compared with non-obese animals at 30 degrees C. At 30 degrees C obese rats accumulated as much lipid in their carcase, but deposited less protein than obese animals at 22 degrees C. Obese rats were hyperinsulinemic compared with non-obese animals at either temperature. Plasma T3 and T4 levels did not differ between phenotypes and T4 levels were lower in both phenotypes at 30 degrees C. Plasma corticosterone levels were higher in obese rats at both temperatures and this phenotypic difference was larger at 30 degrees C. In a second experiment rats were maintained at 22 degrees C from 21-34 days of age and obese rats pair-fed to the ad lib intake of non-obese animals. Obese rats still became more obese than non-obese animals and deposited less protein than either non-obese or ad lib fed obese animals. Pair-fed obese rats were hyperinsulinemic and had higher plasma corticosterone concentrations than non obese animals. These findings suggest that the raised plasma corticosterone concentrations of obese rats kept at 30 degrees C, or not allowed to express their greater appetite, may cause reduced protein deposition. PMID- 3529147 TI - The insertion of large pieces of foreign genetic material reduces the stability of bacterial plasmids. AB - The stability of genetically engineered bacterial plasmids under continuous culture fermentation is of crucial importance in the application of microbiology to many processes of potential industrial importance. In order to determine the effect of inserting large pieces of foreign DNA on the stability of bacterial plasmids we have studied the behavior of pAT153 with DNA inserts of various sizes derived from cytomegalovirus. Foreign DNA up to 2 kb in length had no effect on stability, whereas the insertion of an 8-kb fragment resulted in a transient instability. This instability was overcome by the spontaneous appearance of leu+ cells in the culture. Insertion of a 21-kb DNA fragment resulted in a rapid loss of plasmid, which was not prevented by the appearance of leu+ cells. In all cases copy number analyses indicated that plasmid loss was due to segregational instability, probably because the plasmid placed an unacceptable metabolic load on the cell. PMID- 3529148 TI - Contraceptive and hormonal properties of Achyranthes aspera in rats and hamsters. PMID- 3529149 TI - [New information from the Sonnenstein hospital and nursing facility near Pirna]. AB - Recent findings of historical investigations regarding Sonnenstein Mental Hospital in the early 19th century are presented. Anton Dietrich, assistant doctor of that time seems to have been an outstanding promotor of medical progress. PMID- 3529150 TI - Which depressions respond to placebo? AB - This descriptive study of 55 outpatients with unipolar major depression compared placebo responders (n = 21) and placebo nonresponders (n = 34) with respect to demographic, diagnostic, history of illness and symptomatic features of the current episode of depression. Placebo responders were significantly more likely to be nonendogenous and were more likely to meet criteria for another Research Diagnostic Criteria diagnosis. Additionally, placebo responders were characterized by a shorter length of illness and reported a lower level of depressive symptomatology on the Beck Depression Inventory and the Carroll Rating Scale. Clinician-rated depressive symptom severity (e.g., Hamilton Rating Scale for Depression, Covi Global Anxiety Scale, and Raskin Depression Rating Scale) and demographic variables did not differentiate placebo responders from nonresponders. These data suggest candidates for antidepressant treatment and implications for antidepressant drug trials. PMID- 3529151 TI - Calcium antagonists in mania: a double-blind study of verapamil. AB - Five of seven acutely manic patients improved significantly when taking verapamil but not placebo in a double-blind crossover study. This finding adds support to two other formal studies of verapamil, several case reports of verapamil in manic patients, and one small study of nifedipine suggesting that some calcium antagonists may have antimanic properties. Indirect evidence links this antimanic action to correction of a disturbance of intracellular calcium dynamics in affective disorders. However, the effectiveness of calcium antagonist drugs could also be related to some property other than interference with the action of calcium within brain neurons. PMID- 3529152 TI - On the Genesis of Perversions. PMID- 3529153 TI - Use of calcium antagonists in mania. AB - The organic calcium antagonist verapamil in doses of 320-480 mg/day reduced manic symptomatology in seven of eight patients manifesting a manic or schizomanic syndrome in a placebo-controlled, double-blind study. The delayed onset of antimanic effects parallels the action of lithium in acute mania. Common pharmacological profiles of lithium, certain anticonvulsants, and neuroleptics with regard to calcium dependent processes are discussed. PMID- 3529154 TI - Case reports. PMID- 3529155 TI - Survey of current therapy 1985-1986. Root treatment--part II. PMID- 3529157 TI - [Psychotherapy and psychiatry: their historical separation and its consequences]. PMID- 3529156 TI - Perimenstrual symptoms: prevalence and risk factors. AB - This article provides an overview of information on the prevalence of perimenstrual symptoms. Overall, at least 40% of women experience some cyclical perimenstrual symptoms. Although most women rate their symptoms as mild, approximately 2%-10% report severe symptoms. Prospective studies of perimenstrual symptoms indicate that retrospective reports are reasonably accurate among women who experience moderate to severe symptoms. However, among the majority of women with few or minimal symptoms, retrospective reports may amplify the cyclicity of variation in comparison to concurrent reports. A variety of risk factors are associated with patterns of symptom reporting and may provide clues to the etiology of perimenstrual symptoms and help to identify women most vulnerable to them. A woman's age and cycle characteristics are predictors of the type and severity of perimenstrual symptoms she experiences. In addition, a history of affective illness may be associated with increased reporting of perimenstrual symptoms. Future research should focus on developing new diagnostic criteria for subtypes of perimenstrual syndromes, exploring positive symptoms and experiences associated with the menstrual cycle, and formulating holistic treatment approaches that view perimenstrual syndromes as psychosomatic conditions. PMID- 3529158 TI - The controversy surrounding epilepsy and driving: a review. PMID- 3529159 TI - L-dopa treatment and Parkinson's disease. AB - Seventeen years after its introduction, L-dopa, now administered in combination with a peripheral dopa decarboxylase inhibitor remains the most effective palliative remedy for Lewy body Parkinson's disease. A therapeutic effect to large doses is so consistent that alternative diagnoses should be considered in any patient with a Parkinsonian syndrome who fails completely to respond. Despite improving the quality of life, it probably does not influence appreciably the reduced life expectancy in Parkinson's disease and the long-term therapeutic response is frequently marred by drug-induced oscillations in motor performance, dyskinesias and psychotoxicity. Experimental studies using continuous intravenous infusions of L-dopa in order to obtain constant plasma levels suggests that additional refinements in management may be achieved by the design of a practical controlled delivery system, and prototype pumps and sustained release formulations are already under evaluation. PMID- 3529161 TI - In vitro marginal leakage of acid-etched composite resin bonded castings. PMID- 3529160 TI - Bovine variants of Mycobacterium tuberculosis isolated in Liverpool during the period 1969 to 1983: an epidemiological survey. AB - Between 1969 and 1983 inclusive, the bovine variants of Mycobacterium tuberculosis (M. bovis and M. africanum) were isolated from 75 patients with tuberculosis. This represented 2.9 per cent of all significant mycobacteria identified at the Liverpool Public Health Laboratory during this period. The clinical and radiological features of infection did not differ from those found with M. tuberculosis. There was an association between M. bovis infection, extrapulmonary disease and lifelong United Kingdom residency, and between M. africanum infection, pulmonary disease and immigrant status. Correlations between the present incidence of reactivated M. bovis disease and past prevalence of bovine tuberculosis in man and cattle, and between the isolation rate of M. africanum and the size of the immigrant community served by the laboratory, were also demonstrated. All the patients with M. bovis infection were considered to have a reactivated or slowly progressive primary infection. It is proposed that M. bovis only accounts for a small proportion of isolates from adults with tuberculosis because the organism displays a low tendency to reactivate. PMID- 3529162 TI - Tensile adhesion of composite resin cements to etched alloy and enamel. PMID- 3529163 TI - The use of removable appliances for forced eruption of teeth. PMID- 3529164 TI - [Bond strength of resin cements on sand-blasted cobalt-chromium alloys and acid etched enamel]. PMID- 3529165 TI - [Preparation of cast precious metal crowns for teeth with divergent roots (I)]. PMID- 3529166 TI - [TCP magnet system]. PMID- 3529167 TI - [Preparation of cast precious metal crowns for teeth with divergent roots (II)]. PMID- 3529168 TI - [Cobalt-chromium bonded bridges are attached with enamel etching]. PMID- 3529170 TI - [Distal movement of a permanent premolar arch-ending tooth--an alternative in the prosthetic care of a shortened dental arch]. PMID- 3529169 TI - [State-of-the art in dental prosthetics]. PMID- 3529172 TI - [Direct modelling technics for preparation of cast post cores in teeth with divergent canals]. PMID- 3529171 TI - [2-part root post crown preparation system using titanium trans-dental fixation and apicoectomy (I)]. PMID- 3529173 TI - [Hydrocolloid impressions--ease of use in practice]. PMID- 3529174 TI - [2-part root post crown system of titanium using transdental fixation and root tip resection (II)]. PMID- 3529175 TI - [Indications for anterior Konus crowns and esthetic and materials science problems of synthetic veneers (I)]. PMID- 3529176 TI - [Control is good--control with a stereomicroscope is better]. PMID- 3529178 TI - [Mechanical root planing--new method]. PMID- 3529177 TI - [Indications for anterior Konus crowns and esthetic and materials science problems of synthetic veneers (II)]. PMID- 3529179 TI - [Self designed composite color guide]. PMID- 3529180 TI - [So-called "non-functional central relation"]. PMID- 3529181 TI - [Provisional care of prepared abutment teeth]. PMID- 3529182 TI - [Basic principles of prosthetics: complete dentures (II)]. PMID- 3529183 TI - [Basic principles of prosthetics: complete denture (III)]. PMID- 3529185 TI - [Basic principles of prosthetics: complete dentures (IV)]. PMID- 3529184 TI - [Epidemics yesterday and today (I)]. PMID- 3529186 TI - [Epidemics yesterday and today (II)]. PMID- 3529187 TI - [Basic principles of prosthetics: complete dentures (V)]. PMID- 3529188 TI - [Cooperation of the dental assistant in orthodontic practice--organization and teamwork (I)]. PMID- 3529189 TI - [Basic principles of prosthetics. Complete dentures (VI)]. PMID- 3529190 TI - [Errors in alginate impressions]. PMID- 3529191 TI - [Basic principles of prosthetics. Complete dentures (VII)]. PMID- 3529192 TI - [Proposals for the finishing of a combination denture having Konus crowns with special reference to esthetics (I)]. PMID- 3529193 TI - [Wax press technic for exact marginal fit of crowns and inlays]. PMID- 3529194 TI - [Precision attachment investment technic--new possibilities and aspects for telescopic and attachment technics (II)]. PMID- 3529195 TI - [Consistent casting results in everyday laboratory procedures]. PMID- 3529196 TI - [Professional pouring of an alginate impression]. PMID- 3529197 TI - [Proposals for the finishing of a combination denture having Konus crowns with special reference to esthetics (II)]. PMID- 3529198 TI - [The casting of CoCrMo alloy in Konus ceramic and telescopic dentures--the Stober Arcus cast connector]. PMID- 3529199 TI - [Esthetics in combined dentures (I)]. PMID- 3529200 TI - [Precision attachment investment technic--new possibilities and aspects for telescopic and attachment technics (III)]. PMID- 3529203 TI - [Model casting technic with system (I)]. PMID- 3529202 TI - [Proposals for the finishing of a combination denture having Konus crowns with special reference to esthetics (III)]. PMID- 3529201 TI - [Technic for the preparation of magnetic anchors]. PMID- 3529204 TI - [New model preparation system]. PMID- 3529205 TI - [Prosthetic care in unilateral cleft lip, jaw and palate]. PMID- 3529206 TI - [Esthetics in combined dentures (II)]. PMID- 3529207 TI - [Combination of form and function (I)]. PMID- 3529208 TI - [Model casting technic with system (II)]. PMID- 3529209 TI - [Long-time temporary prosthesis of VISIO-GEM]. PMID- 3529210 TI - [Esthetics in combined dentures (III)]. PMID- 3529211 TI - [Precision carrier for baking and its preparation]. PMID- 3529212 TI - [Individualized remodelling of manufactured mineral teeth]. PMID- 3529213 TI - [Casting technic with the system (III)]. PMID- 3529214 TI - [Rational working of synthetic resins. Experiences with the Acrymat synthetic resin sprayer]. PMID- 3529215 TI - [A removable mold--unimportant?]. PMID- 3529216 TI - [Systematic procedures for modelling wax frameworks in model casting technics]. PMID- 3529217 TI - [Spring-lock attachment]. PMID- 3529218 TI - [The finishing of a 3-cornered clasp]. PMID- 3529219 TI - [Complete veneering of the Konus crown with SR-Isosit-N]. PMID- 3529220 TI - [Possibility of inducing the adaptive response of cells to exposure to ionizing radiation]. AB - Mechanisms of induction of the antimutagenic and anticarcinogenic adaptive repair response of cells to the effect of alkylating substances and other genotoxic agents are discussed. The possibility of induction of adaptive repair response of mammalian cells to low-level radiation is suggested. PMID- 3529221 TI - [Thermoinduced radioresistance of Escherichia coli cells and heat shock proteins]. AB - Radioresistance of E. coli cells is slightly increased (dose modification factor (DMF) = 1.2) with temperature elevated from 4 degrees to 43 degrees C at the time of gamma-irradiation. However, an appreciable effect of the thermoinduced radioresistance (DMF = 1.7) was observed when the wild-type cells were exposed to gamma-radiation at 15-43 degrees C (but not at 4 degrees C) after 30-min preincubation at 43 degrees C. This effect was absent in htpR mutants, defective in induction of heat shock proteins, and coupled with the decreased post irradiation DNA degradation in gamma-irradiated htpR+ cells. It is suggested that heat shock proteins are involved in the thermoinduced radioresistance. PMID- 3529222 TI - [Photoreactivation in Saccharomyces cerevisiae cells after irradiation with electrons (25 MeV). The role of photoreactivated damage in the manifestation of oxygen effects in radio- and UV-sensitive mutants of Saccharomyces cerevisiae]. AB - Significant photoreactivation was noted in radio- and UV-sensitive rad-mutants of Saccharomyces cerevisiae cells exposed to 25 MeV electrons. In order to make the photoreactivable damage be manifest anoxic conditions of irradiation should be chosen as optimal ones. It was shown that the low oxygen effect was partially associated with the photoreactivable damage involved in the lethal effect of ionizing radiation. PMID- 3529223 TI - Sonographic appearance of craniofacial dysostosis in utero. AB - Crouzon's syndrome, or craniofacial dysostosis, is a rare congenital abnormality which may be associated with life-threatening conditions, such as congenital heart defects. The effects of the premature synostosis and some of the facial abnormalities can be detected antenatally with ultrasound and thus provide the paediatrician with a useful 'early warning system'. PMID- 3529225 TI - Vascular imaging: angiography and the new modalities. PMID- 3529224 TI - The importance of appropriate suite designs in the era of computerized imaging. AB - Careful room design can prevent "headaches" and "heartaches" or both to patients and staff who will use the "extended facility" involved with high-technology imaging. Principles and pitfalls of room design are discussed as they apply to these modalities. PMID- 3529226 TI - Recent advances in contrast agents. AB - Intravascular contrast agents are remarkably safe and inexpensive. With the recent approval of three new low-osmolality, high-cost contrast media, questions arise as to toxicity, side effects, and choice of particular agents for particular patients and examinations. This article examines the nature and the etiology of the effects of all currently available contrast agents in order to achieve an improved understanding of the relative advantages, disadvantages, and utility of each. PMID- 3529227 TI - Minipuncture angiography. AB - The frequency of arterial trauma or hematoma can be reduced by using smaller puncturing needles (21-gauge) and catheters (4- or 5- French). Versatile ultrafine guide wires are now available for selective and superselective catheterization. This miniaturization of angiographic equipment allows many vascular procedures to be performed safely on an outpatient basis or in short procedure units. PMID- 3529228 TI - Utilization of angiography in trauma. AB - In conclusion, I have tried to present a rational approach to the work-up of the traumatized patient. One must consider the mechanism of injury, the region where the most damage has been inflicted, and, most important of all, the clinical condition in which the patient arrives. With injuries in most of the body parts, there will not be time to perform any angiographic procedure in category 1 patients. They may or may not have intraoperative or postoperative angiograms. Category 2 patients benefit most from angiography; therapy will often be dictated based on the results. Category 3 patients are studied as necessary; the decision is made with strong consideration given to the type of trauma and the proximity of major vessels. For all groups of patients, angiography should be performed as soon as possible to avoid the sequelae of delay in treatment, as pointed out previously, particularly delayed rupture of arteries. This is becoming increasingly important as angiography has started to play a bigger role in the early therapeutic intervention of the traumatized patient. It is expected that appropriate and increasing use of arteriography will improve organ, limb, and patient salvage by early surgical or transcatheter techniques. PMID- 3529229 TI - Panvenography and pulmonary angiography in the diagnosis of deep venous thrombosis and pulmonary thromboembolism. AB - In summary, high-quality pulmonary angiography remains the most accurate and reliable means of diagnosing pulmonary embolism. It can be performed with relative safety, and the inherent mortality risks with pulmonary angiography (in the range of 0.2 to 0.5 per cent in active angiography laboratories) must be weighed against the significant risks incurred with inaccurate diagnosis obtained without pulmonary arteriography. Pulmonary arteriography and transvenous catheter embolectomy can be of great benefit in sudden cardiovascular collapse due to massive pulmonary embolism. Transvenous catheter embolectomy has survival rates at least as good as those of open embolectomy, and it has the advantage that it can be performed in any hospital with angiographic facilities and trained personnel, thus allowing more expeditious management of massive pulmonary embolism in hospitals that do not have cardiopulmonary bypass capabilities. PMID- 3529230 TI - Surgically treatable lesions of the extracranial circulation, including the vertebral artery. AB - Stroke is the third most common cause of death in the United States, and 50 per cent of sources arise in the extracranial carotid arteries. Well-performed vascular surgery provides a low-risk approach in preventing this devastating event if these sources can be identified before the stroke occurs. An awareness of the patient at risk, an appreciation of the type and location of the causative lesions, and a timely diagnosis offer the best chance for success. PMID- 3529231 TI - Vascular ultrasonography: abdominal applications. PMID- 3529232 TI - Vascular magnetic resonance imaging. AB - Natural contrast from flow void potentiates the diagnosis of the intimal flap of aortic dissection, the dilated contour of aortic aneurysm, the protruding plaque of atherosclerotic disease, the recognition of deep vein thrombosis, and the identification of a number of acquired and congenital vascular abnormalities. Although MRI is costly at the present, the advantages of vascular MRI include noninvasive multiplanar imaging, no ionizing radiation, no contrast material requirements, and its use as an alternative to technically limited ultrasonography or computed tomography. MRI can define anatomy, measure blood flow, and be used for serial examinations in following disease processes and response to treatment. Future research with tissue characterization of atherosclerotic plaque may allow for early diagnosis and treatment of this ubiquitous disease. Not only chemical but also metabolic studies, including tissue perfusion in the heart and other solid viscera, would be of great value. Undoubtedly, MRI will have a permanent role in cardiovascular diagnosis. PMID- 3529233 TI - The functional and anatomic evaluation of the cardiovascular system with rapid acquisition computed tomography (cine CT). AB - Cine CT combines the advantages of digital cross-sectional imaging with those of angiography. It provides vivid portrayal of complex anatomic relationships as well as important functional data not easily obtainable elsewhere, including quantitation of myocardial wall thickening and regional myocardial blood flow. The blood flow in major vessels following coronary artery bypass graft surgery and cardiac output have been quantified with accuracy. The future of cine CT will depend ultimately on controlled studies comparing this technique with other modalities, including echocardiography, magnetic resonance imaging, radionuclide angiocardiography, and contrast-enhanced catheter angiography. PMID- 3529234 TI - [Bacterial and abacterial inflammatory kidney diseases. Diagnostic value of the sonographic determination of kidney volume]. AB - The diagnostic value of ultrasound kidney biometry in the diagnosis of parenchymatous kidney disease was evaluated in 277 children. Kidney enlargement of more than 140% of normal volume proved to be a sensitive criterion for differentiation of acute bacterial interstitial nephritis (pyelonephritis) and isolated lower urinary tract infection. Mean kidney volume in acute pyelonephritis was 175%. Normalization of kidney volume under antibiotic treatment required 4-6 days. Kidneys with non-bacterial nephritis and glomerulonephritis showed a 63% pathological size increase at biopsy; the kinetics of kidney volume in the acute phase of the disease paralleled the clinical course. PMID- 3529235 TI - [Quantitative evaluation of the relation between bone mass of the metacarpal bone and bone mineral content of the forearm in normal persons and patients with chronic renal failure before and after kidney transplantation]. AB - Twenty-seven healthy normal subjects, 30 non-dialyzed patients with chronic renal failure, 25 hemodialyzed patients on chronic hemodialysis, and 54 renal transplant recipients were evaluated simultaneously with regard to a correlation between the bone mineral content of the forearm and the total cortical thickness and area of the second left metacarpal bone. A significant correlation was found between bone mineral content of the forearm and the cortical bone mass of the metacarpal bone in normal subjects and in the patient groups. PMID- 3529236 TI - [Differential diagnosis of changes in density and structure of the foot bones]. AB - Skeletal disorders of the foot can be assessed radiologically by changes in bone density, structure and/or form. The knowledge of specific morphological criteria is a precondition for differential diagnosis. Our classification of skeletal disorders of the foot is based on the specific signs that can be observed in systemic and local diseases affecting the pedal bones. PMID- 3529237 TI - The neuronal determinants of respiratory rhythm. PMID- 3529239 TI - Issues in the definition and diagnosis of alcoholism: implications for a reformulation. AB - This paper examines definitions of alcoholism from theoretical and historical points of view. It begins with a review of definitions of alcoholism from the 19th century to the present, giving particular attention to medical approaches, psychiatric formulations, behavioral concepts, and definitions proposed by the American Psychiatric Association and the World Health Organization. It is concluded that current definitions differ widely in scope, the meanings attached to words like disease and disorder, the criteria for including signs and symptoms as essential characteristics, and the potential uses of the definitions. Based on these considerations, the practical issues of developing and applying clinically useful diagnostic procedures are discussed. The paper concludes with a discussion of diagnostic issues that should be considered in any effort to improve clinical identification, treatment planning and international communication. PMID- 3529238 TI - Single unit activity of locus coeruleus neurons in behaving animals. PMID- 3529240 TI - Biological markers in alcoholism. AB - The search for biological markers of a predisposition towards alcoholism is the result of data indicating that this disorder is genetically influenced. The present paper reviews some methodological considerations important for trait marker research in alcoholism. To date, the most promising results have come from studies comparing populations at elevated risk (i.e., sons of alcoholics) to controls. Such investigations point towards a decreased intensity of reaction to ethanol in sons of alcoholics, a decreased amplitude of the P300 wave of event related potentials, and the possibility of a unique pattern of waves on the background cortical EEGs. The potential implication of these findings is discussed. PMID- 3529241 TI - [Activated oncogenes in human cancer]. PMID- 3529242 TI - [Membrane lipid metabolism and protein kinase C]. PMID- 3529243 TI - [Role of C-kinase in calcium messenger system]. PMID- 3529245 TI - [Phospholipase D]. PMID- 3529244 TI - [Molecular pharmacology on protein kinase C]. PMID- 3529246 TI - [Protein-synthetic polymer hybrid: polyethylene glycol-modified enzymes are soluble and active in organic solvents]. PMID- 3529247 TI - [Lysyl endopeptidase]. PMID- 3529248 TI - [Boundary concepts, interpretation and Freud's Jewish heritage]. PMID- 3529249 TI - [The life and work of Imre Hermann]. PMID- 3529250 TI - The posterior palatal seal--its forms and functions (I)--Diagnosis. PMID- 3529251 TI - Liquid porcelain buildup step-by-step procedure. PMID- 3529252 TI - A reliable bonding technique for base metal Maryland bridges. PMID- 3529253 TI - Direct bonding of orthodontic brackets. PMID- 3529254 TI - Klaas Breur Medal lecture 1985. The growth and progression of human tumors: implications for management strategy. AB - The natural history of human cancers can be stimulated assuming an exponential growth pattern. This simple model shows that the duration of the tumor growth during the occult phase is always much shorter than the interval between the carcinogenic stimulus and the clinical emergence of the tumor; this is consistent with the existence of several stages of precancerous lesions which precede the development of the neoplastic clone. Metastatic spread can be simulated and a model of tumor growth can be used to predict the proportion of patients in whom metastatic dissemination can be avoided by an earlier diagnosis. The model predicts also that in the subsets of patients in whom metastatic spread occurs early the occult metastases will be large at the time of the treatment of the primary tumor and therefore adjuvant chemotherapy (CT) will be less effective; this is in keeping with clinical data. The model can also help to understand the relationship between the local control of a tumor and the cure of the patient, and to explain the discrepancy between the great reduction in the local incidence of local recurrence obtained with post-operative radiotherapy and its relatively small impact on survival. However, this simple model is insufficient to explain several features of the course of a human cancer, in particular the heterogeneity of the neoplastic cell population and the inexorable tendency for some cancers to progress towards a more malignant type and to become progressively more resistant to any treatment. Genetic instability appears to be an essential characteristic of human cancers and variations in its degree may be the cause of differences in the aggressiveness and in the severity of the various types of cancers. The recent advances in the molecular biology of cancers has already given to clinicians new and powerful prognostic indicators. These will probably, in the near future help, towards a better understanding of the biology of tumor growth and tumor progression. PMID- 3529255 TI - Intraoperative radiotherapy. AB - The potential benefit of intraoperative radiotherapy (IORT) was originally recognized years ago and has recently attracted renewed interest. Modern radiotherapeutic approaches may be more successful as a result of technical innovation, particularly in the use of electron beam accelerators. Preliminary studies, mainly uncontrolled and nonrandomized, have assessed the role of IORT for treatment of a variety of deep seated abdominal, retroperitoneal, and pelvic cancers. The results of some studies show much promise, but prospective trials are needed to scientifically validate these favorable initial observations. PMID- 3529256 TI - [Surgical treatment of morbid obesity]. PMID- 3529257 TI - [Pulmonary granulomatous disease caused by a metallic foreign body]. PMID- 3529258 TI - [Suture of the deep flexor tendon at the distal part of No Man's Land. A technic used in 23 cases]. AB - Modern trends based on new concepts concerning tendon repair after division advise the maximal preservation of the tendon sheath. When the approach to the tendon is limited, its suture may be difficult, particularly on its deep aspect. The authors describe a technique that allows an atraumatic suture to be made, without any rotary displacement of the tendon. PMID- 3529259 TI - [Hepatic serous cysts. Contribution of 3 cases and review of the literature]. PMID- 3529260 TI - [Neurohumoral regulation of intestinal water-electrolyte balance]. PMID- 3529261 TI - Intestinal disaccharidase activities in growing rats as affected by sex. PMID- 3529262 TI - [Treatment of the sleep apnea syndrome by continuous positive pressure]. AB - Six patients with severe sleep apnoea syndrome (SAS) were treated for one night by continuous positive pressure by the nasal route (PPC). The six patients tolerated the treatment well. During the course of the night, while receiving PPC, we noticed that in five patients there was a normalisation of the indices of apnoea, a disappearance of the episodes of desaturation and a re-organisation of sleep pattern. In one patient PPC was effective on obstructive apnoea, but did not make all mixed and central apnoea disappear. After a 4 or 5 day trial in hospital, 4 patients have now been treated at home for at least 6 months. PPC remains effective and well tolerated in the long term. As it is well tolerated and effective, PPC may be used to treat patients with SAS at an earlier stage than that at which tracheotomy is proposed. PMID- 3529263 TI - The pathophysiology of ischaemic acute renal failure. A new hypothesis about the initiation phase. PMID- 3529264 TI - Age effects on the reactivity of antistreptococcal cell membrane antisera to murine glomerular basement membrane. In vitro versus in vivo analysis. AB - Antisera to the streptococcal cell membrane (SCM) were evaluated for their reactivity to murine glomerular basement membrane (GBM) in four strains of mice. Animals were studied on a daily basis from birth through 3 months and weekly thereafter through 18 months. Paired animals were compared for in vivo binding of antibody versus an indirect fluorescent antibody technique on fresh kidney sections. The findings demonstrated a granular type GBM staining for all anti-SCM which were positive. Nonspecific background staining accompanied most of the indirect fluorescent antibody sections tested while being totally absent for the direct fluorescent test on tissue from in vivo challenge of the primary antibody. The in vitro testing showed tissue from young mice (0-6 days old) to be most reactive, while the strongest reactivity was seen in the age group of 10-20 days for in vivo testing. These cross-reactive antibodies, i.e., GBM-binding anti-SCM, are best evaluated by in vivo methods where tissue is taken 4 days after antiserum injection. Animals of the age range 6-8 weeks were often negative, indicating that this age range selected for many studies may not be the most favorable one via either in vitro or in vivo studies. PMID- 3529265 TI - Renal high-molecular-weight renin: unusual formation in the aged stroke-prone spontaneously hypertensive rats. AB - A high-molecular-weight renin (HMWR) was detected in the plasma (molecular weight 50,600) and renal cortical homogenate (molecular weight 57,000) of 25-week-old male stroke-prone spontaneously hypertensive rats (SHRSP), in contrast to the renin with a molecular weight of 38,000 in normotensive Wistar Kyoto rats (WKY) and 5-week-old SHRSP. However, renin granules contained only the renin with a molecular weight of 38,000, indicating that the renal HMWR is not a native form but is probably a renin/renin-binding protein complex. Such HMWR was not produced when the renal cortex was homogenized with an equal amount of renal cortex of WKY. Further, the HMWR of the aged SHRSP was converted into the 38,000-dalton renin, when incubated with the extract of renal cortex of WKY. Thus, the existence of a renal cortical substance that converts the renal HMWR into the 38,000-dalton renin was evidenced. This substance was fractionated with DEAE cellulose and was characterized as a putative SH enzyme. We conclude that a deficiency in the HMWR-converting substance may be attributed to the unusual formation of HMWR in the aged SHRSP. PMID- 3529266 TI - Biphasic alteration of renin-angiotensin-aldosterone system in streptozotocin diabetic rats. AB - The alteration of renin-angiotensin-aldosterone system caused by diabetes mellitus was studied in streptozotocin-diabetic rats. The plasma renin activity (PRA), and plasma levels of angiotensin II (A II) and aldosterone (PAC) were measured in diabetic and age-matched control rats in 1, 2, 4 and 8 weeks after the intravenous injection of streptozotocin (50 mg/kg body weight). Diabetic rats showed the marked hyperglycemia persistently throughout the experimental period. On 1st week PRA, A II and PAC were significantly increased, and A II and PAC were also significantly elevated on 2nd week in diabetic rats compared with control rats. However, on 4th and 8th weeks PRA, A II and PAC in diabetic rats were significantly lower than those of control rats. Hematocrit values in diabetic rats were elevated on 1st week, normalized on 2nd and 4th weeks and then decreased on 8th week. These results may suggest that the hyperglycemia causes a biphasic alteration of renin-angiotensin-aldosterone system, i.e., early stimulated state due to volume depletion and later suppressed state due to volume expansion. PMID- 3529267 TI - Macula densa control of renin secretion and glomerular vascular tone: evidence for common cellular mechanisms. AB - The macula densa is believed to function as a sensor for control of intrarenal vascular tone and renin secretion. Increases in flow rate through the loop of Henle or increases in distal tubular fluid NaCl concentration result in an increase in local vascular tone and a decrease in glomerular filtration rate, the tubuloglomerular feedback (TGF) mechanism. Increases in distal NaCl concentration are also believed to inhibit renin secretion. Evidence will be reviewed that suggests that these two processes may be activated concurrently and may share common cellular mechanisms. Similarities in the sensor step include a similar pattern of ion specificity, with both responses being relatively anion specific but showing little cation specificity. TGF responses are inhibitable by furosemide, and the renin secretion produced by furosemide seems to be in part macula densa dependent. There appear also to be common features in the effector step of both responses. Increases in intracellular calcium are implicated in both the vasoconstrictive response seen with increased macula densa NaCl concentration and in inhibition of renin secretion. Changes in cyclic AMP may play a role in the converse responses. PMID- 3529268 TI - Immunocytochemical study of glutathione peroxidase in normal rat kidney. AB - In the normal rat kidney, immunohistochemical localization of glutathione peroxidase (GSH-Po) was mainly in the proximal tubules (PTs), where the proximal portions (S1 + S2) were more intensely stained than the distal portion (S3). Immunocytochemically, GSH-Po was localized in cytosol including the core of microvilli and lysosomes of the epithelial cells in the PTs. Since albumin and IgG were not found in cytosol, it is suggested that cytosolic GSH-Po may be generated in situ, but is not derived from the serum. PMID- 3529269 TI - Molecular biology of plant cell transformation. PMID- 3529270 TI - Isolation and regeneration of protoplasts from higher plants. PMID- 3529271 TI - Protoplast fusion and early development of fusants. PMID- 3529273 TI - Unusual chromosome movements in sciarid flies. PMID- 3529272 TI - Development of protoplast fusion products. PMID- 3529274 TI - Hereditary predisposition to cancer: opportunities for early detection and intervention. PMID- 3529275 TI - A new direction in preventive oncology: chemoprevention. PMID- 3529276 TI - The immunobiology of B cell lymphoma: clonal heterogeneity as revealed by anti idiotype antibodies and immunoglobulin gene probes. PMID- 3529277 TI - Immunorestoration. PMID- 3529278 TI - [Endogenous inhibitory system in pain]. AB - Electrical stimulation of several brain sites produces profound analgesia in humans, and inhibits nocifensor reflexes in animal studies. Responses of the dorsal horn nociceptive neurons evoked by stimulation onto the receptive fields are also inhibited by brain stimulation. These brain sites are Periaqueductal Gray Matter (PAG), Nucleus Raphe Magnus (NRM), Nucleus Reticularis magnocellularis (NRmc), Locus Coeruleus (LC), Lateral Hypothalamus, and others. We have explained in a general way the mechanism of these stimulation produced analgesia. The mechanism of PAG stimulation analgesia is partly due to an activation of serotonin containing neurons which descend from NRM to the spinal dorsal horn and activated by PAG stimulation. Activation of NRM neurons may produce inhibition of the nociceptive neurons of the dorsal horn by the mechanism of direct postsynaptic inhibition. Currently there is no evidence to support the theory of presynaptic inhibition. Endogenous opioid peptides do not play an important role in PAG stimulation analgesia. On the other hand, the mechanism of NRmc or LC stimulation analgesia may be due to an activation of noradrenaline containing neurons which similarly inhibit the dorsal horn nociceptive neurons in the spinal cord. At present, it still remains unknown whether endogenous opioid peptides play an important role in this type of analgesia. PMID- 3529279 TI - [Current topics for occupational and environmental medicine and physiology in the U.S.A.--with special reference to occupational lung diseases]. AB - Current topics for occupational and environmental medicine and physiology in the U.S.A., especially in the National Institute for Occupational Safety and Health (NIOSH), and the University of California, San Francisco, are reviewed. Reduction of the rate for occupational lung diseases is one of the national objectives for occupational safety and health in the U.S.A., and NIOSH has rated it as the top disease of ten-leading work-related diseases and injuries. Current topics for occupational lung diseases--asbestosis, byssinosis, silicosis, coal worker's pneumoconiosis, lung cancer, and occupational asthma & hyperreactivity, and for pathophysiology of airway hyperreactiveness and pulmonary edema are discussed. PMID- 3529280 TI - Origins of molecular biology in Japan. AB - The purpose of this paper is to discuss the origins of molecular biology in Japan. Japanese molecular biology does not have a long history since it started only after World War II. Especially, molecular genetics which uses "bacteriophage" had hardly been studied before the war and only a few scientists were interested in it immediately after the war. This is one of the origins of molecular biology in Japan. But there are other origins, one of which is the group formed by biologists, biochemists and physicists interested in nucleic acids. This group also started just after the war. Still another origin is the group of enzymologists. Enzymology was one of the main subjects of biochemistry from before the war. In Japan, biochemistry developed in conjunction with the medical and agricultural sciences from the pre-war era. These played an important role in introducing molecular biology from Europe and the United States after the war. A historical study of the development of molecular biology in Japan, comparing it with the history of molecular biology in Europe and the United States, should contribute to the elucidation of the features of the history of molecular biology in Japan. PMID- 3529281 TI - Cardiorespiratory fitness and training in quadriplegics and paraplegics. AB - With the growing interest in exercise and sport and the significance of cardiovascular disease in the spinal cord injured population, the role of endurance training in improving cardiovascular health is of particular interest. Ordinary daily activities of those with spinal cord injury are usually not adequate to maintain cardiovascular fitness, and lack of participation in a regular activity programme may result in a debilitative cycle. As this occurs, there is a reduction in functional work capacity which may limit independence, and the reduction in cardiovascular fitness may increase the risk for cardiovascular disease. Work capacity in those with spinal cord injury is limited by loss of functional muscle mass and sympathetic control. Sympathetic nervous system impairment limits control of regional blood flow and cardiac output, and maximum heart rate following cervical lesions may be reduced to 110 to 130 beats/min. However, endurance training in quadriplegics and paraplegics can elicit improvements in exercise performance similar to those observed in able bodied individuals. Review of 13 cardiorespiratory training studies involving spinal cord injured subjects revealed average improvements of 20% in VO2max and 40% in physical work capacity after 4 to 20 weeks of training. Based upon the positive results of these studies, the general endurance training guidelines for the normal population appear to also be appropriate for the spinal cord injured population. These guidelines can be followed during participation in a number of different activities and sports including wheelchair pushing, arm crank ergometry, aerobic swimming, ambulation training, canoeing and wheelchair basketball. There is no evidence that intense training and competition is harmful, but special areas of risk as a result of impairments in sensation, cardiovascular function, autonomic function and temperature regulation must be considered. The long term benefits of endurance training in those with spinal cord injury has not been adequately studied, but there is suggestion that similar physiological and psychological changes may occur as in able-bodied individuals. PMID- 3529282 TI - Hormonal alterations due to exercise. AB - The study of hormonal alterations due to exercise is of growing interest because of the implications for adaptation, performance, and health. The influence of the sympathoadrenal response on energy metabolism and fluid and electrolyte balance has been of primary interest in past research. Interpretation of results, however, is difficult because of the numerous factors which need to be controlled. Limitations in the interpretation of hormone levels exist because of changes in plasma volume and/or clearance rate and the influences of timing and method of blood sampling. Other factors which must be considered are the design of exercise protocols, and various subject characteristics (sex, age, fitness level, training history, diet, emotional status, diurnal and menstrual variations). Hormonal alterations during acute exercise occur primarily because of sympathoadrenal secretion of the catecholamines which initiate mobilisation of glucose and free fatty acids. This response, in turn, stimulates other endocrine glands and cells (anterior and posterior pituitary, adrenal cortex, thyroid, parathyroid, liver, pancreas, kidney) to secrete secondary hormones which potentiate fuel mobilisation and regulate water and electrolyte concentrations. As duration of exercise increases, nutrient and ion concentrations also influence hormonal responses. In recent years, research has focused on the effect of exercise-induced hormonal alterations on reproductive functioning and various endocrine-related diseases (hypopituitarism, diabetes, osteoporosis, cardiovascular disease). These topics, as well as a better understanding of mechanisms of action via receptor activity, influences on training adaptations, and implications (if any) of hormonal alterations for the growth and development of children, provide challenges for future research. PMID- 3529283 TI - The interactions of intensity, frequency and duration of exercise training in altering cardiorespiratory fitness. AB - This review has grouped many studies on different populations with different protocols to show the interactive effects of intensity, frequency and duration of training as well as the effects of initial fitness levels and programme length on cardiorespiratory fitness as reflected by aerobic power (VO2max). Within each level of exercise duration, frequency, programme length or initial fitness level, the greatest improvements in aerobic power occur when the greatest challenge to aerobic power occurs i.e., when intensity is from 90 to 100% of VO2max. The pattern of improvement where different intensities are compared with different durations suggests that when exercise exceeds 35 minutes, a lower intensity of training results in the same effect as those achieved at higher intensities for shorter durations. Frequencies of as low as 2 per week can result in improvements in less fit subjects but when aerobic power exceeds 50 ml/kg/min, exercise frequency of at least 3 times per week is required. As the levels of initial fitness improve, the changes in aerobic power decreases regardless of the intensity, frequency or duration of exercise. Although these pooled data suggest that maximal gains in aerobic power are elicited with intensities between 90 to 100% VO2max, 4 times per week with exercise durations of 35 to 45 minutes, it is important to note that lower intensities still produce effective changes and reduce the risks of injury in non-athletic groups. PMID- 3529286 TI - [Cardiovascular complications of diabetes]. PMID- 3529284 TI - Physiological differences between genders. Implications for sports conditioning. AB - It is commonly accepted that there are physiological and morphological gender differences. These differences become evident in the specific responses or magnitude of response to various training regimens. Very little difference is seen in the response to different modes of progressive resistance strength training. Men and women experience similar relative strength gains when training under the same programme. The evidence on body composition changes that occur with strength training is equivocal at this point. Researchers, however, suggest that there appears to be less muscle hypertrophy with strength improvement in women when compared to men. The data suggest that there are no differences between genders in central or peripheral cardiovascular adaptations to aerobic training. However, women in general have a reduced O2 carrying capacity. Another factor that may be responsible for the sex differences seen in the metabolic responses to exercise may be the greater, essential sex specific fat of women. Sparling and Cureton (1983) have shown that differences in similarly trained male and female distance runners are due largely to percentage body fat, less to cardiorespiratory fitness and least to running economy. Pate et al. (1985) determined that men and women who are capable of similar performances, in this case a 15 mile race, do not differ in body composition, cardiorespiratory response or metabolic response. There appear to be no differences in relative increases in VO2max for men and women when they are trained under the same intensity, frequency and duration. Mode of training also appears to elicit no sex difference. Hormonal factors lead to greater initial levels of high density lipoproteins in women. This appears to cause a smaller change in the total cholesterol-high density lipoprotein ratio than occurs with aerobic training in men. Generally, the menstrual cycle phase makes no difference to performance in women. The special cases of exercise in hot and cold environments present conflicting evidence. When men and women are matched for surface area:mass, VO2max and percentage body fat, the major disadvantages women have in the heat disappear. The question of gender differences in the cold has yet to be fully explored. When the general population is compared, men appear to have an advantage over women. PMID- 3529285 TI - Muscle damage and endurance events. AB - Intensive training for and competition in endurance events like the marathon are accompanied by injury to fibres in the active skeletal muscles. Evidence for the injury comes from the increases in intramuscular enzymes and myoglobin found in the blood following the exercise, from the subjective sensation of soreness in the muscles in the post-exercise period, and from direct histological examination of samples of the damaged muscles. Histological studies demonstrate that some muscle fibres undergo degenerative changes following the exercise; the necrosis is accomplished by macrophages and other phagocytic cells that invade the injured cells and the adjacent interstitium. Following the degeneration the fibers appear to be regenerated so that there is not a net loss of fibres. Precisely what initiates the cellular damage is not known, but hypotheses suggested include, 'metabolic overload' and 'mechanical strain'. Eccentric contractions are known to cause the greater amount of damage in muscles, which suggests that high local tensions in fibres may be more important than metabolic considerations in the aetiology of the injury. Training reduces the magnitude of the damage that occurs in response to a given exercise task, although competitors in endurance events may demonstrate chronic muscle injury because of increasing training intensities. Other than training, there is no compelling evidence that any drug treatment or preventative measures will lessen this form of injury. PMID- 3529287 TI - [Diabetes and transplantation]. PMID- 3529288 TI - [Infectious endocarditis: outcome and prognostic possibilities]. PMID- 3529289 TI - [Clinico-morphological aspects of arthritis in Reiter's disease]. PMID- 3529290 TI - [Clinical manifestations of the joint hypermobility syndrome]. PMID- 3529291 TI - [Joint instability among the Slovak population]. PMID- 3529292 TI - [Fibrinolytic properties of the blood and synovial fluid in patients with rheumatoid arthritis]. PMID- 3529293 TI - [Clinico-morphological characteristics of the joint syndrome in rheumatoid mono- and oligoarthritis in children]. PMID- 3529294 TI - [A system of specialized combined-modality, predominantly ambulatory treatment (a model of joint diseases): its substantiation, principles, clinical experience and prospects]. PMID- 3529295 TI - [Proteoglycan levels after the surgical treatment of rheumatoid arthritis]. PMID- 3529296 TI - [Clinical approbation of the diagnostic criteria in osteoarthritis deformans]. PMID- 3529297 TI - [Serum glycosaminoglycan levels in relation to the clinical variants of osteoarthritis deformans]. PMID- 3529298 TI - [Two-dimensional echocardiography in the diagnosis and evaluation of the degree of mitral valve stenosis]. PMID- 3529299 TI - [Role of echo- and phonocardiographic examination in the ambulatory care of patients after insertion of mitral valve prosthesis]. PMID- 3529300 TI - [Determining the level of antistreptolysin O in the serum]. PMID- 3529301 TI - [Various problems of deontology in rheumatology]. PMID- 3529302 TI - [Intra-arterial corticosteroid therapy: history, approach to drug administration and the problem of prolongation of the therapeutic effects]. PMID- 3529303 TI - [Arthritis and intestinal diseases]. PMID- 3529304 TI - [Significance of microcirculatory disorders in various rheumatic diseases]. PMID- 3529305 TI - [The dentistry of Johann Peyligk (1499) and Magnus Hundt (1501)]. PMID- 3529306 TI - Infectious diseases in day care: parallels between psychologically and physically healthy care. AB - A review of day care practices in the United States indicates a substantial increase since 1977 in out-of-home care for infants and toddlers, with a preponderance of care in unlicensed family day care homes. The effects of group care on infants and toddlers depend largely on the facility's success at meeting certain criteria for group size, staff-to-child ratio, and staff training. Parallels exist between providing psychologically healthy day care and minimizing the spread of infectious disease in day care facilities. Many of the same factors involved in providing psychologically safe day care are also involved in providing disease-free care. Financial and regulatory obstacles to high-quality care are considerable; however, supplementary child care for working parents is essential, and efforts to address such problems as infectious diseases must keep this perspective. PMID- 3529307 TI - Infectious diseases and day care. AB - Infectious diseases often occurring in epidemics, are to be expected in group day care because of the susceptibility of infants and toddlers to infection and the ready transmission of infection in the day care setting. Children in day care have more respiratory and gastrointestinal infections and are at higher risk for meningitis due to Haemophilus influenzae than are children in home care. Infections acquired by the child in the day care center may spread to members of the household and to the community. Illness in the child in day care may necessitate care at home and a change in plans of the parents; family stress may result. Infections in the day care center can be limited by appropriate use of the physical facilities, education of personnel in standards of hygiene, and maintenance of recommended immunizations of children and adult care givers. Simple techniques of infection control, such as hand washing, are the most effective. PMID- 3529308 TI - Acute respiratory infections in day care. AB - A 16-year, longitudinal study of acute respiratory infections was conducted in a day care center. The incidence of infections peaked in the second six months of life (10 per child per year) and declined thereafter. Fewer than 10% of infections involved the lower respiratory tract. The isolation of respiratory viruses was associated closely with illnesses, and viruses appeared to be the most important causes of respiratory infections. Haemophilus influenzae type b was isolated infrequently and caused no invasive disease. Nontypable H. influenzae and Streptococcus pneumoniae were isolated frequently but were not associated epidemiologically with illnesses. Group A streptococci were isolated with moderate frequency but were not a major problem. Although the data presented are an inadequate basis for firm conclusions, they suggest that the incidence of acute respiratory infections during the first year of life is higher among children in day care centers than among those cared for at home but that the incidence in later years is perhaps lower for children who enter day care as infants and remain in day care through the preschool years. PMID- 3529309 TI - Otitis media among children in day care: epidemiology and pathogenesis. AB - Acute and persistent middle-ear effusions are the most common complications of upper respiratory illness in young children. Knowledge of the impact of day care attendance on the incidence and prevalence of these conditions is not as complete as is desirable. Several studies suggest that the incidence of acute otitis media may be higher in children who attend group and home day care, but from these studies it is difficult to assess the magnitude of the risk of otitis media related to day care attendance. Research by Danish investigators indicates that the point prevalence of middle-ear effusion may be two to four times higher in children younger than four years old attending group day care centers than in children cared for at home or in smaller home day care settings. Recent epidemiologic and laboratory investigations have begun to elucidate the role of viral infections and of virus-bacteria interaction in the pathogenesis of acute middle-ear effusion. A thorough understanding of the relationship between day care attendance and the occurrence of otitis media with effusion would require studies that quantify the differential risk of disease in different care settings and that relate illness risk to the epidemiology of both viral and bacterial infections of the upper respiratory tract in the different environments. This type of research has not yet been conducted. PMID- 3529310 TI - Acute infectious diarrhea among children in day care: epidemiology and control. AB - The incidence of diarrhea among children in day care centers is highest for those under three years of age. Limited studies indicate that diarrhea occurs more frequently among children enrolled at these centers than among age-matched children cared for at home or in family day care. Most reported outbreaks have been caused by rotavirus, Giardia, Shigella, or combinations of these organisms. Children in day care centers commonly excrete enteropathogens in the absence of symptoms; the significance of this phenomenon in transmission is unknown. An association between higher rates of diarrhea and selected characteristics of centers--the most important of which is the presence of non-toilet-trained children--has been shown. The contamination of hands, communal toys, and other classroom objects as well as a lack of infection control measures play a role in the transmission of enteropathogens in outbreaks of diarrhea in day care centers. Spread of infection from non-toilet-trained children in centers to their families is common. Potential ways of dealing with this situation include education; development, implementation, and enforcement of regulations; and use of infection control measures. However, the effectiveness of specific control measures has not been systematically evaluated. PMID- 3529312 TI - Prevention of Haemophilus influenzae type b infections in day care: a public health perspective. AB - The availability of new data regarding the risk of invasive Haemophilus influenzae type b (Hib) among day care attendees allows the formulation of a practical public health approach to this problem. It is now clear that day care attendees are at significantly increased risk for development of primary invasive Hib disease. While the risk of secondary Hib disease for most is low, risk is substantially increased when young day care attendees are exposed to a primary case to a degree analogous to that of household contacts. Because risk for primary Hib disease is increased among day care attendees, immunization of these children with Hib polysaccharide vaccine is of the highest priority and may be appropriate for children as young as 18 months of age. In light of new data documenting the efficacy of rifampin in prevention of secondary disease, the use of this medication is indicated when unvaccinated day care attendees younger than two years old have had significant contact with a primary case. PMID- 3529311 TI - Haemophilus influenzae type b infections in day care attendees: implications for management. AB - Haemophilus influenzae type b is a major cause of several infectious syndromes in young children, the most important of which is meningitis. The mortality rate for H. influenzae meningitis in the United States is less than 10%; 10%-15% of survivors are left with neurologic sequelae. Children in day care may be at increased risk for acquiring primary invasive H. influenzae infection, although the mechanism of increased risk and the age of increased susceptibility are not known. Three prospective studies estimated the risk of subsequent or secondary infections as significantly lower than that observed in age-susceptible household contacts; a retrospective analysis suggested a different conclusion. Asymptomatic carriage rates of H. influenzae type b in day care centers vary widely. A retrospective analysis suggested that the administration of rifampin might have prevented subsequent infections in day care contacts; prospective studies are necessary to convincingly demonstrate the efficacy of rifampin prophylaxis among day care contacts. Acquisition of H. influenzae type b carriage has occurred even among those previously treated with rifampin. Until further data are available, rifampin prophylaxis is usually reserved for use in those facilities in which two or more cases of invasive disease have occurred within 60 days. The impact of the H. influenzae type b capsular polysaccharide vaccine on the epidemiology of disease in day care facilities is not known. However, because the immunogenicity and protective efficacy of the H. influenzae capsular polysaccharide vaccine are strikingly age-related, we recommend immunizing children in day care at 24 months. PMID- 3529313 TI - Vaccine-preventable diseases and child day care. AB - Several diseases that now can be prevented by vaccines (diphtheria, measles, mumps, poliomyelitis, and rubella) have historically been widely transmitted in settings where children first congregate--primarily schools. Increasingly, children are brought together at younger ages in day care centers, and instances of these diseases have been recorded in day care settings. However, there have been few major outbreaks because of high immunization levels in these children. In 46 states, laws require immunization of children attending licensed day care facilities. Surveys show that children in day care have higher immunization levels than children of the same age who are not in day care. Because staff in day care can acquire and transmit communicable diseases, it is important that they also be immune. PMID- 3529314 TI - Surveillance of communicable diseases in child day care settings. AB - Surveillance of child day care-related infections (DCRI) is relatively new and methods are evolving. The objectives of surveillance for DCRI include evaluating the occurrence of DCRI; defining epidemiologic features and risk factors for DCRI; identifying practices resulting in transmission of DCRI; providing data and direction for education and training; promoting the efficacy of disease prevention and control programs; providing reassurance to counselors, employees, and the community; and meeting requirements of regulatory and accrediting agencies. An overview is presented of the process and of mechanisms suggested for implementation. The process includes defining the infections, identifying resources, establishing methods for conducting continuous surveillance, consolidating and tabulating data, reviewing and analyzing data, reporting disease and disseminating data, and reinforcing policies for staff and parents. An effective system is one that is applied consistently, is based in large part on common sense and simplicity, and enhances communication among child day care providers, children, parents, and public and private health care personnel. PMID- 3529316 TI - The unresolved child care dilemma: care for the acutely ill child. AB - The frequency of childhood illness, the exclusion practices of most licensed child care programs, and the limited sick leave policies of many employers all combine to create a particularly difficult dilemma for the working parent. A comprehensive solution to the problem of caring for the sick child must be tackled on three primary fronts: provision of expanded sick leave benefits and/or greater flexibility in the performance of job duties to enable working parents to care for children's illnesses without jeopardy to employment; development of clear regulatory guidelines and supplemental resources to enable care givers to accommodate a mildly ill child in the child's usual child care setting; replication of successful model programs, partially underwritten by public and/or private support, to assist parents with the costs of backup arrangements for the care of sick children when needed. PMID- 3529315 TI - Policies for the exclusion of ill children from group day care: an unresolved dilemma. AB - Although the problem of how to manage children with mild infectious illnesses who attend group day care programs arises often, appropriate criteria for the exclusion of ill children have not been determined. Substantial variation in the policies of different programs for excluding ill children exists. Studies of the epidemiology of common infectious illnesses indicate that asymptomatic children may transmit infections and that symptomatic children often shed infectious particles both before the onset and after the resolution of symptoms. The little information that is available supports the contention that the exclusion of mildly ill children has little effect on the incidence of infections among children who attend group day care programs. Consequently, policies for exclusion should focus on the needs and behavior of the ill child rather than on easily measured but less germane factors such as the child's body temperature. If the facilities and staff available are adequate to meet the needs of both the ill child and other children in the group, it is appropriate to allow children with mild infectious illnesses to attend group day care programs. PMID- 3529317 TI - Training for child day care staff and for licensing and regulatory personnel in the prevention of infectious disease transmission. AB - Recognition of the importance of preventing disease transmission in day care facilities has increased as more mothers of infants join the work force and as evidence of the spread of disease in day care mounts; the effectiveness of licensing agencies has eroded with the shrinking of resources, and limited compliance with current standards exists. Both the staff of child day care facilities and the personnel who are responsible for licensing and regulating such facilities require ongoing training in issues of health promotion and disease prevention. The curriculum of all training programs should include, in addition to child development, topics of general health and safety, such as safety hazards and the risk of infection, knowledge of the infectious diseases likely to be encountered in day care, the use of routine screening tests, the principles of good nutrition, the components of routine health assessment, and the special concerns of disabled, abused, and neglected children. Health professionals in the community and licensing personnel should function as channels for the dissemination of new information as it becomes available; inspection of facilities for the purpose of licensing provides an excellent opportunity for training staff. Monitoring has been found to heighten awareness and improve performance. Employees' compliance with regulations has been shown to increase when staff members are trained as advocates of health. PMID- 3529318 TI - Day care homes: the "silent majority" of child day care. AB - Family day care--child day care provided in a private home other than the child's own--includes more children than any other mode of day care in the United States. Day care homes have traditionally cared for a large proportion of younger children, particularly infants and toddlers, who are most likely to contract and spread infectious diseases. The majority of homes are run on an informal basis and are neither licensed nor registered; a small minority of homes are regulated or operated under sponsorship of an umbrella agency. Homes generally have fewer children than do day care centers, and when children of different ages are cared for, they usually mix freely. Care givers in homes, especially in those that are not registered, are unlikely to have had child care-specific training. Parent fees in homes and centers appear roughly comparable, with fees in nonregulated homes generally lower than those in regulated or sponsored homes. It is difficult to compare the actual costs of child care in these settings. Results of the small number of studies comparing the occurrence of infectious diseases among children in day care centers, day care homes, and at home suggest that the rates of some infections may be lower in day care homes than in centers; this effect may vary by age and infections. Because of the large population of young ages of children involved in family day care, additional study and recommendations regarding infections in this setting are needed. PMID- 3529319 TI - Evaluation of new beta-lactam antibiotics. PMID- 3529320 TI - beta-Lactam antibiotics: structural relationships affecting in vitro activity and pharmacologic properties. AB - The essential nucleus of beta-lactam antibiotics is the four-membered ring, which can exist fused to form bicyclic ring structures or with moieties alone affixed to the four atoms. Penicillins, penems, carbapenems, and clavams have asymmetric centers at C-5 and C-6; cephalosporins and oxacephems have asymmetric centers at C-6 and C-7. Penicillins, cephalosporins, and monobactams require a beta acylamino group for antimicrobial activity. Cephalosporins can undergo modification at C-3 and C-7 in both the alpha and beta position. Sulfur can be replaced with oxygen to achieve a more reactive nucleus. The most useful 7-beta acylamino groups have been a 2-aminothiazolyl and an iminomethoxy or carboxypropyl group. Substitutions on the 7-alpha position increase beta lactamase stability but decrease activity against staphylococci and Streptococcus pneumoniae. C-3 substitutions, particularly pyridinium groups, increase activity against Pseudomonas aeruginosa and Staphylococcus aureus. Carbapenems possess 6 alkyl substitutions in a trans configuration and inhibit aerobic, anaerobic gram positive, and gram-negative bacteria. Monobactams are activated by sulfonic, phosphoric, or carboxyl groups, and their properties are related to the C-3-acyl side chain and their beta-lactamase stability to the C-4 grouping. beta-Lactamase inhibitors acylated by beta-lactamases can be penicillanic acid derivatives or clavulanates. PMID- 3529321 TI - Phenotypic tolerance: the search for beta-lactam antibiotics that kill nongrowing bacteria. AB - beta-Lactam antibiotics rapidly kill bacteria during logarithmic growth but fail to kill nongrowing cells. This trait is the most universal example of phenotypic tolerance (the ability of bacteria to evade the bactericidal activity of antibiotics). Both nongrowing and slowly growing bacteria are found very frequently during infection in vivo, and phenotypic tolerance to the bactericidal activity of antibiotics as a consequence of reduced growth rate can be detected in vivo. With the use of an in vitro model system of nongrowing bacteria, a select group of beta-lactam antibiotics has been found that demonstrates a striking and unusual ability to kill nongrowing bacteria despite phenotypic tolerance to conventional beta-lactam antibiotics. These same compounds also effectively kill phenotypically tolerant cells in cerebrospinal fluid and serum. The extension of bactericidal activity to nongrowing and slowly growing bacteria may be a major advance in efforts to improve the chemotherapy for infectious diseases. PMID- 3529323 TI - Interaction between beta-lactam and other antibiotics. AB - The use of antibiotic combinations remains a necessity in certain clinical circumstances but must be approached with care since the drugs combined may prove antagonistic rather than synergistic. A variety of methods involving different principles are used for the evaluation of drug interactions in vitro; each technique has clear advantages and disadvantages. Information from the literature implies that there is generally a reasonable concordance between in vitro and in vivo results with drug combinations but that discordant results are not uncommon. More specifically, in vitro synergy does not always ensure a successful clinical outcome, but lack of synergy often correlates well with a high rate of therapy failure. A greater knowledge of the mechanisms underlying antibiotic interactions should improve the accuracy of predictions about the in vivo usefulness and safety of drug combinations. PMID- 3529322 TI - Contribution of chromosomal beta-lactamases to beta-lactam resistance in enterobacteria. AB - The two most important factors determining the level of beta-lactam resistance to novel cephalosporins in gram-negative enterobacteria are the chromosomal class C beta-lactamases, which have high affinity for these compounds, and the outer membrane permeability barrier. The individual importance of these factors and the interactions between them are discussed. Wild-type strains carry a chromosomal gene, ampC, encoding class C beta-lactamases. Expression from this gene is normally low, but it can in some species be induced by beta-lactam agents and related compounds. The current knowledge on the molecular mechanism governing both inducible and constitutive beta-lactamase synthesis is reviewed. Insight into these mechanisms explains why mutations leading to high-level enzyme over production and beta-lactam resistance are much more frequent in species with a normally inducible beta-lactamase gene than in other gram-negative bacteria. PMID- 3529324 TI - Limitations of animal models in predicting beta-lactam efficacy for endocarditis and meningitis. AB - Animal models are important in predicting the efficacy in humans of antimicrobial agents for various disease conditions, including endocarditis and meningitis. Screening models are useful in assessing antibiotic effectiveness and toxicity; their advantages include simplicity, a reproducible course of infection, a well defined therapeutic end point, and low cost. However, the inoculum size, the virulence of the organism, and the production of beta-lactamases can have important effects on outcome and must be considered in the interpretation of data obtained from such models. Discriminative models are those designed to mimic human disease as closely as possible with respect to infectious inoculum, host response, and course of disease. Each drug's pharmacokinetics must be carefully documented before being extrapolated to humans. Rigid criteria must be established to minimize misinterpretation of results from animal studies before conclusions from in vivo animal models are applied to human disease. PMID- 3529325 TI - Methods for evaluating the penetration of beta-lactam antibiotics into tissues. AB - Methods for the study of tissue penetration by beta-lactam antibiotics have been critiqued and compared. Mathematical models may be useful in assessments of the influence of lipid solubility and protein binding on tissue penetration. In vitro models may be used for evaluation of the probable pharmacokinetic properties of beta-lactams but are of greater use in studies of the interaction between antimicrobial concentrations and the kinetics of bacterial killing. Numerous animal models have been used. Fibrin clots, intraperitoneal cages, and soft tissue models all tend to yield limited information on tissue penetration as they often have no pathophysiologic counterpart in humans. Three types of studies in humans--tissue homogenates, body fluids, and experimental fluids--all entail certain advantages and problems. Tissue homogenates are often contaminated with body fluids, such as urine and bile. The usefulness of drug assays in ascitic or pleural fluid is limited by the depot effect. Studies of experimental fluids (e.g., fluid from blisters induced chemically or by suction) may have some clinical relevance and yield consistent results. PMID- 3529326 TI - Studies of beta-lactam antibiotics in systemic infections: some personal observations over 25 years. AB - In this paper the problems associated with clinical trials of beta-lactam antibiotics based on 25 years of personal experience are discussed. Clinical trials in patients with uncomplicated urinary tract infections are relatively simple to conduct, but the interpretation of trials in patients with life threatening infections such as endocarditis can be extremely difficult. Open, noncontrolled studies are necessary for the initial evaluation of an antibiotic, but comparative trials with other agents are essential for determining the indications for the use of new chemotherapeutic agents in the treatment of specific infections. Clinical evaluation of new antimicrobial agents must include pharmacologic and toxicologic studies, and trial protocols should be designed so as to obtain as much information as is practical about the absorption, distribution, and excretion of antibiotics in patients and also to determine the incidence and nature of adverse reactions. The problems associated with undertaking clinical trials in specific infections are discussed. PMID- 3529327 TI - Problems of studying infections in the compromised host. AB - Although large numbers of patients have been enrolled in studies of the efficacy and safety of new antimicrobial agents in immunocompromised hosts, many variables other than number affect the outcome and interpretation of therapeutic and prophylactic trials. Most therapeutic studies, even of a comparative nature, show relatively few differences in the outcome of treatment of staphylococcal and gram negative bacillary infections. A major problem has been the accrual of large numbers of cases of proven infection. In the future, clinical studies should concentrate on proven infections due to the more problematic organisms, such as Pseudomonas, Serratia, and Enterobacter species, which are often associated with clinical failure and emergence of high-level resistance. Comparisons of cost effectiveness of regimens and duration of survival of the cohorts treated in randomized studies should be made. The desirability of large or multicenter therapeutic studies seems obvious, but there is room for improvement in the design and execution of such studies. PMID- 3529328 TI - Problems in evaluation of adverse reactions to beta-lactam antibiotics. AB - Despite their high degree of safety, beta-lactam agents cause adverse reactions. This article deals with the types of adverse reactions to various beta-lactam agents that have been reported and, especially, with the difficulties involved in monitoring and evaluating these reactions. Comparisons of the results of studies of the same drug carried out in various countries show striking differences in the incidence of adverse effects reported. A reason for this variation is the lack of strict definitions of the events that should be regarded as adverse effects. Only rarely are all the unexpected events occurring in patients in clinical studies reported, but the investigators are allowed to make subjective judgments about which reactions are related to the drug tested and are thus reportable. With such procedures there is an inherent risk of overlooking unexpected adverse effects. Also, in the analysis of laboratory adverse reactions the rule that "one finds what one looks for" applies. It seems obvious that if stricter rules for registration of adverse effects had been applied, the toxic effects of various beta-lactams, such as the nephrotoxicity of cephaloridine and the coagulopathies associated with moxalactam, would have been detected much earlier. PMID- 3529329 TI - [Pulmonary arterial hypertension and chronic obstructive bronchopneumopathy]. AB - Sooner or later, chronic obstructive lung disease becomes complicated with pulmonary arterial hypertension, largely responsible for chronic cor pulmonale. Its principal cause is an increase in pulmonary resistance due to chronic hypoxia. There is no non-invasive method that can be used to measure pulmonary arterial pressure (PAP) with accuracy. In the course of chronic obstructive lung disease PAP increases slowly, by about 0.5 to 0.6 mmHg per year. As mortality factor, it is the second major variable after FEV1. The usefulness of specific vasodilators has not yet been demonstrated. PMID- 3529331 TI - [Continuing education]. PMID- 3529330 TI - [100 years after the discovery of metachromatic corpuscles by Babes, an important dimension of the scientific creativity of the great Romanian scientist]. PMID- 3529332 TI - [Addresses of educational organizations]. PMID- 3529333 TI - Kulzer's Silicoater: a new technique for bonding methacrylates to metal. Part II. PMID- 3529334 TI - Food fads. PMID- 3529335 TI - James Parkinson's shaking palsy. PMID- 3529337 TI - Canine leishmaniasis in the Isle of Elba, Italy. AB - The recent occurrence of infantile cases of visceral leishmaniasis in the Isle of Elba, Italy, has stimulated research on the prevalence of Leishmania infection in dogs. Out of 3,000 dogs present in the island 914 were examined through immunofluorescent antibody test (IFAT) and 175 of them (19.1%) were found positive. 100% parasitological confirmation through isolation of parasite was obtained in a sample of 38 IFAT-positive dogs. The distribution of positive dogs in the island showed to be non-uniform, the frequencies of infection ranging from 2.5% to 39.6% according to communes. The causes of this distribution and its relationship with the human visceral leishmaniasis cases are discussed. PMID- 3529336 TI - Measurement of serum DNA binding in chronic active hepatitis and systemic lupus erythematosus using the Farr assay. AB - Antibodies to double-stranded DNA (dsDNA), generally regarded as highly specific for systemic lupus erythematosus (SLE), have also been reported in chronic active hepatitis (CAH). Using the Farr assay and E. coli DNA, fractionated by benzoylated-naphthoylated-DEAE cellulose chromatography into dsDNA and dsDNA containing single-stranded regions, we compared the serum DNA binding of CAH and SLE patients. Although CAH sera were found to have dsDNA binding significantly above the normal control group such binding was of low level and we could find no evidence of markedly elevated dsDNA binding in CAH. However 12 of the 20 CAH sera studied did bind preferentially to dsDNA containing single-stranded regions suggesting the presence of anti-single-stranded DNA antibodies. We conclude that the description of elevated anti-dsDNA antibodies, as measured by the Farr assay, in CAH is due to the interaction of anti-single-stranded DNA antibodies or other serum components with single-stranded DNA contaminating dsDNA preparations. PMID- 3529338 TI - Differential recognition patterns of human immunoglobulin classes to antigens of Onchocerca gibsoni. AB - Adult Onchocerca gibsoni worms were fractionated into a surface-enriched fraction, a saline extract, a saline insoluble-detergent soluble fraction and a total glycoproteins extract. The antigens in each fractions were separated by electrophoresis in polyacrylamide gels and examined with an immuno-blot technique for reactive antibodies in sera from individuals infected with a variety of filarial and non-filarial nematode worms. Radiolabelled monoclonal antibodies were used to determine the Ig heavy chain isotypes. A number of antigens were demonstrated in all of the extracts, with many antigens of each extract being unique. Although some Onchocerca antigens stimulated antibodies of all human immunoglobulin classes, the panel of antigens recognized by each Ig isotype was different. The IgE response was restricted and directed at antigens not recognized by antibodies to other nematode parasites. IgM and IgA responses tended to recognize many antigens, whilst IgG responses were directed at intermediate numbers of antigens. The control of isotype balance to individual parasite antigens is thus independently regulated. This survey provides a rational basis for the exploration of Onchocerca antigen-human antibody class systems with relevance for diagnosis, protection and pathology. PMID- 3529339 TI - Isoenzymes of South American Paragonimus peruvianus and P. ecuadoriensis. AB - The characterization of adult Paragonimus peruvianus by isoenzyme electrophoresis of four enzymes, a peptidase, alanine aminotransferase, glucosephosphate isomerase and glucose 6-phosphate dehydrogenase revealed a complete identity of all six individuals examined. Electrophoretic patterns of eight Paragonimus ecuadoriensis showed uniformity concerning the same enzymes. Both species compared were monomorphous with respect to three enzymes and could only be separated by the peptidase. The close relationship, already established by morphology, between adults of P. peruvianus is therefore supported. PMID- 3529340 TI - Detection of pancreas pretumoral stage by means of organ transplantation. AB - Syrian golden hamsters were treated at monthly intervals for three months with N nitrosobis (2-oxopropyl) amine (BOP) at doses of 20 mg/kg. During the treatment program individual pancreases were analysed by histology and transplanted into syngeneic recipients. Within the first 20 weeks following BOP administration, only a few alterations in the acinar cells were detected histologically. Nevertheless, pancreases taken as early as 10 weeks following the initiation of the chemical treatment produced local tumors at the site of subcutaneous implantation. Tumors thus obtained by graft were noted to be carcinomas of ductal type. Organ transplantation was thus observed to be a good method of detecting early neoplastic transformations in the pancreas which were not seen by conventional histology. PMID- 3529341 TI - [Radiologic diagnosis of thoracic outlet syndrome and its vascular complications]. AB - The term "Thoracic Outlet Syndrome" (TOS) applies to all neurological and vascular symptoms caused by compression of the nerves and vessels situated in the outlet (inlet) of the thorax and the costoclavicular area. The clinical and radiological results of 20 patients with acquired and congenital TOS are presented and the relevant literature is reviewed. The different radiological findings of plain chest X-ray, phlebography, intravenous DSA and arteriography are demonstrated with special emphasis on the vascular complications of TOS. PMID- 3529342 TI - Vascular complications of the transplanted kidney--angiographic study. AB - The applied angiographic examination technique of the renal homotransplants performed during a 14-year period has been reported. 101 patients underwent 132 angiographic examinations in the course of 1971-1985. Thirty-two various vascular complications were diagnosed. Arterial stenoses during anastomoses were most frequent. Thromboembolic complications were second (4 arterial, 2 venous). One thrombosis of the iliac artery as a consequence of a wound infection following renal transplantation is described. In addition there were a few other single pseudoaneurysms of the arterial anastomoses and arteriovenous fistulas subsequent to renal biopsies. The importance of this examination technique and the diagnostic use of angiographic investigation of the transplanted kidney is pointed out. PMID- 3529343 TI - [Diagnosis of pheochromocytoma in childhood--case report]. AB - The pattern of phaeochromocytomas and paragangliomas, catecholamine-secreting tumours, is typical. Elevated levels of catecholamines or their metabolites in urine or blood are confirmed by chemical tests. Radiographic evaluation of phaeochromocytoma by sonography, computed tomography and scintigraphy is performed primarily for the purpose of localisation prior to surgery. PMID- 3529344 TI - [Caroli syndrome]. AB - In 1958 Caroli described the syndrome of congenital, either segmental or involving the entire bile duct system, saccular extensions of the intrahepatic bile ducts. He differentiated between two types of this disease pattern. The first form concerns pure cystic dilatations of the intrahepatic bile ducts, whereas the second one is combined with hepatic fibrosis and portal hypertension. Both types are characterised by cystic dilatations in the kidneys and in the extrahepatic bile ducts, pancreas and spleen. PMID- 3529345 TI - [Angiomorphology of arteriosclerotic changes in the area of the carotid bifurcation]. AB - 100 intravenous digital subtraction angiograms of bifurcations were compared to one hundred plain film arteriograms. Both types of examinations were of excellent image quality. Arteriosclerotic lesions in the posterior circumference of the internal carotid artery were found in 55% plain film angiograms and in 49% of intravenous DSA examinations. Plain film angiography was significantly more accurate in the evaluation of arteriosclerotic ulcerations than i.v. DSA. The total amounts of arteriosclerotic stenoses with a smooth or rough surface were equal with both methods. The interindividual comparative study demonstrated that in respect of diagnosis of ulcerative lesions, i.v.. DSA is inferior to plain film angiography, even if an excellent image quality for all projections is achieved in i.v. DSA. PMID- 3529346 TI - [Diagnosis of (intra)-cystic breast cancer]. AB - Besides the known intracystic carcinoma of the breast there are also other cystic tumour types such as, for example, the cystically necrotized carcinoma of the mamma. Preoperative diagnosis of these tumours is effected via pneumocystography and aspiration cytology if mammography alone does not yet permit a definitive assessment of the tumour status. If sonography is used as the only additional examination, diagnostic errors are likely to happen. The well-known recommendation according to which sonographically identified ("simple") cysts can be left as they are, deserves further discussion under this aspect. The problems associated with histological classification and preoperative diagnosis are discussed taking five cystic carcinomas of the breast as basis. PMID- 3529347 TI - Sensitivity of ultrasonography for detecting gallstones. AB - Previous studies have overestimated the accuracy of ultrasonography for the diagnosis of gallstones by neglecting the systematic checking of false negative findings. In the present series only 80% of 331 cases of gallstones seen at autopsy had been detected by ultrasonography. The most frequent reason for a false negative finding was the small size of the gallstones. PMID- 3529348 TI - [Value of sonography following pancreas transplantation]. AB - The authors report on 15 patients with pancreas transplants hospitalised at their clinic and treated appropriately between 1979 and 1984. Nine of these patients were subjected to control sonography directly after the operation and subsequently once weekly. The sonographic findings were compared with laboratory data and the clinical course of the patients' condition. One woman patient was subjected to control via CT. The clinical findings agreed with the laboratory values and the sonographic results. Hence, sonography after pancreas transplantation is an important "must". However, it is imperative to combine this with suitable laboratory tests and with a close watch on the clinical course in order to arrive at a relevant conclusion. PMID- 3529349 TI - [Vacations, travel and physical exercise in the life of the diabetic]. PMID- 3529351 TI - Hydroxyproline/creatinine ratios as estimates of bone resorption in early postmenopausal women. Fasting and 24-h urine samples compared. AB - Ratio of urinary hydroxyproline/creatinine excretion is often used as an index of bone resorption. To establish the difference between the fasting urinary content (FU-HPR/CR) and the 24-h urinary excretion (24 h-U-HPR/CR) we determined hydroxyproline and creatinine in specimens from a group of early postmenopausal women. One hundred and eighty-six early postmenopausal women were randomized into 10 groups receiving various doses of sequential female sex hormones and/or 1,25(OH)2D3, 0.25 microgram per day, or placebo. In all groups there were parallel changes of FU-HPR/CR and 24 h-U-HPR/CR, and in all groups treated with oestrogens the values decreased significantly. The changes in FU-HPR/CR were more pronounced than in the 24-h-U-HPR/CR, which indicates that FU-HPR/CR is a more sensitive marker of changes in bone resorption. The strong correlation between the mean values of 24-h-U-HPR/CR and those of FU-HPR/CR suggests that both methods are convenient for evaluating changes during long-term studies in groups of patients. The correlation on an individual basis is weak. The substantial intraindividual variation in 24-h-U-HPR/CR, (34.6%) indicates that FU-HPR/CR (CV = 17.0%) is the more valid variable for individual patients. PMID- 3529352 TI - Lipoprotein changes during continuous subcutaneous insulin infusion in insulin dependent diabetic patients. AB - We have studied the long-term effects (9 months) in plasma lipoprotein concentrations during continuous subcutaneous insulin infusion (CSII) (n = 11, six females, five males) and compared these changes to conventional insulin therapy (CIT) (n = 12, six females, six males). The two groups were allocated to CSII or CIT randomly, and were comparable as regards lipoprotein values at the start of the study. There were initially normal total plasma cholesterol values in both groups (CSII group: mean plasma cholesterol 3.77 +/- 0.57 mmol/l, CIT group: mean plasma cholesterol 4.37 +/- 0.55 mmol/l, means +/- SD). Further, there were normal total plasma triglyceride values at the start of the study (CSII group: mean plasma triglyceride 0.86 +/- 0.23 mmol/l, CIT group: mean plasma triglyceride 0.84 +/- 0.26 mmol/l, means +/- SD). There were no alterations seen in total plasma cholesterol and total plasma triglyceride in either groups during a 9 months observation period. In the same period no changes in LDL and HDL levels were registered. The very low density lipoprotein (VLDL) was separated into VLDL-1 and VLDL-2 by its binding to heparin-sepharose columns. It was found that CSII treatment for 9 months resulted in a decline in VLDL-2 triglyceride values (0.18 +/- 0.07 mmol/l before versus 0.10 +/- 0.07 mmol/l after, p less than 0.05, means +/- SD) which was not seen in the CIT group. Decline in VLDL-2-triglyceride might delay the development of late diabetic manifestations. PMID- 3529350 TI - Post-renal-transplant hypertension. Urine volume, free water clearance and plasma concentrations of arginine vasopressin, angiotensin II and aldosterone before and after oral water loading in hypertensive and normotensive renal transplant recipients. AB - Urine volume (V), free water clearance (CH2O) and plasma concentrations of arginine vasopressin (AVP), angiotensin II (A II) and aldosterone (Aldo) were determined before and three times during the first 5 h after an oral water load of 20 ml/kg body wt in 19 patients with post-renal-transplant hypertension (group I), in 13 normotensive renal transplant recipients (group II) and in 20 control subjects (group III). Both V and CH2O increased significantly in all groups, but considerably less in groups I and II than in group III. When CH2O was related to glomerular filtration rate no differences existed between patients and control subjects. Basal AVP was the same in groups I (3.3 pmol/l, median) and II (3.0 pmol/l), but significantly (p less than 0.01) higher than in group III (1.9 pmol/l). Basal A II was significantly (p less than 0.01) elevated in group I (18 pmol/l) when compared to both groups II (10 pmol/l) and III (11 pmol/l), and the level was independent of the presence of native kidneys. Basal Aldo was the same in all groups. During loading, AVP was reduced in all groups, A II was almost unchanged, and Aldo was increased in groups I and II and reduced in group III depending on alterations in serum potassium. Thus urinary diluting ability is reduced in renal transplant recipients due to a reduced glomerular filtration rate. The enhanced A II in hypertensive renal transplant recipients gives further evidence for the point of view that hypertension is angiotensin-dependent in most of these patients. PMID- 3529353 TI - Clinical registration of charge transfer between dental metallic materials in patients with disorders and/or discomfort allegedly caused by corrosion. AB - Thirty referred patients and 15 control subjects were investigated with reference to the occurrence of bimetallic corrosion in the oral cavity. No differences between patients and controls could be found regarding the registered charge transfer between dissimilar short-circuited dental metallic restorations and/or appliances. However, a relatively large number of periodontal and mucous membrane affections, carious lesions and stomatognathic and/or temporomandibular joint disturbances were found within the patient group. PMID- 3529354 TI - The 'endocrine' enzyme secretion from the pancreas. PMID- 3529355 TI - Effect of acute portal hypertension on hepatosplanchnic hemodynamics and liver function. AB - Acute prehepatic portal hypertension was mechanically induced in Gottingen minipigs. A 125% increase in portal pressure resulted in a significant decrease in estimated hepatic blood flow. The decrease in blood flow was accompanied by a 25% reduction in the 'true' clearance of indocyanine green and an 18% decrease in splanchnic oxygen consumption. Judged from the splanchnic elimination rate of galactose, the functional liver cell mass was not altered by portal banding, and an unaltered lactate to pyruvate ratio in hepatic venous blood indicated that no functional parts of the liver became severely hypoxic. PMID- 3529356 TI - Ultrasonography in asymptomatic patients with abnormal biochemical liver tests. AB - A substantial number of patients referred for ultrasound examination of the liver, biliary tract, and pancreas are asymptomatic but have abnormal biochemical liver test results. Retrospective evaluations were made of abdominal ultrasonographies in 286 such patients (159 men and 127 women). Normal studies were found in 104 of the men (65%) and 78 of the women (61%). Cholecystolithiasis with or without chronic cholecystitis was found in 24 of the men (15%) and 36 of the women (28%); diffuse liver parenchyma disease was found in 21 of the men (13%) and 7 of the women (6%). Other significant abnormalities were chronic pancreatitis (3), carcinoma of the gallbladder (2), liver metastasis (2), hepatocellular carcinoma (1), lymphoma (1), and ampullary carcinoma (1). Ultrasonography is a suitable technique for evaluation of asymptomatic patients with abnormal biochemical liver test results, and we have adopted it as the method of choice in this setting. PMID- 3529357 TI - The effect of glucagon, glucagon-(1-21)-peptide, and placebo on duodenal pressure activity in healthy subjects. AB - The effects of glucagon and the glucagon-(1-21)-peptide on the duodenal pressure activity in 12 healthy subjects were studied and compared with those of placebo. A 1-mg bolus injection of either glucagon or glucagon-(1-21)-peptide was given at the end of the first interdigestive migrating complex, followed by intravenous infusion of 2 mg of each drug during the subsequent 2 h. Both glucagon and glucagon-(1-21)-peptide caused significant change (p less than 0.05) in the duodenal pressure activity, as the length of the cycle was significantly increased and the migrating motor complexes were significantly reduced. The frequency of side effects and the degree of discomfort during the recordings were significantly higher (p less than 0.01) in the glucagon period than in both the glucagon-(1-21)-peptide and the placebo periods. No differences in side effects and discomfort between glucagon-(1-21)-peptide and placebo were detected. Glucagon caused a significant increase in both serum glucose and insulin levels (p less than 0.01). PMID- 3529358 TI - A new approach in carcinoembryonic antigen-guided follow-up of large-bowel carcinoma patients. PMID- 3529359 TI - Activities of ethanol-metabolizing enzymes in liver diseases. AB - The activities of hepatic alcohol (ADH), aldehyde (ALDH), and lactate dehydrogenases were measured in 69 patients with various liver diseases (15 controls, 20 with alcoholic and 8 with non-alcoholic fatty liver, 13 with alcoholic cirrhosis, 2 with alcoholic hepatitis, 3 with cryptogenic and 3 with primary biliary cirrhosis, and 5 with acute or chronic hepatitis). The specific activities of all these enzymes were decreased in both alcoholic and non alcoholic liver diseases. The activities of ADH and low-Km ALDH were significantly decreased both in alcoholic (ADH, 7.22 mU/mg protein, p less than 0.001; low-Km ALDH, 5.00 mU/mg protein, p less than 0.001) and in other liver diseases (ADH, 10.70 mU/mg protein, p less than 0.001; low-Km ALDH, 6.80 mU/mg protein, p less than 0.005) when compared with controls (ADH, 20.87 mU/mg protein; low-Km ALDH, 14.41 mU/mg protein). The hepatic protein content was significantly (p less than 0.001) increased in alcoholic fatty degeneration but not in alcoholic cirrhosis or other liver diseases. The results suggest that in man alcohol- and acetaldehyde-metabolizing enzymes are not induced by chronic alcohol consumption. On the contrary, the hepatic activities of these enzymes appeared to be lower in alcoholic than in non-alcoholic liver diseases. Consequently, in addition to liver injury alcohol may also directly affect the synthesis or breakdown of alcohol-metabolizing enzymes. PMID- 3529360 TI - 1- and 4-week cimetidine treatment for duodenal ulcer. AB - Forty-eight patients with symptomatic duodenal ulcer were randomized to 4 weeks' treatment with cimetidine, 1 g/day (C4), or 1 week of cimetidine treatment followed by 3 weeks of placebo (C1 + P). The study was performed double blind. The symptoms were recorded daily on a visual analogue scale. Endoscopy was performed after 4 weeks. Two patients receiving C1 + P dropped out during the 2nd week because of worsening symptoms. With the two dropouts being recorded as 'unhealed ulcers', the 4-week healing rates were 16 of 24 (67%) and 15 of 24 (63%), with C4 and C1 + P, respectively (p greater than 0.05). Even without including the two dropouts, the patients treated with C1 + P had significantly more symptoms during the 2nd and 3rd treatment week than those treated with C4. The present study indicates that 1 week of cimetidine treatment is not sufficient in patients with duodenal ulcer. PMID- 3529361 TI - The composition of diet in conjunction with chronic ethanol consumption alters plasma proteinase inhibitor levels in rats. AB - To study the effects of dietary composition and chronic ethanol ingestion on plasma proteinase inhibitor (PI) levels in intact animals, 192 male Wistar rats were divided into 4 groups, which received a standard diet (S), a fat-rich diet (F), a protein-rich diet (P), and a carbohydrate-rich diet (C), respectively, for 12 weeks. Half of the animals in each diet group had 15% ethanol as their drinking solution (A) during this diet period, and the rest drank tap water (W). FW and CW diets caused a significant decrease in the trypsin-inhibiting capacity (TIC) of plasma in comparison with the SW group (p less than 0.05 and p less than 0.001, respectively), and chronic ethanol ingestion in combination with P and C diets decreased plasma TIC levels significantly (p less than 0.01 and p less than 0.001) when compared with the corresponding water-drinking groups. The chymotrypsin-inhibiting capacity (CIC) of plasma behaved differently: in the FW, PW, and CW groups it was significantly higher than in the SW group (p less than 0.001). Chronic ethanol ingestion did not change plasma CIC levels significantly when compared with the corresponding water-receiving groups. In conclusion, dietary intake was found to alter plasma PI levels. Changes in the protein synthesis of the liver might be responsible for these alterations. PMID- 3529362 TI - The effect of ranitidine on the gastroduodenal motility as determined by the maximal pressure periods. AB - Twenty healthy subjects with a mean age of 23.5 years were studied. Identically appearing tablets of 150 mg ranitidine or placebo were given to each subject twice daily for 2 days. After an overnight fast the same dosage of tablets was given 2 h before introduction of two fiberoptic transducers, the tips of which were localized to the mid-portion of the gastric antrum and the upper third of the duodenum. The double-blind crossover study showed in the placebo period a mean duration of the maximal pressure periods (MPP) of 5.5 min in the duodenum and 3.5 min in the antrum of the stomach. The cyclic length (CL) and the cyclic displacement (CD) in the duodenum were 58 min and 67 mm/min, respectively. After ranitidine the duration of the MPP was significantly longer. The CL was also longer in the duodenum, whereas the CD was shortened, indicating a reduction of the wave movements from the stomach antrum to the duodenum in the ranitidine periods. PMID- 3529363 TI - Insulin-mediated glucose metabolism is related to liver structure and microsomal function. AB - The role of the liver in glucose metabolism was investigated in 24 consecutive patients undergoing diagnostic liver biopsy by comparing hepatic morphometry and microsomal enzyme activity in vivo (antipyrine) with fasting blood glucose (BG) and immunoreactive insulin (IRI) levels and with the metabolic clearance rate of insulin and the insulin sensitivity index. The patients had elevated BG and IRI levels and reduced insulin-mediated glucose metabolism, insulin sensitivity index, and microsomal enzyme activity as compared with controls. The insulin metabolic clearance rate did not diverge among the groups. Patients with fatty liver had a high BG associated with a reduced glucose disposal rate, whereas fasting IRI did not diverge when compared with other liver patients. Glucose disposal rate was related to the amount of unaltered liver (r2 = 0.640; p less than 0.001) and antipyrine metabolism (r = 0.631; p less than 0.01) and inversely related to the amount of fat (r2 = 0.585; p less than 0.01). The findings demonstrate that insulin-mediated glucose metabolism is related to liver structure and microsomal function. Accumulation of fat in the liver seems to be a major factor associated with reduced insulin sensitivity and glucose tolerance. PMID- 3529364 TI - Myelopeptides--bone marrow mediators with immunostimulating and endorphin-like activity. AB - Bone marrow cells produce soluble mediators with structural and functional heterogeneity. They were found to stimulate antibody production at the peak of the immune response, owing to compounds of a peptide nature (Mr 2000-1300). Active material was isolated by means of gel chromatography and electrophoresis. This material positively reacts with ninhydrin, and has maximum absorption close to 278 nm. Its antibody-stimulating activity decreased or stopped completely after treatment with proteolytic enzymes. Apart from the immunostimulating activity, bone marrow mediators have opiate-like activity. They have an analgetic effect, and interact with the opiate receptors of brain nerve cells. After a physicochemical and functional analysis, we conclude that bone marrow produces regulatory peptides that were previously unknown. We called them myelopeptides. PMID- 3529365 TI - Antibodies to Escherichia coli and anti-adhesive activity in paired serum, hepatic and gall bladder bile samples. AB - Human bile contains a mixture of immunoglobulins excreted through the liver and produced in the biliary tract. This study examines the specific antibody activity of the biliary immunoglobulins against Escherichia coli antigens. Paired samples of serum, hepatic bile, and gall bladder bile were obtained from 23 patients with gallstones and five patients with healthy gall bladders. Antibody activity against E. coli antigens was found in all the sera and most of the bile samples. The levels of IgA, IgM, IgG, and secretory component (SC)-combined antibodies were lower in bile than in serum. Selective treatment of IgA by the liver was suggested by the finding of a correlation between the serum and the bile IgA antibody activity. IgG antibodies were only found in inflamed gall bladders. The bile was shown to have antibacterial activity against E. coli, i.e. an ability to inhibit the attachment to epithelial cells, but the inhibitory activity was not restricted to the immunoglobulin fraction of the bile. PMID- 3529366 TI - Characterization of a monoclonal antibody recognizing a monomorphic determinant of the alpha chain of class II DQ antigens. AB - We have characterized a monoclonal antibody (L2) specific for a determinant of Human DQ class II antigens. After immunoprecipitation and immunofluorescence analysis performed on a panel of DR homozygous cell lines and HLA deleted mutants, it behaves like a monomorphic anti-DQ reagent and does not react with the products of the various DR alleles. On immunoblotting, it reacts with an epitope of the DQ alpha chain. PMID- 3529367 TI - Discrimination of human macrophages and dendritic cells by means of monoclonal antibodies. AB - Two monoclonal antibodies (MoAb), RFD1 and RFD7, have been used to investigate whether human macrophages and dendritic cells represent phenotypically distinct cell types. RFD7 recognizes a 77 kd antigen, and is specific for acid phosphatase positive tissue macrophages, while RFD1 recognizes a unique Class II antigen, which is associated with dendritic cells. With immunohistological/cytological methods it was found that neither of these reagents reacted with granulocytes, monocytes, or lymphocytes, with the exception that a small proportion (less than 20%) of B cells were stained with RFD1. In tissues, RFD7 reacted with mature macrophages only and did not stain Langerhans cells in the skin or the interdigitating (dendritic) cells of the T-cell zones of lymphoid tissue and the thymic medulla. Conversely, RFD1 appeared specific for the interdigitating (dendritic) cells and did not react with macrophage populations identified morphologically, geographically, and histochemically in any tissue studied. When peripheral blood monocytes (RFD1-, RFD7-) were matured in vitro, two distinct populations of RFD1+ RFD7- and RFD7+ RFD1- cells emerged. It is concluded that in normal tissues these two reagents identify phenotypic differences between macrophages and dendritic cells that may have functional significance. PMID- 3529368 TI - Cardiovascular complications of estrogen therapy for nondisseminated prostatic carcinoma. A preliminary report from a randomized multicenter study. AB - In a prospective multicenter study, 244 men with highly or moderately differentiated prostatic cancer in stage I, II or III (VACURG) were consecutively randomized to three groups of treatment: Group A (77 patients) received polyestradiol phosphate (Estradurin, Leo) 80 mg i.m. every fourth week + ethinyl estradiol (Etivex, Leo) 150 micrograms daily, group B (72 patients) estramustine phosphate (Estracyt, Leo) 280 mg twice daily, and group C (76 patients) no therapy. Only men without current or previous other malignancy and without cardiovascular disease were admitted to the study. After 4 1/2 years 125 of the 244 patients had left the study, 9 because of cancer progression (stage IV, VACURG). The most serious complications were cardiovascular, including ischemic heart disease, cardiac decompensation, cerebral ischemia and venous thromboembolism, which occurred in 24 patients from group A and 9 from group B as compared to only one patient in group C. The subgroup superficial or deep venous thrombosis comprised 11 group A and 2 group B patients. Estrogens (E + e) offered as palliative treatment to patients with non-generalized prostatic carcinoma is burdened with a high incidence of serious cardiovascular complications. PMID- 3529369 TI - The significance of digital subtraction angiography (DSA) before operative treatment of hypernephroma in a horseshoe kidney. AB - A case of hypernephroma in a horseshoe kidney is reported in a patient with total situs inversus organorum. The diagnostic procedures are discussed, and the significance of digital subtraction angiography for both diagnosis and treatment is emphasized, as the presentation of the arterial and venous supplies is of great value for guidance in the surgical intervention, particularly when congenital malformations are present. PMID- 3529370 TI - Patients with primary Sjogren's syndrome treated for two months with evening primrose oil. AB - Twenty-four female and 4 male patients, all fulfilling the Copenhagen criteria for primary Sjogren's syndrome (primary SS), were treated for 8 weeks with evening primrose oil (Efamol). Efamol is a seed oil which consists primarily of the n-6 essential fatty acids (EFA): cis-linoleic acid and gammalinolenic acid (GLA). The investigation was carried out as a randomized, double-blind, placebo controlled, cross-over trial in order to determine whether long-term treatment of patients with primary SS with Efamol would improve the ocular and oral clinical status, and whether the levels of EFA in plasma and erythrocytes increase during Efamol treatment. The objective ocular status, evaluated by a combined ocular score, including the results from Schirmer-I test, break-up time and van Bijsterveld score, improved significantly during Efamol treatment when compared with Efamol start-values (p less than 0.05), but not when compared with placebo values (p less than 0.2). The GLA metabolite and prostaglandin-E1 (PGE1) precursor dihomogammalinolenic acid (20: 3n6, DGLA) increased both in plasma (p less than 0.001) and in erythrocytes (p less than 0.001) during treatment with Efamol. No correlations between objective ocular and oral status and DGLA values in plasma or erythrocytes were found. PMID- 3529371 TI - Revision of total hip replacement with solid cortico-spongious bone graft for medial acetabular disruption. AB - In revision of failed total hip replacements with disruption of the medial acetabular wall the use of autogenous solid cortico-spongious bone graft proved to be a successful surgical procedure. In 7/8 revisions followed for 2-3 years, the bone grafts healed, as seen radiographically on plain film or by conventional tomography and no further acetabular protrusion occurred. Two of these seven hips had a radiolucent zone of 2-5 mm at the bone-cement interface at the inferior part of the cup. In the eighth hip the bone graft was resorbed/eroded and the cup had migrated 4 mm in the mediocranial direction. PMID- 3529372 TI - Sonography and NMR imaging in rheumatoid gonarthritis. AB - Sonography and NMR imaging of the knee joint make it possible to obtain a visual representation of the thickened synovial membrane occurring in patients with rheumatoid gonarthritis, even before inflammatory deformation is radiologically detectable. Both methods can expose effusions and Baker's cysts. In NMR imaging, an indication of the inflammatory genesis can be obtained from the extended relaxation time T1. Due to the good representation of soft tissues, prognostic evidence may be gained of whether a mainly exudative or proliferative form is present. PMID- 3529373 TI - Antibodies to extractable nuclear antigens (ENA) in rheumatoid arthritis assayed by ELISA. A clinicopathological correlation. AB - A clinicopathological study of autoantibodies in the sera of 53 RA patients was performed. Antibodies to extractable nuclear antigens (ENA) were assayed by ELISA and were found in 42% of the subjects, all bound to RNAase sensitive ENA, and these antibodies were significantly associated with the presence of tendon nodules (p less than 0.05). Antibodies to dsDNA were found in 16%, and rheumatoid factor (RF) was present in 81%; neither of these antibody groups were associated with any of the clinical abnormalities examined for. Comparisons between anti ENA, anti-dsDNA and anti-immunoglobulin autoantibody parameters in RA subjects revealed ENA and dsDNA antibody levels to be significantly mutually related (p less than 0.01) but both were independent of RF levels. We concluded that in RA, ENA antibodies constitute a unique autoantibody subset, that may result from an immune response to an autoantigen directly linked with the aetiopathogenesis of RA. PMID- 3529374 TI - Serum beta 2-microglobulin as a marker of activity in systemic lupus erythematosus. AB - A prospective study of 62 patients with systemic lupus erythematosus (SLE) was performed in order to establish whether serum beta 2m could be a good marker of clinical activity. beta 2m was determined by radio-immunoassay and the values compared with a control group of healthy individuals. The mean value of beta 2m in the control group was 1.48 +/- 0.52 mg/l and 2.87 +/- 2.19 mg/l (p less than 0.001) in the SLE group, 4.53 +/- 2.89 mg/l in the 22 patients with active disease and 2.40 +/- 1.80 mg/l (p less than 0.001) in the 40 patients with inactive disease. High beta 2m values (greater than or equal to 3 mg/l) were observed in 64% of the patients with active SLE, VS. only 12% of the patients with inactive disease (p less than 0.001). Significant differences were also observed when beta 2m of the patients with inactive SLE was compared with the control group (p less than 0.001). The beta 2m with a sensitivity of 64%, a specificity of 87%, and an efficiency of 79% could be a good parameter to detect SLE clinical activity. PMID- 3529375 TI - Low-dose methotrexate in rheumatoid arthritis: effect and tolerance. An open trial and a double-blind randomized study. AB - Weekly low-dose Mtx may be considered the preferred drug for the treatment of patients with severe, progressive RA resistant to conventional therapy. The drug is sufficiently safe, provided contra-indications are considered and treatment is carefully supervised. Controlled long-term prospective studies are needed in order to determine whether the drug demonstrably retards progression of the erosions, and to guard against untoward long-term adverse reactions. PMID- 3529376 TI - Health effects of phenoxy herbicides. A review. AB - A review of epidemiological studies on the health effects of exposure to phenoxy herbicides suggests that exposure may be associated with an increased incidence of cancer and unfavorable outcomes of pregnancy. Studies on cancer have found increased risks of 5.3, 6.8 and 3.96 for soft-tissue sarcoma, 7.7 and 6.0 for stomach cancer, 2.05 for lung cancer, 4.8 for lymphoma, 2.3 for all cancers combined, and 5.2 for liver cancer after exposure to 2,4,5-T or dioxin contaminants. Several studies have suggested a possible increase in birth defects after paternal exposure. An increased risk of hydatidiform mole is suggested by Vietnamese studies on the effects of maternal exposure. PMID- 3529377 TI - [Diagnosis and therapy of erectile impotence with special reference to papaverine]. AB - The introduction of intracorporeal papaverin injections has significantly changed the investigation and treatment of erectile dysfunction. Papaverin acts on the smooth (vascular) muscle cell and induces erection. A good response to papaverin injection excludes major vascular disturbances within the penis. The interpretation of a negative result is more difficult. Depending on the Doppler blood-flow measurements, further radiological investigations (dynamic cavernosography or selective angiography of the pudendal arteries) may be needed. Treatment of impotence with papaverin is most successful in patients with psychogenic disturbances, which are often coincident with minor vascular pathology. Autoinjection is easily learned for long-term treatment by patients with moderate vascular disorders or neurogenic dysfunction. Major vascular disturbances, e.g. occlusion of the penile arteries or marked venous shunt, require surgery by a trained urologist. Papaverin may cause side effects, especially priapism, which may lead to definitive impotence. Careful investigation of erectile disturbances and search for the appropriate papaverin dosage are therefore crucial. PMID- 3529378 TI - [Endoscopic treatment of choledocholithiasis]. AB - Since its introduction 10 years ago, endoscopic removal of gallstones from the common bile duct has become a widely accepted method. The procedure is successful in approximately 90% of cases. Complications occur in 5-10%, with a reported mortality of 1-2%. Endoscopic removal of gallstones from the common bile duct appears to be the method of choice in the treatment of patients with previous cholecystectomy. Other important indications are acute cholangitis and biliary pancreatitis. PMID- 3529379 TI - [Results of sonographic diagnosis of choledochal calculi]. AB - To evaluate sonographic accuracy in the diagnosis of choledochal calculi 44 patients were examined prospectively with a mechanical sector scanner before endoscopic retrograde cholangiography (ERC). Calculi with a diameter of more than 1.5 cm could be detected in all cases. Smaller stones (less than 1 cm) were missed in 50% of cases. To quantitate sensitivity in daily clinical practice, the data of 229 patients, suspected to have common bile duct stones, were analysed retrospectively. The overall accuracy was 76%, 90% when an experienced sonographer performed the examination and 47% if the examiner was less experienced. From these data it is concluded that the sonographic detection of choledochal calculi is influenced by the examination technique, experience of the examiner and diameter of the stones. PMID- 3529380 TI - [Sonographic detection and clinical studies in the spontaneous passage of bile duct calculi]. AB - Spontaneous transpapillary stone passage was found in 16 of 84 cases with sonographically detected common bile duct stones. Stone passage was confirmed by ultrasound and retrograde endoscopic cholangiography (ERC) as well as by intraoperative cholangiography and also by clinical observation. Sonographic diagnosis was demonstrated by incontestably safe documentation. 15 of 16 patients with transpapillary stone passage had right upper abdominal pain, three patients an attack of acute pancreatitis, whereas in 5 cases hyperamylasaemia was found. Decreasing levels of bilirubin , alkaline phosphatase and gamma-GT are of minor value in diagnosing a stone passage. Despite a new and more successful sonographic technique in detecting common bile duct stones, ERC remains the standard diagnostic procedure. PMID- 3529381 TI - [Sonography of gallbladder calculi: possibilities and limits in the selection of gallstone patients suitable for conservative lysis]. AB - The sonographic patterns of artificially produced pure cholesterol and pigment gallstones were evaluated in vitro. Cholesterol calculi exhibited a smooth echo with a relatively high beam penetration, whereas pigment calculi showed a sickle like surface echo without beam penetration. Clinical evaluation of these criteria in 107 patients was based on correlating preoperative sonographic diagnosis with postoperative microchemical analysis of the calculi. Although small, smooth cholesterol calculi were detected via ultrasound with an accuracy of more than 90 percent, pigment calculi could not be separated and identified with satisfactory precision. PMID- 3529382 TI - [Is there a "hypertonic gallbladder" in hyperthyroidism? Initial results]. AB - In five female patients with hyperthyroidism the motor function of the gallbladder was examined using sonography. After therapy, the fasting volume and the volume resulting 30 minutes after cholagogue showed a tendency to increase (p approximately 0.15, p approximately 0.25, respectively). The emptied volume and the rate of emptying showed no changes. Although our findings failed to attain statistical significance they suggest an influence on the motor function of the gallbladder resembling a "hypertonic gallbladder". It will be necessary to study a significantly greater number of patients to confirm this thesis. PMID- 3529383 TI - [Quantification of gallbladder kinetics in hypothyroidism using a simple sonographic method]. AB - In 3 patients with hypothyroidism we tried to quantify the kinetics of the gallbladder using a simple sonographic method. The width of the gallbladder was found to be a good parameter for this purpose after we had found a good correlation between the relative decrease of the width with the relative decrease of the plane and the volume in a control group of 7 persons (R = 0.80, p less than 0.05, R = 0.85, p less than 0.05 respectively). After therapy, the speed of decrease of the width was 8-fold after cholagogue (p less than 0.05) and the increase of the shortening fraction was 13-fold (p less than 0.05). It was concluded that the width of the gallbladder in the examined group of patients reflects thyroid hormone application very sensitively. In view of the small number of patients this finding must be confirmed in a study involving a larger group of patients. PMID- 3529384 TI - [Evaluation of gallbladder kinetics using a very simple sonographic method]. AB - Both cholecystographic and sonographic analysis of the contraction of the gallbladder showed good correlation between relative decrease of gallbladder width and relative decrease of the area or volume (R = 0.86, p less than 0.001, n = 14, R = 0.80, p less than 0.05, n = 7 respectively). Therefore, we used the relative decrease in the width of the gallbladder to predict the relative decrease in volume. The volume was calculated using a formula given in the literature, after determination of the length, width and depth, using realtime sonography. Correlation between the calculated relative decrease of volume of the gallbladder and the predicted value, was good (R = 0.90, p less than 0.01, n = 8). The relative decrease in the width of the gallbladder in the with of the gallbladder! Can therefore represent the Contraction of the whole gallbladder. Due to its simple method of determination it can be recommended as a complement to sonography of the gallbladder. First of all, however, it will be necessary to conduct a study in a relatively large number of healthy volunteers to obtain the reference values. PMID- 3529385 TI - [Sonographic determination of spleen size: normal dimensions in adults with a healthy spleen]. AB - Sonography can rapidly and reliably help to determine the size by the spleen. To standardise the sonographic dimensions of the healthy spleen, we effected sonographic examination of 793 female and male patients aged between 17 and 82 years with a healthy spleen. In 95% of the patients the length of the spleen was less than 11 cm, the breadth below 7 cm and the thickness less than 5 cm. The weight of the spleen as determined via the rotation ellipsoid formula was below 190 g in 95% of the patients. Whether or not a spleen larger than standard signals an acute disease can be clinically assessed only on the basis of a synopsis of all findings. PMID- 3529386 TI - [Endocrine tumor of the pancreas--a case report on the differential diagnosis of cystic epigastric tumors]. AB - This is a case report on a 21-year old woman patient having an asymptomatic, mainly cystic tumour of 25 cm size. Microscopic examination after removal revealed a tumour belonging to the APUD cell system. The clinical symptoms and pathology of this unusually large tumour are discussed. PMID- 3529387 TI - [The tilted right-sided paramedian longitudinal section--sonographic imaging of the pancreas head and pancreas tail]. AB - A special examination technique for ultrasonic visualization of the body and tail of the pancreas is demonstrated. The advantages and problems of this technique are discussed. PMID- 3529388 TI - [Cystic echinococcosis of the liver--problems of ultrasound diagnosis]. AB - The authors examined 100 patients with a total of 119 cysts of the liver. The diagnosis was subsequently confirmed via scintigraphy, radiology and laparotomy. This paper reports on a sonographic analysis of cystic echinococcosis of the liver, its sonographically demonstrable types, structures and complications and their differential diagnosis. In 58% of the cases the classical aspect of cystic echinococcosis was seen (Type A). 22.7% of the cases pointed toward a sediment within the cyst (Type B). 8.4% of the cysts were septated (Type C), whereas 6.7% had daughter cysts (Type D). However, only 4.2% of the cysts were important for differential diagnosis, since they had to be set off against other space occupying growths on account of their solid tumorous structure. PMID- 3529389 TI - Tracers of sewage sludge in the marine environment: a review. AB - A review of the available and potential tracers of the movement and distribution of sewage sludge ('sludge') in and on marine sediments is presented. A brief review of 'active' sludge tracers is followed by a more extensive review of 'passive' sludge tracers. These can be broken down into five categories: Natural organic components of sludge--organic carbon, faecal steroids, carbohydrate/TOC ratio, tomato seeds. Synthetic organic compounds--silicones, chlorinated hydrocarbons, non-ionic surfactants and their degradation products, linear alkylbenzenes. Stable isotopes of carbon, nitrogen, hydrogen and sulphur. Inorganic substances and their properties--minerals, paint pigments, trace elements, magnetic properties. Biological/Microbiological--faecal bacteria, Clostridium welchii spores, amoebae, viruses, nitrogen-fixing enterobacteriaceae. A wide variety of sludge tracers are available with the choice of suitable tracers in an individual situation governed by the available equipment and expertise, cost considerations, ease of sampling requirements and determination, and the nature of other pollutant inputs in the vicinity of the input of interest. Ideally, the sludge tracers chosen should be unique to the input of interest, but this will rarely be achievable in practice. In areas of gross sludge contamination, a marine geophysical survey technique can be used to delineate the area affected and this provides a rapid cost-effective method for large areas. PMID- 3529390 TI - Senate votes to expand anti-AIDS drug trials. PMID- 3529391 TI - A genetic approach to analyzing membrane protein topology. AB - Fusions of the secreted protein alkaline phosphatase to an integral cytoplasmic membrane protein of Escherichia coli showed different activities depending on where in the membrane protein the alkaline phosphatase was fused. Fusions to positions in or near the periplasmic domain led to high alkaline phosphatase activity, whereas those to positions in the cytoplasmic domain gave low activity. Analysis of alkaline phosphatase fusions to membrane proteins of unknown structure may thus be generally useful in determining their membrane topologies. PMID- 3529392 TI - Prorenin in high concentrations in human ovarian follicular fluid. AB - Although the kidney is a major source of prorenin, the precursor of renin, there are extrarenal sources for plasma prorenin that have not been identified. The selective increase in plasma prorenin at the time of ovulation suggested that one of these sources might be the ovary. Prorenin was therefore measured in fluid aspirated from 18 ovarian follicles and in plasma collected from three women who were undergoing in vitro fertilization. The follicular fluid contained high concentrations of prorenin that were approximately 12 times higher than plasma prorenin. The prorenin from follicular fluid was immunochemically identical to kidney and plasma prorenin. Thus, the ovary is a likely source for the ovulatory peak of plasma prorenin. PMID- 3529393 TI - Promising results halt trial of anti-AIDS drug. PMID- 3529394 TI - Purification and biochemical characterization of the promoter-specific transcription factor, Sp1. AB - The biochemical analysis of cellular trans-activators involved in promoter recognition provides an important step toward understanding the mechanisms of gene expression in animal cells. The promoter selective transcription factor, Sp1, has been purified from human cells to more than 95 percent homogeneity by sequence-specific DNA affinity chromatography. Isolation and renaturation of proteins purified from sodium dodecyl sulfate polyacrylamide gels allowed the identification of two polypeptides (105 and 95 kilodaltons) as those responsible for recognizing and interacting specifically with the GC-box promoter elements characteristic of Sp1 binding sites. PMID- 3529395 TI - Identification of specific transducin alpha subunits in retinal rod and cone photoreceptors. AB - Transducin is a guanyl nucleotide-binding protein that couples rhodopsin photolysis to hydrolysis of guanosine 3',5'-monophosphate in rod photoreceptor cells of vertebrate retinas. Several complementary DNA clones encoding transducin subunits have recently been characterized. One clone, isolated from a bovine retina complementary DNA library, encodes a previously unidentified polypeptide with an amino acid sequence 78% identical to the sequence of the alpha subunit of bovine rod outer segment transducin. Antibodies to a synthetic peptide with amino acid sequence derived specifically from this novel polypeptide recognize a 41 kilodalton polypeptide in homogenates of bovine retina. Localization of this polypeptide in bovine retina by indirect immunofluorescence demonstrates that it is expressed only in cone outer segments. Antibodies to specific sequences found only in the rod transducin alpha subunit recognize a polypeptide localized only in the rod outer segment. Therefore, bovine rod and cone cells each express structurally related yet significantly different forms of transducin. PMID- 3529396 TI - Detoxification of bacterial lipopolysaccharides (endotoxins) by a human neutrophil enzyme. AB - Lipopolysaccharides in the cell walls of Gram-negative bacteria elicit toxic as well as potentially beneficial inflammatory responses in animals. It is now reported that tissue toxicity caused by lipopolysaccharides is preferentially reduced by an enzymatic activity in human neutrophils. Acyloxyacyl hydrolysis removes fatty acyl chains that are linked to the hydroxyl groups of 3 hydroxytetradecanoyl residues in the bioactive lipid A moiety of the lipopolysaccharides. Maximal acyloxyacyl hydrolysis reduced lipopolysaccharide tissue toxicity, as measured in the dermal Shwartzman reaction, by a factor of 100 or more. In contrast, the ability of the deacylated lipopolysaccharides to stimulate B lymphocytes to divide was decreased only by a factor of 12. It is suggested that during tissue invasion by Gram-negative bacteria acyloxyacyl hydrolysis may be a defense mechanism that reduces the toxicity of lipopolysaccharides while preserving some of their potentially beneficial inflammatory and immune stimuli. PMID- 3529397 TI - Diseases of the pubic symphysis. PMID- 3529399 TI - [External fixation for the protection of pedicled grafts on the back of the hand]. PMID- 3529398 TI - Scleroderma and scleroderma-like disorders. PMID- 3529400 TI - [Is primary spongiosa transplantation with plate osteosynthesis in open fractures still the procedure of choice today?]. PMID- 3529401 TI - [Ultrasonic diagnosis of postoperative hematomas. Indications for early surgical treatment]. PMID- 3529402 TI - [Use of 10 MHz ultrasonography in the determination of depth of burn injuries]. PMID- 3529403 TI - [Preparatory technical modification and standardization of the Spalteholz microangiographic study method]. PMID- 3529404 TI - Perception of radiation hazards. AB - The health risks of radiation have been carefully studied and are relatively well understood in comparison with other risks to the human environment. Public perception of these risks often is distorted, due in part to lack of familiarity with the actual risk levels involved. There is a need for dissemination to the public of accurate information on radiation risks as well as to patients and volunteer subjects for studies involving radiation exposures. Often such information can be presented meaningfully by comparing the risks of radiation exposure with other, more familiar risks. Natural background radiation is a universally present and generally accepted source of risk, and thus serves as one reference against which to compare the risks of other radiation exposures. Natural background radiation averages about 100 mrem/yr, but much higher levels are encountered in some parts of the US (400 mrem/yr) and worldwide (2,000 mrem/yr). These variations are due primarily to differences in cosmic ray intensity with altitude and in terrestrial radiation originating from soil and rocks. Radiation risks also may be compared with the risks of other human activities, both voluntary and involuntary. The former are useful for comparisons with the risks of voluntary radiation exposures such as occupational exposure and participation in medical or research procedures involving radiation. Involuntary radiation exposure, such as might result from the transportation and disposal of radioactive waste, poses a more complicated issue. Comparisons of such exposures to natural background radiation levels and their variations are helpful. Two other concepts that have been proposed for assessing the relative risk of low level radiation exposure are "de minimus risk" and "probability of causation." The former suggests that there is some minimal level of involuntary risk that can be considered acceptable, provided it carries with it some benefit to society or the individual. The latter is a concept that has been introduced in legislation to decide compensation for alleged injuries from radiation exposures. PMID- 3529405 TI - Polycythemia Vera Study Group: a historical perspective. PMID- 3529406 TI - Cardiovascular, pulmonary and renal complications of fulminant hepatic failure. PMID- 3529407 TI - Protective agents for acetaminophen overdose. PMID- 3529408 TI - Experimental artificial liver support with emphasis on fulminant hepatic failure: concepts and review. AB - Coated charcoal hemoperfusion started in the earlier grades of coma appears to improve the survival rate of drug-induced FHF. This is based on randomized control animal studies and clinical trials using historical controls. Even if randomized clinical trials in patients should substantiate these findings, it is still a very small step in artificial liver support. Viral-induced FHF and cirrhotic encephalopathy are much more common conditions that still cannot be supported. However, this initial promising step should encourage us to become more optimistic about the possibility of developing artificial livers for the higher levels of support. A multifaceted approach in research should include evaluations of combined approaches. Increased basic knowledge in toxic and essential substances will be another important requirement. PMID- 3529409 TI - Coagulopathy of fulminant hepatic failure. PMID- 3529410 TI - Fulminant and subfulminant liver failure: definitions and causes. AB - Fulminant or subfulminant liver failure, complicated by encephalopathy and in many cases by death is seen to be a syndrome that may result from numerous causes. Although viral hepatitis, drug-induced hepatitis, and hepatitis due to various types of poisonings, in decreasing frequency, account for 90% of all cases, a variety of miscellaneous conditions account for the remainder. Consideration of the possibility of these less common etiologies by the clinician is of considerable importance, since some, including massive malignant involvement (such as leukemia) or acute fulminant Wilson's disease, may respond to specific treatment measures. Thus, unless hepatic transplantation proves to be applicable in FHF of many etiologic diagnosis may continue to have important therapeutic indications in at least some cases with this syndrome. PMID- 3529411 TI - [Effect of the axial surface angle of prepared abutment teeth and the type of dental cement on retentive forces]. PMID- 3529412 TI - Acute suppurative renal infections. PMID- 3529413 TI - Unemployment-related lifestyle changes and health disturbances in adolescents and children in the western countries. AB - According to official statistics 11 million under 25's, thereof 5-6 million under 20's in the 12 OECD member states are unemployed at any given time. In depth studies show that this figure is at least 40-50% higher. In many countries a systematic under-reporting exists in the registration of unemployed. Surveys used to show more relevant figures. Unemployment hits mainly adolescents, school leavers, young adults (unskilled male and female) immigrants and then, indirectly, those who are in need of familial and social support, i.e. the frail, sick, disabled children and old people. In many cities in Europe 40-50% of 18-25 year olds are unemployed and figures as high as 90% have been reported (inner cities). Unemployment is endangering the socio-economic status of people, in spite of short-time unemployment benefits and is creating inequalities in health and serious social misfits. Loss of job or the mere prospect of becoming jobless have, in follow-up studies on an individual level, been found to cause elevated blood pressure and serum cholesterol, increased concentration of blood catecholamine and elimination of noradrenaline, an increase in the frequency of stress and psychosomatic diseases. After regaining employment, these values have normalized. Unemployment is therefore considered by many as a real source of stress. Chronic stress is now considered as a major contributor to cardiovascular diseases, ulcers, asthma and some other diseases. According to several well designed and controlled studies on the individual level in the developed countries, the majority of young people do not learn to cope with unemployment. It fosters isolation, loss of self-esteem, frustration and hopelessness.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3529414 TI - The pharmaceutical industry and health in the Third World. PMID- 3529415 TI - The proper contributions of social workers in health practice. AB - Current and potential future contributions of social workers to health practice are considered at the three levels of direct service to patients, influence on the processes and procedures of the health setting and influence on its future planning and service development. The capacity of U.S.A. and U.K. social work to contribute at these levels is compared in the light of their contrasting relationships to the health system. U.S.A. social work in health care is practised as employees of the health setting or as private practitioners and contains the majority of U.S.A. social workers. It remains a specialism that sustains a major body of published work, commitment to knowledge-building, standard setting and performance review, and a psycho-social orientation shared by a growing number of medical and nursing professionals. Its approach to the health system is that of the pursuit of professional credibility in the secondary setting by adopting the professional-technical practice model of the clinician. U.K. social work since the early 1970s has been committed to generic education and practice and to the development of its own primary setting in social services departments which now employ almost all U.K. social workers. Area team social work in these departments, typified by statutory work with the most deprived sections of the population, has become the dominant culture of British social work, with implications for the occupational identity and career prospects of those social workers who are outposted or attached to health settings but no longer employed by them. British social work and its management now approach the health system from a position of organizational independence which should strengthen their capacity to influence the health system. The cultural differences between social work and medicine, however, are experienced more keenly than ever as many social workers adopt a socio-political practice model that is at odds with the professional-technical model of the clinician. Provision of social work services to the health system has become a questionable priority and raises the issue of whether much of what is now termed "health care' could more appropriately be termed "social care' and provided in a primary social work setting to which medicine and nursing would make their "proper contributions'. PMID- 3529416 TI - Codes of medical ethics: traditional foundations and contemporary practice. AB - The Hippocratic Coprus recognized the interaction of 'business' and patient health moral considerations, and urged that the former be subordinated to the latter. During the 1800s with the growth of complexity in both scientific knowledge and the organization of health services, the medical ethical codes addressed themselves to elaborate rules of conduct to be followed by the members of the newly emerging national medical associations. After World War II the World Medical Association was established as an international forum where national medical associations could debate the ethical problems presented by modern medicine. The International Code of Medical ethics and the Declaration of Geneva were written as 20th century restatements of the medical profession's commitment to the sovereignty of the patient-care norm. Many ethical statements have been issued by the World Medical Association in the past 35 years; they show the variety and difficulties of contemporary medical practice. The newest revisions were approved by the General Assembly of the World Medical Association in Venice, Italy October 1983. Their content is examined and concern is voiced about the danger of falling into cultural relativism when questions about the methods of financing medical services are the subject of an ethical declaration which is arrived at by consensus in the W.M.A. PMID- 3529417 TI - The social sciences in health policy and practice. AB - In this paper the role of the social sciences in health policy and practice is analysed. The analysis focuses on the disciplines of medical sociology and health economics. The authors attempt to describe the contribution of each of the two disciplines to health policy and health practice, firstly, be reviewing their developments in the past two decades and secondly, by analysing their future perspectives. Special attention in this description is paid to the context of health policy. It is shown that there is a prominence of economists in present day health services research and the factors which are held responsible for this situation are analysed. PMID- 3529418 TI - Labour relations in health services management. AB - 'Labour relations' or 'industrial relations' refers to employer-employee relations which are both economic as in matters of pay and conditions, and managerial, i.e. the political relationships between management and employees, collectivized through trade unions and professional associations. This paper traces the development of managerial relationships as illustrated by experiences in the British National Health Service particularly over the past 20 years focusing on groups of actors--management (within which may be distinguished government and local managers), health professional workers and other workers- whose interactions need to be studied if managerial relations within health services are to be satisfactorily analysed. We conclude that, although until recently, developments in management have had little impact upon worker behaviour outside unskilled groups, changing economic and other circumstances could create the conditions in which stronger managerial control over professional workers might emerge. PMID- 3529419 TI - Cultural components of behavioural epidemiology: implications for primary health care. AB - In this article we discuss the association of culturally linked behaviour and epidemiology: that patterns of disease are significantly related to cultural sets of normative beliefs and behaviour. The literature on this is vast and includes much of what is written under the headings of Medical Anthropology as well as, for example, Cross-cultural Psychiatry and Medical Geography. A comprehensive review is obviously impossible, but as this is presented primarily as a background paper, basic issues are raised, and related to examples from the literature, to stimulate discussion. The article is divided into four subsections which give an indication of our focus: culture, disease and illness causation; utilization and provision of health resources; health, illness and normative socio-political and economic behaviour and primary health care, community participation and culture--implications for the future. PMID- 3529420 TI - Rural development and primary health care in less developed countries. AB - The traditional approach has been to regard health activities as a small component of rural development programmes. Under the Primary Health Care approach health is seen as the lever for rural development. But there are tendencies in the implementation of Primary Health Care in less developed countries towards limiting the range of activities to preventive and curative personal health services and of denuding it of its community development orientation. This paper highlights some of the issues that seem to militate against the establishment of Primary Health Care with its full complement of rural development activities. These activities together with the preventive and curative personal health services undertaken in the framework of community development promise to lead to the achievement of the hitherto elusive goal of improving the socioeconomic and health status of the rural population of less developed countries. PMID- 3529421 TI - Socio-economic status differences in health. AB - This paper is divided into two distinct sections: the first briefly examines the history of discussions on inequalities in health in Britain and how certain ideological approaches have persisted. The second part--taking Spain as an example--considers some of the special difficulties posed by research in countries where the data are inadequate. An attempt is made to suggest how, in such circumstances, research might be undertaken. PMID- 3529422 TI - Marital context and post-infarction quality of life: is it social support or something more? AB - The development of a theory of quality of life following serious illness is currently an important field of endeavour in rehabilitation research. The interpersonal relationships of people and elements of the self-concept appear to be salient factors in causal models of subjective well-being. One such model developed to explain characteristic levels of well-being was used in a longitudinal study of adaptation to a first myocardial infarction. Data were collected from a national sample of male cardiac patients and their spouses on the illness and marital situation as predictors of long-term well-being or ill being. Analyses of data from the first three waves of the study, which is to extend over 5 years after the onset of illness, are to be discussed in the paper. Marital status, the emotional quality of the spouse relationship and long standing marital stressors were found to have direct and indirect effects on the two dimensions of the Bradburn Affect Balance Scale. The same is true of continuing problems associated with the heart attack relative to perceptions of having coped effectively with the after effects of illness. Differences in self esteem and personal competence were suggested as mediators of socio-environmental and illness-related influences. The two-factor conception of well-being developed was found to be a useful framework for investigating positive and negative aspects of psychosocial rehabilitation. The same factors that explain differences between happy and unhappy people in social indicators research also appeared to be determinants of different trajectories of adaptation in the wake of a life threatening illness. Previous research using theoretical models from stress research has overemphasized psychosocial morbidity and stress management and neglected positive processes of adaptation. The identification of love resources related to positive feeling states and life satisfaction has, therefore, not received the attention it deserves. This is especially the case regarding an overemphasis of the concept of social support as a buffer of stress. Instruments were developed to measure high and low marital intimacy, as well as chronic marital role strains, and these measures appeared to explain different trajectories of adjustment to cardiac disease. The two-factor model appears to be useful for future work on quality of life with chronic illness. The same is true of four marital contexts of rehabilitation that were identified in the study. PMID- 3529423 TI - Socioeconomic and demographic effects of malaria eradication: a comparison of Sri Lanka and Sardinia. AB - The relationship between disease control, population growth and economic development is examined through a comparison of changes subsequent to malaria eradication campaigns in Sri Lanka and Sardinia. Both islands were similar in terms of malaria morbidity and mortality rates as well as a history of massive malaria eradication campaigns using DDT immediately after the Second World War. The critical comparative distinction is that Sardinia had a much lower population density than Sri Lanka. In both cases, the anticipated effects of malaria control were increased agriculture production in endemic zones coupled with a relief of population pressure in non-malaria areas. This has not happened. Patterns of demographic change, marked by sharp declines in general mortality and accelerated population rates, are similar in both cases. Malaria control has resulted in economic development in neither case, however, and this is explained using ecological and political-economic analyses. PMID- 3529424 TI - Agricultural development, migrant labor and the resurgence of malaria in Swaziland. AB - Much of the research on the recent resurgence of malaria in Third World areas has focused on the problem of vector resistance arising out of the widespread use of pesticides in conjunction with the development of large-scale agricultural projects. Evidence from southern Africa, and particularly from Swaziland, where a resurgence of malaria has occurred in the absence of pesticide-resistant strains of Anopheles mosquitoes, suggests that changes in agroecosystems, labor utilization and settlement patterns, which are also associated with large-scale agricultural development, may play an equally important role in the resurgence of malaria. Renewed efforts to control malaria must, therefore, take account of the social and economic, as well as the biological determinants of this disease. PMID- 3529425 TI - Health education and community participation in mass drug administration for malaria in Nicaragua. AB - A malaria control effort in Nicaragua involving the mass, short-term distribution of anti-malaria medicines to a target population of all citizens above one year of age is detailed. About 70% of the population received anti-malarials in November, 1981 and 8 million packets of chloroquine and primaquine were distributed by 70,000 health campaign workers and their assistants. Training and mobilization efforts used volunteers from local community organizations. Mass public education was a key focus in the weeks before drug administration. The effects of the campaign were immediately apparent with a rapid decline in incidence after drug administration. Ongoing community environmental control, case finding, and health education activities continued to improve the malaria situation post-campaign. Further, the campaign promoted the decentralization of malaria control activities and integration of the malaria efforts with the nationwide primary health care system. PMID- 3529426 TI - Toward a political-economy of alcoholism: the missing link in the anthropology of drinking. AB - This paper addresses a shortcoming in the existing anthropological and related social science literature on alcohol use and abuse, namely the general inattention to global political-economic forces that have in the past and continue to reshape social relations and drinking practices cross-culturally. Following a critical review of the dominant approaches adopted in the varying explanations of heavy drinking and alcoholism, several alternative concepts are presented and developed in order to lay the ground for the emergence of a political-economy of alcoholism. The paper urges transcendence of the existing narrow boundaries of inquiry and perspective characteristic of most anthropological study of drinking and drinking problems. PMID- 3529427 TI - Breaking the circuit of social control: lessons in public psychiatry from Italy and Franco Basaglia. AB - Much public discourse in the United States and in Canada acknowledges the dismal failure of the policy to 'deinstitutionalize' mental patients and to return them to some semblance of community living. The American Psychiatric Association has recently called for a reassessment of institutional alternatives--a call for a return to the asylum--in response to the needs of the new population of so-called homeless mentally ill. Here we contrast the failures of North American deinstitutionalization with the relative successes achieved in those regions of Italy where deinstitutionalization was grounded in a grassroots alternative psychiatry movement and professional and political coalition, Psichiatria Democratica. Democratic psychiatry challenged both the medical and the legal justifications for the segregative control of the 'mentally ill': madness as disease, and the constant over-prediction of the dangerousness of the mental patient. In addition, the movement challenged traditional cultural stereotypes about the meanings of madness, and was successful in gaining broad-based community support from political parties, labor unions, student groups, and artist collectives that were enlisted in the task of reintegrating the ex-mental patient. The Italian experiment, although flawed and riddled with its own inconsistencies and contradictions, offers evidence that deinstitutionalization can work without recreating in the community setting the same exclusionary logic that was the foundation of the asylum system. PMID- 3529428 TI - The patterning of health by social position in contemporary Britain: directions for sociological research. AB - Associations are described between health (variously measured) and occupational class, gender, marital status, age, ethnicity and area of residence, using British data. It is argued that when exploring the social patterning of health, illness and death, it would be profitable for sociologists to consider several or all of these social positions, and to develop models of general vulnerability to ill-health rather than of specific etiology. Three main types of explanation, artefact, health selection and social causation, are reviewed, and six general points are made about how sociological research on social patterning in health should proceed. PMID- 3529429 TI - [Lacan the man]. PMID- 3529430 TI - [Why "Lacanistic"? And especially! How?]. PMID- 3529431 TI - [Presenting Lacan...]. PMID- 3529432 TI - Malignant lymphoreticular lesions in patients with immune disorders resembling acquired immunodeficiency syndrome (AIDS): review of 80 cases. AB - Reports of high-grade non-Hodgkin's lymphoma, Hodgkin's disease, and lymphocytic leukemia in patients with acquired immunodeficiency syndrome (AIDS) or AIDS-like immune disorders have been increasing. In some cases, histologic alterations of lymph node architecture may precede the development of malignant lesions. Early in the course of the disease, clinical profiles of these patients are indistinguishable from those of patients with AIDS-associated opportunistic infections, but rapidly evolving extranodal lesions often signify the establishment of a lymphoproliferative neoplastic process. The frequent involvement of the central nervous system is responsible for the dismal outcome of the disease in a significant number of patients. A high death rate and poor response to antineoplastic agents have often characterized the course of non Hodgkin's lymphoma and leukemia, but some patients with Hodgkin's disease have had a favorable response to treatment and a long survival. Aggressive multidisciplinary treatment may effectively avert the devastating consequences of this array of lymphoreticular neoplasms. Studies of these intriguing disorders may provide a better understanding of the interrelationships of infection, immunity, and oncogenesis in man. PMID- 3529433 TI - Klinefelter's syndrome: historical background and development. AB - When described more than 40 years ago, Klinefelter's syndrome (small testes, sterility, increased excretion of follicle-stimulating hormone, and usually gynecomastia) was thought to be an endocrine disorder. A second testicular hormone was postulated but has never been isolated. During the ensuing years, the syndrome has been found to be a chromosomal disorder, in which there is an extra X chromosome in 80% of the patients. The disorder occurs once in 500 to 1,000 male births and is best diagnosed by a buccal smear. When there is androgen deficiency, it is treated with testosterone. Gynecomastia is treated surgically because of the potential danger of malignancy or for cosmetic reasons. PMID- 3529434 TI - Esophagitis caused by nonsteroidal anti-inflammatory medication: case reports and review of the literature on pill-induced esophageal injury. AB - We report six cases of pill-induced esophageal injury, two of which were caused by the nonsteroidal anti-inflammatory medications ibuprofen and piroxicam, which have not been implicated previously in pill-induced injury. PMID- 3529435 TI - Antithymocyte globulin: a realistic approach to therapy for severe aplastic anemia. AB - Antithymocyte or antilymphocyte globulin (ATG or ALG) has emerged since 1978 as important therapy applicable to the majority of patients with aplastic anemia. On the basis of similarities of patient populations, nine clinical trials were selected among many for this review. A total of 209 patients with severe aplastic anemia have been analyzed. A hematologic response was observed in 113 (54%). The degree of hematologic improvement is incomplete in the majority of patients, but it is most often sustained and independent of further transfusion. The survival rate is 42% to 75% with a follow-up ranging between 12 and 55 months; three of 113 responders have had relapse. The similarities in treatment outcome suggest that different preparations of ATG or ALG carry an identical efficacious component. PMID- 3529436 TI - Chloramphenicol: what we have learned in the last decade. AB - Chloramphenicol is a unique antibiotic. The kinetics and efficacy of the oral and intravenous preparations are comparable. Chloramphenicol is usually bacteriostatic but is bactericidal against Haemophilus influenzae, Streptococcus pneumoniae, and Neisseria meningitidis, and chloramphenicol's clinical efficacy against these meningeal pathogens is well established. Chloramphenicol can be used to treat serious pediatric infections when Haemophilus influenzae is a likely pathogen, as well as typhoid fever, anaerobic infections, bacterial meningitis in patients allergic to penicillin, brain abscesses, and rickettsial infections. The use of chloramphenicol is limited because of its toxicity. Aplastic anemia is very rare but can occur after either oral or intravenous administration. The gray syndrome can be eliminated and marrow suppression minimized by using chloramphenicol at the recommended doses and monitoring levels. During the last decade the increased use of chloramphenicol has not resulted in increased resistance or in frequent reports of toxicity. Thus, chloramphenicol remains an important inpatient antibiotic that can be invaluable for treating certain life-threatening infections. PMID- 3529437 TI - Applications of the microcomputer in the health care environment. AB - From maintaining patient records to analyzing data to documenting time of professional efforts, microcomputers provide specific benefits to today's health care professional. Recent advances in microprocessor technology has made a new generation of personal computers feasible and affordable. The use of these microcomputers in clinical management, education, and data manipulation promises to offer unlimited potential for improving health care delivery. PMID- 3529438 TI - Surgical maggots. PMID- 3529439 TI - [Technology in choosing the goals of scientific research programs]. PMID- 3529440 TI - [Elimination of the health consequences of war in the Ukraine]. PMID- 3529441 TI - [The use of medical museums and exhibits in anti-alcohol propaganda]. PMID- 3529442 TI - [The Soviet medical press of the '20s in the fight against drunkenness and alcoholism]. PMID- 3529443 TI - [Leningrad Research Institute of Vaccines and Sera (on the centenary of vaccine and serum production in the USSR)]. PMID- 3529444 TI - [Immunologic reactivity of patients with early gastric cancer]. PMID- 3529445 TI - [Multiple cysts of the renal sinus]. PMID- 3529446 TI - [Use of immobilized proteinases in the treatment of suppurative wounds]. PMID- 3529447 TI - [Esophageal achalasia]. PMID- 3529448 TI - [Current methods of treating destructive pancreatitis]. PMID- 3529449 TI - [Means of increasing the effectiveness of drug therapy of malignant neoplasms]. PMID- 3529450 TI - [Clinical investigation and the quality of medical care]. PMID- 3529451 TI - Epidemiological research methods. Part I. Why epidemiology? PMID- 3529452 TI - Socio-environmental factors and lung function. AB - The literature was reviewed to assess whether the evidence implicating socio environmental (SE) factors as determinants of adult lung function was sufficient to require that they be taken into account in epidemiological studies, together with other factors, such as age and smoking. In six studies involving 11,000 adults resident in the USA, France and Denmark forced expiratory volume in 1 second was related to social class and/or one of a number of other factors including education, area of residence and housing status. Trends in three other studies involving approximately 15,000 children resident in the UK and the USA were similar. The consistency of the findings makes it difficult to escape the conclusion that SE factors should be taken into account in comparisons of lung function between populations when the purpose is to assess the role of other environmental factors such as occupational exposure. PMID- 3529453 TI - Insulin levels in South African Indians with abnormal glucose tolerance. PMID- 3529454 TI - Conversion from cyclosporin to azathioprine 3 months after renal transplantation- is it safe? AB - In 26 renal allograft recipients treated with low-dose steroids and cyclosporin A (CyA) the CyA was withdrawn after 3 months and azathioprine substituted. Seventeen patients (65%) had no rejection episodes after stopping CyA (mean follow-up of 13 months). Only 2 patients (7.7%) developed acute rejection episodes in the first month after withdrawal of CyA. In 1 the rejection was easily reversed with intravenous methylprednisolone but in the other CyA had to be reintroduced; graft function then improved. Despite the very low dose of CyA used, a comparison of the mean plasma levels of urea and creatinine in the month before and after stopping CyA revealed a significant fall (P less than 0.001). The findings suggest that this policy is safe and avoids the potential hazards of long-term CyA. PMID- 3529455 TI - Chronic digestive disease in an urban black population. AB - There is a marked contrast in incidence of chronic digestive diseases between black populations of sub-Saharan Africa and Western populations. Environmental factors inherent in modern Western civilization have been incriminated as largely responsible for the differences observed. The significance of these factors in chronic digestive disease in Soweto is emphasized since they provide clues to aetiology. In this context research avenues with regard to specific diseases are suggested. PMID- 3529456 TI - Chloroquine-resistant malaria. A case report. AB - Chloroquine-resistant Plasmodium falciparum malaria contracted in Mozambique by a patient taking correct prophylaxis is reported. The fact that misdiagnosis of malaria still occurs, the need to have intravenous quinine readily available country-wide, and the fact that a P. falciparum strain resistant to chloroquine is present across our border are stressed. PMID- 3529457 TI - Pre-eclampsia--is there an abnormality in carbohydrate metabolism? PMID- 3529458 TI - [Oncocytoma, a rare tumor of the kidney?]. PMID- 3529459 TI - [Nutritional metabolic progress in patients with a kidney transplant in treatment with low doses of steroids and azathioprine or cyclosporin A]. PMID- 3529460 TI - [Skinfolds in the evaluation of the nutritional status of the transplant patient]. PMID- 3529461 TI - [Immediate and delayed complications of femoral catheterization for hemodialysis. Preliminary study]. PMID- 3529462 TI - [Antidiuretic hormone (ADH) in the dialysed patient and after renal transplant]. PMID- 3529463 TI - [Cyclosporin A and pregnancy. Description of a clinical case]. PMID- 3529464 TI - Actuarial status of the HI and SMI Trust Funds. AB - This article is adapted from the 1986 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 barely sufficient to ensure the payment of benefits through the late 1990's 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- 3529465 TI - Management of primary sarcomas of the pulmonary artery and reperfusion intrabronchial hemorrhage. PMID- 3529466 TI - Interpeduncular perforating branches of the posterior cerebral artery. Microsurgical anatomy of their extracerebral and intracerebral segments. AB - Interpeduncular perforating branches were found in all 69 examined posterior cerebral arteries. They varied in number from 1 to 10, with an average of 2. They arose directly from the posterior cerebral artery (47.8%), from the collateral branches of the posterior cerebral artery (30.3%), or by their own common stems (88.4%). Their extracerebral segments varied from 100 to 750 microns in diameter (average, 321 microns). They gave off collateral branches to the cerebral peduncle, posterior perforated substance, oculomotor nerve, and mammillary bodies. Intracerebral segments had proximal and distal portions. The mean diameter of the former was 254 microns, and of the latter, 227 microns. The perforating arteries were divided into short interpeduncular and long mesencephalic and diencephalic vessels. Anastomoses among them were noticed in four-fifths of the cases. Despite this fact, the perforating arteries must be preserved during operations on aneurysms in the interpeduncular fossa. PMID- 3529467 TI - Peripheral corneal disorders. AB - The peripheral cornea is anatomically and physiologically distinct from its central counterpart. The major differences relate to the gradual transition of corneal tissues to those of the conjunctiva, episclera, and sclera; furthermore, the vascular structures, lymphatics, and inflammatory cells from these neighboring structures are intimately associated with the limbus and periphery of the cornea. The peripheral cornea is thereby predisposed to three main classes of disorders which do not normally involve the central cornea. First, local conditions affecting the sclera and conjunctiva may secondarily spread to involve the limbus and peripheral cornea. These include several infectious diseases, as well as hypersensitivity conditions, mass lesions, and degenerations. Second, due to the associated blood vessels and lymphatics, the peripheral cornea may be involved in a variety of systemic diseases, including vasculitides, autoimmune disorders, and abnormal metabolic conditions. Finally, there are several conditions, such as the noninflammatory peripheral degenerations, which primarily affect the peripheral cornea without associated ocular or systemic changes. In this review, we present a classification and discussion of the various disorders which may involve the peripheral cornea. PMID- 3529468 TI - Acquired dyschromatopsia in glaucoma. AB - Recent studies have suggested that the recognition of blue-yellow color vision deficits may have some predictive value in determining which ocular hypertensives are at risk of developing glaucoma and in monitoring the progress of the disease in glaucoma patients. This article reviews current theories of normal color vision and the differences that may occur in glaucoma, outlining methods of color vision testing and interpretation, and summarizing the results of recent studies. PMID- 3529469 TI - Infectious crystalline keratopathy. AB - A 57-year-old white female was noted to have unusual intrastromal crystalline like opacities in her failing right corneal graft five months after transplant surgery. Cultures grew Streptococcus viridans; since the graft was failing it was replaced and sent for pathologic examination. H&E stains revealed intrastromal pockets of basophilic material between the lamellae; there was a notable absence of inflammatory cells. Gram's stain showed the basophilic material to be gram positive and transmission electron microscopy confirmed the presence of intrastromal pockets of bacteria. The term "infectious crystalline keratopathy" was coined by Meisler for this entity, which occurs following longterm topical steroid usage. The quite clinical appearance may make its infectious etiology unapparent. Management consists of discontinuation of the steroids and the administration of antibiotics; continued infection, corneal scars, or graft failure may occur and transplantation is then required. PMID- 3529470 TI - [Ultrasonic diagnosis. Nurses specially suitable for ultrasound field]. PMID- 3529471 TI - [Occlusal reconstruction in excessive abrasion]. PMID- 3529472 TI - [Prefabricated root canal posts]. PMID- 3529473 TI - [What does an ideal root canal post look like?]. PMID- 3529474 TI - [Scaling equipment--a comparative study]. PMID- 3529475 TI - The automation of leeches. PMID- 3529476 TI - Depression and cancer: an update. PMID- 3529477 TI - A Canadian pioneer in Texas: Dr Nicholas Labadie, 1802-1867. PMID- 3529478 TI - Dr Ferdinand von Herff, idealistic pioneer and distinguished Texas physician. PMID- 3529479 TI - Off duty: Dallas MDs have fun with music (Wayne Z. Burkhead and Fred Lester). PMID- 3529480 TI - Effect of a "stop smoking" booklet on smokers attending for chest radiography: a controlled study. AB - At two chest clinics 1206 cigarette smokers referred by their general practitioners for chest radiography only either were dealt with in the normal way or in addition were given a How to Stop Smoking booklet by the clinic receptionist or nurse. Follow up one year later showed that 3.2% of all patients had successfully given up smoking, older patients doing better than younger ones and men doing better than women. Overall 3.9% of the group receiving a booklet were successful compared with 2.7% of the controls (p = 0.14). At one clinic the groups were not well matched for age but at the other, where there was no such imbalance, there was a suggestion that the booklet group did better than the controls (6.5% v 2.7% success), although the difference did not achieve conventional statistical significance (p = 0.09). If this can be confirmed as a real effect then this cheap, simple strategy could easily be applied on a large scale. PMID- 3529481 TI - Changes in pulmonary clearance of technetium labelled DTPA during haemodialysis. AB - An index of pulmonary epithelial permeability has been studied in 12 patients with chronic renal failure during haemodialysis. It was assessed by the half time clearance from lung to blood (t 1/2 LB) of a nebulised solution containing technetium labelled diethylene triamine pentacetic acid (99mTc DTPA). Six patients were cigarette smokers and six were non-smokers. The non-smokers had greater predialysis permeability (mean 37.7, range 24-54 min) than non-smokers without renal disease (mean 60.2, range 38-99 min; p less than 0.025). The t 1/2 LB was measured before dialysis and during the first half hour and the last half hour of dialysis in all 12 patients and also during other periods of dialysis in 10 of them. Dialysis lasted for five hours in 11 patients and four hours in one patient. There was no significant change in the t 1/2 LB of 99mTc DTPA during early dialysis; but as dialysis progressed there was a statistically significant increase in t 1/2 LB, suggesting a reduction of pulmonary epithelial permeability. These results show no increase in an index of pulmonary epithelial permeability in association with the pulmonary sequestration of neutrophils that occurs in early haemodialysis. They also suggest that in chronic renal failure the epithelial permeability is increased and that this can be modified by haemodialysis. PMID- 3529483 TI - [Therapeutic monitoring of cyclosporin A by the HPLC assay of whole blood]. PMID- 3529482 TI - [Influence of aspirin on the hemodynamic effects of molsidomine in healthy volunteers]. PMID- 3529484 TI - Ticlopidine and platelet function. PMID- 3529485 TI - [The Norwegian Medical Association as a negotiating organization]. PMID- 3529486 TI - [The Norwegian Medical Society's secretariat]. PMID- 3529487 TI - [The Journal. A goal-setting cavalcade]. PMID- 3529488 TI - [The Norwegian Medical Society's presidents through 100 years]. PMID- 3529489 TI - [Glucagon-stimulated plasma c-peptide in diabetics. Clinical parameters in the choice of therapy?]. PMID- 3529490 TI - [Treatment of acute cystitis in women. Single-dose versus a 3-day and 10-day therapeutic regimen with with trimethoprim-sulfamethoxazole]. PMID- 3529491 TI - [Acute dysuria/pollakisuria syndrome in women]. PMID- 3529492 TI - [Is chemical pest control coming to an end?]. AB - Problems that arise when chemical control of pests is applied--risks for producer, applier, consumer and the environment as well as development of resistance against pesticides--have led to the conclusion that other forms of pest control have to be searched for to guarantee production of sufficient crops in the future. Out of the many available methods to prevent or reduce pests two methods seem to offer most possibilities for the near future: development of (partial) host-plant resistance against pests and the search for natural enemies of pests (the so called biological control). In this article the development of biological pest control is described and a comparison is made between working methods, efficiency and risks in application of chemical and biological control. Several examples are given of successful biological control projects as applied in greenhouses in the Netherlands. PMID- 3529493 TI - [Plastic bonded bridges]. PMID- 3529494 TI - [Current developments in the study and management of unwanted childlessness]. AB - After some introductory remarks on the investigation of the infertile couple in general, more specific new technologies in diagnosis and ways of treatment of infertility are discussed. In the infertile male with a varicocele the advantages of phlebography and embolisation over surgical ligation of the internal spermatic vein is presented. The value of the hamster ovum penetration test in order to evaluate the fertilizing capacity of spermatozoa is commented. A new method for diagnosis of immunologic infertility in men is briefly explained as well as the possibility for treatment of immunologic infertility by means of corticosteroids. In women the indications and disadvantages of LHRH ovulation induction are presented as well as the advantages of monitoring follicle growth during ovulation induction or stimulation by means of ultrasound. The major breakthrough in infertility therapy of course is in vitro fertilization (IVF): only a few indications other than tubal occlusion are commented and the impact and some future aspects of IVF for other medical disciplines are briefly discussed. PMID- 3529495 TI - Major histocompatibility complex class II antigen (HLA-DR, DQ and DP) expression in human fetal skin. AB - Monoclonal antibodies were used to analyse skin samples from human fetuses (15-19 weeks gestational age) for the presence of class II major histocompatibility antigens (HLA-DR, DQ and DP). Cells expressing these antigens were clearly demonstrated within the epidermis from a proportion (4/7) of cases and were completely absent from the others. The negative samples were uniformly those with an epidermis of three cell layers or less. Such material may prove useful in studying the induction of class II antigen expression and the role of these antigens in allostimulation. PMID- 3529496 TI - Factors involved in decreased detection of class II histocompatibility antigens on blood mononuclear cells from transplanted patients receiving immunosuppressive drugs. AB - Class II histocompatibility antigens were assessed by complement-dependent cytotoxicity on B enriched mononuclear cells and on purified monocytes isolated from the peripheral blood of renal patients before and after transplantation. After transplantation, a significant decrease of detection of DR alloantigens (cytotoxicity score before transplantation 3 +/- 0.1; after transplantation 0.95 +/- 0.1; p less than 0.001) was found. A similar defect was observed both on B enriched frozen cells and on purified monocytes isolated during the post transplant period. Nevertheless, antigens could be adequately detected by a sensitive microabsorption method and by a procedure involving preincubation of mononuclear cells at 37 degrees C for 3 h followed by B cells enrichment by rosetting. The 37 degrees C induced reexpression could be inhibited by 10 micrograms/ml cycloheximide and by 50 microM monensin. No difference was found in the magnitude either of decreased expression or of temperature-induced reexpression between patients treated by CyS-Pred and those receiving Aza-Pred. It is concluded that transplanted recipients disclose a reversible defect of the expression of class II histocompatibility antigens probably related to perturbation of various steps of intracellular biosynthesis and traffic of these molecules. PMID- 3529497 TI - Development and characterization of a monoclonal antibody to class II MHC antigens in rhesus macaques. AB - The characterization of a monoclonal antibody with specificity for a monomorphic determinant on rhesus macaque class II antigens is described. This antibody, designated 2D16, is an IgG2b immunoglobulin which also displayed useful cross reactivity with lymphoreticular cells and cell lines of other species including man, bonnet and stumptail macaques, sheep, dog and horse. Limited polymorphism of the 2D16 epitope was observed in the dog. PMID- 3529498 TI - Mitogen-induced disorganization of capillary-like structures formed by human large vessel endothelial cells in vitro. AB - Endothelial cells (EC) from human aorta, umbilical vein and pulmonary artery were grown in Medium 199 supplemented with 20% human serum (HS), endothelial cell growth factor (ECGF) from bovine and human brain (200 micrograms/ml) and heparin (100 micrograms/ml) in gelatin-coated flasks. Under these conditions cells rapidly proliferated and survived 15-25 passages (40-60 cumulative population doublings). When cells were cultured on plastic substrate and without growth factors a capillary-like network appeared after 3-4 weeks of growth. According to TEM, this network consisted of tubes with the lumen encircled by one or several cells. The reduction of serum concentration in the medium or the replacement of plasma-derived serum (PDS) for HS reduced the time of network formation to 3-5 days. S-180 conditioned medium mitogenic for EC induced a rapid spreading of the cells and a partial reversion to a two-dimensional monolayer structure. Trypsin inhibitor did not abolish the effect of tumour conditioned medium. Other EC mitogens, e.g. ECGF and fibroblast growth factor (FGF), also disorganized the capillary-like network. In a day or two the network was completely restored. In contrast, culturing EC on gelatin-coated substrate is a sufficient condition for monolayer formation from tubes and long-term maintenance. We suggest that mitogens can influence the EC morphology but that it is the nature of the substrate that determines the stage of large vessel EC differentiation. PMID- 3529499 TI - Direct visualization of microtomy artefacts in sections of twisted fibrous extracellular matrices. AB - Twisted fibrous extracellular matrices observed in section often show alternating clear and dark bands. Three different methods of observation (high voltage electron microscopy, shadowing of thin sections and stereoscopic views) show the presence of ruffling effects and relief at the surface of crab cuticle sections. These effects appear uneven on both sides of the sections. As shown in a series of diagrams, the localization of the microtomy artefact is a function of the orientation of the cuticle laminae relative to the knife direction, and this creates variations in the position and the extent of the microtomy effect over each lamina. Confirmation of this analysis is obtained in a particular geometrical situation which appears in sections of tubercles in the crab cuticle where the twisted plywood stratification is deformed into a dome. By shadowing thin sections, perpendicular to the tubercle axis, nested crescents are visualized on the surface of the samples. All observations demonstrate that the clear and dark lamellae are due to a microtomy artefact which is a three dimensional process, and not, as usually considered, due to chemical or physical variations in the structure. PMID- 3529500 TI - [Research nurse in rheumatology. A new tree in the forest?]. PMID- 3529501 TI - [Protected living. Living according to human measure, but for whom?]. PMID- 3529502 TI - Effects of carbohydrates on insulin release from the isolated islets. AB - Effects of monosaccharides and disaccharides on insulin release from the isolated islets were studied. Insulin release from the isolated islets was 26.2 microU/5 islets/hr in carbohydrate-free medium and increased by the addition of D-glucose or D-mannose. L-Glucose was ineffective by itself but potentiated the insulin release stimulated by D-glucose. Effects of glucuronic acid and N-acetyl-D glucosamine on insulin release were similar to those of L-glucose. Among monosaccharides, 2-deoxy-D-ribose, D-galactosamine, L-fucose, N-acetylneuraminic acid and D-ribose decreased insulin release and had no effect on insulin release by D-glucose. D-Galactose and D-fructose also decreased insulin release. However, they potentiated the insulin release when D-glucose was also present. Cellobiose and lactose, which have a beta(1-4) linkage to glucose molecule at the reducing end, inhibited insulin release stimulated by D-glucose. On the other hand, sucrose and maltose lacking the beta(1-4) linkage, did not inhibit the insulin release stimulated by D-glucose. These results suggest that insulin release from the isolated islets is stimulated by carbohydrates which can be metabolized in B cells. Non-metabolizable analogues of D-glucose or disaccharides show different effects on glucose transport or glucose metabolism in the B-cells according to their chemical structures. PMID- 3529504 TI - A code for the identification of the 'viridans' streptococci. PMID- 3529503 TI - Inhibition of batroxobin, a serine proteinase from Bothrops snake venom, by derivatives of benzamidine. AB - Benzamidine derivatives which are competitive inhibitors of trypsin-like serine proteinases also inhibited the enzymatic activity of batroxobin, a thrombin-like snake venom proteinase. Structure-activity relationships showed that primary amides of 4-amidinophenyl-alpha-aminobutyric acid have pronounced, relatively selective antibatroxobin activity. Identical effects were found on batroxobin isolated from the venoms of Bothrops atrox or Bothrops moojeni. Esters containing a benzamidine moiety acylated the active centre serine hydroxyl of either batroxobin, however, the inhibition was temporary. Such compounds, especially 4 amidinophenyl esters of substituted benzoic acids, are a particularly useful tool for designing acyl-batroxobin intermediates with different deacylation rates. With 4-nitrophenyl 4'-guanidinobenzoate, the acyl enzyme was formed so rapidly that titration of the active site of batroxobin was possible. Irreversible inhibition of batroxobin was caused only by the selective thrombin inhibitor D Phe-Pro-ArgCH2Cl. PMID- 3529505 TI - [Analysis of negative results following osteoplasty of the mandible]. PMID- 3529507 TI - [Use of a sliding flap in eliminating deformities of the tip of the nose accompanied by unilateral congenital clefts of the upper lip]. PMID- 3529506 TI - [Correction of age-related changes in the face and neck by tightening the surface muscle-aponeurosis layer]. PMID- 3529508 TI - [Dependence of the time periods of adaptation to different orthodontic apparatus and prostheses on the type of pathology of the maxillodental system]. PMID- 3529509 TI - [Gingival fluid: composition and properties]. PMID- 3529510 TI - [Biotechnical factors affecting adaptation to removable dentures]. PMID- 3529511 TI - [Endodontic post procedures. A possibility for the use of "post bolting" in patient care]. PMID- 3529512 TI - Clinical electroencephalography and the study of suicide behavior. PMID- 3529513 TI - Electroconvulsive therapy and suicide. PMID- 3529514 TI - Genetics, twin studies, and suicide. PMID- 3529515 TI - Measurement of lidocaine free concentration. AB - Since lidocaine exhibits significant variation in serum protein binding, the availability of a practical method for measuring free lidocaine concentration could contribute to the optimization of individual lidocaine dosage regimens. Fifty serum samples from patients receiving lidocaine were partitioned by ultrafiltration and equilibrium dialysis. The lidocaine concentration in the ultrafiltrate was measured using an enzyme multiplied immunoassay (EMIT) and a gas-liquid chromatographic assay (GLC). The lidocaine concentrations in dialysates and filtered retentates were measured by EMIT. Ultrafiltrate concentrations measured by EMIT correlated well with those measured by GLC (r2 = 0.77), but the EMIT results were approximately 10-20% higher than the GLC measurements (GLC = 0.09 + 0.79 EMIT). At least a portion of this difference could be attributed to minor calibrator differences. The concentrations in dialysate and filtered retentate agreed well (r2 = 0.93; filtered retentate = 0.05 + 1.12 X dialysate). The fraction free values obtained by ultrafiltration were slightly lower than those obtained by equilibrium dialysis (0.301 +/- 0.086 vs. 0.345 +/- 0.137; p less than 0.05). It can be concluded that sample partitioning with ultrafiltration and measurement of free lidocaine concentration by EMIT yields results similar to those obtained by equilibrium dialysis or a GLC assay procedure. PMID- 3529516 TI - Evaluation of a rapid ultrafiltration technique for determination of quinidine protein binding and comparison with equilibrium dialysis. AB - The free level ultrafiltration (UF) assay by the enzyme multiplied immunoassay technique (EMIT) for determination of unbound quinidine concentration in serum (Qf) was evaluated in 50 samples obtained from cardiac patients treated with quinidine for ventricular arrhythmias. Equilibrium dialysis (ED) at 37 degrees C and high performance liquid chromatography (HPLC) served as standard methods for comparison. A good agreement was found between EMIT and HPLC at the low range of free quinidine concentration (0.1-0.7 mg/L) observed in our patients (r = 0.959). Although the correlation between UF and ED was high (r = 0.972), Qf was systematically underestimated by UF. This bias was due to the fact that UF was performed according to the recommendations of the manufacturer at 25 degrees C. No systematic differences were found when 20 additional samples were assayed by the two methods at the same temperature (25 degrees C; r = 0.992). The quinidine binding ratio showed a correlation with the serum concentration of alpha 1-acid glycoprotein (r = 0.61). The metabolites 3(S)-hydroxyquinidine and quinidine-N oxide did not influence the protein binding of the parent drug. The importance of adjusting the serum pH to physiological values before measurement of Qf was confirmed in this study. Our results show that, if performed under the same conditions, ED and UF yield practically identical values. Because of easy handling, the EMIT Free Level System II should be applicable under clinical conditions. PMID- 3529517 TI - Quinidine assays: enzyme immunoassay versus high performance liquid chromatography. AB - Plasma quinidine results determined by enzyme multiplied immunoassay (EMIT) (Syva) were compared with results from a quinidine-specific high performance liquid chromatographic (HPLC) assay. During a clinical study, 16 patients with stable ventricular arrhythmias were treated with three oral quinidine preparations given during three consecutive 3-day periods. Seventeen plasma samples were drawn from each patient at steady-state during each period. Each specimen was divided into two portions, one for assay by EMIT and the other for assay by HPLC. EMIT assays were done on a Syva Autolab 6000 System using Syva quinidine kits and bilevel Ortho Diagnostics controls. The overall mean (+/- SD) quinidine concentrations by EMIT and HPLC were 2.16 +/- 0.58 and 1.81 +/- 0.60, respectively, n = 816, with a mean overall EMIT/HPLC ratio of 1.23 +/- 0.18. Mean ratios in individual patients ranged from 1.01 to 1.56; the average of mean individual ratios was 1.23 +/- 0.13. The EMIT assay, which also reports dihydroquinidine and small amounts of quinidine metabolites as quinidine, reported quinidine values that averaged 1.2-fold greater than results from a quinidine-specific HPLC method. PMID- 3529518 TI - Comparison of the Amicon Centrifree micropartition system with the Sartorius SM 13249E Centrisart I device to determine protein free phenytoin concentrations. AB - The Amicon Centrifree micropartition system was compared with the Sartorius SM 13249E Centrisart I ultrafiltration device to determine non-protein-bound phenytoin levels. Phenytoin was measured by an enzyme multiplied immunoassay technique (EMIT), adapted to a Cobas Bio centrifugal analyzer, and by a radiometric assay. From pooled human plasma with total phenytoin concentrations of 19.1, 44.0, and 95.1 microM, the following percentages of free phenytoin levels in the ultrafiltrate were obtained with Amicon: 10.6 +/- 1.3, 10.5 +/- 0.4, and 8.8 +/- 0.2. The corresponding figures with Sartorius were 5.4 +/- 0.8, 5.4 +/- 0.5, and 4.9 +/- 0.4, respectively (n = 5). Similar results were obtained with 3H-labeled phenytoin, ruling out the possibility that the discrepancies were due to interference with the EMIT assay. Phenytoin binding to the Amicon membrane was less than or equal to 5% of the free phenytoin concentration, whereas the Sartorius membranes absorbed 80%. With the Amicon device, the free phenytoin concentration remained constant as serial ultrafiltrate volumes from the same sample were collected, whereas with Sartorius, free phenytoin increased from 2.5 +/- 1.8% of the total concentration in the first fraction to 13.4 +/- 1.6% in the last collection (n = 6). The results indicate that the Amicon Centrifree filter is an excellent tool to obtain protein-free phenytoin ultrafiltrates, whereas the Sartorius Centrisart I device is not suited for this purpose because of excessive adsorption of phenytoin. PMID- 3529519 TI - Methotrexate measurements in plasma: comparison of enzyme multiplied immunoassay technique, TDx fluorescence polarization immunoassay, and high pressure liquid chromatography. AB - One hundred nine patient plasma samples were examined for methotrexate (MTX) levels by enzyme multiplied immunoassay technique (EMIT), fluorescence polarization immunoassay (TDx), and high pressure liquid chromatography (HPLC). EMIT analysis was performed twice within a time span of 18 months. All three methods measure MTX with a high degree of specificity, sensitivity, and precision. There was no evidence of decay of MTX concentrations in samples stored at -20 degrees C for 1.5 years. EMIT, TDx, and HPLC are adequate methods for MTX quantification in the clinical laboratory. PMID- 3529520 TI - Diurnal variation in cyclosporine kinetics. PMID- 3529521 TI - Thymectomy for renal transplantation--a late follow up. PMID- 3529522 TI - The circulating nurse: educator in the OR. PMID- 3529523 TI - Increasing utilization of bone marrow transplantation. PMID- 3529524 TI - Monoclonal antibodies for the prevention of graft-versus-host disease and marrow graft rejection. The depletion of T cell subsets in vitro and in vivo. AB - One of the major complications of allogeneic bone marrow transplantation is graft versus-host disease. This can be avoided by removing the mature T cells from the marrow, most conveniently by the use of monoclonal antibodies. However, T cell purging results in an increased tendency for the recipient to reject the donor marrow. We have developed monoclonal antibodies to L3/T4 and Lyt-2 that specifically deplete functional T cell subsets in mice. We demonstrate that such reagents can be used to control both graft-versus-host disease and marrow rejection in mouse models of bone marrow transplantation across one-haplotype or two-haplotype major histocompatibility differences. Such strategies to abrogate host resistance, by administration of anti-T-cell monoclonal antibodies to the recipient, may complement marrow T cell purging for human allogeneic bone marrow transplantation. PMID- 3529525 TI - Cure of murine thalassemia by bone marrow transplantation without eradication of endogenous stem cells. AB - alpha-Thalassemic heterozygous (Hbath/+) mice were used to investigate the possible selective advantage of transplanted normal (+/+) hemopoietic cells. Without conditioning by total-body irradiation (TBI), infusion of large numbers of normal bone marrow cells failed to correct the thalassemic peripheral blood phenotype. Since the recipients' stem cells are normal with respect to number and differentiation capacity, it was thought that the transplanted stem cells were not able to lodge, or that they were not stimulated to proliferate. Therefore, a nonlethal dose of TBI was given to temporarily reduce endogenous stem cell numbers and hemopoiesis. TBI doses of 2 or 3 Gy followed by infusion of normal bone marrow cells proved to be effective in replacing the thalassemic red cells by normal red cells, whereas a dose of 1 Gy was ineffective. It is concluded that cure of thalassemia by bone marrow transplantation does not necessarily require eradication of thalassemic stem cells. Consequently, the objectives of conditioning regimens for bone marrow transplantation of thalassemic patients (and possibly other nonmalignant hemopoietic disorders) should be reconsidered. PMID- 3529526 TI - Characterization of antileukemia cells' cytotoxic effector function. Implications for monitoring natural killer responses following allogeneic bone marrow transplantation. AB - We have studied here cytotoxic function of three cloned cell lines--TC12, 48, and 50--derived from circulating lymphocytes that were potentially able to eliminate residual tumor cells in a patient transplanted for treatment of acute lymphocytic leukemia. These cloned cells, which have both phenotypic and functional characteristics of natural killer lymphocytes, were tested in chromium release assays against a panel of 16 uncultured populations of leukemia cells. In addition, their activity was compared with that of cloned and uncloned NK cells from normal individuals. It was found that TC clones induced a much weaker degree of killing against fresh tumor cells compared with conventional NK target cell lines such as K562 or MOLT 4. In addition, there was great heterogeneity in their individual lytic capacity against the various leukemia blasts (TC12, 48, and 50 cells killed in a significant fashion, respectively 7, 1, and 4 of the 16 leukemias), reflecting the functional diversity of normal NK cell populations. Thus, for a fraction of leukemias, there was no correlation between lytic ability of TC cells and that of uncloned lymphokine-activated large granular lymphocytes from normal peripheral blood. Together, these results support the view that direct identification of patients' cytotoxic lymphocytes screened against in vivo relevant tumor cells is necessary to evaluate potentially beneficial immunologic responses in the context of bone marrow transplantation. PMID- 3529527 TI - Prediction of crossmatch outcome in highly sensitized dialysis patients based on the identification of serum HLA antibodies. AB - High levels of allosensitization (greater than 50%), which often occur in dialysis patients awaiting renal transplant, make donor selection difficult. Such patients may be included in elaborate protocols in which they are crossmatched with all available ABO compatible donors, or crossmatching may be deferred until a very-well-matched donor becomes available. The former approach of random crossmatching is costly and inefficient, while the latter approach may overlook crossmatch-compatible donors. We believe that the identification of antibodies present in highly reactive sera and the use of this information in donor selection would increase the frequency of crossmatch-negative donors for these patients. In this study eleven sera, reactive with 70% to 100% of a random cell panel, were obtained from multiply transfused dialysis patients. Sera were analyzed by standard (CDC) and antiglobulin augmented (AHG-CDC) lymphocytotoxicity, and by differential absorption with HLA-typed platelets. All sera contained only one or two antibodies directed against the high frequency public HLA epitopes, accounting for 85% to 100% of each serum's total reactivity. These characterized sera were crossmatched with 114 random normal donors. The frequency of negative crossmatches was 20.5%. However, if the serum antibody data had been used to preselect donors for crossmatch--that is, to exclude donors that were likely to be positive--the negative crossmatch frequency would have increased to 86.4%. The use of the serum analysis data in donor selection would have reduced the total number of required crossmatches by 78%. Serum analysis correctly predicted the outcome of 95.6% of crossmatches performed with an average of 3% false positives and 1.3% false negatives. This approach to donor selection reduces unnecessary crossmatching and increases the likelihood of finding crossmatch-compatible donors for highly reactive patients. PMID- 3529528 TI - Induction of B cell tolerance in rats by large doses of allogeneic erythrocytes. AB - Several studies have now confirmed our original observation that transfusions of large doses of donor-specific allogeneic erythrocytes (E) induce humoral unresponsiveness to E-associated antigens (including major histocompatibility complex (MHC) class I antigens) in rats, which is associated with prolonged survival of subsequently inserted renal grafts. To examine whether this tolerance was due to induction of suppressor (T) cells or to anergy or deletion of antigen specific B cells, an in vitro system was developed that allowed generation of primary immune responses of rat splenocytes to allogeneic erythrocytes. Cocultivation of B and non-B cells from tolerant and normal rats in this system showed that E transfusions had induced B cell tolerance in the recipients; no evidence was obtained that suppressor T cells were involved in the maintenance of unresponsiveness. On the contrary, non-B cells from tolerant rats could "help" normal B cells for antibody formation to allogeneic E. In vivo, tolerance to allogeneic E could be broken in one rat strain combination by skin allografts. Therefore, the state of B cell tolerance induced by E transfusions may be referred to as "reversible clonal anergy". PMID- 3529529 TI - Abrogation of the immunosuppressive effect of donor spleen cells on renal allografts in the rat by irradiation or heat treatment. AB - In the donor-recipient strain combination Lewis (RT1l) to Dark Agouti (RT1a), indefinite renal allograft survival (MST greater than 100 days) was induced by pretreating recipient animals i.v. with 10(6) to 10(8) viable spleen lymphocytes, seven days before transplantation. Pretreatment with 10(4) or 10(5) cells was ineffective (MST 10 days). However when 10(7) live, but heat-treated (55 degrees C for 10 min) or irradiated (1000 rads) cells were used, all the animals rejected the allograft in a normal fashion (MST 10 and 11 days, respectively). Median survival time of third-party controls was 10 days. The relative amount of cell surface major histocompatibility antigens (class I and class II) expressed by the three spleen cell preparations was investigated using monoclonal antibodies and fluorescence activated cell sorter analysis and found to be similar. After 24 hr in culture, only 1% of heat-treated and 10% of irradiated cells were viable, in contrast to 75% of untreated splenocytes. Trafficking of these lymphocytes in recipient animals was investigated by 51chromium labeling of the cells: 30% of lymphocytes had localized in the liver within 3 hr with little difference in localization among the different cell preparations. But, although 20% of normal and irradiated cells localized in the spleen within 3 hr, at no stage were more than 5% of the heat-treated cells found in the spleen. It is suggested that the length of time viable donor lymphocytes remain in the recipient circulation is important in the induction of specific immunosuppression by spleen lymphocytes. PMID- 3529530 TI - Intravascular coagulation and kidney donation. PMID- 3529531 TI - Pilot study of CAMPATH-1, a rat monoclonal antibody that fixes human complement, as an immunosuppressant in organ transplantation. PMID- 3529532 TI - Ranitidine, cimetidine, and the cyclosporine-treated recipient. PMID- 3529533 TI - A shorter procedure for preparation E-rosette-depleted bone marrow for transplantation. PMID- 3529534 TI - Development of bullous pemphigoid after allogeneic bone marrow transplantation. Report of a case. PMID- 3529536 TI - Pancreaticoduodenal transplantation in the rat. A technique update. PMID- 3529535 TI - Prolonged survival of cyclosporine-treated allogeneic hepatocellular implants. PMID- 3529537 TI - Cuff technique for orthotopic liver transplantation in the rat. A simplified method for the suprahepatic vena cava anastomosis. PMID- 3529538 TI - A randomized double blind trial of aspirin versus placebo in cholera and non cholera diarrhoea. AB - A randomized double blind controlled clinical trial was conducted on 30 patients with cholera and 18 patients with severe non-cholera diarrhoea, to study the antisecretory effect of acetylsalicylic acid (aspirin). The criteria for selection of patients was a stool output of 4 ml/kg per hour over 6 hours of baseline observation. On inclusion into the study, the groups were comparable in sex, age, body weight, duration of diarrhoea and severity of dehydration. Aspirin and placebo (starch) were given by mouth in doses of 25 mg/kg/day for 24 hours in four equally divided doses. Fourteen patients with cholera and 10 with non cholera diarrhoea received aspirin and the others received placebo. The aspirin and the placebo groups did not differ in their rate of stool output. The results suggest that aspirin in the above mentioned dose has no antisecretory activity. PMID- 3529539 TI - [The origin of the eukaryotic cell. I. Historical sources and current state of the concept of symbiotic and autogenic origins of the cell]. AB - The exogenous (symbiotic) conception of the eukaryotic origin is now widely spread. It is based on the recognition of the principle of combination (addition or enclosing) of diverse prokaryotic organisms; so the complicated unicellular eukaryotic organism (eukaryotic cell) was resulted. the principle of combination takes its historical scientific sources from the ideas of Buffon. With reference to the cell this principle was claimed for the first time. In our time the exogenous conception is characterized as a "symbiotic boom", because it is widely used in attempts to explain the origin of all the main organelles of the cell (right up to the micro-bodies). The autogenetic (endogenous) conception is based on the principle of straight phyliation, on the recognition of a successive evolutionary transformation of prokaryotic forms into eukaryotic ones. In this way all the cell organelles may have an endogenous origin. This principle springing from Lamarck has got a contemporary meaning in the doctrine of Darwin. In the next papers the author will present his own analysis and generation of the present day relevant facts to find out which of these two conceptions based on quite different scientific methodological principles may be correct. PMID- 3529540 TI - [Hybridoma cultures using porcine serum not containing immunoglobulin and dialysis fractions]. AB - The whole swine serum was treated with ammonium sulphate to precipitate immunoglobulins. The remained IgG was removed with the use of protein A sepharose. The hybridoma cells producing monoclonal antibodies to lambda phage (class IgG) were cultured in Dalbecco's modified Eagle medium with addition of a 5% whole swine serum or of a treated unwhole one (final concentration of the protein being 3 mg/ml). Upon these conditions, hybridoma cells had similar growth rate and population density (1-1.3 X 10(6) cells/ml). Maximal antibody concentration was almost similar (80-90 mcg/ml). Purity of a sample of monoclonal antibodies isolated by the method of chromatography with the use of protein A sepharose from supernatant containing the unwhole serum was no less than 99%, whereas it was considerably lower (12-15%) in the case of the whole serum. PMID- 3529541 TI - [Surface changes in irradiated thymocytes studied by partition in 2-phase systems and electrophoresis]. AB - A study was made of thymocyte surface changes 1-6 hour after the irradiation in a dose of 4 Gy by means of two phase partition in dextran-polyethylenglycole systems and of electrophoretic mobility registration. A decrease in the two phase partition coefficient (by 20% per cent in one hour after irradiation) was registered. The electrophoretic mobility of irradiated cells did not change. PMID- 3529542 TI - [Treatment of thyrotoxicosis with radioactive iodine (131I). Evaluation of a method]. PMID- 3529544 TI - [Salmonellosis associated with abdominal aortic aneurysm]. PMID- 3529543 TI - [Preventive use of lignocaine against laryngeal spasm after extubation]. PMID- 3529545 TI - [Stenosis of the subclavian artery]. PMID- 3529546 TI - [Treatment of acute pain due to ureteral calculi with intravenous indomethacin or pethidine]. PMID- 3529547 TI - [The effects of boric acid and chlorhexidine on bacterial flora of the umbilical stump in newborn infants. Comparative analysis]. PMID- 3529548 TI - [Local anesthesia for intravenous drop infusion]. PMID- 3529549 TI - [Benzodiazepines as hypnotics. The importance of short half-life]. PMID- 3529550 TI - [Intraoperative and postoperative hemorrhage in total hip replacement. A comparison between epidural analgesia and general anesthesia]. PMID- 3529551 TI - [Hip replacement after renal transplantation]. PMID- 3529552 TI - [Zip closure technic compared with conventional suture in skin closure]. PMID- 3529553 TI - [Pneumocystis carinii infections in a Danish case population of renal transplants]. PMID- 3529554 TI - [The toxic shock syndrome 1981-1985]. PMID- 3529555 TI - [Neonatal icterus. Therapeutic indications and treatment]. PMID- 3529556 TI - [Purulent pericarditis in Haemophilus influenzae type B bacteremia in adults]. PMID- 3529557 TI - [Primary suture of perianal abscesses and infected pilonidal cysts under metronidazole and ampicillin cover for 4 days]. PMID- 3529558 TI - [Ureteral leakage diagnosed by computed tomography]. PMID- 3529559 TI - [Connective tissue metabolites in tissue fluids. New possibilities for monitoring the fibrotic process]. PMID- 3529560 TI - [Epithelioid cell granulomas of the liver]. PMID- 3529561 TI - [Aerobic training increases the effect of ephedrine on energy expenditure]. PMID- 3529563 TI - [Supralethal treatment and bone marrow autotransplantation in the treatment of patients with leukemia and malignant lymphoma]. PMID- 3529562 TI - [The effect of domperidone and metoclopramide on stomach emptying and pH in patients admitted for elective surgery]. PMID- 3529564 TI - [Digital subtraction angiography postprocessing]. PMID- 3529565 TI - Quantitative sonography. AB - The review presents a perspective on ultrasonic techniques which place numerical values on properties of tissue or physiological function. Two distinct approaches to tissue characterisation are identified and the various techniques employed are reviewed. The range of Doppler techniques currently in use or under development are described. The potential roles of the various techniques are discussed, using clinical results from the Ultrasonics Institute as a basis. Attenuation measurements show a considerable spread in results, but sound speed appears to correlate closely with the degree of fibrosis in liver and spleen. Other methods have been found useful in specialised areas. The use of pulsed Doppler with a resolution cell sufficiently large to encompass the entire vessel, in conjunction with B-mode imaging to determine geometry, permits volumetric flow measurements to be made in deep vessels and reveals previously inaccessible physiological data. The use of analysis techniques to provide quantitative information in the physiological state or function of tissue promises to add a new dimension to diagnostic ultrasound. PMID- 3529566 TI - Doppler frequency ratio and peak frequency in the assessment of carotid artery disease: a comparative study with angiography. AB - A retrospective analysis compared the sensitivity, specificity, and predictive value of two methods using noninvasive Doppler ultrasound for detecting the severity of carotid artery disease. Doppler spectral analyses were used in determining the peak systolic frequency (PF) found within the stenosis, as well as the ratio of the peak systolic frequency distal to the stenosis, to the peak systolic frequency within the stenosis (f2/f1). The results of the noninvasive tests were compared with carotid arteriography. The sensitivity of the two methods were similar, but the specificity of f2/f1 was much higher (98%) than PF (88%) with stenosis greater than 50%, and marginally better, 97 and 94%, respectively, with stenosis greater than 75%. The positive predictive value was also better for f2/f1 than PF; 91% and 71% for stenosis greater than 50%, and 77% and 67%, respectively for stenosis greater than 75%. The use of Doppler frequency ratio in conjunction with peak frequency measurements provide a quantitative and fairly accurate evaluation of the severity of carotid artery disease. PMID- 3529567 TI - Ultrasound findings in urolithiasis in the lower ureter. AB - Thirty-two cases of urolithiasis in the lower ureter, difficult to detect by ordinary X-ray studies, were diagnosed accurately by ultrasound. Stonelike echoes were easily detected on the ultrasonograms when the ureter of the affected side was dilated. Patients should be examined by ultrasound prior to invasive retrograde pyelography. PMID- 3529568 TI - Bibliography of biomedical ultrasound. No. 56. PMID- 3529569 TI - Effects of prostaglandins on the isolated human minor calyx. AB - Effects of prostaglandins (PGE1, PGE2, PGF2 alpha, and PGI2) on the isolated human minor calyceal strips were isometrically investigated in vitro. PGE2 and PGF2 alpha, 10(-7) to 10(-6) g/ml, increased the basal tone of spontaneous contractions. PGE1 and PGI2 did not affect the contractions of the isolated human minor calyceal strips. The increases on the basal tone induced by PGE2 and PGF2 alpha were not affected by the pretreatment with atropine, hexamethonium, and phentolamine. Following incubation in a Ca2+-free medium, spontaneous contractions and the responses to PGE2 and PGF2 alpha were abolished. The results suggest that the contractile effects of PGE2 and PGF2 alpha may not be mediated by activation of muscarinic, nicotinic, or alpha-adrenergic receptors and result from a consequent increase of the transmembrane Ca2+ influx. PMID- 3529571 TI - Endourology in perspective. PMID- 3529570 TI - Detection of transitional cell carcinoma in bladder by intravesical injection of monoclonal antibodies. AB - Monoclonal antibodies produced against tumor associated antigens of human bladder transitional cell carcinoma have proved to be useful in detecting malignant cells in tumor sections and bladder washings. The present study evaluated the capacity of one such antibody G4 to identify sites of malignancy when introduced into the lumen of intact bladders immediately after cystectomy. An ex vivo immunoperoxidase staining (IPS) method was applied to four cystectomy specimens- three with solitary invasive transitional cell carcinomas (TCC) and one with carcinoma in situ (CIS) using monoclonal antibody G4 injected intravesically immediately after cystectomy. The tumor sites, normal appearing mucosa and other exposed and non exposed tissues from the same patient were examined for G4 binding. In all cases preferential intravesical binding of G4 antibody to the tumor size was demonstrated without binding to the normal mucosa except in one case. This study showed that monoclonal antibody injected intravesically can be focused on the tumor site and indicates that G4 and other antibodies may be useful intravesically for selectively assessing field changes associated with malignancies or as specific therapeutic agents. PMID- 3529572 TI - Clinical experience with Mentor inflatable penile prosthesis in 206 patients. AB - The Mentor inflatable penile prosthesis (IPP) has been implanted in 206 patients with organic (95.2%) or psychologic (4.8%) impotency. The patients have been followed up for an average of 18.1 (4-42) months. A satisfactory result has been achieved in 98 per cent of these patients. A life analysis of the series shows that 88 per cent of all devices implanted will survive forty-two months without mechanical failure. One hundred sixty-four of these patients had not had previous penile surgery while 42 had had one or more penile prostheses implanted previously. The projected forty-two-month survival for the Mentor prosthesis in these subgroups is 94 per cent and 74 per cent, respectively. The improved life expectancy of the Mentor IPP, compared with the Scott IPP, is due to the superior durability of Mentor's polyurethane cylinders and to the increased reliability of the Mentor snap-on connector system. In this respect, there have been only one cylinder failure and 3 connector failures in the Mentor series. The connector failures occurred early in the series before the development of connector pliers; there have been no connector failures in the last 202 consecutive implantations. Wear-induced tubing leaks, the most common cause of device failure, occurred in 2.9 per cent of all implantations. Tubing failures were more common in patients who have had previous surgery, occurring in 9 per cent of salvage procedures and 1.3 per cent of primary implantations. The reason for the difference in tubing survival in virgin and salvage procedures is unknown; possibly the subcutaneous scar tissue present in secondary surgical procedures increases the chance of tubing segments touching and abrasing each other. Laboratory studies suggest that the nylon-reinforced tubing used in the manufacture of devices implanted since 1985 is more durable than is the standard silicone tubing used in the construction of devices implanted previously. PMID- 3529573 TI - ["Vestnik Otorinolaringologii"--50th anniversary]. PMID- 3529574 TI - [Correction of soft tissue defects of the head and neck with a cutaneo-muscular flap from the greater pectoral muscle]. AB - Plasty of defects of head and neck by a flap with musculus pectoralis major is described. In 20 patients the substitution of the defects was fulfilled simultaneously with the main operation. In 12 patients it was performed within 2 12 months. The method described gives a valuable substitution of lack of the soft tissues resulting from oncological operations, gives good cosmetic results and shortens the period of staying at the hospital. PMID- 3529575 TI - [Intermediate revascularization of complex composite flaps in plastic surgery of extensive penetrating defects of the skull]. AB - The authors propose an original method of closure of vast penetrating defects of the skull after a radical removal of basal cell carcinoma of skin of the skull. It was used in 2 patients and consisted in using forearm as an intermediate field in transplantation of a complex cutaneous flap on microvascular anastomoses. PMID- 3529576 TI - [Plastic surgery using islet triangular flaps in 4th degree frostbite of the fingers]. AB - In 36 patients with IV degree frostbites the guillotine amputation of 91 fingers was performed at the level of the ungual, middle and distal thirds of main phalanges. The wound of the stump butt was substituted by an islet triangular flap. It gave a functionally adaptable stump without shortening the bone phalange. PMID- 3529577 TI - [Surgical treatment of open pneumothorax]. AB - An analysis of clinical observations shows the successful treatment of most patients with open pneumothorax to be possible under conditions of urgent suturing of the wound defect of the chest, drainage of the pleural cavity and antishock therapy. Thoracotomy is necessary for a small amount of the patients. PMID- 3529578 TI - [Prevention of postoperative recurrence after the treatment of varicose veins of the lower extremities]. PMID- 3529579 TI - [Intravascular hemolysis in patients with artificial heart valves]. PMID- 3529580 TI - [Open treatment of postoperative peritonitis]. AB - Results of using the open method of treatment of postoperative peritonitis in 26 patients are presented. Relaparotomy technique is described when "open abdomen" was used as a typical operation irrespective of causes of progressing peritonitis. In addition to surgical measures the authors stress the importance of intensive therapy. In relation with the character of postoperative peritonitis the abdominal cavity was closed by primary-delayed or secondary sutures on the 5 12th day. Lethality after using the open method of treatment of postoperative peritonitis was 30.7%. PMID- 3529581 TI - [Surgical treatment of extension contractures of the knee joint after femoral fractures complicated by osteomyelitis]. AB - An experience with the treatment of 26 patients has shown high efficiency of open mobilization of the knee-joint in extension contractures following fractures of the femoral bone complicated by osteomyelitis. Extended scarry degeneration of certain muscles is not thought to be a contraindication for operation provided the intact muscle heads are sufficiently trained. The aggravation of osteomyelitis in part of the patients at late terms did not deteriorate favorable functional outcome of the mobilizing operation. PMID- 3529582 TI - [Migration of multiple bladder calculi under the skin of the scrotum in a child]. PMID- 3529584 TI - [Development of a cryogenic method in bone oncology]. PMID- 3529583 TI - [Mycetoma of the lungs]. AB - Mycetomas of the lungs are, as a rule, localized in the upper (62), medial (22) and very rarely (8) in the lower portions of the lungs. Most frequent localization is the right lung. Operations were fulfilled on 68 of 92 patients. Surgery was shown to be the most effective method of treatment of patients with lung mycetomas. It results in complete and clinical recovery. PMID- 3529585 TI - [Treatment of peritonitis]. AB - Different forms of peritonitis were observed in 209 patients. Generalized results of treatment have shown positive effects of the complex treatment including preoperative management, timely radical operation aimed at liquidation of the source of peritonitis, lavage of the abdominal cavity and adequate drainage and finally, intensive therapy in the postoperative period. Lethality in generalized peritonitis was 11.1%. PMID- 3529586 TI - [Isolated venous aneurysms]. AB - The author has observed 9 patients with isolated aneurysms of the neck and extremity veins. Clinical manifestations of the disease, diagnosis and surgical methods of treatment are described. PMID- 3529587 TI - [Gastropancreatoduodenal resection in stomach cancer]. PMID- 3529588 TI - [The gas syndrome in damage to and destructive processes of the respiratory organs]. PMID- 3529589 TI - [Surgical treatment of duodenal ulcer with maximum acid production]. PMID- 3529590 TI - [Treatment of fractures of the extremities and pelvis in severe multiple injuries]. PMID- 3529591 TI - [The non-contrasted gallbladder]. AB - Results of an analysis of causes of the absence of contrast of the gallbladder in preoperative radiopaque examinations are presented. In most cases the exclusion of the gallbladder was due to cholelithic disease. The ultrasonic echotomography in some cases associated with a choleretic test allows to considerably facilitate and improve the diagnosis of the excluded gallbladder. PMID- 3529592 TI - Simian models of acquired immunodeficiency syndrome (AIDS): a review. PMID- 3529593 TI - Naturally occurring lesions in some endocrine glands of laboratory maintained baboons (Papio sp.). AB - The pituitary gland was examined from 623 immature baboons (Papio cynocephalus and Papio anubis). Findings included microscopic cysts in the pars distalis (132), pars intermedia (two) and pars nervosa (one). In 641 necropsies five cases of unilateral thyroid glands were noted. Microscopic thyroid lesions included ectopic thymus (328), minor lymphocytic infiltrates (14) and cysts (two). Parathyroid lesions consisted of ectopic thymus (73) and cysts (24). Dilated capillaries in the islets of Langerhans was the only microscopic change seen in the endocrine pancreas. All lesions generally occurred in both untreated control and treated baboons at similar incidences. They were considered to be naturally occurring, a part of the "background" pathology of these endocrine glands in immature baboons. PMID- 3529594 TI - Polyneuropathy and hormone profiles in a chow puppy with hypoplasia of the islets of Langerhans. PMID- 3529595 TI - Efficacy of ivermectin against anthelmintic resistant isolates of sheep nematode parasites. PMID- 3529597 TI - Distal renal tubular acidosis in a cat with pyelonephritis. AB - A four-year-old castrated male domestic shorthair cat with recent onset of lethargy and depression was found to have hypokalaemia, low plasma bicarbonate concentration and a urine pH of 7. Subsequent findings of hyperchloraemic metabolic acidosis with failure to produce acid urine led to a diagnosis of distal renal tubular acidosis. Pyelonephritis associated with Escherichia coli infection of the urinary tract was also diagnosed. The urinary tract infection was eliminated by antibiotic treatment. For two years subsequently, the clinical effects of distal renal tubular acidosis have been controlled by oral administration of potassium bicarbonate, although some biochemical abnormalities have persisted. PMID- 3529596 TI - Maple syrup urine disease as a cause of spongiform encephalopathy in calves. AB - Estimates of branched chain amino acid concentrations in plasma and, or, serum, urine, cerebrospinal fluid, formalin-fixed cerebral tissue and the associated formalin, provided evidence for a diagnosis of branched chain keto acid decarboxylase deficiency in five polled Hereford calves. The similarity of the clinical signs of dullness, recumbency and opisthotonos, and the observation of severe status spongiosus within the central nervous system, indicated that this condition had probably affected seven other newborn calves. It is suggested that this condition is analogous to branched chain keto acid decarboxylase deficiency or maple syrup urine disease of children. PMID- 3529598 TI - Pregnancy diagnosis in the sow using real-time ultrasonic scanning. PMID- 3529599 TI - An introduction to clinical neuromuscular electrophysiology. AB - This paper serves as a brief and general introduction to the basic elements of neuromuscular electrophysiology. The technical and clinical principles of electromyography and electroneurography; as well as the pathophysiology of nerve conduction, are described. PMID- 3529600 TI - Trypanosomiasis in Indonesia. A review of research, 1900-1983. AB - This review describes research conducted from 1900-1983 on trypanosomiasis due to Trypanosoma evansi in Indonesia. Clinical signs and post-mortem findings in horses, cattle, buffaloes, pigs and dogs, experimental transmission tests to establish possible surra vectors in Indonesia, and research on chemotherapy and chemoprophylaxis are discussed. PMID- 3529601 TI - The enzyme-linked immunosorbent assay for detecting antibodies against Dirofilaria immitis in dogs. AB - Antisera prepared in mice by injection of antigens from Dirofilaria immitis, Toxocara canis, Dipylidium canium and Fasciola hepatica and sera from Dirofilaria infected and non-infected dogs were tested at different dilutions using an enzyme linked immunosorbent assay (ELISA). For this ELISA, adult D. immitis antigen was fractionated by gel filtration methods and then absorbed with immunoadsorbent fixed IgG fractions from mouse sera immunized with various parasites. The results indicated satisfactory discrimination between antisera to D. immitis and those to other parasites. A significant ELISA O.D. value was considered to be greater than or equal to 0.30 with a 1 : 250 dilution of the dog sera. However, the lack of significant differences between the O.D. value of microfilaraemic and amicrofilaraemic infections was observed. These facts suggest that the use of immunoadsorbent chromatography for canine dirofilariasis is especially useful for purifying antigens and eliminating cross-reactions against other parasitic infections, when immunological methods are used for serodiagnosis. PMID- 3529602 TI - Prevalence and control of benzimidazole-resistant small strongyles on German thoroughbred studs. AB - The prevalence of benzimidazole-resistant small strongyles was determined in a survey, conducted on 14 thoroughbred studs, which compared the faecal egg counts of groups of horses before and after treatment with the recommended doses of cambendazole (20 mg kg-1 b.w.) or febantel (6 mg kg-1 b.w.). Benzimidazole resistant cyathostomes were found on all farms examined. Pyrantel pamoate (19 mg kg-1 b.w.), oxibendazole (10 mg kg-1 b.w.) and ivermectin (0.2 mg kg-1 b.w.) reduced the strongyle egg counts on these studs by 97-100% at 2 weeks post treatment. However, 6 weeks after dosing the reduction of the strongyle egg output had decreased to an average of 67.8% (8.7-97.1%) with pyrantel pamoate and 51.2% (0-95.8%) with oxibendazole, whereas ivermectin still suppressed the egg counts by 98.2% (95-100%). PMID- 3529603 TI - American Association of Poison Control Centers 1986 Individual Membership Directory. PMID- 3529604 TI - Septicaemic Escherichia coli and experimental infection of calves. AB - Three strains of Escherichia coli with a common surface antigen, 31a, capable of adhering to calf enterocytes in vitro were compared to reference strains of septicaemic E. coli (RVC 330 and vir E. coli). The surface antigen 31a was present in the RVC 330 reference strain. E. coli vir had a surface antigen which was not present in E. coli 31a or E. coli RVC 330. The RVC 330 and vir reference strains also adhered to calf enterocytes in vitro. Oral infection of calves not receiving colostrum with E. coli 31a was generally followed by septicaemia and death in less than 48 h. Post-mortem examination revealed pneumonia and oedema of the kidneys and gall bladder. Oral infection of calves receiving colostrum had no effect, but intravenous inoculation produced arthritis within 15 days. The comparison of these results with those previously described by other workers did not lead to the identification of pathognomonic characteristics, which could be clearly correlated with properties specific to E. coli 31a. It is suggested that, like ColV and vir, antigen 31a may be a virulence marker for certain strains of bovine septicaemic E. coli. Furthermore, the 31a antigen appears to be carried on a plasmid. PMID- 3529605 TI - Development of intestinal antibodies against Escherichia coli antigens in piglets with experimental neonatal E. coli diarrhoea. AB - Intestinal immune responses to Escherichia coli antigens were studied in conventionally reared piglets orally infected on the first day of life with a virulent enterotoxigenic E. coli (O149: K88). During the first week of life intestinal antibodies were produced against the homologous lipopolysaccharide (LPS) as well as against the K88 antigen and the heat-labile enterotoxin (LT). On Day 7, anti-LPS antibodies of the IgA and IgG classes were detected in most piglets, whereas anti-K88 antibodies of the IgG and IgM classes predominated; antibodies against the enterotoxin were usually of the IgG class. In 21-day-old piglets antibodies of all immunoglobulin classes had usually been produced. In most cases, the levels of intestinal antibodies were substantially higher on Day 21 compared to Day 7, but the levels varied considerably both between and within litters. The intestinal immune responses did not correlate with the severity of clinical symptoms. One-, 7- and 21-day-old piglets reared in a specific-pathogen free (SPF) herd lacked significant intestinal antibodies to the antigens examined. The oral challenge did not stimulate systemic immune responses. After colostral intake, all piglets had high antibody levels in the circulation. These levels decreased continuously during the 3-week study period. The possibility that high amounts of antibodies in colostrum could interfere with this early intestinal antibody formation should be considered when planning vaccination programmes against E. coli diarrhoea in piglets. PMID- 3529606 TI - Comparative antigenic analysis of extracellular proteins of Bacteroides nodosus isolated from virulent and benign ovine footrot. AB - Antigens in the extracellular protein (ECP) complexes of Bacteroides nodosus, isolated from sheep with either benign or virulent footrot, were studied by immunoelectrophoresis (IEP). Rabbit antisera against ECP from virulent and benign strains, were used in homologous and heterologous crossed IEP. Four precipitin peaks unique to the virulent strain, and five peaks unique to the benign strain were identified. In an attempt to characterize the different antigens in ECP, rabbit antisera were raised against an outer membrane protein (OMP, mol. wt. 35 000 daltons), pili and various proteases of virulent and benign strains of B. nodosus. No precipitin band was observed when ECP from both B. nodosus strains were reacted against anti-OMP and anti-pilus antisera. However, single precipitin bands unique to one protease from the benign strain and one protease from the virulent strain were identified. The results suggest that specific antigens other than proteases or pili are important in determining whether a B. nodosus isolate is virulent or benign. PMID- 3529607 TI - A comparison of the STAPH-Ident and STAPH-Trac systems to conventional methods in the identification of staphylococci isolated from bovine udders. AB - The STAPH-Ident and STAPH-Trac systems (Analytab Products, Plainview, N.Y.) were compared to conventional methods for identification of staphylococci isolated from bovine udders. The STAPH-Ident system identified 80.5% of isolates correctly. An additional 7.6% of Staphylococcus hyicus strains were delineated from S. epidermidis by characterizing acetoin and pigment production. Final accuracy of the STAPH-Ident system was 88.1%. The STAPH-Trac system identified 66.1% of isolates. Negative phosphatase tests for 42.3% of S. hyicus strains resulted in misidentification as S. simulans. Consequently, only 45.5% of S. hyicus isolates were identified correctly by the STAPH-Trac system. Minor modification of each system would permit accurate, rapid identification of staphylococci isolated from bovine udders. PMID- 3529608 TI - [Case of multiple cortical hyperostosis in a 3-week-old infant]. PMID- 3529610 TI - Functional expression of influenza A viral nucleoprotein in cells transformed with cloned DNA. AB - Simian cells permissive for influenza A virus infection were stably transformed with a full-length cloned influenza A nucleoprotein gene under the control of an inducible metallothionein promoter and linked to a dihydrofolate reductase gene to facilitate cell selection. Transformed cells synthesized a virus-specific nucleoprotein which was indistinguishable from the nucleoprotein synthesized in virus-infected cells with respect to molecular weight and intracellular localization. It was estimated that transformed cells produced only 1% of the amount of nucleoprotein synthesized in simian cells infected with influenza A virus. Nonetheless, when transformed cells were infected with influenza virus mutants which synthesized temperature-sensitive nucleoprotein, protein expressed by the cloned gene was able to complement the synthesis of plus-strand and minus strand viral RNA for one mutant and only plus-strand synthesis for another mutant. This indicated that the influenza A nucleoprotein expressed in the transformed cells exhibited functional activity. PMID- 3529609 TI - Physiological aspects of absorption and secretion in intestine. AB - Two differently oriented approaches in intestinal physiology can be distinguished. One, mainly based on in vitro experiments, seeks explanations at the level of the epithelium itself. The other, mainly based on in vivo experiments, looks for explanations at the level of regulatory nervous and endocrine mechanisms and their interaction. These two approaches complement each other. PMID- 3529611 TI - [The work of sorting-evacuation hospitals at intake of the hospital base during the World War II]. PMID- 3529612 TI - [Participation of Soviet physicians in the testimony against war criminals at the Nuremberg trial]. PMID- 3529613 TI - [Use of hospital ships for medical and evacuation services in the military forces of the United States during the Vietnam war]. PMID- 3529614 TI - [Effect of radioprotectors on treatment efficacy in combined radiation lesions (a review of the literature)]. PMID- 3529615 TI - [Heat exhaustion as a consequence of body dehydration]. PMID- 3529616 TI - [Development of measures for increasing the work capacity of submariners and divers in World War II]. PMID- 3529617 TI - [Growth of health resort rheumatology in the Ukraine]. PMID- 3529619 TI - [Contribution of V.S. Derkach, Corresponding Member of the USSR Academy of Medical Sciences to the development of medical microbiology and the science of antibiotics]. PMID- 3529618 TI - [Physical therapy factors in the practicing career of N. I. Pirogov (on the 175th anniversary of his birth)]. PMID- 3529620 TI - [Silabolin in the treatment of patients with chronic circulatory insufficiency]. PMID- 3529621 TI - [Reiter's syndrome]. PMID- 3529622 TI - [Use of quadevit and bicillin in the complex anti-recurrence treatment of rheumatism]. PMID- 3529623 TI - [Value of thin-needle biopsy under echographic control for determining the microflora of liver abscesses]. PMID- 3529624 TI - [Mechanism of the allergenic action of surface-active substances after different routes of entry into the body (review of the literature]. PMID- 3529625 TI - [Various patterns in the isolation of agents of escherichioses in the Ukrainian S.S.R]. PMID- 3529626 TI - [Clinical picture and treatment of Escherichia meningitis and meningoencephalitis]. PMID- 3529627 TI - [A study on ultra-low temperature freezing of bacterial cultures]. PMID- 3529628 TI - A register of controlled trials in perinatal medicine. PMID- 3529629 TI - What caused the plague of Athens? PMID- 3529630 TI - Doctor Bethune served the people. PMID- 3529631 TI - The pharmacology of neonatal resuscitation and cardiopulmonary intensive care. Part II--Extended intensive care. AB - An optimal outcome for a distressed newborn infant can be achieved only if immediate resuscitation is followed by appropriate cardiopulmonary intensive care. In the preceding article in this series, we provided recommendations for drug therapy during the initial resuscitation. When an infant is stable enough for transfer to an intensive care nursery, extended cardiopulmonary intensive care should be initiated. If the infant remains distressed, this may require drug therapy to improve cardiac output, either by enhancing cardiac performance (dopamine, dobutamine or epinephrine) or by reducing afterload (nitroprusside). Drugs that alter the distribution of the circulation may be required for infants with persistent hypoxemia due to pulmonary hypertension or congenital heart disease (tolazoline, nitroprusside, prostaglandin E(1)), or with pulmonary congestion due to persistent patency of the ductus arteriosus (indomethacin). Infants with pulmonary disease may benefit from administration of agents that alter pulmonary function (furosemide, nitroprusside or neuromuscular blockers). Finally, treatment of the underlying disorder, with antibiotics or naloxone, for example, must not be neglected. PMID- 3529633 TI - Diagnostic immunopathology. AB - The application of immunologic techniques to tissue sections has added a new dimension to the investigation and classification of various processes. Virtually every section of diagnostic pathology has been enhanced by using specific monoclonal antibodies or polyclonal antiserum. Neoplasms formerly diagnosed as poorly differentiated or anaplastic may be precisely identified as to their origin through the use of specific membrane or cytoplasmic markers. Other cellular products, including viruses, hormones, enzymes or highly specific proteins, are also available to study neoplastic and nonneoplastic processes. New and more specific reagents are regularly becoming available for the diagnostic repertoire of pathologists. We present some of the principles of diagnostic immunopathology to show the scope and importance of the techniques. PMID- 3529635 TI - Reactivation of coccidioides infection. PMID- 3529634 TI - Digitalis toxicity--turning over a new leaf? PMID- 3529632 TI - Lung cancer--current concepts and controversies. AB - The recent literature contains a variety of controversial management alternatives for patients with pulmonary malignancy that affect all aspects of the lung cancer problem. Revisions in the classification system have been advanced in which the prognostic implications of specific ultrastructural and histochemical information are acknowledged. Computed tomography and, to a lesser extent, nuclide scanning have revolutionized the staging process, but limitations in these procedures are emerging. Improved survival following aggressive surgical treatment has challenged the adequacy of the standard staging system. The palliative role of radiotherapy is becoming more widely appreciated. Results of immunotherapy are equivocal and gains from chemotherapy are modest. Combinations of treatment modalities will require further documentation before they can be recommended with confidence. PMID- 3529636 TI - [Membrane filtration--new prospects in cerebrospinal fluid cytology]. PMID- 3529637 TI - [Intraoperative evaluation of renal artery stenosis using the Doppler signal histograph]. PMID- 3529638 TI - [Disorders of cardiac rhythm and conduction in Chagas cardiomyopathy]. PMID- 3529639 TI - [Treatment of cerebral cysticercosis with praziquantel]. PMID- 3529640 TI - [The life and work of Leon Konrad Glinski]. PMID- 3529641 TI - [Methods of confirmation of death in view of the prevention of live burials ("apparently dead persons") in the 18th and 19th centuries]. PMID- 3529642 TI - [Induction of ovulation using pulsatile GnRH administration to infertile females]. AB - 6 infertile women with primary or secondary amenorrhoea or anovulation, who failed to ovulate after clomiphene and HMG/HCG treatment, underwent 11 treatment cycles with pulsatile GnRH therapy using a portable pump. Normal ovulation occurred in 9 out of 11 treatment cycles; the luteal phase was normal in 6 cycles. One woman conceived in the second treatment cycle. PMID- 3529643 TI - [Normal sizes of internal genitals in girls before and after the menarche]. AB - Knowledge of the average size of the organs of the true pelvis is a prerequisite for the diagnosis and treatment of suspected disorders of the uterus and ovaries in children and adolescents. 76 girls in the premenarche (age = 1 to 14 years) and 31 girls in the postmenarche (age = 13 to 18 years) underwent ultrasound investigation of the inner genitals. Firstly, measurements of the uterus were taken in three dimensions. The volumes of the ovaries were calculated from 3 dimensional measurements of ovarian size. The results of measurements and calculations were used to establish median values and 10th and 90th percentile. Our results show nearly linear growth of the uterus and the ovaries between the 2nd and the 14th year of age. After the menarche accelerated growth of the organs of the true pelvis was detectable in all dimensions. PMID- 3529644 TI - [Sonographic diagnosis of hypertrophic pyloric stenosis]. AB - 50 infants admitted during the years 1981 to 1985 for suspected hypertrophic pyloric stenosis were examined sonographically. A pyloric cockade of 14 mm or more in diameter is diagnostic. A diameter up to 10 mm can be considered normal, whereas values between 11 and 13 mm represent borderline cases, which need consideration of the clinical symptoms and repeated controls. Because of its accuracy sonography can replace X-ray examinations in most of the cases with suspected hypertrophic pyloric stenosis. PMID- 3529645 TI - [Sonographic monitoring in blunt abdominal injuries in children]. AB - Sonography is nowadays the most important examination in diagnosing lesions of the parenchymatous organs after blunt abdominal trauma. Also for monitoring this method is recommended. Under the premises of 1. no clinical deterioration, 2. the possibility for repeated ultrasound investigations, and 3. readiness to operate at any moment it is possible to treat traumatized parenchymatous organs conservatively. This is of utmost importance in paediatric surgery because of the risk of overwhelming postsplenectomy infection after splenectomy especially for young children. Examples for conservative treatment for trauma to spleen, liver and kidney are discussed. PMID- 3529646 TI - [Remarks on sonography in obstetrics]. AB - For the near future two routine examinations by sonar for every pregnancy in Austria were announced by government. Therefore an analysis of 3076 ultrasonographic examinations of 1217 pregnancies seen in 1984 may lead to an estimation of the frequency of pathological factors to be expected. More than 90% of all pregnant women seen in our department for delivery or other indications had had sonographic examinations during pregnancy, 74% of them as outpatients. The most common pathological factors diagnosed were discrepancies between sonographic estimated and anamnestic gestational age (14.1% of cases), pathological fetal growth (11.0%), pathologics of placenta and umbilical cord (8.6%), pathological presentation (5.9%). Accompanying pathological factors as a cervical length less than 30 mm, an uterus myomatosus, uterine malformations, cystic adnexal masses were found in 1-2% of cases each. Fetal malformations and anomalies were seen in 0.8%. Problems arising from low frequencies of certain rare pathological findings, especially for their detection by office sonographiers or small departments, are discussed. For solution of such problems the multiple step programs as well as an intensive interdisciplinary local or countrywide collaboration is proposed. In Upper-Austria, such collaboration takes place organized by the collaboration group for antenatal detection of fetal malformations, which was founded in 1985 by the Upper-Austrian part of the Osterreichische Gesellschaft fur Ultraschall in der Medizin (OGUM). PMID- 3529647 TI - Ob/gyn on the rise: the evolution of professional ideology in the twentieth century--Part II. AB - The first part of this article (Volume 11, No. 1) looked at the formation of ideology in the specialty of obstetrics and gynecology from 1920 to World War II. This was a period of professional establishment and self-definition; it saw the emergence of interventionist ideology as the dominant belief system influencing ob-gyn practice. Part II in this issue begins with the period of optimism and expansion marked by a surging post-war birth rate, and ends in 1980 with the profession on the defensive, feeling "under siege" from both lay and medical forces. PMID- 3529648 TI - Clinical management of persistent and/or recurrent primary hyperparathyroidism. PMID- 3529649 TI - Prospective comparison of radionuclide, computed tomographic, and sonographic localization of parathyroid tumors. PMID- 3529650 TI - Intraoperative ultrasound and reoperative parathyroid surgery: an initial evaluation. PMID- 3529651 TI - Serum calcium as an early indicator for surgical treatment of hyperparathyroidism after renal transplantation. PMID- 3529652 TI - State Medical Society of Wisconsin. 1986 Membership Directory as of July 1, 1986. PMID- 3529653 TI - Mutagenicity of para-nitroso-dimethyl- and diethyl-anilines. AB - Low concentrations of para-nitroso-dimethylaniline (NdMA) were mutagenic to Salmonella typhimurium TA100 with optimal effect at 1.5 microM in fluctuation assays, without activating enzymes. The diethyl homologue (NdEA) had little or no mutagenic effect at low concentrations, although the bacteriocidal effects of NdMA and NdEA were similar. At higher bacteriocidal concentrations (approximately LC55-LC80) both NdMA and NdEA were mutagenic. NdMA and some other C-nitroso compounds proved carcinogenic in animal bioassays, and further research is needed to assess the human hazard from exposure to C-nitroso compounds in food, medicines or industry. PMID- 3529654 TI - Effects of calcium channel blockers and insulin on the platelet function in patients with diabetes mellitus. PMID- 3529655 TI - The role of non-thermal factors in the control of skin blood flow during exercise. AB - Arguments in favor of the importance of non-thermal factors in the control of skin circulation are presented. Such factors include exercise, posture, water and electrolyte balance, state of training, and acclimatization. The first three factors probably elicit their effects via high- and low-pressure baroreceptors, while the mechanisms involved for the remainder are unknown. PMID- 3529656 TI - Non-thermal factors are important in the control of skin blood flow during exercise only under high physiological strain. AB - Several authors have argued that skin blood flow (SkBF) during exercise is less than during rest at the same levels of body core and whole-body skin temperatures (Tc and Tsk). Since such an effect does not prevent SkBF during exercise from rising above pre-exercise levels, it is sometimes called a relative cutaneous vasoconstriction. Such a vasoconstriction is considered to be either part of a thermoregulatory adjustment during exercise (elevated thermoregulatory "set point") or a compensatory response to allow adequate perfusion of exercising muscle. In this paper, some of the pertinent experimental evidence is reviewed, and the following conclusions are reached: the evidence does not support a change in thermoregulatory set-point during exercise; under conditions of high physiological strain (high Tsk and intense exercise), there is quite clearly a relative cutaneous vasoconstrictor effect of exercise; the evidence does not support such an effect under more moderate conditions; and it is likely that, under mild to moderate conditions, other compensatory cardiovascular responses are sufficient to allow adequate perfusion of exercising muscle and are invoked in preference to relative cutaneous vasoconstriction, which has been demonstrated only at higher levels of strain. The thermoregulatory SkBF required during sustained exercise is thus maintained as much as possible. PMID- 3529657 TI - [In memory of Lorenz Bohler (1885-1973)]. PMID- 3529659 TI - ["Historical pathology" and "historical epidemiology" in dentistry in the 19th and 20th century]. PMID- 3529658 TI - [Differentiation between Staphylococcus and Micrococcus genera in the routine laboratory diagnosis using the lysostaphin sensitivity test]. PMID- 3529660 TI - [Notes on the health conditions in the city of Rostock around the end of the 19th century]. PMID- 3529661 TI - [Possibilities of using cardiovascular assist systems and the artificial heart]. AB - The mechanical support of the cardiovascular circulation of the reversibly or irreversibly damaged natural heart is possible in a different way. Beginning with the balloon pulsation with limited haemodynamical efficacy the application of left-or right-ventricular assist-systems finally leads to the biventricular assistance, when there are signs of the global cardiac dysfunction and an ability of recovery the heart function is assumed. The trend to use assist-systems over longer periods is perceptible also in patients in terminal phases of chronic cardiac diseases. Thus the importance of artificial hearts is increasing which are to be regarded as biventricular assist-system in orthotopic position. For a short-time use the up to now developed blood pumps, drives and regulation units are suited in few centres of the world. The orthotopic implantation of artificial hearts permits as second step the transplantation of a suitable donor heart. The heart transplantation guarantees high success rates and a cardiac function adapted according need. The demands on the long-term implantation of artificial hearts are at present so high that the majority of the specialists at the present stage of the development has a sceptical attitude to the long-term use. PMID- 3529662 TI - [Current status of liver transplantation]. AB - The importance of the liver transplantation for the treatment of infaust liver diseases is nowadays regarded as undisputed. The results could be improved during the last years: on an average 40% of the patients still live one year after the transplantation. The control of the transplant rejection and the diminution of the ischaemic liver damage are preeminent pathophysiological problems. Clinical routine and experience essentially further the optimization of the results. PMID- 3529663 TI - [Present status and perspectives of kidney transplantation]. AB - The kidney transplantation and the dialysis are established procedures in the treatment of patients with renal insufficiency. The indication for kidney transplantation could be enlarged by new recognitions of immunology and by the introduction of new immunosuppressive medicaments with simultaneous improvement of the results of the transplantations during the last ten years. The urgently necessary increase of the frequency of transplantation by the supply of donor kidneys must be the task of the next years. PMID- 3529664 TI - [Status and perspectives of automated insulin therapy]. AB - The aim of the optimization of insulin supply in insulin-dependent diabetes mellitus is by means of restoration of blood glucose regulation resembling the physiological control to contribute to the secondary prevention of the late diabetes-specific complications. An individually different permanent supply of a basic insulin dose, the adapted application of additional doses during the meals and the avoidance of an induced hyperinsulinism are to be achieved. Several apparative or biomaterial-depending techniques of an optimized insulin supply are still at the stage of technological research and of animal experiments: bioartificial (hybrid) pancreas and implantable therapeutic systems. Artificial beta-cells (feedback controlled insulin infusion systems) are hitherto commercially available only as bedside apparatuses and for this reason above all suitable for purposes of research; portable and in a few cases implantable insulin pumps (not automatically glucose-dependent controlled) are at present subject of long-term, controlled clinical-ambulatory studies on the borderline to highly specialized therapy. From experience in the use of these methods results the strategy of an "intensified conventional" insulin therapy which may be recommended for wide-spread application. PMID- 3529665 TI - [Papillomatosis of the bile ducts]. AB - In patients with signs of obstructive jaundice also rare diseases such as biliary papillomatosis should be taken into consideration. These primarily benign epithelial tumours show a tendency of recurrence and malignant degeneration and, therefore, have to be regarded as precancerous. An early preferably preoperative diagnosis is essential, because extensive surgical treatment is required. Today this diagnosis can be made by ultrasound, ERCP or PTC. This study describes 2 cases of progressive biliary papillomatosis observed in 1978 and 1985. (One female 48 years, one male 53 years). The first case was only diagnosed after relaparotomy, and several palliative operations were carried out without satisfying results. In contrast, in 1985 the diagnosis was suspected by ultrasound, confirmed by ERCP and biopsy, and a liver transplant was performed successfully. PMID- 3529666 TI - [Instrumental technology for assisted circulation from the Manfred von Ardenne Research Institute, Dresden]. PMID- 3529667 TI - [Stress-induced changes in the spleen and thymus of the mouse after skin transplantation]. AB - The influence of the unspecific stress factors at the distribution of the lymphocyte subpopulations in spleen and thymus was investigated in skin transplantation model of the mouse after operation. The parameters total lymphocyte content, electrophoretic distribution pattern, activity and isoenzyme pattern of the LDH were compared in allogenic, syngenic, and sham transplanted mice with untreated control animals. Stress reactions were observed in the electrophoretic distribution pattern of the spleen cells as an increase of the quickly moving fraction (S-fraction) still on the 14th day after transplantation. Such reactions as an increase of the S-fraction were provable in the thymus cells on the 3rd and 7th day. The influence of the operation stress was further shown in a changed isoenzyme pattern of the thymus cells LDH. The relative portions of the LDH 1 and LDH 2 were reduced still 10 days after transplantation with an increase of the LDH 5. PMID- 3529668 TI - [Immunohistochemical studies of paraffin-embedded material of solitary cutaneous neurofibromas]. AB - Nine cutaneous solitary neurofibromas have been studied using antibodies against vimentin, S 100 protein, lysozyme, myoglobin, factor VIII, neurofilament, neuron specific enolase, and myelin-associated antigen. Most of the tumor cells showed positive reactions to S 100 protein and vimentin with different patterns of staining. Whereas vimentin was detected in the cell periphery, S 100 protein was concentrated in the perinuclear area and distinct in the cytoplasm. About 60 percent of the tumor cells revealed positive staining for laminin. Myoglobin, neurofilament, and neuron specific enolase could not be proved in the tumor tissue. Our results suggest that the majority of neurofibroma cells may derive from Schwann's cells. PMID- 3529669 TI - [Dermatosurgical treatment possibilities in leg ulcers]. AB - On he basis of our own investigational findings in patients suffering from leg ulcers during the past 3 years, we report on general aspects regarding preoperative treatment of ulcus cruris. In addition, we give an illustrated synopsis of current dermatosurgical treatment, especially referring to leg ulcers in venous disorders. Aside from local surgical procedures, we discuss the various techniques of skin grafting as well as surgical possibilities with regard to the treatment of incompetent perforator veins. PMID- 3529670 TI - [Improved reproducibility of contrast echocardiography by SH U 454. Experimental studies using digital subtraction echocardiography]. AB - The right heart chambers of 10 animals were contrasted by conventional (NaCl, CO2, H2O2, indocyanine green (ICG), haemaccel) and a newly developed echo contrast medium (SH U 454) and studied by 2-D echocardiography. By means of digital subtraction echocardiography (DSE) endocardial borders were defined automatically and the results were compared with the manual input of endocardial borders of original and contrast echocardiograms. The area enclosed by these borders served as basis for the calculation of reproducibility (in %) and correlations. The following correlation coefficients (r) and SEE were calculated between the areas defined by the different contrast media and DSE and manually derived borders: r = 0.85, 3.98 cm2 (ICG), and 0.89, 1.00 cm2 (haemaccel). The best calculations were found using SH U 454 in concentrations between 100 and 300 mg/ml. The correlation coefficients were in the range of r = 0.95 and 0.98 with an SEE of 0.21 to 0.56 cm2 between manually and automatically derived contours. Comparing the reproducibility of data between the different evaluation methods we found the following results: manual input of endocardial borders in original echocardiograms 12.3%-16.9%; manual definition of endocardial borders in contrast echocardiograms 2.0% (SH U 454) - 15.7% (CO2); automatic contour finding in original echocardiograms 8.6%-28.9% (mean 21.6%); automatic definition of endocardium by DSE in contrast echocardiograms 7.6% (ICG) - 0.9% (SH U 454, 300 mg/ml). Our results demonstrate that digital subtraction echocardiography is a simple an safe procedure to define endocardial contours if echo contrast media lead to a uniform and homogeneous opacification of the left and right cardiac cavities.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3529671 TI - [Immunoenzyme determination of IgM in the direct two-sided binding assay]. PMID- 3529672 TI - [Immunoenzyme assay for the demonstration of antibodies against hepatitis B surface antigen (anti-HBs)]. PMID- 3529674 TI - Surface antigens of Angiostrongylus cantonensis developing in permissive and non permissive hosts. AB - The immunofluorescent antibody test and immunocytochemical method were employed to study the surface antigens of Angiostrongylus cantonensis obtained from infected rats, mice and guinea pigs. Positive results with intense fluorescence and brownish peroxidase staining were observed on the cuticular surface of A. cantonensis recovered from rats 22 days (late cerebral phase) and 34 days (lung phase) post-infection when tested with antisera against host (normal rat serum) antigens as well as crude extracts of A. cantonensis. However, host antigens were not observed on the surface of the nematode recovered from the brain of mice and guinea pigs 15 days post-infection. PMID- 3529673 TI - Autoantibodies to intermediate filaments in experimental infections with Trypanosoma brucei gambiense. AB - Sera from rats with chronic Trypanosoma brucei gambiense infection were tested for autoantibodies by an indirect immunofluorescence assay. All the sera contained IgM autoantibodies which reacted with blood vessel walls. On cultured vascular smooth muscle cells positive sera reacted with cytoplasmic filaments which were rearranged into perinuclear coils of filaments in colcemid-pretreated smooth muscle cells. These observations strongly suggest that the cytoplasmic autoantigens are intermediate filaments (I.F.). It is probable that the anti intermediate filament autoantibodies result from polyclonal lymphocyte activation, since in rats experimentally infected with T.b. gambiense the appearance of these autoantibodies occurs already 1 week post-infection. PMID- 3529675 TI - Reduced development of Plasmodium falciparum in beta-thalassaemic erythrocytes. PMID- 3529676 TI - [Effect of the Hoffa fat pad on revascularization of the ruptured anterior cruciate ligament. A histologic study of the rabbit model]. AB - After intersection of anterior cruciate ligament both ends were stitched together again. In group A the ligament was surrounded by a flap of fat pad, whereas in control group B the intersected ligament just was sutured. Postoperative the leg was immobilised by cast from 4 to 8 weeks. After that time intraarterial injection by Romeis method was performed, the bone-ligament-bone block was fixed in paraffine and the histological investigation followed. All ligament blocks of group A (n12) showed an intact anterior cruciate surrounded by well vascularized soft tissue which has been transformed from the fat pad. Ligaments of group B did not heal and where regressive changed. PMID- 3529677 TI - [Clinical effectiveness of Spondyvit (vitamin E) in activated arthroses. A multicenter placebo-controlled double-blind study]. AB - 50 patients with osteoarthritis were randomly assigned to two groups and treated over a period of 6 weeks with vitamin E-capsules (daily dose 400 I.E. d-alpha tocopherylacetate) or an identical placebo preparation. The results of this double-blind controlled clinical trial showed that vitamin E was superior to placebo with respect to the relief of pain (pain at rest, pain during movement, pressure-induced pain) and the necessity of additional analgetic treatment (p less than 0.05 to p less than 0.01). Improvement of mobility was better in the group treated with vitamin E. However, this result was not statistically significant. The profile and the intensity of adverse reactions in both the vitamin E and placebo group was practically identical. This clinical study shows antiphlogistic efficacy of vitamin E in patients with osteoarthritis. In view of the possibility to reduce standard antiphlogistic, analgetic therapy together with the very good tolerance this result may be very important for the treatment of chronic rheumatic inflammatory disease. PMID- 3529678 TI - [Tonic mechanism of the conditioned reflex]. PMID- 3529680 TI - [Tissue component of the physiological system regulating the aggregate state of the blood and cell structures]. PMID- 3529679 TI - [Effects of the stimulation and destruction of the thalamic nuclei in an experiment]. PMID- 3529681 TI - [The gastrointestinal tract as a local regulator and organ-effector of the blood coagulation system]. PMID- 3529682 TI - [Catecholamine release in the sympathetic ganglia during antidromic stimulation]. PMID- 3529683 TI - Alternative retention mechanism in cast post and cores: a case report. PMID- 3529684 TI - [SSEF (Swedish Student Nurses' Association) celebrates its 40th anniversary]. PMID- 3529685 TI - [Kamp och kamratskap (Fight and Comradeship)--new book on SSEF's history. Interview by Anne Sorman]. PMID- 3529686 TI - [Puerperal fever]. PMID- 3529687 TI - [The historical development of pelvis-enlarging operations]. PMID- 3529688 TI - [Pathophysiological bases of intensive therapy in severe craniocerebral trauma]. PMID- 3529689 TI - [Morphological and immunological characteristics of organic lesions in experimental infection with the L form of Streptococcus group B]. PMID- 3529690 TI - [Immediate theoretical and practical tasks in studying pathogenic streptococci]. PMID- 3529691 TI - [Chemical and biological properties of lipoteichoic acid of Streptococcus group A]. PMID- 3529692 TI - [Antibodies reacting with epithelial cells of the thymus and skin in the sera of patients with rheumatism and erysipelas]. PMID- 3529693 TI - [Virus-specific modification of cell membranes as a factor in the adhesion of streptococci B]. PMID- 3529694 TI - [Immunoglobulin Fc receptors of streptococci and its relation to the virulence of the microbes]. PMID- 3529695 TI - [Induction of anti-immunoglobulin synthesis during the immunization of rabbits with streptococci group A]. PMID- 3529696 TI - [Identification of streptococci group B using the CAMP test. Christie-Atkins Munch-Petersen]. PMID- 3529697 TI - [The participation of streptococcal plasmids and their deletion derivatives in the correction of Rec mutations in S. pyogenes]. PMID- 3529698 TI - [Complications of catheterization of the central veins]. PMID- 3529699 TI - Cell-surface expression of influenza virus haemagglutinin in insect cells using a baculovirus vector. AB - A baculovirus transfer vector was constructed using a cloned copy of the Autographa californica nuclear polyhedrosis virus (AcNPV) polyhedrin gene. The ATG translation initiation codon and 32 bases of the polyhedrin mRNA 5' leader sequences were deleted and replaced with a cDNA clone of the A/PR/8/34 influenza virus haemagglutinin (HA) gene. The hybrid HA/polyhedrin gene was transferred to AcNPV and polyhedrin-negative recombinants identified which expressed HA activity. The insect cell-derived HA bound a monoclonal antibody specific for the HA gene in immunofluorescence tests and was shown to be plasma membrane-bound by haemadsorption assays. A 65 kDa protein was identified in infected cells by immunoprecipitation. The mRNA from recombinant-infected cells was analysed and revealed a major transcript of 2.95 kilobases consistent with transcription initiation and termination at the authentic polyhedrin sites. Other transcripts of different length were also detected so it was not possible to conclude which was responsible for producing the protein. The results demonstrated that AcNPV can be used to express plasma membrane-bound virus glycoproteins. PMID- 3529700 TI - The International Drinking Water Supply and Sanitation Decade. Review of regional and global data (as at 31 December 1983). PMID- 3529701 TI - The trained traditional birth attendant and neonatal tetanus. PMID- 3529702 TI - [Evolution: molecular biology provides effective methods for reconstructing phylogeny]. PMID- 3529703 TI - Small-area variations in the epidemiology of malaria in Madang Province. PMID- 3529704 TI - Malaria control through health services in Papua New Guinea. PMID- 3529705 TI - Recent studies of hyperreactive malarious splenomegaly (tropical splenomegaly syndrome) in Papua New Guinea. PMID- 3529706 TI - Cell-mediated aspects of malaria. PMID- 3529707 TI - Studies of the host response in man to infection with Plasmodium falciparum. PMID- 3529708 TI - Identification of key antigens of Plasmodium falciparum as vaccine candidates. PMID- 3529709 TI - Measurement of antibody response to individual cloned antigens of Plasmodium falciparum. PMID- 3529710 TI - Chromosomes of Plasmodium falciparum. PMID- 3529711 TI - Detection of soya proteins in heated meat products by "blotting" and "dot blot". AB - Soy proteins (isolates, concentrates and texturates) as well as meat products containing soya isolate were analysed by SDS-electrophoresis. The separated proteins were blotted on nitrocellulose and stained with a selective immunoperoxidase system with the following sequence: primary (anti-soya) serum, goat anti-rabbit IgG serum and peroxidase-antiperoxidase complex (rabbit allotype). By developing the blot with a peroxidase substrate the antigenic soya fractions were visualised while the meat proteins did not stain. All major (reduced) soya fractions alpha, alpha', beta conglycinin, the acid and basic subunits of glycinin as well as some minor fractions became visible with a commercially available anti-soya serum as primary antiserum. The pattern thus obtained provides a high evidence for the presence of soya protein in meat products. Detection level is about 0.02% of soya protein. During a 24-h incubation at room temp. (before heat processing) of a meat product containing soya product and raw liver a remarkable loss of antigenic material was observed. PMID- 3529712 TI - [In vitro toxicity tests of diethyleneglycol with cell cultures and an automated bacterial test system]. AB - Diethyleneglycol was tested for its general cytotoxic effects in three cell culture test systems and in a novel, automated bacterial test system. The first cytotoxic effects were detected in the cell culture test systems at DEG concentrations of 1 g/1 and 3g/1. The bacterial test system showed a minimal inhibitory concentration of 5 g/1 DEG (20% growth reduction). Morphological observations showed evidence of membrane damage to the cultured cells by DEG. With the bacterial test system one could determine the amount of DEG semiquantitatively in wines to which this material had been added. PMID- 3529713 TI - [Indications for attachment elements in partial dentures]. PMID- 3529714 TI - [Preprosthetic diagnosis and therapy as part of functional guide systems]. PMID- 3529715 TI - [Biomechanics of various anchoring systems. Principles for indications of attachments, posts and telescopic anchors]. PMID- 3529716 TI - [Acid etch technic in the continued rehabilitation of adolescent occlusion (I)]. PMID- 3529717 TI - [Mechanical aspects in the evaluation of attachment elements between the residual dentition and the denture]. PMID- 3529718 TI - [The so-called "difficult" patient in prosthetic practice]. PMID- 3529719 TI - [Processing of palladium-silver alloys for metalloceramics]. PMID- 3529720 TI - [20 years of correct impressions--experiences in practice and teaching]. PMID- 3529721 TI - [Individualized preparation of resin veneers (laminates)]. PMID- 3529722 TI - [Acid etch technic in the continued rehabilitation of adolescent dentitions (II)]. PMID- 3529723 TI - [Pinless precision working models for crown and bridge technics]. PMID- 3529724 TI - [The protector program for root restoration]. PMID- 3529725 TI - [Initial studies with bonded bridges and splints--a retrospective cross-sectional study. 1: Treatment and prognosis]. PMID- 3529726 TI - [Possibilities of bonding technics with the incorporation of newer materials science technology]. PMID- 3529728 TI - [Abrasion and biostatic shape retention in a rigid-support free-end denture]. PMID- 3529727 TI - [Basic principles of bonding technics]. PMID- 3529729 TI - [Implantation for the improvement of function in a unilaterally shortened dental arch]. PMID- 3529730 TI - [Differential therapy of the loss of a single tooth. Implantation or bonded bridge]. PMID- 3529731 TI - [Branemark system in theory and practice]. PMID- 3529732 TI - [The denture in Branemark implants]. PMID- 3529733 TI - [The hygienic design of dentures]. PMID- 3529734 TI - [Follow-up studies and failure analysis of bonded bridges]. PMID- 3529735 TI - [Water-resistance of NiCr-PMMA adhesive bonds]. PMID- 3529736 TI - [Metal-ceramic bond strength testing--special materials science problems]. PMID- 3529737 TI - [Initial bond strength of various adhesives of different material classes on a non-precious metal alloy and a bi-polyester adhesive on a palladium-based alloy]. PMID- 3529738 TI - [Musculature and denture retention]. PMID- 3529739 TI - [Problems of color selection in dentures using objective measurements]. PMID- 3529740 TI - [Erkoscope--a new control mirror for parallel preparations]. PMID- 3529741 TI - [Crown preparations]. PMID- 3529742 TI - Cytochemical detection of ABH antigens in human body fluids. AB - The use of the peroxidase-anti-peroxidase (PAP) technique has been described previously for the detection of cellular antigens and in particular ABO antigens from tissue samples (Pedal and Hulle 1984; Pedal and Baedeker 1985; Pedal et al. 1985). In this survey, the PAP method has been employed to study the detection of ABO antigens in cells from body fluids of particular interest to forensic science, namely buccal cells and vaginal cells. Also tested, but in a limited number, were mixtures of body fluids and semen samples. No false reactions were obtained from buccal cells, all samples corresponding to the ABO blood type of the donor. Preliminary results from vaginal cells, vaginal/buccal cell mixtures, and semen were encouraging but must be treated with caution due to the limited number tested. Vaginal smears contaminated with semen showed varying degrees of nonspecificity. PMID- 3529743 TI - [New diagnostic possibilities of postmortam coronary angiography by digital subtraction angiography]. AB - Postmortal digital subtraction angiography permits vessels filled with a contrast agent to be visualized selectively in a video film shot and the contrast agent flow to be observed directly in the coronary arteries. Compared to conventional static methods of postmortal coronary angiography, the judgment on the hemodynamic effects of stenosis and occlusion, as well as of collaterals and anastomosis, will be improved and therefore the diagnosis of acute coronary death. The diagnostic possibilities and advantages of DSA are demonstrated in two cases. PMID- 3529744 TI - [Effect of plasmapheresis in kidney transplantation--a controlled study]. AB - Until recently it has been controversial whether plasmapheresis is benefitial in graft rejection therapy. Here we present a controlled trial in 44 kidney transplanted patients with biopsy proven acute vascular rejection and specific anti-HLA-antibodies. 23 randomized patients were treated additionally with plasmaexchange (group A), whereas the remaining 21 received drug therapy only (group B). 7 out of 23 (30%) lost their graft in group A and 17 out of 21 (81%) in group B. Mean serum creatinine and actuarial graft survival underline the significant effect of plasmaexchange therapy which appears especially benefitial when rejection occurs later than one month after surgery. PMID- 3529745 TI - [Effect of immunization with K1-antigen of Escherichia coli on the course of experimental urinary tract infection in the rat]. AB - The influence of the vaccination with an immunogenic K1-antigen of Escherichia coli on the course of an experimental pyelonephritis in rats due to Escherichia coli O2:K1:H3 was investigated. K1-antigen is a poor immunogen. Therefore a conjugate of K1-antigen with bovine serum albumin (BSA) was used. This K1-BSA conjugate was immunogenic in preliminary experiments. The influence of a vaccination on the course of pyelonephritis may be dependent on the route of infection. Rats which are infected by a retrograde route shows significant less inflammated kidneys when they received a vaccination by K1-BSA-conjugate within the first six weeks of infection. PMID- 3529746 TI - ["Anti-fascists" are happy about the "Great Lady"]. PMID- 3529747 TI - [The Zack model system]. PMID- 3529748 TI - [Scientific self-appraisal in German surgery in the 19th and 20th century]. PMID- 3529749 TI - [Current resistance in surgical infections and its development since 1970]. AB - More than 7,000 bacteriological samples were received by the authors and were analysed for the frequency of resistance among pyogenic cocci which are relevant to surgical practice. Staphylococcus aureus accounted for 41 per cent and Escherichia coli for 15.3 per cent. These were the most common germs in 1984. Resistance of Staphylococcus aureus to ampicillin was as high as 78 per cent. Resistance levels below eight per cent were recorded in the context of lincomycin, erythromycin, gentamicin, oxacillin, and berlocombin. Resistance ratios of Escherichia coli were 55.2 per cent to ampicillin, 4.5 per cent to gentamicin, and 12.6 per cent to berlocombin. PMID- 3529751 TI - Antibacterial mechanism of volatile fatty acids in the intestinal tract of pigs against Escherichia coli. PMID- 3529750 TI - [Erosion hemorrhage of the brachiocephalic trunk following tracheotomy]. PMID- 3529752 TI - Bacterial growth in mastitic milk and whey. PMID- 3529753 TI - Experimental infection of caesarean derived, colostrum deprived calves with bovine rotaviruses and enterotoxigenic Escherichia coli (ETEC): a histological, electromicroscopic, and morphometric investigation. PMID- 3529754 TI - [Effectiveness of preventive local and/or parenteral vaccination against salmonellosis in calves with vaccines of inactivated pathogens]. PMID- 3529755 TI - [Detection and identification of anti-idiotypic antibodies in heterogeneous immunoenzyme analysis]. AB - The antigen-antibody equilibrium in the presence of a competitive agent of immunoglobulin nature, represented by anti-idiotypic antibodies, has been analyzed in the case of the immobilized antigen. As shown in this investigation, the amount of immunoglobulin bound with the carrier is determined both by the competition of anti-idiotypic antibodies for the active center of idiotype carrying antibodies and by the binding of anti-idiotypic antibodies with the antigen-antibody complex. If idiotype-carrying and anti-idiotypic antibodies are represented by serum immunoglobulin of the same species, the titration of the competitive agent leads to obtaining a characteristic relationship between the amount of immunoglobulin bound with the insoluble phase and the amount of the competitive agent in the system passing through the maximum. The theoretical results have been confirmed on the experimental model and used for the identification of auto-antiidiotypic antibodies in patients' sera. PMID- 3529756 TI - [Theoretical bases and experimental verifications in using cell cultures in developing new quality assessment and standardization criteria for medical immunobiological preparations]. PMID- 3529757 TI - [Taxonomic position of Brucella isolated from reindeer]. PMID- 3529758 TI - [Experience in isolating Campylobacter jejuni from patients with acute intestinal diseases]. AB - Erythrite agar, a commercial culture medium produced by the Research Institute for Culture Media (Makhachkala, USSR), is suitable for the cultivation of C. jejuni after the addition of hemolized sheep blood. The addition of antibiotics to the medium permits its use for the isolation of C. jejuni from feces. By means of this medium C. jejuni has been isolated from the feces of 10% of patients hospitalized on account of acute infectious intestinal diseases. PMID- 3529759 TI - [2-cycle culture of Vibrio cholerae in a fermenter]. AB - The method for the two-cycle cultivation of V. cholerae, reference strains Inaba and Ogawa, in a fermenter has been developed. In the first and second cultivation cycles no difference in the yield of the biomass and in the ultrastructure of the vibrios has been established. In the second cycle a decrease in the minimum time of generation has been observed. The vaccines obtained in the first and second cultivation cycles have not been found to differ in their antigenic and immunogenic activity. The vaccines meet the WHO requirements. PMID- 3529760 TI - [Effect of immunization with an enterobacterial vaccine on the rate of plating out of Shigella from the intestinal mucosa of mice orally infected]. AB - The oral and subcutaneous immunization of mice with the vaccine prepared from S. minnesota strain R595, chemotype Re, known as enterobacterial vaccine, was found to significantly decrease the number of shigellae in cultures obtained by the inoculation of homogenized mucosal samples taken from the large intestine of mice, the vaccine prepared from S. minnesota isogeneous strain SF 1111 with the intact structure of lipopolysaccharide had no such activity. Antisera, obtained by the immunization of rabbits with enterobacterial vaccine, contained high titers of antibodies to Re-glycolipid and were capable of decreasing the isolation rate of shigellae from homogenized mucosal samples taken from the large intestine of mice; at the same time S. flexneri were found capable of binding with antibodies to glycolipid of Re-chemotype. PMID- 3529761 TI - [Enterotoxigenic capacity of strains of Klebsiella and Enterobacter genera isolated in acute intestinal diseases in children]. AB - 234 strains, including 104 K. pneumoniae strains, 28 K. oxytoxica strains, 64 E. cloacae strains and 40 E. aerogenes strains, have been isolated from the intestine of 266 children with diarrhea, aged up to 1 year, and studied for enterotoxigenicity. By the coagglutination test, made with G. Kronvall's staphylococcal reagent prepared with the use of antiserum to Escherichia coli LT enterotoxin, and the biological assay on suckling mice enterotoxigenic activity has been revealed in 119 strains, including 48 K. pneumoniae strains (12.6%), 33 E. cloacae strains (27.4%) and 23 E. aerogenes strains (19.7%). The strains producing only LT-enterotoxins, only ST-enterotoxins, and both LT- and ST enterotoxins have been found. The determination of the enterotoxigenic activity of the clinical isolates of opportunistic enterobacteria makes it possible to improve the etiological interpretation of acute intestinal infections. PMID- 3529762 TI - [Live influenza vaccine in the USSR: its development, study and practical use]. PMID- 3529763 TI - [Purification and properties of Bordetella pertussis toxin]. AB - The modified method for the isolation and purification of B. pertussis toxin has been proposed. Chromatography with the use of hydroxylapatite and lentil lectin- Sepharose 4B has permitted the isolation of the preparation purified 600 times. Its molecular weight is about 90,000. The preparation has been found to possess leukocytosis-stimulating, histamine-sensitising and hemagglutinating activity. Electrophoretic analysis has revealed that the isolated substance consists of four subunits with molecular weights 28,400, 24,300, 21,800 and 15,200. This substance has proved to be capable of hydrolyzing NAD+, as well as of suppressing the GTPase activity of transducin, which is indicative of the covalent modification (ADP-ribosylyzing) of GTP-binding protein under the action of B. pertussis toxin. Two methods for the isolation of B. pertussis toxin (from liquid and solid growth media), as well as the isolation of the toxin from different B. pertussis strains, are evaluated. PMID- 3529765 TI - [Basic characteristics of the process of Candida adhesion to human epitheliocytes]. AB - The adhesion of fungi belonging to the genus Candida to the epithelial cells of the mouth cavity reached its maximum at pH 6.2-7.0. The process of adhesion had similar dynamics at temperatures of 37 degrees, 28 degrees and 25 degrees C, but the adhesive activity decreased 2 times when temperature dropped from 37 degrees to 25 degrees and 4 times when temperature dropped to 4 degrees C. The introduction of the ions Ca2+ (1 and 10 mM) and Mg2+ (10 mM) led to the increase of adhesion by 80, 100 and 24% respectively. The heating of the fungal cells at 100 degrees C (for 1 hour) and at 63 degrees C (for 2 hours) decreased adhesion to 8 and 24% respectively, and treatment with formaldehyde (for 24 hours) decreased adhesion to 70% of that observed in experiments with live Candida cells. PMID- 3529764 TI - [Isolation and characteristics of an antibacterial substance produced by a strain of Streptococcus sp. Thom-1606. A study of the biological activity of the metabolic products of Streptococcus sp. Thom-1606]. AB - The data on the biological properties of the culture fluid of Streptococcus strain sp. TOM-1606 are presented. The native preparation has been shown to possess the capacity for stimulating the rate of the clearance of the peritoneal cavity of mice from Staphylococcus aureus cells, strain MT-1, rif. r., found to be insensitive to the action of the above-mentioned preparation in vitro. The crude preparation produces a transitory bacteriostatic effect on the streptococcal and staphylococcal strains under study. The preparation produces a prolonged bacteriostatic effect only on Micrococcus luteus test strain. All these data suggest that the crude preparation contains at least two active principles. PMID- 3529766 TI - [Determination of the optimal method of numerical taxonomy]. AB - A great number of numeric taxonomy methods, varying in the techniques of coding signs, similarity calculations and group analysis, as well as the insufficiency of criteria for the evaluation of numeric taxonomy methods, permitted us to propose the quantitative approach to the evaluation of the optimum method of numeric taxonomy. The dendrograms obtained by different methods were compared by calculating the measure of "proximity" which was assumed to be the sum of distances between divisions on different grouping levels. PMID- 3529767 TI - [Detection of pneumococcal antibodies in children with acute pneumonia and pleurisy by an immunoenzyme method]. AB - The samples of sera and pleural fluid from sick children have been analyzed by means of EIA techniques. To detect the time course of antibody production, the antigenic preparations of pneumococci (monovalent capsular polysaccharides, polyvalent polysaccharide vaccine and complex pneumococcal antigen) have been used. Antibody response observed in the forms of pneumococcal infection, studied in this investigation, has proved to be highly variable. It is expedient to determine antibodies to polysaccharide antigens not earlier than on days 10-12 from the beginning of the disease. But, besides the positive dynamics of antibodies, their unchanged level is sometimes observed in the patients at the beginning of the disease. As a rule, there is a coincidence between the dynamics of antibody formation in response to polysaccharide antigens and to complex pneumococcal antigen. PMID- 3529768 TI - [Use of solid-phase immunoenzyme analysis for the serodiagnosis of pseudotuberculosis]. AB - The diagnostic test system based on the solid-phase enzyme immunoassay (EIA) for the detection of antibodies to Yersinia pseudotuberculosis in the sera of patients with the use of Soviet-made preparations and reagents has been developed. The test has been performed in microchambers for immunological reactions, thus making it possible to decrease the consumption of reagents 10-20 times in comparison with the traditional technique with the use of plates. The results of the titration of 42 sera in EIA and in the passive hemagglutination test (PHAT) are indicative of the presence of positive correlation (r = 0.78; p less than 0.05) between antibody titers in EIA and PHAT. A fourfold or greater increase in antibody titers has been determined by means of EIA in 80% of cases and with the use of PHAT in 55% of cases. The minimum diagnostic titer yielded by EIA has been determined: 1:256. PMID- 3529769 TI - [Bacteriosorption reaction on a smooth surface for detecting antibodies and antigens]. AB - The solid-phase technique for the detection of antibodies and antigens has been developed and named the bacteriosorption test. The test is based on binding staphylococci containing protein A with the Fc-regions of IgG-antibodies attached to antigens immobilized on polystyrene. The possibilities of this technique have been analyzed with the use of diphtheria toxoid, house-dust allergen and homologous rabbit antisera. In the detection of antibodies the proposed test is not inferior to the passive hemagglutination test, and its sensitivity in the detection of antigens by the sandwich technique reaches 0.05-0.1 micrograms/ml. The specificity of the technique has been experimentally confirmed by the inhibition of the reaction with soluble antigen and staphylococcal protein A. The variability factor of the technique does not exceed 10%. PMID- 3529770 TI - [Development of psychiatric services in Eastern Siberia during the Soviet period]. PMID- 3529771 TI - [Pathogenetic mechanisms of lesions of the nervous system in disorders of glucose homeostasis (review)]. PMID- 3529772 TI - Prevention of postoperative thromboembolisms in general surgery by the combination of heparin and dihydroergotamine. AB - The effect and the degree of safety of administering a fixed combination of 5000 IU of heparin + 0.5 mg dihydroergotamine (HDHE s.c. per every 12 hours) as opposed to 5000 IU of heparin (LDH s.c. every 8 hours) was assessed in a prospective randomized study on 86 patients having undergone major abdominal operation. Postoperatively a deep vein thrombosis was detected by the radiofibrinogen test in 10% of the 40 patients of the HDHE group and in 13% of 46 of the LDH group. Four patients died. At autopsy neither fatal nor a contributing pulmonary embolism was found. 'Non-lethal' pulmonary embolism diagnosed by lung perfusion scintigraphy and by chest X-rays, developed in 2 patients treated with LDH and in one treated with HDHE. Two-thirds of the dose of heparin were identically effective in prevention of venous thromboembolisms than the whole dose if heparin was combined with DHE. The decrease of the heparin dose significantly reduced the number of wound haematomas and of suffusion due to injection. PMID- 3529773 TI - Anastomoses of the colon made by inverting sutures. AB - The authors report on the advantages of inverting suture in the anastomoses of the colon. The comparative evaluation of the stapler gun technique and the sleeve technique is presented. PMID- 3529774 TI - Oesophageal, gastric and small bowel anastomoses made by the sleeve technique. AB - The authors report on their experiences in oesophageal, gastric and small bowel anastomoses made by inverting sutures. The technique of constructing the anastomoses is described with an emphasis on the necessity of considering the sizes and proportions. The advantages of the method are summarized and the operations performed so far are presented. PMID- 3529775 TI - Lower gastro-intestinal hemorrhage: diagnosis and treatment. PMID- 3529776 TI - Immunogenicity of semisynthetic human insulin in man. Long-term comparison with porcine monocomponent insulin. AB - The levels of circulating IgG-insulin antibodies were determined in two groups of diabetic patients before and at 3-month intervals after starting insulin treatment either with monocomponent porcine insulin (n = 17) or with human semisynthetic insulin (SH) (n = 16). Patients were followed during 15.1 +/- 1.0 and 19.9 +/- 1.1 months, respectively (m +/- SEM). In addition, the quality of metabolic control and residual B-cell function were evaluated in the group under treatment with SHI. The percentage of patients who remained antibody-free after 12-21 months of treatment was 67.75% in the human insulin-treated group and only 25-43% in the one receiving porcine insulin (p less than 0.01). Moreover, insulin antibody titers, when present, were usually lower in subjects treated with human insulin. In SHI-treated patients: metabolic control was excellent during the first months of treatment as evidenced by values of mean daily blood glucose (7.3 +/- 0.6 mmol/l), M-index according to Schlichtkrull (7.4 +/- 2.4) and Hb1c (6.8 +/- 0.6%); residual B-cell function, evaluated at 3-month intervals by a circadian profile of plasma C-peptide did not decrease throughout the study; and a significant deterioration of blood glucose control occurred after 18 months of treatment, which might have been due to a less intensive supervision of the patients by the physicians and/or less careful attention by the patients themselves. This observation confirms the need for a continuous education of the patients regardless of the type of insulin used. PMID- 3529777 TI - Bedside diagnosis of cardiac autonomic damage by computerized analysis of heart rate-respiration relationship. AB - In this study we propose a method for the analysis of the relationship between heart rate changes and respiration as a possible diagnostic tool for cardiac autonomic damage. The method consists in recording R-R intervals and respiratory amplitude by a suitably equipped personal computer, and by evaluating the cross correlation peak between the two signals. This mathematical function appeared to be more sensitive to the degree of concordance between the two signals, rather than their absolute amplitude. The cross-correlation appeared to be lower in diabetics with autonomic dysfunction, markedly decreased after injection of atropine (only in normals), slightly increased after propranolol. Hyperpnea increased the cross-correlation peak between 3-18 breaths/min in normals, but only at lower frequencies, if at all, in diabetic subjects with various degrees of autonomic dysfunction. The cross-correlation showed the best reproducibility among R-R change tests. These preliminary results suggest that this method may provide new information on autonomic integrity and a substantial advantage in terms of reproducibility. PMID- 3529778 TI - The role of ranitidine infusion on glucose, insulin and C-peptide serum levels induced by oral glucose tolerance test in healthy subjects. AB - In 9 healthy subjects we evaluated the effect of a constant ranitidine infusion (100 mg) on glucose (mg/dl), insulin (microU/ml) and C-peptide (ng/ml) serum levels promoted by oral glucose tolerance test (75 g). Ranitidine significantly increased the area under concentration/time curves for glucose and insulin but not that of C-peptide. Our data indicate that ranitidine does not affect pancreatic insulin release nor peripheral glucose utilization and are consistent with the hypothesis that ranitidine influences the hepatic clearance of glucose and insulin both of which undergo high first-pass liver extraction. PMID- 3529780 TI - Long-term results of stereotactic radiosurgery to the pituitary gland in Cushing's disease. AB - Gamma radiation from 60Co delivered with stereotactic technique was given to the pituitary gland in 35 patients, aged 18-65 years, with Cushing's disease. The doses were 70-100 Gy in each single irradiation. The size of the sella turcica was normal in the majority of the patients. The observation time was 3-9 years in 29 patients. Out of them, 14 (48%) obtained clinical remission and normal urinary cortisol after one irradiation. Eight achieved remission after two to four irradiations. In total, 22 out of 29 patients (76%) obtained remission. In 12 of them remission was obtained in 1 year and in another 10 within 3 years. No recurrences were observed. Improvement was seen in 2 patients after one and three irradiations. Bilateral adrenalectomy was performed in 5 patients owing to unsatisfactory effect of irradiation. Pituitary insufficiency with gonadotropin, thyrotropin or corticotropin failure was demonstrated in 12 of 22 patients in remission. This occurred 4 months to 7 years after the first irradiation. Another 6 patients were followed less than 3 years after the first irradiation. Two obtained remission after the first treatment, whereas the other 4 improved. Stereotactic pituitary irradiation is suggested as a non-invasive therapeutic alternative in Cushing's disease for example in patients with considerable surgical risk or as a supplement to pituitary microsurgery. PMID- 3529779 TI - Diabetes in the tropics: differences from diabetes in the West. PMID- 3529781 TI - Relationship between oral glucose tolerance and insulin sensitivity in healthy man and type 1 diabetic patients. AB - The relationship between insulin sensitivity and oral glucose tolerance was studied in 8 conventionally treated type 1 diabetic patients (age 34 +/- 4 years, relative body weight (RBW) 113 +/- 5%) and in 11 healthy subjects (age 35 +/- 3 years, RBW 114 +/- 2%). In each subject and patient, oral glucose tolerance (75 g glucose) and in vivo sensitivity to insulin (euglycaemic clamp technique, 1 mU/kg/min insulin) were measured. The response to oral glucose in the diabetic patients was measured during maintenance of similar peripheral plasma free insulin levels as in the normal subjects during the oral glucose tolerance test (OGTT). During the OGTT, the post-glucose plasma glucose values in the diabetic patients were markedly higher (P less than 0.001) than in the normal subjects. During the clamp study, the rate of glucose metabolism in the diabetic patients (4.53 +/- 0.58 mg/kg/min) was 37% lower than in the normal subjects (7.19 +/- 0.67 mg/kg/min, P less than 0.02). The area under the glucose curve was inversely related to the rate of glucose metabolism in both the diabetic (r = -0.72, P less than 0.02) and the normal (r = -0.69, P less than 0.02) subjects. The slope of the curve was substantially steeper in the diabetic than the control subjects. Thus, peripheral insulin sensitivity contributes to oral glucose tolerance both in healthy man, and even to a greater extent, in type 1 diabetic patients. PMID- 3529782 TI - Effects of acarbose on the relationship between changes in GIP and insulin responses to meals in normal subjects. AB - The relationship between changes in gastric inhibitory polypeptide (GIP), C peptide and insulin responses to meals was studied in 8 normal subjects after 2 weeks of Acarbose treatment. Acarbose caused a significant reduction of GIP and insulin responses (P less than 0.05). The decrease in insulin response could not be explained by changes in the glycaemic stimulus of insulin secretion, as Acarbose did not significantly change the plasma glucose response to meals during the study. The reduced insulin response was seen without a concomitant reduction in the C-peptide response to the meals, thus resulting in a decreased insulin/C peptide ratio after Acarbose treatment (P less than 0.05). The changes in GIP response after Acarbose correlated positively with the change in insulin/C peptide ratio (r = 0.69; P less than 0.05). Our data thus challenge the concept that Acarbose therapy affects the secretion of insulin. The positive relationship between changes in GIP response and changes in the insulin/C-peptide ratio rather suggests that GIP affects the metabolism of insulin or C-peptide. PMID- 3529783 TI - Insulin release and pancreatic insulin is reduced in young prediabetic BB rats. AB - The pancreases of approximately 50 days old diabetes-prone BB/Hagedorn (BB/H) and of the genetically closely related, but non-diabetic BB w-subline (control BB) rats were perfused to determine the capacity of D-glucose to release insulin before the expected development of diabetes. The BB/H rats were from a colony with 82-84% incidence of insulin-dependent diabetes mellitus (IDDM) by 140 days of age. The total amount of insulin released from the BB/H rat pancreas during stimulation with 20 mmol/1 mmol/ D-glucose was reduced by nearly 50% (P less than 0.01). The initial peak of insulin release was similar between the two groups of animals, whereas the amount of insulin released during the second peak accounted for the diminished release (P less than 0.01). The extractable pancreatic insulin was 30% (P less than 0.05) less in the BB/H rats. Total insulin release expressed relative to the pancreatic insulin content, was therefore not different between the two groups. It is concluded that about 20-40 days before the mean age of clinical onset of IDDM in BB/H rats, the capacity to release insulin in response to D-glucose is reduced along with a diminished pancreatic insulin content. This abnormality seems to be preceded only by islet cell surface antibodies but not by insulitis. PMID- 3529784 TI - Insulin resistance in human liver cirrhosis is not modified by porto-systemic surgical shunt. AB - Cirrhosis of the liver is characterized by glucose intolerance and hyperinsulinaemia. It is considered an insulin resistant state with both a receptor and a post-receptor defect of insulin activity. It would appear that reduced hepatic degradation rather than increased B-cell production is responsible for hyperinsulinaemia. The effect of surgical portosystemic shunt on insulin resistance was studied in 18 cirrhotics with impaired glucose tolerance (12 males, 6 females; mean age 46.9 +/- 0.7 years) by measuring: glucose production (3H-glucose infusion), glucose utilisation (euglycaemic clamp at approximately 100, approximately 1000 and approximately 10,000 microU/1), plasma insulin and C-peptide levels, and liver function indices (serum bilirubin, albumin, ALT, GGT) before and 2 months after surgery. Liver sorbitol clearance was also employed to measure variations in the functional liver plasma flow induced by the shunt. No significant changes were noted in: glucose production (1.94 +/- 0.17 SEM vs 1.96 +/- 0.17 mg/kg/min), glucose utilisation (metabolic clearance rate: 3.32 +/- 0.48 vs 3.42 +/- 0.43 at approximately microU/ml; 9.70 +/- 1.0 vs 9.16 +/- 0.9 at approximately 1000 microU/ml; 10.92 +/- 1.1 vs 11.07 +/- 0.8 ml/kg/min at approximately 10 000 microU/ml), fasting plasma insulin, C peptide and C-peptide/insulin molar ratio (4.66 +/- 0.47 vs 5.50 +/- 0.54), and the liver function indices. By contrast, there was a significant decrease in functional liver plasma flow (813 +/- 34 vs 604 +/- 34 ml/min, P less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3529785 TI - Goitre epidemiology: thyroid volume, iodine excretion, thyroglobulin and thyrotropin in Germany and Sweden. AB - Thyroid volume of 1397 German and 303 Swedish adults were estimated by sonography. Thyroid size of 6-16 year old Germans (n = 619) was determined and compared with findings on palpation. Thyroid volume was more than twice as great in German (21.4 +/- 15.6 ml, mean +/- SD) than in Swedish adults (10.1 +/- 4.9 ml). The echopattern was abnormal in 16% of the Germans and in 3.6% of the Swedes. German children have a thyroid volume ranging from 1.8 +/- 0.4 ml at 6 years to 10.8 +/- 6.0 ml at 16 years of age. Palpation is by comparison an unreliable method for determining thyroid size. In Germany, the iodine excretion was less in children (n = 619, 39.5 +/- 30.5, 34.1 micrograms I/g creatinine, mean +/- SD, median) than in adults (n = 1193, 83.7 +/- 94.4, 62.6), (P less than 0.001) and much lower than that observed in Sweden (adults n = 98, 170.2 +/- 93.3, 141.4; 13 year olds n = 113, 172.9 +/- 224.1, 124), (P less than 0.0001). Serum thyrotropin concentration was significantly higher (P less than 0.001) in Sweden (n = 62, 1.49 +/- 0.82 mU/ml), than in Germany (n = 91, 0.97 +/- 0.52 mU/ml), while serum thyroglobulin was increased in Germany (n = 91, 72.6 +/- 50.6 micrograms/l) as compared to Sweden (n = 62, 23.5 +/- 17.4), (P less than 0.0001). These results indicate the goitrogenic effect of iodine deficiency and the continuing need for an effective iodine prophylaxis in the FRG. PMID- 3529786 TI - Intrathyroidal thyroglobulin in streptozotocin-diabetic rats. AB - In order to elucidate whether or not the 'coupling defect' observed in thyroids from diabetic rats is due to a structural defect of intrathyroidal thyroglobulin (Tg), the sedimentation pattern and the stability of the thyroidal soluble iodoproteins were studied in control (C), food restricted (FR), diabetic (D) and insulin-treated diabetic (D+I) rats fed a low iodine diet either with (NID) or without (LID) iodide supplementation and labelled with 125I: acutely, 24 h prior to sacrifice and chronically, by feeding the corresponding diet labelled for 60 days. Diabetes resulted in a decrease of thyroidal weight, an increase of both thyroidal 127I content and concentration and decreased plasma TSH, irrespective of the diet. Insulin treatment reversed these alterations. Food restriction led to an intermediate situation between C and D. The iodoamino acid distribution in the acutely labelled thyroidal soluble iodoproteins showed a significant increase in the percent of organified 125I found as iodotyrosines (MIT and DIT) and a decrease of that found as iodothyronines (T3 and T4) both in D and FR. However, in the isotopically equilibrated groups, no differences were found except in LID D where a slight increase in DIT and a decrease in T3 was found as compared to the corresponding control. The sedimentation patterns of both acutely and chronically labelled thyroidal soluble iodoproteins from all experimental groups displayed two peaks. The main one, corresponding to Tg, had a slightly lower sedimentation coefficient than the 19 S internal marker run in parallel, while the second one, relatively small, formed probably by dissociation of the main Tg peak, sedimented more slowly (12- 14 S).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3529787 TI - Characterization of insulin-binding to the hepatoma cell line H35. AB - We have studied the characteristics of insulin-binding to its receptor in H35 hepatoma cells. Insulin-binding was time, temperature and pH dependent. Optimum pH was 8.0-8.2. Binding at 21 degrees C reached a steady state after 90 min of incubation at a level of 30.0 +/- 2.6% per mg protein. Pre-incubation of the cells with unlabelled exogenous insulin resulted in a decrease of insulin-binding which was time and concentration dependent. Pre-incubation with 10 micrograms/ml for 24 h resulted in a decrease to 35-40% of initial binding. Scatchard plots of the binding data were curvilinear in control as well as in down regulated cells. Analysis of the Scatchard plots revealed that decrease of insulin-binding to down regulated cells was due to a decrease of insulin-binding sites, while affinity constants did not change. PMID- 3529788 TI - Serial amniocenteses in the treatment of twin to twin transfusion complicated with acute polyhydramnios. AB - Twin to twin transfusion, complicated by acute polyhydramnios in a monozygous twin pregnancy, is a difficult clinical problem. A precipitous course usually results in termination of the pregnancy within a few days and often is associated with a high perinatal mortality rate. Two cases are presented that were treated with repeated amniocenteses for the relief of extreme abdominal discomfort and to prevent imminent premature labor. The amount of amniotic fluid removed each time varied from 300 cc to 1200 cc, which was enough to relieve symptoms but not enough to induce uncontrolled uterine activity. A total of 3500 cc and 4750 cc of amniotic fluid were removed from the first and the second patient, respectively. The procedure was found to be safe and resulted in prolonging the pregnancies by 14 and 11 days, respectively. This management, with the addition of tocolysis and close fetal surveillance can offer some hope in an otherwise hopeless situation. PMID- 3529789 TI - The holoacardius: a correlative computerized tomographic, radiologic, and ultrasonographic investigation of a new case with review of literature. AB - A holoacardius from a monozygotic, monochorionic twin pregnancy of 36 weeks is described. Trisomy-18 was diagnosed in the viable female cotwin. Computerized tomographic, radiologic, and ultrasonographic procedures were applied to the acardiac. Its three-vessel umbilical cord was velamentously attached to the single placenta. Grossly malformed and poorly developed craniofacial structures, absence of neck and upper extremities, sirenomelic lower extremity, absence of heart, and development of only a few skeletal elements were prominent features. A review of selected world literature emphasizes the limits of the estimates dealing with the total number of reported cases and the incidence of acardii. PMID- 3529790 TI - Outcome of the surviving cotwin of a fetus papyraceus or of a dead fetus. AB - Serial ultrasound examinations have demonstrated that one of two gestational sacs in a twin pregnancy may often disappear. When it disappears at an early stage of gestation, the pregnancy may advance without any disturbance and the cotwin can be delivered well developed and lively. When the intrauterine death occurs in the second trimester, the dead fetus usually results in a fetus papyraceus and the cotwin continues to be alive near term. However, when death occurs in the last trimester, the viable twin may be spontaneously delivered soon and be premature. In some cases of late fetal death, the dead fetus may induce intravascular thromboses in many organs of the surviving cotwin, so that the living infant may develop cerebral palsy later after birth. PMID- 3529791 TI - Six human pancreas transplants: results and perioperative management. AB - Satisfactory results were obtained in 5 type I diabetic recipients of 6 human pancreas transplantations. We chose the three following options: diversion of the pancreatic juice by a pancreaticojejunostomy, simultaneous kidney transplantation from the same donor and cyclosporin A as the basic drug in the immunosuppressive regimen. Further conclusions were also drawn from our experience. Firstly, biological data alone might not be relevant for donor selection: histologic examination of the non transplanted cephalic portion of the donor pancreas is needed to rule out pancreatitis. Secondly, donor management usually needs large amounts of fluids and blood. Finally, besides the general rules of recipient management common to kidney transplantation, pancreas transplantation further requires heparinization, insulin therapy and parental nutrition during the immediate postoperative period. PMID- 3529792 TI - Anesthetic experience in adult and pediatric orthotopic liver transplantation. AB - The authors report their experience with orthotopic liver transplantation in 8 adults and 6 children operated during a 14 months period. The anesthetic technique is described and three points of it are underlined: Renal failure is prevented by a systematic low-dose dopamine infusion added to optimal preloading and mannitol given during the anhepatic phase. Donor liver flush via the portal vein with lactated Ringer's solution is checked by serial measurements of K+ concentration in the fluid draining from the infrahepatic vena cava: the flush is assumed adequate if that K+ level is less than 10 mmoles/l. The risk of air embolism at the time of unclamping is minimized by discontinuing N2O, adding a mild PEEP and placing the patient in Trendelenburg position. The values of hemodynamic and metabolic measurements are given and discussed. There was no peroperative mortality. PMID- 3529793 TI - Anesthetic protocol in human renal transplantation: twenty-two years of experience. AB - This paper reviews the experience of 22 years of transplantation. From June 1963 to December 1984, 1362 human renal grafts were performed in our center. Throughout this period, advances in surgical techniques, kidney preservation methods and immunosuppressive regimen have improved patient and graft survival. Simultaneously, progress in anesthetic monitoring and techniques (particularly the use of new muscle relaxants and isoflurane) led to better and safer surgical conditions. A protocol of maximal intraoperative hydration using pulmonary arterial pressure monitoring was progressively developed. This protocol has allowed to reduce significantly the incidence of delayed graft function. PMID- 3529794 TI - Immunofluorescence characterization of Legionella: narrow specificity of polyclonal immunsera to various serogroups and species. AB - This study was to determine by direct fluorescent antibody staining with antibodies prepared in rabbits, the degree of cross-reactions between serogroups of Legionella pneumophila (1 to 6) and the other antigenic species of Legionella (L. bozemanii, L. dumoffii, and L. micdadei), in order to increase the accuracy of diagnosis and to allow us to reduce the number of conjugates. The polyclonal antibodies were highly species and serogroup-specific without absorption for characterization of Legionella either in patient specimens or in isolated cultures by direct fluorescent antibody staining. No cross-reaction was observed with non-legionella bacteria isolated from sputum specimens. A battery of conjugates for different serogroups and species is necessary for increasing the accuracy of diagnosis of legionellosis. PMID- 3529795 TI - Serological studies in Chlamydia trachomatis associated pneumonia of infants. AB - Serological results provided evidence for the clinical diagnosis of chlamydial pneumonia in 8 out of 51 cases. Elevated chlamydia-specific IgM titres (128-2048) and IgG titres (128-2048) were recorded in 5 and 8 infants, respectively. High titres of chlamydial antibodies (512-8192) in the sera of mothers of seropositive children proved genital Chlamydia trachomatis infection. PMID- 3529796 TI - Virulence factors of Escherichia coli. III. Correlation with Escherichia coli pathogenicity of haemolysin production, haemagglutinating capacity, antigens K1, K5, and colicinogenicity. AB - A total of 1156 Escherichia coli strains including 489 faecal, 384 urinary, 283 other extraintestinal isolates was compared for haemolysin production (Hly), mannose resistant haemagglutinating activity (MRA), presence of antigens K1 and K5 and colicinogenicity (Col). K1 capsule which was demonstrated only in a few serogroups (O1, O2, O7, O18) occurred more frequently among extraintestinal (32.1%) than among faecal (4.3%) or urinary (7.3%) isolates. In the incidence of antigen K5 there was no difference between faecal and urinary (3.3%; 3.1%) or between urinary and other extraintestinal (5.3%) isolates belonging mainly to serogroups O2, O6, O18 and O75. Col+ isolates occurred frequently in all samples (23.5% of faecal, 31.7% of urinary and 43.4% of other extraintestinal strains), they being significantly more frequent in serogroups O1, O2, O7, O18 than in others. A close association existed between K1+ and Col+ properties, mainly (24.4%) among strains isolated from extraintestinal sources other than urine. The frequent coexistence of K1+ and Col+ in serogroups O1, O2, O7, O18 offers a further explanation for the extraintestinal pathogenicity of these serogroups. Neither Hly+ and K1+, nor Hly+ and Col+ were associated. MRA+ and K1+ correlated mainly in serogroups O1, O2 but never occurred simultaneously in serogroup O18. Connection between MRA+ and Hly+ was not associated with other virulence factors (K1, Col). The results showing a close connection among certain serogroups (O1, O2, O4, O6, O7, O18) and certain markers of pathogenicity (MRA, Hly, K1, Col) support the concept that E. coli strains have a clonal connection. PMID- 3529797 TI - Ferric ammonium citrate decomposition--a taxonomic tool for gram-negative bacteria. AB - The iron uptake test of Szabo and Vandra has been modified and used for the differentiation of Gram-negative bacteria. Nutrient agar containing 20 g per litre of ferric ammonium citrate was distributed into narrow tubes and solidified so as to form butts and slants. Considering the localization of the rusty-brown coloration produced after seeding and incubation, 2367 strains were classified into four groups. (1) Unchanged medium: Escherichia coli, Shigella spp., Yersinia spp., Hafnia alvei and Morganella morganii 100% each, Klebsiella spp., 50%, Enterobacter cloacae 37%, Proteus vulgaris 59%, Acinetobacter spp. 42%, Pseudomonas fluorescens 19%, some other bacteria 2-12%. (2) Rusty-brown slant, unchanged butt: Salmonella subgenera II, III and IV 98%, Citrobacter freundii 65%, E. cloacae 55%, P. vulgaris 41%, Proteus mirabilis 98%, Providencia rettgeri 100%, urease-negative Providencia 96%, Acinetobacter spp. 58%, Pseudomonas aeruginosa 100%, P. fluorescens 81%, UFP (unclassified fluorescent pseudomonads) 100%, other Pseudomonas spp. 55%. (3) Unchanged slant, brown butt: S. typhi 88%, Salmonella subgenus I 3%, Klebsiella spp. 31%, some other bacteria 2-3%. (4) Rusty-brown slant, brown butt: Salmonella subgenus I 75%, C. freundii 20%, Klebsiella spp. 12%, some other bacteria 1-5%. Colour reactions in ferric ammonium citrate agar are associated with the accumulation of ferric hydroxide: bacteria giving positive reactions on the slant took up as an average, 63 times more iron than those with negative test. The localization of colour reaction correlated partly with aerobic and anaerobic citrate utilization or decomposition in Simmons' minimal and in Kauffmann's peptone water medium. PMID- 3529798 TI - Surgery for epilepsy: a review. AB - This year marks the centennial of the first surgical resection for epilepsy performed by Horsley. While epilepsy is generally considered a disease best treated with anticonvulsant medications, surgical therapy is of significant benefit to some patients in whom medical therapy has proved ineffective. Anterior temporal lobectomy has been the single most successful operation commonly performed today. In this paper we review current techniques of preoperative evaluation, the role of scalp and intracranial electrophysiologic monitoring, as well as the contribution of PET and MRI scanning to improving the selection of patients for surgical therapy. The role of focal cortical excisions, hemispherectomy, and corpus callosotomy in the surgical armamentarium is also outlined. A plea is made for establishment of additional regionalized centers for epilepsy surgery in which close collaboration among neurologists, neuropsychologists, neurosurgeons and neurophysiologists can enhance patient care and advance our knowledge of the partial epilepsies and human cerebral function. PMID- 3529799 TI - Cholinesterase inhibitors lack therapeutic effect in amyotrophic lateral sclerosis. A controlled study of physostigmine versus neostigmine. AB - Seven patients with amyotrophic lateral sclerosis participated in a double-blind cross-over trial of oral physostigmine and neostigmine (10 and 45 mg/day, respectively, for 3 days). Six of the patients were also given intravenous injections (1 and 1.5 mg, respectively) of the drugs in an open trial. No significant effects on muscle strength or neurophysiological parameters were observed. PMID- 3529800 TI - No additive effect of tranexamic acid and naproxen on corneal deswelling. A study on oedema after uncomplicated intracapsular cataract extraction with anterior chamber lens implantation. AB - The influence of systemic antifibrinolytic and antiprostaglandin medication on post-operative central corneal thickness was studied. Thirty patients underwent uncomplicated intracapsular cataract extraction with implantation of anterior chamber lens. The patients received either tranexamic acid, naproxen or both. The post-operative oedema did not differ significantly between the three groups studied. Models for studying changes in central corneal thickness are discussed. A review of the influence of drugs on corneal thickness is presented. PMID- 3529801 TI - Intersubject variability in corneal swelling response to anoxia. AB - A controlled, double-masked, randomized experiment was conducted on 9 human subjects, to determine whether there is an intersubject difference in the corneal swelling response to anoxia. A statistically significant intersubject variability was observed (P less than 0.001), with oedema ranging from a mean of 3.6% to 7.3% following 3 h exposure to humidified nitrogen gas (anoxia). This result supports the hypothesis of previous workers that the intersubject difference in the corneal oedema response to a thick HEMA "stress lens" is due to oxygen deprivation and not some other physiological variable resulting from lens wear. PMID- 3529802 TI - Progressive microscopical changes in the closed system incubated rat lens. AB - A phase contrast microscopy investigation of 18 cultured rat lenses was undertaken. After an initial latent phase, the outline of the epithelial cells anteriorly became enhanced and posteriorly the lens fibers began to swell. This was followed by an anterior and posterior subcapsular accumulation of fluid, epithelial swelling and formation of posterior subcapsular vacuoles. At the end of the incubation period, no increase in the light dissemination from the lens was observed. It is concluded, that, when these changes are taken into account, the closed system cultured rat lens is an excellent and applicable model for studying the induced progressive changes in the microstructure of the living lens due to different agents. PMID- 3529803 TI - Intraocular pressure in the first days after implantation of posterior chamber lenses with the use of sodium hyaluronate (Healon). AB - Intraocular pressure (IOP) was measured before and 6, 24, 48 and 72 h after extracapsular cataract extraction with implantation of a posterior chambers lens in 3 groups of patients. Group I (30 patients): Sodium hyaluronate (Healon) was used during anterior capsulotomy and lens implantation and was aspirated at the end of surgery. Group II (22 patients): Healon as in group I + 500 mg acetazolamide at the end of surgery. Group III (17 patients): BSS and/or air was used instead of Healon during surgery. In all groups statistically significant rises in IOP after 6 h were followed by significant falls in the remaining post operative period. The rise and subsequent fall in IOP was significantly greater in group I than in group III. Acetazolamide in group II did not prevent excessive rises in IOP. Aspiration probably shortens the period of Healon-induced hypertension. We recommend a meticulous aspiration of Healon at the end of surgery. PMID- 3529804 TI - Dislocated intraocular lens after biodegradation of fixation loops. A case report. AB - A boy aged 3 years had a Worst Medallion intraocular lens with loops made of nylon 6 implanted in his right eye after aspiration of traumatic cataract. Post operatively, the eye was irritated and showed increased tendency to secondary membrane formation. The patient was lost to follow-up 3 months post-operatively. He returned 5 years later because of 4 days of pain and redness in his right eye. On examination, the optic part of the intraocular lens was seen to lie free in the anterior chamber. The loops were broken near their insertions in the lens body. The distal ends of the broken loops could not be detected in the pupillary region. No traces of the iris fixation suture were to be seen. The lens was removed and subjected to scanning electron microscopy which revealed extensive biodegradative changes in the 3 loop stumps, the 4th being totally dissolved. The young age of the patient and the chronic inflammation may have had an accelerating effect on the nylon degradation. We conclude that children with eyes implanted with nylon-loop lenses should stay under regular ophthalmological control. PMID- 3529805 TI - [A little history. Practical treatise on auscultation by Barth and Roger]. PMID- 3529806 TI - [Cholesteatoma of the frontal sinus: a personal observation]. PMID- 3529807 TI - Bilirubin and brain toxicity. PMID- 3529808 TI - Changing etiology and outcome of neonatal septicemia in Riyadh, Saudi Arabia. AB - To study the etiology of neonatal septicemia and factors associated with outcome, all charts of neonates with bacteremia and clinical sepsis admitted to a neonatal unit in Saudi Arabia, from 1 November 1980 to 31 October 1984 were reviewed. The results were compared to a previous study period in the unit (1 November 1976-31 October 1980). Septicemia was diagnosed on 50 occasions in 49 neonates. The incidence of neonatal sepsis among patients born in the hospital was 2.5/1,000 live births. Mortality from sepsis was 33% and was associated with neutropenia in 63%. The most commonly isolated bacteria were E. coli, Klebsiella and Staphylococcus aureus. Salmonella enteritidis serotypes were isolated in 4% of the cases. Group B streptococci (GBS) were isolated, for the first time, from blood of 3 neonates. Salmonella species were less frequently and GBS more often isolated than previously. GBS have now appeared as etiologic organisms in neonatal sepsis also in Saudi Arabia. Salmonella septicemia remains more common in Saudi Arabia than in the West. PMID- 3529809 TI - Central diabetes insipidus in children. V. Oral treatment with a vasopressin hormone analogue (DDAVP). AB - 1-deamino-8-D-arginine-vasopressin, or DDAVP, a potent long acting antidiuretic analogue of AVP, is the treatment of choice in central diabetes insipidus (DI). We have studied the clinical and biological effect in 10 children with DI treated with peroral administration of DDAVP. During a dose ranging study in hospital, followed by 6 months of treatment at home, this peroral DDAVP tablet proved to be as effective as the intranasal administration of DDAVP and was preferred by the patients. Even doses as small as 12.5 micrograms, have an effect on diuresis and urinary osmolality. Therapeutic effects start at above 100 micrograms. During the dose ranging study 200 micrograms peroral DDAVP produced antidiuresis varying from 8 to 12.5 hours, in different patients. The recommended dose is 100-300 micrograms 2-3 times a day. This treatment offers an important alternative to that traditionally used and constitutes one of the first examples of a peptide conserving its biological activity after gastrointestinal transport. PMID- 3529810 TI - Experimental studies on hepatic cirrhosis and hepatocarcinogenesis. II. Influence of cirrhotic liver on 2-FAA hepatocarcinogenesis in rats. AB - The effects of hepatic cirrhosis on chemical hepatocarcinogenesis were studied in rats using an experimental model for hepatic cirrhosis established by chronic furfural administration (described in a previous report) and N-2 fluorenylacetamide (2-FAA). Sixteen male Wistar rats were fed with 2-FAA feeding 3 cycles, which consisted of 3 weeks consuming 0.03% 2-FAA diet and 1 week basal diet, after 120 days of furfural feeding. Grossly and histologically all livers of experimental animals showed formation of multiple hyperplastic nodules with atypical features in parts. These hyperplastic nodules were positively immunostained with alpha fetoprotein. On the other hand, none of the livers of 16 rats fed with furfural alone showed formation of hyperplastic changes and only 2 livers of 16 rats fed 2-FAA without preadministration of furfural showed one small hyperplastic nodule each, respectively. These results indicate that the cirrhotic liver induced by chronic furfural feeding has an enhancing effect on 2 FAA chemical hepatocarcinogenesis, and suggests that the presence of hepatic cirrhosis induces increased susceptibility to hepatocarcinogenic stimuli. PMID- 3529811 TI - Adrenoleukodystrophy. Report of an autopsy case with adrenoleukomyeloneuropathy. AB - The patient was a 27-year-old man who developed spastic quadriplegia and cerebral disorders. Initial signs were gait disturbance, spastic paraplegia, and sphincter disturbance; these occurred when he was 21. Upon autopsy, the white matter of the brain and spinal cord showed diffuse demyelination, and the adrenal glands and right testis were atrophic. Cytoplasmic striations seen by light microscopy and trilamellar inclusions seen by electron microscopy were found in ballooned adrenocortical cells. Trilamellar inclusions were also observed in macrophages of the affected cerebral white matter. Biochemical analysis disclosed a high ratio (0.27) of hexacosanoic acid (C26:0) to docosanoic acid (C22:0) in cerebrosides and sulfatides of the cerebrum. The histological features as well as the result of biochemical analysis were those of classical adrenoleukodystrophy. However, the time of the onset of clinical signs and the duration of the disease were different in the present case from classical adrenoleukodystrophy. The case presented here was diagnosed as adrenoleukomyeloneuropathy, which is a variant of adrenoleukodystrophy. PMID- 3529812 TI - A neuroendocrine (Merkel) cell carcinoma with coexisting intraepidermal squamous cell carcinoma of the skin. Its growth accelerated by an extrinsic factor. AB - A case of neuroendocrine (Merkel) cell carcinoma with coexisting intraepidermal squamous cell carcinoma of the skin was studied histologically, immunohistochemically and ultrastructurally as well as with tissue-culture and transplantation into nude mice. The primary tumor found in the lower leg of a 68 year-old Japanese man had remained thumb-sized for five years and, after contusion, had begun to enlarge rapidly up to 5 cm in size during one month. The patient died of metastatic neuroendocrine cell carcinoma nine months after excision of the primary tumor. Histologically the primary tumor was composed of neuroendocrine cell carcinoma extending down to subcutaneous adipose tissue and a small amount of intraepidermal squamous cell carcinoma, not associated with a wide range of necrosis, hemorrhage, granulation tissue or fibrosis. The tumor cells of the former were diffusely positive for neuron-specific enolase. They contained a few secretory granules, 100 nm in diameter. The tumor cells both cultured in media and transplanted into nude mice died two months later. The present case is the first report of Merkel cell carcinoma in which the growth accelerated by an extrinsic factor was proved. Histogenesis of neuroendocrine cell carcinoma with coexisting squamous cell carcinoma is also discussed. PMID- 3529813 TI - Intestinal metaplasia-dysplasia-carcinoma sequence of the gallbladder. AB - One thousand cases of resected gallbladders were histologically investigated by serial step sections. Intestinal metaplasia was found at rates of 4.0% and 30.6% in the cases without and with stone, respectively. It was found at rates of 69.8% and 61.1% in the cases of dysplasia and carcinoma, respectively. The goblet cells were found at rates of 34.5% and 26.3% in the lesions of carcinoma and dysplasia, respectively. On the other hand, the dysplasia and adenoma intermingled in the tumor tissue at the rates of 22.2% and 8.3% in 36 cases of carcinoma, respectively. Although normal epithelial cells of the gallbladder contain mainly sulfomucin, the goblet cells have sialomucin. The ratio of sialomucin-containing cells increased in the tissue of dysplasia and carcinoma. As to their location, intestinal metaplasia, dysplasia, and carcinoma showed a similar distribution in the gallbladder. Accordingly, it should be considered that the sequence of intestinal metaplasia-dysplasia-carcinoma is significant. Pseudo-pyloric glandular metaplasia was found at rates of 45.5% in the cases of cholecystitis without stone, 77.2% in those with stone, 100% in those with dysplasia, and 72.3% in those with carcinoma. However, it should be considered that pseudo-pyloric glandular metaplasia has less relationship for the bases of carcinogenesis as compared with intestinal metaplasia. PMID- 3529814 TI - Immunoadsorbent-purified antibodies in the study of antigenic relatedness of outer membrane proteins of enteric bacilli. AB - Immunoadsorbent chromatography was used for purification of antibodies to E. coli 055 outer membrane proteins. Antibodies to the 33.5 kD and 7.5 kD proteins were eluted when rabbit antisera were applied to an epoxy-activated Sepharose 6B column to which the outer membrane was coupled in the presence of dioxane. ELISA coats prepared with sonicated bacteria showed binding of the eluted antibodies with strains of all of seven different species of the enteric bacilli, but not with other Gram-negative bacilli or cocci, or with Gram-positive cocci; immunoblot analysis of transblots of SDS-PAGE-separated bacteria showed that antibodies to both of the 33.5 kD and 7.5 kD E. coli outer membrane proteins cross-reacted with the enteric bacilli of different species. Both of the anti 33.5 kD and -7.5 kD antibodies were bound by intact E. coli 055 cells, but more efficiently by sonically disrupted or heat-treated bacteria. The results show that affinity-purified anti-OM antibodies were useful for the study of the antigenic relatedness of E. coli OM proteins with proteins of other bacteria. PMID- 3529815 TI - Autoreactive lymphocytes in thyroid disorders. II. Comparison of anti thyroglobulin antibody production by plaque-forming cell, radio-immunological and enzyme-linked immunosorbent assays. AB - Blood mononuclear cells (MNC) from 9 randomly selected patients with autoimmune thyroiditis were stimulated in vitro with pokeweed mitogen (PWM), a polyclonal B lymphocyte activator. The secretion of immunoglobulins (Ig) and anti thyroglobulin antibodies (TgAb) was assayed by means of haemolytic plaque-forming cell (PFC) assays, radio-immune assay (RIA) and enzyme-linked immunosorbent assays (ELISA). Total Ig and TgAb production was maximal using MNC cultured at 1.0 X 10(6)/ml as estimated by PFC, RIA and ELISA. The Ig and TgAb production as measured by RIA and ELISA was 1.5 - 3 times higher after 12 days' culture compared to 6 days' culture. Ig and TgAb production measured by PFC-assays at day 6 correlated positively to the results obtained by RIA and ELISA at day 12. PWM induced TgAb secretion correlated positively to TgAb titres in serum. As judged by PFC, TgAb production was found in 8/9 patients; about 5% (range 0 - 7.9%) of the total PWM-stimulated IgG-secreting cells were involved in TgAb secretion. TgAb production as measured by ELISA and RIA was found in 6/9 patients. By reference to an affinity-purified human TgAb preparation, the TgAb secretion was about 0.7% (range 0 - 21.3%) of the total PWM-induced IgG secretion. PMID- 3529816 TI - The mitogenic properties of lipoteichoic acid from Staphylococcus aureus. AB - Lipoteichoic acid (LTA) isolated from Staphylococcus aureus Cowan I induced an in vitro blastogenic response in isolated mononuclear cells (MNC). Seventeen of 20 normal donors responded strongly, with peak response after 3-5 days of incubation. Significant stimulation was also obtained with human cord blood MNC from 3 donors, further indicating that the stimulation was due to a general mitogenic effect. The mitogenicity of deacylated LTA (dLTA) was similar to that of LTA. Binding of LTA to isolated MNC was demonstrated by an indirect immunofluorescent technique staining with specific rabbit anti-LTA antibodies and by rosette inhibition experiments. Results obtained in cell fraction experiments indicated that LTA had a monocyte dependent mitogenic effect on T lymphocytes. PMID- 3529817 TI - [Types of controlled-release dosage forms]. PMID- 3529818 TI - Integration of pharmacy history into the pharmaceutical sciences. PMID- 3529819 TI - Interaction between prostacyclin and colchicine on the gastric mucosa of rat in different experimental ulcer models. AB - The effect of prostacyclin and colchicine on the fundic gastric mucosa of adult female Wistar rats was investigated in stress (immobilization) and indomethacin induced ulcer models. Under prostacyclin treatment the ulcer index decreased significantly in both ulcer models. This effect was inhibited by colchicine. The nuclear volume of fundic epithelial cells increased significantly after application of either type of ulcerogenic stimulus. Prostacyclin did not influence the nuclear volume changes in stress ulcer, while it prevented this phenomenon in indomethacin-induced ulceration. Following colchicine treatment the nuclear volume decreased in both ulcer models. After combined prostacyclin and colchicine treatment the nuclear shrinkage remained unaltered in stress ulcer, while in indomethacin ulcer the nuclear volume decreasing effect of the separately administered drugs disappeared after combined treatment. The latter phenomenon was interpreted as an antagonistic interaction between prostacyclin and colchicine. PMID- 3529820 TI - Effect of leucopaine on the processes of purulent wound repairing in experiments and clinical cases. AB - The article presents data about the effect of leucopaine, a vegetable enzyme preparation, on the regenerative processes of injured tissue in rabbits as well as about the treatment of purulent wounds in 303 patients under clinical conditions. Leucopaine was shown to have positive effect on the dynamics of purulent wound repair, to facilitate wound cleaning from necrotic tissues and to promote liquidation of inflammatory reaction and purulent exudation, creating favorable conditions for active growth of granulation tissue, formation of fine, unobtrusive scar. It also shortened 1.5 times the wound repairing period. PMID- 3529821 TI - Oxygen-derived free radicals and acute pancreatitis: a review. AB - The role of oxygen-derived free radicals in the pathogenesis of acute pancreatitis has been investigated in a series of studies using an ex vivo, perfused canine pancreas preparation. Three models of experimental acute pancreatitis have been developed in this preparation: ischemic pancreatitis, gallstone pancreatitis, and alcohol-induced pancreatitis. In each model, the pancreas becomes edematous, gains weight, and the perfusate develops hyperamylasemia during the 4 hour period of perfusion. Pretreatment with the free radical scavengers superoxide dismutase and catalase significantly ameliorates these manifestations of pancreatic injury in each of the three models. The source of the free radical generation was investigated by pretreating the preparation with allopurinol, a quite specific inhibitor of xanthine oxidase. In each of the three models, this also significantly ameliorated the injury process. These experiments demonstrate that oxygen-derived free radicals, generated by activated xanthine oxidase, appear to play a central role in the pathogenesis of acute pancreatitis in these models. These findings shed light on the fundamental pathophysiology of this disease and may provide the basis for more effective therapy in the future. PMID- 3529822 TI - Ischemia-reperfusion injury: role of oxygen-derived free radicals. PMID- 3529823 TI - Xanthine oxidase: a critical mediator of myocardial injury during ischemia and reperfusion? AB - Myocardial ischemia initiates a series of cellular reactions which unless checked will culminate in cell death and tissue necrosis. Although reperfusion provides a means of preventing cell death it is not without hazard. In cases of mild ischemia, where tissue injury is in its reversible phase, reperfusion may precipitate potentially lethal ventricular arrhythmias and in cases of severe injury it may actually accelerate the process of cell death leading to hemorrhage and other forms of severe injury. The identity of mediators of cellular injury, and particularly the critical transition from reversible to irreversible injury, remains controversial. Whereas for a number of years ATP depletion, calcium overload and catecholamines have been considered as key factors in tissue injury, attention has recently been directed towards oxygen-derived free radicals (e.g. superoxide and the hydroxyl radical). In this article we discuss sources of free radicals in the mammalian heart (xanthine oxidase, mitochondria, leucocytes, and catecholamines) and present arguments based on quantitative and temporal considerations that the xanthine oxidase-mediated degradation of hypoxanthine is the most important source of free radicals and as such is the most appropriate target for therapeutic intervention. To support our arguments we present data from two species, the dog and the rat, in which we have shown how allopurinol, the specific inhibitor of xanthine oxidase, can afford a reduction of infarct size in the dog and can dramatically reduce the incidence of potentially lethal reperfusion-induced arrhythmias in the rat. Arising from these and other studies is the proposition that anti-free radical interventions (particularly those directed towards xanthine oxidase inhibition) may provide an important new therapeutic principle in the management of ischemia and reperfusion. PMID- 3529824 TI - Xanthine oxidase: biochemistry, distribution and physiology. PMID- 3529825 TI - Potentiation of glucose-induced insulin secretion in the perfused rat pancreas by porcine GIP (gastric inhibitory polypeptide), bovine GIP, and bovine GIP(1-39). AB - Porcine GIP (gastric inhibitory polypeptide) potentiates glucose-induced insulin secretion under a variety of experimental conditions. Recently GIP was isolated also from bovine intestine, and found to differ from porcine GIP by having isoleucine instead of lysine in position 37. We have compared the effects of porcine GIP to that of bovine GIP and bovine GIP(1-39) on glucose-induced insulin secretion from the perfused rat pancreas. We found that porcine GIP, bovine GIP, and bovine GIP(1-39) all strongly potentiated both first and second phases of glucose-induced insulin secretion (glucose concentration 6.7 mM; polypeptide concentration 1 nM). There was no significant difference between the polypeptides with regard to the potency to potentiate glucose-induced insulin secretion. We conclude that bovine GIP, as porcine GIP, potentiates glucose-induced insulin secretion, and that the insulinotropic activity of GIP is not confined to the last three amino acids at the C-terminal end. PMID- 3529826 TI - Studies of the renal component of the hypertension in rats with aortic constriction. Role of angiotensin II. AB - The object of this study was to investigate the renal component of hypertension in aortic constriction. In 40-day-old Sprague-Dawley rats the aorta were constricted either proximal (PAC) or distal (DAC) to the renal arteries. The rats were examined 3 weeks later together with control rats. The arterial pressure proximal to the constriction was elevated in the PAC group but not in the DAC group. In PAC rats the arterial pressure was also elevated distal to the constriction. There was a significant pressure gradient across the constriction in both PAC and DAC rats. The PAC rats had a significant decrease of renal blood flow, a significant increase in renal vascular resistance and a numerical but not significant decrease of glomerular filtration rate. Serum levels of angiotensin II were not significantly different in PAC and control rats. The pressor effect of a bolus dose of angiotensin II was significantly increased in PAC rats. Captopril, a converting enzyme inhibitor, decreased the arterial pressures and renal vascular resistance in PAC rats. The pressure elevating effects of angiotensin II and pressure lowering effect of captopril were more pronounced distal than proximal to the constriction. We conclude that the kidneys play a major role in the development of hypertension in PAC, and that the local effect of angiotensin II on the renal vascular bed is an important contributor to the renal component of the hypertension. PMID- 3529827 TI - The effect of sodium load on the development of hypertension, plasma renin and kininogen in rats with renal artery constriction. AB - Effects of sodium load on the development of hypertension, plasma renin activity (PRA) and kininogen were studied in rats with renal artery constriction and untouched contralateral kidney. After the operation or sham-operation, 0.9% NaCl or water were given as drinking fluid. A marked hypertension (systolic pressure greater than 150 mmHg) developed in all operated rats on saline, but only in 2/3 of operated rats on water. In none of the sham-operated controls did systolic pressure exceed 150 mmHg during 7 postoperative weeks. Within the operated group on water, hypertensive rats had significantly higher PRA values than normotensive animals (P less than 0.05). Salt load slightly suppressed the PRA in sham operated rats but not in animals with constriction renal artery, compared to sham operated controls on water. The operated rats on salt excess had higher plasma kininogen levels than the operated normotensive rats on water (P less than 0.05), but there were no other significant differences in kininogen values between different study groups, regardless of whether blood pressure was increased or not. The results indicate that in this form of hypertension, the high blood pressure can be maintained without any increase in PRA if animals are subjected to a sodium load which sensitizes vascular beds to angiotensin. The increase in plasma kininogen, suggesting suppression of kallikrein-kinin system, is unlikely associated with the increase of blood pressure. PMID- 3529828 TI - [Labor psychology in a general hospital]. AB - At the present article the author describes a personnel recruitment investigation made among aspirants to make Nurse studies (college level). There are used, as selection instruments, on one hand, an interview and projective techniques like Bender and HTP ("House, Tree, Person") tests; on the other hand, the Holland's "Vocational Preferences Inventory" (V.P.I.) is utilized as a psychometric technique. It is possible to demonstrate in this study, as the author believes, that there is a positive correlation between the results due to interview and projective tests, and those responding to the psychometric inventory mentioned before. Besides, a "Nurse Ideal Profile" based en V.P.I. Scales is obtained: successful aspirants must procure high scores in Scale 2 (Intellectual) and 3 (Social), and must get low scores in Scale 1 (Realistic, which tests interest in instruments rather than social motivations. PMID- 3529830 TI - Clonidine versus chlomethiazole in alcohol withdrawal. PMID- 3529829 TI - Treatment of alcohol abstinence symptoms with the alpha 2-agonist clonidine. PMID- 3529831 TI - Clonidine treatment of the opiate withdrawal syndrome. A review of clinical trials of a theory. PMID- 3529832 TI - A double-blind controlled study of chlormethiazole and triazolam as hypnotics in the elderly. AB - This study compared the hypnotic efficacy and the psychometric effects of treatment with either chlormethiazole or triazolam for 9 weeks in elderly patients with sleep disturbance. Chlormethiazole and triazolam were found to be similarly effective in short-term use. However, evidence of sustained hypnotic efficacy throughout the 9 weeks of treatment was obtained for chlormethiazole but not for triazolam. There were daytime withdrawal effects with triazolam, but none with chlormethiazole. PMID- 3529833 TI - Parameters affecting the course and results of delirium tremens treatment. AB - The histories of 778 patients were analysed in respect of the course, type of treatment and lethality of delirium tremens. The lethality was highest in patients in the higher age range, those who were overweight and in spirit drinkers. The lowest mortality was in the patients treated with chlormethiazole (other drugs used included haloperidol and phenothiazines). PMID- 3529834 TI - A comparison of chlormethiazole and thioridazine in agitated confusional states of the elderly. AB - Chlormethiazole and thioridazine were found to be equally effective in the management of the agitational component of agitated confusional states in the elderly. Confusion and nocturnal awakening were found to be controlled more effectively with chlormethiazole than with thioridazine. Chlormethiazole treatment also resulted in significant reductions in physical disability as assessed by the Clifton Behaviour Rating Scale. A greater incidence of adverse effects was associated with thioridazine treatment. PMID- 3529835 TI - Adverse reactions to intravascularly administered contrast media. AB - A hypothesis is formulated about the mechanisms causing adverse reactions to contrast media. Contrast media act in two ways. They stimulate the mast cells to release histamine and leukotrienes, and they inhibit the enzymes which otherwise degrade leukotrienes. Thus individuals, especially those with a history of allergy, are easily exposed to undue amounts of leukotrienes and these are responsible for the adverse reactions. PMID- 3529836 TI - Computed tomography in pre- and postoperative evaluation of aortic dissection. AB - Thirty-seven patients with angiographically or operatively confirmed acute, chronic or postoperative aortic dissection were examined by means of dynamic CT and the results compared with those obtained by angiography and ultrasonography (US). The diagnostic accuracy was 87 per cent for CT, 97 per cent for angiography, and 76 per cent for US, although US was only available in less than half of the cases. The highest accuracy (95%) of CT was achieved in the pre operative group, which is comparable with the 97 per cent accuracy achieved using angiography. Three patients in the postoperative group had false negative CTs, resulting in an overall accuracy of 82 per cent as compared with 100 per cent for angiography. Despite its diagnostic capacity, CT could not define the complete extent of dissection in four patients. The descending thoracic aorta was the area most difficult for CT examinations because of frequent artifacts in the images. PMID- 3529837 TI - Effects of surgery on cervical spondylotic myelopathy. AB - The results of surgery for treatment of cervical spondylotic myelopathy (CSM) were assessed 3 months (early results) and 2-8 years (late results) postoperatively in 99 patients. Extensive laminectomy as well as anterior decompression and fusion, or the two procedures at staged intervals, were used. Immediate postoperative deterioration was never seen after laminectomy performed under local anaesthesia (84 patients), while transient deterioration occurred after anterior surgery in 2 of 28 patients. Cervical spondylotic radiculopathy (CSR) was found in 73% of the patients. Operative treatment for CSM also improved root symptoms, anterior surgery to a larger extent than posterior decompression. Only 10% of the patients treated with extensive laminectomy needed a second anterior operation for radiculopathy. The progression of myelopathy was arrested in 95% of the patients after surgery. Improvement was obtained in 80% both in the early and late follow-up review when compared to the preoperative functional status. The evaluation disclosed a tendency of rapid improvement during the first 3 months, subsequently followed by slow improvement in 50% and slight deterioration in 15% of the patients. The degree of improvement was in many patients not sufficient to raise the functional capability to a higher level in the employed grading system. In our opinion it is therefore important to operate patients with CSM as early as possible before neurological deficits are too pronounced. PMID- 3529838 TI - Proliferative activity of meningiomas as evaluated by bromodeoxyuridine uptake examination. AB - Proliferative activity of meningiomas was examined in 12 consecutive cases by administering bromodeoxyuridine (BrdU) before surgical removal and by immunohistochemical staining of the removed tumours using anti-BrdU monoclonal antibody (anti-BrdU MAb) to detect BrdU-labelled tumour cells. The 12 cases consisted of 6 with a primary tumour and 6 with a recurrent tumour. All of the tumours contained labelled cells and the labelling index (LI) was obtained in each tumour. The highest average LI was 13.6% and the second highest was 9.0% both in recurrent cases of histologically malignant meningothelial meningioma. The high LIs of both cases were thought to correspond well with the rapid recurrence of the tumour. The average LI of a case of recurrent haemangiopericytic tumour was 2.0%, and that of a case of meningioma associated with von Recklinghausen disease was 1.5%. The other 8 meningiomas showed the average LIs ranging from 0.1 to 0.9%, which were considered to be the LIs of usual benign meningiomas. The results of the BrdU uptake examination was considered to reflect well the clinical behaviour of meningiomas. The usefulness of the BrdU uptake examination in brain tumours, which can be employed in the clinical practice without any serious side-effects, is stressed. PMID- 3529839 TI - Clinical pathology of primitive gliomas in the cerebrum. AB - To clarify the biological features of primitive gliomas in the cerebrum and clearly distinguish them from malignant or anaplastic gliomas and glioblastomas, we studied eight cases clinically and pathologically. Our evaluations included immunohistochemical and electron microscopic observations. We divided the patients into two groups, children and young adults. Most tumours appeared as ring-like, enhanced masses on computed tomography and avascular or ring-like, vascular masses on angiography. Macroscopically, the tumours were well demarcated and contained cysts. Occassionally we found tumour dissemination. Microscopically, the tumours were composed of small, round cells without remarkable structural features. Ependymal, astroglial, and oligodendroglial differentiation was evident, in varying proportions; tumours in which the differentiated areas constituted more than half of the mass were classified as poorly differentiated gliomas. By these criteria, this series comprised four undifferentiated and four poorly differentiated gliomas. Cell anaplasia and polymorphism were rare in both undifferentiated and differentiated areas of the tumours. Immunohistochemical and electron microscopic examinations also revealed glial differentiation. These primitive gliomas appear to be biologically similar, but not identical, to cerebellar medulloblastomas. In this series, five patients died because of recurrence or dissemination. Whole brain and spinal irradiation should be considered after total or subtotal surgical removal. PMID- 3529841 TI - Target localization on standard axial images in computed tomography (CT) stereotaxis for functional neurosurgery--a technical note. AB - A simple technique for marking functional neurosurgery target on computed tomography (CT) axial image is described. This permits the use of standard axial image for computed tomography (CT) stereotaxis in functional neurosurgery. PMID- 3529840 TI - Infection of the intervertebral space following conventional and microsurgical operation on the herniated lumbar intervertebral disc. A controlled clinical trial. AB - Review of the literature reveals that considerable knowledge has accumulated on intervertebral space infection following lumbar disc surgery. This is based on more than 400 observations. There are, however, no unifying concepts regarding the pathogenesis of the condition. While the reported incidence has seemed to increase in the last three decades, we noticed a significant reduction in frequency of this important complication of lumbar disc surgery after introducing microsurgical techniques. The significance of this finding is discussed with respect to pathogenesis. PMID- 3529842 TI - [Emphysematous cystitis]. PMID- 3529843 TI - [Dental occlusion, what dental occlusion?]. PMID- 3529844 TI - [The surgeon-dentist and the Navy in the XVIIIth century]. PMID- 3529845 TI - [Composite resins for posterior use]. PMID- 3529846 TI - The comparative anatomy of neurons: homologous neurons in the medial geniculate body of the opossum and the cat. PMID- 3529847 TI - General recombination: functions and structure of RecA protein. PMID- 3529848 TI - Transcription signals and factors in Escherichia coli. PMID- 3529849 TI - Regularity of gene arrangement among multigene operons and its implications for the genesis of prokaryotic genes. PMID- 3529850 TI - Organization of chloroplast genomes. PMID- 3529851 TI - The physiological significance of the creatine phosphate shuttle. PMID- 3529852 TI - Compartmentation of adenine nucleotides and phosphocreatine shuttle in cardiac cells: some new evidence. PMID- 3529853 TI - Function of creatine kinase localization in muscle contraction. PMID- 3529854 TI - Organization of the mitochondrial matrix. PMID- 3529855 TI - Isotope labeling ratios: a tool for the exploration of metabolic compartments. PMID- 3529856 TI - The mitochondrial creatine phosphokinase is associated with inner membrane cardiolipin. PMID- 3529857 TI - Aspects of heart respiratory control by the mitochondrial isozyme of creatine kinase. PMID- 3529858 TI - Control of respiration in intact muscle. PMID- 3529859 TI - The oxygen dependence of cellular energy metabolism. AB - In isolated perfused rat hearts coronary flow appears to be regulated through the tissue energy level ([ATP]free/[ADP]free[Pi]), a metabolic product of oxygen metabolism by mitochondria, and not by the tissue oxygen tension. Mitochondrial oxidative phosphorylation in intact cells and tissues is dependent on oxygen tension throughout the physiological range. This allows oxidative phosphorylation to serve as an important tissue oxygen sensor. The apparent Km of mitochondrial cytochrome c oxidase for oxygen is dependent on the pH of the suspending medium, [ATP]/[ADP][Pi] and the state of reduction of cytochrome c. When physiological levels of [ATP]/[ADP][Pi], pH and cytochrome c reduction are used, oxidative phosphorylation by suspensions of isolated mitochondria has an oxygen dependence similar to that observed in intact cells. PMID- 3529860 TI - Regulation of mitochondrial respiration in liver. PMID- 3529861 TI - The time course of ATP cleavage by contracting amphibian and mammalian skeletal muscles. AB - The pattern of energy liberation by tetanically stimulated muscle is reasonably well defined. The energy liberation and ATPase rate are affected by a variety of mechanical factors which, aside from the case of shortening mammalian muscles, are well documented. The amount of ATP consumed by processes associated with the calcium release and sequestration is not trivial, amounting to 30-40% of the energy liberation in an isometric contraction. The energy liberated by isometric and shortening muscles is ultimately accounted for by known chemical reactions. However, there are two instances in which the time course of energy liberation does not correspond to the time course of high energy phosphate utilization. In an isometric tetanus, 30-40 mJ of energy per gram of muscle is produced by reactions probably associated with intracellular circulation of calcium, but not immediately involving ATP hydrolysis. Second, in rapidly shortening muscles, an unknown reaction can produce 6-7 mJ of energy per gram of muscle which is not immediately associated with high energy phosphate splitting. However, immediately after the cessation of shortening, this reaction is reversed by an ATP hydrolysis. Finally, a technique is now available which permits one to perform transient kinetic studies on skinned muscle fibers which are shortening and/or developing force. This development should enable the design of experiments in which the effect of mechanical conditions upon specific steps of the ATPase mechanism can be examined. PMID- 3529862 TI - Why is there a delay in the increased oxygen consumption during the rest-work transition in skeletal muscle? PMID- 3529863 TI - Compartmentation and functional mechanisms in myocardial failure and myocardial infarction. AB - Changes in compartmentation and specific mechanism in acute myocardial failure due to global ischemia and in regional myocardial ischemia in dog hearts are described. Ischemic failure was produced by periodic arrest of flow to supported heart preparations perfused with a fluorocarbon (FC-43). Sarcolemmal vesicles (SL) prepared from ischemic failing heart preparations exhibited diminished Ca++ binding and phosphorylation. TA-064, a beta-1-agonist partially abolished the reduction in Ca++ binding and phosphorylation of SL vesicles. The addition of cyclic-AMP (cAMP) and of protein kinase (PK) increased phosphorylation of SL vesicles obtained from non failing heart preparations. Combination of cAMP and of PK had the greatest effect. In contrast to myocardial failure, myocardial infarction is known to produce a large variety of specific disturbances in intermediary cardiac metabolism. Apparently in ischemic failing heart preparations, Ca++ binding and phosphorylation by SL are deficient. The results with TA-064 and isoproterenol suggest that phosphorylation of SL may play a role in the positive inotropic effect of beta-1-agonists. PMID- 3529864 TI - Heart myocytes as models of the cellular response to ischemia. PMID- 3529865 TI - Biologic basis for limitation of infarct size. PMID- 3529866 TI - Sarcomere length-tension relationship in toad atrioventricular pacemaker: length dependent activation. PMID- 3529867 TI - Vascular metabolism and energetics. PMID- 3529868 TI - Myocardial glutamate dehydrogenase activity. PMID- 3529869 TI - Long term model for evaluation of myocardial metabolic recovery following global ischemia. AB - Myocardial ATP levels remain depressed following significant periods of ischemia (Isc) despite reperfusion (Rpf). Neither the rate of in vivo ATP return following global Isc nor the factors which influence recovery have been defined. In order to determine the time course to complete the return of ATP levels and evaluate methods of enhancing recovery of ATP levels, we have devised a chronic canine model of global Isc. In this model serial ventricular biopsies can be taken in the awake animal over several days without reoperation which allows an investigation of the recovery of the myocardium following a uniform global insult to be performed. Recovery of ATP levels has been shown to depend, at least in part, on the availability of precursors and the activity of the ATP regenerating enzymes. Because complete recovery of ATP levels takes days, short term (hours) models have limitations. Previous attempts at enhancing ATP recovery following Isc have been only partially successful because either the degree of depression was not great or the period of observation was short, resulting in incomplete return. To identify the best precursor choice, we previously measured the activity of the AMP regenerating enzymes, adenosine kinase (AdK) (adenosine--- AMP) and adenine phosphoribosyl transferase (APRT) (adenine----AMP). Because APRT activity was 20 fold higher than AdK with similar Km values for substrates, it appeared that adenine (A) is preferred to adenosine for AMP regeneration in the dog's myocardium. The formation of 5-phosphoribosyl 1-pyrophosphate (PRPP) may also be rate limiting and, therefore, the effect of ribose (R) on ATP recovery was also evaluated. Recovery of ATP levels was assessed in three groups: (1) normal saline (NS), (2) A (20 mM) in normal saline (A/NS) or (3) A with R (80 mM) in normal saline (A/R) were infused (1.0 ml/min) into the right atrium of dogs for 48 hours following Isc. In all groups, ATP levels fell to between 46-60% of pre-Isc levels during Isc. In the NS dogs, ATP levels continued to fall slightly to 46% pre-Isc levels during the first four hours of Rpf after Isc. By 24 hours no appreciable recovery had occurred and the measured ATP was only 51% of the pre Isc value. Even by seven days, ATP had not returned fully, and by extrapolation, complete recovery required 9.9 +/- 1.4 days. Treated dogs showed, however, that ATP recovery could be significantly enhanced.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3529870 TI - Isozymes of creatine kinase in mammalian myocardial cell culture. PMID- 3529871 TI - Calcium compartmentation in mammalian myocardium. PMID- 3529872 TI - Sodium-calcium exchange: calcium regulation at the sarcolemma. PMID- 3529873 TI - Sodium modulation of resting force, contractile properties, and metabolism with particular emphasis on its role in the development of calcium overload states. PMID- 3529874 TI - Lessons for muscle energetics from 31P NMR spectroscopy. PMID- 3529875 TI - The effect of inorganic phosphate on mitochondrial, creatine kinase. PMID- 3529876 TI - Regulation of adenovirus mRNA formation. PMID- 3529877 TI - Plant viruses in rivers and lakes. PMID- 3529878 TI - Nonpersistent viruses: epidemiology and control. PMID- 3529879 TI - Adverse effects of anticonvulsant drugs--a critical review. PMID- 3529880 TI - Data quality in post-marketing surveillance. PMID- 3529881 TI - Bone marrow depression due to mianserin, phenylbutazone, oxyphenbutazone, and chloramphenicol--Part I. PMID- 3529882 TI - New developments concerning leukotriene antagonists: a review. AB - The numbers and subtypes of leukotriene (LT) receptors have only recently been investigated and more work is needed to evaluate the distribution of receptors on tissues and cells in both normal and pathological states. Classification of the heterogeneity of LT receptors may assist in the discovery of new antiallergy and antiinflammatory drugs much in the same way as the study of different adrenergic receptors has benefited cardiovascular drug discovery. The clinical evaluation of the currently available LT antagonists is awaited with interest; however, their therapeutic role in the treatment of asthma, a primary goal for the majority of these agents, will require painstaking clinical appraisal. They seem unlikely to supplant the currently used bronchodilators but may provide a valuable prophylactic adjunct that may suppress some of the inflammatory events that occur in obstructive lung disease. Whether the LT antagonists modify the hyperreactive state that prevails in asthma is also the subject of much speculation. PMID- 3529883 TI - Serotonin in the lung. Demonstration of a close correlation to blood platelet. AB - The dependency of a high level of serotonin (5-hydroxytryptamine, 5HT) in the lung on blood 5HT was examined. The whole lung excised from NOD/Shi mice (male, 8 12 week old) immediately after being sacrificed by cervical dislocation contained 2.86 +/- 1.21 micrograms/g of 5HT per wet tissue. This amount was much higher than that explained by the included blood which was estimated by the hemoglobin concentration in the lung extract. In order to decrease 5HT level in the blood, platelet was depleted by an exposure to gamma-ray. On the 10th day after the irradiation the amount of 5HT in the lung and blood decreased to about 3.1% and 1.5% of the respective normal values. The progressive decrease in 5HT in the lung and blood of the irradiated mice was prevented by the transplantation of normal bone marrow cells (10(7) cells/mouse). 5HT in the intestine did not change significantly. The correlation between 5HT in the excised lung and the number of platelets in the blood was statistically significant (correlation coefficient r = 0.61). The irradiated, platelet-deficient mice were incapable of accumulating serotonin in the lung, while normal mice increased the lung serotonin more than 3 fold, when high doses of 5HT were administered. The results indicated that the high level of 5HT in the dissected lung was closely related to platelet in the blood. A question remained where the majority of the measured 5HT was located in the lung tissue. PMID- 3529884 TI - A study to determine the clinical relevance of the pharmacokinetic interaction between aspirin and diclofenac. AB - Interaction studies in the rat and healthy human volunteers have shown that protein binding of diclofenac is reduced by the addition of salicylic acid causing an increased free drug level of diclofenac. The diclofenac area under curve (AUC) is also reduced by approximately one-third in the presence of salicylate. We have performed a crossover comparison of soluble aspirin, diclofenac and the two drugs in combination in patients with rheumatoid arthritis to determine whether this had clinical relevance. 36 patients entered the study. There was a high dropout rate on aspirin alone but analysis of completors (22 patients) showed diclofenac either alone or in combination to be superior to aspirin alone on two of the five clinical parameters measured. There was no significant difference between disclofenac and aspirin + diclofenac. We thus found no clinical manifestations of the pharmacokinetic interaction. PMID- 3529885 TI - Knorr and Filehne in Erlangen. PMID- 3529886 TI - 100 years of pyrazolone drugs. PMID- 3529887 TI - Evoked potentials as correlates of pain and pain relief in man. AB - This contribution reviews the practical applications of evoked potentials (EPs) in the evaluation of experimental studies on analgesic intervention in humans. It is also intended as an introduction to EP methodology, its possibilities, and its limitations, for all fellow researchers working in other fields. PMID- 3529888 TI - [Biochemical and immunohistochemical determinations of gangliosides in the lenses from congenital mice (cac-strain and ICR/M-strain)]. PMID- 3529889 TI - [Morphologic study of microscopic hematuria using phase contrast microscopy]. AB - Phase contrast microscopic examination of the urine has been recently reported to be valuable in predicting whether hematuria is due to glomerulonephritis or not. Phase contrast microscopy can differentiate glomerular red cells from nonglomerular ones since the former varies in size and shape with distortion, whereas the latter is uniform in size and shape. Urinalysis of 217 cases of microscopic hematuria was performed at our Hospital. Red blood cells were classified into two types, glomerular and nonglomerular type. Ninety percent of the cases of bladder leukoplakia as well as all cases of glomerulonephritis had glomerular type red blood cells. PMID- 3529890 TI - [A case of renal cell carcinoma during pregnancy]. AB - Renal cell carcinoma during pregnancy is extremely rare. This 30-year-old patient was first seen on Dec. 18, 1983 at the 7th week of her 2nd pregnancy. She had asymptomatic hematuria. Cystoscopy revealed normal findings and sonogram showed well defined echogenic mass in the upper pole of the right kidney. She was admitted to our hospital on account of gross hematuria and severe lumbago on Jan. 19, 1984. The pregnancy was stopped by artificial abortion. Renal angiography revealed a rich-vascularized tumor in the upper pole of the right kidney. Preoperatively, arterial embolization was done and nephrectomy was performed. Histological examination showed a well-differentiated adenocarcinoma. There was no involvement of the renal vein and no lymph-node metastases were found in the operation specimen. The post-operative course was uneventful. This rare case of renal cell carcinoma during pregnancy is herein reported along with some discussion. PMID- 3529891 TI - Colicin resistance in relation to pathogenicity factors in strains of Escherichia coli isolated from the intestinal tract of piglets. PMID- 3529892 TI - Vascular complications after liver transplantation: a 5-year experience. AB - During the past 5 years, 104 angiographic studies were performed in 87 patients (45 children and 42 adults) with 92 transplanted livers for evaluation of possible vascular complications. Seventy percent of the studies were abnormal. Hepatic artery thrombosis was the most common complication (seen in 42% of children studied, compared with only 12% of adults) and was a major complication that frequently resulted in graft failure, usually necessitating retransplantation. In six children, reconstitution of the intrahepatic arteries by collaterals was seen. Three survived without retransplant. Arterial stenosis at the anastomosis or in the donor hepatic artery was observed in 11% of patients. Portal vein thrombosis or stenosis occurred in 13% of patients. Two children and one adult with portal vein thrombosis demonstrated hepatopetal collaterals that reconstituted the intrahepatic portal vessels. Uncommon complications included anastomotic and donor hepatic artery pseudoaneurysms, a hepatic artery-dissecting aneurysm, pancreaticoduodenal mycotic aneurysms, hepatic artery-portal vein fistula, biliary-portal vein fistula, hepatic vein occlusion, and inferior vena cava thrombosis. PMID- 3529893 TI - Society of Gastrointestinal Radiologists Roscoe E. Miller Award. Monitoring hepatic cryosurgery with sonography. AB - The intraoperative sonographic appearance of frozen hepatic tumors and frozen normal liver was correlated with the histologic appearance of pathologic specimens from six patients. Frozen tissue was visualized as a hyperechoic rim with posterior acoustic shadowing. Normal liver that was frozen and then thawed appeared hypoechoic when compared with normal unfrozen liver. These findings allowed visualization of the extent of freezing in relation to tumor margins. Pathologically, frozen tumors showed definite evidence of necrosis. Normal liver tissue was extremely sensitive to cold and was completely necrotic after freezing. The sonographic appearance of frozen and thawed liver correlated precisely with the gross morphologic and histologic changes seen in the cryolesion. It appears that intraoperative sonography allows accurate monitoring of hepatic cryosurgery. PMID- 3529894 TI - Digital subtraction venography in central venous obstruction. AB - Thirty-five patients had central venous digital subtraction venography (DSV) to assess its value in detecting central line/shunt patency (13 patients) and central venous obstruction (22 patients). All examinations were easily performed and provided diagnostic images without conventional venographic supplementation. The disadvantages of DSV are outweighted by the advantages, which include saving time and money, superior contrast resolution, flexibility of image display, and reduced dosage of contrast agent. PMID- 3529895 TI - Chronic acalculous gallbladder disease: multiimaging evaluation with clinical pathologic correlation. AB - Despite the recent advances in hepatobiliary imaging, the diagnosis of chronic acalculous gallbladder disease remains difficult. A retrospective study was undertaken to assess the value of a multiimaging approach in detecting chronic acalculous gallbladder disease and in predicting which patients would obtain symptomatic relief after cholecystectomy. Of 199 patients with chronic cholecystitis, 26 (13%) had no gallstones. Of these 26, only 17 (65%) had symptoms related to chronic cholecystitis; in the remainder, the histologic diagnosis was made incidentally. After cholecystectomy, 13 (76%) of the 17 symptomatic patients obtained long-term symptomatic relief, while in four, the symptoms recurred. Among patients with histologic changes of chronic cholecystitis, biliary scintigraphy was the most sensitive technique (sensitivity, 89%). The sensitivity of sonography and oral cholecystography was 61.5% and 66%, respectively. However, for identifying symptomatic patients who may obtain long-term symptomatic relief after cholecystectomy, the accuracy of sonography, oral cholecystography, and biliary scintigraphy was 82%, 86%, and 38%, respectively. When two tests were in agreement the accuracy was 88%. For chronic acalculous cholecystitis, more than one study must be performed in order to make the correct diagnosis and to predict good results from cholecystectomy. PMID- 3529896 TI - Sonography in the diagnosis of hepatic artery aneurysms. AB - In five cases of hepatic artery aneurysms, the findings on sonography suggested the diagnosis or indicated the need for angiography. The intrahepatic aneurysms (four cases) were anechoic, well-circumscribed masses with good through transmission of sound. None were pulsatile, but flow within the mass was observed in one case. An intrahepatic mass adjacent to the aneurysm was identified in every case, representing hematoma in three and postoperative abscess in one. The sonogram in a patient with a common hepatic artery aneurysm (one case) showed a lobulated, pulsatile, anechoic mass within a pancreatic head pseudocyst. Sonography offers a noninvasive means of screening for this abnormality. PMID- 3529897 TI - Fetal omphalocele and gastroschisis: pitfalls in sonographic diagnosis. AB - The prenatal sonographic findings in 10 infants with omphalocele or gastroschisis diagnosed either by sonogram or by physical examination at birth are reviewed. There were six true-positive diagnoses, as well as two false-positive and two false-negative diagnoses by sonography. The false-positive cases resulted from confusion of umbilical cord with extruded bowel (1 case) and oligohydramnios coupled with improper scanning technique (1 case). The false-negative cases resulted from poor documentation of fetal anatomy (1 case) and confusion of extruded bowel with umbilical cord (1 case). These pitfalls may be avoided by using optimal scanning technique with documentation of fetal anatomy and pulsed Doppler sonography. PMID- 3529898 TI - Neonatal renal candidiasis: sonographic diagnosis. AB - With improved survival of very-low-birth-weight infants, the incidence of neonatal renal candidiasis is increasing. The clinical and sonographic features of four premature infants with renal candidiasis are presented. Both parenchymal and intrapelvic renal lesions, with or without hydronephrosis, were detected. Abdominal sonography is a useful noninvasive technique for the diagnosis and follow-up management of renal candidiasis. Early diagnosis allows prompt intervention with antifungal therapy and should increase survival. PMID- 3529899 TI - Early American Radiology: the pioneer years. PMID- 3529900 TI - Eye banking practices in Alabama. PMID- 3529901 TI - Impaired cardiac PGI2 and PGE2 biosynthesis in patients with angina pectoris. AB - Thirty-four patients with unstable angina and 14 patients with stable effort angina were investigated for cardiac prostacyclin and prostaglandin E2 (PGE2) biosynthesis, under resting conditions and after cold pressor testing. Twenty seven patients undergoing cardiac catheterization and coronary angiography for congenital or acquired heart diseases other than coronary artery disease were studied as a control group. Prostacyclin (as 6-keto-PGF1 alpha) and PGE2 were measured by specific radioimmunoassay of blood from the coronary sinus and aorta. During resting conditions no significant differences in plasma 6-keto-PGF1 alpha and PGE2 concentrations were found between coronary sinus and aortic blood, and no transcardiac gradient existed either in control subjects or in patients with stable and unstable angina, respectively. In control subjects cold pressor testing induced a significant increase in 6-keto-PGF1 alpha and PGE2 levels in blood from the different sampling sites, and a significant transcardiac gradient occurred (+11.2 +/- 6.4 pg/ml for 6-keto-PGF1 alpha and +5.1 +/- 3.4 pg/ml for PGE2). However, in angina patients no significant increase in 6-keto-PGF1 alpha and PGE2 plasma levels was found and no transcardiac gradient was formed after cold pressor testing. These results indicate impaired cardiac prostacyclin and PGE2 biosynthesis both in patients with stable and unstable effort angina. PMID- 3529902 TI - Effects of aerobic training on exercise tolerance and echocardiographic dimensions in untrained postmenopausal women. AB - The cardiovascular effects of physical training were evaluated in a controlled trial involving 32 healthy, untrained, postmenopausal women. The subjects were randomly assigned to an aerobic exercise training program or a control group. The exercise group participated in at least three 40-minute supervised sessions per week for 8 months. Twenty-five subjects completed the study: eight in the control group and 17 in the training group. The training group had a significant increase over the training period in maximal oxygen consumption (27.3 +/- 4.6 ml/kg/min vs 30.8 +/- 5.4 ml/kg/min, p less than 0.05) and maximal treadmill exercise duration (9.8 +/- 2.6 minutes vs 11.3 +/- 2.2 minutes; p less than 0.05). The control group had no significant change in maximal treadmill exercise duration (9.0 +/- 1.2 minutes vs 9.2 +/- 1.4 minutes) but had a slight increase in maximal oxygen consumption (23.7 +/- 3.4 ml/kg/min vs 24.4 +/- 4.1 ml/kg/min, p less than 0.05). The training group had significant increases in M-mode echocardiographic left ventricular end-diastolic dimension (4.6 +/- 0.6 cm vs 4.8 +/- 0.4 cm, p less than 0.05) and calculated left ventricular ejection fraction (0.66 +/- 0.14 vs 0.74 +/- 0.12, p less than 0.05). M-mode echocardiograms demonstrated no significant change in left ventricular dimensions or wall thickness in the control group. In this group of untrained postmenopausal women, a training effect was associated with enhanced resting left ventricular ejection fraction and increased resting left ventricular end-diastolic dimension. PMID- 3529903 TI - The interventricular septum in health and disease. AB - The interventricular septum constitutes a major part of the heart and contributes to both left and right ventricular function. It is directly affected in certain disease states which can be diagnosed by echocardiographic examination of the septum. The septum also demonstrates characteristic patterns in cardiac conditions that do not directly affect it. These abnormal patterns have physiologic and diagnostic value. As a general rule, no matter what the diastolic configuration of the interventricular septum, it tries to assume its characteristic concave shape in systole. The significant exception is the presence of right ventricular pressure overload. The introduction of echocardiography has greatly increased our understanding of the interventricular septum in both health and disease. PMID- 3529904 TI - Competitive incentive program. Analysis and proposal. PMID- 3529905 TI - Characterization of dusts collected from swine confinement buildings. AB - As part of a project to evaluate health hazards for workers in swine confinement buildings, the air in 21 different buildings was sampled with 37 mm cassette filters with and without cyclone preselectors and with cascade impactors. Filter results yielded a mean total aerosol of 6.3 mg/m3, a mean respirable aerosol of 0.5 mg/m3; the geometric mean diameter was 2.9 microns. Cascade impactor measurements revealed a mean total aerosol of 7.6 mg/m3, a respirable aerosol of 2.5 mg/m3 and a mass median diameter of 9.6 microns. The two major constituents in these aerosols were grain particles and dried fecal matter. The grain particles were larger than fecal particles and proportionately more abundant in finishing buildings where 50 kg X 100 kg animals are housed. Therefore the respirable fraction was less in finishing buildings than in farrowing and nursery buildings. Culturing of settled dusts yielded six different mold species, with the highest counts for Verticillium sp. (5 X 10(2) cfu/mg dry dust) grown at 37 degrees C. Thermophilic Actinomycetes and both gram negative and gram positive bacteria were isolated. Azocasein proteinase activity was found in most dust samples analyzed. This dust had a protein content of about 23% and a mean adsorbed ammonia content of 0.4%. PMID- 3529906 TI - Assessment of antiarrhythmic drug efficacy in the treatment of supraventricular arrhythmias. AB - Few guidelines exist for judging the efficacy of antiarrhythmic drugs in patients with supraventricular arrhythmias. Useful definitions concerning the frequency and duration of supraventricular arrhythmias are offered, and complete and partial efficacy criteria are outlined for noninvasive electrocardiographic and invasive electrophysiologic techniques. Several open label, double-blind, parallel and crossover study designs are suggested for efficacy studies concerning the termination and prevention of supraventricular tachycardia. These recommendations are useful for designing new drug trials needed to evaluate properly the efficacy of antiarrhythmic agents in the treatment of various supraventricular arrhythmias. PMID- 3529907 TI - Long-term continuous electrocardiographic recordings and electrophysiologic testing to select patients with ventricular arrhythmias for drug trials and to determine antiarrhythmic drug efficacy. AB - Long-term continuous electrocardiographic recordings (Holter recordings) and electrophysiologic testing are useful for selecting patients for antiarrhythmic drug trials and for evaluating efficacy and adverse effects during therapy. These 2 methods are used to establish patient eligibility and to stratify patients during randomization. Both noninvasive testing and electrophysiologic studies help to classify arrhythmias as benign, potentially malignant or malignant. Holter monitoring and electrophysiologic studies each have unique advantages and disadvantages for baseline evaluation before starting antiarrhythmic drug treatment and for evaluation of efficacy or adverse effects during follow-up. Both methods have been shown to predict outcome of treatment in patients with malignant ventricular arrhythmias (i.e., can be used as surrogates for sudden death). Several ongoing studies are attempting to extend our knowledge of these 2 techniques. A multicenter study in the United States is comparing the 2 methods for applicability, predictive accuracy and cost. Investigators in the Netherlands are testing the validity of electrophysiologic studies by continuing antiarrhythmic drug treatment whether or not programmed ventricular stimulation predicts success or failure. Finally, new proposals have been made for conducting randomized, controlled studies in selected patients with malignant ventricular arrhythmias using time to drug failure as the endpoint. PMID- 3529908 TI - Coronary thrombolysis during acute myocardial infarction by intravenous BRL 26921, a new anisoylated plasminogen-streptokinase activator complex. AB - The safety and fibrinolytic efficacy of a new anisoylated plasminogen streptokinase activator complex (APSAC) was tested in 50 patients with acute myocardial infarction (AMI) less than 4 hours in duration. APSAC (30 mg) was given intravenously as a bolus injection 151 +/- 47 minutes after clinical symptoms. Coronary angiography was then performed to assess coronary artery patency: 28 patients had an inferior AMI and 22 an anterior AMI. A patent infarct related artery was found in 32 patients (64%) on first coronary angiography 66 +/ 21 minutes after administration of APSAC. Subsequent reperfusion was observed in 10 patients after 74 +/- 16 minutes (84%). Bleeding complications or hematomas were observed in 18 patients, of whom 3 required blood transfusions. Marked hypofibrinogenemia was observed within 24 hours in most patients. A control coronary angiogram was recorded in 37 patients (74%) after 25 +/- 19 days and showed reocclusion in 5 patients. PMID- 3529909 TI - Comparative antianginal effects of bepridil and propranolol in angina pectoris. AB - Eighteen patients with chronic, stable angina were studied in a double-blind, placebo-controlled, 3-way, crossover study in which they received 4 weeks of treatment with a once-daily dose of bepridil, 300 mg, a once-daily dose of long acting propranolol, 160 mg, and placebo. Heart rate at rest during bepridil treatment was less than that during placebo (p less than 0.01), whereas propranolol reduced heart rate compared with placebo (p less than 0.001) and bepridil (p less than 0.01). Systolic blood pressure at rest did not change during the 3 treatment phases. Exercise time to onset of angina and to development of moderate angina were reproducible over the 24-hour period during each treatment phase. Treadmill walking time to onset of angina and to development of moderate angina was significantly prolonged during bepridil (p less than 0.01) and during propranolol treatment (p less than 0.05). Heart rate at peak exercise was similar during bepridil and during placebo, but was markedly reduced with propranolol treatment (p less than 0.001). Systolic blood pressure during exercise was similar during placebo and bepridil, but was substantially lower during propranolol treatment (p less than 0.01). PMID- 3529910 TI - Electrophysiologic effects and clinical efficacy of mexiletine used alone or in combination with class IA agents for refractory recurrent ventricular tachycardias or ventricular fibrillation. AB - The electrophysiologic effects and clinical efficacy of mexiletine used alone or in combination with class IA agents were studied in 35 patients with recurrent sustained ventricular tachycardia (VT) or ventricular fibrillation refractory to nonexperimental antiarrhythmic agents. At baseline before therapy, all patients had inducible VT by programmed stimulation (1 to 3 extrastimuli) and frequent (at least 30/hour) ventricular premature complexes (VPCs) during Holter monitoring. Mexiletine therapy was effective by programmed stimulation (VT no longer inducible or 15 or less beats) in 8 and ineffective in 27 patients. Twenty patients were discharged with mexiletine (14 of whom took an additional class IA agent). The discharge regimen was effective by programmed stimulation in 6 of these 20 patients. In 14 patients the discharge regimen was ineffective by programmed stimulation, but all patients had a marked reduction of ventricular ectopic activity (at least 83% reduction of VPCs and abolition of non sustained VT). During the follow-up period of 18 +/- 13 months (mean +/- standard deviation), 4 patients had recurrences (3 with an ineffective regimen by programmed stimulation and 1 with an effective regimen by programmed stimulation). Arrhythmia-free survival rates at 12 and 24 months were 86% and 77%, as determined by the Kaplan-Meier method, in patients with an ineffective regimen by programmed stimulation, and 80% and 80% in patients with an effective regimen by programmed stimulation (p = 0.979 by log rank test).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3529911 TI - Flecainide versus quinidine for conversion of atrial fibrillation to sinus rhythm. AB - The effectiveness and safety of flecainide and quinidine for conversion of atrial fibrillation (AF) to sinus rhythm were compared. Sixty consecutive patients were treated with either flecainide (up to 2 mg/kg intravenously and then orally) or quinidine (up to 1.2 g orally). There was no statistical difference in age, left atrial size, duration of the arrhythmia and underlying cardiac diseases between the 2 groups. The overall conversion rate to sinus rhythm was 63% (38 patients): AF was converted in 18 patients (60%) treated with quinidine and 20 (67%) with flecainide. If AF lasted less than 10 days, the conversion rate was 86% in the flecainide group and 80% in the quinidine group (difference not significant). When AF lasted more than 10 days the rate was 22% in the flecainide group and 40% in the quinidine group. Adverse effects were more frequent in the quinidine group (27%) (gastrointestinal disturbances) than in the flecainide group (7%) (conduction disturbances), but they were less severe in the quinidine group. Thus, flecainide given intravenously appeared to be as effective as quinidine given orally for conversion of AF of recent onset (within 10 days). However, quinidine should probably remain the preferred drug for conversion of AF of long duration (more than 10 days) to sinus rhythm. Adverse effects occurred less often with flecainide therapy, but they were more severe. PMID- 3529912 TI - Intravenous atenolol for ventricular arrhythmias. AB - To determine the efficacy and safety of intravenous atenolol in patients with frequent and repetitive benign or potentially lethal ventricular arrhythmias, 40 patients received an open-label, single dose of 10 mg of intravenous atenolol, given in aliquots of 2.5 mg every 10 minutes. Twenty-four-hour Holter monitoring was performed on the day before, the day of, and the day after infusion of atenolol. A full 10-mg dose was given to 37 patients; asymptomatic bradycardia developed in 3 patients, and they were not included in the efficacy analysis. A single 10-mg dose of intravenous atenolol was effective rapidly in suppressing ventricular arrhythmias, with peak suppression occurring 1 to 2 hours after infusion and significant suppression lasting for 7 hours. Only 1 patient had symptoms (lightheadedness), plus hypotension lasting 45 minutes after the infusion was concluded. The mean plasma level of atenolol was 231 ng/ml 10 minutes after the infusion, with individual patient values of 148 to 457 ng/ml. Thus, a single intravenous dose of 10 mg of atenolol can significantly reduce the frequency of ventricular premature complexes and ventricular tachycardia within the first hour after infusion; suppression can last for 7 hours. Atenolol is well tolerated. PMID- 3529913 TI - Pharmacokinetic interaction between oral metoprolol and verapamil for angina pectoris. PMID- 3529914 TI - Changes in ventricular septal thickness in systemic hypertension during treatment with methyldopa and prazosin. PMID- 3529915 TI - Borderline mild systemic hypertension: should it be treated? PMID- 3529916 TI - High-carbohydrate diet: antinatriuretic and blood pressure response in normal men. AB - The hypothesis that high-carbohydrate feeding leads to increased insulin secretion, sodium retention, and elevation in blood pressure was examined in seven healthy men. A baseline 7-day balance study on low (13%) or high (52%) carbohydrate was followed by a 2-wk balance on the alternate diet and a 1-wk balance on the baseline diet. Results indicated that changing carbohydrate intake caused a rapid (2-3 day) inverse change in urinary sodium excretion and balance. By the second week, however, urinary-sodium level returned to baseline accompanied by an inverse change in plasma aldosterone. No significant rise in blood pressure was detected throughout the study. High-carbohydrate feeding promotes sodium retention in normal subjects, but the effect is counterregulated by a reduction in plasma aldosterone. A high-carbohydrate diet in healthy subjects does not cause a significant short-term increase in blood pressure. PMID- 3529917 TI - Commercial canning increases the digestibility of beans in vitro and postprandial metabolic responses to them in vivo. AB - Six weight-stable subjects consumed three test meals containing 50 g carbohydrate in random order after a 12-h fast: D-glucose, canned baked beans, or home-cooked (boiled) baked beans. Postprandial glucose and insulin responses were greatest to glucose, lowest to home-cooked baked beans, and intermediate to canned baked beans. Profiles of glucose and insulin responses to home-cooked beans were flatter and more attenuated than responses to canned beans or glucose, which correlates with the in vitro data showing a six-to-eight times higher rate of starch hydrolysis in canned beans relative to boiled beans. Increases in temperature (pressure) and duration of pressure-cooking resulted in increased starch digestibility, whereas even mildly acidic conditions (pH 5.0) markedly reduced it. None of the processes studied affected the total amount of available carbohydrate. PMID- 3529918 TI - Estimation of total body water by bioelectrical impedance analysis. AB - Total body water (TBW) measured by bioelectrical impedance analysis (BIA) was directly compared with deuterium-isotope dilution in a total of 58 subjects. First, sex-specific and group equations were developed by multiple regression analysis in (10 each) obese and nonobese men and women. Height/resistive impedance was the most significant variable used to predict deuterium-dilution space (D2O-TBW) and, combined with weight, yielded R = 0.99 and SE of estimate = 1.75 L. Equations predicted D2O-TBW equally well for obese and nonobese subjects. Second, the equations were prospectively tested in a heterogeneous group of 6 males and 12 females. Sex-specific equations predicted D2O-TBW with good correlation coefficients (0.96 and 0.93), total error (2.34 and 2.89 L), and a small difference between mean predicted and measured D2O-TBW (-1.4 +/- 2.05 and 0.48 +/- 2.83 L). BIA predicts D2O-TBW more accurately than weight, height, and/or age. A larger population is required to validate the applicability of our equations. PMID- 3529919 TI - High-dose cyclophosphamide, BCNU, and etoposide followed by autologous bone marrow rescue as treatment for adult acute leukemia in relapse. AB - High-dose cyclophosphamide, 1,3-bis-(2 chloroethyl)-1-nitrosourea (BCNU), and VP 16-213 followed by autologous bone marrow rescue was administered to 29 adult patients with acute leukemia in relapse who had failed to respond to prior salvage treatment, with the following results: 14 patients (48%) achieved complete remission (CR), two patients died early of infection and hemorrhage during hypoplasia, and 13 patients had relapsed with leukemia after an initial hypo-plastic phase. Median remission duration was 3 1/2 months (range, 1-8 months). Maintenance treatment with cyclophosphamide and VP-16, which was given to six patients, did not prolong remission duration. Subsequent salvage treatment was well tolerated by both responders and patients who failed to reach CR. This regimen, which is active in both acute lymphocytic leukemia and acute myelogenous leukemia, had a mild toxicity. PMID- 3529920 TI - The pulse wash instrument. A new sampling method for uterine cervical cancer detection. AB - A new sampling method for uterine cervical cancer detection is described. In this method, sampling of cytologic material is done by using a pulse wash instrument. Liquid jets with a diameter of 0.2 mm at a speed of 20 m/s create a successful rinsing effect of cervical epithelial cells due to the high kinetic energy produced. Because cells are suspended in the flushing liquid it is possible to collect material for additional cytochemical, immunocytochemical, and microbiologic diagnostic techniques in addition to a conventional smear technique. Compared to a conventional Papanicolaou smear technique performed in 75 women at two cervical atypia clinics at the Karolinska Hospital, the pulse wash technique is suggested to result in a more representative cellular sample, thus offering a method to decrease false negative diagnoses in uterine cervical cancer detection. PMID- 3529921 TI - Estramustine phosphate compared with diethylstilbestrol. A randomized, double blind, crossover trial for stage D prostate cancer. AB - In a double-blind, crossover comparison, 236 patients with metastatic prostate cancer were randomized to receive estramustine phosphate (EMP) or diethylstilbestrol (DES). Previously castrated patients (66) were separately randomized. Patients kept taking their first drug until progression was proved by objective studies, at which time alternative treatment was begun. The primary determinant of efficacy was the duration between start of therapy and date of objective progression. Uncastrated patients treated with EMP had a significantly longer duration without progression than those treated with DES (p less than 0.01). The following subcategories of entry were further evaluated: little or no pain, moderate to severe pain, little reduction in activity, significant reduction in activity, presence or absence of cardiovascular disease, age above or below 70 years, and "good" or "bad" histology. For all but the last category, EMP was statistically superior to DES. Patients who underwent orchiectomy less than 3 months before randomization had nonprogression rates similar to those for noncastrated men in both groups. Secondary (crossover) therapy was less effective than first therapy in both groups: 46% of patients receiving EMP and 40% receiving DES had no progression at 6 months. Clinical and laboratory adverse experiences were similar for both drugs, except that gastrointestinal disturbances were more common in the EMP group. PMID- 3529922 TI - Detection of lymphocyte antigens in tissues placed in transport medium. Comparison with cryostat fresh-frozen section technic. An immunologic study of 56 cases. AB - It has been suggested recently that use of a transport medium (Michel's medium) satisfactorily preserves the antigenicity of surface markers on lymphocytes for immunologic evaluation. Transport medium has been reported to be especially useful when immediate preparation of a specimen for immunologic study is not possible. Because adverse conditions such as changes in temperature during the transport of fresh-frozen tissue may markedly alter immunologic markers, it is desirable to transport fresh tissue in a medium that does not adversely affect the immunoreactivity of the tissue antigens. Therefore, we undertook a comparative study in which we compared cryostat-cut, fresh-frozen sections and tissues fixed in transport medium. The specimens were obtained from 56 consecutive patients who had various malignant lymphomas and benign lymphoid disorders. The results of our study indicate that the morphologic and immunologic findings obtained from the frozen sections that had been maintained in the transport medium (Michel's) may be confusing and may be interpreted inaccurately. This study also confirms our previous observation that the inconclusive or spurious results occasionally obtained with cell suspension technics can be avoided if the immunohistochemical technics are applied to cryostat-cut, fresh frozen sections. We conclude that immunohistochemical study of cryostat-cut fresh frozen sections remains the technic of choice for the identification and evaluation of both the morphologic and immunologic characteristics of tissues involved by lymphoproliferative diseases. PMID- 3529923 TI - More on the spot-CAMP. PMID- 3529924 TI - Reed-Sternberg and Hodgkin cells in lymphocyte-predominant Hodgkin's disease of nodular subtype contain J chain. AB - To throw light on the question of whether B-cell-derived forms of Hodgkin's disease exist, more than 100 cases of Hodgkin's disease (including all four major histologic categories) were investigated for the presence of J chain and were also immunostained for epithelial membrane antigen and the granulocyte-associated antigen X hapten. Reed-Sternberg and Hodgkin cells (RS & H) expressed J chain in 22 cases, 8 of which also expressed epithelial membrane antigen (EMA). X hapten was found in 62 cases, but all of these were J chain negative. J chain-positive RS & H cells were restricted to cases of lymphocyte-predominant disease, while X hapten-positive tumor cells were found frequently in nodular sclerosis, mixed cellularity, and lymphocyte-depletion Hodgkin's disease, but only occasionally in cases of lymphocyte-predominant disease. These findings indicate that nodular lymphocyte-predominant Hodgkin's disease differs from the other subtypes of Hodgkin's disease and that the neoplastic cells are of B-lymphoid origin. PMID- 3529925 TI - Transient effect of aspirin on collagen-induced platelet accumulation. AB - A piece of collagen fiber (catgut) was placed into polyethylene tubing and perfused with heparinized blood. The perfusion pressure was monitored, and the pressure rise indicated platelet accumulation around collagen leading to occlusion of the tubing. Continuous slow infusion of prostacyclin into the blood or monoclonal antibody against von Willebrand factor completely prevented thrombus formation. Aspirinization of blood (0.1-2 mM) resulted in a concentration-dependent delay of the onset of thrombus growth, but even at the highest aspirin concentration, the thrombus did finally grow and at the same rate as that of the nonaspirinated control platelets. These findings question the clinical anti-thrombotic benefit of aspirin as platelet release inhibitor. PMID- 3529926 TI - Significance of Gardnerella vaginalis in urine cultures. AB - During a 15-month period, 12,343 consecutive routine urine cultures from female patients were screened for the presence of Gardnerella vaginalis. Of the positive urine cultures, Escherichia coli was found in 1,256 (57%) and presumptive G. vaginalis in 163 (5%). Of the 163 presumptive G. vaginalis isolates, 115 were present in quantitative categories sufficient to suggest the diagnosis of probable urinary tract infection. Of these 115 isolates, 92 were available for specific identification, of which 69 (75%) proved to be G. vaginalis. Comparison of clinical urinary tract diagnoses for the 69 G. vaginalis patients and a matched cohort of E. coli patients showed a significant correlation of E. coli recovery with the diagnosis of urinary tract infection and a significant correlation of G. vaginalis recovery with no urinary tract infection. G. vaginalis was frequently recovered from nonsymptomatic pregnant patients. G. vaginalis appeared at best to be an uncommon urinary tract pathogen. PMID- 3529927 TI - Evaluation of the modified Chlamydiazyme immunoassay for the detection of chlamydial antigen. AB - The modified Chlamydiazyme enzyme immunoassay (EIA) was compared with McCoy cell culture with 336 paired genital swabs collected from patients attending gynecology and urgent care clinics and transported to the regional laboratory for testing. Of the 299 female and 37 male genital specimens, 47 (15.7%) cervical and 14 (37.8%) urethral specimens were positive. All 60 specimens positive for Chlamydia trachomatis also were EIA reactive (sensitivity, 100%). The specificity was 91.3%, with 24 paired swab specimens positive by EIA only. A number of factors may have contributed some culture false negatives, as 91.7% of the EIA only positive patients were symptomatic. The reproducibility of the EIA method was evaluated with different washing technics. The Chlamydiazyme EIA was found to be a cost-effective, rapid, and sensitive test for detection of chlamydial antigen in genital specimens. PMID- 3529928 TI - Microcomputer-assisted interpretative reporting of sequential cardiac profile data. AB - The authors have developed a microcomputer-based system for interpretative reporting of sequential cardiac profile data, which consists of creatine kinase and lactate dehydrogenase isoenzyme levels. Patient demographic data and test results (total creatine kinase [CK], MB isoenzyme of CK [CK-MB], lactate dehydrogenase isoenzyme 1 [LD-1], and lactate dehydrogenase isoenzyme 2 [LD-2]) are entered manually through the keyboard. Percent MB and LD ratio are calculated. The test results are compared with normal range values, and an interpretative report is generated, including all pertinent demographic information and graphic display of up to 36 previous CK and LD isoenzyme determinations. Interpretative statements are printed beneath the graphic display after analysis of previous test results. The combination of graphic data display and interpretations based on prior data provides useful and accurate information to the cardiologist. Significant discrepancies between computer-assisted and pathologist interpretation were not encountered. PMID- 3529929 TI - Birefringent hemozoin identifies malaria. AB - The diagnosis of malaria is still sometimes difficult because of the insensitivity of microscopic screening at low levels of parasitemia. The malarial pigment, hemozoin, is a crystalline product of the digestion of hemoglobin by the parasites. Under polarized light at 500X magnification, brilliantly birefringent granules of the pigment were detected in Wright's stained smears, and the parasites easily localized, in 18 cases of malarial infection. Fresh, wet, coverslipped preparations of cultures of Plasmodium falciparum also were examined under polarized light. Serial dilutions of the cultures showed that, even at the very low level of 0.01% parasitemia, intracellular birefringent granules were detected in an average of 45 +/- 16 (SE) seconds at 500X magnification. Using polarized light is a simple, fast, sensitive, and specific method for localizing intracellular pigmented malaria parasites in wet preparations of blood. PMID- 3529930 TI - Non-Hodgkin's lymphoma following Hodgkin's disease. A case report and immunohistochemical corroboration. AB - Two non-Hodgkin's lymphomas, one a follicular mixed cell type and the other a diffuse large cell type (Working Formulation), appeared 7 and 12 years, respectively, after the initial histopathologic diagnosis of Hodgkin's disease (nodular sclerosis) in an elderly male. The clinicopathologic implications of non Hodgkin's lymphoma complicating Hodgkin's disease as a second malignant neoplasm are discussed on the basis of immunohistochemical studies performed on the sequentially biopsied lymph nodes using various monoclonal antibodies, in particular, anti-Leu-M1, which is known as a valuable marker of the neoplastic cells of Hodgkin's disease. PMID- 3529931 TI - Need for improved instrument and kit evaluations. AB - A review of method comparison studies published in the American Journal of Clinical Pathology indicates that hematology evaluations are less rigorous than their chemistry counterparts and rely heavily on the correlation coefficient. While clinical chemistry evaluations depend more on linear regression, they tend to omit relevant, lesser-known statistics, such as the standard error of the estimate. The authors reiterate guidelines for the collection and statistical analysis of method comparison data and recommend that both hematology and chemistry evaluations be improved. PMID- 3529932 TI - Direct bonding comparing a polyacrylic acid and a phosphoric acid technique. AB - The purpose of this study was to compare in vitro a polyacrylic acid technique (crystal bonding) with a conventional phosphoric acid-etch technique for the preparation of teeth for bonding. The potential value of the polyacrylic acid technique was evaluated for bond strength, enamel loss, cleanup, and fracture location--with and without the use of a sealant. Ninety-six premolars were evenly divided into two groups. Group A was preconditioned with polyacrylic acid and group B with phosphoric acid. Half of each group was treated with a sealant before direct bonding of orthodontic brackets. Sealant was not used on the other half of each group and brackets were bonded directly to the conditioned labial surfaces with a composite cement. Bonding and rebonding shear strength tests were carried out for both groups. Results indicated that shear bond strength values for the polyacrylic acid group were approximately one third those of the phosphoric acid group using a composite cement as the adhesive. Enamel loss was measured on the lingual surfaces of 30 of the 96 premolars. The lingual surfaces were conditioned with polyacrylic acid. Following debonding and cleanup procedures, the polyacrylic acid treated surface was left slightly pitted with no resin tags remaining. Cleanup procedures required only a rubber-cup silicate prophylaxis. The total enamel loss was minimal (4.5 micron), thus preserving most of the outermost fluoride-rich layer of enamel. PMID- 3529933 TI - Business principles in an orthodontic practice. Part I. PMID- 3529934 TI - Infant botulism. Three cases in a small town. AB - Through Dec 31, 1985, there have been six cases of infant botulism reported in Colorado. Three of these infants have lived in the same town of 800 people in western Colorado. Two of these three infants developed infant botulism within a six-month period in late 1981. The infants lived approximately 400 m apart; they had used the same crib at the time each developed botulism. A specimen from the crib yielded Clostridium botulinum, as did four soil samples from the town and house-dust samples from the home of a relative of the second infant. The third infant developed infant botulism in September 1984. This infant had not shared the crib. In this case, all seven samples of soil from various locations in the town yielded C botulinum, as did a sample of house dust from the home of this infant. The occurrence of these three cases in such a small town seems unlikely to be only coincidental. Investigations and reports of other such clusters may provide insight into modes of transmission of infant botulism. PMID- 3529935 TI - Mechanisms of bile formation and cholestasis: clinical significance of recent experimental work. PMID- 3529936 TI - Gastric carcinoma in the young: a clinicopathological and immunohistochemical study. AB - Seventeen patients 40 yr of age and less with gastric carcinoma were studied retrospectively. Clinicopathological findings and survival data were collected on all patients. Immunohistochemistry for serotonin, gastrin, somatostatin, carcinoembryonic antigen, beta-human chorionic gonadotropin, and alpha fetoprotein was performed and the results correlated with pathological and survival data. Patients were divided into two groups according to the presence or absence of endocrine markers in their tumors. The group with endocrine immunoreactivity tended to present with less advanced disease and had longer survival than the group without endocrine immunoreactivity (p less than 0.05). Although the number of patients in the study is too small to reach definite conclusions, our results are interesting in light of current knowledge of the pathobiology of gastric carcinoma and have important implications for future investigations. PMID- 3529937 TI - Intestinal permeability to 99mTc-diethylenetriaminopentaacetic acid in inflammatory bowel disease. AB - Intestinal permeability in inflammatory bowel disease and its relation to periods of disease activity has been investigated by measuring the urinary excretion of DTPA labeled with 99mTc. Urine excretion in 10 control subjects was 2.7 +/- 1% of the test dose. Twelve patients with ulcerative colitis excreted 5.08 +/- 1.6% in remission, 10.61 +/- 2% during periods of mild activity, 19.41 +/- 0.9% during moderate activity, and 15.41 +/- 6.3% with severe activity. Sixteen patients with Crohn's disease excreted 5.7 +/- 1.9% in remission, 8.47 +/- 2.8% during mild activity of the disease, and 14.29 +/- 5.8% during moderate activity. No differences were observed between ulcerative colitis and Crohn's disease, or between ileal and colonic forms of Crohn's disease. Excretion in remission was significantly greater than in control subjects and there was a correlation between excretion and disease activity. In serial determinations done in seven patients we found that urine excretion of the test substance correlated with disease activity. We also studied DTPA excretion in 10 cases with gastric or duodenal ulcer (2.28 +/- 1.4%), six cases of acute gastroenteritis (4.87 +/- 3.1%) and nine cases with other intestinal diseases (3.6 +/- 1.1%). In all these cases, DTPA excretion was lower than in inflammatory bowel disease. Our results show that the urinary excretion of DTPA is a simple test that measures accurately the degree of activity of inflammatory bowel disease. The test is useful in Crohn's disease as well as in ulcerative colitis, and detects intestinal permeability abnormalities even in clinical remission. Significantly lower excretions are found in other intestinal diseases. The test may be recommended as a screening test for use in clinical practice. PMID- 3529938 TI - Gastrointestinal injury due to medicinal agents. PMID- 3529939 TI - High-dose cytosine arabinoside in the treatment of preleukemic disorders: a leukemia intergroup study. AB - Fifteen patients with myelodysplastic/myeloproliferative disorders were treated with high-dose cytosine arabinoside therapy. While severe toxicity was produced in every patient, only two of the 15 patients entered complete remission and two achieved partial remission status. The therapeutic responses were confined to patients who had severe myelofibrosis of apparently recent onset. PMID- 3529940 TI - A serum ferritin assay for prevalence studies of iron deficiency. AB - A specialized serum ferritin assay has been developed for the detection of iron deficiency in epidemiologic studies. An enzyme immunoassay (EIA) was employed to eliminate the need for radioisotopes. The problem of low sensitivity inherent with the EIA for serum ferritin was eliminated by the use of monoclonal immunologic reagents. The working range of the assay is 1-100 micrograms/L with a sensitivity of 0.5 micrograms/L. Excellent agreement in serum ferritin levels was observed between the present method and the two-site immunoradiometric assay (IRMA), while the variability at low ferritin concentrations was significantly less with the EIA. Because only 10 microliter of serum is required for each assay, duplicate measurements can be performed on a single capillary tube of blood. When an automatic microtiter plate reader for optical density measurements is used, 80-100 duplicate determinations can be completed by one technologist in a single working day. PMID- 3529941 TI - Slow infusion of vincristine in the treatment of idiopathic thrombocytopenic purpura. PMID- 3529942 TI - Host-parasite relationships in acute pyelonephritis. AB - During a 1-year prospective study, a total of 15 patients (seven children and eight adults) were observed with acute nonobstructive pyelonephritis. P fimbriated Escherichia coli was the causative pathogen in all 15 patients. The same serotype of E coli that was P-fimbriated was isolated from the vaginal introitus of 60% and from the fecal flora of 86% of these patients. The only host abnormality was moderate vesicoureteral reflux in 20% of the patients. Uroepithelial cells were isolated from the first morning-voided urine from patients, who had recovered from pyelonephritis, and from age-matched controls. Using fluorescein-labelled type 1 and P-fimbriated reference strains of E coli and fluorescence-activated cell sorting (FACS) analysis, we evaluated their ability to adhere to these uroepithelial cells. P-fimbriated E coli was more adherent than type 1 fimbriated E coli, and more P-fimbriated E coli adhered to the patients' cells. Our data show that both colonization with P-fimbriated strains of E coli and receptor availability are important in the pathogenesis of pyelonephritis. PMID- 3529943 TI - Glomerular filtration rate in children: validation and longitudinal use of determination from the 99mTc DTPA renogram. AB - The glomerular filtration rate (GFR) was estimated from the technetium diethylenetriaminepentacetic (99mTc DTPA) renogram by empirically correlating the renogram and clearance of the tracer as measured by plasma disappearance kinetics. To expand the potential application of this technique from its original description, minor changes in methodology were made; a new regression was generated with 30 subjects, and that formula was then validated prospectively. For the 50 children and adolescents in the prospective series whose GFR normalized for surface area (NGFR = GFR X 1.73 m2/SA; SA, surface area) was less than 120 mL/min/1.73 m2; renal function was estimated with a mean residual error of 8.0 mL/min/1.73 m2, and a mean relative error of 11%. These results are at least as good as those in the initial report, thus validating this method in a prospective series. To examine the use of this method longitudinally, 129 examinations were reviewed in 55 subjects who had NGFR estimated from the renogram (estimated) on at least two occasions. For 28 sets of serial examinations, NGFR was also measured by the plasma disappearance of 99mTc DTPA (measured). The true change in function for each set of serial examinations was defined as the increment for whichever method (estimation or measurement) was more stable. The mean longitudinal errors were 2.1 and 4.8 mL/min/1.73 m2 for measured and estimated NGFR, respectively. The increments in NGFR for these methods were correlated with a regression line near identity and r = .852. This indicates that a change in estimated NGFR reflects a change in measured NGFR of similar magnitude. This method can accurately estimate GFR from the 99mTc DTPA renogram, and it can be used longitudinally to follow children with renal disorders. PMID- 3529944 TI - Experience with renal transplantation in children undergoing peritoneal dialysis (CAPD/CCPD). AB - For children with end-stage renal disease, renal transplantation is the ultimate goal because it offers the potential of maximum rehabilitation. In order to evaluate the infectious risk of renal transplantation in patients previously maintained on continuous ambulatory peritoneal dialysis (CAPD) and/or continuous cycling peritoneal dialysis (CCPD), we retrospectively evalauted the clinical course of 44 pediatric patients (mean age 12.0 +/- 5.7 [SD] years) who received 32 cadaver and 16 live-related donor renal grafts after being maintained on peritoneal dialysis for 756 patient-months (mean 17.1 +/- 11.5 months). In the posttransplant period, 25 patients (57%) required dialysis because of acute tubular necrosis or acute rejection. Peritonitis developed in five patients (11%) following transplantation; two were being dialyzed at the time. Exit-site and tunnel infections occurred in nine patients (20%). In all instances, antibiotic treatment and/or catheter removal was curative. Posttransplant ascites developed in 12 patients (27%) and was alleviated by catheter drainage. The catheters were left in situ at the time of transplantation and electively removed when stable graft function was present. The 1- and 2-year actuarial graft survival rate was 65% and 55%, respectively. One patient died in the immediate posttransplant period, which was unrelated to peritoneal dialysis. In conclusion, pediatric patients maintained on CAPD and/or CCPD can be safely transplanted. The potential infectious risks related to peritoneal dialysis can be managed with appropriate management of the catheter and prompt antibiotic therapy. The patient and graft survival rates are comparable to those with patients receiving hemodialysis prior to transplantation. There is no need to limit access to transplantation in children undergoing CAPD and/or CCPD. PMID- 3529945 TI - Assignment of a third purine biosynthetic gene (glycinamide ribonucleotide transformylase) to human chromosome 21. AB - Using a series of human-hamster hybrid cell lines, a gene coding for glycinamide ribonucleotide transformylase was mapped to human chromosome 21. The availability of hybrids containing only portions of chromosome 21 allowed the gene to be assigned to the region between the q11.2 and the q22.2 bands, inclusive. Differentiation of human and hamster glycinamide ribonucleotide transformylase was accomplished via an immunoprecipitation assay that employed a polyclonal antibody raised against the human enzyme. PMID- 3529946 TI - Comparative genetic mapping of cellular rel sequences in man, mouse, and the domestic cat. AB - We used in situ hybridization techniques to assign the human c-rel locus to the centromere-proximal portion of the short arm of chromosome 2 (2cent-2p13). We also determined the chromosomal location of c-rel sequences in the domestic cat and the laboratory mouse by using a human c-rel fragment to screen panels of rodent X cat and hamster X mouse somatic cell hybrid DNAs. The c-rel locus apparently maintains similar syntenic relationships with other known genetic markers in the human and cat, but displays different linkage relationships in the mouse. PMID- 3529947 TI - Normal dosage of the insulin and insulin-like growth factor II genes in patients with the Beckwith-Wiedemann syndrome. AB - Several patients in whom the Beckwith-Wiedemann syndrome (BWS) is associated with duplication of chromosomal region 11p15 have recently been observed. The genes encoding insulin and insulin-like growth factor II (IGF-II), proteins that affect cellular growth and pancreatic function, have been mapped to 11p15, and their increased expression might, thus, account for the physical features of BWS. To determine whether BWS is frequently associated with small duplications of 11p15, we performed dosage analyses of the insulin and IGF-II genes in somatic DNAs of seven patients with BWS. In each case, we observed apparent diploid representation of these genes. These data suggest that BWS is not frequently associated with small duplications of 11p15 material that embed the insulin and IGF-II genes. PMID- 3529948 TI - Comparison of the Seralyzer and EMIT systems for determination of theophylline concentrations. AB - A reflectance photometry assay for measurement of serum theophylline concentration was evaluated by comparison with an enzyme-multiplied immunoassay technique (EMIT). The concentration of theophylline in blood samples obtained from patients receiving intravenous theophylline therapy in the pediatric intensive-care unit was measured by both the Seralyzer and the EMIT systems. The interday and intraday variability of each method were also determined by means of calibrators of known concentration (5 to 40 micrograms/mL). There was significant correlation between the serum theophylline concentrations determined by the Seralyzer system and the EMIT system. The overall standard error of the estimate was 2.3 micrograms/mL, but with operator experience this improved to 1.3 micrograms/mL. Intraday variability was 1.2 micrograms/mL for the Seralyzer and 0.7 micrograms/mL for EMIT; the respective values for interday variability were 1.4 micrograms/mL and 0.8 micrograms/mL. The Seralyzer method measures theophylline concentrations with reliability, convenience, and speed. It could be potentially useful in a satellite, clinic, or acute-care pharmacy area. PMID- 3529949 TI - Stability of clindamycin phosphate with aztreonam, ceftazidime sodium, ceftriaxone sodium, or piperacillin sodium in two intravenous solutions. AB - In admixtures containing clindamycin and either aztreonam, ceftazidime, ceftriaxone, or piperacillin in either 5% dextrose injection (D5W) or 0.9% sodium chloride injection (NS), the stability of each drug was studied. Each of the following combinations of drugs was added to 100-mL glass bottles of base solution: clindamycin phosphate 0.9 g and aztreonam 2.0 g, clindamycin phosphate 0.9 g and ceftazidime sodium 2.0 g, clindamycin phosphate 1.2 g and ceftriaxone sodium 2.0 g, and clindamycin phosphate 0.9 g and piperacillin sodium 4.0 g. Duplicate samples were prepared. Admixtures containing each single drug were also tested. Samples were visually inspected and tested for pH and drug concentration immediately after mixing and at 1, 4, 8, 12, 24, and 48 hours of storage in room temperature and light. Drug concentrations were determined by high-performance liquid chromatographic assay methods. Ceftriaxone retained greater than 90% of its original concentration for 24 hours in single-drug admixtures in NS, for eight hours with clindamycin in NS, and for one hour with clindamycin in D5W. Ceftazidime retained greater than 90% potency for 24 hours with clindamycin in D5W. In all other test admixtures, all drugs were stable for 48 hours. Under the conditions studied, clindamycin is compatible in the admixtures tested with aztreonam and piperacillin. Admixtures of clindamycin and ceftazidime in D5W should be used within 24 hours at room temperature. Clindamycin and ceftriaxone can be mixed in NS if administered within eight hours, but ceftriaxone is stable for only one hour in combination with clindamycin in D5W. PMID- 3529950 TI - Renal prostaglandin synthesis. Sites of production and specific actions of prostaglandins. AB - Prostaglandins are substances that exert their effects at the site of their production. Therefore, the synthesis and effects of prostaglandins have to be considered separately for each nephron segment. In the cortex, major sites of prostaglandin synthesis include arteries and arterioles as well as the glomerulus. At these sites, prostaglandins are important in maintaining blood flow and glomerular filtration, especially during conditions of enhanced vasoconstrictor activity. Vasoconstrictors such as angiotensin II, norepinephrine, and vasopressin increase production of the vasodilator prostaglandins, thereby preventing an overshoot of their action. The role of arteriolar-glomerular prostaglandins in maintaining blood flow and filtration may be even more prominent during renal diseases. The proximal tubule and the loop of Henle show little ability to produce prostaglandins, but may generate considerable amounts of epoxygenase products of arachidonic acid. These epoxygenase products may play a prostaglandin-independent role in water and electrolyte transport in the thick ascending loop of Henle and the collecting tubule. Both the cortical and the medullary collecting tubules produce large amounts of prostaglandins, predominantly prostaglandin E2 (PGE2). In these segments, synthesis of PGE2 is stimulated by bradykinin and to a somewhat more variable degree by vasopressin. The PGE2 generated antagonizes the hydroosomotic effect of vasopressin both in vivo and in vitro, and may influence electrolyte excretion. Thus, the overall role of PGE2--and possibly of epoxygenase products of arachidonic acid--in tubular functions seems to be one of local modulation of water and electrolyte transport. Finally, interstitial cells are a major site of medullary prostaglandin production. Prostaglandins generated by the interstitial cells may play a role in maintaining blood flow to this poorly oxygenated and hypertonic region of the kidney. PMID- 3529951 TI - Effects of nonsteroidal anti-inflammatory drugs on proteinuria. AB - Most nonsteroidal anti-inflammatory drugs are anti-proteinuric agents, especially if the patient is sodium-depleted. The decline in urinary protein excretion induced by these agents always markedly exceeds the decrease in glomerular filtration rate. Moreover, the remaining proteinuria appears to be more selective. Together, these findings suggest that the anti-proteinuric effect of nonsteroidal anti-inflammatory drugs is hemodynamically mediated. Nonsteroidal anti-inflammatory agents that reduce renal prostaglandin E2 excretion also decrease proteinuria, whereas sulindac decreases neither prostaglandin E2 nor protein excretion. In a retrospective study, it appeared that administration of indomethacin improved renal survival of nephrotic patients with an initial serum creatinine concentration of less than 110 mumol/liter. The anti-proteinuric effect of indomethacin itself or indomethacin-induced hemodynamic changes might explain this observation. PMID- 3529952 TI - Role of renal prostaglandins and the effects of nonsteroidal anti-inflammatory drugs in patients with liver disease. AB - Renal prostaglandins have several key functions in patients with severe liver disease and ascites. Increased activity of vasodilatory prostaglandins counters the underlying impairment in renal perfusion and the effects of vasoactive hormones. Prostaglandins also participate in renin secretion, renal diluting ability, sodium excretion, the action of diuretics, and, possibly, the development of the hepatorenal syndrome. Nonsteroidal anti-inflammatory drugs inhibit these compensatory actions of prostaglandins and cause a functional reduction in glomerular filtration rate and an impairment in sodium and fluid excretion. The severity of these nephrotoxic effects depends on the potency of the drug in inhibiting renal prostaglandins and on patient susceptibility. Patients with ascites and avid sodium retention, sodium-restricted diets, or concurrent diuretic use are most at risk. If nonsteroidal anti-inflammatory drugs must be administered to these patients, the type of drug should be carefully selected and renal function should be closely monitored. PMID- 3529953 TI - Effect of alternate-day regular and enteric-coated aspirin on platelet aggregation, bleeding time, and thromboxane A2 levels in bleeding-time blood. AB - The effectiveness of low-dose aspirin for primary prevention of cardiovascular mortality is being assessed among the nearly 22,000 United States physicians currently participating in the Physicians' Health Study. Because of occasional reports of gastric irritation among study participants, two enteric-coated aspirin preparations were tested as possible alternatives to regular compressed aspirin for platelet inhibition. Thirty-three volunteers were assigned randomly to one of four treatment groups: regular aspirin (325 mg), placebo, and two enteric-coated aspirin preparations (325 mg). Pills were administered every other day, duplicating the regimen used in the Physicians' Health Study. Bleeding times, platelet aggregation, and thromboxane A2 levels produced by aggregating platelets in vitro, as well as in collected bleeding-time blood, were determined. Measurements were taken before and after a single dose as well as after seven alternate-day doses. Regular and enteric-coated aspirin preparations were equally efficacious in prolonging the bleeding time, inhibiting platelet aggregation, and suppressing thromboxane A2 production. There was virtually complete suppression of thromboxane A2 production (over 99 percent), by platelets in vitro and in collected bleeding-time blood. The levels were still profoundly reduced (89 percent) 48 hours after the last dose. Enteric-coated aspirin may provide an alternative to regular aspirin in a low-dose regimen designed to inhibit platelet activity. PMID- 3529954 TI - Stability and reproducibility of the biologic activity of premixed short-acting and intermediate-acting insulins. AB - Mixtures of short-acting and intermediate-acting insulins often represent an effective regimen to achieve near-normal blood glucose values, yet controversy exists concerning the stability and predictability of such mixtures. In a study of diabetic patients, the biologic activity of a specific intermediate-acting insulin (insulatard) and a short-acting insulin (Velosulin) premixed in a 70:30 ratio was reproducible at three intervals and was stable for a period of up to three months. The serum levels of free insulin and the rate of onset and extent of the blood glucose lowering effects were not altered, showed two distinct peaks, and were comparable to those experienced with separate injections of equivalent doses of the intermediate-acting and short-acting insulins. PMID- 3529955 TI - High-density lipoprotein subclasses in diabetes. AB - This cross-sectional study evaluated high-density lipoprotein subclasses measured by a precipitation technique before and after treatment in men and women with types I and II diabetes. Total high-density lipoprotein cholesterol was lower in subjects of both sexes with untreated type I and type II diabetes, the change occurring primarily in subclass 2. Insulin therapy raised total and subclass 2 high-density lipoprotein levels in men and women with type I and type II diabetes, the predominant rise occurring in subclass 2. The improvement was unrelated to metabolic control. Normalization of total and subclass 2 high density lipoprotein was not achieved in women with type II disease who had higher body weights and triglyceride levels. Treatment with oral hypoglycemic agents did not lower total high-density lipoprotein or subclass 2 levels. It is concluded that therapies affecting high-density lipoprotein produce the preponderant change in subclass 2, insulin therapy increases total and subclass 2 high-density lipoprotein but may not restore levels to normal in the presence of elevated body weight and lipid levels, there is no relation between control of diabetes and changes in total and subclass 2 high-density lipoprotein levels, and treatment with oral hypoglycemic agents does not adversely affect high-density lipoprotein levels. PMID- 3529956 TI - Estrogens and endometrial cancer. Responses to arguments and current status of an epidemiologic controversy. PMID- 3529957 TI - Malignant lymphoma of the testis. AB - Malignant lymphomas of the testis account for approximately 5 percent of testicular neoplasms, and they are the most common testicular malignancy between the ages of 60 and 80. Testicular lymphoma has a propensity to be associated with involvement of the skin, the central nervous system, Waldeyer's ring and adjacent structures, and the contralateral testicle. In general, essentially all patients with testicular lymphoma have been categorized as having "poor-risk" non Hodgkin's lymphoma, with diffuse histiocytic lymphoma being the most common histologic subtype. All patients with testicular lymphoma should be treated with aggressive combination chemotherapy, with or without radiotherapy. PMID- 3529958 TI - Flecainide: a new agent for the treatment of ventricular arrhythmias. AB - Flecainide has been shown to be a relatively safe and effective antiarrhythmic agent. Its twice daily dosage schedule and demonstrated efficacy in suppression of ventricular ectopy suggest that it will be a valuable agent in the therapy of ventricular arrhythmias. PMID- 3529959 TI - Non-Q-wave myocardial infarction. AB - The rationale for introducing the term "non-Q-wave myocardial infarction" is identified. The incidence, pathology, pathogenesis, and diagnostic criteria for this condition, previously identified as nontransmural or subendocardial infarction, are reviewed. In reviewing the diagnostic criteria, the various noninvasive techniques that may be applied are discussed. The clinical course, prognosis, and management are discussed under the headings of early postinfarction period, late clinical course, predischarge evaluation, and long term care. The issues of the management of infarct extension and acute interventional therapy are raised and reviewed. Suggestions regarding specific aspects of therapy in non-Q-wave myocardial infarction are included in the summary. PMID- 3529960 TI - Endocarditis and infections of intravascular devices due to Eikenella corrodens. AB - Eikenella corrodens, a microaerophilic gram-negative rod, is a normal inhabitant of human mucosal surfaces. Infections involving Eikenella have been reported with increasing frequency during the past 10 years. Despite a demonstrated ability to invade the blood stream, Eikenella has rarely been implicated in endocarditis or other vascular space infections. Two patients are reported with prolonged illness due to infection of peripheral vascular prostheses with E. corrodens and prior reports of Eikenella vascular space infections are reviewed. When Eikenella is the sole infecting organism, vascular space infections tend to be indolent. However, removal of vascular prostheses may be required for cure. PMID- 3529962 TI - AICD: some lifesaving advice. PMID- 3529961 TI - Mineralocorticoid-induced kaliuresis in type-II pseudohypoaldosteronism. AB - Type II pseudohypoaldosteronism is an uncommonly reported disorder. The authors recently evaluated a patient who in many respects appeared to have this syndrome. He had hyperkalemia, a normal glomerular filtration rate, "normal" serum and urinary aldosterone levels, and low plasma renin activity. In addition, he had a hyperchloremic metabolic acidosis and hypertension. Fractional excretion of potassium was reduced in response to sodium chloride loading. However, renal potassium excretion in response to administration of sodium sulfate was normal. Thiazide diuretic restored the serum potassium, the low bicarbonate, and blood pressure to normal. He developed marked natriuresis and kaliuresis in response to high-dose exogenous mineralocorticoid. The magnitude of the kaliuretic response achieved to exogenous mineralocorticoid has been reported only once previously. PMID- 3529963 TI - Nurses who served--and did not return. PMID- 3529964 TI - Maternal-perinatal outcome associated with the syndrome of hemolysis, elevated liver enzymes, and low platelets in severe preeclampsia-eclampsia. AB - During an 8-year period, 112 severe preeclamptic-eclamptic patients with the above syndrome were studied. The incidence of this syndrome was significantly higher in white patients, in patients with delayed diagnosis of preeclampsia and/or delayed delivery, and in multiparous patients. Twenty-six patients had amniocentesis and 16 received epidural anesthetics. There was one maternal bleeding episode associated with epidural anesthetics. The use of steroids in 17 patients did not improve maternal platelet count. The overall perinatal mortality was 367 per 1000 and neonatal morbidity was significant. There were two maternal deaths and two patients with ruptured liver hematoma, and nine had acute renal failure. Thirty-eight percent had intravascular coagulopathy and 20% had abruptio placentae. On follow-up, 44 patients used oral contraceptives without maternal morbidity and 38 patients had 49 subsequent pregnancies. Only one patient had recurrence of the syndrome in subsequent pregnancies. The presence of a "true" syndrome of hemolysis, elevated liver enzymes, and low platelets (HELLP syndrome) in preeclampsia is associated with poor maternal-perinatal outcome. PMID- 3529965 TI - Adult-onset amenorrhea: a study of 262 patients. AB - A series of 262 patients with amenorrhea of adult onset are reported. Hypothalamic suppression followed by inappropriate positive feedback, and then hyperprolactinemia and ovarian failure are the most frequently encountered etiologies. Other etiologies are diverse and numerically less frequent. Amenorrhea after use of oral contraceptives, or postpill amenorrhea, occurred in 77 (29%) of all patients. The average age of presentation, prior menstrual history, associated morbidity, and subsequent reproductive potential of each diagnostic group are reported. Adult-onset amenorrhea has a less significant impact on future wellbeing than was reported for a similar-sized group of patients whose amenorrhea developed as a result of pubertal aberrancy. PMID- 3529966 TI - The fetal-pelvic index as an indicator of fetal-pelvic disproportion: a preliminary report. AB - The objective of this study was to develop a standardized method of identifying fetal-pelvic disproportion by comparing fetal head and abdomen circumferences with the respective maternal pelvic inlet and midpelvis circumferences. Fetal ultrasound and maternal x-ray pelvimetry measurements were performed on 75 term pregnant women with indications for a trial of labor. By means of individually measured fetal and maternal pelvic diameters, circumferences of the fetal head, fetal abdomen, maternal pelvic inlet, and maternal midpelvis were computed. Based on four circumference differences between the fetus and maternal pelvis (fetal head--maternal pelvic inlet, fetal head--maternal midpelvis, fetal abdomen- maternal pelvic inlet, and fetal abdomen--maternal midpelvis), a fetal pelvic index number was derived from the sum of the two most positive values. Of the 27 patients requiring cesarean sections for failure to progress in labor, all but four had positive fetal pelvic index values (sensitivity = 85%). Of the 48 patients who were delivered vaginally, all but four had negative fetal pelvic index values (specificity = 92%). PMID- 3529968 TI - Magnetic resonance imaging and ultrasonography in the antenatal evaluation of conjoined twins. AB - Magnetic resonance imaging and sonography were used as diagnostic aids in the antepartum evaluation of two sets of conjoined twins. Magnetic resonance imaging was performed at 20 weeks' estimated gestational age on thoracopagus/omphalopagus twins and on omphalopagus twins at 20 and 30 weeks. Magnetic resonance imaging is a complementary adjunct to ultrasonography and provides additional anatomically precise clinical data. The advantages of this noninvasive technique include a large diagnostic window allowing total fetal imaging with excellent resolution of tissue composition. Unlike computerized tomographic imaging, there is no associated radiation exposure. The principal disadvantages of magnetic resonance imaging at this time are the cost of the equipment and the lack of real-time imaging capability. PMID- 3529967 TI - Efficacy of mathematical methods for ultrasound examinations in diabetic pregnancies. AB - The efficacy of a new principle for evaluation of fetal growth has been compared to standard methods in a population of pregnant diabetic women. Methods for projecting fetal weight at birth and determining the deviation of growth from an expected fetal weight increase based on our growth model provided significant information for the detection of fetal growth abnormalities 3 weeks (mean) before delivery. (Large for gestational age: sensitivity, 81%; specificity, 85%. Small for gestational age: sensitivity, 100%; specificity, 98%.) With the exception of two models for estimation of fetal weight based on ultrasound measurements of the fetal head and abdomen only, none of the standard methods gave results that were significantly better than the use of the biparietal diameter against a population standard. The new methods are expected to provide valuable information for the treatment of fetal growth disorders. PMID- 3529969 TI - Maternal hemorrhage into the amniotic sac producing an apparent umbilical cord mass on sonogram. AB - A case of a mass around the fetus secondary to maternal hemorrhage and blood clot is presented. The sonographic features that allow distinction of a clot from a fetal teratoma are discussed. PMID- 3529970 TI - Therapy of candidal vaginitis: the effect of eliminating intestinal Candida. Nystatin Multicenter Study Group. AB - A total of 258 patients with candidal vulvovaginitis, all of whom also exhibited Candida organisms in the rectum, were treated for 1 week with vaginal tablets only (nystatin or clotrimazole) or with both vaginal and oral tablets (nystatin). Mycologic and symptomatic responses were superior for the group receiving combined intravaginal-oral therapy; the vaginas of 88% of those treated by both routes were cleared of Candida, as compared with 75% of those receiving only intravaginal medication (p less than 0.05). Nystatin and clotrimazole were equally effective. When the 258 patients, regardless of treatment regimen, were grouped into those whose intestinal tracts after therapy contained Candida or those free of Candida, the response rates of the vaginal infection at all follow up examinations favored the latter group (p less than 0.05 to less than 0.001). Vaginal infection recurred in 19.7% of patients treated only intravaginally and 14.7% of those receiving combined therapy. These results suggest the value of eliminating any intestinal reservoir of Candida when treating patients with candidal vulvovaginitis. PMID- 3529971 TI - Comparison of two treatment schedules for combined timolol and dipivefrin therapy. AB - In a prospective, randomized, single-masked, cross-over study, 18 patients with primary open-angle glaucoma were treated for one month with each of the following regimens: timolol 0.5% twice daily, timolol 0.5% plus dipivefrin 0.1% twice daily given ten minutes apart, and timolol 0.5% plus dipivefrin 0.1% given twice daily four hours apart. An eight-hour intraocular pressure curve was obtained before treatment and at the end of each monthly regimen. When added to timolol therapy, dipivefrin produced a small but statistically significant additional mean decrease in intraocular pressure. The difference in intraocular pressure reduction between the two regimens for combined timolol and dipivefrin therapy was not statistically significant. PMID- 3529972 TI - Visual results in repeat penetrating keratoplasty. AB - In a study of visual prognosis after repeat penetrating keratoplasty, we found that 18 of 29 eyes required only one regraft and 11 required multiple repeat penetrating keratoplasties. After an average follow-up of 15.7 months, six of the 18 eyes with only one regraft had achieved visual acuities of 20/100 or better. After an average follow-up of 27.5 months, only one of 11 eyes with multiple regrafts achieved a best corrected visual acuity of 20/100 or better. PMID- 3529973 TI - Endothelial cell survival on transplanted human corneas preserved at 4 C in 2.5% chondroitin sulfate for one to 13 days. AB - A comparison of transplantation of 37 corneas preserved in 2.5% chondroitin sulfate (K-Sol) at 4 C for one to 13 days (mean, 6.8 days) with those of 37 corneas preserved in McCarey-Kaufman medium at 40 C for one to 81 hours (mean, 39 hours) yielded the following results. The mean endothelial cell loss noted two months after keratoplasty was 6% in each group. The grafts preserved in K-Sol were significantly thinner two months postoperatively. Within the K-Sol group, there was a significant positive correlation between preservation time and both epithelialization time and corneal thickness three weeks after keratoplasty. There was also a significant positive correlation between preservation time and endothelial cell loss in both groups, with the highest cell losses (greater than or equal to 30%) all occurring after two days of storage in the McCarey-Kaufman group and after ten days of storage in the K-Sol group. These results appear to justify the use of chondroitin-sulfate-based preservation media to extend donor storage time; they also indicate that donor corneas should be used as early as feasible. PMID- 3529974 TI - Late wound dehiscence after penetrating keratoplasty in association with digital massage. PMID- 3529975 TI - Platinum spatula vs Dacron swab in the preparation of conjunctival smears. PMID- 3529976 TI - Projection microscopy with the slit lamp and an eyepiece. PMID- 3529977 TI - Post-pleistocene changes in tooth root and jaw relationships. AB - Mandibles of 126 sexed skeletal specimens, from Near Eastern sites dating over the past 12,000 years were radiographed. From the radiographs obtained, digitised tracings were made of crown length (mesiodistal), root height and width, and corpus height mesial to the premolars and first and second molars. The data obtained were analysed using rank transformation procedures. The significance of unidirectional trends in relation to periods sampled was examined graphically and analytically through linear regression analysis of the ranks on the chronological scale, and Spearman's rank correlation was used to compare relationships between different parameters of individual teeth in different periods. Significant reduction was found in crown length between 12,000 B.P. and 6,000 B.P., but no further reduction was found between 6,000 B.P. and 1,000 B.P. Little change was observed in root size, but corpus height showed significant reduction over the past 6,000 years. The differences observed in the timing and extent of reduction in crown, root, and corpus height are associated with a low intrapopulation correlation between them. PMID- 3529978 TI - Skin calcium binding protein: effect of ultraviolet B irradiation. AB - Skin calcium binding protein (SCaBP) has been found in the epidermal basal layer but not in the suprabasal layers, suggesting that its presence is correlated with the position of the cell and/or the cells' low degree of differentiation and high proliferation capacity. Rats were exposed to ultraviolet B (UVB) irradiation (280 320 nm, 0.1 J/cm2) to dissociate these two main characteristics of basal layer cells. Skin biopsy specimens were taken 24 and 48 h after UVB exposure. The [3H]thymidine labeling index, SCaBP localization (indirect immunofluorescence), and SCaBP levels monitored by radioimmunoassay were investigated. The [3H]thymidine labeling index was significantly increased after UVB treatment, and the [3H]thymidine-labeled cells were present not only in the basal layer but also in the suprabasal epidermal layers. Anti-SCaBP immunofluorescence was observed in both suprabasal and basal layers (rather than exclusively in the basal layer, as in control conditions). The radioimmunoassay indicated an overall increase in skin SCaBP content. No evidence was obtained that this increase was due to humoral factors, as no changes in SCaBP concentration on cell proliferation were observed in nonirradiated epidermal areas. Topical application of a single dose of vitamin D3, equivalent to the amount synthesized by UVB exposure, was also without effect. Thus the presence of this marker is correlated with the low degree of cell maturity and the cells' ability to proliferate rather than their basal position. PMID- 3529980 TI - Lipoprotein lipase in adipose tissues of exercise-trained, cold-acclimated rats. AB - The combined effects of exercise training and cold acclimation on serum lipids and on the activity of lipoprotein lipase (LPL) in epididymal white (WAT) and interscapular brown adipose tissues (BAT) of the rat were evaluated. Sedentary and exercise-trained (treadmill) rats were housed and trained at either 24 or 4 degrees C for 45 days. Although neither treatment given alone influenced serum total cholesterol, exercise training in the cold resulted in a 54% increase in this variable. Serum triglycerides were lowered to 80% of control values by exercise training and to 44% of control by cold acclimation. Both treatments resulted in lower insulin and thyroxine concentrations, while triiodothyronine levels were unaffected. Total LPL activity in WAT was increased twofold by exercise training at both temperatures, whereas cold acclimation stimulated WAT LPL activity to a lesser extent. Exercise training had no overall effect on LPL activity of BAT, whereas cold acclimation increased the latter in both sedentary (217%) and trained (420%) animals. These results emphasize the potential importance of LPL-mediated lipid assimilation in the metabolic events that lead to energy production in response to environmental stresses and lend support to the notion that the regulation of LPL activity is tissue specific. PMID- 3529979 TI - Two types of collecting duct mitochondria-rich (intercalated) cells: lectin and band 3 cytochemistry. AB - Anion exchange plays an important role in renal ion transport and acidification. To further understand the molecular nature of renal epithelial anion exchange, we used a monoclonal antibody to the membrane domain (52 kDa) of human erythrocyte band 3 protein to immunocytochemically search for this polypeptide in the rabbit kidney. In cryostat sections, a subpopulation of cells in the cortical and outer medullary collecting tubules showed immunoreactivity; labeling was restricted to the basolateral membrane. Proximal tubules and thick and thin limbs of Henle showed no immunoreactivity. Approximately 11% of cells in the cortical, but 43% of cells in the medullary, collecting tubule were positive for band 3. To determine the type of cells that were band 3 positive, mitochondria-rich (intercalated) cells were identified by their positive histochemical staining for succinic dehydrogenase activity and by their ability to bind peanut lectin at the apical membrane. In the cortical collecting tubule, the majority of mitochondria rich cells bound peanut lectin but were band 3 negative; the remainder were band 3 positive but lectin negative. This distribution was reversed in the inner stripe of the outer medulla: all mitochondria-rich cells were band 3 positive and lectin negative. Thus mitochondria-rich cells are of at least two types, each of which has a distinct axial distribution pattern. Given available information about in vitro HCO3 transport properties of rabbit collecting tubules, it is likely that the lectin-positive, band 3-negative mitochondria-rich cells secrete HCO3, whereas the lectin-negative, band 3-positive cells reabsorb HCO3 (secrete H). PMID- 3529981 TI - Effect of pure zinc deficiency on glucose tolerance and insulin and glucagon levels. AB - The effect of zinc deficiency on glucose tolerance was investigated using intragastric force feeding to obviate decreased food intake and altered eating patterns. Three groups of weanling male Sprague-Dawley rats were fed a purified zinc-deficient diet: zinc-deficient, ad libitum-fed animals (ZDA) were offered powdered zinc-deficient diet; zinc-replete, force-fed controls (ZRF) were tube fed a diet blended with water containing 25 ppm of zinc; zinc-deficient, force fed animals (ZDF) were similarly tube fed the zinc-deficient diet. The ZRF and ZDF groups received a diet of identical amount based on the intake of ad libitum fed, zinc-replete rats. After 8 days of feeding, the ZDF group had impaired glucose tolerance curves, yet blood insulin and glucagon levels were normal. The ZDA group had normal glucose tolerance with low insulin levels compared with the ZRF group. The islet cell morphology among the three dietary groups were similar. These results suggest that the glucose intolerance observed in ZDF rats is not due to altered blood insulin and glucagon levels but rather to peripheral resistance to insulin action. PMID- 3529982 TI - Stimulation by thyroid hormone of renin mRNA in mouse submandibular gland. AB - Renin in the female mouse submandibular gland (SMG) is known to increase in response to thyroid hormone. In the present study a 500 base-pair renin cDNA was used to quantify renin mRNA, the product of transcription of the Ren-2 gene, in the female mouse SMG in response to thyroid hormone to assess more directly the nature of stimulation of renin biosynthesis. After daily injection for 1 wk renin mRNA increased from control values of 36 +/- 3 SE ng/g tissue to 212 +/- 41 with triiodothyronine (T3; P less than 0.005) and to 217 +/- 33 with thyroxine (T4; P less than 0.005). Treatment of mice with propylthiouracil (PTU) decreased renin mRNA to 1.2 +/- 0.3 (P less than 0.005) and after subsequent injection of T3 for 1 wk renin mRNA increased to 289 +/- 35 ng/g tissue. The time course of the response to a single injection of thyroid hormone indicated a rapid response with significant increases in renin mRNA by 1 h, reaching values 3.5 +/- 0.4 times control (P less than 0.005) by 5 h. Such rapid effects are consistent with a direct nuclear action of thyroid hormone in stimulating transcription of the Ren 2 gene in mouse submandibular gland or in stabilization of nuclear precursor renin mRNA or both. PMID- 3529983 TI - Insulin sensitivity in adipocytes from subjects with varying degrees of glucose tolerance. AB - Previous studies showed that the sensitivity of glucose transport to insulin is lower in adipocytes isolated from subjects with noninsulin-dependent diabetes mellitus and impaired glucose tolerance compared with subjects with normal glucose tolerance. This study analyzed the relationship between insulin sensitivity of glucose transport and glycemia in a large group of nondiabetic nonglucose-intolerant subjects with a wide range of glycemic response to oral glucose. Seventy-four Pima Indians with 2-h postglucose load glucoses between 77 and 197 mg/100 ml, fasting plasma glucoses between 76 and 108 mg/100 ml, and no postload glucoses less than 199 mg/100 ml were studied. Isolated adipocytes were prepared in vitro after an abdominal fat biopsy, ED50 of insulin for glucose transport was correlated with 2-h postload glucoses, but not between insulin binding per cell or per cell surface area or in ED50 of insulin for antilipolysis and 2-h postglucose load glucoses. Although only 17% of the variation in glucose tolerance could be explained by a change in the sensitivity of glucose transport to insulin, the data suggests that a postinsulin-binding defect in the coupling of insulin binding to glucose transport may be an early step in the development of insulin resistance in human adipocytes. PMID- 3529984 TI - Dose-response curves of effects of insulin on leucine kinetics in humans. AB - To determine the effects of physiological and pharmacological insulin concentrations on leucine-carbon kinetics in vivo, eight postabsorptive normal volunteers were infused with L-[4,5-3H]leucine and alpha-[1-14C]ketoisocaproate (KIC). Insulin concentrations were sequentially raised from 8 +/- 1 to 43 +/- 6 and 101 +/- 14 and to 1,487 +/- 190 microU/ml, while maintaining euglycemia with adequate glucose infusions. At the end of each 140-min insulin-infusion period, steady-state estimates of leucine and KIC rates of appearance (Ra), KIC (approximately leucine-carbon) oxidation, nonoxidized leucine-carbon flux [an index of leucine incorporation into protein (Leu----P)], and leucine and KIC interconversion rates were obtained. After the three insulin infusions, leucine Ra decreased by a maximum of approximately 20%. KIC Ra decreased by a maximum of approximately 50%. The sum of leucine plus KIC Ra in the basal state was 2.59 +/- 0.24 mumol X kg-1 X min-1 and decreased by approximately 30% at the maximal insulin concentrations. KIC oxidation decreased by a maximum of approximately 65%. Leu----P did not increase after hyperinsulinemia. Interconversion rates were promptly and markedly suppressed by 50-70%. Leucine clearance increased by approximately 120%. We conclude that euglycemic hyperinsulinemia, at physiological and pharmacological concentrations, decreased leucine and KIC concentrations, leucine-carbon turnover and oxidation, and leucine and KIC interconversions in a dose-dependent manner in vivo. PMID- 3529985 TI - Effects of glucose-insulin-potassium on intestinal hemodynamics and substrate utilization during endotoxemia. AB - This study examined the effects of endotoxin on small intestinal hemodynamics and metabolism with and without an infusion of glucose-insulin-potassium (GIK). Glucose uptake and lactate release were determined by arteriovenous differences across a segment of canine ileum, which was vascularly isolated in vivo, and by the direct measurement of intestinal blood flow. Free fatty acid (FFA) utilization by intestinal tissue was assessed by the constant infusion of albumin bound [14C]palmitate and [3H]oleate. Endotoxemic dogs showed a sustained reduction of mean arterial blood pressure (MABP) and intestinal blood flow. In contrast, endotoxemic dogs infused with GIK demonstrated a decreased intestinal vascular resistance and an increased blood flow (two-fold), whereas MABP was transiently improved. Intestinal glucose uptake was not different from control values in endotoxemic animals; however, a sixfold increase was seen in shocked dogs treated with GIK. The endotoxin-induced increase in the plasma lactate concentration and intestinal lactate release was similar between dogs infused with saline or GIK. After endotoxin, the arterial FFA concentration remained unchanged and whole-body FFA turnover was decreased. FFA uptake by the gut was reduced, but FFA oxidation was not altered. Similar changes in FFA metabolism were seen in endotoxemic animals infused with GIK. The metabolic pattern after endotoxin suggests an elevated rate of aerobic glycolysis by the gut that increases the availability of lactate to the liver. Compared with saline-infused endotoxemic animals, GIK produced an elevation in glucose uptake without a further increase in lactate output, suggesting an increased storage of glucose by this tissue. PMID- 3529986 TI - Effect of trimebutine on intestinal motility and plasma motilin in the dog. AB - In a previous report, trimebutine was shown to induce premature periods of phase III activity in fasting dogs, and its action was blocked by naloxone. In this study, we observed that trimebutine (5 mg X kg-1 iv) could induce premature phase IIIs in canine small intestine during interdigestive and digestive periods; trimebutine-induced phase IIIs were migrating along the small intestine faster than spontaneous activity fronts and; trimebutine-induced phase IIIs were accompanied by sharp rises in concentrations of plasma motilin. To further elucidate the trimebutine-stimulatory mechanism, we verified its effects on the release of various circulating peptides that influence intestinal motility: short interval blood sampling during trimebutine infusion revealed that plasma motilin increases induced by trimebutine preceded the beginning of phase III in proximal duodenum; and gastrin and insulin postprandial releases were abolished by trimebutine. Therefore, trimebutine, by its simultaneous but opposite effects on various peptides that individually carry positive (e.g., motilin) or negative (e.g., gastrin and insulin) influences on the generation of activity fronts, could alter the equilibrium between stimulatory and inhibitory forces in such a way that, in some circumstances (e.g., postprandial period), stimulatory mechanisms become predominant. PMID- 3529987 TI - Primary culture of flounder renal tubule cells: transepithelial transport. AB - Renal proximal tubule cells from the winter flounder (Pseudopleuronectes americanus) were maintained in a functionally differentiated state for up to 16 days in primary culture on floating collagen gels. The cells were confluent after 7-8 days in culture, contracted the collagen gels, and exhibited ciliary activity. Electron microscopy indicated that the cultures were composed of continuous sheets of columnar epithelial cells that had established structural polarity. When mounted in Ussing chambers, the cultures exhibited a small mucosa negative potential difference (0.6 +/- 0.10 mV) and a low transepithelial resistance (23 +/- 2.3 omega X cm2). Short-circuit current averaged 24 microA/cm2. The cultured epithelium was four times more permeable to Na than to Cl and actively secreted sulfate and p-aminohippuric acid and reabsorbed hexoses. Glucose reabsorption was rheogenic and occurred via a high-affinity (Km = 0.16 mM), low-capacity (Vmax = 5 microA/cm2), phlorizin-sensitive transport system. We concluded that the cultured cells express many of the differentiated properties of the intact flounder proximal tubule and thus provide a suitable model system for studying renal transport processes. PMID- 3529988 TI - Metabolic features of diet-induced obesity without hyperphagia in young rats. AB - Diet-induced obesity (DIO) developed in 1-mo-old male Sprague-Dawley rats over an 8-wk period on a relatively high-fat (16%) high-calorie (4.6 kcal/g) diet (DIO diet). Percent carcass lipid (56%) and body weight gain (15%) were greater, whereas food intake was decreased over the first 3-5 wk in DIO diet-compared with chow-fed controls. Overall, 8-wk body weight gain (15%), percent carcass lipid (26%), and feed efficiency (15%) were greater, but food intake was not increased. Norepinephrine (NE) turnover rate, indicative of organ sympathetic activity, increased in interscapular brown adipose tissue (IBAT; 57-218%), heart (21-44%), and pancreas (25%) during the first 3 wk and remained elevated for the entire 8 wk. IBAT weight (51%) and in vitro lipolytic capacity (68%) increased by 1 wk and brown adipocyte size (43%) by 3 wk; IBAT thermogenic capacity (maximal NE stimulated in vitro O2 consumption) increased by 5 wk (39%). Plasma insulin levels were similar in both diet groups over the entire 8-wk period. Why DIO diet fed rats had increased metabolic efficiency is unknown, but activation of IBAT metabolism and thermogenesis failed to prevent the development of DIO. PMID- 3529989 TI - Endocrine mechanisms regulating sodium excretion during water deprivation in dogs. AB - The time course and mechanism of the natriuresis that accompanies 24 h of water, but not food, deprivation were studied in eight chronically catheterized dogs. Dogs were fed a controlled diet containing 35 meq of sodium, 110 meq of potassium, and 107 ml of water at 9:00 A.M. every day (time 0), and urine and blood samples were taken at 0, 2, 4, 6, 8, 10, 12, 16, 20, and 24 h after feeding on 3 consecutive days: the control, dehydration, and recovery days. Twenty-four hours of water deprivation decreased body weight by 880 g, increased plasma sodium by 7.2 meq, and increased plasma osmolality by 22.5 mosmol/kg. Cumulative daily sodium excretion increased from 30.4 +/- 2.8 meq on the control day to 50.7 +/- 5.7 meq on the dehydration day (P less than 0.01) and resulted in significant negative sodium balance that developed during the last half of the dehydration day. Cumulative sodium excretion during the first half of the dehydration day was not different from the corresponding period of the control day. Cumulative potassium excretion also increased from 91.9 +/- 4.5 meq during the control day to 123.0 +/- 6.7 meq during the dehydration day (P less than 0.01). Significant and progressive increases in plasma vasopressin concentration and renin activity were observed during water deprivation, but plasma aldosterone did not change from control levels. Furthermore, there was no correlation between the rate of sodium excretion and plasma vasopressin or aldosterone concentrations.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3529990 TI - Enhancement of slow-wave sleep by endotoxin and lipid A. AB - Some muramyl peptides derived from bacterial peptidoglycan enhance slow-wave sleep (SWS). The purpose of this study was to test whether another cell wall component, lipopolysaccharide (LPS), and its lipid A moiety also have an effect on sleep. When injected intravenously, both LPS and lipid A enhanced the duration of SWS, increased electroencephalogram delta-wave amplitudes, suppressed rapid eye movement (REM) sleep, and induced biphasic fevers. The effects of intravenously administered lipid A and LPS on SWS were present primarily during the first 3 h postinjection. Intraventricular lipid A administration enhanced SWS, did not suppress REM, and induced a monophasic fever; the SWS effect had a 3 h latency, whereas temperature started to rise during the second hour. Regardless of the route of administration, within the dose range used here, sleep was normal by the following criteria: sleep was episodic, animals could be easily aroused, and brain temperature, although elevated to "febrile" levels, continued to fluctuate during sleep-state transitions indistinguishably from control conditions. We conclude that LPS and lipid A are capable of modulating sleep. PMID- 3529991 TI - Gastric emptying of glucose loads in rats: effects of insulin-induced hypoglycemia. AB - Previous work has established that the increased food intake of rats in response to insulin-induced hypoglycemia can be inhibited by the intravenous infusion of fructose, a sugar that cannot cross the blood-brain barrier and nourish cerebral chemoreceptors, and that this effect of fructose is abolished by hepatic vagotomy. The present series of experiments examined the effects of these treatments on gastric emptying of various glucose solutions in rats. Gastric emptying of the administered loads decreased in proportion to increasing concentration of glucose solution but not by enough for caloric delivery to be regulated precisely. Insulin-induced hypoglycemia increased the rate at which the glucose solutions emptied from the stomach. This enhanced emptying was suppressed by infusion of fructose, and that suppression was eliminated by hepatic vagotomy. These and other findings support previous proposals that food intake is controlled in part by satiety signals reflecting the nutrient content of the stomach and in part by satiety signals related to the delivery of utilizable calories to the liver. PMID- 3529992 TI - Meyerian psychobiology, personality development, and the role of life experiences. AB - The psychobiological life history approach to psychiatry is perhaps the most important of Adolf Meyer's contributions to psychiatric thinking. The author outlines the implications of that approach for current concepts and practice. He reviews the literature regarding the causative role of life experiences in the genesis of psychiatric disorder, the extent to which the effects of stressors are situation-specific, the effects of stress on the organism, the reason for individual variations in the response to stress, and the cause of life stressors. PMID- 3529993 TI - Two-year follow-up of exposure and imipramine treatment of agoraphobia. AB - Sixty-two agoraphobic patient who had completed a controlled study of therapist assisted in vivo exposure (flooding) and imipramine were assessed 1 month, 6 months, 1 year, and 2 years later. Overall, improvement during treatment was maintained throughout follow-up. At 1 month but not subsequently, imipramine and flooding had significant effects on central measures of agoraphobia. Patients who were marked treatment responders had a favorable clinical course and did not experience secondary depression, unlike patients who had not responded markedly to treatment. These findings suggest that treatments which evoke maximum therapeutic benefit initially are likely to foster long-term maintenance and reduce subsequent depressive sequelae. PMID- 3529994 TI - Julia Rush's diary: coping with loss in the early nineteenth century. AB - Julia Rush (1759-1848), wife of Benjamin Rush (1745-1813), recorded her thoughts over a 33-year period in an unpublished devotional journal. Many of the entries relate to her experience of the loss of Benjamin Rush. Although the diary is inadequate as a source of understanding psychodynamic processes at work, it provides considerable information about Julia Rush's coping behavior. An analysis of this journal reveals that she used three major coping strategies to deal with the loss of her husband: ritualized language, time marking, and cognitive reframing. These devotional meditations also illuminate the way early nineteenth century religious views shaped Julia Rush's response to loss. PMID- 3529995 TI - Graft and donor denial in heart transplant recipients. AB - Eighteen of 20 survivors of a heart transplant used denial as a coping mechanism. In seven of the subjects, denial was expressed toward the graft, in five it was toward the donor, and in six it was toward both. Other feelings expressed at the time of discharge were euphoria, gratitude, curiosity, ambivalence, guilt, anxiety, and a feeling of a change in body image. The author suggests that denial serves a protective and adaptive function in heart transplant recipients. PMID- 3529996 TI - Bloodletting as purging behavior. PMID- 3529998 TI - Spiritual "mourning" and altered consciousness. PMID- 3529997 TI - Double-blind, placebo-controlled studies of bulimic patients. PMID- 3529999 TI - An enzyme-linked immunosorbent assay for measuring antisperm autoantibodies following vasectomy in Lewis rats. AB - An indirect enzyme-linked immunosorbent assay (ELISA) was devised to measure antisperm auto-antibodies in the Lewis rat following vasectomy. The assay system was validated by employing prevasectomy sera and postvasectomy antisera, previously demonstrated to contain antisperm antibodies by indirect immunofluorescence. A standardized ELISA protocol was developed employing 10(5) sperm per microtiter plate well and sucrose-polyvinylpyrrolidone as a postcoat stabilizer solution. The ELISA was shown to yield significant detectable antibody at dilutions of 1/512 or greater in the most reactive sera. A standard for scoring positive titers was adopted: 1.96 standard deviations above the mean of the preimmune value. Using the criterion, 88% of 7-week postvasectomy samples could be discriminated from preimmune samples at a 1:16 dilution, which was adopted for subsequent assays. The ELISA demonstrated 73% and 91% reproducibility for an intraassay analysis of single prevasectomy and postvasectomy serum samples (7 weeks postvasectomy) tested in 160 determinations on a standard sperm pool. When this single antigen pool was employed in 35 determinations at 0, 1, and 4 weeks in an interassay study, 56% and 70% reproducibility was found for pre- and postvasectomy sera respectively. A correlation (r = 0.75) was made between a single absorbance value and the endpoint titer of the same sera, which indicated that single absorbance values could be used to predict serum titer and single dilutions could be used for general screening of a large number of samples. The ELISA described provides a rapid, sensitive, and reliable method that discriminated between samples taken before and after vasectomy. PMID- 3530000 TI - From Mayo to Kirklin: riding on Bigelow's coattails. PMID- 3530001 TI - Immunologic effects of blood transfusion upon renal transplantation, tumor operations, and bacterial infections. AB - Blood transfusions appear to exert a suppressive effect on many aspects of the immune system. In transplantation, this has been used to advantage; in other areas, the consequences can be deleterious. It is likely that various components of the immune system are affected by different mechanisms and possibly by different components of transfused blood. Before rational strategies can be evolved for minimizing the deleterious effects of blood transfusions, it is essential that these mechanisms be clearly defined. Studies must take into account any influence the underlying disease state might have on the immune system. In the absence of any satisfactory substitute, blood transfusion remains an essential therapeutic modality in the management of surgical patients. With current evidence, however, it seems reasonable to avoid the administration of small-volume transfusions whenever possible and encourage the use of autodonated blood for elective surgery. PMID- 3530002 TI - Plasma insulin response to oral glucose load in Meniere's disease. AB - Oral glucose tolerance tests and plasma insulin measurements were carried out in 74 patients with Meniere's disease and 74 control subjects. No statistically significant differences were observed in fasting, one-hour, and two-hour blood glucose levels or in fasting, one-hour, and two-hour plasma insulin levels between patients with Meniere's disease and control subjects. The results do not confirm the hypothesis that disturbances in glucose metabolism or plasma insulin response are etiologic factors in Meniere's disease. PMID- 3530003 TI - [Immunoglobulins in the serum of pregnant women with habitual abortions and skin grafts]. PMID- 3530004 TI - [Ultrasonic diagnosis in placental insufficiency]. PMID- 3530005 TI - [Relationship between placental maturity established by ultrasound and fetal lung maturity in late toxicoses]. PMID- 3530006 TI - [Nonimmune fetal hydrops--etiology, diagnosis and management]. PMID- 3530007 TI - [Current possibilities for the early diagnosis of endometrial cancer]. PMID- 3530008 TI - Charles E. Flowers, Jr., MD. PMID- 3530009 TI - Festschrift: The Charles E. Flowers Symposium on Obstetrics and Gynecology. PMID- 3530010 TI - Current concepts in cardiac transplantation. PMID- 3530011 TI - Recent advances in hepatic surgery including transplantation. PMID- 3530012 TI - Early use of general anesthesia in Alabama, 1847 to 1853. PMID- 3530013 TI - On the relevance of animal models to alcoholism in humans. PMID- 3530014 TI - Regression of severe alcoholic cardiomyopathy after abstinence of 10 weeks. AB - Alcoholic cardiomyopathy usually has a poor prognosis, but the case presented here documents a dramatic regression of left ventricular dysfunction in a patient with alcoholic cardiomyopathy. Ejection fraction determined by echocardiography increased from 12% at the time of presentation to 45% 10 weeks later. This was associated with clinical resolution of congestive heart failure and a decrease in cardiac and left ventricular size documented by chest x-ray and echocardiography. PMID- 3530015 TI - Preferential alcoholic embryopathy among contiguous siblings of Long-Evans rats. AB - Ethanol exposure alters sex steroidogenesis and sexually dimorphic behaviors in rodent offspring. Contiguity to siblings of the same or opposite sex in utero also affects steroidogenesis and sexual dimorphism in rodents. The present study with Long-Evans rats shows that maternal exposure to ethanol during the critical period of rodent organogenesis preferentially affects body weights and increases malformations in offspring dependent on their in utero contiguity to siblings of the opposite sex. PMID- 3530016 TI - The effect of ethanol intake on propoxyphene absorption and biotransformation in dogs. AB - The effect of ethanol (0.5 and 1.0 g/kg) on gastrointestinal absorption and presystemic biotransformation of propoxyphene (4 mg/kg) was studied in dogs in a crossover design. Low ethanol doses (0.5 g/kg) had no effect on the bioavailability of propoxyphene. High ethanol doses (1.0 g/kg) enhanced the bioavailability of orally administered propoxyphene significantly (p less than 0.05). With this dose of ethanol, the area under the blood concentration versus time curve (AUC)0-5 h of propoxyphene was approximately 200% of the control value. The level of norpropoxyphene, a major metabolite of propoxyphene, was significantly decreased (p less than 0.05) after administration of high ethanol doses. In all blood samples, after propoxyphene administration, an unidentified metabolite of propoxyphene was found, which formation was dose dependently inhibited by ethanol. PMID- 3530017 TI - Effects of dietary fat on alcohol-pyrazole hepatitis in rats: the pathogenetic role of the nonalcohol dehydrogenase pathway in alcohol-induced hepatic cell injury. AB - Rats were fed with two different alcohol-containing (36% of total calories) liquid diets of high fat and low fat (35% and 15% of total calories) with or without 2 mM of pyrazole for 12 weeks. At the 12th week, the serum glutamic oxaloacetic transaminase level was significantly elevated in the alcohol-pyrazole high fat group, but not in the low fat group. Ballooning and necrotic changes of the hepatocytes in the centrolobular area were more prominent in the alcohol pyrazole high fat group than in the low fat group and alcohol alone groups, indicating that high fat diet accelerates the development of alcohol-pyrazole hepatitis. In the alcohol-pyrazole high fat group, a decrease of hepatic microtubules content and an accumulation of hepatic export proteins in the hepatocytes were found. The protein accumulation was prominent only in the ballooned hepatocytes. Hepatic acetaldehyde levels were significantly higher in the alcohol-pyrazole high fat group than in the alcohol-pyrazole low fat group. These results suggest that the accelerated ethanol metabolism in the nonalcohol dehydrogenase pathway by a high fat diet may play an important role in the development of hepatocytic injuries, by impairing the microtubular function of the hepatocytes. PMID- 3530018 TI - Binding, uptake, and metabolism of chylomicron remnants by hepatocytes from control and chronic ethanol-fed rats. AB - Chylomicron remnants, but not lymph chylomicrons, showed a receptor-dependent high affinity saturable binding to normal rat hepatocytes. The Scatchard analysis of the specific binding data showed a high affinity binding site for the remnants with a dissociation constant of 0.61 nM, assuming a molecular weight of 50 X 10(6) for chylomicron remnants. Based on the heparin-releasable bound radioactivity, approximately 80% of the bound remnants seemed to be internalized. The binding process was markedly inhibited by pronase as well as by protein synthesis inhibitors. Competitive binding studies revealed that the order of competition for the binding of labeled remnants by homologous unlabeled lipoproteins was remnants greater than chylomicrons greater than very low density lipoproteins greater than high density lipoproteins. Human low density lipoproteins showed virtually no competition. Studies on the catabolism of triacylglycerol moiety of the remnants showed that 15.2% of the 14C label in the triacylglycerol moiety of the remnants was catabolized by the hepatocytes to 14CO2 due to specific interaction. This amounted to 93% of the total 14CO2 evolution. This was in sharp contrast to the catabolism of the triacylglycerol moiety of very low density lipoproteins from human and rat, where most of the 14CO2 evolution was due to pathways associated with nonspecific binding. Chronic ethanol feeding caused a 29% (p less than 0.02) decrease in the dissociation constant of the high affinity binding site of the liver cell for the remnants, whereas the extent of internalization was decreased by 19% (p less than 0.01) as compared to the pair-fed control animals.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3530019 TI - Study of dose-dependence and urinary folate excretion produced by ethanol in humans and rats. AB - Acute ethanol ingestion by human alcoholic subjects produces a marked decrease in serum folate levels within 16 hr. A similar decrease occurs in rats and can be explained by a marked increase in urinary folate excretion following ethanol treatment. To assess the effects of acute ethanol ingestion on urinary folate excretion in healthy human volunteers, two studies were carried out at initial ethanol dose levels of 0.8 g/kg and 1.0 g/kg, respectively. Blood ethanol levels peaked at 70 mg/dl in the first study, but in the second study were 100 +/- 20 mg/dl through 6 hr. Only in the second study were urinary folate levels significantly increased by ethanol administration, and this 8 hr after ingestion. This increase was accompanied by a decrease in urine volume so that in neither study was the total amount of urinary folate excreted from 0-12 hr increased by ethanol ingestion. Studies with various dose levels of ethanol in rats showed that there was a linear dose-response relationship between the total urinary folate excretion and the dose of ethanol. Peak urinary ethanol levels also correlated with urinary folate excretion. These results suggest that doses of ethanol larger than 1.0 g/kg produce increases in urinary folate excretion and that the inability to observe large increases in studies in human subjects is probably related to the limited doses of ethanol chosen. PMID- 3530020 TI - The effect of chronic ethanol consumption on salivary gland morphology and function in the rat. AB - Chronic ethanol consumption in rats resulted in a striking fat accumulation in the acinar cells of the parotid gland demonstrated by light microscopy. In addition, a significant decrease in parotid wet weight (p greater than 0.02) and in protein content of the gland (p greater than 0.02) was observed following alcohol feeding. Wet weight, protein content, and morphology of the submaxillar gland were not affected by ethanol feeding. Alcohol metabolism, similar to that found in the pancreas, via a cytosolic alcohol dehydrogenase could be demonstrated in both the parotid and the submaxillar gland. However, the activity of this enzyme was not affected by chronic ethanol ingestion. Subsequently, chronic ethanol consumption significantly decreased salivary flow rate stimulated by pilocarpine hydrochloride (p greater than 0.02), salivary alpha-amylase activity (p greater than 0.02), and salivary sodium concentration (p greater than 0.01), whereas potassium concentration of the saliva was increased (p greater than 0.05). In contrast salivary total protein concentration was not affected by alcohol ingestion. The changes of salivary electrolyte composition observed after chronic ethanol feeding could be due to an altered aldosterone metabolism or to a change in aldosterone receptors of the parotid gland caused by ethanol administration. The reduced salivary flow could play a role in the pathogenesis of oropharyngeal cancer in the alcoholic. PMID- 3530021 TI - Pituitary and thyroid hormones in pregnant alcohol-fed rats and their fetuses. AB - The effect of maternal alcohol consumption on serum and pituitary concentrations of hormones was investigated in pregnant rats and their fetuses. Rats were given 20% ethanol in water prior to pregnancy and 30% ethanol in water throughout gestation, with rat chow ad libitum (alcohol group), or water with an equicaloric diet in which corn starch was substituted for alcohol (pair-fed group), or rat chow and water ad libitum (ad libitum control group). Growth hormone (GH), prolactin (Prl), thyroid-stimulating hormone (TSH), thyroxine (T4), and triiodothyronine (T3) were measured in maternal serum, GH, Prl, and TSH in maternal pituitary, and GH, T4, and T3 in fetal serum. Fetuses of alcohol-fed rats weighed significantly less than fetuses of pair-fed or ad libitum controls. GH, Prl, and TSH were significantly reduced in the maternal serum of alcohol and pair-fed rats compared to ad libitum controls, but T4 and T3 did not differ among the three groups. Pituitary GH was reduced in the alcohol-fed rats, but pituitary Prl and TSH did not differ among the three groups. In the fetuses, neither GH nor T4 differed among the three groups. Fetal T3 was not detectable by this assay. It is suggested that alcohol ingestion affects maternal growth hormone levels, possibly by influencing either the synthesis or the release of the hormone from the pituitary gland. The other hormonal changes may be the result of the reduced food intake, rather than a specific effect of alcohol. PMID- 3530022 TI - Gastric emptying of solid meal in male chronic alcoholics. AB - Nausea and vomiting are common complaints in chronic alcoholics. Autonomic neuropathy and esophageal motor abnormalities are frequently observed in chronic alcoholics, but gastric emptying has not been studied in these patients. Gastric emptying of a solid meal was measured, using 99mTc-sulfur colloid cooked in a scrambled egg, in 10 male chronic alcoholics with upper gastrointestinal complaints of nausea and vomiting. All patients were adequately nourished, recently drinking, but just over withdrawal and free of clinical peripheral neuropathy. Gastric emptying in 10 alcoholics was similar to 5 normal controls (t 1/2 115 +/- 12 versus 107 +/- 8 min). These data suggest that upper gastrointestinal symptoms in chronic alcoholics are not related to gastric motor dysfunction. PMID- 3530023 TI - Initiation of ethanol reinforcement using a sucrose-substitution procedure in food- and water-sated rats. AB - Rats, maintained on free access to both food and water, were trained to press a lever to obtain a 20% sucrose solution. When presentation of the sucrose solution was maintaining responding, low ethanol concentrations were added to the solution. Over 25 sessions, the solution presented as reinforcement was gradually reduced in sucrose concentration until a 10% ethanol solution with no sucrose was presented. Following this initiation procedure, ethanol concentrations up to and including 40% ethanol were found to maintain responding. At the higher ethanol concentrations, the rats consumed doses of ethanol between 0.90 and 0.95 g/kg in the 30-min session. When a concurrent choice between ethanol and water was available in the operant chamber, the rats responded on the lever associated with 10% ethanol presentation. Home cage preference between ethanol and water was found to be altered following the operant ethanol experience with the rats acceptability for 10% ethanol increased prior to the start of the experiment. This initiation procedure provides another manner in which ethanol reinforcement can be instigated in animals that have not been either food- or fluid-deprived. It is hypothesized that mechanisms which may regulate the intravascular and intragastric self-administration of ethanol may also be operating when the oral route is employed. PMID- 3530024 TI - Characterization of an automated apparatus for precise control of inhalation chamber ethanol vapor and blood ethanol concentrations. AB - Inhalation chambers with a monitoring and control apparatus for ethanol vapor exposure of small animals were constructed. A thermal conductivity detector was employed for continuous measurement of inhalation chamber ethanol vapor concentration. The concentration was maintained within a very narrow range (+/- 1 mg/liter) by incorporating into the design a feedback loop which controls the ethanol pump. As expected, the blood ethanol concentrations (BEC) of male Sprague Dawley rats were positively and linearly correlated to the chamber ethanol concentration. When rats were exposed for 24 hr to a chamber ethanol concentration of 17, 25, or 32 mg/liter, correspondingly low, moderate, or high mean blood ethanol levels were obtained. When a large population of this strain of rats (n = 121) was exposed to a constant ethanol vapor concentration for 14 days (25 mg/liter) considerable interindividual variation in blood levels occurred. There was also individual variation over time in the BEC of animals monitored. The mean +/- SD BEC was 189 +/- 90 mg/100 ml for this population and a gaussian-like distribution was obtained with regard to BEC. Behavior characteristic of alcohol withdrawal was observed in rats with BEC greater than 120 mg/100 ml after 3.5, 7, or 14 days of exposure. This apparatus and inhalation paradigm make possible the precise control of chamber ethanol concentration which markedly enhances control over both intra- and intersubject fluctuation in blood ethanol levels during alcohol exposure and the comprehensive examination of relationships between a wide range of blood ethanol concentrations and their physiological and biochemical effects. PMID- 3530025 TI - The influence of both drinking and familial risk statuses on cognitive functioning of social drinkers. AB - Problem and nonproblem drinking, college student sons of alcoholics were compared to problem and nonproblem drinking college student sons of nonalcoholic fathers with respect to cognitive functioning. Problem drinkers performed more poorly on two of the four cognitive tasks, Group Embedded Figures and Symbol-Digit Paired Associates Learning Task, thus supporting earlier findings of cognitive deficits in problem drinking nonalcoholics. Additionally, sons of alcoholics tended to perform more poorly than sons of nonalcoholics on the Group Embedded Figures Test. Cognitive performance was not predicted by any of four measures of impulsive/antisocial personality and behavior-preadult antisocial behavior, childhood behavior problems, sensation seeking, and the MacAndrew Alcoholism Scale. The findings of the research pointed to the importance of considering both drinking and familial alcoholism risk statuses in studies of the cognitive performance of nonalcoholics. Further implications and limitations of the findings are discussed. PMID- 3530026 TI - Effects of ethanol on gastrointestinal transit in mice. AB - The acute effects of ethanol on gastrointestinal transit were studied in mice. Intraperitoneal injection of 2 or 3 g of ethanol/kg had a dose-dependent inhibitory effect on gastrointestinal transit. Subcutaneous injection of 4 g of ethanol/kg also inhibited gastrointestinal transit, but this route was less effective than the intraperitoneal route of administration. Further examination of both the time course of inhibition and the weight of the stomach contents suggested that intraperitoneal injections of moderate doses of ethanol did not alter gastric emptying. The data indicated that gastrointestinal transit is inhibited by ethanol and that the most sensitive locus is the small intestine rather than the stomach. PMID- 3530027 TI - Voluntary ethanol consumption in rats: an examination of blood/brain ethanol levels and behavior. AB - The temporal pattern of food, water, and ethanol consumption was examined in rats maintained on a 24-hr ethanol access schedule. These data demonstrated that rats consume ethanol in discrete, short bouts mainly during the lights-out cycle. Simulation of a single ethanol drinking bout was carried out by limiting ethanol access to a short time period each day. Detectable levels of blood and brain ethanol were observed following these individual drinking bouts. Behavioral evidence is provided indicating that rats drink ethanol in quantities sufficient to produce pharmacological effects. PMID- 3530028 TI - Depression of iron uptake from transferrin by isolated hepatocytes in the presence of ethanol is a pH-dependent consequence of ethanol metabolism. AB - Incubation of freshly isolated rat hepatocytes with highly purified radiolabeled rat transferrin in weakly buffered medium in the presence of 10 mM ethanol resulted in a marked diminution of iron uptake by these cells, associated with a greater pH depression than in ethanol-free control studies. This effect on iron uptake persisted, even when the cells were preincubated for 90 min with ethanol before the addition of transferrin. Increasing the buffering capacity of the system or the addition of a metabolic inhibitor of alcohol dehydrogenase (4 methylpyrazole) returned iron uptake to control values. Acetaldehyde, acetate, lactate (products of ethanol metabolism), and 3-butanol (an alcohol not metabolized by alcohol dehydrogenase) had no influence on iron uptake. Further investigation of iron uptake over the pH range 6-8.5 revealed a marked dependency of iron uptake on the extracellular pH. Leucine incorporation into cell protein was also found to be pH dependent. It is suggested that, in the light of current understanding of transferrin recycling by other cell types, the disturbances of iron homeostasis observed in alcoholics can be partially accounted for by alterations in their acid-base metabolism. PMID- 3530029 TI - Mechanisms of pancreatic islet cell destruction. Dose-dependent cytotoxic effect of soluble blood mononuclear cell mediators on isolated islets of Langerhans. AB - Supernatants of peripheral blood mononuclear cells from healthy human donors stimulated with recall antigen (purified protein derivative of tuberculin) or lectin (phytohaemagglutinin) markedly inhibited the insulin release from isolated human and rat islets of Langerhans, and decreased rat islet contents of insulin and glucagon in a dose-dependent manner. A maximal effect on islet function was obtained with supernatant concentrations down to 5%. Supernatants of mononuclear cells stimulated with tuberculin were more potent than supernatants produced by lectin stimulation. Culture medium reconstituted with tuberculin or phytohaemagglutinin did not impair islet function. Electron microscopy demonstrated that supernatants were cytotoxic to islet cells. The cytotoxic mononuclear cell mediator(s) was non-dialysable, sensitive to heating to 56 degrees C, labile even when stored at -70 degrees C, but stable when lyophilised. PMID- 3530030 TI - Oral immunotherapy of children with rhinoconjunctivitis due to birch pollen allergy. A double blind study. AB - Thirty children with rhinoconjunctivitis due to birch pollinosis were treated in a double blind manner for 10 months with enteric-coated capsules containing either a birch pollen preparation (n = 14) with doses up to 1.4 X 10(6) biologic units per day or placebo (n = 16). Compared with the placebo group the actively treated children had less symptoms during the birch pollen season after 3 months of therapy (P = 0.035). Skin prick reactions decreased significantly more in the active group than in the placebo group after 10 months (P = 0.01). Conjunctival sensitivity was lower in the active group than in the placebo group after 3 months of treatment (P = 0.01) but not after 10 months. Compared with the placebo group the treated children more often increased their levels of IgG (P = 0.007) and pre-seasonal IgE (P = 0.001) against birch. There was a seasonal increase of IgE antibody level against birch in the placebo but not in the treatment group (P less than 0.001). None of the treated children developed asthma, compared with five of the untreated children. No general reactions occurred and few side effects were seen during the treatment period. We conclude that in children with birch pollinosis oral immunotherapy with high doses of a biologically potent preparation in enteric-coated capsules is effective, easy to perform, economic and safe. PMID- 3530031 TI - Simplification of inhalation therapy in asthmatic children. A comparison of two regimes. AB - In a placebo-controlled double blind cross-over study of 3 X 3 weeks' duration the effectiveness of a new set of simple instructions for the use of spacer aerosols was compared with that of the rather complicated manufacturer's instructions in the daily treatment of 22 children with severe asthma. All children received inhaled budesonide and terbutaline at the lowest dose possible for satisfactory symptom control. Both the simple and complicated regimes were significantly better than placebo (P less than 0.01), but there was no indication that the complicated regime was superior to the simple regime. On the contrary, the children used significantly more rescue terbutaline and experienced more daytime symptoms when treated according to the complicated regime (P less than 0.01). 19 of 21 children who completed the study preferred to use the simple regime (P less than 0.01). It is concluded that instructions for the use of spacer aerosols should be substantially simplified and that conclusions from laboratory studies should be tested in the day-to-day management of asthmatics before these aerosols become widely used. PMID- 3530033 TI - Directory of accredited organizations approved programs/offerings, and accredited continuing education certificate programs preparing nurse practitioners. PMID- 3530032 TI - Sustained-release terbutaline in nocturnal asthma. AB - Fifteen adult patients with nocturnal asthma entered a double blind study. They received a single evening dose of one sustained-release (SR) terbutaline tablet a 7.5 mg or an identical placebo tablet for 1 week, each in a randomised cross-over fashion in addition to their usual medication. In the 12 evaluated patients there was no change in evening PEF but a significant improvement in morning PEF (P less than 0.05) and in overnight fall of PEF (P less than 0.01) on active treatment. Symptoms were improved by both placebo and active medication. Three patients experienced tremor as a side effect. A single evening dose of SR-terbutaline can be of help in nocturnal asthma. PMID- 3530034 TI - Bedford Square. A connexion with mesmerism. AB - Nine Bedford Square has now been established as a Centre for Anaesthesia. It is a town house of considerable merit in the first square to have been planned on the London estate of the fifth Duke of Bedford. Built between 1775 and 1780, it is now the last complete Georgian square in Bloomsbury. This brief note on the history of Bedford Square shows that this part of London was prominent in nineteenth century medicine and, in particular, was involved in the early practice of mesmerism in this country. The place of mesmerism in the evolution of anaesthesia is restated and attention is drawn to the extraordinary coincidence that the new home that has been chosen for the Association of Anaesthetists of Great Britain and Ireland should be in an area which already has connexions with anaesthesia through mesmerism. PMID- 3530035 TI - Nikolai Ivanovich Pirogoff. AB - A short description of the life of Nikolai Ivanovich Pirogoff and some of his accomplishments are given. His book on administration of ether for anaesthesia (analgesia) by inhalation and by rectum is of special interest. In this book he also describes his experiments, mainly on dogs, with all kinds of administration. He was one of the first to write a book on ether and also to utilise anaesthesia under war conditions. Later he tended to favour chloroform, which he considered to be better. He accomplished a lot in life and was highly regarded at home and abroad. PMID- 3530036 TI - Air embolus and epidural anaesthesia. PMID- 3530037 TI - [The history of the tracheotomy. II]. PMID- 3530038 TI - Mechanical ventilation and ventilators. PMID- 3530039 TI - Physiological aspects of intermittent positive pressure ventilation. AB - The mechanical properties of the lungs and chest wall dictate the relationship between tidal volume, flow rate and airway pressure developed during intermittent positive pressure ventilation (IPPV). The increase in intrathoracic pressures associated with IPPV has consequences for the intrapulmonary distribution of ventilation and perfusion (hence gas exchange), cardiac output and regional blood flows. Barotrauma is a potential hazard. IPPV also affects the homeostatic mechanisms that keep the air spaces dry. Strategies to maximise the benefits and minimise the side effects of IPPV include positive end-expiratory pressure, intermittent mandatory ventilation, differential lung ventilation and high frequency ventilation. Understanding the physiological effects of IPPV and associated therapies allows a rational approach to the adjustment of ventilation against pulmonary, cardiovascular and systemic responses so as to optimise gas exchange and peripheral oxygen delivery. PMID- 3530040 TI - PEEP and CPAP. AB - Positive end-expiratory pressure (PEEP) maintains airway pressure above atmospheric at the end of expiration, and may be used with mechanical ventilation or spontaneous breathing. CPAP, or continuous positive airway pressure, refers to spontaneous ventilation with a positive airway pressure being maintained throughout the whole respiratory cycle. PEEP/CPAP primarily improves oxygenation by increasing functional residual capacity, and may increase lung compliance and decrease the work of breathing. PEEP/CPAP may be applied using endotracheal tubes, nasal masks or prongs, or face masks or chambers to treat a wide range of adult and paediatric respiratory disorders. Complications associated with their use relate to the pressures applied and include pulmonary barotrauma, decreased cardiac output and raised intracranial pressure. PMID- 3530041 TI - Ventilators--reported classifications and their usefulness. AB - In this paper, a number of reported systems for classifying ventilators are considered and their usefulness commented on. Most omit the concept of power, which is an important factor in how the ventilator will perform. It is recommended that a system of classification should be backed by bench tests and clinical trials. Not enough is known about high frequency ventilation to permit reasonable evaluation of the classifications proposed in this area. PMID- 3530042 TI - High-frequency ventilation. AB - Over the last six years high-frequency ventilation has been extensively evaluated both in the clinical and laboratory settings. It is now no longer the great mystery it once was, and it is now no longer believed (as many had hoped), that it will solve all the problems associated with mechanical pulmonary ventilation. Although the technique is safe and appears to cause no harm even in the long term, it has not yet been shown to offer any major advantages over conventional mechanical ventilation. PMID- 3530043 TI - New generation ventilators. AB - Desirable features of new generation intensive care ventilators include the ability to ventilate a wide range of patient sizes, an uncomplicated control panel, an appropriate but not excessive variety of ventilatory patterns, adequate patient monitoring and alarm functions, and simplicity of cleaning and routine maintenance. Examples of currently available ventilators include the Servo 900-C, CPU-1, Engstrom Erica, Bear 5, Drager EV-A and Hamilton Veolar. The incorporation of microcomputer control into some of these ventilators has resulted in improved flexibility and a limited number of automatic responses to detected patient changes. However, the function of components provided to allow spontaneous ventilation, such as demand valves, requires considerable improvement. Current trends in ventilator design include further refinement of computer control and the provision of graphic displays showing the results of continuous sophisticated analysis of respiratory function. The extent to which these developments will prove clinically useful will require careful evaluation. PMID- 3530045 TI - Infrared spectrometry. PMID- 3530044 TI - Determination of serum creatinine by isotope dilution mass spectrometry as a candidate definitive method. PMID- 3530046 TI - The distribution and significance of aberrant ganglion cells in the facial nerve trunk of the cat. AB - The distribution and peripheral connections of aberrant ganglion cells in the facial nerve trunk of the cat were studied by means of Kluver-Barrera staining and retrograde transport of horseradish peroxidase (HRP). By the Kluver-Barrera staining, aberrant ganglion cells were observed in the facial nerve trunk between the geniculate ganglion and the junction of the auricular branch of the vagus with the facial nerve trunk, although the number varied considerably with each animal. These cells were generally medium-sized and of round or oval shape, with densely stained Nissl substance, the features of which were essentially similar to those of the geniculate ganglion. In cases where HRP injections were made into the anterior wall of the auricle, several HRP-labeled cells were found ipsilaterally in the facial nerve trunk in addition to cell labeling of the geniculate ganglion. The present study in the cat demonstrated that at least some of the aberrant ganglion cells scattered in the facial nerve trunk are parental to the axons to the auricle, subserving the cutaneous sensory function. PMID- 3530047 TI - Granulocyte elastase as a sensitive diagnostic parameter of silent male genital tract inflammation. AB - Elastase, a specific inflammatory parameter of polymorphonuclear (PMN) granulocytes, was quantified with a sensitive enzyme immunoassay in the ejaculates of 188 patients consulting the andrological outpatient service. Correlations of the elastase concentrations to other parameters used up to now for the diagnosis of silent male genital tract inflammation were statistically evaluated by the CHI2-test. A correlation was found neither to the percentage of morphologically intact spermatozoa in the differential spermiocytogram and the total number of spermatozoa nor to the pH-value and viscosity of the ejaculate. However, release of elastase into the ejaculates was clearly associated with the occurrence of bacteria in native and stained smears or with the numbers of round cells present. Moreover, leukocyte counts in stained smears as well as an inflammation coefficient were highly significantly correlated to elastase concentrations. Obviously, quantification of granulocyte elastase in seminal plasma enables a rapid diagnosis of silent male genital tract inflammation, since even a single determination gives a reliable criterion and sequential determinations may allow the control of the course of the disease during therapy. PMID- 3530050 TI - Harold Randall Griffith, 1894-1985. PMID- 3530049 TI - Lack of effect of intravenous lidocaine on hemodynamic responses to rapid sequence induction of general anesthesia: a double-blind controlled clinical trial. AB - A double-blind, randomized trial was conducted in 16 women aged 20-48 yr, to assess the effect of intravenous lidocaine on the circulatory responses to rapid sequence induction of general anesthesia. None of the patients suffered from heart or lung diseases, all were scheduled for hysterectomy, and all were premedicated with 0.3 mg/kg diazepam orally 2 hr beforehand. Induction, preceded by preoxygenation, included simultaneous injection of thiopental and succinylcholine, without starting manual ventilation until the airway was secured with the endotracheal tube. Two minutes before laryngoscopy and intubation half of the patients received lidocaine, 1.5 mg/kg, intravenously (IV). The other half received an equal volume of saline. Cuff blood pressure was measured repeatedly by an automatic recording device, and heart rate and left ventricular ejection fraction (LVEF) were monitored by a portable nonimaging nuclear probe. After laryngoscopy and intubation, mean blood pressure increased 46%, heart rate 57%, and the rate pressure product (RPP) 84% from control values in patients given lidocaine, compared to 45, 66, and 113%, respectively, in the saline group (P greater than 0.05). Pronounced, but similar decreases in LVEF were observed in the two groups, to 0.40 from 0.65 in the lidocaine group and to 0.41 from 0.65 in the saline group. In all patients, RPP reached a level considered potentially dangerous to patients with ischemic heart disease. We conclude that lidocaine, 1.5 mg/kg IV, 2 min prior to laryngoscopy and intubation does not prevent hemodynamic reactions evoked by rapid sequence induction. PMID- 3530048 TI - Continuous noninvasive monitoring of cardiac output with esophageal Doppler ultrasound during cardiac surgery. AB - Esophageal Doppler ultrasonography offers a continuous and noninvasive alternative to standard thermodilution cardiac output monitoring. A total of 372 simultaneous measurements of Doppler and thermodilution cardiac output were compared in 16 patients undergoing cardiac surgery. In addition, echocardiographic aortic diameter measurement, necessary for Doppler calibration, was compared with direct surgical measurement in 23 patients. Echocardiographic aortic measurement was often time consuming and correlated poorly (r = 0.31) with surgical measurement. On the other hand, Doppler cardiac output was determined easily and accurately tracked thermodilution cardiac output (R2 = 0.95, common slope coefficient 1.050, by multiple linear regression). Furthermore, Doppler cardiac output was more reproducible, showing less short-term variability than thermodilution cardiac output. The esophageal Doppler technique allows cardiac output monitoring in patients for whom invasive monitoring is not warranted. PMID- 3530051 TI - Acquired immunodeficiency syndrome: an overview for anesthesiologists. PMID- 3530052 TI - Junctional rhythm can mimic air embolism during precordial Doppler monitoring. PMID- 3530053 TI - Partial expiratory limb obstruction by a foreign body abutting upon an Ohio 5400 Volume Monitor Sensor. PMID- 3530055 TI - [Use of hyperbaric oxygenation in the complex treatment of acute hepatitis before and after kidney allograft]. PMID- 3530054 TI - [Use of a computer to assess the severity of a condition from clinical and experimental data]. PMID- 3530058 TI - Sterility of preloaded insulin syringes. PMID- 3530057 TI - Numbers that count: analytic methods for hospital epidemiology, Part 1. AB - The hospital epidemiologist is responsible for generating information that will be used to evaluate and assure high quality, minimal risk medical care. To accomplish this objective, the epidemiologist uses standard epidemiologic methods. Although used primarily in infection control, these methods are also applicable in the analysis of other types of institutional risks and in the assessment of quality of care. This review provides the reader, who we assume has minimal formal training in epidemiology and statistics, with some basic tools for analyzing data and generating useful information. We consider three major topic areas: basic concepts regarding numbers and data, analysis of nominal data, and analysis of discrete and continuous data. Hypothetical problems that may be encountered in the hospital illustrate the application of epidemiologic methods to studies of risk control, quality assurance, and infection control. The infection control practitioner who is adept in using epidemiologic methods to solve infection control problems should be able to adapt these methods to other programs in her or his institution. PMID- 3530059 TI - Immunologic and atopic aspects of pregnancy and lactation. PMID- 3530062 TI - Screening for genetic diseases with molecular probes. AB - Over 500 human genes have now been cloned. The study of many of these has greatly improved our knowledge of the causes of certain genetic diseases, and our ability to diagnose them. The linkage of random polymorphic DNA probes has also aided the mapping of disease loci, and the diagnosis of human pathology. In some cases linkage may prove to be the starting point for the isolation of genes causing disease where the biochemical defect is not characterised. This review looks at the impact of recombinant DNA technology on the study of human genetic disease. PMID- 3530060 TI - Immediate hypersensitivity reactions to foods: blinded food challenges in children with atopic dermatitis. PMID- 3530064 TI - Chinese restaurant syndrome: a review. AB - CRS is a benign, self-limited process that has an excellent prognosis for immediate and rapid recovery. While questions remain about exactly who is susceptible, how much MSG is needed, and even whether MSG is the sole etiologic agent, there appears to be little reason to embark on an extensive workup and treatment regimen with a presumptive diagnosis of MSG intoxication. Rather, knowledge of CRS and recognition of its associated signs and symptoms and its clinical course are important. PMID- 3530061 TI - [Methods of assaying 3-methylhistidine in biological media]. PMID- 3530063 TI - Inhibition of production and action of tissue metalloproteinases. AB - There is strong evidence that a family of MPs involved in the resorption of the matrices of connective tissues. These proteinases seem to be induced by specific stimuli whereas cells and tissues normally produce a specific inhibitor, TIMP. In many experimental situation there is good evidence that increased resorption is correlated with an imbalance of TIMP over active MPs. Current research is aimed at finding better compounds than corticosteroids to increase the balance of TIMP over MPs. PMID- 3530056 TI - [Effect of optimal parameters of artificial pulmonary ventilation in children]. PMID- 3530065 TI - Experimental Babesia equi infection in mature horses. AB - Nine 4-year-old Arabian geldings were experimentally infected with Babesia equi of European origin. All horses developed detectable parasitemia an average of 30 days after they were inoculated, which was accompanied by a decrease in PCV. The infections were generally mild with no animal deaths. All horses became serologically positive by the indirect fluorescent antibody test within an average of 23 days after they were inoculated and by the complement-fixation test 30 days after they were inoculated. PMID- 3530068 TI - Comparison of metrizamide and iohexol for cisternal myelographic examination of dogs. AB - A double-blind study, using metrizamide, iohexol, or Ringer's solution (control) as cisternal myelographic agents, was performed on 25 dogs. Before myelographic examination was done, each dog was subjected to physical, clinical pathologic, and neurologic examinations, as well as examinations by electroencephalography and computerized tomography. These were repeated 24 hours after completion of the myelographic examination. The group of dogs given metrizamide (group II) had a significantly greater occurrence of seizure activity (6 of 10) than did the control dogs (group I; 0 of 5) or dogs given iohexol (group III; 0 of 10; P less than 0.003). In group II, the CSF microprotein concentration was significantly greater 24 hours after myelography was done than were the values in groups I and III (P less than 0.003). Myelograms of the group II dogs (metrizamide) and group III dogs (iohexol) had similar diagnostic qualities. At 24 hours after myelographic examination was done, computerized tomography scan revealed that each dog given metrizamide and iohexol had myelographic contrast material in the brain and cervical spinal cord parenchyma. Seemingly, iohexol has good diagnostic quality, but is less epileptogenic than metrizamide when used in cervical myelographic examinations of dogs. PMID- 3530066 TI - Effects of exogenous iron on Escherichia coli septicemia of turkeys. AB - The effect of inoculation with Escherichia coli on serum iron concentrations of turkeys and the effect of exogenous iron, as ferric ammonium citrate, on E coli septicemia in turkeys were determined. Inoculation of air sacs with E coli produced hypoferremia in 18-day-old turkeys. Administration of iron with E coli significantly (P less than 0.01) increased mortality, frequency and degree of bacteremia, and severity of lesions in inoculated turkeys, compared with those in turkeys given E coli but not given iron. Similar results were seen whether iron was inoculated at the same location as E coli or at a different location. PMID- 3530067 TI - Immunologic response and resistance to experimentally induced pneumonic pasteurellosis in cattle vaccinated with various dosages of lyophilized Pasteurella haemolytica. AB - Pasteurella haemolytica was lyophilized in an enriched soybean polypeptone broth. Lyophilization in this medium resulted in a mean 10-fold loss in P haemolytica viability, as opposed to up to a 10(4)-fold loss in viability when other media were used. Lyophilized P haemolytica was reconstituted and used as a live vaccine in 3 experiments. Calves were challenge exposed by transthoracic injection with virulent P haemolytica. In experiment 1, 2 subcutaneous injections (7-day interval between injections) with 5 ml of recently harvested (1 X 10(9) colony forming units [CFU]/ml) or lyophilized (1 X 10(8) CFU/ml) P haemolytica significantly (P less than 0.001) enhanced resistance against challenge exposure, compared with resistance in calves given saline solution or sterile medium (control calves) or calves vaccinated with lyophilized organisms at a concentration of 1 X 10(6) CFU/ml. In experiment two, 1, 2, or 5 ml of lyophilized P haemolytica (1 X 10(8) CFU/ml) significantly (P less than 0.05) enhanced resistance, compared with resistance in calves given saline solution (control calves). In experiment three, 1 or 2 injections of lyophilized P haemolytica significantly (P less than 0.01) enhanced resistance against challenge exposure, compared with that of calves given saline solution. The mean lesion score for calves given 1 injection was not significantly higher than the mean lesion score for the group given 2 injections. Vaccination with lyophilized P haemolytica vaccine caused significant (P less than 0.05) increases in serum antibody to P haemolytica somatic antigens, to a carbohydrate-protein subunit of the organism, and to leukotoxin. PMID- 3530069 TI - A four-drug regimen for initial treatment of cavitary disease caused by Mycobacterium avium complex. AB - Forty-six patients with positive sputum cultures for Mycobacterium avium complex and cavitary disease were placed on a 4-drug regimen consisting of isoniazid, rifampin, and ethambutol daily and streptomycin twice weekly. Forty-two (91.3%) converted their sputum to negative and 4 (8.7%) failed to convert. All of the 4 nonconverters had prior subtotal gastrectomy. Twenty-two patients were available for long-term follow-up: 12 patients completed 24 months of chemotherapy, all experienced sputum conversion, but 2 reactivated, 1 at 9 and the other at 27 months after termination of chemotherapy. These 2 patients had prior subtotal gastrectomy. Ten patients completed 18 months of chemotherapy with sputum conversion, 2 of these reactivated but had not had prior subtotal gastrectomy. In this group of patients, subtotal gastrectomy appeared to be an adverse risk factor for both initial treatment response and reactivation in pulmonary disease caused by Mycobacterium avium complex. PMID- 3530071 TI - Evaluation of danazol therapy for patients with PiZZ alpha-1-antitrypsin deficiency. AB - An inherited deficiency of alpha 1-antitrypsin with blood concentrations less than 80 mg/dl is associated with the accelerated development of emphysema. Current concepts of the pathogenesis of emphysema suggest that an imbalance between neutrophil elastase and alpha 1-antitrypsin in the lung allows neutrophil elastase to work unimpeded to destroy the alveolar structures. Because the common form of the inherited deficiency (homozygous Z) results from impaired hepatic release of alpha 1-antitrypsin, one therapeutic approach to increase plasma and hence lung alpha 1-antitrypsin concentrations is to enhance hepatic release or production of alpha 1-antitrypsin. In a preliminary trial with 6 alpha 1 antitrypsin-deficient subjects, we have previously shown that in 1 month, the impeded androgen danazol can augment serum alpha 1-antitrypsin concentrations by 37%. To evaluate the use of impeded androgens in alpha 1-antitrypsin deficiency on a broader scale, we have treated: 43 homozygous Z patients with danazol 200 mg given orally 3 times a day for 30 days; 6 homozygous Z patients with a similar danazol dose but given for 6 to 18 months; and 7 homozygous Z patients with stanazolol, another synthetic androgen, 2 mg given orally 3 times a day for 30 days. Of the 43 patients treated with danazol for 1 month, 23 (53%) responded with a serum alpha 1-antitrypsin concentration greater than or equal to 20% higher than baseline, an average increase of 52% over the pretreatment concentration.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3530072 TI - Characteristics of bronchial hyperresponsiveness in smokers with chronic air-flow limitation. AB - The characteristics of bronchial hyperresponsiveness (BHR) were studied in 18 smokers with mild chronic air-flow limitation (CAL) by measuring responsiveness to inhaled histamine, methacholine (high dose), methoxamine (an alpha-adrenergic agonist), and histamine after ipratropium bromide. The response of the smokers to histamine was reproducible and in the same range as that found in asthmatics. The smokers were significantly less responsive to methacholine than to equimolar doses of histamine (p less than 0.001). The dose-response curves to methacholine reached a plateau or maximal effect after a 30 to 50% fall in FEV1 in 14 of the 16 smokers challenged. Only 1 of the subjects responded to alpha-adrenoreceptor stimulation, and pretreatment with ipratropium bromide had no effect on the histamine dose-response curve. By comparing these results with previously published data from similar studies performed on asthmatic subjects, it is concluded that BHR in smokers with CAL has characteristics different from those that occur in subjects with asthma. PMID- 3530073 TI - Nasal CPAP therapy, upper airway muscle activation, and obstructive sleep apnea. AB - In treating obstructive sleep apnea, positive pressure applied through the nose (CPAP) might cause a reflex increase in upper airway muscle activity or might enlarge the airway passively. We studied the effect of CPAP applied by a nasal mask on the electromyographic (EMG) activation of the alae nasi and genioglossal muscles in 8 patients with obstructive apneas during sleep, and correlated EMG activity with concentrations of oxygenation by ear oximeter, and with the end expiratory position of the rib cage and abdomen by DC-coupled inductance plethysmography. One to 3 cm H2O of CPAP did not eliminate the cyclic occurrence of obstructive apneas. The greatest tonic and phasic EMG activity occurred at apnea termination; the least occurred at apnea onset. With 13 to 15 cm H2O CPAP, apneas were eliminated; mean oxygen saturation rose from 84 +/- 6% (mean +/- SD) to 92 +/- 2%, and EMG activity was reduced or eliminated. With abrupt lowering of CPAP, end-expiratory positions fell, and an obstructive apnea ensued; however, EMG activity did not immediately return. We conclude that the elimination of apneas with CPAP is not attributed to increased EMG activity in the upper airway. The reduction in EMG activity observed with nasal CPAP was closely related to the improvement in hemoglobin oxygen saturation. Therefore, CPAP may act as a pneumatic splint and passively open the upper airway to prevent obstructive apnea. PMID- 3530070 TI - Effect of varying the time interval between intratracheal administration of eglin c and human neutrophil elastase on prevention of emphysema and secretory cell metaplasia in hamsters. With observations on the fate of eglin-c and the effect of repeated instillations. AB - Eglin-c is a naturally occurring polypeptide of 70 amino acids with a molecular mass of 8,100 daltons. It is a strong inhibitor of human neutrophil elastase (HNE) and cathepsin-G, and, when given intratracheally to hamsters 1 h before human neutrophil elastase, it can prevent or ameliorate the emphysema produced by HNE. The present experiments were designed to determine the duration of the effectiveness of eglin-c, prepared by DNA technology from Escherichia coli, in preventing the emphysema and secretory cell metaplasia induced by HNE. Eglin-c (2,000 micrograms in 0.5 ml saline) was effective in ameliorating emphysema, as determined histologically and physiologically, when it was given intratracheally to hamsters 1, 2, 4, and 8 h before the intratracheal instillation of 300 micrograms of HNE. Eglin-c ameliorated bronchial secretory cell metaplasia when given 1 h before HNE but not when the time intervals were 2 h or longer. The clearance of [3H]eglin-c from the lungs was assessed. Four h after intratracheal instillation of 446 micrograms of [3H]eglin-c, 33% of the tritium was found in the lung tissue and bronchoalveolar lavage fluid; 83% of the radioactivity in the lavage fluid supernatant was associated with functionally active eglin-c. No evidence of bronchopulmonary toxicity was seen in hamsters given 4 intratracheal instillations of 2,000 micrograms of eglin-c at 1-wk intervals. PMID- 3530074 TI - Tracheal permeability in rats exposed to ozone. An electron microscopic and autoradiographic analysis of the transport pathway. AB - Exposure of rats to ozone (O3), 0.8 ppm increases the tracheal permeability to 99mTc-diethylenetriaminepentaacetate (99mTc-DTPA) about twofold but to 125I bovine serum albumin (125I-BSA) to a lesser extent. It is generally believed that exposure to air pollutants causes perturbation of tight junctions and formation of intercellular channels for the passage of molecules from airway lumen to blood. We now report that a second mechanism, vesicular transport, is operative in the transepithelial movement of molecules, that this mechanism is speeded in tracheas of O3-exposed rats, and that there is a concurrent delay in movement of BSA from connective tissue to capillaries after O3 exposure. Horseradish peroxidase (HRP) instilled in trachea was taken up by endocytic vesicles, which could be localized in apical as well as basal regions of ciliated and nonciliated cells. A count of HRP-positive vesicles and measurement of their surface area revealed an approximate twofold increase in O3-exposed rats over that in control animals breathing clean air; this paralleled a twofold increase in transport of 99mTc-DTPA from tracheal lumen to blood. An autophagocytic process induced in tracheal epithelial cells by O3 is proposed. Despite the difference in the size of HRP and BSA, the 2 molecules migrated through common pathways and were colocalized in the luminal membranes as well as in endocytic vesicles and intercellular spaces in double labeling experiments involving simultaneous detection of HRP by cytochemistry and 125I-BSA by autoradiography. This procedure proved particularly useful in detecting a dramatic accumulation of 125I-BSA autoradiographic grains in subepithelial connective tissue and HRP accumulation in intercellular spaces and at the basal membrane-connective tissue junction in O3-exposed rats.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3530075 TI - A randomized controlled trial of moxalactam versus clindamycin/tobramycin in the treatment of mixed anaerobic/aerobic infections. AB - Many infections are due to mixtures of facultative gram-negative bacilli and anaerobic bacteria. Moxalactam, a semisynthetic beta lactam antibiotic, is active against a wide range of anaerobic organisms, including most strains of Bacteroides fragilis, as well as many aerobic gram-negative bacilli. We performed a prospective, randomized controlled trial comparing moxalactam alone with the regimen of clindamycin and tobramycin for treatment of mixed aerobic/anaerobic infections. One hundred and six patients with presumed mixed infections were randomized to the study groups. The resultant groups were clinically and microbiologically comparable. The effectiveness of treatment was similar with both antibiotic regimens. Five of 25 patients tested in the moxalactam group had a prolongation of their prothrombin time and one of them developed clinically important bleeding. Two of the 23 patients tested in the clindamycin/tobramycin group had a prolonged prothrombin time with no bleeding. Decreases in hematocrit which could be "probably" or "possibly" related to antimicrobial use were seen in 6 of 48 moxalactam patients and none of 50 clindamycin/tobramycin patients (P = .03). Moxalactam, a potent antimicrobial for both anaerobic and aerobic organisms, demonstrated effectiveness in treating mixed anaerobic/aerobic infections similar to clindamycin/tobramycin but was associated with clinically important decreases in hematocrit. PMID- 3530076 TI - [Change in behavior in breast feeding world-wide. 1920-1985 review]. AB - Articles about lactation enquiries from 1920 to 1985 are revised by the authors in order to design a graphic showing the trends in different countries. Factors that have been related with changes in lactation performance practices are also studied. PMID- 3530077 TI - [Shwachman syndrome: apropos of a case with characteristic echographic changes and review of the literature]. PMID- 3530078 TI - Tattoos from insulin needles. PMID- 3530079 TI - The importance of disease prevalence in transporting clinical prediction rules. The case of streptococcal pharyngitis. AB - Because clinical prediction rules often are applied in new settings to calculate the probability of a disease, we evaluated the accuracy of three rules for predicting streptococcal pharyngitis in 310 patients. Use of the rules led to overestimations of disease probability in 47%, 82%, and 93% of the patients. When we used receiver-operating characteristic curve analysis, no rule lost power to discriminate streptococcal from nonstreptococcal causes of pharyngitis. The overestimations in disease probability likely were caused by differences in disease prevalence between our setting (5%) and the settings in which they were developed (15% to 17%). All rules led to accurate predictions when they were adjusted for the disease prevalence found in our setting using a likelihood ratio formulation of Bayes' theorem. The value of prediction rules, like that of other diagnostic tests, is affected by differences in disease prevalence in different settings. Failure to recognize and adjust for these differences may cause poor decision making or the premature dismissal of valid rules. PMID- 3530080 TI - Issues for American internal medicine through the last century. AB - The content, role, and purpose of internal medicine, organized as an American specialty 100 years ago, have been marked by ambivalence from the beginning. Nevertheless, molded to a large extent by external events, including the strategic and symbolic importance of surgery in American medicine, the rise of university medical schools, development of other specialties, and, more recently, the demand for primary care and the incentives built into reimbursement schemes and organized health care systems, internal medicine has become a powerful entity in American medicine. Its role in the future is likely to be more influential than in the past, both in policy and substantive areas. Continuing tensions in internal medicine include uncertainties about the relation between generalism and specialism, primary care and subspecialties, and internal medicine and general medicine. PMID- 3530082 TI - New modes of insulin administration. PMID- 3530081 TI - Hepatic veno-occlusive disease and renal transplantation. PMID- 3530083 TI - How to keep up with the medical literature: IV. Using the literature to solve clinical problems. AB - Ideally, searches for published articles to solve clinical problems should lead to the best evidence on a given topic quickly and at reasonable expense. This goal can be achieved with modern information skills, sources, and services. In this article, we describe and compare various means, from textbooks to computers, that provide access to information of potential value in addressing clinical problems as they arise. Using the problem of understanding and controlling the risk for the acquired immunodeficiency syndrome among personnel of a community hospital, we examined the following sources for their utility in locating journal literature: general and specialty medical texts, personal reprint collections, expert clinicians, recent journal issues, library textbook collections, the Index Medicus "Bibliography of Reviews" and subject index, and MEDLINE computer searching. For this problem, Index Medicus and MEDLINE were the best sources of up-to-date articles, but MEDLINE was three times as fast. PMID- 3530084 TI - [Comparative estimate of the rates of infection with sporozoites and filaria in various forms of the Anopheles gambiae complex in a village in Mali]. PMID- 3530085 TI - [Validation of an EIA test for the determination of anti-toxoplasma IgG antibodies in pre-conception preventive medicine]. PMID- 3530086 TI - [Further discussion on human pseudo-haemogregarines]. PMID- 3530087 TI - [Isoenzyme typing of strains of Plasmodium berghei and Plasmodium yoelii]. PMID- 3530088 TI - [Probable loss of chloroquine resistance in Plasmodium berghei inoculated in Mus musculus previously irradiated with sublethal doses (300 R) of x-rays]. PMID- 3530089 TI - [Activity of 2 aminoglycoside antibiotics in Plasmodium berghei infection in Mus musculus]. PMID- 3530090 TI - Recent progress in nickel carcinogenesis. PMID- 3530091 TI - Nutritional aspects of zinc deficiency in the elderly. PMID- 3530092 TI - Toxicity of aluminium in biological model systems. PMID- 3530093 TI - Cellular mechanisms of aluminium toxicity. PMID- 3530094 TI - [A multicenter study of tinnitus. Epidemiology and therapy]. AB - A comparative, randomized multicenter study of 259 patients with tinnitus had three objectives. First, to conduct an epidemiology survey of cases of tinnitus of less than one year duration. Second, to determine prognostic factors to establish profiles of patients with different courses of the disorder. Third, to quantify therapeutic efficacy of three medicines of the same therapeutic class but with different modes of action: Ginkgo biloba extract, almitrine-raubasine and nicergoline. Statistical analysis of findings showed prognostic significance for 3 parameters: chronicity, periodicity and uni- or bilateral nature of symptom, as well as the value of Ginkgo biloba in the treatment of tinnitus unrelated to its initial description. PMID- 3530095 TI - [Pruritus of chronic renal insufficiency]. PMID- 3530096 TI - Atypical gallbladder content in newborn infants: ultrasonic demonstration. PMID- 3530097 TI - Ultrasonic study of pseudosurgical viral hepatitis. About four cases. PMID- 3530098 TI - Evaluation of the superior vena cava system in children with digital subtraction angiography. PMID- 3530099 TI - Method and results of ultrasound in hip studies. PMID- 3530100 TI - Fetal renal dysplasia: sonographic visualisation of six characteristic patterns with histological correlation. PMID- 3530101 TI - Simple renal cyst and hypertension. PMID- 3530102 TI - Investigations of dilated ureters in children. PMID- 3530103 TI - Acute cholangitis in Singapore. AB - 115 cases of acute calculous cholangitis were analysed for their presentations, treatment and complications. There were slightly more Chinese males than females (1.4:1) and the mean age was 62 years old. Though pain was the commonest symptom (95.7%), only 35.7% of patients had complete Charcot's triad. 21.7% presented in septicaemic shock. E. Coli and Klebsiella were the commonest organisms isolated. All patients had cholecystectomy and exploration of common bile ducts. Twenty patients had additional choledochontrostomy performed. 50.4% of patients developed complications and the overall mortality was 16.5%. Patients over 60 presented in shock carried a significantly higher mortality (40%). PMID- 3530104 TI - Ultrasonography in the diagnosis of cholestatic jaundice. AB - Fifty consecutive patients (32 males and 18 females) with cholestatic jaundice were examined by grey-scale ultrasound from June 1981 to June 1983. All patients were studied without access to case notes. All patients had a diagnosis established by subsequent liver biopsy, clinical course, surgery or autopsy. Using the presence or absence of a dilated biliary system as the criterion, intrahepatic or extrahepatic cholestasis was correctly differentiated in 48 of the 50 patients, giving an overall accuracy of 96%. All 16 patients with intrahepatic cholestasis were correctly identified. Two of the 34 patients with extrahepatic cholestasis, each of whom had biliary stones, were misdiagnosed as intrahepatic cholestasis. In the 34 patients with extra-hepatic cholestasis, site of obstruction was defined in 55.9%, and specific aetiology diagnosed in 44.1%. Ultrasound proves to be an accurate method for the evaluation of cholestatic jaundice, and would have a definite value as a screening test before proceeding to invasive studies. PMID- 3530105 TI - Canine orthotopic liver transplantation--is systemic veno-venous shunting necessary? AB - The experience of a single operating team performing the first 30 consecutive orthotopic liver transplants in dogs is reported. In 22 experiments during the anhepatic phase and as the liver graft is inserted in the recipient animal, the portal circulation is protected by a shunt to the jugular vein. Nine dogs survived 2-17 days. In 8 other unselected animals, both the portal vein and the infrahepatic vena cava were shunted to the jugular vein. Although blood pressure was better maintained in animals with 2 shunts, only one dog survived 10 days. Mention is also made of 11 subsequent transplant operations using a single porta jugular shunt but reducing operating time by having 2 surgeons working on the donor and recipient animal simultaneously. Nine of the 11 dogs survived 2-6 days after the liver transplantation. The survival figures are comparable to those of other centres where double shunting is routinely performed. Our experience suggests that systemic veno-venous shunt may be omitted if the transplant procedure is performed expeditiously. PMID- 3530106 TI - Spontaneous bacterial peritonitis in cirrhotics: clinical and ascitic fluid findings. AB - During a two-year period, 30 patients with spontaneous bacterial peritonitis were documented. All patients had ascites and 70% were alcoholic cirrhosis. Fever and abdominal pain were the most frequent presenting manifestations (96.66% and 76.66% respectively). Triads of fever, abdominal pain and rebound tenderness were found in 40%. A third had hepatic encephalopathy and decreased bowel sound. Ascitic fluid was transudate. Positive ascitic fluid culture and blood culture were obtained in 40% and 59% respectively, and three quarters were due to gram negative enteric bacilli. There was no significant statistic correlation among the result of ascitic fluid gram's stain and ascitic fluid culture, and of ascitic fluid culture and blood culture. The clinical and laboratory findings of patients with positive and negative ascitic fluid culture were similar. Significant increased mortality was found in patients who had hepatic encephalopathy, hypotension, increased bilirubin level and serum creatinine. The over all mortality was 33.33%. We recommend abdominal paracentesis in every cirrhotic patients with ascites who were admitted into hospital. PMID- 3530107 TI - Significant correlation between the immunofluorescence of alpha 2-plasmin inhibitor in glomeruli and the effects of urokinase therapy in patients with IgA nephropathy. AB - Correlation between the deposition of alpha 2-plasmin inhibitor (alpha 2-PI), which is one of the inhibitory factors of fibrinolytic activities, in the glomeruli and the effects of urokinase therapy in patients with IgA nephropathy is described. Urokinase (UK) is a plasminogen activator derived from fresh human urine. Urinalysis and measurements of renal function tests, i.e., serum creatinine, blood urea nitrogen, glomerular filtration rate and phenolsulfonphtalein, were performed before and at 8 and 48 weeks after the administration of urokinase. There was marked improvement of proteinuria after UK therapy in patients without deposition of alpha 2-PI in the glomeruli. In contrast, the improvement of proteinuria after UK therapy was not observed in patients with positive deposition of alpha 2-PI in the glomeruli. It was concluded that the administration of UK may be useful for treatment of proteinuria in patients with IgA nephropathy. PMID- 3530108 TI - [Indications for mechanical anastomoses]. AB - The author critically reviews indications, advantages and disadvantages of EEA staplers in colo-rectal surgery, basing on literature and personal experience. According with the overwhelming majority of scholars, the authors states that the applications of the EEA stapler represent a remarkable advance in the specific field making operations easier and safer. PMID- 3530109 TI - [Carcinoembryonic antigen. Evaluation in intestinal lavage fluids and in the tissue of colorectal tumors]. AB - Carcinoembryonic antigen in pre-operative or pre-endoscopic intestinal lavage rinsing fluids was assayed in 21 healthy subjects, 15 presenting polyps and 12 presenting colorectal cancer. Comparison of the results with those of histological and immunohistological studies showed that this assay did not allow detection of intestinal cancer or evaluation of its developmental stage. PMID- 3530110 TI - Insulin metabolism is a major factor responsible for high or low peripheral insulin levels in response to oral glucose loading in the healthy man. AB - In the present study we evaluated C-peptide peripheral levels after an oral glucose load in 30 healthy subjects (18 females, 12 males, aged from 15 to 55) with high or low insulin response to glucose challenge in order to clarify whether or not their beta-cell secretion rate keeps pace with peripheral insulin levels. Moreover, by the study of the relations between C-peptide and insulin in peripheral blood, we had an insight into the extent of insulin metabolism. On the basis of an insulin incremental area higher or lower than the mean +/- 1 SD after a 100-gram oral glucose load, 6 subjects were classified as 'high insulin responders' and 6 other subjects as 'low insulin responders'. Their insulin incremental area after glucose averaged 0.25 +/- 0.01 nmol X 1-1 X min and 0.078 +/- 0.005 nmol X 1-1 X min, respectively (p less than 0.001). The two groups were matched for sex, age and body weight. The glycemic profile after oral glucose load was higher in low insulin responders than in high insulin responders. C peptide concentrations after glucose load were similar in the two groups, as well as C-peptide incremental areas (0.92 +/- 0.12 vs. 0.74 +/- 0.08 nmol X l-1 X min in high insulin responders and low insulin responders, respectively). The molar ratios of C-peptide to insulin after oral glucose load, as well as the relations between the incremental areas of the two peptides, were significantly lower in high insulin responders than in low insulin responders.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3530111 TI - Effects of the type of dietary fatty acid on the insulin receptor function in rat epididymal fat cells. AB - Feeding young rats diets containing sunflowerseed oil (SSO) or palm oil (PO) induced several differences in the properties of the isolated epididymal fat cells: insulin stimulated deoxyglucose uptake 127% over the basal value in cells of the SSO group but only 47% in those of the PO group; the insulin concentration giving half maximal stimulation differing only slightly; insulin binding to the cells was higher in the SSO group; Scatchard analysis revealed that this was due to a significantly higher number of low-affinity binding sites, and the epididymal fat pad showed a concomitant change in the fatty acid pattern of the phospholipids, reflecting to a limited extent the differences in the composition of the diets. Neither the average diameters of the isolated fat cells, nor the serum insulin level at the time of sacrifice of the rats differed for the two types of dietary fat. These results indicate that a diet high in linoleic acid (SSO) induces a better response of fat cells to insulin than a diet high in saturated fatty acids (PO). PMID- 3530112 TI - The functions of eosinophils. AB - The observations summarized above were made because of the striking associations between peripheral blood eosinophilia and various human diseases. Clinicians caring for patients with asthma have known for years that peripheral blood eosinophilia and marked bronchial and sputum eosinophilia are associated with asthma. As a consequence of studies using the eosinophil granule MBP, we are now able to postulate that eosinophils damage bronchial epithelium during the course of asthma. This model proposes that eosinophils are attracted into bronchial epithelium and degranulate, releasing toxic cationic proteins which cause desquamation and damage to bronchial epithelium. This model explains many of the features of bronchial asthma, but it leaves open the question of the mechanism(s) for eosinophil attraction to the bronchial epithelium. The studies of eosinophils in cutaneous diseases have led to the hypothesis that the eosinophil loses its morphologic integrity in the skin either by degranulation and loss of its characteristic granules or by frank death of the cell. In either event, there is a strong association between deposition of eosinophil granule MBP and cutaneous oedema. Finally, a molecule indistinguishable from eosinophil granule MBP is found in the human placenta. PMID- 3530113 TI - Aspirin-sensitive asthma: a model for a role of platelets in hypersensitivity reactions. PMID- 3530114 TI - Increased phagocytic activity in mice treated by a mouse granuloma protein. AB - Intravenous injection of a protein extracted from a talc-induced granuloma (MGP) enhanced the blood clearance of a highly virulent strain of Salmonella typhimurium. This protein was able to enhance mouse resistance to systemic infection with Listeria monocytogenes when injected one or two days prior to infection. Furthermore, since MGP-treated athymic mice were also protected against Listeria infection, mature T cells were most likely not involved in this enhanced resistance. These findings suggest that this increased resistance to infection correlates with an activation of liver and spleen macrophages. This protective effect of MGP was not due to possible endotoxin contamination of the preparation, as the MGP activity was destroyed by heating. PMID- 3530115 TI - Interference with polyamine biosynthesis and/or function by analogs of polyamines or methionine as a potential anticancer chemotherapeutic strategy. AB - The obvious goal in cancer chemotherapy is selectivity. Highly cytotoxic agents abound but their usefulness as anticancer agents extends only so far as their specificity for tumor cells and tissues. In this context, we have reviewed those aspects of polyamine and AdoMet metabolism and function which might contribute to their potential as target sites for chemotherapeutic intervention. Although largely untested to date and far from unequivocal, these various considerations seem to provide sufficient rationale for continued evaluation of the therapeutic potential of these sites. Polyamine analogs and methionine analogs designed to modulate polyamine biosynthesis directly or through AdoMet formation have been discussed as strategies to effect this goal and previous studies with similar analogs have been reviewed. Progress achieved thus far with analogs derived from our own laboratories provides novel insights into polyamine and AdoMet metabolism and/or function as well as new leads towards the design of more effective agents and drug combinations. More detailed reading of the biochemistry of polyamines in eukaryotes and prokaryotes is available in several very excellent current reviews (6-9, 77). PMID- 3530116 TI - Evaluation of platinol analogs using the M5076 murine sarcoma. AB - The M5076 sarcoma was used to evaluate the antitumor activities of several analogs of Platinol presently undergoing clinical trials. The objective was to find a model yielding preclinical data which correlated with evolving clinical results, and thus potentially provide a validated model for the subsequent testing of new Platinol analogs. The model found to be useful consisted of mice implanted s.c. with M5076 tumor fragments. Platinol, carboplatin, and iproplatin were consistently active (T/C values greater than or equal to 125%), whereas spiroplatin was consistently inactive. These findings reflect the clinical activities of Platinol, carboplatin, and iproplatin and the essential clinical inactivity of spiroplatin thus far reported. PMID- 3530117 TI - Endogenous tumor lectins: overview and perspectives. AB - Lectins are carbohydrate-binding proteins of non-immune origin that can be assayed as agglutinins. They are potential mediators in recognitive processes and cell adhesion by interaction with glycoconjugates. These functions are areas of particular relevance to tumor growth and metastatic spread. The presence of lectins in tumors has first been inferred by histochemical and cytological methods. The biochemical analysis for lectins with various specificities reveals differences in the lectin profile between tumors of different classes (eg, mammary adenocarcinoma, rhabdomyosarcoma, or teratoma) and of the same class (eg, testicular germ cell tumors) and differences in relation to normal tissues. The presence of endogenous lectins in tumors, their relation to lectins of normal tissues, and their interaction with glycoconjugates of tumors and normal tissues may contribute to an understanding of intercellular interactions during the complex process of metastatic spread, and may allow to establish a new tool for diagnosis and a lectin-based therapy. PMID- 3530118 TI - Connective tissue as an active participant in the process of malignant growth. AB - This review deals with the different ways connective tissue stroma is involved both in carcinogenesis and cancer growth. Changes may be regressive or productive, of a quantitative or a qualitative nature. Both cells and extracellular matrix exhibit profound alterations. To explain the diversity of involvement it is argued that tumour cells and stroma form an integrated system that also in malignancy reacts as an entity by virtue of its many functional interrelationships. PMID- 3530119 TI - Cerebrospinal fluid pharmacokinetics of intrathecal morphine sulfate and D-Ala2-D Leu5-enkephalin. AB - Using an implantable pump system to deliver drugs and sample cerebrospinal fluid (CSF), we assessed rostral redistribution and systemic uptake after intrathecal bolus injection and steady-state infusion of morphine sulfate and the opioid peptide D-Ala2-D-Leu5-enkephalin (DADL) in two patients. Following bolus injection, the mean CSF elimination half-lives for morphine sulfate and DADL were 94 and 115 minutes, respectively. With the catheter tip at L2, the ratio of lumbar to cisternal (L/C) concentrations of morphine sulfate was about 7:1, and with the catheter tip at T10, the L/C ratios of morphine sulfate and DADL were approximately 2:1, indicating that this ratio is dependent in part on the level of intrathecal drug administration. CSF levels of morphine sulfate at steady state were three orders of magnitude higher than those in plasma. The CSF pharmacokinetics of morphine sulfate and DADL are similar, with supraspinal redistribution of these opioids via the CSF likely playing an important role in the generation of analgesia and central nervous system side effects. PMID- 3530120 TI - Familial myoclonic dementia masquerading as Creutzfeldt-Jakob disease. AB - We describe a kindred with 7 confirmed and 2 probable cases of subacute dementia accompanied by myoclonus. The inheritance pattern is consistent with autosomal dominance and shows anticipation. The pathological changes involve marked gliosis with neuronal loss of the dorsomedial and midline thalamic nuclei, with lesser involvement of the anterior, lateral, and posterior thalamic nuclei. Medullary olivary hypertrophy is prominent. Spongiform change is minimal or absent. Attempted disease transmission to primates from 3 affected family members has been unsuccessful; Western immunoblot tests have likewise failed to detect the presence of specifically reactive 27-30 kD Mr proteins in brain tissue from 2 of these patients. We conclude that this family has a rare inherited neurological systems degeneration with associated thalamic dementia, the clinical course of which is very similar to Creutzfeldt-Jakob disease. PMID- 3530121 TI - Modification of penicillin-binding proteins as mechanisms of beta-lactam resistance. PMID- 3530122 TI - Plants as sources of antimalarial drugs: in vitro antimalarial activities of some quassinoids. AB - Fourteen quassinoids, obtained from simaroubaceous plants, were tested for in vitro antimalarial activity. All of these inhibited the incorporation of [3H]hypoxanthine into Plasmodium falciparum in vitro at concentrations below 0.41 microgram ml-1. The two most potent quassinoids, bruceantin and simalikalactone D, showed 50% inhibitory concentration values of 0.0008 and 0.0009 microgram ml 1, respectively. The results are compared with the antiamoebic, antileukemic, and cytotoxic activities of these compounds reported in the literature. PMID- 3530123 TI - Penetration of cefuzoname into the cerebrospinal fluid of rabbits. AB - Concentrations of cefuzoname in cerebrospinal fluid (CSF) were determined in a total of 16 rabbits, 5 with healthy meninges, 5 with Staphylococcus aureus meningitis, and 6 with Escherichia coli meningitis. Mean percentages of the maximum concentration of the drug in CSF versus that in serum were 0.57, 3.37, and 4.40% for healthy rabbits, those with staphylococcal meningitis, and those with E. coli meningitis, respectively. The percentages of the area under the concentration-time curve of cefuzoname in CSF versus that in serum were, in the order of healthy group, staphylococcal meningitis group, and E. coli meningitis group, 0.61, 4.99, and 8.04% at 15 to 60 min, 1.44, 7.09, and 12.7% at 15 to 120 min, and 1.87, 8.07, and 15.8% at 15 to 180 min after administration, showing significant differences between the healthy and meningitis groups. All of the values in the E. coli meningitis group were greater than those of the staphylococcal meningitis group, but the differences were not significant. The ratios of the half-life of cefuzoname in CSF to that in serum were 2.10, 1.98, and 3.37 for the healthy, staphylococcal meningitis, and E. coli meningitis groups, respectively, with no significant difference between the three groups. Cefuzoname seems to be among the middle ranks of beta-lactam agents as far as penetration rate is concerned; however, when its potent antibacterial activity and broad spectrum are taken into account, the concentrations in CSF in patients with meningitis seem worth examining. PMID- 3530124 TI - Susceptibility of Eikenella corrodens to newer and older quinolones. AB - The susceptibilities of 44 clinical strains and a reference strain (ATCC 23834) of Eikenella corrodens were determined by agar dilution. All isolates were very susceptible (MICs, less than 2 micrograms/ml) to amifloxacin, ciprofloxacin, difloxacin, enoxacin, norfloxacin, ofloxacin, and Win 35439. PMID- 3530125 TI - Methodology for the study of beta-lactamases. PMID- 3530126 TI - Randomized comparison between two ceftazidime-containing regimens and cephalothin gentamicin-carbenicillin in febrile granulocytopenic cancer patients. AB - Because the results of our published trial [R. Ramphal, B. S. Kramer, K. H. Rand, R. S. Weiner, and J. W. Shands, Jr., J. Antimicrob. Chemother. 12(Suppl. A):81 88, 1983] of ceftazidime versus cephalothin, gentamicin, and carbenicillin (KGC) revealed a preponderance of gram-positive superinfections, including those caused by clostridia, in patients treated with ceftazidime, we added vancomycin to the ceftazidime regimen at study entry 49 and continued with a 2:1 randomized comparison of ceftazidime-vancomycin (CV) versus KGC. Criteria for study entry were fever (temperature, greater than or equal to 38.5 degrees C on one occasion or greater than or equal to 38 degrees C on two occasions 6 h apart) and granulocytopenia (less than 500/mm3 or a falling count anticipated to be less than 500/mm3). Ninety-five entries (79 patients) were evaluable. The numbers of initial clinical responses for ceftazidime-, KGC-, and CV-treated patients were 9 of 21 (43%), 21 of 37 (57%), and 21 of 37 (57%), respectively; differences were not significant. The death rate was lower with CV (2 of 37 patients) than with KGC (10 of 37 patients) (P less than 0.05 by two-tailed analysis) or with ceftazidime alone (7 of 21 patients) (P less than 0.025). Death from presumed infections occurred in 9 of 37 KGC-treated patients versus 1 of 37 CV-treated patients (P less than 0.025). Superinfections occurred in five ceftazidime treated patients (24%) versus 7 KGC-treated patients (19%) but not in CV-treated patients (CV versus KGC, P less than 0.05; CV versus ceftazidime, P less than 0.01). CV appears to be superior to KGC or ceftazidime alone in the management of febrile granulocytopenic cancer patients. PMID- 3530127 TI - Lincomycin stimulates synthesis of TEM-2 beta-lactamase by Escherichia coli. AB - Lincomycin increased the TEM-2 beta-lactamase activity of Escherichia coli K-12 cells carrying plasmid RP4 at a concentration which slightly inhibited cell growth. In a control culture beta-lactamase activity reached its maximal level in late log phase, whereas when lincomycin was present beta-lactamase activity continued to increase into the stationary phase. Lincomycin (100 micrograms/ml) inhibited both cell growth and protein synthesis by about 35% but stimulated beta lactamase activity 2.5-fold per ml of culture and about 4-fold per cell after 20 h of growth. The amount of beta-lactamase produced in each culture was also compared by densitophotometry of a stained sodium dodecyl sulfate-polyacrylamide gel. The relative values were in good agreement with the relative enzyme activities, indicating that the stimulatory effect of lincomycin was due to an increase in the amount of beta-lactamase protein. Inactivation of beta-lactamase appeared to be faster when lincomycin was present. This was determined by measuring the decrease in beta-lactamase activity when phenethyl alcohol was present to prevent maturation of the enzyme. There was no significant difference in plasmid copy number between the cells grown in the presence or absence of lincomycin. These results indicate that lincomycin stimulates transcription, translation, or translocation of beta-lactamase. PMID- 3530128 TI - Double-blind, prospective, multicenter trial comparing ceftazidime with moxalactam in the treatment of serious gram-negative infections. AB - Ceftazidime is a new antimicrobial agent possessing excellent in vitro activity against most members of the family Enterobacteriaceae and against Pseudomonas aeruginosa. We conducted a double-blind, prospective, multicenter trial to compare ceftazidime with moxalactam in the treatment of serious gram-negative infections. The overall favorable response rates for the two regimens were similar (93 of 106 [88%] and 84 of 97 [86%], respectively). Among these, the response rates of the 56 gram-negative bacteremias and the 23 P. aeruginosa infections were comparable. Both groups had similar incidences of subsequent infections with P. aeruginosa, enterococci, and yeasts. A total of 13% of the patients in the moxalactam group developed a prolonged prothrombin time (P less than 0.01), and three patients demonstrated clinical bleeding. These results suggest that although the overall efficacy of both regimens was similar, treatment with moxalactam resulted in a higher incidence of prolongation of prothrombin time with an attendant risk of bleeding. In nonneutropenic patients, ceftazidime as a single agent is safe and effective in gram-negative bacillary infections. PMID- 3530129 TI - Medicare regulations on OR circulator final; subcommittee hears testimony on Medicare physician payment reform. PMID- 3530130 TI - Alzheimer's disease. Using direct drug infusion to the central nervous system. PMID- 3530131 TI - The many faces of the liability insurance crisis. AB - The purpose of this column is to provide an overview of some of the issues and arguments encompassed in the liability insurance crisis, and to impress upon nurses that they can no longer view them as relevant to physicians and hospitals only. This brief overview cannot cover all you need to know before making decisions about insurance or forming strategies to address your state regulations. It is intended to provide you with an impetus to work within your state nurses' association to learn more. PMID- 3530132 TI - DNA probes for clinical applications. Patents and literature. PMID- 3530133 TI - Metabolism of the herbicide bromoxynil by Klebsiella pneumoniae subsp. ozaenae. AB - Enrichment of soil samples for organisms able to utilize the herbicide bromoxynil (3,5-dibromo-4-hydroxybenzonitrile) as a nitrogen source yielded bacterial isolates capable of rapidly metabolizing this compound. One isolate, identified as Klebsiella pneumoniae subsp. ozaenae, could completely convert 0.05% bromoxynil to 3,5-dibromo-4-hydroxybenzoic acid and use the liberated ammonia as a sole nitrogen source. Assays of cell extracts of this organism for the ability to produce ammonia from bromoxynil revealed the presence of a nitrilase (EC 3.5.51) activity. The enzyme could not utilize 3,5-dibromo-4-hydroxybenzamide as a substrate, and no 3,5-dibromo-4-hydroxybenzamide could be detected as a product of bromoxynil transformation. Comparison of related aromatic nitriles as substrates demonstrated that the Klebsiella enzyme is highly specific for bromoxynil. PMID- 3530134 TI - Physical and immunological analysis of the two domains isolated from a variant surface glycoprotein of Trypanosoma brucei. AB - A specific surface glycoprotein of a variant of Trypanosoma brucei was cleaved with trypsin and the two major domains of the molecule have been purified. We have studied the chemical composition of each domain and compared the data to published results of the specific cDNA sequence. Circular dichroism measurements show that the amino-terminal domain includes preferentially alpha-helical or beta sheet structure. The physicochemical analyses are supplemented by a prediction of secondary structure and a statistical pattern of hydrophilicity-hydrophobicity. The results are discussed in light of the internal limits that were described in the process of partial gene conversion occurring between the variant gene sequence and related members of the same gene family. Immunoblots with homologous antiserum indicate that the amino-terminal domain is implicated in antigenicity. In addition, immunoblotting with heterologous antiserum on native antigen, tryptic hydrolysates, or purified domains suggests a site of interaction supported by the two domains. PMID- 3530135 TI - Preferential action of rat brain cathepsin B as a peptidyl dipeptidase converting pro-opioid oligopeptides. AB - Purified rat brain cathepsin B (EC 3.4.22.1) converted prodynorphins or proenkephalins to shorter active forms by the preferential removal of C-terminal dipeptides. The substrate affinities for Met-enkephalin-Arg-Phe or -Arg-Gly-Leu were Km 46 and 117 microM, and kcat/Km ratios were 67 and 115 microM-1, min-1, respectively. Met-Enkephalin was inactivated by the same mechanism (Km-450 microM; kcat/Km = 0.12 microM-1 min-1). The comparison of cathepsin B hydrolysis for pro-opioids, a synthetic hexapeptide and its fragments, C-blocked peptides (pro-opioid amides, Met-enkephalin amide, substance P), and bovine myelin basic protein, provided information on the influence of the C-terminal residues on dipeptide release, the rates as correlated to peptide length, and the optimal arrangement of residues favoring scission at the P1-P'1 sites. The brain enzyme was stereospecific and did not act on peptides with C-terminal D-amino acid substituents. Arg hindered and Pro blocked the release of C-terminal dipeptides when in the P'2 positions. The suppression of dipeptide release by agents inhibiting endopeptidase actions such as E-64 and leupeptin, and the endogenous brain factor (cerebrocystatin) point to similar catalytic mechanisms for the exopeptidase action. PMID- 3530136 TI - Conformational properties of membrane-bound fumarate reductase of Escherichia coli. AB - Anaerobically grown cells of Escherichia coli harboring the plasmid pFRD63 over produce fumarate reductase, a membrane-bound complex localized in the inner membrane of the cell, where this enzyme represents at least 90% of the total membrane proteins (B. D. Lemire, J. J. Robinson, and J. H. Weiner (1982) J. Bacteriol. 152, 1126-1131). Preparations of inner membrane fractions suspended in 40% sucrose are optically clear, allowing optical spectroscopic measurements. Circular dichroism spectra showed that between pH 6 and 11 the secondary structure of the enzyme is at least 55% in alpha helix and that above pH 11 the structure abruptly changes to a beta-like conformation. The same phenomenon is observed in samples solubilized in the nonionic detergent C12E9. Absorption spectra of the enzyme either membrane bound or solubilized in detergents or exposed to alkaline pH showed that the accessibility of the active site to solvent components is modulated by the interaction of the protein with the membrane. Solubilization of the membrane-bound enzyme with 1% Triton X-100 or C12E9 produced a decrease in ellipticity and in enzymatic activity. PMID- 3530137 TI - [Comparative clinical study of MF(mitomycin and 5-fluorouracil) and MF.BH-AC therapy]. AB - Sunrabim for injection (BH-AC), one of the antitumor agents available for acute leukemia, has considerable activity against a variety of transplanted solid tumors in rats and mice. A comparative clinical study was performed by randomized controlled trial on two different combined chemotherapies of MMC, 5-FU (MF group), and MMC, 5-FU, BH-AC (MF . BH-AC group) for 64 patients with a variety of solid cancers. Among 64 patients, 47 were evaluable for response (MF group: 23/32, MF . BH-AC group: 24/32). The partial response rate of the MF group was 4.3% (1/23), and that of the MF . BH-AC group was 33.3% (8/24). MF . BH-AC therapy was found to be more effective than MF therapy. The toxicity rates of the two therapies were similar (MF group: 46.7%, MF . BH-AC group: 50.0%). This study suggests that combined chemotherapy of MF plus BH-AC is more effective on a variety of solid cancers in comparison to MF therapy. PMID- 3530138 TI - [A comparative study of mitoxantrone and adriamycin in patients with non Hodgkin's lymphoma: a preliminary result]. AB - In order to compare the efficacy and toxicity of mitoxantrone and adriamycin in non-Hodgkin's lymphoma, a randomized trial has been conducted by a cooperative study group since June 1984. Previously untreated patients with non-Hodgkin's lymphoma of intermediate-grade-malignancy were allocated to either MCOP (a combination of mitoxantrone, cyclophosphamide, vincristine, and prednisolone) or CHOP (a combination of adriamycin, cyclophosphamide, vincristine, and prednisolone) regimens. Forty-four patients were entered and 43 of these were fully evaluated for tumor response and toxicity. The complete remission rate was 80% for 20 patients receiving MCOP compared to 61% for 23 patients treated with CHOP. Response duration and overall survival were similar for the two treatments. Toxicity was almost comparable for the two treatments. Only alopecia was significantly less frequent in patients given MCOP than in those receiving CHOP. Mitoxantrone thus appears to be as effective as adriamycin in the treatment of non-Hodgkin's lymphoma. PMID- 3530139 TI - [Results of clinical trials with a CMitF (cyclophosphamide, mitoxantrone, and 5 fluorouracil) regimen versus a CAF (cyclophosphamide, adriamycin, and 5 fluorouracil) regimen in advanced/relapsed breast cancer]. AB - Randomized clinical trials were conducted in patients with advanced/relapsed breast cancer, using CMitF (mitoxantrone, cyclophosphamide, and 5-fluorouracil) regimen in comparison with CAF (cyclophosphamide, adriamycin, and 5-fluorouracil) regimen. The response rate was 50% (13/26) for the CMitF group and 50% (10/20) for the CAF group. Classified by disease site, CAF group showed a tendency for a higher response rate in soft tissue, but in bone and viscera the rates were similar for both regimen groups. The median weeks to response (range) was 5 (3 21) weeks for the CMitF group, and 8 (3-22) weeks for CAF group, a tendency for slightly earlier response thus being shown in the CMitF group. The median duration of response (range) was 10 (4-47) weeks for the CMitF group, and 9 (4 50) weeks for CAF group, whereas by the method of Kaplan-Meier, at 40 weeks after the start of therapy, the proportion showing response still continued to be 60% for the CMitF group, which was a higher rate than the 27% for CAF group. The survival rate at 48 weeks was for both groups with no difference shown. Leukopenia, gastrointestinal symptoms and alopecia were major side effects in both groups, but the incidence and severity grade of gastrointestinal symptoms (nausea and vomiting) and alopecia were significantly less in the CMitF group than in CAF group. In both groups, the WBC nadir was 2,100/microliter and the time to nadir was 14 days, with no difference shown in hematological toxicity between the two groups. No severe cardiac, hepatic, or renal toxicity was noted. PMID- 3530140 TI - [A phase III study of BHAC-MMP (behenoyl-ara-C, mitoxantrone, 6-mercaptopurine prednisolone) in acute leukemia. Hanshin Cooperative Study Group of Hematological Disorders]. AB - BHAC-MMP therapy, a combination of behenoyl-ara-C, mitoxantrone, 6-mercaptopurine and prednisolone, was applied to 49 patients with acute leukemia for remission induction. Complete remission was obtained in 6 out of 11 previously untreated patients (55%), and in 16 of 38 pretreated patients (42%). Median duration of complete remission was 41 weeks in previously treated patients, while 67% of untreated patients were still in complete remission. Most frequent side effects other than hematological toxicities were gastrointestinal disturbances, and GPT elevation etc., although most of these were not severe. In conclusion, BHAC-MMP therapy seems to be very promising for remission induction or for possible intensification treatment for acute leukemia. PMID- 3530141 TI - Serine proteinases in human cutaneous mastocytosis. AB - The main chymotryptic and tryptic proteinases of human skin were found in high salt extracts of human dermis. The levels of these enzymes were markedly increased in salt extracts of human cutaneous mastocytosis as compared to the levels found in extracts of involved skin from the same patients, human cutaneous hemangiomas, and normal human skin. These data suggest that the chymotryptic and tryptic proteinases of human skin are primarily of mast-cell origin. PMID- 3530142 TI - Ruthenium nitrosyl complexes: toxicity to Escherichia coli and yeasts and uptake by marine bacteria. PMID- 3530143 TI - [Ureteral fistula after renal transplant. Surgical treatment]. PMID- 3530144 TI - [Determination of tumor extension in renal cancer using echography, axial computed tomography and arteriography. A comparative study (II)]. PMID- 3530145 TI - [Thrombosis of the renal vein in the transplanted kidney]. PMID- 3530146 TI - Management of the diabetic transplant recipient. PMID- 3530147 TI - Common complications of immunosuppression in the renal transplant patient, (continuing education credit). PMID- 3530148 TI - [Effect of maintaining a strain of Plasmodium berghei Anka on gametogenesis]. PMID- 3530149 TI - [Parasitological and serological observations during pregnancy in mice infected with Plasmodium berghei]. PMID- 3530150 TI - A tradition of humanism. The voluntary hospital. PMID- 3530151 TI - Extracorporeal membrane oxygenation (ECMO) in neonatal respiratory failure. 100 cases. AB - Extracorporeal membrane oxygenation (ECMO) was used in the treatment of 100 newborn infants with respiratory failure in three phases: Phase I (50 moribund patients to determine safety, efficacy, and risks); Phase II (30 high risk patients to compare ECMO to conventional ventilation); and Phase III (20 moderate to high risk patients, the current protocol). Seventy-two patients survived including 54% in Phase I, 90% in Phase II, and 90% in Phase III. The major complication was intracranial bleeding, which occurred in 89% of premature infants (less than 35 weeks) and 15% of full-term infants. Best survival results were in persistent fetal circulation (10, 10 survived), followed by congenital diaphragmatic hernia (9, 7 survived), meconium aspiration (44, 37 survived), respiratory distress syndrome (26, 13 survived), and sepsis (8, 3 survived). There were seven late deaths; in follow-up, 63% are normal or near normal, 17% had moderate to severe central nervous system dysfunction, and 8% had severe pulmonary dysfunction. ECMO is now used in several neonatal centers as the treatment of choice for full-term infants with respiratory failure that is unresponsive to conventional management. The success of this technique establishes prolonged extracorporeal circulation as a definitive means of treatment in reversible vital organ failure. PMID- 3530152 TI - The outcome of 304 primary renal transplants in children (1968-1985). AB - Of 304 children who received primary renal transplants at the University of Minnesota between January 1, 1968, and December 31, 1985, 48 (16%) were under the age of 24 months, 60 (20%) were 2-5 years old, and 196 (64%) were 6-17 years old at transplantation. Currently, 254 (84%) are alive at 2 months to 18 years following their first transplants, 77% with functioning grafts (188 first, 45 retransplants) and 7% on dialysis. Overall, patient and graft survival were not significantly different from the primary graft outcome of nondiabetic adults. The actuarial primary graft function rates at 1, 5, and 10 years were 100, 100, and 90% in 16 HLA-identical sibling kidneys; 84, 64, and 52% in 210 mismatched related kidneys; and 72, 54, and 47% in 78 cadaver kidneys (p less than 0.002). The 1-year patient survival and primary graft function rates in 44 mismatched related recipients under the age of 24 months were 92 and 88%. The use of deliberate, pretransplant random blood transfusion since 1979 has been associated with a decreased rejection rate. Primary graft function of mismatched related kidneys in children receiving standard immunosuppression has significantly improved from 78% at 1 year in the pretransfusion era to 91% (p less than 0.01) in the transfusion era. The overall primary cadaver graft function rate, however, did not improve in the transfusion era. Whether cyclosporine use will improve the cadaver renal allograft function in very young recipients remains to be established. However, with the use of related donors, even very young children can be transplanted safely and with excellent results. PMID- 3530153 TI - New method of hepatocyte transplantation and extracorporeal liver support. AB - A technique has been developed by the authors that allows hepatocyte attachment on collagen-coated microcarriers resulting in prolonged hepatocyte viability and function both in vivo and in vitro. Rat hepatocytes were obtained by portal vein collagenase perfusion. Intraperitoneally transplanted microcarrier-attached normal hepatocytes into congeneic Gunn rats were functioning 3-4 weeks later, as shown by the presence and persistence of conjugated bilirubin in recipient bile, sustained decrease in serum bilirubin, uptake of Tc99m-DESIDA, and morphologic criteria. Intraperitoneal transplantation of normal microcarrier-attached hepatocytes into genetically albumin deficient rats (NAR) resulted in marked increase in plasma albumin levels (6 days without and 21 days with Cyclosporin A immunosuppression). Microcarrier-attached hepatocytes transplanted after 2 weeks of storage at -80 C into congeneic Gunn rats were viable and functional as assessed by criteria outlined above. An extracorporeal liver perfusion system was developed using the microcarrier-attached hepatocytes that was capable of synthesizing and conjugating bilirubin and synthesizing liver-specific proteins. PMID- 3530154 TI - Cardiac transplantation. Emerging from an experiment to a service. AB - Cardiac transplantation was resumed at the University Health Center of Pittsburgh in 1980 after a hiatus of 12 years. Prior to April 15, 1986, 270 hearts had been transplanted. Participants have been forced to reorder personal, professional, and institutional commitments to adapt to new demands of pre- and post-operative care and to develop flexibility in the operative scheduling of routine cardiac surgical cases. The actuarial survival has been 78, 69, and 64% at 1, 2, and 3 years. Much has been learned about evolving immunosuppression based on cyclosporine and of the allogenic response. An increasing proportion of recipients are mortally ill (54%), and for these urgent patients the wait for a donor organ continues to lengthen. The cardiac surgeon performing transplantations will need to grow with allied developments in xenotransplantation and mechanical cardiac support devices in order to keep pace with his evolving specialty. PMID- 3530155 TI - Use of the donor specific transfusion protocol in living-unrelated donor recipient combinations. AB - The scarcity of suitable cadaver or living-related kidneys remains the major problem in renal transplantation. The use of the donor-specific transfusion protocol (DST) has allowed for the expansion of the donor pool to one- and two haplotype mismatched living-related donor-recipient combinations. This study deals with the use of DST in living-unrelated donor-recipient combinations (LURD). The following 34 LURD combinations were entered: husband to wife; wife to husband; friend to friend; stepfather; brother-in-law and sister-in-law. Donor specific sensitization occurred in 21%. Actuarial graft survival at 4 years is 92.6%, and patient survival is 100%. It is concluded that this study indicates that the results with the use of LURDs equal the results with living-related donors and, therefore, it is suggested that the use of LURDs can be considered in situations when a medically and ethically acceptable unrelated donor is available. PMID- 3530156 TI - Monthly antimalarial chemotherapy to children in a holoendemic area of Liberia. AB - Two hundred and eighty-two children, two to nine years old, were included in a prospective three-year study in four villages with holoendemic malaria. In three villages the children received monthly doses of either chloroquine, pyrimethamine or chlorproguanil respectively for two years. In the fourth, vitamin tablets were used as placebo. Presumptive treatment with chloroquine (10 mg base kg-1) was given to all children with fever of suspected malarial origin. The two-year drug distribution was satisfactorily fulfilled to 168 children. Surveys, including physical and laboratory examinations were performed every six months, four weeks after medication. A fifth village was only visited at the start of the study and after two years. The mean crude parasite rate was initially 92%. Plasmodium falciparum was the main species. Splenomegaly was recorded in all children. In the chloroquine-treated children, the parasite rates varied between 30% and 50% during the study. By the end of the second year the spleen rate was reduced from 100% to 50%. Reported episodes of fever were reduced to half and mean haematocrit levels increased by 6% in comparison with children receiving the placebo. Total IgG concentrations were reduced from 36.7 g l-1 to 25.9 g l-1, whereas no significant decrease was observed in malarial seropositivity as measured by indirect immunofluorescence. Chlorproguanil had a weaker impact on parasitaemia with parasite rates between 50% and 90%. However, the spleen rate was reduced to 67% and there was a significant reduction of reported fever episodes. Mean haematocrits increased by 4%. Total IgG decreased from 31.8 g l-1 to 23.8 g l-1. In contrast, in the pyrimethamine group, the placebo group and the untreated group from the fifth village, the malariometric indices after two years were comparable to each other and to the initial values. During the third year only presumptive chloroquine treatment was given, and by the end of the study all malariometric indices were again comparable. From clinical observations there was no apparent impairment of protective immunity to malaria from the two years of regular distribution of the drugs. We conclude that a certain degree of malaria control could be achieved in Liberian children by the administration of monthly doses of chloroquine 10 mg base kg-1. The administration of chlorproguanil (1.5 mg kg-1) represents an alternative regimen. PMID- 3530157 TI - Analogues of N-benzyloxydihydrotriazines: in vitro antimalarial activity against Plasmodium falciparum. AB - The antimalarial activities of a series of chlorophenyloxyalkoxy and chlorophenalkoxy N-substituted diamino-dihydrotriazines were determined in vitro against three strains of Plasmodium falciparum (Malayan Camp, Vietnam Smith, FCB) with diverse levels of resistance to chloroquine, pyrimethamine, and cycloguanil. Parasite viability was assayed by the inhibition of the uptake of radiolabelled hypoxanthine. Most of the ID-50S of these compounds were less than 1.0 ng ml-1. Consistent differences in sensitivities to these compounds were observed and appeared to be strain related. The Malayan Camp was the most sensitive and Vietnam Smith was the least sensitive. These differences appeared to be related primarily to an inherent sensitivity of a particular strain to the series of analogues examined rather than to a pattern of cross-resistance to chloroquine, pyrimethamine, or cycloguanil. PMID- 3530158 TI - The prevention of anaemia in pregnancy in primigravidae in the guinea savanna of Nigeria. AB - Two hundred Hausa primigravidae at Zaria were divided into five groups in a randomized double-blind trial of antenatal oral antimalarial prophylaxis, and haematinic supplements. Group 1 received no active treatment. Groups 2 to 5 were given chloroquine 600 mg base once, followed by proguanil 100 mg per day. In addition, group 3 received iron 60 mg daily, group 4 folic acid 1 mg daily, and group 5 iron plus folic acid. Forty-five percent were anaemic (haemoglobin (Hb) less than 11.0 g dl-1) at first attendance before 24 weeks of gestation, and malaria parasitaemia (predominantly Plasmodium falciparum) was seen in 27%, of whom 60% were anaemic. The mean Hb fell during pregnancy in group 1, and seven patients in this group had to be removed from the trial and treated for severe anaemia (packed cell volume (PCV) less than 0.26). Only five patients in the other groups developed severe anaemia (P = 0.006), two of whom had malaria following failure to take treatment. Patients in group 1 had the lowest mean Hb at 28 and 36 weeks of gestation, and patients receiving antimalarials and iron (groups 3 and 5) had the highest Hb at 28 weeks, but differences were not significant, possibly due to removal from the trial of patients with severe anaemia. Anaemia (Hb less than 12.0 g dl-1) at six weeks after delivery was observed in 61% of those not receiving active treatment (group 1), in 39% of those protected against malaria but not receiving iron supplements (groups 2 and 4) and in only 18% of patients receiving both antimalarials and iron (groups 3 and 5). Folic acid had no significant effect on mean Hb. Proguanil was confirmed to be a highly effective causal prophylaxis. Prevention of malaria, without folic acid supplements, reduced the frequency of megaloblastic erythropoiesis from 56% to 25%. Folic acid supplements abolished megaloblastosis, except in three patients who were apparently not taking the treatment prescribed. Red cell folate (RCF) concentrations were higher in subjects with malaria, probably due to intracellular synthesis by plasmodia. Infants of mothers not receiving antimalarials appeared to have an erythroid hyperplasia. Maternal folate supplements raised infants' serum folate and RCF. Fourteen per cent had low birth weight (less than 2500 g), and the perinatal death rate was 11%; the greatest number were in group 1, but not significantly. A regime is proposed for the prevention of malaria, iron deficiency, folate deficiency and anaemia in pregnancy in the guinea savanna of Nigeria. PMID- 3530159 TI - 3H-hypoxanthine incorporation into fresh and stored blood: implications for resistance determination in P. falciparum malaria. PMID- 3530160 TI - Mechanical decalcification of the aortic valve. AB - Thromboembolism and anticoagulant-related complications secondary to prosthetic aortic valve replacement constitute a significant risk (28% at 5 years). From 1978 through 1984, decalcification of the aortic valve was performed in 8 patients who were undergoing coronary artery revascularization. Preoperative gradients of between 30 and 80 mm Hg (mean, 50 mm Hg) were abolished after operation. To determine the viability of decalcification, the records of 84 additional patients who had undergone this procedure between 1959 and 1978 were reviewed (86% before 1965). There were 60 male and 32 female patients ranging from 14 to 74 years old (mean, 49 years). The cause of the calcification was a bicuspid valve in 32 patients (35%), senile calcification in 9 (10%), and rheumatic fever in 50 (54%); the cause in 1 patient was unknown. Thirty-day mortality was 13%. Follow-up was 98% complete and ranged from 6 months to 22 years (mean, 7 years). Aortic valve replacement was subsequently required in 25 patients. Freedom from reoperation at 1, 5, 10, and 15 years was 98%, 75%, 43%, and 26%, respectively, for patients with rheumatic valves compared with 97%, 76%, 57%, and 51%, respectively, for those with bicuspid valves. Survival for patients with rheumatic valves at 1, 5, 10, 15, and 20 years was 93%, 70%, 48%, 40%, and 35%, respectively, compared with 100%, 66%, 57%, 46%, and 46% for patients with bicuspid valves. At follow-up, 61% of the patients were in New York Heart Association Functional Class I or II. Causes of late death were valve related (30%), congestive heart failure (27%), and myocardial infarction (24%).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3530161 TI - Reduction of infection after cardiac surgery: a clinical trial. AB - Between January 1, 1975, and June 1, 1984, 3,275 patients underwent cardiac operations with cardiopulmonary bypass. No operations were performed in 1978. In Phase I of the study, general operating rooms were used for cardiac operations, and standard methods of antisepsis and asepsis were used. Phase II began in January, 1979, with the opening of two specially constructed operating rooms with complete separation of incoming and outgoing personnel and supplies, and with a laminar airflow system. All personnel scrubbed 3 minutes and changed into autoclaved clothing before entering the operating suite, and scrubbed again for 5 minutes before putting on gowns. By Phase III, which began in July, 1982, all additional protocols against infection were in place including strict techniques in the intensive care unit and a continuous antiinfection surveillance program. In Phase I, 7.3% (70% confidence limits [CL] 6.4 to 8.2%) of patients had an infectious complication; in Phase II, 2.7% (CL 2.3 to 3.2%), and in Phase III, 0.8% (CL 0.5 to 1.2%). The reductions were similar in the four subtypes of infection (superficial presternal infection, mediastinitis, endocarditis, and septicemia). The study indicates that improving the surgical environment, improving the surgical and operating room protocols, and increasing the awareness of the dangers of infection among the personnel can strikingly reduce the incidence of infections after cardiac operations. PMID- 3530162 TI - Primary anterior mediastinal tumors in children and adults. AB - This review details pertinent anatomical, radiological, pathological, and clinical information regarding primary anterior mediastinal tumors. Although the majority of these lesions are included in one of several subgroups, for example, thymic tumors, teratomas, or thyroid abnormalities, other less common entities will occasionally be encountered by the practicing surgeon. Likewise, there are variations in the frequency distribution of anterior mediastinal lesions in children as opposed to adults. Management of these individual lesions is outlined. PMID- 3530163 TI - Renography with captopril. Changes in a patient with hypertension and unilateral renal artery stenosis. AB - In a 56-year-old man with severe familial hypertension and unilateral renal artery stenosis, captopril induced striking changes in the renograms of the affected kidney. After injection of orthoiodohippurate sodium I 131, the uptake phase was unchanged but the later curve showed continuous accumulation. In contrast, the uptake of technetium Tc 99m diethylenetriamine pentracetic acid was abolished. These changes are compatible with a cessation of filtration and maintenance of renal blood flow. After balloon dilatation of the stenosis, the blood pressure became lower, and these changes could no longer be demonstrated. The captopril renogram may provide useful information on the dependency of hypertension on unilateral renal artery stenosis. PMID- 3530164 TI - Acute pancreatitis in patients with end-stage renal disease without transplantation. AB - Acute pancreatitis is infrequently described in patients with end-stage renal disease (ESRD) who have not undergone transplantation. We observed 35 attacks of acute pancreatitis in 23 of 1001 patients with ESRD and one additional patient with irreversible acute renal failure, during a ten-year period. Pancreatitis occurred more frequently in association with peritoneal dialysis than with hemodialysis. Four patients died of complications related to a pancreatic pseudocyst, and a fifth died from hemorrhagic pancreatitis. The ten-year incidence of pancreatitis was 2.3% and the overall mortality was 20.8% in patients with ESRD treated without transplantation. We conclude that clinically evident acute pancreatitis occurs more often than has been previously recognized in patients with ESRD who have not undergone transplantation and, particularly, in those patients managed with peritoneal dialysis. PMID- 3530165 TI - Nonassociation of caffeine and fibrocystic breast disease. AB - Fibrocystic breast disease (FBD) is common in women. Caffeine-containing foods and beverages have been implicated as a cause of FBD or as an important factor in its progression. Relationships of causation are difficult to demonstrate. Only rigorous investigational methods can show true association between cause and effect. Our critical review of the medical literature indicated that there is weak evidence for an association between caffeine and FBD. We conclude that physicians need not recommend the avoidance of caffeine in otherwise healthy women who have FBD. PMID- 3530166 TI - Aging and the kidney. AB - Numerous anatomic and physiologic alterations occur in the kidney with aging. These changes affect the ability of elderly patient(s) to maintain homeostasis and alter response to medications, stress, illness, or changes in diet, mobility, or environment. Drug-induced illness and drug interactions are major problems in the elderly. Bone disease and fractures are associated with negative calcium balance and decreased production of 1,25-dihydroxycholecalciferol seen with aging. The geriatric patient is not immune to the primary glomerular diseases that occur in younger patients, although the relative incidence of pathologic diagnoses may differ. The high incidence of membranous glomerulonephritis in the elderly, and the well-known association between malignancy and membranous nephropathy strongly favor aggressive evaluation of the nephrotic syndrome in the geriatric age group. Attention must be given to consideration of appropriate end stage renal disease treatment alternatives for the geriatric population, which now comprises the fastest-growing segment of the end-stage renal disease population. PMID- 3530167 TI - Hypotension with postural syncope secondary to the combination of chlorpromazine and captopril. AB - A 49-year-old man with severe hypertension and chronic schizophrenia developed marked hypotension with postural syncope following therapy with the combination of chlorpromazine and captopril. Previously, the patient's blood pressure (BP) had been poorly controlled on a regimen of chlorpromazine and hydrochlorothiazide, nadolol, and prazosin. The supine and standing BP and 24 hour ambulatory BP were subsequently studied while the patient was maintained on chlorpromazine and captopril, chlorpromazine alone, and on no therapy. Chlorpromazine alone caused a moderate reduction in supine and standing BP with a reversal of the circadian BP profile. The combination of chlorpromazine and small doses of captopril (12.5 mg/d) induced a reduction in supine BP of 84/32 mm Hg compared with chlorpromazine alone and exaggerated the postural hypotension. Hormonal investigation demonstrated low baseline renin activity that increased during therapy with captopril and a physiologic catecholamine response to change in posture. These data demonstrate that there is a synergism between captopril and chlorpromazine that may result in marked, symptomatic hypotension that is probably unrelated to the baseline level of plasma renin activity or catecholamines. PMID- 3530168 TI - Effect of anticalmodulin drugs on the action of yeast alpha factor pheromone. AB - Saccharomyces cerevisiae alpha factor pheromone arrest growth of cells of the a mating type (MAT a) at the G1 phase of the cell cycle. When treatment of MAT a cells with alpha factor was carried out in the presence of anticalmodulin drugs, trifluoperazine or chlorpromazine, the extent of cell growth arrest induced by alpha factor was reduced or even became undetectable. These results lend support to the hypothesis that calmodulin plays a role as mediator in the action of alpha factor on MAT a cells. PMID- 3530169 TI - Analysis of the energy metabolism after incubation of Saccharomyces cerevisiae with sulfite or nitrite. AB - After addition of 5 mM sulfite or nitrite to glucose-metabolizing cells of Saccharomyces cerevisiae a rapid decrease of the ATP content and an inversely proportional increase in the level of inorganic phosphate was observed. The concentration of ADP shows only small and transient changes. Cells of the yeast mutant pet 936, lacking mitochondrial F1 ATPase, after addition of 5 mM sulfite or nitrite exhibit changes in ATP, ADP and inorganic phosphate very similar to those observed in wild type cells. They key enzyme of glucose degradation, glyceraldehyde-3-phosphate dehydrogenase was previously shown to be the most sulfite- or nitrite-sensitive enzyme of the glycolytic pathway. This enzyme shows the same sensitivity to sulfite or nitrite in cells of the mutant pet 936 as in wild type cells. It is concluded that the effects of sulfite or nitrite on ATP, ADP and inorganic phosphate are the result of inhibition of glyceraldehyde-3 phosphate dehydrogenase and not of inhibition of phosphorylation processes in the mitochondria. Levels of GTP, UTP and CTP show parallel changes to ATP. This is explained by the presence of very active nucleoside monophosphate kinases which cause a rapid exchange between the nucleoside phosphates. The effects of the sudden inhibition of glucose degradation by sulfite or nitrite on levels of ATP, ADP and inorganic phosphate are discussed in terms of the theory of Lynen (1942) on compensating phosphorylation and dephosphorylation in steady state glucose metabolizing yeast. PMID- 3530170 TI - [Leopold Szondi (1893-1986)]. PMID- 3530171 TI - [Primary intestinal lymphangiectasis with antenatal manifestation]. AB - Antenatal ascites diagnosed by ultrasound examination was punctured and shunted in utero. Radiologic, endoscopic and histologic data led to diagnosis of primitive intestinal lymphangiectasia during the second year of life. Antenatal revelation of Waldmann's disease is extremely rare in pediatric literature. PMID- 3530172 TI - [A Parisian case of congenital malaria]. AB - A case of symptomatic congenital malaria (Plasmodium vivax) was diagnosed and treated in a 3 week-old girl in Paris. This led to discuss the characteristics of transplacental contamination and symptomatology of congenital malaria and the methods for diagnosis and treatment of this very rare disease. PMID- 3530173 TI - [Radiologic case of the month. Ultrasonic diagnosis of duodenal duplication in the neonatal period]. PMID- 3530174 TI - [Early diagnosis of cerebral malformations]. PMID- 3530175 TI - [Homozygous C6 deficiency disclosed by Streptococcus A infection]. PMID- 3530176 TI - [Combination chemotherapy of disseminated skin melanoma with nitrosomethylurea]. AB - Since 1971 the efficacy of a combination chemotherapy, which included the nitrosoalkylurea derivative nitrosomethylurea, was tested in three clinical trials. The combination of vincristine (VCR), nitrosomethylurea (NMM) and actinomycin-D (Act.-D) showed an activity of 34.9% (10.9% CR + 24% PR) with a duration of remission from 2 to 30 months in 92 patients. The comparison of the combination VCR, NMM, Act.-D (group 1 = 44 pat.), VCR, NMM, Act.-D, DTIC (group 2 = 46 pat.) and VCR, Act.-D, CCNU, DTIC (group 3 = 48 pat.) showed an efficacy (CR + PR) of 29.6%; 28.3% and 18.8%. The duration of remission within all three groups is significantly longer in patients with a CR. In the first and second group the survival after 12, 18 and 24 months is significantly better than in the third group. The median survival time of patients reaching CR is in the first and second group (30.4 and 28.7 months) significantly better than in the third group (20.5 months). The comparison of a DTIC-monotherapy (group 1 = 56 pat.) and the combination VCR, NMM, Act.-D. (group 2 = 58 pat.) showed 7.1% CR and 16.0% PR, and 13.7% CR and 10.4% PR respectively. A cross over, when a progression occurred, was ineffective; survival time being 6.9 and 6.5 months did not differ. PMID- 3530178 TI - [Polish physicians--alumni of Vienna University]. PMID- 3530179 TI - [Stanislaw Marcinkowski (1882-1939), the Wielkopolska pharmacist]. PMID- 3530177 TI - [Metastases--with no end in sight. I. Clinical and experimental pathology]. AB - In the recent century research in cancer metastasis has greatly improved; nowadays it is a superior topic in cancer literature. Most of its problems result from alternate assumptions: The functional seed and soil and the hemomechanic hypothesis, after all putting two questions on account of metastasis being either a permanent likewise passive or a cascade phenomenon. In regard of metastasizing bronchial-, breast- and prostate carcinomas or multifocal tumors and most of rodent neoplasms a passive tumor cell transport might be a single effect, but the characteristic feature rather a step by step metastasizing cascade, implicating special organ localizations, and the fact, that metastasis distribution correlates with tumor biology, localization of the first metastasis and in manifold metastasizing tumors with typical organ patterns. From introduction of recent in vitro and cloning-techniques the metastasizing potency of tumors now becoming able to be defined by function of its genetic heterogeneity, developing metastasizing phenotypes respective neoplastic evolution by mutation, gene amplification, and epigenetic factors. On the other side having an unique xenobiotic metabolism metastasizing tumor cells are in accordance with the conception of their inherent "commonality". PMID- 3530180 TI - [On medical culture (an introduction to the subject)]. PMID- 3530181 TI - [An Austrian field hospital in Warsaw 1809]. PMID- 3530182 TI - [Polish physicians--creators and collectors of ex libris 1905-1955]. PMID- 3530183 TI - [Child care in Torun in the inter-war period (1920-1939)]. PMID- 3530184 TI - [Teodor Tomasz Weichardt, a physician in the period of Enlightenment]. PMID- 3530185 TI - The role of immunocytochemistry in the diagnosis of rhabdomyosarcoma. PMID- 3530186 TI - The clinical significance of the in vivo antinuclear antibody phenomenon. AB - We describe a patient with systemic lupus erythematosus (SLE) with demonstrated direct immunofluorescent staining of epidermal nuclei in a rim pattern, the second case of in vivo antinuclear antibody (ANA) producing a rim pattern in normal epidermis. A review of the literature showed that 258 cases have been reported of in vivo ANA deposition in epidermal nuclei from nonlesional skin. This phenomenon, which is most common in patients with mixed connective tissue disease, SLE, and scleroderma, correlates frequently with antibodies to extractable nuclear antigens. In vivo ANA have also been described in renal and pulmonary tissue from patients with SLE. In most cases, the pathogenic significance of the phenomenon is unknown. PMID- 3530187 TI - Immunohistochemical studies of rhabdomyosarcoma. AB - We performed immunoperoxidase studies in 29 cases of rhabdomyosarcoma from the Intergroup Rhabdomyosarcoma Study I using antisera against actin, myosin, myoglobin, alpha-actinin, and tropomyosin. Although each of these antisera reacted with some of the tumors, none reacted with all of the tumors, and some tumors showed no reactivity. Antimyosin reacted with more tumors than any of the others, while antiactin and antimyoglobin were about equally sensitive. Antitropomyosin and anti-alpha-actinin reacted with few of the tumors. The better differentiated tumors were more likely to react compared with the poorly differentiated tumors. PMID- 3530188 TI - Proximal renal tubular surface membrane antigens identified in primary and metastatic renal cell carcinomas. AB - Polyclonal antibodies to the brush border membrane of the human renal proximal tubule were found to identify two proteins with apparent molecular weights of 35,000 and 46,000 daltons. The antigens are distinct in their molecular weights from other antigens that have been localized to the human proximal tubular brush border. The antibodies were extensively studied for their immunoreactivity to fixed, embedded tissue sections by indirect immunoperoxidase staining. These sections were from 36 primary and 37 metastatic renal cell carcinomas, three renal oncocytomas, 87 cases of 28 different types of neoplasms, and 33 different types of normal tissues. Ninety-four percent of primary and 78% of metastatic renal cell carcinomas demonstrated expression of the antigens. Eight cases in which both primary tumor and its metastases were available revealed a general quantitative decrease in expression of the antigens in the metastases. Specificity analysis revealed immunoreactivity to the luminal surfaces of cells lining the epididymis, breast lobule, and bile ductules; the cytoplasm of the submandibular gland ductules; and to some adenocarcinomas of lung, breast, and small intestine, astrocytomas of brain, and squamous carcinomas of skin. The antibodies may be of some utility in the surgical pathology laboratory to help determine the primary site of metastatic clear cell tumors and may also be of use in the in vitro differentiation of renal epithelial cells. Development of monoclonal antibodies to these antigens may improve specificity and clinical utility. PMID- 3530189 TI - Embryonal rhabdomyosarcoma in ascitic fluid. Immunocytochemical and DNA flow cytometric study. AB - We report the case of an 18-year-old woman who had a small-cell malignant neoplasm of the left paranasal sinuses and who, 18 months later, developed malignant ascites. Immunoperoxidase stains of the ascitic fluid cells and, subsequently, the original tumor, identified it as embryonal rhabdomyosarcoma. Flow cytometric DNA analysis of the ascitic fluid demonstrated an aneuploid cell population that was also present in the paraffin-embedded tissue on which the original diagnosis had been made. PMID- 3530190 TI - Acetabular reinforcement in total hip replacement. AB - In 21 cases of severe secondary protrusio acetabuli with extensive or total destruction of the acetabular cortical structures, the double anchorage of conventional polyethylene cups with nine Muller acetabular reinforcement rings and 12 Burch-Schneider anti-protrusio reinforcement cages was carried out. They were applied in combination with reconstructive surgery of cancellous bone in three primary total hip replacements and in 18 revision operations for loosened acetabular cups following total arthroplasties. Indication for and technique of the acetabular reinforcement are described. The radiological and clinical results in 21 patients followed up were satisfactory. They confirm the efficiency of these screw-fixed reinforcement implants for the solid fixation of the plastic cup in patients with extreme acetabular deficiencies. PMID- 3530191 TI - Use of the acetabular reamer to harvest autogeneic bone graft material: a simple method for producing bone paste. AB - In comparison with solid bone grafts, the particulate form as a paste-like material offers several advantages. The method reported for harvesting a homogeneous mixture of ground cortical and cancellous bone has proven to be simple, time-saving, and productive. A normal acetabular reamer is used to procure the graft from the outer surface of the posterior iliac wing, transforming it simultaneously into paste-like material. PMID- 3530192 TI - Quantitative and qualitative changes of serum proteolytic activity in rats with liver damage induced by galactosamine. AB - Serum proteolytic activity was determined in galactosamine-treated rats and in controls. Injection of the hepatotoxin at a dose of 400 mg/kg resulted in a 3.4 fold elevation in the serum proteolytic activity, while AST (aspartate aminotransferase), ALT (alanine aminotransferase) and bilirubin were increased by factors of 3.9, 8.8 and 4.5, respectively. Studies with proteinase inhibitors revealed that the serum proteolytic activity was partially metal-dependent as well as puromycin and antipain sensitive. Differences in susceptibility to a combination of N-ethylmaleimide and antipain indicated presence of different proteolytic systems in the sera of liver damaged and control rats. Separation of serum proteinases by gel filtration showed that the galactosamine-intoxicated rat serum contained activity which did not appear in the control serum. This activity was partially metal dependent, antipain and N-ethylmaleimide sensitive, and was more susceptible to dithiothreitol than the control activity. These findings demonstrate that hepatocellular damage induced by galactosamine caused not only an increase in serum proteinases, but was also associated with the appearance of enzymes not normally released by the liver of untreated animals. PMID- 3530193 TI - Detection of viral antigens in cerebrospinal fluid of rabbits with experimental herpes simplex virus type 1 encephalitis. AB - We investigated several methods for the rapid diagnosis of herpes simplex virus induced encephalitis in a rabbit model. The corneas of twenty-two rabbits were infected with herpes simplex virus type 1 (HSV-1) and diagnosis of Herpes encephalitis was made by virus isolation, immunofluorescent and peroxidase staining of brain biopsies, demonstration of anti-HSV IgM in cerebrospinal fluid (CSF) and by an indirect enzyme-linked immunosorbent assay (ELISA), designed for detection of viral antigens. With the last method we were able to demonstrate viral antigens in cerebrospinal fluid six days post infection, before clinical signs of encephalitis appeared. In three rabbits this was before anti-HSV IgM appeared in the CSF. Virus was isolated from brain samples of 67 per cent of the animals which died from Herpes encephalitis. Nine rabbits received cortisone before infection, resulting in markedly lower antibody titers and a higher lethality, 77 per cent, as compared to 46 per cent in nontreated rabbits. For rapid diagnosis of Herpes encephalitis in rabbits, demonstration of herpes simplex virus antigens in CSF by means of an indirect ELISA is superior to the other methods investigated. PMID- 3530195 TI - History of the code for nurses. PMID- 3530196 TI - [Concentration and distribution of insulin and insulin-like protein in the organs of normal and diabetic mice]. AB - Presence of insulin or insulin-like protein has been studied in mouse liver, kidneys, lungs, duodenum, jejunum, submandibular and parotid salivary glands, in femoral, diaphragmal and abdominal wall muscles by means of the immunofluorescent method. In order to understand the role of the extrapancreatic insulin for compensation of the insular insufficiency, corresponding organs have been examined in mice with alloxan diabetes. The immunoreactive insulin is proved to be present only in cells of the granular parts of the salivary tubules of the submandibular and striated ducts of the parotid glands. As demonstrates microfluorometry, a relative amount of insulin in the submandibular gland cells is 1.5 times and in the parotid gland cells--2 times as small as in beta-cells of the pancreatic glands. Under alloxan diabetes insulin content in the salivary gland cells decreases by 1.3-1.9 times (in the beta-cells--by 2.7 times). This may designate that the extrapancreatic insulin (or insulin-like protein) participates in compensation of hypoinsulinemia. In mice with alloxan diabetes, immunoreactivity of insulin is also revealed in hepatocytes. PMID- 3530194 TI - Assay of measles virus IgM and IgG class antibodies by use of peroxidase-labelled viral antigens. AB - Purified measles virions, nucleocapsid protein and crude lysate of measles infected cells were labelled with horseradish peroxidase, and used for the detection of IgM and IgG antibodies to measles virus by direct enzyme immunoassay. The assays consisted of three layers: anti-human IgM or IgG immunoglobulins on solid-phase, test serum specimen and enzyme labelled viral antigen. For the expression of the results, a standard curve was included in each test and the O.D. values were changed to arbitrary antibody units. Specificity and sensitivity of the assays were compared with indirect EIAs. The specificity studies included a collection of serum specimens containing either rheumatoid factor, antinuclear antibodies or IgM antibody specific for other viruses. The assays proved both reliable and simple to perform and sensitivity was slightly higher than that for indirect EIAs. However, specificity was dependent on the purity of the viral antigens. When crude infected cell lysate antigen was used, some nonspecific results were obtained, particularly with serum specimens containing antinuclear antibodies. When virion or nucleocapsid protein were used, no nonspecific reactions were obtained. PMID- 3530197 TI - [Possibilities for acceleration of morphometric analysis using a microprocessor analyzer of graphic information (MAGI)]. PMID- 3530198 TI - [Electrotonic synapses in the mammalian spinal cord]. AB - By means of light and electron microscopy methods structural peculiarities of motor nuclei have been studied in the rat spinal cord (17 animals) on the 1st-3d and on the 10th-18th days of postnatal ontogenesis. Synaptic junctions of the gap type are revealed; they are considered as electrotonic synapses. Dendro-somatic and dendrodendritic synaptic junctions of the gap type are found. Together with the electrotonic synapses, morphologically mixed synapses of axo-somatic and axo axonal types are disclosed; they contain, besides organells, specific for chemical synapses, close opposition areas of pre- and postsynaptic membranes of the gap junction type. Morphologically mixed synapses occur in neuropil of the motor nuclei of the spinal cord in young rats of all age groups studied. Homologous synapses are detected in the motor nuclei of the white mouse spinal cord. Synaptic junctions of the gap type in the mammalian spinal cord could be a substrate of electrical interaction between its motor neurons. PMID- 3530199 TI - [Vascular anastomoses of the blood microcirculatory bed of the human heart]. AB - Using a complex of morphological techniques both injective and non-injective, scanning electron microscopy including, the hemomicrocirculatory bed and vascular anastomoses have been studied in various parts of the human heart. In most cases anastomoses between the microcirculatory links are realized at the level of capillaries, precapillary arterioles and postcapillary venules. Venulo-venular anastomoses are demonstrated in the myocardium. Existence of terminal arterioles is discussed. PMID- 3530200 TI - [Efferent connections of the striatum with the Ep field of the temporal cortex in the cat]. AB - When horseradish peroxidase was injected into the Ep area of the temporal cortex of 5 cats, the distribution of the labelled neurons in the strio-pallidum and in the nucleus of Meynert was similar in all the cases. In the striatum predominantly large cells (in the nucleus caudatus and in the putamen), as well as middle and small (in the putamen) cells were labelled. Comparing the form and size of the labelled cells in the striatum, revealed in Golgi preparations, it is possible to conclude that large labelled neurons correspond to long-axonal sparsely-branching reticular neurons, and middle and small--to long-axonal densely-branching dendroid "spinular" neurons. The large cells of the striatum can be considered as a part of a vast macrocellular ascending system of the forebrain, its preservation maintains the higher integrative functions of the brain. PMID- 3530201 TI - [A memoir of a great anatomist. The exhibit on Nikolai Ivanovich Pirogov in Simferopol]. PMID- 3530202 TI - [Prelipid stage of the morphogenesis of atherosclerosis]. AB - On the basis of presented data it can be concluded, that in the preclinical stage of atherosclerosis development when macroscopically observable arterial lesions are still undetectable, a complex process of structural-functional changes takes place in the arterial wall. Under modern methods of investigation it was shown that the concept of "pre lipid" stage of atherosclerosis morphogenesis is somewhat conventional. The infiltration of atherogenic lipoproteids in the arterial wall, their modification and interaction with cell elements of vascular wall serve the basis for complex cell reactions directed to adaptation to new conditions and expelling of excessive lipoproteids. The obtained data introduce a new level of knowledge about patho- and morphogenesis of atherosclerosis. PMID- 3530203 TI - [Importance of morphologic examination of the kidneys of patients with vasorenal hypertension for predicting the results of surgical treatment]. AB - Light-optical, electron microscopic and morphometric studies of biopsy material from kidneys of 24 patients with vasorenal hypertension were performed. It was determined that sclerosis of the arteries and arterioles on the side of the lesion was more marked, than in the contralateral kidney. At a later stage of the disease (more than 3 yr.) there were occasional signs of increased renin synthesizing activity of the juxtaglomerular apparatus (JGA) with its simultaneous decrease at the stenotic side. JGA activation in the contralateral kidney can be one of the mechanisms supporting hyperrenin arterial hypertension and can prevent the decrease of the blood pressure after surgery. Studying of the biopsy material with the estimation of the sclerosis degree of the arterial tree vessels, as well as JGA activity, is important for prognosing the results of surgical treatment of vasorenal hypertension. PMID- 3530204 TI - [Specific chromosomal changes (aberrations)--supplementary marker of malignant degeneration in oncomorphologic studies]. AB - The paper deals with some methods studying chromosome set in tumour cells. The latest data on tumour chromosome aberrations are reported. The latter are subdivided by the authors into non-specific and specific, characteristic only of certain variants of tumour differentiation, and are of diagnostic significance. The authors put forward further tasks of combined oncomorphologic and cytogenetic studies of specific chromosome aberrations as a valuable marker for the diagnosis of malignancy. PMID- 3530205 TI - [Role of modern methods of morphological research in the exact definition of the biological characteristics and morphogenesis of human breast cancer]. AB - Combined use of modern methods of morphologic investigation will allow one in every diagnosed case of breast carcinoma to determine its histogenesis, make a differential diagnosis. Knowledge of biological features of malignant cells will allow one to apply an individual approach to treatment and prognosis. To clarify the morphogenesis of breast carcinoma, it is important to study the stromal component, as parenchymal-stromal relationship is a fundamental link in structural homeostasis. PMID- 3530206 TI - [Method of treating the breast in total histological studies]. AB - The presented method of breast treatment, used in a total histologic study, allows one to avoid freasing microtome for large sections, hence, deformation of histologic structures. In cases, when breast consists mainly of fatty tissue, it is impossible to obtain histotopographic sections. The presented scheme of tissue treatment involving standard sledge microtome, acetone, thermostat heat provides 25-35 micron sections. The method can be widely used by pathologists for total histotopographic study of the organ. PMID- 3530207 TI - The impact of the Transactions--American Society for Artificial Internal Organs. PMID- 3530208 TI - Retrospective on artificial organs and the role of the Transactions--American Society for Artificial Internal Organs. PMID- 3530209 TI - Early history of the Seattle dialysis programs as told in the Transactions- American Society for Artificial Internal Organs. PMID- 3530210 TI - Convective mass transport and the Transactions. PMID- 3530211 TI - Evolution of vascular access. PMID- 3530212 TI - Nutrition in renal failure. PMID- 3530213 TI - Evolution of renal transplantation in a prominent dialysis center. PMID- 3530214 TI - Plasmapheresis: development and application in treatment of renal disorders. PMID- 3530215 TI - The technological Transactions. PMID- 3530216 TI - Translation of Broca's 1865 report. Localization of speech in the third left frontal convolution. AB - Modern texts continue to cite Broca's 1861 study of a single patient, Tan, as the first definitive localization of a cerebral function, specifically, articulate speech. We describe the development of Broca's theory from his initial support in 1861 for Bouillaud's view that speech is localized in both frontal lobes to his description in 1865 of a center for articulate speech in the third left frontal convolution. We have translated Broca's 1865 French report. Despite the revival of "classical" anatomically based concepts of discrete aphasic syndromes, numerous clinicoanatomical correlation studies have failed to confirm the specific language impairment described by Broca. Broca's own descriptions of language development in the third right frontal convolution following left hemisphere damage also raise questions about the validity of theories of brain behavior relationships based on punctate localization of specific mental functions. PMID- 3530217 TI - Penetration of various molecular-weight proteins into the enamel organ and enamel of the rat incisor. AB - During enamel maturation, most of the organic matrix is removed as the mineral content increases; it is postulated that proteolytic enzymes within enamel break down large proteins into more mobile fragments. To predict how such fragments might leave the enamel, the entry and penetration of various proteins into it was examined. Rats (100 g) were injected via the external jugular vein with 125I iodinated calcitonin (3600), insulin (5700), epidermal growth factor (EGF; 6100) and albumin (68,000). They were killed after 10 min and radioautographs made to visualize these molecules in the incisor enamel organ and enamel. In addition, dissected incisors were wiped free of their enamel organs, dipped in the iodinated protein solutions for 10 min, and processed for radioautography. In all dipped teeth, except those exposed to albumin, there was a gradient of silver grain density over the entire thickness of enamel in both the secretion and maturation zones. In all injected animals, enamel labelling in the secretion zone was only slightly above background. In the maturation zone of animals injected with calcitonin and insulin, many grains were over enamel adjacent to smooth ended ameloblasts but not ruffle-ended ones. Animals injected with EGF and albumin had no labelled enamel in the maturation zone. Thus dipped rat incisor enamel was permeable to proteins with molecular weights as high as 6100. Localization of injected proteins indicates that the enamel organ restricts their passage into enamel, but proteins with molecular weights as high as 5700 may pass into enamel through or between smooth-ended ameloblasts. As exogenous proteins readily diffused into the enamel, it seems likely that enamel proteins of similar size can leave enamel by a similar route. PMID- 3530218 TI - Assay of trypsin-like protease in rat submandibular saliva and gland. AB - Trypsin-like protease activity was high in the submandibular gland, low in the pancreas, and absent in the liver, kidney and brain of adult rats. The alpha sympathomimetic agent, norepinephrine, induced a marked secretion of the enzyme into submandibular saliva and the remaining protease activity within the gland decreased to about 64 per cent of control levels. Six peaks of protease activity, found by isoelectric focusing in intact submandibular glands, were also detected in the saliva of norepinephrine-stimulated rats. Isoprenaline also increased the protease activity in saliva, but far less so than norepinephrine. The parasympathomimetic agent, pilocarpine, had little effect on the secretion of the enzyme into saliva. PMID- 3530219 TI - Quantitative histological analysis of the human coronal dentine in dentinogenesis imperfecta types I and II. AB - The coronal dentine of 3 teeth from dentinogenesis imperfecta (DI) type I, 9 teeth from DI type II and 4 controls were examined by a quantitative histological technique. In each case, two representative demineralized sections, one stained in H + E and the other in Schmorl's picrothionin were used. The relative amount of dentinal tubule, atubular dentine and canals/clefts were assessed using the point-counting method. Three basic patterns of distribution of tubules were observed. Pattern 1 formed the largest group and showed a gradual decrease in tubule count from enamel-dentine junction (EDJ) pulpwards, pattern 2 was characterized by a drop in tubule count approximately midway between EDJ and pulpal border, and pattern 3 exhibited a gradual increase in tubule score as the pulp was approached. At the 5 per cent level, both patterns 1 and 2 were found to be statistically significant. Pattern 3 was statistically insignificant for the test specimens and highly significant for the controls. The variation in the distribution of the tubules in coronal dentine in this study indirectly supports the concept of abnormal dentinogenesis in DI attributable to a diminution or lack of normal functional odontoblasts. PMID- 3530220 TI - Outpatient cataract surgery. PMID- 3530221 TI - Corneal preservation. PMID- 3530222 TI - Epikeratophakia for keratoconus. The nationwide study. AB - The nationwide study of epikeratophakia for the treatment of keratoconus involved 69 surgeons in the United States; they operated on 177 eyes as of Dec 31, 1985. In this first report, the results from 35 surgeons involving 82 cases with 30 or more days of follow-up after suture removal are described. In all but two patients, uncorrected visual acuity improved; 17 patients showed improvement of three Snellen lines, and 38 patients showed improvement of four or more lines. The majority of patients' vision returned to within one line of their best corrected acuity; in 78% it was 20/40 or better postoperatively. Eight patients needed no postoperative overrefraction at all. The mean flattening by keratometry readings was 9.36 diopters, and the mean decrease in myopia in terms of spherical equivalent was 5.26 D. No significant changes in intraocular pressure or endothelial cell counts were noted. Some advantages of epikeratophakia for keratoconus over the traditional penetrating keratoplasty include the lack of serious, vision-threatening complications or permanent vision loss, the reversible nature of the surgery, and the absence of potential immunogenic rejection phenomena. PMID- 3530223 TI - Treatment of dislocated posterior chamber intraocular lenses. AB - We treated five patients with posterior chamber intraocular lenses that were dislocated into the vitreous cavity. Using a pars plana approach, a vitrectomy was performed, and the intraocular lens was grasped with forceps and repositioned behind the iris with the lens loops in the ciliary sulcus. The loops were sutured to the iris in four cases. Visual acuity returned to 20/25, or better, in each case. PMID- 3530224 TI - Efficacy of perioperative ceftazidime in the surgical treatment of chronic otitis media due to Pseudomonas aeruginosa. Preliminary report of a prospective, controlled study. AB - A prospective open and controlled study of perioperative antibiotics was conducted in patients with chronic otitis media (COM). Drug efficacy was found in a subgroup of 26 patients, who were characterized by preoperative aural drainage culturing Pseudomonas aeruginosa. Fourteen of these patients were randomized to receive ceftazidime (cephalosporin) for 5 days at the operation, while 12 had no antibiotic treatment. The occurrence of subsequent aural drainage was compared with the actual clinical and microbiological conditions of the ears 2 months after the operation; statistically significant differences were found in favor of the group treated with ceftazidime. Further studies must define the role of ceftazidime and other antibiotics in the management of patients with COM. PMID- 3530225 TI - The mycotic flora of adenoids and antibodies to Candida albicans in children. AB - We cultured the adenoid tissues of 72 children with recurrent respiratory infections for fungal organisms. We also took fungal cultures of nasopharyngeal secretions from 20 healthy children and 13 healthy adults as controls. Culture for fungi were positive in 15% of the patients, in 15% of the healthy adults and in 25% of the healthy children. Candida albicans, C. parapsilosis, C. tropicalis and Aspergillus sp. were the most common organisms found. In studying the children with recurrent respiratory infections, we were unable to find any significant correlation between the positive cultures and the age, type of day care and previous antibiotic therapy given. We then studied the hemagglutination titers against C. albicans in 44 patients. This titer was 1:160 or lower in all but three patients, and was 1:320 in these latter three patients. However, fungal cultures were negative in all patients having hemagglutination titers of 1:80 or more. PMID- 3530226 TI - Comparative double-blind trial of the effectiveness and antigenicity of semisynthetic human insulin and purified porcine insulin in newly treated diabetic subjects. AB - A double-blind comparative trial of the effectiveness and antigenicity of semisynthetic human insulin (Novo) and highly purified (Monocomponent) porcine insulin was performed over a 12 month period in 20 diabetic subjects newly treated with insulin. Human insulin was shown to be indistinguishable from porcine insulin of comparable purity with respect to plasma glucose and glycosylated hemoglobin levels and insulin dose requirements. Human insulin was no less antigenic than porcine insulin; significant IgG-associated insulin binding activity was detected in six of the ten patients in the human insulin treated group and four of the ten patients in the porcine insulin treated group. In all patients, the binding activity was of low capacity. No adverse reactions to human insulin were noted. It is concluded that semisynthetic human insulin, like purified porcine insulin, is safe and effective. Although there may be advantages for human insulin in the setting of insulin allergy, this study does not indicate that human insulin has advantages over purified porcine insulin with respect to elicitation of antibodies of the IgG class. PMID- 3530227 TI - Oral complications of bone marrow transplantation. PMID- 3530228 TI - Parenthood after renal transplantation. PMID- 3530229 TI - Liver trauma. AB - A series of 97 patients has been studied who were treated for liver injury at Westmead Hospital between January 1979 and January 1985. Patients were noted to be younger than those reported in previous series from Sydney, and to have suffered more frequent, significant, head injuries. Paramedical roadside intervention probably allowed more patients to reach hospital alive than was the case before the advent of the Intensive Care Ambulance system. Improved organ imaging has allowed more confident non-operative management of 13% of patients. Hepatic resection has been used infrequently (10%). Packing has been used in six patients as part of the definitive treatment of severe injuries and coagulopathy, and to allow the transfer of a further seven patients from peripheral hospitals. Ten of these 13 patients survived. Head injury continues to be a major cause of death in these patients. Death from the liver injury itself is usually associated with high grade damage to the liver and the associated hepatic veins and vena cava. It is speculated that improvement in the management of these lethal injuries will come about only from the early identification of patients likely to have suffered such trauma, and the pre-operative control of bleeding. Balloon catheter placement under radiological control, to tamponade the inferior vena cava and abdominal aorta, is suggested as one means by which this goal might be achieved. PMID- 3530230 TI - Evaluation of a new oestrogen receptor assay. AB - Replicate assays of oestrogen receptor (ER) concentration on 81 specimens of human breast carcinoma were performed to compare the ligand binding Sephadex separation method with a polystyrene bead linked anti-oestrogen receptor monoclonal antibody technique (enzyme immunoassay [EIA], Abbott Laboratories). Each specimen was homogenized and the cytosol divided into four fractions. Replicate assays by each method gave an estimate of reproducibility. The mean CV (coefficient of variation = standard deviation/mean) for the ligand binding method was 9.73% compared with a mean CV of 17.9% for the EIA method. In the clinically significant range of ER values, around the cut-off point between negative and positive assays, there was no difference in the precision of the two assays (Mann Whitney U-test). The correlation between methods gave a Pearson's Product Moment Correlation Coefficient (r value) of 0.822, significant at the P less than 0.001 level, indicating a close correlation between the two methods. The highest CVs for both methods were in the range of oestrogen receptor concentrations, below 10 fmol/mg cytosol protein. Using 10 fmol/mg cytosol protein as a cut-off between negative and positive assays, 9.87% of the specimens would be reclassified as either positive or negative by the new assay method. The new assay method is, therefore, acceptable for clinical use. PMID- 3530231 TI - A modified indirect immunofluorescent assay for the detection of antibody to Eperythrozoon ovis in sheep. AB - Experimental ovine eperythrozoonosis was studied using Giemsa staining of blood films and a modified indirect immunofluorescent antibody assay (IFAA). The serums of 21 Border Leicester Merino cross lambs between 12 weeks and 7 months-of-age were analysed before and after infection with Eperythrozoon ovis (E. ovis) using the IFAA test. No rise in the IFAA titre was seen until day 7 and this coincided with the first detection of E. ovis organisms in blood smears stained with Giemsa. The percentage of E. ovis infected red blood cells peaked on day 14, but the IFAA titre did not peak until day 35. Titres to E. ovis, on average, had begun to drop by day 63. There was considerable individual variation in response to E. ovis infection as measured by the IFAA. Titres as high as 6,400 were observed in individual sheep at the peak of E. ovis parasitaemia of red cells. One sheep had a titre of 51,200 nineteen days after infection, and titres of 3,000 were maintained for several months in a few sheep. The assay proved reliable, and up to 100 samples per day could be tested. The antigenicity of the slide preparations was found to be satisfactory after storage for 6 months at -20 degrees C and 4 degrees C and for 28 months at -70 degrees C. Temperature fluctuations during storage rendered slides unsuitable for the IFAA after these times. A method of storing E. ovis infected blood in liquid nitrogen is described. PMID- 3530232 TI - Microleakage at the etched enamel-resin interface with bonded orthodontic brackets. PMID- 3530233 TI - Biochemical defects in epidermolysis bullosa--a review. PMID- 3530234 TI - Cement burns: rare or rarely reported? PMID- 3530235 TI - Plasma proteins, immunomodulators, tumor therapeutics. Dedicated to Dr. Wolfgang von Polnitz on the occasion of his 65. birthday. PMID- 3530236 TI - Toxicity of "hydrophobic groupings" and the role of carbohydrates in Plasmodium falciparum infection. AB - We have tested various carbohydrate structures and neoglycoproteins (carbohydrate haptens attached to BSA) as inhibitors of the invasion of human red blood cells by Plasmodium falciparum merozoites (strain FCB) in synchronous in vitro cultures, using 3H-hypoxanthine incorporation into intraerythrocytic parasites as analytical tool, and have got the following results: The inhibition rate of N acetyl-D-glucosamine glycosides is increased with increasing lipophilicity of the aglycon or spacer: CH3 less than (CH2)2NHCO(CH2)2COOCH3 less than (CH2)8COOCH3; p Nitrophenyl glycosides proved to exhibit a toxic effect; The inhibition rate of synthetic disaccharide glycosides increased in the order beta DGal(1----4) beta DGlcNAcOCH3 less than beta DGlcNAc(1----4) beta DGlcNAcOCH3 less than beta DGlcNAc(1----4) alpha DManOCH3 less than beta DGlcNAc(1----4) beta DManO(CH2)8COOCH3; The O-linked tetrasaccharide alpha NeuAc(2----3) beta DGal(1-- -3) [alpha NeuAc(2----6)] alpha DGalNAcol, isolated from glycophorin A, was the best carbohydrate inhibitor tested so far; The inhibition rate of carbohydrates attached to BSA by an aliphatic spacer [-(CH2)8COOCH3] was not enhanced compared to the haptens; [DNP]33-BSA proved to be an extraordinary inhibitor of invasion which, however, most likely has to be attributed to a toxic effect; Observed toxicities appear to be attributable to hydrophobic interactions between the inhibitors and the RBC and merozoite membranes, which hampers both, intraerythrocytic growth of the parasite and its capability of RBC invasion. PMID- 3530237 TI - Screening for chemoimmunotherapeutics, success rate and predictivity of models: a five years experience. AB - While repository adjuvants are already established drugs for antigen specific immunomodulation, no unspecific active immunomodulator has successfully passed clinical trials in tumor patients in western countries yet. As this is in striking contrast to the effects seen with unspecific immunomodulators in experimental immunological and tumor test systems, the value of those screening models to predict clinical success may be asked for. To improve the success rate, it is recommended to test compounds for their immunomodulatory effects as broad as possible in ex vivo and in vivo test systems. Subsequently, the prophylactic as well as therapeutic potency of selected immunomodulating drugs should be evaluated in various models of aptitude, such as chronic infection, autoimmune diseases and chronic inflammatory reactions. Those diseases are at least to a certain extent influenced by the immune system, in contrast to the uncertainty in case of tumor diseases. In a battery of chronic infection models we could find that different chemoimmunotherapeutics with very similar immunopharmacological activity behaved quite differently. Most compounds were ineffective, a part enhanced chronic diseases and only in a few cases a therapeutic effect could be shown. On the other hand, effectivity in protection against the pathogenicity of subsequently applied, selected microorganisms does not predict the therapeutic potency for the same pathogen. Altogether the data show that activation of cells of the immune system by an immunostimulating drug does not predict its therapeutic potency. Moreover, activation of immune cells may also lead to impairness of the immune resistance. PMID- 3530238 TI - The effects of reassurance, relaxation training and distraction on chronic tinnitus sufferers. PMID- 3530239 TI - An animal model for situational panic attacks. PMID- 3530240 TI - Individual response patterns and the effects of different behavioral methods in the treatment of dental phobia. PMID- 3530241 TI - [Experiences in thrombocyte substitution following bone marrow transplantation]. PMID- 3530242 TI - [Substitution with blood coagulation factor XIII concentrates in patients with acute leukemia]. PMID- 3530243 TI - [Bacteriologic studies of the occurrence, biochemistry and antibiotic resistance of Haemophilus somnus (spec. incertae sed.) in cattle]. PMID- 3530244 TI - [The end of the beginning]. PMID- 3530245 TI - Cleavage lines of the skin. AB - Detailed investigation on cleavage lines over the entire area of the body was undertaken in 3 each of male and female cadavers. The directions of cleavage lines showed sex and individual differences. Minute comparison of the diagrams obtained in this study with earlier diagrams revealed the presence of delicate differences in the directions of cleavage lines. Microscopical evaluation of cleavage lines showed that in the regions where cleavage lines were linearly arranged, collagen fibers were regularly arranged in a uniform direction, conforming to the direction of cleavage lines from the shallow reticular layer immediately below the papillary layers to the inner reticular layer where sebaceous and sweat glands existed and that in the regions where cleavage lines were ramified, collagen fibers in these layers lacked directional regularity. The morphology of cleavage lines were considered most influenced by collagen fibers in the epidermal reticular layers from their shallow layers immediately below the papillary layers to the layer where sebaceous and sweat glands existed. PMID- 3530246 TI - Developmental modulation of neuronal cell surface determinants. AB - Proceeding from the hypothesis that cellular differentiation processes are correlated with structural changes of the cell membrane, the expression of antigen and lectin receptors, as well as lectin-like molecules during migration and differentiation of pre- and perinatal neurons in the cerebral cortex, was analysed. It could be shown that a number of cell surface structures exist throughout the whole pre- and perinatal period, e.g. receptors for Robinia pseudoacacia lectin (RPL), pokeweed lectin (PWL) and concanavalin A (ConA) and the Ia and H-2-D/K antigens of the major histocompatibility complex (MHC). The expression of other cell surface structures, for example receptors for peanut and Limulus polyphemus lectin (LPL) and of Thy-1, is determined by the developmental stage; i.e. in the perinatal period higher amounts are found than in early prenatal stages. Binding sites for Phaseolus vulgaris lectin, PWL and anti-Thy 1.2 are not only demonstrated on perikaryal membranes, but additionally on diverse tangential or radial fibre structures. While on cells of the ventricular layer - the proliferating cell compartment - peanut lectin (PNL) receptors are observed in low density, LPL receptors in high density, in the migration zone, i.e. the intermediate layer, receptors are found predominantly for PNL and only few cells carry a significant number of LPL-binding sites. After the preneurons have migrated through the intermediate layer and the neighbouring cortical plate, remaining at the pia-near border of the latter, LPL receptors are again expressed on the cell surface of the now bipolar preneurons, while PNL receptors cannot be demonstrated any more. Experimental evidence is put forward indicating the possibility that this modulation of exposed carbohydrate residues on the cell surface might be mediated by a membrane-associated enzyme system on the same single molecule. For the investigation of neuronal cell interaction the ability of disintegrated suspended preneurons was used to reaggregate spontaneously in vitro and to build histiotypic cell formations within these reaggregates. It was found that this reaggregation of suspended neuronal single cells is dependent on the presence of ionized calcium, on the temperature, and on the conditions that influence the frequency of cell contacts. Furthermore, the structures expressed on the cell surface of preneurons during the pre- and perinatal period were investigated in regard to their influence on the reaggregation of these cells by means of a blockade by monoclonal antibodies or saccharides, respectively.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3530247 TI - Detection of lactate dehydrogenase B4 in human hemolysate of patients deficient in lactate dehydrogenase B subunit activity using enzyme immunoassay. AB - We developed a sensitive enzyme immunoassay system specific for human lactate dehydrogenase (LDH)-B4 with antiacetylated LDH-B4 Fab'-horseradish peroxidase conjugate. The enzyme immunoassay system was not interfered with by up to 0.3 mg/tube of hemoglobin. Thus, we measured LDH-B4 concentrations in the hemolysate of seven heterozygous individuals deficient in LDH-B subunit activity and eight normal individuals. We could not find a significant difference between the LDH-B4 concentrations in heterozygous and those in normal individuals. These results demonstrate that heterozygous individuals deficient in LDH-B subunit activity produce enzymatically inactive B subunits. PMID- 3530249 TI - Pea chloroplast DNA encodes homologues of Escherichia coli ribosomal subunit S2 and the beta'-subunit of RNA polymerase. AB - The nucleotide sequence has been determined of a segment of 4680 bases of the pea chloroplast genome. It adjoins a sequence described elsewhere that encodes subunits of the F0 membrane domain of the ATP-synthase complex. The sequence contains a potential gene encoding a protein which is strongly related to the S2 polypeptide of Escherichia coli ribosomes. It also encodes an incomplete protein which contains segments that are homologous to the beta'-subunit of E. coli RNA polymerase and to yeast RNA polymerases II and III. PMID- 3530250 TI - The effects of lactate, acetate, glucose, insulin, starvation and alloxan diabetes on protein synthesis in perfused rat hearts. AB - Compared with glucose, lactate + acetate stimulated ventricular protein synthesis in anterogradely perfused hearts from fed or 72 h-starved rats. Stimulation was greater on a percentage basis in starved rats. Atrial protein synthesis was not detectably stimulated by lactate + acetate. Insulin stimulated protein synthesis in atria and ventricles. The stimulation of protein synthesis by lactate + acetate and insulin was not additive, the percentage stimulation by insulin being less in the ventricles of lactate + acetate-perfused hearts than in glucose perfused hearts. Perfusion of hearts from 72 h-starved or alloxan-diabetic rats with glucose + lactate + acetate + insulin did not increase protein-synthesis rates or efficiencies (protein synthesis expressed relative to total RNA) to values for fed rats, implying there is a decrease in translational activity in these hearts. In the perfused heart, inhibition of protein synthesis by starvation and its reversal by re-feeding followed a relatively prolonged time course. Synthesis was still decreasing after 3 days of starvation and did not return to normal until after 2 days of re-feeding. PMID- 3530251 TI - Beneficial effect of combined glucose-insulin-potassium and mechanical support in acute myocardial ischaemia. AB - The influence of glucose-insulin-potassium infusion in combination with a mechanical assist device (intraaortic balloon pumping, IABP) on the levels of high energy phosphates in the canine heart after coronary artery ligation was compared with the effect of a separate application of these measures to protect the acute ischaemic myocardium. The combined method normalized the tissue content of creatine phosphate in the nonischaemic tissue contrary to the application of the mechanical or pharmacological assistance alone. In the ischaemic cardiac tissue only the combination of both methods reduced the loss of creatine phosphate, ATP and the sum of adenine nucleotides. With the balloon pumping a reduction in lactate accumulation was achieved, which, however, was significantly lower than that obtained by the combination of heart protective measures: IABP plus glucose-insulin-potassium. PMID- 3530248 TI - Initiation of protein synthesis in mammalian cells. PMID- 3530252 TI - Cloning of Lentinus edodes mitochondrial DNA fragment capable of autonomous replication in Saccharomyces cerevisiae. AB - Mitochondrial (mt) DNA of the higher basidiomycetes Lentinus edodes with a molecular weight of about 69 kb was partially digested with Sau3AI, cloned with plasmid YIp32 (a hybrid of pBR322 and the yeast leu2 gene) and analyzed for sequences capable of autonomous replication (ARSs) in the eukaryote Saccharomyces cerevisiae. One recombinant plasmid was isolated which contained 3.2 kb fragment of the mtDNA with ARS activity. This plasmid (named pSK52) exhibited a high frequency yeast transformation and was found to be maintained within the cell as an extrachromosomal element. The stability and copy number properties of pSK52 were similar to those of the recombinant plasmid of YIp32 and S. cerevisiae mt ARS constructed as a reference. Subcloning experiments were carried out to assess the localization of ARS on the above 3.2 kb fragment, revealing that the fragment contains at least two ARSs. PMID- 3530253 TI - Association of the heat shock protein hsp90 with steroid hormone receptors and tyrosine kinase oncogene products. AB - Monospecific, polyclonal rabbit antibody raised against the 90-kd non-hormone binding component of molybdate-stabilized steroid hormone receptor specifically recognises the 90-kd molecular weight heat shock protein (hsp 90) in mink cell extracts. Partial proteolytic digestion experiments indicate that this protein is identical to the 90-kd phosphoprotein found in a highly stable complex with the protein products of at least three members of the tyrosine kinase family of oncogenes (src, fes, fgr). PMID- 3530254 TI - Phorbol esters, but not epidermal growth factor or insulin, rapidly decrease soluble protein kinase C activity in rat hepatocytes. AB - Exposure of freshly isolated rat hepatocytes to tumor-promoting phorbol esters like phorbol 12-myristate 13-acetate resulted in a time- and concentration dependent translocation of protein kinase C from the soluble to the particulate fraction of the cells. No such disappearance of soluble protein kinase C activity was observed with either epidermal growth factor or insulin, indicating that activation of protein kinase C is not necessarily involved in the short-term metabolic action of physiological growth factors on rat hepatocytes. PMID- 3530255 TI - Detection of native and denatured DNA antibody forming cells by the enzyme-linked immunospot assay. A clinical study of (New Zealand black x New Zealand white)F1 mice. AB - A new method for measuring DNA antibody forming cells (DNA-AFC) using the enzyme linked immunospot (ELISPOT) assay is described. This method uses enzyme-linked immunosorbent assay (ELISA) techniques applied to cells cultured on DNA-coated plates, which allows visual quantitation of spots representing imprints of specific antibodies from DNA-AFC. Specificity for DNA was confirmed by inhibition studies and lack of reactivity by anti-lysozyme hybridomas. Isotypes of IgG and IgM can be measured using the appropriate antisera in the assay. A study of 16 female (New Zealand black x New Zealand white)F1 ([NZB x NZW]F1) female mice showed significant correlation between age, rising blood urea nitrogen levels, and increasing proteinuria and increasing numbers of DNA-AFC. In contrast, the correlation between circulating antibodies to DNA (ELISA method) and clinical parameters of nephritis was not significant. Both the native DNA ELISPOT and the native DNA ELISA had similar significant linear correlations with age. This is the first report of use of the ELISPOT assay for measurement of DNA-AFC. The DNA AFC measured by this method were specific and correlated with the presence of clinical nephritis in (NZB x NZW)F1 mice. This method should allow further study on the regulation of DNA-AFC in vitro and in vivo, and will be useful in the investigation of DNA-AFC and cellular mechanisms of autoimmunity. PMID- 3530256 TI - Dialysis-related amyloid is amyloid of beta-2-microglobulin (AM beta 2M) origin. PMID- 3530257 TI - Carpal tunnel syndrome and type of dialysis membrane used in patients undergoing long-term hemodialysis. PMID- 3530258 TI - ASHA's Foundation celebrates it's 40th anniversary. American Speech-Language Hearing Association. PMID- 3530259 TI - An important force in our future. PMID- 3530261 TI - Student computer facilities. A guide to strategic planning. PMID- 3530260 TI - Continuing education--a growing trend for the 80s. PMID- 3530262 TI - The localisation of immunoglobulin in chronic periaortitis. AB - An immunohistochemical study was undertaken in an attempt to localise immunoglobulin in sections of human advanced atherosclerosis with thinning of the media (sub-clinical periaortitis) and without thinning of the media as well as sections of artery from patients with clinical periaortitis. The findings were that in routinely processed sections of advanced atherosclerosis showing medial attenuation and in sections from cases of clinical periaortitis IgG, and to a lesser extent IgM, was localised to insoluble lipid, ceroid, within the atheroma itself. It is suggested that these observations support the hypothesis that chronic periaortitis has an auto-allergic cause and that the allergen may be a component of ceroid, which is elaborated within the atheroma. PMID- 3530263 TI - Poorly encapsulated Cryptococcus neoformans from patients with AIDS. I: Preliminary observations. AB - Ten isolates of Cryptococcus neoformans recovered from individual patients with the acquired immunodeficiency syndrome (AIDS) were studied in conjunction with three other isolates from non-AIDS patients. On primary culture nine out of ten of the AIDS isolates grew as nonmucoid, dry, pasty colonies resembling those produced by "diphtheroids." One isolate formed moist colonies. In contrast, the three non-AIDS Cryptococcus neoformans isolates produced highly mucoid colonies. India ink mounts of primary cultures of the ten AIDS isolates after 48 hours incubation in 5% CO2 showed markedly smaller capsules than the three non-AIDS isolates. India ink preparations of fresh cerebrospinal fluid of two specimens from AIDS patients in which capsule sizes were systematically determined showed a few moderately encapsulated cells dispersed among numerous others that were poorly encapsulated. This observation was confirmed in mucicarmine-stained smears of cerebrospinal fluid. Poorly encapsulated Cryptococcus neoformans seem to be associated with infections in AIDS patients. PMID- 3530264 TI - Poorly encapsulated Cryptococcus neoformans from patients with AIDS. II. Correlation of capsule size observed directly in cerebrospinal fluid with that after animal passage. AB - Cryptococcus neoformans recovered from the cerebrospinal fluid (CSF) of eight patients, seven with the acquired immunodeficiency syndrome (AIDS) or AIDS related complex (ARC), were studied to assess the relationship between degree of encapsulation noted in fresh CSF with that observed after animal passage. We further correlated encapsulation with extent of immunodeficiency in these patients. Results of these studies showed poor encapsulation (mean capsule plus cell diameter less than 10 micron) in six patients, intermediate in one (mean 15.5 micron), and full encapsulation in one (mean 24.4 micron). The last isolate was observed in the CSF from the only patient without convincing clinical evidence for AIDS. Mouse passage of cryptococci from 5 AIDS patients and one with ARC resulted in a statistically significant (P less than 0.05) increase in capsule size over that observed directly in fresh cerebrospinal fluid. Cryptococci derived from the non-AIDS patient did not show an increase in encapsulation after mouse passage. These studies suggest that the immune deficiency state associated with AIDS exerts little selective pressure on inhaled poorly encapsulated C. neoformans. PMID- 3530265 TI - Perineal scanning. AB - Although various techniques have been described to aid in the ultrasound diagnosis of placenta previa and incompetent cervix, these maneuvers depend on the precise identification of the internal cervical os, a feat which is notoriously difficult to accomplish consistently. In an attempt to get a closer view of the cervix we tried another approach. This simple technique of perineal scanning has the potential to help considerably with these problems. PMID- 3530266 TI - Megacystis-microcolon-intestinal hypoperistalsis syndrome. Prenatal sonographic findings and review of the literature. AB - A case of megacystis-microcolon-intestinal hypoperistalsis syndrome (MMIHS) in a male infant followed with serial prenatal sonographic examinations is presented. Upon review of the literature, 26 cases of MMIHS have been previously reported of which only 3 were males. The prenatal sonographic diagnosis of this rare syndrome is discussed along with the clinical, pathologic findings and outcome of all reported cases. PMID- 3530267 TI - Accurate ultrasonic estimation of fetal weight. Prospective analysis of new ultrasonic formulas. AB - Five new ultrasonic weight formulae incorporating head circumference, fetal femur length, and a correction for oligohydramnios were prospectively analyzed in a group of 198 unselected patients scanned within 72 hours of birth. Comparison with the Shepard formula showed that inclusion of these parameters slightly, but significantly, improved the random error of weight estimation. The best-fit formula was: Log(10) BW = .04355HC + .05394AC - .0008582HC X AC + 1.2594 (FL/AC) 2.0661. PMID- 3530268 TI - Aortic and pulmonary blood velocities during the first 3 days of life. AB - Newborn infants undergo major cardiovascular changes to accomplish the transition from fetal to newborn circulation. These include a drop in pulmonary vascular resistance and closure of the ductus arteriosus. We measured blood velocities by pulsed-Doppler ultrasound in the great vessels of normal newborns during this transition period. Our goals were to understand the timing of these changes and to assess cardiac function as measured by flow velocities. We concluded that shunting of blood through the ductus arteriosus continues for 1-2 days after birth without apparent hemodynamic consequences, cardiac function, as assessed by the Doppler technique, remains remarkably stable during this time period, the timing of ductal closure is not affected by the mode of delivery, and Doppler ultrasound is a portable, reproducible method which is useful in assessing the cardiovascular system of the neonate. PMID- 3530269 TI - Rapid mechanical ventilation effects on tracheal airway pressure, lung volume, and blood gases of rabbits. AB - The purpose of this study was to demonstrate that ventilation of rabbit lungs (whose mechanics are similar to those of human infants) at rapid rates will lead to large alterations in tracheal airway pressures, tidal volume, and functional residual capacity (FRC) with only minor changes in arterial blood gases. Thirteen rabbits were ventilated at rates of 30, 60, 90, and 120 breaths per minutes (BPM) with pressures of 17/2 cm H2O. Tracheal peak inspiratory pressure (PIP) was always lower than ventilator PIP and decreased to 11 +/- 1 cm H2O at 120 BPM. Positive end-expiratory pressure (PEEP) in the trachea was always greater than 2 cm H2O and increased with rate (3.5 cm H2O at 120 BPM). Tidal volume decreased as rates were increased such that rates above 60 BPM resulted in insignificant changes in minute ventilation and arterial blood gases. However, the FRC increased from 16 (30 BPM) to 25 ml/kg (120 BPM), a 56% increase, suggesting large increases in end-expiratory alveolar pressure. We conclude that rapid-rate ventilation (greater than 60 BPM) of healthy rabbits results in significant increases in both tracheal PEEP and FRC without significantly affecting arterial blood gases. The increased tracheal PEEP and FRC are manifestations of inadvertent PEEP. The increased FRC without concomitant increase in PaO2 implicates alveolar overdistention. We speculate that rapid-rate ventilation of human infants having lung mechanics similar to rabbits, will also result in inadvertent PEEP and alveolar overdistention. PMID- 3530270 TI - Incidence and severity of intraventricular hemorrhage: 1981-1984. AB - We have examined the trend in the incidence and mortality of intraventricular hemorrhage (IVH) in low birthweight infants from 1981 through 1984. During this time we admitted 407 infants in the first week of life with a birthweight less than or equal to 1500 gm in whom a cranial ultrasonogram or autopsy had been performed. Though the mean birthweight and gestational age, proportion of infants who were inborn, and percentage of infants requiring mechanical ventilation did not change over the 4 years, cesarean deliveries were performed more frequently (P less than .001). The overall incidence of IVH was 62% in 1981, 56% in 1982, 49% in 1983, and 58% in 1984, thus no significant trend was evident. Although the incidence of minor hemorrhages (grades I and II) remained relatively constant, there was a decrease in the incidence of grade III IVH (1981, 11%; 1984, 2%, P = .01). The incidence of grade IV hemorrhage did not change during the 4 years and ranged from 7 to 9%. Mortality rate for all infants weighing less than or equal to 1500 gm and for infants with a minor hemorrhage remained unchanged; however, the mortality rate for infants with a major hemorrhage (grade III or IV) tended to decrease (P = .07). We conclude that although some minor changes in the incidence and mortality have occurred, IVH continues to be a major problem in very-low-birthweight infants at our institution. PMID- 3530271 TI - Treatment of hypothermia. Review of the literature. PMID- 3530272 TI - Clinical experience with expanded polytetrafluoroethylene suture. PMID- 3530273 TI - Study designs for diet and chronic disease. PMID- 3530274 TI - Transplantation of the heart in a man from Puerto Rico: a case report. PMID- 3530275 TI - [Anesthesia performed by physicians in the early history of anesthesiology]. PMID- 3530276 TI - [Evaluation of group and type-specific antisera for the typing of streptococcal infections in Mexico]. PMID- 3530277 TI - [Difference in the positivity of antinuclear antibodies in pediatrics using rat kidney and human epithelial cells as a source of antigens]. PMID- 3530278 TI - The visual evoked potential in neonates with occipital lesions and holoprosencephaly. AB - Visual evoked potentials (VEPs) were studied in 4 preterm and 2 fullterm infants in whom unilateral lesions of the occipital cortex were demonstrable on cranial ultrasonography. In the neonatal period, symmetrical responses were recorded from the two hemispheres, and the VEPs only became asymmetrical at the age of 2-3 months. Evoked responses to flash stimulation were also recorded initially in an infant with complete holoprosencephaly. These findings, together with previous reports on the maturation of the VEPs in the neonatal period, suggest that the early evoked response may be subcortical rather than cortical in origin. PMID- 3530279 TI - Endogenous ethanol--its metabolic, behavioral and biomedical significance. AB - Ethanol is constantly formed endogenously from acetaldehyde, and level of the former can be measured in both human beings and animals. Acetaldehyde can be generated in situ from the metabolism of pyruvate, threonine, deoxyribose-5 phosphate, phosphoethanolamine, alanine and presumably from other substrates. The levels of blood and tissue endogenous ethanol change as a function of various physiologic and experimental conditions such as starvation, aging, stress, cooling, adrenalectomy, etc. and are regulated by many exogenous compounds such as antimetabolites, derivatives of amino acids, lithium salts, disulfiram, cyanamide, etc. Under free choice alcohol selection situations, the levels of endogenous ethanol in rat blood and alcohol preference by the animals are negatively correlated. Similar negative correlations have been found between the levels of blood endogenous ethanol and the frequency of delirium in alcoholic patients undergoing alcohol withdrawal. Endogenous ethanol and acetaldehyde can therefore be regarded as compounds which fulfil substrate, regulatory and modulator functions. PMID- 3530280 TI - Further studies on human cholesterol-binding pancreatic protease/elastase 1. Immunological detection of analogous enzymes in several animal species and identification of the porcine-derived enzyme as protease E. AB - Antibodies against the human cholesterol-binding pancreatic protease/elastase 1 (Sziegoleit, A., Linder, D., Schluter, M., Ogawa, M., Nishibe, S. & Fujimoto, K. 1985) Eur. J. Biochem. 151, 595-599) recognize a distinct protein in the pancreas homogenate of various animal species. The CBPP/elastase 1-related porcine protease was purified and characterized. Its properties, including specificity, proved to be the same as those of the well classified porcine pancreatic protease E (Kobayashi, R., Kobayashi, Y. & Hirs, C.H.W. (1981) J. Biol. Chem. 256, 2460 2465). While the common features of all these proteins seem to be the proteolysis with elastase-like specificities (investigated for the human-, porcine-, dog- and rat-derived protein) and an isoelectric point at about pH 5 (determined for the pancreatic proteins from man, swine, rat dog and cattle), the bile salt and cholesterol-binding capacity varies significantly among the animal species. Charge shift crossed immunoelectrophoresis of the pancreatic proteins from rat, dog, cat, swine, horse, zebra, cattle and rabbit reveals that only the protein from rat pancreas binds the negatively charged bile salt sodium deoxycholate to an extent comparable to that of human CBPP/elastase 1. Thus, within the diverse elastase family, there seems to be a distinct enzyme which merits distinct classification. PMID- 3530281 TI - Control of glucose balance in the perfused rat liver by the parasympathetic innervation. AB - Electrical stimulation of the nerve bundles around the hepatic artery and the portal vein activates both the sympathetic and parasympathetic liver nerves; the sympathetic effects clearly predominate. Parasympathetic effects were therefore studied in the rat liver perfused in situ by perivascular nerve stimulation in the presence of both an alpha- and a beta-blocker. In the presence of the alpha blocker phentolamine and the beta-blocker propranolol all sympathetic nerve effects were prevented; the remaining parasympathetic stimulation had no influence on the basal glucose and lactate metabolism nor on the hemodynamics. Insulin alone, with both alpha- and beta-blockade, provoked a small, parasympathetic nerve stimulation in the presence of insulin a more pronounced enhancement of glucose utilization. In the presence of an alpha- and beta-blocker perivascular nerve stimulation antagonized the glucagon stimulated glucose release, but did not affect lactate exchange. The nerve effect was abolished by the parasympathetic antagonist atropine. Acetylcholine or insulin, with both an alpha- and beta-blocker present, mimicked the effects of nerve stimulation antagonizing the glucagon-stimulated glucose release. Nerve stimulation in the presence of insulin was more effective than either stimulus alone. The present results show that in rat liver stimulation of the parasympathetic hepatic nerves has direct effects on glucose metabolism synergistic with insulin and antagonistic to glucagon. PMID- 3530282 TI - Inhibition of mast cell chymase by eglin c and antileukoprotease (HUSI-I). Indications for potential biological functions of these inhibitors. AB - Recombinant eglin c (originally isolated from the medical leech) and antileukoprotease (HUSI-I from human seminal plasma) were examined for their ability to inhibit the mastcell protease chymase. Both inhibitors react rapidly with the enzyme: when about equimolar concentrations (in the range of 10(-8) M) of chymase and HUSI-I or eglin c were incubated the complex formation was apparently at equilibrium after 1 or 5 min respectively. When a constant amount of chymase (approximately 3 X 10(-8) M) was incubated with increasing concentrations of inhibitor a concentration of HUSI-I of 7 X 10(-7) M was necessary to cause 50% inhibition of the initial enzyme activity, whereas 8 X 10( 8) M eglin c was sufficient. The dissociation constant of the chymase-eglin c complex was calculated to be 4.4 X 10(-8) M. These results are discussed with respect to the possible in vivo function of antileukoprotease as an inhibitor of mast cell chymase. PMID- 3530283 TI - Taking care of the caregiver. Five strategies for stamina. PMID- 3530284 TI - Complications of the external (combination) rhinoplasty approach. AB - More rhinoplastic surgeons are using the external (combination) rhinoplasty approach for selected patients. Although several large series report few complications, the initial experience of newcomers may be different. A series of 26 external rhinoplasty approaches was examined, representing the initial experience of supervised residents. The most common complication was incising the anterior margin of the lower lateral cartilage at the juncture of the lateral and medial crura. To prevent this problem, it is recommended that the skin be elevated off the lower lateral cartilages from both a medial direction up over the domes and a lateral direction downward. To repair this complication, a figure of-eight suture is used to reapproximate the incision. PMID- 3530285 TI - Parathyroid aspiration biopsy under ultrasonographic guidance. AB - Localization of hyperfunctioning parathyroid glands is difficult. We examined 16 patients with biochemically proven primary or secondary hyperparathyroidism, using a 5-MHz 90 degrees real-time sector transducer. In those 16 patients, ultrasonographically guided fine-needle aspiration biopsy of 26 hypoechogenic retrothyroid nodules was performed. Hyperplastic parathyroid tissue was obtained from 24 retrothyroid nodules in 14 patients. In the other two patients, normal thyroid tissue was obtained. Both specificity and sensitivity of the aspiration biopsy technique were 100%. No complications occurred. We concluded that this technique is safe, simple, and very helpful in the localization of parathyroid tumors before surgery or before alcoholization. PMID- 3530286 TI - The laterality of dreaming. AB - The cortical locus of dream generation could be lateralized to the right or left hemisphere, or be bilaterally represented with either equal or unequal contributions from each hemisphere. In this paper we review the neurological literature for cases of loss or alteration of dream report after brain damage. The distribution of lesion sites is used to test the various hypotheses concerning the laterality of dreaming. The hypothesis receiving best support is that dreaming is lateralized to the left hemisphere in individuals with typical neurologic organization. PMID- 3530287 TI - Hemispheric lateralization of functions related to emotion. AB - We have reviewed the evidence that processes and functions related to perception and expression of emotions are represented asymmetrically in the cerebral hemispheres. The literature describes three possible aspects of emotional lateralization: that emotions are better recognized by the right hemisphere; that control of emotional expression and related behaviors takes place principally in the right hemisphere; and that the right hemisphere is specialized for dealing with negative emotions, while the left is specialized for dealing with positive emotions. Evidence for the three hypotheses derives from methodologically diverse studies in unimpaired, brain-lesioned, and mood-disordered populations. Relatively little of the work has been precisely replicated, and conclusions rest on parallel lines of evidence from diverse sources. The present level of knowledge suggests a model of emotional control based on interactive inhibition between a right negatively biased and left positively biased hemisphere. However, the details of such a model, including the precise conditions under which emotion related functions are lateralized, and the mechanisms of such lateralization have yet to be elucidated. PMID- 3530288 TI - [Ultrasonographic evaluation of skeletal muscle in the diagnosis of muscular dystrophy: comparison of ultrasonography with computed tomography]. PMID- 3530289 TI - [Malformations of the central nervous system]. PMID- 3530290 TI - Harold Randall Griffith. The pioneer of the use of muscle relaxants in anaesthesia. PMID- 3530291 TI - Conversation with Jaroslav Skala. PMID- 3530292 TI - The 1985 Dent memorial lecture. 'I need heroin'. Thirty years' experience of drug dependence and of the medical challenges at local, national, international and political level. What next? PMID- 3530293 TI - English interest in the treatment of alcoholism in the United States during the early 1870's. PMID- 3530294 TI - Tobacco battered and the pipes shattered: a note on the fate of the first British campaign against tobacco smoking. PMID- 3530295 TI - The mechanism of action of calcium antagonists relative to their clinical applications. AB - As a class of therapeutic agents calcium antagonists have attracted increasing attention in recent years. Their major indications have been in the treatment of ischaemic myocardial syndromes, certain cardiac arrhythmias, hypertension, obstructive cardiomyopathies, and a number of lesser clinical disorders in which their role is less clearly defined. With the widening spectrum of therapeutic utility and an increasing plethora of newer agents under development, it is of importance to relate the overall pharmacodynamics of individual agents to their clinical effects. Calcium antagonists have a variable specificity for cardiac and peripheral activity. Based on such activity, it is useful to construct a classification of these compounds, new and old, into four categories. Type I agents, typified by verapamil and its congeners (tiapamil and gallopamil) and diltiazem, prolong AV nodal conduction and refractoriness with little effect on ventricular or atrial refractory period. These actions account for their direct antiarrhythmic properties. Type II agents include nifedipine and other dihydropyridines. In vivo, these agents are devoid of electrophysiologic effects in usual doses. They are potent peripheral vasodilators with some selectivity of action for different vascular beds; their overall haemodynamic effects are dominated by this peripheral vasodilatation and reflex augmentation of sympathetic reflexes. Type III agents include flunarizine and cinnarizine (piperazine derivatives), which, in vitro and in vivo, are potent dilators of peripheral vessels, with no corresponding calcium-blocking actions in the heart. Type IV agents are agents with a broader pharmacologic profile (perhexiline, lidoflazine and bepridil); they block calcium fluxes in the heart, in the peripheral vessels, or both. They may inhibit the fast channel in the heart and have other electrophysiologic actions. A clear understanding of the varied pharmacologic properties of the different classes of calcium antagonists is likely to provide a rational basis for the use of these agents in clinical therapeutics. PMID- 3530296 TI - Salt and hypertension. AB - Studies comparing different communities have suggested that the amount of salt in the diet may play an important role in determining blood pressure levels within a particular community. Intervention studies have also suggested that salt intake may play an important role in determining blood pressure levels in man. In animals, where more clearcut experiments can be done, an increase in salt intake both in inherited forms of hypertension and experimental hypertension causes a further rise in blood pressure. Recent work has suggested that this rise in blood pressure could be related to an inherited or imposed defect in the kidney's ability to excrete sodium, which will give rise to greater compensatory mechanisms to overcome the sodium retention. These compensatory mechanisms might eventually be responsible for the development of high blood pressure. In patients who have already developed high blood pressure, restricting the amount of salt in the diet does cause a fall in blood pressure in many patients. However, short term reduction of salt intake in normotensive subjects causes little, if any, fall in blood pressure. The effectiveness of short term salt restriction in lowering blood pressure in adults therefore appears to be related to the severity of the high blood pressure and, probably more directly, to the suppression of the renin system that occurs as blood pressure rises. PMID- 3530298 TI - Once a day verapamil in essential hypertension. AB - Pharmacodynamic and therapeutic studies with a new slow release 240 mg verapamil formulation were performed in a total of 73 patients with essential hypertension (WHO I-II, diastolic greater than or equal to 100 mm Hg). Chronic administration of slow release 240 mg verapamil, one or two tablets in the morning, resulted in 24 h plasma concentration profiles with trough levels greater than 40 ng ml-1 in 14 of 16 patients and good 24 h blood pressure control. There was no correlation between plasma verapamil or norverapamil concentration and blood pressure response. Monotherapy with slow release verapamil was well tolerated and resulted in good blood pressure control (less than or equal to 95 mm Hg diastolic) in 46 of the 57 patients. Responses were best in older patients and those with low plasma renin or higher control blood pressure. Slow release 240 mg verapamil given once daily is a simple and effective regimen. PMID- 3530299 TI - Studies on verapamil in the treatment of essential hypertension: a review. AB - Various doses of verapamil, using the conventional and sustained release formulations, have been administered for the treatment of mild or moderate hypertension in different controlled studies for periods of 4-6 weeks, involving a total of 103 patients, and in one long-term trial for 1 year in 12 patients. A double-blind comparison of verapamil and nifedipine showed that the two calcium antagonists had equal antihypertensive action. A significant blood pressure (BP) reduction was achieved with verapamil both at rest and during isometric exercise in the great majority of patients. No significant correlation was found between age and BP reduction, but pretreatment BP and pressure reduction correlated positively. Heart rate (HR) was moderately but significantly reduced by verapamil. The established wide interindividual differences in verapamil pharmacokinetics were confirmed. There was no significant correlation between plasma drug concentrations and BP reduction, but the dosage regimens with the highest mean plasma drug concentrations were associated with the greatest mean reduction in BP. A moderate, but significant, prolongation of AV-conduction was demonstrated. QRS- and QT-intervals were unaffected. Side-effects, with all formulations of verapamil, were generally mild and often transient. No significant haematological or metabolic effects were observed during long-term treatment. It is concluded that the calcium antagonist verapamil is an effective and safe drug. It can be considered as an alternative drug in mild and moderate essential hypertension. PMID- 3530297 TI - The management of hypertension. PMID- 3530300 TI - Verapamil in arrhythmia. AB - The antiarrhythmic effects of verapamil were observed before it was appreciated that it was a calcium ion-antagonist. Intravenous verapamil is highly effective in the termination of paroxysmal reciprocating atrioventricular tachycardia, whether associated with preexcitation or involving the atrioventricular node alone. It consistently slows and regularises the ventricular response in atrial fibrillation, and usually increases the degree of AV-nodal block in atrial flutter though it occasionally induces a return to sinus rhythm. Given orally it is useful for the prophylaxis of atrioventricular reentry tachycardia, and also in modulating the atrioventricular nodal response in atrial fibrillation. Favourable response in ventricular tachycardia is exceptional and then seen in specific benign varieties. Verapamil is the agent of choice for the termination of paroxysmal supraventricular tachycardia. PMID- 3530301 TI - The Danish studies on verapamil in acute myocardial infarction. The Danish Study Group on Verapamil in Myocardial Infarction. AB - A double-blind study comparing verapamil with placebo was conducted in 16 Danish departments of internal medicine with coronary care units (CCU). All patients below 75 years of age admitted to the CCU with a suspicion of acute myocardial infarction (AMI) were evaluated. Of 7415 patients, 3917 were excluded on admission because of heart failure, heart block, other severely disabling diseases, or treatment with beta-adrenoceptor blockers or calcium antagonists. Treatment was started in 3498 patients with 0.1 mg kg-1 verapamil i.v. and 120 mg orally on admission followed by 120 mg three times daily, or matched placebo. Treatment was continued for 6 months for patients verified to have had an AMI according to all three WHO criteria. Treatment was stopped in patients for whom the diagnosis of AMI was ruled out. Of 1436 patients with AMI, 717 were treated with verapamil and 719 with placebo. After 6 months, 92 patients (12.8%) in the verapamil group and 100 patients (13.9%) in the placebo group were dead (NS). Fifty patients (7%) in the verapamil group and 60 patients (8.3%) in the placebo group had reinfarctions (NS). After 12 months, 109 patients (15.2%) in the verapamil group and 118 patients (16.4%) in the placebo group were dead (NS). It is concluded that verapamil treatment used in the early phase of an AMI does not improve survival. Based on the experience from the first study we are at present performing a further secondary prevention study with verapamil to a modified design. PMID- 3530302 TI - Dose determinants of rebound insomnia. AB - A polysomnographic assessment in healthy normal sleepers of possible dose relations for rebound insomnia was conducted. As an additional measure of rebound the study included a direct test of sleep/wake tendency during the night of drug discontinuation. Twelve, healthy men (21-30 years) each received placebo, 0.25 mg and 0.50 mg triazolam for 6 consecutive nights followed by a discontinuation night and 14 nights of recovery at home. The three conditions were presented, double-blind, in a latin square design. On night 6 of drug administration both doses increased total sleep time compared to placebo, but 0.50 mg did not improve sleep beyond 0.25 mg. On drug discontinuation (night 7) wake time over the 8 h recording and sleep latency after an experimental awakening (02.30 h) were increased with 0.50 mg compared to placebo and 0.25 mg. On these measures of rebound 0.25 mg did not differ from placebo. Thus rebound insomnia occurred only at a dose (0.50 mg) which produced no additional hypnotic efficacy in these normal sleepers. Whether tests of sleep/wake tendency make a useful measure of rebound insomnia needs further clarification. PMID- 3530303 TI - Influence of nisoldipine on haemodynamic effects and plasma levels of digoxin. AB - In a placebo controlled double-blind study including 10 patients with heart failure the nisoldipine/digoxin interaction was studied. Nisoldipine was shown to elevate digoxin plasma concentrations significantly by about 15% (trough levels). During chronic combination therapy with nisoldipine trough levels and plasma concentrations 4 h after the morning dose of digoxin were 1.35 +/- 0.14 and 1.92 +/- 0.16 ng ml-1 respectively, whereas they averaged to 1.16 +/- 0.14 and 1.52 +/ 0.16 ng ml-1 with digoxin and placebo (P less than 0.05; mean +/- s.e. mean). Systolic time intervals were significantly altered by nisoldipine co administration compared with digoxin plus placebo. In certain patients the elevation of digoxin plasma levels due to nisoldipine co-administration could be of clinical relevance. PMID- 3530304 TI - Drug-specific antibodies in patients receiving captopril. AB - IgG anti-captopril (CP) antibody activity was detected by enzyme-linked immunosorbent assay (ELISA) in serum from two out of 45 patients receiving the drug (25-75 mg day-1). Five of the 45 patients, including one whose serum was antibody-positive, suffered skin rashes which were thought to be drug-induced. The specificity of the antibody for the disulphide-conjugated form of captopril was established as follows: serum IgG bound to disulphide-linked captopril-human albumin (CP-S-S-HSA) conjugate but not to HSA; binding of IgG to CP-S-S-HSA was inhibited by disulphide-linked captopril-ovalbumin (CP-S-S-OVA) conjugate and captopril disulphide (CP-S-S-CP). The structurally related drug D-penicillamine (PA) in disulphide-linked form (PA-S-S-OVA and PA-S-S-PA) was without inhibitory activity. The inhibitory preparations of CP-S-S-OVA and CP-S-S-CP were shown to be inactive in an ELISA for human IgG directed against the unrelated benzylpenicilloyl antigen. Since disulphide-linked CP-plasma protein conjugates are formed extensively in vivo, and since the antibodies we describe are directed against CP in disulphide-linked form, it appears that CP may be immunogenic in some patients receiving the drug. PMID- 3530306 TI - A general practice study of the efficacy of Regulan in functional constipation. PMID- 3530305 TI - The effect of lamotrigine, a novel anticonvulsant, on interictal spikes in patients with epilepsy. AB - Lamotrigine, a novel anticonvulsant, has been evaluated in patients with epilepsy using the method of interictal EEG spike counting. In a randomised double-blind trial it was found that oral lamotrigine (240 mg) was more effective than placebo, but less effective than diazepam (20 mg) in suppressing interictal spikes. Further clinical evaluation of lamotrigine is recommended in patients with epilepsy. PMID- 3530307 TI - Prostacyclin and thromboxane in benign and malignant breast tumours. AB - 6-keto-PGF1 alpha and thromboxane B2 were determined by radioimmunoassay in 37 extracts of breast carcinomata, 8 fibroadenomata, 12 sclerocystic-disease specimens and 51 normal breast tissues. More prostanoids were extracted from carcinomata than from normal specimens, fibroadenomata or sclerocystic-disease tissues (P less than 0.05). The 6-keto-PGF1 alpha/TXB2 ratio was higher in carcinomata than in normal tissues and fibroadenomata (P less than 0.05) but was not significantly different from the ratio in sclerocystic disease. The prostaglandin levels and the 6-keto-PGF1 alpha/TXB2 ratios from carcinomata did not correlate significantly with age, tumour size, differentiation, lymph node status, nuclear-cytoplasmic ratio, host cell reaction, mast cells, necrosis, elastosis, fibrosis or blood vessel density. Lower nuclear density was associated with lower 6-keto-PGF1 alpha/TXB2 ratios (P = 0.01) whereas the latter value was higher when infiltration was lower (P = 0.03). There was a positive correlation between mitotic index and the 6-keto-PGF1 alpha/TXB2 ratio (P = 0.04). Cumulation of variables revealed lower prostanoid ratios in tumours greater than 2 cm without lymph node metastasis then tumours less than 2 cm with lymph node metastasis (P = 0.04). A first follow-up (14 months) showed a higher 6-keto-PGF1 alpha/TXB2 ratio in patients who developed metastasis (P = 0.04). Our study does not confirm the hypothesis that high prostacyclin levels are a good prognostic index in breast cancer. PMID- 3530308 TI - Low dose irradiation permits immunization of A/J mice with subimmunogenic numbers of SaI cells. PMID- 3530309 TI - Photosensitivity due to retinoids: clinical and laboratory studies. AB - Six subjects taking isotretinoin were studied, none of whom had clinical or phototest evidence of photosensitivity. Of nine subjects taking etretinate, one had convincing clinical photosensitivity consisting of a burning erythema on sunlight exposure. His phototesting results showed a marked abnormality from 300 +/- 5 nm to 365 +/- 30 nm which returned close to normal limits within one month of stopping therapy. Although clinically normal, another subject taking etretinate had similar phototest evidence of abnormal photosensitivity. In vitro photohaemolysis studies demonstrated that tretinoin (all-trans-retinoic acid) and isotretinoin have a potential, while etretinate has none. However, the major metabolite of etretinate (Ro 10-1670) had a phototoxic potential greater than that of tretinoin. The apparently low incidence of photosensitivity suggests that an idiosyncrasy is responsible, perhaps due to a disorder of pharmacokinetics or metabolism. Clinical cases should use appropriate photoprotection against UVB and UVA wavebands. PMID- 3530310 TI - Immunopathological and ultrastructural findings in human allergic and irritant contact dermatitis. AB - The histopathological features of allergic contact dermatitis were compared with those of irritant contact dermatitis in a group of 17 subjects. Each patient received simultaneous patch tests of a known allergen and a standardized irritant (benzalkonium chloride). The cellular changes occurring between 3 h and 7 days after patch test application were studied by light and electron microscopy and immunocytochemistry. No differences were observed between the induced allergic contact dermatitis (ACD) and the irritant contact dermatitis (ICD), either in the responding cell types or the sequence of cellular events. Both reactions showed a predominantly T lymphocyte infiltrate with no polymorphonuclear leukocyte involvement. Apposition of Langerhans cells to lymphocytes in the epidermis was seen in both types of response. Considerable variability in the intensity of reaction to irritant and allergen occurred within individuals. There was no statistically significant difference between the intensity of the reactions to the irritant and the allergen. PMID- 3530311 TI - Immunogold labelling of epidermal Langerhans cells on tissue sections of normal human skin. AB - A colloidal gold staining procedure was developed for immuno-electron microscopy, which allowed the demonstration of T6 surface antigens of epidermal Langerhans cells on sections of normal human skin with consistent ultrastructural preservation of subcellular structures. All the observed Birbeck granule-bearing Langerhans cells revealed immunogold labelling along the plasma membrane. The penetration of the tissue by the gold particles was adequate, as was the sensitivity and the specificity of the reaction. A major advantage of the present method in comparison with immunoperoxidase techniques is the absence of non specific staining of the membranes of keratinocytes facing the labelled plasma membrane of the Langerhans cells. PMID- 3530312 TI - Is spontaneous mutation the major 'cause' of childhood acute lymphoblastic leukaemia? PMID- 3530313 TI - Recovery of immunoglobulin isotypes following T-cell depleted allogeneic bone marrow transplantation. AB - After conventional bone marrow transplantation serum IgG, IgM and IgA levels fall from pre-transplant levels and may not return to normal for 3-12 months. In contrast IgE may rise to supranormal levels, an event that may be associated with graft-versus-host disease. We have investigated the recovery of immunoglobulin isotypes in the recipients of allogeneic marrows depleted of T-cells to prevent graft-versus-host disease. We find that pre-transplant IgG, IgM and IgA levels are maintained throughout the post-transplant period but that there is a short lived rise in IgE about 3 weeks after transplantation: this rise occurs in the absence of clinically detectable graft-versus-host disease. We conclude that specific T-cell depletion does not impair and may actually enhance the functional recovery of B cells after allogeneic BMT. PMID- 3530314 TI - Prediction and prevention of relapse of acute lymphoblastic leukaemia after bone marrow transplantation. AB - Results of bone marrow transplantation (BMT) in 63 adults and children with ALL transplanted in the 5-year period 1979-83 were analysed. Twenty-one patients (33%) relapsed, 25% of the group died in relapse and 19% died from complications of BMT. The actuarial disease-free survival at 6 years was 38%. Relapse after BMT could be predicted by standard prognostic diagnostic features such as age, sex, cell type and presenting blast cell count. Patients transplanted in first remission selected for their poor prognosis had a lower relapse risk than a similar group of poor prognosis patients transplanted in second or subsequent remission (P less than 0.05). Relapse following second and subsequent remission BMT was predicted by a score based on standard prognostic features or by the pace of the disease: patients with an interval of less than 2 years between diagnosis and first relapse having a 15% actuarial disease-free survival, compared with 81% for patients with an interval greater than 2 years (P less than 0.001). These results emphasize that ALL is a heterogeneous disease and establishes the importance of determining relapse risk when selecting BMT and other treatment schedules for ALL patients. PMID- 3530315 TI - Evidence against immune haemolysis in falciparum malaria in Thailand. AB - Evidence of immune mediated haemolysis was sought in 83 patients with P. falciparum malaria in eastern Thailand. Amongst 73 patients with uncomplicated infection 12 (16.4%) had a weakly positive direct antiglobulin test (DAT). The incidence in 32 children aged 8-16 years was similar to that in adults. Of 10 patients with cerebral malaria, six adults, all of whom were in unrousable coma, had a positive DAT. Erythrocyte-bound IgG1 accounted for the positive DAT in all cases; sensitization with complement or other IgG subclasses was not found. Patients with uncomplicated malaria had a median value of 70 IgG molecules per erythrocyte compared with 65 molecules per cell in 67 healthy controls. This difference was not statistically significant but could account for the lower incidence of a positive DAT in control subjects (4.5%). There was no correlation between the number of IgG molecules per cell and the degree of anaemia during the acute or convalescent phases of the infection. There is no evidence from this study that an immunohaemolytic process contributes to the anaemia of falciparum malaria in eastern Thailand. PMID- 3530316 TI - Standardization of T-cell depletion in HLA matched bone marrow transplantation. AB - The IBM 2991 Blood Cell Processor has been used to isolate a mononuclear cell (MNC) fraction from the marrow of 31 allogeneic donors. The MNC fraction was then incubated with a combination of two murine monoclonal antibodies MBG6 (CD6) and RFT8 (CD8) followed by two rounds of treatment with rabbit complement resulting in a marrow inoculum significantly reduced in the number of T-lymphocytes. We report here new specifications for the use of Ficoll-Metrizoate, the method used to calculate T-lymphocyte depletion and the details of our attempts to improve T depletion. Following marrow transplantation with this T-depleted fraction, 29 patients are evaluable for engraftment, one patient failed to engraft and one died too early for evaluation. Twenty-two had no acute graft-versus-host disease (aGvHD), at a minimum of 60 d, six had grade I acute GvHD and one grade III. No correlation was found between the absolute number of MNC infused and time to engraftment, nor any relationship between the number of residual viable T lymphocytes in the infused marrow and the incidence of GvHD, but the patient with the most severe aGvHD also had the highest number of T-lymphocytes infused. PMID- 3530317 TI - Rapid diagnosis of Chlamydia trachomatis infection in patients attending an ophthalmic casualty department. AB - Direct immunofluorescence (DIF) techniques were compared with conventional cell culture for the diagnosis of ocular infections with Chlamydia trachomatis. The DIF test was found to have a sensitivity of 100% and a specificity of 97.5%. Of 178 patients studied, 19 patients (11%) were positive by DIF and 15 (8.4%) by conventional cell culture technique. Four patients who had previous treatment with chloramphenicol eye drops were negative by cell culture but positive by the DIF test. The DIF test is considered to be a rapid, accurate test with a number of advantages over culture techniques for the detection of C. trachomatis. The importance of appropriate referral of positive patients to prevent more serious sequelae due to C. trachomatis infection is discussed. PMID- 3530318 TI - Purification of a protein C activator from the venom of the southern copperhead snake (Agkistrodon contortrix contortrix). AB - A protease has been purified by ion-exchange chromatography from the venom of Agkistrodon contortrix contortrix (Southern copperhead snake) that can activate the vitamin K dependent protein, protein C. The apparent molecular weight of this protease, determined by sodium dodecyl sulfate-polyacrylamide gel electrophoresis, was 20,000 under nonreducing conditions. Incubation of this protease with plasma resulted in a prolongation of the clotting time and a time dependent increase in amidolytic activity. Incubation of the protease with purified protein C resulted in an increase in both amidolytic and anticoagulant activity. The protease had no inhibitory effect on thrombin, factor V, fibrinogen, or factor X. It had slight clotting activity toward fibrinogen. The apparent Km of the protease for protein C was 0.28 microM. Calcium ions were observed to inhibit protein C activation with an apparent Ki of 0.2 mM. Ethylenediaminetetraacetic acid, diisopropyl fluorophosphate, and soybean trypsin inhibitor were observed to inhibit the venom protease. These results suggest that the venom of the Southern copperhead snake contains a protease that is a specific activator of protein C. PMID- 3530319 TI - Crystal structure of a novel trimethoprim-resistant dihydrofolate reductase specified in Escherichia coli by R-plasmid R67. AB - Crystalline R67 dihydrofolate reductase (DHFR) is a dimeric molecule with two identical 78 amino acid subunits, each folded into a beta-barrel conformation. The outer surfaces of the three longest beta strands in each protomer together form a third beta barrel having six strands at the subunit interface. A unique feature of the enzyme structure is that while the intersubunit beta barrel is quite regular over most of its surface, an 8-A "gap" runs the full length of the barrel, disrupting potential hydrogen bonds between beta-strand D in subunit I and the adjacent corresponding strand of subunit II. It is proposed that this deep groove is the NADPH binding site and that the association between protein and cofactor is modulated by hydrogen-bonding interactions along one face of this antiparallel beta-barrel structure. A hypothetical model is proposed for the R67 DHFR-NADPH-folate ternary complex that is consistent with both the known reaction stereoselectivity and the weak binding of 2,4-diamino inhibitors to the plasmid specified reductase. Geometrical comparison of this model with an experimentally determined structure for chicken DHFR suggests that chromosomal and type II R plasmid specified enzymes may have independently evolved similar catalytic machinery for substrate reduction. PMID- 3530320 TI - Beta-elimination of indole from L-tryptophan catalyzed by bacterial tryptophan synthase: a comparison between reactions catalyzed by tryptophanase and tryptophan synthase. AB - Although tryptophan synthase catalyzes a number of pyridoxal phosphate dependent beta-elimination and beta-replacement reactions that are also catalyzed by tryptophanase, a principal and puzzling difference between the two enzymes lies in the apparent inability of tryptophan synthase to catalyze beta-elimination of indole from L-tryptophan. We now demonstrate for the first time that the beta 2 subunit and the alpha 2 beta 2 complex of tryptophan synthase from Escherichia coli and from Salmonella typhimurium do catalyze a slow beta-elimination reaction with L-tryptophan to produce indole, pyruvate, and ammonia. The rate of the reaction is about 10-fold higher in the presence of the alpha subunit. The rate of indole production is increased about 4-fold when the aminoacrylate produced is converted to S-(hydroxyethyl)-L-cysteine by a coupled beta-replacement reaction with beta-mercaptoethanol. The rate of L-tryptophan cleavage is also increased when the indole produced is removed by extraction with toluene or by condensation with D-glyceraldehyde 3-phosphate to form indole-3-glycerol phosphate in a reaction catalyzed by the alpha subunit of tryptophan synthase. The amount of L tryptophan cleavage is greatest in the presence of both beta-mercaptoethanol and D-glyceraldehyde 3-phosphate, which cause the removal of both products of cleavage. The cleavage reaction is not due to contaminating tryptophanase since the activity is not inhibited by (3R)-2,3-dihydro-L-tryptophan, a specific inhibitor of tryptophanase, but is inhibited by (3S)-2,3-dihydro-L-tryptophan, a specific inhibitor of tryptophan synthase. The cleavage reaction is also inhibited by D-tryptophan, the product of a slow racemization reaction.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3530321 TI - Isomerization of (3S)-2,3-dihydro-5-fluoro-L-tryptophan and of 5-fluoro-L tryptophan catalyzed by tryptophan synthase: studies using fluorine-19 nuclear magnetic resonance and difference spectroscopy. AB - We are exploring the active site and the mechanism of the pyridoxal phosphate dependent reactions of the bacterial tryptophan synthase alpha 2 beta 2 complex by use of substrate analogues and of reaction intermediate analogues. Fluorine-19 nuclear magnetic resonance studies and absorption spectroscopy are used to study the binding and reactions of the D and L isomers of 5-fluorotryptophan, of tryptophan, and of (3S)- and (3R)-2,3-dihydro-5-fluorotryptophan. Tryptophan synthase specifically and tightly binds the 3S diastereoisomer of both 2,3 dihydro-5-fluoro-D-tryptophan and 2,3-dihydro-5-fluoro-L-tryptophan, whereas it binds 5-fluoro-D-tryptophan more tightly than 5-fluoro-L-tryptophan. Unexpectedly, we find that the D and L isomers of 5-fluorotryptophan, of tryptophan, and of (3S)-2,3-dihydro-5-fluorotryptophan are slowly interconverted by isomerization reactions. Since these isomerization reactions are 10(3)-10(5) times slower than the beta-replacement and beta-elimination reactions catalyzed by tryptophan synthase, they have no biochemical significance in vivo. However, the occurrence of these slow reactions does throw some light on the nature of the active site of tryptophan synthase and its requirements for substrate binding. Our results raise the interesting question of whether tryptophan synthase itself serves a catalytic role in these slow reactions or whether the enzyme simply binds the substrate and pyridoxal phosphate stereospecifically and thus promotes the intrinsic catalytic activity of pyridoxal phosphate. PMID- 3530322 TI - Amino acid sequence of a basic Agkistrodon halys blomhoffii phospholipase A2. Possible role of NH2-terminal lysines in action on phospholipids of Escherichia coli. AB - A basic (pI = 10.2) phospholipase A2 of the venom of the snake Agkistrodon halys blomhoffii is one of a few phospholipases A2 capable of hydrolyzing the phospholipids of Escherichia coli killed by a bactericidal protein purified from human or rabbit neutrophil granules. We have shown that modification of as many as 4 mol of lysine per mole of the phospholipase A2, either by carbamylation or by reductive methylation [Forst, S., Weiss, J., & Elsbach, P. (1982) J. Biol. Chem. 257, 14055-14057], had no effect on catalytic activity toward extracted E. coli phospholipids or the phospholipids of autoclaved E. coli. In contrast, modification of 1 mol of lysine per mole of enzyme substantially reduced activity toward the phospholipids of E. coli killed by the neutrophil protein. To explore further the role of lysines in the function of this phospholipase A2, we determined the amino acid sequence of the enzyme and the incorporation of [14C]cyanate into individual lysines when, on average, 1 lysine per molecule of enzyme had been carbamylated. After incorporation of approximately 1 mol of [14C]cyanate per mole of protein, the phospholipase A2 was reduced, alkylated, and exhaustively carbamylated with unlabeled cyanate. The amino acid sequence was determined of the NH2-terminal 33 amino acids of the holoprotein and of peptides isolated after digestion with trypsin and Staphylococcus aureus V-8 protease. The protein contains 122 amino acid residues, 17 of which are lysines. The NH2 terminal region is unique among more than 30 phospholipases A2 previously sequenced because of its high content of basic residues (His-1, Arg-6, and Lys-7, -10, -11, and -15).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3530323 TI - Purification and characterization of aminoimidazole ribonucleotide synthetase from Escherichia coli. AB - Aminoimidazole ribonucleotide (AIR) synthetase has been purified 15-fold to apparent homogeneity from Escherichia coli which contains a multicopy plasmid containing the purM, AIR synthetase, gene. The protein is a dimer composed of two identical subunits of Mr 38,500. The N-terminal sequence, amino acid composition, and steady-state kinetics of the protein have been determined. AIR synthetase has been shown to catalyze the transfer of the formyl oxygen of [18O]formylglycinamide ribonucleotide to Pi. PMID- 3530324 TI - Chromatographic analysis of the chiral and covalent instability of S-adenosyl-L methionine. AB - The chirality of biologically active S-adenosyl-L-methionine (AdoMet) is S,S, where the designations refer to the sulfur and the alpha-carbon, respectively. This paper describes a cation-exchange high-performance liquid chromatographic (HPLC) method for separating (S,S)-AdoMet from the biologically inactive (R,S) AdoMet that results from racemization at the sulfur. This method was used to measure the rates of the degradation reactions of (S,S)-AdoMet as a function of pH. These reactions and the first-order rate constants, which were found at 37 degrees C and pH 7.5, are racemization, 1.8 X 10(-6) s-1; cleavage to homoserine lactone and 5'-(methylthio)adenosine, 4.6 X 10(-6) s-1; and hydrolysis to adenine and S-pentosylmethionine, 3 X 10(-6) s-1. Racemization showed no change in rate over the pH range from 7.5 to 1.5. The cleavage reaction persisted until the pH was lowered to 1.5, but hydrolysis ceased at pH 6. Commercial samples of nonradioactive AdoMet contained 20-30% (R,S)-AdoMet, while a sample of [methyl 3H]AdoMet had less than 1% (R,S)-AdoMet. Preparing enzyme substrates by mixing such samples will cause an underestimate of specific activity and an overestimate of the amount of product. The (R,S)-AdoMet/(S,S)-AdoMet ratio in mouse liver was 0.03, much less than the value of 0.19 calculated from the above rate constants. An enzyme extract from mouse liver did not degrade (R,S)-AdoMet, but a more thorough search may find such an activity. In any event, the cleavage and hydrolysis reactions partially balance the racemization of (S,S)-AdoMet in vivo and prevent excessive accumulation of (R,S)-AdoMet. PMID- 3530325 TI - Selectivity properties of pores induced in host erythrocyte membrane by Plasmodium falciparum. Effect of parasite maturation. AB - The intraerythrocytic malarial parasite permeabilizes its host cell membrane by inducing pore-like pathways which mediate the passage of nonelectrolytes and anions. In the present work we show that, although the permeability increases with parasite maturation, the selectivity of the pores to various solutes is essentially preserved, suggesting that the number of pores increases without any alteration in their intrinsic solute conductance. PMID- 3530326 TI - Mechanism of action of Pseudomonas syringae phytotoxin, syringomycin. Interaction with the plasma membrane of wild-type and respiratory-deficient strains of Saccharomyces cerevisiae. AB - The effects of the phytotoxin, syringomycin, produced by Pseudomonas syringae pv. syringae, were examined on cells of a wild-type and a respiratory-deficient (rho0) mutant of Saccharomyces cerevisiae. The growth of both strains in liquid culture was inhibited by 0.5 micrograms syringomycin per ml and higher. Uptake rates of tetraphenylphosphonium and dimethyloxazolidine ions in cell suspensions of both strains increased when 1.5 micrograms per ml syringomycin was added. These responses were kinetically and quantitatively similar in the two strains and indicated increases in electrical potential (cell interior negative) and pH differences (cell interior alkaline) across the plasma membrane. Glucose (0.1 M) enhanced the effect on the electrical potential, was required for the pH changes, and increased the cellular ATP levels. These results show that the effects of syringomycin are energy-dependent and are due to alterations of plasma membrane and not to mitochondrial function. PMID- 3530327 TI - Fluorescence polarization studies on Escherichia coli membrane stability and its relation to the resistance of the cell to freeze-thawing. I. Membrane stability in cells of differing growth phase. AB - Physical properties of Escherichia coli membrane lipids in logarithmic- and stationary-phase cells were studied by measuring the fluorescence polarization change of cis- and trans-parinaric acid as a function of temperature. In aqueous dispersions of phospholipids extracted from cytoplasmic and outer membranes of cells of differing growth phase, a similar polarization increase was observed over the range from physiological temperature to below 0 degrees C, and nearly the same transition ratios were obtained in all samples. The cytoplasmic membrane of both of the growth-phase cells showed a higher polarization ratio above the transition temperatures, compared to that in the aqueous dispersion of phospholipids. The polarization ratios below the transition temperatures of these specimens were lower than the value obtained with the lipids, especially in the stationary-phase specimens. The outer membrane specimens showed a similar polarization change but the transition temperature ranges were considerably higher both in the logarithmic- and the stationary-phase specimens, compared to those in the cytoplasmic membrane specimens. Freeze-thawing of logarithmic-phase cells showed the emergence of activity of certain enzymes which are known to be located in the membranes. The stationary-phase cells did not suffer from any such deleterious effect and maintained a high level of cell viability in a similar treatment. These results indicate that in the stationary-phase cell membranes lipids are in a highly ordered state, and the lipid state causes a membrane stability which results in the high resistance of the cell to freeze-thawing. PMID- 3530328 TI - Fluorescence polarization studies on Escherichia coli membrane stability and its relation to the resistance of the cell to freeze-thawing. II. Stabilization of the membranes by polyamines. AB - The effects of polyamines, spermine, spermidine and putrescine on the stabilization of the membrane organization of Escherichia coli cells were studied using measurements of fluorescence polarization change of extrinsic fluorescence probes in membrane specimens as a function of temperature. The effects of the polyamines on the restoration of the cell viability after freeze-thawing were also investigated. In logarithmic-phase membrane specimens, polyamines depressed the polarization ratio increase below the transition temperatures in a dose dependent manner. The physiologically relevant concentration of polyamines repressed the ratios to the same levels as are obtained with the stationary-phase specimens. In the stationary-phase specimens, no effect of polyamines on repression of the polarization increase was observed. A preliminary exposure of logarithmic-phase cells to polyamines protected the cells from the reduction of viability in freeze-thawing. However, a considerably high concentration and a certain length of preincubation time were required in order to an effect to be exerted. These results indicate that the intracellular polyamines could stabilize the membrane organization of logarithmic-phase cells to the same extent as in the stationary-phase cell membranes. It is conjectured that the membrane stability which is mediated by the polyamines results in cellular resistance to freeze thawing, as it is attained by increasing the growth phase of the cells. PMID- 3530329 TI - Tetraphenylphosphonium is an indicator of negative membrane potential in Candida albicans. AB - The characteristics of the uptake of lipophilic cations tetraphenylphosphonium (TPP+) into Candida albicans have been investigated to establish whether TPP+ can be used as a membrane potential probe for this yeast. A membrane potential (delta psi, negative inside) across the plasma membrane of C. albicans was indicated by the intracellular accumulation of TPP+. The steady-state distribution of TPP+ was reached within 60 min and varied according to the expected changes of delta psi. Agents known to depolarize membrane potential caused a rapid and complete efflux of accumulated TPP+. The initial influx of TPP+ was linear over a wide range of TPP+ concentrations (2.5-600 microM), indicating a non mediated uptake. Thus, TPP+ is a suitable delta psi probe for this yeast. PMID- 3530330 TI - Purification and characterization of a high molecular weight proteinase (macropain) from human erythrocytes. AB - An alkaline proteinase, previously identified in rat liver and heart, has been purified from the soluble fraction of human erythrocytes. The proteinase has an apparent molecular weight of 600 000 and is composed of eight subunits with molecular weights ranging from 32 000 to 21 000. The proteinase degrades both protein and synthetic peptide substrates with a broad pH optimum of 7.5-11.0. Among the synthetic peptides tested, tripeptides with arginine at the P1 position (e.g. Z-Val-Leu-Arg-4-methoxy-2-napthylamine and Boc-Leu-Gly-Arg-4-methylcoumarin 7-amide) are particularly good substrates. The proteinase appears to be sulfhydryl-dependent and is inhibited completely by mersalyl acid and by hemin; inhibitors of serine and metallo-type proteinases have no effect on proteinase activity. Interestingly, a variety of other proteinase inhibitors such as leupeptin, chymostatin and N-ethylmaleimide failed to completely inhibit protein hydrolyzing activities of the enzyme. These results indicate that these activities may be accounted for by at least two different catalytic sites. Proteinase activity is stable in the presence of 1 M urea, 0.5% Triton X-100 or 0.03% SDS and is not affected by ATP. Based on the high molecular weight and sulfhydryl-dependence, we have named this proteinase macropain. PMID- 3530331 TI - Immunochemical analysis of molecular forms of mammalian DNA ligases I and II. AB - Using specific antibodies against calf thymus DNA ligases I and II (EC 6.5.1.1), we have investigated the polypeptide structures of DNA ligases I and II present in the impure enzyme preparations, and estimated the polypeptides of DNA ligases I and II present in vivo. Immunoblot analysis of DNA ligase I after sodium dodecyl sulfate-polyacrylamide gel electrophoresis revealed a 130-kDa polypeptide as a major one in the enzyme preparations from calf thymus throughout the purification. In addition to the 130-kDa polypeptide, a 200-kDa polypeptide was detected in the enzyme preparations at the earlier steps of the purification, and a 90-kDa polypeptide was observed as a minor one in the enzyme preparations at the later steps of the purification. The polypeptides with molecular weight of 130 000 and 90 000 were detected by SDS-polyacrylamide gel electrophoresis of DNA ligase I-[3H]AMP complex. These results suggest that a 200-kDa polypeptide of DNA ligase I present in vivo is degraded to a 130-kDa polypeptide and then to a 90 kDa polypeptide during the isolation and purification procedures. On the other hand, the monospecific antibody against calf thymus DNA ligase II cross-reacted with only a 68 kDa polypeptide in the enzyme preparations throughout the purification, suggesting that the 68-kDa polypeptide is a single form of calf thymus DNA ligase II present in vivo as well as in vitro. PMID- 3530332 TI - Altered phospholipid secretion in type II pneumocytes isolated from streptozotocin-diabetic rats. AB - To study the effect of diabetes on pulmonary surfactant secretion, type II pneumocytes from adult streptozotocin-induced diabetic rats were placed in short term culture. As opposed to a linear secretory rate by control type II cells, the secretory rate of type II cells from diabetic animals was biphasic reaching a minimum at 1.5 h. When exogenous surfactant containing radioactive phosphatidylcholine was added to the incubation media for 1.5 h, the cells from diabetic animals incorporated more exogenous phosphatidylcholine into lamellar bodies than control cells. This suggests that in the type II cell from diabetic animals, the rate of reutilization is greater than the rate of secretion until 1.5 h, at which time the rate of secretion becomes greater. The altered secretory pattern was reversed by in vivo insulin treatment 30 min prior to killing but not by the addition of insulin to the incubation media. When challenged by isoproterenol, a beta-adrenergic agonist, the secretory pattern of cells from diabetic animals was biphasic as observed with basal secretion; however, secretion was stimulated 30% as opposed to 100% increase in control cells. These data suggest that basal and stimulated secretion are altered in the cultured type II cell from diabetic animals and restored by in vivo but not in vitro insulin treatment. PMID- 3530333 TI - Altered phospholipid biosynthesis in type II pneumocytes isolated from streptozotocin-diabetic rats. AB - To determine whether type II pneumocytes isolated from diabetic animals could serve as a useful model for the study of surfactant phospholipid biosynthesis and its regulation, type II pneumocytes were isolated from adult streptozotocin diabetic rats and placed in short-term primary culture. On a DNA basis, total cellular disaturated phosphatidylcholine (disaturated PC) and phosphatidylglycerol (PG) were decreased 36 and 66%, respectively, in type II cells from diabetic animals. 7 days of insulin treatment of diabetic rats returned the cellular disaturated PC and PG content to control values and increased the total cellular phosphatidylethanolamine (PE) content by 51%. The rates of glucose and acetate incorporation into disaturated PC per unit DNA were reduced 32 and 38%, respectively, in cells isolated from diabetic rats, while glycerol incorporation was increased by 143%. Insulin treatment of diabetic rats returned the glucose and glycerol incorporation rates to control values and increased acetate incorporation into disaturated PC by 66%. These data suggest that the biosynthesis of surfactant is altered by both diabetes mellitus and in vivo insulin treatment. PMID- 3530334 TI - Genetic relationship between lysosomal and lamellar body-specific alpha glucosidases in human lung. AB - In lamellar bodies isolated from adult human lung at least two acid alpha glucosidases are present: one similar to the lung lysosomal alpha-glucosidase, and another lamellar body-specific isoenzyme. In the present study we measured the activity of this lamellar body-specific alpha-glucosidase and of lysosomal alpha-glucosidase in a patient with an inherited deficiency of lysosomal alpha glucosidase. The activity of the lamellar body-specific alpha-glucosidase was not affected in the patient, whereas the lysosomal alpha-glucosidase activity was strongly depressed. The results strongly suggest that the lysosomal alpha glucosidase and the lamellar body-specific alpha-glucosidase are different gene products. PMID- 3530335 TI - Lipoprotein lipase in guinea pig tissues: molecular size and rates of synthesis. AB - Lipoprotein lipase was immunoprecipitated from guinea pig tissues which had been pulse labeled with [35S]methionine. The apparent size of the product (on SDS gels) was 55 kDa in all tissues studied. Lipoprotein lipase released by heparin from adipocytes and from perfused hearts had the same apparent size. No significant amounts of immunoreactive protein with smaller size were found on immunoblotting of tissue homogenates, or in preparations partially purified by heparin-Sepharose chromatography. Lipoprotein lipase accounted for only a small proportion of total protein synthesis. The highest value was in adipose tissue (0.3-0.8%). In lactating mammary gland lipoprotein lipase accounted for about 0.1%, a figure similar to that previously estimated for the proportion of lipoprotein lipase protein in milk. This suggests that lipoprotein lipase is secreted into milk as efficiently as other milk proteins are, in contrast to the previous opinion that the enzyme appears in milk because small amounts leak out from tissue sites. Relative synthesis of lipoprotein lipase was the same in adipocytes from fed or fasted animals, whereas relative synthesis of several other proteins changed dramatically. This indicates that some proteins in guinea pig adipose tissue are under transcriptional control in response to feeding fasting, but that lipoprotein lipase is not. PMID- 3530336 TI - Some properties of the fatty alcohol oxidation system and reconstitution of microsomal oxidation activity in intestinal mucosa. AB - This paper describes the metabolism of fatty alcohols by microsomal and cytosolic fractions from intestinal mucosa. Microsomes of rabbit intestinal mucosa had a high activity of [1-14C]dodecanol oxidation as did those of liver. The intestinal cytosolic fraction also exhibited oxidation activity to a lesser extent than the microsomes did. The reaction product was determined as lauric acid using thin layer chromatography. Laurylaldehyde was detected as another product, when semicarbazide was added to the incubation system. Cyclodextrins exhibited a stimulation effect similarly to bovine serum albumin on the microsomal activity. We have compared the stimulatory effects of dimethyl-beta-cyclodextrin, beta cyclodextrin, gamma-cyclodextrin and alpha-cyclodextrin, which decrease in that order. Effects of NAD+ and dodecanol concentrations, pH and pyrazole on microsomal activity were compared with those on cytosolic activity. Dodecanol oxidation activity was solubilized and reconstituted with a fatty alcohol dehydrogenase and a fatty aldehyde dehydrogenase separated from the intestinal microsomes. These findings indicate that both the dehydrogenases participate in microsomal oxidation of fatty alcohols to fatty acids with fatty aldehydes as intermediates in the reaction. PMID- 3530337 TI - Accumulation of cadmium in pancreatic beta cells is similar to that of calcium in being stimulated by both glucose and high potassium. AB - The transport of Cd2+ and the effects of this ion on secretory activity and metabolism were investigated in beta cell-rich pancreatic islets isolated from obese-hyperglycemic mice. The endogenous cadmium content was 2.5 mumol/kg dry wt. After 60 min of incubation in a Ca2+-deficient medium containing 2.5 microM Cd2+ the islet cadmium content increased to 0.18 mmol/kg dry wt. This uptake was reduced by approx. 50% in the presence of 1.28 mM Ca2+. The incorporation of Cd2+ was stimulated either by raising the concentration of glucose to 20 mM or K+ to 30.9 mM. Whereas D-600 suppressed the stimulatory effect of glucose by 75%, it completely abolished that obtained with high K+. Only about 40% of the incorporated cadmium was mobilized during 60 min of incubation in a Cd2+-free medium containing 0.5 mM EGTA. It was possible to demonstrate a glucose-induced suppression of Cd2+ efflux into a Ca2+-deficient medium. Concentrations of Cd2+ up to 2.5 microM did not affect glucose oxidation, whereas, there was a progressive inhibition when the Cd2+ concentration was above 10 microM. Basal insulin release was stimulated by 5 microM Cd2+. At a concentration of 160 microM, Cd2+ did not affect basal insulin release but significantly inhibited the secretory response to glucose. It is concluded that the beta cell uptake of Cd2+ is facilitated by the activation of voltage-dependent Ca2+ channels. Apparently, the accumulation of Cd2+ mimics that of Ca2+ also involving a component of intracellular sequestration promoted by glucose. PMID- 3530338 TI - [Characteristics of prostaglandin E1 interaction with components of biological membranes]. AB - To estimate the connection between physico-chemical characteristics and biological activity of prostaglandins the interaction of prostaglandin E1 with biological membrane lipids was studied. It is shown that as a result of prostaglandin interaction with phosphatidylcholine a complex is formed that behaves as an individual component and occupies in the surface layer twice as large area than the complex with prostaglandin F2 alpha. The prostaglandin E1 film collapses earlier than F2 alpha. Both facts indicate that the first is more friable. A difference in morphology of prostaglandin monolayers was revealed by electron microscopy. When studying the catalytic activity of peroxidase incorporated in prostaglandin E1 and F2 alpha monolayers some differences were also revealed. In the second case oxidation with methylblue located under the monolayer proceeds more actively. The results obtained point to the connection between the regulatory function of prostaglandins and their chemical structure. Molecular rearrangements of the monolayer caused by prostaglandin incorporation were recorded. PMID- 3530339 TI - [Genetic-demographic approach to anthropologic research. I. Method of non traditional collection and non-graphic construction of pedigrees]. PMID- 3530340 TI - Fetal encephalopathies of circulatory origin. AB - Fetal brain damage may be due to a variety of pathological conditions resulting in circulatory impairments. With generalized ultrasonography of the fetus, the lesions can be detected in utero and subsequent neurological handicaps of the infants will no longer be attributed to difficult labor and birth. The type of the lesions may be anoxic-ischemic and/or hemorrhagic. The morphological appearance depends on the time of occurrence of the insult in utero and on the time elapsed between the insult and the examination of the brain. Although the pathogenesis of the lesions is not fully understood, they may be related either to maternal, fetal, or placental pathological situations. In a last group of cases no causes as yet have been found. PMID- 3530341 TI - Genetics of schizophrenia: II. Vulnerability traits and gene markers. AB - The author reviews research strategies for identifying biological vulnerability traits and gene markers. The application of these methods to schizophrenia are discussed. He concludes that, based on the available evidence, none of the proposed biological traits qualifies as a major factor in the genetic susceptibility to schizophrenia. Some of these traits (such as attentional, neurophysiological, and brain morphology measures) appear promising, but the data are inadequate to arrive at a firm conclusion. Studies with gene markers have not produced consistent results. The author presents the methodological issues that concern this area of research and offers recommendations for future studies. PMID- 3530342 TI - The effects of mianserin therapy on plasma renin activity in depressed patients. PMID- 3530343 TI - [Biocompatibility testing--a 2-phase model]. PMID- 3530344 TI - Phospholipid surface bilayers at the air-water interface. III. Relation between surface bilayer formation and lipid bilayer assembly in cell membranes. AB - Lipid bilayer assembly in cell membranes has been simulated with total lipid extracts from human red blood cells and from mesophilic and thermophilic bacteria grown at several temperatures. Aqueous dispersions of these natural lipid mixtures form surface bilayers, a single bimolecular lipid state, but only at the growth temperature of the source organism. Thus, a single isolated bilayer state forms spontaneously in vitro from lipids that are available in vivo at the growth temperature of the cell. Surface bilayers form at a specific temperature that is a function of hydrocarbon chain length and degree of fatty acid unsaturation of the phospholipids; this property is proposed as an essential element in the control of membrane lipid composition. PMID- 3530345 TI - The use of the air pouch to study experimental synovitis and cartilage breakdown. AB - This mini-review outlines the development and application of the air pouch model during the past five years. It shows the importance of using the appropriate aged pouch to establish long-lasting chronic inflammation following immune and non immune stimuli. Subsequently, the effects of different inflammatory environments were studied on implanted cartilage. It has been found that the inflammation used to date did not lead to an appreciable increase in the rate of cartilage degradation. This is discussed with the implications for new trends in therapeutic research applied to rheumatology. PMID- 3530346 TI - [Autoantibodies to the thymus and skin epithelium in NZB/N mice and (NZBxNZW)F1 hybrids]. AB - Antibodies reacting with thymus and skin epithelial cells were revealed by indirect immunofluorescence in sera of NZB/N mice and (NZB X NZW)F1 hybrids (B/W) 1-2 and 4-5 months of age. Similar antibodies were not found in sera of BALB/c mice. The inhibition experiments with DNA have shown that antibodies reacting with the thymus and skin epithelium differ from those reacting with the cellular nucleus. Positive reactions with the epithelium were obtained in all thymus and skin tissue samples of humans, guinea-pigs and NZB/N, B/W and BALB/c mice, including autologous tissues of NZB/N and B/W mice. Thus, antibodies reacting with thymus and skin epithelial tissues belong to autoantibodies. These autoantibodies are revealed during the first month of life before the onset of autoimmune processes. The role of these autoantibodies in the damage of thymus epithelium and the development of immunoregulatory disturbances, typical of autoimmune processes, needs further study. PMID- 3530347 TI - The liabilities of iron deficiency. AB - Iron has been recognized as a potent hematinic since the inception of hematology as a clinical discipline. Even ancient civilizations believed in the beneficial effects of medicinal iron. Nevertheless, the precise functional liabilities of iron lack remain the subject of continuing debate. The consequences of iron deficiency, particularly from a socioeconomic standpoint, are especially important in light of its high global prevalence. A recent review of the literature indicates that approximately 30% of the estimated world population of nearly 4.5 billion are anemic, and at least half of these, 500 to 600 million people, are believed to have iron deficiency anemia. PMID- 3530348 TI - What should be the morphologic criteria for the subdivision of follicular lymphomas? AB - The members of the Pathology Panel for Lymphoma Clinical Studies undertook a collaborative study with the hope of resolving some of the controversies regarding the criteria and methods for the subclassification of follicular lymphomas (FLs). A group of 105 patients with FL were subclassified by seven hematopathologists according to two methods. In the first method, cases were subclassified according to the Rappaport, Lukes and Collins, and Working Formulation systems. In each of these systems, FLs are subclassified by estimation of the different cell populations, without actual counting of cells. In the second method, precise counts of different cells were made according to the standard and modified Berard methods. With this counting method, diagnoses were independently derived, based on counts provided by the seven pathologists, for large cleaved (LC), small noncleaved (SNC), and large noncleaved (LNC) cells. To ascertain what method and which criteria are most useful in predicting survival, we made clinicopathologic correlations. When the subjective (first method) diagnoses were rendered, and when the consensus diagnoses of the seven pathologists were used, there were no significant differences in survival among patients with the different subtypes. On the other hand, when we used the counting method of Berard (second method) and the cut-off points for the cell counts suggested by him for the subclassification, we were able to divide the patient population into prognostic subgroups. Because the cut-off points proposed by Berard are not derived objectively, we made statistical comparisons of survival curves to determine cut-off points (and thus to establish objective criteria). We found that the patient population could be separated into at least two prognostic groups, for SNC and/or LNC and for SNC + LNC + LC cells. The cut off points which we derived differed with cell type, however. Until the usefulness of these new cut-off points is established, we recommend that the cut off points and the counting method of Berard be used for the subclassification of FL. Because the choice of treatment for the different subtypes of FL is totally dependent on the histologic diagnosis, and because of the variability among the diagnoses of pathologists, treatment planning is difficult. PMID- 3530349 TI - Characterization of host cells involved in resistance to marrow grafts in dogs transplanted from unrelated DLA-nonidentical donors. AB - A canine model of marrow transplantation was used to further define the host cells mediating resistance to marrow engraftment. Recipient dogs were given 9.2 Gy of total body irradiation followed by marrow infusion from unrelated DLA nonidentical donors. No postgrafting immunosuppression was given. At three and ten days posttransplantation recipient marrow and peripheral blood cells were obtained and characterized by the following in vitro studies: morphologic analysis; phenotypic analysis with monoclonal antibodies; assays for natural killer cell (NK) activity; and cocultures with donor marrow to study the effect on donor CFU-GM growth. Daily differential cell counts revealed a proliferation of peripheral blood mononuclear cells approximately eight days posttransplant. By day 10 surviving host cells were uniformly large granular lymphocytes which were phenotypically of T cell lineage, had NK activity, and were capable of suppressing donor marrow CFU-GM growth. Mononuclear cells from dogs given total body irradiation only and no marrow infusion (radiation control group), did not suppress CFU-GM growth when cocultured with marrow from unrelated DLA-mismatched dogs. These results suggest that radioresistant host cells with the morphology of large granular lymphocytes and NK activity and which proliferate in response to the infused donor marrow cells mediate resistance to DLA-nonidentical marrow grafts. It remains to be determined, however, whether in vitro functional studies reflect the mechanisms involved in vivo. PMID- 3530350 TI - c-myc and c-fos expression during interferon-alpha therapy for hairy cell leukemia. AB - Low-dose interferon-alpha (IFN-alpha) therapy is consistently effective in the treatment of hairy cell leukemia (HCL). In two cases of resistance to IFN-alpha administration, we diagnosed variant HCL, a form of HCL with intermediate features between typical HCL and B cell prolymphocytic leukemia. We tried to distinguish variant and typical hairy cells (HCs) by Northern blot analysis of the oncogenes expressed in vivo. We report that variant HCs contain c-myc transcripts in contrast to typical HCs, whereas c-fos transcripts are detected in both cell types. We also report that the mRNA levels of c-myc are not modified in variant HCs by IFN-alpha treatment, whereas the level of c-fos mRNA is modulated in both types of HCs. Our findings suggest that the failure to modulate c-myc expression in vivo might indicate the limits of low-dose IFN-alpha therapy. PMID- 3530351 TI - The role of CFU-GEMM in human hemopoiesis. AB - The assay for CFU-GEMM has provided a measurement for pluripotent hemopoietic precursors in normal and abnormal hemopoiesis. While these cells are able to express the functional repertoire that includes not only myelopoiesis but also lymphopoiesis attempts to determine their self-renewal have shown little or no self-renewal capability. It is currently not known whether this observation reflects culture conditions favouring differentiation processes and suppressing self-renewal, or whether the observation made in culture truly reflects the potential of cells in vivo. Recent advances in molecular biology have lead to the identification of the genomic sequences of at least one of the hemopoietic growth factors thus confirming their importance as regulators. PMID- 3530352 TI - Ceftazidime does not enhance cyclosporin-A nephrotoxicity in febrile bone marrow transplantation patients. AB - Ceftazidime was used as monotherapy for 30 febrile episodes in 28 patients, who underwent allogeneic bone marrow transplantation and who were treated concomitantly with the immunosuppressive agent cyclosporin-A. Ceftazidime did not enhance the well established nephrotoxicity of cyclosporin-A as measured by serum creatinine levels or creatinine clearance. Although an increasing number of Gram positive infections in these patients warrants vigilance, ceftazidime as initial empirical monotherapy proved to be successful in 95% of all febrile post transplantation patients. All Gram-negative and 69% of the Gram-positive infections were cured with ceftazidime alone. The overall clinical cure rate was 72%, with microbiological clearance in 63%. This compares favourably with aminoglycoside containing schedules and avoids the aminoglycoside associated nephrotoxicity. PMID- 3530353 TI - Transplantation of bone marrow with constitutional chromosomal anomalies. Cytogenetic studies and clinical implications. AB - We report on two cases of transplantation of bone marrow with constitutional chromosomal anomalies. A female patient with acute myelocytic leukemia (FAB, M 3) in first complete remission received a bone marrow graft from her sister with the karyotype 47 XXX (triple-X-syndrome). A male patient with Ph-positive CML and a constitutional Robertsonian t(14; 15) received HLA and MLC loci compatible bone marrow from his sister who was also a carrier of the Robertsonian t(14; 15). Our findings indicate that transplantation of marrow from donors with balanced chromosomal translocation is possible, although no conclusion can be made regarding long term results as both recipients died early from infectious complications. PMID- 3530354 TI - Carbohydrate antigen 19-9 (CA 19-9) and carcinoembryonic antigen (CEA) in pancreatic cancer. Role of age and liver dysfunction. AB - In order to ascertain the clinical usefulness of CA 19-9 in detecting pancreatic cancer in comparison with CEA, and to verify the influence of age and liver dysfunction on serum levels of these two antigens, serum CA 19-9 and CEA were assessed in 32 control subjects, 32 patients with pancreatic cancer, 26 with chronic pancreatitis and 43 with gastrointestinal extra-pancreatic diseases. Sensitivity, specificity and diagnostic accuracy of CA 19-9 and CEA in detecting pancreatic cancer were: 69% and 44%, 91% and 75%, 60% and 19% respectively. Linear correlations were observed between the age of the subjects on the one hand and CA 19-9 or CEA on the other. Significant relationships were also noticed between alanine-amino-transferase or bilirubin serum levels and CA 19-9 values. Serum CA 19-9 seems to be a better diagnostic tool than CEA in the assessment of pancreatic cancer; nevertheless the influence of liver dysfunction and age to some extent limits the diagnostic value of CA 19-9. PMID- 3530355 TI - From the patient's point of view: illness and health in the letters of Liselotte von der Pfalz (1652-1722). PMID- 3530356 TI - The historical riddle of milk-borne scarlet fever. PMID- 3530357 TI - Electrotherapy in gynecology: the American experience. PMID- 3530358 TI - Good-bye to Jim Crow: the desegregation of Southern hospitals, 1945-70. PMID- 3530359 TI - Private institutions in the genesis of psychiatry. PMID- 3530360 TI - Computed tomography and sonography of cystic adventitial disease. PMID- 3530361 TI - Ultrasound stone localisation for extracorporeal shock wave lithotripsy. AB - An extracorporeal shock wave lithotriptor using an ultrasound scan head pantograph location system has been designed. The shock wave ellipsoid reflector position is adjusted to the stone with a computer assisted positioning device. Seven dogs with stones implanted into the renal pelvis were treated and stone fragmentation occurred in all cases. Subsequently, 45 patients with stones were treated. The stones ranged in size from 5 to 29 mm (mean 16). Radio-opaque as well as poorly opaque or radiolucent stones were treated and fragmentation was achieved in 85% of cases. An additional endoscopic procedure was performed in four cases. No fragmentation occurred in four patients. Further shock wave treatment was necessary in two patients who presented with stones larger than 2 cm. Both radio-opaque and poorly opaque stones can be treated with this system. Ultrasound localisation and the ellipsoid positioning device avoid the need for expensive fluoroscopic equipment and a hydraulic patient positioning system. PMID- 3530362 TI - The value of ultrasound in the diagnosis of renal failure. AB - Seventy-four patients with impaired renal function were investigated by ultrasound. By assessing renal length, renal echogenicity and collecting system dilatation, one can establish whether renal function is impaired by chronic or acute renal changes or by obstructive changes. PMID- 3530363 TI - Immunohistochemical identification of lymphocyte subsets and macrophages in normal human urothelium using monoclonal antibodies. AB - Monoclonal antibodies were used to examine the pattern of distribution of lymphocyte subpopulations and macrophages in normal human urothelium. T lymphocytes (T11-positive cells) were demonstrated within the epithelium and within the lamina propria of both the ureter and the urinary bladder. Suppressor/cytotoxic T cells (T8-positive cells) predominated, with the average ratio of suppressor/cytotoxic T cells to the helper/inducer T cells being approximately 8.9 in the epithelium and 1.5 in the lamina propria. Leu M3+ cells (monocytes/macrophages) were detected in both epithelium and lamina propria. The character and distribution of these immunocompetent cells within the urothelium suggest a protective function, especially against infection and in tumour surveillance. PMID- 3530364 TI - Antibiotic prophylaxis and secondary haemorrhage following transurethral resection of the prostate: a prospective trial. AB - One hundred and sixty-two patients were studied in a random double-blind controlled trial of co-trimoxazole to prevent secondary haemorrhage following transurethral resection of the prostate (TURP). There was a significant correlation between the incidence of post-operative urinary infection and secondary haemorrhage (P less than 0.05) but no difference between the incidence of bleeding in the treatment and placebo groups. Although infection may play a role in the development of secondary haemorrhage, co-trimoxazole for 10 days does not decrease the incidence of this complication. PMID- 3530365 TI - Spontaneous rupture of nephrostomy-drained renal transplant. PMID- 3530366 TI - Influence of anticoagulant treatment in preventing graft occlusion following saphenous vein bypass for femoropopliteal occlusive disease. AB - Seventy-one patients underwent a classical reversed saphenous vein graft for femoropopliteal occlusive disease and were enrolled in a controlled clinical trial. During the second postoperative week the patients were allocated randomly into one of two groups; group 1 consisted of 34 patients who received coumarin, group 2 (37 patients) served as a control group without any anticoagulant treatment. The mean follow-up was 18 months. After 12 months the cumulative patency rate was 81 per cent and after 18 months 75 per cent; for patients receiving coumarin treatment, the respective figures were 90 and 82 per cent and for those with no anticoagulant treatment 72 and 67 per cent, the decrease being significant. When the bypass operation was performed for limb salvage (clinical stages III and IV) the overall results were worse (12 months, 72 per cent; 18 months, 68 per cent) than in stage II and stage II-III (12 months, 90 per cent; 18 months, 85 per cent). In limb salvage surgery the positive effects of anticoagulant treatment were significant (with treatment: 12 months, 87 per cent; 18 months, 87 per cent; without treatment: 12 months, 60 per cent; 18 months, 53 per cent). The site of the distal anastomosis (above knee: 12 months, 81 per cent; 18 months, 73 per cent versus below knee: 12 months, 80 per cent; 18 months, 75 per cent) did not have any demonstrable influence on the patency rate. PMID- 3530367 TI - Low molecular weight heparin plus dihydroergotamine for prophylaxis of postoperative deep vein thrombosis. AB - In a prospective, double-blind investigation of the prophylaxis of deep vein thrombosis (DVT) in patients undergoing elective major abdominal surgery, 269 patients were randomized into two groups. One hundred and thirty-two patients received a fixed combination of heparin sodium 5000 units plus dihydroergotamine mesylate 0.5 mg (H/DHE) twice a day and 137 patients received a fixed combination of low molecular weight heparin 1500 units plus dihydroergotamine mesylate 0.5 mg (LMWH/DHE) once a day as well as one injection of placebo per day. Treatment was initiated 2 h pre-operatively in both groups and continued for 7-10 days. The frequency of DVT determined by the 125I-labelled fibrinogen uptake test and phlebography was 10.3 per cent in patients receiving H/DHE and 10.4 per cent in those receiving LMWH/DHE. DVT of the femoral vein was detected in four patients of the H/DHE group and in none of the LMWH/DHE group. Intra- and postoperative blood loss did not differ significantly between both groups. Also no difference in the development of wound haematoma and injection site haematoma was found. While intra-operative volume substitution was comparable in both groups, significantly more patients under H/DHE prophylaxis received volume substitution during the postoperative phase. These results show that once-daily prophylaxis with the combination of low molecular weight heparin and dihydroergotamine is equally as effective and as safe as the twice-daily regimen using a combination of unfractionated heparin and dihydroergotamine in patients undergoing elective, major abdominal surgery. The advantages of the once-daily regimen of LMWH/DHE include greater patient acceptance, less nursing time and greater cost effectiveness, provided the new combination can be sold at a cost which maintains this advantage. PMID- 3530368 TI - Controlled trial of transcutaneous electrical nerve stimulation (TENS) for postoperative pain relief following inguinal herniorrhaphy. AB - We have evaluated the effect of transcutaneous electrical nerve stimulation (TENS) on postoperative pain following inguinal herniorrhaphy in a prospective randomized controlled trial. Forty male patients undergoing unilateral inguinal herniorrhaphy for the first time were randomized to receive either active or inactive TENS. Electrical stimulation was delivered by electrodes placed along either side of the wound following operation. An identical apparatus, which did not deliver an electrical current, was applied to control patients. Pain was assessed over the first 3 postoperative days by visual analogue pain scores, expiratory peak flow rates and analgesic requirements. There was no difference between the two groups for pain scores, peak flow rates or analgesic requirements and we conclude that TENS as used in this trial does not reduce postoperative pain. However, TENS had considerable patient appeal and many patients believed that it was effective. PMID- 3530369 TI - Pathway of the blink reflex in the brainstem of the cat: interneurons between the trigeminal nuclei and the facial nucleus. AB - Blink reflex responses evoked by electrical stimulation of the supraorbital nerve were examined using cats and the pathway of the blink reflex in the brainstem was elucidated. Both early response (ER) and late response (LR) were mediated by the main sensory trigeminal nucleus and the spinal trigeminal nucleus. However, a lesion of the main sensory trigeminal nucleus had less effect on the blink reflex than a lesion of the spinal trigeminal nucleus. The ER was mediated not only by the shorter disynaptic pathway of 3 neurons through the trigeminal nerve, the trigeminal nuclei and the facial nucleus but also by a polysynaptic pathway of 4 neurons. The interneurons were located between the trigeminal nuclei and the facial nucleus. Some of these interneurons participated in the production of both ER and LR. The area of the brainstem responsible for ER and LR of the blink reflex was the reticular formation from the rostral part of the medulla to the pons except the medial area around the median sulcus. The LR interneurons were distributed more widely than the ER interneurons. PMID- 3530370 TI - The epileptogenic action of 6-aminomethyl-3-methyl,1-4H-1,2,6-benzothiadiazine 1,1-diazide hydrochloride (TAG): non-specific versus specific antitaurine pathogenesis. AB - Cortical superfusion with 6-aminomethyl-3-methyl, 1-4H-1,2,6-benzothiadiazine-1,1 diazide hydrocholoride (TAG) at a concentration which selectively blocks taurine (Tau) action fails to modify electroencephalographic (EEG) activity, cortical neuronal firing and caudate-induced inhibition of cortical neuronal activity. Higher concentrations of TAG increase neuronal firing rate and eventually induce EEG interictal spikes that can be suppressed by topical gamma-aminobutyric acid (GABA), but not by glycine or beta-alanine. Topical Tau consistently enhances the epileptiform activity. It is concluded that specific blockade of Tau does not affect any of the physiological function under observation and that the epileptogenic effect of TAG is due to its GABA antagonistic action. PMID- 3530371 TI - Immunocytochemical localization of GABA in the cochlear nucleus of the guinea pig. AB - The immunocytochemical distribution of gamma-aminobutyric acid (GABA) was determined in the cochlear nucleus of the guinea pig using affinity-purified antibodies made against GABA conjugated to bovine serum albumin. Light microscopic immunocytochemistry shows immunoreactive puncta, which appear to be GABA-positive presynaptic terminals, distributed throughout the cochlear nucleus. In the ventral cochlear nucleus, these puncta are often found around unlabeled neuronal cell bodies. While occasional labeled small cells are found in the ventral cochlear nucleus, most GABA-immunoreactive cell bodies are present in the superficial layers of the dorsal cochlear nucleus. Based on size and shape, immunoreactive cells in the dorsal cochlear nucleus are divided into 3 classes: medium round cells with diameters averaging 16 microns, small round cells with average diameters of 9 microns and small flattened cells with major and minor diameters averaging 11 and 6 microns, respectively. Labeled fusiform and granule cells are not seen. A similar distribution of label was seen using antibodies against glutamic acid decarboxylase. Electron microscopic immunocytochemistry of the anteroventral cochlear nucleus shows GABA immunoreactive boutons containing oval/pleomorphic synaptic vesicles on cell bodies and dendrites. Other major classes of terminals, including those with small round, large round and flattened synaptic vesicles are unlabeled. PMID- 3530372 TI - Monoclonal antibody to glial fibrillary acidic protein reveals a parcellation of individual barrels in the early postnatal mouse somatosensory cortex. AB - The relative dispositions of cells in immature and mature mouse barrel field cortices that bind antibody to glial fibrillary acidic protein (GFAP) were examined and photographed under the light microscope. Light micrographs demonstrate that radially oriented glial cells are present in the barrel field of postnatal day 6 cortices and that they are located predominantly within the presumptive barrel sides and/or septae, thus sharply delineating individual barrels from each other. The relative dispositions of radial glial fibers observed at this time implicate glia in development of topographic order during early postnatal development of the somatosensory cortex. In contrast, no such delineation could be detected in the cortices of more mature mice, because GFAP positive astrocytes are present throughout the barrel field and are not confined to barrel sides. This ephemeral nature of the GFAP-delineated barrel field is of interest with respect to the recently reported ephemeral lectin-delineated barrel field. PMID- 3530373 TI - CNS distribution of a novel pituitary protein '7B2': localization in secretory and synaptic vesicles. AB - A detailed study of the immunoreactivity distribution of a novel pituitary protein, '7B2', within specific brain regions and in spinal cord revealed a complex network of neurons and fibers. Immunoreactive cell bodies were found exclusively in the hypothalamus. Stained fibers were more widely distributed and encompassed nearly 100 structures, including several limbic and autonomic nuclei. Biogenic amine centers such as substantia nigra, raphe nuclei and locus coeruleus have also contained immunoreactive 7B2. Subcellular fractionation using differential centrifugation and Percoll gradient revealed the preferential localization of this protein within granule-enriched fractions of rat neurointermediate lobe of the hypophysis. In agreement, ultrastructural studies revealed the presence of 7B2 within secretory-like granules in the median eminence and within synaptic vesicles of selected extrahypothalamic nuclei. Based upon migration on SDS-PAGE, the apparent molecular weight of the major form of 7B2 extracted from different brain regions was found to be 22,000, identical to that of the pituitary form. PMID- 3530374 TI - Common projection areas of 5-HT- and GABA-like immunoreactive fibers in the visual system of the honeybee. AB - The visual system of the honeybee contains gamma-aminobutyric acid-(GABA)-like and 5-hydroxytryptamine-(5-HT)-like immunoreactive tangential fibers of similar morphology. These tangential fibers belong to two different cell types, as revealed by a double labelling procedure on the same section with GABA- and 5-HT antisera, raised in different animals. The common projection areas of both fiber types suggests a possible interaction of serotonergic and GABAergic pathways in an insect visual system. PMID- 3530375 TI - A chronic unit study of the sensory properties of neurons in the forelimb areas of rat sensorimotor cortex. AB - The sensory properties of neurons in the several forelimb areas of rat sensorimotor cortex were examined using the technique of extracellular single unit recording in the awake, head-restrained rat. Cells with peripheral receptive fields were tested for the amount and modality of sensory input during joint manipulation and brushing and tapping of limbs, face and trunk. Input-output correlations were made on the basis of the results of receptive field mapping and intracortical microstimulation in the same electrode penetration. It was found that neurons (n = 117) in the rostral forelimb area receive virtually no sensory input while 30% of neurons (n = 114) in the caudal forelimb primary motor area do receive such input. The inputs to caudal forelimb motor area neurons were primarily (83%) from single joints; along perpendicular electrode penetrations the same joint that activated a cortical cell also moved when microstimulation was delivered along the same electrode penetration. In the granular and dysgranular zones of somatic sensory forelimb cortex, 70% of neurons (n = 82) were responsive to peripheral sensory inputs, with most of the cells in the granular cortex responsive to cutaneous inputs while cells in the dysgranular cortex were more responsive to deep inputs. The lack of sensory inputs to the rostral forelimb motor area is consistent with the proposal that this region may be a part of the supplementary motor area of the rat. PMID- 3530376 TI - Choline acetyltransferase immunohistochemical staining in the goldfish (Carassius auratus) brain: evidence that the Mauthner cell does not contain choline acetyltransferase. AB - In the hatchetfish, the Mauthner cell (M-cell) is thought to be cholinergic based on electrophysiological studies using cholinergic agents and on the localization of acetylcholinesterase (AChE) and alpha-bungarotoxin to M-cell-giant fiber synapses. Immunocytochemical studies have shown that mammalian and non-mammalian cholinergic neurons stain positive for choline acetyltransferase (ChAT), the enzyme responsible for synthesizing acetylcholine. We processed tissue from the goldfish (Carassius auratus) for the immunohistochemical detection of ChAT using the monoclonal antibody AB8 and the peroxidase-antiperoxidase procedure. ChAT immunoreactivity was found in selected areas of the goldfish brain including the cranial nerve nuclei and the ventral horn motoneurons of the spinal cord. Interestingly, the M-cell soma which stains positive for AChE was ChAT negative. This immunohistochemical evidence does not support cholinergic functioning of the Mauthner cell. PMID- 3530377 TI - Immunoreactive thymopoietin in the mouse central nervous system. AB - A thymopoietin-immunoreactive substance (TP-IRS) has been detected in homogenates of mouse spinal cord and brain using a radioimmunoassay; levels were maximal at birth. TP-IRS was also detected in supernatants of mouse neuroblastoma (NIE-115) and primary spinal cord cultures but not human astrocytic and meningeal tumors or mouse primary astrocyte cultures. With affinity purified rabbit anti-TP globulin, immunofluorescent staining was seen in mouse spinal cord cultures in association with nuclear membranes of neurons and, to a lesser degree, flat background cells. From supernatants of NIE-115 cells grown in tritiated leucine and lysine, proteins of approximately 8000 and 4500 Da were isolated by TP affinity chromatography (compared with 5562 Da for thymic thymopoietin). When injected into mice, these neural proteins partially blocked neuromuscular transmission in a manner similar to thymic thymopoietin. PMID- 3530378 TI - Effects of estradiol and progesterone on the gonadotropin-releasing hormone (GnRH)-immunoreactive neuronal system of the anestrous ewe. AB - The effects of treatment with estradiol-17 beta (E2) and progesterone (P4) on the neuronal system for gonadotropin-releasing hormone (GnRH) of the ovariectomized ewe during the non-breeding season were examined using immunocytochemical and radioimmunoassay analyses. The majority of GnRH-immunoreactive cell bodies are located in the medial preoptic area (POA). Clusters of labelled cell bodies also are found in the septum and anterior hypothalamus. GnRH fibers projected from the medial POA to a dense fiber plexus in the median eminence (ME). For ewes treated with E2, the percentage of GnRH cell bodies that were multipolar was approximately twice that for ewes not treated with E2 (P less than 0.05). The intensity of immunocytochemical staining in the GnRH cell body, and the incidence of fiber branching close to the cell body also were significantly greater for ewes treated with E2 (P less than 0.01 and P less than 0.05, respectively). The intensity for staining of GnRH in the ME appeared to be greater for ewes not treated with steroid, and this was reflected by a greater density of GnRH fibers in ewes not treated with steroid (P less than 0.05). The mass of GnRH in the ME of the ewes not treated with E2 was approximately twice that for E2-treated ewes; however, there was little difference in the total contents of GnRH in the hypothalamus and POA between E2 and non-E2-treated ewes.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3530379 TI - The presence of catechol-o-methyltransferase activity in separately cultured cerebromicrovascular endothelial and smooth muscle cells. AB - The activity of catechol-o-methyltransferase (COMT) was investigated in cultured and propagated cerebromicrovascular endothelial and smooth muscle cells using high performance liquid chromatography and immunocytochemistry. The existence of COMT was detected in both cell types. The demonstration of this enzyme activity in the cerebromicrovascular smooth muscle cells, in addition to the endothelium, indicates that the enzymatic barrier to catecholamine is not limited to capillaries, the main constituents of the blood-brain barrier. PMID- 3530380 TI - Immunocytochemical and biochemical studies with the monoclonal antibody 69A1: similarities of the antigen with cell adhesion molecules L1, NILE and Ng-CAM. AB - We have previously raised a monoclonal antibody (69A1) which recognises a cell surface antigen expressed on rat cerebellar neurons both in culture and in tissue sections of the developing cerebellum prior to postnatal day 17. In our current study we have undertaken a detailed analysis of the loss of labelling from the molecular layer of the cerebellum and show that this parallels the gradient of fibre maturation in this zone. This loss of labelling occurred in paraformaldehyde-fixed tissues but not in unfixed or acetone-fixed sections, suggesting it is the result of antigen modification rather than antigen loss. In cultures of dorsal root ganglia antibody 69A1 labelled neurones and some Schwann cells. Antigen 69A1 was immunoprecipitated from lysates of cultured cerebellar cells and appeared as two bands when separated by SDS-PAGE with apparent molecular weights of ca. 210 and 150 kDa. The antigen is distinct from N-CAM but shows similarities with the L1, nerve growth factor-inducible large external glycoprotein (NILE) and Ng-CAM group of cell adhesion molecules. PMID- 3530381 TI - Expression of alpha 2-glycoprotein by glial precursor cells: an immunocytochemical study with glial cultures. AB - Studies on the presence of the brain-specific alpha 2-glycoprotein in cultures of newborn rat brain cells revealed that a population of glial precursor cells expressed this antigen at an early stage of development. This cell population consisted of small, phase-dark cells that proliferated in culture and occupied the surface of a layer of flat epithelial-like astrocytes. The latter cell type did not react with the antibodies. The number of alpha 2-glycoprotein positive cells gradually decreased from a high concentration of 88% of the total overlying cells at 6 days of culture to 44% at 23 days. The morphological heterogeneity of the overlying cells was noticeable after 10 days in culture as clusters of cells with elaborate processes started to develop. alpha 2-Glycoprotein was found to be concentrated in these structures. A glioma cell line (C-6 glia) which represents a unique in vitro model for the glial progenitor cells, was also found to express this glycoprotein antigen. PMID- 3530382 TI - Autosomal aneuploidy in mice: generation and developmental consequences. AB - Spontaneous aneuploidy in the mouse is uncommon, but specific mating schemes have been developed that produce aneuploid conceptuses at high frequencies. The most commonly reported aneuploid condition in the mouse is autosomal trisomy, in which there is an extra copy (in whole or in part) of a chromosome. In this review, we present several of the schemes used in producing trisomic, partially (tertiary) trisomic, and monosomic conceptuses and summarize the developmental consequences that are associated with each of the autosomal trisomies of the mouse. PMID- 3530383 TI - [The reticulospinal system. II. Functional connections with the neuronal system of the spinal cord]. PMID- 3530384 TI - [An analysis of cases of familial Creutzfeldt-Jakob disease in Slovakia]. PMID- 3530385 TI - [Differential diagnosis of subacute spongioform encephalopathy]. PMID- 3530386 TI - [Computers and decision-making processes in medicine]. PMID- 3530387 TI - [Space medicine]. PMID- 3530388 TI - [History of space medicine in France. Future prospects]. PMID- 3530389 TI - [Medical screening of French astronauts]. PMID- 3530390 TI - [Cardiovascular function in astronauts (Mission STG 51 G--June 1985)]. PMID- 3530391 TI - [Control of posture in microgravity]. PMID- 3530392 TI - [Bone demineralization in microgravity]. PMID- 3530393 TI - [University hospital reforms discussed at the Medical Academy: the patient at the center of all concerns. Report of the working group]. PMID- 3530394 TI - [Eulogy for Maurice Derot (1901-1985)]. PMID- 3530395 TI - [Does light pose a hazard to the human eye?]. PMID- 3530396 TI - [Brain metabolism of L. tryptophan and food]. PMID- 3530397 TI - [Metabolic studies using sugars naturally enriched in 13C]. PMID- 3530398 TI - "Shop" talk uses and abuses. PMID- 3530399 TI - Pre-licensure and other professional concerns. PMID- 3530400 TI - Placement and location of graduates. PMID- 3530401 TI - Periodontal status of a group of Canadian adults. PMID- 3530402 TI - Specialty certification in Canada. PMID- 3530403 TI - Repair of a periodontal defect caused by the improper use of the electrosurgical instrument. PMID- 3530404 TI - Reevaluation following initial (non-surgical) periodontal therapy. Its significance. PMID- 3530405 TI - McSpadden compactor. Vertical condensation technique to deliver calcium hydroxide. PMID- 3530406 TI - The influence of fixation on the morphology of mitotic chromosomes. AB - It is well known that there is a strong influence of fixation, i.e., acetic methanol versus formaldehyde, on the chromosome morphology at stages of the first meiotic division. In this study the influence of both these types of fixation on the morphology of mitotic chromosomes was examined in human lymphocytes. After methanol-acetic acid (3:1) fixation, the chromosomes show the "classical" condensed shape in which it is not always possible to recognize the two sister chromatids. These chromosomes are accessible to the conventional G-, R-, and C banding techniques. After formaldehyde fixation at a relatively high pH, the chromosomes are thinner and longer (two to six times) when compared with chromosomes following methanol-acetic acid fixation. They show a scaffold-like morphology, sometimes with a halo of thin material around it. In all cases the two sister chromatids could be recognized. This chromosome structure could be easily stained with silver, Giemsa, 4,6-diamino-2-phenyl-indole (DAPI), and fluorescein isocyanate isomere 1 (FITC). The results obtained following these stainings gave no indication to any specific chemical composition of a probable central scaffold. The scaffold-like structures were not accessible to G-, R-, or C-banding techniques. The only effect observed following these banding techniques was the disappearance of the halo of thin material around the central scaffold like structure. PMID- 3530407 TI - How are we to determine whether dietary interventions do more good than harm to hypertensive patients? AB - This paper categorizes studies of dietary interventions in hypertensive patients into five categories based on the levels of evidence: level I, randomized trials with low false-positive (alpha) and low false-negative (beta) errors (high power); level II, randomized trials with high false-positive (alpha) and (or) high false-negative (beta) errors (low power); level III, nonrandomized concurrent cohort comparisons between contemporaneous patients who did and did not receive a nutritional intervention; level IV, nonrandomized historical cohort comparisons between current patients who did receive a nutritional intervention and former patients (from the same institution or from the literature) who did not; level V, case series without controls. PMID- 3530408 TI - Session on sodium and calcium in the management of hypertension summary of remarks of discussant and chairman. AB - The evidence favouring a link between sodium and blood pressure, namely the interpopulation comparisons, the experimental animal models, and clinical trials of high sodium intake and very low sodium diets, appears to outweigh the evidence disputing this relationship. Differences between studies on the effect of sodium restriction on blood pressure may be explained by differences in a large number of factors including the nature of the study population, dietary sodium intake, amount of reduction of sodium, concurrent dietary intake of other ions and alcohol, and blood pressure at entry into the study. Further research is needed in order to answer the questions raised herein and to provide additional information on sodium and calcium management of hypertension. PMID- 3530409 TI - Alterations of dietary calcium intake as a therapeutic modality in essential hypertension. AB - Alterations of calcium metabolism in hypertensive disease have been increasingly observed, although the specific manner in which these alterations contribute to the increased blood pressure remains unclear. We have studied calcium metabolism in essential hypertension and have adopted an approach based on analysis of renin system activity, which emphasizes the heterogeneity of human hypertensive disease. With this approach we have defined parallel deviations of plasma renin activity, circulating ionized calcium, and calcium-regulating hormones, which suggest a calcium deficiency in some hypertensives and, an excess of calcium in others. These deviations can be used to predict and may mediate the blood pressure sensitivity of hypertensives to dietary salt, and may also target those individuals most likely to benefit from oral calcium supplementation. Calcium itself has enhanced antihypertensive effects in low renin subjects, having lower ionized calcium and higher endogenous 1,25-dihydroxyvitamin D values, and in subjects on higher dietary salt intakes. Calcium may alter pressure, at least in part, by suppressing endogenous vitamin D metabolites and by stimulating calcitonin secretion. We hypothesize that calcium-regulating hormones participate in the physiology of the renin-angiotensin system and in the pathophysiology of human hypertension. PMID- 3530410 TI - Is weight loss an effective treatment for hypertension? The evidence against. AB - Although there are many studies reporting correlations between relative body weight and blood pressure, the correlations are generally of low order. Furthermore, these observational studies provide, at best, circumstantial evidence concerning the effect of weight reduction on elevated blood pressure. After outlining key methodologic criteria for testing the hypothesis that weight loss lowers blood pressure among hypertensive obese subjects, this article reviews the best intervention studies that are available. Despite the demonstration in these randomized trials that weight reduction programs can lower weight successfully, the results for blood pressure lowering are in considerable disagreement. Two studies reported significant lowering of both systolic and diastolic blood pressure, one found significant lowering of systolic pressure only, and two failed to find significant differences in either. The definitive study of substantial weight loss among patients receiving no other antihypertensive treatment or standardized medical treatment with long-term follow-up has yet to be done. At best, weight loss offers very limited benefit for overweight hypertensives. At worst, weight loss programs are expensive to run, cause considerable patient discomfort and may delay the implementation of more effective therapy. PMID- 3530411 TI - Comparison of Doppler and strain-gauge plethysmography to detect vasculogenic impotence. AB - Doppler penile-pressure determinations to diagnose vasculogenic impotence require an experienced technician, can be time-consuming, yield inconsistent results and require much penile manipulation. Therefore the authors assessed and compared strain-gauge plethysmography as an alternative noninvasive procedure. Sixty-one patients with erectile failure had penile blood pressure determined by Doppler and indium-gallium alloy in Silastic strain-gauge plethysmography. Penile brachial indices were calculated. Strain-gauge results agreed with the Doppler measurements in all but three patients whose indices were found to be normal by Doppler and borderline by strain-gauge plethysmography. The sensitivity, accuracy and specificity of strain-gauge plethysmography were 93%, 95% and 100% respectively. Doppler determinations required an average of 20 minutes to perform, strain-gauge measurements only 4. The authors conclude from this study that strain-gauge plethysmography is a rapid, reliable, accurate method of determining penile blood pressures. PMID- 3530413 TI - Schofield memorial lecture. Bull semen and muscle ATP: some evidence of the dawn of medical science in ancient Egypt. AB - The importance of animal experimentation to human and animal health is not well understood by an increasingly articulate segment of the public. This could have very unfortunate consequences for man and his domestic animals. Even veterinarians and physicians are not as conversant as they need be about the great extent to which advances in human health have depended upon animal observations and experiments. Some believe that resort to "animal models" of biomedical phenomena, including diseases--a comparative or analogical approach to medical studies--is a relatively recent event. Even medical historians often treat these subjects as occasionally recurring aberrations which began with the Greeks, thus largely overlooking the historical meaning and continuing importance of "one medicine" irrespective of species. In fact, comparative medicine has probably been basic to medical progress ever since the dawn of a medical science. Recent research indicates that this approach to biomedical mysteries began to evolve in the minds of Egypt's healer-priests long before Aristotle and the later Alexandrian Greeks made the whole process explicit. Here we examine the origins of what were possibly the first two biomedical theories profounded from inferences based upon dissections, confirmed in at least one instance by experiment, and then applied to medical practice. PMID- 3530412 TI - Esophageal obstruction secondary to a mediastinal pancreatic pseudocyst. AB - The authors report a rare complication of pancreatic pseudocyst. A 47-year-old man suffered rapidly progressing dysphagia and complete esophageal obstruction secondary to extrinsic compression by mediastinal extension of a pancreatic pseudocyst. Ultrasonography and especially computerized tomography were instrumental in diagnosis and in the planning of the operation. A posterior cystogastrostomy successfully drained the pseudocyst and relieved the esophageal obstruction. PMID- 3530414 TI - Galactose epimeraseless mutants of Salmonella typhimurium as live vaccines for calves. AB - The purpose of the study was to evaluate the safety and efficacy of a galactose epimeraseless mutant of Salmonella typhimurium administered as an oral vaccine to one week old calves and to investigate properties of galactose epimeraseless mutants which affect their virulence and immunogenicity. The galactose epimeraseless mutant S. typhimurium strain G30D caused diarrhea and fever in three calves to which it was administered orally at a dose of 10(10) organisms; all three calves died following challenge with virulent S. typhimurium ten days postvaccination. Mild illness developed in four calves vaccinated with a dose of 9 X 10(6) organisms and one of these calves survived challenge. Three unvaccinated calves died following challenge. The vaccine organism persisted in tissues and was shed for a prolonged period by calves which received 10(10) organisms. Studies of characteristics of galactose epimeraseless mutants of S. typhimurium showed that, in the presence of galactose, there is selection for secondary mutants which are galactose resistant. The studies indicate that galactose epimeraseless mutants of S. typhimurium are not good candidate live vaccine organisms for use in calves. PMID- 3530415 TI - The effects of gonadotrophin releasing hormone administration four days after insemination on first-service conception rates and corpus luteum function in dairy cows. AB - One hundred and eighty-five Holstein-Friesian dairy cows received either sterile water or 250 micrograms of gonadotrophin releasing hormone intramuscularly on the fourth day after the first service postpartum. Heparinized blood samples were taken immediately prior to treatment (day 4) and on day 8 postinsemination for analysis of plasma progesterone concentration. Pregnancy diagnosis was carried out by rectal palpation at 42 days postinsemination and reconfirmed after 60 days postbreeding. The pregnancy rates after first, second or third service were not significantly different between gonadotrophin releasing hormone-treated and control cows. Plasma progesterone concentrations on day 4 and day 8 postinsemination, as well as the change in plasma progesterone concentration from day 4 to day 8, were similar for gonadotrophin releasing hormone-treated and control cows. The plasma progesterone concentrations on day 8 postbreeding were significantly higher (p less than 0.005) and the change in progesterone concentrations between days 4 and 8 were significantly greater (p less than 0.002) in pregnant cows compared to nonpregnant cows. PMID- 3530416 TI - An evaluation of the API ZYM system as a means of identifying Haemophilus somnus and related taxa. AB - The commercially available API ZYM microbiological identification system was evaluated for the rapid identification of Haemophilus somnus. Eighty-seven isolates of the organism had API ZYM profiles which were characteristic. The API ZYM profiles demonstrate clear differences between H. somnus and other genera but suggest a close association to three related organisms. Enzyme activity of H. somnus isolates were similar to organisms identified as Histophilus ovis, Haemophilus agni and strains UQV of Actinobacillus actinoides and Actinobacillus seminis but was clearly different from isolates of Pasteurella haemolytica, Pasteurella multocida, Bordetella bronchiseptica and group EF4. The API ZYM system allowed more rapid identification of H. somnus than conventional biochemical tests and may be a useful adjunct to conventional methods used for identification of H. somnus isolates. The test did not reveal obvious differences between isolates from various anatomic locations. PMID- 3530418 TI - Upjohn celebrates a century of research and growth. PMID- 3530417 TI - Comparison of two chamber devices in patients using a metered-dose inhaler with satisfactory technique. AB - A randomized clinical crossover trial was carried out to compare the use in the home, during 1-week periods, of two commercially available chamber devices (the Aerochamber and the Spacer) and a standard metered-dose inhaler (MDI) in 24 patients with reversible bronchospasm and satisfactory inhaler technique. Measurements of peak flow, forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), ratio of FEV1 to FVC and forced midexpiratory flow rate were made immediately before and 15 minutes after inhalation of terbutaline sulfate. No difference was noted in results of spirometry, peak flow readings or side effects between the devices. The results of spirometry were better during the trial than immediately before it (p less than 0.01). The mean score for inhaler technique was significantly lower at follow-up than during the trial (p less than 0.001). The results suggest that in this population there is no advantage to using either a chamber device rather than an MDI or one chamber device rather than the other. PMID- 3530419 TI - First-trimester fetal diagnosis: prudential ethics. PMID- 3530420 TI - Kidney transplantation in Canada, 1981-84. AB - The Canadian Renal Failure Register was established in 1980. Data have been collected annually for all Canadian patients in whom irreversible kidney failure developed and who required dialysis or transplantation. The authors present actuarial patient and graft survival rates for 1981-84. In 1984, patients with a functioning renal graft accounted for 43.9% of the patients with end-stage renal disease. The number of transplants performed increased from 482 in 1981 to 662 in 1984; however, 1,022 patients undergoing dialysis (25.2%) were on an active waiting list for a transplant at the end of 1984. Greater effort is needed to increase the transplantation rate. PMID- 3530422 TI - The Halifax disaster. CMAJ 1918. PMID- 3530421 TI - Every bullet has its billet. PMID- 3530423 TI - Hemingway: could his suicide have been prevented? PMID- 3530424 TI - The lost world of Lord Lister. PMID- 3530425 TI - A brief story about Dr. Hermine Hug-Hellmuth. AB - Dr. Hermine Hug-Hellmuth was the world's first practicing child psychoanalyst. From this vantage point of being the first person to apply psychoanalysis to the treatment of children, she was also the first person to make use of systematic child observation from a psychoanalytic point of view. In addition Dr. Hug Hellmuth was among the very first of the lay adherents to psychoanalysis to practice psychoanalysis. Further, she was one of the first women to obtain a doctorate degree in physics from the University of Vienna. We see that in all these aspects, as a woman, with a lay education, practicing psychoanalysis with children and employing psychoanalytic child observation, she was the first, or among the very first. In this perspective her pioneer status becomes understood to be very important. Others followed and psychoanalysis grew and flourished as did the contributions and the stature of those who would become giants of psychoanalytic history. In part, it was in the shadows of these later giants that the memory of Dr. Hug-Hellmuth has faded. PMID- 3530426 TI - S-100 protein, fibronectin, and laminin immunostaining in lymphomas of follicular center cell origin. AB - Forty-nine paraffin-embedded biopsy specimens of involved nodal and extranodal tissue (bone marrow, spleen, and liver) from 13 patients with follicular center cell lymphomas (FCCL) and 14 with small lymphocytic lymphomas (SLL), including 11 cases with chronic lymphocytic leukemia, were tested for S-100 protein immunoreactivity. Analysis for fibronectin and laminin immunoreactivities was limited to the lymph node biopsy specimens. In FCCL, S-100-positive dendritic reticulum cells (DRCs) were found in 23 of the 26 tissue specimens examined, regardless of the involved sites and the growth pattern. Cases with completely or predominantly follicular pattern were usually associated with a spherical meshwork pattern of S-100-positive DRCs; in the FCCL specimens with a diffuse pattern (lymph nodes and bone marrow) as well as in the specimen areas with a minimally follicular tumor pattern, S-100-positive DRCs were consistently fewer in number and composed loosely aggregated nests. No S-100-positive DRCs were found in all the biopsy specimens in SLL. Concerning fibronectin and laminin immunostainings, results showed that no differences were present between areas of follicular and diffuse neoplastic growth and that the neoplastic growth of FCCL maintained for each antiserum the same distribution pattern as that seen in normal follicles. Analysis of the microenvironmental components as revealed with antisera used in the current study--particularly with anti-S-100 protein antiserum--appears to be a useful adjunct for the identification of FCCL in paraffin-embedded biopsy specimens, especially in extranodal sites. PMID- 3530427 TI - Tubular adenoma of the human stomach. An immunohistochemical analysis of gut hormones, serotonin, carcinoembryonic antigen, secretory component, and lysozyme. AB - A total of 49 gastric tubular adenomas and 6 tubular adenomas with foci of adenocarcinoma from surgically resected stomachs were examined histologically and immunohistochemically for gut peptide hormones, serotonin, carcinoembryonic antigen (CEA), secretory component (SC), and lysozyme. A variety of endocrine cells were detected in tubular adenoma with mild to moderate atypia. Both the frequency and distribution density were highest for serotonin-containing EC cells, often showing hyperplasia, followed by glicentin-containing L cells, somatostatin-containing D cells and motilin-containing Mo cells in the order given. Adenoma cells with SC immunoreactivity were more dominant than those with CEA immunoreactivity. In tubular adenoma with severe atypia, endocrine cells were markedly decreased, whereas adenoma cells with CEA immunoreactivity were increased. The distribution density of lysozyme-containing cells in tubular adenoma of the intermediate zone and fundus was significantly higher than that of the antrum. In the subjacent mucosa of the adenoma, L cells and SC-positive epithelial cells were detected in 24 and 33 cases, respectively. These findings suggest that gastric tubular adenoma develops from intestinal metaplasia. In addition, gastric tubular adenoma showed a tendency to lose various intestinal markers with increase of histologic atypicality. PMID- 3530429 TI - Ovarian leukemia detected by pelvic sonography. A case report. AB - Asymmetric enlargement of the right adnexa in a prepubertal, asymptomatic, 7-year old girl with acute lymphocytic leukemia (ALL) was detected by pelvic sonography as part of examinations after the discontinuation of therapy. The case is the first where asymptomatic ovarian relapse has been detected prospectively by sonography. The technique should be considered for the follow-up female patients with ALL in remission, although more extensive studies are needed to establish its effectiveness. PMID- 3530428 TI - Bone marrow transplantation for chronic granulocytic leukemia. AB - Thirty patients with chronic granulocytic leukemia (CGL), were given cyclophosphamide 60 mg/kg on each of 2 consecutive days, followed by total body irradiation (TBI) 10 Gy and an HLA-identical bone marrow transplant (BMT). Eleven patients were in the accelerated phase of their disease (CGLacc) or in second/secondary chronic phase (CGL-2CP), with a median age of 33 years: four patients died of transplant related complications, and four of recurrent leukemia; three patients are alive and well 19, 31, 33 months from BMT. The actuarial 33-month survival is 27%. The actuarial relapse rate is 50%. Nineteen patients were in their first chronic phase (1CP), with a median age of 32 years: three died of graft versus host disease (GvHD), two of infection, and two of acute respiratory distress syndrome (ARDS); 12 are alive and well 6 to 29 months post-BMT. The actuarial 29-month survival is 63%. The actuarial survival of patients younger than 30 years is 63%, compared to 62% for patients older than 30 (P = 0.1). The survival of patients grafted within or after 24 months from the onset of CGL is respectively 87% and 45% (P = 0.04). None of the patients grafted in 1CP had a true hematologic-cytogenetic relapse. The Ph' chromosome was detected on one occasion in two patients 12, 13 months post-BMT: they both remain hematologically normal and Ph1-negative 3 to 6 months later, after discontinuation of cyclosporin A. This study confirms that survival exceeding 60% can be obtained in CGL in the first chronic phase, whereas less than 30% of patients will survive if grafted in accelerated, second/secondary chronic phase, mainly because of leukemic relapse. The duration of the disease seems to be relevant to the outcome of the transplant. The effect of post-transplant immunosuppression, in our case cyclosporin A, on the interaction between normal and Ph1-positive hemopoietic cells, may deserve further attention. PMID- 3530430 TI - Vitamin A, carotenoids, and retinoids. AB - One promising area of current research in chemoprevention is the possibility that micronutrients, including vitamin A analogues, may decrease cancer incidence. The term "vitamin A" refers either to retinol (preformed vitamin A) and its synthetic analogues, or to certain carotenoids (provitamin A), which are converted to retinol in the body, as needed. Retinol and the other retinoids are integrally involved in cell growth and differentiation, which may affect carcinogenesis. Such a role has been supported by a large number of in vitro and animal experiments. Data from studies among humans are sparse, in part because most dietary studies have been conducted in populations in which the vast majority of vitamin A intake is actually beta-carotene and other carotenoids, found in carrots and other vegetables and fruits. Although the carotenoids do not have the hormone-like properties of retinol, they do have a potent antioxidant effect and could thus reduce cancer risk by preventing tissue damage due to oxidation. This possibility is supported by data from a large number of observational epidemiologic studies, most of which have consistently found an inverse relation between consumption of carotene-rich vegetables and cancer risk. However, the only direct way to determine whether carotenoids have a beneficial effect is through large, carefully conducted randomized trials. Several such studies are currently underway and should provide sound evidence on which future medical policy and practice can be based. PMID- 3530431 TI - Prostatic involvement in bladder cancer. Prostate mapping in 20 cystoprostatectomy specimens. AB - Twenty prostate glands from patients with either high-grade papillary tumors (19 patients, 15 of whom also had peripheral carcinoma in situ) or multifocal carcinoma in situ (1 patient) of the bladder who underwent cystoprostatectomy were studied histologically by mapping. Prostatic duct involvement by urothelial carcinoma was noted in nine patients, two with extensive involvement and seven with focal involvement confined to periurethral ducts. Carcinoma in situ of the bladder was observed in each of the nine patients and intraepithelial permeation appeared to be the predominant manner of spread of cancer cells into the prostate. The prostatic involvement was clinically silent and it may be a potential source of failure of conservative modalities of treatment of high-grade bladder cancer. A routine diagnostic transurethral prostatic biopsy may be recommended in the workup of patients with carcinoma in situ and high-grade carcinomas of the bladder. An incidental observation was the presence of 14 occult prostatic adenocarcinomas. PMID- 3530432 TI - Metastatic interstitial pneumonitis after autologous bone marrow transplantation. A consequence of reinjection of malignant cells? AB - Two cases of fatal interstitial pneumonitis developing after an autologous bone marrow transplantation are described. In both cases the autopsy revealed diffuse malignant pulmonary involvement. The first case involved a 4-year-old boy who had a Burkitt's lymphoma; the second case involved a 4-year-old girl with a neuroblastoma. The authors postulate that in these cases, the clinical picture may have been related to reinfusion of malignant cells. PMID- 3530433 TI - Trisomy 12 correlates with elevated expression of p21 ras in a human adenosquamous carcinoma of the lung. AB - Reported herein is the first case in which a specific chromosomal abnormality, namely trisomy 12, was observed in primary cultures of a human adenosquamous carcinoma of the lung. Because the c-K-ras had been shown to localize on chromosome 12, the relationship between trisomy and oncogene expression was examined in this tumor by concurrently assaying for the levels of ras oncogene protein product, p21, in both the tumor and adjacent normal tissues. An approximately tenfold increase in the level of p21 ras was observed in the tumor, compared with the adjacent normal tissue. The present finding suggests a possible relationship between chromosomal trisomy and oncogene activation. PMID- 3530434 TI - O-alkyl pyrimidines in mutagenesis and carcinogenesis: occurrence and significance. PMID- 3530435 TI - Reactivity of monoclonal antibody DF3 with a high molecular weight antigen expressed in human ovarian carcinomas. AB - We have previously described the monoclonal antibody (MAb) DF3, prepared against a human breast carcinoma. MAb DF3 reacts with a high molecular weight glycoprotein detectable in human breast carcinomas and in human milk. Previous studies have demonstrated that DF3 antigen levels are elevated in the plasma of patients with breast and ovarian cancer. The present study has further examined the reactivity of MAb DF3 with human ovarian carcinomas. Immunoperoxidase staining demonstrated reactivity of MAb DF3 with 95% of benign, borderline, and malignant tumors (serous, mucinous, and endometrioid) of the ovary. Furthermore, malignant tumors contained cytoplasmic DF3 antigen while benign tumors expressed the antigen only on apical surfaces. Western blot analyses demonstrated that the MAb DF3 reactive ovarian antigen (DF3-O) was a glycoprotein with a heterogenous molecular weight ranging between 300,000 and 450,000. This antigen was detectable by immunofluorescence on the cell surface of five of six cultured human ovarian carcinoma cell lines. The extent of cell surface reactivity with MAb DF3 was equivalent to or greater than that obtained with MAb OC125, an antibody generated against coelomic epithelium and developmental amnion. Furthermore, uptake of 125I labeled MAb DF3 by human ovarian carcinoma xenografts in athymic mice was 5.4- and 6.2-fold higher than the respective uptake noted in liver and control tumor (P = 0.031). These findings suggest that DF3-O antigen is similar if not identical to the antigen detected in human breast carcinomas by MAb DF3. Thus, MAb DF3 may be a useful reagent in immunodiagnostic evaluation of patients with ovarian cancer. PMID- 3530436 TI - Distribution of a squamous cell lung carcinoma-associated antigen, KA-32, in human tissues and sera defined by monoclonal antibody KM-32. AB - The distribution of a variant of blood group A antigen recognized by a murine monoclonal antibody, KM-32, generated against human squamous cell lung carcinoma was investigated in various tissues and sera. By immunoperoxidase staining, the antibody was found to react with a number of lung carcinoma tissues of squamous cell carcinoma, adenocarcinoma, and small cell carcinoma, and several other tumor tissues. Positive staining was also observed in a small number of cells of some normal tissues, such as bronchiolar epithelium, gastrointestinal glands, and convoluted tubules of the kidney. The antibody could also be used in detecting macromolecular antigens, designated KA-32, in sera of patients with lung cancer. The antigen level in serum was determined by an inhibition assay using purified KM-32. The higher level of inhibition was seen in sera from over half of patients with lung cancer and patients with benign diseases when compared with those in sera from healthy adults. Purification of the antigen in serum was performed by gel filtration chromatography, immunoaffinity chromatography, and polyacrylamide gradient gel electrophoresis. Purified antigen exhibited a glycoprotein nature, and its molecular weight was estimated at more than 500,000. PMID- 3530437 TI - Acid protease secreted from human pancreatic carcinoma cell line HPC-YT into serum-free, chemically defined medium. AB - Active acid protease was found in serum-free spent medium of human pancreatic carcinoma cell line HPC-YT. These cells have been maintained for over 215 generations in a serum-free, chemically defined medium. Acid protease was partially purified about 3000-fold by Mono Q ion-exchange chromatography, pepstatin-aminohexyl-Sepharose affinity chromatography, hydroxylapatite affinity chromatography, lectin affinity chromatographies, and gel filtration on TSK G3000SW. The molecular weight of the purified enzyme was estimated to be 63,000. An acid protease isolated from normal pancreas has two forms with molecular weights of 11,000 and 32,000. Isoelectric focusing of acid protease derived from HPC-YT revealed five isotypes, whereas the enzyme from normal pancreas showed only three bands. The optimal pH using bovine hemoglobin as substrate was 3.0 for both the normal and the HPC-YT-derived acid proteases. The HPC-YT enzyme was more heat stable than the enzymes of normal pancreas. Sulfhydryl compounds and metal ions had no apparent effects on this enzyme; however, pepstatin strongly inhibited it. We suggest that acid protease secreted from cancer cells may play a role in the destruction of the surrounding tissue matrix. PMID- 3530438 TI - Predictive model for prognosis in advanced diffuse histiocytic lymphoma. AB - The purpose of this study was to examine the validity of a predictive model for response to treatment and survival in advanced diffuse histiocytic lymphoma. One hundred twenty-seven consecutive patients with Ann Arbor stage II-IV diffuse histiocytic lymphoma, who completed treatment between 1974 and 1984 in one of four different Memorial Hospital combination chemotherapy protocols, were reviewed. The median follow-up time was 66.9 months for survivors (range, 21 153.1 months). Factors studied included: age; sex; Ann Arbor stage; prior therapy; B symptoms; serum lactic dehydrogenase (LDH); sites of initial disease; and tumor bulk. LDH was grouped accordingly (units/liter): low, less than 225; medium, 225-500; high, greater than 500. Each patient was assigned an overall level of site involvement (LSI) from the following mutually exclusive groups: group I, peripheral lymph node (PLN) (including +/- Waldeyer ring involvement, +/ spleen); group II, extranodal disease (EN) +/- PLN; group III, retroperitoneal lymph node (RLN) +/- PLN; group IV, bulky mediastinal disease (MED) +/- any other disease; group V, EN with RLN +/- PLN. The Ann Arbor staging system failed to dissect patient groups differing significantly in their prognosis. Serum LDH, LSI, and age were the only factors important for predicting response and survival after multivariate logistic regression and a parametric Weibull survival analysis. Using three levels of serum LDH and correlating them with the different LSI, four tentative "stages" differing significantly in their survival at 48 months were defined: stage I, low LDH, any LSI (80% alive); stage II, medium LDH, PLN, and/or EN (50% alive); stage III, high LDH, PLN, and/or EN or medium LDH, RLN +/- PLN +/- EN, and/or MED (35% alive); stage IV, high LDH, RLN +/- PLN +/- EN, and/or MED (15% alive). Identification of prognostic stages on the basis of LDH level and LSI will allow more accurate comparison of clinical trials for patients with advanced diffuse histiocytic lymphoma. PMID- 3530439 TI - In vitro analysis of donor bone marrow following monoclonal antibody treatment for the prevention of acute graft versus host disease. AB - Graft-versus-host disease (GVHD) remains a major cause of morbidity and mortality following bone marrow transplantation. The in vitro removal of the GVHD-causing T lymphocytes from donor marrow is one approach which could control this complication. Treatment of the donor bone marrow with lectins and erythrocyte forming rosette depletion, anti-T-cell antisera or monoclonal antibodies are methods currently being tested to accomplish this. CT-2 is an immunoglobulin monoclonal antibody specific for the T-cell erythrocyte-forming rosette receptor. Bone marrow from 23 consecutive donors was treated in vitro with CT-2 and complement, prior to infusion, as a potential means of controlling GVHD. Surface marker analysis using erythrocyte-forming rosetting, and OKT-3 and OKT-11 monoclonal antibodies on paired samples of treated and untreated marrow demonstrated a mean depletion to 1% of the original number of T-cells. Proliferative responses to alloantigens and mitogens as well as cytotoxic and natural killer cell function were tested and found to be markedly reduced. Despite these effects on T-lymphocytes, viable hematopoietic stem cell colonies were retained. Clinical results following the in vitro T-lymphocyte depletion of donor bone marrow for the 8 histocompatible and 15 nonhistocompatible bone marrow transplantation are reported. Prompt engraftment with minimal GVHD, despite no posttransplant GVHD prophylaxis, was seen in seven of the matched patients. In the nonhistocompatible bone marrow transplantation, failure of engraftment occurred in 11 patients. Grades III-IV GVHD were seen in two of the four patients that engrafted despite good T-lymphocyte depletion. No predictive correlation could be found between the in vitro analysis of marrow following CT-2 treatment and clinical outcome. PMID- 3530440 TI - The multifaceted retrovirus. AB - I have attempted to illustrate the many different properties of retroviruses and their presence in a wide variety of animal species including humans. Since the turn of this century, progress in the field of retrovirology has been noteworthy and many new and important scientific observations have been made (Table 7). Along the way, certain dogmas were replaced with new tenets. The recent recognition of retroviruses associated with human cancer and immunodeficiency places them into consideration as potential agents responsible for other human diseases such as autoimmunity and multiple sclerosis. Not only can retroviruses be oncogenic or cytopathic agents but they can also exist highly conserved as endogenous genes in the chromosomal DNA of many different species and not cause disease. In fact, this latter group appears to be predominant, suggesting their role in normal developmental processes and as progenitors of the pathogenic types. The virus-like genomes recognized in Drosophila and other lower animal species could be examples of this fact and may represent important biological entities throughout nature. The genetic material of retroviruses resembles transposons and may reflect the ability of these viruses to be passed within the host and to affect the evolutionary pathway. They could, as transposable elements, be transmitted as well to many different animal species. By their ability to move within the genetic machinery of the cell, these viruses could influence development in animals through promotion, enhancement, or suppression of specific cellular genes. This idea has been proposed for the noninfectious type A particles that have been observed to show these effects in cultured cells. One important observation is that the effect of retroviruses on cells has a varied pattern which may be emphasized by one group (e.g., vacuolization by foamy virus) or shared by other groups (e.g.., syncytial cell formation by type C and type D oncovirinae, spumavirinae, and lentivirinae) (Table 6). Moreover, the heterogeneity of the lentiviruses and the transduction of normal cellular genes by many of the oncogenic viruses indicate the changes that can occur as retroviruses infect and replicate within the cell. The overview is very informative. Virus-cell interaction can lead to biological expressions that depend on the phenotype of the cell and the viral genetic structure. Throughout its existence in nature the retrovirus has been evolving, conserving certain features while developing new ones with different properties; it clearly emerges as a multifaceted agent. PMID- 3530441 TI - Monoclonal antibodies to kidney and tumor-associated surface antigens of human renal cell carcinoma. AB - Three IgG1 monoclonal antibodies derived from BALB/c mice immunized with the Caki 1 human renal cell carcinoma (RCC) line react with antigens present in most human RCCs but restricted in their expression in normal adult tissues. Antibody DAL-K20 reacted with five of six RCCs and the lining epithelium of normal proximal and distal convoluted tubules. Antibody DAL-K29 reacted with eight of nine RCCs, with glomeruli, where it outlined the capillaries, and more weakly with prostatic glandular epithelium and the basal layer of the epidermis. K29 precipitated molecules with molecular weights of 118,000 and 150,000 from extracts of surface labeled Caki-1 cells. Antibody DAL-K45 reacted with four of six RCCs but not with any normal adult tissue including kidney. It precipitated Mr 177,000 and 150,000 antigens. The three antibodies showed distinct patterns of reactivity with human tumor cell lines. PMID- 3530442 TI - Intratumoral Bacillus Calmette-Guerin immunotherapy prior to surgery for carcinoma of the lung: results of a prospective randomized trial. AB - A prospective randomized trial of preoperative intratumoral therapy with Bacillus Calmette-Guerin (BCG) was conducted in non-small cell lung cancer patients. Eighty-eight patients (48 BCG-treated and 40 control subjects) were entered into the study; three control subjects were removed from data analysis because histology revealed pathology other than non-small cell lung cancer. There were no differences between BCG-treated and control patients in sex, age, cigarettes smoked per day, pack-years of cigarette smoking, white blood cell count, or number of peripheral blood lymphocytes. Toxicity of BCG was limited to transient malaise and fever (average peak temperature, 38.7 degrees C). There was no significant difference in outcome (recurrence or survival) between BCG-treated and control groups with Stage I or Stage III tumors; there were too few Stage II tumors for separate statistical analysis. Outcome was not affected within or between the two treatment groups by tuberculin skin test status. Combining both treatment groups, Stage III patients had a worse outcome than did Stage I-II patients, non-squamous cell tumor patients (large cell and adenocarcinoma) had worse outcomes than did squamous cell tumor patients, and men had a worse outcome than women. We conclude that, although preoperative intratumoral BCG therapy is safe, it does not lengthen disease-free interval or prolong survival in patients with non-small cell lung cancer. PMID- 3530443 TI - Carboplatin, an active drug in advanced head and neck cancer. AB - Because of the clinical activity of carboplatin in several types of tumors, this drug was studied in a phase II trial of 25 patients with advanced head and neck cancer [stage IV (M0)] without prior treatment. Six patients (24%) achieved objective response, including two patients with complete response. Carboplatin toxicity was mild in most patients, with nausea, vomiting, and myelosuppression being the most frequent side effects. No renal or neurologic toxicity was observed. Further trials of carboplatin in advanced head and neck cancer are warranted. PMID- 3530444 TI - Doxorubicin versus mitomycin versus doxorubicin plus mitomycin in advanced breast cancer: a randomized study. AB - In a randomized trial the antineoplastic and toxic effects of doxorubicin (ADR), mitomycin (MMC), and the combination of the two were evaluated in postmenopausal patients with advanced breast cancer using the following treatment regimens: ADR (75 mg/m2 by iv bolus every 3 weeks); MMC (20 mg/m2 by iv bolus every 6 weeks); and ADR (45 mg/m2 by iv bolus every 3 weeks) and MMC (10 mg/m2 by iv bolus every 6 weeks). One hundred one patients were entered in the study. Entrance to single agent MMC therapy was stopped after allocation of 12 patients because of unacceptable side effects, especially nausea and vomiting, and the suggestion of minor efficacy. One of these patients had partial response, eight had no change, and three had progressive disease. The patients in the ADR and ADR plus MMC group were similar as to the following: age (median, 60 years); menopausal age; disease free interval; performance status, extent of previous cytotoxic therapy (approximately 90% were pretreated) and radiation therapy; and dominant site of disease but with significantly more involved organ sites in the ADR plus MMC group. Among evaluable patients (42 in the ADR group and 39 in the ADR plus MMC group), response rates were as follows: complete response--21 versus five; partial response--26 versus 44; no change--40 versus 38; and progressive disease- 12 versus 13 (P greater than 0.10). Median times to disease progression were 5.2 and 7.8 months, respectively (log-rank test, P = 0.03), but survival times were similar, 9.3 and 10.2 months, respectively (log-rank test, P greater than 0.40). For the two treatment groups suppression of wbc count was similar, while anemia, thrombopenia, and nausea and vomiting were significantly more common among the ADR plus MMC-treated group. Five treatment-induced deaths were observed in the ADR plus MMC group (one from sepsis; two from diffuse hemorrhage; and two from cardiomyopathy), compared to none in the ADR group. In conclusion, this study disclosed no major advantage of the combination of ADR plus MMC compared to ADR alone as second-line treatment of advanced breast cancer, but results from other studies may imply a possible role of MMC as part of second-line combination chemotherapy regimens. PMID- 3530445 TI - Effect of high-dose cyclophosphamide and total-body irradiation on left ventricular function in adult patients with leukemia undergoing allogeneic bone marrow transplantation. AB - Protocols used to prepare patients with leukemia for bone marrow transplantation have the potential for cardiac toxicity due to high-dose cyclophosphamide and total-body irradiation. We have reported one regimen, combining cytarabine (5 mg/kg), cyclophosphamide (90 mg/kg), and total-body irradiation (900 cGy), which is relatively effective in the treatment of leukemia. To assess cardiac effects of this treatment regimen, we performed serial echocardiography and radionuclide ventriculography in 28 patients with leukemia (age range, 18-48 years; mean, 31; 21 males) undergoing allogeneic bone marrow transplantation. No significant change in left ventricular fractional minor axis shortening or increase in left ventricular diastolic dimension was seen with weekly echocardiography. At an average of 77 days (range, 28-358) after transplant, repeat radionuclide ventriculography in 17 patients revealed no significant change in resting left ventricular ejection fraction compared to that on admission to the hospital (58% +/- 6.8% vs 56% +/- 8.0% SD; P = not significant). In seven of these 17 patients (41%), resting ejection fraction fell between baseline and discharge (from mean of 60% to 50%). Resting ejection fraction in four of these patients (23% of the entire group) fell into the abnormal range (from mean of 56% to 44%; lowest, 41%). Ten patients also had exercise radionuclide ventriculography and all had normal responses (greater than 5% increase with exercise) pre- and post transplant. We conclude that this effective bone marrow transplantation regimen has little apparent short-term cardiac toxicity in the majority of patients; since a few patients do exhibit a deterioration in left ventricular function, continued cardiac surveillance is probably indicated in posttransplant patients. PMID- 3530446 TI - Phase II study of carboplatin in patients with ovarian carcinoma: a National Cancer Institute of Canada Clinical Trials Group Study. AB - The National Cancer Institute of Canada Clinical Trials Group conducted a phase II study of carboplatin (400 mg/m2) given as an iv bolus every 4 weeks in patients with measurable advanced ovarian cancer who had failed or relapsed following standard platinum-containing therapy. Four complete and eight partial responses were seen in 43 evaluable patients. Toxicity was primarily hematologic. Myelosuppression, particularly thrombocytopenia, was severe in one-third of patients treated at the 400-mg/m2 starting dose. Carboplatin has antitumor activity in this clinical setting, but a lower starting dose is recommended. PMID- 3530447 TI - Randomized comparison of tamoxifen versus diethylstilbestrol in estrogen receptor positive or -unknown metastatic breast cancer: a Southeastern Cancer Study Group trial. AB - In a randomized study 115 postmenopausal women with advanced breast cancer who were estrogen receptor-unknown or -positive were treated initially with tamoxifen or diethylstilbestrol (DES). Their pretreatment characteristics showed no significant difference. The frequency of response was identical with tamoxifen and DES, showing a complete response rate of 2% versus 2% and a partial response rate of 4% versus 8%, respectively; stable disease was present in 78% versus 73% of the patients, respectively. The median time to disease progression (5 vs 6 months) and median survival depending on initial hormone therapy (34 vs 35 months) were identical for tamoxifen and DES, respectively. Gastrointestinal toxicity was more frequent and more severe with DES than tamoxifen. Responses were seen with withdrawal of each agent and on crossover to the alternative agent. Our conclusions are that: DES and tamoxifen are equally effective in treating metastatic breast cancer in the postmenopausal patient who is estrogen receptor-positive or -unknown; withdrawal and crossover responses are seen with both agents; side effects are minimal but more frequent with DES; and on the basis of cost-effectiveness DES is the preferable agent. PMID- 3530448 TI - Phase II evaluation of bolus gallium nitrate in lymphoproliferative disorders: a Southeastern Cancer Study Group trial. AB - Gallium nitrate was administered as a 700-mg/m2 iv bolus infusion over 15-30 minutes every 2 weeks to 138 patients with malignant lymphoproliferative diseases. Responses occurred in patients with well-differentiated lymphomas (five responses among eight patients), but the drug produced few responses in any other group of patients. Toxic effects were primarily gastrointestinal and reversible renal abnormalities and anemia. As a single agent, bolus gallium nitrate has little activity in lymphoproliferative diseases. PMID- 3530449 TI - High-dose cisplatin in the treatment of advanced adenocarcinoma of the colon and rectum: a Southeastern Cancer Study Group trial. PMID- 3530450 TI - Teniposide in epithelial ovarian carcinoma: a phase II trial of the Gynecologic Oncology Group. PMID- 3530451 TI - Phase II trial of m-AMSA therapy in refractory Hodgkin's disease and non Hodgkin's lymphoma: Cancer and Leukemia Group B Study 7972. PMID- 3530452 TI - Phase II clinical trial of acivicin in advanced breast cancer: an Eastern Cooperative Oncology Group Study. PMID- 3530453 TI - Phase II trial of esorubicin in patients with advanced colorectal carcinoma. PMID- 3530454 TI - Phase II trial of dichloromethotrexate in epidermoid carcinoma of the esophagus. PMID- 3530455 TI - Phase II trial of acivicin in advanced breast carcinoma: a Cancer and Leukemia Group B Study. PMID- 3530456 TI - A facile synthesis of 3,6-di-O-methyl-D-glucose. PMID- 3530457 TI - Lessons learned from randomized trials of coronary bypass surgery: viewpoint of the cardiologist. PMID- 3530458 TI - Lessons learned from the three randomized coronary bypass surgery trials. PMID- 3530459 TI - Lessons learned from randomized trials of coronary bypass surgery: viewpoint of the surgeon. PMID- 3530460 TI - Atherosclerosis after coronary artery bypass surgery: results of recent studies and recommendations regarding prevention. AB - Atherosclerosis is the most frequent cause of occlusion of aortocoronary saphenous vein grafts between 5 and 10 years after coronary artery bypass surgery. The typical atherosclerotic plaque appears between 1 and 3 years after operation and, at a mean of 5 years, histologic changes of atherosclerosis are present in 21% of grafts and in 27% of patients. Only approximately 60% of saphenous vein grafts remain patent at repeat angiography between 10 and 12 years after bypass surgery; 45% of patent grafts show atherosclerotic changes at angiography and 43% of patients show evidence of atherosclerosis in one or more saphenous vein grafts. We do not know whether the development or the progression of these atherosclerotic changes can be modified; however, the data currently available suggest that the administration of platelet inhibitors and/or of lipid lowering agents offer two promising avenues of investigation in patients undergoing aortocoronary saphenous vein bypass surgery. Until this has been carefully studied, the internal mammary artery should remain the preferred conduit for aortocoronary bypass grafting, whenever possible. PMID- 3530461 TI - Clinical cardiac electrophysiology: history, rationale, and future. AB - The discipline of clinical cardiac electrophysiology has evolved over the past 40 years. Intense interest has resulted in the clinical application of intracardiac electrophysiologic techniques over the past 20 years. Clinical cardiac electrophysiologic studies have developed since the demonstration that programmed electrical stimulation could be performed in the human heart to evaluate tachyarrhythmias and that cardiac electrical activity that could not be detected on the body surface could be measured with intracardiac electrodes. Clinical electrophysiologic techniques have evolved for the assessment of sinus nodal, AV nodal, and His-Purkinje system function. The evaluation of tachyarrhythmias has progressed rapidly, and pharmacologic, device, and surgical therapy can now be guided by electrophysiologic studies. Invasive electrophysiologic studies have confirmed the utility of noninvasive electrocardiographic analysis and in several circumstances have proved that invasive studies are not necessary. Alternatives to invasive electrophysiologic evaluation continue to be debated. It is clear that when performed by well-trained individuals in appropriately equipped laboratories, electrophysiologic studies are safe and can be shown to be beneficial. Clinical cardiac electrophysiology continues to evolve, and problems of uniformity of methods, definitions of terms, and protocols remain to be resolved. The future of clinical cardiac electrophysiology appears to be one of continued evolution of techniques, refinement of indications, and continued clinical applications. PMID- 3530462 TI - Normal electrophysiologic responses of the human heart. AB - A thorough understanding of physiologic behavior of the human conduction system is essential to define the abnormalities. This article deals with normal responses of the cardiac conduction system to both antegrade and retrograde direction. Responses to electrical as well as mechanical stimulation are discussed. PMID- 3530463 TI - Indications for electrophysiologic studies. AB - The indications for invasive electrophysiologic evaluation of patients with arrhythmia problems have broadened considerably in the last decade. The major advantage of electrophysiologic studies over other forms of arrhythmia evaluation, particularly passive monitoring techniques, is the ability to detect the arrhythmia by provocative stimulation techniques, eliminating the need for serendipitous recording of a sporadic event. Once the arrhythmia can be reproducibly induced, its electrophysiologic characteristics may be studied and the effect of drugs and/or pacemakers in preventing or terminating the arrhythmia can be determined. Furthermore, if these therapeutic modalities are unsuccessful, electrophysiologic mapping procedures can be performed to determine the feasibility of surgical therapy of the arrhythmia and can help to guide the surgical approach and maximize success. Electrophysiologic evaluation is not without its limitations. It is applicable only to arrhythmias that can be reproducibly induced by programmed ventricular stimulation, and it has the potential for significant complications, including vascular complications of catheterization plus potential morbidity from the induction of life-threatening arrhythmias. Therefore, electrophysiologic evaluation should not be applied haphazardly to any patient with arrhythmia-related symptoms or even documented asymptomatic arrhythmias. Still, in the hands of experienced personnel and in the appropriate setting, electrophysiologic studies have become a valuable tool in the evaluation and therapy of patients with significant and often life threatening arrhythmias. PMID- 3530464 TI - Electrophysiologic evaluation of sinus node function. AB - Sinus node dysfunction can be evaluated by invasive and noninvasive means. In this article, invasive testing of sinus node function and its clinical utility are reviewed. Sinus recovery times, sinoatrial conduction times, sinus node refractory periods, and sinus node electrograms are all reviewed in detail, with regard to both theory and practice. PMID- 3530465 TI - Distal atrioventricular conduction system function. AB - This article addresses electrophysiologic evaluation of the distal AV conduction system in patients with chronic bifascicular block. It was formerly thought that progression to complete AV block was a common cause of morbidity and even sudden death in this condition, and it was hoped that electrophysiologic evaluation, including measurement of the H-V interval, would facilitate prospective identification and prophylactic treatment of patients prone to these complications. However, a decade of clinical investigation has revealed that progression to complete AV block is rare and that although cardiovascular mortality, including sudden death, is substantial, this mortality usually relates to underlying organic heart disease. The current role for electrophysiologic studies in chronic bifascicular block is limited to delineation of the site of electrocardiographically documented second- or third-degree AV block and to the evaluation of unexplained syncope. PMID- 3530466 TI - Supraventricular tachycardia in patients without overt preexcitation. AB - In this article, the authors discuss the features and differential diagnosis of supraventricular tachycardia with a regular ventricular rate that occurs in patients without overt preexcitation during sinus rhythm. In the authors' experience, the two most common mechanisms of these tachycardias are reentry within the atrioventricular node (AV nodal reentry) and atrioventricular reentry using a concealed accessory pathway for retrograde conduction and the AV node/His Purkinje system for antegrade conduction (AV reentry). Sinus nodal reentry, intra atrial reentry, automatic atrial tachycardia, and nonparoxysmal junctional tachycardia account for the remaining episodes of regular supraventricular tachycardia. Therapy for AV and AV nodal reentry is also discussed. PMID- 3530467 TI - Electrophysiologic evaluation of patients with preexcitation syndromes. AB - The evaluation of patients with preexcitation syndromes includes the electrophysiologic documentation of preexcitation and an evaluation of the functional status of the accessory pathway. Electrophysiologic techniques allow identification of the site of the accessory pathway and its participation in arrhythmias. Electrophysiologic testing can also be used to evaluate pharmacologic, device, and surgical therapy. PMID- 3530468 TI - General concepts and mechanisms of ventricular tachycardia. AB - The predominant mechanism of ventricular tachycardia is thought to be reentry, although this has been proved to exist in definitely a minority of patients studied owing to technical limitations. Other mechanisms, such as spontaneous triggered automaticity, undoubtedly also cause clinical ventricular tachycardia. During electrophysiologic testing, sustained unimorphic ventricular tachycardia can be induced in the majority of patients who have this arrhythmia clinically. It is extremely rare to induce this rhythm in a patient who has not had ventricular tachyarrhythmias. Nonsustained ventricular tachycardia, repetitive ventricular responses, and pleomorphic ventricular tachycardia and ventricular fibrillation are all nonspecific responses to electrical stimulation and thus are not suitable end points for either the baseline study or serial drug testing. Although an optimal pacing protocol for all subjects does not exist, an adequate test should include pacing with multiple drive rates, at least two (and in some cases, three) extrastimuli, and more than one pacing site in the right ventricle. Isoproterenol infusion and left ventricular pacing may also be necessary in selected patients. During serial drug testing, a drug should not be considered effective if more than 15 repetitive beats are induced unless an extremely aggressive pacing protocol is used. Patients treated with drugs predicted to be effective at electrophysiologic study have a better prognosis than those treated with drugs predicted to be ineffective or those treated with drugs selected empirically. PMID- 3530469 TI - Pharmacologic therapy of ventricular tachycardia using electrophysiologic techniques. AB - Serial pharmacologic trials guided by electrophysiologic techniques provide an objective method for instituting effective medical therapy in patients with sustained ventricular arrhythmias. Suppression of induced ventricular tachycardia by administered antiarrhythmic agents predicts the results of chronic treatment with a high degree of accuracy. Although some controversy exists with regard to precise stimulation protocols, the ability to evaluate the advantages and potentially detrimental actions of individual drugs in a controlled environment contributes substantially to the utility of electrophysiologic testing in the selection of an optimal antiarrhythmic regimen. PMID- 3530470 TI - Proarrhythmic responses during electrophysiologic testing. AB - Proarrhythmia is a potentially lethal adverse effect of antiarrhythmic drugs. Underlying mechanisms and the approaches to identification are discussed. The applicability of electrophysiologic testing is considered, with particular reference to the validity of the different responses to programmed stimulation considered to be manifestations of proarrhythmia. The incidence of proarrhythmia in relation to individual antiarrhythmic agents is also reviewed. PMID- 3530471 TI - Mapping of ventricular arrhythmias. AB - Mapping of ventricular arrhythmias is essential for their reliable surgical and ablative management. Activation mapping is the most widely used technique but demands induction of the arrhythmia. Mapping strategies that can identify an arrhythmogenic substrate in sinus rhythm are clinically attractive but require further investigation before their widespread application. PMID- 3530472 TI - Prospective evaluation of ventricular arrhythmias using electrophysiologic techniques. AB - Electrophysiologic testing is known to be of value both diagnostically and in the evaluation of treatment modalities for patients with recurrent sustained ventricular tachycardia, out-of-hospital cardiac arrest, and syncope of unknown etiology. Attention is being focused on the possibility of identifying patients at high risk for such lethal ventricular arrhythmias in the hope that prophylactic therapy could prevent such arrhythmias from occurring. In this article, the authors discuss the potential role of electrophysiologic testing in this prospective identification and review the current data in the two groups of patients that have been studied extensively in this regard--post-myocardial infarction patients and patients with left ventricular dysfunction and congestive heart disease. The element of study artifact is also addressed. PMID- 3530473 TI - The evaluation of syncope with electrophysiologic studies. AB - An electrophysiologic study is appropriate in patients with syncope that remains unexplained after a complete clinical, neurologic, and non-invasive cardiovascular evaluation. However, not all abnormalities demonstrated by electrophysiologic testing can be assumed to be related to syncope. The findings that have a high and low probability of being clinically significant are summarized in Table 2. If patients with the carotid hypersensitivity syndrome are screened out before electrophysiologic testing, the most common clinically significant abnormality in patients with structural heart disease is inducible unimorphic ventricular tachycardia, which is found in approximately 30 per cent of patients. The overall yield of clinically significant findings in patients with unexplained syncope is 40 per cent. In contrast, the overall yield of clinically significant abnormalities in patients who do not have structural heart disease is extremely low, less than 10 per cent. Because the yield is low, an electrophysiologic study is not indicated in patients without structural heart disease unless the syncope is recurrent and problematic or there is a specific reason to suspect an arrhythmia as the cause of syncope. However, in patients who have structural heart disease, an electrophysiologic study is appropriate after even one episode of unexplained syncope, because of the importance of identifying those patients in whom a potentially lethal arrhythmia may be the cause of syncope. PMID- 3530474 TI - Electrical devices for the treatment of tachyarrhythmias. AB - Pacing techniques may be useful in both prevention and termination of tachycardias. In this article, current techniques and hardware are reviewed and evaluated. Mechanisms for termination and acceleration are outlined. Evaluation of candidates for implantable devices, both pacers and defibrillators, is provided, together with the long-term results and the likely future role of such devices. PMID- 3530475 TI - Interventional electrophysiology: catheter ablation for patients with cardiac arrhythmias. AB - Catheter ablative techniques have introduced an exciting new chapter of interventional therapy for patients with drug-resistant cardiac arrhythmias. A variety of techniques are presently available, and proper choice depends on proper localization of the tachycardia focus and mechanism of the arrhythmia. These techniques should be performed only in laboratories with personnel experienced in invasive electrophysiologic procedures. Over the past 5 years, we have learned that catheter ablation of the AV junction for patients with drug resistant supraventricular tachycardia has replaced the need for surgery in these patients. In addition, preliminary experience suggests that the catheter technique may be highly effective for patients with tachycardia incorporating a posteroseptal accessory pathway. The precise role of catheter ablation for patients with atrial or ventricular tachycardia has not been clearly defined. PMID- 3530476 TI - Invasive electrophysiologic studies in children. AB - Although the technique of performing invasive electrophysiologic studies is similar in children and adults, the indications, interpretation, and management based on the studies are different. The major indications in children are determination of the specific diagnosis of an unknown arrhythmia and mapping prior to surgical treatment; chronic drug studies are performed for severely symptomatic patients, but technical considerations in the child limit the routine use of repeated drug trials. The greatest potential indication for invasive studies is in prognostication of symptomatic arrhythmias; this has not been possible in sinus node dysfunction and AV block, and the role in ventricular arrhythmias is under investigation. In the area of therapeutics, although drugs may have a similar effect in adults and children, the mechanism for the underlying arrhythmias may differ. The ventricular arrhythmias after congenital heart disease may have as their underlying cause the hypertrophic ventricle, not the pediatric substrate. Thus, some of the investigations originally performed in children eventually may contribute to a better understanding of arrhythmias in patients of all ages. PMID- 3530477 TI - A noninvasive perspective of electrophysiologic testing. AB - In this article, the author addresses the comparison between non-invasive and invasive approaches to detect and follow treatment of cardiac arrhythmias. Four major areas are discussed: determination of the mechanism of arrhythmias, arrhythmia diagnosis, defining the patient's risk from arrhythmia, and selection of therapy. PMID- 3530478 TI - Pacemaker treatment of cardiac arrhythmia. AB - The role of pacing for arrhythmias will inevitably increase, both temporarily until a patient can be controlled with drug therapy and permanently in those cases in which drug therapy fails. While "ideal" antiarrhythmic drugs will continue to be sought, "ideal" pacing therapies will be developed. Inevitably the average patient with severe arrhythmia will benefit from a synergistic use of both modalities. The methods for capture, techniques to ensure success, standard and advanced pacing sequences, and specific indications will become as much a part of the armamentarium of the front-line clinician controlling the initial potentially lethal episodes as it has for the experienced electrophysiologist. PMID- 3530479 TI - Hypertensive emergencies. PMID- 3530480 TI - Role of radionuclides in acute cardiac care: current status. AB - The aforementioned studies demonstrate the varied and important clinical information concerning acute myocardial infarctions that is obtainable from certain radionuclide procedures. Limitations of these procedures as well as futuristic improvements are also discussed. PMID- 3530481 TI - The medical emergency of cardiac tamponade: recognition and management. PMID- 3530482 TI - Prosthetic cardiac valve dysfunction. PMID- 3530483 TI - Thrombolysis in acute myocardial infarction. AB - Emergency cardiac catheterization and angiography in patients have resulted in an appreciation of the pathogenesis of AMI and the efficacy of thrombolytic therapy. Simple reperfusion of the infarcted myocardium, however, does not necessarily guarantee myocardial salvage, and preliminary studies have been somewhat confusing as to its beneficial effects. Metabolic support of the ventricle during early reperfusion may enhance left ventricular performance. Although the potential effects of thrombolytic therapy are still unclear, the routine administration of these agents has resulted in more frequent performance of early coronary angiography, with the result that appropriate therapeutic decisions can be made immediately regarding medical treatment, coronary angioplasty, or complete myocardial revascularization. In fact, in prolonged chest pain syndromes, emergency angiography may play a very important role in establishing appropriate initial therapy early in the course of hospitalization, potentially lowering mortality, morbidity, and cost. These issues will be answered ultimately only by carefully designed long-term randomized trials. PMID- 3530484 TI - Emergency coronary bypass surgery: indications and results. AB - Advances in cardiovascular pharmacology and monitoring, cardiac catheterization, and cardiovascular surgical techniques have made emergency coronary artery bypass surgery relatively safe for acute myocardial ischemia and infarction. The results are starting to approach those in the nonacute situation and are improving survival over previous nonsurgical management. Further advances in limiting myocardial infarction size and reperfusion injury will enhance the safety of emergency coronary artery surgery and increase the amount of myocardium that can be returned to a functional state. At present, left ventricular dysfunction, especially when severe enough to result in cardiogenic shock, is the major incremental risk factor for postinfarction surgery. The interval between infarction and surgery in itself does not seem to have a strong effect on operative risk. If operation can be performed within 8 hours of infarction, risk is low and myocardial salvage is probable. After 8 hours, surgery seems advisable if residual critical lesions or active myocardial ischemia is present, regardless of ejection fraction or postinfarction interval. PMID- 3530485 TI - [Glomerular filtration measured by plasma clearance of 169Yb-DTPA in kidney recipients. Comparison with the clearance of inulin, polyfructosan S and creatinine]. PMID- 3530486 TI - [Present experience with the orthotopic transplantation of the heart]. PMID- 3530487 TI - [Jan Evangelista Purkyne and Karel Havlicek Borovsky]. PMID- 3530488 TI - [The death of King Ladislav Pohrobek. The Society of Czech Physicians in Prague. From a meeting held on 12 May 1986]. PMID- 3530489 TI - Growth stimulation and apoptosis induced in cultures of neonatal rat liver cells by repeated exposures to epidermal growth factor/urogastrone with or without associated pancreatic hormones. AB - In untreated primary cultures of neonatal rat liver kept in high-calcium (1.8 mmol/l), foetal bovine serum (10% v/v)- containing minimal essential medium (FBS MEM), the absolute numbers of hepatocytes did not change between day 4 and day 9 because ongoing cell loss was counterbalanced by proliferation of a discrete sub population of the cells. By contrast, the number of stromal cells increased linearly with time. Growth of hepatocytes and stromal cells was differently affected by the daily addition, between day 4 and day 8 of culture, of fresh medium to which peptide mitogen(s) in concentrations ranging from 10(-14) to 10( 8) mol/l had been added. Epidermal growth factor/urogastrone (EGF/URO) with or without equimolar mixtures of glucagon and insulin, induced first hyperplasia of hepatocytes and stromal cells and then apopotosis (degeneration and death) of the progeny of the stimulated cells. By contrast, equimolar mixtures of glucagon and insulin caused a progressive increase in the number of hepatocytes and stromal cells unbalanced by any increase in cell death. At subphysiological concentrations glucagon, in synergism with EGF/URO and/or some other unknown heat stable component of serum, acted as a trophic factor for hepatocytes. By contrast, insulin alone did not enhance growth of hepatocytes, but rather blocked the mitogenic effects of EGF/URO. The three hormones exerted neither mitogenic nor apoptotic effects when administered in a low calcium (0.01 mmol/l) FBS-MEM medium. These results reveal that EGF/URO may control the size of cell populations in neonatal liver by calcium-dependent mechanisms that make it unlikely to be a promoter of hepatocyte tumours. They also show that glucagon acts as a positive trophic regulator for hepatocytes. PMID- 3530490 TI - The influence of androgen administration on the structure and function of the brain-pituitary-gonad axis of sexually immature platyfish, Xiphophorus maculatus. AB - This report demonstrates that the administration of testosterone (T) or 11 ketotestosterone (11-KT) to sexually immature (8 wks old) male platyfish (Xiphophorus maculatus) of early- and late-maturing genotypes affects the synthesis and/or release of luteinizing hormone-releasing hormone (LHRH), as assessed by immunocytochemical evaluation, increases the number and activity of pituitary gonadotropes, stimulates the production of sperm and, thus, advances the age of sexual maturation over that dictated by the genome. We also show that 11-KT and T affect different LHRH-containing centers in the brain and have differential effects on rate and degree of sexual maturation, regardless of whether the hormones are administered to early or late-maturing genotypes. PMID- 3530491 TI - Immunocytochemical localization of catechol-O-methyltransferase in the oviduct and in macrophages in corpora lutea of rat. AB - Catechol-O-methyltransferase (COMT) (EC 2.1.1.6) was localized in rat ovary, oviduct, and uterus using immunocytochemical methods. Immunoreactive deposits were found in the cytoplasm of macrophages in the ovary, epithelial cells of the oviduct, and glandular epithelial cells of the non-pregnant uterus. The pattern of localization observed in the extraneuronal elements suggest that enzyme may function in extraneuronal inactivation of catechols in the ovary, oviduct, and uterus. PMID- 3530492 TI - Immunohistological localization of 17 beta-estradiol and testosterone in the ovary of the rainbow trout (Salmo gairdneri Richardson) during the preovulatory period. AB - Antisera (AS) raised in rabbits against 17 beta-estradiol (E) and testosterone (T) were tested for their suitability to localize E and T on deparaffinized, rehydrated sections of preovulatory trout ovaries, using the unlabeled antibody technique. Conventional control experiments demonstrated the specificity of the staining reactions. Furthermore, no staining was observed after the removal of T specific antibodies by affinity chromatography, or following gonadectomy when non gonadal tissue sections of male trout were incubated with T-AS. Antiserum, raised against 11-oxotestosterone and devoid of antibodies cross-reacting with T, did not stain ovarian sections. The loci at which E and T are detected in the somatic compartment are consistent with the two-cell concept of estrogen synthesis, where aromatizable androgens are produced in the thecal/interstitial layer and serve as substrates for estrogen synthesis in granulosa cells. Both steroids were detected in yolk vesicles from the stage of endogenous vitellogenesis. T-AS showed affinity for nuclei of vitellogenic oocytes. Nucleoli were not stained. PMID- 3530493 TI - Effects of phalloidin and cytochalasin B on cytoskeletal structures in cultured rat hepatocytes. AB - In short-term cultures of rat hepatocytes, bile canaliculi enclosed between unseparated cell couplets are able to perform periodical contractions resulting in expulsion of bile. Pericanalicular cytoskeletal proteins are involved in canalicular contractility: F-actin, myosin and tropomyosin are associated around bile canaliculi, as revealed by staining with tetramethylrhodaminyl-phalloidin and by immunofluorescence. Bile canalicular contractility is distributed by cholestatic agents that are known to interfere with actin polymerization; e.g., phalloidin and also cytochalasin B inhibit canalicular contractility and cause pericanalicular vacuolization and formation of blebs. Whereas the association of the cytoskeletal proteins is not affected by treatment with cytochalasin B, treatment with phalloidin results in dissociation of F-actin and myosin, indicating that binding of phalloidin to F-actin impairs its molecular interaction with myosin. PMID- 3530494 TI - Ultrastructural and immunohistochemical studies on steroid-secreting cells of testis and ovary of normal and 3-methylcholanthrene-treated mice. AB - The testis and ovary of normal and 3-methylcholanthrene-treated mice were studied ultrastructurally and immunohistochemically in order to learn whether steroid secreting cells of the gonads are involved in drug metabolism. The steroid secreting cells, i.e., Leydig cells of the testis, and theca interna cells, interstitial gland cells, and corpus luteum cells of the ovary of 3 methylcholanthrene-treated mice show a strong positive reaction to the antiserum against, hepatic microsomal cytochrome P-450, of liver which is the terminal oxidase of the drug-metabolizing enzyme complex. In addition, it was found that elements of smooth endoplasmic reticulum (SER) in drug-treated mice become well developed as compared with those in control animals. These findings indicate that the steroid secreting cells in testis as well as ovary are involved in the metabolism of both endogenous and exogenous chemical compounds. PMID- 3530495 TI - Transcriptional selectivity of viral genes in mammalian cells. PMID- 3530496 TI - Functional dissection of a eukaryotic transcriptional activator protein, GCN4 of yeast. AB - Yeast GCN4 protein binds specifically to the promoters of amino acid biosynthetic genes and coordinately induces their transcription. Serially deleted GCN4 and hybrid LexA-GCN4 proteins were assayed for specific DNA binding activity in vitro, and for stimulation of transcription in vivo. The specific DNA binding activity resides in the 60 C-terminal amino acids, a basic region of GCN4. However, certain deletions containing the entire DNA binding region are unable to activate transcription and instead act as repressors in vivo. The activation function appears to critically involve just 19 amino acids that are centrally located in an acidic region of GCN4. In addition to their functional separation, the DNA binding and transcriptional activation regions of the protein can be separated physically by elastase cleavage. The implications of these results for the mechanisms of DNA sequence recognition and transcription activation are discussed. PMID- 3530497 TI - Correlation of competence for export with lack of tertiary structure of the mature species: a study in vivo of maltose-binding protein in E. coli. AB - Sensitivity to proteolytic degradation was used to monitor folding of polypeptides in vivo. A correlation between competence for export and lack of stable tertiary structure was established by comparing the kinetics of folding of mutated precursor maltose-binding protein that carries a defective leader peptide with the kinetics of folding of wild-type precursor that is competent for export. It is proposed that during export a kinetic competition exists between productive translocation and folding of precursor intracellularly into a stable conformation that is not compatible with transfer. PMID- 3530498 TI - Plakoglobin: a protein common to different kinds of intercellular adhering junctions. AB - We have established, by means of a monoclonal antibody and a cDNA clone, that a desmosomal polypeptide of Mr 83,000 also occurs at the plaques of other types of adhering junctions, including the vinculin-actin-associated intercellular junctions, e.g., the zonula adhaerens of epithelial cells and the endothelial, lens, and Sertoli cell junctions. This is the first component found in common among otherwise biochemically distinct plaque domains. Despite its concentration at these intercellular junctions, it is absent from the respective cell substratum contact sites. In addition, it appears in a globular soluble 7S form in the cytoplasm. We discuss the significance of this protein, for which the name plakoglobin is proposed, in terms of its interaction with such biochemically diverse membrane domains and their different types of associated cytoskeletal filaments. PMID- 3530499 TI - Developmental progression of myosin gene expression in cultured muscle cells. AB - Myosin heavy chains are encoded by distinct members of a multigene family at different stages of muscle development. Study of the underlying regulatory mechanisms has been hindered because transitions in myosin expression have not been readily attained in tissue culture. Here we show a transition from early (fetal) to late (perinatal/adult) myosins defined by two monoclonal antibodies, F1.652 and N3.36, in the myotubes of mouse C2C12 cells. On day 1 of differentiation, essentially all myosin was early myosin. By day 8, early myosin dropped to 25% of its day 1 value and was replaced by late myosin. The transition occurred without neural contact, connective tissue components, or complex substrates, suggesting that its regulation may be intrinsic to the muscle cell. Our results demonstrate that a developmental progression in myosin gene expression, which occurs rapidly, with high frequency, and under relatively simple conditions, is now amenable to molecular analysis in cultured muscle cells. PMID- 3530500 TI - The membrane-spanning segment of invariant chain (I gamma) contains a potentially cleavable signal sequence. AB - The human invariant chain (I gamma) of class II histocompatibility antigens spans the membrane of the endoplasmic reticulum once. It exposes a small amino-terminal domain on the cytoplasmic side and a carboxy-terminal, glycosylated domain on the exoplasmic side of the membrane. When the exoplasmic domain of I gamma is replaced by the cytoplasmic protein chloramphenicol acetyltransferase (CAT), CAT becomes the exoplasmic, glycosylated domain of the resulting membrane protein I gamma CAT. Deletion of the hydrophilic cytoplasmic domain from I gamma CAT gives rise to a secreted protein from which an amino-terminal segment is cleaved, most likely by signal peptidase. We conclude that the membrane-spanning region of I gamma contains a signal sequence in its amino-terminal half and that hydrophilic residues at the amino-terminal end of a signal sequence can determine cleavage by signal peptidase. PMID- 3530501 TI - Trans-activation of human immunodeficiency virus occurs via a bimodal mechanism. AB - A novel, highly quantitative transient expression assay based on the human interleukin-2 (IL-2) gene was used to examine the trans-activation of the Human Immunodeficiency Virus (HIV/HTLV-III/LAV/ARV) long terminal repeat (LTR) in a range of eukaryotic cell lines. In the absence of the trans-activating viral gene product, tat-III, IL-2 transcripts specific for the HIV LTR were present in low abundance in transfected cells and showed a low translational efficiency, when compared with IL-2 mRNAs transcribed from other viral promoters. Coexpression of tat-III resulted in a marked increase in the steady state level of IL-2 mRNAs transcribed from the HIV LTR, and these mRNAs also demonstrated a specific enhancement of their translational efficiency. These results suggest a bimodal mechanism of action for tat-III in the trans-activation of HIV-specific gene expression. PMID- 3530502 TI - U2 RNA from yeast is unexpectedly large and contains homology to vertebrate U4, U5, and U6 small nuclear RNAs. AB - I have determined the structure of the gene from Saccharomyces cerevisiae coding for the yeast homolog of vertebrate U2 snRNA. Surprisingly, the RNA is 1175 nucleotides long, six times larger than U2 RNAs from other organisms, including Schizosaccharomyces pombe. Nearly 100 nucleotides of the large RNA share sequence homology and potential secondary structure with metazoan U2. The large RNA also contains homology to vertebrate U4, U5, and U6 snRNAs, implying a "poly-snRNP" structure for the RNP containing the large RNA. The gene LSR1, encoding the large RNA, is essential for growth, suggesting that the yeast spliceosome can be dissected using genetic approaches. The different organization of spliceosomal RNA may underlie differences in splicing between yeast and metazoans. PMID- 3530503 TI - Age-related change in the potential of bone marrow cells to repopulate the thymus and splenic T cells in mice. AB - Bone marrow chimeras were produced between various combinations of young and old mice using either C57BL/6 mice only or a combination of C57BL/6 and B10.Thy-1.1 mice. The wet weight of the thymus and the number of thymocytes and splenic T cells of donor origin were assessed at appropriate intervals after the bone marrow transplantation. It was revealed that the old bone marrow was inferior to young in terms of the capacity to repopulate the thymus and splenic T cells. Moreover, some age-related qualitative changes appeared to occur in the thymocyte progenitors, as the composition of Lyt phenotype of donor-type T cells in the spleen was different between chimeras produced with young bone marrow and those with old. PMID- 3530504 TI - Separation of immunomodulatory effects of mannan from Candida albicans into stimulatory and suppressive components. AB - Mannan extracted from Candida albicans was studied for its immunomodulatory activity on in vivo antibody responses to type III pneumococcal polysaccharide (SSS-III), a helper-T-cell-independent antigen, and to sheep erythrocytes (SRBC), a helper-T-cell-dependent antigen. In some studies, the antibody response to SSS III was converted to a helper-T-cell-dependent response by attaching it to a carrier (horse erythrocytes, HRBC); this complex then was used to immunize mice primed with a subimmunogenic dose of HRBC. Mannan enhanced the antibody response to both SSS-III and SRBC when administered at the same time or 1 or 2 days after immunogen. However, when both mannan and SSS-III were coated onto HRBC for immunization, either enhancement or suppression was noted; the effect depended upon the amount of mannan used. Larger amounts stimulated, whereas smaller amounts suppressed, the antibody response to SSS-III. The enhancing and suppressive components of mannan could be separated by molecular size or charge by chromatography on Sepharose 4B or on DEAE-Sephadex A-50 columns, indicating that mannan extracts contain individual components having opposing immunomodulatory properties. These components can be separated on the basis of molecular size and charge. PMID- 3530505 TI - Higher ADCC of murine peritoneal cells after immunization with allogenic tumor cells as compared with stimulation by adriamycin, BCG, and thioglycolate. AB - Normal peritoneal cells or spleen cells from C57BL mice could not lyse SRBC in an ADCC assay. After intraperitoneal injection of Adriamycin, BCG or thioglycolate the ADCC of peritoneal cells toward antibody-coated SRBC was elevated to 30% in contrast to the ADCC of spleen cells. However, peritoneal cells but not spleen cells of mice immunized with allogenic tumor cells (DBA SL2) showed ADCC levels at least two times higher than the levels observed after stimulation by other agents. Maximal ADCC levels (55.8%) were observed 10 to 15 days after immunization. Direct cytotoxicity towards SRBC increased to a maximum of 17.7% at 9 days after immunization. The effector cells in this system are thought to be macrophages, for ADCC activity was only present in the plastic-adherent cell fraction. Cell to cell contact was necessary for ADCC to occur; nonsensitized erythrocytes were not lysed when added to a mixture of effector cells and sensitized erythrocytes. Concentrations of antibody of 1 pg/ml were sufficient to induce ADCC, and effector cell to target cell ratios could be as low as 0.05. The finding that macrophages of mice immunized with allogenic tumor cells exhibit higher ADCC levels than macrophages elicited in other ways can contribute to the investigation of combined cancer therapy with antibodies and biological response modifiers. PMID- 3530506 TI - Induction, maintenance, and reinduction of tumoricidal activity in bone-marrow derived mononuclear phagocytes by macrophage-activating lymphokines. AB - Rat bone-marrow-derived mononuclear phagocytes, induced to differentiate in vitro from precursors and virtually homogeneous with respect to the cell lineage, were the source of effector cells. These effector cells do not manifest spontaneous cytolytic activity in the resting state, but readily acquire marked long-term tumoricidal activity upon incubation with macrophage-activating lymphokines (MAF). MAF-induced tumoricidal activity of bone marrow-derived effector cells decays rapidly. However, in sharp contrast to tissue macrophages, bone marrow derived mononuclear phagocytes retain in vitro responsiveness to a primary exposition to MAF over a period of several weeks, postcytolytic mononuclear phagocytes recover reactivity to MAF after a variable time interval. PMID- 3530507 TI - Cloning of mitogen- and antigen-reactive B lymphocytes on filter paper discs. II. Paratope frequencies within the mitogen-selected repertoire. AB - Paratopic frequencies of C57BL/6 (Igh-Vb) and BALB/c (Igh-Va) mice were compared by determining the frequency of lipopolysaccharide-reactive, splenic B lymphocytes secreting antibody specific for (4-hydroxy-5-iodo-3-nitrophenyl) acetyl (NIP), trinitrophenyl (TNP), phosphorylcholine (PC), NIP/TNP, NIP/PC, and sheep erythrocytes. Despite the known genotypic and phenotypic differences between the two Igh-V loci, no significant differences in paratope frequencies were demonstrated. Similar determinations in C.B-20 mice, Ighb congenics of the BALB/c strain, and in C57BL/10 nude mice indicated that the mitogen-generated paratope frequencies directly reflected the capacity of immunoglobulin variable region elements rather than complex interactive or regulatory controls to generate diversity. We conclude that at least for the paratopic repertoire, the role of the somatic processes for the generation of antibody diversity exceeds the influence of germ-line differences between the Ighb and Igha haplotypes. PMID- 3530508 TI - Anti-antibodies and anti-idiotype immunoregulation, 1899-1904: the inexorable logic of Paul Ehrlich. PMID- 3530509 TI - Insulin inhibits the phosphorylation of the membrane cytoskeletal protein spectrin in pig erythrocytes. AB - Incubation of either ghost membranes with 32P- -ATP or intact erythrocytes with 32P-inorganic phosphate led to phosphorylation of the beta-chain of the major membrane-associated protein spectrin. This phosphorylation was reduced by 30% by insulin (10-100 microU/ml) both in membranes and in intact cells. The results show that the membrane-cytoskeleton is responsive to extracellular signals such as hormone receptor activation. PMID- 3530510 TI - Naturally occurring tubulin-containing paracrystals in Allogromia: immunocytochemical identification and functional significance. AB - Bundles of microtubules (MTs) are readily visualized in vivo by videomicroscopy in highly flattened reticulopodia of the foraminiferan protozoan Allogromia sp. strain NF. In this report we use videomicroscopy, immunocytochemistry, and high voltage electron microscopy to characterize the dynamic changes that occur in this extensive MT cytoskeleton, and in the associated cytoplasmic transport, during induced withdrawal and subsequent reextension of reticulopodia. Within seconds after application of the withdrawal stimulus (seawater substitute made hypertonic with MgCl2) intracellular bidirectional transport along linear MT containing fibrils ceases and is replaced by an inward, constant-velocity flow of cytoplasm along the fibrils. As withdrawal continues, most fibrils become wavy and coalesce to form phase-dense pools. These wavy fibrils and phase-dense pools contain a paracrystalline material and few if any MTs. Same-section correlative immunofluorescence and high-voltage electron microscopy reveal that the paracrystalline material contains tubulin. During recovery linear fibrils (MTs) rapidly extend from the phase-dense pools (paracrystals), which concurrently shrink in size, thus reestablishing normal network morphology and motility. We conclude that the MT cytoskeleton in Allogromia reticulopodia is transformed during withdrawal into a tubulin-containing paracrystal, which serves as a temporary reservoir of MT protein and an initiation site for MT regrowth. PMID- 3530511 TI - [50 years of the Gynecologic Society]. PMID- 3530512 TI - [60 years of the Czechoslovak Ophthalmologic Society]. PMID- 3530513 TI - [40 years' of the Otorhinolaryngology Clinic at the Medical School of Palacky University in Olomouc]. PMID- 3530514 TI - [Sonography in the diagnosis of complicated acute cholecystitis]. PMID- 3530515 TI - [Ultrasonography in the diagnosis of ascites]. PMID- 3530516 TI - [Use of sonography in the diagnosis of intestinal diseases]. PMID- 3530517 TI - [Ultrasonic examination in the differential diagnosis of hydrocephalus in children]. PMID- 3530518 TI - [The importance of a screening examination of the kidneys using ultrasound]. PMID- 3530519 TI - [Ultrasonography in the differentiation of renal insufficiency]. PMID- 3530520 TI - [Ultrasonography in the diagnosis of the extension of malignant kidney tumors into the inferior vena cava and the heart]. PMID- 3530521 TI - [Renal pseudotumor based on hypertrophy of the columnae Bertini]. PMID- 3530522 TI - [Ultrasonic diagnosis of the most important pancreatic diseases]. PMID- 3530523 TI - Fetal epithelial binding of 1,2-dibromoethane in mice. AB - Whole-body autoradiography and computer-assisted image analysis were used to study the tissue binding of the volatile carcinogenic pesticide 1,2 dibromo[14C]ethane (DBE) in C57BL mouse fetuses. Autoradiograms obtained from pregnant mice in late gestation (day 16-17), showed a high level of non-volatile metabolites in the epithelia of the fetal upper alimentary tract and respiratory tract. As determined by image analysis, the concentration of non-extractable (presumably covalently bound) metabolites in the oral epithelium was three times higher than in the maternal liver (day 17). The concentrations in the junction region of the forestomach and the mucosa of the nasal cavity were equal to that in the maternal liver, whereas the bronchi contained lower levels of non extractable metabolites than the maternal liver. Autoradiography of excised fetal tissues incubated with DBE showed that high levels of non-extractable metabolites were present in the epithelia of the oral cavity, oesophagus and forestomach also in vitro. The results indicate that the fetal epithelia can activate DBE to products that bind to the tissue; they also raise the possibility that DBE is a transplacental carcinogen in mice. PMID- 3530524 TI - Histamine-induced coronary spasm in regions of intimal thickening in miniature pigs: roles of serum cholesterol and spontaneous or induced intimal thickening. AB - The pathogenesis of histamine-induced coronary spasm was examined angiographically and morphometrically in Gottingen miniature pigs. In five of 36 consecutive pigs that were 4 to 5 months of age, coronary spasm was provoked by the intracoronary administration of histamine, and the left coronary arteries were examined histologically without endothelial denudation (group 1). Endothelial balloon denudation of the major branch of the left coronary artery was performed in 31 of 36 pigs and five died during the procedure. The remaining 26 pigs were randomly allotted to one of two groups, one fed a cholesterol supplemented (group 2, n = 13) and one fed a regular low-cholesterol diet (group 3, n = 13). After 3 months, serum cholesterol increased significantly from 57 +/- 6 to 222 +/- 27 mg/dl (p less than .01) in group 2, but remained unchanged (48 +/ 5 to 55 +/- 6 mg/dl) in group 3. Percent narrowing of the coronary diameter induced by 10 micrograms/kg ic histamine after administration of the H2 blocker cimetidine (60 mg/kg iv) was 39 +/- 3% and 24 +/- 2% (p less than .05 between groups 2 and 3) at the nondenuded site and 78 +/- 3% and 74 +/- 4% at the denuded site in groups 2 and 3, respectively (p less than .01 between nondenuded and denuded sites). Histamine-induced percent narrowing of the coronary diameter after cimetidine in group 1, 2, and 3 pigs correlated well with the degree of intimal thickness on an exponential curve (r = .92, p less than .001). Since percent narrowing at the intact site was 27% (n = 19) in all three groups, predicted histamine-induced percent narrowing at the spastic site, applying the geometric theory, was 33 +/- 3%. Accordingly, enhanced constriction of the coronary artery with intimal thickening in response to histamine can largely be explained by the acquired hyperresponsiveness of the vascular wall to autacoids. This phenomena, not related to the level of serum cholesterol, may be uniquely linked to the basic pathology of evolution of atherosclerosis. PMID- 3530525 TI - Phasic mitral blood flow and regional left ventricular dimensions: possible mechanism of active assist to ventricular filling. AB - Postsystolic myocardial segment shortening (PSS) has been observed in dogs and humans by means of ultrasonic crystals but has never been studied specifically. In this study, both subendocardial and subepicardial regional function in the basal circumflex and midventricular anterior myocardium (LAD) was studied during late systole and early diastole with ultrasonic crystals. Fifteen open-chest dogs were instrumented with electrocardiographic leads; Millar catheters for measurement of left ventricular pressure, left ventricular dP/dt, and aortic blood pressure; flow probes for determination of aortic and mitral blood flow; and subendocardial and subepicardial crystal pairs to measure subendocardial segment length shortening velocity (dL/dt). Crystal pairs were placed in the subendocardial left oblique mode and the extreme subendocardial right oblique mode (-50 and +50 degrees from equator) in the lateral basal (circumflex, n = 9) and anterior midventricular myocardium (LAD, n = 6). Subendocardial segments showed PSS averaging 34 +/- 7% of the total shortening distance in the circumflex bed and 21 +/- 2% in the LAD bed (p = NS). The rate of subendocardial segment shortening during PSS increased 273 +/- 42.6% (p less than .05) relative to the rate of segment shortening during ejection in the circumflex bed and 126 +/- 40% (p less than .05) in the LAD bed (p = NS). The most rapid diastolic increase in subendocardial length (peak +dL/dt) occurred immediately after subendocardial PSS. Subendocardial diastolic peak +dL/dt occurred after the onset of mitral inflow during the acceleration limb of the rapid ventricular filling phase. Overlying subepicardial segments began lengthening 82 +/- 12 msec before onset of subendocardial segment lengthening in the circumflex bed and 63 +/- 9 msec before subendocardial lengthening in the LAD bed (p less than .05), indicating that the subepicardial segment had begun to lengthen while subendocardial segment shortening continued after end-systole. Onset of early segmental subepicardial lengthening varied with respect to the point of end-systole. Early segmental subepicardial lengthening with subendocardial PSS may be a mechanism by which the rapid filling phase of the left ventricle is actively potentiated by storing potential energy released as early diastolic elastic recoil. PMID- 3530526 TI - Endogenous digitalis-like immunoreactive substances in cord serum characterized by anti-digitoxin and anti-digoxin antibodies. Effect of modulated incubation conditions. AB - Digoxin-like immunoreactive substances (DLIS) have been extensively described in biological fluids of pregnant women, neonates and renal impaired patients, by the use of several digoxin immunoassays. In this paper a similar interference with anti-digitoxin antibodies is reported by investigating 20 cord sera. By increasing both the time and the temperature of the incubation, the levels of digitalis-like immunoreactive substances may be modulated and decreased to zero. Digitoxin- and digoxin-like immunoreactive substances have been successfully extracted with methanol and concentrated from cord serum. Our data suggest the competitive nature of DTLIS and DLIS interactions with digitalis antibodies. They also show a means of minimizing these interferences in routine digitalis immunoassays. PMID- 3530527 TI - Choline in plasma measured by liquid-chromatography with electrochemical detection. AB - We have developed a simple, specific, and sensitive method for plasma choline measurement based on the HPLC procedure of Potter et al. (J Neurochem 1983; 41: 188) for the measurement of acetylcholine and choline in neuronal tissue. The effluent from a reverse-phase column is mixed with choline oxidase in a post column reaction coil to produce hydrogen peroxide which is monitored electrochemically. Plasma samples are prepared by deproteinization with perchloric acid. Choline is recovered quantitatively from the plasma, but an internal standard (homocholine) is added to compensate for any variation in electrode response. Choline can be measured in plasma samples containing less than 1 mumole per litre of plasma; the method response is linear in the 1-20 mumol/L range. Catecholamines and ascorbic acid do not interfere. The chromatography, enzymatic reactions, and electrochemistry all contribute to the specificity of the method. PMID- 3530528 TI - Determination of urinary lysozyme for potential detection of tubular dysfunction in diabetic nephropathy. AB - Seeking to study whether measurement of lysozyme (EC 3.2.1.17) in urine by a reliable radioimmunoassay can provide a suitable index of renal tubular function and how lysozymuria develops in temporal relation to proteinuria in diabetic nephropathy, we have compared the urinary excretion of lysozyme and beta 2 microglobulin with the 15-min excretion rate of phenolsulfonphthalein in 39 patients with Type 2 (non-insulin-dependent) diabetes and investigated the temporal relation between the onset of lysozymuria and proteinuria in 15 patients with Type 1 (insulin-dependent) diabetes. The concentrations of lysozyme and beta 2-microglobulin in urine increased in proportion to the decrease in the rate of excretion of phenolsulfonphthalein in these patients. The coefficient of correlation between lysozyme concentration and the 15-min excretion rate of phenolsulfonphthalein (r = -0.70) was higher than that between beta 2 microglobulin concentration and the 15-min excretion rate of phenolsulfonphthalein (r = -0.46). Abnormally high lysozymuria, suggesting the existence of tubular dysfunction, was demonstrated in six of the patients with Type 1 diabetes who showed no proteinuria or only a slight increase in urinary protein excretion. Lysozymuria may thus be added to a list of the indicators for diabetic nephropathy. PMID- 3530529 TI - Relationships of cyclosporine concentrations in serum, whole blood, and bile after renal and hepatic transplantation. AB - "Trough" (minimum inter-dose) cyclosporine concentrations were measured by liquid chromatography in samples of serum and whole blood or bile obtained from renal- and hepatic-transplant patients. Overall, concentrations in whole blood correlated poorly with concentrations in concurrently obtained serum. The poor correlation also held for individual patients over time. The degree of variability observed for individuals is especially disconcerting. Although cyclosporine measurements in whole blood may mitigate time- and temperature dependent changes in the drug's distribution after collection, concentrations in serum separated after distribution are less dependent on the cellular mass in blood, and may better reflect the amount of drug available to receptor sites. This consideration may be particularly important in the postoperative period, when fluctuations in the cellular mass of blood are frequent. Concentrations of cyclosporine were also determined in concurrently collected bile and serum samples after liver transplantation. Concentrations of unchanged drug in bile were variably higher than those in serum. Bile/serum concentration ratios ranged from 65/1 to 4.6/1. It is postulated that bile/blood concentration ratios may reflect liver function. PMID- 3530530 TI - Use of monoclonal and polyclonal antibodies to detect prostatic acid phosphatase by immunoblotting. AB - We investigated two techniques of immunoblotting--the Western blot and the dot blot--for use in detecting prostatic acid phosphatase (PAP, EC 3.1.3.2). We used polyclonal antisera to human PAP, produced in rabbits by hyperimmunization with purified PAP, and PAP-specific monoclonal antibodies in the immunoenzymatic protocols. We conclude that PAP can be readily detected by Western blots with use of polyclonal antisera, but not with monoclonal antibodies. On the other hand, using a dot blot assay, we could easily detect PAP with both polyclonal and monoclonal antibodies. PMID- 3530531 TI - Immunofluorometry of thyrotropin, from whole-blood spots on filter paper, to screen for congenital hypothyroidism. AB - We have evaluated a time-resolved immunofluorometric assay (IFMA) for determining thyrotropin. This "sandwich"-type system involves two monoclonal antibodies directed against different epitopes. A linear relationship between signal and thyrotropin concentration was observed up to 6000 milli-int. units/L. This procedure takes one day, vs six days with our present RIA technique, and requires only a tenth as much sample. Furthermore, intra- and interassay CVs are lower than with RIA. Assay of 19 paper-disc blood specimens from newborns identified as having congenital hypothyroidism, both by RIA and by clinical evidence, also gave positive results with IFMA. In prospective assay of 3944 specimens by both methods we identified one case of congenital hypothyroidism, which was detected by both techniques. Technical false-positive reactions, identified as such by repeated analyses, were fewer with the IFMA method than with RIA. PMID- 3530532 TI - Measurement of urinary retinol-binding protein by enzyme-linked immunosorbent assay, and its application to detection of tubular proteinuria. AB - An enzyme-linked immunosorbent assay (ELISA) for urinary retinol-binding protein (RBP) has been developed and compared with urinary beta 2-microglobulin for the detection of tubular proteinuria. The assay has a working range of 10 to 250 micrograms of RBP per liter of urine. The within-assay CV was 3.2-7.1%, the between-assay CV 12.5%. A control population of 118 male subjects gave a geometric mean urinary RBP concentration of 7.7 micrograms per millimole of creatinine and a 95th centile of 22 micrograms per millimole of creatinine. Comparison of urinary RBP and beta 2-microglobulin concentrations in 80 control subjects and 117 subjects exposed to cadmium fumes gave correlations of r = 0.59 and 0.91, respectively. Of the 117 subjects exposed to cadmium fumes, 103 gave both RBP and beta 2-microglobulin concentrations on the same side of the upper 95th centile values of 22 and 38 micrograms per millimole of creatinine for RBP and beta 2-microglobulin respectively (Chi-square analysis p less than 0.001), demonstrating that RBP and beta 2-microglobulin detect tubular proteinuria with equal sensitivity and specificity. ELISA and an established latex immunoassay gave well-correlated results. PMID- 3530533 TI - Evaluation of a quantitative immunoturbidimetric assay for rheumatoid factors. AB - A quantitative immunoturbidimetric assay for rheumatoid factors (RF) is described, based on the immunoprecipitation between aggregated human IgG and rheumatoid factors in serum. The resulting turbidity is measured photometrically at 340 nm. The method is standardized against the WHO international reference preparation and the results are expressed in international units per milliliter (int. units/mL). Results correlate well with those by different latex agglutination techniques (r = 0.80-0.96). The correlation with Waaler-Rose test modifications were 0.75 and 0.92. The within-run and between-run coefficients of variations were respectively from 1.2 to 2.6% and 1.3 to 1.9% for high and low RF concentrations. Quantitative and reproducible results, together with high throughput of samples and compatibility with most clinical chemistry analyzers and photometers, make this new assay well suited for routine screening and monitoring of rheumatoid factors. PMID- 3530534 TI - Activity concentration and mass concentration (monoclonal antibody immunoenzymometric method) compared for creatine kinase MB isoenzyme in serum. AB - Results of the "Tandem-E CKMB" immunoenzymometric procedure (y) for creatine kinase (CK; EC 2.9.3.2) were compared with electrophoresis (x) for 160 serum samples from patients suspected of having sustained myocardial infarctions. The results correlated well: y, microgram/L (Tandem assay) = 1.3x-6.3 U/L(electrophoresis) (r = 0.95). CK-MB mass measurement was more stable than enzyme activity after storage and appeared to be more sensitive. Sera from 86 other people, which had no detectable CK-MB upon electrophoresis, gave a mean CK MB value of 1.1 microgram/L (SD 1.3, range 0-8) with the Tandem assay. To determine whether these low values represented actual isoenzyme, we tested for possible interference by heterophile antibodies in the patients' sera by preincubating the samples with mouse serum before the Tandem assay. The mouse serum did not interfere with the assay of sera that had substantial quantities of CK-MB by electrophoresis. However, in five of six samples that were negative by electrophoresis, the CK-MB values were substantially smaller, indicating that the values measured were false-positives caused by the presence of heterophile antibodies directed against mouse proteins, an interference that could be eliminated by pretreatment with mouse serum. PMID- 3530535 TI - Estradiol receptors in human breast carcinomas assayed by use of monoclonal antibodies. AB - Our aim here was to compare a new enzyme immunoassay for estradiol receptors (ER) in breast cancer with a standard assay involving radiolabeled estradiol. A significant correlation was obtained between the standard binding assay and immunoassay (rs = 0.945, p less than 0.001, n = 100). Immunoreactive ER were also found in endometrial carcinomas but not in lung carcinomas, malignant melanomas, or basal cell carcinomas. Patients with breast cancers containing immunoreactive ER survived significantly longer after operation than patients whose tumor lacked immunoreactive ER. This immunoassay for ER is simpler than the binding assay and requires less time and tissue. PMID- 3530536 TI - Stability of subfractions of high-density lipoproteins in stored sera. PMID- 3530537 TI - Cellular mechanisms of insulin action: implications for insulin resistance and type II diabetes mellitus. PMID- 3530538 TI - Nonenzymatic glycosylation: role in the pathogenesis of diabetic complications. AB - Prolonged hyperglycemia is the primary metabolic abnormality responsible for the development of irreversible tissue damage in chronic diabetes. However, patients with similar levels of chronic hyperglycemia can differ markedly in their susceptibility to diabetic complications. Among the mechanisms by which hyperglycemia may lead to tissue damage, nonenzymatic glycosylation involves excessive chemical attachment of glucose to proteins without the involvement of enzymes. The early Amadori products, resembling hemoglobin A1c, slowly give rise to complex irreversible glycosylation adducts. Only these post-Amadori products accumulate in diabetic tissues over long periods. However, early nonenzymatic glycosylation or Amadori product formation can alter such physiological processes as enzyme activity or binding of regulatory molecules. Advanced glycosylation end products can covalently trap extravasated serum proteins to the extravascular matrix, and thus may contribute to capillary closure in the retina and glomerulus, and to arterial narrowing in the coronary, cerebral, and peripheral circulation. Although a macrophage receptor system may antagonize this glycosylation-mediated accumulation of proteins by recognizing and ingesting those proteins with advanced glycosylation end products, excessive formation of those proteins in diabetes may saturate the capacity of the macrophage removal system. PMID- 3530539 TI - Historical view of the classifications of diabetes. PMID- 3530540 TI - Overview of the complications of diabetes. AB - Currently, we can make the following generalizations about the major long-term complications of diabetes. First, they occur commonly after 10 to 15 years of diabetes. Second, the complications of renal and retinal disease, but not of atherogenic and neurological disease, appear to be related to the severity of hyperglycemia. Third, some complications do not seem to be readily reversible by decreasing blood glucose for one to three years. Fourth, whether retinal and renal disease can be prevented or reduced by an early intervention is not yet known but is under intensive study. Fifth, the risks of some forms of intensive therapy include hypoglycemia, ketoacidosis, skin infection, weight gain, and poor adherence to arduous regimens. Finally, an analysis of the relationship of benefits to risk in intensive therapy is not yet possible and must await further study. Meanwhile, the diabetes research community will need to evaluate whether alternative procedures, e.g., aldose reductase inhibitors or islet transplants, might not be more reasonable than currently available modes of intensive therapy for reducing the long-term complications of diabetes. PMID- 3530541 TI - Complications of diabetes mellitus and factors affecting their progression. PMID- 3530542 TI - Glycated hemoglobin: methodologies and clinical applications. PMID- 3530543 TI - Pre-hyperglycemic diabetes mellitus. PMID- 3530544 TI - Pancreas transplantation. PMID- 3530545 TI - Use of artificial devices in intensive insulin therapy of diabetes mellitus. PMID- 3530546 TI - Determination of blood pressure in children. AB - The present paper reviews the epidemiologic patterns of blood pressure in children by demographic variables such as age, race, sex, education and social class. Other possible determinants for high blood pressure in both adults and children are also discussed, including obesity and salt intake. Special attention is given to the phenomenon of tracking and to genetic influences in blood pressure, the latter discussed in the context of the strengths and limitations of twin and familial aggregation studies. PMID- 3530547 TI - Electrolytes and blood pressure levels in childhood hypertension: measurement and change. AB - Research into the relationship between dietary electrolytes and the primary cause and treatment of hypertension has now reached the stage where long-term, detailed, controlled, randomized, clinical trials of intervention need to be carried out among those at high risk, including children. Such trials must incorporate methods for estimating "sensitive" responders. The designs should also include precise measures of change in dietary electrolyte intake and allow for analysis of interaction of the effects of individual electrolytes. We have sketched the unforeseen errors, that now must be avoided, from earlier studies and given an outline of a current study that sets out to meet optimum requirements. It is to be hoped that many similar studies will soon be initiated in multiple population groups. PMID- 3530548 TI - Genetics of primary hypertension. AB - Geneticists seek to understand the interaction between genetic and environmental causes of phenotypic variation among individuals in a population. Clinical studies have established that an individual's blood pressure (BP) level is the consequence of the interaction of biologically determined characteristics of the nervous, renal, endocrine and circulatory systems with factors that define one's environment, such as dietary salt, stress and exercise. The many genes that orchestrate the development of these biologically determined characteristics are expected to determine one's BP level, one's increase in BP with age and one's BP response to changes in the environment. One consequence of such a multifactorial etiology is that there are multiple combinations of genetic and environmental factors that may lead to the same BP level. The prevention and control of hypertension will be enhanced when intervention strategies take into account this etiological heterogeneity in determining the hypertensive endpoint. We are pursuing a level crossing strategy in the study of the causes of interindividual BP differences. According to this approach relevant phenotypes that link genetic and environmental factors with blood pressure levels are identified, the genetic contribution to variability in these phenotypes is estimated and then the contribution of this genetic etiology to blood pressure variability is evaluated. We have successfully carried out such a level crossing approach in our investigations of the genetics of red cell sodium lithium countertransport and the relationship between sodium lithium countertransport and blood pressure. A single gene effect on red cell sodium lithium countertransport levels is the only single gene known to affect interindividual blood pressure variability. PMID- 3530549 TI - Multiple sites of regulation of mouse renin expression in ontogeny. AB - How local renin expression is regulated in many tissues has yet to be defined. In the present studies the ontogeny of renin in submandibular gland (SMG) and kidney of CD-1 mice was examined in order to determine whether renal and extrarenal renin are similarly expressed. In males, submandibular gland (SMG) renin and renin secretory rate increase at puberty as androgen rises. The ratio of secreted forms (1-chain renin cf. 2-chain) seen on Western blots shows predominance of 1 chain prior to puberty and 2-chain thereafter. This androgen influence on renin processing and secretion was supported by reversion to prepubertal patterns with castration of adult males and by conversion to male pattern in androgen treated females which otherwise have low renin levels. In contrast, renal renin remains unchanged throughout development. The influence of ontogeny on renal and SMG renin mRNA was examined by Northern analysis using renin cDNA: SMG renin mRNA increases from near zero to high levels at puberty while renal renin mRNA level is high throughout. Taken together, these data suggest that SMG renin is influenced by androgens, whereas renal renin is not. Apparent differences in tissue renin regulation may have important implications for local function of this enzyme. PMID- 3530550 TI - Hypertension in the neonate. AB - Blood pressure (BP) is low at birth. It increases with age, by about 1 mm Hg per day within the period of 3 to 8 days. It rises by about 1 mm Hg per week between ages 5 to 6 weeks. At a latter age, systolic BP is close to 95 +/- 10 mm Hg. Hypertension is a rare condition in the neonate, where it carries a high risk of cardiorespiratory failure and cerebral distress. Causes of neonatal hypertension are either secondary to congenital malformations or to acquired disease states: Congenital malformations: renal artery stenosis, renal artery hypoplasia, abdominal aortic atresia, coarctation of the aorta, kidney cystic disease, reflux nephropathies. Acquired diseases: thrombo-embolic renal artery complications secondary to umbilical artery catheterization or to thrombosis of ductus arteriosus, closure of abdominal wall defects, adrenal hematoma with renal artery compression, seizures in preterm infants, central nervous system disorders, drug induced hypertension, infants of drug-dependent mothers. The morbidity and the mortality of neonatal hypertension are elevated. Death may be caused by severe uncontrollable hypertension or by concomitant problems. Morbidity may be related to drug-resistant hypertension, or to the side-effects of hypotensive drugs. Surgery in these severely ill infants also carries a significant risk. PMID- 3530552 TI - Renin-angiotensin-aldosterone system: a long-term follow-up study in 17 alpha hydroxylase deficiency syndrome (17OHDS). AB - We studied the mineralocorticoid pattern in 4 patients with 17OHD during long term glucocorticoid treatment. We observed reduction of BP, normalization of K levels, a gradual increase in PRA and in urinary Aldosterone (ALDO); a normal response of plasma ALDO to ACTH and to angiotensin II was present only in one case. We observed a prompt decrease of mineralocorticoid hormones, normalized by long-term therapy only in one case. Discontinuation of treatment induced an increase of ALDO that became suppressed in late off-treatment. Thus, glucocorticoid treatment decreases abnormal steroid levels and activates zona glomerulosa (ZG) function, even if it may take years for ALDO to normalize. Brief discontinuation of therapy induces a surge in ALDO levels, revealing no biosynthetic defect in ZG, while in late off-treatment mineralocorticoids seem to come exclusively from zona fasciculata. PMID- 3530551 TI - The utility of renin profiling in childhood hypertension. AB - Criteria to categorize children as having hypertension associated with high, low or normal PRA as determined by the technique of renin sodium indexing; or with PRA responsiveness which was normal, suppressed or excessive after acute volume depletion induced by a loop diuretic were established in 30 normotensive adolescents. Four hour upright PRA corrected for daily sodium excretion was elevated in 16% of 43 and 84% of 25 children with essential and renal related hypertension. Low PRA was found in 5 of 43 and 0 of 25 children. In 36 children with essential hypertension evaluated after acute volume depletion, 4 and 5 had hyper- and hypo- responsive PRA compared to the 30 normotensive children. The application of these two approaches enables the renin angiotensin system to be systematically categorized in hypertensive children. PMID- 3530553 TI - Blood pressure behaviour and control in Turner syndrome. AB - Adult Turner syndrome (TS) patients frequently present hypertension. To clarify the pathogenesis of this hypertension we examined the blood pressure (BP) behaviour and the renin-angiotensin-aldosterone system in 31 TS patients (2-22 years of age). BP levels were occasionally elevated in 47% of the subjects and constantly elevated in 23%. Most of the patients were on estrogen replacement therapy, but 26% of them presented with elevated levels since childhood. Supine and upright plasma renin activity (PRA) values were higher in TS compared to controls and more elevated in hypertensive TS than in the normotensive ones. At Captopril challenge TS showed different PRA responses regardless of the karyotype and clinical features. Patients on estrogen therapy, however, exhibited higher increments of PRA after Captopril. CONCLUSIONS: TS patients show high frequency of hypertension in pediatric age. Estrogen therapy is an outbreaking and worsening factor. An estrogen independent role of the renin-angiotensin aldosterone system in the pathogenesis of TS hypertension is still uncertain. PMID- 3530554 TI - Renal arterial hypertension in pediatric patients. AB - Three hundred twenty-three children with hypertension due to different kidney disorders were analysed. Acute transient hypertension was the most frequent form of renal hypertension and was usually due to acute post-infectious glomerulonephritis. Chronic hypertension was frequently associated with renal insufficiency. In glomerular disorders the appearance of hypertension was usually accompanied by renal failure. PMID- 3530555 TI - Non-pharmacological intervention in primary hypertension in childhood. AB - In children with blood pressure levels persistently in the upper part of the distribution and without evidence for known causes of hypertension, one may ask which approach should be used to lower blood pressure. In general, non pharmacological intervention will be preferred over drug treatment as a first choice in children with primary hypertension. No specific non-pharmacological treatment is available for children with high blood pressure. The main objective of this review is to underscore the need for further intervention studies in hypertensive children. Although the scientific evidence is rather scanty, some general recommendations concerning body weight, physical activity and fitness, dietary intake of electrolytes and relaxation procedures can be made. In obese children, weight reduction, combined with increase of physical activity, is the measure of first choice to lower blood pressure. In children with a high sympathetic outflow, as evidenced by high levels of circulating catecholamines, increase of physical activity and use of relaxation procedures may be the first approach to lower blood pressure. In children with evidence for disturbances in electrolyte metabolism, as evidenced by high intralymphocytic sodium, low serum calcium, or high PTH, a dietary approach to high blood pressure may be used. In these children, an increase of potassium intake or calcium intake seems a promising way to lower blood pressure. PMID- 3530556 TI - Blood pressure response to sodium restriction and potassium supplementation in healthy normotensive children. AB - To examine the effects of dietary sodium on blood pressure 149 healthy, normotensive children (64 males, 85 females) participated in a study to restrict sodium intake to 60 mEq/day or half of the usual intake for 3 months. Sodium excretion was significantly decreased during the study period (100.6 +/- 3.4 mEq vs 46.5 +/- 2.0 mEq, P less than .001). As a group there was no significant change in systolic and a small decrease in diastolic blood pressure (54.2 +/- 0.8 mmHg vs 53.0 +/- 0.7 mmHg, p less than .03, one tailed). Adjustment of blood pressure for weight and age and analysis of residuals yielded significant decreases in both mean arterial (p less than .05) and diastolic blood pressure (p less than .05). In the potassium supplement study, comparison of supplementation to post-supplement periods in 31 children (13 male, 18 female) showed a significantly lower (p less than .05) systolic blood pressure during supplementation (101.3 +/- 2.1 mmHg vs 103.3 +/- 20 mmHg). Analyses of diastolic pressures, sodium excretion and weight were not significant. These studies show heterogeneity in the blood pressure response to sodium restriction and suggest that sodium restriction and potassium supplementation have different effects on blood pressure in children. PMID- 3530557 TI - Antihypertensive drug therapy with captopril in children and adolescents. AB - Captopril was administered to three groups of hypertensive children and adolescents: patients with renal disease; neonates with umbilical artery related hypertension; and post-renal transplant patients. In older children with renal disease, increasing the captopril dose above 0.5 mg/kg did not improve the antihypertensive response. A maximal drug concentrations occurred one hour after dosing, and captopril concentration returned to predose levels by eight hours. Neonates responded to significantly lower doses of captopril (0.01-0.5 mg/kg) and the duration of response to higher doses appeared to be longer than that observed in older children. In post-renal transplant patients, blood pressure decreased after captopril in 94% of subjects, but in 62% a concomitant increase in serum creatinine was observed (correlation [r] = 0.55, p less than .02). This increase could not be correlated with renal biopsy histopathology. Thus, captopril has proven to be an effective antihypertensive agent in children over a broad age range and for a variety of clinical conditions. PMID- 3530558 TI - Long-term treatment with captopril in pediatric patients with severe hypertension and chronic renal failure. AB - Captopril was given to 42 hypertensive patients aged 1 to 17 years who were treated by regular haemodialysis because of terminal renal failure. Initially all patients were on antihypertensive treatment without sufficient control of blood pressure. Under captopril all patients presented a significant decrease of both systolic and diastolic blood pressures. The mean decrease of systolic blood pressure was from 162 to 114 and that of diastolic blood pressure from 106 to 86 mmHg. Plasma renin activity rose significantly in all cases whereas plasma aldosterone dropped and reached normal levels for age. The maximum effective dosage was 3 mg/kg/day. Total duration of treatment with captopril ranged from 1 1/2 to 6 1/12 (mean 3 2/12) years. At last observation the dosage of captopril varied between 0.3 and 3 mg/kg/day. PMID- 3530559 TI - Treatment of renal hypertension in children by captopril. AB - Nine children aged 2 months to 13 (mean 6.6) years with renal hypertension were treated with captopril. The treatment lasted for 1.5 to 14 months. Maintenance doses ranged between 1 and 5 mg/kg/day. Good effect was achieved with captopril in children with normal renal function and in mild renal insufficiency. In patients with end-stage renal disease when dialysis failed to maintain normal body water captopril was ineffective. PMID- 3530560 TI - Blood pressure and hormonal responses to sublingual nifedipine in acute childhood hypertension. AB - Twelve infants and children were treated with sublingual application of the calcium antagonist nifedipine. Blood pressure fell within 1 h following administration of nifedipine to age-related normal values. Whereas plasma renin activity, plasma concentrations of aldosterone and arginine vasopressin did not change within 1 h after drug application, plasma noradrenaline rose (p less than 0.05), probably in response to vasodilatation. Plasma concentration of nifedipine at 30 and 60 min after application correlated positively with the fall in mean arterial pressure. Nifedipine was well tolerated and appeared to be an effective and safe drug in the treatment of acute rises of blood pressure in infants and children. PMID- 3530561 TI - Nifedipine in hypertensive crises of infants and children. AB - Nifedipine given by the sublingual route has been used in the treatment of 30 hypertensive emergencies in 20 children suffering from renal disease. The mean dosage of nifedipine was 0.33 mg/kg body weight. In 20 hypertensive crises occurring in 16 patients a single dose of nifedipine was sufficient to lower systolic as well as diastolic blood pressure significantly within 90 min. for a period of 4 to 12 hours. No side effects were noted with the exception of a transient flush in one patient. Nifedipine proved to be suitable for the primary treatment of hypertensive emergencies in children suffering from renal hypertension. The advantages of nifedipine compared to other drugs used for treating hypertensive crises is the rapid onset of the antihypertensive action without need for an intravenous form of administration. PMID- 3530562 TI - Effects of heparin and defibrinotide on malignant hypertension in rats. AB - This study examines the effects of anticoagulant and antithrombotic drugs on blood pressure (BP), plasma renin activity (PRA) and renal glomerular and vascular lesions in rats following aortic ligation. Whole heparin, low molecular weight (LMW) heparin or defibrinotide was administered for 4 weeks to rats following complete aortic ligation between the renal arteries. BP and PRA in whole heparin treated rats were significantly lower than those in control rats (p less than 0.01, p less than 0.01). Renal morphology also revealed a reduced number of epithelial cell droplets (ECD) (the nature of which is unknown) in glomeruli and less severe vascular lesions (p less than 0.005, p less than 0.005). Decreased BP and PRA were seen in rats receiving LMW heparin, but the failure of LMW heparin to prevent vascular damage indicates that an increased anti-Xa activity or reduction of PRA is not enough to prevent these lesions in hypertensive rats. The rats receiving defibrinotide showed reduced BP only. PMID- 3530563 TI - Factors that determine the response of people with mild hypertension to a reduced sodium intake. AB - One hundred and eighty-six males who had had 3 run-in visits entered the study with a supine diastolic BP 95-110 mm Hg. This was followed by 3 pretreatment and 3 post-treatment visits. One hundred and sixty patients were given advice to reduce sodium intake after visit 3, and twenty-six patients served as control. In the control group there were relatively insignificant changes between the pre and post visits. In the diet group blood pressure fell by 13/9 mm Hg; urine sodium from 168 to 85 mmol/day and plasma renin activity rose from .50 to .77 ng AI/ml/h. Regression analysis showed that the only cross-sectional correlations were PRA with age, urine sodium and plasma potassium. There were highly significant correlations between the change in urinary sodium and the change in blood pressure and between the changes in blood pressure and plasma renin activity. Multiple Regression Analysis indicated that the final diastolic blood pressure achieved depended upon the initial diastolic blood pressure, the fall in sodium intake, and was reduced by the rise in plasma renin activity. Patients who responded to sodium restriction had a lower initial renin value than other patients. This study emphasises the importance of the interaction between sodium, potassium and renin in the determination of blood pressure levels. PMID- 3530564 TI - Autosomal whole arm translocations in man. A patient with t(5p7p;5q7q) type rearrangement and review of the literature. PMID- 3530565 TI - Prenatal diagnosis and pathoanatomy of iniencephaly. AB - The authors discuss the diagnostic criteria of iniencephaly based on data from the literature and eleven additional, new cases. The most important differential diagnostic problems involve anencephaly with spinal retroflexion and the Klippel Feil syndrome. Ultrasound indicated cranio-spinal alterations while amniotic fluid AFP estimation and exfoliative cytology substantiated abnormal closure of the neural tube, thus comprising helpful means for prenatal diagnosis of iniencephaly. The authors emphasize the need for median-sagittal sectioning through the spinal column for accurate evaluation of vertebral abnormalities. This, together with close observation of the occiput and the foramen magnum, helps the precise diagnosis of iniencephaly and once regularly applied will most likely result in more frequent recognition of this developmental abnormality. PMID- 3530566 TI - Successful use of captopril in the treatment of "scleroderma renal crisis". AB - A 53-year-old man with scleroderma and severe renal failure was treated with the angiotensin converting enzyme inhibitor captopril. Adequate control of blood pressure was achieved with this single agent and an impressive improvement of renal function followed. This case illustrates many features of the syndrome of "scleroderma renal crisis" and supports the use of captopril for its treatment. PMID- 3530567 TI - Incidence of circulating immune complexes in patients with acute poststreptococcal glomerulonephritis and in patients with streptococcal impetigo. AB - In an attempt to further study the possible contribution of circulating immune complexes (CIC) in the pathogenesis of acute poststreptococcal glomerulonephritis, 61 patients with APSGN were studied during the first three weeks of the disease, and 13 patients with noncomplicated streptococcal impetigo as a control group. C1q solid phase ELISA and Conglutinin (K) solid phase ELISA were used to measure the levels of immune complexes. The incidence of CIC in a single serum sample from patients with APSGN was 48%. Elevated levels of immune complexes were found in 46% of the patients with streptococcal impetigo. The absolute levels of CIC were comparable in both groups of patients. No correlation was found among the presence of CIC and the clinical, immunoserological or pathological findings of the disease. Our results do not support the hypothesis that trapping of the circulating immune complexes play an important role on the renal injury poststreptococcal infection. Instead, we suggest that CIC are an epiphenomena present in APSGN, and may represent rather a systemic inflammatory immune response in patients with group A streptococcal infection. PMID- 3530568 TI - Simple renal cyst and hypertension: cause or coincidence? AB - Hypertension and simple renal cysts are frequent clinical diagnoses. With the widespread use of new non-invasive diagnostic technics such as abdominal ultrasound and computer-assisted tomography renal cysts are diagnosed with increasing frequency. In patients 50 years or older renal cysts of various size may be found in nearly one third. Similarly, the incidence of hypertension increases with age. Thus, the coexistence of a simple renal cyst and hypertension in a patient may represent a pure coincidence or be a cause of high blood pressure. The effect of cyst removal upon hypertension has been documented in 22 patients in the literature. Surgical cyst removal or percutaneous cyst aspiration caused a significant fall in blood pressure in most patients. The drop in blood pressure was closely related to an activation of the renin angiotensin system in the involved kidney. Fifteen patients (68%) were considered cured and 2 improved after the intervention. All patients had large cysts. It is suggested that in patients with large renal cysts the lesion may, through local tissue and/or renal arterial compression, cause ischemia and in turn activate the renin angiotensin system. Since most of the renal cysts are 2 cm or less in diameter this may represent a very rare event. In patients with large renal cysts and hypertension percutaneous needle aspiration of the cyst and/or renal venous renin determination may be useful tools to determine a causal rather than a coincidental relation between the 2 lesions. PMID- 3530569 TI - Renal vein entrapment syndrome: frequency and diagnosis. A lesson in conservatism. AB - Two boys investigated for gross hematuria and left loin pain were found on ultrasound (US) to have left renal vein (LRV) entrapment associated with isomorphic urinary red blood cells, but normal renal venograms. Over the next 18 months ten children with gross hematuria were investigated and two more boys were discovered with the LRV entrapment syndrome, i.e., isomorphic red cells and a diagnostic US. Venography has a low yield in detecting renal venous compression, and since urinary red cell morphology may localize the origin of renal bleeding, we strongly recommend simple procedures, i.e., phase microscopy and renal US to evaluate all cases of hematuria before employing invasive or radiation dependent investigations. Since there is a range of LRV compression and associated dilatation in asymptomatic patients, strict criteria must be applied to diagnose renal vein entrapment. PMID- 3530570 TI - Prospective comparison of exercise digital subtraction and exercise first pass radionuclide ventriculography. AB - In order to test the comparative sensitivities of first-pass radionuclide and digital subtraction ventriculography in detecting wall motion abnormalities during exercise, 29 patients referred for coronary angiography were submitted to both types of stress ventriculograms. Resting and exercise ventriculograms by both techniques were reviewed by independent observers and the five equal ventricular wall segments were graded as normal, mildly, moderately, severely hypokinetic, akinetic, or dyskinetic. Of the 29 patients, 24 had arteriographically defined ischemic potential (at least greater than 50% obstruction of a major coronary artery supplying viable myocardium). Exercise digital subtraction ventriculography correctly identified 17 (71%) of these by a worsening of wall motion during exercise, while radionuclide ventriculography identified only eight (33%) by the wall motion response. When either a worsening of wall motion or the failure to increase ejection fraction by at least 5 points were used as criteria for an abnormal test, the sensitivities of digital and radionuclide ventriculographies were 96% and 79%, respectively. Though the number of patients without ischemic potential (5 patients) was too small to judge the relative specificities, digital subtraction ventriculography appears to be more sensitive than radionuclide ventriculography in identifying exercise-induced wall motion abnormalities and in predicting coronary occlusions. PMID- 3530571 TI - Electrophysiologic effects of ethmozin on sinus node function in patients with and without sinus node dysfunction. AB - To compare the effects of ethmozin on sinus node (SN) function in the presence (9 patients) and absence (17 patients) of SN dysfunction, sinus cycle length (SCL), maximal corrected sinus recovery time (CSRT), paced cycle length yielding peak SN suppression, and indirect sinoatrial SA conduction time (SACT) were determined before and after intravenous administration of ethmozin in the dose 2 mg/kg. The mean +/- SD SCL were significantly shortened in patients with normal SN and were not changed in patients with SN dysfunction after ethmozin administration. The mean maximal CSRT was 252 +/- 72 before and 284 +/- 86 ms after ethmozin administration in patients with normal SN function (p less than 0.05). In patients with SN dysfunction (p less than 0.1) the mean maximal CSRT was found to be 1016 +/- 434 before and 2170 +/- 1756 ms after ethmozin administration. The mean SACT was 158 +/- 41 before and 174 +/- 51 ms after drug administration in patients with normal SN (p less than 0.05). Four out of nine patients with SN dysfunction developed second degree SA exit block after ethmozin administration, whereas SACT increased significantly in the remaining group of patients (180 +/- 35 to 210 +/- 32 ms; p less than 0.05). The PR, PA, AH, and HV intervals significantly lengthened and the valves of QRS and QT were not changed after ethmozin administration in either group. The conclusion is drawn that ethmozin should be administered cautiously to patients with SN dysfunction, particularly to patients with SA exit block, sinus pauses, or secondary pauses (in particular, with bradycardia-tachycardia syndrome). PMID- 3530572 TI - Acute, short- and long-term efficacy of oral bevantolol in patients with coronary artery disease: a placebo-controlled, randomized, double-blind study. AB - The efficacy and safety of bevantolol (new cardioselective beta-blocking agent without intrinsic sympathetic activity) were evaluated in chronic stable angina pectoris. Acute effects on heart rate (HR) and pulmonary function (forced expiratory volume in the first second, FEV1, and vital capacity, VC) (double blind placebo, propranolol, 80 mg, and bevantolol, 150 mg) and the antianginal efficacy during early (double-blind placebo period) and chronic bevantolol therapy (long-term follow-up for 52 weeks) were studied. Bevantolol reduces HR in the same way as propranolol (both p less than 0.01). Pulmonary function is modified significantly only by propranolol (decreasing FEV1, p less than 0.05). Bevantolol reduces antianginal attacks and nitroglycerin consumption (p less than 0.01) and improves exercise tolerance (p less than 0.01) during early and chronic therapy. PMID- 3530573 TI - Louis Nelson Katz (1897-1973): an appreciative profile. PMID- 3530574 TI - Effects of indomethacin on furosemide induced renal prostaglandin synthesis and action in man. AB - We had previously shown that the early increment in plasma renin activity occurring within ten minutes of intravenous furosemide is accompanied by an increase in urine 6-keto-prostaglandin F1 alpha (6-keto-PGF1 alpha) the hydrolysis product of prostacyclin. Renal prostacyclin and thromboxane A2 synthesis are apparently limited to the cortex. To assess whether indomethacin would inhibit renal cortical eicosanoid synthesis and whether such reduction correlated with reduced early renin release, we assessed responses to intravenous furosemide (0.5 mg/kg) before and after indomethacin (150 mg/day for seven days) in ten normal male volunteers. Indomethacin did not change blood pressure but increased weight slightly (79.7 +/- 2.5 kg to 80.4 +/- 2.4 kg, p less than 0.05). Serum thromboxane B2 (TXB2), a measure of platelet thromboxane A2 production, was profoundly depressed (142 +/- 29 ng/ml to 4.8 +/- 1.6 ng/ml, p less than 0.001). Neither diuresis nor natriuresis were changed by indomethacin but potassium excretion was reduced (33 +/- 4 mmol/4 hr to 27 +/- 3 mmol/4 hr, p less than 0.05). Basal as well as furosemide stimulated plasma renin activity (at 10, 30 and 240 minutes) was reduced, as well as the transient increase in excretion rates of 6-keto-PGF1 alpha and TXB2. We conclude that the reduction in furosemide stimulated renin release by indomethacin is due to renal cyclo-oxygenase inhibition which is reflected in decreased excretion rates of hydrolysis products of renal eicosanoids. PMID- 3530575 TI - Can vitamin supplements prevent neural tube defects? Current evidence and ongoing investigations. PMID- 3530576 TI - Imaging techniques in the staging of gynecologic malignancy. PMID- 3530577 TI - Status spongiosus in Creutzfeldt-Jakob disease. AB - The initial stage of status spongiosus in Ammon's horn of two brains with panencephalopathic type of Creutzfeldt-Jakob disease (PE-CJD) was examined electron microscopically. The results obtained in this examination were as follows: initial formation of large vacuoles or cavities seemed to be the result of distension within cell processes, mainly astrocytes, and these vacuoles and cavities might gradually form status spongiosus. A very important finding in the present study was that all kinds of glial cells showed degenerative changes. It is concluded that glial insufficiency might be one of the pathogenetic mechanisms effective in panencephalopathic Creutzfeldt-Jakob disease. PMID- 3530578 TI - Sir Harry Platt. An appreciation. PMID- 3530579 TI - The classic. Traction lesions of the external popliteal nerve. By Harry Platt. 1940. PMID- 3530580 TI - British contribution to knee arthroplasty. AB - British surgeons and engineers contributed various types of knee prostheses, including hinged, unconstrained, and semiconstrained prostheses, in the development of total knee arthroplasty. Methods of implant fixation, the place of stems, pegs, the use of special instrumentation, and alignment procedures ensure both intrinsic and extrinsic prosthetic stability. PMID- 3530581 TI - Diagnosis of CNS lymphoma using immunofluorescent phenotyping of CSF mononuclear cells. AB - We describe the use of a panel of monoclonal antibodies, directed against leukocyte surface antigens to characterize CSF mononuclear cells with regard to malignancy when cytopathology was inconclusive. Cytocentrifuged preparations from three patients in which traditional modalities had not yielded a diagnosis were studied, utilizing a panel of antibodies for B and T cell antigens. All three patients were found to have B cell lymphoma of the CNS. Rapid institution of the appropriate therapy resulted in marked improvement of CNS symptoms in each case. Our results indicate that in patients with CNS disease and CSF pleocytosis of undefined nature, this technique may provide rapid and precise diagnostic information. PMID- 3530582 TI - Clinical pharmacokinetics of vancomycin. AB - Vancomycin utilisation has increased dramatically in the last 10 years due to the increasing clinical significance of infections with methicillin-resistant staphylococci. Recent studies have focused on characterising the disposition of vancomycin in patients and assessing the relationship between serum concentrations and therapeutic as well as adverse effects. Although vancomycin is not appreciably absorbed from the intact gastrointestinal tract, several recent case reports have documented the attainment of therapeutic and potentially toxic vancomycin serum concentrations following oral administration to patients with pseudomembranous colitis. The disposition of parenterally administered vancomycin has been best characterised by a triexponential model. The half-life of the initial phase (t1/2 pi) is approximately 7 minutes, that of the second phase (t1/2 alpha) is approximately 0.5 to 1 hour, while the terminal elimination half life (t1/2 beta) ranges from 3 to 9 hours in subjects with normal renal function. The volume of the central compartment (Vc) in adults is approximately 0.15 L/kg while the steady-state volume of distribution (Vdss) ranges from 0.39 to 0.97 L/kg. More than 80% of a vancomycin dose is excreted unchanged in the urine within 24 hours after administration, and the concentration of vancomycin in liver tissue and bile has been reported to be at or below detection limits. Vancomycin renal clearance approximates 0.5 to 0.8 of simultaneously determined creatinine or 125I-iothalamate clearances, suggesting that the primary route of renal excretion is glomerular filtration. Recently, non-renal factors such as hepatic conjugation have been proposed as an important route of vancomycin elimination. However, these data are difficult to reconcile with other studies showing minimal non-renal clearance of vancomycin in subjects with end-stage renal disease. As yet, the disposition of vancomycin in patients with hepatic disease has not been adequately defined. Only limited data are available regarding the concentrations of vancomycin in biological fluids other than plasma. The penetration of vancomycin into cerebrospinal fluid (CSF) in patients with and without meningitis has been quite variable. Although early studies suggested that adequate CSF concentrations may not be achieved in subjects with uninflamed meninges, more recent investigations have reported contradictory results. Therapeutic concentrations of vancomycin, i.e. greater than 2.5 mg/L, have, however, been reported in ascitic, pericardial, pleural and synovial fluids. Tissue concentrations of vancomycin have exceeded simultaneous serum concentrations in heart, kidney, liver and lung sp PMID- 3530583 TI - Obstetric analgesia. Clinical pharmacokinetic considerations. AB - All drugs used in obstetric analgesia are more or less lipophilic, their site of action is in the central nervous system, and they have good membrane penetrability in the fetomaternal unit. Thus the dose and method of administration as well as the duration of treatment are important clinical determinants of drug effects in the fetus and newborn. In the past, too much emphasis has been placed on fetomaternal blood concentration ratios of different agents; it is now appreciated that the extent of fetal tissue distribution and the neonatal elimination rate are pharmacokinetically much more important. Extensive fetal tissue distribution is reflected in a low fetomaternal drug concentration ratio, which may be followed by prolonged neonatal elimination of the drug. Currently, the most effective and safest method for obstetric analgesia is regional epidural administration of bupivacaine or lignocaine (lidocaine); only low doses are needed and the newborn is able to handle these agents efficiently. On the basis of pharmacokinetic and neurobehavioural assessments, inhalational anaesthetic agents appear to be more attractive than pethidine (meperidine) or benzodiazepines. Intermittent administration and fast pulmonary elimination of inhalational agents ensure that long-lasting residual effects are unlikely to occur. The kinetics of epidural and intrathecal opiates explain the problems associated with their use in obstetrics. Among the newer drugs used in obstetric analgesia, the properties of meptazinol and isoflurane appear interesting and these agents warrant further study. All drugs used in obstetric analgesia have a potentially detrimental effect on the neonate and, therefore, knowledge of fetal and neonatal pharmacokinetics is of importance to the clinician. PMID- 3530585 TI - Renal safety of two analgesics used over the counter: ibuprofen and aspirin. AB - The incidence of potentially serious drug-related elevations of BUN or serum creatinine was examined among 1468 patients with rheumatoid arthritis or osteoarthritis who took daily therapeutic doses of aspirin, ibuprofen, or oxaprozin, an investigational nonsteroidal antiinflammatory drug (NSAID), in multicenter clinical trials. Algorithms were developed to identify patients with potentially important elevations of these renal laboratory parameters and to assess the possible relation between these elevations and the study drugs. All three drugs were associated with a low (4% to 6%) incidence of potentially significant elevations in renal function parameters. Changes considered serious occurred in only three (less than 1%) patients (one treated with oxaprozin and two with ibuprofen), all of whom were receiving concomitant diuretic therapy. None of the changes led to adverse clinical consequences. Thus despite recent controversy regarding the renal safety of NSAIDs, all three drugs proved safe in these studies, despite the fact that aspirin and ibuprofen were given in doses equal to or higher than those used for over-the-counter indications. PMID- 3530584 TI - Clinical pharmacokinetics of dapsone. AB - Dapsone (DDS) has for about 4 decades been the most important antileprosy drug. Concentrations of dapsone and its monoacetyl metabolite, MADDS, can be determined in biological media by high-performance liquid chromatography. After oral administration, the drug is slowly absorbed, the maximum concentration in plasma being reached at about 4 hours, with an absorption half-life of about 1.1 hours. However, the extent of absorption has not been adequately determined. The elimination half-life of dapsone is about 30 hours. The drug shows linear pharmacokinetics within the therapeutic range and the time-course after oral administration fits a 2-compartment model. The concentration-time profile of dapsone after parenteral administration is reviewed. Of clinical importance is the development of a new long acting injection, which permits monthly supervised administration as recommended by the World Health Organization. Following dapsone injection in gluteal subcutaneous adipose tissue, a sufficiently sustained absorption for this purpose has been reported. Dapsone is about 70 to 90% protein bound and its monoacetylated metabolite (MADDS) is almost completely protein bound. The volume of distribution of dapsone is estimated to be 1.5 L/kg. It is distributed in most tissues, but M. leprae living in the Schwann cells of the nerves might be unaffected. Dapsone crosses the placenta and is excreted in breast milk and saliva. Dapsone is extensively metabolised. Dapsone, some MADDS and their hydroxylated metabolites are found in urine, partly conjugated as N glucuronides and N-sulphates. The acetylation ratio (MADDS:dapsone) shows a genetically determined bimodal distribution and allows the definition of 'slow' and 'rapid' acetylators. As enterohepatic circulation occurs, the elimination half-life of dapsone is markedly decreased after oral administration of activated charcoal. This permits successful treatment in cases of intoxication. The daily dose of dapsone in leprosy is 50 to 100mg, but varies from 50 to 400mg in the treatment of other dermatological disorders. In malaria prophylaxis, a weekly dose of 100mg is used in combination with pyrimethamine. Side effects are mostly not serious below a daily dose of 100mg and are mainly haematological effects. The dapsone therapeutic serum concentration range can be defined as 0.5 to 5 mg/L. Alcoholic liver disease decreases the protein binding of dapsone; coeliac disease and dermatitis herpetiformis may delay its oral absorption and severe leprosy has been reported to affect the extent of absorption.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3530586 TI - Comparison of short and long half-life benzodiazepine hypnotics: triazolam and quazepam. AB - Two benzodiazepine hypnotics, triazolam, 0.25 mg, with a short elimination t1/2, and quazepam, 15 mg, with a long t1/2, were evaluated in 22-night sleep laboratory studies. Quazepam improved sleep significantly during both short- and intermediate-term use. Daytime sleepiness, which decreased with continued use, was the side effect most often associated with quazepam dosing. In contrast, triazolam dosing did not significantly improve any of the major sleep efficiency parameters, and there was a rapid development of tolerance for the drug's slight initial effectiveness. In addition, there were a number of behavioral side effects including amnesia, confusion, and disinhibition. Withdrawal of triazolam was associated with sleep and mood disturbances (rebound insomnia and rebound anxiety), whereas quazepam exerted carryover effectiveness. Thus the data in this study show that the 0.25 mg dose of triazolam, which is being prescribed increasingly, has a profile of side effects that is similar to that of the 0.5 mg dose. PMID- 3530587 TI - The role of epinephrine in the circulatory effects of coffee. AB - The circulatory response to coffee was studied in 10 normotensive, 10 bilaterally adrenalectomized, and 10 hypertensive subjects. In the normotensive group, drinking coffee exerted a rise in blood pressure (+5.1/+11.5 mm Hg), a fall in heart rate (-6.0 bpm), a rise in plasma epinephrine (+257.2%), and no change in plasma norepinephrine. The response to coffee in the hypertensive group was similar or even enhanced. In the patients who had undergone adrenalectomy, the coffee-induced rise of diastolic blood pressure was attenuated (+7.9 mm Hg; P less than 0.05), whereas plasma norepinephrine showed a fall (-20.8%) and plasma epinephrine remained undetectable throughout all tests. Additionally, a fall of plasma renin activity after coffee was observed in all three groups. We conclude that the pressor response to coffee is not purely a result of circulating epinephrine or to stimulation of the renin-angiotensin-aldosterone system. On the other hand, the coffee-induced increase of plasma epinephrine may increase the pressor response to coffee. PMID- 3530588 TI - Age-dependent cyclosporine: pharmacokinetics in marrow transplant recipients. AB - We evaluated the effect of age on cyclosporine pharmacokinetics in 69 nonobese patients aged 10 months to 56 years (median 22 years) undergoing allogeneic bone marrow transplantation for treatment of aplastic anemia or hematologic malignancy. Cyclosporine pharmacokinetics were studied during the first 2 posttransplant weeks after an intravenous dose of 2.6 to 3.5 mg/kg. Serum cyclosporine concentrations were measured by HPLC. Cyclosporine concentration time data were fitted to a two-compartment model with a nonlinear regression program. There was a significant inverse linear correlation between age and both total systemic clearance (CL) (r = 0.42; P less than 0.001) and volume of distribution at steady-state (Vss) (r = 0.33; P less than 0.01). Mean (+/- SE) cyclosporine CL was 82 +/- 21, 45 +/- 5, 38 +/- 9, 44 +/- 8, and 20 +/- 3 ml/min/kg and mean cyclosporine Vss was 34 +/- 11, 28 +/- 10, 15 +/- 4, 14 +/- 5, and 4.7 +/- 0.7 L/kg in patients 0 to 10 (n = 12), 11 to 20 (n = 19), 21 to 30 (n = 12), 31 to 40 (n = 17), and greater than 40 (n = 9) years old, respectively. Patients 0 to 10 years old had a significantly higher cyclosporine CL than those 11 to 40 or greater than 40 years old and also had a significantly larger Vss than those greater than 40 yrs old (P less than 0.05). Age-related differences in CL or Vss were also observed when these parameters were normalized by body surface area.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3530589 TI - Effect of tripamide on glucose tolerance in patients with hypertension. AB - The effects of tripamide and hydrochlorothiazide on blood pressure and glucose tolerance were studied in 20 hypertensive patients, half of whom had type II diabetes mellitus. Each patient underwent intravenous glucose tolerance testing before and after 4 weeks of treatment with tripamide, 10 mg, and, at a separate time, hydrochlorothiazide, 50 mg. Both tripamide and hydrochlorothiazide lowered blood pressure; for both drugs, the magnitude of the reduction in mean arterial pressure was positively correlated with the pretreatment mean arterial pressure. Hydrochlorothiazide produced a greater fall in serum potassium than did tripamide. In the nondiabetics, neither drug produced a significant change in the glucose disappearance curve or the plasma insulin response. In the diabetics, hydrochlorothiazide produced an increase in serum glucose levels, but the plasma insulin response, which was blunted in comparison to the nondiabetics, did not change. Tripamide did not affect serum glucose or plasma insulin levels in either group of patients. Tripamide at a dose of 10 mg daily does not affect glucose tolerance in either nondiabetic hypertensive patients or patients with type II diabetes mellitus. PMID- 3530590 TI - Effect of chemical sympathectomy on renal hydroelectrolytic handling in dogs with chronic caval constriction. AB - The effect of renal selective chemical sympathectomy by intrarenal infusion of 6 hydroxydopamine (6-OHDA, 5 mg/kg body weight) on the renal excretion of water and electrolytes was studied in 7 dogs in whom a syndrome of sodium and water retention and ascites formation was induced by partial constriction of thoracic inferior vena cava. Propranolol (1 mg) and phentolamine (3 mg) were also injected to obviate acute systemic hemodynamic changes. Sympathectomy was performed once in 4 dogs and three times in 3 dogs. Sympathectomy induced an abrupt and transient increase in urinary flow (from 170 +/- 30 to 890 +/- 60 ml/24 h) and sodium excretion (from 4.5 +/- 1.5 to 178 +/- 21 mEq/24 h). This was accompanied by an important fall in plasma renin activity (from 2.2 +/- 0.2 to 0.5 +/- 0.1 ng angiotensin I/ml/h) and aldosterone, and disappearance of ascites. It is concluded that chemical sympathectomy, by increasing renal sodium and water excretion, mobilizes the ascites induced by chronic caval constriction, a fact that highlights the role of the renal sympathetic system in the pathogenesis of sodium and water retention by the kidney. PMID- 3530591 TI - Urine dopamine in starving obese subjects. AB - In seven obese female subjects undergoing a period of therapeutic starvation, the excretion of sodium, potassium and dopamine and plasma levels of renin and aldosterone were measured. Sodium excretion increased during starvation and was maximal on the 2nd day. The urinary excretion of dopamine was significantly higher on day 4 and it remained elevated till the end of the study. Plasma renin activity and plasma aldosterone levels were also higher on the 4th-6th days of starvation. These findings suggest that dopamine may not play a significant role in the natriuresis of starvation. PMID- 3530592 TI - Effects of glipizide on various consecutive insulin secretory stimulations in patients with type 2 diabetes. AB - Immunoreactive insulin (IRI) and C-peptide secretory responses to consecutive stimulations with terbutaline, glucagon, glucose and a standard meal were investigated in fasted subjects with newly diagnosed, untreated Type 2 diabetes with and without concomitant administration of the sulphonylurea agent glipizide (5 mg). Basal concentrations of blood glucose were 8.7 +/- 0.8 mmol/l without glipizide, and 6.6 +/- 0.5 mmol/l with glipizide (p less than 0.01). This difference in prestimulation glucose levels persisted throughout the study. It was found that glipizide potentiated the IRI and C-peptide secretion in response to terbutaline (125 micrograms i.v.). The absolute IRI and C-peptide secretory responses to glucagon (250 micrograms i.v.) were of similar magnitudes with or without glipizide, despite the lower blood glucose concentrations after glipizide. Allowing for the lower blood glucose, IRI and C-peptide responses to glucagon were potentiated by glipizide. Glucose (6 g i.v.) exerted no IRI or C peptide secretory effect in these patients either without or with glipizide. The changes in blood glucose concentration after injection of glucagon were not altered by glipizide. On the contrary, the terbutaline-induced increment in blood glucose concentration was inhibited by glipizide and the glucose elimination rate after glucose injection was slightly enhanced by glipizide; effects explained by the higher plasma insulin levels. After meal ingestion, the absolute IRI and C peptide secretory responses were slightly enhanced by glipizide. Glipizide had no effect on the meal-induced changes in blood glucose concentrations. In conclusion, glipizide had the ability to cause an absolute potentiation of beta 2 adrenoceptor-stimulated and meal-induced insulin secretion.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3530593 TI - Diabetic orthostatic hypotension: the role of total exchangeable sodium and nephropathy. AB - The purpose of this report was to examine the influence of nephropathy and sodium balance on the orthostatic blood pressure and renin (PRA) responses of diabetic patients with orthostatic hypotension (OH). Four groups of similar age were studied: non-diabetic controls (n = 7), diabetics free of OH and other diabetic complications (n = 7), diabetics with OH but no nephropathy (n = 6), and diabetics with OH and nephropathy (24-hr urine protein greater than 400 mg, n = 6). In the diabetics with OH, mean systolic BP fell 49 and 47 mmHg on standing in the groups without and with nephropathy respectively. NaE (expressed as % predicted by leanness index) differed significantly between the groups and was 100 +/- 2 in the controls, 109 +/- 3 in the diabetics free of complications, 102 +/- 2 in the diabetics with OH free of nephropathy, and 121 +/- 6 in diabetics with OH and nephropathy (p less than 0.05 compared to diabetics with OH and no nephropathy). Both supine (r = 0.68, p less than 0.02) and upright (r = 0.78, p less than 0.005) mean arterial pressure correlated with NaE in diabetics with OH but not in the other groups. Upright PRA was greatest in diabetics with OH but no nephropathy and lowest in diabetics with OH and nephropathy. These findings suggest that the presence of nephropathy markedly influences sodium balance in diabetics with OH and has a substantial influence on orthostatic BP and PRA responses. PMID- 3530594 TI - Insulin sensitivity in the initial phase of type 1 diabetes mellitus. AB - The blood glucose response to a brief infusion of insulin (0.012 U/kg body wt) was studied in the initial phase of Type 1 diabetes in 21 children and in 20 healthy controls. The insulin effect was impaired in most of the diabetics and the mean blood glucose decrement was 14.3 +/- 3.5% (SEM) as compared with 20.9 +/ 2.1% in the normals. Subgrouping the diabetics according to the severity of the diabetic condition revealed normal (or even supranormal) sensitivity in the diabetics with mild metabolic derangement (mean blood glucose decrement 36.2 +/- 6.0%). In children with more disturbed metabolism mean blood glucose decrement was only 5.6 +/- 0.8% indicating a marked insulin resistance. Further evidence for a relationship between the insulin sensitivity and the severity of the diabetic state was found in the correlation between the percentual blood glucose decrement and the fasting blood glucose (r = -0.79, p less than 0.01), the glucose assimilation rate (r = 0.71, p less than 0.01), as well as the blood glucose level at 120 min during the OGTT (r = -0.76, p less than 0.01). Four of the insulin-resistant patients were re-tested during remission and exhibited then normal insulin sensitivity. PMID- 3530595 TI - Comparison between monocomponent human insulin U-40 and U-100 in CSII treatment of type 1 diabetics. AB - A multicentric study has been carried out to compare the efficacy and the safety of monocomponent human insulins of different concentration (Novo Actrapid HM U-40 and U-100) in CSII-treated Type 1 diabetics. 15 males, all of whom had been diabetic for at least 2 yr, had been treated by CSII and were skillful in the self-monitoring of diabetes were selected for observation at 3 different clinical centres (Bologna, Chieti and Torino). After a 1-week period of insulin dose optimization, the patients were asked not to modify either basal or pre-prandial insulin infusion during the following 2 weeks in which they were treated alternately by U-40 or by U-100 insulin (7 days for each treatment in random sequence). Each day or at least every other day, patients recorded at home a 9 point blood glucose profile by means of glucose-sensitive strips and photometric reading (Reflocheck System-BOEHRINGER MANNHEIM, FRG). The patients used the microinfuser Miles Microjet Bolus 2 for the U-40 infusion and the same model with appropriate modifications for the U-100 infusion. On the last day of each study period, blood samples were drawn after the pre-breakfast insulin bolus. Paired Student's t-test analyses between blood glucose values obtained with different regimens did not show a significant difference in metabolic control. Similarly no difference could be observed in insulin absorption after an identical bolus of U 40 or U-100 insulin. In conclusion human U-100 insulin seems to be as effective and safe as U-40 and is recommended in order to reduce the size of microinfusers. PMID- 3530596 TI - The effects of insulin and glucose on bone modelling in vitro. AB - The direct effects of insulin and glucose on bone modelling was studied in an in vitro system. 16 day old mice fetal radii and ulnae prelabelled with 45Ca were cultured for 48 hr in BGJ medium supplemented with either 4 mg/ml of human serum albumin or 10% fetal calf serum. Insulin at concentrations of 10(-8)-10(-10) M induced an increase in the periosteal bone formed as well as in calcium, phosphate and hydroxyproline content. Glucose at concentrations of 200-800 mg/dl decreased bone length, calcium, phosphate and hydroxyproline content. There was no change in the 45Ca released into the medium, by either insulin or glucose, implying that these substances have no effect on bone resorption. The results of this study imply that insulin and glucose have a direct effect on bone modelling and that they may be important factors in growth disturbances occurring during diabetic pregnancy. PMID- 3530597 TI - Stimulation by glucose and carbamylcholine of phospholipase A2 in pancreatic islets. PMID- 3530598 TI - Immunological monitoring of bone marrow transplantation. PMID- 3530599 TI - Studies of monoclonal antibodies against human chorionic gonadotropin. II. Applications of human chorionic gonadotropin monoclonal antibodies on immunoassays. AB - Monoclonal antibodies generated against human chorionic gonadotropin (hCG) were utilized in radio- and enzyme-immunoassays of this reproductive hormone in biological fluids. One of the monoclonal antibodies, beta-4D6, was shown to have extremely high affinity (Ka = 8 X 10(10) M-1)) and high specificity (less than or equal to 0.6% LH cross-reactivity) to beta-subunit of hCG and whole hCG. It was used in competitive radioimmunoassays (RIA) for the determination of low levels of serum hCG. An excellent correlation was obtained concerning the assay results between the monoclonal antibody-based system and others using conventional polyclonal anti-sera. In combination with another discrete hCG monoclonal antibody, solid-phase sandwich radiometric and enzyme immunoassays were established. These immunoassays could easily be performed, and they offer sensitivity and efficacy of hCG determination comparable to those of conventional ones. PMID- 3530600 TI - The detection of autoantibodies on HEp-2 cells using an indirect immunoperoxidase kit (Colorzyme). AB - An indirect immunoenzyme (IIE) kit to detect autoantibodies in the sera of patients with systemic rheumatic diseases has been evaluated and compared to a conventional indirect immunofluorescence (IIF) assay. Both IIF and IIE were performed on a human epithelial cell line (HEp-2) using sera categorized on the basis of their autoantibody specificity. The correlation coefficient between the two assays was greater than 0.77 for all autoantibodies except antimitochondrial antibodies, which had higher end-point titers with the IIE kit. The inter- and intratest variability of IIE and IIF was comparable, differing by no more than one tube dilution. The IIE test had less background staining, allowing for better resolution and easier interpretation of staining patterns. IIE assay in the form of a commercially available kit is a reliable alternative to IIF. PMID- 3530601 TI - Direct contact B-scan ultrasound in the diagnosis of solid breast masses. AB - Our experience of breast ultrasound in the differentiation of benign and solid malignant breast masses indicates a specificity of 93% for carcinoma; 7% of cancers were regarded as benign. Eight of 89 proven fibroadenomas were considered possibly malignant. Typical, and overlapping, features are described, and the world literature is discussed. Whereas most previous workers have used a water path technique, we employ direct contact B-scanning, which is quick, simple, and apparently at least as successful. The small group of solid masses where there is overlap between fibroadenoma and carcinoma needs further study; this might be helped by histological correlation with the ultrasound appearances of malignancy, the causes of which are still debated. The exclusion of a focal solid mass in a patient with a breast lump can reduce the biopsy rate. PMID- 3530602 TI - A comparison of iohexol and iopamidol for lumbar myelography. AB - The use of iopamidol and iohexol for lumbar myelography is compared in this study. Fifty-eight patients were examined, the contrast media being allocated on a randomised double-blind basis. Radiographic quality was good with both media. Headache and an increase of back pain were the most frequent symptoms, though the incidence of side-effects was slightly but significantly greater with iohexol. We conclude from our study that while the radiographic quality is comparable, iopamidol seems to be slightly better tolerated. PMID- 3530603 TI - Discrepancy between ultrasound and retrograde cholangiographic measurements. PMID- 3530604 TI - Ion transport in hypertension: are changes in the cell membrane responsible? AB - Disturbances in several, distinct cell membrane ion transport processes have been demonstrated in essential hypertension but their variable relationship to blood pressure in different populations has made it difficult to achieve a unifying hypothesis. We suggest that altered composition of the lipid fraction of the cell membrane is the common underlying factor. This would produce many of the reported perturbations of cell membrane properties and function, not all of which relate directly to the development of hypertension, but which act as markers for the underlying abnormality. However, functions such as phosphoinositol turnover, calcium binding and Ca2+,Mg2+-ATPase dependent calcium efflux, which are influenced by the lipid composition of the membrane, provide a possible link between the membrane disturbance, intracellular calcium, vascular smooth muscle contraction and blood pressure. Alteration in the lipid content of the cell membrane not only provides an explanation for the variability in the ion transport abnormalities between populations but perhaps also for some of the variability in blood pressure within a single population. It also provides a potential means of influencing blood pressure by dietary intervention. PMID- 3530605 TI - Parathyroid hormone and bone. PMID- 3530607 TI - Nicotine does not cause 'bronchitis' in the rat. PMID- 3530606 TI - Regulation of sodium-coupled phosphate transport by extracellular phosphate in cultured kidney cells (JTC-12). AB - Cultured monkey kidney cells (JTC-12) have a Na+-dependent phosphate (Pi) transport system with characteristics similar to that of the renal proximal tubule. Na+-dependent Pi uptake in JTC-12 cells is affected by Pi concentrations in the culture medium. In this investigation, further characterization of this phenomenon was carried out. Lowering the concentration of extracellular Pi (3.0 mmol/l to 0.3 mmol/l) induced an increase in Na+-dependent Pi uptake compared with that in control cells maintained in 3.0 mmol/l Pi, whereas Na+-dependent transport of hexose and amino acid was not altered. This response was first evident at 4 h after the extracellular Pi concentration was reduced and slowly developed over the subsequent 24 h. Kinetic analysis showed an increase in the Vmax without a change in the apparent Km for Pi in cells cultured in the low Pi concentration compared with control cells. The response of Pi uptake was only partially prevented by cycloheximide, suggesting that both protein synthesis dependent and -independent mechanisms are involved in the development of the response. Insulin, which has a stimulatory effect on Pi uptake in JTC-12 cells, did not affect this response. These data indicate that JTC-12 cells respond to changes in extracellular Pi concentration by changing the Na+-dependent Pi uptake system. This response has a number of properties typical of the phenomenon of adaptation of renal Pi transport in vivo to dietary phosphorus load. PMID- 3530608 TI - New possibilities for intracellular renin and inactive renin now that the structure of the human renin gene has been elucidated. PMID- 3530609 TI - The contribution of the autonomic nervous system, the renin-angiotensin system and vasopressin to the maintenance of arterial blood pressure in adrenalectomized Wistar rats. AB - Factors contributing to the maintenance of resting arterial blood pressure in sham-operated and adrenalectomized rats were assessed 14 weeks after operation; some animals were given 1% NaCl to drink throughout, and some animals were given sodium-free water instead of 1% NaCl for 2 days before the experiment. Inhibition of the renin-angiotensin (ANG) system (with captopril) and of the cardiovascular actions of vasopressin [with 1-(beta-mercapto-beta, beta cyclopentamethylenepropionic acid),8-D-arginine vasopressin (d(CH2)5DAVP)] had no hypotensive effects in sham-operated rats under any conditions, but antagonism of nicotinic ganglionic transmission (with pentolinium) caused a prompt fall in blood pressure. During combined administration of captopril, d(CH2)5DAVP and pentolinium to sham-operated rats, there was no significant recovery of blood pressure. Adrenalectomized rats drinking 1% NaCl showed a marked hypotension and tachycardia in response to captopril, but d(CH2)5DAVP had little effect, whether administered before or after captopril. Addition of pentolinium rendered these animals more hypotensive than the sham-operated rats. Adrenalectomized rats drinking sodium-free water for 2 days were hypotensive and blood pressures were lowered further by d(CH2)5DAVP or captopril under these conditions; there was no accompanying tachycardia. The results indicate that, in chronically adrenalectomized rats drinking 1% NaCl, blood pressure is maintained by autonomic nervous and renin-ANG systems with no discernible contribution from the peripheral cardiovascular actions of vasopressin. However, the latter contribute importantly to the support of blood pressure when the adrenalectomized rats are rendered hypovolaemic and hypotensive by substitution of sodium-free water to drink. PMID- 3530610 TI - The combined effects of two pairs of mediators, adenosine with methacholine and prostaglandin D2 with histamine, on airway calibre in asthma. AB - Mediators released from mast cells and secondary effector cells in the airways contribute to bronchoconstriction of allergic asthma. This study investigates methods for defining the effect of two inflammatory mediators on airway calibre in asthma. In an initial study on three asthmatic subjects, subconstrictor (subthreshold) concentrations of two mast cell derived mediators, histamine and prostaglandin (PG) D2, produced similar displacement to the left of a histamine concentration-specific airways conductance (sGaw) response curve. With both agonists enhancement of histamine-induced bronchoconstriction was greater at low histamine concentrations. Since potentiation of histamine-induced bronchoconstriction was independent of the class of subconstrictor agent given, it is likely to represent a physiological rather than a pharmacological interaction. During provoked asthma different constrictor mediators are likely to be released simultaneously into the airways. A method was therefore devised to investigate the combined effect of equiconstrictor concentrations of two mediators on airway calibre. Two pairs of inhaled bronchoconstrictor agonists were chosen for study: adenosine with methacholine and PGD2 with histamine. For each agonist, concentration-sGaw response curves were constructed, from which were derived the provocation concentrations of agonist causing a 25% fall in sGaw from baseline (PC25) and required to further this to 50% (PC50-25). On separate days, eight subjects received paired inhalations of methacholine-adenosine, methacholine-methacholine and adenosine-adenosine. The concentration used for the first inhalation was the PC25 value and for the second inhalation the PC50-25 value. Before, immediately after the first inhalation, and at regular intervals after the second inhalation, sGaw was followed for 30 min.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3530611 TI - Impaired sodium excretion in response to volume expansion induced by water immersion in insulin-dependent diabetes mellitus. AB - The renal response to volume expansion produced by water immersion to the neck at 35 degrees C was examined in eight young normotensive uncomplicated insulin dependent diabetic subjects and in eight matched normal control subjects. Both the diabetic and normal subjects manifested a renal response of natriuresis and kaliuresis on immersion, but the natriuretic response was reduced in the diabetic group. Thus the induced excretion of sodium over the 4 h of immersion was 40 +/- 5 mmol (mean +/- SEM) in the normal group compared with 22 +/- 4 mmol in the diabetic group (P less than 0.02). In the normal subjects creatinine clearance did not change during immersion compared with pre-immersion control values while in the diabetic group it rose from pre-immersion control values of 112 +/- 11 ml/min to a mean value of 127 +/- 11 ml/min during immersion (P less than 0.01). The diabetic subjects thus excreted less sodium despite an increased filtered load during water immersion. Fractional excretion of sodium was significantly reduced in the diabetic subjects compared with the normal control subjects (P less than 0.05). The suppression of plasma renin and aldosterone was similar in normal and diabetic groups. Tubular sodium retention could be an early functional change in the diabetic kidney, and be implicated in the development of diabetic nephropathy. PMID- 3530612 TI - Insulin resistance and regulation of serum amino acid levels in myotonic dystrophy. AB - To quantify the degree of whole body insulin resistance in patients with myotonic dystrophy and to determine if these same patients display signs of a whole body decrease in the action of insulin on amino acid uptake and glucose disposal, three separate 120 min studies employing the euglycaemic insulin clamp technique (20, 80 and 200 m-units min-1 m-2) were performed on five ambulatory patients with myotonic dystrophy. The results were compared with findings obtained in identical studies in 21 normal volunteers. Myotonic dystrophy patients showed a slower, less marked decline in the serum concentration of insulin sensitive amino acids (threonine, valine, leucine, isoleucine, tyrosine, phenylalanine) during all three insulin infusions compared with normals. The greatest difference occurred at the low physiological elevations of insulin produced by the 20 m units min-1 m-2 infusion. Alanine levels fell significantly below baseline in patients with myotonic dystrophy after 60 and 120 min of insulin infusion with all three rates of insulin infusion. Normal subjects had only a minimal, insignificant decline in arterialized alanine concentrations during the three different insulin infusions. Creatinine adjusted rates of whole body glucose disposal were 30-40% lower in the myotonic dystrophy group at all three doses of insulin compared with the normals. This demonstrates that their insulin resistance was not due simply to a reduction in muscle mass. The overall pattern of findings in these studies of patients with myotonic dystrophy indicates that there is a whole body derangement in the regulation of circulating amino acid levels by insulin as well as a marked decrease in the action of this hormone in stimulating glucose uptake by target tissues. PMID- 3530613 TI - Stereophotogrammetry for measuring rates of cutaneous healing: a comparison with conventional techniques. AB - A portable stereocamera linked to a computer has been developed capable of taking photographs in the clinical situation. The accuracy and precision of this system has been measured and compared with direct tracing and simple photography, the two systems currently in use for this type of work. It was found to have a precision of better than 2% and to be accurate to within 1% for edge length and area in models of chronic leg ulcers whose dimensions were known exactly. These results are between five and ten times better than direct tracing and simple photography measured under similar circumstances. When used on patients' ulcers, stereophotogrammetry was found to have a precision of 2% for edge length and 3.4% for area, again between five and ten times more accurate than the other two systems. The accuracy with which an epithelial edge can be identified with the naked eye, a possible limiting factor in any visual measuring system, was measured on fixed preparations of healing wounds on pigs. The mean error was found to be 240 micron with a confidence limit of 440 micron. Finally, the rate of healing of chronic leg ulcers was measured in a clinical trial on patients. Only stereophotogrammetry had errors consistently smaller than the changes being measured in the clinical trial, making it the only system which can validly be used to study rates of healing in this model. It is also able to measure volume to within 5% and is unique in being able to do this noninvasively. PMID- 3530614 TI - Imipenem-cilastatin sodium, a broad-spectrum carbapenem antibiotic combination. AB - The chemistry, antimicrobial spectrum, mechanism of action, pharmacology and pharmacokinetics, clinical use, adverse effects, dosage and administration, place in therapy, cost-effectiveness, and formulary considerations of imipenem cilastatin sodium are reviewed. Imipenem is the first carbapenem antibiotic of the thienamycin class to be used clinically. Imipenem has the widest spectrum of antimicrobial activity of currently available beta-lactam agents and, in contrast to other beta-lactam antibiotics, lacks cross resistance with recently introduced extended-spectrum penicillins and third-generation cephalosporins. Against gram positive and gram-negative aerobic and anaerobic organisms, imipenem demonstrates excellent activity. Pseudomonas maltophilia, some strains of Pseudomonas cepacia, and Streptococcus faecium are resistant. Strains of methicillin-resistant staphylococci should also be considered resistant to imipenem. For clinical use imipenem is coadministered in equal parts with cilastatin. Cilastatin is a renal dehydropeptidase inhibitor that inhibits the metabolism of imipenem by renal brush-border enzymes, thus increasing imipenem concentrations in urine. Imipenem cilastatin is administered by the intravenous route only. The adverse reaction profile of imipenem-cilastatin is similar to t that of other beta-lactam antibiotics. Recommended dosage reductions appropriate for renal impairment should be guided by periodic assessments of renal function, with close adherence to recommended dosage schedules, particularly among patients who are predisposed to seizures or receiving anticonvulsant medication. Imipenem-cilastatin performed well in both comparative and noncomparative trials of clinical efficacy and safety. For infections with multiple organisms (e.g., pelvic, intra-abdominal, or soft-tissue infections), imipenem-cilastatin may be a cost-effective and less toxic single-agent alternative to "standard" combination (e.g., aminoglycoside penicillin plus an antianaerobic agent) therapy. However, in patients with serious pseudomonal infections (e.g., pneumonia), isolates may rapidly acquire resistance to imipenem or be replaced by resistant strains of Ps. aeruginosa when imipenem is used alone. Therefore, when the recovery of Ps. aeruginosa is anticipated or documented, treatment with imipenem-cilastatin should include an aminoglycoside to reduce the likelihood of the emergency of resistant organisms during therapy. PMID- 3530615 TI - Clinical features and management of cyanide poisoning. AB - The pathophysiology, clinical features, and management of cyanide toxicity are reviewed and sources of cyanide are listed. Cyanide is a deadly poison that is found in many foods and household and industrial products, including some that are readily available. Cyanide binds with cytochrome oxidase, the enzyme responsible for oxidative phosphorylation, and paralyzes cellular respiration. Because the tissues cannot use oxygen that is delivered, aerobic metabolism ceases. The signs and symptoms of cyanide poisoning reflect the extent of cellular hypoxia. Manifestations may include respiratory abnormalities (progressing from tachypnea and dyspnea to respiratory depression and apnea), hemodynamic instability, metabolic acidosis, and, possibly, local irritant effects after oral ingestion of cyanide. The mainstays of therapy are 100% oxygen and specific antidotes to cyanide. Sequential treatment with amyl nitrite by inhalation, intravenous sodium nitrite 3%, and intravenous sodium thiosulfate 25% is directed toward decreasing the amount of cyanide available for cellular binding. Nitrites convert hemoglobin to methemoglobin, which reacts with cyanide to form cyanomethemoglobin. Sodium thiosulfate serves as a source of sulfur groups, which are needed for conversion of cyanide to thiocyanate, a compound that is relatively less toxic and is excreted renally. Supportive care also is important. Cobalt EDTA, hydroxocobalamin, and aminophenols have also been used but are not considered standard treatments. Cyanide poisoning is a medical emergency that requires prompt recognition and immediate and aggressive treatment. PMID- 3530616 TI - Current concepts in clinical therapeutics: Parkinson's disease. AB - The etiology, pathophysiology, diagnosis and clinical presentation, and clinical management of Parkinson's disease are reviewed. The cause of Parkinson's disease, a progressive, degenerative neurologic motor disorder, is unknown. Both endogenous and environmental factors appear to play a role. The clinical features of parkinsonism result from a depletion in dopaminergic transmission in the corpus striatum; the dopamine deficiency is caused by a loss of melanin containing nerve cells within the substantia nigra and locus ceruleus. In the remaining neurons, hyalin-like masses called Lewy bodies increase in number, but the importance of this is unclear. The diagnosis of Parkinson's disease is based on the clinical presentation of the patient, which initially includes sensory complaints of aching pains, paresthesias, numbness, and coldness. As the disease progresses, the four classic symptoms become prominent: tremor, rigidity, bradykinesia, and postural difficulties. Drug therapy is the cornerstone of clinical management of Parkinson's disease, but no treatment has been found that will retard or reverse the disease. Therapy is usually initiated with anticholinergic agents such as biperiden hydrochloride or trihexyphenidyl hydrochloride with or without amantadine. The mainstay of therapy is levodopa, which is used in combination with dopa decarboxylase inhibitors to decrease the peripheral conversion of levodopa to dopamine. Bromocriptine is a dopamine agonist useful in treating Parkinson's disease. Therapy, which must continue for life, eventually becomes less effective or completely ineffective in all patients. Drug therapy has improved greatly the functional ability of patients with Parkinson's disease, but new agents that can extend the length of effective treatment or reverse the disease are needed. PMID- 3530617 TI - Reticulocytes. PMID- 3530618 TI - [Controlled study on the effects of 2 different therapeutic approaches in the treatment of chronic constipation]. PMID- 3530619 TI - [Spa treatment of chronic rheumatic and bronchial diseases. Multiple regression multivariate analysis of therapeutic results]. PMID- 3530620 TI - [Therapeutic action of a new xanthine derivative in respiratory pathology]. PMID- 3530621 TI - [Diagnostic and therapeutic approach in childhood tumors]. PMID- 3530622 TI - [Drug-induced headache]. PMID- 3530624 TI - [Pathology of the periodontium in diabetes mellitus: possible pathogenetic correlations and therapeutic indications]. PMID- 3530623 TI - [Venotropic therapy: results of clinical experimentation]. PMID- 3530625 TI - Improvement of positive blood culture detection by agitation. AB - To evaluate the advantages of agitation in reducing the detection time and increasing the recovery rate of positive blood cultures, 1,000 three-bottle sets of tryptic soy broth on adult inpatients were analyzed. Two bottles were transiently vented, one of which was agitated (250 rpm) for 7-19 hr at 35 degrees C. The other vented bottle and the anaerobic bottle were incubated stationary at 35 degrees C. Smears and subcultures were performed 7-19 hr after collection on both agitated and nonagitated vented bottles. Subcultures were done on all bottles at 72 hr and smears were performed on the anaerobic bottle. There were 137 of 1000 (13.7%) positive cultures from 90 patients. The agitated bottle detected 112 of 137 (81.8%) positive cultures, was the first or only means of detection in 57 of 137 cultures (41.6%), and was the only positive bottle in 30 of 137 (21.9%) cultures. The nonagitated vented bottle detected 89 of 137 (65.0%) of positive cultures and was the only means of detection in 13 of 137 (9.5%), but was never the first means of detection. The anaerobic bottle detected 76 of 137 (55.5%) of positive cultures, was the first or only means of detection in 11 of 137 (8.0%), and was the first means of detection in one of 137 (0.7%) cultures. When both the agitated and nonagitated bottle were positive, the agitated bottle was positive on the average 35 hr earlier. We conclude that agitation of the vented bottle in a conventional blood culture system significantly decreases the detection time of positive blood cultures and increases the number of positive blood cultures detected. PMID- 3530626 TI - Rapid detection of Chlamydia trachomatis by an enzyme immunoassay method. AB - Chlamydia trachomatis has been shown to be a major cause of sexually transmitted diseases in the United States. An enzyme immunoassay (Abbot Laboratories) has been developed that detects chlamydial antigen directly in the urogenital specimens of patients. We have evaluated specimens from 1,074 patients belonging to one of three risk groups. Three swabs were collected from each patient--one each for Neisseria gonorrhoeae, chlamydia cell culture, and enzyme immunoassay. When compared with cell culture, the sensitivity and specificity of the enzyme immunoassay for symptomatic males and females attending a sexually transmitted disease clinic was 82% and 100%, and 91.3% and 95.0%, respectively. A moderate risk group, consisting of female patients seen at either urology or gynecology clinics for genitourinary symptoms was also evaluated. The sensitivity and specificity of the test on this group was 96% and 96.7%. A population of females at low risk were also screened for chlamydial infection. In this group, the sensitivity and specificity of the enzyme immunoassay was 89.3% and 93.2%, respectively. This rapid test is a highly specific and sensitive procedure for the detection of chlamydial antigen in genital specimens from high risk female patients as well as symptomatic males. PMID- 3530627 TI - Susceptibility of Candida albicans to flucytosine when tested in different formulations of yeast nitrogen base broth. AB - The influence of various formulations of yeast nitrogen base broth and temperature on the flucytosine sensitivity of Candida albicans was examined. Each of 15 isolates was tested concurrently in yeast nitrogen base from two different suppliers, with or without supplemental dextrose and L-asparagine, and with incubation at either 30 degrees C or 37 degrees C. Observed differences were related to media source, media supplementation, and temperature of incubation. For all three variables, higher endpoint results were associated with greater rates of yeast growth as reflected by turbidity after 24 hr of incubation. Despite these differences, their magnitudes were sufficiently small so that variations in yeast nitrogen base formulation appear not to be an important source of imprecision in susceptibility testing of yeasts. PMID- 3530628 TI - Does a fibroblast membrane proteinase affect the binding, uptake and metabolism of epidermal growth factor? AB - Pre-treatment of human fibroblasts to inhibit a cell-surface growth-related proteinase inhibits the mitogenic action of epidermal growth factor. It also reduces the binding of epidermal growth factor to these cells, and lowers the rate of internalisation and degradation of the growth factor, but quantitative considerations render it unlikely that these parameters contribute directly to the inhibition of mitogenesis. PMID- 3530629 TI - Distribution and properties of glutathione S-transferase from T. infestans. AB - The glutathione transferase from T. infestans is able to render aqueous metabolites when incubated in vitro with malathion, parathion and fenitrothion. It is a soluble enzyme present in every developmental stage and widely distributed in all insect organs. The purification procedure applied, consisting of fractionation with ammonium sulfate and Bio-Gel P-60 chromatography, gives an unique molecular form catalytically active using methyl iodide as substrate in polyacrylamide gel electrophoresis (PAGE). One of the most active substrates is the 1-chloro-2,4-dinitrobenzene (CDNB), with an activity maximum at pH 7.5 and at 45 degrees C temperature. Its activation energy calculated from an Arrhenius plot is 14,846 cal mol-1. The enzyme susceptibility to inhibition by thiol reagents shows three degrees of responses; slight, moderate or high, depending on the compounds used. The kinetics of the enzyme catalysed reaction with the purified fraction is complex, and resembles that reported for glutathione S-transferase A from rat liver, showing a biphasic kinetic mechanism in which the reaction pathway depends on the concentration of GSH. In general, the properties of this insect enzyme are similar to those enzymes isolated from vertebrate organisms. PMID- 3530631 TI - An overview of two hundred and sixty years of pediatrics in New Haven: 1662-1921. PMID- 3530630 TI - Who founded the American Psychopathological Association? PMID- 3530632 TI - CPRO and hereafter. PMID- 3530633 TI - A comparative clinical trial of Copper T 220 C and Alza T IPCS 52 intrauterine devices in Thai women. AB - Two IUDs (Copper T 220 C and Alza T IPCS 52) were comparatively studied by randomized insertions in 200 Thai women who attended the Family Planning Clinic at the Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University. Point estimates of the pregnancy rate and rate of removal for bleeding and pain at 18 months were lower for the copper device than for the Alza T IPCS 52, but neither these nor any other pertinent event rates reached statistical significance. Study of the Alza device was halted before the completion of 2 years because reports from other centres indicated an unacceptable pregnancy rate beyond 2 years. PMID- 3530634 TI - A randomized comparative clinical evaluation of the Steel Ring, the VCu200 and the TCu220c IUDs. AB - A randomized comparative clinical study of the Steel Ring, VCu200 and TCu220c IUDs was carried out in Beijing. Six-hundred subjects were recruited and each group of 200 was inserted with one of the three devices. The TCu220c and the VCu200 had statistically significantly lower pregnancy and expulsion rates at one and two years of use than the Steel Ring. However, the Steel Ring consistently had the lowest rate of removal for pain and/or bleeding. At two years, the early differences of use-related discontinuation and continuation between the higher rates of the Steel Ring and the lower rates of the VCu200 and TCu220c were significantly reduced. There were no statistically significant differences of net event rates between VCu200 and TCu220c. PMID- 3530635 TI - Control of cell growth and division in Saccharomyces cerevisiae. AB - Considerable advances have been made in recent years in our understanding of the biochemistry of protein and nucleic acid synthesis and, particularly, the molecular biology of gene expression in eukaryotes. The yeast Saccharomyces cerevisiae, and to a lesser extent Schizosaccharomyces pombe, has had a preeminent role as a focus for these studies, principally because of the facility with which these organisms can be experimentally manipulated biochemically and genetically. This review will be designed to critically examine and integrate recent advances in several vital areas of regulatory control of enzyme synthesis in yeast: structure and organization of DNA, transcriptional regulation, post transcriptional modification, control of translation, post-translational modification and secretion, and cell-cycle modulation. It will attempt to emphasize and illustrate, where detailed information is available, principal underlying molecular mechanisms, and it will attempt to make relevant comparisons of this material to inferred and demonstrated facets of regulatory control of enzyme and protein synthesis in higher eukaryotes. PMID- 3530636 TI - Effect of mechanical ventilation and volume loading on left ventricular performance in premature infants with respiratory distress syndrome. AB - Left ventricular (LV) performance was assessed by echocardiography in 19 premature infants with severe respiratory distress syndrome. Measurements of LV size and function were made from digitized M-mode echocardiographic data in 14 babies (group 1) before and during treatment with mechanical ventilation and positive end-expiratory pressure. During ventilation, maximum LV dimension decreased (p = .001) as did peak filling rate (p = .01). LV shortening fraction decreased slightly (p = .05). There were marked reductions in calculated stroke volume (SV) (p = .001) and cardiac output (p = .0001) but systemic BP was unchanged, presumably due to peripheral vasoconstriction. The effect of simultaneous volume loading was studied in five other babies (group 2) who were ventilated under similar conditions. Blood transfusion with packed cells (10 mg/kg) prevented the fall in LV filling rate, while LV dimensions (max, p = .01; min, p = .02), SV (p = .05), cardiac output (p = .05), and systolic BP (p = .05) increased. This indicates that a low preload was responsible for the decreases observed in group 1. PMID- 3530637 TI - Bacteriologic assessment of the lower respiratory tract in intubated patients. AB - Twelve patients with an endotracheal tube and a new infiltrate were assessed for differences in the bacteriologic information that could be obtained by routine tracheal suctioning (RTS), a double-lumen protected-sheath brush passed through a flexible fiberoptic bronchoscope (B-FFB), and suctioning through a flexible fiberoptic bronchoscope (S-FEB). Gram stains and cultures were performed on all specimens. There was 100% agreement for the culture results obtained by RTS and S FEB. It is concluded that RTS obtains comparable information to that obtained by the more expensive and more personnel-intensive B-FFB. PMID- 3530638 TI - Elective orotracheal intubation and aspiration for microbiologic diagnosis in children. AB - Endotracheal intubation is generally performed to facilitate the treatment of respiratory failure or to control the airway during general anesthesia. We electively intubated 14 children with undiagnosed pneumonia to obtain tracheobronchial secretions for microbiologic diagnosis. Three were intubated awake, three with sedation, and eight with sedation and neuromuscular blockade. Mycobacterium tuberculosis was isolated in four of six patients suspected of having tuberculosis. Other bacterial pathogens were isolated in three patients and viral pathogens in three patients. The procedure proved useful in 11 (79%) of the 14 patients, with no complications. We conclude that elective orotracheal intubation is a safe, simple, fast, and effective method of obtaining secretions for the culture of organisms responsible for lower airway and lung parenchymal infections in children. PMID- 3530639 TI - Biological effects of acetamide, formamide, and their monomethyl and dimethyl derivatives. AB - The industrial use of certain acetamides and formamides (particularly DMAC and DMF) for their solvent properties has resulted in rather extensive examination of their biological properties. Both DMAC and DMF are rapidly absorbed through biological membranes and are metabolized by demethylation first to monomethyl derivatives and then to the parent acetamide or formamide. Relatively high single doses to various species following oral, dermal, i.p., i.v., or inhalation exposures generally are required to produce mortality. The liver is the primary target following acute high level exposure, but massive doses can also produce damage to other organs and tissues. Repeated sublethal treatment by various routes also shows the liver to be the target organ with the degree of damage being proportional to the amount absorbed. With MMF, the potential usefulness as a cancer chemotherapeutic agent needs to be measured against the hepatotoxic effects produced in man. Acetamides and formamides are generally inactive in mutagenicity tests. Mammalian test systems do not appear to be genetically sensitive and DMF has been recommended for use as the vehicle in microbial assays designed to test for genetic activity of hard-to-dissolve chemicals. Embryotoxicity can be demonstrated at high doses; doses which generally show toxicity to the maternal animals. Structural abnormalities in sensitive species such as the rabbit are produced following exposure at near-lethal levels. The spectrum of abnormalities seen is broad and fails to show any time or site specificity in terms of developing organs/organ systems. Inhalation exposures to DMAC and DMF at levels producing some maternal toxicity in rats have produced no teratogenic response and only slight evidence of embryotoxicity. Long-term feeding of relatively high levels of acetamide produces liver cancer in rats. DMAC and DMF appear to be noncarcinogenic. The environmental toxicity of these chemicals is low. Liver damage can be produced by overexposure to these chemicals in man. Airborne concentrations need to be controlled and care should be taken to avoid excessive liquid contact as the chemicals are absorbed through the skin. A relationship exists between the amount of DMAC or DMF absorbed and the amount of MMAC or MMF excreted in the urine so that biomonitoring of the urinary metabolites can indicate situations in which total exposures, both dermal and inhalation, are excessive. An interaction between DMF and ethanol occurs such that signs, including severe facial flushing, appear when DMF-exposed individuals consume alcoholic beverages. PMID- 3530640 TI - Histamine food poisoning: toxicology and clinical aspects. AB - Histamine poisoning can result from the ingestion of food containing unusually high levels of histamine. Fish are most commonly involved in incidents of histamine poisoning, although cheese has also been implicated on occasion. The historic involvement of tuna and mackerel in histamine poisoning led to the longtime usage of the term, scombroid fish poisoning, to describe this food-borne illness. Histamine poisoning is characterized by a short incubation period, a short duration, and symptoms resembling those associated with allergic reactions. The evidence supporting the role of histamine as the causative agent is compelling. The efficacy of antihistamine therapy, the allergic-like symptomology, and the finding of high levels of histamine in the implicated food suggest strongly that histamine is the causative agent. However, histamine ingested with spoiled fish appears to be much more toxic than histamine ingested in an aqueous solution. The presence of potentiators of histamine toxicity in the spoiled fish may account for this difference in toxicity. Several potentiators including other putrefactive amines such as putrescine and cadaverine have been identified. Pharmacologic potentiators may also exist; aminoguanidine and isoniazid are examples. The mechanism of action of these potentiators appears to be the inhibition of intestinal histamine-metabolizing enzymes. This enzyme inhibition causes a decrease in histamine detoxification in the intestinal mucosa and results in increased intestinal uptake and urinary excretion of unmetabolized histamine. PMID- 3530641 TI - Human choroidal melanocytes in tissue culture. AB - Human choroidal melanocytes were isolated from eye bank tissue and cultured in vitro with 10 ng/ml cholera toxin and 10 ng/ml phorbol myristate acetate. These growth factors induced rapid proliferation of spindle-type melanocytes. Similar results were obtained using 10 mM putrescine. Phenotypic analysis of these cells by immunoperoxidase staining with anti-HLA-DR monoclonal antibodies revealed 40 70% positive cells. HLA-DR positive melanocytes were isolated and purified from the HLA-DR negative population by rosetting with protein-A coupled sheep erythrocytes followed by differential centrifugation. Ultrastructural analysis of choroidal melanocytes revealed evidence of premelanosomes and melanosomes. Choroidal melanocytes in tissue culture are important experimental controls for the study of the cell biology of choroidal melanoma. PMID- 3530642 TI - Contrast evaluation of structural lesions of the pharynx. PMID- 3530643 TI - Reduction of nocturnal asthma by an inhaled anticholinergic drug. AB - Although the mechanisms of nocturnal asthma are still uncertain, increased vagal cholinergic tone may be contributory factor. To examine this hypothesis, we have studied the effect of an anticholinergic drug, oxitropium bromide, on the early morning fall in peak expiratory flow (PEF) in patients with nocturnal asthma. Eighteen patients (aged 18 to 76 years; seven men) with documented nocturnal asthma were studied in a double-blind randomized cross-over study in which they received either oxitropium bromide (200 micrograms or 400 micrograms) or placebo in a single dose at night for two-week periods. With placebo the mean (+/- SE) fall in PEF (expressed as percentage of evening PEF) was 17.3 +/- 2.0 percent, which was significantly reduced to 10.3 +/- 3.3 percent after oxitropium (400 micrograms) (p less than 0.05; ANOVA). Closer analysis revealed that nine of the 18 patients had responded in a dose-dependent manner, with the mean percentage decreases with placebo, 200 micrograms, and 400 micrograms of oxitropium being 19.1 +/- 3.2, 11.5 +/- 4.4, and 5.0 +/- 4.5 percent, respectively (p less than 0.01 between each treatment). The remaining patients were unaffected by therapy. There were no differences between "responders" and "non-responders" in terms of age, atopic status, duration of asthma, severity of asthma, or bronchodilator response to albuterol (salbutamol). There were no differences in nocturnal symptoms between periods of treatment, and no side effects were recorded. We conclude that anticholinergic drugs may protect against nocturnal asthma in some patients, indicating the involvement of vagal cholinergic mechanisms. PMID- 3530644 TI - Double-blind crossover study of five bronchodilator medications and two delivery methods in stable asthma. Is there a best combination for use in the pulmonary laboratory? AB - The effects of five bronchodilator drugs and two methods of delivery (nebulizer vs metered-dose inhalers) on pulmonary function were studied in ten subjects with stable asthma. All subjects demonstrated statistically significant improvements (p less than 0.05) in pulmonary function relative to baseline and placebo effects after each medication, regardless of method of delivery; however, there was no statistically significant difference between the changes in pulmonary function caused by medication, method, or medication-method combination (p greater than 0.05). The choice of medication and device for delivery would appear to depend on the budget and time available in the laboratory. PMID- 3530645 TI - A randomized comparison of nifedipine and sodium nitroprusside in severe hypertension. AB - We randomized patients with severe hypertension in the Medical Intensive Care Unit to a treatment regimen of oral nifedipine or intravenous nitroprusside. Patients treated with nifedipine achieved a sustained reduction in diastolic blood pressure to less than or equal to 120 mm Hg in an average of less than five hours. Patients treated with nitroprusside achieved a similar reduction in 14 hours (p less than 0.05). Treatment with nifedipine was less expensive and required less time in the ICU than treatment with nitroprusside and was accompanied by no associated increase in morbidity or mortality. Oral nifedipine can be used as an alternative to intravenous nitroprusside in severe uncomplicated hypertension. PMID- 3530646 TI - Antibody coating and quantitative cultures of bacteria in sputum and bronchial brush specimens from patients with stable chronic bronchitis. AB - Antibody coating of bacterial isolates has been proposed as a method of identifying bacteria responsible for chronic lower respiratory infections. This study was designed to determine the specificity of antibody coating by examining bronchial secretions obtained from a group of patients with chronic bronchitis who had no clinical evidence of acute infection. Routine and quantitative bacterial cultures were performed at the same time. The bronchial brush specimens contained potentially pathogenic bacteria in all 18 patients examined, and 17 of these 18 specimens had antibody coating of bacteria. Quantitative cultures yielded greater than 10(4) colony forming units in only one patient and he subsequently developed a lower respiratory tract infection. We conclude that in patients with chronic bronchitis, the determination of antibody coating of bacterial isolates does not significantly increase the specificity of routine culture. Quantitative cultures of specimens obtained via the protected brush catheter are useful in identifying potential pathogens. PMID- 3530647 TI - Positive end-expiratory pressure following coronary artery bypass grafting. AB - Pulmonary dysfunction commonly follows open heart surgery. To evaluate the effects of positive end-expiratory pressure (PEEP) upon the course and severity of impaired oxygen transfer and roentgenographic evidence of atelectasis after coronary artery bypass grafting (CABG), we randomly assigned 44 patients to positive pressure ventilation and 0, 5, or 10 cm H2O PEEP. Study groups did not differ with respect to preoperative P(A-a)O2 or time on cardiopulmonary bypass. We observed a significant reduction of P(A-a)O2 during positive pressure ventilation with 10 cm H2O PEEP and FIO2 = 0.6 (182 +/- 6 vs 135 +/- 7 mm Hg, p less than .005). Following extubation, P(A-a)O2 measurements of the three groups did not differ when compared 24, 48, 72, 96, or 120 hours after surgery. Roentgenographic atelectasis scores did not differ on the fifth postoperative day. Five days after CABG, P(A-a)O2 exceeded preoperative P(A-a)O2 (29 +/- 1 vs 18 +/- 1 mm Hg, p less than .001), although the roentgenographic distances from hemidiaphragm to lung apex were unchanged (21.2 +/- 0.9 vs 22.0 +/- 0.9 cm). We conclude that routine PEEP improves pulmonary oxygen transfer but, once discontinued, PEEP offers no sustained beneficial effect upon impaired oxygen transfer or roentgenographic evidence of atelectasis following CABG. PMID- 3530648 TI - Intermittent positive pressure breathing in patients with respiratory muscle weakness. Alterations in total respiratory system compliance. AB - Intermittent positive pressure ventilation (IPPB) is reported to improve lung compliance and decrease the work of breathing in subjects with kyphoscoliosis. These results suggest that IPPB may improve chest wall and lung compliance in patients with neuromuscular disease. We studied the short-term effects of IPPB on total respiratory system compliance in 14 subjects with neuromuscular disease. Seven were quadriplegics, and seven had muscular dystrophy. Vital capacity was reduced to 38 +/- 14 percent of the predicted normal values. Baseline measurements of total respiratory system compliance were 57 +/- 18 percent when compared to normal control values. After a 20 minute treatment of IPPB delivered with inspiratory pressures of 20 to 25 cm H2O that more than tripled resting tidal volume, there was no significant change in total respiratory system compliance in either group of patients. These findings indicate that patients with quadriplegia or muscular dystrophy do not derive immediate improvement in ventilatory mechanics from IPPB treatments. PMID- 3530649 TI - Captopril effects on pulmonary and systemic hemodynamics in chronic cor pulmonale. AB - A placebo-controlled single-blind study on acute effects of captopril on hypoxic pulmonary hypertension was performed in 15 patients with severe chronic obstructive lung disease recovering from right heart failure. Ten patients received active drug (25 mg captopril orally), five patients received placebo and served as control subjects. Before drug administration, there was no difference in lung function data and pulmonary hemodynamics between patients in both groups. Captopril produced highly significant fall in systemic arterial pressure. No change in breathing frequency, minute ventilation, and pulmonary gas exchange was observed. There was no significant change in studied variables after placebo. The presented data suggest that captopril does not decrease pulmonary vascular resistance in patients with hypoxic pulmonary hypertension. A fall in pulmonary wedge pressure reflects a decrease in left ventricular afterload. PMID- 3530650 TI - The role of mast cell derived mediators in airway hyperresponsiveness. PMID- 3530651 TI - Clinical use of lung water measurements. Report of a workshop. PMID- 3530652 TI - Silent myocardial ischemia. Clinical significance and relation to sudden cardiac death. PMID- 3530653 TI - High adenosine deaminase activity level in pleural effusion. PMID- 3530654 TI - Effect of ciprofloxacin on stationary bacteria studied in vivo in a murine granuloma pouch model infected with Escherichia coli. AB - A granuloma pouch model in mice was used to investigate the effect of ciprofloxacin in vivo on cells of Escherichia coli (Neumann) under stationary growth conditions. The animals were treated up to three times intraperitoneally with 2.5, 10 or 40 mg/kg ciprofloxacin 24 h after infection. The numbers of viable bacteria in the pouch exudate were determined over a period of 24 h. A rapid decline of more than 1 logarithmic unit of the number of colony forming units was observed after 2-4 h with all treatment schedules. The effect on stationary cells was more pronounced with the high dose of ciprofloxacin and also dependent on the frequency of treatment. Ciprofloxacin penetrated well into the pouch exudate and reached concentrations of 2.08 +/- 0.16 microgram/ml and 0.1 +/ 0.05 microgram/ml 2 h after treatment with 40 and 2.5 mg/kg, respectively. The results of this study demonstrate that ciprofloxacin is effective in the treatment of a local inflammatory abscess in mice harbouring a stationary population of E. coli. PMID- 3530655 TI - [A photoelastic analysis on force distribution of abutment teeth or splinted teeth in various amounts of alveolar bone]. PMID- 3530656 TI - [Stress distribution analysis of a loaded mandibular posterior fixed bridge with the finite element method]. PMID- 3530657 TI - [The comparison of the healing process between full thickness skin graft and the preserved subdermal vascular network of skin grafts]. PMID- 3530658 TI - [Clinical manifestations and mycological diagnosis of oral candidiasis]. PMID- 3530659 TI - [Nasal pharyngoscopy--an advanced instrument for assessing velopharyngeal closure after the management of cleft palate]. PMID- 3530660 TI - [Advances in the chemotherapy of malaria]. PMID- 3530661 TI - [Relations between pathogenesis and therapy in adult respiratory distress syndrome (ARDS)]. PMID- 3530662 TI - [Ultrasonic diagnosis of lumbar spinal stenosis]. PMID- 3530663 TI - [Localization of the parathyroid by ultrasonography]. PMID- 3530664 TI - [Significance of spinal evoked potentials in spinal cord diseases]. PMID- 3530665 TI - [Microskin grafting in animal experiments and clinical practice]. PMID- 3530666 TI - [Analysis of failure in the replantation of 34 severed fingers]. PMID- 3530667 TI - [High-frequency positive-pressure ventilation in tracheoplasty and bronchoplasty]. PMID- 3530668 TI - [Fluid resuscitation of burn patients in the early stage]. PMID- 3530669 TI - Oncogenes, cancer and analytical cytology. PMID- 3530670 TI - Salmonella typhimurium infection after colectomy with mucosal proctectomy, a pouch, and ileoanal anastomosis. AB - Severe Salmonella typhimurium infection is described in a patient who was treated previously for ulcerative colitis by total colectomy and mucosal proctectomy with a pouch and ileoanal anastomosis. PMID- 3530671 TI - Classic articles in colonic and rectal surgery. Richard von Volkmann 1830-1889. Concerning rectal cancer and the removal of the rectum. PMID- 3530672 TI - Noninvasive evaluation of hepatic fibrosis using frequency demodulation of ultrasound signals. AB - A new ultrasound image can be produced by frequency demodulation (FM) of the conventional ultrasound signal. This new FM image appeared to produce a more accurate representation of the fine structure of the liver. The individual features of the FM image were correlated with hepatic portal fibrosis and cirrhosis on liver biopsy in 34 patients with minimal hepatic fat and sinusoidal collagen. An overall ultrasound score correlated with portal fibrosis (r = 0.788; P less than 0.001). We conclude that the FM image may be helpful in measuring and following the progression of hepatic fibrosis in patients with chronic liver disease. PMID- 3530673 TI - Effects of phenylephrine on systemic and pulmonary artery pressure during sepsis induced pulmonary hypertension in piglets. AB - The effects of intravenous phenylephrine (PE) on aortic blood pressure (AOP), pulmonary artery pressure (PAP), and cardiac output (CO) were evaluated in piglets with normal PAP and piglets with sepsis-induced pulmonary hypertension. Anesthetized, ventilated piglets (1-4 weeks; n = 22) were divided into four groups - group 1 (n = 5) received group B beta streptococci (GBS) followed by PE (300 micrograms/kg); group 2 (n = 6) received GBS alone; group 3 (n = 6) received placebo infusion; group 4 (n = 5) received PE alone (300 micrograms/kg). Infusion of GBS in piglets (groups 1 and 2) elevated PAP by 149 and 176%, reduced CO by 34 and 28%, and did not affect AOP. Administration of PE (groups 1 and 4) raised AOP by 30 and 27% without significantly affecting PAP. However, CO fell after PE by 31 and 39%, respectively. If selective elevation of systemic blood pressure is to become an effective strategy for human newborns with right-to-left shunts caused by sepsis-induced pulmonary hypertension, agents other than PE, with less associated reduction of CO, need to be identified. PMID- 3530674 TI - Influence of prostaglandin D2 on hemodynamic effects of group B streptococcus in neonatal lambs. AB - Infusions of group B streptococci cause pulmonary hypertension in several neonatal animal models. A continuous infusion of prostaglandin D2 reduced the magnitude of this pulmonary hypertensive response; indomethacin completely blocked the response. Prostaglandin D2 or cyclooxygenase inhibitors may be important therapeutic agents for infants with group B streptococcal sepsis who manifest pulmonary hypertension. PMID- 3530675 TI - Regulation of neonatal heart glycogen metabolism by thyroxine. AB - We investigated the effect of hyperthyroidism and hypothyroidism on the myocardial glycogen metabolism by quantitating 125I-insulin binding, glycogen content, glycogen synthase and phosphorylase enzyme activities in the newborn rabbit. Although an increase in 125I-insulin binding was observed in response to hyperthyroidism (p less than 0.01), a decrease in myocardial glycogen (p less than 0.01) along with no change in the synthase and phosphorylase enzyme activity was demonstrated. On the other hand, propylthiouracil-induced hypothyroxinemia did not affect the 125I-insulin binding, glycogen content or the two enzyme systems. We conclude that the depletion of myocardial glycogen secondary to hyperthyroidism is independent of an increase in 125I-insulin binding or any change in the major glycogen enzyme activities (synthase and phosphorylase). We speculate that this decline in neonatal heart glycogen may be secondary to thyroxine-induced altered glucose uptake or modified postinsulin receptor events. PMID- 3530676 TI - Penicillin-binding proteins of filaments of Escherichia coli induced by low concentrations of nalidixic acid, oxolinic acid, novobiocin or nitrofurantoin. AB - Nalidixic acid, novobiocin, oxolinic acid and nitrofurantoin, each at low concentrations, cause filamentation of Gram-negative bacilli. Filamentation induced by beta-lactam antibiotics has been correlated to the binding of these antibiotics to specific penicillin-binding proteins (PBPs) of the envelope of Gram-negative bacilli. The studies reported herein indicate that the former group of non-beta-lactam antibiotics do not bind to any of the PBPs of Escherichia coli. However, PBP 1a, PBP 4 and PBP 5/6 of the filaments induced by these agents are increased significantly. PMID- 3530677 TI - Effect and tolerability of omeprazole in the treatment of duodenal ulcer disease. AB - In an open clinical trial, 16 hospital outpatients with endoscopically proven duodenal ulcer were given 30 mg omeprazole once daily for four weeks. After two weeks' treatment 14 of the 16 patients had healed and after four weeks all patients were healed. Reduction of pain was rapid and occurred during the first part of the trial. No serious adverse events or clinically significant deviations from normal laboratory values were reported. Serum gastrin levels significantly increased during treatment but returned to normal levels after the treatment was discontinued. PMID- 3530678 TI - Clinical trial of high doses of Bay I 7433 (Copovithane). AB - Bay i 7433 (Copovithane) is a biological response modifier with antitumour activity in vivo, but no cytotoxic or cytostatic effect in vitro. A clinical trial of the compound at doses of 15g/m2/week was carried out for six weeks in 10 patients with various forms of cancer. Tolerance was good: no systemic toxicity was observed but local inflammation occurred in two cases at the site of injection. No objective antitumour response was observed. PMID- 3530679 TI - Cyclosporine monitoring. AB - Cyclosporine is an important immunosuppressive agent in organ and bone marrow transplantation. The pharmacokinetics of cyclosporine are quite complex and are complicated by the availability of two assay systems that yield differing results. This article summarizes the views from two major solid organ transplant centers and one bone marrow transplant center on important cyclosporine monitoring questions. A general consensus exists in the four areas discussed that: cyclosporine concentrations must be monitored due in part to the extreme variability in kinetics, either blood or plasma can be used in monitoring programs, the radioimmunoassay or high pressure liquid chromatography can be used in routine monitoring, and the interpretation of cyclosporine concentrations must be performed in relation to patient variables that affect drug response and toxicity. PMID- 3530680 TI - Pharmacotherapy of eating disorders: a critical review. AB - The pharmacotherapy of anorexia nervosa and bulimia are critically reviewed. No chemical treatment has been shown effective for anorexia nervosa. Antidepressants with a low incidence of annoying adverse reactions (e.g., desipramine) may be used as initial drug therapy in patients with concomitant depression. Cyproheptadine also is an attractive agent for initial therapy consideration in anorectics because of its relative safety. Both uncontrolled and controlled trials have found antidepressant drugs effective in bulimia, and they represent the pharmacotherapy of first choice. Alternative drug therapies include anticonvulsants (phenytoin and carbamazepine) and lithium. However, these agents need further controlled trials to substantiate their efficacy. PMID- 3530681 TI - Dilemmas in primary care: antibiotic treatment of acute otitis media. AB - Antibiotic treatment of acute otitis media (AOM) accounts for a significant number of all antibiotic prescriptions each year. In the primary care setting, initial antibiotic selection is rarely based on direct evidence, such as cultures of middle ear fluid. Initial antibiotic therapy by the primary care practitioner involves the evaluation and application of information related to prevalence of infecting organisms; in vitro antibiotic spectrum and penetration into middle ear fluid; initial cure rate, relapse and recurrence rates; and antibiotic cost, safety, and convenience. The influence of these factors on the initial antibiotic choice for AOM is reviewed. Several therapeutic dilemmas confronting the prescriber are discussed and a rational approach to initial antibiotic therapy is presented. PMID- 3530682 TI - An updated pKa listing of medicinal compounds. AB - A tabulated listing of pKa values is presented for 87 medicinal compounds commercially marketed since 1978. Medicinal compounds are listed alphabetically under their respective generic name. The pKa values reported are listed as either acid or base depending upon the ionization characteristics of the functional group corresponding to the respective pKa value. PMID- 3530683 TI - [Bullous phototoxic contact dermatitis caused by Dictamnus albus. The Bible's "burning bush"?]. AB - A bullous phototoxic reaction occurred in a 27-year-old man working with the plant Dictamnus albus. The skin changes disappeared, leaving behind areas of hyperpigmentation, after treatment with corticoid-containing ointments. Possible causes are 5- and 8-methoxypsoralen, perhaps also photodynamically active alkaloids of the plant, as well as sun-ray exposure and sweating. Dictamnus albus may be the biblical "burning bush". Since the plant becoming ever more popular in German gardens, a phytophototoxic reaction should be considered in the differential diagnosis of the described symptoms. PMID- 3530684 TI - [Why still perform autopsies?]. PMID- 3530685 TI - [Factors influencing the sonographic examination of the upper abdominal organs]. PMID- 3530686 TI - [Splenomegaly]. PMID- 3530687 TI - [Requirement for drinking and other usable water in animal husbandry]. PMID- 3530688 TI - [Behavior-adapted supply of drinking water for cattle and swine]. PMID- 3530689 TI - [Bacteria-induced risks in drinking and other usable water and recommendations for standards]. PMID- 3530690 TI - [Virus-induced risks in drinking and other usable water and recommendations for standards]. PMID- 3530691 TI - [Health aspects of usable water in dairying]. PMID- 3530692 TI - [Parasite-induced risks for cattle, swine and chickens in drinking and other usable water]. PMID- 3530693 TI - [Problems of drug administration in drinking water in poultry husbandry]. PMID- 3530694 TI - [Problems of drug administration in drinking water for swine]. PMID- 3530695 TI - [Drinking and other usable water from the public water supply--status, standards, legal principles, problems]. PMID- 3530696 TI - [Are neutralizing antibodies detectable in the ejaculate of boars following vaccination for Aujeszky's disease?]. PMID- 3530697 TI - [Aggregated occurrence of "hyena disease" in a dairy herd (short report on pathogenesis)]. PMID- 3530698 TI - [Bioavailability of commercial drugs in cattle following subcutaneous and intramuscular administration at different body sites]. PMID- 3530699 TI - [Detection of calf rotavirus in the Rotascreen latex test and electron microscopy -a comparative study]. PMID- 3530700 TI - [Echinococcosis in a thoroughbred horse imported from Ireland]. PMID- 3530701 TI - [Monensin poisoning in horses]. PMID- 3530702 TI - Pharmacokinetic profile of tylosin in mastitic cows. PMID- 3530703 TI - Cefonicid. A review of its antibacterial activity, pharmacological properties and therapeutic use. AB - Cefonicid is a 'second generation' cephalosporin administered intravenously or intramuscularly. It is similar to cefamandole in its superiority to first generation cephalosporins against several enterobacteriaceae as well as its activity against Haemophilus influenzae, including beta-lactamase-producing strains. Its activity against Staphylococcus aureus is similar to that of cefoxitin and inferior to cefamandole and first generation cephalosporins. It has excellent in vitro activity against Neisseria gonorrhoeae, but is inactive against Pseudomonas, Acinetobacter, Serratia, and Bacteroides fragilis. Due to high achievable plasma concentrations and a relatively long half-life, in most clinical trials cefonicid has been administered once daily. It was comparable in efficacy with cefamandole or cefazolin in the treatment of patients with urinary tract, lower respiratory tract, and soft tissue and bone infections. It has also been compared with penicillin in the treatment of uncomplicated gonorrhoea. Results from a small series of patients with endocarditis appear to indicate that cefonicid should not be used in patients with serious staphylococcal infections. Single doses of cefonicid given preoperatively appear to offer a similar degree of protection against post-surgical infection as multiple doses of other antibiotics, but further data from studies involving larger numbers of patients are needed to confirm these impressions. Patients who require prolonged antibiotic therapy, such as those with osteomyelitis being treated as outpatients after a relatively short inpatient course, could benefit from the once daily dose regimen of cefonicid. PMID- 3530704 TI - The effects of antihypertensive drugs on serum lipids and lipoproteins, I. Diuretics. AB - Potassium-losing diuretic drugs, when used in the treatment of hypertension, cause unfavourable short term alterations in blood lipid and lipoprotein concentrations. The disturbance is characterised by increases in total cholesterol of 4 to 13%, in low density lipoprotein (LDL) cholesterol of 7 to 29%, in very-low density lipoprotein (VLDL) cholesterol of 7 to 56%, and in total triglyceride of 14 to 37%. The disturbance is variable among patients and over time in individual patients; it is absent in some. In long term treatment the data are fragmentary, but total cholesterol and triglycerides usually return to baseline values or below. The variability of the lipid response to diuretics has several consequences: firstly, it necessitates a sizeable study population (minimum of 30 patients) in order to document convincingly its presence or absence; secondly, lipoprotein fractions must be examined to define the pattern of the disturbance; and thirdly, the subsidence of the diuretic-induced lipid effects in long term treatment may be more apparent than real because even larger decreases have been noted in untreated groups in the few studies that wisely included these important controls for comparison. While the cause of the lipid lipoprotein aberration is unclear, existing data suggest that certain attributes of the study population influence the response, i.e. age, habitual diet, hormonal milieu (gender), baseline cholesterol concentrations, and induced glucose intolerance. The apparent absence of lipid alterations with indapamide needs to be substantiated and compared with low doses of a standard thiazide-type drug. The lipid-lipoprotein effects of diuretics seem inconsequentially small, but they may contribute to the disappointing failure of diuretic-based regimens to lower the incidence of coronary heart disease in hypertensive patients. Nevertheless, diuretic-based treatment remains the only therapeutic regimen of proven benefit to congestive heart failure in patients with hypertension, and it is superior to beta-blockade in preventing stroke. Hence, alternative antihypertensive drug regimens must be compared prospectively with diuretics in order to verify any theoretic superiority. PMID- 3530706 TI - Oral and maxillofacial surgery for cleft lip and palate. PMID- 3530705 TI - Diabetic neuropathies. Current concepts in prevention and treatment. AB - Diabetic nerve damage leads to a wide variety of unpleasant problems: painful sensations, muscle weakness, numb feet predisposing to ulcers, impotence, and a series of distressing effects due to autonomic dysfunction. At present, there is no single effective treatment for the many clinical syndromes--each of which may well have a different cause. Improved blood glucose control must remain the first line of treatment, hopefully to improve nerve structure and function but also to raise the pain threshold. A variety of sedatives and analgesics may also help some patients. Inhibition of the enzyme aldose reductase with resultant interference with neural sorbitol and myo-inositol metabolism would seem to have a good theoretical basis in therapy, and detailed results of long term clinical trials of aldose reductase inhibitors such as sorbinil and tolrestat are awaited with interest. Their role in the future could be more important in prevention of nerve damage than in attempting to reverse gross end-stage nerve destruction. In diabetic subjects with loss of pain sensation in the foot due to neuropathy or in the more advanced state of foot ulceration, intensive educational and clinical efforts should be exerted to prevent this distressing and common problem. In the future, a more detailed understanding of the biochemical abnormalities occurring in nerves and their effect on nerve function, structure and vasculature may lead to more satisfactory and logical treatments for this the commonest single complication of diabetes. PMID- 3530707 TI - [Immunologic and clinical findings in different liver diseases (statistical studies)]. AB - In 140 out-patients of a liver dispensary department 18 clinical and immunological markers (autoantibodies) in 7 well defined diseases were found. We them underwent to a multiple linear factor analysis. 4 different and independent structural factors could be defined: 1. a so-called autoimmunity factor, 2. a parenchymatous factor, 3. an ethanol factor and, finally, a dysproteinemia factor. By individual factor analysis different hepatological diseases could be characterized. PMID- 3530708 TI - [Results of ultrasound tomography in the diagnosis of liver diseases]. AB - In a prospective study the impact of ultrasound tomography in the recognition and exclusion, respectively, of liver diseases was investigated. 646 patients with a suspected liver disease were sonographed in real-time procedure. The investigator was familiar with the history as well as with clinical and lab findings before the examination was started. The sonography was performed before a laparoscopy, liver blind punktion, scintigraphy, angiography, computerized tomography. The diagnoses were confirmed by sufficient, comparable methods (see above) or operatively; they were supported by a follow-up for one year. While liver cysts, cystic livers, liver abscesses, haematomas, metastases (with a diameter of more than 10-20 mm), stasis liver, cirrhoses with portal hypertension and fatty livers could be diagnosed with a high rate of confidence by sonography, healthy livers and the following disorders could not exactly be separated by ultrasound: acute hepatitis, reactive hepatitis hepatoses, chronically persisting hepatitis, chronic active hepatitis, and livers with a low incorporation of fat. PMID- 3530709 TI - Production and characterization of antibodies to rat pancreatic acinar cells. AB - The contribution of immunologic noxae to the damage of the cells and the induction of autodigestion in the course of acute pancreatitis in rats should be regarded. The isolation of intact acinar cells from rat pancreas offers a new approach to a more specific antiserum being directed against antigens at the outside of the cell membrane. Proof of circulating antibodies was performed using the indirect immunofluorescence reaction method (IFAR). A defined membrane fluorescence was observed at the surface of the acinar cells in vitro and a fluorescence at the septa of lobules marking the borders of acini in vivo. PMID- 3530710 TI - [Rapid and reproducible method for determining the primary antibody response to sheep erythrocytes]. PMID- 3530711 TI - [Computer technology in the teaching of biochemistry]. PMID- 3530712 TI - [Melatonin and tumor growth]. AB - The role of melatonin in the process of oncogenesis is reviewed. The problems connected with functional state of the epiphysis and other melatonin-producing cells in cancer, as well as the influence of melatonin on experimental tumours and melatonin level changes in blood and urine in patients with malignant tumours are discussed. A probable mechanism of melatonin level changes in cancer is considered taking into account its extra-pineal synthesis. PMID- 3530713 TI - [Molecular mechanisms of the transformation of protooncogenes into oncogenes]. AB - The problem of cellular protooncogene activation is considered. This stage during carcinogenesis is evaluated as critical in the whole process of neoplasia development. Four possible principal pathways of protooncogene activation are discussed: oncogene amplification; chromosomal translocations; insertions and transpositions of genetic material; point mutations. Two ideas in carcinogenesis based on the oncogene conception have attracted special attention: the "dose hypothesis" emphasizing the importance of the quantitative changes of oncoproteins and the idea of the qualitative alterations of protooncogenes. PMID- 3530714 TI - Processing of hormones and hormone-like substances from milk in the gastrointestinal tract of suckling rats. AB - Colostrum and milk contain insulin, epidermal growth factor and prostaglandins. Experiments performed in our laboratory have demonstrated that these three substances can be absorbed by the gastrointestinal tract of suckling rats in biologically active form in considerable amounts. Prostaglandins are metabolized by the gastrointestinal tract during postnatal development. There are quantitative and qualitative differences in the metabolism of orally administered prostaglandins between suckling and weanling rats. Nevertheless, a significant amount of intact prostaglandin appears in the liver of suckling rats after oral administration. Gastric administered insulin can result in hypoglycemia. In suckling rats, there is a considerable decrease in blood glucose levels, while no effect is seen in 30-day-old rats. Epidermal growth factor is processed in the gastrointestinal tract as shown by size exclusion and affinity columns and surface receptor binding. Oral administration of epidermal growth factor has several effects on gastrointestinal functions. Analysis of epidermal growth factor processing by the gastrointestinal tract demonstrated postnatal developmental differences (either during normal development, or one accelerated by steroid treatment). These studies show that the gastrointestinal tract can be influenced by orally administered hormones known to be present in milk, and that these substances can be delivered to peripheral organs of suckling animals intact. PMID- 3530715 TI - Data suggesting that milk of early lactation period might be involved in sexual differentiation of rat brain. AB - The contribution of a hypothetic milk factor in the masculinization process of gonadotropin secretion pattern was investigated using a cross-fostering model. Adult female rats whose nipples had been previously excised were mated. At the time of delivery their pups were given to recipient dams that had given birth one week earlier. Pups remaining with their own (intact) mother served as control group. At the age of 37-39 days (birth = day 0) male rats from the experimental and the control groups were castrated and also control females were ovariectomized. Ten days later gonadectomized animals received ovarian grafts excised from 20-day-old rats. Four and seven days after transplantation the grafts were processed for histology. Corpus luteum formation suggests that male rats nursed by recipient dams did not undergo the masculinization process normally occurring during the first few days of postnatal life. In a separate experiment, male pups nursed by dams being at the early lactation (control) or at the midlactation period were decapitated on postpartum day 1 and serum testosterone levels were measured by RIA. Mean testosterone concentration was almost twice as high in the control group than in pups nursed by recipient dams of the midlactation period. These data suggest that milk of the early lactation period might be necessary for the normal masculinization process of the male rat. PMID- 3530716 TI - Perinatal thyroid activity in farm animals and the role of iodocompounds in maternal milk (minireview). AB - There is a sudden rise in serum thyroid hormone concentrations immediately after birth, with some species differences related to the degree of the increase and to the iodothyronine involved. Extrauterine cooling stimulates TSH release; however, the marked release of the thyroid hormones from the gland is somewhat dependent on the process of transition from fetal to neonatal state. It seems that hemodynamic changes together with the sympathetic nervous system, which comes in force at the moment of cord cut, are indispensable co-factors of TSH action. Four factors, at least, may attribute to the immediate postnatal hyperiodothyroninemia: abrupt depletion of the preformed fetal hormonal iodine stores, preferential T3 secretion, increase in the T4 to T3 monodeiodination in the peripheral tissues, a release of TH content from peripheral reservoirs to plasma. The course of the postnatal hyperiodothyroninemia is dependent on the maturation level reached at birth, food intake, and cooling relative to extrauterine environment. One of the physiological significances of the postnatal thyroid hyperactivity lies in the metabolic thermostability mediated by iodothyronines and adrenaline in the thyroxine types of newborns, in contrast to newborns in which thyroxine does not results in an increase of oxygen consumption (noradrenaline type). Measurable quantities of T3 and T4 are present in colostrum and milk but their contribution to normal hormone production so far calculated does not exceed 7% of daily requirement for an individual hormone. PMID- 3530717 TI - Thyroid hormones and insulin in milk; a comparative study. AB - Thyroid hormones (TH) in milk can be measured by RIA after prolonged extraction with alkaline ethanol at low temperature. The results of this method agreed with those obtained by gas chromatography-mass spectrometry, though they show the concentrations lower than in most of the already published studies based on radioimmunoassay. The levels of thyroxine (T4) in colostrum and milk in rabbit, cow and women were found to be similar, about 2 nmol l-1, which represented a small fraction of those in blood serum. Triiodothyronine (T3) content approximated one third of that in serum and was about 1.0, 1.8, 0.3 and 0.5 nmol l-1 in the rabbit, pig, human and cow, respectively. Although in a relatively high blood concentration, reverse-T3 does not appear in cow milk, but it passes through the blood/mammary gland barrier into the milk in rabbits in which it appears in a very low concentration. Of TH in milk, T3 may exert some physiological role in offsprings, particularly during the early adaptive postnatal period. Insulin (INS) in human, cow and pig milk was found in concentrations approximate to those in blood serum. They were high at the peri parturient period and then fell rapidly in the pig and more gradually in the women, to a relatively low and constant levels. Transfer of INS into the mammary gland and milk was positively related to the actual concentrations of this hormone in the blood, in quantities which, following ingestion of milk, might exert some biological action in neonates. PMID- 3530718 TI - Growth factor control of rat thyroid follicular cell proliferation. AB - We have investigated the proliferative responses of rat thyroid follicular cells in serum-free culture to a range of growth factors including TSH, epidermal growth factor, and insulin, added singly or in combination. Follicles released from normal thyroids by collagenase/dispase digestion were cultured in suspension in agarose-coated microtiter plates to prevent monolayer formation. Growth responses were measured by [3H] thymidine incorporation and by autoradiography over successive 24- or 36-h periods. Insulin, even in the absence of other growth factors, stimulated [3H]thymidine incorporation in a concentration-dependent manner, rising from basal levels of 486 +/- (SE) 18 cpm to 4222 +/- 367 cpm/5 X 10(4) cells at 8 micrograms/ml. In contrast, TSH alone had no effect. In the presence of threshold levels (0.08 micrograms/ml) of insulin, however, there was a highly significant (P less than 0.001) response to TSH, [3H]thymidine incorporation rising from 1089 +/- 163 cpm in the absence of TSH to a maximum of 7548 +/- 585 with 1 mU/ml TSH. There was a synergistic interaction between insulin and TSH over the concentrations tested. Epidermal growth factor either alone or in combination with insulin failed to produce a significant response. Parallel autoradiographic studies were concordant with the [3H]thymidine incorporation data. We conclude that whereas in the absence of other growth factors TSH is unable to stimulate DNA synthesis in isolated rat thyroid follicles, the inclusion of just a single growth factor, insulin, permits a marked response. These observations emphasize the need for inclusion of appropriate permissive growth factor(s) when assessing the in vitro effect of a suspected tissue-specific mitogen. PMID- 3530719 TI - Glucagon-like peptides GLP-1 and GLP-2, predicted products of the glucagon gene, are secreted separately from pig small intestine but not pancreas. AB - We developed specific antibodies and RIAs for glucagon-like peptides 1 and 2 (GLP 1 and GLP-2), two predicted products of the glucagon gene, and studied the occurrence, nature, and secretion of immunoreactive GLP-1 and GLP-2 in pig pancreas and small intestine. Immunoreactive GLP-1 and GLP-2 were identified in glucagon-producing cells of the pancreatic islets, and in glicentin-producing cells of the small intestine. Immunoreactive GLP-1 and 2 in intestinal extracts corresponded in molecular size to peptides synthesized according to the predicted structure. By reverse phase HPLC, intestinal and synthetic GLP-1 behaved similarly, whereas synthetic and intestinal GLP-2 differed. Pancreatic extracts contained a large peptide with both GLP-1 and GLP-2 immunoreactivity. Secretion was studied using isolated perfused pig pancreas during arginine stimulation, and isolated perfused pig ileum during either luminal glucose stimulation or vascular administration of the neuropeptide, gastrin-releasing peptide (GRP). Immunoreactive GLP-1 and GLP-2 were secreted in parallel with pancreatic glucagon and intestinal glicentin. The molecular forms of secreted immunoreactive GLP-1 and 2 corresponded to those identified in the tissue extracts. PMID- 3530720 TI - The metabolic clearance, distribution, and degradation of dimeric and monomeric growth hormone (GH): implications for the pattern of circulating GH forms. AB - The ratio of oligomeric (big) to monomeric (little) human (h)GH forms in plasma exceeds that in the pituitary gland severalfold. To investigate whether delayed metabolic clearance of oligomers could explain this discrepancy, we measured MCR, distribution volumes, and degradation rates of radio-labeled hGH22K dimer, hGH20K dimer, hGH22K monomer, and hGH20K monomer in the rat. Hormones were injected as a bolus, and disappearance from plasma was followed by immunoprecipitation and trichloroacetic acid precipitation. MCRs of the dimers were significantly lower than those of the corresponding monomers (5-fold in the case of hGH22K, and 2 fold in the case of hGH20K). Both dimers were also degraded at slower rates than the monomers. Distribution volumes for the dimers, although somewhat smaller, were not statistically different from those for the monomers and were consistent with distribution in the extracellular space. We conclude that hGH dimers are relatively protected from degradation and hence cleared more slowly from the blood than hGH monomers. This may lead to their accumulation in the circulation relative to their monomeric counterparts, which may explain their high proportion in plasma as compared to pituitary. PMID- 3530721 TI - Hormonal induction of secretory granules in a pituitary tumor cell line. AB - GH4C1 cells are a rat pituitary tumor cell strain that secretes PRL and GH but contains almost no secretory granules. Treatment of GH4C1 cells with a combination of estradiol (1 nM), insulin (300 nM), and epidermal growth factor (10 nM) increased the cellular content of PRL by more than 30-fold above control levels but only increased PRL accumulation in the medium 6-fold. To determine whether the increase in intracellular PRL was accompanied by an increase in secretory granules, we compared the numbers of granules in ultrathin sections from untreated GH4C1 cells and from cells treated with the combined hormone regimen and found a nearly 50-fold increase in granule number. Only 75% of the granules stained for PRL by the protein-A gold technique; the other 25% stained for neither PRL nor GH. The occasional granules found in untreated GH4C1 cells stained for PRL. The data demonstrate that the number of granules in GH4C1 cells can be regulated by hormone treatment and that the increase in intracellular PRL is found in storage granules. PMID- 3530722 TI - Immunoreactive arginine vasopressin in the rat thymus. AB - Immunoreactive arginine vasopressin (ir-AVP), coeluting with authentic nonapeptide on reverse phase HPLC, is present in the thymus of Sprague-Dawley, Long-Evans, and homozygous (di/di) Brattleboro rats, and BALB/c mice. By immunohistochemistry, ir-AVP positive cells are sparse, and do not appear to be lymphocytes. Adrenalectomy and dexamethasone administration to intact rats produces an identical response in terms of thymic ir-AVP, with a rise after 1-2 days followed by a fall to levels below baseline after 8 days. The rise 2 days after adrenalectomy, and the fall 8 days later, were both prevented by administration of aldosterone, but not by corticosterone or dexamethasone to adrenalectomized animals. The role(s) of thymic ir-AVP, and the physiological significance of its mineralocorticoid dependence, remain to be established. PMID- 3530723 TI - Effect of vagotomy on serum insulin in rats with paraventricular or ventromedial hypothalamic lesions. AB - The effects of vagotomy on plasma glucose and insulin levels in rats with paraventricular nuclear (PVN) or ventromedial hypothalamic (VMH) lesions were measured during a constant glucose infusion. In one experiment, vagotomy was performed 50 min after the lesions, and in a second experiment, it was performed at the same time as the lesions. After the introduction of lesions in the PVN, there was a significantly greater rise in plasma glucose than in animals with either large or small VMH lesions, both of which had plasma glucose values similar to those in the sham-lesioned animals. The rise in insulin was greater in all three lesion groups than in the sham-operated animals. Although both plasma glucose and insulin had begun to decline before the vagotomy performed 50 min after lesioning, there was a further subsequent fall after vagotomy which was greater in the VMH-lesioned animals with large lesions than in rats with PVN lesions or small VMH lesions. In the sham-lesioned rats, there was no significant change in insulin or glucose after vagotomy. When the vagotomy and hypothalamic lesions were performed simultaneously, the glucose and insulin values in all groups were the same. The present experiments suggest that VMH and PVN exert different controls over pancreatic hormone secretion. The VMH lesions appear to remove an inhibitory effect on the vagus, with resultant hyperinsulinemia in the absence of hyperglycemia. The PVN-lesioned animals show a hyperglycemia which is abolished by vagotomy, suggesting that the PVN connects to vagal fibers which activate the glucagon secretory system in the alpha-cell of the pancreas. PMID- 3530724 TI - Demonstration of insulin receptors and modulation of alkaline phosphatase activity by insulin in rat osteoblastic cells. AB - Osteoporosis is a known complication of diabetes mellitus, suggesting a role for insulin in bone homeostasis. We studied insulin receptors and insulin action in the osteoblast-like rat osteogenic sarcoma cell line ROS 17/2.8. These cells share many common features with the osteoblast, such as 1,25-dihydroxyvitamin D3 receptors, PTH receptors, and 1,25-dihydroxyvitamin D3-induced modulation of alkaline phosphatase activity and osteocalcin. Competition binding studies revealed high affinity insulin receptors, with an ED50 for insulin of 1 nM. The receptors were highly specific for insulin, with 60% inhibition of insulin binding by an antireceptor antibody, no competition by epidermal growth factor, and an ED50 of 300 nM for proinsulin. Steady state maximal insulin binding was obtained by 40 min at 37 C, and insulin degradation, as measured by trichloroacetic acid solubility, was 1%/h at 37 C. ROS cells readily internalized insulin, and under steady state binding conditions at 37 C, 56% of the cell associated radioactivity consisted of intracellular material. Chloroquine (100 microM) inhibited intracellular processing of insulin, leading to a 300% increase in cell-associated insulin by 2 h (37 C). Photoaffinity labeling of the insulin receptor with the photosensitive analog of insulin, B2 (2-nitro-4-azidophenyl acetyl)des-pheB1-insulin, followed by solubilization and sodium dodecyl sulfate polyacrylamide gel electrophoresis, revealed specific bands of 125K and 430K mol wt under reducing and nonreducing conditions, respectively. Thus, the structure of insulin receptors in ROS cells appears comparable to that of insulin receptors of known target tissues. Insulin action was also examined. Insulin did not stimulate [2-3H]deoxyglucose uptake or [1-14C]leucine incorporation into protein. In contrast, physiological concentrations of insulin inhibited alkaline phosphatase activity in nonconfluent cells. After exposure to insulin for 24 h, alkaline phosphatase activity was decreased compared to basal by 39.5% and 50% with 5 and 50 ng/ml insulin, respectively. In conclusion, ROS cells bind insulin to specific receptors that are similar to insulin receptors on other target tissues; receptors internalize insulin, which is then processed through a chloroquine-sensitive pathway; insulin does not affect membrane substrate transport; and insulin does inhibit the activity of an enzyme that is important in bone metabolism. ROS cells represent a model for studying insulin effects on bone. PMID- 3530725 TI - Pituitary binding and internalization of radioiodinated gonadotropin-releasing hormone agonist and antagonist ligands in vitro and in vivo. AB - In rat pituitary gonadotrophs, the rates of binding and endocytosis of two GnRH superagonist analogs, [D-Ala6,Pro9-NEt]GnRH and [D-Lys6,Pro9-NEt]GnRH, were compared with those of the potent antagonist analog [N-acetyl-D-pCl-Phe1,2,D Trp3,D-Lys6,D-Ala10]GnRH by quantitative electron microscopic autoradiography. In dispersed pituitary cells, the two agonist analogs showed similar binding kinetics and comparable degrees of sequestration, as measured by their resistance to dissociation by low pH buffer. However, quantification of silver grain localization suggested that cellular internalization of the [D-Ala6]GnRH agonist increased more rapidly than that of the [D-Lys6]GnRH analog. These discrepancies, and the finding that a larger amount of the specifically bound 125I-[D-Ala6]GnRH agonist was removed during glutaraldehyde fixation, indicated that the proportional internalization of this analog was over estimated by quantitative autoradiography owing to loss of cell surface-bound radioligand. We, therefore, employed radioiodinated D-Lys6-substituted analogs to analyze the receptor binding and cellular uptake of GnRH agonist and antagonist derivatives in vivo. After iv injection, a high proportion of the 125I-[D-Lys6]GnRH agonist was translocated into pituitary gonadotrophs within 60 min, whereas the D-Lys6 antagonist was predominantly associated with the plasma membrane during that time. Four hours after injection of the antagonist, an appreciable proportion of silver grains was associated with intracellular organelles, and this trend increased progressively at later time points. The relatively prolonged cellular processing of the GnRH antagonist is consistent with in vivo binding kinetics, and its slower internalization may reflect the basal rate of GnRH receptor turnover in the cell membrane. In addition, the marked difference between the rates of internalization of the bound [D-Lys6]GnRH agonist and antagonist ligands supports the proposal that receptor activation is responsible for the rapid endocytosis of agonist ligands by the GnRH-stimulated pituitary gonadotroph. PMID- 3530726 TI - Carrier-mediated transport of thyroid hormone into rat hepatocytes is rate limiting in total cellular uptake and metabolism. AB - We investigated if carrier-mediated transport into rat hepatocytes is rate limiting in total cellular uptake and metabolism of thyroid hormone. Rat hepatocytes in primary monolayer culture were incubated under equilibrium conditions with tracer T4, T3 or rT3 in the absence or presence of inhibitors of thyroid hormone uptake, i.e., ouabain and ER-22, a monoclonal antibody against the rat hepatocyte plasma membrane. The results for all three iodothyronines show that inhibition of clearance from the medium during incubation is paralleled by a similar decrease in iodide production. This indicates that the decrease in metabolism of thyroid hormone is directly related to the inhibition of cellular uptake. These findings underline the potential importance of the plasma membrane in the regulation of thyroid hormone metabolism and, therefore, determination of expression of thyroid hormone activity. PMID- 3530727 TI - Comparative study of primates' transcortin: immunoreactivity and steroid-binding activity. AB - To investigate the phylogenic aspect of transcortin (corticosteroid-binding globulin, CBG), the immunoreactivity of transcortin with anti-human transcortin antiserum was studied in primates. The anti-human transcortin antibody was recognized by plasma proteins obtained from Catarrhini, taxonomically the most evolved monkey group. The immunoreactivity was not observed in plasma obtained from Platyrrhini and Prosimiae, classified as less evolved monkey groups than Catarrhini. Though comparison of immunoreactivity among different classes of Catarrhini was difficult because of non-parallelism of their displacement curves, displacement of 125I-labelled human transcortin from the antiserum by 1:10 and 1:100 diluted plasma was highest in human followed by Pongidae, Cercopithecoidea. The immunoreactivity of thyroxine-binding globulin (TBG) with anti-human TBG antiserum was also examined. The anti-human TBG antibody was only recognized in plasma from Pan (anthropoid ape) among Pongidae, highly evolved monkeys among Catarrhini. The existence of immunoreactive transcortin and TBG to respective human protein antibody in the highly evolved ape agreed well with the cladogenetic division of primate species delineated by Goodman and Moore (1971). Cortisol-binding activity of transcortin was detected in all monkeys except three, tafted capuchin monkey, night monkey and cotton-headed tamarin, which belong to Platyrrhini. The absence of cortisol-binding activity in these animals might be attributed to high levels of endogenous cortisol and low cortisol binding capacity of transcortin. It is speculated that the structure of the immunoreactive site in transcortin could be modified by evolution without affecting the biologically important site, the site for cortisol binding. PMID- 3530728 TI - Plasma thromboxane and prostacyclin: comparison during normal pregnancy and pregnancy complicated by hypertension. AB - Plasma levels of thromboxane B2 (TXB2) and 6-keto-prostaglandin F1 alpha (6-keto PGF1 alpha), stable metabolites of two prostanoids with opposing biological effects, TXA2 and prostacyclin, were measured by radioimmunoassay in normal pregnancy (controls) and pregnancy complicated by hypertension (PIH) from 32 to 36 (Period 1; P1) and from 36 to 40 (Period 2; P2) weeks of gestation. The plasma concentration of each compound in the control subjects was 265.6 +/- 58.4 (TXB2), 132.4 +/- 16.5 (6-keto-PGF1 alpha) for P1 (n = 10) and 142.6 +/- 11.8 (TXB2), 68.5 +/- 5.2 (6-keto-PGF1 alpha) for P2 (n = 10) respectively (pg/ml, mean +/- s.e). In the patients with PIH, TXB2 concentrations increased moderately for P1 (419.2 +/- 21.2; n = 7) and significantly (p less than 0.005) for P2 (452.8 +/- 31.0; n = 7) respectively (pg/ml, mean +/- s.e), while the plasma levels of 6 keto-PGF1 alpha revealed a slight to moderate decrease both for P1 (84.5 +/- 4.0; n = 7) and P2 (59.7 +/- 8.1; n = 7) respectively (pg/ml, mean +/- s.e). The physiological balance of TXB2 to 6-keto-PGF1 alpha was significantly greater (p less than 0.005) in the patients with PIH, where the TXB2/6-keto-PGF1 alpha ratio was 5.2 +/- 0.7 for P1 and 9.4 +/- 2.3 for P2 respectively (mean +/- s.e) compared with that of the controls, where it was 2.4 +/- 0.4 for P1 and 2.0 +/- 0.2 for P2 respectively (mean +/- s.e).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3530729 TI - Preparation of a monoclonal antibody to common amino acid sequence of LHRH and its application. AB - In order to prepare an antibody directed at the common amino acid sequence of mammalian, avian, and fish luteinizing hormone-releasing hormones (LHRHs), C terminal free LHRH was conjugated with bovine thyroglobulin, and was used as the antigen. A monoclonal antibody (LRH13) was obtained as an ascitic fluid by fusing the spleen cells of a BALB/c donor mouse immunized with the antigen to X63.Ag8.653 mouse myeloma cells followed by limiting dilution cloning and transplanting a positive clone to BALB/c mice. This monoclonal antibody seems to belong to IgG2b as it was eluted from protein A-Sepharose CL-4B with citrate buffer pH 3.5. competitive binding experiment using fragment peptides of LHRH indicated the binding site of LRH13 was a region around serine and tyrosine, and modification of mammalian LHRH by radioiodination caused a marked decrease in the binding activity. LRH13 has an affinity constant of 0.134 X 10(9) M-1 to native mammalian LHRH, and binds C-terminal free LHRH with a similar affinity (1.6X), however, it binds with higher affinities to N- and C-terminal free LHRH (12.9X), N-terminal free LHRH (10.4X), salmon LHRH (8.3X) and chicken LHRH-I (6.0X). Chicken LHRH-II, where tyrosine is replaced for histidine, has a lower affinity (0.3X) than that of mammalian LHRH. From its high affinity to N-, C-terminal free LHRH, LRH13 is also expected to bind possible precursor peptides of LHRH. Immunohistochemical staining of the brain sections obtained from rats, mice, chickens, Japanese quail, and rainbow trout successfully visualized cell bodies and fibers distributed from the olfactory bulb to the median eminence, indicating high LHRH specificity and wide crossreactivity in animal classes of this monoclonal antibody. With this antibody, LHRH-like immunoreactive substance in the pineal gland was also stained with fixation at neutral pH. PMID- 3530731 TI - How can we diagnose the depth of cancer invasion in the esophagus? PMID- 3530730 TI - Hypercalcemic effect of insulin in thyroparathyroidectomized alloxan-treated rats. AB - The acute effect of a hypoglycaemic dose of 0.5 U/100 g BW insulin administered intramuscularly on calcium metabolism was investigated in fasted alloxan-treated rats. It was found that the hypercalcaemic effect of insulin was evident only in thyroparathyroidectomized (TPTX) and not in parathyroidectomized (PTX) rats. A subcutaneous administration of 180 MRC mU/100 g BW calcitonin abolished the calcium raising effect of insulin in TPTX rats suggesting a protective role of calcitonin against insulin action in intact rats. In an attempt to elucidate the mechanism of the calcium raising effect of insulin 45Ca administered intravenously was used to indicate the movement of calcium from the plasma pool. Insulin administration delayed the plasma 45Ca disappearance rate but had no effect on bone 45Ca uptake within 120 min. In contrast, insulin administration resulted in a 31% reduction of urinary 45Ca excretion while the urine volume remained unchanged. However, the insulin-induced reduction of urinary calcium excretion could not totally account for the calcium raising effect of insulin in TPTX animals. PMID- 3530732 TI - How can we diagnose the early stage of esophageal cancer? Diagnosis of early esophageal cancer. PMID- 3530733 TI - Endoscopic ultrasonography in the diagnosis of esophageal carcinoma, with particular regard to staging it for operability. AB - We report on the usefulness of endoscopic ultrasonography (EUS) for the staging of esophageal carcinoma for operability, including the diagnosis of infiltrating depth and lymph node metastases. The accurate diagnosis of the depth of invasion of a carcinoma by means of EUS was achieved in 75% of all cases. Concerning the evaluation of resectability, it should therefore be concluded that EUS can provide us with accurate information on the invasion of the carcinoma beyond the adventitia and/or its distant metastatic growth to the neighboring organs including lymph nodes. From this investigation it can be concluded that EUS is an excellent method for the staging of esophageal carcinoma with regard to its operability. PMID- 3530734 TI - Conformational dynamics of the anticodon loop in yeast tRNAPhe as sensed by the fluorescence of wybutine. AB - Conformational and dynamic properties of the anticodon loop of yeast tRNAPhe were investigated by analyzing the time resolved fluorescence of wybutine serving as a local structural probe adjacent to the anticodon GmAA on its 3' side. The influence of Mg2+, important for stabilizing the tertiary structure of tRNA, and of the complementary anticodon s2UUC of E. coli tRNA2Glu were investigated. Fluorescence lifetimes and anisotropies were measured with ps time resolution using time correlated single photon counting and a mode locked synchronously pumped and frequency doubled dye laser as excitation source. From the analysis of lifetimes (tau) and rotational relaxation times (tau R) we conclude that wybutine occurs in various structural states: one stacked conformation where the base has no free mobility and the only rotational motion reflects the mobility of the whole tRNA molecule (tau = 6 ns, tau R = 19 ns), an unstacked conformation where the base can freely rotate (tau = 100 ps, tau R = 370 ps) and an intermediary state (tau = 2 ns, tau R = 1.6 ns). Under biological conditions, i.e. in the presence of Mg2+ and neutral salts, wybutine is found in a stacked and immobile state which is consistent with the crystallographic picture. In the presence of the complementary codon however, as exemplified by the E. coli-tRNA2Glu anticodon, our analysis indicates that the codon-anticodon complex exists in an equilibrium of structural states with different rotational mobility of wybutine. The conformation with wybutine freely mobile is the predominant one and suggests that this conformation of the codon-anticodon structure differs from the canonical 3'-5' stack. PMID- 3530735 TI - Culture of airway epithelial cells: research techniques. PMID- 3530736 TI - Chronological supplement to the Carcinogenic Potency Database: standardized results of animal bioassays published through December 1982. AB - This paper is a chronological supplement to our earlier publication, "A Carcinogenic Potency Database of the Standardized Results of Animal Bioassays." We report here results of carcinogenesis bioassays published in Technical Reports of the National Cancer Institute/National Toxicology Program between July 1980 and December 1982, and the general literature between July 1981 and December 1982. This supplement includes results of 280 long-term, chronic experiments of 114 test compounds, and reports the same information about each experiment in the same plot format as the earlier paper: e.g., the species and strain of test animal, the route and duration of compound administration, dose level and other aspects of experimental protocol, histopathology and tumor incidence, TD50 and its statistical significance, dose response, author's opinion about carcinogenicity, and literature reference. While a number of appendices are provided to facilitate use of this supplement, we have not duplicated here the material published earlier. Instead, we refer the reader to the earlier publications (Peto et al. and Gold et al.) for a thorough description of the numerical index of carcinogenic potency (TD50), a guide to the plot of the database, and a discussion of the sources of data, the rationale for the inclusion of particular experiments and particular target sites, and the conventions adopted in summarizing the literature. For 44 of the 114 chemicals reported in this second plot, results of earlier experiments are also given in the first plot; since only 1981-1982 results are reported here, the first plot is required for these repeated compounds. In this paper we also give corrections for errors that appeared in the earlier publication. PMID- 3530738 TI - Past, present, and future of mutagens in cooked foods. AB - Mutation assay with Salmonella typhimurium enabled us to detect various types of mutagens in cooked foods. A series of mutagenic heterocyclic amines has been isolated and identified in broiled fish and meat and in pyrolyzates of amino acids and proteins. Feeding experiments showed these mutagens to be carcinogenic in mice and rats. The mechanism of formation and pathway of metabolic activation of these heterocyclic amines have been elucidated. Their contents in various cooked foods have been determined. The presence of mutagenic nitropyrenes (some of which were confirmed as carcinogens) in grilled chicken was also established. Roasted coffee beans also yield mutagens such as methylglyoxal. The formation of mutagen precursors, including beta-carboline derivatives and tyramine which become mutagens with nitrite treatment, was found during food processing. Oncogene activation in animal tumors induced by some of these food mutagens/carcinogens has been confirmed. The role of mutagens/carcinogens in cooked foods in human cancer development has not yet been exactly evaluated. In order to do this, more information on their carcinogenic potency, human intake, metabolism in the human body, and the effects of combined administration with other initiators, promoters and other modifying factors in food is required. PMID- 3530739 TI - Mutagen formation during commercial processing of foods. AB - Levels of bacterial mutagenicity 3-17 times above spontaneous are generated during commercial thermal processing (canning) of foods, particularly foods high in protein. The potential for other processing operations, including pasteurization, dehydration, and concentration, to produce substances active in the Ames Salmonella assay was also examined. Two heated fish model systems, canned salmon and fried sole, were established by extracting mutagen precursors from fish tissues with water. The model system studies suggest that the limiting reactants for mutagen formation differ from one food product to another, and that Maillard type browning reactions are involved in mutagen production. Bisulfite treatment was found to inhibit mutagen formation in modal systems and whole food products. Isolation and partial characterization of the mutagens in both fried and canned pink salmon showed that at least three distinct mutagens were present. These mutagens exhibited HPLC retention time patterns on C18, cyano, and amino columns different than the major mutagens present in other cooked and grilled meats and fish. PMID- 3530741 TI - Functional heterogeneity of periportal and perivenous hepatocytes. AB - Periportal and perivenous hepatocytes differ in their content of many key enzymes and subcellular structures. The cells also receive different regulatory signals due to the gradients established during liver passage of oxygen, substrates and hormones. The signal heterogeneity is important not only for short-term regulation of metabolism but also for long-term control, i.e. the induction of liver cell heterogeneity. The zonal heterogeneity changes upon longer lasting physiological and pathological alterations of the metabolic situation such as starvation, diabetes or regeneration after partial hepatectomy; it develops only gradually during the first weeks of postnatal life. The model of 'metabolic zonation' proposes a functional specialization for the two zones: in the periportal zone oxidative energy metabolism with beta-oxidation and amino acid metabolism, ureagenesis, gluconeogenesis, cholesterol synthesis, bile formation and oxidation protection are the predominant activities, and in the perivenous zone glycolysis, liponeogenesis, ketogenesis, glutamine formation and biotransformation are the prevalent processes. PMID- 3530740 TI - A current genotoxicity database for heterocyclic thermic food mutagens. I. Genetically relevant endpoints. AB - Cooking, heat processing, or pyrolysis of protein-rich foods induce the formation of a series of structurally related heterocyclic aromatic bases that have been found to be mutagens. The primary genetic assay utilized to detect and isolate these mutagens has been the his reversion assay in Salmonella typhimurium. The classification and nomenclature of these chemicals is revised to reflect recent advances. The findings of short-term tests for genetic injury that have been applied to these agents are presented in a systematic way. Cell-free, bacterial, mammalian cell culture, and in vivo systems are included. Major results, the mutagens tested, and key references are presented in tabular form, with text commentary. Integrated conclusions on the state of current knowledge of the genetic toxicity of thermic food mutagens are presented. Areas in need of further research are defined. Finally, an outline is presented of a suggested path leading to the determination whether normal methods of food preparation and processing constitute a human health hazard. PMID- 3530742 TI - Health care and the poor: psychological implications of restrictive policies. AB - Medicaid proposals increasingly focus on cost-saving strategies that restrict clients' control over where and when they may receive services. This study used a field experiment in an urban welfare office to examine the possible effects of two aspects of restrictive policies: the loss of choice of providers and adverse patient mix (i.e., when the majority of a provider's clients are Medicaid beneficiaries). Results indicate that health care presented within the context of not having a choice is derogated and that choice and patient mix combine to influence intentions to seek care. Persons who did not choose the health plan in a simulated choice, who had fewer choices than expected, and who did not accept restricted choice also had negative perceptions. PMID- 3530743 TI - What else could I have done? Patients' responses to failed treatment decisions. AB - Successful and failed renal transplant patients were compared concerning their perceptions of the initial decision to undergo transplantation. Results suggest that, relative to successful transplant patients, failed transplant patients recalled the circumstances of the initial decision in a manner that lessened personal responsibility for that decision. In essence, they indicated that they had had little choice but to make the decision they had made. There was slight evidence that failed transplant patients diffused responsibility for the decision or its outcome onto others. Implications for patient involvement in medical decision making and for the informed consent procedure are discussed. It is concluded that cognitive factors may play a role in undermining possible self recrimination following failed treatment decisions in which a patient has been involved. PMID- 3530744 TI - Review of large intestinal motility and mechanisms of impaction in the horse. AB - The large intestine has distinct motility patterns which include non-rhythmic haustral kneading of ingesta and stronger rhythmic retropulsive and propulsive contractions which move ingesta along the tract. A variable site electrical pacemaker exists at the pelvic flexure where the strong rhythmic contractions begin. The large intestine can contract adequately with only the intrinsic nerve supply intact. Neurotransmitters have profound effects on large intestinal activity. PMID- 3530745 TI - Identification and characterization of the protein encoded by the human c-myb proto-oncogene. AB - We have identified the product of the human c-myb proto-oncogene as a 80,000-Mr protein, p80c-myb, by using polyclonal and monoclonal antibodies raised against a bacterially synthesized polypeptide from the amino terminus of the viral myb protein. p80c-myb shares at least two distinct antigenic sites with the amino terminal region of the v-myb protein. p80c-myb is found only in hematopoietic cells or in cells that contain amplified c-myb genes. Like the chicken myb proteins, p80c-myb is a nuclear DNA-binding protein that is predominantly associated with chromatin and exhibits a short half-life of approximately 1 hour. PMID- 3530737 TI - Chemical carcinogens: a review of the science and its associated principles. U.S. Interagency Staff Group on Carcinogens. AB - In order to articulate a view of chemical carcinogenesis that scientists generally hold in common today and to draw upon this understanding to compose guiding principles that can be used as a bases for the efforts of the regulatory agencies to establish guidelines for assessing carcinogenic risk to meet the specific requirements of the legislative acts they are charged to implement, the Office of Science and Technology Policy, Executive Office, the White House drew on the expertise of a number of regulatory agencies to elucidate present scientific views in critical areas of the major disciplines important to the process of risk assessment. The document is composed of two major sections, Principles and the State-of-the-Science. The latter consists of subsections on the mechanisms of carcinogenesis, short-term and long-term testing, and epidemiology, which are important components in the risk assessment step of hazard identification. These subsections are followed by one on exposure assessment, and a final section which includes analyses of dose-response (hazard) assessment and risk characterization. The principles are derived from considerations in each of the subsections. Because of present gaps in understanding, the principles contain judgmental (science policy) decisions on major unresolved issues as well as statements of what is generally accepted as fact. These judgments are basically assumptions which are responsible for much of the uncertainty in the process of risk assessment. There was an attempt to clearly distinguish policy and fact. The subsections of the State-of-the-Science portion provide the underlying support to the principles articulated, and to read the "Principles" section without a full appreciation of the State-of-the-Science section is to invite oversimplification and misinterpretation. Finally, suggestions are made for future research efforts which will improve the process of risk assessment. PMID- 3530746 TI - The bacteriophage T4 gene for the small subunit of ribonucleotide reductase contains an intron. AB - The bacteriophage T4 gene nrdB codes for the small subunit of the enzyme ribonucleotide reductase. The T4 nrdB gene was localized between 136.1 kb and 137.8 kb in the T4 genetic map according to the deduced structural homology of the protein to the amino acid sequence of its bacterial counterpart, the B2 subunit of Escherichia coli. This positions the C-terminal end of the T4 nrdB gene approximately 2 kb closer to the T4 gene 63 than earlier anticipated from genetic recombinational analyses. The most surprising feature of the T4 nrdB gene is the presence of an approximately 625 bp intron which divides the structural gene into two parts. This is the second example of a prokaryotic structural gene with an intron. The first prokaryotic intron was reported in the nearby td gene, coding for the bacteriophage T4-specific thymidylate synthase enzyme. The nucleotide sequence at the exon-intron junctions of the T4 nrdB gene is similar to that of the junctions of the T4 td gene: the anticipated exon-intron boundary at the donor site ends with a TAA stop codon and there is an ATG start codon at the putative downstream intron-exon boundary of the acceptor site. In the course of this work the denA gene of T4 (endonuclease II) was also located. PMID- 3530747 TI - Increase in rat intestinal permeability to endotoxin during hyperthermia. AB - Victims of heat stroke exhibit several clinical features which are also encountered in endotoxaemia. In order to investigate these similarities hyperthermic rats were used to explore the possibility that high body temperature results in increased permeability of intestinal wall to endotoxin. 125I endotoxin was introduced into intestinal segments taken from non-heat exposed rats. The segments were then incubated at 37 degrees C or 45 degrees C. Intestinal segments from heat stressed rats were similarly prepared and incubated at 37 degrees C. Leakage of endotoxin from segments taken from heat stressed rats was three times greater than from those from non-heat stressed rats, as were the segments from non-heat stressed rats which were incubated at 45 degrees C. These results indicate that the intestinal membrane is damaged by heat and that an increase in outward leakage of microbial endotoxins from the gut then occurs. This might contribute to the pathophysiological picture of heatstroke. PMID- 3530749 TI - In vitro killing of erythromycin-exposed group A streptococci by polymorphonuclear leukocytes. AB - After exposure to erythromycin, group A streptococci were tested for susceptibility to the antimicrobial activity of human peripheral blood neutrophils in the absence of the antibiotic. Bacterial susceptibility to phagocytic killing increased after prior exposure to supra-inhibitory levels of erythromycin for even as brief as three minutes. Extended exposure and higher concentrations of erythromycin increased phagocytic killing. Although the degree of sensitization varied in different strains of streptococci, all strains tested were significantly more susceptible to phagocytic killing after erythromycin exposure. Killing of erythromycin-treated bacteria that occurred in the absence of antibiotic was dependent upon internalization of the bacteria. Thus, the brief exposure of group A streptococci to inhibitory levels of erythromycin increases their susceptibility to phagocytic killing by peripheral blood neutrophils. PMID- 3530750 TI - Diagnosis of systemic candidiasis: development of co counterimmunoelectrophoresis. AB - To improve the results of counterimmunoelectrophoresis for serological diagnosis of candidiasis, a new method was devised to characterize human sera precipitins: co-counterimmunoelectrophoresis. Cellulose acetate was chosen as the support in order to observe identity reactions between precipitin lines from serum systems run conjointly (thus, co-counterimmunoelectrophoresis). Different experimental antisera (anti-somatic and anti-cytoplasmic antigens and anti-whole fixed germ tube antisera) were tested for reactions of identity with sera from selected patients with systemic candidiasis caused by Candida albicans. The reaction of patient sera and anti-germ tube antiserum with a selected somatic antigen always resulted in an identity reaction as proven by the continuity of major precipitin lines. The precipitating system, named the co-specific precipitin line, involved polysaccharide antigens; it was not present in human control sera. PMID- 3530748 TI - New developments in the diagnosis of opportunistic fungal infection. AB - This review considers recent developments in the diagnosis of aspergillosis, candidosis and cryptococcosis and discusses the prospects for routine application of a number of novel methods. The introduction of lysis-centrifugation and radiometric methods for blood culture has improved the diagnosis of deep candidosis, but the value of these methods for the diagnosis of aspergillosis has not yet been determined. Recent developments in serological diagnosis have included the evaluation of newly discovered antigens of Candida albicans in an attempt to distinguish colonization from significant infection. Antigen detection, an established method for the diagnosis of cryptococcosis, has also been evaluated and appears promising for the diagnosis of aspergillosis and candidosis. Another promising approach has been the use of gas-liquid chromatography to detect fungal metabolites in serum and other host fluids. PMID- 3530751 TI - Diagnosis of systemic candidiasis: application of co counterimmunoelectrophoresis. AB - The accuracy of co-counterimmunoelectrophoresis was compared with mycological and clinical data for different groups of inpatients. The specificity and sensitivity of this method ranged from 100 to 69%. The co-specific precipitin line was observed during systemic infections caused by most opportunistic Candida species. The variations in the line in successive serum samples provided a simple means of serological surveillance. The test also detected seroconversion. The gradual disappearance of the line reflected a favourable prognosis, whereas its abrupt disappearance indicated unfavourable prognosis and correlated with the appearance of detectable circulating antigens. PMID- 3530752 TI - Evaluation of the biomed bacteroides IF kit for identification of Bacteroides fragilis group strains. PMID- 3530753 TI - Contaminated lemons as possible source of infection in heroin abusers with disseminated candidiasis. PMID- 3530754 TI - Characterization of the phosphoproteins of Escherichia coli cells by electrophoretic analysis. AB - The phosphorylated proteins of Escherichia coli, radioactively labeled with [32P]orthophosphate, have been analyzed by the O'Farrell gel technique and autoradiography. The effects of various culture conditions on the pattern of protein phosphorylation have been studied, including growth on different carbon sources in either exponential or stationary phase, treatment of cells with ethanol, heat shock and amino acid starvation. A total number of 128 different phosphoproteins, labeled to a varying extent, have been detected and each of them has been characterized by both its molecular mass and isoelectric point. These proteins are located mainly in the cytosolic fraction of cells, none of them being present within either ribosomes or nucleoids, and only three being associated with membranes. Analysis of their phosphoamino acid content has shown that they are phosphorylated mostly at serine residues and, less frequently, at threonine and tyrosine residues. PMID- 3530755 TI - Prokaryotic features of a nucleus-encoded enzyme. cDNA sequences for chloroplast and cytosolic glyceraldehyde-3-phosphate dehydrogenases from mustard (Sinapis alba). AB - Two cDNA clones, encoding cytosolic and chloroplast glyceraldehyde-3-phosphate dehydrogenases (GAPDH) from mustard (Sinapis alba), have been identified and sequenced. Comparison of the deduced amino acid sequences with one another and with the GAPDH sequences from animals, yeast and bacteria demonstrates that nucleus-encoded subunit A of chloroplast GAPDH is distinct from its cytosolic counterpart and the other eukaryotic sequences and relatively similar to the GAPDHs of thermophilic bacteria. These results are compatible with the hypothesis that the nuclear gene for subunit A of chloroplast GAPDH is of prokaryotic origin. They are in puzzling contrast with a previous publication demonstrating that Escherichia coli GAPDH is relatively similar to the eukaryotic enzymes [Eur. J. Biochem. 150, 61-66 (1985)]. PMID- 3530756 TI - Relationship between the cysteine-proteinase-inhibitory function of rat T kininogen and the release of immunoreactive kinin upon trypsin treatment. AB - The potential kininogenic function of rat T kininogen has been studied in parallel with the cysteine-proteinase-inhibitory function also carried by this molecule. Proteolytic cleavage of the molecule was observed upon incubation with catalytic amounts of trypsin. These conditions do not permit any significant release of immunoreactive kinin and do not modify the total papain-inhibiting capacity of T kininogen. As trypsin concentration increases in the reaction mixture, immunoreactive kinin is liberated and the total papain-inhibiting capacity decreases accordingly, as indicated by titration studies. This decrease, however, does not exceed 50% of the initial value even at a trypsin concentration as high as 75 microM, indicating that only one of the two inhibitory sites has been inactivated. The remaining inhibitory fragment corresponds to a peptide of apparent Mr 24 000, which binds papain at least as well as native T kininogen. T kininogen, therefore, appears as a potent proteinase inhibitor and/or a proteinase inhibitor precursor, whereas its kininogenic function remains questionable since no specific kininogenase able to release T kinin or another kinin under physiologically compatible conditions has been found so far. PMID- 3530757 TI - Gastric inhibitory polypeptide receptor in hamster pancreatic beta cells. Direct cross-linking, solubilization and characterization as a glycoprotein. AB - 125I-labelled gastric inhibitory polypeptide (125I-GIP) is directly cross-linked to its specific receptor in hamster pancreatic beta cell membranes by using an ultraviolet irradiation procedure. This approach results in the identification of a GIP-protein complex of apparent Mr 64,000. The labelling of this protein species is specific since it is inhibited when incubating the membranes with increasing doses of native GIP (0.1 nM-1 microM) together with 125I-GIP, half maximal inhibition being elicited by 5 nM peptide. Reduction of the GIP-protein complex by 100 mM dithiothreitol induces a decrease of the electrophoretic mobility of the complex. Alternatively pretreatment of membranes with dithiothreitol (up to 1 M) does not prevent the binding of 125I-GIP to its receptor. When prelabelled membranes are extracted by 0.5% Triton X-100 (v/v) and the extract is layered on a Sephadex G-50 column, a high peak of radioactivity is eluted with the void volume of the column. Treatment of this peak by 10 min ultraviolet irradiation followed by SDS-PAGE leads to identification of a major band of Mr 64,000. When the peak is further layered on Sephacryl S-200 it yields a single peak of radioactivity corresponding to a protein species with a Stokes radius of 3.2 nm and an apparent Mr of 65,000. The solubilized GIP-receptor complex is specifically adsorbed by Sepharose coupled to wheat germ agglutinin and concanavalin A and eluted from these lectins by their respective sugars. In conclusion the GIP receptor in pancreatic beta cells is a protein monomer of apparent Mr 59 000; its structure is maintained by intrachain disulfide bridges, these bonds being, however, not involved in the interaction of GIP with its receptor; the GIP receptor is a glycoprotein containing N-acetylglucosamine, mannose and probably sialic acid in its carbohydrate moiety. PMID- 3530758 TI - The light-dependent accumulation of the P700 chlorophyll a protein of the photosystem I reaction center in barley. Evidence for translational control. AB - The light-dependent accumulation of the P700 chlorophyll a protein of the photosystem I reaction center has been studied in greening barley (Hordeum vulgare L.) seedlings. Immunoblot analysis of total cellular protein fractions and immunogold labelling of the P700 chlorophyll a protein in ultrathin sections of Lowicryl-embedded leaf tissue revealed that the concentration of this chlorophyll-binding protein in plastids of dark-grown barley seedlings is below the limit of detection. Upon illumination with white light, a rapid accumulation of this protein is induced. This light effect seems not to be regulated at the level of transcription. The gene for the P700 chlorophyll a protein has been mapped within the large single-copy region of the plastid DNA of barley. High levels of transcripts of this gene are present already in dark-grown seedlings and remain fairly constant throughout an extended illumination period. Polysomes were isolated from etioplasts and chloroplasts. The same high relative concentration of mRNA encoding the P700 chlorophyll a protein was present in both polysome fractions. This result suggests that the light-dependent accumulation of the P700 chlorophyll a protein during chloroplast formation in barley seedlings is regulated at the translational, or posttranslational, level. PMID- 3530759 TI - Carbohydrate-dependent induction of fatty acid synthase in primary cultures of rat hepatocytes. AB - The glucose and insulin-dependent long-term regulation of fatty acid synthase was studied in primary cultures of hepatocytes from adult female rats. Under basic culture conditions, i.e. 5.5 mM glucose and 0.5 nM insulin, the enzyme activity was continuously decreased over 6 days. In the presence of 100 nM insulin this decrease was reduced but it was not prevented. Enhancement of glucose to 20 mM was followed by an increase of the enzyme activity; after 5 days of treatment the activity was three times higher than under basic culture conditions. The simultaneous presence of 20 mM glucose and of 100 nM insulin resulted in a much more pronounced increase of the activity; after 5 days of treatment the activity was eight times higher than under basic culture conditions. The enhancement was prevented by inhibition of glycolysis. This may indicate that the increase of fatty acid synthase was mediated by a metabolite of glucose rather than by glucose itself. The coordinate regulation of fatty acid synthase and of other lipogenic enzymes was specific as demonstrated by comparison with the activity of lactate dehydrogenase and with synthesis and degradation of cytosolic proteins. The enhancement of the enzyme protein, demonstrated by rocket immunoelectrophoresis, was due to an increase in the rate of enzyme synthesis by 600% as well as to a prolongation of the apparent half-life of the enzyme by 50% (45 h). PMID- 3530760 TI - Structure predictions and surface charge of nitrogenase flavodoxins from Klebsiella pneumoniae and Azotobacter vinelandii. AB - A first approximation to the tertiary structure of the nitrogenase flavodoxins of Klebsiella pneumoniae and Azotobacter vinelandii can be obtained by superimposing their amino acid sequences upon the crystallographically determined structure of the long-chain flavodoxin from Anacystis nidulans. This procedure is validated by secondary structure predictions based on the sequence alone and by the distribution of polar and hydrophobic residues. It reveals, among other things, a distinctive distribution of surface charge peculiar to the nitrogenase flavodoxins, which is probably important in determining the kinetics of electron transfer with their physiological redox partners. The most likely positions of the phosphodiester bridge which has been described in the A. vinelandii molecule can also be assessed. PMID- 3530761 TI - Immunofluorescence of the microtubular skeleton in growing and drug-treated yeast protoplasts. AB - The microtubular system in growing protoplasts of Saccharomyces uvarum was visualized by immunofluorescence using the monoclonal antitubulin antibody TU 01. We confirmed the coexistence of regular spindle configuration and extensive cytoplasmic networks in growing protoplasts and also observed a distinct distortion of cytoplasmic microtubules in association with wall removal. After a short period for recovery of protoplasts in nutrient medium a restitution of cytoplasmic microtubules and their resumed contact with the protoplast surface was observed. Treatment of growing protoplasts with nocodazole resulted in the disappearance of spindle and cytoplasmic microtubules in the relevant fraction of the protoplast population. In carbendazime (MBC)-arrested protoplasts spindle microtubules were absent but cytoplasmic microtubules associated with spindle pole bodies were clearly visible. Microtubule reassembly on spindle pole bodies occurred within 30 min after washing out nocodazole as well as carbendazime. The approach using protoplasts suggests a simple way in which the differential effect of antimicrotubule agents can be experimentally tested and the microtubule organizing activity of yeast protoplasts visualized at the population level. PMID- 3530762 TI - Ultrastructure of two secretory mutants of Saccharomyces cerevisiae as revealed by freeze-fracture technique. AB - Permissive and restrictive phenotypes of two secretory mutants of Saccharomyces cerevisiae, sec 1 and sec 18, were studied by freeze-fracture technique. The sec 1 mutant, in addition to accumulating secretory vesicles, was characterized by a disappearance of the plasma membrane invaginations and by an aggregation of intra membrane particles in vacuolar membranes. A prolonged incubation of the cells at 37 degrees C led to pathological fusion of some vesicles with the plasma membrane. After the cells were transferred back to the permissive temperature the invaginations reappeared rapidly while the accumulated vesicles disappeared only after budding had been resumed. The sec 18 mutant, apart from having distended endoplasmic reticulum membranes, also lost the plasma membrane invaginations at 37 degrees C and regained them at 24 degrees C. The described ultrastructural changes are typical for the restrictive phenotypes and represent further manifestations of the pleiotropic effect of the respective sec mutations. PMID- 3530763 TI - Early phorbol ester induced release of cell surface fibronectin: direct observation by photoelectron microscopy. AB - One of the early effects of the phorbol ester tumor promoter 12-0 tetradecanoylphorbol-13-acetate (TPA) on cultured normal fibroblasts is the release of fibronectin into the culture medium. Immunophotoelectron microscopy was used to follow the loss of fibronectin from the upper cell surface of normal human foreskin fibroblasts exposed to TPA. Fibronectin labeled with silver enhanced colloidal gold-antibody conjugates appears in photoelectron images as streak- and network-like patterns of bright dots against the less photoemissive uncoated cell surface. Labeled fibronectin present beneath the culture is not detected due to the surface-specificity of this technique. Ten to 30 min of exposure to 100 ng/ml TPA in culture medium results in a readily visible decrease in upper cell surface fibronectin. In these experiments, 60 min of exposure to TPA releases nearly all upper cell surface fibronectin, leaving only occasional short streaks of label. In contrast, extracellular matrix fibronectin between cells is apparently more resistant to release and can still be seen in photoelectron images even when the upper cell surface appears to be fibronectin free. This immunophotoelectron study shows the distribution of fibronectin on fibroblasts at high resolution and demonstrates that the initial fibronectin release resulting from TPA exposure is at the expense of preexisting cell-surface fibronectin. These results also illustrate the application of photoelectron microscopy as a useful technique in cell biology. PMID- 3530764 TI - Distribution of 125I-insulin in cardiocytes at steady state binding conditions at 37 degrees C. AB - The distribution of 125I-insulin in cardiocytes was analyzed by light microscope autoradiography. Semithin sections were used to distinguish between surface-bound and internalized tracer. At 37 degrees C, when steady state binding conditions were reached, 40 to 60% of the cell-bound tracer was located in the plasma membrane region and the remainder was in the cell interior. Autoradiograms of whole cells were used to study the distribution of tracer molecules on the cell surface. Because Poisson distributions of silver grains were observed on 90% of the cells, it was concluded that the distribution of the insulin-receptor complexes was close to random. In contrast to the findings of Schlessinger et al., no aggregation of insulin-receptor complexes into patches was observed. PMID- 3530765 TI - Non-specific binding of protein-stabilized gold sols as a source of error in immunocytochemistry. AB - The observation that protein-A conjugated gold sols bound to fibronectin-collagen (FNC) fibres in human fibroblast cultures prompted a series of studies on the binding of gold particles stabilized in various ways (Staphylococcal protein A, bovine serum albumin, avidin, streptavidin, gelatin, hemoglobin, polyethylene glycol (MW 20 000), methylcellulose and the nonionic detergent Tween 20) to cell and tissue components, to protein dot blots and SDS-PAGE blots on nitrocellulose paper. We found that binding of gold particles to certain cell and tissue components and to various immobilized proteins did occur irrespective of the stabilizing agent. We argue that, albeit gold sols are stabilized against salt coagulation by adsorption of proteins and other stabilizing agents, "naked areas" are (constantly or intermittently) present on particle surfaces, available for interaction with cell and tissue components that have a high electrostatic affinity for the charged gold surface under prevailing experimental conditions. Non-specific binding may be reduced or abolished by competing proteins (i.e. proteins with a higher affinity for gold than any component in the object studied) provided the proteins and the gold conjugate are present concomitantly during incubation. We found gelatin (Bloom number 60-100) to be an effective competitive protein probably due to its high affinity for gold over a wide pH range. Further, gelatin did not appreciably inhibit the specific interaction in dot blots between SpA and IgG except at very low IgG concentrations. A protocol for the use of gold-protein conjugates to circumvent the hazards of unspecific gold binding is suggested. PMID- 3530766 TI - Orientation response of arterial smooth muscle cells to mechanical stimulation. AB - Arterial smooth muscle cells from rabbit aortic media in primary culture and subculture were grown on hydrophilized and collagen-coated silicone membranes which were then subjected to cyclic and directional stretches and relaxations at a frequency of 60 times/min. The membranes were stretched with various amplitudes ranging from 2% to 20%. Smooth muscle cells on unstretched membranes in the same incubation chamber served as controls. In long-term experiments the stretching and relaxing of the membranes was continued for several days. While the smooth muscle cells grown on unstretched membranes remained in random orientation in all experiments, the cells which underwent mechanical stimulation showed a high degree of orientation. The angle of cell orientation varied in direct relation to the stretching amplitude and became steeper in correlation to the intensity of the mechanical stimulus. The angle of cell orientation was reversible, as preoriented cells changed their orientation when another stretching amplitude was applied. To study the role of cytoskeleton in the process of cell orientation, we examined the behaviour of the intracellular actin filament system. In short-term experiments the smooth muscle cells were exposed for 3 to 12 h to cyclic and directional stretches and relaxations with an amplitude of 10%. We observed a rearrangement of the intracellular actin filament system prior to the orientation of the whole cell bodies. The present study provides evidence that stretching the artery wall by blood pulsation may result in an orientation response of the intracellular actin cytoskeleton and in the orientation of the smooth muscle cells within the media of artery walls. PMID- 3530767 TI - On a possible role for calcium antagonists in atherosclerosis. A personal view. AB - An overview is provided of current thinking regarding the origin(s) of atherosclerosis on the basis of clinical evidence, experimental models and pharmacological investigations with calcium antagonists. Because this group of drugs inhibits the influx of Ca2+ into the smooth muscle cell of the cardiovascular wall, it has been argued that when endothelial damage is anticipated or has occurred, the 'protective' action of calcium antagonists might avoid, delay or even help to repair the calcium overload seen with cell membrane damage. In the real world the situation must be far more complex as will become evident but as a concept the avoidance of Ca2+ overloading is enticing. In fact, based on circumstantial evidence, a major clinical trial is currently in progress in which the long term effect of nifedipine on coronary atherosclerosis is being evaluated in a double blind randomized fashion. The end-point of this study lies in the reduction of the severity and number of coronary artery lesions. Although not yet completed, the design and goals of that study are provided. PMID- 3530768 TI - Withdrawal of long-term amrinone therapy in patients with congestive heart failure: a placebo controlled trial. AB - To verify favourable long-term effects, 14 patients with chronic congestive heart failure, NYHA class II-IV, who had been treated with oral amrinone for 8-15 months with apparent clinical benefit, had the drug withdrawn according to a 12 week placebo controlled double-blind crossover protocol. Evaluation was performed noninvasively by means of exercise stress test, echocardiogram, radionuclide angiography and systolic time intervals. None of these variables were significantly changed after discontinuation of amrinone, regardless of whether placebo was introduced during the first (group B, N = 7) or the second 6 week period (group A, N = 5), nor when the medication was finally openly withheld for another 6 weeks. In 2 further group A patients, premature termination of the trial was due to deterioration of symptoms on blinded amrinone. Hence, no sustained drug related effects could be proven by controlled withdrawal of long term amrinone in this trial. PMID- 3530769 TI - Calcium antagonists in secondary prevention after acute myocardial infarction: the Secondary Prevention Reinfarction Nifedipine Trial (SPRINT). AB - SPRINT was a double-blind, randomized placebo controlled multi-centre trial based in Israel, designed to test whether nifedipine 10 mg X 3 daily would reduce morbidity and mortality during 1 year follow-up in 2279 male and female survivors of acute myocardial infarction. 335 patients were adjudged to be trial deviations. 130 (5.7%) of patients died and 105 (4.6%) experienced a non-fatal myocardial reinfarction. Analysis of the results by trial medication is awaited. PMID- 3530770 TI - 90-minute 99mTc-MDP scintigraphy and 131I-hippuran renography in recently allotransplanted kidneys: evaluation of renal ischemia. AB - Renal ischemic damage in 31 transplanted kidneys was evaluated by renal scintigraphy with 99mTc-methylene diphosphonate and 131I-hippuran renography. The renal uptake of phosphate was monitored for 100 s at 10-min intervals during 90 min following injection. The average uptake of radioactivity in the graft on the 60-, 70-, 80-, and 90-min scintigram was calculated. Grafts with an average uptake of 99mTc-MDP of 150% or below had a significantly more frequent onset of function within the first 3 days following operation than grafts with an average uptake above 150%. Renography was shown to be an equally good method for predicting the onset of function. The success rate (correct prediction of onset of function) was almost equal for the two methods, but in 11 patients the results of the two methods diverged. An obvious degree of overlap limits the usefulness of both methods in any one particular patient. It is concluded that renal scans with 99mTc-MDP and 131I-hippuran renography are complementary in the assessment of ischemic damage following transplantation. PMID- 3530771 TI - Effect of glucose and insulin infusion on the myocardial extraction of a radioiodinated methyl-substituted fatty acid. AB - We investigated the one-way, AV extraction of 14-iodophenyl-tetradecanoic acid (BMTDA) in the canine heart under fasting conditions and during infusion of glucose plus insulin in eight anesthetized greyhound dogs. Myocardial extraction measurements were made with dual tracer approach, using Tc-99m albumin as reference tracer. Prior to, and during, infusion of 10% glucose and 25 units of regular insulin, heart rate, blood pressure, plasma glucose, insulin and free fatty acid levels were measured. Myocardial blood flow was determined using Sn 113 and Ru-103 radioactive microspheres. The mean extraction fraction of BMTDA was 0.38 +/- SEM 0.06 at baseline and increased to 0.44 +/- 0.06 during hyperglycemia plus insulin (P less than 0.025). Plasma glucose and insulin were higher during the infusion (P less than 0.01) while plasma free fatty acids significantly declined (P less than 0.01). There were no changes in hemodynamics or myocardial blood flow during the infusion. We conclude that glucose and insulin infusion result in increased first-pass extraction fraction of radioiodinated BMTDA unaccompanied by changes in coronary flow or hemodynamics, implying an insulin-mediated augmented transport of BMTDA. PMID- 3530772 TI - An autoradiographic study of bone grafts in small animals. AB - Bone remodelling was studied in allografts and isografts by means of autoradiography. Collagen and proteoglycans of the organic bone matrix were labelled with H-3 amino acids and S-35 sodium sulphate. The principles of primary bone formation are followed in graft remodelling as well. Matrix breakdown and reformation are carried out by mononuclear cells. Components of the original matrix can be seen in osteoclasts, perivascular cells, osteoblasts, young osteocytes, and in new bone. The label allows tracing of these components and proves their reuse. PMID- 3530773 TI - Pharmacopsychological effects of flunarizine in geriatric patients with light brainorganic psychosyndrome. Preliminary communication. AB - The effects of the cerebral calcium antagonist flunarizine in 50 geriatric patients with light brainorganic psychosyndrome were determined in the course of a 12 weeks' placebo-controlled pharmacopsychological double-blind study. Factor analysis on the basis of 19 individual psychological tests served as multivariate evaluation model. Advantages of flunarizine became evident in factors 1 (contentedness), 3 (alertness) and 4 (good memory/sound sleep). The increased performance (factor 2) in both groups may well be due to a training effect and would, therefore, be artificial. PMID- 3530774 TI - Calcium and ischemic brain damage. AB - An account is given of calcium metabolism in the brain, with particular reference to the possibility that loss of calcium homeostasis is the cause of ischemic neuronal necrosis. The hypothesis of calcium-related cell damage is based on the fact that dense ischemia leads to an influx of calcium into cells, and that raised intracellular calcium concentrations activate lipases and proteases, and cause disaggregation of neurotubuli and enhanced protein phosphorylation. Such changes have the potential of inducing membrane damage and dysfunction of intracellular transport mechanisms. An attempt is made to critically review available evidence on the calcium hypothesis of cell death. PMID- 3530775 TI - Role of calcium entry blockers in the prophylaxis of migraine. AB - Published double-blind studies of the effectiveness of Ca2+ entry blockers in migraine prophylaxis are critically reviewed. The evidence in case of flunarizine is satisfactory, and the drug exerts few and minor side effects. Nimodipine also seems to be effective, but the evidence is not quite satisfactory. The interpretation of two studies with verapamil is hampered by serious methodological problems, and the evidence is clearly insufficient to recommend the use of verapamil in migraine prophylaxis. Mechanisms of action are understandable in classic migraine, but still completely unknown in common migraine. Ca2+ entry blockers open up new and fascinating aspects of migraine research. PMID- 3530776 TI - Calcium entry blockers in the treatment of vertebrobasilar insufficiency. AB - The influence of different calcium entry blockers on the vestibular system was investigated. The paper reports results from animal experiments and also from clinical studies with flunarizine and nimodipine. An animal experimental model of vertebrobasilar insufficiency was developed. The effect of the two drugs on the vestibular nystagmus was studied in Alsatian dogs before and after occluding one vertebral artery. In order to analyze the influence of the drugs on the vestibular nystagmus and on the clinical symptoms in patients with vertebrobasilar insufficiency, different open and double-blind studies were performed. PMID- 3530777 TI - Treatment of vasospasm due to subarachnoid hemorrhage with calcium entry blockers. AB - Cerebral vasospasm is the most important factor causing neurological deterioration later than 72 h after subarachnoid hemorrhage (SAH). The few clinical studies investigating the effect of calcium entry blockers on SAH demonstrate that patients treated with nimodipine have a better clinical outcome. The experimental data do not explain the mechanism of the observed clinical effect. Nimodipine does not reverse large vessel spasm, but it seems that it dilates microvessels and that it exerts a protective effect on nervous tissue by influencing metabolic processes not yet known. PMID- 3530778 TI - Add-on therapy in epilepsy with calcium entry blockers. AB - In view of the known role of Ca2+ in the paroxysmal depolarization shifts of epileptic neurones, the possibility arises that certain Ca2+ entry blockers possess antiepileptic activity. The only drug of the class which readily passes the blood-brain barrier is flunarizine. This is effective in experimental models of epilepsy and produced significant seizure reduction in two therapeutic trials in therapy-resistant patients. It has few and mild side effects at therapeutic blood levels. PMID- 3530779 TI - Orthotopic liver transplantation in pigs without cold perfusion of the donor liver. Evaluation by quantitative liver function tests. AB - Orthotopic liver transplantation (OLT) was performed in 12 pigs and liver function assessed before and after transplantation. In 6 pigs OLT was carried out without cold perfusion of the donor liver, whereas in the other 6 animals the donor organ was perfused in situ. 5/6 animals without perfusion and 4/6 with cold perfusion survived for more than 10 days. Significantly better liver function was revealed by the aminopyrine breath test (ABT) and the indocyanine green (ICG) disappearance in the group with the cold perfusion of the liver, whereas no differences in routine liver function tests were seen between the two groups. Although OLT without cold perfusion of the donor liver is feasible and prolonged survival of animals is possible, the function of these organs is markedly reduced compared to the cold perfused organs. This method can, therefore, not be recommended. ABT and ICG disappearance are sensitive tests for the evaluation of the liver function in the post-transplant period. PMID- 3530780 TI - Therapeutic traditions in Northern Ireland, Norway and Sweden: I. Diabetes. WHO Drug Utilization Research Group (DURG). AB - A questionnaire survey was carried out to explore differences in the approach to treatment of patients with Type II diabetes between physicians in Northern Ireland, Norway and Sweden, and to discover to what extent it could account for the three-fold difference in drug use between the countries. A representative sample of 400 physicians in each country was asked to give their opinions on the choice of therapy for three model cases designed to cover the spectrum of treatment - from diet alone to insulin. Significantly more Swedish (65%) than Northern Irish (51%) and Norwegian (52%) doctors suggested diet alone for uncomplicated diabetes recently discovered in a middle aged, overweight man. For symptomatic diabetes in a 76 year old over-weight woman with few retinal microaneurysms, the majority of physicians in all three countries suggested treatment with sulphonylureas. Biguanides were here a more common alternative in Northern Ireland than in Scandinavia. For suspected secondary treatment failure in a 63 year old woman with no signs of complications, insulin was suggested by 71% of the Norwegian doctors but only by 44 and 49% of those in Northern Ireland and Sweden, respectively. General practitioners tended to suggest oral treatment earlier and to maintain it longer than hospital physicians. The study has demonstrated significant differences in the approach to treatment of Type II diabetes mellitus between physicians in the three countries. However, the differences were more prominent in the choice of drugs than in the threshold of drug treatment.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3530781 TI - The effect of bucindolol on the airway function of asthmatics. AB - The airway and cardiovascular effects of separate single oral doses of 50, 100 and 200 mg of bucindolol were compared to those of placebo in a double-blind trial in 16 patients with mild to moderately severe asthma. Heart rate (HR), blood pressure (BP), forced vital capacity (FVC), forced expired volume in one second (FEV1), maximum expiratory flow at 50% of vital capacity (FEF50) and maximum expiratory flow at 75% of expired vital capacity (FEF75) were measured before and at intervals for 4h, when salbutamol (200 micrograms) was inhaled and the measurements repeated 15 min later. There was an interval of at least 4 days between each drug treatment day. Four of the 16 patients developed clinically significant bronchoconstriction with 50 mg (3) or 100 mg (1) of bucindolol and were withdrawn from the study. The remaining patients showed impaired bronchodilator response to salbutamol for each bucindolol dose as compared to placebo. No significant BP or HR effects were measured. Two patients withdrew because of circumstances unrelated to bucindolol induced bronchoconstriction. The development of bucindolol induced bronchoconstriction in this group of mild to moderate asthmatics was not predicted by the level of baseline pulmonary function, or the level of histamine responsiveness. However, there was a weak relationship between bucindolol induced bronchoconstriction and salbutamol induced bronchodilation. There are no definitive asthmatic characteristic to predict the likelihood of significant bucindolol induced bronchoconstriction in this asthmatic population. PMID- 3530782 TI - Dosage adjustment for ceftazidime in patients with impaired renal function. AB - Ceftazidime has good antibacterial activity against many Gram-negative micro organisms including Ps. aeruginosa. The aim of the present study was to calculate a dosage adjustment regimen for renal failure patients and to test it in a second group of patients. A study was made of the pharmacokinetics of ceftazidime 1 g given as a single bolus i.v. injection in 20 patients in an intensive care unit with varying degrees of renal function, including patients on regular haemodialysis. The serum half-life of elimination (t1/2 beta) varied from 1.6 to 45 h depending on renal function. During haemodialysis the mean t1/2 was 4.7 h. A good correlation between the renal clearance of creatinine and ceftazidime was observed. In most patients protein binding was lower than previously observed. From the pharmacokinetic data, a dosage adjustment regimen for patients with renal insufficiency was calculated, which studies in 7 further patients showed to be effective. PMID- 3530783 TI - Interaction between cyclosporin and erythromycin in a kidney transplant patient. PMID- 3530784 TI - Ligand binding by the p150,95 antigen of U937 monocytic cells: properties in common with complement receptor type 3 (CR3). AB - U937 cells (a monocytic cell line) grown in the presence of phorbol myristate acetate were surface labeled with 125I and the iC3b-binding proteins isolated by affinity chromatography on iC3b-Sepharose in the presence of divalent cations. Three polypeptides of 170, 150 and 95 kDa were found to bind specifically to iC3b Sepharose. The polypeptides of 170 and 95 kDa were identified as the alpha and the beta subunits of CR3 by immunoprecipitation with OKM1 monoclonal antibody. The 150-kDa polypeptide was not immunoprecipitated by antibodies to the alpha subunit of CR3 or LFA-1. However, the 150-kDa polypeptide, together with the 95 kDa polypeptide, was immunoprecipitated with an anti-beta subunit-specific antibody IB4, which immunoprecipitates LFA-1, CR3 and p150,95. These results indicated that the 150-kDa polypeptide is the alpha subunit of the p150,95 antigen. The binding of p150,95 and CR3 to iC3b-Sepharose is specific as neither binds to C3u-Sepharose. A monoclonal antibody, 3.9, which immunoprecipitated the 150 and a 95-kDa polypeptide from U937 cells was characterized as being directed against the alpha-subunit of the p150,95 antigen. Phorbol myristate acetate stimulated U937 cells from rosettes with EAC3b and EAiC3b but not with EAC3d cells. Monoclonal antibody 3.9 does not inhibit either type of rosetting, but we were unable to exclude a role for p150,95 in adherence of iC3b-coated particles. Since there is no rosetting with C3d-bearing particles it is unlikely that p150,95 is a receptor for C3d, a role for p150,95 which has been suggested by others (Wright, S.D., Licht, M.R. and Silverstein, S.C., Fed. Proc. 1984. 43: 413). PMID- 3530785 TI - Release of eicosanoids from isolated lungs of guinea-pigs exposed to pure oxygen: effect of dexamtethasone. AB - The effect of dexamethasone on bradykinin-induced release of eicosanoids from isolated lungs of guinea-pigs exposed to pure oxygen (O2) is described. Pathological changes were induced in the lungs of guinea-pigs exposed to pure O2 for 72 and 96 h. Bradykinin-induced release of 6-oxo-PGF1 alpha and thromboxane B2 (TXB2) was increased in lungs from guinea-pigs exposed to 72 and 96 h of O2. Removal of PGI2 and PGE2 was not affected by the exposure to O2, but the removal of bradykinin was significantly reduced after 96 h of O2 exposure. Dexamethasone did not reduce bradykinin-induced release of eicosanoids from lungs of control animals, but it did inhibit the release from lungs of guinea-pigs exposed to O2. Dexamethasone had no effect on the metabolism of Bk by the inflamed lungs. PMID- 3530786 TI - Systemic synthesis of prostaglandin I2 following sustained infusion of angiotensin II in conscious dogs. AB - Acute infusion of pharmacological doses of angiotensin II stimulates the release of prostaglandin I2 (PGI2), which may modulate the vasoconstrictor response. It is uncertain whether sustained small increases in the plasma concentration of angiotensin II has the same effect. To investigate this further, low doses of angiotensin II were infused into conscious sodium replete dogs for 3 h. PGI2 synthesis was assessed by measurement of a major metabolite of PGI2, 2,3-dinor-6 keto PGF1 alpha, in urine and plasma, using gas chromatography mass spectrometry. Angiotensin II infusion (15 ng/min per kg body weight) resulted in a 3-fold increase in plasma angiotensin II (50.8 +/- 5.4 to 149 +/- 11.2 pg/ml, P less than 0.01). Mean blood pressure increased (84.8 +/- 4.3 to 108 +/- 4.7 mm Hg, P less than 0.02) and renal blood flow decreased (201 +/- 46 to 127 +/- 13 ml/min, P less than 0.01) throughout the infusion. However there was no change in either the plasma concentration (11.3 +/- 2.5 to 9.1 +/- 1.0 pg/ml) or rate of urinary excretion of dinor-6-keto PGF1 alpha (1.75 +/- 0.28 to 1.85 +/- 0.41 ng/30 min) during the angiotensin II infusion. The results suggest that small sustained elevations of the plasma concentration of angiotensin II such as are likely to occur in conscious animals, do not persistently stimulate release of PGI2 in the systemic circulation. PMID- 3530787 TI - Role of bradykinin for orthostatic hypotension in diabetes mellitus. AB - A possible contribution of circulating kinin for orthostatic hypotension (OH) in diabetic patients was investigated using a sensitive RIA of plasma bradykinin (BK). Thirty six diabetics underwent 10 min of orthostasis, in which 20 patients developed OH. The baseline plasma BK was 15.8 +/- 1.8 pg/ml in diabetics with OH, which increased to 31.0 +/- 5.6 pg/ml (p less than 0.05). The basal plasma BK was 19.4 +/- 4.1 and 17.8 +/- 2.3 pg/ml in normal subjects (n = 10) and in diabetics without OH (n = 16), respectively. These values were not significantly different from the diabetics with OH. In response to standing there were no significant changes in plasma BK in both groups. There was a significant correlation between the absolute increment of plasma BK and the decrement of systolic blood pressure (BP) when all diabetic patients were compared (r = -0.364, p less than 0.05). The baseline PRA and plasma norepinephrine (NE) were similar in normal subjects and diabetics with or without OH. In response to standing there were approximately two-fold increases in PRA and plasma NE. There was no significant correlation between plasma NE increment and the fall in systolic BP. These results suggest that kinins may participate in OH in diabetic patients. PMID- 3530788 TI - Studies on the diurnal variations of 17-hydroxyprogesterone in saliva by enzyme immunoassay in patients with congenital adrenal hyperplasia. AB - The diurnal rhythm of 17-hydroxyprogesterone concentration in the saliva was determined in 11 patients with congenital adrenal hyperplasia ranging in age from 9 to 20 years. A total of 21 tests were performed using a 17-OHP-enzyme immunoassay. The investigations were carried out during normal school or working days. The tests were done 16 times in patients with optimal therapeutic control and 5 times in patients with undertreatment. The concentrations of saliva 17-OHP in the morning were significantly lower after a therapy interval during the night of 8 hours than of more than 10 hours. In patients with poor substitution all values of the days were higher than in patients with optimal therapy control. The morning values are appropriate for the evaluation of the therapy control. With regular 8 hours' therapy intervals the limit between normal and pathological values may be about 500 pmol/l saliva. PMID- 3530789 TI - Direct evidence for the non-random localization of mammalian chromosomes in the interphase nucleus. AB - Indirect immunofluorescence staining with human anti-centromere autoantibodies from a patient (LU 851) suffering from the CREST form of scleroderma was used to analyse chromosome topology in interphase nuclei of rat-kangaroo (PTO) and Indian muntjac (IM) cells. In some cells, centromeres were arranged in pairs suggesting association of homologous chromosomes. Clustering of centromeres at one pole of the nucleus (Rabl configuration) and other patterns suggesting higher order organization were also observed. In one fifth of the IM cells it was possible to identify the intranuclear location of each single chromosome on the basis of the morphology of the immunostained centromeres. In 30% of the IM cells in which centromeres could be identified, homologous chromosomes occupied adjacent territories within the interphase chromatin. PMID- 3530791 TI - Sir Frank MacFarlane Burnet 1899-1985. PMID- 3530790 TI - Calcitonin gene-related peptide: occurrence in corneal sensory nerves. PMID- 3530792 TI - Detection performance of normal cats and those lacking areas 17 and 18: a behavioral approach to analyse pattern recognition deficits. AB - The ability of cats to discriminate between two geometrical outline patterns in the presence of superimposed Gaussian visual noise was tested before and after bilateral removal of cortical area 17 and parts of area 18. The detection probability PD was measured as a function of the signal-to-noise ratio for the parameters: noise bandwidth, spatial frequency content and rate of movement of patterns. In both normal and lesioned cats a broadband noise was found to be most effective in masking the large patterns while two other types of noise, a medium frequency noise and a high frequency noise had little or no masking effect. For recognition of the smaller patterns in normal cats the medium frequency noise was found to be more effective than the broadband noise. The performance of the lesional cats was disturbed severely at low signal-to-noise ratios and was significantly inferior to that of normal cats-especially for small patterns. However, at high S/N ratios and for large patterns the performance of the lesioned cats was comparable to that of normals while for the small patterns they reached PD values inferior to those of normal cats. It is concluded that although pattern recognition can be performed successfully by cats lacking areas 17 and 18, these cortical areas probably make an essential contribution to this function under natural conditions in two ways: because of the X-type input of area 17, they increase the acuity of the system by making it more sensitive to higher spatial frequencies, and they permit detection of patterns at much lower S/N ratios i.e. they lower the signal-to-noise ratio at which the system is able to detect the presence of a pattern in a background of statistical visual noise. The latter effect is not limited to the higher spatial frequencies but also affects the very low spatial frequencies which are normally used for pattern detection. Previous failures to demonstrate clear deficits in pattern discrimination after 17/18 lesions in cats may be attributed to the fact that the patterns presented for discrimination were not masked by visual noise. Movement of patterns led to a slight, but not significant improvement of the performance in both normal and lesioned cats, but the deficits found for stationary and moving patterns were more or less equal. PMID- 3530793 TI - Different patterns of corticopontine projections from separate cortical fields within the inferior parietal lobule and dorsal prelunate gyrus of the macaque. AB - Corticopontine projection patterns were studied after injections of an 3H-leucine and 3H-proline mixture into each of four distinct cortical fields within the inferior parietal lobule and dorsal prelunate gyrus. Different preferential patterns of pontine labeling were observed for each of the four cortical areas studied. Multiple injections across the dorsal aspect of the prelunate gyrus (area DP) yielded scattered patches of label limited to the dorsolateral pontine nuclear region. A single injection within the lateral intraparietal area (area LIP), located in the caudal portion of the lateral bank of the intraparietal sulcus resulted in a series of labeled patches across the dorsal tier of cells stretching across the dorsal portions of the dorsolateral, peduncular and dorsal pontine nuclei. Injection of the cortex on the caudal aspect of the inferior parietal convexity (area 7a) produced multiple patches of label along the lateral margin of the ventral, lateral, and dorsolateral nuclei. Injection of area 7b resulted in label along the lateral aspects of the ventral, lateral and dorsolateral nuclei, as seen with area 7a injections, as well as additional label in the ventromedial portions of the ventral, peduncular and paramedian pontine nuclei. These results provide supporting anatomic evidence for the functional subdivision of the inferior parietal lobule and dorsal aspect of the prelunate gyrus and provide new information about the organization of cortical projections to the primate pontine nuclei. PMID- 3530794 TI - Anti-5-hydroxytryptamine antibodies: studies on their cross-reactivity in vitro and their immunohistochemical specificity. AB - Antibodies to 5-hydroxytryptamine (5-HT) were obtained from 4 rabbits after injections of 5-HT coupled to bovine serum albumin by means of paraformaldehyde (PF). Two methods were used to monitor the development of antibodies (AB): the one based on the "in vitro" competitive binding properties of the antibodies with 3(H)5-HT, the other, on their "in situ" binding properties to endogenous 5-HT, using the peroxidase-anti-peroxidase immunohistochemical technique, applied to paraffin embedded sections of cat brainstem. No pharmacological processing, detergents or proteolytic enzymes were used. The specificity of the antiserum was tested by competitive procedures with 20 analogs using the "in vitro" and "in situ" techniques. "In vitro" studies were performed with 5-HT free analogs and with analogs previously coupled with PF to lysine. Radioimmunological tests showed that the antibodies recognize mainly the ethylamine (CH2-CH2-NH2)-chain of the free analogs and that the best specificity was obtained with the 5-HT conjugate (5-HT-lysine-PF). The results suggest that the hapten is coupled through the phenolic positions C4 or C5. The "in situ" immunohistochemical extinction assays also revealed a distinct specificity for 5-HT. Possible optical and ultrastructural applications are illustrated in the raphe nuclei of the cat. These results confirm the reliability of radioimmunological tests for studying the specificity of AB directed against haptens, provided that haptens and analogs tested were first chemically transformed to resemble the immunogen (herewith lysine-PF coupling) with regard to its antigenic structure. PMID- 3530795 TI - Immunocytochemical demonstration of astrocytes in the eighth cranial nerve of the red-eared turtle. AB - Coronal sections through the eighth cranial nerve and medulla of the red-eared turtle were immunocytochemically stained for the astrocytic intermediate filament protein, glial fibrillary acidic protein. Reaction product appeared in the medial one-third of the eighth cranial nerve fibers as they penetrated the medulla. The remaining two-thirds of the nerve did not show any staining for glial fibrillary acidic protein. The lateral aspect of the nerve corresponds with the extracranial portion of the nerve. When the eighth cranial nerve of the turtle has been transected extracranially it still regenerates into the cochlear nuclei. Results of the present study indicate that the eighth cranial nerve was transected in earlier studies in a region devoid of astrocytes. PMID- 3530796 TI - Inflammation, glycolytic metabolism, and glycosaminoglycans. PMID- 3530797 TI - Calmodulin in epithelial intestinal cells during rat development. AB - Calmodulin was immunocytochemically localized in the brush borders of rat intestinal epithelial cells from the tip to the base of the villi, from day 18 of fetal life up to the adult stage. The early (14th day) fetal cells, like the adult crypt cells, were not immunoreactive, although their calmodulin content was equal to that of the mature cells from the tips of the villi. PMID- 3530798 TI - Myeloma proteins. PMID- 3530799 TI - Biological role of major transplantation antigens in T cell self-recognition. AB - The proposal is made, illustrated and supported by experimental evidence that T cell-mediated immunopathology triggered initially by low- or non-cytopathic infectious agents may cause diseases, susceptibility to which is linked to the major histocompatibility gene complex. PMID- 3530800 TI - Cell-extracellular matrix interactions in morphogenesis: an in vitro approach. AB - We briefly review evidence from in vitro models that supports a role for the extracellular matrix in two essential steps of organogenesis: the establishment of appropriate three-dimensional cell-to-cell relationships, and the determination of a correct cell polarity. PMID- 3530801 TI - Stable isotopes of lithium: dissimilar biochemical and behavioral effects. AB - Lithium, which is used routinely in the treatment of mania, is composed of two stable isotopes, lithium-7 (92.58%) and lithium-6 (7.42%). Usually there is minimal physiological or biochemical differentiation between isotopes of an element, but lithium is an exception. Data derived from a variety of biochemical and behavioral experiments are reviewed to support this idea. Additionally, the clinical implications of this work are presented. PMID- 3530802 TI - Elastase activity in granulomatous inflammation in experimental murine leprosy. AB - Proteolytic activity for [3H]elastin, pyro-Glu-Pro-Val-pNA(S-2484), and Suc (Ala)3-pNA(AAApNA) was demonstrated in the bound fraction extracted with 2 M KSCN + 0.1% Triton X-100 from hypersensitivity-type murine lepromas in C57BL/6N mice, while elastase-inhibitor activity was separately observed in the soluble fraction extracted with a Tris-saline buffer. Sephacryl S-200 gel chromatography showed a peak of elastolytic activity with approximately 20,000 in molecular weight. The following DEAE-Sepharose chromatography demonstrated three fractions of elastolytic activity (E-I, II, III). The inhibitory profile showed that E-I is a thiol proteinase, while E-II and E-III belong to serine proteinase-type elastases. Both E-II and E-III showed different properties with neutrophil elastase or elastase secreted from cultured macrophages, but identical characteristics to membrane bound-type elastase of monocytes. A lower level of elastolytic activity was detected in the bound fraction of nonhypersensitivity type murine lepromas in CBA/N mice, suggesting a more involvement of membrane bound-type elastase from monocytes/macrophages during the tissue remodelings of hypersensitivity-type granulomas. PMID- 3530803 TI - [Effect of drug preparations on IgE antibody production]. PMID- 3530804 TI - [Possible routes of the drug regulation of macrophages]. PMID- 3530805 TI - [Triiodinated contrast media for angiocardiography and coronary radiography]. PMID- 3530806 TI - [Methodological approaches to evaluating the sensitizing properties of new drug preparations in preclinical trials]. AB - For testing allergenic activity of 18 drugs with various pharmacological properties the reaction of specific leukocyte agglomeration, specific leukocyte lysis reaction, determination of Mg2+ blood serum content and epicutaneous drug application were used. An attempt was made to establish the relationship between the development of immunological response and the time and duration of allergization, the dosage and routes of allergen administration and also to determine the optimal experimental conditions for appearance of the most pronounced response. PMID- 3530807 TI - Template-free ribosomal synthesis of polypeptides from aminoacyl-tRNA. Polyphenylalanine synthesis from phenylalanyl-tRNALys. AB - Misacylated phenylalanyl-tRNALys, just as lysyl-tRNALys, but not phenylalanyl tRNAPhe, have been shown to serve as substrates for ribosomal synthesis of polypeptides (polyphenylalanine and polylysine, respectively) in the absence of a template polynucleotide (poly(A)). The conclusion was made that it is the structure of tRNA that determines the ability of the aminoacyl-tRNALys to participate in peptide elongation on ribosomes without codon-anticodon interactions. PMID- 3530808 TI - Activation of S6 kinase activity in astrocytes by insulin, somatomedin C and TPA. AB - Treatment of cultured astrocytes from 2-day-old rat cerebral hemispheres with insulin or somatomedin C (IGF1) promoted a rapid activation of a cytosolic protein kinase which phosphorylates ribosomal protein S6. Phosphorylation of substrates currently used for protein kinase assays (histone H2B and phosvitin) was not stimulated. Neither the cyclic AMP-dependent protein kinase activity nor that of protein kinase C was modified. Treatment of these astrocytes with TPA also promoted a rapid increase in S6 kinase activity in the cytosolic fraction. Simultaneously, protein kinase C disappeared from the cytosol. Neither cyclic AMP dependent protein kinase activity nor phosvitin kinase activity was modified. The effects of insulin, IGF1 and TPA were also observed in the presence of cycloheximide. Cycloheximide also potentiated their effects. These data indicate that S6 kinase activity in astrocytes is promoted from a pre-existing molecule via the tyrosine kinase-insulin receptor and suggest that protein kinase C is implicated in the process. PMID- 3530809 TI - Structural relationship between link proteins and proteoglycan monomers. AB - Structural homologies between link proteins and proteoglycan monomers are demonstrated. A possible redundancy in the proteoglycan monomers structure is discussed and the link proteins domains homologous to other proteins are specified. PMID- 3530810 TI - Chain folding in the dihydrolipoyl acyltransferase components of the 2-oxo-acid dehydrogenase complexes from Escherichia coli. Identification of a segment involved in binding the E3 subunit. AB - The state of assembly of the pyruvate and 2-oxoglutarate dehydrogenase multienzyme complexes was examined after the dihydrolipoyl acyltransferase (E2) component of each enzyme system had been subjected to varying degrees of limited proteolysis. Dissociation of the dihydrolipoyl dehydrogenase (E3) component accompanied specifically the excision of a homologous segment of each E2 chain that connects the N-terminal lipoyl domain(s) with a C-terminal catalytic domain. The latter remains aggregated as a 24-mer and retains its capacity to bind the 2 oxo-acid decarboxylase (E1) component. The relevant segment of the E2o chain from the 2-oxoglutarate dehydrogenase complex was isolated and shown to be a folded protein which still binds to E3. PMID- 3530811 TI - 31P-NMR studies of respiratory regulation in the intact myocardium. AB - The mechanism by which mitochondrial respiration is coupled to ATP consumption in intact tissues is unclear. We determined the relationship between high-energy phosphate levels and oxygen consumption rate in rat hearts operating over a range of workloads and perfused with different substrates. With pyruvate +glucose perfusion, ADP levels were in general very low, and varied with MVO2 yielding an apparent Km of 25 +/- 5 microM, suggesting regulation of oxidative phosphorylation through availability of ADP. In contrast, with glucose perfusion in the presence or absence of insulin, ADP levels, ADP/ATP ratio or the phosphate potential were relatively constant over the workload range examined and generally not correlated with alterations in MVO2; it is suggested that under these conditions, carbon substrate delivery to the mitochondria may control mitochondrial respiration. The common feature of both of the suggested regulatory mechanisms is substrate limitation which, however, is exercised at different metabolic points depending on the carbon substrate available to the myocardium. PMID- 3530812 TI - Palindromic units from E. coli as binding sites for a chromoid-associated protein. AB - Several hundred copies of a highly conserved extragenic palindromic sequence, 20 40 nucleotides long, exist along the chromosome of E. coli and S. typhimurium. These have been defined as palindromic units (PU) or repetitive extragenic palindromes (REP). No general function for PUs has been identified. In the present work, we provide data showing that a protein associated with a chromoid extract of E. coli protects PU DNA against exonuclease III digestion. This provides the first experimental evidence that PU constitutes binding sites for a chromoid-associated protein. This result supports the hypothesis that PUs could play a role in the structure of the bacterial chromoid. PMID- 3530813 TI - The reduction-oxidation status may influence the degradation of glyceraldehyde-3 phosphate dehydrogenase. AB - NADH and NADPH accelerate the 'in vitro' rate of proteolysis of glyceraldehyde-3 phosphate dehydrogenase (GAPDH) by elastase and other proteases, including lysosomal proteases. NAD+ and NADP+ have the opposite effect. Since there is a good correlation between proteolytic susceptibility of proteins and their 'in vivo' degradation rates, a possible role of the reduction-oxidation status in controlling the intracellular degradation of GAPDH is advanced. PMID- 3530814 TI - Growth factors--their biochemistry and role in tumour growth. PMID- 3530815 TI - Head and neck surgery. PMID- 3530816 TI - [Medicine in the caliphates]. PMID- 3530817 TI - [History of the creation of the 1st midwife schools in Russia]. PMID- 3530818 TI - [The discovery by W. C. Rontgen]. PMID- 3530819 TI - [Alcoholism in women (a review of the foreign research)]. PMID- 3530820 TI - [Medicine and physicians of the Arab caliphates reflected in philately]. PMID- 3530821 TI - [V. O. Portugalov--a great public health physician, publicist and social activist]. PMID- 3530822 TI - Smoking and reproduction. PMID- 3530823 TI - Ovulation induction with pulsatile gonadotropin-releasing hormone: a study of the subcutaneous route of administration. AB - The efficacy of ovulation induction with the use of intermittent gonadotropin releasing hormone (GnRH) therapy was examined in seven infertile women with hypothalamic amenorrhea. GnRH was administered every 90 minutes via the subcutaneous route in doses ranging from 50 to 300 ng/kg. Analysis of the induced gonadotropin pulse pattern revealed normal to modestly increased luteinizing hormone secretory parameters (e.g., pulse amplitude) in six of the seven patients. Six of seven women and 15 of 16 treatment cycles (94%) were ovulatory. The conception rate was 43% per woman and 19% per cycle. However, detailed hormonal analysis of 13 treatment cycles revealed that only 1 cycle was entirely normal in terms of duration and/or steroid secretion. PMID- 3530824 TI - Urinary pregnandiol-3-glucuronide and estrone conjugates to creatinine ratios in early pregnancies complicated by vaginal bleeding. AB - There is no simple and rapid test available to predict the outcome of an early pregnancy complicated by vaginal bleeding. In this prospective study, 15 women with normal pregnancies collected a weekly urine sample between 6 and 13 weeks' gestation. A single random urine sample was obtained from 15 women with bleeding who continued to carry their child and 50 women who proceeded to have a spontaneous abortion (SAB). Pregnandiol-3-glucuronide (PDG) was determined with the use of enzyme-multiplied immunoassay technique (EMIT) and estrone conjugates (E1C) were measured by radioimmunoassay (RIA). The ratios of these metabolites to creatinine (C) were calculated. PDG/C ratios in normal women rose gradually from 6 weeks on. All women with bleeding during a normal pregnancy had ratios in the normal range, but 94% of women with a SAB had ratios below the normal range. The E1C/C ratio remained unchanged from 6 to 11 weeks and then rose rapidly. Until 11 weeks, there was no clear separation between the E1C/C ratios of the women with a SAB and the women with bleeding who continued their pregnancies. The prognosis of threatened abortion can be made by a urinary PDG/C ratio but not by an E1C/C ratio. EMIT is simple and quick and uses technology present in many laboratories. PMID- 3530825 TI - [Method of correcting the stereotaxic coordinates of diencephalic structures of the brain of the monkey using intracranial bony reference points]. PMID- 3530826 TI - A new H-2 congenic strain B10.ABQ/Ph carrying a recombinant H-2 haplotype derived from balanced lethal stock Ttf/t12. AB - A new H-2 congenic strain, B10.ABQ/Ph, has been established. It carries the recombinant H-2 haplotype derived from balanced lethal stock Ttf/t12. The recombinant H-2 haplotype was designated bq5 and possesses the following alleles at individual loci of the H-2 complex: Kb A beta b A alpha b E beta b or q E alpha b or q Sb or q Dq Lq. PMID- 3530827 TI - Preparation and characterization of a monoclonal antibody against boar acrosin. AB - BALB/c mice were immunized with the crude fraction of boar acrosin. Immune spleen cells were fused with myeloma cells SP2/0-Ag14. One of the 6 hybridomas produced was cloned and characterized by ELISA and SDS-PAGE. Possible uses of the monoclonal antibody against acrosin for immunological detection of the amount of acrosin liberated after manipulations with spermatozoa and for selection of undamaged spermatozoa for insemination are discussed. PMID- 3530828 TI - [Neonatal screening for congenital adrenal hyperplasia due to 21-hydroxylase deficiency. 1. Enzyme immunoassay of dried blood 17 alpha-hydroxyprogesterone and its application to neonatal screening for congenital adrenal hyperplasia]. AB - An enzyme immunoassay for measuring 17 alpha-hydroxyprogesterone (17-OHP) in dried blood collected on filter paper has been developed. The method is easy and rapid and has specificity, accuracy and precision. 17-OHP values of neonates with congenital adrenal hyperplasia (CAH, 40 ng/ml) were extremely high compared with normal neonates (1.1 +/- 0.7 ng/ml). There was a negative correlation between the 17-OHP value and birth weight. The method has been applied to neonatal screening for CAH due to 21-hydroxylase deficiency. During 38 months, 67,392 neonates were screened. The recall rate and the medical evaluation rate were 1.16% and 0.09%, respectively. A third of recalled neonates were low birth weight infants. 5 neonates were proven to have CAH, and its incidence was 1:13,478. The present study demonstrates the feasibility of a neonatal screening for CAH and indicates that the frequency of CAH may be greater than previously reported by case assessment method in Japan. PMID- 3530829 TI - Splenomegaly in malaria. PMID- 3530830 TI - Biochemical method for the detection of chloroquine resistance in P. falciparum. PMID- 3530831 TI - Incrimination of Anopheles culicifacies as vector of malaria in Orissa. PMID- 3530832 TI - Effects of linoleic acid and cations on the activity of a novel high-molecular weight protease, ingensin, from human placenta. AB - A linoleic acid-sensitive protease, ingensin, was purified to homogeneity from human placenta. The physical properties of the placental ingensin were found to be very similar to those of skeletal muscle ingensin [Ishiura et al. (1985) FEBS Lett. 189, 119-123]. The purified ingensin was activated by linoleic acid and SDS. The linoleic acid-activated form was inhibited preferentially by divalent cations, whereas the SDS-activated form was inhibited by monovalent cations instead. PMID- 3530833 TI - Enzymatic reduction of phenylglyoxal and 2,3-butanedione, two commonly used arginine-modifying reagents, by the ketoacyl reductase domain of fatty acid synthase. AB - Fatty acid synthase catalyzes the reduction of one of the carbonyl groups in phenylglyoxal and 2,3-butanedione using NADPH as the reductant. Selective inactivation of the enoyl reductase, one of the two reductase domains that could catalyze this reduction, did not affect the carbonyl reduction showing that the ketoreductase domain catalyzed the reaction. The apparent Km for the two arginine specific reagents were lower than that for 3-acetoacetyl-N-acetyl cysteamine, the commonly used model substrate for the ketoreductase activity of the synthase. PMID- 3530834 TI - Multicentre double-blind clinical trials of ciclopirox olamine cream 1% in the treatment of tinea corporis and tinea cruris. AB - In separate multicentre, randomized, double-blind clinical trials, 1% ciclopirox olamine cream was compared with its cream vehicle and with 1% clotrimazole cream as treatment for tinea corporis and tinea cruris. Patients who demonstrated clinical and mycological findings consistent with the diagnoses of tinea corporis or tinea cruris were included in the study. Clinical and mycological evaluations were made pretreatment, at the end of each of the four weeks of treatment, and weekly for the two weeks immediately following cessation of treatment. In both studies, use of ciclopirox olamine cream resulted in demonstrable improvements after the first week of therapy and in complete clinical and mycological clearing in two thirds of the patients at the end of the treatment period. These results were maintained through the two-week drug-free observation period that followed the end of treatment. Statistically, the results with ciclopirox olamine cream were significantly better than those with the vehicle and were equivalent to those with clotrimazole cream. All treatments were well tolerated. PMID- 3530835 TI - Glucose uptake and phosphorylation in fat cells of fasted and hypophysectomized rats. AB - Fat cells of hypophysectomized and fasted rats metabolize 10 times less glucose than adipocytes of normal rats in the presence of insulin. Glucose transport (3-O methylglucose influx), transport plus phosphorylation (2-deoxyglucose uptake), hexokinase, pyruvate dehydrogenase and glucose-6-phosphate dehydrogenase activities were determined in an attempt to localize the metabolic defects. Insulin stimulates 3-O-methylglucose influx 5-fold in normal cells and 3-fold in cells of fasted rats. The basal influx in cells of fasted rats is increased and even more so in cells of hypophysectomized rats where the rate of basal influx is the same as that in cells of normal rats under maximal insulin stimulation. It cannot be further stimulated by insulin. In contrast to 3-O-methylglucose influx, basal uptake and phosphorylation of 2-deoxyglucose in cells of fasted and hypophysectomized rats is drastically decreased and stimulation by insulin is abolished. Total hexokinase and pyruvate dehydrogenase activities are drastically reduced in the homogenate of fat cells of hypophysectomized and fasted rats. Phosphorylation by hexokinase appears to become one of the rate-limiting steps of glucose metabolism in cells of hypophysectomized rats. PMID- 3530836 TI - Internalization and recycling of 125I-photoreactive insulin-receptor complexes in hepatocytes in primary culture. AB - When the insulin receptor is tagged with a 125I-photoreactive insulin analogue that can be covalently coupled to it by UV irradiation, the fate of this labeled receptor can be followed both morphologically and biochemically. In the present study we have applied this tool to trace the pathway followed by 125I photoreactive insulin-receptor complex in hepatocytes in primary culture. As determined by quantitative electron microscopic autoradiography, the internalized labeled material first associates with clear vesicles, second is found in multivesicular bodies, third associates with dense bodies and fourth returns to the cell surface via clear vesicles. This recycling process is inhibited by lysosomotropic agents, i.e. NH4Cl or chloroquine. These data confirm, in another cell system, our previous observations carried out in freshly isolated rat hepatocytes and demonstrate the feasibility and complementarity of both freshly isolated hepatocytes and hepatocytes in primary culture to study internalization and recycling of the insulin receptor. PMID- 3530837 TI - A renin-like enzyme in luteal tissue. AB - The aim of this study was to identify immunologically and biologically a renin like enzyme (RLE) in rat corpora lutea (CL). The biological activity of partially purified extracts of CL was tested in vivo by injection into anesthetized pentolinium-treated rats, obtaining a pressor response similar to renal renin. The enzyme activity in vitro was inhibited to about 50% by pretreatment with a specific antibody against renal renin. When the extracts were incubated with angiotensinogen, the product was inhibited mainly by angiotensin I antibody. The fact that there was no change in RLE content in 24 or 48 h nephrectomized rats, suggested the idea of a local production rather than an active blood renin sequestration. PMID- 3530838 TI - Spatial patterning in Polysphondylium: monoclonal antibodies specific for whorl prepatterns. AB - In this report we describe three monoclonal antibodies which detect prepatterning events preceding the appearance of visible tips in Polysphondylium pallidum whorls. A spatial and temporal analysis of the antigens against which these antibodies are directed reveals that the radial distribution of arms within whorls has its origins in an initial global amplification of tip-specific antigens over the surface of very early whorl masses. This two-dimensional distribution becomes restricted with time to a single dimension, a smooth distribution of antigen in a band about the equator of the whorl mass. This equatorial distribution breaks up into patches which eventually become visible tips. These results reveal that a spatial pattern can arise from a smooth prepattern, and grow through a series of intermediates characteristic of the symmetry breaking model first described by A. Turing (1952). PMID- 3530839 TI - Patterning of the head in hydra as visualized by a monoclonal antibody. I. Budding and regeneration. AB - A monoclonal antibody, CP8, has been isolated which displays a position-specific binding pattern to epithelial cells of Hydra oligactis. Antibody binding is restricted to the head of adult animals. When a new head develops during the budding process, CP8 binding is present in the area which will form the head well before morphological signs of it. Similarly, following decapitation as a new head regenerates, CP8 label appears covering a domed area at the apical end of the regenerate before tentacles evaginate delineating the head. When bud development or regeneration is complete, CP8 label is restricted to the new head. Experiments indicate the appearance of CP8 label during the formation of a head correlates closely with the patterning events which result in the determination of the tissue to form a head. The usefulness of CP8 as a diagnostic tool for exploring the dynamics of head pattern formation in hydra is discussed. PMID- 3530840 TI - Position specific binding of a monoclonal antibody in chick limb buds. AB - To analyze the molecular mechanism of the limb pattern formation, we have tried to make monoclonal antibodies against antigens from chick limb buds. We obtained one antibody named AV-1 which recognized a specific region of chick limb buds. AV 1 reacted with the distal portion of the anteroventral mesoderm of only developmentally early chick limb buds. Grafts of ZPA region tissue to an anterior site in an embryonic chick wing bud resulted in mirror-image dupliction of the AV 1 antigen region. These data show the possibility that this antigen plays some role in the limb pattern formation. This is the first evidence that a position specific substance really exists in developmentally early limb buds in which the pattern has been considered to be unspecified. PMID- 3530841 TI - Body composition, adipocyte size, free fatty acid concentration, and glucose tolerance in children of diabetic pregnancies. AB - Previous studies show that children of women who are diabetic during pregnancy are more obese and have a higher prevalence of non-insulin-dependent diabetes mellitus (NIDDM) than children of women who first developed NIDDM greater than 1 yr after the pregnancy (prediabetic mothers) and children of women who have never developed diabetes (nondiabetic mothers). To determine whether lean and obese children of glucose-intolerant pregnancies can be distinguished from similar children of glucose-tolerant pregnancies, we measured body composition, abdominal and gluteal adipocyte size, fasting free fatty acid (FFA), and fasting and stimulated glucose and insulin concentrations during an oral glucose tolerance test in prepubertal children of glucose-intolerant and prediabetic mothers. Each group ranged in adipocity from 6 to 40% body fat. Age, weight, height, and percentage of body fat were similar in the two groups. There were no significant differences in adipocyte size or in glucose, FFA, C-peptide, and insulin concentrations between the groups. The correlation between abdominal adipocyte size and fasting insulin concentration (r = .91 and .18, t = 2.8, P = .01) was stronger in children from glucose-intolerant than from glucose-tolerant pregnancies, respectively. In terms of the parameters we measured, there are no major differences between children of glucose-intolerant and glucose-tolerant pregnancies. PMID- 3530842 TI - Interleukin 1 inhibits insulin secretion from isolated perifused rat islets. AB - Preincubation of collagenase-isolated rat islets for 150 min with 100 U/ml purified human interleukin 1 (IL-1) altered their ability to secrete insulin. Whereas basal release rates with 4 mM glucose were comparable in control and IL-1 treated islets, both the first and second phases of release in response to 20 mM glucose were significantly reduced from IL-1-treated tissue. IL-1 pretreatment also impaired the secretory response to the combination of 100 nM cholecystokinin plus 7 mM glucose. However, the secretory response to 10 mM alpha-ketoisocaproate was comparable in control and IL-1-pretreated islets. Reducing the IL-1 exposure time to 60 min was accompanied by an augmented first phase of release to 20 mM glucose. Second phase secretion was diminished. The use of glucose measured after the perifusion was similar in control and IL-1-treated islets. Similar to other compounds that adversely impact on beta-cell viability, the inhibitory effect of IL-1 on release may presage a cytotoxic action of monokine. PMID- 3530843 TI - Sympathetic outflow in human muscle nerves increases during hypoglycemia. AB - The normal response to insulin-induced hypoglycemia bears many characteristics of activation of the sympathetic nervous system. In this study, the impulse pattern of muscle nerve sympathetic activity (MSA) involved in cardiovascular homeostasis was identified by microneurography in the peroneal nerve of seven healthy and two adrenalectomized subjects. After recordings at rest and an intravenous injection of 0.15 IU insulin/kg body wt (0.10 IU insulin/kg body wt in adrenalectomized subjects), MSA was followed for 90 min. Nadir of hypoglycemia (2.0 +/- 0.1 mM) was reached at 30 min. All subjects, including the two adrenalectomized subjects, exhibited an increase of MSA, which peaked at the glucose nadir. The time course of MSA increase was a mirror image of the blood glucose curve. This directly measured increase of MSA may be part of the hemodynamic adjustment to the fall in plasma volume known to occur in hypoglycemia. Another possible cause is direct stimulation of central sympathetic motoneurons. PMID- 3530844 TI - Effect of choline and methionine treatment on cardiac dysfunction of diabetic rats. AB - There is an abnormal lipid accumulation in the myocardium that might be involved in the congestive heart failure frequently associated with individuals with diabetes mellitus. Because choline and methionine have been reported to modify the incidence of myocardial necrosis in rats fed various fat diets, we decided in our study to assess their effect on the cardiac dysfunction of diabetic rats. Female Wistar rats were made diabetic with streptozocin (STZ, 55 mg/kg i.v.). One week after diabetes induction, one group received choline (0.3 mg/ml), another received methionine (0.25 mg/ml), a third received a combination of the same doses of choline and methionine, and a fourth received neither of these agents; all were administered in the drinking water. Animals were treated for 7 wk. Insulin levels were lower and glucose values higher in the serum of STZ rats relative to controls. Serum cholesterol and triglycerides were significantly elevated in all diabetic animals, and they were also elevated (P less than .05) in the hearts of untreated diabetics. In contrast, the myocardial values of the same lipids were drastically reduced in the treated diabetic animals. Cardiac performance was depressed in all STZ animals, but there was a significant improvement in heart function in treated diabetics relative to untreated ones. Thus, it appears that the buildup of cholesterol and triglycerides in the myocardium are important contributors to the cardiac dysfunction that frequently accompanies diabetes mellitus. PMID- 3530845 TI - Myocardial cell dysfunction in diabetes mellitus. A review of clinical and experimental studies. AB - Evidence for an abnormal myocardial cell function in diabetes mellitus, influenced by acute metabolic changes, has appeared within recent years. Few but interesting clinical studies focus on this aspect of diabetic cardiopathy, and experimental studies have delivered possible explanations at the cellular level. These are concerned with the intracellular calcium homeostasis and transsarcolemmal receptor signaling. Because these changes are reversible by short-term insulin treatment, a new aspect for the study of diabetic heart disease has appeared. PMID- 3530846 TI - Identification of glucokinase as an alloxan-sensitive glucose sensor of the pancreatic beta-cell. AB - Alloxan inactivated glucokinase in intact, isolated pancreatic islets incubated in vitro. Inactivation of glucokinase was antagonized by 30 mM glucose present during incubation of islets with alloxan. Glucokinase partially purified from transplantable insulinomas or rat liver was inactivated by alloxan with a half maximal effect at 2-4 microM alloxan. Inactivation of purified glucokinase was antagonized by glucose, mannose, and 2-deoxyglucose in order of decreasing potency but not by 3-O-methylglucose. Glucose anomers at 6 and 14 mM were discriminated as protecting agents, with the alpha-anomer more effective than the beta-anomer. Glucokinase was not protected from alloxan inactivation by N acetylglucosamine, indicating that the reactive site for alloxan is not the active site; therefore, glucose may protect glucokinase by inducing a conformational change. Glucokinase is thought to be the glucose sensor of the pancreatic beta-cell. The finding that glucokinase is inactivated by alloxan and protected by glucose with discrimination of its anomers similar to inhibition of glucose-stimulated insulin secretion by alloxan supports this hypothesis and appears to explain the mechanism for inhibition of hexose-stimulated insulin secretion by this agent and the unique role of glucose and mannose as protecting agents. PMID- 3530847 TI - Blood-brain glucose transfer in diabetes mellitus. Decreased number of glucose transporters at blood-brain barrier. AB - This study describes the effects of streptozocin (STZ)-induced diabetes mellitus on the glucose-transporter system of the rat blood-brain barrier. Subcellular membrane fractions, i.e., plasma membranes and high- and low-density microsomes, were prepared from isolated brain microvessels derived from control and diabetic animals. The number of glucose transporters in each of the membrane fractions from both control and diabetic animals was determined by the D-glucose inhibitable cytochalasin B-binding assay. The total number of glucose transporters was decreased by 43% in STZ-treated rats compared with controls (35 vs. 115 pmol/mg protein; P less than .05). The glucose-transporter number in plasma membranes was decreased by 50%, in high-density microsomes by 38%, and in low-density microsomes by 45%. Incubation of isolated microvessels from control animals with 7 microM insulin for 30 min at 37 degrees C led to a cycloheximide sensitive 27% increase (P less than .05) in the number of transporters in high density microsomes. This insulin effect was significantly diminished to 15% in the diabetic animals (P less than .05). In conclusion, STZ-induced diabetes decreases the glucose-transporter number in all subcellular membrane fractions derived from isolated rat brain microvessels, and the insulin-induced increase in de novo synthesis of glucose transporters in brain microvessels is diminished in these chronically diabetic animals. PMID- 3530848 TI - Insulin receptors in embryo and extraembryonic membranes of early somite rat conceptus. AB - Intact rat conceptuses were cultured from day 9.5 of gestation on. Individual components of the conceptus, including the embryo and the extraembryonic membranes (consisting of yolk sac, amnion, and allantoic placenta), were isolated and examined for insulin receptors at two time points during organogenesis: day 10.4 of gestation (approximately 10-12 somites) when the yolk sac had become vascularized and just before closure of the anterior neuropore and day 11.6 (approximately 27-31 somites) when vascularization of the chorioallantoic placenta had been established and the neural tube was closed completely. The studies were designed to provide inferential insights about the possible role of insulin in embryogenesis during different phases of nutrient delivery. Active insulin degradation occurred with embryo as well as membrane homogenates during incubation at 37 degrees C. Degradation was markedly reduced at 4 degrees C, and binding of 125I-labeled insulin by embryo or membrane homogenates prepared on day 10.4 or 11.6, respectively, of gestation approached equilibrium after a 20-h incubation at this temperature. Values for the specific binding of tracer (0.4 ng/ml) or carrier (10.4 ng/ml) insulin by embryo and membrane homogenates were the same on days 10.4 and 11.6; specific binding was significantly greater with preparations of membranes than embryo at both time points. Full binding curves on day 11.6 showed similar affinities for insulin by embryo and membranes (Ke = 1.2 X 10(8)/M and 4.6 X 10(8)/M, respectively).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3530849 TI - Renal effects of nicardipine, a calcium entry blocker, in hypertensive type II diabetic patients with nephropathy. AB - We studied the renal effects of nicardipine, a calcium entry blocker, in eight patients with essential hypertension (group A, WHO I or II), six hypertensive type II diabetics with mild-to-moderate nephropathy (group B, urinary albumin 200 789 mg/day), and six hypertensive type II diabetics with severe or advanced nephropathy (group C, urinary albumin 1,596-4,300 mg/day). The patients received an intravenous dose of nicardipine hydrochloride (0.5 mg) or saline placebo in a random order. Glomerular filtration rate (GFR) and renal blood flow (RBF) were measured by means of thiosulfate sodium and p-aminohippurate, respectively, during the 30 min after the nicardipine or saline injection. Blood pressures were serially monitored during the study. Nicardipine reduced both systolic and diastolic blood pressures significantly (P less than .05 to .01) at all measurement periods in all study groups compared with the respective placebo. Nicardipine increased RBF (P less than .01), GFR (P less than .05), and urinary Na+ excretion (P less than .01) and decreased total renal vascular resistance (P less than .01) in groups A and B, but these parameters remain unchanged in group C. The filtration fraction remained unaltered in all groups. The results indicate that nicardipine has several favorable renal effects with a concomitant hypotensive action in hypertensive type II diabetics with mild-to-moderate nephropathy, as observed in patients with uncomplicated essential hypertension, and the renal pharmacological responsiveness appears to be related to the severity of nephropathy.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3530850 TI - Aberrant expression of HLA-DR antigens by insulin-containing beta-cells in recent onset type I diabetes mellitus. AB - The pancreases of 14 children who died of type I diabetes were studied immunohistochemically for aberrant expression of HLA-DR antigens on islet endocrine cells. Two cases in which no residual insulin-secreting beta-cells were present had no evidence of HLA-DR expression on endocrine cells. Insulin containing islets were present in the remainder, and HLA-DR-positive endocrine cells were demonstrable in all of them. Endocrine cells expressing HLA-DR were present in 171 of 630 insulin-containing islets from all the cases. However, HLA DR-positive endocrine cells were not seen in 2060 insulin-deficient islets, providing evidence that of the four hormone-producing cells in the pancreas only the beta-cells expressed HLA-DR. Sections double stained for HLA-DR and the pancreatic hormones confirmed this view. Most islets in which HLA-DR-positive endocrine cells were seen had no evidence of insulitis, suggesting that within an individual islet, aberrant expression of HLA-DR on beta-cells may precede the inflammatory infiltrate. PMID- 3530851 TI - A new case of abnormal insulinemia with diabetes. Reduced insulin values determined by radioreceptor assay. AB - A 44-yr-old Japanese woman was found to have diabetes with marked fasting hyperinsulinemia. Her fasting plasma glucose, serum insulin, and C-peptide levels were 137 mg/dl, 204 microU/ml, and 1.13 pmol/ml, respectively, and the C-peptide to-insulin molar ratio was markedly reduced. Insulin antibodies and insulin receptor antibodies were negative. Fasting levels of counter-insulin hormones were normal. She had normal hypoglycemic response to exogenous insulin injection. Binding of 125I-labeled insulin to erythrocytes was normal. Oral glucose tolerance tests in eight members of her first-degree relatives revealed four members (mother, sister, brother, and daughter) with fasting hyperinsulinemia (111-314 microU/ml), and two of them (mother and sister) were overtly diabetic. Thus, the abnormality was thought to be an autosomal dominant trait. Reverse phase high-performance liquid chromatograph analysis of immunopurified insulin obtained from her serum revealed two peaks of insulin immunoreactivity. The amount of the abnormal insulin peak was seven times greater than that of normal insulin. The abnormal insulin was eluted after bovine, human, and porcine insulins, indicating it has a more hydrophobic nature than normal human insulin. Radioreceptor assay (RRA) for serum insulin with guinea pig kidney membrane revealed that the binding activity of their serum insulin was markedly decreased. Discrepancies between the values measured by RRA and those measured by radioimmunoassay were also found in her family members with hyperinsulinemia but not in her family members without hyperinsulinemia and other hyperinsulinemic patients.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3530852 TI - Brown adipose tissue in lean and obese mice. Insulin-receptor binding and tyrosine kinase activity. AB - Insulin-receptor binding and tyrosine kinase activity have been studied in brown adipose tissue from lean and obese mice. Brown adipose tissue carries functional insulin receptors comparable with those of conventional insulin target tissues. The alpha-subunit (Mr, 130,000) was labeled with photoreactive insulin; the beta subunit (Mr, 95,000) was phosphorylated in a cell-free system, and its level of phosphorylation was increased in a dose-dependent manner by insulin. Two types of obese mice, mice rendered obese by gold thioglucose injection (GTG obese) and genetically obese ob/ob mice, were used. Insulin-receptor number was decreased by 60-70% in obese mice, when expressed per milligram of plasma membrane protein or per microgram of glycoprotein, whereas only a 30-40% diminution was observed in skeletal muscle, indicating that insulin receptors from brown adipose tissue are greatly affected by the downregulation process. Insulin-stimulated autophosphorylation of the insulin-receptor beta-subunit was decreased by 60-70% in preparations of obese mice compared with lean mice in direct proportion to the diminished level of insulin-receptor number. Similarly, the ability of receptors to catalyze the phosphorylation of a synthetic substrate (copolymer glutamate tyrosine) was reduced. These results suggest that the decrease in insulin receptor number and in associated tyrosine kinase activity could explain the insulin-resistant glucose uptake and the alteration in diet-induced thermogenesis described in obese animals. PMID- 3530853 TI - Leucine metabolism in type II diabetes mellitus. AB - Severe muscle wasting is a well-recognized characteristic of untreated insulin deficient diabetes mellitus, a condition in which leucine turnover and oxidation are accelerated. To ascertain whether a similar circumstance exists in type II diabetes when insulin is present but with reduced efficacy, we investigated leucine turnover and oxidation in five obese type II diabetic women by tracer infusion of L-[1-13C,15N]leucine in the postabsorptive state both before and after intensive insulin therapy. With conventional treatment, the type II diabetic women received 61 +/- 33 (SD) U/day of insulin, and their fasting plasma glucose averaged 194 +/- 41 (SD) mg/dl. Leucine carbon flux (QC), nitrogen flux (QN), and oxidation (C) averaged 6.4 +/- 1.2, 15.6 +/- 4.6, and 1.4 +/- 0.3 mmol/h, respectively. These values were not different from the respective values of 6.6 +/- 1.3, 17.0 +/- 8.3, and 1.0 +/- 0.2 mmol/h in matched obese nondiabetic controls, suggesting that leucine metabolism is not altered in insulin-treated type II diabetics. After a week of intensive insulin therapy in which the same diabetic subjects received 94 +/- 36 U/day of insulin, postabsorptive plasma glucose declined to 117 +/- 26 mg/dl. Leucine QC (6.2 +/- 1.0), QN (14.8 +/- 3.7), and C (1.5 +/- 0.5 mmol/h) were unaltered by the increased insulin therapy. Thus, obese type II diabetics had normal leucine kinetics but were hyperglycemic while receiving conventional insulin therapy. Additional intensive insulin therapy in these diabetic subjects improved plasma glucose but did not alter leucine kinetics.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3530854 TI - Demonstration of islet cell surface antibodies in sera of New Zealand black mice and inhibitory effect on insulin release. AB - Islet cell surface antibodies (ICSAs) in sera of New Zealand Black (NZB) and New Zealand White (NZW) mice were detected by the indirect immunofluorescence method with cultured Balb/c mouse islet cells as antigens. Circulating ICSAs appeared in NZB mice from age 20 wk; at 30 wk, 73% of male mice and 88% of female mice had detectable ICSAs. The ICSAs were significantly absorbed with mouse islet cells but hardly absorbed with spleen cells or liver powder. The ICSAs also bound with islet cells of ICR mice, Sprague-Dawley rats, and NZB mice. NZB mice showed glucose intolerance especially at ages 10 and 30 wk. Although plasma glucose levels tended to be higher in NZB mice with strongly positive ICSAs, pancreatic insulin content was not reduced, and insulitis was rarely observed in the pancreases. On the other hand, 30-wk-old NZW mice had normal or mildly impaired glucose tolerance and only weak, if any, ICSAs. The ICSA-positive serum of NZB mice significantly suppressed glucose-induced insulin release by cultured islet cells. The ICSAs may be responsible, at least in part, for glucose intolerance in NZB mice after age 20 wk through the inhibitory effect on insulin secretion. PMID- 3530856 TI - Rubella virus-induced diabetes in the hamster. AB - The congenital rubella syndrome provides the best documentation in humans that a viral infection is associated with the subsequent development of insulin dependent diabetes mellitus. We have developed an animal model in neonatal golden Syrian hamsters infected with rubella virus passaged in beta-cells that closely parallels the diabetes observed with congenital rubella. The hamsters develop hyperglycemia and hypoinsulinemia, which are sustained throughout the 15-wk study period. A mononuclear infiltration of the islets, isolation of rubella virus from whole pancreas, the presence of viral antigen in beta-cells by immunofluorescent localization, and cytoplasmic islet cell antibodies (40%) are demonstrated. These data suggest that an autoimmune process and diabetes develop after rubella virus infection in neonatal hamsters. This model may uncover the precise mechanism by which rubella virus induces similar disease in humans. PMID- 3530855 TI - Effects of NIDDM on very-low-density lipoprotein triglyceride and apolipoprotein B metabolism. Studies before and after sulfonylurea therapy. AB - To evaluate mechanisms of diabetes-induced changes in very-low-density lipoprotein (VLDL), VLDL triglyceride (TG) and VLDL apolipoprotein B (apoB) metabolism were studied in 12 obese Pima Indian control subjects and in 15 Pima Indian obese non-insulin-dependent diabetics. Eleven of the diabetics were restudied after reduction of hyperglycemia with oral sulfonylurea therapy. In addition, adipose, muscle, and postheparin lipoprotein lipase and postheparin hepatic lipase activities were measured in all subjects. Obese diabetics as compared with obese controls showed a trend toward increased production of VLDL TG (46 +/- 4 vs. 35 +/- 6 g/day, P = .10) but not of VLDL apoB (1595 +/- 106 vs. 1597 +/- 164 mg/day, NS); production of VLDL TG declined to control levels (33 +/ 4 g/day, P less than .05) during therapy, whereas there was no change in production of VLDL apoB. Diabetics had a clearance defect for VLDL, indicated by significantly lower fractional catabolic rates for both VLDL TG (10.6 +/- .9 vs. 13.1 +/- .9 pools/day, P less than .05) and VLDL apoB (5.6 +/- .4 vs. 7.5 +/- 0.7, P less than .05) as compared with controls; fractional catabolic rates increased after therapy (to 13.3 +/- 1.5, P less than .05, and 6.7 +/- .4, P less than .05, respectively). In the diabetics, this decrease in clearance was accompanied by a lower adipose lipoprotein lipase (.30 +/- .09 vs. .92 +/- .25 mumol X g-1 X h-1, P less than .01), which increased during therapy (to .61 +/- .17, P less than .05). Hepatic lipase also decreased significantly after therapy (27.4 +/- 3.6 to 26.4 +/- 3.2, P less than .01). Composition of VLDL in diabetics was also abnormal, indicated by a higher TG/apoB ratio (14.7 +/- .6 vs. 11.7 +/- .8, P less than .01); this ratio fell during therapy (to 12.5 +/- .8, P less than .05). The data indicate there are multiple abnormalities in structure and metabolism of VLDL in non-insulin-dependent diabetics. Control of hyperglycemia with sulfonylureas has the capability of reversing some of these abnormalities. PMID- 3530857 TI - Regulation of ketogenesis, gluconeogenesis, and glycogen synthesis by insulin and proinsulin in rat hepatocyte monolayer cultures. AB - The metabolic actions of porcine insulin and biosynthetic human proinsulin on fatty acid and glucose metabolism were studied in rat hepatocytes cultured in monolayer for 24 h. Our aim was to establish whether proinsulin action in the liver is similar to insulin action and whether the relative potencies of the two hormones are the same for different metabolic processes. Proinsulin and insulin exerted a similar maximal inhibitory effect on ketone body formation from palmitate and on gluconeogenesis from pyruvate. The half-maximal effective concentration of proinsulin was 11-13 times that of insulin. The antiketogenic effects of insulin and proinsulin were associated with an increased glycerol 3 phosphate content and a decreased affinity of carnitine palmitoyltransferase for its substrate palmitoyl-CoA. When the basal rate of ketogenesis was increased with isobutyl methylxanthine, the half-maximal effective concentrations of both proinsulin and insulin were decreased, but the relative potency of the two hormones was unchanged. Proinsulin and insulin exerted similar maximal stimulatory effects on glycogen synthesis and on the activities of pyruvate kinase, glucose 6-phosphate dehydrogenase, phosphogluconate dehydrogenase, and malic enzyme. The half-maximal effective concentration of proinsulin was 10-30 times that of insulin. These findings are consistent with receptor binding studies on liver membranes that suggest that proinsulin interacts with insulin specific and not proinsulin-specific receptors. Our findings also suggest that proinsulin action does not differ from insulin action at a postreceptor site. PMID- 3530859 TI - Aspects of the surgical management of myelomeningocele: a review. PMID- 3530858 TI - Utilization of oral sucrose load during exercise in humans. Effect of the alpha glucosidase inhibitor acarbose. AB - We investigated the hormonal and metabolic response to a 100-g sucrose load given 15 min after adaptation to moderate-intensity (50% VmaxO2) long-duration (4-h) exercise in healthy volunteers. The effect of a 100-mg dose of the alpha glucosidase inhibitor Acarbose ingested with the sucrose load was also investigated. "Naturally labeled [13C] sucrose" was used to follow the conversion to expired-air CO2 of the sugar ingested by isotope-ratio mass spectrometry. Circulating hormone and metabolite data were obtained in nine subjects, and indirect calorimetry and stable isotope methodology were applied to six of them. Under placebo, 93 +/- 4 g sucrose were entirely oxidized during the 4 h of exercise, total carbohydrate utilization was 235 +/- 14 g, endogenous carbohydrate utilization was 142 +/- 13 g, and total lipid oxidation was 121 +/- 7 g. A single oral dose of 100 mg Acarbose ingested with the sucrose load did not significantly modify total carbohydrate (239 +/- 2 g/4 h) or lipid (122 +/- 6 g/4 h) oxidation. In contrast, sucrose oxidation was reduced to 53 +/- 6 g/4 h and endogenous carbohydrate utilization increased to 186 +/- 7 g/4 h. Reduction of the rises in blood glucose and fructose and of the increases in plasma insulin and C peptide under Acarbose confirmed these effects, whereas lower circulating levels of alanine suggested a higher rate of gluconeogenesis. These data show that a 100-g glucose load ingested soon after initiation of exercise is a perfect available metabolic substrate.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3530860 TI - Skeletal muscle adaptability. II: Muscle properties following spinal-cord injury. PMID- 3530861 TI - A comparison of colloidal bismuth subcitrate tablets and ranitidine in the treatment of chronic duodenal ulcers. AB - In a randomized, endoscopically controlled trial, the effects of colloidal bismuth subcitrate (CBS) tablets on the healing of chronic duodenal ulcers were compared with those of ranitidine (R). 38 patients were originally allocated to the CBS group and 37 to ranitidine. There were 5 dropouts in each group. Of 33 patients given CBS, 25 (75%) showed complete ulcer healing by 4 weeks and 30 (91%) by 8 weeks. Of the 32 patients given ranitidine, 28 (87%) showed complete ulcer healing by 4 weeks and 30 (94%) by 8 weeks. There was no significant difference between these results. Symptom resolution was similar in both groups and no significant adverse effects were noted. PMID- 3530863 TI - [Extracardiac side effects of Aminodarone]. PMID- 3530862 TI - Studies on overnight insulin requirements and metabolic clearance rate of insulin in normal and diabetic man: relevance to the pathogenesis of the dawn phenomenon. AB - In order to assess whether the metabolic clearance of insulin changes overnight, 11 patients with Type 1 (insulin-dependent) diabetes and low insulin antibody titre, and 6 nondiabetic subjects were studied. In these studies insulin was always infused by a Harvard pump. Initially, the nocturnal insulin requirements were assessed in the diabetic patients by an overnight feedback insulin infusion to maintain euglycaemia. The insulin requirements decreased continuously after midnight to a nadir of 0.115 +/- 0.014 mU X kg-1 X min-1 at 04.30 hours, but after 05.00 hours the insulin requirements increased nearly 40 percent to a maximum of 0.16 +/- 0.012 mU X kg-1 X min-1 at 07.00 hours. To assess whether plasma insulin clearance changes overnight, the diabetic patients were studied on two different occasions, from 22.00-02.30 hours and from 04.00-08.30 hours. During each of these two studies insulin was infused in sequential steps of 90 min each at the rate of 0.13, 0.40 and 0.20 mU X kg-1 X min-1. Despite changes in plasma free insulin concentration, the metabolic clearance of insulin in the interval 22.00-02.30 hours (12.6 +/- 0.17 ml X kg-1 X min-1) was no different from that of the interval 04.00-08.30 hours (12.5 +/- 0.19 ml X kg-1 X min-1). The nondiabetic subjects were studied on two different occasions to assess whether the metabolic clearance of insulin changes overnight. Somatostatin (0.25 mg/h) and insulin (0.3 mU X kg-1 X min-1) were infused from 22.00-02.30 hours on one occasion, and from 04.00-08.30 hours on the other.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3530864 TI - [Pancreatic secretory response to intestinal stimulants]. PMID- 3530865 TI - Healing and relapse of reflux esophagitis during treatment with ranitidine. AB - In 108 patients the healing and relapse of reflux esophagitis, defined endoscopically by the presence of epithelial defects (erosions and ulcerations) of the esophageal mucosa, were studied. In the first study, with open treatment of ranitidine, the healing rate after 6 wk was 50%. The most important factor that negatively influenced healing was the extent of esophageal erosions. Patients with isolated erosions had a 6-wk healing rate of 78%; the healing rate was 38% in patients with longitudinally confluent lesions and 23% in those with circumferential erosions of the distal esophagus. Smoking also had an unfavorable effect. Age, sex, duration of history, body weight, and alcohol consumption were not related to outcome. Symptoms improved during treatment with ranitidine, but the correlation between symptoms and endoscopic findings at 6 wk was weak. In the second study, relapse was investigated in 61 patients with healed esophagitis in a randomized, double-blind trial comparing placebo and ranitidine (150 mg at bedtime for 6 mo). In both groups, relapse occurred in more than one-third of the patients, with no significant difference between ranitidine and placebo treatment. Patients with worse daytime symptoms at the time of previous healing had a higher relapse rate. The initial severity of esophagitis and smoking did not influence recurrence. Thus, the initial endoscopic findings are of prognostic value in reflux esophagitis. Smoking retards healing. Low-dose maintenance treatment with ranitidine does not prevent relapse. PMID- 3530866 TI - Identification and characterization of brush-border membrane-bound neutral metalloendopeptidases from rat small intestine. AB - Neutral metalloendopeptidase enzymes were identified and partially characterized in the brush-border membranes of rat small intestinal mucosal cells using insulin B chain and glutaryl-trialanine-4-methoxy-beta-naphthylamide as substrates. Three different molecular species of endopeptidase were identified by disc gel electrophoresis. These enzymes were shown to be distinct from pancreatic endopeptidases on the basis of the following: enrichment in the brush-border membrane fraction, site of hydrolysis of peptide substrates, sensitivity to specific proteinase inhibitors, and the presence of brush-border membrane associated endopeptidase activity in mucosal cells of Thirty-Vella loops. Hydrolysis of the substrates was shown to be a two-step process involving initial cleavage by endopeptidase with secondary hydrolysis of the peptide products by brush-border membrane aminopeptidase N. Hydrolysis of both substrates was maximum at a neutral pH and was strongly inhibited by metal chelating agents, phosphoramidone, and amastatin. Intestinal perfusion studies using glutaryl trialanine-4-methoxy-beta-naphthylamide suggest that these enzymes play a physiologic role in protein digestion. It was concluded that neutral endopeptidases are integral components of the intestinal brush-border membrane and work in concert with aminopeptidase N to hydrolyze dietary protein. This process may be of nutritional importance in normal subjects and those with diminished exocrine pancreatic function. PMID- 3530867 TI - [Clinical aspects of 7 pregnancies following in vitro fertilization and embryo transfer (IVF/ET)]. AB - Between September 1, 1983 and June 15, 1984 69 patients were treated by in-vitro fertilization as part of a clinical research project. The scientific questions were aimed at optimizing the principal methodological aspects of the new technique. One hundred and sixty-nine follicle punctures were performed under laparoscopic or ultrasonographic control. A total of 207 preovulatory oocytes were obtained, 57 of which were transferred to the uterus as cleaving embryos following in-vitro fertilization. Seven clinical pregnancies were diagnosed. Two resulted in spontaneous abortion in the fifth and sixth week of gestation, the remaining five as three single and two twin births. The infrastructure of reproduction medicine has been broadened successfully within a short time. Considering the results of current clinical and experimental research, the efficiency of the methods used is likely to be improved. PMID- 3530868 TI - [Sonographic evaluation of the quantity of amniotic fluid. II. Oligohydramnios- significance for the course of pregnancy and labor]. AB - 3,274 pregnant women were examined sonographically in this study, with particular emphasis on the quantity of amniotic fluid present. In 8% of the patients a reduced amount of amniotic fluid was seen. If the largest pocket of amniotic fluid was less than 2 cm that particular case was classified as oligohydramnios. If the largest pocket of amniotic fluid was between 2 cm and 3 cm, it was assumed to be in the lower standard range. These cases were compared with a randomly selected control group with normal amounts of amniotic fluid, in respect of the occurrence of complications during gestation and delivery and of the incidence of fetal malformations. Patients with reduced amounts of amniotic fluid showed signs and symptoms of gestosis more often (p less than 0.001) and delivered more often before the 36th week of pregnancy (p less than 0.001) and growth-retarded children (p less than 0.001) than women with standard amounts of amniotic fluid. The incidence rate of Caesarean section was 42%, and hence far above the standard level (p less than 0.001). In oligohydramnios, 13% (p less than 0.001) of the children had severe fetal malformation, whereas, with an amount of amniotic fluid in the lower standard range, only 5.5% (not significant) showed severe foetal malformation. The stated sonographic criteria are suitable as an objective measure for quantifying the amount of amniotic fluid. PMID- 3530869 TI - [Urine drainage following vaginal gynecologic operations]. AB - In a retrospective study covering 161 patients, postoperative discharge of urine by means of a suprapubic catheter (SPC) and a transurethral indwelling catheter (TIC) following vaginal hysterectomy with reconstructive surgery were compared. The incidence of urinary tract infections differed clearly in the two groups, though not significantly (SPC 20.9%, TIC 37.2%). The SPC has clear advantages, causing fewer micturition difficulties and being more readily accepted. Isolated complications such as macrohematuria, bladder tamponade, and blocking of the catheter represent disadvantages of the SPC as compared to the TIC. PMID- 3530870 TI - [Bacteriologic findings and therapeutic consequences in adnexitis]. AB - After laparoscopic confirmation of adnexitis, a bacteriological examination was made of specimens taken from the small pelvis of 63 patients, with an average age of 26.4 years, at the Rheinischen Landesfrauenklinik (Gynecological Hospital) in Wuppertal. To this end, various aerobic and anaerobic optimal and selective culture media were used. The cultured germs were identified with API systems, other conventional methods, and by using gas chromatography. All bacilli were tested for their sensitivity to mezlocillin and metronidazole. In 40 cases (63.5%), it was possible to determine 1-10 bacilli from the inner genital tract. In most cases there was an aerobic/anaerobic mixed infection, with participation of streptococci, staphylococci, enteric bacteria, as well as peptococci, peptostreptococci and bacteroid types. Neisseria gonorrhoeae was only identified three times. In 23 cases (36.5%), it was not possible to determine bacilli in spite of definite inflammatory symptoms. Since, according to international literature, Chlamydia trachomatis was to be found on the inflamed tubes of roughly one third of cases of adnexitis, the presence of this bacillus is suspected even in the many bacteriologically negative cases in the author's own study. Only in one case of a monoinfection by Staphylococcus aureus did the combination of mezlocillin and metronidazole prove to be unsuitable. In 25% of the cases where the presence of bacilli was proved, metronidazole was even necessary, since bacilli of the Bacteroides fragilis and Bacteroides bivius and disiens groups were involved, all of which are capable of inactivating penicillins and cephalosporins by formation of a beta-lactamase.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3530871 TI - [Monoclonal antibodies for the immunohistochemical detection of estrogen receptor status in tissue sections of primary breast cancers]. AB - The article reports on first experiences with immunohistochemical staining methods (ER-ICA and ER-D5) using monoclonal antibodies for determination of oestrogen receptor status in tissue slides. 95 primary breast cancers were analysed by ER-ICA; in addition, a subgroup of 31 cases was stained for ER-D5. The results of the two immunohistochemical procedures revealed a large measure of agreement with the standard ligand binding assay. The evaluation of the immunohistochemical staining reaction led to the formation of a staining Score: Score points of ER-ICA, not those of ER-D5, revealed good correlation with oestrogen receptor concentrations in cytosol, determined by standard ligand binding assay. The used staining Score was examined for intra- and inter individual differences of evaluation and proved to be well reproducible. Further clinical studies have to prove how far immunohistochemical features can convey clinically relevant information not yielded by the steroid binding assay. PMID- 3530872 TI - [Sonographically detectable fetal epiphyseal centers as a criterion for maturity in comparison to L/S ratio]. AB - In 62 pregnant women between the 31st and 39th week of gestation who underwent amniocentesis for determination of the lecithin: sphingomyelin ratio in the amniotic fluid, sonographical identification and measurement of epiphyseal centres around the foetal knee joint were performed. If an epiphyseal centre in the proximal area of the tibia and/or an epiphyseal centre of 6 mm or more in the distal area of the femur could be identified, this showed that a lecithin: sphingomyelin ratio greater than or equal to 2 was present. This noninvasive method of measurement of epiphyseal centres by ultrasound allows not only an exact determination of gestational week in late pregnancy, but also supplies particularly in cases of nondiabetic pregnancies, an indirect pointer to foetal maturity. PMID- 3530873 TI - [Prepartum expectations, behavior in labor and the puerperium and postpartum satisfaction with the birth experience. II. Rooming-in and breast feeding]. AB - Quite a number of young parents want to consciously experience and take active part in the very first days after childbirth. We interviewed prospectively 95 women as to their attitude towards rooming-in, breast-feeding and child care and how they had been able to carry out their intentions. Special consideration was given to those personal and institutional factors that might promote or reduce their feeling of satisfaction with the rooming-in experience. 89 couples made use of the rooming-in offer. 78 of them found the offered times "just right". Women wanting to go back to work used rooming-in significantly more often than housewives. 92% of the persons interviewed regretted not being allowed to change diapers or to bathe the baby. Those women who even before parturition had been wanting to bathe their infants and change diapers, returned their baby to the nurses significantly less often. Thus, both institutional and interactional problems contribute towards the successful management of the postnatal period. Women whose partners attended rooming-in, and those who retrospectively agreed with their decision of how to give birth, were significantly more satisfied with their overall experience. PMID- 3530874 TI - [The study of intracellular immunoglobulins by the immunoperoxidase method in lymphoproliferative diseases]. PMID- 3530875 TI - [Functional properties of thrombocytes and the antiaggregative activity of the vascular wall in healthy persons in various seasons of the year]. PMID- 3530876 TI - [Burn toxin: its identification and biological activity]. PMID- 3530877 TI - Blood pressure control in pithed rat. AB - In the pithed Wistar rats Captopril (2 mg/kg) decreased the mean arterial pressure (MAP) 21%. Further injection of a specific antagonist decreased the vasoconstrictor action of vasopressin (aAVP, 10 micrograms/kg) an additional 6%. Reversal in the order of drug administration did not change these percentages. The osmotic stimulus evoked by the infusion of hypertonic saline (ClNa 9%, 0.018 ml/min, 2 hr) significantly increased MAP, this increase being almost totally reversed by the aAVP (10 micrograms/kg). These findings suggest a greater role of the renin-angiotensin system than of the vasopressin (AVP) in the maintenance of MAP in the pithed rat; AVP, moreover, can be released by means of an osmotic stimulus. PMID- 3530878 TI - Cloning and expression of the glutaredoxin (grx) gene of Escherichia coli. AB - Two DNA segments, together comprising 1147 bp and containing the glutaredoxin (GRX) gene, grx, from Escherichia coli K-12 were cloned and characterized in M13mp9. The gene was identified by hybridization with synthetic oligodeoxyribonucleotide probes corresponding to parts of the amino acid (aa) sequence of GRX. The sequence of 255 bp comprising the GRX structural gene gave a deduced as sequence identical to the directly determined one. The coding region is preceded by two possible ribosome-binding sites and three possible promoters with -10 and -35 regions as judged by homology to consensus sequences. The presence of a stable stem-loop structure, delta G = -17.0 kcal, followed by six thymine bases indicates that the transcription of the grx gene is Rho independently terminated. An over-representation of rare codons in the grx gene, as compared to the genes for thioredoxin (TRX) and highly expressed proteins, is suggested as one possible explanation for the large difference in the synthesis between TRX and GRX in wild-type E. coli cells. GRX production was amplified at least 100 fold in strain JM103[pEMBL9ECG] over that in wild-type E. coli cells. The protein purified from the overproducing strain was identical in aa sequence with the previously analyzed GRX protein. PMID- 3530879 TI - High-level expression of a gene encoding the human complement factor C5a in Escherichia coli. AB - The synthetic C5a gene was initially found to be expressed poorly in Escherichia coli. We undertook studies to determine the reasons for poor expression and to increase expression. The work was focused on the role of the mRNA structure in C5a expression and stability of its product in E. coli. We present data on the effects of varying the sequence at the 5' end of mRNA as well as different ribosome-binding sites on expression. Evaluation of the stability of C5a showed rapid degradation of C5a in wild-type E. coli (half-life 3-5 min). Screening of several protease-deficient strains of E. coli showed that C5a was much more stable in an htpR strain carrying a mutation in the sigma subunit of RNA polymerase that is specific for heat shock promoters. The mutation is associated with a proteolytic deficiency. The half-life of C5a was increased to 20 min. By manipulating the expression vector, the regulatory region for the C5a gene, the host strain, growth conditions and methods for recovering the protein, C5a levels were increased 300-fold over previously reported amounts to about 3% of total cellular protein. PMID- 3530880 TI - Medicare 1986: can society afford quality physician care? Part II. PMID- 3530881 TI - "Captain of the ship": coping with nonphysicians in geriatric care. Panel discussion. PMID- 3530882 TI - Fibrinolysis in cornea and conjunctiva: evidence of two types of activators. AB - The nature of corneal and conjunctival plasminogen activators (PAs) from human and rabbit eyes was examined in tissue culture. The fibrinolytic activity of culture fluid from human corneas was low, roughly one-eighth of that of rabbits. The main activity was found to be of the urokinase (UK) type, as demonstrated by crossed immunoelectrophoresis against alpha 2-antiplasmin after incubation with mixed plasma. The fibrinolytic activity of culture fluid from human conjunctival tissue was higher and a mixed secretion of tissue type (tPA) and UK activator was demonstrated. These activators were separated by affinity chromatography against Sepharose-immobilized antibodies against tPA. Fibrinolytic activity in tears was quenched by antibodies against tPA but not by the use of anti-UK antibodies. Thus, in man, tear fibrinolytic activity may depend primarily on a release of PAs from conjunctival tissue. PMID- 3530883 TI - Short-term organ culture of the retinal pigment epithelium in microtitration plates: ultrastructural studies. AB - Microtitration plates were used to culture simultaneously multiple, small (6 mm diameter) explants of bovine retinal pigment epithelium (RPE). Evaluation of tissue by light microscopy and by scanning and transmission electron microscopy after various incubation periods up to 6 h showed that RPE maintained in this system retains near normal morphology. Initially, the explanted RPE lacks apical microvilli, but during the first 2-3 h in culture recovery of apical microvilli occurs. The results suggest that the system is suitable for short-term maintenance of RPE for experimental purposes. Moreover, the ability to culture up to 16 explants from one bovine eye aids statistical evaluation of RPE behaviour under varying experimental conditions. PMID- 3530884 TI - Tissue culture of human choroidal melanoma cells obtained by fine-needle aspiration biopsy. AB - The optimal treatment of choroidal melanoma is controversial. Many patients are now being treated with nonenucleation therapies. Fine-needle aspiration biopsy of intraocular tumors may well prove to be safe; we used a needle biopsy technique on three freshly enucleated globes and established choroidal melanoma cell lines in culture from these specimens. This report describes our needle biopsy and tissue culture techniques. PMID- 3530886 TI - [F. Engels on the social bases of health protection of the working class (on the 165th anniversary of Engels' birth]. PMID- 3530887 TI - [Anthropogenic eutrophication of surface reservoirs and its effect on population health]. PMID- 3530885 TI - Evaluation of the endothelium of human donor corneas by induced dilation of intercellular spaces and trypan blue. AB - The endothelium of 30 pairs of human cadaver corneas was stained by trypan blue and the intercellular spaces were visualized by induced dilation prior to corneal culture. Trypan blue staining and induced dilation of intercellular spaces by 0.9% and 0.45% NaCl were found to be atraumatic. Only a fraction of damaged cells were stained by trypan blue. Endothelial cell losses in culture did not correlate with the number of trypan-blue stained cells, the post-mortem time, or donor age. PMID- 3530888 TI - [Hygienic evaluation of the content of chemical elements in human biosubstrates]. PMID- 3530889 TI - [Technical sanitary measures for limiting the numbers of rodents with epidemiological importance in the Far North]. PMID- 3530890 TI - [Time of exposure in modeling poisoning in toxicological and hygiene studies]. PMID- 3530891 TI - [Characteristics of microflora of the air in school buildings]. PMID- 3530892 TI - [Use of the gas chromatographic method for environmental analysis (a review of papers from 1981-1983)]. PMID- 3530893 TI - [Intravenous myomatosis: a risk factor for women with uterine myomas]. PMID- 3530894 TI - [Sources of collateral circulation of the pulmonary vascular bed in pulmonary artery atresia with interventricular septal defect]. PMID- 3530895 TI - Identification of pancreas necrosis in severe acute pancreatitis: imaging procedures versus clinical staging. AB - One hundred and five of 395 patients with acute pancreatitis were surgically treated in our clinic from 1981 to 1984. Ninety three of these patients were examined with contrast enhanced computed tomography and/or ultrasound and were clinically assessed according to Ranson's objective criteria before operation. At operation, 77 patients showed necrotising pancreatitis and 16 showed biliary acute interstitial pancreatitis. Ninety per cent of the cases with extensive and 79% of those with minor necroses of the pancreas had been demonstrated with contrast enhanced computed tomography. Ultrasound failed to be diagnostic in 24% of the patients due to meteorism; the sensitivity of the diagnostic studies for pancreatic necrosis was 73% regardless of the extent of the process. Using the early objective signs, seven patients with acute interstitial pancreatitis were classified as having a severe attack, whereas 30 patients with necrotising pancreatitis were categorised as mild attacks. We conclude that the contrast enhanced computed tomography is an aid in deciding on conservative or surgical treatment in a case of acute pancreatitis. Ultrasound does not appear to be an adequate method for determining pancreatic necrosis. The early objective signs fail to sufficiently identify the necrotising form of acute pancreatitis. PMID- 3530898 TI - [The nature of parturition]. PMID- 3530897 TI - Acute treatment of duodenal ulcer: a multicentre study to compare ranitidine 150 mg twice daily with ranitidine 300 mg once at night. AB - A randomised double blind clinical trial was undertaken in the UK and Ireland to compare ranitidine 300 mg given as a single bed time tablet with ranitidine 150 mg twice daily in the acute treatment of duodenal ulcers. Of the 594 patients with endoscopically diagnosed duodenal ulcer entered into the trial, 424 patients had complete endoscopic findings on which healing rates at four weeks were determined. By this time 156 of 201 (78%) patients healed with ranitidine 300 mg nocte compared with 186 of 223 (83%) receiving ranitidine 150 mg twice daily (p = 0.28). After eight weeks of treatment 97% of the patients in each group were healed. The healing rates for smokers and non-smokers did not differ significantly at either four or eight weeks. Each regimen was equally effective in reducing day and night-time pain. Adverse events were reported in 23 patients overall; 12 were withdrawn from the trial. Minor abnormalities in liver function tests were noted in three patients. The trial confirmed that a single dose of ranitidine 300 mg given at night is a safe, effective alternative treatment to ranitidine 150 mg bd for the acute treatment of duodenal ulcer. PMID- 3530899 TI - Studies of the vitamin K-dependent carboxylase and vitamin K epoxide reductase in rat liver. AB - Vitamin K is required as a cofactor for a microsomal enzyme that converts glutamyl residues in precursor proteins to gamma-carboxyglutamyl residues in completed proteins. These residues are essential for the biological function of prothrombin, factors VII, IX, and X, protein C, and protein S. Current data suggest that recognition of protein substrates by the carboxylase requires an unidentified protein-protein interaction in addition to the Glu substrate binding site. The primary vitamin K-dependent event has now been shown to be the abstraction of the gamma-hydrogen of the substrate Glu residue with the concurrent formation of vitamin K 2,3-epoxide. Coumarin anticoagulants appear to inhibit the microsomal vitamin K epoxide reductase and one of a number of microsomal quinone reductases. They therefore block vitamin K action by preventing the recycling of vitamin K epoxide to the quinone and to the active cofactor form, the hydroquinone. Excess vitamin K can reverse a coumarin anticoagulant effect as the nonsensitive quinone reductase can continue to furnish the active coenzyme. PMID- 3530896 TI - Hepatic osteodystrophy: vitamin D metabolism in patients with liver disease. PMID- 3530900 TI - The prothrombin gene. AB - Using recombinant DNA techniques, DNA fragments coding for bovine prothrombin mRNA have been cloned and characterized. Structural studies have revealed that prothrombin mRNA encodes a precursor protein having an amino-terminal extension of 43 amino acid residues. Using bovine prothrombin cDNA as a hybridization probe, the genes coding for human and bovine prothrombin have been isolated and partially characterized. The organization of the prothrombin gene is similar, but not identical to the organization of the genes coding for the other vitamin-K dependent clotting factors. PMID- 3530901 TI - Osteocalcin: the vitamin K-dependent Ca2+-binding protein of bone matrix. AB - Osteocalcin is an abundant Ca2+-binding protein indigenous to the organic matrix of bone, dentin, and possibly other mineralized tissues. This protein contains 47 50 amino acid residues (molecular weight 5,200-5,900) depending on the species. Osteocalcin is distinguished by its content of three gamma-carboxyglutamic (Gla) residues. The vitamin-K-dependent biosynthesis of osteocalcin occurs in bone, and the protein is not homologous to the Gla-containing regions of known vitamin-K dependent blood coagulation proteins. The two major structural features of osteocalcin which appear to control its function include: the 'Gla helix', a compact Ca2+-dependent alpha-helical conformation, in which the three Gla residues are aligned to facilitate adsorption to hydroxyapatite, and the 'COOH terminal beta-sheet' which exhibits chemoattractant activity toward mononuclear leukocytes, specifically monocytes, the putative precursors of osteoclasts. While the biological function of osteocalcin is unknown, it appears to be a highly specific osteoblastic marker produced during bone formation, and is rapidly becoming a clinically important diagnostic parameter of bone pathology. This article reviews recent advances in the understanding of osteocalcin. PMID- 3530902 TI - Vitamin K-dependent processes in tumor cells. AB - Tumor cells are known to interfere with blood coagulation pathways of the host by producing procoagulants and other substances, thereby deriving certain advantages relating to tumor growth, metastasis, and angiogenesis. Anticoagulants may diminish these advantages under certain conditions. The interaction between coumarin anticoagulants and tumor cells has been reviewed with respect to procoagulants and their vitamin K-dependent properties. Evidence is also presented which suggests that vitamin K-dependent protein carboxylation is a general property of tumor cells. PMID- 3530903 TI - Vitamin K-dependent procoagulant in cancer cells: a potential target for the antimetastatic effect of warfarin? AB - Anticoagulants of the coumarin type have long been reported to inhibit metastasis growth in experimental animals; however, the mechanisms of such effects has not been clarified. Systemic anticoagulation per se does not appear to account completely for such metastasis growth depression. More recent information gathered on a cell procoagulant activity, which is vitamin K-dependent, could probably supply a fresh insight into this problem. Indeed, vitamin K deficiency induced either dietarily or pharmacologically by warfarin, does inhibit the activity of a cysteine protease with direct factor-X-activating properties. This protease is only present in warfarin-sensitive tumors. The correlation of this activity with cancer cell invasiveness is supported by experimental data in metastatic variants and, lately, also by the observation of markedly higher cancer procoagulant activity in extracts from metastases than from primary human melanomas. PMID- 3530905 TI - The effect of platelet homogenate fractions on megakaryocytopoiesis in the mouse. AB - Platelet homogenate suppresses megakaryocytopoiesis more effectively than intact platelets do. In mouse experiments mitochondrial, lysosomal, and microsome fractions separated by ultracentrifugation from platelet homogenate did not influence megakaryocytopoiesis, while the cytosol fraction inhibited it similarly as platelet homogenate. Besides thrombopoietin, the substance released from the platelets also takes part in the regulation of thrombocytopoiesis and this substance passes into the cytosol fraction on separation by ultracentrifugation. PMID- 3530904 TI - gamma-Glutamyl carboxylase activity in experimental tumor tissues: a biochemical basis for vitamin K dependence of cancer procoagulant. AB - Rabbit V2 carcinoma tissues have been described to possess a procoagulant activity with specific characteristics; this material has been purified and identified as a cysteine proteinase able to directly activate coagulation factor X. We have shown here that the procoagulant activity of V2 carcinoma extracts is depressed in warfarin-treated animals, thus suggesting that cancer procoagulant could represent a new vitamin K-dependent protein. The biochemical basis for this effect is offered by the identification of gamma-glutamyl carboxylase in the microsomal fraction of tumor tissues. The V2 carcinoma has a carboxylase activity which is increased in warfarin-treated animals. An endogenous substrate of tumor carboxylase, the nature of which has not been identified, has been found 5-fold increased in warfarin-treated animals. The presence of gamma-glutamyl carboxylase was also described in several murine tumors including both carcinomas and fibrosarcomas. It is worth mentioning that all the tumors tested produce a procoagulant with the peculiar characteristics of that described in V2 carcinoma. It is conceivable that cancer procoagulant could represent at least one of the substrates for gamma-glutamyl carboxylase in these experimental tumor tissues. PMID- 3530906 TI - Cerebrospinal fluid beta-2-microglobulin level as marker of central nervous system involvement in lymphoma. AB - The cerebrospinal fluid (CSF) and serum beta-2-microglobulin (B-2-m) level was determined in 15 patients affected by lymphoma with and without central nervous system (CNS) involvement and in 15 normal controls. No statistical difference in CNS B-2-m was found between patients affected by lymphoma without CNS involvement and normal subjects. CSF B-2-m was significantly increased (p less than 0.001) in patients with CNS involvement as compared to normal subjects or patients without CNS involvement. These findings suggest that CSF B-2-m can be used as a useful marker of CNS involvement in patients affected by lymphoma. PMID- 3530908 TI - [Immunological aspects of pregnancy. Part I: Mother-fetus relationships]. PMID- 3530907 TI - Quantitative problems in bone marrow transplantation by peripheral blood stem cells. AB - Investigation into radiation bone marrow aplasia in mice, guinea pigs, dogs and clinical trials in man presented clear evidence of successful engraftment of autologous or allogeneic peripheral blood stem cells. The quantitative donation problems are discussed arising with the use of continuous cytopheresis to obtain a sufficient quantity of peripheral blood mononuclears (stem cells) for repopulation of aplastic bone marrow. Although bone marrow repopulation is possible by using peripheral blood mononuclears (stem cells) in individual cases, the method can only be used in practice after discovering an appropriate stimulator able to augment several times the number of bone marrow stem cells in the peripheral blood, or a new method for stem cell multiplication in vitro. PMID- 3530909 TI - [X-ray examinations, cosmic radiation, the fetus and the doctors]. PMID- 3530910 TI - [The effect of anesthesia and monitoring on the incidence of perioperative myocardial reinfarction]. PMID- 3530911 TI - [Fire toxicology]. PMID- 3530912 TI - [Constipation in childhood]. PMID- 3530913 TI - [Ultrasound scanning of ovarian follicles]. PMID- 3530914 TI - [Prolonged and complicated course of empyema in a child]. PMID- 3530915 TI - [Intrahepatic cholestasis due to Shigella in an infant]. PMID- 3530916 TI - [Psychoneuro-immunology--meaning and applications in medicine]. PMID- 3530917 TI - [Antibodies to insulin--obvious and possible effects]. PMID- 3530918 TI - [Dementia in Parkinson's disease]. PMID- 3530919 TI - [Home oxygen therapy in chronic obstructive pulmonary disease]. PMID- 3530920 TI - [The exocrine pancreas in cystic fibrosis]. PMID- 3530921 TI - [Pain syndromes in spinal cord injured patients]. PMID- 3530922 TI - Analysis of interspecific relationships in mesostigmatid mites (Acari: Mesostigmata) in the nests of the bank vole (Clethrionomys glareolus (Schreber, 1780)). AB - An analysis is presented of a community of mesostigmatid mites from the nests of Clethrionomys glareolus found in the forest biotopes of Vsetinske Beskydy Mts. (North Moravia) throughout all seasons of the year. Main attention was paid to the structure of the nest community, relationships of mites to their host and interspecific relationships in the mites themselves. Primarily cluster and factor analyses based on correlation matrix were used for mathematical assessment. The particular elements of correlation matrix were Spearman's non-parametric correlation coefficients computed from frequencies of species in the nests studied. PMID- 3530923 TI - [Intensified conventional insulin therapy. 10 years' experience in internal medicine practice]. PMID- 3530924 TI - [The female in historical medicine. A critical view of current literature--II]. PMID- 3530925 TI - [Therapy of obstructive sleep apnea syndrome]. AB - Symptomatology and sequelae, as well as diagnosis and therapy of the obstructive sleep apnea syndrome are discussed. The Esmarch prosthesis, which we developed for the prosthetic treatment of obstructive sleep apnea syndrome, was tested in 7 patients. Patients were polysomnographically recorded during two sequential nights with and without Esmarch prosthesis. All apnea parameters improved significantly (apnea time by 78%, apnea index by 67% of baseline values). The mean duration of the remaining apnea phases diminished by 31%. Improvement of O2 saturation of haemoglobin and O2 partial pressure in the tissue paralleled that of the apnea parameters. The severely disturbed sleep profile of the patients showed a clear tendency towards normalization. The Esmarch prosthesis is an efficient method for the treatment of the obstructive sleep apnea syndrome. PMID- 3530926 TI - The birth of the Frontier Nursing Service--the first words, the first steps. PMID- 3530927 TI - [Disorders of thrombocyte function and/or endothelial cell damage as a cause of primary pulmonary hypertension?]. AB - The pathophysiology of pulmonary hypertension is, in many cases, unclear and this is true especially for patients with dietary pulmonary hypertension. This paper discusses the hypothesis that platelets, directly or through their interaction with the pulmonary endothelial cell, are involved in the development of pulmonary hypertension. Platelets release vasoactive substances during aggregation or activation and these substances lead to pulmonary vasoconstriction and pulmonary hypertension. The primary target of the activated platelets could be the endothelial cell which has also been demonstrated in animal experiments with crotalaria-induced pulmonary hypertension. Changes in thromboxane--platelets and prostacyclin--endothelial cell interactions could be the basic mechanism responsible for endothelial proliferation and pulmonary vasoconstriction. It has not been ascertained, however, whether the activation of platelets or endothelial dysfunction is the primary lesion. In various animal experiments, changes in platelet function and endothelial damage, as well, have been shown to be initiated by exogenous influences. The investigation of platelets or endothelial cell function in patients with pulmonary hypertension showed evidence of platelet activation but not platelet hyperreactivity. An impaired fibrinolytic activity, which was found in the majority of these patients, was regarded as indicative of endothelial dysfunction. An interference in the physiological interaction of circulating platelets and endothelial cells in the lung with resulting endothelial proliferation and vessel occlusion could well be the initial factor. This process would be self-perpetuating in the development of pulmonary hypertension. An additional example of dietary-induced pulmonary hypertension was observed in patients in Spain after the ingestion of toxic oil.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3530928 TI - Primary pulmonary hypertension: recent advances. AB - This review highlights newer insights into possible pathogenic mechanisms, clinical features, and treatment of primary pulmonary hypertension. A disease once believed to be found only in younger women, it has now been well documented to occur in both the young and elderly, with a female to male distribution of approximately 1.7:1 at all ages. Several possible etiologic mechanisms have recently been elucidated. Evidence has been forthcoming suggesting a possible role for thromboxane being produced by the pulmonary vascular bed, an underlying abnormality in clot lysis, the presence of antinuclear antibodies which could represent a collagen vascular disorder involving the lung, and a potential aggravating role of female hormones. Unfortunately, the major frustration with primary pulmonary hypertension remains its treatment. Some investigators suggest that anticoagulation may have beneficial effects on long-term survival, although this remains controversial. Most of the recently published articles on therapy have dealt with the use of vasodilators. A careful review of the effectiveness of vasodilators in these patients has failed to show that their chronic use alters either the patient's clinical course, survival, or the disease process itself. It does appear, however, that sustained beneficial effects can be realized in some patients if a substantial reduction in the pulmonary artery pressure is achieved with drug treatment. A thorough understanding of the physiologic characteristics of the pulmonary vascular bed is necessary in order to avoid misinterpreting the effects of vasodilators, which can also be detrimental. The development of vasodilators that are more specific for the pulmonary vascular bed may lead to better clinical results. Strategies for making an earlier diagnosis, however, may be equally important in our attempts to improve the prognosis. PMID- 3530930 TI - Ultrasonographic evaluation of the wall of the fluid-filled stomach--case report of a leiomyoblastoma. AB - Filling the stomach with fluid makes possible the ultrasonographic representation of its wall. As a supplement to endoscopy and radiology, the procedure is a suitable means of demonstrating and evaluating circumscribed and infiltrating submucosal processes in the stomach and proximal duodenum. The technique is described in the case of an 18-year-old female patient presenting with a leiomyoblastoma of the stomach. PMID- 3530929 TI - Intravenous glucose tolerance after Whipple's procedure in patients with chronic pancreatitis--relative influence of occlusion of the pancreatic duct. AB - An intravenous glucose tolerance test was carried out to compare chronic pancreatitis patients (n = 17) who had undergone partial duodenopancreatectomy with (n = 9) and without (n = 8) occlusion of the residual pancreatic duct by Prolamin. The results obtained in 10 healthy volunteers were plotted as background information reflecting the normal metabolic response. Insulin- and C peptide secretion were greatly decreased after both resection alone, and resection plus occlusion. However, the glucose tolerance (integrated glucose; K values) appeared relatively well preserved in the two groups. The decrease in insulin appeared more marked after resection plus occlusion as compared with the non-occluded group. It is concluded that partial duodenopancreatectomy without or with ductal occlusion impairs insulin secretion, and leaves tolerance to an intravenous glucose load relatively stable. The mechanism underlying the latter observation is unknown at present. PMID- 3530931 TI - [Nonclostridial gas-producing phlegmone originating in the right thigh of a diabetic patient: report of a case with autopsy findings]. AB - A 49-year-old male with a history of diabetes mellitus of a period of twenty years noticed pain and feverish sensation in both thighs and both inguinal regions: they were more severe in the right than in the left. There were redness and swelling of the skins of the scrotum and of the superomedial aspects of both thighs. He had no diabetic ulcer on the right foot or right leg. Examination revealed evidence of gas retention in the subcutaneous tissue of the right thigh. Incision confirmed the presence of pus, from which Escherichia coli and Bacteroides fragilis were cultured. His condition gradually deteriorated despite wide incision, debridement, irrigation, and intensive chemotherapy. He expired on the 26th hospital day. Autopsy showed phlegmone of the right loin, right buttock, right thigh, and upper half of the right leg. We presume that the skin of the superomedial aspect of the right thigh was first infected. Bacteria rapidly invaded into the subcutaneous tissue; they induced phlegmone with gas production. We conclude that phlegmone of the right thigh simultaneously spread both to the right loin and right buttock, and to the right leg. PMID- 3530932 TI - Hypoglycemia following insulin and proinsulin. A comparison. AB - The counterregulatory hormonal response to proinsulin-induced hypoglycemia was investigated in eight volunteers. Proinsulin cleared slower from the circulation than insulin. Hypoglycemia occurred slower (2P less than 0.005) and was prolonged, while the overall hypoglycemic activities were comparable. The antilipolytic effect of proinsulin was also prolonged (2P less than 0.001). The response of epinephrine to hypoglycemia was less pronounced after proinsulin (2P less than 0.05). The amount of epinephrine was correlated to the rate of fall in plasma glucose (P less than 0.005). The production of lactate induced by beta stimulation was also correlated to the fall of glucose (P less than 0.005). The responses of prolactin (2P less than 0.02), norepinephrine (2P less than 0.02), cortisol, and growth hormone were attenuated following proinsulin. The decreases of serum potassium and serum phosphate (2P less than 0.05) were less pronounced. Symptoms like sweating (2P less than 0.01) and dizziness (2P less than 0.01) were milder after proinsulin. It is concluded that the rate of fall in glucose concentration determines the differing counterregulatory responses. We don't relate the differing counterregulatory responses to special insulin-like properties of proinsulin, but to the slower kinetics which is emphasized by the intravenous bolus injection. PMID- 3530933 TI - Dose and duration effects of estradiol valerate on serum and lipoprotein lipids. AB - Non-alkylated estrogens, like estradiol valerate (F2V), are widely used in the treatment of the postmenopausal hormonal deficiency syndrome. Their effects on serum and lipoprotein lipids are characterized by an increase in the lipid constituents of high density lipoproteins (HDL) and, usually, a decrease in low density lipoproteins (LDL). These effects are considered beneficial as regards atherogenesis and the risk for cardiovascular diseases. Unlike the effects of alkylated estrogens, no concomitant increase in triglycerides (TG) in serum and very low density lipoproteins (VLDL) - adverse effects - are seen in doses of up to 2 mg E2V. In order to compare the effects of 2 and 4 mg of E2V on serum and lipoprotein lipids, 19 bilaterally oophorectomized women participated in a cross over study after a 4 week long wash-out period. To evaluate the influence of the time factor, 10 of the women continued taking 2 mg and 9 taking 4 mg of E2V respectively for an additional period of 12 weeks, resulting in a total treatment period of 24 weeks per group. The serum lipoproteins were separated by preparative ultracentrifugation, the serum and lipoprotein lipids being assessed using commercially available kits. In the cross-over part of the study, total (TC) and free cholesterol (FC) and phospholipids (PL) increased in HDL and decreased in LDL. Neither dose increased TG in serum or VLDL. These changes in the lipoprotein pattern persisted at the end of the entire study. Consequently, within the range of commonly used doses (2 and 4 mg) E2V seems to have a constant and, in terms of cardiovascular disease, favourable influence on lipoprotein metabolism irrespective of doses and periods studied. PMID- 3530934 TI - Progesterone and LH variations after LH-RH administration in the luteal phase of the menstrual cycle. AB - We have investigated the pituitary and luteal responses to LH-RH and their related changes. 11 normal women were studied during the luteal phase (day +4/+11). Blood samples were collected every 15 min for a basal period of 180 and 120 min after the intravenous administration of 25 micrograms of LH-RH. Progesterone (P) and LH were assayed by radioimmunoassay. Data were analyzed as maximum peak and its percent increase (delta max), integrated secretory area (ISA) and percent increase of ISA (delta A) in respect to basal values for both P and LH. LH-RH elicited a secretory response of both hormones in all cases. ISA of LH was significantly greater after LH-RH administration in respect to basal values (p less than 0.001) and delta max accounted to 475 +/- (SE) 36% of the basal concentration. Luteal responsiveness varied from about 115-130% to more marked increments. ISA of P differed from basal to stimulated conditions (p less than 0.05) and delta max was 166 +/- (SE) 14%. The analysis of temporal relationship between P and LH secretion showed that LH promptly rose after LH-RH, while the enhancement of P plasma levels occurred within 31 +/- 19 min after LH rise. Then P levels reached a plateau, values of which were statistically different from those observed before LH-RH administration. In two cases where luteal function was blunted or absent, in spite of marked increments of LH, P secretion did not occur. These data are consistent with the presence of close relationships between hypothalamic, pituitary and luteal functions and strengthen the contention about the usefulness of LH-RH during luteal phase for the lifespan and maintenance of corpus luteum. PMID- 3530935 TI - Characteristics of insulin and glucagon release from the perfused pancreas, intact isolated islets, and dispersed islet cells. AB - There are a variety of different tissue preparations which have been used to study secretion from the endocrine pancreas and there are considerable differences in the results obtained from these. The purpose of this study was to compare several preparations in one laboratory using the same rats, buffers, and radioimmunoassays. The preparations included the isolated perfused rat pancreas, fresh isolated intact islets and dispersed cells, and cultured islets and cells. Insulin release from the perfused rat pancreas at 2.8 mM glucose was so low that it could not be measured, such that over a 90-min time period the amount of insulin released was less than 0.004% of pancreatic insulin content. In contrast, islets in static incubation appear to release 2.0% of their stored content and dispersed cells appear to release 2.6% of their content. Samples were taken at early time points during incubations of fresh islets and dispersed cells, and it was found that almost all of the insulin found at the end of a 90-min incubation period was present during the first 5 min. It is therefore suspected that the true secretory rate of insulin at a low glucose concentration is far lower than had been generally appreciated. Glucagon release patterns showed similarities in that with isolated islets and dispersed cells a disproportionate amount of glucagon release was found during a 0- to 30-min incubation period when compared with the 30- to 90-min period. In summary, artifacts have been identified in some of the in vitro systems used for the study of endocrine pancreatic secretion and these deserve greater recognition. PMID- 3530936 TI - Evaluation of insulin-like growth factor (somatomedin) levels in acromegaly. AB - In untreated acromegalic patients, mean serum level of insulin-like growth factor (IGF) is two times higher than in controls, and all patients have IGF values above the mean + 2 SD of the controls, while some of these patients have normal GH values. After treatment, clinical status correlates better with IGF than with GH. Thus, measurements of serum IGF can be helpful in the diagnosis of acromegaly and in assessment of the efficiency of therapy. PMID- 3530937 TI - Insulin-like growth factors/somatomedins: structure, secretion, biological actions and physiological role. AB - Insulin-like growth factors (IGFs, somatomedins) are structural homologues of insulin with insulin-like biological activity. They are mainly synthesized and secreted by the liver, but may also be produced by extrahepatic tissues. In their native from in blood they are bound to specific carrier protein(s). This determines essentially their biological actions. The complexed factors stimulate growth indices in vitro and in vivo, but, in contrast to the free factors, do not exert acute effects on insulin target tissues. PMID- 3530938 TI - Molecular aspects of the human somatomedins. AB - The primary structure of the somatomedins (SM) IGF-I and IGF-II has been known for some years. Both from isolation of the SMs from plasma and from the study of cDNAs it has become evident that there are more SMs, needing further study. In plasma the SMs are present in larger molecules of two size-classes: 150 kD and 40 kD, behaving as specific SM-binding proteins. The possibility that such protein classes are heterogeneous and also contain precursor molecules undergoing proteolytic processing is considered. The somatomedin genes are discontinuous and span large regions of the human genome. PMID- 3530939 TI - Pathophysiological and clinical aspects of the insulin-like growth factors. AB - Except in acromegaly, where insulin-like growth factor I (IGF I) levels are elevated, only decreased IGF levels have been observed under pathophysiological conditions. These are hypopituitarism, Laron dwarfism, leprechaunism, liver disease, primary hypothyroidism, extrapancreatic tumor hypoglycemia and severe insulin deficiency in experimental animals. For most of these diseases the diagnostic value of IGF determinations is limited. IGF I determinations may serve as a useful additional diagnostic index in acromegaly and in the evaluation of successful operative and/or radiotherapy of this disease. PMID- 3530940 TI - Somatomedin-C/insulin-like growth factor-I as a modulator of growth during childhood and adolescence. AB - Normal growth during childhood and adolescence is a complex process which requires the participation of a number of hormones and growth factors. Sm-C/IGF-I plays a central role in this process, with variations in both its serum concentration and the cellular responsiveness to it being important mechanisms regulating growth. PMID- 3530941 TI - Somatomedins and steroids. AB - Somatomedin levels measured by radioreceptor assay, competitive protein-binding assay or radioimmunoassay are normal in hypercortisolism; the decrease of somatomedin activity consistently found in this condition is due to an increase in circulating somatomedin inhibitors resulting in an inhibition of somatomedin action. Progestagens could possibly have a direct stimulatory effect on somatomedin-C (Sm-C) production. During puberty, the increase of Sm-C is correlated with the increase in plasma estradiol and testosterone. In young subjects, relatively low doses of estrogens and of testosterone enhance Sm-C secretion, and in adult menstruating women, a positive relationship is found between testosterone and Sm-C values. An inhibitory effect of estrogens on Sm-C is observed with higher doses and/or in older subjects. Thus, somatomedin levels might be modulated by variations of sex steroids. PMID- 3530942 TI - Is therapy with testosterone or anabolic-androgenic steroids useful in the treatment of alcoholic liver disease? PMID- 3530943 TI - The combined effects of protein deficiency and chronic ethanol administration on rat ethanol metabolism. AB - This investigation was performed to examine the combined effects of protein deficiency and chronic ethanol consumption on ethanol clearance and hepatic ethanol metabolism of the rat. Protein deficiency alone was associated with reduced ethanol clearance and decreased activity of hepatic alcohol dehydrogenase and the microsomal ethanol-oxidizing system. However, when ethanol (as 36% of energy) was administered concurrently with protein-deficient diets, accelerated ethanol clearance and increased microsomal oxidation of ethanol was observed. Furthermore, in protein-deficient animals fed ethanol, liver alcohol dehydrogenase levels were less decreased when compared with values observed in animals fed protein-deficient diets without ethanol, and this effect was associated with markedly reduced serum testosterone levels in the former group. PMID- 3530944 TI - Peripheral T-cell lymphoma presenting as predominant liver disease: a report of three cases. AB - Three cases of a peculiar form of peripheral T-cell lymphoma presenting as predominant hepatic disease with splenomegaly are reported. The three patients had marked liver enlargement without lymphadenopathy; white blood cell count was normal, and modifications of hepatic tests were mild. In the three cases, the diagnosis of the lymphoma was mainly based on the results of hepatic morphological changes. Liver involvement was histologically characterized by a predominantly sinusoidal infiltration by tumor cells in the three cases, associated with perisinusoidal fibrosis in two of them; portal infiltration was noted in two patients. Immunopathological study showed that tumor cells were T lymphoid cells that were different from normal T-lymphocytes by the lack of expression of one T-cell membrane antigen, i.e., Leu-1. These findings suggest that a distinct clinical, pathological and immunopathological entity might be individualized within the large group of T-cell lymphomas. PMID- 3530945 TI - Evaluation of aztreonam in the treatment of spontaneous bacterial peritonitis in patients with cirrhosis. AB - To determine the efficacy of aztreonam in the treatment of spontaneous bacterial peritonitis in patients with hepatic cirrhosis, 14 patients (7 males, 7 females) with 16 Gram-negative infective episodes (12 Escherichia coli and 4 Klebsiella pneumoniae) were treated with aztreonam infusions at doses of 1 gm per 8 hr for a planned 14-day period. Ages ranged from 40 to 75 years with a mean of 57 +/- 10 years. All organisms were highly susceptible to aztreonam (minimal inhibitory concentration less than or equal to 0.06 to 0.12 micrograms per ml). Serum antibiotic levels were 61.9 +/- 25.5 micrograms per ml (peak) and 27 +/- 18.5 micrograms per ml (trough). Ascitic fluid antibiotic levels were 33.6 +/- 22.5 micrograms per ml (peak) and 32.7 +/- 16.8 micrograms per ml (trough). Although the symptoms of infection were controlled within 3 days and ascitic fluid cultures became negative after 48 hr, 10 patients (62.5%) died, with hepatorenal syndrome and digestive tract hemorrhage as the principal causes of death. Three patients developed streptococcal superinfections during treatment; Streptococcus faecalis peritonitis in one case and spontaneous bacteremia due to Streptococcus equinus and Streptococcus mutans in the other two. Aztreonam was well tolerated and clinically and bacteriologically efficacious in controlling the infection. Serum and ascitic fluid levels were considerably higher than the minimal inhibitory concentration for the causative organisms, suggesting that lower doses may achieve suitable therapeutic levels. A negative aspect of the antibiotic therapy was the superinfections. The high mortality rate was attributable to the generally poor underlying condition of the patients. PMID- 3530946 TI - Release of prostanoids into the portal and hepatic vein in patients with chronic liver disease. AB - Arterial and hepatovenous concentrations of circulating prostaglandin E2 and prostaglandin F2 alpha, the stable metabolites of prostacyclin and thromboxane A2 were measured in patients with chronic liver disease and compared with those in control patients with coronary artery disease but without hepatic dysfunction. Specific radioimmunoassays were used after extraction on octadecyl C 18-silica gel columns and thin-layer chromatography. While low levels of all cyclooxygenase products were found in hepatic arterial blood in patients with proven cirrhosis (n = 10) and fibrosis (n = 8), significantly higher concentrations were detected in the hepatic vein. A similar concentration profile was observed in controls (n = 4). Thus, there is a marked but comparable release of prostanoids from the normal as well as the diseased liver. Hepatovenous prostaglandin E2 was 11.6 fold, prostaglandin F2 alpha was 7.5-fold, prostacyclin was 12.2.-fold and thromboxane B2 was 3.9-fold above the level in the artery in both groups of patients. The hepatovenous concentrations of all arachinodate metabolites were unrelated to changes of liver morphology, biochemical abnormalities or the presence of ascites. No correlation could be demonstrated between hepatic venous pressure gradient and the concentration of prostanoids in the hepatic vein with the exception of thromboxane B2 (r = 0.55, p less than 0.05). The occurrence of esophageal varices was not associated with a specific pattern of circulating prostanoids in the posthepatic vasculature. Moreover, the portal-venous concentrations of all prostanoids (five patients: two with fibrosis, three with cirrhosis) exceeded the level in the hepatic vein substantially.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3530947 TI - Prognostic value of preoperatively obtained clinical and laboratory data in predicting survival following orthotopic liver transplantation. AB - Twenty-seven clinical and laboratory data and the subsequent clinical course of 93 consecutive adult patients who underwent orthotopic liver transplantation for various chronic advanced liver diseases were analyzed retrospectively to assess the risk factors of early major bacterial infection and death after the procedure. Forty-one patients (44%) had early major bacterial infection during hospitalization for orthotopic liver transplantation. The mortality rate was 70.7% in patients with early major bacterial infection and was 7.7% in patients without early major bacterial infection (p less than 0.001). Total serum bilirubin, total white blood cell count and polymorphonuclear cell count, IgG (all p less than 0.05) and plasma creatinine level (p less than 0.001) were higher in patients that developed early major bacterial infection than in those who did not. By step-wise discriminant analysis, the strongest risk factor for early major bacterial infection was the serum creatinine level, which achieved an accuracy of 69% for a creatinine level greater than 1.58 mg per dl. Seven variables (ascites, hepatic encephalopathy, elevated white blood and polymorphonuclear cell count, decreased helper to suppressor T cell ratio and elevated plasma creatinine and bilirubin levels) were associated with a significant increased risk for death. A step-wise discriminant analysis of these seven factors resulted in the demonstration of serum creatinine as the greatest risk factor for mortality. A preoperative serum creatinine either less than or greater than 1.72 mg per dl accurately predicts survival or death, respectively, in 79% of cases.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3530949 TI - Hepatic inclusions during interferon therapy in chronic viral hepatitis. AB - Two types of cytomembranous abnormalities were identified for the first time in liver biopsies from patients with chronic active type B hepatitis during treatment with recombinant alpha-interferon. Tubuloreticular inclusions were present in the hepatic endothelial cells, Kupffer cells and perisinusoidal cells of liver biopsies from both patients, and they were absent in liver biopsies obtained before treatment. Cylindrical confronting lamellae, having "test tube" or "ring-shape" forms were observed in the cytoplasm both of Kupffer cells and macrophages in the second liver biopsy of one of the patients. The findings suggest that interferon can be involved in the pathogenesis of both cytomembranous abnormalities, but that additional biological factors may play a role in formation of the cylindrical confronting lamellae. PMID- 3530948 TI - Cellular localization of alpha-interferon in hepatitis B virus-infected liver tissue. AB - Cells expressing alpha 2-interferon were identified by indirect immunofluorescence using both a polyclonal and a monoclonal anti-alpha-interferon antibody reagent. In hepatitis B or delta virus infection, focal clusters of alpha-interferon-positive infiltrating mononuclear cells and (to a lesser extent) fibroblasts were regularly seen in liver sections from patients who had chronic active hepatitis and cirrhosis and evidence of virus replication, but in a minority of patients with chronic persistent hepatitis B and not in nonvirally infected livers. This report provides evidence for local alpha-interferon production near the site of virus replication in hepatitis B infection, identifies mononuclear cells and fibroblasts (but not hepatocytes) as the main cell types producing interferon in this infection and suggests that locally produced alpha-interferon may be a natural regulator of virus replication in HBsAg-positive chronic active hepatitis. Furthermore, serological characterization of the interferon species produced locally may predict which particular interferon species could be of the greatest therapeutic benefit in specific disease states or individual patients. PMID- 3530950 TI - In situ distribution of major histocompatibility complex products and viral antigens in chronic hepatitis B virus infection: evidence that HBc-containing hepatocytes may express HLA-DR antigens. AB - Using a double-staining immunohistochemical procedure, the topographical relationship between viral antigens on the one hand and the expression of major histocompatibility complex products by hepatocytes on the other hand was analyzed in a series of 19 liver biopsies from patients with chronic hepatitis B virus infection. In areas of piecemeal necrosis, periportal hepatocytes demonstrated Class I major histocompatibility complex products or HLA-A, B and C antigens, but did not show a preferential expression of either HBcAg or HBsAg. The cellular infiltrate of piecemeal necrosis consisted of helper/inducer and suppressor/cytotoxic T-lymphocytes, and was admixed in four cases with branching dendritic processes of sinusoidal lining cells which strongly expressed Class II major histocompatibility complex products or HLA-DR antigens. The latter surrounded small groups of periportal hepatocytes. In areas of spotty necrosis, the hepatocytes expressed HLA-A, B and C antigens in all cases, and were admixed with variable numbers of suppressor/cytotoxic T-lymphocytes. In 14 cases, the clustered hepatocytes in areas of spotty necrosis expressed HLA-DR antigens, associated in 11 of the cases with immunoreactive HBcAg in the nuclei of some of the HLA-DR-positive hepatocytes. Immunoelectron microscopy, performed in one such case, demonstrated the presence of HLA-DR antigen in a discontinuous pattern at the plasma membrane of some hepatocytes, together with the presence of core particles in the nucleus of HLA-DR-positive hepatocytes. Our findings further contribute to the growing evidence that HBcAg represents the major target antigen for T-cell attack in areas of spotty necrosis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3530952 TI - Distribution of basement membrane laminin and type IV collagen in human reactive lymph nodes. AB - The location of two basement membrane components, laminin and the 7-S domain of type IV collagen, was studied in human lymph nodes using the peroxidase antiperoxidase method. Basement membrane antigens were present on the walls of blood vessels and of marginal, trabecular and medullary sinuses. Thin, fragmented fibre-like staining was present also in parenchyma outside the germinal centres, in a pattern overlapping with reticular fibres as seen on conventional reticulin stains. This finding suggests that basement membrane components are a part of the reticular fibres of lymph nodes, or are closely associated with them. PMID- 3530951 TI - Interactions between liver allografts and lymphocytotoxic alloantibodies in inbred rats. AB - Several clinical and experimental findings suggest that liver allografts are less sensitive than other organ allografts to lymphocytotoxic antibodies. In this experimental study in hypersensitized inbred rat recipients, rejection of liver allografts was delayed compared to that of heart allografts. Furthermore, there was a marked decrease in the level of cytotoxic antibodies after liver allografting but not after heart allografting in these animals. The decrease in the level of antibodies also occurred after donor-specific extracorporeal liver hemoperfusion in hypersensitized recipients. Whether the decrease was caused by a massive absorption of antibodies on the liver or related to excretion of major histocompatibility complex antigens in a soluble form remains to be demonstrated. These results support the hypothesis that the liver has a privileged position in regard to rejection and are consistent with clinical observations made following ABO incompatible or cross-match positive liver transplantations. PMID- 3530954 TI - Human collagens: biochemical, molecular and genetic features in normal and diseased states. PMID- 3530953 TI - Metallothionein gene regulation in Menkes' disease. AB - Metallothioneins are a family of ubiquitous, cysteine rich proteins, whose amino acidic and genomic sequences have been highly conserved during evolution. MT synthesis is induced by heavy metals, glucocorticoids and a bacterial lipopolysaccharide in vivo and in vitro. MT forms stable complexes with heavy metals. One MTIIA gene, four MTI class genes and five pseudogenes have been isolated in humans. The cluster of MT genes is located on chromosome 16. The cloned, transfected genes retain metal inducibility. The first 150 bp of the 5' flanking region of mouse and human MT genes are essential for transcription and metal regulation. Two control regions have been identified. The distal region, between -151 and -78 is essential for efficient transcription and binding of cellular factor(s) which regulates MT gene expression. In Menkes' disease, a lethal X-linked recessive disorder, copper accumulates intracellularly bound to MT. Low doses of copper induce MT synthesis in Menkes' fibroblasts, but not in normal controls. Transfection experiments using the mouse MTI promoter fused to CAT show that the effect of copper in MT transcription is in trans. Menkes' cells are more sensitive to copper than normal controls and respond to copper poisoning by synthesizing two heat-shock like proteins. A mutation affecting copper transport or metabolism is discussed. PMID- 3530955 TI - In vitro transformation of epithelial cell by acute retroviruses. PMID- 3530956 TI - Aldolase gene and protein families: structure, expression and pathophysiology. PMID- 3530957 TI - Psychiatric interventions for AIDS-spectrum disorders. AB - Although the medical and psychosocial problems posed by acquired immune deficiency syndrome (AIDS) are unique, interventions to treat AIDS-related psychiatric disorders are currently available. The depression, delirium, and denial that occur in medically hospitalized patients with AIDS respond to standard psychotherapeutic and psychopharmacological approaches. Outpatients with AIDS or AIDS-related complex benefit from clarification, abreaction, and support if the therapist accepts the regression associated with the sick role, focuses initially on somatic rather than on psychological concerns, and overcomes unwarranted fears of contagion. Patients with AIDS-related dementia are helped considerably by early diagnosis and planning, and patients with antibodies to the AIDS virus require a psycho-educational approach that includes stress inoculation and problem-solving techniques. The authors describe the above interventions as well as common countertransference responses that impede their implementation. PMID- 3530958 TI - The Canton Asylum for Insane Indians: an example of institutional neglect. AB - Based on archival data, the author chronicles the history of the Canton (S.D.) Asylum for Insane Indians, which was established by Congress in 1903 and was closed in 1934 because of inadequate conditions. In 1926 a nationwide survey found that patients at Canton received minimal care. The rates of patient death and discharge at Canton reported in a 1931 survey compared unfavorably to those at other mental institutions in the U.S. The 1929 and 1933 inspection reports of psychiatrist Samuel Silk, which documented the hospital's outmoded custodial care and questioned the necessity of institutionalization for 35 to 40 of Canton's 90 patients, played a key role in the decision to close the asylum. The author attributes the decline of the Canton Asylum to gradual neglect by its superintendent and various government agencies. PMID- 3530959 TI - Psychiatric episodes in general hospitals without psychiatric units. AB - Forty percent of inpatient psychiatric episodes are treated in general hospitals without psychiatric units, but little is known about these patients and their treatment. A survey of medical records personnel at 452 hospitals without psychiatric units revealed that the hospitals' psychiatric patients typically lived at home, were admitted through the emergency room because of a substance abuse disorder, received active medical treatment, were discharged back home after about four days, and paid with private insurance. The hospitals that treated primarily substance abusers provided a significantly different mix of treatments than did those that treated primarily patients with traditional diagnoses. The data suggest that general hospitals without psychiatric units may provide appropriate treatment for psychiatric patients, especially those with a substance abuse disorder. PMID- 3530960 TI - A clinical overview of syndromes following withdrawal of antidepressants. PMID- 3530961 TI - Medicare denying payments for day psychiatric care. PMID- 3530962 TI - Penny-pinching Administration angers providers. PMID- 3530963 TI - Rural hospitals socked by token DRG rate boost. PMID- 3530964 TI - Hospitals reach consensus on capital reform. PMID- 3530965 TI - New bill tightens GME payments. PMID- 3530966 TI - Imaging centers continue to grow. PMID- 3530967 TI - DRG system flunks test for rehabilitation providers. PMID- 3530968 TI - Hospital profit reports trigger well-planned CT response. PMID- 3530969 TI - The health lifeline: out of the reach of women and children? PMID- 3530970 TI - CFOs see future differently: study. PMID- 3530972 TI - Glomerular basement membrane abnormalities associated with apparently idiopathic hematuria: ultrastructural morphometric analysis. AB - In a recent review of 480 renal biopsies, 41 cases were identified in which glomerular basement membrane (GBM) ultrastructural abnormalities were the major lesion. All of the patients had hematuria. None had evidence of immune-mediated glomerulonephritis. Positive family histories of renal disease were present in the majority of cases, and one case of Alport's syndrome was included. Subjectively, the GBM changes were variable but nearly always included membrane thinning. For objective characterization of this glomerular abnormality, a detailed morphometric study of GBM thickness was undertaken: 12 of these patients (study group) were compared with seven patients (control subjects) with subjectively normal glomeruli who underwent biopsy for reasons other than nonsurgical hematuria but who were also thought to have normal glomerular ultrastructure. The seven control subjects had a mean GBM thickness of 394 nm (SD, 19; range, 356 to 432 nm). Of the 12 study group patients, 11 had mean GBM thicknesses significantly different from control values (nine had mean GBM thinning: range, 235 to 327 nm; two had thickening: means, 440 and 469 nm). In the remaining case (Alport's syndrome) the overall mean was normal, but an abnormal distribution of very thin and very thick GBM regions was seen. Of the four apparently normal hematuric patients, significant mean GBM thinning (326 to 347 nm) was demonstrated in three, with an excess of thin GBM in the fourth case, although the mean thickness was normal. Thus, measurable abnormalities were defined in all of the cases of hematuria examined. The GBM measurements confirmed the subjective impression of membrane abnormality, usually attenuation, as the principal finding in this group of hematuric patients. Furthermore, morphometric analysis may reveal subtle changes of GBM thickness missed by subjective assessment. PMID- 3530971 TI - Immunoglobulin gene rearrangements in Hodgkin's disease. AB - An initial survey of biopsy specimens from 16 cases of Hodgkin's disease revealed clonal immunoglobulin gene rearrangements in one specimen, which contained large numbers of Reed-Sternberg (R-S) cells. As a result of this finding, the configuration of immunoglobulin and T-cell receptor gene DNA was investigated in biopsy tissues from other cases that were histologically and immunophenotypically consistent with Hodgkin's disease and contained numerous R-S cells. In six of seven such specimens (all of the nodular sclerosing subtype), selected solely on the basis of high R-S cell content and sufficient frozen tissue for study, at least one immunoglobulin gene was found to be rearranged in a clonal manner. Additionally, tissue samples obtained at two different time points from the original patient who showed immunoglobulin gene rearrangements revealed identical patterns of rearrangement. In the majority of cases, only a single gene showed rearrangement, and the rearranged bands in Southern blot autoradiograms were usually considerably less intense than the germline bands. No rearrangements of T cell receptor DNA were detected in any case with a probe for the beta T-cell receptor gene. The results suggest that clonal cell populations possessing uniform immunoglobulin gene rearrangements are present in tissue in some cases of Hodgkin's disease. It is not possible to determine which cells contain these rearranged genes, but the increased incidence of detectable rearrangements in cases with high numbers of R-S cell raises the possibility that immunoglobulin gene rearrangement occurs in these cells. PMID- 3530973 TI - Mycobacterial coronary arteritis in a heart transplant recipient. AB - A case of mycobacterial vasculitis in a chronically rejected transplanted heart is described. The coronary arteries were the only vessels involved by mycobacteria, although the patient had a generalized infection. The process of chronic rejection, with persistent injury to the intimal vascular lining of a transplanted organ, may lead to defects in the endothelial cell barrier and thus facilitate infiltration of a vessel wall by acid-fast bacilli. PMID- 3530974 TI - Myocardial contraction bands in transplant biopsies. PMID- 3530975 TI - Toxic terror: a counterattack. PMID- 3530976 TI - The extracellular matrix in "sclerosing" follicular center cell lymphomas: an immunohistochemical and ultrastructural study. AB - "Sclerosis" is frequently seen in follicular center cell (FCC) lymphomas. The mechanism of its deposition, as well as its composition and significance, are unknown. Several clinical studies have suggested that the course of these lymphomas is more indolent than that of lymphomas of the same histologic type without sclerosis. Nine immunologically characterized cleaved FCC lymphomas with sclerosis and 14 reactive lymph nodes with follicular hyperplasia were investigated by special staining methods, electron microscopy, and immunohistochemical studies with antibodies to types I, III, IV, and V collagen, laminin, and fibronectin. The sclerotic tissue in FCC lymphomas stained uniformly with periodic acid-Schiff (PAS) and Masson's stain, with the patterns ranging from delicate filamentous strands to dense doubly refractile bands. Ultrastructurally, the bands of connective tissue were continuous with the adventitia of vessels and composed of varying amounts of banded collagen (types I and III) admixed with filamentous and flocculent material. In all cases the neoplastic lymphocytes were separated from the extra-cellular matrix by fibroblasts and myofibroblasts with long cell processes. Immunohistochemical studies demonstrated intense staining of sclerotic bands with antibodies to fibronectin and type I collagen and, usually, weaker marking with antibodies to types III and V collagen. No significant staining of sclerotic bands was found with antibodies to type IV collagen or with laminin. Weak pericellular staining for type V collagen was present in eight of nine lymphomas and half of the control lymph nodes. These studies suggest that the increased amounts of extracellular matrix in cleaved FCC lymphomas are produced primarily by fibroblasts and myofibroblasts and represent predominantly fibronectin and types I, III, and V collagen. The composition of the sclerotic areas of FCC lymphomas is similar immunohistochemically to that of the capsule and trabeculae of reactive lymph nodes, which are also intimately associated with fibroblasts and myofibroblasts. PMID- 3530979 TI - Group-specific component (Gc): subtypes in the Finnish population. Description of a new allele and an apparent mother-child incompatibility. AB - The group-specific component (Gc) subtypes were determined in 575 adult Finns by immunoblotting after isoelectric focusing in agarose gel. The gene frequencies were Gc1S = 0.661, Gc1F = 0.139 and Gc2 = 0.200. This material included one rare allele, a more acidically focusing Gc 2 (named Gc 2A18). The phenotypes of 200 mother-child pairs studied were in accordance with the three-allelic mode of inheritance. An apparent mother-child incompatibility observed during routine paternity testing is reported. PMID- 3530978 TI - The evolution of the alpha- and beta-globin gene clusters in human populations. AB - DNA analysis of the alpha- and beta-globin gene clusters has revealed substantial variability between individuals and populations. As well as restriction enzyme site and length polymorphisms, variation in gene copy number and type is observed. Because of this extensive polymorphism DNA analysis offers a highly informative method of studying genetic affinities between human populations. Haplotypes, consisting of a set of restriction enzyme polymorphisms distributed along the cluster, have been developed for both loci. Analysis of the molecular basis of numerous beta-thalassaemia alleles has revealed, in general, different sets of mutations in different populations, indicating that these postdate the racial divergence. Recent microepidemiological studies on the distribution of alpha-thalassaemia support the hypothesis that this condition, like the beta s mutation, has been selected because it confers protection against malaria. Population-specific DNA polymorphisms at these and other loci promise to be of considerable value to genetic anthropology. PMID- 3530980 TI - State of the science. Effects of imagery. PMID- 3530977 TI - The nuclear skeleton and the spatial arrangement of chromosomes in the interphase nucleus of vertebrate somatic cells. AB - The topologic distribution of interphase chromosomes established by using various cytologic methods and data concerning the DNA-nuclear skeleton interactions in isolated nuclear fractions were reviewed and discussed. Comparison of these different data clearly showed that the position of chromosomes observed in situ is in agreement with the results obtained from isolated nuclear fractions, indicating that all DNA molecules are bound to the peripheral nuclear skeleton. Moreover, the in situ position of the rDNA near the nuclear envelope can be correlated with the existence of a nucleolar skeleton connected to the peripheral nuclear skeleton. Taking into account the discrepant results regarding the actual existence of an internal nuclear skeleton, we attempted to analyze how the various nuclear skeletal structures described in the literature can be involved in both the distribution of chromosomes and in their chromatin organization. As many questions are still unanswered, we considered the modes of investigation that seem to be the most promising. PMID- 3530982 TI - Con A induction of IgG secretion from a B-lymphoid tumour cell line, A20. AB - We have examined the effect of concanavalin A (Con A), a conventionally known T cell mitogen, on the induction of Ig secretion from BALB/c B lymphoid cell lines expressing membrane IgM (X16C8.5, BALENTL 17.7.2 and BCL1) or membrane IgG (A20 and M12.4). A20 tumour cells, but not other tumour cells, responded to Con A by secreting Ig as measured by the reverse plaque-forming cell (PFC) assay. Another typical T-cell mitogen, phytohaemagglutinin (PHA), did not have any effect on the differentiation of A20 tumour cells. The addition of NaN3 abolished the PFC formation, showing that IgG PFC formation of A20 tumour cells was due to the active synthesis of secreted IgG and not due to the shedding of mIgG. The increase in the biosynthesis of secreted IgG from A20 tumour cells by Con A was also observed by polyacrylamide gel electrophoresis. The ability of Con A to induce IgG secretion from A20 tumour cells was abolished by the addition of alpha methylmannoside, confirming that Con A itself, and not some contaminating material in Con A, induced the maturation of A20 tumour cells. Con A was also shown to induce Ig secretion, but not proliferation, in a subset of normal B cells. Thus, we conclude that Con A does give a differentiation signal to a subset of B cells. PMID- 3530981 TI - Does complement kill E. coli by producing transmural pores? AB - Three lines of evidence are presented to indicate that C5b-9 kills serum sensitive E. coli K 12 cells by generating functional pores across the outer and inner bacterial membrane. First, viable cells carrying C5b-8 complexes are impermeable to o-nitrophenyl-beta-D-galactoside (ONPG), but lose viability and become permeable to this marker upon post-treatment with purified C9 in the absence of lysozyme. Cells killed with colicin E1 or gentamicin are also impermeable to ONPG but take up the marker if they are post-treated with lysozyme free serum. Second, killing by C5b-9 is highly effective, deposition of only a small number of complexes being lethal. This has been demonstrated in experiments where viable cells carrying 2000-4000 C5b-7 complexes per CFU were permitted to multiply in broth culture, and the daughter generations subsequently treated with purified C8 and C9. Fifty percent killing was observed in the fifth to sixth generation, corresponding to a dilution of C5b-7 complexes to 50-100 molecules/CFU. In the presence of 2 mM EDTA, further dilution of C5b-7 down to 8 30 complexes/CFU still caused 50% killing of daughter cells. Third, treatment of C5b-7 cells with purified CC8 and C9 results in the release of intracellular K+, which commences immediately after addition of C8/C9. This was shown in experiments where C5b-7 cells were packed to high density in saline, post-treated with C8 + C9, and K+ directly measured in the cell supernatants. Based on these results, we propose that C5b-9 pores deposited in the outer bacterial membrane periodically fuse with the inner membrane, the transmural pores thus generated permitting rapid K+ efflux, with cell death ensuing through the collapse of membrane potential. PMID- 3530983 TI - Autologous lymphoid cells exposed to recombinant interleukin-2 in vitro in the absence of antigen can induce the rejection of long-term tolerated skin allografts. AB - The intraperitoneal (i.p.) administration of autologous spleen cells treated with recombinant interleukin-2 (IL-2) in vitro resulted in the rejection of C57BL/10ScSn (B10) skin grafts that had survived for 18 months on CBA/Ca mice tolerant to B10 alloantigens. Cytotoxic lymphocytes specific for the graft alloantigens, assayed by limiting dilution analysis, appeared after the breaking of this immunological tolerance, whereas they were not detectable in tolerant mice. In these mice the frequencies of precursor cytotoxic cells specific for third-party alloantigens were unaffected by the IL-2 treatment. PMID- 3530984 TI - Generation of cells expressing cytoplasmic and/or surface T-cell receptor beta chains during the development of mouse fetal thymus. AB - We have used a double immunofluorescence technique to identify newly formed cells expressing cytoplasmic and/or surface T-cell receptor beta chains in mouse embryo thymus. In addition, we have localized these cells to the developing thymic cortex by immunoperoxidase labelling of frozen sections. The first positive cells appear in small numbers in the thymus at Day 15 of gestation and express cytoplasmic but not surface beta chains (C beta+). At Day 16 of gestation, cells appear that express small capped areas of surface beta chains as well as cytoplasmic beta chains (C beta+S beta+ cells). Just prior to birth, a cohort of cells appears that express surface beta chains but no cytoplasmic beta chains detectable by the methods employed (S beta+ cells). These results and vincristine mitosis-blocking studies suggest that a proliferating population of cortical thymocytes accumulate cytoplasmic beta chains before giving rise to T cells that express surface beta chains (presumably in association with alpha chains). When a monoclonal antibody to beta chains is present in organ cultures of embryonic thymus, C beta+ thymocytes continue to be generated but there is an absence of S beta+ cells. The latter appear after the cultures are transferred to fresh medium not containing the antibody. PMID- 3530985 TI - [Nitrate isoconazole: a new topical use antimycotic]. PMID- 3530986 TI - [The centenary of the Italian Society of Dermatology and Venereology (1885-1985). A brief history and perspectives of action]. PMID- 3530987 TI - Dermatology and venereology in Italy 100 years ago. Relations with American and German dermatology and venereology. I: Dermatology. PMID- 3530988 TI - [Dermatology and venereology in Italy 100 years ago. Relations with american and german dermatology and venereology. II: Venereology]. PMID- 3530989 TI - [Association of erosive lichen of the mucosa, chronic hepatopathy of uncertain classification, bullous pemphigoid]. PMID- 3530990 TI - Subpopulations of circulating lymphocytes in adults with coeliac disease. AB - Circulating lymphocytes were enumerated in 25 patients with coeliac disease and in 24 healthy donors by immunofluorescent staining using monoclonal antibodies for T cell surface phenotypic markers T11 (mature), T4 (helper) and T8 (suppressor) or polyvalent antisera for surface immunoglobulins (B cells). Proportions of peripheral T and B cells and percentages and ratio of T cell subsets in coeliac disease were not significantly different from those in controls. Individual ratios of helper to suppressor T cells did not correlate with disease activity or with keeping the diet. PMID- 3530991 TI - Characterization of circulating immune complexes in heart disease. AB - Circulating immune complexes (CIC) were characterized for the content in IgG, IgA, IgM, C3 and C4 in patients with heart disease. The levels of IgG, IgM and C4 in PEG-precipitates of patients' sera were significantly higher than those found in controls, and the precipitation profile was similar to that of rheumatoid arthritis patients. Differences were observed in the composition of CIC: IgM was highest in association with myocarditis, and C3 predominated in cases of valvular disease. Complex-bound C4 was significantly higher in patients with myocardial infarction which developed pericarditis either early or late in the evolution of the disorder. Antimyocardial antibodies could be detected in sera and in corresponding PEG-precipitates. The bulk of the data suggests that CIC might play a pathogenetic role in various heart diseases. PMID- 3530992 TI - Effects of cyclosporin A on the activity of mouse natural killer cells and hybrid resistance. AB - It was found that a single dose of cyclosporin A (CSA) administered intraperitoneally resulted in rapid, but transitory reduction of (C57B1/6 X DBA/2)F1 spleen cell natural killer (NK) activity (on day 1 after CSA), then a return to the normal level (on day 3 after CSA) and finally gradual, but sharp decrease of this activity (the lowest activity on day 9). It was also found that CSA injected 3 days before semi-allogenic bone marrow transplantation (BMT) has no effect on hybrid resistance (HR), but administered 9 days before BMT caused abrogation of HR. So, there was a correlation between changes of NK activity after CSA and effects of CSA on HR, suggesting that NK cells are responsible for HR. In contrast, there was no effect of CSA on the engraftment of syngeneic bone marrow cells. PMID- 3530993 TI - Anti-idiotypic antibodies and disease. PMID- 3530994 TI - Production and utilization of a mouse monoclonal antibody to rat IgA: identification of gender-related differences in the secretory immune system. AB - The present study was designed: to produce a mouse monoclonal antibody to rat IgA; and to examine, by using the monoclonal antibody, possible gender-related differences in the secretory immune system. Hybridomas were prepared that secreted mouse monoclonal antibodies directed specifically against rat IgA. These antibodies were identified as IgG1 and kappa chain positive and could be used to purify rat IgA by affinity chromatography, detect tissue IgA by immunofluorescence and measure IgA levels in external secretions by radioimmunoassay. In utilizing these antibodies, we found that a distinct, gender related difference exists in the number of IgA-containing cells in the rat lacrimal gland. Lacrimal tissue from male rats had a significantly higher content of IgA-positive cells than did that from female rats. This difference correlated well with our previous observations on the sexual dimorphism in tear IgA levels. We also observed in the present study that gender-associated variations in IgA content occur in respiratory secretions. In contrast to the eye, however, females had significantly greater IgA concentrations than did males. No effect of gender was found on IgA levels in small intestinal secretions, saliva or serum. Overall, our results indicate that gender may play a role in the immune response of specific mucosal tissues. PMID- 3530995 TI - Antinuclear antibody activity of IgD immunoglobulins. PMID- 3530996 TI - Effect of 2,5-di(4-methyl phenyl)-1,3,4-oxadiazole on pregnancy in golden hamster. PMID- 3530997 TI - Clinical trial on the effect of domperidone on non-ulcer dyspepsia. PMID- 3530998 TI - Distribution of malarial parasites in eastern Bihar. PMID- 3530999 TI - The practical use of anticonvulsants in pediatric practice. PMID- 3531000 TI - The role of ultrasound in renal disease. PMID- 3531001 TI - Long term prophylaxis of febrile seizures. PMID- 3531002 TI - Cerebral malaria in children. PMID- 3531003 TI - Salmonella meningitis: report of five cases. PMID- 3531004 TI - Modulation of kidney renin messenger RNA levels during experimentally induced hypertension. AB - Several experimental procedures produce dramatic alterations in kidney renin production, leading to increased plasma renin levels with attendant hypertension in animal model systems. The pattern of changes for kidney renin messenger RNA (mRNA) levels relative to changes for tissue and plasma renin activity was studied in Sprague-Dawley rats made hypertensive by either coarctation of the aorta between the two renal arteries or clipping of the left renal artery. In both models, the renin mRNA content of the contralateral hypertrophied kidney transiently decreased to undetectable levels while the ischemic kidney exhibited transient increases in renin mRNA. In aorta-coarctated rats ischemic kidney renin mRNA increased 10-fold to 16-fold during the first 3 days after coarctation but returned to the level observed in sham-operated rats 14 days after operation. However, differences between the time course and magnitude of changes in renin mRNA levels and the pattern of alteration in tissue and plasma renin activities were observed. Thus, although the kidney renin mRNA transiently increased in hypertensive animals, the extent of this increase was insufficient to account for the 30-fold to 50-fold increases in plasma renin activity. Similarly, the transient increase in kidney renin mRNA was inconsistent with only a twofold increase in tissue renin enzyme activity of the ischemic kidney. These data indicate that in addition to alterations in the kidney renin mRNA pool, posttranslational processing and/or release of renin from the kidney are cocontributors in regulating the plasma renin levels in these experimental models. PMID- 3531005 TI - Preferential inhibitory effect of nifedipine on angiotensin II-induced renal vasoconstriction. AB - The inhibitory effects of nifedipine on renal vasoconstrictor response to angiotensin II, norepinephrine, or renal nerve stimulation were tested in anesthetized dogs. Intrarenal infusions of nifedipine (0.3, 1, and 3 micrograms/min) dose-dependently suppressed the renal vasoconstriction induced by intrarenal injections of angiotension II (0.03, 0.05, and 0.1 microgram) or norepinephrine (0.3-1 micrograms) but not that by renal nerve stimulation (4-7 Hz). However, the inhibitory effect of nifedipine on angiotensin II-induced vasoconstriction was greater than its effect on norepinephrine-induced or renal nerve stimulation-induced vasoconstriction (i.e., 50% reduction in renal blood flow). Furthermore, a greater renal vasodilation induced by intrarenal bolus injections of nifedipine (1,3, and 10 micrograms) but not by acetylcholine (0.1 and 0.3 microgram) was observed during the reduction in the perfusion pressure of the contralateral kidney to approximately 50 mm Hg, which resulted in an increase in plasma renin activity and plasma angiotensin II concentration but no change in plasma norepinephrine concentration. There was a significant positive correlation between plasma renin activity and plasma angiotensin II concentration before nifedipine injections and the subsequent increase in renal blood flow produced by each dose of nifedipine. These results indicate that nifedipine has a relatively preferential inhibitory effect on the renal vasoconstriction produced by both exogenous and endogenous angiotensin II in canine renal vasculature. PMID- 3531006 TI - Effects of acute renal denervation on kidney function in deoxycorticosterone acetate-hypertensive swine. AB - Deoxycorticosterone acetate-induced hypertension in Yucatan miniature swine appears to involve elevated peripheral sympathetic activity. Abnormalities in renal function in these hypertensive animals are also apparent. To determine the extent to which renal nerve activity controls kidney function in animals with established deoxycorticosterone acetate hypertension, the effects of acute renal surgical denervation were assessed in five normal and 10 deoxycorticosterone acetate-treated swine. After 12 to 16 weeks of treatment, mean arterial pressure rose from the normal level of 110 to 120 to 164 +/- 4 mm Hg but was decreased to 131 +/- 4 mm Hg by anesthesia. In the normal animals, blood pressure under anesthesia was 114 +/- 9 mm Hg. Acute left kidney surgical denervation significantly decreased renal vascular resistance and increased renal blood flow, glomerular filtration rate, urine flow, and sodium excretion only in the treated animals. In an additional group of six normal and eight deoxycorticosterone acetate-treated swine, the responses to renal pharmacological denervation with intrarenal guanethidine were evaluated. Guanethidine had no significant effect on renal blood flow, vascular resistance, glomerular filtration rate, urine flow, or sodium excretion in the normal animals. In contrast, in the mineralocorticoid hypertensive animals, guanethidine significantly decreased renal vascular resistance and caused a diuresis and natriuresis with no change in glomerular filtration rate. We conclude that, in deoxycorticosterone acetate-treated miniature swine with established hypertension, renal nerve activity appears to be elevated and important in determining renal hemodynamics and sodium and water excretion. PMID- 3531007 TI - A case of adrenal tumor producing renin, aldosterone, and sex steroid hormones. AB - A 27-year-old woman with an adrenal tumor that produced renin and aldosterone, associated with hypertension and adrenogenital syndrome, is described. Severe hypertension, cardiomegaly, a low serum potassium level, clinical symptoms of adrenogenital syndrome, and a left upper abdominal tumor also were found. Endocrinological studies showed that plasma and urinary levels of sex steroid hormones such as dehydroepiandrosterone, androsterone, and testosterone were markedly increased. Plasma renin activity, plasma angiotensin II, and plasma aldosterone levels also were increased markedly, although deoxycorticosterone levels remained within the normal range. The possibility of renovascular hypertension was excluded by angiography of the renal artery and by venous sampling of plasma renin activity. Abnormal elevations in plasma aldosterone levels persisted despite normalization of plasma angiotensin II by converting enzyme inhibitor administration. It was suspected that this patient had an adrenal tumor producing renin as well as sex steroids and aldosterone. Microscopy of the resected tumor revealed that the tumor was composed mostly of cells with large nuclei and light cytoplasm. The tumor contained dehydroepiandrosterone, dehydroepiandrosterone sulfate, testosterone, aldosterone, and renin. Immunohistochemical study showed that some of the tumor cells produced renin. Biopsy of the left renal tissue showed evident atrophy of the juxtaglomerular cells and pronounced arteriosclerosis. After resection of the tumor, all blood and urinary levels of the abnormally increased hormones returned to a normal range and an apparent fall of blood pressure was noted. To our knowledge, this is the first report of a renin and aldosterone-producing adrenal tumor associated with hypertension and adrenogenital syndrome. PMID- 3531008 TI - The interpretation of ribosome determinations to assess protein synthesis in human skeletal muscle. AB - A survey is given on the determination and interpretation of ribosomal concentration and size distribution in animal and human muscle biopsy samples as a means to assess protein synthesis under various physiological and pathological conditions. PMID- 3531009 TI - Fat emulsions are more than energy suppliers. AB - The type of triglycerides in exogenous fat emulsions as well as the phospholipid: triglyceride ratio influences the plasma clearance. The plasma clearance cannot be used for indicating the utilization of fat emulsions as energy substrate. Introducing exogenous fat in replacement of part of the calories provided by glucose reduces a series of complications associated with large glucose intake. There are exchanges of triglycerides, esterified cholesterol, phospholipids and apoproteins between exogenous lipids and endogenous lipoproteins, depending on the composition of exogenous lipid emulsions. These interactions can significantly modify the composition of both, exogenous particles and endogenous lipoproteins. In future it will become essential to determine the removal site of 'exogenous remnants'. Future progress will allow a better understanding of the influence of these modifications on the metabolism of endogenous lipoproteins and the utilization of exogenous fat emulsions. PMID- 3531010 TI - [Zeitschrift fur Stomatologie, Volume 31, 1933: The crisis in orthodontics, I. By Albin Oppenheim]. PMID- 3531011 TI - Protection of C3H/HeJ mice from lethal Salmonella typhimurium LT2 infection by immunization with lipopolysaccharide-lipid A-associated protein complexes. AB - C3H/HeJ mice were immunized intraperitoneally (i.p.) with lipopolysaccharide (LPS)-lipid A-associated protein (LAP) complexes or with purified protein-free LPS prior to lethal i.p. or intravenous Salmonella typhimurium LT2 challenge. Our results demonstrated that these Salmonella-hypersusceptible mice can be effectively protected against 1,000 100% lethal doses of S. typhimurium LT2 (i.e., 1,000 viable bacteria) administered by intravenous challenge when previously immunized with LAP-LPS complexes. In contrast to these results, immunization with LPS afforded markedly less protection regardless of the route of challenge, thus suggesting that the LAP portion of LAP-LPS complexes may be necessary for inducing protection against Salmonella infections. For most experiments, antigens were emulsified in complete Freund adjuvant (CFA); however, the CFA portion of the vaccine was suggested not to be an essential component for the induction of immunity to Salmonella infections, since equivalent levels of protection were obtained when it was omitted from the vaccine. The induction of immunity to murine salmonellosis by prior immunization with CFA-LAP-LPS was demonstrated not to be a transient phenomenon, since C3H/HeJ mice were still protected against lethal S. typhimurium LT2 challenge as late as 225 days postimmunization. PMID- 3531012 TI - Macrophage uptake and retention of radiolabeled glycopeptidolipid antigens associated with the superficial L1 layer of Mycobacterium intracellulare serovar 20. AB - Glycopeptidolipid (GPL) antigens which are associated with the superficial L1 layer of Mycobacterium intracellulare serovar 20 were labeled with radioisotopes by means of internal labeling techniques and used in macrophage uptake and retention studies. The use of tritiated alanine and phenylalanine allowed the incorporation of label into the GPL invariant fatty acyl peptide core, which is common to all members of the Mycobacterium avium-M. intracellulare complex. Radiolabeled GPL antigens were then purified by a one-step column chromatographic procedure and subsequently used to determine the maximum uptake and retention in peritoneal macrophages isolated from C57BL/6 and CBA/J mice. Maximum uptake for peritoneal macrophages from both strains of mice occurred at a concentration between 200 and 250 micrograms of antigen per ml of medium when 3.4 X 10(5) cells were pulsed. Timed experiments demonstrated that approximately 20% of the antigens remained associated with the macrophages up to 4 days after a pulse of 200 micrograms of GPL, and examination of chloroform-extractable components from both macrophages and spent medium revealed that 98% or more of the radioactivity corresponded to intact GPL components. The ability of the GPL antigens to become associated with macrophages is demonstrated by these results, which strongly suggest that these potentially important mycobacterial antigens are inert to degradation by those cells. PMID- 3531013 TI - Passive transfer of mucosal antibody to Streptococcus equi in the foal. AB - Passive transfer of mucosal antibody to Streptococcus equi was studied in foals during the first 2 months of life. Immunoglobulin G (IgG) and IgA antibodies were found in sera and nasal secretions of foals shortly after colostrum intake. Titers were highest 2 days after birth; IgG predominated in sera, and IgA predominated in nasal washes. Intragastrically administered 99mTc-labeled IgA was transported from the bloodstream to the nasal mucosa of a newborn foal within a few hours of colostrum intake. Western blot analysis of the specificities of colostral and serum antibodies showed that selective transfer of immunoglobulins of defined specificity did not occur. Antibodies from milk samples taken a month or more into lactation had different specificities than those of colostrum or serum samples. Acid-extracted M protein fragments of S. equi recognized by milk antibodies were the same as those recognized by IgG and IgA from nasopharyngeal mucus of horses recently recovered from strangles. We postulate that passive antibody protection of the foal is derived both by secretion of colostral immunoglobulins onto the nasopharyngeal mucosa and by immunoglobulins ingested in milk that directly coat the upper respiratory and oral mucosa during the first months of life. PMID- 3531015 TI - A monoclonal antibody to a cell wall component of Candida albicans. AB - A heterologous fusion between mouse myeloma cells and rat lymphocytes resulted in the isolation of a rat immunoglobulin M monoclonal antibody with both agglutinating and precipitating activity. Indirect immunofluorescence and direct agglutination tests showed that the corresponding antigen was present in the cell wall of the three Candida species considered to be the most pathogenic, C. albicans, C. tropicalis, and C. glabrata, and also in the cell wall of C. guilliermondii. The antigen appeared to be predominantly polysaccharide in nature. Precipitation by counterimmunoelectrophoresis suggested that the epitope is shared by at least two separate molecules with different electrophoretic mobilities. Presence of this epitope varied from strain to strain within a given species and may be related to the morphological stage in the cell cycle. Antigen was shown to be present in the cytoplasm, in the periplasmic space, and at the cell surface of C. albicans. Indirect immunofluorescence also suggested that antigen is excreted from the cell. PMID- 3531014 TI - Treponemal infection specifically enhances node T-cell regulation of macrophage activity. AB - Hamsters experimentally inoculated in the inguinal region with Treponema pallidum subsp. endemicum develop considerable pathology at that site. We examined the cell populations from these inguinal lymph nodes to determine their intercellular responses to infection. In vitro, syphilitic-node T cells markedly suppressed C3b receptor-mediated ingestion (C3bMI) in syphilitic macrophages derived from sites both proximal and distal to the inoculation. This activity was more pronounced when node T cells rather than peritoneal T cells were used. When treponemal preparations or live treponemes were added to the coculture system, the suppression was specifically enhanced, whereas the addition of heterologous agents did not promote this effect. Syphilitic macrophages from either compartment cultured alone showed no significant inhibition of C3bMI. In parallel studies on syphilitic macrophages, we observed that the expression of Ia quickly became elevated and was sustained throughout the infection. Moreover, in vitro culturing of the syphilitic-node T cells with these macrophages did not alter this function. These observations suggest that the syphilitic node contains a subpopulation of T cells that can selectively suppress macrophage C3bMI activity and concurrently regulate their cellular response to treponemal infection. PMID- 3531016 TI - Bactericidal-activities of human polymorphonuclear leukocyte proteins against Escherichia coli O111:B4 coated with C5 or C8. AB - The postnuclear supernatant of disrupted polymorphonuclear leukocytes exhibited bactericidal activity on Escherichia coli O111:B4 coated with immunoglobulin M antibodies and C5 or C8 but not on C3- or C7-coated bacteria. To characterize this antimicrobial activity further, granules obtained from the postnuclear supernatant were extracted with sodium acetate (pH 4) and the soluble extract was subsequently fractionated through carboxymethyl cellulose and Sephacryl S-200. Over 90% of the activity present in the starting material was recovered in the soluble granule extract. Kinetic and dose-response analyses of the bacterial activity of the polymorphonuclear leukocyte extract on BAC1-5 and BAC1-8 revealed different susceptibilities to killing of these two bacterial intermediates; they also differed for their susceptibilities to killing at 37 degrees C and at room temperature. The suggestion raised by these data, that BAC1-5 and BAC1-8 could be killed by different bactericidal factors, was confirmed by the findings that separate fractions of the soluble granule extract obtained by carboxymethyl cellulose and Sephacryl S-200 chromatography exhibited specific activity on either BAC1-5 or BAC1-8, whereas other fractions were active on both intermediates. PMID- 3531017 TI - Lyophilized airborne Clostridium botulinum spores as inocula that intestinally colonize antimicrobially pretreated adult mice. AB - Adult mice, made susceptible to Clostridium botulinum by feedings of metronidazole, were immobilized with an anesthetic and held for 30 min in isolators in which a fine powder of lyophilized pathogen spores was made airborne. Exposed mice were surface decontaminated before being kept for 2 days in holding isolators. Mice were intestinally colonized by the pathogen. Colonization rates were related to spore numbers (10(4) to 10(7) type A or B) seeded into isolators. PMID- 3531018 TI - Influence of growth conditions on cell surface hydrophobicity of Candida albicans and Candida glabrata. AB - The effect of cultural conditions on cell surface hydrophobicity of Candida albicans and Candida glabrata was tested. C. albicans cells grown at room temperature were more hydrophobic than cells grown at 37 degrees C. No consistent pattern was observed with C. glabrata. Relative hydrophobicity was found to vary with the growth phase and growth medium for both species. The implications for pathogenesis studies are discussed. PMID- 3531019 TI - Polyclonal response of human lymphocytes to Chlamydia trachomatis. AB - The mitogenicity of Chlamydia trachomatis was investigated. Umbilical cord blood cells from healthy newborns were used. These cells were stimulated in cultures with partially purified C. trachomatis elementary bodies. Proliferation of cultured lymphocytes and secreted immunoglobulins and leukocyte migration inhibitory factor were measured in the culture supernatants. Our results showed that C. trachomatis is able to elicit polyclonal antibody, lymphokine, and DNA synthesis. PMID- 3531020 TI - Role of capsule and O antigen in resistance of Klebsiella pneumoniae to serum bactericidal activity. AB - The ability of Klebsiella pneumoniae strains to resist the bactericidal activity of serum was quantitated. The K. pneumoniae strains tested included mutants lacking the capsular polysaccharide and mutants having a modified lipopolysaccharide structure. The last mutants were obtained as phage-resistant mutants, and their lipopolysaccharide was characterized by sodium dodecyl sulfate polyacrylamide gel electrophoresis and chemical analysis. Serum-resistant mutants derived from phage-resistant mutants (lipopolysaccharide mutants) were also characterized. Resistance to the bactericidal activity of complement was mediated by the lipopolysaccharide, especially by the O-antigen polysaccharide chains. The capsular polysaccharide seemed not to play any important role in resistance to serum bactericidal activity in this bacterium. PMID- 3531021 TI - Analyses of rat Pneumocystis carinii antigens recognized by human and rat antibodies by using western immunoblotting. AB - The major Pneumocystis carinii antigens inducing antibody responses in infected hosts were identified by Western immunoblotting techniques. The biochemical nature of these antigens was also elucidated. Sodium dodecyl sulfate polyacrylamide gel electrophoresis followed by protein staining revealed a major component with a molecular weight (MW) of greater than 205,000. This major component disappeared and a new major protein staining component of approximately 110,000 to 116,000 MW appeared when electrophoresis was done in the presence of beta-mercaptoethanol. Periodic acid-Schiff staining revealed that this major component contains carbohydrate moieties. A major component in the 55,000- to 60,000-MW region was visible with periodic acid-Schiff stain, but not with a protein stain, after electrophoresis in the presence of beta-mercaptoethanol. The majority of sera tested from humans with diagnosed pneumocystosis and from rats allowed to recover from steroid-induced pneumocystosis reacted strongly with 110,000- to 116,000-, and 55,000- to 60,000-MW components. These sera often, but not always, detected antigens with MWs of approximately 170,000, 125,000, and 30,000 to 32,000. The data suggest that the antigenic composition of P. carinii is relatively complex and that rat and human P. carinii probably share antigenic determinants. Competitive studies between infection-derived human and rat antisera for the major rat P. carinii components revealed competition; rat antisera appeared to recognize a greater range of antigenic epitopes than did human antisera. Protease treatment of the antigenic components that had been immobilized on nitrocellulose paper destroyed their antigenic reactivity with rat antibody. Treatment with sodium periodate decreased reactivity of this 110,000- to 116,000-MW component and completely destroyed the reactivity of the 55,000- to 60,000-MW component with rat antibody. PMID- 3531022 TI - Meningitis caused by Streptococcus suis: case report and review of the literature. AB - A case of purulent meningitis caused by Streptococcus suis type 2 (group R streptococcus) is described. It occurred in a 69-year-old farmer's wife who raised pigs on her farm. Here, as well as in nearly all other cases of S. suis meningitis reported to date, close occupational contact with pigs or pork preceded the infection; this epidemiological link can be explained by the frequent occurrence of S. suis as a commensal and opportunistic pathogen in pigs. Up until now, S. suis infection in man has been rare and has had a good prognosis. However, disturbances of the eighth cranial nerve have been found in many patients, even causing permanent deafness in some. These and other clinical, epidemiological and microbiological features of S. suis disease in man are discussed here. PMID- 3531023 TI - Activity of the trometamol salt of fosfomycin in an in vitro model of the treatment of bacterial cystitis. AB - The response to trometamol fosfomycin of four strains of Escherichia coli was studied in an in vitro model in which the hydrokinetic aspects of the treatment of bacterial cystitis can be stimulated. Two strains of E. coli that were fully susceptible to fosfomycin, and a strain of intermediate susceptibility responded well to relatively low concentrations of the trometamol salt: doses achieving peak concentrations of 50 or 250 mg/l suppressed bacterial growth for at least 18 h; however, the emergence of resistance was completely suppressed only when a peak concentration of 2500 mg/l was achieved in the bladder model. A strain of E. coli that was fully resistant to fosfomycin in conventional minimum inhibitory concentration titrations responded to the highest dosage used, but this did not prevent further resistance from emerging. These results were obtained in the absence of the potentiating agent, glucose-6-phosphate, which is commonly used in susceptibility tests of fosfomycin. The implications of the results for fosfomycin dosage in bacterial cystitis and for the interpretation of susceptibility tests is discussed. PMID- 3531024 TI - Comparative therapeutic activities of ciprofloxacin, amoxicillin, ceftriaxone and co-trimoxazole in a new model of experimental infection with Escherichia coli. AB - A new mouse model for systemic infection with Escherichia coli is presented. Whereas in other models 10(7)-10(8) bacteria have to be injected into an animal to induce toxic effects resulting in death within 24 hours, now, only 10(3)-10(4) bacteria of an appropriate strain are required to produce a genuine infection characterized by an increase in the bacterial load over several days. The quantitative determination of bacterial counts per liver allows a more sensitive measurement than recording death rates. Furthermore, few animals are required for a definite result in contrast to the LD50 determination of other models. The salient point regarding this new model is that conditioning of animals has to be achieved by incorporating the inoculum into agar which is injected subcutaneously. The resulting infection is completely dependent on the E. coli strain used. Whereas a hemolytic, uropathogenic strain is so virulent that an overwhelming infection develops within 48 hours after the injection of 10(3) bacterial cells, a non-hemolytic variant of this strain is completely avirulent, being unable to multiply in spite of the potentiating agar. The hemolytic E. coli strain ATCC 25922 is intermediate in virulence. The bacterial counts per liver increase steadily until death occurs five to seven days after the injection of 10(4) bacteria. This bacterial infection can be therapeutically influenced by daily treatment with various drugs. Ciprofloxacin, ceftriaxone and co-trimoxazole are able to cure the infection, whereas amoxicillin given orally is only moderately active against this ATCC strain, which is relatively resistant to amoxicillin. PMID- 3531025 TI - [Pharmacokinetics and antimicrobial activity of imipenem]. PMID- 3531026 TI - [Effect and tolerance of daily 2 X 1 g imipenem/cilastatin in general surgery]. AB - The clinical efficacy, tolerability and safety of imipenem/cilastatin were studied in a open, prospective trial with 63 general surgical patients suffering from bacterial infections. According to study criteria, 48 of the patients were evaluable. Clinical cure was achieved in 47 of these 48 patients (97.9%). The causative organisms were eliminated in 39 of the 47 patients cured. Clinical side reactions were observed in 4.2% of the 63 patients treated. In 8.3% of these laboratory parameters were changed. 77 of the 78 microorganisms isolated before therapy were sensitive to imipenem (MICs 0.02-2.0 mg/l). In one patient a coagulase-negative staphylococcus with an MIC of 16 mg/l was isolated after five days of therapy. PMID- 3531027 TI - [In vitro activity and resistance of 4-quinolones]. PMID- 3531028 TI - [Enoxacin: spectrum and activity of its antibacterial effect]. PMID- 3531029 TI - [Results of treatment of bacterial inflammation of the skin with enoxacin]. AB - In a microbiologically controlled, open study the 4-quinolone derivative enoxacin was tested in 51 patients suffering from infectious dermatoses. Clinical cure or improvement was observed in 91% of the patients, microbiological cure occurred in 65%. According to the results of our trial enoxacin is recommended as a therapeutic alternative, especially for the treatment of dermatitis caused by gram-negative bacilli. PMID- 3531030 TI - Analysis by electrophoretic transfer blotting of Japanese cedar pollen allergens which react with IgG and IgE antibodies in the serum of patients. AB - Crude extract of Japanese cedar pollen was fractionated by DEAE-cellulose chromatography to separate the major allergenic components. In order to analyze which antigens react with IgG or IgE antibodies in the serum of Japanese cedar pollinosis patients, an electrophoretic transfer blotting was performed. Both IgE and IgG antibodies reacted with several common antigens, while IgG additionally reacted with some low-molecular-weight proteins. PMID- 3531031 TI - A monoclonal antibody reacting with endothelial cells of budding vessels in tumors and inflammatory tissues, and non-reactive with normal adult tissues. AB - This report describes a monoclonal antibody (MAb) generated by immunization of mice with cell suspensions of capillary-rich fragments of mammary carcinomas. The antibody (EN 7/44) belongs to the IgM class and detects a 30.5 kDa antigen which is found in the cytoplasm of human placental and umbilical vein-endothelial cells (HUVEC) and on the surface of tumor endothelium. Using indirect immunofluorescence and immunoperoxidase techniques, we did not find the MAb in peripheral blood cells or in any human cell lines tested, nor in endothelial cells from normal, nonproliferating adult tissues. Positively staining endothelium was found in the placenta, the umbilical vein and in proliferating normal tissues (intestine). Positive endothelial cells were found in acute inflammatory reactions and in tumors. In the latter, the strongest reactions were seen in newly formed budding capillaries, which were identified by their reactivity with Ulex europaeus I-lectin and antibodies against F VIII-RAG. In tumor tissues, large vessels could be positively stained with the EN 7/44 antigen, in contrast to inflammatory tissues. It is concluded that endothelial cells at the tip of a budding capillary express distinct phenotypic characteristics. PMID- 3531032 TI - St. Etheldreda and the death of Gervase. AB - We have discovered an interesting account of sudden death reported in the Liber Eliensis, a Latin compendium of twelfth century happenings in the environs of Ely, the cathedral town found just north of Cambridge in the fenlands of England. The account tells how Gervase, a Norman official of the Sheriff, oppressed the local Saxons. The abbot took the people's part and was summoned before Gervase. However, during the night before the abbot arrived, Gervase dreamed that the local Saxon saint of the shrine, St. Etheldreda, struck him with her staff in the chest. He woke with pain, crying out that St. Etheldreda was about to strike him again, and died. PMID- 3531033 TI - Clinical trial of captopril (Aceten) in Indian patients with essential hypertension. AB - ACE inhibitors are not available in India. Response to captopril in comparison with M-dopa was therefore seen in Indian hypertensive patients. A double blind randomized non-crossover study was carried out on 39 adult patients of either sex suffering from essential hypertension. Twenty-five patients included were resistant to earlier drug therapy. The remaining 14 were freshly detected hypertensive patients. Patients received either 150 mg/day captopril (Aceten) or 750 mg/day M-dopa in 3 equally divided doses every day for 30 days. The mean systolic and diastolic blood pressure in captopril (Aceten) group before starting drug therapy was 171 +/- 4.11 (mean +/- SE) and 111 +/- 0.22, respectively. At the end of therapy the systolic blood pressure was 132 +/- 1.86 and diastolic blood pressure was 84 +/- 1.36 mm of mercury. This fall in the blood pressure within the group was statistically highly significant (p less than 0.001). Similarly patients on M-dopa produced statistically highly significant fall in blood pressure (p less than 0.001) at the end of 4 weeks therapy. Initial systolic and diastolic blood pressure in both groups were comparable and, at the end of 2 and 4 weeks therapy, patients on captopril (Aceten) showed greater fall in both systolic (p less than 0.001) and diastolic (p less than 0.005) blood pressure than patients on M-dopa. None of the patients in the trial demonstrated clinically significant changes in the biochemical parameters. Six of nineteen patients on methyl dopa had side effects which are well known to this drug. None in the captopril showed any side effect.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3531034 TI - A double-blind trial of fentonium bromide in the treatment of incontinent unstable bladder. AB - The effects of fentonium were compared with those of placebo in a double-blind, cross-over trial involving 28 incontinent women with unstable bladder. Fentonium bromide proved significantly more effective in reducing urgency and urge incontinence (p less than 0.05), in reducing detrusor pressure rise during bladder filling (p less than 0.01) and in increasing bladder volume at first stimulus (p less than 0.05). Well tolerated, fentonium bromide proved useful in the treatment of unstable bladder. PMID- 3531035 TI - Effect of curing R-plasmids in Salmonella species on their serum sensitivity. AB - Thirteen salmonella strains of clinical isolates were tested for serum sensitivity, antibiotic resistance, colicin production and plasmid existence. Nine serum resistant strains were smooth and harboring plasmids of different sizes. Transfer of R-plasmids by conjugation from three strains to E. coli K12 conferred slight decrease in serum sensitivity. Curing the nine resistant strains with ethidium bromide or acriflavine affected their serum resistance, plasmid content and cell surface. Rough isolate of S. johanesberg became serum sensitive after curing the R-factors. The suggested mechanisms involved in the change in serum sensitivity after curing are discussed. PMID- 3531036 TI - Pathogenesis and prevention of aortocoronary bypass graft occlusion. AB - Aortocoronary bypass graft occlusion starts intraoperatively, is progressive over time, and correlates with the return of ischaemic symptoms and left ventricular dysfunction during exercise. Based on an animal model and tests of in vivo platelet consumption and deposition, a prospective, randomized, double-blind trial was designed and carried out comparing dipyridamole (instituted two days before operation plus aspirin (added seven hours after operation) with a placebo in 407 patients. Vein-graft angiography was performed in 88% of patients early after operation. Within 4-6 months of operation, 4% of 488 distal anastomoses were occluded in the treated patients and 15% of 520 distal anastomoses were occluded in the placebo group. The proportion of patients with one or more distal anastomoses occluded was 10% of 176 patients in the treated group and 30% of 184 patients in the placebo group (p = 10(-6)). Unlike other less convincing studies that did not start therapy before operation and did not affect high risk subgroups, benefit in graft patency in this study persisted in each of over 50 subgroups of high and low risk. Perioperative bleeding was similar in the two groups. Late after operation (11-18 months, median 12 months), 11% of 478 vein graft distal anastomoses were occluded in the treated group, and 25% of 486 were occluded in the placebo group. The proportion of patients with one or more distal anastomoses occluded was 22% of 171 patients in the treated and 47% of 172 patients in the placebo group (p = 10(-6)).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3531037 TI - Converting enzyme inhibitors for the treatment of hypertension in the elderly. AB - Recent epidemiological studies have confirmed that high blood pressure increases the risk of cardiovascular morbidity and mortality not only in young and middle aged subjects but also in elderly patients. For this reason there is an increasing tendency to treat hypertension also in this age group. However in doing so several problems may be encountered, if the particular physiopathological characteristics of these patients are not taken into account. Recently captopril has been proposed as a useful agent in these cases since it does not reduce coronary, cerebral and renal blood flow and does not cause orthostatic hypotension. These properties are of the utmost importance because elderly patients often present a decreased renal function, ischaemic heart disease, cerebrovascular disease and an impaired baroreflex sensitivity. Although to date no controlled studies have been published on the use of captopril in hypertensives over 60 years old, the results of a recent captopril surveillance programme indicate that this agent is efficacious and well tolerated in these patients. PMID- 3531039 TI - Exercise-induced ultrastructural changes in skeletal muscle. PMID- 3531038 TI - A comparative study of endralazine and captopril in essential hypertension: effect on renin levels, pulmonary function studies and lipid profile. AB - A comparative study of the effects of captopril, an angiotensin converting enzyme inhibitor and endralazine, a new vasodilator drug, were performed in a group of 20 homogeneous patients with moderate hypertension (WHO: phase I and II). Both drugs produced a marked (p less than 0.001) decrease in mean arterial pressure, but the drop in blood pressure levels and the percentage of patients free of side effects (p less than 0.001) were greater in patients treated with endralazine. Neither drug affected the lipid profile, nor pulmonary function tests and both increased significantly (p less than 0.001) plasma renin activity levels. The results of this study suggest that both drugs may be recommended for the treatment of hypertensive asthmatic patients, but endralazine should be preferred as first-choice drug, due to its lower incidence of side-effects and higher hypotensive effect obtained with the administration of a lower daily dosage. PMID- 3531040 TI - Cutaneous manifestations of the acquired immunodeficiency syndrome. PMID- 3531041 TI - The quinolones and dermatologic practice. PMID- 3531042 TI - Profile of cutaneous toxoplasmosis. PMID- 3531043 TI - A rapid immunoperoxidase technique to distinguish herpetic types. AB - The United States is experiencing an epidemic of herpetic infections. Rapid specific diagnosis of herpes simplex types and herpes zoster is important epidemiologically and also for individual cases since treatment as well as prognosis for recurrence or dissemination varies with virus type. We report a rapid test for the diagnosis and differentiation of these infections. This test uses scrapings from viral vesicles. It employs standard immunoperoxidase techniques and takes 2 hours to perform at 37C. Smears from 13 patients with clinical and/or culture confirmation of viral type were tested. Eleven of eleven who had fresh smears (vesicles present less than 5 days) had positive staining for the viral type expected clinically. Two patients with vesicles 5 days or older showed nonspecific staining. PMID- 3531044 TI - Dapsone in the treatment of cutaneous leishmaniasis. AB - Fifty patients with cutaneous leishmaniasis were treated with dapsone (DDS) approximately 2 mg per kilogram body weight per day for 21 days. Forty patients (80%) were declared cured on the basis of clinical and pathologic criteria. Follow-up examination after 6 months revealed no recurrences. No major side effects were noted. In the control group of 15 patients not receiving the drug, no significant change was seen in the lesions. Dapsone thus was used successfully for the first time. PMID- 3531045 TI - Historical aspects of cutaneous toxoplasmosis. PMID- 3531046 TI - Treatment of lichen planus with griseofulvin. PMID- 3531047 TI - Detection and determination of cyanide--a review. AB - Cyanides, whether organic or inorganic, are highly toxic to all forms of life, i.e., animals and plants alike. This necessitates its detection and determination even when present in trace amounts. Various optical, electrometric, radiochemical and chromatographic methods so far reported for this purpose have been reviewed. An exhaustive bibliography of 154 references is given. PMID- 3531048 TI - Ovarian strumal carcinoid: immunohistochemical, ultrastructural, and clinicopathologic observations. AB - A review of 13 ovarian strumal carcinoids in the files of the Armed Forces Institute of Pathology has established further evidence that these tumors have both endocrine and neuroendocrine differentiation. The two functional routes of differentiation occur even within individual tumor cells. Immunohistochemical reaction for thyroglobulin was positive in the strumal regions of all 12 cases tested. This positivity was also present in transitional zones where the thyroid follicles merged with nests of carcinoid cells. Electron microscopy performed in six cases showed cells with neuroendocrine granules in the thyroid follicles; these cells resemble the C-cells of the normal thyroid gland. An immunoperoxidase reaction for calcitonin, however, revealed no positivity in any of the cells corresponding to the neuroendocrine cells within the follicles or those in the carcinoid component. Variable positivity for serotonin was observed, however. It is proposed that cells within the struma that have morphologic similarities to the C-cells of the thyroid give rise to the carcinoid component. These cells appear capable of producing thyroglobulin as well as neuroendocrine granules. PMID- 3531049 TI - Argyrophil cells in Brenner tumors: histochemical and immunohistochemical analysis. AB - Argyrophil cells were identified by the single-impregnation Grimelius technique in 11 of 28 (39%) Brenner tumors, accounting for less than 1% of the tumor cell population in all the cases. All tumors with argyrophil cells were stained to demonstrate calcitonin, somatostatin, gastrin, adrenocorticotropic hormone, neurotensin, insulin, glucagon, and serotonin; and four of them (three benign and one borderline) were also stained for chromogranins with the monoclonal antibody LK2H10. Serotonin was present in nine of the 11 cases with argyrophil cells. Neurotensin and somatostatin were found in one borderline tumor, which also contained serotonin. Chromogranin reactivity was demonstrated in all four cases in which it was examined. Ultrastructural examination of one tumor revealed that the argyrophil cells contained secretory granules, 80 nm in diameter, and had elongated cytoplasmic processes that extended between the more numerous nonargyrophil tumor cells. The argyrophil cells of Brenner tumors are similar to those of urothelium in the frequency with which they are immunoreactive for serotonin and the rarity with which they are reactive for peptide hormones. These cells differ from those of mucinous ovarian tumors, which often contain both serotonin and peptide hormones. The findings of this study lend additional support to the close similarity of the epithelial components of Brenner tumors and urothelium. PMID- 3531050 TI - Leiomyosarcoma of the uterus with giant cells resembling osteoclasts. AB - A case of leiomyosarcoma of the uterus with osteoclast-like giant cells was examined by light and electron microscopy, histochemistry, and immunoperoxidase techniques. A panel of antibodies was used, including monoclonal antibodies raised against various macrophage determinants and PD 7/26, which detects a leucocyte-common antigen. The giant cells contained nonspecific esterase, stained with PD 7/26 and with two antimacrophage antibodies. These findings strongly suggest that these giant cells are derived from macrophages. PMID- 3531051 TI - Comparison of ultrasound and skinfold caliper measurement of subcutaneous fat tissue. AB - Subcutaneous fat thickness of 26 young males (aged 18-32 years) was measured at eight sites (biceps, triceps, subscapula, axillary, subcosta, paraumbilica, suprailiaca, quadriceps) using a commercial high-resolution B-scan ultrasound equipment with a 7.5-MHz transducer as well as a Holtain skinfold caliper. The aim of the study was to investigate the relationship between ultrasound and skinfold caliper measurements of subcutaneous fat and body density determined by the hydrostatic weighing technique. Correlations between ultrasound and caliper measurement were above 0.7. The variability of duplicate measurements with the skinfold caliper appeared to be somewhat lower than with ultrasound measurements. Using all possible subsets regression, for both techniques measuring subcutaneous fat thickness those multiple regression equations were chosen which predicted body density best. The best equations for the two techniques explained about 80 percent of the variance of body density in this group. These results indicate that in young men, body fat can be estimated with the same degree of accuracy using either the skinfold caliper or the ultrasound technique, but for estimates of actual subcutaneous fat thickness, ultrasound is to be preferred. PMID- 3531052 TI - Effect of trestatin, a new inhibitor of pancreatic alpha-amylase, on starch metabolism in man. AB - The effect of two doses (3 mg and 10 mg) of the inhibitor of pancreatic alpha amylase trestatin on the metabolism of an oral load of 75 g of starch was observed in healthy human subjects. The mean elevation of plasma glucose over the 4 h following the load was markedly reduced both with 10 mg (mean +/- s.e.m.: 1.4 +/- 1.2 mg/dl) and with 3 mg of trestatin (7.2 +/- 2.0 mg/dl) when compared to placebo (19.5 +/- 5.1 mg/dl) (P less than 0.01 in both cases). The mean elevation of plasma insulin was decreased with both 10 mg (mean +/- s.e.m.: 1 +/- 1 microU/ml) and 3 mg of trestatin (6 +/- 2 microU/ml) when compared to placebo (20 +/- 4 microU/ml) (P less than 0.01 in both cases). Suprabasal glucose oxidation, measured by indirect calorimetry, was markedly decreased by trestatin (mean +/- s.e.m.: 2.5 +/- 1.1 g/4 h with 10 mg of trestatin versus 12.0 +/- 2.0 g/4 h with placebo, P less than 0.001). To examine whether trestatin had any action on alpha 1-4 glycosidase activity, an oral load of 100 g sucrose together with either 50 mg trestatin or with a placebo was administered to four healthy human subjects. Trestatin was observed to have only few effects on plasma glucose and insulin levels following sucrose ingestion. This suggests that its main site of action is at the alpha-amylase level. Breath hydrogen was shown to increase after ingestion of starch plus trestatin at the two doses studied. It is concluded that trestatin is a powerful inhibitor of pancreatic alpha-amylase which could be of great help in the dietary management of diabetic patients. PMID- 3531053 TI - Histidine racemization in the synthesis of an analog of the luteinizing hormone releasing factor. Investigation by HPLC and enzymatic methods. AB - To investigate histidine racemization in the synthesis of a LHRH analog, (D-Trp)6 LHRH2-10 was built up by stepwise elongation of the sequence 3-10 using the solid phase technique on a 1% cross-linked chloromethyl polystyrene. For the whole synthesis the tert.-butyloxycarbonyl (BOC) group was used for temporary N terminal protection. To protect the pi-nitrogen in histidine the benzyl-oxymethyl (BOM) group was utilized. The condensation position in the (D-Trp)6-LHRH analog was chosen so as to be able to investigate the racemization of histidine. We coupled BOC-His(BOM) with the (D-Trp)6-LHRH3-10 fragment using three different activating agents, mixed anhydride, carbonyldiimidazole (1 equiv.)/1 hydroxybenzotriazole (2 equiv.) and dicyclohexylcarbodiimide/1 hydroxybenzotriazole. The racemization was investigated by enzymatic digestion and by HPLC. For HPLC, (D-His(BOM)2-(D-Trp)6-LHRH2-10 was also synthesized. It could be proved that practically no racemization occurs during the actual peptide synthesis. The small amount (1%) of D-histidine found is due to racemization in the synthesis of BOC-His(BOM). PMID- 3531055 TI - The oxygen effect in radiation inactivation of DNA and enzymes. AB - A survey is made of literature data dealing with the influence of oxygen on radiation effects in biologically active DNA and enzymes irradiated extracellularly. There is evidence that oxygen takes part in physico-chemical events, directly or indirectly produced by radiation in several ways: from scavenging reducing primary water radicals to reacting directly with macromolecular radical sites. There is evidence that radiation-induced secondary radicals, originating from a variety of low molecular weight biomolecules, can react with DNA and enzymes in their native state, and produce inactivation. By reaction with oxygen secondary radicals become peroxidized and in this form are generally more harmful to biological macromolecules. There are indications that thiol peroxy radicals can also act in the same way. Possible implications for the oxygen effect observed in vivo are discussed. PMID- 3531054 TI - Synthesis of alpha-thiophenylglycine peptides. Novel peptide substrates useful in the study of microbial peptide transport. AB - The synthesis of peptides useful for the investigation of microbial peptide transport is reported. These peptides, L-alanyl-L-2-thiophenylglycine (Ala-alpha TPG), L-alanyl-L-2-thiophenylglycyl-L-alanine (Ala-alpha-TPG-Ala) and L-alanyl-L alanyl-L-2-thiophenylglycine (Ala-Ala-alpha-TPG), contain a phenylthio group attached to the alpha carbon of glycine. PMID- 3531056 TI - Uptake and clearance of plutonium-238 from liver cells transplanted into fat pads of F344 rats. AB - This research is directed toward understanding the role of liver cells and the liver environment in plutonium biokinetics. Animals injected with liver cells and control animals received a single intraperitoneal injection of 37 kBq (1 microCi) 238Pu citrate and were serially sacrificed 1, 5, 10, 15, 30, 60 or 70 days later. Uptake, retention and distribution of Pu in intact liver and in liver cells growing in fat pads were determined. From these measurements, it was observed that the cells of the intact liver took up about twice as much 238Pu as liver cells transplanted into the fat pads of the same animal. The retention half-life was 8.3 days for the total activity in the liver, 20 days using tracks/cell measurements in the liver and 16 days for the tracks/cell measurements in the liver cells translocated to fat pads. When the data on tracks/cell were standardized relative to the amount of Pu present at 5 days after the injection, there was no significant difference between the retention of Pu in liver cells from intact animals and liver cells transplanted into the fat pads. About 20 per cent of the 5-day Pu liver burden in both liver cells and liver cells transplanted into fat pads was retained at 70 days. The smaller retention and clearance for liver cells in different environments indicate that uptake and clearance of Pu from the body is dependent, to a major extent, upon hepatocyte function. PMID- 3531057 TI - Urinary excretion of cyclic nucleotides, creatinine prostaglandin E2 and thromboxane B2 from mice exposed to whole-body irradiation from an enhanced neutron field. AB - Urine volume and excretion of cyclic AMP, cyclic GMP, prostaglandin E2 (PGE2), thromboxane B2 (TxB2) and creatinine were evaluated as potential indicators of radiation damage in mice given 2-5 Gy to the whole body from an enhanced neutron field. In general, urinary cyclic AMP, cyclic GMP, creatinine and urine volumes were positively correlated across time postexposure, for each radiation dose. TxB2 levels positively correlated with urine volume and cyclic AMP excretion only in animals given 2.0 Gy. None of these parameters suggests their use as a prognostic indicator of the extent of radiation damage. Urinary excretion of PGE2 was negatively correlated with other urinary parameters. Biphasic increases in urinary PGE2 were also observed. The initial transient elevation 2-3 days postexposure was not correlated with the dose (2-5 Gy). The second elevation of PGE2 excretion occurred at 6-10 days. The magnitude of the latter increase suggests that urinary PGE2 excretion may be a useful indicator of whole-body or kidney exposure to neutron fields. PMID- 3531058 TI - Effectiveness of 1.5 keV aluminium K and 0.3 keV carbon K characteristic X-rays at inducing DNA double-strand breaks in yeast cells. AB - Induction of DNA double-strand breaks in diploid wild-type yeast cells, and inactivation of diploid mutant cells (rad54-3) unable to repair DNA double-strand breaks, were studied with aluminium K (1.5 keV) and carbon K (0.278 keV) characteristic X-rays. The induction of DNA double-strand breaks was found to increase linearly with absorbed dose for both characteristic X-rays. Carbon K X rays were more effective than aluminium K X-rays. Relative to 60Co gamma-rays the r.b.e.-values for the induction of DNA double-strand breaks were found to be 3.8 and 2.2 for carbon K and aluminium K X-rays respectively. The survival curves of the rad54-3 mutant cells were exponential for both ultrasoft X-rays. For inactivation of rad54-3 mutant cells, the r.b.e.-values relative to 60Co gamma rays were 2.6 and 2.4 for carbon K and aluminium K X-rays, respectively. The DNA double-strand break data obtained with aluminium K and carbon K X-rays are in agreement with the data obtained for gene mutation, chromosome aberrations and inactivation of mammalian cells, suggesting that DNA double-strand breaks are the possible molecular lesions leading to these effects. PMID- 3531059 TI - Rationale and technique for ridge preserving removable partial dentures. PMID- 3531060 TI - Histologic evaluation following intraoral use of freeze-dried skin in humans. PMID- 3531061 TI - A solution for the prosthetic problem of the hemidentate arch--tissue integrated prosthesis. PMID- 3531062 TI - Attached gingiva--mucogingival therapy and restorative dentistry. PMID- 3531063 TI - Cell interactions during the seminiferous epithelial cycle. PMID- 3531064 TI - The cytoskeleton in protists: nature, structure, and functions. PMID- 3531065 TI - The electrical dimension of cells: the cell as a miniature electrophoresis chamber. PMID- 3531066 TI - Connectin, an elastic filamentous protein of striated muscle. PMID- 3531067 TI - [Non-Hodgkin's lymphomas. A brief introduction to their problems]. PMID- 3531068 TI - [Current problems of the histopathology and classification of non-Hodgkin's lymphomas]. PMID- 3531069 TI - [Strategies in the treatment of non-Hodgkin's lymphomas]. PMID- 3531070 TI - [Radiotherapy of non-Hodgkin's lymphoma]. PMID- 3531071 TI - [Superfluous diagnosis in nephrology and hypertonology]. PMID- 3531072 TI - [Superfluous cardiologic diagnosis]. PMID- 3531073 TI - [Superfluous endocrinologic diagnosis]. PMID- 3531074 TI - [Superfluous diagnosis in gastrointestinal diseases]. PMID- 3531075 TI - [What is superfluous in hematologic diagnosis?]. PMID- 3531076 TI - [Superfluous pneumologic diagnosis]. PMID- 3531077 TI - [Superfluous hemostaseologic diagnosis?]. PMID- 3531078 TI - [Immune diagnosis without sensible clinical significance]. PMID- 3531079 TI - Partial purification and characterization of serum protease from tumor-bearing rats which cleaves type IV collagen. AB - Activity of neutral protease was increased in sera of rats bearing ascites hepatoma AH109A compared to those of normal rats. The protease was isolated from serum protein and partially purified approximately 1,150 times in specific activity after sequential column chromatography of hemoglobin affinity, lysine Sepharose, Ultrogel AcA34 and TSK-gel G2000SW in that order. The protease fraction still seemed to contain at least two kinds of proteases, serine and cysteine protease. It had a molecular weight of 18-21 kilodaltons with broad optimal pH range of 7.0-9.0, maximum at 8.0. Intradermal injection of the crude preparation of the neutral protease fraction induced extravascular emigration of circulating tumor cells in vivo. Moreover, partially purified protease degraded pepsin-treated chains of bovine glomerular type IV collagen in vitro, but such an in vitro action of the protease was inhibited by an addition of soybean trypsin inhibitor or mercuric chloride. It failed to cleave salt-extracted rat skin type I collagen under the same digestive conditions for bovine type IV collagen. The serum neutral proteases of tumor-bearing host may play some cooperative roles during extravascular emigration of tumor cells by destruction of vascular basement membrane. PMID- 3531080 TI - Organization of collagen types I and V in the embryonic chicken cornea. AB - The distribution and organization of type I and type V collagens were studied in the embryonic chicken cornea using anti-collagen, type specific, monoclonal antibodies and immunoelectron microscopy. These studies were performed on lathyritic 17-day corneas treated at 4 degrees C or 37 degrees C. At the lower temperature, collagen fibril structure is disrupted; at the higher temperature, normal fibril structure is maintained. Corneas from non-lathyritic 17-day chick embryos, reacted at the two different temperatures, were studied for comparison. In Bowman's membrane, the thin (20 nm) fibrils were labelled by antibodies against both type I and type V collagen under all conditions studied. In the corneal stroma, the striated collagen fibrils (25 nm) were labelled with the antibodies against type I collagen in all cases, and by antibodies against type V collagen under conditions where fibril structure was disrupted. These results are consistent with the concept of heteropolymeric fibrils consisting of both type I and type V collagen molecules assembled such that the epitopes on the type V molecule are unavailable to antibody unless the fibrillar structure is disrupted. We suggest that the interaction of type V collagen with type I collagen may be responsible for the small diameter fibrils and the rigid control of fibril structure found in the cornea. PMID- 3531082 TI - Gonadotropin-releasing hormone and its analogs. PMID- 3531081 TI - Effect of 1% sodium hyaluronate (Healon) on a nonregenerating (feline) corneal endothelium. AB - A series of experiments were performed to investigate the effect of 1% sodium hyaluronate (Healon) on the nonregenerating corneal endothelium of the cat. Aqueous humor replacement with 1% sodium hyaluronate resulted in mild, transient elevations of intraocular pressure compared to eyes that were injected with balanced salt solution. Sodium hyaluronate 1% protected the feline endothelium against cell loss incurred by contact with hyaluronate-coated intraocular lenses compared to endothelial contact with lenses that were not coated with sodium hyaluronate. The use of intraoperative 1% sodium hyaluronate, however, did not protect against endothelial cell loss incurred by penetrating keratoplasty or prevent subsequent skin graft-induced corneal homograft rejections. Homograft rejections were milder, however, in some eyes that received grafts coated with 1% sodium hyaluronate. Image analysis of photographs of trypan blue- and alizarin red-stained corneal buttons after trephining, stretching of Descemet's membrane, rubbing against iris-lens preparations, or immediately after penetrating keratoplasty demonstrated that the stretching of the posterior cornea is an important cause of endothelial damage that would not be protected against by a viscoelastic coating. PMID- 3531083 TI - Isolated gonadotrophin deficiency: a current perspective on presentation, diagnosis and treatment. PMID- 3531084 TI - Biographical sketches--67. Galvani. PMID- 3531085 TI - Ultrasound-clinical correlations in the assessment of the newborn at risk for brain damage. AB - In the Pavia Neonatal Intensive Care Unit all newborns at risk for brain damage have, since 1983, undergone transfontanellar ultrasound scanning regularly for the early diagnosis of hemorrhage and/or anoxia-ischemia. They have also been assessed clinically by a child neuropsychiatrist during the hospital stay and every two months at outpatients' for the first year of life as a check on the prognostic value of ultrasound scanning. The results relating to a sample of 56 at risk newborns, with normal and abnormal ultrasound scans, who have now reached 12 months corrected age are reported. A normal ultrasound scan presupposes normal neuropsychic development in 87% of cases, as happens in the event of uncomplicated hemorrhage. Major sequelae occur in as many as 83% of cases of complicated hemorrhage. The diagnosis of severe anoxia-ischemia likewise argues for a pathological neuropsychic development. Our results convince us that transfontanellar ultrasound scanning is an indispensable tool not only for the early diagnosis of brain damage but also as a guide to prognosis in the newborn at risk. PMID- 3531086 TI - Inhibition of immune-mediated low-dose streptozotocin diabetes by agents which reduce vascular permeability. AB - Low-dose streptozotocin treatment in C57Bl/6J mice causes development of hyperglycemia within two weeks. Diabetes development is due to the specific loss of beta cells from pancreatic islets which can be blocked by immunosuppressive treatment. The role of vascular permeability in pancreatic islet destruction was studied by administration of methysergide or pargyline in addition to low-dose streptozotocin. Both drugs impair serotonin-enhanced vascular permeability. Administration of methysergide or pargyline during the first 11 days following streptozotocin treatment caused substantial suppression of diabetes development. These observations suggest a role of enhanced vascular permeability in immune mediated beta cell destruction. PMID- 3531087 TI - Immunopotentiative effect of polysaccharide from kefir grain, KGF-C, administered orally in mice. AB - Since a water-soluble polysaccharide (KGF-C) from the kefir grains was shown to have the property of retarding tumor growth in vivo when administered orally, the effect of KGF-C was examined on antibody responses to thymus-dependent antigen, sheep red blood cells (SRBC), and thymus-independent antigen, dinitrophenyl Ficoll and trinitrophenyl-lipopolysaccharide. Antibody response in mice intubated with KGF-C was enhanced to low doses of SRBC, but not to optimal or high doses. The optimal dose of KGF-C required for the enhancement was 100 mg/kg body weight. The time-course studies on KGF-C administration implied that KGF-C exerted its effect on the early events of anti-SRBC response. The enhancement was not due to the alteration of kinetics of anti-SRBC responses. Furthermore, the enhancing effect on antibody responses to thymus-independent antigens, such as dinitrophenyl-Ficoll and trinitrophenyl-lipopolysaccharide, was observed neither in nu/nu nor in nu/+ mice, and the effect on delayed-type hypersensitivity response to a low dose of SRBC in normal mice was also found. These findings suggest that the oral immune enhancement by KGF-C is elucidated probably through T-cell but not through B-cell participation. PMID- 3531088 TI - Community practice and cancer clinical trials: I. Relevance of creatinine clearances. PMID- 3531089 TI - Community practice and cancer clinical trials: II. Detection of recurrences in rectal cancer. PMID- 3531090 TI - Community practice and cancer clinical trials: III. Value of platelet and differential counts. PMID- 3531091 TI - Community practice and cancer clinical trials: IV. Relationship between early toxicity and treatment outcomes in GI cancer patients. PMID- 3531092 TI - [Cyclosporin A in the treatment of pemphigus foliaceus and pemphigus erythematosus]. AB - We present the cases of two female patients with pemphigus foliaceus and pemphigus erythematosus, respectively, who did not respond to long-term azathioprine and prednisone treatment in high dosages. In both patients the skin condition improved nearly completely after therapy with cyclosporine A (3.5-6.5 mg/kg per day) in combination with prednisone (7.5-10 mg every 2 days). We did not observe any side-effects during 1 year of this therapy. PMID- 3531093 TI - [Hyperplasia of growth hormone-producing cells in the hypophysis in psoriasis. Study of 10 patients]. AB - In previous investigations we observed an increase of growth hormone (HGH) in the blood serum of patients suffering from various clinical forms of psoriasis. The skin lesions disappeared in about 70% when treated systemically with somatostatin and/or bromocriptine, which are inhibitors of HGH secretion. These findings suggested a post mortem investigation of the pituitary glands of 10 patients who had suffered from psoriasis or psoriatic arthritis. Using histochemical and immunochemical methods, we investigated the distribution of cells producing HGH, PRL, LH or FSH. In all 10 pituitary glands we found hyperplasia of the HGH cells, whereas cells producing LH, TSH, FSH and PRL had a normal distribution. The pituitary glands of controls showed no accumulation or hyperplasia of HGH cells. PMID- 3531094 TI - Health care for the indigent: overview of critical issues. AB - Health care for the indigent is a major problem in the United States. This review of the literature on health care for the indigent was undertaken to determine which major questions remain unresolved. Overall, this article finds that a very large pool of individuals under age 65 are at risk of being medically indigent. A myriad of health programs for some economically disadvantaged individuals do exist, but their level of funding has fluctuated over time--and many poor individuals must rely entirely on the generosity of a relatively small number of hospitals and other providers for their care. Economic pressures on these providers as well as structural changes in the health care sector can only adversely affect the amount of charity care that they offer. It is clear that a well-planned solution to indigent care in the United States, rather than a piecemeal approach, is needed. PMID- 3531095 TI - Health policy and cost containment laws: lessons for public health education in social and behavioral change. AB - As an extension of a contribution by Health Policy and Law to Public Health Education in areas of mutual concern, a descriptive model of cost containment policy in health care delivery is developed. The model starts from the basis of a typology of key Congressional enactments promoting economically motivated policymaking in the Medicare and Medicaid programs. These policies and laws are, in turn, related to the resulting multilevel adaptive behavior in health care services delivery and acquisition. From this descriptive model the thesis is developed that although government has improved its effectiveness in attaining economic and budgetary goals, this type of policy is also creating displacements and generally leading to the retrenchment of national commitment to equity promoting social welfare policy and the possibility of abandoning longstanding historical commitments on strictly economic and budgetary grounds. The article concludes by placing emphasis on the need for public health disciplines to collaborate in order to strengthen national policy, to create a new health policy synthesis, and to strengthen the ability of individuals to qualitatively improve their situation and more effectively assert their health and social welfare rights. PMID- 3531096 TI - The relationship between endotracheal suctioning and changes in intracranial pressure: a review of the literature. PMID- 3531097 TI - Mitral valve prolapse: a review of the scientific and medical literature. AB - In summary, the scientific literature on mitral valve prolapse reveals many unanswered questions about the significance of MVP. Patients with MVP exhibit a wide range of symptoms and problems, ranging from none to serious and disabling ones. Although the prognosis is highly favorable in the majority of cases, patients with significant symptoms may not experience improvement from medications and may benefit from nursing interventions directed toward reducing discomfort and fear. PMID- 3531098 TI - Joseph A. Johnston, MD: an appreciation. PMID- 3531099 TI - Management of alcohol withdrawal in the critically ill patient: a selected review. PMID- 3531100 TI - A post-embedding avidin-biotin peroxidase system to demonstrate the light and electron microscopic localization of lectin binding sites in rat kidney tubules. AB - A post-embedding method for the light and electron microscopic demonstration of lectin binding sites in rat kidney tubules is described. The use of biotinylated lectins, followed by treatment with avidin peroxidase and the DAB-H2O2 sequence, produced intense staining of acrylic sections at the electron microscope level: brush borders and associated structures, cytoplasmic granules, basal infoldings and basement membrane-plasmalemmal interfaces of proximal tubules bound erythrophytohaemagglutinin, while distal tubules were mainly unstained. At the light microscope level, epoxy resin sections showed a similar staining pattern after etching, as did acrylic resin sections after intensification of the final reaction product. The binding of wheatgerm agglutinin to cytoplasmic granules and brush border structures in the proximal tubules was abolished, at both the light and electron microscope levels, by the competing sugar tri-N-acetylchitotriose. Epoxy resin ultrathin sections required etching before staining was achieved in the electron microscope, and results were far inferior to those obtained with acrylic resin. This method allows rapid and inexpensive screening of large numbers of lectins, if required, at both the light and electron microscope levels, using reagents that are stable for long periods of time. PMID- 3531101 TI - Presence of chromogranin A, B and C in bovine endocrine and nervous tissues: a comparative immunohistochemical study. AB - Antisera against chromogranin A, B and C were used to study the distribution of these acidic proteins in bovine endocrine and nervous tissues. The three chromogranins occur together in several endocrine organs (adrenal medulla, anterior pituitary, endocrine pancreas) and in sympathetic ganglion cells. In the posterior pituitary, only chromogranin C and in the intermediate lobe only A and C are found. The parathyroid gland contains only A, and enterochromaffin cells are immunoreactive for A and B. Cells of the thyroid gland and some cells of the anterior pituitary apparently do not contain any chromogranins. It is concluded that the three chromogranins are not always stored together and that they are not present in all endocrine cells. This distinct localization of the chromogranins indicates some special, although still undiscovered, function for these proteins. PMID- 3531102 TI - Immunohistochemical localization of cell surface receptors using a novel method permitting simple, rapid and reliable LM/EM correlation. AB - A method is presented which allows correlative serial section analysis by light and electron microscopy of cell surface antigens in monolayer cultures. Sites of antigenicity are shown by deposition of diaminobenzidine after pre-embedding, immunoperoxidase immunocytochemistry. Osmication is replaced by the use of gold chloride which specifically enhances the electron density of diaminobenzidine. In addition gold chloride bound to diaminobenzidine survives embedding and provides the basis for a post-embedding photochemical amplification method. Immunostained cells are embedded in LR White by a rapid technique which preserves their structure and leaves them available for subsequent post-embedding immunocytochemistry. The method is illustrated by the demonstration of epidermal growth factor (EGF) receptors on the EGF receptor-rich human carcinoma cell line A431 using a well characterized monoclonal antibody raised against EGF receptor. PMID- 3531103 TI - Nutrition and dietetics in the West Indies. PMID- 3531104 TI - McCance and Widdowson's 'The composition of foods': supplementary information and review of new compositional data. AB - Publications are reviewed which give detailed nutritional analyses of a wide range of representative samples of UK foods that have been undertaken since the publication of the fourth edition of McCance and Widdowson's 'The composition of foods'. These include trace elements, vitamin A, immigrant foods, cereals, milk and milk products and potatoes. Typographical corrections to the fourth edition are also given as well as the weight loss on cooking the recipe dishes. PMID- 3531105 TI - Neuropeptide Y (NPY)-like immunoreactivity in peripheral and central nerve fibres of the golden hamster (Mesocricetus auratus) with special respect to pineal gland innervation. AB - Information on the ambient lighting conditions is conveyed from the retina to the pineal organ by a neuronal pathway involving the suprachiasmatic nucleus (SCN) which acts as a circadian pacemaker. In the hamster, circadian rhythms have been shown to be influenced by injection of neuropeptide Y (NPY) into the SCN. Since NPY-immunoreactive nerve fibres are present in the rat and guinea-pig pineal glands it appeared of interest to investigate the hamster pineal as part of the circadian rhythm generating/regulating system. For comparison kidney, small intestine and cerebral cortex were studied. Like in the other rodent species so far investigated only a few of the abundant sympathetic nerve fibres in the hamster pineal gland are NPY-immunoreactive, in contrast to the relatively rich innervation of the other organs. This speaks in favour of a possible central origin of pineal NPY-immunoreactive fibres. These may either exert vasoregulatory effects on pineal vasculature or be involved in the modulation of alpha adrenergic receptor mediated regulation of pineal metabolism. PMID- 3531106 TI - Immunohistochemical localization of neuropeptide Y in the guinea pig medulla oblongata. Correlation with VIP and DBH. AB - The immunohistochemical localization of neuropeptide Y (NPY) was correlated with those of dopamine-beta-hydroxylase (DBH) and vasoactive intestinal polypeptide (VIP) by mapping serial 7 micron paraffin sections at three levels of the guinea pig lower brainstem: a) area postrema, b) dorsal motor nucleus of the vagus, and c) nucleus prepositus of the hypoglossal nerve. Based on differences in transmitter expression, three populations of NPY-immunoreactive (IR) neurons were distinguished: NPY-IR catecholaminergic cells (NPY/CA), NPY-IR VIP-ergic cells (NPY/VIP), and NYP-IR cells which were not reactive to either DBH or VIP. Within these populations, size differences among neurons in characteristic locations allowed differentiation among the following subpopulations: NPY/CA neurons in the lateral reticular nucleus--magnocellular part (mean neuronal size 538 micron2) and parvocellular part (318 micron2)-, in the vagus-solitarius complex (433 micron2), and in the dorsal strip (348 micron2); NPY/VIP neurons in the vagus solitarius complex (368 micron2) and in the nucleus ovalis (236 micron2). Apart from scattered NPY-IR cell bodies in the regions listed above, NPY-IR cell bodies in the lateral portion of the nucleus solitarius and in the caudal part of the spinal nucleus of the trigeminal nerve did not exhibit IR to either DBH or VIP. NPY-IR neurons in the area postrema occurred too infrequently for co-localization studies. The differential distribution of heterogeneous NPY-IR cell subpopulations may reflect the involvement of NPY in a variety of neuronal functions. PMID- 3531107 TI - [Thorotrastoma--late damage following thorotrast arteriography]. AB - We report two cases of cervical thorotrastoma. Thorotrast is no longer used as a radiographic contrast agent, so that the rare thorotrastoma is often forgotten in the differential diagnosis of hypopharyngeal tumours. Surgical treatment of a thorotrastoma is not recommenced. PMID- 3531108 TI - A bone marrow transplant with an acquired anti-Le(a): a case study. AB - A patient with aplastic anemia received an ABO incompatible bone marrow transplant (BMT) from an HLA identical sibling. Weekly HLA antibody screens were performed as part of the BMT protocol. At the time of transplant, a hemolytic anti-Le(a) was detected in the Le (a-b-) donor. The Le (a-b+) recipient had no red cell or LCT antibody. A hemolytic anti-Le(a) was detected in the recipient on day 8, but no LCT reactivity was noted at this time. On day 15, the LCT panel demonstrated reactivity with 9 of 50 panel cells without apparent HLA specificity. Graft vs. host disease (GVHD) was present on the skin at this time. The dose of cyclosporin A was increased, but by day 20 the GVHD worsened and the LCT titers increased to 8. This strong reactivity was noted only in the Le (a+) panel members (12/50) and was neutralized with commercial Lewis substance. On day 34 there was no evidence of GVHD, but the lymphocytotoxic anti-Lea continued to be present. The patient began experiencing renal and gastrointestinal difficulties by day 48, and expired on day 60. In renal transplants the kidneys retain their Lewis type and secrete Lewis substance in the urine. In our experience BMT patients retain their Lewis type regardless of the type of the donor. The Lewis system has been linked to renal allograft rejection, and Lewis antigens may function as transplantation antigens in BMT patients as well. In addition, lymphocytotoxic Lewis antibodies can mask other significant HLA antibodies and must be identified when screening patients in need of plateletpheresis products. PMID- 3531109 TI - Reactive arthropathy (Reiter's syndrome) after salmonellosis: report of two cases and review of the literature. PMID- 3531110 TI - A randomized comparison of misonidazole sensitized radiotherapy plus BCNU and radiotherapy plus BCNU for treatment of malignant glioma after surgery: final report of an RTOG study. AB - This randomized RTOG study evaluated misonidazole radiosensitized radiation therapy in the treatment of malignant glioma. One hundred and forty-six evaluable patients were treated with conventional radiation therapy to 60.00 Gy in 6-7 weeks plus BCNU 80 mg/m2/d for 3 days every 8 weeks (XRT + BCNU). One hundred and forty-seven evaluable patients were treated with misonidazole 2.5 gm/m2 once a week for 6 weeks, radiation therapy to 60 Gy and BCNU (MISO + XRT + BCNU). Patients were stratified according to the prognostic factors of age, performance status, and histology. Distribution of these characteristics was comparable among the treatment groups. The median survival for XRT + BCNU was 55.0 weeks, and for MISO + XRT + BCNU 46.0 weeks (p = 0.35). With patients on a minimum dose of dexamethasone of 3 mg/d, misonidazole neurotoxicity included 8.8% peripheral neuropathy, 2.7% CNS toxicity, and a 0.68% ototoxicity. BCNU pulmonary toxicity occurred in 9.3% of patients who received 902-2062 mg/m2 of BCNU. PMID- 3531111 TI - Oxygen delivery to tumors. AB - Sensitization of hypoxic cells in tumors, by increasing their oxygen supply, has been attempted for at least 30 years. Only the use of hyperbaric oxygen has been shown unequivocally as a beneficial adjunct to radiotherapy; and even then, the number of sites sensitized is limited to head and neck and cervix. It is not clear whether this implies that all other tumors reoxygenate fully during treatment, or whether a better method would sensitize other sites. Nevertheless, the elimination of hypoxic cells is viewed by many as a worthy goal in radiobiology and many strategies have been tested in animal systems. These include: oxygen releasing chemicals, artificial oxygen carriers, inhibitors of oxygen consumption, blood flow modifiers, or the exploitation of tumor adaptation to altered oxygen availability. We must be aware that any procedure which improves tumor oxygenation will not only increase radiosensitivity, but will induce an adaptive response in the tumor such that, sensitization will be of limited duration. It is likely that in the apparent failure of measures to improve substantially the oxygen delivery to tumors, the elimination of most of the hypoxic cells, of the type accessible to them, may have been achieved. If, as has been suggested, there are two distinct types of hypoxic cells, a combination of more than one strategy may be necessary to achieve more substantial gains. PMID- 3531112 TI - Late results of a trial of hyperbaric oxygen and radiotherapy in head and neck cancer: a rationale for hypoxic cell sensitizers? AB - 104 patients with head and neck cancer were entered into a prospective controlled trial of radiotherapy in hyperbaric oxygen (HBO). The trial compared 10 fractions of radiotherapy in HBO with 30 fractions of radiotherapy in air. Survival and local control rates were significantly higher in the HBO group. No difference in normal tissue effects were detected. The greatest advantage of HBO was seen in the less advanced tumors. PMID- 3531113 TI - Irradiation with misonidazole and hyperbaric oxygen: final report on a randomized trial in advanced head and neck cancer. AB - One hundred and thirty patients with locally advanced squamous carcinoma of the head and neck were treated in a prospective randomized trial to compare conventional irradiation (63.00 Gy in 30 fractions) with a combination sensitizer regimen of misonidazole and hyperbaric oxygen. The drug (2.0 gm/m2) was given with each of six fractions of 6.0 Gy in hyperbaric oxygen at 3 ATA. The results support a previous study and favor the combination at 1 year at better than the 10% level. This regimen could be useful for bulky primary or nodal disease. PMID- 3531114 TI - The roles of intracellular glutathione in antineoplastic chemotherapy. AB - Glutathione is a sulfhydryl containing tripeptide that participates in detoxification of xenobiotic compounds, including the alkylating agents melphalan, cyclophosphamide, and BCNU. The role of glutathione in the detoxification of these compounds, both in terms of initial tumor response, and drug-induced resistance to these alkylating agents is examined. Since glutathione disulfide and glutathione are a pivotal redox pair, the modulation of intracellular glutathione levels is shown to change the cytotoxicity of drugs dependent on the redox cycle, such as adriamycin and bleomycin, as well as the oxygen dependent drug neocarzinostatin. Areas of further research are discussed. PMID- 3531115 TI - Radiation-chemotherapy interactions. AB - The design of radiobiological experiments to study radiation-chemotherapy interactions in tumors and normal tissues is critically reviewed. It is suggested that such experiments should not be designed in such a way as to optimize the treatment strategy for the respective animal model, but to study the influence of one modality on the effectiveness of the other modality with regard to one specific endpoint at a time and its dependence on dose and timing, preferentially in multifraction experiments. PMID- 3531116 TI - Enhancement of radiation-induced cell kill by platinum complexes (carboplatin and iproplatin) in V79 cells. AB - Two second generation platinum complexes currently undergoing clinical chemotherapeutic trials, carboplatin (CBDCA) and iproplatin (CHIP), were evaluated for their ability to alter the survival of cultured Chinese hamster V79 cells following irradiation. Two protocols were employed. In the first, the drug was added to preplated cells, some of which were subsequently made hypoxic with nitrogen gas. These hypoxic cells were irradiated following 1 hour exposure to drug and survival was assessed by standard colony forming unit (CFU) methods. Enhancement ratios (ER) of approximately 1.4 were obtained for irradiation under hypoxic conditions, if the cells were exposed to equitoxic doses of CBDCA (500 microM) CHIP (50 microM). In the second series of experiments, cells were treated with 10 Gy in air and then incubated for various times prior to trypsinization and serial dilution of single cell suspensions. Six hours after irradiation, cells treated with X rays alone had recovered to produce a surviving fraction twice that of cells trypsinized immediately after irradiation (not held). Post irradiation administration of CBDCA (50 microM) or CHIP (20 microM), at a time when free radical-mediated radiosensitization would not be possible, operationally inhibited this recovery from radiation-induced potentially lethal damage (PLD). Inhibition, expressed as recovery inhibition factor (RIF) after 6 hr with drug, was 2.0 for CBDCA and 1.2 for CHIP. These results suggest that the rationale for designing clinical trials to exploit interactions between cisplatin and radiation might also extend to include combined modality therapy using radiation with either of these two platinum complexes. PMID- 3531117 TI - Defense mechanisms of normal and tumor cells. AB - This paper reviews the protective systems of normal and tumor cells against chemical and radiation injury. The glutathione redox cycle is an important cell defense system that can be compromised by various chemical modifiers. Acute cell injury can involve the glutathione pools of both the cytosol and the mitochondria. Intracellular calcium may have a role in cell death following acute cell injury but extracellular calcium does not seem to initiate the events leading to cell death. Changes in the glutathione redox status affects the distribution of intracellular calcium and the protein thiol-disulfide redox status. Formation of glutathione protein-mixed disulfides is discussed in terms of a possible protective mechanism against oxidative injury. PMID- 3531118 TI - The use of non-hypoxic cell sensitizers in radiobiology and radiotherapy. AB - Many different non-hypoxic cell radiosensitizers have been identified over the years. Radiosensitization by these agents is mediated through a variety of mechanisms, including inhibition of repair (both enzymatic and chemical), modification in the DNA molecule, and perturbation and redistribution in the cell cycle. Recent clinical interest in the use of halogenated pyrimidines as radiosensitizers has prompted a number of questions requiring both laboratory and clinical research to maximize this therapeutic approach. Other radiosensitizers that alter cellular redox processes in different ways are discussed in the context of better understanding the cellular biochemical systems that are affected in aerobic radiosensitization. Advancement in the use of non-hypoxic cell sensitizers in radiation cancer treatment will most likely depend on a knowledge of the detailed biochemical mechanisms of these agents and how they might be used to exploit any subtle biochemical differences between tumor and normal tissue. PMID- 3531119 TI - Implications of the density of clonogenic infestation in radiotherapy. AB - Treatment schemes must be evaluated in a clinical context. It was observed by Coutard in the 1920s that exophytic tumors disappear by the third to fourth week of treatment and are more often controlled, stage for stage, than ulcerative and/or infiltrative tumors. It has also been demonstrated that the control rate is higher in patients whose tumor has clinically disappeared at the end of treatment than in those with clinically residual tumor. A possible explanation is that, after the clinical disappearance tumor cells that remain are euoxic during the latter part of treatment. Since some parameters, such as reoxygenation and proliferation, may work in opposite directions, a balance has to be found for each tumor mass. Furthermore, there are clinical facts that, although without explanation, must be considered. PMID- 3531120 TI - Contraceptive use in the chronically ill adolescent female. Part II. PMID- 3531121 TI - Management of infertility in the cow. PMID- 3531122 TI - Aerobic blood culturing in cows with coliform mastitis. AB - Aerobic culturing was performed on blood samples from 20 cows with coliform mastitis and signs of systemic illness, and on blood samples from 21 cows with mastitis caused by other agents. No bacteria other than the skin contaminant Bacillus sp were isolated from the blood. PMID- 3531123 TI - Relationship between mastitis pathogen numbers in bulk tank milk and bovine udder infections in California dairy herds. AB - Samples of bulk tank milk and cow-composite milk from 23,138 dairy cows from 50 California dairies were examined by use of microbiologic procedures. The number of colonies of mastitis pathogens isolated per milliliter of bulk tank milk (used as a predictor of the percentage of infected cows in the herd) was evaluated, using simple regression analysis and Spearman's rank correlation. Correlations between the pathogens and the percentage of cows in each herd shedding the pathogens were found for Streptococcus agalactiae (r = 0.71) and mycoplasma (r = 0.59), but were considerably lower for other pathogens. When greater than or equal to 4,000 colonies of Streptococcus agalactiae were found per milliliter of bulk tank milk, at least 7% of the cows in the herd was shedding this organism. However, a pattern was not found between the number of mycoplasma colonies per milliliter of bulk tank milk and the percentage of infected cows in the herd. PMID- 3531124 TI - Treatment of severely comminuted diaphyseal fractures in the dog, using standard bone plates and autogenous cancellous bone graft to span fracture gaps: 11 cases (1979-1983). AB - Severely comminuted diaphyseal fractures in 11 dogs were repaired with standard bone plates that spanned a fracture gap filled with autogenous cancellous bone graft. Five dogs had closed injuries, 4 dogs had open fractures, and 2 dogs had infected nonunion fractures for which previous attempts at internal pin fixation had failed. A second autogenous cancellous bone graft was performed in 3 of the dogs during the healing period. The technique was successful in all dogs. The technique was considered a versatile and relatively simple alternative, compared with meticulous small fragment reconstruction and cortical bone allografts. PMID- 3531125 TI - Splenic hematoma and abscess as a cause of chronic weight loss in a horse. AB - An 8-year-old gelding with a 3-month history of anorexia and weight loss was found to have a massive subcapsular splenic hematoma. At flank laparotomy, 36 L of fluid was removed from the hematoma. The horse's condition improved after drainage. Fifteen months later, the horse became depressed and febrile. A splenic abscess containing Bacteroides ruminicola and Clostridium sporogenes was found at necropsy. PMID- 3531126 TI - Treatment of Streptococcus agalactiae mastitis in dairy cows: comparative efficacies of two antibiotic preparations and factors associated with successful treatment. AB - A commercially available, penicillin-novobiocin, intramammary infusion product and a solution of procaine penicillin G (1.2 X 10(6) IU) in 10 ml of sterile saline solution were evaluated for their comparative efficacies against Streptococcus agalactiae mastitis in 3 California dairy herds. After composite milk samples from each cow in each herd were bacteriologically cultured, cows infected with S agalactiae (n = 228) were assigned randomly to 2 treatment groups. Milk samples were reevaluated bacteriologically 21 to 25 days after treatment. Both preparations were highly effective against S agalactiae in first lactation cows and in cows scored negative or trace by use of the California Mastitis Test. Efficacy was significantly decreased in cows with California Mastitis Test scores of 1, 2, or 3. Herd and treatment were associated significantly with treatment success or failure. Most treatment failures were in one herd in cows that were given procaine penicillin G in sterile saline solution. Milk production and lactation stage were not associated with success or failure of treatment. PMID- 3531127 TI - Cancellous bone grafting at plate removal to counteract stress protection. AB - Fractures of the radius and ulna in dogs of miniature breeds can be clinically troublesome because of bone resorption during healing, causing increased possibility of refracture. Bone plates allow early weight-bearing, but substitute the problem of stress protection for disuse atrophy. To overcome the disuse atrophy, early plate removal plus cancellous bone grafting was used in 4 limbs of dogs. Visible thickening or increased bone density of the fracture site was observed 3 weeks after the procedure. PMID- 3531128 TI - Plasmid pVA517C from Escherichia coli V517 is required for the expression of an antibiotic microcin. PMID- 3531129 TI - Structural modification of Escherichia coli peptidoglycan induced by bicyclomycin. AB - We have studied the modification of Escherichia coli peptidoglycan induced by bicyclomycin. For this purpose liquid chromatography for peptidoglycan analysis has been used. The main alteration found was an increase of diaminopimelyl diaminopimelyl bridge containing subunits. Our results show that bicyclomycin impairs the normal breakage of that interpeptidic bond, whose cleavage is needed for the normal remodeling of peptidoglycan and cell growth. Based on the analysis of the possible structure of diaminopimelyl-diaminopimelyl bond and bicyclomycin, we propose a hypothesis on the mechanism of action of bicyclomycin. PMID- 3531130 TI - Therapeutic effect of SF-2103A, a novel carbapenem antibiotic, in combination with cefotaxime, cefoperazone and other cephalosporins. AB - Combinations of SF-2103A with cefotaxime, cefoperazone or cefazolin showed synergistic efficacy at a wide range of combination ratios against experimental infection in mice due to Proteus vulgaris GN76/C-1, producing type Ic cephalosporinase, Escherichia coli No. 29/36 RGN823, producing type IIIa (TEM-2) penicillinase and E. coli GN206, producing type Ib cephalosporinase. These effects by SF-2103A were greater than those seen with sulbactam. The in vitro and in vivo synergistic activities were roughly correlated. Potent in vivo activity of SF-2103A was related to good pharmacokinetic properties, with blood half-life of 30 minutes and urinary recovery of 55.2% after parenteral administration to rats. Furthermore, SF-2103A was stable to rat kidney homogenate. The high stability of SF-2103A in aqueous and biological media was correlated with the sulfonate group at C-3. PMID- 3531131 TI - Comparative effects of cefpirome (HR 810) and other cephalosporins on experimentally induced pneumonia in mice. AB - The chemotherapeutic efficacy of cefpirome (HR 810), a new polar aminothiazolylcephalosporin and that of ceftazidime, cefotaxime, cefoperazone, latamoxef and cefodizime were examined against experimental pneumonia caused by Klebsiella pneumoniae DT-S in mice. When compared in terms of MIC values against the infecting organism and the pharmacokinetic pattern, cefpirome showed equal activity and a similar pharmacokinetic behavior to ceftazidime and cefotaxime in mice. Trials to assess the bactericidal activity in vivo, however, showed that cefpirome displayed a more marked bactericidal effect in pneumonic mice than the other cephalosporins tested. Only cefodizime, a cephalosporin with extremely high and prolonged blood and tissue levels in experimental animals exerted chemotherapeutic effects similar to cefpirome. After cefpirome or cefodizime medication (50 mg/kg), the viable counts in the lungs of experimental animals fell steadily to 1/10,000 of the pretreatment level and, in contrast to the reference compounds, no regrowth of the challenge organisms could be observed with both drugs. Moreover, with ED50s ranging from 1.1 to 59.1 mg/kg in treatment studies, cefpirome as well as cefodizime were two to ten times more effective than ceftazidime and cefotaxime, whereas cefoperazone and latamoxef were considerably less effective. PMID- 3531132 TI - Isolation of an aminoglycoside hypersensitive mutant and its application in screening. AB - An aminoglycoside hypersensitive mutant, Kp-126, was isolated from the aminoglycoside-resistant strain, Kp-8, of Klebsiella pneumoniae through selection using sorbistin, a non-aminocyclitol-aminoglycoside antibiotic. The mutant Kp-126 was approximately 100-fold more sensitive to sorbistin than the parent strain Kp 8. The mutant also showed hypersensitivity to various aminocyclitol aminoglycoside antibiotics. K. pneumoniae Kp-126 was used in screening and a new aminoglycoside antibiotic, 3,3'-neotrehalosadiamine (BMY-28251), was discovered in the fermentation broths of soil isolate strain of Bacillus pumilus. PMID- 3531133 TI - Further studies on the biosynthesis of chlorothricin. AB - Feeding experiments with [U-13C3]- and (2R)-[1-2H2]glycerol showed that glycerol is incorporated intact into carbon atoms 22, 23 and 24 of the aglycone of chlorothricin. C-1 of glycerol gives rise to C-22 with retention of one atom of deuterium, which occupies the H-22R position. A mechanism for the assembly of the aglycone is proposed which invokes phosphoenolpyruvate as the direct precursor of the 3-carbon moiety and a Baeyer-Villiger oxidation as the mode of formation of the macrocyclic lactone functionality. A feeding experiment with [1,2 13C2]succinate suggests that the propionate units of the aglycone polyketide are formed entirely via the methylmalonyl-CoA mutase reaction. The formation of the two 2,6-dideoxy-D-rhamnose moieties of chlorothricin from glucose was shown to involve replacement of the 2-hydroxyl group of the sugar by hydrogen with inversion of configuration at C-2. This contrasts with the retention stereochemistry observed earlier for the analogous formation of the 2,6 dideoxyhexose moiety of the antibiotic granaticin. PMID- 3531134 TI - Genetic parameter estimates for reproductive traits of male and female littermate swine. AB - Reproductive traits of purebred and crossbred pigs produced in a four-breed diallel mating system using the Duroc, Landrace, Spotted and Yorkshire breeds were collected for five consecutive farrowing seasons (two farrowing seasons/year) beginning in fall 1976. Paternal half-sib heritabilities and genetic correlations for testicular traits (120 boars from 36 sires), serum testosterone (TE) and luteinizing hormone (LH) concentrations before and after treatment with gonadotropin releasing hormone (GnRH; 131 boars from 37 sires) and breeding performance traits (151 boars from 38 sires) were estimated. Heritability estimates were generally small to moderate except for sperm/gram testis (SGT), LH concentrations before (LHO) and at 3 h (LH3) after treatment with GnRH (.73 +/- .48, .61 +/- .46 and 1.19 +/- .45, respectively). A large positive genetic correlation was found for LHO with LH3 (.94 +/- .39), while a negative relationship existed for LH3 with TE concentrations at 3 h after GnRH injection. The genetic correlation between a boar's average first service conception rate and average conception rate also was significant (.82 +/- .54). Genetic correlations among littermate traits would suggest that selection for decreased age at puberty in gilts could cause an increase in LH concentrations in boar offspring, before and after GnRH injection, and may also have adverse effects on their ability to settle females. Selection for increased weight at puberty of gilts could cause TE concentrations of boar offspring to increase while having little effect on their breeding performance. PMID- 3531135 TI - Induction of estrus in ovariectomized cows and heifers: effects of estradiol benzoate and gonadotropin releasing hormone. AB - Three experiments were conducted with ovariectomized (OVX) cows and heifers to investigate potential neuroendocrine mechanisms controlling estrous behavior. In Exp. 1, 10 OVX cows were treated with either 125 micrograms estradiol benzoate and 10 cc saline (125 micrograms EB + SAL), 125 micrograms EB and 500 micrograms gonadotropin releasing hormone (125 micrograms EB + GnRH), 250 micrograms EB and 10 cc SAL (250 micrograms EB + SAL), 250 micrograms EB and 500 micrograms GnRH (250 micrograms EB + GnRH) or 500 micrograms EB and 10 cc SAL (500 micrograms EB + SAL) in a replicated 5 X 5 Latin-square design. During the 48 h following EB injection, 2-h observation blocks were alternated with 2-h non-observation blocks. During each 2-h observation block, 14 behavioral interactions were monitored. The percentage of cows in estrus was lower for cows receiving 125 micrograms EB as compared with those given the higher doses. However, the cows receiving 125 micrograms EB + SAL did not differ in their estrous response from those receiving 125 micrograms EB + GnRH. The interval from injection to the onset of estrus and the duration of estrus were similar for all treatments. In Exp. 2, 10 OVX heifers were subjected to the same treatments and observation procedures utilized in Exp. 1. The results of Exp. 2 were similar to those of Exp. 1. In Exp. 3, 10 OVX cows were treated with either 300, 600, 1,200, 2,400 or 4,800 micrograms EB in a replicated 5 X 5 Latin-square design.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3531136 TI - Implanting young bulls with zeranol from birth to four slaughter ages: III. Growth performance and endocrine aspects. AB - Seventy-two Simmental bull calves were assigned randomly either to a zeranol implanted (I) or nonimplanted (NI) control group. Within 3 d after birth, bulls assigned to the I treatment were implanted with 36 mg zeranol and reimplanted every 84 d until slaughter. Calves were weaned at 7.2 mo, preconditioned for 2 wk, and assigned within treatment to slaughter ages 12.0, 13.8, 15.7 and 17.4 mo. Blood samples were taken bimonthly from 8.3 to 16.6 mo of age. Weight gains, feed:gain ratios and slaughter and carcass weights were similar (P greater than .10) for I and NI bulls for the total feeding period. Weight gains for NI bulls were larger (P less than .05) from 7.7 to 9.5 mo and from 11.3 to 12.2 mo of age, whereas gains for I bulls were greater from 12.2 to 14.1 mo. Serum estradiol-17 beta (E2) and testosterone (T) concentrations were higher (P less than .05) for NI bulls at 8.3, 9.2, 10.2, 11.1, 12.1 and 13.0 mo. However, at 13.9 and 14.8 mo, E2 concentrations were higher (P less than .10) for I bulls. A similar, but nonsignificant (P greater than .10), trend was noted for T concentrations of I bulls at 13.9 and 14.8 mo. Rapid increases in E2 concentrations were observed from 8.3 to 9.2 mo in NI bulls, but from 12.1 to 13.9 mo in I bulls. Similarly, T concentrations increased rapidly from 8.3 to 10.2 mo in NI bulls, but from 12.1 to 14.8 mo in I bulls. Peak concentrations of T and E2 for NI bulls were observed near 11 and 13 mo, respectively, whereas peak T and E2 levels were delayed in I bulls until near 14 mo. Periods of greater weight gains for both NI and I bulls corresponded to rapidly increasing E2 and T concentrations. Serum thyroxine concentrations were lower (P less than .05) for I bulls at 13.9 mo but similar to NI bulls at all other ages. Serum insulin concentrations were higher (P less than .05) for I bulls than for NI bulls at 8.3, 10.2, 11.1 and 12.1 mo. Regardless of treatment, insulin concentrations increased with increasing age. Carcasses from I bulls were fatter (P less than .05) and tended (P = .09) to have smaller ribeye areas/100 kg carcass. Fat thicknesses for both treatments increased (P less than .05) from 13.8 to 15.7 mo. Skeletal maturity scores, 9-10-11th rib bone percentages and femur measurements indicated an increased skeletal maturation in I bulls.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3531137 TI - Intrauterine migration of the porcine embryo: coordination of bead migration with estradiol. AB - Forty crossbred gilts were used in three experiments to examine the effects of estradiol on embryo migration. Small, spherical beads of Silastic glue containing either cholesterol or estradiol-17 beta were used to mimic embryo migration. In the first experiment, 10 cholesterol- and 10 estradiol-impregnated beads were injected into the tip of the uterine horns, either on the same side (n = 5) or opposite from each other (n = 5). The second experiment consisted of a localized release of cholesterol or estradiol and observing migration of cholesterol containing beads inserted 10 cm anterior and posterior to this site (n = 5). In the third experiment, 10 cholesterol-impregnated beads were injected into either the tip or base of one uterine horn. Additionally, these gilts were exposed to vehicle or exogenous estradiol in a 2 X 2 factorial arrangement of treatments (n = 5). Results of these experiments indicated that cholesterol-impregnated beads migrated further (P less than .05) when adjacent to estradiol-containing beads than when in an opposite uterine horn. Localized release of estradiol failed to induce movement of beads away from the site of steroid release. Finally, beads inserted at the base of the uterus moved anteriorly following treatment of gilts with estradiol. We suggest from these experiments that the porcine uterine horn cannot discriminate between estradiol- and cholesterol-releasing beads and, further, lacks a coordinated ability to displace adjacent beads. A site-dose dependent mechanism(s) of estrogenic induction of migration may exist such that porcine embryos become bilaterally intermixed following posterior, then anterior, waves of uterine contractions. PMID- 3531138 TI - Effect of active immunization against LHRH or LH in boars: reproductive consequences and performance traits. AB - Forty crossbred boars were equally divided into eight groups at birth. Four groups were immunized (200 micrograms/boar) at 12 wk of age against either luteinizing hormone-releasing hormone (LHRH) conjugated to human serum globulin (LHRH-hSG) in complete Freund's adjuvant (CFA), LHRH-hSG in muramyldipeptide adjuvant (PEP), procine luteinizing hormone (LH) conjugated to hSG (pLH-hSG) in CFA or ovine LH (oLH) in CFA. Equal doses of boosters were given in either PEP or incomplete Freund's adjuvant (IFA) at 16 and 18 wk of age. Two groups of boars were immunized with either hSG + CFA or hSG + PEP (adjuvant controls). Two groups were castrated either at the time of weaning (castrate weaning) or at 16 wk when immunized boars were given their first booster injections (castrate booster). All pigs were slaughtered at 24 wk of age. Serum levels of LH and testosterone (T), LHRH or LH antibody titers, as well as testicular and accessory sex gland weights and histology were determined. By wk 16, LHRH antibody titers began to rise in those boars immunized against LHRH-hSG. Luteinizing hormone-releasing hormone antibody titers on wk 18, 20 and 22 were greater than those at wk 16. By 22 wk of age, LHRH-hSG boars had non-detectable plasma LH and T and reduced weights of testes and acessory sex glands. Boars immunized against oLH did not respond to treatment, whereas pLH-hSG boars showed a reduction in serum T levels and accessory sex gland weights. Immunization had no effect on average daily gain, hot carcass weights or loin eye area.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3531139 TI - The effect of citric acid on growth of proteolytic strains of Clostridium botulinum. AB - In strictly anaerobic conditions in a culture medium adjusted to pH 5.2 with HCl and incubated at 30 degrees C, inocula containing less than 10 vegetative bacteria of Clostridium botulinum ZK3 (type A) multiplied to give greater than 10(8) bacteria per ml in 3 d. Growth from an inoculum of between 10 and 100 spores occurred after a delay of 10-20 weeks. Citric acid concentrations of 10-50 mmol/l at pH 5.2 inhibited growth from both vegetative bacteria and spore inocula, a concentration of 50 mmol/l increasing the number of vegetative bacteria or of spores required to produce growth by a factor of approximately 10(6). The citric acid also reduced the concentration of free Ca2+ in the medium. The inhibitory effect of citric acid on vegetative bacteria at pH 5.2 could be prevented by the addition of Ca2+ or Mg2+ and greatly reduced by Fe2+ and Mn2+. The addition of Ca2+, but not of the remaining divalent metal ions, restored the concentration of free Ca2+ in the medium to that in the citrate-free medium. The inhibitory effect of citric acid on growth from a spore inoculum was only partially prevented by Ca2+. Citric acid (50 mmol/l) did not inhibit growth of strain ZK3 at pH 6 despite the greater chelating activity of citrate at pH 6 than at pH 5.2. The effect of citric acid and Ca2+ at pH 5.2 on vegetative bacteria of strains VL1 (type A) and 2346 and B6 (proteolytic type B) was similar to that on strain ZK3. PMID- 3531140 TI - Laboratory studies on salmonella-contaminated cheese involved in a major outbreak of gastroenteritis. AB - A major outbreak of gastroenteritis was traced to Cheddar cheese contaminated with Salmonella typhimurium. There were no significant differences in pH values of the contaminated (mean pH 5.31) and non-contaminated (mean pH 5.39) cheese. The isolation rates of Salm. typhimurium were about the same when cheese samples were homogenized in lactose broth, lactose broth containing 1% Tween 80, or in aqueous 2% sodium citrate. Salmonella typhimurium was isolated regardless of preenrichment in lactose broth, but required selective enrichment in selenite cystine or tetrathionate brilliant green broth. There were no marked differences in the isolation rates obtained with different selective enrichment media, or after incubation at 36 degrees and 43 degrees C for 24 or 48 h. Contaminated samples of cheese failed to yield Salm. typhimurium consistently despite large and multiple samplings; samples from the interior of cheese blocks yielded positive results more frequently than the samples from the exterior. The number of Salm. typhimurium in factory sealed blocks as well as in samples obtained from the homes of known cases of salmonellosis was found to range from less than 3/100 g to 9/100 g of cheese. The infective dose of Salm. typhimurium in contaminated cheese was probably no greater than 10(4) organisms, and a rapid decline in numbers of Salm. typhimurium must have occurred subsequent to the outbreak. PMID- 3531142 TI - Satranidazole: mechanism of action on DNA and structure-activity correlations. AB - Satranidazole (CG-10213-Go), a novel nitroimidazole possessing a C-N linkage at C2 of the imidazole ring has been examined, during reduction, for its ability to damage DNA. Physical damage to DNA was measured by viscometry, thermal denaturation and renaturation, and hydroxyapatite chromatography. Biologically relevant DNA damage was measured by a bacteriophage transfection assay. The drug produces extensive DNA damage characterized by helix destabilization and strand breakage. Its comparison with other 2- and 5-nitroimidazoles indicate it may be more active towards anaerobes than many 5-nitroimidazoles because its relatively high redox potential may make it more resistant to inactivation by oxygen. PMID- 3531141 TI - Prevention and treatment of experimental influenza A virus infection in volunteers with a new antiviral ICI 130,685. AB - The initial prophylactic and therapeutic trials of ICI 130,685 against influenza A virus infection are reported. Prophylaxis with either 200 mg/day (38 volunteers received drug and 40 received placebo) or 100 mg/day (28 volunteers received drug and 28 received placebo) for seven days significantly reduced illness, mean clinical score and nasal secretion weight when volunteers were challenged with 10(4.1) EID50 of influenza virus A/Eng/40/83 (H3N2). Overall, prophylaxis with 200 mg/day and 100 mg/day gave 91% and 72% protection against illness relative to placebo, respectively. In addition, prophylaxis with both regimens for seven days also significantly reduced the number of volunteers who excreted virus. In a therapeutic study, volunteers were inoculated with the same dose of virus and those who developed symptoms which persisted for 6-15 h were treated with 200 mg/day of drug (20 volunteers) or placebo (19 volunteers) for four days. Generally, treatment reduced both the amount of virus excreted and the mean daily clinical score. However, these reductions were only statistically significant (P less than 0.05) on the third day of medication for the amount of virus excreted and on the fourth day of treatment for the mean clinical score. It was concluded that ICI 130,685 is effective in the prevention and treatment of influenza virus infection. An initial tolerance study in 16 volunteers who received either drug (200 mg/day) (8 volunteers) or placebo (8 volunteers) for seven days, indicated that the drug was generally well tolerated. Combining data from all studies, 43% of volunteers who received the drug at the 200 mg/day dosage and 21% who received placebo complained of one or more symptoms. However, symptoms were generally minor and of short duration. At the lower dosage (100 mg/day) the symptoms were qualitatively similar to those reported with placebo. PMID- 3531143 TI - The in-vitro activity and beta-lactamase stability of carumonam. AB - Carumonam is a monobactam with a beta-carbamyloxmethyl group at position 4. It inhibited 90% of Enterobacteriaceae at less than or equal to 8 mg/l and had in vitro activity similar to that of cefotaxime, ceftazidime and aztreonam. Fifty per cent of Enterobacter, Citrobacter and Serratia isolates were inhibited by 4 mg/l, but isolates resistant to aztreonam and ceftazidime were not inhibited. Carumonam, like aztreonam, did not inhibit Gram-positive or anaerobic species. Carumonam was not destroyed by the common plasmid- and chromosomally-mediated beta-lactamases and was more stable than aztreonam to attack by the K-1 beta lactamase of Klebsiella oxytoca. Carumonam inhibited Richmond-Sykes type Ia and Id beta-lactamases but was a poor inhibitor of type III enzymes. It did not induce beta-lactamases. PMID- 3531144 TI - Ketoconazole and flucytosine alone and in combination against Candida spp. in a neutropenic site in rabbits. AB - Ketoconazole and flucytosine were administered alone and in combination for ten days to rabbits with four candida isolates growing in subcutaneously implanted semipermeable chambers. The peak concentrations of ketoconazole in serum and in the chamber were 20.3 and 3.8 mg/l, respectively, and the concentrations of flucytosine 47.7 and 37.3 mg/l, respectively. The two drugs combined resulted in better fungistatic activity than either drug alone against all four isolates. Correlation of efficacy in the rabbit model with in-vitro MICs was good for flucytosine, but poor for ketoconazole. PMID- 3531145 TI - Metabolic response to [13C]glucose and [13C]fructose ingestion during exercise. AB - Seven healthy male volunteers exercised on a cycle ergometer at 50 +/- 5% VO2max for 180 min, on three occasions during which they ingested either water only (W), [13C]glucose (G), or [13C]fructose (F) (140 +/- 12 g, diluted at 7% in water, and evenly distributed over the exercise period). Blood glucose concentration (in mM) significantly decreased during exercise with W (5.1 +/- 0.4 to 4.2 +/- 0.1) but remained stable with G (5.0 +/- 0.4 to 5.3 +/- 0.6) or F ingestion (5.4 +/- 0.5 to 5.1 +/- 0.4). Decreases in plasma insulin concentration (microU/ml) were greater (P less than 0.05) with W (11 +/- 3 to 3 +/- 1) and F (12 +/- 4 to 5 +/- 1) than with G ingestion (11 +/- 2 to 9 +/- 5), and fat utilization was greater with F (103 +/- 11 g) than with G ingestion (82 +/- 9 g) and lower than with W ingestion (132 +/- 14 g). However F was less readily available for combustion than G; over the 3-h period 75% (106 +/- 11 g) of ingested G was oxidized, compared with 56% (79 +/- 8 g) of ingested fructose. As a consequence, carbohydrate store utilizations were similar in the two conditions (G, 174 +/- 20 g; F, 173 +/- 17 g; vs. W, 193 +/- 22 g). These observations suggest that, during prolonged moderate exercise, F ingestion maintains blood glucose as well as G ingestion, and increases fat utilization when compared to G ingestion. However, due to a slower rate of utilization of F, carbohydrate store sparing is similar with G and F ingestions. PMID- 3531146 TI - Effects of positive end-expiratory pressure on the right ventricle. AB - Transmural cardiac pressures, stroke volume, right ventricular volume, and lung water content were measured in normal dogs and in dogs with oleic acid-induced pulmonary edema (PE) maintained on positive-pressure ventilation. Measurements were performed prior to and following application of 20 cmH2O positive end expiratory pressure (PEEP). Colloid fluid was given during PEEP for ventricular volume expansion before and after the oleic acid administration. PEEP significantly increased pleural pressure and pulmonary vascular resistance but decreased right ventricular volume, stroke volume, and mean arterial pressure in both normal and PE dogs. Although the fluid infusion during PEEP raised right ventricular diastolic volumes to the pre-PEEP level, the stroke volumes did not significantly increase in either normal dogs or the PE dogs. The fluid infusion, however, significantly increased the lung water content in the PE dogs. Following discontinuation of PEEP, mean arterial pressure, cardiac output, and stroke volume significantly increased, and heart rate did not change. The failure of the stroke volume to increase despite significant right ventricular volume augmentation during PEEP indicates that positive-pressure ventilation with 20 cmH2O PEEP decreases right ventricular function. PMID- 3531147 TI - The growth-promoting effect of human whole blood serum on cultured human aortic smooth muscle cells is a constant serum donor-dependent property. AB - We studied the variation in the mitogenicity of sera derived from any particular subject at different time points. Two sets of sera were taken at an interval of 3 wk from 12 healthy male conscripts, and the samples were tested with regard to their ability to support proliferation of cultured human aortic smooth muscle cells (HSMC). Sera from 12 individuals showed markedly different growth stimulating effects. On the other hand, sera from any particular individual taken at different time points gave constantly the same result. This was evident when the sera from the two time points were tested fresh in separate experiments and when they were tested together in one experiment after storage of 4 to 5 mo. The growth-promoting effects of the sera did not correlate significantly with the concentration of certain measurable serum factors which are known to be mitogenic for arterial smooth muscle cells (low-density lipoprotein cholesterol, high density lipoprotein cholesterol, growth hormone, insulin, or insulinlike growth factor-I). Our results indicate that the growth-promoting effect of human serum on cultured HSMC is a constant serum donor-dependent property. This implies that it is possible to make reliable comparisons between the growth-promoting effects of the sera derived from different subjects, and to measure the effects of treatments, e. g. medical or dietary, on the mitogenicity of the sera from any given individual. PMID- 3531149 TI - Comparison of two new controlled-release theophylline formulations in the management of asthma in children and reliability of salivary theophylline concentration. AB - Two slow-release preparations of theophylline have been compared in an open crossover trial in the treatment of 20 asthmatic children. Theophylline concentrations were measured in both serum and saliva. Although the treatment preference of both patients and clinicians was for Somofillina Ritardo, there was no significant difference between the two treatments in respect to either serum and salivary concentrations. Nor did their mean bioavailabilities differ significantly. The results indicated that concentration in saliva was not a useful indicator of the serum concentration. PMID- 3531148 TI - Role of serum and hormones during the growth and development of rat mammary tumor epithelial cells in collagen gel culture. AB - The characteristics of hormone-dependent rat mammary tumors in response to serum and hormones were determined in collagen gel matrix culture. Epithelial cells from 7,12-dimethylbenz[a]anthracene (DMBA)-induced mammary adenocarcinomas were embedded in collagen gel and the effect of estrogen, progesterone, prolactin, insulin, and serum was tested. The total cell number and [3H]thymidine incorporation were used to determine the growth pattern of the cells in culture. It was found that in medium containing 20% porcine serum and supplemented with insulin, estrogen, progesterone and prolactin, both the cell number and [3H]thymidine labeling index increased with time, after an initial lag. Serum seemed to be essential to maintain growth of the tumor cells, because hormones alone, in the absence of serum, were unable to sustain growth of the cells. When estrogen, progesterone, prolactin, and insulin were tested individually in the presence of 20% porcine serum, only estrogen demonstrated a significant stimulatory effect. PMID- 3531150 TI - Arnold Schoenberg and Alban Berg. The serial music and serious asthma of two leading 20th-century composers. PMID- 3531151 TI - Clinical trial of ethyl acetate extract of gum gugulu (gugulipid) in primary hyperlipidemia. PMID- 3531152 TI - Febrile convulsions. PMID- 3531153 TI - Medical treatment of oesophageal varices. PMID- 3531154 TI - Doppler echocardiography. PMID- 3531155 TI - Cerebral malaria--a clinicopathological study. PMID- 3531156 TI - Mild hypertension--an enigma. PMID- 3531157 TI - Computer-assisted instruction in medicine. PMID- 3531158 TI - [Echographic appearance of thrombosis of the portal vein]. PMID- 3531159 TI - Recanalized umbilical vein in portal hypertension. PMID- 3531160 TI - Antenatal diagnosis of fetal digestive (sub)obstruction. Ultrasonic semeiology and follow-up. PMID- 3531161 TI - [Experiences with echographic diagnosis in congenital hip dysplasia using Graf's method]. PMID- 3531162 TI - Export of glutathione by some widely used Salmonella typhimurium and Escherichia coli strains. AB - Significant levels of extracellular glutathione (GSH) were detected in aerobically grown cultures of some strains of Salmonella typhimurium LT-2 and in Escherichia coli K-12, B, and B/r but not in cultures of nine freshly isolated clinical isolates of E. coli. Cultures of S. typhimurium generally contained less total GSH (intracellular plus external) than did E. coli cultures. S. typhimurium TA1534 contained about 2 mM intracellular GSH and exported about 30% of its total GSH. The external GSH concentration increased logarithmically during exponential growth and peaked at about 24 microM in early-stationary-phase cultures. External accumulation of GSH was inhibited by 30 mM NaN3. GSH was predominantly exported in the reduced form. Two-dimensional paper chromatography of supernatants from cultures labeled with Na2(35)SO4 confirmed the presence of GSH and revealed five other sulfur-containing compounds in the media of S. typhimurium and E. coli cultures. The five unidentified compounds were not derivatives of GSH. PMID- 3531163 TI - Origin of transfer of IncF plasmids and nucleotide sequences of the type II oriT, traM, and traY alleles from ColB4-K98 and the type IV traY allele from R100-1. AB - The complete nucleotide sequences of the ColB4-K98 (ColB4) plasmid transfer genes oriT, traM, and traY as well as the traY gene of R100-1 are presented and compared with the corresponding regions from the conjugative plasmids F, R1, and R100. The sequence encoding the oriT nick sites and surrounding inverted repeats identified in F was conserved in ColB4. The adenine-thymine-rich sequence following these nick sites was conserved in R1 and ColB4 but differed in F and R100, indicating that this region may serve as the recognition site for the traY protein. A series of direct repeats unique to the ColB4 plasmid was found in the region of dyad symmetry following this AT-rich region. This area also encodes 21 base-pair direct repeats which are homologous to those in F and R100. The traM gene product may bind in this region. Overlapping and following these repeats is the promoter(s) for the traM protein. The traM protein from ColB4 is similar to the equivalent products from F, R1, and R100. The traY protein from ColB4 is highly homologous to the R1 traY gene product, while the predicted R100-1 traY product differs at several positions. These differences presumably define the different alleles of traM and traY previously identified for IncF plasmids by genetic criteria. The translational start codons of the ColB4 and R100-1 traY genes are GUG and UUG, respectively, two examples of rare initiator codon usage. PMID- 3531164 TI - Induction kinetics and cell surface distribution of Escherichia coli lipoprotein under lac promoter control. AB - The induction kinetics and surface accessibility of the outer membrane lipoprotein were studied in an Escherichia coli strain with the lpp gene under control of the lac promoter. Free lipoprotein appeared rapidly after induction with isopropyl-beta-D-thiogalactopyranoside and reached a steady-state level after 30 min. The newly induced lipoprotein was slowly bound to the peptidoglycan layer. Immunological methods were developed to detect lipoprotein accessible at the cell surface after various pretreatments as well as peptidoglycan-bound lipoprotein at the surface of isolated peptidoglycan sacculi with specific antibodies in combination with 125I-protein A. With these methods an increase in lipoprotein molecules at the cell surface and bound to the peptidoglycan sacculus could be detected following induction. The topology of newly synthesized lipoprotein was examined in thin sections as well as at the cell surface and the surface of the peptidoglycan sacculus with immunoelectron microscopy. Ultrathin cell sections, whole cells, and isolated peptidoglycan sacculi showed lipoprotein distributed homogeneously over the entire surface. PMID- 3531165 TI - Molecular cloning of the genes for lipid A disaccharide synthase and UDP-N acetylglucosamine acyltransferase in Escherichia coli. AB - Several enzymes have been discovered recently in crude extracts of Escherichia coli that appear to be involved in the biosynthesis of the lipid A component of lipopolysaccharide. Two of these are lipid A disaccharide synthase and UDP-N acetylglucosamine acyltransferase. Lipid A disaccharide synthase activity is barely detectable in cells harboring a lesion in the lpxB (pgsB) gene. We subcloned the lpxB gene from plasmid pLC26-43 of the Clarke and Carbon collection (L. Clarke and J. Carbon, Cell 9:91-99, 1976) and localized it to a 1.7-kilobase pair fragment of DNA counterclockwise of dnaE on the E. coli chromosome. Furthermore, we discovered a new gene (lpxA) located adjacent to and counterclockwise of lpxB that encodes or controls UDP-N-acetylglucosamine acyltransferase. Our data prove that lpxB and lpxA are transcribed in the clockwise direction and suggest that they may be cotranscribed. PMID- 3531166 TI - Effect of uncoupler on assembly pathway for pigment-binding protein of bacterial photosynthetic membranes. AB - The uncoupler carbonylcyanide m-chlorophenylhydrazone (CCCP) was used to investigate membrane protein assembly in the phototrophic bacterium Rhodobacter capsulatus. As found for Escherichia coli (T. Date, G. Zwizinsky, S. Ludmerer, and W. Wickner, Proc. Natl. Acad. Sci. 77:827-831, 1980) and mitochondrial proteins (N. Nelson and G. Schatz, Proc. Natl. Acad. Sci. USA 76:4365-4369, 1979), assembly across the bacterial photosynthetic membranes was sensitive to CCCP. At uncoupler concentrations which were sufficient to block the export of the periplasmic cytochrome c2 and an outer membrane protein, the integration of pigment-binding protein into the photosynthetic apparatus was abolished. The unassembled protein was detected on the inner surface of the intracytoplasmic membrane. After inactivation of CCCP, accumulated protein continued insertion into the membrane. The data suggest that after binding to the cytoplasmic face of the membrane, translocation of protein into a transmembrane orientation takes place, which is a prerequisite for the formation of a functional pigment-protein complex. PMID- 3531167 TI - Activity of penicillin-binding protein 3 from Escherichia coli. AB - The activity of penicillin-binding protein 3 of Escherichia coli has been studied both in vivo and in ether-permeabilized cells. The peptidoglycan transpeptidase activity of penicillin-binding protein 3 appears to use either nascent or exogenously added UDP-N-acetylmuramyl tripeptide-derived substrates as acceptors. By means of a defilamentation system which elicited the activity of penicillin binding protein 3 in vivo, the structure of peptidoglycan made by this enzyme has been elucidated. This peptidoglycan, very probably of septal location, contained increased amounts of cross-linked peptidoglycan as well as a higher ratio of tripeptide-containing cross-linked subunits. PMID- 3531168 TI - Participation of the dnaK and dnaJ gene products in phosphorylation of glutaminyl tRNA synthetase and threonyl-tRNA synthetase of Escherichia coli K-12. AB - The heat shock proteins DnaK and DnaJ of Escherichia coli participate in phosphorylation of both glutaminyl-tRNA synthetase and threonyl-tRNA synthetase. When cellular proteins extracted from the dnaK7(Ts) and dnaJ259(Ts) mutant cells labeled with 32Pi at 42 degrees C were analyzed by two-dimensional gel electrophoresis, no phosphorylation of these proteins was observed when they were compared with those from wild-type cells. PMID- 3531169 TI - DNA and amino acid sequence analysis of structural and immunity genes of colicins Ia and Ib. AB - The nucleotide sequences for colicin Ia and colicin Ib structural and immunity genes were determined. The two colicins each consist of 626 amino acid residues. Comparison of the two sequences along their lengths revealed that the two colicins are nearly identical in the N-terminal 426 amino acid residues. The C terminal 220 amino acid residues of the colicins are only 60% identical, suggesting that this is the region most likely recognized by their cognate immunity proteins. The predicted proteins for the colicin immunity proteins would contain 111 amino acids for the colicin Ia immunity protein and 115 amino acids for the colicin Ib immunity protein. The colicin immunity proteins have no detectable DNA or amino acid homology but do exhibit a conservation of overall hydrophobicity. The colicin immunity genes lie distal to and in opposite orientation to the colicin structural genes. The colicin Ia immunity protein was purified to apparent homogeneity by a combination of isoelectric focusing and preparative sodium dodecyl sulfate-polyacrylamide gel electrophoresis. The N terminal amino acid sequence of the purified Ia immunity protein was determined and was found to be in perfect agreement with that predicted from the DNA sequence of its structural gene. The Ia immunity protein is not a processed membrane protein. PMID- 3531170 TI - Molecular analysis of the UV protection and mutation genes carried by the I incompatibility group plasmid TP110. AB - The imp genes, responsible for the UV protection and mutation effects of the I incompatibility group plasmid TP110, have been cloned into vector plasmids, and their products have been analyzed. The genetic information required for expression of these properties was carried in a continuous DNA sequence of approximately 1.7 kilobases, encoding the production of two proteins with molecular weights of 11,000 and 51,000. The genetic arrangement of this system therefore appears similar but not identical to the functionally related umuDC and mucAB operons. A third protein with a molecular weight of 40,000 was produced from sequences downstream from imp and could be overproduced by high-level transcription through the imp genes. This protein was not required for the protection and mutation properties. PMID- 3531172 TI - Cloning and expression of the Acinetobacter calcoaceticus mutarotase gene in Escherichia coli. AB - This article describes the cloning of the mutarotase gene from Acinetobacter calcoaceticus and its expression in Escherichia coli. Purification of mutarotase (EC 5.1.3.3) led to a single polypeptide of 40 kilodaltons. The sequences of 27 N terminal and 76 C-terminal amino acids were determined. From six amino acids of the N-terminal and seven amino acids of the C-terminal portion of the protein, the sequences of two oligonucleotides were deduced. These were synthesized and used as gene probes. Completely restricted chromosomal DNA from A. calcoaceticus was size fractioned, and only fractions hybridizing with the gene probes were used to construct gene banks enriched for the mutarotase determinant. With the N terminal gene probe, a bank of 6- to 7-kilobase-pair BclI fragments in pBR327 was obtained. A total of 1,200 candidates were screened by colony hybridization followed by dot-blot analysis of purified plasmids from positive candidates and subsequent Southern blot analysis of the respective restricted plasmids, and 500 base pairs (bp) from the 5' end of the mutarotase gene were isolated by this procedure. The 3' portion of the gene was isolated from a gene bank containing 1,500-bp-long HindIII fragments inserted in M13mp11. This bank was screened by dot-blot analysis of single-stranded phage DNA with the C-terminal gene probe. The isolated gene fragments were fused at a common restriction site in their overlapping region to yield the complete mutarotase gene. High-level expression of mutarotase in E. coli was achieved when the gene was placed under transcriptional control of the phage lambda promoter pL. More than 90% of mutarotase activity was found in the culture medium. The E. coli-derived mutarotase was purified and shown to be identical to the A. calcoaceticus-derived product with respect to the molecular weight and N-terminal amino acid sequence. The expression of mutarotase in E. coli was increased 200-fold in comparison to that the wild-type A. calcoaceticus. PMID- 3531171 TI - Nucleotide sequence of the phoM region of Escherichia coli: four open reading frames may constitute an operon. AB - The phoM gene is one of the positive regulatory genes for the phosphate regulon of Escherichia coli. We analyzed the nucleotide sequence of a 4.7-kilobase chromosomal DNA segment that encompasses the phoM gene and its flanking regions. Four open reading frames (ORFs) were identified in the order ORF1-ORF2-ORF3 (phoM)-ORF4-dye clockwise on the standard E. coli genetic map. Since these ORFs are preceded by a putative promotor sequence upstream of ORF1 and followed by a putative terminator distal to ORF4, they seem to constitute an operon. The 157 amino-acid ORF1 protein contains highly hydrophobic amino acids in the amino terminal portion, which is a characteristic of a signal peptide. The 229-amino acid ORF2 protein is highly homologous to the PhoB protein, a positive regulatory protein for the phosphate regulon. The ORF3 (phoM gene) protein contains two stretches of highly hydrophobic residues in the amino-terminal and central regions and, therefore, may be a membrane protein. The 450-amino-acid ORF4 protein contains long hydrophobic regions and is likely to be a membrane protein. PMID- 3531173 TI - Cloning and characterization of the cysAMK region of Salmonella typhimurium. AB - A total of 30 kilobases of DNA comprising the cysAMK region of S. typhimurium was cloned as a series of fragments in phage lambda 1059. The genetic organization of this region was established through studies of gene expression from fragments subcloned in pBR322 and from blot hydridization analyses of restriction sites in chromosomal DNA from multisite deletion strains. The results give a gene order of cysA-cysM-crr-ptsl-ptsH-cysK over a distance of approximately 12 kilobases. cysM and cysA have been cloned and expressed in pBR322; attempts to obtain stable pBR322 derivatives carrying cysK were unsuccessful. PMID- 3531174 TI - Control of lipopolysaccharide biosynthesis and release by Escherichia coli and Salmonella typhimurium. AB - The influence of the relA gene on lipopolysaccharide (LPS) biosynthesis and release by Escherichia coli and Salmonella typhimurium was investigated. Similar results were obtained with both species. The incorporation of [3H]galactose into LPS by galE mutants was inhibited by at least 50% (as compared with normal growing controls) during amino acid deprivation of relA+ strains. This inhibition could be prevented by the treatment of the amino acid-deprived relA+ bacteria with chloramphenicol, a known antagonist of the stringent control mechanism. Furthermore, LPS biosynthesis was not inhibited during amino acid deprivation of isogenic relA mutant strains. These results indicate that LPS synthesis is regulated by the stringent control mechanism. Normal growing cells of both relA+ and relA strains released LPS into the culture fluid at low rates. Amino acid deprivation stimulated the rate of LPS release by relA mutants but not by relA+ bacteria. Chloramphenicol treatment markedly stimulated the release of cell-bound LPS by amino acid-deprived relA+ cells. Thus, a low rate of LPS release was characteristic of normal growth and could be increased in nongrowing cells by relaxing the control of LPS synthesis. PMID- 3531175 TI - Immunocytochemical localization of enterobacterial common antigen in Escherichia coli and Yersinia enterocolitica cells. AB - Enterobacterial common antigen (ECA) was localized on Lowicryl K4M sections and on ultrathin cryosections by using either a mouse monoclonal antibody or an absorbed rabbit polyclonal immune serum with the corresponding gold-labeled secondary antibodies. Comparable results were obtained with both monoclonal antibody and polyclonal immune serum. Controls with two ECA-negative mutants revealed the ECA specificity of both labeling systems. On Lowicryl K4M sections, good labeling of the outer membrane and of membrane-associated areas in the cytoplasm was obtained. Unexpectedly, however, the ribosome-containing areas of the cytoplasm also showed significant labeling. On ultrathin cryosections, labeling of the cytoplasmic areas was much weaker, although the density of label in the outer membrane was comparable to that obtained with the Lowicryl K4M sections. With the techniques used, it cannot be completely excluded that the appearance of ECA in the cytoplasm is due to displacement of ECA-reactive sites during the preparation procedure. PMID- 3531176 TI - Two genetically distinct pathways for transcriptional regulation of anaerobic gene expression in Salmonella typhimurium. AB - Expression of the tripeptide permease gene tppB is anaerobically induced. This induction is independent of the fnr (oxrA) gene product, which is known to be required for the anaerobic induction of several respiratory enzymes. We isolated, characterized, and mapped mutations in two genes, oxrC and tppR, which prevent the anaerobic induction of tppB expression. Mutations in oxrC were highly pleiotropic, preventing the anaerobic expression of the formate dehydrogenase component of formate hydrogen lyase (fhl), a tripeptidase (pepT), and two of the three known hydrogenase isoenzymes (hydrogenases 1 and 3). On the other hand, expression of nitrate reductase, fumarate reductase, and a number of other fnr (oxrA)-dependent enzymes was not affected by mutations in oxrC. Thus, there appeared to be at least two distinct classes of anaerobically induced genes, those which required fnr for their expression and those which required oxrC. It seems that fnr-dependent enzymes perform primarily respiratory functions, whereas oxrC-dependent enzymes served fermentative or biosynthetic roles. We found the primary defect of oxrC mutants to be a deficiency in phosphoglucose isomerase activity, implying that a product of glycolysis functions as an anaerobic regulatory signal. Mutations in tppR were specific for tppB and did not affect expression of other oxrC-dependent genes. However, tppR did exhibit phenotypes other than the regulation of tppB. Both oxrC and tppR mutants were hypersensitive to the toxic NAD analog 6-aminonicotinic acid. This suggests that oxrC and tppR may play a role in the regulation of NAD biosynthesis or, alternatively, that NAD or a related nucleotide serves as the anaerobic signal for oxrC-dependent enzymes. PMID- 3531177 TI - Characterization and physiological roles of membrane-bound hydrogenase isoenzymes from Salmonella typhimurium. AB - We found that Salmonella typhimurium strain LT2 (Z) possessed two immunologically distinct, membrane-bound hydrogenase isoenzymes, which were similar in electrophoretic mobilities and apoprotein contents to hydrogenase isoenzymes 1 and 2 of Escherichia coli. The S. typhimurium enzymes cross-reacted with antibodies raised to the respective hydrogenase isoenzymes of E. coli. As for E. coli, an additional membrane-bound hydrogenase activity (termed hydrogenase 3), which did not cross-react with antibodies raised against either hydrogenase 1 or 2, was also present in detergent-dispersed membrane preparations. The physiological role of each of the three isoenzymes in E. coli has remained unclear owing to the lack of mutants specifically defective for individual isoenzymes. However, analysis of two additional wild-type isolates of S. typhimurium revealed specific defects in their hydrogenase isoenzyme contents. S. typhimurium LT2 (A) lacked isoenzyme 2 but possessed normal levels of hydrogenases 1 and 3. S. typhimurium LT7 lacked both isoenzymes 1 and 2 but retained normal hydrogenase 3 activity. Characterization of hydrogen metabolism by these hydrogenase-defective isolates allowed us to identify the physiological role of each of the three isoenzymes. Hydrogenase 3 activity correlated closely with formate hydrogenlyase-dependent hydrogen evolution, whereas isoenzyme 2 catalyzed hydrogen uptake (oxidation) during anaerobic, respiration-dependent growth. Isoenzyme 1 also functioned as an uptake hydrogenase but only during fermentative growth. We postulate that this enzyme functions in a hydrogen recycling reaction which operates during fermentative growth. PMID- 3531178 TI - Analysis of spontaneous base substitutions generated in mismatch-repair-deficient strains of Escherichia coli. AB - We used the lacI system of Escherichia coli to examine the distribution of base substitution mutations occurring spontaneously in different mismatch-repair deficient strains. The examination of almost 1,200 nonsense mutations generated in strains carrying the mutS, mutH, and mutU alleles confirmed that transitions are highly favored over transversions. The detailed analysis of relative mutation rates at different sites revealed that the pattern of hot spots and cold spots is strikingly similar in each of the three strain backgrounds, strongly supporting the notions that the products of the three genes are part of the same system and that in the absence of any of the components the entire system fails to function. The distribution of mutations occurring in the absence of mismatch repair defined a pronounced topography of the lacI gene. There was no obvious correlation of the hot spots or cold spots with either nearest-neighbor sequences or A X T richness of the immediate surrounding sequence. PMID- 3531179 TI - Cloning in Saccharomyces cerevisiae of a cycloheximide resistance gene from the Candida maltosa genome which modifies ribosomes. AB - We have previously shown that cycloheximide resistance can be induced in a strain of Candida maltosa by modifying ribosomes (M. Takagi, S. Kawai, Y. Takata, N. Tanaka, M. Sunairi, M. Miyazaki, and K. Yano, J. Gen. Appl. Microbiol. 31:267 275, 1985). The present paper describes the cloning of the gene involved in this resistance (designated RIM-C for ribosome modification by cycloheximide) by using a host-vector system of Saccharomyces cerevisiae. PMID- 3531180 TI - Global control in Salmonella typhimurium: two-dimensional electrophoretic analysis of starvation-, anaerobiosis-, and heat shock-inducible proteins. AB - The response of Salmonella typhimurium to various forms of environmental stress was examined by using O'Farrell two-dimensional gel electrophoresis. Polypeptides (a total of 110) which quantitatively increased during various starvations, anaerobiosis, or heat shock were identified and cataloged in reference to a standard polypeptide map. Although significant overlap was noted during comparison of proteins induced by different starvations, only a few proteins produced during heat shock or anaerobiosis were also identified as starvation inducible. PMID- 3531181 TI - Expression and regulation of the penicillin G acylase gene from Proteus rettgeri cloned in Escherichia coli. AB - The penicillin G acylase genes from the Proteus rettgeri wild type and from a hyperproducing mutant which is resistant to succinate repression were cloned in Escherichia coli K-12. Expression of both wild-type and mutant P. rettgeri acylase genes in E. coli K-12 was independent of orientation in the cloning vehicle and apparently resulted from recognition in E. coli of the P. rettgeri promoter sequences. The P. rettgeri acylase was secreted into the E. coli periplasmic space and was composed of subunits electrophoretically identical to those made in P. rettgeri. Expression of these genes in E. coli K-12 was not repressed by succinate as it is in P. rettgeri. Instead, expression of the enzymes was regulated by glucose catabolite repression. PMID- 3531182 TI - Localization of the structural gene for threonine dehydrogenase in Escherichia coli. AB - The threonine dehydrogenase (tdh) gene of Escherichia coli, cloned within the plasmid pDR121, was inactivated in vitro by inserting a segment of DNA carrying the chloramphenicol acetyltransferase (cat) gene. The insertionally inactivated tdh gene was then transferred by homologous recombination into the E. coli chromosome by the procedure of Winans et al. (J. Bacteriol. 161:1219-1221, 1985). Mating experiments, followed by P1-mediated two- and three-point crosses, enabled us to localize tdh near min 81.2. The order with respect to known markers is mtl cysE-tdh-pyrE. PMID- 3531183 TI - Cloning and characterization of the gene encoding 3-deoxy-D-manno-octulosonate 8 phosphate synthetase from Escherichia coli. AB - The cloning of the gene for Escherichia coli PL-2 2-keto-3-deoxy-D-manno-octonate 8-phosphate synthetase is reported. Positive transformants showed an increase of approximately three-fold in specific activity of the enzyme both in E. coli and in Salmonella typhimurium as host cells. A subclone containing a 1.5-kilobase PvuII fragment overproduced active enzyme. Minicell experiments that allow the detection of plasmid encoded proteins revealed an insert-coded single protein band of 34 kilodaltons. PMID- 3531184 TI - SOS-associated division inhibition gene sfiC is part of excisable element e14 in Escherichia coli. AB - The cell division inhibition gene sfiC and the excisable element e14, both associated with the SOS response in Escherichia coli, are located at 25 min on the E. coli map. Blotting with a fragment of e14 DNA showed a strict correlation between the presence of e14 and the sfiC+ genotype. Introduction of only e14 into a recA- sfiC- strain made the strain sfiC+. These results show that the sfiC gene is part of e14. PMID- 3531185 TI - Mediation, by Saccharomyces cerevisiae translocation signals, of beta-lactamase transport through the Escherichia coli inner membrane and sensitive method for detection of signal sequences. AB - Signal sequences of Saccharomyces cerevisiae invertase and alpha-factor pheromone were tested for the ability to mediate protein transport through the inner membrane of Escherichia coli by fusion to bacterial beta-lactamase lacking the signal sequence (blaS0). Both types of transformants exhibited ampicillin resistance in accordance with the transport of the fused protein to the periplasmic compartment. This compartment contained most of the beta-lactamase activity present in the cell. Therefore, the tested yeast signal sequences, which conferred translocation of their proteins across the membrane of the endoplasmic reticulum in S. cerevisiae, can provide the same function in E. coli. The screening for ampicillin resistance among blaS0 fusions provides a convenient method for the isolation of functional yeast and possibly higher eucaryotic signal sequences. PMID- 3531186 TI - Isolation and characterization of Escherichia coli mutants defective for phenylpropionate degradation. AB - Mutants of Escherichia coli defective in catabolism of 3-phenylpropionate, 3-(3 hydroxyphenyl)propionate, or both were isolated after mutagenesis with ethylmethane sulfonate. Nine phenotypically distinct classes of mutants were identified, including strains lacking each of the first five enzyme activities for the degradation of these compounds and mutants pleiotropically negative for some of these activities. Characterization of these mutants was greatly facilitated by the use of indicator media in which accumulation of 3-(2,3 dihydroxyphenyl)propionate or 2-hydroxy-6-ketononadienedioic acid led to the formation of dark red or bright yellow colors, respectively, in the medium. Assays with wild-type and mutant strains indicated that 3-phenylpropionate (or its dihydrodiol), but none of the hydroxylated derivatives tested, induced the synthesis of enzymes for its conversion to 3-(2,3-dihydroxyphenyl)propionate. The remaining enzymes were induced by the 2- or 3-hydroxy or 2,3-dihydroxy derivatives of 3-phenylpropionate, with the 2-hydroxy compound acting as an apparent gratuitous inducer. Metabolism to nonaromatic intermediates appeared to be unnecessary for full induction of any pathway enzyme. One unusual class of mutants, in which 2-keto-4-pentenoate hydratase appeared to be uninducible, indicated a level of control not previously shown in meta-fission catabolic pathways. PMID- 3531187 TI - Characterization by deletion and localized mutagenesis in vitro of the promoter region of the Escherichia coli ompC gene and importance of the upstream DNA domain in positive regulation by the OmpR protein. AB - The ompC gene codes for a major outer membrane protein whose expression is regulated by the ompR and envZ genes. Two sets of promoter deletion mutants, with upstream and downstream deletions, were constructed on a plasmid in vitro, and their promoter activity was studied by connecting them with the lacZ gene. The DNA sequence for the ompC promoter, including the -35 and -10 regions and the mRNA start site, was defined at the region about 100 base pairs upstream from the ATG initiation codon for the pro-OmpC protein. An additional 61-base-pair sequence extending upstream from the -35 region was required for the ompC promoter to function fully. After targeting the upstream region of the ompC promoter fused to the lacZ gene on a plasmid, in vitro-localized mutagenesis was performed to isolate cis-dominant mutations that affect ompC transcription. Four mutant groups, each of which had common phenotypes for expression and regulation of the gene, were identified. The individual groups also had common base substitutions. In two of the groups, the common base substitutions were localized in the upstream region of the ompC promoter, whereas in the other two they were localized in the -35 region. From these results, the upstream region of the ompC promoter was considered to be the domain responsible for activation by the ompR gene product. PMID- 3531188 TI - Dothiepin hydrochloride: treatment efficacy and safety. AB - Dothiepin, a thio analogue of amitriptyline, has been used extensively in Europe during the past 15 years. It is a safe and effective agent for the treatment of major depressive disorder. Although the onset of action is comparable to that of other tricyclic antidepressants, dothiepin may cause fewer intolerable side effects and have less cardiotoxicity than these other compounds. In addition, dothiepin reduces the anxiety associated with some major depressive episodes. These features suggest that dothiepin may be particularly helpful for treating anxious depressed patients and patients who have underlying cardiac disease or who are elderly. PMID- 3531189 TI - Panic disorder: epidemiology, diagnosis, and treatment in primary care. AB - Anxiety is the fifth most common clinical diagnosis in the primary care setting. Panic disorder, a severe episodic form of anxiety, has been found to occur in approximately 6% of primary care patients. These patients often selectively focus on one of the frightening autonomic symptoms and are frequently misdiagnosed. The three most common presentations of panic disorder in the medical setting are cardiac symptoms (chest pain, tachycardia), neurologic symptoms (headache, dizziness/vertigo, syncope), and gastrointestinal symptoms, especially epigastric distress. The presentation of cardiac symptoms by patients with panic disorder is especially likely to lead to expensive and potentially iatrogenic medical testing. Hypertension and peptic ulcer are the most commonly associated medical diagnoses in patients with panic disorder. Major depression, alcohol abuse, simple phobias, and posttraumatic stress disorder are the most frequently associated psychiatric diagnoses. Psychopharmacologic treatment of panic disorder has been demonstrated to be highly effective in double-blind, placebo-controlled studies. Effective psychopharmacologic agents include the tricyclic antidepressants (notably imipramine and desipramine), the monoamine oxidase inhibitors (phenelzine), and the high-potency benzodiazepines (alprazolam). PMID- 3531190 TI - Depression: medical interface with psychiatry and treatment advances. AB - A number of advances, primarily pharmacologic, have occurred in recent years in the treatment of depression. Some of the recent advances relating to neurotransmitters and other neuropsychiatric factors believed to be related to depression are discussed, including how antidepressants may affect these systems. Some more recently recognized or often overlooked side effects of antidepressants are also discussed, as well as differential side effect profiles. The second generation antidepressants are critiqued and are generally believed to be no better than many of the first generation antidepressants. The usefulness of and indications for tricyclic serum levels and standard neuroendocrine tests for depression are summarized. Recent findings regarding lithium, including augmentation, and monoamine oxidase inhibitors, especially for atypical depressions with panic symptoms, are included, as is the use of psychostimulants, especially for medically ill patients who cannot take other antidepressants. PMID- 3531191 TI - Therapeutic monitoring of antidepressant drugs: current methodology and applications. AB - In the two decades since initial studies demonstrated an association between clinical response and blood levels of tricyclic antidepressants (TCAs), measurement of serum levels of TCAs has become routine in many laboratories and the use of these measurements is rapidly becoming a routine part of psychiatric practice. However, practical therapeutic monitoring of TCAs is complicated by a lack of suitable reference methodology, a diversity of analytic methods, and factors that contribute to difficulties in obtaining useful clinical data. Therapeutic ranges for many antidepressants have still not been firmly established and clinical guidelines for monitoring patients and using therapeutic drug monitoring data for psychoactive drugs are not well understood. Nonetheless, monitoring of antidepressant serum levels has prompted technical advances in methodology. This paper presents an overview of the clinical and pharmacologic issues surrounding the utility of serum level measurements. Technical issues that concern investigators and clinicians in the field are discussed and recent developments and applications in high performance liquid chromatography and immunoassays for the TCAs are reviewed. PMID- 3531192 TI - Characterization of a mitochondrial matrix protease catalyzing the processing of adrenodoxin precursor. AB - Adrenodoxin (Ad) is synthesized as a larger precursor (preAd) by cytoplasmic polysomes and then transported into mitochondria concomitant with its proteolytic processing to the mature form. The protease in bovine adrenal cortex mitochondria, which converts preAd to the mature form, is a metalloprotease in the matrix (Sagara, Y., Ito, A. & Omura, T. (1984) J. Biochem. 96, 1743-1752). In this study, the protease was purified about 100-fold from the matrix fraction of bovine adrenal cortex mitochondria. The partially purified protease converted not only preAd, but also the precursors of malate dehydrogenase (MDH) and 27 kDa protein (P-27) to the corresponding mature forms. However, it was inactive toward the precursors of P-450(SCC) and of P-450(11 beta). Since isolated rat liver mitochondria can import and process preAd as efficiently as bovine adrenal cortex mitochondria, we partially purified a preAd-processing protease from rat liver mitochondria and compared its properties with those of the bovine adrenal cortex enzyme. The properties of the rat liver protease were indistinguishable from those of the bovine adrenal cortex enzyme in molecular weight determined from Sephadex G-150 gel filtration, metal requirement and ability to process preMDH and preP-27. The rat liver enzyme was also inactive toward the precursors of P 450(SCC) and P-450(11 beta). These results indicate the presence in both adrenal cortex and liver mitochondria of the same type of processing protease, which processes preAd and also the precursors of some other mitochondrial proteins. PMID- 3531193 TI - Stimulation of growth hormone synthesis by glucose in islets of Langerhans isolated from transgenic mice. AB - To examine further the mechanism by which the synthesis of proteins translated on the rough endoplasmic reticulum is regulated in pancreatic beta-cells, the synthesis of growth hormone in islets from transgenic mice carrying the metallothionein-rat growth hormone gene fusion was studied. High glucose (17 mM) stimulated the synthesis and secretion of an apparently normally processed growth hormone. The stimulation of synthesis of growth hormone was less efficient than the stimulation of insulin synthesis in these islets, whereas the stimulation of release of labeled growth hormone paralleled that of insulin. These results are consistent with the hypothesis that signal recognition particle-mediated mechanism(s) may be involved in regulating the translational efficiency of secreted proteins in isolated islets (Welsh, M., Scherberg, N., Gilmore, R., and Steiner, D. F. (1986) Biochem. J. 235, 459-467). Furthermore, in the beta-cells, growth hormone follows the normal regulated pathway of secretory granule transport and exocytosis. PMID- 3531194 TI - Cloning, expression, and nucleotide sequence of the formate dehydrogenase genes from Methanobacterium formicicum. AB - The genes for the two subunits of the formate dehydrogenase from Methanobacterium formicicum were cloned and their sequences determined. When expressed in Escherichia coli, two proteins were produced which had the appropriate mobility on an SDS gel for the two subunits of formate dehydrogenase and cross-reacted with antibodies raised to purified formate dehydrogenase. The genes for the two formate dehydrogenase subunits overlap by 1 base pair and are preceded by DNA sequences similar to both eubacterial and archaebacterial promoters and ribosome binding sites. The amino acid sequences deduced from the DNA sequence were analyzed, and the arrangement of putative iron-sulfur centers is discussed. PMID- 3531195 TI - ATP-independent renaturation of complementary DNA strands by the mutant recA1 protein from Escherichia coli. AB - In an effort to clarify the requirement for ATP in the recA protein-promoted renaturation of complementary DNA strands, we have analyzed the mutant recA1 protein which lacks single-stranded DNA-dependent ATPase activity at pH 7.5. Like the wild type, the recA1 protein binds to single-stranded DNA with a stoichiometry of one monomer per approximately four nucleotides. However, unlike the wild type, the mutant protein is dissociated from single-stranded DNA in the presence of ATP or ADP. The ATP analogue adenosine 5'-O-3' (thiotriphosphate) appears to stabilize the binding of recA1 protein to single-stranded DNA but does not elicit the stoichiometry of 1 monomer/8 nucleotides or the formation of highly condensed protein-DNA networks that are characteristic of the wild type recA protein in the presence of this analogue. The recA1 protein does not catalyze DNA renaturation in the presence of ATP, consistent with the dissociation of recA1 protein from single-stranded DNA under these conditions. However, it does promote a pattern of Mg2+-dependent renaturation identical to that found for wild type recA protein. PMID- 3531196 TI - An insulin-stimulated ribosomal protein S6 kinase in 3T3-L1 cells. AB - A protein kinase that is stimulated from 2-10-fold by insulin and that phosphorylates ribosomal protein S6 has been characterized in 3T3-L1 cells. The detection of this activity in the 100,000 X g supernatant is facilitated by the presence of beta-glycerol phosphate or vanadate in the homogenization buffer. The activity has been purified 55-fold by chromatography on DEAE-cellulose and phosphocellulose. The resulting specific activity is 584 pmol/min/mg of protein. DEAE-cellulose chromatography followed by gel filtration on Ultrogel AcA54 or by glycerol gradient centrifugation suggests that the protein has a molecular mass of 60,000-70,000 daltons. Mg2+, and to a lesser extent Mn2+, will support phosphorylation of S6 by the activity. No proteins tested other than ribosomal protein S6 are phosphorylated. Based on its chromatographic properties and substrate specificity, the enzyme appears to be distinct from several other protein kinases that are known to phosphorylate ribosomal protein S6 in vitro. The complete characterization and purification of this enzyme may be essential to the elucidation of the mechanism of regulation of S6 phosphorylation by insulin. PMID- 3531197 TI - Influence of quaternary structure on glycosylation. Differential subunit association affects the site-specific glycosylation of the common beta-chain from Mac-1 and LFA-1. AB - The influence of quaternary structure on glycosylation was evaluated in a macrophage-like cell line, P388D1. This cell line simultaneously synthesizes two structurally related glycoproteins, Mac-1 and LFA-1. Mac-1 and LFA-1 each contain two subunits in noncovalent association in an alpha 1 beta 1 structure. The beta chain polypeptides of these two glycoproteins have identical primary structures while their alpha-chain polypeptides are distinct. For both Mac-1 and LFA-1, the association of the alpha- and beta-chains occurs prior to any Golgi-mediated processing of the oligosaccharide moieties on either one of the subunits. To evaluate the effects of differential subunit association on the site-specific glycosylation of the beta-chain, [3H]glucosamine-labeled oligosaccharides were isolated from the beta-chain of Mac-1 and LFA-1 and were compared by a variety of enzymatic and chromatographic techniques. Reverse-phase high performance liquid chromatography analyses of tryptic-chymotryptic glycopeptides suggest that each beta-chain has at least five glycosylation sites. Structural analysis of oligosaccharides from each corresponding glycopeptide fraction of the beta-chains of Mac-1 or LFA-1 (comparing their glycosidase sensitivities, behavior on serial lectin affinity chromatography, size heterogeneity, extent of sialylation, and branching) indicates that the LFA-1 beta-chain is glycosylated substantially differently on at least four of its sites, compared to the corresponding sites of the Mac-1 beta-chain, even though they are simultaneously synthesized in the same cells. Thus, these data demonstrate that quaternary structure can influence the site-specific glycosylation of a protein, even when the polypeptide structure and the cellular glycosylation machinery remain constant. PMID- 3531198 TI - Prothrombin activation by an activator from the venom of Oxyuranus scutellatus (Taipan snake). AB - The prothrombin activator from the venom of Oxyuranus scutellatus (Taipan snake) was purified by gel filtration on Sephadex G-200 and ion-exchange chromatography on QAE-Sephadex. The activator is a large protein with a molecular weight of approximately 300,000, which is composed of subunits of Mr 110,000 and 80,000 and two disulfide-linked polypeptides of Mr 30,000. One or both of these Mr 30,000 subunits contain the active site. The venom activator readily converts Factor Xa specific chromogenic substrates and is also able to activate prothrombin (Km = 166 microM, Vmax = 2.5 mumol of prothrombin activated per min/mg of venom). Gel electrophoretic analysis of prothrombin activation indicates that the venom activator randomly cleaves the Arg274-Thr275 and Arg323-Ile324 bonds of prothrombin since both thrombin and meizothrombin are formed as reaction products. Venom-catalyzed prothrombin activation is not affected by bovine Factor Va but is greatly stimulated by phospholipids plus Ca2+ ions. This stimulatory effect is explained by a decrease of the Km for prothrombin. In the presence of 50 microM phospholipid vesicles (25% phosphatidylserine/75% phosphatidylcholine; mole/mole), the Km is 0.34 microM and the Vmax is 7.1 mumol of prothrombin activated per min/mg of venom. The purified venom activator contains gamma carboxyglutamic acid residues which presumably function in the interaction between the venom activator and phospholipids. Treatment of the activator with 0.8 M NaSCN strongly reduces its ability to activate prothrombin but has no effect on its amidolytic activity. The prothrombin-converting activity of the NaSCN-treated activator can be restored with bovine Factor Va. During prolonged gradient gel electrophoresis, the Mr 300,000 activator dissociates into smaller subunits. This causes a loss of the prothrombin-converting activity, while the amidolytic activity is recovered in a protein with an apparent molecular weight of 57,000. This protein can, however, rapidly activate prothrombin in the presence of Factor Va or in the presence of a protein component of Mr 220,000 that also migrates on the gel. These results suggest that the prothrombin activator from the O. scutellatus venom is a multimeric protein complex consisting of a Factor Xa-like enzyme and a Factor Va-like cofactor. PMID- 3531199 TI - The nuclear lamin protein family in higher vertebrates. Identification of quantitatively minor lamin proteins by monoclonal antibodies. AB - The nuclear lamina, a structure closely apposed to the inner nuclear membrane, is believed to provide a framework important for nuclear envelope integrity and interphase chromatin organization. So far, in mammalian and avian species three major constituents of the lamina, lamins A, B, and C, have been identified. These proteins migrate to characteristic positions on two-dimensional gels, lamin B being more acidic than lamins A and C. Here, we show that the composition of the nuclear lamina in avian and mammalian cells is more complex than previously assumed. When analyzed on two-dimensional gels, the major 66-kDa chicken "lamin B" protein can readily be identified. However, an additional 68-kDa protein migrates to a similarly acidic position. Based on the following evidence, both proteins can be considered as two distinct members of the lamin protein family. First, peptide mapping experiments and immunological criteria demonstrate that these two proteins are not related to each other or to lamin A via postsynthetic modifications or precursor-product relationships. Second, as determined by immunocytochemical techniques, both proteins are located exclusively at the nuclear periphery. Third, both proteins display the biochemical properties characteristic of lamin proteins, i.e. they are resistant to extraction of nuclei with nonionic detergents, nucleases, and high salt. Fourth, both proteins are immunologically related to previously characterized lamin proteins: the major 66 kDa chicken "lamin B" protein shares at least two epitopes with lamin A. However, contrary to what current nomenclature might suggest, this 66-kDa chicken "lamin B" protein is not related to rat liver lamin B, but to a minor component of rat liver pore-complex lamina preparations that had not previously been recognized as a lamin protein. Conversely, the minor 68-kDa component of chicken lamina preparations that had not previously been considered to be a lamin protein is immunologically related to rat liver lamin B. Thus, in addition to demonstrating the existence of quantitatively minor lamin proteins in higher vertebrates, our results caution against assigning structural homologies between lamin proteins from different species on the basis of gel electrophoresis analyses. PMID- 3531200 TI - Protein kinase C and phosphatidylserine bind to Mr 110,000/115,000 polypeptides enriched in cytoskeletal and postsynaptic density preparations. AB - The selective binding of protein kinase C to nitrocellulose-immobilized polypeptides from rat brain and human erythrocytes was investigated. Bound enzyme was detected immunochemically with a monospecific protein kinase C antibody, or by using radiolabeled enzyme. Two polypeptides from erythrocyte membranes with Mr values of 110,000 and 115,000 bound protein kinase C in the presence of phosphatidylserine (PS) and were highly enriched in the cytoskeletal fraction. A prominent protein kinase C-binding polypeptide at Mr about 115,000 was also evident in brain cytoplasm, postsynaptic densities, and nuclei. Overlays of electrophoretic blots with 14C-phospholipids revealed that the protein kinase C binding polypeptides also bound PS but not other phospholipids. The binding of both protein kinase C and PS was markedly inhibited after phosphorylation of the Mr 110,000/115,000 polypeptides with the kinase itself. The relevance of the results to the binding of protein kinase C to membranes and to phospholipid cytoskeletal interactions is discussed. PMID- 3531201 TI - Low Mr tropomyosin isoforms from chicken brain and intestinal epithelium have distinct actin-binding properties. AB - Tropomyosin isoforms of the low Mr class were isolated from chicken intestinal epithelium and brain, and their physical and functional properties were characterized. Tropomyosin from each tissue contains four distinct polypeptides, all of about 32,000 daltons. In two-dimensional gels, brain tropomyosin contains two major and two minor polypeptides; the major epithelium isoforms coelectrophorese with the two minor brain isoforms. Conversely, only small amounts of the major brain isoforms are detected in the epithelium. Actin-binding properties of brain tropomyosin isoforms are distinct from those of the intestinal epithelium. At 2.5 mM MgCl2 and physiological ionic strength, the intestinal epithelial tropomyosin binds to filamentous actin with an apparent Ka of 8 X 10(6) M-1 whereas brain tropomyosin has an apparent Ka of 8 X 10(5) M-1. Tropomyosin from either tissue binds actin cooperatively with a Hill coefficient of 2.3 for intestinal epithelial cell and 1.95 for brain tropomyosin. Isoforms from both tissues exhibit reduced head-to-tail polymerizability as compared to muscle tropomyosin. The actin-binding properties of intestinal epithelial cell tropomyosin are therefore similar to those of the muscle tropomyosins even though the isoforms have lower molecular weight, a paracrystal structure, and reduced head-to-tail polymerizability typical of the other nonmuscle tropomyosins. These results indicate that a heterogeneity of functional properties may be expressed among the low Mr tropomyosin isoforms. PMID- 3531202 TI - Structure of the spectrin-actin binding site of erythrocyte protein 4.1. AB - The complete primary structure of the functional site of erythrocyte protein 4.1 involved in spectrin-actin associations has been determined. The sequence of this domain, which contains 67 amino acids and has a molecular mass of 8045 daltons, has been obtained by NH2-terminal sequence analysis of an 8-kDa chymotryptic peptide, three endoproteinase lysine C-cleaved peptides and two peptides obtained by Staphylococcus aureus protease V8 cleavage. All peptides including the 8-kDa domain peptide were purified by reverse-phase high performance liquid chromatography. Antibodies against two different synthetic peptides of the 8-kDa domain are able to inhibit the association between protein 4.1, spectrin, and F actin, corroborating that the 8-kDa domain is responsible for the formation of a ternary complex. A computer search of the 8-kDa sequence with the National Biomedical Research Foundation database did not detect any significant homologies to known sequences. Protein 4.1 is not related to any known proteins and may represent a new protein superfamily. PMID- 3531203 TI - Secretory granules of heparin-containing rat serosal mast cells also possess highly sulfated chondroitin sulfate proteoglycans. AB - Rat serosal mast cells, which synthesize only heparin proteoglycans as detected by intrinsic labeling with [35S]sulfate, were analyzed for the presence of intracellular chondroitin sulfate proteoglycans by chemical and immunochemical means. Rat serosal mast cells of greater than 99% purity were treated with Zwittergent 3-12 and 4 M guanidine HCl, and the extracted nonradiolabeled proteoglycans were purified by density gradient centrifugation. As assessed by quantification of the unsaturated disaccharides released from the proteoglycans by chondroitinase ABC treatment, 10(6) rat serosal mast cells contained 2.4-4.5 micrograms of chondroitin sulfate proteoglycans. Analysis of the chondroitinase ABC digests by high performance liquid chromatography revealed the unsaturated disaccharides delta Di-4S, delta Di-diSB, and delta Di-diSE which were derived from GlcA----GalNAc-4-SO4, iduronic acid-2-SO4----GalNAc-4-SO4, and GlcA--- GalNAc-4,6-diSO4, respectively. The molar ratio of the monosulfated to disulfated disaccharides was approximately 2:1 with delta Di-diSE greater than delta Di diSB. When analyzed with a mouse anti-chondroitin sulfate monoclonal antibody and fluorescein-labeled F(ab')2 goat anti-mouse IgG, approximately 91% of permeabilized and chondroitinase ABC-treated cells in the mast cell preparations exhibited intracellular fluorescence, and the pattern of staining indicated that the chondroitin sulfate molecules were located in the secretory granules. The specificity of the monoclonal antibody for the unsaturated double bond created by chondroitinase ABC treatment of the proteoglycan in situ was established by the absence of fluorescence when the chondroitinase ABC step was omitted or when heparinase digestion was substituted for chondroitinase ABC. Furthermore, the ability of the anti-chondroitin sulfate monoclonal antibody to mediate fluorescence in situ was markedly reduced by absorption with solid-phase chondroitin sulfate proteoglycan that had been chondroitinase ABC-treated, but not by absorption with undigested proteoglycan or with solid-phase heparin. The highly sulfated chondroitin sulfate proteoglycans of rat serosal mast cells are the same type synthesized by the rat mucosal mast cell subclass.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3531204 TI - A "CAT" family of repetitive DNA sequences in Saccharomyces cerevisiae. AB - An oligonucleotide probe was used to isolate yeast genomic clones containing DNA sequences with repetitive elements consisting primarily of a tandemly arranged trinucleotide, CAT. Hybridization analyses estimate that the yeast genome contains 40-50 CAT clusters, representing the first repetitive DNA sequence family found in yeast. Sequence analyses show short spacers between the CAT repeats consisting of closely related trinucleotides, primarily CGT. Some of the CAT clusters are located in longer repeating elements with lengths of 7 nucleotides or more. In one case a three-times-repeated 27-nucleotide sequence bears striking homology to the 21-base pair repeat region of the mammalian simian virus 40 promoter element. Hybridization studies further suggest that the "CAT" sequences may be widely dispersed in many diverse organisms including Escherichia coli, Drosophila, and man. PMID- 3531205 TI - Regulation of the balanced synthesis of membrane phospholipids. Experimental test of models for regulation in Escherichia coli. AB - In Escherichia coli, highly effective regulation controls the balanced synthesis of membrane phospholipids, important for optimal growth. Regulation is such that normally about 70% of a common pool of cytosine liponucleotide precursor is utilized by phosphatidylserine synthase and eventually converted to phosphatidylethanolamine, while about 30% is utilized by the competing enzyme phosphatidylglycerophosphate synthase and converted to phosphatidylglycerol (25%) plus cardiolipin (5%). Although the ratio of phosphatidylglycerol to cardiolipin may vary with conditions of growth, the sum of these two lipids remains relatively constant at about 30% of the total. Alternative models, postulating coordinate regulation of the two competing enzymes, or independent feedback regulation are proposed. These models were tested in experiments in which phosphatidylglycerol was continuously removed from growing cells treated with arbutin (4-hydroxyphenyl-O-beta-D-glucoside), causing its conversion to arbutinphosphoglycerol (Bohin, J.-P., and Kennedy, E.P. (1984) J. Biol. Chem. 259, 8388-8393.) The synthesis of phosphatidylglycerol was increased by a factor of 7 in cells treated with arbutin, with only small changes in phospholipid composition and with no significant change in the level of phosphatidylglycerophosphate synthase. The synthesis of phosphatidylethanolamine was not significantly increased, decisively eliminating the model that requires coordinate regulation of phosphatidylserine synthase and phosphatidylglycerophosphate synthase, and supporting the model of independent feedback inhibition, sensitive to very small changes in composition of cellular phospholipids. PMID- 3531206 TI - Limited proteolysis of IIIGlc, a regulatory protein of the phosphoenolpyruvate:glycose phosphotransferase system, by membrane-associated enzymes from Salmonella typhimurium and Escherichia coli. AB - In the present studies we report that membrane-associated proteases in Salmonella typhimurium and Escherichia coli catalyze limited proteolysis of IIIGlcSlow. We have previously reported (Meadow, N. D., and Roseman, S. (1982) J. Biol. Chem. 257, 14526-14537) the isolation of two electrophoretically distinguishable forms of IIIGlc, which is a phosphocarrier and regulatory protein of the phosphoenolpyruvate:glycose phosphotransferase system. The two species of IIIGlc were designated IIIGlcFast and IIIGlcSlow; IIIGlcSlow is 7 amino acid residues longer than IIIGlcFast at its NH2 terminus. The majority of the protease activity is located in the outer membrane fraction from both species of bacteria, with the cytoplasmic fraction being devoid of activity. The site of cleavage is at the Lys Ser bond located at residues 7-8 of IIIGlcSlow. The enzyme is an endopeptidase which liberates the expected heptapeptide (Gly-Leu-Phe-Asp-Lys-Leu-Lys). Both the large fragment of the limited proteolytic reaction, IIIGlcFast, and the small fragment, the heptapeptide, are stable to further proteolysis by membranes for more than 17 h at 37 degrees C. The activity in E. coli membranes has an absolute requirement for divalent metal ion (Mg2+ or Ca2+) and is heat-resistant, whereas the activity in S. typhimurium membranes is stimulated by divalent metal ion and is heat-sensitive. These results suggest significant differences between the two enzymes. The physiological function of the limited proteolysis of IIIGlc is not known. PMID- 3531207 TI - Insulin and phorbol esters affect the maximum velocity rather than the half saturation constant of 3-O-methylglucose transport in rat adipocytes. AB - The kinetics of the equilibrium exchange flux of 3-O-methylglucose (MeGlc) were examined in isolated rat adipocytes using a recently described technique (Whitesell, R. R., and Abumrad, N. A. (1985) J. Biol. Chem. 260, 2894-2899) in which the cells, under basal conditions, were reported to exhibit a high Km (35 mM) that was reduced (to 3 mM) upon treatment with insulin. When this technique was employed in the present study, the Km observed in basal adipocytes was 6.4 +/ 0.4 mM; insulin treatment did not affect this parameter (6.3 +/- 0.5 mM), although it increased the maximum velocity (phi max) 21-fold (from 3.0 +/- 0.3 to 63.7 +/- 1.1 nmol X min-1 X microliter of intracellular water-1). The large discrepancy in the basal Km values observed in the previous (35 mM) and the present (6.4 mM) studies is shown to be associated with relatively minor differences in basal MeGlc flux; these minor differences may reflect insufficient mixing of labeled MeGlc in the flux measurements of the previous study. In addition, the active phorbol ester, 12-O-tetradecanoylphorbol 13-acetate, at a concentration of 0.3 microM, caused a 2.8-fold elevation of phi max, with no modulation of Km. These results indicate that phi max, not Km, is the major kinetic parameter of hexose transport affected by insulin and phorbol esters, leading to enhancement of hexose uptake by the isolated rat adipocyte. PMID- 3531208 TI - Fluorescence studies of chicken liver fatty acid synthase. Segmental flexibility and distance measurements. AB - The 4'-phosphopantetheine of chicken liver fatty acid synthase was specifically labeled with the fluorescent substrate analog coenzyme A 6-[7-nitrobenz-2-oxa-1,3 diazol-4-yl]aminohexanoate at low salt concentrations. A serine at the active site of the thioesterase was specifically labeled with the fluorescent compounds 6-[7-nitrobenz-2-oxa-1,3-diazol-4-yl]aminopentylmethylphosphono fluoridate and/or pyrenebutyl methylphosphonofluoridate. Dynamic anisotropy measurements indicate the thioesterase has considerable segmental flexibility, whereas the fluorescent labeled 4'-phosphopantetheine does not display detectable local or segmental flexibility. Fluorescence resonance energy transfer measurements indicate that the distance between the fluorescent label at the end of the 4' phosphopantetheine and NADPH bound to the beta-ketoacyl reductase or enoyl reductase site on the same polypeptide chain is essentially the same, approximately 38 A. The two types of reductases were distinguished by specifically blocking enoyl reductase with pyridoxal 5'-phosphate. No significant energy transfer occurs between sites on different polypeptide chains so that the distances must be greater than 55 A. The distance between the serine on the thioesterase and the 4'-phosphopantetheine on the same polypeptide is 48 A; again no interpolypeptide chain energy transfer was observed. The distance between the serines of the two thioesterases within a fatty acid synthase molecule is greater than 56 A. The monomeric enzyme obtained at 1 degree C does not have beta ketoacyl synthase and reductase activities. Also fluorescent titrations indicate NADPH is not bound to beta-ketoacyl reductase in monomeric enzyme. The addition of potassium phosphate to the monomers at 1 degree C rapidly dimerizes the enzyme and restores the beta-ketoacyl reductase activity. The beta-ketoacyl synthase activity is slowly restored when the dimer is raised to room temperature. The results obtained suggest that relatively large conformational changes may be part of the catalytic cycle. PMID- 3531209 TI - Human adenine phosphoribosyltransferase. Complete amino acid sequence of the erythrocyte enzyme. AB - We defined the amino acid sequence of adenine phosphoribosyltransferase isolated from human erythrocytes. Peptide fragments formed by cleavage at arginine, lysine, glutamic acid, and methionine were purified by high pressure liquid chromatography and sequenced by manual Edman degradation. The complete primary structure of human adenine phosphoribosyltransferase was established by sequence analysis of 19 peptide fragments. Presumed homology between the human and rodent enzymes was used to order fragments that had inadequate overlapping sequences. The enzyme has 179 residues with a calculated subunit molecular weight of 19,481. Mass spectrometry indicated that the NH2-terminal residue is acetylated. Human adenine phosphoribosyltransferase has sequence homology with xanthine-guanine phosphoribosyltransferase from Escherichia coli in 110-amino acid region encompassing the NH2-terminal section of the enzyme. PMID- 3531211 TI - The purification of fully active recombinant transforming growth factor alpha produced in Escherichia coli. AB - Recombinant human transforming growth factor alpha (TGF alpha), which is active as assessed by competition with epidermal growth factor (EGF) for binding to the EGF receptor, has been produced in Escherichia coli and separated from misfolded and inactive forms of recombinant TGF alpha using reverse-phase high performance liquid chromatography. The purified recombinant TGF alpha was used to produce a monoclonal antibody that binds to active TGF alpha specifically. The antibody was coupled to Sepharose and used as an independent method for purifying active TGF alpha. The EGF receptor binding activity of antibody affinity purified TGF alpha is comparable to that of high performance liquid chromatography-purified active TGF alpha, and is 0.55 mg of EGF eq/mg of TGF alpha. The disulfide arrangement of the active TGF alpha was determined after digestion with thermolysin, and found to be analogous to the disulfide arrangement previously determined for EGF (Savage, C. R., Hash, J. H., and Cohen, S. (1973) J. Biol. Chem. 248, 7666-7672). PMID- 3531210 TI - Proton magnetic resonance study of kringle 1 from human plasminogen. Insights into the domain structure. AB - The aromatic H NMR spectrum of the kringle 1 domain from human plasminogen has been investigated by proton Overhauser experiments, acid-base titration, and two dimensional chemical shift correlated spectroscopy. Spin-echo and pH response experiments lead to the identification of the N-terminal Tyr-3 phenol ring signals. The connectivities among the tryptophanyl aromatic protons have been established and sets of singlet-doublet-triplet resonances stemming from each of the two indole groups sorted according to their common side chain origin. Similarly, the four histidyl singlets have been identified and paired per imidazole group. From their pH responses, it is indicated that a histidyl (His31) and a tryptophanyl (Trp-II) residue are placed in the neighborhood of carboxyl groups. The high-field chemical shifts observed for proton resonances of the ligand epsilon-aminocaproic acid upon binding to kringle 1 indicate that the ligand-binding site is rich in aromatic components. Overhauser experiments reveal that Leu46 is surrounded by a cluster of interacting aromatic side chains, which includes Trp25, Phe36, His41, Trp62, and Tyr64, and define a hydrophobic region contiguous to the kringle lysine-binding site. Relative internuclear distances have been estimated for aromatic H-atoms in the vicinity of Leu46 by reference to one of the latter's CH3 sigma, sigma' groups. Some of the connectives have previously been found for Leu46 in kringle 4 which further supports the idea of a common structure for the homologous domains. PMID- 3531212 TI - The role of the polar, carboxyl-terminal domain of Escherichia coli leader peptidase in its translocation across the plasma membrane. AB - Leader peptidase, an integral membrane protein of Escherichia coli, is made without a cleavable leader sequence. It has 323 amino acid residues and spans the plasma membrane with a small amino-terminal domain exposed to the cytoplasm and a large, carboxyl-terminal domain exposed to the periplasm. We have investigated which regions of leader peptidase are necessary for its assembly across the membrane. Deletions were made in the carboxyl-terminal domain of leader peptidase, removing residues 141-222, 142-323, or 222-323. Protease accessibility was used to determine whether the polar, carboxyl-terminal domains of these truncated leader peptidases were translocated across the membrane. The removal of either residues 222-323 (the extreme carboxyl terminus) or residues 141-222 does not prevent leader peptidase membrane assembly. However, leader peptidase lacking both regions, i.e. amino acid residues 142-323, cannot translocate the remaining portion of its carboxyl terminus across the membrane. Our data suggest that the polar, periplasmic domain of leader peptidase contains information which is needed for membrane assembly. PMID- 3531213 TI - The influence of the type of immunosorbent on rabies antibody EIA; advantages of purified glycoprotein over whole virus. AB - Two types of in vitro assay (enzyme immunoassay and sero-neutralization test) for the titration of rabies antibodies were used to assay sera from mice and humans immunized with cell culture vaccines or neural tissue vaccines. Enzyme immunoassays (EIA) were performed in plates sensitized with whole virus, purified glycoprotein or purified nucleocapsid. Neutralizing antibody titres were determined by the rapid fluorescent focus inhibition test (REFIT) and by an in vitro seroneutralization test including a rapid enzyme immunotitration of intracellular antigens (REITICA). The results obtained with sera of immunized mice and humans showed that (1) cell culture vaccines mainly induced the synthesis of antiglycoprotein neutralizing antibodies; and (2) neural tissue vaccines induced a high synthesis of antinucleocapsid non-neutralizing antibodies and a more or less important synthesis of antiglycoprotein antibodies depending on the origin of the tissue used for their preparation. Consequently, it was emphasized that when using EIA, the antibody titration must be run in glycoprotein-coated plates rather than in whole virus-coated plates to appreciate correctly the immunizing potency of a rabies vaccine, especially neural tissue vaccine. PMID- 3531214 TI - Diagnostic significance of influenza subtype-specific IgG, IgA, and IgM antibodies. AB - Up to now, the complement fixation test (CFT) has been the basis for the serological diagnosis of influenza virus infection in routine laboratories. Generally, low CF titers (1:20 or 1:40) are difficult to interpret. This means that the differentiation between recent and remote influenza infections is not possible by CFTs on single sera. Nonetheless this is generally possible by the subtype- and immunoglobulin class-specific immunofluorescence test (IFT) reported in this paper. Sera from 76 patients with confirmed influenza infection were tested and we obtained the following results: only 27.6% contained antibodies of all immunoglobulin classes, 51% contained IgG and IgA antibodies (without IgM) and 3.9% responded only with the IgG isotype. The IFT-positive and CFT-negative were 5.2% and the IFT-negative and CFT-positive 4%. In 7.9% no antibody rises were detected by CFT or by IFT despite virus isolation. Results from IFT may permit the interpretation of low CF titers. In contrast to CFT, IFT makes possible the differentiation between vaccinated and unvaccinated persons because vaccinated persons regularly produce IgM antibodies against all strains of the vaccine. PMID- 3531215 TI - A rapid rabies enzyme immuno-diagnosis (RREID): a useful and simple technique for the routine diagnosis of rabies. AB - A Rapid Rabies Enzyme Immuno-Diagnosis (RREID) technique has been developed. This technique for the diagnosis of rabies was performed in microplates which had been previously sensitized with IgG to purified antinucleocapsids. Suspensions of homogenized material were incubated in the plate and the specific binding of rabies antigen was revealed by the use of the same IgG conjugated with peroxidase. With the RREID technique it was possible to detect rabies antigens in brain specimens with the same specificity and sensitivity as that of the direct immunofluorescence test or the neuroblastoma cell inoculation technique regardless of the species of animal from which the specimen was derived. Moreover, RREID was performed with fox salivary gland specimens with the same results as were obtained with brain specimens. RREID does not require an UV light microscope and a photometer is not essential. It is a useful and simple technique for the routine laboratory diagnosis of rabies. PMID- 3531216 TI - Long-term maintenance of hepatocyte functional activity in co-culture: requirements for sinusoidal endothelial cells and dexamethasone. AB - Sinusoidal cells isolated from adult rat liver have been established in primary culture and in cell line. The presence of factor VIII R:Ag and peroxidatic/phagocytosis activities were the criteria used to distinguish in freshly isolated cells the endothelial cells from the Kupffer cells and suggested the endothelial origin of the cell line. Using a co-culture system, the effect of sinusoidal liver cells on hepatocyte functional activity was characterized. A plateau in which the state of differentiation was stabilized could be generated for co-cultured hepatocytes isolated from adult rat and a disappearance of the initial expression of alpha 1-fetoprotein (AFP) and the increase and/or maintenance of albumin secretion were measured with co-cultured hepatocytes isolated from suckling rat. The presence of dexamethasone was required for such beneficial effect. The hepatocyte-stabilizing activity was also produced by a pulmonary endothelial cell line. PMID- 3531217 TI - Modulation of WI-38 cell proliferation by elevated levels of CaCl2. AB - Elevating the level of extracellular calcium (CaEx2+) increases the saturation density achieved by the normal human diploid cell line, WI-38, but does not change the growth rate. Day 7 cell yields remain unchanged when [CaEx2+] is between 0.5 mM and 3.0 mM, decrease when [CaEx2+] less than 0.5 mM, and increase when [CaEx2+] greater than 3.0 mM. Combining hydrocortisone with additional CaCl2 results in an additive effect on the saturation density relative to that obtained with each treatment separately. The stimulatory effect of elevated [CaCl2] is independent of serum concentration but is lost when WI-38 cells are grown in conditioned medium. Stimulation is recovered when conditioned medium is diluted with serum-free medium. In the case of young cultures grown in conditioned medium, stimulation can also be recovered when higher than usual levels of additional CaCl2 are used (2-3 mM). A glutamine supplementation to the conditioned medium potentiates cell response to elevated [CaCl2]. These results indicate that the loss of an enhanced saturation density when cells are grown in conditioned medium is not due to serum depletion but is more likely the effect of metabolites and/or nutrient depletion. When older or less vigorously growing cultures are grown in conditioned medium, additions of up to 3 mM CaCl2 only lead to inhibition, suggesting an age-related change in proliferative regulation. Elevated levels of CaEx2+ also enhance the proliferative response of quiescent monolayers to serum stimulation. This finding, along with the increase in saturation density of Ca2+-treated cultures, suggests that an elevated level of CaEx2+ affects cell entry into and exit from quiescence brought on by density dependent inhibition. PMID- 3531218 TI - Sponge aggregation factor: in situ localization by fluorescent monoclonal antibody techniques. AB - The aggregation factor (AF) from sponges mediates a heterophilic interaction of homologous cells. Applying electron microscopical means, we succeeded only very rarely in identifying the 90 S AF particle in tissue sections from Geodia cydonium. By means of a fluorescent antibody technique, we have now localized the cell binding domain of the AF in situ. Previous studies in this laboratory have led to the identification of the 47-kDa cell binding protein of the AF, using the monoclonal antibody (mab) 5D2-D11 [Gramzow M, Bachmann M, Zahn RK, Uhlenbruck G, Dorn A, Muller WEG, J Cell Biol, 102: 1344-1349, 1986]. This mab and mab 7D5, directed against a 92-kDa protein in the AF complex, were chosen for the fluorescent studies. By using mab 5D2-D11, the plasma membranes of cells from different regions in the sponge could be brightly stained. However, mab 7D5 reacted only very weakly with the sponge surfaces. By applying the immuno blotting technique it was furthermore demonstrated that the cell binding protein is present both in the associated form with AF complex and in a free state. Moreover, it was established that the 47-kDa binding protein is not present in homologous glycoconjugates, lectin, or collagen; these components are known to be involved in cell-matrix interaction. PMID- 3531219 TI - Optimistic bias in the assessment of sensitivity and specificity. PMID- 3531220 TI - Naloxone-induced luteinizing hormone secretion in normal, precocious, and delayed puberty. AB - The aim of the present study was to evaluate the activity of opiate receptors involved in the control of LH secretion during pubertal development, as determined by the LH response to naloxone. Normal children (n = 28) of both sexes, subdivided according to breast (girls) or testicular (boys) development, and patients with idiopathic precocious puberty (n = 7), delayed puberty (n = 8), or hypergonadotropic hypogonadism (n = 4) were studied. Plasma LH levels were measured after the administration of naloxone (NLX; 0.08 mg/kg BW, iv), GnRH (50 micrograms, iv) or placebo. In healthy subjects, NLX significantly increased plasma LH levels only in girls and boys at the most advanced stage of gonadal maturation. NLX was ineffective in prepubertal and early pubertal children, and it did not significantly alter LH levels in children with delayed puberty or hypogonadism or in most of the children with precocious puberty. GnRH injection consistently increased plasma LH levels in healthy subjects as well as in the children with pubertal disturbances. These results indicate that the LH response to NLX occurs only at the most advanced stages of pubertal maturation when normal or precocious and is absent in early puberty or in children with pubertal disturbances. Furthermore, the results suggest that opioid regulation of LH secretion in humans changes during puberty, reaching an adult-like functional state with maturation of the hypothalamus-pituitary-gonadal axis. PMID- 3531221 TI - 8-Bromo-3',5'-adenosine monophosphate stimulates the endocrine activity of human cytotrophoblasts in culture. AB - Cytotrophoblasts, purified from human term placentae, were cultured in the absence or presence of 8-bromo-cAMP or 8-bromo-cGMP. 8-Bromo-cAMP provoked a dose dependent increase in the secretion of hCG and progesterone within 24 h. After 48 h, hCG secretion increased by more than 200-fold, and progesterone secretion increased nearly 5-fold. 8-Bromo-cGMP had no effect on hCG secretion. In culture in serum-supplemented medium, the mononuclear cytotrophoblasts aggregated and fused to form syncytia. This morphological transformation was not affected by 8 bromo-cAMP. Immunocytochemical studies of the alpha- and beta-subunits of hCG in control and 8-bromo-cAMP-stimulated cultures demonstrated that the cyclic nucleotide analog promoted the synthesis of both subunits in all cellular forms, including single mononuclear cells, cell aggregates, and syncytia. In serum-free medium, the cytotrophoblasts did not aggregate or form syncytia, yet they responded to 8-bromo-cAMP with an increase in hCG secretion. We conclude that the endocrine function of cytotrophoblasts can be stimulated by a cAMP-dependent mechanism which can be initiated independently of the formation of a syncytium. PMID- 3531222 TI - [Estimation of gestational age by ultrasonic measurements of the gestational sac]. PMID- 3531223 TI - [Growth responses of Salmonella typhi in the presence of antibiotics, bile acid and Escherichia coli]. PMID- 3531224 TI - Western blot analyses of measles virus antibody in normal persons and in patients with multiple sclerosis, subacute sclerosing panencephalitis, or atypical measles. AB - A version of the Western blot was developed to detect serum antibodies against measles virus polypeptides. With this technique, a seroepidemiological survey of antibodies to the several measles virus proteins in diverse measles-related conditions was conducted. The sera were obtained from individuals with a recent or long-past history of natural measles, from persons with a history of immunization with live attenuated measles vaccine, and from patients with multiple sclerosis, subacute sclerosing panencephalitis, or atypical measles. The findings indicated that live attenuated measles vaccine elicits an antibody response qualitatively resembling that of a natural infection. In addition, multiple sclerosis patients made less antibody to the measles virus M protein than did individuals with a long-past history of natural measles. Thus, the immunological reaction of multiple sclerosis patients to measles virus is qualitatively, as well as quantitatively, different from that of normal persons. Finally, persons with subacute sclerosing panencephalitis and atypical measles mounted abnormally high antibody responses to measles virus polypeptides, in particular the P protein. PMID- 3531225 TI - Latex agglutination test for rubella antibodies: report based on data from the College of American Pathologists surveys, 1983 to 1985. AB - In the College of American Pathologists (CAP) rubella survey program, 45% of laboratories rely on the latex agglutination (LA) card assay for detecting rubella immunoglobulin G (IgG) antibodies. By using CAP survey data over a 3-year period, we compared LA results with hemagglutination inhibition (HI) and enzyme immunoassay (EIA) results. EIA indices were used to classify results into three categories: nonimmune, EIA index of 0.300 or less; borderline, EIA index of 0.300 to 0.619; and immune, EIA index of 1.700 or greater. There was 91% or more agreement between LA, HI, and EIA for categories i and iii. In category ii, the response from LA users varied, depending on the level of antibody present in the survey samples; at an EIA index of 0.346, 81% reported nonimmune status, whereas at an EIA index of 0.619, 48% reported nonimmune status. Less than 10% indicated borderline status. In testing of samples in the same category, approximately 40%, using the HI method, reported titers of less than 1:8 (nonimmune status). Among EIA users, 97 to 99% regarded the specimens as nonimmune. On analysis of specimens in the borderline category, the LA test showed a pattern of sensitivity and specificity comparable to that reported with the HI technique, whereas the EIA method showed a greater degree of precision. The LA card assay provides a rapid screening test in which LA is read macroscopically, and the procedure differs considerably from the fully quantitative HI and EIA methods.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3531226 TI - Safety of and serum antibody response to cold-recombinant influenza A and inactivated trivalent influenza virus vaccines in older adults with chronic diseases. AB - Forty older adults with chronic diseases were vaccinated intranasally with either influenza A/California/10/78 (H1N1) (CR37) or influenza A/Washington/897/80 (H3N2) (CR48) virus. No clinically significant morbidity or decrement in pulmonary function occurred postvaccination. Two (15%) recipients of CR37 virus and twelve (44%) recipients of CR48 virus became infected with vaccine virus, as indicated by a fourfold rise in serum hemagglutination inhibition antibody titer; a fourfold rise in serum immunoglobulin G (IgG) or IgA antibody titer, indicated by enzyme-linked immunosorbent assay; isolation of vaccine virus from nasal washings; or all of these. Within 1 year after cold-recombinant vaccine virus vaccination, 18 vaccines received inactivated trivalent influenza virus vaccine parenterally. Of the vaccinees, 13 (72%) developed a fourfold rise in serum antibody titer to H1N1 antigen and 16 (89%) developed a fourfold rise in serum antibody titer to H3N2 antigen. We conclude that administration of these cold recombinant vaccine viruses to older adults with chronic diseases was safe, but that serum antibody response rates were lower than those achieved with subsequently administered inactivated influenza virus vaccine given parenterally. However, the higher seroconversion rates attained by using the inactivated trivalent influenza virus vaccine do not necessarily mean that it is more efficacious in preventing infection or severe illness or both due to natural wild type influenza A virus. PMID- 3531227 TI - Evaluation of dot enzyme-linked immunosorbent assay for mucocutaneous leishmaniasis and comparison with microplate enzyme immunoassay. AB - A dot enzyme-linked immunosorbent assay (dot ELISA) was evaluated and compared with a standard microplate ELISA (immunoglobulin G [IgG] ELISA) for the serological diagnosis of mucocutaneous leishmaniasis. The two assays were used to test 113 serum specimens from the following groups: normal individuals and patients with deep mycoses, toxoplasmosis, mucocutaneous leishmaniasis, visceral leishmaniasis, Chagas' disease, malaria, and schistosomiasis. Both tests exhibited cross-reactivity when testing specimens from cases of visceral leishmaniasis and Chagas' disease. The dot ELISA proved to be economical with respect to use of reagents and was easy to perform. Interpretation could easily be made by visual inspection of reaction endpoints in the nitrocellulose disks, obviating the need for spectrophotometric readings. There were no significant differences in sensitivity between the dot ELISA and the IgG ELISA at a cutoff level either of 20 or 40. However, its most remarkable feature was the high specificity compared with that of the IgG ELISA. Because of its ease of performance and high sensitivity and specificity, the dot ELISA should be an excellent test to be executed in the field during seroepidemiological surveys. PMID- 3531228 TI - Comparison of beta-glucuronidase-based substrate systems for identification of Escherichia coli. AB - Methods based on the measurement of beta-glucuronidase have been shown to be specific and inexpensive for the identification of Escherichia coli from bacterial colonies within 1 h. Recently, commercial systems incorporating beta glucuronidase substrates were introduced. Rapid Identification Method E. coli (Austin Biological Laboratories, Curtin Matheson Scientific, Inc., Houston, Tex.) and Rapid Detect E. coli (Organon Teknika, Morris Plains, N.J.) are single-tube test combinations to simultaneously measure beta-glucuronidase (fluorescence at 366 nm), o-nitrophenyl-beta-D-galactopyranoside (yellow), and indole (red). To determine the accuracy and utility of these two systems, we used them to test 169 E. coli and 150 non-E. coli and compared them with conventional substrate tests. The Rapid Detect test was more efficient than the Rapid Identification Method in demonstrating beta-glucuronidase activity, but the commercial systems were equal to each other and to the conventional tests for o-nitrophenyl-beta-D galactopyranoside and indole. There were no false reactions by either system. PMID- 3531229 TI - Immunoglobulin G subclasses of fluorescent anti-Treponema pallidum antibodies: evidence for sequential development of specific anti-T. pallidum immunoglobulin G responses in patients with early syphilis. AB - The development of immunoglobulin G (IgG) subclass-specific anti-Treponema pallidum antibodies during the course of syphilis in humans was studied with sera from 50 untreated male patients. The patients were divided into five diagnosis groups. In the fluorescent treponemal antibody test, which delineates the presence of cross-reacting antibodies, as well as specific antitreponema antibodies, IgG1, IgG2, and IgG3 subclass antibodies were already present during the seronegative primary stage. Specific antibodies, which were detected by the fluorescent treponemal antibody absorption test, were first present during the serotype-variable primary stage. These antibodies were almost exclusively of the IgG1 and IgG3 subclasses. In later stages, antibodies of other subclasses were detectable. Titration of IgG1 antitreponema antibodies in three electrophoretically different IgG fractions revealed an asymmetric distribution in these fractions during primary syphilis. The antibodies were largely confined to the most basic fraction during primary syphilis. A sudden change in the distribution was noted between the end of the primary stage and the secondary stage; an even distribution of IgG1 antitreponema antibodies existed in the late latent stage. These findings confirm and extend previous results from our laboratory. The development of antibodies detected by both tests is discussed in terms of a sequential stimulation of the immune system due to the presence of an extracellular layer covering the treponemas or, alternatively, in terms of a suppression of the immune response during early syphilis. PMID- 3531230 TI - Clinical trial comparing bacitracin with Strep-A-Chek for accuracy and turnaround time in the presumptive identification of Streptococcus pyogenes. AB - In a clinical trial, Strep-A-Chek (a 10-min chromogenic test) was compared with the bacitracin disk susceptibility test for accuracy and turnaround time in the presumptive identification of Streptococcus pyogenes. Among 461 isolates of beta hemolytic streptococci (344 throat isolates and 117 isolates from other sites), 303 group A S. pyogenes isolates were found. The sensitivities of the Strep-A Chek and bacitracin tests were high (96.4 and 100%, respectively), but the bacitracin test had a lower specificity (84.2%) than the Strep-A-Chek test (98.7%). The predictive values for positive and negative test results were 99.3 and 93.4%, respectively, for Strep-A-Chek and 92.4 and 100%, respectively, for bacitracin. Strep-A-Chek correctly identified all isolates upon repeat testing. All bacitracin tests were performed on subcultures of isolates from the primary plate. Strep-A-Chek testing was performed on colonies from the primary plate when isolated colonies were available. This shortened the turnaround time for Strep-A Chek compared with bacitracin by at least 24 h on nearly one-half (45%) of the isolates. A peripheral finding of this study was that sulfamethoxazole trimethoprim blood agar offered no advantage over conventional blood agar with regard to the number of false-positive bacitracin tests obtained from each medium. PMID- 3531232 TI - Human and nonhuman infections caused by Yersinia pseudotuberculosis in Canada from 1962 to 1985. AB - The incidence of human and nonhuman infections of Yersinia pseudotuberculosis in Canada is presented on the basis of a literature review and serotyping of 101 cultures referred to the Canadian National Reference Center for Yersinia enterocolitica and Yersinia pseudotuberculosis. PMID- 3531231 TI - Rapid diagnosis of severe Haemophilus influenzae serotype b infections by monoclonal antibody enzyme immunoassay for outer membrane proteins. AB - A highly sensitive and specific enzyme immunoassay (EIA) for the detection of Haemophilus influenzae serotype b antigens in body fluids and broth cultures was developed, with a polyclonal antibody directed against polyribose phosphate as the solid-phase reagent and a biotinylated monoclonal antibody directed against H. influenzae type b outer membrane protein as the liquid-phase reagent. H. influenzae type b antigens could be detected in broth cultures containing as little as 50 organisms per ml. The sensitivity and specificity of this system were compared with those of two commercial kits and counterimmunoelectrophoresis. The overall detection of H. influenzae type b antigens in clinical specimens collected from children infected with H. influenzae type b was as follows: with Phadebact, 86 and 86% in cerebrospinal fluid and urine specimens, respectively; with Bactigen, 86, 80, and 92%, with counterimmunoelectrophoresis, 78, 73, and 75%, and with biotin-avidin EIA, 100, 100, and 100% for cerebrospinal fluid, serum, and urine specimens, respectively. In the biotin-avidin EIA, no positive reactions were noted in specimens collected from patients infected with other bacteria or from patients without evidence of bacterial infection, whereas false positive reactions were found by counterimmunoelectrophoresis and the commercial kits. These results suggest that this monoclonal antibody reacting with the outer membrane protein is more specific and sensitive than the conventional methods using polyclonal antisera for the detection of H. influenzae type b antigens during severe infections in children. PMID- 3531233 TI - Comparison of DNA probes and the Sereny test for identification of invasive Shigella and Escherichia coli strains. AB - Forty-two Shigella and 29 Escherichia coli strains were screened for invasiveness in the Sereny test and for hybridization with two recently described DNA probes for the invasiveness plasmid. Both probes produced identical results. All Sereny positive strains hybridized with both DNA probes. Three Sereny-negative strains also hybridized with the probes, suggesting that there are strains containing the invasiveness plasmid that are not pathogenic in animal models. PMID- 3531234 TI - Sonographic clarification of the problems of neonatal hip instability. AB - Real-time ultrasound examinations of neonatal hips were performed to define the natural history of hip instability in the neonate. In clinically unstable hips, ultrasound confirmed displacement of the femoral head of variable severity that was usually bilateral even if unilateral instability had been diagnosed clinically. Ultrasound also revealed that the "reduction" after the Ortolani test may be spurious. Normal sonographic location resulted in all unstable hips that were splinted. In some unstable hips that were not splinted, resolution of sonographic displacement to normal was also documented. In other unstable hips that were unsplinted, persistent sonographic displacement occurred despite early resolution of clinical instability, and later treatment was required. PMID- 3531235 TI - Insulin regulation of rat growth hormone gene transcription. AB - We have previously shown that insulin suppresses growth hormone (GH) messenger (m) RNA levels in rat pituitary cells. To further delineate the molecular mechanism of insulin action, the effect of insulin treatment on GH gene transcription rates was examined in GH3 pituitary cells grown in serum-free defined medium. A transcriptional run-off assay was performed when intact isolated nuclei were allowed to continue RNA synthesis in an in vitro reaction. Specific incorporation of [32P]GTP into RNA was quantified by hybridization to rat GH complementary (c) DNA. Hybridization efficiency was measured with an internal [3H]cRNA standard and ranged from 30 to 48%. Alpha-amanitin (1 microgram/ml) inhibited total transcription, and excess unlabeled rat pituitary mRNA (250 ng) competitively inhibited GH mRNA hybridization by greater than 80%. Insulin (0.7 nM) inhibited new GH mRNA synthesis, and maximal inhibition (30% of control) was observed with 7 nM insulin after 4 h treatment. The inhibitory effects of insulin on new GH mRNA synthesis were abolished by both insulin receptor-antiserum and by guinea-pig anti-insulin serum. The results show that insulin exerts a rapid suppression of new GH mRNA synthesis. These data provide evidence for the direct transcriptional regulation of the GH gene by insulin. PMID- 3531236 TI - Distribution of glucose transporters in membrane fractions isolated from human adipose cells. Relation to cell size. AB - We examined insulin's effects on glucose transport and on subcellular transporter distribution in isolated human omental adipocytes of various sizes. Insulin stimulated 3-O-methylglucose transport by twofold in small cells, while a smaller and insignificant effect was measured in large cells. In the small cells, basal concentrations of glucose transporters were 2.9 and 17.2 pmol/mg membrane protein in the plasma and the low density microsomal membranes, respectively. Increasing cell size was associated with a 50% decrease in the concentration of transporters in each fraction, with no change in their total number per cell. Insulin stimulated the translocation of transporters from the intracellular pool to the plasma membranes, irrespective of cell size. Thus, insulin resistance at the postreceptor level, observed in human obesity, may be associated with a relative depletion of total transporters per cell together with a reduction in their intrinsic activity at the plasma membrane level. PMID- 3531237 TI - Antigens of Borrelia burgdorferi recognized during Lyme disease. Appearance of a new immunoglobulin M response and expansion of the immunoglobulin G response late in the illness. AB - Using immunoblots, we identified proteins of Borrelia burgdorferi bound by IgM and IgG antibodies during Lyme disease. In 12 patients with early disease alone, both the IgM and IgG responses were restricted primarily to a 41-kD antigen. This limited response disappeared within several months. In contrast, among six patients with prolonged illness, the IgM response to the 41-kD protein sometimes persisted for months to years, and late in the illness during arthritis, a new IgM response sometimes developed to a 34-kD component of the organism. The IgG response in these patients appeared in a characteristic sequential pattern over months to years to as many as 11 spirochetal antigens. The appearance of a new IgM response and the expansion of the IgG response late in the illness, and the lack of such responses in patients with early disease alone, suggest that B. burgdorferi remains alive throughout the illness. PMID- 3531238 TI - Immunoreactive apolipoprotein E is a widely distributed cellular protein. Immunohistochemical localization of apolipoprotein E in baboon tissues. AB - Apolipoprotein (apo)E is an important protein determinant in cholesterol homeostasis in man. The protein is synthesized by the liver as well as by a number of extrahepatic tissues. In the present study, immunohistochemical techniques were used to identify apoE in specific cells in various baboon organs. In the 11 tissues studied, the following cell types have been found to harbor apoE immunoreactivity: cerebral astrocytes; thyroid follicular cells; alveolar type II pneumocytes; hepatocytes, and Kupffer cells; adrenocortical cells in zona fasciculata and zona reticularis; adrenal medullary cells; some renal tubular epithelia; some pancreatic islet cells; histiocytic macrophages in lymph nodes and the spleen; some gastric mucosal epithelia; and ovarian oocytes. These observations indicate the wide distribution of apoE in many organs and suggest that the protein might perform other important functions such as regulation of local hormonal homeostasis in addition to its role in cholesterol metabolism. PMID- 3531240 TI - Therapeutic progress--review XX. Drug treatment of Parkinson's disease. PMID- 3531241 TI - New antibacterial agents and their uses. PMID- 3531242 TI - Studies on the evaluation of preservative efficacy--II. The determination of antimicrobial characteristics of benzylalcohol. AB - A successful kinetic approach to the screening of preservation efficacy of benzylalcohol--a neutral-type preservative--is described. The D-value, activation energy (Ea), temperature coefficient (Q10) and concentration exponent (n) were used as parameters in determining the influence of different factors on the efficacy of benzylalcohol. Factors, such as the pH of the solution, temperature and concentration of the preservative were investigated. The study was carried out using five micro-organisms: Aspergillus niger, Candida albicans, Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus. PMID- 3531239 TI - Designed transfer of specific immune responses with bone marrow transplantation. AB - Bone marrow transplant donors were immunized with tetanus/diphtheria toxoids 6-7 d before bone marrow donation to investigate the role of B cell subpopulations in reconstitution of humoral immunity. Lymphoblastoid B cells spontaneously producing IgG antitetanus and/or antidiphtheria toxoid were detected in the donor marrows at the time of transplantation. Recipients rapidly demonstrated 3-90-fold increases in serum IgG antitetanus and antidiphtheria toxoid levels. Antidiphtheria fragment A antibody in three donor/recipient pairs demonstrated spectrotypic identity indicating transfer of the donors' response. Reimmunization of three recipients 64-154 d after transplant revealed an IgG antibody response associated with reappearance of spontaneous antibody-producing B cells and an antidiphtheria fragment A response characteristics of the donor's immune response. These observations extend the understanding of the role of B cell subpopulations and provide a basis for specific modulation of immunity in the setting of bone marrow transplantation. PMID- 3531244 TI - Relationship of gingival thickness and bleeding to loss of probing attachment in shallow sites following nonsurgical periodontal therapy. AB - Periodontal sites of shallow initial probing depth often seem to lose probing attachment following various types of periodontal therapy, including nonsurgical therapy. The susceptibility to this treatment-associated probing attachment loss may conceivably be related to gingival architecture as well as to the inflammatory status of the tissues. This study was designed to study the relationship of buccolingual gingival thickness and bleeding on probing in shallow buccal sites (less than or equal to 3.5 mm probing depth) to loss of probing attachment following nonsurgical therapy. 3 months following treatment consisting of oral hygiene instruction and supra- and subgingival debridement, thin (less than or equal to 1.5 mm), initially non-bleeding sites displayed a mean loss of probing attachment of 0.3 mm. Thick (greater than or equal to 2.0 mm), non-bleeding sites displayed a less noticeable mean loss of probing attachment, whereas bleeding sites of both categories of gingival thickness showed a tendency towards gains in probing attachment levels. It may be concluded that the mean loss in probing attachment levels, commonly seen for shallow sites post-therapy, may be primarily due to the changes in shallow, thin healthy areas. PMID- 3531243 TI - Pulmonary megakaryocytes: "missing link" between cardiovascular and respiratory disease? AB - Pulmonary megakaryocytes were quantitated in a series of 30 consecutive hospital necropsies using a two stage immunoperoxidase stain for factor VIII related antigen. In all 30 cases they were found with a mean density of 14.65 megakaryocytes/cm2 in lung sections of 5 micron in thickness. The maximum concentration of intrapulmonary megakaryocytes was consistently found to be in the central zone of the right upper lobe. Less than 22% of the observed cells possessed abundant cytoplasm, the rest appearing as effete, naked, and seminaked nuclei. The mean megakaryocyte count was found to be increased in association with both respiratory pathology (positive smoking history and impaired lung function) and cardiovascular disease states--shock; thromboembolism; myocardial infarction; and severe atheroma in the abdominal aorta, the coronary circulation, and the circle of Willis. Pulmonary megakaryocytes probably embolise from bone marrow. This may reflect stimulated thrombopoiesis, caused by increased platelet consumption in association with atherosclerotic disease, but it cannot be taken to confirm that the lung is the principal site of platelet production. PMID- 3531245 TI - Detection and serotyping of Actinobacillus actinomycetemcomitans isolates on nitrocellulose paper blots with monoclonal antibodies. AB - A combination of blotting of bacterial colonies on nitrocellulose paper discs and immunoenzymatic detection of bound antigens with specific monoclonal antibodies was used to detect and serotype Actinobacillus actinomycetemcomitans directly off the initial agar culture dish. The A. actinomycetemcomitans antigens, representative of specific colonies, were identified immunoenzymatically using monoclonal antibody specific for a species-specific antigen. The serotype of the bacteria in colonies was identified by dividing the blotting paper into sections and immunoenzymatically identifying the serotype antigens with serotype-specific monoclonal antibodies. This procedure provides for simple, rapid, sensitive and accurate identification and characterization of A. actinomycetemcomitans isolates from the initial isolation agar plates. PMID- 3531246 TI - The effectiveness of citric acid as an adjunct to surgical re-attachment procedures in humans. AB - The purpose of this study was to clinically evaluate the effect of citric acid on re-attachment and re-adaptation in conjunction with periodontal surgery. A split mouth design was used in 10 patients involving 30 quadrants of surgery. A total of 120 teeth were treated. Each quadrant consisted of at least 2 teeth from cuspid to second molar. One quadrant was treated with a modified Widman flap alone while the root surfaces of the contralateral side were also treated with a 3 min application of citric acid. Immediately following hygienic phase and at 3 and 6 months postsurgically, the following measurements were taken in this sequence: gingival index, gingival crevicular fluid flow, plaque index, furcation involvement, level of attachment and probing depth. All the data were statistically analyzed using the paired t-test, chi 2 and Fisher exact probability test. The biometric results showed that both surgical techniques resulted in a loss of attachment in shallow pockets and a gain in deeper pockets. Both techniques resulted in similar amounts of recession and probing depth reduction at 6 months. Gingival index, plaque index and furcation values decreased at 3 and 6 months postsurgically. The gingival crevicular fluid values remained essentially the same up to 6 months postsurgically. PMID- 3531247 TI - Treatment of juvenile periodontitis without antibiotics. A follow-up study. AB - 20 patients with juvenile periodontitis (JP) were treated with oral hygiene instruction, scaling and root planing, possibly with flap surgery but with no antibiotics. The patients were monitored after 6 to 12 years. Re-examination revealed that no probing depth of 7 mm or more existed any longer, and that sites with probing depth of 4 to 6 mm had decreased from 237 to 46. The bone loss scores had changed from 18% (range 2.0 to 48.1) to 14% (range 0 to 44.4) and the bleeding on probing scores from 39% (range 0 to 100) to 10% (range 0 to 40). Actinobacillus actinomycetemcomitans (A.a.) had neither been cultivated nor serologically tested at the initial examination. At the re-examination, it was found in 2 patients out of 20 at 5 sites. 7 patients, the 2 with positive cultures included, had elevated titers to A.a. strain Y4 in whole or parotid saliva or both. It is concluded that there is a marked improvement in the periodontal condition of these patients, and that good periodontal health in patients with JP can be reached without antibiotics. PMID- 3531248 TI - Prophylaxis of migraine attacks with a calcium-channel blocker: flunarizine versus methysergide. AB - In this study, flunarizine, a selective calcium-channel blocker, was employed in the prophylactic treatment of headache and was compared with methysergide in terms of efficacy. The trial was conducted with 104 patients (53 treated with flunarizine and 51 treated with methysergide) and lasted six months--one month of pretreatment and five months of therapy. Patients in both groups experienced a highly significant reduction in the number and duration of migraine attacks. Unlike those in the methysergide group, patients treated with flunarizine achieved a significant reduction in the intensity of attacks with very negligible side effects. PMID- 3531249 TI - The effect of once-daily minoxidil on blood pressure and plasma lipids. AB - Once-daily minoxidil administration was added to the treatment regimen of 11 patients with hypertension that was inadequately controlled by nadolol 160 mg and chlorthalidone 50 mg given once daily. Additional diuretic therapy was needed by five patients. During treatment without minoxidil and at three and six months of maintenance minoxidil therapy, respectively, 24-hour postdose supine blood pressure fell significantly (P less than .01) from 142 +/- 19/96 +/- 6 mm Hg to 132 +/- 16/87 +/- 4 and 131 +/- 12/87 +/- 4 mm Hg, and home recordings showed that minoxidil induced a mean increase of about 5 beats/min in heart rate. Resting plasma renin activity was not significantly altered. High-density lipoprotein (HDL) cholesterol increased from 31.6 +/- 9.9 to 35.2 +/- 10.9 mg/dL (P less than .05) and to 34.4 +/- 11.3 mg/dL (NS), and low-density lipoprotein (LDL) cholesterol decreased from 146 +/- 36 to 136 +/- 32 mg/dL (P less than .05) and to 126 +/- 35 mg/dL (P less than .01) over the same periods. At six months, approximately 20% changes in ratios of HDL cholesterol to either LDL or total cholesterol were seen. These changes occurred despite a three-pound mean increase in body weight (P less than .05); these alterations are potentially beneficial in terms of reducing the estimated risk of coronary artery disease. PMID- 3531250 TI - Initiation of captopril therapy: the first-dose effect. PMID- 3531251 TI - Three types of swine immunoglobulin-producing tumours: lymphoplasmacytic lymphosarcoma, immunoblastic lymphosarcoma and plasmacytoma. AB - Three types of swine immunoglobulin-producing tumours are described. Case 1 was a lymphoplasmacytic lymphosarcoma, in which IgG was intracellularly identified in the plasmacytoid cells. Case 2 was an immunoblastic lymphosarcoma, the large cells of which possessed intracytoplasmic IgG and well developed RER. Case 3 was diagnosed as a plasmacytoma. There were two distinct immunoglobulins, IgG and IgA, in single plasmacytoid cells and the RER was highly developed. The origins of the three cases are discussed according to the theory of B-lymphocyte differentiation sequences and the origins of B-cell lymphomas. The mechanism of "double producers" is discussed with reference to DNA and RNA. PMID- 3531252 TI - Dermatologic considerations of stoma care. AB - Stomas are artificial openings from the gastrointestinal tract or the urinary tract to the outside of the body. Patients with stomas require appliances to protect peristomal skin and contain the stomal effluent. Cutaneous problems that often arise around the stoma may be unique to these patients or may reflect more typical dermatoses and neoplasia arising in an atypical setting. Dermatologists must learn to recognize these disorders and must be aware of preventive and therapeutic techniques and the resources available to manage them. Much can be gained, in both the education of the dermatologist and in the care of the patient, by close cooperation with the specialized enterostomal therapy nurse. PMID- 3531253 TI - The eosinophil and cutaneous edema. AB - Although eosinophils are readily identified in skin tissue, their role in cutaneous disease has been obscure. Recent studies have elucidated the structure, content, and several activities of the eosinophil. The eosinophil is a potent parasite-killer cell and probably mediates damage to respiratory epithelium in bronchial asthma. We review information showing an association between cutaneous edema and eosinophil degranulation in tissue. These studies show that eosinophils release and deposit toxic granule proteins extensively in the skin despite the existence of few intact eosinophils in tissue. The evidence suggests that the eosinophil functions not only as a parasite-killer cell but also as a proinflammatory cell that may be pathophysiologically related to the development of cutaneous edema. PMID- 3531254 TI - Disorders of the nails. PMID- 3531255 TI - Effect of continued ultraviolet B phototherapy on the duration of remission of psoriasis: a randomized study. AB - Phototherapy using sunburn spectrum ultraviolet radiation (UVB) is now a frequently utilized treatment for psoriasis that is extensive or has not responded to topical preparations. Four university centers performed a prospective randomized clinical trial to compare remission times of patients with psoriasis who continued UVB phototherapy after initial clearing with this therapy and patients whose UVB phototherapy was discontinued within 3 weeks of clearing. As assessed by life table methods, the time to flare after initial clearing for patients on UVB maintenance therapy was significantly longer than for patients who discontinued UVB within 3 weeks after initial clearing. Our data suggest that continuing UVB phototherapy after initial clearing contributes to the duration of disease control and is justified for many patients. PMID- 3531256 TI - Machiel K. Polano, M.D. PMID- 3531257 TI - Effects of cold, short day and melatonin on thermogenesis, body weight and reproductive organs in Alaskan red-backed voles. AB - This study examined whether cold, short day or melatonin causes reproductive regression and stimulates nonshivering thermogenesis in a subarctic rodent Clethrionomys rutilus. Red-backed voles born and raised at 23 degrees C and 22 h light per day (LD 22:2) at Fairbanks, Alaska (65 degrees N) were exposed in one of six groups to: 1) long day (LD 22:2), 23 degrees C, injected daily with melatonin or saline 2 h before lights out, 2) long day, 3 degrees C, injected daily with melatonin or saline, 3) short day (LD 8:16), 23 degrees C or 3 degrees C. Voles were tested for nonshivering thermogenesis (NST) prior to and after 8 wk exposure. Body weight, testes weight and female reproductive tract weight were assessed after 8 wk in long day and 12 wk in short day. NST was not altered by short day or melatonin but cold (3 degrees C) caused an increase in NST which was similar in long day and short day. Body weight of males and females was not affected by short day but was decreased by melatonin. Short day did not alter mean testes weight (about 20% voles regressed) but reduced mean female reproductive tract weight (more than 40% voles regressed). Melatonin reduced testes weight and female reproductive tract weight (more than 50% of voles of both sexes regressed). The results suggest that in northern red-backed voles: the pineal does not mediate seasonal changes in thermogenic capacity, the pineal may mediate reduction of body weight and regression of reproductive organs but, in addition to day-length, other cues or factors may be important, populations may exhibit variability in sensitivity of reproduction to photoperiod which could allow for opportunistic breeding. PMID- 3531258 TI - Microbial lipases: their characteristics, role in food spoilage and industrial uses. PMID- 3531259 TI - Growth of gram-positive mastogenic bacteria in normal, simulated bulk tank, and mastitic milk held at simulated fluctuating temperatures of farm bulk tank. AB - Growth of Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus agalactiae, Streptococcus dysgalactiae, Streptococcus bovis, and Streptococcus uberis was studied in normal milk, simulated bulk tank milk, and aseptic mastitic milk held at simulated fluctuating temperatures of farm bulk tank for 48 h. With the exception of S. bovis, growth rates of the other five bacteria were similar in both normal and simulated bulk tank milk. Mastitic milk inhibited growth of all bacteria studied. A 24-h adjustment period occurred before most of the bacteria started growing. The mastitis level in a dairy herd may be monitored by cultures of bulk tank milk samples and by calculations as discussed in this study. PMID- 3531260 TI - Effect of crude protein and solubility on performance and blood constituents of dairy cows. AB - Thirty-six mature Holstein cows were assigned at parturition to isocaloric diets of either 14.4 or 19.0% crude protein from highly soluble or insoluble nitrogen sources. The objective was to determine if elevated dietary crude protein affected milk production or serum metabolites. Cows individually were fed blended rations. Hourly blood samples were taken for a 12-h period during wk 1, 4, 7, and 10 postpartum. Rumen fluid samples were taken during wk 2, 4, and 6 postpartum. Cows fed diets containing 19% crude protein of high nitrogen solubility had larger dry matter intakes and tended to produce more milk than cows fed 14.4% crude protein. High crude protein intakes elevated rumen ammonia and blood urea nitrogen. Cows fed high crude protein, low nitrogen solubility diets had increased acetate to propionate ratio in rumen fluid. Serum insulin was increased in cows consuming high crude protein diets, regardless of the protein source. Serum nonesterified fatty acids decreased and albumin and glucose increased with week postpartum. Body weight change and fat-corrected milk production were not affected significantly by protein intake. Protein intakes in excess of requirements have no adverse effect on the production of early postpartum cows. PMID- 3531261 TI - Controlling first service and calving interval by prostaglandin F2 alpha, gonadotropin-releasing hormone, and timed insemination. AB - Our objective was to determine if calving intervals could be shortened and made less variable by using prostaglandin F2 alpha to control the occurrence of first services. Holstein cows (n = 348) were assigned at calving to four treatment groups. Control cows (n = 88) were inseminated at their first observed estrus after 40 d postpartum. Estrous cycles of the remaining cows were synchronized with prostaglandin F2 alpha to allow insemination (first services) 80 h after the second injection (n = 86), insemination at 80 h preceded by gonadotropin releasing hormone at 72 h (n = 86), or insemination at 72 and 96 h (n = 88) after the second injection (51 to 57 d postpartum). By design, interval to first service was reduced to 57 d for treated cows (63 d for controls) and was less variable (12% of that for controls). Conception rate at first service was lower after timed inseminations than that of controls. Intervals to conception and subsequent calving were similar in all treated cows and controls. Of cows sampled, 23 of 176 (13%) failed to respond with luteolysis when progesterone in serum exceeded 1 ng/ml, and 26 of 176 (15%) had low concentrations of progesterone in serum and could not respond to prostaglandin F2 alpha. Poor response to timed inseminations may have occurred because only 72% of 176 cows sampled responded with luteolysis. When only cows observed in estrus were considered, conception rate approached that of controls (51%).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3531262 TI - Acid-etching of caries-like lesions of enamel treated with acidulated phosphate fluoride: an in vitro study. AB - Using the scanning electron microscope and the polarized light microscope, the effects of acid-etching on acidulated phosphate fluoride (APF)-treated caries like lesions of enamel were investigated, with respect to the etching patterns produced and the suitability of those patterns for resin bonding, and the histopathological features of the caries-like lesions. PMID- 3531263 TI - Dental materials: 1983 literature review. Part 2. PMID- 3531264 TI - The treatment of results for tensile bond strength testing. PMID- 3531265 TI - [Esthetic dentistry: a way to look at everything!]. PMID- 3531267 TI - The Journal of Dental Education, Vol. I, No. 1, October, 1936: The preparation of the student for active research or for an appreciation of research: a study with six case histories. By Isaac Schour. PMID- 3531266 TI - [The use of citric acid as a method for regeneration therapy? Review of the literature]. PMID- 3531268 TI - Prognostic significance of initial skin lesions in epidermotropic cutaneous lymphoma. PMID- 3531269 TI - Effect of plant worm extract on mouse hair growth. PMID- 3531271 TI - A tumor with sebaceous differentiation showing intraepidermal epithelioma. PMID- 3531270 TI - Combination therapy of oral methoxypsoralen: photochemotherapy (PUVA) and an aromatic retinoid (etretinate, tigason) in the treatment of psoriasis. PMID- 3531272 TI - A unique case of subepidermal bullous disease. PMID- 3531274 TI - Lupus like syndrome induced by 2-mercaptopropionylglycine. PMID- 3531273 TI - Three cases of erythema nodosum associated with Yersinia enterocolitica infection. PMID- 3531275 TI - Hirsutoid papillomas of vulvae. PMID- 3531276 TI - Definition and classification of eczemas--a pertinent challenge to dermatologists. PMID- 3531277 TI - Burn therapy 1985: acute management. AB - Mortality occurs from a burn injury because of infections which result from the metabolic and bacterial consequences of a large open wound, depression of the host's resistance, and both protein and total caloric malnutrition. Systemic antibiotics, topical wound therapy, and gentle wound debridement constitute traditional burn therapy. The systemic antibiotics and topical wound therapy do not solve problems presented by large open wounds and the related protein and caloric deprivation. A more rational approach uses antibiotics and topical wound therapy only as adjuncts to a program of early operative removal or excision of the devitalized, burned tissue and immediate closure of the wound. The excised wound is normally closed with available autograft, but in massive burn injuries, donor skin is insufficient. In these massive injuries, artificial skin can provide that immediate wound closure. As long as devitalized, burned tissue remains present in the setting of depressed host resistance, cross infection tends to colonize those remaining devitalized burn wounds with more virulent organisms than those that were already present. Bacterial controlled nursing units (BCNU) provide strict protection against that cross infection. Though inevitably a catabolic response occurs with massive injury, intensive nutritional support provides the calories necessary for the response to injury to avoid a prolongation of that negative nitrogen balance. PMID- 3531278 TI - Attenuation measurement uncertainties caused by speckle statistics. AB - Attenuation measurements can be derived from the decay of backscattered signal with depth in an inhomogeneous material. In cases such as liver tissue, where many small inhomogeneities are likely to be included in sample volumes defined by pulse and beam widths, Rayleigh statistics describe the random nature of the magnitude of backscattered pressure. The statistics of speckle underlie the uncertainties in estimates of attenuation at discrete frequencies, and of the magnitude and frequency dependence of attenuation over a bandwidth. This paper derives expressions for the standard deviations of attenuation magnitude and frequency dependence in terms of parameters such as the dimensions of the region of interest, and the bandwidth of the ultrasonic system. Practical examples are given using published data, and comparisons to other techniques which measure "attenuation slope" are made. The analysis yields insights into trade-offs among variables such as the dimensions and shape of regions of interest, and the segmenting of data in time and frequency domain. PMID- 3531279 TI - A computer model for simulating reflected ultrasound signals. AB - This letter describes a model for simulating an ultrasound signal reflected from a medium composed of randomly distributed scatterers, as typified by soft biological tissue, such as liver. The model is specified in terms of the effective transducer beam radius B and the mean scatterer spacing S. The novel feature of the model is that the transducer field is partitioned by packing cylinders, called microbeams, into concentric annular regions that lie parallel to the transducer axis. The radii of the microbeams and the annuli are related to S. An independent reflector sequence is generated for each microbeam, the microbeam sequences in each annulus are summed and convolved with the impulse response of a point reflector. The reflected waveform sequence is then generated by summing the annular contributions and convolving with a band-limited pulse waveform. Simulated signals were generated for different values of B and S and compared with actual signals reflected from two in vivo livers and a tissue equivalent phantom. Estimates of the kurtosis for the simulated signals indicate the range of signals that can be generated by varying the values for S and B. PMID- 3531280 TI - Telematics in the future of health care delivery: implications for nursing. PMID- 3531281 TI - The presidents. Bernerd C. Kingsbury 1955-1956. PMID- 3531282 TI - Veterans Administration cooperative study on hepatitis and dentistry. AB - Personnel in the VA dental facilities were screened for the detection of viral hepatitis and identification of factors implicating infectivity. A total of 963 personnel from 126 dental facilities throughout the United States voluntarily participated in the study. The rate of seroconversion for any hepatitis B markers was approximately 1% per year. Serial positive tests for antibody to hepatitis B core antigen or antibody to hepatitis B surface antigen (or both) were present in 16.2% of dentists and 13.0% of dental auxiliary personnel. Oral and maxillofacial surgeons composed the highest prevalence occupation (24.0%), and clinical personnel composed the lowest prevalence occupation (8.9%). There was a significant association between years in dental environment and serological positivity for viral B infection. The dentists and dental auxiliary personnel had significant linear trends of increasing serological positivity with years in the dental environment. Although a majority of personnel reported wearing gloves while treating high-risk patients or performing invasive procedures, inadequate prophylactic measures were exercised for most patients undergoing a variety of less invasive procedures. The results of the study show the need for an active immunization program against type B viral infection for dental and dental auxiliary personnel, preferably before the initial exposure to the professional environment. PMID- 3531284 TI - Coronary artery bypass surgery to prolong life?: Less anatomy/more physiology. PMID- 3531283 TI - Effective delivery systems for prolonged fluoride release: review of literature. AB - Controlled-release delivery systems have been investigated for use in fluoride therapy as a result of their ability to control the rate and site of fluoride release. Both sustained-release fluoride delivery systems and controlled-release fluoride preparations have been developed, including sustained-release fluoride tablets, fluoride-releasing polymers, microencapsulated fluoride in aerosols, and membrane-controlled fluoride reservoirs. Laboratory and clinical studies have confirmed the ability of these preparations to produce high levels of fluoride in saliva and plaque without toxic or adverse side effects. From these studies, it appears that controlled-release fluoride delivery systems have great potential as effective anticaries agents in cariesprone populations. PMID- 3531285 TI - Quantitative evaluation of regional myocardial blood flow by videodensitometric analysis of digital subtraction coronary arteriography in humans. AB - Videodensitometric analysis of digital subtraction coronary arteriography, a new approach for calculating contrast disappearance half-life (T1/2), was assessed in determining regional myocardial blood flow quantitatively. Forty-one patients with coronary artery disease and 12 with angiographically normal coronary arteries underwent digital subtraction coronary arteriography by manual injection of contrast medium into the left main coronary artery. The T1/2 was calculated from a time-density curve generated in the four sectors of the myocardium perfused by the left anterior descending coronary artery. The mean T1/2 value of the four sectors correlated inversely with the great cardiac vein flow measured by the thermodilution method (r = -0.89), and appeared to be a reliable index of myocardial blood flow. The relation of mean T1/2 with percent stenosis of the left anterior descending coronary artery was curvilinear (r = 0.88) and an abnormally high T1/2 occurred in patients with coronary stenosis greater than 75%. In patients with comparable stenosis of the left anterior descending artery, the apical T1/2 was significantly increased in those with impaired apical wall motion, while it was significantly decreased in those with coronary collateral vessels. These findings suggest that regional myocardial blood flow begins to decrease in vessels with greater than 75% stenosis, and that myocardial contraction and collateral flow are additional factors that modify regional myocardial blood flow. Thus, the contrast disappearance half-life (T1/2) derived by computerized washout analysis of digital subtraction coronary arteriograms proved useful as an index for quantitative evaluation of regional myocardial blood flow. PMID- 3531286 TI - The promise of digital cardiac angiography. PMID- 3531287 TI - Real-time Doppler color flow mapping for detection of patent ductus arteriosus. AB - In this study, ultrasound Doppler color flow mapping systems were utilized to examine flow in the pulmonary artery in 31 premature and term infants (aged 4 hours to 9 months) with patent ductus arteriosus accompanying respiratory distress syndrome, as an isolated lesion, or with patent ductus in association with other cyanotic or acyanotic congenital heart disorders. The flow mapping patterns were compared with those of a control population of 15 infants who did not have patent ductus arteriosus. In unconstricted ductus arteriosus, the flow from the aorta into the pulmonary artery was detected in late systole and early diastole and was distributed along the superior leftward lateral wall of the main pulmonary artery from the origin of the left pulmonary artery back in a proximal direction toward the pulmonary valve. In constricted patent ductus arteriosus, or especially in a ductus in association with cyanotic heart disease, the position of the ductal shunt in the pulmonary artery was more variable, often directed centrally or medially. Waveform spectral Doppler sampling could be performed in specific positions guided by the Doppler flow map to verify the phasic characteristics of the ductal shunt on spectral and audio outputs. Shunts through a very small patent ductus arteriosus were routinely detected in this group of infants, and right to left ductal shunts could also be verified by the Doppler flow mapping technique. This study suggests substantial promise for real-time two dimensional Doppler echocardiographic flow mapping for evaluation of patent ductus arteriosus in infants. PMID- 3531289 TI - Application of the office or home computer to searching the medical literature. AB - Search of the medical literature has, until recently, most often been conducted by medical librarians. The recent development of "user friendly" systems and competition among an increasing number of commercial and non-commercial vendors now provide the opportunity to personally conduct literature searches using a home or office computer without enormous investment in time, training or equipment. Hardware requirements and general principles of computerized literature searching are described, and the various services available for individual subscription are summarized, including National Library of Medicine (NLM) MEDLINE; Bibliographic Retrieval Services (BRS) and BRS/Saunders Colleague; PaperChase; Dialog/Knowledge Index; American Medical Association (AMA) Minet; and MEDIS. PMID- 3531288 TI - The changing role of the exercise electrocardiogram as a diagnostic and prognostic test for chronic ischemic heart disease. AB - The exercise electrocardiogram has been the subject of intense research over the last 50 years, as both a diagnostic and prognostic method to assess patients with chronic ischemic heart disease. In 1986, the strengths and limitations of the technique to predict coronary and multivessel disease in clinical patient subsets are understood. The diagnostic accuracy of the test is improved by consideration of Bayesian theory, multivariate models and new non-ST segment criteria. Post test coronary disease risk estimates are best reported in terms of a conditional probability, rather than statements of "positive" or "negative." The value of exercise testing in prognostic risk stratification is considerably enhanced by recent reports of long-term follow-up data in asymptomatic and symptomatic patients. Powerful prognostic information can be obtained when the clinical, electrocardiographic and physiologic data from the exercise test are used to formulate the post-test risk of a cardiac event, even in patients whose coronary anatomy is known. The changing role of the exercise electrocardiogram as a diagnostic and prognostic test is reviewed, with emphasis on the strengths and limitations of the procedure. PMID- 3531290 TI - John M. Sheldon lecture. Host-defense mechanisms responsible for lung injury. PMID- 3531291 TI - Species-specific allergens from the salivary glands of Triatominae (Heteroptera:Reduviidae). AB - We investigated allergenic cross-reactivity among species of the blood-feeding insects of the subfamily Triatominae. By skin testing, patients allergic to either Triatoma protracta or T. rubida gave positive responses only to the respective salivary antigen. RAST-inhibition experiments demonstrated that binding of IgE antibodies to T. protracta antigen was not inhibited by salivary extracts from T. rubida, T. cavernicola, T. rubrofasciata, or Rhodnius prolixus. The same level of species specificity was found for IgE antibodies to T. rubida. By direct RAST, no T. rubida positive serum bound T. protracta antigen, and 29 of 30 T. protracta positive sera failed to bind T. rubida. One serum from a T. protracta-allergic patient contained IgE antibodies to both T. protracta and T. rubida. RAST-inhibition experiments demonstrated that these antibodies did not cross-react and that this person had separate species-specific antibodies to T. protracta and T. rubida antigens. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis analysis of salivary extracts demonstrated that the lower molecular weight bands that contain the antigens responsible for human allergic reactions differed in number and size in all species tested. These studies demonstrate species specificity for the allergic response to Triatoma and stress the importance of accurate insect identification and the need for species specific antigens for diagnosis and immunotherapy. PMID- 3531292 TI - Identification and partial purification of species-specific allergens from Triatoma protracta (Heteroptera:Reduviidae). AB - This article describes the immunochemical characterization of allergens from Triatoma protracta, a hematophagous insect that causes IgE-mediated anaphylactic reactions when it bites sensitized allergic persons. Comparison of the allergenic potency of T. protracta salivary gland extract, thoracic and abdominal hemolymph, and a whole body extract by RAST inhibition demonstrated that salivary glands were the main source of T. protracta allergens. Concentrated salivary gland extracts were purified by gel filtration and isoelectric focusing. Fractions were tested for allergenic activity by RAST inhibition and for protein purity by polyacrylamide gel electrophoresis and immunoelectrophoresis. Two protein peaks were obtained on gel filtration. The high-molecular-weight peak contained a 70,000 MW protein/glycoprotein that had little allergenic activity. The low molecular-weight peak comprised six proteins, molecular weight 17,000 to 25,000, and T. protracta allergen(s) eluted in parallel with this peak. These proteins were resolved by isoelectric focusing, and two fractions, pI 6.7 to 7.3 and pI 8.2, contained most of the allergenic activity. By RAST, 25/28 sera from T. protracta-allergic patients contained IgE antibody to these fractions, suggesting that they were major allergens. Each fraction demonstrated a single precipitin arc on immunoelectrophoresis and two bands, molecular weight 18,000 to 20,000, on gel electrophoresis. Cross-inhibition radioimmunoassays demonstrated that each fraction completely inhibited binding of the other fraction to IgE antibody, suggesting that they contained different isoelectric forms of the same allergen. PMID- 3531293 TI - Children's attitudes toward the mentally ill as reflected in human figure drawings and stories. PMID- 3531294 TI - The effect of prednisone on the levels of serum albumin of 20 patients with renal transplants. PMID- 3531295 TI - Low-dose captopril in mild to moderate geriatric hypertension. AB - The safety and efficacy of captopril in geriatric patients with mild to moderate hypertension was examined in an eight-week multicenter study of 99 patients. Following a placebo period, patients were treated with captopril 25 mg twice daily. Patients who were uncontrolled after two weeks of active therapy were randomized to either captopril 25 mg plus hydrochlorothiazide 15 mg or captopril 50 mg twice daily. The average decrease in blood pressure at study completion was -16.9/11.9 mmHg. At the conclusion of the trial, 75.8% of patients responded to therapy. Captopril was well tolerated and believed to be a good therapeutic alternative for treating hypertension in the elderly population. PMID- 3531296 TI - Agitated behaviors in the elderly. I. A conceptual review. AB - Agitation is a significant problem for the elderly, their families, and their caretakers. Although much of the literature on agitation is pharmacologic in nature, several papers demonstrate demographic and environmental approaches to the problem. The literature review accentuates the gaps in both assessment and knowledge of the phenomenon. A conceptual framework and a rigorous methodology need to be developed for studying agitation. On these bases, research could explore the manifestations of agitation and the frequency of occurrence, predisposing factors for agitation, precipitating factors which trigger agitation, consequences of agitation for the elderly and for their caretakers, and the efficacy of alternative interventions. This paper proposes a definition of agitation and develops an initial conceptual framework in which to examine it. PMID- 3531297 TI - Medical care of veterans. A brief history. PMID- 3531298 TI - Mutagenicity testing of selected analgesics in Ames Salmonella strains. AB - Acetaminophen (APAP), aspirin (ASA), phenacetin (PA) and ibuprofen (IB) were tested for mutagenic activity in the Ames Salmonella plate incorporation assay using strains TA98, TA100, TA1535, TA1537 and TA1538. These analgesics were tested in four separate tests: without metabolic activation, and in the presence of a rat, hamster or mouse liver post-mitochondrial supernatant (S-9, Aroclor 1254-induced). Treatment of all five strains of Salmonella with APAP, ASA or IB under all four metabolic conditions did not induce any appreciable increases in revertant colony counts, as compared to the negative controls. A dose-related increase in revertant colony counts, reaching levels twice the negative control values, were seen with PA at doses greater than or equal to 500 micrograms per plate. This response was only seen in strain TA100 in the presence of hamster S 9. Therefore, these findings constitute a positive result for PA in the Ames test. APAP, ASA and IB did not show any mutagenic potential under these conditions of testing. These findings are discussed along with previously published results concerning the genotoxicity of these analgesics. PMID- 3531299 TI - Screening pesticides for their ability to damage bacterial DNA. AB - Twenty-six pesticides and pesticide degradation products were screened (125 micrograms - 2000 micrograms) for their ability to induce unrepairable damage to bacterial DNA. Three repair test systems were utilized in this study, the Salmonella typhimurium (TA1538/TA1978), the E. coli K-12 (Pol A1+/Pol1-) and the E. coli WP2 (WP2, WP2uvrA, WP67, CM611 and CM571). Aldicarb (1000 micrograms), benomyl (250 micrograms), 2-aminobenzimidazole (2000 micrograms), captan (125 micrograms), fenazalor (500 micrograms), 5,6-dichloro-2 trifluoromethylbenzimidazole (NC-2983) (250 micrograms), isothymol (250 micrograms), maleic hydrazide (1000 micrograms), pentachloronitrobenzene (1000 micrograms) were DNA-damaging to one or more bacterial test systems. Isothymol and NC-2983 affected all three test systems. Chlorinated hydrocarbon insecticides, some being recognized as carcinogens, did not produce a zone of inhibition in any of the tester strains possibly due to their poor solubility and diffusion in the agar overlay. It was concluded that these tests can be performed along with bacterial reversion tests to complement each other as short-term screening tests for potential carcinogens and mutagens. PMID- 3531300 TI - Maternal insulin and placental 3-O-methyl glucose transport. AB - The effects of insulin in the maternal circulation on the placental clearance of 3-O-methyl glucose were investigated in 7 animals in the presence of a constant maternal glucose concentration. While maternal insulin concentration changed from 12 +/- 4 to 175 +/- 33 mu Units/ml, the placental clearance remained constant at 16.2 +/- 1.2 (control) and 15 +/- 1.3 ml/min per kg fetus under the influence of the insulin. To test the secondary hypothesis that in the control condition the hexose transport system was saturated, we performed a further series of experiments in 6 fasted animals. In these animals the control maternal plasma insulin concentration was 2 +/- 0.3 mu Units/ml and after the infusion of insulin it increased to 562 +/- 26 mu Units/ml. Under conditions of constant maternal and fetal plasma glucose concentrations, this massive elevation of plasma insulin did not change the placental clearance of 3MeG which was 15.2 +/- 1.6 in the control condition and 13.3 +/- ml/min per kg under the influence of high insulin. We conclude that maternal insulin ranging from 2 mu Units/ml to supraphysiologic doses does not effect a physiologically significant change in placental hexose transfer. Placental glucose transfer can probably therefore, be changed only be changing the concentration of glucose in the maternal and fetal plasma. PMID- 3531301 TI - Effect on maternal and fetal renal function and plasma renin activity of a high salt intake by the ewe. AB - The effect on renal function of replacing maternal drinking water with a solution containing 0.17 M NaCl was studied in 9 ewes and their chronically catheterised fetuses over a period of 9 days. Maternal sodium intake increased from control values of 2.19 +/- 0.09 mmol/h to 44.3 +/- 7.4 (P less than 0.001) and 46.3 +/- 6.5 mmol/h (P less than 0.001) on the 3rd and 6th days of salt ingestion. Maternal plasma sodium levels were not affected, but the urinary sodium/potassium ratio increased from 0.15 +/- 0.07 to 2.26 +/- 0.34 (P less than 0.001) after 6 days and plasma renin activity fell from 2.87 +/- 0.76 to 1.00 +/- 0.25 ng/ml per h (P less than 0.05). The changes in maternal sodium intake had no effect on fetal plasma sodium levels nor on fetal plasma renin activity. Sodium excretion and fetal urinary sodium/potassium ratio did not change. However, 3 days after the ewes returned to drinking water fetal plasma renin activity was significantly higher than it was prior to maternal ingestion of 0.17 M NaCl. Fetal plasma renin activity was inversely related to fetal plasma sodium levels (P less than 0.01). The results show that changes in maternal sodium intake had no long term effect on fetal plasma sodium levels nor on fetal renal sodium excretion. The fall in maternal plasma renin activity in the absence of any change in the fetal renin activity, indicates that the fetal renin angiotensin system is controlled by factors other than those influencing the maternal renin angiotensin system. Since fetal urinary sodium/potassium ratios remained unchanged it would suggest that fetal sodium excretion is not influenced by maternal levels of aldosterone. PMID- 3531302 TI - Monoclonal antibodies to cytotrophoblast and syncytiotrophoblast of human placenta. AB - Mouse monoclonal antibodies were raised against plasma membranes-enriched fractions of 8-12 week placental villi. Several antibodies were obtained and three of these are described in detail: ED822 reacts with the outer membrane of the syncytiotrophoblast; ED235 reacts with the cytotrophoblast layer; ED341 reacts with the whole trophoblastic layer. Antibodies ED235 and ED341 were useful markers for identification of trophoblast cells in culture. PMID- 3531303 TI - Age dependent heart rate responses to prostacyclin (PGI2) in unanaesthetized fetal and neonatal sheep. AB - Intravenous injections of PGI2 (1.5-12 X 10(-5) nmol/ml blood volume) caused hypotensive responses which increased with dose in both fetal and neonatal sheep. In the fetus, as gestation advanced and basal heart rate declined, the predominant heart rate response to PGI2 changed progressively from bradycardia to tachycardia. In the neonate, PGI2 always induced tachycardia and the effect was unrelated to postnatal age. The bradycardia induced by PGI2 in young fetal sheep (123-132 days) was converted to tachycardia following either bilateral vagotomy or cervical cord transection. Heart rate was unchanged by PGI2 in fetal sheep subjected to both procedures. The depressor response to PGI2 was enhanced by cervical cord transection but was essentially unchanged in fetal sheep subjected to either bilateral vagotomy alone or combined vagotomy and cord section. Despite increased plasma renin activity following PGI2, the cardiovascular response was not modified by bilateral nephrectomy. It is concluded that while intravenous PGI2 has a similar depressor effect in both fetal and neonatal sheep the heart rate response is age-dependent. Bradycardia is the principal response in young fetal sheep and is mediated by vagal pathways while tachycardia, which is the more usual response in older sheep, is probably sympathetic in nature. PMID- 3531305 TI - Silicone rubber carpal implants: a study of the incidence of late osseous complications. AB - This clinical review of 53 silicone rubber carpal implants done by the senior author (P. R. C.) between 1976 and 1983 determines the incidence of so-called "silicone rubber synovitis." Although previously reported in small series, the true incidence of this complication of wear of the implant has not been documented. In this study late radiographic follow-up demonstrated lytic lesions adjacent to the carpal implants in 75% of the scaphoid implants, 55% of the lunate implants, and 75% of the scapholunate implants. In patients with x-ray film evidence of lytic lesions, more than half (56%) complained of pain, and more than one fourth (27%) have already had revision surgery. In every patient who had reoperation in this study, the histologic examination of the tissue in the wrist showed a chronic granulomatous process identical to that previously reported in cases of so-called "silicone rubber synovitis". These "lytic lesions" must be differentiated from "degenerative cysts" that are a part of the natural progression of degenerative arthritis. Four cases were submitted for mass spectrophotometric analysis, and the positive identification of the silica atom was made in all four. This study shows that the wear of carpal bone implants of silicone rubber and subsequent "silicone rubber synovitis" are common occurrences and not rare as has been previously inferred from isolated case report studies. This study suggests that implantation of these implants in young, healthy individuals is rarely indicated, and careful follow-up of patients who already have these implants in place is important.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3531304 TI - Reactive synovitis after silicone arthroplasty. AB - A number of patients with silicone rubber implants performed by us and other surgeons initially had excellent results; however, they returned with swelling and discomfort. We studied 18 patients ranging in age from 16 years to 57 years who presented 8 to 78 months (average, 31.7 months) after silicone arthroplasty (four scaphoid, six lunate, one scapholunate, four finger, two wrist, one trapezium, and one ulnar head for metacarpal hemiarthroplasty). Erosive osteolysis was seen on x-ray films, with progressive destruction evident in patients followed serially. None of the patients' conditions responded to conservative care. The severity of the proliferative, inflammatory synovitis and the foreign material in the multinucleated giant cells correlated with the interval since arthroplasty. Implant surface analysis by scanning electron microscope and x-ray spectrometer showed that silicone microparticles were the result of implant degeneration and erosion. All joint cultures were negative. Silicone particulate synovitis and destruction were arrested by the removal of the implant, a synovectomy, and curettage of the lytic lesions at salvage (resection arthroplasty or arthrodesis). Patients who have had silicone arthroplasties should be followed indefinitely, at regular intervals, by x-ray films and clinical examination. PMID- 3531306 TI - Scientific requirements for diagnostic tests in gastroenterology. AB - Diagnostic tests in gastroenterology ought to help clinicians provide effective patient care. However, this may not be achieved if a promising new test is widely advocated before it has undergone a thorough scientific evaluation. Adherence to a set of common sense scientific requirements, such as those presented here, both provides quality control for diagnostic test research and assists clinicians to appraise critically the results of this research and determine for themselves the accuracy and usefulness of a new diagnostic test. PMID- 3531307 TI - The efficacy of endoscopy in the evaluation of dyspepsia. A review of the literature and development of a sound strategy. AB - Diagnostic approaches to the patient with dyspepsia include immediate evaluation with an upper gastrointestinal series, immediate study with esophagogastroduodenoscopy (EGD), or empiric medical treatment, reserving diagnostic evaluation for patients with complications and persistent symptoms after therapy. A literature review of dyspepsia as a symptom, and of duodenal ulcer, gastric ulcer, gastroduodenitis, and gastric cancer summarizes how the diagnostic approaches to the dyspeptic patient affect the precision of diagnostic information, efficacy, patient outcome, and cost. For patients without clinically obvious disease, an approach is developed which reduces cost and retains optimal patient management. The strategy proposes the use of empiric medical therapy while reserving EGD for those few dyspeptic patients who have no or minimal response to therapy after 7 to 10 days, and for the approximately 30% of patients whose symptoms persist, improved, but not resolved after a 6 to 8 week period. PMID- 3531308 TI - A multicenter study of ranitidine treatment of duodenal ulcers in the United States. AB - Treatment of duodenal ulcer with the histamine H2-receptor antagonist, ranitidine, was assessed in a double-blind, randomized, multicenter trial in which patients were treated for two consecutive 4-week periods with ranitidine 150 mg b.i.d. or a placebo. All patients were allowed to take antacids as necessary for symptoms. Three hundred eighty-two patients were entered and 355 completed the first 4-week trial period. Ranitidine significantly improved healing at 2 weeks (37 versus 19%, p less than 0.01) and at 4 weeks (73 versus 45%, p less than 0.01), with better relief of pain and lower use of antacids. In the second 4-week trial period, 124 unhealed patients from the first 4 weeks were re-randomized. Ranitidine treatment resulted in a greater healing rate regardless of previous treatment (p less than 0.05). In this trial, side effects were uncommon and not different between placebo and the tested drug. One case of hepatitis in the ranitidine treated group was presumed on the evidence to be non A non-B. Ranitidine is effective and appears to be safe in the treatment of duodenal ulcer and its symptoms. PMID- 3531309 TI - A single nighttime dose of ranitidine 300 mg versus ranitidine 150 mg twice daily in the acute treatment of duodenal ulcer: a European multicenter trial. AB - Six hundred and five patients with endoscopically diagnosed duodenal ulcer were randomly allocated to treatment with ranitidine 300 mg at night or ranitidine 150 mg twice daily in a prospective double-blind multicenter trial conducted in nine European countries. Endoscopy at 4 weeks showed complete ulcer healing in 246 of 301 patients (82%) treated with ranitidine 150 mg b.i.d. and 230 of 304 patients (76%) treated with ranitidine 300 mg at night. Cumulative healing rates at 8 weeks were 95 and 94% respectively. Both treatment regimens were equally effective at rapidly reducing the incidence of ulcer-related symptoms. Adverse events were few and consistent with those reported in previous studies with ranitidine 150 mg twice daily. The results of this trial indicate that a single nighttime dose of ranitidine is an effective and safe alternative to the twice daily regimen in the acute treatment of duodenal ulcer. PMID- 3531311 TI - Reduction of aspirin-induced gastroduodenal mucosal damage with ranitidine. AB - A randomized, double-blind, placebo-controlled study was conducted to determine if concomitant administration of ranitidine, an H2-receptor antagonist, could reduce the gastroduodenal mucosal damage associated with short-term (3 day) aspirin therapy. Nineteen subjects received ranitidine 150 mg b.i.d. plus aspirin 650 mg q.i.d., and 21 received placebo b.i.d. plus aspirin 650 mg q.i.d. for 3 days. Gastric injury and duodenal injury were assessed separately on the basis of pre- and posttreatment endoscopic examinations. The ranitidine/aspirin group had significantly less mucosal damage in the stomach (p less than or equal to 0.01) and duodenum (p less than 0.05) than the placebo/aspirin group. There was no significant difference in mean serum salicylate levels between treatment groups after 3 days of aspirin consumption, indicating that the protective effect was achieved without compromising salicylate absorption. PMID- 3531310 TI - Treatment of benign chronic gastric ulcer with ranitidine. A randomized, double blind, and placebo-controlled six week trial. AB - A randomized, multicenter, double-blind, placebo-controlled study was conducted to determine whether ranitidine 150 mg b.i.d. for 6 weeks would expedite endoscopic healing or relief of symptoms in patients with benign gastric ulcer. Of 203 patients enrolled, 101 received ranitidine and 102 received placebo. Endoscopic evaluations were conducted at baseline and at 2 and 6 weeks. At 6 weeks 68% of the patients treated with ranitidine had healed compared with 53% in the placebo group (p = 0.02). In those patients who had not healed by 6 weeks, ranitidine provided greater relief from pain than placebo. More patients in the placebo group dropped out of the study because of worsening symptoms (13 versus 4, p = 0.04). No differences in laboratory abnormalities or incidence of adverse events were detected between the two study groups. These results indicate that ranitidine 150 mg b.i.d. is superior to placebo in the treatment of benign gastric ulcer. PMID- 3531312 TI - Intramural gastrointestinal hemorrhage. AB - Intramural gastrointestinal hemorrhage should be suspected in patients taking anticoagulants who develop acute abdominal symptoms with clotting parameters out of the therapeutic range. Likewise, patients with inherent bleeding disorders may present with intramural hemorrhage. Characteristic features are seen on radiological examination; ultrasonography or computed tomography may be valuable noninvasive diagnostic approaches. The diagnosis may be supported by abdominal paracentesis. Surgical intervention is not necessary as conservative treatment, with replacement of clotting factors leading to rapid recovery. PMID- 3531314 TI - A controlled trial of cimetidine for the treatment of nonulcer dyspepsia. AB - Sixty patients with nonulcer dyspepsia took cimetidine 1 g daily or a placebo for 5 weeks in a double-blind trial. Thirty-four men and 26 women with normal double contrast barium meals were included. Five percent had the endoscopic appearances of duodenitis. Symptoms improved during treatment in 62% of those taking cimetidine and in 54% of the placebo group (NS, p = 0.5). We suggest that significant duodenitis is uncommon in the absence of active or quiescent duodenal ulcer disease. From this study there is no evidence that cimetidine benefits those patients with normal double-contrast barium meals and no duodenitis endoscopically who nonetheless have symptoms similar to those of peptic ulcer disease. PMID- 3531313 TI - A comparison of two different doses of omeprazole versus ranitidine in treatment of duodenal ulcers. AB - In a study involving three centers, 105 patients with duodenal ulcer proven by endoscopy were randomly assigned to treatment with either the H+, K+, ATPase inhibitor omeprazole (20 mg or 40 mg taken as a single morning dose), or ranitidine (150 mg morning and night). It was a double-blind study using a double dummy technique. Clinical assessment and laboratory investigations were carried out at 2, 4, and 8 weeks; endoscopy was done at 2 weeks, and if not healed, at 4 and 8 weeks. The patients in the three treatment groups were well matched. Significantly more patients treated with omeprazole healed compared with ranitidine at 2 weeks (p = 0.007) and at 4 weeks (p = 0.007), but there was no statistically significant difference between the two omeprazole groups. Pain was of similar severity at the start in all groups, but patients treated with omeprazole had fewer days with pain (median values being omeprazole 20 mg: 2 days; omeprazole 40 mg: 1 day; ranitidine: 7 days). The difference between the combined omeprazole groups and ranitidine was significant (p less than 0.02). There was also a tendency towards less severe daytime pain on omeprazole during the first week. The difference was statistically significant between omeprazole (40 mg) and ranitidine for days 2-7 (p less than 0.01). No change in laboratory screen attributable to drug treatment occurred. After healing, 79 patients entered a 6-month follow-up study with endoscopy at 3 and 6 months or whenever symptoms occurred. After 6 months relapses occurred in 14/24, 19/23, and 15/25 after 20 mg omeprazole, 40 mg omeprazole, and ranitidine, respectively.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3531315 TI - A comparison of sucralfate dosage schedule in duodenal ulcer healing. Two grams twice a day versus one gram four times a day. AB - The conventional dosage schedule for sucralfate is 1 g 4 i.d., but a dose of 2 g 2 i.d. may be equally effective in duodenal ulcer healing. We compared the efficacy of these two regimens in duodenal ulcer healing. Seventy-seven patients with endoscopically proven duodenal ulceration were entered into a double-blind, controlled study and randomized to treatment with sucralfate 2 g 2 i.d. (on waking and at bedtime) or 1 g 4 i.d. (1/2 h before meals and at bedtime). The patients were endoscoped before entry into the study, after 4 weeks, and after 8 weeks if unhealed at 4 weeks. Of the patients considered suitable for analysis at 4 weeks, 79% (26/33) of those taking 2 g 2 i.d. had healed ulcers in comparison to 72% (23/32) of those taking 1 g 4 i.d. After 8 weeks, cumulative healing rates were 85% (28/33) and 80% (24/30), respectively. The results suggest that the more convenient dosage schedule of 2 g 2 i.d. is as effective as the 1 g 4 i.d. regimen in the short-term treatment of duodenal ulcer. PMID- 3531316 TI - Functional dyspepsia. Symptoms and underlying mechanism. AB - We define the concept of functional dyspepsia and analyze the putative mechanisms involved in its pathogenesis. We consider the evidence for gastroduodenitis, including the relationship of spiral organisms and viruses in this entity, and for functional dyspepsia as a manifestation of gastric secretory dysfunction and upper gut dysmotility. Functional dyspepsia is probably a heterogeneous condition in which multiple etiopathogenetic mechanisms are involved. Nevertheless, patients with functional dyspepsia constitute a sizable fraction of gastroenterological practice and therefore this disorder deserves intense research. PMID- 3531317 TI - What about R.A. Fisher's statement of the "too good" data of J.G. Mendel's Pisum paper? AB - Mendel was accused by Fisher that his observed data, which corresponded to expectations, were too good to be true, and, further, that Mendel, growing only 10 plants per offspring, disregarded in his genotypical analysis the loss of recessives by assuming a ratio of 1:2 instead of 1.1126:1.8874. In contrast, it is proposed here that all chi-square statistics of genetic segregations fall short because the variance of genetic segregations is smaller and not of a binomial type as assumed. Furthermore, this variance and the corresponding chi square statistics are not homogeneous in different segregation types. Consequently, it is not possible to summarize the different chi-square statistics as Fisher did. It is only in this way that he was able to obtain his unrealistic result (a probability of "seven times in 100,000 cases"). Regarding Fisher's second accusation, it should be taken into account that Mendel selected his 10 plants from offspring with a finite and not an infinite number of entities. Although this number is different from offspring to offspring, the average number is about 30. This means that the loss of recessives must be calculated by using a hypergeometric and not a binomial model as Fisher did. Consequently, the real deviation from the 1:2 ratio can be disregarded. PMID- 3531318 TI - [In memoriam Friedrich Sanides. 7 March 1914-20 December 1984]. PMID- 3531319 TI - [Electron microscopy and ultrahistochemical studies on the innervation of the vagotomized dog pancreas]. AB - The ultrastructural features of axon profiles and synapses within islets of Langerhans and pancreas have been examined after a bilateral truncular vagotomy (1, 2 and 20 weeks). The results are as follows: The cholinergic and noradrenergic axons were not reduced according to controls. The integrity of neuro-cellular synapses was unchanged in the pancreas and islets of Langerhans. Intrinsic axon profiles formed synapses with A- and B-cells and acinous cells 2 or 20 weeks after vagotomy. It is concluded that the innervation of the endocrine and exocrine pancreas cells remains unchanged after extrinsic denervation (vagotomy). PMID- 3531320 TI - Lesbian history: a history of change and disparity. PMID- 3531321 TI - A note on May Sarton. PMID- 3531322 TI - Love between women in 1928: why progressivism is not always progress. AB - Because lesbianism, as described by sexologists of the late 19th and early 20th centuries, was treated overtly in a number of novels of the 1920s, while earlier literature seemed seldom to recognize its existence, it appeared that what had been a taboo subject suddenly "came out of the closet" in a liberal and sophisticated era. In fact, fiction of earlier eras often dealt with love between women in the most romantic and positive terms. The fiction of the 1920s was no more frank about affection between women than its predecessors, but it differed from earlier work by depicting women who loved other women as congenitally abnormal, neurotic, peculiar, or outcast. These changes in the literary view of love between women came about because the spread of sexology "wisdom" created a hitherto seldom acknowledged category of abnormality. Women's increasing economic independence opened the possibility of permanence in such relationships, posing an ostensible threat to heterosexuality. And the new interest in companionate marriage encouraged heterosociality and heterosexuality as it had not been encouraged before, to the exclusion of love between women. PMID- 3531323 TI - Strange country this: lesbianism and North American Indian tribes. AB - This article is an exploration of historical names and functions of gay and lesbian people among traditional North American Indian tribes. Some detailed descriptions of individual offices are included, such as "manly hearted" women and shamanic cross-dressing men, as well as the original definition of "dyke" and "ceremonial lesbian" as described by Paula Gunn Allen (Laguna Pueblo). PMID- 3531324 TI - To write "like a woman": transformations of identity in the work of Willa Cather. AB - Willa Cather's early life resembles one of the histories in Jonathan Katz's Gay American History. Her cross-dressing, invention of a male pseudonym, and details of behavior, together with her love for two women in her adulthood, Isabelle McClung and Edith Lewis, make it clear that Cather was a lesbian. Defensive about One of Ours, Cather nonetheless wrote much of her fiction in a male persona--A Lost Lady, The Professor's House, "Tom Outland's Story," Death Comes to the Archbishop, O Pioneers!, My Antonia, and One of Ours, as well as numerous short stories. Much of the fictional material in these works is curiously inconsistent with the male persona, but instead resembles lesbian experiences: the inaccessibility (to the narrator) of women who are nonetheless accessible to other men, absolute heartbreak at the untouchability of the women rather than anger or guilt or the search for sexual release elsewhere, and the women's intimacy with the men involved, as in One of Ours or O Pioneers!, without any suggestion of sexual involvement or explicit sexual history. Lesbian isolation, in adolescence at any rate, produces such situations; Carson McCullers's and some of May Sarton's work are cases in point. Speaking in masquerade, Cather is capable of describing lesbian experience with a fullness and unconsciousness which is now impossible. Innocence gave way to guilty self-consciousness, and that to politically conscious rebellion. The gain is in honesty, but Cather's record of lesbian experience, under whatever disguise, is nonetheless irreplaceable. PMID- 3531325 TI - My gay Antonia: the politics of Willa Cather's lesbianism. AB - Although Willa Cather's lesbianism has recently been publicly acknowledged, her personal and artistic political decisions about the revelation of her sexual preference have not been explored. Most critics who acknowledge Cather's homosexuality see no traces in her fiction of what Lillian Faderman calls "same sex love." Because of the political consequences of writing openly about lesbianism in the time that Cather came of age, according to Faderman, "perhaps she felt the need to be more reticent about love between women than even some of her patently heterosexual contemporaries because she bore a burden of guilt for what came to be labeled perversion." While it would certainly have been possible for Cather to live a discreet lesbian life without showing traces of her sexuality in her writing, it is more likely that her sexual preferences are present in her works, particularly in her most autobiographical book, My Antonia, in the character who represents Cather, Jim Burden. The "emptiness where the strongest emotion might have been expected," the relationship between Antonia and Jim, is more understandable when we realize that both Jim Burden and Antonia Shimerda were imagined by Cather as homosexuals whose deep friendship was based on mutual understanding of their oddness in the heterosexual world of 1918. PMID- 3531326 TI - From lesbian heroine to devoted wife: or, what the stage would allow. AB - Plays written by English women on the same historical subject appeared in 1696 and 1841. The earlier play, written in a period of active feminism, features Agnes de Castro as a lesbian heroine, probably the first in English stage history. The second, written in the age of Solomon Grundy, characterizes de Castro as a self-sacrificing, devoted heterosexual wife. Since both plays were written by women who would now be defined as lesbians, the treatment of the heroine seems more a reflection of audience than author. Study of the two plays with their sources and their authors' lives reveals much about audiences and the pressures a homophobic society can exert on lesbian artists who write for a living. PMID- 3531327 TI - Responder strain-specific enhancement of endothelial and mononuclear cell Ia in delayed hypersensitivity reactions in (strain 2 X strain 13)F1 guinea pigs. AB - This study was undertaken to test the hypothesis that preferential responder strain-specific Ia expression can be detected in delayed hypersensitivity (DH) skin reactions. Seven adult (strain 2 X strain 13)F1 and two strain 13 guinea pigs were sensitized with poly-L glutamic acid-lysine (GL), poly-L glutamic acid tyrosine (GT), and bovine insulin in complete Freund's adjuvant, and were skin tested with GL, GT, PPD, bovine insulin, porcine insulin (which has the same B chain as bovine insulin), and saline. Strain 2 guinea pigs react with bovine insulin A chain, GL, and PPD but not with GT or the bovine insulin B chain, whereas strain 13 guinea pigs react with bovine insulin B chain, GT, and PPD but not with GL or bovine insulin A chain. The (2 X 13)F1 animals had positive DH responses to GT, GL, PPD, and bovine insulin. At 24 hr, areas of induration were measured and the test sites and draining lymph nodes were biopsied. Cryostat sections were stained with monoclonal antibodies to strain 2 Ia, strain 13 Ia, and Ia framework determinants with immunoperoxidase. Stained dermal and subdermal inflammatory cells and vessels were counted on coded slides. In GT tests, there was more staining of dermal and subdermal cells and vessels for strain 13 Ia than strain 2 Ia (p less than 0.02). In bovine insulin tests there was more staining of dermal cells and vessels for strain 13 than strain 2 Ia (p less than 0.05). In GL tests there was more staining on dermal vessels and subdermal cells and vessels of strain 2 Ia than strain 13 Ia (p less than 0.05). There was much greater staining of strain 2 Ia of dermal cells and vessels in GL tests compared with strain 2 Ia staining in GT and bovine insulin tests (p less than 0.02, cells; p less than 0.01, vessels). No significant differences between strain 2 and strain 13 Ia expression were found in PPD, porcine insulin tests, saline controls, or in lymph nodes that drained sensitization sites from animals in which GL and GT had been injected on different sides. Anti-Ia framework expression generally correlated with the greater parental strain Ia in each reaction. These findings and previous observations in experimental allergic encephalomyelitis suggest that responder type Ia may be selectively found in vivo on mononuclear and endothelial cells in sites of T cell-mediated hypersensitivity reactions. PMID- 3531328 TI - Cross-linking of insulin receptors to MHC antigens in human B lymphocytes: evidence for selective molecular interactions. AB - Molecular interactions between insulin receptors and MHC antigens were investigated in human B cells. Two B lymphoblastoid cell lines, IM-9 and 526, chosen for their high insulin binding capacity, were found to express 15,000 and 25,000 insulin receptors per cell, respectively. Insulin receptors were labeled with a 125I-photoreactive insulin analogue, and all other surface proteins by lactoperoxidase-catalyzed radioiodination. Neighbor proteins were cross-linked with a cleavable homobifunctional reagent dithio-bis-(succinimidyl propionate) (DSP) and solubilized before immunoprecipitation by anti-HLA monoclonal antibodies. Gel analysis of the precipitated proteins showed that 90% of insulin receptors precipitable by anti-insulin receptor antibodies were precipitated by anti-class I antibodies (anti-heavy chain and anti-beta 2-microglobulin) after cross-linking with 2 mM DSP. In neither IM-9- nor 526 cells could HLA antigens be precipitated by anti-insulin receptor antibodies, suggesting that the concentration of class I antigens largely exceeds the concentration of insulin receptors at the cell surface. In 526 lymphocytes, class I MHC antigens were also found to adjoin class II antigens, since both molecules could be coprecipitated with anti-HLA A, B, C and with anti-HLA-DR antibodies after chemical cross linking. Down-regulation of insulin receptors by chronic exposure of IM-9 cells to insulin did not affect the amount of MHC molecules present on the cell surface, and conversely, class I MHC molecules were internalized in 526 cells irrespective of the presence of insulin. These results thus show that insulin receptors and MHC antigens form multimolecular complexes in the plasma membrane of cultured human B cells. These interactions, which do not appear to influence the regulation of these proteins on the cell surface, may be involved in the mechanism of hormone signaling. PMID- 3531329 TI - Characterization of Shigella flexneri-specific murine monoclonal antibodies by chemically defined glycoconjugates. AB - Chemically defined glycoconjugates are demonstrated to have considerable potential for selecting hybridoma antibodies directed toward O-antigenic determinants, especially when used in combination with a panel of well characterized LPS molecules. Monoclonal antibodies specific for the Shigella flexneri O-antigens of serogroup 5b, variants X and Y, were generated after immunization of BALB/c mice with killed bacterial cells, and active hybrids were selected on the basis of ELISA performed with the purified serotype-specific LPS antigen. Subsequent screening with a variety of glycoconjugates, derived from synthetic oligosaccharides and larger structures obtained by phage Sf6/endo rhamnosidase hydrolysis of purified LPS established a detailed profile of binding characteristics for Shigella flexneri variant Y-specific antibodies. Together with the results of precipitin analysis and heavy chain isotyping experiments, a limited number of antibodies were selected as candidates for detailed studies of the antibody combining site. PMID- 3531330 TI - Monoclonal antibody 45-2D9 recognizes a cell surface glycoprotein on a human c-Ha ras transformed cell line (45-342) and a shared epitope on human tumors. AB - A monoclonal antibody (45-2D9) produced after immunization of BALB/c mice with the c-Ha-ras NIH 3T3 tertiary transfectant (45-342) recognized a determinant expressed by the primary, three of three secondary, and one of three tertiary transfectants, but not by NIH 3T3 cells. The determinant was present on the cell surface and was distinct from murine leukemia virus gp70 by absorption studies. Biosynthetic labeling and immunoprecipitation studies with [35S]methionine and [3H]glucosamine demonstrated that 45-2D9 recognizes a 74,000 Mr glycoprotein with minor bands of 90,000 and 180,000 Mr on SDS-PAGE. Pulse chase studies demonstrated a 68,000 Mr precursor molecule that incorporated only [35S]methionine. The distribution of the epitope recognized by 45-2D9 was assessed by immunoperoxidase staining. The antigen was not detected on 10 primary and metastatic murine tumors or 11 transformed murine cell lines. However, a variety of surgically excised human tumors demonstrated intense staining, whereas staining of normal tissues was minimal or not detectable. Thus a human oncogene transfected cell can express a new cell surface determinant apparently unrelated to the oncogene product, which is also selectively expressed by human tumors. PMID- 3531331 TI - Effect of age on the capacity of the bone marrow and the spleen cells to generate B lymphocytes. AB - The effect of age on the regeneration of the B cell population was studied by cell transfer methods, using the allotype-congenic mouse strains BALB/c (Igha) and C.B-17 (Ighb) as donors of old and young bone marrow (BM) and spleen cells, and C.AL-20 (Igho) as recipients. This design allowed us to identify the origin of the sIgD+ B cells present in the recipients. It was found that in a simple cell transfer, BM cells or spleen cells of aged donors could reconstitute the peripheral B cell population of irradiated, thymectomized recipients essentially as effectively as could BM or spleen cells from young donors. However, when BM cells from aged donors and from young donors were mixed and were used to reconstitute a single recipient, the cells from the aged donor were less efficient than were the cells from the young donor. We found that sIgD+ B cells of young donor origin predominated in the peripheral B cell population of the recipient at 3 to 6 wk after cell transfer. In the BM of the recipients, however, there was no difference in the incidence of sIgD+ B cells derived from the young and the old donors. When recipients were reconstituted with a mixture of spleen cells from old and young mice, the sIgD+ cells of young donor allotype showed a tendency to predominate in the peripheral B cell population, although this predominance was not statistically significant. Under such competitive conditions, the spleen cells of aged donors were less efficient than the BM of aged donors in reconstituting the sIgD+ B cell population of the recipient's BM, but were more efficient in reconstituting the splenic sIgD+ cells. Thus, a subtle defect in the B cell precursor population of the BM and the spleen of aged mice has been demonstrated. The role of T cells in the generation of sIgD+ cells was also analyzed. PMID- 3531332 TI - Differential expression of lymphokine-activated killer cells and natural killer cells in adoptive transfer experiments utilizing fractionated bone marrow. AB - Precursors of murine natural killer (NK) cells and lymphokine-activated killer (LAK) cells can be distinguished by utilizing an adoptive transfer system in which donor bone marrow is fractionated on Percoll discontinuous gradients. Although precursors of LAK cells are present in all fractions, one fraction (greater than 65% Percoll) contains LAK precursors and is depleted of NK precursors. Both in vitro NK activity and in vivo hybrid resistance is abrogated in recipients of bone marrow from the greater than 65% Percoll fraction, whereas LAK activity can be readily demonstrated. PMID- 3531333 TI - The regulatory role of sialic acids in the response of class II reactive T cell hybridomas to allogeneic B cells. AB - Two different kinds of alloreactive T cell hybridomas were established in previous experiments. One is reactive and the other is nonreactive to allogeneic I-A region-associated membrane antigen (mIa) on B cells. In the present experiments the difference between these hybridomas were analyzed by using representative clones, B cell mIa-reactive clone CB-11.4, and nonreactive clone HTB-9.3. Unresponsiveness of HTB-9.3 clone to allogeneic B cells could not be due to the inability of B cells in interleukin 1 production or the density of mIa molecules on B cells. HTB-9.3 clone could respond to C57BL/6 mouse B cells treated with neuraminidase (Nase), and Nase-treated HTB-9.3 clone could respond to normal B cells from C57BL/6 mouse, indicating that sialic acid on both B cells and HTB-9.3 clone plays a regulatory role in the alloreactivity of the clone. In response to B cells from C57BL/6 mouse, T cells from C3H/He mouse spleen showed similar reactivity to HTB-9.3 clone; that is, T cells could respond to Nase treated B cells, and Nase-treated T cells to B cells, and T cells primed with C57BL/6 spleen cells in vitro showed similar reactivity to CB-11.4 clone. These results suggest that HTB-9.3 clone represents virgin T cells and CB-11.4 clone primed T cells at least in alloreactivity. Anti-L3T4a was shown to block alloreactivities of both T cell hybridomas and splenic T cells against B cells more efficiently than against splenic adherent cells. These results suggest that L3T4a on T cell plays more important role in allogeneic response to B cells than to splenic adherent cells. PMID- 3531334 TI - Correlation of cell surface antigen expression on human thymocytes by multi-color flow cytometric analysis: implications for differentiation. AB - Thymocytes undergo a complex series of phenotypic and genotypic changes during maturation in the thymus. This dynamic process involves qualitative and quantitative changes in the expression of certain cell surface differentiation antigens. In this study, we have directly examined the relationship of T cell differentiation antigen expression on normal human thymocytes by using multi color immunofluorescence and multi-parameter flow cytometric analysis. The results from these studies have provided new insights into the complexity of antigen expression during thymic maturation and suggest that the CD3/T cell antigen receptor complex is expressed early in the development of thymocytes. Direct quantitative measurements of antigen expression by using multi-parameter flow cytometric analysis also suggest quantitative co-regulation of certain antigens (e.g., CD3 and CD5) during thymic maturation. PMID- 3531335 TI - A highly conserved 72,000 dalton centromeric antigen reactive with autoantibodies from patients with progressive systemic sclerosis. AB - An autoantibody reactive with a 72,000 dalton centromeric antigen was detected by immunoblotting with the use of a nuclear enriched HeLa cell preparation in 42 of 77 patients with progressive systemic sclerosis (PSS). Reactivity with the 72,000 dalton polypeptide was associated with anti-centromere autoantibodies (ACA) detected by immunofluorescence (IF), and the antigen was highly conserved, being present in both human cells and Leishmania tropica. Thirty-five (83%) of the 42 sera reactive with the 72,000 dalton polypeptide also reacted with a 19,500 dalton polypeptide, and antibodies eluted from both the 72,000 dalton and the 19,500 dalton polypeptides reacted with the centromere when retested by IF on intact HEp2 cells, demonstrating that both polypeptides are antigenic components of the centromere. Only one of the 42 sera had precipitating antibodies to the Scl-70 antigen detected by counterimmunoelectrophoresis, indicating that the 72,000 dalton polypeptide was not related to the previously described Scl-70 antigen. The other 35 of the 77 sera tested were negative for ACA, although all had ANA, with the main patterns of IF being fine speckling of the nucleus (18 sera) and homogeneous or speckled staining of the nucleolus (17 sera). Anti-Scl 70 antibodies were detected in 17 of these 35 patients, 15 (88%) of whom reacted with an 89,000 dalton polypeptide, one with a 140,000 dalton polypeptide, and one with a 74,000 dalton polypeptide. Ten of the 15 sera reacting with the 89,000 dalton polypeptide also reacted with a 74,000 dalton polypeptide, and 2-D gel analysis suggested a relationship between the two molecules. Clinically defined types of scleroderma tended to associate with antibodies to particular molecular antigenic specificities. Thirty-seven (88%) of the 42 patients reactive with the 72,000 dalton polypeptide had sclerodactyly and features of the CREST syndrome, whereas patients reactive with the 89,000 dalton polypeptide and with Scl-70 tended to have more extensive cutaneous and visceral involvement. PMID- 3531336 TI - Cells containing IgE in the intestinal mucosa of mice infected with the nematode parasite Trichinella spiralis are predominantly of a mast cell lineage. AB - To determine whether IgE+ cells in the intestinal mucosa of nematode-infected mice were of a mast cell or a lymphocyte lineage, the intestinal mucosae of mast cell-deficient w/wv mice were examined for IgE+ cells after inoculation with Trichinella spiralis muscle-stage larvae. Immunofluorescence staining techniques were used to detect IgE associated with cells in the intestinal mucosa. Comparisons were made among four strains of mice, w/wv (mast cell-deficient), +/+ (normal congenic littermates of w/wv), BALB/c, and SJL, that were either uninfected controls or inoculated with T. spiralis. Tissue sections from the small intestine of T. spiralis-infected BALB/c, SJL, and +/+ mice were fixed in ethanol and were stained with an affinity-purified F(ab')2 rabbit anti-mouse IgE followed by FITC goat anti-rabbit IgG. Large numbers of cells in the intestinal mucosa exhibited bright fluorescence. When other sections of intestines from these mice were processed in Carnoy's fixative and were stained with alcian blue at low pH (a metachromatic stain for mast cells) or alcian blue followed by immunofluorescence staining for IgE, large numbers of mast cells were observed in the intestinal mucosa, and 70 to 90% stained positively for IgE. There was a considerable number of cells in the intestinal mucosa which were IgE+ but which did not stain with alcian blue. Few alcian blue-positive cells and no IgE+ staining cells were present in the intestinal mucosa of control, uninfected +/+, BALB/c, and SJL mice. To determine whether these IgE+ alcian blue-negative cells were of a lymphocyte or a mast cell lineage, the mast cell-deficient w/wv mouse strain was examined after infection with T. spiralis. In contrast to BALB/c, SJL, or +/+ mice, few cells in the intestinal mucosa of T. spiralis-infected w/wv mice stained with alcian blue or were positive for IgE. However, when the IgE response in the MLN of the w/wv mice was compared to the IgE response of BALB/c, SJL, and +/+ mice, numerous IgE+ cells, but no alcian blue-positive cells, were observed in the parenchyma of the MLN from all four strains of T. spiralis-infected mice. In addition, flow microfluorometric analysis of MLN cells stained for surface IgE in suspension showed a comparable proportion of IgE-bearing cells, which were mostly B lymphocytes, among all four strains of T. spiralis-infected mice.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3531337 TI - Expression of mouse beta 2-microglobulin in frozen and formaldehyde-fixed central nervous tissues: comparison of tissue behind the blood-brain barrier and tissue in a barrier-free region. AB - Previous work indicates that the weak expression in neural tissues of beta 2 microglobulin (beta 2-m) and major histocompatibility complex (MHC) class I gene products can be increased experimentally. Physiologic conditions in which greater neural MHC expression occurs are not well defined. Here we have asked whether protection from blood-borne antigens afforded by the blood-brain barrier is related to the lack of MHC expression. A rabbit antiserum raised against purified mouse beta 2-m was used in an immunocytochemical assay. The serum reacted strongly with lymphoid tissues and was inhibited by purified beta 2-m. No beta 2 m was detected in neurons or glia in any brain area examined. A barrier-free region, the area postrema, showed the same lack of neural cell staining. Blood vessel walls in the same sections were beta 2-m+. It is unlikely that these staining patterns are due to cell type-specific beta 2-m degradation, since frozen and formaldehyde-perfused, paraffin-embedded preparations gave similar results. Failure to detect beta 2-m in the area postrema suggests that passive exposure to environmental antigens, immunomodulators, or immunocompetent cells is not sufficient to induce neural class I expression. Rather, if increased expression of beta 2-m and class I occurs in vivo, additional stimulus is required. PMID- 3531338 TI - Distribution of beta 2-microglobulin in olfactory epithelium: a proliferating neuroepithelium not protected by a blood-tissue barrier. AB - The olfactory neuroepithelium is unique in adult vertebrates in that bipolar sensory neurons are constantly dying and being replaced. The sensory neurons are also unusual because they are directly exposed to the external environment via their dendritic processes in the nasal cavity. Surveillance of this tissue by major histocompatibility complex (MHC) class I-restricted cytotoxic T cells would presumably serve as an important means of defense against foreign pathogens. Although adult brain shows a lack of class I molecules, it has not been reported if either proliferating neurons or sensory neurons in olfactory neuroepithelium also lack class I. To examine olfactory neuroepithelium, an antiserum against beta 2-microglobulin (beta 2-m), the invariant light chain associated with all class I molecules, was employed as a general probe in an immunocytochemical assay. beta 2-m was detected in columnar respiratory epithelium, blood vessel walls, and a small population of interstitial cells in the lamina propria, but no cell in the olfactory neuroepithelium stained for beta 2-m. Parallel patterns were obtained in the vomeronasal organ. These results suggest that lack of beta 2 m, and presumably class I, may be a general phenotype of neuronal cells regardless of their mitotic state or exposure to environmental antigens. PMID- 3531339 TI - A synthetic analogue of Escherichia coli lipoprotein, tripalmitoyl pentapeptide, constitutes a potent immune adjuvant. AB - Lipoprotein from the outer membrane of Escherichia coli and other Enterobacteriaceae constitutes a potent B lymphocyte mitogen and polyclonal activator in various species. Tripalmitoyl pentapeptide (S-(2,3-bis (palmitoyloxy)-(2RS)-propyl)-N-palmitoyl-(R)-cysteinyl -(S)-seryl-(S)-seryl-(S) asparaginyl-(S)-alanine) is a synthetic analogue of the N-terminal part of lipoprotein and has, in all assays tested, a biologic activity similar to native lipoprotein. It also exhibits a strong adjuvant activity in vitro: In the presence of 3.3 to 33.3 micrograms/ml of tripalmitoyl pentapeptide, the stimulation of the primary antibody response toward underivatized sheep red blood cells (SRBC) and toward trinitrophenylated (TNP-) SRBC was markedly enhanced, as measured by a direct hemolytic plaque assay. At optimal mitogen- and antigen doses, plaque formation was increased up to 100-fold, and at suboptimal doses (0.03 to 0.3 microgram/ml) a 10- to 60-fold increase of plaque numbers was achieved. In the presence of tripalmitoyl pentapeptide, the antigen-specific IgM response was increased about sevenfold and the IgG response was augmented about 10-fold, as measured by ELISA. Similarly, in the secondary in vitro response to TNP-SRBC, a 7 to 10-fold enhancement of the antibody titer was obtained in the presence of the adjuvant. The application of tripalmitoyl pentapeptide and antigen had to occur concurrently in order to achieve a strong adjuvant effect. Addition of tripalmitoyl pentapeptide to the cell cultures 1 day after or 1 day before antigen application had no significant positive effect, and in several instances a decrease in antibody production was found. Thus, tripalmitoyl pentapeptide, a well-characterized synthetic product available in major amounts, constitutes a potent immune adjuvant for potential animal and clinical use. PMID- 3531340 TI - Production and characterization of monoclonal antibodies to rabbit lymphocyte subpopulations. I. Tissue immunofluorescence and flow cytometric analysis. AB - Nine monoclonal antibodies to rabbit T cells and B subpopulations have been generated from three separate fusions of spleen cells from mice immunized with fractionated populations of rabbit lymphocytes. These monoclonal antibodies, as well as a previously described rabbit T cell monoclonal antibody, 9AE10, have been analyzed by immunofluorescence staining on frozen tissue sections of rabbit thymus, spleen, and appendix. This screening method permits rapid identification of the lymphocyte subdomains in each tissue which is not possible by other screening methods. Each monoclonal antibody selected has a unique tissue staining pattern. Flow cytometric analysis of these monoclonal antibodies, using indirect immunofluorescence techniques on thymocytes, splenocytes, and PBL, revealed varying percentages of positive cells and individual mean fluorescence intensities indicating different epitope densities for each antigen. These monoclonal antibodies are now being used to characterize normal lymphocyte function and the role of specific lymphocyte subpopulations in experimental disease models in the rabbit. PMID- 3531341 TI - The antibody response in mice to carrier-free synthetic polymers of Plasmodium falciparum circumsporozoite repetitive epitope is I-Ab-restricted: possible implications for malaria vaccines. AB - The immunogenicity of a novel synthetic peptide consisting of an average of 40 (Asn-Ala-Asn-Pro) repeats of the circumsporozoite protein of Plasmodium falciparum, (NANP)40, was studied in mice without using any carrier proteins. First, high titers of anti-(NANP)40 antibodies could be obtained after immunization of C57BL/6 mice. These antibodies also reacted with an extract of mosquitoes infected with P. falciparum sporozoites. C57BL/6 nu/nu mice did not produce antibodies against (NANP)40. Secondly, when 14 strains of mice with nine different H-2 haplotypes were immunized with (NANP)40 without carrier, only H-2b mice were found to produce anti-(NANP)40 antibodies, whereas all non-H-2b mice were consistently unresponsive. This response was demonstrated to be I-A-linked by using recombinant and mutant mice. I-Ab [B10.A(5R)] mice produced anti (NANP)40 antibodies as well as H-2b inbred mice. B6CH-2bm12 I-Ab-mutant mice showed only a very low response. Third, the antibody response against (NANP)40 could be induced in nonresponder mice by immunization with the peptide coupled to a carrier protein. In view of the existence of such an exceptional H-2b restriction in the response to sporozoite synthetic peptides in mice, the triggering of peptide-specific T cell responses in humans receiving sporozoite malaria vaccines might be difficult to achieve. PMID- 3531342 TI - Evasion of the alternative complement pathway by metacyclic trypomastigotes of Trypanosoma cruzi: dependence on the developmentally regulated synthesis of surface protein and N-linked carbohydrate. AB - Epimastigotes (EPI) of Trypanosoma cruzi are highly sensitive to lysis in fresh normal human serum by the alternative complement pathway (ACP). In contrast, metacyclic trypomastigotes (CMT) derived from EPI in stationary culture fail to activate the ACP and are thus resistant to serum-mediated lysis. To investigate the nature of the parasitic surface molecules which enable infective metacyclic trypomastigotes to evade the ACP, CMT were treated with a variety of different proteolytic and glycosidic enzymes, and their sensitivity to ACP-dependent lysis was tested. Pretreatment with pronase was found to cause a near complete reversal in the resistance of CMT to serum lysis, whereas trypsin or chymotrypsin induced smaller increases in complement sensitivity. Similarly, pretreatment with N glycanase or neuraminidase also partially abrogated the resistance of CMT to ACP dependent lysis. The effect of these enzymes on susceptibility to complement mediated lysis was paralleled in increased C3 and C9 deposition on the organism. In addition, electrophoretic analysis of parasite-bound C3 indicated that the hemolytically inactive fragment, iC3b, was the major form of the molecule on CMT, while the hemolytically active fragment, C3b, predominated on pronase-treated CMT. Furthermore, when C3 was deposited on the parasite surface by means of purified ACP components, 80% of C3b on pronase-pretreated CMT but only 14% of the C3b on CMT bound the amplification protein factor B with high affinity, a prerequisite for efficient ACP activation. When cultured at 37 degrees C after pronase treatment, CMT gradually regained their resistance to ACP-mediated lysis. This process was blocked if puromycin, cycloheximide, or tunicamycin were included in the culture medium. The above findings suggest that evasion of the ACP by CMT is dependent on the developmentally regulated synthesis of protein as well as N-linked carbohydrate chains. A stage-specific 90,000 to 115,000 m.w. glycoprotein doublet present on the surface of CMT was shown to be uniquely sensitive to pronase digestion. Thus, this complex, which is also recognized by a CMT-specific monoclonal antibody, may be the glycoprotein component responsible for control of ACP activation PMID- 3531344 TI - Demonstration of human autoantibodies by quantitative enzyme immunoassays. PMID- 3531343 TI - The antigenic interrelationship between the endoflagella of Treponema phagedenis biotype Reiter and Treponema pallidum Nichols strain. I. Treponemicidal activity of cross-reactive endoflagellar antibodies against T. pallidum. AB - Treponemicidal activity against Treponema pallidum, Nichols strain, by anti endoflagellar antibodies and the presence of antigenic interrelationships between the endoflagella of Treponema phagedenis biotype Reiter (TPR) and T. pallidum have been demonstrated. SDS-PAGE profiles of purified endoflagella from both organisms were similar, identifying five polypeptide bands for TPR (37,000, 33,000 doublet, 30,000, and 27,000 daltons) and five polypeptide bands for T. pallidum (35,000, 33,000 doublet, 30,000, and 27,000 daltons). Antiserum against TPR endoflagella identified identical bands on Western blots of TPR, T. pallidum, and the respective endoflagellar preparations. Western blots confirmed the presence of antibodies in normal human serum (NHS) against the 33,000 dalton treponemal endoflagellar proteins. The complement-dependent treponemicidal activity of NHS against T. pallidum was completely removed by absorption with purified TPR endoflagella. Furthermore, rabbit antisera against TPR endoflagella were reactive in the Treponema pallidum immobilization (TPI) test. These findings demonstrate that anti-endoflagellar antibodies are treponemicidal against T. pallidum. A possible mechanism for this activity is discussed in relation to the subsurface location of endoflagella. PMID- 3531345 TI - Luminescent visualization of antigens on blots. AB - Proteins separated by SDS gel electrophoresis and transferred to a nitrocellulose sheet can be visualised by 'probing' with peroxidase-linked reagents which are detected by luminescence. A modified luminescent substrate is described containing 4-methylumbelliferone which enhances light emission four-fold. Using the modified substrate, luminescent detection was found to be more sensitive than chromogenic detection of peroxidase using 4-chloro-1-napthol. The new technique was used in conjunction with the immunoblot method to demonstrate antigenic differences between rat and mouse erythrocytes. PMID- 3531346 TI - Determination by ellipsometry of the affinity of monoclonal antibodies. AB - The reaction between monoclonal antibodies and surface-immobilised hapten was studied by ellipsometry, a method allowing absolute measurement of the surface concentration of proteins. Monoclonal antibodies against 2-phenyloxazolone were used and their affinity for the antigen in solution was determined by calculations of the equilibrium constant from data obtained by measuring fluorescence quenching of the hapten due to antibody binding. The binding rate of antibody to surface-immobilised hapten and the dissociation rate of the complex were measured by ellipsometry. The equilibrium constant of the heterogeneous antigen-antibody reaction was determined by a Scatchard plot. The affinity of the antibodies for the antigen was found to be higher in the heterogeneous than in the homogeneous reaction by a factor which varied between different monoclonal antibodies. PMID- 3531347 TI - Direct antibody rosette-forming reactions using monoclonal markers of lymphocyte subpopulations. Methodology and applications illustrated by investigations with rat pan-T antibodies of the CAMPATH series. AB - A sensitive direct antibody rosette assay has been developed for the detection of antigens on the lymphocyte cell membrane. Indicator cells for rosette tests were prepared by chromic chloride coupling of rat or mouse monoclonal IgG or IgM anti lymphocyte antibodies to untreated or trypsinized bovine red blood cells. The monoclonal antibodies used were reactive with a range of cell surface markers which identify various lymphocyte subpopulations, including T cell antigens, HLA class II (Ia-like antigens), Leu-7 (HNK-1) and VEP 13, a determinant of Fc gamma receptors on large granular lymphocytes. Results obtained by direct rosette formation correlated well with those of parallel tests using indirect immunofluorescent antibodies staining. Several applications of the direct antibody rosetting procedure are described in further investigations with a series of pan-T monoclonal (CAMPATH) antibodies. These include the morphological examination of antibody-binding cells in cytocentrifuge smears, the separation of lymphocyte subsets by density gradient centrifugation, and the use of a rosette inhibition assay to identify monoclonal antibodies binding to the same (or closely associated) epitopes of the lymphocyte cell membrane. PMID- 3531348 TI - Effect of a bacterial extract on cellular and humoral immune responses in humans. AB - A lyophilized extract from E. coli (OM-89) was studied for its immunomodulating properties and tolerance in humans. Its oral administration to healthy volunteers produced a selective increase in the active T-cell population without changes in other lymphocyte populations. A significant increase in the proliferative response to concanavalin A and phytohemagglutin was recorded, but not to pokeweed mitogen. No significant changes were observed in the serum levels of IgG, IgA and IgM. The clinical and biological tolerance of OM-89 was excellent, without any adverse side-effects or production of circulating immune complexes or of autoantibodies, while the in vitro investigation showed that it is not a mitogen. Thus in healthy subjects OM-89 seems to act mainly on the cell-mediated immune responses. PMID- 3531349 TI - Campylobacter pyloridis-associated gastritis. PMID- 3531350 TI - Haemochromatosis presenting with a double Yersinia infection. AB - A patient suffering from diabetes mellitus presented with Yersinia pseudotuberculosis septicaemia and serological evidence of concomitant infection with Yersinia enterocolitica. He was later shown to have idiopathic haemochromatosis. PMID- 3531351 TI - Renal failure in the course of reactivation of varicella-zoster virus infection in a renal transplant recipient. AB - Renal failure developed in a 20-year-old female renal transplant recipient in the course of reactivation of varicella-zoster virus infection. The patient was treated with acyclovir and immunosuppression was continued. The year later renal function in the transplanted kidney was satisfactory. PMID- 3531352 TI - Food poisoning in a hospital staff canteen. AB - Eighty-two confirmed cases of salmonella food poisoning arose among hospital staff due to consuming contaminated tartar sauce served in the staff canteen. Many key personnel were affected and the hospital was closed to non-urgent admissions. In order to maintain the accident and trauma services, the normal policy of excluding infected persons from work had to be modified. Staff returned to work 48 h after they had become asymptomatic provided that they did not have contact with patients' mouths, food or drink. There were no secondary cases. During the investigation of the outbreak, lack of national guidelines for the preparation and handling of mayonnaise-based food products became apparent. PMID- 3531353 TI - [Current diagnostic technics in the prediction of the functional recovery of a urographically silent kidney]. AB - 25 patients with a silent kidney, because of obstructive uropathy, have been studied. Authors' aim was to find out some parameters which could be able to predict renal function recovery once the obstruction was removed. 99m Tc DTPA renal scintiscanning, renal ultrasonography, and the study of renal clearances on the urine obtained via a percutaneous nephrostomy were executed. The authors observed that when the nuclide renal uptake is absent a minimal functional recovery is still possible and it may be foretold only analysing the urine collected through a percutaneous nephrostomy. PMID- 3531354 TI - Regulated synthesis of low-molecular-weight antigens in keratinocyte cell cultures. AB - Proteins from mouse epidermis cytosol extracts react on immunoblots with a polyclonal rabbit antiserum raised against rat skin calcium-binding protein (SCaBP), a parvalbumin of the panniculus carnosus. Three mouse epidermal proteins with molecular weights between 10-12K, which are distinct from SCaBP, are recognized by the antiserum. The synthesis of these proteins in keratinocyte culture is modulated by Ca++, as is the differentiation of the keratinocytes. Proliferating mouse keratinocytes in medium containing 0.07 mM Ca++ (low Ca++) undergo terminal differentiation when the Ca++ concentration is elevated to 1.8 mM (high Ca++). Synthesis of the 3 antigens can be demonstrated when soluble extracts of keratinocytes labeled with [35S]methionine in low Ca++ medium are immunoprecipitated with anti-SCaBP serum. These antigens are not synthesized in cultures of dermal fibroblasts. When keratinocytes are switched to high Ca++ medium, synthesis of these antigens is greatly diminished over the course of 48 72 h. However, the antigens persist in differentiating cells. When proliferating keratinocytes in low Ca++ medium are exposed to the tumor promoter 12-O tetradecanoylphorbol-13-acetate (TPA), differentiation is induced in a subpopulation of cells, and specific antigen synthesis is transiently inhibited. The inhibition correlates with the time when many cells are differentiating in response to TPA. When proliferating keratinocytes are pulse-labeled with 32PO4, the 11K antigen is phosphorylated and the phosphorylation is not enhanced by TPA exposure. All 3 antigens are synthesized in a reticulocyte lysate preparation with added newborn mouse epidermis messenger RNA or mRNA from keratinocytes cultured in low Ca++ medium. Thus, these antigens are likely to represent unique proteins rather than processed or degraded ones. The coordinately regulated expression of these antigens associated with the differentiation state of the keratinocytes suggests that these proteins are important in keratinocyte proliferation and differentiation. PMID- 3531355 TI - Alterations in the metabolism of filaggrin in the skin after chemical- and ultraviolet-induced erythema. AB - We have investigated the effect on the normal synthesis and metabolism of filaggrin of treatment of guinea pig skin with a chemical irritant, hexadecane, or with erythemal doses of UV radiation. Examination of the skin by immunofluorescence with an antiserum against filaggrin demonstrates 3 phases of the response. The first phase is an apparent stabilization of the filaggrin present at the time of treatment. Thus, a zone of stratum corneum is produced which moves up toward the skin surface over the days following treatment, without the loss of immunoreactivity which normally results from the metabolism of filaggrin to free amino acids. The second phase of the reaction, which occurs during the first day after treatment, is a loss of immunoreactive material from the upper viable epidermis, which results over the next day in the formation of a zone of filaggrin-deficient stratum corneum. The third phase, 2-3 days after the treatment, is the reestablishment of immunoreactivity in the newly re-formed granular layer, followed by the formation of an immunoreactive zone at the bottom of the stratum corneum. This zone remains very thin despite the rapid passage of cells through it. This shows that the filaggrin being formed during this phase of the reaction is being broken down normally as the stratum corneum matures. Investigations of the kinetics of filaggrin synthesis and breakdown using a [3H]histidine pulse/chase method, confirm the impression gained from immunofluorescence studies that the time between formation and breakdown of the filaggrin is much reduced in the hyperplastic epidermis resulting from the irritation. Thus, although the hyperplasia is reflected in a thickening of malpighian and granular layers of the epidermis, it does not result in any thickening of the filaggrin-positive zone at the bottom of the stratum corneum. This suggests the action of a control mechanism designed to prevent the extension of this filaggrin-positive zone into the upper stratum corneum. PMID- 3531356 TI - Flow cytometry for separation of keratinocyte subpopulations from the viable epidermis. AB - Human epidermal cell suspensions were analyzed and sorted with flow cytometry. The desmosome and differentiation-related KM48 monoclonal antibody was used for indirect immunofluorescence and permitted staining of keratinocytes at various stages of the cell maturation. Intensity of the staining correlated with the degree of differentiation. Three sorting gates were chosen to obtain subpopulations which varied distinctly in KM48 expression. The flow cytometry sorted cells were characterized by their ultrastructural appearance and by the bullous pemphigoid antigen expression. According to the ultrastructure criteria, about 50% of the cells obtained from the "IF negative" gate were basal layer keratinocytes (45.5% expressed bullous pemphigoid antigen); 90% of the "intermediate" gate cells were spinal layer keratinocytes, and over 80% of the cells sorted through the "strongly IF positive" gate were of the granular layer type. The method of keratinocyte separation proposed allows samples to be obtained for further biochemical and functional studies on keratinocyte subpopulations in normal and pathologic skin. PMID- 3531357 TI - Serial cultivation of single keratinocytes from the outer root sheath of human scalp hair follicles. AB - A method for the isolation of outer root sheath keratinocytes from plucked human hair follicles and for their subsequent cultivation has been developed. The selective trypsinization of outer root sheath keratinocytes provided a single cell suspension of defined origin within the hair follicle. The 3T3 feeder layer technique supports sustained growth of these cells in that as little as one single plucked hair follicle (yielding approximately 1.5 X 10(4) cells) consistently gave rise to a confluent 35-mm culture dish (with approximately 1.5 X 10(6) cells) within about 2 weeks. The outer root sheath keratinocytes can be serially passaged for up to 3 times and also cryopreserved. PMID- 3531358 TI - Discordance of SSA/Ro and SSB/La cellular antigens in synchronized cells. AB - SSA/Ro and SSB/La are soluble cellular proteins to which antibodies are frequently produced in patients with Sjogren's syndrome and systemic lupus erythematosus. In this investigation, we examined anti-SSA/Ro and anti-SSB/La staining patterns on synchronized WiL2 cells and mixed lymphocyte culture cells using monospecific antisera. In addition to its presence in the nucleoplasm, the SSB/La antigen was highly concentrated in the nucleolus of cells during the late G1 and early S phase and is thus cell cycle-related. In contrast, the SSA/Ro antigen was found to be independent of cell cycle, showing a nuclear speckled pattern in all phases. Blocking experiments indicated that free SSB/La is responsible for the nucleolar staining, whereas the combination of both SSA/Ro and SSB/La determines the nucleoplasmic speckled staining pattern. PMID- 3531359 TI - An in situ immunogold method applied to the identification of plasma membrane associated antigens of skin-infiltrating cells. AB - This report concerns a pre-embedding in situ double-step immunogold technique to detect cell surface antigens of skin infiltrating cells. Reliable immunogold labeling of cell surface antigens, as well as good ultrastructural preservation of cell and tissue details, were achieved. In comparison with the commonly used method of in situ immunoperoxidase labeling, the present in situ immunogold labeling has some advantages, such as higher specificity, higher sensitivity, and the possibility of estimating the density of the labeling. However, a drawback in the present technique is the compulsory high-magnification analysis of the specimens at the electron microscope, due to the small size of the gold particles. PMID- 3531360 TI - [Orthotopic transplantation of the canine heart after prolonged preservation by simple immersion]. PMID- 3531361 TI - [Congenital cystic adenomatoid malformation of the lung--a case report in a 14 year-old patient and a review of the literature dealing with features in older cases]. PMID- 3531362 TI - [Interaction of protein with lipid in plasma lipoprotein and its structure and function]. PMID- 3531363 TI - [Perspectives in microbial secondary metabolism]. PMID- 3531364 TI - [Cadmium binding peptides in fission yeast]. PMID- 3531365 TI - [Role of rice phytoalexin on plant host-parasite interactions]. PMID- 3531366 TI - [Studies on the genetic regulation of glycolipid expression]. PMID- 3531367 TI - [Role of 2-mercaptoethanol in the stimulation of lymphocyte growth]. PMID- 3531368 TI - Dynamics of allospecific T lymphocyte infiltration in vascularized human allografts. PMID- 3531369 TI - [Reflections on the fifty-year history of the Japanese Society of Stomatology]. PMID- 3531370 TI - Transvesical/transuterine collection of oocytes by ultrasound. PMID- 3531371 TI - [An experimental study on the bond strength and dimensional accuracy of a combined agar-agar and alginate impression]. PMID- 3531372 TI - An onion in your ear. PMID- 3531373 TI - Syrup formulations for post-tonsillectomy analgesia: a double-blind study comparing ibuprofen, aspirin and placebo. AB - Post-tonsillectomy analgesia from ibuprofen, aspirin and placebo is compared in a double-blind study. The results are reported showing ibuprofen to have greater therapeutic benefit than placebo whereas aspirin did not. Methods of providing pain relief after tonsillectomy and the relative clinical merits of ibuprofen and aspirin are discussed. PMID- 3531374 TI - Synthetic substrates of lecithin: cholesterol acyltransferase. AB - Investigation of the substrate specificity of lecithin: cholesterol acyltransferase has been greatly aided by the use of synthetic particles containing the molecular lipid substrates and the apolipoprotein activators of the enzyme. These synthetic particles, in vesicle or disc-like micelle form, are described in some detail noting their preparation, properties, advantages, and limitations as substrates for lecithin:cholesterol acyltransferase. The reactions of the enzyme with the synthetic particles are reviewed in terms of acyl donor and acceptor specificity, activation by apolipoproteins, effects of various inhibitors, and the kinetics of the reaction. PMID- 3531375 TI - Coexistence of incompatible plasmids in a bacterial population living under a feast and famine regime. AB - A model is formulated to examine the possibility of (co)existence of plasmids of the same incompatibility and surface exclusion group in a bacterial population living under a feast-and-famine regime. The condition is given under which a growth rate decreasing plasmid can invade a bacterial population. It appears that in case only one plasmid type is present, the frequency of plasmid bearers will tend to a stable equilibrium if the food supply at each growth site gets exhausted and if both plasmid-free and plasmid-bearing bacteria need an equal quantity of food per cell division. If these two conditions are not satisfied, the frequency of plasmid-bearers might oscillate. Two plasmids will sometimes be able to coexist, but only if they follow different survival strategies; one with a high conjugational transfer rate and a lower fitness of its host, and the other with a low transfer rate and a higher host fitness. Coexistence of three plasmids of the same surface exclusion group is impossible. PMID- 3531376 TI - In vitro comparison of dowel and core techniques for endodontically treated molars. PMID- 3531377 TI - Rat embryonic ectoderm as renal isograft. PMID- 3531378 TI - A potential role for spectrin during neurulation. AB - An actin-myosin complex located in apical regions of the neurectoderm has been postulated to play a role in neurulation. Numerous studies have documented the presence of microfilaments in this area and confirmed their composition as actin. By necessity, if such a contractile system is to exert a force, these filaments must be anchored in some way to the cell membrane. In this study, the presence of the actin-binding protein, spectrin (fodrin), is demonstrated in the neurectoderm of neurulating mouse embryos using antispectrin antibodies and indirect immunofluorescent techniques. The patterns of spectrin localization correlate with the previously reported regions of increased numbers of microfilaments and also with the morphology of the neural folds. Thus, during the initial stages of cranial fold elevation, a process reportedly dependent on increased glycosaminoglycan synthesis, little spectrin is present in the neuroepithelial cells. Later as the folds begin to converge toward the midline, deposition of the protein, as demonstrated by the intensity of fluorescence, is increased in the apices of these cells, and is most prominent in regions of greatest bending in the neural folds. Caudal neural fold regions show a similar pattern of staining. Thus, the hypothesis that a cytoskeletal system assists in neurulation is supported by these results, which for the first time demonstrate the presence of a putative actin-membrane attachment protein in a morphogenetically active system. PMID- 3531379 TI - The distribution of fibronectin, laminin and entactin in the neurulating rat embryo studied by indirect immunofluorescence. AB - This paper forms part of our study of the extracellular matrix and its role in the morphogenesis of the brain during the period of neurulation in the rat embryo. Using indirect immunofluorescence with polyclonal antibodies, we present here a descriptive study of the distribution of the matrix glycoproteins fibronectin, laminin and entactin. The observed distribution of the fibronectin matrix implicates it in providing a structural element in several morphologically active sites; in addition our observations support the previously suggested involvement of fibronectin in the migration of neural crest cells. Entactin was present only in the basement membranes in conjunction with laminin which was not itself confined to these regions. Laminin was also identified within the mesenchymal extracellular matrix, and its general distribution confirms the previously documented role of laminin in maintaining epithelial structure and organization. No patterning in the distribution of these three glycoproteins could be correlated with the change in shape of the neural epithelium associated with either tube formation or neuromere morphogenesis. PMID- 3531380 TI - Defective lymphopoiesis in bone marrow of motheaten (me/me) and viable motheaten (mev/mev) mutant mice. I. Analysis of development of prothymocytes, early B lineage cells, and terminal deoxynucleotidyl transferase-positive cells. AB - This study identifies defects in the early stages of lymphopoiesis that may contribute to the abnormalities in the development and/or function of peripheral T and B lymphocytes in mice homozygous for the motheaten (me/me) and viable motheaten (mev/mev) mutations. The results indicate that in me/me and mev/mev mice prothymocytes in bone marrow are present in essentially normal numbers, as determined by intrathymic injection, but apparently lack the ability to home effectively to the thymus, as determined by intravenous transfer; early B lineage cells in bone marrow, identified by the B220 antigen, are markedly depleted, including immature B cells (sIg+), pre-B cells (cIg+, sIg-), and pro-B cells (B220+, cIg-, sIg-); TdT+ bone marrow cells, especially a subset that expresses the B220 B lineage antigen, are markedly depleted by two weeks of age; normal numbers of TdT+ thymocytes are present during the first 3 wk of postnatal life, but rapidly decrease thereafter. The results further indicate that neither the defective thymus homing capacity of prothymocytes nor the deficiency of TdT+ bone marrow cells is due to autoantibodies. The possible relationship of the defective development of lymphoid precursor cells to the premature onset of thymic involution and to the abnormalities of peripheral T and B lymphocytes in me/me and mev/mev mice is discussed; as are the results of in vitro studies (presented in a companion paper), which suggest that a primary defect in the stromal microenvironment of the bone marrow is responsible for the abnormal development of the lymphoid precursor cells. PMID- 3531381 TI - Prevention of diabetes in BioBreeding/Worcester rats with monoclonal antibodies that recognize T lymphocytes or natural killer cells. AB - Diabetes-prone BioBreeding/Worcester (BB/Wor) rats received thrice weekly injections of mAb against antigens expressed on the surface of all T cells (OX19), cytotoxic/suppressor, and NK cells (OX8), helper/inducer cells (W3/25, OX35, OX38), and Ia+ cells (OX6, 3JP, OX17). Treatment with OX8 or OX19 achieved stable reductions of splenic and peripheral blood NK cells and helper/inducer T lymphocytes, respectively, and protected against diabetes. OX19 injections also prevented lymphocytic insulitis, thyroiditis, and the synthesis of autoantibodies to thyroid colloid and smooth muscle antigens. OX8 injections reduced splenic NK mediated YAC-1 cell lysis, but did not prevent insulitis, thyroiditis, or autoantibody synthesis. Injections of mAb specific for antigens on the surface of helper/inducer cells, and for cells expressing IaE antigens provided marginal protection against diabetes without reductions of phenotypic subsets. These findings suggest that pancreatic beta cell destruction in the spontaneously diabetic BB/Wor rat is mediated by the combined action of NK and helper/inducer cells. PMID- 3531382 TI - Isolation of a Treponema pallidum gene encoding immunodominant outer envelope protein P6, which reacts with sera from patients at different stages of syphilis. AB - A phage directing the synthesis of an abundant 45-kD Treponema pallidum surface protein was isolated from an EMBL-4 bacteriophage lambda library of T. pallidum DNA. The recombinant phage was identified using an mAb that was directed toward an immunodominant, outer envelope T. pallidum protein designated P6. The recombinant P6 protein possessed the same mol mass as the native treponemal antigen detected from total T. pallidum protein preparations, confirming the cloning of the structural gene for this molecule. Furthermore, E. coli was transformed by a 4.5-kb Eco RI lambda insert fragment subcloned into the plasmid vector pUC19. These transformed cells expressed and translocated the 45-kD protein to their outer membranes. Finally, all sera from patients with different stages of syphilis (primary, secondary, and latent) contained antibody reactive to this protein. PMID- 3531383 TI - Dendritic cell-lymphoid cell aggregation and major histocompatibility antigen expression during rat cardiac allograft rejection. AB - To determine the pattern of cellular expression of donor MHC class I and class II antigens during the course of rat cardiac allograft rejection, ACI cardiac allografts transplanted to BN recipients were examined from day 2 to day 6 using immunohistologic and immunoelectron microscopic methods. We used both monomorphic and donor-specific mouse anti-rat MHC class I and class II mAbs in this study. In normal ACI hearts, MHC class I reactivity was confined to the vascular endothelium and to interstitial cells. Ongoing rejection was characterized by an increased donor MHC class I staining intensity of microvascular endothelium and induction of donor class I surface reactivity on cardiac myofibers. Donor MHC class II reactivity was exclusively confined to interstitial dendritic cells (IDC) in both normal ACI hearts and in rejecting allografts, although rejection was associated with marked fluctuations in class II IDC frequency. An early numerical depression in class II IDC present in both allografts and syngeneic heart grafts was attributed to a direct effect of the transplantation procedure. By days 3-4, allografts showed an absolute overall increase in donor class II IDC frequency, which was associated with the presence of multiple localized high density IDC-lymphocyte aggregates. The lymphocytes present in the focal areas were predominantly of the class II-reactive Th cell subpopulation. These aggregates may thus represent the in vivo homologue of dendritic cell-lymphocyte clustering, which has been shown to be required for primary class II allosensitization in the rat and mouse in vitro. During the late phase of rejection, there was a marked numerical fall in donor class II IDC, which correlated with extensive overall graft destruction. This study has shown that acute rat cardiac allograft rejection can occur in the absence of donor MHC class II expression by allograft vascular endothelium and cardiac myofibers. The IDC, which are believed to represent the principal class II alloantigen presenting cells in the rat heart, remain the sole class II-expressing cellular constituents of the graft throughout the course of rejection. PMID- 3531384 TI - Macrophage type 3 complement receptors mediate serum-independent binding of Leishmania donovani. Detection of macrophage-derived complement on the parasite surface by immunoelectron microscopy. AB - In this study, direct visual evidence for local opsonization of L. donovani by macrophage (M phi)-derived complement components was obtained using immunoelectron microscopy. C3 deposition was detected on the surface of both promastigotes and amastigotes after 20 min serum-free incubation with murine resident peritoneal M phi (RPM), followed by fixation and incubation first with specific antibody directed against C3 and then with gold-labelled protein A. Gold deposition was not observed around either form of the parasite if the anti-C3 antibody was omitted. For promastigotes, the degree of C3 deposition under serum free conditions was comparable with that observed in the presence of an exogenous (serum) source of C3, but did not result in the same severe damage to the parasite as did the latter. Addition of sodium salicyl hydroxamate, which prevents covalent binding of C3 to activator surfaces, abrogated promastigote binding. Hence, although the anti-C3 antibody did not distinguish between native C3 and its breakdown product iC3b, these data support our earlier conclusion that promastigote binding to the CR3 of murine RPM is complement dependent. For amastigotes, gold deposition and binding to murine RPM were not eliminated by sodium salicyl hydroxamate. The presence of normal mouse serum resulted in increased gold deposition, but did not mediate either enhanced binding to M phi or damage to the amastigote. These data suggest that a proportion of C3 binding to the amastigote surface may be via noncovalent linkages, and that the C3 bound may not be in the correct form to mediate binding to CR3. PMID- 3531386 TI - Enzymuria in streptozotocin-diabetic rats. AB - Twenty four hour urine samples of male control and streptozotocin-diabetic Wistar rats were analysed for a series of commonly known kidney-specific enzymes, for electrolytes, creatinine, glucose, total protein and urine volume. The examination was done during two periods of 5 days between the 25th and 30th and the 32nd and 36th day after streptozotocin application. In the first period the animals had free access to food and water, whereas in the second period on days 32, 34 and 36 food was withdrawn. In the first observation period the diabetic rats showed increased excretion rates of 15 measured urinary parameters, while alanine aminopeptidase (EC 3.4.1.2) and gamma-glutamyltransferase (EC 2.3.2.2) activities were lowered and inorganic phosphate was unchanged. The removal of food resulted in decreased excretion values for alanine aminopeptidase, gamma glutamyltransferase and total protein as compared with fasted nondiabetic animals. The activities of N-acetyl-beta-D-glucosaminidase (EC 3.2.1.30), acid phosphatase (EC 3.1.3.2), lactate dehydrogenase (EC 1.1.1.27), pyruvate kinase (EC 2.7.1.40), C1-fructose 1.6-diphosphatase (EC 3.1.3.11) and the excretion values for sodium, calcium, magnesium, chloride and glucose were higher than in fasted nondiabetic rats. beta-Glucosidase (EC 3.2.1.21), potassium, inorganic phosphate, creatinine, and urine volume showed no differences between fasted diabetic and fasted control animals. The enzymes in the renal cortex at the end of the experiment showed only decreased activity of alanine aminopeptidase in diabetic rats. Lactate dehydrogenase, pyruvate kinase, beta-glucosidase, C1 fructose 1.6-diphosphatase and glucose 6-phosphatase (EC 3.1.3.9) were increased and gamma-glutamyltransferase, N-acetyl-beta-D-glucosaminidase, acid phosphatase and glucose 6-phosphate dehydrogenase (EC 1.1.1.49) showed no change.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3531385 TI - Polyspecificity of antistreptococcal murine monoclonal antibodies and their implications in autoimmunity. AB - mAbs produced by immunization of BALB/c mice with Streptococcus pyogenes M type 5 membranes were further characterized for their reaction with S. pyogenes pep M5 protein and with autoantigens associated with human cell lines. mAbs 36.2.2 and 54.2.8 simultaneously reacted with M protein and a membrane protein(s) of S. pyogenes. When cell lines were mixed with 54.2.8, we saw nuclear fluorescence along with staining of the cytoskeleton. Subsequent experiments revealed that 54.2.8 was an anti-DNA antibody that reacted with DNA, poly(I), poly(dT), and weakly with cardiolipin. Its reactivity with the cytoskeleton could be blocked with anti-vimentin. On the other hand, 36.2.2 reacted with the cytoskeleton, sparing the nucleus, and was inhibited by the alpha helical proteins myosin, actin, and keratin. mAb 54.2.8 was inhibited with myosin, but not with actin and keratin. None of the antibodies studied were inhibited by collagen, and none of them were rheumatoid factors. The results imply that Group A streptococci can activate B cell clones against myosin, alpha helical proteins, or DNA, thereby contributing to the enhancement of autoantibody production. PMID- 3531387 TI - Clinical evaluation of a new digitoxin enzyme-immunoassay. AB - A solid-phase enzyme-immunoassay for the determination of the digitoxin concentration in human serum (Enzymun-Test Digitoxin) was developed, and subsequently evaluated in seven laboratories. The test is based on the competition principle. Polystyrene tubes coated with anti-digitoxin antibodies (from sheep) were used as the solid phase. In the concentration range 10-40 micrograms/l, the coefficient of variation for the majority of laboratories was between 2 and 7%. The day-to-day precision only slightly differed from the within run precision. The measuring range was between 4 and 60 micrograms/l. Enzymun Test Digitoxin showed good agreement with three known methods for digitoxin determination. No influence on the values was observed in lipaemic, uraemic and icteric samples, dysproteinaemia sera and in the presence of various digoxin derivatives. The new enzyme-immunoassay permits the practical and reliable determination of serum digitoxin and is suited for use in routine analysis. PMID- 3531388 TI - Computers and literature search. PMID- 3531389 TI - The value of needle aspiration in the management of cellulitis. AB - Needle aspirations from 103 young, healthy patients (mean age 22 years) with cellulitis were prospectively analyzed to determine the percentage yield and causative organisms. A standard technique of needle aspiration was performed using a 22-gauge needle, a 10-cc syringe, and 1 cc of sterile water. Aspirations were performed at the leading edge and midpoint of the cellulitis (halfway between the leading edge and the center of the cellulitis). Fifteen of the 103 patients (14.5 percent) had positive aspirates. Nine of the 103 aspirates were positive at the leading edge (8.7 percent) and 6 of 70 were positive at the midpoint (8.6 percent), giving a total aspiration positivity of 8.7 percent (15/173). The organisms recovered were Staphylococcus aureus (53 percent). Staphylococcus epidermidis (27 percent), alpha-hemolytic streptococci (13 percent) and Streptococcus pyogenes (7 percent). The low-percentage yield and predictable organisms recovered speak against needle aspiration being a necessary procedure in a young, healthy population. Similarly, the site of aspiration does not increase yield. Empiric treatment with antibiotics aimed at staphylococcal and streptococcal organisms is appropriate. PMID- 3531390 TI - Diagnostic value of captopril test in primary aldosteronism. PMID- 3531391 TI - Ultrasonically guided percutaneous mediastinal cytology and biopsy. PMID- 3531392 TI - Isolated levocardia with interruption of infrahepatic inferior vena cava--a case report. PMID- 3531393 TI - Characterization of SE1, a new general transducing phage of Salmonella typhimurium. AB - A transducing phage, SE1, which is able to infect Salmonella typhimurium was isolated from a Salmonella enteritidis strain. SE1 is a temperate phage which is heteroimmune with respect to phages P22, L, KB1 and ES18. It is similar in morphology and size to phages P22, L and KB1 and is serologically related to phages P22 and L but not to KB1. Efficiencies of generalized transduction effected by phage SE1 are similar to those for P22HT (int7), a mutant which mediates a high frequency of chromosomal gene transduction. The lengths of chromosomal DNA transduced by SE1 and P22HT (int7) are similar. Furthermore, the SE1 prophage does not exclude the transducing particles from cells it has lysogenized; consequently it is possible to use both SE1 lysogens and non lysogenic strains as recipients in SE1-mediated transduction experiments, and obtain similar transduction efficiencies. However, the SE1 prophage gives rise to a lysogenic conversion that decreases the rate of adsorption of SE1 and L phages by about 50%, but does not affect adsorption of P22. Altogether these results suggest that phage SE1 may be a useful tool in the genetic manipulation of S. typhimurium. PMID- 3531394 TI - Purification and characterization of a bacteriocin from Klebsiella pneumoniae 158. AB - Klebocin, a bacteriocin produced by Klebsiella pneumoniae 158, was purified to homogeneity by ammonium sulphate fractionation and sequential DEAE-Sephacel and Sephadex G-150 column chromatography. The purified preparation had an Mr of approximately 40 000 on SDS-PAGE. Chemical analysis of the purified preparation showed it to be a protein, and it was sensitive to digestion by various proteolytic enzymes. PMID- 3531395 TI - Cell-surface hydrophobicity of Candida species as determined by the contact-angle and hydrocarbon-adherence methods. AB - Cell-surface hydrophobicities of six Candida species were studied by two methods: measurement of the contact angle, and partitioning with aqueous-hydrocarbon (n octane, n-hexadecane and p-xylene) mixtures. C. tropicalis, C. glabrata and C. krusei adhered better to the hydrocarbons than did C. albicans, C. stellatoidea and C. parapsilosis. Contact angles for the less adherent species were smaller than those for the more adherent species. Thus the two methods gave results that were similar overall and indicated that C. tropicalis, C. glabrata and C. krusei have greater cell-surface hydrophobicities than C. albicans, C. stellatoidea and C. parapsilosis. PMID- 3531396 TI - Determination of the spiral conformation of Aquaspirillum spp. by scanning electron microscopy of elongated cells induced by cephalexin treatment. AB - The effect of the beta-lactam antibiotic cephalexin on the spiral conformation of cells of Aquaspirillum spp. was examined by scanning electron microscopy. A. itersonii and A. peregrinum, which are known to have a left-handed spiral shape, elongated and still showed left-handed spirals in medium containing cephalexin. The spiral conformation of the elongated cells is therefore considered to represent the natural condition. The spiral conformations of A. metamorphum and A. psychrophilum grown in ordinary cultures were difficult to determine because they have short cells without a complete spiral. After cephalexin treatment, the cells of these species elongated and displayed spiral forms, right-handed in A. metamorphum and left-handed in A. psychrophilum. This elongation method may be useful for checking and determination of the spiral handedness of short spiral or curved bacteria such as vibrios. PMID- 3531397 TI - Isolation and characterization of Ca2+-sensitive mutants of Saccharomyces cerevisiae. AB - Thirty Ca2+-sensitive (cls: calcium sensitive) mutants of Saccharomyces cerevisiae were isolated by replica-plating. These mutants, which each had a single recessive chromosomal mutation, were divided into 18 complementation groups. Some cls mutants showed a phenotype of specific sensitivity to Ca2+, while others showed phenotypes of sensitivities to several divalent cations. From measurements of the calcium contents and initial rates of Ca2+ uptake of the cls mutants, 16 of the 18 cls complementation groups were classified into four types: type I mutants (cls5, cls6, cls13, cls14, cls15, cls16, cls17, and cls18) had both elevated calcium contents and increased uptake activities. A type II mutant (cls4) had a normal calcium content and normal uptake activity; type III mutants (cls1, cls2 and cls3) had elevated calcium contents but normal initial rates of Ca2+ uptake; type IV mutants (cls8, cls9, cls10 and cls11) had normal calcium contents but increased initial rates of Ca2+ uptake. Two of the mutants (cls7 and cls12) had intermediate biochemical properties. The primary defects of these four types of cls mutants were considered in terms of the Ca2+ transport system(s). Both type I and type III mutants, which had elevated calcium contents, simultaneously showed a trifluoperazine-sensitive phenotype, suggesting a close correlation of this phenotype with elevated calcium content. In addition, all type IV mutants were unable to utilize nonfermentable sugars. One CLS gene, CLS7, was located on the left arm of chromosome V. PMID- 3531398 TI - An inverted repeat sequence of the IncFI plasmid ColV2-K94 increases multimerization-mediated plasmid instability. AB - A detailed physical map of the region of the IncFI plasmid ColV2-K94 containing the Rep1 replicon, a Tn903 transposon, and an inverted repeat structure (X1) with unknown properties was prepared by cloning restriction fragments into pBR325. Inserts carrying the 1.2 kb repeated sequence of X1, but not the IS903 sequence of Tn903, had a destabilizing effect on pBR325 and pBR322 plasmid maintenance. One of these derivatives, pWS139, was studied further and was shown to have elevated levels of multimeric DNA forms; this resulted in decreased copy number and plasmid instability, as multimerization reduces the effective number of randomly segregating plasmids per cell. A ColV2-K94 miniplasmid, which has a copy number much lower than that of ColE1-derived vectors, was also less stably inherited if it contained the X1 structure. This destabilizing effect of the X1 repeat sequence was dependent on the RecA function, but not the RecB or the RecC functions of the host. These results suggest that the inverted repeat sequence of the X1 structure serves as a 'hot-spot' for generalized recombination. Thus, when present in cis, this sequence can generate plasmid instability because plasmid molecules are readily converted into multimeric forms through enhanced recombination at this site. PMID- 3531399 TI - Vaccinia virus expression vectors. PMID- 3531400 TI - Nuclear accumulation of measles virus nucleoprotein associated with a temperature sensitive mutant. AB - A measles virus (MV) Lec strain conditional-lethal (temperature-sensitive) mutant, designated MV ts38, has been isolated from 5-fluorouracil-mutagenized stock. The mutant has been characterized with regard to growth characteristics at 32 degrees C (permissive temperature) and 39 degrees C (non-permissive temperature). Virus-specific RNA transcription and/or translation appeared to be blocked at the non-permissive temperature as no virus-specific products could be detected by biochemical or immunological procedures. Following initiation of viral replication at 32 degrees C, with subsequent shift-up to 39 degrees C, presynthesized nucleoprotein (NP) was transported to, and accumulated in the cell nucleus whereas other viral proteins could not be detected there. A corresponding accumulation of NP in the nucleus is most often seen in association with MV neurotropic subacute sclerosing panencephalitis isolates in vivo and in vitro. PMID- 3531401 TI - [Pena-Shokeir syndrome. Malformed sequence. 2 case reports]. AB - The authors report two cases of Pena-Shokeir syndrome; they emphasize its place among the numerous etiologies of hydramnios, among the different AMC, particularly the autosomal recessive entities. PMID- 3531402 TI - [Incidence of occult lumbro-sacral spina bifida in parents of children with spina bifida (concerning 80 pairs of parents with affected children)]. AB - Authors examined 80 pairs of parents with affected children with spina-bifida. They compared the incidence of spina-bifida occulta in parents and in 211 controls. The conclusion is: there is no increased incidence of spina-bifida occulta in parents of spina-bifida. PMID- 3531403 TI - Cadmium stimulates glucose metabolism in rat adipocytes. AB - Cd2+ caused an increase in CO2 formation from glucose in rat adipocytes. The apparent Km value for glucose was 2.02 mM for control condition, with Cd2+, and with insulin. Cd2+ stimulates glucose metabolism even though specific diffusion of glucose is blocked. A possible site effected by Cd2+ is discussed. PMID- 3531404 TI - Phosphate-activated glutaminase in the crude mitochondrial fraction (P2 fraction) from human brain cortex. AB - The kinetics and other properties of phosphate-activated glutaminase have for the first time been studied in the crude mitochondrial fraction (P2 fraction) from human brain. The enzyme is for unexplained reasons inactivated postmortem. The enzyme activity decreases by storing the tissue or homogenate at 37 degrees C. The inactivation is not caused by formation of a dialysable inhibiting compound. No large proteolytic degradation has occurred, since the phosphate-activated glutaminase-like immunoreactive band did not disappear during the storage. The molecular weight of the subunit of the enzyme as determined by immunoblots of sodium dodecyl sulfate-treated homogenates from human brain is estimated to be approximately 64 K. The enzyme has been shown to have a pH optimum of 8.6; it is activated by phosphate, inhibited by glutamate, and partially inhibited by ammonia. Double-inverse plots of enzyme activity against phosphate are concave upward, and more so in the presence of an inhibitor. The inhibition by glutamate appears to be noncompetitive with the substrate glutamine, and competitive with the activator phosphate. These kinetic properties are not significantly different from our earlier observations concerning phosphate-activated glutaminase from pig brain and pig kidney. PMID- 3531405 TI - The brain 68-kilodalton microtubule-associated protein is a cognate form of the 70-kilodalton mammalian heat-shock protein and is present as a specific isoform in synaptosomal membranes. AB - The relationship between the 68-kilodalton microtubule-associated protein (68KMAP) and the major heat-induced protein (HSP70) in rat and human cells was investigated by comparison of their heat induction properties and by tryptic and Cleveland peptide mapping procedures. HSP70 synthesis was induced by heat shock of rat and human cells, whereas 68KMAP was a major synthesised protein in the absence of heat shock, with its synthesis being only slightly increased on heat shock. Tryptic peptide mapping, however, indicated strong peptide homology between the two proteins. These data, therefore, confirm that 68KMAP represents a constitutively expressed, heat-shock cognate gene. Two-dimensional gel electrophoretic analysis of subcellular fractions of rat brain, combined with peptide mapping procedures, indicated that 68KMAP exists as at least two isoforms separable by isofocussing, the more acidic of which (alpha 68KMAP) is present in fractions enriched in microtubules, cytosol, microsomes, synaptosomal plasma membranes, and synaptic vesicles, and the more basic of which (beta 68KMAP) is present predominantly in fractions enriched in synaptic vesicles and synaptosomal plasma membranes. These two forms are distinguishable in terms of changes in Cleveland peptide maps, and we conclude that alpha- and beta 68KMAP, therefore, represent distinct forms. The significance of these findings to the molecular pathogenesis of Down's syndrome in the human brain is discussed. PMID- 3531407 TI - Regional differences in 5-hydroxytryptamine and catecholamine uptake in primary astrocyte cultures. AB - The uptake of 3H-labelled 5-hydroxytryptamine (5-HT, serotonin) norepinephrine ([3H]NE), and 3,4-dihydroxyphenylethylamine ([ 3H]dopamine, [3H]DA) was studied in primary astrocyte cultures prepared from the cerebral cortex, corpus striatum, and hippocampal regions of neonatal rat brain. Na+-dependent uptake showed marked regional differences. For [3H]5-HT the magnitude of uptake was corpus striatum greater than or equal to cerebral cortex greater than hippocampus, whereas for [3H]NE the order was hippocampus greater than corpus striatum greater than cerebral cortex. For [3H]DA, only the hippocampal cultures showed significant Na+ dependent uptake. [3H]5-HT uptake was specifically inhibited by 10(-7) M fluoxetine whereas [3H]NE uptake was preferentially inhibited by 10(-7) M desipramine. These results may reflect regional brain specialization and/or different developmental patterns of high affinity uptake of serotonin and catecholamines by astrocytes in situ. PMID- 3531406 TI - Effect of excitotoxin lesions in the medical prefrontal cortex on cortical and subcortical catecholamine turnover in the rat. AB - Catecholamine turnover in brain areas innervated by dopaminergic neurons was examined 2, 6, and 12 days after bilateral, N-methyl-D-aspartate lesions confined to the rat medial prefrontal cortex. The lesion produced a significant regional increase in the concentration of 3,4-dihydroxyphenylethylamine (DA, dopamine) in both the medial prefrontal cortex and the ventral tegmental area. DA concentrations were increased in the nucleus accumbens on day 6 (128% of control), in the ventral tegmental area on day 2 (130% of control), and in the medial prefrontal cortex on days 2 (145% of control) and 6 (127% of control). The only significant changes in the concentration of 3,4-dihydroxyphenylacetic acid (DOPAC) (197% of control), and in the ratio DOPAC/DA (163% of control) were found in the medial prefrontal cortex on day 6 post-lesion. All parameters had returned to control levels by day 12. DA depletion after the administration of alpha methyl-p-tyrosine (AMPT) was not significantly different between excitotoxin lesioned and sham animals on day 6 in all brain regions. Noradrenaline (NA) and 3,4-dihydroxyphenylethyleneglycol concentrations and their ratios, and the depletion of noradrenaline after AMPT were also determined, and the lesion resulted in a significant regional increase in NA in both the nucleus accumbens and the ventral tegmental area. An elevation of NA (147% of control) in the nucleus accumbens was found on day 12. Since the excitotoxin lesion destroys corticofugal efferents from medial prefrontal cortex to the nucleus accumbens, the anterior corpus striatum and the ventral tegmental area, our results provide no evidence for a role of these cortical projections in the regulation of subcortical DA metabolism.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3531408 TI - Anatomical validation of middle cerebral artery position as identified by transcranial pulsed Doppler ultrasound. AB - The basal cerebral arteries were insonated using transcranial pulsed Doppler ultrasound (TPDU) at 2 MHz. The Doppler sample volume (SV) depths at which signals were obtained which could be attributed to the middle, anterior and posterior cerebral arteries (MCA, ACA and PCA) were compared with measurements in adult cadavers and with B-scan ultrasound studies in infants. The depth of the internal carotid artery (ICA) terminal division into ACA and MCA was closely correlated for both groups. In adults, it was found at 5.6 +/- 1.0 cm using TPDU while in cadavers it was found at 5.3 +/- 0.5 cm from the temporal bone. In infants, it was found at 3.2 +/- 0.3 cm for the right side, and 3.2 +/- 0.2 cm for the left side using TPDU, and at 3.4 +/- 0.4 cm and 3.4 +/- 0.5 cm for right and left sides respectively using B-scan ultrasound. The mean depth of the MCA mid-point in infants as defined by TPDU and B-scan was also closely correlated, with values of 2.8 +/- 0.3 cm and 2.7 +/- 0.3 cm for right and left sides respectively using TPDU and of 2.8 +/- 0.4 cm and 2.7 +/- 0.4 cm for right and left sides respectively using B-scan ultrasound. Values for the most lateral part of the MCA did not correlate. In adults, signals from the ACA and PCA were obtained at greater SV depth than the MCA, thus preventing confusion. PMID- 3531409 TI - Iatrogenic ex vacuo subdural hygroma: and a complication of the modified "Poppen" suture. PMID- 3531410 TI - John Hughlings-Jackson: a sesquicentennial tribute. AB - One hundred and fifty years have elapsed since the birth of John Hughlings Jackson, a pivotal figure in the development of clinical neuroscience. In this review the origin of Jackson's postulate of a hierarchical organisation of function in the nervous system is described in the context of his education and his contacts with contemporaries, both in his clinical practice at The London Hospital and at the National Hospital, Queen Square, and in relation to the evolutionary approach to the organisation and ideas on biology and society set out by the philosopher Herbert Spencer. PMID- 3531411 TI - Capillary fiber ratio and electrolyte content of compensatory hypertrophied rat soleus. AB - Capillary-to-fiber ratio and the content (mu moles/g muscle) of Na, K, Mg, Ca and Zn was measured in compensatory hypertrophied (CH) soleus muscles of adult Sprague-Dawley rats. The soleus hypertrophy was induced by unilateral tenotomy of the gastrocnemius and the plantaris muscles. Seven days after synergistic tenotomy the compensatory hypertrophied Soleus muscles showed no difference in the capillary-fiber ratio, Sr-extractable calcium ([Ca]Ext.) or the total content of Na, K, Mg and Zn. However, compared to the contralateral control side, the CH muscles showed an increase in the wet muscle weight (31.6%, P less than 0.01) and a significant decline (57.1%, P less than 0.05) in the residual calcium ([Ca]Res.) and 43.2% (P less than 0.05) decrease in the total calcium ([Ca]Total) content. It is concluded that during compensatory hypertrophy of skeletal muscles, the residual Ca reserves are significantly depleted, which may lead to a lower isometric tension generation in the muscle. PMID- 3531412 TI - Cell membrane abnormalities and genetic hypertension. AB - Evidence indicates that an alteration in kidney function has a causal role in the pathogenesis of hypertension in the Milan hypertensive strain (MHS) rat. At the prehypertensive stage, these animals have increased glomerular filtration rate and 24-hour urinary output, whereas plasma renin activity and urinary kallikrein are lower. After transplantation, the MHS kidney increases the blood pressure of a normotensive recipient. Micropuncture experiments, where single nephron filtration rate, tubuloglomerular feedback, proximal tubular reabsorption, micro pressures in tubuli, and interstitium and interstitial oncotic pressure were measured, suggest that the intrinsic ability of MHS proximal tubular epithelium to reabsorb solute and water is greater in prehypertensive MHS rats than in Milan normotensive strain (MNS) rats. Also rheogenic Na transport across the brush border vesicles isolated from proximal tubular cells is faster. When erythrocytes and proximal tubular cells of MHS rats are compared to those of MNS rats, the former have smaller volume and Na content, whereas the Na transport is faster and the Ca ATPase at Vmax is lower. This indicates that the genetic cellular abnormality responsible for the renal functional abnormality and hypertension is also present in erythrocytes. Moreover, MHS erythrocyte abnormalities are genetically determined within the stem cells and are genetically associated with hypertension. Because a correlation was also found in human hypertension between erythrocyte Na transport abnormality and renal function, it is proposed that the erythrocyte may be used for studying the genetic molecular mechanisms of hypertension. PMID- 3531413 TI - Sodium and potassium intake in the management of high blood pressure. AB - Reduction of sodium intake lowers blood pressure in many patients with essential hypertension. The fall in blood pressure with salt restriction is related to the severity of blood pressure before treatment, and this may explain why there is continuing controversy about the role of sodium restriction in patients with mild or borderline hypertension. The mechanism whereby salt restriction lowers blood pressure appears to be dependent on a relative lack of rise in renin and, thereby, angiotensin II with the salt restriction. Moderate reduction of sodium intake is additive to the effect of blood-pressure-lowering drugs, particularly those that block the renin-angiotensin system such as beta-blockers and converting enzyme inhibitors. Increasing potassium chloride intake has also been shown to cause a fall in blood pressure in patients with essential hypertension when on their normal sodium intake. However, more recent work shows that when patients are already restricting salt intake, potassium chloride supplementation has little or no effect on blood pressure. PMID- 3531414 TI - Energy balance and blood-pressure regulation. Update and future perspectives. AB - The relationship of blood pressure to body weight within populations is well documented: it is also generally accepted that the body mass index, as well as the change in body mass index over time, are predictive of risk for future hypertension. Short-term clinical trials suggest that satisfactory blood-pressure control can be more easily achieved in obese hypertensive subjects by a successful program of weight reduction. On the other hand, the pathophysiological aspects of the association between excessive weight and high blood pressure are still obscure; particularly the putative role of hyperinsulinemia, as well as exaggerated sympathetic activity, need to be confirmed. Recent evidence indicates that upper body fat predominance and low habitual physical exercise may be factors contributing to the increase in blood pressure, but the importance of still other factors, such as associated abnormalities of cell cation transport, has to be further elucidated. From the therapeutic point of view, there is a strong need for controlled trials to confirm feasibility and effectiveness of long-term programs of weight reduction as a means to control hypertension in the obese. Based on these considerations and the enormous potential for primary prevention, the problem of energy balance and blood-pressure regulation stands as a most important issue for future cardiovascular research. PMID- 3531416 TI - Caloric intake and sympathetic nervous system activity. Implications for blood pressure regulation and thermogenesis. PMID- 3531415 TI - Hypertension and other complications in human obesity. AB - Human obesity is characterized by differences in the distribution of excess fat. Only when obesity is mainly located in the abdominal regions are obesity associated diseases prevalent, including hypertension. It is possible that this is due to an excess production of free fatty acids from these lipolytically active depots. This, in turn, might cause hyperinsulinemia via reduced hepatic insulin uptake, followed by peripheral hyperinsulinemia, insulin resistance and, perhaps, diabetes mellitus and hypertension. PMID- 3531417 TI - The role of alcohol in hypertension. AB - The association between alcohol and hypertension was first described by Lian in 1915. He found that the prevalence of hypertension was high in heavy drinkers. However, this association did not receive much attention until the past 20 years. In this relatively short time, several epidemiological and a few clinical studies have been performed to investigate this association. In this article, the various studies are discussed, with a review of the possible mechanisms and a discussion of the importance of this association. PMID- 3531418 TI - Clinical trials on the treatment of hypertension. A critical appraisal. PMID- 3531419 TI - Drug therapy in hypertension: risks and benefits. AB - Controlled clinical trials have confirmed the benefit of antihypertensive therapy with drugs in moderate and severe hypertension. There is little doubt that the benefits in reduction of stroke and heart and kidney failure in these patients greatly exceed any risks of long-term drugs. In mild hypertension, benefit for the individual may be less easy to identify. Long-term drug therapy in mild hypertension may interfere with the quality of life through symptom side effects or even increase overall cardiovascular morbidity by adversely affecting other risk factors, such as lipids or serum potassium. Although the majority of patients will require drug therapy, nonpharmacological approaches are preferable if they can be used, as long as they themselves do not introduce any new hazards. It remains to be seen whether different drug regimens are associated with differences in long-term outcome. PMID- 3531420 TI - The diuretic dilemma and the management of mild hypertension. AB - Diuretics are presently used as antihypertensive medications as first-step monotherapy or in combination with adrenergic-inhibiting agents in the majority of hypertensive patients in the United States. A 30-year experience has demonstrated that blood pressure is lowered to as great or greater degree with diuretics than with many of the antihypertensive drugs presently available, including converting enzyme inhibitors, calcium entry blockers, beta- or alpha adrenergic inhibitors, or centrally acting sympatholytic agents. Diuretics appear to be especially effective in the elderly and in black patients. All of the major hypertension clinical trials on which we base our decisions for treatment have employed diuretics as first-step therapy, with a reduction in morbidity and mortality. The debate concerning the long-term safety of diuretic therapy has focused on the United States Multiple Risk Factor Intervention Trial results and several papers suggesting that the lipid-raising or potassium-lowering properties of diuretics may produce adverse effects. Suggestions have been made that the use of other drugs without metabolic side effects may result in greater benefit with less risk, especially in the management of mild hypertension where the risk of the disease is not immediate or great. A review of the MRFIT and lipid data from long-term studies have failed to establish the "toxicity" of diuretic agents. In addition, recent studies have not confirmed previous observations that diuretic induced hypokalemia increases ventricular ectopy or contributes to sudden death.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3531421 TI - The significance of bone marrow involvement in non-Hodgkin's lymphoma: the Eastern Cooperative Oncology Group experience. AB - Data from four clinical trials conducted by the Eastern Cooperative Oncology Group (ECOG) were used to investigate the importance of bone marrow involvement as a prognostic factor in patients with non-Hodgkin's lymphoma (NHL). A total of 502 patients, 275 with nodular, poorly differentiated lymphocytic lymphoma (NLPD) and 227 with diffuse histiocytic lymphoma (DHL) or diffuse mixed-cell lymphoma (DML), were included in this analysis. Patients were separated into four categories: stage III, stage IV with bone marrow involvement (stage IV-M), stage IV without marrow involvement (stage IV-O), and stage IV with bone marrow and other organ involvement (stage IV-OM). Among the DHL and DML patients, the incidence of marrow involvement was 23%. However, stage IV-M patients had a prognosis that is similar to stage IV-O and stage IV-OM and worse than stage III patients. In contrast, the incidence of involvement with NLPD was 59% and patients with stage IV-M had a survival not different than stage III and not worse than stage IV-O and stage IV-OM. The results suggest that the current emphasis on bone marrow biopsy(s) as a routine diagnostic staging procedure for patients with NHL should be reevaluated. The necessity for this procedure in stage III patients with NLPD is not apparent from our data. One can still justify a bone marrow biopsy in stage I and II patients and can confirm the complete clinical response when all nodes have regressed in more advanced disease. PMID- 3531422 TI - Follicular lymphoma: prognostic factors for response and survival. AB - One hundred forty-eight patients with newly diagnosed follicular lymphoma were treated over a 12-year period. Twenty-two patients received radiotherapy for stage I and II disease, followed by adjuvant chemotherapy in 14 patients. One hundred thirteen were treated at presentation with short courses of chemotherapy, most often with single-agent chlorambucil for bulky stage II and stages III and IV disease. Thirteen patients were managed expectantly until there was evidence of disease progression. The median survival was 9 years. Patients treated with radiotherapy for stage I and II disease had an 83% relapse-free survival, but those with bulky stage II or stages III and IV disease treated with chemotherapy pursued a remitting and relapsing course with a 70% response rate at initial and subsequent retreatments, but a median duration of remission of 4 years in stage III and 1 year in stage IV disease (P = .041). Patients were observed in relapse and retreatment was administered as appropriate, once every 33 months on average. Poor prognosis patients could be identified by a combination of the presentation characteristics: B symptoms, hepatosplenomegaly, anemia, and abnormal liver function. These factors predicted a poor response to treatment and correlated with a short survival. Histologic subgroups were not associated with differences in survival, but transformation to a diffuse high-grade lymphoma was observed in 23 of the 72 patients (32%) at risk, with a median follow-up of 6 years and 6 months, and was associated with a very poor prognosis. The present treatment strategy has proved successful for most patients with localized disease and those older patients with indolent small volume disseminated follicular lymphoma. New approaches are being investigated for the younger poor prognosis patients. PMID- 3531423 TI - Bone marrow transplantation for hematologic malignancies in patients aged 30 years or older. AB - During the past 10 years, 86 patients 30 to 54 years of age with hematologic malignancies were prepared with high-dose radiochemotherapy and received histocompatible bone marrow grafts. Thirty-four of these patients are surviving for 4 months to 9 years (median, 26 months) following marrow transplantation and 32 of them are in continuing complete remission (CR). Disease-free survival is 44% for 37 patients who were in first remission of acute leukemia or in the chronic phase of chronic granulocytic leukemia (CGL), 23% for 39 patients whose leukemia had relapsed at least once before transplantation or who had advanced stages of CGL, and 60% for ten patients who had hematologic malignancies other than leukemia. The median age of the surviving 34 patients is 36 years (range, 30 to 43 years). The incidence of moderate to severe acute graft-v-host disease (GVHD) was 48% and of chronic GVHD, 26%. The major causes of failure were interstitial pneumonia in 31 patients (24 of whom had antecedent acute GVHD) and recurrent leukemia in 12 patients (11 of whom had either never entered a CR or had relapsed at least once with acute leukemia or had progressive CGL before transplantation). Our data warrant further prospective studies in patients with hematologic malignancies who are older than 30 years. PMID- 3531424 TI - Carboplatin (NSC-241-240): an active platinum analog for the treatment of squamous-cell carcinoma of the head and neck. AB - Carboplatin (CBDCA, Bristol-Meyers, New York) is a second generation platinum analog. Preclinical and phase I clinical studies have indicated a different spectrum of toxicity compared with the parent compound. In order to study the activity of carboplatin against cancer of the head and neck, 31 patients with recurrent or metastatic disease (30 squamous-cell and one adenoid cystic carcinoma) were treated with doses of 60 to 80 mg/m2 administered daily by intravenous (IV) bolus injections for five days, repeated at every 4- to 5-week intervals. In most cases, treatment was administered on an outpatient basis. Eight patients (26%; 95% confidence interval, 12% to 45%) had complete (CR) or partial responses (PR) with a median duration of 4.5 months. Moderate bone marrow suppression was the main toxicity. Mild nausea and vomiting was unusual and no neuro- or nephrotoxicity were seen. These preliminary data suggest that carboplatin has activity against advanced squamous-cell carcinoma of the head and neck comparable with the results reported with cisplatin alone in similar patient populations. The potential advantages over the parent compound relate to the absence of nephrotoxic effects and mild gastrointestinal toxicity which allows for outpatient treatment. Because carboplatin toxicity is directly dependent on its mechanism of renal excretion, particular attention should be given for its use in patients with impaired renal function or when combined with nephrotoxic agents. Similarly, because the dose limiting toxicity with this agent is primarily hematologic, its use in combination with other myelotoxic agents should be carefully undertaken. Further studies are indicated in order to define the spectrum of activity of the new generation platinum analogs in various tumors in humans. PMID- 3531425 TI - Hodgkin's disease presenting below the diaphragm: a review. PMID- 3531427 TI - Spectrin subtypes in mammalian brain: an immunoelectron microscopic study. AB - Spectrin is a major cytoskeletal component of the brain. At least 2 distinct spectrin subtypes are found in mammalian brain: brain spectrin(240/235) and brain spectrin(240/235E). In the present study spectrin subtypes were localized in the adult mouse brain by immunoelectron microscopy using antibodies that recognize each subtype. Brain spectrin(240/235E) was concentrated in neuronal cell bodies, dendrites, and postsynaptic terminals. It was also prominently associated with the plasma membrane, microtubules, filaments, mitochondria, endoplasmic reticulum, and nuclear envelope, and it appeared to interconnect structural elements within the cell. Brain spectrin(240/235E) also was localized to the plasma membrane, nuclear envelope, and cytoplasmic organelles of glial cell bodies. Brain spectrin(240/235) was detected in axons and presynaptic elements, where it was associated with the plasma membrane, microtubules, filaments, synaptic vesicles, and mitochondria. These results show that spectrin is distributed throughout the cytoplasm of neural cells, the location of spectrin is dependent on subtype, and the cytoplasmic surface of plasma membrane and organelles contains an extensive and intricate spectrin meshwork. PMID- 3531426 TI - Homoharringtonine--perspectives on an active new natural product. PMID- 3531428 TI - Pharmacological properties of immuno-isolated neuronal nicotinic receptors. AB - Recently we immunoaffinity-purified an ACh receptor from chicken brain using a monoclonal antibody raised against receptors from fish electric organ (Whiting and Lindstrom, 1986). This neuronal receptor could be affinity-labeled with 3H bromoacetylcholine, and antisera to it specifically blocked ACh-induced depolarization of chicken ciliary ganglion cells. Here we show that this neuronal ACh receptor binds 3H-nicotine with high affinity (KD = 6.61 +/- 0.13 nM). 3H Nicotine binding was blocked by various nicotinic cholinergic ligands but not by alpha-bungarotoxin or the muscarinic antagonist atropine. Binding was also blocked by affinity labeling the receptor with bromoacetylcholine (after reduction by dithiothreitol). Additionally, we were able to use rat antisera raised against the chicken brain receptor to isolate a component from detergent extracts of rat brain that also bound 3H-nicotine with high affinity (KD = 1.5 nM). The pharmacology of this putative ACh receptor from rat brain was almost identical to the receptor from chicken brain, and its regional distribution was in good agreement with that of 3H-nicotine binding to rodent brain membranes reported by other workers. Thus, by analogy to the receptor we have purified and characterized from chicken brain, this nicotine-binding component from rat brain is probably a functional mammalian neuronal nicotinic ACh receptor. PMID- 3531429 TI - Reproducibility of the border outline of working impressions of the edentulous mandible obtained by the Slack-Herbst method. PMID- 3531430 TI - A frameless stereotaxic integration of computerized tomographic imaging and the operating microscope. AB - A computer-based system has been developed for the integration and display of computerized tomography (CT) image data in the operating microscope in the correct perspective without requiring a stereotaxic frame. Spatial registration of the CT image data is accomplished by determination of the position of the operating microscope as its focal point is brought to each of three CT-imaged fiducial markers on the scalp. Monitoring of subsequent microscope positions allows appropriate reformatting of CT data into a common coordinate system. The position of the freely moveable microscope is determined by a non-imaging ultrasonic range-finder consisting of three spark gaps attached to the microscope and three microphones on a rigid support in the operating room. Measurement of the acoustic impulse transit times from the spark gaps to the microphones enables calculation of those distances and unique determination of the microscope position. The CT data are reformatted into a plane and orientation corresponding to the microscope's focal plane or to a deeper parallel plane if required. This reformatted information is then projected into the optics of the operating microscope using a miniature cathode ray tube and a beam splitter. The operating surgeon sees the CT information (such as a tumor boundary) superimposed upon the operating field in proper position, orientation, and scale. PMID- 3531431 TI - Ultrasound-guided stereotaxic biopsy using a new apparatus. AB - A skull-mounted apparatus is described for use with ultrasound probes 16 mm in diameter (5.0-MHz probes for near-field and 7.5-MHz probes for far-field lesions). The system permits ultrasound-guided stereotaxic biopsy of intracranial lesions through a burr hole in awake or anesthetized patients. This apparatus has been used in 19 patients for biopsy of central nervous system lesions 1.5 to cm in diameter and for drainage of abscess cavities and cysts. The time required to obtain a tissue sample after incision of the skin ranged from 25 to 40 minutes. The only complication was a delayed hemorrhage in a patient with acquired immunodeficiency syndrome. The advantages of this method over those guided by computerized tomography (CT) include less time required for the entire procedure, immediate confirmation of the biopsied target by imaging the echogenic needle track, assessment of cyst or abscess drainage, and detection of hemorrhage within minutes after biopsy. The apparatus may be especially useful in pediatric patients because it obviates the need for general anesthesia during transport to and from the CT scanner. This ultrasound-guided system does not require a craniotomy, craniectomy, or two separate burr holes. PMID- 3531433 TI - Transition programs for new graduates. How effective are they? PMID- 3531434 TI - Concept mastery in nursing staff development. PMID- 3531432 TI - Brain abscess aspiration in nursery with ultrasound guidance. Case report. AB - The authors report the case of a 1000-gm neonate who developed a frontal brain abscess due to a Serratia marcescens infection. The relationship of the mass to the neighboring ventricle and to the coronal suture was determined by computerized tomography. The mass was then successfully aspirated in the intensive care nursery with ultrasound guidance. A more prolonged operative procedure was avoided. PMID- 3531435 TI - Nurse executives can mean business. PMID- 3531436 TI - Midwifery care: a political perspective. PMID- 3531437 TI - Dietary fatty acid modulation of murine B-cell responsiveness. AB - These studies were designed to determine how dietary fat concentration and degree of saturation influence antibody response to a T-dependent antigen. In vivo fatty acid manipulation did not affect the total number of nucleated spleen cells or IgM or IgG-bearing cells. After primary immunization with sheep red blood cells (SRBC), the number of splenic IgM and IgG antigen specific plaque-forming cells (PFC) was lower in mice fed a diet containing a high level of polyunsaturated fat (PUF, safflower oil) than in mice fed a diet containing minimal essential fatty acids (EFA, 0.5% corn oil). Mice fed a high level of saturated fat (SF, coconut oil) exhibited greater IgM PFC responses than the control. After secondary immunization, the number of IgG-producing cells followed a similar response pattern. These differences were also reflected in the serum anti-SRBC IgM and IgG levels as determined by solid-phase radioimmunoassay. Although the level of linoleic acid in whole lymphocytes has been previously reported to change in direct relation to the serum fatty acid level, no differences in the fatty acid composition of isolated lymphocyte plasmalemma were observed. Thus, changes in the number of antibody-forming cells appear to be inversely related to the levels of linoleic acid in other cell compartments. Fluorescence polarization measurements of the lipopholic probe, 1, 6-diphenyl-1,3,5-hexatriene (DPH), in the purified lymphocyte plasmalemma from mice fed a diet high in PUF indicated an increase in mobility. Polarization values for lymphocyte plasmalemmas from mice receiving diets high in SF were not significantly different from the controls. We conclude that dietary fat modulation of splenic B-cell responses was manifested through changes in the number of cells producing antibody and level of antibody produced, not through total splenic B-cell numbers. This B-cell response can be modified, depending upon the fatty acids available to the cell, and may be related to differential effects upon plasma membrane structure. PMID- 3531438 TI - Reinvestigation of compound X, a suspected biotin intermediate: identification of N-formyl derivatives of biotin and dethiobiotin. AB - Compound X, reported as an intermediate in the biosynthesis of biotin from dethiobiotin (DTB) (Biochem. Biophys. Res. Commun., 88, 312 (1979)), was found to contain N-formyl DTB and biotin. The methyl ester of N-formyl biotin was considered to be a product from the biotin, which was biosynthesized from DTB by resting cells of E. coli C 124, through treatment with diazomethane in the presence of a trace amount of formic acid after Dowex 1X2 column chromatography. NMR analysis revealed that biotin was formylated at 1'-N. N-Formylated DTB and biotin are new biotin derivatives. PMID- 3531439 TI - The mysterious case of Sherlock Holmes's creator. PMID- 3531440 TI - Edgar Rudolph "Painless" Parker (1872-1952). The "P.T. Barnum" of dentistry. Part I: Canadian beginnings. PMID- 3531441 TI - "Fatal Serratia marcescens infection of the neck in acute leukemia". PMID- 3531442 TI - Autogenous dermal grafts for repair of temporomandibular joint disc perforations. AB - In five Macaca fascicularis monkeys bilateral 5-mm perforations of the intra articular disc were followed by unilateral repair with autogenous dermal grafts. The monkeys were killed at three, six, 12, 24, and 36 weeks after surgery. The temporomandibular joints (TMJs) were removed en bloc, decalcified, and sectioned in the sagittal plane for histologic examination. All of the control untreated disc perforations, with the exception of one, failed to heal. With all of the grafted disc perforations, viable dermis and fibrous connective tissue proliferation were seen in the area of the repaired perforation. Therefore, autogenous dermal grafting appears to be an acceptable technique for repair of the damaged disc in degenerative joint disease of the TMJ. PMID- 3531443 TI - Clinical and radiographic observations after 6 years on bridge abutment teeth carrying pinledge retainers. AB - A group consisting of 108 bridge recipients (71 female, 37 male) with a total of 114 bridges retained solely (n = 40) by pinledges or retained by a combination (n = 74) of pinledges and complete crowns was examined clinically and radiographically 6 years after completion. The study was to review evidence of any displacement of bridges as well as the incidence of periapical changes and carious lesions of those abutment teeth fitted with pinledges (n = 210). The results showed that bridges retained solely by pinledges had become displaced more frequently than bridges retained by a combination of crowns. The failure rates (%/year) for bridges retained solely by pinledges was 2.5% and for bridges with a combination of retainers 0.25%. Three teeth (1.4%) experienced pulp exposure during the preparatory work and 6 teeth (2.8%) had been or had to be rootfilled after 6 years. Carious lesions had developed in 6 abutments (1.9%). PMID- 3531444 TI - Changes in physical and chemical properties of a dental palladium-silver alloy during metal-porcelain bonding. AB - The hardening ability of a dental palladium-silver (Pd-Ag-Sn-In) bonding alloy has been investigated, and the distribution of the elements along the metal ceramic interface have been studied by microprobe analysis. The alloy was found to be highly heterogeneous in its 'as-cast' condition, but homogenized alloy was obtained after heating the alloy at 1000 degrees C for 2 h. Hardening occurred after annealing at 650 degrees C for 1 h. A longer thermal treatment caused the hardness to decrease (over-ageing). The change in hardness could be attributed to an internal oxidation phenomenon. The additional elements tin and indium segregated towards the ceramic-metal interface, with a diffusion of indium only into the porcelain. Diffusion of silver in the ceramics, supposed to be the cause of the 'greening' of dental porcelains baked on silver-rich alloys, has not been detected by the microprobe across the interface. PMID- 3531445 TI - Inaccuracies and defects in frameworks for removable partial dentures. AB - We studied the accuracy of 167 removable partial denture frameworks made in five commercial dental laboratories according to detailed instructions given by dental students, under the supervision of experienced teachers. Fewer than one half of the frameworks proved to be perfect. Some of the faults were accepted in the clinic, but 42% had to be corrected: 26% in the clinic, and 16% in the laboratory. Laboratory problems could be blamed for two-thirds of the faults, and one-third seemed to be attributable to the clinic. The advantages of, for example, new impression materials seemed to disappear under other factors. PMID- 3531446 TI - An examination of the surface corrosion state of dental fillings and constructions. II. A clinical study on patients with orofacial complaints. AB - A group of 115 patients with orofacial complaints has been examined. A new method for intraoral measurement of electrode potentials on the surface of the amalgam fillings and prosthetic constructions has been developed and applied. The possible connections between the measured electrode potentials and patients' saliva properties and their complaints have been discussed. No correlations between measured electrode potentials of the metallic fillings and constructions and important saliva properties could be found. No connections between the measured electrode potentials and the patients' complaints could be proved. PMID- 3531447 TI - An immunohistochemical study of a colonic mucus antigen in normal and neoplastic gastrointestinal tissues. AB - A monoclonal antibody YPC 44.3 which reacts with human large intestinal goblet cell mucus has been used to examine normal gastrointestinal mucosa and a series of gastric and colorectal carcinomas in an immunohistochemical study. In normal colonic mucosa the antibody is shown to detect an antigen which is expressed polymorphically and depends on the presence of the active allele at the Lewis locus for its expression. However the antigen appears distinct from regular Lewis antigens on the basis of immunoabsorption studies and organ distribution. Results of immunostaining tumours show no correlation with the site, classification or grade of tumour or the type of metaplasia adjacent to gastric cancers. The relationship of YPC 44.3 to other mucus antibodies and the importance of screening tissues with a wide range of blood group phenotypes is discussed. PMID- 3531448 TI - Associated expression of HLA class I and class II antigens on melanoma cells in surgically removed metastases. AB - Malignant transformation of melanocytes and further neoplastic progression may be associated with qualitative and/or quantitative changes in expression of HLA class I and class II antigens. Since previous immunohistochemical studies of surgically removed melanoma lesions have suggested a relationship in the expression of HLA class I and class II antigens, we have investigated the expression of these antigens at the single cell level. Double immunofluorescence staining of frozen sections of melanoma metastases and immunoelectron microscopic double labelling of melanoma cell suspensions prepared from three of these lesions has detected three HLA phenotypes on the large majority of melanoma cells: either both HLA class I and class II antigens, neither HLA antigen or only HLA class I antigens. In four out of the 11 lesions a few melanoma cells were found to express HLA class II antigens and to lack HLA class I antigens. A relationship was also found in the level of expression of HLA class I and class II antigens, as estimated by the intensity of staining with monoclonal antibodies. The level of expression of HLA class II antigens appeared to be similar to or lower than that of HLA class I antigens on the large majority of melanoma cells. This coordinated heterogeneity in the expression of HLA class I and class II antigens by melanoma cells may have implications in the interactions of tumour cells with the host's immune system. PMID- 3531449 TI - Bacteremia in sickle hemoglobinopathies. AB - We analyzed 178 episodes of bacteremia that occurred during 13,771 patient-years of follow-up of 3451 patients with sickle hemoglobinopathies. Age-specific incidence rates of bacteremia were calculated for patients with sickle cell anemia (SS) and sickle cell-hemoglobin C (SC) disease. The incidence rate was highest among children with SS and SC younger than age 2 years. Children with SC showed an abrupt decrease after age 2 years, whereas children with SS had a gradual decline in rate from 2 to 6 years of age. The predominant pathogen in patients younger than 6 years was Streptococcus pneumoniae (66%); gram-negative organisms were responsible for 50% of bacteremias in patients 6 years and older. Urinary tract infection was present during 73% of Escherichia coli bacteremias, and 77% of Salmonella bacteremias were associated with osteomyelitis. In contrast, no focus of infection was present in 52% of pneumococcal bacteremias. The incidence of pneumococcal bacteremia in children with SS younger than age 3 years was 6.1 events/100 patient-years; the case fatality rate for pneumococcal sepsis in this age group was 24%. No hematologic or demographic variables were associated with occurrence of pneumococcal bacteremia in young children. Retrospective analysis of pneumococcal bacteremia suggests that the prophylactic use of penicillin may decrease the incidence in children younger than 3 years of age. PMID- 3531450 TI - Course of nephropathic cystinosis after age 10 years. AB - We identified 80 patients with nephropathic cystinosis older than age 10 years in the United States and Canada. The oldest reported individual was 26 years of age. Ninety percent of patients had received at least one renal allograft. Age at the time of first transplant varied between 7 and 17 years (mean 10.0 years). Almost three fourths of the patients required thyroid replacement, 27% had splenomegaly, and 42% had hepatomegaly. Photophobia was noted in 86% of patients, decreased visual acuity in 32%, and corneal ulcerations in 15%. Neurologic involvement, renal osteodystrophy, and diabetes mellitus were unusual. All these late complications of nephropathic cystinosis contribute to a description of the natural history of the disease and provide a rationale for the therapeutic use of cystine-depleting agents after renal transplantation. PMID- 3531451 TI - Rapid diagnosis of Chlamydia trachomatis pneumonia in infants by direct immunofluorescence microscopy of nasopharyngeal secretions. PMID- 3531452 TI - Pharmacokinetics and nephrotoxicity of continuous intravenous infusion of gentamicin in low birth weight infants. AB - We evaluated the pharmacokinetics and renal effects of continuous intravenous infusion of gentamicin compared with multiple-dose therapy given in equivalent daily amounts. Nine infants (mean gestational age 34.7 weeks, mean birth weight 2107 gm) were given intermittent injections of gentamicin and 10 infants (mean gestational age 34.8 weeks, mean birth weight 2078 gm) received gentamicin by continuous infusion. Comparison of gentamicin pharmacokinetic data revealed a larger volume of distribution and AUC, prolonged terminal t1/2, and slower total body clearance of the drug in those infants receiving gentamicin by continuous infusion. During and after therapy the fractional excretion of sodium was significantly increased in the continuous infusion group. After treatment the creatinine clearance and excretion of beta 2-microglobulin were significantly lower in the continuous therapy group. Our results indicate that infants receiving gentamicin by constant infusion are at higher risk of nephrotoxicity. The extent of this nephrotoxic hazard remains to be determined. PMID- 3531453 TI - Methods for culturing streptococci from throat swabs. PMID- 3531454 TI - Prevention of variceal bleeding. PMID- 3531455 TI - Jejunal bacterial overgrowth in acute and persistent infectious diarrhea. PMID- 3531456 TI - Duodenal microflora in infants with acute diarrheal disease. AB - The duodenal microflora was determined qualitatively and quantitatively in a group of infants early in the course of diarrheal disease. Abnormal bacterial overgrowth in the duodenal aspirate was demonstrated in 70%. Coliforms and bacteroides species were present in significant numbers in 53%. No differences were found in the duodenal microflora distinguishing infants whose diarrhea persisted after 7 days in the hospital from those whose diarrhea resolved earlier. PMID- 3531457 TI - Comparative studies of different gliadin preparations in detecting antigliadin antibodies. AB - Antigliadin antibodies (AGA) have been used as indicators of celiac disease. The presence of these antibodies in other gastrointestinal and liver disorders and even in normal healthy controls casts a shadow on the diagnostic significance of AGA. We examined 91 normal controls of varying ages and 97 patients with various gastrointestinal and liver disorders. Forty-eight of 97 nonceliac patients were positive for AGA, and diagnosis-specific incidences ranged as high as 75% in patients with small bowel disease. In addition, the levels of AGA were dependent upon age as their presence increased from 12% in children with a mean age of 10, to 35-40% in normals within the 60-70 age group. The lack of celiac disease specificity of AGA was not due to either the source of gliadin nor to the sensitivities of the test methods. Both the enzyme-linked immunosorbent assay (ELISA) and the immunofluorescence methods gave comparable results. ELISA was more sensitive than immunofluorescence. These results thus strongly suggest that AGA are not markers of celiac disease and increase with age in normals. PMID- 3531458 TI - Antigliadin and antireticulin antibodies in children with dermatitis herpetiformis. AB - The serum samples of 27 children with dermatitis herpetiformis (DH) were examined for the presence of antigliadin (AGA) and antireticulin (ARA) antibodies. AGA were determined with an enzyme-linked immunosorbent assay (ELISA) and ARA with an immunofluorescence method. Increased IgA or IgG class AGA levels were found in four of ten children on a normal diet, in two of 25 on a gluten-free diet (GFD), and in two of four children on gluten challenge. The corresponding figures for ARA were nine of ten, two of 25, and four of four, respectively. All nine patients with ARA on a normal diet had either subtotal or partial villous atrophy, whereas the patient negative for ARA had a normal jejunal mucosa. ARA were mostly of IgA class, and after gluten withdrawal, increased levels fell to normal range. Four children were challenged with gluten, and they all developed subtotal villous atrophy and demonstrated IgA class ARA. These results suggest that in childhood DH, ARA is a more sensitive indicator of gluten-sensitive enteropathy than AGA, but both antibody determinations can be used in monitoring adherence to GFD treatment. PMID- 3531459 TI - Effects of the composition and caloric value of infant formulas on intake and hormone levels. AB - Seventy-six normal full-term infants have been observed from birth to the fourth month of life. Thirty-six were breast-fed; the others were fed four different feeds (conventional or adapted formulas) containing different amounts of calories, protein, fat, and carbohydrate. The control mechanism of volume intake appears to be well functioning in infants fed human milk and adapted formulas providing conventional calorie concentrations. The other formulas were associated with either a high BUN or high base insulin concentrations. It is concluded that uncontrolled amounts of milk should be fed only to breast-fed infants and those receiving adapted formulas but not to those fed formulas that provide high calorie or protein concentrations. PMID- 3531460 TI - Enzyme immunoassay for captopril. AB - A simple enzyme immunoassay for the determination of captopril was developed. A specific antibody for captopril was produced in rabbits that were immunized with a hapten-bovine immunoglobulin G conjugate, which was prepared by using 4 (maleimidomethyl)cyclohexane carboxylic acid as a spacer group. The limit of detection in plasma is 0.5 ng/mL. The assay has an adequate specificity, so isolation of captopril is unnecessary. PMID- 3531461 TI - Effect of short-term cyclosporine administration in rats on renin-angiotensin and thromboxane A2: possible relevance to the reduction in glomerular filtration rate. AB - A short-term treatment with Cyclosporine A (CyA) induces a decrease in glomerular filtration rate (GFR), promptly reversible after withdrawal of the drug. Several lines of evidence are now available as to indicate that this phenomenon is dependent on a hemodynamic perturbation resulting in a renal vasoconstriction. With the present work we have examined the relationship between the reduction in GFR which follows a short-term administration of CyA in rats and the biochemical changes in renin-angiotensin system and renal arachidonic acid metabolism. Our results show that CyA administration (25 mg/kg/day) for 45 days stimulates renin angiotensin system with an increase in plasma renin activity. These changes are not accompanied by a parallel increase in the renal synthesis of vasodilatory prostaglandin E2 and prostacyclin as it occurs in other conditions of renin angiotensin stimulation. At variance glomerular synthesis and urinary excretion of thromboxane A2 (TxA2) are increased progressively during CyA treatment. These changes in renal Tx precede the increase in serum creatinine and the decrease in GFR thus indicating that TxA2 might be an additional factor potentiating the effect of angiotensin II on glomerular hemodynamics. In conclusion the early reduction in GFR which follows daily administration of CyA in rats might be the result of a synergic action of angiotensin II and TxA2 on vascular tone and mesangial contraction which is not modulated by an increase in glomerular vasodilatory prostaglandins. If this explanation may be applied to early reduction in GFR observed in humans treated with CyA before tubular toxicity develops needs to be investigated further. PMID- 3531462 TI - Estrogen modulation of uterine adrenergic-cholinergic interaction: effects on vasoactivity and adrenergic receptors in the guinea pig. AB - The regulation of uterine blood flow (UBF) in the guinea pig was investigated by determining the effects of steroid-catecholamine interaction on guinea pig UBF in cyclic (Day 0 = estrus) and ovariectomized (OVX)-steroid treated females. In cyclic guinea pigs, parallel elevations in uterine weight, UBF, beta and alpha receptor levels were observed during the estrus period, whereas uterine norepinephrine (NE) levels were low. In contrast, all parameters remained at low levels except NE levels during the luteal phase of the cycle which remained elevated in both normal and OVX-oil treated animals. Estrogen (E1)-treated females showed elevated uterine weights, UBF, beta, and alpha receptor levels but low uterine NE concentrations. Combined progesterone-estrogen (P2E1) treatment caused similar changes but maintained tissue NE at control levels. In the exposed uterine artery preparation, the sequential administration of acetylcholine followed by NE application induced a marked elevation in UBF in OVX, E-1-treated animals which was blocked by phentolamine (10(-6) M). This phenomena could not be demonstrated in either oil- or progesterone-treated OVX guinea pigs. In uterine membrane preparations from ovariectomized guinea pigs pretreated with either oil or progesterone, methacholine (cholinergic agonist; 10(-6) M) failed to alter the affinity of the alpha receptor for NE. However, in uterine preparations from OVX, estradiol-treated guinea pigs, methacholine significantly (P less than .05) increased the affinity of the alpha receptor for NE.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3531463 TI - Fabrication of treatment restorations using acrylic resin denture teeth. AB - A technique is disclosed for fabricating esthetic, long-term treatment restorations by using acrylic resin denture teeth facings. The advantages of this method for provisional restoration construction are reduced costs and predictable, satisfying results. PMID- 3531464 TI - Electrosurgical management of hyperplastic tissue. AB - Electrosurgery is a safe, effective modality for tissue management in conjunction with restorative dentistry. It can be used to remove redundant tissue to gain access for tooth preparation, develop a gingival trough around the margins of a prepared tooth for an accurate impression, control hemorrhage, remove opercula, and plane and reshape tissue of an edentulous area for the construction of a hygienic and esthetic pontic. PMID- 3531465 TI - Retention and resistance in preparations for extracoronal restorations. Part II: Practical and clinical studies. PMID- 3531466 TI - Porous metal coatings for resin-bonding systems. AB - Two porous coating systems produced surfaces 20 to 30 microns thick, capable of engaging the unfilled component of composite during bonding procedures. A technique is suggested whereby the thickness of porous coating may be compensated by die spacing. The film thickness of the cement tested would be unlikely to affect the fit of any such prosthesis. Prostheses constructed in this manner would have the benefits of microretention without the technical problems of electrolytic etching. PMID- 3531467 TI - A chemical etching system for creating micromechanical retention in resin-bonded retainers. AB - A method of chemically etching selected nonnoble alloys has been developed. This report provided data supporting that an effective attachment is created between resin and etched metal. This system reduces the disadvantages in creating a micromechanical retention by the electrochemical approach. The simplification of the process and reduction in the equipment needed should encourage greater use of etched-metal resin-bonded retainers. PMID- 3531468 TI - Comparison study of elastic impression material. AB - The study of four elastic impression materials indicated that master castings could be more accurately seated on casts made from MOD impressions than from full crown impressions. A discrepancy between clinical acceptance and statistical identity was also demonstrated. The study indicated that by altering just one variable, the pour time, a wide range of results is obtained, some clinically acceptable and others clinically unacceptable. PMID- 3531469 TI - Evaluating six sprue designs used in making high-palladium alloy castings. AB - Six different sprue designs were studied to determine which, if any, could be used to produce more complete castings with a high-palladium alloy. A standardized mesh test pattern was used to ensure objective measurements and accurate evaluations of the spruing techniques. This study of problems usually encountered when casting high-palladium alloys found that: Differing sprue designs effect significant differences in obtaining complete castings (p less than .05) as indicated in the ANOVA. The connection between the casting and the sprue should be constricted to improve castability of high-palladium alloys. Although this spruing technique may be used in different sprue designs to improve the quality of castings, further research seems indicated. PMID- 3531470 TI - Canines as removable partial denture abutments. Part I: Tooth rank and canine incidence. PMID- 3531471 TI - An esthetic removable partial denture retainer for the maxillary canine. AB - The use of a distofacial ridge on a maxillary canine abutment for a distal extension base of a removable partial denture is described. The distofacial ridge will permit the placement of a less conspicuous I-bar arm on the distofacial surface of the tooth. The ridge provides bracing against distal movement during function and thus prevents the subsequent loss of retention for the prosthesis. It also permits a more precise path of insertion and withdrawal for the prosthesis. Three methods of establishing a distofacial ridge on a canine abutment are described. PMID- 3531472 TI - Preliminary study of a method of measuring removable partial denture abutment tooth movement in vitro and in vivo. PMID- 3531473 TI - Gingival augmentation for osseointegrated implant prostheses. AB - A method of solving some problems inherent with osseointegrated implant prosthesis has been presented. A removable flange can reestablish lip support or block escape of unwanted air while allowing the access necessary for competent hygiene procedures. Overdentures may be indicated to provide the prosthetic gingival surface necessary for adequate food control or speech. PMID- 3531474 TI - Elimination of mandibular labial undercut with autogenous bone graft from a maxillary tuberosity. AB - A brief review of various grafts and implants that may be used to eliminate labial undercuts was described. A technique for elimination of the mandibular labial undercut with autogenous bone from the maxillary tuberosity was presented. PMID- 3531475 TI - Load cycling of lingual rest seats prepared in bonded composite. AB - A study to investigate the suitability of lingual composite rest seats for anterior teeth was based on the single criterion of repetitive load cycling. A 3 year minimum survival was chosen, with load and cycling values based on a review of the literature. An attempt was made to simulate the effect of saliva on composite. PMID- 3531477 TI - Blockout before making impressions of bars. PMID- 3531478 TI - Etched-metal resin-bonded intracoronal cast restorations. Part II: Design criteria for cavity preparation. AB - Intracoronal cast restorations can now be designed without dentinal involvement and with minimal alterations of the enamel. Exposure of the dentin is avoided during cavity preparation unless necessitated by disease, trauma, or previous restorations. Bonded retention also compensates for reduced frictional retention and provides support to weakened cusps. This article compared conventional intracoronal cast restorations with a design based on resin-bond retention. The proposed etched-metal resin-bonded restorations were found to be less invasive and more retentive. PMID- 3531476 TI - Use of the split pontic nonrigid connector with the tilted molar abutment. PMID- 3531479 TI - Increasing the bond strength of metal-ceramic restorations. AB - The combination of sandblasting, ultrasonics, and radio frequency glow discharge is suggested to effectively eliminate contaminants and improve the metal-ceramic bond for base metal alloys. PMID- 3531480 TI - A survey of crown and fixed partial denture failures: length of service and reasons for replacement. AB - The mean length of service of all restorations observed in this study was 8.3 years. Caries was the most common cause of failure, affecting 22.0% of the units failed and leading to the necessity for replacement of 24.3% of the units observed. Mechanical problems accounted for 69.5% of the failed units as opposed to 28.5% for oral disease. Resin veneer metal crowns provided the longest service of all crown types observed (13.9 years) and failed most frequently because of worn or lost veneers. The complete veneer metal crown had a life span of 6.1 years and was most likely to fail because of caries or defective margins. Ceramic metal crowns also showed a relatively short period of service at 6.5 years, needing replacement primarily because of porcelain failure or poor esthetics. The resin-veneer metal crown also provided the longest service as a retainer, with a mean length of service of 14.7 years. This was closely followed by the partial veneer retainer (14.3 years), while the ceramic-metal retainer had the shortest life span (6.3 years). No apparent relationship was found between the span of prosthesis and its length of service. The six-unit canine-to-canine fixed partial denture exhibited the greatest longevity of the prostheses studied (10.4 years), while the two-unit cantilever fixed partial denture provided a mean of only 3.7 years of service before replacement was required. PMID- 3531482 TI - Forced eruption in crown-lengthening procedures. PMID- 3531481 TI - The effects of surface texture and grooving on the retention of cast crowns. PMID- 3531483 TI - Influence of heat treatment on the surface texture of an etched cast nickel chromium base alloy: an evaluation by profilometric records. AB - Profilometric measurements were performed to test the electrochemically etched surface roughness of a Ni-Cr-Be alloy in the as-cast state and after porcelain firing simulation. A Student's t test at 5% risk leads to the conclusion that a heat-treated surface is significantly rougher than an as-cast surface after electrolytic etching. The exact cause of the increased roughness and how it improves metal-to-resin bonding must be evaluated by further research. PMID- 3531484 TI - Microleakage measurement of selected restorative materials: a new in vitro method. PMID- 3531485 TI - Canines as removable partial denture abutments. Part II: Rest and undercut location for retainers. PMID- 3531486 TI - Photoelastic stress analysis of mandibular removable partial dentures with mesial and distal occlusal rests. PMID- 3531487 TI - Photoelastic analysis of stresses in resin-bonded cingulum rest seats. AB - Two-dimensional photoelastic analysis of resin-bonded cingulum rest seats demonstrated improvement in stress distribution when the lingual surface of the tooth was prepared with a cingulum groove. This preparation is more important for teeth that are more vertically or lingually oriented and have flatter lingual surfaces, such as mandibular canines. PMID- 3531488 TI - Technique to restore staple bone implants with semiprecision attachments. AB - A technique has been described that allows the dentist to correct the relation of the implant abutment to the alveolar ridge of the mandibular staple bone implant postoperatively. This correction is often necessary to provide room within the denture space. In addition, heat-cured acrylic resin bases are united to O-ring attachments intraorally. This technique improves predictability for success. PMID- 3531489 TI - Adenocarcinoma of the tongue complicated by a hemimandibulectomy: soft tissue support for a tongue prosthesis in an edentulous glossectomy patient. PMID- 3531490 TI - How dentists learned about resin-bonded prostheses. AB - The need and value to predict how dentists learn about new information after they graduate from dental school is important to educators. The results of a simple questionnaire designed to determine how dentists became aware of and later learned about the RBP has been presented. The authors believe that CDE should play a vital role in providing dentists with the awareness and knowledge of new dental technology. PMID- 3531491 TI - Dental implications of nickel hypersensitivity. PMID- 3531492 TI - Use of polyvinyl siloxane as blockout material during indirect placement of overdenture attachments. PMID- 3531493 TI - An alternate technique for dowel pin placement. PMID- 3531494 TI - Mixing bowl traction strips. PMID- 3531495 TI - Primary non-Hodgkin's lymphoma of larynx (a case report). PMID- 3531496 TI - Chronic secondary caeco-colic intussusception in a boy associated with primary malignant lymphoma of caecum (a case report). PMID- 3531497 TI - Relaxation and stress management in the treatment of essential hypertension. AB - Thirty-two male and female hypertensives, 34 to 65 yr of age, systolic blood pressure (SBP) less than 200 mmHg and diastolic blood pressure (DBP) between 90 and 109 mmHg, were randomly allocated to receive either relaxation and stress management (experimental condition) or mild physical exercise (control condition). Half the participants were taking antihypertensive drugs, which were constant for six months prior to the study and controlled during the study. Outcome measures included various measures of blood pressure in the clinic and at home, cardiovascular responsiveness, moods and 24-hr urinary adrenaline and noradrenaline. The study schedule consisted of 3-months baseline, 10 weeks treatment and 3-months follow-up. Relaxation was superior to the control procedure in reducing blood pressure as assessed by nurses blind to the participants' treatment at post-treatment for DBP and at follow-up for DBP and SBP. PMID- 3531498 TI - Partner support and the use of coping techniques in labour. AB - This study examined the relationship between partner support, use of pain control techniques and epidural anaesthesia in 80 primiparous women. It was found that the use of psychological 'pain control' techniques did not reduce the intensity of labour pain, nor did their use enable women to do without an epidural anaesthesic. However, the use of techniques did correlate with reduced frequency of anaesthesia when women were consistently supported and encouraged throughout labour, and when the labour was relatively short. PMID- 3531499 TI - [Value of ultrasonic diagnosis in the evaluation of hip dislocation in neonates and infants. Apropos of 340 cases]. AB - Ultrasound imaging of hip (UIH) was performed in 170 children (340 hips) with normal (193) and dysplasic (147) hips and findings compared with results of clinical and radiologic examinations. Ultrasound demonstrated 100% sensitivity in cases with abnormal clinical and radiologic finding, and 94% specificity for UIH when clinical and radiologic examinations were negative. Sensitivity and specificity of ultrasound screening (respectively 96 and 81%) were comparatively superior to those of radiography of the pelvis (83 and 78%) in relation to the clinical examinations. These findings predict further development of UIH for screening of congenital dislocation of the hips and for follow up surveillance of treated children. PMID- 3531500 TI - [Tuberculous trochanteritis: value of ultrasonic diagnosis and x-ray computed tomography. Apropos of 3 cases]. AB - Trochanteritis is a rare osteoarticular site of tuberculosis which initiates within the serous bursa of the gluteus maximus and extends only secondarily to the greater trochanter. Its course is a slow one. Diagnosis is usually delayed but should be made earlier by the use of ultrasound and the CT scan. These provide details of the bone remodelling detected on standard radiography, and show the presence of a variable fluid collection of a topography that attaches it to the serous bursa of gluteus maximus, and provides a guide to diagnostic needle puncture for biopsy. Overall data allow improved adaptation of medico-surgical treatment. PMID- 3531501 TI - [Value of ultrasonography in the diagnosis of carcinoma of Vater's ampulla. Apropos of 9 cases]. AB - In ten patients where ampullary carcinoma was proved, ultrasonography has been performed in 9 cases and failed in 1 case. The results reported, could be put into two different groups. In 7 cases out of 9, sonogram did not show any specific signs: In 3 of these cases, it mimicked a pancreatic carcinoma; in the other 4 cases, dilatation of biliary and/or pancreatic ducts has only been evaluated. In the 2 remaining cases (20% of the 10 patients of the series) the diagnosis of ampullary carcinoma could be suggested on sonographic features. It showed the "double duct sign" and a bulging mass filling the lumen of the distal common bile duct. In one of these 2 cases, the mass was also detectable in the second duodenum, previously filled with water. Endoscopy with biopsy is the most reliable procedure in the diagnosis of ampullary carcinoma but the interest of ultrasonography is: 1 degree to show suggestive findings when the tumor bulges in the common bile duct and the duodenum; 2 degrees to evaluate the tumor extension in the pancreatic parenchyma. PMID- 3531502 TI - [Tumefactive biliary sludge. Ultrasonic aspects]. AB - Twenty two patients presenting a typical sonographic pattern of tumefactive biliary sludge are studied. In all cases was observed a polypoid mobile, rounded mass, without acoustic shadow. The lesion stayed in the gallbladder in 15 cases and in distended main bile duct in 3 others. There was a double localisation in 4 cases. Seven verified cases proved to be constituted of very thick biliary sludge. PMID- 3531503 TI - Reflection photometry of oxygen supply of skin flaps and replanted fingers. AB - A method is presented that allows noninvasive, direct, and rapid control of the oxygen supply of the skin, by registration of cutaneous hemoglobin spectra. Axial pattern flaps, free transfer flaps, and replanted fingers were investigated using this method intra- and postoperatively. The results showed that with such a control, complications in the revascularization and healing process can be detected fairly early, so that therapeutic measures can be taken. PMID- 3531504 TI - Pituitary response to LHRH, LH pulsatility and plasma melatonin and prolactin changes in ewe lambs treated with melatonin implants to delay puberty. AB - Prepubertal ewe lambs were treated with empty or filled melatonin implants. The implants were placed s.c. at birth and pituitary responsiveness to various doses of LHRH, LH/FSH pulsatility and prolactin and melatonin secretion were examined at 10, 19, 28, 36 and 45 weeks of age. Control animals (N = 10) showed no consistent alteration in pituitary responsiveness to LHRH during development. Ewes treated with melatonin (N = 10) had puberty onset delayed by 4 weeks (P less than 0.03) but no effect of melatonin on LH or FSH response to LHRH injection was observed at any stage of development. In the control and melatonin-treated ewe lambs the responses to LHRH injection were lower during darkness than during the day at all stages of development. No consistent differences in LH or FSH pulsatility were observed between treatment groups or during development. Prolactin concentrations, however, failed to decrease at the time of puberty (autumn) in the melatonin-treated group. Melatonin-treated ewe lambs maintained normal rhythmic melatonin production which was superimposed on a higher basal concentration and showed the same increase in melatonin output with age as the control ewes. These results indicate that the delayed puberty caused by melatonin implants is not due to decreased pituitary responsiveness to LHRH or to dramatic changes in basal LH or FSH secretion. PMID- 3531505 TI - A combined radioimmunoassay and immunocytochemical study of ovarian oxytocin production during the periovulatory period in the ewe. AB - Corpora lutea and follicles were taken from the ovaries of 12 ewes at intervals from the start of luteolysis until 3 days after ovulation. RIA analysis of the tissue oxytocin content showed that luteal oxytocin concentrations declined during luteolysis to reach basal values at about the time of the next ovulation. Oxytocin was first measurable in the walls of 3 out of 6 preovulatory follicles during the LH surge, with a small increase in concentration to 26.1 +/- 6.6 pg/mg before ovulation, and a further increase in the young corpus luteum to concentrations exceeding 1 ng/mg 2-3 days later. After the LH surge, oxytocin was also found in the follicular fluid at a concentration of 3.4 +/- 0.3 ng/ml. Using immunocytochemical techniques, oxytocin and neurophysin were first detected in the follicle wall immediately before ovulation, and were localized in the granulosa cells. After ovulation the stained cells initially formed strands which appeared to break down to clusters and then to individual cells as the corpus luteum matured. The immunocytochemical picture also suggested that neurophysin immunoreactivity increased within a few hours of ovulation but that processing to oxytocin may be delayed. Measurements of circulating oxytocin concentrations revealed a pulsatile release pattern throughout the follicular phase with the height of the pulses decreasing from 25 +/- 5 pg/ml during luteolysis to a minimum of 11 +/- 2 pg/ml during the LH surge. PMID- 3531506 TI - A survey of the effects of proteases and glycosidases on culture of rabbit morulae to blastocysts. AB - The effects of a range of commercially available proteases and glycosidases on blastocyst development and hatching were examined on rabbit embryos cultured from the morula stage in a defined medium supplemented with charcoal-treated bovine serum albumin. The proteases tested were trypsin, alpha-chymotrypsin, thrombin, elastase, plasmin, papain, clostripain, collagenase, Streptomyces griseus protease and cathepsin C. The glycosidases tested were neuraminidase, alpha mannosidase, beta-galactosidase and hyaluronidase. None of these enzymes appeared to stimulate blastocyst growth. The only enzymes which digested the embryonic investments, the zona and mucin coat, sufficiently to cause complete blastocyst hatching were trypsin and Streptomyces griseus protease at relatively low concentrations (250 ng/ml) and chymotrypsin and elastase at higher concentrations. PMID- 3531507 TI - Effect of male presence and of photoperiod on the sexual maturation of the field vole (Microtus agrestis). AB - The effect of mature males on the sexual development of young female and male field voles, reared in either long (stimulating) or short (inhibiting) photoperiods, was examined. Females reared in the presence of a mature male had a more advanced state of sexual maturation (as indicated by uterine weight) than did females reared in isolation from males, in long and short photoperiods (P less than 0.01). No interaction between photoperiod and male presence was found. Augmented uterine growth occurred not only when young females were separated from mature males by a wire mesh or solid metal screen but also when they were merely exposed to bedding previously used by mature males. Castrated males had no effect on the sexual development of females. The effect of mature males on the sexual development of young males was less clear, although there was some indication that the presence of adult males inhibited their sexual development in long and short photoperiods. For males and females, growth rate was stimulated by long photoperiod, but no effect of male presence on growth rate was found. PMID- 3531508 TI - Influence of cryoprotective diluent on post-thaw viability and acrosomal integrity of spermatozoa of the African elephant (Loxodonta africana). AB - Electroejaculates from free-ranging, African elephants were frozen to test various seminal diluents, freezing methods and thawing media on post-thaw sperm viability and structural integrity. In Study I, each ejaculate was tested with each of 7 cryoprotective diluents. After cooling to 5 degrees C and equilibration on ice (4 degrees C) for 120 min, each aliquant was pellet frozen on solid CO2, stored in liquid nitrogen and thawed (37 degrees C) in saline or tissue culture solution. Amongst all diluents, post-thaw sperm motility, motility duration in vitro (37 degrees C) and acrosomal integrity were greatest (P less than 0.05) when diluent BF5F was used. Thawing medium had no effect on results. In Study II, the optimal diluent from Study I (BF5F) was compared with the diluent SGI. Results were not affected by a 90- or a 150-min cooling-equilibration interval in an electronic cooler (5 degrees C); however, post-thaw sperm motility rating and duration of motility in vitro were greater (P less than 0.01) with the pellet than the straw container freezing method. When the pelleting method was used, diluents BF5F and SGI provided comparable cryoprotection. Duration of post-thaw motility was enhanced 2-fold and up to 12 h by maintaining thawed semen at 21 rather than 37 degrees C (P less than 0.05). All diluents provided some protection on acrosomal integrity, but the overall proportion of intact acrosomes after thawing was markedly less in Study II, apparently as a result of the slower initial cooling rate (approximately 1.5 degrees C/min) compared to that of Study I (approximately 6.5 degrees C/min). This study demonstrates the feasibility of cryopreserving semen from free-ranging African elephants and indicates that spermatozoa must effectively survive freezing when the BF5F or SGI diluent is used in conjunction with the pelleting method. PMID- 3531509 TI - Age- and hormone-related changes in vaginal smear patterns in the gray-tailed vole, Microtus canicaudus. AB - Female voles, Microtus canicaudus, exhibited age-related changes in vaginal smear patterns when isolated from males after weaning. Between 30 and 50 days of age, nearly all females exhibited persistently leucocytic vaginal smears. By 90-120 days, most females showed vaginal cyclicity with alternating predominance of leucocytes, nucleated epithelial cells or cornified epithelial cells. Most females examined between 150 and 200 days of age exhibited persistent vaginal cornification. The vaginal cyclicity seen in females between 90 and 120 days was not a reflection of cyclic ovulatory changes; plasma progesterone concentrations remained constant, regardless of age or vaginal smear pattern, and corpora lutea were never seen in unmated females. Although progesterone concentrations did not differ among vaginal smear patterns of 120-day-old females, plasma oestrogen values were highest in females exhibiting vaginal cornification. PMID- 3531510 TI - Age-related changes in plasma oestrogen concentration, behavioural responsiveness to oestrogen, and reproductive success in female gray-tailed voles, Microtus canicaudus. AB - Age-related increases in the incidence of vaginal cornification were associated with increases in the reproductive success of female gray-tailed voles previously isolated from males. The pregnancy rate of females first paired with males at 30 50 days of age was significantly lower than that of females first paired at 90 120 or 150-200 days of age. The improvement was due to increases in propensities to display receptive behaviours and decreases in the incidence of sterile matings. Although plasma oestrogen concentrations increased with age and were higher in receptive than unreceptive females, plasma oestrogen values alone did not account completely for differences in receptive behaviours amongst females of different ages. Females ovariectomized at 30-50 days of age rarely displayed receptive behaviours when treated with large doses of oestradiol benzoate, whereas nearly all females similarly treated were receptive if ovariectomies were performed between 150 and 200 days of age. The receptivity rate of females ovariectomized between 90 and 150 days was intermediate between the rates of the other two groups. PMID- 3531511 TI - Luteinizing hormone and ovulation timing. AB - Serum luteinizing hormone (LH) levels are routinely used in the treatment of infertility for ovulation assessment and timing of artificial insemination, in vitro fertilization and endometrial biopsies. Extensive clinical research has shown the LH surge in serum or plasma to be the standard for precise ovulation timing. The relationship of the LH surge to oocyte maturation (preovulatory) and fresh ovulatory stigmata (postovulatory) enhances the status of LH as the standard. Within this context, the advantages and disadvantages of the method are weighed against broad clinical application for general ovulation prediction. PMID- 3531512 TI - Ultrasonic indices of ovulation. AB - Ultrasound affords direct observation of anatomic changes leading to ovulation. It is useful in many clinical applications, such as monitoring ovulation induction regimens, determining the time of oocyte harvest in in vitro fertilization programs and assisting with timing artificial insemination. The specific time of ovulation cannot be predicted accurately enough using ultrasound to make it optimal for routine monthly cycle use. PMID- 3531513 TI - The Society's contribution to periodontology. PMID- 3531515 TI - Pseudomyxoma peritonei. PMID- 3531514 TI - Trial of (+)-cyanidanol-3 in patients with hepatitis B chronic liver disease. AB - A double-blind controlled trial of 12 months' treatment with (+)-cyanidanol-3 was carried out in 26 patients with chronic hepatitis B liver disease. Treatment did not improve liver blood tests nor histological appearances of the liver, but there was a trend towards reduction of serum titres of hepatitis B surface antigen. PMID- 3531516 TI - Sustained brain-specific delivery of estradiol causes long-term suppression of luteinizing hormone secretion. PMID- 3531517 TI - Design and synthesis of potent and specific renin inhibitors containing difluorostatine, difluorostatone, and related analogues. AB - Peptides that contain difluorostatine and difluorostatone residues have been shown to be potent inhibitors of the aspartyl protease renin. The readily hydrated fluoro ketone is proposed to mimic the tetrahedral intermediate that forms during the enzyme-catalyzed hydrolysis of a peptidic bond. It is suggested that the sp3-hybridized ketal acts as a transition-state analogue renin inhibitor. The fluoro ketone is shown to be a much more effective inhibitor than the corresponding nonfluorinated ketone, which acts as a pseudosubstrate. More lipophilic side chains at the P1 site can enhance the inhibitory potency of the difluorostatine analogue, but this cannot be demonstrated in the difluorostatone series. Additionally, high renin specificity has been shown for a difluorostatone containing peptide. PMID- 3531518 TI - Design and synthesis of a potent and specific renin inhibitor with a prolonged duration of action in vivo. AB - A structure-activity analysis of peptides containing backbone C alpha-methyl and N alpha-methyl modifications led to the discovery of potent renin inhibitors with high metabolic stability. In vitro, Boc-Pro-Phe-N alpha-MeHis-Leu psi [CHOHCH2]Val-Ile-Amp (XII) is a potent inhibitor of human plasma renin with IC50 of 0.26 nM. It is a much weaker inhibitor of other aspartic proteases such as porcine pepsin or bovine cathepsin D (IC50 = 6 microM). It was shown not to be degraded by a rat liver homogenate preparation. In vivo, it inhibited plasma renin activity and lowered blood pressure of furosemide-treated cynomolgus monkeys. At a dose of 5 mg/kg iv, the pronounced hypotensive response persisted for greater than 3 h postinfusion. PMID- 3531519 TI - The effect of feedback in learning clinical diagnosis. AB - There is evidence that students who are given information about how they appear to weight information in reaching a judgment can learn to make judgments more accurately. In teaching medical diagnosis, the present authors used a microcomputer system to generate simulated cases and then calculate the relationship between the data presented and the student's diagnosis. Students who were given feedback comparing their apparent weighting of clinical information with the correct weighting learned to diagnose urinary tract infection more accurately than control students who received feedback only on the outcome of their diagnosis. PMID- 3531520 TI - The effect of cyclosporine on canine lymphocyte activity. AB - Cyclosporine is a potent new immunosuppressive agent that has an important role in organ transplantation. The exact mechanism of action of this agent is unclear. The present study was designed to demonstrate the effects of a single dose infusion of cyclosporine on canine leukocyte subsets and on the functional capabilities of T cells from these animals. The proportion of polymorphonuclear cells increased in the first 12 hr following intravenous administration of cyclosporine. There was no evidence, however, for alteration in the proportions of lymphocytes or T cells. The ability of peripheral blood mononuclear cells from a cyclosporine-treated dog to respond to T-cell mitogens varied depending on culture conditions. Washed cells cultured in pooled dog serum showed a paradoxical enhancement in responsiveness, whereas cells cultured in the presence of autologous cyclosporine-containing plasma showed significantly diminished responsiveness. Normal canine cells cultured in plasma from cyclosporine-treated dogs also showed suppressed mitogenic responses. These results indicate that cyclosporine must be present at the time of lymphocyte activation for suppression to occur. The unexpected response to T-cell mitogens by washed cells suggests that this agent affects cells, possibly at the membrane level, such that they potentially demonstrate enhanced responses to nonspecific stimuli. This latter observation may have important clinical significance for management of allograft recipients. PMID- 3531521 TI - Developments of new Lowicryl resins for embedding biological specimens at even lower temperatures. AB - Two new Lowicryl resins have been developed for embedding biological materials at temperatures down to 210 K (hydrophilic K11M) and to 190 K (hydrophobic HM23). They have similar properties to Lowicryl K4M and HM20. The new resins were first tested for low temperature applications by the 'progressive lowering of temperature' procedure and this shows that the low viscosity of K11M and HM23 is favourable for the infiltration of biological specimens. Hardening is achieved through photo-polymerization at these lower temperatures. These properties make K11M and HM23 suitable for cryosubstitution of rapidly frozen material and it is speculated that the preservation of antigenicity may be further improved. PMID- 3531522 TI - On crystal size and cooling rate. AB - A theoretical model is proposed which is used to derive a quantitative relationship between the critical cooling rate and average crystal size at any location within a biological specimen of given shape subject to rapid freezing. The model is applicable to the slamming, plunging or spraying methods of cryofixation provided the ice crystal size is at least 5 times greater than the size of the critical nucleus. Complete vitrification of pure water or aqueous solutions is shown to take place at cooling rates in excess of about 3 X 10(6) K/s. PMID- 3531523 TI - Post-embedding cytochemistry with gold-labelled reagents: a review. AB - The detection of antigens and glycoconjugates with the protein A-gold and the lectin-gold techniques, respectively, is reviewed. Special attention is directed to the necessary conditions for fixation and embedding as well as to the staining procedures of tissue sections for light and electron microscopy. PMID- 3531524 TI - Application of cryoultramicrotomy to immunocytochemistry. AB - This paper reviews the most recent status of immuno-cryoultramicrotomy. The technical aspects of each step of the method are also analysed in detail with the intention of providing a useful source of information for investigators using this method. PMID- 3531525 TI - Immunogold-silver staining of lymphocyte surface antigens on cells in suspension and in lymph node cryostat sections. AB - An immunogold-silver staining (IGSS) technique for the light microscopical detection of leucocyte cell surface antigens in cell suspensions and cryostat sections is described. The specimens were first incubated with monoclonal mouse antibodies and then with colloidal gold-labelled goat anti-mouse antibodies. They were then immersed in a physical developer, counterstained and mounted. In light microscopy, the tissue architecture and the cellular morphology were well preserved. Positive cells showed dark granules on their surface membranes. Optimal labelling conditions were determined. This method proved to be a reliable tool for the enumeration of T-cells and their subsets in peripheral blood. The dense labelling permitted the use of panoptic counterstains like May-Grunwald Giemsa or Wright's stain. This IGSS technique was used to determine the distribution of the T- and B-cell subsets in cryostat sections of reactive lymph nodes. The sensitivity of the method was comparable with that of immunofluorescence microscopy for cell suspensions and that of the biotin-avidin peroxidase technique for tissue sections. Immunogold-silver staining was combined with enzyme cytochemistry. In dark-field or epipolarization microscopy the labelling appeared as bright granules on a dark background. With its dense granular membrane labelling and its good morphology IGSS is an ideal method for the study of particular cell types in mixed cell suspensions. In addition, it could be a general method for the detection of cell surface antigens in all kinds of cells and tissues. PMID- 3531526 TI - Problems in the production and use of 5 nm avidin-gold colloids. AB - Over the past 5 years we have encountered several problems in the production and use of 5 nm avidin-gold colloids for markers in electron microscopy. These problems include flocculation of colloids during reduction of chloroauric acid, insoluble gold pellets following ultracentrifugation, and non-specific binding of avidin-gold colloids to biological membranes. We are able to avoid these problems by: avoiding the use of crystalline chloroauric acid; succinoylating egg white avidin prior to adsorption on the gold sols; resuspending the pellets following ultracentrifugation in 5 mM phosphate buffer, pH 7.5; and using the avidin-gold colloids within 4 weeks of production. PMID- 3531527 TI - Simultaneous immunoenzyme double labelling using two different enzymes linked directly to monoclonal antibodies or with biotin-avidin. AB - A novel and rapid method for immunoenzyme double staining with monoclonal antibodies (McAb) is described. The principles of this method are the simultaneous application of primary antibodies and the unrelatedness of the two detection systems. One McAb is directly labelled with horseradish peroxidase and the other McAb is labelled with biotin. This second McAb is thereafter detected using an avidin-alkaline phosphatase conjugate. This conjugate was prepared by a new method using a heterobifunctional reagent. Double staining of cell surface membranes of human tonsil was studied in cryosections using various combinations of McAbs to lymphoid cell markers. As expected, suppressor T cells were found to be contained within the pan T cell population on the basis of the distinguishable intermediate colour produced. Similarly, it was shown that most of the suppressor T cells were not HLA-DR activated in this tonsil. In cryostat sections of human skin T6 positive Langerhans cells in the epidermis were shown to carry the HLA-DR antigen. PMID- 3531528 TI - Immuno- and enzyme-histo/cytochemical analysis of resin sections and cell suspensions: a comprehensive diagnosis of bone marrow on a single aspiration sample. AB - A protocol is described in which a single bone marrow aspiration specimen is used to prepare resin sections and cell suspensions. Using this protocol, a full battery of morphological, enzyme-histochemical, immuno-histochemical and cyto pathological techniques can be applied. This allows a definitive bone marrow diagnosis to be established without resorting to bone marrow biopsy in the majority of patients. PMID- 3531529 TI - The "G spot" and "female ejaculation": a current appraisal. AB - In the light of the available evidence, this paper reviews two current controversial issues in the area of female sexuality: the "G spot" and "female ejaculation." It is concluded that evidence in support of the "G spot"--defined as a discrete anatomical structure located on the anterior vaginal wall, which swells upon being tactilely stimulated--is inconclusive, and, in the event of its existence, no evidence has been produced linking it to Skene's glands. However, it seems reasonable to accept that women possess a zone of tactile erotic sensitivity on the anterior vaginal wall, which in many of them may extend to the entire anterior wall and to the posterior vaginal wall. It also seems that some women emit a fluid through the urethra at orgasm, although its true nature and anatomical origin are still unclear. PMID- 3531530 TI - Pathology of digestive organs in renal transplant recipients. AB - A necropsy study of the pathological findings in the digestive system of 19 renal transplant recipients revealed that gastrointestinal (GI), hepatobiliary, and pancreatic pathologies are common in renal transplant recipients. Fifteen of the 19 patients studied had GI pathology. Hepatobiliary pathology was the most common finding with all but one of the 19 cases exhibiting one or more abnormalities. Pancreatic abnormalities were less frequent with 11 patients demonstrating normal findings. PMID- 3531531 TI - Cholesterol and heart disease: current concepts in pathogenesis and treatment. AB - One of the modifiable risk factors associated with coronary heart disease (CHD) is hypercholesterolemia. This paper reviews the major plasma lipids and how they relate to coronary heart disease. Among blacks, CHD is the leading cause of death and disability. Blacks, in general, have been found to have lower low density lipoprotein (LDL), lower very low density lipoprotein (VLDL), and higher high density lipoprotein (HDL) levels than whites, but there is some evidence to suggest that lipid and lipoprotein profiles may differ in middle and upper socioeconomic subgroups of the black population from those reported for lower socioeconomic groups.The results of the Lipid Research Clinics Coronary Primary Prevention Trial and the National Heart, Lung and Blood Institute Type II Coronary Intervention Study have shown that lowering cholesterol levels in persons with high blood cholesterol will decrease the rate of coronary heart disease events.Diet therapy is the mainstay of treatment, and may lower blood cholesterol levels by 10 to 15 percent. For those unresponsive to diet therapy alone, a number of hypolipidemic drugs are available; some drugs (cholestyramine and colestipol) work by increasing the clearance of lipoprotein and others (clofibrate, nicotinic acid, and probucol) decrease the production of lipoproteins. The combination of diet and drugs may result in a decrease in cholesterol levels of 30 percent or more. For each 1 percent that cholesterol is decreased, there is a 2 percent decrease in coronary heart disease events. PMID- 3531534 TI - Sickle cell crisis and the acute abdomen. AB - Abdominal pain is one of the most common symptoms in sickle cell crisis, and its cause remains controversial. Simple vaso-occlusive crisis may be an explanation. The abdominal pain may also reflect an acute surgical abdomen.A patient presented with sickle cell crisis and abdominal pain; he had a periappendiceal abscess at the site of an appendiceal stump five months after appendectomy. The role of sickle cell anemia in the pathogenesis of this abscess is uncertain. PMID- 3531532 TI - Update in cancer chemotherapy: gastrointestinal cancer, cancer of the small intestines, gallbladder, liver, and esophagus. AB - This article updating cancer chemotherapy of gastrointestinal cancer completes the fivepart series begun in the April issue of the Journal. Treatment of cancer of the small intestine, the gallbladder and bile duct, primary cancer of the liver, and the esophagus are reviewed in this concluding article.Treatment of choice of cancer of the small intestine is surgical resection. Small bowel cancer is less responsive than gastric cancer to chemotherapy. While chemotherapy may produce temporary partial remissions in patients with gallbladder and bile duct cancer, there is no evidence that it produces longterm survival time. In primary liver cancer, surgery is the only curative treatment, but only 30 percent of patients are diagnosed with resectable lesions, and the surgical mortality rate is high. The most active single agents appear to be doxorubicin, fluorouracil, and neocarcinostatin. Data on combination chemotherapy are limited.With carcinoma of the esophagus, 95 percent of patients die of the condition. The standard treatment for locoregional disease is surgical resection and/or radiation therapy. Chemotherapy has been slow to develop; single-agent chemotherapy has been reported to be active in 15 percent of cases with durations of 2 to 5 months. Combination chemotherapy is so recent that data are incomplete as to long term results of disease-free and total survival times, but polychemotherapy appears to be more effective than single agents.With earlier detection, prompt surgery, earlier chemotherapy, improved dose scheduling, and further exploration of combination therapy, better overall results with a major impact years later may be expected. Because of the lack of data, there remains uncertainty as to the place of chemotherapy in the treatment of gastrointestinal cancer. PMID- 3531533 TI - Immunodiagnosis by prostatic acid phosphatase to differentiate primary male breast cancer from metastatic prostate cancer. AB - A patient who was treated with estrogens for carcinoma of the prostate was later diagnosed with apparent primary cancer of the male breast. He received chest-wall radiation therapy with curative intent. Later, immunodiagnosis by immunoperoxidase staining for human prostate-specific acid phosphatase of the breast tissue revealed that the patient actually had metastatic prostate cancer to the breast rather than primary breast cancer secondary to estrogen therapy. Use of highly specific peroxidase-antiperoxidase tissue staining for human prostate-specific acid phosphatase is recommended to differentiate primary male breast cancer from metastatic prostate cancer. PMID- 3531535 TI - Review of the toxicity of multifunctional acrylates. AB - Multifunctional acrylates and methacrylates (MFA) represent a class of materials with considerable chemical reactivity that are used in many applications with opportunity for contact exposure. They represent appreciable eye and skin contact hazards, and several members of the class may be absorbed from skin to cause systemic effects. A number of MFAs have been identified as sensitizers. While the acute toxicity of MFAs is certain, the effects of repeated or chronic exposure are less clear. Data are presented that suggest that MFAs are not appreciable fetotoxic or teratogenic hazards and do not elicit a strong carcinogenic response following chronic dermal exposure. The use of these data for product safety purposes and research needs is discussed. PMID- 3531537 TI - Alcohol and hypertension: implications from research for clinical practice. AB - Despite the fact that recent epidemiological and laboratory studies appear to confirm that alcohol has an effect upon blood pressure, its impact has largely been ignored in clinical practice. This study was undertaken in an effort to answer four basic questions Is there an association between blood pressure and ethanol ingestion and if so is it causal or related to common genetic and/or environmental factors?; If an association exists, what is its likely physiological mechanism?; What additional studies are needed in order to further elucidate the relationship between alcohol and blood pressure?; What clinical recommendations, if any, are justified with our present state of knowledge? PMID- 3531536 TI - Application of response-surface methodology to detect interactions of genotoxic agents in cultured mammalian cells. AB - Response-surface methodology (RSM) techniques provide a useful statistical approach for the design and analysis of experiments involving multiple variables. Although it has been used for some time in the areas of chemical engineering and agriculture, RSM has only recently been applied to the solution of biological problems. Here we have utilized RSM to investigate the interaction of two direct acting, monofunctional alkylating agents [ethyl methanesulfonate (EMS) and ethylnitrosourea (ENU)] in Chinese hamster V79 cells with respect to the in vitro induction of sister chromatid exchanges (SCEs). A factorial design was employed in which the cells were exposed to the agents singly and in simultaneous combinations for 4 h. The cells were collected for SCE determination 30 h after treatment. The analysis revealed concentration-dependent increases in SCEs for both of the agents, with ENU being the more effective on an equimolar basis. In addition, single- and multiple-agent interactions were detected. The most important finding was that over the treatment range studied, a significant negative interaction occurs between EMS and ENU with regard to SCE induction. It is suggested that RSM not only may be useful in determining the statistical relevance of experimental variables but also may generate hypotheses the evaluation of which could provide additional insights into the underlying mechanisms involved. PMID- 3531538 TI - Children of substance abusers: a review of the literature. AB - The proportion of women in substance abuse treatment programs or in need of substance abuse treatment has been increasing. Concern with female substance abusers has led to increased attention on identifying the problems and needs of children of substance abusers, particularly on neonates. This literature review summarizes the contents of the research on children of substance abusers (COSAs) available through 1985. Areas requiring further research and methodological problems in the research are identified. The literature has been organized into several areas: estimates of the numbers of COSAs, and research on pregnant addicts, neonates, infants, older children, and parenting issues. PMID- 3531539 TI - Gray-scale (B-mode) sonography of the maxillary sinus. AB - Gray-scale sonographic examination of the maxillary sinuses of five normal volunteers and 12 patients with maxillary sinus disease was performed and correlated with other radiologic imaging modalities, clinical follow-up, and, in two cases, surgical findings. B-mode scanning is a rapid, potentially useful, nonionizing diagnostic modality for determining whether the maxillary sinuses contain fluid or are normally aerated. Sonography may also demonstrate mucosal thickening, focal soft tissue masses, and complex collections. PMID- 3531540 TI - Sonographic demonstration of bladder-flap hematoma. AB - A bladder-flap hematoma is generally thought of as a blood collection in a potential space located between the urinary bladder and lower uterine segment (vesicouterine space). These collections can also extend over the bladder and uterus beneath the peritoneal reflection. In this study, ten patients with a bladder-flap hematoma were evaluated for fever, mass, or dropping hematocrit after surgery. No one sonographic appearance is specific for bladder-flap hematoma; however, the diagnosis can be made by finding a mass in the extraperitoneal pelvic space in the postoperative patient. PMID- 3531541 TI - Increased echogenicity in the lower fetal abdomen: a common normal variant in the second trimester. AB - Ten cases displaying a focal area of increased echogenicity in the lower fetal abdomen on prenatal sonography are reported. This was an isolated finding in each case. Nine cases were noted early in the second trimester. The last case corresponded to a postmature gestation. In all cases, a normal lower abdomen was documented on follow-up prenatal sonography, at birth, or at autopsy. The authors believe that increased echogenicity in the lower fetal abdomen represents a normal variant that is more common than suggested by the literature. A possible explanation of this pattern is offered. PMID- 3531543 TI - The significance of the postmenopausal simple adnexal cyst. AB - In order to help clarify the clinical problem of the postmenopausal woman with an adnexal cyst, 13 patients with sonographically detected relatively simple adnexal cysts were reviewed. Only one patient had a "borderline" malignancy; the remaining cysts were all benign. The 8 per cent malignancy rate in this small series suggests that the simple postmenopausal adnexal cyst may not necessarily be an ominous finding. PMID- 3531542 TI - Sonographic examination of the abdominal aorta through the left flank: a prospective study. AB - Ultrasonographic evaluation of the abdominal aorta is most often done with the patient in the supine position. The right lateral decubitus position, which views the aorta through the left flank has, until now, been considered unsatisfactory for aortic evaluation. One hundred consecutive patients were prospectively examined for visualization of the aorta both through the left flank and the anterior abdomen. Twenty-one patients were then comparatively examined from the right coronal and left coronal approach. These studies showed that the aorta was clearly visualized using the left flank approach in the majority of patients (96 per cent). The combined approach yielded 99 per cent satisfactory visualization, and in a few select cases (13 per cent) the left flank was actually superior. The left flank approach was superior when directly compared with the right flank in 42 per cent of patients and comparable in 48 per cent. The right flank approach was superior in only 10 per cent. PMID- 3531544 TI - An extensive intrauterine hematoma mimicking a nonviable early pregnancy. PMID- 3531545 TI - Renal cell carcinoma: an unusual sonographic appearance. PMID- 3531547 TI - Prenatal sonographic diagnosis of a fetal facial hemangioma. PMID- 3531546 TI - Long-term follow-up after removal of an abdominal pregnancy: ultrasound evaluation of the involuting placenta. PMID- 3531548 TI - Prenatal sonographic diagnosis of a suprasellar arachnoid cyst. PMID- 3531549 TI - Sonographic diagnosis of fetal cardiac rhabdomyoma. PMID- 3531550 TI - An evaluation of apramycin soluble powder for the treatment of naturally acquired Escherichia coli infections in broilers. AB - During 1983, a series of trials was carried out in Greece, Italy and Jordan, to test the efficacy of the aminocyclitol antibiotic apramycin as a treatment for naturally acquired Escherichia coli infections in broilers. The trials involved a total of 40,389 broilers, 27-39 days of age, in twelve houses at eight different production sites. Three levels of apramycin medication were evaluated: 125, 250 and 500 mg activity/litre drinking water, administered for five consecutive days. Treatment was only initiated after disease had been confirmed by laboratory examination of dead birds. Not all treatments were evaluated in every house. However, each house contained a group of unmedicated birds as controls, while the remaining birds were allocated to one or more apramycin treatment groups. There was a reduction in mortality and an improvement in the final weight and the economic feed conversion ratio in all three treatment groups. The data presented provide support for the use of apramycin sulphate administered in the drinking water for the treatment of E. coli infections in broilers. PMID- 3531552 TI - Accuracy and repeatability of bladder volume measurement using ultrasonic imaging. AB - We assessed 6 methods for calculating bladder volume from ultrasonic cross sectional scans. The technique that used the largest number of features from the scans gave the best results. For volumes greater than 150 ml. an accuracy of 0.87 and repeatability of +/- 9 per cent (standard deviation) were obtained. PMID- 3531554 TI - Vesicocalicostomy as ultimate solution for recurrent urological complications after cadaveric renal transplantation in a patient with poor bladder function. AB - We report a case of a neurogenic bladder in which hydronephrosis recurred early after renal transplantation. After 2 unsuccessful attempts at ureteroneovesicostomy of the donor ureter a vesicocalicostomy was performed, since reconstruction with the donor pelvis or ureter was impossible owing to the extended fibrosis and scar formation around the renal hilus and ureter. During the 23 months of followup renal function has been good without serious infectious sequela with a regimen of self-catheterization and no antibiotic maintenance therapy. PMID- 3531553 TI - Noninvasive testicular screening in childhood leukemia. AB - To evaluate the potential of transscrotal ultrasound and magnetic resonance imaging as noninvasive screening methods we studied 8 boys with acute lymphocytic leukemia before testicular biopsy. Ultrasonic images of the testes were performed in 4 patients, including 2 with negative and 2 with positive biopsies, and all images were interpreted as normal. Magnetic resonance images of the testes also were interpreted as normal in 4 patients, including 2 with negative and 2 with positive biopsies, and they were technically inadequate in the remaining 4. The results suggest that neither transscrotal ultrasonography nor magnetic resonance imaging as currently applied may substitute reliably for testicular biopsy as a screen for occult testicular leukemia. PMID- 3531556 TI - Leads from the MMWR. Aseptic meningitis among kidney transplant recipients receiving a newly marketed murine monoclonal antibody preparation. PMID- 3531555 TI - Immunology of pyelonephritis. VII. Effect of allopurinol. AB - The inflammatory response and the respiratory burst of bacterial phagocytosis have been shown to be at least partially responsible for the renal damage from infection. In addition, we have shown that renal blood flow decreases following infection. Hypoxanthine is produced in ischemic tissue during the anaerobic metabolism of adenosine monophosphate (AMP). During reperfusion hypoxanthine is metabolized to uric acid and superoxide in the presence of xanthine oxidase. The toxicity of this oxygen radical was prevented by preventing its formation with pretreatment with allopurinol, an xanthine oxidase inhibitor. The data suggest that xanthine oxidase may be the enzyme responsible for the respiratory burst of phagocytosis, as well as preventing reperfusion damage which occurs after ischemia. PMID- 3531557 TI - Hypocalcemia in critical illness. PMID- 3531558 TI - Aerospace medicine; the first 200 years. PMID- 3531559 TI - Medical informatics/computers in medicine. PMID- 3531561 TI - Sexual transmission of human immunodeficiency virus. PMID- 3531560 TI - A comparison of verapamil and propranolol for the initial treatment of hypertension. Racial differences in response. AB - We compared verapamil and propranolol hydrochloride for monotherapy of hypertension. Verapamil lowered blood pressure (BP) more effectively than propranolol in black and white patients. Verapamil was equally effective in blacks and whites, whereas propranolol was more effective in whites. Heart rate was reduced by 6.0 beats per minute by verapamil, and by 13.6 beats per minute by propranolol. In blacks, verapamil lowered systolic BP 16.9 vs 8.1 mm Hg for propranolol; verapamil reduced diastolic BP 12.8 vs 8.6 mm Hg for propranolol. In whites, verapamil lowered systolic BP 19.0 vs 12.7 mm Hg for propranolol; verapamil reduced diastolic BP 16.7 vs 12.3 mm Hg for propranolol. Increases in systolic BP were observed in 22% and 3.4% of patients receiving propranolol and verapamil, respectively. The PR interval was increased from 163.5 to 174.9 ms for verapamil vs 160.3 to 164.4 ms for propranolol. Constipation (15%) and headaches (10%) were most frequent complaints for verapamil vs fatigue (18%) and dizziness (7%) for propranolol. Changes in blood biochemistry values were of small magnitude. We conclude that verapamil monotherapy is a safe and effective means of achieving BP control in patients with essential hypertension. PMID- 3531562 TI - Rational therapeutic drug monitoring. AB - The simple act of ordering a serum drug level does not guarantee that the information will be meaningful or useful. The interpretation of serum concentrations can be profoundly influenced by such factors as the timing of the sample, the patient's clinical state, the drug's pharmacokinetics and metabolism, and the tube type and analytic methodology used. The likelihood of obtaining clinically meaningful and useful results can be maximized when these factors are taken into account. PMID- 3531563 TI - Net protein catabolic rate after kidney transplantation: impact of corticosteroid immunosuppression. AB - Protein catabolic rate (PCR) was measured during the first 3 to 7 weeks after kidney transplantation in nine nondiabetic patients (16-52 yr old) who were receiving azathioprine and corticosteroid immunosuppression. Five of the patients received additional amounts of corticosteroids to treat rejection episodes. The PCR paralleled the amounts of corticosteroids administered initially as prophylactic immunosuppression and later as treatment for rejection episodes. In spite of a diet containing 1.2 g of protein per kg ideal body weight, net urea generation reflected severe lean body mass breakdown, roughly equivalent in magnitude to a 50% body surface area full-thickness burn. This catabolism was accompanied by a fall in serum albumin without significant weight loss. Hypercatabolism in the early posttransplant period is severe. After transplantation diet should be modified to try to satisfy these nitrogen demands. PMID- 3531564 TI - Nutrition education in schools of nursing in the United States. Part 1. The evolution of nutrition education in schools of nursing. AB - In 1981 the Nurses' Committee of the American Society for Parenteral and Enteral Nutrition appointed an Ad Hoc Committee to investigate the evolution of and the current status of nutrition education curriculum in schools of nursing accredited by the National League for Nursing. This investigation identified current trends in the teaching of nutrition content in baccalaureate and graduate schools of nursing. Part one explores the evolution of nutrition content in school of nursing curriculum; while part two (to be published in a later journal) presents the results of a descriptive survey of accredited schools of nursing in the United States. PMID- 3531565 TI - [Clinical studies of cefixime in pediatric field]. AB - Pharmacokinetic and clinical studies of cefixime (CFIX) in children were done and the following results were obtained. Serum and urinary concentrations of CFIX were determined in 6 children aged 5 to 14 years given single doses of 1.5 or 6.0 mg/kg. Mean serum concentrations peaked at 4 hours after the administration of either 1.5 or 6.0 mg/kg, and respective peak values were 0.71 and 4.46 micrograms/ml. Biological half-lives for the low and the high doses were 5.28 and 4.45 hours, respectively. The 12-hours urinary recovery ranged from 7.0 to 13.8% after administration of 1.5 mg/kg, and the 8-hours urinary recovery was 18.1% after administration of 6.0 mg/kg. Therapeutic responses were recorded as excellent or good in 43 (97.7%) of the children, comprising 13 with tonsillitis and 31 with scarlet fever. The microbiological effectiveness of CFIX on identified pathogens comprising 29 strains of S. pyogenes and 2 strains of S. aureus was satisfactory as evidence by a high eradication rate of 93.5%. No clinical side effects were observed. Abnormal laboratory findings were elevation of GOT and/or GPT in 4 patients and eosinophilia in 1 patient. In conclusion, CFIX was found to be efficacious and safe for the treatment of bacterial infections in children. PMID- 3531566 TI - [Ofloxacin]. PMID- 3531567 TI - [A comparative, well-controlled study of ceftizoxime suppository against ceftizoxime intravenous injection in infantile acute pneumonia]. AB - We have attempted to clinically define the therapeutic usefulness of ceftizoxime suppository (CZX-S) in children with bacterial pneumonia, in a randomized trial. Intravenous injection of ceftizoxime (CZX) was used as the control. The results are summarized below. Subjects were inpatients with bacterial pneumonia, ranging in age from 9 months to 7 years and 10 months. As a rule, the daily dose was either four 250 mg (in potency) suppositories given at 6-hour intervals or 60 mg/kg body weight intravenous CZX (control) given in 4 injections at 6-hour intervals over a period of 7 days. The number of children in the study was 67. These children were divided into 2 dosage groups (suppository, 35; injection, 32) with matching pretreatment background factors. The severity of the target disease in the majority of the children was "moderate". The rate of therapeutic effectiveness was 97.1% for the suppository and 93.8% for the injection, and did not differ significantly between the 2 groups. Rates of efficacy by severity, presence or absence of underlying diseases, daily dose and/or complications were high without exception, and did not differ significantly between the 2 groups. Eradication rates for causative microorganisms, as studied in 16 children of each group, were both 93.8%. The 2 most frequently isolated causative organisms were Haemophilus influenzae and Streptococcus pneumoniae. Side effects were examined for 36 children of each group. The frequency of side effects did not differ significantly between the suppository group (2 with diarrhea and 1 with abdominal pain) and the injection group (1 with urticaria), and 8.3% and 2.8%, respectively. The frequency of abnormal laboratory test findings differed significantly (P less than 0.01) with respect to eosinophilia which occurred in 7 (20.6%) of the injected subjects but was not encountered in the subjects treated with suppositories. Other abnormal laboratory findings included thrombocytosis in 3 (14.3%) of the injection group and increased GOT in 1 (3.2%) of the suppository group. The suppository formulation of CZX appears to be a highly useful substitute for the injectable form, and should find a special use in children whose treatment with injections experiences some difficulty. PMID- 3531568 TI - [Fundamental and clinical studies of imipenem/cilastatin sodium in the field of obstetrics and gynecology. Study group of imipenem/cilastatin sodium in the field of obstetric and gynecological infections]. AB - Fundamental and clinical studies were performed by our study group to evaluate the usefulness of the combination (1:1) of imipenem (MK-0787), a carbapenem antibiotic, and cilastatin sodium (MK-0791), an inhibitor of dehydropeptidase-I, in the treatment of patients with obstetric and gynecologic infections. The following results were obtained. Antimicrobial activities of MK-0787 were tested with inocula of 10(6) cells/ml of organisms isolated from patients with obstetric and gynecologic infections. Peak MIC's of MK-0787 were less than or equal to 0.20 micrograms/ml for S. aureus, less than or equal to 0.20 micrograms/ml for S. epidermidis, 1.56 micrograms/ml for E. faecalis, 0.39 micrograms/ml for E. coli, less than or equal to 0.20 micrograms/ml for K. pneumoniae and less than or equal to 0.20 micrograms/ml for B. fragilis. When 0.5 g/0.5 g of MK-0787/MK-0791 was administered by a 30-minute intravenous drip infusion, maximum concentrations of MK-0787 in all female genital tissues were obtained at the end of the infusion, and Cmax ranged from 9.4 micrograms/g to 17.0 micrograms/g. In addition, the maximum concentration of MK-0787 in pelvic dead space exudate was 13.2 micrograms/ml at 88 minutes after the start of the infusion. The penetration of MK-0787/MK-0791 into female genital tissues and dead space exudate was found to be good and sufficient to cover MIC's against organisms isolated from patients with obstetric and gynecologic infections. Clinical efficacy was evaluated in 201 evaluable patients out of a total of 253 patients with obstetric and gynecologic infections. Clinical responses were excellent in 2, good in 181 and poor in 18 patients, and the efficacy rating was 91.0 percent. Efficacy ratings classified by types of infections were 93.2% (82/88) for intrauterine infections, 83.0% (39/47) for intrapelvic infections, 100% (26/26) for adnexitis, 90.0% (18/20) for infections of the external genital organs and 90.0% (18/20) for other infections. Side effects were observed in 6 of the 253 patients; rash in 4, nausea and vomiting in 1 and diarrhea in 1 patient. Abnormal laboratory findings were observed in 10 of the 253 patients; elevation of GOT, GPT, LDH and Al-P in 1, elevation of GOT, GPT and Al-P in 1, elevation of GOT and GPT in 4, elevation of GPT in 1, elevation of BUN in 1, increase of eosinophiles in 1, decrease of segmented neutrophils in 1 patient. PMID- 3531569 TI - Factors influencing spontaneous initiation and termination of ventricular fibrillation. PMID- 3531571 TI - [Structure of T lymphocyte receptors]. PMID- 3531570 TI - [Successful bolus-methylprednisolone therapy after rejection of bone marrow transplantation in severe aplastic anemia: a case report]. PMID- 3531572 TI - [Changes in pathogenic microbes in infectious diseases--urinary tract infections including urethritis]. PMID- 3531573 TI - [Progress in chemotherapeutic agents--trends in developing antibiotics]. PMID- 3531574 TI - [Progress in chemotherapeutic agents--beta-lactam antibiotics and beta-lactamase inhibitors]. PMID- 3531576 TI - [Progress of chemotherapy in various fields--internal medicine (septicemia and fungemia)]. PMID- 3531577 TI - [Progress of chemotherapy in various fields--internal medicine (biliary tract infections)]. PMID- 3531578 TI - [Progress of chemotherapy in various fields--surgery (postoperative infections)]. PMID- 3531575 TI - [Progress in chemotherapeutic agents--antiprotozoal agents and anthelmintics]. PMID- 3531579 TI - [Prophylactic administration of antimicrobiological agents and reflections thereon--prevention of traveler's diarrhoea]. PMID- 3531580 TI - [Prophylactic administration of antimicrobiological agents and reflections thereon--prevention of postoperative infections. 1. Abdominal surgery]. PMID- 3531581 TI - [Prophylactic administration of antimicrobiological agents and reflections thereon--prevention of postoperative infections. 2. Obstetrics and gynecology]. PMID- 3531582 TI - [Development of oral synthetic antibiotics: international trends]. PMID- 3531583 TI - [Application and problems of combination drug therapy--drug interactions of antineoplastic agents and antibiotics]. PMID- 3531584 TI - [Adverse effects of antimicrobiological agents and countermeasures--current state of adverse effects]. PMID- 3531586 TI - [Adverse effects of antimicrobiological agents and countermeasures--TDM and countermeasures against adverse effects]. PMID- 3531585 TI - [Adverse effects of antimicrobiological agents and countermeasures--Clostridium difficile enteritis: with special reference to early diagnosis]. PMID- 3531587 TI - [Drug resistance of bacteria and countermeasures--current status of resistance. 2. Intestinal bacteria]. PMID- 3531588 TI - [Drug resistance of bacteria and countermeasures--current status of resistance. 4. Haemophilus and Yersinia]. PMID- 3531589 TI - [Progress in emergency medicine and cardiovascular imaging methods: X-ray imagings--cineangiography and digital radiography]. PMID- 3531590 TI - [Progress in emergency medicine and cardiovascular imaging methods: ultrasonic imaging of acute myocardial infarction]. PMID- 3531591 TI - [Progress in emergency medicine and cardiovascular imaging methods: magnetic resonance imaging]. PMID- 3531592 TI - [Progress in emergency medicine and cardiovascular imaging methods: imaging of heart electrophysiology]. PMID- 3531593 TI - [Angina pectoris: classification and clinical significance--the AHA classification and WHO classification]. PMID- 3531595 TI - [Critical angina pectoris: diagnosis of unstable angina and its therapy]. PMID- 3531594 TI - [Etiology of angina pectoris: coronary artery lesions and coronary vasospasm]. PMID- 3531596 TI - [Comparison of surgical therapy and internal therapy in angina pectoris]. PMID- 3531597 TI - [Prognosis of variant angina pectoris]. PMID- 3531598 TI - [Acute myocardial infarction: diagnosis of infarct location by ECG]. PMID- 3531599 TI - [Acute myocardial infarct: quantitative measurement of infarction by the ECG mapping method]. PMID- 3531600 TI - [Acute myocardial infarction: the ischemic area and occurrence of arrhythmia]. PMID- 3531601 TI - [Acute myocardial infarction: emergency drug therapy--1). Cardiogenic shock]. PMID- 3531602 TI - [Acute myocardial infarction: emergency drug therapy--2). Arrhythmia]. PMID- 3531603 TI - [Acute myocardial infarction: emergency drug therapy--3). Heart failure]. PMID- 3531604 TI - [Clinical application of special emergency therapy: intra-aortic balloon pumping in the therapy of cardiogenic shock due to myocardial infarction and its limitations]. PMID- 3531605 TI - [Clinical application of special emergency therapy: effect of cardiac pacing on acute myocardial infarction and its limitations]. PMID- 3531606 TI - [Progress in coronary surgery and emergency medicine: diagnosis of complications with myocardial infarction and emergency surgery]. PMID- 3531607 TI - [Etiology and therapy of multiple organ failure]. PMID- 3531608 TI - [Use of microwaves in image diagnosis]. PMID- 3531609 TI - [Physiology of sweating]. PMID- 3531610 TI - [Lacrimation]. PMID- 3531611 TI - [Secretion of the salivary glands: morphological approach]. PMID- 3531612 TI - [Secretion of the salivary glands: neurophysiologic approach]. PMID- 3531613 TI - [Secretion of gastric juice: with special reference to regulatory factors]. PMID- 3531614 TI - [Mechanism of bile secretion]. PMID- 3531615 TI - [Secretion of the pancreas]. PMID- 3531616 TI - [Intestinal secretions]. PMID- 3531617 TI - [Secretion of milk]. PMID- 3531618 TI - [Dysfunction of the sweat glands]. PMID- 3531619 TI - [Dysfunction of lacrimation]. PMID- 3531620 TI - [Dysfunction of salivation]. PMID- 3531621 TI - [Dysfunction of digestive system secretion: gastric secretion]. PMID- 3531622 TI - [Dysfunction of digestive system secretion: pancreatic secretion]. PMID- 3531623 TI - [Sjogren's syndrome]. PMID- 3531624 TI - [Xerostomia]. PMID- 3531625 TI - [C kinase: with special reference to recent findings]. PMID- 3531626 TI - [Progress in prosthetic heart valves]. PMID- 3531627 TI - [Retinoids and their binding proteins from basic science to clinical medicine]. PMID- 3531628 TI - [Advances in clinical technology during the first half of the twentieth century]. PMID- 3531629 TI - [Advance of ultrasound diagnosis]. PMID- 3531630 TI - [An approach to microcomputer-supported interpretation system of pathologic states by chemical and hematological multitest data]. PMID- 3531631 TI - [Dynamic pattern display and interpretation of blood-chemical data by personal computer]. PMID- 3531632 TI - [An attempt for an automatic system of laboratory microbiology]. PMID- 3531633 TI - [An assay system employing cultured hepatocytes for anti-insulin receptor antibody detection]. PMID- 3531634 TI - [Ultrasonic examination of the prostate]. PMID- 3531635 TI - [Tests for prostate-derived enzymes. B. Immunochemical analysis of serum PAP and its clinical significance]. PMID- 3531636 TI - [Analysis of seminal plasma proteins. B. Histopathological localization of gamma Sm]. PMID- 3531637 TI - [Determination of gamma-Sm]. PMID- 3531638 TI - [Preclinical evaluation of serum gamma-Sm determination and its normal value]. PMID- 3531639 TI - [Current status of cyclotron nuclear medicine]. PMID- 3531641 TI - [Ultrasonography of diffuse goiter]. PMID- 3531642 TI - [Digital subtraction angiography of pediatric idiopathic hematuria]. PMID- 3531640 TI - [Longitudinal-transverse ratio of breast masses in ultrasonic diagnosis]. PMID- 3531643 TI - [Study of the ultrasonic findings of metastatic liver cancer]. PMID- 3531644 TI - [Sonographic and computed tomographic diagnosis of obstructive jaundice]. PMID- 3531645 TI - [A case of early stage biliary cystadenocarcinoma]. PMID- 3531646 TI - [Intravenous digital subtraction angiography with low-dose contrast material]. PMID- 3531647 TI - Effect of milbemycin D against microfilariae of Litomosoides carinii. AB - The filaricidal effect of milbemycin D, a compound closely related to ivermectin, was studied in vivo and in vitro using Litomosoides carinii. Microfilaria (mf) densities in the peripheral blood of cotton rats, Sigmodon hispidus, were reduced to less than 3% of initial densities within 24 hours after treating either subcutaneously or orally at doses of 0.05 to 50 mg/kg body weight. In cotton rats treated with diethylcarbamazine at a single dose of 200 mg/kg, mf densities were reduced transiently but recovered to initial levels within 2 weeks, whereas they remained at less than 20% of the initial levels in rats treated with milbemycin D even with a single dose of 0.05 mg/kg. No microfilaricidal effect was observed in cotton rats treated with milbemycin D at a dose of 50 mg/kg for 5 consecutive days. The microfilaricidal effect of milbemycin D was also shown in vitro in RPMI 1640 medium. The minimal effective dose of this compound was estimated to be between 1 and 10 micrograms/ml of medium. PMID- 3531648 TI - [Actinomycosis of the sigmoid colon--a case report and review of the literature]. PMID- 3531649 TI - [Studies of renal dysfunction among the inhabitants of a cadmium polluted area. II. The changes of disc electrophoretic patterns of urinary proteins observed after a twelve-year interval]. PMID- 3531650 TI - [Studies on the abdominal sonographical screening examination--with special reference in relation to aging and metabolic abnormalities]. PMID- 3531651 TI - [Boundary element fundamentals for mathematical model simulation]. PMID- 3531652 TI - Immunocytochemical studies on the development of the pancreatic islet cells in the domestic fowl. PMID- 3531653 TI - The role of V antigen in mice experimentally infected with Yersinia pseudotuberculosis; histopathological study using enzyme immunoassay. PMID- 3531654 TI - Changes of glucokinase and hexokinase activities in the diabetic Microtus arvalis Pallas. PMID- 3531655 TI - Decrease in plasma insulin concentration in lactating rat. PMID- 3531656 TI - Immunofluorescence for IgG and C3 in the swine kidney with trypsin-treated paraffin section: the influence of condition of formalin-fixation. PMID- 3531657 TI - Insulin responses induced by glucose, ketone body or volatile fatty acids in Microtus arvalis Pallas. PMID- 3531658 TI - Radiation-induced mouse liver neoplasms and hepatocyte survival. AB - Transplantation of hepatocytes from CBA/Cne mice into the fat pads of isogeneic recipients has been used for the quantitative in vivo study of cell survival and risk of transformation after x-ray irradiation (1-7 Gy). A survival curve for liver cells was generated in vivo with a D0 of 3.08 Gy and an extrapolation number not significantly different from 1. Data on liver tumor incidence in whole body irradiated CBA/Cne and C57BL/Cne X C3H/HeCne (BC3F1) mice are also reported. A statistical analysis of trend in both cases proved a significant induction of tumors by x-rays mainly for doses above 2 Gy. The risk of transformation per surviving cell was estimated for both mouse strains. For CBA mice the data points suggested the presence of a linear component in the dose-effect curve at low doses, whereas for BC3F1 mice a quadratic expression appeared to provide a better description of the points from 1 to 6 Gy. The data of this study suggested that liver tumors can be induced by radiation in mouse strains with either a high or low spontaneous hepatoma incidence. PMID- 3531659 TI - [Clinical trial of initial intensive short-course chemotherapy supplemented by pyrazinamide for pulmonary tuberculosis--report of the 26th A series of controlled trials of chemotherapy--Cooperative Study Unit of Chemotherapy of Tuberculosis of National Sanatoria in Japan (CSUCTNS)]. PMID- 3531660 TI - [Role of electrophysiological research in the detection of ischemic heart disease patients at high risk for the development of sudden death]. PMID- 3531661 TI - [Current problems of electrocardiotopography]. PMID- 3531662 TI - [Surgical treatment of arrhythmias]. AB - Current status of antiarrhythmic surgical treatment is reviewed. In the bradyarrhythmias section, wide use of physiologic stimulation is recommended, and the tachyarrhythmias section outlines indications for the surgical treatment of the Wolff-Parkinson-White syndrome, supraventricular tachyarrhythmias and ventricular tachycardias, and reviews its results. Treatment for tachycardias should necessarily follow this order: medication--electric impulse therapy- electrodestruction--surgery. PMID- 3531663 TI - [Significance of the dynamic indices of the electrocardiotopogram in assessing the course of acute myocardial infarct]. AB - Electrocardiographic and myocardial pump and contractility parameters were studied, using non-invasive procedures, in 103 patients with acute large-focal anterior myocardial infarction who showed rapid and delayed patterns of ECG change. Rapid changes were associated with favorable course of the disease. In cases of delayed changes associated with severe or medium conditions, central hemodynamic and intracardiac kinetic parameters can supply additional information to support clinical data in the assessment of the patient's condition. PMID- 3531664 TI - [Methods of studying data from postmortem coronary radiography and their diagnostic reliability]. PMID- 3531665 TI - [Diagnosis of chronic forms of ischemic heart disease at different stages in patient examination]. PMID- 3531666 TI - [Determination of the cortisol, insulin and aldosterone content of the blood as possible indices of the course and prognosis of myocardial infarct]. AB - The predictive value of cortisol, insulin, aldosterone as indicators of emotional/painful stress was studied. A natural pattern in the variation of these hormones was identified in cases of myocardial infarction taking a favorable course, while the absence of such was associated with a complicated course of infarction. PMID- 3531667 TI - [Laser angioplasty: current status, problems and prospects]. PMID- 3531668 TI - [Georgii Fedorovich Lang (on the 110th anniversary of his birth)]. PMID- 3531669 TI - [Electrophysiologic research on the anti-arrhythmia properties of bonnecor--a new dibenzazepine derivative]. AB - A new dibenzepin derivative, bonnecor, showed marked antiarrhythmic and antifibrillation properties in anesthetized cats. One and 2 mg/kg doses of the drug reduce cardiac assimilation of imposed ventricular electric stimuli, increase ventricular fibrillation threshold with a strong and lasting effect and prevent arrhythmias and fibrillation due to 10-minute occlusion and subsequent reperfusion of the anterior descending branch of the left coronary artery. Experimental holding of atrial trabecular membrane potential in a frog, in conditions of a double saccharose bridge, showed bonnecor, in 5 X 10(-7) and 1 X 10(-6) g/ml concentrations, to inhibit rapid sodium inflow and slow calcium inflow. It is expected that bonnecor can be used clinically to control critical arrhythmias and prevent sudden cardiac death. PMID- 3531670 TI - [Current aspects of the search for and preclinical study of anti-arrhythmia agents]. PMID- 3531671 TI - [Clinical and hemodynamic effects of captopril in patients with chronic circulatory failure]. AB - The effect of a new drug, captopril, an inhibitor of the enzyme responsible for the conversion of angiotensin I to angiotensin II, were examined in 15 patients with chronic circulatory insufficiency in the presence of coronary heart disease. The efficiency of single doses and four-week courses of the drug was assessed. Captopril was shown to reduce significantly pulmonary arterial occlusion pressure and total peripheral resistance and increase the minute volume, thus improving left-ventricular function. Considering good tolerance of the drug, it can be recommended for the treatment of chronic circulatory insufficiency. PMID- 3531672 TI - Micropuncture techniques. PMID- 3531673 TI - Transport studies in plasma membrane vesicles isolated from renal cortex. PMID- 3531674 TI - Continuous measurements of cell volume changes in single kidney tubules. PMID- 3531675 TI - Studies of kidney cells in culture. PMID- 3531676 TI - The electrophysiological analysis of tubular transport. PMID- 3531677 TI - Immunoelectron microscopy in kidney research: some contributions and limitations. PMID- 3531678 TI - Cell culture approaches to the analysis of glomerular inflammation. AB - In this paper, we have attempted to provide an overview of the methods and findings of a large number of investigators who have dealt with an analysis of the glomerular inflammatory response using tissue culture techniques. These observations represent only a beginning. With the growing interest in this aspect of kidney disease, it is to anticipated that many further advancements in the understanding of the cell biology of the glomerulus are forthcoming. The translation of this fundamental information into new diagnostic and therapeutic modalities is an exciting challenge to investigative nephrology. PMID- 3531679 TI - Quantitation of exogenous and endogenous components of glomerular immune deposits. PMID- 3531680 TI - [Exogenous allergic alveolitis in childhood]. PMID- 3531681 TI - [Legionellosis]. PMID- 3531682 TI - [Etiology, pathogenesis, diagnosis and treatment of Raynaud's disease and syndrome]. PMID- 3531683 TI - [Effectiveness of lumbar sympathectomy in arteriosclerotic lesions of the arteries of the lower extremities]. PMID- 3531684 TI - [Aleksei Alekseevich Ogloblin (on the centenary of his birth)]. PMID- 3531685 TI - [Perforating gastric and duodenal ulcers in children]. PMID- 3531686 TI - [Treatment of large skin-defect wounds of the scalp]. PMID- 3531687 TI - [Cholecystitis in middle and old age]. PMID- 3531688 TI - [An ultrasonic method for determining the amount of residual urine in patients with obstruction in the lower urinary tract]. PMID- 3531689 TI - [N. I. Pirogov in Bulgaria]. PMID- 3531690 TI - [The surgical service in the Serbo-Bulgarian War (1885)]. PMID- 3531691 TI - [10 years' experience with ruthenium 106/rhodium 106 treatment of malignant melanoma of the choroid--report on 264 irradiated tumors]. AB - In 75% of the patients with malignant melanoma of the choroid useful vision can be retained by beta-radiation with ruthenium-106/rhodium. Tumors with a prominence of more than 6 mm should be treated only for very special reasons. There is a statistically proven correlation between the initial tumor volume and the occurrence of residual tissue volume. Histopathological investigations have shown that residuals of the tumor do not permit any conclusions concerning the dignity or vitality of tumor cells. The risk to life is not increased by the conservative procedure, and it may even be reduced. PMID- 3531692 TI - [New developments in the treatment of keratoconus]. AB - The results of penetrating and lamellar keratoplasty in patients with keratoconus are communicated. In penetrating keratoplasty the graft healed clear in 93.5% of the cases treated (266 operations). A new method of surgical treatment of acute total keratoconus by "biological covering" with a lamellar corneal graft is proposed, which enables the process to stabilize, the eye to be saved, and in isolated cases a visual acuity of 0.5 or more to be achieved. The authors describe a new trend in studying the pathogenesis of keratoconus on the basis of biochemical investigations of the damaged areas of the cornea (lowering of the activity of enzymes of the antioxidant system and reduction in tocopherol content). A new method of conservative treatment for the initial forms of keratoconus using phonophoresis of Vitamin E (tocopherol) is proposed on the basis of the data gathered in the biochemical investigations. PMID- 3531693 TI - [Cytologic studies of the aqueous humor to determine immune reactions]. AB - Although corneal grafting is performed on a so-called privileged (i.e., unvascularized) tissue, it is not always successful. Depending on the degree of vascularization of the host cornea (Stages I-IV) allograft reactions occur in 3 to 70% of patients thus treated. In an animal experiment (rabbits) a graft reaction was produced in the anterior chamber of one eye following presensitization with soluble corneal proteins, after implanting corneal tissue in the anterior chamber under the protection of a viscoelastic substance. The same grafting procedure was repeated on the fellow eye without previous sensitization. In the course of the immunoreaction the cell content of both eyes was studied and, 14 days after grafting, the result of aspiration cytology was compared with findings from light-microscopic examinations of the corneal graft and host cornea. A correlation was established between the results of aqueous humor cytology and the cytological findings in the corneal graft. It follows that immunoreactions can be interpreted reliably by aqueous humor aspiration cytology. PMID- 3531694 TI - [Regeneration capacity in retina and vitreous body changes following extraction of intravitreal copper particles]. AB - On the basis of experiments with 42 rats, quantitative statements are made regarding the influence of surface area and dwelling time of intravitreal copper particles on the electroretinogram. The influence of these factors on the extent of recovery of function after extraction of the foreign body is demonstrated. The rate of mental intoxication (metallosis retinae) is indicated separately from the mechanical damage. Ophthalmoscopic findings are also described. The practical relevance of these results to the clinical situation is discussed in detail in connection with earlier reports. PMID- 3531695 TI - [Klippel-Feil syndrome and status dysraphicus]. AB - Apart from the obligatory symptoms of Klippel-Feil syndrome (short neck, low hairline on nape, limited rotation of the head) many other so-called facultative dysraphic impairments may be found. The most common is spina bifida, which is the prototype of the "dysraphia syndrome". Therefore, Klippel-Feil syndrome belongs to a heredo-degenerative constitution type of "status dysraphicus". PMID- 3531696 TI - [Eduard Zirm (1863-1944)]. AB - Eduard Zirm (1863-1944) was the first ophthalmologist to perform a successful keratoplasty, in 1905. He submitted his report on the operation for publication in the "Graefe Archiv fur Ophthalmologie" on July 9, 1906. The report appeared that same year. A brief historical survey is given here. PMID- 3531697 TI - [Keratoplasty in Hungary]. AB - The author reports on the results of keratoplasty in Hungary on the occasion of the 80th anniversary of the first successful keratoplasty performed by Eduard K. Zirm. PMID- 3531698 TI - [Technic and results of Fox bridge plasty for covering defects of the lower lid]. AB - The present paper communicates results of reconstruction of lower lid defects following tumor excision. Surgery was performed on 25 patients using a modified Fox procedure. Functionally and cosmetically the results were good. Three patients developed an ectropion of the lower lid, one of them requiring surgical repair. In 3 cases there was some loss of cilia, though the patients did not find this disturbing. In 2 cases a minor sagging of the lower lid border was seen. A modified version of Fox's original method is proposed as a means of avoiding these complications. PMID- 3531699 TI - [Immunocytochemical detection of involucrin in precancerous and cancerous non pigmented conjunctival tumors]. AB - Involucrin is a precursor of the cross-linked envelope protein of the human stratum corneum. Its appearance in the upper layers of the epidermis reflects normal differentiation of keratinocytes. This study uses an immunoperoxidase technique for localization of involucrin in paraffin sections of normal conjunctiva, conjunctival dysplasia, carcinoma in situ, and invasive carcinoma. Clinicoimmunocytochemical correlations are presented. The results demonstrate that the distribution patterns of involucrin differ in precancerous and cancerous conjunctival lesions: normal limbal conjunctiva shows involucrin only in the three superficial cell layers; the fornix conjunctivae contains no involucrin. All 23 conjunctival dysplasias show an involvement also of deeper layers of the epithelium, sparing the basal layers. Three carcinomas in situ and one invasive squamous cell carcinoma, however, demonstrate an involvement of all layers of the epithelium. The involucrin staining pattern helps in histologic differential diagnosis of epithelial lesions of the conjunctiva. PMID- 3531700 TI - [Discovery of Loa ophthalmia by the French ship's surgeon Francois Guyot (1742 1816)]. AB - We are indebted to Francois Guyot (4. 10. 1742-13. 6. 1816) for the term "loa," designating a species of filaria, pathogenic in humans, which is common tropical West Africa. Biographical details about this French ship's surgeon are published here for the first time. On several slave-trading voyages between Africa and America, Guyot noticed that some of the negroes suffered from recurrent ophthalmia. He established that it was caused by a worm roaming around under the conjunctiva, and succeeded in extracting the parasite. In 26 May 1781 Guyot submitted a report on his findings to the "Academie Royale de Chirurgie" in Paris. This article discusses details of the report, which was hitherto believed lost. PMID- 3531701 TI - [Fetal hydrothorax]. AB - Three cases of bilateral congenital hydrothorax concomitant with hydrops fetalis are presented and compared with similar cases in literature. The hydrops fetalis to our opinion is caused by peripheral hypoxia. The hypoxia has its origin in the restricted cardiac output caused by the bilateral hydrothorax. PMID- 3531702 TI - [Sonographic detection of an intragastric blood clot in neonatal hemorrhage disease]. AB - Caused by a hemorrhagic disease of a newborn without laboratory findings of coagulopathy, a dramatic blood loss due to gastrointestinal bleeding was observed in a high risk female newborn of 37. weeks of gestational age. By ultrasound the globular 3 centimeter diameter tumor in the stomach was defined as a blood clot. It disappeared in the following days under ultrasound observation. PMID- 3531703 TI - [Hodgkin's disease following kidney transplantation with cyclosporin A]. AB - A 44-year-old patient with polycystic kidney disease received a renal transplant in December 1984. Nine months after immunosuppressive therapy with cyclosporin A and prednisolone the patient developed Hodgkin's disease of the mediastinum. PMID- 3531704 TI - [Bolus injection of anisoylated plasminogen-streptokinase activator complex (BRL 26921) as an alternative concept of systemic lysis in acute myocardial infarct]. AB - The thrombolytic properties of anisoylated plasminogen streptokinase activator complex (BRL 26921) and clinical results of the treatment were studied in 10 consecutive patients with acute myocardial infarction. Exclusion criteria were general contraindications against thrombolytic therapy and a time interval of more than 4 h between the onset of symptoms and admission to the hospital. All patients received a 250-mg bolus of prednisolone prior to intravenous injection of 30 mg BRL 26921 within 2 min. A continuous infusion of heparin at a dose of 1,000 USPU/h was started 2 h after the injection. Blood pressure was monitored via an arterial line. Arrhythmias and changes in the ST segments were documented by conventional ECG recording and computer-based ECG monitoring. Coronary arteriography and left ventriculography were carried out within 72 h. Besides routine laboratory tests, serial CK and CK-MB activity measurements were carried out. We determined the following hemostaseological parameters before and 15 min, 30 min, 1 h, 4 h, and 12 h after application of BRL 26921: prothrombin time, activated partial thrombosplastin time, thrombin time, thrombin coagulase time, fibrinogen, streptokinaseplasminogen activator activity, plasminogen and alpha-2 antiplasmin. Our results (reperfusion in all patients angiographically and in 7 to 8 of 10 patients from noninvasive criteria) show that BRL 26921 is a highly effective thrombolytic agent in patients with myocardial infarction, when compared with high-dose systemic fibrinolysis. Applied in dosages required for early reperfusion, it does not appear to be selectively thrombolytic and is not free of hypotensive effects in man. The decrease of fibrinolytic activity is biphasic with a half-disappearance time of 112 min. PMID- 3531705 TI - Influence of a cod liver oil diet in healthy and insulin-dependent diabetic volunteers on fatty acid pattern, inhibition of prostacyclin formation by low density lipoprotein (LDL) and platelet thromboxane. AB - Ten healthy and twenty diabetic volunteers (type 1) received 15 capsules (a 450 mg) cod liver oil for 2 weeks daily in addition to a "normal" diet. The levels of eicosapentaenoic acid in the plasma phospholipids of both groups were increased after the treatment. The inhibition of the prostacyclin formation by LDL was diminished when the LDL was isolated after the treatment in comparison to LDL taken in the same concentration and from the same donors before it. The thromboxane B2 (TXB2) synthesis capacity of clotting whole blood, thrombin induced TXB2 formation by platelets as well as the 15(S)-hydroxy-11 alpha,9 alpha epoxymethano-5Z, 13E-prostadienoic acid-induced platelet aggregation were not altered by the treatment in healthy volunteers, whereas in diabetics the TXB2 formation capacity of clotting whole blood was decreased after the treatment in comparison with before it. PMID- 3531706 TI - Glucagon responses to L-arginine and insulin after treatment of insulin dependent diabetes mellitus in childhood. PMID- 3531707 TI - [Cardiomyopathies (classification, clinical aspects, diagnosis and treatment]. PMID- 3531708 TI - [The role of D.D. Pletnev in the development of Soviet cardiology]. PMID- 3531709 TI - [Hippocrates]. PMID- 3531710 TI - [The Aesculapius museum in Epidaurus]. PMID- 3531711 TI - [Experience with using streptodecase in the acute period of myocardial infarction]. PMID- 3531712 TI - [Secretion of insulin and C-peptide and insulin sensitivity in patients with ischemic heart disease]. PMID- 3531713 TI - [Potentials of ultrasonic methods for assessing the hemodynamic characteristics of the cardiocerebrovascular system]. AB - This paper reviews ultrasonic methods used at present to evaluate hemodynamic parameters of different organs and velocity characteristics of circulating blood. The ultrasonic methods make it possible not only to diagnose different vascular lesions but also to investigate the effects of unusual environmental parameters on the human body. The paper give a classification of the existing and advanced procedures based on ultrasonic location when applied to determine hemodynamic characteristics of the cardiocerebrovascular system. The paper presents a description of ultrasonic methods used in studying the heart (velocity characteristics of the circulation of cardioelements), brain (pulse oscillations of vessel blood filling in the cranial cavity), and large arteries (blood filling and blood flow velocity. PMID- 3531714 TI - [Determination of the enzyme activity of the urine in kidney lesions]. PMID- 3531715 TI - Role of secretory phospholipases A2 in the pathobiology of disease. PMID- 3531716 TI - Cyclosporin-induced endothelial cell injury. AB - The administration of Cyclosporin-A (CyA) to animals and humans may induce an arteriolar damage. It has also been reported that CyA in some instances may cause an hemolytic uremic-like syndrome. This is a syndrome of vascular damage with thrombotic occlusions of the microcirculation. Endothelial injury is considered the first event in the pathogenetic cascade leading to hemolytic-uremic syndrome. We have used bovine aortic endothelial cells in culture to address the issue of CyA-induced arteriolar damage. Exposure of endothelial cells to different concentrations of CyA induced a time- and dose-dependent cell injury in vitro. The damage induced by CyA was characterized by an early cell detachment from culture substrate followed by cell lysis as documented by the increase in lactate dehydrogenase (LDH) and 51Cr release. Both detachment and lysis were negligible after short-term incubation of 1 microM CyA with endothelial cells. One micromolar CyA only induced lysis if incubations were prolonged above 6 hours. Ten and 50 microM CyA both induced marked endothelial cell detachment and lysis; lysis started 3 hours after incubation of endothelial cells with CyA and was maximal at the end of 24 hours incubation. CyA-induced injury was associated with dose- and time-dependent increase in prostacyclin and thromboxane A2 release by endothelial cells exposed to CyA independently from the concentrations of CyA used. CyA-induced generation of prostacyclin and thromboxane A2 was inhibited when the incubations were performed in the presence of aspirin (500 microM). These studies indicate that CyA exerts a direct cytotoxic effect on endothelial cells and might help in understanding the pathogenesis of CyA-induced vascular damage. PMID- 3531717 TI - The intermediate filament complement of the spectrum of nerve sheath neoplasms. AB - The intermediate filament complement of the spectrum of nerve sheath neoplasms including 12 typical benign schwannomas, 1 ancient schwannoma, 2 cellular schwannomas, 6 neurofibromas and 4 malignant schwannomas was investigated by immunofluorescence microscopy, two dimensional electrophoresis, and immunoblot analysis. Studies were performed on freshly frozen tumor tissue samples; a broad spectrum of antibodies against all classes of intermediate filaments was utilized. Samples were also studied by electron microscopy, and immunohistochemically for S-100 protein and desmoplakins. By immunofluorescence microscopy, all nerve sheath neoplasms revealed intense positivity for vimentin throughout the cytoplasm while 2 benign schwannomas displayed co-expression of vimentin and glial filament proteins. Two-dimensional gel electrophoresis and immunoblot analysis confirmed the presence of vimentin and showed that it was the predominant protein in all tumors. Electrophoretic analysis of the 2 benign schwannomas that immunostained for glial filament proteins confirmed the presence of this protein which was shown to comigrate with a known human control sample. Neither immunofluorescence microscopy nor biochemical analyses revealed cytokeratin polypeptides, neurofilament proteins, desmin, or desmoplakin in any of the tumors. We conclude that while vimentin is the predominant intermediate filament expressed by the entire spectrum of nerve sheath neoplasms, at least occasional benign schwannomas are capable of co-expressing glial filament proteins. It remains to be determined whether the subgroup of nerve sheath neoplasms that co-expresses vimentin and glial filament proteins is otherwise distinguishable from their more frequent counterparts that express vimentin exclusively. PMID- 3531718 TI - Peter Pan stumbles. PMID- 3531719 TI - Neonatal periventricular haemorrhage and its sequelae. PMID- 3531720 TI - Erythrocytic glucose-6-phosphate dehydrogenase deficiency and its significance with special emphasis on malaria. PMID- 3531721 TI - Computers in paediatrics. 18. Medical decision making: computer program to calculate sensitivity, specificity, false positive and negative rates, positive and negative predictive values and accuracy of a diagnostic test. PMID- 3531723 TI - Prostacyclin reduction of regional ischemic injury in the canine myocardium. AB - The effect of prostacyclin (PGI2) on the myocardium of the awake dog subjected to coronary artery occlusion was examined. Animals were randomly administered PGI2 200 ng/kg/min (n = 6), PGI2 100 ng/kg/min (n = 6), or the vehicle control (n = 6), beginning 30 min prior to coronary artery occlusion. Radiolabeled microspheres (15 microns) were used to measure myocardial blood flow. The myocardial region at risk was determined by fluorescein injection, and infarct size was assessed by triphenyl tetrazolium staining. Segmental myocardial function was evaluated from the systolic ejection shortening (SES) by subendocardial ultrasonic dimension crystals in normal, ischemic, and border zones. PGI2 200 ng/kg/min produced significant decreases in aortic pressure and systemic vascular resistance. PGI2 100 ng/kg/min, which achieves 95% platelet inhibition, had no significant hemodynamic effects. Animals receiving PGI2 200 ng/kg/min had significantly higher blood flow to the ischemic region, better border zones SES, and a smaller infarct. PGI2 ameliorates myocardial injury and reduces functional impairment produced by ischemia in doses that elicit vasodilation. This beneficial effect of PGI2 does not appear to be mediated solely by an antiplatelet mechanism. PMID- 3531722 TI - Foot pressure measurement: a review of clinical findings. AB - In this review, a description of what is known about plantar pressure distribution in standing and in gait is followed by sections on clinical findings. Two major clinical areas are treated extensively, namely the diabetic foot and the foot in rheumatoid arthritis. Other applications, including the assessment of surgical procedures for orthopaedic corrections are also included. A large variety of different techniques for foot pressure measurement have been used; interpretation of the results has to be made on the basis of a firm understanding of the technique employed. Often, quantitative results from different pieces of apparatus are difficult to compare, indicating a need for accurate calibration and a standardized presentation. An up-to-date summary of pressure measurement systems reported over the past five years is included. PMID- 3531724 TI - Defects in monocyte chemotaxis in patients with neoplastic disease. PMID- 3531725 TI - A child with streptococcal pharyngitis and jaundice. PMID- 3531726 TI - Bilateral ovarian involvement as the only manifestation of malignant lymphoma. AB - A 16-year-old girl presented with a large pelvic mass. At laparotomy, bilateral ovarian tumors were disclosed and bilateral salpingo-oophorectomy was performed. No evidence of extra-ovarian disease was found. Histopathological examination and histochemical immunoperoxidase studies demonstrated the tumors to be malignant lymphoma of the lymphoblastic type. The patient had radiotherapy and systemic chemotherapy and more than 10 years later she is alive with no evidence of recurrent disease. The rarity of ovarian involvement as the initial manifestation of malignant lymphoma is discussed. The question of whether this patient represents a case of a primary ovarian malignant lymphoma or merely represents a case of ovarian initial manifestation of an occult generalized disease cannot be answered. PMID- 3531727 TI - Adenosquamous carcinoma of the common bile duct: a case report. AB - Reported here is a case of primary adenosquamous carcinoma of the common bile duct. This unusual variant of the ordinary adenocarcinoma has not, to the best of our knowledge, been previously reported as occurring in the extrahepatic bile ducts. A tumor of notorious prognostic significance, it represents an exceedingly rare and peculiar biological phenomenon of malignant metaplastic change. PMID- 3531728 TI - An unusual presentation of colon cancer. AB - A rare case of asymptomatic cancer of the ascending colon presenting as a subcutaneous groin mass is reported. At the time of right hemicolectomy with resection of the groin mass there was no sign of incontinuity spread or lymph blockage. Sequential determination of carcinoembryonic antigen levels (CEA) in serum reflected the reduction in tumor mass after surgery as well as subsequent recurrences of disease in the groin and in the lung after 2 years. Immunoperoxidase staining of the primary tumor and the metastases showed strong positivity for CEA confirming the origin of the serum CEA. There have been no signs of liver involvement. The route of spread of this unusual metastasis is not known. PMID- 3531729 TI - Screening Azadirachta indica and Pisum sativum for possible antimalarial activities. AB - Solvent-free extracts obtained from the leaves of Azadirachta indica and Pisum sativum were screened for antimalarial action using Plasmodium berghei in mice. Four days of oral dosing with 500 mg/kg and 125 mg/kg of the methanol extract of A. indica showed a parasite suppression which was statistically significant although all test animals died after 5 days, just 1 day longer than the untreated control group. A 50 mg/kg oral dose of the aqueous extract of P. sativum was found to have significant prophylactic activity by producing a parasite suppression of 31.9%. PMID- 3531730 TI - Eleven-year experience with composite graft replacement of the ascending aorta and aortic valve. AB - Between September, 1974, and December, 1985, 127 patients had replacement of the ascending aorta and aortic valve with a composite graft. Annuloaortic ectasia was the most common indication for operation (69 patients), followed by aortic dissection (51 patients). Twenty-four patients (19%) had the Marfan syndrome. Hospital mortality was 4.7%. Emergent operation for acute dissection was the only independent predictor of hospital death (p = 0.03). Reoperation for postoperative hemorrhage was required in 15 patients (11.8%) and for prosthesis-related complications (pseudoaneurysm, prosthetic endocarditis, technical problems, and valve thrombosis) in 16 patients (12.6%). Since we adopted a technique of preclotting the prosthesis with whole blood or albumin plus autoclaving and abandoned the inclusion technique, the reoperation rate has declined substantially. At 5 years, the actuarial freedom from reoperation for any reason on the ascending aorta or aortic valve for the 24 patients in whom this modification was used was 90% and for the remaining 103 patients, 73% (p = 0.17). No reoperations for pseudoaneurysms or technical problems were required in these 24 patients, whereas 10 reoperations for these complications were necessary in the other patients. The mean duration of follow-up was 54 months. The actuarial survival rate at 7 years for the entire group was 65%; for the patients with annuloaortic ectasia, 70%; for those with aortic dissection, 61%; for the patients with the Marfan syndrome, 57%. Actuarial freedom from operation on the remainder of the aorta at 7 years was 89%, but it was 78% for the subgroup with the Marfan syndrome. The satisfactory results with extended follow-up support the continued use of the composite graft technique as the preferred method of treatment for patients with annuloaortic ectasia or recurrent aneurysms of the sinuses of Valsalva and for patients with aortic dissection who require aortic valve replacement. PMID- 3531731 TI - New membrane oxygenator (LPM 50): influence on extravascular lung water and pulmonary function in comparison to bubble oxygenator. AB - A prospective, randomized, clinical study involving 30 patients undergoing aorta coronary bypass grafting was designed to compare the influence of a new membrane oxygenator and a commonly used bubble oxygenator on extravascular lung water and pulmonary function after extracorporeal circulation. Although membrane oxygenators might have some advantages from the biochemical and biophysical points of view, in this clinical study no differences in lung water accumulation and pulmonary gas exchange could be detected between bubble and membrane oxygenators after extracorporeal circulation. PMID- 3531732 TI - RAB-1: a new monoclonal antibody to leukemic hairy cells. AB - RAB-1, a new monoclonal antibody (McAb) to human leukemic hairy cell (HC) was produced. Using indirect immunofluorescence methods and microscopic or flow cytometric analysis, it was found that the RAB-1 antigen was expressed on few resting B cells and not on resting T lymphocytes, platelets, monocytes, erythroid and myeloid cells. RAB-1 expression on malignant cells was as follows: strongly positive in 15/15 hairy cell leukemia (HCL), negative with non-T and T-acute lymphoblastic leukemia and T-chronic lymphocytic leukemia (CLL); weakly expressed on myeloma and Waldenstrom cells; moderately on 10-25% of the cells in 4/10 B-CLL and 6/10 B lymphomas and in 7/7 B-prolymphocytic leukemia (PLL). Amongst human cell lines that were tested, RAB-1 reacted strongly with one HC line, moderately with the EBV-lymphoblastoid Daudi and Raji Burkitt's lines and was not expressed on Ramos, ALL, myeloid and erythroid cell lines. Normal B cells activated with PWM or anti-mu beads, and malignant B cells activated with anti-mu and TPA did not show an increase of expression of RAB-1 antigen. Interestingly, 30-40% of T4 Class II antigen positive cloned cells and T cells activated with PHA and Con.A expressed RAB-1, suggesting that this McAb recognizes surface molecule, newly induced during T-cell activation and constitutively expressed on HC and some B cell malignancies. PMID- 3531733 TI - Involvement of chromosomal region 9q34 in a case of variant Ph1 translocation t(22;22). AB - In a patient with chronic myelocytic leukemia chromosome analysis showed a translocation (22;22) (q13;q11). Chromosomes 9 were apparently not involved. Using somatic cell hybrids and a v-abl probe, we demonstrated the translocation of c-abl sequences from chromosome 9 to chromosome 22q-. This confirms the hypothesis that the translocation of c-abl oncogene is essential for the development of Ph1 positive CML. PMID- 3531734 TI - Jose Jeronimo Triana: Colombian botanist. PMID- 3531735 TI - Aortico-left ventricular tunnel: diagnosis based on two-dimensional echocardiography, color flow Doppler imaging, and magnetic resonance imaging. AB - Aortico-left ventricular tunnel is a rare congenital cardiac lesion that often results in severe aortic insufficiency in infancy. In previously reported cases, the diagnosis has often been missed initially despite use of cardiac catheterization and angiography. We describe a patient who underwent successful surgical correction of this malformation at 10 months of age after the diagnosis had been established by use of two-dimensional echocardiography, color flow Doppler imaging, and magnetic resonance imaging. Aortico-left ventricular tunnel can be diagnosed by use of these noninvasive means without cardiac catheterization. PMID- 3531736 TI - Medical care utilization by Hispanic children. How does it differ from black and white peers? AB - Factors associated with the utilization of medical care by Hispanic, black Non Hispanic, and white Non-Hispanic children were analyzed using multivariate regression techniques on a Health Interview Survey sample. The findings indicate that Medicaid coverage was the sharpest enhancer of entry into care for Hispanics and blacks, contributing significantly to the amount of physician visits. While financial factors seemed more influential determinants of physician contacts for minorities, perceived health needs appeared to be important contributors to entry into health care for white children. Such differences reveal that important racial-ethnic disparities persist with respect to physician utilization among children. Improved insurance coverage for Hispanics, particularly children of Mexican origin, is suggested as an important intervention to facilitate access for this population. PMID- 3531737 TI - Differences between female and male children in the receipt of prescribed psychotropic and controlled-analgesic drugs. A five-year epidemiologic study. AB - This study describes the differences between male and female children in the receipt of prescriptions for psychotropic and controlled-analgesic drugs in office practice. The study encompassed 341,422 children of ages 0 through 17 years enrolled in the Tennessee Medicaid program during the 5 years 1977-1981. These children made 1,342,573 office visits and received 1,636,127 prescriptions during the study. There were 18,023 (5.3%) children who received prescriptions for psychotropic drugs and 18,744 (5.5%) who received prescriptions for combination products containing psychotropic drugs. There were 26,071 (7.6%) children who were prescribed controlled analgesics and 50,240 (14.7%) who received prescriptions for these substances as fixed combination medications. In this population, proportions of male and female children who received prescriptions for psychotropic and controlled-analgesic drugs were similar through age 11. After age 11, females were increasingly more likely to receive prescriptions for drugs from both categories than were males of the same age. By age 17, the rate of psychotropic drug prescription receipt for female children (6.3%) was nearly twice that for males (3.3%), a ratio consistent with numerous studies in adults. These differences were consistent over diagnostic categories and were only partially explained by differences in office-visit rates. These findings suggest that the known greater rates of psychotropic drug use among adult females are the result of factors whose influence begins at puberty, not before. PMID- 3531738 TI - [Uses of growth hormone]. PMID- 3531739 TI - [New perspectives in the origin of obesity. I: Regulation of intake and body weight]. PMID- 3531740 TI - [Factors determining the adhesive capacity of S. agalactiae for epithelial cells]. PMID- 3531741 TI - [Biochemical properties of group B Streptococci isolated from human and animals]. PMID- 3531742 TI - [Use of the capture antibody method for the detection of the presence of IgM in the sera of persons immunized against rabies]. PMID- 3531743 TI - [Usefulness of the indirect immunofluorescence method in the serological diagnosis of rabies]. PMID- 3531744 TI - [Experiences up to now with diagnosis and microsurgical revascularization in disorders of erection]. AB - Nine patients with impaired erection and a mean age of 41 years were diagnosed by means of a battery of multidisciplinary examinations: specific anamnesis, urological, neurological, endocrinological, angiological, psychosomatic and metabolic investigations, electromyography, measurement of the latency period and duration of the bulbocavernosus reflex, measurement of the nocturnal penis tumescence, penile blood-pressure index (PBPI), artificial erection with papaverine, flowmetry, phalloarteriography, dynamic cavernosonography. In all cases, an arterial and/or venous genesis was discovered as well as neurological or psychological factors. Three microsurgical techniques were employed: the end to-side anastomosis of the A. epigastrica inferior preferably with the A. dorsalis penis (two cases), with the V. dorsalis penis profunda (four cases) and with the two combined (three cases). In the last cases, the vein was ligated or constricted proximal to the anastomosis. The primary factor in choosing the particular reconstruction method was the angiogram. Diagnosis entailed no complications for the patients. In addition to minor postoperative complications such as a hematoma, scar pains or hypervascularization of the glans and the corpus spongiosum, three early occlusions occurred in reconstructions up to one month postoperatively. One to five months after surgery the erectile potency had improved or normalized in seven out of nine patients, making intercourse possible. Two patients, the only two with a posttraumatic interruption in the bulbocavernosus reflex curve, showed no change. For purposes of postoperative control of arterio-venous anastomoses, the typical shunt sound is observed by stethoscope. After revascularization of the A. dorsalis penis, it is recommended that the PBPI be taken at the Aa. profundae penis and, when necessary, that a control angiography be performed. For the treatment of potency disturbances stemming from vascular causes, our results advocate that microsurgical vascular reconstruction be given due consideration before implantation of a penile prosthesis. PMID- 3531745 TI - [Penicillinosis of the paranasal sinuses]. AB - A 29-year old female patient suffering from severe pain in her right eye, headache, ophthalmoplegia and ptosis of the right eye, total roentgenological opacity of the right maxillary sinus and ethmoidal cells , as well as signs of bone destruction in the orbital floor, was operated on under the suspicion of a tumour. Histological and bacteriological examinations as well as fungus cultures indicated, however, that the patient was suffering from a chronic infection caused by Penicillium notatum. Surgical treatment and postoperative intravenous administration of amphotericin B resulted in complete recovery of the patient. PMID- 3531746 TI - [Echographic diagnosis in injuries of the paranasal sinuses]. AB - A-scan and B-scan sonography was performed in 86 patients with fractures in the paranasal region (73 blow-out, 8 ethmoidal, 5 frontal sinus fractures). In all of them echography provided a correct diagnosis by delineating fracture lines and bone fragment dislocation. Additionally, sonography detected a haematosinus in 17, and a subperiosteal haematoma in 6 patients, respectively. Although echography can never replace radiologic diagnostics, it should be performed in the primary evaluation and in the follow-up of all patients with paranasal traumatology because of its high accuracy. PMID- 3531747 TI - Frederick Thayer Hill, 1889-1969. PMID- 3531748 TI - A systematic approach to the surgical management of acoustic neuroma. AB - Contemporary otomicrosurgical techniques have made total removal of acoustic tumor with preservation of the seventh and sometimes the eighth cranial nerves possible. The four approaches currently used in acoustic tumor surgery are the middle cranial fossa, the translabyrinthine, the suboccipital, and the combined translabyrinthine-suboccipital. This review examines the surgical results in the removal of more than 600 acoustic tumors and outlines a rationale for the choice of approach. Tumor size on computed tomographic scan and auditory reserve establish the parameters used in planning the surgical procedure. The translabyrinthine exposure is used most frequently followed by the combined translabyrinthine-suboccipital. The middle fossa and suboccipital approaches are used when preservation of hearing is attempted. Total removal of tumor was accomplished in more than 99% of patients with a mortality rate of less than 1%. Anatomic preservation of the facial nerve, which is directly related to tumor size, was achieved in more than 80% of patients. Preservation of hearing is unlikely when the tumor is larger than 2 cm; anatomic preservation of the cochlear nerve was successful in 73% of hearing preservation procedures. PMID- 3531749 TI - Photodynamic therapy: the state of the art. AB - Photodynamic therapy is a new and exciting treatment modality for many forms of localised malignant disease. A considerable amount of laboratory and clinical research has been carried out using the tumour sensitiser haematoporphyrin derivative activated by red light at a wavelength of 630 n commonly produced by either an argon/dye laser or a pulsed gold vapour laser. It appears certain that continuing research will produce better tumour sensitisers activated by different wavelengths of light, but it will be several years before any new drug/light combination is ready for clinical trials. This paper presents an overview of the current situation and a summary of some of the exciting results that are being obtained in clinical trials throughout the world. PMID- 3531750 TI - Purification and degradation of purified neurofilament proteins by the brain calcium-activated neutral proteases. AB - The effect of the three forms (CANP1, CANP2 & CANP3) of calf brain calcium activated neutral protease (CANP) on the hydrolysis of purified neurofilament triplet proteins was investigated. It was observed that: each of the purified neurofilament proteins, was hydrolyzed slowly by CANP2 whereas the hydrolysis of 150 KDa and 68 kDa proteins by CANP1 & CANP3 was rapid; when assembled neurofilaments were used as a substrate, again differences in the rate and extent of degradation of the triplet proteins by the three proteases were observed. For example, little cleavage of the 68 kDa protein by CANP2 and CANP3 was noted whereas 210 kDa and 150 kDa proteins remained largely intact. CANP1 degraded the 150 kDa and 68 kDa proteins more rapidly than 210 kDa protein, where only a slight effect was noted. These data provide further proof of the existence of three different forms of CANP in the brain, and indications of the resistance of 210 kDa protein to proteolysis which may be compatible with its proposed special role in crossbridge formation. PMID- 3531751 TI - Dose dependent radiation-induced hypotension in the canine. AB - Radiation-induced early transient incapacitation (ETI) is often accompanied by severe systemic hypotension. However, postradiation hypotension does not occur with equal frequency in all species and is not reported with consistency in the canine. In an attempt to clarify the differences in reported canine postradiation blood pressures, canine systemic blood pressures were determined both before and after exposure to gamma radiation of either 80 Gy or 100 Gy. Data obtained from six sham-radiated beagles and 12 radiated beagles indicated that 100 Gy, whole body, gamma radiation produced a decrease in systemic mean blood pressure while 80 Gy, whole-body, gamma radiation did not. Analysis of this data could be consistent with a quantal response to a gamma radiation dose between 80 Gy and 100 Gy. PMID- 3531752 TI - A comprehensive bioethical code for medical exploitation of humans facing imminent and unavoidable death. PMID- 3531753 TI - [Lymphography, computed tomography and ultrasonic examination in determining the involvement of retroperitoneal and abdominal lymph nodes in Hodgkin's disease]. AB - Altogether 45 patients with Hodgkin's disease were examined with the help of lymphography (LG), computerized tomography (CT) and ultrasonography (USG). The LG, CT and USG results obtained in 20 patients were compared with the histological findings. The retroperitoneal lymph nodes contrasted in LG, when involved in a pathological process, were detected with approximately the same accuracy in CT and USG. The abdominal lymph nodes undiscernible on lymphograms, were visualized in CT and USG, the sensitivity of USG was higher than that of CT. An optimum scheme for examination of patients with Hodgkin's disease with USG as the chief method was proposed. CT and LG are conducted depending on USG results and a clinical picture of disease. PMID- 3531754 TI - [Current problems in the prevention, diagnosis and treatment of radiation sickness]. PMID- 3531755 TI - [Radiographic methods of breast imaging in the early diagnosis of cancer]. PMID- 3531756 TI - Teaching ethics in medical school. PMID- 3531757 TI - [Dispersion injection needle for insulin administration]. AB - A new dispersion syringe needle is proposed to administrate insulin to diabetics. It features side location of injection holes 4-8 of which are arranged along the needle body. The needle so designed provides greater absorption area, thus increasing absorption rate and reducing insulin decay in the subcutaneous layer. With the needle, more effective insulin action to compensate glucose content is achieved as compared to the conventional design. PMID- 3531758 TI - The metabolic and hormonal adaptations of normal dogs to long-term exogenous sulfated insulin infusions. AB - Hyperinsulinism frequently accompanies glucose normalization in type I diabetes but the long-term consequences of this exaggerated hormonal state are not known. To study this condition, normal dogs received constant exogenous sulfated insulin infusions for prolonged periods up to 43 weeks. During the interval and inspite of prevailing postabsorptive and fasting hypoglycemia, overt resistance to the infused insulin or loss of sensitivity did not occur. In counterring the imposed fasting hyperinsulinemia and the resulting hypoglycemia, fasting pancreatic glucagon levels rose while the fasting levels of several glucogenic precursors (lactate, pyruvate, and alanine) decreased. Fasting free fatty acid (FFA) levels were suppressed, but beta-hydroxybutyrate (beta-OHB) levels were unchanged. Body weight did not change. Most remarkably, all changes measured in the fasting levels of the hormones and metabolites reverted to normal following the cessation of exogenous sulfated insulin infusion. In addition to the hormonal and metabolite adaptations invoked by chronic exogenous hyperinsulinism in the fasting state of these normal dogs, there were interesting responses to their usual mixed meals. Of particular interest in this regard were the plasma glucose, insulin, and FFA diurnal profiles. First of all, a definite and unusual postprandial glycemic excursion occurred. Second, insulin levels were elevated some sixfold, and rather unresponsive to the meal in general. Inspite of the depressed fasting FFA levels and the absence of a postprandial rise in insulinemia, FFA showed a distinct fall after the meal. Whether the sulfated insulins infused were of the bovine or porcine species of origin made no discernible difference.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3531759 TI - Effect of testosterone on whole body amino acid utilization in myotonic dystrophy. AB - Patients with myotonic dystrophy are markedly insulin resistant and have an associated abnormality in the regulation of arterialized amino acid concentrations during euglycemic insulin infusions. We studied the effect of testosterone treatment on whole body amino acid balance in myotonic dystrophy, since it increases muscle mass and muscle protein synthesis rate. Six patients with myotonic dystrophy underwent studies of glucose disposal and amino acid regulation during low dose insulin infusions with maintenance of euglycemia, prior to and after 10 to 13 weeks of testosterone (3 mg/kg/wk). Testosterone increased the insulin-stimulated decline of certain amino acids, but did not improve whole body glucose uptake. The anabolic effect of testosterone is separate from the anabolic effect of insulin. PMID- 3531760 TI - Effects of carbohydrate and protein meals on plasma large neutral amino acids, glucose, and insulin plasma levels of anorectic patients. AB - The response of large neutral amino acids (LNAA), glucose, and insulin plasma levels to a protein-rich and a carbohydrate-rich test meal was studied in anorectic patients (upon admission to hospital and after weight gain) and in a control group of young women. Patients showed reduced glucose tolerance, as well as increased and prolonged insulin secretion. After the protein meal, the ratio of tyrosine to other LNAA (a predictor of tyrosine flow into brain) was increased in patients and the ratio of tryptophan to other LNAA (a predictor of tryptophan flow into brain) depressed. The carbohydrate meal resulted in a smaller increase in the ratio of tryptophan to other LNAA in patients. Not all alterations showed a trend to normalization with weight gain. Implications of findings for monoamine metabolism and regulation of food choice are discussed. PMID- 3531761 TI - Effect of insulin on growth hormone-induced metabolic derangements in diabetes. AB - To investigate the mechanism of growth hormone-induced hyperglycemia in diabetes, two studies were done in insulin-dependent diabetic patients receiving intensive insulin therapy with the insulin pump. First, the metabolic response to a standard breakfast following a subcutaneous insulin bolus was examined before and after 20 hourly boluses of intravenous growth hormone in eight patients. Despite unchanged insulin therapy, growth hormone administration produced a marked rise in fasting glucose concentrations (197 +/- 21 v 96 +/- 11 mg/dL), as well as increases in fasting levels of free fatty acids and branched chain amino acids. Nevertheless, postprandial blood glucose increments were only slightly greater after growth hormone (36 +/- 14 v 20 +/- 12 mgdL). Moreover, the increased levels of other insulin-sensitive fuels induced by growth hormone fell to normal following the meal. In a second study, six patients received a low-dose insulin clamp (designed to reproduce the mean postprandial concentrations of glucose and insulin observed in the meal study) before and after growth hormone administration. Despite endogenous glucose overproduction after growth hormone, modest elevations in free insulin (40 to 50 microU/mL) were sufficient to suppress glucose production to an extent comparable to the control day (from 2.8 +/- 0.2 to 0.6 +/- 0.3 mg/kg min after growth hormone v 1.6 +/- 0.1 to 0.4 +/- 0.2 mg/kg min on the control day). However, the normal stimulation of glucose uptake by insulin was abolished by growth hormone. We conclude that in diabetic patients growth hormone-stimulated hepatic glucose overproduction (and the increases in other insulin-sensitive fuels) can be relatively easily overcome with extra insulin.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3531762 TI - Altered gas exchange, limited glucose and branched chain amino acids, and hypoinsulinism retard fetal growth in the rat. AB - We measured several growth stimulating variables in growth retarded (small-for gestational-age [SGA]) rat fetuses on days 18, 19, 20, and 21 of their 21.5-day gestation. Bilateral maternal uterine artery ligation on day 18 was used to retard fetal growth, and fetuses of sham and nonoperated (normal) mothers served as controls. SGA fetuses had the lowest body and placental weights, while sham fetuses had intermediate weights from days 19 to 21. Similarly, SGA fetuses had the most profound alterations in arteriovenous PO2, PCO2, and pH, while sham fetuses had significant but less severe alterations. Fetal plasma concentrations and fetal/maternal ratios of glucose were significantly diminished in SGA fetuses on days 18 and 19; sham fetuses had intermediate values on day 19. Plasma concentrations and fetal/maternal ratios of leucine, isoleucine, and valine, but not the other amino acids, were significantly diminished in SGA fetuses on days 18, 19, and 20. Plasma insulin concentrations were significantly diminished in SGA fetuses on days 19 and 20, and hepatic concentrations of glycogen were significantly diminished on all days. Despite significantly elevated plasma glucagon concentrations in SGA fetuses, hepatic cytosolic phosphoenolpyruvate carboxykinase (PEPCK) activity was not elevated. These data indicate that bilateral uterine artery ligation retards fetal growth in the rat by altering gas exchange and limiting fuel availability. The limited insulin in SGA fetuses might further have retarded growth.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3531764 TI - Purification of recombinant human IFN-alpha 2. PMID- 3531763 TI - Large-scale purification of recombinant human leukocyte interferons. PMID- 3531765 TI - Purification of recombinant human fibroblast interferon produced in Escherichia coli. PMID- 3531766 TI - Purification of recombinant human interferon beta expressed in Escherichia coli. PMID- 3531767 TI - Effect of purification procedures on the composition of human leukocyte interferon preparations. PMID- 3531768 TI - Labeling of recombinant interferon with [35S]methionine in vivo. PMID- 3531769 TI - Measurement of a receptor for (2'-5')-oligoadenylate(trimer) on macrophages. PMID- 3531770 TI - Procedures for expression, modification, and analysis of human fibroblast interferon (IFN-beta) genes in heterologous cells. PMID- 3531771 TI - Measurements of changes in histocompatibility antigens induced by interferons. PMID- 3531772 TI - Cumulative subject index. Volumes 81-94, 96-101. PMID- 3531773 TI - Lowered induction of genetic tandem duplications in Salmonella by the pKM101 plasmid. AB - Selection for 3-amino-1,2,4-triazole (AT) resistance in certain strains of Salmonella typhimurium has been previously shown to select for genetic tandem duplications of the histidine operon. We show here that agents which induce tandem duplications are less effective in such induction in the presence of the pKM101 plasmid. The presence of the plasmid also produces an increase in AT resistance due to mechanisms other than duplication, presumably because pKM101 produces high levels of error-prone repair. We suggest that high levels of error prone repair may cause decreases in tandem duplication induction and propose that error-prone repair and tandem duplication may be alternative cellular responses to certain DNA lesions. PMID- 3531774 TI - Thermal resistance of UV-mutagenesis to photoreactivation in E. coli B/r uvrA ung: estimate of activation energy and further analysis. AB - Ultraviolet light (UV) induced mutations in the glnU and glnVa tRNA genes in Escherichia coli are thought to be targeted by UV photoproducts. In a previous study with a uracil-DNA glycosylase deficient strain, UV-induced glnU0 and glnV0 tRNA suppressor mutations became resistant to photoreactivation (PR) following thermal treatment. It was proposed that deamination of cytosine in the cytosine containing cyclobutyl dimers at the sites of these suppressor mutations produced uracil residues in sequence upon PR. In the absence of glycosylase, the C----U conversion yielded the requisite G:C----A:T transitions. In the present study, this thermal resistance of UV-mutagenesis to PR is characterized. It is dependent on the initial UV-fluence and temperature of holding but not on the UmuC+ gene product. The data obtained yield an estimate of an activation energy of 17 +/- 3 kcal/mol for the deamination of cytosines contained in dimers. This compares to 29 kcal/mol for unaffected cytosines in DNA. In addition, an estimate of the probability of cyclobutyl dimer formation at the target sites for glnU0 and glnV0 suppressor mutations indicate that these lesions can not entirely account for the mutation frequencies recovered in the absence of PR. This is interpreted as an indication that, in addition to thymine-cytosine cyclobutyl dimers, other UV induced lesions, possibly Thy(6-4)Cyt photoproducts, may also target glnU0 and glnV0 suppressor mutations. PMID- 3531775 TI - Mutation probe of gene structure in E. coli: suppressor mutations in the seven tRNA operon. AB - Cells defective in uracil-DNA glycosylase (ung::Tn10) were used in two ways to reveal differences in select point mutations (GC to AT transitions) within the seven-tRNA operon of E. coli. The mutations were indicated as de novo or converted glutamine tRNA suppressor mutations in the genes glnU and/or glnV: the kinetics of photoenzymatic monomerization of pyrimidine dimers quantitated by ung dependent UV mutagenesis indicated more rapid repair of dimers at sites for converted suppressor mutation than of dimers at sites for de novo suppressor mutation, and spontaneous deamination of cytosine was considerably more frequent at sites for converted suppressor mutation than at sites for de novo suppressor mutation. To explain these results we suggest the physical structure of the DNA in vivo is different at different sites in the seven-tRNA operon. The non transcribed strand including specifically the anticodon region of the site for converted suppressor mutation may frequently be looped out in a single strand so that a T = C dimer is more accessible to DNA photolyase or a free cytosine residue of non-irradiated DNA is in an aqueous environment conducive to deamination. In addition, we analysed the spontaneous de novo suppressor mutation data to determine an estimate for the in vivo rate of cytosine deamination in double strand DNA of 3.2 X 10(-13)/sec. PMID- 3531777 TI - Use of commercial 'authoring systems' for medical education. AB - A recent development in computer-assisted medical instruction has been the introduction of 'authoring systems'. Authoring systems are computer programs which can allow an instructor to prepare computer-based medical instructional materials without the need to know programming languages or have more than minimal familiarity with the computer hardware. This report documents the use of a commercially available authoring system that was used to prepare a tutorial for medical student instruction. This lesson presented information about paediatric developmental disabilities in both a text and question-and-answer format. Significant improvement in knowledge was demonstrated by the pre- and post-test results of the study group compared to the control group. The control group consisted of students who did not view the tutorial but had been assigned to a paediatric developmental disabilities clinic. The medical students who viewed the tutorial generally had very favourable comments about the use of such a system for the presentation of new information. PMID- 3531776 TI - Transient suppression of F-plasmid incompatibility in a strain of Escherichia coli. AB - The incompatibility between F plasmids is transiently suppressed in Escherichia coli strain CSH54. As a result this strain is able to maintain two F' factors or an F' factor and a mini-F plasmid for considerably longer periods than normal strains. When selective pressure for two markers carried by two separate F's (or an F' and mini-F) is imposed on normal strains, the two plasmids tend to form a cointegrate structure which can be detected genetically by the joint transfer of both the markers upon mating. This does not happen in CSH54; instead, the two plasmids are maintained and transferred independently. Physical evidence for the maintenance of an F' and a mini-F plasmid is provided by agarose gel electrophoresis. PMID- 3531778 TI - Approaches to curriculum planning. AB - This booklet describes different ways used to tackle the problem of curriculum planning. By studying these approaches teachers can get an insight into the process in their own school. First they must decide whether there should be a particular focus for curriculum planning and if so what it should be. In the light of this they can modify their school's approach. To what extent do they wish to focus on: aims and objectives (engineering approach), teaching methods (mechanics approach), content (cookbook approach), timetable (railway approach), problems (detective approach), one idea or strategy (religious approach), the regulations (bureaucratic approach), or a curriculum designed to attract sponsorship (public relations approach)? The magician approach, in which it is not clear how a curriculum is developed, is not recommended. Second, what should be the pattern of staff involvement--a representative group or committee (United Nations approach), all the teachers (people's congress approach), one individual (the dictator approach), a collaboration with students, patients and other professional colleagues (consumer approach), or a collaboration with an external consultant (consultant approach)? Whichever approach is adopted, advantages should be maximized and deficiencies minimized. PMID- 3531780 TI - [Dental aspects of Bidloo's "Anatomy" (1685), illustrated by Lairesse and plagerized by Cowper (II)]. PMID- 3531779 TI - [Dental aspects of Bidloo's "Anatomy" (1685), illustrated by Lairesse and plagerized by Cowper (I)]. PMID- 3531781 TI - [Dental aspects of Bidloo's "Anatomy" (1685), illustrated by Lairesse and plagerized by Cowper (III)]. PMID- 3531782 TI - Newer subtraction and filtration techniques. AB - This article attempts to describe and superficially evaluate the present and future application of a number of newer subtraction techniques, including recursive temporal filtration, matched filtration, hybrid subtraction, tomography and tomosynthesis, and parametric imaging and image processing. At this time, it is difficult to put each of these techniques into proper focus with regard to future clinical use. Suffice it to say that these and other techniques, which will almost certainly arise as our technical base expands, show promise of providing the diagnostician with unique information that will expand our ability to provide improved patient care based on better understanding of the physiology as well as the anatomy of both normal and pathologic processes. Critical evaluation of both the comparative clinical usefulness and the cost of such innovative digital technology requires careful study in academic centers before widespread commercial dissemination into the general diagnostic imaging community is warranted. PMID- 3531783 TI - Digital subtraction angiography: technology, equipment, and techniques. PMID- 3531784 TI - Who wants cholescintigraphy? PMID- 3531785 TI - The impact of fine-needle aspiration biopsy on surgery for single thyroid nodules. AB - Biopsy by fine-needle aspiration has emerged as the most effective single technique for the investigation of single thyroid nodules. A comparison was made of patients who underwent surgery for single nodules in 1979 (before the introduction of fine-needle aspiration biopsy to this Department) and in 1984, after this technique had become fully established. Biopsy by fine-needle aspiration proved to be reliable in the selection of patients for surgery. The incidence of malignancy in each category was: malignant, 83%; atypical, 26%; inadequate, 7%; and benign, none. This contrasted with nuclear scanning and ultrasound techniques that were in use over that period, where the malignancy rate of nodules that showed no uptake of radioisotope was 11% and that of an ultrasound scan that demonstrated a "solid" or "cystic/solid" was 16%. Similarly, nodules that showed an uptake of radioisotope or an ultrasound scan that demonstrated a "cystic" image did not exclude malignancy reliably. As a result of fine-needle aspiration biopsy, there was a 60% reduction in the number of thyroidectomies for single nodules during its use with a higher yield, but no change in the absolute number, of patients with malignancy of the thyroid gland. PMID- 3531786 TI - Hepatobiliary scintigraphy. Increasing the accuracy of the preoperative diagnosis of acute cholecystitis. AB - The ability of hepatobiliary scintigraphy (HBS) to influence accurately the clinical diagnosis of acute cholecystitis was assessed prospectively in 70 consecutive patients with suspected acute cholecystitis. Before and after HBS, the referring surgeons completed a questionnaire on the probability of acute cholecystitis. Accuracy of diagnosis was assessed by clinical follow-up and chart review in all patients and by surgical and pathological evaluation in the 31 patients who underwent laparotomy. There were 27 patients with positive HBS results and 40 with negative HBS results; the results for three patients were indeterminate. None of the positive or negative HBS results were confirmed to be inaccurate. Negative results influenced diagnosis more often than did others. Results were negative in 13 patients whose assigned probability of acute cholecystitis was very high before HBS; in all 13 the assigned probability was very low after HBS, and in none of these patients was acute cholecystitis confirmed subsequently. These results support the use of hepatobiliary scintigraphy before proceeding to urgent cholecystectomy in patients with a clinical diagnosis of acute cholecystitis. PMID- 3531787 TI - Local muscle fatigue. A precursor to RSI? AB - Some musculoskeletal conditions that are prevalent in occupations where the handling of materials and/or tools is required have been linked with the musculoskeletal load that results from activities that are undertaken to fulfil that occupation. The excessive loading of muscles under these conditions may lead to local muscle fatigue which may, in turn, manifest as pain, localized discomfort or kinaesthetic dysfunction. Local muscle fatigue is recognized as a precursor to some of these musculoskeletal conditions. This paper postulates the probable physiological mechanisms that provoke it. The changes to intramuscular blood flow during contraction, and their significance in relation to local muscle fatigue, are also reviewed. Methods to measure local muscle fatigue, as well as their objectivity and practicality, are discussed together with their plausible clinical implications. PMID- 3531788 TI - Thyroid masses and nodules: evaluation and management. PMID- 3531789 TI - Rapid mental deterioration in a young man. PMID- 3531790 TI - Appropriate timing of ultrasound scans in early pregnancy. PMID- 3531791 TI - Monoclonal antibodies for kidney allograft rejection. PMID- 3531792 TI - Group B streptococcal polysaccharide detection in the urine of neonates by staphylococcal co-agglutination. AB - Staphylococcal co-agglutination reagents were prepared by the sensitization of commercially available staphylococci with commercially available grouping serum. The reagents were able to detect from 31 ng/ml to 62.5 ng/ml of purified group B polysaccharide lacking type specificity, when 20 microliters of polysaccharide solution was used. The reagents were able to identify group B streptococcal polysaccharide in the concentrated urine of all six patients with positive group B streptococcal blood cultures (sensitivity = 100%). Two of 72 patients with negative blood cultures had positive tests when concentrated urine was tested (specificity = 97%). Prepared reagents had a sensitivity and specificity similar to that reported by others for commercially available reagents for the detection of group B polysaccharide at five to ten percent of the total cost. PMID- 3531793 TI - [Pharmacokinetic aspects of a pyrimethamine combination with sulfanilamides]. PMID- 3531794 TI - [Effect of vitamins D and E on the development of Plasmodium berghei infection in mice]. PMID- 3531795 TI - [In vivo sensitivity of Plasmodium falciparum to chloroquine in Bamako (the Republic of Mali)]. PMID- 3531796 TI - [Coordination and planning of basic research in applied medical parasitology]. PMID- 3531797 TI - [Filtration methods in the diagnosis of human tropical helminthiases (trematodiasis, intestinal nematodiasis and filariasis) (a review of the literature)]. PMID- 3531798 TI - [Artemisinines--a new class of antimalarial preparations (a review of the literature)]. PMID- 3531799 TI - More than economism: the politics of workers' safety and health, 1932-1947. AB - Even within the context of the New Deal, an agency of the Department of Labor was unusual for its innovations and activism. The Division of Labor Standards went beyond the economism of hours and wages to the advocacy of a safe and healthy work place. Unlike the Public Health Service, the division eschewed the "neutrality" of research and information gathering; it sought to intervene, directly and through the states, in the work place. The end of World War II unleashed a conservative reaction that restrained government's responsibility for several decades. PMID- 3531800 TI - Providing health care for low-income children: reconciling child health goals with child health financing realities. AB - The goal of equitable access to health care continues to be elusive for poor children. Medicaid, the major source of financing such care, has been eroded by a series of actions by the administration and the Congress. A survey of the Medicaid-based EPSDT (Early and Periodic Screening, Diagnosis, and Treatment) programs in the fifty states pinpoints shortcomings in adequate financing and sound standards of practice. Reconciling child health goals with program realities will require new federal and state initiatives. PMID- 3531801 TI - Osteosarcoma: state of the art. PMID- 3531802 TI - Cystic lymphangioma presenting as subacute thyroiditis. PMID- 3531803 TI - The emergence of sick children's nursing. Part 1. Sick children's nursing before the turn of the century. PMID- 3531804 TI - The repair potential of a posterior composite material. PMID- 3531805 TI - Enkephalin-degrading dipeptidylaminopeptidase: characterization of the active site and selective inhibition. AB - The enkephalins are degraded in vitro by three types of metallopeptidases including a dipeptidylaminopeptidase (DAP) which releases Tyr-Gly. In order to test the physiological significance of this enzyme in enkephalin metabolism, a membrane-bound DAP from porcine brain was purified. The structural characteristics of the active site of this enzyme were studied using several enkephalin-related fragments as substrates and various peptides as inhibitors. The active site possesses an anionic moiety able to interact with the ammonium group of the substrate and four hydrophobic subsites S2, S1, S1', S2' surrounding the metal-containing catalytic site. This porcine brain enzyme shows the same characteristics as a partially purified DAP from rat brain. Potent inhibitors of both enzymes were obtained with compounds interacting with either the S1', S2', or S1, S2 parts of the active site and containing a hydroxamate of an N-acyl-N hydroxy amino group as the metal-chelating agent. The compounds synthesized to bind the S1', S2' subsites, such as HN(OH)--CO--CH2--CH(CH2 phi)-CONH--CH(CH2 phi)--COOH, behave as highly potent and mixed inhibitors of both DAP (Ki = 2.5 nM) and enkephalinase (Ki = 0.3 nM). In contrast, Tyr-Phe-NHOH, designed to interact with S2,S1 subsites through its positively charged Tyr as the P2 component, is a highly potent (Ki = 9 nM) and selective DAP inhibitor. The ability of Tyr-Phe-NHOH to protect, in vivo, endogenous enkephalins was evaluated using the hot plate test with mice. The intracerebroventricular injection of Tyr Phe-NHOH alone (0.17 mumol, 60 micrograms) does not significantly modify the jump latency time as compared to the control. The effect of the association of Tyr-Phe NHOH (0.17 mumol, 60 micrograms), bestatin (0.16 mumol, 50 micrograms) and thiorphan (0.20 mumol, 50 micrograms) is not statistically different from that produced by bestatin (0.16 mumol) plus thiorphan (0.20 mumol). Likewise, the effect of bestatin (50 micrograms) or thiorphan (25 micrograms) is not significantly modified by intracerebroventricular co-administration of increasing concentrations of Tyr-Phe-NHOH. These results seem to indicate that the DAP does not play a major role in enkephalin metabolism, at least at the supraspinal level. PMID- 3531806 TI - Effects of 1-beta-D-arabinofuranosylcytosine on proto-oncogene expression in human U-937 cells. AB - We have previously demonstrated that declines in c-myc expression precede the induction of c-fos and c-fms transcripts during monocytic differentiation of human leukemia (HL-60 and U-937) cell lines. The present study has monitored the effects of 1-beta-D-arabinofuranosylcytosine (ara-C) on proto-oncogene expression in U-937 cells. The results demonstrate that ara-C inhibits both U-937 proliferation and c-myc expression in a concentration- and time-dependent manner. At non-toxic concentrations of ara-C, these decreases in c-myc RNA occur in the absence of changes in the level of actin transcripts. The results also demonstrate that ara-C increases c-fos but not c-fms expression. Similar findings have been obtained with retinoic acid. Furthermore, although both agents induce a more mature U-937 phenotype, ara-C is a relatively weak inducer of these cells. These findings would suggest that the changes in proto-oncogene expression induced by ara-C may be related to induction of differentiation or the inhibitory effects of this agent on proliferation. PMID- 3531807 TI - Lampbrush chromosomes. PMID- 3531808 TI - Modification of 40S ribosomal subunits from yeast with dimethylmaleic anhydride. AB - Modification of 40S ribosomal subunits from Saccharomyces cerevisiae with dimethylmaleic anhydride (DMMA), a reagent for protein amino groups, is accompanied by loss of polypeptide-synthesizing activity and by dissociation of proteins from the particles. The protein-deficient ribosomal particles, originated from 40S subunits by treatment with dimethylmaleic anhydride at a molar ratio of reagent to particle of 250, can partially reconstitute active subunits upon addition of the corresponding released proteins, and regeneration of the modified amino groups. PMID- 3531809 TI - [Study of the substrate-induced changes in the state of Eco dam methylase using a method of small-angle x-ray scattering]. AB - Interaction of Ecodam methylase (E.C. 2.1.1) with synthetic oligonucleotide substrates of various primary structure was studied by the small angle X-ray scattering method. Complex formation between the enzyme and substrates occurs after addition of double-stranded oligonucleotides to the methylase. In the presence of 1 M NaC1 (when the enzyme is inactive) addition of the synthetic substrates does not result in complex formation. Comparison of the experimental scattering parameters with the calculated ones has been made. The best coincidence of these data is obtained for the model which proposed Ecodam methylase dimer formation in the course of its interaction with the substrates. PMID- 3531811 TI - [Statistical characteristics in primary structures of functional regions of Escherichia coli genome. II. Non-stationary Markov chains]. AB - We introduced non-stationary Marcov chains for statistical description of the DNA E. coli structural domains. The values of all needed parameters for those chains was determined by the preliminary statistical processing of a wide set of the E. coli coding regions. It was shown that non-stationary models predict frequencies of occurrences of various combinations of nucleotides within the coding fragments of DNA, better than stationary ones. In particular non-stationary models give good approximation for short and long distance arrangement of nucleotides in the coding regions. The correlation parameters for neighbour codons and for neighbour amino acid residuals in E. coli protein's primary structure was determined from the non-stationary model of the second order. With the aid of the statistical criteria it was found that neighbour residuals in polypeptide chains can't be considered as independent. The new model of the DNA structural domain may be used in computer algorithms for recognition and classification of DNA functional regions. PMID- 3531810 TI - [Statistical characteristics in primary structures of functional regions of Escherichia coli genome. I. Frequency characteristics]. AB - Analysis of the frequencies of occurrence of mono- and dinucleotides in sequenced E. coli DNA fragments was performed. The DNA sequences of total length 135 000 nucleotides were considered. It was demonstrated that the fragments of DNA which have different functional properties also have different parameters of neighbour nucleotides correlation. Moreover, periodical positional dependence of correlation parameters in coding regions was found. The evolution significance of stated observation is discussed, so as the opportunity of using them in the special model of nucleotide's sequences, which is needed for development of the computer recognition algorithms for genomic functional units. PMID- 3531812 TI - [Mechanism of coupling of oxidation and phosphorylation]. AB - The mechanism of the energy coupling process proposed in the present investigation is based on energy transformation with participation of chemical intermediates, paramagnetic molecules formed in unsaturated fatty acid chains of the phospholipid membrane. The proposed mechanism is a modification of the chemical-intermediate hypothesis, with energy-rich lipid radicals serving as an intermediate. Although there are some points of inconsistency with the chemiosmic theory and Williams's hypothesis about the energy-rich proton, the proposed mechanism accounts for the delta mu H+ gradient and intramembrane proton during the coupling process in oxidative phosphorylation. The existence of the delta mu H+ gradient and its variation during phosphorylation may be a way of oxidative control realization. PMID- 3531813 TI - IgG subclass changes in response to vaccination. PMID- 3531814 TI - IgG subclasses in animal species. PMID- 3531815 TI - Antigenic markers of neuroendocrine tumors: their diagnostic and prognostic value. PMID- 3531816 TI - Diagnosing the anaplastic tumor. PMID- 3531817 TI - Cellular aspects of neoplasia. PMID- 3531818 TI - Oncogenes and cancer. PMID- 3531819 TI - Ionizing radiation and neoplasia. PMID- 3531820 TI - [The effect of the dentist's position on abutment tooth preparation for a full cast crown--upper left 2d premolar]. PMID- 3531821 TI - [The effect of the home operating position on the prepared abutment contour of full cast crowns--with special reference to the mandibular left 1st molar]. PMID- 3531822 TI - [The combined agar-alginate impression technic--in reference to the bond strength]. PMID- 3531823 TI - [Periodontal evaluation of abutment teeth. 1. pH value in gingival crevices and periodontal pockets]. PMID- 3531824 TI - [Use of an ultrasonic pulse-echo method in prosthodontics--equipment and ultrasonography]. PMID- 3531825 TI - [Masticatory efficiency using a particle-counting sieve-system method]. PMID- 3531826 TI - [Clinical considerations for better esthetics in a clasp denture]. PMID- 3531827 TI - Nonneoplastic asbestos-induced disease. PMID- 3531828 TI - Neoplastic asbestos-induced disease. PMID- 3531829 TI - Relationship between mutagenic potency in Salmonella typhimurium strains and the chemical structure of nitro biphenyls. AB - Most of the positional isomers of mono-, di-, tri- and tetranitrobiphenyls were synthesized and assayed for their mutagenicity in Salmonella typhimurium strains TA98, TA98NR and TA98/1,8DNP6 in the absence of S9 mix. In mono- and dinitrobiphenyls, the structure requirements favoring mutagenic activity are the presence of a nitro group at the 4-position and its absence at the 2-position. TA98 and TA98/1,8DNP6 were reverted by 2-position-free 4-nitro analogues, but TA98NR was not reverted. The results suggest that direct-acting mutagenicity involves the reduction of the nitro group by bacterial nitroreductase but does not involve specific esterification enzymes. Some of the tri- and tetranitrobiphenyls e.g. 3,4,3'-, 3,4,4'-, 3,4,3',4'- and 3,4,2',4'-derivatives reverted not only TA98 and TA98/1,8DNP6 but also TA98NR. Those derivatives commonly have 2 nitro groups at an adjoining position (3,4-dinitro group), whereas 2,4,2',4'-tetranitrobiphenyl, which has strong potency not only in TA98 and TA98/1,8DNP6 but also in TA98NR, possesses 2 nitro groups at the 2-position of each benzene ring. PMID- 3531830 TI - Metabolic conversion of IQ and MeIQ to bacterial mutagens. AB - The metabolic conversion of 2-amino-3-methyl- and 2-amino-3,4-dimethyl imidazo[4,5-f]quinoline (IQ and MeIQ respectively) to bacterial mutagens was studied using a bacterial mutation assay. Studies were performed using S9 fractions derived from either corn oil (uninduced) or Aroclor-1254-treated Sprague-Dawley rats. Aroclor 1254 treatment lowered the S9 protein concentration required for optimum levels of mutagenesis, enhanced the numbers of mutants observed and altered the effects of metabolic inhibitors and cofactors added to the assay. Studies with uninduced preparations revealed that IQ and MeIQ exhibited similar responses to the effects of metabolic inhibitors and cofactors involved in detoxication reactions. Both IQ and MeIQ activation appeared to be inhibited by the biogenic amines tryptamine and tyramine and inactivated by conjugation with either acetyl coenzyme A or glutathione. PMID- 3531831 TI - Effects of carcinogenic halogenated aliphatic hydrocarbons on [3H]thymidine incorporation into various organs of the mouse. A comparison between 1,2 dibromoethane and 1,2-dichloroethane. AB - The effects of 1,2-dibromoethane (DBE) and 1,2-dichloroethane (DCE) on the incorporation of [3H]thymidine into DNA were evaluated in various tissues of mice. The compounds were given intraperitoneally 24 h before sacrifice in an equimolar dose (293 mumoles/kg body weight). 2 h before the animals were killed, 0.5 mu Ci [3H]thymidine/g body weight was injected intraperitoneally. Both agents inhibited the [3H]thymidine incorporation in the forestomach, a site for their carcinogenic action. Whereas DBE also suppressed the [3H]thymidine incorporation in the nasal mucosa, the thymus, and the "glandular stomach", DCE was inhibitory only in the kidney. The observed difference in the effect of DBE and DCE on the thymus had its counterpart in a DBE-induced decrease of acid-insoluble radioactivity, demonstrated with whole-body autoradiography. The results indicate that in vivo screening of [3H]thymidine incorporation into various organs of an intact experimental animal is a sensitive technique for comparing cyto- and/or genotoxic effects of chemicals with a similar chemical structure. PMID- 3531832 TI - Evaluation of homology between cloned Escherichia coli and yeast DNA photolyase genes and higher eukaryotic genomes. AB - Repair of ultraviolet-induced pyrimidine dimers by photoreactivation is catalyzed by a single enzyme, DNA photolyase. However, the process of photoreactivation is difficult to detect reproducibly in cultured mammalian cells. We have used clones containing yeast and Escherichia coli DNA photolyase genes to determine whether their sequences are conserved and whether there is homology between either cloned sequence and chick or human genomic DNA and mRNA sequences. The cloned sequences failed to hybridize to each other even under nonstringent conditions, indicating little conservation of sequence between the yeast and E. coli genes. Furthermore, only weak hybridization under nonstringent conditions was found between the cloned photoreactivating genes and human or chick genomic DNA or mRNA. This indicates that there is negligible homology between the cloned probes and mammalian DNA, but we are unable to conclude whether this indicates sequence divergence for prokaryotic and eukaryotic photoreactivation genes or the absence of such genes from the mammalian genome. PMID- 3531833 TI - Mutagenicity testing experiments with the Cobas Bact. AB - The feasibility of mutagenicity assays with the Cobas Bact Automatic analyser was explored using selected model mutagens. The reduction of the latency period (the period until the growth of the mutant cells becomes optically measurable) was found to be a valid measure for the mutagenic activity of strong mutagens. For weaker mutagens an evaluation analogous to the fluctuation test seemed the more appropriate approach. The influence of various variables, such as concentration of histidine, size of inoculum, medium composition and S9 concentration, is described. Adaptation of the Cobas Bact system to the differential growth inhibition test is also mentioned. PMID- 3531834 TI - Mutagenicity of the photochemical reaction products of pyrene with nitrogen dioxide. AB - The mutagenicity of the photochemical reaction products of pyrene with nitrogen dioxide (NO2) and the mutagens in them were investigated for the interpretation of their biological significance as genetoxic hazards of polycyclic aromatic hydrocarbons (PAHs) in airborne particles. Samples extracted from the photochemical reaction products of pyrene with NO2 diluted with air using a high pressure mercury lamp were mutagenic for Salmonella typhimurium strains TA97 and TA98 in the absence of S9 mix, with a trend to detoxification in the presence of the metabolic system. The mutagens in the crude samples extracted from their products, which were fractionated by normal-phase high-performance liquid chromatography (HPLC) on a column of Nucleosil 100-30 with n-hexane-benzene as an eluting solution, were analyzed by HPLC, mass spectrometry and Fourier transform infrared (FT-IR) spectrometry. Based on these results, it was recognized that 1 nitropyrene (1-NP), 1,3-dinitropyrene (1,3-DNP), 1,6-dinitropyrene (1,6-DNP) and 1,8-dinitropyrene (1,8-DNP) was formed by the photochemical reaction of pyrene with NO2. The yield of DNPs peaked at 2-3 h irradiation. PMID- 3531835 TI - Selective mutagenic activity of 2-bromo-propanamides on Salmonella typhimurium. A structure-activity study. AB - Nineteen 2-halogeno-acetamides, -propanamides, and -iso-butyramides and four related epoxyamides were tested as mutagens for Salmonella typhimurium TA100. Mutagenic activity was observed in strictly selected 2-halogenoamides and in all epoxyamides. The effectiveness of 2-halogenoamides depends upon: the character of the carbon carrying the halogen (1 degree, 2 degrees, 3 degrees); the nature of the halogen (Br, Cl); the substitution at nitrogen. Some considerations concerning the selectivity observed are presented. PMID- 3531836 TI - Xanthine oxidase-mediated mutagenicity of the bladder carcinogen 4-nitrobiphenyl. AB - Xanthine oxidase catalyzed mutagenicity of 4-nitrobiphenyl (NBP), a dog-bladder carcinogen, was tested in Ames assay using Salmonella typhimurium TA98 strains. NBP was active as a mutagen in the parent strain TA98 which is proficient in nitroreductase, while it was inactive in the strain TA98NR which is deficient in nitroreductase. However, preincubation of NBP at 37 degrees C with NADH and commercial preparations of xanthine oxidase for 30 min resulted in a dose dependent increase in the mutagenic activity in TA98NR. Allopurinol blocked the xanthine oxidase catalyzed mutagenicity of NBP in TA98NR and the extent of inhibition was dependent upon the concentration of the inhibitor. Rat-liver and dog-bladder cytosol preparations also enhanced the mutagenic activity of NBP in TA98NR in a dose-dependent manner. In addition, the cytosol-mediated activity was also inhibited by allopurinol, implying that the cytosolic enzyme activity might be due to xanthine oxidase. In vitro enzymatic reduction of NBP using bacterial cell lysates of TA98 and TA98NR revealed the major product of reduction to be 4 aminobiphenyl. The transient intermediates of reduction were not detected during the in vitro incubation. The reduction intermediate N-hydroxylaminobiphenyl showed direct and equal mutagenic activity in both TA98 and TA98NR, in contrast to NBP. These results suggest that N-hydroxylaminobiphenyl is generated during the preincubation of NBP with xanthine oxidase or cytosolic preparations and the former might account for the mutagenicity of NBP. Furthermore, the occurrence of such enzyme(s) in the target tissue for NBP carcinogenesis, support the hypothesis that metabolic activation of the bladder carcinogen NBP could occur within the target organ by virtue of its intrinsic metabolic potential. PMID- 3531837 TI - Comparative mutagenicity of aliphatic epoxides in Salmonella. AB - 37 aliphatic epoxides comprising 6 subclasses (unsubstituted aliphatic epoxides, halogenated aliphatic epoxides, glycidyl esters, glycidates, glycidyl ethers and diglycidyl ethers) were tested, under code, for mutagenicity in Salmonella strains TA98, TA100, TA1535 and TA1537 and/or TA97 with and without metabolic activation using a standardized protocol. The 4 halogenated aliphatic epoxides and the 4 diglycidyl ethers were all mutagenic. The 2 glycidates were negative in all strain/activation systems used while all 5 glycidyl esters were mutagenic. 3 of the 8 unsubstituted aliphatic epoxides and 11 of the 12 glycidyl ethers were mutagenic. Glycidol also was mutagenic whereas 9,10-epoxyoctadecanoic acid, 2 ethylhexyl ester was not mutagenic. Of the 28 mutagenic compounds, all but neodecanoic acid, 2,3-epoxypropyl ester and 2-ethylhexyl glycidyl ether were detected in TA100 without activation. The latter two were detected only with activation in TA100 and TA1535. The majority of the other 26 chemicals were also mutagenic in TA1535 without activation. Good intra- and interlaboratory reproducibility was seen in the results of each of the 4 chemicals tested in more than one set of experiments. The current results confirm and extend the observations of other investigators regarding structural effects on the mutagenicity of members of the aliphatic epoxide class of chemicals. PMID- 3531838 TI - A comparative study on selected chemical carcinogens for chromosome malsegregation, mitotic crossing-over and forward mutation induction in Aspergillus nidulans. AB - 10 "false negative" chemical carcinogens, i.e. ineffective in bacterial mutagenicity assays, were thoroughly investigated for their genotoxic activity in the mould Aspergillus nidulans. Forward mutations (methionine suppressors), mitotic crossing-over and chromosome malsegregation were the end-points scored. Positive results were obtained in tests for the induction of mitotic segregation with benzene, ethylenethiourea and urethane, which increased the frequency of abnormal presumptive aneuploid colonies with euploid sectors showing whole chromosome segregation (i.e. non-disjunctional diploids and haploids). The same compounds were ineffective in increasing the frequency of mitotic crossing-over or forward mutations. The other chemical carcinogens investigated, namely acetamide, amitrole, dieldrin, heptachlor epoxide, nitrilotriacetic acid, p,p' DDT and thiourea were ineffective both as inducers of forward mutations and mitotic segregation. PMID- 3531839 TI - Mutagenic properties of spent bleaching liquors from sulphite pulps and a comparison with kraft pulp bleaching liquors. AB - Parameters influencing the mutagenic properties of spent bleaching liquors from sulphite pulps have been studied. In addition a comparison has been made between the properties of spent liquors from sulphite and kraft pulp bleaching. In the sulphite process the cooking base had no influence on the mutagenicity of the chlorination stage. In contrast, removing the extractives before chlorination especially for dissolving pulp resulted in an increase in mutagenic activity. The mutagenicity decreased significantly after substituting 40% of the chlorine with chlorine dioxide. Sequential addition of chlorine and chlorine dioxide resulted in higher activity than simultaneous or premixed chlorination as observed for liquors from kraft pulp. Increasing the pH of the extracts or addition of sulphur dioxide decreased the mutagenicity. Expressed as 10(7) revertants per kappa number and ton pulp the mutagenicity varied between 10 and 40 for sulphite pulp while the corresponding figures for kraft pulp were 100-225. PMID- 3531840 TI - Combined mutagenicity of cobalt(II) salt and heteroaromatic compounds in Salmonella typhimurium. AB - Mutagenic activities of 4-aminopyridine (4AP), 4-aminoquinoline (4AQ), 9 aminoacridine (9AA) and harman (HM) were examined by the Salmonella test system in the presence of cobalt(II) chloride (CoCl2), which itself is non-mutagenic in this system. Mutagenic activity of the mixture of 9AA and CoCl2 was found to be much higher than that of 9AA alone in strains TA1537 and TA2637. A similar enhancing phenomenon was observed in 4AQ-CoCl2 and HM-CoCl2 mixtures but not in that of 4AP-CoCl2. Judging from visible and nuclear magnetic resonance spectral data, this increased mutagenicity may be attributable to the formation of moderate to weak complexes between these chemicals and the Co(II) cation. A survey of the mutagenicity of several Co(II) complexes supported this interpretation. PMID- 3531841 TI - A method with enhanced sensitivity for the induction of 6TG-resistant mutants in V79 Chinese hamster cells. PMID- 3531842 TI - Uracil-DNA glycosylase in benign and malignant maturing human hematopoietic cells. AB - The expression of uracil-DNA glycosylase was studied in human normal hematopoietic bone marrow cells and in malignant counterparts obtained from patients with chronic granulocytic leukemia. We observed that the expression of the enzyme was highest in the proliferating granulocytic compartment (myeloblasts through myelocytes) and that it was diminished in more mature cells. Furthermore, we demonstrated that uracil-DNA glycosylase activity was higher in immature red blood cells or reticulocytes than in more mature red cells. The same tendency was also demonstrated in human malignant monoblasts, which were induced to terminal maturation by phorbol ester. It can be concluded from these results that uracil DNA glycosylase expression is equal in benign and malignant hematopoietic progenitor cells; no selectivity towards malignant vs. benign progenitors can be expected in possible chemotherapeutic approaches relying on uracil-DNA glycosylase. PMID- 3531843 TI - Differential enhancement of spontaneous transition mutations in the lacI gene of an Ung- strain of Escherichia coli. AB - In this communication, the contribution of cytosine deamination to spontaneous mutagenesis in the lacI gene of E. coli was examined. In a wild-type strain, 75% of the amber mutations recovered were G:C----A:T transitions and 60% of these were at the 5-methylcytosine spontaneous hotspots Am6, Am15 and Am34. In a strain deficient for uracil-DNA glycosylase (Ung-), 96% of the amber mutations were G:C- --A:T transitions while only 15% of these occurred at the hotspot sites. This shift in the mutational distribution demonstrates that cytosine deamination is a potent mutagenic process, which is enhanced in the absence of glycosylase. Moreover, some amber sites were greatly enhanced in the Ung- strain while others were only slightly enhanced. This result suggests that the rate of cytosine deamination at individual sites may be influenced by surrounding base composition. Therefore, we examined the neighboring sequences and found a strong correlation between the fold-increase in mutation and the A/T richness of the surrounding sequence. It is suggested that A/T-rich regions denature more often, forming transient single strands in which cytosine residues would be expected to deaminate more readily. PMID- 3531844 TI - Aspects of chloroquine mutagenicity. AB - Using the Ames plate reversion and fluctuation tests, the mutagenic activity of chloroquine was tested in the new tester strains of Salmonella typhimurium, TA97, TA102, and Escherichia coli strains WP2, WP2hcr, WP6 and WP67. The E. coli transconjugants obtained from the mating transfer of R-plasmid(s) in strains TA97 and TA102 respectively to E. coli WP2, i.e. EE97 and EE102, were also tested. Chloroquine reverted strain TA97 from histidine dependence to independence and also reverted E. coli strains EE97 and EE102 from tryptophan dependence to independence. The E. coli strains WP2, WP2hcr; WP6 and WP67 and S. typhimurium TA102 were not affected. S. typhimurium TA97 could be reverted with 250 ng/ml of chloroquine (therapeutic blood level of chloroquine is 300 ng/ml). Reversion generally occurred optimally at the relatively lower concentrations of chloroquine i.e. 25, 50 micrograms/ml than at higher concentrations. From the properties of the reverted tester strains, the results indicated that chloroquine per se mediated frameshift reversion. PMID- 3531845 TI - A double-blind, placebo-controlled, crossover study of verapamil in exertional muscle pain. AB - Eleven patients, comprising three cases of McArdle's disease and eight with an exertional muscle pain syndrome (EMPS) of unknown cause, entered a double-blind crossover study of verapamil and placebo. None of the patients with McArdle's disease responded to verapamil, but two patients with unclassified EMPS experienced a striking improvement in symptoms and two others showed a partial response. No patient responded to placebo. Six of the eight cases with unclassified EMPS, including the four patients who responded to verapamil, had symptoms that indicated possible abnormalities of muscle metabolism, and four showed nonspecific biochemical, electromyographic, and muscle biopsy abnormalities. The two other EMPS patients had symptoms that suggested that a primary muscle disease was unlikely. They showed no laboratory evidence of muscle disorder, but had abnormal profiles on personality (MMPI) testing. Calcium antagonists, such as verapamil, may be useful in the treatment of some patients with benign exertional myalgia, but the mechanism of action of the drug in such cases is unclear. PMID- 3531846 TI - Identification of Candida albicans antigens recognized by sera of patients with candidiasis. PMID- 3531847 TI - Naftifine solution (1%) in the treatment of pityriasis versicolor in Zambia. PMID- 3531848 TI - Inhibitory action of the antitumor agent lonidamine on mitochondrial respiration of Trypanosoma cruzi and T. brucei. AB - The antitumor and antispermatogenic agent lonidamine inhibits Trypanosoma cruzi epimastigotes growth in culture with an ID50 around 80 microM. The main site of action appears to be the mitochondria, where the rate of uncoupled respiration was inhibited in 50% at a similar lonidamine concentration (50 microM). Hexokinase (the other point where lonidamine inhibits tumor energy metabolism) was not sensitive to this drug. Lonidamine also inhibited uncoupled respiration in T. brucei procyclic trypomastigotes, suggesting a common mechanism of action with T. cruzi. When lonidamine was added to T. brucei trypomastigotes, there was little effect on the CN-insensitive respiration, demonstrating that at least in T. brucei glycolysis is not affected by the drug. PMID- 3531849 TI - Variable antigen associated with the surface of erythrocytes infected with mature stages of Plasmodium falciparum. AB - Immune human sera were used to select a cDNA clone expressing an asexual blood stage antigen of Plasmodium falciparum. Antibodies affinity-purified on extracts from this clone were used to characterize the antigen by immunoblotting and immunofluorescence. The antigen is present in mature-stage parasites as a high molecular weight protein of about 250 kDa and is apparently processed to smaller fragments in the merozoite. It varies in molecular weight and antibody reactivity in different isolates, and has been localized at the erythrocyte membrane by immunoelectronmicroscopy. Part of the protein is composed of exactly repeated hexapeptide units that constitute the strain-specific determinant. This molecule has similar characteristics to the strain-specific molecule believed to be responsible for cytoadherence. PMID- 3531851 TI - A randomized controlled trial of a low-molecular-weight heparin (enoxaparin) to prevent deep-vein thrombosis in patients undergoing elective hip surgery. AB - There is experimental evidence that low-molecular-weight fractions of heparin are as effective as the standard form but cause less bleeding. We therefore performed a double-blind, randomized trial comparing PK10169 low-molecular-weight heparin with placebo for the prevention of venous thrombosis in patients undergoing elective hip surgery. Prophylactic treatment with a fixed dose was begun postoperatively and continued for 14 days. Fifty patients in each treatment group underwent surveillance with [125I]fibrinogen leg scanning and impedance plethysmography. In the first 24 patients, venography was performed only if either surveillance test was positive. Because the rate of venous thrombosis detected in those patients was unexpectedly low, venography was requested in the remaining 76 patients, even if the screening tests were negative. In this latter group, venous thrombosis occurred in 4 patients (10.8 percent) given PK10169 heparin and 20 patients (51.3 percent) given placebo (P = 0.0002); the corresponding rates for proximal-vein thrombosis were 5.4 percent and 23.1 percent, respectively (P = 0.029). In the entire group of 100 patients, venous thrombosis occurred in 12 percent of those given PK10169 heparin and 42 percent of those given placebo (P = 0.0007), and the corresponding rates for proximalvein thrombi were 4 percent and 20 percent, respectively (P = 0.014). The observed hemorrhagic rate was 4 percent in each treatment group. We conclude that prophylaxis with fixed-dose PK10169 heparin is effective and safe for patients undergoing elective hip replacement. PMID- 3531850 TI - Acquired defect in interleukin-2 production in patients with type I diabetes mellitus. AB - Deficient production of interleukin-2 has been reported in Type I diabetes, but its cause has not been elucidated. We therefore measured interleukin-2 production in 27 patients with Type I diabetes, 20 patients with Type II diabetes (6 requiring insulin), 5 monozygotic twin pairs discordant for Type I diabetes, and 10 nondiabetic persons with islet-cell antibodies. Interleukin-2 production was decreased in patients with Type I diabetes as compared with controls (35.8 +/- 2.5 vs. 61.6 +/- 4.6 percent, P less than 0.001). Interleukin-2 production did not differ between patients with Type II diabetes and controls, regardless of whether the patients used insulin. Twins with Type I diabetes had decreased interleukin-2 production as compared with normal controls (33.2 +/- 5.4 vs. 61.6 +/- 4.6 percent, P less than 0.001) and with their nondiabetic twins (33.2 +/- 5.4 vs. 54.5 +/- 3.4 percent, P less than 0.005). Interleukin-2 production in nondiabetic twins and in nondiabetic persons with islet-cell antibodies was normal. There was no correlation between glycosylated hemoglobin levels and interleukin-2 production in any diabetic group. We conclude that patients with Type I diabetes have an acquired defect in interleukin-2 production, whereas patients with Type II diabetes do not, and that this defect is not correlated with an ongoing autoimmune process, with hyperglycemia, or with insulin administration or oral hypoglycemic therapy. Thus, the defect appears to be related to marked beta-cell destruction, although not to the metabolic consequences thereof or the responsible autoimmune process. PMID- 3531853 TI - Patterns of persistent viral infections. PMID- 3531852 TI - A randomized clinical trial of early hospital discharge and home follow-up of very-low-birth-weight infants. AB - To determine the safety, efficacy, and cost savings of early hospital discharge of very-low-birth-weight infants (less than or equal to 1500 g), we randomly assigned infants to one of two groups. Infants in the control group (n = 40) were discharged according to routine nursery criteria, which included a weight of about 2200 g. Those in the early-discharge group (n = 39) were discharged before they reached this weight if they met a standard set of conditions. For families of infants in the early-discharge group, instruction, counseling, home visits, and daily on-call availability of a hospital-based nurse specialist for 18 months were provided. Infants in the early-discharge group were discharged a mean of 11 days earlier, weighed 200 g less, and were two weeks younger at discharge than control infants. The mean hospital charge for the early-discharge group was 27 percent less than that for the control group ($47,520 vs. $64,940; P less than 0.01), and the mean physician's charge was 22 percent less ($5,933 vs. $7,649; P less than 0.01). The mean cost of the home follow-up care in the early-discharge group was $576, yielding a net saving of $18,560 for each infant. The two groups did not differ in the numbers of rehospitalizations and acute care visits, or in measures of physical and mental growth. We conclude that early discharge of very low-birth-weight infants, with follow-up care in the home by a nurse specialist, is safe and cost effective. PMID- 3531854 TI - Cardiac allotransplantation in newborns as therapy for hypoplastic left heart syndrome. PMID- 3531855 TI - Cardiac transplantation: where are we? PMID- 3531856 TI - Mechanisms of unstable angina. PMID- 3531857 TI - Artificial hearts--permanent and temporary. PMID- 3531858 TI - Administrative waste in U.S. health care. PMID- 3531859 TI - Platelet activation in unstable coronary disease. AB - Pathological and clinical studies have suggested that platelets have a role in the pathogenesis of unstable angina and myocardial infarction. However, the relation of platelet activation to episodic ischemia in patients with unstable angina is unknown. We assessed the biosynthesis of thromboxane and prostacyclin as indexes of platelet activation in patients with stable and unstable coronary disease by physicochemical analysis of metabolites in plasma and urine. Prostacyclin biosynthesis was markedly elevated in patients with acute myocardial infarction and correlated with plasma creatine kinase (r = 0.795; P less than 0.001). The largest rise in thromboxane synthesis was observed in patients with unstable angina, in whom 84 percent of the episodes of chest pain were associated with phasic increases in the excretion of thromboxane and prostacyclin metabolites. However, 50 percent of such increases were not associated with chest pain, possibly reflecting silent myocardial ischemia. These data indicate that platelet activation occurs during spontaneous ischemia in patients with unstable angina. The increment in prostacyclin biosynthesis during such episodes may be a compensatory response of vascular endothelium that limits the degree or effects of platelet activation. If so, biochemically selective inhibition of the synthesis or action of thromboxane A2 would be desirable in the treatment of unstable angina. In contrast, thromboxane inhibitors or antagonists would not be expected to be effective in patients with chronic stable angina, in whom there was no increase in the formation of thromboxane A2. PMID- 3531860 TI - Interferon therapy for condylomata acuminata. AB - Current therapy for condylomata acuminata (genital warts) is not consistently effective. Therefore, we conducted a randomized, double-blind trial to compare interferon alpha-2b with placebo in the treatment of this disorder. Our rationale was that interferon has both antiproliferative and antiviral properties. The placebo or interferon (1 X 10(6) IU) was injected directly into one to three warts three times weekly for three weeks. The injections were well tolerated by both groups of patients. The side effects of fever, chills, myalgia, headache, fatigue, and leukopenia occurred more commonly in the interferon group than in the placebo group, but such effects rarely disrupted daily routines. Only 13 of 296 patients (4 percent) discontinued therapy because of side effects (11 in the interferon group and 2 in the placebo group). Twenty-six other patients were excluded from analysis because of a loss to follow-up or other deviations from protocol, thus leaving 257 patients in the final evaluation. At one week after the completion of therapy, interferon had produced a large and significantly greater reduction in mean wart area (a 62.4 percent decrease), as compared with placebo (a 1.2 percent increase in mean area) (P less than 0.001). At the conclusion of the study (13 weeks after the completion of therapy), the mean wart area was still decreased 39.9 percent below the initial size in the interferon group, whereas it had increased by 46 percent over base-line measurements in the placebo group (P less than 0.001). At the same time, all treated warts had completely cleared in 36 percent of the interferon recipients and in 17 percent of the placebo recipients (P less than 0.001), whereas treated warts progressed in 13 percent of the interferon recipients and in 50 percent of the placebo recipients (P less than 0.001). We conclude that injection of interferon alpha-2b directly into genital warts appears to be an effective and fairly well-tolerated form of therapy. PMID- 3531861 TI - The forensic investigation of the death of Josef Mengele. PMID- 3531862 TI - Continuous intravenous heparin compared with intermittent subcutaneous heparin in the initial treatment of proximal-vein thrombosis. AB - We performed a randomized double-blind trial comparing continuous intravenous heparin with intermittent subcutaneous heparin in the initial treatment of 115 patients with acute proximal deep-vein thrombosis. Intermittent subcutaneous heparin as administered in this trial was inferior to continuous intravenous heparin in preventing recurrent venous thromboembolism. The subcutaneous heparin regimen induced an initial anticoagulant response below the target therapeutic range in the majority of patients and resulted in a high frequency of recurrent venous thromboembolism (11 of 57 patients, 19.3 percent), which was virtually confined to patients with a subtherapeutic anticoagulant response. In contrast, continuous intravenous heparin induced a therapeutic anticoagulant response in the majority of patients and a low frequency of recurrent events (3 of 58 patients, 5.2 percent; P = 0.024); the recurrences were limited to patients with an initial subtherapeutic anticoagulant response. The results of this trial establish the efficacy of intravenous heparin in the treatment of proximal venous thrombosis and suggest a relation between the effectiveness of heparin and the levels of anticoagulation achieved; such a relation could explain the observed failure of the subcutaneous regimen. PMID- 3531863 TI - Antimicrobial prophylaxis in surgery. PMID- 3531864 TI - The Thucydides syndrome: another view. PMID- 3531865 TI - After the Challenger. Biomedical opportunities in space. PMID- 3531866 TI - More on bone marrow transplantation for glycogen storage disease type II (Pompe's disease) PMID- 3531867 TI - Prion-protein immunoreactivity in human transmissible dementias. PMID- 3531868 TI - Type II diabetes: insulin versus oral agents. PMID- 3531869 TI - In vivo determination of phagocytic indices and candidacidal activities of Candida species by rat peritoneal macrophages. AB - A possible correlation between pathogenesis and phagocytosis is established through comparison of the kinetics of the ingestion of nine Candida species by rat peritoneal macrophages in the early stages of infection. After 3 h of intraperitoneal injection of 6.10(8) yeasts to Sprague-Dawley rats, the phagocytic indices, candidacidal activity and the fate of the yeasts are assayed. Phagocytic indices allow separation of the species into four groups. Candidacidal activity and phagocytic indices are coincidently smaller in the more pathogenic species. Common events occur with the species assayed. All the yeasts can be isolated from blood, spleen and kidneys from the first h, whilst invasion to liver occurs from the second h post-infection. PMID- 3531870 TI - Isolation and some properties of beta-hemolysin produced by Nocardia asteroides. AB - An intracellular beta-hemolysin capable of lysing human, sheep and cow erythrocytes but not cells from some other animals was isolated from the cell walls of the three developmental cell-forms of Nocardia asteroides and characterised. The spherical cell-forms contained the highest amounts of the hemolysin (100 h.u./mg protein) and the least LD50 for mice suggesting that this may be the cell-form most pathogenic to susceptible animals. The hemolysin has the properties of a protein, was pH stable and sensitive to both catabolite repression and temperature. The activity of the hemolysin was enhanced by Ca++ and Na+ ions. The hemolysin was immunogenic in rabbits. PMID- 3531871 TI - A new medium for the production of chlamydoconidia by Candida albicans. AB - Several isolates of Candida albicans were tested for production of chlamydoconidia and metabolic changes when grown on several different solid and liquid media. A liquid medium, consisting solely of sterilized skimmed milk and a solid medium containing processed cheese stimulated more rapid and greater production of chlamydoconidia than the corn meal agar and the other media tested. PMID- 3531872 TI - Sell your car and buy a microcomputer. PMID- 3531873 TI - The oligodendrocyte-type-2 astrocyte cell lineage is specialized for myelination. AB - Astrocytes are one of the most numerous cell types in the vertebrate central nervous system (CNS) and yet their functions are largely unknown. In the rat optic nerve there are two distinct types of astrocyte: type-1 astrocytes develop from one type of precursor cell, and type-2 astrocytes develop from bipotential, oligodendrocyte-type-2 astrocyte (O-2A) progenitor cells, that initially give rise to oligodendrocytes (which make myelin in the CNS), and then to type-2 astrocytes. Type-1 astrocytes form the glial limiting membrane at the periphery of the optic nerve and are probably responsible for glial scar formation following nerve transection. The functions of type-2 astrocytes, which, like oligodendrocytes, are found mainly in tracts of myelinated axons throughout the CNS, are unknown. In this report we provide evidence that processes from type-2 astrocytes contribute to the structure of nodes of Ranvier, suggesting that the O 2A cell lineage is specialized for constructing myelin sheaths and nodes in the mammalian CNS. PMID- 3531874 TI - Preliminary results of the "Antibio" experiment. PMID- 3531875 TI - Effects of microgravity on genetic recombination in Escherichia coli. PMID- 3531876 TI - Cancer control. Objectives for the nation: 1985-2000. Division of Cancer Prevention and Control. National Cancer Institute. PMID- 3531877 TI - Incorporating hospitals' capital-related costs within Medicare prospective payments. PMID- 3531878 TI - [The treatment of vomiting caused by the administration of cytostatic agents]. PMID- 3531879 TI - [History of medicine. The non-collected book]. PMID- 3531880 TI - [Insulin for non-insulin dependent patients with diabetes mellitus]. PMID- 3531881 TI - [The development of a private medical and historical library]. PMID- 3531882 TI - Visions of history: changing attitudes to the medical book as an historical source. PMID- 3531883 TI - [Consensus diagnosis of deep venous thrombosis]. PMID- 3531884 TI - [Authors who are physicians. The doctor and the wanton woman]. PMID- 3531885 TI - [Authors who are physicians, 1856-1986]. PMID- 3531886 TI - [Jan Pieter Heije: physician and popular poet]. PMID- 3531887 TI - [Frederik van Eeden as psychiatrist]. PMID- 3531888 TI - [Arnold Aletrino]. PMID- 3531889 TI - [Physicians in the works of S. Vestdijk]. PMID- 3531890 TI - [15 physicians as writers]. PMID- 3531891 TI - Some British literary doctors. PMID- 3531892 TI - [Poetry-writing physicians from England and America in the 16th-19th century]. PMID- 3531893 TI - CT directed stereotactic biopsy, a new neurosurgical tool. PMID- 3531894 TI - The effect of fibrinogen-methotrexate derivatives on HeLa cell growth. AB - Proteolytic cleavage of bovine fibrinogen with covalently bound methotrexate (MTX) was studied using four different proteolytic enzymes--trypsin, chymotrypsin, pepsin, and cathepsin D and the interaction of the modified fibrinogen (or fibrin) with HeLa cells was investigated. The presence of fibrin MTX derivative did not induce any significant morphological alternations of cells. The fibrin-MTX derivative in the gel form was solubilized easily by the action of all proteinases investigated, hydrolysis of highly crosslinked denatured fibrin-MTX in suspension proceeded slower. The solubilized fibrin-MTX degradation products had a strong inhibiting effect on the growth of HeLa cells cultured in monolayer indicating the liberation of chemotherapeutically active MTX from its fibrin derivative. PMID- 3531896 TI - Results of genotoxicity testing of theophylline on bacteria and two lines of mammalian cells. AB - In study of the genotoxic effects of theophylline, this substance was subjected to a series of tests. Its potential mutagenicity was followed at the level of both bacteria and mammalian cells. The capacity of the substance to damage human DNA was determined by the so-called DNA inhibition test and by the method of alkaline elution of DNA. In the absence of the enzymatic microsomal S9 fraction, theophylline showed very weak mutagenic effects on bacteria and mammalian cells. However, in both cases this weak mutagenic effect was eliminated through a simultaneous application of theophylline and the S9 fraction. The results of the remaining tests proved negative regardless of whether the S9 fraction was present or absent. Our results lead us to infer that theophylline exerts no genotoxic action under in vivo conditions. PMID- 3531895 TI - Change of mutagenic activity of N-methyl-N-nitrosoguanidine during its decomposition studied by SOS chromotest. AB - N-methyl-N-nitrosoguanidine (MNNG) decomposition kinetics in H2O was studied under in vitro conditions by spectrometry in different buffers and at different pH. Parallely the change of mutagenic activity of decomposing mixture was studied by SOS chromotest (in which the change of beta-galactosidase was observed). The MNNG decomposition was confirmed to be the reaction of the pseudofirst order. MNNG mutagenic activity decreases parallely with MNNG decomposition. From the observed facts it has been concluded that the MNNG decomposition proceeding outside the biological target gradually leads to the inactive stable decomposition products. PMID- 3531897 TI - [Specific membrane glycoproteins of the surface of nerve tissue cells]. PMID- 3531898 TI - [Cumulative data on the central action of hypothalamic regulator peptides]. PMID- 3531899 TI - Liver transplantation for end-stage liver disease. PMID- 3531900 TI - Causes of death in fulminant hepatic failure. A guide to future management. PMID- 3531901 TI - Maternal and fetal characteristics affecting alcohol's teratogenicity. AB - Thousands of children are born each year with alcohol-related birth defects. However, despite comparable levels of prenatal alcohol exposure, some children are affected less severely than others, whereas others do not appear to be affected at all. Epidemiological investigations and experimental studies in animals suggest that maternal or fetal genetic factors, maternal age or parity, and pattern of drinking are important risk factors affecting alcohol's actions on the embryo/fetus. Identifying these and other risk factors may provide a means for cost-effective prevention efforts. PMID- 3531902 TI - Irreversible changes in mature and aging animals following intrauterine drug exposure. AB - Neurobiological and functional changes in mature and aging rodents following intrauterine exposure to tobacco products, amphetamine and the barbiturates are reviewed. The types of behavior surveyed include activity, maze learning, steady state performance, and passive and active avoidance. Hormonal and neurochemical changes are discussed as well. Two opposing hypotheses to account for deficits following fetal drug exposure are presented and evidence for their validity is discussed. One theory states that functional change is nonspecific to the class of drug, whereas the opposing theory is that behavioral change is specific to a drug class. PMID- 3531903 TI - Cannabinoid exposure: effects on development. AB - The literature concerning the teratologic effects of cannabinoids is reviewed, and some methodological issues associated with perinatal cannabinoid exposure are discussed. The long-term consequences of perinatal cannabinoid exposure on brain, endocrine, immune, and hepatic functions are considered. In our studies, perinatal cannabinoid exposure affected the long-term development of body weight regulation, neuroendocrine function, and adult sexual behaviors. In addition, the immune system and hepatic cytochrome P-450 levels were also influenced in adult male mice perinatally-exposed to cannabinoids. It is hypothesized that these effects may be mediated by cannabinoid-induced alterations in the fetal and/or neonatal hormonal milieu. In addition, the possibility that perinatal cannabinoid administration affects the subsequent ability of the exposed offspring to adapt to the environment is discussed. Finally, possible mechanisms of cannabinoid action in altering development are evaluated. It is concluded that the evidence to date indicates that cannabinoids can be embryocidal, affect gestational length and labor, induce maturational delays, and that these substances affect a myriad of physiological processes in the developing offspring, including effects on behavioral parameters, not only in laboratory animals, but also in the human neonate. Consequences of perinatal cannabinoid exposure on development are described and possible mechanisms of action of cannabinoids are discussed. PMID- 3531904 TI - Perinatal toxicology and the law. AB - New perinatal toxicology research findings not only extend scientific knowledge but they also produce legal changes as they reach public domain. This article examines the interaction between perinatal drug research and the law. The reactivity of the law in assimilating research on exposure of the developing organism to a broad range of neurotoxins, including both licit and illicit drugs, is illustrated. Outcomes of some cases depend to a great extent upon legal concepts invoked rather than upon the scientific evidence involved. Proposed policy changes and their implications for scientists are discussed. PMID- 3531905 TI - Methodological issues in detecting specific long-term consequences of perinatal drug exposure. AB - Children who were chronically exposed to drugs of abuse during gestation typically are at elevated risk on other biomedical and socioenvironmental bases as well. Identifying additional risk or specific effects of perinatal drug exposure may require research designs and standardization of measures different from those now in use. The design and measurement issues in the assessment of the psychological characteristics of these children are discussed, with particular attention to the composition of control groups and the psychometric properties of measures. PMID- 3531906 TI - Does melatonin alter pituitary responsiveness to gonadotropin-releasing hormone in the ewe? AB - The diurnal secretion of melatonin from the pineal gland transduces information about day length to the reproductive axis of many seasonal breeders including the ewe. In the sheep the target for melatonin is thought to be neural, such that the hormone acts through the GnRH pulse generator to produce seasonal alterations in the frequency of pulsatile LH secretion. These effects on the pulse generation mechanism take approximately 50 days to become evident. It is possible that melatonin also exerts direct effects at the level of the pituitary gland to alter responsiveness to GnRH. Such effects have been noted in other species. The site of action of melatonin to regulate pulsatile LH secretion was assessed in the ewe by determining whether the animal's endogenous melatonin acutely modifies pituitary responsiveness to sustained pulsatile administration of GnRH. Using an animal model in which endogenous GnRH was blocked, pituitary responsiveness to hourly pulses of exogenous GnRH was assessed under conditions of both high (dark period) and low (light period) melatonin. No evidence for acute effects of melatonin on pituitary response to GnRH was found. In another experiment, the amplitude and frequency of endogenously generated LH pulses in ovariectomized ewes was found not to change during the 24-hour light/dark cycle. These data lead to the conclusion that melatonin does not act at the pituitary gland to produce acute effects on LH secretion. Rather, our findings are consistent with the hypothesis that the action of melatonin, in this short-day breeder is long term, and is directed towards the neural elements of the hypothalamic pulse-generating mechanism. PMID- 3531907 TI - Short-term pituitary desensitization to LH-RH after pulsatile LH-RH in the ovariectomized rat: an in vivo experiment. AB - The development of acute insensitivity of pituitary LH secretion to LH-RH after a short exposure to LH-RH is described. In the first experiment, ovariectomized (OVX), phenobarbital-pretreated rats were given pulses of LH-RH (1.25 or 6.25 ng/100 g body weight (b.w.), intravenously). In rats given 1.25 ng at time 0, 6.25 ng at 60 min, 1.25 ng at 80 min and 1.25 ng at 120 min, there was a substantial increase in plasma LH after the first two injections, no increase after the third injection and a relatively small increase after the fourth one. In other rats treated identically but not given a 1.25-ng dose at 80 min, the plasma LH rise in response to the 1.25-ng dose at 120 min was comparable to that seen after the 1.25-ng dose given at time 0. If the 1.25-ng LH-RH pulses given at times 0 and 80 min were replaced by a rat pituitary extract, the plasma LH rise in response to the 1.25-ng dose at 120 min was comparable to that seen after administration of pituitary extract. In the second experiment, OVX phenobarbital pretreated rats were given 1.25 ng LH-RH/100 g b.w. at t = 0. They were then divided into three groups, each receiving 1.25, 3.75 or 6.25 ng LH-RH/100 g b.w. at t = 60 min. Each of these three groups was again divided into three groups which received 1.25 ng LH-RH/100 g b.w. at 80, 100 or 120 min.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3531908 TI - The effect of morphine on the electrophysiological activity of the hypothalamic luteinizing hormone-releasing hormone pulse generator in the rhesus monkey. AB - In ovariectomized rhesus monkeys, the electrophysiological manifestation of luteinizing hormone-releasing hormone (LHRH) pulse generator activity was arrested by morphine and reinitiated by naloxone. These responses were noted within 1 and 2 min, respectively, after the intravenous injection of the drugs. Naloxone given alone had no effect. These results support the view that opioids modulate pulsatile gonadotropin release by an action on the hypothalamic LHRH pulse generator. PMID- 3531909 TI - Periventricular hypothalamic cells in the rat brain contain insulin mRNA. AB - In situ hybridization histochemistry with a 35S-labeled oligodeoxyribonucleotide probe for insulin was performed in the rat. Labeled cells were observed in the pancreas and in the periventricular nucleus of the hypothalamus. No labeling was seen elsewhere in the brain, including the olfactory bulb, the choroid plexus, and the tissue adjacent to the lateral ventricles. This finding suggests that insulin may be released from cells in the periventricular nucleus for transport via cerebrospinal fluid to other brain regions. PMID- 3531910 TI - Elevation of brain norepinephrine concentration after experimental subarachnoid hemorrhage. AB - Regional brain tissue catecholamine concentrations were measured in 5 control rats and in 10 rats 72 hours after experimental subarachnoid hemorrhage (SAH). Catecholamine levels were determined in the cerebral hemispheres, brain stem, and cerebellum of each animal using a radioenzymatic assay. Three days after SAH, the tissue concentration of norepinephrine (NE) in the cerebral hemispheres was 64% greater than that in control rats (P less than 0.001). NE levels did not change significantly in either the brain stem or the cerebellum. Most if not all of the NE in the brain tissue rostral to the brain stem is derived from neurons that originate in the locus coeruleus (LC). These data may therefore indicate that the LC is activated after SAH. The possible pathophysiological consequences of activation of the LC in relation to delayed cerebral ischemia after SAH will be discussed. PMID- 3531911 TI - Further experience utilizing the Gildenberg technique for computed tomography guided stereotactic biopsies. AB - Initial experience using the Gildenberg technique for computed tomography-guided stereotactic biopsies is reviewed. Of 50 patients, adequate tissue was obtained in 49. In one patient, the stereotactic frame was unable to reach the selected biopsy site. In 32 of 49 patients, the diagnosis was obtained with one biopsy; in the remainder, two to five samples were required. In 4 cases, a subsequent craniotomy was performed; these provided similar histopathological tissue and in no case was the diagnosis altered. The lesions were categorized by CT as ring enhancing lesions (REL), enhancing lesions with surrounding low density (ELLD), and low density lesions with and without peripheral areas of enhancement. Of the REL, 21 of 23 were primary tumors. Of the ELLD, 5 of 13 were primary tumors; the remainder had a wide spectrum of disease. Of the low density lesions without enhancement, 6 were primary tumors and 1 was an inflammatory process. Three patients had low density lesions with peripheral areas of enhancement and proved to have malignant primary tumors. The remaining patients had multiple lesions with both primary and metastatic disease. Twelve RELs were biopsied in multiple sites. An accurate diagnosis was best obtained by performing the first biopsy in the enhancing rim with additional biopsies as needed in the low density center. Homogeneous lesions could be biospied with target selection based upon a primary regard for safety rather than imaging characteristics. Three patients had transiently increased hemiparesis and one had a transient decrease in level of consciousness after biopsy.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3531912 TI - Intramedullary neurilemomas of the spinal cord: report of two cases and review of the literature. AB - Two patients harboring intramedullary neurilemomas of the spinal cord are presented. Published reports of these rare lesions and possible mechanisms of their origin are reviewed. Based on the authors' experience and review of the literature, they think that the treatment of choice for these rare lesions is laminectomy and resection and that intraoperative frozen section diagnosis is essential. Incorrect interpretation of the biopsy material that suggests an original diagnosis of infiltrating glioma, perhaps because a neurilemoma was not expected, has made second operations necessary. PMID- 3531914 TI - The detection of intracranial carotid artery disease by continuous-wave Doppler sonography. AB - We have investigated 6,587 patients with directional continuous-wave (c-w) Doppler sonography of the carotid arteries during the last 33 months, and have developed criteria for the diagnosis of a significant increase in peripheral resistance of the internal carotid artery in conjunction with 1,671 retrograde brachial and direct carotid angiograms. We distinguished stenoses proximal (15 cases) and distal (4) to the origin of the ophthalmic artery, supraclinoid internal carotid artery occlusions (8), stenoses (2) and acute occlusions (10) of the middle cerebral artery. Stenoses in the carotid siphon (proximal or distal to the origin of the ophthalmic artery) of at least 60% reduction in lumen diameter showed a reduction of the relative end-diastolic flow velocity (modified Pourcelot's index) of more than 40%; additionally, stenoses proximal to the origin of the ophthalmic artery exhibited a variable alternating flow, or flow reversal, in the supratrochlear artery. Stenoses distal to the origin of the ophthalmic artery rarely revealed the theoretically expected increase in orthograde flow velocity in the supratrochlear artery. Stenoses of the middle cerebral artery consisting of more than atherosclerotic irregularities proved to be an exception. Supraclinoid occlusions of the internal carotid artery were reliably demonstrated by Doppler sonography. However, the majority of acute occlusions of the middle cerebral artery could not be detected by this means, probably due to anastomoses between the anterior and the middle cerebral arteries, which were detected by angiography. Thus, we believe that c-w Doppler sonography is a reliable tool to detect stenoses of the carotid siphon of more than 60% reduction in lumen diameter and and supraclinoid carotid artery occlusions.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3531913 TI - 'Fingerprints' of central stimulatory drug effects by means of quantitative radioelectroencephalography in the rat (tele-stereo-EEG). AB - The new electrophysiological model earlier described as stereo-EEG is extended now to allow recording from the freely moving rat by means of a telemetric device. Chronic implantation of 4 electrodes into the brain allows simultaneous transmission of field potentials from frontal cortex, hippocampus, striatum and reticular formation. Frequency analysis of these potentials results in a drug specific 'fingerprint' which cannot only be used to compare different chemicals with each other but also to detect onset and time dependence of drug actions. Application of the model to the question if fenetylline has its own intrinsic mode of action or merely develops its stimulatory effect after metabolic separation into its molecular moieties amphetamine and theophylline (prodrug hypothesis) revealed that fenetylline indeed displays its own stimulatory effect to the same extent and at a similar time course as amphetamine and theophylline. The 'fingerprint' as obtained by the analysis of the action of fenetylline in the rat resembles closely that obtained after the application of theophylline with respect to decreased alpha activity, but resembles amphetamine with respect to beta 1 activity. Thus the applied method allows studying structure function relationships as the action of fenetylline seems to reflect both its molecular moieties. PMID- 3531915 TI - Localization and identification of neurons with cholecystokinin and gastrin-like immunoreactivity in wholemounts of Aplysia ganglia. AB - Immunohistochemical procedures were applied to wholemounts of the central nervous system and posterior intestine of the mollusc, Aplysia californica, to facilitate localization of cells that were immunoreactive to several antisera recognizing various epitopes of the peptides cholecystokinin and gastrin. Only antisera that recognized the carboxyl terminal sequence common to cholecystokinin and gastrin reacted with the Aplysia tissues tested. Intracellular electrophysiological studies of identified postsynaptic targets of immunoreactive neurons in the cerebral ganglia indicated that mammalian forms of gastrin 1-17, several cholecystokinin fragments, and the related peptide, amphibian caerulein, did not mimick the synaptic response mediated by the immunoreactive presynaptic neurons. Combinations of electrophysiological, immunohistochemical, and biochemical studies of several neurons in the buccal ganglia indicated that neurons B7 and B13 were immunoreactive to antisera against cholecystokinin and gastrin and that neuron B13 also contained a concentration of the neurotransmitter acetylcholine as high as in the identified cholinergic buccal neurons, B4 and B5. Several differences in the immunoreactivity of the various antisera were observed. Only one of the antisera was effective in staining neurons in the abdominal ganglia and another antiserum stained subsets of neurons that were immunoreactive to most of the other antisera recognizing the carboxyl terminus common to cholecystokinin and gastrin. The giant serotoninergic metacerebral neurons in Aplysia were not immunoreactive to the cholecystokinin/gastrin antisera even though it has been reported that the homologous neurons in a pulmonate mollusc contain cholecystokinin-like immunoreactivity. These studies demonstrated that there are many neurons with cholecystokinin/gastrin-like immunoreactivity in the Aplysia central and peripheral nervous system and suggested that the peptide may differ from vertebrate forms of cholecystokinin and gastrin. The identification of immunoreactive neurons with known postsynaptic target neurons and buccal neurons with acetylcholine co-localized with a cholecystokinin/gastrin-like peptide will facilitate elucidation of the functions of peptides in the nervous system since the Aplysia preparation is well known to be amenable to multidisciplinary studies. PMID- 3531916 TI - Insulin-induced hypotension and neurogenic orthostatic hypotension. AB - Insulin-induced hypoglycemia induced a fall in blood pressure (BP) in patients with idiopathic orthostatic hypotension (IOH) and multiple system atrophy (MSA), but not in control subjects. Only in IOH was there a correlation between plasma norepinephrine (NE) levels and maintenance of BP during the test. The hypotension was not affected by pretreatment with propranolol. Hypotension during insulin induced hypoglycemia is manifested in patients who lack an adequate NE response. The hypotension, however, may be due to a central action of insulin because not all MSA patients with impaired NE release become hypotensive. PMID- 3531917 TI - Cigarette smoking and Parkinson's disease. AB - Epidemiologic evidence has suggested a negative association between cigarette smoking and the risk of Parkinson's disease. Although many of the studies had limitations, in aggregate they suggest that smoking may actually be a protective exposure. Other lines of evidence support this view, especially animal data indicating a dopaminergic effect of smoking on the brain. PMID- 3531918 TI - Origin of the distinction between Alzheimer's disease and senile dementia: how history can clarify nosology. AB - Since the beginning of the century, psychiatrists and neurologists have been arguing about the identity of presenile (Alzheimer's disease) and senile dementia. History reveals that the distinction was originally based on anecdotal clinical observations and that competition among universities was one of the underlying determinants. The personal opinion of Kraepelin played a major role. Given his widespread reputation and authority, he generated a dogma difficult to change. Reports based on large clinicopathologic series have shown that the pathologies of presenile and senile dementia are not qualitatively different. Although the controversy continues, many have come to regard Alzheimer's disease and senile dementia as part of the same spectrum of disease, independent of the age of onset. PMID- 3531919 TI - Unilateral Creutzfeldt-Jakob disease. AB - A 73-year-old woman had progressive right hemiparesis, aphasia, and focal motor seizures. EEG showed periodic discharges on the left. She died 8 weeks after onset. At autopsy, there was marked spongiform change, neuronal loss, and severe proliferation of astrocytes predominantly on the left and most prominently in the insular and centroparietal cortex. The changes were consistent with Creutzfeldt Jakob disease (CJD), but pathology was slight or absent on the right side. This case appears as the first report of what might be called unilateral CJD. Such a condition should be included within the differential diagnosis of progressive unilateral cerebral disorders. PMID- 3531920 TI - [The duplex scanner in evaluation of vascular prostheses: follow-up of patients with arterial diseases following direct surgery. Preliminary note]. PMID- 3531921 TI - [Prognostic value of the detection of ABO surface antigens by indirect immunofluorescence technic in transitional tumors of the bladder]. AB - Experience is described in the use of indirect immunofluorescence to reveal ABO surface antigens in transitional tumours of the bladder on histological preparations from 50 patients given endoscopic resection or demolitive surgery. After an adequate period of follow-up (mean 13.7 months) of the same patients it is concluded that the prognostic validity of the survey still fails to offer sufficient specificity for guaranteed support of therapeutic decisions. PMID- 3531923 TI - [Percutaneous drainage of abdominal abscesses guided by echography and x-ray computed tomography]. AB - The therapeutic use of computerised tomography (CAT) and echography (ECT) includes guided percutaneous drainage of abdominal abscesses. The indications, method and results are described. As widely reported in the literature in recent years the results appear promising. The advantages of the technique over the traditional surgical technique are also emphasised. PMID- 3531922 TI - [Comparison of 12-month treatment with porcine and human insulin (semisynthetic and biosynthetic)]. AB - In recent years two forms of human insulin--semisynthetic and biosynthetic--have been perfected and several experiments have been conducted to assess their effective therapeutic advantages. The present study compares the activity of porcine and human insulin. On the basis of the parameters considered--fasting and post-prandial glycaemia, body weight, glycosilated Hb--it is concluded that are no substantial therapeutic advantages in either porcine or human insulin. For this reason the latter should be reserved for special cases like initial juvenile etc., but offers no advantage in patients already responding adequately to the old insulin preparations. PMID- 3531924 TI - [Treatment of acute symptoms of hemorrhoid disease with high-dose oral O-(beta hydroxyethyl)-rutosides]. AB - The pharmacological treatment is widely used in the therapy of haemorrhoids. An efficient treatment is particularly useful in case of haemorrhoids of 2nd, 3rd and 4th degree, when phlogosis, oedema and pain are present. Forty patients were treated with either O-(beta-hydroxyethyl)-rutosides (4 g/day orally) or placebo in a double blind randomized comparative trial. The groups of treatment were homogeneous. O-(beta-hydroxyethyl)-rutosides induced a statistically significant reduction of pain and bleeding; placebo did not induce any significant improvement. Tolerability was good and similar for both treatments. It has never been necessary to stop treatment for side effects. The results obtained in this study confirm the usefulness on administering an oral treatment, and not only a local treatment, to patients with acute symptoms of haemorrhoids, both in case of intermittent treatment and in case it is used to prepare quickly the patient for surgery. PMID- 3531925 TI - Membrane labeling of the cortex of 'aging' rats by anti-fatty acid antibodies. AB - The cortex of 'aging' rat brain exhibits no significant difference in the lipid and fatty acid composition in comparison with that of control rat brain, except for a lowered value of the cholesterol/phospholipids ratio. However, an antiserum raised against oleic acid, specifically labels neurones of the cortex of the 'aging' rat mainly within layers IV and V. An electron microscopical study revealed that immunoreactivity was associated with cytoplasmic vesicular inclusions (lipofuscin) and with membranes. Thus, these anti-fatty acid antibodies may help in the evaluation of local modifications of membranes which are not predictable on the basis of biochemical analysis of lipids. PMID- 3531926 TI - Laminar profiles of the changes in extracellular calcium concentration induced by repetitive stimulation and excitatory amino acids in the rat dentate gyrus. AB - Changes in extracellular free calcium concentration ([Ca2+]o) were measured with ion-selective microelectrodes in the dentate gyrus of the rat hippocampal slice preparation. Repetitive stimulation (20 Hz/10 s) of the perforant path or mossy fibers, or alternatively, iontophoresis of the excitatory amino acids N-methyl-D aspartate (NMDA) or quisqualate (Quis) elicited decreases in [Ca2+]o (delta Ca2+) which were unequally distributed along the axis of the granule cells. Laminar profiles of the [Ca2+]o changes revealed marked differences between stimulus- and amino acid-induced responses. The delta Ca2+ induced by either anti- or orthodromic stimulation were relatively small (less than 0.15 mM) and were found to be maximal at the cell body layer (stratum granulosum). In contrast, the excitatory amino acids NMDA and Quis evoked large delta Ca2+ (greater than 1.2 mM) which were maximal at dendritic sites, 100 microns away from the cell body layer in the inner stratum moleculare. The effect of NMDA was reversibly blocked by 2-amino-5-phosphonovaleric acid without antagonism of the synaptic responses or the stimulus-induced changes in [Ca2+]o. Therefore, under normal conditions, NMDA receptors appear not to participate in synaptically induced delta Ca2+ in the dentate gyrus. PMID- 3531927 TI - Ketamine selectively suppresses synchronized afterdischarges in immature hippocampus. AB - The role of excitatory amino acid neurotransmission in epileptogenesis was investigated in the developing hippocampus. Bath application of ketamine blocked penicillin-induced, synchronized afterdischarges in immature rat CA3 hippocampal neurons. Ketamine also decreased the duration of the preceding intracellularly recorded depolarization shift but had no measurable effect on the resting membrane potential or input impedance of pyramidal cells. Concentrations of ketamine that blocked afterdischarge generation dramatically depressed intracellular depolarizations produced by iontophoretic application of N-methyl-D aspartate (NMDA) but not quisqualate. The effects of the NMDA antagonist 2-amino 7-phosphonoheptanoic acid on epileptiform discharges were identical to those of ketamine. These results suggest that an endogenous excitatory amino acid acting on an NMDA receptor plays a key role in the pronounced capacity of immature hippocampus for seizures. PMID- 3531928 TI - Vasoactive intestinal peptide- and peptide histidine isoleucine amide-like immunoreactivity colocalize with vasopressin-like immunoreactivity in the canine hypothalamo-neurohypophysial neuronal system. AB - The distribution of vasoactive intestinal peptide (VIP) and peptide histidine isoleucine amide (PHI) was investigated in the canine hypothalamus by immunocytochemistry. VIP- and PHI-like immunoreactive neurons were detected in the magnocellular supraoptic and paraventricular nucleus. These magnocellular VIP and PHI-producing neurons coexist with vasopressin-like immunoreactivity and send axons to the median eminence and neurohypophysis. These findings may serve as an anatomical basis for studying the function of VIP and PHI on pituitary hormone secretion. PMID- 3531929 TI - Emergency medical services: twenty years of growth and development. PMID- 3531930 TI - Severe falciparum malaria. PMID- 3531931 TI - The mandibular staple bone plate. PMID- 3531933 TI - Induction of ovulation with gonadotropin-releasing hormone. PMID- 3531932 TI - Placental sulfatase deficiency: maternal and fetal expression of steroid sulfatase deficiency and X-linked ichthyosis. AB - PSD-X-linked ichthyosis are manifestations of a similar disorder of an inborn error of metabolism characterized by a deficiency of steroid sulfatase. The decreased enzyme activity is due to the absence of the expression of enzyme (steroid sulfatase) protein. Affected individuals with this disorder are males (X linked inheritance) with a frequency of 1/2000 to 1/6000 births. Homozygous females from cosanguineous marriages have been reported with this disorder. The diagnosis is suspected and confirmed by: Low estriol excretion; Negative DHEAS loading test Increased DHEAS in amnionic fluid; Normal DHEAS in cord plasma; Possible delayed or abnormal labor patterns; Decreased sulfatase activity in the placenta, fibroblast, erythrocytes, lymphocytes or leukocytes of affected individuals; Development of ichthyosis in male infants at 2 to 3 months of age. PMID- 3531935 TI - Endometriosis--associated infertility: a critical review of therapeutic approaches. PMID- 3531934 TI - Neonatal considerations in the management of premature rupture of the fetal membranes. PMID- 3531936 TI - Ripening of the human cervix and induction of labor with intracervical purified porcine relaxin. AB - In a randomized double-blind placebo-controlled trial involving 71 patients, a viscous gel containing distilled water or 1 or 2 mg pure porcine relaxin was instilled in the cervical canal on the evening before the surgical induction of labor. Eleven of 48 patients receiving relaxin labored overnight, whereas only one of 23 patients went into labor. Only the 2-mg dose significantly improved the mean cervical score compared with the placebo treatment; the effect was greatest in primigravid patients with unripe cervixes. Intracervical application appeared to confer no benefit over vaginal application in effecting cervical ripening or inducing labor. Systemic absorption of the porcine relaxin after its intracervical application was confirmed by the measurement of immunoreactive relaxin in a homologous porcine relaxin radioimmunoassay. Thus, the cervical ripening effect of exogenous relaxin may be mediated either systemically or by direct action at the site of local application. This trial confirms the responsiveness of the human term cervix to exogenous relaxin and supports the suggestion that endogenous relaxin may play a similar role at term in facilitating cervical ripening and parturition. PMID- 3531937 TI - A correlative study of Papanicolaou smear, fluorescent antibody, and culture for the diagnosis of Chlamydia trachomatis. AB - A prospective study of 300 patients undergoing therapeutic termination of pregnancy was conducted. A Papanicolaou smear was obtained and a clinical evaluation of the cervix was made. Specimens from the cervix were examined by both direct fluorescent antibody and culture techniques for the presence of Chlamydia trachomatis. The presence of inflammation on Papanicolaou smear could be correlated with C trachomatis isolation. Papanicolaou smear findings consistent with C trachomatis lacked both sensitivity and specificity when compared with direct fluorescent antibody and/or culture techniques. A correlation was found between the clinical diagnosis of cervicitis and C trachomatis. This interrelationship was absent when the component findings of cervicitis (ectopy, friability, and purulent mucus) were examined independently. PMID- 3531938 TI - Inhibition of Candida-induced lymphocyte proliferation by antibody to Candida albicans. AB - Antibodies to Candida albicans do not prevent the occurrence of candidal vulvovaginitis. To determine if antibodies may be involved in enhancing infectivity, the effects of purified rabbit anti-Candida immunoglobulin G (IgG) on the in vitro cellular immune response to this organism was examined. In four individuals, 50 micrograms/mL rabbit anti-Candida IgG, but not control rabbit IgG, inhibited the lymphocyte proliferative response to Candida antigens by a mean of 92.3%. The degree of inhibition was proportional to antibody concentration over a 5-25 micrograms/mL range. Addition of antibody at the initiation of Candida incubation with peripheral blood mononuclear cells or up to 48 hours later led to a 60-83% inhibition; antibody addition 24 hours before Candida caused only a 29% inhibition. Addition of antibody to purified macrophages concomitantly with Candida or after an overnight incubation of macrophages and Candida, both followed by the addition of lymphocytes, demonstrated that the uptake and/or processing of Candida antigens by macrophages and the recognition by lymphocytes of Candida antigen on the macrophage surface were both inhibited by antibody. Candida-specific antibody may enhance the ability of this organism to escape immune destruction. PMID- 3531939 TI - Quantitative transcervical uterine cultures in asymptomatic women using an intrauterine contraceptive device. AB - Quantitative transcervical uterine cultures were obtained in 100 asymptomatic women using intrauterine contraceptive devices for varying periods. Twenty women using barrier forms of contraception served as controls. Cultures were obtained safely and satisfactorily without trauma to either the endocervix or endometrium. It was found that normal uterine sterility was significantly compromised in women using an intrauterine contraceptive device. The number of intrauterine organisms cultured was associated with neither the type of intrauterine contraceptive device (Cu-7, Lippes Loop, Saf-T-Coil) nor the duration of use (less than one month to greater than five years). PMID- 3531940 TI - Comparison of ultrasonographic and digital cervical evaluation. AB - Findings on ultrasound scanning of the cervix and lower uterine segment were compared with those on digital examination in patients in preterm labor or those in whom induction was planned. An ultrasound scoring system gave results that corresponded closely to those of the Bishop score. PMID- 3531941 TI - Aftermath of Chernobyl presents grueling test for medical professionals. PMID- 3531942 TI - Companies must be able to advise fire department in emergencies. PMID- 3531943 TI - Ohio's heritage of dentistry ... The Frederick H. Rehwinkel story. PMID- 3531944 TI - [A method of reinforcing the wall of the filtrable cushion in fistulizing antiglaucoma interventions]. PMID- 3531945 TI - [The diagnosis of multiple myeloma]. AB - The diagnosis of multiple myeloma (MM) is often made in an advanced phase when using the established criteria. Derived from the modern diagnostic procedures used in malignant lymphomas, an alternative diagnostic strategy in MM is proposed. The prognostic value of a histologic classification of MM has been demonstrated, based on bone marrow biopsies of 577 myeloma patients. Furthermore, the infiltration volume in the biopsy proved to be an important prognostic parameter and complements the used clinical staging system. The different possibilities of a reliable follow-up of myeloma patients are shown. PMID- 3531946 TI - [A comparison of staging classifications of plasmacytoma]. AB - In 152 patients treated with cytostatic agents for multiple myeloma the prognostic value of seven staging systems was evaluated: Carbone et al. Acute Leukemia Group B, Southeastern Cancer Study Group, Durie and Salmon, Alexanian, Merlini et al., British Medical Research Council. The staging systems of the ALGB and SECSG, both dividing patients into "good risk"- and "poor risk"-groups gave significantly different survival curves. Nevertheless, the differences were rather small. In the systems of Carbone et al., Merlini et al., Alexanian, and Durie and Salmon some of the differences in the survival curves were statistically significant while others were not. Our data best fitted into the British Medical Research Council staging system, the survival curves of all three stages showing significant differences with median survival time dropping from 83 months in stage A to 52 months in stage B and 26 months in stage C. Nevertheless, none of those systems was clearly superior to single risk factors especially creatinine and hemoglobin. PMID- 3531947 TI - [The clinical picture of multiple myeloma]. AB - Diagnosis of multiple myeloma is based on the triad paraproteinemia, osteolytic bone lesions and bone marrow plasma cell infiltration. Clinically, rheumatoid like pain induced by osteolytic skeletal lesions often prevails. Occasionally, foudroyant bacterial infections - the most frequent cause of death in myelomatosis - or acute/subacute renal failure or rarely, acute hemi- or paraparesis precede diagnosis. Establishment of diagnosis early in the course of the disease and improved cytostatic and symptomatic treatment has led to a decrease in episodes of hyperviscosity-syndromes. Severe renal insufficiency due to Bence-Jones proteinuria prevails in 20% of patients already at time of diagnosis. With increasing duration of the disease, frequency of renal insufficiency further increases. Hypercalcemia with consecutive dehydration and renal insufficiency usually is a complication of long-standing disease. Anemia, leukopenia and thrombo-cytopenia are not only side effects of cytostatic treatment, but also consequences of tumor-induced suppression of hematopoiesis. Polyneuropathies are common in myelomatosis. They probably are the result of specific and/or unspecific binding of paraproteins to myelin sheaths. Effective treatment for this complication is not available at present. Thrombohemorrhagic complications are more frequent in patients with myeloma than in the control group of other hospitalized patients. Non-secretory myeloma, osteoblastic myeloma and Takatsuki syndrome are variants of myelomatosis. Solitary and extramedullary plasmocytoma are different, potentially curable entities. Prognosis is especially poor in patients with plasma cell leukemia and poor in primary amyloidosis. PMID- 3531948 TI - Therapy of primary resistant and relapsed multiple myeloma. AB - This article reports the efficacy of two salvage programs for primary resistant and relapsed multiple myeloma. Employing high dose dexamethasone alone or combined with continuous infusions of vincristine and adriamycin (VAD) in 83 patients, 1/3 achieved a greater than or equal to 75% tumor cytoreduction. The highest response rate of 65% was observed among previously responding patients receiving VAD compared to approximately 1/4 among those receiving VAD for primary resistant disease or dexamethasone alone regardless of prior response status. Tumor halving times were short with values of 0.5 months for VAD and 1.3 months for dexamethasone alone. The single most important pretreatment variable associated with failure to achieve remission was a low RNA content of myeloma plasma cells in the bone marrow. The second program evaluated high dose melphalan with or without autologous bone marrow transplantation in 23 patients resistant to VAD salvage treatment. Ten of 23 patients responded for at least 2 months, and 4 others had a comparable anti-tumor effect but died between 4-6 weeks from disseminated infection. Unlike the VAD regimen, responses occurred regardless of prior response or plasma cell RNA content, and tumor halving times were extremely short with a median of 0.3 months. With autologous bone marrow support, the higher melphalan dose (140 vs. 100 mg/m2) could be more safely administered to an older patient population (median of 63 vs. 44 years) with 1 of 7 vs 6 of 16 drug related deaths in the absence of marrow support.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3531949 TI - [Acceptable risks in the curative therapy of malignant diseases]. AB - Therapy with cytostatic drugs is inevitably associated with risks. Basically the lower the magnitude of foreseeable risks, the higher the chance of cure. Yet, dealing with the individual patient the physician finds himself very often in a situation which cannot be solved by scientific reasoning only. PMID- 3531950 TI - [Risks of alternative cancer treatment]. AB - Alternative methods of cancer treatment, which are by definition unproven methods, are not generally harmless, atoxic. Severe direct side-effects are rare, but the risk of 'indirect side effects' detrimental for the patient is quite high. Examples are: lack of a potentially successful, curative treatment, provocation of guilt, anxiety, aggression. Alternative methods have to be tested according to the same principles as scientific methods with proven efficacy. PMID- 3531951 TI - Phase-II trial of oral idarubicin (4-demethoxydaunorubicin) in advanced breast cancer. PMID- 3531952 TI - Recovery of blood and bone marrow stem cells following intense chemotherapy and autologous bone marrow transplantation. AB - Sixteen patients with advanced (stage III) malignant melanoma were treated with escalating doses of intravenous BCNU and melphalan starting at 400 and 35 mg/m2, respectively, and escalating to 1,000 and 110 mg/m2, respectively, combined with autologous marrow transplantation. The duration of granulocytopenia and time to granulocyte recovery was similar in all groups regardless of chemotherapy dose. Platelet recovery was delayed in patients receiving the highest doses of chemotherapy. This study showed that bone marrow colony-forming units in culture took as long as 6 months to recover. This was adequate to bring peripheral blood counts to normal but not to pretreatment levels. These studies indicate that autologous bone marrow transplantation is beneficial in enhancing short-term recovery, but may not be beneficial in the long-term hematopoietic recovery. PMID- 3531953 TI - Analgetic activity of calcitonin in patients with painful osteolytic metastases of breast cancer. Results of a controlled randomized study. AB - The analgesic effect of salmon calcitonin was tested by a double-blind clinical randomized controlled trial in 40 female patients with painful osteolytic metastases. Twenty patients were administered (daily) 100 IU of salmon calcitonin subcutaneously over 28 days, while the other 20 were administered identical ampoules containing 2 ml of physiological solution over the same period of time. The basic treatment (chemotherapy, hormone therapy) was not changed during the trial, and had to be stabilized for a minimum of 3 months prior to the trial. The effect of calcitonin was monitored with respect to daily analgesic consumption, duration of pain, patient's functional capacity, patient's own assessment of pain, and assessment of efficacy by the investigator. Statistically significant differences were established in terms of reduced analgesic consumption, shorter duration of pain and the patient's subjective assessment of pain duration and intensity; the difference was not statistically significant with regard to patient's functional capacity. The objective assessment of the analgesic effect of calcitonin by the investigator showed the drug to be extremely useful in 3 patients and moderately useful in 11 patients; 3 instances of 'moderately useful' were observed in the placebo group. No changes were observed in serum calcium levels; there were likewise no skeleton changes as established by X-rays and bone scintiscans before and at the end of treatment. The trial has shown calcitonin to produce a pronounced analgesic effect in breast cancer patients with painful osteolytic metastases. PMID- 3531954 TI - Elevated pancreatic oncofetal antigen levels measured by enzyme immunoassay in pure pancreatic juice of patients with pancreatic cancer. AB - Pancreatic oncofetal antigen (POA) was measured by enzyme immunoassay in pancreatic juice from patients with pancreatic cancer, chronic pancreatitis, or other diseases. POA levels in pancreatic cancer were significantly higher than in other disorders, and POA was seen by immunofluorescence to be in the cancerous tissues of pancreatic cancer. Assay of POA in the pancreatic juice may be more reliable than serum POA, and could contribute to the diagnosis of pancreatic cancer. PMID- 3531955 TI - Diagnostic value of the computerized tube leukocyte adherence inhibition (LAI) assay for human colorectal, breast and lung cancers. AB - We have tested by the computerized tube leukocyte adherence inhibition (LAI) assay, 319, 100 and 342 patients and controls for the presence of antitumor immunity to colorectal, breast and lung cancers. The assay was standardized and its sensitivity increased by using, as a challenging antigen, spent medium of human carcinoma cell lines and by the addition of prostaglandin E2 (PGE2). By large, the sensitivity of the assay (after the addition of PGE2) was inversely related to tumor burden, namely, it was 82.7, 78.9, and 88.6% as compared to 57.1, 33.3, and 29.6% for the early and late stages of colorectal, breast and lung cancers, respectively. Calculating the frequency of disease in the population studied and in comparison with known frequencies of the same in the general population, the positive and negative predicting values (PVpos, PVneg) were obtained. Our results demonstrate that the LAI assay cannot be applied for mass screening since its low PVpos would impair its effectiveness. However, its application to a population at high risk for developing a particular malignancy or as a second-line modality to more conventional screening methods would increase its cost-effectiveness and favor its applicability. PMID- 3531956 TI - Ocular histoplasmosis syndrome. AB - The Macular Photocoagulation Study (MPS) is a multi-center clinical trial supported by the National Eye Institute whose purpose is to assess argon laser photocoagulation as a treatment for choroidal neovascular membranes (NVMs) that do not involve the fovea. The MPS documented that in patients with ocular histoplasmosis syndrome argon laser photocoagulation in comparison with no treatment can reduce the risk of severe visual loss from 46 to 13% in the first two years. Accordingly, patients with ocular histoplasmosis and NVMs outside the fovea are advised to undergo prompt treatment with argon laser photocoagulation. PMID- 3531957 TI - Argon laser photocoagulation treatment in central serous chorioretinopathy. AB - Central serous chorioretinopathy, a sporadic self-limited disease of young adults, is associated with loss of central vision, image distortion, and imparied dark adaptation. The diagnosis is verified with fluorescein angiography, which demonstrates and expanding point of fluorescein dye leakage under a serous detachment of the sensory retina. Treatment should ordinarily be delayed four or more months but may be considered if there is evidence of microarchitectural changes in the macular retina, if the best corrected visual acuity declines to 20/40 or less, or if there have been multiple recurrences. Argon laser photocoagulation should be directed to the leakage site, using spot sizes of 200 mu in diameter, exposure times of 0.2 seconds, and low-power intensities. PMID- 3531958 TI - Argon laser photocoagulation for macular edema in branch vein occlusion. AB - The Branch Vein Occlusion Study is a multicenter, randomized controlled clinical trial that was designed to answer several questions regarding the management of complications of branch vein occlusion. Recently, this study reported the benefit of argon laser photocoagulation for improving visual acuity in certain eyes with macular edema, performing the laser photocoagulation in a "grid" pattern over the area demonstrated as leaking by fluorescein angiography. Comparing treated patients with control patients (mean follow-up 3.1 years for all study eyes), a gain of at least two lines of visual acuity from baseline maintained for two consecutive visits was significantly greater in treated eyes (P = 0.00049 log rank test). Because of this improvement in visual acuity with argon laser photocoagulation, the study recommends laser photocoagulation for patients with macular edema associated with branch vein occlusion who meet the eligibility criteria of the study. PMID- 3531959 TI - Diabetic macular edema. A review. AB - Diabetic macular edema can be classified into a focal variety, characterized by focal leakage from microaneurysms, often with accumulation of extravascular lipoprotein in a circinate pattern around the focal leakage, and a diffuse variety, with diffuse leakage from retinal vessels often accompanied by cystoid macular changes. Laser photocoagulation is directed at microaneurysms for focal leakage and is applied in a grid pattern for diffuse leakage. Several prospective randomized clinical trials have shown that laser-treated eyes fare better than untreated eyes: there is a higher rate of modest visual improvement and a lower rate of visual deterioration in eyes treated with laser photocoagulation. In patients with diabetic macular edema, especially the diffuse variety, systemic factors also may play a pathogenic role. Fluid retention and hypertension due to cardiovascular and renal disease exacerbate retinal capillary leakage. Correction of systemic abnormalities (reduced blood pressure, diuresis) may reduce macular edema and should be included as part of the total management of patients with diabetic macular edema. PMID- 3531960 TI - Malakoplakia of the eyelid. AB - A 35-year-old white man, on immunosuppressive medications for 3 1/2 years following a renal transplant, presented with a whitish-yellow mass at the medial end of the left lower eyelid. An initial incisional biopsy was performed that was misinterpreted as granular cell myoblastoma. The mass was subsequently excised and histopathologic examination revealed malakoplakia. A more extensive recurrent lesion was excised one year later. About two years after the resection of the original lesion the patient died of complications of chronic renal failure. At autopsy there was no evidence of malakoplakia either of the eyelid-or systemically. This is the first case reported of eyelid involvement by malakoplakia, a histiocytic disorder with pathognomonic histopathologic features. PMID- 3531961 TI - The origin of the ophthalmoscope. PMID- 3531962 TI - Overview of on-line information data bases in orthopedics. AB - For the last 20 to 25 years, American society has experienced exponential growth in the amount of medical information available. With the advent of computers and microcomputers, much of this information has been organized into on-line computer data bases accessible by health care practitioners. This article presents an overview of those on-line data bases that contain information of interest to the orthopedic health care professional. PMID- 3531963 TI - Computer-assisted instruction in orthopedic biomechanics. AB - A computer-aided instructional (CAI) course in biomechanics was developed at the University of Texas Medical Branch in Galveston. This was used by our residents in preparation for the 1984 OITE. The course was developed on a 256K IBM personal computer with a color graphics board and color monitor. The course requires about 6 hours of user time to complete. The program was written in the Basic computer language and consists of a master and teaching program. The master program keeps track of the name of the user and his or her progress. The teaching program contains the chapters of biomechanical concepts with a quiz after each chapter. The chapters present the basic concepts of biomechanics with interactive color graphics. The quizzes contain about 20 board-type questions. Six residents voluntarily used the CAI and nine residents chose not to use the CAI. There was no difference in the two groups' outside reading of biomechanical texts or other methods of study. There was no statistical difference between the two groups 1983 OITE biomechanics score. There was also no statistical change in the nonusers' score from 1983 to 1984. The users, however, showed a statistically significant improvement (p less than .05) from the previous year. We conclude that with the wide use of properly developed CAI is an effective and efficient method to provide education for orthopedists. PMID- 3531964 TI - Orthopedic simulation for microcomputers. AB - Graphic illustration has, for many years, played an important role in medical education. This article discusses the means for adapting graphic material to enhance orthopedic educational efforts using the microcomputer. PMID- 3531965 TI - Computer-aided simulation, analysis, and design in orthopedic surgery. AB - Three-dimensional computer reconstructions of bony anatomy based on computed tomographic images and radiographs may be used to analyze, simulate, and design certain orthopedic procedures. In osteotomy surgery, the computer-reconstructed models may be used to measure critical angles, surface area, and congruity of the joint surfaces. Computer reconstructions may be used in total joint replacement surgery to simulate the effect of surgical reamers and rasps, to select the geometrically optimum standard implant, or to design a custom implant. In allograft reconstructive surgery, computer reconstructions may be used to measure bony defects and to identify the appropriate allografts for the reconstruction. Plastic models may be sterilized and used as templates to sculpt the allografts immediately preoperatively. In all three applications in orthopedic surgery, three-dimensional, computer-aided reconstructions have the potential to improve results and reduce morbidity. PMID- 3531966 TI - Computer graphic modeling in surgery. AB - The application of computer-based solid modeling techniques to human anatomy shows great promise for enhancing surgical instruction and research. Such advances will directly benefit patient care. The increasing availability of powerful modeling programs for the microcomputer and the interactive peripheral technologies make the delivery of this new modality practical at the present time. We continue to refine our methodology for producing accurate and esthetic anatomic models and have developed a technique for three-dimensional "sculpting" of elongated structures. We continue to explore the possibility of using sectional scanning data to create anatomic images. Several applications have been described, ranging from surgical simulations to a ballistic injury model, in order to indicate the potential scope of this powerful technology. PMID- 3531967 TI - [Results of alloplasty of extensive defects of the long bones in children]. PMID- 3531968 TI - [Spinal compression syndrome in scoliosis (review of the literature)]. PMID- 3531969 TI - [Selman A. Waksman, science-historian]. PMID- 3531970 TI - [Imre Ivanka, factotum of the Red Cross, died 90 years ago]. PMID- 3531971 TI - [Hungarian pioneer of dermatology: Frigyes Reiss]. PMID- 3531972 TI - [Physicians of Hungarian miners in the l6th-l7th centuries]. PMID- 3531973 TI - [Aba Sztankay, his life in Hont]. PMID- 3531974 TI - [Prenatal diagnosis of the ADAM (amniotic deformity, adhesion, mutilation) syndrome]. PMID- 3531975 TI - [Centenary of the birth of Janos Angyan]. PMID- 3531976 TI - [Mikhail Bulgakov, rural physician]. PMID- 3531977 TI - [Pathomorphologic aspects of the conservative therapy of arthroses]. AB - The paper reviews the different ways in which osteoarthrosis can occur. Structural alterations that take place in the subchondral bone or in the collagenous network of the superficial or mid-zone cartilage can be regarded as the initial events leading to injuries of the chondrocytes. Loss of cartilage either due to increased enzymatic degradation and/or reduced synthesis of proteoglycans may follow. The hypothetical influence of pharmacotherapy on several pathogenetic steps is discussed. However, from the viewpoint of a pathologist, it is concluded that there is no pharmacotherapeutic regimen that can significantly influence the natural course of the disease. PMID- 3531978 TI - [Drug therapy of arthroses]. AB - Osteoarthritis (OA) is one of the most common diseases requiring treatment. A clear clinical and pathophysiological understanding of the disease is required before treating a patient with OA. Drug therapy of patients with OA is mainly divided into two groups: a group receiving symptomatic therapy and a group receiving drugs intended to modify or improve the disease. Symptomatic therapy includes pure analgesics as well as non-steroidal antirheumatic drugs and muscle relaxants. Their use depends on the activity as well as on the form of clinical manifestation (activated/decompensated disease). If there are signs of severe activation, intra-articular steroids, orgotein or even synoviorthesis with yttrium are administered as local therapy. All of these therapies are used in the sense of trouble shooters, as they cannot alter the course of the disease in the long run. The disease-modifying substances have well been investigated in vitro and in animal models. Furthermore, some clinical trials have shown evidence for the usefulness of these substances in the therapy of OA. PMID- 3531979 TI - [Physical therapy of arthroses]. AB - The physical therapy of arthrosis as a symptomatic and stage-oriented therapy is illustrated in a review. All of the various therapeutic procedures are discussed regarding their effectiveness and applicability in the different stages. There have been some changes within the last few decades and treatments have been introduced with more or less success. Mild thermotherapy of active arthrosis, suggested earlier, has been replaced by cryotherapy, which is more effective. Peloid therapy has now also been introduced into this cryotherapy, which only used to be applied as a type of heat therapy. Naturally, most of the new developments are in the field of electrotherapy. Nevertheless, the newer types have not led to any significant improvement in therapeutic success compared with "classical" electrotherapy (diadynamic, Trabert ultrastimulation, interferential current). The only remarkable innovation seems to be therapy with low-frequency magnetic fields, although the basic means of the working mechanism have not been thoroughly investigated. Regarding the most recent publications, laser therapy has not shown complete proof of its effectiveness. Passive physical therapy of arthrosis only shows persistent success when it is combined with a careful amount of physical therapy. PMID- 3531980 TI - A classification system of cognitive coping strategies for pain. AB - Cognitive strategies have received considerable interest in pain management, alongside the traditional approaches of physical intervention and behavior modification. However, the literature on these strategies is ridden with inconsistencies of terminology that present major difficulties in the conceptualization and evaluation of different strategies. A new classification scheme is hence proposed in which these strategies are grouped into 3 broad categories: imagery, self-statements and attention-diversion--which are further divided into a total of 10 subcategories. Examples are drawn from the literature to illustrate the use of each strategy. The new classification system offers a comprehensive nomenclature for the identification of cognitive coping strategies for pain and provides a basis for guiding research on the relative efficacy of different cognitive strategies in pain management. PMID- 3531981 TI - The artificial ventilation of acute spinal cord damaged patients: a retrospective study of forty-four patients. AB - The case histories of the 44 ventilated spinal cord damaged patients who have been treated at the Mersey Regional Spinal Injuries Centre prior to 1985 were reviewed. Complications of ventilation were commoner in patients whose ventilation was initiated prior to transfer to the specialised centre. Inappropriate early management before or during transfer to the spinal injuries centre led to the need for ventilation in several cases. Spinal cord damaged patients should be transferred to a specialised comprehensive centre as soon as possible after injury so that the requirement for ventilation can be minimised, the incidence of cardiac and respiratory arrest reduced, optimal methods of ventilation and weaning employed and global emotional and educational support provided from the outset for the patient and his family. PMID- 3531982 TI - Edinburgh, St Giles, Percival Pott and paraplegia. PMID- 3531983 TI - [HLA related diseases. The situation in 1986]. PMID- 3531984 TI - [Relations between the HLA system and disease]. PMID- 3531985 TI - [The chromosomal HLA region]. AB - HLA is located on the short arm of chromosome 6. This region includes several genes which are subdivided into 4 classes: class I (with HLA-A, B, and C), class II (HLA-D region), class III (complement components) and class IV (enzymes). PMID- 3531986 TI - [Usual statistical methods for studying HLA-disease associations and linkages]. AB - Statistical methods used for the study of correlation and/or linkage between HLA and diseases susceptibility will be different according to the aim of the study. In case of a search of an association between disease character and HLA markers in unrelated populations, the methodology used will be based upon chi square and Relative Risk. In case of linkage study: multiplex families with 2 or more patients bring the most informative data. In all cases, a particular attention must be paid to criteria used for selection of patients and controls, and for studies of linkage to the hypothesis concerning mode of inheritance and penetrance required by the model chosen. PMID- 3531987 TI - [Idiopathic hemochromatosis. Immunogenetics and diagnosis. Prevention by HLA genotypes]. AB - Idiopathic hemochromatosis is an hereditary iron overload. The study of HLA types demonstrated clearly the linkage with HLA system. The preferential correlation established with A3 (72%) but other alleles were linked: B7, B14. HLA alleles were only the markers of hemochromatosis allele (H) and were not implicated in other iron overload. Family studied, defined two linked haplotypes: A3, Cw7, B7, Bw6, BfS, DR2, GLO1 et A3, Cw8, B14, Cw6, BfF, DRw6, GLO2. Demonstration of the recessive mode of inheritance was established by family studies. The affected siblings had the same HLA haplotype that the proband and homozygous or heterozygous expressed state was assessed in siblings. The HLA family types allowed to detect in 147 families 88 potential diseased patients among of them 73% had early blood-drawing. PMID- 3531988 TI - [HLA and Bf in idiopathic nephrotic syndrome in children: differences between corticosensitive and corticoresistant forms]. AB - An association between HLA-DR7 and the steroid sensitive idiopathic nephrotic syndrome in the children has already been reported. Immunogenetic data in the less frequent steroid resistant form of this disease have never been published. In this study, we analyse HLA-A, B and DR typing in 99 cases of nephrotic children divided in 72 with the steroid sensitive (SS) form and 27 with the steroid resistant (SR) syndrome, in comparison with those of 207 healthy controls; Bf allotypes were determined in 53 of the patients. The results show the increased frequency of DR7 in the SS syndrome (75% vs 30%, RR = 6.9, pc less than 10(-6), while the SR one is more associated to DR3 (52% vs 27%, RR = 3, p less than 0.004). In the SS patients, atopy is associated to DR7 (p less than 0.001), which is not the case in the SR group. Furthermore, a high relative risk is associated to the phenotype DR3/DR7 (30% vs 4%; RR = 9.3; pc less than 0.0004), for the SR disease; besides, this phenotype is associated to an early onset of the disease and to lesions of focal sclerosis. Thus a heterozygous effect in the SR form of idiopathic nephrotic syndrome of children has been demonstrated; the steroid sensitive and the steroid resistant forms of the disease seem to have different immunogenetic components. PMID- 3531989 TI - [HLA and leprosy]. AB - Although there is now accumulating evidence that the host response to Mycobacterium leprae is genetically controlled, the nature of the genetic component is still imprecise. Case-control studies as well as family studies, in various populations, have shown that HLA linked factors confer susceptibility to tuberculoid leprosy and lepromatous leprosy respectively. Recently, associations between Gm allotypes and the disease have also been reported. Further studies of the familial cosegregation of the different forms of leprosy together with the HLA and Gm markers may permit a better understanding of the underlying genetic mechanisms. PMID- 3531990 TI - [HLA markers in leukemia patients]. AB - The relationship of genes of the HLA system with leukemogenesis has been controversial for many years. However HLA antigens such as A2, B12 and DR7, have been found associated with prolonged survival in patients with acute leukemia. Recent studies have also shown an excess of shared HLA antigens (especially DR) among the parents of patients with acute leukemia. This phenomenon may possibly reflect the expression in patients of recessive immune response genes linked to the HLA complex; the role of such immune response genes in susceptibility or resistance to virus-induced leukemia has clearly been established in mice. PMID- 3531991 TI - [Expression of class I and class II markers on populations of leukemic cells]. AB - The study of class I and class II antigen expression on leukemic cells brought the following conclusions: most of the leukemic cells show a slower number of class I antigenic sites than normal peripheral blood lymphocytes (PBL) but, in most cases, this does not hinder HLA typing; contrarily to normal PBL, leukemic cells seem to carry "non HLA" antigens (and/or non classical HLA antigens) which are probably responsible of the false positive reactions frequently observed at the time of HLA typing; most of the leukemic cell types express DR antigens (except those belonging to the T lineage) but DQ antigen expression (and in some cases MT antigen expression) varies depending on the cell type studied: well defined on mature B hemopathies, DQ expression is often lower than DR expression on acute leukemic cell types. PMID- 3531992 TI - [HLA typing in classical and African Kaposi's disease]. AB - HLA A, B, C, typing have been done in 39 patients with clinically and histologically documented classical Kaposi's sarcoma. Thirty three were also typed for HLA DR antigens. Twenty seven were males, 12 were females and three ethnic groups were represented: european caucasoids 41%, north african caucasoids 38.5% and negroids 20.5%. The only statistically significant abnormality is an increase of HLA DR5 frequency (60.6 vs 26. p less than 0.001 et RR = 4.2). Such an increase has been evidenced also in AIDS patients, with or without Kaposi's sarcoma and then is not discriminant between all this different types of the disease. PMID- 3531993 TI - [Risk factors in insulin-dependent diabetes]. AB - The relative risks (RR) of the immunogenetic markers of insulin-dependent diabetes mellitus (IDDM) have been calculated in a population of 235 IDDM patients compared with a control population. The highest relative risk was that of subjects heterozygous DR3/DR4 (RR = 47, P less than 0.001) which was still more increased in those who carry this combination associated with the RFLP cluster DQR4 (RR = 72). Further, a sample of 51 secondary affected siblings of IDD index cases has been compared with 265 non affected siblings (one child of each family, excluding index cases). The highest risks have been found in addition to DR3/DR4, for DR3 alone and particularly for the combination C4BQ0, DR3 (RR = 9, p less than 0.001) suggesting a role for this peculiar association in the familial penetrance. In the group of siblings HLA-identical with the index case, only two factors showed some capacity of discriminating between affected and non affected siblings: HLA-DR3 and age (less than or equal to 10 years old at onset of IDDM in the index case) (p less than 0.01). In the group of haploidentical siblings, the combination DR3/DR4 and the associations C4BQ0, DR3 and BfF1, DR3 significantly increased the susceptibility for higher familial occurrence of the disease. If confirmed by additional family series, this scale of risk factors could be helpful in predicting risk of IDDM to siblings of diabetic children. PMID- 3531994 TI - [Familial studies of systemic lupus erythematosus. HLA markers and complotypes]. AB - Particular susceptibility to systemic lupus erythematosis (SLE) could be due to a certain alleles of class I, II or III of the major histocompatibility complex (MHC). The existence of total hereditary deficiencies of factor 2 or 4 of the complement in this syndrome suggests the presence of silent alleles which could conceivably play a determining role in the appearance of SLE. In this study, the HLA haplotypes and complotypes (C2, C4, Bf) were determined in 20 individuals suffering from SLE, and compared with 108 healthy, genotyped individuals. The results obtained showed a significant increase in the frequency of C4 BQ0 in patients compared with that found in controls (chi 2 = 12.27, p less than 0.001, Relative Risk = 3.78), and confirm the HLA association, DR3/SLE (chi 2 = 5.45, p less than 0.02, RR = 2.53). PMID- 3531995 TI - Autoimmune disease: synergy of HLA class II overexpression and abrogation of self tolerance. PMID- 3531996 TI - [Immunization against the ZWa (PLA1) platelet antigen: group at risk, prevention of complications. Apropos of 132 cases]. AB - The identification of anti-ZWa (-PLA1) alloimmunisation is not very frequent. It can be observed in most perinatal alloimmune thrombocytopenias (PAT) and rare post transfusional purpuras (PTP). On the other hand, the clinical consequences of these immunisations are often dramatic, particularly for the foetuses for which there has been no prevention so far. The retrospective study of 132 cases, 123 PAT and 9 PTP, shows the possible irreversible complications for 18% of the newborns with PAT, but especially for 10% of the foetuses which will show PAT at birth. HLA markers are very useful to detect the people who are likely to develop an anti-PLA1 immunization for they are PLA1 negative and HLA DR3. Then, it becomes possible to prevent the complications of these immunisations. It is what we tried to do through the diagnosis and the treatment of PAT in 3 foetuses. PMID- 3531997 TI - [HLA antigens and different clinical forms of 21-hydroxylase deficiency in the French population]. AB - HLA associations with 21-OH deficiency were studied on respectively 109 and 60 congenital and late onset French index cases. Significant negative associations were found with antigens B8: congenital forms; B5, DR3: late onset. Significant positive associations were observed with A3, Bw47 (A3 Cw6 Bw47 DR7): congenital forms; B40: salt-wasting form; B5: simple virilizing form; Aw33, B14, DR1, DR2, DRw6 (Aw33 B14 DR1): late onset form. Among late onset patients not bearing B14 antigens significant positive associations were observed with B12 and B35. PMID- 3531998 TI - New methods for detection of HLA genes polymorphism useful for associated diseases studies. AB - We have studied in 22 informative families typed for HLA the segregation of DNA restriction fragments obtained with five restriction enzymes and hybridized with one class I and three class II probes. Most of the fragments correlate with serologically defined specificities. Many fragments can be grouped in clusters, whose genetic significance is discussed. The RFLP distribution in patients with insulin-dependent diabetes mellitus, multiple sclerosis or narcolepsy, three diseases known to be associated with some HLA-DR specificities, has been also studied. Many fragments allow to distinguish between patients and HLA-DR matched controls. Hybridization of genomic DNA with synthetic oligomers will refine moreover the understanding of the HLA system polymorphism. PMID- 3531999 TI - [Human T lymphocyte clones: a new approach for studying relations between the major histocompatibility complex and pathology]. AB - Human T cell clones specific of, or restricted by, HLA molecules allow the definition of HLA molecule polymorphism. The advantages of this technical approach are: the definition of a functional polymorphism on the one hand, and the monospecificity of this definition of the other hand. Therefore human T cell clones are unique tools for defining functional epitopes borne by HLA molecules and playing a role in disease associated with HLA. PMID- 3532000 TI - [Prospects and ethics of predictive medicine]. PMID- 3532001 TI - Tissue damage caused by free oxygen radicals. PMID- 3532002 TI - Lectin binding patterns and monoclonal antibodies to epidermal antigens in tumours of the skin. AB - Monoclonal antibodies to epidermal antigens and cell surface carbohydrate markers, as defined by lectin binding, were used to analyze the cells in squamous and basal cell carcinomas of the skin (SCC and BCC). The cells in BCC failed to stain with the lectin peanut agglutinin (PNA), which stains surface carbohydrates of cells in the stratum spinosum and stratum granulosum layers of normal epidermis, confirming histological observations that the cells in BCC are incapable of differentiation beyond the basal cell stage. Conversely, the central cells in SCC did react with PNA, suggesting that they can differentiate to a stage equivalent to the stratum spinosum of epidermis. The zone immediately surrounding BCC differed from that around SCC in lectin binding and staining with antisera to laminin and fibronectin, an observation which could be connected with the failure to metastasize. It was of interest that histologically normal skin immediately adjacent to and overlying these tumours showed marked changes in reaction with markers of normal epidermis. The outer layers of this epidermis showed aberrant retention of the lower molecular weight cytokeratins marked by the monoclonal antibodies LMM2 and LMM3, and occasional strong staining of individual cells by the stratum granulosum-reactive LMM1. These changes appear to be indicative of a 'premalignant' state in these cells and the monoclonal antibodies are thus potentially useful reagents for early detection of skin malignancies. PMID- 3532003 TI - A method of rapid fixation of large biopsy specimens using microwave irradiation. AB - This report describes the use of microwave irradiation for the rapid fixation of large biopsy specimens. Two hundred and twelve fresh large specimens subjected to non-ionizing irradiation in a domestic microwave oven (600 watt output, 2450 MHz) for 4-9 min were rendered sufficiently firm to be dissected and sampled immediately without the need for any formalin fixation. The tissues hardened in this manner remained pliable, retained much of their natural colour and were free of noxious fumes. Lymph nodes became opaque and firm and their pink-tan colour contrasted with the bright yellow of adipose tissue, making them easily dissectable. This procedure, combined with a further 4-7 min exposure to microwaves of the trimmed tissue blocks (in batches of 40), completed fixation and allowed the specimens to be processed on a 3 h 15 min cycle in an autoprocessor which did not contain formalin. PMID- 3532004 TI - Juvenile dermatomyositis. AB - Myositis in childhood is characterized by elevated serum levels of muscle-derived enzymes, proximal symmetrical muscle weakness, abnormal EMG findings, and a muscle biopsy, which frequently documents an inflammatory process. In the pediatric age group, JDMS, which has characteristic cutaneous involvement in addition to myositis, is much more common than PM and is more common among female patients. With the use of steroids, mortality has been reduced from 33 per cent to 7 per cent. The development of calcifications can be the most debilitating consequence of JDMS. It is our premise that JDMS is a distinct disease entity and that the increase in HLA-B8 and DR3 in JDMS suggests that genetic background may predispose to disease development. There are conflicting data concerning immunologic abnormalities in JDMS, but there appears to be impairment of natural killing and evidence of complement activation. Results of tests for ANA frequently are positive in JDMS, but Jo-1 antibody, found in some adults with PM, has not been found in JDMS. Most newly diagnosed JDMS patients have antibodies to coxsackie B that may be related to the pathogenesis of this disease. Specific pathologic findings of endothelial cells containing reticulotubular inclusions are associated with small vessel occlusion, subsequent obliteration, and increased factor VIII levels in clinically active disease. In addition to physical therapy, steroids are used most frequently, but other immunosuppressive agents and plasmapheresis have been tried in severely ill children. Rigorous evaluation of the efficacy of these modalities is needed. PMID- 3532005 TI - Scleroderma in childhood. AB - Scleroderma is a rare disease in children. Heterogeneous in its many forms, it ranges from circumscribed and self-limited pigmentary disorders to disabling and disfiguring involvement of an extremity. It also may include diffuse skin disease, multiple internal organ derangements, and a rapidly fatal outcome. Outcome varies widely and is related to the location and extent of cutaneous involvement, evaluation of disfigurement or impairment, and which treatment resources are available. PMID- 3532006 TI - Kawasaki syndrome. AB - Kawasaki's syndrome is an acute, largely self-limited multisystem vasculitis of childhood with prominent rheumatic complaints, involving both the heart and the joints. Although the etiologic agent has not been discovered, the evidence appears overwhelming that a microbial agent is the responsible trigger for this multisystem disease. Immunologically mediated phenomena appear to be important in the development of the significant complications of KS carditis, coronary vasculitis, and arthritis. Although truly effective therapy is not yet available, there is an exciting possibility that immunologic treatment may have beneficial effect. More effective preventive and therapeutic methods will become available when the elusive agent is discovered. PMID- 3532007 TI - The immunologic basis of lupus. AB - This article reviews the immunologic basis of systemic lupus erythematosus. It covers basic immunologic abnormalities, possible role of diet in autoimmune diseases, and the basis for specific abnormalities, such as renal and central nervous system disease. PMID- 3532008 TI - Community programs for children with rheumatic diseases. AB - There is an evident need for both qualitative and quantitative expansion of services to children with rheumatic or connective tissue diseases. These are necessary for diagnosis, amelioration, rehabilitation and reconstruction at the physical level. They are equally important for the development of appropriate and gratifying career and other biopsychosocial goals and for the achievement of them. Two model programs have been described. Such programs should be designed to accommodate local and regional conditions within the broad context of comprehensive care. Numerous governmental and private agencies are available to assist in this process, but it is still dynamic and evolutionary. PMID- 3532009 TI - Does nifedipine affect the diurnal variation of asthma in children? AB - Diurnal variations in airway caliber and in bronchial reactivity have been described. The mechanisms underlying these variations are not known. The hypothesis that these variations can be diminished by calcium channel blockers was tested by giving 22 asthmatic children 10 mg of nifedipine or identical placebo three times a day for 4 weeks in a double-blind, randomized, crossover designed study. Treatment with nifedipine did not diminish the diurnal variations in airway caliber, judged from peak expiratory flow rates, or in bronchial reactivity, judged from bronchodilator responsiveness. Group mean amplitude of the diurnal variation in airway caliber was 10.5% on nifedipine and 10.6% on placebo. Group mean amplitude of the diurnal variation in bronchodilator responsiveness was 75.4% on nifedipine and 69.5% on placebo. There were no differences in mean peak expiratory flow rate between nifedipine and placebo periods. This study did not find any evidence to support the hypothesis that the diurnal variations in airway caliber and in bronchial reactivity can be diminished by calcium channel blockers. PMID- 3532010 TI - Aerosolized metaproterenol compared to subcutaneous epinephrine in the emergency treatment of acute childhood asthma. AB - In a double-blind, randomized trial, we compared the effects of aerosolized metaproterenol to subcutaneous epinephrine in 35 episodes of acute asthma in children between 6 and 19 years of age. Patients were randomized to two parallel groups and then received both a placebo medication and an active medication to a maximum of three treatments. Repeated treatments were given to 15 patients on metaproterenol and 12 patients on epinephrine. Initial improvement in PEFR and FEV1 were statistically significant and comparable in both groups. Patients receiving a second metaproterenol treatment had more improvement in respiratory rate and clinical score compared with those in the epinephrine group. There were fewer treatment failures in the metaproterenol group. Followup at 24 to 48 hours showed significant treatment failure differences between the two groups (metaproterenol = 0, epinephrine = 5; p less than 0.05). Side effects were similar in both groups; in all instances they were mild, and their frequency did not increase in patients receiving repeated doses of medications. In conclusion, aerosolized metaproterenol was well tolerated in acute childhood asthma in repeated doses, and it appeared to be associated with prolonged bronchodilation and improved outcome. PMID- 3532011 TI - The potential value of a 750-ml spacer for the administration of inhaled corticosteroids to children. AB - An open, cross-over trial was conducted on 25 asthmatic children, aged 6-13 years, who required inhaled steroids. They inhaled Budesonide 200 micrograms twice daily, either directly from the metered dose inhaler or via the pear spacer (PS), for 2 months on each, in randomized order. The effects of the treatment were monitored with diary cards recording peak expiratory flow rates twice daily, symptoms and treatment taken, and with monthly clinical assessments including more sensitive lung function studies (flow-volume loops and single breath nitrogen wash-out tests). There was no specifically PS-related improvement in symptoms or in the majority of tests, but the results showed improvement with time when using either method. The improvement was more distinct in some tests reflecting proximal airway calibre (i.e., PEFR) than in tests thought to reflect predominantly peripheral airway calibre (i.e., F50, RV). The bronchodilator responsiveness, as shown by the increase in lung function tests after a beta agonist was given, was significantly greater for FVC during the periods when the PS was used, although there was no significant improvement in FEV2 or PEFR. The improvement in tests reflecting proximal airways may have been due to optimization of the inhalation technique, greater understanding of asthma, or better compliance with medication associated with regular attendance for the study. The greater bronchodilator response whilst children were inhaling budesonide by the PS may have been due to increased deposition or better distribution of the steroid but was probably related to a difference between the two groups in initial baseline function tests. PMID- 3532012 TI - Bronchial lavage in patients with cystic fibrosis: a critical review of current knowledge. PMID- 3532013 TI - Evaluation of the pediatric patient for liver transplantation. AB - In a 36-month period from 1981 to 1984, 209 pediatric patients were evaluated for liver transplantation. The purpose of the evaluation was to assess the severity and progression of the disease, anatomical suitability for transplantation, and psychosocial stability and to initiate family education. Of the 209 patients evaluated, 85 (41%) underwent transplantations and 64 (75%) survived at least 12 months. Thirty-four (16%) patients were not considered candidates for transplantation. The mean waiting period increased from 80.3 days to 232 days. Of 174 patients considered for transplantation, 41 (24%) died prior to surgery. A formal evaluation for liver transplantation permitted appropriate selection of candidates and provided education for informed consent. We also stress the need for greater participation in pediatric organ donation. PMID- 3532014 TI - Splenic trauma in the pediatric patient: the integrated roles of ultrasound and computed tomography. AB - Seven children who sustained splenic trauma were scanned by ultrasound and computed tomography (CT) or ultrasound and nuclear liver/spleen scan. All patients were managed conservatively and did not need abdominal surgery. On the initial sonogram, the majority of children had multiple areas of both increased and decreased echogenicity. Hematomas were followed to resolution in five of seven children and were usually multiple and hypoechoic prior to complete disappearance. On contrast-enhanced CT scans, areas of splenic hemorrhage appeared as low attenuation. Our small patient population demonstrates that, following an initial CT scan, sonography is helpful for sequential splenic imaging to show when the appearance of the spleen returns to normal. When correlated with the clinical information, such data are helpful to the clinician in determining when a child who has sustained splenic trauma may resume normal activity. PMID- 3532015 TI - Intracranial hemorrhage during extracorporeal membrane oxygenation in neonates. AB - Intracranial hemorrhage is a complication of extracorporeal membrane oxygenation for the treatment of neonatal respiratory failure. A retrospective review of 35 neonates treated with extracorporeal membrane oxygenation was performed; ten had intracranial hemorrhage. Infants with intracranial hemorrhage had lower birth weights and were gestationally younger than infants with intracranial hemorrhage. Eight of eight neonates of less than 35 weeks' gestational age sustained intracranial hemorrhage. Six died immediately after extracorporeal membrane oxygenation was stopped. Two lived less than 1 year. Two of 27 neonates older than 34 weeks' gestational age sustained intracranial hemorrhage. One child is normal, the other died at 18 months of age. Based on the results of this study, the risk of intracranial hemorrhage appears low in neonates of greater than 34 weeks' gestational age who undergo extracorporeal membrane oxygenation treatment for severe respiratory failure. The use of extracorporeal membrane oxygenation, as it is presently performed, is contraindicated in neonates of less than 35 weeks' gestational age because of the risk of intracranial hemorrhage. PMID- 3532016 TI - Reduced incidence of hyaline membrane disease in extremely premature infants following delay of delivery in mother with preterm labor: use of ritodrine and betamethasone. AB - Data from two groups of infants (24 to 28 weeks' gestational age) excluded from a controlled trial of the use of calf lung surfactant extract for the prevention of hyaline membrane disease are reported. The two groups were excluded from the trial because the mothers had received betamethasone for greater than 24 hours prior to delivery or because, on admission to the hospital, labor was too far advanced for proper informed consent to enter the trial. Attempts were made to delay delivery of threatened premature labor by the use of ritodrine in all mothers without evidence of infection, heavy vaginal bleeding, or severe preeclampsia and to induce surfactant production by maternal injection of betamethasone. A prospective scoring system and respiratory support variables were used to compare the groups. Infants born to mothers who successfully completed this regimen had a 28% incidence of hyaline membrane disease v a 68% incidence in infants in whose mothers it was unsuccessful due to inability to stop advanced labor (P = .001). Inspired oxygen, mean airway pressure, and ventilator rate were lower and the ventilator efficiency index was higher in the treated group during the first 48 hours of life. An aggressive approach to postpone premature delivery and to induce surfactant production by using tocolysis and a regimen of glucocorticoids reduces the incidence of hyaline membrane disease in very premature infants, 24 to 28 weeks' gestation. PMID- 3532017 TI - Emotional and health impact of home monitoring on mothers: a controlled prospective study. AB - The psychologic and health effects of home monitoring were evaluated in mothers, whose infants (epidemiologically not at high risk for sudden infant death syndrome) were placed on electronic surveillance because of results obtained from a laboratory sleep study conducted at 4 weeks of age. Mothers of these infants were studied prospectively at several periods following the infants' births: 6 weeks, 12 weeks, and 1 year. The initial sample consisted of 56 mothers. Evaluation procedures included the Neonatal Perception Inventories, Anxiety Inventory (State and Trait), Depression Inventory, Brief Symptom Inventory, and a Recent Life Changes Questionnaire. The results obtained from these women were compared with those of women who had delivered at about the same time but whose infants were not placed on a home monitoring program. A total of 57 women started in the control group. Very few statistically significant group differences were observed between the two subject groups: 2 weeks after initiating the home monitoring program, monitor mothers (when compared to nonmonitor mothers) perceived their infant's behavior differently (although not more bothersome) and had an increased degree of situational anxiety (although not to an abnormal degree). There were no statistically significant differences between the two groups 12 weeks or 1 year after giving birth. These results suggest that a home monitoring program, which includes an aggressive and readily available support system, does not impose a marked health hazard to mothers. PMID- 3532018 TI - Alternative treatment to tracheostomy in obstructive sleep apnea syndrome: nasal continuous positive airway pressure in young children. AB - Two groups of prepubertal children with severe obstructive sleep apnea syndrome received continuous positive airway pressure (CPAP) treatment using a nasal mask. The five children in group A had nasal CPAP only in a hospital setting; the five children in group B received the treatment at home as well. Four of these five children, who have now been followed for as long as 10 months, have adapted well to the treatment at home. The problems encountered with nasal CPAP as a home treatment, such as poor cooperation from parents, allergic rashes, eye irritation resulting from air leaks, are discussed. Despite the problems, nasal CPAP is a valid alternative to tracheostomy in children as young as 3 years of age. PMID- 3532019 TI - Access to ambulatory care services for economically disadvantaged children. AB - Using data from the 1981 Child Health Supplement to the National Health Interview Survey, we examined differences in access to ambulatory services for children of different family incomes. The results indicate that much progress has been made in equalizing access since the War on Poverty was initiated in the mid-1960s. Poor children with superior health status now generally see physicians at the same rates as children in similar health but from higher income families. However, children with substantial health problems from low-income families continue to lag behind their higher income counterparts in similar health. Medicaid was shown to substantially improve access to ambulatory services for economically disadvantaged children in poor health, but less than half of these children are covered by Medicaid. Recent changes in federal and state policies concerning Medicaid are discussed as well as policy options for addressing the needs of children afflicted by both poverty and ill health. PMID- 3532020 TI - Renal ultrasound evaluation of urinary tract infections in children. AB - Ultrasonography of the kidney may replace the intravenous pyelogram as the study of choice in identifying treatable abnormalities in children with urinary tract infection. In a series of 64 consecutive children with urinary tract infection in whom an intravenous pyelogram, renal ultrasound, and voiding cystogram were performed, only one treatable abnormality (calyceal dilation) was identified by intravenous pyelogram, and it was not detected by ultrasound. Eleven children showed vesicoureteral reflux on the cystogram. In an additional 43 children in whom intravenous pyelogram was done only if the ultrasound or cystogram were abnormal, there were five abnormal cystograms. Four treatable abnormalities were identified by ultrasound, and there were confirmed by the intravenous pyelogram. Ultrasound should replace the intravenous pyelogram in children with a normal cystogram because of its accuracy, safety, and high patient acceptance. We have also documented a significant volume increase with acute infection in one or both kidney(s) of those children having upper urinary tract infection. Fifteen of 18 children with upper urinary tract infection had volume increases of 30% or more in at least one kidney; whereas only four of 21 children with lower urinary tract infection had increases of greater than 30% (P less than .005). Ultrasound volume measurements provide a new, noninvasive method for identifying the probable site of urinary tract infection. PMID- 3532021 TI - Prenatal diagnosis of urinary tract abnormalities by ultrasound. AB - The capacity of a general ultrasound screening program to detect fetal malformations affecting the urinary tract was evaluated in an epidemiologic study. A total of 11,986 pregnant women, representing 97% of the pregnant population in Malmo, Sweden, from April 1978 through August 1983 were examined. On routine examinations performed by midwives in the 17th and 33rd gestational weeks, the fetal anatomy was carefully surveyed. The overall frequency of fetal malformations was 0.5%, with urinary tract abnormalities representing approximately 50% of the total number. In 20 of 33 cases, the ultrasound findings were those of hydronephrosis or hydroureter. In ten cases, a cystic renal malformation was found, and the remaining three cases represented double renal pelvis, Potter syndrome, and posterior urethral valve. A total of 28 abnormalities were unilateral and five bilateral. No case of unilateral absence of renal tissue was noted prenatally. Prenatal diagnosis of urinary tract abnormalities known to precipitate neonatal urosepsis and subsequent renal scarring and other complications makes it possible to start an early antibiotic prophylaxis regimen. A complete workup of the infants can be started early and before life-threatening complications occur. PMID- 3532022 TI - Shigella and child abuse. PMID- 3532023 TI - [Diagnostic value of the analysis of C-reactive protein in childhood pathology]. PMID- 3532024 TI - [Combined treatment of hypoplastic idiopathic conditions of hematopoiesis in children]. PMID- 3532025 TI - [Clinical course of hypoplastic anemia in children after administration of allogeneic bone marrow]. PMID- 3532026 TI - [Bronchospasmolytics in the therapy of bronchial asthma in children]. PMID- 3532027 TI - [Experimental and clinical studies of non-ionic isoosmolality contrast medium (iohexol 140)--II. IADSA in clinical practice]. PMID- 3532028 TI - [Efficacy of angiographic technic for abdominal trauma--the significance of vascular catheterization in diagnosis and hemostasis]. PMID- 3532029 TI - [Evaluation of the diagnostic efficacy of ultrasound examination for hepatic, biliary system and pancreatic diseases]. PMID- 3532030 TI - Control of cell division in Escherichia coli. DNA sequence of dicA and of a second gene complementing mutation dicA1, dicC. AB - A mutation in a gene dicA of Escherichia coli leads to temperature-sensitive cell division, by allowing expression of a nearby division inhibition gene dicB (1). We have now established the sequence of the DicA region and identified DicA as a 15.5 KD protein. A second gene dicC transcribed divergently from dicA and coding for an 8.5 KD protein can also complement mutation dicA1 when provided on a multicopy plasmid. PMID- 3532031 TI - Promoter selectivity of Escherichia coli RNA polymerase: alteration by fMet tRNAfMet. AB - An in vitro mixed transcription system was employed to examine the possible alteration of the promoter selectivity of Escherichia coli RNA polymerase by specific tRNAs. Transcription in vitro was inhibited by most of the tRNAs examined, although the extent of the inhibition differed with the tRNA species. The inhibition by tRNAs was due to competition with DNA for binding RNA polymerase. This inhibitory effect remained after charging of the tRNAs with amino acids. The charging of tRNAfMet with fMet, but not with Met, abolished its inhibitory effect, and instead gave a stimulatory effect on the transcription from some promoters. These observations suggest that fMet-tRNAfMet plays a specific regulatory role in the coupling of transcription to translation. PMID- 3532033 TI - Nucleotide sequence of the gene responsible for D-xylose uptake in Escherichia coli. AB - The nucleotide sequence of the cloned DNA, 363 bp in length, has been determined. It can complement the mutation of Escherichia coli having a decreased activity of D-xylose uptake at low temperature. Nucleotide sequence analysis found one possible reading frame coding for a polypeptide consisting of 61 amino acids. Several signal sequences conserved in the promoter regions of E. coli were found in the upstream regions of the open frame. This included the Shine-Dalgarno sequence, the Pribnow box, and the sequence conserved in the "-35 region" with a preferable spacing from each other for an efficient transcription. Downstream from the termination codon, the inverted repeat sequence was present, followed by 3 successive T's. PMID- 3532032 TI - Chemical and functional characterization of an altered form of ribosomal protein S4 derived from a strain of E. coli defective in auto-regulation of the alpha operon. AB - We have isolated a mutant form of Escherichia coli ribosomal protein S4. This mutant is temperature sensitive and apparently fails to autogenously regulate the gene products of the alpha operon, which consists of the genes for proteins S13, S11, S4, L17, and the alpha subunit of RNA polymerase (1). We have shown that this mutation results in the production of an S4 protein with a molecular weight approximately 4,000 daltons less than the wild-type protein. Our chemical analyses demonstrate that the mutant protein is missing its C-terminal section consisting of residues 170-203. However, our studies to determine the capacity of this mutant protein to bind 16S RNA show that this protein is unimpaired in RNA binding function. This observation suggests that the functional domain of protein S4 responsible for translational regulation of the S4 gene products requires more of the protein than the 16S RNA binding domain. PMID- 3532034 TI - Cloning and expression of a cDNA encoding a maize glutathione-S-transferase in E. coli. AB - The isolation and characterization of a family of maize glutathione-S transferases (GST's) has been described previously. These enzymes are designated GSTs I, II and III based on size, substrate specificity and responsiveness to safeners. GST III has been shown to act on the herbicide alachlor as well as the commonly used substrate 1-chloro-2,4-dinitrobenzene (CDNB). Clones were isolated from a maize cDNA library in lambda gt10. Three clones contained the entire coding region for GST III. The sequences of these clones were consistent with the known amino terminal GST III protein sequence. Moreover, expression of one of these clones in E. coli resulted in a GST activity as measured with both CDNB and alachlor, proving that at least one of the clones encodes an active GST III species. With the enzyme expressed in E. coli it will become possible to study enzyme structure-function relationships ex planta. While a number of different GST proteins are present in maize tissue the GST III gene is present in single or low copy in the genome. PMID- 3532035 TI - A YIp5-kanr plasmid useful for isolating ars from yeast and other eukaryotes based on G418 resistance selection. PMID- 3532036 TI - Tumor markers as target substances in the radioimmunologic detection of malignancies. AB - Although none of the known tumor markers, including the relatively new ones characterized by monoclonal antibodies, are sufficiently sensitive or specific as to be useful in the primary diagnosis of incipient malignancies, many of them turned out, nevertheless, to be of great clinical importance: their main field of interest lies in the surveillance of the already diagnosed patient in the post operative phase. More recently some of them, e.g. tumor proteins like CEA and AFP, hormones (HCG), some enzymes, and monoclonal antibody-characterized membrane components, are used also as target antigens for the radioimmuno-detection (RAID) of carcinomas and their metastases. Most of the tumor marker antigens were already successfully used as targets for tumor imaging with radiolabelled antibodies; however, many immunological and technical problems still remain to be resolved. PMID- 3532037 TI - [Diagnostic use of radioactive aerosols in pulmonology]. PMID- 3532038 TI - [Production of radioactive aerosols]. PMID- 3532039 TI - Computing in nursing. Computerised patient assessment. PMID- 3532040 TI - Health visitors: birthday honours. PMID- 3532041 TI - Wound care. Make haste slowly. PMID- 3532042 TI - Temporary restorations: a review. PMID- 3532043 TI - Effects of 15 vs 60 second enamel acid conditioning on adhesion and morphology. PMID- 3532044 TI - [Effect of hydrochlorothiazide treatment on the secretion of insulin, glucagon and pancreatic polypeptide in patients with arterial hypertension]. PMID- 3532045 TI - [Bacterial adherence]. PMID- 3532046 TI - [Selected problems of peritoneal transport and the possibilities of increasing the effectiveness of standard peritoneal dialysis]. PMID- 3532047 TI - [Captopril--mechanisms of action and its use in the treatment of arterial hypertension]. PMID- 3532048 TI - The amebic meningoencephalitides. PMID- 3532049 TI - Transfer of Typhimurium from tigers to a toddler. PMID- 3532050 TI - Incubation period necessary to detect bacteremia in neonates. PMID- 3532051 TI - Trimethoprim-sulfamethoxazole therapy of neonatal Proteus mirabilis meningitis unresponsive to cefotaxime. PMID- 3532052 TI - Localized cryptococcal osteomyelitis in an immunocompetent host. PMID- 3532053 TI - Neuropeptide processing activity in Aplysia bag cell homogenates. AB - The neurosecretory bag cells of the mollusk, Aplysia, generate a peptide egg laying hormone (ELH) from a 29,000 Dalton precursor protein by proteolytic cleavage to a 6-9,000 Dalton intermediate, followed by cleavage of the intermediate. We report here the initial characterization of these cleavage activities. Homogenates of bag cells in low ionic strength buffer process endogenous precursor to a peptide which is indistinguishable from ELH in molecular weight and isoelectric point. Non-specific proteolysis in the homogenates is not detectable. The pH optimum for cleavage of the precursor and the intermediate is 5.5-6.5. The cleavage activities exhibit a substantial degree of membrane association, and the inhibitor profile of each is characteristic of a thiol protease without a metal cofactor requirement. Precursor cleavage activity differs from that of the intermediate cleaving activity in inhibitor profile, solubility, and slightly, in pH optimum. PMID- 3532054 TI - The endogenous tripeptide Tyr-Gly-Gly as a possible metabolite of opioid peptides in rat brain: identification, regional distribution, effects of lesions and formation in depolarized slices. AB - Using a sensitive radioimmunoassay, the tripeptide Tyr-Gly-Gly (YGG) which corresponds to the N-terminal sequence of opioid peptides was detected in rat brain and identified by HPLC. Its regional distribution paralleled that of (Met5)enkephalin (YGGFM), a marker of enkephalin neurons. Ablation of these neurons in the striato-pallidal pathway by intrastriatal kainate, induced a significant decrease in YGG levels in caudateputamen and globus pallidus (-49%), consistent with the hypothesis that YGG originates from enkephalin neurons. When pallidal slices were incubated under various conditions, YGG was mainly found in the incubation medium indicating a predominantly extracellular localization. Depolarization of these slices by a K+-stimulus elicited a release of YGGFM accompanied by a marked increase in YGG levels. Bestatin and amastatin further enhanced YGG levels, reflecting the participation of aminopeptidases in the metabolism of the tripeptide and its precursor. Captopril, an inhibitor of the angiotensin-converting enzyme (ACE) showed no effect on the recovery of YGGFM and YGG. In contrast, the formation of YGG was completely prevented by Thiorphan (IC50 value = 9 nM) and phosphoramidon, two inhibitors of "enkephalinase" (EC 3.4.24.11; membrane metallo-endopeptidase), thus identifying the latter as the YGG-forming enzyme. The K+-induced increase in YGG + YGGFM levels in medium containing bestatin exceeded by about 60% the amount of YGGFM released from tissues, suggesting that YGG was mainly formed by extracellular hydrolysis of the various opioid fragments of the proenkephalin molecule. In vivo, YGG levels of cerebral regions were also markedly reduced in rats treated with acetorphan, a parenterally active "enkephalinase" inhibitor. All data suggest that YGG levels constitute an index of opioid peptide release. PMID- 3532055 TI - Norepinephrine stimulates LH-RH secretion into the hypophysial portal blood of the rat. AB - The present study was designed to investigate the effect of intracerebroventricular infusion of norepinephrine (NE) on the secretion of luteinizing hormone-releasing hormone (LH-RH) into the hypophysial portal blood of steroid-primed ovariectomized rats. Saline infusion into the third ventricle caused no significant change in LH-RH levels. NE infusion (20 micrograms) resulted in a significant release of LH-RH (p less than 0.05) into the portal blood 10-30 min later. This endogenous LH-RH was similar to synthetic LH-RH when characterized by thin-layer chromatography. LH secretion in similarly treated rats but with intact portal vessels, also was significantly elevated (p less than 0.05) at 20 and 40 min after the start of NE infusion. These results show that NE stimulated the secretion of LH-RH into the hypophysial portal blood and this correlated with an enhanced release of LH. PMID- 3532056 TI - [Carcinogenic and immunomodulatory properties of chromium]. PMID- 3532057 TI - [Effect of benzene on the body in the light of genetic studies]. PMID- 3532058 TI - [Ultrasonographically-guided thin-needle biopsy in the diagnosis of focal changes in the liver]. PMID- 3532059 TI - [Imaging methods in the differential diagnosis of cholestatic jaundice]. PMID- 3532060 TI - [Role of magnesium, cadmium and zinc in the pathogenesis of primary arterial hypertension]. PMID- 3532061 TI - [Role of serotonin in the pathogenesis of arterial hypertension]. PMID- 3532062 TI - [Advances in the pharmacological treatment of arterial hypertension]. PMID- 3532063 TI - [Evaluation of the passive hemagglutination test in the localization of asymptomatic bacteriuria in pregnant women]. PMID- 3532064 TI - [A case of 5-month ovarian pregnancy]. PMID- 3532065 TI - Primary non-Hodgkin's lymphomas of the central nervous system. AB - Thirty-five primary non-Hodgkin's lymphomas (NHL) of the central nervous system (CNS) were examined in a retrospective study and classified according to the Kiel classification. Diagnosis was made on surgical biopsies in 28 cases and on autopsy specimens in seven cases. The tumors were predominantly located in the frontal lobe and were unifocal in all but two cases. Patients ranged in age from seven to 74 years, with a male-female ratio of 1.3:1. The lymphomas were probably all of B cell type. In contrast to NHLs of the lymph nodes, the NHLs of the CNS we encountered were more often high grade (immunoblastic, lymphoblastic) than low grade malignant. All but one low grade malignant NHL found in our study were lymphoplasmacytoid (LP) immunocytomas. PMID- 3532066 TI - What's new in cellular cation exchange and humoral factors in primary hypertension? AB - In essential hypertension abnormalities of cellular Na+ and Ca++ handling have been described. The latter disturbance probably offers an explanation for the increased vasoconstriction in essential hypertension. The etiology of those disturbances in cellular Na+ and Ca++ metabolism may be related to genetic disturbances of membrane transport, or to a humoral factor influencing cellular cation metabolism. PMID- 3532067 TI - What's new in transplacental carcinogenesis? AB - The discovery that a non-steroidal oestrogen may cause malformations and neoplasia following transplacental administration in man has led to a considerable amount of experimental work on this type of carcinogenesis. In general, there are a number of features which suggest that this is unlikely to be a commonly occurring mode of carcinogenesis in man and the reasons for this are discussed and considered here together with some experimental justification for this position. PMID- 3532068 TI - Professor Roman Jozef Rembiesa. PMID- 3532069 TI - Fluorides and fluorosis in Kenya. Part II: The occurrence of dental and skeletal fluorosis. PMID- 3532070 TI - [Immunopathology and clinical aspects of acquired immunodeficiency syndrome (AIDS)]. PMID- 3532071 TI - [Effect of lead on the hematopoietic system with reference to environmental and occupational exposure]. PMID- 3532072 TI - [Possible mechanisms of activation of the cellular myc gene in Burkitt's lymphoma]. PMID- 3532073 TI - [Monoclonal antibodies against hematopoietic stem cells]. PMID- 3532074 TI - [Benzene and the hematopoietic system in humans]. PMID- 3532075 TI - [Biochemical aspects of alcoholism. III. The effect of acetaldehyde on cellular metabolism]. PMID- 3532076 TI - [Cellular mechanisms of bile production]. PMID- 3532077 TI - [Zinc metabolism in patients with chronic uremia]. PMID- 3532078 TI - Noninvasive testing for carotid artery atherosclerosis. A key role in diagnosis of stroke. PMID- 3532079 TI - Straub Clinic and Hospital. Hawaii's healthcare innovator. PMID- 3532080 TI - Thromboembolism after hip surgery. Comparison of screening methods. AB - Venous thromboembolism is a serious and, often, asymptomatic complication of hip surgery. A reliable screening test is needed to detect thrombi early to prevent death from pulmonary emboli. Noninvasive screening tests were ineffective in our study of 453 patients. We recommend early use of ventilation/perfusion lung scanning in all patients after hip surgery. In those who have positive results, ascending venography can be used to localize the thrombus and anticoagulation therapy can be started early. PMID- 3532081 TI - Pleural effusions. 1. Preliminary evaluation--recognition of the transudate. AB - Part 1 of this two-part article describes how to document the presence and location of pleural effusion, perform thoracentesis, and differentiate transudates from exudates. If the pleural fluid is found to be a transudate, no further tests are indicated. Part 2, starting on page 181, details pleural fluid analysis, describes pleural biopsy and thoracoscopy, and presents a clinical strategy for evaluating pleural effusion. PMID- 3532083 TI - Tuberculosis and renal transplantation--observations from an endemic area of tuberculosis. AB - Ninety-five renal transplant recipients from an endemic area of tuberculosis were investigated to find out the prevalence and course of tuberculosis in pre- and post-transplant periods. Eleven patients had tuberculosis in the pre-transplant period - pulmonary (2), pleural (2), miliary (1), abdominal (2), lymph node (5) and pericardial (1). They were transplanted after antituberculous therapy of 3 to 6 months with satisfactory results. The anti-tuberculous treatment was usually continued for 2 years. Only one of the above 11 patients had evidence of tuberculosis in the post-transplant period. Nine patients developed tuberculosis for the first time in the post-transplant period - pulmonary (4), pleural (1), miliary (1), lymph node (4) and pericardial (1). There was no mortality due to tuberculosis. Thorough search for tuberculosis is mandatory both during pre transplant assessment and post-transplant follow-up in areas of endemic tuberculosis. PMID- 3532082 TI - The restless legs syndrome. PMID- 3532084 TI - Pneumonia. PMID- 3532085 TI - Hypoglycaemia and cerebral malaria. AB - A patient with severe hypoglycaemia complicating cerebral malaria is reported. No other recognized cause of hypoglycaemia was detected during life or at autopsy. This case adds to the existing evidence that, through several possible mechanisms, cerebral malaria can give rise to life-threatening hypoglycaemia. PMID- 3532086 TI - [Review of etiological factors in the formation of denticles (literature review)]. PMID- 3532087 TI - Carnitine: an overview of its role in preventive medicine. AB - Carnitine (beta-hydroxy-gamma-N-trimethylaminobutyric acid) is required for transport of long-chain fatty acids into the inner mitochondrial compartment for beta-oxidation. Widely distributed in foods from animal, but not plant, sources, carnitine is also synthesized endogenously from two essential amino acids, lysine and methionine. Human skeletal and cardiac muscles contain relatively high carnitine concentrations which they receive from the plasma, since they are incapable of carnitine biosynthesis themselves. Since the discovery of a primary genetic carnitine deficiency syndrome in 1973, carnitine has become the subject of extensive research. It is now recognized that carnitine deficiency may also occur secondary to genetic disorders of intermediary metabolism as well as to a variety of clinical disorders, including renal disease treated by hemodialysis, the renal Fanconi syndrome, cirrhosis, untreated diabetes mellitus, malnutrition, Reye's syndrome, and certain disorders of the endocrine, neuromuscular, and reproductive systems. Administration of the anticonvulsant valproic acid and total parenteral nutrition may also induce hypocarnitinemia. In many instances, the physiological implications of secondary carnitine deficiency have not been resolved. However, evidence for a specific carnitine requirement for the newborn, especially if preterm, is accumulating. Moreover, carnitine administration may have a favorable effect on some forms of hyperlipoproteinemia. Carnitine, now recognized as a conditionally essential nutrient, is a significant factor in preventive medicine. PMID- 3532088 TI - [Aspartase activity of Escherichia coli, strain 85, cells grown on glucose mineral medium with yeast extract]. AB - The conditions for cultivation of E. coli 85 on a glucose-mineral medium with a yeast extract were optimized. The cells obtained had a high aspartate ammonia lyase activity. The aspartase activity was determined kinetically both by consumption of the substrate, ammonium fumarate, and by accumulation of the product, aspartic acid. PMID- 3532089 TI - [Chemical mutagenesis and the use of indirect enzymatic criteria for the selection of virulent clones of Bacillus thuringiensis]. AB - The effect of the mutagene nitrosoguanidine (N-methyl-N'-nitro-N nitrosoguanidine) on the growth of Bacillus thuringiensis subsp. galleriae st. 69/6 was being studied. It depends on the physiological state of the cells, dose of the mutagene, pH of the culture medium and exposition. Nitrosoguanidine was found to have the maximum mutagenic effect on the vegetative cells at pH 6.2 and on the spores at pH 5.6. PMID- 3532090 TI - [Effect of various factors on the biosynthesis of alkaloids in a culture of Claviceps CP II]. AB - The effect of a carbohydrate medium component, aeration, tryptophane and Tween additions on the biosynthesis of alkaloids by Claviceps CP II was being studied. The quantity of synthesized alkaloids and the composition of produced alkaloids depended on the nature of the carbohydrate and its concentration. A few alkaloids were accumulated on media containing xylose, lactose and glucose, whereas active production of alkaloids was observed when galactose maltose, sucrose and sorbit were used. Intensified aeration and introduction of Tween-80 and Tween-40 resulted in an increased alkaloid yield. Exogenous tryptophane had slight stimulatory effect on alkaloid production. PMID- 3532091 TI - [Changes in the level of Krebs cycle metabolites in the brain tissue in the hypoglycemic nervous syndrome]. AB - Different levels of pyruvate, citrate and alpha-ketoglutarate were investigated in the brain tissue of white rats exposed to insulin-induced coma or in various periods following its glucose-cutting. The emergence of pronounced hypoglycemic nervous disorders was followed by a significant decrease in the content of all mentioned acids. Glucose arrest of insulin-caused coma took place in the presence of inactive initial stages of Krebs cycle (citrate synthesis). Restoration of hypoglycemia-affected brain functions had no correlation with the activated citrate synthesis. The levels of citrate and alpha-ketoglutarate normalized 15 minutes after glucose injection and the pyruvate level augmented 30 minutes after the drug administration. It was suggested that the glucose arresting effect demonstrated in insulin coma was conditioned by transformations in glucose carbon lattice regarding pyruvate carboxylising into oxalacetate with further inclusion into brain amino acids and peptides. PMID- 3532092 TI - [The angiotensin-forming system of the brain and the regulation of water electrolyte metabolism and hemodynamics]. PMID- 3532093 TI - Overview of strategic planning: impact on operating room nursing (continuing education credit). PMID- 3532094 TI - Planning your wellness: personalized strategies for the perioperative nurse (continuing education credit). PMID- 3532095 TI - Intraoperative ultrasound of the brain and spinal cord. PMID- 3532096 TI - Chirurgery: an ethical commentary on surgical technology and the allocation of surgical resources (continuing education credit). PMID- 3532097 TI - [Physical development and the status of the hormonal system in adolescents with various clinical forms of tuberculosis]. PMID- 3532098 TI - Diagnosis, screening, and 'demoralization': epidemiologic implications. AB - The Dohrenwends have associated psychiatric screening instruments with Frank's concept of 'demoralization' through negative evidence of the criterion validity of the instruments for identifying 'diagnosable mental disorders'. New evidence from the Stirling County Study is given to suggest that absence of validity stems from symptom-enumerative scoring procedures and that concordance with clinical judgment is improved by employing diagnostic algorithms. The concepts of diagnosis and 'demoralization' are discussed, and the history of screening instruments is reviewed. It is suggested that, while 'demoralization' may be a useful concept for clinicians, it poses serious drawbacks for epidemiological research because of the assumptions it involves about etiology and outcome. PMID- 3532099 TI - Quantitative analysis of speech behavior of depressed patients under a drug therapy. AB - Reduced speech activity is an important nonverbal symptom of retarded depressions. But speech patterns are also related to many other factors. Under an antidepressive drug treatment the speech behavior could be influenced not only by the therapeutic improvement but also by special pharmacological side effects. In a double-blind trial 21 endogenously depressed inpatients were treated with amitriptyline or pirlindol. Diagnostic interviews with the patients were recorded on TV-tapes on day 0, 4, 7, 14, 21 and 28. To investigate the psychopathological changes the tapes were analyzed under time-blind conditions. The AMP documented results of these ratings showed significantly better therapeutic effects in the amitriptyline-group than in the pirlindol-group. To study speech variables the tapes were computer analyzed. After 4 weeks the degree of improvement in the total group of patients was significantly correlated with the reduced length of speech pauses of both patients and interviewers. On the other hand remarkable drug influences in the course of speech variables were found. These could be interpreted as specific pharmacological effects. PMID- 3532100 TI - Pervasive developmental disorders and immunological tolerance. AB - A wide range of studies in man and other species suggest that early compromise of immunological tolerance (both maternal-fetal and self) may lead to severe and varied cognitive deficits. This article briefly reviews what is known of the genesis and maintenance of normal tolerance and current ideas on pathological deviances in tolerance. These ideas are discussed in relation to risk factor, family, twin, biochemical, anatomical, and immunological studies of pervasive developmental disorders (particularly infantile autism). A range of immunological injury hypotheses for the genesis of the pervasive developmental disorders are considered and technical problems in deciding among them are presented. PMID- 3532101 TI - Depression and cancer. AB - Depression appears to be a frequent complication of neoplastic disease. Recent surveys suggest that it is not only a common reason for psychiatric referral but that a substantial minority of hospitalized cancer patients suffer from an affective disturbance severe enough to warrant psychiatric intervention. In view of its reported prevalence it is likely that this complication adversely affects the quality of patients' lives and interferes with the management of their disease. Given the nature of this problem it is disturbing that so little systematic research has been done, especially in the area of treatment. In this article we critically review the literature concerned with the relationship of depression to cancer. We begin with comment on the nature of the association between cancer and depression and the question of whether depression is an etiologic factor in neoplastic disease. Before considering the prevalence of affective disorders among cancer patients, we examine the difficulty of diagnosing depression in seriously ill patients. Next, we explore the role of various psychological and biological factors in the etiology of this complication and, finally, we offer recommendations for treatment and suggest directions for future research. PMID- 3532102 TI - High-level expression of enzymatically active human Cu/Zn superoxide dismutase in Escherichia coli. AB - Expression of human Cu/Zn superoxide dismutase (SOD) with activity comparable to the human erythrocyte enzyme was achieved in Escherichia coli by using a vector containing a thermoinducible lambda PL promoter and a beta-lactamase-derived ribosomal binding site. The recombinant human SOD was found in the cytosol of disrupted bacteria and represented greater than 10% of the total bacterial protein. The enzyme was purified to homogeneity by salt precipitation, gel filtration chromatography, and ion exchange chromatography. The active enzyme was obtained in high yield only when 1 mol of copper and 1 mol of zinc were incorporated into each mol of subunit during bacterial growth or by reconstitution of the apoenzyme. Human Cu/Zn SOD produced in bacteria has an apparent subunit molecular mass of 19 kDa on NaDodSO4/polyacrylamide gels. The native enzyme behaves as a dimer of 32 kDa as determined by gel filtration. Sequence analysis of the NH2 terminus revealed that the first 14 amino acids corresponded to authentic human SOD except that the NH2-terminal alanine was not acetylated. Thus, the bacterial processing system readily removes the NH2 terminal methionine residue from recombinant human SOD. PMID- 3532103 TI - Restoration of flagellar clockwise rotation in bacterial envelopes by insertion of the chemotaxis protein CheY. AB - When cells of the bacterium Salmonella typhimurium are incubated with penicillin and lysed in a dilute buffer, flagellated cytoplasm-free envelopes are formed. When the envelopes are tethered to glass by their flagella and then energized, some of them spin. The direction of rotation of wild-type envelopes is exclusively counterclockwise (CCW). We perturbed this system by including in the lysis medium (and hence in the envelopes) the chemotaxis protein CheY. As a result, some of the envelopes rotated exclusively clockwise (CW). The fraction of envelopes that did so increased with the concentration of CheY; at a concentration of 48 microM (pH 8), all functional envelopes spun CW. The fraction also increased with the pH of the lysis medium in the range of 6.6-8.4. The results were the same in the presence or absence of intracellular Ca2+. Reconstituted envelopes failed to respond to chemotactic stimuli. None of them changed the direction of their rotation. However, when the intracellular pH was lowered to 6.6 or below, envelopes that spun CW stopped rotating, while envelopes that spun CCW continued to rotate. This phenomenon was reversible. We conclude that CheY per se, without any additional free cytoplasmic mediators, interacts with a switch at the base of the flagellum to cause CW rotation. PMID- 3532104 TI - Oligonucleotide-directed double-strand break repair in plasmids of Escherichia coli: a method for site-specific mutagenesis. AB - A DNA double-strand break can be efficiently repaired in Escherichia coli if an oligodeoxyribonucleotide is provided to direct the repair. The oligonucleotide must be at least 20 residues long and have a sequence identical to sequences flanking the break. The phenomenon can be used to introduce defined mutations into DNA in the area of a double-strand break. To obtain mutants, the oligonucleotide that carries a mutation and the denatured linearized plasmid DNA are introduced into E. coli by transformation. No enzymatic manipulation in vitro is required. The mutants can constitute up to 98% of the total number of transformants obtained. The efficiency of mutagenesis decreases as the distance between the mutation and the plasmid cleavage site increases. The universality of the method was tested by introducing mutations into four genes, using four plasmids and three E. coli strains, as well as eight restriction enzymes to linearize DNA. Several models of the oligonucleotide-directed DNA double-strand break repair are discussed. PMID- 3532105 TI - Isolation and characterization of a cDNA encoding a human liver/bone/kidney-type alkaline phosphatase. AB - Alkaline phosphatases (ALPs) [orthophosphoric-monoester phosphohydrolase (alkaline optimum), EC 3.1.3.1] isolated from human liver, bone, and kidney (L/B/K) exhibit very similar biochemical and immunologic properties that differentiate them from other human ALPs, such as those characteristically found in placenta and intestine. Despite their similarities, the L/B/K ALPs produced in different tissues show slight physical differences. To examine structural and evolutionary relationships between the various ALPs, a cDNA corresponding to L/B/K ALP mRNA has been isolated. A lambda 11 cDNA expression library was constructed using poly(A) RNA from the osteosarcoma cell line Saos-2 and screened with anti-liver ALP antiserum. The 2553-base-pair cDNA contains an open reading frame that encodes a 524 amino acid polypeptide with a predicted molecular mass of 57.2 kDa. This ALP precursor protein contains a presumed signal peptide of 17 amino acids followed by 37 amino acids that are identical to the amino-terminal sequence determined from purified liver ALP. In addition, amino acid sequences of several CNBr peptides obtained from liver ALP are found within the cDNA-encoded protein. The deduced L/B/K ALP precursor polypeptide shows 52% homology to human placental ALP and 25% homology to Escherichia coli ALP precursor polypeptides. Sixty percent nucleotide homology exists between the human L/B/K and placental cDNAs over the protein coding regions. The 5' and 3' untranslated regions of the L/B/K ALP cDNA, 176 and 805 base pairs, respectively, show no homology to the corresponding regions of placental ALP cDNA. PMID- 3532106 TI - Isolation of an episomal yeast gene and replication origin as chromatin. AB - A multicopy yeast plasmid containing the TRP1 gene (coding for N-5' phosphoribosylanthranilate isomerase) and ARS1 (autonomously replicating sequence 1) has been purified as chromatin. Electrophoretic analysis of nucleic acid and proteins and electron microscopy show that the plasmid chromatin is largely free of contaminants. Electron-microscopic and linking-number analyses indicate that the plasmid chromatin contains seven nucleosomes, as predicted by the indirect end-label analyses of Thoma, Bergman, and Simpson [J. Mol. Biol. (1984) 177, 715 733]. Indirect end label mapping of micrococcal nuclease cuts demonstrates that nucleosome positions and nuclease-sensitive regions are not altered by the purification. The plasmid chromatin behaves homogeneously with respect to its elution from nuclei, template activity, and intrinsic buoyant density. Taken together, these observations suggest that different copies of the TRP1ARS1 plasmid do not differ from each other grossly in chromatin structure. We discuss the potential for understanding eukaryotic gene regulation offered by the ability to isolate unique genes as chromatin. PMID- 3532107 TI - Structural evidence that endothelial cell growth factor beta is the precursor of both endothelial cell growth factor alpha and acidic fibroblast growth factor. AB - Two endothelial cell growth factors (ECGF) have been purified from bovine brain and termed alpha- and beta-ECGF [Burgess, W. H., Mehlman, T., Friesel, R., Johnson, W. V. & Maciag, T. (1985) J. Biol. Chem. 260, 11389-11392]. Amino acid sequence analysis indicates that beta-ECGF represents a 20 amino acid amino terminal extension of alpha-ECGF and a 14 amino acid amino-terminal extension of acidic fibroblast growth factor. These data indicate that both alpha-ECGF and acidic fibroblast growth factor may be derived from beta-ECGF by posttranslational processing. Analysis of the amino-terminal 14 residues of beta ECGF by fast-atom-bombardment mass spectrometry established the amino acid sequence of this region and the identity of the blocking group at the amino terminus (acetyl). PMID- 3532108 TI - A cell surface desmosome-associated component: identification of tissue-specific cell adhesion molecule. AB - Autoantibodies in the serum of patients suffering the blistering skin disease pemphigus vulgaris recognize a 140-kDa glycoprotein (GP) present in enriched fractions of bovine tongue epidermal desmosomes. Immunofluorescence observations of cryostat sections of bovine tongue epidermis reveal that affinity-purified rabbit antibodies to the 140-kDa GP generate a punctate intercellular stain that is similar to that generated by antibodies directed against a desmosome plaque component (desmoplakin). In cultured mouse keratinocytes, the antibodies against 140-kDa GP recognize desmosomes along areas of cell-cell contact. Double immunofluorescence of cultured keratinocytes with these antibodies and a desmoplakin antiserum reveals that the antibodies against the 140-kDa GP stain a single fluorescent line along areas of cell-cell contact. This single fluorescent line lies between double fluorescent lines generated by the desmoplakin antiserum. Immunogold ultrastructural localization reveals that the 140-kDa antigen is localized not only along the intercellular area of the desmosome but also is found along the whole epidermal cell surface. The antibodies to the 140 kDa GP are able to induce a disruption of cell-cell contact in cultured keratinocytes that possess desmosomes. We propose that the 140-kDa GP is a cell adhesion molecule (CAM). Furthermore we discuss the heterogeneity of desmosomes in the light of our findings that antibodies against the 140-kDa GP recognize specific stratified squamous epithelial tissues. PMID- 3532109 TI - Intranuclear appearance of the phosphorylated form of cytoskeleton-associated 350 kDa proteins in U1-ribonucleoprotein regions after growth stimulation of fibroblasts. AB - Cytoskeleton-associated 350-kDa and 80-kDa polypeptides, which were immunoprecipitated with polyclonal antibody against microtubule-associated protein 1 (MAP-1), were rapidly phosphorylated on mitogenic stimulation of quiescent fibroblasts with serum or growth factors. The enhanced phosphorylation was evident within 5 min and reached a maximum 2 hr after the stimulation. Phosphorylated MAP-1 analogues were first detected in the cytoplasm around the microtubule-organizing center and then in the nucleus by immunofluorescent staining with a monoclonal antibody that recognized the phosphorylated form of MAP-1. The monoclonal antibody reacted with the 350-kDa protein in immunoblot analysis and immunostained intranuclear speckles; both immunoreactions were abolished by treatment with alkaline or acid phosphatase. The nuclear speckles stained by the monoclonal antibody were also stained by anti-U1 small nuclear ribonucleoprotein antibodies on double immunofluorescence, suggesting that the stained regions are sites of maturation of messenger RNA. These results support the idea that part of the cytoskeleton-associated 350-kDa protein is phosphorylated and transferred to the nuclear region of mRNA modification as a common early process after growth stimulation. PMID- 3532110 TI - Transformation of Phycomyces blakesleeanus to G-418 resistance by an autonomously replicating plasmid. AB - The fungus, Phycomyces blakesleeanus, shows many well-defined responses to a number of external stimuli. Genetic analysis shows that at least eight genes are involved in Phycomyces sensory transduction. As a first step toward the molecular analysis of these genes and their products, we have developed a transformation protocol for Phycomyces by using a plasmid containing the kanamycin-resistance gene from Tn903 and a Phycomyces DNA fragment capable of supporting autonomous replication in yeast (ARS). Our results demonstrate that the Tn903 gene is expressed in Phycomyces and that the ARS fragment selected in yeast supports autonomous replication in Phycomyces as well. PMID- 3532111 TI - Nucleotide sequence of the yeast regulatory gene STE7 predicts a protein homologous to protein kinases. AB - The nucleotide sequence of the STE7 gene from Saccharomyces cerevisiae has been determined. It is one of several regulatory genes implicated in the control of cell-type-specific gene expression in yeast. The predicted amino acid sequence shows homology to several members of the protein kinase family. These results suggest protein phosphorylation may play a key role in regulation leading to cell type specialization in yeast. PMID- 3532112 TI - Promoters selected from random DNA sequences. AB - We have selected a group of Escherichia coli promoters from random DNA sequences by replacing 19 base pairs at the -35 promoter region of the tetracycline resistance gene tetr of the plasmid pBR322. Substitution of 19 base pairs with chemically synthesized random sequences results in a maximum of 4(19) (about 3 X 10(11)) possible replacement sequences. From a population of about 1000 bacteria harboring plasmids with these random substitutions, tetracycline selection has revealed several functional -35 promoter sequences. These promoters have retained only partial homology to the -35 promoter consensus sequence. In three of these promoters, the consensus alignment shifts 10 nucleotides downstream, allowing the RNA polymerase to recognize another Pribnow box from within the original pBR322 sequence. Two of the sequences promote transcription more strongly than the native promoter. This technique may have application for the selection of additional DNA sequences with varied biological activity. PMID- 3532113 TI - Ia+ murine epidermal Langerhans cells are deficient in surface expression of the class I major histocompatibility complex. AB - Murine epidermal Langerhans cells were analyzed with fluorescence microscopy and multicolor flow cytometry for the surface expression of major histocompatibility complex (MHC) class I and class II antigens. Langerhans cells of H-2k haplotype were identified in situ or in epidermal-cell suspensions by their surface expression of the MHC class II determinants I-Ak and I-Ek. More than 90% of class II-positive Langerhans cells in epidermal-cell suspensions expressed no or barely detectable amounts of MHC class I antigens. Quantitation by flow cytometry revealed that H-2k Langerhans cells expressed only 1.6-3.3% as much H-2Kk as did class II-negative keratinocytes in the same epidermal-cell suspensions. By fluorescence microscopy, class I MHC antigens were not detectable on Langerhans cells in situ when analyzed on sheets of intact epidermis. The deficient expression of class I MHC permitted highly purified Langerhans cell populations to be isolated from epidermal cell suspensions by treatment with anti-class I MHC monoclonal antibody and complement. It is likely that the uniquely low cell surface expression of class I MHC antigen by Langerhans cells has relevance to both immune responses in the skin as well as to mechanisms of skin allograft rejection. In addition, it is conceivable that regulation of class I MHC expression on antigen-presenting cells in general is an important but hitherto unrecognized mechanism of immune regulation. PMID- 3532114 TI - Beta 2-microglobulin is not required for cell surface expression of the murine class I histocompatibility antigen H-2Db or of a truncated H-2Db. AB - beta 2-Microglobulin (beta 2m) has been thought essential for transport of all major histocompatibility complex class I antigens to the cell surface. Here, we show that the mouse class I antigen H-2Db is expressed at the cell surface even when there is no beta 2m present within the cell. This was established by transfecting the H-2Db gene into the R1E cell line, which lacks beta 2m. The conformation of the Db antigen expressed by the R1E transfectant is very different from that of the native molecule. This Db antigen is not recognized by Db-allospecific and Db-restricted cytotoxic T lymphocytes or by most monoclonal antibodies to the native Db. We show further that a deletion construct of the Db gene, which consists of exon 1 linked to exons 4-8, expresses a truncated Db antigen lacking domains 1 and 2 [Db-(1 + 2)] at the cell surface after transfection into the R1E line. Previous biochemical and crystallographic data have indicated that domain 3 is associated with beta 2m; unexpectedly, Db-(1 + 2) does not associate with beta 2m when the mouse beta 2mb gene is transfected into the R1E transfectant expressing the truncated Db. This suggests that interactions with domains 1 and 2 are important for the paired association of domain 3 and beta 2m in the native Db antigen. PMID- 3532115 TI - Expression of the F glycoprotein of respiratory syncytial virus by a recombinant vaccinia virus: comparison of the individual contributions of the F and G glycoproteins to host immunity. AB - A cDNA clone representing the mRNA coding sequence of the fusion glycoprotein (F) gene of human respiratory syncytial virus (RSV) was constructed and inserted into the thymidine kinase gene of vaccinia virus (WR strain) under the control of a vaccinia virus promoter. The resulting recombinant vaccinia virus, vaccinia F, expressed the F1 and F2 cleavage products (48 and 20 kDa, respectively) of the F glycoprotein in cell culture. F1 and F2 were indistinguishable from their authentic RSV counterparts with respect to glycosylation, disulfide linkage, electrophoretic mobility, cell-surface expression, and antigenic specificity. Cotton rats infected intradermally with vaccinia F developed a high titer of serum F-specific antibodies, which neutralized infectivity of RSV. This neutralizing antibody response exceeded that induced by infection of the respiratory tract with RSV and was 6-fold higher than that induced by vaccinia G, a recombinant vaccinia virus that expressed the RSV G glycoprotein gene. Immunization with vaccinia F stimulated almost complete resistance to replication of RSV in the lower respiratory tract as well as significant resistance in the upper respiratory tract. The degree of resistance conferred by vaccinia F exceeded that induced by vaccinia G. PMID- 3532116 TI - Analysis by immunocytochemistry and in situ hybridization of renin and its mRNA in kidney, testis, adrenal, and pituitary of the rat. AB - Renin gene expression in cells and tissues of the rat was examined by in situ hybridization histochemistry and immunocytochemistry. By using a mouse cDNA probe, hybridization histochemistry revealed renin mRNA in the renal juxtaglomerular cells, testicular Leydig cells, adrenal zona glomerulosa cells, the intermediate lobe of the pituitary, and scattered cells of the anterior lobe of the pituitary. With four separate antisera to mouse submaxillary renin, there was immunoreactivity in the renal juxtaglomerular cells. However, only one of the antisera stained the Leydig cells, a second stained the adrenal zona glomerulosa, a third stained the intermediate lobe of the pituitary, and a fourth stained scattered cells of the anterior lobe of the pituitary that were identified as gonadotrophs. The variations with the different antisera in detecting extrarenal renin are unexplained but could imply that posttranslational proteolysis or glycosylation of preprorenin varies in different tissues with consequent variations in immunoreactivity. The finding of renin mRNA and renin-like immunoreactivity in these tissues supports the notion that these tissues are sites for production of renin. PMID- 3532117 TI - Regulation of expression of genes for light-harvesting antenna proteins LH-I and LH-II; reaction center polypeptides RC-L, RC-M, and RC-H; and enzymes of bacteriochlorophyll and carotenoid biosynthesis in Rhodobacter capsulatus by light and oxygen. AB - RNA levels were measured by blot hybridization to study the coordinate and differential expression of Rhodobacter capsulatus genes for light-harvesting I antenna proteins LH-I and LH-II; reaction center (RC) polypeptides L, M, and H; and bacteriochlorophyll and carotenoid biosynthesis in response to light and O2. The genes for LH-II alpha and beta subunits only have one transcript, 0.5 kilobase (kb) long, whereas the genes for LH-I have two transcripts (0.5 and 2.6 kb). The small transcript (0.5 kb) is the mRNA only for LH-I beta and alpha polypeptides, whereas the large transcript (2.6 kb) codes for RC-L, RC-M, and the beta and alpha polypeptides of LH-I, as well as the product of an unknown open reading frame designated ORF C2397. These five genes thus comprise a single operon (designated the puf operon). The mRNA specifying the LH-II polypeptides is more abundant, more sensitive to changes in O2 concentration, and shows a variation over a wider range than that of the mRNA for LH-I, indicating that the genes for LH-II and LH-I/RC are regulated independently. The gene for RC-H (puhA) has at least two transcripts (1.2 and 1.4 kb) that initiate within ORF F1696 and respond differentially to light intensity. The expression of the genes coding for RC-L, RC-M, and RC-H is coordinately regulated by light intensity and O2 concentration. An increase in light intensity causes a decrease in the expression of the genes for LH-I, LH-II, and RC proteins. The genes coding for the enzymes in the bacteriochlorophyll biosynthetic pathways are regulated by light intensity and O2 in a manner similar to that of the genes for LH and RC proteins. The crt genes coding for the enzymes in carotenoid biosynthetic pathways, however, are regulated in an opposite fashion: high light intensity results in increased expression of crt genes. These results are interpreted based on the protective function of carotenoids under high light intensity in the presence of O2. PMID- 3532119 TI - Cloning and expression of Bradyrhizobium japonicum uptake hydrogenase structural genes in Escherichia coli. AB - To identify the structural genes for the components of Bradyrhizobium japonicum uptake hydrogenase (Mr 60,000 and 30,000), we have expressed these genes in Escherichia coli and shown that the products cross-react with antibodies to the respective hydrogenase subunits. We constructed subclones of overlapping DNA fragments from an uptake hydrogenase-complementing cosmid, pHU52 [Lambert, G. R., Cantrell, M. A., Hanus, F. J., Russell, S. A., Haddad, K. R. & Evans, H. J. (1985) Proc. Natl. Acad. Sci. USA 82, 3232-3236], in pMZ 545, a plasmid expression vector. DNA fragments inserted into one or more of the four cloning sites downstream from the E. coli lac operon promoter (Plac) on pMZ 545 generate transcriptional, but not translational, fusions. Two subclones that directed the synthesis of Mr 60,000 and 30,000 proteins in E. coli "maxicells" were identified. The DNA inserts from these subclones were then inserted down-stream of the bacteriophage lambda PL promoter on a transcriptional fusion vector. When the PL promoter was activated in vivo by heat inactivation of the temperature sensitive cI repressor of lambda in an appropriate E. coli strain, the respective fragments expressed higher levels of Mr 60,000 and 30,000 proteins that could be detected in immunoblots. These data provide direct evidence for the presence of uptake hydrogenase structural genes on the uptake hydrogenase-complementing cosmid pHU52. PMID- 3532118 TI - Mismatch correction catalyzed by cell-free extracts of Saccharomyces cerevisiae. AB - Heteroduplex DNA substrates containing a 4- or 7-base-pair insertion/deletion mismatch or each of the eight possible single-base-pair mismatches were constructed. Extracts of mitotic Saccharomyces cerevisiae cells catalyzed the correction of mismatched nucleotides in a reaction that required Mg2+ and had a partial requirement for ATP and the four dNTPs. The insertion/deletion mismatches and the A X C and G X T mismatches were repaired efficiently, while the six other single-base-pair mismatches were repaired poorly or at undetectable rates. Mismatch correction was accompanied by the specific incorporation of less than 20 nucleotides at or near the site of the repaired mismatch. PMID- 3532120 TI - Hemorrhage in lesions caused by cowpox virus is induced by a viral protein that is related to plasma protein inhibitors of serine proteases. AB - Several recombinant cowpox viruses were constructed and used to identify a viral gene that controls the production of hemorrhage in lesions caused by the Brighton Red strain of cowpox virus (CPV-BR). This gene is located in the KpnD fragment of CPV-BR DNA, between 31 and 32 kilobases from the end of the genome. This position corresponds well with that predicted from analyses of the DNA structures of spontaneously generated deletion mutants. The gene responsible for hemorrhage encodes a 38-kDa protein that is one of the most abundant early gene products. The 11-base-pair sequence GAAAATATATT present 84 base pairs upstream of its coding region is also present upstream of three other early genes of vaccinia virus; therefore, this sequence may be involved in the regulation of transcription. There is extensive similarity between the predicted amino acid sequence of the 38-kDa protein and the amino acid sequences of several plasma proteins that are inhibitors of various serine proteases involved in blood coagulation pathways. This suggests that the viral protein may possess a similar biological activity, which may enable it to effect hemorrhage by inhibiting one or more of the serine proteases involved in the host's normal processes of blood coagulation and wound containment. PMID- 3532121 TI - "Replacement" of COOH-terminal truncation of v-fms with c-fms sequences markedly reduces transformation potential. AB - Protooncogenes when transduced by retroviruses may undergo structural modifications that render their gene products oncogenic. The c-fms gene encodes a transmembrane protein with tyrosine kinase activity that is very similar or identical to the receptor for the monocyte-macrophage colony-stimulating factor. Its transforming homologue (v-fms) in the Susan McDonough strain feline sarcoma virus causes fibrosarcomas in cats. Molecular cloning and sequence analysis of the cDNA that encodes the cytoplasmic domain of the human c-fms gene shows that the product of the transduced viral homologue, v-fms, is truncated at the COOH terminal end. The COOH-terminal 40 amino acids of the c-fms gene product are replaced in the v-fms gene product by 11 amino acids encoded by the retroviral genome. Hybrid v-fms/c-fms genes, in which either the entire cytoplasmic domain or the COOH-terminal coding sequences of the v-fms gene were replaced by the corresponding segments of the c-fms gene, had a reduced ability to transform fibroblasts despite a high level of encoded protein on the cell surface. These data indicate that the COOH-terminal modifications contribute to the transforming potential of the v-fms viral oncogene product. PMID- 3532122 TI - Differential expression of six light-harvesting chlorophyll a/b binding protein genes in maize leaf cell types. AB - Bundle sheath chloroplasts of maize leaves contain about one-fourth as much light harvesting chlorophyll a/b binding protein of photosystem II (LHCP-II) as do mesophyll chloroplasts. We have determined that this difference is, in part, the result of differential expression of different LHCP-II genes. We have prepared and partially characterized cDNA clones specific for six LHCP-II genes of maize. Transcripts of these six LHCP-II genes are present at vastly different levels and account for about 95% of total LHCP-II mRNAs in bundle sheath and mesophyll cells of illuminated dark-grown maize leaves. Three genes are preferentially expressed in mesophyll cells, and their mRNAs constitute about 54% of the total LHCP-II transcripts in greening (24 hr) maize leaves. Two genes are expressed equally in bundle sheath and mesophyll cells. Most interestingly, the RNA of one gene that contributes about 8% of the total LHCP-II transcripts in leaves greening for 24 hr is present at a much higher level in bundle sheath than in mesophyll cells. Moreover, immunoblot analysis of maize thylakoids reveals at least five sizes of LHCP-II; these also differ from one another in their relative abundance in bundle sheath and mesophyll cells of developing maize leaves. PMID- 3532123 TI - Functional complementation between mutations in a yeast suppressor tRNA gene reveals potential for evolution of tRNA sequences. AB - Successive rounds of mutagenesis of a Schizosaccharomyces pombe strain bearing the UGA-reading sup3 tRNASer suppressor have been carried out for two cycles of inactivation and reactivation of the suppressor. The suppressor phenotype at each stage was found to involve different combinations of three mutations, A30, A53, and A67, in the sup3-UGA gene. Single mutations A30 and A53 inactivate the suppressor as does the presence of all three mutations. A67 by itself is phenotypically neutral, but in combination with either A30 or A53 suppressor function is restored. The frequency with which these and other complementation events occur in S. pombe demonstrates a significant potential for nucleotide sequence evolution in tRNA. Differential expression of the S. pombe genes in Saccharomyces cerevisiae suggests that the two yeasts have diverged at the transcriptional and RNA processing level. Processing of the mutant tRNA precursors in S. cerevisiae reveals a hierarchy of structural domains within the tRNA that vary in their importance for RNase P cleavage. PMID- 3532124 TI - Polymerization of intact beta 2-microglobulin in tissue causes amyloidosis in patients on chronic hemodialysis. AB - Systemic amyloidosis with a predilection for bone and synovium may complicate the course of patients on long-term hemodialysis. This form of amyloidosis can be typed as distinct from other amyloid diseases by using small tissue samples obtained by bone biopsy and at postmortem. Immunoblot analysis of two-dimensional gels of partially solubilized amyloid fibrils established that tissue deposits are composed of monomers, dimers, and higher polymers of beta 2-microglobulin (beta 2m) and that amyloid P component was also present. Anti-beta 2m antiserum recognized fibrils, as shown by immunoelectron microscopy. Purified monomer isolated from dissociated fibrils yielded peptides corresponding to the entire known sequence of beta 2m. Virtually all serum beta 2m, as well as that present in tissue fluid bathing amyloid fibrils, was monomeric. Hemodialysis-related amyloidosis is an example of a deposition disease occurring in hemodialysis patients. We have shown conclusively that, in this amyloid disease, polymerization of an intact normal serum protein to a fibrillar configuration may occur without proteolysis. We propose the designation A beta 2m for this form of amyloid fibril subunit protein. PMID- 3532125 TI - Inhibition of the development of radiation-induced leukemia in mice by reduction of food intake. AB - We have reported previously that the incidence of tumors induced in Sprague Dawley rats by total-body gamma-ray irradiation can be considerably reduced by restriction of food intake [Gross, L. & Dreyfuss, Y. (1984) Proc. Natl. Acad. Sci. USA 81, 7596-7598]. In experiments reported here we investigated the influence of reduced food intake on the development of radiation-induced leukemia in C3H(f) mice. The incidence of spontaneous leukemia in mice of this strain does not exceed 0.5%, but it can be considerably increased by total-body x irradiation. In our study, two groups of C3H(f) mice were submitted to fractionated total-body gamma-irradiation (150 rads, five times at weekly intervals; 1 rad = 0.01 gray). The first group received a full ad lib diet (4.5 5.4 g of Purina Rodent Lab Chow pellets per day, each). In this group 31 out of 58 females (53.4%) and 24 out of 50 males (48%) developed leukemia at an average age of 8 months. In the second group, consisting of sisters and brothers of the first group, and submitted to the same gamma-irradiation but receiving a restricted diet (2 g of Purina Lab Chow pellets each, followed by 3 g on alternate days), only 2 out of 55 females (3.6%), and 1 out of 36 males (2.8%), developed leukemia at an average age of 9 and 12 months, respectively. Leukemia in both groups was predominantly of the lymphatic or lymphoblastic form, the leukemic cells infiltrating most organs, particularly the thymus, mesenteric and peripheral lymph nodes, spleen, liver, kidneys, and bone marrow; in most instances the peripheral blood was also leukemic. PMID- 3532126 TI - Histidine-rich domain of the knob protein of the human malaria parasite Plasmodium falciparum. AB - Membranes of erythrocytes infected with the human malaria parasite Plasmodium falciparum develop protrusions called knobs. These structures are essential for the survival of the parasite in the host, and their induction requires the synthesis of the knob protein by the parasite. We describe the isolation of a cDNA clone encoding the amino-terminal half of the knob protein. A cDNA library was constructed from RNA prepared from ring stages of a P. falciparum isolate that has retained its ability to induce knobs (knob+ phenotype). A synthetic oligonucleotide probe encoding polyhistidine was used to isolate the cDNA clone, which encodes the amino-terminal half of a polypeptide with all the known attributes of the knob protein. The gene is not transcribed in variants that do not synthesize the knob protein and thereby cannot induce knobs (knob- phenotype). The apparent lack of transcription in knob- variants is due to different mechanisms: although the gene is present in one knob- isolate, it has been deleted in a cloned knob- variant. The primary structure of the polypeptide deduced from a partial sequence of the cDNA is distinctly different from other malarial histidine-rich polypeptides. The amino-terminal sequence shows the characteristic features of a signal peptide. This is followed by a histidine-rich domain and a subsequent region which contains one histidine. Peptide map analysis of the knob protein is consistent with the structural features deduced from the sequence analysis of the cDNA. PMID- 3532127 TI - Effects of dietary linoleic acid on blood pressure and renal function in subtotally nephrectomized rats. AB - The effect of a high linoleic acid diet on blood pressure, renal function, and urinary prostaglandin excretion was studied in rats with decreased renal mass. Subtotally nephrectomized (5/6 nephrectomy) male rats received either a 15% linoleic acid (high linoleic acid, HLA) diet containing 20% safflower oil or a 0.28% linoleic acid (low linoleic acid, LLA) diet containing 20% coconut oil. Sham-operated rats were also placed on either HLA or LLA diet. The subtotal nephrectomized rats developed similar degrees of hypertension during the first 3 weeks after subtotal nephrectomy. However, 4 weeks after subtotal nephrectomy, the rats on HLA diet had significantly lower blood pressure than the rats on LLA diet [HLA 152 +/- 3 (mean +/- SE) mm Hg versus LLA 171 +/- 3 mm Hg]. This difference persisted until termination of the experiment at 7 weeks after subtotal nephrectomy (HLA 159 +/- 7 mm Hg versus LLA 192 +/- 6 mm Hg). The GFR measured 7 weeks after subtotal nephrectomy was significantly lower in both of the subtotally nephrectomized groups. However, the HLA subtotal nephrectomized rats had significantly higher GFR than the LLA-treated rats (HLA 0.23 +/- 0.05 ml/min 100 g versus LLA 0.12 +/- 0.02 ml/min/100 g, P less than 0.05). There was no difference in the GFR or blood pressure in the sham-operated rats treated with HLA or LLA diet. PGE2 excretion was lower in the two groups of subnephrectomized rats, but there was no difference between the HLA and LLA treated rats. Urinary 6 ketoPGF1 alpha was not decreased by subtotal nephrectomy and there was no difference between the dietary groups. However, TXB2 excretion was higher in the groups with subtotal nephrectomy, but there was no difference between the two dietary groups. In conclusion, the HLA diet attenuates the rise in blood pressure after subtotal nephrectomy in the rat and preserves renal function. There was no difference in urinary excretion of PGE2, 6-keto-PFG1 alpha, or thromboxane B2 between the two dietary groups. PMID- 3532128 TI - Evolutionary perspectives and the new genetics. Proceedings of an international symposium honoring Dr. James V. Neel. Ann Arbor, Michigan, June 17-18, 1985. PMID- 3532129 TI - Scientist, journalist, orchidist--will the real James V. Neel please stand up. PMID- 3532130 TI - Evolution and tinkering: the molecular genetics of bacterial adaption. PMID- 3532131 TI - Homologous pairing & strand exchange mediated by rec A nucleoprotein filaments & networks. PMID- 3532132 TI - Gene conversion. PMID- 3532133 TI - Prostacyclin synthesis by the corpora cavernosa of the human penis: evidence for muscarinic control and pathological implications. AB - The present study demonstrates that human corpus cavernosum tissue has the capacity to produce prostacyclin (PGI2), a vasodilator and potent inhibitor of platelet aggregation. The release of PGI2 was stimulated by cholinergic (muscarinic) but not adrenergic agents. Since penile erection in man is dependent upon parasympathetic stimulation, the vasodilatory action of PGI2 may contribute to the initiation and maintenance of erection. PMID- 3532134 TI - Effect of indomethacin treatment on prostaglandin excretion and tissue phospholipid fatty acid composition in rats bearing mammotropic pituitary tumor, MtT-F4. AB - The hypothesis that hormonal changes induced by the mammotropic pituitary tumor, MtT-F4, might accelerate the conversion of n-6 fatty acids to prostaglandins, resulting in a partial depletion of n-6 fatty acids was examined. In tumor bearing rats, the administration of indomethacin induced a 50% reduction of the urinary prostaglandin levels, but exerted no significant effect on the fatty acid composition of the tissue phospholipids. It is concluded that the observed depletion of n-6 fatty acids in tumor-bearing rats is not caused by an increased production of prostaglandins. PMID- 3532135 TI - Effects of intravenous administration of a calcium antagonist on prostaglandins and thromboxane in plasma and urine in humans. AB - The effects of a calcium antagonist [Nicardipine hydrochloride (NH)] on the prostaglandin [prostaglandin E2 (PGE2), and 6-keto-prostaglandin F1 alpha (6-keto PGF1 alpha)] and thromboxane B2 levels in the blood and urine were examined in 6 patients with essential hypertension following intravenous infusion of NH for 120 minutes. At the same time, the plasma renin activity (PRA), plasma aldosterone concentration (PAC), and plasma and urinary electrolyte levels were also determined. During NH administration, the blood pressure was significantly decreased (p less than 0.05) with an increased pulse rate (p less than 0.05). PRA was significantly increased after NH loading (p less than 0.05) but PAC showed no change. The plasma PGE2 and 6-keto-PGF1 alpha levels tended to increase slightly, while the blood thromboxane B2 level showed a decreasing tendency. The 6-keto PGF1 alpha to thromboxane B2 ratio was significantly increased after NH loading as compared to the preloading ratio (p less than 0.05), and then returned to the preloading value at about 30 minutes after discontinuation of NH loading. The urinary excretions of PGE2, 6-keto-PGF1 alpha and thromboxane B2, PGE2 and 6-keto PGF1 alpha tended to decrease after NH loading. In particular, the decrease in PGE2 was statistically significant (p less than 0.05). No change occurred in the urinary excretion of thromboxane B2. The above findings indicate that NH increased the plasma 6-keto-PGF1 alpha to thromboxane B2 ratio but decreased the urinary excretion of prostaglandins. In addition, the possible involvement of an enhanced 6-keto-PGF1 alpha/thromboxane B2 ratio in part of the hypotensive mechanism of NH is suggested. PMID- 3532136 TI - Absence of myocardial protection with prostacyclin during cardiac arrest. AB - Prostacyclin (PGI2) has been shown to present myocardial protective effects which could be beneficial during cardiac arrest. We tested this hypothesis in a closed chest dog model in which electromechanical dissociation (EMD) can be predictably observed after 90 to 120 seconds of ventricular fibrillation without chest compression. Six dogs were pretreated with a PGI2 infusion at a rate of 1 mcg/kg/min and six other dogs served as control animals. After 60 seconds of ventricular fibrillation, EMD was already observed in 3 PGI2-treated dogs but in no control dog. After 90 seconds of ventricular fibrillation, EMD was present in 2 PGI2-treated dogs and in 2 control dogs, so that 4 control but only one PGI2 treated animal survived after 90 seconds of ventricular fibrillation. Ventricular defibrillation was also not facilitated in PGI2-treated dogs. The present study does not support PGI2 administration in cardiopulmonary resuscitation. PMID- 3532137 TI - Further acquisitions on gonadal function in bromocriptine treated hyperprolactinemic male patients. AB - The diurnal variation of plasma total and free testosterone (tT and fT) and the gonadotropinemic response to LH-RH were evaluated in a group of hyperprolactinemic impotent males with pituitary microprolactinoma before and during therapy with bromocriptine, a well known dopamine agonist drug. Before treatment, basal levels not only of tT but also of fT were decreased and the diurnal variation of both tT and fT was absent. Moreover, the LH-RH test showed a delay in the LH response peak, together with normal basal levels of LH. Bromocriptine therapy caused normalization of both the secretion response of LH to LH-RH and of the secretion pattern of tT and of fT (basal levels and diurnal variation) besides a significant decrease in PRL levels and an improvement in sexual function. The possible effects of high plasma levels of PRL at various levels of the hypothalamus-pituitary-testicular axis are discussed. PMID- 3532138 TI - [The history of pharmaceutical science. 16. The Medicinal Regulation for Swedish Pommern and Rugen of 1779]. PMID- 3532139 TI - [The history of pharmaceutical science. 17. The development of pharmacy at the University of Greifswald between 1903 and 1968. 2. The development of personnel structure]. PMID- 3532140 TI - Numerical considerations for interface reflections in medical ultrasound. AB - The original concept of the echo mechanism in diagnostic medical ultrasound--of step impedance discontinuities--is investigated in terms of the numerical implications of more refined models. The effect of a discontinuity in the attenuation coefficients is found to have as much significance as the impedance discontinuity at low reflection interfaces. An approximate analytical model is developed for spatially varying changes in the impedance. Numerical calculations are presented for reflections from delta-function and Gaussian-envelope RF pulses for two different models: an impedance gradient, and a connective tissue layer. The models used are well documented in acoustics textbooks, but the numerical results for typical tissue parameters show that a wide variety of interface structures may give rise to reflected amplitudes in the same range as that determined by the step impedance model. It is suggested that experimental investigation of interface structures may increase our understanding of the tissue: ultrasound interaction in diagnostic processes. PMID- 3532141 TI - Effect of short leg casting on ambulation in children with cerebral palsy. AB - The purpose of this study was to compare and analyze changes in ambulation between two groups of children with cerebral palsy, with and without short leg casting. Sixteen children with spastic cerebral palsy, aged 10 to 108 months, were assigned randomly to either a short leg casted group or an uncasted group. All children were tested by me, before and after 10 weeks of neurodevelopmental treatment, by recording an ink print ambulation pattern on a length of paper fastened to the floor. Measurements of stride length, stride width, foot angle, and footprint clarity were taken to quantify the ambulation patterns. The percentage of improvement in stride length, stride width, and foot angle was analyzed using a t test, and the percentage of improvement in footprint clarity was analyzed using the Mann-Whitney U test. An alpha level of .05 was assumed to determine whether the differences between groups were large enough to be statistically significant. A significant difference was found in the percentages of improvement in stride length between the two groups, although the other results were nonsignificant. Short leg casting appears to be valuable in the management of spastic hemiplegia, diplegia, and quadriplegia. Clinical observations included improvement in muscle tone, trunk control, and symmetry. These results constitute the first objective measure, using a control group, supporting the therapeutic value of short leg casting for children with cerebral palsy. PMID- 3532142 TI - Anti-Mullerian hormone. PMID- 3532143 TI - Adrenal steroid receptors and actions in the nervous system. PMID- 3532144 TI - Cells of bone: proliferation, differentiation, and hormonal regulation. PMID- 3532145 TI - Electrophysiology of excitable endocrine cells. PMID- 3532146 TI - [The bumpy road to success (Anna Sendecka)]. PMID- 3532147 TI - [35th anniversary (the M. S. Sklodowska Medical School in Szczecinek)]. PMID- 3532148 TI - [Sexual taboo]. PMID- 3532149 TI - Restoration of the upper lip and nasolabial area by means of an intraoral approach. AB - Superomedial repositioning of the superficial musculoaponeurotic system (SMAS) in the upper lip is accomplished by means of intraoral incisions. The procedure reestablishes the convexity of the lateral vermilion border, elevates the upper lip, and restores a more youthful appearance to the upper-lip profile. Depth of the nasolabial folds are reduced. We have performed this procedure on 14 patients. Follow-up intervals range from 6 to 20 months, averaging 14 months. All patients received concomitant rhytidectomy; usual operative time was increased by 20 minutes. Results have been rated good to excellent by patients and surgeons. There have been no recurrences of nasolabial fold deepening or upper lip depression, and there have been no complications. In selected patients, this procedure, along with rhytidectomy, may provide a more youthful appearance. PMID- 3532150 TI - Reconstruction of the burned nipple-areola complex. AB - Reconstructive results of 115 burned nipple-areola complexes in 84 female patients were reviewed. Results of nipple reconstruction using local quadrapod flaps (33 percent good, 45 percent fair, 22 percent poor) and composition grafts from the earlobe (20 percent good, 60 percent fair, 20 percent poor) were comparable, and both were superior to results obtained with the "double-bubble" technique (24 percent good, 35 percent fair, 41 percent poor). Differences in nipple reconstruction techniques were not appreciated until 1 year postoperatively. The early appearance of areola reconstruction with tattooing and split-thickness grafts was excellent. However, significant late hypopigmentation changes were observed with both techniques. Areola reconstruction with full thickness skin grafts from the superomedial thigh (47 percent good, 33 percent fair, 20 percent poor) were superior to those obtained with tattooing (14 percent good, 35 percent fair, 51 percent poor) and split-thickness skin grafts from the contralateral unburned areola (21 percent good, 21 percent fair, 58 percent poor). We recommend employing local quadrapod flaps (for nipple), provided there is adequate surrounding dermis, and full-thickness skin grafts (for areola) in the reconstruction of the burned breast. PMID- 3532151 TI - Cranioplasty and cranial prosthesis. By P. Lecene. 1920. PMID- 3532152 TI - Human bites of the eyelid. AB - Five patients with traumatic colobomas of the eyelid secondary to human bites were surgically repaired with retrieved autogenous tissue. All patients were treated with prophylactic intravenous antibiotics. Surgical repair consisted of debridement of the autograft, meticulous layered closure of the autograft to the wound, and placement of a lid margin suture. In two of the patients, mild upper eyelid retraction was noted, and two patients had loss of cilia. PMID- 3532153 TI - Reconstruction and/or salvage of nipple projection. AB - A simple method of creating nipple projection in flattened nipple-areola complexes is presented. The results required, on average, 14 months of follow-up, with very good projection and general appearance in all patients. This technique eliminates the unnecessary surgical gymnastics of other methods when obtaining nipple projection. PMID- 3532155 TI - Pericranial flaps. PMID- 3532154 TI - Construction of the nipple with a mushroom-shaped pedicle. AB - Construction of the nipple-areolar complex has been the subject of much interest and many papers. We believe that the best way to ensure nipple protrusion is by the entrapment of tissue above the skin surface so that it cannot retract. This, in principle, is similar to creating an irreducible hernia. This technique for nipple construction employs a circular split-thickness island of skin which has its central circulation preserved through its attachment at the new nipple site. This central stalk represents about one-quarter of the total surface area of the constructed areola. The total diameter of the areolar disk is usually determined by the size of the opposite nipple-areolar complex. The new areola is developed from a full-thickness skin graft taken from the area below the inguinal crease. Once removed, it is sutured over the elevated nipple segment with its central island. The full-thickness graft is sutured into place before a small cruciate incision is made in the center. It should be just large enough to permit the delivery of the dermal-epidermal flap on its stalk up through the opening. Nothing more need be done to the raw undersurface of the split-thickness skin. Its raw surface has no place to reattach because its bed is now covered with the full-thickness graft.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3532156 TI - [Arthur Kronfeld (1886-1941)--a psychiatrist in the service of psychotherapy]. AB - The psychotherapeutic life-work of psychiatrist Arthur Kronfeld has almost fallen into oblivion. Against the background of the 100th anniversary of his birth the author traces Kronfeld's psychotherapeutic career, pointing out his activity at the Berliner "Institute of Sexual Research" under Magnus Hirschfeld, and his psychotherapeutic concept--the psychagogic guidance of the patient--and its connection with the individual psychology of Alfred Adler. Kronfeld translated his theoretical positions into activities directed towards socialization and the teachability of psychotherapy which are still worthy of note by those engaged in the field. PMID- 3532157 TI - The diary of a madman, seventeenth-century style: Goodwin Wharton, MP and communer with the fairy world. AB - Goodwin Wharton (1653-1704) was a nobleman's son and a Whig MP who played no small part in English public life. His manuscript journal shows, however, that he also lived a bizarre secret life of the mind of a kind which, in later generations, would have led to his confinement as suffering from mental illness. Above all, through the offices of his medium and lover, Mary Parish, he entered into elaborate relations both with the fairy world and with God and His Angels. This paper examines our records of Wharton's consciousness. PMID- 3532158 TI - Origin of dreams: anticipation of modern theories in the philosophy and physiology of the eighteenth and nineteenth centuries. PMID- 3532159 TI - In memoriam. Sydney G. Margolin, M.D.: 1909-1985. PMID- 3532160 TI - Was Robert Whytt (1714--1766) right? Remarks on the retirement of John C. Nemiah as psychiatrist-in-chief; Beth Israel Hospital. PMID- 3532161 TI - Tissue metabolism studied in vivo by nuclear magnetic resonance. AB - N.m.r. is finding increasing application as a non-invasive method of studying metabolism in vivo. 31P n.m.r. is particularly useful for studies of energy metabolism, while other nuclei, in particular 1H, 13C and 19F, can provide additional information about certain aspects of cellular metabolism that are not amenable to investigation by 31P n.m.r. The major problem with n.m.r. is lack of sensitivity. The main implications of this are first that signals can only be detected from metabolites that are present at fairly high concentrations, and secondly that the spatial resolution for localized studies, particularly of internal regions of the body, is limited. N.m.r. could considerably enhance our understanding of metabolic abnormalities in disease, but the precise role of such metabolic studies in a clinical setting remains to be evaluated. PMID- 3532162 TI - A comparison of energy metabolism in the new-born infant, piglet and lamb. AB - Characteristics of energy metabolism in the new-born infant, piglet and lamb have been compared quantitatively in order to assess how the constraints imposed by the availabilities of energy substrates in body reserves and colostrum differ between species and affect the new-born's well being during the first day after birth. Three air temperature ranges, described as thermoneutral (32-38 degrees C), moderate (18-26 degrees C) and cold (0-10 degrees C) and representing the usual birth environments of infants, piglets and lambs, respectively, have been considered. The analysis revealed the following noteworthy points. Carbohydrate and lipid are the major energy substrates for heat production because protein catabolism is minimal during the first day after birth in all three species. The availability of carbohydrate determines how long the new-born can avoid hypoglycaemia, which threatens well being because it leads to hypothermia or compromised cerebral function, but lipid availability can affect the periods for which the carbohydrate can last. Thus, in unfed piglets and lambs the available reserves of liver and skeletal muscle glycogen (g/kg body weight) are similar in normal (n.) and growth retarded (g.r.) individuals, but glycogen exhaustion occurs earlier in g.r. new-borns because a reduced lipid availability in them increases their dependence on carbohydrate. In contrast, lipid energy is plentiful in g.r., preterm (p.) and n. infants, so that the faster depletion of glycogen in g.r./p. than in n. individuals is primarily due to a restricted prenatal glycogen deposition in the former. The usual colostrum intakes of n. infants are very low during the first day, but their body reserves can supply the required energy, the major source of carbohydrate being liver glycogen. However, g.r./p. infants require supplementary feeding, the choice of feed being determined by factors such as the intakes the infants can achieve, the carbohydrate content of the feed and the need to ensure a balanced supply of minerals, electrolytes and other substances. In their usual birth environments piglets and lambs, whether growth retarded or not, require colostrum to avoid hypothermia during the first day. The colostrum of both species is rich in lipid, which corrects any deficit in the new-born and thus extends the availability of glycogen, but at the usual colostrum intakes the amounts of lactose can provide sufficient carbohydrate energy for only about half a day. Piglets and lambs, even when fed fully, are therefore obliged to call on their body glycogen reserves in order to make up the difference.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3532163 TI - Insulin and the parasympathetic dependence of pancreatic juice secretion in healthy and alloxan diabetic sheep. AB - Pancreatic function was measured in four ewes following vagal stimulation under control conditions and after the induction of alloxan diabetes. The volume and protein content of the pancreatic juice was measured along with simultaneous measurement of blood glucose and plasma insulin. The volume of pancreatic juice and its protein content decreased markedly in the diabetic state and returned to the initial value after insulin treatment. In normal animals, vagal stimulation markedly increased; the volume of pancreatic secretion and its protein content as well as the plasma insulin concentration. In the diabetic animals vagal stimulation caused only a slight increase in the protein content of pancreatic juice and plasma insulin concentration. It is suggested that insulin is probably one of the more important factors directly regulating the secretion of pancreatic juice. PMID- 3532164 TI - Serum thyroglobulin and thyroid cancer. PMID- 3532165 TI - Clinical research and the MRC. PMID- 3532166 TI - Renal functional reserve in kidney donors. AB - The glomerular filtration rates of 28 subjects, who had undergone donor nephrectomy up to 22 years previously, were measured before and after ingestion of an 80 g protein meal. A renal functional reserve was demonstrated in all cases. There was no evidence of loss of this reserve with time after nephrectomy. This study supports the view that long-term compensatory hyperfiltration of the remaining kidney after donor nephrectomy is not damaging, at least over this time scale. PMID- 3532167 TI - Sex ratio variation in mammals. AB - Parents will increase their fitness by varying the sex ratio of their progeny in response to differences in the costs and benefits of producing sons and daughters. Sex differences in energy requirements or viability during early growth, differences in the relative fitness of male and female offspring, and competition or cooperation between siblings or between siblings and parents might all be expected to affect the sex ratio. Although few trends have yet been shown to be consistent, growing numbers of studies have demonstrated significant variation in birth sex ratios in non-human mammals. These are commonly cited as evidence of adaptive manipulation of the sex ratio. However, several different mechanisms may affect the birth sex ratio, and not all of them are likely to be adaptive. Valid evidence that sex ratio trends are adaptive must be based either on the overall distribution of those trends or on cases in which the sex ratio can be shown to vary with the relative fitness of producing sons and daughters. The distribution of observed sex ratio trends does not conform closely to the predictions of any single adaptive theory. Some recent studies, however, indicate that, within species, the sex ratio varies with the costs or benefits of producing male or female offspring. PMID- 3532168 TI - Dentin adhesives--do they protect the dentin from acid etching? PMID- 3532169 TI - Chairside characterization of porcelain restorations. PMID- 3532170 TI - The use of posterior templates for cusp analysis of the curves of Spee and Wilson. PMID- 3532171 TI - [Telescopic construction using non-precious metal alloys in a 1-piece casting procedure]. PMID- 3532172 TI - [Results of approximal interlocking abutments in anterior tooth esthetics]. PMID- 3532173 TI - Some problems concerning 99mTc-sulphur colloid stability in vivo. PMID- 3532174 TI - [Value of radiotherapy in the interdisciplinary therapeutic treatment concept of rectal cancer]. AB - Postoperative radiotherapy reduces the local recurrence rate of rectal carcinoma. However, the recurrence free interval and survival time are not influenced. Postoperative radio- and chemotherapy reduce the local recurrence rate as well and prolongs the recurrence free interval. The survival rate is not significantly improved. Combined pre- and postoperative radiotherapy are presently being evaluated in prospective randomised trials. The actual results demonstrate a reduced local recurrence rate, a prolongation of the recurrence free interval and an improved survival time. Because of the relatively small numbers of patients in the different treatment groups a final evaluation is not yet possible. PMID- 3532175 TI - [Intra-arterial digital subtraction angiography using 4-F-catheters for evaluating cerebrovascular insufficiency]. AB - 82 patients were examined by IA-DSA using 4-F-catheter, 70 on an hospital and 12 on an outpatient basis. The examination included imaging of the aortic arch and selective depiction of both carotid arteries and required 30 ml of contrast agent for these three consecutive series. Image quality was evaluated for each vessel respectively. Cerebrovascular insufficiency could be diagnosed with the same accuracy as in conventional angiography. A definite diagnosis could be made in 96% of the cases for the right and in 98% for the left carotid artery. The vertebral arteries posed more problems for evaluation and required additional imaging depending on the clinical situation. Since introduction of IA-DSA the procedure seems to be less hazardous compared with conventional angiography because less contrast agent is needed and smaller catheters can be used. PMID- 3532176 TI - Sonographic evaluation of normal and induced ovulation. AB - The adult premenopausal ovary exists in a dynamic state of flux, with ovarian position, size, activity, and structure constantly undergoing changes. Pelvic sonograms must be interpreted with knowledge of the stage of the menstrual cycle and the expected normal range of sonographic findings, because features that are normal in one phase may be abnormal in another. Only against this background knowledge can the challenging task of interpretation of pelvic sonograms be successfully performed. US also plays an increasingly important role in monitoring ovulation induction and alternative methods of fertilization and has improved pregnancy rates by distinguishing between the presence of one or more mature follicles as opposed to a cohort of immature follicles, suggesting the possibility of multiple ovulation with the risks of hyperstimulation or poor pregnancy outcome from multiple gestation, indicating optimum timing of human chorionic gonadotropin administration, allowing detection and confirmation of normal follicular rupture and ovulation, indicating optimum timing of oocyte retrieval in programs of in vitro fertilization with embryo transfer (IVF-ET) or insemination programs, and assessing pathologic pelvic conditions and ovarian accessibility in IVF-ET programs. Oocyte retrieval and embryo transfer are also being performed under US guidance. PMID- 3532177 TI - Gastric trichobezoar: sonographic findings. AB - Ultrasonographic diagnosis of trichobezoar may be relatively specific. A broad band of high-amplitude echoes can be seen superficially, with complete sonic shadowing behind. The authors describe a patient in whom the diagnosis was made prior to conventional barium studies and in whom the question of trichobezoar had not been raised clinically. PMID- 3532178 TI - US diagnosis of choledocholithiasis: a reappraisal. AB - Sonographic detectability of choledocholithiasis using real-time sector scanners appears to be improved in comparison with series previously reported. To establish this premise, 78 consecutive patients with choledocholithiasis were evaluated prospectively by ultrasound (US) prior to surgery or endoscopic retrograde cholangiopancreatography. Preoperative US analysis yielded a 55% sensitivity for detection of choledocholithiasis (43 patients), representing more than a threefold increase over previous series. Dilated extrahepatic ducts were seen in 52 patients (67%), 40 of whom (77%) were seen to have an intraluminal stone. Extrahepatic ducts were normal in size in 26 patients (33%), only three of whom were seen to have a stone. This marked improvement in detection rate probably is related to improvements in imaging technology as well as to increased diagnostic efforts based on cognizance of the difficulty in making the diagnosis of choledocholithiasis sonographically. PMID- 3532180 TI - Multicystic dysplastic kidneys: spontaneous regression demonstrated with US. AB - In nine neonates, spontaneous regression of a multicystic dysplastic kidney (MCDK) was witnessed by means of repeated ultrasound (US) examinations. In three of these patients, the diagnosis was made in utero. Follow-up examinations at the ages of 3, 5, and 32 weeks post-partum showed what would have been called unilateral agenesis of the affected side if no fetal US study had been done. In the remaining neonates, the diagnosis was made postnatally, and marked reduction in size or complete disappearance of the MCDK was observed on serial US examinations. Three neonates underwent surgical exploration. No trace of a kidney, renal artery, or ureter was found in two. A small MCDK was removed in the third patient. US reveals new features of the natural history of MCDKs. Because malignant transformation of an MCDK is rare and because US provides a means of serial assessment, the authors believe a more conservative, nonsurgical approach is appropriate and recommend an observation time of 1 year before deciding on surgical intervention, unless other problems necessitate surgical removal of the MCDK. PMID- 3532179 TI - Undifferentiated (embryonal) sarcoma of the liver: radiologic-pathologic correlation. AB - Undifferentiated (embryonal) sarcoma (UES) is an uncommon malignant mesenchymal hepatic tumor that occurs in older children and young adults. Fourteen cases are correlated with radiologic and pathologic findings. Radiologic findings reflect the spectrum of solid to cystic appearances observed in the gross specimens. Sonography typically demonstrates a large mass that may be predominantly solid with many small anechoic spaces or may be cystic. Computed tomography reveals a hypodense mass with hyperdense septa of variable thickness and a dense peripheral rim corresponding to the fibrous pseudocapsule of the tumor. Angiographically, UES is usually hypovascular with tumoral vessels, although hypervascular and avascular patterns occur. Prognosis of UES is poor, with a median survival of less than 1 year. Radiologists should be familiar with this malignant tumor since it may present as a large cystic hepatic mass, suggestive of a benign lesion. PMID- 3532181 TI - Multicystic dysplastic kidney: observations of contralateral disease in the fetal population. AB - To evaluate multicystic dysplastic kidney (MDK) and associated contralateral renal abnormalities in the fetal population, 27 cases detected and followed in utero were reviewed retrospectively. The sonographic assessment included estimation of amniotic fluid volume and interval growth, evaluation for non genitourinary anomalies, and postnatal follow-up study. Contralateral renal anomalies were detected in 41% of the fetuses and included obstruction of the ureteropelvic junction, renal agenesis, renal hypoplasia, and bilateral MDK. The incidences of these malformations were compared with results of earlier studies of MDK in the pediatric and adult populations. Lethal anomalies, such as bilateral MDK and MDK associated with contralateral agenesis, are common (19% and 11%, respectively) in the fetal population; obstruction of the contralateral ureteropelvic junction, a nonlethal anomaly, was seen less commonly (7%). Perinatal death from lethal abnormalities may spuriously raise the incidence of nonlethal contralateral abnormalities in the pediatric and adult populations. Contralateral mild fetal pyelectasis, found in 15% of fetuses with MDK, was not clinically significant. PMID- 3532182 TI - One-shot dual-energy subtraction imaging. AB - Dual-energy subtraction imaging by a single x-ray exposure (one shot) can easily be performed by using computed radiography with scanning laser-stimulated luminescence. In a phantom study, a thin copper filter placed between two imaging plates produced a dual-energy subtracted image from a single x-ray exposure. One shot dual-energy subtraction imaging was also useful in the diagnosis of thoracic lesions. PMID- 3532183 TI - Breast cancer: age-specific growth rates and screening strategies. AB - In an earlier work, the author and colleagues predicted that the lead time gained by mammographic screening of an asymptomatic, randomly selected population of women was 2 years +/- 0.5 for women aged 35-49 years and 3.5 years +/- 0.5 for those over age 50. At the completion of long-term follow-up of 10,530 women (with a total of 111,087 "person years"), the resultant lead time actually gained seems to be 12-24 months for women aged 35-49 years at entry and 3.5-4 years for older women. Failure to take this lead time into account in the design of controlled trials may well result in failure to decrease mortality due to breast cancer. The results of the present study and those of recent Dutch and Swedish trials suggest that the most effective screening strategy may be annual mammographic and clinical examinations for women aged 40-49 years and biennial examinations thereafter. PMID- 3532184 TI - Parathyroid carcinoma: high-frequency sonographic features. AB - The authors reviewed the features on high-frequency (10 MHz), realtime sonograms of parathyroid carcinoma in eight patients to identify characteristics that could preoperatively distinguish malignant from benign lesions. The mean diameter of the eight carcinomas was 2.4 cm. They were typically ovoid or round and had a lobulated contour. The carcinomas were predominantly hypoechoic relative to the adjacent thyroid, but two of the eight contained both hypoechoic and hyperechoic regions, and three contained cystic spaces. Two carcinomas were grossly invasive on ultrasonographic (US) examination, although seven were proved histologically to be invasive. High-resolution US provides a noninvasive means to localize primary and locally recurrent parathyroid carcinomas preoperatively but fails to distinguish carcinomas from large adenomas reliably, except in cases with extensive invasion of adjacent structures. PMID- 3532185 TI - Hypertrophic pyloric stenosis: diagnosis using US. PMID- 3532186 TI - Postappendectomy fluid collections in children: incidence, nature, and evolution evaluated using US. AB - At the authors' medical center, most patients with postappendectomy fluid collections are treated conservatively. Thirty-two (15%) of 216 children underwent postoperative sonography following appendectomies. In ten patients (31%), a total of 16 fluid collections were found on the initial postoperative sonogram. In the seven patients (70%) whose fluid collections were confined to the pelvis, the condition was treated conservatively and it resolved in 2-9 weeks. In three patients, fluid collections required surgical drainage and proved to be abscesses. In two of the three patients, abscesses were multiple and widely distributed in the abdomen, and the patients were clinically ill. The authors conclude that clinically symptomatic fluid collections develop postoperatively in approximately 5% of children who have undergone appendectomy for acute appendicitis and that the size and course of the fluid collection can be objectively monitored using sonography. Such fluid collections confined to the pelvis ultimately resolve with conservative, nonoperative therapy, although resolution may take up to 2 months. PMID- 3532187 TI - Certificate issued by the ABR to Henry Pancoast in June 1934. PMID- 3532188 TI - Cirrhosis: value of caudate to right lobe ratio in diagnosis with US. AB - To verify the value of ultrasound (US) in the diagnosis of cirrhosis, the ratio of transverse caudate lobe width to right lobe width (C/RL) was determined with US in 25 healthy subjects and 156 consecutive patients with either histologically proved acute viral, chronic persistent, or chronic active hepatitis or cirrhosis. The C/RL ratio had a sensitivity of 43%, a specificity of 100%, and an accuracy of 79% in cirrhosis. The sensitivity was very low in alcoholic cirrhosis, low in cryptogenic cirrhosis, and high in hepatitis B virus related cirrhosis. In spite of its fairly low overall sensitivity, the C/RL ratio is a useful measurement in assessing chronic liver disease because of its high specificity in cirrhosis. PMID- 3532189 TI - FM sonography in diffuse liver disease: prospective assessment and blinded analysis. AB - FM sonography - a signal-processing technique that uses frequency and phase information as well as amplitude data - shows promise in evaluation of patients with diffuse liver disease. In a prospective blinded review of 37 patients with biopsy-proved liver disease and 42 healthy volunteers, FM sonography was clearly superior to traditional amplitude-based (AM) sonography in distinguishing healthy from diseased subjects. Statistically significant differences were seen in accuracy (FM, 98.7%; AM, 84.8%), sensitivity (FM, 97.3%; AM, 70.3%), and negative predictive value (FM, 97.7%; AM, 78.8%). Our data also suggest that current FM sonographic techniques cannot differentiate among histologic findings associated with different hepatic parenchymal abnormalities. It is unclear, therefore, whether FM imaging can reduce the numbers of patients who require biopsy for diagnosis or the frequency of biopsy procedures in patients with known disease. PMID- 3532190 TI - Changing appearance of the normal uterus during the menstrual cycle: MR studies. AB - The authors obtained sagittal magnetic resonance (MR) images twice a week from six healthy women during one full menstrual cycle to establish the changes depicted in the uterine layers. Parallel endocrine and ultrasound studies were used to establish the day of ovulation precisely. Consistent changes in the thickness and intensity of the endometrium and myometrium wer noted in all subjects during the menstrual cycle. Both myometrial thickness and endometrial area increased linearly during the follicular (preovulatory) phase of the cycle; the rate of increase dropped significantly during the luteal phase. Two myometrial layers were observed; the best contrast between the layers was demonstrated during the first half of the cycle. PMID- 3532191 TI - Intradecidual sign: a US criterion of early intrauterine pregnancy. AB - The uterine cavity appears on sonograms as a linear echo, which is usually visible during early pregnancy and remains straight until the eighth to ninth week of gestation. The early gestational sac is not enveloped by two layers of decidua, as suggested by descriptions of the double decidual sac sign; the sac (or echogenic area of early implantation) is actually located within a markedly thickened decidua on one side of the uterine cavity. The combination of these two sonographic characteristics is called the "intradecidual sign." An early implantation of 25 days gestational age can be detected by the presence of the intradecidual sign, which is sooner than a gestational sac can be seen. The implantation site can also be located by means of the intradecidual sign. In a study of 36 patients with early intrauterine pregnancy and five with ectopic pregnancy, the intradecidual sign was more sensitive (91.7% vs. 63.9%) and specific (100% vs. 60%) than the double decidual sac sign in the detection of early intrauterine pregnancy. PMID- 3532192 TI - Renal allograft rejection: US evaluation. AB - Real-time ultrasonography (US) was performed on the allografts of 100 consecutive renal transplant recipients at the time of allograft biopsy. Evaluation of the sonograms included the grading of parameters previously demonstrated to be indicative of allograft rejection. The appearance of the renal sinus fat, allograft size, corticomedullary ratio, sharpness of the corticomedullary junction, medullary conspicuity, presence of focal parenchymal abnormalities, and thickening of the pelvic or infundibular wall were individually evaluated. The authors correlated the US and the histopathologic findings. While the accuracy of a positive prediction of rejection was relatively high (83%-90%), this result is influenced by the relatively high prevalence of rejection in the biopsy group (83%). Accuracy of a negative prediction was uniformly low (17%-30%). Mild rejection was difficult to differentiate ultrasonographically from no rejection, although severe rejection could usually be differentiated from mild or no rejection, particularly in patients with the interstitial type of rejection. PMID- 3532193 TI - Extraadrenal pheochromocytoma: detection during pregnancy using MR imaging. AB - This case report demonstrates the usefulness of magnetic resonance (MR) imaging to demonstrate an abdominal mass during pregnancy. A pregnant woman presented in midgestation with symptoms and chemical evidence of a pheochromocytoma. The use of MR imaging permitted early localization of a retrouterine tumor when it would have been undesirable for the woman to undergo computed tomography because of radiation exposure. Evaluation of the MR images formed the basis of the therapeutic strategy used by the patient's physicians. PMID- 3532194 TI - Giant cell tumor of bone: radiographic changes following local excision and allograft replacement. AB - The authors retrospectively evaluated the clinical records and radiographs obtained from 41 patients who had giant cell tumor of bone and who were treated by local resection and allograft replacement. Postoperative complications developed in 41% of the patients. However, the eventual clinical outcome was considered to be satisfactory in 85% of all cases. There were no instances of tumor recurrence, and surprisingly, postoperative arthritis was not a major problem. The major complications encountered were infection and allograft fracture; bone infection accounted for most of the clinical failures. All infections were associated with the increasing soft-tissue swelling and bone resorption detected on radiographic studies. Other radiographic parameters that were associated with an increased rate of complications included osteopenia, increased periosteal reaction, and decreased bone formation at the host-donor junction site. The clinical outcome was distinctly less favorable in those cases in which the patient had had a pathologic fracture or a previous resection, or in whom the graft was implanted at the distal radius. PMID- 3532195 TI - Cerebrovascular disease: evaluation with transbrachial intraarterial digital subtraction angiography using a 4-F catheter. AB - Three hundred sixty-one patients underwent intraarterial digital subtraction angiography for definite or probable occlusive vascular disease of the carotid arteries. Examinations were performed with 65-cm-long, 4-F aortic catheters. A transbrachial approach was used. Images were good or excellent in nearly all cases. No postprocedural neurologic deficits or hematomas occurred. Permanent pulse deficit occurred in two patients, and temporary deficit occurred in three patients, an improvement over the frequency found in previous transbrachial series using 6-8-F catheters. While these results establish the efficacy of this technique, they also indicate a possible greater relative safety in men than in women. PMID- 3532196 TI - Vessel sizing wire: accurate vessel measurement using digital subtraction arteriography. AB - A simple method of measuring vessel diameters using intraarterial digital subtraction angiography has been designed. With a catheter in place within the vessel of interest, a segmented guide wire with known dimensions is advanced into the catheter in the area to be measured. We have used the method successfully for balloon angioplasty as well as balloon embolization. PMID- 3532197 TI - What is a useful adjunct to mammography? PMID- 3532198 TI - Medicare amendments change teaching hospital reimbursement. AB - The author discusses changes in Medicare legislation that will affect the amount paid to teaching hospitals for residents or interns. The implications of such changes are also addressed. PMID- 3532199 TI - An appraisal of cholesterol feeding in experimental atherogenesis. PMID- 3532200 TI - Invasive bedside hemodynamic monitoring. PMID- 3532201 TI - A review of pacemakers that physiologically increase rate: the DDD and rate responsive pacemakers. PMID- 3532202 TI - Differential inhibition of human placental prostaglandin release in vitro by a GnRH antagonist. AB - Previously, we have demonstrated that the production of prostaglandins by human placental tissue varied with gestational age. In addition, we have shown that placental prostaglandin release was affected by GnRH, and that its response was also dependent on the gestational age of the placenta. Thus, we have studied the effect of a GnRH antagonist ([N-Ac-Pro1,D-p-Cl-Phe2,D-Nal(2)3,6-LHRH, Syntex Research, Palo Alto, CA) on basal prostaglandin release from placentas of 6 to 15 weeks' gestation and found that this antagonist (1 microgram/ml) effects an inhibition of the release of prostaglandin E, prostaglandin F, and 13,14-dihydro 15-keto-prostaglandin from placentas of 13 and 15 weeks of gestation. This effect was not overridden by GnRH at 10 times the antagonist concentration in the 13 week placental cultures, but was totally reversed by GnRH (10 micrograms/ml) in the 15-week placental cultures. These data demonstrate that this GnRH antagonist can affect human placental prostaglandin production at 13 to 15 weeks of gestation and indicate that endogenous placental GnRH-like activity may exert a control over placental prostaglandin release at this gestational stage. PMID- 3532203 TI - The effect of intrauterine administration of prostacyclin on the contractility of the non-pregnant uterus in vivo. AB - Prostacyclin was infused into the uterus of non-pregnant women either during early menstruation or in the secretory phase of the cycle. A dose of 5 micrograms/min produced little systemic effect and caused a significant decrease in uterine activity on Days 1 and 2 of the menses whereas 0.5 microgram/min did not. However, when dysmenorrhoeic pain and increased uterine activity were produced by infusion of PGF2 alpha during the secretory phase, PGI2 neither decreased the activity nor the pain. This indicates that PGI2 does not cause uterine relaxation by blocking the action of PGF2 alpha. PMID- 3532204 TI - 12-Hydroxyeicosatetraenoic acid reduces prostacyclin production by endothelial cells. AB - 12-Hydroxyeicosatetraenoic acid (12-HETE), a lipoxygenase product released by activated platelets and macrophages, reduced prostacyclin (PGI2) formation in bovine aortic endothelial cultures by as much as 70%. Maximal inhibition required 1 to 2 h to occur and after 2 hr, a concentration of 1 microM 12-HETE produced 80% of the maximum inhibitory effect. 5-HETE and 15-HETE also inhibited PGI2 formation. The inhibition was not specific for PGI2; 12-HETE reduced the formation of all of the radioactive eicosanoids synthesized from [1 14C]arachidonic acid by human umbilical vein endothelial cultures. Inhibition occurred in the human cultures when PGI2 formation was elicited with arachidonic acid, ionophore A23187 or thrombin. These findings suggest that prolonged exposure to HETEs may compromise the antithrombotic and vasodilator properties of the endothelium by reducing its capacity to produce eicosanoids, including PGI2. PMID- 3532205 TI - Trypsin-like activity and thromboxane release in adult respiratory distress syndrome. AB - Plasmatic immunoreactive trypsin (IRT), thromboxane and trypsin-like enzymatic activity were measured in 117 patients at risk of developing adult respiratory distress syndrome (ARDS) (53 multiple injury, 30 abdominal surgery, 17 acute pancreatitis, 12 burnt and 5 disseminated intravascular coagulation patients). 69 of these patients developed ARDS. Immunoreactive trypsin and thromboxane were measured by radio-immuno-assay and trypsin-like enzymatic activity by spectrophotometry, using a specific chromogenic substrate. Mean IRT value was 675 ng/ml in ARDS and 265 ng/ml in non ARDS patients (p less than 0.05). Mean IRT value was 685 ng/ml in septic and 170 ng/ml in non septic patients (p less than 0.01). An abnormal trypsin-like enzymatic activity was measured in 26 ARDS patients. In 60 patients (37 ARDS and 23 non ARDS), thromboxane appeared in plasma simultaneously or about 24 hours after the beginning of IRT release. The importance of thromboxane release parallels the intensity of IRT. Originating from pancreas, trypsin can appear in plasma either by absorption from gastrointestinal tract or after pancreatic ischemia. PMID- 3532206 TI - Prostacyclin-stimulating drugs: new prospects. AB - SKF 525-A (proadifen), a well-known inhibitor of drug metabolism and cytochrome P 450 activity, stimulated the release of prostacyclin (PGI2) from the rabbit aorta in vitro. The PGI2-stimulating activity of SKF 525-A was characterized by specific structural requirements: activity was abolished by the deletion of the terminal propyl chain and increased by its elongation into an isobutyl chain; chlorination of the phenyl rings increased the potency. SKF 525-A increased the production of PGI2 by cultured endothelial cells from bovine aorta and human umbilical vein, but had no effect on cultured smooth muscle from the bovine aortic media. In human platelets, SKF 525-A inhibited prostaglandin and thromboxane production induced by A23187, thrombin and ADP. Simultaneous stimulation of endothelial PGI2 and inhibition of platelet TxA2 represents an original pharmacological profile: SKF 525-A might thus constitute the prototype of a new class of antiplatelet drugs. PMID- 3532207 TI - Prostacyclin production by the bovine aortic smooth muscle. AB - It is well known that cultured aortic smooth muscle cells, the phenotype of which has modulated from contractile to synthetic, are able to release prostacyclin (PGI2). We have studied the release of PGI2 from cultured explants of bovine aortic media, which represent an homogeneous population of smooth muscle cells with a contractile phenotype. These explants released spontaneously huge amounts of PGI2, which was the major eicosanoid produced. PGI2 release was stimulated by serum and by serotonin. This experimental model seems useful to evaluate the contribution of smooth muscle to the biosynthesis of PGI2 by the arterial wall. PMID- 3532208 TI - Basal level of prostaglandin D2 in rat brain by a solid-phase enzyme immunoassay. AB - A solid-phase enzyme immunoassay for prostaglandin D2 (PGD2) was developed in which PGD2 was labeled with horseradish peroxidase. After competitive binding to the immobilized antibody between enzyme-labeled and free PGD2, the activity of the enzyme bound to the antibody was assayed fluorometrically using 3-(p hydroxyphenyl)-propionic acid and hydrogen peroxide as substrates. The procedure allowed determinations of 3-100 pg for PGD2. The IC50 value for PGD2 in the solid phase enzyme immunoassay was about 25 pg and the sensitivity was improved about 10 times compared to those in radioimmunoassay and in solution-phase enzyme immunoassay. The solid-phase enzyme immunoassay was applied to the measurement of PGD2 content in rat brain and thereby an octadecylsilyl silica cartridge and a reversed-phase HPLC were sequentially used for sample preparations. Heads were immediately frozen in liquid nitrogen after decapitation to avoid a postmortem formation of PGD2. PGD2 contents measured by solid-phase enzyme immunoassay correlated well with the values obtained by radioimmunoassay (r = 0.966) after raising its contents by intravenous administration of PGD2. The in vivo level of PGD2 in rat brain was extremely low but determined to be 0.11 +/- 0.03 ng/g tissue (mean +/- S.E.M.) with this enzyme immunoassay. The result was equal to the value extrapolated to zero time from the postmortem change. PMID- 3532209 TI - Clinical evaluation of endocervical prostaglandin E2-triacetin-gel for preinduction cervical softening in pregnant women at term. AB - In an open randomized clinical trial 100 pregnant women with low Bishop Scores at term were treated either with intracervical Prostaglandin (PG) E2 (0.5 mg in 2.5 ml triacetin-gel) 12 hours before labor induction with intravenous oxytocin or with oxytocin infusion alone. In 46 of the 50 pretreated patients (92%) the Bishop Score progressed at least 3 points, in four cases only 2 points. The mean Bishop score in the untreated patients increased insignificantly. After PGE2-gel administration 16 patients delivered during the 12 hour interval compared to 3 in the group without pretreatment. The first induction attempt was successful in 14 (64%) of the 22 patients that were left to be induced after cervical softening and in 26 (57%) of the 47 women without cervical priming. The Cesarean section rate was 10% (n = 5) in the PGE2-gel group and 12% (n = 6) in the control group. Dosage of oxytocin required for labor induction was significantly lower after cervical softening. No serious fetal or maternal side effects were observed after PGE2 pretreatment. PMID- 3532210 TI - [Georges Devereux. The concept of psychoanalysis as an epistemologic and transcultural discipline]. PMID- 3532211 TI - The posterior palatal seal--its forms and functions (II)--Design and cast preparation. PMID- 3532212 TI - Anterior porcelain laminate veneers: clinical and laboratory procedures. PMID- 3532213 TI - Technique for fabrication of a full-coverage restoration to fit an existing removable partial denture. PMID- 3532214 TI - Factors affecting the design of the porcelain-fused-to-metal substructure. PMID- 3532215 TI - Effect of bead spacing on the tensile bond strength of resin veneers to cast alloys. PMID- 3532216 TI - Sverker Toreskog, D.D.S., M.S.D., talks of Swedish dentistry and the Swedish color system. PMID- 3532217 TI - Genetically-engineered microorganisms: II. Survival multiplication and genetic transfer. PMID- 3532218 TI - Discussions on human gene therapy. PMID- 3532220 TI - Central and peripheral proglumide administration and cholecystokinin-induced satiety. AB - Peripheral (50 mg/ml) or central (50 micrograms/microliter) injections of proglumide were made into Sprague-Dawley rats which displayed satiety-like responses after the peripheral (100 micrograms/kg) or central (50 ng in 1 microliter) administration of cholecystokinin (CCK). The satiety produced by CCK injection into the lateral hypothalamus, area postraema and ventromedial hypothalamus was significantly reversed by proglumide injections into these areas during a 4 h food intake test. Peripheral injection of proglumide after central or peripheral CCK injection did not modify this type of CCK-induced satiety. Central proglumide injection produced a reliable decrease in water intake and this is compatible with previous findings which describe the stimulation of water intake after central gastrin administration. These results suggest that various central and peripheral mechanisms which are involved in the regulation of appetite may function independently as a 'failsafe' system. PMID- 3532219 TI - Calcitonin gene-related peptide (CGRP): perivascular distribution and vasodilatory effects. AB - The distribution of perivascular nerve fibers displaying calcitonin gene-related peptide (CGRP) immunoreactivity and the effect of CGRP on vascular smooth muscle were studied in the guinea-pig. Perivascular CGRP fibers were seen in all vascular beds. Generally, they were more numerous around arteries than veins. Small arteries in the respiratory tract, gastrointestinal tract and genitourinary tract had numerous CGRP fibers. The gastroepiploic artery in particular received a rich supply of such fibers. Coronary blood vessels had a moderate supply of CGRP fibers. In the heart, a moderate number of CGRP fibers was seen running close to myocardial fibers. The atria had a richer supply than the ventricles. Numerous CGRP immunoreactive nerve cell bodies and nerve fibers were seen in sensory (trigeminal, jugular and spinal dorsal root) ganglia. Sequential or double immunostaining with antibodies against substance P and CGRP suggested co existence of the two peptides in nerve cell bodies in the ganglia and in perivascular fibers. In agreement with previous findings CGRP turned out to be a strong vasodilator in vitro as tested on several blood vessels (e.g. basilar, gastroepiploic and mesenteric arteries). Conceivably, perivascular CGRP/SP fibers have a dual role as regulator of local blood flow and as carrier of sensory information. PMID- 3532221 TI - [Study of adenopathies: what is the current role of magnetic resonance?]. AB - The actual role that MR imaging can play in detection of adenopathies in different body sites has been evaluated in 54 oncologic patients with pathologic nodes already seen with other methods. Enlarged lymph-nodes seen by CT or ultrasound were all visible by MR as well. Relaxation times of pathologic tissue (T1-T2) were calculated at a 0,5 magnetic field: it's our opinion that at present it's not already possible to state the capability of MR to distinguish different pathologic tissues. PMID- 3532222 TI - [Updating the diagnosis of neonatal cerebral pathology. Comparison of ultrasonic diagnosis and CT x-ray in hemorrhage-ischemia-anoxia]. AB - The authors compare the accuracy of Ultrasound and Computed Tomography in the diagnosis of hypoxic-ischemic brain damage and intracranial haemorrhage in 25 newborns with respiratory distress syndrome. Both examinations are performed at a maximum interval of 48 hours, within the first 8 days of life, and lately, after the third week. The results allow the introduction of a diagnostic protocol. PMID- 3532223 TI - [Radiological and echographic aspects of milk of calcium bile]. AB - In a series of 17 patients with milk of calcium bile radiologically examined, 9 underwent even ultrasound. A constant sonographic pattern was not observed, and an explanation for this finding is attempted. Ultrasound is not considered a suitable procedure for identifying this pathology, and it should be associated with plain x-ray examination. PMID- 3532224 TI - [Star-shaped calculus of the bladder. Presentation of a case]. PMID- 3532225 TI - [Pit and fissure sealing: fiction or reality]. PMID- 3532226 TI - [Current improvements and future composites]. PMID- 3532227 TI - [Infantile polycystic kidney]. PMID- 3532229 TI - [Percutaneous biopsy of the thorax using real-time ultrasonography]. PMID- 3532228 TI - [Evaluation of the cardiovascular autonomic nervous system in diabetic patients and heart transplant recipients]. PMID- 3532230 TI - [Mental deterioration with sudden worsening and the development of myoclonus in a 72-year-old man]. PMID- 3532231 TI - [Community-acquired bacteremic pneumonia caused by Escherichia coli. Report of 2 cases in healthy individuals]. PMID- 3532232 TI - [Complement (C3) receptor dependent monocyte recognition in uncompensated diabetes mellitus types I and II]. PMID- 3532233 TI - [Hepatic hydatidosis: comparative sero-immunologic and echographic diagnostic values in 31 cases]. PMID- 3532234 TI - [Allogeneic bone marrow transplantation. Current status and future perspectives]. PMID- 3532235 TI - [Lymphoma associated with autoimmune pancytopenia]. PMID- 3532236 TI - [Anesthesia management in tumors of the anterior mediastinum. Apropos of a case]. PMID- 3532237 TI - [Fistula of the brachiocephalic arterial trunk and the trachea: a post tracheostomy complication]. PMID- 3532238 TI - [Nucleus tractus solitarius, serotonin and regulation of vigilance]. AB - A brief historical survey of the vagal influences on sleep is lightly sketched first by analyzing the hypnogenic effects of the medullar area of the solitary tract nucleus (STN) where the vagal afferents terminate. Then the vagal effects and more extensively the sinusal or aortic effects are developed. It is shown that serotonin could play a crucial role in this so-called "vago-aortic" sleep mechanisms. Finally, these results are discussed and confronted with other experimental and human pathological data. PMID- 3532239 TI - [Superior vena cava syndrome and pacemaker]. PMID- 3532240 TI - [The present and future of liver transplantation]. PMID- 3532241 TI - [A case of pemphigus induced by captopril?]. PMID- 3532242 TI - [Myocardial infarct promoting type A behavior--an attempt to modify stress inducing behavior]. AB - To change some crucial elements of coronary-prone behaviour in cardiac patients is considered an important task of behaviour medicine, to reduce physico-chemical and, in particular, psychosocial "risk factors". The experimental study presented had examined whether the type A behaviour pattern, defined as the essential element of coronary-prone behaviour for its latent provocation of stress reactions, can be positively modified through behaviour therapy-focussed treatment within a clinical setting. A total of 91 persons, i.e. 49 recent-MI patients from an inpatient rehabilitation programme and 42 clients of a smoker counselling centre, were examined to identify type A or type B behaviour patterns (Rosenman u. Friedman, 1964). Of 39 type A post-MI patients, 13 (randomly selected) subjects were included in the "trial group" (VG), and participated, within a 4-8 week inpatient rehabilitation programme, in psychological training of stress management, relaxation, and self-control techniques; 3 patients denied participation; the remaining 23 type A post-MI patients, and the 20 type A smoker counselling clients, served as control group KG (A) and KG (B), who did not receive psychological training. Psychological and physiological parameters were assessed at the beginning (t1), the end (t2), as well as 3 and 6 months (t3 and t4) following completion of the psychological training. The results obtained confirm that the MI group includes significantly more type A persons (80 percent) than the cardiologically inconspicious control group of smokers (48 percent). Analysis of the data obtained at the various measurement points show that, as opposed to KG (A) and KG (B), significant improvements have in fact occurred in the trial group, such as reduced mental and psychovegetative stress reactions, which persisted even 3 months after programme completion.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3532243 TI - Localization of phenobarbital- and 3-methylcholanthrene-inducible cytochromes P 450 in mouse lung with monoclonal antibodies. AB - The cytochromes P-450 are key components of the mixed-function oxidase system responsible for the biotransformation of many foreign compounds to mutagens and carcinogens. In the present study, the distribution of these hemoproteins in frozen sections of mouse lung was determined immunohistochemically, using monoclonal antibodies (Mabs). Mab 1-7-1 is specific for 3-methylcholanthrene inducible cytochromes P-450; this Mab reacted intensely with parenchymal cells, but not epithelial cells of pulmonary bronchioles of 3-methylcholanthrene-treated mice. Mab 1-7-1 did not react with pulmonary cells of either untreated or phenobarbital-treated mice. Mab specific for phenobarbital-inducible cytochromes P-450, Mab 2-66-3, reacted with parenchymal and bronchiolar epithelial cells in the lungs of phenobarbital-treated, 3-methylcholanthrene-treated, and untreated mice. The localization of constitutive and induced forms of cytochrome P-450 in different cells of the lung may provide insight into the mechanisms by which cell specific damage and carcinogenicity are evoked by xenobiotics. PMID- 3532244 TI - Experimental pulmonary embolism with electrically activated autologous blood. AB - Pulmonary thromboembolism is one of the most frequent causes of death in our days. Notwithstanding the great efforts made in clinical and experimental medicine there has been no success as yet in filling the existing gaps in the understanding of pathophysiology of this disease. The blood electrically activated in vitro by direct current reacts like an endogenic thrombogenic substance. On the condition that such a substance is injected into the inferior vena cava, the clot is introduced into the pulmonary circulation and gives rise to pulmonary thromboembolism of a varying degree, each depending on the electrically activated blood injected. In the animal experiment it has thus become feasible, under standardized and reproducible conditions, to produce severe thromboembolism or chronic microembolism with subsequent hypertrophy of the right ventricle. The object of this contribution is a demonstration of a new, easy, and effective method for the induction of pulmonary embolism, which can be treated by thrombolysis. PMID- 3532246 TI - Immunohistochemical study of gastroenteropancreatic endocrine cells of the herbivorous Japanese field vole, Microtus montebelli. AB - The gastroenteropancreatic (GEP) endocrine cells of the Japanese field vole were studied immunohistochemically. Somatostatin-, 5-hydroxytryptamine-, glicentin-, glucagon-, bovine pancreatic polypeptide-, gastrin-, gastric inhibitory polypeptide-, cholecystokinin-, substance P-, secretin-, neurotensin- and insulin immunoreactive cells were revealed. The characteristic findings of the regional distribution and relative frequency of these immunoreactive cells in the GEP system of the vole were as follows. Somatostatin-immunoreactive cells were more numerous in the oxyntic glands than in the pyloric glands. Some somatostatin immunoreactive cells were found in small clusters in the oxyntic glands. Gastrin immunoreactive cells were detected not only in the pyloric glands and small intestine but also in the caecum and spiral colon. Gastric inhibitory polypeptide immunoreactive cells were also detected in the pyloric glands and no motilin immunoreactive cell was found in the gastroenteropancreatic system. PMID- 3532245 TI - Experimental Escherichia coli endotoxin-induced sensitisation and abortion in sows. AB - Subcutaneous injection of 235 micrograms endotoxin from E coli 08: K87, K88ab into two sows 14 days before the expected farrowing date elicited a toxic shock reaction but the sows recovered and farrowed normally. No reaction was observed in two other sows which had received endotoxin-free 0.9 per cent saline. In a subsequent pregnancy, the same four sows were injected subcutaneously with 23 mg of the same endotoxin preparation. Those which had previously received endotoxin exhibited a severe shock reaction and aborted after 28 and 40 hours, respectively, while the other two sows showed a milder reaction and farrowed normally. PMID- 3532247 TI - [Sexual life in patients with heart disease]. PMID- 3532248 TI - [Clinical significance of QT interval]. PMID- 3532249 TI - [Magnetic resonance imaging of the cardiovascular system]. PMID- 3532250 TI - [Doppler study in algodystrophy. Apropos of 10 cases]. AB - Algodystrophy is usually attributed to disorders of microcirculation, and one may reasonably expect to demonstrate these by the Doppler method applied to arteries. Ten patients with algodystrophy stage I were explored and compared with 10 healthy controls and 10 patients with diseases likely to encourage the development of algodystrophy. Systolic, diastolic and mean blood flow velocities were recorded at different levels in the limbs involved and compared with velocities recorded at the same levels in the limbs of healthy subjects and in the clinically healthy limb of control patients. Algodystrophic patients actually had local circulatory abnormalities consisting of an increase in mean velocity with a diastolic component. A diastolic velocity superior to 3 cm/sec on the main arterial axis of the affected limb, or a difference of more than 5 cm/sec in mean velocity between the right and left sides provided an early diagnosis of algodystrophy with an 80 p. 100 sensitivity in this small series. Moreover, in 3 out of 10 cases Doppler velocimetry demonstrated abnormalities at varying levels of the contralateral limb. PMID- 3532251 TI - [Major endemic biotopes, human migrations and infectious risks]. PMID- 3532252 TI - [Functional studies of the microcirculation]. PMID- 3532254 TI - [Bicentennial of Agustin Nathaniel Miers-Cox]. PMID- 3532253 TI - [Physiopathologic bases of the treatment of systemic scleroderma]. AB - Numerous drugs have been suggested for the treatment of systemic scleroderma. They may be studied and classified according to their site of action on the chain of events that leads from vascular abnormalities to sclerosis of the skin. Thus, proline analogues, colchicine, lathyrogenic agents, D-penicillamine, coagulation factor XIII and oestrogens are thought to act on collagens and their metabolism. Ketanserin has been suggested by the discovery of tryptophan abnormalities. Corticosteroids exert an inhibitory effect on fibroblasts. The use of calcium antagonists, angiotensin-converting enzyme inhibitors, prostacyclin and anti platelets rests on the presence of vascular abnormalities. The purpose of treatments with immunosuppressive drugs or plasma exchanges is to act on possible lymphocytic and/or macropageal factors. PMID- 3532255 TI - [Metolazone, a new diuretic in essential arterial hypertension]. PMID- 3532256 TI - Semiologic relations of psychiatric care delivery of self-aggressive behaviour. PMID- 3532257 TI - [Role of echography in the diagnosis of digestive lesions]. PMID- 3532259 TI - [History of pharmacy in Bucovina (Suceava County)]. PMID- 3532258 TI - [Diazabicyclic systems (VIII). Cyclo addition reactions of benzoquinoline and 3,8 dimethyoxybenzoquinoline via ylidic intermediaries]. PMID- 3532260 TI - [Man and night work. II. Problems of pathology]. PMID- 3532261 TI - [Hematologic stress syndrome]. PMID- 3532262 TI - [Serratia marcescens septicemia. Comments on 6 cases]. PMID- 3532263 TI - The significance of the imported P. vivax in the epidemiological context in Moldavia (Romania). PMID- 3532264 TI - [Prostacyclin--its therapeutic safety]. PMID- 3532265 TI - [Genetic implications in alcoholism. Some considerations of ethanol metabolism]. PMID- 3532266 TI - [Radial immunohemolysis in the assay of serum antibodies to the measles virus]. PMID- 3532267 TI - [Medicine and philosophy (XIII)]. PMID- 3532268 TI - [Experimental research on using lactic acid for the disinfection of water]. PMID- 3532269 TI - A critical review of epidemiologic studies on black-foot disease. AB - An endemic disease in Taiwan named "Black-foot Disease", which has been researched since 1958 and about which many papers have been published, was considered caused by arsenic poisoning from artesian well water. In the beginning some information related to the disease before 1958 is introduced and then, reviews of the six papers titled "Epidemiologic Studies" on "Black-foot Disease" are made without referring to any findings from other papers. The data related to the incidence and severity of the disease from the papers are reevaluated, paying special attention to the fact that the incidence of the disease increased after the installation of pipe system water-supply to replace the artesian wells. With the above-mentioned result the theory which considers arsenic poisoning as the cause of the disease, is disproved. PMID- 3532270 TI - Heat stress: a threat to health and safety. AB - This review offers a rational basis for the use of fundamental physiological controlling mechanisms in setting safe environmental limits for occupational situations where heat stress is encountered. There is no single index of heat stress that has been universally accepted. However, the use of wet bulb glove temperature (WBGT) has been adopted by various organizations on occupational health and safety in several industrial countries. Thermal limits suggested for everyday work continue to be subject to argument. The controversies arise from the fact that many factors such as individual variations, acclimatization, clothing, age, sex, physical fitness and work load lead to significant effects on tolerance of man to heat. Several measures for prevention of heat stress under industrial situations are summarized briefly. There is no agreement on a single measure to be used, rather a combination of these measures can be the most effective mean to alleviate or prevent severe heat stress. It is to be hoped that this review may help public health officials and medical doctors of various work occupations resolve some of the problems that arise in setting thermal limits and preventive measures, thus contributing to increase productivity and efficiency of work. PMID- 3532271 TI - Genetic epidemiology: a review of the statistical basis. AB - Genetic epidemiology is the analysis of the familial distributions of traits, with a view to understanding any possible genetic basis; the fundamentals of this area are reviewed. The terminology of genetic models is fully described, since it is this wealth of terminology which can make it difficult for a statistician to enter the area. The statistical approaches to the analysis of data on sets of interrelated individuals are then discussed, and resulting problems of sampling design and analysis are considered. PMID- 3532272 TI - Rheumatoid nodulosis: an immunohistochemical and ultrastructural study. PMID- 3532273 TI - [Psychological and psychiatric aspects in cancerology]. PMID- 3532274 TI - [Demographic evolution and current risk factors in gastric ulcer]. PMID- 3532275 TI - [The use of computers in electrocardiography]. PMID- 3532276 TI - [The artificial heart]. PMID- 3532277 TI - [Use of new materials in technics of crown reconstruction]. PMID- 3532278 TI - [Cancer of the ovary and pregnancy. Apropos of a case]. AB - Following a case of ovarian cancer diagnosed during pregnancy, the authors examined the problems of screening for ovarian tumors and management of tests and treatment. PMID- 3532279 TI - [A case of septic necrobiosis in leiomyoma of the uterus in the postpartum period. Clinical, echographic and x-ray computed tomography study]. AB - The authors report a case of septic necrobiosis of leiomyoma uteri the first signs of which were seen at the eighth day after childbirth. After several episodes of discharge of Proteus into the blood, separated by a period of apparent resolution, the disorder was only resolved by hysterectomy carried out upon the request of intensive care staff, despite the desire of the patient for subsequent pregnancies. Bacteriological examination of the necrobiotic myoma showed the presence of Proteus morgani, the antibiotic resistance characteristics of which were the same as those of the Proteus seen in the blood. PMID- 3532280 TI - [Efficacy and tolerance of veralipride in the treatment of flushing in the menopause. A multicenter study]. AB - An open ended multicentric study has enabled to evaluate the efficacy and the tolerance of veralipride on sudden flushes and associated disorders of menopause. It included 166 women (125 in natural menopause) between the ages of 32 and 68 (mean age: 52). Veralipride was administered at a dose of 100 mg/day (1 capsule) for three sequences of 20 days separated by 10 days without treatment. The results were observed on 138 cases (28 withdrawals) at DO, D3M (after 3 months of treatment), D6M (three months after interruption of the treatment). The results were considered as excellent or good in 89.9 per cent of the cases at D3M. Three months later, the results were still excellent or good in 64.5 per cent of the cases. The self evaluation by the patients gave similar results: 91.1 per cent of favorable opinions at D3M and 80.7 per cent at D6M. The systolic and diastolic blood pressure did not vary during the observation period. These results confirm those obtained in previous studies. PMID- 3532281 TI - [Effect of thalidomide on serum levels of immunoglobulins IgM and IgA, rheumatoid factor and isohemagglutinins anti-A and anti-B in patients with lepromatous leprosy. A double-blind study]. PMID- 3532282 TI - [Evaluation of an antirabies conjugate by titration using various fluorescent microscopes]. PMID- 3532283 TI - Effects of Mycobacterium bovis BCG, bacterial lipopolysaccharide and hydrocortisone on the development of immunity to Plasmodium berghei. PMID- 3532284 TI - [Inferior vena cava compression syndrome in paracoccidioidomycosis]. PMID- 3532285 TI - Separation and characterization of complement-fixing immune complexes in juvenile rheumatoid arthritis patients. AB - Immune complexes (IC) in sera from patients with juvenile rheumatoid arthritis (JRA) were isolated by the use of immunoabsorbent columns. Sera from 14 JRA patients (four seropositive for 19S IgM RF and 10 seronegative, but nine having hidden 19S IgM RF) were analyzed by the anti-human Clq (alpha HClq) and anti human C3 (alpha HC3) columns. The columns were sequentially eluted with veronal buffer, 0.02 M EDTA, 0.5 M NaCl, and 1 M propionic acid. By the alpha HClq column, IgM RF were detected in at least one of the separated IC fractions of 13 of 14 patients and IgG RF in three patients. By the alpha HC3 column, only five patients demonstrated IgM RF and only one IgG RF in the eluted fractions. On sucrose density gradient analysis (SDGA), all IC were demonstrated in the peaks greater than or equal to 19S.19S IgM RF were demonstrated by ELISA in all 14 patients, but IgG RF in only three. These studies demonstrate that complement fixing 19S IgM RF, IgG, and IgG RF containing IC can be detected in the serum of JRA patients. PMID- 3532286 TI - Change in collagen synthesis of human chondrocyte culture. I. Development of a human model, demonstration of collagen type conversion by immunofluorescence. AB - A research system constituted entirely of components of human origin was developed to study conversion of collagen synthesis by human chondrocytes. Type specificity of affinity chromatography-purified antibodies to human type II or type I collagen was proven by ELISA inhibition and immunofluorescence analysis. Human chondrocytes were isolated from articular cartilage and kept in monolayer cultures for eight subpassages. Conversion of type II to type I synthesis by chondrocytes was investigated by immunofluorescence. Staining with anti-type II collagen antibodies could be detected during primary cultures and in the first subpassage, whereas staining with anti-type I collagen antibodies occurred beginning from the end of primary cultures and was present up to the eighth subpassage. Results are compared to observations obtained in animal systems and their relevance to conditions in osteoarthritis is discussed. PMID- 3532287 TI - [Acquired immunodeficiency syndrome (AIDS): present and future]. PMID- 3532288 TI - Plasma and red cell ferritin in normal subjects, in iron deficient patients and in patients with thalassaemic trait measured by an immunoenzymatic method. PMID- 3532289 TI - [Heterogeneity of erythrocyte surface antigens in subjects with homozygous beta thalassemia: observations by immunoelectron microscopy]. PMID- 3532290 TI - [Anti-HTLV III/LAV antibodies of the IgM class in subjects at risk with negative anti-HTLV III/LAV IgG ELISA results (preliminary results)]. PMID- 3532291 TI - Autoimmune disease induced by oral administration of mercuric chloride in Brown Norway rats. AB - Only few reports are available on the consequences of chronic oral administration of low doses of mercuric chloride (HgCl2). Forty Brown-Norway rats received 150 micrograms HgCl2/100 g body weight 3 times a week by gavage or by i.m. injection with 100 micrograms twice per week. After 2 weeks of oral HgCl2 administration, the rats lost weight and hair. Phases of proteinuria were observed in weeks 5-8 and then continuously from week 12 until the end of the experiment at week 39. Antibodies binding to renal, intestinal, and vascular basement membrane developed after 2 weeks; circulating immune complexes were detectable in increasing titers starting at week 3. There were linear deposits of IgG, IgM, and IgA in the glomerular basement membrane and tubular basement membrane, and along the intestinal basement membrane. After week 11, the first granular immune deposits were observed in renal and intestinal basement membranes. Light microscopy showed thickening of glomerular basement membrane, mesangial matrix, and tubular basement membrane. In addition, interstitial nephritis was observed in some animals. Interestingly, kidney involvement was as severe in the orally as the i.m.-treated animals. PMID- 3532292 TI - The evolution of anti-ulcer therapy with cimetidine. Is a single large nocturnal dose of cimetidine the right therapy for duodenal ulcer? AB - Peptic ulcer results from the prevalence of agents causing endoluminal lesions over the defence mechanisms of the mucosa of the upper GI tract. Particularly, in the case of duodenal ulcer, the pathogenetic relevance of non-buffered acid secretion of the early nighttime period has been emphasized. This is indeed confirmed by the fact that a single night dose of 800 mg cimetidine has apparently been proved able--in numerous controlled clinical trials--to provide results that are similar to those obtained with the classic dose of 1 g daily or 400 mg twice daily. Our centre carried out a crossover double-blind controlled trial aimed at evaluating titrable acidity and pH during the 24-h period in seven patients with active duodenal ulcer. The single nighttime dose of cimetidine resulted in a significant and long-lasting inhibition of acid secretion during the entire night. During the day, secretory values returned to levels similar to those obtained with placebo, hence allowing normal digestive functions. PMID- 3532293 TI - Cimetidine, 800 mg once daily: preliminary European clinical data evaluation. AB - A multicenter study was carried out on a total of 574 patients to investigate the safety and efficacy of a 800-mg nighttime dose of cimetidine in comparison with 400 mg twice daily for 4 or 8 weeks in the treatment of patients with duodenal ulcer. No statistically significant differences were observed between the two regimens. Healing rates were as follows: at 4 weeks 212 of 269 patients (79%) healed with the once daily regimen whereas 200 of 270 patients (74%) healed with the twice daily dosage; at 8 weeks 242 of 251 patients (96%) healed with the once daily regimen as compared with 232 of 246 (94%) treated with the twice daily dosage. The dosages were equally effective in relief of pain during the study period. The results confirm that a single nighttime dose of cimetidine is as effective as the twice daily regimen. PMID- 3532294 TI - Nocturnal gastric acid secretion: its importance in the pathophysiology and rational therapy of duodenal ulcer. AB - The importance of nocturnal acid secretion has long been acknowledged. The aim of therapy at present is to control acid secretion throughout the entire 24-h period. However, the fact that in DU patients a 400-mg nighttime dose of cimetidine is more effective than a 200-mg one, along with the observation that poorly responsive patients also show little decrease in H+ activity, suggests that a larger single nocturnal dose is an effective primary treatment for DU patients. In studies investigating the effects of different regimens of H2 antagonists on 24-h H+ activity and nocturnal acid secretion in DU patients and healthy volunteers, 400 mg cimetidine twice daily was compared with 800 mg cimetidine at night, 150 mg ranitidine twice daily, 300 mg ranitidine at night, and placebo. In 12 DU patients no significant difference was observed between twice daily or nighttime cimetidine and twice daily or nighttime ranitidine in the reduction of 24-h H+ activity. Cimetidine at night was significantly more effective than the twice daily regimen in reducing nocturnal acid output. Ranitidine, 300 mg at night, decreased nighttime H+ activity more than 800 mg cimetidine at night, although no significant differences in overnight acid output were observed. In another study of four DU patients and four volunteers, 400 mg cimetidine twice daily was compared with 800 or 1200 mg cimetidine at night, 150 mg ranitidine at night, and placebo. All treatments were equally effective at night but had no effect during the day. Hence, early reports seem to confirm that daytime administration of H2 antagonists is unnecessary. PMID- 3532295 TI - Effects of 800 mg cimetidine once daily on gastric acid secretion. AB - Today, the reduction of nocturnal acid secretion is believed to be the most important point in duodenal ulcer therapy. This is supported by the fact that during the day gastric acid secretion is largely buffered by meals. Moreover, independently of food intake the intragastric H+ activity during the day is lower than during the night. During nighttime (2300-0700 h) there was a mean hourly H+ activity of 38 mmol/l--that is, a 65% increase compared with daytime H+ activity with meals--and still a 30% increase without meals. Nocturnal acidity can be suppressed best by single large bedtime doses of H2-receptor antagonists. Cimetidine, 800 mg at night, reduces nocturnal intragastric acidity by 85%; 300 mg ranitidine at night and 40 mg famotidine at night reduce it by 95%. The first clinical trials show that a single nighttime dose of cimetidine or ranitidine is at least as effective in promoting ulcer healing as is twice daily administration. PMID- 3532296 TI - Results of long-term treatment with cimetidine. AB - Forty-two patients, 35 with duodenal ulcer, 6 with prepyloric ulcer, and 1 with gastric ulcer, were, in accordance with their own choice, allocated to either maintenance therapy with cimetidine or intermittent therapy in connection with symptoms and endoscopically proven relapse. Dosage during maintenance therapy was kept as low as possible to keep patients free of symptoms. Patients receiving maintenance therapy were mostly free of symptoms, but 6 out of 24 patients had from one recurrence every 2nd year to 3 recurrences per year. Patients receiving intermittent therapy had two recurrences per year (median). The yearly dose of cimetidine in maintenance therapy was high (219 g; range, 73-292 g) compared with 59 g (range, 42-84 g) in intermittent therapy. To conclude, we cannot recommend the use of maintenance therapy for years in the routine management of ulcer patients. PMID- 3532297 TI - Prevention of relapse with various antiulcer drugs. AB - The relative value of maintenance therapy with cimetidine, ranitidine, pirenzepine, and antacids only (when used for symptomatic relief) has been evaluated in 205 patients with a subsequent follow-up period of 2 years. The patients had a completely healed duodenal ulcer after 8 weeks of treatment and were then randomly allocated to four groups, which were as follows: group 1: 60 patients treated with 400 mg cimetidine at night; group 2: 55 patients treated with 150 mg ranitidine at night; group 3: 50 patients treated with 50 mg pirenzepine at night; and group 4: 40 patients treated only with antacids as needed for symptomatic relief. Endoscopy was repeated after 6, 12, 18, and 24 months of treatment, and whenever symptoms suggested recurrence. Although the number of dropouts was high (27 in group 1, 20 in group 2, 18 in group 3 and 12 in group 4), statistical analysis by the life-table method showed that cimetidine, ranitidine, and pirenzepine had similar therapeutic value. After 1 and 2 years the relapse rate of duodenal ulcer was 17.5% and 43.6% respectively, for cimetidine, 21% and 69.3% for ranitidine, 21.7 and 50.2% for pirenzepine, and 49.8% and 77.7% for antacids. The incidence of erosions was lower in those groups with the higher ulcer relapse rate, a point discussed in the present study. PMID- 3532298 TI - Cimetidine, 800 mg at night versus 400 mg twice daily, in the treatment of duodenal ulcer. AB - A multicentre double-blind study was carried out on a total of 197 patients, to evaluate the safety and efficacy of an 800 mg nighttime dose of cimetidine in comparison with 400 mg twice daily in the treatment of duodenal ulcer. At 4 weeks 84% of the 187 patients eligible for analysis had healed ulcers with the once daily regimen and 68% with the twice daily regimen (p less than 0.05). An early decrease in both day and nighttime pain and in antacid consumption was observed during the first 2 weeks. Adverse effects were few and mild, confirming the safety profile of cimetidine. PMID- 3532299 TI - Haemolysis after T-cell depleted bone marrow transplantation involving minor AB0 incompatibility. AB - 9 recipients of T-cell depleted allogeneic bone marrows (8 group A, 1 group AB) from group 0 donors were monitored after transplantation. Free anti-A/B was demonstrable in 8 of the 9 recipients 10-19 d post-transplant, 5 patients developed a positive direct anti-globulin test and 7 showed a rise in bilirubin. The presence of antibody was generally unrelated to the infusion of incompatible plasma, although 2 patients who also received anti-CMV immunoglobulin subsequently shown to contain high titre IgG anti-A/B were more severely affected, sustaining a fall in Hb of up to 2 g/d. These observations suggest that, after T-cell depleted bone marrow transplantation, immunocompetent B lymphocytes of donor origin are transferred, secrete antibody in the recipient, and may be responsible for self-limiting haemolytic episodes. PMID- 3532300 TI - Accessory spleen imaging. Radionuclide, ultrasound and CT investigations in a patient with thrombocytopenia 25 yr after splenectomy for ITP. AB - A 42-yr-old man presented with thrombocytopenia 25 yr after splenectomy for idiopathic thrombocytopenic purpura (ITP). Preoperative investigations with 99Tc colloid scan, ultrasound and computed tomography (CT) revealed 2 accessory spleens. The patient recovered completely after splenunculectomy. CT was superior to radionuclide and ultrasonography in describing the exact location of the 2 spleens, thereby facilitating the operative procedure. PMID- 3532301 TI - Regulation of human natural killing. IV. Role of lipoxygenase in regulation of natural killing activity. AB - In this study we demonstrated that natural killer (NK) cell lysis by human peripheral blood nonadherent (NA) cells against K562 target cells was rapidly inhibited by four agents that inhibit the lipoxygenase pathway of arachidonic acid metabolism, nordihydroguaiaretic acid (NDGA), U-60257, alpha-phenanthroline, and esculetin. However, human NK cells activated by interferons (IFN) or poly I:C were partially resistant to suppression by NDGA and U-60257. Pretreatment of the NA cells with the four lipoxygenase inhibitors at 37 degrees C for 18 h led to suppression of NK activity. The inhibition of NK activity by NDGA was not reversed by aspirin at a concentration that inhibits PGE2 synthesis. Thus, suppression of NK activity by NDGA was not mediated by the effects on PGE2 synthesis. However, the inhibition of endogenous NK activity by NDGA, U-60257, alpha-phenanthroline, or esculetin was partially reversed by IFN or poly I:C. These results suggest that products of lipoxygenation are required for maintenance of human NK activity. PMID- 3532302 TI - Yersinia enterocolitica septicemia: clinical and microbiological aspects. AB - Septicemia is a rare but serious complication of infection with Yersinia enterocolitica (Y.e.). Seven cases of Y.e. septicemia are presented. Five of the patients had no underlying disease predisposing to septicemia. Five patients displayed recurrent episodes of septicemia, despite treatment with recommended doses of antibiotics to which the isolates were sensitive in vitro. One patient developed endocarditis which required surgical replacement of the aortic valve. Other clinical manifestations were arthritis, diverticulitis and pulmonary abscesses. The outcome was fatal to 3 elderly patients. The serological response to Y.e. was followed by tube agglutination and a diffusion-in-gel enzyme-linked immunosorbent assay. One patient, with a benign course of illness, had transient elevated Y.e. antibody titres, while the 3 cases with a protracted disease showed sustained antibody responses for 6-18 months. Blood isolates of Y.e. had ordinary virulence characteristics identical to fecal isolates and produced extracellular beta-lactamase. All isolates were sensitive in vitro to trimethoprim sulfamethoxazole, mecillinam, piperacillin, cefotaxime, ceftazidime, chloramphenicol and gentamicin. The lowest MIC values were recorded for mecillinam. Full synergistic activity was demonstrated when mecillinam was combined with trimethoprim-sulfamethoxazole, cefuroxime or rifampicin. PMID- 3532303 TI - Prevalence of Legionnaires' disease in pneumonia patients admitted to a Danish department of infectious diseases. AB - During a 14-month study period, 92 patients admitted to the University Clinic for Infectious Diseases with pneumonia were investigated to determine the prevalence and severity of Legionnaires' disease (LD). The diagnosis of LD was based on positive serology. Antibodies to 10 different legionella antigens--Legionella pneumophila serogroups 1-6, Fluoribacter (Legionella) bozemanae, F. dumoffii, F. gormanii, and Tatlockia (Legionella) micdadei--were measured by the microagglutination (MA) and indirect fluorescent antibody (IFA) techniques. LD was diagnosed in 22 patients showing a 4-fold or greater rise of MA titers. 10 patients showed a 4-fold or greater rise of IFA titer, 2 had standing high titer. One patient died. Legionella infection was the second most common cause of pneumonia. However, in half of the cases legionella infection occurred concomitantly with Streptococcus pneumoniae, Haemophilus influenzae, Mycoplasma pneumoniae, Chlamydia psittaci, or viral infections. All 22 LD cases were sporadic. LD had been contracted abroad by 6 patients. Two of the legionella pneumonias were hospital-acquired. Half of the LD patients were older than 60 years. The majority of cases occurred during the winter months. Neither clinical chemistry parameters nor clinical features could distinguish LD from other types of pneumonia. PMID- 3532304 TI - Clinical significance of nontuberculous mycobacteria. A bacteriological survey of Swedish strains isolated between 1973 and 1981. AB - An account is rendered of mycobacteria other than Mycobacterium tuberculosis isolated from specimens sent for culture during 9 years. The possible etiological significance of these bacteria was estimated from clinical data and the degree of bacterial growth. Pulmonary infection was the most common nontuberculous manifestation in the adults. In about 50% of the patients with slowly growing mycobacteria in their respiratory tract, these bacteria were considered to be an etiological factor. This applied to the species of the M. avium-intracellulare (MAI) complex and M. xenopi. M. Kansasii, a common cause of lung disease in many other countries, was rarely isolated. The corresponding figure for the rapidly growing mycobacteria belonging to the M. fortuitum-chelonei complex was 15%. These patients were all severely debilitated by other diseases. Lymphadenitis was the most common nontuberculous infection in children, but occurred only in children not vaccinated with BCG. Bacteria of the MAI complex was the predominating cause. Lung infection caused by nontuberculous mycobacteria did not occur in children. PMID- 3532305 TI - Experimental intestinal infection of rats by Yersinia enterocolitica 0:3. A follow-up study with specific antibodies to the virulence plasmid specified antigens. AB - Rats were infected by intragastric inoculation of Yersinia enterocolitica 0:3 grown at room temperature. The events of the first 6 days of the infection were followed by staining sections of small intestine using an immunoperoxidase method. The specific antibodies used were either rabbit antibodies to antigens of Y. enterocolitica, to the temperature-inducible antigens specified by the virulence plasmid (pYV) of Y. enterocolitica, or monoclonal antibody to the pYV specified autoagglutination protein P1. In the course of the infection Y. enterocolitica organisms were detectable in the terminal ileum already 1 h after the challenge. By 1 h the pYV-specified temperature-inducible antigens were expressed in Y. enterocolitica both in the lumen of the intestine and in the intestinal tissues, which indicates that the activation of pYV in vivo was very rapid. Y. enterocolitica organisms which had penetrated into the lamina propria of the villi were rapidly removed by phagocytic cells. Later organisms were located intracellularly in the lamina propria, in Peyer's patches and in the regional lymph nodes. The terminal ileum was the most severely affected part of the small intestine. PMID- 3532306 TI - Rubella-specific IgM determination of heat-treated sera. PMID- 3532307 TI - Cognitive psychology in Scandinavia. Attention, memory, learning and memory dysfunctions. PMID- 3532308 TI - [Therapy of cholelithiasis. Advances and disappointments in the last 50 years]. AB - For many decades cholecystectomy has been the standard treatment for symptomatic cholecystolithiasis. In asymptomatic patients a waiting attitude can be taken. In recent years, non-surgical therapies have been developed for selected patients. Thus, in patients with mild or no symptoms medical dissolution of gallstones with ursodeoxycholic acid, chenodeoxycholic acid or a combination of these two bile acids can be tried if radiolucent stones with diameters below 15 mm are present in a functioning gallbladder (not more than half full of stones). Besides this therapy, cholelithotripsy with extracorporeal shock waves represents a new procedure, which, together with percutaneous or retrograde instillation of methyl tert-butyl ether, needs further evaluation. For elimination of stones from the common bile duct, endoscopic sphincterotomy and stone extraction have proved valuable non-surgical procedures. For choledochal stones not amenable to endoscopic extraction or dissolution by instillation of solvents, treatment by extracorporeal shock waves represents a valuable alternative to surgery. Thus, the past decades have not only brought progress in knowledge of gallstone disease but have also broadened the therapeutic armoury. Therefore, it is essential to select the most appropriate method for each situation. PMID- 3532309 TI - [Severe, acute bleeding ulcer: which criteria are decisive for therapeutic procedures?]. AB - Prognostic and therapeutic implications of acute severe gastrointestinal bleeding were retrospectively analyzed, on the basis of history, clinical and endoscopic findings, in a group of 50 consecutive patients with endoscopically documented ulcer of the stomach or duodenum. In patients with hemorrhagic shock and a history of melena and/or hematemesis represents the most important indication for urgent action. In this setting the surgical approach remains the therapy of choice if other measures (endoscopic coagulation, somatostatin application) are unable to prevent further bleeding. Except in situations with acute arterial bleeding, the endoscopic finding itself is not decisive in selecting the therapeutic procedure. PMID- 3532310 TI - [Ultrasonic diagnosis of intestinal mural hematoma during anticoagulant therapy]. AB - Report on a patient with a complication of anticoagulant treatment, in whom intramural colon wall bleeding was diagnosed and followed up by ultrasonography. PMID- 3532311 TI - Immunodeficiency and cancer: mechanisms involved. AB - This is a short overview concerning possible relationships between immunodeficiency and cancerogenesis/leukemogenesis. Following introductory remarks on concomitant and sinecomitant antitumor immunity, various factors/mechanisms that could influence tumor-host-interactions are discussed, in particular properties of neoplastic cell lines, the microenvironment, cellular components of nonspecific resistance, and specific, i.e. antigen-directed, cell mediated and humoral immune responses against cancer cells. The increased incidence of malignant neoplastic processes in patients with inherited or acquired immunodeficiency raises the question if a lack of antitumoral defense or ineffective antiviral immunity is more important. Available data indicate that once a cancer has reached a certain size, the chances for the host to reject it solely with the help of its immune apparatus are minimal. The possibility remains that immune reactions may be more efficacious against small numbers of immunogenic tumor cells, i.e. in the very earliest phase of a neoplastic process and when the cancer begins to metastasize. PMID- 3532312 TI - [Cytostatic agents and defense]. AB - The defence mechanisms of the human body against harmful influences from the environment are manifold. The aggressions on the integrity of the organism are physical, chemical, or biological in nature. In this paper the interactions of the commonly used cytotoxic drugs with various defence mechanisms are discussed. Impairment of these defence mechanisms by cytotoxic drugs results in a whole variety of clinical pictures, such as delayed wound healing, secondary malignant neoplasms or many different infectious diseases. These cytotoxic drug-induced diseases are summarized under the term IDDSS (Induced or Iatrogenic Defence Deficiency SyndromeS). PMID- 3532314 TI - [The role of broncho-alveolar lavage in clinical pneumology and research]. AB - Bronchoalveolar lavage is a recently developed technique which serves to sample the cells free in the alveolar spaces. It has thus been found that many pulmonary interstitial disorders are characterized by increased cellularity involving lymphocytes and/or polymorphonuclears, neutrophils or eosinophils. Bronchoalveolar lavage is rarely of diagnostic use but may provide interesting information on the inflammatory activity of many pulmonary diseases. Bronchoalveolar lavage appears to be a promising tool for study of the pathogenesis of these diseases. PMID- 3532313 TI - [Intensive treatment and autologous bone marrow transplantation in cases of acute leukemia and lymphoma]. AB - Experience with 19 autologous bone marrow transplantations shows that this approach may produce a high proportion of complete remissions in otherwise resistant tumours. Although most responses are of short duration, they suggest that longterm disease-free survival may be achieved in patients with poor prognosis if treated earlier in the course of disease. PMID- 3532315 TI - [Comparative study of the effects of regular or on-demand salbutamol inhalation in the treatment of asthma]. AB - 52 asthmatic patients aged 18 to 70 years took part in a double-blind crossover trial comparing the effects of regular treatment of asthma with inhaled salbutamol (400 micrograms qds) versus irregular treatment (400 micrograms prn), each prescribed for 4 weeks. There were no differences between the two schedules regarding intensity of clinical symptoms, morning and evening values of peak expiratory flow rates and spirometric measurements. The mean daily consumption of salbutamol was higher in the period of regular treatment (2148 +/- 548 micrograms) than in the period of free treatment (800 +/- 700 micrograms). Patients expressed an obvious preference for the period of regular treatment (26 vs 13). Salbutamol given prn or on a regular qds regimen was shown to be equally effective and safe in controlling the signs and symptoms of asthma. No tolerance or drug abuse was observed. In view of the patients' preference for regular treatment, this schedule is a safe alternative in cases where low-dose symptomatic treatment given prn fails to alleviate symptoms. PMID- 3532317 TI - [Effect of the shaping of occlusion on the alignment of occlusal forces during mastication with a complete denture]. PMID- 3532316 TI - [Root canal preparation using high-speed instruments]. PMID- 3532318 TI - [Problems of temperature elevation during the treatment of bone with rotating instruments--a review of the literature]. PMID- 3532319 TI - Immunofluorescent studies on microtubules of normal and malignant human esophageal cells. AB - Anti-tubulin antibody indirect immunofluorescence microscopy is used in this report. Difference of intracellular microtubule fluorescent staining patterns between normal and malignant human esophageal cells has been observed. Primarily cultured human esophageal epithelial cells display an elaborate array of fluorescent cytoplasmic microtubule filaments, the cytoplasmic microtubule complex (CMTC), in interphase cells and mitotic spindle microtubules in mitotic cells. Malignant esophageal cells from human esophageal carcinoma, ECa109 cells, contain very few cytoplasmic microtubules in interphase cells, but there is no difference of mitotic spindle microtubule fluorescence between normal and malignant cells. The results presented in this report suggest that the diminution of interphase cytoplasmic microtubules in tumor cells is probably due to the deficiency of microtubule organizing mechanism in interphase tumor cells. PMID- 3532320 TI - Proteolytic processing. PMID- 3532321 TI - Saturation mutagenesis of the yeast his3 regulatory site: requirements for transcriptional induction and for binding by GCN4 activator protein. AB - Expression of the yeast his3 and other amino acid biosynthetic genes is induced during conditions of amino acid starvation. The coordination of this response is mediated by a positive regulatory protein called GCN4, which binds specifically to regulatory sites upstream of all coregulated genes and stimulates their transcription. The nucleotide sequence requirements of the his3 regulatory site were determined by analysis of numerous point mutations obtained by a novel method of cloning oligonucleotides. Almost all single base pair mutations within the nine base pair sequence ATGACTCTT significantly reduce his3 induction in vivo and GCN4 binding in vitro, whereas changes outside this region have minimal effects. One mutation, which generates a sequence that most closely resembles the consensus for 15 coregulated genes, increases both the level of induction and the affinity for GCN4 protein. The palindromic nature of the optimal sequence, ATGACTCAT, suggest that GCN4 protein binds as a dimer to adjacent half-sites that possibly overlap. PMID- 3532322 TI - Participation of c-myc protein in DNA synthesis of human cells. AB - The protein product of oncogene c-myc is believed to be important in regulation of the cell cycle. However, its direct role in DNA synthesis has not been explored. Experiments presented here show that the addition of affinity-purified antibodies against the human c-myc protein to nuclei isolated from several types of human cells reversibly inhibited DNA synthesis and DNA polymerase activity of these nuclei. This suggests that c-myc encodes a protein that is functionally involved in DNA synthesis. PMID- 3532323 TI - The 1986 Nobel Prize for physiology or medicine. PMID- 3532324 TI - Fertility in the United States. AB - From the postwar high of 3.8 births per woman at the peak of the baby boom, the total fertility rate in the United States has fallen to 1.8, where it has remained unchanged for nearly a decade. This below-replacement level of fertility has, in recent decades, characterized most Western countries, some of which have shown declines to well below 1.5 births per woman. Were it not for the continued infusion of immigrants, the U.S. population, which already shows the aging characteristic of low fertility, would stop growing and begin to decline before the middle of the next century. The low fertility in the United States has been accomplished by a postponement of marriage and by the widespread use of contraception, with heavy reliance on surgical sterilization as a contraceptive method. Judging from the experience of other Western countries and from our own historical experience of two centuries of fertility decline interrupted only by the baby boom, as well as from the absence of social trends that would counteract those contributing to that decline, the prognosis is for a continued low level of fertility in the United States. PMID- 3532325 TI - Genetic selection of a Plasmodium-refractory strain of the malaria vector Anopheles gambiae. AB - The anopheline mosquito is the target in most malaria control programs, primarily through the use of residual insecticides. A mosquito was studied that is refractory to most species of malaria through a genetically controlled mechanism. A strain of Anopheles gambiae, which was selected for complete refractoriness to the simian malaria parasite Plasmodium cynomolgi, also has varying degrees of refractoriness to most other malaria species examined, including the human parasites P. falciparum, P. ovale, and P. vivax for which this mosquito is the principal African vector. Furthermore, the refractoriness extends to other subhuman primate malarias, to rodent malaria, and to avian malaria. Refractoriness is manifested by encapsulation of the malaria ookinete after it completes its passage through the mosquito midgut, approximately 16 to 24 hours after ingestion of an infective blood meal. Fully encapsulated ookinetes show no abnormalities in parasite organelles, suggesting that refractoriness is due to an enhanced ability of the host to recognize the living parasite rather than to a passive encapsulation of a dead or dying parasite. Production of fully refractory and fully susceptible mosquito strains was achieved through a short series of selective breeding steps. This result indicates a relatively simple genetic basis for refractoriness. In addition to the value these strains may serve in general studies of insect immune mechanisms, this finding encourages consideration of genetic manipulation of natural vector populations as a malaria control strategy. PMID- 3532326 TI - [Problems at the donor site in autologous bone transplantation]. PMID- 3532327 TI - [The value of autologous spongiosa transplants in anterior plate spondylodesis of the lower cervical spine]. PMID- 3532328 TI - Immunosuppression and infection in multiple myeloma. AB - Patients with multiple myeloma are at increased risk of severe bacterial infection. A variety of immune deficits has been described in such patients, including a decreased primary antibody response and defects in complement and granulocyte function. The depressed humoral response appears to result primarily from the activity of suppressor monocytes. Pneumovax (Merck Sharp & Dohme, West Point, Penn) should be administered to patients with myeloma, although its effectiveness in this population has not been proven. The role of other potential modalities of treatment and prophylaxis, such as IV gamma globulin, requires further study. PMID- 3532329 TI - Staging and kinetics of multiple myeloma. PMID- 3532330 TI - Chemotherapy of previously untreated multiple myeloma patients: an analysis of recent treatment results. PMID- 3532331 TI - Treatment of refractory multiple myeloma and considerations for future therapy. PMID- 3532332 TI - The role of interferon in the treatment of hairy cell leukemia. AB - Hairy cell leukemia (HCL) is a rare chronic lymphoproliferative disorder usually manifested by pancytopenia. Prior to the use of interferon in the treatment of this disease, initial therapy most often consisted of splenectomy. Patients with progressive disease after splenectomy often benefited from low-dose chlorambucil, although many other treatment modalities had been tested. Interferon (partially purified) was first reported to be effective in HCL by Quesada et al in 1984, with responses in seven of seven patients. Subsequent studies demonstrated that recombinant interferon was also effective. Major responses (normalization of peripheral blood counts) have been obtained in 50% to 80% of patients treated to date, and virtually all patients show some improvement. There is rapid improvement in the platelet count (1 to 2 months), followed by improvement in absolute neutrophil count (2 to 3 months) and hemoglobin (3 to 6 months). In addition, leukemic patients have a rapid reduction in circulating hairy cells. Interferon alpha also has been demonstrated to reduce the incidence of serious infections and the need for transfusions, as compared to the 6-month period prior to therapy. Bone marrow shows improvement as well, with a reduction in hairy cells and an increase in normal precursors. However, bone marrow remains abnormal, with increased reticulin, decreased myeloid precursors, and, usually, discernible hairy cells. Following discontinuation of therapy, a slow increase in hairy cells may occur. The mechanism of interferon's action is unknown. Interferon induces the synthesis of new proteins and the formation of new organelles. Although natural killer cell activity increases with the introduction of interferon, these changes probably do not mediate the response to the agent. Interferon has been demonstrated in vivo to have a direct antiproliferative effect on hairy cells. We conclude that interferon is highly effective in progressive disease following splenectomy. Its exact role in nonsplenectomized patients remains to be determined, as does its optimal use in the long-term management of HCL. PMID- 3532333 TI - Preclinical biology of alpha interferons. AB - The availability of large quantities of purified recombinant human alpha interferons has permitted an expansion of studies on the preclinical biology of interferon. These purified preparations have definitively established that interferon exhibits pleiotypic effects on cellular function, including antiviral, antiproliferative, and immunomodulatory activities. Thus, interferon can exert therapeutic activity by both direct effects on the growth of the tumor and by modulation of the biologic response of the host. The exact mechanism of action will most probably vary from patient to patient. The variety of biologic activities that interferon displays, as well as the fact that it is highly species-specific, makes it difficult to design preclinical studies that can provide guidance for the clinical application of interferon as an antineoplastic agent. Two models that have provided useful preclinical data on human cell lines or fresh biopsies are reviewed: the human tumor clonogenic assay and human tumor xenografts in immunodeficient mice. These models indicate that interferon is likely to be an effective treatment for a broad range of malignancies, and that the response will be highly dependent on the type of interferon as well as its dose, schedule, and route of administration. Both models have provided evidence that alpha interferon may demonstrate a synergistic or additive interaction with standard chemotherapeutic agents like cyclophosphamide or doxorubicin. The utility of any preclinical model for predicting an individual patient's response to interferon is yet to be established. PMID- 3532334 TI - Alpha interferon treatment of low-grade B-cell non-Hodgkin's lymphomas, cutaneous T-cell lymphomas, and chronic lymphocytic leukemia. AB - The interferons represent an important first member of a family of biologic response modifiers used in treating human malignancies. Activities associated with the interferons include inhibition of viral replication, influence on cellular protein production, direct antiproliferative effects, and a variety of modulatory effects on the immune response. These regulatory functions of interferon underlie the interest in its use as an anticancer agent. Interferon alpha is the most extensively studied interferon species. Although antitumor activity has been seen both in vivo and in vitro in some solid malignancies, the most impressive responses have occurred in the hematologic malignancies. For the low-grade non-Hodgkin's lymphomas, response rates of 50%, with 10% to 15% complete responses, have been reported. A response rate of 15% has been reported for chronic lymphocytic leukemia in studies outside of the National Cancer Institute (NCI); in our phase II trials at the NCI, only two (11%) of 18 patients had brief partial responses to recombinant interferon alpha. For patients with cutaneous T-cell lymphomas (mycosis fungoides and the Sezary syndrome), a response rate of 45%, with 10% complete responses, was seen in patients treated with recombinant interferon alpha. Based on such findings, interferon appears to be one of the most effective single agents for cutaneous T-cell lymphomas. Further phase II trials are being conducted to determine whether lower doses of interferon alpha are as effective as the high doses used in the previously reported studies. Phase III trials will involve the use of interferons in combination with chemotherapeutic agents as well as in the adjuvant setting. PMID- 3532335 TI - Alpha interferon therapy of AIDS-associated Kaposi's sarcoma. AB - Alpha interferon has been the most widely studied biologic response modifier for the treatment of Kaposi's sarcoma (KS) associated with acquired immune deficiency syndrome (AIDS). At San Francisco General Hospital's AIDS Clinic, three sequential trials of recombinant interferon alfa-2b (Intron A) were conducted between August 1982 and April 1984. In the first study, ten patients with early KS were randomized to receive either low-dose (1 MU/m2) subcutaneous (SC) or high dose (50 MU/m2) intravenous (IV) treatment 5 days per week, every other week, for eight weeks. A perceived advantage of the latter regimen led to a subsequent trial in which 20 subjects received high-dose IV therapy. A 32% objective response rate was achieved, despite the fact that these patients had less favorable disease status and more constitutional symptoms than those in the first trial and had also experienced previous opportunistic infections (OIs). A final 8 week investigation evaluated the use of 30 MU/m2 three times per week in 30 subjects. Drug-related toxicity seemed more pronounced with this regimen, but overall objective responses were identical to those seen in the high-dose IV study. None of the trials produced evidence of immune reconstitution on laboratory evaluation. The patients were not protected from developing AIDS related OI either during or following interferon therapy, although OI was diagnosed less frequently in responders, who also displayed a distinct survival advantage over those with progressive disease. These trends remained evident when the data from the three studies were pooled with those from three parallel trials conducted at the University of California, Los Angeles (UCLA). Studies evaluating the combined use of alpha interferon and chemotherapeutic agents known to be active against AIDS-related KS (such as VP-16 and vinblastine) have thus far failed to demonstrate a synergistic antitumor effect, while toxicity has increased. In light of in vitro evidence that alpha interferon suppresses the AIDS retrovirus and has clinical efficacy in KS comparable to that of cytotoxic agents, additional investigations, focusing on maximizing therapeutic potential, are warranted. PMID- 3532336 TI - Potential applications of the interferons in oncology: lessons drawn from studies of human melanoma. AB - The rationale for application of interferons in the treatment of melanoma is based on evidence suggesting that this tumor exhibits antigens capable of eliciting a host immune response. Agents that act as immunomodulators or that enhance the expression of tumor antigens may have greater therapeutic potential than agents that act solely as direct cytotoxic or antiproliferative agents. Data suggest that interferons may manifest all three categories of antineoplastic function. Early empirical trials with naturally derived leukocyte-lymphoblastoid interferons yielded poor therapeutic results. In contrast, in four subsequent trials conducted using recombinant DNA-synthesized interferon alfa 2's at three independent institutions, an objective response rate of 19% was achieved. Of the 20 responses obtained in the 102 evaluable patients, eight were complete. Three further preliminary reports enlarged the data base to 215 patients, 35 of whom showed an objective response. The response to systemic interferon alfa-2's appears to be associated with several factors including (1) continuous treatment for periods of up to several months at dosages greater than 10 MU/day intravenously (IV) or intramuscularly (IM) or 12.5 MU/m2/day IM on alternate days, and (2) metastatic tumor involving nonvisceral sites and the lung. The analysis of immunologic and other factors that may be related to or predictive of response has been hampered by the low overall frequency of response. New trials currently in progress to determine the efficacy of interferon alfa-2's as an adjuvant to surgery in candidates at high risk of recurrence and the efficacy of interferon alfa-2's when used in combination with gamma interferon, other biological agents, and chemotherapy may allow these questions to be resolved. PMID- 3532337 TI - Superficial carcinoma of the bladder: natural history and the role of interferons. AB - Superficial transitional cell carcinoma of the bladder is a chronic disease. Patients face a lifetime with the potential for further neoplastic manifestations -the recurrence of either superficial or deeply invasive tumor. To some extent, the likelihood of disease recurrence can be predicted. Further, certain clinical interventions can alter the probability of tumor recurrence. This paper focuses on those patient and tumor characteristics that predict for the propensity to develop recurrent disease, with emphasis on the potential of the interferons to both treat this disease and to modify its natural history. PMID- 3532338 TI - Intron A (interferon alfa-2b): clinical overview and future directions. AB - The clinical development of the recombinant alpha interferons represents a prototype for the clinical development of biological compounds. Their testing raises fundamental questions concerning phase I objectives and strategies for biologicals, eg, study design in an immune model v a cytotoxic model. However, with over 5,000 patients treated with these compounds, some general principles have emerged. 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 almost universally 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 production of antibodies and serum-neutralizing factors. Reports with small patient numbers confirmed the occasional development of serum-neutralizing activity to some alpha interferons, which may coincide with a loss of detectable serum interferon and loss of clinical activity. A large study with interferon alfa-2b (Intron A) has reported a low overall incidence of neutralizing activity (2.5%) and no association with loss of clinical activity. The significance of the neutralizing activity and the reasons for an apparently higher incidence of this phenomenon with other 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. Efficacy data available to date and phase I combination studies are reviewed. PMID- 3532339 TI - Maternal adaptation in twin pregnancy. PMID- 3532340 TI - Ultrasound in the antenatal management of twin gestation. PMID- 3532341 TI - The controversy of mode of delivery in twins: the intrapartum management of twin gestation (Part II). PMID- 3532342 TI - Congenital anomalies in twins. PMID- 3532343 TI - Selective birth. PMID- 3532344 TI - Comparison of midazolam, diazepam and placebo in the treatment of insomnia. PMID- 3532345 TI - Early high-dose oral corticosteroids and avascular hip necrosis in renal transplants. PMID- 3532346 TI - A prospective randomized study of the copper 7, Multiload Cu 250 and copper 220C IUDS in Singapore. PMID- 3532347 TI - Escherichia coli lung abscess in a young adult. PMID- 3532348 TI - Case report 386: Thanatophoric dysplasia (TD). PMID- 3532349 TI - Aedes aegypti mosquitoes in the Americas: a review of their interactions with the human population. AB - This paper describes the significant changes in the relationship between Aedes aegypti mosquitoes and the human population in the Americas from the 1800s to present. First, the history of the arrival of the mosquito, the consequent epidemics of yellow fever and dengue, and the eventual implication of the mosquito as vector is described. Second, the Pan American Health Organization's Aedes aegypti Eradication Program is discussed and the potential threat to the Americas of development of the dengue hemorrhagic fever/dengue shock syndrome (DHF/DSS) is emphasized. Third, the limited efforts of the United States to control its A. aegypti population, which has serious implications for the success of the control of the species in the rest of the Americas, are commented upon. It is shown, in conclusion, that politics and economics, in addition to the state of biomedical knowledge, have a significant impact on the relationship between the mosquito and human populations in the Western hemisphere. PMID- 3532350 TI - The changing structure of Dutch mental health care. AB - Current mental health care policy in The Netherlands emphasizes a major shift from intramural to extramural care. A decline in psychiatric hospital admissions is to result from intensified psychiatric care offered by non-residential provider agencies, an increase in sheltered housing and day care capacity and an integral role in mental health care for the general practitioner. To allow for such a far reaching change, fortification of the greatly fragmented non residential sector of Dutch mental health care was necessary (in 1982 more than 300 agencies in a country of 14.5 million inhabitants). Mergers have recently led to 60 Regional Institutes for Ambulatory Mental Health Care (RIAGG). This amalgamation within the non-residential sector is considered a major step towards the integration of the entire Dutch mental health care system. The article provides insight into the development of mental health care policy in The Netherlands and offers an analysis of the process of merger of non-residential services. As a necessary preface to this material a sketch of the historical and administrative context of Dutch health care is provided. PMID- 3532351 TI - 'Reprofessionalization' or 'occupational imperialism'?: some reflections on pharmacy in Britain. AB - Drawing upon preliminary research findings, this paper considers whether pharmacists in Britain face a crisis in their occupational status and identity as a result of changes in their work and market situations. It further examines some of the ways in which they are responding to the challenges and opportunities presented. The paper also comments on the utility of the concepts of 'reprofessionalization' and 'occupational imperialism' in the study of British pharmacy. PMID- 3532352 TI - Psychological aspects of pain in rheumatoid arthritis: a review. AB - Pain in rheumatoid arthritis (RA) is reviewed from a socio-cognitive perspective. Questions are raised about the usefulness of the distinction between organic vs non-organic pain patients, and alternative explanations for the behaviour of seronegatives is presented. A case based on physiology and behaviour is made for more studies of the acute and prechronic stages of RA. Four major areas of methodology are considered: studies of lay explanations about RA show that people hold relatively accurate views about the nature of pain in RA, and where causal explanations are given for pain and illness, this is conducive to good mental health. A section on the measurement of pain addresses issues about the applicability and standardisation of scales, and welcomes the move from the exclusive use of quantitative to qualitative multidimensional measures. The pain language of RA is described. Experimental studies of pain in RA appear to be of limited use. A review of activities and functional disability indicates that cognitive and behaviour modification techniques appear to have most promise in motivating chronic patients to be more active, and to comply with medication, as well as improving mental health. In a discussion of successful therapies, the principles of reducing uncertainty and increasing perceptions of control are the underlying features. However the reliability of cognitive therapies in the treatment of RA so far remains unproven. PMID- 3532353 TI - Treatment of gastrointestinal cancer: the Southeastern Cancer Study Group experience, 1979 to 1983. AB - The treatment of gastrointestinal cancer was studied in 20 phase I, II, and III clinical trials from 1979 to 1983 at 30 member institutions of the Southeastern Cancer Study Group (SECSG). These studies used both new and commercially available drugs, as well as surgery and/or radiation therapy in 1,087 patients. No significant benefit was seen from 18 agents, and one agent is still under evaluation. Unfortunately, no recommendations can be drawn from these studies that would alter presently accepted methods of management. Adenocarcinoma of the gastrointestinal tract remains a major challenge to tumor biologists and clinical oncologists because it is generally resistant to chemotherapy and radiation therapy, yet common enough to represent a vital public health concern in America. PMID- 3532354 TI - Endurance athletes: physiologic changes and nonorthopedic problems. AB - The current increased participation in long distance running and endurance events brings new challenges to the physician. Adaptive changes of exercise must be differentiated from disease states. Left ventricular hypertrophy, Wenckebach rhythm, elevated creatine kinase (myocardial fraction), gastrointestinal bleeding, hematuria, hemoglobinuria, amenorrhea, and apparent anemia may all be exercise related. New syndromes have arisen--from "runner's high" to athletic amenorrhea. These dedicated athletes can be difficult patients. They are highly motivated and will continue training despite significant pain and danger of permanent damage. Speaking their language--carbohydrate loading, "the bonk," "slow twitch," "the wall"--is helpful in their treatment. Traditional health problems are less likely to bring the fitness addict to the physician than some new and peculiar disorders. PMID- 3532355 TI - [Results and prospects of historical medical research in the USSR]. PMID- 3532356 TI - [Social organizations in the fight against alcoholism in the USSR in the 20s]. PMID- 3532357 TI - [E. N. Fedorova--a member of the St. Petersburg League of the Struggle for the Emancipation of the Working Class]. PMID- 3532358 TI - [A participant in 3 revolutions (Konstantin Khrisanfovich Orlov)]. PMID- 3532359 TI - [I. Ia. Olimpiev--a public health organizer in the Don Basin]. PMID- 3532360 TI - [The outstanding Soviet pediatrician M. S. Maslov]. PMID- 3532361 TI - [Phagocytizing blood cells in dysentery]. PMID- 3532362 TI - [Varicose veins of the esophagus]. PMID- 3532363 TI - [Total occlusion of the pancreatic ducts]. PMID- 3532364 TI - [Laser therapy in gynecological endocrinology]. PMID- 3532365 TI - [Immobilized proteolytic enzymes in chronic suppurative bronchitis]. PMID- 3532366 TI - [Diagnosis of erectile impotence using digital subtraction angiography]. PMID- 3532367 TI - Urinary tract infection in childhood. AB - The importance of establishing significant bacteriuria in the diagnosis of urinary tract infection and the need for a keen awareness of its presence, particularly in young children, is stressed. The approach to the diagnosis, investigation, management and follow-up of children with urinary tract infection is described. PMID- 3532368 TI - Congenital heart block detected in utero. A case report. AB - Fetal heart movement and fetal heart rate are easily observed with real-time ultrasonography. Certain aspects of fetal cardiac disorders can thus be further evaluated by M-mode echocardiography. Congenital heart block and associated connective tissue disorders are discussed. PMID- 3532369 TI - Problems in the treatment of bacterial sexually transmitted diseases. AB - Despite the development of many antimicrobial drugs that are active against sexually transmitted bacterial pathogens, various problems limit the success of treatment of bacterial sexually transmitted diseases (STD). These problems include the evolution and spread of antibiotic-resistant pathogens, inconsistent therapeutic efficacy of some regimens despite in-vitro activity against the infecting organism, toxicity, inconvenience of administration, lack of compliance by patients, and cost. Diseases affected by one or more of these therapeutic problems include gonorrhea, chlamydial infections, pelvic inflammatory disease, bacterial vaginosis, syphilis, and chancroid. Ceftriaxone, a new cephalosporin, addresses some of these problems as they relate to gonorrhea, chancroid, and, possibly, syphilis. PMID- 3532370 TI - Advances in the diagnosis and management of chancroid. AB - Improved technologies for the cultural diagnosis of chancroid have resulted in increased interest in the management and control of genital ulcer disease. New treatment regimens have been identified, and new control strategies have evolved. These strategies now permit localized introductions of chancroid into developed countries to be contained rapidly. However, additional work is still necessary in developing countries. PMID- 3532371 TI - Pelvic inflammatory disease. AB - Acute pelvic inflammatory disease (PID) is a major public health problem. An estimated 1 million cases occur annually in the United States. PID is a major cause of infertility and ectopic pregnancy. Prevention of the significant medical and economic sequelae of acute PID relies on the institution of appropriate treatment regimens that are based on the true microbiologic etiology of acute PID and take cognizance of the polymicrobic nature of this etiology. The clinician must maintain a high index of suspicion for acute PID so that early diagnosis can be made and treatment begun. Hospitalization and utilization of parenteral antimicrobial therapy will be of greatest benefit to the patient. This therapy should include combination agents that provide coverage for Neisseria gonorrhoeae, Chlamydia trachomatis, anaerobes (including Bacteroids and anaerobic cocci), gram-negative aerobic rods, and gram-positive aerobes (including group B Streptococcus). Finally, to prevent repeated infection, it is crucial to locate the sexual partners of women with acute PID and to screen and treat them for sexually transmitted diseases. In this way, the recurrent infections, which lead to a poor prognosis for fertility, can be avoided. PMID- 3532372 TI - Consolidated Omnibus Budget Reconciliation Act of 1985. AB - This article briefly describes the legislative history of the old-age, survivors, and disability insurance (OASDI) and supplemental security income (SSI) provisions, as well as related Medicare and Medicaid provisions, of the Consolidated Omnibus Budget Reconciliation Act of 1985 (Public Law 99-272). It includes a chronology outlining the interaction of the budget reconciliation process with the development of the OASDI minor and technical changes bill (H.R. 2005) and the development of other social security related legislation resulting in proposals that ultimately combined in the overall Consolidated Omnibus Budget Reconciliation Act of 1985. The article also provides a detailed summary of the provisions of the legislation. PMID- 3532373 TI - Dental diagnosis and treatment for musicians. PMID- 3532374 TI - A clinical survey on the use of a new form of denture adhesive. PMID- 3532376 TI - Food and cancer: cause and effect? AB - The occurrence of cancer involves the effects of two types of agents: those that alter the genetic material to give rise to neoplasms and others that modulate tumor development through epigenetic effects. In the etiology of some of the major cancers in the North American population--cancers of the upper alimentary tract, stomach, large bowel, pancreas, breast, and prostate--food can contribute elements of both types. Thus, dietary modification has the potential both to prevent the occurrence of cancers at these sites and to control recurrences in treated patients. PMID- 3532375 TI - Fat metabolism and cancer. AB - Progressive weight loss and anorexia are frequent phenomena in cancer patients. Although cachexia is an expected occurrence in the terminal stages of nearly all malignancies, it may be a presenting sign when the tumor burden is quite small. Lipid depletion occurs out of proportion to the protein loss and accounts for most of the weight loss in cancer. Lipids, more specifically fatty acids, are the major source of fuel in mammals and may also be used in the synthesis of new cell products. Lipolysis and lipogenesis are under the influence of several important enzymes and peptide hormones that may be modulated by a variety of exogenous factors. There is evidence that cancer patients have lost the normal homeostatic responses to decreased energy intake or starvation that allow a decrease in oxygen consumption and protein sparing. An increase in Cori cycle activity or futile recycling of metabolic products occurs with a net energy expenditure rather than energy production. Clinical studies have shown that the body lipid depletion accompanying tumor progression is not solely secondary to decreased food intake and may be reproduced by the transplantation of certain noninvasive tumors to normal hosts. Elevated basal lipolysis has occasionally been seen early in tumor growth. Such findings suggest the presence of a tumor-associated factor responsible for this increase in lipid mobilization. Some of the potential mechanisms for the altered lipid metabolism seen in cancer have been discussed. Metabolic substrates may be remodeled and directed away from fuel-efficient into energy-requiring pathways. An increased energy expenditure may occur as a result of the energy costs of tumor synthesis, an uncoupling of oxidative phosphorylation, or energy-requiring futile cycling. An overall depletion of lipid may be the final outcome of the inhibition of lipid deposition. TNF/cachectin has recently been found to suppress the activity and synthesis of several key lipogenic enzymes, including lipoprotein lipase. Abnormalities in insulin secretion or sensitivity may be involved in the decrease of fat storage in malignancy. Insulin also exerts a significant antilipolytic effect by its antagonism of hormone-sensitive lipase. Mediators of lipolysis and abnormal lipid metabolism may occur in a number of clinical conditions and include ectopic hormone production, growth factors, and tumor-associated lipolytic factors (lipid mobilizing factor, toxohormone). PMID- 3532377 TI - The role of non-nutritive dietary constituents in carcinogenesis. AB - Very low levels of a large variety of non-nutritive chemicals occur in the diet. Among those that occur naturally are metabolites of molds (for example, mycotoxins) and bacteria (for example, nitrosamines) and natural constituents of plants (for example, pyrrolizidine alkaloids). Many of these are occasional contaminants, whereas others are normal components of relatively common foods. Some compounds (for example, aflatoxin, nitrosamines, and hydrazones) have been found to be carcinogenic in laboratory animals and mutagenic in bacterial and other systems, thereby posing a potential risk to humans. However, there have been very few definitive epidemiologic studies. Therefore, further investigations are necessary to determine the significance of these experimental findings for humans. It is apparent that many foods naturally contain substances with mutagenic properties and that some substances found in foods can enhance or inhibit the mutagenic activity of other compounds. Furthermore, mutagens can be formed during the cooking or processing of foods. However, caution is needed in the interpretation of these findings. Although mutagens by definition are "suspect" carcinogens, many mutagens detected in foods have not been adequately tested for carcinogenicity, and therefore their significance for human health cannot be fully assessed. With the exception of studies on non-nutritive sweeteners like saccharin and cyclamate, or those on nitrate and nitrite, very few epidemiologic studies have been conducted to examine the effect of food additives on cancer risk. Of the few direct food additives that have been tested and found to be carcinogenic in animals, all except saccharin have been banned from use in the food supply. Minute residues of a few indirect additives that are known either to produce cancer in animals (for example, vinyl chloride and acrylonitrile) or to be carcinogenic in humans (for example, vinyl chloride) are occasionally detected in foods. Thus far, the increasing use of food additives does not seem to have contributed significantly to the overall cancer risk for humans. However, the relatively short duration of use of many of these substances and the inadequacy of the data base preclude definitive conclusions. Very low levels of a large and chemically diverse group of substances--environmental contaminants (for example, residues of pesticides, polycyclic aromatic hydrocarbons, and traces of toxic metals)--may be present in foods.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3532378 TI - Dietary factors for cancer of specific sites. AB - Even though the issues have been greatly simplified in this article by citing of only the most salient data, when a number of different cancers are examined, a diverse range of dietary factors is implicated. For a number of cancers, very little is known, and for others, competing hypotheses are supported by conflicting data. Despite these obvious limits, some generalizations regarding common patterns of risk at different cancer sites may be possible. For example, although the nutrients and mechanisms may vary by site, lack of consumption of fruits and vegetables has been linked repeatedly to cancers of the mouth, larynx, esophagus, and lung. A similar association is suggested for cancers of the cervix and bladder. Another commonality is the association of dietary fat with cancers of the breast, ovary, prostate, and, possibly, colon. Alcohol is associated with cancers of the mouth, larynx, and, possibly, rectum. Coffee has been studied in association with cancers of the pancreas, ovaries, and lungs, but few of these studies have been replicated and the role of this common dietary exposure remains in question. In most other instances, unique cancers are linked to unique dietary exposures, for example, fiber and colorectal cancer or nitrates and stomach cancer. Given that both common and unique sources of dietary risk may be identified for different cancers, future research may benefit from a two-pronged research strategy. Basic nutrients need to be examined for multiple cancers, and specific aspects of diet require in-depth study for specific cancers. From such an approach, it may be possible to resolve some of the questions and issues reviewed herein. PMID- 3532379 TI - Postulated cancer prevention diets. A guide to food selections. AB - We believe that sufficient circumstantial and epidemiologic data exist linking diets and nutrients to cancer to warrant modification of eating habits. The proposed menus and diets are examples of the types of foods that might be beneficial in reducing the risk factors of cancer and also consistent with good nutritional habits. PMID- 3532380 TI - General metabolic abnormalities in cancer patients: anorexia and cachexia. AB - Cancer cachexia is a chronic wasting illness directly associated with the presence of uncontrolled malignancy. The authors discuss the various causes of inadequate nutrient intake, including the known data on anorexia, and outline the potential role of humoral factors as mediators of cachexia. PMID- 3532381 TI - Metabolic abnormalities in cancer patients: carbohydrate metabolism. AB - Weight loss in patients with a variety of cancers is associated with a poor prognosis. Consistent abnormalities of carbohydrate metabolism are seen in cancer patients with weight loss and appear to represent derangements in host metabolism that are induced by the presence of cancer. To define therapeutic strategies to improve the poor clinical outcome for patients with cancer cachexia, investigations are under way to define the relationships among glucose metabolism, altered energy expenditure, caloric intake, weight loss, and clinical outcome. PMID- 3532382 TI - Sonographic evaluation of the adnexa during early pregnancy. AB - Of 3,918 obstetric patients who underwent scanning during the first 20 weeks of gestation, 94 had sonolucent adnexal masses identified. These represented predominantly the corpus luteum of pregnancy. The incidence of such a mass significantly declined after the tenth gestational week. This pattern of degeneration is physiologic and represents the normal course of events for the ovary in the first half of pregnancy. Characteristics of these masses and indications for operative intervention are discussed. The obstetric outcome for eight patients who underwent surgical treatment was uncomplicated. Guidelines for management of significant adnexal masses in pregnancy is similar to that of the nonpregnant state. PMID- 3532383 TI - Use of illuminated ureteral catheters for the repair of obstructed ureters in transplanted kidneys. PMID- 3532384 TI - Transverse or sigmoid loop colostomy fixed by skin flaps. PMID- 3532385 TI - Brahms and Billroth. PMID- 3532386 TI - Jerzy Chorobski. PMID- 3532387 TI - [Value of transrectal sonography in irradiation planning and oncological follow up in prostatic cancer]. AB - Transrectal ultrasonic scanning of the prostate is a simple, cheap, easily employed examination method which requires no preparation. In radiation therapy of prostatic carcinoma it allows in staging and follow-up during and after therapy, an exact imaging of shape, size, capsule infiltration and structure of the prostate, thus permitting a more exact evaluation of the treatment response than with usual methods of examination. The analysis of the acoustic characterisation allows an early recognition of recurrences. PMID- 3532388 TI - [Prostacyclin- and thromboxane synthesis in the vascular wall after gammatron irradiation]. AB - One year aged rabbits were exposed to a single dose of 100, 500 or 1000 rd (1.0, 5.0 or 10 Gy) to the abdominal aorta. The non-irradiated thoracic aortic segment served as control. The animals were killed between one and 336 hours after the irradiation. Four animals were examined in each group. The prostacyclin formation was assessed by means of a radioimmunoassay against its stable breakdown 6-oxo PGF1 alpha, the thromboxane A2-formation using a radioimmunoassay for thromboxane B2. Local irradiation causes a temporary increase of both the compounds. In contrast to thromboxane B2, the 6-oxo-PGF1 alpha exhibits a long-lasting depression. The higher the radiation dose, the more intensive the increase and the long-lasting depression of 6-oxo-PGF1 alpha. The liberation of eicosanoids and subsequent hemostatic dysregulation at different intervals after irradiation might contribute to an important extent to the radiation induced vasculopathy. PMID- 3532389 TI - Pathologic nature of cystic thyroid nodules selected for surgery by needle aspiration biopsy. AB - Sixty euthyroid patients with cystic hypofunctioning thyroid nodules were selected for operation by the criteria of evidence of needle aspiration of cyst fluid with malignant cytologic findings, suspicion of malignancy on the basis of recurrent cyst fluid formation after at least two aspirations, or incomplete decompression after aspiration. Other factors such as size (greater than 3 cm in diameter), history of radiation, and cervical lymphadenopathy were given weight. Radiation exposure occurred in 14% of patients. Surgical pathologic findings revealed malignancy in 32%, adenoma in 43%, and colloid nodule in 25%, with a total neoplasia rate of 75%. The types of malignant tumors included six papillary, six mixed, three follicular, and four Hurthle. Surgical treatment included 26 near total thyroidectomies, 34 partial thyroidectomies, and four neck dissections without major morbidity or deaths. Cytologic false-negative rates were 50% cancer, 50% Hurthle cell 50%, and 60% adenoma, even after nucleopore filtration, emphasizing the value of surgical selection on the basis of cyst response to aspiration. Cytologic false-positive rate in the colloid group was 6% and 25% for false (solid) positive for echography. Bloody fluid occurred in all types of lesions but was more common in the cancer group. Thyroid ultrasonography does not appear to be an important way to assess thyroid nodular disease and has been, in our estimation, superseded by needle aspiration cytology. It should be recognized that cystic thyroid nodules, when selected for operation on the basis of the above mentioned needle biopsy and clinical criteria, have the same frequency of neoplasia and cancer as solid hypofunctioning thyroid nodules. Hence, it is recommended that all cystic lesions of the thyroid gland be assessed in accordance with such criteria to exclude underlying cancer. PMID- 3532390 TI - Therapeutic efficacy of Biobrane in partial- and full-thickness thermal injury. AB - Cadaver allograft skin, porcine xenograft skin, and amniotic membranes have been proved to be adequate temporary thermal wound coverings in four clinical situations: coverage of shallow wounds while awaiting epithelialization (SW), coverage of deep wounds after eschar excision (DEW), coverage of widely meshed autograft while awaiting closure of interstices (AC), and coverage of massive donor sites (DS). This study was undertaken to evaluate the therapeutic efficacy of a new biosynthetic bilaminate dressing, Biobrane. Two hundred one applications of Biobrane were studied in 82 SW, 46 DEW, 19 AC, 54 DS. A total of 124 applications were left in place until healing occurred, with a mean healing time of 12.8 days. Sixty of SW, 10/46 DEW, 10/19 AC, and 44/54 DS remained intact until complete healing. Only four DEW, two SW, and 0 AC applications had to be removed because of suppuration. Twenty five of the applications (SW and DEW) with the Biobrane glove had rare complications. PMID- 3532391 TI - The antibody crossmatch in liver transplantation. AB - Six hundred sixty-seven first, second, and third orthotopic liver allografts in 520 patients were reviewed to determine the effect of recipient panel-reactive antibody (PRA) and donor-recipient antibody crossmatch on 2-year patient and liver allograft survival rates. Neither a high panel-reactive antibody nor a positive crossmatch for donor-specific preformed antibody was associated with decreased patient or liver allograft survival for primary grafts or retransplants. Two patients have been given kidney transplants immediately after a liver allograft from a donor with whom each patient had an initial strongly positive donor-specific antibody crossmatch. The liver apparently removed or neutralized circulating anti-donor antibody, since the renal allografts functioned promptly and did not experience hyperacute rejection. PMID- 3532392 TI - Hyperinsulinism, glucose-dependent insulinotropic polypeptide, and the enteroinsular axis in morbidly obese patients before and after gastric bypass. AB - The role of glucose-dependent insulinotropic polypeptide (GIP) in the hyperinsulinism of morbid obesity and its correction after gastric bypass was studied in 12 morbidly obese (150 +/- 15 kg) patients. After oral glucose, significant increases in serum glucose, insulin, and GIP levels occurred both before and after gastric bypass. Compared with preoperative values, fasting concentrations and integrated incremental areas for glucose, insulin, and GIP were decreased after a 25% weight loss after gastric bypass. The hyperinsulinism of morbid obesity and its amelioration after gastric bypass may be caused by markedly elevated levels of GIP before surgery and its reduced release after bypass. Reduced release of GIP after gastric bypass may partly occur because of exclusion of ingested glucose from contact with the mucosa of the duodenum and proximal jejunum, sites with the highest concentration of GIP. PMID- 3532393 TI - [Diabetic microangiopathy and oxygen transport disorder (a review of the literature and the authors' own data)]. AB - Proceeding from biochemical and instrumental investigations on a vast material (560 patients with various forms of diabetes mellitus) and literature data the authors propose a new concept of occurrence and progression of diabetic microangiopathies. Importance is attached to tissue hypoxia related to an entire complex of hormonal-metabolic changes resulting in a disturbed supply of oxygen to the tissues. PMID- 3532394 TI - [Therapists and scientists of the Central Institute of Physicians Advanced Training--participants in World War II]. PMID- 3532396 TI - [Means of preventing heart rupture in myocardial infarct]. PMID- 3532395 TI - [Alcohol and the pancreas]. PMID- 3532397 TI - [Chronic bronchitis. Stages in its development and prophylactic outlook]. PMID- 3532398 TI - [Evaluation of the effectiveness of diucifon in rheumatoid arthritis and systemic scleroderma]. PMID- 3532399 TI - [Methotrexate in the treatment of rheumatoid arthritis]. PMID- 3532400 TI - [Subgroups of systemic lupus erythematosus in animals and humans]. PMID- 3532401 TI - [Treatment of psoriatic arthritis with gold salts (chrysotherapy)]. AB - The paper is concerned with the results of a 6- and 12-month comparative randomized study of the efficacy of chrysanol (calcium-aurothiopropanol sulfonate) in 21 patients with verified psoriatic arthritis. Patients of the study group (11 patients) received in addition to chrysanol nonsteroid antiinflammatory drugs (NAD), patients of the control group (10) received NAD only. The efficacy of annual treatment was assessed in 10 patients (5 in each group). Therapeutic efficacy was assessed on the basis of an analysis of 19 clinical and laboratory findings. Six months later improvement was noted in 80% of the patients of the study group, of them considerable improvement in 30%. A significant positive time course was observed for 9 parameters including those characterizing vertebral mobility. Improvement in the control group was noted in 50% of the patients, 2 parameters changed significantly. One year later improvement was recorded in all the patients of the study group and in 40% of the patients of the control group. A significant positive time course was noted for 10 parameters in the study group and not a single one in the control group. In the latter group 7 values got worse, the deterioration of one value was statistically significant. Side effects of chrysanol were noted in 2 patients (agranulocytosis and nephropathy). The aggravation of skin psoriasis was not noted in any patients. PMID- 3532402 TI - [Changes in the levels of soluble HLA antigens and their light chains (beta 2 microglobulin) in rheumatoid arthritis and systemic lupus erythematosus]. AB - An increase in the level of soluble HLA-A and B antigens in the blood serum of patients with rheumatoid arthritis and systemic lupus erythematosus was observed using IKO-1 monoclonal antibodies and polyspecific alloantisera. This increase was accompanied by the elevation of the concentration of beta 2-microglobulin (the light chain of the molecules of HLA-antigens of the 1st class). A degree of the concentration of soluble HLA-antigens and beta 2-microglobulin depended on a degree of disease activity, a variant of a clinical course and the presence of visceral involvement. PMID- 3532403 TI - [Indicators of streptococcal infection and HLA antigens in patients with rheumatism]. AB - A study of histocompatibility antigens in 165 patients with rheumatic fever showed that the most commonly high titers of ASL-O, ASH, ADNAse B were found in the carriers of HLA, A11, B27, CW1, CW2, CW3, DR5 and DR7 antigens which, according to our data, were associated with rheumatic fever. High titers of streptococcal antibodies were found in persons with HLA-A1 and B27. PMID- 3532404 TI - [Study of pirprofen (rengasil) combined with maintenance doses of corticosteroids in rheumatoid arthritis in a double-blind multicenter trial]. AB - A study of pirprofen (rengasil) combined with small doses of corticosteroids in 93 patients with rheumatoid arthritis during a double blind multicentre testing showed good and satisfactory therapeutic results in 60%. A decrease in morning rigidity, pains in the joints especially at night, the joint index and in the number of inflammed joints was noted. Rengasil tolerance was good, side effects were few. The new nonsteroid antiinflammatory drug rengasil combined with maintenance doses of corticosteroids can be recommended for a prolonged treatment of patients with rheumatoid arthritis. PMID- 3532405 TI - [Experimental substantiation of the treatment of patients with rheumatoid arthritis with prednisolone and its combination with retabolil (clinico experimental study)]. AB - Fifty RA patients receiving prednisolone and prednisolone combined with retabolil were examined. Prednisolone made a negative effect on central hemodynamics, the effect being less with the use of retabolil. A dystrophic action of prednisolone on the myocardium and the weakening of this effect in a combined use of prednisolone and retabolil were shown on a RA model in rabbits. PMID- 3532406 TI - [Characteristics of carbohydrate metabolic disorders and of the secretion of insulin, glucagon and somatotropin in patients with chronic glomerulonephritis and chronic kidney failure]. AB - A course of chronic glomerulonephritis is accompanied by carbohydrate metabolic derangement (a decrease in glucose tolerance), change in insulin secretion and the development of relative insulin insufficiency. The revealed changes develop up to the appearance of the clinical signs of chronic renal failure and progress with its development. A decrease in renal function and the development of chronic renal failure is accompanied by the accumulation of insulin hormonal antagonists: somatotropin, glucagon and prolactin. Treatment with chronic hemodialysis does not completely eliminate carbohydrate metabolic derangements, nor does it correct growth hormone, glucagon and prolactin secretion. PMID- 3532407 TI - [Secondary hyperparathyroidism in chronic kidney failure]. PMID- 3532408 TI - [Pathology of the respiratory organs in diabetes mellitus]. PMID- 3532409 TI - [Beta 2-microglobulin in the blood serum and urine of patients with interstitial kidney lesions]. AB - A study of the level of beta 2-microglobulin (beta 2-MG) in the blood serum and urine was conducted in 67 patients: 22 with chronic pyelonephritis, 13 with gout with renal lesion, 25 with chronic glomerulonephritis (5 without hyperuricemia, 20 with hyperuricemia) and 7 with amyloidosis accompanied mainly by renal lesion. A raised level of beta 2-microglobulin was found in the patients with chronic pyelonephritis, gout, latent glomerulonephritis with hyperuricemia, and in over half of the cases its raised level was found in the urine. The results obtained indicate a frequent and in some cases predominant involvement of the tubules as well as interstition in the patients with hyperuricemia. PMID- 3532410 TI - [Echodiagnosis of the kidney lesion in gout]. AB - An echographic study of the kidneys was performed in 24 men with proved gout aged 40 to 50 and a disease duration of 10-20 yrs. On the basis of case history data urolithiasis was noted in 4 patients, whereas by echodiagnosis it was found in 12. Cysts were detected in 6 patients with gout complicated by urolithiasis and in 1 patient without it. Echoroentgenography was shown to be a highly informative method in the diagnosis of urolithiasis and cystic regeneration of the kidneys opening up prospects for earlier treatment of complications in gout. PMID- 3532411 TI - [Morpho- and pathogenesis of nephrosclerosis: a clinico-morphological analysis]. AB - The authors have defined 2 phases in morphogenesis of nephrosclerosis: "nosological" and "syndrome". In the first phase the development of nephrosclerosis is determined by the peculiarities of pathogenesis of the main disease and associated with a certain structural element of the kidney (arterioles, glomerula, stroma). The second phase occurs after the formation of block of the renal blood flow at one or another structural level (arteriolar, glomerular, capillary-parenchymatous) including the hypoxic factor which determines subsequent progression of nephrosclerosis. The nosological signs of nephrosclerosis in this phase are leveled down, replaced by the signs of the syndrome of chronic renal failure. Arterial hypertension is a factor contributing to the progression of nephrosclerosis irrespective of nosological entity. PMID- 3532412 TI - [Clinical syndromes of kidney diseases associated with infectious endocarditis]. PMID- 3532413 TI - [Microcirculatory disorders in the genesis of sclerodermic nephropathy]. AB - Biomicroscopy of the vessels of the conjunctiva (BMV), the determination of erythrocyte and platelet aggregation capacity and investigations of the effective cutaneous and muscular blood flow and blood plasma renin activity were employed to study microcirculation in 110 patients with systemic sclerodermia (SSD) (74 with and 36 without renal lesion). The detected disturbances were correlated with the nature and gravity of sclerodermic nephropathy (SN). In BMV the frequency of intravascular platelet aggregation increased with a rise of the gravity of renal pathology. The quantitative determination of erythrocyte and platelet aggregation capacity revealed a significant acceleration of the aggregation of the blood cell elements in the SSD patients which correlated with SN presence and gravity as well as with renal function indices. Renin plasma activity was significantly raised in patients with severe renal pathology. There was correlation between the indices of function of the kidneys and ultrastructural signs of lesion of their microcirculatory bed. The results of the study served as a basis for the differential use of vascular drugs and the development of new pharmacotherapeutic methods for SSD patients with renal lesion. PMID- 3532414 TI - [Risk factors and results in kidney transplantation]. AB - The authors analyzed the results of 139 kidney transplantations in 115 patients with chronic renal failure depending on a degree of risk. The most frequent risk factors were poor compatibility, high arterial hypertension, myocardial and valvular lesions and retransplantation. As to the combination of various risk factors 4 types of risk were defined. It was proved that in the 4th type of risk kidney transplantation was inappropriate. In the 2nd and 3rd types of risk sparing immunodepression was indicated. PMID- 3532415 TI - [Acute tubulo-interstitial nephritis combined with uveitis (clinical case and review of the literature)]. AB - The authors have presented a review of literature and their own data on acute tubulointerstitial nephritis combined with uveitis in a patient aged 47. In foreign literature this combination is defined as a separate syndrome (TIN uveitis or TINU). The development of nonspecific symptoms (fatigue, weakness, nausea, loss of body mass, pains in the joints, skin rash) was characterized by change in some laboratory indices (raised ESP, anemia, eosinophilia, hyperproteinemia, hypergammaglobulinemia) and nephropathy. The signs of nephropathy were polyuria, a decrease in relative urine density, proteinuria of tubular genesis, renal glucosuria and aminoaciduria. A decrease in glomerular filtration and an increase in the level of blood serum creatinine were noted in most of the cases. In spite of the development of renal failure TINU prognosis is favorable: renal function gets back to normal by itself or after corticosteroid therapy. Uveitis shows a tendency to recurrence. The immune genesis of the TINU syndrome is assumed. PMID- 3532416 TI - [Captopril in the treatment of arterial hypertension in chronic nephritis]. AB - The effect of captopril on arterial pressure, indices of renal function and renal function regulating factors was studied in 13 patients suffering from chronic glomerulonephritis with arterial hypertension. Captopril considerably decreased the expression of hypertension irrespective of the initial status of the renin angiotensin-aldosterone system. A prolonged use of captopril resulted in an increase in the renal blood flow, a considerable decrease in the resistance of the renal vessels. A transient decrease in a glomerular filtration value was noted on the first days of treatment. The use of captopril did not cause significant changes in sodium balance; potassium excretion with urine decreased, its concentration in the blood increased. Captopril caused a sharp increase in the blood renin activity, a decrease in aldosterone production and excretion and an increase in the synthesis of renal prostaglandins. Captopril was well tolerated by the patients, noticeable side effects were undetectable. Mechanisms of the hypotensive effect of the drug and mechanisms of its action on renal function were discussed. PMID- 3532418 TI - Two plasma fibronectin fragments with different gelatin-binding properties. AB - Two subtilisin-generated fragments of human plasma fibronectin exhibit significantly different gelatin affinities. One fragment of 60 kdaltons elutes from gelatin-Sepharose, after intact fibronectin, with pH 5.5, 50 mM citrate, 0.1 M NaCl. A 40 kdalton fragment, which can be derived from the 60 kdalton fragment, remains bound to gelatin under the same conditions. Furthermore, upon urea gradient elution, the 60 kdalton fragment dissociates from gelatin before the smaller fragment. Of the two fragments, the 60 kdalton fragment also demonstrates affinity for heparin. Identical amino-terminal sequences for the two fragments indicate that the heparin-binding activity resides in the difference region at the carboxyl-terminal of the 60 kdalton fragment. PMID- 3532417 TI - Stability of prostacyclin in human and rabbit whole blood and plasma. AB - The stability of prostacyclin (PGI2) in whole blood and plasma was studied in vitro by measuring the disappearance rate of labeled prostacyclin during a 37 degrees C incubation. Prostacyclin was assayed using a quantitative chromatographic method. The half-life of PGI2 was 6.3 +/- 0.8 minutes (mean +/- s.d., n = 6) in citrated human whole blood, significantly shorter (p less than 0.001) than the 10.7 +/- 2.3 minute half-life in citrated human plasma (n = 7). Prior freezing and thawing of plasma did not affect the rate of PGI2 hydrolysis. These values, including the prolonged half-life in plasma, were similar in the blood (5.4 +/- 1.8 min, n = 7) and plasma (9.0 +/- 1.9 min, n = 14) of diabetic patients. In plasma samples from patients with thrombotic thrombocytopenic purpura, the half-life of prostacyclin (4.9 +/- 1.0 min, n = 4) was significantly shortened (p less than 0.001) compared to that in plasma from normal volunteers. The stability of prostacyclin in rabbit blood and plasma was also quantified. The PGI2 half-life in citrated rabbit plasma (10.8 +/- 1.1 min, n = 3) was similar to that in citrated human plasma from control subjects. In contrast to the findings in human blood, the half-life of PGI2 in citrated rabbit whole blood (11.7 +/- 3.3 min, n = 4) was not different from the rabbit plasma value. Substitution of EDTA for citrate did not affect the half-life in rabbit blood or plasma. PMID- 3532419 TI - [Comparison of naproxen and piroxicam in rheumatoid arthritis and Bechterew's syndrome. A double-blind parallel multicenter study]. PMID- 3532420 TI - [Stomach ulcer. Treatment with nocturnal doses of 300 mg ranitidine]. PMID- 3532421 TI - [Outcome of twin pregnancies. Importance of early diagnosis]. PMID- 3532422 TI - [Prevention of food-borne diseases in the Netherlands. Are we on the right course?]. AB - It is estimated that in the Netherlands several hundreds of thousands of patients are affected with food-borne diseases or poisoning each year. Though the symptoms are usually mild and mortality is low, the financial impact on society is enormous. The consumer is hardly aware of this fact and the--substantial- government efforts to achieve prevention are not very effective. In view of the present state of science, it should be possible to ensure the consumer of safe food on the market, which may be eaten without any risk after sound preparation. The origin, magnitude and effects on society of this complex problem are studied in the present review. An attempt is made to evaluate the possibilities of reducing the morbidity of food-borne diseases, regarded by the World Health Organization as the most important problem in public health after diseases of the respiratory tract in the coming decades. Particular attention is paid to the role to be played by the authorities in these efforts to reduce morbidity. PMID- 3532423 TI - [Bone marrow biopsy in children with leukemia. Determination and reduction of pain and fear reactions]. AB - The development and reduction of distress in children with leukemia was studied during a frequently recurring medical procedure, i.e., a bone marrow aspiration (BMA). The role of a number of factors in the development of distress display in children during this procedure was studied. The intensity of distress display was assessed with a behavioral rating scale. The intensity of distress display was found to be independent of the physician who performed the punction, the part of the body to which the punction was administered, the number of previously administered BMA'S, whether the child had to undergo a lumbar puncture after the BMA, and whether the child was sedated. The intensity of distress display varied with age and sex of the child. The intensity of distress display was weaker in older children, but this age effect was stronger for boys than for girls. An experimental program was developed and administered in order to reduce distress display during medical treatment. This program consisted of three parts (relaxation, imagination of a pleasant situation and arousal of the concomitant feelings, as well as watching a model). The experimental program was found to be effective in reducing distress display in children. The amount of reduction was dependent of the number of prior BMA'S (the fewer the prior BMA'S, the greater the decrease) and of the level of pretreatment display of distress (the higher the level, the smaller the decrease. PMID- 3532424 TI - Evaluation of effect of treatment for primary lesions of stage D2 prostatic cancer by means of transrectal ultrasonotomography. AB - The effect of treatment for primary prostatic lesions of Stage D2 prostatic cancer was evaluated by means of transrectal ultrasonotomography and was compared with that for distant metastatic lesions. A new score system was introduced to assess the effect of treatment for the primary lesions of prostatic cancer from the ultrasonic findings of the prostate on a single examination after treatment. In 19 subjects evaluated as effective or moderate in the treatment of primary lesions, 9 were also evaluated as effective or moderate in the treatment of metastatic lesions, while 10 were judged as poor in the treatment of metastatic lesions. In 12 subjects which were evaluated as poor in the treatment of primary lesions, 3 were judged as moderate in the effect of treatment of metastatic lesions, while 9 were judged as poor. It was proved that the correct evaluation of the primary prostatic tumor was required to perform adequate treatment for Stage D2 prostatic cancer. PMID- 3532425 TI - A rat model for monitoring homograft rejection of the lung. AB - A new surgical procedure was devised for the experimental homograft of the lung. The pulmonary artery and vein and bronchus were anastomosed under the operation microscope using interrupted sutures in group W (30 outbred Wistar rats) and continuous sutures in group F (7 inbred F344/Ducrj Rats). Mean ischemia time during the operation was 95.3 +/- 10.3 min in the group W and 55.6 +/- 5.8 in group F. Eight out of 30 rats (27%) of group W and all rats of group F survived more than 24 hr after the surgery. Pulmonary functions of grafted lungs were evaluated by serial x-rays and the perfusion ratio was 27.4 +/- 11.6% (mean +/- S.D.) in group W and 25.4 +/- 7.7% in group F. A patent opening of the hilar anastomosis in these rats was confirmed at autopsy. This model with continuous suture would be useful for the rat lung transplantation. PMID- 3532426 TI - Medicare reimbursement issues. PMID- 3532427 TI - Cytoplasmic vacuolation of pancreatic beta cells of rats after oral administration of a derivative of isoquinoline. AB - beta cells in islets of Langerhans were studied in Sprague-Dawley rats dosed by gavage with 0 (control), 75, 150, 250 or 300 mg/kg body wt/day S-H 966 BS [1-(1 oxido-4-thiomorpholino)-3-(1-piperazinyl)], an isoquinoline derivative. All doses caused a significant and dose-dependent increase in serum glucose (diabetes mellitus). At 250 mg/kg, degranulation of beta cells was discovered after 1 day and vacuole formation after 2 days. Ultrastructural alterations compared well with that seen after treatment with cyproheptadine and other structurally related compounds. The vacuolation of beta cells was fully developed following 6 weeks of daily treatment, when a dose-dependent elevation of blood glucose was first observed. The effects were more severe in males than in females. Lesions were reversible within 6 weeks except at 300 mg/kg in males. PMID- 3532428 TI - Experimental sensitization to subtilisin. I. Production of immediate- and late onset pulmonary reactions. AB - Four experiments were undertaken to explore the nature of pulmonary sensitivity which may result from inhalation of subtilisin aerosols. In the first study, immediate- and late-onset responses were identified. Groups of guinea pigs were exposed to atmospheres containing 0.15 to 15 mg/m3 bacterial subtilisin for 15 min/day on each of 5 consecutive days. Following an exposure-free period, reexposure to subtilisin at 1.9 mg/m3 for 20 min resulted in pulmonary responses characterized as "rapid shallow breathing." In some cases, reactions were severe and resulted in respiratory anaphylaxis; in one case, it was fatal. These responses usually occurred during the inhalation challenge or within 1 hr of challenge. However, late-onset reactions, maximum at 3-6 hr postchallenge, were occasionally observed. Results from the second series of experiments indicated that pulmonary responses were most prevalent in animals initially exposed to high concentrations of subtilisin (greater than 0.15 mg/m3) whereas no responses were observed in animals which had been exposed to 8.3 X 10(-3) or 41 X 10(-3) mg/m3 subtilisin. A third study indicated that exposure to 1.9 mg/m3 subtilisin for 20 min could result in pulmonary hypersensitivity. Additionally, when animals received subtilisin exposure on Days 1-5, pulmonary responses were equally severe whether elicited by inhalation challenge on Day 10 or on Day 17. Lastly, long term exposure of animals to low levels of the enzyme did not result in any cases of pulmonary sensitivity even though the total cumulative exposure received by these animals when administered over a short period of time regularly induced sensitivity. The identification of a "threshold" concentration for sensitization in this animal model implies that it should be possible to recommend a safe industrial exposure level to subtilisin and thus prevent sensitization of exposed workers. PMID- 3532429 TI - Immunotoxicity studies in mice exposed to methyl isocyanate. AB - The effects of methyl isocyanate (MIC) on systemic immunity were evaluated in female B6C3F1 mice exposed via inhalation to 0, 1, or 3 ppm for 6 hr per day on four consecutive days. Humoral immunity, measured as the antibody response to sheep erythrocytes, and natural killer cell activity were not affected by MIC. Furthermore, resistance to the infectious agents Listeria monocytogenes, mouse malaria parasite, and influenza virus, or to B16F10 transplantable tumor cells, was not compromised by MIC exposure. Although lymphoproliferative responses to mitogens were not significantly suppressed, the response of splenic lymphocytes to allogeneic leukocytes in a mixed leukocyte response (MLR) was suppressed in a dose-related fashion and differed significantly from the control response at the 3-ppm level. These studies indicate that MIC exposure in mice does not severely alter systemic immunity. The moderate changes detected in immune function may be a secondary consequence of respiratory toxicity which occurred in these animals. PMID- 3532430 TI - Orthognathic surgery 1980-1985--a review. PMID- 3532431 TI - Intra-oral yeasts in an indigent South African community. PMID- 3532432 TI - Late-life migraine accompaniments--further experience. AB - In 1980, 120 cases with late-life migrainous accompaniments resembling transient ischemic attacks were presented. In the present paper, 85 further cases examined in the past five years are analyzed. The findings support the concept advanced previously. In general, the cases are divided into the same categories: visual- 21 cases, visual and paresthesias--6, visual and speech disturbance--2, visual, paresthesias and speech disturbance--3, visual, paresthesias, speech disturbance, and weakness--20, visual and brainstem symptoms--3, and cases without visual symptoms--32. The ages ranged from 40 to 73 years. Headache occurred in association with the episodes in only 40% of cases. There was a history of recurrent headache in 65%. The condition can justifiably be regarded as benign. Migrainous accompaniments account for some of the cases of transient ischemia with normal angiograms. Knowledge of the condition helps in the planning of rational management. PMID- 3532433 TI - Red blood cell disorders and stroke. PMID- 3532434 TI - Diaschisis. PMID- 3532435 TI - The sex difference in manifestations of carotid bifurcation disease. AB - One would think that risk factors for transient ischemic attack (TIA) and asymptomatic carotid bruit (ACB) would be similar. In our referral population and in several previously reported cohort populations, however, men outnumber women among patients with TIA. In contrast, women outnumber men among patients with ACB. We found in two independent populations that women with ACB are up to 5.7 times less likely than men to have carotid stenosis. Thus women are more prone than men to have ACB, but their bruits much less commonly reflect carotid stenosis. Women are probably predisposed to have carotid bruit even in the absence of carotid stenosis. In our referral population of ACB, this tendency among women for carotid bruit without stenosis does not seem to be related to lower hematocrit, higher prevalence of heart murmur, constitutionally smaller carotid arteries, or differences in pulse rate or body habitus. PMID- 3532436 TI - Transcranial Doppler in cerebrovascular disease. AB - Doppler analysis of flow in intracranial arteries is now possible using a 2 MHz probe allowing sufficient penetration of bone to obtain signals noninvasively. Thirty-two normal subjects, and 11 patients with cerebrovascular diseases including vasospasm following subarachnoid hemorrhage, middle cerebral artery stenosis, and extracranial internal carotid artery stenosis were studied by transcranial Doppler. Increased peak velocity and spectral broadening of the reflected signal corresponded to clinical and angiographic evidence of middle cerebral artery vasospasm or stenosis. Decreased peak velocity and blunted waveforms occurred in the middle cerebral artery ipsilateral to severe extracranial internal carotid stenosis with poor crossfilling from the contralateral carotid artery. Abnormalities resolved following carotid endarterectomy. Transcranial Doppler identifies vasospasm or stenosis of the middle cerebral artery and may allow noninvasive evaluation of collateral flow across the anterior circle of Willis in patients with extracranial carotid artery stenosis. PMID- 3532437 TI - Transorbital Doppler diagnosis of intracranial arterial stenosis. AB - Forty-two intracranial internal carotid arteries were visualized by both arteriography and 2 MHz pulse ultrasonic Doppler examinations. The intracranial internal carotid artery Doppler signals were studied at 5-7 cm depth behind the eyelid using frequency spectral analysis. Stenosis criteria were developed and methods of avoiding confusion with collateral effects devised. Among 33 intracranial ICAs visualized on the arteriograms, 22 were normal without stenosis and 11 displayed some degree of stenosis ranging from 20 to 75 percent. An additional 7 were totally occluded. Doppler criteria of stenosis representing elevated frequencies and symmetrical prominent low frequencies (SPLF) were utilized and separated from collateral effects to provide an overall accuracy of the technique of 88 percent with a 95 percent specificity and a 73 percent sensitivity. The technique appears sufficiently promising to justify further development and utilization. PMID- 3532438 TI - Range-gated pulsed Doppler power frequency spectrum analysis for the diagnosis of carotid arterial occlusive disease. AB - Carotid arterial disease was investigated with a Duplex Scanner using Power Frequency Spectrum Analysis. Sixty-one carotid systems were evaluated noninvasively and angiographically, while 20 controls were examined and assumed to be normal. Peak frequency and 50% frequency bandwidth, a quantitative index of spectral broadening, were correlated with the percentage of stenosis. Peak frequency predicted the presence or absence of hemodynamically significant stenoses (greater than or equal to 50% diameter reduction) with 90.8% accuracy, while 50% frequency bandwidth correctly identified similar lesions with 93.2% accuracy (p = NS). Also, with the latter results, carotid systems were grouped into less than 25%, 25% to 49%, and greater than or equal to 50% stenosis categories with an 86.4% accuracy. Similar statistical evaluation was attempted for peak frequency results. It was not possible to separate hemodynamically insignificant lesions (less than 50% diameter reduction) into distinct groups because of the overlap of results among those arteries with less than 50% stenosis. Finally, all eight occluded internal carotid arteries were identified with combined Doppler/imaging analysis. However, with imaging alone, only 5 of 8 (63%) occluded arteries were correctly identified. PMID- 3532439 TI - Failure of central nervous system serotonin blockage to influence outcome in acute cerebral infarction. A double blind randomized trial. AB - To determine the effect of blocking central nervous system (CNS) serotonin reuptake in the outcome of acute cerebral infarction (ACI), 49 patients were studied in a double blind, randomized trial. All patients suffered hemispheric ACI, were seen within 24 hours of onset, and were treated with low dose, subcutaneous heparin to prevent venous thrombosis; 25 received 10 mg. of trazodone hydrochloride intravenously every 12 hours for seven days and 24 were given an identically appearing placebo. To monitor trazodone effect, indol derivatives were measured in spinal fluid collected before and after treatment in 38 patients. Treatment and placebo patients had similar demographic characteristics, comparable risk factors, and neurologic deficit at onset. No appreciable difference was seen between treatment and control patients in regard to intercurrent events, degree of neurologic deficit, time of hospitalization, and mortality. Indol derivatives were consistently higher in the spinal fluid of trazodone patients after treatment, confirming serotonin reuptake blockage; however, this seems to have had no beneficial effect on the outcome of ACI. PMID- 3532440 TI - [Use of computer analysis methods in solving current problems of forensic medical and clinical toxicology]. PMID- 3532441 TI - [Establishment of the intra vitam occurrence and time of mechanical injury in forensic medicine]. PMID- 3532442 TI - Epikeratophakia--an alternative to glasses, contact lenses and intraocular lens for optical correction of aphakia in children. PMID- 3532443 TI - The carotid and the eye: correlations using digital substraction angiography. PMID- 3532444 TI - Ocular hypotensive effect of haloperidol. PMID- 3532445 TI - Philadelphia and the White Plague. PMID- 3532446 TI - William Edmonds Horner (1793-1853), America's first clinical investigator. PMID- 3532447 TI - ABH antibodies causing platelet transfusion refractoriness. AB - Two alloimmunized patients with multispecific anti-HLA and high-titered ABH antibodies showed transfusion failures after ABH-mismatched HLA-identical platelet transfusions, whereas ABH-matched HLA-identical platelets showed sufficient increments. The anti-A and -B could be demonstrated on platelets by immunofluorescence tests using FITC-labeled goat anti-human IgG. These platelet antibodies could be absorbed with red cells and platelets of the appropriate ABH type. In contrast to previous reports about the influence of ABH antibodies on platelet survival, not only a proportion of the platelet population were destroyed after infusion, but almost all ABH-incompatible platelets were destroyed. PMID- 3532448 TI - Immunoadsorption of human plasma with protein A-sepharose columns. AB - Four patients with refractory acute leukemia were treated a total of 31 times with an immunoadsorption system consisting of protein A-sepharose columns, a cell separator, and an elution monitor to test its safety and capacity to remove immunoglobulins. The procedure was tolerated well, and acutely reduced plasma IgG levels by approximately 18 percent. When the procedure was repeated two to three times per week for 3 weeks, IgG levels dropped by 30 to 40 percent, but they gradually returned to pretreatment levels after completion of the course of treatment. Single columns became saturated with IgG after approximately 1500 ml of plasma had passed through the columns. The use of multiple columns sequentially provided continuous extraction of immunoglobulin. One patient regained responsiveness to platelet transfusions after removal of platelet antibodies. These preliminary studies suggest that this immunoadsorption system is effective for specifically removing IgG and that it merits further clinical testing. PMID- 3532449 TI - The effects of cyclosporine on the induction of donor class I and class II MHC antigens in heart and kidney allografts in the rat. AB - We have previously reported 5-30-fold increases in the expression of class I and class II major histocompatibility complex (MHC) antigens in rejecting heart and kidney allografts in the DA-to-PVG rat strain combination. We examine here the effects of immunosuppression with cyclosporine on the induction of donor class I and class II MHC antigens in heart and kidney allografts in this strain combination. Immunohistological studies and quantitative absorption analyses using monoclonal antibodies and assay systems specific for donor class I and class II MHC antigens were used throughout. Heart allografts in cyclosporine treated rats were examined on day 3,5,7,9,11, and 14 after transplantation, and kidney allografts in cyclosporine-treated rats were examined at day 7. In addition, untreated heart and kidney isografts were studied at days 1,3,5, and 7 after grafting. Immunohistological studies on frozen sections showed that cyclosporine-treated heart and kidney allografts showed no induction of class II MHC antigens, in contrast to untreated heart and kidney allografts. Class I MHC antigen induction did occur in spite of cyclosporine-therapy, but at levels lower than those seen in untreated allografts. Moreover, the pattern and degree of class I induction in the cyclosporine-treated allografts resembled very closely those seen in isografts, and so this induction was, in all probability, a consequence of the transplantation procedure rather than of specific immune responses. We also noted, in the cyclosporine-treated heart allografts, that all donor interstitial dendritic cells had disappeared and been replaced by recipient interstitial dendritic cells by the end of the second week after grafting. In addition, there was no reduction in the class II antigen content of kidney allografts treated for 7 days with cyclosporine. The absence of class II antigen induction in allografts where rejection is effectively suppressed with cyclosporine might be of clinical value in the differential diagnosis between rejection and cyclosporine toxicity in renal transplantation, and between active and inactive cellular infiltrates in heart transplantation. PMID- 3532450 TI - Impairment of the immune response to influenza vaccination in renal transplant recipients by cyclosporine, but not azathioprine. AB - Influenza vaccination has been strongly recommended for immunosuppressed renal transplant recipients. However, immunosuppression may lead to impaired antibody responses. We studied the antibody response to an inactivated trivalent influenza vaccine in 59 renal transplant recipients with life-sustaining kidney function: 21 were on cyclosporine and prednisone, 38 on azathioprine and prednisone. Healthy volunteers (n = 29) and patients on hemodialysis (n = 28) served as controls. Despite comparable renal allograft function, cyclosporine-treated patients had a significantly lower immune response against influenza A viruses than azathioprine-treated patients, whether mean antibody levels, fourfold titer rise, or seroconversion to protective titers was analyzed. No significant differences in antibody responses were found between healthy controls and patients on azathioprine. The patients on hemodialysis showed an impaired response to vaccination. However, in contrast to the cyclosporine-treated patients, booster immunization proved valuable in this group. PMID- 3532451 TI - Reduction in the incidence of rejection of heterotopic murine corneal transplants by pretreatment with ultraviolet radiation. AB - A reduction in the incidence of rejection of mouse heterotopic corneal allografts was achieved by in vitro pretreatment of the graft with ultraviolet light. By day 21, 68% of untreated BALB/c corneas transplanted into s.c. abdominal pouches of C57BL/6 recipients demonstrated rejection. In contrast, corneas pretreated with UV-A, -B, or -C at 150 mJ/cm2 showed an incidence of rejection at day 21 of 30%, 33%, and 18%, respectively. Experiments indicate a significant reduction in rejection with doses of UV-B radiation above 75 mJ/cm2. The mechanism of this reduction is unknown, but may be due to a depletion or alteration of ocular surface Langerhans cells residing in the corneal epithelium. PMID- 3532452 TI - The role of TDTH and Tc populations in organ graft rejection. I. Functional analysis of graft-infiltrating T cells. AB - To analyze the role of T cell subpopulations in the rejection of organ allografts, we developed a new model for obtaining large numbers of graft infiltrating cells (GICs). We isolated W3/25+ Th/DTH and OX8+ Ts/c from vascularized, irradiated rat spleen allografts. W3/25+ GICs obtained from spleen allografts transplanted to normal recipients were highly effective in eliciting cardiac allograft rejection when transferred to sublethally irradiated recipients, however, the OX8+ subset was incapable of eliciting rejection. On the other hand, when OX8+ GICs were obtained from spleen allografts transplanted to previously immunized recipients, they were as efficient as the W3/25+ Th/DTH subset in eliciting cardiac allograft destruction. These results indicate that the W3/25+, OX8- T cell is required for the rejection of primary organ allografts, but that the rejection of a secondary allograft by an immune recipient may be mediated, independently, by both W3/25+ and OX8+ cells. PMID- 3532453 TI - Drug-induced tolerance to allografts in mice. IX. Establishment of complete chimerism by allogeneic spleen cell transplantation from donors made tolerant to H-2-identical recipients. AB - Graft-versus-host reaction (GVH) after allogeneic spleen cell transplantation was completely suppressed in an H-2-matched murine combination (AKR/J Sea [H-2k]--- lethally irradiated C3H/He Slc [H-2k]) by pretreatment of the donors with recipient spleen cell antigen plus cyclophosphamide (CP). Irradiated recipients receiving cells became chimeric. In contrast to the H-2 matched combination, lethal GVH reaction could not be prevented in an H-2-mismatched fully allogeneic combination (C57BL/6 Cr Slc [H-2b]----lethally irradiated C3H/He Slc [H-2k]) by pretreatment of the donors. The results suggest that the effectors responsible for the GVH reaction were abrogated by pretreatment of the donors with allogeneic recipient spleen cells plus CP in the H-2-matched combination, but donor pretreatment failed to abrogate GVH reaction in the H-2-mismatched combination. PMID- 3532454 TI - Toxic shock syndrome complicating orthotopic liver transplantation--a case report. PMID- 3532455 TI - Segmental pancreatic canine neck autotransplantation with exocrine drainage to the parotid duct. PMID- 3532456 TI - Positive antiglobulin cytotoxicity crossmatch in renal allograft recipients treated with cyclosporine. PMID- 3532457 TI - Postoperative bone marrow injections with cyclosporine or antithymocyte globulin in rat cardiac allografts. PMID- 3532458 TI - Hellenic Society for Transplantation. Abstracts of the Fourth Congress. Athens, 1986. PMID- 3532459 TI - Second congress of the European Society for Organ Transplantation. Munich, FR Germany, November 27-29, 1985. PMID- 3532461 TI - Goat blood agar. Inexpensive media for culturing common bacterial pathogens. PMID- 3532460 TI - First International Workshop and Colloquium on the Pathology of Liver Transplantation. May 28, 1986, London, Ontario, Canada. PMID- 3532462 TI - [Chromosomes. Aging. Longevity]. AB - Investigations dealing with the characteristics of chromosomal apparatus at late stages of ontogenesis are analyzed. Both structural and functional changes in the chromosomal apparatus are observed in ageing. Some papers indicate to the association of certain variants of chromosomal polymorphism with the longevity "phenomenon". PMID- 3532463 TI - [Characteristics of the surface topography of Swiss 3T3 cells with altered proliferative activity]. AB - A scanning electron microscope study of the Swiss 3T3 cell surface topography was made in association with changes in proliferative activity. On the phase of logarithmic growth the cell shape is similar to that of an actively migrating fibroblast. When the growth promoting factors are depleted, the cells are seen spread and forming numerous cell-to-cell contacts. The stimulation of cell proliferation induced by a 10% serum or by epidermal growth factor is associated with a disturbance of cell interaction because of the centripetal cell contraction. PMID- 3532464 TI - [5 clinical cases of highly decayed molars restored with various types of sectional dowels and core]. PMID- 3532465 TI - [Microleakage studies in a composite resin core using 14C labelled glucose]. PMID- 3532466 TI - [Silver alloys used for metal cores]. PMID- 3532467 TI - Single radial hemolysis test for the detection of rinderpest antibody. AB - The single radial hemolysis [SRH] test was employed for detection of rinderpest antibodies in post-vaccinated serum samples as also in serum samples from animals recovered from rinderpest infection. The results were compared with counterimmunoelectrophoresis [CIE] and serum neutralisation [SN] tests. The CIE test was found to be more sensitive than SRH but because of ease and simplicity SRH can also be used for monitoring antibody development after vaccination. PMID- 3532468 TI - Combined treatment of 4'-epi-doxorubicin and radiation on hamster lung cells. AB - The purpose of this study was to test the type and the degree of cytotoxic effects of epirubicin and radiation in combined treatment on Chinese hamster lung cells in vitro. Experiments were performed with proliferating tissue culture cells. Cell kill was determined by colony-forming ability. The maximum killing effects were obtained when simultaneous action of drug treatment and irradiation occurred. Their interaction was synergistic. Synergism depended on time of drug incubation (epirubicin present for 1 h). Slight antagonism was noted after prolonged drug action (24 h). PMID- 3532470 TI - 25-year index. 1958-1983. PMID- 3532469 TI - A clinical trial of homoharringtonine in the treatment of advanced breast cancer. AB - Two combination chemotherapy protocols, CMF (cyclophosphamide, methotrexate, fluorouracil) and CMFH (CMF plus homoharringtonine), were tested in advanced breast cancer patients. The response rate of CMF was 50% in 44 cases, and that of CMFH was 54.16% in 48 cases; the difference was not significant. There was also no difference between the median duration of response and the median survival of the two protocols. It was concluded that the addition of homoharringtonine to the CMF protocol gave no additional benefit. PMID- 3532471 TI - A metastatic abdominal tumor. PMID- 3532472 TI - [Penicillin-resistant gonococcal infection found by routine culture from cutaneous abscesses]. PMID- 3532473 TI - [Value of ultrasonic therapy in resorption of hematomas]. PMID- 3532474 TI - Steady progress, special issues, familiar proceedings. PMID- 3532475 TI - The use of ultrasound in developing countries. AB - In many developing countries ultrasound services are either nonexistent or inadequate, although the diagnostic problems for which ultrasound is particularly suited are common in such countries. In view of this, the World Health Organization (WHO) has outlined the indications for diagnostic ultrasound together with the technical specifications for equipment. Where there are larger hospitals the basic ultrasound services should be complemented with the proposed general-purpose ultrasound scanner while at the level of major medical centres there will be need for a variety of special purpose ultrasonic units, e.g. for cardiac, intraluminal and interventional investigations. The usefulness of any ultrasound appliance depends to a great extent on the skill and experience of the operator. Therefore, WHO provides guidance on the training of general practitioner and expert sonographer that is necessary for proper implementations of this technology. In this review the authors discuss the various problems affecting the use of ultrasound in developing countries. PMID- 3532476 TI - Diagnostic spectrum analysis in ophthalmology: a physical perspective. PMID- 3532478 TI - First symposium on safety and standardisation of ultrasound in obstetrics. Proceedings of World Federation of Ultrasound in Medicine and Biology. Sydney, Australia, 22-24 July 1985. PMID- 3532477 TI - Bibliography of biomedical ultrasound. No. 57. PMID- 3532479 TI - Bibliography of biomedical ultrasound. No. 58. PMID- 3532480 TI - [Posterior shoulder dislocation]. AB - Posterior dislocations of the shoulder can be caused by various mechanisms, the most common one, being epileptic seizures. Therefore many patients or their relatives hesitate to admit, how the injury has actually occurred. Spangler et al. published in 1975 several reasons why the diagnosis of "posterior subluxation of the humeral head" is often missed. Usually very typical errors in the evaluation of the clinical findings lead to misinterpretation of the radiograms. In spite of the fact that long-term results of untreated posterior subluxations can be surprisingly good, reduction must be achieved as soon as possible. Deep impression-fracture of the humeral head are the cause of recurrent dislocations. Various methods have been described to treat this condition by filling the defect with subscapularis tendon or cancellous bone. Avulsion-fractures of the posterior rim of the glenoid can successfully be refixed with small screws. In case of dislocation fractures through the anatomical neck, prosthetic replacement of the head leeds to satisfying results. So-called habitually dislocations are more common in boys and do usually not require surgery, as the inclination to dislocate becomes less frequent in later years. Only in adults operation may be indicated. Posterior apposition of a bone graft can be recommended. PMID- 3532481 TI - [Blood pressure-dependent, process-controlled hemostasis to minimize tourniquet syndrome]. AB - The usual limitation of the pneumatic blood arrest period to 1.5 hours is a protective measure in order to prevent permanent injuries due to tissular hypoxia and local pressure. The generally applied cuff pressure of 300 mm Hg for the upper and 500 mm Hg for the lower extremity is an arbitrary value which has been obtained by empiric research and is completely lacking in scientific foundation. The risk of damaging tissues lying under the cuff which are sensitive to pressure would be considerably reduced by decreasing this pressure to a value just beyond the systolic blood pressure. The differences between systolic pressure and cuff pressure leading to a safe blood arrest in the extremity operated upon have been determined in narcotized patients. It was shown that the cuff pressure only has to be a little higher than the systolic blood pressure in order to produce a constant blood arrest. This difference, however, is also dependent on the circumference of the extremity as well as on the age and sex of the patient and the tissue turgor. It was therefore necessary to construct a unit providing a permanent pressure control in the pneumatic blood arrest cuff depending on the variations of blood pressure during surgical intervention. This was obtained by the use of rapidly working minicomputers and new monitoring devices. PMID- 3532482 TI - [Management of combination injuries of the femur shaft and femoral neck fractures with a locking nail. Multicenter study of 26 cases from 4 trauma clinics]. AB - Twenty-six patients with femoral shaft- and ipsilateral neck-fracture, treated in four different hospitals, have been analysed. The majority of these fractures was treated by a distally locked dynamic nail and fixation of the femoral neck by two or three lag-screws. In some cases a "contralateral" nail with a proximal locking screw in the femoral neck was used. Results are excellent without non-union or mal-union. Only one case of avascular necrosis occurred in an 68 years old patient. Interlocking intramedullary nailing certainly has its place in the treatment of associated femoral shaft- and neck-fractures. This closed method presents a stable fixation and permits early mobilisation and joint-function. PMID- 3532483 TI - [Echocardiography of the endurance athlete as a function of VO2 max]. PMID- 3532484 TI - [Bone marrow transplantation. Experience of the Maisonneuve-Rosemont hospital center and insight concerning indications]. PMID- 3532485 TI - [Efficacy of psychotherapy: contextual and structural ingredients]. PMID- 3532486 TI - [Acute obstructive pyelonephritis (experimental research)]. PMID- 3532487 TI - [Potential use of the computerized substraction angiography method in patients with kidney lesions]. PMID- 3532488 TI - [Determination of the enzyme activity of the blood serum in the diagnosis of liver diseases in patients following a kidney transplant]. PMID- 3532489 TI - [Immunopathological mechanisms of the development of pyelonephritis and its potential immunotherapy]. PMID- 3532491 TI - [Cancer of the urachus]. AB - Carcinoma of urachal origin is a special type of primary vesical adenocarcinoma. Because of the anatomic and histologic character of this tumour the therapy is different from that of transitional carcinomas. Diagnostic modalities including ultrasonography and computed tomography are demonstrated. The findings are compared with those of an ovarial carcinoma metastasis also located in the bladder dome. PMID- 3532490 TI - [Disintegration of kidney calculi with a piezoelectric instrument system. Initial clinical experiences]. AB - Since December 1985 extracorporeal piezoelectric renal lithotripsy has been tested in humans. Up to now 50 patients with renal calculi have been treated. The lithotriptor consists of a special mobile table with an opening in the surface to apply shock waves. Urinary calculi are located by integrated ultrasound location systems. As the piezoelectrically generated high-energy sound pulse does not cause pain, treatment is possible without anesthesia. Permanent ultrasonic control of the stones in the focus during lithotripsy allows effective application of shock waves. With this piezoelectric system the electrocardiogram does not have to be triggered. So far the results have been encouraging and following these tests clinical application is expected to be successful. PMID- 3532492 TI - Fetal megaureters masquerading as bowel obstruction. AB - As a result of repeated ultrasound assessments for determination of gestational age, more congenital anomalies are detected in the fetus. Early diagnosis has serious implications for both mother and fetus. We present our experience in the management of a male fetus with obstructive uropathy diagnosed at seventeen weeks of gestation. In serial ultrasounds the tortuous megaureters were mistaken for distended loops of bowel. When the question of obstructive uropathy is raised, and the bladder cannot be visualized, administration of diuretics to the mother may promote fetal bladder filling. Since the advent of intrauterine surgical intervention, distinguishing between megaureters and obstructive bowel disease may have important clinical implications. PMID- 3532493 TI - Seminal vesicle cyst and ipsilateral renal agenesis. AB - A case of seminal vesicle cyst with ipsilateral agenesis is presented. The embryologic events, clinical symptoms, and diagnosis are discussed, emphasizing the value of sonography and computer tomography in identifying the cyst. Surgical resection is the treatment of choice. PMID- 3532494 TI - Large renal masses in young adults. PMID- 3532495 TI - Combined renal and pyelic fusion with crossed ectopia of single ureter. AB - A case of a forty-five-year-old woman with fused kidneys and intercommunicating pelves drained by a single ureter crossing the midline is reported. A review of the literature is presented. PMID- 3532496 TI - [Features of the technic of laminar transplantation of the cornea and use of lyophilized cornea as graft material]. PMID- 3532497 TI - [Comparative evaluation of the effect of different types of contact lens on the condition of the eye]. PMID- 3532498 TI - [Modification of the method of mobilizing the distal portion of the large intestine in the surgical treatment of cancer]. PMID- 3532499 TI - [Possibilities of correcting the rheological properties of blood in surgery]. PMID- 3532500 TI - [Recurrence of cancer of the intrathoracic portion of the esophagus]. PMID- 3532501 TI - [Gastric esophagoplasty in cancer of the middle third of the esophagus]. AB - The examination of 119 corpses, experiments in 67 dogs and clinical management of 127 patients with the II-III degrees of cancer of the middle third of the esophagus have supported new methods of esophagoplasty by a tube from the greater curvature of the stomach with highly germetic sutures, longer transplants and diaphragmo-percutaneous conduction of it onto the neck. The method is shown to be more safe, less traumatic, not followed by functional alterations of the heart, lungs, diaphragm. PMID- 3532502 TI - [Diadynamophoresis of chemical and biologically active substances in the treatment of suppurative and inflammatory diseases in diabetes mellitus]. AB - Treatment of pyo-inflammatory diseases in patients with diabetes mellitus should be complex, individual and controlled. Obligatory total and local examinations of the organism should be performed with the involvement of cytological, histological bacteriological methods and with determination of alterations of the carbohydrate, protein, water-salt, electrolytic metabolism, acid-base state and non-specific resistance of the organism. It was shown that diadynamophoresis of proteolytic enzymes, sodium thiosulfate, potassium permanganate in the treatment of pyo-destructive diseases in 362 patients with diabetes mellitus accelerated necrolysis of tissues, shortened time of cleaning the wound and thus made the period of treatment at the hospital shorter. PMID- 3532503 TI - [Occlusion of the ductal system in complete transverse rupture of the pancreas in a child]. PMID- 3532504 TI - Periodontal disease. Therapy and prevention. AB - Success in veterinary dentistry lies in good home care and regular, thorough dental prophylaxis. The removal of supragingival and subgingival calculus must be accomplished before periodontal disease can be controlled. When gingival sulcus depths exceed 4 or 5 mm, the gingivae must be excised or reflected to allow proper treatment of the pocket area. Antibiotic therapy should be instituted in the extensively involved veterinary dental patient. PMID- 3532505 TI - Restorative dentistry. Clinical applications. AB - Restorative techniques for human teeth have been used and refined for centuries. Most of these techniques can be applied with few modifications to restore diseased or damaged teeth in animals. The results can be both functionally sound and cosmetically pleasing. PMID- 3532506 TI - Teat factors in E coli mastitis. PMID- 3532507 TI - Salmonella in sewage effluent and the relationship to animal and human disease in the north of Scotland. AB - During the period July 1982 to December 1984, the presence of salmonella organisms was investigated at weekly intervals in the sewage system and abattoir effluent of a town in the north of Scotland. Three hundred and fifteen isolations, representing 37 different serotypes, were made which included 20 different Salmonella typhimurium phage types and four different S enteritidis phage types. Ten of the serotypes were isolated from livestock in the district during the survey as well as in the periods immediately before and after the survey. There were seven recorded incidents of human infection, involving four salmonella serotypes, only three of which were isolated concurrently from sewage. PMID- 3532508 TI - [Effect of digital subtraction ventriculography on left ventricular hemodynamics of patients with unstable stenocardia]. PMID- 3532509 TI - [Digital subtraction angiography in the diagnosis of pulmonary artery thromboembolisms]. PMID- 3532510 TI - [Angiographic symptoms of acute myocardial infarct]. PMID- 3532511 TI - [New methods of producing an image in pulmonology]. PMID- 3532512 TI - [In memoriam Iurii Nikolaevich Sokolov (on the 80th anniversary of his birth)]. PMID- 3532513 TI - The use of artificial gynogenesis in studies on the immune system of carp (Cyprinus carpio L.). AB - Gynogenetic carp were obtained by using gamma-irradiated sperm for fertilization followed by a cold shock. The gynogenetic fish and normal siblings of the same parents were analysed for 3 genetic markers: scale pattern, transferrin (Tf) and allograft rejection. Gynogenetic offspring showed only the maternal scale pattern (scattered). In the majority of the gynogenetic fish a heterozygous Tf pattern identical to the mother was observed. Animals homozygous for Tf were rare in this group. A typical paternal Tf band was only seen in normal siblings. An exchange of skin grafts between normal animals was always followed by rejection (median survival time, 12 days at 23 OC). However, the rejection was delayed in the gynogenetic group (MST, 19,6 days). There were even signs of acceptance in some animals. This approach can be used for the identification of 2nd and 3rd generation gynogenetic fish, which are homozygous for certain MHC haplotypes. PMID- 3532514 TI - Modulation of the immune response in fish. AB - This is a brief overview of the field of immune modulation in fish. Special attention is given to the effects of biological rhythms on the immune responses of animals. Biological rhythms in fish appear to be poorly studied and the effects of such rhythms on fish immune responses needs to be evaluated. Implications for research on the modulation of fish immune responses are discussed. PMID- 3532515 TI - Tuberculin elicited cellular immune response in the lactating bovine mammary gland vaccinated intramammarily with Mycobacterium bovis. AB - The development of a local antigen-specific sensitivity was monitored histologically and in secretions of the bovine mammary gland. Three cows in mid lactation were immunized by injecting 50 microliter of a killed Mycobacterium bovis vaccine into the dorsal secretory tissue of the rear mammary glands; two cows served as unvaccinated controls. Ten weeks after vaccination, all cows were challenged by intramammary infusion of 1.0 microgram tuberculin in 5 ml phosphate buffered saline (PBS). Three quarters of each cow received tuberculin at 72, 48, and 24 hours before slaughter; a control quarter received PBS at 72 hours. Vaccinated cows exhibited an intense, local cellular reaction to tuberculin in teat-end tissues at all times post infusion; PBS-infused glands were normal. A moderate leukocyte response in parenchymal tissues adjacent to the gland cistern of tuberculin-infused quarters was observed, but deep parenchymal tissues were normal; no effect on milk yield was found. Tuberculin-infused quarters exhibited histological responses in teat cisternal tissues similar to those in delayed-type hypersensitivity reactions. Leukocytic accumulation was primarily macrophages and lymphocytes with few neutrophils. Erythema was observed in the distal half of the cistern, and fibrin deposits were found in subepithelial connective tissues. The epithelium, although distended with leukocytes, was intact and numerous mitotic figures were present. Unvaccinated cows showed no response to challenge. Results demonstrated a marked and specific cellular response in sensitized cows to challenge with tuberculin. PMID- 3532516 TI - [Experiments to increase the conception rate in cows with disordered ovulation and spontaneous estrus]. AB - Studied was the time period for the setting in of an ovulation that did not really take place, and the follicular cysts in cows following calving with regard to the effectiveness of the preparation Gn-RH vet. "Berlin-Chemie" in the treatment of the diseased animals. Attempts were made to raise the conception rate of cows manifesting delayed ovulation (with estral and postestral metrorrhagia). It was found that the preparation was effective in the treatment of cows with follicular cysts when applied at the rate of 1 mg in i/m injections. The therapeutic result was 75.4 percent. When introduced at 0.5 mg some 60 min prior to insemination (that is to be performed before the appearance, resp., the presence of estral and post-estral bleeding) the preparation was shown to induce ovulation. It also prevented hemorrhages, and raised the conception rate at first insemination. PMID- 3532517 TI - [Regulation of the reproductive functions of cows by hormonal preparations]. AB - Studied was the effect of some hormonal preparations--progesteron, GnRH, and HCG with progesteron--injected immediately prior to artificial insemination on the reproductional functions of cows raised under industrial conditions. It was found that the conception rate of cows at first insemination was highest upon treatment with GnRH--67.86 percent, i.e., by 14.29 percent higher than that of the control group. The same trend remained with the total conception rate. Lowest was the use of pellets per cow--1.33--with animals treated with GnRH prior to insemination. The application of GnRH (Berlin Chemie, GDR) was sufficiently effective at single i/m injection before artificial insemination. It could be employed to raise conception rate as well as to lower the use of pellets for impregnation of cows. PMID- 3532518 TI - [Immunofluorescence for the rapid diagnosis and complex study of various acute and chronic respiratory infections]. AB - Direct and indirect immunofluorescence techniques were used to investigate the presence of some viral, chlamydial, Rickettsia and Mycoplasma antigens in the exfoliated nasal and pharyngeal epithelial cells from 156 patients with acute or chronic respiratory infections. Positive results were found in 98 (62.82%) of them, parainfluenza (36.88%) and herpes (23.3%) antigens, being the most frequent. Herpes, parainfluenza and adenoviral antigens were found the most frequently among patients with pharyngitis (76 cases). Parainfluenza, Mycoplasma, Chlamydia and Rickettsia burneti antigens had the highest prevalence among the patients with rhinitis (34 cases). The presence of a single antigen was detected only in 36 patients (36.73%), two or more antigens being found simultaneously in other 62 cases (63.27%). The results demonstrate the utility and efficiency of the immunofluorescence techniques for the rapid etiological diagnosis of acute or chronic respiratory infections. PMID- 3532519 TI - [An improved method of antibody elution from erythrocytes]. PMID- 3532520 TI - [The character and work of Dr. A. Vancura (1899-1956)]. PMID- 3532521 TI - [A half century since the isolation of crystalline ferritin by Professor Laufberger]. PMID- 3532523 TI - [Hormonal homeostasis of blood glucose in diabetics]. PMID- 3532522 TI - [Hormonal homeostasis of blood glucose in healthy persons, in endocrine diseases and in conditions with a deficiency of contraregulating hormones]. PMID- 3532524 TI - [Immunology of monocytes. The present state]. PMID- 3532525 TI - [Transplantation of bone tissue in correcting defects and deformities of the mandible and temporomandibular joint]. PMID- 3532526 TI - [Use of dowel inserts and stump crowns for restoring tooth form and function]. PMID- 3532527 TI - [Black Sea medics in the defense of Odessa]. PMID- 3532528 TI - [Aviation surgeon (Grigorii Izrailevich Aranovich)]. PMID- 3532529 TI - [150th anniversary of the founding the Department of Advanced-Level Therapy of the S. M. Kirov Military Medical Academy]. PMID- 3532530 TI - [The use of highly purified staphylococcal alpha-toxin in the immunochemical purification of antibodies]. AB - A simple procedure is described for isolation of highly purified staphylococcal alpha-toxin (SAT) by means of sorption on macroporous glass beads and gel filtration. Various conditions were tested of affinity immunosorption of antibodies and SAT. Highly-porous polyacrylamide gel activated by glutaraldehyde was found as a readily available and selective immunosorbent. The immobilized antigen was stabilized using reduction of azomethyne bonds. Specific activity of antibodies was elevated as the SAT purification degree increased. Correlation between antihemolytic and antilethal activities was unaltered during the immunochemical purification of antibodies. PMID- 3532531 TI - [Creatine kinase activity in guinea pig tissues in experimental pseudotuberculosis]. AB - Dynamics of creatine kinase activity was studied in heart muscle, liver tissue, lymphatic glands, intestine and spleen of guinea pigs infected with pseudotuberculosis microbes. The maximal increase in creatine kinase activity was observed in lymphatic glands and in heart muscle within the first day after the pseudotuberculosis infection. The enzymatic activity increase in liver tissue occurred within the fifth day, while in spleen--within twelfth day after pseudotuberculosis infection. The data obtained were considered in correlation with the clinical manifestations of experimental pseudotuberculosis. PMID- 3532532 TI - [Biochemical and ultrastructural changes in animal brain after intracisternal administration of the cerebrospinal fluid from patients with schizophrenia]. AB - After intracisternal administration of liquor from patients with schizophrenia into rabbits and rats content of catecholamines, gangliosides and cerebrosides was decreased, while acid proteinase was activated in brain tissue. At the same time, ultrastructural impairments occurred in nervous cells. These data suggest that cytotoxic antibrain antibodies are present in liquor of schizophrenic patients. PMID- 3532533 TI - [Outlook for treating cancer from the clinical point of view]. PMID- 3532534 TI - [Cellular and molecular mechanisms of radiation carcinogenesis]. PMID- 3532535 TI - [Prospective randomized study of the efficacy of adjuvant hormone therapy in patients with breast cancer]. AB - Tentative results of a randomized controlled evaluation of the effectiveness of adjuvant hormonal therapy of breast cancer are discussed. The data on 118 cases examined in 1981-1984 were considered on the basis of menstrual cycle characteristics and extension of tumor. The results obtained as a result of an average 16.9 month-long examination pointed to a relatively higher recurrence incidence in untreated patients and suggested that such studies should be continued. Tolerance evaluation established a higher incidence of side-effects in cases treated with diethylstilbestrol (33.3%) than with tamoxifen (3.8%). PMID- 3532536 TI - [The contribution of N. V. Lazarev to the development of the problem of drug prophylaxis and therapy of tumors (on the 90th anniversary of his birth)]. PMID- 3532537 TI - [New data on the biologically active factors in milk, their properties and specificity]. PMID- 3532538 TI - [Breakdown of the soluble soybean antigen in the digestive tract of adult rats]. AB - Adult male Wistar rats received intragastrically a protein mixture containing 3H labeled reserve protein of soy beans (PSB), the soy protein isolate 500-E of Ralston Purina Co (USA) being chosen as a protein source. Immunoreactive and TCA precipitable 3H-PSB was determined in the stomach and small bowel content, 20 and 60 minutes after the administration. The experiment showed more complete inactivation of soy antigen as compared to chick ovalbumin (the authors' data), bovine serum albumin, chick ovomucoid and Kunitz trypsin inhibitor (the literature data). Basing on the results obtained, it is suggested that the soy reserve protein possesses low allergenic properties. PMID- 3532539 TI - [Oxidative destruction of the fatty acid components in dietary lipids]. PMID- 3532540 TI - Evaluation of HLA-haplotype disparate parental marrow grafts depleted of T lymphocytes by differential agglutination with a soybean lectin and E-rosette depletion for the treatment of severe combined immunodeficiency. AB - The factors that impact upon successful bone marrow transplantation leading to immunologic reconstitution in severe combined immune deficiency (SCID). Wiskott Aldrich syndrome, and in other lethal congenital immunodeficiencies are reviewed. Evidence is presented that graft-versus-host disease (GVHD) can be abrogated by the depletion of T cells, even from histoincompatible marrow grafts. However, graft resistance or restricted immune reconstitution has been observed with significant frequency. The bases for T cell reconstitution and limitations in B cell humoral immune recovery in the postgrafting period are reviewed, together with emerging evidence that pretransplant cytoreduction might obviate some of these problems. PMID- 3532541 TI - Progress in broadening the uses of marrow transplantation: donor availability. AB - The use of bone marrow transplantation as a curative treatment for congenital immunodeficiencies is limited by the lack of available histocompatible sibling donors. The problems associated with mismatched donor transplantation and efforts to overcome these difficulties are discussed, as are results obtained in transplantation with partially matched related and unrelated donors. The use of haploidentical relative donors, an attractive option due to the wider availability of such donors, is explored, along with the consequent need for T cell depletion. Methods of T cell depletion are compared, and efforts at improving depletion methods are discussed. PMID- 3532542 TI - [Glycoproteins of enveloped viruses. Isolation of purified preparations and evaluation of their immunogenic properties]. PMID- 3532543 TI - [Principles of virus lyophilization]. PMID- 3532545 TI - [Fluorescent antibody method in studying the Simbu group Bunyaviridae]. PMID- 3532544 TI - [Detection of rabies virus antibodies in human blood serum by an immunoenzyme method]. AB - In a coded experiment on rabies virus antibody detection in the blood sera of humans immunized with rabies vaccines, coincidence of the results of indirect ELISA, neutralization test and radial hemolysis test (RHT) was observed in 83% and 90% of the cases. The correlation coefficient of antibody titres in ELISA and NT was r = +0.75, ELISA and RHT r = +0.81. Instances of discrepancy of the results were observed with sera of low titres, no more than 1:50 by neutralization test. PMID- 3532546 TI - [Methods of isolating immunoglobulins for the preparation of luminescent sera to arboviruses]. PMID- 3532547 TI - [Influenza antineuraminidase antibodies studied by a modified method]. PMID- 3532548 TI - [Past, present and future of the specific prophylaxis of hydrophobia (on the centenary of the 1st Pasteur antirabies inoculation)]. PMID- 3532549 TI - [Immunoenzyme analysis of monoclonal antibodies on solid-phase infected cells]. AB - Monoclonal MAK-14-7 antibodies to the surface antigen of Venezuelan equine encephalomyelitis virus and OKA series to vaccinia virus antigens were studied by enzyme-immunoassay (EIA) on the solid phase of the infected Vero, BHK-21, and HeLa cells. The immunoglobulins under study from the culture and ascitic fluids of hybridomas were shown to bind specifically with the appropriate antigens of the infected cells. The activity of monoclonal antibodies to viral antigens in EIA on the solid phase of the infected cells was 10-fold higher than in indirect immunofluorescence test. The method has a number of useful advantages such as the simplicity of preparation of the antigen solid phase, rapidly obtainable results, long-term preservation of ready panels with the specific antigen at room temperature. The high sensitivity of the method makes it effectively useful for screening of hybrid clones producing monoclonal antibodies. PMID- 3532550 TI - [Preparation of conjugates for an immunoenzyme method of diagnosing viral hepatitis A]. AB - Evaluation of the activity of peroxidase conjugates with immunoglobulins isolated by different methods from the sera of the subjects with a history of virus hepatitis A, and at various molar ratios of peroxidase and immunoglobulins showed the activity of immunoperoxidase conjugates to depend upon the method of isolation of immunoglobulin used for conjugation. The most active immunoperoxidase conjugates were obtained with immunoglobulins isolated by a column-free method on sephadex DEAE-50A. When peroxidase with a low specific activity is used, the quality of conjugate may be improved by increasing the amount of the enzyme added in conjugation. PMID- 3532551 TI - [Generation of HTLV-III-specific polypeptides in E. coli cells]. AB - Cloning and expression in E. coli cells of a fragment of the env gene of HTLV-III virus is described. This fragment coding for from 294 to 757 aminoacid residue of virus protein was cloned in plasmid pUC 18. Conditions are described contributing to the regulated functioning of Lac-promoter allowing the expression of proteins toxic for E. coli. Solid-phase enzyme-immunoassay demonstrated a specific reaction of polypeptides synthesized in E. coli with an AIDS patient's serum. The sizes of these polypeptides were determined by the Western-blot method. They were found to be 18, 24, and 32 kilodaltons. The polypeptides synthesized in E. coli may apparently be used for preparation of test-systems for AIDS diagnosis. PMID- 3532552 TI - [Characteristics of the preparation of monoclonal antibody-based immunoenzyme conjugates]. PMID- 3532553 TI - [Pulsed Doppler echocardiography in the diagnosis and determination of the degree of aortic insufficiency]. PMID- 3532554 TI - [Genetic factors in ischemic heart disease]. PMID- 3532555 TI - [Pulmonary embolism--its incidence, diagnosis, prevention and treatment]. PMID- 3532556 TI - [Glucose clamping--a modern method for research on insulin secretion and resistance]. PMID- 3532557 TI - [Clinical testing of the Bulgarian Diamex dialyzers]. AB - The Bulgarian dialyzers "Diamex" were clinically tried as well as original patterns of the firm Fresenius--"Hemaflow" in 28 patients from the Centre of hemodialysis at the Medical academy. The results obtained for the clearances of Bulgarian dialyzers (urea clearance--2.61 ml/s, creatinine clearance--2.18 ml/s, clearance of inorganic phosphor--1.63 mg/s and clearance of uric acid--2.14 ml/s) and their ultrafiltration possibilities revealed no statistically significant difference as regards the data of the original patterns. No essential deviations in those indices with the first and third use of the dialyzers. The percentage of clearing during 4-hour hemodialysis, being 51.7% for urea, 48.2% for creatinine and 52.6% for uric acid, remains unaltered even with their third use. No allergic reactions have been established to the membrane in the groups of patients examined. It could be stress in conclusion that the Bulgarian dialyzers, according to quality and effectiveness, correspond to the original patterns could be used several times with no risk for the patients. PMID- 3532558 TI - [Radiocardiographic assessment of hemodynamics in different types of acquired heart valve defects]. AB - The hemodynamic disorders in various types of cardiac defects were studied in 133 subjects, 82 of them patients with aquired combined valvular defects of the heat and the results obtained were juxtaposed. The hemodynamics was determined by the method of quantitative radiocardiography (QRCG). The volume of circulating blood was determined as well as the indices of cardiac output, ventricular, pulmonary quantities and the indices of aortic route. The results obtained by the numerous indices followed up, juxtaposed to the separate defects, reveal hemodynamic disorders, manifested to various degrees in the various heart defects. The hemodynamic disorders in two-axis heart defects (mitral and aortic) proved to be most severe. Stroke and minute volumes were diminished. The time for filling of the right and left heart was twice prolonged. The rate of pulmonary and systematic hemodynamics was retarded two and a half times. Better manifested hemodynamic disorders advance in mitral stenosis as compared with mitral insufficient. The hemodynamic disorders in combined aortic defects proved to be the lightest. PMID- 3532559 TI - [Potentials and limits of Doppler echocardiography in the diagnosis of mitral insufficiency]. PMID- 3532561 TI - [On the 110th anniversary of the birth of Stoian Kirkovich]. PMID- 3532560 TI - [Orthostatic hypotension in diabetes mellitus]. PMID- 3532562 TI - [Morphological classification and objective assessment problems in chronic hepatitis]. PMID- 3532563 TI - [Echographic diagnosis of hypernephroid cancer]. AB - A total of 28 hypernephroid tumours have been diagnosed within a period of 32 months. The data from echographic, intravenous urography, computer tomography and thin-needle aspiration biopsy and renovasography were compared in the patients studied. Two basic variants of echographic picture have been described. It has been concluded that the combination of abdominal ultrasound tomography with thin needle aspiration biopsy is a valuable method for the diagnostics of hypernephroid cancer. Computer tomography proved to be appropriate in solving the problem of operability, renovasography--pre-operatively, and the rest of the methods--in suspected and undistinguished echographic evaluations. PMID- 3532564 TI - [Effect of compensation on the basal blood level of contrainsular hormones in diabetics]. AB - The effect of the compensation of diabetes on the basal level of II contrainsular hormones was studied. Some of the hormonal deviations were completely normalized with the compensation of the diabetes, another part showed values closer to those of the healthy, and only a quarter of the hormones studied--showed no essential dynamics in their levels. The tendency to normalization of the established hormonal changes was more distinct in case of more accurately selected criteria of compensation, justifying the effort at optimal compensation of diabetes. The results obtained suggested that the hormonal deviations had a reactive character. PMID- 3532565 TI - [Comparative studies on the basal blood levels of contrainsular hormones in diabetics with and without retinopathy]. AB - Comparative studies on the basal blood level of II contrainsular hormones have been carried out in patients with diabetes mellitus in subgroups with present, absent resp. retinopathy. The presence of diabetic retinopathy was established to be accompanied by the reduction of T3 and serotonin, whereas its absence was accompanied with the increase of TTH. The elucidation of the significance of the hormonal discrepancies established for the pathogenesis of retinopathy requires additional studies. PMID- 3532566 TI - Capitation in California--an analysis of at-risk financing of Medicaid services. AB - Recent legislative changes have fostered the growth of a highly competitive health care market in California. In addition to selective hospital contracting for Medicaid (Medi-Cal) services, the California Medical Assistance Commission is attempting to initiate pilot projects to capitate Medi-Cal beneficiaries in selected geographic areas throughout the state. Selective contracting with county capitated organized health systems is also underway in Santa Barbara County, with plans for other counties on the drawing boards. This paper describes these capitated programs as well as addressing problems that may arise in this transition from a fee-for-service to a capitated Medi-Cal system. Specifically considered are issues related to underutilization, quality of care, implementation, eligibility and effects on existing patterns of care. PMID- 3532568 TI - Long-range planning. PMID- 3532567 TI - Drug-induced pulmonary vascular disease--mechanisms and clinical patterns. AB - An extensive vascular surface area places the lungs at risk for damage by blood borne drugs. Drug-induced pulmonary vascular disease may present clinically as acute pulmonary edema, pulmonary edema followed by diffuse interstitial lung disease, pulmonary vascular occlusion, pulmonary hypertension or hemorrhage. It is important to recognize these reactions as drug-related because many are reversible with discontinuation of the drug and supportive therapy. Failure to recognize drug-induced pulmonary vascular disease can lead to significant morbidity and, in some cases, death. PMID- 3532569 TI - It could be an important first step. PMID- 3532570 TI - [Carcinoid tumor of the common bile duct]. PMID- 3532571 TI - [Aleksander Majkowski--a physician and writer]. PMID- 3532572 TI - [Liver cirrhosis in childhood--etiology, diagnosis and conservative therapy]. AB - Liver cirrhosis is relatively rare in children as compared to adults; frequently it is diagnosed too late. Biliary cirrhosis of early childhood is often the result of neonatal cholestatic syndromes. Beyond infancy, cirrhosis as a consequence of chronic active autoimmune hepatitis or of Wilson's disease may be prevented, if causal therapy is begun in time. Hence paediatricians should exclude both diseases in all children with elevated transaminases and clinical features of a liver disorder. PMID- 3532573 TI - [Liver transplantation in childhood]. AB - From 1977 to 1985 altogether 143 children were referred to our hospital for liver transplantation. These children were aged 6 months to 15 years. According to the results of a defined examination protocol liver transplantation was indicated in 102 of these children. Contraindications were observed in 17 patients. In 14 children liver transplantation was not yet indicated. Parents of 8 children refused transplantation. Only 30 children have been transplanted so far. Out of these, 21 actually survive. The cumulative 5-year survival rate after transplantation is calculated to be 60.5%. PMID- 3532574 TI - Cardiac surgery--25 years on. PMID- 3532575 TI - Immune mechanisms and host resistance in the trauma patient. AB - Sepsis is responsible for 75 percent of late deaths following major thermal injury or traumatic injury. Efforts to prevent and/or control sepsis should include an understanding of normal host resistance, proper resuscitation techniques, and nutritional support. Recent studies identifying T suppressor cell abnormalities in burn patients and macrophage defects in trauma patients are presented in this paper. Concluding remarks regarding future directions for research and therapy in this area are also made. PMID- 3532576 TI - Risk of infection following penetrating abdominal trauma: a selective review. AB - Post-operative infectious complications following penetrating abdominal trauma are a major cause of morbidity and contribute significantly to increased length of hospitalization and costs of patient care. Our recent study suggests the individual patient's probability of major infection following traumatic intestinal perforation is high and can be predicted from risk factors identified at the time of surgery. The determinant of primary importance for development of infection confirmed by this study is peritoneal contamination by intestinal contents. Other significant risk factors (p less than 0.05) were number of organs injured, number of units of blood administered, ostomy formation for left colon injury, and the patient's age. Risk of infection can be calculated from these data and could potentially be used to guide post-operative decisions. Areas of trauma care in which alteration of therapy might result in significant savings include choice of antibiotics, duration of antibiotic administration, and wound management. This study supports the use of standardized operative procedures and parenteral antibiotics effective against endogenous aerobic and anaerobic organisms. If such observations continue to be supported by further randomized prospective studies, there is tremendous potential to further tailor surgical management for the individual patient in a more cost-effective manner. PMID- 3532577 TI - In vitro fertilization and embryo transfer: a brief overview. AB - The in vitro fertilization process breaks down into three essential components: induction of ovulation, fertilization of the oocyte, and development of embryos that are transferred into the uterus. Problems may arise resulting in failure at any one of these junctions. In 1984, the World Congress on In Vitro Fertilization was held, looking at 9,641 laparoscopies yielding 1,101 clinical pregnancies, with an overall pregnancy rate of 11 percent--clearly indicating that in vitro fertilization/embryo transfer (IVF/ET) was an idea whose time had come. Ovulation induction is monitored by both the use of ultrasound and daily estradiol levels, ultrasound indicating the number of oocytes that will be available for capture, and estradiol indicating in an indirect way the quality of those oocytes. It is a major aim in each patient to obtain at least four embryos, since this optimizes success rates. Ovulation induction at Yale is carried out with a high-dose human menopausal gonadotropin (HMG)/human chorionic gonadotropin (HCG) regimen. This regimen has insured us a success rate of 17 percent clinical pregnancies per laparoscopy. In the future, modification will occur in the process with cryopreservation of oocytes and embryos, and gamete manipulation. The modifications will be effected primarily to increase pregnancy rates. Research will continue mainly to delineate better biochemical markers for oocyte quality, but also to further explain the mystery of implantation. PMID- 3532579 TI - [Sir Archibald Edward Garrod (1857-1936)]. PMID- 3532580 TI - [Diabetic coma]. PMID- 3532578 TI - The biomedical and epidemiological characteristics of asbestos-related diseases: a review. AB - The purpose of this paper is to provide the reader with an overview of the biomedical and epidemiological characteristics of asbestos-related disease based upon currently available information. Epidemiological and experimental data developed over the past 20 years have greatly added to our knowledge of the biological effects of asbestos, particularly in relation to clinical disease. This information has substantially strengthened the evidence linking asbestos to specific health effects. Lung cancer and mesothelioma are clearly the most important asbestos-related causes of death among exposed individuals, although the accumulated data is suggestive of the existence of an excess risk of gastrointestinal and a variety of other neoplasms. Animal studies confirm the human epidemiological results and indicate that all commercially available fiber types are capable of producing lung cancer and mesothelioma. Experimental implantation and injection studies also show that the carcinogenicity of mineral fibers (including asbestos) is directly related to their dimensionality and not their chemical composition. Although the asbestos-related medical and scientific literature is voluminous, many issues related to the biological activity of asbestos fibers are as yet unresolved. Due to experimental and analytical limitations, questions concerning risk at low-level exposure, dose-response relationships, and individual susceptibility remain problematic. PMID- 3532581 TI - [Hereditary Alport nephropathy]. PMID- 3532582 TI - [Some ethical problems of practical surgery in the 19th century]. PMID- 3532583 TI - [Reflections on the 90 year existence of the German Central Committee for the Control of Tuberculosis]. AB - The Deutsche Zentralkomitee zur Bekampfung der Tuberkulose (German Central Committee on the Fight against Tuberculosis) is one of the oldest institutions of this kind in the world. Already at the end of the past century, it was the starting point of the fight against tuberculosis at the international scale. It created a cooperation between state and private initiatives, and between scientific work and management, based on voluntary congregation of all partners. In spite of considerable political and social changes, its effective work could be continued during 90 years. As future task remains the world-wide fight against tuberculosis. Its elimination has nowadays become feasible. PMID- 3532584 TI - [Case finding in Stuttgart 1980-1985. Diagnosing institutions and cause for diagnosis]. AB - From January 1, 1980, to April 30, 1985 in Stuttgart of 537 adult cases of registered bacteriologically confirmed endothoracic tuberculosis 31.1% were detected by the Public Health Office, of the 435 cases without bacteriological confirmation 40.9%. The rate of detection by general practitioners was 2.4 and 2.6 respectively in these groups from 1980 to 1982 and increased to 10.3 and 10.5% from 1983 to 1985. With bacteriological confirmation 54.6% were detected because of symptoms, 10.2% by general examination, 7.8% by mass miniature X-ray, and 27.4% by other active diagnostic measures. Without bacteriologic confirmation the figures are 41.4, 4.1, 17.9, and 36.6%. Only very few differences as given by nationality, sex and age are statistically significant. Two of three cases with bacteriologic confirmation were positive by direct smear. If the detection was by symptoms the percentage is 74.4 which should be compared with 58.2% by general examination, 50.0% by mass miniature X-ray, and 59.2% by other active diagnostic measures. Active diagnostic must be continued in risk groups. PMID- 3532585 TI - [Daily ultrashort chemotherapy and intermittent short-term chemotherapy with 4 drugs of communicable pulmonary tuberculosis treated for the first time. Results of a cooperative multicenter study]. AB - Three short-course regimens, all comprising isoniazide (H), rifampicine (R), streptomycine (S) and pyrazinamide (Z), are compared in a randomized prospective cooperative clinical trial. The drugs are given daily in a 3-month regimen (3 HRSZ), twice a week in a 6-month regimen (6-HRSZ2), and in a further two-phase 6 month regimen the 4 drugs are administered 3 times a week for the first 3 months followed by the administration of HSZ twice a week (without R) for further 3 months (3-HRSZ3/3-HSZ2). The number of patients admitted to study is 80, 144 and 139 respectively. The 3-month regimen has been stopped because of a high rate of relapses. 17 p.c. of the patients admitted have to be excluded from analysis for various reasons, out of these 5.8 p.c. because of adverse reactions. Two thirds of the patients had heavily positive sputum cultures at the start. 300 patients completed therapy. At the end of therapy cultures were negative in 94 p.c., 100 p.c. and 99 p.c. respectively. The rate of bacteriological relapses is 19 p.c. in 3-HRSZ, 9 p.c. in 3-HRSZ3/3-HSZ2 and 3 p.c. in 6-HRSZ2, during a follow-up period of 3-4 years after completing therapy. The acceptability was good in all treatment groups. Adverse reactions like "flu" were rarely observed. Increased blood urea was common but in general without clinical symptoms. Elevation of ALAT and ASAT was relatively frequent but mostly transient and without clinical importance. The results served as basis for the new "Recommendation for Treatment of Tuberculosis" and are interpreted with regard to practical consequences and possibilities for further rationalisation of treatment. PMID- 3532586 TI - [Bacteriological findings in selected inflammatory bronchopulmonary diseases]. AB - Actual bacterial flora was bronchologically examined in 561 patients with inflammatory bronchopulmonary diseases, 291 out of them with acute pictures. Facultative pathogenic organisms were found in 70 per cent of bronchiectases, in 24.4 per cent of pneumonia and in 17 per cent of acute bronchitis. In the first place of infections were Haemophilus influenzae and gram-negative bacteria; in contrast to that pneumococci and staphylococci were less frequent. Sensitivity tests showed that especially in the case of gram-negative organisms and staphylococci a well-directed antibiotic treatment should be carried out. PMID- 3532587 TI - [Comparative studies of the detection of klebsiellas in water]. PMID- 3532588 TI - [Paleopathology and historical epidemiologic research in dentistry of the 19th and 20th century]. PMID- 3532589 TI - [Ars medica Anhaltina (III): the Anhalt Hahnemann interpretation and the Kothen Homeopathic Institute]. AB - In the years between 1821 and 1835 the domiciliation of Samuel Hahnemann in Kothen induces a consolidation of the homoeopathy in the district of the Anhalt territories. By dynastic order hereby the existing medical laws concerning the self-dispensing of the physicians are cancelled. By the establishment of an institute called Institutum homoeopathicum et magneticum the homoeopathy concentrates for a long time on Anhalt territories also after Hahnemann's retirement. The fight against homoeopathy permanently remains on the programme of the scholastic medicine, which certainly appeals to existing laws, but cannot prevent the development of a prospering business with homoeopathy. The reconstruction of these events became possible by the preserved documents. PMID- 3532590 TI - [Bacterial meningitis]. AB - A survey is given of important bacterial pathogens of meningitis. It is referred to the necessity to include rare pathogens into the differential-diagnostic considerations. The importance of the microbiological diagnostics and the empiric initial therapy for the prognosis of the bacterial meningitis is discussed. PMID- 3532591 TI - [Experimental hyperlipoproteinemia and arteriosclerosis in minipigs--effect of various drugs]. AB - Experimental hyperlipoproteinemia and atherosclerosis were produced in mini-pigs of the Gottingen strain by adding egg yolk and cholesterol to the diet for one and a half year. Phenotyping of the hyperlipoproteinemia showed a great similarity with the human type IIa according to the Fredrickson classification system. Cholesterol ester-rich atherosclerotic lesions were developed, predominantly located in the abdominal aorta and the coronary arteries. Prophylactic treatment of the hyperlipoproteinemia with the drugs niceritrol (Perycit) and beta-pyridylcarbinol (Ronicol) significantly reduced the elevated plasma cholesterol level and reduced the degree of atherosclerosis in the abdominal aorta and the coronary arteries. Studies of the regression of the cholesterol ester accumulation showed an important difference between the two vascular regions. A very slow regression was observed in the abdominal aorta, while a more marked regression was present in the coronary arteries. Treatment with the drug clofibrate (Atromidin) normalized the plasma cholesterol level within a month and enhanced the regression of cholesterol esters in the coronary arteries. PMID- 3532592 TI - [Therapy and prevention of reflux esophagitis. Results of a multicenter study with cimetidine. I: Epidemiology and results of acute therapy]. AB - In a sequential observational study efficacy and safety of two dosage regimens of cimetidine for the treatment of reflux-oesophagitis (RE) were examined. 22 office based specialists took part in the trial. 187 patients received 1600 mg cimetidine (400 mg q.i.d.) daily and 136 patients received 800 mg cimetidine (400 mg b.i.d.) daily, over twelve weeks. The two dosages proved to be equally effective. In the group of patients with RE of stage I at the beginning of the trial, the healing rates were 82% under 1600 mg cimetidine/die and 86% under 800 mg cimetidine/die. In the group of those patients, who entered the study with RE of stage II, in both dosage groups the lesions of 87% of the patients were healed completely or had decreased to stage I. The severity of the mucosal lesions was judged endoscopically, based on a classification scheme modified according to Savary and Miller. The incidence of unwanted symptoms was not significantly different in both dosage groups (1600 mg: 5.3%, 800 mg: 3.4%); none of the symptoms which occurred was judged as definitely caused by cimetidine. The patient collective of the trial was characterized epidemiologically; out of the risk factors examined, only duration of RE history and number of previous RE episodes correlated with the severity of the disease, smoking and alcohol consumption showed no influence. PMID- 3532593 TI - [2 or 1 daily doses of ranitidine in the treatment of reflux esophagitis]. AB - In a randomized multicentre study 96 patients with mild to moderate types of reflux esophagitis (stages I and II according to Savary-Miller) the effect of 150 mg ranitidine b.i.d. (49 patients) was compared to that of 300 mg ranitidine nocte (47 patients). In both patient groups similar healing rates were observed. 81.6% and 74.5%, respectively, of the patients with esophagitis healed within 6 weeks, and 95.9% and 93.6%, respectively, within 12 weeks. Reflux symptoms disappeared in both treatment groups in 91.8% and 80.9%, respectively, within 6 weeks, and 98.0% and 100%, respectively, within 12 weeks. Drug safety was good. Thus, in mild to moderate types of reflux esophagitis treatment with ranitidine can be reduced to one single dose of 300 mg at night. PMID- 3532594 TI - [Insulin resistance in liver diseases]. AB - Coexistence of hyperinsulinemia and normal or impaired carbohydrate tolerance indicates insulin resistance which is frequently observed in patients with liver diseases such as liver cirrhosis, fatty liver, acute and chronic hepatitis and idiopathic haemochromatosis. Insulin resistance in liver diseases can be due to circulating insulin antagonists or a target tissue defect in insulin action, either due to changes in the state of the insulin receptor or due to a postreceptor defect, that means any abnormality in the insulin action sequence following the initial binding step. High insulin levels in liver diseases are caused by diminished degradation of insulin by the liver whereas hypersecretion only plays a minor role under basal conditions. High levels of glucagon, free fatty acids and growth hormone are well known in liver diseases but until now there is no evidence of the pathogenetic importance of these factors. Conflicting results on insulin binding, methodological criticism on binding data and the question whether or not diminished insulin binding on peripheral blood cells plays any physiological role make it unlikely that studies on insulin receptors of peripheral blood cells contribute to the revelation of insulin resistance in liver diseases. The clamp technique allows to quantify the sensitivity of the body to exogenous insulin. The results on liver cirrhosis in connection with studies on glucose metabolism show that under basal conditions insulin insensitivity is due to peripheral resistance (primarily muscle) according to a postreceptor defect. Finally the causes of insulin resistance in liver diseases are still not known. PMID- 3532595 TI - [Differential diagnostic evaluation of chronic pancreatitis in relation to pancreatic cancer based on clinical, laboratory chemical and diagnostic parameters. Studies of 174 patients in 10 years]. AB - 174 patients with chronic pancreatic diseases, 30 patients with pancreatic carcinoma and 144 with chronic relapsing pancreatitis, 50 of them with calcifications, were observed in the Department of Internal Medicine of the University of Marburg/FRG between 1972 and 1982. In order to differentiate between carcinoma and relapsing pancreatitis the data of these patients were analysed retrospectively with regard to patient history, actual complaints, findings of laboratory, sonography, ERCP and X-ray investigations. The following results were obtained: Of discriminating value are steatorrhoe, local palpatory pain, alcohol ingestion, a history of earlier attacks and relapsing pain situations; however, general abdominal pain, nausea, vomiting and weight loss (if not exactly specified) are not. Within the laboratory findings bilirubin, GOT, alkaline phosphatase, gamma-GT, serum potassium, blood sugar and chymotrypsin content of the stool were significant while serum and urine amylase were similarly distributed within the groups of patients. Carcinoma and chronic relapsing pancreatitis can be identified by sonography in the majority of patients, but calcifications of the pancreas were rarely demonstrated during this observation period. The obstruction of the extrahepatic bile ducts--mostly due to a carcinoma of the pancreas head--was usually well documented by sonography. Intraabdominal air proofed to be the most disturbing factor. In carcinoma patients, the ERCP is important in demonstrating a complete obstruction of the pancreatic duct and stenosis and dilatation of the extrahepatic bile ducts. In patients with chronic relapsing pancreatitis the pancreatic duct alterations such as dilatations and partial stenosis are well documented by ERCP especially if calcifications occur. In patients without calcifications, dilatation of the branches of the main duct are less relevant in the diagnosis of pancreatic diseases. Radiological demonstration of calcification of the pancreatic area is important for the differential diagnosis. Longstanding characteristical complaints, symptoms and calcifications within the pancreatic area are the most relevant factors in discriminating carcinoma and chronic relapsing pancreatitis. PMID- 3532596 TI - [Primordial growth deficiency--a case report for the diagnosis of early intrauterine growth retardation]. AB - A case of Silver-Russel-Syndrome is presented. Fetal growth retardation in the second trimester is caused by genetic anomalies in almost 14% of all cases. Oligohydramnios is frequently associated with IUGR and can prevent a precise sonographic diagnosis which is essential for the obstetric management. Cesarean section is the best mode of delivery in cases of established gestational age and absence of fetal abnormalities. PMID- 3532597 TI - [Fetal megacystis--prenatal diagnosis and attempt at therapy]. AB - Dilatations of the fetal urinary tract are suspect for obstructions. An extremely dilated bladder may also point to an innervation disorder. In the here presented case a very rare disease is the cause for the dilatation of the fetal bladder, the Megacystis-Microcolon-Hypoperistalsis-Syndrome. No mature ganglionic cells are detectable in the bladder wall histologically. Up to now eight cases have been reported, all female neonates died within the first days after birth. Our presented child - also a female - is now more than one year old, but artificial feeding is still necessary. PMID- 3532598 TI - [Prenatal ultrasonic diagnosis of a cystic abdominal tumor--liver cyst and its differential diagnosis]. AB - A report is presented on the prenatal development of a solitary hepatic cyst in a fetus of the 39th week of pregnancy. Sonography revealed that nearly the entire abdomen was filled by a cyst that caused displacement of the stomach and intestine as well as elevation of the diaphragm. Abdominal distension necessitated delivery before term by cesarean section. The laparotomy subsequently performed because of increasing dyspnea of the newborn showed the left lobe of the liver to be the point of origin of a solitary hepatic cyst that could be removed in toto. Possibilities of post partum therapy are discussed in addition to obstetrical management. The incidence, localisation and size of solitary hepatic cysts as well as their differential diagnosis are also described. PMID- 3532599 TI - [Glossodynia--indication for patch testing?]. AB - 100 patients suffering from glossodynia without pathologic changes of the oral mucosa and 16 patients with suspected allergic contact stomatitis underwent patch testing using standard patch test and dental materials. The results were compared with those of patients in dental occupations suffering from hand eczema. As there is no clinical relevance of allergens in patients with glossodynia, patch testing seems to be unnecessary. On the other hand, patch test results of patients with stomatitis and dentures often suggest a causal allergy. In most of those cases, this was confirmed by complete healing after changing the denture bases, whereas in glossodynia such replacements never brought about a convincing improvement of the symptoms. PMID- 3532601 TI - Felice Fontana--his life and works. PMID- 3532600 TI - [Benign chronic bullous dermatosis in childhood with involvement of the mouth mucosa]. AB - We report on a rare case of benign chronic bullous dermatosis of childhood (BCBDC) in a 5-year-old girl. In addition to the characteristic symptoms such as abrupt onset of the disease, tense blisters, predominant affection of the face, and later imitation of impetigo, we observed uncommonly extensive involvement of the oral mucosa. Whereas histopathology was not diagnostic, direct immunofluorescence could verify BCBDC as it showed linear deposits of IgA along the basement membrane zone. This case gives rise to the discussion of the clinical entity and nomenclature of BCBDC in relation to similar bullous diseases of childhood and adults. PMID- 3532602 TI - Comparative clinical study of a new 17D thermostable yellow fever vaccine. AB - The immunogenicity and the safety of a new heat-stable 17D yellow fever vaccine have been assessed in a randomized comparative study by reference to a non stabilized vaccine preparation. Seronegative adults were used and 115 and 143 were given the heat-stable and the non-stabilized vaccine, respectively. Fifty two days after the immunization, haemagglutination inhibiting antibodies were found in 77.6 and 73.9% of the vaccinees, neutralizing antibodies in 99.3 and 100% of them. The percentage of seroconversion and the geometric mean of antibody titres were not significantly different. No complaints or adverse reactions in association with the vaccines were recorded. This study demonstrates the high immunogenicity of this new stabilized vaccine whose stability has already been proven. PMID- 3532604 TI - Long-term antibody response after measles vaccination in an isolated arctic society in Greenland. AB - Scoresbysund is an isolated district on the east coast of Greenland with 500 inhabitants, mainly Polar Eskimos, which had never been exposed to natural measles. In 1968 more than 90% of the population were vaccinated with the Schwarz live further-attenuated measles vaccine and subsequently children born after 1968 likewise received the measles vaccination. Upon the initial measles vaccination no clinical cases of measles have been observed. The immunity status of the isolated population has been followed for 16 years after vaccination by IgM, IgA, and IgG ELISA tests and by HI test on a series of serum samples taken at intervals. Immunoblotting was performed on sera obtained 16 years after the vaccination. In general, antibody studies have demonstrated some decline in antibody titres after the initial measles vaccination. However, a temporary moderate increase in measles antibodies occurred in some individuals 2-4 years after vaccination, probably due to a reinfection of vaccinees. Most of these individuals did not have demonstrable IgA antibodies prior to the supposed reinfection. PMID- 3532603 TI - Effectiveness of liposomes as potential carriers of vaccines: applications to cholera toxin and human malaria sporozoite antigen. AB - Two antigens, cholera toxin (CT) and a synthetic albumin-conjugated 16-residue peptide derived from the circumsporozoite (CS) protein of Plasmodium falciparum sporozoites, were tested as immunogens in rabbits. The malaria peptide-albumin conjugate by itself was completely nonimmunogenic, and although cholera toxin was immunogenic it also expressed considerable native toxicity. After attachment of CT to liposomes containing ganglioside GM1, toxicity of CT was completely eliminated and antigenicity was enhanced. Therefore liposomes may be capable of reducing toxicity of certain potentially dangerous antigens such as toxins. After incorporation of the malaria peptide-albumin conjugate into liposomes a high titre of specific antibodies was induced against the malaria peptide but not against albumin. These antibodies also reacted with native CS protein. Three adjuvants, including lipid A and two types of lipophilic muramyl dipeptide, were compared and found to be effective in liposomes. Based on the conversion of synthetic P. falciparum CS peptide from a nonimmunogenic to an immunogenic form and on the 'toxoiding' effect of liposomes for CT, it is concluded that liposomes should be considered as being a useful carrier for antigens and adjuvants for vaccines for poorly antigenic or toxic substances. PMID- 3532605 TI - Evaluation of a new Rift Valley fever vaccine: safety and immunogenicity trials. AB - A formalin-inactivated Rift Valley fever vaccine prepared in primary monkey kidney cells has been used to protect laboratory workers from disease since 1967. A similar but improved vaccine was prepared in 1978-1979 using well characterized diploid fetal rhesus lung cells. In initial clinical trials reported here, the new vaccine elicited high levels of plaque neutralizing antibodies and caused only minimal local reactions at the injection site. Significant variability was observed in the geometric mean titre evoked by various vaccine lots. This variability had not been predicted by conventional pre-filtration or pre inactivation virus infectivity assays, or the results of animal potency tests. These findings emphasize the need for statistically valid human potency testing and the development of accurate predictive preclinical measurements for this and other vaccines. PMID- 3532606 TI - From king to culprit: tobacco. PMID- 3532607 TI - Smoking and heart trouble. PMID- 3532608 TI - Effect of calcium dobesilate on blood viscosity in diabetic microangiopathy. A review. PMID- 3532609 TI - [Effects of polyenylphosphatidylcholine (PPC) on serum lipids in patients with hyperlipoproteinemia. A double-blind study]. PMID- 3532610 TI - [General principles of the functional control of enzymes and multienzyme complexes]. PMID- 3532611 TI - [Possible use of the hybridization of oligomeric enzymes in biomedical research]. PMID- 3532612 TI - [Characteristics of the disordered regulation of monoamine oxidase activity in pathological states and the regulatory role of the monoamine oxidases]. PMID- 3532613 TI - [Alcoholism--an important factor in the spread of venereal diseases]. PMID- 3532614 TI - [50th anniversary of the International Physiology Congress]. PMID- 3532615 TI - [Is it necessary to confirm the results of drug screening with a 2d analytical method?]. AB - Systematic analyses of positives from urine drug screening with immunochemical techniques have shown the importance of the confirmation of results by a chromatographic procedure. 15 to 30% of false positives can be encountered for opiates. The confirmation technique should have better sensitivity (and specificity) in order to discard divergence from differences between detection limits. Potential false negatives or falsification of positives are discussed. Propositions for a coherent behavior in the Swiss situation are given. PMID- 3532616 TI - [Frederick H. Epstein and cardiovascular epidemiology. In honor of his 70th birthday (24 July 1986)]. PMID- 3532617 TI - Conrad Ramstedt--an appreciation. AB - C. Ramstedt's biographical data are presented and his surgical and scientific capacity is appraised. Special emphasis is on his role in the development of the surgical treatment of hypertrophic pyloric stenosis. PMID- 3532618 TI - Mycoflora of potential sanitary interest present in illicit heroin. AB - The injection of heroin mixtures poses difficult problems in some cases to both pathologist and toxicologist in evaluating the cause of death. Direct heroin toxicity, allergic or idiosyncratic reactions, and bacterial and mycotic infections are different complications that can be found in these cases. The mycotic profile (mycoflora) present in illicit heroin from street samples (sachets) has been studied. The profile was obtained after incubating the samples at pH5 in 2% and 3% agar-maltose media. Only two samples (nos. 24 and 26) yielded negative results. Twenty-seven taxa were isolated. Penicillium and Aspergillus were the genera most frequently found in the samples. Other genera, such as Cladosporium, Absidia, Rhizopus and Micelia sterilia were also detected. Most of the fungi isolated presented a high allergenic potential and were liable to result in allergic reactions connected with "drug deaths". All the fungi found were commonly present in our environment. PMID- 3532619 TI - [Experimental studies on intracavitary sonography]. AB - In intravesical sonography artificial reflexes often lead to optical misinterpretation and mistaken diagnosis. In several experiments we followed up the ultrasound-capacity of dissolution and demonstrate different phenomena of reflexes. The findings are compared with intravesical and intrarectal sonograms; they are of use to interpret intracavitary B-Scan-Ultrasound. PMID- 3532620 TI - [Latzko-plasty for closing vesicovaginal fistulas]. AB - It is reported on 68 Latzko-grafts in vesicovaginal fistulae. In 63 cases (92.6%) the closure was successful in the first session; 4 of the 5 failures were corrected with the same technique in the second session. The method is technically simple and little stressing for the patient. It is to be recommended particularly for the treatment of the typical posthysterectomy fistula. The shortening of the vaginal canal is insignificant also in young women. PMID- 3532621 TI - [Serologic studies in patients with early transplant failure]. AB - The appearance, specificity and dynamics of donor reactive antibodies have been studied in 9 patients who experienced early irreversible graft failure. In 5 out of 9 patients we were able to detect donor reactive antibodies. Their reaction patterns may be ascribed to a common responder type ("high responder"). Diagnostic and preventive possibilities for preventing early irreversible graft failures have been discussed. PMID- 3532622 TI - [Production and regeneration of yeast protoplasts: a review]. AB - The latest advance in protoplast technology results from a long and detailed study of cell wall composition and protoplast systems relating to their isolation and culture. The reports on protoplast preparation and fusion discussed in this review clearly demonstrate the applicability of technique for the genetic manipulation of microorganisms. These points have been demonstrated in Candida strains. The behaviour of protoplasts especially with respect to reversion could be an additional factor that operates during selection. Furthermore the fusion technique, in providing a mechanism which genetic recombination can be readily achieved, should be of great potential in empirical breeding and strain improvement. These aspects are reviewed. PMID- 3532623 TI - [Our surgical heritage. Surgery in ancient Egypt]. AB - In its 3,000 years History the surgery of the Old Egypt came on to an important development. Some of the antique instruments used in traumatology, the general surgery and in cosmetic-plastic operations, are in a scarcely modified manner employed for the same purposes in modern surgical interventions nowadays. The surgical diagnostics and therapy of that time is demonstrated by the surgical instruments stock being in the possession of the "Agyptisches Museum" of the "Staatlichen Museen zu Berlin". The surgery of Egypt transferred its leading part to the prosperous medical schools of Greece at the late period of the Old Egyptian empire (1085-332 B.C.). Its surgical diagnostics and therapy depending on an empirical rationalism, the applied instruments but also its ethical attitude towards the patients have been one of the dedisive bases influencing the development of the surgery in the antiquity. PMID- 3532624 TI - [Dynamic pexis (teresplasty) in the treatment of reflux esophagitis]. AB - For teresplasty, the lig. teres has to be prepared together with a palmarsize patch of peritoneal layer to the effect that by suturing the edges of that peritoneal layer a solid cord is produced which is firmly connected to the liver via the lig. falciforme and lig. teres. The loose end of that cordlike structure is fixed by suturing between the distal part of the oesophagus and the gastric floor. The left lobe of the liver comes to lie on top of the ligament, and a permanent longitudinal tension is applied to the oesophagus via the liver. Necessary restressing is thus produced, as recommended by Stelzner for restoration of the lower oesophageal sphincter function. The effect is dilatory angiomuscular closure of the distal oesophagus. Evidence to the effectiveness of teresplasty has so far been produced from 48 patients with therapy-resistant oesophagitis and severe complaints. The approach proved to be superior to other surgical techniques to cope with reflux, in that, different from plication, no detrimental sequels were recordable (gas bloat syndrome, telescopic phenomenon). PMID- 3532625 TI - [Preparation and documentation of lymph nodes in breast cancers. Experiences in pathologic-anatomic practice]. AB - The following conclusions were drawn from analysis of 292 specimens of amputated female breasts and statistical evaluation of the clinical data: Preparation of lymph nodes from unfixed material should be left to medical preparation engineers. All data on sizes and numbers should be recorded for documentation with high accuracy. Communication of clinical data has often been insufficient. It has happened all too often that no diagnostic extirpation was undertaken, and the time interval between such extirpation and radical surgery was found to be too long in some hospitals. PMID- 3532626 TI - [Amine colpitis]. AB - Significance of KOH test and isonitril (isocyanide) reaction tested in 104 patients was compared with our microbial culture results. In Gardnerella vaginalis as well as in no spores forming anaerobic germs the KOH test was not and the isonitril reaction was only insignificant reliable. Both tests are not able to substitute the procedures of culturing germs including those of Mycoplasma hominis and Ureaplasma urealyticum. PMID- 3532627 TI - [Problems in documentation in gynecologic ultrasound consultation. A computer aided system of documentation]. AB - Problems of making findings in gynaecological ultrasonic examinations and the demands on these are elaborated. A computer-aided system is created permitting the individual findings to be printed immediately based as well as on fixed and any free text parts. This meet all wishes of documentation, is time saving and include a growth of information. PMID- 3532628 TI - [The Society of Obstetrics and Gynecology of the main city of Berlin and the districts Potsdam and Frankfurt/O. Retrospective and prospective views]. PMID- 3532629 TI - Albumin bound to the surface of M protein-positive streptococci increased their phagocytosis by human polymorphonuclear leukocytes in the absence of complement and bactericidal antibodies. AB - Using a phagocytosis assay (Leijh 1980, Infect. Immun. 30, 421), determination of chemiluminescence, and transmission electron microscopy, the influence of the binding of albumin to M protein-positive group A streptococci on their phagocytosis by human polymorphonuclear leukocytes (PMNL) was investigated. Coating of streptococci with albumin in the absence of other serum components enhanced phagocytosis but not killing of the bacteria. Complement had no additional effect on engulfment. Fibrinogen reduced the enhancing effect of albumin. Albumin had no additional effect on the high phagocytosis rate of an M protein-negative strain. It could be demonstrated that human PMNL bound human serum albumin-gold conjugate. The results are discussed with regard to the role of plasma proteins in the phagocytosis of streptococci under in vivo-conditions. PMID- 3532630 TI - Effect of streptolysin S from Streptococcus pyogenes on contact sensitivity in mice. AB - Streptolysin S, a hemolytic toxin produced by strains of Streptococcus pyogenes, was examined for its effect on cellular immune reaction in mice. The toxin given intraperitoneally for six consecutive days did not influence intensiveness of delayed hypersensitivity to oxazolone which has been used as a model of cellular immune reaction. Streptolysin S injected subcutaneously, closely to lymph nodes directly involved in immune response, markedly suppressed delayed hypersensitivity. Significant inhibition of lymphocyte proliferation by streptolysin S was observed both in vivo as well as in vitro experiments. PMID- 3532631 TI - The susceptibility of Cryptococcus neoformans to an antimycotic agent (G2) from alfalfa. AB - Compound G2, 2-beta-hydroxy-3-beta-O-(beta-D-glucopyranosyl)-delta 12-oleanene 23,28-dionic acid, isolated from alfalfa roots, demonstrated considerable activity against Cryptococcus neoformans (MIC value of 2 micrograms/ml). Compound G2 exhibited rapid killing of this fungus (MFC value of 4 micrograms/ml) suggesting that it might be a useful active agent in the treatment of cryptococcosis. PMID- 3532632 TI - Aspergillosis--clinical aspects. AB - Allergic bronchopulmonary aspergillosis (ABPA) is much more common than originally suspected, can have its onset in childhood and remain undiagnosed for years or decades, at which time it presents in a patient with end-stage fibrotic lung disease. In other patients, ABPA may cause a finite number of roentgenographic lesions and not be associated with chronic sputum production or widespread bronchiectasis. Clinical symptoms range from the patient being asymptomatic with a new roentgenographic infiltrate being suspected only by a sharp elevation of total serum IgE to wheezing dyspnea or status asthmaticus. Serologic assays that are of major value in diagnosis of ABPA include elevation of total serum IgE--not all of which is directed against Aspergillus fumigatus, precipitating antibodies to A. fumigatus--unless the patient is in remission, and elevated serum IgE-A. fumigatus and IgG-A. fumigatus compared to serum from patients with asthma with immediate cutaneous reactivity to A. fumigatus but without evidence of ABPA. Five stages have been identified which reflect the time of recognition of ABPA and disease activity. They are Acute, Remission, Recurrent Exacerbation, Corticosteroid-Dependent Asthma, and Fibrotic. Stage I (Acute) patients have the classic clinical, serologic, and radiologic features of ABPA. Stage II (Remission) occurs after prednisone has resulted in resolution of the chest infiltrate and can be tapered and discontinued for 6 months without new infiltrates. Stage III (Exacerbation) occurs when a new roentgenographic infiltrate occurs associated with elevation of total serum IgE. Stage IV (Corticosteroid-Dependent Asthma) is present when repeated attempts to discontinue prednisone results in severe wheezing that cannot be prevented with other therapy. Some Stage IV patients continue to develop new ABPA infiltrates. Stage V (Fibrotic) patients have irreversible obstructive and restrictive pulmonary function abnormalities and may present or progress to respiratory failure and death. PMID- 3532633 TI - Aspergillus fumigatus antigens used in the serodiagnosis of aspergillosis. AB - The diagnostic antigens in Aspergillus serology are mycelial or culture filtrate concentrates. Recent work has been directed towards the separation of defined, reproducible products of greater sensitivity and specificity than crude extracts. Conventional methods of separation have been used; they include fractional precipitation, detergent extraction, chromatography, and preparative isoelectric focusing. Selective staining of the separated fractions has shown many of the more reactive components to be glycoproteins. Affinity binding to Concanavalin A has demonstrated the presence in these of alpha-D-glucopyranose, alpha-D mannopyranose and/or terminal alpha-D-N-acetylglucosamine. Major amino acid constituents are serine and threonine, together with glutamic and aspartic acids. The more reactive and specific components, as judged by their antibody binding capacity, have molecular weights greater than 70,000; in some cases they are as high as 150,000 to 180,000. Isoelectric focusing gave products with acidic pI values which specifically bound the IgG present in sera from aspergillosis patients. Results from a number of laboratories suggest that a group of acidic glycoproteins constitute the most promising source of a diagnostic reagent for aspergillosis. However, further analysis and a comparison of these substances in an international collaborative study is needed before agreement can be reached on a "standard" antigen preparation. PMID- 3532634 TI - Allergens of Aspergillus fumigatus: identification and characterization of components combining with specific IgE antibody. AB - Aspergillus fumigatus-specific IgE antibodies, mediating immediate type hypersensitivity reactions are found in a proportion (16-26%) of patients with asthma and their presence is a criterion for diagnosis of allergic bronchopulmonary aspergillosis (ABPA). Sensitive radiolabelled or enzyme-linked immunoassays are required for detection/quantification of these antibodies in patient's serum, and the fungal components, allergens, to which they combine, may be identified in crossed radio-immunoelectrophoresis tests. Of the 40 or more components antigenic for rabbits, as many as 18 have been identified as allergenic, two as major allergens. One major allergen with a molecular weight of approximately 24,000 daltons, pI 4.5, has been partially characterized. Further, in ABPA patients whose sera also contain IgG antibodies, both classes of antibody can combine with the same components forming IgE/IgG antigen complexes in vitro. PMID- 3532635 TI - Detection of fungal antigen in body fluids for diagnosis of invasive aspergillosis. AB - In clinical trials, the diagnostic utility of a radioimmunoassay (RIA) to detect Aspergillus antigen was demonstrated in sera obtained from patients with invasive pulmonary, endothelial, and disseminated aspergillosis, in cerebrospinal fluids from patients with Aspergillus meningoencephalitis, and in bronchoalveolar lavage fluids from patients with invasive pulmonary aspergillosis. The RIA was further evaluated in three blinded, controlled clinical trials. In one, sera were collected prospectively from patients with acute leukemia. Antigenemia was detected in four patients with invasive pulmonary aspergillosis (IPA) due to A. flavus, appeared early in the course of infection of three patients concurrent with the onset and evolution of lung infiltrates, and remitted with antifungal chemotherapy. Antigenemia was not detected in three patients before the onset of IPA, in eight leukemic controls, or in the 24 normals. In contrast, seven bronchoscopies were performed in five patients with IPA; fungi were not isolated in three. In a second study, antigenemia was found in coded sera from two patients with invasive aspergillosis but not in eight controls. In the third controlled study, 616 sera from 79 hematology patients admitted on 152 occasions were analyzed for circulating fungal antigen. The diagnostic utility of the RIA was confirmed and levels of antigenemia correlated with the patients' clinical course. These studies demonstrate the utility of the Aspergillus antigen RIA for diagnosis of invasive aspergillosis in hospitalized high risk patients. PMID- 3532636 TI - Recent statistical survey of visceral aspergillosis in Japan, and experimental studies on the pathogenicity of Aspergillus fumigatus in rabbits. AB - A statistical survey of visceral aspergillosis in Japanese pathological autopsies (1972-1981) was carried out. It was found that the infection has increased remarkably in recent years, and the results obtained were briefly described. Pathogenicity of several strains of Aspergillus fumigatus in rabbits was studied on three occasions in the past 31 years. The pathogenicity appeared to be unchanged even after long subcultures for 13 years, while lowered pathogenicity was noted with long-term subcultures over 30 years. However, the lowered pathogenicity of the fungus seemed to be recovered by animal passage. PMID- 3532637 TI - [Epidemiologic evaluation of a sample of 91 rats (Rattus norvegicus) captured in the sewers of Lyon]. AB - 91 rats captured in 1982 in the sewers of Lyon (France) have been examined for the presence of some microorganisms implicated in infections transmissible to man, by direct examination, bacteriological culture or detection of specific antibodies. Bacteriological results have shown a high proportion of carriers of Yersinia enterocolitica and frederiksenii (29%), of Pasteurella pneumotropica (29%), of Staphylococcus aureus (53%), and of Campylobacter jejuni (18%), a low proportion of carriers of Salmonella typhimurium (6%) and Leptospira (7%), and an absence of Listeria. Immunological reactions were often positive with Leptospira (21%), sometimes with Salmonella typhimurium, and always negative with Yersinia and Listeria. This work is a contribution to the knowledge of the health status of sewer rats considered to be an important public health risk as transmitters of anthropozoonoses. PMID- 3532638 TI - Fibular graft in anterior surgery of cervical spondyloarthrosis myelopathy. AB - A report on the use of fibular graft in 15 cases of myelopathy secondary to cervical spondyloarthrosis with anterior compression of the dural sac at more than two levels. The surgical procedure is based on a midline somatotomy by anterior approach. The fibula appears to be more suitable for the purpose than the iliac crest due to homogeneity of structure throughout its length and to the mechanical strength afforded by its cortical ring. PMID- 3532639 TI - [The comparative study of nerve tissue lipids in the works of Academician E. M. Kreps]. PMID- 3532640 TI - [The invariance of the genetic code and its possible evolutionary path]. PMID- 3532641 TI - [Creatine kinase: the evolution and multifunctionality of the enzyme]. PMID- 3532642 TI - [Bibliography of the works of E. M. Kreps]. PMID- 3532643 TI - [Detection of immunosuppression factors in Shigella sonnei]. AB - A factor, making noninvasive shigellae and other bacteria capable of suppressing immunological memory and secondary immune response manifested as delayed hypersensitivity, has been detected in the germ-free filtrates of the broth cultures of invasive S. sonnei. PMID- 3532644 TI - [Participation of prostaglandins in the regulation of infection and immunity]. PMID- 3532645 TI - [Names of microbiologists, epidemiologists and infectious disease specialists immortalized in Odessa]. PMID- 3532646 TI - [On the centenary of the birth of M. N. Solov'ev]. PMID- 3532647 TI - [Changes in the properties of erythrocyte membranes in hereditary diseases of the neuromuscular system (review)]. PMID- 3532648 TI - [Cerebral hemodynamics according to the results of REG when using sinusoidally modulated currents in accordance with the electrosleep method during the early recovery period after surgery on intracranial arteries]. AB - On the basis of clinical observations and REG recorded in 50 patients in the early restorative period after operations on intracranial cerebral arteries the author recommends a new effective and pathogenetically substantiated method of treatment--sinusoidal modulated currents (SMC) after the method of electric sleep. SMC promotes regression of the focal neurological symptomatology and increases the intensity of cerebral blood flow, evidence of which is the positive time course of REG values. PMID- 3532649 TI - [Normotensive hydrocephalus and its treatment]. PMID- 3532650 TI - [Controlled arterial hypotension using sodium nitroprusside in neurosurgery]. PMID- 3532651 TI - Purification and characterization of a proteinase from Euphausia superba Dana (Antarctic krill). AB - The thiol-dependent serine proteinase (inhibited by DFP, PMSF, pCMB and iodoacetate) was isolated from the whole krill specimens and from the content of the krill digestive tract. The enzyme was purified to homogeneity using a seven step procedure. Its specific activity with denatured haemoglobin as a substrate was about 6.0 unit/mg. The molecular weight of the enzyme, as determined by gel exclusion chromatography was 33 000 and by polyacrylamide gel electrophoresis with SDS 31 600 (12.5% gel) and 27 000 (7.5% gel). The enzyme is an acidic glycoprotein (pI below 2.9) containing about 5% of carbohydrate. The pH optimum of the enzyme with haemoglobin was 6.0 at the optimal temperature of 40 degrees C in 15-min reaction. The enzyme showed the esterase activity (hydrolysis of BAEE) and was inactive with carbobenzoxy- and benzoyl-dipeptides with the following C terminal amino acids: Phe, Tyr, Lys, Gly and Leu. PMID- 3532652 TI - [Postoperative syndromes and recurrence in highly selective vagotomy]. AB - In a prospective multicenter trial the clinical results and recurrences after proximal gastric vagotomy (PGV) in different gastroduodenal ulcer types have been investigated. Pyloric and prepyloric ulcers showed a significantly higher recurrence rate after PGV without drainage than duodenal and gastric ulcers. The secretory pattern could not explain the failure of PGV in these two ulcer types, which exhibit an alteration of the muscular layer at the pylorus and the distal antrum, a so called antropyloric dystrophy. About 60% of the recurrent ulcers after PGV stay asymptomatically. A refined concept for surgical treatment of peptic ulcer is proposed. PMID- 3532653 TI - [Analysis of 66 cases of colorectal side-to-end anastomosis by the Baker method]. AB - From 1976 to 1985, 66 elective side to end colorectal anastomosis according to Baker's technique were performed. 36 of those 66 anastomoses (54.5%) were performed lower than 10 cm from the anal verge. Our series includes 17 cases of diverticular disease, 1 case of post radiotherapy stenosis of the rectosigmoid junction and 49 carcinomas. 50% of all carcinomas were Dukes' C or D lesions and more than 34.8% of all lesions were subobstructive. The method of preoperative colonic preparation is described. The results are the following:--clinical fistulas: 2 (3.0%)--wound infections: 3 (4.5%)--deaths: 4 (6.1%). None of the colorectal sutures were protected by a colostomy whereas 4 colostomies previously instaured were suppressed at the time colorectal continuity was restored. This study clearly demonstrates that manual colorectal anastomosis following Baker's technique are as secure as stapled anastomosis although very less expensive. PMID- 3532654 TI - Effect of epidural analgesia on muscle amino acid pattern after surgery. AB - Free amino acids in muscle were studied before and 96 hours after skin incision in 14 patients undergoing elective hip replacement and allocated to general anesthesia or epidural analgesia (T10-S5) effective before incision and maintained with intermittent 0.5% bupivacaine during the first 24 postoperative hours. The general anesthesia group (n = 8) showed the characteristic changes in muscle amino acids, with increase of branched chain amino acids and phenylalanine and decreased glutamine, arginine and lysine, as well as raised plasma levels of cortisol and glucose. The epidural group (n = 6), contrastingly, showed no significant changes in plasma cortisol and glucose and an attenuated postoperative response in all amino acids, without significant difference from the preoperative values. Differences in postoperative muscle amino acid concentrations between the epidural and the general anesthesia group were significant as regards glutamine, valine and asparagine. These results suggest that post-trauma changes in muscle amino acids are predominantly mediated by afferent neurogenic stimuli and the secondary increase in catabolic hormones. PMID- 3532655 TI - The electrostimulation test for intraoperative control of vagotomy. AB - A prospective randomized study was made of the Burge-Vane intraoperative electrostimulation test (EST) following selective proximal vagotomy for duodenal ulcer. Histologically proven nerve fibres were demonstrated by EST in 6 of 50 patients. The postoperative acid values and the ulcer recurrence rate were compared in these 50 patients and in 50 who did not undergo EST. The postoperative acid values did not differ significantly between these two groups. Ulcer recurred in 16% of the EST and 14% of the non-EST group during 6-8 year follow-up. Use of EST thus did not influence the results in this trial. PMID- 3532656 TI - Beneficial effect of treatment with a prostacyclin analogue in severe peripheral atherosclerosis. A case report. PMID- 3532657 TI - Autoreactive lymphocytes in thyroid disorders. Quantitation of anti-thyroglobulin antibody formation by a specific haemolytic plaque forming cell (PFC) assay. AB - Blood mononuclear cells (MNC) from 21 patients with autoimmune thyroiditis were assayed for secretion of immunoglobulins in vitro by a reverse haemolytic plaque forming cell (PFC) assay. An antigen-specific assay was employed to quantify anti thyroglobulin antibody (TgAb) secreting cells. The sensitivities of the two PFC assays were similar. The antigen specificity of the Tg-PFC assay was demonstrated by the ability of free Tg to inhibit PFC formation. The number of spontaneous TgAb-secreting cells was low (median 3 IgG-Tg-PFC/10(6), range 0-35/10(6)); TgAb activity was found in 3% (range 0-11%) of total IgG-PFC. The number of spontaneous IgG-TgAb-secreting cells correlated positively to TgAb titres in serum. MNC from most patients secreted IgG-TgAb upon polyclonal stimulation in vitro for six days with pokeweed mitogen (52 IgG-Tg-PFC/10(6), range 0 478/10(6)); TgAb activity was found among 2% (range 0-8%) of total IgG-PFC. Again, pokeweed mitogen-induced TgAb secretion correlated positively to TgAb titres in serum. Finally, MNC from most patients secreted TgAb after culture with Tg. The Tg-induced response was about 1/3 of the pokeweed mitogen-induced TgAb response. Tg did not increase the production of total IgG indicating that Tg is not a polyclonal stimulus. Few TgAb-secreting MNC were discovered in euthyroid sex and age-matched control patients. PMID- 3532658 TI - Insulin binding and action in adipocytes in vitro in relation to insulin action in vivo in young and middle-aged subjects. AB - The effect of age on glucose metabolism in vivo was compared to that found in adipocytes in vitro in young (n = 8, age 23 to 31 years) and middle-aged (n = 7, age 37 to 55 years) non-diabetic subjects. During the OGTT, the incremental glucose or insulin areas did not differ significantly between the groups. Fasting and 2 h plasma glucose (P less than 0.01) and the 2 h plasma insulin (P less than 0.05) levels were, however, slightly higher in the middle-aged than in the young group. During iv induced hyperinsulinaemia (approximately 85 mU/l), rates of glucose uptake were comparable between the middle-aged (6.32 +/- 0.94 mg/kg/min) and the young subjects (7.56 +/- 0.78 mg/kg/min, P greater than 0.5). In fat cells, both basal and insulin stimulated rates of glucose transport were 35% lower (P less than 0.05) in the middle-aged than in the young subjects. Basal and insulin stimulated rates of glucose oxidation and lipogenesis were both markedly lower (P less than 0.01) in the middle-aged than in the young group. The rates of glucose transport, oxidation and lipogenesis were inversely related to age, whereas none of these parameters was related to fat cell size. In conclusion, adipocyte glucose metabolism in middle-aged healthy subjects was markedly impaired. In contrast, rates of glucose uptake during iv hyperinsulinaemia and glucose responses during hyperinsulinaemia in the OGTT were comparable in young and middle-aged subjects.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3532659 TI - Glycosylated proteins in normal and diabetic pregnancy. AB - The methods available for and the clinical usefulness of measuring glycosylated proteins in pregnancy complicated by diabetes is reviewed. The need for standardization of reference ranges for pregnancy and for highly accurate and precise methods of measurement is emphasized. Measurement of glycosylated proteins is useful in patients with established diabetes to identify pregnancies at risk for complications known to be associated with significant hyperglycaemia. These include spontaneous abortion and malformations, foetal loss due to premature labour or intrauterine death, and macrosomia and other neonatal morbidities. The use of glycosylated protein measurements as a diagnostic test for gestational diabetes appears limited. PMID- 3532660 TI - Some aspects of the metabolic and hormonal adaptation to pregnancy. AB - Metabolic adaptations to pregnancy are directed towards ensuring fetal growth and development, provision of a fetal store of energy, and the establishment of a maternal bank of energy. At any one time the demands of these objectives are competing for the available dietary energy, yet to ensure successful reproduction all three must be met. Current concepts suggest that the metabolic adaptation to pregnancy is designed primarily to safeguard against variable and restricted energy intake and that this is achieved by 1) a reduction in energy expenditure, resulting from decreased activity combined with increased metabolic efficiency, 2) phased metabolic activity affecting carbohydrate, fat and protein. Conservation of energy in maternal adipose tissue dominates the first half of pregnancy, while in late pregnancy the available energy is redirected to the fetus. This biphasic metabolism is programmed by the placental steroids whose secretion is independent of maternal diet. Internal redistribution of substrate under hormonal control is the main characteristic of the metabolic adaptation to pregnancy. The precise mechanisms underlying these adjustments have still to be defined. PMID- 3532661 TI - Continuous subcutaneous insulin infusion (CSII) in pregnant diabetic women. AB - Insulin infusion pump treatment (CSII) in pregnancy was compared with conventional therapy (IIT) in 12 pregnant diabetic women. In patients poorly controlled on IIT a plasma glucose equilibrium was achieved with CSII (mean of: glucose levels = 84 vs 137 mg/dl; SD = 36 vs 63 mg/dl; MAGE = 65 vs 112 mg/dl). In patients well controlled on IIT, CSII led to a reduction in the variation of glucose excursions (SD = 29 vs 36 mg/dl; MAGE = 48 vs 76 mg/dl). CSII generally led to a reduction of 20-37% of daily insulin dose but in 3 cases there was an increase of dose with the achievement of glycaemic control. A significant relation between bolus/basal ratio of insulin daily dose and the quality of glycaemic control was also found during CSII. All infants were born at or near to term and none were macrosomic or had neonatal complications. It is concluded that CSII is highly efficient in pregnancy not only in type I but also in type II or gestational diabetes. PMID- 3532662 TI - Obstetric complications in diabetic pregnancy. AB - Some of the most common complications in diabetic pregnant women are discussed in this paper. These include hydramnios, pre-eclampsia, prematurity and birth trauma. Further, the author discusses a method to measure the uteroplacental blood flow, the choice of treatment for hypertension and treatment of premature uterine contractions. PMID- 3532664 TI - Metabolic adaptations during the neonatal period in infants of diabetic mothers. AB - Infants of diabetic mothers (IDM's) are prone to develop severe but usually asymptomatic hypoglycaemia during the first postnatal hours. High maternal plasma glucose concentrations at the time of delivery increase this risk, especially if the mode of delivery is cesarean section. Newborn IDM's are hyperinsulinaemic and the neonatal hypoglycaemia seems to result from this together with a retarded increase in plasma glucagon levels. Despite very high plasma insulin concentrations, lipolysis, as indicated by a rise in plasma glycerol concentrations, appears to be normal in IDM's. The IDM's are able to respond to both physiologic and metabolic stress with an increased catecholamine secretion during the first hours of life, and the catecholamines seem to counteract the inhibitory effect of insulin on lipolysis and, at least partly, to oppose the blood glucose lowering effect of insulin. PMID- 3532663 TI - Contraception in diabetic women. AB - In diabetic women investigations have been performed covering the clinical consequences of intrauterine contraception and the influence on glucose and lipid metabolism of oral contraceptives. Insertion of copper-T intrauterine contraceptive devices in insulin-dependent diabetic women resulted in accidental pregnancy rates and total continuation rates after 12 months which were at the same levels as in non-diabetic women. No differences were observed in the maximum depth of corrosion or in the constitution of the corrosion products. The glucose tolerance as well as the serum lipoprotein levels remained unchanged when low dose hormonal compounds were administered to women with a previous gestational diabetes. In insulin-dependent diabetic women it was found, that the use of oral contraceptives containing natural oestrogen may not give rise to difficulties with the diabetes control or disturbance in the lipid metabolism. PMID- 3532665 TI - Endocrine pancreatic function in women with gestational diabetes. AB - Glucose tolerance deteriorates in normal human pregnancy but 99% of all pregnant women retain normal glucose tolerance whereas the remaining 1% develop abnormal glucose tolerance and are designated gestational diabetics. The possibility that glucose tolerance deteriorates in pregnancy because of diabetes-like changes in the secretory function of the endocrine pancreas has been investigated in gestational diabetics and healthy controls. Even though the insulin responses to oral glucose and mixed meals are equally large in gestational diabetics and normal pregnant women, the insulin responses of the gestational diabetics differ in two pertinent ways from those of the normals. First, a delayed insulin response is frequently seen, and second, the insulin response per unit of glycaemic stimulus (the 'insulinogenic index') is normally significantly lower than that of the normal pregnant women. Diabetes-like changes in the secretion of glucagon are not seen in neither group. Insulin degradation is unaffected by pregnancy and the proinsulin share of the total plasma insulin immunoreactivity does not increase in pregnancy. It is therefore likely that the main reason for the diabetogenicity of pregnancy is insulin resistance. Most pregnant women are able to increase their insulin secretion and thus overcome the resistance. Some pregnant women do, however, seem to have a more limited insulin secretory capacity which eventually may lead to the development of gestational diabetes. PMID- 3532666 TI - Insulin receptors in normal pregnant women and women with gestational diabetes. AB - In a serial study of insulin receptor binding to monocytes from normal pregnant women, a significant increase in insulin binding in mid pregnancy followed by a significant decrease in late pregnancy at tracer insulin concentration was found. No changes in the insulin concentration necessary to reduce tracer binding by 50% (ID50) were observed. At delivery, binding to isolated adipocytes was significantly lower in normal pregnant women than in non-pregnant normal controls while no difference in ID50 was observed. No differences in insulin binding at tracer insulin concentration to monocytes and adipocytes between normal weight women with gestational diabetes and healthy non-diabetic pregnant controls were found, but the ID50 was significantly lower in women with gestational diabetes diagnosed in late pregnancy than in pregnant controls at the same weeks of gestation. PMID- 3532667 TI - Endocrine pancreatic function in insulin-dependent diabetic pregnant women. AB - In order to better understand the role of A- and B-cell function in diabetic pregnancy, we studied four groups of pregnant women at week 34-36 of gestation. Seventeen were healthy controls (C), 24 had gestational diabetes (GD), 16 had type 2 diabetes (NIDD) and 37 had type 1 diabetes (IDD). At times -20, 0, 20, 30, 45, 60, 90 and 120 min from the beginning of a 30 min infusion of 30 g of arginine intravenously, plasma glucose, glucagon (IRG) and C-peptide (CPR) were measured. Plasma glucose was higher in diabetic than in control subjects. IRG values were also higher in the GD and the NIDD women. CPR values were similar to, or slightly higher than control values in the GD and the NIDD and were much lower in the IDD women. All three variables increased during the arginine infusion in all groups, with the exception that CPR remained unchanged in the IDD. The CPR/IRG molar ratio was similar in control, GD and NIDD women; in the IDD, it was much smaller than in the other groups and was not affected by arginine. In all the diabetic patients, IRG was negatively correlated with the maternal weight gain and in the IDD IRG was positively correlated with the increase in the insulin need and with the CPR levels. In conclusion diabetes appeared to enhance the A-cell function also in pregnancy, possibly impairing the 'facilitated anabolism' and stressing the 'accelerated starvation' which are typical of normal pregnancy. Glucagon was confirmed as one possible determinant of the insulin resistance seen in diabetic pregnancy. PMID- 3532668 TI - Gastro-entero-pancreatic hormones in amniotic fluid from normal and diabetic pregnant women. AB - Clinical applications of analyses of hormones in amniotic fluid (AF) have recently been increased. In diabetic pregnancy, determinations of insulin and C peptide in AF have been suggested as good indicators of the status of the foetus. We have investigated the pancreatic alpha and beta cell function by measuring insulin (IRI), C-peptide (CPR), glucagon (IRG), somatostatin (SLI), and gastric inhibitory polypeptide (GIP) in amniotic fluid collected during basal conditions or 2 h after an arginine test in 92 diabetic and 32 non-diabetic pregnant women. During basal conditions, in diabetic pregnant women, IRI, CPR and the insulin: glucagon molar ratio (I/G) were all significantly higher while amniotic fluid-IRG was significantly lower than in the controls. After arginine stimulation, IRI increased in AF of the diabetic pregnant women but not in AF of the controls while no differences were observed in AF-GIP and AF-SLI concentrations. Higher IRI and CPR, as well as lower IRG values were significantly related to poor maternal metabolic control. The occurrence of neonatal morbidity including macrosomia was significantly associated with increased AF, IRI and CPR concentrations after an arginine challenge and these factors were the most sensitive predictors of neonatal morbidity in infants of diabetic mothers. Increased AF glucose concentrations and I/G ratios were related to neonatal hypoglycaemia; jaundice and respiratory distress syndrome were associated to low concentrations of SF-IRG. PMID- 3532669 TI - Low energy diets in the treatment of gestational diabetes. AB - A randomised prospective study of treatment with dietary restriction alone or insulin therapy with dietary advice was performed in 15 women with glucose intolerance diagnosed early in the third trimester of pregnancy. Twenty-four hour profiles of plasma glucose and 3-hydroxybutyrate were performed before and four weeks after commencing treatment. The effect on neonatal outcome was assessed. The case history of one of the patients in the study was sent to British physicians with a special interest in diabetes to obtain their opinion about the appropriate initial treatment of women with gestational diabetes. PMID- 3532670 TI - Therapy of gestational diabetes. AB - Even minor abnormalities of maternal carbohydrate metabolism may influence foetal development. This study aimed at examining the relations between impaired glucose tolerance and blood glucose behavior under a standardized diet in late pregnancy and at looking for the obstetrical and neonatal outcome after normalization of blood glucose profiles in gestational diabetics. The study included 97 women in the second half of pregnancy. Severely abnormal blood glucose profiles were observed in most patients with impaired glucose tolerance who had a fasting capillary blood glucose concentration above 4.7 mmol/l. Normalization could usually only be achieved by combining a strict dietary regimen with insulin treatment. The obstetrical and neonatal outcome in the group of patients treated with diet plus insulin was similar to that in the group of patients treated with diet alone. PMID- 3532671 TI - Treatment of non insulin-dependent diabetic women during pregnancy. AB - From 1981 to 1984 90 cases of diabetic pregnancy were seen at the Palermo Center. Twenty-nine patients (32%) had prepregnancy type 2 diabetes, 20 (69%) of these were obese and were studied further. The patients were divided into 2 groups of 13 and 7 patients. The first group was given a diet of 30 kcal/kg ideal prepregnancy weight. The second group was prescribed a low energy diet of on average 1200 kcal/day. In the diet-restricted group, weight gain was less pronounced (7.9 +/- 1.2 SD vs. 12.7 +/- 8.6 kg), insulin requirement was lower (0.56 +/- 0.22 vs. 1.00 +/- 0.34 U/kg body weight) and the metabolic control was better than observed in the group given 30 kcal/kg body weight. The weight gain during pregnancy was proportional to the fetal weight index at birth (r = 0.72, P less than 0.0005). It is concluded that obese type 2 diabetic women are best treated by a low caloric diet and, when necessary, small doses of insulin. To establish the optimal caloric intake for obese pregnant type 2 diabetic women, the following formula is proposed: (30 kcal/kg prepregnancy ideal body weight/24 h) - X, where X is the % of prepregnancy obesity exceeding 120. PMID- 3532672 TI - Treatment of diabetic pregnant women with monocomponent insulins. AB - Very little immunological research has been undertaken in pregnant diabetic women in relation to insulin therapy. We investigated the relations between treatment with insulins of varied immunogenic character and the presence of immune factors such as insulin antibodies, immune complexes and insulin antiinsulin complexes as well as some maternal and neonatal complications of diabetic pregnancy. 128 insulin treated diabetic pregnant women and 121 of their newborns were included in the study. The incidence of insulin antibodies, immune complexes and insulin antiinsulin complexes was lower in patients treated with highly purified insulins than in those treated with conventional insulins. The insulin antibody levels were significantly related to the occurrence of maternal and neonatal morbidity. The presence of insulin antiinsulin complexes in the cord blood of infants of diabetic mothers was related to the presence of these complexes in their mothers. Our results seem to indicate that the use of highly purified insulin could favour the outcome of diabetic pregnancy. PMID- 3532673 TI - Treatment of pregnant insulin-dependent diabetic women. AB - The treatment of 620 insulin-dependent diabetic pregnant women is reported. The goal of treatment was to achieve a normal blood glucose concentration as soon as possibly during early, or even before pregnancy. When intensified conventional insulin therapy was started before conception, about 88% of the patients achieved normal blood glucose levels during the first weeks of pregnancy. In only about 20% of the pregnant diabetics without intensified preconceptional treatment a normal blood glucose level was obtained during their first hospitalization in pregnancy. The rate of congenital malformations was 1.1% in the former and 7.1% in the latter group. PMID- 3532674 TI - Intensified treatment of pregnant insulin-dependent diabetic women. AB - Intensified treatment of glycaemic excursions has become the standard of care for all insulin-dependent diabetic women. This paper reviews the rationale for intensified insulin treatment programs and offers the algorithms of one approach to achieve and maintain normoglycaemia throughout pregnancy. PMID- 3532675 TI - Methods of fetal monitoring and assessment of placental function in diabetic pregnancy. AB - The clinical usefulness and limitations of the methods available for monitoring fetal well-being and assessing placental function in diabetic pregnancy are reviewed. PMID- 3532676 TI - [Vascular architecture of the spleen of the musk shrew, Suncus murinus]. PMID- 3532677 TI - Hemopoietic progenitors before and after bone marrow transplantation. PMID- 3532678 TI - Improved method of separation of bone marrow stem cells by the IBM 2,991 blood cell processor. PMID- 3532679 TI - [Sonographically established thyroid volume in 7- to 11-year-old children]. AB - Since the introduction of thyroid sonography as a routine method for thyroid investigation sonographically determined volumes are being increasingly used for comparative studies concerning the incidence of goitre. The main purpose of this paper is to establish mean values in seven to eleven years old children with sufficient iodine supply as evaluated by urine iodine excretion. Thus it was possible to fix standard mean values to be applied also in non endemic areas. The average thyroid volume of seven to eleven years old subjects was established to be 4.89 +/- 1.83 ml. Additionally the significance of palpatory findings in this age group was compared with sonographic values. The palpation alone especially in the age mentioned is mostly unsuitable in order to differentiate between normals and early goitre development. Consequently sonography is essential in epidemiological studies of goitre incidence. PMID- 3532680 TI - Self-administered prophylactic postoperative positive expiratory pressure in thoracic surgery. AB - Application of self-administered postoperative prophylactic positive expiratory pressure (S-PEP) treatment in addition to conventional physiotherapy was investigated in 75 patients undergoing thoracotomy. Twenty-nine patients used a face-mask set supplied with an expiratory resistance (S-PEP group) and 27 patients used a face-mask set without resistance (control group). The observation period and postoperative treatment with the face-mask was 3 days. In the S-PEP group 13 patients developed radiographic atelectasis during the 3 postoperative days compared to eight patients in the control group (P greater than 0.05). The postoperative PaO2 in the S-PEP group was 0.36 kPa lower than in the control group (P greater than 0.05). We conclude that application of S-PEP postoperatively after thoracotomy in addition to conventional physiotherapy including early mobilization had no beneficial effect in preventing atelectasis, as evaluated by changes in blood gas tensions and chest roentgenograms. PMID- 3532681 TI - Methods for the study of the human foetal arterial system. AB - Microarteriography followed by enlargement of the photographs, resin cast preparation and serial sections were techniques applied to study the arterial system of the human foetal abdomen from 12 to 20 weeks ovulation age. In order to illustrate the advantages of these techniques, the blood supply of the second portion of the duodenum of the developing foetus was demonstrated for the first time. Particular attention was directed to the recognition of anatomical variations. Vascular patterns were found to be complete in the age group studied. PMID- 3532682 TI - Immunoreactive prolactin in mouse urethral glands. AB - Immunoreactive prolactin was demonstrated in the acinar cells of urethral glands in some inbred strains of mice by immunoperoxidase technique. The significance of the presence of prolactin or its related substances in the urethral glands in relation to their role in the urinary tract is discussed. PMID- 3532683 TI - Cluster headache: a review. AB - Cluster headache is a rare headache entity that predominantly occurs in younger males. The clinical features are characterized by sudden attacks of unilateral excruciating pain localized periorbitally, associated with ipsilateral autonomic symptoms. The attacks occur in periods: clusters. The pathophysiology is still unknown. Such vasodilating substances as histamine, nitroglycerin and alcohol may provoke attacks. These substances may be used as diagnostic tests, but the interpretation of a negative result must be careful, as the attacks can not be induced in a refractory period after spontaneous occurrence, or at the beginning and end of cluster periods. As symptomatic treatment, ergotamine is the drug of first choice. High attack frequency may lead to overconsumption with ergotisme and further increased frequency. In such cases and for nocturnal attacks, oxygen inhalations represent an alternative. As prophylactic treatment ergotamine, methysergide, lithium and prednisone have proved efficacious. Most patients benefit from such treatment and may become virtually free from attacks. It is, therefore, important to differentiate this headache entity from classical migraine, common migraine and trigeminal neuralgia. PMID- 3532684 TI - Activities of some antioxidative and hexose monophosphate shunt enzymes of skeletal muscle in neuromuscular diseases. AB - The activities of some antioxidative and hexose monophosphate shunt enzymes, as well as of 2 hydrolases were studied in skeletal muscle biopsy specimens taken from 39 patients with neuromuscular diseases and from 15 controls. The activity of Se-dependent glutathione peroxidase was higher in patients with congenital myotonia, whereas in the other diagnostic groups this enzyme activity was the same as in the controls. The Se-independent and total glutathione peroxidase activity of patients in the various diagnostic groups did not differ from the controls. Moreover, no difference were observed in catalase activity between the patient groups and the controls. The activities of the rate limiting enzymes of hexose monophosphate shunt, glucose-6-phosphate dehydrogenase and 6 phosphogluconate dehydrogenase of muscle biopsy samples of various patient groups did not show any significant difference from controls. The activity of a lysosomal hydrolase, beta-N-acetylglucosaminidase, was increased in patients with polyneuropathy and the activity of a nonlysosomal protease, alkaline protease, was high in patients with Charcot-Marie-Tooth disease. The activities of Se dependent glutathione peroxidase, 6-phosphogluconate dehydrogenase and of both hydrolases showed a significant correlation to the magnitude of muscle atrophy. PMID- 3532685 TI - An immunocytochemical comparison of cytoskeletal proteins in aluminum-induced and Alzheimer-type neurofibrillary tangles. AB - Exposure of the central nervous system (CNS) of rabbits to aluminum salts produces a progressive encephalopathy. Examination of CNS structures discloses widespread perikaryal neurofibrillary tangle (NFTs) formation. The aluminum induced NFTs consist of collections of normal neurofilaments, and differ ultrastructurally and in their solubility characteristics from Alzheimer-type NFTs, the latter being composed of largely insoluble paired helical filaments. The present study compares NFTs found in the rabbit to those of Alzheimer's disease, using monoclonal antibodies (SMI 31, SMI 32) that recognize phosphorylated and non-phosphorylated determinants respectively in normal neurofilaments, and an antiserum raised against purified microtubules. Paraffin embedded sections were stained by the avidin-biotin immunocytochemical method. Intense staining of aluminum-induced NFTs was found after processing with SMI 31 and SMI 32, while no staining of non-tangled perikarya of control rabbits or of Alzheimer-type NFTs was seen. Antimicrotubule anti-serum gave weak, nonfocal staining in the aluminum-treated and control rabbits, while Alzheimer-type NFTs were stained intensely. These results show that phosphorylated and non phosphorylated neurofilaments accumulate in aluminum-induced NFTs, thus complementing the previously demonstrated specific slowing of the axonal transport of neurofilaments in aluminum intoxication. Further, they suggest that the presence of microtubular proteins may be necessary for altered neurofilaments to take on a paired helical configuration. PMID- 3532686 TI - Non-specific binding of mouse myeloma IgM immunoglobulins by human myelin sheaths and astrocytes. A potential complication of nervous system immunoperoxidase histochemistry. AB - The immunoreactivity of purified mouse myeloma IgM immunoglobulins (mouse IgM) to human myelin sheaths and astroglial cells was evaluated with the peroxidase antiperoxidase method on paraffin-embedded tissues from human gliomas and areas of multiple sclerosis, and from normal human cerebrum, spinal cord and spinal nerve roots. The mouse IgM reacted positively with central and peripheral myelin sheaths and, as shown independently by others, with the cytoplasm of neoplastic and reactive astroglia. Parallel immunostaining of successive sections with an anti-glial fibrillary acidic protein (GFAP) serum and/or the anti-Leu 7 monoclonal antibody was of considerable assistance in identifying the immunoreactive elements and in distinguishing specific from non-specific immunostaining of myelin sheaths and astroglia. Pretreatment with normal human serum inhibited the non-specific binding by mouse IgM without altering GFAP and Leu 7 reactivities. The non-specific binding of mouse IgM to human myelin sheaths and astroglia can therefore be overcome, and the specificity of mouse IgM monoclonal antibodies retained, by the parallel immunostaining of successive sections with mouse IgM. If non-specific binding by mouse IgM is found to occur, it can then be inhibited by preincubation with normal human serum without loss of specific antigenicity. PMID- 3532687 TI - Pathological reaction of astrocytes in perinatal brain injury. Immunohistochemical study. AB - Astrocytic reaction to various types of pre- and perinatal damage in the brain was studied using the immunohistochemical method for glial fibrillary acidic protein. The reactive gliosis could be detected as early as 20 weeks gestation. Reactive proliferation of the astrocytes could be seen already at 4 days after the insult. In addition to reacting to focal lesions, the astrocytes also proliferated diffusely throughout the white matter. The diffuse proliferation is the most significant finding in the evaluation of the perinatal damage, in both the acute state and in the long-term survivors. PMID- 3532688 TI - Immunocytochemical search for JC papovavirus large T-antigen in multiple sclerosis brain tissue. AB - The large T-antigens of papovaviruses JC (JCV) and BK share a C-terminal subsequence with myelin basic protein (MBP). Since this sequence functions as a phosphate acceptor site in MBP, expression of a competing T-antigen sequence in oligodendroglia might adversely affect their ability to post-translationally process MBP and thus to maintain myelin. We have used techniques which demonstrate JCV T-antigen in small oligodendroglial cells from progressive multifocal leukoencephalopathy tissue to search for a possible latent JCV infection expressing T-antigen in nine cases of multiple sclerosis (MS) and three normal brains. No cells expressing T-antigen were detected in plaque or periplaque regions of the MS brains or in control CNS tissue. PMID- 3532689 TI - Alveolar soft part sarcoma, granular cell tumor, and paraganglioma. An immunohistochemical comparative study. AB - Five cases of alveolar soft part sarcoma, 5 cases of granular cell tumor, and 6 cases of paraganglioma were investigated immunohistochemically to examine the expression of tissue-specific intermediate filaments (cytokeratin, vimentin, desmin, and glial fibrillary acidic protein (GFAP], actin, myoglobin, and nervous tissue markers (S-100 protein, neuron-specific enolase, and Leu-7). In alveolar soft part sarcomas, some of the tumor cells were positive for desmin, but negative for nervous tissue markers. The tumor cells of granular cell tumors were stained with anti-S-100 protein antibody, but not with anti-neuron-specific enolase antibody. In contrast, the tumor cells of paragangliomas were positive for neuron-specific enolase, but not for S-100 protein except for stellate cells surrounding the tumor cell nests. This immunohistochemical approach was valuable for the differential diagnosis of these three tumors. Furthermore, the complete absence of cytokeratin in all of the tumor cells may be helpful in distinguishing these three tumors from metastatic carcinoma in soft tissue. The histogenesis of alveolar soft part sarcoma is a matter of controversy. The result that besides desmin actin was also demonstrated in some of the tumor cells may support the myogenic origin of this tumor. PMID- 3532690 TI - Ultrastructure of hyaline cartilage. I. A comparative study of cartilage from different species and locations, using cryofixation, freeze-substitution and low temperature embedding techniques. AB - Important progress in the cryofixation of tissues has recently been made with the introduction of a new technique which permits a great reduction in the rates of ice-crystal growth and nucleation by rapid freezing under a pressure of 2 100 bar. Tissue pieces up to 0.5 mm in thickness can now be processed at a freezing rate sufficient to prevent the formation of detectable ice crystals at the ultrastructural level. In the present investigation this technique, in combination with freeze substitution and low temperature embedding was applied for ultrastructural and immunocytochemical studies of hyaline cartilage. No extraction of matrix proteoglycans was observed during the substitution procedure, and there are good reasons to believe that in preparations obtained by this technique the native state of the matrix components is preserved, since, for example, the collapse temperature of the macromolecules is not exceeded. Furthermore, no chemical fixatives or cryoprotectants are required. Ultrastructural differences in the hyaline cartilage of the growth-plate between normal rats and mice were observed, and also differences between cartilage at different locations, such as tracheal cartilage and growth-plate. Using this technique, further comparative ultrastructural studies enable us to obtain information about the macromolecular organisation of cartilage matrix under various normal and pathological conditions in vivo. In addition, using monoclonal antibodies to the main macromolecules of the matrix, it was found that this technique not only provides excellent tissue preservation but is also well suited for immunocytochemistry with colloidal gold as a marker. PMID- 3532691 TI - Renin-angiotensin system and renal excretory function under conditions of hypovolemia and limited sodium intake. AB - The renal excretory function of rats was investigated under conditions of reduced extracellular fluid volume (ECV) obtained by peritoneal dialysis with isotonic glucose solution 10% of the body mass and using sodium-deficient diet (consisting of boiled rice) with intact renin-angiotensin system (RAS) and after angiotensin converting enzyme blockade by Captopril. The experiments were made on male Wistar rats placed in metabolic cages. The diuresis, the excretion of sodium, potassium, chlorine and osmotically active substances in spontaneously released urine were tested over a period of 6 hours. Captopril was administered with Alzet osmotic minipumps at 80 micrograms/h rate of infusion (in the experimental animals with peritoneal dialysis) and intraperitoneally 1 mg/kg (in the animals subjected to sodium-deficient diet). Blocking of the converting enzyme with Captopril was found to increase the diuresis, as well as the sodium and total osmotic excretion after peritoneal dialysis and under sodium-deficient regime. Blocking of RAS with Captopril reduced the adaptive possibilities of the organism in the cases of reduced ECV and sodium-deficient diet. PMID- 3532692 TI - A schizophrenic composer--Jakob Adolf Hagg. PMID- 3532693 TI - Severe hypertension with cerebral symptoms treated with furosemide, fractionated diazoxide or dihydralazine. Danish Multicenter Study. AB - Emergency treatment of acute, severe hypertension defined as diastolic blood pressure (DBP) greater than or equal to 135 mmHg combined with cerebral symptoms was prospectively monitored in a randomized multicenter study including 64 patients. Treatment was divided into two periods. In the first hour the patients were observed in the supine position after being given 40 mg furosemide intravenously. If DBP remained greater than 125 mmHg (n = 52), the patients were put on fractionated diazoxide administered intravenously (n = 28) or dihydralazine administered intramuscularly (n = 24). Blood pressure (BP) decreased with diazoxide from an average of 241/149 mmHg to 180/111 mmHg after 5 hours and with dihydralazine from 237/149 to 161/101 mmHg. The inter-individual BP response varied considerably. A clear and identical regression in neurological symptoms was observed on both drug regimens. No new neurological symptoms were seen to develop. It is concluded that a gradual fall in BP can be obtained after fractionated dosage of diazoxide (i.v.) as well as after dihydralazine (i.m.). The indication of acute parenteral therapy compared to less aggressive oral treatment is discussed. PMID- 3532694 TI - Reversibility of cerebral symptoms in severe hypertension in relation to acute antihypertensive therapy. Danish Multicenter Study. AB - Cerebral symptoms were registered in a multicenter study including 64 patients with severe hypertension, diastolic blood pressure (DBP) greater than or equal to 135 mmHg, and more or less pronounced hypertensive encephalopathy. The symptoms were: headache (70%), dizziness (35%), consciousness disturbances (28%), nausea (27%), paresis (23%), blurred vision (22%), paraesthesia (21%) and vomiting (14%). None had convulsions or coma. Initial treatment was furosemide i.v., and if DBP was greater than or equal to 125 mmHg after one hour, patients were randomized to treatment with either i.v. diazoxide (bolus injections of 75-150 mg) or i.m. dihydralazine (bolus injections of 6-12.5 mg). A gradual fall in blood pressure (BP) was obtained in all three groups. Along with BP reduction a substantial regression of neurological symptoms was registered. After 5 hours only minor cerebral symptoms were present without significant difference between diazoxide and dihydralazine. None developed cerebral complications. The study failed to show a significant correlation between BP reduction and regression of neurological symptoms graded semiquantitatively. Reduction of BP by titration using small repeated bolus injections is recommended, but oral treatment should be considered in the patients who are able to ingest peroral medication in spite of neurological symptoms. PMID- 3532695 TI - Reduction of nonfatal reinfarctions in patients with a history of hypertension by chronic postinfarction treatment with metoprolol. AB - The Stockholm Metoprolol Trial is a prospective double-blind placebo-controlled postmyocardial infarction study of 301 patients treated with metoprolol, 100 mg b.i.d., or matching placebo for three years. From this study we have retrospectively evaluated the outcome in patients with a history of treatment for hypertension prior to the index infarction. There were 41 such patients in the placebo group and 35 in the metoprolol group. Blood pressures during follow-up were nearly identical in the two groups. During the three years 11 patients died in the placebo group and 7 in the metoprolol group. Corresponding figures for nonfatal events such as reinfarction, coronary artery bypass surgery, cerebrovascular events and lower limb amputation were 12 vs. 1 (p less than 0.005), 3 vs. 0, 4 vs. 0 and 1 vs. 0, respectively. The numbers of patients with fatal and nonfatal events were 24 vs. 8 (p less than 0.01). In a retrospective subgroup analysis the results must always be interpreted with caution. The present results may, however, imply that postinfarction treatment with metoprolol reduces nonfatal atherosclerotic complications, especially nonfatal reinfarctions, in patients with a history of hypertension. PMID- 3532696 TI - Hyperthyroidism and glucose intolerance. PMID- 3532697 TI - Central haemodynamics in acute myocardial infarction. Natural history, relation to enzyme release and effects of metoprolol. AB - The aim of this investigation was to study central haemodynamics in initially uncomplicated acute myocardial infarction (AMI) with respect to natural history, relation to enzyme estimated infarct size, mortality and effects of metoprolol. A total of 212 patients with AMI but without clinical signs of serious heart failure or hypotension and with a mean delay from onset of pain to study entry of about 7 hours were studied. They were randomised to placebo or metoprolol (15 mg i.v. + 50 mg orally q.i.d.) treatment. Central pressures and cardiac output were evaluated by repeated measurements over 24 hours by means of pulmonary artery catheters. The pharmacokinetics of metoprolol were studied in further 20 patients with AMI. The natural history, as reflected by the placebo group, was observed to be a gradual significant fall in systemic artery pressures, pulmonary capillary wedge pressure (PCWP; 13.6-10.5 mmHg) and stroke volume, while heart rate increased, leaving cardiac output unchanged. The decrease in PCWP was confined to the group with baseline pressure above the median of 13 mmHg and was of equal magnitude in the group given concomitant medication to that of those who required no such therapy. Significant but weak correlations between the peak serum aspartate aminotransferase level and the baseline PCWP (r = 0.28) and stroke volume (r = 0.22) were found. Non-survivors had a significant baseline depression of cardiac output and stroke volume, while PCWP was increased. However, the overlap with survivors was large. The dosage of metoprolol used resulted in mean plasma levels of about 200 nmol/l, which should induce a rapid and sustained degree of beta-blockade. The patients randomised to placebo or metoprolol were assessed according to initial heart rate. The haemodynamic changes induced by metoprolol were similar but were more pronounced in patients with high heart rate compared to those with low rate. In patients with heart rate greater than 65 beats/min, the metoprolol treated group, in comparison to the placebo group, was characterised by a decrease of 10-20% in systolic artery pressure and heart rate, suggesting a decreased myocardial oxygen consumption. Cardiac index (2.9-2.2 l/min/m2) and stroke volume index (36-32 ml/beat/m2) decreased to a minimum after 30 minutes and gradually rose thereafter. The PCWP increased from 13.7 to 15.4 mmHg, 30 minutes after the injection of metoprolol. This increase was confined to the group with baseline low pressure and the difference compared to the placebo group disappeared after 8 hours.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3532698 TI - GABA and gonadotropin secretion: evidence from in vitro studies on regulation of LHRH secretion. PMID- 3532699 TI - The GABAergic extrinsic innervation of the rat fallopian tubes: biochemical evidence and endocrine modulation. PMID- 3532700 TI - Purine and pyrimidine metabolism in man V. Part B: Basic science aspects. Festschrift for J.E. Seegmiller. PMID- 3532701 TI - Increased level of ribonucleotide reductase in deoxyadenosine resistant adenosine deaminase deficient human histiocytic lymphoma cells. PMID- 3532702 TI - Purification of mammalian glycinamide ribonucleotide (GAR) synthetase. PMID- 3532703 TI - Cell surface adenosine deaminase (ADA) and its complexing protein (ADCP) in human T-lymphoid cells. PMID- 3532704 TI - On the role of cytidine deaminase in cellular metabolism. PMID- 3532705 TI - Years with Elizabeth and James Miller: in appreciation. PMID- 3532706 TI - Identification of intratissue sites for xenobiotic activation and detoxication. AB - Results of immunohistochemical and histochemical investigations on xenobiotic metabolizing enzymes and aryl hydrocarbon hydroxylase activity have demonstrated that xenobiotic activation and detoxication do not occur uniformly throughout the liver, skin, respiratory tract, and pancreas, four tissues that are targets for the toxic actions of xenobiotics that are biotransformed into reactive metabolites. It has been shown that there can be significant differences in the levels and activities of xenobiotic-metabolizing enzymes among even morphologically similar cells, that an inducer can affect a specific xenobiotic metabolizing enzyme to significantly different extents within different cells in a tissue, and that inducers of xenobiotic-metabolizing enzymes can alter differentially the extents to which different cells within a tissue participate in xenobiotic metabolism. These studies also have revealed that the route of administration of an inducer can affect significantly the induction of xenobiotic metabolizing enzymes and aryl hydrocarbon hydroxylase activity within an organ such as the pancreas. Some of the immunohistochemical findings reported for the cellular localizations of xenobiotic-metabolizing enzymes within specific tissues, e.g., the nasal mucosa, may not appear to be entirely consistent with the intratissue distribution of benzo[a]pyrene hydroxylase activity, especially after induction. However, it must be appreciated that other cytochrome P-450 isozymes undoubtedly are present within these tissues which, although not studied, also are capable of catalyzing aryl hydrocarbon hydroxylase activity. PMID- 3532707 TI - The role of glutathione in the toxicity of xenobiotic compounds: metabolic activation of 1,2-dibromoethane by glutathione. AB - Unstable metabolites may arise during the metabolism of xenobiotic compounds with enzyme systems other than the cytochrome P-450 system. This depends on the enzyme system involved and the structure of the xenobiotic compound being metabolized. Normally detoxifying pathways may transform selected chemicals into toxic metabolites. In our laboratory we have demonstrated that DBE is metabolized by both cytochrome P-450 and GSH S-transferases. Although the cytochrome P-450 metabolite is reactive and will covalently bind to protein and nucleic acid to some extent, and the GSH S-transferase system conjugates it and under conditions of low DBE exposure is able to detoxify it. In contrast, GSH S-transferase catalyzes the direct conjugation of GSH with DBE. This can result in formation of a reactive intermediate that preferentially binds to nucleic acids and is responsible for the DNA damage observed following DBE exposure. The selective toxicity of this xenobiotic compound may be due to the preponderance of activating GSH conjugating enzymes in the extrahepatic organs. However, this difference alone does not appear sufficient to explain the selection of extrahepatic organs as sites of DBE-induced toxicity. PMID- 3532708 TI - Purification, properties and function of N-hydroxyarylamine O-acetyltransferase. PMID- 3532709 TI - Mutagens and carcinogens formed during cooking. PMID- 3532710 TI - Investigation of the immunological basis of halothane-induced hepatotoxicity. PMID- 3532711 TI - Mechanistic studies of acetamide hepatocarcinogenicity. PMID- 3532712 TI - Flavin-containing monooxygenase activity in human liver microsomes. PMID- 3532713 TI - S9-dependent activation of 1-nitropyrene and 3-nitrofluoranthene in bacterial mutagenicity assays. PMID- 3532714 TI - H-2 modulation of aryl hydrocarbon hydroxylase induction and the mutagenicity of benzo(a)pyrene after 3-methylcholanthrene treatment. AB - All strains except the DBA/2J, B10.S and B10.RIII exhibited an increase in hepatic cytochrome P-450 levels following MC treatment; furthermore, the P-450 response of the B10.D2 strains was greater than that seen in the B10 and B6 strains. MC treatment increased BP metabolism in all congenic strains relative to their corn oil controls. Both relative and absolute changes in AHH activity were higher in the B10.D2 than the B6 or B10 reference strains. All congenic strains exhibited an enhanced capacity to produce mutagenic metabolites of BP following treatment with MC; the B10.M, B10.WB and B10.D2 segregated with the B6 and B10 in this regard, while the B10.S and B10.RIII changed least following MC administration. PMID- 3532716 TI - Occurrence, biochemistry and physiology of phenazine pigment production. PMID- 3532715 TI - Mode of action of clinically important antifungal drugs. PMID- 3532717 TI - Nature and development of phenotypic resistance to amphotericin B in Candida albicans. PMID- 3532718 TI - Microbial cyanide metabolism. PMID- 3532719 TI - Immunohistochemical evidence for mast cells containing 5-hydroxytryptamine in rat portal vein. AB - Serotonin was localized to mast cells in the adventitia of the rat portal vein by indirect immunohistochemistry. The mastocytes where preferentially localized to a region delimited by the pyloric and splenic veins. Since neither 48/80 nor reaginic antibody induced a significant change in the intrinsic spontaneous activity of the portal vein it would appear that the mast cells are not involved in a direct vasomotor function. It is suggested that amines released from the mastocytes could regulate blood flow in the vasa vasorum and/or have a role associated with the sensory functions displayed by this vein. PMID- 3532720 TI - Phospholipase inhibition and prostacyclin generation by gastric muscularis and mucosa layers. AB - The effects of drugs which interfere with arachidonate metabolism as well as glucocorticoid-induced anti-phospholipase proteins (APP) have been studied on PGI2 generation by rat stomach tissue. Indomethacin inhibited PGI2 generation both in vitro and ex vivo while dexamethasone was ineffective in both instances. APP inhibited PGI2 generation in vitro. The results are discussed in the light of the possible mode of action of glucocorticoids. Prostacyclin (PGI2) is the major cyclo oxygenase metabolite in the rat gastric mucosa and exerts gastroprotective actions. Therefore a correlation between the inhibition of PGI2 synthesis and the induction of gastric damage has been suggested for the non-steroidal anti inflammatory drugs. Glucocorticoids inhibit phospholipase A2 (PLA2) by inducing in the target cells the synthesis of inhibitory proteins, the lipocortins, and consequently reduce the release of eicosanoids in a number of cells and tissues. However, there is a surprising paucity of information on the effect of glucocorticoids on arachidonic acid (AA) metabolism in the gastro-intestinal tract. Moreover, the relationship between steroid administration and gastric damage is still controversial. The present work was undertaken to investigate the effect of drugs which interfere with AA metabolism on the synthesis of PGI2 by rat stomach mucosa and by the underlying muscularis layer both in vitro and ex vivo. PMID- 3532723 TI - [Diagnosis of neonatal chlamydial infection by fluorescent antibody technique and its treatment with a new quinoline derivative]. PMID- 3532722 TI - Prostanoid mediated effects of centchroman, a non-steroidal oral contraceptive. AB - The effect of centchroman, a non-steroidal oral contraceptive, has been studied on platelet aggregation and on the products of arachidonate metabolism. Centchroman inhibited platelet aggregation in vitro and ex vivo after acute as well as chronic treatment for one year in laboratory animals. It did not affect aggregation of platelets in women taking centchroman for one year. It is an inhibitor of platelet cyclooxygenase as indicated by the inhibition of malonaldehyde and thromboxane B2 but has no effect on vascular cyclooxygenase activity ex vivo or at low concentration in vitro. Thus, centchroman is a safe antifertility agent without risk of thrombotic episodes associated with hormonal oral contraceptives. PMID- 3532721 TI - Blood platelets in human essential hypertension. AB - Blood platelets of patients with essential hypertension display signs of both increased sensitivity in vitro to aggregating stimuli believed to contribute to thrombosis and of activation in vivo possibly expressing the release of vasoactive products. The mean features of the modified platelet profile in hypertension include an increased alpha 2-adrenergic receptor density, an enhanced rate of adhesion/aggregation in particular in response to ADP and arachidonic acid, a greater sensitivity for thrombin and adrenaline to stimulate increases in cytoplasmic-free Ca2+, increased resting levels of cytoplasmatic free Ca2+, a reduced content of serotonin often combined with a defective uptake mechanism, a facilitated efflux rate of noradrenaline, an exaggerated release reaction in vivo as indicated by the increased plasma levels of Beta thromboglobulin and a shortened platelet life span. These changes occur to various extents in some, but not all, hypertensive patients and are not always strictly related to the degree of blood pressure increase. On the contrary, platelet cyclooxygenase and thromboxane synthetase activity are in the normal range. PMID- 3532724 TI - [Chemotactic factor to polymorphonuclear leucocytes in the human lens. 6. Chemotactic factor in low molecular weight fractions]. PMID- 3532725 TI - [Two cases of testicular torsion diagnosed by the ultrasonic Doppler method]. AB - Two cases of testicular torsion diagnosed with ultrasonic Doppler method are reported. Case 1. A 17-year-old male noticed pain and swelling of the right intrascrotal contents during sleeping and visited our clinic. A Doppler signal was obtained from the normal testicle, but not from the affected one. Bilateral orchiopexy was therefore done under the diagnosis of right testicular torsion. Case 2. A 20-year-old male visited our clinic with complaints of pain and swelling of the right intrascrotal contents. The ultrasonic Doppler method revealed no blood flow to the right testicle. After manual detorsion, pain improved and Doppler sound was audible. Bilateral prophylactic orchiopexy was performed later. PMID- 3532726 TI - [Clinical effects of oxybutynin hydrochloride on neurogenic bladder]. AB - Clinical effects of oxybutynin hydrochloride on lower urinary tract function at a dosage of 2 mg given orally three times daily (6 mg/day), were studied on 10 patients with neurogenic bladder by cystometry and measurement of residual urine. There was a significant increase, of about 34% in FDV, but no significant changes in MBV, or maximum voiding pressure of residual urine after administration. Urinary frequency, incontinence and urgency in subjective symptoms were decreased in patients given this drug. The effective rate (excellent and good) was 50% in global evaluation. Side effects were observed in 4 out of 10 patients; 3 had dry mouth and 1 had diarrhea. There were no serious side effects. These findings suggested that oxybutynin hydrochloride may be a useful drug for neurogenic bladder. PMID- 3532727 TI - Clinical experiences with Domosedan in horses and cattle. A review. PMID- 3532728 TI - MR evaluation of the portal vein in pediatric liver transplant candidates. AB - Nine pediatric liver transplant candidates underwent preoperative MR evaluation of the portal vein and the inferior vena cava. Sonographic correlation was available in all patients and angiographic correlation was available in five. Pathologic correlation was obtained in seven cases either at liver transplantation or autopsy. MR demonstrated portal vein patency in three cases when it was not seen by angiography and confirmed portal vein patency in one patient when it was questionably identified on sonography. The portal vein was not seen on MR imaging in two cases when it was seen on sonography and angiography: in one case, it was small and to-and-fro flow was demonstrated angiographically; in the second case, the portal vein was occluded by tumor thrombus. Two vessels in two patients were misidentified by sonography and identified correctly by MR. These were an azygous continuation of the inferior vena cava and a large collateral vein in the portal region. Knowledge of the anatomy and documentation of vascular patency are essential in evaluation of patients before liver transplantation. In patients with complex anatomy or hemodynamics, it may be necessary to obtain this information from several imaging techniques (sonography, angiography, and MR). PMID- 3532730 TI - Congenital urethral polyp. PMID- 3532729 TI - Mesenchymal hamartomas of the liver in childhood: sonographic and CT findings. AB - Mesenchymal hamartomas of the liver usually present within the first 2 years of life. Abdominal enlargement and respiratory distress are the most common presenting features. Pathologically, the lesion is composed of large cysts separated by septations. Review of sonograms and CT scans in nine patients shows that a large, predominantly cystic mass with internal septae is characteristic of the tumor. Angiography shows peripheral hypervascularity with a septated avascular center. A confident preoperative diagnosis of mesenchymal hamartoma based on these features is possible. PMID- 3532731 TI - Sonographic findings in abdominal pregnancy. AB - The sonograms of 20 proven cases of abdominal pregnancy were evaluated to determine the frequency of specific abnormalities associated with this condition. The most frequent and reliable finding was separation of the uterus from the fetus (90%). Extrauterine placenta (75%) and oligohydramnios (45%) were next in frequency. Other features such as fetal parts close to the maternal abdominal wall (25%), failure to visualize myometrium between the fetus or placenta and maternal bladder (15%), abnormal fetal lie (25%), poor visualization of the placenta (25%), and maternal bowel gas impeding fetal visualization (25%) were noted. PMID- 3532732 TI - CT of fibrous tissues and tumors with sonographic correlation. AB - Fibrous tissues and tumors may appear hyperdense relative to muscles and solid viscera on CT both before and after IV contrast injection. In addition, fibrous tissues generally have a homogeneously hypoechoic sonographic appearance. The diagnostic value of these criteria is illustrated in a group of 21 fibrous tissue abnormalities that includes retroperitoneal, mediastinal, and perigraft fibrosis, sclerosing pseudotumor of the orbit, generalized fibromatosis, desmoids, malignant fibrous histiocytoma, and normal tendons and ligaments. It is concluded that while hyperdensity on CT and echopenia on sonography are not pathognomonic of fibrous tissue, they occur with sufficient frequency that their presence raises the possibility of a fibrous lesion. PMID- 3532733 TI - Pseudotumor of the quadrate lobe in hepatic sonography: a sign of generalized fatty infiltration. AB - Sonograms of 43 patients demonstrated a focal area of decreased echogenicity in the medial segment of the left hepatic lobe (quadrate lobe). The shape ranged from ovoid to sheetlike, and the diameter ranged from 0.7 to 8.6 cm. The echogenicity of the right hepatic lobe was abnormally increased in 34 of 37 scans graded. In 20 patients with follow-up sonograms, 11 showed no change, six disappeared and three decreased in size. In 12 patients with unenhanced CT scans, 10 had decreased attenuation of the hepatic parenchyma and normal attenuation in the observed quadrate lobe focus. The hypoechoic focus in the quadrate lobe represents focal sparing in generalized fatty infiltration of the liver. When present, this focus represents a useful qualitative sign of generalized fatty infiltration in the rest of the liver. PMID- 3532734 TI - Retractile mesenteritis involving the colon: barium enema, sonographic, and CT findings. AB - Retractile mesenteritis is a rare disorder characterized by either focal or diffuse thickening of the mesentery due to chronic inflammation and fibrosis. Six cases are reported in which stenosis of the colon, an uncommon complication of retractile mesenteritis, was the predominant radiologic finding. Diagnosis was suggested by the tapered, serrated appearance of the stenotic segment on barium enema complemented by the findings on sonography and CT. PMID- 3532735 TI - MR imaging of renal transplants. AB - Fifty-six MR studies were obtained in 32 renal transplant patients, by using T1 weighted, spin-echo, and inversion-recovery pulse sequences. The findings, particularly the loss of corticomedullary differentiation, and the extent of vascular penetration into the renal parenchyma, were compared with the clinical and histologic diagnosis of transplant rejection. Thirteen MR studies on 11 patients with clinically normal renal transplants demonstrated normal corticomedullary differentiation. Renal vessels extended into the parenchyma in all 11 patients and to the cortex in 38%. In 37 MR studies on 22 patients with a clinical or histologic diagnosis of acute and/or chronic transplant rejection, the corticomedullary differentiation was normal in 8%, faint in 24%, and absent in 68%. Renal parenchymal vessels were visualized in 32%, but extended to the level of the cortex in only 8%. In 68% of the studies with transplant rejection, no parenchymal vessels were seen. When the corticomedullary differentiation was either faint or absent, the vascular pattern was normal in 6%; in 68% of cases no parenchymal vessels could be identified. We conclude the corticomedullary differentiation and the renal vascular pattern are useful parameters in the evaluation of renal transplant rejection. PMID- 3532736 TI - Differential diagnosis of renal transplant rejection: is MR imaging the answer? PMID- 3532737 TI - CT changes in dementing diseases: a review. AB - The present review describes the primary CT features of a variety of dementing disorders. An understanding of the differential neuropathologic and CT changes occurring in dementing illnesses can greatly increase the diagnostic utility of CT. CT is valuable not only in diagnosing space-occupying lesions but also in recognizing numerous degenerative brain diseases. PMID- 3532738 TI - MR and CT of occult vascular malformations of the brain. AB - The need for improved specificity in the diagnosis of "occult" vascular malformations led to the use of MR in suspected cases in order to determine MR's potential for improved diagnostic accuracy. Six patients with six lesions histologically diagnosed as vascular malformation after partial (1) or complete (5) microsurgical excision were studied by CT, MR, and selective magnification subtraction angiography. In all cases, the cerebral lesions were apparently solitary and were visible as focal lesions on both CT and MR. Since angiography failed to reveal the pathologic blood vessels of the lesions, and no arteriovenous shunting was evident, these lesions were termed vascular malformations occult to angiography (VMOTA). Angiography revealed a mass effect in only two cases. MR did not reveal additional vascular malformations missed by CT. In each case, MR, which was performed in an attempt to support the diagnosis suggested by CT, did in fact do so by revealing signal abnormalities indicative of nonacute hemorrhage within the lesion on T1- and T2-weighted pulse sequences. Although, as on CT, MR features of these lesions were found to be nonspecific, the MR criteria reinforced the probable diagnosis of VMOTA in an additional 30 cases that had shown similar nonspecific CT features. In this second group, excluded from this study, in which histologic verification was not obtained because of perceived hazards of surgery, the increased assurance regarding the diagnosis led to proton-beam therapy without histologic verification in 18 cases. It is concluded that MR can provide significant improvement in the accuracy of diagnosing VMOTA beyond that obtainable just by plain and contrast-enhanced CT. PMID- 3532739 TI - Nonsteroidal anti-inflammatory agents: an update. AB - Nonsteroidal anti-inflammatory drugs (NSAIDs) provide potent analgesic, anti inflammatory activity as a result of their inhibition of prostaglandin synthesis. They are highly bound to plasma proteins and have half-lives that vary from two hours to more than 24 hours. While gastrointestinal reactions are well known, the renal and hepatic toxicities of NSAIDs have only recently been characterized. Elderly patients in general may be at risk of toxicity and should be evaluated frequently. PMID- 3532740 TI - Management of transient ischemic attacks. PMID- 3532741 TI - Biophysical profile for antepartum fetal assessment. AB - The biophysical profile assesses fetal well-being by evaluating five variables: fetal heart rate reactivity, breathing movements, gross body movements, muscular tone and qualitative amniotic fluid volume. These are estimated through nonstress test monitoring and fetal ultrasound. The biophysical profile reduces the high false-positive rate that is characteristic of single-parameter testing methods, and it can be helpful in monitoring high-risk pregnancies. PMID- 3532742 TI - Effects of early intracoronary streptokinase on infarct size estimated from cumulative enzyme release and on enzyme release rate: a randomized trial of 533 patients with acute myocardial infarction. AB - The effects of early intracoronary streptokinase (SK) on enzymatic infarct size and rate of enzyme release were studied in a randomized multicenter trial. A total of 533 patients with acute myocardial infarction (AMI) were allocated to either the SK treatment group (n = 269) or the conventional (control) treatment group (n = 264). Enzymatic infarct size was represented by the cumulative quantity of alpha-hydroxybutyrate dehydrogenase (HBDH) released by the heart per liter of plasma in the first 72 hours. Rate of enzyme release was represented by the ratio of HBDH quantities released in 24 hours and 72 hours. On an "intention to treat" basis, the SK group had a smaller (by 30%; p = 0.0001) median enzymatic infarct size and a higher (by 35%; p = 0.0001) median rate of enzyme release than the control group. Limitation of infarct size was less apparent in patients treated with intracoronary SK only (25%) than in patients treated with intravenous plus intracoronary SK (34%). Compared to the control group, the enzyme release rate in patients treated with intracoronary SK only was slightly less (34%) than that in patients treated with intravenous plus intracoronary SK (38%). Patients with a patent infarct-related coronary artery at acute angiography had a median infarct size which was 55% (p = 0.0001) smaller than the median infarct size of the control group, and the median rate of enzyme release was 38% (p = 0.001) higher than the median release rate of the control group. Patients with successful recanalization during intracoronary SK infusion had a median infarct size which was 31% (p = 0.002) smaller than the median infarct size of the control group and a median rate of enzyme release which was 42% (p = 0.0001) higher than the median release rate of the control group. Patients with persistent coronary occlusion in spite of thrombolytic therapy had a median infarct size which was 11% (NS) higher than the median infarct size of the control group, although the median rate of enzyme release was still 23% (p = 0.02) higher than the median release rate of the control group. It is concluded that thrombolysis in the early phase of AMI limits infarct size and that intracoronary SK treatment itself accelerates the process of enzyme release from infarcted myocardium, independent of the angiographic result. PMID- 3532743 TI - Development of an experimental model of acute myocardial infarction and the effects of a thromboxane synthetase inhibitor (OKY-046). AB - An experimental model of acute myocardial infarction is presented. Intracoronary thrombus was precipitated by a mock ruptured atheromatous plaque, which is a cholesterol-collagen mixture, protruding into the stenosed left anterior descending coronary artery. Twenty-five dogs, divided into two groups, were studied: a control group of 15 dogs and a treated group of 10 dogs. Intracoronary thrombus was precipitated by the mock atheromatous plaque in 13 of 15 control animals. Myocardial infarction was induced in 10 and sudden death in two. Coronary blood flow decreased gradually or cyclically to end in myocardial infarction. The model was utilized to investigate the effects of a thromboxane synthetase inhibitor, OKY-046, on 10 additional animals. OKY-046 could significantly decrease the incidence of occlusive thrombus formation and myocardial infarction when administered intravenously during coronary blood flow reduction (3 of 10 in the treated group vs 12 of 15 in the control group, p less than 0.02). Thromboxane B2 was significantly elevated in the coronary venous blood during reduction of the coronary blood flow, while thromboxane B2 was reduced and 6-ketoprostaglandin F1 alpha increased during OKY-046 administration. The reduction in thromboxane A2 production associated with increased prostacyclin appeared to be the major mechanism of the interruption of the thrombus formation by OKY-046. PMID- 3532744 TI - Overall and coronary heart disease mortality rates in relation to major risk factors in 325,348 men screened for the MRFIT. Multiple Risk Factor Intervention Trial. AB - The influence of risk factors on CHD and all-cause mortality rates in 35- to 57 year-old men is examined by means of data on 325,348 white men who were screened for the MRFIT. This large data set permits an unusually detailed analysis of factors associated with the 6968 deaths, including 2426 ascribed to CHD, that were detected in the Social Security Administration data set during 6 years of follow-up. Simple cross classification of the data confirms the independent effect of serum cholesterol concentration, diastolic blood pressure, and cigarette smoking as risk factors for CHD and all-cause mortality rates. A distinct escalation of risk is noted for combinations of these risk factors. The strength of the association of each of the risk factors with CHD and all-cause mortality rates diminished with increasing age, although the number of excess deaths attributable to the risk factors increased because of the higher death rates in older men. Comparison of these findings with those observed in the five populations studied in the Pooling Project revealed an overall similarity in the risk relationships. It is estimated that elimination of these risk factors has the potential for reducing the CHD mortality rate by two thirds in 35- to 45-year old men, and by one half in 46- to 57-year-old men. PMID- 3532745 TI - The sympathetic nervous system in essential hypertension. AB - Enhanced activity of the sympathetic nervous system (SNS) could contribute to essential hypertension (EH). Results of over 80 studies measuring norepinephrine (NE) in EH patients show that only a minority of younger EH patients have elevated plasma NE. Younger EH patients also have increased renal NE spillover and elevated 24-hour NE levels. Another method to evaluate SNS in EH patients is examination of depressor responses to SNS blocking agents. The level of plasma NE predicts the degree of depressor response after acute clonidine administration in EH patients, suggesting increased SNS outflow in EH. Stimulation of SNS activity by stress, isometric exercise, or tilt table shows exaggerated NE responses in EH patients and young normotensive individuals from hypertensive-prone families. EH patients with high plasma NE tend to be younger, thinner, have higher pulse rates, greater cardiac indices, accentuated depressor responses to SNS inhibition, and blunted baroreflex sensitivity. Patients with EH also display enhanced vascular reactivity to infused NE despite high plasma NE, which should normally blunt vascular reactivity. Baroreceptors modulate blood pressure increases through central inhibition of SNS outflow. EH patients display diminished baroreceptor control early in the development of EH, as seen in younger patients with borderline or mild EH. However, most evidence indicates that baroreflex abnormalities in EH are a secondary event. Elevations of plasma epinephrine (E) are also seen in EH. Stress in EH subjects causes increases in plasma E, accompanied by sodium retention and enhanced vascular reactivity. Stress-induced increases in plasma E may result in prejunctional uptake of E in nerve terminals with release of E as a cotransmitter with NE--i.e., facilitation of NE release leading to postjunctional vasoconstriction and hypertension. Another catecholamine product of SNS activity, dopamine (DA), may contribute to EH by its effects on aldosterone and sodium excretion. DA inhibits aldosterone secretion and enhances sodium excretion. Studies in EH patients show reduced urinary-free DA responses to salt loading. This suggests an intrinsic deficiency of DA-modulated natriuretic mechanisms in EH. PMID- 3532746 TI - Heterogeneous pathophysiology of essential hypertension: implications for therapy. PMID- 3532747 TI - Efficacy of clonidine as transdermal therapeutic system: the international clinical trial experience. AB - Worldwide clinical trial data concerning the pharmacokinetic and pharmacodynamic characteristics of the clonidine transdermal therapeutic system (TTS) are reviewed with reference to its antihypertensive efficacy. The amount of clonidine delivered to the systemic circulation is a direct function of TTS size. After initial patch application, there is a delay of 2 to 3 days before the onset of action, but after removal of the patch, plasma clonidine levels decline slowly, at an elimination half-life of about 20 hours. Evaluation in approximately 2000 patients with mild to moderate hypertension has shown that the bioavailability of transdermal clonidine is comparable to that of oral clonidine and that equivalent blood pressure reductions are achieved. The rate at which dose increases were found necessary to maintain adequate blood pressure control over extended periods reflects a low incidence of tolerance to this new once-a-week dosage form of clonidine, and there has been little evidence of rebound hypertension after discontinuation of TTS treatment. PMID- 3532748 TI - The mutagenicity of emissions from eight binder systems used in steel foundries. AB - Emissions generated when molten steel was poured into sand molds fabricated with eight different binder systems were collected separately and tested for mutagenic activity using the Ames Salmonella assay. The sampling device consisted of an initial 8 X 10 in. glass fiber filter in a custom fabricated apparatus through which air was drawn using a Hi-Vol motor and fan. A portion of the airstream, which passed this filter, was in turn passed through a smaller glass fiber filter and then into two glass impingers filled with ice-cold methanol. All the binder systems generated material, which induced mutations in the absence of added S-9 extract, and in all emissions a higher level of activity was found when S-9 was added. In the presence of S-9, the shell-core system produced by far the most mutagenic activity followed by the oil-clay-cereal system. The green sand, furan and Kold Set systems produced much lower levels while the two reclaimed sand systems and sodium silicate system were intermediate. PMID- 3532749 TI - Comparison and additivity of nitrendipine and hydrochlorothiazide in systemic hypertension. AB - Calcium channel blockers are highly effective antihypertensive agents and provide a good alternative to other medications used as initial or monotherapy. Although the calcium channel blockers act as peripheral vasodilators, they are unique among this group of drugs in lowering blood pressure in a sustained manner; several compensatory mechanisms are inhibited by virtue of either direct or indirect effects of these agents. In recent years, hypertension has generally been treated with a step-care approach, the limitations of which are now becoming apparent. Today, 4 classes of agents are effective and well tolerated as single therapy and might therefore be considered as first-line drug therapy: diuretics, beta blockers, converting enzyme inhibitors and calcium channel blockers. Preliminary results from an ongoing double-blind randomized trial comparing nitrendipine (a calcium channel blocker) and hydrochlorothiazide (a diuretic) in mild to moderate hypertension will be presented. Results from 63 patients showed the 2 agents to be equivalent in antihypertensive effects and in frequency of adverse reactions. Other data indicate that when nitrendipine and hydrochlorothiazide were combined, a further decrease in blood pressure was observed. Patient characteristics affecting drug choice and clinical situations in which calcium channel blockers can be used most effectively can now often be delineated. PMID- 3532750 TI - Implications of recent clinical trials in systemic hypertension. Results of a multicenter trial of nitrendipine, for mild to moderately severe systemic hypertension. AB - Results of the European Working Party group study and the Medical Research Council clinical trial in mild hypertension have important implications for the practicing physician. They appear to confirm 2 previous impressions. The first is that therapy for elderly patients with both systolic and diastolic hypertension is beneficial; cardiovascular mortality can be reduced by lowering blood pressure. These data are consistent with the findings in the 60- to 69-year-old cohort in the Hypertension Detection and Follow-up Program study in the US. The second is that specific treatment with antihypertensive agents in patients with mild hypertension will decrease overall cardiovascular mortality compared with placebo treatment. The approach to treatment in both of these studies was relatively simple, using a diuretic as step 1 therapy in the European study, and either a diuretic or a beta-adrenergic inhibiting agent in the Medical Research Council study. These data provide further evidence for the benefits of treatment of hypertension. PMID- 3532751 TI - Current therapy, present limitations and future goals for systemic hypertension. AB - During the past 2 decades, encouraging strides have been made in the recognition and treatment of patients with high blood pressure and in the development of antihypertensive therapy. Concerns surrounding the control of hypertension, however, continue to emerge. As many as two-thirds of hypertensive patients in the US remain inadequately controlled. Although overall cardiovascular mortality has declined since the mid- 1960s, a significant impact of antihypertensive therapy on coronary artery disease morbidity and mortality has not been conclusively demonstrated. Unfavorable metabolic effects associated with traditional step-care antihypertensive therapy with diuretics and beta blockers are increasingly implicated for failure to demonstrate a decrease in coronary artery disease. The availability of newer efficacious antihypertensive therapy that does not adversely affect metabolic parameters is resulting in a reappraisal of traditional step-care. Of particular interest are the calcium channel blockers, because they are efficacious, well tolerated and offer favorable metabolic and hemodynamic profiles. Nitrendipine is a new long-acting member of the 1,4 dihydropyridine class of calcium channel blockers that has shown encouraging results for treatment of hypertension. PMID- 3532752 TI - Comparison of nitrendipine with propranolol and its use in combined cardiovascular therapy. AB - New antihypertensive agents with favorable hemodynamic and metabolic profiles have resulted in reappraisal of traditional step-care therapy using diuretics and beta blockers. Calcium channel blockers are among the new antihypertensive agents that offer better hemodynamic effect compared with beta blockers, and they do not have unwanted metabolic effects as do diuretics. Calcium channel blockers, such as nitrendipine, are effective as monotherapy and in combination with other antihypertensive agents, and are particularly useful in elderly, black and low renin patients. Preliminary results from a multicenter, double-blind, randomized, parallel study comparing nitrendipine with propranolol in patients over 40 demonstrate similar blood pressure-lowering effectiveness; however, propranolol was associated with a higher incidence of side effects and study withdrawals. In a second study, addition of propranolol to nitrendipine monotherapy produced a further decrease in blood pressure that was sustained over the year of study. These data suggest that nitrendipine provides additional effective and safe antihypertensive therapy, which can be used in place of or in combination with beta blockers. PMID- 3532753 TI - Videodensitometric quantitation of aortic regurgitation by digital subtraction aortography using a computer-based method analyzing time-density curves. AB - To assess the clinical role of computer analysis of time-density curves in the evaluation of aortic regurgitation (AR), digital subtraction aortography (DSA) and cineaortography were performed sequentially in 17 patients with varying degrees of AR (1+ to 4+) and in 4 control patients. DSA was performed at a rate of 30 frames/s on a 512 X 512 X 8 bit pixel matrix using the same total volume and injection rate, but with half the amount of contrast agent as standard cineaortography. A 30 X 30 pixel area of interest was identified in the aorta above the valve plane and in the left ventricle where the AR stream was seen. The density of both areas of interest and the ratio of left ventricular/aortic area of interest density was calculated in each frame and then plotted vs time. The ratio at the end of injection (LVd/Aod) had an excellent correlation with cineaortography (chi 2 = 19, p less than 0.001), ranging from 0 to 0.2 in patients with no AR, 0.2 to 0.5 in those with 1+ AR, 0.5 to 0.7 in those with 2+ AR, 0.7 to 0.9 in those with 3+ AR and more than 0.9 in those with 4+ AR. Thus, quantitative assessment of AR by computer analysis of time-density curves derived from DSA is a new and objective technique with significant clinical potential. PMID- 3532754 TI - Noninvasive assessment of left ventricular diastolic function: comparative analysis of pulsed Doppler ultrasound and digitized M-mode echocardiography. AB - The relation between Doppler and digitized M-mode echocardiographic indexes of left ventricular (LV) diastolic function was analyzed. Diastolic variables obtained with these 2 techniques were compared in 19 normal volunteers and in 25 patients with a variety of cardiac diseases. The 2 techniques were in agreement in distinguishing normal from abnormal diastolic function in 20 of the 25 patients (80%) with cardiac disease. Furthermore, a close linear relation with a high correlation coefficient and a small standard error of the estimate was identified between measurements of isovolumic relaxation determined by Doppler and by M-mode echocardiography (r = 0.82, standard error of the estimate = 18 ms). Doppler indexes of diastolic filling such as the slope (descent) and the duration of the early diastolic flow-velocity peak did not show a close correlation with the peak rate and the time to peak rate of increase in LV internal dimension determined by digitized echocardiography. Thus, Doppler and digitized echocardiography were consistent in distinguishing normal from abnormal diastolic function in most of the study patients, although specific variables of LV ventricular filling determined by the 2 techniques were not closely related. In addition, Doppler and M-mode echocardiographic measurements of isovolumic relaxation showed an excellent correlation. PMID- 3532755 TI - From irritable heart to mitral valve prolapse--World War I, the British experience and Thomas Lewis. PMID- 3532756 TI - Dietary and other correlates of changes in total and low density lipoprotein cholesterol in hypercholesterolemic men: the lipid research clinics coronary primary prevention trial. AB - Correlates of changes in total (TOTAL-C) and low density lipoprotein cholesterol (LDL-C) were examined in the 3806 hypercholesterolemic men of the Lipid Research Clinics Coronary Primary Prevention Trial. These correlates included changes in weight, dietary and alcohol intake, plasma glucose and thyroxine, cigarette smoking, packet count, lipid-lowering drugs other than cholestyramine, and antihypertensive drugs. In both placebo plus diet and cholestyramine plus diet treatment groups, decreases in Quetelet index and in saturated fat and cholesterol intake and increases in polyunsaturated fat intake were consistently associated with reductions in TOTAL-C and in LDL-C. In the cholestyramine group, plasma glucose and smoking were predictors of increased TOTAL-C and LDL-C; age and packet count were predictors of decreased TOTAL-C and LDL-C. Diuretic use was associated with increases in TOTAL-C in both groups and with increases in LDL-C in the cholestyramine group. PMID- 3532758 TI - The marginal zone in the human reactive lymph node. AB - The presence and localization of the marginal zone (MZ) in the human lymph node is controversial. The authors analyzed the distribution of sIgM+sIgD- MZ lymphocytes (MZL) expressing alkaline phosphatase (ALP) activity in a series of reactive lymph nodes and spleens with the use of immuno- and enzymehistochemistry, and a combination of both technics. MZL were found scattered in lymphocytic coronas composed of densely packed, small, round lymphocytes. In the lymphocytic coronas showing prominent zonal layering into an inner, densely packed rim and outer, loosely arranged rim, the latter area proved to be composed of sIgM+sIgD-ALP+ MZL, in contrast to the inner rim, which was composed of sIgM+sIgD+ALP- small, round lymphocytes. It is concluded that the human reactive lymph node, like the spleen, contains MZL. These MZL apparently belong to a dynamic B-cell compartment, the morphologic expression of which may vary from scattered singular cells hidden in the lymphocytic corona to a clearly recognizable peripheral rim of medium-sized lymphoid cells. PMID- 3532757 TI - Thermic effect of medium-chain and long-chain triglycerides in man. AB - The thermic effects of 400 kcal meals of medium-chain triglycerides (MCT) and long-chain triglycerides (LCT) were compared in seven healthy men. Metabolic rate was measured before the meals and for 6 h after the meals by indirect calorimetry. Mean postprandial oxygen consumption was 12% higher than basal oxygen consumption after the MCT meal but was only 4% higher than the basal oxygen consumption after the LCT meal. There was a 25-fold increase in plasma beta-hydroxybutyrate concentration and a slight increase in serum insulin concentration after MCT ingestion but not after LCT ingestion. Plasma triglyceride concentrations increased 68% after the LCT meal and did not change after the MCT meal. These data raise the possibility that long-term substitution of MCT for LCT would produce weight loss if energy intake remained constant. PMID- 3532759 TI - Comparison of two rapid latex agglutination methods for detection of group A streptococcal pharyngitis. AB - Throat swabs from 404 patients with suspected pharyngitis were collected using duplicate swabs. Both swabs were used to inoculate 5% sheep blood agar plates, which were incubated in an anaerobic atmosphere for the isolation of Group A streptococci. The throat swabs were tested for the presence of Group A antigen using the Culturette Brand 10-Minute Group A Strep ID kit (Marion Scientific, Kansas City, MO), and the Direct Antigen Identification D.A.I. Strep A Test (Difco Laboratories, Inc., Detroit, MI). We found that 77 of the 404 specimens were culture positive for Group A streptococci. The Strep ID kit had a sensitivity of 83.7% and a specificity of 91.6%. The positive and negative predictive values were 72% and 95.6%, respectively. The D.A.I. test had a sensitivity of 80.2% and a specificity of 100%. The positive and negative predictive values were 100% and 94.5%, respectively. There was not a significant difference in the sensitivity of the two kits (P less than 0.1), but there was a significant difference in the specificity (P less than 0.01). PMID- 3532760 TI - Is cardiac transplantation in children an experimental procedure? PMID- 3532761 TI - Intraventricular hemorrhage in extremely small premature infants. AB - The incidence, timing, severity, and outcome of intraventricular hemorrhage (IVH) were studied in extremely small premature infants with birth weights (BWs) between 500 and 700 g; 366 infants with BWs between 701 and 1500 g, admitted during the same period, served as a comparison group. Intraventricular hemorrhage occurred in 34 (62%) of 55 infants with BWs less than 700 g vs 91 (25%) of the 366 comparison infants. In the group with BWs less than 700 g, IVH occurred in the first 18 hours, from 19 to 72 hours, and after 72 hours of life in 62%, 20%, and 18% of the infants, respectively. In the comparison group, the occurrence for these periods was 13%, 82%, and 5%, respectively. The severity of IVH in infants with BWs less than 700 g was grade III (with or without intraparenchymal hemorrhage) in 97% of the lesions, but in the comparison group such severe IVH accounted for only 32% of the lesions. Intraventricular hemorrhage was a common contributor to death in the infants with BWs less than 700 g. Thus, in 24 infants who died before 72 hours of life, 21 infants (88%) had severe IVH. In addition, intracranial hemorrhage (four infants with IVH and two infants with intracerebellar hemorrhage) occurred late (days 8 to 25) and contributed to death in six of the infants with BWs less than 700 g. These data indicate that in comparison with larger premature infants, infants with BWs less than 700 g exhibit a higher incidence of IVH, which is more severe, occurs earlier, and is associated more often with a fatal outcome. In addition, late and lethal intracranial hemorrhage is also more likely to occur in these smaller infants. PMID- 3532762 TI - Perinatal factors and periventricular-intraventricular hemorrhage in preterm infants. AB - We studied 49 consecutively admitted infants of less than 34 weeks' gestation to analyze the role of several maternal, intrapartum, and neonatal factors associated with the occurrence of periventricular-intraventricular hemorrhage (PIVH). To detect PIVH, ultrasound studies were performed every eight hours during the first three days of life and every 12 hours during the following four days. In 20 infants (41%) PIVH was detected. Of these 20 cases, 30% were diagnosed immediately after birth and 55%, 70%, 90%, and 100% after 24, 48, 72, and 108 hours, respectively. Hypoxia, hypercapnia, and acidosis were the most important factors associated with the development of PIVH. Hypothermia was also an antecedent. Suctioning, serum osmolality, weight loss, transfusions, pneumothorax, patent ductus arteriosus, and bolus infusions with sodium bicarbonate were not associated with the onset of PIVH. PMID- 3532763 TI - Pneumococcal carriage and type-specific antibody. Failure of a 14-valent vaccine to reduce carriage in healthy children. AB - No consistent effect on nasal carriage rates of Streptococcus pneumoniae belonging to vaccine types was observed during a randomized, controlled trial of a 14-valent pneumococcal vaccine, which included 1273 Australian children aged 6 to 54 months. Nasal carriage of S pneumoniae was associated with a significantly elevated homotypic serum antibody concentration for types 18C, 19F, and 23F, but not for types 6A and 14 (these five types are the most important causes of pneumococcal infections in children). Upper respiratory tract carriage seems to play an important role in natural acquisition of antibody to some but not all pneumococcal serotypes. These findings help to explain why pneumococcal vaccine fails to protect young children from acute otitis media. PMID- 3532764 TI - Use of a tube spacer to improve the efficacy of a metered-dose inhaler in asthmatic children. AB - Many children with asthma do not use the standard metered-dose inhaler (MDI) skillfully. To improve drug delivery, correct problems of hand-lung incoordination, and reduce local side effects, a number of spacer devices have been developed. We evaluated one such device, a tube spacer (Aerochamber), in 16 asthmatic children (5 to 12 years). On four separate days and in a randomized, double-blind, placebo-controlled manner, they received either metaproterenol sulfate by MDI aerosol (130 micrograms) or placebo with and without the tube spacer. To maximize techniques, at each visit the children had proper instructions, including viewing a videotape. Spirometry was performed at baseline and 5, 15, and 30 minutes, and hourly for six hours, and the patient was monitored. Analysis of the entire group (forced expiratory volume at 1 s and midmaximal expiratory volume) revealed no difference between metaproterenol administered with or without the tube spacer, and both were significantly different than placebo through two hours. Six children had longer and three had better bronchodilatation with the MDI plus tube spacer than with the MDI alone. Side effects and vital signs did not differ between treatments. Under the circumstances of our study, the tube spacer device might enhance the use of the MDI in children who are not properly taught and/or who forget or cannot perform proper technique. PMID- 3532765 TI - The lack of effect of metoclopramide on gallbladder volume and contraction in diabetic cholecystoparesis. AB - Impaired gallbladder contraction has been previously shown in diabetes mellitus. In this study gallbladder contraction was measured by real-time ultrasonography in 20 subjects (eight healthy controls and 12 diabetics) studied twice on 2 consecutive days, before and after intravenous metoclopramide injection. Contraction was expressed by fasting gallbladder volume and residual gallbladder volume after maximal emptying. Fasting volumes were significantly larger in the diabetics (22.4 +/- 2.1 ml) as compared to the controls (16.15 +/- 1.69 ml) (p less than 0.001). Residual volumes were also significantly larger in the diabetics (12.4 +/- 2.09 ml) as compared to the controls (5.6 +/- 0.58 ml) (p less than 0.001). The rate of gallbladder emptying was significantly (p less than 0.001) slower in the diabetics (0.0326 +/- 0.0056) as compared to the controls (0.0498 +/- 0.0066), but no difference could be shown in the diabetics after administration of metoclopramide (0.0368 +/- 0.0048). No difference was found in the diabetic group before and after injection of 10 mg metoclopramide. The results imply that diabetic cholecystoparesis is not entirely related to autonomic neuropathy since it is not corrected by metoclopramide, a known cholinergic stimulant. PMID- 3532766 TI - The logic of Sir Karl Popper and the practice of epidemiology. PMID- 3532767 TI - The effect of misclassification of disease status in follow-up studies: implications for selecting disease classification criteria. AB - For many diseases, a set of diagnostic criteria with perfect sensitivity and specificity does not exist. In the design of a follow-up study of such a disease, one often has a choice between using a set of narrow classification criteria for the disease outcome (i.e., a test with relatively high specificity and relatively low sensitivity) or a broader set of criteria (i.e., a more sensitive, less specific test). A model was investigated which simulated choices one may have between disease classification tests, to determine how the required sample size and bias in the estimates of the risk ratio and risk difference varied between tests. A two-sample study with nondifferential misclassification of disease outcome was assumed. Based on the model, the bias in the risk ratio increases as one increases the sensitivity of the diagnostic test at the expense of specificity. Conversely, the bias in the risk difference decreases with increasing sensitivity and declining specificity. The required sample size is minimized at relatively high sensitivity and relatively low specificity. Selection of the disease classification test as that at which the required sample size is minimized could reduce some of the large data collection costs of follow up studies. The advantages and limitations of applying this technique to actual studies are discussed. PMID- 3532768 TI - Depletion of T lymphocytes from human bone marrow by the use of counterflow elutriation centrifugation. AB - Normal donor bone marrow buffy coat (BMBC) cells were fractionated into three subsets by counterflow elutriation centrifugation. Fraction 1 (Fr-1) was lymphocyte-enriched, fraction 2 (Fr-2) was a mixture of lymphocytes and myelomonocytic cells, and fraction 3 (Fr-3) was enriched for myelomonocytic cells. The extent of T cell depletion was determined by limiting dilution analysis of the growth of T cells. The cells in each group were stimulated with phytohemagglutinin and cultured in the presence of interleukin-2. These conditions allowed clonogenic growth of one of three T cells purified from peripheral blood. After a 3-week culture period, replicate wells were scored for growth and precursor frequency was determined. The frequency of T cells in BMBC was 1/22 (n = 4), 1/16 in FR-1 (n = 4), and 1/246 in Fr-2 (n = 2), and in Fr-3 it ranged from 1/3,000 to 1/10,000 (n = 4). For comparison, depletion of T cells from bone marrow by cytofluorographic sorting with OKT-11 and twice E-rosetting yielded 98.1% and 97.4% removal of T cells, respectively. Thus, the clonogenic assay assured that more than 99.3% of the original T cells were depleted by elutriation; however, hematopoietic progenitor assay (CFU-GM, CFU-GEMM, and BFU E) showed no enrichment in any particular fraction, implying that the progenitors measured in this assay are of diverse sizes. Elutriation represents a useful method for depletion of T cells from human bone marrow. Limiting dilution assay of T cell growth is a sensitive measure to monitor T cell depletion. PMID- 3532769 TI - Sexual dysfunction in the male dialysis patient: pathogenesis, evaluation, and therapy. AB - Impotence is a common problem in male dialysis patients. Although dialysis patients may appear to have more reasons to be depressed than nondialysis patients, depression has not been found to be correlated with erectile dysfunction in this group. Primary testicular failure is common in male dialysis patients as is hyperprolactinemia. These disorders may be the cause of impotence in some of these patients. An algorithm for the evaluation and treatment of impotence in the male dialysis patient is presented. Successful renal transplantation is associated with improvement in the testicular failure, in the hyperprolactinemia, and in the erectile dysfunction of the male patient with end stage renal disease. PMID- 3532770 TI - Living-related kidney donors: a multicenter study of donor education, socioeconomic adjustment, and rehabilitation. AB - To determine the consequences of living-related kidney donation, a study was conducted of 536 donors whose nephrectomies had been performed at nine geographically dispersed centers during the past 12 years. The data demonstrated that greater than 84.0% of the donors thought they had been adequately informed regarding all aspects of donation, and less than 15.0% reported being pressured in their decision. Only two serious medical complications were directly attributable to the surgery, greater than 92.0% of the donors believed their health had not been adversely affected by donation, and 96.8% reaffirmed their decision regardless of the graft's success or the financial distress they experienced (P greater than .05). However, greater than 14.0% experienced direct pressure, particularly not to donate. Donation also appeared to stress previously troubled marriages, especially among donors without a religious affiliation, who were pressured to donate by their families, or who borrowed from family members (P less than .05). Substantial unreimbursed expenses (greater than or equal to $1,000) were incurred by 43 donors, and 23.2% of all donors reported that donation caused a financial hardship. PMID- 3532771 TI - The effect of dialysate calcium levels on blood pressure during hemodialysis. AB - A controlled double-blind prospective study was undertaken of the effect of dialysate calcium levels on BP during hemodialysis. Twenty patients and 240 dialyses were studied using a protocol in which patients underwent alternate hemodialyses with dialysate calcium of 2.5 and 3.5 mEq/L. Dialysate composition was otherwise the same. Mean BPs during dialysis were significantly lower at 1.5, 2.5, and 3.5 hours of dialysis when the lower dialysate calcium was used (P = .007 to .02). However, the difference in BP between the high and low dialysate calcium treatments was clinically minor, with a maximum mean difference (at 1.5 hours) of 4.6 mm Hg. Subgroups of patients with frequent hypotension and low or normal serum calcium did not appear more sensitive to the hypotensive effect of low calcium dialysate. Dialysate calcium levels of 2.5 and 3.5 mEq/L thus differ in their effect on intradialytic BP in a statistically significant, but clinically minor, way. Low calcium dialysate thus may prove useful in the management of patients in whom large amounts of enteric calcium absorption are indicated or unavoidable. PMID- 3532772 TI - A comparison of inpatient and outpatient Medicare allowable charges for continuous ambulatory peritoneal and center hemodialysis patients: a single center study. AB - Medicare allowable charges were compared between 21 continuous ambulatory peritoneal dialysis (CAPD) and 25 center hemodialysis (CHD) patients for the 12 month period from Sept 1982 through Aug 1983 to determine if savings from CAPD therapy were offset by higher hospitalization charges. All adult patients on a single therapy for the 12-month period who were not dialyzed or hospitalized at other institutions were included. The CAPD and CHD patient groups did not differ significantly by age, sex, or incidence of systemic disease. However, the CHD group had significantly more black patients. The primary renal disease, the incidence of diabetes mellitus, and other systemic diseases did not differ between the groups. The number of hospital admissions was similar between the two groups. However, the CHD patients tended to have a higher number of hospital days than the CAPD group (17.5 v 12.4). Although the total hospital charges tended to be higher for CHD ($16,145) than CAPD patients ($9,872), this difference was not significant. Outpatient dialysis charges were significantly less expensive for CAPD ($16,470) than CHD ($28,233). Emergency department charges were also significantly less for the CAPD group. Charges for patients with and without systemic disease were analyzed separately. In both subgroups, all charges were less for CAPD therapy; however, this difference was significant only for outpatient dialysis charges. Total charges for the 12-month period were significantly less for the CAPD group ($26,453) than for CHD ($45,586). This demonstrates that hospitalization charges did not offset the savings of home dialysis in these patients. PMID- 3532773 TI - Idiopathic crescentic membranous glomerulonephritis. AB - A case of idiopathic crescentic membranous glomerulonephritis is reported. In addition to the present case, eight cases of this type of glomerulonephritis reported in the literature are reviewed. This is an uncommon form of glomerulonephritis, seen in middle age and in both sexes. Clinical presentation is similar to idiopathic membranous nephropathy. Lupus and antiglomerular basement membrane nephritis should be excluded by serological tests. Prognosis is grave, resulting in end-stage renal failure (ESRD) within a year in most patients. There is no specific therapy known to alter the course of the disease. In this patient, short courses of high-dose corticosteroids, administered during flares of glomerulonephritis, seemed to improve renal function. PMID- 3532774 TI - Benign intracranial hypertension: a complication of subclavian vein catheterization and arteriovenous fistula. AB - Thrombosis of the right innominate vein occurred in a patient on maintenance hemodialysis following repeated subclavian vein catheterization. The patient had a functional right brachial arteriovenous fistula for blood access that resulted in a massive retrograde blood flow into the cerebral venous system with the development of the benign intracranial hypertension. The symptoms and signs of intracranial hypertension abated following ligation of the arteriovenous fistula. This unusual association of benign intracranial hypertension with an arteriovenous fistula and innominate vein thrombosis has not been reported previously. Pertinent literature dealing with benign intracranial hypertension and complications of subclavian vein catheterization is reviewed. PMID- 3532775 TI - Multipoint mapping studies of the beta-globin, insulin, and c-Ha-ras-1 loci on 11p. PMID- 3532776 TI - Hazardous agents in agricultural dusts and methods of evaluation. AB - Organic dusts in agriculture vary with type of agriculture, weather conditions, geographical location, and agricultural practices. It is difficult to ascribe a specific biological effect to a specific agent in agricultural dusts, and we are only able to develop a list of candidates for disease-causing agents. Future studies should be designed to define more specifically the hazardous agents in agricultural dusts by using more precise analytical techniques and documenting the clinical effects to man, developing dose-response relationships. PMID- 3532777 TI - Strategic planning for clinical services: St. Joseph Hospital and Health Care Center. AB - A pharmacy department at a 340-bed community hospital based its strategic plan for developing patient-oriented services on a sound drug distribution system, a credible work-measurement program, and fiscal responsibility. In 1982 the department of pharmacy and i.v. therapy implemented a strategic plan for improving pharmaceutical services. The plan involved developing goals and objectives for the department; marketing the department's services and fiscal management to hospital administrators, medical staff, and nursing staff; building teamwork among the pharmacy staff; and improving the drug distribution system before instituting clinical services. Hiring of additional pharmacy staff was justified on the basis of work-measurement data. By adjusting staffing levels every two weeks based on work-measurement data, the department increased the efficiency of drug distribution activities; the pharmacy also implemented cost saving programs like selection of therapeutic alternates and formulary restrictions. The savings were then reinvested in labor-intensive patient oriented pharmaceutical services. A staff development program using staff pharmacists as preceptors expanded the breadth and depth of pharmacists' clinical skills. The planning efforts were successful because the needs of hospital administrators, the pharmacy department, and staff members were addressed. PMID- 3532778 TI - Strategic planning for clinical services: the University of Texas M.D. Anderson Hospital and Tumor Institute. AB - A formal, hospitalwide strategic-planning process provides structure for the pharmacy's plans for implementing clinical services. The state-supported clinical cancer and research center began a formal strategic-planning process in 1981. The institution's planning report, prepared every two years and covering three two year periods, drives the institution's budget through the state's biennial budget process. The report focuses on each department's responsibilities, areas of service, and relationship to the mission of the institution. Through the long range planning process, upper-level administrators learned that pharmacy was eager not only to provide high-volume drug distribution services but also to assume direct patient-care and research responsibilities. This prompted an organizational change for pharmacy from a hospital department to a clinical division. The division of pharmacy now consists of three professional departments (patient care, pharmacy research, and pharmacy academic programs) and an administrative support service area. Services offered by each of the three departments are discussed, along with specific initiatives planned for the years 1987-1993. Within the next few years, all managers will come from the ranks of clinical practitioners; nonpharmacists will oversee financial and human resource functions. The division encourages existing pharmacy staff members to enhance their clinical skills through staff development programs. Strategic planning serves the dual purposes of structuring plans for implementing clinical pharmacy services and communicating pharmacy's goals within the institution. PMID- 3532779 TI - Strategic planning for clinical services: panel discussion. AB - A panel of hospital pharmacy managers representing three institutions discussed issues related to planning for patient-oriented pharmacy services. The panelists discussed organizational benefits of strategic planning, ways to gain momentum for change among pharmacy staff members and from others within the institution, the need for setting realistic goals, and problems in differentiating roles for pharmacy staff. They also discussed the funding of strategic-planning programs. The panelists advocated an integrated approach to providing drug distribution and clinical services. Management must provide whatever support is necessary for integrating patient-oriented services into the daily activities of all pharmacists. That support may be in the form of additional personnel, better use of supportive personnel, staff development programs, or automation. Pharmacists, too, must recognize their combined responsibilities for drug distribution and clinical services. Only by having all pharmacists clinically trained can a department provide clinical services when needed. The experiences of these panelists may be useful to other institutions planning patient-oriented pharmacy services. PMID- 3532780 TI - Concepts of illness in populations as applied to fibromyalgia syndromes. AB - Fibromyalgia syndromes are common noninflammatory, painful musculoskeletal disorders that vary in the extent and intensity of involvement. The biologic gradient of musculoskeletal pain varies from no or few symptoms and tender points in the majority of persons to generalized fibromyalgia with multiple tender points. Standardized criteria are needed in order to categorize different strata of the biologic gradient of fibromyalgia syndromes and differentiate them from other conditions. Both the sensitivity and specificity of criteria should be high. The course and prognosis of fibromyalgia syndromes are not yet known. Limited clinical data suggest three basic patterns: remitting-intermittent; fluctuating-continuing; and progressive. However, course patterns need to be derived scientifically. Multiple host and environmental factors seem to contribute to the onset and course of fibromyalgia syndromes, and these require definition. Generalized fibromyalgia syndromes share many constitutional manifestations with other common functional disorders, e.g., irritable bowel syndrome and tension headache syndrome, which suggest common underlying psychoneurophysiologic mechanisms in a subset of patients. Progress made in fibromyalgia research will find application in many dysfunctional syndromes without obvious organ pathology. PMID- 3532781 TI - Tender points: evolution of concepts of the fibrositis/fibromyalgia syndrome. AB - The association of chronic pain, exhaustion, and multiple somatic complaints with apparent physical good health and long survival has a long history. The syndrome was called by many names including neuresthenia, rheumatism, and invalidism. When skeletal pain and stiffness were prominent, many observers recorded the existence of sites of tenderness and sometimes of areas of induration. The work of Lewis and Kellgren provided an experimentally reproducible method of study of the phenomena of referred pain and referred tenderness, which led to hypotheses about the nature of many of these syndromes, which were unfortunately too numerous and often contradictory. More recently, it has been learned that the sites of tenderness are precisely predictable in location and, under some circumstances, experimentally inducible. They are unknown to the patient and, therefore, due to mechanisms other than distortions of interpretation. The association with a variety of forms of sleep disturbance was discovered. These events have permitted the rapid evolution of controlled, numerical studies of these associations, which are reviewed briefly in this article. PMID- 3532782 TI - A critical reappraisal of the fibrositis concept. AB - Physicians could use such terms as "fibrositis" and "the myofascial pain syndrome" simply to describe an easily recognized quality of illness. But the terms are chosen as part of a privileged vocabulary designed to assert a pathophysiologic insight(s). On careful consideration, these insights are tenuous at best. Furthermore, the terms, with their pathophysiologic insights, become labels that may perturb the patient's experience of disease in a fashion that is counterproductive. PMID- 3532783 TI - Immunofluorescent studies of skin in primary fibrositis syndrome. AB - Primary fibrositis syndrome is a painful musculoskeletal disorder of unknown cause. Although numerous hypotheses have been proposed to explain its clinical features, few studies have demonstrated a reproducible tissue abnormality in this condition. Recently, five reports of cutaneous immunoreactant deposition in primary fibrositis syndrome have become available and form the basis of this review. Four of these reports have described immunoglobulin G deposition at the dermal-epidermal junction of sun-exposed skin with a prevalence ranging from 12 to 76 percent. One study reported immunoglobulin M deposition in the dermal vasculature of patients with primary fibrositis syndrome. The reasons for the lack of uniformity in reported prevalence rates and types of skin immunofluorescence in primary fibrositis syndrome are unknown but are assumed to be due to differences in patient populations and immunofluorescence techniques between reporting centers. These factors are discussed in detail and speculations as to the significance of these skin findings are expressed, particularly with respect to the concept of enhanced vascular permeability in these patients. PMID- 3532784 TI - Role of physical fitness training in the fibrositis/fibromyalgia syndrome. AB - Cardiovascular fitness training has been suggested as a treatment for the fibrositis/fibromyalgia syndrome. Thirty-four patients with fibrositis/fibromyalgia who met Smythe's original criteria were randomly assigned to enter either a cardiovascular fitness training program or a program consisting only of flexibility exercises. Patients met in supervised groups three times weekly for a 20-week observation period. The cardiovascular fitness group underwent gradual heart rate-elevated training using a bicycle ergometer and achieved a 29.1 +/- 24.4 percent increase in peak work capacity at 170 beats per minute (PWC-170). Patients undergoing flexibility training had a net reduction in their PWC-170 scores of 4.3 +/- 9.4 percent. Patients in the cardiovascular fitness group had statistically significant improvements in the visual analogue pain scale of current pain intensity; total myalgic scores in which pain thresholds at five fibrositic tender points selected for acceptable intra-rater and inter-rater reliability were measured using a dolorimeter; percentage total body area affected as measured by self-administered pain diagrams; and patients' and physicians' global assessment scores. Psychologic profiles as measured by Symptom Checklist-90R also improved in the cardiovascular fitness group compared with the flexibility training group. It is concluded that cardiovascular fitness training is feasible in patients with fibrositis/fibromyalgia and that such training improves subjective measurements of pain-reporting behavior. A theoretic basis for improvements in pain measurement scales and psychologic profiles is discussed in light of recent literature. PMID- 3532785 TI - Development of criteria for the diagnosis of fibrositis. AB - The essential symptoms of fibrositis--widespread aching and pain, disturbed sleep, morning stiffness, and fatigue--are common in both rheumatic and nonrheumatic patients. But the essential sign of fibrositis--widespread local tenderness over specific anatomic sites ("tender points")--is rare in any patients except those with fibrositis. Clinical criteria for the diagnosis of fibrositis rely heavily on a high tender point count in the presence of characteristic fibrositic symptoms. Multiple tender points are uncommon in normal subjects and in those with rheumatic and nonrheumatic disorders. The tender point count thus also serves to distinguish fibrositis from other musculoskeletal diseases. PMID- 3532786 TI - Auranofin therapy and quality of life in patients with rheumatoid arthritis. Results of a multicenter trial. AB - In a six-month, randomized, double-blind study at 14 centers, auranofin (3 mg twice daily) was compared with placebo in the treatment of patients with classic or definite rheumatoid arthritis. All patients had unremitting disease for at least the previous six months and at least three months of therapy with nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs, oral steroids, and analgesics were allowed throughout the trial. Efficacy was analyzed in 154 patients who received auranofin and 149 who received placebo. To reflect an expanded view of outcome assessment, the measures used included some 20 nontraditional measures of functional performance, pain, global impression, and utility (worth or value) in addition to five standard clinical measures of rheumatoid synovitis (e.g., number of tender joints). The nontraditional measures were mainly in the form of structured questionnaires administered by trained interviewers. To minimize the statistical problem of multiple comparisons, most of the measures were grouped into four composites--clinical (standard measures), functional, global, and pain--and the treatment effect for each composite was tested at the 0.0125 level of significance. Auranofin was superior to placebo in the clinical (p = 0.003), functional (p = 0.001), and global (p = 0.007) composites and trended similarly in the pain composite (p = 0.021). Individual measures within the composites consistently favored auranofin. Other measures, not part of the composites, also favored auranofin, including a patient utility measure designed for this study, the PUMS (p = 0.002). Results confirm the hypothesis that the favorable effect of auranofin on clinical synovitis is accompanied by improvements across a range of outcomes relevant to the patient's quality of life. PMID- 3532787 TI - High prevalence and high titers of LAV/HTLV-III antibodies in healthy hemophiliacs in the midwestern United States. AB - Twenty-eight patients from the Nebraska Regional Hemophilia Center were studied for the prevalence and titers of antibodies to lymphadenopathy-associated virus/human T cell lymphotropic virus type III (LAV/HTLV-III) and for clinical symptoms of possible progression to the acquired immune deficiency syndrome (AIDS). Ten of 18 (56 percent) patients with hemophilia A who were frequently treated with commercial factor VIII concentrate were seropositive for LAV/HTLV III antibodies as determined by immunofluorescent study and Western blot testing. Of the four factor VIII-deficient patients who were seronegative, one had received only heat-treated factor VIII concentrates, two had received only cryoprecipitate, and one had received no transfusions since 1983. None of the patients treated only with factor IX concentrate, volunteer donor plasma, or cryoprecipitate had LAV/HTLV-III antibodies. In nine of 10 seropositive hemophiliacs, titers of serum antibodies to LAV/HTLV-III ranged from 1:1,280 to 1:10,240, indicating a strong immune response against LAV/HTLV-III antigens and/or persistent infection with the virus. Serum from seropositive hemophiliacs interacted on Western blot testing with all the major LAV/HTLV-III polypeptides, including envelope proteins gp 42 and gp 120. Despite the possible exposure to LAV/HTLV-III during the past four years, none of the patients in this group had symptoms suggestive of progression towards AIDS. Whether or not immunity to the AIDS retrovirus developed in this group of patients remains to be determined. PMID- 3532788 TI - Neurohumoral activation during exercise in congestive heart failure. AB - Neurohumoral factors were assessed in 14 subjects with chronic, stable New York Heart Association functional class II or III congestive heart failure and nine comparably aged normal subjects at rest and during moderate (50 W) and strenuous (100 W) upright exercise. Heart failure was associated with elevated plasma renin activity and plasma antidiuretic hormone (ADH) concentrations at rest. However, plasma renin activity almost doubled (from 4.7 +/- 0.6 to 8.4 +/- 1.1 ng/ml per hour) during strenuous exercise in subjects with heart failure, and changed only minimally in normal control subjects. Plasma ADH concentration did not change during exercise in the presence of heart failure, but rose in normal subjects during strenuous exercise to levels comparable to those of subjects with heart failure. Similar plasma osmolality values were present in both groups. Circulating norepinephrine concentrations were insignificantly elevated by heart failure both at rest and during exercise, and plasma epinephrine concentrations were similar. These findings suggest independent neurohumoral activation during exercise in the presence of congestive heart failure, with predominant activation of the renin-angiotensin-aldosterone axis. PMID- 3532789 TI - Evaluation of cardiovascular risk for renal transplantation in diabetic patients. AB - Cardiovascular disease contributes in a major way to morbidity and mortality in diabetic patients with end-stage renal disease. Sixty patients with type I diabetes were evaluated prior to renal transplantation to determine the risk of cardiovascular complications. On the basis of results of thallium stress testing and/or cardiac catheterization, each patient was assigned to one of five categories. There were no cardiovascular events in the seven patients who had negative results on stress testing. Of the remaining 53 patients, all of whom underwent cardiac catheterization, 30 had normal coronary arteries. None of these 30 patients had any cardiac morbidity, and the two deaths that occurred in this group were not attributable to cardiac causes. Significant coronary artery disease was present in 38 percent of the patients. The overall mortality rate was 5.4 percent in those patients without coronary artery disease and 43.5 percent in those with the disease. In addition, the mortality rate in patients with coronary disease classified as severe was 62 percent, whereas it was 20 percent in those categorized as having moderate disease. The data indicate that patients with diabetes and end-stage renal disease who are at highest risk for cardiovascular events can be identified, and these patients probably should not undergo renal transplantation. PMID- 3532790 TI - Infection and infarction. Acute viral (and other) infection in the onset, pathogenesis, and mimicry of acute myocardial infarction. AB - Because a prospective controlled investigation showed a highly significant association of the onset of acute myocardial infarction with signs of preceding respiratory infection, the clinical, laboratory, experimental, and epidemiologic evidence more directly supporting this association was analyzed. Inflammation- specifically of infectious, usually viral, origin--has been shown by several lines of evidence to be capable of precipitating or mimicking clinical myocardial infarction. Myocardial biopsy is producing rapidly increasing confirmation that myocarditis can perfectly mimic clinical acute myocardial infarction. Coronary arteritis, with implications for vasospasm and thrombosis, is being increasingly demonstrated when deliberately sought in necropsy and biopsy material. Effects of blood-borne infectious agents, particularly viremia, on platelets in vivo and in vitro--aggregation and lysis with release of vasoactive substances--have even more serious potential for coronary thrombosis and vasospasm. It is not clear whether such mechanisms operate entirely independently or are more potent in high risk patients, particularly in view of the demonstrable hypercoagulable state in many patients with coronary disease. Because of the great importance of confirming precipitating mechanisms for acute myocardial infarction (as well as its frequent mimic, myocarditis), intensive investigation of the relation between infection and infarction has important preventive and therapeutic implications. PMID- 3532791 TI - Cocaine-associated myocardial ischemia. Review of clinical and angiographic findings. AB - The incidence of cocaine use is increasing in the United States among both adolescents and adults. Once thought to be a relatively safe street drug, cocaine has recently been implicated in 12 episodes of myocardial infarction. The case reports of these patients were retrospectively reviewed to determine the clinical and angiographic findings. All 12 patients exhibited electrocardiographic and angiographic evidence of myocardial infarction "shortly after" the use of cocaine by the nasal or intravenous routes. Most of the patients had fixed coronary artery disease. There appears to be increasing evidence of a temporal relationship between the use of cocaine and subsequent myocardial ischemic events in a subgroup of patients with or without fixed coronary artery stenosis. Physicians should inquire about cocaine use in patients with unexplained ischemic episodes since this may represent a potentially reversible factor in the later development of myocardial infarction. PMID- 3532792 TI - Nutritional status of the elderly. PMID- 3532793 TI - Anorexins, asthenins, and cachectins in cancer. PMID- 3532794 TI - Explosive pleuritis. Manifestation of group A beta-hemolytic streptococcal infection. AB - Two young adults had clinical and roentgenographic evidence of explosive pleuritis that was caused by group A beta-hemolytic streptococci. Persistent high fever and intense pleuritic pain following severe pharyngitis should suggest streptococcal pleural infection and prompt careful roentgenographic investigation. These cases show that group A beta-hemolytic streptococcal infection can cause explosive pleuritis in the absence of apparent bronchopneumonia. PMID- 3532795 TI - Exhibiting mentally retarded people for amusement and profit, 1850-1940. AB - Historians in the field of mental retardation have neglected to document the exhibition of people for amusement and profit, commonly known as "freak shows." The exhibition of people we would now call "mentally retarded" during the period 1850 to 1940 in the United States was discussed. Biographical sketches were given to five famous persons who were exhibited in the 19th century. Information on other individuals who were exhibited was also provided. Patterns and trends in exhibitions and in the significance of "freak show" imagery for current attitudes toward those known as mentally retarded was discussed. PMID- 3532796 TI - A link between relative hypoglycemia-hypoinsulinemia during oral glucose tolerance tests and intrauterine growth retardation. AB - Early identification of the intrauterine growth-retarded fetus is a key factor in improving associated perinatal morbidity and mortality. We investigated, in a prospective study of 43 patients at high risk of intrauterine growth retardation, the predictive value of a derived glucose index and whether hypoglycemia accompanied by hypoinsulinemia in normotensive patients is associated with intrauterine growth retardation. Our findings suggest that the glucose index and 2-hour plasma glucose concentration appear to be useful antepartum predictors of intrauterine growth retardation in normotensive high-risk pregnancies. There is an apparent link between selective maternal hypoglycemia, hypoinsulinemia, and being small for gestational age. A "flat" glucose tolerance test should be regarded as an abnormal pattern in normotensive pregnancies as it was associated with a twentyfold increased risk of intrauterine growth retardation in this study. PMID- 3532797 TI - Transabdominal and transvaginal endosonography: evaluation of the cervix and lower uterine segment in pregnancy. AB - The clinical value of conventional transabdominal and transvaginal sonography (endosonography) for the evaluation of the cervix and lower uterine segment between 14 and 36 weeks' gestation was evaluated in 20 unselected obstetric patients. Sonographic evaluation of the cervix and lower uterine segment was adequately depicted in 76% with the transabdominal technique compared to 83% with the transvaginal approach. According to set guidelines, these preliminary results suggest that the transvaginal technique may be superior in obtaining an adequate evaluation of the lower uterine segment and cervix and may offer an advantage of not depending on a fully distended bladder for evaluation. PMID- 3532798 TI - Motor and cognitive development of infants with intraventricular hemorrhage, ventriculomegaly, or periventricular parenchymal lesions. AB - Two hundred twenty-six moderate- or high-risk newborn infants were studied to examine the relationship between ultrasound findings in the newborn period and at 6 months and motor and cognitive deficits at 1 year. A three-part classification of abnormal ultrasound findings was used to grade intraventricular hemorrhage, ventriculomegaly, and parenchymal lesions. Abnormal ultrasound findings were observed in 48 infants, of whom 21 had intraventricular hemorrhage, 18 persistent ventriculomegaly, and nine parenchymal lesions. The incidence of deficits was as follows: normal ultrasound examination, 20%; intraventricular hemorrhage, 33%; persistent ventriculomegaly, 67%; and parenchymal lesions, 89%. The present study indicates that serial ultrasound examinations are indicated in preterm newborn infants less than 1500 gm and in selected newborn infants at risk and greater than 1500 gm at birth. The three-part classification of abnormal ultrasound findings should be used because of the predictive significance of persistent ventriculomegaly and parenchymal lesions for motor and cognitive deficits at 1 year of age. PMID- 3532799 TI - Regression of uterine leiomyomas after treatment with gestrinone, an antiestrogen, antiprogesterone. AB - Ninety-seven women, aged 18 to 53 years, with uterine leiomyomas diagnosed by bimanual palpation and ultrasonography, were treated for 4 to 13 months with gestrinone, a potent steroidal, antiestrogen, antiprogesterone. Thirteen women were less than 30 years old and six 50 years old or older. Forty-six women were 30 to 40 years old and 32 others were 40 to 50 years old. Sixty-one women were nulliparous. Patients were divided in a random fashion into three groups according to treatment schedule. In group A, 34 patients received capsules containing 5 mg of gestrinone twice weekly. In group B, 36 patients received 2.5 mg capsules three times weekly. In group C, 27 patients were instructed to insert 2.5 mg tablets in the vagina three times weekly. Uterine volume was measured by ultrasonography before and at the end of treatment. At the end of 4 months, uterine volume fell from 303 to 251 cm3 in group A, from 361 to 266 cm3 in group B, but increased from 371 to 387 cm3 in group C. For those patients treated for 10 (+/- 1) months, mean uterine volume fell from 368 to 282 cm3 in group A and from 384 to 327 cm3 in group B, but increased from 262 to 290 cm3 in group C. Mean uterine volume of patients who were treated for 13 (+/- 1) months also fell from 325 to 259 cm3 in group A, from 416 to 268 cm3 in group B, and from 406 to 399 cm3 in group C. Changes in uterine volume measured at the time of discontinuation for the various groups revealed volume decrease in 71 and increase or no change in 26. Differences between groups A, B, and C were statistically significant when comparisons were made at 4 and 13 months. Uterine bleeding ceased by the second month of treatment in half the patients initially complaining of menometrorrhagias. After 4 months of treatment, 95% of the women were amenorrheic. Hemoglobin increased in 85 of 90 patients for whom values were available before treatment began. Both dyspareunia and chronic pain were significantly reduced by the gestrinone treatment. Androgenic side effects such as seborrhea, acne, and hirsutism, whenever they occurred, were benign and reverted soon after discontinuing the medication. PMID- 3532800 TI - Triplet pregnancy after low-dose pulsatile gonadotropin-releasing hormone in polycystic ovarian disease. AB - In a patient with polycystic ovarian disease, low-dose intravenous pulsatile gonadotropin-releasing hormone (5 mcg every hour) and no exogenous human chorionic gonadotropin induced multiple follicular development and elevated estrogen levels and resulted in a triplet pregnancy. Patients with polycystic ovarian disease may have a higher risk of complications and should be monitored more closely during ovulation induction with pulsatile gonadotropin-releasing hormone. PMID- 3532801 TI - Office diagnosis of asymptomatic bacteriuria in pregnant women. AB - Diagnosis and treatment of asymptomatic bacteriuria in pregnant patients can virtually eliminate pyelonephritis, the most common medical cause for antepartum hospitalization. However, the ever-increasing cost of the urine culture has led most clinicians away from routine urine screening. Uricult dip-slide paddles provide an inexpensive, efficient way to screen urine. Clean-catch urine specimens were obtained from 544 consecutive asymptomatic pregnant patients seen in the outpatient obstetric clinic at the Medical University of South Carolina. Specimens were analyzed by both traditional culture techniques and the Uricult dip-slide paddles. By comparison, the Uricult test detected 55 of the 56 significant gram-negative urinary pathogens found by culture. Detection of potential gram-positive pathogens is more difficult. A scheme is proposed that allows reliable, inexpensive surveillance in all pregnant patients. Hopefully, this algorithm will rekindle the obstetrician's interest in urine screening. PMID- 3532802 TI - Nonimmune hydrops fetalis: clinical experience and factors related to a poor outcome. AB - Twenty-one cases of nonimmune hydrops fetalis diagnosed at the Medical College of Georgia during a 2-year period are presented. All fetuses satisfied strict diagnostic criteria and were evaluated according to a standard protocol. The corrected mortality rate was 95% with pulmonary hypoplasia being the most common cause of perinatal death. The mean gestational age at diagnosis was 24.8 weeks; in 57% of the cases the cause of nonimmune hydrops fetalis was identified. Fifteen fetuses had serial ultrasound assessment and in 19 cases postnatal evaluation was performed. Two factors that consistently conveyed a poor perinatal outcome were ultrasonographic evidence of malformation and/or the presence of persistent pleural effusions. A method for the quantification of fetal pleural effusions is presented and its clinical relevance is discussed. PMID- 3532803 TI - In utero treatment of a fetus with diaphragmatic hernia complicated by hydrops. AB - A case of diaphragmatic hernia is reported where the prenatal diagnosis was made sonographically in a hydropic fetus and the large associated fluid collection in the right side of the chest was aspirated in utero. Almost complete drainage of the chest and abdominal fluid was accomplished, with resolution of the hydrops and no reaccumulation during the last 2 weeks of the pregnancy. After a spontaneous vaginal delivery, the infant was easily stabilized, and underwent operation in good condition. PMID- 3532804 TI - Ultrasonic measurement of fetal femoral length in singleton and twin pregnancies. AB - The fetal femoral length and biparietal diameter were measured by ultrasound on 1657 occasions in 1289 singleton pregnancies between 12 and 41 weeks' gestation. Mean values for fetal femoral length were significantly lower than those demonstrated in previous studies, with the difference becoming greater approaching term. Three hundred twenty-two measurements of fetal femoral length were made on 57 patients with twin pregnancies, with no significant difference noted between the means of these recordings and the means of the singleton pregnancies. PMID- 3532805 TI - Antenatal diagnosis of fetal seizure activity with use of real-time ultrasound. AB - Neonatal seizures have been observed as early as the first hour of life. It has been postulated that for certain central nervous system disorders, seizure activity may occur in utero. This report describes two cases of spontaneous fetal seizure activity diagnosed by real-time ultrasound. PMID- 3532806 TI - Myosin detection in human myometrium with a monoclonal antibody. AB - A monoclonal antibody was prepared from a mouse immunized with human gravid uterine myosin. This monoclonal antibody is specific for the myosin heavy chains of human smooth muscle as determined by radioimmunoassay and immunoblotting experiments. Frozen cryostat sections isolated from different uterine regions were studied by immunofluorescence in order to detect myosin distribution within cells of nongravid, gravid, and pathologic human uteri. Myosin was detectable in the cytoplasm of all uterine muscle cells. No fiber heterogeneity with regard to myosin distribution was detected among or within the different uterine regions, regardless of which physiologic or pathophysiologic situation was studied. A large increase in the cell size was observed during pregnancy. These preliminary observations suggest the value of further production of monoclonal antibodies specific for the different putative molecular variants of uterine myosin and their potential use in identifying individual cells containing different myosin variants. PMID- 3532807 TI - Oral acyclovir in the treatment of acute herpes zoster ophthalmicus. PMID- 3532808 TI - Glaucoma treatment with once-daily levobunolol. PMID- 3532809 TI - Tools of practice: heritage or baggage? 1986 Eleanor Clarke Slagle lecture. AB - Occupational therapists have used many media and methods over the years to achieve the therapeutic potential of occupational therapy. Yet the reasons for selecting a specific medium or method frequently have been lost or changed without consideration of the result to the therapeutic situation. When neither therapist nor patient understands fully the rationale for a medium or method, the therapeutic potential of that medium or method may be compromised. The author suggests there are eight factors that influence the selection and discarding of media and methods in the practice of occupational therapy. The effects of the eight factors can be summarized in 14 assumptions. Three examples--arts and crafts, sanding blocks, and work-related programs--are used to illustrate the factors and assumptions. It is suggested that improved analysis of occupations based on values and interests could reduce the separation of meaning and purpose in the selection and discarding of media and methods used in occupational therapy practice. PMID- 3532810 TI - The Glenn A. Fry award lecture: adaptive regulation of accommodative vergence and vergence accommodation. AB - The tonic resting level of accommodation, measured with an objective infrared optometer in an open-loop state (pinhole pupil or empty field), was increased by more than 1.75 D from baseline measures of resting focus after adapting monocularly for 1 min to a 2 D minus lens. The accommodative aftereffect disappeared in darkness, but returned when a visible stimulus reappeared in the open-loop state. Stimulation of disparity vergence with 10 delta, while accommodation was in an open-loop state, also increased the resting focus of accommodation. Similarly, the tonic resting level of vergence became more esophoric after adapting for less than 1 min to base-out prism or to a minus lens presented while the vergence loop was opened. The effects of tonic accommodation on accommodative vergence and the effects of tonic vergence on vergence accommodation were investigated with the temporal frequency responses of the AC/A and CA/C ratios to sinusoidal variations in blur (2 D) and disparity (10 delta), respectively. Accommodative vergence was unresponsive to low temporal frequency sinusoidal variations in blur (less than 0.1 Hz). Similarly, vergence accommodation was unresponsive to low temporal frequency sinusoidal variations in disparity. However, accommodative vergence and vergence accommodation were responsive to higher temporal frequency stimuli (up to 0.5 Hz). When negative feedback to the stimulated system (accommodation or vergence) was cancelled electronically, the low temporal frequency response increased for the AC/A and CA/C ratios, respectively. There was also a nonlinear increase of both AC/A and CA/C ratios as stimulus amplitude increased. It is hypothesized that the nonlinearity resulted from limitations of adaptation to small stimuli. An inverse complementary relation is suggested between the amplitude of the AC/A ratio and adaptable tonic accommodation, and between the amplitude of the CA/C ratio and adaptable tonic vergence. This model predicts that in this complementary relation, adaptable tonic elements would sustain motor responses of accommodation and vergence that were initiated by phasic elements and cross-link interactions. It also predicts that the AC/A and CA/C ratios would decrease in time as dynamic control shifted from the phasic to the adaptable tonic control mechanisms of accommodation and vergence, respectively. PMID- 3532811 TI - Solar radiation and the eye: a review of knowledge relevant to eye care. AB - Solar radiation has been implicated, with a variety of evidence, as a causative agent in photokeratoconjunctivitis, pinguecula and pterygium, nodular band keratopathies, epidermoid carcinoma, cataract, solar retinopathy, and macular degeneration. Much of the support for claims relating to chronic conditions having serious consequences and significant prevalence in the United States rests on investigations using animals and short-time exposures at high intensities. The direct applicability of these studies to humans in natural environments is uncertain, but they have been relied on because one cannot deliberately induce significant trauma in humans. The use of animal data is made difficult by the need to convert animal thresholds to human equivalents, to equate laboratory cycles and magnitudes of exposure to those in the natural environment, and to quantify the impact of avoidance and protective mechanisms. Risk can be assessed adequately only by epidemiological studies, but their potential has been only partially realized because of poorly controlled confounding variables. Epidemiologic evidence suggests that corneal trauma from ultraviolet radiation (UVR) is a risk of prolonged exposure in regions containing much ultraviolet (UV) or in highly reflective environments. The impact of UV-B on cataractogenesis has been investigated inadequately and no evidence exists for retinal trauma arising from routine exposure in even the brightest surroundings. However, there can be no question that enough solar energy reaches the earth to harm the eye if unattenuated. Damage to vision as a result of direct solar viewing demonstrates that unequivocally. The lack of clear evidence of radiation damage occurring other than in regions of high reflectivity and/or low horizons suggests that in normal surroundings there is little or no risk to the eye, although more careful epidemiological investigation is required before all concern can be ruled out completely. The major improvement required is the quantification of individual exposure histories. This step is necessary if we are to make significant progress toward better understanding the practical impact of solar radiation on the eye. PMID- 3532812 TI - The role of interleukin-1 in neutrophil leukocyte emigration induced by endotoxin. AB - Chemotactic factors induce neutrophil emigration into tissues. Interleukin-1 (IL 1) was found to be several log times more potent in this respect than C5a des Arg, leukotriene B4, and f-Met-Leu-Phe and of comparable potency to endotoxin. Kinetic studies revealed a rapid and transient neutrophil influx, with the peak rate at 30-90 minutes. Cross tachyphylaxis was observed between IL-1 and endotoxin; and this, together with its high potency and rapid onset of action, suggest that IL-1 mediates endotoxin-induced neutrophil emigration. PMID- 3532813 TI - Mast cells in human keloid, small intestine, and lung by an immunoperoxidase technique using a murine monoclonal antibody against tryptase. AB - A murine monoclonal antibody (G5) against human lung mast cell tryptase was used for selective staining of human mast cells by an indirect immunoperoxidase method. Human tissues (keloid, small bowel, lung) were fixed in either Carnoy's fluid or neutral buffered formalin. In all three tissues the number and location of G5-stained mast cells corresponded closely with metachromatic toluidine blue stained mast cells, although the immunospecific technique appeared to be more sensitive. In lung the average concentration of G5-positive mast cells after Carnoy's fixation was 15,695/cu mm of subepithelial tissue in bronchi and bronchioles and 26,580/cu mm of alveolar wall, in small bowel was 20,958/cu mm of mucosa and 8576/cu mm of submucosa, and in keloid was 3068/cu mm. Formalin fixation significantly reduced concentrations of G5-positive mast cells in all tissues except keloid. PMID- 3532815 TI - Involvement of a cytoplasmic protein in calcium-dependent potassium efflux in red blood cells. AB - The potassium permeability of the human red blood cell increases with the free intracellular calcium concentration. The efflux of potassium can be inhibited by iodoacetic acid. This inhibitory effect correlates directly with the carboxymethylation of a protein band found in both the hemolysate and membrane fractions. The present study provides two additional lines of evidence that this protein is involved directly with the calcium-dependent changes in potassium permeability: its association with the membrane is calcium dependent; and calcium dependent potassium efflux from resealed ghost is inhibited by the incorporation of antibodies raised against this cytoplasmic protein. PMID- 3532814 TI - Induction of peroxisome proliferation in hepatocytes transplanted into the anterior chamber of the eye. A model system for the evaluation of xenobiotic induced effects. AB - The effect of two hypolipidemic peroxisome proliferators, ciprofibrate and di(2 ethylhexyl)phthalate (DEHP), on hepatocytes transplanted into the anterior chamber of the eye was examined. Young male F-344 rats transplanted with dissociated hepatocytes were fed either a control diet or a diet containing 0.025% ciprofibrate or 2% DEHP. After 4-5 weeks of treatment, all rats were sacrificed and the transplanted liver cells and portions of homotopic liver were processed for light and electron microscopy and for immunofluorescence microscopy. Morphometric analysis of transplanted hepatocytes showed a ninefold and fivefold increase in the volume density of peroxisomes in ciprofibrate and DEHP-fed rats, respectively. Indirect immunofluorescence studies revealed a marked induction of peroxisome-associated enzymes. From these data it is concluded that hepatic peroxisome proliferators cross the blood aqueous humor barrier and the transplanted hepatocytes in the anterior chamber of the eye retain their ability to recognize and respond to peroxisome proliferators. PMID- 3532816 TI - Renin heterogeneity in stroke-prone hypertensive and normotensive rats. AB - Six forms of renin are found in the rat kidney. We studied their secretion in renal slices from spontaneously hypertensive stroke-prone rats (SHRSP) and Wistar Kyoto rats (WKY). Incubation media from renal slices were subjected to isoelectric focusing. Six peaks of renin activity with different isoelectric points were found. The renin concentration of each form was expressed as a percentage of the total recovered from the gel. We established that the forms secreted by renal slices of SHRSP differed from those of WKY: SHRSP slices released a higher proportion of forms focusing at the more acidic pH. The distribution of the six renin forms and of blood pressure (BP) among animals of the F1, F2, and backcross progenies resulting from the cross of SHRSP and WKY rats were studied. In the F1, BP, percentage of renin form 2, and a combination of the percentage of forms 4 + 5 + 6 were intermediate between the parental lines. The backcross rats showed BP and percentages of forms closer to their SHRSP or WKY parent. In the F2, the distribution of BP, percentage of forms 2 and 4 + 5 + 6 take the form of a unimodal distribution with a significantly larger variance than F1. The increase in the correlation between percentage of renin forms and BP, and between renin concentration of BP, in the segregating progenies over that observed in the parental lines and the F1, are support for the hypothesis that these traits are under the control of common genetic mechanisms. PMID- 3532817 TI - Potentiating synergism between adenosine diphosphate or triphosphate and acetylcholine on insulin secretion. AB - The interaction between adenosine di- or triphosphate (ADP or ATP) and acetylcholine (ACh) was studied on insulin secretion. The experiments were performed on the isolated perfused rat pancreas, in the presence of a physiological nonstimulating glucose concentration (5.5 mM). ADP or ATP (1.65 microM) and ACh (0.05 microM) elicited a comparable peak of insulin secretion. When either ATP or ADP was simultaneously infused with ACh, insulin secretory response was significantly higher than the sum of the responses of each agonist applied separately. Similar effects were obtained with stable structural analogues of ATP and ADP (adenylimidodiphosphate, AMP-PNP, and alpha, beta methyleneadenosine 5'-diphosphate, alpha, beta-methylene ADP) whether they acted alone or in combination with ACh. In contrast, adenosine was ineffective. Furthermore, the study of combined half doses of ATP (or ADP) and ACh allowed us to establish a potentiating synergism between both agonists. These data indicate a potentiating synergism on the beta-cell between ACh and ATP or ADP, the substances acting, respectively, via muscarinic cholinergic receptors and purinergic P2 receptors. So, ATP and ADP by activating P2 receptors could be involved in the parasympathetic control of insulin secretion. PMID- 3532818 TI - Heterogeneity of insulin action in muscle: influence of blood flow. AB - The influence of blood flow (BF) and basal neuromotor tone on in vivo insulin stimulated glucose uptake (Rg') in muscle was examined using the euglycemic clamp plus deoxyglucose/glucose tracer (insulin action) and labeled microsphere (BF) techniques. Anesthesia was used to produce perturbations in BF and/or activity compared with conscious rats. An index of muscle glycolytic flux (Gf) was estimated from Rg' in excess of glycogen synthesis. Gf and glycogen synthesis were significantly increased in soleus and red gastrocnemius (RG) during insulin infusion (150 mU/l) in conscious rats. Rg' was related to muscle BF in conscious rats (r = 0.92). In anesthetized rats, Rg' and BF were reduced in soleus, RG, red quadriceps, and plantaris (e.g., soleus 69%, P less than 0.001, and 80%, P less than 0.001, respectively). However, it is unlikely that Rg' and BF are causally related because fractional extraction of glucose by muscle was low (approximately 9%); fractional extraction increased during anesthesia (17%, P less than 0.01); BF but not Rg' was reduced by anesthesia in extensor digitorum longus, white gastrocnemius, and white quadriceps; and reduced Rg' during anesthesia in soleus and RG was mainly due to reduced GF. In conclusion, BF is not a major contributor to the heterogeneity in insulin-stimulated glucose uptake among individual muscles under basal conditions. These data suggest that neuromotor tone may indirectly influence the magnitude of muscle glucose uptake during insulin elevation via a substrate switching effect. This may give rise to a significant increase in glycolytic flux of glucose in those muscles that exhibit elevated activity even at rest (e.g., soleus).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3532819 TI - Chronic hypoglycemia increases brain glucose transport. AB - Glucose transport into the brain is depressed in chronically hyperglycemic (diabetic) rats. To determine whether hypoglycemia has the opposite effect, brain transport of hexoses and other substrates was examined in chronically and acutely hypoglycemic rats. We produced chronic hypoglycemia by implanting insulin secreting tumors or insulin-releasing osmotic mini-pumps or by repeated injection of protamine zinc insulin (PZI) and acute hypoglycemia by intravascular injection of regular insulin. Blood-brain barrier (BBB) transport was measured using the brain uptake index (BUI) method. In the three models of chronic hypoglycemia, brain glucose extraction was increased compared with controls. The extraction of deoxyglucose and several other hexoses was also increased by chronic hypoglycemia. Acute hypoglycemia had no effect on brain transport. The transport of other substrates was either not affected or depressed, suggesting increased brain hexose transport is specific. Studies of freeze-blown brain in insulinoma engrafted rats showed that brain glucose levels were depressed while creatine phosphate, ATP, and glucose 6-phosphate were maintained. Tumor removal led to a reversion of brain glucose transport to control rates but only after 5-25 days. These findings support the view that glucose transport across the BBB is modulated by chronic alterations in the ambient glucose concentration. They also may explain why some patients with chronic hypoglycemia tolerate low blood glucose concentrations. PMID- 3532820 TI - Effects of fetal insulin infusion on glucose kinetics in pregnant sheep: a compartmental analysis. AB - A three-compartment model, consisting of fetus (F), uteroplacenta, and mother (M) was applied to quantitate the effects of fetal hyperinsulinemia on glucose kinetics in pregnant sheep late in gestation. The approach combines the Fick principle with isotope dilution of differentially labeled glucose isotopes, infused simultaneously to F [U-14C]- and M [2-3H]glucose. In the basal state, rates of umbilical glucose uptake (8.37 +/- 0.98 mg/kg per min) and fetal glucose utilization (7.38 +/- 1.13) were equivalent (mean +/- SE; n = 12). When fetal insulin was increased from 13.7 +/- 2.2 to a plateau of approximately 100 microU/ml, arterial glucose decreased from 18.9 +/- 0.8 to a new steady state of approximately 13 mg/dl (P less than 0.001). Whereas umbilical glucose uptake increased at 90 min and remained elevated thereafter (P less than 0.01), fetal glucose utilization increased only transiently at 60 min by 1.9 +/- 0.8 mg/kg per min (26%; P less than 0.05) and then returned to base line. Insulin's persistent effect, however, was evident from the sustained doubling of the glucose clearance rate from 39.3 +/- 5.9 to 66.6 +/- 10.5 ml/kg per min (P less than 0.005). No endogenous fetal glucose production was evident throughout the experiments. Maternal glucose production and utilization remained unchanged, although there was a small decline in M glucose concentration and an increase in glucose transfer from M to the uteroplacenta and F, from 33.9 +/- 8.1 to 48.1 +/- 7.0 mg/min at 60 min (P less than 0.01 by paired analysis). We conclude that fetal hyperinsulinemia initially lowers glucose concentration by transiently increasing fetal glucose utilization.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3532821 TI - Lipoprotein lipase-suppressing mediator in serum of endotoxin-treated rats. AB - The conditions under which lipoprotein lipase-suppressing mediator is present in serum of endotoxin-treated rats was determined in this study. The suppression of lipoprotein lipase activity in 3T3-L1 cells was used as a bioassay for mediator in serum. Endotoxin (0.1-10 micrograms/ml) and serum from control rats did not suppress lipoprotein lipase activity. Maximum suppression of cell lipoprotein lipase activity (70%) by serum from endotoxic rats required a cell exposure time of 5 h. At the highest dose of endotoxin used (1 mg/100 g), significant suppression was achieved when cells were incubated with 0.5% serum from endotoxic rats (P less than 0.05). Serum obtained 2-3 h after endotoxin injection possessed the maximal ability to suppress lipase activity, but suppressing activity was not present in serum collected 8 h after endotoxin. Rats rendered tolerant to endotoxin by 5 daily injections (0.1 mg/100 g) did not contain detectable levels of mediator in serum after endotoxin injection. The results demonstrate that the presence of lipoprotein lipase activity-suppressing mediator is transitory after in vivo exposure of naive rats to endotoxin, but does not appear in serum of endotoxin tolerant rats. PMID- 3532822 TI - Dissociation of contraction and muscarinic receptor binding to isolated smooth muscle cells. AB - We examined changes in [3H]QNB binding and cell length induced by muscarinic ligands in a suspension of single smooth muscle cells isolated from the canine stomach. Cells contracted following a brief (30 s) exposure to picomolar concentrations of muscarinic agonists and yielded ED50 values of 1.0 +/- 0.7 pM for oxotremorine, 12.5 +/- 1.8 pM for carbachol, and 16.0 +/- 2.9 pM for metacholine. Contraction was inhibited by atropine with a pA2 value of 10.2 +/- 1.1. The binding of [3H]QNB was rapid and reversible and was stereospecific and pharmacologically appropriate. Specific binding of [3H]QNB was saturable and bound with high affinity (KD 1.04 +/- 0.23 nM) to a single class of sites, of which there were approximately 200,000/cell. In competition experiments antagonist binding was generally homogeneous, whereas that of agonists was heterogeneous and subpopulations of binding sites with different affinities for agonists were identified. The Ki value of 8.1 +/- 1.1 nM for inhibition of QNB binding by atropine was greater than the pA2 of 10.2 +/- 1.1 derived from contraction studies. Furthermore, whereas picomolar concentrations of agonists induced cell contraction, substantially higher concentrations (10 nM to 10 mM) were required to inhibit [3H]QNB binding to the isolated cells. PMID- 3532824 TI - Substrate support of medullary thick ascending limb oxygen consumption. AB - The oxygen consumption of medullary thick ascending limb tubule suspensions was measured in the presence and absence of exogenous glucose. In the absence of exogenous glucose, the control oxygen consumption decreased 15%. Under identical conditions, the nystatin-stimulated oxygen consumption was inhibited 36%, indicating that oxidation of endogenous substrates could not meet the ATP demand of the fully stimulated Na+-K+-ATPase. Addition of inhibitors of fatty acid oxidation (bromooctanoate and tetradecylglycidic acid) further inhibited oxygen consumption, revealing that endogenous fats are oxidized in control and nystatin stimulated states. Inhibition of endogenous carbohydrate (2-deoxy-D-glucose present) or amino acid (aminooxyacetate present) oxidation suppressed the nystatin response. In the presence of 10 mM glucose, only aminooxyacetate inhibited the nystatin-stimulated oxygen consumption, suggesting that the involvement of the malate-aspartate shuttle in redox balance during increased glycolytic flux. Addition of fatty acids or acetoacetate increased the control, nystatin-stimulated and uncoupler-stimulated oxygen consumption of tubules suspended in 10 mM glucose, indicating that these tubules oxidize exogenous fatty acids and ketones and oxidation of exogenous glucose alone may not meet all the energy demands of the tissue. Conversely, the addition of organic acids failed to enhance control oxygen consumption, possibly due to the absence of transport systems for these compounds in the medullary thick ascending limb tubules.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3532823 TI - Sodium chloride, extracellular fluid volume, and blood pressure regulation. AB - Data from humans and experimental animals indicate that hypertensive diseases triggered by extracellular fluid volume expansion are characterized, in their chronic phases, by relatively normal blood volume (BV) and heightened pressure volume relationship may be viewed as corresponding to a condition of "virtual hypervolemia," where BV is inappropriately "high" relative to blood pressure. The limited data available on the phasic relationship between these variables indicate that the BV expansion appears to be a prerequisite to alterations in vascular ion metabolism, that both of these changes precede the rise in blood pressure, and that structures within the central nervous system may be a critical link between the body fluid volumes and vascular functional changes. In contrast, hypertensive diseases triggered by secretion of pressor agents or their precursors appear to be characterized in their chronic phases by low BV. These relationships and the associated alterations in plasma aldosterone and renin levels are summarized for a variety of clinical syndromes, including essential hypertension and pregnancy-induced hypertension. Direct or indirect evidence of a primary or secondary defect in renal function is apparent as an underlying event in many of these diseases. PMID- 3532825 TI - Interrelationship of blood flow, juxtaglomerular cells, and hypertension: role of physical equilibrium and Ca. AB - Recent experimental evidence has provided important clues as to the role of electrolytes, particularly Ca, in the regulation of blood flow, renin secretion, and blood pressure. The smooth muscle cells of arterioles in general and the juxtaglomerular cells in the renal afferent arterioles have been shown to have Ca channels sensitive to voltage, hormones, and stretch. This paper reviews a model that utilizes these features along with a fundamental law of physics to point to some plausible explanations for some interesting experimental observations on renal blood flow, renin secretion, and hypertension. The chief features of the model are that in the steady state the arteriole must achieve a stable physical equilibrium in which the forces tending to distend the vessel (transmural pressure) counterbalance the forces tending to prevent distension (wall tension); the wall tension consists of a passive and an active component, the latter of which is sensitive to stretch of the vessel; and stretch activates the opening of stretch-sensitive Ca permeability channels that promote the influx of Ca to trigger active tension development. Thus Ca is the signal that couples stretch to contraction. This latter feature is the so-called myogenic response. Altered equilibrium may be initiated either by a rise in perfusion or tissue pressure to alter the distending force or by a rise in cytosolic Ca to increase active tension development and the constricting force. Several factors may initiate disequilibrium, some of which are discussed. Equilibrium is soon reestablished, however, at a new steady state. The model predicts curves for renal blood flow autoregulation and renin secretion in response to changes in renal perfusion pressure, tissue pressure, extracellular Ca, and blockers and promoters of Ca influx and Ca efflux. These predictions agree well with existing experimental evidence and suggest new experiments. The model provides a theoretical basis for explaining the steady-state blood pressure profile observed in renovascular hypertension and perhaps in other forms of hypertension as well. The model also provides a theoretical basis for understanding the volume-vasoconstriction approach used by some workers and the autoregulation approach used by others in explaining the mechanisms of hypertension.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3532827 TI - Pressor contributions from angiotensin and vasopressin after polyethylene glycol. AB - Isosmotic volume depletion was induced by subcutaneous injection of 5 ml of polyethylene glycol (PEG; 20 M; 30%) in Long-Evans rats and in rats deficient in hypothalamic vasopressin (Brattleboro rats). In the PEG-treated Long-Evans rats, captopril caused a hypotension that was greater than that seen in saline-injected controls. Pretreatment with the vasopressin (V1 receptor) antagonist d(CH2)5DAVP did not, itself, cause a fall in blood pressure, but it enhanced the hypotensive effect of captopril in the PEG-treated Long-Evans rats. The PEG-treated Brattleboro rats had similar resting blood pressures to the PEG-treated Long Evans rats, but in the former group, captopril caused a more profound and progressive hypotension than was seen in any of the present experimental regimes used in the Long-Evans rats. This suggests that, during hypovolemia induced by PEG, Brattleboro rats were either more dependent on the renin-angiotensin system for the maintenance of arterial blood pressure than were Long-Evans rats treated acutely with a vasopressin (V1) receptor antagonist or less able to recruit sympathoadrenal mechanisms to compensate for the sudden loss of the renin angiotensin system. PMID- 3532826 TI - Salt appetite is suppressed by interference with angiotensin II and aldosterone. AB - Blockade of central but not peripheral mineralocorticoid receptors, with the antimineralocorticoid RU-28318, reduces but does not suppress salt appetite aroused by sodium depletion in the rat. When central mineralocorticoid blockade is combined with captopril treatment to prevent formation of endogenous angiotensin II the appetite is completely suppressed. Suppression of the appetite occurred without changes in the animals' spontaneous ingestive behaviors, sodium excretion, or insulin-induced food intake. These results demonstrate that a synergy of angiotensin II and aldosterone is responsible for the expression of depletion-induced salt appetite in the rat. PMID- 3532828 TI - Neuroscience and psychiatry: marriage or coexistence? AB - Psychiatry, which has experienced the influence of many thrusts in its history, is currently experiencing the impact of neuroscience. Clinicians view the impact with excitement and with apprehension. The author reviews examples of the excitement of scientific developments related to psychiatry. He traces the coexisting evolution of a more differentiated clinical psychiatry and deals with questions of reconciling neuroscience and behavioral approaches. The author's contention is that neuroscience will strengthen psychiatry and that biological and psychological integration will thus be enhanced. PMID- 3532829 TI - Preliminary data on the relationship between nortriptyline plasma level and response in depressed children. AB - Twenty-two subjects 6-12 years old who met Research Diagnostic Criteria and DSM III criteria for major depressive disorder received a fixed daily dose of nortriptyline during an 8-week protocol. Weekly plasma levels were measured; the raters performing behavioral assessments were blind to these levels. There was a highly significant difference between the mean steady-state plasma levels and the milligram-per-kilogram doses of the responders and nonresponders. The data suggest that the lower limit of the therapeutic range of nortriptyline in children (over 60 ng/ml) is similar to that reported for adults. The disadvantages of the use of a milligram-per-kilogram dose rather than a pharmacokinetic approach are discussed. PMID- 3532830 TI - Carbamazepine for treatment-resistant depressions? PMID- 3532831 TI - Limitations of a psychobiological concept of the integration of psychotherapy and meditation. PMID- 3532832 TI - Computer advances towards the realization of a cybernated health-science diagnostic system. PMID- 3532834 TI - Future of the chronic schizophrenic patient: prediction and recommendations. AB - A glimpse into the future for the schizophrenic patient requires a grasp of the history of American psychiatry and the many factors which led to the deinstitutionalization process and its negative effects. The paper reviews this material in some depth. It covers in detail the past forty years of legislation which saw psychiatry rise to heights of good care and then slowly decline to its present state. Some predictions are made about the continuing fate of the state system, how schizophrenic patients are likely to be viewed and treated, and where they will tend to live. Long-term psychotherapy increasingly will fall into disrepute, hospital care will be increasingly brief, biologic in its emphasis and the numbers of chronically ill schizophrenics will grow out of control. It is predicted that there will not be a breakthrough in either the biologic or social fields, and pessimism will reign. PMID- 3532833 TI - Antidepressants in children: indications, benefits, and limitations. AB - The clinical applications of antidepressant drugs in childhood behavioral and emotional disorders were reviewed briefly as a means of introducing advances that have emerged over the past decade in the field of pediatric psychopharmacology. Using prepubertal major depressive disorder as a prototype, the benefits and limitations of antidepressant treatment were discussed in a conceptual way that builds on the current state of the evidence. Syndromic depression and major depression as a disorder with a distinct natural history, pattern of familial aggregation, and emerging set of psychobiological correlates can be supported by this evidence, and can be reliably diagnosed in children. Given the long duration of symptoms in depressed children, the degree of functional impairment they experience during and following recovery from an episode, and the high risk of relapse, treatment with antidepressant medication appears warranted despite attendant risks and potential disadvantages. Although psychosocial treatments are not as empirically defensible as drug treatment, there are compelling reasons why they should be used and investigated more exhaustively. Some suggestions regarding research directions and guidelines for clinical practice are offered. PMID- 3532835 TI - Empirical study of alexithymia: methodology and results. AB - Starting with a review of selected examples of empirical studies on the concept of alexithymia, this paper then presents a new perspective that helps to integrate these diverse results. Studies are grouped into two types: those employing instruments (questionnaires, ratings) that directly assess alexithymia, and experimental studies. Studies of the first type are found to be inconclusive in that the search for a personality trait of alexithymia in psychosomatic patients has not been very fruitful. The evidence from experimental studies, however, does allow for some interesting interpretations: The apparent diversity in results can be resolved, if certain crucial dimensions are analyzed. On the stimulus side, interpersonal relevance and the degree of subjective involvement are found to be crucial, as results pointing towards alexithymia are mainly found when both of these are high. On the measurement side, large variations in results can be explained by reference to the "depth" of measurement level. On a more superficial or cognitive level, it is possible to find indications of alexithymia, whereas on a deeper, more unconscious level, psychosomatic patients' response to experimental stimuli are similar to that of controls. The implications of this are that alexithymia, rather than being understood as a personality trait, should be seen as a label for a set of coping behaviors that occurs in specific situations only. PMID- 3532836 TI - Monoclonal antibodies to human choriocarcinoma. AB - We have established two monoclonal antibodies (TM7-3 and TM3-8) that react to choriocarcinoma cells. Both of these monoclonal antibodies have shown a similar reactive pattern to human cell lines, normal and neoplastic trophoblast tissues, and other fetal and adult tissues. They have reacted to nine of the ten choriocarcinoma cell lines, as well as to Hela cells (a cervical carcinoma cell line). During a cellular radioimmunoassay, neither TM7-3 nor TM3-8 reacted to two T lymphoblastoid cell lines or three B lymphoblastoid cell lines. Immunofluorescence and immunoperoxidase staining showed that both monoclonal antibodies reacted selectively to the cytotrophoblast-like tumor cells of a choriocarcinoma and a hydatidiform mole but not to syncytiotrophoblast-like tumor cells. TM7-3 and TM3-8 also reacted slightly to the normal cytotrophoblast of early human chorionic villi under the same conditions as they did to choriocarcinoma tissues, TM7-3 and TM3-8 bind only to a part of the urinary tubles of the kidney and to the ducts of the pancreas of both adult and fetus. PMID- 3532837 TI - Fetal heavy chain skeletal myosin. An oncofetal antigen expressed by rhabdomyosarcoma. AB - Fetal heavy chain skeletal myosin is normally present in fetal skeletal muscle. The study of 21 cases of rhabdomyosarcoma using specific antisera for fetal myosin, as well as for slow myosin, myoglobin, and desmin, led to positive findings in all cases with at least one antiserum. Desmin was localized in all cases and fetal myosin in 17 cases (81%), while myoglobin and slow myosin were present in 11 and eight cases, respectively. The localization of fetal myosin in rhabdomyosarcoma indicates that it is a type of oncofetal antigen. Because fetal myosin is found in small rhabdomyoblasts, it can be a useful marker in cases that usually constitute diagnostic problems. PMID- 3532838 TI - Calcitonin-secreting carcinomas of the prostate. An immunohistochemical and ultrastructural analysis. AB - Two cases of calcitonin-producing carcinomas of the prostate are reported. Light microscopical, immunohistochemical, and ultrastructural investigations have been performed. These tumors displayed a remarkable dual, endocrine and common epithelial (exocrine), differentiation. However, they presented two different architectural growth patterns. Of particular interest, numerous calcitonin cells were immunocharacterized. In addition, the endocrine component could harbour carcinoembryonic antigen, serotonin, human chorionic gonadotrophin, and prostate specific acid phosphatase immunoreactive cells. Ultrastructural analysis confirmed the presence of numerous endocrine cells. These findings are not unexpected, since calcitonin, serotonin, and human chorionic gonadotrophin immunoreactive cells are normal and constitutive inhabitants of prostate gland. In the current cases, calcitonin cells showed a strong carcinoembryonic antigen immunoreactivity, as observed also in thyroidal C-cells. This peculiar kind of prostatic carcinoma might be compared to certain thyroidal tumors of intermediate type coupling parafollicular and follicular differentiation. PMID- 3532839 TI - Anaplastic astrocytoma mimicking metastatic carcinoma. AB - A case of anaplastic astrocytoma mimicking a metastatic carcinoma is presented. This rare type of astrocytoma with epithelial features is compared to cases reported in the literature, and the importance of staining brain tumor biopsies for glial fibrillary acidic protein is emphasized. PMID- 3532840 TI - Mantle-zone lymphoma: another opinion. PMID- 3532841 TI - Standardization and evaluation of an enzyme immunoassay as a screening test for the seroepidemiology of human hydatidosis. AB - The immunodiagnosis of human hydatidosis caused by Echinococcus granulosus is based on the detection of antibodies against arc 5 antigens by the double diffusion (DD5) or counterimmunoelectrophoresis (CIE5) tests. However, neither of those tests is practical for seroepidemiological surveys in which a great number of samples have to be processed. The present study was carried out to evaluate if a solid phase enzyme immunoassay (EIA) standardized to detect total antibodies against E. granulosus cyst fluid antigens would permit the selection of sera with antibody activity against arc 5 antigens detectable by DD5. Groups of sera representing 5 possible results with DD5 were studied by the EIA proposed as a screening test. Using the EIA all the sera with antibody activity against arc 5 antigens were differentiated from all those which did not produce any precipitation band in DD5. It was also possible to differentiate those with no antibodies from all those with antibodies against 3 non-arc 5 antigens, most with antibodies against 2 non-arc 5 antigens and about a fifth with antibodies against 1 non-arc 5 antigen. It is concluded that the EIA, standardized as described, is capable of detecting with a high degree of efficiency all the sera that should be tested by DD5 and excludes most of those in which results with DD5 have no diagnostic significance. PMID- 3532842 TI - Identification of African swine fever viral antigens in the hemolymph of soft ticks (Argasidae: Ornithodoros) by the immunodot blot test. AB - The immunodot blot test was used to identify African swine fever virus (ASFV) antigens in the hemolymph from soft ticks (Ornithodoros coriaceus) fed on ASFV infected pigs. The immunodot blot test was sensitive and specific for ASFV antigens and has potential field application. Hemolymph from field-collected ticks can be screened for ASFV and a variety of other tick-borne pathogens using this test. PMID- 3532843 TI - Use of the avidin-biotin-peroxidase complex immunocytochemical procedure for detection of Rift Valley fever virus in paraffin sections of mosquitoes. AB - The avidin-biotin-peroxidase complex (ABC) immunocytochemical procedure was used to locate Rift Valley fever (RVF) virus antigen in infected Aedes albopictus C6/36 cultured cells and in serial paraffin sections of intrathoracically injected Egyptian Culex pipiens. Fixation of the cultured cells in formaldehyde or periodate-lysine-paraformaldehyde, and fixation of whole mosquitoes with formaldehyde resulted in good preservation of morphology and excellent differential staining between uninfected and infected specimens. Two primary antibodies against RVF virus were tested on the cultured cells: a polyclonal rabbit antiserum and a mixture of mouse monoclonal antibodies. Only the mouse monoclonal antibody mixture was tested on the Cx. pipiens. Specific staining of tissues in paraffin sections occurred at dilutions as high as 1:5,000. In both cultured Ae. albopictus cells and sections of Cx. pipiens, only the cytoplasm was positive for antigen. A preliminary list of tissues in Cx. pipiens that exhibited specific or nonspecific staining is given. PMID- 3532844 TI - Potential vectors of malaria and their different susceptibility to Plasmodium falciparum and Plasmodium vivax in northern Brazil identified by immunoassay. AB - During the period from May 1983 to July 1985 we conducted an epidemiological study to determine potential vectors of malaria in 6 districts in the state of Para in northern Brazil. The examination of random human blood smears, prepared at the time of mosquito capture, indicated overall human infection rates of 16.7% and 10.9% for Plasmodium falciparum and P. vivax, respectively. Two immunoassays, the immunoradiometric assay (IRMA) and the enzyme-linked immunosorbent assay (ELISA), based on the use of species-specific antisporozoite monoclonal antibodies, were used to analyze a total of 9,040 field-collected Anopheles mosquitoes for plasmodial infection. P. falciparum sporozoite antigen was detected in A. darlingi at rates varying from 2.7% to 4.2%, and in small numbers of A. oswaldoi collected in 1 of the districts. In contrast, sporozoite antigen of P. vivax was found in A. darlingi, A. triannulatus, A. nuneztovari, and A. albitarsis at rates ranging from 0.9% to 12.0%. By dissection, sporozoites were found in the salivary glands of these same 4 species at rates ranging from 0.8% to 2.2%. The latter 3 species had not previously been implicated as malaria vectors of any significance in northern Brazil. PMID- 3532845 TI - Polyamine oxidase in human retroplacental serum inhibits the growth of Plasmodium falciparum. AB - Human retroplacental serum (RPS) containing polyamine oxidase inhibited the growth of the Camp strain of Plasmodium falciparum in vitro as assayed by the parasite's decreased incorporation of 3H-hypoxanthine. Inhibition was dose dependent on the concentrations of serum polyamine oxidase and added polyamines. Almost complete inhibition was seen in 96-hr asynchronous cultures containing 10% RPS and in those containing 1.2% RPS plus 50 microM polyamine. Subtle morphologic changes in mature stages and decreased numbers of new rings were associated with inhibition seen in 19-hr synchronous cultures initiated at the trophozoite stage. These incubation times were longer than in previous reports showing inhibition of malaria parasites by bovine polyamine oxidase but not by human polyamine oxidase. Macrophages contain polyamine oxidase, the reaction products of which are known to be similar to those of RPS polyamine oxidase but different from those of bovine polyamine oxidase. It remains to be determined whether human polyamine oxidase, acting upon ubiquitous polyamines, contributes to host defenses against malaria. PMID- 3532846 TI - Factors influencing invasion of erythrocytes by Plasmodium falciparum parasites: the effects of an N-acetyl glucosamine neoglycoprotein and an anti-glycophorin A antibody. AB - When schizont-infected erythrocytes were incubated with N-acetyl glucosamine coupled to bovine serum albumin (GluNAc-BSA), the number of new ring forms which appeared several hours later was reduced and the number of abnormal and unruptured schizont-infected erythrocytes was increased compared with controls, indicating that GluNAc-BSA prevents invasion by a toxic effect on schizonts rather than by receptor blockade. Invasion of erythrocytes by Plasmodium falciparum was inhibited by a monoclonal antibody against glycophorin A, but inhibition also occurred with P. knowlesi, a parasite that is known to invade independently of glycophorin A. Inhibition of invasion with anti-glycophorin A is unlikely to be related to receptor blockade and is probably related to decreased deformability of the erythrocyte membrane caused by the binding of this antibody. Previous studies suggesting that GluNAc-BSA and anti-glycophorin A antibodies inhibit invasion by receptor blockade should be reevaluated. Erythrocytes deficient in glycophorin C and band 4.1 were also resistant to invasion by both P. falciparum and P. knowlesi. PMID- 3532847 TI - Malarial pigment-dependent error in the estimation of hemoglobin content in Plasmodium falciparum-infected red cells: implications for metabolic and biochemical studies of the erythrocytic phases of malaria. AB - Measurements of mean corpuscular hemoglobin (MCH) in Plasmodium falciparum infected red cells cultured in vitro revealed that malarial pigment (hemozoin) interferes with a true estimate of the actual hemoglobin content in Drabkin's reagent. When the hemozoin pigment was removed by passage of the lysate over a Biorex 70 column, a lower MCH value was obtained which allowed one to estimate that, under these conditions, the parasite consumes about 25% of the red cell's initial hemoglobin. Because spectrophotometric examinations of infected red cell lysates in Drabkin's reagent detect the unchanging heme content of infected red cells (hemoglobin + hemozoin), it can be used for expressing enzymatic activity or metabolite content. Results agree with simultaneous measurements on a per cell basis. However, it is suggested that instead of per gram hemoglobin, the activity should be stated as per mmole (or mumole) heme pigment. The ability to estimate accurately the consumption of intracellular hemoglobin will be useful in metabolic and pharmacologic studies of the parasite/red cell interaction. PMID- 3532848 TI - Evaluation of a synthetic oligonucleotide probe for diagnosis of Plasmodium falciparum infections. AB - A radiolabeled synthetic oligonucleotide was evaluated as a diagnostic probe specific for Plasmodium falciparum using blood samples lysed directly on nitrocellulose filters. The probe technique successfully diagnosed malaria in experimentally infected chimpanzees that had 0.001% parasitemias (50 parasites/microliter) as determined by blood smears, and in 1 chimpanzee whose blood smear was negative, but whose blood was culture-positive for P. falciparum. In a double blind study of 50 patient samples from the Philippines, the probe results correlated well with blood smear results when the autoradiographs were read after 4-8 hr exposure. The results indicate that the oligonucleotide probe may be useful in the rapid and specific diagnosis of P. falciparum infection. PMID- 3532849 TI - A new liquid medium without blood and serum for culture of hemoflagellates. AB - A liquid medium without blood or serum was developed for cultivation of hemoflagellates. To a basic LIT medium containing liver infusion broth and tryptose, a mixture of RPMI 1640 and Medium 199 was added. This combination permitted high parasite yields useful for biochemical and immunological studies. PMID- 3532850 TI - Tissue localization of excretory-secretory antigens of larval Toxocara canis in acute and chronic murine toxocariasis. AB - The distribution of excretory-secretory antigens of larval Toxocara canis (TEX) in tissue was studied in cases of both acute and chronic experimental murine toxocariasis. Liver samples were collected from BALB/c BYJ mice killed either 2 days (acute) or 8 months (chronic) after intragastric inoculation with infective T. canis eggs. Cryostat sections of liver were stained using biotin-conjugated, rabbit anti-TEX antibody with an avidin-fluorescein isothiocyanate indicator. In both acute and chronic infections larval sections were brightly fluorescent. The patterns of antigen deposition in acute infections were indicative of larval migration. In tissue sections from chronic infections, antigens were observed mainly within the core of granulomas centered around larvae and within the inner rim of the collagen capsule of granulomas in which a larva or larval remnant was not detected. When present within the collagenous capsule, TEX appeared to be extracellular. These findings suggest that an accurate histopathological diagnosis of larval toxocariasis may be possible in biopsy or autopsy material lacking an obvious etiological agent. PMID- 3532851 TI - Hydatid cyst of the spleen. AB - Though hydatid disease is quite common in Saudi Arabia, splenic echinococcal cysts are rare. Our experience with the diagnostic problems encountered in three patients seen during a three-year period is presented. The helpful role of ultrasonography and computerized tomography in the preoperative evaluation of this disease also is demonstrated. PMID- 3532852 TI - Ultrasound measurement of the ventricular size in newborn infants. AB - High resolution real-time ultrasound scans were obtained through the anterior fontanelle to measure the lateral ventricles of 540 neonates of various gestational ages. Coronal scans showed that the distance between the falx and the lateral wall of the body of the lateral ventricle (ventricular index) and the greatest axis of the lateral ventricle (ventricular axis) were correlated with increasing gestational age. Growth charts were constructed for neonates of various gestational ages, from 24 to 40 weeks. The greatest distance perpendicular to the ventricular axis was defined as the ventricular depth. The depth of normal lateral ventricles was 0.18 cm (range, 0.13-0.23 cm). Hopefully, the data concerning ventricular sizes obtained in this survey can be utilized for the early diagnosis and control of posthemorrhagic ventriculomegaly. PMID- 3532853 TI - An immunologic study of psoriasis. AB - Thirty-five patients with psoriasis and 18 normal controls were studied in order to assess the role of humoral immunity in psoriasis. Direct immunofluorescent study of skin biopsy specimens taken from the lesions revealed deposits of immunoglobulins (IgA, IgG, IgM) and complement components (Clq, C3), mainly in the stratum corneum. Deposits were also found in Munro's microabscesses, spongiform pustules of Kogoj, upper layers of the stratum malpighii, dermal blood vessels, and cells of the dermal inflammatory infiltrate. Uninvolved skin of the patients and normal controls revealed negative fluorescent results. There was a significant increase in the mean levels of IgA and IgG in patients with psoriasis, whereas IgM was within the normal range. The present study showed humoral abnormalities in psoriasis that may be involved in its pathogenesis. PMID- 3532854 TI - Fatal disseminated bacillus Calmette-Guerin infection and arrested growth of cutaneous malignant melanoma following intralesional immunotherapy. AB - An 84-year-old man with aggressive cutaneous malignant melanoma, which failed to respond to systemic chemotherapy, was electively treated with intralesional bacillus Calmette-Guerin (BCG) immunotherapy. He died with widespread miliary granulomas, most likely representing disseminated BCG infection. However, at autopsy, the patient was found to have a minimal tumor burden and only a single focus of visceral metastatic malignant melanoma. In view of the clinically documented aggressive nature of this patient's disease, the arrested growth of his tumors is best attributed to the beneficial effect of BCG immunotherapy. PMID- 3532855 TI - Julius Caesar and the Julian emperors. A family cluster with Hartnup disease? PMID- 3532856 TI - The man behind the eponym. Dr. Jacob Churg. PMID- 3532857 TI - George Hector Percival and British dermatopathology. PMID- 3532858 TI - Methodological aspects of nasal allergen challenges based on a three-year tree pollen immunotherapy study. AB - During 3 years of immunotherapy with tree pollen extracts, 31 patients were provoked annually. Changes in nasal reactivity were followed by registration of expiratory nasal peak flow, number of sneezes, and amount of secretion. The reproducibility of the peak flow measurements was studied. The results from all three parameters were used to form a total nasal provocation score which, better than each parameter separately, could demonstrate the variation in sensitivity. Provocation with an allergen concentration of 1 HEP was the most effective means of showing changes in specific sensitivity of nasal mucosa. PMID- 3532859 TI - Collection of house dust for analysis of mite allergens. Allergen-reducing effect of a self-administered procedure. AB - To assess allergen-reducing effect of dust collection from mattresses, patients were asked to vacuum clean the entire surface of their mattresses for 5 min with their household cleaners at specified intervals ranging from 1-21 days. Ten patients performed four collections, nine patients only two. Amounts of dust, concentrations and amounts of major allergens from Dermatophagoides pteronyssinus (Dp42), Dermatophagoides microceras (Dm6), and Dermatophagoides farinae (Df6) were determined. The first sampling caused a statistically significant reduction in the absolute amounts of allergens in a following sample. The same tendency was seen in dust weight but not in concentrations of allergens. At intervals of 1 or 3 weeks no consistent changes could be registered. Differences were small and good reproducibility of the sampling and analysing procedure could be assumed. Since the self-administered procedure is much cheaper and easier to handle than sampling done by technicians with special equipment, it can be recommended for sequential analysis of allergen exposure. PMID- 3532860 TI - Development of a sensitive, direct luminescent enzyme immunoassay for plasma estradiol-17 beta. AB - A rapid, sensitive, precise, chemiluminescent enzyme immunoassay for estradiol-17 beta has been developed and validated. Antibodies were produced in rabbits using estradiol-17 beta-6-(O-carboxymethyl)oxime coupled to bovine serum albumin, purified and immobilized on polystyrene beads (6.4 mm diameter). The same derivative was used to prepare the enzymatic tracer by coupling with horseradish peroxidase. The assay, direct on the serum sample, featured a 4-h binding step at 4 degrees C followed by the chemiluminescent detection using luminol/H2O2. The detection limit was 0.15 pg/tube and the assay was carried out on 20-100 microliter of sample, allowing measurement of estradiol-17 beta in plasma concentrations from 1.5 to 500 pg/ml. The method fulfills all the standard requisites of precision and accuracy and the results agree well with a radioimmunoassay procedure on extracted serum. PMID- 3532861 TI - Separation of large DNA molecules by modified pulsed field gradient gel electrophoresis. AB - Resolution of DNA fragments by pulsed field gradient gel electrophoresis is a function of the pulse time, geometry, and strength of the orthogonal electric fields. The first field geometry described had a number of disadvantages. We show that these disadvantages can be largely overcome by a modified electric field geometry together with an altered switch pattern. These changes are shown to have critical consequences for the technique. Resolution is more uniform across the gel, which permits more samples to be analyzed on the same gel. In addition, DNA molecules follow a migration path that is approximately straight down the gel. This aspect also increases the number of usable wells. One important property of the system described here provides some insight into the mechanism whereby DNA molecules are resolved by this method. PMID- 3532862 TI - A method for screening penicillin G acylase-producing bacteria by means of 2 nitro-5-phenylacetaminobenzoic acid test paper. AB - A simple, rapid assay for screening penicillin G acylase-producing bacteria is presented. The method is based on the formation of yellow 2-nitro-5-aminobenzoic acid by penicillin G acylase acting on 2-nitro-5-phenylacetaminobenzoic acid (NIPAB). NIPAB test paper is briefly applied to bacterial colonies on the agar surface, which are subsequently scored individually on the paper by color; bright yellow indicates the presence of penicillin G acylase, natural color its absence. The present method is suitable not only for screening penicillin G acylase production by a variety of bacteria but also for detection from a large number of transformant colonies of clones containing a gene encoding for the enzyme. PMID- 3532863 TI - Effects of the modification of transfer buffer composition and the renaturation of proteins in gels on the recognition of proteins on Western blots by monoclonal antibodies. AB - Two modifications to Western blots which enhance immunochemical recognition have been developed. The first is transfer in carbonate buffer at pH 9.9, rather than the more commonly used Tris-glycine buffer at pH 8.3. This alteration improved the recognition of four of the five subunits of Escherichia coli F1-ATPase by monoclonal antibodies, the smaller subunits showing the greatest effects. Recognition of dinitrophenyl groups attached to the subunits by polyclonal antibodies was improved by the carbonate buffer only for the smallest ATPase subunit, epsilon. The second modification was incubation of the gel in mild buffers, designed to promote the renaturation of proteins, before the electrophoretic transfer step. The most effective buffer was 20% glycerol in 50 mM Tris-HCl, pH 7.4. Improvements in the signal obtained with monoclonal antibodies to all the subunits of ATPase were obtained by this procedure. As the subunits vary markedly in size, isoelectric point, and other properties, this method should be useful for most proteins. The fate of the 15,000-Da epsilon subunit, labeled with 125I, was followed through a blotting experiment. As long as no sodium dodecyl sulfate was added to the transfer buffer, epsilon was bound to nitrocellulose efficiently in either Tris-glycine or carbonate buffer. However, the epsilon was retained much more strongly during the subsequent incubation steps if the transfer was done in the carbonate buffer. The binding of epsilon to the nitrocellulose was even more stable when the gel had been treated with the buffered glycerol solution before transfer. These results indicate that the conditions under which epsilon subunit first encounters the nitrocellulose markedly affect the stability of binding during subsequent steps. The F1-ATPase was partially fragmented by treatment with proteases and then run on a gel and either transferred immediately in Tris-glycine buffer or else treated with the buffered glycerol solution and transferred in the carbonate buffer. The second blot gave stronger recognition of residual alpha subunit and fragments by an anti alpha monoclonal antibody, with the largest improvement for the smaller fragments. This result suggests that the modified procedure may be particularly useful in enhancing the detection of small proteins. PMID- 3532864 TI - Bioassay-directed chemical analysis in environmental research. PMID- 3532865 TI - On-line differential pulse polarographic detection of carboplatin in biological samples after chromatographic separation. PMID- 3532867 TI - The infant and the myoneural junction. PMID- 3532866 TI - The carotid body of the harbour seal (Phoca vitulina richardsi). AB - The bilateral distribution of carotid body type 1 and 11 cells was investigated in five harbour seals (Phoca vitulina richardsi), by serially sectioning the carotid bifurcation regions. The cells occurred bilaterally in the animals and were also present in one specimen from a sixth animal available for study. The type 1 and 11 cells were located in the space between the internal and external carotid arteries and had a varied relationship to the occipital and condyloid arteries. They lay within a division of connective tissue with irregular but defineable borders and this combination of connective tissue and type 1 and 11 cells constituted the principal mass of the carotid body. The carotid body occurred in a variety of forms: wedge-shaped, crescentic or horse-shoe shaped, or as a discrete oval structure. In some specimens the carotid body had a central 'neurovascular' core of small blood vessels and nerves. The artery to the organ originated from either the external carotid, internal carotid or common carotid arteries. Using an interactive image analysis system in eight specimens, which had been perfusion-fixed at a normal arterial pressure, the mean volume of the carotid body was 1.666 +/- 0.45 (SD) mm3. Caudally and separate from the principal mass of the carotid body periadventitial type 1 and 11 cells were noted in 4 out of 11 specimens in the connective tissues adjacent to the external carotid artery, origin of the occipital, and the rostral part of the common carotid artery and its bifurcation. PMID- 3532868 TI - Cushing's contributions to anesthesia: two comments. PMID- 3532869 TI - A modified ECG-triggered cinefilm-mark unit for DSA studies of the heart and great vessels. AB - The authors developed an inexpensive, reliable, and easy-to-install, ECG triggered cinefilm-mark device that permits performance of high-quality subtraction studies of the coronary circulation. PMID- 3532870 TI - A brief tour of psychoneuroimmunology. PMID- 3532872 TI - Mortality in swine herds endemically infected with Haemophilus pleuropneumoniae: effect of immunization with cross-reacting lipopolysaccharide core antigens of Escherichia coli. AB - The benefit of increased immunity to cross-reacting lipopolysaccharide core antigens of gram-negative bacteria induced by vaccination with an Rc mutant of Escherichia coli 0111:B4 (strain J5) was evaluated in commercial swine herds endemically infected with Haemophilus pleuropneumoniae. Weanling pigs were vaccinated IM with E coli J5 (group 1) before the expected time of H pleuropneumoniae infection. Clinical signs, antibiotic treatment frequency, mortality, growth performance (days to market weight), and serologic responses of the pigs were monitored for approximately 5 months after vaccination. The results were compared with those of pigs vaccinated IM with a commercial H pleuropneumoniae bacterin (group 2) and with those of nonvaccinated control pigs of the same age (group 3). The treatment frequency and growth performance were similar in the 3 groups. However, vaccination with E coli J5 or with the H pleuropneumoniae bacterin lowered mortality, compared with mortality in the controls. Serum titers against E coli J5 increased after vaccination with the E coli J5 bacterin, but were not increased by vaccination with the H pleuropneumoniae. In contrast, serum titer to E coli J5 increased in all treatment groups as a result of H pleuropneumoniae infection or exposure. The protection against lethal H pleuropneumoniae infections in swine that was provided by vaccination with the E coli J5 and the H pleuropneumoniae bacterin appeared to be immunologically distinct on the basis of serologic analysis, indicating the possibility of different mechanisms of protection. PMID- 3532871 TI - Cardiac output measurements. A review of current techniques and research. AB - Cardiac output is the volume of blood ejected by the heart per unit time. It is a useful measurement in that it can be used to evaluate overall cardiac status in both critically ill patients and patients with suspected cardiovascular disease. An ideal cardiac output measurement system would have automated continuous output capability, be minimally invasive, accurate, fast, small, low cost and clinically adaptable. This paper presents a theoretical and practical description of the variety of clinical techniques in use today and lists their advantages and shortcomings with respect to the ideal system. Included are the Fick method, indicator dilution techniques, velocity measurements and transthoracic impedance and combined Doppler ultrasound as noninvasive techniques. In addition, several experimental methods are described along with their desirable features and possible constraints. These include intravascular heating/recording, thermistor tracking of cardiac output, ejection fraction measurements and magnetic susceptibility plethysmography. PMID- 3532873 TI - Study of porcine postweaning diarrhea involving K88(-) hemolytic Escherichia coli. AB - The onset of fecal shedding, serogroup involvement, and association of hemolytic Escherichia coli with the postweaning diarrhea syndrome were studied in swine. The only E coli O antigen, detected by slide agglutination with the antisera used, was O157; K antigens were not detected. The ligated intestinal loop test (LILT) was used for enterotoxigenicity testing. All O157 serogroup isolates (n = 9) were hemolytic, and 89% (8 of 9) were LILT positive. Of all hemolytic isolates tested, 59% (10 of 17) were LILT positive. Twenty-seven nonhemolytic isolates were tested for enterotoxigenicity; of these, 45% (12) were LILT positive. The onset of postweaning diarrhea coincided with the modal onset of hemolytic E coli shedding at postweaning day 7. At postweaning day 7, hemolytic E coli shedding was concurrently associated with diarrhea (P less than 0.0005), whereas later during the postweaning period, this was not the situation. PMID- 3532874 TI - Hemolytic and bactericidal activities of bovine complement in mammary secretions of cows during the early nonlactating (dry) period. AB - Hemolytic and bactericidal complement-dependent activities were measured in quarter mammary secretions obtained during the first 21 days of the nonlactating (dry) period from 8 Holstein-Friesian cows. We demonstrated an inhibition of hemolytic activity and bactericidal activity against a serum-sensitive Escherichia coli strain. Both hemolytic and inhibitory titers increased markedly during active involution. The bactericidal activity of dry secretions required a minimal threshold of complement and an inhibitory titer lower than the hemolytic titer. PMID- 3532875 TI - High-frequency jet ventilation during pneumothorax in dogs. AB - Pneumothorax (45 ml of N/kg of body weight insufflated into the pleural space) in anesthetized dogs ventilated with air caused a significant (P less than 0.05) increase in pleural pressure, central venous pressure, capillary wedge pressure, and venous admixture. Cardiac index (CI) and arterial O2 tensions were decreased. Ventilation with 100% O2 increased arterial O2 tensions, but did not affect calculated intrapulmonary shunting of blood or CI. Application of 10 cm of H2O positive end-expiratory pressure in the presence of pneumothorax during positive pressure ventilation and high-frequency jet ventilation reduced intrapulmonary shunting of blood, which remained higher than control values, and caused a further decrease in CI. Cardiopulmonary function during pneumothorax in anesthetized dogs was more profoundly affected by the application of positive end expiratory pressure than by the form of mechanical ventilation. PMID- 3532876 TI - Endocrinologic, hematologic, and heart rate changes in swimming horses. AB - Two identical experiments, using Standardbred and Thoroughbred horses (experiment A, n = 31; experiment B, n = 17) on a swimming regimen, were performed 1 week apart to evaluate short-term heart rate, hematologic, and endocrinologic changes. Horses were placed in 4 categories based on duration of swimming (1 to 5, greater than 5 to 10, greater than 10 to 15, and greater than 15 minutes). Heart rate, PCV, and plasma concentrations of total protein, cortisol triiodothyronine, thyroxine, insulin, and glucose of each horse were evaluated before, immediately after, and 1 hour after swimming. For experiment A, there was a main effect of time of sampling on PCV, total protein, triiodothyronine, thyroxine, and insulin. There was a main effect of duration of swimming on insulin concentration and an interaction of duration of swimming and time of blood collection on heart rate and cortisol concentration. For experiment B, there was a main effect of time of blood collection on all the variables except glucose. PMID- 3532877 TI - Comparison of four test procedures to identify Staphylococcus aureus isolated from bovine intramammary infections. AB - A comparison was made between conventional tube coagulase, macrocupsular coagulase, latex agglutination, and miniaturized biochemical test systems for identification of Staphylococcus aureus of bovine origin. A total of 303 gram positive, catalase-positive cocci of bovine origin were tested. Agreement between each pair of 4-hour tube coagulase, macrocupsular coagulase, latex agglutination, and miniaturized biochemical test results within isolates was greater than 95.0. Seventeen (5.6%) isolates were test negative for 4-hour tube coagulase, but test positive for 24-hour tube coagulase. Thirteen (76.5%) of these isolates were identified as S hyicus, 3 were S aureus, and 1 was not identified. PMID- 3532879 TI - Memoir is alive with spirit of nursing. PMID- 3532878 TI - Induction of mycoplasmosis in goat kids by oral inoculation with Mycoplasma mycoides subspecies mycoides. AB - A one-time, orally administered dose of greater than or equal to 1 X 10(6) colony forming units of Mycoplasma mycoides subspecies mycoides was sufficient to induce clinical mycoplasmosis (n = 37) terminating in fatal mycoplasmemia in 73% (37 of 51) of the clinically affected kids. The pathogen was isolated from the blood samples as early as 24 hours after oral inoculation; hot, swollen joints frequently were evident by 4 or 5 days after exposure. Pyrexia (to 42.3 C) was detected in about 95% (35 of 37) clinically affected kids, although about 5% (2 of 35) died peracutely without fever or other premonitory signs. At necropsy, the cardinal lesions were a fibrinopurulent polyarthritis and red, patchy to diffuse areas of consolidation in 1 or more lung lobes. At death, usually within 4 to 16 days after oral inoculation, the concentration of M mycoides subspecies mycoides in the blood was 1 X 10(6) to 1 X 10(7) colony-forming units/ml. Histologically, the kids had diffuse fluid leakage into pulmonary alveoli and to a lesser extent into small vessels of various other organs. Fibrinocellular thrombi of terminal occurrence were occasionally present in various organs. The meningeal, pleural, and peritoneal surfaces had vascular leakage and a minimal perivascular accumulation of leukocytes. The disease was contagious. Of 14 noninoculated control kids in close confinement with affected kids, 8 (57%) developed mycoplasmosis in 7 to 15 days and died of mycoplasmemia. The remaining 5 noninoculated kids remained healthy, as did noninoculated kids that were kept isolated from affected kids. PMID- 3532880 TI - Psychology in the Veterans Administration: a storied history, a vital future. PMID- 3532881 TI - Veterans Administration psychology. A professional challenge for the 1980s. PMID- 3532882 TI - Cytokine regulation of lung fibroblast proliferation. Pulmonary and systemic changes in asbestos-induced pulmonary fibrosis. AB - A complex series of interactions between immunocompetent cells and fibroblasts exists. Because pulmonary fibrosis may result from an increased number of collagen-producing fibroblasts, we studied the production of fibroblast growth factors derived from alveolar macrophages (AM) and peripheral blood mononuclear leukocytes (PBML) during the development of asbestos-induced fibrosis. Three groups of rats received, respectively, a single intratracheal injection of saline (control), 5 mg of asbestos, and 10 mg of asbestos. Bronchoalveolar lavage (BAL) and PBML isolation were performed on each animal 1, 3, and 6 months after instillation. Differential cell analyses revealed no significant change in the BAL cell populations except for a small but significant increase in the proportion of lymphocytes in the 10-mg group at 1 month and in both asbestos groups at 3 months. Similar analyses of PBML revealed only a small reduction in total PBML in the 10-mg group at 6 months. Bronchoalveolar cells (98% AM) from control rats spontaneously released a fibroblast growth factor (FGF), whereas Con A-stimulated PBML of the same animals produced fibroblast growth inhibitory activity (FGIF). One month after asbestos exposure, when fibrotic lesions were apparent, AM production of FGF was significantly enhanced, and such increase persisted for as long as 6 months. By contrast, no significant change in FGIF production by Con-A-stimulated PBML was seen at the 1-month interval. However, 3 months after exposure, there was a significant suppression of FGIF production by PBML from rats in the 10-mg group and at 6 months by PBML from rats in both asbestos groups.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3532883 TI - Do physicians need objective measurements to diagnose asthma? AB - The frequency with which disagreement occurs between the clinician's diagnosis of asthma and the objective measurement of methacholine airway responsiveness is not known. We have examined this in 51 consecutive new adult patients presenting with symptoms consistent with asthma but with normal spirometry. Disagreement between the physician's assessment and the result of the methacholine test occurred in 20 patients (39%). Of these, 13 had a clinical diagnosis of asthma but normal responsiveness and 7 had an unexpected increase in methacholine responsiveness. There was no difference in the type of symptoms experienced whether or not there was agreement between the test and the physician's assessment. Thus, an objective measurement like a methacholine inhalation test is clinically useful when spirometry is normal. A normal methacholine test in the presence of symptoms suggestive of asthma should alert the physician to the need for further investigation. PMID- 3532884 TI - Maximal airway narrowing in humans in vivo. Histamine compared with methacholine. AB - Maximal airway narrowing to inhaled nonsensitizing stimuli is limited to a mild degree in nonasthmatic and mildly asthmatic subjects. We investigated whether this limitation is due to a nonspecific inhibitory mechanism (with regard to the agonist) by comparing the maximal response plateaus of histamine and methacholine dose-response curves. Twenty subjects (15 nonasthmatics, 5 asthmatics) were selected in order to cover a wide distribution of airway responsiveness from the normal into the mildly asthmatic range. The subjects inhaled doubling doses of either histamine (up to 54 mumol) or methacholine (up to 340 mumol), delivered to the mouth during tidal breathing, on 2 separate days. The response was measured from volume-history-standardized, partial expiratory flow-volume curves as the flow at 40% of the control vital capacity (V40p), and expressed as the percentage fall from baseline value. Sixteen subjects demonstrated a plateau for both histamine and methacholine. The maximal response on the plateau was not significantly different between the 2 agonists, nor was there a difference in the provocative dose causing a 40% fall in V40p (PD40). The slope of the dose response curve was significantly steeper for histamine than for methacholine (p less than 0.001), whereby the histamine plateau was reached at relatively lower doses (p less than 0.01). The maximal response was inversely related to logPD40, and this relationship did not differ between histamine and methacholine. We conclude that maximal airway narrowing in vivo is limited by an inhibitory mechanism that is not dependent on the pharmacodynamic properties of the agonist. The results suggest that the extent of inhibition and the degree of airway responsiveness are determined by related mechanisms. PMID- 3532885 TI - Pulmonary epithelial clearance of 99mTc-DTPA after thrombin-induced pulmonary microembolism. AB - We investigated the effect of thrombin-induced pulmonary microembolism on the pulmonary clearance rate of aerosolized 99mTc diethylenetriamine pentaacetic acid (99mTc-DTPA) in awake, chronically prepared sheep. Chest activity was recorded after administration of a 0.44 micron aerosol of 99mTc-DTPA. Decay-corrected data were fit to an exponential and expressed as percent decrease per min (%/min). Sheep were given alpha-thrombin intravenously (80 U/kg for 10 min) 60 min after the aerosol administration. The clearance rate prior to alpha-thrombin was 0.35 +/- 0.05 %/min (mean +/- SEM). During alpha-thrombin administration, the clearance rate increased to 5.84 +/- 0.70 %/min (p less than 0.001 from baseline), but returned to 0.41 +/- 0.06 %/min within 30 min after the end of the thrombin infusion. The increased clearance rate during alpha-thrombin administration was not due to increased lung volume since alpha-thrombin did not change functional residual capacity. Moreover, the clearance rate was unchanged during gamma-thrombin administration, which does not induce coagulation, or during alpha-thrombin challenge in defibrinogenated animals. alpha-thrombin administration in neutrophil-depleted sheep caused a transient increase in DTPA clearance similar to that in control sheep, suggesting that the increase occurred independently of neutrophils. The results indicate that alpha-thrombin causes a large, transient increase in 99mTc-DTPA clearance, which may be the result of increased epithelial permeability. This response is dependent on the activation of intravascular coagulation. PMID- 3532886 TI - Depressed prostaglandin E1 and 5-hydroxytryptamine removal in patients with adult respiratory distress syndrome. AB - Because experimental lung injury is associated with decreased removal of 3H prostaglandin E1 (3H-PGE1) and 14C-5-hydroxytryptamine (14C-5-HT), we questioned whether a similar reduction would be evident in patients with the adult respiratory distress syndrome (ARDS). Accordingly, we measured, by indicator dilution techniques, pulmonary removal of 3H-PGE1 and 14C-5-HT in 11 patients undergoing cardiopulmonary bypass surgery in whom respiratory function was essentially normal, and compared them with similar measurements in 9 patients who had ARDS. In addition, we made 5 successive measurements of lung removal functions in the bypass group of patients during the 48-h period after the first measurement. These measurements were made before and 4 times (within 48 h) after the first measurement. Before bypass, removal of 3H-PGE1 and 14C-5-HT was 78 +/- 2 SEM and 89 +/- 2%, respectively; these did not change during the subsequent 48 h. Therefore, we compared prebypass values in this group with measurements made in patients with ARDS. The latter group had significantly decreased removal of 3H PGE1 and 14C-5-HT (values were 66 +/- 3 and 72 +/- 5%, respectively). We suggest that these changes reflect a diffuse functional injury to the endothelium similar to that seen after acute lung injury in laboratory animals. PMID- 3532887 TI - Alveolar macrophage function in a canine model of endotoxin-induced lung injury. AB - Humans with bacterial sepsis are predisposed to acute lung injury with respiratory failure and have an increased risk of pulmonary infection. Because the alveolar macrophage is the resident phagocyte in the lung and a defect in antimicrobial activity could predispose to infection, we assessed the functional integrity of these cells in vitro in a canine model of Escherichia coli endotoxin induced lung injury with respiratory failure. Dogs were given 2 or 20 mg/kg of E. coli endotoxin 055:B5, and alveolar macrophages from pulmonary lavage were compared with those from control dogs. The physiologic criteria for the adult respiratory distress syndrome and pathologic confirmation of acute lung injury were produced in all endotoxin-treated animals. The production of acute lung injury with respiratory failure by E. coli endotoxin was associated with several alterations in alveolar macrophage function. Adherence was significantly reduced for cells from the endotoxin groups. The alveolar macrophages from endotoxin treated animals differed from those from control animals, with significantly greater production of hydrogen peroxide, significantly greater peaks in chemiluminescence, significantly reduced phagocytosis of Staphylococcus aureus and E. coli at all times, and a diminished ability to kill cell-associated S. aureus and E. coli over time. These derangements could play a role in the therapeutic failures of pneumonia, an increased risk for nosocomial pneumonias, or the propagation of acute lung injury with respiratory failure. PMID- 3532888 TI - Developmental changes in glycoconjugate secretion by ferret tracheas. AB - Surface epithelium and submucosal glands of the ferret trachea undergo extensive postnatal development. This study examined developmental changes in rates of release and types of high molecular weight glycoconjugates secreted by explanted ferret tracheas. Digestion with bovine testicular hyaluronidase separated the high molecular weight glycoconjugates into two types, hyaluronidase-resistant mucins and hyaluronidase-susceptible glycosaminoglycans. Release rates were measured under unstimulated conditions and in the presence of known secretagogues. The unstimulated rate of release of total 3H-glycoconjugates was 4 fold higher at birth than after complete maturation. The mucin content varied from 39 to 74% of total 3H-glycoconjugates; however, no age-related pattern was observed for mucin/glycosaminoglycan ratios. The rate of release of 3H-mucins was 6-fold higher at birth than in the adult but rapidly dropped to adult levels by 28 days of age. The secretory cells in the tracheal epithelium of newborn ferrets had more abundant rough endoplasmic reticulum than did mature goblet cells, suggesting increased synthesis of secretory product. Response to methacholine and trypsin, both known stimulators of mucin release, was not observed until 28 and 54 days of age, respectively. Incorporation of 35S-sulfate into mucins relative to that for 3H-glucosamine increased with age, consistent with increasingly acidic histochemical staining properties of secretory cells. These developmental differences in rates of release, modulation of release, and relative sulfation of mucins may represent changes in secretory and synthetic mechanisms of the secretory cells. PMID- 3532889 TI - Physiologic basis of therapy for sleep apnea. PMID- 3532890 TI - Comparison of arteriography and noninvasive techniques for the diagnosis of carotid artery disease. A statistical analysis of 140 patients. AB - The carotid arteriograms of 140 patients are compared to noninvasive studies performed on the same group using a SAS statistical package for correlation and identity of information obtained. Chi-square and gamma is calculated for all pairs using total number of arteries and also individual sides of the neck. These reveal significant relationship and identity of information for the arteriograms and the Echoflow (continuous wave Doppler imaging) (Diagnostic Electronic Corp.; Lexington, MA). Discrepancies found between the two groups are a higher frequency of normal findings in the arteriograms and a higher frequency of significant stenoses in the Echoflow group. Differences in frequency of occlusion as a diagnosis are difficult to explain because of the time interval between exams. Other noninvasive studies--OPG, wave-form analysis, supraorbital directional flow -showed poor or no correlation and were unreliable for surgical decisions. A comparison of x-ray interpretations (original report, review interpretation, calculated lumen) reveals statistical identity, although there was a 10 per cent variation in those classified as normal and significant stenosis. No attempt was made to determine whether arteriography or Echoflow was more accurate. PMID- 3532891 TI - Ultrasonic imaging in the diagnosis of carotid vascular disease with attention to operated upon nonangiographic lesions. AB - Two thousand carotid arteries were evaluated by B-mode real-time ultrasound, Doppler ultrasound, carotid phonoangiography, and oculoplethysmography. All patients were referred for evaluation of asymptomatic bruits, transient ischemic attacks, or stroke. Angiography was performed on 760 vessels and operative intervention upon 248 arteries. B-mode correctly identified 123/126 vessels said to be normal by angiography; it identified nonstenotic plaques in 296 vessels where angiography only noted 288 instances of nonstenotic plaque. In 341/346 vessels, lesions greater than 50 per cent stenosis were correctly identified by B mode. Compared with angiography, B-mode ultrasound has a sensitivity of 98.5 per cent for greater than 50 per cent stenosis and a specificity of 100 per cent. For lesions less than 50 per cent stenotic, B-mode has a sensitivity of 100 per cent, a specificity of 98.3 per cent, and a calculated accuracy of 98.9 per cent. PMID- 3532892 TI - Increased lethality of endotoxemia in murine frostbite. AB - Because frostbite (FB) is associated with increased intravascular coagulability, it is reasonable to assume that endotoxin, by enhancing platelet aggregation, will adversely affect FB. Swiss mice (25 +/- 2 g) were anesthetized, and the tails of the animals totally immersed in a freezing solution of equal volumes of ethylene glycol and water (-18 C) for 8 min. The tails were then thawed at room temperature (24 C). Half an hour after removal from the freezing solution, the animals were given either (Group A) 0.1 cc saline I.P. or (Group B) 0.1 mg E. coli endotoxin (055:B5; 1/3 LD50 dose) in 0.1 cc saline IP. A third group (Group C), was given the same dose of endotoxin but was not subjected to frostbite. Survivals in each group at 2 weeks were as follows: (A) 14/14 (100%), (B) 4/20 (20%), (C) 13/14 (93%). Using Fisher's exact test, A versus B P less than .001; B versus C P less than .001; A versus C NS. The data presented here emphasize the increased lethality of endotoxemia in murine FB. PMID- 3532893 TI - Calcium-regulating hormones in essential hypertension. Relation to plasma renin activity and sodium metabolism. AB - Circulating levels of the calcium-regulating hormones, calcitonin, calcitriol, and parathyroid hormone, were analyzed in relation to plasma renin activity in 10 persons with normal blood pressure and in 51 persons with essential hypertension. Calcitriol (p less than 0.008) and parathyroid hormone (p less than 0.01) levels were elevated in hypertensives with low renin activity, whereas calcitonin levels were higher in patients with high renin activity (p less than 0.008), compared with normotensive controls and other hypertensive patients. Continuous relationships were observed between calcitriol levels and plasma renin activity in all patients (r = -0.65, p less than 0.001) and between parathyroid hormone levels and urinary sodium excretion in hypertensive patients with low renin activity (r = -0.63, p less than 0.01). Together, these results support a linkage between calcium metabolism and renin-sodium factors in essential hypertension. Calcium-regulating hormones and the renin-aldosterone system may coordinately mediate the blood pressure effects of differing dietary calcium and sodium intakes at the cellular level by altering cellular handling of monovalent and divalent ions. PMID- 3532894 TI - Nifedipine in myocardial ischemia, systemic hypertension, and other cardiovascular disorders. AB - The advent of calcium (slow-channel) blockers introduced a potent new pharmacologic tool to cardiovascular therapy. Among these agents, the dihydropyridines have been shown to be the most potent vasodilators and the uses for their clinically available representative, nifedipine, in particular, have expanded. Beyond the standard use of nifedipine to treat various ischemic heart disorders, the drug's potent vasodilatory properties often make it a powerful antihypertensive agent. Although dihydropyridines might be effective in the treatment of other disorders such as central nervous system vascular accidents, some valvular heart disorders, hypertrophic obstructive cardiomyopathy, pulmonary hypertension, and perhaps antiatherogenesis, nifedipine's clinical role remains the treatment of myocardial ischemia and systemic hypertension. PMID- 3532895 TI - Infection with human immunodeficiency virus in the hospital. Epidemiology, infection control, and biosafety considerations. AB - Infection with the human immunodeficiency virus (HIV) (formerly HTLV-III/LAV) is transmitted by sexual contact, by blood and blood products, and perinatally. There is no evidence for casual transmission. The risk to health care workers is low but appropriate infection control precautions should be taken. Specimens should be transported to the laboratory in plastic bags labeled with an easily recognized biohazard warning. Placing patients in private rooms is unnecessary unless a patient has an additional illness that requires such an arrangement. Disinfection, sterilization, housekeeping, and waste management must be done according to recommended guidelines. Asymptomatic hospital personnel with HIV antibody can safely engage in direct patient care. Routine HIV serologic screening of personnel or patients is not recommended. Counseling and HIV antibody testing should be offered to pregnant high-risk women. Laboratories that process specimens potentially containing HIV virus should adhere to maximum containment procedures. An intensive and continuing educational program on the epidemiology of HIV infection and appropriate infection control practice is recommended. PMID- 3532896 TI - UCLA conference. Biochemistry of collagen in diseases. AB - Collagen, the major extracellular matrix component, comprises a family of closely related, yet genetically distinct proteins that provide physiologic tensile properties to the tissues. The recent progress made in understanding the normal biochemistry and biology of collagens has permitted us to identify different levels at which errors might be introduced into the structure and metabolism of this protein. Several acquired and heritable diseases are now known to involve distinct abnormalities in collagen. This conference reviews some of the latest discoveries in the biochemistry of collagen and highlights some disease entities in which definitive information on molecular alterations in collagen is available. PMID- 3532897 TI - The changing face of twentieth-century American cardiology. AB - The meaning of American cardiology has been transformed over the past century. During that time, cardiology has been defined by several organizations: by the American Board of Internal Medicine through subspecialty certifications; by the two major American cardiology societies, the American Heart Association and the American College of Cardiology; and by the four major cardiology journals. These organizations have sometimes cooperated, sometimes competed. Cardiology has also had to negotiate relationships with several external interest groups, including pediatrics, surgery, hospitals, and internal medicine. Throughout the 20th century, the word cardiology has had no meaning save its definition within a larger web of organizations, relationships, and ideas. The meaning, like the meaning of all specialties and subspecialties, is historically mediated and constantly changing. PMID- 3532898 TI - How to keep up with the medical literature: V. Access by personal computer to the medical literature. AB - Access to the medical literature through personal computers is now readily available and can greatly reduce logistical barriers to using recently published journal articles to support clinical decisions. In this article, we describe many of the options available to clinicians who wish to do their own computer searching of MEDLINE, the largest of the electronic services for the biomedical literature. The "bare bones" computer equipment needed includes a terminal or personal computer, a modern and telephone line, and a printer. Access to MEDLINE is then gained through subscribing to any of a burgeoning number of database vendors. A comparison of 17 permutations and combinations of software and vendors shows that the software and vendors vary substantially in efficiency, cost, and ease of use. Direct subscription to MEDLINE is least expensive, PaperChase is the simplest service to use, and Colleague and Medis provide both MEDLINE access plus full-text journals online. Basic search techniques are illustrated for three clinical problems. PMID- 3532900 TI - [Treatment of systemic scleroderma with ketanserin. Randomized, double-blind 6 months study of 27 cases]. AB - Twenty-seven patients with systemic scleroderma and Raynaud's phenomenon underwent a randomised double blind therapeutic trial: monotherapy with Ketanserine (80 mg/day for 6 months) against Placebo. The secondary effects were comparable in both groups as were the withdrawals from the trial for aggravation of Raynaud's phenomenon (one in each group). No significant difference was observed between the two groups as regards the evolution of the Raynaud's phenomenon or skin changes. Dysphagia was improved in the Ketanserine group (p less than 0.05) but not in the Placebo group. Some patients in the Ketanserine group experienced an improvement in the Raynaud's phenomenon at the end of the trial period; there were no improvements in the Placebo group. Three haemorrheological parameters (total blood viscosity, plasma viscosity and thixotropism) were abnormal at the beginning of the trial and did not improve by the end in the Ketanserine group. The K infinity coefficient of Quemada's law was normal at the start of the trial and increased after treatment (p less than 0.05). PMID- 3532899 TI - Pathogenesis of osteomalacia in chronic renal failure and its relationship to vitamin D. AB - Considerable confusion arises in defining osteomalacia in the presence of renal disease. There are no radiographic or biochemical features which satisfactorily identify all patients with osteomalacia. Histological definitions need to distinguish increased amounts of osteoid due to defective mineralisation from that due to increased bone turnover, both of which may coexist in chronic renal failure. The pathogenesis of osteomalacia in renal failure is multifactorial and not always due to defective metabolism of vitamin D. Deficient production of 25 hydroxyvitamin D may occur because of nutritional privation or urinary losses in the nephrotic syndrome, but these are rare causes of osteomalacia in patients on haemodialysis treatment. It is not clear to what extent defective production of calcitriol, characteristic of end-stage chronic renal failure is causally related to osteomalacia, in part due to uncertainties as to whether vitamin D acts directly on bone to promote mineralisation or whether its effects are mediated indirectly by modulating calcium and phosphate transport at other sites. Following the institution of renal replacement therapy, the incidence of osteomalacia varies markedly between renal units due to the skeletal retention of aluminium caused by the contamination of dialysis fluid or by the chronic ingestion of aluminium-containing phosphate binding agents. This form of osteomalacia is associated with a high risk of fracture, probably more related to depressed bone formation than to the presence of osteomalacia. Rarer causes of osteomalacia include parathyroidectomy and calcium and phosphate deficiency. PMID- 3532901 TI - A perspective on the role of decision analysis in clinical practice. AB - The upsurge in interest in clinical decision support techniques is not accidental. Clinical decision situations are more and more characterized by complexity and uncertainty, due to increasing diagnostic and therapeutic possibilities, the fast growth of medical knowledge, the increasing quality demands by the public, and the pressure towards cost-conscious decision making. On the other hand, information science is increasingly able to provide the tools for building decision-support systems. There are several approaches to the development of decision aids. The present paper is mainly concerned with one potentially very powerful method: decision analysis. Basically, decision analysis is a method for explicitating, structuring and analysing clinical decision situations for individual patients. Suggestions for therapy choice, and diagnostic and prognostic statements are obtained by integrating the probability and value judgments made during the analysis. A clinical decision analysis can conveniently be divided into four stages: defining and structuring the clinical problem, assessing the relevant probabilities and utilities, calculation of the preferred course of action, including sensitivity analysis, and formulation of the results of the analysis in a clinically useful way. An optimistic scenario of the future role of decision analysis in clinical medicine would describe--among others--decision-consultation departments, decision-oriented clinical data-bases and medical knowledge bases, research groups for development, testing, and updating of clinical strategies, decision-analysis courses in all levels of medical education, and decision-oriented clinical textbooks. Moreover, decision analysis will help in setting priorities in clinical research, in quality control and peer review, and in development of protocols for use by the paramedical personal. Some illustrations from applied decision analysis are given. PMID- 3532902 TI - [Transcultural epidemiology of depression]. PMID- 3532903 TI - [Medico-psychological Society. List of members]. PMID- 3532904 TI - Efficacy of acoustic reflectometry in detecting middle ear effusion. AB - The acoustic otoscope measures the amount of sound reflected from the tympanic membrane. Since the amount of reflected sound is increased by fluid in the middle ear, it seemed likely that the acoustic otoscope could be used for detection of otitis media. We compared acoustic reflectometry with over 4,000 tympanometric and otoscopic examinations in 451 children who were examined at regular intervals following surgery for chronic otitis media with effusion. The data indicate a lower sensitivity and specificity of acoustic reflectometry than had been reported previously. The receiver-operator characteristics of this device are discussed. PMID- 3532905 TI - Implantable bone conduction hearing device: Audiant bone conductor. Update on our experiences. AB - An implantable hearing device has been developed and has undergone testing by animal experimentation and clinical trials in humans. Recently, the Food and Drug Administration has approved the use of this device in adults who are within the criteria of its utilization, mainly patients with conductive hearing impairments who have good inner ear reception and who are unable to benefit from surgical correction. This update describes observations and experiences we have had during the device's development and defines its limitations as well as its unique thrust into the future relief of hearing impairment. Clinical trials during the investigational period and engineering problems as well as progress are thoroughly discussed. PMID- 3532906 TI - [Cyclosporin in the treatment of bullous pemphigoid: preliminary study]. AB - Bullous pemphigoid is a typical autoimmune disease. It is classically treated with systemic corticosteroids alone or combined with immunosuppressants. Cyclosporine A (CyA), a new immunosuppressive agent with high activity in organs and bone marrow transplantation, could be expected to prove effective in this disease owing to its action on lymphocytes. Seven patients with bullous pemphigoid were treated with CyA in daily doses of 6 to 8 mg/kg bodyweight. Treatment was monitored by measurements of serum CyA, creatinine and liver enzyme levels. The effectiveness of treatment was assessed on clinical changes. The seven cases are dealt with individually, with a brief case-report for each of them. The only side-effects observed were reversible rises in serum creatinine levels and hypertrichosis in two cases; these are usual reactions to the drug. Hormonal assays were normal in two female patients. Concerning results, our patients fell into two groups. Among those treated with CyA alone there were two failures and two sustained satisfactory results. Treatment was successful in all patients treated with CyA during relapses under corticosteroid therapy, but two patients relapsed after CyA was discontinued. It is concluded that CyA is of no interest in the acute phase of bullous pemphigoid, that the long-term stability of the results obtained is doubtful and that this potentially nephrotoxic drug should be avoided or administered with extreme caution in elderly people, since their renal function may be at the limit of normality. PMID- 3532907 TI - [Endoluminal occlusion of the aorta in massive traumatic hemoperitoneum. Apropos of 5 cases]. PMID- 3532908 TI - Analytical reviews in clinical biochemistry: the estimation of creatinine. PMID- 3532909 TI - Single-reagent polarisation fluoroimmunoassay for the cocaine metabolite, benzoylecgonine, in urine. AB - A polarisation fluoroimmunoassay is described for the detection in urine of benzoylecgonine, the major metabolite of cocaine. The method uses a single reagent comprising sheep anti-benzoylecgonine serum pre-mixed with a fluorescein labelled benzoylecgonine derivative as tracer. Under the assay conditions the antiserum has equal cross-reactivity with cocaine and the metabolite. The test is performed by the addition of 10 microL of urine to an aliquot of the single reagent, incubation for a few minutes and measurement of fluorescence polarisation. The assay has a positive/negative cut-off level of 1 mg/L benzoylecgonine and results compare favourably with the EMIT-d.a.u.TM (Syva) system. PMID- 3532910 TI - Enhanced luminescent quantitation of horseradish peroxidase conjugates: application in an enzyme immunoassay for digoxin. AB - A p-iodophenol-enhanced luminescent end-point has been incorporated into a commercially available heterogeneous competitive enzyme immunoassay for digoxin based on a horseradish peroxidase-digoxin conjugate. The luminescent end-point could be completed in less than 1 min and significantly reduced overall assay time. Results for the assay obtained using enhanced luminescence showed good agreement with those obtained using a colorimetric end-point (correlation coefficient 0.98). Both assays gave acceptable precision within the therapeutic range. The incubation time for the luminescent immunoassay was reduced to 15 min and still gave differentiation between sub-therapeutic, therapeutic and toxic levels of digoxin. PMID- 3532911 TI - A more sensitive and less time-consuming sandwich enzyme immunoassay for insulin in human serum with less serum interference. AB - This paper describes an improved sandwich enzyme immunoassay for insulin in human serum. The detection limit was significantly improved from 0.1 mU/L to 0.02 mU/L, by incubation with guinea-pig anti-insulin Fab'-peroxidase conjugate in the presence of normal guinea-pig F(ab')2 to reduce the non-specific binding of the conjugate. The degree of serum interference was considerably reduced by coating polystyrene balls with acid-treated anti-insulin IgG and by incubating the polystyrene balls with serum samples at a lower temperature for a shorter time. The time for incubation with anti-insulin Fab'-peroxidase conjugate was also shortened. As a result, the volume of serum that could be used increased from 10 microliters to 50 microliters, and the time for immuno-reactions was reduced from 8 h to 4 h. Applicability of the present improvement to enzyme immunoassay of other antigens in human serum is discussed. PMID- 3532912 TI - Evaluation of an aldosterone radioimmunoassay: the renin-angiotensin-aldosterone axis as a function of sex and age. AB - A highly specific radioimmunoassay for aldosterone in plasma has been developed utilising extraction from plasma into dichloromethane, an antiserum raised to aldosterone-3-carboxy-methyloxime-BSA and a radio-iodinated derivative of aldosterone. The plasma values obtained after only extraction correlated very well with the results following chromatography over celite. The within- and between-batch variations for plasma pools ranged between 5 and 15%. The range obtained, 100-1806 pmol/L for 96 random upright subjects, was comparable to others reported. Measurement of plasma aldosterone and plasma renin activity in these subjects showed that both these parameters are higher in subjects under 40 years of age than in those over 40. In addition, plasma aldosterone levels are higher in women than in men even though their plasma renin activity levels are similar. The plasma aldosterone/renin activity ratios which provide an index of adrenal sensitivity to stimulation, are lower in men than in women. The findings in this study suggest that higher aldosterone levels in younger subjects are associated with greater stimulation of the adrenals than in older subjects and that the adrenal is more sensitive in women than in men. PMID- 3532913 TI - The role of testosterone measurement in the investigation of androgen disorders. PMID- 3532914 TI - Comparison of the analytical characteristics of ten urinary hCG tests for early pregnancy diagnosis. AB - A comparison of assay design, sensitivity and specificity is given for 10 urinary human chorionic gonadotrophin (hCG) test kits for early pregnancy diagnosis. One slide test applies a polyclonal anti-hCG serum, while nine, more recently developed, tube and slide tests use one or more monoclonal antibodies toward intact hCG or its free subunits. Colour development for five immunoenzymetric (IEMA) 'sandwich' assays, or (haem/latex) agglutination (HA, LA)-inhibition (HAI, LAI) for the other systems provide assay sensitivities from 1000-50 IU/L within 3 120 min. The 'best' slide-(i.e., LA, LAI), haem-(i.e., HA, HAI) and IEMA-tests detect respectively 500, 75 and 50 IU/L within 2.5, 120 and 3 min. Assay specificities (i.e., as false-positive and false-negative test results) are studied using intact hCG, hLH and their free alpha- and beta-subunits. The presented assays are improved, perform more sensitively at shorter reaction times with increased specificity, and may, therefore, establish pregnancy at an earlier stage with greater reliability. PMID- 3532915 TI - Interference by diflunisal with the FETI method for serum thyroxine. PMID- 3532916 TI - Usefulness of measurements of trace elements in hair. PMID- 3532917 TI - Analytical goals for glucose analyses. AB - Analytical goals may be defined as those standards of performance required to facilitate optimal patient care. Review of the considerable amount of published work on glucose analyses allows delineation of the following current goals: For plasma glucose: within-laboratory between-batch imprecision--CV less than or equal to 2.2%; inaccuracy - no bias; linearity - 1 to 28 mmol/L; detection limit 1 mmol/L; turnaround time - 30 min (in emergency situations). For urine glucose (quantitative): within-laboratory between-batch imprecision - SD less than or equal to 0.1 mmol/L; inaccuracy - no bias. For urine glucose (qualitative or semi quantitative): negative - should be negative; positive - should be positive +/- one positive colour block; detection limit - 2.8 mmol/L. Moreover, each laboratory should develop goals for the many pre-analytical factors affecting glucose analyses. While the above goals are not always achieved in current practice, they are attainable and are worthy targets to strive to reach. The general principles discussed here for glucose analyses are applicable to other analytes of interest to the clinical biochemist. PMID- 3532918 TI - Basic principles and problems of haemocytometry. AB - After some brief remarks on counting chambers, references to the ICSH-recommended haemoglobin-determination are given. The microhaematocrit of normal blood is advocated as a potential routine calibration method. Comments are given on discrepancies between centrifugal and flow haemocytometry haematocrits of abnormal and artificial bloods. Flow haemocytometry instruments are classified into analogue and digital instruments or into electrical and optical instruments. Their hydrodynamic properties are discussed. The principles and problems of electrical and optical cell counting and sizing are dealt with. The importance of the refractive index and of flow-induced cell shape changes for the MCV determinations is stressed. It is argued that MCV and haematocrit values are exaggerated at both low and high values and consequently MCHC is erroneously constant. Various prevailing red cell distribution width (RDW) and platelet distribution width (PDW) definitions bring about considerable confusion. The major features of the counting and sizing of white blood cells and platelets are described. PMID- 3532919 TI - Alkaline phosphatase and cholestasis. AB - The process of cholestasis in both man and rat leads in the majority of cases to the appearance of a biliary band in the electrophoresis of alkaline phosphatase isoenzymes. In this article, the biochemical nature and mode of formation of the biliary band is discussed, with reference to its appearance in cholestasis and other hepatobiliary diseases. PMID- 3532920 TI - A rapid HPLC method for monitoring plasma levels of caffeine and theophylline using solid phase extraction columns. AB - A simple HPLC method for the determination of caffeine and theophylline in plasma is described. Separation of theobromine, paraxanthine, theophylline, beta hydroxyethyltheophylline and caffeine is obtained using a mobile phase of 1% acetic acid/methanol (83:17, v/v) and a Waters Associates NOVA-PAK C18 column protected by a Guard-PAK precolumn module containing a Guard-PAK CN cartridge. Rapid sample preparation is achieved by solid-phase extraction columns (Bond-Elut C18, 1 mL capacity) which provide excellent recovery values for both drugs. The cost per sample using this approach can be minimised by column regeneration and re-use. Results obtained for theophylline are in good agreement with values determined by other techniques. PMID- 3532921 TI - Clinical and analytical validation of an enzymometric assay for creatine kinase MB isoenzyme. AB - The analytical validation of an immunoenzymometric technique for the specific measurement of the creatine kinase-MB isoenzyme is described. Its application is shown in the diagnosis of myocardial infarction. A difference in the correlation of the mass and catalytic activity of the CK-MB isoenzyme is shown between patients suffering myocardial infarction and those with skeletal muscle damage. PMID- 3532922 TI - Single-reagent polarisation fluoroimmunoassay for cotinine (a nicotine metabolite) in urine. AB - A rapid, single-reagent, non-separation, non-isotopic immunoassay was developed for determining levels of the nicotine metabolite, cotinine, in urine. The single reagent was prepared by pre-mixing an appropriate dilution of sheep anti-cotinine serum with a fluorescein-labelled cotinine tracer. All normal reliability criteria were satisfied. The assay was found to be specific for cotinine and there was no cross reactivity with other available nicotine metabolites and structurally-related compounds. The results obtained correlated closely with those of an established radioimmunoassay. The assay was well-suited to application in the discrimination of active smokers from non-smokers (and passive smokers). PMID- 3532923 TI - Micro-scale ultracentrifugation as an alternative to ultrafiltration for the determination of the unbound fraction of phenytoin in human serum. AB - Free phenytoin has been determined using micro-scale ultracentrifugation followed by analysis by EMIT. The effect of temperature on the determined free fraction was investigated and the ultracentrifugation procedure validated against ultrafiltration. Ultracentrifugation gave free fractions which were on average 16% lower than those obtained using ultrafiltration, but correlation was good, as was the correlation with measurements of total phenytoin (r = 0.90). Micro-scale ultracentrifugation is a simple procedure which can be of great utility in the measurement and investigation of free drug levels. PMID- 3532924 TI - [In situ hybridization of messenger RNA in the central nervous system]. AB - Beside the standard approach for the study of peptide hormone gene expression that quantitate the amount of specific mRNA in the total RNA extracted from an homogenate of tissue by filter or solution hybridization, a technique called in situ hybridization has been developed for the location of specific mRNA populations in tissue section. The in situ technique can be useful in answering anatomical question but its greatest interest in neuroendocrinology lies in its ability to resolve hybrids at the levels of cells and therefore in its potential as a semiquantitative assay for mRNA levels in individual neurons. PMID- 3532925 TI - [Hormonal regulation of the expression of genes coding for pituitary gonadotropins]. AB - In the rat, gonadectomy increases and injection of estradiol or of testosterone depresses the translational capacity of mRNAs encoding gonadotropin subunits alpha, LH beta and FSH beta. This inhibitory effect of steroids can also be demonstrated in vitro using pituitary cells in culture. Thus, steroids appear to regulate gonadotropin synthesis, at least in part, by a direct action on the pituitary gland. Hybridization experiments, using labeled cDNA probes, show gonadal steroids to act by decreasing the number of copies of specific mRNAs encoding each one of the gonadotropin subunits. Definite evidence has been obtained that GnRH stimulates biosynthesis of the polypeptide chains of LH subunits, thus confirming our previous observations. Preliminary results suggest cAMP could be involved in this process as a mediator of GnRH action. Although actinomycin D prevents the stimulatory effect of GnRH on gonadotropin biosynthesis, the translational capacity of specific mRNAs encoding LH subunits did not increase after incubation of the cells with GnRH, thus suggesting that GnRH does not act directly either on the gonadotropin subunit genes or on the intrinsic messenger activity of mRNAs encoding the gonadotropin subunit precursors. Our data demonstrate that the synthesis of pituitary gonadotropins is under a dual hormonal control, by gonadal steroids and GnRH. We suggest that the negative control by steroids and stimulatory effect of GnRH occur via different routes, the former at the genomic level, the latter at another step which remains to be elucidated. PMID- 3532926 TI - [Different immunoreactive forms of hypothalamic LHRH]. AB - The radioimmunological detection of higher molecular weight (HMW) forms of LHRH is attempted in acidic extracts of the rat hypothalamus. Three antibodies are used: antibodies directed against the N or the C terminal part of LHRH (N-or C antibodies) and recognizing synthetic LHRH molecules with N or C peptidic extensions; one conformational antibody accepting none modification of LHRH extremities. Hypothalamic LHRH immunoreactivity is distributed between three peaks after molecular sieve filtration. The first one (peak I) is eluted in the void volume of the column. Its apparent molecular weight is estimated to 26,000 daltons. Its detection is possible with the N-antibody only. The second one (peak II) is eluted before the total volume of the column. The third one (peak III) is eluted like synthetic LHRH. Its detection is easy with all antibodies. Nevertheless, it is more important with the N-antibody. This peak corresponds to the native LHRH. The excess of the N-immunoreactivity has not been yet elucidated. Several immunological detections for the peak II also: easily detected by the N-antibody, it is partially recognized by the C-antibody. By using different molecular sieve filtrations, ion exchange or affinity chromatographies, it is suggested that molecules detected with the C-antibody could correspond to C-terminal catabolites of LHRH. Molecules recognized with the N-antibody would be a LHRH sequence extended on the C-part with 1,800 daltons for the apparent molecular weight.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3532927 TI - [Effect of LHRH on the synthesis and phosphorylation of proteins in gonadotropic cells]. AB - Protein secretion by cultured pituitary cells from 14 day-old female rats was estimated using [35S]-methionine incorporation, electrophoresis and autoradiography. Stimulation by LHRH promoted biosynthesis and fast release of a protein of apparent molecular weight 87,000 daltons and pI 4.6. Gonadotrophs enriched by centrifugal elutriation were particularly rich in this polypeptide which was thus called GP-87 (Gonadotrope polypeptide). Cells were then cultured with [32P]-orthophosphate and proteins were analyzed. Our first results tend to show that GP-87 is phosphorylated, at least in the cells. We suggest that this specific protein, the secretion of which is correlated with LH release, participates to the response mechanisms of gonadotrope cells stimulated by LHRH. PMID- 3532928 TI - [Localization and identification of neuropeptide Y (NPY) in the brain of an anuran amphibian]. AB - A neuropeptide Y (NPY)-like peptide has been localized in the frog brain by the direct immunofluorescence method. Subcellular localization of NPY has been studied by PAP immunocytochemistry and the immunogold technique. Using a specific radioimmunoassay technique, NPY-like peptide has been quantified in various brain areas and the immunoreactive material was characterized by Sephadex G-50 gel filtration and high performance liquid chromatography. The results indicate that frog NPY is closely related to the porcine molecule and largely distributed in the frog brain. This peptide may play both neurotransmitter and neuroendocrine functions in amphibia. PMID- 3532929 TI - Nerve growth factor and Alzheimer's disease. AB - Alzheimer's disease is associated with a pronounced loss of the cholinergic neurons that form the ascending cholinergic projections of the basal forebrain. Even though the disease is also characterized by changes in other neuronal systems and by a high frequency of neuronal plaques and tangles, the cholinergic deficit seems to be a principal element responsible for the memory loss typical of Alzheimer's disease. This review summarizes findings in experimental animals which indicate that nerve growth factor (NGF), a well-characterized protein, acts as a neurotrophic factor for cholinergic neurons of the basal forebrain. NGF is present in the target areas of these cholinergic neurons and affects their survival, fiber growth, and expression of transmitter-specific enzymes. Furthermore, NGF is able to prevent the degeneration of cholinergic neurons in adult rats with experimental lesions mimicking the cholinergic deficit in Alzheimer's disease. These findings suggest that increasing the availability of NGF to human cholinergic cells might promote their survival in certain disease processes. Additional steps are discussed for establishing the possible involvement of NGF in the pathogenesis of Alzheimer's disease and the development of an effective therapy. PMID- 3532930 TI - Immunohistochemical identification of HTLV-III antigen in brains of patients with AIDS. AB - Human T-cell lymphotropic virus type III (HTLV-III) has been isolated from neural tissues and cerebrospinal fluid (CSF) of patients with neurological syndromes associated with the acquired immune deficiency syndrome (AIDS) and the virus may be directly involved in the pathogenesis of the syndromes. To detect HTLV-III antigen in neural tissues from patients with AIDS, immunoperoxidase studies using a goat anti-HTLV-III serum were performed on frozen tissue sections of brain, spinal cord, and nerve from 13 patients with AIDS or HTLV-III-related neurological syndromes. HTLV-III was cultured from neural tissues or CSF in 11 of 13 of these patients. HTLV-III antigen was detected in the brains of 5 patients with AIDS and in none of the 13 non-AIDS control subjects. Rare positively stained cells were seen, frequently associated with capillaries and often located near microglial nodules. Morphologically, the cells resembled monocyte/macrophages and were found most frequently in the cortex of the frontal, temporal, and parietal lobes. These results provide further evidence that the subacute encephalitis of AIDS is associated with central nervous system infection by HTLV-III and that monocyte/macrophages are among the infected cell populations. PMID- 3532932 TI - HLA study of Japanese patients with Creutzfeldt-Jakob disease: significant association with HLA-DQw3. AB - To demonstrate genetic susceptibility to Creutzfeldt-Jakob disease (CJD), 10 Japanese patients with pathologically proved CJD and 6 patients with clinically definite CJD were tissue typed for 48 class I and 14 class II human leukocyte antigen (HLA) specificities. The patients were scattered throughout Japan and there were no consanguineous relationships. Among 62 HLA specificities, HLA-DRw53 and DQw3 were found in all pathologically proved CJD cases. When the frequencies of the HLA antigens in the 16 CJD cases were compared to those of normal Japanese, a highly significant (p less than 0.005) increase was found for HLA DQw3 in the CJD group. The present findings provide evidence for genetic control of susceptibility to CJD in humans. PMID- 3532931 TI - Immunoglobulin abnormalities in cerebrospinal fluid and blood over the course of lymphocytic meningoradiculitis (Bannwarth's syndrome). AB - The conditions of 5 patients with untreated lymphocytic meningoradiculitis (Bannwarth's syndrome, probably equivalent to Lyme disease) with serologically confirmed infection resulting from Borrelia spirochetes were followed with repetitive lumbar punctures up to 221 days after the onset of symptoms. Using a protein A plaque assay, high numbers of IgG-, IgM-, and IgA-producing cells were found in the cerebrospinal fluid (CSF), whereas there were mostly normal numbers of immunoglobulin-producing cells in peripheral blood. A markedly increased CSF IgM index and an elevated IgG index were observed in all patients during the early phase, reflecting production of these immunoglobulins within the central nervous system. All patients had oligoclonal IgG bands in the CSF that persisted during follow-up; in the 2 patients tested, the bands contained Borrelia antibodies. Most serum immunoglobulin concentrations were normal and in only 1 patient was it possible to detect in serum some of the oligoclonal IgG bands present in CSF. Declining numbers of CSF cells producing immunoglobulin and decreasing immunoglobulin index values were observed during follow-up, but 3 patients had an elevated CSF IgM index in the presence of normal IgG and IgA indices when examined during the later phases of disease. An intense and prolonged IgM response within the central nervous system seems to be a characteristic of the disease. PMID- 3532933 TI - [Penicillin-binding proteins. Their enzymatic activity and properties]. PMID- 3532934 TI - [Mutasynthesis of aminoglycoside antibiotics]. PMID- 3532935 TI - [Tactics in creating optimal conditions for microbiological processes]. PMID- 3532936 TI - [Rifampicin in the treatment of staphylococcal infection]. PMID- 3532937 TI - [Antibiotic formation by gram-negative nonsporulating bacteria]. PMID- 3532938 TI - [Increase in the coefficient of component utilization by balancing the composition of the nutrient medium for growing pneumococci]. AB - The possibility of using the experimental-analytical balance method (EABM) for development of balanced media, optimal and economic by their composition is shown. The method is based on the specific growth activity of the medium components and mathematical calculation of their concentrations. A balanced medium containing human placenta hydrolysate was developed. The medium has a high component consumption coefficient and provides maintenance of high levels of the pneumococcal culture biological properties such as growth, capsule formation, virulence and agglutinability. The quantities of nutrient yeast extract, cystine, glucose and sodium chloride in the balanced medium are 2, 18-20, 4-4.7 and 32-33 times lower respectively than those in the initial medium. The use of the balanced medium instead of the initial unbalanced one or instead of the meat medium based on the Hottinger broth will provide the total economy of 1010 or 2360-2580 roubles respectively per. 1000 liters of the medium. It is concluded that a wider use of this method in optimization of microbiological nutrient media in production of medical and biological preparations is promising. PMID- 3532939 TI - [Effect of prodigiozan, levamisole and methyluracil on the course of an experimental infection and primary immune response]. AB - The effect of prodigiosan, levamisol and methyluracil on the process of experimental sepsis caused by Proteus was studied comparatively on mice, and the primary immune response was studied on intact animals treated with prednisolone, cyclophosphan or azathioprin. It was shown that prodigiosan was a more active stimulator of antiinfectious resistance of the intact animals than levamisol or methyluracil. Its effect was evident with administration before the infection, while the effect of levamisol or methyluracil was evident in administration after the infection. When used prophylactically, prodigiosan increased the average life span of the mice given prednisolone, had no effect on the infection process in the presence of cyclophosphan and increased the antibiotic therapy efficiency at the background of either prednisolone or cyclophosphan. Administration of prodigiosan after the infection without the use of antibiotics was not efficient in immunosuppression, whereas in combination with levamisol it increased the tolerance to the infection at the background of cyclophosphan. When used for the treatment purposes, levamisol had no effect on survival of the animals. However, it increased the average life-span of the intact mice also at the background of prednisolone. Prodigiosan stimulate the primary immune response in the intact animals at the background of azathioprin or cyclophosphan but not prednisolone. Levamisol increased the number of the antibody-producing cells (APC) in the intact animals in some experiments. At the background of azathioprin it had no effect on the number of the APC and at background of prednisolone or cyclophosphan it even lowered their number.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3532940 TI - [Mechanism of the antibacterial action of monocarboxycellulose and other ion exchange derivatives of cellulose]. AB - The mechanism of the antibacterial effect of monocarboxyl cellulose (MCC) and other ion exchange derivatives of cellulose was studied. It was shown that MCC, cellulose phosphate and aminocellulose had a pronounced antibacterial effect due to the presence of the ionogenic group H+ or OH- in the initial drugs. A certain role in this process was played by sorption. The level of the antibacterial activity of MCC depended on the number of the carboxylic groups. MCC is promising as a dressing material. PMID- 3532941 TI - [Antibiotic resistance of revertant cultures of Streptococcus group A and of unclassified streptococci isolated from the blood of rheumatism patients]. AB - Sensitivity of one strain of group A Streptococcus, its L-form and revertant was tested to 7 antibiotics and it was observed that the revertant was highly resistant to beta-lactam antibiotics and lincomycin, tolerant to ristomycin and had a high value of MBcC/MIC for erythromycin and tetracycline. Testing of other analogous revertant strains showed the same results. In streptococcal strains freshly isolated from blood of patients with rheumatism and resistant to some antibiotics there were recorded by electron microscopy heterogeneity of their population and presence in it of a significant number of cells with altered (unevenly thickened) cell walls and cells with microcapsules on the cell wall surface characteristic of the revertants. In vivo occurrence of streptococcal revertants may be the cause of their antibiotic resistance which obviously requires correction of the rational antibiotic therapy schemes. PMID- 3532942 TI - Imipenem-cilastatin as initial therapy for febrile cancer patients. AB - Imipenem-cilastatin was used to treat 79 febrile episodes in 71 cancer patients, most of whom had neutropenia. The overall response rate was 67%, and 76% of the 45 documented infections responded. The response rates for septicemias and pneumonias were 79 and 62%, respectively. Only 1 of the 17 infections caused by gram-negative bacilli failed to respond to this therapy. The most common side effects were skin rash, nausea, and diarrhea. Eight superinfections were detected during therapy. PMID- 3532943 TI - Action of lombazole, and inhibitor of fungal ergosterol biosynthesis, on Staphylococcus epidermidis. AB - Lombazole had no effect on respiration at any tested concentration and had little effect on the K+ permeability of Staphylococcus epidermidis. Of the major metabolic processes investigated in this bacterium, only de novo synthesis of the cell envelope was inhibited by lombazole well in advance of an effect on growth. The time course of inhibition indicated that lombazole exerted its primary effect via inhibition of lipid synthesis; other induced changes, such as reduced synthesis of lipoteichoic acid and cell wall components, were considered to be secondary effects. Although the precise site of action in S. epidermidis has to be established, the absence of alterations in lipid patterns after treatment with lombazole suggests the toxicant may affect an essential step in lipid biosynthesis. In Candida albicans, lombazole inhibited the sterol C-14 demethylation step in the ergosterol biosynthesis pathway. PMID- 3532944 TI - Isolation and characterization of norfloxacin-resistant mutants of Escherichia coli K-12. AB - We isolated spontaneous mutants from Escherichia coli K-12 with low-level resistance to norfloxacin. These mutants were classified into the following three types on the basis of their properties: (i) NorA appeared to result for mutation in the gyrA locus for the A subunit of DNA gyrase; (ii) NorB showed low-level resistance to quinolones and other antimicrobial agents (e.g., cefoxitin, chloramphenicol, and tetracycline), and the norB gene was considered to map at about 34 min on the E. coli K-12 chromosome; (iii) NorC was less susceptible to norfloxacin and ciprofloxacin but was hypersusceptible to hydrophobic quinolones such as nalidixic acid and rosoxacin, hydrophobic antibiotics, dyes, and detergents. Susceptibility to bacteriophages and the hydrophobicity of the NorC cell surface also differed from that of the parent strain. The norC gene was located near the lac locus at 8 min on the E. coli K-12 chromosome. Both NorB and NorC mutants had a lower rate of norfloxacin uptake, and it was found that the NorB mutant was altered in OmpF porin and that the NorC mutant was altered in both OmpF porin and apparently in the lipopolysaccharide structure of the outer membrane. PMID- 3532946 TI - Moxalactam in the treatment of typhoid fever. AB - Moxalactam therapy was evaluated in 25 patients with typhoid fever. A satisfactory initial response was observed in all cases. Treatment for 3 days resulted in a much higher relapse rate (three of five patients) than did treatment for 5 days (one of nine patients). None of the 11 patients treated for 10 to 11 days relapsed. Moxalactam is effective in typhoid fever, but its use is better restricted to special indications. PMID- 3532945 TI - Therapy of experimental cerebral nocardiosis with imipenem, amikacin, trimethoprim-sulfamethoxazole, and minocycline. AB - A mouse model of cerebral nocardiosis was used to determine relative antibiotic efficacy by reducing bacterial colony counts per gram of brain tissue. The antimicrobial agents employed were demonstrated in vitro to be inhibitory to most strains of Nocardia asteroides at very low concentrations. The agents used in this study were imipenem-cilastatin, amikacin, trimethoprim-sulfamethoxazole, and minocycline. Antibiotics were administered every 4 h for 72 h before animal sacrifice. Bacterial colony counts were assayed at various time points before the completion of therapy. Imipenem-cilastatin and amikacin were the most effective agents tested. Trimethoprim-sulfamethoxazole was less effective than imipenem and amikacin but more effective than minocycline. Minocycline did not eradicate intracerebral organisms and was similar to saline (control) in its effects. PMID- 3532947 TI - Modeling of microbial substrate conversion, growth and product formation in a recycling fermentor. AB - Paracoccus denitrificans and Bacillus licheniformis were grown in a carbon- and energy source-limited recycling fermentor with 100% biomass feedback. Experimental data for biomass accumulation and product formation as well as rates of carbon dioxide evolution and oxygen consumption were used in a parameter optimization procedure. This procedure was applied on a model which describes biomass growth as a linear function of the substrate consumption rate and the rate of product formation as a linear function of the biomass growth rate. The fitting procedure yielded two growth domains for P. denitrificans. In the first domain the values for the maximal growth yield and the maintenance coefficient were identical to those found in a series of chemostat experiments. The second domain could be described best with linear biomass increase, which is equal to a constant growth yield. Experimental data of a protease producing B. licheniformis also yielded two growth domains via the fitting procedure. Again, in the first domain, maximal growth yield and maintenance requirements were not significantly different from those derived from a series of chemostat experiments. Domain 2 behaviour was different from that observed with P. denitrificans. Product formation halts and more glucose becomes available for biomass formation, and consequently the specific growth rate increases in the shift from domain 1 to 2. It is concluded that for many industrial production processes, it is important to select organisms on the basis of a low maintenance coefficient and a high basic production of the desired product. It seems less important that the maximal production becomes optimized, which is the basis of most selection procedures. PMID- 3532948 TI - You can fool some of the people, some of the time, but not this time. PMID- 3532949 TI - Perioperative nursing research. A study of priorities. PMID- 3532950 TI - CT-compatible system for stereotactic biopsy and brachytherapy of infratentorial tumors. AB - Teletherapy of nonresectable radiosensitive brain tumors is the mainstay of adjunctive treatment. In the past two decades brachytherapy has begun to play an ever-increasing role, particularly on the European continent. Yet this attention has been addressed almost exclusively to lesions of the supratentorial space. This article describes modifications of the Riechert-Mundinger stereotactic system which were made by one of us (P.D.) to allow an unencumbered yet precisely computerized stereotactic approach to posterior fossa lesions for biopsy and interstitial radiation with iridium 192. A case report is described to illustrate the technical details involved in such an undertaking. PMID- 3532951 TI - Respiratory changes after stereotactic high cervical cord lesions for pain. AB - Stereotactic cordotomy affected forced expiratory volume in 1 sec (FEV1) less than open cordotomy, but 11 of 15 patients had some effect on respiratory functions. Central cord lesions produced a small (9%) fall in values. Of 10 patients with trigeminal lesions 7 had no charge in respiratory function, but 2 had reduction of more 50% associated with transient extremity paresis, attributed to injury to a corticospinal pathway to respiratory neurones. PMID- 3532952 TI - Practical direct plaque assay for coliphages in 100-ml samples of drinking water. AB - A practical single-agar-layer plaque assay for the direct detection of coliphages in 100-ml samples of water was designed and evaluated. With this assay a 100-ml sample of water, an agar medium containing divalent cations, and the host Escherichia coli C (ATCC 13706) were mixed in a single container, and the mixture was plated on 10 14-cm-diameter petri dishes. It was more sensitive, reliable, and accurate than various other methods and proved rapid, simple, and economic. PMID- 3532953 TI - Comparison of Clark's presence-absence test and the membrane filter method for coliform detection in potable water samples. AB - A total of 2,601 water samples from six different water systems were tested for coliform bacteria by Clark's presence-absence (P-A) test and by the membrane filter (MF) method. There was no significant difference in the fraction of samples positive for coliform bacteria for any of the systems tested. It was concluded that the two tests are equivalent for monitoring purposes. However, 152 samples were positive for coliform bacteria by the MF method but negative by the P-A test, and 132 samples were positive by the P-A test but negative by the MF method. Many of these differences for individual samples can be explained by random dispersion of bacteria in subsamples when the coliform density is low. However, 15 samples had MF counts greater than 3 and gave negative P-A results. The only apparent explanation for most of these results is that coliform bacteria were present in the P-A test bottles but did not produce acid and gas. Two other studies have reported more samples positive by Clark's P-A test than by the MF method. PMID- 3532954 TI - Use of geostatistics to predict virus decay rates for determination of septic tank setback distances. AB - Water samples were collected from 71 public drinking-water supply wells in the Tucson, Ariz., basin. Virus decay rates in the water samples were determined with MS-2 coliphage as a model virus. The correlations between the virus decay rates and the sample locations were shown by fitting a spherical model to the experimental semivariogram. Kriging, a geostatistical technique, was used to calculate virus decay rates at unsampled locations by using the known values at nearby wells. Based on the regional characteristics of groundwater flow and the kriged estimates of virus decay rates, a contour map of the area was constructed. The map shows the variation in separation distances that would have to be maintained between wells and sources of contamination to afford similar degrees of protection from viral contamination of the drinking water in wells throughout the basin. PMID- 3532955 TI - Method for determining virus inactivation during sludge treatment processes. AB - A simple and reliable method is described which allows determination of virus inactivation rates during sludge treatment processes in situ. Bacteriophage f2 was adsorbed onto an electropositive membrane filter which was then sandwiched between two polycarbonate membranes with pores smaller than the virus diameter. The resulting sandwich was fixed in an open filter holder, and several such devices were connected before being exposed in sludge-digesting tanks. The device described prevented uncontrolled virus escape, but allowed direct contact of the various inactivating or stabilizing substances present in the environment tested with the virus adsorbed to the carrier membrane. After exposure to an environment, the surviving fraction of virus was eluted from the inner filter and determined by plaque counting. By using polycarbonate membranes without pores for sandwiching, the influence of temperature alone on virus inactivation could be measured. Thermophilic fermentation at 60 degrees C and at 65 kPa pressure led to a bacteriophage f2 titer reduction of 3.5 log10 units per h, whereas during thermophilic digestion at 54.5 degrees C titers decreased 1.2 log10 units per h. During mesophilic digestion an inactivation rate of only 0.04 log10 units per h was observed. Under these latter conditions, temperature had only a minor effect (19%) on virus inactivation, whereas at 54.5 degrees C during thermophilic digestion heat accounted for 32% of the total inactivation, and during thermophilic fermentation at 60 degrees C temperature and pressure were 100% responsible for virus denaturation. PMID- 3532956 TI - Human prothymosin alpha: amino acid sequence and immunologic properties. AB - Prothymosin alpha has been purified from human thymus and its amino acid sequence determined, except for a 15 amino acid segment including 10 glutamyl residues near the middle of the molecule. Like prothymosin alpha from rat thymus [A. A. Haritos, R. Blacher, S. Stein, J. Caldarella, and B. L. Horecker (1985) Proc. Natl. Acad. Sci. USA 82, 343-346], human prothymosin contains the thymosin alpha 1 sequence at its NH2-terminus. It contains a total of 109-110 residues compared to 111-112 for rat prothymosin alpha, with deletions corresponding to positions Gln39 and Lys108 of the rat polypeptide. Human prothymosin alpha also differs from rat prothymosin alpha at positions corresponding to residues 87, 92, and 102 of the latter, with substitutions of alanine for proline, alanine for valine, and aspartic acid for glutamic acid, respectively. Human prothymosin is significantly less active than rat prothymosin in protecting mice against infection with Candida albicans and in stimulating release in vivo of migration inhibitory factor. Thus, the differences in amino acid sequences, present mainly the COOH terminal half of the polypeptides, may determine species specificity in biological properties. PMID- 3532957 TI - Reductive repression in Escherichia coli K-12 is mediated by oxygen radicals. AB - Cyclic AMP (cAMP) content and the expression of cAMP-dependent phenotypes were positively correlated with respiration capacity in respiration-deficient mutants of Escherichia coli K-12 ("reductive repression," R. Hertz, and J. Bar-Tana, (1982) Arch. Biochem. Biophys. 213, 193-199). Reductive repression in respiration deficient mutants could not be accounted for by respective changes in either the energy charge of adenine nucleotides or the redox state of pyridine nucleotides but could be ascribed to an increased formation of oxygen radicals under conditions of limited respiration. Scavengers of superoxide radicals eliminated reductive repression in respiration-deficient mutants with a concomitant increase in cAMP content. Such scavengers also effected a partial escape from permanent glucose catabolite repression, thus indicating a possible role played by oxygen radicals in both repression modes. PMID- 3532958 TI - [Bone marrow transplantation in cancer patients]. AB - Bone marrow transplantation (BMT) has been done as one mode of cancer therapy which has the possibility of curing some cancer patients. In Nagoya, more than half of leukemia patients who received allogeneic BMT in a remission state became long-term survivors, and autologous BMT for acute lymphoblastic leukemia has been successfully done using monoclonal antibodies for purging leukemia cells from bone marrow. According to our experiences with leukemia BMT, the following essential conditions for performing successful BMT in cancer patients were discussed, 1) preconditioning therapy for eradication of cancer cells, 2) supportive care for prevention of side effects of BMT including virus infections such as cytomegalovirus, and 3) compatibility of HLA antigens. PMID- 3532960 TI - Saprophytic molds as agents of cutaneous and subcutaneous infection in the immunocompromised host. PMID- 3532961 TI - Lymphocutaneous nocardiosis caused by Nocardia asteroides. Case report and literature review. AB - A 22-year-old man developed erythematous nodules and an ulcer mimicking sporotrichosis on his right hand and forearm, which was subsequently diagnosed as lymphocutaneous nocardiosis caused by Nocardia asteroides. To our knowledge, 21 cases of lymphocutaneous nocardiosis have been reported, with the majority of those cases, except for a few that remain uncertain, being due to Nocardia brasiliensis. The case reported herein, the first known definitive case caused by N asteroides (to our knowledge), showed a more chronic course and less inflammatory manifestation compared with that caused by N brasiliensis. This is probably because N brasiliensis has a stronger virulence than N asteroides. PMID- 3532959 TI - [Mitoxantrone-containing combination chemotherapy in patients with non-Hodgkin's lymphoma]. AB - Thirty-one patients with advanced non-Hodgkin's lymphoma were entered in a trial of a four-drug combination of mitoxantrone, cyclophosphamide, vincristine, and prednisolone (MCOP). This trial was intended to test the efficacy of substituting mitoxantrone for adriamycin in the CHOP combination, and to evaluate tumor response in patients who had received anthracycline antibiotic therapy. Of 31 patients, 25 were fully evaluated for tumor response and toxicity. There were 7 responses (4 complete, 3 partial) among 9 patients who had received radiation alone or chemotherapy not containing anthracycline antibiotics, whereas there were 7 responses (3 complete, 4 partial) in 16 patients who had been given anthracycline-containing chemotherapy. Median duration of response was 11+ weeks (range; 5 to 43+ weeks). The major toxicity was myelosuppression, although patients tolerated this well. This study suggested that mitoxantrone is not fully cross-resistant with anthracycline antibiotics and that MCOP is an effective regimen in patients with previously treated non-Hodgkin's lymphoma. However, when salvage chemotherapy for CHOP-failure is intended, cyclophosphamide and vincristine in MCOP should be further substituted by other agents such as etoposide and cis-platinum. PMID- 3532962 TI - Prolonged positive airway pressure for severe neonatal tracheobronchomalacia. AB - A very low birthweight preterm baby with respiratory distress at birth was found to have severe congenital tracheobronchomalacia. Continuous positive airway pressure was given through an endotracheal tube without tracheostomy for 15 weeks before unassisted respiration could be maintained. Diagnosis was made and progress monitored by laryngobronchoscopy on three occasions. PMID- 3532963 TI - Screening for the detection of congenital dislocation of the hip. PMID- 3532964 TI - [Endo-urologic technics in the treatment of complications of renal transplantation]. PMID- 3532965 TI - [Endo-urology in renal transplantation]. PMID- 3532966 TI - Cyclosporin treatment for rheumatoid arthritis: a placebo controlled, double blind, multicentre study. AB - The efficacy and safety of cyclosporin for patients with rheumatoid arthritis (RA) were assessed in a six month double blind, placebo controlled, multicentre study. The initial dosage of the drug was 10 mg/kg daily for two months. There were many discontinuations in both the cyclosporin group (eight out of 17) and the placebo group (six out of 19). Of the patients who completed the six months of therapy, those who had received cyclosporin showed a significant improvement in the number of swollen joints, the Ritchie articular index, and pain at active movement and at rest, compared not only with their condition at the start of the study, but also with the end results of the placebo group. Major adverse reactions to the drug were gastrointestinal disturbances and nephrotoxicity, which were probably due to the relatively high dosages of cyclosporin given in combination with non-steroidal anti-inflammatory drugs. PMID- 3532967 TI - Cyclosporin A (CyA) in primary Sjogren's syndrome: a double blind study. AB - The efficacy and toxicity of cyclosporin A (CyA) were studied in a blind fashion in 20 patients with primary Sjogren's syndrome (pSS). The dose of CyA or placebo was 5 mg/kg of body weight daily. Among the 20 patients, 10 received CyA and 10 placebo. The two groups were matched for age, sex, and disease duration. Patients treated with CyA improved in subjective xerostomia in comparison with patients treated with placebo. Subjective xerophthalmia and recurrent parotid gland enlargement did not differ in the two groups. No change in Schirmer's test and stimulated parotid flow rate was observed in either group. In contrast, the histopathological lesion of patients treated with CyA remained unchanged in most of the patients, while in the placebo treated group the lesion deteriorated. Laboratory parameters did not change before or after treatment in either group. The only clinical side effect observed in the CyA treated group was hypertrichosis. PMID- 3532968 TI - Splenopancreatic disconnection. Improved selectivity of distal splenorenal shunt. AB - Distal splenorenal shunt (DSRS) improves survival from variceal bleeding in nonalcoholic cirrhotics but not in alcoholic subjects. The metabolic response after DSRS is also different in alcoholic and nonalcoholic cirrhotics. Portal perfusion, quality of blood perfusing the liver, cardiac output, and liver blood flow do not change in nonalcoholics. In alcoholics, portal perfusion is frequently lost (60%), quality of blood perfusing the liver decreases, and cardiac output and liver blood flow increase. It is proposed that portal flow is lost in alcoholics via pancreatic and colonic collaterals after surgery. Elimination of this sump by adding complete dissection of the splenic vein and division of the splenocolic ligament to DSRS (splenopancreatic disconnection, SPD) could preserve portal perfusion, decrease shunt loss of hepatotrophic factor, and improve survival in alcoholic cirrhotics. This report compares data 1 year after surgery in two groups of cirrhotics: group I (8 nonalcoholic; 16 alcoholic) had DSRS without SPD; group II (17 nonalcoholic; 11 alcoholic) received DSRS + SPD. METHODS: Portal perfusion grade, cardiac output (CO), liver blood flow (f), hepatic function (GEC), and hepatic volume (vol) were measured before and 1 year after surgery. Shunt loss of hepatotrophic factor was estimated by insulin response (change in plasma concentration over 10 minutes: AUC) after arginine stimulation. RESULTS: Groups I and II were similar before surgery. Metabolically, nonalcoholics remained stable after both DSRS and DSRS + SPD. After standard DSRS, alcoholics lost portal perfusion (75%, p less than 0.05), CO, and f increased (p less than 0.05), and quality of blood perfusing the liver was decreased (GEC/f: p less than 0.05). DSRS + SPD preserved portal perfusion better (p less than 0.05) in alcoholic cirrhotics than did DSRS alone. After DSRS + SPD, the metabolic response in alcoholics resembled that of nonalcoholics. CO, f, and GEC/f remained stable. These data show: DSRS + SPD preserves postoperative portal perfusion in alcoholic cirrhotics better than DSRS alone. Metabolic response to DSRS + SPD is similar in alcoholic and nonalcoholic cirrhotics. Because portal perfusion and metabolic integrity are preserved after DSRS + SPD, its use in alcoholic cirrhotics should improve survival. PMID- 3532969 TI - Survival from hepatic transplantation. Relationship of protein synthesis to histological abnormalities in patient selection and postoperative management. AB - Forty-one patients, all in end stage hepatic failure, underwent 46 liver transplantations with a long-term survival rate of 63%. Six patients died of uncontrollable bleeding due to primary graft malfunction at or immediately after operation. Nine died early or late with overwhelming infection. In addition to clinical assessment, needle liver biopsy, central plasma clearance rate of amino acids (CPCR-AA), and routine "liver function tests" were employed to aid in selection of patients for transplantation and for guidance in postoperative management. Although liver biopsies usually afforded an exact diagnosis, neither they nor the routine liver function tests quantitated the extent to which hepatocyte function was impaired. CPCR-AA, which measures the rate of amino acid uptake by the liver and other central tissues for oxidation, gluconeogenesis, and protein synthesis was 91 +/- 9 ml/M2/min in the preoperative transplant group. This compares with a value of 97 +/- 16 in a previously studied series of cirrhotics who died following other forms of surgery and a CPCR-AA of 220 +/- 26 ml/m2/min in those who survived. In addition, the preoperative CPCR-AA was found to correlate with the in vitro hepatic protein synthetic rate of slices from the resected recipient liver (r = 0.72, p less than 0.02). After operation, serial hepatic needle biopsies were classified by histology into four grades of injury, ranging from normal liver transplant (Grade I) to mild hypoxic or rejection injury (Grade II), viral hepatitis (Grade III), and severe hypoxic or rejection injury (Grade IV). Significant relationships of the histological grades to ultimate mortality, CPCR-AA, and prothrombin times were found. CPCR-AA and prothrombin time correlate inversely (r = 0.57, p less than 0.001), further demonstrating the relationship of CPCR-AA to protein synthesis of clotting factors. These patterns of posttransplant response were delineated by serial CPCR AA values. "Early" responders had values over 290 ml/M2/min and all survived. Twelve patients with delayed response were characterized by values of 150 +/- 12, rising to over 200 ml/M2/min after 2 weeks. Two who failed to increase CPCR-AA died. In six "poor" responders, CPCR-AA with Grade IV injury remained below 110 ml/M2/min. All died except for one whose CPCR-AA subsequently rose following retransplantation. It is concluded that percutaneous hepatic needle biopsies and CPCR-AA measurements in combination are of proven value, not only in understanding the nature of injury and functional impairment of the liver, but are also important as guides to selection of patients and for their posttransplant management. PMID- 3532970 TI - Fetal allograft survival in immunocompetent recipients is age dependent and organ specific. AB - This study explores whether fetal allograft survival is age dependent and organ specific. Fetal rat tissue (renal, gonadal, hepatic) from the third trimester of gestation (days 15-21) was transplanted into 306 outbred adult rats for 10-30 days. Grafts were studied by morphometric and histologic analysis. Ten days after implantation, renal tissue (N = 75) from late gestation (days 19-21) showed no increase in size. In contrast, 17-day fetal grafts (N = 20) grew 6.8 +/- 3.4 times,* while 15-day fetal grafts (N = 28) grew 17.5 +/- 6.1* times. (The symbol "*" indicates p less than 0.05, compared to original size). Twenty days after implantation, these 15-day fetal grafts (N = 20) grew 48.8 +/- 17.7* times. Ten days after grafting, the younger fetal tissue showed excellent maturation of renal elements and no sign of rejection; older fetal grafts had poor renal architecture and a dense lymphocytic infiltrate. The 15-day fetal gonadal tissue (N = 18) showed a moderate 10.6 +/- 3.2* increase in size while the 15-day hepatic grafts (N = 16) were regularly rejected within 10 days. Selected fetal allografts from early in the third trimester can not only survive but can grow and mature in an immunocompetent recipient. This fetal graft growth appears to be both age dependent and organ specific. The use of fetal organs may broaden the potential pool for transplantation. However, further studies are needed to define the ontogeny of graft acceptance. PMID- 3532971 TI - Prospective study of gastrinoma localization and resection in patients with Zollinger-Ellison syndrome. AB - In 1982, a prospective study was initiated of 52 consecutive patients with proven Zollinger-Ellison syndrome (ZES), involving surgical exploration with the goal of removing the gastrinoma after an extensive protocol to localize the tumor. Each patient underwent ultrasound, computed tomography (CT) with oral/intravenous (IV) contrast, and selective arteriography. Eighteen patients had metastatic disease identified by imaging studies and confirmed by percutaneous biopsies, and two patients had multiple endocrine neoplasia type I (MEN-I) with negative imaging studies; therefore, these 20 patients did not undergo laparotomy. Each of the remaining 32 patients (3 with MEN-I and positive imaging studies) underwent laparotomy, and gastrinomas were removed in 20 patients. Preoperative ultrasound localized tumors in 20% of patients, CT in 40%, arteriography in 60%, and any of the modalities in 70% of patients. Infusion CT and arteriography were 100% specific. In 18 patients with either negative imaging (17) or false-positive imaging (1 ultrasound), gastrinomas were found and removed in six patients (33%). Twenty-four gastrinomas were found in 20 patients at laparotomy: eight in lymph nodes around the pancreatic head, four in the pancreatic head, one in the pancreatic body, three in the pancreatic tail, three in the pyloric channel, one in the duodenal wall, two in the jejunum at the ligament of Treitz, one in the ovary, and multiple liver metastases in one patient. If one excludes patients with MEN-I or liver metastatic disease, 12/28 (43%) of patients were biochemically "cured" immediately after operation. This result decreased to 7/23 (30%) with greater than 6 months follow-up. No patients with gastrinomas resected have developed recurrent gastrinoma on follow-up imaging studies (longest follow up: 4 years). This study indicates that 95% of metastatic gastrinoma can be diagnosed before operation and that, by a combination of careful imaging studies and thorough exploration at surgery, 30% of patients with gastrinomas may be curable. PMID- 3532972 TI - An analysis of survival and treatment failure following abdominoperineal and sphincter-saving resection in Dukes' B and C rectal carcinoma. A report of the NSABP clinical trials. National Surgical Adjuvant Breast and Bowel Project. AB - Abdominoperineal resections for rectal carcinoma are being performed with decreasing frequency in favor of sphincter-saving resections. It remains, however, to be unequivocally demonstrated that sphincter preservation has not resulted in compromised local disease control, disease-free survival, and survival. Accordingly, it is the specific aim of this endeavor to compare local recurrence, disease-free survival, and survival in patients with Dukes' B and C rectal cancer undergoing curative abdominoperineal resection or sphincter-saving resection. For the purpose of this study, 232 patients undergoing abdominoperineal resection and 181 subjected to sphincter-saving resections were available for analysis from an NSABP randomized prospective clinical trial designed to ascertain the efficacy of adjuvant therapy in rectal carcinoma (protocol R-01). The mean time on study was 48 months. Analyses were carried out comparing the two operations according to Dukes' class, the number of positive nodes, and tumor size. The only significant differences in disease-free survival and survival were observed for the cohort characterized by greater than 4 positive nodes and were in favor of patients treated with sphincter-saving resections. A patient undergoing sphincter-saving resection was 0.62 times as likely to sustain a treatment failure as a similar patient undergoing abdominoperineal resection (p = 0.07) and 0.49 times as likely to die (p = 0.02). The inability to demonstrate an attenuated disease-free survival and survival for patients treated with sphincter-saving resection was in spite of an increased incidence of local recurrence (anastomotic and pelvic) observed for the latter operation when compared to abdominoperineal resection (13% vs. 5%). A similar analysis evaluating the length of margins of resection in patients undergoing sphincter-preserving operations indicated that treatment failure and survival were not significantly different in patients whose distal resection margins were less than 2 cm, 2-2.9 cm, or greater than or equal to 3 cm. If any trend was observed, it appeared that patients with smaller resection margins had a slightly prolonged survival (p = 0.10). This observation was present in spite of the fact that local recurrence as a first site of treatment failure was greater in the group with less than 2 cm that it was in the greater than or equal to 3 cm category, 22% versus 12%. This increased local recurrence rate in the population with smaller margins was not translated into an in crease in overall treatment failure and had absolutely no influence on survival. It is suggested that local recurrence serves as a marker of distant disease.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3532973 TI - Hemodynamics and coagulation in experimental auxiliary liver transplantation during fulminant hepatic failure. AB - In pigs, ischemic liver cell necrosis was induced by 6 hours' occlusion of the hepatic artery and the portal vein 3 days after construction of a side-to-side portacaval shunt and division of the hepatic ligaments. Two thirds of the liver of an MLC-compatible donor was heterotopically transplanted 13 hours (group I), and 3 hours (group II) after induction of liver failure. In group I (N = 11), three animals died of liver failure before or shortly after induction of anesthesia. Of the remaining pigs, two animals survived more than 2 weeks. In group II (N = 10), intraoperative hypotension was prevented by reduction of the interval between liver failure and transplantation and by thermodilution catheter monitored fluid replacement. A significant decrease in cardiac output and an increase of pulmonary and systemic vascular resistance were observed during auxiliary partial liver transplantation (APLT). In the immediate postoperative period, six pigs died of deficiencies in hemostasis that were caused by consumptive coagulopathy related to severe host liver damage rather than fibrinolysis. Two pigs in group II survived in good condition 12 and 42 days after APLT. In the longer surviving pigs of both groups, either the graft or the host liver recovered. Processes that might be responsible for the observed hemodynamic changes and coagulation disorders are discussed. These results indicate that APLT is technically feasible in severely ill pigs with acute hepatic failure. PMID- 3532974 TI - Stereotaxic needle localization and cytological diagnosis of occult breast lesions. AB - A stereotaxic technique for localization of occult breast lesions and fine needle aspiration for cytological diagnosis was used on examination of 543 patients. Successful localization with the needle tip within 1 mm of the suspected lesion was possible in 490 patients (90.2%). Based on a high mammographic index of suspicion for malignancy, 187 of 490 patients were selected to undergo open biopsy, following aspiration cytology and localization with methylene blue injection. The statistical results (cytologic vs. histologic examination) revealed a sensitivity of 97.5% and a specificity of 95.2% for cytologic diagnosis of occult breast lesions. The technique is easy to learn and takes 20 30 minutes to perform. Compliance was 100% and complications were nil. This new technique expedites localization and maximizes the specificity of mammography for occult breast lesions. PMID- 3532976 TI - Indirect immunofluorescence in the study and diagnosis of organ-specific autoimmune disease. PMID- 3532975 TI - Evaluation of insulin secretion after pancreas autotransplantation by oral or intravenous glucose challenge. AB - Segmental pancreatic autotransplantation is accompanied by surgical alterations to the pancreas that may have consequences for carbohydrate metabolism. Four mongrel dogs were evaluated before operation and sequentially until 40 weeks after total pancreatectomy and autotransplantation of the splenic lobe of the pancreas with bolus intravenous and oral administration. Intravenous glucose tolerance test (IVGTT) (0.5 g/kg) revealed maintenance of fasting euglycemia for as long as 40 weeks after operation. Peak glucose and integrated glucose values did not show significant changes as a result of autotransplantation. Following transplantation, a delayed peak insulin response was seen; however, basal, peak, and integrated insulin values were largely unaltered. Only K values, a measure of glucose disposal, showed severe alterations (2.44 +/- 0.21 before operation to 1.24 +/- 0.30 at 40 weeks after operation). Oral glucose tolerance tests (OGTT) (2.0 g/kg) demonstrated an increased peak hyperglycemic response after autotransplantation with increased integrated glucose responses. Insulin levels remained at those levels seen before operation, and glucose-dependent insulinotropic polypeptide (GIP) responses were unchanged during the OGTT as late as 20 weeks after operation. In conclusion, pancreas autotransplantation after total pancreatectomy results in significant metabolic alterations that the IVGTT fails to detect with absolute glucose or insulin levels. However, K values are significantly lowered, which indicates alterations in cellular glucose transport. The OGTT demonstrates hyperglycemia without increased insulin or GIP levels, which suggests an altered beta cell response to the enteric stimulus of insulin release. These changes are nonetheless well tolerated by animals that have remained clinically healthy and euglycemic in the basal state. PMID- 3532977 TI - [Scalariform incisions. Study of 34 cases]. AB - The scalaire incisions were indicated in 34 hands with 58 longitudinal palmar contracture which restrict extension and usually result of deep burns. The technique was suggested by the incisions used in Dupuytren's followed by directed cicatrization and wearing dynamic extension splints for 2 months. The functional results are good and fair in 85 percent of cases. The failure usually come from important articular stiffness. The cosmetic result is most often very good especially when comparing with the disadvantage of skin graft pigmentation. PMID- 3532978 TI - [Guillaume Dupuytren]. PMID- 3532979 TI - Free radical scavengers and myocardial preservation during transplantation. AB - The efficacy of oxygen radical scavengers in preservation of left ventricular (LV) function after prolonged hypothermic global ischemia was investigated in a model of orthotopic cardiac transplantation in sheep. Group 1 hearts (N = 8) received hypothermic crystalloid cardioplegic solution, and were harvested and stored at 4 degrees C in balanced electrolyte solution for six hours prior to transplantation. Group 2 (N = 9) received identical treatment with the addition of 30,000 units of superoxide dismutase to the cardioplegic solution and the administration of 60,000 units of superoxide dismutase coincident with reperfusion. All animals were weaned from cardiopulmonary bypass. Preischemic and postischemic LV function was determined using sonomicrometry and a micromanometer tipped LV catheter. Coronary blood flow was determined using standard microsphere techniques, and platelet deposition was assayed with autologous platelets labeled with indium 111. Lipid peroxidation products were measured using thiobarbituric acid assay. LV performance was significantly better (p less than .05) in Group 2 hearts when assessed by the slope of the end-systolic pressure-volume relationship and the stroke work versus end-diastolic volume relationship. There was better preservation of endocardial blood flow in the group receiving superoxide dismutase compared with controls (p less than .05). Platelet deposition, as determined by the tissue to blood ratio of scintigraphic counts, was greater (p less than .05) in controls compared with the group receiving superoxide dismutase. In addition, thiobarbituric acid reactive species were significantly less (p less than .05) in Group 2 versus Group 1 hearts.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3532980 TI - Experimental en bloc double-lung transplantation. AB - A technique of en bloc double-lung transplantation through a median sternotomy has been developed. Hypothermic circulatory arrest was used after surface cooling in 7 puppies (mean weight, 3.1 kg; range, 1.5 to 4.1 kg). A double lung block, consisting of the two lungs, distal trachea, the main pulmonary artery, and a large cuff of left atrium, was removed from weight-matched donors. After the arrest of the circulation by inflow occlusion, bilateral pneumonectomies were performed in the recipient. The donor double-lung block was then implanted with anastomoses at the distal trachea, the posterior left atrium, and the main pulmonary artery. All animals were successfully rewarmed and had excellent hemodynamic function and gas exchange for periods of up to 24 hours. If primate experiments with long-term survival confirm these initial results, this procedure may have a role in the treatment of patients with end-stage respiratory disease but acceptable cardiac function. PMID- 3532981 TI - Changes in intrathoracic pressures induced by positive end-expiratory pressure ventilation after cardiac surgical procedures. AB - The consequences of controlled ventilation with positive end-expiratory pressure (PEEP) were studied, after cardiac surgical procedures, in two groups of patients supposed to have different lung and chest wall mechanical properties. The first group included 6 patients who had undergone coronary artery graft surgical procedures (CGS). The second group included 5 patients who had undergone a mitral valve replacement (MVR). Postoperatively, static lung and chest wall compliance was measured by stepwise inflation and deflation of the thorax. Esophageal, pericardial, and pleural pressures were then measured, and cardiac output was determined while PEEP was increased from 0 to 20 cm H2O. Lung and chest wall compliance values sharply decreased in MVR patients. This accounts for the lower values for pleural and pericardial pressures in this group than in the CGS patient group, but the transmission of airway pressure was identical in the two groups when PEEP was increased. The decrease in cardiac output induced by PEEP was similar in the two groups. The results suggest that the opposing influences of lung and chest wall compliance on airway pressure transmission could at least partly explain the hemodynamic effects of PEEP in patients in whom the mechanical properties of the lung and thorax are impaired. PEEP ventilation should be used cautiously in patients suspected of having thoracic rigidity. PMID- 3532982 TI - Effects of prostaglandin E2 and I2 on renal cortical and medullary blood flow in rabbits. AB - The effects of intra-aortic administrations of prostaglandin (PG) E2 and I2 on the renal regional blood flow were investigated in rabbits. Mean arterial blood pressure (MABP) was monitored by the direct method and total renal blood flow (TRBF) was measured using the electromagnetic method. Renal cortical and medullary blood flows (RCBF and RMBF) were measured by the hydrogen gas clearance method. Both PGE2 and PGI2 caused a dose-dependent reduction of MABP. At doses having no significant effect on MABP, PGE2, and PGI2 increased TRBF and decreased renal vascular resistance (RVR). The maximum reduction in RVR induced by PGI2 was significantly greater than that by PGE2. PGE2, produced significant increases in RCBF and in particular in RMBF, while PGI2 induced similar changes in RCBF and RMBF. The results suggest that PGE2, which is a weaker vasodilator than PGI2, mainly acts as a medullary vasodilator, and that PGI2 has similar vasodilatory effects on the cortex and medulla. PMID- 3532983 TI - Klebsiella pneumoniae liver abscess associated with septic endophthalmitis. AB - Metastatic septic bacterial endophthalmitis is a rare, but devastating disease. We encountered seven cases of pyogenic liver abscess associated with septic endophthalmitis during a recent four-year period. The causative organism was a pure culture of Klebsiella pneumoniae. The diagnosis was made by results of a blood culture in seven of the cases, liver aspirate culture in four, and eye contents or conjunctival culture in four. Chest roentgenographic examination showed pulmonary embolization in four patients, purulent meningitis in one patient, and suspicious prostatic abscess in one patient. Despite diligent antibiotic therapy, six patients lost their vision and one had impaired vision. This poor outcome for septic endophthalmitis seems to result from delayed diagnosis and lack of scheduled periocular injections of antibiotics. A combination course of treatment by the internist and ophthalmologist acting aggressively, both diagnostically and therapeutically, is needed in the future. To have seven cases of K pneumoniae liver abscess complicated by septic endophthalmitis during a period of four years in one hospital is very unusual. To our knowledge, it has never been reported in the literature. PMID- 3532984 TI - Milk-alkali syndrome in patients treated with calcium carbonate after cardiac transplantation. AB - Heart and heart-lung transplant recipients at Stanford (Calif) University Medical Center were routinely prescribed long-term calcium carbonate antacid therapy to aid in the prevention of peptic ulcer disease and osteoporosis associated with glucocorticoid immunosuppressive therapy. Patients consumed 4 to more than 10 g/d of elemental calcium. Since calcium carbonate also provides the essential ingredients for the development of the milk-alkali syndrome, the laboratory flow sheets of 297 heart and heart-lung transplant recipients were reviewed to examine the incidence of hypercalcemia. Sixty-five patients developed significant hypercalcemia after transplantation. Thirty-one patients were alkalotic at the time of hypercalcemia; 37 had impairment in renal function. It is likely that most of these patients had the milk-alkali syndrome. While most patients became eucalcemic by discontinuing calcium carbonate therapy, intravenous hydration and forced diuresis were used to treat severe cases. It is possible that the incidence of the milk-alkali syndrome will increase with the current popularity of prescribing calcium carbonate for the prevention and treatment of osteoporosis. PMID- 3532985 TI - The living kidney donor. Alive and well. AB - The results of cadaveric renal transplantation have markedly improved in recent years. Concurrently, a few long-term follow-up studies of living kidney donors found an increased incidence of proteinuria and hypertension. As a result, some have argued that living donors should no longer be the preferred source of kidneys. To see if transplant centers are moving away from the use of living donors, we sent a questionnaire to all US transplant centers. The results of our survey show that rather than becoming extinct, living donors are still the preferred source of kidneys at most US transplant centers. In fact, new ways are being sought to increase the supply of living kidney donors. PMID- 3532986 TI - Two hearts in one chest. PMID- 3532987 TI - Blood pressure response to exercise as a predictor of hypertension. AB - Published studies of the blood pressure response to exercise were reviewed to assess the probability of future hypertension in a subject with a "hypertensive" response to exercise. The reviewed data indicate that the sensitivity of a hypertensive response to exercise for future hypertension varied between 16% and 60%, and the specificity between 53% and 95%. The prevalence of hypertension on follow-up among normotensive subjects with a hypertensive response to exercise testing was 2.06 to 3.39 times higher than that among subjects with a normotensive response. Therefore, blood pressure response to exercise does have a predictive value for future hypertension. However, this predictive value is limited, since 38.1% to 89.3% of those with a hypertensive response to exercise did not have hypertension on follow-up, and a normotensive response only marginally reduced the risk of future hypertension. The use of exercise testing as a predictor of hypertension is still in need of experimental development and confirmation. PMID- 3532988 TI - Antibiotic tetaine--a selective inhibitor of chitin and mannoprotein biosynthesis in Candida albicans. AB - The antibiotic tetaine inhibits in Candida albicans the biosynthesis of two important cell wall constituents, chitin and mannoprotein. This effect is a consequence of inactivation of the enzyme glucosamine-6-phosphate synthetase. Due to the lack of glucosamine-6-phosphate the effective secretion of mannoprotein enzymes, acid phosphatase and invertase, by Candida albicans spheroplasts is inhibited. In the presence of tetaine, probably a modified mannoprotein, lacking a branched polymannan, is synthesized. The antibiotic action decreases the viability of Candida albicans cells, especially that of mycelial forms of this fungus. PMID- 3532989 TI - The influence of clinical glucagon and alanine loading tests on the sugar, glucagon and insulin levels in the blood of piglets. PMID- 3532991 TI - [Culturing of Mycobacteria from various specimens]. PMID- 3532990 TI - [Assessment of the effectiveness of vaccines against coli dysentery of piglets]. PMID- 3532992 TI - [Behavior of indicator enzymes in blood plasma after experimentally induced endotoxin shock in weaned piglets]. PMID- 3532993 TI - [Bacteriological studies on Streptococcus agalactiae in milk samples]. PMID- 3532994 TI - [Percutaneous extraction of pigment lithiasis of the choledochus in an infant]. AB - The authors present the first report of a pigment gallstone of the common bile duct in a 2 month-old infant treated in a non-surgical manner. The gallstone extraction was percutaneous, by a small catheter introduced in the biliary tract under ultrasound control. The clinical and ultrasonographic follow-up (19 months) confirmed complete recovery. This new therapeutic modality might avoid surgery for primary common bile duct cholelithiasis. PMID- 3532995 TI - [Acute viral encephalitis. Current concepts and therapeutic implications]. PMID- 3532996 TI - Family-genetic studies of psychiatric disorders. Developing technologies. AB - During the past decade new concepts and technologies have improved the conduct of family-genetic studies in psychiatry. We compiled and critically evaluated these advances, including study design, pedigree collection, diagnostic procedures in adults and children, and epidemiologic and genetic approaches to data analysis. These approaches have improved the collection of accurate information on the nature and patterns of psychiatric illness in families. The data generated from well-designed and well-conducted family studies are useful for the identification of homogeneous subgroups of psychiatric disorders, for understanding the spectrum of psychiatric disorders, for examining the associations between psychiatric disorders, and for studying the continuity between adult and childhood manifestations of psychiatric disorders. Findings from these studies also may enhance our capacity to identify the mode of transmission of the psychiatric disorders and to select potentially informative families for future genetic linkage studies using the new recombinant DNA techniques. The adaptation of these methods to routine clinical practice and new directions in the application of family-genetic studies employing more refined assessments and analytic methods are also discussed. PMID- 3532997 TI - [Diagnostic imaging of peripheral soft tissue tumors with special reference to computed tomography]. AB - The further development of modern therapeutical procedures in the treatment of soft tissue tumors requires an improvement of radiological diagnostics. The diagnostic values of X-rays, angiography, sonography and computed tomography is estimated critically. The results of own CT examinations in 120 patients with soft tissue tumors and of 50 ultrasound examinations show the importance of these methods in the extent diagnosis of soft tissue tumors. Ultrasound or CT- guided biopsy are helpful to prove the definitive diagnosis. These methods have reduced the use of angiography. PMID- 3532998 TI - Framework of the enteric nerve plexuses: an immunocytochemical study in the guinea pig jejunum using an antiserum to S-100 protein. AB - Immunostained sections and whole-mount preparations of the layers of the guinea pig jejunum were investigated by an improved peroxidase-antiperoxidase method using an antiserum to S-100 protein. A delicate latticework of S-100 protein immunopositive glial cells was demonstrated extending in the longitudinal muscle layer, myenteric or Auerbach's plexus, circular muscle layer including the deep muscular plexus, submucous layer including the submucous or Meissner's plexus, lamina muscularis mucosae and lamina propria mucosae. The whole enteric nerve plexuses consisted of two subsystems; nerve plexuses of the muscular coat and those of the submucous and mucous coats. These two subsystems were joined to each other by thick, connecting branches perforating the inner circular muscle layer. Extrinsic nerves entering the myenteric plexus formed a specialized junctional structure containing S-100 protein immunopositive glial cells, whereas those entering the submucous plexus ran along the submucous arteries. We proposed the term enteroglial cells to designate the S-100 protein immunopositive cells which ensheathed the somata and processes of the enteric neurons. The frameworks of all structures in the enteric nerve plexuses from the largest ganglia to the thinnest nerve fasciculi were constructed of these enteroglial cells. A spectrum of the enteroglial cells was presented. Those in the myenteric and submucous ganglia were found similar to the astroglia of the central nervous system and to the satellite cells in the peripheral ganglia. Those in the primary and secondary fasciculi of the myenteric plexus formed a kind of neuropil together with the neuronal processes. Those in the tertiary fasciculi of the muscular coat formed the framework of the autonomic ground plexus. We tentatively concluded that the interstitial cells of Cajal contain an immunoreactivity for S-100 protein, and thus are glial in nature. The occurrence of specialized enteroglial cells with a neuron-like function was discussed in the autonomic ground plexus of the muscular coat. In the lamina propria mucosae, there was a fine latticework of the S-100 protein immunopositive enteroglial cells. This latticework corresponded to that of the interstitial cells of Cajal in the villous and periglandular plexuses. PMID- 3532999 TI - Fine structure of the neuro-insular complex type II in the cat. AB - Electron microscopy of a neuro-insular complex type II is described in the adult cat. A group of B-cells was recognized in the endoneurial space of a nerve provided with a continuous multi-layered perineurial sheath. The endocrine cells together with unmyelinated axons were enveloped by cytoplasmic processes of Schwann cells. A synaptic-like structure was occasionally noted on the surface of an endocrine cell. The neurotropism of endocrine cells (WATZKA, 1931) which leads to the formation of pancreatic neuro-insular complexes is compared with the neurotropism of Leydig cells and ovarial interstitial cells. It is suggested that such neuro-endocrine complexes generally communicate via vascular connections to the target organs or target tissues. PMID- 3533000 TI - Histochemical classification of systemic amyloid fibril proteins. Alkaline guanidine method. AB - The alkaline guanidine method facilitates differentiation between different types of amyloid fibril proteins in formaldehyde-fixed, paraffin-embedded tissue sections. Systemic AA-type amyloids lost Congophilia (affinity of Congo red) after incubation with alkaline guanidine for one minute. Systemic AL-type amyloids lost or markedly decreased Congophilia after two hours of treatment with alkaline guanidine. Systemic prealbumin-type amyloids were resistant to incubation for two hours. On the other hand, some cerebral amyloid plaques from patients with Creutzfeldt-Jakob disease and Gerstmann-Straussler syndrome markedly decreased Congophilia, while in other amyloid plaques, Congophilia was not decreased even with two hours of treatment. The senile plaques from those patients with Alzheimer's disease did not diminish Congophilia after alkaline guanidine treatment. Thus, while this method does not differentiate types of cerebral amyloid protein, it does clearly differentiate types of systemic amyloid fibril proteins. PMID- 3533001 TI - Minimal renal amyloidosis with nephrotic syndrome. AB - Two patients older than age 50 years had minimal amyloidosis in association with the nephrotic syndrome. The amyloid deposits in each case were so inconspicuous as to have been initially overlooked, and both biopsy specimens were thought to show minimal glomerular changes. A few, widely scattered, silver-positive, epimembranous spicules were found on reexamination by light microscopy, and Congo red and thioflavin T stains and electron microscopy confirmed the presence of small glomerular amyloid deposits. Both patients have since died of renal failure. In our series of biopsy specimens, amyloidosis was found in 14.2% of patients older than age 50 years presenting with nephrotic syndrome or severe proteinuria, over 1 1/2 times the frequency of minimal-change nephrotic syndrome. We therefore urge careful examination for amyloid deposits of all kidney biopsy specimens with the appearance of minimal-change nephrotic syndrome in older patients. Fluorescence microscopy of Congo red- and thioflavin T-stained sections is very helpful in the detection of small deposits. PMID- 3533002 TI - Primary cerebral lymphoma. A histologic and immunohistochemical study of six cases. AB - Between 1981 and 1985, three male and three female patients (age range, 26 to 65 years) with primary central nervous system lymphoma underwent biopsy procedures and were treated in the Wessex Neurological Centre, Southampton, United Kingdom. The primary nature of the disease was confirmed by extensive clinical and radiologic investigation, and a combined approach of cytologic, histologic, and immunohistochemical studies contributed to the diagnosis and characterization of these tumors. By the Kiel classification, the lesions included five diffuse follicle center cell lymphomas and one T-cell lymphoma. Five of the lesions were present in the cerebral hemispheres, and three of these were multifocal. Only one patient presented with a lesion in the posterior fossa. Despite combinations of surgery, radiotherapy, and chemotherapy, all patients died, the longest postoperative survival being two years. PMID- 3533003 TI - Pulmonary histiocytosis X. Immunoperoxidase staining for HLA-DR antigen and S100 protein. AB - Immunoperoxidase staining for S100 protein and HLA-DR antigen was used to identify histiocytosis X (HX) cells in 23 cases of pulmonary histiocytosis X (PHX), three cases of idiopathic pulmonary fibrosis, and one case of hypersensitivity pneumonitis. S100 protein was present in HX cells in 22 of the PHX cases; HLA-DR antigen was present in HX cells from 16 cases. Varying numbers of peribronchiolar and interstitial cells were positive for either S100 or HLA-DR in two of the three cases of idiopathic pulmonary fibrosis, and in the case of hypersensitivity pneumonitis. Immunoperoxidase staining for chromogranin showed isolated neuroendocrine cells within the mucosa and wall or airways, sites in which HX cells were occasionally found. As other types of dendritic cells, as well as some neuroendocrine cells, may contain S100 protein, positive staining for S100 is not specific for HX cells. PMID- 3533004 TI - Multinucleated giant cells in acquired immunodeficiency syndrome encephalopathy. Origin from endogenous microglia? AB - Multinucleated giant cells that are characteristic of the encephalomyelopathy of acquired immunodeficiency syndrome are stained by a lectin histochemical method. The particular lectin used, Ricinus communis agglutinin I, has been shown to bind to endogenous microglial cells in human brain, as well as to endothelial cells of blood vessels. These results suggest that multinucleated giant cells in the brain of patients with acquired immunodeficiency syndrome may be derived from endogenous microglia. PMID- 3533005 TI - Immunohistochemical demonstration of homicidal insulin injection site. AB - Deliberate fatal injection of insulin is apparently a rare event. Its investigation generally requires demonstration of an exogenous insulin injection site and high blood or tissue levels. Interpretation of such results in postmortem samples can be difficult, and the demonstration of an insulin injection site has previously usually involved a tedious extraction procedure. We report a case of infanticide in which insulin was demonstrated immunohistochemically at the fatal injection site and discuss some aspects of interpretation of postmortem insulin levels. PMID- 3533006 TI - A recapitulation. PMID- 3533007 TI - Pressure ulcer management in home health care: efficacy and cost effectiveness of moisture vapor permeable dressing. AB - This prospective randomized study was conducted in the home care setting to compare healing rates and costs of two different dressings for pressure ulcers: the gauze and tape dressing and the transparent moisture vapor permeable dressing (MVP). Demographic variables, healing rates, and cost of treatment were statistically analyzed for 77 pressure ulcers (48 patients). Each wound was randomly assigned to either a gauze dressing or a MVP dressing. Initial ulcer grade (Shea criteria) and measurements were determined at the start of treatment and weekly for an eight-week period. Photographs of the wound were taken at the beginning and end of treatment. The same protocol for irrigating the wound and relieving pressure was followed for both dressing groups. The median improvement for the grade II group was 100% for the MVP (n = 22) and 52% for gauze (n = 12), p less than 0.05 (Wilcoxon rank sum test). The healing rates for grade III ulcers were not significantly different in the two dressing groups. The mean (eight week) labor and supply cost per ulcer using the MVP was $845, while that for gauze treatments was $1359, p less than 0.05 (Wilcoxon rank sum test). The cost difference for grade III ulcers was not significant in the two dressing groups. The MVP improved the healing rate and was more cost effective for grade II ulcers. Both gauze and MVP dressings proved effective for the treatment of grade III ulcers. PMID- 3533008 TI - Comparison of laser-welded and sutured arteriotomies. AB - We compared the histologic features, tensile strength, and collagen synthesis of laser-welded and sutured arteriotomies. Four bilateral canine femoral or carotid arteries, 2 cm long, were studied at one through four weeks postoperatively, with one vessel (control) closed with interrupted 6-0 polypropylene sutures and the contralateral vessel (experimental) welded with an argon laser (0.5 W [1417 J/cm2], four-minute exposure per 1-cm length of incision). Histologic examination revealed that laser-welded arteriotomies had less inflammatory reaction, more normal collagen and elastin reorientation, and similar endothelial continuity when compared with the control, sutured wounds. The tensile strength of the one- and two-week laser-welded specimens was less than that of sutured wounds and became approximately equal to sutured repairs at three and four weeks. There were no significant differences in the rate of collagen synthesis. There was no evidence of abnormal healing in the laser-welded specimens, suggesting that argon laser welding may be an alternative to suture repair of arteriotomies. PMID- 3533009 TI - Suture technique in preventing dehiscence of prosthetic mitral valves. AB - To evaluate suture techniques for mitral valve replacement, 60 fresh porcine hearts were used to determine suture holding strength. Using four techniques (simple interrupted, figure-of-eight, and horizontal without and with pledgets), the anterior leaflet, the posterior leaflet, and the commissures were sutured. The free ends of the sutures were then attached to a force transducer, and tension was increased until disruption occurred. In the anterior leaflet, horizontal mattress sutures disrupted with significantly less force than the other techniques. Pledgets increased the holding strength of mattress sutures, but figure-of-eight and simple interrupted sutures had greater holding strength than sutures with pledgets, suggesting that the direction of the suture vs that of tissue fibers is critical. Histologic studies confirmed this point. The posterior leaflet exhibited less holding strength than the anterior leaflet for all suture techniques but did not demonstrate a superiority for any specific technique. The posterior leaflet is the problem area for suture disruption from the mitral anulus. We secure mitral prostheses with horizontal mattress sutures with pledgets around the entire anulus, placing them from the atrial side. PMID- 3533010 TI - Effect of heparin and heparin fractions on experimental abscess formation. AB - To evaluate the effectiveness of heparin and heparin fractions in decreasing abscess formation, rats were divided into six groups. A fibrin clot containing 10(9) live Escherichia coli was placed in the peritoneal cavity of each rat. Group 1 (controls) received daily subcutaneous (SQ) injections of 0.1 mL of saline solution. Group 2 received daily intramuscular injections of gentamicin, 12.5 mg/kg. Group 3 received a daily SQ dose of 30 U of porcine heparin. In addition to gentamicin, group 4 received heparin, group 5 received heparin fraction PK10169, and group 6 received heparin fraction CY216, all in daily SQ doses of 30 U. Survivors were killed at ten days and examined for intra-abdominal abscesses. All group 1 animals developed abscesses. Abscess formation was significantly decreased in all groups receiving gentamicin. When used with gentamicin, neither heparin nor heparin fractions decreased the number of abscesses formed when compared with gentamicin alone. Heparin or heparin fractions in combination with gentamicin did decrease abscess size significantly when compared with controls. PMID- 3533011 TI - Dynamics of enzymatic activity development in the adherent rumen microflora. AB - In lambs in the period of a milk nutrition, the enzymatic activities of the rumen wall microflora: cellulase (EC 3.2.1.4), beta-glucanase (EC 3.2.1.73), alpha amylase (EC 3.2.1.1), urease (EC 3.5.1.3) and neutral protease have been investigated. For comparison's sake, the enzymatic of adherent microflora of the caecal wall ahs been observed, too. It was found that the functionally latent rumen of lambs contained adherent bacteria with cellulase and beta-glucanase activities which reached their maximum on the 30th day of life. The alpha-amylase and protease activities of the epimural rumen microflora reached their maximum already on the 20th day of life. Contrarily, the urease activity reached its maximum only on the 40th day of life. The results show that already from the 10th day after birth, the rumen of young ruminants has a relatively high microbial enzymatic activity. PMID- 3533012 TI - [Immunopathology of systemic lupus erythematosus]. PMID- 3533013 TI - Medicare cuts 'first bite of the apple,' MD warns. PMID- 3533014 TI - Epikeratophakia with commercially prepared tissue for the correction of aphakia in adults. AB - The records of all adult patients at Louisiana State University Eye Center, New Orleans, who underwent epikeratophakia for aphakia with commercially prepared tissue since February 1984 were reviewed. The epikeratophakia lenticule was maintained in 37 (92.5%) of 40 patients; complications required the removal of three tissue lenses. The average refractive error three months after surgery was +0.67 +/- 1.97 diopters; 25 (90%) of 28 patients were within 3 D of emmetropia. At six months, the average refractive error was -0.18 +/- 2.27 D. Fourteen (58%) of 24 patients whose visual acuity was 20/40 or better with spectacles before surgery achieved 20/40 spectacle visual acuity three months after surgery, as did ten (59%) of 17 patients at six months and five (83%) of six patients at 12 months. The results in these recent cases are better than in previously reported series and reaffirm the usefulness of epikeratophakia in the treatment of aphakia. PMID- 3533015 TI - Interface opacities in epikeratophakia. AB - Although small, peripheral, cystic, or putty-gray infiltrates were observed along the suture tracks in 20 of 100 pediatric patients after epikeratophakia at Louisiana State University Medical Center, New Orleans, they progressed to clinically significant opacities in only three. In one, the interface material was curetted and the lenticule was reattached. The removed material was identified histologically as epithelial cells in varying states of degeneration. In a second case, the graft became hazy and the opacity involved most of the interface. The lenticule was removed, and epikeratophakia was again performed. On the posterior surface of the removed lenticule was a multilayered epithelium that had infiltrated into adjacent stromal lamellae. In the third case, a clear cyst resolved without intervention over a five-year period. These cases illustrate the importance of meticulous removal of all surface epithelium and the necessity for copious irrigation of epithelial debris intraoperatively. Epithelial ingrowth should not be confused with bacterial infection. Such opacities can be treated by curettage or aspiration of the invading material or removal of the epikeratophakia lenticule if spontaneous resolution does not occur. PMID- 3533016 TI - Technique for trouble-free removal of pars plana infusion cannulas. AB - We describe a simple procedure that facilitates the removal of a pars plana cannula. A 2-cm 4-O black silk suture is passed under the double-throw knot, which secures the infusion cannula. When the ends of the silk suture are pulled, the double-throw knot opens easily, allowing the cannula to be removed. PMID- 3533017 TI - Septic induced abortion at Ilorin, Nigeria: an increasing gynaecological problem in the developing countries. PMID- 3533018 TI - Accuracy of fetal weight estimation by ultrasound. PMID- 3533019 TI - Influence of malarial infection on the maternal-foetal relationship in pregnant mice. AB - Pregnant mice infected on gestation day (GD) 6 with Plasmodium berghei showed a more rapid rate of increase in parasitaemia than mice infected later in pregnancy or non-pregnant controls. All mice infected on GD 6 were dead by the 7th post infection day. Pregnant mice infected on GD 13, in contrast, had similar rates of parasitaemia and mortality as non-pregnant controls and 50% delivered normally, the foetuses were absorbed in 20% and 30% died before parturition. The pups born to mice infected on GD 13 were smaller. This compromised foetal development was likely to be the result of maternal anaemia, hyperplasia of placental trophoblast and plugging of placental sinusoids with parasitized red cells. PMID- 3533020 TI - Characterisation of the host response to Plasmodium falciparum infection in acute non-complicated malaria. AB - In this study we have examined serum from patients with Plasmodium falciparum malaria, collected at the time of acute attack and 14 days later. We have also examined sequential samples of sera taken from children living in Madang Province, Papua New Guinea, an area endemic for malaria. The total amount of antibody directed against P. falciparum in acute phase sera was less than that found in matched controls. An in vitro assay measuring inhibition of penetration of uninfected erythrocytes by merozoites of P. falciparum revealed less inhibitory activity in acute phase sera than in matched controls. The longitudinal study of sera from village children demonstrated that non-specific inhibition of intracellular parasite growth was fairly stable, while merozoite inhibiting activity was unstable and varied with time. A cloned P. falciparum species has been used to directly demonstrate the specific growth enhancement by serum in vitro. PMID- 3533021 TI - A collection of studies from the Department of Otorhinolaryngology, Nihon University School of Medicine. Memorial issue to Professor Hideo Saito. PMID- 3533022 TI - Prediction of postoperative complications by clinical and nutritional assessment. AB - This study evaluated a battery of nutritional measures and pre-operative clinical assessment as predictors of postoperative morbidity. Fifty-seven consecutive patients about to undergo major elective abdominal or thoracic surgery were surveyed. Thirty-two per cent of patients had three or more abnormal measurements of nutritional indices. Thirty patients had a total of 52 complications and in 12 patients these were major. The Prognostic Nutritional Index (PNI), formulated by Mullen, was found to be the best predictor of postoperative outcome. It identified 10 of 12 (83%) patients who subsequently developed major complications with a specificity of 73%. Clinical assessment selected six of the 12 patients who developed major complications. PMID- 3533023 TI - Liver transplantation in children: experience with the development of an Australian pilot programme. The Queensland Liver Transplantation Programme. AB - Children with end-stage liver disease now form a major sub-group of patients considered suitable for liver transplantation (ltp), and enjoy better survival statistics after transplantation than do adults. Since June 1984, a paediatric ltp programme has been developed in Brisbane with an initial working relationship and ongoing close links with two USA centres (Pittsburgh, and the UCLA Medical Center). Fourteen children with end-stage liver disease have been referred to the Queensland Liver Transplantation Programme for formal assessment. Following frank, informed discussion with their parents, 10 of these children were offered the option of ltp. During the transition stage, two infants with biliary atresia were referred to UCLA at their parents' request and, subsequently, eight children aged from 9 months to 6 years have been placed on a transplant candidacy list in Brisbane. A donor procurement team with access to a Queensland Government jet has been available to cover all mainland States except Western Australia. Six of the children have now had orthotopic ltp (two children at the UCLA Medical Center; four children at the Royal Children's Hospital, Brisbane). One UCLA patient died with a non-functioning graft, and one Brisbane patient died 5 weeks post transplant with rejection, hepatic artery thrombosis and sepsis. The other four children are alive and well, three with normal liver function and one with unexplained intrahepatic cholestasis, during the 1-20 month follow-up to date. Three further children have died of their liver disease without a donor of an appropriate blood group and size being found, and one patient still awaits a suitable donor.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3533024 TI - Periventricular haemorrhage and leukomalacia in extremely low birthweight infants. AB - Forty (49%) of 82 extremely low birthweight (ELBW, less than 1000 g) infants had periventricular haemorrhage (PVH). Ten (12%) had germinal layer haemorrhage (GLH) alone, 16 (20%) had intraventricular haemorrhage (IVH) and 14 (17%) had intracerebral haemorrhage (ICH). Almost all the cases of PVH had developed by 4 days of age. Small-for-gestational age infants (12% of study population) had a significantly lower incidence and severity of PVH than appropriate-for gestational age infants. Of 94 infants born between 23 and 28 weeks gestation, 45 (48%) had PVH. The PVH incidence was 60% in those of 23-26 weeks and 38% in those of 27-28 weeks. The hospital survival rate of ELBW infants was 69% in those without PVH and 43% in those with PVH; 70% in GLH alone; 50% in IVH and 14% in ICH. Three survivors developed post-haemorrhage hydrocephalus of whom two required ventriculoperitoneal shunting. Five survivors developed periventricular leukomalacia (PVL) evidenced by cysts identified between 3 and 7 weeks of age. A significant decrease in the incidence of PVH occurred over the study period (67% in 1982, 38% in 1983 and 33% in 1984). This decrease was seen for all grades of PVH. The reasons for this decreased incidence are still to be ascertained but this trend suggests that improvements in neonatal intensive care have the potential to improve the neurological outcome of more recent ELBW survivors. PMID- 3533025 TI - The response of asthmatic children to the heated nebulization of salbutamol. AB - The effect of a nebulized solution of Salbutamol heated to 37 degrees C was compared with that of Salbutamol nebulized in the standard manner. Forty asthmatic children were assigned randomly to a heated or standard nebulization. Each child received randomly either half or the full recommended dose of Salbutamol on separate occasions. No untoward side effects were observed. Baseline measurements of peak exploratory flow rate (PEFR), forced vital capacity (FVC) and 1 s forced expiratory volume (FEV1) were not significantly different among the groups. There was no statistically significant difference among the groups when assessed 15 min after treatment, indicating that neither a change in temperature nor in dose had any significant effect on response at this time. It is concluded that at the dosages used there is no advantage in heating nebulized Salbutamol to 37 degrees C. The equipotent effect of half the recommended dose of Salbutamol at both temperatures suggests that the recommended dose of Salbutamol is too high and that the lowest optimal dose to be ascertained. PMID- 3533026 TI - Neonatal cerebral ultrasound and neurodevelopment. PMID- 3533027 TI - Current ideas on the pathophysiology and treatment of lantana poisoning of ruminants. AB - Lantana poisoning in ruminants results from the ingestion of toxic varieties of the plant Lantana camara, which contain the triterpene acids lantadene A and lantadene B. Poisoning results in intrahepatic cholestasis and the consequences of the liver injury include jaundice, photosensitisation and ruminal stasis. The decreased ruminal motility causes toxic material to be retained in the rumen and continuous absorption of toxins from the rumen maintains the disease. Lantana poisoning can best be treated by preventing further absorption of toxins. This can be achieved by giving a large quantity of activated charcoal into the rumen together with a large volume of a multiple electrolyte solution to stimulate ruminal motility and rehydrate the animal. Treatment for photosensitive dermatitis should also be given. PMID- 3533028 TI - A technique for the purification of Mycobacterium paratuberculosis from the ileal mucosa of infected cattle. AB - Mycobacterium paratuberculosis, the causative agent of paratuberculosis, produces considerable economic loss in the cattle industry in many countries. The slow growth of M. paratuberculosis has hindered investigations of the antigenic composition of the organism and the development of species-specific antigen for serological detection of this disease. This paper describes a simple method for the isolation of large quantities of viable M. paratuberculosis from the intestinal mucosa of infected cattle by a combination of trypsin digestion, deoxyribonuclease/lysozyme treatment and differential centrifugation. Purity was about 99% and yield between 10(5)-10(9) bacteria/g tissue. PMID- 3533029 TI - Isolates of salmonella and Escherichia coli serotyped at the Salmonella Reference Laboratory in 1984 from veterinary and human sources. PMID- 3533030 TI - American Association of Avian Pathologists tribute to Charles A. Bottorff (1901 1985). PMID- 3533031 TI - American Association of Avian Pathologists tribute to Melvin S. Hofstad (1915 1986). PMID- 3533032 TI - The realities of screening for the small for dates fetus using ultrasound measurement. AB - Screening for the small for dates fetus using ultrasound measurement of the fetal abdominal circumference resulted in a significantly increased rate of diagnosis compared with clinical examination. However, when the perinatal mortality and morbidity amongst infants with a birthweight less than the 10th percentile for gestation in the screened group was compared with that of similar infants in a nonscreened groups who attended the same antenatal clinic but who either booked or were referred late, there was no significant difference. PMID- 3533033 TI - Hydatidiform mole coexisting with a live fetus: a dilemma of management. A recent review (1965-1985) and report of 2 new cases. AB - A review of 24 patients with a molar placenta and coexisting live fetus, including 2 new cases from the Queensland Trophoblastic Disease Registry, was made. The rate of fetal abnormalities was 33%; all 8 abnormal fetuses were female and in 5 of them in whom cultures were performed the chromosomal karyotype was triploidy 69XXX. There were 3 patients in whom malignant sequelae were detected (12%). After a confident ultrasound diagnosis of a molar placenta and a coexisting live fetus, the decision on whether the pregnancy should be terminated or allowed to continue should be based on the likelihood of the fetus being abnormal. It is recommended that the chromosomal karyotype and amniotic fluid alpha-fetoprotein level be determined by amniocentesis at about 16-18 weeks. This should allow those pregnancies in whom the fetus is potentially normal to be selected for conservative management. PMID- 3533035 TI - From morality to madness: a reappraisal of the asylum movement in psychiatry 1800 1940. AB - This essay outlines the history of the asylum movement in psychiatry, but from a somewhat different angle than usual. It attempts to delineate the historical interactions between perceptions of morality and of madness. Changes in these interactions relate to the rise of the asylum movement, around 1800, and its demise, just after World War II. I argue that, whilst insanity was defined against the rational, secular morality of the eighteenth century, it could be separated from immorality and put aside into its asylum. Once mechanistic science and medical scientism began, during the nineteenth century, to include immorality in the systems of disease, the distinction could not hold. The asylums became flooded with the immoral, and management became custodial and nihilistic. This nexus was broken when the asylums were defined, by a few revolutionary superintendents, as instruments of social control. Nevertheless, intellectual paradigms derived from asylum psychiatry persist. PMID- 3533034 TI - Perinatal colonization of group B streptococcus--an epidemiological study in a Chinese population. AB - An epidemiological study of perinatal colonization of group B streptococcus (GBS) was carried out prospectively in a Chinese population. One hundred and sixty eight mother-infant pairs were studied. Maternal carriage rate from multiple sites was 19.0%, with an overall neonatal colonization rate of 19.6%. There was no neonatal sepsis due to GBS. No obstetrical risk factors that could influence material carriage could be identified. Neonatal colonization was associated with premature/prolonged rupture of membranes, increased duration of rupture of membranes and intrapartum pyrexia. The number of infected sites and the density of organism in each site in the infant were directly proportional to the number and density of organisms in the culture-positive sites in the mother. Serotypical study showed a complete absence of type II GBS in this population. Since the vertical transmission rate was only 37.5%, it is postulated that nosocomial spread of the organism contributed significantly towards colonization of the infants in our study population. PMID- 3533036 TI - Statistical power in psychiatric research. AB - Statistical power is neglected in much psychiatric research, with the consequence that many studies do not provide a reasonable chance of detecting differences between groups if they exist in the population. This paper attempts to improve current practice by providing an introduction to the essential quantities required for performing a power analysis (sample size, effect size, type 1 and type 2 error rates). We provide simplified tables for estimating the sample size required to detect a specified size of effect with a type 1 error rate of alpha and a type 2 error rate of beta, and for estimating the power provided by a given sample size for detecting a specified size of effect with a type 1 error rate of alpha. We show how to modify these tables to perform power analyses for multiple comparisons in univariate and some multivariate designs. Power analyses for each of these types of design are illustrated by examples. PMID- 3533037 TI - Directory of members: Aerospace Medical Association. PMID- 3533038 TI - Antimutagenesis and anticarcinogenesis mechanisms. Proceedings of the International Conference on Mechanisms of Antimutagenesis and Anticarcinogenesis. October 6-10, 1985, Lawrence, Kansas. Dedicated to Dr. Charlotte Auerbach and Dr. Takashi Sugimura. PMID- 3533039 TI - Antioxidants/antimutagens in foods. PMID- 3533040 TI - Role of enzymes in antimutagenesis of human saliva and serum. PMID- 3533041 TI - Antimutagens and their modes of action. PMID- 3533042 TI - Avoidance of errors after DNA damage. PMID- 3533043 TI - Alkylation and oxidative damages to DNA: constitutive and inducible repair systems. PMID- 3533044 TI - Molecular mechanism of adaptive response to alkylating agents. PMID- 3533045 TI - Molecular basis of genomic stability and change. PMID- 3533046 TI - Comparative responses to DNA damage in bacteria and mammalian cells. PMID- 3533047 TI - The relation of activation and inactivation to antimutagenic processes. PMID- 3533048 TI - Carcinogens and anticarcinogens. PMID- 3533049 TI - Alteration of mutagenic potentials by peroxidase, catalase, and superoxide dismutase. PMID- 3533050 TI - [Keratoplasty and enucleation]. PMID- 3533051 TI - [Morphologic analysis of blood stains in a histologic section]. PMID- 3533053 TI - [Possibilities for using sonography for the locomotor system]. PMID- 3533052 TI - [Postreceptor defect in the effectiveness of insulin: significance of the kallikrein-kinin-prostaglandin system]. PMID- 3533054 TI - [Detection of hospital infections in an orthopedic clinic]. PMID- 3533055 TI - [Initial experiences with sonography of the knee joint]. PMID- 3533056 TI - [Clinical echocardiography of the dog and cat]. PMID- 3533057 TI - [Ultrasonic diagnosis in small-animal internal medical and gynecologic practice]. PMID- 3533058 TI - [Applicability of sonography to the diagnosis of diseases of the female genitalia in cattle]. PMID- 3533059 TI - The major excreted protein (MEP) of transformed mouse cells and cathepsin L have similar protease specificity. AB - The major excreted protein of transformed mouse cells is an acid activable cysteine protease. In this paper, oxidized insulin B chain is shown to be a substrate for this protease. By isolation and analysis of the insulin B peptides generated by the protease, the bond specificity of this protease was determined. The bonds preferentially cleaved are glu13-ala14, leu17-val18, and tyr26-thr27. No obvious preference for a specific amino acid was found in these studies. The bond specificity of this cysteine protease for oxidized insulin B chain has been compared with that of other proteases, and it is the same as that reported for cathepsin L, suggesting that the major excreted protein and cathepsin L may be the same protein. PMID- 3533060 TI - Frequent occurrence of short complementary sequences in nucleic acids. AB - The hypothesis, that nucleic acids which code specifically interacting receptor and ligand proteins contain complementary sequences was tested. Human insulin mRNA (HSINSU) contained 16 sequences which were 23.8 +/- 1.4 nucleotides long and were complementary to the insulin receptor mRNA (HSIRPR, 74.8 +/- 1.9% complementary matches, p less than 0.001 compared to randomly occurring matches). However, when examining 10 different nucleic acids (coding proteins not interacting with the insulin receptor), 81 additional sequences were found which were also complementary to HSIRPR. Although the finding of short complementary sequences was statistically highly significant, we concluded that this is not specific for nucleic acids coding specifically interacting proteins. PMID- 3533062 TI - Purification and physicochemical properties of a unique Vero cell cytotoxin from Escherichia coli O157:H7. AB - A unique Vero cell cytotoxin has been purified to homogeneity from a strain of Escherichia coli O157:H7, using ultrafiltration with Pellicon membrane cassettes and chromatography with QAE Sephadex A-50. SDS-PAGE showed the molecular weight of the toxin to be 64,000 and the absence of subunits. Based on analytical isoelectric focusing, the toxin had pI of 5.2. This Vero cell toxin was lethal to mice and showed pathological abnormalities of the mouse colonic mucosa when administered intraperitoneally. Vero cell cytotoxicity of this toxin was not neutralizable with rabbit antiserum to Shiga toxin. Based on physicochemical and immunological properties, this toxin is different from the Shiga-like toxin previously found in this organism. PMID- 3533061 TI - HDL-induced cardiac prostacyclin synthesis: relative contribution of HDL apoprotein and lipid. AB - The objective of this study was to determine if the apoprotein or lipid constituents of high density lipoproteins (HDL) mediate HDL-induced prostacyclin synthesis in the Langendorff-perfused rabbit heart. Acetylation, acetoacetylation, or partial removal by trypsin digestion of HDL apoprotein did not reduce the ability of the lipoprotein to stimulate cardiac prostacyclin synthesis. Delipidated apoproteins were less effective in stimulating cardiac prostacyclin synthesis in comparison to intact HDL. In contrast, protein-free lipid vesicles, made from HDL lipids, caused a pronounced stimulation of cardiac prostacyclin synthesis. These results suggest that HDL apoproteins, in their native state, are not essential for HDL-induced cardiac prostacyclin synthesis. The stimulation of cardiac prostacyclin synthesis by HDL may depend on the lipoprotein's lipid rather than on its apoprotein constituents. PMID- 3533063 TI - Complete purification of human renal renin and sequence of the amino terminus. AB - Renin was completely purified from human kidney cortex using a rapid 3-step procedure which included homogenization and ammonium sulfate precipitation, aminohexyl pepstatin affinity chromatography, and affinity chromatography using a synthetic octapeptide renin inhibitor (H-77) with a reduced peptide bond between Leu5 - Leu6. Three kg of cortex dissected from 10 kg of human cadaver kidney yielded 0.7 mg protein with a specific activity of 1123 GU/mg protein and an overall recovery of 52%. Both gel filtration high pressure liquid chromatography and sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS PAGE) revealed a molecular weight of 44,000, although 22,000 and 18,000 molecular weight bands were also identified by SDS PAGE. Amino terminal sequencing demonstrated a leucine residue at the 1 position indicating that prorenin is converted to renin following cleavage at the carboxyl end of two dibasic residues, Lys-2-Arg-1. Sequencing of the first 19 amino acids was in agreement with the sequence deduced from human renin cDNA sequence. PMID- 3533064 TI - Nerve growth factor enhances the level of the protein kinase C substrate B-50 in pheochromocytoma PC12 cells. AB - Exposure of PC12 cells to nerve growth factor results in arrest of cell growth and induction of differentiation to sympathetic neuron-like cells, bearing neurites. In this study we identify a 48 kDa PC12 phosphoprotein as the neuron specific protein kinase C substrate B-50 (Mr 48 kDa; IEP 4.5) on basis of comigration with purified B-50, immunoreactivity and phosphopeptide mapping. B-50 is present in both undifferentiated and differentiated PC12 cells. Exposure of PC12 cells to nerve growth factor for two days results in a 2.5-fold increase in the amount of B-50 as measured by RIA. Indirect immunofluorescence microscopy reveals that B-50 is mainly localized at the cell membrane and in growth cones. Our data are in line with the hypothesis that B-50 plays a role in neurite outgrowth and indicate that PC12 cells provide a suitable model to study this hypothesis. PMID- 3533065 TI - The presence of multiple intrinsic membrane nickel-containing hydrogenases in Desulfovibrio vulgaris (Hildenborough). AB - Three intrinsic membrane proteins exhibiting oxygen stable hydrogenase activity have been isolated from D. vulgaris. In contrast to the periplasmic exclusively non-heme iron hydrogenase, all three hydrogenases contain Ni in addition to non heme iron, have low specific activities and are insensitive to inhibition by CO. None of the three hydrogenases cross react with IgA against the periplasmic hydrogenase of D. vulgaris but two of the new hydrogenases cross react with IgA against the periplasmic nickel containing hydrogenase of D. gigas and the other new hydrogenase cross reacts with IgA against the periplasmic nickel and selenium hydrogenase of D. desulfuricans (Norway -4). PMID- 3533066 TI - Amino acid sequence homology between yeast hexokinases and rat hexokinase C. AB - Automated Edman degradation of seven purified tryptic peptides from Novikoff hepatoma hexokinase C revealed amino acid sequences that could be easily aligned within the primary structure of yeast hexokinases. This high degree of structural homology suggests a common evolutionary origin for mammalian and yeast hexokinases. Some of the sequenced peptides overlapped with each other, as well as with regions of the sequence of yeast hexokinases, suggesting that during evolution the 100,000 molecular weight subunit mammalian hexokinases may have resulted from gene duplication followed by gene fusion from a pre-vertebrate 50,000 molecular weight hexokinase ancestor. PMID- 3533067 TI - Presence of a histidine at the active site of the neutral endopeptidase-24.11. AB - Diethylpyrocarbonate treatment of the neutral endopeptidase (EC 3.4.24.11) inhibits both catalytic activity and binding of the inhibitor [3H]-N(R,S)-3 hydroxyaminocarbonyl-2-benzyl-1-oxopropyl]-glycine. The loss of activity can be reversed by hydroxylamine and almost completely prevented by the competitive inhibitor phenylalanyl-leucine suggesting the presence, as in thermolysin, of a histidine residue at the active site. Butanedione treatment also reduces both catalytic activity and [3H] inhibitor binding. Phenylalanyl-leucine completely protects from the butanedione induced loss of activity, providing further evidence for an essential arginine at the active site. In contrast, the tyrosine modifying agent N-acetylimidazole has no apparent effect on enzyme activity. PMID- 3533068 TI - Biochemical and biological activities of N-ras proteins. AB - Recombinant N-ras proteins, expressed and produced from synthetic genes cloned into E. coli, have been tested in vitro for GTPase and autophosphorylation activity. The genes corresponding to the assayed proteins were tested for their ability to transform NIH 3T3 cells. Mutations of glutamine to lysine at amino acid position 61 and glycine to valine at position 12 were both found to activate the ability of the N-ras gene to transform NIH 3T3 cells while significantly reducing the GTPase activity of the corresponding protein. N-ras proteins were also found to autophosphorylate in the presence of GTP when a threonine acceptor amino acid is provided at position 59. PMID- 3533069 TI - Regulation of glucokinase activity in the domestic fowl. AB - The factors which regulate soluble and particulate glucokinase and hexokinase activity in the liver of domestic chickens has been investigated. Pretreatment with oral administration (via tube feeding) of glucose plus injection of insulin resulted in a significant increase in the activity of soluble (p less than 0.01) and particulate (p less than 0.01) glucokinase activity whereas fasting for 48 hours reduced glucokinase and hexokinase activity (p less than 0.01) in the particulate fraction only. Treatment of fed chickens for 2 weeks with thyroxine (50 micrograms: i.m. daily) plus triiodothyronine (50 micrograms) resulted in a marginal decrease (NS) in soluble glucokinase activity but significantly increased soluble hexokinase (p less than 0.05) activity. Thyroidectomized animals showed a decline in both soluble glucokinase (p less than 0.01) and hexokinase (p less than 0.025) activity. There was no effect of thyroid hormone manipulation on particulate glucokinase activity although there was a significant reduction in particulate hexokinase activity (p less than 0.05) in thyroidectomized birds. These data establish a physiological role for the glucokinase enzyme activity in avian carbohydrate metabolism and suggest that in contrast with the mammal, the particulate fraction is the more physiologically important enzyme. PMID- 3533070 TI - Characterization of an alveolyn-like protein associated with mouse type 2 pneumocytes using immunochemical methods. AB - Delipidated proteins from a fraction of mouse lung homogenate enriched for lamellar bodies of type 2 pneumocytes were characterized by a combination of gel filtration and enzyme immunoassay for the presence of a surfactant-associated antigen. Immunoreactivity was associated with a protein of Mr 250-270,000 as well as its multimers and proteolytic fragments. The characteristics of the antigenic protein closely resembled those of a surfactant-associated protein termed alveolyn which is reported to be secreted by type 2 pneumocytes of various other species. Surfactant-associated proteins of M 32-38,000 in bronchoalveolar lavage fluid may be derived from this molecule by proteolysis. PMID- 3533071 TI - Homogeneous interferon-beta-inducing 25K factor (IL-1 beta) has connective tissue cell stimulating activities. AB - The human interferon-beta-inducing 22K factor has been shown to have structural homologies with interleukin-1 beta (IL-1 beta) and some of the activities attributed to IL-1. We have shown that 22K factor, purified to homogeneity and endotoxin free, has connective tissue cell stimulating activities, indicating that these activities are due to a naturally occurring species of IL-1 beta and not contaminating factors. 22K factor stimulated the production of prostaglandin E, caseinase activity and plasminogen activator activity in human articular chondrocytes in culture. This cell system appears highly sensitive to 22K factor activity. 22K factor also stimulated the resorption of bovine nasal cartilage and neonatal mouse calvaria. PMID- 3533072 TI - A Trypanosoma cruzi monoclonal antibody that recognizes a superficial tubulin like antigen. AB - A monoclonal antibody (MAB 10), obtained from mice infected with Trypanosoma cruzi, was found to recognize a superficial antigen in living or fixed parasites. It reacted more strongly with T. cruzi than with related parasites such as T. brucei and Leishmania. In immunoblots it recognized a single trypanosoma polypeptide and also brain tubulin, both of which had the same electrophoretic mobility. Further analysis suggested that the alpha-tubulin subunit contained the epitope recognized by MAB 10. These results suggest that a surface tubulin-like protein is present is T. cruzi. PMID- 3533073 TI - 5,6-Epoxyeicosatrienoic acid mobilizes Ca2+ in anterior pituitary cells. AB - Luteinizing hormone releasing hormone stimulates the concomitant release of luteinizing hormone and 45Ca2+ from prelabeled anterior pituitary cells. Indomethacin (10 microM) and nordihydroguaiaretic acid (10 microM) had no effect on the luteinizing hormone releasing hormone-stimulated release of either luteinizing hormone or 45Ca2+. Eicosatetraynoic acid (10 microM) blocked both luteinizing hormone releasing hormone-stimulated luteinizing hormone secretion and luteinizing hormone releasing hormone-stimulated 45Ca2+ efflux. 5,6 Epoxyeicosatrienoic acid stimulated both luteinizing hormone secretion and 45Ca2+ efflux from anterior pituitary cells. Additionally, 5,6-epoxyeicosatrienoic acid closely mimics the ability of luteinizing hormone releasing hormone to increase intracellular free calcium. These results are consistent with the hypothesis that 5,6-EET alters calcium homeostasis in a manner similar to that observed during luteinizing hormone releasing hormone stimulation of luteinizing hormone release. PMID- 3533074 TI - A low molecular weight growth inhibitor secreted in cultures of chicken embryo fibroblasts. AB - We report evidence for the occurrence of a novel type of growth inhibitor in conditioned medium of chicken embryo fibroblasts which inhibits both DNA synthesis and cell proliferation. The inhibitor does not compete with the growth factors present in the serum and its effect on the target cells is non-cytotoxic and reversible. The kinetics of the inhibition of thymidine incorporation indicate that the inhibitor acts in the S-phase of the cell cycle. Comparison of the chemical and physico-chemical properties of the inhibitor with other, recently described growth inhibitors of fibroblasts has demonstrated that it is different in many respects. The inhibitor has a Mr of less than 2000, is protease resistant, and acid- and heat-stable. PMID- 3533075 TI - Peptide analogues of angiotensinogen. Effect of peptide chain length on renin inhibition. AB - Renin inhibition was evaluated for a series of peptide analogues of angiotensinogen with different chain lengths. Systematic deletion of amino acid residues from the hexapeptide BocPheHisLeuR-ValIleHisOCH3 showed that the presence of residues at the N-terminal Phe and His positions was essential for efficient enzyme-inhibitor binding whereas the C-terminal Ile and His residues were much less important. Synthesis of a tetrapeptide analogue shortened at the C terminus and containing modified side chains produced a potent inhibitor of renin which demonstrated hypotensive activity in a salt depleted monkey. PMID- 3533076 TI - Determination of the mean cell age of erythrocytes from diabetic subjects with pyruvate kinase. AB - The pyruvate kinase activity of erythrocytes from normal and diabetic subjects was examined in order to establish this enzyme as a valid indicator of mean cell age in the studies of age-dependent erythrocyte functions. This study reveals that the enzyme activity in the erythrocytes was not affected by the condition of diabetes and suggests that it may provide a simple means for the determination of cell age in erythrocyte insulin binding studies. Present data further indicate that the mean cell age of the erythrocytes from diabetic patients was not significantly different from normal although insulin binding to erythrocytes was markedly reduced when compared with that in the normal subjects. PMID- 3533077 TI - Partial purification and characterization of fatty acid binding protein(s) in Escherichia coli membranes and reconstitution of fatty acid transport system. AB - Fatty acid binding protein(s) in E. coli membranes was solubilized and partially purified by oleate-AH Sepharose 4B column chromatography. The binding of palmitate to the protein was saturable. The protein bound all fatty acids with chain lengths of 10-18 tested, and its maximum activity was observed with palmitate. The incorporation of the protein into liposomes which contained a system for acyl-CoA synthesis significantly increased the uptake of the extracellular [14C] palmitate by the liposomes in comparison with the liposomes without the protein. The uptake of [14C] palmitate was also saturable, and the accumulated radioactive compound was found to be palmitoyl-CoA. PMID- 3533078 TI - Inositol 1,4,5-trisphosphate mobilizes glucose-incorporated calcium from pancreatic islets. AB - Mobilization of intracellular calcium from beta-cell-rich pancreatic islets of ob/ob-mice was studied by measuring unidirectional 45Ca efflux at 37 degrees and 18 degrees C during perifusion with a K+-rich medium deficient in Ca2+ and Na+. Addition of 100 microM carbachol induced a prominent peak of Ca2+ efflux from islets preexposed to glucose. After cell permeabilization with digitonin D-myo inositol 1,4,5-trisphosphate (IP3) caused glucose-dependent mobilization of calcium. In demonstrating that not only carbachol but also IP3 can mobilize calcium incorporated in response to glucose, the present data suggests that the endoplasmic reticulum participates in glucose-induced lowering of cytoplasmic Ca2+ activity in the pancreatic beta-cells. PMID- 3533079 TI - Membrane structural/functional perturbations induced by gossypol. Effects on membrane order, liposome permeability, and insulin-sensitive hexose transport. AB - The effects of gossypol on membrane structure and membrane-associated functions were studied to explore possible reasons for the ability of gossypol to disrupt cellular processes, many of which involve intracellular and plasma membranes. The experiments reported here measured the effects of gossypol on membrane order, permeability, and hexose transport. Electron spin resonance (ESR) studies of I(12,3) nitroxide fatty acid spin-labeled unilamellar liposomes showed that exposure to 0.05 to 4 mM gossypol caused a dose-dependent increase in the polarity-corrected order parameter (S), indicating reduced motional freedom of the spin probe after exposure to gossypol. This observation is consistent with the idea that gossypol causes an ordering or "condensing" of the membrane lipid matrix. Gossypol-induced changes in order parameter in phosphatidylcholine:cholesterol liposomes varied depending on the liposome composition. Liposomes exposed to gossypol also showed increasing permeability to glycerol as the gossypol:phospholipid ratio increased up to 10 mole %. Higher concentrations of gossypol were less effective at enhancing permeability. In addition, basal and insulin-stimulated 2-deoxy-D-[3H]glucose transport were inhibited in freshly isolated rat adipocytes incubated with gossypol at 37 degrees. Half-maximal inhibition occurred at approximately 0.2 mM for uptake in both the presence and absence of 40 ng/ml insulin. Microscopic observation of the cells under low power (40 X) confirmed that diminished hexose transport was not simply due to breakage of the adipocyte plasma membrane, resulting in a decrease in intact cell population and decreased accumulation of label in the gossypol treated cells. Gossypol produced no significant changes in numbers of intact cells or gross morphology at the concentrations tested. We suggest that ordering and increased permeability of the lipid regions of plasma and subcellular membranes may contribute to some of the toxic and pharmacologic properties of gossypol. Our results also support the idea that gossypol may exert more pronounced effects in cells that are most sensitive to variations in availability of glucose substrates for energy metabolism. PMID- 3533080 TI - Cellular and molecular pharmacology of auranofin and related gold complexes. PMID- 3533081 TI - Concurrent unilateral chromatid damage and DNA strand breakage in response to 6 thioguanine treatment. AB - The delayed cytotoxicity of 6-thioguanine (TG) may relate to the arrest of cells in G2 upon completion of one cell cycle after drug exposure. In Chinese hamster ovary (CHO) cells, both the unilateral chromatid damage in G2 chromosomes, determined by induction of premature condensed chromosome condensation [Maybaum and Mandel, Cancer Res. 43, 3852 (1983)], and incorporation of TG into DNA resulting in DNA strand breakage [Christie et al., Cancer Res. 44, 3665 (1984)] were correlated with cytotoxicity. We have studied the correlation between strand breakage and unilateral chromatid damage in L1210 cells. DNA breaks were detected only when cells were treated with TG (0.25 microM) for one cell cycle time (12 hr) followed by 12 hr in drug-free medium containing [3H]thymidine (TdR) to label the DNA. After simultaneous incubation of cells with drug and label during the first or second 12-hr period, strand breaks were not found. Strand breaks increased with dose, which correlated with greater cytotoxicity (0.01 to 0.25 microM). Treatment of cells with 0.25 microM TG for 12 hr, and transfer to drug free medium for 12 hr prior to making prematurely condensed chromosomes (PCC), resulted in unilateral chromatid damage. Prominent curving of G2 chromosomes with gapping and diffuse staining of one of the sister chromatids occurred. The 4-fold increase in the percentage of cells in G2 compared with control cells suggested G2 arrest. When cells were treated with TG for 12 hr and PCC made immediately, neither the arrest of cells in G2 nor unilateral chromatid damage was observed. These data suggest that strand breaks and unilateral chromatid damage occur in the second cell cycle after TG exposure and that this damage may be important in TG-delayed cytotoxicity. PMID- 3533082 TI - Group therapies for rheumatoid arthritis. A controlled study of two approaches. AB - An important unanswered question about rheumatoid arthritis (RA) is how the patient's psychological or emotional state relates to disease activity and functional status. No controlled studies of psychotherapeutic interventions in RA have been reported. To test the hypothesis that a psychosocial intervention would lead to improvement in functional status or disease activity, 57 RA patients were randomly assigned to 1 of 3 groups, which received: 1) conventional group psychotherapy; 2) group assertion/relaxation training; or 3) no treatment (control group). Patient and physician questionnaires collected at baseline, immediately after the interventions, and 12 months after baseline provided outcome data on functional status, social and psychological adaptation, psychological symptoms, and disease activity. There were few outcome measures for which either treatment resulted in significantly higher scores than were seen in controls, though more improvement did occur among patients who received conventional group psychotherapy. PMID- 3533083 TI - [Animal experiment and cell biology study of Saccharomyces cerevisiae Hansen CBS 5926 in the non-specific enhancement of resistance to infection]. AB - In an animal experimental study the effect of Saccharomyces cerevisiae (S.c.) Hansen CBS 5926 (Perenterol) on bacterial infections has been investigated using different forms of application. A significant protective effect after oronasal, intragastric and subcutaneous application of S.c. Hansen CBS 5926 has been found by challenge with Streptococcus pneumoniae and Escherichia coli. In order to investigate the possible mode of action the effect of S.c. Hansen CBS 5926 on chemiluminescence activity of polymorphonuclear cells from porcine blood has been studied. Isolated cells as well as cells in whole blood showed a significant induction of chemiluminescence. In comparison to Zymosan A the yeast cells originating from the commercial formulation showed a less pronounced ability to stimulate the chemiluminescence of blood cells. However, the stimulation was significantly enhanced after inactivation by heat. PMID- 3533084 TI - Treatment of postoperative pain with suprofen injected by the intramuscular route. AB - The analgesic effect and the tolerability of alpha-methyl-4-(2-thienyl carbonyl)phenylacetic acid (suprofen, Suprol) 200 mg/ml were compared with lysine acetylsalicylate 0.9 g/2.5 ml; the study included 60 subjects in severe to very severe pain following orthopedic surgery. The trial was performed in randomized single-blind fashion in patients who had given informed consent. The substances were injected into the upper out quadrant; maximally 4 intramuscular injections were given within 2 days. The test population was homogeneous with respect to the anamnestic data. The intensity of pain prior to treatment was comparable in both groups. Statistical analysis of the data revealed that suprofen was at the rating times (15 min to 4 h) significantly superior to the control groups. The investigator's and the patients' final appreciation indicated good to very good effect in 93% of the subjects on suprofen, and in 40 and 47%, respectively, of the patients in the control group. Here, too, suprofen was significantly superior to the reference Substance. Systemic and local tolerability of both drugs was very good. Adverse drug experience (heartburn) occurred in only 1 patient in the control group. PMID- 3533085 TI - Clinically controlled comparative study of intravenous single doses of suprofen versus indoprofen. AB - The analgesic effects of single intravenous doses of alpha-methyl-4-(2-thienyl carbonyl)phenylacetic acid (suprofen, Suprol) 200 mg/ml and alpha-4-(2 isoindolinyl-2-one)-phenylpropionic acid (indoprofen) 200 mg were compared within the scope of a randomized single-blind study. The test population consisted of 87 patients for whom analgesic treatment was indicated as soon as severe to major pain set in following meniscectomy or disease of a ligament. The treatment groups were homogeneous with respect to demographic data and intensity of pain prior to treatment. In the pain models chosen both drugs resulted in rapid pain relief within 15 min following their application. As to decreased intensity of pain (SPID) and pain relief (TOTPAR), the results obtained 2 h after the test were with indoprofen statistically significantly superior to those obtained with suprofen. The investigator's global appreciation of effectiveness revealed no intergroup differences. Therapeutic results were seen in 95.5% of the subjects on suprofen and in 97.6% of those on indoprofen. The tolerability of suprofen was very good in 95.3% of the cases on suprofen and in 97.3% of those on indoprofen. Four patients in the suprofen group experienced adverse reactions that were, however, not drug related. PMID- 3533086 TI - Controlled single-blind clinical study of suprofen syrup versus metamizole syrup. AB - The analgesic effect and the tolerability of alpha-methyl-4-(2-thienyl carbonyl)phenylacetic acid (suprofen, Suprol) syrup 200 mg and metamizole syrup 500 mg were compared in a randomized single-blind study including hospitalized patients with severe to moderate chronic pain. The 2 treatment groups consisted of 30 subjects each and were homogeneous as to the demographic data. Pain intensity was appreciated by the investigator prior to the treatment and on days 2, 3, and 5 of the study; pain relief was assessed on days 2, 3, and 5 of the therapy. Although pain intensity was on treatment with suprofen more markedly reduced than with metamizole, there was no statistically significant difference between the 2 treatment groups (chi 2-test). The Mann-Whitney test revealed that on days 3 and 5 pain relief with suprofen was significantly superior to that with metamizole. According to the investigator's final global evaluation, suprofen syrup 200 mg had very good to good effect in 70% of the cases, whereas the effectiveness of metamizole was rated good to very good in 44%. Side-effects manifesting themselves as gastric irritation and nausea were recorded for 3 patients on suprofen and 2 subjects on metamizole. PMID- 3533087 TI - Double-blind placebo-controlled study of the efficacy and tolerability of suprofen suppositories in patients with osteoarthritic pain. AB - In a placebo-controlled double-blind trial analgesic effectiveness and tolerability of alpha-methyl-4-(2-thienyl-carbonyl)phenylacetic acid (suprofen, Suprol) 300 mg suppositories were evaluated for 45 informed patients suffering from chronic pain due to osteoarthritis; the subjects were treated rectally, t.i.d., for 10 days. Suprofen proved to be statistically significantly superior to placebo in all the variables considered for evaluation of the analgesic effect, i.e., pain intensity and relief scores, sum of pain intensity differences (SPID), total pain relief (TOTPAR), global assessments by investigator and patient. In particular, the efficacy of suprofen was judged by the physician good or very good in 86.3% of the patients. Similar frequencies of rectal side-effects were observed in both treatment groups, with slightly but not significantly higher incidence in the group treated with suprofen. Haematologic and clinical chemistry laboratory tests showed no statistically significant alterations due to the treatment. PMID- 3533088 TI - [Ovarian stimulation by a new therapeutic principle for the treatment of complications of the climacteric. Results of a double-blind crossover study with a defined spleen dialysate]. AB - In a placebo-controlled double-blind cross-over study (test period 8 weeks) the spleen dialysate Solcosplen is tested for effectiveness and tolerance in 40 women, i.e. 14 pre- resp. 26 postmenopausal women in two consecutive periods (test periods I and II). The treatment begins in the first week of each test period with 2 ampoules i.m. t.i.d. and is to be continued for the following 7 weeks with 2 dragees b.i.d. Besides the incidence of clinical symptoms there intensity is summarized in a graded form to the Kupperman index. For further objectifying the therapeutic results vaginal-cytological examinations and radioimmunological analyses of estradiol (E2), LH, FSH and DHEA-S are carried out. The courses of therapy are frequented on a balanced basis. The progress of clinical symptoms shows in respect of incidence of appearance and intensity measured in Kupperman index in Phase I as well as in the cross-over statistically clear reciprocity, which demonstrates - with homogeneous prefindings - significantly differing results of treatment in favour of the dialysate. In the intraindividual comparison of judging the effectiveness by the physician and patient yields significant preferences for the verum. Side-effects were not observed. The proven effectiveness of the spleen dialysate within this study is explained by the stimulation of the ovarian residual function during menopause. It is discussed and compared to the presently applied monotherapeutic E2 substitution. PMID- 3533089 TI - A double-blind study on the efficacy and tolerance of a new alpha-glucosidase inhibitor in type-2 diabetics. AB - Miglitol (Bay m 1099), a deoxynojirimycin derivative, is a new glucosidase inhibitor. The possible hypoglycemic effect of this new product was tested in 12 volunteer noninsulin-dependent diabetics (NIDDs) in a double-blind crossover acute study. The patients twice received a test meal (1554 kJ including 34 g carbohydrates), once with placebo and on another day with a 50-mg tablet of Bay m 1099. A wash-out period of 2 to 7 days separated the test days. Venous blood samples were collected before and every 30 min for a total of 3 h after the drug administration. Mean blood sugar values were in general lower after the meal + Bay m 1099 than the meal + placebo. The differences were statistically significant at the 60- and 90-min time intervals (8.43 versus 11.17 and 9.24 versus 11.59 mmol/l, respectively, p less than 0.05). No flatulence, diarrhea or other untoward effects were observed. Furthermore no changes in serum glutamic oxaloacetic transaminase, serum glutamic pyruvic transaminase, creatinine, alkaline phosphatase, bilirubin, haemoglobin, white blood count and differential counts were noted. Thus, in a one-day study 50 mg of Bay m 1099 reduced the postprandial hyperglycemia in NIDDs. No signs of any acute renal, liver and blood toxicity were observed. PMID- 3533090 TI - The challenges ahead for the practice of speech-language pathology. PMID- 3533091 TI - Variability in counseling experiences and training among ESB-accredited programs. PMID- 3533092 TI - Morphological aspects of secretion in the arterial smooth muscle cell, with special reference to the Golgi complex and microtubular cytoskeleton. PMID- 3533093 TI - Lectin binding to distinguish cell types in fixed atherosclerotic arteries. AB - In order to assess the possible utility of lectin binding to identify the cellular components of fixed arterial lesions we studied lectin binding in experimental rabbit and monkey vessels, as well as in human atherosclerotic arteries obtained at surgery. The avidin-biotin-peroxidase technique was used to localize the binding of the following biotinylated lectins: Concanavalin A (Con A), Dolicho biflorus agglutinin (DBA), soybean agglutinin (SBA), peanut agglutinin (PNA), Phaseolus vulgaris agglutinin (PHA), Ricinus communis agglutinin (RCA), wheat germ agglutinin (WGA), and Ulex europaeus agglutinin (UEA). PHA demonstrated specific cytoplasmic staining of macrophages in rabbit, monkey, and human tissues and differentiated macrophages from other cell types in atherosclerotic lesions. When morphometric comparisons were made between lesion PHA staining and another macrophage marker, acid lipase, very similar results were obtained. Con A, RCA, and WGA stained macrophages intensely and differentiated them from other cell types in normal reticuloendothelial tissues and lesions, but also stained smooth muscle cells and endothelial cells when these cells developed lipid vacuoles. UEA stained the endothelium of vasa vasorum consistently in human arteries, but staining of artery lumen endothelium was variable. Endothelial cells of rabbit or monkey vessels did not stain with UEA. DBA, PNA, and SBA did not consistently stain any cellular structures in arteries. PHA was found to be an excellent marker to differentiate and quantify macrophages in glutaraldehyde or formalin-fixed, paraffin-embedded experimental and human atherosclerotic lesions. Con A, RCA and WGA merit further detailed study in conjunction with other histochemical tests as possible markers of functional changes in arterial cells during lesion development. PMID- 3533094 TI - [Transport of immunoglobulins in the gingival epithelium. III. In chronic nonspecific inflammation]. PMID- 3533095 TI - [Reconstruction technics of the mandibular alveolar ridge. Hydroxylapatite as a substitute for bone grafts]. PMID- 3533096 TI - Cartilage and bone repair: experimental and clinical studies. PMID- 3533097 TI - Articular cartilage response to arthroscopic surgery: a review of current knowledge. AB - This review is intended to point out the many variables affecting articular cartilage around the time of arthroscopic surgery. Despite the rapid clinical recovery of arthroscopic surgery patients, there may be considerable articular cartilage inhibition related to preoperative, intraoperative, and postoperative factors. Risks to the patient and his joint can be minimized by careful management of these known variables. PMID- 3533098 TI - The manipulation of micro-organisms for the production of secondary metabolites. PMID- 3533099 TI - Reactive-centre variants of alpha 1-antitrypsin. A new range of anti-inflammatory agents. PMID- 3533100 TI - Monoclonal antibodies in veterinary medicine. PMID- 3533101 TI - DNA amplification and genetic instability in Streptomyces. AB - Genetic instability is very common in Streptomyces species, but only affects specific genes in any one strain. It sometimes occurs at high frequency spontaneously, but may be stimulated by treatments such as UV irradiation or intercalating agents. Deletion of genes occurs and may be accompanied by DNA amplifications. It is unlikely that there is plasmid involvement in most cases. Little is yet known about the molecular mechanisms of deletion and DNA amplification. Genetic instability can be a problem during commercial antibiotic production. DNA amplification of cloned genes is potentially useful for achieving both stability and high gene dosage. PMID- 3533102 TI - Synthetic DNA fragments as useful tools in genetic and protein engineering. PMID- 3533103 TI - [Veneering using composites]. PMID- 3533104 TI - [Morphology of enamel after etching]. PMID- 3533105 TI - [Nothing suffices and becomes intractable]. PMID- 3533107 TI - [Microcrystals for the Maryland bridge]. PMID- 3533106 TI - [Technics for model duplication]. PMID- 3533109 TI - [When the mouth becomes a room of buttons]. PMID- 3533108 TI - [Which etching for improvement of the retention of the Maryland bridge. Chemically is better]. PMID- 3533110 TI - [Crowns with vestibular shoulders in porcelain]. PMID- 3533111 TI - [Removable denture with cast attachments]. PMID- 3533112 TI - [For the 2d impression elastomers are better]. PMID- 3533114 TI - [To communicate color]. PMID- 3533113 TI - [The tooth-composite interface with enamel-dentin adhesives]. PMID- 3533115 TI - The rise and fall of biochemistry in Berlin 1825-1945. PMID- 3533116 TI - Cell surface glycoproteins of hepatocytes and hepatoma cells identified by monoclonal antibodies. AB - Eight hybridoma cell lines secreting monoclonal antibodies (MABs) directed to cell surface components of rat hepatocytes were isolated. The antigens of seven MABs were identified as glycosylated plasma membrane proteins. The presence of these glycoproteins on normal hepatocytes and hepatocellular carcinoma cells was analyzed. A semi-quantitative enzyme-linked immunosorbent assay revealed that only two MABs (Be 8.7, Ne 11.3) recognized proteins which were expressed not only in normal liver but also in chemically induced transplantable Morris hepatomas and hepatoma-derived cell lines. The expression of six antigens was found to be sensitive to transformation. The domain specificity of the MABs was determined by indirect immunofluorescence on sections of liver tissue containing neoplastic nodules. Three MABs (Be 8.4, Ne 11.1, Ne 11.3) specifically bound to the sinusoidal domain and two MABs (Be 9.2, De 13.4) to the bile canalicular domain. These five antigens were transformation-sensitive except for the glycoprotein recognized by the MAB Ne 11.3. Three MABs (Be 8.7, Be 9.1, De 13.2) also showed intracellular immunofluorescence. Two of the antigens (Be 9.1, De 13.2) were not present in hepatomas. The relative molar masses (Mr) of the glycoproteins were determined after protein immunoblotting and immunoprecipitation. Four MABs (Be 8.7, Be 9.1, Be 9.2, De 13.4) recognized antigens with a Mr of 110 000 but did not mutually cross-react. The antigen recognized by MAB De 13.4 was identified as the ectoenzyme dipeptidyl peptidase IV (EC 3.4.14.-). PMID- 3533117 TI - Chemical synthesis and expression of a gene coding for hirudin, the thrombin specific inhibitor from the leech Hirudo medicinalis. AB - A DNA containing the coding sequence for the proteinase inhibitor protein hirudin from the leech Hirudo medicinalis has been obtained by enzymic ligation of chemically synthesized deoxyoligonucleotides. The 226 bp synthetic gene carries signals for the translation initiation and termination. Fragment synthesis was performed by the Khorana ligation method as well as by the fill-in method. Efficiencies of these two methods are compared. The synthetic gene was expressed in E. coli as a fusion protein with beta-galactosidase under the control of the lac-promoter as well as a non-hybrid protein under the control of the lambda PL promoter. The non-hybrid expression product was shown to have similar biological properties as the authentic protein isolated from the leech. PMID- 3533118 TI - Single-step purification of superoxide dismutase from bovine erythrocytes by immunosorbent column. AB - A simple and rapid procedure for the purification of superoxide dismutase (SOD) from bovine erythrocytes by means of affinity-purified anti-SOD antibodies coupled to Sepharose 4B is reported. The method allowed 80% recovery of electrophoretically pure enzyme directly from hemolyzed red blood cells. The mild elution conditions (3.5 M MgCl2) and the stability of the immunoadsorbent permit the column to be reused several times (greater than 50). The physicochemical properties of the enzyme obtained by this method are identical to those of the native protein. PMID- 3533119 TI - Neuronal morphology in the human cochlear nucleus. AB - Neuronal morphology in the human cochlear nucleus was studied with a Golgi method to better understand the organization of the nucleus. In ventral portions of the nucleus, three principal cell types and two small cell types previously seen in animals were found. In the dorsal portions of the nucleus, predominant cell types found in animals appear to be absent, indicating that cellular organization here is quite different from that in animals. On the other hand, cell morphology in the ventral nucleus suggests that signal processing here is fundamentally similar to that in animals. A review of the organization of these cells in animals is presented to provide a context of present results. The findings have great relevance in light of efforts to implant electrical prostheses in the nucleus. PMID- 3533120 TI - Sedation of children requiring artificial ventilation using an infusion of midazolam. AB - The sedation of 50 children aged 6 months to 9 years who had undergone open heart surgery was studied. During artificial ventilation a midazolam infusion was used in conjunction with the administration of morphine (and tubocurarine). Sedation for patients breathing spontaneously with positive airway pressure was continued with midazolam alone. The duration of the midazolam infusion (2-6 micrograms kg-1 min-1) ranged from 12 to 197 h. Forty-seven of the children were sedated uneventfully; the remaining three children needed small doses of other sedative agents. In 10 of the children, blood samples were taken for serum midazolam assay and a short Synacthen test was performed. There was no clinical evidence of accumulation of midazolam, but midazolam concentrations were so variable that no conclusions could be drawn. All patients in whom they were measured (n = 10) had high basal cortisol concentrations, but displayed normal responses to Synacthen. PMID- 3533121 TI - Anaesthesia for surgery in a patient with a transplanted heart. PMID- 3533123 TI - The metabolic response to glucagon and glucagon-(1-21)-peptide in normal subjects and non insulin dependent diabetics. AB - The metabolic effects of glucagon leading to hyperglycaemia are well recognised. However, the spasmolytic properties of glucagon have only relatively recently been utilised in clinical medicine. The marked hyperglycaemia accompanying the smooth muscle relaxant action of glucagon has led to the development of smaller peptides derived from glucagon which may retain the spasmolytic effects without the metabolic consequences. This study compares the metabolic and hormonal response to one such peptide, glucagon-(1-21)-peptide, with the parent peptide glucagon. The results demonstrate that glucagon-(1-21)-peptide has no metabolic effects comparable to glucagon. In normal subjects and non-insulin dependent diabetics, glucagon-(1-21)-peptide has no stimulatory effect on the pancreatic beta-cell. PMID- 3533122 TI - States of anxiety and their induction by drugs. AB - Syndromes of anxiety include generalized anxiety states, various forms of phobic disorder and panic attacks. It is unclear whether panic attacks are a separate syndrome from anxiety states or a more severe form. Drug-induced states of anxiety should provide useful models of the mechanisms of anxiety and its treatment. High-risk populations might be identifiable. Catecholamine infusions produce marked peripheral changes without fully reproducing the central feelings. Lactate infusions also produce anxiety-like states lacking full credibility. Experience with the benzodiazepine-receptor contragonists, the beta-carbolines, is limited but panic states have been reproduced following their use. Caffeine produces an anxiety state in high dose and some panic states have been induced. The critical evaluation of drug-induced anxiety states is a promising way of elucidating the mechanisms, psychological and physiological, associated with clinical anxiety. PMID- 3533124 TI - Effect of captopril on changes in plasma noradrenaline induced by sodium nitroprusside. AB - There is much animal data to suggest that angiotensin II has a regulatory role in noradrenaline release. We sought evidence for such a mechanism in man by pretreating six normal volunteers with captopril (50 mg) or placebo and then infusing them with incremental doses of sodium nitroprusside. Pretreatment with captopril had no significant effect on the mean arterial pressure, heart rate or plasma noradrenaline response to sodium nitroprusside, despite increasing plasma renin activity. This suggests that in normotensive salt replete man, normal levels of angiotensin II do not exert any tonic effect on noradrenaline release. PMID- 3533126 TI - Comparison of the analgesic effect of a corticosteroid and paracetamol in patients with pain after oral surgery. AB - In a double-blind crossover study identical oral surgical procedures were performed on two separate occasions in 24 patients. After one operation they were given capsules of methylprednisolone. A total of 84 mg was administered in decreasing doses for 4 days, starting with 24 mg 2 h after surgery. After the other operation 1 g paracetamol was given at 2, 6 and 9 h after surgery, then 500 mg four times daily for the next 2 days. Several measurements/assessments were recorded for paired comparisons of the postoperative courses. There was no significant difference in pain scores when comparing the two treatments. However, 3 and 4 h after the operation, there was a tendency towards better pain relief with paracetamol (P greater than 0.05). The results suggest that methylprednisolone, after a delay, may exert analgesic efficacy comparable to a standard regimen with paracetamol. On the third postoperative day methylprednisolone reduced measured swelling by 29% compared to paracetamol (P = 0.03). Overall preference scores evaluated the two treatments as equally efficient on the day of surgery. The first and second postoperative day the scores were in favour of methylprednisolone (P = 0.03). Present and previous results in this model suggest that corticosteroids deserve attention as a means of reducing both pain and inflammation after surgery and trauma. PMID- 3533125 TI - The pharmacokinetics of intravenous and oral levodopa in patients with Parkinson's disease who exhibit on-off fluctuations. AB - We have studied the clinical effects and pharmacokinetics of levodopa infusions and oral therapy in seven patients with Parkinson's disease. They all showed on off fluctuations whilst receiving long-term treatment with levodopa in combination with a peripheral decarboxylase inhibitor. Intravenous infusion at a constant rate for up to 16 h resulted in a smoother clinical response, and maintained plasma levodopa concentrations within narrower limits compared with conventional oral therapy. Following infusion rates of 32-80 mg h-1 (0.5-1.3 mg kg-1 h-1) the plasma concentration associated with optimum therapeutic response lay between 0.3 and 1.6 mg l-1. There was considerable variation in the oral absorption and elimination of levodopa, both within and between subjects. The concentration of 3-OMe dopa in plasma hardly increased during each day's levodopa therapy. In all cases levels were greater than the maximum concentrations of levodopa, sometimes by as much as a factor of 10. In contrast to most previous reports on the pharmacokinetics of levodopa, the data presented here are consistent with a two-compartment kinetic model. It is not known whether the difference in pharmacokinetics is due to chronic therapy or whether it is specific to those patients who show on-off phenomena, but such changes might be related in some way to the development of fluctuations in clinical response. PMID- 3533127 TI - Clinical and rheological effects of nifedipine in Raynaud's phenomenon. AB - Thirty-four patients with Raynaud's phenomenon, 28 primary and six secondary, were entered into a double-blind placebo controlled, randomized cross-over trial of nifedipine treatment. Nifedipine was given as a 20 mg biphasic release formulation twice daily. Twenty-nine patients completed the study, during which the mean number of attacks was reduced by 25% during nifedipine treatment (P less than 0.001). Twenty patients scored nifedipine higher than placebo on a five point rating scale (P less than 0.001). Unwanted effects were experienced by 26 patients during active treatment, resulting in withdrawal from the study in five. Red cell deformability and fibrinogen concentrations were not altered by nifedipine. PMID- 3533128 TI - The effects of oral nitrendipine and propranolol, alone and in combination, on hypertensive patients with special reference to AV conduction. AB - The effects of oral nitrendipine and oral propranolol, alone and in combination, on AV conduction have been examined in 11 patients with essential hypertension in whom arterial pressure was not adequately controlled despite treatment with thiazide diuretics. The study was performed double-blind. After a drug free period of 1 week, the patients received two 7 day courses of drug therapy after initial control measurements. Five of the eleven patients were randomised to receive nitrendipine 20 mg daily, the other six patients received propranolol (Inderal LA 160 mg daily) for the first week of therapy. During week 2, 10 patients received combined therapy. In the 10 patients who completed the study, oral nitrendipine, given either alone or in combination with oral propranolol, had no significant effect on resting PR, QRS, QT intervals nor on AV conduction as assessed by ambulatory electrocardiography. Propranolol did not affect the resting PR interval but significantly increased PR intervals on the ambulatory ECG recordings during single and combined therapy. However the maximum PR intervals remained within normal limits. PMID- 3533129 TI - Comparison of the effects of penbutolol and propranolol on glomerular filtration rate in hypertensive patients with impaired renal function. AB - Penbutolol and propranolol were administered orally in a dosage of 40 mg once daily and 80 mg twice daily, respectively to 12 patients with hypertension and impaired renal function. Both drugs caused a significant decrease in mean arterial pressure and heart rate. Serum creatinine concentration increased significantly by 10% during therapy with propranolol without concomitant decrease in creatinine clearance. No such effect was seen with penbutolol. GFR measured with [125I]-iothalamate showed no significant changes with both drugs. PMID- 3533130 TI - The effect of inhaled 5-hydroxytryptamine (5-HT, serotonin) on airway calibre in man. AB - Since platelet activation has been incriminated in the pathogenesis of asthma, we have investigated the effect of one of its major granule-derived mediators, 5 hydroxytryptamine (5-HT, serotonin) on airway calibre in normal (12), atopic non asthmatic (12) and atopic asthmatic subjects (16). On separate days subjects inhaled increasing concentrations of 5-HT and methacholine, and airway response was measured as FEV1, Vmax30 and sGaw. All subjects bronchoconstricted with methacholine, geometric mean provocation concentrations causing a 20% fall in FEV1 (PCf20) for the normal, atopic non-asthmatic and atopic asthmatic subjects being 28.6, 18.3 and 0.71 mM respectively. In contrast, 5-HT up to a maximum concentration of 77 mM had no consistent effect on FEV1, Vmax30 or sGaw in any of the subject groups. Thus, in contrast to a variety of animals, 5-HT is unlikely to serve as a significant bronchoconstrictor mediator in man. PMID- 3533132 TI - The antenatal diagnosis by ultrasonography of type III congenital cystic adenomatoid malformation of the lung. Case report. PMID- 3533131 TI - Lack of pharmacokinetic interaction between cholestyramine and acipimox, a new lipid lowering drug. PMID- 3533133 TI - The content and immunohistochemical localization of placental protein 10 (PP10) in the fallopian tube. AB - Radioimmunoassay, gel filtration and immunoperoxidase staining were used to study the content and localization of placental protein 10 (PP10) in 15 fallopian tubes removed on medical grounds from patients aged between 35 and 53 years. PP10 was consistently present in all parts of the tube at all ages and in all phases of the menstrual cycle. The PP10 concentration in tissue ranged from 0.08 to 2.95 micrograms/g of tubal cytosol protein. Immunoperoxidase staining localized PP10 in monocytic and lymphoid cells that were unevenly scattered in the subepithelial layer of the mucosa. In gel filtration, PP10 from the fallopian tube and purified placental PP10 eluted in the same volume, and graded amounts of PP10 immunoreactive material from the tube and purified PP10 gave parallel dose response curves in radioimmunoassay. We conclude that PP10 is another 'placental protein' that has been identified in the fallopian tube. PMID- 3533134 TI - The use of a calcium antagonist (nifedipine) to suppress preterm labour. AB - The efficacy of an orally administered calcium antagonist, nifedipine, in suppressing premature uterine activity, was compared with intravenous ritodrine and no treatment. Nifedipine was found to be significantly more effective than ritodrine or withholding therapy, and was almost devoid of side-effects. PMID- 3533135 TI - Maternal stress response associated with caesarean delivery under general and epidural anaesthesia. AB - The maternal stress response to caesarean delivery with either general or epidural anaesthesia was investigated. Patients given a general anaesthetic showed statistically significant increases in blood pressure, heart rate, and levels of plasma catecholamines, cortisol and glucose. Epidural anaesthesia, to at least the T6 dermatome, obtunded these responses. The significance of these findings to the choice of method of anaesthesia is discussed. PMID- 3533136 TI - Antenatal diagnosis of placental anastomosis in a twin pregnancy using Doppler ultrasound. AB - Qualitative analysis of blood velocity in the umbilical arteries of twin fetuses detected by pulsed Doppler ultrasound revealed discordant patterns which permitted an accurate antenatal diagnosis of an artery-to-artery anastomosis. One twin was consistently larger than the other, had a normal umbilical artery impedance and survived; the other fetus was consistently smaller, had persistently high umbilical artery impedance and died in utero. The death of one fetus did not affect the blood flow patterns within the umbilical artery of the other up to delivery 24 h later. The case demonstrates that intrauterine morbidity due to vascular anastomoses is not confined to the transfusion of significant amounts of blood from one fetus to another. PMID- 3533137 TI - Primary and myoma-associated menorrhagia: role of prostaglandins and effects of ibuprofen. AB - The release of 6-keto-prostaglandin F1 alpha(6-keto-PGF1 alpha), a metabolite of prostacyclin (PGI2) and thromboxane B2 (TxB2), a metabolite of thromboxane A2 (TxA2), was estimated in endometrial biopsies taken from 12 menorrhagic and 12 healthy women during the luteal phase of the cycle. The releases of 6-keto-PGF1 alpha and TxB2 were normal, but the ratio TxB2/6-keto-PGF1 alpha was inversely related to menstrual blood loss in women with measured menstrual blood loss exceeding 70 ml. In the second part of the study, 24 women with excessive menstrual bleeding (13 with primary menorrhagia, 10 with uterine fibromyomas, one with haemostatic factor VIII deficiency) were treated at random with ibuprofen (600 mg/day and 1200 mg/day) and with a placebo. Ibuprofen 1200 mg/day reduced (P less than 0.01) median blood loss from 146 ml (range 71-374 ml) to 110 ml (30-288 ml) in primary menorrhagia but had no effect on blood loss in women with uterine fibroids and factor VIII deficiency. Blood loss was normal in six women and was not affected by ibuprofen. Thus, our data suggest that there is a PGI2 dominance in the endometrium of patients with menorrhagia. In addition, primary, but neither fibromyoma nor coagulation defect-associated menorrhagia, can be treated by ibuprofen. PMID- 3533138 TI - lac permease of Escherichia coli: histidine-205 and histidine-322 play different roles in lactose/H+ symport. AB - The lac permease of Escherichia coli was modified by site-directed mutagenesis such that His-205 or His-322 is replaced with either Asn or Gln. Permease with Asn or Gln in place of His-205 exhibits normal activity, while permease with Asn or Gln in place of His-322 exhibits no activity. The results are consistent with the interpretation that His-205 and His-322 play different roles in lactose/H+ symport, the former involving hydrogen bonding of the imidazole nitrogens and the latter requiring positive charge in the imidazole ring. In addition, it is demonstrated that permease with Arg in place of His-322 does not catalyze efflux, exchange, or counterflow. The observations, in conjunction with those in the accompanying paper [Carrasco, N., Antes, L. M., Poonian, M. S., & Kaback, H. R. (1986) Biochemistry (following paper in this issue)], suggest that His-322 plays an important role in H+ translocation, possibly as a component of a charge-relay system with Glu-325, a neighboring residue in helix 10. PMID- 3533139 TI - Formaldehyde metabolism by Escherichia coli. Detection by in vivo 13C NMR spectroscopy of S-(hydroxymethyl)glutathione as a transient intracellular intermediate. AB - In vivo 13C NMR has been used to detect the transient formation of S (hydroxymethyl)glutathione (GSCH2OH) from glutathione and [13C]formaldehyde in Escherichia coli. Two-dimensional 1H-13C shift correlation was used to locate the chemical shift of the formaldehyde-derived protons of the adduct. The adduct GSCH2OH is formed by chemical reaction in the first few minutes after cells are challenged with formaldehyde and remains within the cell until consumed by metabolism. PMID- 3533140 TI - A cysteine residue (cysteine-116) in the histidinol binding site of histidinol dehydrogenase. AB - Salmonella typhimurium L-histidinol dehydrogenase (EC 1.1.1.23), a four-electron dehydrogenase, was inactivated by an active-site-directed modification reagent, 7 chloro-4-nitro-2,1,3-benzoxadiazole (NBD-Cl). The inactivation followed pseudo first-order kinetics and was prevented by low concentrations of the substrate L histidinol or by the competitive inhibitors histamine and imidazole. The observed rate saturation kinetics for inactivation suggest that NBD-Cl binds to the enzyme noncovalently before covalent inactivation occurs. The UV spectrum of the inactivated enzyme showed a peak at 420 nm, indicative of sulfhydryl modification. Stoichiometry experiments indicated that full inactivation was correlated with modification of 1.5 sulfhydryl groups per subunit of enzyme. By use of a substrate protection scheme, it was shown that 0.5 sulfhydryl per enzyme subunit was neither protected against NBD-Cl modification by L-histidinol nor essential for activity. Modification of the additional 1.0 sulfhydryl caused complete loss of enzyme activity and was prevented by L-histidinol. Pepsin digestion of NBD-modified enzyme was used to prepare labeled peptides under conditions that prevented migration of the NBD group. HPLC purification of the peptides was monitored at 420 nm, which is highly selective for NBD-labeled cysteine residues. By amino acid sequencing of the major peptides, it was shown that the reagent modified primarily Cys-116 and Cys-377 and that the presence of L-histidinol gave significant protection of Cys-116. The presence of a cysteine residue in the histidinol binding site is consistent with models in which formation and subsequent oxidation of a thiohemiacetal occurs as an intermediate step in the overall reaction. PMID- 3533141 TI - Leaving group dependence in the phosphorylation of Escherichia coli alkaline phosphatase by monophosphate esters. AB - Values of kcat and Km have been measured for the Escherichia coli alkaline phosphatase catalyzed hydrolysis of 18 aryl and 12 alkyl monophosphate esters at pH 8.00 and 25 degrees C. A Bronsted plot of log (kcat/Km) (M-1 s-1) vs. the pK of the leaving hydroxyl group exhibits two regression lines: log (kcat/Km) = 0.19 (+/- 0.02) pKArOH + 8.14 (+/- 0.15) log (kcat/Km) = -0.19 (+/- 0.01) pKROH + 5.89 (+/- 0.17) Alkyl phosphates with aryl or large lipophilic side chains are not correlated by the above equations and occupy positions intermediate between the two lines. The observed change in effective charge on the leaving oxygen of the ester (-0.2) is very small, consistent with substantial electrophilic participation of the enzyme with this atom. Cyclohexylammonium ion is a noncompetitive inhibitor against 4-nitrophenyl phosphate substrate at pH 8.00, and neutral phenol is a competitive inhibitor (Ki = 82.6 mM); these data and the 100-fold larger reactivity of aryl over alkyl esters are consistent with the existence of a lipophilic binding site for the leaving group of the substrate. The absence of a major steric effect in kcat/Km for substituted aryl esters confirms that the leaving group in the enzyme--substrate complex points away from the surface of the enzyme. Arguments are advanced to exclude a dissociative mechanism (involving a metaphosphate ion) for the enzyme-catalyzed substitution at phosphorus. PMID- 3533142 TI - Restrained refinement of the monoclinic form of yeast phenylalanine transfer RNA. Temperature factors and dynamics, coordinated waters, and base-pair propeller twist angles. AB - The structure of yeast phenylalanine transfer RNA in the monoclinic form has been further refined by using the restrained least-squares method of Hendrickson and Konnert. For the 4019 reflections between 10 and 3 A, with magnitudes at least 3 times their standard deviations, the R factor is 16.8%. The variation of the atomic temperature factors along the sequence indicates that the major flexibility regions are the amino acid and anticodon stems. The two strands of the amino acid helix exhibit large differential temperature factors, suggesting partial uncoiling or melting of the helix. In this work, the occupancy of all atoms was also varied. Residues D16 and D17 of the dihydrouridine loop as well as U33 and G37 of the anticodon loop have occupancies around 70%, indicating some local disorder or large-scale mobility at these positions. One hundred fifteen solvent molecules, including five magnesium ions, were found in difference maps. The role of several water molecules is clearly related to the stabilization of the secondary and tertiary interactions. The gold sites, which were not previously discussed, are described and show an energetically favored binding mode similar to that of cobalt and nickel complexes with nucleotides. PMID- 3533143 TI - High-resolution analysis of lac transcription complexes inside cells. AB - A new primer extension analysis is used to determine the methylation pattern over the lac UV5 promoter when dimethyl sulfate is added to growing Escherichia coli. The high-resolution analysis reveals altered methylation of 15 bases when the transcription machinery occupies the promoter inside the cell and shows a striking dichotomy in the distribution of methylated bases. Four protected guanosines lie on the side of the helix shown previously to be closely bound by RNA polymerase in vitro [Siebenlist, U., Simpson, R. B., & Gilbert, W. (1980) Cell (Cambridge, Mass.) 20, 269-281]. By contrast, the 11 hyperreactive bases lie on the side of the DNA directly opposite from that bound by protein. Those not in the melted region form two distinct "back-side" patches near -35 and -16. We suggest that such hyperreactive patches can be caused by proteins bending the DNA toward themselves to allow a full range of contacts, thus distorting the helix grooves on the "back" side and facilitating attack by the methylating reagent. This leads to a proposal for the formation of transcription complexes in which RNA polymerase interacts with deformed and torsionally stressed DNA. PMID- 3533144 TI - Transfer RNA contains sites of localized positive charge: carbon NMR studies of [13C]methyl-enriched Escherichia coli and yeast tRNAPhe. AB - The possibility of positively charged nucleosides in tRNA has been suspected because certain posttranscriptional methylations produce quaternary nitrogens. To investigate this possibility and the importance of such methylations to tRNA structure, we have continued our studies of [13C]methyl-enriched phenylalanine tRNA of Escherichia coli [Kopper, R.A., Schmidt, P.G., & Agris, P.F. (1983) Biochemistry 22, 1307-1401] and yeast [Smith, C., Petsch, J., Schmidt, P.G., & Agris, P.F. (1985) Biochemistry 24, 1434-1440]. E. coli and yeast tRNA were 13C enriched in their methyl groups in vivo, and phenylalanine-specific tRNA was isolated. Methyl proton and carbon signal assignments were confirmed and correlated for the purified tRNAs under native conditions via the first application of two-dimensional carbon-proton correlation NMR spectroscopy to a native nucleic acid. The methyl proton chemical shift of the 7-methylguanosine (m7G) signal from tRNA was easily determined, although by conventional 1H NMR spectroscopy it would have been hidden by ribose resonances and H2O. The chemical shift for 1-methyladenosine (m1A) protons was shown to be 3.01 ppm. Resolution of close or overlapping peaks was greatly enhanced by the two-dimensional experiment especially for the proton methyl resonances. In addition, proton-carbon chemical shift correspondence has been determined for the two 5-methylcytidines (m5C's), the methyl esters of wybutosine (Y), and the two ribose methyl groups, Gm and Cm, of yeast tRNAPhe. Thermal denaturation and Mg2+ depletion affect the methyl carbon NMR chemical shifts of tRNA.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3533145 TI - NMR studies of conformations and interactions of substrates and ribonucleotide templates bound to the large fragment of DNA polymerase I. AB - The large fragment of DNA polymerase I (Pol I) effectively uses oligoribouridylates and oligoriboadenylates as templates, with kinetic properties similar to those of poly(U) and poly(A), respectively, and has little or no activity in degrading them. In the presence of such oligoribonucleotide templates, nuclear Overhauser effects (NOE's) were used to determine interproton distances within and conformations of substrates bound to the large fragment of Pol I, as well as conformations and interactions of the enzyme-bound templates. In the enzyme-oligo(rU)54 +/- 11-Mg2+dATP complex, the substrate dATP has a high anti-glycosidic torsional angle (chi = 62 +/- 10 degrees) and an O1'-endo/C3' endo sugar pucker (delta = 90 +/- 10 degrees) differing only slightly from those previously found for enzyme-bound dATP in the absence of template [Ferrin, L.J., & Mildvan, A.S. (1985) Biochemistry 24, 4680-4694]. Both conformations are similar to those of deoxynucleotidyl units of B DNA but differ greatly from those of A or Z DNA. The conformation of the enzyme-bound substrate analogue AMPCPP (chi = 50 +/- 10 degrees, delta = 90 +/- 10 degrees) is very similar to that of enzyme-bound dATP and is unaltered by the binding of the template oligo(rU)54 +/- 11 or by the subsequent binding of the primer (Ap)9A. In the enzyme-oligo(rA)50 Mg2+TTP complex, the substrate TTP has an anti-glycosidic torsional angle (chi = 40 +/- 10 degrees) and an O1'-endo sugar pucker (delta = 100 +/- 10 degrees), indistinguishable from those found in the absence of template and compatible with those of B DNA but not with those of A or Z DNA. In the absence of templates, the interproton distances on enzyme-bound dGTP cannot be fit by a single conformation but require a 40% contribution from a syn structure (chi = 222 degrees) and a 60% contribution from one or more anti structures. The presence of the template oligo(rU)43 +/- 9 simplifies the conformation of enzyme-bound dGTP to a single structure with an anti-glycosyl angle (chi = 32 +/- 10 degrees) and an O1' endo/C3'-endo sugar pucker (delta = 90 +/- 10 degrees), compatible with those of B DNA, possibly due to the formation of a G-U wobble base pair. However, no significant misincorporation of guanine deoxynucleotides by the enzyme is detected with oligo(rU) as template.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3533146 TI - Interaction and reconstitution of carboxyl-terminal-shortened B chains with the intact A chain of insulin. AB - With the S-(thiomethyl)-A chain and despentapeptide (26-30) and desoctapeptide (23-30) S-(thiomethyl)-B chains of insulin at pH 10.8 and a molar ratio of A/B = 1.5, difference spectra of the mixed against the separated chains with negative peaks at 245 and 295 nm and a weak positive peak at 278 nm indicate interaction of the chains leading to Tyr environmental changes as in the case for the intact chains. With the shortened B chains, freshly dissolved from lyophilized powders, it takes some 2 h for the difference spectra to approach completion whereas with the solutions of the shortened B chains left standing overnight at pH 10.8 and 4 degrees C the difference spectra, similar in shape to that described above, appear almost immediately after mixing. Solvent perturbation with 20% ethylene glycol suggests some ordered structure for the despentapeptide but not for the desoctapeptide B chain. The interactions of the A chain with the shortened B chains appear to be weaker as compared to that with the intact B chain as shown by decreasing reconstitution yields for the intact, despentapeptide, and desoctapeptide B chains respectively with the A chain. The above results indicate that the C-terminal portion of the B chain is important not only for the activity of insulin but also for the correct pairing of the chains. PMID- 3533147 TI - Induction of calcium efflux from isolated rat-liver mitochondria by 1,2 dibromoethane. AB - Addition of 1,2-dibromoethane to rat-liver mitochondria induces a concentration dependent depletion of mitochondrial glutathione. This event seems to be associated with the induction of Ca2+ release from mitochondria pre-loaded with a low pulse of Ca2+. The enhancement of the energy-dissipating process to reaccumulate the released Ca2+ ('Ca2+ cycling') results in a progressive drop of membrane potential. Addition of EGTA (ethyleneglycol bis(beta-aminoethyl ether) N,N,N',N'-tetraacetic acid), when the membrane potential has reached the lowest level, restitutes it to a normal value. All these findings and the observation that Ca2+ release also occurs under non cycling conditions (e.g., in the presence of ruthenium red) suggest that 1,2-dibromoethane induces a Ca2+ efflux by activating a selective pathway which is sensitive to critical sulfhydryl groups. PMID- 3533148 TI - Decrease of NADH in yeast cells by external ferricyanide reduction. AB - Ferricyanide reduction catalyzed by vitamin K-3 was accompanied by the decrease in intracellular (NAD(P)H concentration of yeast cells, and the rate of ferricyanide reduction depended on intracellular concentration of NADH rather than NADPH. The addition of glucose to the cell suspensions enhanced both ferricyanide reduction and intracellular NADH concentration. The catalytic action of vitamin K-3 on ferricyanide reduction was observed in the presence of NADH and plasma membrane preparations. As the toxic action of vitamin K-3 on cell growth of yeast was enhanced by addition of ferricyanide, ferricyanide reduction catalyzed by vitamin K-3 may inhibit cell growth by decreasing intracellular NADH concentration. PMID- 3533149 TI - Rat-liver microsomal cytochrome P-450: purification, characterization, multiplicity and induction. PMID- 3533150 TI - Elucidation of the factors which determine reaction-rate constants and biological specificity for electron-transfer proteins. PMID- 3533151 TI - Effect of xylose incubation on the glucose transport system in Saccharomyces cerevisiae. AB - Incubation of Saccharomyces cerevisiae with xylose and ethanol for 16 hours leads to a decrease of hexokinase (and glucokinase) activity in the cells. It does not alter the levels of polyphosphate, orthophosphate and ATP. The transport of the glucose derivative 2-deoxy-D-glucose, a sugar that can be phosphorylated, is inhibited after this treatment, whereas transport of 6-deoxy-D-glucose, which has a blocked phosphorylation site, is not inhibited. Even though, both deoxyglucoses use the same transport system. The decrease in initial velocity of 2-deoxy-D glucose transport is most pronounced under anaerobic conditions. Incubation of the cells with antimycin A, a treatment which has a similar effect as anaerobiosis, shows, that the inhibition of the transport of 2-deoxy-D-glucose is presumably the result of an increase in the Km of the carrier transport. Transport of glucose is probably regulated by kinase enzymes. PMID- 3533152 TI - Fasting and refeeding modulate neutral amino acid transport activity in the basolateral membrane of the rat exocrine pancreatic epithelium: fasting-induced insulin insensitivity. AB - The effects of fasting and refeeding on amino acid transport in the perfused rat exocrine pancreas were investigated using a rapid dual tracer dilution technique. Unidirectional amino acid influx (15 s) was quantified (relative to the extracellular tracer D-mannitol) over a wide range of perfusate concentrations in pancreata isolated frm fed and 24 h, 48 h, and 72 h fasted and 72 h fasted and refed (24 h) animals. In fed animals transport of phenylalanine (1-24 mM) and L serine (1-50 mM) was saturable and weighted non-linear regression analyses of the overall transport indicated an apparent Kt = 10 +/- 3 mM and Vmax = 7.0 +/- 1.0 mumol/min per g (n = 7) for phenylalanine and Kt = 16 +/- 3 mM and Vmax = 20.6 +/ 2.1 mumol/min per g (n = 5) for serine. Fasting animals for 24 h or 48 h did not change the kinetics of either phenylalanine or serine transport. After a 72 h fast the rate of phenylalanine transport (Vmax = 15.9 +/- 2.9 mumol/min per g, n = 5) was enhanced whereas the transport affinity (Kt = 11 +/- 3 mM) remained unaltered. L-Serine transport was essentially unaltered. When 72 h fasted animals were refed for 24 h the Vmax for phenylalanine transport was reduced to values observed in fed animals. In parallel experiments refeeding had no significant effect on serine transport. Perfusion of pancreata isolated from 72 h fasted animals with bovine insulin (1 mU/ml or 1 microU/ml) did not stimulate either phenylalanine or serine transport.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3533153 TI - Idiotypic interactions in immune responses to tumor-associated antigens. PMID- 3533154 TI - Monoclonal antibody applications in bone marrow transplantation. PMID- 3533155 TI - Gene expression during the mammalian cell cycle. PMID- 3533156 TI - Replication time of interspersed repetitive DNA sequences in hamsters. AB - The replication time of 34 hamster genomic DNA segments containing interspersed repeat sequences was determined by probing the cloned segments with nick translated early- and late-replicating hamster DNA. One-third of these cloned families replicated early, one-third replicated late, and one-third replicated without temporal bias. 19 different inserts from these clones along with the SINE, Alu, and the LINE, A36Fc, were used to probe Southern blots of early- and late-replicating hamster or human DNA. We report long interspersed repeats, LINEs, are selectively partitioned into late-replicating DNA and are often concertedly hypomethylated, while short interspersed repeats, SINEs, are selectively partitioned into early-replicating DNA. For some interspersed repeat families, this partitioning is complete or almost complete. The CCGG frequency is very low in late-replicating DNA. The mammalian chromosome's pattern of early replicating R-bands and late-replicating G-bands reflects a differential distribution of LINEs and SINEs. PMID- 3533157 TI - Characterization of influenza virus neuraminidase with hemagglutinin activity and its comparison with that of viral neuraminidase. AB - The neuraminidase associated with the bifunctional protein, hemagglutinin neuraminidase, of influenza virus has been characterized. The enzyme has a pH optimum of 4.5, does not require Ca2+ and is inactivated (98%) by incubation at 50 degrees C. The enzyme has a Km of 2.00 X 10(-3) M and 0.06 X 10(-3) M with the substrates 2-(3-methoxyphenyl)-N-acetylneuraminic acid and fetuin, respectively. The Ki is 400 X 10(-6) with the inhibitor 2-deoxy-2,3-dehydro-N-acetylneuraminic acid. The incorporation of labeled cysteine, valine and leucine in the hemagglutinin-neuraminidase protein is different from that of viral neuraminidase. A comparison of the properties of the neuraminidase associated with protein hemagglutinin-neuraminidase with that of viral neuraminidase or sialidase showed that the former is biochemically different and an antigenically distinct enzyme. The unique feature of the new enzyme is that it has the hemagglutinin activity as well. The two biological activities could not be separated from each other in all systems used. Apparently, protein hemagglutinin neuraminidase is genetically transferable and it is detectable in a laboratory recombinant virus E-2971 (H3 Aichi X N7). These results suggest that protein hemagglutinin-neuraminidase is a unique surface protein of the influenza virus A/Aichi/2/68 (H3N2). PMID- 3533158 TI - Aromatic-L-amino-acid decarboxylase activity in mouse pancreatic islets. AB - Aromatic-L-amino-acid decarboxylase activity has been measured in intact or homogenised pancreatic islets of ob/ob mice (Umea ob/ob). The method used involves the trapping and measuring of the 14CO2 released from L-[1 14C]dihydroxyphenylalanine (L-dopa). Islets showed a decarboxylase activity which was dependent on pyridoxal phosphate and inhibitable by 0.1 mM benserazide or 0.1 mM alpha-monofluoromethyldopa. Maximum activity in intact islets was about 330 mmol/kg dry islet per h with an apparent Km of 3.3 mM. Islet homogenates had a Vmax of about 120 mmol/kg per h with a Km of 0.3 mM. L-5-Hydroxytryptophan, m tyrosine and o-tyrosine interfered with the decarboxylation of L-dopa in a way that suggested a high activity also towards those substrates. L-Phenylalanine, L tyrosine and D-glucose had no effect. At 0.05 mM L-dopa islet homogenates showed a much higher activity than homogenates of liver, kidney, or spleen. Islet uptake of L-[3H]dopa was well in excess of the decarboxylation rate and thus probably not rate-limiting. It is concluded that mouse pancreatic islets have a high activity of aromatic-L-amino-acid decarboxylase. This is in accordance with previous suggestions of a stimulatory effect of this enzyme on insulin secretion. PMID- 3533159 TI - Sex-linked changes in immunoreactive glucose-6-phosphate dehydrogenase in rat liver. AB - The level of hepatic immunoreactive glucose-6-phosphate dehydrogenase protein was found to correlate well with the enzyme activity in adult rats fed the stock laboratory diet in a variety of hormonal conditions. The amount of immunoreactive protein and enzyme activity was 2-fold greater in sexually mature female rats compared with aged matched male animals. However, this difference was absent in diabetic animals, and furthermore although triiodothyronine administration to the diabetic male rat could restore the level of enzyme activity to that of the normoglycaemic animal, it was much less effective in the female animal. In contrast, administration of insulin to the normoglycaemic animal increased the level of glucose-6-phosphate dehydrogenase in the female, but was without effect in the male. These results are discussed in relation to the possible role of thyroid status and steroid sex hormones in the regulation of hepatic glucose-6 phosphate dehydrogenase. PMID- 3533160 TI - Isolation and characterization of galactose-binding proteins from new-born mice. AB - Two galactose-binding proteins were purified from the soluble extracts of new born mice by affinity chromatography using a column of lactamyl-Sepharose. The molecular masses of their subunits were 15 (galactose-binding protein 15K) and 16 (galactose-binding protein 16K) kDa, and the isoelectric points were 5.3 and 6.8, respectively. These galactose-binding proteins agglutinated formaldehyde-fixed trypsinized rabbit erythrocytes. Hemagglutinating activity was inhibited by galactose-containing saccharides and glycopeptides. N-Acetyllactosamine and asialo-glycopeptides having N-acetyllactosamine at non-reducing termini were found to be the most effective inhibitors so far examined. These results suggest that galactose-binding proteins can recognize lactosaminoglycans on erythrocyte surfaces. The elution patterns of gel filtration by high performance liquid chromatography showed galactose-binding protein 15K to form dimers of identical subunits, galactose-binding protein 16K to be monomeric, and neither to interact with each other under the conditions employed. The results obtained by immuno blotting with antisera raised against purified galactose-binding proteins and amino acid analyses indicate that galactose-binding proteins 15K and 16K are not identical molecules. The distribution of galactose-binding protein 15K on frozen sections of new-born mice was surveyed by indirect immunofluorescence staining. Galactose-binding protein 15K was found widely distributed on many tissues, and distinct staining was observed in the liver and epidermis but not in the brain of unfixed samples. PMID- 3533161 TI - Effects of metalloendoproteinase inhibitors on secretion and intracellular free calcium in bovine adrenal chromaffin cells. AB - The possible role of metalloendoproteinase in stimulus-secretion coupling in adrenal chromaffin cells was examined using the metalloendoproteinase inhibitors 1,10-phenanthroline and carbobenzoxy-Gly-Phe-NH2. Catecholamine release elicited by nicotine or by depolarisation with 55 mM K+ was almost completely abolished by 0.5 mM 1,10-phenanthroline. Carbobenzoxy-Gly-Phe-NH2 (2.5 mM) inhibited catecholamine release in response to nicotine but enhanced that due to 55 mM K+. The rise in intracellular free calcium, [Ca2+]i, in response to either nicotine or 55 mM was inhibited by about 50% by both inhibitors. One site of action of metalloendoproteinase inhibitors may, therefore, be at the level of the regulation of [Ca2+]i. Catecholamine release and the rise in [Ca2+]i elicited by the calcium ionophore ionomycin were not reduced by the inhibitors. These results show that metalloendoproteinase inhibitors have complex effects on chromaffin cells including effects on the regulation of [Ca2+]i but do not inhibit calcium activated exocytosis itself. PMID- 3533162 TI - [Study of the conditions of activation and stabilization of DNA-methylases from Shigella sonnei 47 during fractionation, purification and storage]. AB - A comparative study of activation factors and stabilization conditions of partially purified and individual fractions of DNA-methylases of Shigella sonnei 47 was carried out. The stability of DNA-methylases in the course of storage was examined. The influence of activating factors and stabilization conditions differed significantly depending on the degree of purification and composition of methylase preparations. It was shown that glycerol is ineffective as a stabilizing agent. The activating effect of Ca2+ on Shigella sonnei 47 DNA methylases was found to be universal, while albumin was shown to exert a more potent stabilizing action. The inactivating effect of proteases on DNA methylation enzymes during storage was demonstrated. A phenomenon of spontaneous fluctuations in the methylating activity of enzymatic preparations of Shigella sonnei 47 upon storage was observed. PMID- 3533163 TI - [Comparative study of glyceraldehyde-3-phosphate dehydrogenases isolated from rabbit skeletal muscles and baker's yeast using cationic fluorescent probes]. AB - The tetrameric molecule of glyceraldehyde-3-phosphate dehydrogenase possesses the ability to bind fluorescent probes of cationic nature (auramine O and acridine orange) outside the active center. The rabbit skeletal muscle and yeast enzymes share some common features, e.g., the conformational non-equivalency of subunits; two subunits per tetramer can bind auramine O; conformational changes caused by the binding of adenyl mononucleotides and involving the microenvironment of auramine O binding sites; the ability to bind the cationic probe at pH values typical for the maximal activity of the enzyme in the reaction of glyceraldehyde 3-phosphate oxidation. The yeast and rabbit muscle enzymes are distinguished in terms of localization of the probe binding sites with respect to the active center and/or in the nature of conformational changes induced by NAD+ binding. It was demonstrated that nicotinamide mononucleotide may serve as a co-enzyme in glyceraldehyde 3-phosphate oxidation catalyzed by yeast dehydrogenase; this reaction in inhibited by AMP. PMID- 3533164 TI - [Development of catabolic repression during Escherichia coli growth on a carbohydrate mixture]. AB - During the cell growth with mixture of three sources of carbon (mannit-arabinose glycerol, glucose-sorbite-glycerol, glucose-sorbite-galactose) the components of the mixture have been found to be utilized in series. After using up the first, the repression is eliminated unselectively in utilization both the second and the third. Then after the lag-period the utilization repression of the third carbon source by the second one occurs. The phenomenon of "remaining repression" consisting in that at the cell growth with mixture of mannite and sorbite after using up the first carbohydrate the cells cannot start utilizing the second has been described. PMID- 3533165 TI - Duration of ventricular ejection during spontaneous breathing and positive pressure ventilation in newborn infants. AB - Experimental manipulations of intrathoracic pressure at the investigational level have been shown to result in demonstrable changes in ventricular outputs. To assess whether these changes are detectable in the clinical setting of newborn infants, we evaluated changes in the duration of left and right ventricular ejection during spontaneous breathing and during positive pressure ventilation. This was accomplished by measuring left and right ventricular ejection times (VETs) using echocardiography. Values from cardiac cycles during peak inspiration were compared to cycles that occurred during expiration. In 6 infants breathing spontaneously, the mean duration of right VET increased by 4.0% at peak inspiration, while the concomitant mean left VET decreased by 3.3%. In 14 infants requiring positive pressure ventilation, the mean duration of right VET decreased by 7.2% at peak inspiration, while the left VET increased by 2.5%. We conclude that changes in intrathoracic pressure associated with spontaneous breathing and with positive pressure ventilation result in detectable changes in ventricular ejection in the newborn infant. PMID- 3533166 TI - Gonadotropin-releasing hormone at estrus: luteinizing hormone, estradiol, and progesterone during the periestrual and postinsemination periods in dairy cattle. AB - Administering gonadotropin-releasing hormone (GnRH) improved conception rates in our previous studies. Our objective was to determine if the effect of GnRH was mediated through serum luteinizing hormone (LH) and/or by altered secretion of serum progesterone (P) and estradiol-17 beta (E) during the periestrual and post insemination periods. Cattle were given either GnRH (n = 54) or saline (n = 55) at 72 h and inseminated artificially (AI) 80 h after the second of two injections of either prostaglandin F2 alpha or its analog, cloprostenol. Progesterone and E were measured in blood serum collected during 3 wk after AI (estrus) from 60 females. Blood was collected for LH determinations via indwelling jugular cannulae from 14 cows and 11 heifers. Collections were taken every 4 h from 32 to 108 h after the second PGF injection (PGF-2) (periestrual period) and at more frequent intervals during 240 min after administration of GnRH (n = 18) or saline (n = 7). Ten females had a spontaneous preovulatory LH surge before GnRH treatment (GnRH-spontaneous), whereas GnRH induced the preovulatory LH surge in six females. A spontaneous LH surge appeared to be initiated in two heifers at or near the time of GnRH treatment (spontaneous and/or induced). The remaining seven cows had spontaneous LH surges with no subsequent change in LH after saline treatment. Serum P during the 21 days after estrus was lower (p less than 0.05) in both pregnant and nonpregnant (open) cattle treated previously with GnRH compared with saline. Serum P during the first week after estrus was greater (p less than 0.01) and increased (p less than 0.05) more rapidly in saline controls and in GnRH-spontaneous cattle than in those exhibiting GnRH-induced or GnRH spontaneous and/or-induced surges of LH. Conception rate of cattle receiving GnRH was higher (p = 0.06) than that of saline-treated controls. These data suggest that GnRH treatment at insemination initiated the preovulatory LH surge in some cattle, but serum P in both pregnant and open cows was compromised during the luteal phase after GnRH treatment. Improved fertility may be associated with delayed or slowly rising concentrations of serum progesterone after ovulation. PMID- 3533167 TI - GnRH effects on placental hormones during gestation. III. Prostaglandin E, prostaglandin F, and 13,14-dihydro-15-keto-prostaglandin F. AB - We studied the release of prostaglandin E (PGE), prostaglandin F (PGF) and 13,14 dihydro-15-keto-prostaglandin F (MPF) from explants of human placentas of different gestational ages and the effect of gonadotropin-releasing hormone (GnRH) on this release. The greatest basal release of PGE, PGF and MPF was in the cultures from 9- to 13-wk placentas, with the release on the second and third days of culture increasing 4- to 10-fold from that of the first day. In cultures from 15-wk to term placentas, the initial basal release (Day 1) of these prostaglandins was only slightly higher than in cultures from 6-wk placentas. In cultures from term placentas, the later increase with extended culture was absent or very small. Addition of synthetic GnRH to the cultures from 6- to 9-wk placentas effected no significant change in release of PGE, PGF or MPF. However, GnRH added to the cultures from 13-wk placentas effected a dose-related inhibition of these prostaglandins. After 15 wk, we observed a stimulation of these prostaglandins by GnRH that was as much as 50-fold; stimulation was highly significant in the cultures from 16- and 17-wk, as well as in those from the term placentas. These data demonstrate an action of GnRH on prostaglandin release and indicate that both the basal release of PGE, PGF and MPF and the response to GnRH are related to the gestational age of the placenta. PMID- 3533168 TI - Opioid inhibition of luteinizing hormone secretion in the postpartum lactating sow. AB - Twelve lactating sows were used at 22.4 +/- 0.8 days postpartum to determine whether endogenous opioid peptides (EOP) are involved in the suckling-induced inhibition of luteinizing hormone (LH) secretion. Four sows each received either 1, 2, or 4 mg/kg body weight of naloxone (NAL), an opiate antagonist, in saline i.v. Blood was collected at 15-min intervals for 2 h before and 4 h after NAL treatment. All sows were then given 100 micrograms gonadotropin-releasing hormone (GnRH) in saline i.v., and blood samples were collected for an additional h. Pigs were weaned after blood sampling. At 40 h after weaning, sows were treated and blood samples collected as during suckling. Serum concentrations of LH after treatment with NAL were similar for all doses; therefore, the data were pooled across doses. During suckling, serum concentrations of LH were 0.41 +/- 0.04 ng/ml before NAL treatment, increased to 0.65 +/- 0.08 ng/ml at 30 min after NAL treatment, and remained elevated above pretreatment concentrations for 120 min (p less than 0.05). Naloxone failed to alter serum concentrations of LH after weaning. These data indicate that EOP may be involved in the suckling-induced suppression of LH secretion and that weaning may either decrease opioid inhibition of LH secretion or decrease pituitary LH responsiveness to endogenous GnRH released by NAL. PMID- 3533169 TI - Hypothalamic deafferentation and luteinizing hormone-releasing hormone effects on secretion of luteinizing hormone in prepubertal pigs. AB - The control of luteinizing hormone (LH) secretion was investigated in ovariectomized, prepubertal Yorkshire pigs by comparing the effects of anterior (AHD), complete (CHD), and posterior (PHD) hypothalamic deafferentation to sham operated controls (SOC). Gilts (n = 16) were assigned randomly to treatments, fitted with an indwelling jugular catheter, and ovariectomized 2 days before deafferentation or sham-operation (Day 0). Blood for radioimmunoassay (RIA) of LH was collected sequentially at 20-min intervals for a period of 2 h before and 24, 48, 72, and 96 h after hypothalamic deafferentation or SOC. Episodic LH release after AHD or CHD was abolished (p less than 0.01), but not after PHD or SOC. Concentrations of serum LH in AHD and CHD dropped (p less than 0.01) at 24 and 48 h after surgery. Levels of LH before and after surgery in PHD and SOC were similar (p greater than 0.05). Infusion of 25 micrograms LH-releasing hormone (LHRH) i.v. at 72 and 96 h after hypothalamic deafferentation and SOC increased (p less than 0.01) serum LH to peak levels within 15 min. after infusion; LH returned to basal levels 60-80 min later. By 96 h after surgery, LH response to LH-releasing hormone (LHRH) was less in AHD and CHD as compared with the response at 72 h postinjection. Concentrations of LH in PHD and SOC were similar (p greater than 0.05) at 72 and 96 h, respectively. The results from this study clearly indicate that neural stimuli originating or traversing the neural areas rostral to the median eminence are required for secretion of LH in the pig.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3533170 TI - The ontogeny of mullerian inhibiting substance in granulosa cells of the bovine ovarian follicle. AB - Mullerian Inhibiting Substance (MIS) previously detected in the Sertoli cells of the calf testis has been localized in the granulosa cells of the ovarian Graafian follicle by using an immunoperoxidase technique and a monoclonal antibody (IG8) to MIS that almost completely blocks its biological activity. The immunoperoxidase technique (avidin-biotin complex method) demonstrated specific localization of MIS in the cytoplasm of the ovarian granulosa cells in the bovine Graafian follicles over a wide age span, i.e. one day, one week, three months, two-and-a-half years and five years. The presence of MIS in the ovary implies a function that is as yet unknown. PMID- 3533171 TI - Intermediate filament protein as a marker of uterine stromal cell decidualization. AB - An increase in intermediate filaments has been reported in rat uterine stromal cells undergoing decidualization in vivo and in vitro. In order to identify biochemical correlates of this morphological change, we have identified (two dimensional gel electrophoresis, Western blots, indirect immunofluorescent staining) the constitutive intermediate filament proteins of stromal cells decidualizing in vivo and isolated stroma decidualizing in vitro as vimentin and desmin. Vimentin is common to all uterine stromal cells but increases, proportional to total cell protein, in decidualized stroma. Barely detectable in nondecidualized stroma, desmin, unlike vimentin, increases during decidualization at a rate greater than the increase in total cell protein. Neither the increase in vimentin or desmin is observed in hormonally sensitized, nondecidual stromal cells. Desmin, because it is selectively expressed in decidualizing stroma, could be considered unique enough to serve as a marker of decidual cell differentiation. PMID- 3533173 TI - [General and local reactions in the proteolytic system during the development of experimental pneumonia]. AB - Proteolytic enzymes and their inhibitors were studied in the serum and bronchoalveolar lavage of rats with acute and chronic experimental pulmonary inflammation. An increase in the inhibitory potential of the blood serum and bronchoalveolar lavage at the acute stage of inflammation was shown. At the chronic stage of pulmonary inflammation the level of the main inhibitors decreased to normal or zero values in the blood and lavage fluid, respectively. It was observed that alpha 1-proteinase inhibitor serum concentration correlated with the level of bronchoalveolar antitrypsin. PMID- 3533172 TI - The molecular genetics of diabetes mellitus. PMID- 3533174 TI - [Comparative study of the properties of a proteolytic enzyme isolated from the myelin of animals and from the biological fluids of disseminated sclerosis patients]. AB - A proteolytic enzyme with the activity of 8-26 U/mg protein was isolated from purified animal myelin preparation obtained by an original technique. The optimal pH of the enzyme was found to be 9.6-9.8. Its substrate specificity was studied. An enzyme with similar characteristics and identical electrophoretic mobility was isolated from the blood serum of patients with disseminated sclerosis and then purified. The major part of the enzyme activity in the blood and myelin was bound and was manifested only after special treatment. It is suggested that a similar proteolytic enzyme is present in human myelin, whose activation in demyelinating diseases may result in myelin destruction. PMID- 3533175 TI - [Ocular stereometric grid for research on the liver]. AB - A new ocular network of the light microscope and the method of its application for histometric investigation of hepatocytes, and microcirculatory bed of the liver lobe based on the morphofunctional peculiarities of peripheral and central lobular zones are described. Histometry of biopsy material from the dog liver has demonstrated that with a smaller volume of sinusoids in normal animals, the nuclear-cytoplasmic hepatocyte ratio was greater in the peripheral than in the central lobular zones. PMID- 3533176 TI - [Cultivation of cells on modified porous cellulose beads]. AB - New microcarriers for the growth of animal cells have been synthesized and studied. The preparations are porous cellulose beads, modified by diamines. Spreading and growth of L cells, MEVO and HETR cells on these beads were observed. As a result of the cultivation the number of animal cells increased 5 10-fold. PMID- 3533177 TI - Enhanced recovery of gut-associated lymphoid tissue by infusion of buffy coat cells and gut leukocytes in the murine syngeneic bone marrow transplantation model. AB - Ways of accelerating recovery of the mucous membrane immune system in lethally irradiated mice following syngeneic bone marrow transplantation were studied over a 35-day period by quantification of jejunal intraepithelial lymphocytes (IELs) and lamina propria plasma cells. Recovery after a low bone marrow dose allowing 100% animal survival (LBM) was compared with a high (five times minimal) dose (HBM), or a minimal dose augmented with equal numbers of buffy coat cells (LBM + BC) or small gut mucosal lymphocytes (LBM + GL). The maximal decline and subsequent peak repopulation of IELs were: LBM, days 7 through 14, peaking suboptimally by day 28; HBM, day 14, peaking suboptimally but higher than LBM by day 35; LBM + BC, days 11 through 14, peaking at control levels by day 35; and LBM + GL, day 7, peaking at control levels by day 28. The IEL decline was most severe with LBM and HBM treatment and least with LBM + GL. All transplant groups experienced maximal plasma cell decline by day 7. LBM had the most severe depletion, and LBM + GL had the least. Recovery to control levels for the LBM, HBM, LBM + BC and LBM + GL groups occurred by days 28, 21, 21, and 14, respectively. In all instances, greater than 95% of the plasma cells were IgA positive. PMID- 3533178 TI - Variables influencing the timing of marrow transplantation in patients with chronic myelogenous leukemia. AB - The prognosis for patients with chronic myelogenous leukemia (CML) has improved only for patients who can receive marrow transplantation from a histocompatible sibling. The timing of the marrow transplant is made difficult by the high peritransplant mortality of 20% to 35% and a group of patients with a prolonged chronic phase of CML, which can be identified on the basis of prognostic indexes (age, percent blood myeloblasts, spleen size, and platelet count). We have developed a mathematic model and computer program that consider age, prognostic index, and projected survival rate by transplantation to balance the risk of peritransplant mortality against the risk of delaying the transplantation of patients with Philadelphia chromosome-positive CML. The computation assesses the risk of delaying transplantation; it does not offer the option of avoiding transplantation, since long-term survival ultimately requires transplantation. Three prognostic groups were considered as described by Sokal and co-workers (Blood 63:789, 1984) (I, best; II, intermediate; III, worst prognosis). The computation used the projected survival rates of transplantation from the Seattle experience and from the International Bone Marrow Transplant Registry. As an example of the model's utility, we have determined the ratio of the calculated life expectancy to the normal life expectancy for hypothetical patients up to 50 years of age in each of the three prognostic categories. A value of 20% is used for patients who successfully receive transplants after the onset of the accelerated phase. The analysis allows assessment of the risk of delaying transplantation for a finite time in patients with CML. The importance of the method rests in its consideration of multiple variables, including the peritransplant mortality, transplant projected survival before and upon entering the accelerated phase, age, prognostic group, and other risk factors. The program permits a change in these parameters as new information or advances in treatment occur. This analysis does not replace the diagnostic deliberations of the clinician. Rather, it provides a numeric framework for prognosis based on the currently available data. The physician in conjunction with the patient, not the algorithm, makes the decisions of whether and when to transplant. PMID- 3533179 TI - Cyclophosphamide cardiotoxicity: an analysis of dosing as a risk factor. AB - Patients who undergo bone marrow transplantation are generally immunosuppressed with a dose of cyclophosphamide (CYA) which is usually calculated based on the patient's weight. At these high doses of CYA, serious cardiotoxicity may occur, but definitive risk factors for the development of such cardiotoxicity have not been described. Since chemotherapeutic agent toxicity generally correlates with dose per body surface area, we retrospectively calculated the dose of CYA in patients transplanted at our institution to determine whether the incidence of CYA cardiotoxicity correlated with the dose per body surface area. Eighty patients who were to receive CYA 50 mg/kg/d for four days as preparation for marrow grafting underwent a total of 84 transplants for aplastic anemia, Wiskott Aldrich syndrome, or severe combined immunodeficiency syndrome. Fourteen of 84 (17%) patients had symptoms and signs consistent with CYA cardiotoxicity within ten days of receiving 1 to 4 doses of CYA. Six of the 14 patients died with congestive heart failure. The dose of CYA per body surface area was calculated for all patients and the patients were divided into two groups based on daily CYA dose: Group 1, CYA less than or equal to 1.55 g/m2/d; Group 2, CYA greater than 1.55 g/m2/d. Cardiotoxicity that was thought to be related to CYA occurred in 1/32 (3%) of patients in Group 1 and in 13/52 (25%) patients in Group 2 (P less than 0.025). Congestive heart failure caused or contributed to death in 0/32 patients in Group 1 v 6/52 (12%) of patients in Group 2 (P less than 0.25). There was no difference in the rate of engraftment of evaluable patients in the two groups (P greater than 0.5). We conclude that the CYA cardiotoxicity correlates with CYA dosage as calculated by body surface area, and that patients with aplastic anemia and immunodeficiencies can be effectively prepared for bone marrow grafting at a CYA dose of 1.55 g/m2/d for four days with a lower incidence of cardiotoxicity than patients whose CYA dosage is calculated based on weight. This study reaffirms the principle that drug toxicity correlates with dose per body surface area. PMID- 3533180 TI - Growth and development following marrow transplantation for leukemia. AB - One hundred forty-two patients between the ages of 1 and 17 years who survived disease-free more than 1 year after marrow transplantation for hematologic malignancy had growth and development evaluations from one to 14 years posttransplant (median 4 years). Prior to transplant all children received multiagent chemotherapy and 55 also received central nervous system irradiation, but none had growth and development evaluations. Marrow transplant preparation included high-dose chemotherapy and total body irradiation (TBI) given as a single dose of 9.2 to 10.0 Gy (79 patients) or as fractionated doses of 2.0 to 2.25 Gy/d for six to seven days (63 patients). After transplant abnormal thyroid function was present in 39%. Stimulated 11-desoxycortisol levels were subnormal in 24% of patients evaluated. Growth hormone (GH) deficiency was present in 17 of 25 children who received previous cranial irradiation. Partial GH deficiency was present in 4 of 25 who received previous cranial irradiation and in 6 of 18 who had not received cranial irradiation. Height velocity was decreased in all patients. After transplant, height was significantly influenced by chronic graft v-host disease and single-dose TBI. Sixty-eight percent had delayed development of secondary sexual characteristics. Gonadal failure occurred in nearly all who were postpubertal at transplant. While it is not possible to determine how many of these endocrine abnormalities occurred as a result of treatment administered prior to transplantation, these data do demonstrate that children who become long term survivors after marrow transplantation for hematologic malignancy have endocrine abnormalities that adversely affect growth and development. PMID- 3533181 TI - Alpha-thalassemia in blacks: genetic and clinical aspects and interactions with the sickle hemoglobin gene. AB - Recent advances in molecular genetics have permitted detailed study of the human alpha-globin genes and the causes of alpha-thalassemia. In this review, we examine the causes of alpha-thalassemia in the black population and the consequences of the interactions between alpha-thalassemia and structural hemoglobin variants. PMID- 3533182 TI - Perceptions of psychiatric testimony: a historical perspective on the hysterical invective. AB - This paper discusses the perceptions of psychiatric testimony by the public, lawyers, and psychiatrists. Five major criticisms are put into historical perspective: psychiatrists excuse sin; psychiatrists always disagree; psychiatrists give confusing, subjective, uninformed, jargon-ridden testimony; psychiatrists dictate the law; psychiatrists give conclusory opinions. Proposed solutions to these criticisms are analyzed. PMID- 3533183 TI - Therapists' obligations to report their patients' criminal acts. AB - The law governing the obligation of therapists to report their patients' previous criminal acts was reviewed. Most often, discussions of this subject fall under the general category of "misprison of a felony," that is, the presumed general obligation of all citizens to report felonies that come to their attention. Review of federal law revealed that the courts have consistently interpreted the federal misprision statute as requiring active concealment of a crime, not a mere failure to report, in order to convict for the offense. State law is more diverse. Only one state has a general misprison statute labeled as such, and several states have recently repealed such statutes. The strong trend in states without statutes is to reject misprison as a common law crime, because of its incompatibility with modern notions of justice. Most states, however, have limited reporting statutes, such as for child abuse or gunshot wounds, that impose similar obligations. Therapists' reporting of past crimes may be affected by clinical and ethical concerns, as well as by obligations to protect future victims. In almost all jurisdictions, however, the fear of prosecution for failure to report a past crime should not be a factor in deciding on a course of action. PMID- 3533185 TI - [Academic elogy on Prof. Pierre Fredericq, titular member]. PMID- 3533184 TI - [A multicenter trial of a device for treating obstructive sleep apnea by continuous positive pressure]. AB - The efficacy and tolerance of a nasal CPAP device marketed in France (Pression +, Sefam) for the treatment of obstructive sleep apnoea syndromes have been evaluated in a co-operative trial including 12 patients. This study confirmed the efficacy of nasal CPAP on sleep parameters: total sleep time was increased; light non-REM sleep was diminished; slow-wave sleep and REM sleep were augmented; sleep apnoeas were eliminated completely or almost completely; oxygen saturation was markedly improved. At one month follow-up, most clinical features were improved; daytime blood gases showed little change but the number of red cells was decreased. On the whole, the tolerance was good in this highly motivated group of patients: eleven patients (92%) were willing to continue their home treatment with the same device. Most difficulties were due to the making of a tailored molded nasal mask and its use during sleep. PMID- 3533186 TI - [Sleeping sickness from early diagnosis to post-therapy follow-up]. PMID- 3533187 TI - Psychiatry and medicine. By Karl Menninger, M.D. Bulletin of the Menninger Clinic, 1936. PMID- 3533188 TI - Presentation of Academy plaque to Duncan W. Clark, M.D. PMID- 3533189 TI - Presentation of the Academy medal to Irving S. Wright, M.D. PMID- 3533190 TI - Sigmund Freud's dislike of music: a piece of epileptology. PMID- 3533191 TI - "Natural" childbirth among the Kankanaly-Igorot. PMID- 3533192 TI - Emergency blood typing in the field during World War II: a personal narrative. PMID- 3533193 TI - Delayed-type hypersensitivity in human volunteers immunized with a candidate leprosy vaccine. PMID- 3533194 TI - Injuries to the liver. AB - A policy of management of liver trauma that has evolved over 15 years following experience of treating 33 cases of severe liver trauma is presented. Many patients with grave liver damage survived even in the presence of other injuries, often multiple, involving the spleen and vital organs. PMID- 3533195 TI - Radiological investigation of liver trauma. AB - Difficult diagnostic problems may occur both acutely and in the long term in patients who have suffered severe upper abdominal trauma. Radiological investigation accurately demonstrates the presence and extent of liver damage. This article discusses the indications for both diagnostic and therapeutic radiological techniques and their roles in patient management. PMID- 3533196 TI - The behavioural approach in medical practice. AB - This paper gives a description of the behavioural approach, behaviour therapy, and behavioural medicine in a medical and general hospital setting and describes the intimate link between behaviour and illness, showing how knowledge of the way learning takes place and influences behaviour can lead to a better understanding of the aetiology of illness and thus to appropriate treatment. A behavioural approach can be applied to the understanding and treatment of medical problems associated with sphincteric disturbances, such as childhood encopresis and urinary retention, as well as to the improvement of patient compliance and to the better management of pain. In the field of preventive medicine this approach is of importance in modifying behaviour associated with cardiovascular disorders, obesity, and smoking. PMID- 3533197 TI - Carcinoma of the gallbladder. AB - Gallbladder carcinoma is the fourth commonest gastrointestinal malignancy. Its growth is insidious and the majority of cases are advanced at the time of diagnosis. The recognized radiological features occur only in those with advanced disease. Cholecystectomy may be curative when carcinoma is confined to the gallbladder but the place of extensive surgery, chemotherapy or radiotherapy is unproven. PMID- 3533198 TI - Salmonella perinephric abscess. PMID- 3533199 TI - Ultrasound appearances of peripheral nerve tumours. PMID- 3533200 TI - Ultrasound used to detect a stone in the vesico-ureteric junction during pregnancy. PMID- 3533201 TI - Multiple-section radionuclide tomography of the kidney: a clinical evaluation. AB - The clinical utility of radionuclide emission tomography of the kidney in comparison with conventional gamma-camera imaging has been assessed from scans of 60 patients suspected of having space-occupying lesions of the kidney. Nineteen patients had renal tumour, 17 had cysts and seven had renal pseudotumours; the remainder had no lesion. Objective trials using four observers showed only a slight, statistically insignificant advantage from the addition of tomographic sections to conventional images. However, in several individual cases tomography had aided diagnosis, particularly in obese patients, when an alternative non invasive investigation (ultrasonography) was inconclusive. In seven patients a positive diagnosis of renal pseudotumour was made possible by tomography; definite identification of ectopic functioning cortical tissue at the location of a mass suspected after urography was considered to be a distinct diagnostic advantage gained from emission tomography of the kidney. PMID- 3533202 TI - Ultrasonic visualisation of the inflamed appendix. AB - A prospective ultrasonic study of the right lower abdominal quadrant was performed in 46 patients prior to appendicectomy. Ultrasonography revealed an inflamed appendix in 24 out of 29 patients with appendicitis and excluded its presence in 16 out of 17 patients without appendicitis. The ultrasonic pattern of the inflamed appendices appeared as echo-poor/echo-free lesions with lack of movement. In six of seven patients with perforated appendices, ultrasonography revealed free intra-abdominal fluid in addition to bowel disease. The possible value of abdominal ultrasound in patients with suspected acute appendicitis is discussed. PMID- 3533203 TI - Effect of early blood transfusion on gastrointestinal haemorrhage. AB - The effect of citrated stored blood on coagulation was studied initially in a pilot study where 25 patients with acute severe gastrointestinal haemorrhage had their whole blood coagulation measured using the Biobridge Impedance Clotting Time (ICT). This demonstrated that there is a hypercoagulable response to haemorrhage which was partially reversed by blood transfusion. Similar changes were noted in Kaolin Cephalin Clotting Times (KCCT). A further 50 patients were then randomized to receive, during the 24 h after admission, either at least 2 units of blood or no blood transfusion unless the haemoglobin fell below 8 g/dl or they were shocked. In the transfused group nine patients re-bled compared with only one in the non-transfused group (P less than 0.01, chi 2 with Yates' correction). Early blood transfusion appears to reverse the hypercoagulable response to haemorrhage thereby encouraging re-bleeding and hence the need for an operation. PMID- 3533204 TI - Surgery for malignant melanoma: from which limb should the graft be taken? AB - A study of 186 melanomas requiring skin grafts and followed for 1-13 years has shown no preferential implantation in an ipsilateral donor site, despite standard surgical teaching that skin grafts for melanoma defects should not be taken from the same limb as the primary tumour. Two cases were encountered of preferential metastasis to a distant donor site outside the lymphatic drainage of the melanoma and we present a further case where ipsilateral recurrence simulated donor site recurrence. It is clear that the major mechanism of spread to distant donor sites is by the haematogenous route to an area of acute trauma. Hence it is recommended that where possible donor skin is taken from the same limb as the tumour, so that any preferential metastasis will remain within an area amenable to regional limb perfusion. PMID- 3533205 TI - Clinical and radiographic features of simple and hydatid cysts of the liver. AB - The advances of hydatid chemotherapy and the non-operative management of simple (epithelial) hepatic cysts make a correct diagnosis of increasing importance. Twenty-six patients with hepatic hydatid cysts and eleven with simple cysts were reviewed. In both groups clinical presentation was most frequently due to pain. Sex, age and size of the cysts were similar. Hydatid serology was negative in six of the hydatid patients (23 per cent). None of the simple cyst patients had positive serology but one had a borderline titre. Ultrasound and computerized tomography identified daughter cysts within the main cyst in only 17 hydatid cysts (65 per cent) and considerable intra-cyst debris was also present in five of the simple cysts. Seven of the simple cysts were deroofed surgically and the remainder underwent percutaneous aspiration. Sixteen of the hydatid cysts were found to have a biliary communication whereas this was not found with any simple cyst. The difficulties in making a precise diagnosis in some patients with a liver cyst should deter the interventional radiologist and restrain the hydatid chemotherapist. PMID- 3533206 TI - Saphenous saccule. PMID- 3533207 TI - Electrophysiological identification of forebrain connections of the subfornical organ. AB - Experiments were performed in 17 urethane-anesthetized rats to investigate electrophysiologically neurons in the subfornical organ (SFO), which send efferent axons directly to the region of the paraventricular nucleus of the hypothalamus (PVH), the supraoptic nucleus (SON) and the nucleus medianus (NM). Extracellular single unit recordings were made from spontaneously active and silent neurons in the region of SFO (n = 130) and the nucleus triangularis (NT; n = 20). Sixty-five units in SFO were antidromically activated by stimulation of either PVH, SON or NM with latencies corresponding to conduction velocities of 0.54 +/- 0.07 (n = 24), 0.44 +/- 0.05 (n = 17) and 0.23 +/- 0.02 (n = 24) m/s, respectively. Axons of SFO units projecting to NM conducted at significantly slower velocities than those to PVH and SON. An additional 11 units were antidromically activated in NT by stimulation of these forebrain structures. Sixty-seven units were found to respond orthodromically to stimulation of PVH, SON and NM: 58 in SFO and 9 in NT. Orthodromic responses were primarily excitation or inhibition. These data have demonstrated bidirectional pathways between SFO and forebrain structures which are likely involved in the dipsogenic and arterial pressure responses to activation of SFO by blood-borne angiotensin II. PMID- 3533209 TI - Segmental distribution of corticotropin-releasing factor-like and vasoactive intestinal peptide-like immunoreactivities in presumptive sympathetic preganglionic neurons of the cat. AB - The distribution of corticotropin-releasing factor (CRF), vasoactive intestinal peptide (VIP), and luteinizing hormone-releasing hormone (LH-RH) in cell bodies of sympathetic autonomic nuclei of the thoracolumbar spinal cord was studied immunohistochemically in cats after intrathecal administration of colchicine. Neurons containing CRF-like immunoreactivity (CRFir) and VIP-like immunoreactivity (VIPir), but not LH-RH-like immunoreactivity, were found in the intermediolateral nucleus pars principalis (IMLp) and pars funicularis (IMLf). On the basis of identification in previous studies and the size, shape, and location of the immunoreactive cells, it is suggested that the neurons are sympathetic preganglionic neurons. Most of the neurons with CRFir (85.5%) were found in the IMLp in segments T2-T7 and L2-L3 and the remaining 14.5% were found in the IMLf in segments T2-T5. The largest proportion of neurons with VIPir (93.7%) was found in the IMLp in segments T2, T4-T7, and T9-T13. Only 6.3% of the neurons containing VIPir were found in the IMLf in segments T2, T4, T5, and T10. These findings suggest that CRF and VIP may participate in peptide-specific pathways to peripheral organs. PMID- 3533208 TI - Vasopressin release after enhanced serotonergic transmission is not due to activation of the peripheral renin-angiotensin system. AB - Pharmacological enhancement of 5-hydroxytryptamine (5-HT) transmission increases plasma vasopressin in rats. To investigate whether this effect is mediated through activation of the peripheral renin-angiotensin system, plasma vasopressin concentrations were measured after 5-HT activation in rats with lesions of the subfornical organ or pretreated with saralasin. The results show that the 5-HT induced elevation of vasopressin is not due to activation of the peripheral renin angiotensin system. PMID- 3533210 TI - Direct histochemical localisation of 5,7-dihydroxytryptamine and the uptake of serotonin by a subpopulation of GABA neurones in the rabbit retina. AB - The same cells in both the intact retina and retinal cultures of the rabbit retina take up exogenous serotonin or 5,7-dihydroxytryptamine. Both substances can be localised by immunohistochemistry using a monoclonal antibody directed against serotonin. The 5,7-dihydroxytryptamine can also be revealed directly in both fixed and living tissues using appropriate U.V. light. Some of the cells in the intact retina and retinal cultures which take up 5,7-dihydroxytryptamine also stain positively for the immunohistochemical localisation of gamma-aminobutyric acid (GABA). Cell counts in the cultures show that 80% of all 5,7 dihydroxytryptamine-positive cells stain positively for GABA, while 20% of the GABA-immunoreactive cells also accumulate 5,7-dihydroxytryptamine. These results demonstrate unambiguously that a subpopulation of GABA cells has the capacity to take up exogenous 5,7-dihydroxytryptamine and therefore utilise GABA and, probably, serotonin. Findings in favour of the 'co-occurrence' of GABA and serotonin come from studies where tissues were exposed to radioactive GABA and unlabelled serotonin so that the dual localisation of these substances by autoradiography and immunohistochemistry could be followed. It could be shown both in cultures and in intact retinal pieces that certain cells take up GABA and serotonin while other cells take up either GABA or serotonin. PMID- 3533211 TI - Identification and characterization of cell types in monolayer cultures of rat retina using monoclonal antibodies. AB - This study describes the identification and differentiation of neonatal rat retinal cells in monolayer cultures. A panel of monoclonal antibodies was used as a molecular probe of both cell type and developmental stage. Previously described cell-type specific monoclonal antibodies were used to label rod photoreceptors, horizontal cells, amacrine cells or ganglion cells. Two new antibodies that react with rat retina are described. The first, RET-G7, reacts with a cytoplasmic antigen of Muller glia, astrocytes and some horizontal cells. The second, RET-B2, reacts with bipolar cells and photoreceptor inner segments. Two main findings are presented. The first is that each of the major subclasses of retinal neurons have been unambiguously identified in these cultures. The morphology of some subclasses was very characteristic. All photoreceptors, as defined by reactivity with antibody RET-P1, were small spherical cells with one or fewer processes. Horizontal cells, as defined by reactivity with antibody B-1, were large with a characteristic multipolar network of processes. Bipolar and amacrine cells, on the other hand, were of similar size and could only be distinguished on the basis of immunocytochemical labeling. The second finding is that while RET-B2 antigen appeared on bipolar and photoreceptor cells after about 5 days in culture, several Muller cell and photoreceptor antigens were not expressed in monolayer cultures. The results suggest that the expression of some molecules in culture is the result of properties intrinsic to the cells whereas expression of others depends upon extrinsic factors or cell interactions that may not be present in monolayer cultures. PMID- 3533212 TI - A monoclonal antibody labels type II neurons of the spiral ganglion. AB - Tissue from mature rat and cat cochleas was stained with basic dyes in order to distinguish between the cell bodies of type I and II spiral ganglion neurons. This same tissue was then stained with protargol, or processed immunocytochemically using a monoclonal neurofilament antibody, RT-97. Type II neurons were intensely stained, whereas type I neurons were not. We conclude that type II neurons can be clearly distinguished by their abundant neurofilament content. PMID- 3533213 TI - Amphibian terminal nerve: distribution revealed by LHRH and AChE markers. AB - Immunocytochemical and histochemical studies in the tiger salamander and bullfrog demonstrated the presence of luteinizing hormone-releasing hormone-like immunoreactive (LHRH-ir) material and acetylcholinesterase (AChE) in the terminal nerve (TN). Immunoreactive perikarya and processes were found within the olfactory, vomeronasal and trigeminal nerves and in the nasal epithelium. Central TN projections consisted of fibers terminating in the olfactory bulb and bundles that projected to another group of LHRH-ir perikarya in the preoptic region. Up to 4 weeks following hypophysectomy, the labeling intensity and number of TN immunoreactive neurons were not altered. Acetylcholinesterase histochemistry in the salamander revealed two distinct groups of neurons associated with the TN: a lightly labeled group of fusiform perikarya was located in the olfactory nerve proper and a more heavily labeled group of larger oval perikarya was found within AChE-positive trigeminal fascicles in the ventral mucosa. This study has demonstrated that the amphibian TN follows olfactory, vomeronasal and trigeminal nerves to reach peripheral targets in the nasal mucosa. The projection of TN fibers to discrete olfactory bulb glomeruli, especially evident in the bullfrog, suggests that the TN functions in odor processing. The TN projection to the preoptic region in both of these amphibians implicates the TN in reproductive processes. PMID- 3533214 TI - N-methyl-D-aspartate and hypoxia induced Ca2+-changes in the CA1 region of the hippocampal slice. AB - Hypoxic neuronal depolarization was accompanied by a large decrease in extracellular [Ca2+]. After reoxygenation, the time at which [Ca2+] normalized was correlated with the extent of recovery of N-methyl-D-aspartate (NMDA) and synaptic responses. There was no evidence that the NMDA receptor system was more disrupted following hypoxia than the receptors involved in synaptic transmission. The Na+/K+ pump appeared to be better able to recover from hypoxia than the NMDA responses or synaptic transmission. PMID- 3533215 TI - An immunohistochemical study on the ontogeny of cells immunoreactive for spot 35 protein, a novel Purkinje cell-specific protein, in the rat cerebellum. AB - A time course study on the appearance and distribution of cells immunoreactive for spot 35 protein, a novel cerebellar Purkinje cell-specific protein, was conducted in the developing cerebella of fetal and early postnatal rats by PAP immunohistochemistry. Spot 35-immunoreactive cells were first noted in the cerebellar anlage on the 17th embryonic day, appearing as large cellular aggregations in the mantle layer and a small number of elongated cells dispersed between the cell aggregations and the ependymal layer. As the development proceeded, the spot 35-immunoreactive cells gradually accumulated beneath the external granular layer. At birth, they were arranged compactly in 4-5 irregular rows to form a primitive Purkinje cell layer. During their subsequent development, immunostaining for spot 35 protein demonstrated the rearrangement of the Purkinje cells into a single row and the maturation of their somata, axons and dendrites. All these findings indicate that spot 35 protein is a specific marker for the cerebellar Purkinje cells, from their migrating stage throughout the course of their maturation. The present study further describes the transitory lamellar arrangement of spot 35-immunoreactive Purkinje cells located horizontally at a short distance away from the ependymal layer of the cerebellum on the 17th embryonic day. PMID- 3533216 TI - Hypothalamic proline endopeptidase activity is not changed by various behavioral procedures. AB - Proline endopeptidase (E.C.3.4.21.26) is an enzyme which cleaves several neuropeptides at the carboxyl-side of proline residues. Some peptide substrates of this enzyme may be found in the rat hypothalamus (thyrotropin releasing hormone, neurotensin, substance P, oxytocin, vasopressin, beta-endorphin). Recent research has shown that the hypothalamic levels of some of these substances (e.g., vasopressin, beta-endorphin) change by a variety of training procedures. We studied the effect of various forms of training on the activity of proline endopeptidase of rat hypothalamus. The present results show that the activity of this enzyme is not altered by electroconvulsive shock or inhibitory avoidance training when measured, 0, 1, or 3 hr after these procedures. Other behavioral procedures (habituation to an open field, two-way active avoidance conditioning, or 1 min of inescapable footshock) also had no effect on hypothalamic proline endopeptidase activity measured immediately after training or test sessions. We conclude that proline endopeptidase probably does not play a regulatory role in the effect of synaptically released hypothalamic neuropeptides on behavior. PMID- 3533217 TI - Distribution of PNMT-immunoreactive neurons in the cat medulla oblongata. AB - The distribution and morphology of presumptive adrenaline neurons in the cat medulla oblongata were studied in conjunction with the indirect immunoperoxidase technique utilizing antibody raised against bovine adrenal phenylethanolamine-N methyltransferase (PNMT), an enzyme which converts noradrenaline to adrenaline. Small PNMT-immunoreactive (IR) perikarya are located in the dorsomedial part of the medulla (C2 group) extending from P17 to P12, and larger ones in the ventrolateral part (C1 group) from P11 to P9 of the caudorostral extent. In the rostral medulla (P11-10), larger cells extended more dorsally in the lateral tegmental field, where only a few catecholamine cells are localized. No midline PNMT-IR cells were identified corresponding to C3 cell group in the rat. Distinct longitudinal PNMT-IR axon bundles can be traced through the dorsal part of the lateral tegmental field. Comments are made on the relative localizations of the PNMT-IR and DBH-IR cells, as well as on species differences in comparison with the results reported in the rat. PMID- 3533218 TI - Immunohistochemical localization of adenosine deaminase in the retina of the rat. AB - Immunohistochemical procedures were used to determine the localization of adenosine deaminase (ADA) in the rat retina. Small ADA-immunoreactive neurons having a sparse but regular distribution pattern were detected in the ganglion cell layer (GCL) and in somewhat fewer numbers in the inner nuclear layer (INL). ADA-immunoreactive processes eminating from these two cell types were seen distributed in specific sublayers of the inner plexiform layer (IPL). In addition, a dense band of punctate ADA-immunostaining was observed in the IPL immediately adjacent to the GCL. Injections of the retrogradely transported dye, fast blue, into the optic nerve failed to label ADA-immunoreactive neurons in the GCL and unilateral enucleation had no effect on the density of ADA-immunostained fibers in the superior colliculus or lateral geniculate nucleus on the enucleated compared with the contralateral control side. In addition, ADA-immunoreactive cells in the GCL of the rat appeared not to correspond to the population of cells in this layer which in other species have been shown to accumulate 4,6-diamino-2 phenylindole (DAPI) following intraocular injection of this dye. These results indicate that subpopulations of intrinsic neurons in the rat retina express high levels of ADA. PMID- 3533220 TI - Effects of D-glucose anomers on sweetness taste and insulin release in man. AB - Insulin release was examined in human subjects after lingual applications of D glucose and its anomers. A dose-dependent increase in the insulin release was noted following the application of equilibrated D-glucose consisting of 36% alpha and 64% beta-anomer. The response was not reproduced after administration of atropine. The magnitude of insulin release produced by alpha-anomer was different from that induced by beta-anomer in men who could not differentiate between sweetness of the two anomers. Results indicate that recognition of sweetness in the cortex is unrelated to the insulin response, and suggest that a subcortical mechanism may detect qualitative differences in taste and produce the oral phase of insulin secretion via vagus action in humans. PMID- 3533219 TI - Development of specific antisera and a radioimmunoassay procedure for the gonadotropin-releasing hormone associated peptide (GAP) of the LHRH prohormone. AB - Recently, the structure of the cDNAs encoding the human and rat LHRH prohormones were determined and the corresponding peptide sequences deduced. In addition to LHRH, both cDNAs encoded a 56 amino acid sequence which has been designated gonadotropin-releasing hormone associated peptide (GAP). In order to initiate studies on the LHRH prohormone, three antisera (MC-1, MC-2 and MC-3) were generated using the human GAP (hGAP) 25-53 fragment as immunogen and a corresponding radioimmunoassay procedure was developed. The binding of 125I labeled hGAP 1-56 to all three antisera was displaced completely by unlabeled hGAP 1-56. Acid extracts of rat median eminence produced displacement curves that were parallel to the hGAP 1-56 curve. Conversely, extracts of rat cortex and a number of brain and pituitary peptides, including LHRH and LHRH analogs, did not affect tracer binding. Several fragments of the human and rat GAP (rGAP) sequences (hGAP 25-53, hGAP 27-40 and rGAP 20-43) produced tracer displacement curves that were non-parallel with the hGAP 1-56 curve and/or gave only incomplete tracer displacement when all three antisera were tested. This suggests that the antisera contain multiple antibody populations directed toward several different antigenic determinants within the mid portion of the hGAP and rGAP sequences. The rGAP fragments, rGAP 1-11 and rGAP 39-53, failed to displace the tracer, further supporting that the antigenic sites occur within the mid portion of the rGAP sequence.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3533221 TI - Analysis of the change in number of serotonergic neurons in the chick spinal cord during embryonic development. AB - The existence of serotonin (5-HT)-containing neurons in the spinal cord of the chick embryo was examined by anti-5-HT immunocytochemistry. The first immunoreactive cells were observed in embryos at 7 days of incubation (E7) and were initially located within the floor plate of the early spinal cord. By E9, immunostained cells occurred throughout the length of the spinal cord and were frequently encountered in most transverse sections of the cord. When examined at later embryonic ages of E12, 17 and at hatching (E21 or 22), the 5-HT cells became progressively more difficult to find with the advancing age of the embryos. To determine if this population of spinal cord 5-HT neurons actually diminished during development, a detailed quantitative analysis was undertaken to estimate the number of 5-HT cells in the cord of chick embryos at different ages. The results of this investigation demonstrated that the size of the 5-HT neuronal population rose rapidly from E7 and plateaued (at approximately 3500 neurons) between E9 and E12. As anticipated, the number of 5-HT cells at E17 decreased at all cord levels. Surprisingly, however, the number of spinal cord 5-HT neurons at hatching increased (depending on the cord level) either back to, or above, the counts estimated for the earlier ages of E9 and E12. Therefore, cells expressing the 5-HT phenotype in the spinal cord of the chick embryo persist throughout the period of embryonic development, rather than appear transiently.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3533222 TI - FMRFamide: an endogenous peptide with marked inhibitory effects on opioid-induced feeding behavior. AB - The peptide FMRFamide (Phe-Met-Arg-Phe-NH2), which displays a broad phylogenetic distribution, is considered to have important regulatory influences on basic functions in invertebrates. Extensive FMRFamide-like immunoreactive neuropeptides have also been demonstrated in the mammalian central nervous system, suggesting a possible physiological role for these peptides in mammals. There is evidence that FMRFamide, and/or related neuropeptides, may modulate opioid-mediated responses. Intracerebroventricular (ICV) administrations of FMRFamide inhibit in a dose dependent manner (0.01-10 micrograms) mu- (morphine) and kappa- (U-50,488H) opiate-induced feeding in the laboratory mouse. In deer mice, FMRFamide inhibits the display of exogenous opiate-induced components of natural feeding behavior, such as food hoarding and food ingestion. In addition, ICV administrations of FMRFamide also antagonize endogenous opioid-mediated, stress-induced feeding in mice. These observations suggest that FMRFamide, or FMRFamide-like peptides present in the mammalian brain, may have important roles in the control of opioid mediated feeding. PMID- 3533223 TI - Body weight set point studies in weanling rats with dorsomedial hypothalamic lesions (DMNL rats). AB - In order to further characterize a previously postulated "organismic" set point, weanling DMNL and control (CON) rats were maintained on lab chow ad lib (AL) for 55 post-operative days. Subsequently, some DMNL and CON rats were food-restricted (REST) to 80% of the food intake of their AL-fed counterparts for 24 days. At this point, representative rats from each group were killed by decapitation and the remaining animals were re-fed AL and killed 7 and 22 days thereafter. At the end of REST, both DMNL and CON showed significant weight loss, which was greater in CON than in DMNL rats. After 7 days of refeeding, DMNL rats normalized their body weights but re-fed CON still weighed less than AL-fed CON 22 days after refeeding. Food intake in formerly REST groups overshot on refeeding for 7 days, but this was significant only in DMNL rats. Notably, during this time formerly REST-DMNL ate as much as AL-fed CON. Efficiency of food utilization was normal in DMNL during AL feeding and became reduced on REST as it did in REST-CON. Notably, on refeeding formerly REST-DMNL rats overshot that of AL-fed DMNL rats by the same magnitude as previously REST-CON overshot the values of AL-fed CON. After 22 days of refeeding, this overshoot was still evident in DMNL but not in CON. At the end of the REST period, plasma insulin and glucose were similar in AL-fed DMNL and AL-fed CON. They were significantly and comparably reduced in both REST DMNL and REST-CON compared to the AL-fed DMNL and AL-fed CON. On refeeding these changes normalized within seven days. At the end of REST, plasma free fatty acid concentrations were higher in REST-DMNL and REST-CON than in AL-fed DMNL and AL fed CON. After seven days of refeeding they normalized only in formerly REST-CON. Plasma glycerol and total protein were normal throughout all groups, as was carcass protein. Carcass fat was equivalently reduced in both DMNL and CON at the end of REST and normalized 7 days after refeeding. AL-DMNL had the same carcass fat as AL-CON and REST-DMNL had the same carcass fat as REST-CON. In conjunction with previously reported normal anabolic hormone levels the data suggest that DMNL rats are not growth-retarded but are merely scaled down in size without compromise of their homeostatic competence. We take this as strong evidence for the existence of an "organismic" set point. PMID- 3533224 TI - Release of burn scar contractures of the neck in paediatric patients. AB - Burn scar contractures of the neck represent a continuing problem for plastic surgeons. A review of 143 neck-release procedures performed at the Cincinnati Shriners Burns Institute documented a high rate of contracture recurrence. This was especially true in those patients who had previously suffered burns to the entire anterior neck. Treatment of this condition with Z-plasties, or releasing incisions with split thickness skin grafts, had a recurrence rate of 81 per cent and 62 per cent, respectively. The use of a neck hyper-extension brace for over 1 year following skin grafting decreased the recurrence rate to 17 per cent. In patients who were not compliant in wearing a brace, the best result was obtained by using a full thickness skin graft in the release site. Contractures resulting from smaller burns were successfully handled by a variety of techniques. PMID- 3533225 TI - B-mode ultrasonic echo determination of depth of thermal injury. AB - A high-resolution high-frequency prototype B-mode ultrasonic scanning device was utilized to determine the depth of burn in a pilot study of five burned patients. Comparisons with clinical evaluations and histopathological studies of burn wound biopsies of the same burned areas failed to show any substantive improvement in predicting the depth of burn by ultrasonic scanning techniques. Current ultrasonic scanning is of no practical value to the burn surgeon for differentiating precisely between the depth of a deep dermal burn and a full skin thickness thermal injury. PMID- 3533226 TI - An evaluation of Aquaphor Gauze dressing in burned children. AB - Aquaphor Gauze was evaluated as a dressing for skin graft donor sites, for partial thickness burn injuries and for split thickness skin grafts. Control dressings consisted of: fine mesh gauze for skin graft donor sites. silver sulphadiazine (Silvadene) on coarse mesh gauze for the partial thickness burns, and nitrofurazone cream (Furacin) on fine mesh gauze for the skin grafts. The Aquaphor Gauze was found to be inferior to the fine mesh gauze for donor site dressings. No statistically significant difference was identified between Aquaphor Gauze and controls for the treatment of partial thickness burns. As a dressing for skin grafts the Aquaphor Gauze was significantly superior to the control dressing as measured by graft take and reduced patient pain. We would recommend that Aquaphor Gauze be used as a dressing for skin grafts where the risk of infection is not excessive. PMID- 3533227 TI - [3 zinc phosphate cement coating procedures in the sealing of 3 types of root posts]. PMID- 3533228 TI - [Preliminary work for the fellowship level]. PMID- 3533229 TI - [Pontics of removable bridges: a solution of choice in bonded dentures]. PMID- 3533230 TI - [Bonding in periodontics]. PMID- 3533231 TI - [Bonding of orthodontic brackets. 2: Bonding of brackets using the indirect method]. PMID- 3533232 TI - [Anterior esthetic restorations with bonded veneers in composite resins: an original technic]. PMID- 3533233 TI - [Changes in the abutment anchorage teeth of bonded bridges]. PMID- 3533234 TI - [Multiple restorations and concepts of surface preparations: the bonded "enamel bridge"]. PMID- 3533235 TI - [Mechanisms of anchorage and adhesion of bonded bridges. 2: Application of the principles of adhesion to concepts of preparation]. PMID- 3533236 TI - Potentiation of atracurium by pancuronium and d-tubocurarine. AB - In 60 adult patients undergoing general surgical procedures, the effect of pancuronium or d-tubocurarine "pretreatment" on the injection of a 0.1 mg X kg-1 bolus of atracurium was measured in two separate studies. In study 1, the patients received either 0.5 mg (approximately 0.007 mg X kg-1) or 1.0 mg (approximately 0.015 mg X kg-1) pancuronium, or placebo (saline) three minutes before the injection of atracurium 0.1 mg X kg-1. In study 2, the patients received 0.05 mg X kg-1 or 0.1 mg X kg-1 d-tubocurarine, or a placebo. The degree of neuromuscular blockade was assessed by evoked mechanogram (adductor pollicis muscle) using supramaximal train-of-four stimulation. Patients receiving pancuronium or d-tubocurarine pretreatment (equal to an ED5-ED15 dose) showed significantly greater inhibition of twitch (ED70-ED80) and train-of-four ratio compared with the placebo groups (ED35-ED40). Pretreatment with the larger dose of d-tubocurarine (0.1 mg X kg-1) was associated with significant neuromuscular blockade. It is concluded that pancuronium and d-tubocurarine pretreatments potentiate the clinical action of 0.1 mg X kg-1 atracurium in man by 35-100 per cent. PMID- 3533239 TI - William Osler and the genesis of cardiology in Canada. PMID- 3533240 TI - Renal medullary blood flow: its measurement and physiology. AB - The vasculature of the mammalian renal medulla is complex, having neither discrete input nor output. There is also efficient countercurrent exchange between ascending and descending vasa recta in the vascular bundles. These considerations have hampered measurement of medullary blood flow since they impose pronounced constraints on methods used to assess flow. Three main strategies have been used: (i) indicator extraction; (ii) erythrocyte velocity tracking; and (iii) indicator dilution. These are discussed with respect to their assumptions, requirements, and limitations. There is a consensus that medullary blood flow is autoregulated, albeit over a narrower pressure range than is total renal blood flow. When normalized to gram tissue weight, medullary blood flow in the dog is similar to that in the rat, on the order of 1 to 1.5 mL X min-1 X g-1. This is considerably greater than estimated by the radioiodinated albumin uptake method which has severe conceptual and practical problems. From both theoretical and experimental evidence it seems that urinary concentrating ability is considerably less sensitive to changes in medullary blood flow than is often assumed. PMID- 3533237 TI - Pulmonary hypertension in children: perioperative management. PMID- 3533238 TI - Vasodilator therapy in the perioperative period. PMID- 3533241 TI - Plasma lipoprotein cholesterol and triglycerides and lipoprotein lipase activity in epididymal white adipose tissue of rats fed high sucrose or high corn oil diets. AB - The present study was undertaken to compare plasma lipoprotein lipid composition, as well as white adipose tissue lipoprotein lipase activity, in rats fed purified diets high in either sucrose or corn oil. The experimental diets (65% of calories as sucrose or corn oil, 15% as the opposite nutrient, and 20% as casein) were given ad libitum for 4 weeks. An additional group was fed a nonpurified diet as a reference diet. Both sucrose and oil diets were spontaneously consumed in isocaloric amounts by the animals. Despite energy intakes that were 35% lower than that of the reference group, the sucrose and oil groups exhibited final body weights that were only 6 and 9% lower, respectively, than that of the reference group, and accumulated more fat in the epididymal depots. Postprandial as well as fasting total cholesterol levels were similar in the sucrose and oil groups, while the high-density lipoprotein to total cholesterol ratio was highest in the animals fed corn oil. In both the fasted and fed states, plasma total triglyceride levels were 73% higher in the sucrose group than in the corn oil group. The largest triglyceride differences due to diet were observed in the chylomicron + very-low-density lipoprotein fraction. The oil-fed rats accumulated large amounts of triglycerides in their livers. Postprandial lipoprotein lipase activity in epididymal adipose tissue was almost twice as high in the sucrose group as in the oil group.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3533242 TI - Massive hemoptysis. AB - Hemoptysis is usually a symptom of cardiopulmonary disease and is generally not in itself associated with death. A blood loss into the tracheobronchial tree of 600 ml in 24 hours or at a rate that poses a threat to life is referred to as massive hemoptysis. Hypervascularity within the bronchial circulation, usually associated with diffuse inflammatory disease of the lung, is common in patients with massive hemoptysis. Management should be directed at maintenance of oxygenation and localization of the source of bleeding. Temporizing maneuvers such as iced saline lavage, intravenous administration of vasopressin, endobronchial tamponade and bronchial artery embolization will often stabilize the patient in preparation for definitive surgery. Such a sequential plan of management may result in a 50% reduction in the rate of death from massive hemoptysis, which is otherwise 50% to 100%. PMID- 3533243 TI - Effects of obtaining a blood culture on subsequent management of young febrile children without an evident focus of infection. AB - To assess the effects of obtaining a blood culture on the subsequent diagnostic and therapeutic management of young febrile children without an evident focus of bacterial infection, we carried out a randomized controlled clinical trial of this procedure in 146 children 3 to 24 months of age who presented to our emergency department with an unexplained temperature of 39.0 degrees C or higher. Random assignment to either have (67 children) or not have (79) a blood sample taken for culture resulted in groups equivalent in age, sex, weight, socioeconomic status, temperature at enrolment and laboratory test results. No differences were detected in the rates of subsequent hospital admission, outpatient visits, determination of complete blood count or other blood tests, urinalysis or urine culture, chest or other roentgenography, or administration of antibiotics or other medications. Knowledge of the absence of such differences should be helpful in evaluating the relative benefits and costs of blood culture for young febrile children. PMID- 3533244 TI - Complications of tonsillectomy and adenoidectomy in 9409 children observed overnight. AB - In attempts to minimize the cost of health care, physicians are reducing the duration of hospital stay. Traditionally, at the Hospital for Sick Children, Toronto, otherwise healthy children undergoing adenoidectomy, tonsillectomy or adenotonsillectomy have been admitted the morning of surgery and discharged from hospital at 7 am the next day. The nursing records of 9409 patients aged 17 years or less who were managed in this way between 1980 and 1984 were reviewed to determine the occurrence of complications during the observation period. A total of 202 patients (2.15%) bled during the observation period. Of the 202, 6 (0.06% of all the patients) required a second general anesthetic for hemostasis; 1 of these 6 patients and 5 others required blood transfusions. Discharge was delayed for 42 patients (0.45% of all the patients) because of postoperative bleeding and for 57 patients (0.6%) for a variety of other reasons. Delayed discharge for reasons other than hemorrhage was more frequent among children less than 2 years of age and those over 12 years of age. The authors concluded that children undergoing adenoidectomy could safely be discharged the same day after 6 hours of observation following surgery. However, as a substantial number of children bled from the tonsillar fossa more than 6 hours after surgery, the efficacy of periodic examination of the oral cavity during the observation period in reducing the rate of hemorrhage after 6 hours must be evaluated before a same-day discharge program is established for children undergoing adenotonsillectomy. PMID- 3533245 TI - Kindred souls: the meeting of Drs. Arthur Conan Doyle and Thomas Hamilton. PMID- 3533246 TI - Systemic infections with Trichosporon beigelii (cutaneum). Report of three new cases. AB - Three new cases of systemic mycosis due to Trichosporon cutaneum are reported and compared with the 23 previous reports. Two patients had acute leukemia and one patient had a lymphoblastic lymphoma. Blood cultures in two patients and cerebrospinal fluid in the third patient were positive for T. cutaneum. Only one patient recovered after antimycotic therapy and concomitant remission of his leukemia. At autopsy, the two other patients showed widespread infection with T. cutaneum. The authors conclude that diagnosis and management of such infection in the immunosuppressed host are difficult and the prognosis is poor. PMID- 3533248 TI - [Computers in teaching: a necessity]. PMID- 3533247 TI - Nonsecretory parathyroid carcinoma of the mediastinum. Light microscopic, immunocytochemical, and ultrastructural features of a case, and review of the literature. AB - Nonsecretory parathyroid carcinoma is rare, particularly in extracervical sites. The authors present a case of a 51-year-old man with a large mediastinal mass that was found on a chest x-ray. Light and electron microscopy and immunohistochemical analysis of the resected tumor disclosed findings consistent with parathyroid carcinoma. Clinical and laboratory evaluations failed to reveal evidence of hyperparathyroidism. The nonsecretory state of the tumor was further supported by immunoreactivity for parathormone in tissue sections and, at the same time, normal levels of this peptide in serum. Partial shrinkage of the mediastinal mass occurred after 11 months of combined chemotherapy, with subjective improvement. A literature review of both secretory and nonsecretory parathyroid carcinomas was undertaken, revealing similar clinical features with regard to mean age, age range, and sex incidence among both groups. PMID- 3533249 TI - Anticoagulation for cerebral ischemia. PMID- 3533250 TI - Botulinum injection therapy for blepharospasm: a review and report of 75 patients. PMID- 3533251 TI - Gallium nitrate: the second metal with clinical activity. AB - Gallium nitrate is the anhydrate salt of the naturally occurring heavy metal. It has demonstrated antitumor activity in a variety of murine tumor models, including Walker carcinosarcoma 256, fibrosarcoma M-89, leukemia K-1964, adenocarcinoma 755, mammary carcinoma YMC, reticulum cell sarcoma A-RCS, lymphoma P1798, and osteosarcoma 124F. Preclinical studies performed in rats, rabbits, dogs, and monkeys showed the dose-limiting toxicity to be renal. The hepatic, pulmonary, gastrointestinal, hematologic, and integumentary systems were also involved. The major route of elimination is the kidneys, with 35%-71% of the infused dose excreted within 24 hours. Three phase I studies suggested the following phase II doses: 700-750 mg/m2 by short infusion, once every 2-3 weeks; 300 mg/m2/day by short infusion for 3 consecutive days, to be repeated every 2 weeks; and 300 mg/m2/day by continuous infusion for 7 consecutive days, to be repeated every 3-5 weeks. The major organ toxicity reported was renal; however, this can be adequately controlled either by hydration and osmotic diuresis or by use of continuous schedule. (Either maneuver appears to allow delivery of the recommended phase II dose with a less than 30% risk of change in serum creatinine.) In limited phase II evaluation, the drug has shown antitumor activity in patients with either refractory lymphomas or small cell lung carcinoma, with total objective response rates of 28% and 11%, respectively. In addition, it has been effective in the treatment of patients with cancer-related hypercalcemia by having an inhibitory effect on calcium reabsorption from bone. Single-agent phase II studies are planned in all major tumor types. Some are already ongoing in patients with genitourinary malignancies (renal, bladder, prostate, testicular), small cell lung carcinoma, and multiple myeloma. Metabolic studies are in progress at Memorial Sloan-Kettering Cancer Center to further elucidate the mechanism or mechanisms of the hypocalcemic effects. PMID- 3533253 TI - Glycoconjugates. A collection of invited papers in honor of Professor Roger W. Jeanloz. PMID- 3533254 TI - Professor Roger W. Jeanloz. PMID- 3533252 TI - Phase II trial of tamoxifen in chronic lymphocytic leukemia. PMID- 3533255 TI - Structural studies of the O-specific side-chains of the Escherichia coli O 10 lipopolysaccharide. AB - The structure of the O-specific side-chains of the Escherichia coli O 10 lipopolysaccharide has been investigated. Methylation analysis, n.m.r. spectroscopy, and various specific degradations were the principal methods used. It is concluded that the polysaccharide is composed of pentasaccharide repeating units having the following structure, in which D-Fuc4NAcyl is 4-amino-4,6-dideoxy D-galactose, acylated with acetic acid (60%) or D-3-hydroxybutyric acid (40%). (Formula: see text). PMID- 3533256 TI - Immunotherapy with bestatin for acute nonlymphocytic leukemia in adults. AB - In a cooperative randomized control study of immunotherapy with bestatin in combination with chemotherapy in adults with acute nonlymphocytic leukemia (ANLL), 101 patients (48 in the bestatin group and 53 in the control group) out of 115 patients registered were evaluated as eligible. The bestatin group achieved a statistically significant prolongation of survival compared with the control group in overall ANLL and acute myelogenous leukemia. In the analysis of patient age, the bestatin group achieved a statistically significant prolongation of both the remission duration and survival in patients aged 50 to 65 years, while the differences were not significant in the 15 to 49 age group. The bestatin group tended to achieve a higher rate of reinduction of remission in patients who had recurrence of leukemia. Side effects developed in only 5 (9.6%) of 52 patients treated with bestatin. None of these side effects were particularly serious in nature. It is concluded that bestatin is useful for prolongation of survival of adult patients with ANLL, making for a longer remission duration especially in elderly patients and with few side effects. PMID- 3533257 TI - Isolation and dissociation of immune complexes from pleural effusions of lymphoma patients. AB - Immune complexes (IC) isolated from pleural effusions of lymphomas with favorable and unfavorable prognoses were of IgG type. These IC were further dissociated by ion exchange chromatography using 8 M urea. The antibody was found to be a high molecular weight protein (1.5 X 10(5) daltons) and reacted with antihuman IgG immunologically while a second peak obtained on ion exchange chromatography may be an antigen moiety with a molecular weight of 3.2 X 10(4) daltons as it reacted immunologically with the antibody. Strong cytoplasmic fluorescence was observed with various cell suspensions of lymphomas when reacted with the antibody preparations. The antisera raised against two different antigen fractions prepared from two lymphomas--nHL and LL showed positive fluorescence with both nHL and LL suspensions. The absorption of these rabbit antibodies with individual cell extracts or with antigen preparations also entirely blocked the cytoplasmic staining. The antigen moiety (PK-II) may have a common origin in the disease process. Pleural effusions from patients with unfavorable and favorable prognoses showed identical patterns of separation of IC components. PMID- 3533258 TI - The Lyt phenotype of the T cells responsible for in vivo tumor rejection in syngeneic mice. AB - Spleen cells of BALB/c mice hyperimmunized with a transplantable methylcholanthrene-induced sarcoma Meth A (Meth A-Im-SPL) inhibited the growth of Meth A tumor in vivo in a tumor neutralizing test. Meth A-Im-SPL did not neutralize another antigenically distinct sarcoma, Meth 1, indicating that the antitumor activity is tumor specific. Lyt-1+2- cells of Meth A-Im-SPL (Im-Lyt-1+2 ) were the effectors since in vitro treatment of Meth A-Im-SPL with anti-Thy 1.2 or anti-Lyt 1.2 antibody plus complement completely abrogated their neutralizing activity, whereas treatment with anti-Lyt 2.2 plus complement did not. To further confirm the effector activity of Im-Lyt-1+2- cells, T cell subpopulations were separated from Meth A-Im-SPL by the panning method. The purified Im-Lyt-1+2-, but not Im-Lyt-1+2+ cells neutralized the tumor in athymic nu/nu mice as efficiently as in +/+ mice, suggesting that the donor Im-Lyt-1+2- cells but not recipient T cells were primarily responsible for neutralizing the tumor. The present study, however, did not exclude the possible contribution of recipient T cells to the tumor neutralization and this is open to further investigation. PMID- 3533259 TI - Cardiac imaging: new technologies and clinical applications. PMID- 3533260 TI - Use of the computer as an aid to the cardiologist: electrocardiographic and echocardiographic analyses. PMID- 3533261 TI - Determination of severity of stenotic and regurgitant valvular lesions by Doppler ultrasound. PMID- 3533262 TI - Two-dimensional/Doppler echocardiography and its relationship to cardiac catheterization for diagnosis and management of congenital heart disease. AB - The impact of echocardiography on cardiac catheterization in an individual patient with congenital heart disease depends on a number of factors, including the availability of an echocardiographer who is experienced in congenital heart disease and of appropriate "state of the art" equipment, and willingness of clinicians and surgeons to accept echocardiographic data. The latter is influenced by factors such as completeness of the echocardiographic data, familiarity with tomographic cardiac anatomy, and the perceived risk of an invasive procedure. The combined use of echocardiography and catheterization will have an increasing impact on the management of these patients, significantly altering the indications and extent of a catheterization procedure. This will lead to a more goal-directed examination. The relationship between catheterization and 2-D/Doppler echocardiography should not be adversarial, but complementary. Increasingly, noninvasive techniques will support or complement the invasive procedure, particularly as echo technologies for invasive applications are further developed. PMID- 3533263 TI - Digital vascular imaging of the great vessels and heart. PMID- 3533264 TI - Comparative evaluation of captopril and methyldopa monotherapy for hypertension: double-blind study in Indians. AB - A double-blind, parallel-group study was conducted in 41 Indian men and women with hypertension to compare the antihypertensive effects of captopril and methyldopa. Twenty patients received 150 mg of captopril and 21 patients received 750 mg of methyldopa daily. The drugs were administered in three equally divided doses for four weeks. Blood pressure was measured after one, two, and four weeks of therapy. Relevant clinical and biochemical investigations were carried out before and after treatment. Sixteen patients given captopril and 11 given methyldopa responded to therapy. Among the captopril responders, initial mean systolic blood pressure (+/- SE) was 155 +/- 5.0 mmHg and diastolic blood pressure was 105 +/- 2.1 mmHg. These values were reduced to 119 +/- 9.8 and 80 +/ 6.1 mmHg, respectively, after four weeks of therapy. Similarly, among the methyldopa responders, initial mean systolic blood pressure was 180 +/- 7.4 mmHg and diastolic blood pressure was 112 +/- 3.8 mmHg. These values were reduced to 138 +/- 7.0 and 92 +/- 3.8 mmHg, respectively, after four weeks of therapy. The fall in the blood pressure in both groups was highly significant (P less than 0.001). None of the patients in either group had any clinically significant side effects. The results of this study suggest that monotherapy with captopril may be more effective than monotherapy with methyldopa in Indian hypertensives. PMID- 3533265 TI - Humoral and hemodynamic effects of nitrendipine versus clonidine in patients with essential hypertension. AB - A single-blind, randomized controlled study was conducted to assess and compare the antihypertensive effectiveness and the effects on glucose tolerance and renin angiotensin-aldosterone balance of nitrendipine (Bay e 5009), a new dihydropyridine calcium antagonist, and clonidine. Twenty-six outpatients with uncomplicated mild to moderate essential hypertension were randomly allocated to receive 20 mg of nitrendipine or 0.25 mg of clonidine (slow-release formulation) daily for five weeks. One patient in the clonidine group dropped out. Both treatments significantly reduced systolic and diastolic blood pressures with negligible modifications in heart rate. However, diastolic blood pressure was reduced significantly more (P less than 0.001) with nitrendipine. Accordingly, 12 of 13 patients given nitrendipine attained the goal of diastolic pressure less than or equal to 90 mmHg, according to criteria of the Hypertension Detection and Follow-up Program, while only three of 12 patients in the clonidine group achieved this goal. Side effects were mild and transient in both treatment groups. No definite trends in plasma renin activity or plasma aldosterone concentration, or in blood glucose or immunoreactive insulin (measured both in fasting conditions and after an oral glucose tolerance test), were evident when baseline and posttreatment values were compared. The results of this study suggest that nitrendipine is an effective and safe antihypertensive agent and is devoid of adverse effects on glucose tolerance and renin-aldosterone homeostasis. PMID- 3533266 TI - Pharmacological effect of hyaluronic acid (HA) on phagocytes: hypothesis for an HA-induced monocyte chemotactic factor for neutrophils. AB - The connection between hyaluronic acid and phagocyte function is not well documented in the literature. Its action may either inhibit or enhance polymorphonuclear neutrophil (PMN) function, depending on its concentration. Studies were conducted to verify the effect of hyaluronic acid on phagocytes, both directly using hyaluronic acid and indirectly via a mediated route using the medium from a hyaluronic acid monocyte incubation. Determinations were made of phagocytosis, reduction of nitroblue tetrazolium, superoxide production, and chemotaxis before and after incubation with hyaluronic acid. Chemotaxis of PMNs was used to evaluate the chemotactic action of a medium in which monocytes had been incubated with hyaluronic acid. This method resulted in progressive improvement in the chemotactic index. The authors conclude that the monocytes incubated with hyaluronic acid produce a chemotactic factor for neutrophils. PMID- 3533267 TI - Complement split product C5a mediates the lipopolysaccharide-induced mobilization of CFU-s and haemopoietic progenitor cells, but not the mobilization induced by proteolytic enzymes. AB - Intravenous (i.v.) injection of mice with lipopolysaccharide (LPS), and the proteolytic enzymes trypsin and proteinase, mobilizes pluripotent haemopoietic stem cells (CFU-s) as well as granulocyte-macrophage progenitor cells (GM-CFU) and the early progenitors of the erythroid lineage (E-BFU) from the haemopoietic tissues into the peripheral blood. We investigated the involvement of the complement (C) system in this process. It appeared that the early mobilization induced by LPS and other activators of the alternative complement pathway, such as Listeria monocytogenes (Lm) and zymosan, but not that induced by the proteolytic enzymes, was absent in C5-deficient mice. The mobilization by C activators in these mice could be restored by injection of C5-sufficient serum, suggesting a critical role for C5. The manner in which C5 was involved in the C activation-mediated stem cell mobilization was studied using a serum transfer system. C5-sufficient serum, activated in vitro by incubation with Lm and subsequently liberated from the bacteria, caused mobilization in both C5 sufficient and C5-deficient mice. C5-deficient serum was not able to do so. The resistance of the mobilizing principle to heat treatment (56 degrees C, 30 min) strongly suggests that it is identical with the C5 split product C5a, or an in vivo derivative of C5a. This conclusion was reinforced by the observation that a single injection of purified rat C5a into C5-deficient mice also induced mobilization of CFU-s. PMID- 3533268 TI - Effect of thioloxidant diazene dicarboxylic acid bis-(N'-methylpiperazide) (DIP) on 45Ca2+ net uptake into rat pancreatic islets. AB - The effect of DIP (an oxidant of glutathione) on 45Ca2+ net uptake induced by a variety of stimulators of insulin secretion was studied in rat pancreatic islets. In addition the effect of exogenous glutathione (GSH) on 45Ca2+ net uptake in response to glucose was tested. DIP (0.1 mM) inhibited the increase of 45Ca2+ net uptake in the presence of glucose (16.7 mM) and glyceraldehyde (10 mM). A similar inhibitory effect could be demonstrated, when 45Ca2+ net uptake was enhanced by tolbutamide (100 micrograms/ml), glibenclamide (0.5 micrograms/ml), b-BCH (20 mM), 2-ketoisocaproate (20 mM), arginine (20 mM) in the presence of 3 mM glucose or by high extracellular potassium (20 mM). The increase of 45Ca2+ net uptake stimulated by leucine (20 mM) plus glucose (3 mM) was further augmented by DIP. Exogenous GSH did not affect 45Ca2+ net uptake in the presence of (5.6-16.7 mM) glucose. It is suggested that 45Ca2+ net uptake of pancreatic islets depends on the redox state of islet thiols regardless of whether uptake is promoted via inhibition of potassium efflux (nutrients, sulfonylureas) or by high potassium and arginine. The voltage sensitive calcium-channel is the site of action of critical thiols. It is possible that these thiols are localized at the inner side of the plasma membrane. PMID- 3533269 TI - An epidemic of bacillary dysentery in western Rwanda 1981-1982. PMID- 3533270 TI - Nimodipine in the treatment of headache in chronic cerebral ischemia. AB - The aim of this study was to evaluate the influence of nimodipine on non migrainous vascular headache in patients with chronic cerebral ischemia. Eighty six patients were examined in a double-blind trial for 16 weeks (12 weeks of nimodipine or placebo, followed by a 4-week placebo period). Fifty-six patients were studied in an open trial for 12 months. In the total material of the double blind study there was no difference as far as improvement of headache was concerned when comparing the patients treated with nimodipine with those receiving placebo. However, in a group of 38 patients with a higher degree of headache intensity, selected in accordance with the Sandoz Clinical Assessment Geriatric scale, a statistically significant difference was found in favor of nimodipine. The results obtained in the long-term open trial seem to confirm the effect of nimodipine on headache. The underlying mechanisms of the beneficial effect of the drug have been discussed. PMID- 3533271 TI - L-5-hydroxytryptophan versus placebo in childhood migraine prophylaxis: a double blind crossover study. AB - L-5HTP was tested versus placebo in a double-blind crossover study of 27 migraine children aged 6-12 years, who recorded their headaches in a headache diary for 1 month. Twenty-one patients subsequently started the trial. The mean daily dose of L-5HTP was 5 mg/kg body weight, and each treatment period with either L-5HTP or placebo lasted 12 weeks. In group A (L-5HTP-placebo; 10 patients) and group B (placebo-L-5HTP; 11 patients) both L-5HTP and placebo led to a significant reduction of the migraine index and frequency of migraine attacks during the 3rd month of each treatment period. However, we found a treatment X period interaction because the efficacy determinants decreased significantly during the first and the second treatment periods in both groups irrespective of the sequence of treatments. No differences were found between L-5HTP (first period of group A) and placebo (first period of group B). PMID- 3533272 TI - Tizanidine in the management of trigeminal neuralgia. AB - In a double-blind study the efficacy and tolerability of tizanidine was compared with those of carbamazepine in the management of trigeminal neuralgia. Six patients were allocated to treatment with tizanidine and six to carbamazepine. After individual titration the maximum daily doses were 18 mg and 900 mg, respectively. Among the efficacy factors used, the visual analog scale (VAS) and the overall efficacy as assessed by patients and investigator turned out to be the most appropriate. The results indicate that tizanidine was well tolerated, but the effects, if any, were inferior to those of carbamazepine. PMID- 3533273 TI - The basis of multidrug resistance in mammalian cells: homology with bacterial transport. PMID- 3533274 TI - RAM, a gene of yeast required for a functional modification of RAS proteins and for production of mating pheromone a-factor. AB - We have identified a gene (SUPH) of S. cerevisiae that is required for both RAS function and mating by cells of a mating type. supH is allelic to ste16, a gene required for the production of the mating pheromone a-factor. Both RAS and a factor coding sequences terminate with the potential acyltransferase recognition sequence Cys-A-A-X, where A is an aliphatic amino acid. Mutations in SUPH-STE16 prevent the membrane localization and maturation of RAS protein, as well as the fatty acid acylation of it and other membrane proteins. We propose the designation RAM (RAS protein and a-factor maturation function) for SUPH and STE16. RAM may encode an enzyme responsible for the modification and membrane localization of proteins with this C-terminal sequence. PMID- 3533275 TI - Isolation of the yeast calmodulin gene: calmodulin is an essential protein. AB - Calmodulin was purified from Saccharomyces cerevisiae based on its characteristic properties. Like other calmodulins, the yeast protein is small, heat-stable, acidic, retained by hydrophobic matrices in a Ca2+-dependent manner, exhibits a pronounced Ca2+-induced shift in electrophoretic mobility, and binds 45Ca2+. Using synthetic oligonucleotide probes designed from the sequences of two tryptic peptides derived from the purified protein, the gene encoding yeast calmodulin was isolated. The gene (designated CMD1) is a unique, single-copy locus, contains no introns, and resides on chromosome II. The amino acid sequence of yeast calmodulin shares 60% identity with other calmodulins. Disruption or deletion of the yeast calmodulin gene results in a recessive-lethal mutation; thus, calmodulin is essential for the growth of yeast cells. PMID- 3533276 TI - Long term growth of factor-producing lymphoid and myeloid cells in serum-free medium. AB - The ability to grow lymphoid and myeloid cells in serum-free culture medium allows researchers to analyze the factors and mechanisms required for hemopoietic cell growth and differentiation without the interference of undefined serum components. Therefore, we used a serum-free medium, RITC 55-9 that consisted of modified Dulbecco's MEM supplemented with bovine serum albumin (BSA), transferrin (Tf) and insulin (Ins) to culture human T lymphoid (Mo), murine myelomonocytoid (WEHI-3B) and murine interleukin (IL)-3-dependent (32Dcl/H4) cell lines. Mo was maintained in RITC for more than 8 months and had a mean viability of 59% and the same doubling times as in serum-containing medium (SCM). Under these conditions, Mo cells produced hemopoietic colony-stimulating activity that included production of a basophil/eosinophil differentiation factor of similar content to that produced in SCM. WEHI-3B cells grown for more than 12 months in RITC, or for more than 3 months in RITC without Tf and Ins, had a doubling time of 20 h, whereas cells maintained in protein-free RITC showed a 2-fold increase in doubling time then died within 3 months. The IL-3 production by WEHI-3B cells cultured in RITC was higher than the production by cells grown in SCM. When IL-3 was assayed in 32Dcl/H4 cells that had been maintained in RITC for more than 4 months, a lower response to IL-3 was found, an indication that components other than the BSA, Tf and Ins in fetal calf serum are required for optimal cell growth and differentiation. PMID- 3533277 TI - Development of the enteric nervous system in chick embryonic duodenum in terms of the distribution of tubulin. AB - An immunohistochemical method that uses anti-tubulin was utilized to observe the development of the enteric nervous system in chick embryonic duodenum. Neural crest cells, and enteric neuroblasts, or enteric ganglia, which derive from neural crest cells were clearly shown as sharp immunoreactive regions of tubulin. The distributions of enteric neuroblasts and enteric ganglia in chick duodena were in agreement with results of previous reports in which different techniques were used. The initial stage at which cells of neural crest origin were present in the duodenal walls (4-day-old embryos) was earlier than the initial stage (about 6-day-old embryos) reported earlier. This was verified by transmission electron microscopy. Also, the tubulin that is a component of the enteric nervous system was shown to be stable at a low temperature. This tubulin-immunostaining method provides a useful histochemical technique with which to study the development of the enteric ganglion and the function of tubulin as a component of the enteric nervous system. PMID- 3533278 TI - Metabolic and neurophysiologic sequelae of brain injury: a cholinergic hypothesis. AB - This paper reviews a number of lines of evidence developed in our laboratories indicating that at least some components of neurologic disturbances following concussion may be attributable to increased functional activity of cholinergic systems located within specific brain regions. These lines of evidence include EEG studies indicating that disruption of the reticular activating system is not necessary for production of a reversible, flaccid, comatose state following low levels of concussion, systematic transection studies indicating that regions bounded by collicular and midpontine transections may contribute to at least motor components of the behavioral suppression associated with concussion, local rates of glucose utilization following fluid percussion injury increase in restricted areas bounded by collicular and midpontine transections; microinjection of carbachol (but not tetracaine) into these hypermetabolic regions produced behavioral suppression and electroencephalographic changes resembling those following concussion, systemic administration or microinjections of atropine, but not mecamylamine, antagonized the behavioral effects of carbachol, and data indicating that pharmacologic blockage of muscarinic cholinergic systems can attenuate neurologic deficits. Taken in conjunction with data from earlier clinical and laboratory studies, our research also indicates that anticholinergic therapy may potentially benefit head-injured patients. PMID- 3533279 TI - Calcium-activated mediators of secondary injury in the spinal cord. PMID- 3533280 TI - [Psychiatric aspects in the work of French moralists]. PMID- 3533281 TI - [The Neuropsychiatry Clinic of the medical school of Comenius University in Bratislava under Dr. M. Krivy. PMID- 3533282 TI - [The life and work of Professor Stanek]. PMID- 3533283 TI - [The medical school hospital in Prague, 5-Motol: the past, the present and the future]. PMID- 3533284 TI - [Lessons from the history of disability evaluation in the railway industry medical service]. PMID- 3533285 TI - In vitro and in vivo evaluation of L/105, a new topical intestinal rifamycin. AB - L/105 (4-deoxy-4'-methylpyrido [1',2'-1,2] imidazo [5,4-c] rifamycin SV; INN: Rifaximin) is a new rifamycin active in vitro against both gram-positive and gram negative microorganisms. The activity of L/105 was comparable to that of rifampicin and, against gram-positive bacteria, higher than that of neomycin. The antibacterial activities of L/105 and rifampicin were equally affected by the highest size of inoculum used (10 cells/ml) and they were equally bactericidal against Staphylococcus aureus and Escherichia coli. The speed and the degree of development of resistance to L/105 were quite superimposable on those of neomycin. In vivo, L/105 did not show therapeutic activity by oral route in the staphylococcal infection in the mouse till the highest dosage used (10 mg/kg b.w.); under the same conditions, gentamicin was equally ineffective. After subcutaneous administration, L/105 showed therapeutic activity (ED50 = 0.46 mg/kg b.w.) practically superimposable on that of orally administered rifampicin. PMID- 3533286 TI - Influence of pH, inoculum and media on the in vitro bactericidal activity of fosfomycin trometamol, norfloxacin and cotrimoxazole. AB - An in vitro study was made of the bactericidal activity against Escherichia coli of fosfomycin trometamol, a new fosfomycin salt characterized by high bioavailability in relation to the pH, inoculum and culture medium, the latter being nutrient broth or human urine. Cotrimoxazole and norfloxacin were used for comparison. The results obtained show that both in nutrient broth and human urine, fosfomycin trometamol had higher bactericidal action than that of the other two antimicrobial agents. PMID- 3533287 TI - Synthesis and structure of prolinal-containing peptides, and their use as specific inhibitors of prolyl endopeptidases. PMID- 3533288 TI - [Lymph drainage via the thoracic duct in patients undergoing renal transplantation: pre- and postoperative nursing care]. PMID- 3533289 TI - [Prevalence and care of patients with Proteus mirabilis enteritis]. PMID- 3533291 TI - [Common channel for bile and pancreatic ducts. Presentation of 12 cases and discussion]. AB - Between 1978 and 1985, 11 girls and one boy underwent an elective operation for a congenital choledochal dilatation associated with an anomalous biliopancreatic junction. In 10 out of these 12 cases the children suffered several episodes of abdominal pain, and the diagnosis was missed since a jaundice appeared. The ultrasonographic examination demonstrated in all cases a dilatation of both extra and intrahepatic bile ducts. The preoperative diagnosis was always established by the mean of a transhepatic cholangiography (8 cases) or a percutaneous cholecystography (4 cases), which showed in every case a dilated choledochus, and a common biliopancreatic channel, 15 to 35 mm long. A high amylase level was found in the bile in 10/10 cases when it was measured. A cholecystokinin test was performed in 4 cases, resulting in each case in a considerable increase of amylase and lipase levels in bile. All children were treated by excision of the dilated choledochus and gallbladder, followed by an hepaticojejunostomy with a Roux en Y loop. The follow-up is 6 months to 5 years for 9 children: 8 are cured, and on girl, who had a major dilatation of the left intrahepatic bile ducts, suffered from episodic abdominal pain and an episode od cholangitis 6 years after the operation. The role of such a common channel in the pathogeny of congenital choledochal cysts, acute pancreatitis in children, and biliary carcinomas in young adults is discussed according to the literatures of the last 10 years. PMID- 3533290 TI - [Prenatal diagnosis of ovarian cysts]. AB - The authors report 10 cases of ante-natally diagnosed ovarian cysts. Ultrasonography greatly contributed to the diagnosis of this condition rarely described before. These cysts are usually follicular cysts. Physiopathological explanation still remain unclear: excessive fetal gonadotrope activity, enzymatic abnormality of the theca interna, abnormal stimulation by the mother's HCG are the main hypothesis. Ultrasonographic prenatal diagnosis is based on the discovery of an intra-abdominal round liquid area in a female fetus with normal kidneys and bladder. Obstetrical management is very simple: observation and vaginal delivery. After birth, diagnosis is assessed by clinical examination and ultrasonography which may be able to recognize a possible torsion (intracystic fluid septation). Treatment is conditioned by two facts: first these cysts are usually follicular benign lesions, second there is a high risk of complications, mainly torsion or rupture. Non-operative treatment and observation can be justified for very small cysts which have low risk of torsion. Laparotomy confirms the diagnosis: regarding non complicated cysts, surgery must be as conservative as possible: cystectomy is often feasible, leaving a laminated but functional ovary. Percutaneous puncture under ultrasonography could be considered. PMID- 3533292 TI - [Treatment of acute perforated appendicitis with intraperitoneal cefazolin]. AB - Until recently intra-abdominal sepsis following surgery for perforated appendicitis has remained a frequent occurrence. In 1975 Fowler reported an incidence of one intra-abdominal abscess in 36 perforated appendicitis treated with a protocol consisting of saline irrigation at surgery, followed by intraperitoneal administration of cephaloridine q. 6 hours for 48 hours. The same antibiotic was then given i.v. for 72 hours. He concluded that this method was an effective way to minimize post-op intra-abdominal abscess, and that the intraperitoneal route was more effective, for this purpose, than systemic administration. More recently, with better knowledge of the role of anaerobes, improved results have also been obtained by adding clindamycin or metronidazole to the antibiotic regimen. A prospective study based on two groups of patients randomly assigned to two protocols was undertaken. The study group consisted of 45 children operated for perforated appendicitis with abscess or generalized peritonitis. These patients were treated with Fowler's protocol. Because it is less nephrotoxic and is active against the same organisms, cefazolin was used instead of cephaloridine. The control group consisted of 43 patients, also operated for perforated appendicitis, treated with saline irrigation at surgery, with either i.v. gentamycin or tobramycin and clindamycin or metronidazole for an average of 7.8 +/- 3.1 days. Both groups were fairly well matched in terms of age, sex, severity of disease, and bacterial flora. They showed an identical 6% post-op intra-abdominal sepsis rate. Days before afebrile, days under gastric suction, complications and average hospital stay were comparable in both groups. The wound infection rate was 20% in the study group and 9% in the control group.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3533294 TI - [Phagocytosis of a merozoite in a blood smear from a patient with Plasmodium vivax malaria]. PMID- 3533293 TI - Chromosomal changes in secondary leukemias of childhood and young adulthood. AB - The increasing success of antineoplastic therapy has resulted in a growing number of long-term survivors. These people are at risk for complications of the therapy itself. Among these induced acute nonlymphoid leukemia (ANLL) has been both common and often lethal. We reviewed 72 recently reported patients under 30 years of age at the time of initial diagnosis who developed a secondary, karyotypically defined leukemia. Fifty-eight patients contracted ANLL a mean of 4 1/2 years from the initial diagnosis. In 25 patients, this was preceded by a preleukemic phase characterized by a hypercellular bone marrow with abnormal precursors, often accompanied by peripheral pancytopenia, that lasted a mean of 6 months. Three additional patients died in this preleukemic phase. In all 61, the most common chromosomal abnormalities were numerical errors. Twenty-four patients had a hypodiploid karyotype, most often in those in whom the primary diagnosis was lymphoma (22 of 43). The most common chromosomes missing in whole or in part were number 7 (18 patients), number 5 (8 patients), number 17 (5 patients), and number 21 (4 patients). The anomalies were frequently multiple and complex. Monosomy 7 figured particularly strongly and may be similar to a karyotypically identical myeloproliferative disorder characterized by micromegakaryocytes, giant platelets, and abnormal granulocyte function arising de novo in children. These findings are similar to those in older patients with ANLL induced by environmental carcinogens or antineoplastic therapy. They are different from the karyotypic changes seen in de novo ANLL in children and young adults, suggesting a different etiology. Also, they reinforce the need to find less leukemogenic treatment programs. PMID- 3533295 TI - [Is it necessary to perform sensitivity tests for malaria in the hospital environment?]. AB - From January 1984 to June 1985, 20 out of 65 P. falciparum strains isolated in an hospital in Paris were epidemiologically suspect of resistance to chloroquine. 15 of them were submitted to in vitro chemosensitivity tests with several antimalarials drugs. In cases of suspected chloroquine resistance the initial choice of an alternative drug is mainly presumptive and is generally not guided by the in vitro chemosensitivity assay which results are too much delayed. When in vitro assay shows sensitivity to amino-4-quinolines treatment can be modified accordingly. The determination of plasma concentration of drugs are required in any case. However in vitro sensitivity assays would probably appears essential to physicians in cases of resistance to quinine. PMID- 3533296 TI - [Preliminary study, in vitro, of the sensitivity of P. falciparum to chloroquine, mefloquine and quinine during 1985, in Kampuchea]. AB - In vitro sensitivity studies of three antimalarials against 45 strains of P. falciparum isolated in western and north-western provinces of Kampuchea, has been carried out, following the WHO microtest. The results, derived from 15 strains, exhibit a resistance rate of 12/14 with chloroquine, 6/6 with quinine and 0/14 with mefloquine. These results, compared with past and current in vivo studies, confirm that the chloroquine therapy should not anymore employed. Quinine remains efficient, but the parasitemia decrease is slow and this treatment must be often carried out for 14 days and renewed in 6% of the cases. Mefloquine was quite efficient on 21 patients followed for 28 days. While waiting for mefloquine availability, studies are carried out for in vivo and in vitro appraisal of the chemosensitivity condition of P. falciparum strains isolated from other endemic areas of Kampuchea in order to determine the most satisfying antimalarial association as far as cost/effectiveness ratio is concerned. PMID- 3533297 TI - [Wuchereria bancrofti: value of the diethylcarbamazine provocation test for the diurnal detection of microfilaria carriers]. AB - Sixty-nine of 83 (83%) patients with circulating microfilariae of nocturnally periodic Wuchereria bancrofti were detected in daytime blood films following the one-time administration of diethylcarbamazine at a dose per patient of 1 +/- .25 mg/kg of body weight. This method of detecting microfilaria carriers in Haiti is recommended as a reasonably sensitive alternative when circumstances make it impossible to conduct a nighttime blood survey. PMID- 3533298 TI - Approaches to prevention and early detection of cardiomyopathies: memorandum from a WHO meeting. AB - A meeting on cardiomyopathies was held in Geneva on 25-27 March 1985 to review the state of understanding concerning these diseases and to update the information and recommendations contained in the published report of the WHO Expert Committee on Cardiomyopathies which had met in 1983. Particular emphasis was given to discussing new scientific knowledge, priorities for etiological research, proposals for cooperation between research centres in developed and developing countries, early detection of cardiomyopathies, and possible population studies related to the disease. PMID- 3533299 TI - Multicentre clinical trials of benzimidazolecarbamates in human echinococcosis. AB - Studies coordinated by the World Health Organization were conducted in seven clinical centres on the chemotherapy of human echinococcosis with mebendazole, albendazole, and flubendazole. The first phase of these ended with the following conclusions.Treatment of 85 patients with mebendazole for cystic (Echinococcus granulosus) echinococcosis was successful in 8 patients and partially successful in 4 others. Flubendazole was effective in only one case of lung echinococcosis. Albendazole was successful in 5 of 30 patients treated and partially successful in 4 others. Further studies on new drugs or new formulations of existing benzimidazoles and on better forms of their application are needed. In the mean time, chemotherapy of human cystic echinococcosis should be restricted to inoperable cases.In 54 patients with E. multilocularis echinococcosis, it was confirmed that mebendazole therapy may arrest the development of the lesions. This treatment is therefore indicated in most cases of alveolar echinococcosis with or without surgery. However, further studies are needed to clarify the optimal regimen for mebendazole treatment and to explore the effectiveness of albendazole therapy. PMID- 3533300 TI - Comparison of asexual blood-stage antigens of Plasmodium falciparum recognized by antibody reagents from nine laboratories. AB - Several laboratories have reported a large number of plasmodial antigens that may be implicated in the immune-mediated protection against the asexual blood stage of Plasmodium falciparum. In order to establish relationships between the antigens reported by different laboratories, a comparative testing of 37 antibody reagents was carried out at the Reference Laboratory for Malaria Antibodies and Antigens. Based on the results of the comparative testing, these antibodies were divided into seven groups according to similarities in the stage-specificity, the subcellular localization and the apparent molecular mass (M(r)) of the antigens they recognized.Twenty-two antibody reagents were grouped together on the basis that all gave a characteristic grape-pattern in indirect immunofluorescence (IIF) and precipitated a schizont/merozoite antigen of M(r) 190 000 to 205 000. Another group consisted of one antibody which reacted with a M(r) 90 000 protein expressed only in mature trophozoites and young schizonts. A third group consisted of three antibodies which reacted with all blood stages of the parasite and recognized a M(r) 36 000 protein. The fourth group contained one antibody which recognized a M(r) 14 000 protein and gave an IIF staining of schizonts. The fifth group consisted of an antiserum raised against a fusion protein. This antiserum reacted with schizont and ring-stage parasites and precipitated a M(r) 75 000 antigen. One rabbit antiserum raised against a different fusion protein and one monoclonal antibody (Mab) were put together in the sixth group on the basis that both gave a cytoplasmic IIF staining of schizonts and recognized a strain-specific, M(r) 250 000 antigen from one P. falciparum strain. A seventh group was made up of 8 antibodies on the basis that all gave a similar two-dot IIF staining pattern of segmented schizonts and free merozoites, although these antibodies recognized four different sets of antigens.These results were presented to a subcommittee of the Scientific Working Group on the Immunology of Malaria (SWG-IMMAL) during a workshop held at the reference laboratory. The P. falciparum proteins recognized by the antibody reagents used for this workshop represent only some of the different types of asexual blood-stage antigens that have been described in the literature.. PMID- 3533301 TI - Secondary prevention of cancer: an overview. AB - Secondary prevention of cancer (screening) involves the use of tests to detect a cancer before the appearance of signs or symptoms. Before starting such a programme, the available evidence should be analysed to estimate the effectiveness of the proposed activities. Essential requirements are an understanding of the natural history of the particular cancer, availability of a test that can detect it, effective treatment for it, good evidence that early detection reduces the incidence and/or mortality, and that the expected benefits of screening outweigh the risks and costs. A screening programme should be limited to significant cancers and applied selectively, and should be integrated into the total health care programme. Programmes should take into account the risks, costs and expected benefits; provide quality assurance as well as facilities to follow, diagnose, and treat people with positive test results; maintain all records; and keep costs to a minimum. Ideally the effectiveness of screening should be demonstrated by randomized controlled trials showing a reduction in mortality, but this type of evidence exists for few cancers. Often an estimate of the effectiveness of screening must rest on other types of evidence, such as observations that the tests can detect the cancer before the appearance of signs or symptoms; that the tests can find a greater proportion of cancers in early stages; and that the patients with cancers detected through screening have higher survival rates after diagnosis and treatment although it must be recognized that these observations may be biased. This article discusses the available evidence on the effectiveness of screening for eight cancers, and gives estimates of the potential impact of secondary prevention for the year 2000. PMID- 3533303 TI - Elimination of metabolic cooperation by glycyrrhetinic acid, an anti-tumor promoter, in cultured Chinese hamster cells. AB - The effect of glycyrrhetinic acid (GA) on the metabolic cooperation between 6 thioguanine-resistant (6TGR) and sensitive (6TGS) Chinese hamster V79 H3 cells, was investigated. Because GA has been reported to inhibit strongly tumor formation in mouse skin induced by 7,12-dimethylbenz[a]anthracene (DMBA) plus teleocidin or DMBA plus 12-O-tetradecanoylphorbol-13-acetate (TPA), we expected that GA might restore the metabolic cooperation inhibited by TPA. The results were contrary to our expectations. GA (20-50 microM) acted cumulatively with TPA to inhibit metabolic cooperation even more, and GA (20-75 microM), by itself, was found to be a strong inhibitor of metabolic cooperation. GA was not mutagenic at the concentrations examined (0-100 microM). PMID- 3533302 TI - Enzyme immunoassays and related procedures in diagnostic medical virology. AB - This review article describes several applications of the widely used enzyme immunoassay (EIA) procedure. EIA methods have been adapted to solve problems in diagnostic virology where sensitivity, specificity, or practicability is required. Concurrent developments in hybridoma and conjugation methods have increased significantly the use of these assays. A general overview of EIA methods is given together with typical examples of their use in diagnostic medical virology; attention is drawn to possible pitfalls. Recent advances in recombinant DNA technology have made it possible to produce highly specific nucleic acid probes that have a sensitivity approximately 100 times greater than that of EIA. Some applications of these probes are described. Although the non labelled nucleic acid probes for use in the field are not as refined as non labelled immunoassays, their range of applications is expected to expand rapidly in the near future. PMID- 3533304 TI - Enhancement of the clonability of adult parenchymal hepatocytes with the liver tumor promoter phenobarbital. AB - An in vivo clonogenic assay system was utilized to investigate the effect of the tumor promoter, phenobarbital (PB), on adult parenchymal hepatocyte proliferation. Enzymatically dispersed hepatocytes from female Fischer 344 rats were injected into the interscapular and mammary fat pads of isogeneic recipient animals where they proliferate to form hepatocyte colonies within 3 weeks. The number of hepatocytes required to form a colony in 50% of the transplantation sites (LND50) was 23 700 cells and 520 cells when normal adult liver cells were injected into non-hepatectomized and 2/3 hepatectomized normal recipient animals, respectively. Thus, a partial hepatectomy increased the hepatocyte clonogenicity by a factor of 40. A 2-week pre-treatment of both the donor and recipient animals with PB (0.1% in the drinking water) significantly increased the clonogenicity of the liver cells when transplanted into non-hepatectomized (15-fold) and 2/3 hepatectomized (2-fold) animals. However, PB treatment of the recipient animals was not required for the majority of this mitogenic effect since the clonability of PB-treated donor cells was increased (92% of the maximum stimulation observed) even when they were transplanted into untreated control animals. Furthermore, the PB-induced effect on hepatocyte clonability was reversible since the removal of PB from the donor animals 2 weeks prior to their use reduced the clonability of the hepatocytes (LND50 = 20,500 cells) to that observed for cells which were never exposed to PB. These results are consistent with the postulate that rather than PB being directly mitogenic, it primarily increases the clonability of adult parenchymal hepatocytes by inducing a reversible cellular alteration which enhances their responsiveness to endogenous growth stimuli. PMID- 3533306 TI - [Experimental studies on the biological characteristics of Plasmodium vivax in south Yunnan]. PMID- 3533305 TI - Effect of the nitro group conformation on the rat liver microsomal metabolism and bacterial mutagenicity of 2- and 9-nitroanthracene. AB - The aerobic and hypoxic metabolism of 2-nitroanthracene (2-NA) and 9 nitroanthracene (9-NA), two components of diesel exhaust, was studied and the mutagenicities of the parent compounds and their metabolites were compared. 2-NA was metabolized by 3-methylcholanthrene-induced rat liver microsomes under aerobic conditions to 2-NA trans-5,6-dihydrodiol, 2-NA trans-7,8-dihydrodiol, 2 NA 7-keto-5,6,7,8-tetrahydro-trans-5,6-diol, 2-NA 6-keto-5,6,7,8-tetrahydro-trans 7,8-diol, 2-nitro-9,10-anthraquinone and 2-NA 5,6,7,8-tetrahydrotetrol. When incubations were conducted under hypoxic conditions, 2-aminoanthracene was produced facily. N.m.r. spectral analysis indicated that the nitro-substituent of 2-NA and all of its ring-oxidized metabolites preferentially adopted an orientation in which the nitro group was coplanar or nearly co-planar with the aromatic ring system. 2-NA and its two trans-dihydrodiol metabolites were mutagenic in Salmonella typhimurium strain TA98, both in the presence and in the absence of S9 enzymes while the two tetrahydrodiol-ketones were much less mutagenic. When assayed in strains TA98NR and TA98/1,8-DNP6, the mutagenic activities of 2-NA and the trans-7,8-dihydrodiol were decreased. 2 Aminoanthracene was mutagenic in strain TA98 only in the presence of S9 enzymes. When 2-aminoanthracene was metabolized aerobically, the corresponding trans-5,6- and 7,8-dihydrodiols were not detected. These results suggest that 2-NA can be metabolized to mutagenic products by nitroreduction and ring-oxidation followed by nitroreduction, but not nitroreduction followed by ring-oxidation. Aerobic metabolism of 9-NA produced 9-NA trans-1,2- and 3,4-dihydrodiols, while metabolism was not detected under anaerobic conditions. Previous studies indicated that 9-NA and its two metabolites were not mutagenic in TA98. The differences in the orientation of the nitro substituents in 2-NA and its ring oxidized metabolites and in 9-NA and its metabolites can be employed to explain the strong mutagenicity of 2-NA and weak mutagenicity of 9-NA when assayed both in the absence and in the presence of S9 activation enzymes. PMID- 3533307 TI - [Immunity in Paragonimus westermani infection]. PMID- 3533308 TI - [The extent of resistance of chloroquine-resistant falciparum malaria and the geographic distribution in China]. PMID- 3533309 TI - [The effect of human glycophorin A and saccharides on the invasion of human erythrocytes by Plasmodium falciparum]. PMID- 3533310 TI - Assessment of fibrin degradation products during fibrinolytic therapy for acute myocardial infarction. AB - In a group of 39 patients who received fibrinolytic therapy for acute myocardial infarction, serum crosslinked fibrin degradation products (XLDP) were quantitated by an enzyme-linked immunosorbent assay (ELISA) using an antibody reactive with a site near the gamma gamma crosslink of fibrin, and characterized by a gel electrophoretic method to distinguish fibrinogen degradation products (FDP) from XLDP. After coronary artery reperfusion, 63 of 81 (69%) serum samples showed XLDP by gel analysis, whereas the incidence of positive samples before reperfusion, 53 of 144 (37%), was significantly less (p less than .0001). The first appearance of serum XLDP by gel analysis was most often in the 15 min interval immediately before or after angiographic documentation of reperfusion, and the elapsed treatment time required to produce a positive test was shorter with more intensive treatment regimens. However, the appearance of serum XLDP was not a specific indicator of reperfusion in individual patients, since one or more serum samples was positive in five of eight patients who did not show reperfusion as well as in 27 of 29 patients who did show reperfusion. Furthermore, the concentration of serum XLDP as measured by ELISA showed no significant difference in samples from patients who did or did not have reperfusion or between samples taken before or after reperfusion. There was a close temporal correlation between the first appearance of serum XLDP (gel analysis) and the initial decrease in plasma fibrinogen (systemic lytic state), and the degree of elevation of serum XLDP (ELISA) was also correlated with the intensity of the systemic lytic state. In addition, electrophoretic analysis of pretreatment plasma samples demonstrated crosslinked fibrin polymers that disappeared during fibrinolytic therapy coincident with the appearance of serum XLDP and in parallel with fibrinogen conversion to degradation products (fragments X, Y, and D). Two patients without a lytic state showed no change in plasma fibrin polymers during therapy, and XLDP were not present in serum despite coronary reperfusion in one patient. Thus the results indicate that XLDP appearing in the blood during fibrinolytic therapy for acute myocardial infarction are not predictive of successful fibrinolytic therapy, but rather may reflect degradation of circulating fibrin polymers associated with the fibrinogenolysis of the systemic lytic state. PMID- 3533311 TI - The renal, forearm, and hormonal responses to standing in the presence and absence of propranolol. AB - Nine normal volunteers underwent assessment of renal, forearm, and hormonal responses to orthostasis (quiet standing) in the presence and absence of 1 week of oral propranolol (160 mg/day). This was done to test the hypothesis that physiologic decrements in renal function (glomerular filtration rate, effective renal plasma flow, and absolute urinary sodium excretion) are attenuated by propranolol during quiet standing. The present studies, however, demonstrate that propranolol exaggerates the physiologic decrement in glomerular filtration rate, effective renal plasma flow, and absolute urinary sodium excretion during orthostasis. Forearm and renal vascular resistances were also accentuated in the presence of propranolol during quiet standing. These responses were associated with significant increases in plasma norepinephrine. We conclude that long-term administration of propranolol accentuates the physiologic decrement in renal hemodynamic and excretory function as well as in the forearm hemodynamic response to orthostasis in normal subjects. PMID- 3533312 TI - The use of frequency histograms of ultrasonic backscatter amplitudes for detection of atherosclerosis in vitro. AB - This study was designed to determine whether a quantitative analysis of integrated backscatter amplitude distribution is potentially useful in characterizing the atherosclerotic lesion. One hundred measurements (10 X 10 array) were made in fresh aortic regions (2 cm X 2 cm) of nine normal and 19 atherosclerotic arterial walls. A 10 MHz transducer was used. The integrated backscatter distinguished normal from atherosclerotic specimens (-56.7 +/- 4.3 vs -42.5 +/- 8.9 dB, p less than .01). The shape of the integrated backscatter amplitude distribution was analyzed by calculation of skewness and kurtosis of each arterial region. Both skewness values (0.134 +/- 0.325 vs -0.193 +/- 0.491 in normal and atherosclerotic segments, respectively, p = NS) and kurtosis values (0.055 +/- 0.765 vs -0.610 +/- 0.379, p less than .01) discriminated between the two groups. When only the six atherosclerotic specimens with mostly fatty and fibrofatty sites were considered, skewness and kurtosis still distinguished normal from atherosclerotic regions (0.134 +/- 0.325 vs -0.404 +/- 0.232, p less than .05 and 0.055 +/- 0.765 vs -0.558 +/- 0.337, p less than .05, respectively), while integrated backscatter values did not (-56.7 +/- 4.5 vs -52.3 +/- 6.1 dB, p = NS). In conclusion, atherosclerosis may be detected in vitro by the quantitative analysis of integrated backscatter distribution. This variable could also be of help in the identification of less obvious forms of atherosclerotic disease that are not distinguishable on the basis of integrated backscatter amplitude. PMID- 3533313 TI - Cardiac transplantation. PMID- 3533314 TI - Carl Ludwig and the Leipzig Physiological Institute: 'a factory of new knowledge'. PMID- 3533316 TI - Antithrombotic therapy for acute myocardial infarction: mechanisms and prevention of deep venous, left ventricular, and coronary artery thromboembolism. PMID- 3533315 TI - Inhibition of platelet aggregability by moderate-intensity physical exercise: a randomized clinical trial in overweight men. AB - It has been postulated that platelet function plays an important role in the initiation of atherosclerosis. Currently there are no definitive data on the longer-term effects of regular physical exercise on platelet function in humans. We assessed the influence of regular moderate-intensity physical exercise (brisk walking to slow jogging) on platelet aggregation in a population-based sample of middle-aged, overweight, mildly hypertensive men in eastern Finland. In this controlled study, we evaluated the net effect of exercise on platelet aggregation by studying changes in optical density and ATP release in platelet-rich plasma. A significant inhibition of secondary platelet aggregation from 27% to 36% was observed in the men taking regular exercise. These findings give new insight into the possible protective effects of exercise against the risk of ischemic heart disease. PMID- 3533317 TI - Reversal of cardiac transplant rejection without massive immunosuppression. AB - Although cyclosporine has decreased the severity of acute cardiac transplant rejection, most centers have continued to use high-dose intravenous steroids to treat acute rejection. To minimize the morbidity of antirejection therapy, acute rejection episodes in 37 cardiac transplant recipients were treated prospectively with only a boost of oral prednisone. Cyclosporine was continued at the same maintenance dose while oral prednisone was increased to 100 mg/day for 3 days, then rapidly tapered over 1 week to the maintenance dose. Seventy-six of 85 acute rejection episodes (90%) showed histologic resolution of mycocyte necrosis on repeat biopsy. Three acute rejection episodes (3.5%) resolved only after "rescue therapy" with intravenous steroid, and an additional three episodes (3.5%) required the combination of intravenous steroid and rabbit antithymocyte globulin to effect resolution. In addition, three acute rejection episodes (3.5%) resulted in graft loss. This was fatal in two patients and one patient underwent successful retransplantation. Oral steroid therapy alone is adequate therapy for most acute rejection episodes in cyclosporine-treated heart transplant recipients, and low infectious morbidity and mortality has been associated with this antirejection protocol. PMID- 3533318 TI - Noninvasive monitoring of cardiac allograft rejection by intramyocardial electrogram recordings. AB - Rejection after cardiac transplantation was monitored in nine patients by control of intramyocardial electrogram (IMEG) recordings transmitted by an implanted telemetric pacemaker. Under immunosuppression with cyclosporin A and prednisolone, 33 out of a total of 119 endomyocardial biopsy specimens showed moderate rejection (infiltrate with myocytolysis). Twenty-nine of these rejection episodes could be correctly predicted from IMEG recordings with a voltage drop above 15% used as a criterion (sensitivity 87.9%). Eighty-three of 86 negative biopsy results corresponded to negative IMEG results (specificity 96.5%). In this group of patients, amplitude of body surface electrocardiograms was not useful for the diagnosis of rejection because of the broad range of spontaneous variation. Control of IMEG voltage amplitude appears to be more accurate than body surface electrocardiogram amplitude in the detection of rejection episodes. Thus the onset of rejection during biopsy intervals is more readily detected and treatment is instituted earlier. The method is suitable for ambulatory patient monitoring by the patient's local physician. PMID- 3533319 TI - Early function of cardiac homografts: relationship to hemodynamics in the donor and length of the ischemic period. AB - Twenty-four of 124 heart transplant recipients in our study group died in the perioperative period. In five patients the cause of death was unknown even after postmortem examination. The possibility that the cause of death was due either to poor donor selection or poor preservation of the donor heart was evaluated by reviewing the length of ischemic time of the cardiac homografts and the need for inotropic support in the donors before the hearts were harvested. Results of our retrospective analysis indicate that inotropic support in the form of 2 to 10 micrograms/kg/min dopamine and an ischemic time of up to 4 hr do not influence the early survival of heart transplant recipients. PMID- 3533320 TI - In vivo probes: problems and perspectives. AB - Devices constructed for potential use as invasive bioprobes incorporate a selective receiving site for molecular or ionic recognition, and a transducer which is capable of translating a perturbation of physical chemistry of the determinant-site reaction (interaction) into a usable signal. Four types are envisioned--implants for general hospital use, transient-use probes to replace classical blood tests, short-term implantable probes and the long-term variety. Performance criteria are selectivity, sensitivity, fast response, site reversible, small, rugged, inexpensive, biocompatible, calibratible, facile use by non-expert personnel and ease of telemetry. These demands, not surprisingly, create enormous challenges to the sensor specialist. With respect to biocompatibility the sensor must not be involved in infection, clot formation or antigenic response, and, furthermore, protein adsorption, etc., which can affect the sensor response should be avoided. Calibration remains a problem of monumental proportions. Many devices drift from calibrated levels even in in vitro experiments, let alone in the implanted milieu. One solution has been to carry out on-line switching between patient blood and standard solutions. However, this type of approach leaves a lot to be desired with respect to portability. Another method which is attracting increasing attention is the chemometric or artificial intelligence system involving compensation by multi sensor array configurations. Sensitivity and limit-of-detection have attracted little research due to the overwhelming nature of other difficulties. In the present paper we evaluate a number of these technical problems and discuss the architecture of devices that are currently available. Finally, some thoughts as to priorities for re-directing sensor research in the bioprobe area are presented. PMID- 3533321 TI - The responsible use of the clinical laboratory. AB - Concern about spiralling health care costs is leading to a reexamination of the use of the clinical laboratory and other diagnostic technologies in patient care. Laboratory resources are viewed as limited and their use must be measured to meet real needs. Several observers have noted significant overutilization and inappropriate utilization of laboratory services by patient care physicians, especially at teaching hospitals. Efforts to modify physician behavior by use of educational programs, positive incentives and similar means have been largely disappointing. Several laboratory-based initiatives aimed at bringing about more responsible use of the laboratory are discussed. Improved education in the judicious use of the laboratory, beginning in medical school and carrying on through the early stages of a physician's career, is considered the most promising long-term approach. This, along with improved communication between the laboratory and the clinic, is the avenue most likely to bring about more responsible use of the clinical laboratory in health care. PMID- 3533322 TI - A different laboratory for the future. AB - The laboratory of the future will not be exclusively centrally placed in the hospital setting, and Laboratory Medicine will not be hospital-based to the extent it has been in the past. The requirement that Laboratory Medicine support necessary and beneficial clinical care remains. Unless laboratory personnel pay greater attention to all aspects of laboratory performance, including test ordering and reporting, the viability of Laboratory Medicine as a specialty may be jeopardized. PMID- 3533323 TI - Health care delivery models: emerging trends in the delivery of health services. AB - Rising costs, a higher proportion of elderly in the population, proliferation of high technology and increased knowledge about efficient and effective service provision have all led to increased cost-consciousness in the health system. Historically, regulatory approaches have provided equity of access and funding, but for controlling costs they have now become inappropriate because they leave the mix of services untouched. In the future, regulatory approaches may make more use of guidelines and algorithms for care (the "soft" regulatory route), or they may directly control the supply of providers and other resources in the health system (the "hard" regulatory route). An alternative is the competition approach which allows choices by consumers on where to obtain health care based on the efficiency with which those services are provided. The danger in this approach is the potential for equity to be compromised; this may be addressed by combining the regulatory and competitive approaches. PMID- 3533325 TI - Quantitation of human serum apolipoprotein B by enzyme immunoassay in excess antigen. AB - A solid phase enzyme-linked immunoassay based on the 'sandwich' principle was developed for quantitative measurement of apolipoprotein B (Apo B) in human normal or hyperlipoproteinemic sera. The solid phase (polypropylene multi-finned sticks) coated with an excess of sheep anti-Apo B immunoglobulins was incubated with antigen (standards and unknown specimens) and affinity-purified anti-Apo B antibodies conjugated with horseradish peroxidase. In this principle, antigen and conjugate were in excess and fixed amount respectively. A part of antigen was fixed on multi-finned sticks, bound or not to conjugate. Unbound materials were removed by washing. Solid phases were next incubated with the enzyme substrate solution to develop a color which is inversely related to the amount of Apo B. The best technical conditions for the assay were determined. The method was characterized according to precision, sensitivity and accuracy. It yielded values that compared favorably with those obtained by another enzyme-linked immunoassay and by electroimmunoassay. PMID- 3533324 TI - A simple and sensitive fluorometric immunoassay for the measurement of immunoglobulins in culture medium of mitogen-stimulated lymphocytes. AB - A sensitive fluorescent immunoassay (FIA) for the quantification of immunoglobulins (IgG, IgM) in culture supernatants of human lymphocytes has been developed and compared with an ELISA method. FIA, like the ELISA assay, detects nanogram amounts of immunoglobulin (Ig), and has a high degree of specificity and reproducibility. The intra-assay coefficient of variation was about 5% in both test systems; the inter-assay coefficient of variation was approximately 9% in FIA and 13% in ELISA. Quantification of supernatants of lymphocyte cultures by both systems showed a high degree of concordance (correlation coefficient r = 0.93). The advantages of the FIA procedure are the short assay time and the more direct acquisition of signal. PMID- 3533326 TI - Alterations in renal vascular reactivity induced by chronic central administration of captopril in the spontaneously hypertensive rat. AB - We have previously demonstrated that chronic intracerebroventricular (ICV) administration of captopril attenuates the development of hypertension in young SHR in association with a depression in whole animal reactivity to vasoactive agents and an increased baroreflex sensitivity. In the present study we analyzed vascular reactivity in perfused kidneys from SHR treated with captopril or vehicle to determine whether the depression in reactivity was due to changes in baroreflex activity or an effect on the vasculature. Captopril (1.25 micrograms/hr) was infused (osmotic mini pumps) for 4 weeks. Vascular reactivity to norepinephrine, angiotensin and vasopressin was assessed in isolated kidneys perfused with an artificial medium at constant flow. SHR treated with ICV captopril showed a significantly lower arterial pressure and basal renal vascular resistance than SHR treated with ICV vehicle or IV captopril. In addition, these rats showed decreased vascular reactivity to all vasoactive agents tested as signified by a shift in the dose-response curves to the right with an increase in threshold (ED16) and ED50. Kidneys from WKY treated with ICV captopril also showed a decrease in vascular reactivity in comparison to WKY treated with ICV vehicle. Our data suggest that captopril, through a central action, attenuates the development of hypertension by decreasing vascular reactivity to vasoconstrictors. PMID- 3533327 TI - The influence of acute stress on active and inactive renin in the rat. AB - The purpose of this study was to determine the influence acute stress on the plasma levels of active and inactive renin in the rat. Active and inactive plasma renins were measured in calm unanesthetized normal Wistar rats (indwelling catheter) and compared to values obtained after handling, anesthesia and decapitation. All maneuvers resulted in an increase of active renin. Only anesthesia significantly reduced inactive renin. It is concluded that acute stress can significantly change the ratio of active and inactive renins in rat plasma. These changes must be taken into consideration when the influence of "physiological or pharmacological" alterations of these enzymes are under investigation. PMID- 3533328 TI - Hormonal and cardiovascular effects of losulazine hydrochloride in relation to sodium balance in nonhuman primates. AB - Losulazine hydrochloride, a peripheral norepinephrine-depleting agent, was studied in conscious sodium-replete and sodium depleted cynomolgus monkeys. Blood pressure, heart rate, plasma renin activity, and plasma catecholamines were monitored before and after the oral administration of losulazine at a dose which caused a submaximal hypotension in sodium-replete monkeys. The hypotension observed in sodium depleted monkeys was not significantly different from that observed in sodium-replete monkeys. The hypotension from that observed in sodium replete monkeys. The hypotension observed in both sodium states was accompanied by quantitatively similar decreases in plasma norepinephrine concentrations in the absence of significant alterations of heart rate and plasma renin activity. These results were consistent with the conclusion that losulazine reduced arterial blood pressure in nonhuman primates via peripheral norepinephrine depletion. These data also indicated that the hypotensive effect of losulazine in conscious monkeys was not dependent on alterations in renin-angiotensin system activity or on the state of sodium balance. PMID- 3533329 TI - Normal growth and techniques of growth assessment. AB - The shape of the human growth curve is described and illustrated. Growth studies may be longitudinal, cross-sectional, mixed longitudinal or linked-longitudinal; each has advantages and disadvantages, and each requires appropriate statistical methods for handling the data. Standards for height and height velocity for use in a clinical setting wherein follow-up over several years is presumed are described and illustrated. Such standards have to take into account tempo of growth at ages over nine years. Cross-sectionally derived standards do not do this and are not suitable for clinical use. The techniques of measurement of height, sitting height and skinfolds are described and illustrated. Growth and development during puberty is described; there are changes in body composition as well as in body size and shape. Standards for pubertal stages of breasts, pubic hair and genitalia are given and emphasis is laid on the great variation in both the timing and the duration of these pubertal changes. Measurement of developmental age is discussed. The Greulich-Pyle and Tanner-Whitehouse methods for skeletal age are described. These methods can be used for predicting adult height which is useful both in diagnosis and in following the effects of treatment. In diagnosis the predicted adult height is compared to the range of expected heights in the children of the particular pair of parents concerned (the so-called 'target' range of heights) to see if smallness is simply due to delay. Change in Tanner-Whitehouse predicted height occurs on successful treatment of, for example, growth hormone deficient short stature, and is thus a guide to the success of treatment. Standards are also given for height of children from age two to nine inclusive, with allowance for height of their parents. PMID- 3533330 TI - Somatomedin-C/insulin-like growth factor I in acromegaly. PMID- 3533331 TI - Class II antigens in Hashimoto thyroiditis. I. Synthesis and expression of HLA-DR and HLA-DQ by thyroid epithelial cells. AB - Aberrant expression of HLA-DR antigens on epithelial cells is seen in various organ-specific autoimmune disorders including Hashimoto thyroiditis (HT). Expression of HLA-DQ has so far not been demonstrated on these cells. We report here that thyroid epithelial cells (TEC) in HT, in addition to the known aberrant expression of HLA-DR, coexpress HLA-DQ antigens. Furthermore we provide evidence that class II antigens are synthesized by TEC themselves by demonstration of intracellular HLA-DR gamma-chain. These findings support the theory that TEC may be able to present (auto)antigens in vivo thus perhaps contributing to the perpetuation of thyroid destruction. As expression of class II antigens on TEC was never observed in non- or weakly infiltrated areas, we propose that infiltration by T cells is necessary to induce this aberrant expression of class II antigens. PMID- 3533332 TI - Class II antigens in Hashimoto thyroiditis. II. Expression of HLA-DR on infiltrating mononuclear cells in peripolesis. AB - Surgical specimens from patients with Hashimoto thyroiditis (HT) or colloid goiter (CG) were analyzed using an immunofluorescence double staining technique to characterize the infiltrating mononuclear cells (MNC) and to determine the possible expression of HLA-DR antigens by these cells. In HT the majority of infiltrating MNC were T cells. In the interstitium T cells with helper/inducer phenotype (Leu 3a+) were more abundant than those with suppressor/cytotoxic phenotype (OKT8+) and approximately 10-25% of all T cells expressed HLA-DR. Among the cells in peripolesis [i.e., protruding between thyroid epithelial cells (TEC)] OKT8+ cells were observed more frequently than Leu 3a+ cells, expression of DR antigens being 7 and 12%, respectively. The occurrence of Leu 3a+ cells in peripolesis is in marked contrast to the findings in colloid goiter where the intraepithelial population of MNC is almost exclusively composed of OKT8+ cells. The various ways in which the peripoletic Leu 3a+ cells could contribute to the special pathogenesis of HT are discussed. PMID- 3533333 TI - Factors influencing treatment planning in oral rehabilitation. PMID- 3533334 TI - Hyperlipidemia after renal transplantation in children on alternate day corticosteroid therapy. AB - We studied the serum lipid profiles of 29 children, 3.9-17.9 years of age who were 0.6-7.6 years after renal transplantation (Tx). Twenty normoglycemic and non proteinuric children had a well functioning allograft and 5 children had reduced renal function. Both groups were at least 7 months on alternate day corticosteroid (ADCS) therapy. Four additional patients had good renal function but were only 2.3 +/- 0.5 months on an ADCS regimen. Fifteen normal children served as controls. The levels of serum triglycerides (STG) and total cholesterol (CHOL) were elevated and high-density lipoprotein CHOL (HDL-CHOL) were low in all patients compared to control subjects (p less than 0.01). Their cardiovascular risk factor (CHOL/HDL-CHOL) was increased. The lipid abnormalities were most prominent in Tx patients with reduced graft function. These data show that treatment with ADCS does not prevent post-Tx hyperlipidemia. More insight is needed into the mechanisms responsible for the hyperlipidemia after Tx in order to reduce possible future morbidity (and mortality) from premature cardiovascular disease in this group of young, high-risk patients. PMID- 3533335 TI - 6-keto-PGF1 alpha levels and prostacyclin therapy in 2 adult patients with hemolytic-uremic syndrome. AB - Evidence supports the hypothesis that plasma prostacyclin activity is deficient in hemolytic-uremic syndrome (HUS). We studied 2 adult patients with HUS. Plasma levels of 6-keto-PGF1 alpha, the stable metabolite of prostacyclin, were measured by radioimmunoassay. Both patients were found to have elevated 6-keto-PGF1 alpha levels. These findings are in contradiction with the prostacyclin deficiency hypothesis and with earlier reports of low or undetectable plasma levels of this metabolite. The patients were treated with IV prostacyclin after a single plasma exchange. The first patient, admitted with advanced renal failure, obtained a rapid remission but renal function did not recover; the second patient, admitted with a less pronounced degree of renal failure, reacted slowly to therapy but renal function partially recovered. We believe that, if any benefit is to be expected from prostacyclin therapy in HUS, it should be started early in the course of the disease. PMID- 3533336 TI - Rupture of the spleen in hemodialyzed patients. PMID- 3533337 TI - Are anti-platelet drugs of value in the management of patients with chronic stable angina? A study with ticlopidine. AB - Thirty patients (28 males and 2 females) aged 46-68 years with established chronic stable angina were studied in a placebo-controlled double-blind crossover trial to examine the efficacy of oral ticlopidine (an antiplatelet agent) 250 mg twice daily. The baseline mean +/- SEM exercise time of 7.5 +/- 0.5 min rose to 8.1 +/- 0.6 min after 2 weeks of placebo run-in, 8.8 +/- 0.7 min after 4 weeks of double-blind placebo, and to 9.2 +/- 0.6 min with ticlopidine therapy; none of these changes achieved statistical significance. Similarly, time to the development of 1 mm ST-segment depression, maximal ST-segment depression, heart rate, and rate-pressure product failed to show any statistically significant changes during ticlopidine therapy. Ambulatory electrocardiographic monitoring showed that the mean number of episodes of ST-segment depression greater than 1 mm remained unaltered during ticlopidine therapy. Four patients (3 during placebo, 1 during ticlopidine) stopped treatment prematurely because of unstable angina and two because of adverse effects. Our data suggest that ticlopidine has no significant effect on objective indices of myocardial ischemia in patients with chronic stable angina, that placebo has no effect on the objective indices of myocardial ischemia derived from exercise testing and ambulatory electrocardiographic monitoring, and that exercise testing and ambulatory electrocardiographic monitoring in patients with chronic stable angina pectoris are reproducible. PMID- 3533338 TI - Disease distributions in patients with multiple patterns of nuclear staining detected by FANA (immunofluorescent antinuclear antibody) tests. AB - The present study examines disease distributions in patients with multiple nuclear immunofluorescent staining patterns detected by FANA testing. Among 4003 consecutive patient sera examined, we found that 813 yielded conventional well defined single staining patterns, while 46 produced multiple pattern combinations. Homogeneous plus nucleolar was the most prevalent combination, and 5 other combinations were identified. Multiple FANA patterns occurred independently of FANA titers and antibodies to dsDNA and Sm. Compared to control patients with single FANA patterns, patients with multiple patterns were found to have an increased frequency of SLE and diseases of the scleroderma spectrum (DDS) while rheumatoid arthritis (RA) and non-immunologic disease were reduced in frequency. These specific correlations indicate that recognition of multiple FANA patterns adds useful diagnostic information to existing antinuclear antibody testing procedures. PMID- 3533339 TI - Immune deposits in oral mucosa, skin and kidney in patients with systemic lupus erythematosus. AB - Biopsies were obtained simultaneously from normal oral mucosa, sun-protected and sun-exposed skin in patients with suspected or diagnosed systemic lupus erythematosus, in order to compare the deposition of immunoproteins. In patients with renal involvement a kidney biopsy was also studied. Immunofluorescence findings at the connective tissue-epithelial junction (lupus band test) showed a good correlation between keratinized oral mucosa and sun-protected skin in 18 sets of biopsies while sun-exposed skin frequently showed more immune reactants. No close connection could be found between the deposition of immune reactants in skin/mucosa and kidney. It is concluded that diagnostic use of the lupus band test performed on normal mucosa has the same value as that on sun-protected skin. PMID- 3533341 TI - Successfully treated splenic abscess in a systemic lupus erythematosus patient. A case report and review of the literature. AB - A patient with Systemic Lupus Erythematosus (SLE) and solitary splenic abscess is described. This seems to be the first such case diagnosed clinically and treated successfully, reported in the literature. A high index of suspicion is important for the diagnosis of this relatively rare condition, which is confirmed by splenic scintigraphy and selective arteriogram. Prompt splenectomy and appropriate antibiotics are curative. PMID- 3533340 TI - NSAID ionisation in the management of soft-tissue rheumatism: role played by the drug, electrical stimulation and suggestion. AB - Four treatments for soft-tissue rheumatism--sham ionisation, placebo ionisation, and pharmacological ionisation with pirprofen (two-dose levels)--were assessed in a randomized double-blind, between-patient controlled trial in 73 outpatients affected by scapulo-humeral periarthritis or elbow epicondylitis. Treatment lasted two weeks (5 sessions a week). Progress was measured by patient's assessment on pain at rest and on movement and by physician's assessment on functional impairment. At two weeks each treatment was associated with a significant degree of improvement; however, pharmacological ionisation produced a significantly higher improvement in symptoms. No differences were detected between sham ionisation and placebo ionisation. These results suggest that the ionisation procedure displays per se a moderate therapeutic effect which seems to be due more to a simple placebo effect than to the biological effect of electricity. PMID- 3533342 TI - Jaccoud's arthropathy in adult dermatomyositis. AB - A patient with dermatomyositis developed a non-erosive deforming arthropathy of the hands and feet, consistent with Jaccoud's arthropathy. This type of arthropathy has not been described in dermatomyositis or polymyositis. PMID- 3533343 TI - The life and work of John Charnley (August 29, 1911-August 5, 1982) PMID- 3533344 TI - Limb salvage and prosthetic joint reconstruction for low-grade and selected high grade sarcomas of bone after wide resection and replacement by autoclaved [corrected] autogeneic grafts. AB - Wide resection is an acceptable alternative to amputation for the management of primary sarcomas of the long bones or pelvis. The resected bone can be debrided of gross tumor tissue, autoclaved, and then replaced over intramedullary fixation to reconstruct the limb anatomically. The procedure can be combined with prosthetic reconstruction of adjacent joints with sufficient strength to allow early unprotected weight-bearing. Resection and replacement for 28 low-grade (G1) and 14 selected high-grade (G2) sarcomas were performed in 42 patients. The hemipelvis was resected and replaced four times, the proximal or distal femur 28 times, the proximal or distal tibia eight times, and the proximal humerus two times. Replacement of an adjacent joint, most commonly using a long-stemmed hip or knee prosthesis, was accomplished in 33 patients. All patients had been followed for a minimum of two years, nine months after treatment. The mean follow up period is four years, ten months. Six individuals, all with high-grade sarcomas, developed tumor-related complications. Two evidenced a local recurrence of tumor, and four developed distant metastases. None of the patients with low grade sarcomas developed a recurrence or metastases. Fifteen patients suffered complications unrelated to tumor control; 13 required reoperation, including two who required amputations for persistent pseudoarthrosis and graft infection, respectively. There was one other infection, successfully eradicated by drainage followed by local and systemic antibiotics. Due to mechanical failure or loosening, six patients were treated by successful revision of their joint arthroplasties. Two years after initial surgery, five patients had failures of union at the graft-host junction. Four healed after cancellous grafting and one was revised to a custom prosthesis. There were no late fatigue fractures of the grafts. The technique does not compromise the margins for adequate tumor resection. It preserves a graft strong enough to support a joint arthroplasty and to allow early weight-bearing with a low risk of pseudarthrosis or late fatigue fracture. PMID- 3533345 TI - A tribute to Sir John Charnley (1911-1982). PMID- 3533346 TI - The classic. A clean-air operating enclosure. By John Charnley. 1964. PMID- 3533347 TI - The classic. Evolution of medullary fixation of fractures by the longitudinal pin. By Leslie V. Rush, and H. Lowry Rush. 1949. PMID- 3533348 TI - [Disappearance of downbeat nystagmus with stereotaxic operation (ventralis intermedius nucleus thalamotomy)--a case of cerebro-vascular accident with general postural tremor]. PMID- 3533349 TI - [The biochemical and morphological response of proteases and thiol protease inhibitor in the nerve tissues, liver and kidney of methylmercury chloride treated rats]. PMID- 3533350 TI - Sonographic and scintigraphic evaluation of gallbladder duplication. AB - The incidence of unilobar or bilobar pathology is disproportionately high in patients with duplication of the gallbladder. The results of ultrasound and Tc 99m DISIDA studies in one case of gallbladder duplication are presented. An awareness of gallbladder anomalies may improve the accuracy of hepatobiliary imaging by eliminating some false-negative results. PMID- 3533351 TI - Flip-flop phenomenon in radiohippuran renal imaging. A sign of obstructive nephropathy. AB - In the dynamic radionuclide brain study, decreased flow in one cerebral hemisphere during the arterial phase followed by relatively increased radioactivity as compared with the contralateral hemisphere has been termed the flip-flop phenomenon, and reflects the development of collateral circulation to the affected side. In I-131 Hippuran renal imaging, relatively decreased activity in one kidney frequently is observed during the initial phase of the study, and is followed by a gradual increase of radioactivity in the late images when compared with the contralateral kidney. To evaluate the significance of this renal flip-flop phenomenon, the studies from 23 patients with these findings were retrospectively compared with the clinical data and findings from other diagnostic studies (CT, ultrasound, intravenous pyelogram, autopsy). Partial obstruction of the renal collecting system was found in all 23 patients. The causes were various malignant tumors in nine patients (colonic carcinoma, three patients; transitional cell carcinoma, three patients; prostatic carcinoma, two patients; seminoma, one patient), ureteropelvic obstruction in three patients, papillary necrosis in one patient, and ureteral fibrosis in one patient. The flip flop phenomenon reflects asymmetric renal tubular function with decrease (prolonged parenchymal transit time) in the affected kidney as a result of ipsilateral obstruction of the collecting system, while contralateral renal function remains normal or relatively normal. The presence of the flip-flop phenomenon in an I-131 Hippuran renal study suggests the existence of some degree of collecting system obstruction that has persisted long enough to result in renal parenchymal damage. PMID- 3533352 TI - A comparison between four simple methods for measuring glomerular filtration rate using technetium-99m DTPA. AB - Numerous centers perform glomerular filtration rate (GFR) measurements on patients undergoing renal imaging with Tc-99m DTPA. GFR measurement, however, does involve multiple blood samples taken over a 4-hour period, and this has led to attempts to simplify the technique by reducing the number of blood samples required and hence diminish the time taken to perform the test and the inconvenience to the patient. Four different simplified techniques for measuring GFR that have been reported in the literature are compared with a reference 2 blood sample method. Three of the methods do not require any blood samples but have standard errors of greater than 20 ml/min in adults and greater than 14 ml/min in children. The other method requires one blood sample, and if this is taken at 2 hours postinjection, the standard error is 9 ml/min in adults and 5 ml/min in children. The latter method is suitable for routine use in renography when accuracy is not of paramount importance. PMID- 3533353 TI - The human placenta. Anatomy and morphology. AB - This review presents basic aspects of placental morphology with particular reference to the regional specialization of human placental tissues. Intrauterine visualization of the placenta is now possible with new non-invasive methods. Echotomographic ultrasound images of the placenta in vivo and in vitro are of the greatest value for clinical and pathological diagnosis. X-ray computed tomography, though it cannot be applied to pregnant women, is invaluable for the study of circulatory and pathologic changes in the placenta isolated post partum. Nuclear magnetic resonance imaging is another useful adjunct not only for placental localization but also to detect changes of placental morphology with an accuracy almost as good as ultrasonography. Fourier-transform spectroscopy now offers a unique opportunity to obtain computed biochemical data on the metabolic evolution of the human placenta. PMID- 3533354 TI - Placental synthesis. PMID- 3533355 TI - Immunology of the placenta. AB - The central issues of the immunology of the placenta are poorly defined. As an allograft its success almost certainly depends on the absence of transplantation antigens from syncytiotrophoblast. The placenta is an imperfect immune barrier between mother and fetus. Rhesus isoimmunization is one well-known consequence but maternal graft-versus-host disease is another, although much rarer. The placenta performs an important function by transferring maternal IgG to the fetus and filters out potentially harmful cytotoxic antibodies. However, autoantibodies may, in rare circumstances, cause passively acquired fetal autoimmune disease. Direct maternal immune attack on the placenta is not a clear pathological entity but may occur with placental villitis and pemphigoid gestationis; and may contribute to recurrent abortion of unknown aetiology or to pre-eclampsia. PMID- 3533356 TI - Pathology of the placenta. AB - The placenta has a considerable functional reserve capacity, easily repairs ischaemic damage, is able to compensate for toxic injury and does not appear to age. Most of the macroscopically visible abnormalities of the placenta are of no functional significance, the major exception to this general banality being the uncommon large haemangioma which can cause complications in the mother, fetus and neonate. Most of the histological abnormalities seen in the placental villi represent a reaction to alterations in either maternal or fetal blood flow through the placenta, but a failure of adequate maturation of the villous tree may impair the functional efficiency of the placenta, as may defective trophoblastic differentiation. Infections of the placenta are important but do not influence placental function, whilst there is currently no firm evidence that the placenta ever suffers immune-mediated damage. Intrinsic placental 'insufficiency' is extremely rare and it is becoming increasingly clear that this clinical syndrome is usually due to a restricted supply of maternal oxygen and nutrients as a result of inadequate transformation of the spiral arteries into uteroplacental vessels. This failure of placentation represents an abnormality of the relationship between fetal and maternal tissues at a relatively early stage of pregnancy, and it is only by gaining a better understanding of this relationship that the problems posed by such conditions as pre-eclampsia and idiopathic intrauterine growth retardation will be answered. PMID- 3533357 TI - Biophysical assessment of placental function. PMID- 3533358 TI - Biochemical assessment of placental function: early pregnancy. PMID- 3533359 TI - Biochemical assessment of placental function--late pregnancy. PMID- 3533360 TI - Placental proteins in oncology. AB - Many placental proteins appear in the serum and tumours of patients with malignant disease, but few have achieved an established position in clinical management. Chorionic gonadotrophin is a sensitive and effective marker for trophoblastic disease. Gonadal germ cell tumours containing extraembryonic structures can secrete hCG and SPl, which both may provide unique clinical information about recurrent disease. Placental proteins belonging to the PP series are an interesting new group which has added to our knowledge of the biology of tumours. However, none of them has yet proven to be important in clinical practice. Placental alkaline phosphatase isoenzymes are secreted by seminomas and dysgerminomas, and, in some clinics, they are routinely examined for monitoring treatment of these tumours. Whereas the clinical usefulness of the above markers is well established for the monitoring of treatment and early detection of recurrent disease, none of them can be used for the screening of cancer in an apparently healthy population. PMID- 3533361 TI - Chorion villus biopsy. AB - Chorion villus biopsy answers the pressing need for early prenatal diagnosis. The technique is carried out at about 10 weeks gestation and in most instances this tissue is amenable to direct analysis without culture. This technique is particularly suitable for gene probe diagnosis. However, it is now widely offered for cytogenetic diagnosis on the basis of maternal age and some 10 000 patients have been reported to a Central Registry. The procedure-related abortion rate in skilled hands would seem to be about 2-3%, although this is probably lower with the new transabdominal route. Despite the great deal of attention which is focused on this technique, it is still too early to tell whether chorion villus biopsy will replace amniocentesis as the standard method of prenatal diagnosis. PMID- 3533362 TI - Haemorrhage from the placental site. PMID- 3533363 TI - The complexities of solving the problem of human malformations. AB - Although major advances have been made in the epidemiology of birth defect surveillance, in intrauterine diagnosis and treatment, and in clarifying the role of environmental factors, we are uncertain about the causes of the majority of birth defects. Miseducation of the public and some professional groups has led to an overemphasis on the importance of drugs and chemicals as causes of birth defects and has resulted in major health and social problems. Many problems remain in preventing or reducing the incidence of human malformations, which may be solved by the combined efforts of clinical surveillance programs and advances in the fields of genetics, developmental biology, and biochemistry. PMID- 3533364 TI - The law and congenital malformations. AB - In 1967, I indicated that the number of lawsuits involving malformed infants seemed to be increasing, not realizing that the increase was foretelling an epidemic. The reasons for this epidemic are described in this paper and are due to attitudes and happenings in the medical, legal, and lay sectors of our society. Case histories have been used to demonstrate that the litigation process can produce pain and suffering. The case histories also indicate that, when the members of family become orchestrated by a lawyer into the position of devoting a great deal of their energy to litigation, many high priority family responsibilities are ignored and important ethical standards are distorted. To win at all costs may be good for a football team, but it is obviously bad for a family. We must take drastic changes in the method of supporting the victims of disease and injury so that litigation is no longer necessary to compensate and support patients and families, whether negligence is or is not a factor. Recommendations for diminishing the malpractice crises include: education of the patient about the consequences of the litigation process--that only a small portion of the malpractice premium dollar ever reaches the patient and that most human malformations are not produced by medical negligence, altering the deteriorating image of the physician, reversing the increase in irresponsible medical expert testimony and changing the laws pertaining to medical licensure and loss of medical licensure, improving the health care system, making the awards more realistic by taking into consideration community and insurance resources of the patient and by eliminating lump sum awards and "punitive" awards, decreasing lawyer representation in legislative bodies so that legal reforms will become a possibility, and eliminating the contingency fee system by replacing it either with legal insurance so that the attorney is working for the patient or by adopting no-fault malpractice insurance with binding arbitration so that the negligently injured patient is compensated properly. The process of litigation rarely solves the patient's problems and frequently develops into a disease all its own. PMID- 3533365 TI - The thalidomide syndrome: risks of exposure and spectrum of malformations. AB - Echos of the 1959 to 1961 thalidomide disaster are still with us in the form of the continuing appearance, although more rarely, of similarly malformed children. A teratologic timetable could be fashioned retrospectively, supporting the concept that different body parts and systems have periods of vulnerability and of resistance to thalidomide, probably the most potent primate teratogen known. Something between one in every two to one in every ten fetuses exposed at the critical development period were affected. The clinical affects are described from the literature on approximately 2500 children, and from extensive personal experience, and a complex though finite pattern of malformations is described, indistinguishable from sporadic nonthalidomide cases of malformations that continue to occur. PMID- 3533366 TI - Causes of limb reduction defects: the contribution of fetal constraint and/or vascular disruption. AB - Causes for limb defects are often heterogeneous and difficult to discern purely on the basis of their anatomic nature. Because limb defects are common, and because their causes are poorly understood, their occurrence frequently generates concern over the role of prenatal events and exposures. This article serves to guide clinicians as to the proper work-up for such congenital limb anomalies. This evaluation should include a detailed family history, examination of limbs of close relatives, teratogenic history (with full knowledge of which teratogens do and do not cause limb anomalies), evaluation of the uterus, pathologic evaluation of the placenta, and thorough examination of the affected infant for associated defects. PMID- 3533367 TI - Diagnosing congenital malformation in utero: ultrasound. AB - The value of antenatal ultrasound in the detection of fetal defects is discussed in this article. The ways in which ultrasound diagnoses are made are reviewed as well as several of the most important anomalies that may be detected with this diagnostic tool. PMID- 3533368 TI - The effects of embryonic and fetal exposure to x-ray, microwaves, and ultrasound. AB - The term radiation evokes emotional responses both from lay persons and from professionals. Many spokespersons are unfamiliar with radiation biology or the quantitative nature of the risks. Frequently, microwave, ultrasound, and ionizing radiation risks are confused. Although it is impossible to prove no risk for any environmental hazard, it appears that exposure to microwave radiation below the maximal permissible levels present no measurable risk to the embryo. Ultrasound exposure from diagnostic ultrasonographic imaging equipment also is quite innocuous. It is true that continued surveillance and research into potential risks of these low-level exposures should continue, but at present ultrasound not only improves obstetric care but also reduces the necessity of diagnostic x-ray procedures. In the field of ionizing radiation, we have as good a comprehension of the biologic effects and the quantitative maximum risks as of any other environmental hazard. Although the animal and human data support the conclusion that no increases in the incidence of gross congenital malformations, intrauterine growth retardation, or abortion will occur with exposures less than 5 rad, that does not mean that there are definitely no risks to the embryo exposed to lower doses of radiation. Whether there exists a linear or exponential dose-response relationship or a threshold exposure for genetic, carcinogenic, cell-depleting, and life-shortening effects has not been determined. In establishing maximum permissible levels for the embryo at low exposures, refer to Tables 4, 5, 6, 8, and 9. It is obvious that the risks of 1-rad or 5-rad acute exposure are far below the spontaneous risks of the developing embryo because 15 per cent of human embryos abort, 2.7 to 3.0 per cent of human embryos have major malformations, 4 per cent have intrauterine growth retardation, and 8 to 10 per cent have early- or late-onset genetic disease. The maximal risk attributed to a 1-rad exposure, approximately 0.003 per cent, is thousands of times smaller than the spontaneous risks of malformations, abortion, or genetic disease. Thus, the present maximal permissible occupational exposures of 0.5 rem for pregnant women (see Table 10) and 5 rem for medical exposure, are extremely conservative. Medically indicated diagnostic roentgenograms are appropriate for pregnant women, and there is no medical justification for terminating a pregnancy in women exposed to 5 rad or less because of a radiation exposure.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3533369 TI - Mechanism of known environmental teratogens: drugs and chemicals. AB - Basic principles of teratology and mechanisms of teratogenesis applicable to human exposures to environmental drugs and chemicals are discussed. The available clinical and experimental animal literature on environmental agents alleged or known to cause human malformations is critically reviewed and summarized. PMID- 3533370 TI - Prolonged blockade of opioid effect with oral nalmefene. AB - In a placebo-controlled, double-blind study we evaluated the ability of a single 50 mg oral dose of nalmefene to block the effects of intravenous opioid challenge (2 micrograms/kg fentanyl). Fentanyl-induced respiratory depression (CO2 responsiveness), analgesia (tourniquet ischemia), and subjective effects were totally blocked for 48 hours and showed only minimal breakthrough 72 hours after nalmefene. Plasma concentration-time data for nalmefene indicate good oral bioavailability and a prolonged terminal elimination phase (mean t1/2 11.1 hours). These findings suggest that nalmefene could provide prolonged effectiveness in limiting emergence of opioid effects during addiction therapy. PMID- 3533371 TI - The hemodynamic effects of aminophylline and salbutamol alone and in combination. AB - We have studied the hemodynamic effects of salbutamol and aminophylline in eight patients with obstructive airways disease. Aminophylline was administered intravenously as a bolus and an infusion for 150 minutes. Salbutamol was administered by nebulizer after 30 minutes and at the end of the infusion. Compared with placebo, salbutamol decreased ventricular afterload (decreased preinjection period and preinjection period to left ventricular ejection time ratio and diastolic blood pressure). Aminophylline decreased total electromechanical systole, corrected for heart rate, only (mean decrease -10.7 msec; range -6.5 to -15.1), indicating a mild positive inotropic effect. When both active treatments were combined, the effect on total electromechanical systole, corrected for heart rate, was potentiated (mean decrease -23.3 msec; range -19.1 to -33.1). Neither aminophylline nor the combination affected heart rate or blood pressure, suggesting no increase in myocardial oxygen consumption. The hemodynamic effects of aminophylline and salbutamol are potentiated in combination but are unlikely to be harmful in patients with obstructive airways disease. PMID- 3533372 TI - Piretanide, a potent diuretic with potassium-sparing properties, for the treatment of congestive heart failure. AB - The diuretic and clinical efficacy and safety of piretanide, a new high-ceiling loop diuretic, was determined in patients with mild to moderately severe congestive heart failure. Piretanide (n = 20) administered orally in a daily dosage of up to 24 mg was compared with placebo (n = 18) for 28 days, using a double-blind, randomized, parallel design. Patients were hospitalized during the first 5 days of the study when dosage titration was established and 24-hour fractionated urine collections were obtained. Piretanide caused significant diuresis for 3 hours after ingestion with a natriuretic response noted for up to 6 hours. While occasional kaliuretic response was noted, it did not significantly increase 24-hour urinary potassium excretion. Only one patient treated with the highest allowed dose of piretanide developed mild hypokalemia. An improvement in New York Heart Association functional class status was noted after piretanide therapy. In contrast, patients who received placebo exhibited no significant improvement. BUN increased in nine piretanide-treated patients; two were discontinued from the study because of progressive azotemia. However, there was no significant increase in serum creatinine levels. Other blood, physical, ECG, and audiometric examinations also revealed no significant abnormalities. The study suggests that oral piretanide is a relatively safe and effective diuretic for treating congestive heart failure with a potential advantage of having potassium-sparing properties. PMID- 3533373 TI - The evolution of the surgical management of severe lower extremity trauma. AB - A hundred years ago, the question of whether to amputate a severely injured extremity could be answered rather easily and did not pose a serious dilemma. However, the increasing reconstructive capabilities have permitted the retreat to amputation to be made less frequently and occasionally create a dilemma concerning the best means of securing optimal function for the traumatized extremity. The surgeon must carefully balance the extent of trauma with the likelihood that his or her reconstructive efforts would surpass the functional results afforded by prompt amputation and prosthetic fitting. Although the mechanisms of limb destruction have changed in the past 2 centuries, the fundamental dilemma confronting the trauma surgeon has remained unchanged. In the words of Samuel D. Gross: "The cases which may reasonably require and those which may not require interference with the knife are not always so clearly and distinctly defined as not to give rise, in very many instances, to the most serious apprehension ... that, while the surgeon endeavors to avoid Scylla, he may not unwittingly run into Charybdis, mutilating a limb that might have been saved, and endangering life by the retention of one that should have been promptly amputated." PMID- 3533374 TI - Acute management of severe soft-tissue damage accompanying open fractures of the lower extremity. AB - Open fractures of the lower extremity accompanied by extensive soft-tissue damage can be effectively managed by a collaborative approach between orthopedic and plastic surgeons. The fundamental concepts of this aggressive, systematic approach are adequate debridement and soft-tissue healing by delayed primary intention. The protocol that has evolved at the MIEMSS Shock Trauma Unit involves emergency radical debridement of all devitalized soft tissue and bone fragments together with external stabilization of the fractured extremity. The zone of injury, which is often not apparent at presentation, is determined by serial debridements performed in the operating room over several days. When the wound is defined, soft-tissue closure is obtained with local or free muscle transfer. In very high energy-induced trauma, local muscle flaps are often involved in the zone of injury or are inadequate to cover the resultant defects. Free muscle transfers that provide large amounts of undamaged, well-vascularized tissue are therefore the reconstructive alternative of choice for such injuries. Bone defects are bridged 4 to 6 weeks after soft-tissue closure with cancellous or vascularized fibula grafts depending on defect size. This regimen, which has virtually eliminated the problem of infection, has been successful in salvaging and rehabilitating these severely injured lower extremities. PMID- 3533375 TI - Management of difficult lower extremity fractures and nonunions. AB - Difficult fractures and nonunions of the lower extremities are defined as compound fractures with soft-tissue loss, segmental bone fractures, and infected nonunions. A variety of methods for managing these defects are presented, including the use of modern fixation techniques and the application of highly vascularized bone and soft tissues. Vascularized bone grafts play a significant role in the treatment of difficult fractures that previously would have required amputation. PMID- 3533376 TI - Bone reconstruction. AB - The reconstruction of bone defects relies upon the reconstitution of bone in the area. The basic concepts of fracture healing are presented to better understand the mechanism of bone grafting. Conventional bone graft techniques are quite effective in reconstructing defects, including those up to 25 cm in length, provided an adequate vascular bed is available to allow vascularization of the grafts. If an adequate milieu is not available, then the use of a pedicle or free vascular bone graft can be employed. Just as skin and muscle flaps have provided the solution to soft-tissue loss, vascularized bone grafts provide the technique to deal with large bone defects not amenable to conventional treatment. Allografts additionally have a place in skeletal reconstruction but require appropriate management and consideration of host immune response. PMID- 3533377 TI - Foot reconstruction using free microvascular muscle flaps with skin grafts. AB - Free muscle flap transfer with skin graft coverage for extensive foot defects can be a successful form of foot reconstruction in well-selected patients who have overall normal foot innervation and deep pressure sensibility. Cutaneous sensibility does not appear to be necessary to maintain a functional or well healed foot. The major reconstructive goal in plantar foot reconstruction is the restoration of weight-bearing during normal ambulation using regular foot apparel. Based on this reconstructive goal, the authors present their current approach in the reconstruction of extensive defects of the foot using free microvascular muscle flaps with skin grafts. PMID- 3533378 TI - Lower extremity nerve injuries. AB - The surgical and anatomic features pertinent to lower extremity nerve injury are reviewed. The common problems associated with specific nerve lesions are discussed and reparative recommendations are offered. A more informed, aggressive approach to lower extremity nerve repair is suggested. PMID- 3533379 TI - Lower extremity avulsion injuries. AB - Avulsion injuries are best treated by removal of the avulsed tissue and replacing it as a full-thickness skin graft. Additional meshed split-thickness skin grafts from a separate donor area may be necessary to complete the soft-tissue coverage. Fractures commonly accompany avulsion injuries and require appropriate treatment. The atypical avulsion injury is a special problem that occurs infrequently but results in considerable morbidity. This injury is most commonly seen in individuals run over by heavy vehicles, particularly buses. The shearing forces involved cause extensive undermining of tissues, although the external surface of these areas appears uninvolved. This results in an under-estimation of the true extent of the injury. If not recognized, there may be either delayed full thickness necrosis of large areas of skin and subcutaneous tissue or the development of sepsis due to deep necrosis of the fat and fascia at the shear plane. If the true extent of injury is initially recognized, a dilemma exists in terms of deciding how much of the normal-appearing tissue to excise. The proper treatment plan for the atypical injury is not yet established with certainty. However, quantitative dermofluorometry has proven to be a valuable means of assessing the viability of extensively undermined areas of skin and subcutaneous tissue. This test is easily performed and can be used for serial study. Viable areas that are undermined and left in place require an early limited debridement of the undersurface to remove necrotic fascia and subcutaneous fat. This may require additional incisions for exposure. Plantar avulsions are another separate category of avulsion injury. Traditionally, the avulsed plantar surface has been sewn back into place, although this frequently resulted in the loss of this specialized tissue. It has become clear that it is possible to revascularize the plantar surface when major avulsion injuries occur. The plantar surface is thus similar to digital amputations and major scalp avulsion injuries in that replantation or revascularization is worthwhile and should be performed whenever possible. Soft-tissue loss around the ankle frequently co-exists with these injuries, and free tissue transfer may be necessary to complete soft-tissue coverage following revascularization. PMID- 3533380 TI - Management of lower limb vascular injuries. AB - Primary amputation in vascular trauma should be rare in the absence of prolonged ischemia, massive soft-tissue loss, and multiple fractures. Repair of the artery and vein, soft-tissue coverage, and rigid skeletal fixation is associated with an excellent limb salvage rate. Fasciotomy should be performed in cases with compartmental syndrome, and in complex injuries the use of temporary intravascular shunts is recommended for better overall patient management. PMID- 3533382 TI - Liber amicorum presented to Prof. Dr. J.D. Mulder. PMID- 3533381 TI - Aesthetic reconstructions of the leg after trauma. AB - Lower extremity trauma often results in significant skin or contour deformities as a result of the tissues destroyed. Such deformities are poorly tolerated by most patients, especially younger women. To achieve a satisfactory aesthetic reconstruction, the surgeon must be familiar with the special anatomy of the lower extremity as well all the different reconstructive options at his or her disposal. Minor scars or contour deformities can be corrected by traditional methods of scar revision or serial excision. Tissue expanders or silicone implants have a somewhat limited role in the lower extremity as compared with elsewhere in the body. Most major defects require free flaps to replace the surface or contour. Because of the importance of aesthetic results in the legs, free flaps should be utilized more often during the original trauma surgery if their use is deemed necessary for aesthetic reasons (Case 6). PMID- 3533383 TI - Ultrasonography of acute cholecystitis: clinical and histological correlation. AB - Sonograms of 45 consecutive patients with histologically proven acute cholecystitis were retrospectively reviewed. The following sonographic criteria were evaluated for the presence of: thickening of the gallbladder wall; enlargement of the transverse diameter; gallbladder pressure pain (Murphy's sign); local hypoechoic areas in the bladder wall, and finally the indistinct internal appearance. All 4 patients (8.9%) with acalculous cholecystitis were detected by ultrasound. Its sensitivity as a test to detect acute cholecystitis is 88.9%, its specificity and accuracy 97.8 and 96.1%, respectively. PMID- 3533384 TI - The value of target ultrasonic mammography and cytopathology in the assessment of round-shaped shadows on mammograms. AB - The preoperative value of target ultrasonic mammography (TUSM) and cytopathology, combined with clinical examination and mammography, was studied in 146 mammographically demonstrated round-shaped breast lesions. All lesions were biopsied and histology was performed. Advantages of combining TUSM with cytology are the possibility to have a more precise puncture aspiration with TUSM and a subsequently higher predictive value, compared to each technique alone. PMID- 3533385 TI - Clear cell chondrosarcoma: report of three cases and review of the literature. AB - Three cases of clear cell chondrosarcoma, located in the proximal tibia, rib and proximal femur, are reported. Clear cell chondrosarcoma is a cartilaginous tumour of low grade malignancy, most often located in the epiphysis of the long bones, especially of the proximal femur and humerus, with a relatively favourable prognosis. Clinical, radiological and pathologic features are discussed and a review of the literature is given. PMID- 3533386 TI - Digital subtraction arthrography of hip joint prostheses. AB - Digital subtraction arthrography (DSA) was performed in 14 patients in the evaluation of painful hip prostheses. Information about component loosening seems to be as reliable as with conventional arthrography. The examination time is very short, and results are immediately available. Electronic image manipulation allows the examiner to produce optimal picture quality. PMID- 3533387 TI - Thallium-201-technetium-99m parathyroid subtraction scintigraphy: dual channel acquisition or sequential imaging? AB - Parathyroid subtraction scintigraphy has been performed in 108 patients. In 41 cases scintigraphic findings are correlated with surgical and histologic results. Comparison of sequential data acquisition and dual channel acquisition has been made. As the results of these two protocols are comparable, we prefer the dual channel acquisition because of the smaller chance of introducing subtraction artefacts caused by patient movement. PMID- 3533388 TI - Technique of examination of the esophagus. AB - The technique of examination of the esophagus is neither easy nor uniform. There are a number of abnormalities and specific clinical problems, such as the broad spectrum of motility disorders, congenital abnormalities, corpora aliena, the demonstration of subtle mucosal lesions and the demonstration of the different forms of hiatus hernia, these all require a different approach. First of all, attention is paid to the history: the nonspecific complaint 'having trouble swallowing' can often be specified further, which is important for the way in which the examination of the esophagus is to be conducted. After discussion the 'standard examination of the esophagus', the contrast media, the value of single contrast, double contrast, mucosal relief studies and pharmaca, some attention will be paid briefly to special examination techniques of some abnormalities. PMID- 3533389 TI - Graft-versus-host disease of the gastrointestinal tract. AB - Forty-two gastrointestinal examinations performed in 24 patients with a history of bone marrow transplantation were analyzed retrospectively. All patients were clinically suspected of a graft-versus-host disease (GVHD) involving the alimentary tract. No specific abnormalities were found in the esophagus or the stomach. Radiographic features of a GVHD of the small bowel are: edema of mucosal folds in ileum and jejunum; effacement of folds towards the ileum; thickening of the bowel wall, and spasms and stenosis with prestenotic dilatation. In the active phase the bowel appears to be shortened. A short transit time was not a specific finding. Follow-up examinations showed partial regression of these findings. Radiological findings in the colon consisted of loss of haustration, thumbprinting, spasms and ulcerations. PMID- 3533390 TI - [Sonographic diagnosis of kidney calculi--comparative study of ultrasound, excretory urography and computer tomography in 310 patients]. AB - The authors compared the value of sonography with I.V. urography and CT in the diagnosis of nephrolithiasis, employing a retrospective study conducted on 310 patients. False positive and false negative sonographic findings were analysed in retrospect and the differential diagnosis discussed. Sonography proved of equal value to I.V. urography. 90% correct diagnoses were made via sonography; its sensitivity was 89%, its specificity 91%. 29% of the sonographically correctly diagnosed kidney stones had been detected by chance. The smallest sonographically identified stone was 3 mm, whereas the biggest stone that had been missed out was 7 mm. Sonography is definitely superior to I.V. urography in the detection of nephrocalcinosis and of roentgen-negative stones. Sonographically questionable parenchymal calcifications without shadowing should be investigated further by CT in case of clinical significance, even if the plain film is negative. The number of false positive findings in sonography can thus be reduced. Sonographic differentiation between central parenchymal calcification and stone formation is difficult in rare cases only. If required, additional information can be obtained via I.V. urography. The authors recommend sonography as the method of choice for suspected nephrolithiasis before I.V. urography is performed. PMID- 3533391 TI - [Intra-arterial digital angiography study of hemodialysis shunts]. AB - The diagnostic possibilities of intraarterial DSA are demonstrated by means of 76 investigated haemodialysis shunts. No complications were seen. In 85% of the cases venous stenoses or occlusions were proved. 18% of these were localised in the proximal part of the draining veins. For this reason, investigation of the venous inflow into the V. cava superior is recommended in every case. PMID- 3533392 TI - [The coding of roentgen diagnostic findings of studies based on morphologic structural changes. A computer assisted archive system for scientific purposes]. AB - For the last three years our Institute has been using a system based on a microcomputer for archiving scientifically interesting findings. This computer processes data obtained via computed tomography, sonography and angiography. Besides the coding of examination findings the system also enables compilation of efficiency statistics data. The system can be extended with comparatively little effort for processing MR data as well. Coding is not effected, as in most of the generally used systems, according to diagnosis, but according to the pathological change that can be detected via x-ray film. This prevents erroneous coding due to erroneous evaluation of the finding in question. The examinations can be stored immediately without waiting for verification. Search for defined findings is effected via screen where a search profile is set up interactively. Due to the hierarchic structure of code allocation it is possible to call for more or less detailed findings from the stored data. PMID- 3533393 TI - Hyperlipidaemia of diabetes. AB - There is general agreement as to the effects of diabetes on the concentrations of certain plasma lipoprotein lipids. Subdivision of diabetic subjects into several clearly defined subgroups has revealed that the detailed patterns of lipoprotein and lipid changes are dependent upon several factors, perhaps the most important of which is the degree of glycaemic control. Several aspects remain controversial, the most outstanding being whether or not plasma LDL cholesterol levels are elevated. It is possible that this is the case in certain clearly defined subgroups but not in others. In assembling the results of recent research for this review, two important aspects have emerged which require clarification. The first is the question of whether or not insulin directly stimulates hepatic VLDL secretion. The possibility that insulin might regulate production of lipogenic substrate by the gut may have an important bearing on this problem. The exact means by which insulin co-ordinates the metabolic activities of these organs in such a way as to ensure plasma lipid balance is not yet known and further research in this area may help to resolve some outstanding problems associated with diabetic hyperlipidaemia. Second, changes in the relative lipid composition of certain lipoprotein fractions in diabetic subjects has provided indirect evidence that increased lipoprotein 'remnant' concentrations may contribute to the abnormalities observed in some groups of diabetic subjects. This interesting possibility has been supported by metabolic studies, mainly in experimental animals. If this proves to be correct, then it remains to be determined whether the remnants involved are of hepatic or intestinal origin and whether the metabolic defect is related to abnormal production, clearance, or both. Recent work on the effects of changes in the apoprotein and lipid content on the metabolism of other lipoproteins in diabetes may have a useful bearing on studies of this type. In this respect, the bulk of the evidence seems to suggest that these factors, rather than changes in lipoprotein receptor activity per se, are important in determining the clearance of atherogenic lipoproteins such as LDL in diabetes. PMID- 3533394 TI - Vascular sensitivity to prostaglandin I2 and urinary excretion of 6-keto prostaglandin F1 alpha in conscious dogs. AB - A method is described for measuring the urinary excretion of 6-keto-prostaglandin F1 alpha, the stable hydrolysis product of prostaglandin I2, by stable isotope dilution gas chromatography-mass spectrometry. Three different doses of prostaglandin I2 were infused intravenously into conscious dogs and the effects on systemic and renal haemodynamics and urinary sodium excretion were observed. The two highest infusion rates of prostaglandin I2 (15 and 30 ng min-1 kg-1 body weight) induced significant decreases in systematic blood pressure and dose related increases in sodium excretion, but no change in renal haemodynamics. There was a linear relationship between urinary excretion of 6-keto-prostaglandin F1 alpha and the rate of infusion of prostaglandin I2. The calculated basal rate of entry of prostaglandin I2 into the systematic circulation in conscious dogs is 4 ng min-1 kg-1 body weight, which is substantially higher than that previously reported in man. PMID- 3533395 TI - The contribution of PGI2 to the effects of captopril in conscious dogs in differing states of sodium balance. AB - There is some evidence that increased prostaglandin synthesis may mediate some of the effects of the angiotensin converting enzyme inhibitor captopril. The potential role of prostaglandin (PG)I2 in this process was assessed by measurement of changes in urinary 6-keto-PGF1 alpha excretion after captopril in eight sodium replete and depleted conscious dogs. In sodium replete animals captopril induced a small decrease in blood pressure, transient increases in effective renal plasma flow and urinary 6-keto-PGF1 alpha excretion, and progressive increases in plasma renin activity (PRA) and urinary sodium excretion. By contrast, during sodium depletion captopril induced a large decrease in blood pressure, a transient increase in effective renal plasma flow and urinary 6-keto-PGF1 alpha excretion, an early large but transient increase in PRA and small progressive increase in sodium excretion. The time course of changes after captopril suggested that increased PGI2 synthesis may contribute to the transient decrease in renal vascular resistance. The increase in PRA during sodium depletion was not associated with any change in urinary 6-keto-PGF1 alpha excretion. PMID- 3533396 TI - Development and application of a superfusion technique for the study of renin secretion in rat renal cortical cells. AB - A dynamic column superfusion system has been developed for the study of renin secretion in rat renal cortical cells. Cells were isolated by collagenase digestion and mechanical dispersion, before suspension with polyacrylamide beads and superfusion with oxygenated physiological medium. Renin was detected in the superfusate by incubation of fractions with excess nephrectomized sheep substrate in the presence of angiotensinase inhibitors followed by radioimmunoassay of the angiotensin I generated. Optimized methodology included a purpose-built polytetrafluorethylene flow cell, a 1 h equilibration to achieve a steady state, 5 min eluate collections, a 15 min stimulatory and a 30 min recovery period, and duration of perfusion of up to 270 min. Significant increments above baseline renin release were seen with the stimuli of adrenaline, noradrenaline and isoprenaline. These could be demonstrated with concentrations of 10(-9) mol/l (adrenaline), 5 X 10(-10) mol/l (noradrenaline) and 10(-9) mol/l (isoprenaline). This technique has significant advantages over previous methods for the study of renin secretion in vitro at the cellular level. It is reproducible and sensitive, and avoids many of the limitations of static cell suspension and kidney slice methods. PMID- 3533397 TI - Oestrogen-induced changes in renal haemodynamics in the rat: influence of plasma and intrarenal renin. AB - The effect of oestrone acetate (in total doses of 5 and 10 mg) on systemic and renal haemodynamics and the renin-angiotensin system has been studied in adult female rats. The administration of 10 mg of oestrogen resulted in a significant fall in renal blood flow associated with significant rises in both renal vascular resistance and mean arterial pressure. No changes were noted in cardiac output or total peripheral resistance at either dose. Whilst the higher dose of oestrogen induced a significant increase in plasma renin activity, no change was noted in animals receiving 5 mg of oestrogen. Both regimens caused significant reductions in plasma and intrarenal renin concentrations. Although renal blood flow correlated with plasma renin activity in animals with a normal renal blood flow, no such correlation was noted in animals with oestrogen-induced reductions in renal blood flow. The present study demonstrates that oestrogen-induced reductions in renal blood flow result from a rise in intrarenal vascular resistance which cannot be accounted for by simultaneous changes in either plasma renin activity or renal renin concentration. PMID- 3533398 TI - Respiratory pharmacology. Methylxanthines. AB - This article describes the changes that have occurred in the last decade with respect to theophylline: its analogs, its mode of action, and its pharmacokinetics. The underlying principles of the selection of oral, intravenous, or combination therapy with theophylline are presented, along with methods for avoiding and treating theophylline toxicity. PMID- 3533399 TI - Respiratory pharmacology. Steroids. AB - Although glucocorticoids are widely used in the treatment and prophylaxis of asthma and other respiratory diseases, questions as to their mechanisms of action and their effectiveness continue to provoke debate. Controversies also exist in the selection of individual steroid preparations, dosages, and methods of delivery. These concerns are examined from the basis of the pharmacologic actions of these potent drugs. PMID- 3533400 TI - Respiratory pharmacology. Antibiotics. I. Beta-lactam antibiotics, the tetracyclines, chloramphenicol, erythromycin, clindamycin, metronidazole, and the quinolones. AB - Pneumonia, acute bronchitis, and sinusitis are common infections encountered by the pulmonary specialist. Such conditions are usually treated with antibiotics, and their use requires an understanding of their pharmacokinetic properties as well as their antimicrobial spectrum and adverse side effects. PMID- 3533401 TI - Respiratory pharmacology. Antituberculosis drugs. AB - Tuberculosis remains a significant health problem. Its control and treatment depend on a thorough understanding of the basic principles and application of antituberculosis chemotherapy. The pharmacology of the major antituberculosis drugs is presented, including the management of adverse and allergic reactions. PMID- 3533402 TI - Respiratory pharmacology. Antithrombotic and fibrinolytic therapy. AB - Antithrombotic therapy with heparin is effective in reducing the incidence of thromboembolic disease when given prophylactically to high-risk patients. Heparin followed by oral antithrombotic therapy is accepted practice for the management of established thromboembolism. Fibrinolytic therapy has been demonstrated to be effective in recanalization of vessels occluded by thrombus, but is contraindicated if the effect of peripheral embolization from the occlusion is likely to result in severe morbidity. The use of heparin and oral antithrombotic drugs is associated with an increased frequency of bleeding, and requires careful clinical and laboratory control, for which the best methods have not yet been determined. Low-molecular-weight preparations of heparin have been shown to have effectiveness when administered once or twice a day, but not to have less risk for hemorrhage than regular heparin. Fibrinolytic therapy is entering a new phase with the conclusion of clinical trials of the newer agents that are associated with a reduced risk of systemic anticoagulation. PMID- 3533403 TI - Pharmacologic aspects of lung cancer chemotherapy. AB - A relatively small group of chemotherapeutic agents have gained widespread acceptance in the treatment of lung cancer. The pharmacologic properties of these agents are reviewed. PMID- 3533404 TI - Contemporary management of ankylosing spondylitis. AB - The comprehensive management of ankylosing spondylitis has both immediate and long-term objectives. The physician must first suppress the patient's articular discomfort and inflammation with NSAIDs, then begin long-range supportive measures such as postural training and daily exercise in order to prevent, delay, or correct deformity. Acute anterior uveitis and other systemic manifestations must be promptly recognized and treated, often with the help of specialists. While the capacity to function and work can be adequately maintained for most patients, it depends largely on patient education and compliance. Educational material for patients with AS may be obtained from either a local chapter or the national headquarters of the Arthritis Foundation (17 Executive Park Drive, NE, Suite 480, Atlanta, GA 30329), as well as the Ankylosing Spondylitis Association (ASA). Patients should be urged to join the ASA in order to receive the monthly newsletter. The address for ASA membership is 3985 Witzel Drive, Sherman Oaks, CA 91403. PMID- 3533405 TI - Partial purification and characterization of a procollagen C-proteinase from the culture medium of mouse fibroblasts. AB - A procollagen C-proteinase was purified about 100-fold from the medium of cultured mouse fibroblasts by a combination of ammonium sulfate precipitation, gel-filtration, and affinity chromatography on a column of Sepharose coupled to the carboxyl propeptide of type I procollagen. The purified enzyme did not exhibit other proteolytic activities, and it cleaved type I, II and III procollagens to produce the corresponding pN alpha chains and carboxyl propeptides as the only products. Amino acid sequencing of the first 14-18 residues at the N-terminus of the carboxyl propeptides generated by the enzyme from human pro alpha 1(I), pro alpha 2(I) and pro alpha 1(III) chains showed that the cleavage occurred at the physiological site, i.e. at the specific Ala-Asp bond in the pro alpha 1(I) and pro alpha 2(I) chains, and at the specific Gly-Asp bond in the pro alpha 1(III) chain. The pH optimum of the enzyme is 8.5 and its molecular weight as estimated by gel-filtration is about 125,000 daltons. The enzyme is inhibited by metal-chelators, various amines, dithiothreitol, N ethylmaleimide and serum, but it is insensitive to pepstatin, leupeptin and serine proteases inhibitors. The enzyme differs from the C-proteinase described by Njieha et al. (Biochemistry 21:757-764, 1982), and the catheptic activities reported by Davidson et al. (Eur. J. Biochem 100:551-558, 1979) and Helseth and Veis (Proc. Natl. Acad. Sci. USA 81:3302-3306, 1984). The specificity of the enzyme is offered as evidence for a unique, C-proteinase, and its recovery from culture medium supports an extracellular location for procollagen processing. PMID- 3533406 TI - Evidence for a protein that enhances the activity of type I procollagen C proteinase. AB - Gel-filtration separated type I procollagen C-proteinase from a glycoprotein that enhanced the enzyme activity by approximately 4-fold. The enhancer was purified by affinity chromatography on a column of Sepharose coupled to the carboxyl propeptide of type I procollagen. Sodium-dodecyl-sulfate- polyacrylamide gel electrophoresis of the affinity-purified enhancer revealed two active major protein bands with molecular weights of 36 and 34 kdal. Both proteins were glycosylated, as shown by binding to concanavalin-A. The enhancer is extremely heat stable (100 degrees C, 15 min) but its activity is totally abolished by treatment with trypsin or bacterial elastase. The enhancer does not alter the digestion intermediates or final products of the enzymatic reaction but it changes the kinetic properties of the reaction, increasing the apparent Km and Vmax values 16- and 20-fold, respectively. It is suggested that the enhancer might play a regulatory role in procollagen processing. PMID- 3533407 TI - Carbon source assimilation and fermentation tests: study of 77 animal Pasteurella strains by a microtechnique. AB - 77 strains of Pasteurella from various animal species were tested using the API micromethod for their ability to assimilate 147 carbon substrates and ferment 49 carbohydrates. Typical profiles of P. multocida and P. haemolytica were determined. This micromethod should prove useful in establishing the biotypes of Pasteurella species and in studying their epidemiology and pathogenicity. PMID- 3533408 TI - Evaluation of selective media for primary isolation of Treponema hyodysenteriae and Treponema innocens. AB - A total of 2450 samples of feces, intestinal contents and colon mucosal scrapings were bacteriologically examined. A total of 53 strains of Treponema sp. were isolated, and 45 strains of Bacteroides sp., 30 strains of E. coli, 30 strains of Micrococcus sp. and 10 strains of Streptococcus D isolates were randomly selected. Growth promoting studies showed statistically significant stimulation of Treponema sp. growth by yeast extract, chicken egg yolk and rumen fluid. Different growth inhibitors were also tested. For selective medium the following inhibitors were selected: spectinomycin, colistin, vancomycin, brilliant green. Optimal concentrations of these inhibitors in the medium were determined. Finally TSA medium supplemented with 0.05% yeast extract, 5% bovine blood, 0.01% DTT, 400 micrograms spectinomycin, and 250 micrograms/ml vancomycin, appeared to be optimal selective medium for intestinal Treponema sp. isolation. Quantitative studies showed that the number of Treponema C.F.U. on Songers et al. medium with spectinomycin and on spectinomycin-vancomycin medium, did not differ significantly. The number of overgrowing bacteria was statistically significantly lower on spectinomycin-vancomycin medium, than Songers et al. selective medium with spectinomycin. The TSA supplemented with blood, yeast extract 50 micrograms/ml of colistin and 1 microgram/ml of brilliant green was less selective than spectinomycin-vancomycin medium and inhibited some strains of Treponema sp. In the case of spectinomycin-vancomycin resistant of overgrowing bacteria, colistin-brilliant green medium may be suitable for isolation of Treponema sp. PMID- 3533410 TI - Activation of trout gill AMP deaminase by an endogenous proteinase--II. Modification of the properties of the enzyme during starvation, pollution and salinity changes. AB - The relative amount of modified AMP deaminase has been determined by taking advantage of the different effects of monovalent cations on the two enzymatic forms. When trout were subjected to different environmental perturbations (starvation, pollution of the water by a pesticide, transfer to sea water or reverse transfer to fresh water), modified AMP deaminase could be detected in the gill extracts. Depending on the nature of the stress and the period of experimentation, 8 to 100% of the enzyme had been modified by limited proteolysis. As a consequence of the much higher activity of the proteolyzed AMP deaminase form, a 2 to 12 times increase of the intracellular AMP deaminase activity could be expected. At the same time, limited proteolysis will modify the regulatory properties of the enzyme, since it can be estimated that 50 to 100% of the enzyme activity expressed in the cell will be an AMP deaminase form less sensitive to inhibition by inorganic phosphate and ionic strength, and to variations of the intracellular pH. Limited proteolysis will result in increased AMP deaminase activity under conditions of increased energy demand, where the concentration of inorganic phosphate is dramatically increased. The consequence should be stabilization of the adenylate energy charge. PMID- 3533409 TI - Activation of trout gill AMP deaminase by an endogenous proteinase--I. Effects on the regulatory properties of the enzyme. AB - Some regulatory properties of trout gill AMP deaminase were determined in crude extracts, before or after modification of the enzyme by the endogenous proteinase. After proteolysis, the optimal concentrations for activation by sodium and potassium were shifted from 10 to 75 mM, resulting in a large increase of enzyme activity near the physiological potassium concentration. This activation was shown to be the consequence of a much lower sensitivity of AMP deaminase to inhibition by increasing ionic strength. The modified enzyme was also less sensitive to modifications of pH and to inhibition by physiological concentrations of inorganic phosphate. When all these modifications were considered, limited proteolysis of gill AMP deaminase resulted in a 40 times increase of enzyme activity under in vivo conditions. PMID- 3533411 TI - Activation of trout gill AMP deaminase by an endogenous proteinase--III. Comparative studies on the gill AMP deaminase from different fresh water and sea water teleosts. AB - The effects of monovalent cations and inorganic phosphate, on gill AMP deaminase, were compared in different fresh water and sea water stenohaline and euryhaline Teleosts. Generally, sea water species displayed a lower sensitivity to these effectors than fresh water species. During salinity changes, the sensitivity of gill AMP deaminase to cations and phosphate were modified proportionally to the tolerance of a given species to variations of environmental salinity. In particular, these parameters were modified in the weak euryhaline, Salmo gairdneri, but not in the real euryhaline, Anguilla anguilla. In sea water adapted trout, the appearance of a modified AMP deaminase form, with similar properties to that found in sea water species, is suggested. When compared with the conclusions from the preceeding papers [Raffin (1986) Comp. Biochem. Physiol. 85B, 157-162; 85B, 163-171], the results suggest that modification of gill AMP deaminase by limited proteolysis should be a rather general adaptation mechanism to stress. PMID- 3533412 TI - Plasma renin assay calculation using Lotus 1-2-3. AB - The calculation of results from a Plasma Renin Activity (PRA) assay requires many intermediate steps that are both tedious and prone to error. Using Lotus 1-2-3C and the IBM PCT, these assay calculations can be reduced to simply entering the raw counts obtained from the gamma counter. This calculation method is for use with Clinical Assay's Gamma-CoatT PRA kit, one of the most widely used commercial kits. A template that utilizes a logarithmic curve fit equation to calculate a point to point standard curve for the assay is set up on the Lotus spreadsheet. By using a point to point curve fit, a standard curve that is a very close approximation to a manually drawn plot is generated by the computer. Using Lotus's macro feature, a routine is built into the template to automatically move the cursor from cell to cell for the entry of the raw counts. All data can be entered using only the numeric key pad and RETURN key. When all data has been entered, the macro calculates the assay results and prints out a hardcopy report. In 52 samples, comparing the PRA results obtained from the manually plotted standard curve and those calculated by the template yielded a coefficient of correlation of 0.997, p less than 0.001. We conclude that the computer generated results are comparable to results obtained from a manually drawn curve. All calculations can be quickly obtained simply by entering the raw counts from the gamma counter using this application of Lotus 1-2-3C with the Clinical Assay's GammaCoatT PRA kit. PMID- 3533413 TI - ["Ode to Florence Nightingale": its background and revival]. PMID- 3533414 TI - Fifty years of "Connecticut Medicine". PMID- 3533415 TI - A half century of "Connecticut Medicine". PMID- 3533416 TI - Physicians and their concerns--then and now. PMID- 3533417 TI - Pancreatic transplant following total pancreatectomy for chronic pancreatitis: report of a case and literature review. PMID- 3533418 TI - The value of real time ultrasonography in first trimester termination. AB - The value of real time ultrasonography (RTUS) in the management of first trimester elective pregnancy terminations was studied in 120 consecutive patients. RTUS was found essential in determining accurate gestational ages, identifying incomplete pregnancy terminations, diagnosing abnormal pregnancies, and in performing difficult terminations. It is suggested that RTUS be employed in the routine management of first trimester pregnancy terminations. PMID- 3533420 TI - World Health Organization. Special programme of research, development and research training in human reproduction. The first fifteen years: a review. PMID- 3533419 TI - A possible mechanism of action of danazol and an ethinylestradiol/norgestrel combination used as postcoital contraceptive agents. AB - Twenty-seven women requesting postcoital contraception were randomly allocated to take an ethinylestradiol/dl-norgestrel combination or danazol. Urine specimens were assayed for luteinising hormone (LH) and pregnanediol-3-glucuronide (P3G) levels from the day of the postcoital treatment to the next period. In addition, the urine samples of these recruits and 12 additional women were assayed for the Beta-subunit of human chorionic gonadotropin (B-hCG). A consistent pattern of alteration in urinary steroids was lacking, indicating a heterogeneous effect on ovarian function. There was no evidence of early pregnancy in successfully treated cases. We suggest that the main mechanism of action of these drugs is at the endometrial level. PMID- 3533422 TI - Effect of intrinsic positive end-expiratory pressure on respiratory compliance. AB - We evaluated the influence of intrinsic positive end-expiratory pressure (PEEPi) on the measurement of static respiratory compliance in 15 adult patients with acute respiratory failure under mechanical ventilation. Modifying the inspiratory/expiratory ratio from 1:2 to 2:1, and the respiratory frequency from 15 to 20 and 25 breath/min significantly changed compliance values. Because PEEPi can increase the work of breathing, we suggest adjusting ventilatory variables to minimize PEEPi. PMID- 3533421 TI - Changes in specialized cognitive function following changes in hormone levels. AB - Increase of follicle stimulating hormone (FSH) and luteinizing hormone (LH) in men by injection of luteinizing hormone releasing hormone (LHRH) prevented improvement in a spatial orientation test relative to a placebo condition. By contrast, performance on a fluency task was significantly increased after LHRH injection relative to the placebo condition. These data support between-subject results where FSH was negatively correlated with visuospatial skills and positively correlated with fluency. There was no change in cognitive function in males following injection of testosterone. There were also no fluctuations in cognitive function that coincided with hormonal fluctuations of the menstrual cycle in women. PMID- 3533423 TI - Effects of intermittent positive-pressure ventilation on cardiac output measurements by thermodilution. AB - Sequential thermodilution measurements of cardiac output in mechanically ventilated patients undergoing cardiac surgery demonstrated a cyclic modulation which correlated with changes in airway pressure, and was not affected by opening the pericardium. There was no satisfactory point for single measurements, which suggests that random thermodilution measurements of cardiac output during intermittent positive-pressure ventilation should be avoided, even when triplicate measurements are performed. To estimate the mean cardiac output, at least two measurements should be made at predetermined points of the ventilatory cycle. We recommend paired measurements at midinspiration and end-expiration. PMID- 3533424 TI - Host-parasite relationship in opportunistic mycoses. AB - Aspergillosis and mucormycosis are opportunistic fungal infections that share several unique features. The etiologic agents of aspergillosis and mucormycosis are ubiquitous in the environment, but are opportunistic organisms and usually infect only patients predisposed by some underlying disease or treatment. These infections are typically characterized by hyphal tissue invasion and a predilection of the organism for blood vessel invasion with hemorrhage, necrosis, and infarction. Also, these organisms are not dimorphic, like the true pathogenic dimorphic fungi, as they grow both in the environment and within the host in hyphal forms. However, the host must contend with several forms to successfully eliminate them. Each form displays different antigenic and surface features and elicits different host responses. Finally, if germination and hyphal growth occur, the host must compete with a rapidly growing organism that is too large to be ingested by a single cell and so must be handled by extracellular defense mechanisms. PMID- 3533425 TI - Parasitic adaptation of pathogenic fungi to mammalian hosts. AB - Pathogenic fungi involved in medical and veterinary mycology can be classified in three different groups according to their level of adaptation to parasitism. Only a few species belonging to dermatophytes can be considered genuine parasites as opposed to molds or fungi involved in systemic mycoses. Ecological, ethological, biochemical, and immunological factors can play a role in preadaptation or adaptation to parasitic life and are discussed. PMID- 3533426 TI - Ethanol tolerance in yeasts. AB - It is now certain that the inherent ethanol tolerance of the Saccharomyces strain used is not the prime factor regulating the level of ethanol that can be produced in a high sugar brewing, wine, sake, or distillery fermentation. In fact, in terms of the maximum concentration that these yeasts can produce under batch (16 to 17% [v/v]) or fed-batch conditions, there is clearly no difference in ethanol tolerance. This is not to say, however, that under defined conditions there is no difference in ethanol tolerance among different Saccharomyces yeasts. This property, although a genetic determinant, is clearly influenced by many factors (carbohydrate level, wort nutrition, temperature, osmotic pressure/water activity, and substrate concentration), and each yeast strain reacts to each factor differently. This will indeed lead to differences in measured tolerance. Thus, it is extremely important that each of these be taken into consideration when determining "tolerance" for a particular set of fermentation conditions. The manner in which each alcohol-related industry has evolved is now known to have played a major role in determining traditional thinking on ethanol tolerance in Saccharomyces yeasts. It is interesting to speculate on how different our thinking on ethanol tolerance would be today if sake fermentations had not evolved with successive mashing and simultaneous saccharification and fermentation of rice carbohydrate, if distillers' worts were clarified prior to fermentation but brewers' wort were not, and if grape skins with their associated unsaturated lipids had not been an integral part of red wine musts. The time is now ripe for ethanol-related industries to take advantage of these findings to improve the economies of production. In the authors' opinion, breweries could produce higher alcohol beers if oxygenation (leading to unsaturated lipids) and "usable" nitrogen source levels were increased in high gravity worts. White wine fermentations could also, if desired, match the higher ethanol levels in red wines if oxygenation (to provide the unsaturated lipids deleted in part by the removal of the grape skins) were practiced and if care were given to assimilable nitrogen concentrations. This would hold true even at 10 to 14 degrees C, and the more rapid fermentations would maximize utilization of winery tankage.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3533427 TI - Initial interactions of Agrobacterium tumefaciens with plant host cells. AB - Infections of wounded dicotyledonous plants by Agrobacterium tumefaciens result in the formation of crown gall tumors. The initial step in tumor formation is the site-specific attachment of the bacteria to the host cells. The mechanism of recognition and attachment in this interaction has been studied in detail. Current information on the nature of the bacterial binding sites, the nature of the host receptors, the role of bacterial cellulose fibrils, and the genetics of bacterial attachment will be summarized, and a model for the attachment of Agrobacterium to host cells will be presented. PMID- 3533428 TI - Chemotaxis and cell motility in the cellular slime molds. AB - Chemotaxis and cell motility have essential roles to play throughout the developmental cycle of the cellular slime molds. The particular emphasis of this review, however, will be on the amoeboid stages of the life cycle. The nature of the chemoattractants and their detection will be discussed as will the possible mechanisms that may account for the directed locomotion of amoebae. Intracellular chemoattractant-elicited molecular responses thought to play a role in transduction of extracellular signals into a motility response will also be examined. Furthermore, relationships of these transduction pathway components with changes in assembly states of the cytoskeletal proteins contributing to shape change and cell movement will be assessed. Theories of amoeboid movement involving these cytoskeletal proteins will be compared and discussed in terms of their relevance to cellular slime mold motility. PMID- 3533429 TI - The temperature dependence of passive potassium permeability in mammalian erythrocytes. AB - The effect of temperature on the "passive" permeability of mammalian plasma membranes to K+, measured as the residual flux in the presence of ouabain and bumetanide, was investigated in erythrocytes of several species. Without Ca2+ in the medium, only human red cells demonstrated the "paradoxical" rise in passive flux at low temperature (i.e., below 12 degrees C) seen by other workers. In the other species no such effect was apparent; K+ influx decreased progressively with cooling down to 0 degree C. Below 18.5 degrees C the apparent energy of activation (Ea) was very low--close to that for free diffusion in water--for red cells of all species except human. Above 18.5 degrees C the Ea was much greater and was also more variable amongst the red cells of the species chosen. Neither the inhibitors used nor cell volume changes during incubation accounted for the absence of the paradoxical effect in the species studied here. A rise in permeation of K+ with cooling can, however, be produced by the addition of Ca2+ to the medium, probably by activation of the Ca2+-sensitive K+ channel. This effect would account for previous reports of a paradoxical effect in dog and rat erythrocytes. PMID- 3533430 TI - Ontogeny of the 35K epsilon crystallin during Rana temporaria lens development. AB - Epsilon is a recently described eye lens protein from Rana temporaria, an anuran amphibian. It is oligomeric with a subunit M.W. of 35K. The cDNA coding for 35K E in frog lens does not show any homology with cDNA's coding for alpha-, beta-, gamma-, and delta-crystallins. Immunologically, it also does not react with antibodies directed against alpha-, beta-, and gamma-crystallins. The ontogeny of this 35K E-protein has been investigated in R. temporaria lens development by the indirect immunofluorescence staining method with an antibody specific for the 35K E-protein. The purity of the isolated 35K protein and the specificity of the antibody were controlled by Tris-SDS gel electrophoresis and immuno-blotting, respectively. The first positive immunofluorescence reaction was observed in the inner cell wall of a stage V lens. In the external layer/epithelium the reaction was first detected in a single cell of a stage VII lens. Additional positive cells in the external layer/epithelium were detected at an early state VIII and the reaction appeared to be patchy. This type of patchy reaction was also observed in the epithelium of froglet (sub-adult) eye lens. PMID- 3533431 TI - Blocking Candida adherence to contact lenses. AB - The adherence of microorganisms to contact lenses may be an important initial step in the pathogenesis of contact lens-associated infectious keratitis. Using a strain of Candida albicans whose interaction with various polymers has been well characterized we systematically investigated the adherence of this pathogen to hard hydrophobic and soft hydrophilic extended-wear contact lenses. Yeasts adhere to the hydrophobic lenses in direct proportion to the wetting angle of the lens whereas yeasts adhere to the hydrophilic lenses in direct proportion to the water content of the lens. Tear proteins such as albumin, lactoferrin, and lysozyme in addition to fibronectin enhance yeast adherence to both types of lenses (P less than 0.01). Concanavalin A reduces adherence of yeasts to both lens types (P less than 0.01). Among tear components however, only mucin (0.5%) consistently reduced yeast adherence to both lens types. Hydrophilic extended wear lenses worn for at least 28 days by normal patients consistently had greater adherence of yeasts than unworn lenses of the same type, often as much as ten-fold or greater yeasts/mm2 of lens surface area (P less than 0.05). These investigations indicate that tear components both in solution and adsorbed to the lens surface enhance microorganism adherence to contact lenses. PMID- 3533432 TI - Time course for prostaglandin synthesis by rabbit lens during endotoxin-induced ocular inflammation. AB - Three hours to 14 days following the intravitreal injection of 10 ng of E. coli endotoxin into the vitreal chamber of one eye of the New Zealand white rabbit, ocular inflammation was evaluated by clinical and biochemical criteria and prostaglandins were measured in the intraocular fluids and in the incubation medium of the intact lens. Increased synthesis of PGE2 was detected for lenses from inflamed eyes beginning at 18 h post-endotoxin injection. Lenticular PGE2 synthesis remained above control levels for the duration of the time course. Lenses also exhibited increased PGF2 alpha synthesis, which began at 18 h and returned to control levels by day 7. At the times of peak production, aqueous humor PGE2 concentration correlated with lenticular PGE2 synthesis and with aqueous humor leukocyte number. No correlations were found for lenticular PGE2 vs. cell number, or vitreous humor PGE2 vs. aqueous humor PGE2. These results suggest that during ocular inflammation, aqueous humor PGE2 may be derived, at least in part, from the lens and leukocytes. PMID- 3533433 TI - Contribution of plasma proteins to the vitreous of the rat. AB - The extent of plasma proteins in the vitreous humor of the rat was determined. Disc gel electrophoresis of the soluble proteins of the rat vitreous humor showed many protein bands, but most of the bands did not coincide with those of rat plasma. Using antibodies to rat plasma proteins, immunological analyses of vitreous and plasma, including fractions separated by high-pressure gel permeation chromatography, showed that several vitreous proteins react with plasma protein antibodies. However, only albumin and transferrin were found to be completely identical in both fluids. The concentration of albumin in vitreous was about 625 micrograms/ml and that of transferrin was 61.6 +/- 19.1 (S.D.) microgram/ml. The total protein concentration in vitreous was 9.5 +/- 0.5 (S.D.) mg/ml. The ratio of transferrin to albumin in the vitreous was approximate to that of plasma, but the sum of the two proteins accounted for less than 10% of the total protein. These data indicate that in the rat some plasma proteins, particularly albumin and transferrin, are found in the vitreous, but most of the soluble proteins appear to originate from sources other than plasma, such as the vitreous itself or in surrounding tissues including the ciliary body and the retina. PMID- 3533434 TI - Limited proteolysis of MP26 in lens fiber plasma membranes of the galactose induced cataract in the rat. AB - Lenses of rats maintained on a 50% galactose diet displayed the development of a progressive cataract which was cortical at 3-11 days, and progressively internalized (nuclear as well) and mature at 16-20 days of feeding. Lens fiber plasma membranes were isolated from female rats subjected to the galactose diet and from controls at 11, 19, and 31 days of feeding, and analyzed by SDS-PAGE. Examination of the fiber plasma membranes from whole lenses of galactose-fed rats demonstrated the limited proteolysis of MP26 into MP23-24, in both the cortical and mature stages of the resultant cataracts. The limited proteolysis of MP26 was first evident in the lens cortex at 11 days of galactose feeding, and was evident as well, and more severe in proportion, in the lens nucleus at 19 days of feeding. The greatest proportion in MP26 limited proteolysis was observed in whole lenses at 31 days of galactose feeding. The regional progression of MP26 limited proteolysis closely paralleled the morphological progression of the galactose-induced cataract in the rat. The proportion of lens MP26 which underwent limited proteolysis into MP23-24 increased the longer the animals were kept on the galactose diet. PMID- 3533436 TI - Special considerations of exercise in children and adolescents. PMID- 3533435 TI - Acute and chronic metabolism changes following exercise: mechanisms and physiological relevance. PMID- 3533437 TI - Effect of exercise and diet on lipids and cardiovascular disease. PMID- 3533438 TI - Exercise, diet, and the rehabilitation of lung patients. PMID- 3533439 TI - Prescribing an exercise program. PMID- 3533440 TI - Exercise, diet, and thermogenesis. PMID- 3533441 TI - Nutritional enhancement of athletic performance. PMID- 3533442 TI - Protein and amino acid metabolism in relation to physical exercise. PMID- 3533443 TI - Special concerns for exercise in women. PMID- 3533444 TI - Infections in day-care centers. PMID- 3533445 TI - Management of complicated pelvic fractures. PMID- 3533447 TI - The immune response to influenza infection. PMID- 3533446 TI - The interaction of glucan and cefoxitin in prevention of murine abscess. PMID- 3533448 TI - Defective interfering viruses and infections of animals. PMID- 3533449 TI - The regulation of lymphocyte traffic. PMID- 3533450 TI - The cell envelope of gram-negative bacteria: new aspects of its function in transport and chemotaxis. PMID- 3533451 TI - Proteus mirabilis: taxonomic position, peculiarities of growth, components of the cell envelope. PMID- 3533452 TI - Clostridial neurotoxins: handling and action at the cellular and molecular level. PMID- 3533453 TI - Sunscreens. PMID- 3533454 TI - Evaluation of the asthmogenicity of propafenone, a new antiarrhythmic drug. Comparison of spirometry with methacholine challenge. AB - Propafenone is a new membrane-stabilizing antiarrhythmic agent that structurally resembles the beta-adrenergic receptor antagonist, propranolol. To determine the potential asthmogenicity of this new drug, pulmonary function, airway reactivity to methacholine, blood pressure, the electrocardiogram, and plasma concentrations were measured in 12 patients with mild intermittent asthma after 48 to 72 hours of treatment with placebo and with oral propafenone in low dosage (150 mg every eight hours) and high dosage (300 mg every eight hours) in a double-blind crossover manner. The forced vital capacity (FVC), forced expiratory volume in one second (FEV1), forced expiratory flow over the middle half of the FVC (FEF25 75%), heart rate, and blood pressure during the three regimens of treatment were not significantly different; however, the QRS interval on the ECG was significantly widened with both dosages of active drug, and the mean provocative dose of methacholine (+/- SE) required to reduce FEV1 by 20 percent (PD20) decreased from 3.0 +/- 0.6 mg/ml with placebo to 2.1 +/- 0.7 mg/ml with the high dosage of propafenone (p less than 0.01). The mean PD20 on the low-dose regimen was not significantly different from placebo or high-dose therapy. A potentially relevant increase in airway reactivity, as measured by a ratio of less than 0.5 for PD20 after treatment to PD20 after placebo, occurred in seven subjects with high-dose and in one subject during low-dose treatment (p less than 0.01). These data suggest that propafenone should be used with caution in patients with asthma and that bronchial provocation will provide a more sensitive measure of the asthmogenicity of a drug with beta-adrenergic receptor antagonist activity than pulmonary function tests. Moreover, use of bronchial provocation allows the selection of subjects with mild disease, thus reducing the risk of potentially severe bronchospasm. PMID- 3533455 TI - Bronchodilator effect of theophylline preparations and aerosol fenoterol in stable asthma. AB - To compare the acute bronchodilator effect of increasing doses of intravenous theophylline and inhaled beta adrenergic agonists, we administered intravenous theophylline dissolved in ethylenediamine or proxyphylline and diprophylline or placebo in a double blind fashion to nine asthmatics on three different days. At each session, 100 mg theophylline or placebo were given during each of five subsequent periods of 30 minutes' duration and followed by inhalation of 0.4 mg fenoterol. In contrast to placebo, 500 mg theophylline in ethylenediamine or proxyphylline and diprophylline significantly decreased mean specific airway resistance (SRaw in cmH2O.s) from 31.2 to 23.6 or 34.2 to 23.5 at theophylline serum concentrations of 14.4 or 16.6 mg/L, respectively. Fenoterol lowered SRaw to about 40 percent of the respective baseline values independent of theophylline or placebo pretreatment. We conclude that the acute bronchodilator effect of theophylline is weak in comparison to inhaled beta agonists. Furthermore, proxyphylline and diprophylline cause a weak but not significant bronchodilation when compared to ethylenediamine. PMID- 3533456 TI - Increase in bronchial responsiveness to methacholine and late asthmatic response after the inhalation of ultrasonically nebulized distilled water. AB - We studied ten subjects who had an asthmatic response after the inhalation of ultrasonically nebulized distilled water and did not show any refractory period to repeated challenge with such water. The change in responsiveness to methacholine after inhalation of distilled water and the occurrence of any water induced late asthmatic response were investigated on separate days. All of the tested subjects showed a significant increase in bronchial responsiveness to methacholine after prior stimulation with ultrasonically nebulized distilled water, which waned within two hours in eight of them. The other two subjects showed a progressive increase in responsiveness to methacholine, and they also had a further reduction in the caliber of the airways three to four hours after inhalation of distilled water. The late responses were less severe than the initial responses and lasted four to five hours. After the spontaneous recovery, no significant increase in responsiveness to methacholine was detected. Our results confirm previous observations on hyperresponsiveness induced by ultrasonically nebulized distilled water and demonstrate the occurrence of late reactions after inhalation of such water. PMID- 3533457 TI - [The "saga" of dental equipment. Study of the conceptual history of operatory equipment in dentistry]. PMID- 3533458 TI - [Hemorrhoids--choice of treatment and technics]. PMID- 3533460 TI - [Review of the physical and surgical technical properties of modern monofilament suture materials]. AB - This paper documents the differences among 8 monofile sutures in important functions such as linear tensile strength, bending stiffness, knot security and irreversible elongation. The results show that two materials (Prolene and Gore Tex) do not seem to be as suitable as the other materials for long-term tensile loads. The lowest bending stiffness was that of Seralon. The highest knot security can already be reached with three loops of Novafil. Novafil has also got the highest maximal elongation. The knowledge of the different applications of suture materials tested in important practical functions, is the supposition to the right and secure use of suture materials. PMID- 3533459 TI - [Long-term management of tracheoesophageal fistula--successful control by esophageal segmentation and stomach pull-up]. AB - Following amniotic embolism a severe ARDS developed in a 21 year-old women. After two months of respirator therapy a giant tracheoesophageal fistula arose. Successful conservative treatment allowed recovery and weaning from the respirator. Our two step surgical management consisted of esophageal diversion and reconstruction of the intestinal passage by retrosternal gastric tube. The advantages and disadvantages of esophageal diversion in giant tracheoesophageal fistulas are discussed. PMID- 3533461 TI - [Modified Whipple surgical procedure]. PMID- 3533462 TI - [Pregnancy and delivery after kidney transplantation. A case report and review]. PMID- 3533463 TI - [Clinical study of three types of IUD]. PMID- 3533464 TI - [Rhabdomyosarcoma of the female genitalia]. PMID- 3533465 TI - [12 cases of temporal lobe epilepsy treated by antero-temporal lobectomy and destruction of the amygdala]. PMID- 3533466 TI - [Relationship between air pollution and children's prevalence of carrying Streptococcus hemolyticus alpha, beta on the nasal mucosa Environmental Health Monitoring Department of the Nanning Anti-Epidemic Station]. PMID- 3533467 TI - [Effect of pentachlorophenate in the sanitary disposal of human excreta]. PMID- 3533468 TI - [Acquired immunodeficiency syndrome: a world-wide fatal viral disease]. PMID- 3533469 TI - Fluorouracil in chemoprophylaxis of colorectal cancer. Results of a controlled clinical trial. AB - In a randomized prospective clinical trial in 128 patients undergoing radical surgical resection of primary colorectal cancer, 63 patients received intravenous fluorouracil (5-FU) in two courses, four and eight weeks after surgery; 65 controls received no chemotherapy. The duration of follow-up exceeded five years in all cases, and 28 patients have died in each group. Recurrent disease was present in 26 5-FU patients (41.2 percent) and in 22 controls (33.9 percent). There is no evidence that short-term 5-FU therapy was of significant value in the chemoprophylaxis of colorectal cancer. PMID- 3533470 TI - Transrectal repair of rectocele using obliterative suture. AB - Rectocele is a condition that can be repaired transrectally with an obliterative suture technique. The obliterative suture is essentially a tightly drawn continuous lock-stitch suture that strangulates the tissues contained in the suture line, and causes them to slough, yet approximates the tissues at the base of the suture line, the submucosa, and muscularis layers and allows them to heal rapidly. This technique is bloodless, easy to perform, and effective as far as cure and relief of symptoms. The time required for repair of the rectocele is approximately 6 minutes. The presence of a rectocele should be sought for routinely in every proctologic examination in the female. If anorectal surgery is to be performed, the rectocele should be repaired coincidentally, even if the rectocele is asymptomatic. If the rectocele is symptomatic, it should be repaired even if no other anorectal procedure is contemplated. The transrectal obliterative suture technique appears to have advantages over the vaginal or other transrectal techniques and is the method of choice for the repair of rectocele. PMID- 3533471 TI - Ceruletide and neostigmine in postoperative intestinal paralysis. A double-blind clinical controlled trial. AB - A double-blind and randomized clinical trial, which included 48 patients with postoperative intestinal paralysis on the third day after laparotomy, demonstrated no difference between treatment with ceruletide (0.3 microgram/kg body weight) and neostigmine (5.0 micrograms/kg body weight) in restoring normal intestinal function. PMID- 3533472 TI - Ovarian metastasis from colorectal cancer. AB - Controversies exist regarding the surgical treatment of the ovaries in women with primary colorectal cancer. A review of the authors' experience and the surgical literature reveals an incidence of ovarian metastases from colorectal cancer of approximately 6 percent. This problem may occur somewhat more frequently in premenopausal women. Resection of the ovaries at the time of colectomy is unlikely to affect survival. Removal of the ovaries at the time of bowel resection will prevent repeat laparotomy to resect an ovarian mass in approximately 2 percent of women with large bowel cancer. Oophorectomy should be performed in all postmenopausal females at the time of primary resection. Oophorectomy should be performed in premenopausal women if any gross abnormality of the ovary is detected or if peritoneal implants are seen at the time of primary resection. PMID- 3533473 TI - Classic articles in colonic and rectal surgery. Oscar Huntington Allis 1836-1921. Intestinal anastomosis with suturing of the entire thickness of the intestinal wall. Method and Instruments. PMID- 3533474 TI - Bacteriuria and autonomic nerve function in diabetic women. AB - Significant bacteriuria (viable count greater than or equal to 10(5)/ml) was found on single testing in 10% of 400 consecutive diabetic women aged 15-65 yr routinely attending a diabetic clinic. Twenty patients with and 21 without significant bacteriuria were then randomly selected for measurement of cardiovascular autonomic reflexes, bladder ultrasound, and mictiography. There were no significant differences between these two groups in age, duration and type of diabetes, glycosylated hemoglobin, blood urea, and creatinine. Abnormalities of cardiovascular autonomic function were more common in the bacteriuric group (P less than .01). Although the bacteriuric group voided a smaller volume of urine, none had evidence of increased residual bladder volume of urine on ultrasound. Diabetic women with cardiovascular autonomic neuropathy appear to be at increased risk of developing bacteriuria. However, age is probably the most important factor influencing the prevalence of bacteriuria in diabetic and in nondiabetic women. PMID- 3533475 TI - Effect of computer-based learning on diabetes knowledge and control. AB - Two interactive computer-based systems have been evaluated: a teaching program with text and animated graphics and a multiple-choice knowledge-assessment program (KAP) with optional prescriptive feedback. One hundred seventy-four routine-attending insulin-dependent diabetes mellitus (IDDM) and non-insulin dependent diabetes mellitus (NIDDM) patients were allocated to active and control groups to determine the effect of these programs on knowledge and control after a 4- to 6-mo follow-up period. Interactive computer teaching (ICT) resulted in a significant knowledge increment in both IDDM and NIDDM patients (P less than .05), together with a mean fall of 0.8 and 0.7%, respectively, in HbA1c (P less than .05 and P greater than .1), but no changes were observed in respective control groups. The KAP with feedback also produced a significant knowledge increment in both IDDM and NIDDM patients (P less than .05), of similar magnitude to the ICT program, and a mean fall in HbA1c of 1.2 and 1.3%, respectively (P less than .05), with no changes in the corresponding control groups. Even when KAP was used without prescriptive feedback, smaller but significant mean falls in HbA1c of 0.7 and 0.8% (P less than .05) were seen in IDDM and NIDDM patients, respectively, suggesting a motivational effect resulting from program participation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3533476 TI - Diabetes care in rural area: clinical and metabolic evaluation. AB - To evaluate the efficacy of conventional diabetes care in a rural area, metabolic control and the presence of late complications were studied in 622 diabetic patients treated by general practitioners beyond the reach of diabetic centers. Seventy-three (12%) of the patients were classified as type I diabetics (age, 38.0 +/- 16.1 yr; duration of diabetes, 12.8 +/- 9.3 yr) and 549 as type II diabetics (age, 67.0 +/- 10.8 yr; duration of diabetes, 7.3 +/- 5.8 yr). Fifty eight percent of type I diabetic patients administered insulin once daily and 42% twice daily, whereas most (83%) type II diabetics on insulin received only one insulin injection per day. Treatment of type II diabetic patients consisted of sulfonylureas (58%), diet alone (22%), insulin (18%), and biguanides or a combination of sulfonylurea with biguanides (2%). Poor therapeutic efficacy was observed in all patients, and postprandial hyperglycemia (blood glucose greater than 160 mg/dl) was predominant both in type I diabetics (86%) and in type II diabetics on insulin (80%) as well as off insulin (55%). HbA1c above normal (greater than 5.8%) was seen in 96% of type I and in 90 and 73% of type II diabetics with or without insulin therapy, respectively. Accompanying glucosuria was present in type I (73%) and in type II diabetics (on insulin, 71%; off insulin, 33%). Mean prevalence of late diabetic complications was greatest for insulin-treated patients (type I, type II with, and type II without insulin treatment: retinopathy, 41, 56, 22%; proteinuria, 13, 14, 3%; peripheral neuropathy, 21, 51, 12%), whereas macroangiopathy (16, 53, 31%) predominated in type II diabetic patients.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3533477 TI - Early diabetic nephropathy: assessment and potential therapeutic interventions. AB - End-stage renal failure secondary to diabetes has increasingly become a health and socioeconomic issue. Diabetic nephropathy is the major cause of death in type I insulin-dependent diabetic patients and accounts for approximately 25% of all patients beginning hemodialysis in the United States. Once diabetic nephropathy is well established, attempts to modify the relentless downward progression of the disease have been essentially unsuccessful. We focus on the early structural and functional changes that occur as a consequence of diabetic renal disease and examine the evidence for microalbuminuria as an early marker and predictor for future overt diabetic nephropathy. The rationale for different therapeutic interventions to alter the course of early diabetic nephropathy are discussed. PMID- 3533478 TI - Decreased serum C-peptide/insulin molar ratios after oral glucose in hyperthyroidism. PMID- 3533479 TI - Percutaneous fine-needle aspiration biopsy of the pancreas. AB - Percutaneous fine needle aspiration biopsy of the pancreas allows to obtain without surgery a tissue proven diagnosis of focal lesions of the pancreas. Ultrasound (US), computed tomography (CT), or fluoroscopy are used to guide the positioning of the needle in the lesion. Various benign and malignant lesions can be diagnosed and the cytologic features of them are presented. The average sensitivity of the technique in the diagnosis of pancreatic carcinoma is 80.5% in the literature. The use of percutaneous fine needle biopsy of the pancreas decreases the number of investigations to be done in a patient with pancreatic disease. PMID- 3533480 TI - Aspiration biopsy: the pathologist as hands-on consultant. PMID- 3533481 TI - Fine-needle aspiration of metastatic sacrococcygeal myxopapillary ependymoma. AB - A 45-yr-old white woman with a 24-yr history of sacrococcygeal myxopapillary ependymoma developed a large metastasis of scalp and skull diagnosed as metastatic ependymoma on fine-needle aspiration, based on cytologic features, histologic pattern in cell block fragments, and a positive reaction with the glial fibrillary acidic protein immunoperoxidase study. The fine-needle study obviated the need for biopsy in this case, for which a surgical approach was considered to be inappropriate due to the extent of the process demonstrated by various imaging techniques. PMID- 3533482 TI - Diabetic peripheral neuropathies. Physiopathology and clinical guidelines. PMID- 3533483 TI - [Electron microscopy analysis of the levels of structural organization of the Escherichia coli chromosome]. PMID- 3533484 TI - [DNA replication is essential for the fixation of streptomycin resistance-induced mutations in UV-irradiated Escherichia coli cells]. PMID- 3533485 TI - [Microfilamin--a new cytoskeleton protein with a molecular weight of 53000]. PMID- 3533486 TI - [The ssb gene in the inducible and constitutive pathways of recombination in Escherichia coli K-12]. PMID- 3533487 TI - [Experimental model and possible molecular mechanism of induced deletion mutagenesis]. PMID- 3533488 TI - Antimicrobial surveillance in a VAMC teaching hospital--resulting cost avoidance. AB - The economic impact of an antimicrobial surveillance service is presented. The antimicrobial surveillance service operates as a component of antimicrobial utilization review and serves as a means of identifying and reporting patterns of antimicrobial usage for the hospital. A record of all antimicrobial agent orders is maintained by the pharmacy service. Concurrent antimicrobial utilization review is conducted on specific agents using previously approved criteria. All cases of antimicrobial use failing to meet established criteria receive immediate intervention. From September, 1983 to June, 1985, a total of 229 cases of antimicrobial use received clinical pharmacy intervention. The cost avoidance appreciated from the selection of a more cost-effective regimen was $65,381.60. Additionally, extensive educational efforts directed to cefazolin q8h vs. cefazolin q6h administration resulted in a substantial reduction in cefazolin expenditures. Indiscriminate/inappropriate use of antimicrobial agents delivers a tremendous economic burden to the health care system. Utilizing antimicrobial surveillance as a component of antimicrobial utilization review serves as a means for identifying and reporting patterns of antimicrobial usage for the medical center and has a positive economic impact as illustrated. PMID- 3533489 TI - Diprosalic ointment and lotion. PMID- 3533490 TI - [Prenatal sonographic diagnosis of abnormalities and the significance of prepartum therapeutic procedures]. AB - Between 1981 and October 1985, prenatal ultrasound examinations revealed 19 malformations of the central nervous system, 13 intestinal malformations, 15 malformations of the urogenital tract, four non-immunological cases of hydrops fetalis, two sacral teratomas and one cardiac malformation. In only one of eleven cases of hydrocephalus were all preconditions fulfilled for considering an intra uterine ventriculo-amniotic shunt insertion. In bilateral obstructive uropathy the dynamics of amniotic fluid volume both before and after intra-amniotic administration of an infusion is decisive for any further prognostic assessment. There are marked differences regarding the neonatal survival rate between the various organ-specific malformations (gastro-intestinal: 31%; hydrocephalus: 55%; obstructive uropathy: 89%). Personal experience suggests that there are only a few cases requiring intra-uterine, predominantly invasive, treatment. The value of prenatal ultrasound examination lies mainly in early diagnosis and the resulting choice of subsequent obstetric measures. Of particular importance is an interdisciplinary collaboration with specialists in allied fields. PMID- 3533491 TI - [HTLV-III antibodies in hemodialysis patients and following kidney transplantation]. PMID- 3533492 TI - [Duplex sonography in vascular diagnosis]. PMID- 3533493 TI - [Cardiopulmonary resuscitation by the layman to prevent sudden cardiac death]. PMID- 3533494 TI - [Sonographic criteria for studying gastric motility in diabetics with autonomic neuropathy]. AB - Antral contraction after a test meal was measured by ultrasonography in 32 insulin-dependent diabetics with and without autonomic neuropathy and in 12 control subjects. In sequence of the three groups studied the results were: frequency of contractions 3.6 +/- 2.0, 4.8 +/- 1.6, and 4.8 +/- 1.6, respectively, per two minutes; intensity of contraction 30.9 +/- 8.2, 41.4 +/- 5.2 and 57.5 +/- 8.8% of maximal antral surface decrease; and contraction velocity per sec 4.8 +/- 1.5, 8.2 +/- 1.2 and 9.95 +/- 2.8% of maximal antral surface decrease. Different from the frequency, intensity and velocity of antral contraction were reduced in diabetics (compared with normal controls) even without an autonomic neuropathy. In all diabetics, contraction velocity was positively correlated to variations in heart rate and to the postprandial blood glucose rise. The results indicate that disorders of motility in diabetics with autonomic neuropathy can be visualized by ultrasonography and can be diagnosed early from a reduction in contraction velocity. PMID- 3533495 TI - [Preventive sclerosis of esophageal varices]. PMID- 3533496 TI - [Babesiosis--causative agent, clinical picture, detection and therapy]. PMID- 3533497 TI - [Prevention of recurrence of the Chesson strain of Plasmodium vivax malaria]. PMID- 3533498 TI - [Significance of light for the fertility of swine]. PMID- 3533499 TI - [Optoelectronic heart rate telemetry]. PMID- 3533500 TI - [Roentgenologic and comparative pathomorphologic studies of navicular bones with special reference to the sesamoid canals--a contribution to the diagnosis of podotrochilosis]. PMID- 3533501 TI - [Are oligopeptides suitable for growth promotion? A scientific view]. PMID- 3533503 TI - Differential expression of microtubule components during brain development. PMID- 3533502 TI - [Hematocrit, blood glucose and blood urea in white storks (Ciconia ciconia, L.)]. PMID- 3533504 TI - [Laboratory diagnosis of external eye infections]. PMID- 3533505 TI - [Digital subtraction angiography]. PMID- 3533506 TI - [Ultrasonic studies of the newborn brain]. PMID- 3533507 TI - Laboratory diagnosis of chancroid in Nairobi, Kenya. PMID- 3533508 TI - Relative shear bond strength between composite restoratives and hard tooth tissues. PMID- 3533509 TI - In vitro assessment of intact endodontically treated anterior teeth with different restorative procedures. PMID- 3533510 TI - [In memoriam: Dr. Charlie Przetak]. PMID- 3533511 TI - [Composite resins--new fillers, curing technology and dentin adhesive agents]. PMID- 3533512 TI - [SEM study of the cervical margins in composite restorations using bonding agents]. PMID- 3533513 TI - [Experimental study of the bonding of 3 different dental compounds to dentin under variable experimental conditions]. PMID- 3533514 TI - [Instruments in endodontics. Introductory review]. PMID- 3533515 TI - [The deformation of tooth roots under various post placement methods]. PMID- 3533516 TI - [Immunological processes in the apical granulation tissue. II. The cellular immune response, identification and differentiation of T-lymphocyte subpopulations]. PMID- 3533517 TI - Processing and release of insulin and insulin-like growth factor I by macro- and microvascular endothelial cells. AB - Insulin and insulin-like growth factor I (IGF-I) processing by macro- and microvascular endothelial cells was investigated. Specific binding of insulin and IGF-I on the capillary endothelial cells derived from rat fat pads was 4 +/- 0.5% (+/- SE) and 4.3 +/- 0.3%/mg protein, respectively, in contrast to bovine aortic endothelial cells, which bound 9.3 +/- 0.3% IGF-I/mg protein. Both binding and processing of insulin and IGF-I were time and temperature dependent in macro- and microvascular endothelial cells. After 30 min at 37 C, between 40-50% of the bound IGF-I and insulin were internalized in both capillary and aortic endothelial cells, whereas 20-25% insulin and 15-20% IGF-I internalization were observed at 15 C. Less than 20% internalization was observed for both insulin and IGF-I at 4 C. Cellular inhibitors of hormone processing, such as chloroquine and monensin, enhanced cell-associated insulin at 37 C on the bovine aortic endothelial cells from 4.7% to 10.4 +/- 1% and 9.9 +/- 2% mg protein, respectively, at 60 min. Similarly, chloroquine and monensin increased the amount of [125I]IGF-I associated with aortic endothelial cells from 4.3 +/- 0.2% to 5.5 +/- 0.3% and 6.2 +/- 0.7%/mg protein, respectively. Chloroquine and monensin increased [125I]insulin associated with rat capillary endothelial cells from a control of 2.9 +/- 0.1% to 4.0 +/- 0.2% and 3.8% +/- 0.37%, respectively. No effect of chloroquine and monensin was observed on [125I]IGF-I binding to rat capillary endothelial cells. Leupeptin, a lysosomal protease inhibitor, did not affect insulin or IGF-I binding in either cell type. The internalized insulin and IGF-I were both rapidly released, with 70-80% of both hormones being detected in the medium by 120 min. The released hormones were mostly intact (greater than 80 90%), as assessed by trichloroacetic acid precipitability, gel filtration, and immunoprecipitation. Both insulin and IGF-I induced corresponding down-regulation of their receptors, as shown by a 66 +/- 7% decrease in insulin binding in the capillary endothelial cells and a 72 +/- 1% and 58 +/- 1% decrease in IGF-I binding in the aortic and capillary endothelial cells, respectively. Thus, macro- and microvascular endothelial cells bind and process insulin and IGF-I by degradative and nondegradative pathways. The predominance of the nondegradative pathway for the processing of insulin and IGF-I and the modulation of their receptors by physiological hormone concentrations suggested that endothelial cells may regulate the access of insulin and IGF-I to their target cells. PMID- 3533518 TI - Progesterone antagonizes the ability of porcine ovarian inhibin to sensitize ovine pituitary cell culture to luteinizing hormone-releasing hormone: dependence on ovaries in vivo. AB - Progesterone (P4) and a porcine follicular preparation of inhibin (MGRA-IV) have opposite actions on regulation of the ability of LHRH to release LH in ovine pituitary cell culture. Both P4 and inhibin change the response to LHRH. The ability of inhibin to sensitize cultures to LHRH (126-273%) was greatly inhibited (up to 100%) in the presence of P4 (10(-7) M). The inhibitory action of P4 on LHRH-stimulated and inhibin-sensitized LHRH-stimulated LH secretion in ovine pituitary cell culture was dependent on the presence of ovaries in vivo. P4 inhibited 68% of LHRH-stimulated LH secretion in pituitary cultures from intact ewes. However, when cultures were prepared from pituitaries collected on days 9, 21, and 42 after ovariectomy, P4 inhibited LHRH-stimulated LH secretion by only 36%, 13%, and 0%, respectively. Ovariectomy had no effect (P greater than 0.05) on the sensitizing action of inhibin on LHRH-stimulated LH secretion, but ovariectomy did cause a time-dependent decline in the inhibitory action of P4 on inhibin-sensitized LHRH-stimulated LH secretion. Furthermore, when cultures were prepared from pituitaries collected from ewes ovariectomized for 35 days but treated with estradiol implants, both LHRH-stimulated and inhibin-sensitized LHRH stimulated LH secretion were inhibited as well by P4 as in pituitary cultures from intact ewes. These results suggest that although P4 can completely inhibit the sensitizing action of inhibin on LHRH-stimulated LH secretion, its inhibitory action is dependent on the presence of ovaries or estradiol in vivo. PMID- 3533519 TI - Effects of different gonadotropin pulse frequencies on corpus luteum function during the menstrual cycle of rhesus monkeys. AB - In the nonfertile menstrual cycle, the frequency of episodic LH secretion declines from approximately 1 pulse/h in the early luteal phase to 1 pulse/4-8 h in the mid- to late luteal phase, but the relevance of this phenomenon to the initiation of functional luteal regression is not completely understood. We investigated whether a reduction in LH pulse frequency causes a decline in luteal progesterone production by experimentally reducing LH pulse frequency during the early luteal phase, and measured the effects on the subsequent plasma progesterone pattern and the onset of luteal regression. Rhesus monkeys were rendered anovulatory by placing radiofrequency lesions in the arcuate region of the medial basal hypothalamus or surgically transecting the hypothalamic pituitary stalk. Endogenous gonadotropin secretion and ovulatory menstrual cycles were restored by pulsatile infusion of synthetic GnRH at a frequency of 1 pulse/h. Commencing on days 3-6 of the luteal phase, GnRH frequency was changed to either 1 pulse/8 h (four animals) or 1 pulse/24 h (four animals), or maintained at the standard 1 pulse/h frequency (four animals). Luteal phases of 13- to 17-day duration were observed in all animals kept on the 1 pulse/h frequency and in three of four animals in which the frequency was changed to 1 pulse/8 h on day 3 of the luteal phase. Daily midluteal phase (days 5-10) plasma progesterone levels observed in response to the 1 pulse/h and 1 pulse/8 h infusion regimens were similar (mean +/- SE, 4.1 +/- 0.4 vs. 3.2 +/- 0.4 ng/ml; P greater than 0.1). In contrast, short luteal phases were observed in all animals after the LH pulse frequency was reduced to 1 pulse/24 h. Comparison of plasma LH responses to a representative GnRH pulse of each GnRH infusion regimen revealed that the maximal LH levels attained in response to 1 pulse/8 h (47.5 +/- 11.5 ng/ml) were significantly greater (P less than 0.05) than the maximal LH levels attained in response to 1 pulse/h (30.5 +/- 3.2 ng/ml) or 1 pulse/24 h (27.2 +/- 5.0 ng/ml). Progesterone levels remained elevated for 140-200 min after the LH pulse resulting from the 1 pulse/8 h infusion regimen. In response to the 1 pulse/24 h infusion regimen, plasma progesterone levels remained elevated for 60 min after the LH pulse.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3533520 TI - Dynamics of estrogen receptor turnover in uterine cells in vitro and in uteri in vivo. AB - The rate at which the estrogen receptor (ER) is synthesized and degraded (turns over) in target cells is a major factor regulating the levels of ER and cell sensitivity to estrogen. We have used the ability of tamoxifen aziridine [(TAZ)(Z)-1-[4-(2-[N-aziridinyl]ethoxy)phenyl]1,2-diphenyl-1-buten e] to affinity label the ER in intact cells to study the dynamics of ER turnover in uterine cells in vitro and in intact rat uteri in vivo. In primary cultures of rat uterine cells (from 21-day-old rats), ER is degraded with a half-life of 3-4 h, as determined by pulse-chase experiments in which ER in cells are covalently labeled with [3H]TAZ (20 nM) and then exposed to a chase of 10(-6) M estradiol. Density shift experiments, in which uterine cells are exposed for different time periods to medium containing dense (15N,13C,2H) amino acids and the shift of receptor from a normal density to a more dense species is analyzed on sucrose gradients, also confirm this rapid turnover for the uterine ER. A similar half life is obtained for ER in rat uteri in vivo, after intralumenal installation of [3H]TAZ to label effectively ER covalently. Analysis of nuclear ER on sodium dodecyl sulfate-polyacrylamide gels during the chase period reveals the loss of the 65,000 mol wt [3H]TAZ-labeled receptor species; no lower mol wt [3H]TAZ labeled fragments are observed. Likewise, immunoblot analyses of receptor with the ER monoclonal antibody H222Sp gamma reveal only the 65,000 mol wt receptor species, with no evidence of any smaller receptor forms in cells. Interestingly, incubation of uterine cells with 10(-5) M cycloheximide (which inhibits 98% of protein synthesis) completely arrests ER turnover, suggesting that ER turnover, which is rapid, is probably dependent upon the synthesis of other rapidly turning over proteins. Hence, we conclude that ER turnover is rapid in uterine cells, that turnover of uterine ER occurs at a rate similar to that previously reported for ER turnover in MCF-7 human breast cancer cells, and that ER turnover is similar in uterine cells under in vitro and in vivo conditions. These findings indicate that the receptor is a dynamic and rapidly turning over protein whose level could be adjusted quickly by alterations in the rate of synthesis and/or degradation. PMID- 3533521 TI - Nuclear localization of progesterone receptor before and after exposure to progestin at low and high temperatures: autoradiographic and immunohistochemical studies of chick oviduct. AB - The intracellular location of progesterone receptor and tritiated progestin was assessed in chick oviduct before and after in vitro exposure to 5 nM [3H]Org 2058 ([6,7-3H]16 alpha-ethyl-21-hydroxy-19-nor-4-pregnene-3,20-dione) for 5 or 45 min at 4 or 37 C. The experiments were designed to allow the intracellular localization of occupied and unoccupied receptor in relatively intact tissue. Autoradiography and immunohistochemistry were used to localize [3H]Org 2058 and the progesterone receptor, respectively. Autoradiograms showed radiolabeled progestin concentrated in oviduct cell nuclei not only after incubation at 37 C, but after incubation at 4 C as well. Cytoplasmic concentration was never observed. Immunostaining revealed progesterone receptor always located in cell nuclei, regardless of temperature or time of exposure to labeled ligand or whether the tissue was exposed to progestin. The results indicate that the chick oviduct nuclear progesterone receptor does not undergo a temperature-dependent translocation from cytoplasm to nucleus upon binding ligand. PMID- 3533523 TI - Characterization of dopamine receptors associated with aldosterone secretion in rat adrenal glomerulosa. AB - Dopamine (DA) may participate in the control of aldosterone secretion. We report that two different receptors for DA are present in rat adrenal glomerulosa: D-1, associated with stimulation of adenylate cyclase, and D-2, whose action inhibits adenylate cyclase. The adenylate cyclase system was stimulated by DA (EC50, 7.2 microM) and different DA agonists. When the D-1 receptor blocker SCH 23390 was added to the incubation medium, DA elicited a dose-dependent inhibition of adenylate cyclase (IC50, 10 microM); (-)sulpiride specifically blocked this effect. Furthermore, DA blocked angiotensin II-induced aldosterone release from glomerulosa slices in vitro. This effect was prevented by (-)sulpiride, but not by SCH 23390. The results suggest that the D-2 receptor acts to inhibit the cAMP generating system and may be physiologically involved in the regulation of aldosterone secretion. PMID- 3533522 TI - Characterization of rabbit uterine estrogen receptor proteins by radioiodination and partial peptide mapping. AB - Two estrogen binding proteins (Mr = 50,000 and 65,000) were purified from rabbit uterine cytosol using an improved procedure for affinity chromatography on diethylstilbestrol-agarose. The estrogen receptors were radioiodinated while adsorbed to the resin using the lactoperoxidase or Bolton-Hunter techniques. After elution, the labeled receptors were utilized for peptide mapping studies and investigations of receptor function. Partial peptide mapping revealed strong homology between the Mr 50,000 and 65,000 proteins suggesting common structural features. Estrogen receptors labeled by the lactoperoxidase procedure were rendered unable to bind immobilized heparin or hormone; in contrast, the Bolton Hunter labeling technique yields proteins that retain both their ability to bind hormone and to absorb on heparin-agarose. The development of these iodination methodologies appears useful for the investigation of both the structure and functional properties of the receptor proteins. PMID- 3533524 TI - A review of the active agents available for treatment of dentinal hypersensitivity. PMID- 3533525 TI - Glutathione: a protective agent in Salmonella typhimurium and Escherichia coli as measured by mutagenicity and by growth delay assays. AB - Cultures of some aerobically grown strains of Salmonella typhimurium and Escherichia coli contain up to 24 microM extracellular glutathione (GSH) [Owens RO, Hartman PE (1985): Environ Mutagen 7(Suppl 3): 47] in addition to having intracellular GSH concentrations in the millimolar range. The addition of 26 microM GSH to cultures of Salmonella typhimurium strain TA1534 partially protected the bacteria from the toxic effects causing growth delay by 54 microM N methyl-N'-nitro-N-nitrosoguanidine (MNNG). When MNNG was preincubated with equimolar GSH, the mutagenicity of the MNNG was neutralized. The addition of micromolar GSH to cultures of an Escherichia coli GSH- strain protected the cells from growth inhibition by micromolar concentrations of mercuric chloride, methyl mercuric chloride, silver nitrate, cisplatin, cadmium chloride, cadmium sulfate, and iodoacetamide. In the cases of mercuric chloride, cisplatin, MNNG, silver nitrate, and iodoacetamide, reaction products with GSH were detected by paper chromatography. In contrast to reduced GSH, micromolar concentrations of oxidized glutathione (GSSG) provided little or no protection and formed no detectable reaction products. Export of GSH by enteric bacteria may provide an important defense mechanism against exogenous toxic agents otherwise active in the micromolar range. PMID- 3533526 TI - Genetic and physiological modulation of anthracycline-induced mutagenesis in Salmonella typhimurium. AB - The genotoxic properties of adriamycin and daunomycin, anthracycline antibiotics effective in the treatment of a wide variety of malignancies, were examined in the Salmonella/Ames reverse-mutation test. A novel time- and temperature dependent phenomenon that potentiates the mutagenicity of these compounds, termed mutational enhancement, is described. The results of congeneric and chemical attenuation studies imply that anthracycline-induced free radicals contribute substantively to the mutagenic potentials of adriamycin and daunomycin. These studies show that adriamycin and daunomycin are not simple intercalative compounds. Rather, anthracycline-induced mutagenesis entails at least two separate but intimately related steps, namely, intercalation within discrete base sequences and the free-radical-mediated events that ensue. Implications of the nonrandom and site-specific action of the anthracyclines are discussed. PMID- 3533527 TI - Environmental tobacco smoke: comparative characterization by mutagenicity assays of sidestream and mainstream cigarette smoke. AB - Mainstream cigarette smoke particles were collected by means of a smoking machine, and sidestream particles were collected from the room in which the smoking took place. The particles were extracted by sonication with acetone, and the extracts were solvent-exchanged to dimethyl sulfoxide. The samples were tested for mutagenicity in the Ames Salmonella/microsome assay. The mainstream extract is preferentially mutagenic in the presence of S9, with about 30,000 revertants/cigarette in TA98, but has little or no activity in its absence. The sidestream extract is also mutagenic in the presence of S9 with TA98, and this activity is mainly due to basic compounds. Sidestream smoke is also significantly mutagenic in the absence of S9 in the strain TA100 as well as in TA97 and TA104. This "direct" activity is due to components that are labile. The response of sidestream particles is 10,000-20,000 revertants/cigarette in TA98 + S9 and TA100 S9 when the collection is performed in a room where the particle concentration is modulated by deposition to surfaces. Sidestream particles collected on glass fiber filter and by electrostatic precipitation (ESP) with a commercial air cleaning device gave essentially the same mutagenic response, showing that ESP sampling may be an alternative to filter sampling for environmental tobacco smoke (ETS) in indoor environments. ESP sampling in children's rooms in smoking and nonsmoking homes showed that 5-10% of the tobacco smoke emitted in the smoking homes entered the child's room, demonstrating that diffusion of pollutants is faster than ventilation in modern buildings with low ventilation rates. PMID- 3533528 TI - Chromium (VI) comutagenesis: characterization of the interaction of K2CrO4 with azide. AB - In a previous report chromate potentiated the mutagenicity of sodium azide, apparently by affecting repair and/or replication of DNA. Further evidence in support of such a mechanism for chromate potentiation is reported here. Chromate does not react directly with azide or its major mutagenic metabolite, azidoalanine, eliminating such reactions as possible mechanisms for potentiation. Further, azide was unable to potentiate the mutagenicity of chromate in Salmonella typhimurium strain TA104, which is sensitive to chromate mutagenicity but not to azide. Thus, it appears that the potentiation is not due to an action of azide in modulating chromate mutagenicity. Finally, the interaction was not altered by deficiency in recA gene product in S typhimurium GW19, nor by enhancement of SOS repair in the pKM101 containing strain TA100. Thus, induction of recA-dependent functions seems to play no role in the comutagenic actions of chromate. The simplest explanation for potentiation seems to be that chromate is able either to limit error-free recovery from azide-induced DNA damage or to promote error-prone repair or error-prone processing at sites of lesions. PMID- 3533529 TI - A protocol for the combined biochemical and serological identification of the Ames mutagen tester strains as Salmonella typhimurium. AB - Previously published reports have noted biochemical reactions atypical of Salmonella among the Ames tester strains of Salmonella typhimurium, and an inability to assign the strains to a specific Salmonella O (heat-stable cell wall) antigen group. We studied the biochemistry and serology of strains TA97, 98, 100, 102, 104, 1535, 1537, and 1538 in an attempt to develop a protocol to correctly speciate the strains. Biochemical reactions of all eight strains using standard media supplemented with histidine and biotin were consistent with those of the genus Salmonella. Strains TA100, 104, and 1535 were assigned to Salmonella O groups using bacteria treated with hot ethanol (White schema). H (flagellar) antigen assignments were performed successfully with seven of the eight strains. Two H antigen assignments required the use of the Craigie tube test for selection of motile revertants. Combining our biochemical and serological results obtained by this protocol, we were able to correctly speciate TA100, 104, and 1535 as Salmonella typhimurium. Our results demonstrate that representatives of the tester strains can be correctly speciated provided that procedures are followed that allow for the unusual nutrient requirements, the deep rough cell wall mutation, and the variably deficient motility of these organisms. PMID- 3533530 TI - Detomidine: a new sedative for horses. AB - Detomidine, given intravenously at doses of 5 to 30 (mean 13) micrograms/kg bodyweight (bwt), provided adequate sedation for a variety of clinical procedures in 93 per cent of administrations, and improved the ease of handling in the remaining animals. Side effects of ataxia and bradycardia were minimal at the lower dose rates. Higher doses were required for intramuscular use. In experimental trials 10 and 20 micrograms/kg bwt resulted in deep sedation and also significant hypertension and bradycardia of over 15 mins duration. Current literature on the use of detomidine in horses is reviewed. PMID- 3533531 TI - Molecular cloning and expression of cDNA for human antileukoprotease from cervix uterus. AB - We have isolated cDNA clones for the human antileukoprotease HUSI-I, an elastase inhibitor, from a library, containing cDNA inserts made from human cervix uterus. A library of 10 000 recombinants was screened using a mixture of 16 different oligodeoxyribonucleotides which correspond to amino acids 79-84 and one 20mer oligodeoxyribonucleotide corresponding to amino acids 19-26. Two overlapping cDNA clones, containing the entire coding sequence and part of the 5'- and 3' untranslated region, were isolated. DNA sequence data showed that our clone corresponds with the available protein sequence data. For expression, the cDNA fragment was inserted in a derivative of plasmid pPLc236 and expressed under the control of lambda PL promoter. Expression of antileukoprotease was proven by Western blot analysis and inhibition of chymotrypsin. PMID- 3533532 TI - A cell-free system from Rhizobium meliloti to study the specific expression of nodulation genes. AB - An in vitro transcription-translation system was developed using cell-free extracts from the symbiotic nitrogen-fixing bacterium Rhizobium meliloti strain 41. Conditions for preparation of the 30,000 X g supernatant extract and for measurement of protein-synthesizing activity were determined and compared to the activity of an Escherichia coli cell-free system. Genes expressed in the free living or in the symbiotic state were studied. The product of a recA-like gene (41-kDa protein) was synthesized both in R. meliloti and E. coli extracts, although less efficiently in the heterologous system. In agreement with earlier results obtained in E. coli minicells, three proteins (44, 28.5 and 23 kDa) were synthesized from a cloned 3.3 X 10(3)-base DNA region carrying genes for nodulation (nod). However, differences in the transcription-translation of nod and host specificity (hsn) genes were observed when protein expression was compared in R. meliloti and E. coli cell-free extracts, and the possible explanations of these findings are discussed. PMID- 3533533 TI - 3-Azi-1-methoxybutyl D-maltooligosaccharides specifically bind to the maltose/maltooligosaccharide-binding protein of Escherichia coli and can be used as photoaffinity labels. AB - Maltooligosaccharides with two to six (alpha 1-4)-linked glucose residues, carrying at their reducing end a 3-azi-1-methoxybutyl group in either alpha or in beta glycosidic linkage, were synthesized. These maltooligosaccharide analogues inhibit maltose uptake via the maltose-binding-protein-dependent transport system in Escherichia coli. The concentration of half-maximal inhibition of maltose transport, at 15 nM concentration, decreases with increasing chain length of the analogue, levelling off at 40 microM after a chain length of four glucose residues in the alpha series and at 350 microM after a chain length of three glucose residues in the beta series. The inhibition of maltose transport occurs at the level of the periplasmic maltose-binding protein. 3-Azi-1-methoxybutyl alpha-D-[3H]maltotrioside was bound by the maltose-binding protein with a Kd of 0.18 mM. Irradiation at 350 nm of purified maltose-binding protein in the presence of 4 microM of this substrate labeled the protein covalently; labeling was prevented by 1 mM maltose. Using a crude preparation of periplasmic proteins two proteins were labeled, the maltose-binding protein and alpha-amylase. Thus, 3 azi-1-methoxybutyl alpha-D-maltooligosaccharides are potent photoaffinity labels for proteins with maltooligosaccharides-binding sites. PMID- 3533534 TI - Flavin-dependent alcohol oxidase from yeast. Studies on the catalytic mechanism and inactivation during turnover. AB - The kinetic course of the reaction of methanol and deutero-methanol with FAD dependent alcohol oxidase was investigated under single-turnover conditions [kred approximately equal to 15000 min-1 (1H3COH) and approximately equal to 4300 min-1 (2H3COH)] and multiple-turnover conditions [TNmax approximately equal to 6000 min 1 (1H3COH) and approximately equal to 3100 min-1 (2H3COH)]. A kinetic scheme for the overall catalytic mechanism is proposed, which is characterized by (1) formation of a Michaelis complex between enzyme and substrate, (2) the reductive step involving partly rate-limiting scission of the substrate C-H bond, (3) reaction of the complex of reduced enzyme and aldehyde with dioxygen, and (4) a significant contribution of the dissociation rate of product from its complex with reoxidized enzyme to the overall rate. Prolonged turnover of various alcohols, including methanol, results in progressive inactivation of the enzyme by two processes. In the absence of catalase the inactivation rate increases with time due to accumulation of hydrogen peroxide, which is a potent inactivator (Kd approximately equal to 1.6 mM; kinact approximately equal to 0.55 min-1). In the presence of catalase inactivation during turnover is much slower, the process showing pseudo-first-order kinetics (Kinact approximately equal to 0.6 mM; kinact approximately equal to 0.005 min-1 with methanol). The ratio kcat/kinact varies with different alcohols but is always greater than 10(5). Propargyl alcohol and methylenecyclopropyl alcohol cannot be considered as suicide substrates, as compared to analogous substrates of other flavin oxidases. PMID- 3533535 TI - Nucleotide sequence of the pbpA gene and characteristics of the deduced amino acid sequence of penicillin-binding protein 2 of Escherichia coli K12. AB - We have determined the nucleotide sequence of the pbpA gene encoding penicillin binding protein (PBP) 2 of Escherichia coli. The coding region for PBP 2 was 1899 base pairs in length and was preceded by a possible promoter sequence and two open reading frames. The primary structure of PBP 2, deduced from the nucleotide sequence, comprised 633 amino acid residues. The relative molecular mass was calculated to be 70867. The deduced sequence agreed with the NH2-terminal sequence of PBP 2 purified from membranes, suggesting that PBP 2 has no signal peptide. The hydropathy profile suggested that the NH2-terminal hydrophobic region (a stretch of 25 non-ionic amino acids) may anchor PBP 2 in the cytoplasmic membrane as an ectoprotein. There were nine homologous segments in the amino acid sequence of PBP 2 when compared with PBP 3 of E. coli. The active site serine residue of PBP 2 was predicted to be Ser-330. Around this putative active-site serine residue was found the conserved sequence of Ser-Xaa-Xaa-Lys, which has been identified in all of the other E. coli PBPs so far studied (PBPs 1A, 1B, 3, 5 and 6) and class A and class C beta-lactamases. In the higher molecular-mass PBPs 1A, 1B, 2 and 3, Ser-Xaa-Xaa-Lys-Pro was conserved. In the putative peptidoglycan transpeptidase domain there were six amino acid residues, which are common only in the PBPs of higher molecular mass. PMID- 3533536 TI - Studies in vitro on the flavinylation of 6-hydroxy-D-nicotine oxidase. AB - The gene of 6-hydroxy-D-nicotine oxidase (6-HDNO), a flavoenzyme from Arthrobacter oxidans with covalently bound FAD, was expressed with the aid of an expression vector in a cell-free coupled transcription-translation system derived from Escherichia coli MZ9. Ultraviolet irradiation of the E. coli extract did not affect synthesis of the 6-HDNO polypeptide nor total protein synthesis but enzymatic 6-HDNO activity could not be detected. Addition of FAD to the irradiated cell extract restored the capability of the transcription-translation assays to synthesize enzymatically active 6-HDNO. However, enzymatic activity could not be restored on addition of FAD plus cell-free extract to the ultraviolet-inactivated assays after completion of apo-6-HDNO synthesis (60 min) nor to immunoprecipitates thereof. Under similar conditions, addition of [14C]FAD did not increase the protein-bound radioactivity. These results indicate that under conditions of limited FAD supply in the in vitro system a flavinless apo-6 HDNO-polypeptide was synthesized. It was, however, not possible to bind the cofactor to the completed polypeptide chain. These findings argue for a cotranslational cofactor binding. PMID- 3533537 TI - The nifH gene product is required for the synthesis or stability of the iron molybdenum cofactor of nitrogenase from Klebsiella pneumoniae. AB - The MoFe protein of nitrogenase from Klebsiella pneumoniae contains an iron molybdenum cofactor, FeMoco, the synthesis or processing of which involves the products of at least five genes, nifQ, nifB, nifN, nifE and nifV. We have detected FeMoco activity in extracts of strains which synthesise neither of the MoFe protein subunits, indicating that FeMoco can be synthesised prior to combination with the MoFe protein polypeptides. Expression of the nifH gene (or a large part of it), was essential for FeMoco activity to be observed either in the presence or in the absence of the MoFe protein subunits. The nifH gene product was not involved in the control of the transcription of other nif gene products known to be involved in FeMoco synthesis or processing, nor was it essential for the stability of performed FeMoco before its combination with the MoFe protein polypeptides. PMID- 3533538 TI - Differential detergent-solubilization of integral thylakoid membrane complexes in spinach chloroplasts. Localization of photosystem II, cytochrome b6-f complex and photosystem I. AB - Progressive solubilization of spinach chloroplast thylakoids by Triton X-100 was employed to investigate the domain organization of the electron transport complexes in the thylakoid membrane. Triton/chlorophyll ratios of 1:1 were sufficient to disrupt fully the continuity of the thylakoid membrane network, but not sufficient to solubilize either photosystem I (PSI), photosystem II (PSII) or the cytochrome b6-f(Cyt b6-f) complex. Progressive with the Triton concentration increase (Triton/Chl greater than 1:1), a differential solubilization of the three electron transport complexes was observed. Solubilization of the Cyt b6-f complex from the thylakoid membrane preceded that of PSI and apparently occurred early in the solubilization of stroma-exposed segments of the chloroplast lamellae. The initial removal of chlorophyll (up to 40% of the total) occurred upon solubilization of PSI from the stroma-exposed lamella regions in which PSI is localized. The tightly appressed membrane of the grana partition regions was markedly resistant to solubilization by Triton X-100. Thus, solubilization of PSII from this membrane region was initiated only after all Cyt b6-f and PSI complexes were removed from the chloroplast lamellae. The results support the notion of extreme lateral heterogeneity in the organization of the electron transport complexes in higher plant chloroplasts and suggest a Cyt b6-f localization in the membrane of the narrow fret regions which serve as a continuum between the grana and stroma lamellae. PMID- 3533539 TI - Nucleotide sequence and characteristics of the gene for L-lactate dehydrogenase of Thermus caldophilus GK24 and the deduced amino-acid sequence of the enzyme. AB - The gene for L-lactate dehydrogenase (LDH) (EC 1.1.1.27) of Thermus caldophilus GK24 was cloned in Escherichia coli using synthetic oligonucleotides as hybridization probes. The nucleotide sequence of the cloned DNA was determined. The primary structure of the LDH was deduced from the nucleotide sequence. The deduced amino acid sequence agreed with the NH2-terminal and COOH-terminal sequences previously reported and the determined amino acid sequences of the peptides obtained from trypsin-digested T. caldophilus LDH. The LDH comprised 310 amino acid residues and its molecular mass was determined to be 32,808. On alignment of the whole amino acid sequences, the T. caldophilus LDH showed about 40% identity with the Bacillus stearothermophilus, Lactobacillus casei and dogfish muscle LDHs. The T. caldophilus LDH gene was expressed with the E. coli lac promoter in E. coli, which resulted in the production of the thermophilic LDH. The gene for the T. caldophilus LDH showed more than 40% identity with those for the human and mouse muscle LDHs on alignment of the whole nucleotide sequences. The G + C content of the coding region for the T. caldophilus LDH was 74.1%, which was higher than that of the chromosomal DNA (67.2%). The G + C contents in the first, second and third positions of the codons used were 77.7%, 48.1% and 95.5% respectively. The high G + C content in the third base caused extremely non-random codon usage in the LDH gene. About half (48.7%) the codons in the LDH gene started with G, and hence there were relatively high contents of Val, Ala, Glu and Gly in the LDH. The contents of Pro, Arg, Ala and Gly, which have high G + C contents in their codons, were also high. Rare codons with U or A as the third base were sometimes used to avoid the TCGA sequence, the recognition site for the restriction endonuclease, TaqI. Two TCGA sequences were found only in the sequence of CTCGAG (XhoI site) in the sequenced region of the T. caldophilus DNA. There were three segments with similar sequences in the two 5' non-coding regions, probably the promoter and ribosome-binding regions, of the genes for the T. caldophilus LDH and the Thermus thermophilus 3-isopropylmalate dehydrogenase. PMID- 3533540 TI - Ultrasound during surgery of the carotid artery. AB - Operative ultrasonography is very useful in carotid artery surgery--First to show before the reconstruction the site, the degree and the shape of the lesions- second after the reconstruction to appreciate its quality. In our 26 cases, reintervention was performed in five cases but only 3 have had a second reconstruction. Sensitivity of this method is very high, and this must be taken into consideration before any repeat surgery. PMID- 3533541 TI - Utility of DSA in the evaluation of haemodialysis access fistulas. AB - Results of 39 intravenous and intraarterial DSA studies of haemodialysis access fistula are presented. Advantages of DSA versus conventional fistulography and xeroangiography are discussed. Digital subtraction angiography represents an accurate, time-saving and low complication approach to the evaluation of failing dialysis access fistulas. PMID- 3533542 TI - Repetitive echoes in ultrasonography of the diaphragm demonstrated by cadaver studies. AB - For some years past, strange and seemingly inexplicable images frequently appear during sonographic examination of the area below the diaphragm. In order to explain these mysterious phenomena we carried out anatomical experiments. We observed the appearance of such enigmatic images no matter what the kind of probe was used and found that in every case the appearance of a phantom image over the diaphragm signifies the existence of a true image situated elsewhere. It is always possible with necessary adjustments to locate the formation responsible for the phantom images, which are no longer mysterious. PMID- 3533543 TI - Somatic and genetic radiation exposure of the patient in digital subtraction angiography (DSA) AB - The somatic and genetic radiation exposure of patients undergoing Digital Subtraction Angiography (DSA) and traditional Film Arteriography (FA) of cranial, cervical, thoracic and abdominal vascular territories are compared. The radiation doses absorbed within the critical organs--red bone marrow, lung, thyroid gland and female breast--and in the gonads were measured using an anthropomorphic Alderson phantom. A Somatic Dose Index was calculated in order to estimate the somatic radiation risk. The somatic radiation exposure depends upon the location of the critical organs with respect to the entrance site of the x-ray beam, and can be reduced by an appropriate choice of the angiographic projection. Under this condition, the radiation exposure of the patient during DSA can be lower than during FA. For renal DSA an a.p. projection, the use of an abdominal compression device and careful caudal shielding of the field are advocated. PMID- 3533544 TI - Calcifications adjacent to gallbladder simulating gallbladder stones. Two case reports. AB - False positive diagnosis is always unfortunate. Echodensities caused by bowel gas close to the gallbladder can be differentiated from gallbladder stones by careful scanning. Two cases of calcifications adjacent to the gallbladder simulating gallbladder stone are described. PMID- 3533545 TI - Role of programmed electrical stimulation of the heart in the selection and design of implantable units for the treatment of recurrent tachycardia. AB - The introduction of programmed electrical stimulation of the heart opened up new ways for the diagnosis and treatment of recurrent tachycardias. Programmed stimulation not only allows study of the site of origin and mechanisms of arrhythmias, but also the evaluation of the modes of reproducible initiation and termination of tachycardia and the study of effects of drugs on the tachycardia mechanisms. By analyzing results of invasive and non-invasive programmed stimulation, the most successful pacing modality to reproducibly terminate tachycardia can be identified, but complications of pacing can also be recognized (such as the initiation of other arrhythmias). Careful consideration of the results of programmed electrical stimulation is necessary to select the best implantable unit for a particular patient, and to design or redesign new or already implanted antitachycardia units. PMID- 3533546 TI - International Mexiletine and Placebo Antiarrhythmic Coronary Trial (IMPACT): II. Results from 24-hour electrocardiograms. IMPACT Research Group. AB - The sustained release form of mexiletine (Mexitil-Perlongets), 360 mg b.i.d., was evaluated for antiarrhythmic efficacy in a double-blind placebo trial in 630 patients with recent documented myocardial infarction. The drug was effective in reducing the occurrence of complex forms of ventricular arrhythmias as well as frequent premature ventricular complexes during the first four months of treatment. In addition, a favourable trend in antiarrhythmic efficacy of the drug was observed after 12 months of treatment, but this was not statistically significant. The data from this study suggest that mexiletine was as effective in preventing the occurrence of frequent or complex cardiac arrhythmias as in reducing such arrhythmias present during the first four months following acute myocardial infarction. Mortality was higher in the mexiletine group (7.6%) than in the placebo group (4.8%), although the difference was not statistically significant. PMID- 3533547 TI - Cardiovascular reactivity to mental stress during gradual withdrawal of chronic postinfarction treatment with metoprolol. AB - In 34 patients on double-blind postinfarction treatment with metoprolol 100-200 mg daily (N = 20) or matching placebo, the study treatment was gradually withdrawn during one week. The patients were subjected to mental stress (a modified version of Stroop's colour word conflict test) before and 1 and 12 weeks after the completion of double-blind withdrawal. This stress increased heart rate (P less than 0.001), blood pressures (P less than 0.001) and adrenaline (P = 0.003), but not noradrenaline in venous plasma. In the placebo group similar responses were evoked on all three occasions. In the metoprolol group, heart rate responses were reduced while on treatment. Following withdrawal there was no rebound increase in the heart rate response. Rather, some blockade persisted one week after withdrawal. Twelve weeks after withdrawal heart rate and blood pressure responses to mental stress were normalized. During treatment the metoprolol group had fewer ventricular arrhythmias than the placebo group. Following withdrawal, ventricular arrhythmias during stress increased in 4 patients in the metoprolol group. Plasma adrenaline levels were reduced one week after withdrawal of metoprolol treatment. Plasma noradrenaline levels did not change within either group during the follow-up period. Thus, no rebound increase in cardiovascular reactivity to mental stress was found, in contrast to our previous findings with physical stressors in similar patients participating in this study. These differences in responsiveness after metoprolol withdrawal may be related to different clearance rates for metoprolol in different tissues. Our results indicate that central, presumably supramedullary, cardiovascular control mechanisms involving beta-adrenoceptors recover at a slow rate following withdrawal. PMID- 3533548 TI - Left ventricular function before and after kidney transplantation. A prospective study in patients with juvenile-onset diabetes mellitus. AB - The aim of the present investigation was to discover whether disturbed left ventricular (LV) function limits renal replacement therapy in patients with juvenile onset diabetes mellitus. Seventeen patients given functioning kidney grafts were studied non-invasively (M-mode echocardiography, apexcardiography, phonocardiography) before renal transplant and an average of six, 13 and 44 months after transplant. The main pretransplant findings were pronounced LV hypertrophy with impaired diastolic LV function (prolonged relaxation time + signs of decreased LV distensibility) and a hyperdynamic circulation. Most of these abnormalities were significantly less severe after successful kidney transplantation. LV mass decreased by 37% 44 months after transplant (p less than 0.01) and LV diastolic and systolic volumes decreased with a subsequent increase in ejection fraction from 0.65 to 0.78 (p less than 0.01). The LV distensibility and filling pattern improved significantly while the prolonged relaxation time was unchanged. These findings imply that pretransplant disturbances in LV function are related more to factors such as hypertension, volume overload and uraemia than to diabetes per se because no pronounced improvement in the metabolic disorder resulting from diabetes can be expected, even after the most successful transplant. Disturbed LV function should not, therefore, exclude uraemic diabetics from renal replacement. PMID- 3533549 TI - Prenatal diagnosis of "dihydrobiopterin synthetase" deficiency, a variant form of phenylketonuria. AB - Amniocentesis was performed at 19 weeks gestation in a mother who had previously delivered a boy with "dihydrobiopterin synthetase" (DHBS) deficiency. The amniotic fluid contained neopterin in high (136 nmol/l) and biopterin in very low concentrations (1.8 nmol/l). The activity of the phosphate-eliminating enzyme (PEE, also called 6-pyruvoyl tetrahydropterin synthase, substrate: 7,8 dihydroneopterin triphosphate) which is present in liver and erythrocytes and defective in DHBS deficiency, was measured in the erythrocytes of the family members. The fetal sample showed only 2% of the activity of healthy adult controls and was comparable with that of the affected sibling. Obligate heterozygotes had activities around 20% of the controls. Two fetal control samples showed even higher activities than adult erythrocytes, Sepiapterin reductase activities wer normal in all cases. At autopsy, PEE deficiency was confirmed in the liver of the fetus. We concluded that DHBS deficiency (and most probably also GTP cyclohydrolase I deficiency) can be diagnosed by metabolite measurements in amniotic fluid. PEE activity is measurable in erythrocytes, although the assay needs to be improved. Since maternal tetrahydrobiopterin does not cross the placenta, treatment of a tetrahydrobiopterin-deficient fetus with tetrahydrobiopterin in utero is not possible. PMID- 3533550 TI - Radioisotopic evaluation of the renal parenchymal function in children with ureteropelvic junction obstruction. A retrospective study. AB - Separate glomerular filtration rates were evaluated in 21 children with uni- or bilateral ureteropelvic junction stenosis, using the Tc-99m DTPA complex and the scintillation camera. The grade of alteration seen on urograms has influenced the surgeon in his decision to use a conservative or a surgical treatment, whereas the type of intervention (pyeloplasty or nephrectomy) was mainly based on the scintigraphic quantitation. The morphological data provided by an excretory urogram could not predict the degree of functional impairment. The scintigraphic evaluation of single kidney clearance was useful in the evaluation of the effects of medical and surgical treatment. PMID- 3533551 TI - Once a day theophylline in chronic childhood asthma? AB - The therapeutic effects of either morning or evening administration of a once daily controlled release theophylline preparation (Uniphyllin) were studied in 17 asthmatic children. Neither morning nor evening administration produced therapeutic plasma theophylline levels throughout 24h. Similarly, bronchodilation was not maintained during the same period. However, morning peak expiratory flow rates were significantly improved following evening dosage, suggesting a role for evening administration when nocturnal symptoms predominate. PMID- 3533552 TI - Biophysical fundamentals, technical prerequisites, and safety aspects for the application of the neodymium-YAG laser in urology. AB - The relationship between the physical parameters of the biological objects and the parameters of the laser radiation is important when considering the interaction between laser radiation and biological molecules. A consideration of the dependence of absorption and scattering in the tissue on wavelength alone permits a simple explanation of the various thermal effects of the various laser systems used in surgery. The thermal properties of tissue may be assumed to be the same as those of water. As an example of a medical neodymium-YAG laser instrument the mediLas system is presented with different application instruments that are necessary for an efficient use of the laser. The prerequisite for the use of high-power laser in surgery is complete safety not only for the patient when determining the right irradiation dose, but also for the doctor and his staff. PMID- 3533553 TI - Transrectal ultrasonography before and after neodymium-YAG laser irradiation of localized prostatic carcinoma. AB - Transrectal ultrasonography was used to evaluate 54 patients with localized prostatic carcinoma treated with neodymium-YAG laser irradiation. Both pre- and postirradiation scans were obtained in 30 patients, while additional 24 cases were examined after laser irradiation only. The procedure represents a valuable contribution to proper preoperative staging and is mandatory for the follow-up of patients selected for this particular treatment. The shrinkage of the capsule is negligible after laser irradiation. No specific ultrasonic changes due to the laser effect are to be found. Abnormal parenchymal echoes and capsular irregularities are the major parameters indicating early recurrence of disease. The presence of malignancy must be confirmed by biopsy. PMID- 3533554 TI - Limitations of the salmonella/mammalian microsome assay (Ames test) to determine occupational exposure to cytostatic drugs. AB - Urine samples of nursing personnel working in medical oncology divisions of several Swiss hospitals were examined for mutagenic activity. Urine samples were concentrated 100 times following XAD-2 chromatography and mutagenicity was determined using the Salmonella/mammalian microsome assay (Ames test). Apart from the urine samples of patients treated with cytostatic drugs and urine samples of nurses who are cigarette smokers, no mutagenic activity could be found. Also following exposure to an increased and defined quantity of cytostatic drugs no mutagenicity could be recovered from the urine. Four different nurses worked with cyclophosphamide, methotrexate, 5-fluorouracil, adriamycin and cis-platinum for 3 4 hr without using any protection such as gloves, masks or a vertical laminar airflow hood. Aqueous extracts of filters, through which air was pumped during the whole experiment (a personal air-sampler was fixed near the face of the test persons), were non-mutagenic. Parallel to the mutagenicity test chemical analyses were also done. The methotrexate content was determined in serum samples and the aqueous filter extracts and urine samples were examined for cis-platinum. All chemical determinations were negative. With the aid of urine concentrates of a patient treated with sub-therapeutic doses of cyclophosphamide as well as with normal urine to which single small amounts of different cytostatics (adriamycin, cyclophosphamide, cis-platinum) were added, the detection limits for the corresponding cytostatic drugs were determined and found to be in the range of 2 10 mg for cyclophosphamide and approx. 10 micrograms for adriamycin. Cis-platinum was lost during the passage through the XAD-2 columns. With these results at hand the sensitivity of the hitherto preferably used method (Ames test) for the monitoring of exposure to cytostatic drugs must be seriously questioned. PMID- 3533555 TI - Of tumours in mice and men, the different roles of somatic mutation in treatment failure. PMID- 3533556 TI - The subrenal capsule assay: a critical commentary. PMID- 3533557 TI - High dose therapy and autologous marrow transplantation as salvage treatment for patients with diffuse large cell lymphoma. AB - Twenty-nine patients with diffuse large cell lymphoma who failed traditional chemotherapy were treated with high dose chemotherapy with or without total body irradiation followed by infusion of cryopreserved autologous marrow. Complete response was achieved in 11/29 patients (38%), partial response in 13/29 patients (45%) and 5/29 patients (17%) had no response. Six complete responders remain well and free of disease for 5+, 6+, 9+, 10+, 18+ and 25+ months, 3 relapsed at 2, 3 and 8 months after marrow infusion, and 2 died from infectious complications. Complete response was seen more frequently with the absence of bulky tumor (70 vs 21%, P = 0.03), a total body irradiation containing regimen (52 vs 0%, P = 0.03), a history of complete remission with initial chemotherapy (55% vs. 9%, P = 0.03), and a performance status greater than or equal to 80 (56 vs 15%, P = 0.06). High dose therapy had a high response rate (83%) in resistant diffuse large cell lymphoma and yielded durable complete responses in a minority of these patients. PMID- 3533558 TI - Massive therapy and autologous bone marrow transplantation in pediatric and young adults Burkitt's lymphoma (30 courses on 28 patients: a 5-year experience). AB - A 5-yr experience of massive therapy and autologous bone marrow transplantation (ABMT) for Burkitt's lymphoma is reviewed. Thirty courses were given to 28 patients. Three patients were in resistant relapse and all three died before day 54 post ABMT. Thirteen patients were in non-resistant relapse and seven are alive with non-evidence of disease (NED). All three patients grafted in partial remission (PR) are alive NED including two with initial central nervous system (CNS) disease. Nine patients were grafted in 1st complete remission (CR) either because of long delay to achieve CR or as consolidation in those with initial CNS involvement or leukaemia. Three of these nine are alive including 2/3 with a long delay to CR and 1/5 initial CNS. The overall survival NED for the 28 patients is 46%. The median observation time post ABMT, 22 months. Clear indications for ABMT in BL are in our opinion restricted to about 20% of the patients: non-resistant relapses and PR after initial induction therapy. Massive therapy as consolidation of 1st CR after initial CNS involvement and in resistant relapses should still be considered as experimental. In 14 patients whose marrow was purged there is laboratory evidence suggesting that the purging procedures used in this study may have been incomplete. Purging techniques still require perfection at a laboratory level and their rationale should not be judged on the basis of incomplete procedures. PMID- 3533559 TI - Self-regulated learning among exceptional children. PMID- 3533560 TI - Attributional retraining and the teaching of strategies. PMID- 3533561 TI - Comparison of the antihypertensive effect of urapidil and metoprolol in hypertension. AB - The hypertensive effect of urapidil, a new antihypertensive agent that acts via central and peripheral alpha-adrenoceptors, has been compared with that of metoprolol in 40 patients with mild essential hypertension. Blood pressure was significantly reduced by both drugs, while the heart rate was reduced only after metoprolol. The increases in systolic blood pressure and heart rate caused by three progressive work loads of bicycle exercise were not affected during urapidil, whereas both were reduced by metoprolol. A slight reduction in forced expiratory volume was observed in some patients during treatment with the beta blocker. There was no case of orthostatic hypotension during urapidil administration, despite its alpha1-blocking action. Side-effects were rare and negligible with both drugs. PMID- 3533562 TI - Peripheral vascular effects of bufuralol in hypertensive and normal subjects: a comparison with propranolol and pindolol. AB - In a double-blind, single oral dose, cross-over study, the effects of bufuralol (60 mg) on heart rate, blood pressure, and peripheral vascular responses were compared with those of propranolol (160 mg), pindolol (10 mg), and placebo in a group of 12 healthy volunteers. All three beta-adrenoceptor antagonists reduced exercise tachycardia, but at the doses chosen the effects of bufuralol were less than those of propranolol. Forearm blood flow was reduced by propranolol and pindolol, but not by bufuralol. The antihypertensive and peripheral vascular effects of bufuralol (30-60 mg bd) were also compared with those of propranolol (40-80 mg bd) in a double-blind crossover study in 10 patients with mild hypertension. Propranolol and bufuralol produced comparable reductions in systemic blood pressure over a two-week period, but the decreases in forearm and finger blood flow were greater with propranolol. These studies suggest that bufuralol is a beta-adrenoceptor antagonist with antihypertensive properties, and that it produces less peripheral vasoconstriction than propranolol or pindolol. PMID- 3533563 TI - Assessment of the relative safety of the beta-blockers ICI 141,292 and atenolol in patients with bronchial asthma. AB - ICI 141,292 is a beta-blocker with beta 1-selective partial agonist activity. To study its cardioselectivity in humans, comparable beta-blocking doses of 200 mg ICI 141,292 and 100 mg atenolol were given to 12 patients with stable bronchial asthma. Both drugs significantly reduced the midexpiratory flow rate at 50% of vital capacity, whereas no significant reduction in FEV1 or peak expiratory flow rate were observed. It is concluded that the cardioselectivity of ICI 141,292 did not differ significantly from that of atenolol. Since they both had a measurable effect on respiratory mechanics, they should probably not be prescribed in bronchial asthma, or only with the greatest possible caution. PMID- 3533564 TI - Haemodynamic effects of atenolol, pindolol and propranolol during adrenaline infusion in man. AB - In a double blind, cross over study the haemodynamic effects of an i.v. infusion of adrenaline during concomitant administration of atenolol, pindolol, propranolol or placebo were examined in 7 healthy volunteers. During coadministration with placebo, adrenaline caused an increase in systolic blood pressure (SBP) of 26 mm Hg and a decrease in diastolic blood pressure (DBP) of 20 mm Hg. Heart rate (HR) and stroke volume (SV) were increased by about 20-30%. Total peripheral resistance (TPR) fell significantly. When the subjects were pretreated with atenolol, the adrenaline increased SBP by 16 mm Hg, the DBP did not change, HR and SV increased by 19 and 30%, and TPR fell. During concomitant administration of the non-selective betablocker pindolol, which has strong intrinsic sympathomimetic activity (ISA), adrenaline increased SBP by 11 mm Hg and DBP by 17 mm Hg. This pure pressor response led to a significant reduction in HR and SV and an increase in TPR, probably mediated through the baroreceptors. The haemodynamic response to adrenaline during coadministration of propranolol was very similar to that seen after pindolol. It is concluded that a beta1 selective blocker interferes very little with the haemodynamic response to adrenaline, whereas it is changed to a pure pressor response during coadministration of a non-selective betablockers. ISA did not significantly modify the pressor response. PMID- 3533565 TI - Steady-state concentrations of imipramine and its metabolites in relation to the sparteine/debrisoquine polymorphism. AB - Thirty-five imipramine treated patients were phenotyped with regard to polymorphic drug oxidation using sparteine and/or debrisoquine. During treatment with 100 mg imipramine per day the mean steady-state concentrations and ratios in 28 extensive metabolizers were: imipramine 169 nmol/l; desipramine 212 nmol/l; 2 OH-imipramine/imipramine 0.25; 2-OH-desipramine/desipramine 0.57. The corresponding values in two poor metabolizers were: imipramine 455 and 302 nmol/l; desipramine 1148 and 1721 nmol/l; 2-OH-imipramine/imipramine 0.06 and 0.05; 2-OH-desipramine/desipramine: 0.09 and 0.04 respectively. The metabolic ratios (MR) sparteine/dehydrosparteine and debrisoquine/4-OH-debrisoquine (% of dose in 12-h urine samples) correlated poorly with the imipramine steady-state concentrations during administration of 100 mg per day, but quite well with the desipramine steady-state concentrations. Significant negative correlations were found between sparteine and debrisoquine MR and the 2-OH-imipramine/imipramine and 2-OH-desipramine/desipramine ratios. In most patients the initial dose was changed to obtain concentrations in the therapeutic range, and concentrations for imipramine + desipramine of (mean +/- SD) 713 +/- 132 nmol/l were achieved in 33 patients. The therapeutic dose was 50 mg per day in one poor metabolizer and ranged from 50-400 mg per day in 32 extensive metabolizers. There was a weak negative correlation between sparteine MR and daily dose. Treatment with imipramine inhibited metabolism of both sparteine and debrisoquine (MR values about doubled), but did not affect the interpatient correlations. PMID- 3533566 TI - Relationship between the venoconstrictor activity of dihydroergotamine and its pharmacokinetics during acute and chronic oral dosing. AB - In a double-blind, interindividual comparative study 30 healthy volunteers were randomly allocated to oral treatment with 5 or 10 mg of dihydroergotamine (DHE) or placebo once daily for 16 days. Regional basic venous blood volume (BBV), pressure dependent venous capacitance (CV) of the calf, resting heart rate and blood pressure were determined on Days 1 and 15 of treatment. Plasma concentrations of DHE were monitored on Days 2 and 16. Due to spontaneous vasodilation BBV varied considerably, showing that it is an inappropriate parameter for investigating the venoconstrictor activity of DHE. CV remained unchanged after the first dose of DHE but it had declined significantly on both dosage regimens at the end of the treatment phase. In contrast, the blood concentration profiles of DHE were comparable at the beginning and the end of the trial. The discrepancy can best be explained by the existence of an effect compartment, e.g. smooth vascular musculature, which slowly becomes filled with DHE and/or its active metabolites. The venoconstrictor activity of DHE exhibited a significant dose-response relationship. PMID- 3533567 TI - Dose response and length of action of nifedipine capsules and tablets in patients with essential hypertension: a randomised crossover study. AB - Twelve patients with essential hypertension on no other drug treatment were entered into a randomised crossover study of 5, 10 and 20 mg capsules of nifedipine given 3 times a day and 20 mg tablets given twice a day. Each dose was given for 2 weeks in a random order. All forms of nifedipine were effective in lowering blood pressure. However, 5 mg capsules were less effective than the 10 and 20 mg capsules or 20 mg tablets. There was little to choose between the latter. All doses of nifedipine were more effective 1 and 3 h after the dose compared to subsequent times afterwards. Indeed, as time elapsed after the last dose up to 12 h, there was a gradual increase in blood pressure. However, even at 12 h the 10, 20 mg capsules and 20 mg tablets were still causing an approximate 10% reduction in blood pressure. Nifedipine tablets are as effective as capsules though they might be longer acting, particularly around 6 h after the last dose. PMID- 3533569 TI - Airway epithelium modulates the reactivity of guinea-pig respiratory smooth muscle. AB - The influence of the epithelium on the reactivity of guinea-pig tracheal smooth muscle in vitro was investigated. Mechanical removal of the epithelium produced contrasting effects on methacholine-, histamine- and K+-induced contractions of tracheal strips. Epithelium removal resulted in 2.1-fold shifts to the left of histamine and methacholine concentration-response curves, and an increase in the maximum response to histamine; the maximum response to methacholine was unaffected. Epithelium removal had little effect on the sensitivity, but decreased the maximum response to K+. The results suggest that inhibitory and excitatory factor(s) are released from epithelial cells, and that these factors modulate the reactivity of the smooth muscle. Indomethacin (1 microM) produced in epithelium-containing preparations qualitatively identical effects on the sensitivity to methacholine and on the maximum response to histamine as removal of the epithelium. However, indomethacin was without effect on the sensitivity to histamine in the presence or absence of the epithelium. Alterations in the production or release of epithelial cell-derived factors may contribute to the airway hyperreactivity observed in respiratory disorders. PMID- 3533568 TI - Effect of nifedipine on plasma catecholamines in man at rest and during exercise. AB - Blood pressure, heart rate, and plasma catecholamine concentrations were measured in 9 normotensive volunteers during a randomized cross-over study of oral nifedipine (10 mg X 5) and placebo; measurements were made at rest and during maximal anaerobic exercise. At rest nifedipine reduced blood pressure and increased heart rate and plasma noradrenaline, whereas plasma adrenaline did not change. During exercise, the blood pressure response was similar in nifedipine and placebo treated subjects; however, heart rate was significantly higher with nifedipine. Plasma noradrenaline increased more during exercise in nifedipine treated subjects. By contrast, nifedipine inhibited the increase in plasma adrenaline induced by exercise. The results suggest that peripheral vasodilatation induced by nifedipine is responsible for increased sympathetic nerve activity, both at rest and during exercise, and that nifedipine inhibits adrenaline secretion in man. PMID- 3533570 TI - Phosphorylated 350 kD protein in the nucleus as it is associated with cell transformation. AB - Protein kinases are thought to play a key role in signal transduction and oncogenesis, but little is known about the intranuclear phosphorylation events associated with transformation. Here we report on cell cycle-dependent phosphorylation of cytoskeleton-associated 350 kD protein and the regular interchange in its location between the nucleus and cytoplasm of normal cells. Persistent intranuclear location of the phosphorylated 350 kD protein was also found throughout the cell cycle in transformed cells, as detected by immunoprecipitation of 32P-phosphorylated 350 kD protein from isolated nuclei and immunofluorescent staining with a monoclonal antibody that recognized phosphorylated site of 350 kD protein. A conditional transformed phenotype induced by a temperature-sensitive (ts) viral oncogene or a transforming growth factor was also associated with the intranuclear presence of the phosphorylated 350 kD protein. Thus the 350 kD protein seems to be a target molecule of protein kinases that are stimulated directly or indirectly by growth factors or by oncogene products in the nucleus, and appears to be a new transformation-related nuclear antigen. PMID- 3533572 TI - Relationship between pyridine nucleotide levels and ribonucleotide reductase activity in Yoshida ascites hepatoma AH130. AB - We measured both pyridine nucleotide levels and ribonucleotide reductase-specific activity in Yoshida ascites hepatoma cells as a function of growth in vivo and during recruitment from non-cycling to cycling state in vitro. Oxidized nicotinamide adenine dinucleotide (NAD+) and reduced nicotinamide adenine dinucleotide (NADP) levels remained unchanged during tumour growth, while NADP+ and reduced nicotinamide adenine dinucleotide phosphate (NADPH) levels were very high in exponentially growing cells and markedly decreased in the resting phase. Ribonucleotide reductase activity paralleled NADP(H) (NADP+ plus NADPH) intracellular content. The concomitant increase in both NADP(H) levels and ribonucleotide reductase activity was also observed during G1-S transition in vitro. Cells treated with hydroxyurea showed a comparable correlation between the pool size of NADP(H) and ribonucleotide reductase activity. On the basis of these findings, we suggest that fluctuations in NADP(H) levels and ribonucleotide reductase activity might play a critical role in cell cycle regulation. PMID- 3533571 TI - Chick embryonic erythrocyte antigen--tissues sharing expression. AB - There is an antigenic glycoprotein (Mr 48 kD) present on the surfaces of erythrocytes of embryonic and young chickens that cannot be detected on the circulating erythrocytes in adult birds. This antigen, generally defined by this differential expression, has been thought to be associated with the maturation of hematopoietic tissues. We now present evidence, based on the use of a monoclonal antibody, maEE1, and the characteristic pattern of this glycoprotein on two dimensional (2D) gels, that this antigen, which we have named chickEE, is expressed in a number of other embryonic and adult tissues. Immunofluorescent labeling of cryosections and flow-cytometric analysis of cells labeled with maEE1 have revealed the presence of chickEE in the retina (present in all layers), in muscle tissues (present in the endomysium and within the vascular endothelium), in the liver (especially evident on the lateral surface of hepatocytes and within the sinusoids), on epithelia such as the gut and kidney tubule epithelium and within lymphoid organs (present on bursacytes, splenocytes, thymocytes and peripheral leukocytes, and again within the endothelium) of young and adult animals. The 2D gel patterns of chickEE derived from embryonic tissues (retina, hind limb, thymus and bursa) and the adult tissues (retina and spleen) are very similar to that of the embryonic erythrocyte. Thus, the extended reactivity of the monoclonal antibody to chickEE, maEE1, with additional tissues is, in at least the tissues examined, based on the presence of the chickEE glycoprotein and not on incidental cross-reactivity. The evidence presented in this paper for the widely-shared expression of chickEE antigen makes it necessary to reconsider the function of this component of the cell surface. PMID- 3533573 TI - Distribution of 5-methylcytosine-rich regions in the polytene chromosomes of Phaseolus coccineus embryo suspensor as shown by the immunoperoxidase technique. AB - 5-Methylcytosine (5-mC) has been visualized in polytene chromosomes of Phaseolus coccineus, scarlet bean using specific antibodies to 5-mC and the immunoperoxidase technique. The results obtained indicate that most heterochromatic regions are methylated, even though the frequency of methylation is highly variable and sometimes low. A preferential binding of anti-5-mC to centromeric heterochromatic blocks was observed. Comparison between anti-5-mC binding and the results of hybridization with highly repetitive DNA and satellite DNA shows, moreover, that centrometric heterochromatic regions hybridize in particular with both DNAs. This finding is consistent with the fact that repetitive DNA and satellite DNA are methylated to a considerably greater extent than main band DNA, in line with many data to be found in the literature. The binding pattern of anti-5-mC that we observed also suggests that methylation does not occur in all classes of repetitive DNA. The high variability of band methylation frequency is discussed in relation to a possible characteristic DNA composition of the band. PMID- 3533574 TI - Changes in the organization of non-epithelial intermediate filaments induced by triethyl lead chloride. AB - The in vivo effect of triethyl lead chloride (TriEL) (10(-6)-10(-8) M) on the organization of non-epithelial intermediate filaments (vimentin and desmin filaments) was studied by indirect immunofluorescence microscopy employing different mammalian cell lines. The in vitro effect of TriEL on filament formation as well as on the structure of preformed filaments was investigated by electron microscopy. TriEL induces perinuclear coil formation of intermediate filaments in SV40-transformed human fibroblasts and baby hamster kidney (BHK21) cells. The rearrangements observed are not correlated with significant changes in the microtubular system as tested by double labelling of both filament systems. The effect of TriEL is reversible. Assembly of intermediate filaments in vitro is disturbed in the presence of TriEL such that only short filaments and various kinds of fragments are formed. When preformed filaments are incubated in the presence of TriEL, unravelling of fibres into protofilamentous strands is observed. Possible mechanisms of TriEL-filament interaction are discussed. PMID- 3533575 TI - TPA-induced alteration of actin organization in cultured human keratinocytes. AB - Distribution of actin filaments of human epidermal keratinocyte in the primary culture was observed by immunofluorescence staining. In the cytoplasm, actin was distributed diffusely, and strong antiactin immunofluorescence was observed along the leading edge, showing ruffling and the contact zone to the neighboring cell. 12-O-Tetradecanoylphorbol-13-acetate (TPA) induced organization of actin filaments. Many short bundles of actin filaments appeared shortly after the addition of 16 nM TPA, and large actin-containing ribbons of crescent-shape, circular or gyrus-like form were sometimes observed. Phorbol-12-13-diacetate, a non-promoter phorbol ester, induced a similar change, but to a much lesser extent. Addition of 1 mM cycloheximide did not interfere with the organization of actin filaments by TPA. La3+ aborted it completely possibly by replacing Ca2+ at the binding site of the cell surface, and the cultivation in low Ca2+ environment suppressed the effect of TPA. These findings make a contrast to those reported in fibroblasts, and may be linked to the characteristic response of cultured human keratinocytes to TPA in the proliferation of cells and induction of ornithine decarboxylase. PMID- 3533576 TI - Localization of the deoxyribonucleotide biosynthetic enzymes ribonucleotide reductase and thymidylate synthase in mouse L cells. AB - Two different approaches were used to define the intracellular localization in mouse L929 cells of two deoxyribonucleotide biosynthetic enzymes: ribonucleoside diphosphate reductase (EC1.17.4.1) and thymidylate synthase (EC2.1.1.45). The first involved treatment with saponins, which render the plasma membrane permeable to proteins without disrupting intracellular organelles. Under conditions where nuclear DNA synthesis and the activity of the nuclear enzyme NMN adenylyltransferase were unaffected, the entire cellular complements of a cytosolic enzyme, glucose-6-phosphate dehydrogenase, and of ribonucleotide reductase and thymidylate synthase were released at the same rate and with similar dependence on saponin concentration. The second approach involved centrifugal enucleation of cells treated with cytochalasin B (CB) and measurement of the distribution of enzyme activities in the resulting cytoplast and karyoplast fractions. Whereas most NMN adenylyltransferase activity remained with the karyoplasts, glucose-6-phosphate dehydrogenase, ribonucleotide reductase, and thymidylate synthase were almost exclusively associated with the enucleated cytoplasts. These results indicate that, under conditions where nuclear DNA synthesis is apparently unperturbed, the intracellular distribution of the deoxyribonucleotide biosynthetic enzymes studied is the same as that of glucose-6 phosphate dehydrogenase, a typical cytosol enzyme, and clearly differs from that of NMN adenylyltransferase, a nuclear enzyme. PMID- 3533577 TI - Intermediate filament proteins in human sperm heads. AB - Monoclonal antibodies made against human sperm cells have been characterized with regard to binding patterns and molecular coordinates of the recognized antigens. Antibodies T5 and T6 gave uniform binding to the acrosomal cap in an intact cell, and decreased to equatorial segment binding in an 'acrosome-reacted' cell. Monoclonal antibody T15 gave the reverse: equatorial segment binding in intact cells and uniform acrosomal cap binding in reacted cells. From staining patterns on cultured cell lines, determination of molecular coordinates, immunoblots, and partial peptide analysis, we have determined that T15 is directed against the cytoskeletal protein, vimentin, while T5 and T6 recognize a keratin-like protein which may be unique to sperm cells. This is the first immunological and biochemical study to analyse both types of intermediate filament proteins in human sperm cells. PMID- 3533578 TI - Different mitogenic and phenotypic responses of human breast epithelial cells grown in two versus three dimensions. AB - Human breast epithelial cells, derived from fibroadenomas, were cultured under conditions promoting growth in two-dimensions (2D) as monolayers using the collagen-coated dishes and in three-dimensions (3D) inside the collagen gel matrix. Both epidermal growth factor (EGF) and cortisol (F) were required for maximal stimulation in 3D growth, but only cortisol was required for 2D growth. The growth stimulation of exogenously added type IV collagen was no greater than that of type I as a substrate in both the 2D and 3D growth. Immunocytochemical staining, using a polyclonal actin antibody, showed homogeneous staining in all cells in 2D monolayers, whereas more restricted distribution was observed in 3D outgrowths in the collagen gel matrix. The same cells, when cultured in 2D vs 3D, elicit different responses and the original phenotypes may be better maintained in 3D. PMID- 3533579 TI - The decline in gastric cancer: epidemiology of an unplanned triumph. PMID- 3533580 TI - Epidemiologic observations in familial paroxysmal polyserositis. PMID- 3533581 TI - Epidemiologic evidence for health benefits from improved water and sanitation in developing countries. PMID- 3533582 TI - The persistence of influenza A in human populations. PMID- 3533583 TI - Alcohol and pancreatic cancer. Insufficient epidemiologic evidence for a causal relationship. PMID- 3533584 TI - Estrogen receptors and breast cancer. AB - The literature indicates that relationships between epidemiologic variables and estrogen receptor activity are not clearly defined. Conflicting and unconfirmed results have been published. Most studies have been based on clinical case series rather than on carefully conducted population-based epidemiologic investigations. In addition, previous reports have not generally considered the potential role of confounding and interaction in the interpretation of the associations reported between estrogen receptor status and risk factors for breast cancer. Given these considerations, the need for further research in this area is obvious. Application of an estrogen receptor scheme (positive vs. negative) for defining breast cancer may allow delineation of cases that may appear quite similar but that represent two different types of disease. Estrogen receptor-positive and estrogen receptor-negative breast cancer behave differently biologically, have different treatment and prognostic implications, and thus may also possibly have different risk factor patterns. Moreover, the extent to which receptor status reflects effects associated with exposure, the disease process, or host influences is not clearly understood. There is some evidence that estrophilin is a biochemical marker of tumor differentiation. Moolgavkar et al. suggested that all breast cancers are initially estrogen receptor-positive, but that as the tumor undergoes clonal evolution and becomes more undifferentiated, the ability to express estrophilin is lost in some cases. If this is true, estrogen receptor results may reflect temporal changes in the biologic characteristics of the tumor as it progresses from a well differentiated to a poorly differentiated state. Receptor status could also reflect changes in host resistance and tumor aggressiveness. This concept is consistent with previous observations that anaplastic, rapidly growing cancers are less likely to be receptor-positive. It has not been established whether estrogen receptor-negative tumors represent an advanced stage of the disease or arise de novo. Clinical studies have failed to demonstrate a relationship between extent of disease at diagnosis and receptor results. Estrophilin concentrations also are apparently not related to stage of disease, lending no support for the notion that receptor level declines with progression of the disease. It is possible that certain etiologic factors lead to the natural selection and growth of receptor-negative cells and that receptor negativity is an early, inherent characteristic of some breast cancers.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3533585 TI - Epidemiology of inflammatory bowel disease. PMID- 3533586 TI - Epidemiology of fecal mutagenicity. AB - Fecal mutagenicity presents unique difficulties of measurement (63); nonetheless, population studies of fecal mutagenicity typify the common methodological problems of colorectal cancer epidemiology. For example, correlational studies have linked fecal mutagenicity both to colorectal cancer incidence and to dietary practices postulated to increase the risk of colorectal cancer. The threat of an ecologic fallacy, however, is just as strong for biochemical assays as for other epidemiologic data. Fecal mutagenicity may represent, along with high-fat or low fiber intake, a mere correlate of some true risk factor still to be elucidated in high-risk populations. Dietary trials, on the other hand, may directly confirm the influence of diet on fecal mutagenicity (or another presumed "intermediate end point") but cannot directly address the relationship of mutagenicity to colorectal cancer risk. Case-control comparisons of fecal mutagenicity might initially seem to promise more compelling evidence regarding colorectal cancer risk, but they are actually unsuitable, since the possibility of disease affecting this "exposure" is so strong. Specifically, fecal mutagenicity might be affected by the clinical tests required to diagnose colorectal cancer; it might also be affected by the malignancy itself, or indirectly by the dietary modifications that can accompany gastrointestinal illness. The resultant biases threaten to confound a case-control comparison as much as recall bias can affect interview data. A proper case-control study of fecal mutagenicity and colorectal cancer must therefore consider the effect of diagnostic workup on each mutagenicity assay, before the test is used to compare case and control specimens. In addition, case subjects should be followed through hospitalization and recovery, in the hope that for some cured patients the measurements after surgery will exclude any effect of disease on exposure. A case-control study incorporating these extra efforts is now underway. It seems reasonable to state that most biochemical assays incorporated into case-control studies of colorectal cancer will require similar modifications. Moreover, even if an effect of disease or of health care on biochemical measurements is excluded, an additional concern regarding the role of fecal mutagenicity or other assays in case-control studies will remain. The use of biochemical tests in a case-control context is analogous to asking questions regarding current smoking or current diet in a case-control interview. The current measurements reflect past values only to the degree that the exposure variable remains stable during the subject's lifetime.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3533587 TI - Enrichment for GM-CFU from human bone marrow using Sambucus nigra agglutinin: potential application to bone marrow transplantation. AB - A new lectin, purified from black elder-berries, Sambucus nigra L. (SNA I, hereafter called SNA), was used for fractionation of normal human marrow cells. The stem cell enrichment capability of SNA was investigated by comparing colony formation (GM-CFU) in unagglutinated cell fractions (SNA-) following agglutination with SNA with that with soybean agglutinin (SBA-). GM-CFU recovery in SNA- was equal or superior to that in the SBA- fraction. A modified procedure was developed to combine stem cell enrichment and depletion of E-rosette-forming T-lymphocytes. Bone marrow cells were exposed in one step to SNA and to untreated sheep red blood cells (SRBC). Nonagglutinated, nonrosetting cells were collected after Ficoll-Hypaque-gradient separation. The procedure, a modification of Reisner's multistep procedure involving the agglutination of SBA+ cells; separation of the unagglutinated SBA- cells from the top of a 5% bovine-serum albumin gradient; the formation of E-rosettes with SRBC; and the separation of rosettes over a Ficoll-Hypaque gradient, is faster, simpler, and as effective for T-cell depletion and stem cell enrichment. PMID- 3533588 TI - Asthma and the role of inflammation. AB - Asthma has been defined as variable airflow obstruction. The symptoms of asthma are not specific for the condition and, therefore, the presence of variable airflow obstruction needs to be objectively confirmed. When airflow obstruction is present and when it can be completely reversed with treatment, confirmation of the diagnosis is easy. When spirometry is normal or when there is chronic airflow limitation, however, other methods of investigation are required. These methods include inhalation tests with histamine or methacholine, diurnal variation of peak flow rates and tests with exercise or hyperventilation. When spirometry is normal, methacholine or histamine tests appear to be the most sensitive method but, if results are normal, they do not exclude past or future asthma. However, when there is chronic airflow limitation neither variable airflow obstruction nor methacholine or histamine hyperresponsiveness are specific for asthma; tests with hyperventilation (and probably others that act through mediator release) may be more specific. The presence of asthma probably requires the release of chemical mediators, from mast cells and other cells, which can produce inflammation. This has been particularly studied after inhalation of allergens or chemical sensitizers which can trigger both early and late asthmatic responses. The late responses are associated with prolonged increases in airway responsiveness and are considered to be a result of the cellular phase of inflammation. It is possible that persistent or recurrent inflammation, due to these and other stimuli, is the cause of the persisting airway hyperresponsiveness and variable airflow obstruction in asthma, as well as the other features of cough and sputum, but this requires further investigation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3533589 TI - Inflammation and its clinical relevance in airway diseases: summing-up. PMID- 3533591 TI - Evaluation of non-specific bronchial hyperreactivity in different respiratory diseases. AB - Bronchial hyperreactivity (BHR) has been observed in respiratory disorders other than asthma but asthmatics usually show BHR to differing degrees. The presence and degree of BHR in asthma was evaluated and compared with that in other respiratory disorders. High BHR was observed in asthma (84%, with no difference between atopics and non-atopics), recurrent or persistent cough (36%), laryngeal spasm (50%), Kartagener's syndrome (66%) and cystic fibrosis. BHR was low in patients with allergic rhinitis but no asthma and was absent in patients with unexplained dyspnoea (100%) and in healthy controls (91%). PMID- 3533590 TI - The pathology of obstructive and inflammatory airway diseases. AB - The diseases included are those commonly called chronic bronchitis, bronchiolitis, bronchiectasis and asthma. The definitions most commonly used are those called for and applied in epidemiological studies. In this symposium, it is the role of inflammation in these various diseases that will be explored. The term bronchiectasis describes bronchial or bronchiolar distortion and scarring. It is well described by the terms bronchitis obliterans and bronchiolitis obliterans. In the 'wet' form of the disease, chronic sputum production is a feature. The factors that cause mucus hypersecretion in chronic bronchitis probably operate. Chronic bronchitis is characterized by mucus hypersecretion. Recent studies reveal that change in the nature of secretion is an early sign: new constituents appear before the amount is appreciably increased. Bronchial aspirate from normal non-smoking human volunteers, as judged by density gradient ultracentrifugation, contained no typical epithelial glycoprotein but did contain a glycoconjugate of higher buoyant density that included sugars characteristic of proteoglycans. In normal volunteers who had smoked, albeit mildly, macromolecular yield was not increased; however, a glycoconjugate of buoyant density typical of epithelial glycoprotein but with sugars characteristic of both proteoglycans and glycoprotein was identified. In simple, chronic bronchitis a typical epithelial glycoprotein can be identified. Study of the canine model of chronic bronchitis supports these findings. In organ culture, human and canine airways do not secrete the typical epithelial glycoprotein under baseline conditions but they do when stimulated, as by cholinergic agents. Analysis of lipids also yields a similar picture in human disease and in the canine model. Cholesterol is typical of normal mucus. When secretion is obviously increased, glycolipid is also present. PMID- 3533592 TI - The cells causing airway inflammation. AB - Inflammation is the response of living tissue to injury and serves to restore the affected area to its original function. To a large extent the nature of the injury (e.g. micro-organisms, parasites, trauma or allergy) will determine the pattern of cell infiltration, as will the chronicity (the balance between the persistence of the insult and repair). Neutrophils and macrophages are the principal cells of acute inflammation, with eosinophils also participating in special circumstances, e.g. allergic and helminthic parasitic processes. In chronic inflammation, macrophages, lymphocytes and plasma cells are present in large numbers; again, the predominance of one cell type or other depends on the nature of the injury. Large numbers of basophils are also observed in certain delayed-in-time chronic processes but their role in lung pathology is uncertain. Similarly, platelets have potential for lung injury and their role in certain inflammatory states is established, although their participation in lung injury is still debated. The mast cell must also be considered since it is the repository for mediators which cause increased vascular permeability and has the potential for eliciting, and possibly sustaining, some of the white cell mediated events associated with the inflammatory process. Inflammatory cells cause injury by secretion of inflammatory mediators derived from their membranes (principally prostaglandins, leukotrienes and PAF-acether) and by elaboration of their granule constituents. Neutrophils have primary and secondary granules which contain an array of proteases and other enzymes, whereas eosinophils possess large amounts of unique basic proteins which have potential for direct cytotoxicity, i.e. of mucosal epithelium.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3533593 TI - Inflammation: a two-edged sword--the model of bronchiectasis. AB - A short-lived, controlled inflammatory response by the host is required to protect against incursions by foreign material into the upper and lower respiratory tract. If this response fails to eliminate the aggressor, inflammation is amplified and becomes chronic in an attempt to rectify the situation. This unsuccessful response is poorly controlled and caused damage to surrounding normal tissue, leading to progressive disease. Hence, inflammation can be helpful or harmful--a two-edged sword. Chronic bronchial sepsis, of which bronchiectasis is an example, and chronic sinusitis display the hallmarks of this 'vicious circle' of host-mediated, inflammatory tissue damage and provide a useful model in man in which to ask questions, the answers to which provide valuable information about the pathogenesis of chronic inflammatory disease of the lung. PMID- 3533594 TI - Mucosal immunological protection mechanisms in the airways. AB - The respiratory tract is protected by immune mechanisms. These comprise a combination of local mucosal immunity, especially characteristic of the upper respiratory tract, and peripheral-type immune reactions which characterize the lower portion. The initiation of inflammatory events may occur in the lumen or in the tissues and to some extent the response seen is greatly modulated by the types of cells involved and their secreted products. The presentation will deal with the way in which various immune reactions are initiated and regulated in the respiratory tract and how these may differ from other tissues. PMID- 3533595 TI - Mucus transport and inflammation. AB - Mechanisms which disturb mucociliary transport may act on the mucus, the ciliary action or both. Inflammation of the airways almost invariably induces reversible functional disturbances but can, in chronic diseases, also lead to irreversible morphological lesions. Infectious inflammation acts mainly through ciliostatic or cytotoxic effects on ciliated cells. Infections with rhinovirus, influenza virus A and M. pneumoniae may induce profound disturbances of the mucociliary system, with effects lasting up to 1 year. In non-infectious inflammation, the mucociliary system might be influenced by serum factors leaking through the bronchial wall, by inflammatory cells such as granulocytes and eosinophils, and by mediators released from mast cells. In a very early phase of the acute allergic reaction in bronchial asthma, these mediators are responsible for an acceleration of mucus transport, which is followed by a long-standing depression mainly due to the production of highly viscous mucus. Any positive therapeutic effects resulting from drug administration can only be achieved in early phases of the disease, before irreversible morphological lesions have occurred. PMID- 3533596 TI - The clinical relevance of airway inflammation. AB - Inflammation forms an integral part of the normal defence mechanisms of the airways. Airway inflammation is therefore in essence beneficial, although prolonged exposure to noxious stimuli, overwhelming damage or insufficient control of the inflammatory process may lead to clinical disease. However, the factors contributing to the type and magnitude of airway inflammation, including the level at which damage occurs, the individual difference in sensitivity and inflammatory response to noxious stimuli and the evolution from acute to chronic inflammation, are insufficiently characterized. Clinical, pathological and experimental investigations clearly show that airway inflammatory disorders are heterogeneous. Mucus hypersecretion and bronchial hyperresponsiveness are different characteristics of airway diseases with distinct clinical manifestations and prognostic significance. Epidemiological studies have shown that bronchial hyperresponsiveness is associated with a worse prognosis in obstructive airway disease. Further efforts are needed to understand the impact of different parts of the airway inflammatory process on the physiological and clinical manifestations of airway diseases. Understanding the mode of action of existing and newly developed therapeutic agents on airway inflammation will teach us more about its role in these frequent disorders. PMID- 3533597 TI - Triggers of airway inflammation. AB - Most asthmatics have hyperresponsive airways. This makes them more sensitive than non-asthmatics to bronchoconstricting environmental exposures which, in their turn, may enhance responsiveness. Airway inflammation is considered to be a key determinant of airway hyperresponsiveness: the fact that chronic airway inflammation in cystic fibrosis does not lead to airway hyperresponsiveness of any importance indicates, however, that the role of airway inflammation is complex and incompletely elucidated. The main inducers of airway inflammation are viral infections, antigens, occupational stimuli and pollutants. Although exercise, airway cooling and hyper- or hypotonic aerosols are potent stimuli of bronchoconstriction, it is questionable if airway inflammation is involved in their mode of action. Each of the above-mentioned stimuli is discussed, with emphasis laid on the relation of symptoms to mechanisms. PMID- 3533598 TI - Effects of GABA and bicuculline on N-methyl-D-aspartate- and quisqualate-induced reductions in extracellular free calcium in area CA1 of the hippocampal slice. AB - Decreases in extracellular free calcium ([Ca2+]o) and concomitant field potentials were recorded from the dendritic and cell body layers of the CA1 field in transverse hippocampal slices. They were elicited by tetanic stimulation of Schaffer collaterals and commissural fibers or by iontophoretic application of the excitatory amino acids N-methyl-D-aspartate (NMDA) and quisqualate (Quis). Under control conditions, decreases in [Ca2+]o were found to be maximal in stratum pyramidale (SP). In stratum radiatum (SR), 100 micron away from SP, decreases in [Ca2+]o were half the size of those observed in SP. Bicuculline methiodide, bath-applied at concentrations of 10-100 microM, enhanced the reductions in [Ca2+]o, increased the field potentials in all layers and also induced "spontaneous" epileptiform activity. In the presence of bicuculline, the decreases in [Ca2+]o were particularly enhanced in SR and were often greater than those recorded in SP. This was the case for changes in [Ca2+]o induced either by repetitive electrical stimulation or by application of NMDA and Quis. When synaptic transmission was blocked by perfusing the slices with a low Ca2+ medium, all NMDA and Quis-induced changes in [Ca2+]o were predictably reduced but there was a relative enhancement of changes in [Ca2+]o in SR with respect to those in SP. We propose that, under normal conditions, an inhibitory control mediated by GABA limits the reductions of [Ca2+]o particularly in SR. In support of this proposal, we found that bath-applied GABA had a depressant action on changes in [Ca2+]o. PMID- 3533599 TI - Biochemical diagnosis of genetic disease. PMID- 3533600 TI - Medical genetics. PMID- 3533602 TI - First trimester fetal karyotyping using chorionic villi: technical development and diagnostic application. PMID- 3533601 TI - Microcytogenetics 1984. PMID- 3533603 TI - Some trends in medical populations genetics. AB - Five topics concerning medical population genetics have been selected for discussion: in the field of population cytogenetics, the frequency of chromosomal aberrations and the roles of mutation and selection in the maintenance of balanced rearrangements are studied; the long term genetic effects of treatment and prevention of genetic diseases are reviewed; the relationships between malaria and the sickle-cell trait are discussed; some recent works concerning human DNA polymorphisms in the field of population genetics are presented, and finally, some methods of genetic epidemiology are described. PMID- 3533604 TI - The genetics of human reproduction. PMID- 3533605 TI - The role of somatic cell genetics in human gene mapping. PMID- 3533606 TI - Immunogenetics. AB - The 1985 Catalog of Mapped Genes (Human Gene Mapping 8; 33) has been used to pick out the known, immunologically important genes; these are then discussed in the following order: genes controlling organs, tissues and cells of the immune apparatus, genes determining 'self' structures, genes determining the structures of immunological specificity, genes determining substances with immunoregulatory and effector properties. The symbols for the genes and the biological functions of their products are explained. The genetics of the ABO blood groups, of the HLA system and of antibody formation are given in rather more detail. PMID- 3533608 TI - Immunocytochemical and enzymatic detection of lysozyme in human colon carcinoma cell lines. AB - Six of a total of 14 human colon carcinoma cell lines produce and secrete lysozyme in vitro. Three also produce the enzyme when propagated in vivo in athymic mice. None of the lysozyme positive cells stained in a manner typical of Paneth cells. Additionally, lysozymes from all six colon lines possess identical molecular weights (approximately 14,000 daltons). PMID- 3533609 TI - Epidemic Reiter's syndrome following an outbreak of shigellosis. AB - We prospectively studied the occurrence of Reiter's syndrome (RS) or reactive arthritis (ReA) in 205 of 349 cruise-ship passengers who attended a buffet ashore and developed Shigella flexneri 2a enteritis. Five passengers probably had RS/ReA and 16 were possible or doubtful cases of RS/ReA. HLA-B27 was identified in 4 of 5 probable RS cases, but was not present in any of the 16 possible or doubtful cases nor in any of 20 passengers (controls) without any symptoms of RS/ReA. There was no statistically significant difference in the frequency of B7-Creg antigens in persons with possible or doubtful RS/ReA (9/16) compared to controls (8/20). PMID- 3533610 TI - Phagocytosis and resistance to Salmonella typhimurium infection in mice fed with lipidic diet. AB - The peritoneal macrophages from mice on a lipidic diet have shown an increase of surface hydrophobicity of cytoplasmatic membrane. This fact is correlated with a decrease of the phagocytic index and with an impairment of Salmonella typhimurium. PMID- 3533607 TI - Pharmacogenetics and ecogenetics. PMID- 3533611 TI - Comparison of two immunofluorescence tests for detecting antibodies to C. trachomatis. AB - Two immunofluorescence tests were compared for detecting antibodies to chlamydiae. The inclusion antigen test was more sensitive, detecting antibodies in more sera and at higher titres. The micro-IF test was more specific, differentiating between antibodies to C. trachomatis and those to C.IOL 207. Antibodies to this non-genital chlamydial type accounted for half the positive results. These antibodies can cause the prevalence of C. trachomatis infections to be over estimated when genus-specific serology tests are used. PMID- 3533613 TI - [Morphological transition in Candida albicans]. PMID- 3533612 TI - Metastatic focal infections due to multiresistant Salmonella typhimurium in children: a 34 month experience in Rwanda. AB - Nineteen out of 139 children with severe systemic disease due to multiresistant Salmonella typhimurium observed during a 34-month period in an in-patient department in Rwanda had focal metastatic infections. More than 80% of the invasive Salmonella infections were acquired in the hospital. Focal metastatic infections occurred after longer hospital stays than bacteremia (29.1 +/- 17.4 days as against 13.5 +/- 9.0 days, p less than 0.01) and were diagnosed more time after the first sign of infection (3.28 +/- 1.41 days as against 1.86 +/- 1.10 days, p less than 0.01). Bacteremia was documented in 13 of the 17 children with focal infection from whom blood cultures were obtained. Seven of 12 had positive stool cultures. The sites of metastatic focal infection were meninges (7 cases), soft tissue (5 cases), joint or bone (4 cases), pleura (2 cases), eye (1 case). The clinical course of meningitis was fulminant and 6/7 patients died before receiving adequate antimicrobial therapy. One child with meningitis and 9 patients with focal infections at other sites were treated with cefotaxime and were cured or improved. PMID- 3533614 TI - Study on the application of the light-cured composite resin inlay in primary molars (I). PMID- 3533615 TI - [Pharmacologic correction of the cellular immunity disorders in infants in the 1st 3 months of life with escherichiosis]. AB - Seventy-five children in the first three months of life with escherichiosis were studied. It was found that levamisole to a lesser degree and methyluracyl decrease total duration of the disease by shortening periods of disorders of the gastrointestinal tract functions and bacterial excretions; the drugs improved indices of the condition of the cellular link of the immunity system. PMID- 3533616 TI - [The method of statistical moments and the integral model-independent parameters of pharmacokinetics]. PMID- 3533618 TI - [Analgesic effect of D-phenylalanine]. PMID- 3533617 TI - [General patterns in the action of psychotropic agents]. AB - Modern concepts about the formation and realization of the action of psychotropic drugs at different levels of regulation of the central nervous system are presented. The notion of psychounitropism characterizing community of the influence of psychotropic drugs on the central nervous system at biochemical, electrophysiological and other levels of analysis of the brain activity is introduced. The experimental material confirming this conclusion is presented and the comparison with the literature evidence of a possibility of the presence of such effects is made. PMID- 3533619 TI - [Methodologic problems in studying cardiologic drugs]. AB - Methodological difficulties arising on studying clinical efficacy of novel antiarrhythmic and antianginal drugs are discussed. Combined data on the evaluation of the action of the drugs are presented. The comparison of the results obtained in an acute drug test and during course treatment indicates the agreement of the data on efficacy of the absolute majority of antianginal and antiarrhythmic drugs. The interaction of propranolol and nifedipine was taken as an example to show that despite an opposite character of the pharmacodynamic action potentiation of the effect is observed. The author believes that the final determination of the drug value can be given only following the assessment of its effect on long-term outcomes. PMID- 3533620 TI - [New approaches to pharmacodynamic research on anti-angina agents]. AB - Methods of evaluating efficacy of antianginal drugs with exercise tests are described. The use of the methods makes it possible to choose adequate antianginal therapy for most patients with ischemic heart disease and stable effort angina and also to control efficacy of treatment with the chosen drug at its regular administration. PMID- 3533621 TI - [Development of methods for research on the clinical pharmacology of drugs used in cardiovascular diseases]. AB - Repeated pharmacodynamic studies of more than 30 drugs with hypotensive, antianginal and antiarrhythmic effects were performed in over 1,200 patients suffering from cardiovascular diseases, predominantly ischemic heart disease and hypertensive disease. The result of the work was optimization of the drug dosage regimen during course treatment; real diagnostic possibilities of functional research methods were revealed. PMID- 3533622 TI - [Effect of ethmozin and Ritmilen on microcirculatory hemostasis in patients with heart rhythm disorders]. AB - Effects of ethmozine and ritmilen were studied in 75 patients with different disorders of cardiac rhythm predominantly proceeding in the form of extrasystole arrhythmia. The drugs were found to exert a distinct antiaggregant action on platelets and erythrocytes which was particularly pronounced at intravenous administration and transiently increased the number of leukocytes and their aggregation. A decrease of platelet aggregation was accompanied by an increase of their number and rejuvenascence of thrombocytogram. A marked antiarrhythmic effect was seen in 66% of patients, in the remaining patients cardiac extracontractions became more rare. PMID- 3533623 TI - Precursors for peptide hormones share common secondary structures forming features at the proteolytic processing sites. AB - We have analyzed the amino acid sequences situated around the putative proteolytic cleavage sites in twenty different biosynthetic precursors of peptide hormones by processing enzymes. The prediction of the probability for forming secondary structures around the basic amino acids, constituting the cleavage sites, was made using the modified method of Chou and Fasman. The results indicate that the processing sequences which are cleaved in vivo, are in all cases located inside regions with high beta-turn formation probability or else immediately adjacent to these structures. The beta-turn forming region at the cleavage locus, is flanked on both sides by amino acid sequences with a high probability for forming highly ordered structures, either beta-sheet or alpha helix. These conformational features are not found in precursors around dibasic pairs, i.e. putative cleavage loci, but which are not cleaved in vivo and appear to be conserved. We hypothesize that beta-turns including the basic amino acids doublets, flanked by highly ordered secondary structures (either beta-sheet or alpha-helix) may constitute a minimal requirement for the recognition by the endoproteases involved in the processing of these precursors. PMID- 3533624 TI - Analysis of inactive renin by renin profragment monoclonal antibodies. AB - Two peptides were synthesized, corresponding to the sequences (-19 to -7) and ( 26 to -17) of the prorenin prosegment. Monoclonal antibodies were raised to these sequences and used to characterize human plasma inactive renin. Only anti (-19 to -7) reacted with inactive renin, as measured by direct assay or affinity chromatography. The data were used to evaluate two possible inactive renin stuctures: plasma inactive renin is a truncated prorenin lacking the prosegment N terminal portion; its spatial conformation masks the N-terminal extremity, preventing interaction of this region with specific antibodies. PMID- 3533625 TI - Loss of heat-shock acquisition of thermotolerance in yeast is not correlated with loss of heat-shock proteins. AB - Yeast cells when subjected to a primary heat shock, defined as a temperature shift from 23 to 37 degrees C for 30 min, acquired tolerance to heat stress (52 degrees C/5 min). Primary heat shocked cells incubated at 23 degrees C for up to 3 h, progressively lost thermotolerance but retained high levels of the major heat-shock proteins as observed on polyacrylamide gels. On the other hand, a temperature shift back up to 37 degrees C for 30 min fully restored thermotolerance. The major high-molecular-mass heat-shock proteins (hsp) identified were of approximate molecular mass 100 kDa (hsp 100), 80 kDa (hsp 80) and 70 kDa (hsp 70). The results indicate that loss of heat-shock acquisition of thermotolerance is not correlated with loss of heat-shock proteins. PMID- 3533626 TI - Close evolutionary relationship between the chromosomally encoded beta-lactamase gene of Klebsiella pneumoniae and the TEM beta-lactamase gene mediated by R plasmids. AB - Sixty-three percent homology of nucleotide sequence and 67% homology of deduced amino acid sequence were found between the chromosomally encoded beta-lactamase gene of Klebsiella pneumoniae and the TEM beta-lactamase of transposon Tn3. Moreover, 22 out of 24 amino acid residues are identical around the predicted active site. It is therefore suggested that these two kinds of beta-lactamases share a common evolutionary origin. The 0.5 kb DNA fragment of the cloned gene hybridized specifically with the chromosomal DNA of all the K. pneumoniae strains tested which had been isolated in Japan, USA and Europe. PMID- 3533627 TI - Exogenous ATP raises cytoplasmic free calcium in fura-2 loaded piglet aortic endothelial cells. AB - Cultured piglet endothelial cells were grown to confluence on glass coverslips and loaded with the fluorescent Ca2+ indicator, fura-2. Using a dual-wavelength excitation fluorescence spectrophotometer it was found that ATP caused a rapid transient elevation in [Ca2+]i in the presence of extracellular calcium which decreased to a maintained elevated level. With no extracellular calcium ATP evoked a similar transient increase which returned to the basal level. Addition of 50 mM K+ had no effect on [Ca2+]i or on the effect of ATP on [Ca2+]i in the presence of extracellular Ca2+. The data suggest that ATP causes both discharge of calcium from an intracellular pool and influx across the plasma membrane although this is unlikely to be via a voltage-operated channel. ATP stimulated simultaneously the production of PGI2 to a similar extent in the presence or absence of extracellular calcium. Elevated [Ca2+]i may be an important activation pathway in the endothelial cell. PMID- 3533628 TI - Mechanism of translational initiation in prokaryotes. Evidence for a direct effect of IF2 on the activity of the 30 S ribosomal subunit. AB - Initiation factor IF2 from either Escherichia coli or Bacillus stearothermophilus was found to possess the previously undetected property of stimulating the template-dependent ribosomal binding of aminoacyl-tRNAs with free alpha-NH2 groups. IF1, which had no detectable activity alone, was found to stimulate the activity of E. coli IF2 and, to a lesser extent, that of B. stearothermophilus IF2. Since in the absence of ribosomes not even a weak interaction between the two IF2 molecules and the aminoacyl-tRNAs was detected, the present findings indicate that IF2 can act at the ribosomal level stimulating aminoacyl-tRNA binding without prior formation of a binary complex with the aminoacyl-tRNA. IF2 does not appear to open or strengthen a weak A-site binding, but rather to enhance aminoacyl-tRNA binding to a 30 S site equivalent to the P-site by slowing down the rate of aminoacyl-tRNA dissociation from ribosomes. PMID- 3533629 TI - Expression of cytochrome P-450d by Saccharomyces cerevisiae. AB - Rat liver microsomal cytochrome P-450d was abundantly expressed in the yeast Saccharomyces cerevisiae by using a yeast-Escherichia coli shuttle vector consisting of rat liver P-450d cDNA and yeast acid phosphatase promoter. The expressed cytochrome P-450d was immunologically crossed with rat liver P-450d. The hydroxylase activity of estra-1,3,5(10)-triene-3, 17 beta-diol was 11 nmol/min per nmol P-450d, which is comparable to that reported previously for rat liver P-450d. The expressed P-450d content was nearlyt 1% of total yeast protein as estimated from immunoblotting, hydroxylase activity and optical absorpton of the reduced CO form. PMID- 3533630 TI - Inactivation of the galactose transport system in Saccharomyces cerevisiae. AB - The galactose transport system of Saccharomyces cerevisiae consists of one component which shows a Km value of approx. 4mM in growing cells. A rapid and irreversible inactivation of this transport is detected on impairment of protein synthesis. This inactivation shows the following characteristics: (i) it is due to changes in the Km and Vmax of the transport system; (ii) it follows first order kinetics; (iii) it is an energy-dependent process and is stimulated by the presence of an exogenous carbon source; (iv) fermentable sub-dependent process and is stimulated by the presence of an exogenous carbon source; (iv) fermentable substrates stimulate inactivation more efficiently than non-fermentable substrates. PMID- 3533631 TI - Guanine nucleotide activation of adenylate cyclase in saponin permeabilized glioma cells. AB - We have compared the regulation of adenylate cyclase activity in membrane fractions from C6 glioma cells and in monolayer cultures of C6 cells that had been permeabilized with saponin. Guanine nucleotides (GTP and GTP gamma S) and isoproterenol increase adenylate cyclase activity in C6 membranes and in permeabilized C6 cells. In C6 membranes, guanine nucleotides activate adenylate cyclase in the presence or absence of isoproterenol; in permeabilized cells, however, guanine nucleotides increase adenylate cyclase activity only in the presence of isoproterenol. We suggest that the properties of the permeabilized cells more closely resemble those of intact cells, and that some component which is present in permeabilized cells but is lost following cell disruption may be important for the normal regulation of adenylate cyclase activity. PMID- 3533632 TI - Differential reactivity of 9-NH2-ellipticine on apurinic and apyrimidinic sites in circular DNA. AB - Endonucleases for apurinic sites as well as chemical compounds reacting with aldehydes do not generally differentiate between apurinic and apyrimidinic sites. We have studied the effect of the apurinic site reagent, 9-NH2-ellipticine, on apyrimidinic sites enzymatically generated on PBR322 DNA and compared it to its' action on apurinic PM2 and PBR322 DNAs. In conditions where this compound induces breakage of apurinic sites, it does not display any action on apyrimidinic sites. PMID- 3533633 TI - GD2 ganglioside biosynthesis is a distinct biochemical event in human melanoma tumor progression. AB - Gangliosides from cell cultures established from melanocytic lesions, representing different stages of melanoma tumor progression, were analyzed by chemical and immunological means on thin-layer chromatograms. The GD2 ganglioside and N-acetylgalactosaminyl transferase, which catalyzes the biosynthesis of GD2 from its precursor GD3, were detected in cultures established from advanced primary and metastatic melanomas, but not in cultures of normal melanocytes. Immunohistochemical studies on tissue sections from all progression stages confirmed GD2 expression only in these advanced lesions. A distinct biochemical event thus coincides with the onset of faster growth and acquisition of metastatic competence in human melanoma tumor progression. PMID- 3533634 TI - Effects of magnesium and sodium ions on the outer membrane permeability of cephalosporins in Escherichia coli. AB - Both Mg2+ and Na+ stimulated the outer membrane permeation of negatively charged cephalosporins in Escherichia coli without any significant alteration of the permeation of a zwitterionic cephalosporin. Such stimulation was not observed in an E. coli mutant lacking porins. The stimulation was caused by the direct interaction between the cations and the porin pores, which resulted in a decrease in cation selectivity of both the Omp F and Omp C porin pores. PMID- 3533635 TI - Identification of granzyme A isolated from cytotoxic T-lymphocyte-granules as one of the proteases encoded by CTL-specific genes. AB - A serine esterase called granzyme A, which is specifically expressed in cytolytic lymphocytes has been characterized. It is a disulfide-linked dimer and exhibits a trypsin-like specificity cleaving best after Arg. N-terminal sequence analysis revealed that granzyme A is identical to a protease recently predicted from a cloned CTL-specific gene. PMID- 3533636 TI - The Columbian exchange: American physiologists and neuroscience techniques. AB - Neurophysiological techniques, far from being mere manual or instrumental procedures, are intimately bound up with the concepts and social processes of experimental physiology. This proposition is argued by examining the prepublication history of four important technical innovations in 20th-century neurophysiology, and their associated innovators: the vacuum-tube amplifier (Lucas, Williams, and Forbes, 1912-1922); the cathode-ray oscillograph (Gasser, Newcomer, and Erlanger, 1919-1923); single-fiber recording (Adrian, Zotterman, Forbes, Davis, and Gasser, 1912-1926); and the intracellular microelectrode (Graham, Gerard, Ling, Hodgkin, and Nastuk, 1940-1950). From these episodes I conclude that: each technique has its own set of conceptual presuppositions, limitations, and biases--in a word, techniques are idea-laden; techniques have an inertia of use that is overcome often only in unusual circumstances of crisis or opportunity; techniques, in their origin, evaluation, demonstration, and diffusion, are embedded in a network of social contacts among researchers; and 4) techniques evolve with favorite biological materials that, by fitting the apparatus and the questions asked, also impose limits on the concepts educed from that preparation. PMID- 3533637 TI - Representation of movements and muscles within the primate precentral motor cortex: historical and current perspectives. AB - A major problem with the study of the control of movement and posture is to determine how specific brain areas contribute to the selection of those particular muscle patterns that underlie a coordinated movement. With this problem in mind, a selective review is presented of mapping studies of the primate motor cortex, whose results bear on the question of how the spatial organization of cortical efferent cells might contribute to the production of organized muscle synergies. More recent findings are also summarized, which appear to resolve previous controversies on the question of whether movements or muscles are the primary units of motor cortex organization. These same findings suggest also a form of spatial organization within the primate precentral gyrus that would allow spatially simple afferent inputs to evoke the muscle synergies that are necessary for a variety of simple movements of the arm and hand. PMID- 3533638 TI - Metabolic considerations and cellular mechanism related to calcium's antihypertensive effects. AB - Whether maintenance of normal calcium homeostasis can afford protection against the development of hypertension in humans has emerged as a controversial area of both clinical and basic cardiovascular disease research. The data that have provoked this debate are derived from epidemiological reports, human studies, animal investigations, and cellular research. Ten published reports have identified an association between greater dietary calcium consumption and lower blood pressure in humans. In both humans and experimental animals with hypertension, several end-organ defects have been identified that are consistent with an inability to maintain external calcium balance. With the provision of supplemental dietary calcium, both humans and experimental models with high blood pressure have reduced their blood pressure. A variety of membrane-associated defects of Ca2+-ATPase-dependent calcium transport have been identified in cells derived from multiple organs of both the hypertensive animal and human. These abnormalities of cellular calcium handling could account for the failure of the hypertensive subject to appropriately defend its calcium balance. More important, they provide a theoretical mechanism by which calcium, interacting with calmodulin, might favorably modify vascular smooth muscle function and, thereby, peripheral vascular resistance. PMID- 3533639 TI - Calcium metabolism in essential hypertension: relationship to altered renin system activity. AB - Hypertensive disease is associated with various abnormalities of calcium metabolism although how these abnormalities relate to the elevated pressure remains unclear. Based on the use of renin-sodium profiling, we have defined heterogeneous deviations in circulating levels of ionized calcium and magnesium as well as of the calcium-regulating hormones parathyroid hormone, calcitonin, and 1,25-dihydroxyvitamin D (1,25D), which parallel similar deviations in plasma renin activity. Essential hypertensive subjects with a profile of low renin, lower ionized calcium, and elevated 1,25D respond best to the calcium channel blocker nifedipine, demonstrate an enhanced sensitivity to the blood pressure effects of dietary salt loading, and have significantly lower blood pressures in response to oral calcium supplementation. Hypertensive subjects with the opposite metabolic profile--higher renin activity, higher serum ionized calcium, and lower 1,25D levels--are relatively insensitive to the blood pressure effects of either dietary salt loading or nifedipine, and show no significant hypotensive response to calcium supplements. Altogether, these alterations of calcium ionic and hormonal metabolism suggest that the hormonal control of calcium metabolism is linked to renin system activity as well as to the pathophysiology of the hypertensive process. PMID- 3533640 TI - The nature and role of disturbances in calcium metabolism in genetic hypertension. AB - Abnormalities in Ca metabolism in genetic hypertension have been suggested by studies of the spontaneously hypertensive rat and of humans with essential hypertension. A state of relative Ca deficiency in genetic hypertension was previously hypothesized to explain the reduced serum ionized Ca, increased serum parathyroid hormone levels, and the association between oral Ca loading and mild reduction in blood pressure. Renal Ca leak, reduced intestinal Ca absorption, and diminished Ca intake were further postulated to account for the Ca deficient state. This hypothesis, however, is not supported by the following lines of evidence in genetic hypertension: the absence of fasting hypercalciuria owing to intrinsic tubular defects, increased net Ca absorption in vivo despite greater Ca retention before and during established hypertension, increased intracellular free Ca concentrations, the failure to aggravate the hypertension by 50% reduction in dietary Ca intake, and the failure to ameliorate the hypertension by maneuvers that augment Ca balance (parenteral Ca administration, a high Mg diet, and 1,25-dihydroxyvitamin D3 injections). The available literature may be explained by the alternative hypothesis that genetic hypertension is characterized by generalized membrane defects in Ca regulation, resulting in a relative increase in cytosolic free Ca. The mechanism (or mechanisms) and physiological consequences of the disturbances in Ca homeostasis, however, remain to be defined. PMID- 3533641 TI - The calcium requirement and factors causing calcium loss. AB - Studies carried out under strictly controlled conditions during different calcium intakes in adult males have shown that the average calcium balance was only slightly positive (+22 mg/day) during a calcium intake of 800 mg/day, the recommended dietary calcium intake, not taking into consideration dermal losses of calcium. During this calcium intake, the calcium balances were negative in 34% of the subjects studied. Increasing the calcium intake to 1200 mg/day resulted in a significant increase of the calcium balance; further increases to different intake levels up to 2300 mg/day did not improve the calcium balance further. Increasing the phosphorus intake up to 2000 mg/day as well as increasing the protein intake from 1 g/kg body weight to 2 g/kg, given as meat, did not have an adverse effect on calcium metabolism. A variety of drugs, notably aluminum containing antacids, induced calcium loss. Increasing the calcium intake more than 10-fold from 200 to 2500 mg/day did not lower the blood pressure in a large number of normotensive patients and in a small number of hypertensive patients studied. PMID- 3533642 TI - Design of dihydrofolate reductase inhibitors from X-ray crystal structures. AB - Dihydrofolate reductase (DHFR) is an important therapeutic target for treatment of cancer and microbial disease. Its species specificity has resulted in the sequencing of a number of vertebrate and bacterial DHFRs, and the three dimensional structure of isozymes from Escherichia coli, Lactobacillus casei, and chicken liver has been elucidated, in the presence of the coenzyme NADPH and of a number of inhibitors. This information has enabled scientists to try to design improved and more selective inhibitors, based on the known coordinates of the enzyme features. Simple use of computer graphics or wire models has resulted in the design of inhibitors with 50 times the activity of trimethoprim, an antibacterial DHFR inhibitor, by making use of an unused ionic binding site. However, in a number of instances this approach was completely unsuccessful because hydrophobic sites of interaction were preferred. More sophisticated techniques involve energy minimization of the small molecule-macromolecule interactions to optimize the geometry. In this paper I describe the use of a molecular mechanics program, AMBER, for predicting the geometry and relative energetics of binding. Very encouraging results have been obtained for a closely related series of compounds. Where differing entropic and solvent effects are involved, predictions may be poor. The use of super computers and molecular dynamics methods should increase this capability in the near future. PMID- 3533643 TI - Design and synthesis of multisubstrate analog inhibitors of one-carbon transfer reactions. AB - The design and synthesis of multisubstrate analog enzyme inhibitors offer new opportunities in the creation of potent, highly specific drug molecules. Selected examples of inhibitors of 1-carbon transfer serve to illustrate the potential of this approach. Inhibitors of indole-N-methyltransferase, L-aspartyl transcarbamoylase, and thymidylate synthase are illustrative of many compounds that have demonstrated considerable specificity and potency. Several of these inhibitors and the rationale for their syntheses are described. PMID- 3533644 TI - Role of iron in adriamycin biochemistry. AB - Adriamycin forms a chelate with Fe(III) that exhibits complex redox chemistry. The drug ligand is able to directly reduce the bound Fe(III) with the concomitant production of a one-electron oxidized drug radical. This Fe(II) can reduce oxygen to hydrogen peroxide and cleave the peroxide to yield the hydroxyl radical. In addition, the drug X Fe complex can catalyze the transfer of electrons from reduced glutathione to molecular oxygen to yield superoxide, hydrogen peroxide, and hydroxyl radicals. The adriamycin X Fe complex binds to DNA to form a ternary drug X Fe X DNA complex, which is also able to catalyze the thiol-dependent reduction of oxygen and the formation of hydroxyl radical from hydrogen peroxide. As a consequence of this chemistry, the adriamycin X Fe complex can cleave DNA on the addition of glutathione or hydrogen peroxide. Although less well defined, the adriamycin X Fe complex can bind to cell membranes and cause oxidative destruction of these membranes in the presence of thiols or hydrogen peroxide. PMID- 3533645 TI - Mechanism of copper transport from plasma to hepatocytes. AB - The effects of plasma components on the kinetics of copper transport by rat hepatocytes were examined in an attempt to determine how copper is mobilized from plasma for uptake by the liver. Specific protein-facilitated transport was indicated by saturation kinetics, competition by related substrates, and similar kinetic parameters for uptake and efflux. For copper uptake, Km = 11 +/- 0.6 microM and Vmax = 2.7 +/- 0.6 nmol Cu/(min X mg protein). Zinc is a competitive inhibitor of copper uptake, and copper competes for zinc uptake. Copper efflux from preloaded cells is biphasic. The kinetic parameters for the initial rapid phase are similar to the parameters for uptake. Copper transport by hepatocytes is strictly passive. A variety of metabolic inhibitors have no effect on uptake and initial rates are solely dependent on extracellular-intracellular concentration gradients. Albumin markedly inhibits copper uptake by a substrate removal mechanism, and histidine facilitates albumin-inhibited copper uptake. The active species that delivers copper to hepatocytes under conditions of excess albumin and excess histidine is the His2Cu complex. Experiments with [3H]His2 64Cu showed that the transported species is free ionic copper. The kinetic parameters of copper transport by hepatocytes isolated from the brindled mouse model of Menkes' disease are normal. However, these cells show a decreased capacity to accumulate copper on prolonged incubation. An intracellular metabolic defect seems to be involved. PMID- 3533646 TI - Zinc uptake and metabolism by hepatocytes. AB - Hepatocytes are in a dynamic equilibrium with the plasma zinc supply. Kinetic analysis of zinc uptake by isolated rat liver parenchymal cells defines two intracellular pools. In one pool zinc is bound relatively weakly and equilibrates rapidly with the medium at 37 degrees C. In the other pool zinc is bound tightly and interacts with the medium slowly at 37 degrees C. Of the two intracellular pools, the slower responding component represents an exchange process with the bulk of total cell zinc. The slow phase of uptake is saturable with albumin in the medium. The smaller pool is in rapid equilibrium with the medium and represents a labile zinc pool that accounts for net zinc accumulation. Both intracellular pools respond to hormonal stimuli. The factors that augment the uptake/exchange of zinc, namely glucocorticoids, glucagon, epinephrine, and dibutyryl cyclic AMP, are also those that stimulate metallothionein gene expression in hepatocytes. Changes in zinc flux into intracellular pools are directly related to the metallothionein content of hepatocytes. Characteristics of the labile zinc pool suggest that it may serve as an initial intermediate in zinc metabolism by hepatocytes as well as more general aspects of liver function related to zinc. PMID- 3533647 TI - Iron uptake and metabolism by hepatocytes. AB - The hepatocytes form part of the iron storage system of the body. In serving this function they exchange iron bidirectionally with the plasma iron transport protein transferrin (Tf). Iron uptake involves binding of the iron-Tf complex to cell membrane receptors and endocytosis into low-density vesicles, where the iron is released from its carrier protein before the Tf is returned undegraded to the extracellular medium. Two components of the iron uptake process can be distinguished, one saturable at low concentrations of diferric Tf and the other not saturable by increasing the Tf concentration. Both result in net uptake of iron by the cells and both appear to depend on specific binding to the cell membrane and endocytosis. Hepatocytes also obtain some iron from haptoglobin hemoglobin, heme-hemopexin, and ferritin (Fn), in each case by interaction with membrane receptors and endocytosis. Within the cell iron from all sources enters one or more transit pools, where it is available for exchange with the iron storage protein Fn, and for release from the cell to plasma Tf or to iron chelators administered therapeutically or experimentally. Chelator-mediated iron release occurs to the plasma and/or to the bile, depending on the nature of the chelator and the source of the iron. PMID- 3533648 TI - [Relation between the distribution of vitamin E in the blood and tissues of the rat in the 2d half of ontogenesis, its concentration in feed and insulin administration]. PMID- 3533649 TI - [Proteolysis and permeability of blood-tissue barriers in experimental peritonitis]. PMID- 3533650 TI - [Effect of physiologically active substances on intestinal absorption]. PMID- 3533651 TI - [Glycocalyx vesicles of enterocytes--membrane hydrolysis reserve?]. PMID- 3533652 TI - Target enzymes for plasma proteinase inhibitors. AB - The control of proteolytic activity in tissues is primarily under the influence of plasma inhibitors which function to rapidly inactivate specific target proteinases by either covalent interactions or trapping reactions. Each inhibitor is designed to control a specific proteolytic event, although many may show weaker activities against other proteinases. Kinetic experiments, however, indicate that reactions with target enzymes are much more rapid than with other and that modification of the inhibitor dramatically interferes with the rate at which inhibition occurs. This latter effect is almost certainly due to the fact that the inhibitor itself acts as a perfect substrate for the proteinase in question, resulting in a rapid association with the enzyme followed by a very slow dissociation so that the enzyme is essentially trapped in a complex. PMID- 3533653 TI - The interaction between some serine proteinases and horse leucocyte inhibitor. AB - Horse blood leucocyte cytosol exhibits a broad inhibitory activity against serine proteinases. The purified inhibitor was exposed to investigated enzymes (trypsin, chymotrypsin, elastases and serine proteinase from S. aureus) for variable time and the products were analyzed by gradient polyacrylamide gel electrophoresis in the presence of sodium dodecyl sulphate. The molar ratio I:E, association rate constants k on and inhibition constants Ki for the enzymes and inhibitor were determined. The examined elastases form stable, stoichiometric complexes with the inhibitor (Ki less than 10(-10) M), and do not undergo proteolytic degradation during 30 min incubation at 20 degrees C even at the 2-fold molar excess of the proteinases. The reactions with elastases are extremely rapid (k on greater than 10(7) M-1 s-1) and are completed within one second whereas similar reactions with chymotrypsin and trypsin are much slower (k on = 3 X 10(5) M-1 s-5 and 5 X 10(2) M-1 s-1, respectively). Serine proteinase from S. aureus neither react nor inactivates the investigated inhibitor. The complexes of the inhibitor with trypsin and chymotrypsin are digested even at a molar ratio I:E = 2:1. All these observations point out that the inhibitor from horse leucocyte cytosol is a specific and effective inhibitor of elastases. PMID- 3533654 TI - Emigration and accumulation of PMN-leukocytes induced by endotoxin, interleukin 1 and other chemotactic substances. AB - This publication describes polymorphonuclear leukocyte (PMN) emigration and accumulation, which is prerequisite for their defensive function in infected tissues. The extravasated PMNs can kill microorganisms, but in this process they also release proteolytic enzymes and other cell constituents which can alter and even injure the tissues, primarily the microcirculation. In the first part of the paper in vivo quantitation of the acute inflammatory reaction is described with emphasis on PMN emigration and accumulation. With 51Cr-labeled PMNs the kinetics of their emigration induced by a number of chemotaxins and chemotaxinigens was found to be similar, peaking in 1-4 hour old lesions and returning to baseline values thereafter. The most potent substance tested was endotoxin, which induced a PMN influx at a molar concentration a least 3 orders of magnitude lower than the other substances tested, implying the these substances are not the primary endogenous mediators of endotoxin induced inflammation. Next we describe an observation which shed considerable light on the mechanisms underlying PMN emigration. When a chemotaxin or endotoxin was injected intradermally and after varying periods of time reinjected into the same site, the PMN influx into those sites was diminished, compared to sites not previously injected, i. e. injected for the first time. This tachyphylaxis or diminished responsiveness was attributed to a downregulation of receptors, presumably on endothelial cells, coupled to a facilitatory mechanism. Other mechanism proposed to terminate emigration of PMNs during inflammatory reaction were unlikely, based on our experimental findings. Endotoxin is not chemotactic in vitro but it induces PMN emigration when injected intradermally. Hence the third part of the publication deals with PMN emigration induced by interleukin 1 and its significance for endotoxin-induced inflammation. IL 1 is the only chemotaxin which induces PMN accumulation at a concentration comparable to that of endotoxin and considerably lower than the other chemotaxins. There was cross tachyphylaxis between endotoxin and IL 1 and vice versa. The PMN influx into IL 1 sites injected 6 hours earlier with IL 1 or with endotoxin was diminished compared to IL 1 sites injected into normal skin. Sites injected first with IL 1 and then with a low dose of endotoxin also exhibited cross tachyphylaxis. FMLP or LTB4 injected into sites pretreated with endotoxin did not exhibit cross tachyphylaxis, i. e. the PMN influx was similar to sites injected for the first time with these chemotaxins.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3533655 TI - Granulocyte proteinases as mediators of unspecific proteolysis in inflammation: a review. AB - In severe inflammatory response, various blood and tissue cells, including polymorphonuclear granulocytes, release lysosomal proteinases, extracellularly and into the circulation. Such enzymes, as well as normally intracellular oxidizing agents produced during phagocytosis, enhance the inflammatory response by degrading connective tissue structures, membrane constituents and soluble proteins by proteolysis or oxidation. We first used polymorphonuclear elastase (E) as a marker of such release reactions. The liberated proteinase competes with susceptible substrates, including alpha 1-proteinase inhibitor (alpha 1PI) and alpha 2-macroglobulin, and is eliminated finally as inactive enzyme-inhibitor complexes by the reticulo-endothelial system. Using an enzyme-linked immunosorbent assay, we determined the plasma levels of E-alpha 1PI following major abdominal surgery, multiple trauma and pancreatogenic shock. Whereas the operative trauma was followed by up to 3-fold increase of the E-alpha 1-PI, postoperative septicemia was associated with a 10 to 20 fold increase. The increase of E-alpha 1-PI and a concomitant decrease of plasma factors, such as antithrombin III, clotting factor XIII and alpha 2-macroglobulin, were correlated. Multiple trauma causes a substantial increase of E-alpha 1-PI up to 14 hours after accident. The released elastase seems to correlate with severity of injury, but assessing the relationship to consumption of plasma factors is complicated by concomitant transfusions. In acute pancreatitis, peaks, of E-alpha 1-PI coincide with a massive consumption of antithrombin III and alpha 2 macroglobulin during shock. PMID- 3533656 TI - [Implantology: possibilities and limits]. PMID- 3533657 TI - [Experimentation with relaxation technics. IV]. PMID- 3533658 TI - [Pulp damage due to overheating in conservative dentistry]. PMID- 3533660 TI - [Implantology: success if the case is right]. PMID- 3533659 TI - [Description of a psychophysical relaxation technic. III]. PMID- 3533661 TI - [Comparative evaluation of the marginal adaptation of 3 types of composites in various restorative technics]. PMID- 3533662 TI - [Possibilities of light and balneotherapy for the treatment of psoriasis in Hungary and in other socialist countries]. PMID- 3533663 TI - Simple denture copying using the Murray-Wolland duplicating box system. PMID- 3533664 TI - Acupuncture and pain in dermatology. PMID- 3533665 TI - Anapsos modifies immunological parameters and improves the clinical course in atopic dermatitis. PMID- 3533666 TI - Acute generalized exanthematous pustular dermatitis and viral infection. AB - Three patients with acute generalized exanthematous pustular dermatitis (AGEPD) are presented. This new clinical entity comprises generalized erythema, erythema multiforme, amicrobial pustules, fever and spontaneous healing over a 10-day period. Histologically, there are a mixed neutrophilic and eosinophilic vasculitis and an eosinophilic subcorneal and spongiform pustule. All the patients experienced pharyngitis 1 week before the onset of the rash. Two of them had high-titered IgM-neutralizing antibodies to enteroviruses and 1 had an enterovirus in stool and urine. AGEPD may be related to a viral infection and may occur in patients with a genetic predisposition to psoriasis. The diagnosis of AGEPD should be made early enough so that the patients are not given the often aggressive therapy of pustular psoriasis. PMID- 3533667 TI - Immunocytochemical localization of vitamin D-dependent calcium-binding protein in the growing chick lymphoid organs. AB - Monospecific antiserum against chick duodenal vitamin D-dependent calcium-binding protein (D-CaBP) was used to localize this protein by the peroxidase antiperoxidase method (PAP) in the thymus, spleen and bursa of Fabricius of normal growing chicks in 20 day old embryos; in normal growing chicks at 1, 2, 3, 4 and 6 weeks of age in chicks fed a rachitogenic diet for 4 weeks. In the normal chick thymus, D-CaBP was localized throughout the cytoplasm and in the nucleus of cortical epithelial reticular cells (ERC) and in Hassal's corpuscles of the medulla. In the normal spleen reticular cells of the marginal zones showed dense deposition of reaction product in the nucleus and throughout the cytoplasm. In the bursa of Fabricius, only a few scattered cells in the medulla showed some staining. Wide variation was encountered in D-CaBP staining in the thymus and spleen of 4 week old chicks from different broods. In 4 week old rachitic chicks, staining in the thymus and in the spleen was generally reduced in intensity and occasionally was entirely absent. The presence of D-CaBP in some reticular cells of the thymus, spleen and bursa of Fabricius, identifies these lymphoid organs as vitamin D3 targets. Thus, 1,25(OH)2D3 may have an important role in some aspects of the immune defence mechanism. PMID- 3533668 TI - Glucose tolerance after portacaval shunt in liver cirrhosis. AB - The liver plays a key role in glucose homeostasis and insulin metabolism. Altered glucose and insulin levels in peripheral blood are common findings in chronic liver disease. The aim of the present study was to investigate the effect of surgical portosystemic shunt on plasma glucose and insulin responses to glucose administration in a group of cirrhotic patients. For this purpose 10 cirrhotic subjects (8 males and 2 females) aged 42 to 65 years underwent an oral glucose tolerance test (OGTT, 75 g), and an intravenous glucose tolerance test (IVGTT, 0.33 g/kg) before and after undergoing a side-to side portocaval anastomosis (PCS). 6 noncirrhotic, nondiabetic patients matched for sex, age and body weight who underwent abdominal vascular surgery served as controls. In cirrhotic subjects, the PCS resulted in: increased plasma glucose and insulin levels during OGTT; decreased C-peptide level during OGTT; unmodified plasma glucose and insulin concentrations during IVGTT. In control subjects the abdominal surgery did not affect plasma glucose and insulin responses to oral or intravenous glucose loads. These results suggest that in cirrhotic subjects surgical portocaval shunt results in: deterioration of oral but not intravenous glucose tolerance, due to an escape of ingested glucose from the liver; increased peripheral insulin response to oral glucose administration as a consequence of reduction in hepatic removal of the hormone; and decreased pancreatic response to oral glucose due possibly to a greater feed back inhibition of beta-cell. These events seem to be a consequence of the shunt per se and not of a deterioration of hepatocellular function. PMID- 3533669 TI - Disturbances in the regulation of glycaemia in rabbits following pancreatic duct ligation. Biochemical and immunocytochemical studies. AB - The effects of pancreatic duct ligation on endocrine function in the rabbit were studied over the short and medium term period (5 to 180 days). Hyperglycaemia appeared 30 days after ligation and persisted until the end of the experimental period (180 days). The highest glucose values were observed on day 90 after ligation (351 +/- 25 mg/100 ml). Glucose loading tests performed 5, 15, 30 and 180 days after ligation showed weak insulin release. Reduced pancreatic insulin stores could not account for this failure. Immunocytochemical studies showed dissociation of the islets (30 days after ligation) leading to small clusters of B cells scattered in a degenerative exocrine tissue (180 days). PMID- 3533670 TI - Effects of metformin treatment on erythrocyte insulin binding in normal weight subjects, in obese non diabetic subjects, in type 1 and type 2 diabetic patients. AB - We have evaluated the effects of metformin administration on erythrocyte insulin receptors in 21 subjects: 5 normal weight subjects, 5 obese non diabetics, 5 insulin-dependent diabetics (Type I) and 6 obese non insulin-dependent (Type II) diabetics. Plasma glucose, plasma insulin and erythrocyte insulin receptors were studied after 15 days of metformin (850 mg, t.d.) or placebo administered in a double blind random order. Maximum specific insulin binding to erythrocytes increased after metformin in the normals (p less than 0.01), in the obese non diabetics (p less than 0.01) and in the obese Type 2 diabetics (p less than 0.005), but not in Type I diabetics. Scatchard analysis showed that the receptor number per cell increased by 37% in the normals, by 17% in the obese non diabetics and by 182% in Type 2 diabetics. Receptor affinity increased in obese subjects but did not increase in normals and in diabetics. Only in Type II diabetics was there a significant decrease in plasma glucose. Metformin, thus, increased binding in normals by moderately increasing the capacity of cell receptors, in obese non diabetics by increasing the affinity, whereas in obese Type II diabetics it dramatically increases receptor capacity. This is consistent with the fact that metformin has a hypoglycaemic effect mainly in Type II diabetics, but not in non diabetics (whether obese or not), and could be due to a direct effect on the cell membrane. PMID- 3533671 TI - Porcine and human semisynthetic insulin bind equally to the insulin receptor on red blood cells. PMID- 3533672 TI - Tiaprofenic acid in the treatment of primary dysmenorrhoea. AB - Thirty-one patients with primary dysmenorrhoea were treated in a double-blind, six-period, cross-over clinical trial with tiaprofenic acid, naproxen sodium and a placebo in randomized order, each for 2 consecutive cycles. Complete disappearance of the symptoms or pronounced therapeutic effects were obtained with tiaprofenic acid, naproxen sodium and the placebo in 74%, 65% and 35% of cases, respectively, while these treatments were ineffective in 3%, 6% and 38% of cases, respectively. Tiaprofenic acid was superior to the placebo for relieving pelvic pain and overall discomfort and for reducing the need for bed-rest. Naproxen sodium compared favourably with the placebo with respect to pelvic pain and overall discomfort. The effects of tiaprofenic acid and naproxen sodium were not significantly different. Tiaprofenic acid had no side-effects, whereas tiredness was experienced in 3 cases of naproxen sodium treatment. The results indicate that tiaprofenic acid is a useful alternative for the treatment of primary dysmenorrhoea. PMID- 3533673 TI - Successful use of transabdominal isthmic cerclage in the management of cervical incompetence. PMID- 3533674 TI - A comparative study of Miraxid (pivmecillinam plus pivampicillin) and Augmentin (amoxycillin plus clavulanic acid) in the treatment of lower respiratory tract infections in general practice. AB - Two treatments, pivmecillinam 200 mg plus pivampicillin 250 mg (Miraxid) given twice-daily and amoxycillin 250 mg plus clavulanic acid 125 mg (Augmentin) given three times daily were compared in two parallel groups of 388 general practice patients with acute bronchitis or acute exacerbations of chronic bronchitis. Patients with acute bronchitis (140 on Miraxid, 144 on Augmentin) received a 7 day course of treatment and those with acute exacerbations of chronic bronchitis (55 on Miraxid, 49 on Augmentin) a 10-day course of treatment. Both treatments were equally effective, with 99 (71%) patients with acute bronchitis being successfully treated with Miraxid and 107 (74%) with Augmentin. In acute exacerbations of chronic bronchitis, Miraxid was successful in 29 (53%) patients and Augmentin in 24 (49%) patients. Side-effects were reported by 26 (12%) of patients in both treatment groups. This single blind multicentre general practice study comparing twice-daily Miraxid with 3 times daily Augmentin demonstrated that both treatments were equally effective clinically and equally well tolerated. PMID- 3533675 TI - Ketotifen in the treatment of infants and young children with wheezy bronchitis and bronchial asthma. AB - Ketotifen, an orally-administered anti-anaphylactic and antihistamine compound, was given in a dose of 0.06 mg/kg to 142 infants and young children presenting either with non-infected wheezy bronchitis or bronchial asthma to an allergy out patient department. Treatment continued for 12 weeks. At the end of this time, ketotifen was considered to be very effective or effective in 70% of the children. The effect was more marked in non-infected wheezy bronchitis (83.55% response) than in bronchial asthma (56.5% response), perhaps because factors such as leukotrienes, prostaglandins and thromboxanes tend to produce a sustained bronchoconstriction in the latter condition. Ketotifen was not associated with any adverse effects and did not cause behavioural problems. Patients found it palatable and acceptable. The main disadvantage was that symptoms recurred within days of stopping treatment. Especially in non-infected wheezy bronchitis, ketotifen should be given for a year or longer to older children (older than 30 months) who have shown an initial good response to the drug. PMID- 3533676 TI - Differential dosing of trazodone in elderly depressed patients: a study to investigate optimal dosing. AB - We investigated the comparative efficacy and tolerance of two initial starting doses of trazodone in 20 elderly inpatients suffering from depressive illness. The first 2-week phase was double-blind. Patients received either 25 mg trazodone tds or 50 mg tds. After this time the study was open, the dose of trazodone being titrated from the initial starting dose to maximise efficacy and tolerance. Patients received study medication for a total of 6 weeks. Assessments for efficacy included the Hamilton Depression rating scale, Zung anxiety scale, visual analogue scales for depression, euphoria and tension, and global assessments of severity and improvement of condition. Tolerance was assessed by means of a checklist of symptoms and adverse effects. Assessments were performed at base line and at weekly or bi-weekly intervals thereafter. A total of 18 patients were included in the analysis. The Zung and visual analogue scales indicated significant superiority for the high-dose group at Week 2. The Hamilton ratings indicated significant superiority for the high-dose group at Week 6 with a strong trend in favour of the high dose group at Week 2. Measures of severity of illness and improvement indicated more rapid improvement over time in the high dose group. The treatment was generally well tolerated and at no time did adverse events outweigh therapeutic benefit. The incidence of headache and nausea was more frequent in the high-dose group in the first 2 weeks. The group of elderly patients studied benefited from trazodone therapy initiated at a higher therapeutic dose. This dose (150 mg total daily) was well tolerated and proved effective over the course of 6 weeks' treatment. PMID- 3533677 TI - Acetazolamide in prevention of acute mountain sickness. AB - A controlled comparative between-group study of 48 climbers ascending Kilimanjaro (5895m) was designed as an extension to our previous double-blind cross-over trial on the same peak in 1980, using acetazolamide to decrease the incidence and effects of Acute Mountain Sickness. A group taking acetazolamide 500 mg each morning for one day before reaching 3000m were compared with 3 control groups of Caucasian subjects and lowland and highland Africans. Efficacy was assessed on climbing performance and scores derived from symptoms recorded daily by subjects. Those taking acetazolamide reached higher altitudes and had lower symptom scores than those in control groups. The results support the use of acetazolamide as an effective prophylactic for Acute Mountain Sickness, for most people in a dose of 500 mg in the morning starting one day before ascent above 3000m. The optimal dose of prophylactic acetazolamide is not established, nor is the most appropriate time for medication prior to ascent. PMID- 3533678 TI - Activity of maturation promoting factor in mammalian oocytes after its dilution by single and multiple fusions. AB - Mouse and porcine fully grown oocytes at metaphase I(MI) were fused to one or more fully grown oocytes of the same species that contained an intact germinal vesicle (GV). In fused cells containing one GV, premature chromosome condensation (PCC) was observed. In fused cells containing more than one GV, germinal vesicle breakdown (GVBD) and PCC were delayed. Fusion of an MI fully grown oocyte with a growing oocyte resulted in rapid PCC, whereas, fusion of an MI fully grown oocyte with more than one growing oocyte resulted in neither PCC nor GVBD. Moreover, MI chromosomes formed a clump of chromatin. Results of these experiments suggest that the delay in GVBD in fusions of MI oocytes with multiple GV-intact oocytes was due to dilution of maturation promoting factor (MPF) by the cytoplasm of the GV-intact oocytes and that the cytoplasm of growing oocytes can inhibit MPF present in MI oocytes. PMID- 3533679 TI - Preservation of hepatocyte plasma membrane domains during cell division in situ in regenerating rat liver. AB - We have utilized antibodies against five domain-specific integral proteins of the rat hepatocyte plasma membrane to examine the fates of the plasma membrane domains during hepatocyte division in the regenerating rat liver. The proteins were quantified on immunoblots of liver homogenates prepared during the peak of hepatocyte mitotic activity, 28-30 hr after two-thirds hepatectomy. Two sinusoidal/lateral proteins, CE 9 and the asialoglycoprotein receptor, and one bile canalicular protein, dipeptidylpeptidase IV, were not changed significantly in amount; whereas one sinusoidal/lateral protein, the epidermal growth factor receptor, and one bile canalicular protein, HA 4, were reduced to less than or equal to 50% of control levels. Light microscopic examination of plastic sections of regenerating liver tissue revealed that the mitotic hepatocytes generally appeared to retain normal contacts with neighboring interphase hepatocytes. Immunofluorescence was used to localize the domain-specific proteins on mitotic hepatocytes identified in 0.5-micron frozen sections of 28- to 30-hr regenerating liver tissue. Independent of mitotic stage, the hepatocytes retained mutually exclusive bile canalicular and sinusoidal/lateral domains, as defined at the molecular level by the distributions of specific proteins, such as HA 4 and CE 9, respectively. PMID- 3533680 TI - Selective unresponsiveness of pancreatic beta-cells to acute sulfonylurea stimulation during sulfonylurea therapy in NIDDM. AB - Patients with non-insulin-dependent diabetes mellitus (NIDDM) who have chronic hyperglycemia lose acute incremental insulin responses to glucose but are able to briskly respond to other beta-cell secretagogues. To investigate whether this is a defect specific for glucose or represents a more general phenomenon, we measured the insulin responses to acute intravenous tolbutamide in 10 obese patients with NIDDM both before and during sulfonylurea therapy with tolazamide. Comparable glycemia was achieved with oral dextrose 2 h before intravenous testing. To assess beta-cell responsiveness to a nonsulfonylurea secretagogue, 1 mg glucagon was administered intravenously during tolazamide therapy. In seven patients, the mean peak insulin increment 5 or 10 min after intravenous tolbutamide was 54 +/- 11 microU/ml when not receiving tolazamide (0.14 +/- 1.3 microU/ml) with tolazamide (P less than .001), even though serum insulin responded rapidly to intravenous glucagon. In four patients tested for reversibility of their refractoriness to intravenous tolbutamide during chronic tolazamide therapy, the mean peak insulin increment 1 wk after discontinuing tolazamide was 79 +/- 22 microU/ml. A relatively rapid development of refractoriness was documented in four patients who were tested only 12 h after beginning tolazamide therapy; the mean peak insulin increments 5-10 min after intravenous tolbutamide were undetectable (-0.5 microU/ml), yet responses to intravenous glucagon were evident. In these NIDDM patients, exposure of pancreatic beta-cells to sustained levels of sulfonylureas induces a reversible state of refractoriness to acute stimulation with sufonylureas but not to another secretagogue.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3533681 TI - Insulin dose-response characteristics for suppression of glycerol release and conversion to glucose in humans. AB - To compare the dose-response characteristics for suppression of lipolysis and suppression of glucose production by insulin, 13 normal nonobese individuals were infused with insulin at rates of 0.1, 0.2, 0.4, 0.8, and 1.6 mU X kg-1 X min-1 while normoglycemia was maintained with the glucose clamp technique. Glucose appearance and glycerol appearance (taken as index of lipolysis) were measured isotopically with simultaneous infusions of 3-[3H]glucose and U-[14C]glycerol. Baseline glucose and glycerol rates of appearance were 14 +/- 0.5 and 1.7 +/- 0.2 mumol X kg-1 X min-1, respectively. Approximately 3% of plasma glucose originated from glycerol, and this accounted for approximately 50% of glycerol disposal. During the insulin infusions, arterial insulin (basal, 9.8 +/- 0.6 microU/ml) increased to 14 +/- 0.5, 20 +/- 0.5, 31 +/- 1, 58 +/- 2, and 104 +/- 6 microU/ml; calculated portal venous insulin (basal, 24 +/- 2 microU/ml) increased to 26 +/- 1, 32 +/- 3, 70 +/- 4, and 115 +/- 6 microU/ml. The rate of glucose appearance was suppressed 100%, whereas the rate of appearance of glycerol was maximally suppressed only 85%. Nevertheless, the insulin concentration that produced half maximal suppression of glucose appearance was twice as great as that required for half-maximal suppression of glycerol appearance (26 +/- 2 vs. 13 +/- 2 microU/ml, P less than .001). Insulin decreased both the absolute rate of glycerol conversion to plasma glucose and the percent of glycerol disposal appearing in plasma glucose (both P less than .001).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3533682 TI - Mechanism of abnormal oral glucose tolerance of genetically obese fa/fa rats. AB - The genetically obese fa/fa rat is glucose intolerant when tested in a conscious state after the spontaneous ingestion of a glucose solution. The aim of this study was to investigate the mechanism(s) underlying the abnormal oral glucose tolerance test of obese animals with the non-steady-state measurement of glucose turnover proposed by Steele et al. in 1968. Our results show that the total rate of glucose appearance is enhanced in obese compared with lean animals. This abnormality is not due to an increased gut glucose absorption but to a lack of suppression and even a transient stimulation of hepatic glucose production after the ingestion of glucose. The rate of glucose utilization by the obese animals is somewhat increased compared with controls or unchanged when expressed as glucose metabolic clearance rate, thus excluding this parameter from the factors contributing to the observed glucose intolerance. The results obtained with genetically obese rats agree with those reported for type II diabetes in humans. The observed defect of the obese group could be related to an abnormal regulation of insulin counterregulatory hormone(s) or of hepatic innervation as well as to other defects of hepatic glycogen handling. PMID- 3533683 TI - Diacylglycerol modulation of insulin receptor from cultured human mononuclear cells. Effects on binding and internalization. AB - Tumor-promoting phorbol esters alter binding of growth factors and hormones to their specific receptors. Action of diacylglycerols, endogenous phorbol ester analogues, on 125I-labeled insulin binding to its receptor from human cells was therefore investigated. A variety of 1,2-diacylglycerols and 1,3-diacylglycerols inhibited 125I-insulin binding to intact human monocyte-like (U-937) and lymphoblastoid (IM-9) cells in a dose-, time-, and temperature-dependent manner within 30 sec at 37 degrees C in a fashion analogous to that of the tumor promoting phorbol diester 12-O-tetradecanoylphorbol-13-acetate (TPA). Inhibition of insulin binding by diacylglycerols, analyzed by Scatchard plot, seems to be due to altered binding affinity of the insulin receptor. Diacylglycerol effects were reversible, were seen regardless of the order of addition of 125I-insulin and diacylglycerols, and were demonstrated only with occupied insulin receptors. Corresponding fatty acids or phospholipids did not affect specific insulin binding to the intact U-937 cells. Diacylglycerols also inhibited binding of 125I insulin-like growth factor (IGF) I but not that of 125I-human growth hormone (HGH) to the human cells. The non-tumor-promoting phorbols (phorbol, 4-alpha phorbol, phorbol-12,13-distearate) did not affect insulin binding to intact cells. Both diacylglycerols and TPA stimulated internalization of 125I-insulin by U-937 and IM-9 cells. The ability of diacylglycerol to mimic the effects of TPA on the insulin receptor supports the concept of diacylglycerols as endogenous phorbol diester analogues even though the sole role of protein kinase C in our system is doubtful.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3533684 TI - Metabolic consequences of prolonged hyperinsulinemia in humans. Evidence for induction of insulin insensitivity. AB - Hyperinsulinemia is frequently associated with a variety of insulin-resistant states and has been implicated causally in the development of insulin resistance. This study examines the metabolic consequences of prolonged hyperinsulinemia in humans. Basally and 1 h after cessation of a 20-h infusion of insulin (0.5 mU X kg-1 X min-1, aimed at elevating plasma insulin levels to approximately 30 mU/L) or normal saline, subjects were assessed for glucose turnover with 3-[3H]glucose; insulin sensitivity, as measured by either the euglycemic glucose-clamp technique or the intravenous glucose tolerance test (IVGTT) minimal model method of Bergman; and monocyte insulin-receptor binding. Hepatic glucose production (Ra) was suppressed by greater than 95% during each euglycemic clamp and during the 20 h insulin infusion. After the insulin infusion, Ra and glucose utilization rate returned to the initial basal level within 1 h, as did insulin levels. At that time, insulin sensitivity was significantly decreased, as measured by the "insulin action" parameter during the 40- to 80-min phase of the clamp (0.049 +/- 0.003 vs. 0.035 +/- 0.007 min-1, P less than .05) and during the 80- to 120-min phase (0.047 +/- 0.005 vs. 0.039 +/- 0.007 min-1, .05 less than P less than .1).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3533685 TI - Cysteine analogues potentiate glucose-induced insulin release in vitro. AB - In rat pancreatic islets, cysteine analogues, including glutathione, acetylcysteine, cysteamine, D-penicillamine, L-cysteine ethyl ester, and cysteine potentiated glucose (11.1 mM) induced insulin secretion in a concentration dependent manner. Their maximal effects were similar and occurred at approximately 0.05, 0.05, 0.1, 0.5, 1.0, 1.0 mM, respectively. At substimulatory glucose levels (2.8 mM), insulin release was not affected by these compounds. In contrast, thiol compounds, structurally different from cysteine and its analogues, such as mesna, tiopronin, meso-2,3-dimercaptosuccinic acid (DMSA), dimercaprol (BAL), beta-thio-D-glucose, as well as those cysteine analogues that lack a free-thiol group, including L-cystine, cystamine, D-penicillamine disulfide, S-carbocysteine, and S-carbamoyl-L-cysteine, did not enhance insulin release at stimulatory glucose levels (11.1 mM); cystine (5 mM) was inhibitory. These in vitro data indicate that among the thiols tested here, only cysteine and its analogues potentiate glucose-induced insulin secretion, whereas thiols that are structurally not related to cysteine do not. This suggests that a cysteine moiety in the molecule is necessary for the insulinotropic effect. For their synergistic action to glucose, the availability of a sulfhydryl group is also a prerequisite. The maximal synergistic action is similar for all cysteine analogues tested, whereas the potency of action is different, suggesting similarity in the mechanism of action but differences in the affinity to the secretory system. PMID- 3533686 TI - Lymphocyte subsets and activation in prediabetes. AB - Peripheral blood lymphocytes were obtained from 65 individuals: 34 nondiabetic patients with islet cell autoantibodies (ICA) (prediabetic phase), 9 patients with newly diagnosed insulin-dependent diabetes mellitus (IDDM), 6 ICA-negative siblings or offsprings of IDDM patients, and 16 ICA-negative controls. The presence of lymphocyte abnormalities and/or activation was examined with dual fluorescence flow cytometry. The percentages of B cells, total T-lymphocyte, and helper T-lymphocyte (Th) and cytotoxic/suppressor T-lymphocyte (Tc/s) subsets and their ratio were not significantly different among the patient groups. No increased expression of interleukin 2 receptor on T-lymphocyte was found in newly diagnosed IDDM or prediabetic individuals. Sixteen of 49 patients had significantly increased number of T-lymphocyte expressing HLA-DR. A significant increase in the number of both Th and Tc/s subsets expressing HLA-DR was found in only 3 of 16 patients. This increase was unrelated to the patients's relative ICA titer or HLA-DR phenotype. On the other hand, the relative density of the DR antigen (RAD-DR) was significantly increased on both Th (886 +/- 120) and Tc/s (1250 +/- 273) in 13 of 38 patients compared with control patients (Th 484 +/- 129 and Tc/s 460 +/- 166). The RAD-DR on Tc/s correlated with the relative ICA titer and was greatest on DR3/4-phenotyped T-lymphocytes. In addition, significantly increased RAD-DR was found in noncontrol patients with impaired insulin release responses at 1 and 3 min to intravenous glucose.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3533687 TI - Neuroanatomy, neurophysiology, and central auditory assessment. Part II: The cerebrum. AB - In this second article of a three-part series, the auditory areas of the cerebrum are defined. Anatomical descriptions of various structures within the auditory areas of the brain as well as an overview of selected electrophysiological research on auditory cortex are presented. Ablation studies involving auditory cortex and principal aspects of the vascular neuroanatomy are also reviewed. Finally, extensive clinical findings are presented from a case with damage to the cerebral auditory areas. PMID- 3533689 TI - Hepatic vein occlusion: morphologic features on computed tomography and ultrasonography. AB - Hepatic vein occlusion causes morphologic changes that can be demonstrated by computed tomography (CT) and ultrasound. In this study the imaging findings of acute, subacute, and chronic occlusion of the hepatic veins were analyzed retrospectively in 9 patients and correlated with the histopathologic changes. The CT findings were focal or scattered hypodense parenchymal lesions of the liver before and a patchy enhancement after intravenous bolus injection of contrast material. In none of the cases could the hepatic veins be identified. Hepatomegaly with relative enlargement of the caudate lobe was almost always observed. Ultrasonography demonstrated solid material within the major hepatic veins, intrahepatic venous collaterals, and focal parenchymal lesions, which varied with the stage of the disease: a hypoechogenic area was observed in acute hepatic vein thrombosis with subsequent hemorrhagic infarction; hyperechogenic lesions corresponded with fibrotic zones in chronic disease. Ascites was shown by both methods in all patients. PMID- 3533688 TI - Localization of immunoreactive transthyretin (prealbumin) and of transthyretin mRNA in fetal and adult rat brain. AB - We used a combination of immunohistochemical and molecular-biological techniques to investigate the localization of transthyretin (TTR) in the brains of adult and fetal rats. The immunohistochemical studies employed antibodies purified by immunosorbent affinity chromatography, permitting the specific staining and localization of TTR using the unlabeled peroxidase-antiperoxidase method. TTR mRNA levels were measured by Northern-blot analysis of poly (A+) RNA, followed by hybridization to 32P-labeled TTR cDNA; TTR mRNA was localized in brain tissue sections by in situ hybridization. Immunoreactive TTR was found to be specifically localized in the choroid plexus epithelial cells of adult rat brain. High levels of TTR mRNA were found in poly (A+) RNA samples obtained from the choroid plexus. In addition, the specific localization of TTR mRNA in the epithelial cells of the choroid plexus was demonstrated by in situ hybridization. Neither immunoreactive TTR nor TTR mRNA were found in other regions of adult rat brains. The levels of TTR mRNA in the choroid plexus were at least 30 times higher than those observed in the adult liver. Immunoreactive TTR was observed in the brains of fetal rats on as early as the 11th day of gestation. This immunoreactive TTR was localized in the tela choroidea, the developmental forerunner of the choroid plexus. Immunoreactive TTR was also observed in the fetal choroid plexus as it began to form (14th day of gestation) as well as in the more completely developed choroid plexus (18th day of gestation).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3533691 TI - Aneurysmal dilatation of the portal vein: a case diagnosed by real-time ultrasonography. AB - A case of aneurysmal dilatation of the portal vein is reported. A real-time ultrasound study showed a cystic mass behind the pancreatic head, freely communicating with the lumen of the portal, superior mesenteric, and splenic veins, which was diagnostic of portal vein aneurysm. The diagnosis was confirmed by dynamic computed tomography and celiac and superior mesenteric angiograms. PMID- 3533690 TI - Portal vein thrombosis: real-time sonographic demonstration and follow-up. AB - Twelve patients with portal vein thrombosis (PVT) associated with various disorders were examined. In 11 the diagnosis of PVT was made primarily by ultrasound. Endovenous lesions that presented with a mainly homogenous texture pattern of different echodensity could be clearly displayed, but failed to disclose specific echographic features that allow conclusive discrimination between blood clots (n = 7; mean diameter 13 +/- 1.7 mm) and venous tumor invasion (n = 5; mean diameter 24 +/- 12 mm). Thrombus resolution on therapy as well as cavernous transformation of the portal vein following acute PVT may be visualized by serial sonograms. Secondary findings in PVT that can be displayed by sonography include splenomegaly and superior mesenteric vein obstruction with intestinal ischemia. Real-time sonography has proved to be a valuable noninvasive method for the early diagnosis and follow-up of PVT. PMID- 3533692 TI - Mesenteric vein thrombosis: early CT and US diagnosis and conservative management. AB - We report a case of isolated superior mesenteric vein thrombosis with acute ischemic bowel disease, diagnosed early by a screening ultrasound scan of the upper abdomen and definitively assessed by computed tomography and angiography. This report stresses the contribution of cross-sectional techniques in the early diagnosis and management of venous occlusive disease of the small bowel. PMID- 3533693 TI - Radiographic features of liver allograft rejection. AB - The radiographic features of 19 transplanted patients with failure of the liver allograft were evaluated. These features were: poor filling, stretching, attenuation of intrahepatic biliary ducts documented by T-tube cholangiogram, attenuation of branches of the hepatic artery seen on angiogram as well as a decrease of blood flow through the liver seen on angiogram and nuclear medicine dynamic scintigram. These findings were secondary to swelling of the transplanted liver and were not specific for rejection; they may also be present in hepatic infarction or infection. PMID- 3533694 TI - Ultrasound diagnosis of ruptured hydatid cyst of the liver with biliary obstruction. AB - Communication between a hydatid cyst of the liver and biliary tract results in a clinical picture of obstructive jaundice because of occupation of the extrahepatic biliary tract by intracystic material. Five cases of this complication are presented. Ultrasound criteria for diagnosis are analyzed, based on previous publications as well as our own experience. PMID- 3533695 TI - Diagnostic accuracy of ultrasound in acute cholecystitis. AB - This work attempts to assess the diagnostic accuracy of ultrasound for acute cholecystitis in 98 clinically suspected patients from the emergency unit in whom at least 3 of 6 relevant criteria are present. Gallbladder distention to 5 cm or more transversely or in the anterior-posterior axis (criterion 1) was present in 64 patients; thickening of the gallbladder wall of at least 5 mm (criterion 2) in 95; cholelithiasis (criterion 3) in 86; sonolucent halo in the gallbladder wall (criterion 4) in 40; sonolucent fluid band surrounding the gallbladder (criterion 5) in 27; and intraluminal echogenic mass with no posterior acoustic shadow (criterion 6) in 35. A diagnostic accuracy index, corrected for chance, was statistically and clinically more relevant with 3 as the minimum number of criteria for the ultrasonic diagnosis of acute cholecystitis. PMID- 3533696 TI - Intraoperative ultrasonic localization of a small pancreatic pseudocyst. AB - Intraoperative pancreatic ultrasound can be useful to identify small masses or cysts that are not readily palpable at surgery. In our case, a small (2.0 cm diameter) pseudocyst was demonstrated preoperatively by ultrasound and computed tomography, but could not be palpated at surgery. Intraoperative ultrasound located and helped to guide needle aspiration of the pancreatic pseudocyst. Other indications for intraoperative pancreatic ultrasound are reviewed. PMID- 3533697 TI - Radiographic appearance of diffuse splenic hemangiomatosis. AB - The evaluation of splenomegaly in a patient with a consumptive coagulopathy included a liver-spleen scan, an abdominal sonogram, and an abdominal computed tomographic scan, which demonstrated an enlarged spleen with a diffuse parenchymal textural abnormality. A diffuse hemangiomatous pattern was present on splenic angiography. A splenectomy was performed and splenic hemangiomatosis was confirmed. The radiographic findings in this rare entity are presented and discussed. PMID- 3533698 TI - The effect of insulin and glucagon on the insulin receptor of cultured hepatoma cells. AB - To elucidate the mechanism of glucagon-insulin (G-I) therapy, the effect of insulin and/or glucagon on the insulin receptor was studied in an experiment utilizing cultured cells (JTC-16) of rat ascites hepatoma. Insulin specific receptors were present on JTC-16 cells and were similar in nature to the receptors of primary culture rat hepatocytes. There were two kinds of insulin receptors. One had a high insulin affinity and the other had low insulin affinity. In the experiment involving addition of insulin the number of insulin receptors decreased after 24 hrs incubation in proportion to the increase in added insulin concentration. On the other hand, the number of insulin receptors increased with glucagon addition and the increase in proportion to the concentration of glucagon added. In the experiment involving simultaneous addition of insulin and glucagon, a 20% decrease in the number of receptors induced with 10(-9) M insulin was restored to the control level with simultaneous glucagon addition of the same concentration. The number of insulin receptors increased as the concentration of additive glucagon increased. These results show that simultaneous addition of insulin and glucagon inhibits the decrease in number of insulin receptors with insulin alone. These facts may obtain more potent action of insulin in G-I therapy via insulin receptor. PMID- 3533699 TI - Randomized trial of chlorambucil for primary biliary cirrhosis. AB - Twenty-four patients with primary biliary cirrhosis were entered into a prospective, randomized trial of chlorambucil therapy. Thirteen patients received chlorambucil (0.5-4 mg/day) and 11 patients received no therapy; all have been followed for 2-6 yr (mean, 4.1 yr). Two control but no treated patients died. Average serum bilirubin, serum aspartate aminotransferase activities, and albumin levels improved or remained unchanged in treated patients but worsened in controls. Serum alkaline phosphatase levels did not change in either group. Immunoglobulin M levels decreased and became normal in all treated patients but in only 3 control patients. Liver biopsy histology revealed an improvement in inflammatory cell infiltrate in treated patients in comparison with controls, but no significant change in degree of fibrosis or the histologic stage of disease. Side effects of therapy included bone marrow suppression necessitating discontinuation of the drug in 4 patients. These findings indicate that chlorambucil therapy may retard the progression of primary biliary cirrhosis. Whether such therapy will ultimately decrease morbidity and improve survival in this disease can only be demonstrated by large-scale, placebo-controlled trials. PMID- 3533700 TI - Structural features of absorptive cell and microvillus membrane preparations from rat small intestine. AB - Absorptive cells of the small intestine are highly polarized cells with distinct microvillus membrane (MVM) and basolateral plasma membrane domains. We compared membrane structure in the following preparations of rat small intestine commonly used for in vitro study of MVM function: epithelial sheets, isolated epithelial cells, and four different MVM vesicle preparations, using electron microscopy of thin sections and freeze fracture replicas. We also quantitated mean vesicle diameter of the four MVM preparations by quasielastic light scattering and determined their actin content. Epithelial sheets maintained their plasma membrane polarity as judged by intramembrane particle (IMP) distribution for at least 30 min after isolation. In contrast, the plasma membrane of isolated cells showed redistribution of IMPs, indicating considerable loss of polarity in the few minutes required for cell recovery. The P-face IMPs in MVM prepared by Ca++ precipitation were randomly distributed but became aggregated after exposure to potassium thiocyanate, which removed approximately 50% of core actin. The P-face IMPs in Mg++ precipitated MVM were aggregated whether or not core actin was depleted with potassium thiocyanate. The shape and size of MVM vesicles differed considerably with different preparative techniques. The extremely rapid loss of plasma membrane polarity of isolated intestinal epithelial cells and the striking structural heterogeneity of MVM vesicles prepared by commonly used techniques should be considered in the interpretation of functional studies with these preparations. PMID- 3533701 TI - Gallstone dissolution therapy. Current status and future prospects. AB - Findings by several groups of investigators have provided a reliable data base that supports a nonoperative approach toward the management of so-called silent gallstones. Considerable progress has been made in the medical dissolution treatment of selected patients with cholesterol gallstones. Ursodeoxycholic acid, and, more recently, a combination of ursodeoxycholic and chenodeoxycholic acids have been shown to be both effective and safe in dissolving gallstones that are predominantly composed of cholesterol. A drawback of the bile acid dissolution therapy lies in a significant recurrence rate after treatment is discontinued. Currently, several new methods of gallstone treatment are under study, which involve either the injection of a cholelitholytic solution, such as methyl tert butyl ether, into the gallbladder or the use of mechanical means, such as excorporeally induced shock waves, to disintegrate gallstones. These treatments, however, are effective only if the stones are composed mainly of cholesterol without significant admixtures of calcium salts, pigment, or mucus. Most of the treatment failures are probably related to the presence of calcifications that are not visible on conventional radiographs. Future improvements of gallstone dissolution therapy can be expected from the following possible developments: improvement in ability to predict gallstone composition; dissolution of calcium salt-, pigment-, and mucus-containing stones; early treatment, before calcifications occur; combination of chemical and mechanical methods of treatment; stimulation of gallbladder contraction; prevention of stone recurrence after dissolution; and synthesis of new cholelitholytic agents. PMID- 3533702 TI - Hemostatic effect of endoscopic local injection with hypertonic saline epinephrine solution and pure ethanol for digestive tract bleeding. AB - An uncontrolled study for the assessment of the hemostatic effects of endoscopically injected hypertonic saline-epinephrine (HS-E) solution and pure ethanol (PE) was carried out in 67 patients with nonvariceal gastrointestinal bleeding. The HS-E group included duodenal ulcer (18), gastric ulcer (9), gastric cancer (2), polyp (2), marginal ulcer (1), and esophageal cancer (1). Bleeding was active in 15 (pulsating, 3; oozing, 12). The hemostatic effect was permanent in 29 cases (87.9%) but failed in four cases (12.1%). The PE group consisted of 34 patients with duodenal ulcer (25), gastric ulcer (4), polyp (2), marginal ulcer (2), and gastric cancer (1). There was active bleeding in 14 (pulsating, 3; oozing, 11). The hemostatic effect was permanent in 31 cases (91.2%), temporary in 1 case (2.9%), and failed in 2 cases (5.9%). We conclude that endoscopic local injection with HS-E or PE is a simple maneuver with reasonable cost, high safety, and satisfactory hemostatic efficacy in the treatment of nonvariceal gastrointestinal bleeding. PMID- 3533703 TI - Bacteremia with gastrointestinal endoscopic procedures. AB - The authors have reviewed 40 prospective studies of bacteremia with gastrointestinal procedures. Endoscopic procedures with a low mean frequency of bacteremia were esophagogastroduodenoscopy (4.2%), endoscopic retrograde cholangiopancreatography (5.6%), colonoscopy (2.2%), and sigmoidoscopy (4.9%). A higher mean frequency of bacteremia was encountered with esophageal dilation (45%) and variceal sclerotherapy (31%), although the number of patients studied was small. Potentially pathogenic organisms, such as Streptococcus viridans, Staphylococcus aureus, and Staphylococcus epidermidis have been isolated. Recommendations for antibiotic prophylaxis are reviewed. Less cumbersome regimens encourage compliance and are preferred. PMID- 3533704 TI - [Prognosis of pregnancy in diabetes mellitus]. AB - From 1970-1984 116 pregnant diabetic patients were monitored and delivered at the University Hospital of Freiburg, Department of Obstetrics and Gynecology. During these 15 years, a decrease in maternal and fetal complications was observed. Today the risk of some complications in diabetic pregnancy is not greater than that of pregnancy in nondiabetic women. There is, however, still a higher incidence of gestosis and polyhydramnion in diabetics. The main fetal risk is macrosomia. There is an increasing tendency to spontaneous delivery near term. Today incidence rate of caesarean sections is below 30%. PMID- 3533705 TI - [Monitoring of pregnancy in diabetes mellitus]. AB - From 1970-1984 116 diabetic pregnant patients were monitored and delivered at the University Hospital of Freiburg, Department of Obstetrics and Gynaecology. The pregnant diabetics were managed and controlled by an interdisciplinary team of internists and obstetricians. For better control of the maternal metabolic status, the diabetic patients were admitted to the hospital three times during their pregnancy. Foetal monitoring was done by ultrasonography, hormone analyses and cardiotocography. In most cases foetal growth retardation and macrosomia were detected early via sonography. Decreased urinary excretion of total oestrogen was measured during late pregnancy in 13% of the diabetic patients. In cardiotocography a loss of foetal reactivity was observed in 11% of all non stress tests (NST). In more than 50% of these cases, the total oestrogen excretion also decreased. In patients with normal oestrogen values, an abnormal NST was rarely observed. Abnormal oxytocin challenge tests (OCT) were recorded in 19% of the patients. Among these cases most of the patients with a non-reactive NST were found. In 85% of the patients with pathological changes in the OCT a Caesarean section had to be performed, and among these in all patients with a loss of foetal reactivity in the cardiotocogram. In correlation with the foetal outcome, loss of reactivity in the cardiotocogram has greater pathological relevance than deceleration with maintenance of reactivity. For an early recognition of imminent placental insufficiency, OCT proved to be the most sensitive parameter. The increased incidence of acute placental insufficiency in diabetics during delivery underlines the need for repeated stress tests during late pregnancy. PMID- 3533706 TI - [Blood coagulation after the infusion of emulsions of perfluoroorganic compounds]. PMID- 3533707 TI - [Immunologic reactivity of donors after voluntary immunization with tetanus anatoxin]. PMID- 3533708 TI - The new Flexi-post overdenture attachment. PMID- 3533709 TI - Temporary dentures over carious retained root tips. PMID- 3533710 TI - Ultrasonic debonding of anterior etched-metal resin-bonded retainers. PMID- 3533711 TI - Diverse molecular forms of gonadotropin-releasing hormone in an elasmobranch and a teleost fish. AB - Immunoreactive and biologically active gonadotropin-releasing hormones (GnRHs) in dogfish (Poroderma africanum) and teleost (Coris julis) brain extracts were studied by high-performance liquid chromatography (HPLC), radioimmunoassay with region-specific antisera, and assessment of luteinizing hormone (LH)-releasing activity in a chicken dispersed pituitary cell bioassay. In dogfish brain extract, seven GnRH molecular forms with LH-releasing activity were demonstrated. Three of these forms coeluted with synthetic mammalian GnRH; His5,Trp7,Tyr8-GnRH; and Trp7,Leu8-GnRH on HPLC. The peaks coincident with His5,Trp7,Tyr8-GnRH and Trp7,Leu8-GnRH had immunological and biological properties identical to those of the synthetic peptides. However, the molecular form coeluting with mammalian GnRH had immunological and biological properties different from those of mammalian GnRH and is thus a novel molecular variant of GnRH. The four remaining forms are also novel GnRHs or structurally unrelated peptides with LH-releasing activity. Dogfish systemic blood contained immunoreactive GnRH. In teleost brain extract, three biologically active GnRH forms with LH-releasing activity were present. The major peak of GnRH immunoreactivity coeluted with Trp7,Leu8-GnRH, and a second immunoreactive form coeluted with His5,Trp7,Tyr8-GnRH. The third biologically active peak is a novel, early-eluting molecular variant of GnRH or a structurally unrelated peptide with LH-releasing activity. PMID- 3533712 TI - General selection for specific DNA-binding activities. AB - We present a general strategy for the selection of bacterial clones that express DNA-binding activities corresponding to particular DNA recognition sites. The selection uses a "challenge phage" vector, P22 Kn9 arc-amH1605, into which is substituted a synthetic DNA-binding site for a site that controls transcription of the P22 antirepressor (ant) gene. Constitutive synthesis of antirepressor channels a challenge phage into lytic development and efficiently kills an infected host, unless the substituted site is bound by a specific protein; in this case, the challenge phage prefers lysogenic development, and the host survives and acquires an antibiotic-resistance phenotype. Infections with challenge phages carrying the E. coli Lac operator, phage lambda OL1 operator, or synthetic, "idealized" E. coli Trp and Tn10 Tet operators select clones that express each of the corresponding binding activities. The use of challenge phage vectors may be extended to select clones that express eukaryotic DNA-binding activities. PMID- 3533713 TI - Recessive nonsense suppressors in Saccharomyces cerevisiae: action spectra, complementation groups and map positions. AB - Three genes SUP111, SUP112 and SUP113 of Saccharomyces cerevisiae have been identified that can mutate to give recessive omnipotent nonsense suppressors. Alleles of these loci can also act as allosuppressors; that is, different phenotypes, due apparently to different efficiencies of suppression, can result from different alleles at a given locus. The SUP111, SUP112 and SUP113 loci map to the right arms of chromosomes VIII, VII and XIII, respectively. PMID- 3533715 TI - Consultation-liaison psychiatry: the first half century. AB - Consultation-liaison psychiatry is over 50 years old. Its main goal has been to bring medicine and psychiatry closer together so as to improve patient care in its psychosocial and psychiatric aspects. The history of this field may be divided into four overlapping phases: the beginnings, the organizational phase, the phase of conceptual development, and the phase of rapid growth. The highlights of each phase are outlined. The author concludes that C-L psychiatry has achieved the status of a full-fledged subspecialty of psychiatry, one whose main contribution has been to draw attention of clinicians and researchers to psychosocial aspects of physical illness, and to the psychiatric complications of such illness and of the medical and surgical therapies. PMID- 3533714 TI - Induction of intrachromosomal recombination in yeast by inhibition of thymidylate biosynthesis. AB - The biosynthesis of thymidylate in the yeast Saccharomyces cerevisiae can be inhibited by antifolate drugs. We have found that antifolate treatment enhances the formation of leucine prototrophs in a haploid strain of yeast carrying, on the same chromosome, two different mutant leu2 alleles separated by Escherichia coli plasmid sequences. That this effect is a consequence of thymine nucleotide depletion was verified by the finding that provision of exogenous thymidylate eliminates the increased production of Leu+ colonies. DNA hybridization analysis revealed that recombination, including reciprocal exchange, gene conversion and unequal sister-chromatid crossing over, between the duplicated genes gave rise to the induced Leu+ segregants. Although gene conversion unaccompanied by crossing over was responsible for the major fraction of leucine prototrophs, events involving reciprocal exchange exhibited the largest increase in frequency. These data show that recombination is induced between directly repeated DNA sequences under conditions of thymine nucleotide depletion. In addition, the results of this and previous studies are consistent with the possibility that inhibition of thymidylate biosynthesis in yeast may create a metabolic condition that provokes all forms of mitotic recombination. PMID- 3533716 TI - Recent research developments in consultation-liaison psychiatry. AB - With the major changes in health care and general hospital practice in the last decade, practice and research in consultation and liaison psychiatry have also changed dramatically. The authors present a selected review of recent advances and implications for five important topics in consultation-liaison research: diagnosis, disease mechanisms, biologic treatments, health services, and psychosocial treatments for medical disorders. PMID- 3533717 TI - The homeless mentally ill in the general hospital: a question of fit. AB - The evolution of general hospital psychiatry and the growth of the homeless mentally ill population in the United States have coincided temporally. Although the two have many points of confluence, their interaction has largely been of a last-resort variety, sometimes occurring by default and rarely adequately planned. The general hospital psychiatric unit has an important role to play in serving the homeless mentally ill--a role that is consonant with its mission of providing care to individuals whose service needs include special treatment interventions in short-term settings. That role may be most effectively implemented in a pluralistic service system, where the general hospital psychiatric unit is one of many facilities responding appropriately, but differentially, to the needs of individual members of the homeless mentally ill population. PMID- 3533718 TI - The changing patient population in general hospital psychiatric services. AB - There has been a profound expansion in the past 25 years in the numbers and categories of psychiatric patients treated in general hospital programs. These changes have been stimulated by new technologies, better integration of health and other human services systems, and changing fiscal concerns. Particularly affected have been inpatient units, emergency services, and the ambulatory care and consultation-liaison sections. Much greater attention and more effective treatments are currently available for involuntary, geriatric, and substance abuse patients, as well as patients with chronic psychiatric illnesses and a few discrete clinical entities. General hospitals need to continue to refine and expand their role as a major clinical component in the comprehensive psychiatric care delivery system. PMID- 3533719 TI - The role of psychiatry in the training of primary care physicians. AB - The question of psychiatry's role in medicine, and in particular its role in the training of primary care physicians (PCPs), is heightened by the knowledge that 60% of the 15% of patients who have DSM-III diagnosable alcohol, drug abuse, and mental health (ADM) disorders are seen exclusively in the general health sector. In addition, although PCPs have a low recognition rate of ADM disorders and are pessimistic about their outcome even with treatment, they prescribe the majority of tricyclic and anxiolytic medications. Models of mental health training for PC residents in training are examined, with particular emphasis on competencies taught, pedagogic vehicles, disciplines of the mental health teacher, and the relationship to departments of psychiatry. A computerized approach to assist the mental health training of primary care physicians developed at the Mount Sinai School of Medicine and Northwestern is presented. Finally, critical policy issues with regard to psychiatry's future role in training is described. PMID- 3533720 TI - [Mutants of Saccharomyces cerevisiae supersensitive to the mutagenic effect of 6 N-hydroxylaminopurine]. AB - Yeast mutants hypersensitive to the mutagenic action of 6-N-hydroxylaminopurine (HAP) were obtained by EMS mutagenesis. One of the mutants segregated monogenically and possessed reduced capacity to utilize HAP as a purine source. A set of diploids suitable for parallel study of mutagenesis and induction of recombination, and differing in the trait of mutability after exposure to HAP ("hm" trait or HAP mutability), were constructed. It was shown that a weak recombinogenic effect of HAP is not enhanced in "hm" mutants when HAP mutability increases. PMID- 3533721 TI - [Genetic analysis of mitochondrial rho-mutability in Saccharomyces. I. Polygenic determination of spontaneous rho-mutability: gene-modifiers and srm mutation]. AB - The phenotypic trait "starry colony" in Saccharomyces is associated with a high spontaneous rho- petite mutability. Genetic analysis of this trait has shown the high rho- mutability to be caused by several modifying genes present together in the cell genome. Every single modifying gene only produces a relatively small enhancement in the rho- mutability. Mutations in four nuclear srm (spontaneous rho- mutability) loci were isolated after mutagenic treatment of highly rho- mutable haploid cells. In contrast to the modifying genes, each of these mutations has a pronounced effect on the spontaneous rho- mutability, causing significant decrease in it. PMID- 3533722 TI - [Study of promutagen biotransformation in the Ames test. III. The role of conjugation with glucuronic acid and sulfate in the modification of mutagenic effect of nitrosomorpholine, diethylnitrosamine and cyclophosphamide]. AB - The role of reactions of conjugation with uridine diphosphoglucuronic acid (UDPGA) and with 3-phosphoadenosine-5-phosphosulfate (PAPS) in modification of the mutagenic effect of diethyl nitrosamine (DENA), nitrosomorpholine (NM) and cyclophosphane (CP) was studied by the Ames test. It was shown that adding UDPGA to the activating mixture significantly decreased the level of the mutagenic effect of DENA, NM and CP on bacteria Salmonella typhimurium TA 1950, when S9 and microsomal fractions of rat liver homogenate were used. Adding PAPS to the activating mixture when S9 and cytosole fractions were used, did not affect mutagenic action of DENA on S. typhimurium TA 1950 and TA 1535, enhancing the mutagenic effect of CP on TA 1535, with no such influence on TA 1950. Introduction of PAPS into the activating mixture elevated the mutagenic effect of NM on both bacterial strains using S9 fraction but not cytosole fraction. PMID- 3533723 TI - [Study of promutagen biotransformation in the Ames test. IV. The effect of transplanted tumors on the biotransformation of various antineoplastic agents]. AB - The effect of transplantation of rat tumours Jensen sarcoma, sarcoma 45, sarcoma M-1, as well as of inoculation of rat normal connective tissue on the processes of biotransformation of antitumour preparations cyclophosphane (CP), thiophosphamide, prospidine and of model compound nitrosomorpholine (NM) was studied. The study was accomplished by means of the Ames test with indicator bacterial strain Salmonella typhimurium TA 1950 in relation to the reactions of the 1st and the 2nd phases of xenobiotics metabolism. It was shown that the presence of tumours leads to inhibition of both metabolic activation processes of the promutagens NM and CP and the conjugation reactions of genetically active metabolites of these compounds with reduced glutathione. Genetic danger is supposed to be increased during application of antitumour preparations, the mutagenic activity of which is due to the activity of their metabolites. It is noted that the most essential effect on biotransformation processes of NM and CP was exhibited by sarcoma M-1, the most important changes of the biotransformation processes of promutagens being observed in the initial period of pathologic process, i.e. on the 3rd day after inoculation. Transplantation of the normal connective tissue of rats had no effect on reactions of both the 1st and the 2nd phase of metabolism of the promutagens studied. PMID- 3533725 TI - Enhancement of transcriptional activity of the Escherichia coli trp promoter by upstream A + T-rich regions. AB - The Escherichia coli trp promoter has two A + T-rich blocks in the upstream region. The deletion of the segments containing these blocks resulted in a decrease in promoter strength. By replacing the upstream region of trp promoter with one or two large A + T-rich blocks of the major leftward lambda promoter (pL), modified trp promoters (designated let) were constructed, and the transcriptional activities of these promoters towards the expression of the human interferon-gamma gene were measured. The let promoters which contain one (designated letI) or two (designated letII) A + T-rich blocks were about 6 times (at the levels of interferon activity produced) or about 3 times (at the levels of mRNA synthesized de novo) stronger than the wild-type trp promoter. The transcription from the letI promoter was controlled both by the trpR-coded repressor and the cI-coded repressor of phage lambda. PMID- 3533724 TI - Nucleotide sequence of the alkaline phosphatase gene of Escherichia coli. AB - The nucleotide sequence of the alkaline phosphatase (APase) gene (phoA) of Escherichia coli strain 294 has been determined. Pre-APase has a total of 471 amino acids (aa) including a signal sequence of 21 aa. The derived aa sequence differs from that obtained by protein sequencing by the presence of aspartic acid instead of asparagine at positions 16 and 36, and glutamic acid instead of glutamine at position 197. Two open reading frames (ORF1 and ORF2) located downstream from phoA or upstream from proC have been found. ORF1 encodes a putative presecretory protein of 106 aa with a signal sequence of 21 or 22 aa. If this protein is actually produced, it may be one of the smallest periplasmic proteins in E. coli. PMID- 3533726 TI - Transcription and processing signals in the 3-phosphoglycerate kinase (PGK) gene from Aspergillus nidulans. AB - The 3-phosphoglycerate kinase gene from Aspergillus nidulans contains two 57-bp introns and codes for a 421-amino acid (aa) protein with considerable homology to the Saccharomyces cerevisiae (68%) and mammalian (64%) proteins. Almost total conservation is found in Aspergillus of residues thought to be important to the structure and function of the yeast enzyme, and the introns fall between coding sequences for postulated structures in the N-domain. The strong codon preference found is more similar to that in other filamentous fungi than in yeast. The transcription start point (+1) has been mapped 32 bp upstream from the start codon, and the promoter region contains potential homologies for CAAT (-80 bp) and TATA (-30 bp) sequences, and certain other features common to other highly expressed genes in ascomycetes. There are three major termini 23, 83 and 115 bp beyond the stop codon and two of these are preceded by the polyadenylation consensus sequence and contain potential secondary structure. PMID- 3533727 TI - Subjective age correlates: a research note. PMID- 3533728 TI - [Ultrasound as a screening procedure for the detection of ovarian neoplasms]. PMID- 3533729 TI - [Value of imaging procedures in tumors of the adnexa]. PMID- 3533730 TI - Fetal weight prediction by ultrasound measurements. A prospective study. AB - Fetal weight prediction with ultrasonic measurements of biparietal diameter (BPD) and abdominal circumference (AC) using the equation by Shepard et al. [1982] was tested prospectively in 310 fetuses. Fetuses of all weight categories were included. The error of weight prediction was in the range of +684 to -880 g. One SD of prediction error was 242 g or 8.5% of birth weight. An overestimation was seen in a fetus with a birth weight of less than 2,500 g (1 SD = 183 g or 10% of birth weight). An underestimation could be observed in a fetus with a birth weight of more than 4,000 g (1 SD = 259 g or 5.7% of birth weight). The use of a combination of BPD and AC is more accurate than the use of each of these parameters. In a fetus with a birth weight of less than 2,500 g, the equations by Thurnau et al. [1983] and Weinberger et al. [1984] are of equal clinical value. The method of Shepard et al. should be complemented with measurements of the 'cephalic index' to exclude fetuses with brachycephaly or dolichocephaly, but one should be aware that the variability of weight prediction is high (2 SD = 11.4 19.8% of birth weight). PMID- 3533731 TI - Administration of human chorionic gonadotropin but not of luteinizing hormone releasing hormone at pro-oestrus or late di-oestrus has a deleterious effect on pregnancy in the rat. AB - Embryonic and fetal mortality is studied, which is induced by human chorionic gonadotropin (hCG) and luteinizing hormone-releasing hormone (LHRH) given prior to ovulation. 5-day cyclic rats were injected with 20 IU hCG or with 1 microgram LHRH on day 3 of di-oestrus or on the day of pro-oestrus, and mated 4 h later. Autopsy was performed on day 3 or between days 13 and 18 of pregnancy. Advancement of ovulation by LHRH did not induce embryonic or fetal mortality. Administration of hCG at pro-oestrus or day 3 of di-oestrus induced a considerable mortality, which for the greater part occurred after day 3 of pregnancy but before implantation. This embryonic mortality could be prevented by anti-hCG serum given 21 h after hCG. It is speculated that embryonic mortality induced by hCG is caused by a relatively long-lasting disturbance of steroid metabolism, due to a long metabolic half-life of hCG. The disturbance of steroid metabolism as a possible cause of implantation failure is discussed. PMID- 3533732 TI - Relationship of maternal glycosylated hemoglobin and fetal beta-cell activity with birth weight. AB - A population of 40 mother-newborn pairs with a wide range of birth weight has been studied. Seventeen of the mothers were diabetic, while the other 23 were normal pregnant women. The chronic blood glucose levels were assessed in the mothers through the percentage of glycosylated hemoglobin (HbA1) at delivery. The functional activity of the pancreatic beta-cells in the newborns was estimated through the concentration of insulin and C-peptide in the cord blood. Maternal HbA1 was not quantitatively related to the birth weight ratio. In contrast, both insulin and C-peptide correlated significantly with it. Is is concluded that in populations with a good metabolic control, blood glucose levels, as measured by HbA1, are not the major determinant of fetal growth. PMID- 3533733 TI - [Intravenous streptokinase versus heparin in fresh acute myocardial infarct. Randomized multicenter study in Franche-Comte]. PMID- 3533734 TI - [Fresh myocardial infarction and thrombolysis: synthesis and discussion]. PMID- 3533735 TI - [Indication and technic of regional fibrinolysis in the treatment of acute ischemia of the limbs. Apropos of a series of 22 patients]. PMID- 3533736 TI - [Breast reconstructions using a dermal fat flap]. AB - The popular breast reconstruction using a prosthetic implant has many disadvantages. Severe capsular contracture, for example, leads to breast deformities associated with pain. The development of many new types of prosthesis has not solved the fundamental problem. We therefore think it is better to reconstruct a female breast with a dermo-fat flap than a prosthesis. In this article we describe the indication and surgical techniques of our procedure to reconstruct a female breast. PMID- 3533737 TI - [Direct closure of donor defects of the radial flap by preliminary stretching of the skin with a skin expander]. AB - One of the disadvantages of the radial forearm flap is the donor defect covered by split skin grafts. The use of a tissue expander allows direct closure of smaller donor defects resulting in a cosmetically more acceptable linear scar. The skin expander must be implanted adjacent to the planned radial forearm flap in the epifascial plane for at least six weeks, preferably for two to three months. The operative technique is demonstrated at a typical clinical case and experiences with six further patients reported. PMID- 3533739 TI - [Immunological aspects of pregnancy. Part II: Immunopathology of gestational diseases]. PMID- 3533738 TI - [A multicenter clinical comparison study between Tevacor and Trasicor in hypertension]. PMID- 3533740 TI - [Primary lymphoid disorders of the lung]. PMID- 3533741 TI - [Leiomyomatosis peritonealis disseminata]. PMID- 3533742 TI - [Insertion of the Prophy-Jet instrument for enamel polishing after debonding]. PMID- 3533743 TI - [Determining the of intraocular tumors using calipers and combined A and B image echography]. PMID- 3533744 TI - [The bare sclera technic in eye muscle operations]. PMID- 3533745 TI - [The female in historical medicine. A critical study of the recent literature- I]. PMID- 3533746 TI - Aggressive angiofollicular lymph node hyperplasia (Castleman's disease) treated with high dose melphalan and autologous bone marrow transplantation. AB - A case of aggressive widespread angiofollicular lymph node hyperplasia in a 42 year-old male, treated with high dose melphalan is presented. The disease had failed to enter a durable remission after chemotherapy. High dose melphalan with autologous bone marrow transplantation achieved a complete remission which has lasted for 15 months to date. This approach can be considered when other measures fail. PMID- 3533747 TI - Oklahoma turns "thumbs down" on swing-bed option. PMID- 3533749 TI - HCFA pursues "prudent" payment for Part B. PMID- 3533748 TI - Senate bill provides cutting edge in high-tech race. PMID- 3533750 TI - [A case report of polyclonal IBL-like T-cell lymphoma. Histopathology, immunohistochemistry and immunoelectron microscopic observation]. PMID- 3533751 TI - [An enzyme histochemical study of Hodgkin's disease: the origin of Reed-Sternberg cells and their derivatives]. PMID- 3533752 TI - Transfusion-associated graft-versus-host disease. PMID- 3533753 TI - Blood group-related antigens as markers of malignant potential and heterogeneity in human carcinomas. AB - The expression of BGR-Ags is often aberrant in human carcinomas. The observation that BGR-Ag expression in human bladder carcinomas correlates with prognosis for patients with these tumors is especially interesting in light of the numerous reports of correlations between cell surface glycosylation and malignant phenotype in experimental animal tumors. Many observations suggest how this relation might be mediated. It seems reasonable to anticipate that the study of the BGR-Ags and their expression in carcinoma may emerge from its current predominantly descriptive phase and become an important part of the investigation of human tumor biology. PMID- 3533754 TI - Duodenal gangliocytic paragangliomas: a study of 10 cases with immunocytochemical neuroendocrine markers. AB - Ten cases of duodenal paraganglioma were studied by conventional histologic and immunocytochemical techniques at both light and electron microscopic levels. Histologically, mixtures of epithelial, ganglion, and spindle cells were seen. In all of the cases immunoreactivity for neuron-specific enolase (NSE) and protein gene product (PGP) 9.5 was seen in each component. Pancreatic polypeptide immunoreactivity was detected in eight cases, mainly in epithelial cells. Somatostatin immunoreactivity was present in epithelial and ganglion cells in nine cases. In seven cases immunoreactivity for neurofilaments, a marker for neurons, was seen in ganglion and spindle cells. However, immunoreactivity for chromogranin, a protein found in endocrine storage granules, was found in only two cases, and the staining was confined to well-granulated epithelial cells. The spindle cells were immunostained only for neuronal markers, NSE and neurofilaments, and the glial marker S-100 protein. PMID- 3533756 TI - Aetiology of urinary symptoms in sexually active women. AB - Two hundred and fifty six unselected women, 50 of whom had urinary symptoms (frequency of urination or dysuria, or both), and who were attending a department of genitourinary medicine, were investigated. The urinary symptoms were associated both with pyuria and the isolation of undoubted pathogens from midstream urine (MSU) specimens. No associations were found between urinary symptoms and the isolation of Neisseria gonorrhoeae or Chlamydia trachomatis from the urethra or cervix; the recovery of Mycoplasma hominis from the urethra, cervix, or MSU; the recovery of Trichomonas vaginalis or Candida albicans from the vagina; or the presence of bacterial vaginosis. Urethral leucocytosis was associated with the isolation of T vaginalis but not with the recovery of N gonorrhoeae, C trachomatis, C albicans, or urinary pathogens. Pyuria was associated with the isolation of urinary pathogens and with the presence of trichomoniasis; it was not associated with the recovery of C trachomatis or M hominis. PMID- 3533755 TI - Comparison of oral treatment of uncomplicated urogenital and rectal gonorrhoea with cefuroxime axetil ester or clavulanic acid potentiated amoxycillin (Augmentin). AB - In a randomised study of two drugs for the oral treatment of uncomplicated urogenital and rectal gonorrhoea the therapeutic effect of cefuroxime axetil ester (CAE) and amoxycillin plus clavulanic acid (A + C) was compared. Cefuroxime axetil ester 1.5 g was given to 129 men and 118 women. Amoxycillin 3.0 g and clavulanic acid 0.25 g was given to 131 men and 122 women. Both treatments were combined with probenecid 1.0 g and administered in a single oral dose. Of the 500 patients thus treated, 376 were assessable. In the group taking CAE, failure rates were 0.9% for the men and 0% for the women; and the overall failure rate was 0.5%. In the group taking A + C the equivalent failure rates were 4.6%, 1.2%, and 3.1%. The differences were not significant. Penicillinase producing Neisseria gonorrhoeae (PPNG) was isolated from 5.6% of the assessable patients. All 10 PPNG infections in the group taking CAE and four of 11 PPNG infections in the group taking A + C were cured. These numbers were too small to draw a definite conclusion about the efficacy of both drugs in this type of infection. Postgonococcal urethritis was observed in 35% of the men in the group taking CAE and in 32% of those in the group taking A + C. Side effects were noted in 38% of the group taking CAE and 28% of the group taking A + C. Nausea and vomiting were more commonly observed in the group taking CAE; and diarrhoea was more commonly observed in the group taking A + C. PMID- 3533757 TI - Monoclonal antibodies embedded in their hybridoma cells: an immunodiagnostic concept. AB - Aldehyde fixation of hybridoma cells during active production of monoclonal antibodies (MAbs) resulted in the formation of an insoluble phase because a large number of immunologically active antibody molecules were immobilized on the fixed hybridoma cells. Such MAb preparations specific to large protein molecules and small haptens were used for the development of a homogeneous immunoassay concept. PMID- 3533758 TI - A microprocessor-based system for diagnosis of cognitive dysfunction. PMID- 3533759 TI - Greene Vardiman Black, 1836-1915. By Bessie M Black. 1931. PMID- 3533760 TI - Characteristics of insulin receptors solubilized from rabbit erythrocytes. PMID- 3533761 TI - [Toxoplasmosis after bone marrow transplantation]. AB - An opportunistic infection with Toxoplasma gondii is a rare complication in the immunocompromised host following bone marrow transplantation. In addition to the variability in the clinical picture, difficulty in interpretation of the antibody titers is one of the main obstacles limiting early diagnosis of manifest toxoplasmosis. This report deals with 3 patients out of 86 bone marrow transplant recipients who had manifest toxoplasmosis mainly affecting the central nervous system and cardiac muscle. The clinical picture was that of acute disseminated encephalitis and myocarditis, while the nature of the disease was only disclosed at autopsy. PMID- 3533762 TI - [A simple enzyme assay for the simultaneous determination of penicillin derivatives and clavulanic acid in biological fluids]. AB - A simple enzymatic assay for simultaneous determinations of amino /ureidopenicillins and clavulanic acid concentrations in various body fluids is described; no pretreatment of the samples is required. The assay is based on the competitive inhibition of the chromogenic compound Padac by clavulanic acid in the presence of Proteus vulgaris beta-lactamase. Detection limit for clavulanic acid amounts 0.02 mg/l. Interferences with other antibiotics such as aminoglycosides, macrolides, quinolones etc. can be ruled out. PMID- 3533763 TI - Suppression of migration inhibition factor (MIF) production by mitomycins in vitro. AB - The effects of a series of mitomycins in a modified version of the Migration Inhibition Factor (MIF) test were investigated. This modified assay, which uses monocytes of the mouse cell line WEHI3 as target cells for MIF, discriminates between effects on the migrating monocytes, the production of MIF by lymphocytes and the activity of the produced MIF. The 7-methoxy mitomycins were found to be more active than the 7-amino and 7-hydroxy derivatives in suppressing both the spontaneous migration of target monocytes and the MIF production by lymphocytes. Neither of the compounds had a significant effect on the activity of produced MIF. A relationship between the activities of the mitomycins and their lipophilicity and polarographic half-wave potential is discussed. Further attention is paid to the stability of the mitomycins under the test conditions and additional advantages of the modified MIF assay over related in vitro tests for cell-mediated immunity. PMID- 3533764 TI - Natural cytotoxicity for Plasmodium berghei in vitro by spleen cells from susceptible and resistant rats. AB - The susceptibility of 30-day-old rats to Plasmodium berghei infection has traditionally been ascribed to the higher levels of circulating blood reticulocytes for which P. berghei has a predilection. However, spleen cells soon develop natural cytotoxicity for P. berghei which may account, in part, for the increased natural resistance of older rats. Spleen cells from normal 30- or 50 day-old rats were cultured overnight with erythrocytes parasitized by P. berghei and then injected into MF1 mice. Six days later, the percentage parasitaemia was determined and the extent of killing by the spleen cells in vitro determined. Spleen cells from 50-day-old resistant rats were found to be four times better at killing P. berghei in vitro than those from 30-day-old susceptible rats. Antibody dependent cell cytotoxicity (ADCC) was, at best, only a minor component. About 12% of total cytotoxicity was destroyed by pretreatment of spleen cells with monoclonal anti-Thy-1.1 antibody and complement. The possibility that natural cytotoxicity in these experiments is mediated by natural killer cells is discussed. PMID- 3533765 TI - Antibody-dependent and -independent cytotoxic activity of spleen cells for Plasmodium berghei from susceptible and resistant rats. AB - Antibody-dependent cell cytotoxicity (ADCC) mediated by spleen cells from 30- or 50-day old rats against 51Cr-labelled rat erythrocytes parasitized by Plasmodium berghei in the presence of anti-P. berghei antibody showed only slight age differences. However, in the absence of specific antibody, the total cell mediated cytotoxicy (CMC) per spleen was four times higher in the spleen cells from 50-day-old rats compared with those from 30-day-old rats. CMC accounted for about 50% of total cytotoxic activity in 50-day-old rat spleens. Spleen cells mediating ADCC and CMC are Thy-1.1 positive, and those mediating ADCC are nearly all non-adherent to Sephadex G-10 columns. PMID- 3533766 TI - Lack of serologically defined arthritogenic Shigella flexneri cell envelope antigens in post-dysenteric arthritis. AB - Post-dysenteric or reactive arthritis (ReA) is closely associated with HLA-B27. This histocompatibility antigen is heterogeneous and consists of 2 serologically defined variants: B27M1+M2+ and B27M1+M2-. This paper gives a qualitative evaluation of the antibodies present in the sera of 62 patients with dysentery due to Shigella flexneri 2a, a known arthritogenic bacterium. The patients were classified in 4 groups: B27M1+M2+ReA+ (n = 5), B27M1+M2+ReA- (n = 7); B27M1+M2 ReA- (n = 1); B27-ReA- (n = 49). The isolated infectant possessed cell envelope antigens with B27M2-like epitopes (Mr 20,000). Analysis of the spectrum of antibodies directed against the separated cell envelope antigens of S. flexneri in the sera of these patients revealed 7 main patterns of reactivity. The detectable immunogens encompassed protein stainable antigens (Mr 98, 78, 68, 54, 50, 44, 41, 35, 14 and 13 kDa), lipopolysaccharides and peptidoglycan. None of the sera possessed detectable antibodies to the B27M2-like antigen. Consequently, this antigen is unlikely to be associated with ReA, and this applies equally to other antigens or patterns of antigens. The arthritogenicity of S. flexneri may therefore not be determined by the presence or absence of detectable antibody titers to certain cell envelope antigens. We hypothesize that other properties of these antigens could be of significance. PMID- 3533767 TI - Mutagenic and genotoxic activities of certain organophosphorus compounds, using Ames Salmonella assay, with and without microsomal induction. PMID- 3533768 TI - Methods of pinealectomy in some vertebrates. PMID- 3533769 TI - Sewage as a source of phages for typing strains of Salmonella typhimurium isolated in India. PMID- 3533770 TI - A new phage typing scheme for strains of Salmonella typhimurium isolated in India. PMID- 3533771 TI - Isolation & selection of lysogenic phages for characterization of untypable strains of Salmonella typhimurium isolated in India. PMID- 3533772 TI - Poisoning by ethylene di-bromide--six cases: a clinicopathological and toxicological study. PMID- 3533773 TI - [Abstracts. 21st congress of the German Society for Blood Transfusion and Immunohematology. Hannover, 24-27 September 1986]. PMID- 3533774 TI - The use of the Foley catheter in the emergency room treatment of penetrating cardiac injuries. AB - The invaluable use of a Foley catheter is well known to cardiac surgeons, having been originally advocated in dealing with an atrial tear at valvotomy. Its use is reported in a case in the emergency room, where it acted as a simple, rapid and highly efficient means of providing immediate control of a penetrating cardiac injury, and for maintaining control while the patient was transferred to the main operating theatre. Its use in such circumstances is recommended. PMID- 3533775 TI - Priorities in diagnosis and treatment of blunt chest injuries. AB - The evaluation of thoracic injuries is only one aspect of the total assessment of a severely injured patient. In a series of 675 hospitalized patients, blunt chest injury was associated with craniocerebral injury in 55 per cent, with abdominal injuries in 20 per cent and with fractures of the extremities in 38 per cent. Both diagnostic and therapeutic procedures go hand in hand. Immediately life threatening situations (hypovolaemia, respiratory insufficiency, tension pneumothorax and cardiac tamponade) should be diagnosed by clinical signs and treated before radiographs are taken. The chest radiograph is the basic tool for diagnosis of thoracic injuries, although it will not reveal a possible impairment of lung function. Special attention should be paid, and further evaluation is necessary, in suspected rupture of the diaphragm (present in 4 per cent), rupture of the aorta (2 per cent), bronchial rupture (0.5 per cent) and cardiac contusion (16 per cent). Most blunt thoracic injuries can be treated adequately by intercostal tube drainage. Operative intervention has been found necessary in 8 per cent of cases. Indications for thoracotomy are clearly defined. PMID- 3533776 TI - A comparison of the Milch and Kocher techniques for acute anterior dislocation of the shoulder. AB - Two methods of reduction for anterior dislocation of the shoulder were compared in 111 patients. Milch's technique was found to be atraumatic and relatively painless. Greater success with Milch's technique was experienced in patients under 40 years of age in whom the dislocation had been present for less than 4 hours. Milch's technique should be tried initially in patients fulfilling these criteria. In other cases Kocher's technique should be used first, especially in those of heavy build. PMID- 3533778 TI - Interaction of Clostridium difficile and Escherichia coli with microfloras in continuous-flow cultures and gnotobiotic mice. AB - We studied the interactions between the entire cecal flora of hamsters and the pathogens Clostridium difficile and Escherichia coli in gnotobiotic mice and in a continuous-flow (CF) culture system in which the growth medium consisted of an extract of fecal pellets from germfree mice. CF cultures and germfree mice were colonized first with C. difficile and E. coli and then with the cecal flora of hamsters. Both in vivo and in vitro hamster flora markedly suppressed the potential pathogens. Contents of CF cultures inoculated with hamster flora were introduced into gnotobiotic mice previously colonized with C. difficile and E. coli. These mice were compared with mice given homogenates of hamster ceca. In both groups, the C. difficile population decreased by a factor of more than 10(6) and the E. coli population decreased by a factor of 10(4) to 10(5). CF culture contents also reduced the size of the dilated germfree mouse cecum to normal. When veal infusion broth was used as a medium, contents of CF cultures colonized with hamster flora failed to eliminate C. difficile from mice. Thus, the extract of fecal pellets appeared to contain a substance important for sustained colonization by important components of the cecal flora. We also studied the ability of collections of isolates to suppress the potential pathogens in both gnotobiotic mice and CF cultures. A total of 150 isolates obtained from predominant hamster flora at the ecologic climax stage (C flora) suppressed C. difficile and E. coli to 10 and 1 to 3%, respectively, of the population sizes attained in monoassociated mice. A total of 67 isolates obtained during ecologic succession combined with a C flora consisting of 100 isolates suppressed the potential pathogens to 0.3 and 0.03% of their original levels, respectively. Similar degrees of suppression occurred in CF cultures, further indicating that anaerobic CF cultures are promising models for investigation of the microbial ecology of C. difficile. PMID- 3533777 TI - Immune response of athymic and euthymic germfree mice to Campylobacter spp. AB - Pure cultures of several Campylobacter spp. induced a specific humoral immune response after they colonized and infected gnotobiotic mice; however, Campylobacter-immune mouse serum was not bactericidal (in vitro), manifested a weak agglutination reaction (in vitro), and showed specificity (strain 45100 immune mouse sera) for the homologous (infecting) Campylobacter strain, but was not able to passively protect germfree athymic (nu/nu) BALB/c mice against Campylobacter infection and diarrhea. Active immunization of germfree nu/nu mice with Formalin-killed C. jejuni also did not protect the gnotobiotic mice from Campylobacter infection and diarrhea. It appears from the results of our initial gnotobiotic studies that antibodies in serum against the infecting strain of C. jejuni may not play an essential role in resistance to Campylobacter disease in mice. PMID- 3533779 TI - Immunization against fatal experimental Klebsiella pneumoniae pneumonia. AB - The ability of serospecific anti-capsular polysaccharide (CPS) antibody to prevent fatal Klebsiella pneumoniae pneumonia was evaluated in a rat lung model. Rats were immunized intramuscularly with 100 micrograms of purified serotype 2 CPS and challenged intrabronchially 14 days later with a serotype 2 strain of K. pneumoniae. Vaccination engendered high levels of serum anti-CPS antibody which afforded significant protection (P less than 0.01) against fatal pneumonia. Immunization promoted clearance of the challenge bacteria from the lungs and prevented bacteremia. Histological examination of lung tissue from infected control animals showed pronounced inflammatory cellular infiltrate in the alveolar spaces, intra- and peribronchial inflammation, and tissue necrosis. In contrast, pathological changes noted in lungs from immunized animals were restricted to infrequent intra- and peribronchial involvement. PMID- 3533781 TI - Heterogeneous activity of immature and mature cells of the murine monocyte macrophage lineage derived from different anatomical districts against yeast phase Candida albicans. AB - Mature mononuclear phagocytes have been receiving much attention as effectors of spontaneous candidacidal activity, although with controversial results due to differences in the effector populations and the methods used in different laboratories. We here systematically compare the fungistatic activity of immature and mature cells of the murine macrophage series. The results show that nonadherent, nonphagocytic precursor cells (isolated either [90% purity] from bone marrow liquid cultures or from the organs of mice in which inflammatory conditions had been elicited in vivo) exerted a strong extracellular candidastatic activity. In contrast, mature macrophages, either obtained from different anatomical areas (spleen, liver, lung, peritoneal cavity) or matured in vitro from the precursor populations, displayed striking heterogeneity in their ability to inhibit the growth of Candida albicans, depending on the anatomical site they were derived from. Lymphokine activation did not alter the fungistatic pattern of the untreated cells. The different macrophage populations behaved very differently also in the production of reactive oxygen intermediates (ROI) in response to phagocytosis of C. albicans. The amounts of ROI generated, however, showed no correlation with candidastatic ability. Low levels of candidastatic activity exerted by resident peritoneal macrophages (good ROI producers) were inhibited by catalase, whereas high levels of growth inhibition by Kupffer cells (poor ROI producers) after 8 h of assay were hardly influenced by the enzyme. Our data suggest the existence of two different effector mechanisms in macrophage mediated C. albicans growth inhibition, a rather inefficient ROI-dependent one, and a second, very efficient oxygen-independent mechanism. The implications of these findings are discussed. PMID- 3533782 TI - The ability to sensitize host cells for destruction by autologous complement is a general property of lipoteichoic acid. AB - Previous studies have demonstrated that lipoteichoic acid (LTA) from Streptococcus pneumoniae binds to erythrocytes and renders them susceptible to lysis by autologous complement. The present study was performed to determine whether LTA from two other gram-positive bacterial species had the ability to render mammalian cells susceptible to lysis by autologous complement. Human erythrocytes were sensitized with LTA from S. pneumoniae, Streptococcus pyogenes, or Lactobacillus fermentum. Under incubation in normal autologous serum, lysis was observed with each of the LTA-sensitized erythrocyte preparations. When erythrocytes from a C2-deficient patient were sensitized with the LTA preparations and then incubated in autologous, C2-deficient serum, the erythrocytes sensitized with S. pyogenes or L. fermentum LTA demonstrated relatively little lysis, whereas the erythrocytes sensitized with S. pneumoniae LTA yielded near-total lysis. After reconstitution of the C2-deficient serum with purified human C2, lysis was observed with all three LTA preparations. When erythrocytes from an agammaglobulinemic patient were sensitized with either the S. pyogenes or the L. fermentum LTA, they were not lysed in the presence of autologous agammaglobulinemic serum, whereas the erythrocytes sensitized with S. pneumoniae LTA were completely lysed. Serum obtained from the agammaglobulinemic patient after reconstitution with intravenous pooled gamma globulin was able to lyse autologous erythrocytes sensitized with each of the three LTA preparations. These results demonstrate that the ability to render host cells susceptible to lysis by autologous complement is a general property of LTA. Whether activation of the autologous complement occurs by the classical or alternative pathways and whether it is antibody dependent depends on the nature of the bacterial LTA. PMID- 3533780 TI - Antibody-independent interactions of fibronectin, C1q, and human neutrophils with Treponema pallidum. AB - Although recent evidence suggests that fibronectin may be involved in the attachment of treponemes to mammalian cells, its possible role in promoting phagocytosis of Treponema pallidum has not been investigated. In the present study, we examined the antibody-independent interactions of fibronectin, C1q, and human polymorphonuclear leukocytes with T. pallidum. Binding of [125I]fibronectin was specific and saturable with an affinity constant of approximately 2 X 10(7) M 1. The number of binding sites per treponeme at 37 degrees C, irrespective of the mammalian source of fibronectin, was between 2,500 and 7,500, with a mean of approximately 4,700. Binding of [125I]C1q to T. pallidum, in the absence of antibodies to the organism, also was saturable and specific. Pretreatment of treponemes with C1q enhanced binding of soluble [125I]fibronectin two- to threefold and also increased attachment of 125I-surface-labeled treponemes to fibronectin-coated surfaces. Treatment of 125I-labeled T. pallidum with fibronectin alone, or together with C1q, however, did not enhance surface phagocytosis by neutrophils. PMID- 3533783 TI - Studies on the genetic and cellular control of sensitivity to enterotoxins in the sealed adult mouse model. AB - A sealed adult mouse (SAM) model was developed for studies on the effects of cholera enterotoxin (CT). With this system, 38 strains of outbred, inbred, congenic, recombinant, and mutant mice were starved for 24 h, anorectally occluded with cyanoacrylamide ester glue, given CT per os, and sacrificed at 6 h. Fluid accumulation (FA) values were calculated as gut weight to body weight ratios. At a saturating dose of CT (24 micrograms per mouse), FA responses were found to be independent of body weight and gut length. It was found, using recombinant and congenic mice, that mice which possess the H-2k haplotype (homozygous or heterozygous) are 2.5 to 3 times less responsive to CT than animals with the H-2b haplotype. The allele(s) responsible for this affect is located near the K end of the H-2 complex. Inbred and congenic mice given CT intravenously exhibited the same (b = responder, k = nonresponder) pattern in terms of weight loss and death, thus indicating that the H-2 effect is not limited just to the small intestinal epithelium. Mice given sublethal doses of CT intravenously and challenged after conversion to SAM 14 days later showed an immune response inversely related to weight loss (i.e., b haplotypes lost 10 to 15% body weight, recovered, but were not protected against challenge; k haplotypes lost little or no weight but were protected). To examine the possibility of a cellular basis for control of innate responses to CT, responder C57BL/10 (B10) mice were irradiated with 950 rads and immediately reconstituted with bone marrow from (B10 X B10.BR)F1 (nonresponder) mice. The chimeras became nonresponsive to CT when challenged 5 weeks after reconstitution. Reconstituted B10 controls responded normally. Outbred and inbred nude athymic mice also were nonresponsive when compared with normal responder controls. These data demonstrate a genetic basis for resistance to CT and that response and nonresponse is mediated, at least in part, by cells derived from bone marrow. PMID- 3533784 TI - Production of type II heat-labile enterotoxin by Escherichia coli isolated from food and human feces. AB - Escherichia coli strains isolated in Sao Paulo, Brazil, from feces of patients with diarrhea and from food samples produced toxin(s) that was shown to be related both immunologically and genetically to the recently characterized type II heat-labile enterotoxin of E. coli. The new isolates of type II heat-labile enterotoxin-producing E. coli belonged to five different serotypes and did not represent a single clone. PMID- 3533785 TI - A fraction of beech wood mutagenic in the Salmonella/mammalian microsome assay. AB - Base-pair substitution mutagens were isolated from the dusts of several untreated samples of beech wood and tested for mutagenicity in the Salmonella/mammalian microsome assay. These compounds reverted Salmonella typhimurium his- TA 100 in the presence of Aroclor-induced rat S9. These mutagens were found to be toxic to the cells when tested in a histidine-rich medium (complete medium). Mutagenicity of the non-fractionated wood-dust extracts due to the presence of some inhibitory compounds of wood could not be confirmed significantly. These inhibitors counteracted the reversion of bacteria when the known mutagens, such as benzo(a)pyrene, aflatoxin B1 and ethyl methanesulfonate, were tested. The results indicate that beech wood-dust contains mutagenic constituent(s) which may contribute to their assumed tumor bearing effects among wood-workers. PMID- 3533786 TI - Prosthodontic considerations for patients with cleft lip and palate. AB - The prosthodontist provides the final active treatment for the patient with a cleft. He must anticipate and decide upon the prosthodontic procedures in collaboration with the plastic surgeon and/or the orthodontist during the period of their interventions. The purpose of prosthodontic treatment is to prevent the relapse of the maxillary segments and the teeth after surgical and/or orthodontic correction, as well as the rehabilitation of mastication, speech and aesthetics. The individual peculiarities of the cleft patient should be taken into consideration from the beginning. They are: discrepancy in the maxillo-mandibular relationship, malposition, malformation and tipping of teeth, caries, flat palate resulting from severe scarring, perforations. It is imperative to preserve the teeth in any condition with the exception of occlusal interference. Extraction of teeth adjacent to the cleft or in scar tissue leads to extensive bone resorption, enlargement of the cleft and gingival recession. Generally speaking, two teeth in each alveolar segment should be used as abutment teeth in bridge work. The teeth likely to relapse should be reconstructed in good intercuspal digitation and splinted primarily or secondarily. Bridge work is the first choice among the various prosthodontic procedures. If, however, a removable prosthesis is inevitable, rigid support should be obtained. PMID- 3533787 TI - Current understanding of the aetiology and progression of periodontal disease. AB - There is overwhelming evidence that bacteria cause periodontitis and that they do so by extending apically along the surfaces of the tooth roots and creating pockets. A very complex mixture of microbial species, mostly although not exclusively gram-negative, anaerobic, and motile, is involved. Infection probably occurs in a progressive and sequential manner. The bacteria involved include various species of Bacteroides, Actinobacillus, Eikenella, Fusobacterium, Capnocytophaga, and Eubacterium. Local oral conditions such as tooth position play an aetiologic role by affecting plaque accumulation and retention. Host defence factors, particularly the phagocytic cells and the immune system, play a determinative role in the aetiology by monitoring, controlling, and regulating microbial colonization and infection. These diseases begin as an acute inflammation of the marginal gingiva, and they progress through orderly stages to the formation of a gingival pocket. Transition from gingivitis to periodontitis is not well-understood, but it probably involves colonization by additional microbial species or invasion of the periodontal tissue by species already present. Progression of periodontal destruction is episodic, possibly as a consequence of successful host defence. In most patients, periodontal destruction occurs more infrequently than previously suspected. In both treated and untreated patients, a small subgroup accounts for most of the disease activity. The most important problem we now face is to develop diagnostic methods to identify individuals in this subgroup and devise ways to prevent and control their diseases. PMID- 3533788 TI - Periodontal health and disease in young people: screening for priority care. AB - Gingivitis is the most common chronic disease affecting young people. Almost all teenagers exhibit gingival lesions in the interproximal areas of posterior teeth. Gingivitis is caused by supragingival bacterial plaque which contains more than 165 species and subspecies. No single organism or group of bacteria can be directly implicated in the development of gingivitis. Periodontitis occurs before 20 years of age, is also first found in the interdental areas of posterior teeth and is preceded by gingivitis. It progresses slowly through the decades of adult life with varying rates in different individuals and teeth within the same mouth. Subgingival plaque contains more gram-negative, anaerobic organisms and more motile bacteria than supragingival plaque. Progression of periodontitis coincides with the occurrence of certain Bacteroides species, fusobacteria and other anaerobic motile rods as well as spirochetes. However, at this time the concept of specific pathogenicity cannot be applied. Rapidly progressing localized or generalized periodontitis is characterized by the rate of periodontal destruction and usually occurs in less than one per cent of juveniles. These patients exhibit increased prevalence of Actinobacillus actinomycetemcomitans and abnormalities in neutrophil function. At present, simple clinical screening tests that can predict who will and who will not suffer from chronic periodontitis, that can provide early identification of high risk patients or forewarn the development of juvenile periodontitis are non-existent. Research in this area is seeing significant progress and several technologies have shown promise. While awaiting new screening methodologies, the clinician must continue to rely on periodontal probing, radiographic techniques, visual inspection and clinical acumen as the main means of periodontal diagnosis. PMID- 3533789 TI - Juvenile periodontitis. AB - Juvenile periodontitis occurs in children and young adults and can be classified into: periodontitis which occurs in otherwise healthy individuals, and periodontitis which occurs in juveniles with systemic disease. The periodontitis which occurs in otherwise healthy individuals consists of two major forms: juvenile periodontitis, also called periodontosis or localized juvenile periodontitis (LJP), and generalized juvenile periodontitis which includes early onset adult periodontitis, recurrent necrotizing ulcerative periodontitis and the true generalized form of juvenile periodontitis. Periodontitis in systemically diseased individuals can be divided into three subgroups: juvenile periodontitis associated with primary neutrophil disorders, juvenile periodontal disease in which neutrophils are secondarily abnormal, and juvenile periodontitis associated with other diseases. Juvenile periodontitis is perhaps the best understood form of periodontal disease. A major infecting organism, Actinobacillus actinomycetemcomitans, is strongly associated with the disease, and may be an exogenous pathogen since it is not found in healthy individuals or in healthy sites in LJP patients. It is virulent with marked leukaggressive properties and it induces a marked antibody response in infected patients. Eradication of Actinobacillus actinomycetemcomitans requires attention to the fact that it invades the tissue and hence systemic antimicrobials or surgical excision of the tissues is necessary for eradication. Marked suppression of the organism from subgingival sites is associated with healing. Host responses in LJP have also been well described and most immune functions studied appear to be normal. The notable exception is neutrophil chemotaxis which is depressed. Associated with depressed neutrophil chemotaxis is a reduction of neutrophil receptors for several chemotactic factors including C5a, the fifth component of complement.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3533790 TI - Raised serum IgG4 levels in patients with atopy and filariasis: application of an automated particle-counting immunoassay using monoclonal antibody. AB - We show here an automated (50 samples/h) assay for serum IgG4 having a throughput time of 40 min per sample and a sensitivity of 10 micrograms/ml. The assay procedure is based on the inhibition by sample of the agglutination reaction between monoclonal anti-IgG4 antibodies and latex particles to which IgG4 myeloma protein has been coupled. Assay reliability was ascertained by testing for linearity, analytical recovery (96.4%), interassay precision (less than or equal to 8%), specificity and correlation between the results obtained with monoclonal and polyclonal anti-IgG4 antibodies (n = 84; rs = 0.97). Application of the assay to sera from various groups of patients indicated significantly (p less than 0.00005) higher geometrical means (Gx) in patients suffering from atopy (n = 87; Gx = 617 micrograms/ml), atopic dermatitis (n = 28; Gx = 1,043 micrograms/ml), filariasis with Onchocerca volvulus (n = 48; Gx = 1,681 micrograms/ml) and Brugia malayi (n = 20; Gx = 1,078 micrograms/ml) as compared to nonatopic subjects (n = 103; Gx = 302 micrograms/ml) and randomized paired maternal/cord sera (n = 41; Gx = 276 and 296 micrograms/ml, respectively). IgG4 in the paired maternal/cord sera correlated (r = 0.98; p less than 0.00005). There was no significant influence of age or sex on the IgG4 levels either among the nonatopics or the atopics even though low IgG4 (less than or equal to 30 micrograms/ml) was more common among women. The results suggest that IgG4 and IgE responses are somehow closely related in atopic and parasite-infested patients at the physiological, pathogenic or genetic level. PMID- 3533791 TI - Immunomodulating properties of substances to be used in combination with liposomes. AB - Liposomes haptenated with tripeptide-enlarged dinitrophenyl (DNP) are known to act as thymus-independent antigens which induce a strong IgM response and only limited amounts of circulating IgG. When haptenated liposomes are used in vaccination studies, it is of practical importance to improve the immunogenicity of these complexes. Therefore, an evaluation was made of the potency of various substances to modulate the immune response in such a way that the total antibody production is increased, including a relative great increase of 2-mercaptoethanol (2-ME)-resistant antibodies and immunological memory is induced. The following substances were used: glycophorin A (GP-A), sialogangliosides (monosialo-, disialo- and trisialoganglioside), 6-0-stearoyl-MDP (MDP-SA) and lipid A (lip A). Lip A incorporated into liposomes was the only substance inducing considerable increases of both total and 2-ME-resistant haemagglutination (HA) titre after immunization. Depending on the dose tested, the sialic-acid-containing protein GP A had a small and varying influence on the serum antibody response. Sialogangliosides transiently decreased in a dose-dependent manner the total antibody titre in serum. In contrast to lip A, the lipophilic bacterial adjuvant MDP-SA did not influence HA titres significantly. The number of plaque-forming cells (PFC) in the spleen was enhanced considerably after both primary and secondary immunization with liposomes containing lip A. The other substances tested induced only minor differences of the number of PFC. To some extent, lip A induced immunological memory. In conclusion, it can be stated that of the agents tested, only lip A is a potent and consistent stimulator of the humoral immune response to liposomes haptenated with DNP groups.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3533792 TI - Insulin secretion at high altitude in man. PMID- 3533793 TI - Suppression and re-expression of transformed phenotype in hybrids of HA-ras-1 transformed rat-1 cells and early-passage rat embryonic fibroblasts. AB - Rat-1 cells which had been transformed with the activated Ha-ras-1 gene from human EJ bladder carcinoma cells were fused with diploid embryonic rat fibroblasts. Four selected cell hybrids expressed the human transforming gene product p21 at levels of 10 to 30% compared to 100% in the transformed parental cells. The hybrid cells, however, exhibited normal morphology, anchorage requirement for proliferation, and largely extended latency periods of tumorigenicity in newborn rats. Tumorigenic hybrid derivatives contained lower numbers of chromosomes than the tetraploid parental hybrids. DNA of the non tumorigenic cell hybrids transformed Rat-1 cells to anchorage-independent proliferation as expected for the transforming human Ha-ras gene present in the donor DNA. We conclude that the transforming properties of the activated Ha-ras gene in Rat-1 cells can be suppressed at the post-translational level by the presence of the genome from diploid embryonic rat fibroblasts but additional controls of expression of the transforming gene are likely to exist. Normal cells contain suppressor gene(s) which safeguard these cells against transformation by the product of the transforming Ha-ras-1 oncogene. PMID- 3533794 TI - Alcohol use and abuse in college students. I. A review of individual and personality correlates. AB - This review of alcohol use and abuse in college students presents a summary of the relationships between college student alcohol use and demographic and individual characteristics. A summary of the findings suggests two distinct patterns of alcohol use. For some demographic groups, heavy drinking may be most associated with personal problems, while for others it may be more associated with social and environmental factors. Suggestions for future research of this important issue are presented. PMID- 3533795 TI - Alcohol use and abuse in college students. II. Social/environmental correlates, methodological issues, and implications for intervention. AB - This review of alcohol use and abuse in college students presents a summary of the relationships between college student alcohol use and social/environment characteristics. A theoretical integration of the findings of this review with those of Part I of this series supports the prior paper's finding of two patterns of college drinking. This review further suggests that the two types may have differential predictive ability with regard to future problem drinking. Methodological issues in this type of research are reviewed and implications for intervention are considered. PMID- 3533796 TI - Lymphatics of the skin. Neglected but important. PMID- 3533797 TI - Cutaneous ulcer therapy. PMID- 3533798 TI - Bibliography of secondary sources on the history of dermatology. III. Books, monographs and chapters in English supplemented through 1985. PMID- 3533799 TI - Cryotherapy in acute cutaneous leishmaniasis. AB - Fourteen patients with acute cutaneous leishmaniasis entered a study testing the efficacy of liquid nitrogen. All lesions were cured clinically and protozoologically within 3-8 weeks, without noticeable scarring. The patients did not experience adverse side effects, and there was no relapse 4 months after cessation of therapy. The results of this study indicate that cryotherapy is a safe and effective method for treating cutaneous leishmaniasis. PMID- 3533800 TI - Rhinoscleroma and rhinosporidiosis. An approach through history. PMID- 3533801 TI - Snakebite treatment in the United States. PMID- 3533802 TI - Cutaneous associations of chronic renal failure and dialysis. PMID- 3533803 TI - Congenital self-healing reticulohistiocytosis (Hashimoto-Pritzker type). PMID- 3533804 TI - Bibliography of secondary sources on the history of dermatology. I. Journal articles in English supplemented through 1985. PMID- 3533805 TI - Treatment of dandruff with a 2% ketoconazole scalp gel. A double-blind placebo controlled study. PMID- 3533806 TI - A comparative study of amcinonide and halcinonide 0.1% ointments in the treatment of psoriasis. PMID- 3533807 TI - The history of dermatology at St. Bartholomew's Hospital. PMID- 3533808 TI - Linear alkylbenzene sulfonates (LAS) in sewage sludges, soils and sediments: analytical determination and environmental safety considerations. AB - Linear Alkylbenzenesulphonates (LAS), a major anionic surfactant used in laundry products, can be measured specifically in the environment by instrumental analysis. In addition to a desulphonation-gas chromatography approach, a method based on high performance liquid chromatography has been developed. The main features of the methods are outlined, and LAS concentrations measured in sewage sludge, sediments and sludge amended soils are reported. Knowledge of usage volumes, sewage treatment practices and environmental transport and transformation mechanisms has been used to predict concentrations of LAS. These calculated concentrations were found to agree well with those actually measured in the environment. Both measured and calculated ambient concentrations of LAS are below those which could produce potentially adverse effects in representative surface water, benthic and terrestrial organisms. PMID- 3533809 TI - Immunoassays in environmental analytical chemistry. AB - A review is presented which summarizes the recent developments of immunoassays in environmental analytical chemistry. The basic principle of the method and the following steps in the development of an immunoassay procedure are discussed in detail: Synthesis of the immunogen, immunization procedure, synthesis of the labelled antigen (tracer), advantages and drawbacks of radioimmunoassay, fluoroimmunoassay and enzyme immunoassay. A special emphasis is put on approved methods which can be applied in almost any analytical laboratory. Numerous examples of immunoassays for different pesticides and pollutants (dioxins, polychlorinated biphenyls, mycotoxins) are presented. Besides the respective test features, their applicability for residue determinations in biological samples is kept in the foreground. The advantages and drawbacks of the immunoassays are discussed in comparison with conventional analytical methods. An outlook to future application fields for immunoassays and new trends (e.g. the utilization of monoclonal antibodies) is presented. PMID- 3533810 TI - A plague epidemic in voluntary quarantine. AB - In September 1665, an outbreak of plague occurred in Eyam, a small village 10 miles west of Sheffield, in an isolated valley of Derbyshire. Eighty per cent of the population died during the 14 months of the epidemic, a greater proportion than any other community in England. When plague threatened to cause panic and desertion of the village, the vicar of Eyam persuaded the villagers to stay, and to impose a voluntary quarantine on their village, in order to avoid spreading the plague to the surrounding villages. Quarantine was strictly observed for the last five months of the epidemic, when it was at its height. A boundary about one mile in diameter was marked out around the village, and food was left at the boundary for villagers to collect. The parish register can be used to describe the natural history of this plague epidemic in quarantine; in the light of current knowledge of plague epidemiology, it shows the traditional account of the origin of the Eyam plague to be improbable. The pattern of the epidemic suggests a typical epidemic of bubonic plague with a rodent reservoir. The policy of quarantine, rightly judged as heroic, was also tragically misguided, and was probably responsible for the unparalleled mortality. PMID- 3533811 TI - Effects of a 'physiological' dose of triiodothyronine on obese subjects during a protein-sparing diet. AB - Twenty obese euthyroidian women followed an exclusively proteic diet for 18 days (74 g/day). Half received placebo, and half received 10 micrograms L triiodothyronine. In the control group, as expected, mean weight loss was 7 percent of initial body weight; serum T3 and TSH decreased; rT3 increased; basal oxygen consumption diminished by 11 percent; nitrogen balance reached equilibrium at day 11. As compared to this group, the T3-treated group lost significantly more weight; serum T3 and TSH increased; rT3 decreased; oxygen consumption remained stable and nitrogen balance did not deteriorate. Thus, the physiological decrease in thyroid hormones provoked by a restricted diet is linked to energy expenditure but not to nitrogen balance equilibrium. PMID- 3533812 TI - Muscle tissue in obesity with different distribution of adipose tissue. Effects of physical training. AB - Obese men and women with the same body fat mass, as well as obese women in another study, were divided into groups with male or female type of body fat distribution, but again with similar body fat mass. The participants were examined with measurements of body composition, including muscle fiber distribution, as well as circulatory and metabolic variables before and after physical training under controlled conditions. Obese men had higher lean body mass, blood pressure, blood glucose and plasma insulin, C-peptide, cholesterol and triglyceride concentrations than age- and body fat-matched obese women. Obese women with male type of adipose tissue distribution showed the same differences (except cholesterol) in comparisons with women with female type of adipose tissue distribution. The women with male type obesity were also more insulin resistant in glucose clamp measurements, and had male type of muscle fiber distribution. Physical training in the group of obese men resulted in a decrease of body fat, a further increase of lean body mass, an increase of fast twitch, aerobic type, muscle fibres as well as lower plasma insulin, cholesterol and triglyceride concentrations and lower blood pressure. Obese women with male type distribution of adipose tissue responded to physical training essentially like men. The insulin sensitivity was improved to the same level as in obese women with female type of adipose tissue distribution. In contrast, the latter women showed an increase of body fat and no metabolic improvements after training. These results show that obese women with male type of body fat distribution also have male characteristics of muscle mass, morphology and function. It is suggested that the obesity complications associated with this condition are improved by physical training because of an adaptation to a negative energy balance, in combination with an improvement of insulin sensitivity of the muscle mass. In contrast, the failure of obese women with female type of adipose tissue distribution to adapt to a negative energy balance during physical training is probably explaining their failure to decrease body fat and to improve metabolism during physical training. PMID- 3533813 TI - 1H n.m.r. studies of insulin. Reversible transformation of 2-zinc to 4-zinc insulin hexamer. AB - 1H n.m.r. studies at 270 MHz were made of the transformation of 2 Zn insulin hexamer to 4 Zn hexamer produced by the addition of anions (thiocyanate ion). Four separate H2 histidine resonances were observed for the B5 and B10 histidines in 2 Zn hexamer at pH 7 and 9 and four separate resonances also occurred in the 4 Zn hexamer. The observation of these resonances and others from phenylalanine, tyrosine and leucine residues showed that the 2 Zn to 4 Zn transformation probably occurred in solution in a similar manner to that observed in the crystal. Furthermore as occurred in the crystal, it was found that in solution the transformation was reversible (on removal of thiocyanate) and that 2 Cd insulin was unable to undergo the transformation. Des-Phe-Bl-insulin did not undergo the transformation. Addition of SCN- to Zn-free insulin (mainly dimer) produced only a small transformation, consistent with the idea that Zn2+ promotes formation of hexamer from dimer but probably does not otherwise affect the transformation. PMID- 3533815 TI - [Current status of the use of heterologous materials in periodontal bone defects]. PMID- 3533814 TI - Isolation and characterization of a galactose binding lectin with insulinomimetic activities. From the seeds of the bitter gourd Momordica charantia (Family Cucurbitaceae). AB - A galactose binding lectin was isolated from the seeds of the bitter gourd Momordica charantia by delipidation with petroleum ether, extraction with phosphate buffered saline, ammonium sulfate precipitation and affinity chromatography on lactogel. The lectin had a molecular weight of 124,000 and approximately 5% carbohydrate content. The molecular weights of the individual subunits were 37,000, 35,000 and 33,000. The lectin exhibited potent hemagglutinating activity. In addition, it demonstrated antilipolytic and lipogenic activities in isolated rat adipocytes although it did not possess intrinsic lipolytic activity. The antilipolytic activity was susceptible to destruction by heat, trypsin, chymotrypsin, glutathione and galactose, indicating that the integrity of the protein moiety, the disulfide linkages, and galactose, which is the sugar specifically bound by the lectin, all play an important role in interaction with the adipocyte leading to an expression of this insulin-like activity. PMID- 3533816 TI - The effects of low-level radiofrequency and microwave radiation on brain tissue and animal behaviour. AB - There has been much public interest and controversy about the effects of exposure to low levels of microwave and radiofrequency radiation. Of particular interest are reports of radiation-induced changes in brain tissue and animal behaviour. This review considers the evidence supporting some of these effects. The main conclusions of the review are: The levels of tracer substances in the brain tissue of conscious or anaesthetized animals can be altered by acute exposure to microwave radiation that is sufficient to raise the brain temperature by several degrees Celsius. However, the results of such experiments are difficult to interpret, being in some cases contradictory or influenced by various confounding factors, and the data cannot be considered sufficient to recommend a threshold for human tolerance. The evidence that calcium ion exchange in living nervous tissues is affected by amplitude-modulated radiofrequency and microwave radiation is inconclusive. Exposure sufficient to cause an increase in core temperature of about 1 degree C, corresponding to specific energy absorption rates of about 2-8 W kg-1 may adversely affect animal behaviour. PMID- 3533817 TI - Fast neutron r.b.e. for lethality and genotoxicity in a wild-type and a repair deficient strain of yeast. AB - The relative biological effectiveness (r.b.e.) of cyclotron-produced fast neutrons (11 MeV) in relation to 60Co gamma-rays, was studied in a wild-type and a DNA repair-deficient yeast strain for cell killing and genotoxicity. In the wild-type (D7) strain the r.b.e. varied from 2.7 to 4.1 for lethality, 2.8 to 7.1 for reverse mutation and 3.5 to 7.8 for mitotic gene conversion. At different survival levels, the repair deficient strain (D7 rad 52/rad 52) generally showed a lower r.b.e. for both cell killing and genotoxicity (25.2 to 37.2 per cent reduction for the cell death and 24.8 to 70.6 per cent for mutation and gene conversion) compared to the wild type. Except at very low dose levels, the r.b.e. values for cell killing and genotoxicity were similar within a given strain. At similar survival levels, neutrons were no more genotoxic than gamma-rays. PMID- 3533819 TI - Sonography of neck masses in children: is it useful? AB - 111 patients aged two days to 20 years with neck masses were examined by ultrasound. Results were compared to subsequent histo-pathological or clinical diagnosis. Sonography allowed us to divide neck masses into two groups, a sonospecific group in which an accurate presurgical diagnosis was made in 92%, and a non-sonospecific group. The sonospecific group contained 48 patients and included thyroid masses, cystic hygromas, certain cases of adenopathy and a cervical myelomeningocele. The non-sonospecific group contained 63 patients and included a variety of neck masses such as dermoid cysts, branchial cleft cysts, the majority of cases of adenopathy, hemangiomas, lymphangiomas and various other neoplastic masses. Sonography serves to delineate the extent of neck masses, define the relationship of the mass to the thyroid and major neck vessels and guide fine needle aspiration biopsy. PMID- 3533818 TI - The effect of intravenous immunoglobulin treatment in recurrent acute otitis media. AB - The effect of serial intravenous infusion of human immunoglobulin on the frequency of acute otitis media (AOM) episodes and on other upper respiratory tract infections was prospectively studied in a group of 22 otitis-prone children, 1-4 years old. After pair-matching, the children were allocated to immunoglobulin treatment or to a control group. Increased specific IgG antibody activities against pneumococcal types associated with recurrent AOM (rAOM) were generally achieved, but no significant difference was noted in the frequency of AOM attacks or other respiratory tract infections between the immunoglobulin treated children and their pair-matched untreated controls. The results indicate that, although serum antibody activities against bacteria associated with AOM are increased by immunoglobulin infusions, this does not prevent the development of AOM in children suffering from rAOM. PMID- 3533820 TI - The history of inguinal herniorrhaphy. AB - The history of inguinal herniorrhaphy certainly presents some peculiar aspects. Until the 18th century this disease was studied with interest and found a place in the books of several important authors, but in practice it was treated by empiricists and barbers. We must recognize however that some of their surgical methods are still effective--mostly methods tending to preserve the spermatic cord. The 18th century brought forth new surgical treatments and surgeons like the Saxon Richter and Antonio Scarpa began to intervene in the matter. The latter illustrated this surgical and anatomical problem with beautifully drawn tables. In Padua, Edoardo Bassini proposed reparative plastic surgery designed to prevent relapses in the year 1884. Since then, the surgical history of inguinal herniorrhaphy has been one of long and lasting success. PMID- 3533821 TI - The original Bassini technique in the surgical treatment of inguinal hernia. AB - Bassini's technique represents a fundamental step in the treatment of inguinal hernia. It can be asserted that a new era in its surgical therapy started with Bassini. As many difficulties exist in comprehending the archaic language used a century ago by the Italian surgeon, the principles of his technique are analysed. It is to Bassini's credit that he invented a simple and easily performed technique to be applied in each case, respecting all the anatomic structures without using any foreign material. Accordingly, it is believed that by using this technique correctly, good results can still be obtained today. PMID- 3533822 TI - Recurrent inguinal hernia. AB - The problem of recurrent inguinal hernia is still open. The authors after an analysis of the main causes of recurrences, show the fact that the reoperations employing the traditional techniques can present a risk of further recurrence much higher then the first operation. The use of properitoneal prosthesis through a median approach, can considerably lower the risk of recurrence. PMID- 3533823 TI - Acute renal vein thrombosis in adults. AB - We had the chance to follow up 7 adult patients with acute R.V.T. for 3 years. Four patients had positive histories of either diagnosed or undiagnosed renal trouble. Dehydration was the most prominent predisposing factor seen in 3 cases of pilgrims due to low fluid intake and hard physical effort in severe hot weather (42-44 degrees C). Massive haematuria and severe lumbar pain were the most characteristic clinical symptoms. With the aid of ultrasonography, we were able to detect perirenal collections in 4 cases. Careful clinical examination, retrograde pyelography and ultrasound examination were found to be non-invasive diagnostic modalities. PMID- 3533824 TI - Profuse haematuria. AB - Out of 1170 patients with macrohaematuria treated at the Clinic of Urology, "Pirogov" Institute, Sofia, 592 had profuse haematuria. With reference to the volume of blood loss the criteria for haematuria to be designated profuse are discussed. The most frequent diseases which led to profuse haematuria, as well as the methods for the etiological diagnosis of haematuria are reviewed. The authors present the experience they obtained from conservative and operative treatment of the syndrome, and stress that preference is given to the methods aiming at radical sanation of the basic disease. PMID- 3533825 TI - Thiazides in the prophylactic treatment of recurrent idiopathic kidney stones. AB - In a double-blind prospective clinical study patients with at least two verified episodes of urolithiasis, but stone-free at the time of inclusion in the study, were subjected to prophylactic treatment with either bendroflumethiazide (2.5 mg) + 573 mg potassium chloride 3 times a day, or placebo. The material included a total of 22 patients, all males, aged 20-49 years. We found a clear tendency to reduced stone formation in the group treated with the active drug (P less than 0.01). Calcium excretion was reduced by 25-50% in 7 of 12 patients treated with thiazide. PMID- 3533827 TI - Cell-specific gene expression in the nematode. PMID- 3533826 TI - High and low sodium acetate haemodialysis and ultrafiltration. II. Comparison of plasma renin activity (PRA), catecholamine levels (CA) and plasma aldosterone concentration (PAC). AB - CA levels, PRA, PAC responses to low and high sodium dialysates in haemodialysed patients were investigated. Increased levels of dopamine (DA), adrenaline (A) and noradrenaline (NA) were found during dialysis and ultrafiltration with high sodium dialysate (148 mEq/l), and significantly higher PRA with low sodium dialysate (131 mEq/l). PAC slightly but significantly decreased during dialysis with low sodium dialysate and significantly increased during ultrafiltration. The present results suggest that sodium dialysate concentration has a significant influence on the function of the autonomic system, PRA and PAC in haemodialysed patients. PMID- 3533828 TI - Neuropeptide Y in the peripheral adrenergic and enteric nervous systems. PMID- 3533829 TI - Early hemopoietic and stromal precursor cells. PMID- 3533830 TI - Isoelectric equilibrium properties of normal and malignant cells and biological macromolecules. PMID- 3533831 TI - Blood cell nuclei: the structure and function of lymphoid and erythroid nuclei. PMID- 3533832 TI - Advances in imaging thoracic aortic disease. PMID- 3533833 TI - Current problems of contrast materials. PMID- 3533834 TI - Driving ability after intravenous fentanyl or diazepam. A controlled double-blind study. AB - Uncomfortable or moderately painful radiologic diagnostic and therapeutic procedures are being performed increasingly on outpatients. If sedation and analgesia are used, patients cannot drive themselves home or return rapidly to normal activities. This study compares the effect of fentanyl (100 micrograms), diazepam (7.5 mg), and placebo on driving ability of young volunteers as measured by the thacometer. Speed and accuracy were impaired at 30 and 120 minutes by both drugs, and by fentanyl more than diazepam. This study design may be suitable for the assessment of whether patients can drive safely after other analgesic drugs. PMID- 3533835 TI - Whole-breast US imaging: four year follow-up. PMID- 3533836 TI - T. C. J. O'Connell (an appreciation of a surgeon). PMID- 3533837 TI - Forty years on: a reflection and a contemplation. PMID- 3533838 TI - Biographical sketches--68. Hill. PMID- 3533839 TI - W. J. MacNeven: father of American chemistry. PMID- 3533840 TI - W. M. Stanley's crystallization of the tobacco mosaic virus, 1930-1940. PMID- 3533841 TI - Ancient Chinese sulfur manufacturing processes. PMID- 3533842 TI - A complex odyssey. "Lavoisier and the chemistry of life: an exploration of scientific creativity." By Frederic Lawrence Holmes. Essay review. PMID- 3533843 TI - History of Hispanic science: El boom. Essay review. PMID- 3533844 TI - Venous involvement by follicular carcinoma of the thyroid gland. AB - Involvement of the great veins by thyroid neoplasms is a rare event: to date 9 cases have been reported and only 2 of them have been surgically treated. The authors describe a case of follicular thyroid carcinoma involving the proximal tract of the left innominate vein at its confluence with the superior vena cava: a neoplastic bud was protruding into the lumen, but the endothelial lining appeared to be perfectly preserved. Full radicality was obtained by a major vascular procedure. PMID- 3533845 TI - In organ transplants, Americans first? PMID- 3533846 TI - Hawaii's first ophthalmologist. PMID- 3533847 TI - [Pemphigus vulgaris--malignant course]. AB - A 42-year-old woman with extensive pemphigus vulgaris failed to respond to high dosage systemic steroids, immunosuppressive drugs and plasmapheresis. The treatment resulted in severe depression of the immune system, without marked effect on the disease activity. Eleven weeks after onset of disease she died of pneumonia and sepsis. PMID- 3533848 TI - [Keratoacanthoma on the left cheek of Galileo Galilei]. AB - In an oil painting from the School of Sustermans, which can be seen in the Palazzo Pitti in Florence, we diagnosed the alterations typical of a keratoacanthoma in the left cheek-bone area of the portrayed Galileo Galilei. PMID- 3533849 TI - Health Visitors' Association--90th anniversary 1896-1986. PMID- 3533850 TI - Memories. HVA members share memories of health visiting and nursing. PMID- 3533851 TI - Memories of 1958 to 1984. PMID- 3533852 TI - Professional from the start. PMID- 3533853 TI - Molecules labeled with positron emitting halogens. PMID- 3533854 TI - A look at radiolabeled blood cells. PMID- 3533855 TI - Kidney graft rejection studies with labeled platelets and lymphocytes. AB - The usefulness of In-111-labelled platelets and lymphocyte scintigraphy in acute kidney graft rejection is evaluated. One hundred fifty-five patients (36 treated with cyclosporine A) were studied with labelled platelets and 27 with labelled lymphocytes. Blood cels were labelled with 100-150 microCi of In-111-oxine and reinjected. Subsequently patients were scanned once daily from 2 hours post reinjection up to a week. The graft/contralateral area activity ratio was calculated in all scans (index I). Four groups of patients were established: Functioning grafts (FG); post-operative acute renal failure (p-ARF); acute rejection (AR) and nephrotoxicity (NTX), the last one only in patients under cyclosporine therapy. Results with labelled platelets showed similar index I mean values in FG, p-ARF and NTX patients I = 1.1 +/- 0.1 and a significant increase (p less than 0.001), in acutely rejecting grafts I = 1.9 +/- 0.4. Evolving controls showed a decrease a decrease of graft activity parallel to rejection resolution while the activity maintains or increases in patients with less or no response to treatment. Overall sensitivity was 97.2%, specificity 90.2% and accuracy 92.8%. Results with labelled lymphocytes were similar to those with platelets. They showed a significant (p 0.001) difference of activity index between rejecting (I = 1.86 +/- 0.3) and non rejecting grafts (I = 1.05 +/- 0.1). Decrease of graft activity was only seen in patients with good response to treatment. It is concluded that In-111-labelled platelets scintigraphy is nowadays the method of choice for acute kidney graft rejection diagnosis, especially in patients under cyclosporine immunosuppression. PMID- 3533856 TI - The French procedure for granting new drug approval for radiopharmaceuticals. PMID- 3533857 TI - The concept of radiopharmaceuticals: a general report. PMID- 3533858 TI - Generators for short-lived gamma and positron emitting radionuclides: current status and prospects. PMID- 3533859 TI - An investigation of the mutagenic effect in bacteriophage T4D of nine oil dispersants. PMID- 3533860 TI - Immunohistochemical studies of experimental diabetic neuropathy. PMID- 3533861 TI - Effect of saliva on candidal adherence to polymethyl methacrylate resin. PMID- 3533862 TI - Validation of the deuterium dilution technique for the measurement of fluid intake in infants. AB - The validity of the deuterium dilution technique as a method of measuring fluid intake was investigated by comparing values obtained with this technique and direct measurements of milk intake in 10 exclusively bottle-fed infants recovering from protein-energy malnutrition. Values for total body water were derived from body weight and length using Friis-Hansen's formula. During a 15-d period, average daily milk intake, measured with the deuterium technique, ranged between 519 and 963 ml and was similar to values obtained by direct measurement (range 531-1002 ml). Correlation between both sets of values was highly significant (r = 0.97; P less than 0.001). The data indicate that the deuterium dilution method provides good estimates of daily fluid intake in young infants. PMID- 3533863 TI - Relationship between anaemia, iron and folacin deficiency, haemoglobinopathies and parasitic infection. AB - Iron status, folacin status, haemoglobinopathies, malarial infection and intestinal parasitosis frequencies were assessed in a representative sample of 586 subjects living in a rural district of South Benin. Anaemia according to WHO reference values for haemoglobin was observed in 42 per cent of subjects. The prevalence was higher in children and menstruating women. Iron deficiency, defined by two or more abnormal values in the four independent indicators of iron status used (transferrin saturation, erythrocyte protoporphyrin, serum ferritin, and mean corpuscular volume) was present in 30 per cent of subjects. Half of the anaemias were associated with iron deficiency. Folate deficiency was associated with anaemia in 20 per cent of subjects. Anaemia, iron and folacin status were not significantly related to the degree of malarial infection nor to the type of haemoglobin. Although hookworm infection was very common, there was no significant relationship between egg count and haemoglobin level or haematological parameters of iron and folacin status. The lack of correlation can be explained by the low wormload observed. PMID- 3533864 TI - The monoaminergic innervation of primate neocortex. AB - In brain, the monoamines, dopamine, norepinephrine, and serotonin, are confined to anatomically distinct neuronal systems, each of which furnishes widespread projections to neocortex. In primate, but not in rat, the terminal patterns of each of these systems have a high degree of regional and laminar specificity. These findings suggest that there are different sites of action and possibly different functional roles for each of the monoamines. This type of precise anatomic information is essential to our understanding of the possible involvement of monoamines in human disease states. PMID- 3533865 TI - Oncogenic transformation of cells in culture: pragmatic comparisons of oncogenicity, cellular and molecular mechanisms. PMID- 3533866 TI - Anemia: a problem or an opportunity in radiotherapy? AB - Anemia may often become a problem in the treatment of the cancer patient. There are insufficient clinical data to assess the overall importance of anemia in radiotherapy, but there is clear evidence that uncorrected anemia is detrimental to local tumor control in some sites. There may be situations, however, when the transfused, previously anemic patient is at an advantage. These patients have shown a dramatically better response than non-anemic patients when radiotherapy for cancer of the cervix was given in hyperbaric oxygen. Animal experiments suggest that adaptive processes may be responsible for this effect. There is an important difference between acute and chronic anemia in their influence on the radiosensitivity of mouse tumors; while acute anemia consistently causes radioresistance, this effect is lost as the duration of the anemia prior to irradiation is prolonged. This would suggest that anemia per se should not cause tumor radioresistance in the chronically anemic patient. Blood transfusion in previously anemic animals has been shown to produce a markedly increased tumor radiosensitivity, but again this is only transient and sensitivity returns to normal when the interval between transfusion and irradiation is extended to 24 hrs. The mechanisms responsible for tumor adaptation to anemia and blood transfusion are not known, but there is evidence that changes in diffusion distances occur within tumors in response to alterations in oxygen availability and that changes in blood chemistry through the 2,3-DPG system may alter the release of oxygen to the tissues. These are complex processes and it remains to be determined what influence they have in the treatment of human cancer. However, the animal data suggest a clear benefit of blood transfusion to restore the hemoglobin level in radiotherapy, but they also emphasize the need to irradiate immediately so that adaptive mechanisms cannot erode the effect. PMID- 3533868 TI - Francisco de Santillana: first veterinary practitioner in North America? PMID- 3533867 TI - History of irradiation in squamous cell carcinomas of the larynx and hypopharynx. PMID- 3533869 TI - Pleuritis and pneumonia attributed to a conifer twig in a bronchus of a horse. AB - A conifer twig was responsible for severe fibrinopyogranulomatous adhesive pleuritis and pneumonia in a horse. At necropsy, the twig was found in a terminal bronchus and extended into the lung parenchyma, through the pleura, and into the accumulated exudate. Inhalation of plant material may be a more common cause of pleuritis than previously recognized. Meticulous examination at necropsy would be necessary to make the diagnosis. PMID- 3533870 TI - False carotid aneurysm in a sheep. AB - A false carotid aneurysm was diagnosed in an adult Suffolk sheep examined because of dyspnea and dysphagia associated with a parotid-area mass. Ultrasonography, radiography, and endoscopy were used to delineate the mass. Surgical excision was accomplished; however, the ewe's dysphagia failed to improve. This case illustrates an unusual cause of dyspnea and dysphagia in a sheep. PMID- 3533871 TI - Feline sporotrichosis. PMID- 3533872 TI - Ehrlichia canis-related polyarthritis in a dog. AB - Ehrlichia canis-related polyarthritis was diagnosed in a 7-month-old Boxer. The diagnosis was based on intraneutrophilic morulae found in synovial fluid specimens, thrombocytopenia, a positive result for indirect fluorescent antibody testing for E canis, the presence on the dog of the known vector of E canis infection (Rhipicephalus sanguineus), and a favorable response to treatment with tetracycline hydrochloride. The dog has had no recurrence of lameness for 18 months after cessation of treatment. PMID- 3533873 TI - Use of radiotherapy for the treatment of intranasal tumors in cats: six cases (1980-1985). AB - Six cats with intranasal neoplasia treated with radiotherapy were evaluated. The mean survival time from the initiation of radiotherapy was 19 months, with 2 cats still known to be alive. Two cats died for reasons unrelated to the primary tumor. One cat had no clinical evidence of nasal tumor 41 months after treatment, but was lost to further follow-up evaluation. PMID- 3533874 TI - Interrelationships between uterus and conceptus to maintain corpus luteum function in early pregnancy: sheep, cattle, pigs and horses. AB - Processes associated with "Maternal Recognition of Pregnancy" are reviewed extensively from the ovine, bovine, porcine and equine species. Comparisons among these species indicate that CL maintenance is achieved primarily by a predominant antiluteolytic-anti PGF effect, and there is strong evidence for antiluteolytic luteoprotective and luteotropic controls that complement this basic system. The nature of the chemical signals (steroids, prostaglandins and proteins) to regulate these processes among the species are described. Common to all of the species reviewed is a change in vascular dynamics to and from the uterus and ovary during early pregnancy. The dialogue between endometrial epithelium and trophectoderm of the developing conceptus is described. The consequence of these various physiological and biochemical responses of early pregnancy is maintenance of the CL to provide a sustained embryotrophic environment. Either in the absence of or death of a conceptus, an efficient and acute system is operational to terminate this progestational environment via regression of the CL through uterine production of PGF. PMID- 3533875 TI - Utero-ovarian interactions during early pregnancy: role of conceptus-induced vasodilation. AB - Recent studies of utero-ovarian blood flow have indicated an interaction between the gravid uterus and the ovary in maintaining luteal function during early pregnancy. On days critical for the continuation of pregnancy, blood flow to the corpus luteum (CL) increases several-fold, coincident with an increase in concentrations of progesterone (P4) in systemic blood. Enhanced ovarian secretion of P4 may amplify the vasodilatory "signal" of the conceptus and thus ensure an adequate uterine blood supply to support early fetal growth. Utero-ovarian vasodilation during early pregnancy may not only stimulate luteal function directly but also enhance transport of luteotropic substances to the ovary. Possible candidates for the vasodilatory factor(s) secreted from the early gravid uterus include estrogens and prostaglandins (PG) E. In addition, conversion of estrogens to their catechol forms, which have both vasodilatory and luteotropic activities, may be important for the successful establishment of pregnancy. PMID- 3533876 TI - Ovarian peptides: role of luteal oxytocin in the control of estrous cyclicity in ruminants. AB - The peptide hormone oxytocin has long been known to affect the life-span of the corpus luteum on administration. There is now a good deal of evidence to suggest that endogenous oxytocin may also be involved in this process, probably through a stimulatory action on uterine prostaglandin synthesis. Recently the role of oxytocin in controlling estrous cyclicity has been given added prominence by the discovery that oxytocin is secreted by the ruminant corpus luteum. This paper reviews current ideas in this area, and deals particularly with the mechanism of action of oxytocin. PMID- 3533877 TI - Role of luteal prostaglandins in the control of bovine corpus luteum functions. AB - Current and emerging concepts on regulation of bovine corpus luteum function by various metabolites of arachidonic acid are reviewed. A series of experiments are presented which support the concept that prostacyclin (PGI2), a metabolite of arachidonic acid via the cyclooxygenase pathway, plays a luteotropic role, and that products of the lipoxygenase pathway of arachidonic acid metabolism, particularly 5-hydroxyeicosatetraenoic acid (5-HETE), play a luteolytic role in the function of the bovine corpus luteum (CL). These ideas are supported by the following findings: injection of PGI2 directly into CL at mid-cycle produced a prolonged increase in peripheral plasma concentrations of progesterone; PGI2 stimulated synthesis of progesterone by dispersed luteal cells; synthesis of PGI2 by luteal cells was greatest during the period of early CL development (d 5 and 10), and diminished as the CL aged unless pregnancy ensued, causing a maintenance of the CL and synthesis of PGI2; administration of indomethacin, a blocker of synthesis of prostaglandin by the cyclooxygenase pathway, twice daily on d 4 to 6 of the estrous cycle inhibited CL development and caused a reduction in cycle length, suggesting the presence of a luteotropic prostaglandin; oxytocin administration twice daily on d 4 through 6 inhibited CL development and was accompanied by a 50% reduction in luteal synthesis of PGI2 by CL collected on d 7; large quantities of 5-HETE were found in luteal tissue; the addition of 5-HETE to dispersed luteal cells inhibited synthesis of progesterone and PGI2, while production of PGF2 alpha was unaffected.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3533878 TI - A review of patterns of change in luteal function. AB - Puberty: For the gilt and filly, the first corpus luteum (CL) appears to have a normal lifespan. For both species, first CL usually is associated with estrus but can form in the absence of estrus. For the ewe and cow, a transient (1 to 4 d, ewe; 3 to 10 d, cow) rise and fall of ovarian derived progesterone (P4) is detected in peripheral blood (80% of ewes; 50% of heifers) prior to first "normal" CL. The first CL of apparent normal lifespan is not accompanied by estrus in the ewe. The first CL in the cow may or may not be accompanied by estrus; first estrus in the cow can be anovulatory. Data are required to describe definitively variation in lifespan of first CL in these species. Persistent CL: Data that the CL can be prolonged in the absence of uterine abnormality are strongest in the mare, suggestive for the ewe under conditions of "more constant light," equivocal in the cow, and not reported in the pig. First CL after the anovulatory season: As reported for the pubertal ewe, the anestrous ewe can have a progesterone rise over a 2- to 4-d interval at about 25 d before estrus. The ewe has a P4 pattern similar to that of a normal estrous cycle in the absence of estrus immediately prior to the first estrus and CL. CL lifespan was reported for the first estrous cycle to be both normal and on the order of 4 to 10 d in up to 50% of the ewes, following introduction of rams. For the mare, first CL usually is associated with estrus and has a normal lifespan. Data suggest no P4 rise prior to first CL. The occurrence of estrus without formation of a CL is usual during the anovulatory season and during the transition from anovulatory to ovulatory seasons. Postpartum: The CL of pregnancy regressed at parturition and was not functional postpartum in the sow and cow, regressed at about d 180 of gestation in the mare (both primary CL and secondary CL), and regressed after d 140 of gestation and before d 2 postpartum in the ewe. Postpartum estrus occurring within d 1 to 3 postpartum was anovulatory for both the sow and ewe; postpartum estrus within d 5 to 12 was ovulatory for the mare.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3533879 TI - Mechanisms associated with subnormal luteal function. AB - Mechanisms associated with subnormal luteal function are reviewed with particular reference to sheep and cattle. Since the corpus luteum is a continuation of follicular maturation, mechanisms during both the follicular and luteal phase have been considered. During the follicular phase, extrafollicular and intrafollicular events are important for adequately preparing follicular cells for luteinization and secretion of progesterone (P4). Mechanisms which alter the microenvironment of the preovulatory follicle may impair the ability of follicular cells to subsequently secrete P4 and result in subnormal luteal function. During the luteal phase, secretion of P4 is probably dependent upon a balance between luteotropic and luteolytic stimuli. Subnormal luteal function may be due to an inadequate luteotropic stimulus and(or) an inability of luteal tissue to respond to a luteotropic stimulus. Additionally, a premature luteolytic stimulus may be involved in reduced luteal function. Specifically, premature luteolysis may result from an increased or premature release of a luteolysin or perhaps an increased responsiveness of luteal tissue to a luteolysin. PMID- 3533880 TI - Osseointegration for restorative dentists. Part II: Case reports. PMID- 3533881 TI - The effect of water activity on Legionella spp. growth and survival. AB - Growth and survival of Legionella spp. at various water activity (aw) levels were determined. Compared with Escherichia coli, the growth of Legionella spp. was limited to a high aw environment (greater than or equal to 0.98). PMID- 3533882 TI - The application of genetically engineered micro-organisms in the production of drugs. PMID- 3533883 TI - The renaissance of erythromycin. PMID- 3533884 TI - Quinolones in chest infections. PMID- 3533885 TI - Antibacterial activity of resolved temocillin epimers. AB - The antibacterial activity of pure resolved R and S epimers of temocillin was determined in a variety of in-vitro test systems, including those that allowed measurement of activity during the early period following exposure to the agents, thus minimising the effect of epimerization. In conventional agar- and broth dilution susceptibility tests involving incubation at 37 degrees C for 18 h, little difference was evident between the activities of the individual epimers. In contrast, in other tests of antibacterial activity, such as time-kill and turbidimetric studies, the R epimer and temocillin (R/S mixture 1.8:1.0) were shown to be more rapidly bactericidal than the S epimer. Overall, the R epimer and temocillin (R/S) exhibited a similar degree of bactericidal activity in vitro. PMID- 3533886 TI - In-vitro uptake of gentamicin and tobramycin by rat renal tubules in the presence or absence of Escherichia coli endotoxin. AB - Renal tubules of rats were incubated with aminoglycoside (gentamicin or 3H tobramycin, 10 mg/l) in the presence or absence of Escherichia coli endotoxin (10 mg/l). The kinetics of aminoglycoside uptake by the tubule were only slightly affected by endotoxin. The percentage of serum in the medium affected the tobramycin uptake. This uptake decreased from a mean ratio of concentration in the tubules/concentration in the medium (T/M) of 1.63 in 5% serum to a mean T/M of 0.86 in 10% serum (P less than 0.01). PMID- 3533887 TI - The volume of distribution of ceftazidime and albumin in normal, immature and infected bone. AB - The penetration of ceftazidime into bone was determined by measuring the volume of distribution of 14C-ceftazidime in infected and non-infected bone of adult mongrel dogs. The volume of distribution in non-infected cortical bone was 0.114 +/- 0.011 l/kg (mean +/- S.E.M.) and increased significantly in non-infected immature callus to 0.484 +/- 0.13 l/kg (P less than 0.05). In the presence of infection, the volume of distribution in non-infected cortical bone was 0.144 +/- 0.05 l/kg, and significantly higher in infected reactive cortical bone, 0.453 +/- 0.07 (P less than 0.05). We conclude that ceftazidime penetrates infected and non infected bone and that this penetration is greater into immature bone. PMID- 3533888 TI - Comparative efficacy of different beta-lactam antibiotics and gentamicin in Klebsiella pneumoniae septicaemia in neutropenic mice. AB - The in-vivo activity of ceftazidime, cefotetan, imipenem/cilastatin, piperacillin and gentamicin against two strains of Klebsiella pneumoniae was evaluated in a model of experimental septicaemia in neuropenic mice. Single agent therapy with the aminoglycoside was highly effective against both strains. Among the beta lactams, ceftazidime and cefotetan were nearly as active as gentamicin, whereas imipenem/cilastatin was slightly less effective, and the results achieved with piperacillin were markedly inferior. PMID- 3533889 TI - Comparison of a slow-release trimethoprim with co-trimoxazole: efficacy and selection of resistance in the Enterobacteriaceae. AB - One hundred and fifty one patients with symptoms of urinary tract infection were treated randomly in a double blind study with a slow release form of trimethoprim or with co-trimoxazole. Similar cure rates were seen. There was no difference between the proportions of patients in the two groups who acquired trimethoprim resistant Enterobacteriaceae. Further clinical trials with slow release trimethoprim should be performed. PMID- 3533890 TI - Inhibition of K88-mediated adhesion of Escherichia coli to mammalian receptors by antibiotics that affect bacterial protein synthesis. AB - The ability of ten inhibitors of bacterial protein synthesis to decrease adhesion of Escherichia coli bearing K88ac fimbriae was examined. In the presence of the antibiotics at concentrations below the MIC values neomycin was the least effective inhibitor of adhesion and minocycline the most active. The effect of minocycline on the synthesis of individual polypeptides encoded by the K88ac determinant was examined in detail. The rate of synthesis of K88ac pilus protein in the presence of minocycline 0.75 mg/l (0.5 MIC) was less than that of total cell protein synthesis, suggesting that pilus protein becomes progressively 'diluted' in the outer membrane during exposure to this antibiotic concentration. Furthermore, the synthesis of two 'helper' polypeptides (molecular weights of 27.5 K and 27 K) which are probably involved in secretion of K88ac pilus protein through the cell envelope, was particularly sensitive to minocycline. Our observations suggest that the ability of translational inhibitors to decrease K88ac mediated adhesion probably results from direct inhibition of synthesis of fimbrial protein itself, together with inhibition of 'helper' polypeptide synthesis. PMID- 3533891 TI - Comparative multicentre evaluation of the safety and efficacy of ceftazidime versus cefamandole for pneumonia. AB - Ceftazidime and cefamandole were compared in a randomized multicentre trial in hospitalized patients with pneumonia. Of 290 patients enrolled, 92 patients in the ceftazidime group and 71 patients in the cefamandole group were evaluable. Geometric mean MICs of organisms isolated and tested to ceftazidime were within achievable therapeutic serum concentrations of ceftazidime. Satisfactory clinical responses were observed in 91% (84/92) of ceftazidime-treated patients and 83% (59/71) of cefamandole-treated patients (P greater than 0.05). Superinfection occurred in one (1%) ceftazidime-treated patient and in five (7%) cefamandole treated patients. Side effects were infrequent with either treatment. Ceftazidime is as safe and effective as cefamandole for the treatment of pneumonia due to a variety of Gram-positive and Gram-negative pathogens. PMID- 3533892 TI - The effect of altered porin expression in Escherichia coli upon susceptibility to 4-quinolones. PMID- 3533893 TI - A method to generate microcells from human lymphoblasts for use in microcell mediated chromosome transfer. AB - A method is described to generate microcells from human lymphoblasts for use in microcell-mediated chromosome transfer (MMCT). Micronuclei were induced in cells from a human lymphoblastic cell line by prolonged colcemid treatment, and were separated from these lymphoblasts by: attaching the cells to Concanavalin A coated plastic slides designed for enucleation, and centrifuging the slides in medium containing cytochalasin B. Microcells of less than 3 microns in diameter were fused with thymidine kinase negative mouse fibroblasts (LMTK-). HAT medium (hypoxanthine, aminopterin, and thymidine) was used to select microcell hybrids expressing thymidine kinase activity. Positive clones were isolated and Q-banded for chromosome analysis. Unlike previous methods, this procedure permits microcells to be easily generated from lymphoid cells. The methodology of enucleation of microcells may be extended to a variety of other donor cell types which can be micronucleated but which do not adhere tightly to enucleation slides and do not exhibit extrusion subdivision. This feature makes our methodology particularly useful for constructing a library of hybrid clones containing one or a few human chromosomes. PMID- 3533895 TI - How to produce a research report with ease and elegence (or how to publish and not perish in the process). AB - Microcomputers can be used by scientists to search online bibliographic sources and to integrate the references into a research report. Commercial programs, such as Sci-Mate, are available to aid in the search of online databases, and the storage of retrieved references and abstracts. PMID- 3533894 TI - Problems of official methods and new techniques for analysis of foods and feeds for vitamin A. AB - The official methods for measuring vitamin A and carotene in foods and feeds have evolved over several decades. New procedures are needed to permit the use of modern analytical techniques such as liquid chromatography (LC), and to expand the application of official methods to a wide variety of foods. Recent improvements in methodology are reviewed. Emphasis is often placed on the separations achieved by LC, but all factors that affect quantitation, such as sampling, preparation of standards, and protection of the vitamin against oxidation, must be considered in the development of new methods. Many approaches to analysis are possible because of the versatility of LC but not all of them can be used in official methods. Methods for milk, margarine, and feeds can be prepared now for collaborative assays. Although straightforward methods can be developed for the measurement of beta-carotene in certain foods, a full examination of provitamins will probably continue to require a flexible approach and special expertise. PMID- 3533896 TI - Enzyme immunoassay for detection of Salmonella in foods: collaborative study. AB - A collaborative study was performed in 25 laboratories to validate an enzyme immunoassay (EIA) procedure utilizing 2 specific monoclonal antibodies for rapid detection of Salmonella in foods. The EIA was compared with the standard culture procedure for detection of Salmonella in 6 food types: ground black pepper, soy isolate, dried whole eggs, milk chocolate, nonfat dry milk, and raw deboned turkey. Uninoculated and inoculated samples were included in each food group analyzed, with the exception of poultry which was naturally contaminated. There was no significant difference in the productivity of the EIA and culture procedures at the 5% level for any of the 6 foods. The enzyme immunoassay screening method has been adopted official first action. PMID- 3533897 TI - Gas chromatographic method for ethylene dibromide in grains and grain-based products: collaborative study. AB - Nine laboratories analyzed samples of whole grain, intermediate, and ready-to-eat products for ethylene dibromide (EDB) residues. Supplied samples of wheat, rice, and flour contained both fortified and incurred EDB; corn bread mix, baby cereal, and bread contained only fortified EDB. The whole grains and intermediates were analyzed by the same basic procedural steps as in the official method for multifumigants: They were extracted by soaking in acetone-water (5 + 1). The baby cereal and bread were analyzed by a modification of the Rains and Holder hexane co-distillation procedure. EDB was determined by electron capture gas chromatography operated with an SP-1000 column. All products contained 3 different levels of EDB and were analyzed as blind duplicates. Overall mean recoveries ranged from 85.2% for 69.6 ppb to 105.0% for 4.35 ppb, both in baby cereal. Interlaboratory relative standard deviations ranged from 5.7% for 869 ppb in wheat to 20.2% for 69.6 ppb in baby cereal, both fortified. Mean levels of incurred EDB in wheat, rice, and flour were 926.7, 982.0, and 49.9 ppb, respectively; corresponding relative standard deviations were 9.9, 7.7, and 13.1%. The method was adopted official first action. PMID- 3533898 TI - Long term captopril therapy in severe congestive heart failure. PMID- 3533899 TI - Glucose and insulin levels in obese non-diabetics. PMID- 3533900 TI - Digitalis in therapeutics state of the art. PMID- 3533901 TI - [Intraoperative sonography in hepatic surgery]. PMID- 3533902 TI - Ultrasonic imaging during vascular surgery. PMID- 3533903 TI - Ultrasonic imaging during renal surgery for calculi. PMID- 3533904 TI - [Intraoperative echography of the pancreas. Apropos of 53 cases]. PMID- 3533905 TI - Sonography of normal and pathological scrotal contents. PMID- 3533906 TI - Intraoperative ultrasound of the brain. PMID- 3533907 TI - [Intraoperative echography]. PMID- 3533908 TI - Intraoperative spinal ultrasonography. PMID- 3533909 TI - Pattern analysis of antidepressant response to fluoxetine. AB - Seventy patients with unipolar major depressive disorder were treated with fluoxetine or placebo in a 6-week double-blind trial and were evaluated by changes in scores on the Hamilton Rating Scale for Depression (HAM-D) and the global improvement measure of the Clinical Global Impressions (CGI) scale. High correlations were found between the changes in HAM-D scores from baseline to endpoint and the final CGI improvement ratings. In patients with moderate depression (baseline HAM-D score of 20 or more), the differences in endpoint analysis between active treatment and placebo groups were significant. A persistent pattern of improvement was noted in 27% of those receiving fluoxetine but in none of those receiving placebo. Physician and patient evaluations as determined by the improvement measure of the CGI were closely correlated. PMID- 3533911 TI - Potential for immunological intervention against dental caries. AB - Potentiation of the host immune system has been considered, in addition to non immunological measures as a means of preventing the development of dental caries. Because specific antibodies in the oral cavity are derived from two sources--the salivary glands that produce secretory IgA, and the general circulation that provides IgG antibodies--immunization efforts in various experimental models have been aimed at stimulating either of these compartments. Streptococcus mutans, the principal cariogenic microorganism, and various cell wall components and extracellular enzymes have been used as antigens. In experimental animals, systemic or oral routes of immunization have induced protective IgG or IgA antibodies respectively, but the mechanisms of protection have not been clearly established. The possibility of stimulating a generalized secretory immune response by oral ingestion of antigens may have advantages for the induction of protective antibodies in humans, because parenteral immunization routes may not be readily acceptable for reasons discussed in this review. Nevertheless, further experimental work is required to select appropriate antigens, and to determine optimal doses and immunization schedules for inducing antibodies at an age that is critical in the development of dental caries. PMID- 3533910 TI - Implications of cytochrome b6/f location for thylakoidal electron transport. AB - The cytochrome b6/f complex of higher plant chloroplasts is uniformly distributed throughout both appressed and nonappressed thylakoids, in contrast to photosystem II and photosystem I, the other major membrane protein complexes involved in electron transport. We discuss how this distribution is likely to affect interactions of the cytochrome b6/f complex with other electron transport components because of the resulting local stoichiometries, and how these may affect the regulation of electron transport. PMID- 3533912 TI - Inositol 1,4,5-trisphosphate and guanine nucleotides activate calcium release from endoplasmic reticulum via distinct mechanisms. AB - A sensitive and specific guanine nucleotide regulatory process has recently been shown to rapidly mediate a substantial release of Ca2+ from endoplasmic reticulum within the N1E-115 neuronal cell line (Gill, D. L., Ueda, T., Chueh, S. H., and Noel, M. W. (1986) Nature 320, 461-464). The relationship between this mechanism and Ca2+ efflux mediated by the intracellular regulator inositol 1,4,5 trisphosphate (IP3) has been investigated. Using saponin-permeabilized N1E-115 cells, studies reveal a number of distinctions between the activation of Ca2+ release mediated by GTP and IP3. Thus, the GTP-mediated Ca2+ release process is specifically activated by polyethylene glycol which increases both GTP sensitivity and the extent of GTP-activated Ca2+ release; in contrast, IP3 dependent Ca2+ release is unaffected by polyethylene glycol. The non-hydrolyzable GTP analogue guanosine 5'-O-(3-thio)triphosphate, which completely inhibits GTP mediated Ca2+ release, does not alter release mediated by IP3. Decreasing the release temperature from 37 to 4 degrees C decreases IP3-activated Ca2+ release by only 20%, whereas the action of GTP on Ca2+ release is abolished at 4 degrees C. Activation of Ca2+ release by IP3 is completely inhibited by increasing free Ca2+ from 0.1 to 10 microM, whereas the fraction of GTP-dependent Ca2+ release (approximately 50% of ionophore-releasable Ca2+) remains unaltered with increasing free Ca2+. These distinctions between IP3- and GTP-mediated Ca2+ release indicate that the two effectors function via distinct mechanisms to activate Ca2+ release; however, they do not preclude the possibility that coupling between the two mechanisms can occur or that a common Ca2+-translocating pathway activated by both effectors exists. PMID- 3533913 TI - Metabolic concomitants in pure, pancreatic beta cells during glucose-stimulated insulin secretion. AB - The role of the redox potential in insulin secretion by beta cells stimulated with high glucose was investigated using an in vitro pancreas perfusion system. To assess glycolytic flux the sum of fructose-1,6-P2 + triose-P was determined in pure beta cells microdissected from lyophilized sections of the isolated perfused pancreas quick frozen during the early insulin secretory response. L-Glycerol 3 phosphate and dihydroxyacetone phosphate were measured as indicators of the free cytosolic [NAD+]/[NADH] ratio and NADH and NADPH were also measured. Fructose-1,6 P2 + triose-P was increased in beta cells simultaneously with the onset of insulin secretion indicating an increase in glucose metabolism had occurred. The ratio of [dihydroxyacetone phosphate]/[L-glycerol 3-phosphate] increased simultaneously with the onset of insulin secretion. NADH content increased only after initiation of insulin secretion and NADPH levels remained unchanged during the early secretory response to high glucose. These data contradict the hypothesis that insulin secretion is triggered by a more reduced cytosolic redox state and instead indicate that insulin secretion is initiated by other metabolic coupling factor(s) generated in beta cells stimulated by high glucose. PMID- 3533914 TI - Glycosylation defects alter insulin but not insulin-like growth factor I binding to Chinese hamster ovary cells. AB - Insulin binding to two Chinese hamster ovary cell lines with well-defined defects in their glycosylation pathway has been characterized and compared to insulin like growth factor I (IGF-I) binding in the same cell lines. Insulin competition curves indicate that B4-2-1 cells, which transfer co-translationally to proteins an endoglycosidase H insensitive, truncated lipid-linked oligosaccharide, bind insulin with higher than normal affinity. Lec 1 cells, which fail to process oligosaccharide side chains to complex types, bind with a reduced affinity. The potencies of chicken and guinea pig insulins are appropriate for an insulin receptor in the control (WTB) and both mutant cell lines, whereas rat IGF-II is 3 times more potent than expected in the Lec 1 cells and human IGF-I is less potent than anticipated. Insulin bound to Lec 1 cells dissociates more quickly upon dilution than does insulin bound to either WTB or B4-2-1 cells. The Lec 1 insulin receptor is insensitive to pH change, whereas the other lines show the usual optimum of 8. 125I-IGF-I binds well to all three cell lines and is equally pH sensitive in all three. Serum from a patient with circulating autoantibodies to the insulin receptor competes for insulin but not IGF-I binding, whereas alpha IR3, a monoclonal antibody directed toward the human IGF-I receptor inhibits IGF I but not insulin binding. Cross-linking of either 125I-insulin or 125I-IGF-I reveals a typical alpha-subunit in the WTB and B4-2-1 cells but a band with faster mobility in the Lec 1 cells. Insulin (10(-8) M) stimulates autophosphorylation of a beta-subunit in all three lines, but again the Lec 1 subunit demonstrates an anomalous mobility on sodium dodecyl sulfate polyacrylamide gel electrophoresis. These data demonstrate the differential effect of glycosylation on two closely related receptor molecules. PMID- 3533915 TI - alpha 1-Antichymotrypsin in lung secretions is not an effective proteinase inhibitor. AB - This paper presents evidence that alpha 1-antichymotrypsin in lung secretions is not effective as an inhibitor of chymotrypsin-like enzymes. First, lung secretion samples inhibited more cathepsin G on a one-to-one molar basis than could be accounted for by the alpha 1-antichymotrypsin present. Second, the major cathepsin G inhibitory capacity of sputum was in gel filtration fractions that corresponded to a low molecular weight (10,000-15,000) and contained immunoreactive antileucoprotease. Third, although alpha 1-antichymotrypsin purified from plasma was almost fully active against cathepsin G, that purified from lung lavage retained less than 15% of its inhibitory function. Immunoblotting following sodium dodecyl sulfate-polyacrylamide gel electrophoresis showed that alpha 1-antichymotrypsin in plasma and lung secretions are of similar molecular size and no enzyme-alpha 1-antichymotrypsin complexes could be detected in sputum or bronchoalveolar lavage fluids. However, in contrast to the alpha 1-antichymotrypsin purified from plasma, the lavage protein gave a broad elution profile following anion-exchange chromatography. PMID- 3533916 TI - Protein topography of the 40 S ribosomal subunit from Saccharomyces cerevisiae as shown by chemical cross-linking. AB - Protein-protein cross-linking was used to examine the spatial arrangement of proteins within the 40 S ribosomal subunits of Saccharomyces cerevisiae. Purified ribosomal subunits were treated with either 2-iminothiolane or dimethyl 3,3' dithiobispropionimidate under conditions such that the ribosomal particle was intact and that formation of 40 S subunit dimers was minimized. Proteins were extracted from the treated subunits and fractionated on Sephadex G-150 or by acid urea-polyacrylamide gel electrophoresis. Cross-linked proteins in these fractions were analyzed by two-dimensional diagonal sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Constituent members of cross-linked pairs were radiolabeled with 125I and identified by two-dimensional gel electrophoresis and comparison with nonradioactive ribosomal protein markers. Forty-two pairs involving 25 of the 32 40 S subunit proteins were identified. Many proteins were detected in several cross-linked dimers. These proteins with multiple cross-links form foci for the construction of a schematic model of the spatial arrangement of proteins within the 40 S subunit. PMID- 3533917 TI - The 110-kDa reaction center protein of photosystem I, P700-chlorophyll a-protein 1, is an iron-sulfur protein. AB - Germination and growth of barley (Hordeum vulgare L.) in the presence of 59Fe2+ or 35SO4(2-) allows heavy incorporation of both isotopes into the thylakoid membranes and into isolated photosystem I particles. Analysis of 59Fe-labeled preparations by sodium dodecyl sulfate-polyacrylamide gel electrophoresis under mild conditions demonstrates that a minimum of four iron atoms/P700 is carried on P700-chlorophyll a-protein 1. When isolated from 35S-labeled preparations, P700 chlorophyll a-protein 1 binds zero valence 35S, which is converted into acid labile [35S]sulfide by dithiothreitol reduction. Isolated photosystem I particles contain 14 acid-labile sulfide atoms and 10 iron atoms for each molecule of P700 and are composed of polypeptides of 110, 18, 15, 10, and 8 kDa of which the 10 kDa component is loosely bound. Under the electrophoretic conditions used, none of the low molecular weight polypeptides could be shown to be specifically associated with iron or acid-labile sulfide. Carboxymethylation of cysteine residues shows a high cysteine content in the 8-kDa polypeptide and an intermediate content in the 110- and 18-kDa polypeptides, whereas the 15-kDa polypeptide is devoid of sulfur amino acids. The experiments with the 59Fe labeled thylakoids reveal other labeled polypeptides not associated with photosystem I, namely cytochrome f and possibly cytochromes b6 and b559. PMID- 3533918 TI - The inactivation of human plasma alpha 1-proteinase inhibitor by proteinases from Staphylococcus aureus. AB - The interaction of three proteinases (seryl, cysteinyl, and metallo-) from Staphylococcus aureus with human plasma alpha 1-proteinase inhibitor has been investigated. As expected, none of the enzymes was inactivated by this protein, each, instead causing the conversion of the native inhibitor into an inactive form of decreased molecular weight. Amino-terminal sequence analysis indicated that inhibitor inactivation had occurred by peptide bond cleavage near the reactive center of this protein. When the inhibitor was modified by this treatment, it became resistant to both pH and temperature denaturation and, in contrast to the intact denatured protein, did not undergo further proteolytic degradation. This process of inactivation of alpha 1-proteinase inhibitor by pathogenic proteinases could result in a deregulation of its target enzyme, neutrophil elastase, and, therefore, may be important in the consumption of some plasma proteins by this enzyme during septicemia. PMID- 3533919 TI - Structural differences between liver- and muscle-derived insulin receptors in rats. AB - The structure of insulin receptors, solubilized from rat skeletal muscle and liver, was studied. The alpha subunit was identified by specific cross-linking to A14 125I-insulin with disuccinimidyl suberate. Muscle- and liver-derived alpha subunits migrated on sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) with a Mr of 131,000 and 135,000, respectively. There was no significant difference in insulin binding affinity. Treatment of cross-linked, immunoprecipitated receptors with either neuraminidase or endoglycosidase H decreased the Mr of muscle- and liver-derived alpha subunits but did not affect the difference in Mr. Autophosphorylated beta subunits migrated with a Mr of 98,000 for muscle and 101,000 for liver. After partial V8 digestion of autophosphorylated, immunoprecipitated receptors the major phosphopeptide fragment migrated on SDS-PAGE at Mr 57,000 from muscle and 60,000 from liver. Glycosidase digestion of autophosphorylated receptors suggested that Mr heterogeneity was due in part to differences in the sialic acid content of beta subunits. Muscle and liver are the major target organs of insulin; the apparent heterogeneity of insulin receptor structure may be relevant to tissue-specific differences in insulin action. PMID- 3533920 TI - Multiplication-stimulating activity-induced alkalinization of canine renal proximal tubular cells. AB - The actions of a variety of polypeptide growth factors on isolated cells are thought to be initiated by stimulation of Na+-H+ exchange across the plasma membranes of the cells resulting in intracellular alkalinization. To determine whether insulin-like growth factors (IGFs) exert actions through such a mechanism, we incubated suspensions of canine renal proximal tubular segments with insulin or IGF I or with multiplication-stimulating activity (MSA)/IGF II. Changes in intracellular pH were detected by measurements of the distribution of [14C]5,5-dimethoxazolidine-2,4-dione. Incubation of segments with 10(-9) M MSA under conditions such that extracellular [Na+] greater than intracellular [Na+] effected intracellular alkalinization detectable within 1-2 min. Alkalinization was not observed under conditions where this gradient was not present. Alkalinization was not prevented by inclusion of 1 mM 4-acetamido-4' isothiocyanostilbene-2,2'-disulfonic acid or 1 mM ouabain in incubations, but was inhibited by amiloride. Incubation of proximal tubular segments with as little as 10(-11) M MSA effected intracellular alkalinization. Incubation with as much as 10(-6) M insulin or IGF I did not. Our findings are consistent with an action of MSA/IGF II to stimulate Na+-H+ exchange across the plasma membrane of the renal proximal tubular cell. It is possible that the stimulation represents a mechanism by which actions of IGF II are initiated in growth factor-sensitive cells. PMID- 3533921 TI - Activities and incision patterns of ABC excinuclease on modified DNA containing single-base mismatches and extrahelical bases. AB - ABC excision nuclease of Escherichia coli is a DNA repair enzyme that recognizes major helical distortions caused by bulky base adducts and incises on both sides of the adduct, thus removing the modified nucleotides in the form of a 12-13-base long oligomer. We tested the enzyme with substrates that contained unusual helical structures caused by single-base mismatches or one, three, or four extrahelical bases (loops). We find that the enzyme does not cut DNAs containing helical perturbations caused by these structures. However, when the mismatched or extrahelical bases are modified with 1-cyclohexyl-3-(2-morpholinoethyl) carbodiimide, a reagent specific for unpaired G and T residues, the enzyme incises at the modified nucleotides in the regular manner. In addition, we find that when mismatches and loops are located near pyrimidine dimers and (6-4) photoproducts they do not inhibit incision at the photoproducts by the excinuclease but sometimes affect the incision pattern. Our results indicate that ABC excinuclease may be a useful enzymatic reagent to probe the structural changes caused by mismatches and deletions in DNA and provide additional information on the requirements for incision by this repair enzyme. PMID- 3533922 TI - tRNA binding sites on the subunits of Escherichia coli ribosomes. AB - Programmed 30 S subunits expose only one binding site, to which the different classes of tRNA (deacylated tRNAPhe, Phe-tRNAPhe, and N-acetylphenylalanyl (AcPhe)-tRNAPhe) bind with about the same affinity. Elongation factor Tu within the ternary complex does not contribute to the binding of Phe-tRNA. Binding of acylated or deacylated tRNA to 30 S depends on the cognate codon; nonprogrammed 30 S subunits do not bind tRNA to any significant extent. The existence of only one binding site/30 S subunit (and not, for example, two sites in 50% of the subunits) could be shown with Phe-tRNAPhe as well as deacylated tRNAPhe pursuing different strategies. Upon 50 S association the 30 S-bound tRNA appears in the P site (except the ternary complex which is found at the A site). Inhibition experiments with tetracycline demonstrated that the 30 S inhibition pattern is identical to that of the P site but differs from that of the A site of 70 S ribosomes. In contrast to 30 S subunits the 50 S subunit exclusively binds up to 0.2 and 0.4 molecules of deacylated tRNAPhe/50 S subunit in the absence and presence of poly(U), respectively, but neither Phe-tRNA nor AcPhe-tRNA. Noncognate poly(A) did not stimulate the binding indicating codon-anticodon interaction at the 50 S site. The exclusive binding of deacylated tRNA and its dependence on the presence of cognate mRNA is reminiscent of the characteristics of the E site on 70 S ribosomes. 30 and 50 S subunits in one test tube expose one binding site more than the sum of binding capacities of the individual subunits. The results suggest that the small subunit contains the prospective P site and the large subunit the prospective E site, thus implying that the A site is generated upon 30 S-50 S association. PMID- 3533923 TI - Reactivity of a sulfhydryl group of the ras oncogene product p21 modulated by GTP binding. AB - We have studied the sensitivity of sulfhydryl groups of a highly purified p21 protein of the v-rasH oncogene to a thiol-specific reagent, N-ethylmaleimide (NEM). Approximately 70% of GTP binding and autokinase activities of p21 were inactivated by NEM, and excessive amounts of GTP or GDP protected p21 activities. Thiol titration revealed the presence of one fast reactive cysteine residue, the susceptibility of which is modulated by GTP binding. A total of 4 and 6 residues, respectively, became titratable upon denaturation and reduction, suggesting the presence of a disulfide bond. This GTP-modulated sulfhydryl group was identified as Cys-80 in the following tryptic peptide sequence: NH2-Thr-Gly-Glu-Gly-Phe-Leu Cys-Val-Phe-Ala-Ile-Asn-Asn-Thr-Lys-COOH. This is based on the comparative tryptic peptide mapping of [14C]NEM-modified p21 in the presence and absence of GTP. The GTP-modulated peptide co-chromatographed with a synthetic peptide of the predicted sequence. Amino acid analysis of the purified [14C]NEM-modified peptide from tryptic digests of p21 also confirmed its identity. This region of p21 shares an extensive sequence homology with various G-proteins and appears to be in the vicinity of the GTP-binding domain of these proteins. PMID- 3533924 TI - Cloning and characterization of a mouse cysteine proteinase. AB - cDNA clones encoding a mouse cysteine proteinase were isolated from a cDNA library constructed from mRNA derived from the macrophage-like cell line J774. The DNA sequence predicts a protein that is closely related to, but distinct from, the lysosomal enzyme cathepsin H. Alignment of the predicted amino acid sequence with the known protein sequences for seven other cysteine proteinases suggests that the cloned DNA encodes a 334-residue protein containing both a 17 amino acid pre-region and a 96-amino acid pro-region. Consistent with this prediction, antiserum raised to a recombinant fusion protein expressed in Escherichia coli immunoprecipitated multiple forms of the cysteine proteinase in mouse peritoneal macrophages and fibroblasts. In pulse-chase experiments, a 36 kDa precursor, presumedly the pro-form, was converted intracellularly into a 28 kDa protein and subsequently into a 21-kDa protein. Indirect immunofluorescence microscopy results suggested that the cysteine proteinase was localized to lysosomes. Western blot analysis detected significantly more of the proteinase in thioglycolate-elicited peritoneal macrophages than in resident peritoneal macrophages. Northern blot analysis revealed that several cell lines failed to express mouse cysteine proteinase mRNA. PMID- 3533925 TI - Expression of smooth muscle and nonmuscle myosin heavy chains in cultured vascular smooth muscle cells. AB - We explored the hypothesis that discrepancies in the literature concerning the nature of myosin expression in cultured smooth muscle cells are due to the appearance of a new form of myosin heavy chain (MHC) in vitro. Previously, we used a very porous sodium dodecyl sulfate gel electrophoresis system to detect two MHCs in intact smooth muscles (SM1 and SM2) which differ by less than 2% in molecular weight (Rovner, A. S., Thompson, M. M., and Murphy, R. A. (1986) Am. J. Physiol. 250, C861-C870). Myosin-containing homogenates of rat aorta cells in primary culture were electrophoresed on this gel system, and Western blots were performed using smooth muscle-specific and nonmuscle-specific myosin antibodies. Subconfluent, rapidly proliferating cultures contained a form of heavy chain not found in rat aorta cells in vivo (NM) with electrophoretic mobility and antigenicity identical to the single unique heavy chain seen in nonmuscle cells. Moreover, these cultures expressed almost none of the smooth muscle heavy chains. In contrast, postconfluent growth-arrested cultures expressed increased levels of the two smooth muscle heavy chains, along with large amounts of NM. Analysis of cultures pulsed with [35S] methionine indicated that subconfluent cells were synthesizing almost exclusively NM, whereas postconfluent cells synthesized SM1 and SM2 as well as larger amounts of NM. Similar patterns of MHC content and synthesis were found in subconfluent and postconfluent passaged cells. These results show that cultured vascular smooth muscle cells undergo differential expression of smooth muscle- and nonmuscle-specific MHC forms with changes in their growth state, which appear to parallel changes in expression of the smooth muscle and nonmuscle forms of actin (Owens, G. K., Loeb, A., Gordon, D., and Thompson, M. M. (1986) J. Cell Biol. 102, 343-352). The reappearance of the smooth muscle MHCs in postconfluent cells suggests that density-related growth arrest promotes cytodifferentiation, but the continued expression of the nonmuscle MHC form in these smooth muscle cells indicates that other factors are required to induce the fully differentiated state while in culture. PMID- 3533926 TI - Deletion of the propeptide from human preproapolipoprotein A-II redirects cotranslational processing by signal peptidase. AB - The functions of NH2-terminal propeptides are not known. We have used apoA-II as a model to study prosegment structure/function relationships. The primary translation product of human apolipoprotein A-II mRNA contains an 18-amino acid signal peptide, a 5-amino acid propeptide, and the mature 77-amino acid plasma protein sequence. Its propeptide was deleted by site-directed mutagenesis of a cloned cDNA. The effects of this mutation on cotranslational translocation and proteolytic processing were assessed using an in vitro transcription/translation/microsomal membrane processing system. Deletion of the propeptide did not affect cotranslational translocation. However, without its propeptide, signal peptidase cleavage was redirected to a different site located between the 2nd and 3rd residues of the mature protein. Since the primary structure of the signal peptide was not altered in the mutant, these results suggest that sequences located downstream from the signal peptidase cleavage site (e.g. in propeptides) may modulate, or participate in defining, the correct site of cotranslational proteolytic processing. PMID- 3533927 TI - A mutation in Escherichia coli tRNA nucleotidyltransferase that affects only AMP incorporation is in a sequence often associated with nucleotide-binding proteins. AB - Escherichia coli strain 5C15 contains a mutation in the cca gene that decreases AMP incorporation by tRNA nucleotidyltransferase while leaving CMP incorporation unaffected. Earlier studies of the purified mutant enzyme suggested that the mutation was localized to the AMP-incorporating site. In order to analyze this mutation in more detail, the cca gene from strain 5C15 was cloned into plasmid pUC8. Analysis of tRNA nucleotidyltransferase activity in extracts of a strain transformed with this plasmid demonstrated an elevated level of CMP incorporation, but low AMP incorporation, as expected from the properties of the original mutant. Sequence analysis of the mutant cca gene revealed only a single G to A point mutation leading to a glycine to aspartic acid substitution at position 70 of the peptide chain. The amino acid change was localized to one of two Gly-X-Gly-X-X-Gly sequences present in the protein. This sequence has been identified previously near the nucleotide-binding domain of various proteins, but it has not been noted in enzymes that incorporate nucleotide residues. However, other sequences often associated with ATP-binding domains are not found in tRNA nucleotidyltransferase. The implications of these findings for our understanding of nucleotide-binding domains are discussed. PMID- 3533928 TI - Mechanism of hepatic assimilation of dipeptides. Transport versus hydrolysis. AB - To investigate dipeptide assimilation by the liver, a series of interrelated experiments were performed in rats. Partial hepatectomy prolonged the plasma half life (min) of Gly-Ala (3.42 +/- 0.22 versus 4.90 +/- 0.35, p less than 0.05) but had no significant effect on plasma half-life of Gly-Leu, Gly-Pro, or Gly-Sar. We then investigated the rate of disappearance (mumol X (g liver X h)-1) of the above four dipeptides (initial concentration = 1 mM) from the medium during isolated liver perfusion. The order of dipeptide disappearance was: Gly-Leu (8.75 +/- 0.65) greater than Gly-Ala (3.36 +/- 0.46) greater than Gly-Pro (1.29 +/- 0.54) greater than Gly-Sar (0.35 +/- 0.12). This order of dipeptide disappearance corresponded exactly to the order of the rates of glycine accumulation in the medium during liver perfusion with the four dipeptides. Addition of glucagon had no effect on the disappearance rate of Gly-Ala from the medium, but reduced accumulation rates of glycine (3.39 +/- 0.30 versus 1.42 +/- 30, p less than 0.01) and alanine (4.42 +/- 0.66 versus 1.35 +/- 0.39, p less than 0.01). Finally, we found that hydrolysis by the liver plasma membranes and/or perfusion medium accounted for disappearance of dipeptides. In conclusion, the liver does not appear to have a transport system for dipeptides, but assimilates dipeptides by extracellular hydrolysis. Hydrolysis is achieved by enzymes either located on the plasma membranes or released from the cytosol. The amino acid residues released as the result of dipeptide hydrolysis are then taken up by the liver. PMID- 3533929 TI - Use of an azido-ubiquinone derivative to identify subunit I as the ubiquinol binding site of the cytochrome d terminal oxidase complex of Escherichia coli. AB - The radiolabeled, photoreactive azido-ubiquinone derivative (azido-Q), 3-azido-2 methyl-5-methoxy-6-(3,7-dimethyl-[3H]octyl)- 1,4-benzoquinone, was used to investigate the active site of ubiquinol oxidase activity of the cytochrome d complex, a two-subunit terminal oxidase of Escherichia coli. The azido-Q, when reduced by dithioerythritol, was shown to support enzymatic oxygen consumption by the cytochrome d complex that was 8% of the rate observed with ubiquinol-1. This observation provided the rationale behind further studies of the possible photoinactivation and labeling of the active site by this azido-Q. Ten min of photolysis of the purified cytochrome d complex in the presence of the azido-Q resulted in a 60% loss of the ubiquinol-1 oxidase activity. Uptake of the radiolabeled azido-Q by the cytochrome d complex was correlated to the photoinactivation of the ubiquinol-1 oxidase activity. Both increased linearly during the first 4 min of photolysis and reached 90% of the maximum within 10 min. Photolysis times longer than 10 min resulted in no increase in the maximum of 2 mol of azido-Q incorporated per mol of enzyme. The rate of azido-Q uptake by subunit I, but not subunit II, correlated well with the rate of loss of ubiquinol oxidase activity. Use of ubiquinol-0, which is not oxidized by the enzyme, to competitively inhibit radiolabeling of nonspecific binding sites, resulted in a significant decrease (42%) of azido-Q labeling of subunit II while it did not affect the labeling of subunit I. After photolysis for 4 min, the ratio of radiolabeled azido-Q in subunits I to II of the complex was 4.3 to 1.0. These observations support the conclusion that the ubiquinol substrate binding site is located on subunit I of the cytochrome d complex. PMID- 3533930 TI - The role of thioredoxin in filamentous phage assembly. Construction, isolation, and characterization of mutant thioredoxins. AB - Filamentous phage assembly in vivo shows an absolute requirement for thioredoxin and a partial requirement for thioredoxin reductase. Mutants in which one or both of the active site cysteine residues of thioredoxin were changed to alanine or serine were constructed and shown to support filamentous phage assembly. Some of the mutants were almost as effective as wild-type thioredoxin, while others supported phage assembly only when high levels of the mutant protein were present in the infected cell. The mutant proteins were all inactive in an assay which couples oxidation of NADPH to reduction of 5,5'-dithiobis-2-nitrobenzoic acid) via thioredoxin reductase and thioredoxin. These active site mutants make phage assembly completely independent of thioredoxin reductase, which suggests that the phage needs, and the active site mutants provide, the proteins in the reduced conformation. Other mutants were isolated on the basis of their failure to support filamentous phage growth. These specified mutant thioredoxin proteins with varying levels of redox activity in vivo and in vitro. The locations of these mutations suggest that the surface of thioredoxin thought to interact with thioredoxin reductase also interacts with the filamentous phage assembly machinery. An in vivo assay for thioredoxin redox function, based on the ability of cells to utilize methionine sulfoxide, was developed. Met- cells containing mutant thioredoxins that are inactive in vitro do not form colonies on plates containing methionine sulfoxide as the sole methionine source. PMID- 3533931 TI - Interaction of mutant thioredoxins of Escherichia coli with the gene 5 protein of phage T7. The redox capacity of thioredoxin is not required for stimulation of DNA polymerase activity. AB - DNA polymerase activity in Escherichia coli cells infected with bacteriophage T7 resides in a protein complex consisting of the T7 gene 5 protein and E. coli thioredoxin in a 1 to 1 stoichiometry. We have analyzed nine mutant thioredoxins, both in vivo and in vitro, for their ability to interact with the T7 gene 5 protein and stimulate the DNA polymerase and exonuclease activities inherent in gene 5 protein. The efficiency of plating of T7 on E. coli thioredoxin mutants depends strongly on the copy number of the respective mutant thioredoxin allele. Plating efficiencies at a constant copy number correlate well with the affinity of the purified mutant proteins for T7 gene 5 protein. The observed dissociation constant, Kobs, is increased between 5 and several hundredfold at 42 degrees C compared to wild-type thioredoxin. The maximum polymerase activity of the reconstituted gene 5 protein-thioredoxin complex at saturating concentrations of mutant thioredoxins, however, is reduced by less than 20%. Consequently, none of the mutant thioredoxins acts as a competitive inhibitor of wild-type thioredoxin. The active-site disulfide of thioredoxin is not essential for the activities of the gene 5 protein-thioredoxin complex. Both cysteines can be replaced without significantly affecting the maximum polymerase or exonuclease activities. Substitution or alkylation of either cysteine, however, reduces the affinity for gene 5 protein drastically, indicating that the active site is part of the thioredoxin surface involved in the protein-protein interaction. PMID- 3533932 TI - A role for proteins S3 and S14 in the 30 S ribosomal subunit. AB - Small ribosomal subunits prepared by the method of Kirillov et al. (Kirillov, S. V., Makhno, V. I., Peshin, N. N., and Semenkov, Yu. P. (1986) Nucleic Acids Res. 5, 4305-4315) are active but fail to reconstitute. The inability to reconstitute is due to a deficiency in proteins S3 and S14. Supplementation of the protein component with pure S3 and S14 leads to an enhancement of the activity of the reconstituted product. Our results provide evidence that these two proteins are involved in assembly but may not be required once the 30 S subunit has been properly assembled. PMID- 3533933 TI - Kinetic analysis of lamB mutants suggests the signal sequence plays multiple roles in protein export. AB - We have developed a quantitative assay to measure the rate of processing of precursor LamB into mature protein and have used this assay to characterize 10 previously isolated and 3 new lamB signal sequence mutants. The data suggest that the LamB signal sequence serves a complex function. Our assay has revealed five types of signal sequence defect: 1) a strong kinetic defect resulting from alteration of the secondary structure in the putative alpha-helical region in the hydrophobic core, 2) a strong, or 3) a weak kinetic defect due to placement of a charged residue in the hydrophobic core, 4) decreased synthesis of LamB, and 5) both a decrease in synthesis and a strong kinetic defect. The effect of an extragenic suppressor, prlA4 on the rate of processing pLamB containing signal sequence mutations was also examined and compared to the rates in wild-type strains. It was found that prlA4 increases the rate of processing in some, but not all, mutants having a kinetic defect while having no effect on the decreased synthesis seen in mutants of types 4 and 5. PMID- 3533934 TI - Modulation of basal glucose transporter Km in the adipocyte by insulin and other factors. AB - We have previously described experimental conditions where basal methylglucose transport in adipocytes exhibited an apparent Km of approximately 35 mM. Under those conditions insulin stimulated transport predominantly by decreasing the transport Km (Whitesell, R. R., and Abumrad, N. A. (1985) J. Biol. Chem. 260, 2894-2899). Our findings were in contrast with earlier reports that the Km of basal glucose transport was low (3-5 mM) and similar to that of transport in insulin-treated cells. In this study we have investigated the effect of different experimental conditions on the kinetics of basal glucose transport in adipocytes. When transport was assayed at 37 degrees C, cell agitation for 10 min prior to the transport assay decreased the basal Km from 35 to 12 mM. Deprivation of metabolic substrate produced a further reduction down to 2 mM. Refeeding starved cells with 1 mM glucose returned the Km back up to 12 mM in agitated cells and to 40 mM in stabilized cells. The effects of agitation to lower and of glucose to raise the basal Km were prevented by preincubating cells with dinitrophenol. Cell agitation or substrate lack did not alter the Vmax of basal transport and were without effect on both Km and Vmax in insulin-treated cells. The temperature dependencies of the kinetics of basal and stimulated transport were studied. A decrease in the assay temperature from 37 to 23 degrees C caused both basal Km and Vmax to drop proportionately from 25 to 5 mM, and 13 to 3.6 nmol/(microliter X min), respectively. In insulin-stimulated cells, only the Vmax was decreased (Km went from 3.5 to 3 mM, Vmax from 45 to 17 nmol/(microliter X min]. The results support the concept that experimental conditions can produce large changes in the Km of basal glucose transporters. Furthermore they explain why, under certain assay conditions (with temperatures around 23 degrees C or with deprivation of metabolic substrate), the effect of insulin on transport Km is not observed. Our data also suggest that basal transport characteristics do not persist in insulin-treated cells. We would propose that one of the actions of insulin (in addition to raising Vmax) is to change the characteristics of basal transporters by overriding metabolic factors which keep the Km high. Alternatively, insulin could cause the disappearance of basal transporters as new and different ones are recruited from intracellular stores. PMID- 3533935 TI - Enzymes of vitamin B6 degradation. Purification and properties of pyridoxine 5' dehydrogenase (oxidase). AB - Isolation and identification of a soil bacterium, Arthrobacter Cr-7, that grows with pyridoxine as a sole source of carbon and nitrogen are described. An inducible pyridoxine 5'-dehydrogenase (oxidase) (EC 1.1.99.9) that catalyzes conversion of pyridoxine to isopyridoxal, Pyridoxine + X----isopyridoxal + XH2, the first step in utilization of pyridoxine as a growth substrate by this organism, was purified about 520-fold to homogeneity. The enzyme (Mr = 112,000) is a dimer of probably identical subunits and requires FAD (KD(app) = 0.24 microM) as coenzyme. It oxidizes only pyridoxine (Km = 0.18 mM) and a few related compounds (4-deoxypyridoxine, pyridoxamine, pyridoxal) that contain a free 5 CH2OH group and utilizes oxygen (Km = 0.28 mM), 2,6-dichloroindophenol, or quinones, but not NAD+ or NADP+, as hydrogen acceptors (X in reaction above). With pyridoxine and oxygen as substrates, the enzyme has a broad pH optimum (from pH 7.0 to 8.3), a Vmax of 11.9 mumol X min-1 X mg-1, and a turnover number of 22 s-1 at 25 degrees C. The enzyme is strongly inhibited by sulfhydryl reagents. Except for its substrate specificity, these properties do not differ greatly from those of other flavin-dependent oxidases. PMID- 3533936 TI - Enzymes of vitamin B6 degradation. Purification and properties of isopyridoxal dehydrogenase and 5-formyl-3-hydroxy-2-methylpyridine-4-carboxylic-acid dehydrogenase. AB - Two NAD+-dependent, highly specific pyridine-5-aldehyde dehydrogenases, 5-formyl 3-hydroxy-2-methylpyridine-4-carboxylic-acid (Compound 1) dehydrogenase and isopyridoxal dehydrogenase, were purified to homogeneity from Pseudomonas MA-1 and Arthrobacter Cr-7, respectively. Both enzymes are induced in response to growth of the organisms on pyridoxine and catalyze steps in the degradation of this compound by these organisms. Compound 1 dehydrogenase (Mr = 65,000) contains two subunits of equal size with methionine as the NH2-terminal amino acid and acts optimally at pH 7.8-8.5. It catalyzes with equal facility (turnover number = 400-670 s-1 molecule-1) both the oxidation of Compound 1 (Km = 65 microM) by NAD+ (Km = 25 microM) to 3-hydroxy-2-methylpyridine-4,5-dicarboxylic acid and the reduction of Compound 1 by NADH (Km = 20 microM) to 4-pyridoxic acid and appears to act as a true dismutase. The possible advantage to the organism of its ability to act as a dismutase is discussed briefly. No oxidation of 4-pyridoxic acid by this enzyme was observed. Isopyridoxal dehydrogenase (Mr = 242,000) contains four subunits of equal size, again with methionine at the NH2 terminus. At its optimal pH of 8.0-8.6, it catalyzes the oxidation of isopyridoxal (Km = 40 microM, turnover number = 10 s-1 molecule-1) by NAD+ (Km = 40 microM) to a mixture of 5 pyridoxic acid and 5-pyridoxolactone, which are produced in constant ratio throughout the course of the reaction. Formation of the two products, although unusual, is readily understandable in terms of the structure of isopyridoxal in solution or the structure of a possible acyl-enzyme intermediate in the oxidative reaction. PMID- 3533937 TI - Hormonal regulation of lipogenic enzymes in chick embryo hepatocytes in culture. Expression of the fatty acid synthase gene is regulated at both translational and pretranslational steps. AB - Mechanisms involved in the multihormonal regulation of fatty acid synthase have been investigated by comparing levels of its mRNA with rates of enzyme synthesis in chick embryo hepatocytes in culture. Triiodothyronine or insulin caused about a 2.5-fold increase in the relative rate of synthesis of fatty acid synthase. Together, these hormones were synergistic, stimulating enzyme synthesis by nearly 40-fold (Fischer, P.W.F., and Goodridge, A.G. (1978) Arch. Biochem. Biophys. 190, 332-344). Addition of triiodothyronine stimulated increases in mRNA levels comparable to increases in enzyme synthesis whether insulin was present or not. Thus, triiodothyronine regulates fatty acid synthase primarily by controlling the amount of its mRNA. Addition of insulin, in the presence of triiodothyronine, stimulated enzyme synthesis by 14-fold and mRNA levels by only 2-fold. In the absence of triiodothyronine, insulin had no effect on mRNA levels. Thus, insulin has a major effect on the translation of fatty acid synthase mRNA. After the addition of triiodothyronine, fatty acid synthase mRNA accumulated with sigmoidal kinetics, approaching a new steady state about 48 h after the addition of hormone. Puromycin, an inhibitor of protein synthesis, blocked the effect of triiodothyronine. We suggest that the abundances of both fatty acid synthase and malic enzyme mRNAs are regulated by a common triiodothyronine-induced peptide intermediate which has a relatively long half-life. Glucagon caused an 80% decrease in the synthesis of fatty acid synthase (Fischer, P.W.F., and Goodridge, A.G. (1978) Arch. Biochem. Biophys. 190, 332-344) and a 60% decrease in the level of fatty acid synthase mRNA. Thus, glucagon regulates fatty acid synthase by controlling the concentration of its mRNA. The synthesis of malic enzyme also was inhibited by glucagon at a pretranslational step, but the inhibition was almost complete. Thus, despite coordinated regulation of the concentrations of these enzymes during starvation and refeeding, individual hormones sometimes regulate synthesis of the two enzymes at the same step and to about the same degree and sometimes at different steps or to very different degrees. PMID- 3533938 TI - A high molecular weight protease in the cytosol of rat liver. II. Properties of the purified enzyme. AB - The properties of a soluble endoprotease from rat liver were studied. The enzyme was purified in a latent form. It sedimented as a single component with a sedimentation coefficient (S(0)20,w) of 19.8 S. Measurement by quasi-elastic light scattering gave a diffusion coefficient (D(0)20,w) of 2.5 X 10(-7) cm2 X s 1 and an effective hydrodynamic radius of 85 A. The enzyme had an unusually high molecular weight, estimated as 743,000 by sedimentation equilibrium and 722,000 by sedimentation velocity and diffusion measurements and as 760,000 by a recently developed low-angle laser light scattering method. Judging from electron microscopic observation and the calculated frictional and axial ratios, the enzyme molecule is disc-shaped. Analysis of the far-ultraviolet circular dichroic spectrum showed that the enzyme contains 50% alpha-helical, 25% beta-sheet, and 15% unordered structures with 10% beta-turns. The isoelectric point of the enzyme is 5.0. These properties indicate that the purified enzyme is a homogeneous molecule. In addition, the enzyme is a simple protein since it contains no measurable amounts of nucleic acid carbohydrate or lipid. PMID- 3533939 TI - Interactions of the DNA polymerase and gene 4 protein of bacteriophage T7. Protein-protein and protein-DNA interactions involved in RNA-primed DNA synthesis. AB - Three proteins catalyze RNA-primed DNA synthesis on the lagging strand side of the replication fork of bacteriophage T7. Oligoribonucleotides are synthesized by T7 gene 4 protein, which also provides helicase activity. DNA synthesis is catalyzed by gene 5 protein of the phage, and processivity of DNA synthesis is conferred by Escherichia coli thioredoxin, a protein that is tightly associated with gene 5 protein. T7 DNA polymerase and gene 4 protein associate to form a complex that can be isolated by filtration through a molecular sieve. The complex is stable in 50 mM NaCl but is dissociated by 100 mM NaCl, a salt concentration that does not inhibit RNA-primed DNA synthesis. T7 DNA polymerase forms a stable complex with single-stranded M13 DNA at 50 mM NaCl as measured by gel filtration, and this complex requires 200 mM NaCl for dissociation, a salt concentration that inhibits RNA-primed DNA synthesis. Gene 4 protein alone does not bind to single stranded DNA. In the presence of MgCl2 and dTTP or beta, gamma-methylene dTTP, a gene 4 protein-M13 DNA complex that is stable at 200 mM NaCl is formed. The affinity of DNA polymerase for both gene 4 protein and single-stranded DNA leads to the formation of a gene 4 protein-DNA polymerase-M13 DNA complex even in the absence of nucleoside triphosphates. However, the binding of each protein to DNA plays an important role in mediating the interaction of the proteins with each other. High concentrations of single-stranded DNA inhibit RNA-primed DNA synthesis by diluting the amount of proteins bound to each template and reducing the frequency of protein-protein interactions. Preincubation of gene 4 protein, DNA polymerase, and M13 DNA in the presence of dTTP forms protein-DNA complexes that most efficiently catalyze RNA-primed DNA synthesis in the presence of excess single-stranded competitor DNA. PMID- 3533941 TI - Purification and characterization of the OmpR protein, a positive regulator involved in osmoregulatory expression of the ompF and ompC genes in Escherichia coli. AB - The OmpR protein is a positive regulator involved in osmoregulatory expression of the ompF and ompC genes, which respectively code for major outer membrane proteins OmpF and OmpC of Escherichia coli. The OmpR protein has been purified to homogeneity from an overproducing strain harboring an ompR gene-carrying plasmid. Throughout the purification the OmpR protein behaved as a single entity. The molecular weight determined on sodium dodecyl sulfate-polyacrylamide gel, the total amino acid composition, and the NH2-terminal amino acid sequence of the purified protein were essentially the same as those deduced from the nucleotide sequence of the ompR gene. Molecular weight determination and cross-linking study on the native protein revealed that the purified protein exists as a monomer. The purified OmpR protein was specifically bound to the promoter regions of the ompC and ompF genes. Experiments with a series of upstream deletions of the ompC and ompF promoters revealed that the region upstream from the -35 region was indispensable for OmpR binding to both the ompC and the ompF promoters. Although it has been proposed that depending on the medium osmolarity the OmpR protein may exist in two alternative structures, which respectively regulate functioning of the ompC and the ompF promoters, the purified OmpR protein appeared to be homogeneous and interacted with both promoters to the same extent. PMID- 3533940 TI - Dissection of RNA-primed DNA synthesis catalyzed by gene 4 protein and DNA polymerase of bacteriophage T7. Coupling of RNA primer and DNA synthesis. AB - Gene 4 protein and DNA polymerase of bacteriophage T7 catalyze RNA-primed DNA synthesis on single-stranded DNA templates. T7 DNA polymerase exhibits an affinity for both gene 4 protein and single-stranded DNA, and gene 4 protein binds stably to single-stranded DNA in the presence of dTTP (Nakai, H. and Richardson, C. C. (1986) J. Biol. Chem. 261, 15208-15216). Gene 4 protein-T7 DNA polymerase-template complexes may be formed in both the presence and absence of nucleoside 5'-triphosphates. The protein-template complexes may be isolated free of unbound proteins and nucleotides by gel filtration and will catalyze RNA primed DNA synthesis in the presence of ATP, CTP, and the four deoxynucleoside 5' triphosphates. RNA-primed DNA synthesis may be dissected into separate reactions for primer synthesis and DNA synthesis. Upon incubation of gene 4 protein with single-stranded DNA, ATP, and CTP, a primer-template complex is formed; it is likely that gene 4 protein mediates stable binding of the oligonucleotide to the template. The complex, purified free of unbound proteins and nucleotides, supports DNA synthesis upon addition of DNA polymerase and deoxynucleoside 5' triphosphates. Association of primers with the template is increased by the presence of dTTP or DNA polymerase during primer synthesis. DNA synthesis supported by primer-template complexes initiates predominantly at gene 4 recognition sequences, indicating that primers are bound to the template at these sites. PMID- 3533942 TI - Crystallization and preliminary X-ray study of AMP nucleosidase. AB - Adenosine-5'-monophosphate nucleosidase from Escherichia coli has been crystallized in the presence of its strong competitive inhibitor formycin 5' monophosphate and its allosteric activator adenosine 5'-triphosphate. Crystals are tetragonal bipyramids which grow to 1.2 mm in the longest dimension, are resistant to radiation damage, and diffract to a resolution of 3.5 A. The space group is P4(1)2(1)2 or P4(3)2(1)2, and the unit cell dimensions are a = 120.1 A and c = 243.7 A. The asymmetric unit is estimated to contain four subunits of 52,000 daltons. The crystals appear suitable for single crystal x-ray structure investigation. PMID- 3533943 TI - ["In vitro" adhesion of a composite resin with a dentin adhesive. Effect of microhardness]. PMID- 3533944 TI - [Rational use of posterior composites. Current criteria for selection and use]. PMID- 3533945 TI - [Comparative structural study of 2 precious alloys (Au, Pd, In) for ceramometal technics. 1]. PMID- 3533946 TI - [Current status of semi-precious alloys for dental use. Development of chemical, structural, electrochemical and biocompatible properties]. PMID- 3533947 TI - The use of demineralized bone matrix in the repair of segmental defects. Augmentation with extracted matrix proteins and a comparison with autologous grafts. AB - A soluble protein component of bone, bone morphogenetic protein, and decalcified bone matrix have been shown to induce the formation of bone in extraosseous tissue. Clinical and animal studies investigating the use of these materials as bone grafts have shown radiographic and histological evidence of formation of bone, but the clinical usefulness of these grafts remains unknown. This study compared the healing processes when plasma-coated demineralized bone matrix and autologous cancellous bone were used to graft segmental defects of bone. A standard procedure was used to make a two-centimeter defect bilaterally in the ulna of forty-eight skeletally mature New Zealand White rabbits. In each rabbit, one ulnar defect was grafted with autologous citrated plasma-coated demineralized bone matrix while the other defect served as a control and was grafted with either autologous cancellous bone from the iliac crest, demineralized bone matrix, or demineralized bone matrix augmented with bone proteins that had been extracted with guanidinium hydrochloride. The ulnar defect was stabilized by the intact radius, and no supplemental device was necessary for fixation. To examine spontaneous healing in this model, one group of rabbits had a control defect that was not grafted. The grafts were periodically evaluated by radiographs, and twelve weeks after surgery the grafts were harvested and tested to failure in a standard torsion-test machine. The mechanical parameters were calculated, and histological examination of major fragments of the grafts was performed. The results of the radiographic and histological evaluation showed that all of the grafted ulnae healed, with fusion of the graft to the cut ends of the defect and reformation of approximately normal anatomy. No ungrafted ulnar defects healed. The results from the mechanical tests were evaluated by comparing the defect that was grafted with plasma-coated demineralized bone matrix with the control graft in each animal. These data showed that: twelve weeks after grafting, the normal ulnae were significantly stronger than the ulnae that had been grafted with plasma-coated demineralized bone matrix; the ulnae that had been grafted with plasma-coated demineralized bone matrix and those that had been grafted with autologous bone were equivalent in strength; and twelve weeks after grafting, grafts of demineralized bone matrix that were augmented with extracted bone proteins were significantly stronger than those that had not been so augmented. PMID- 3533948 TI - Free flaps in selected burn patients. PMID- 3533949 TI - The role of DNA damage in chemical carcinogenesis of aromatic amines. AB - Many findings support the notion that the generation of DNA adducts by aromatic amines is causally related to carcinogenesis. Adducts have been identified in most cases and representative examples are reviewed. However, extent and persistence of DNA adducts (DNA dose) does not correlate satisfactorily with the tumor response of different tissues. Distribution of DNA damage, repair, indirect and secondary DNA damage are discussed as possible explanations for the observed noncorrelations. In addition, however, it is proposed to pay attention to specific mechanisms such as receptor mediated cellular effects which are not related to the generation of electrophiles. The effects of trans-4-aminostilbene and 2-amino-fluorene derivatives on rat liver are compared. It is concluded that trans-4-acetylamino-stilbene is a strong liver tumor initiator but an incomplete liver carcinogen lacking tumor promoting properties, and that 2 acetylaminofluorene is a complete liver carcinogen with initiating and promoting properties. PMID- 3533950 TI - DNA adducts by N-nitroso compounds. AB - Some unsolved problems in DNA alkylation by N-nitroso compounds are discussed in this overview. Does O6 alkylation of guanine represent the initiating event exclusively or are O4 alkylation of thymidine and phosphate triester formation also involved in the initiating process? Does the formation of rearranged DNA alkylation products by longer chained alkylnitroso compounds have any significance for the carcinogenic effects of these compounds? The concept of hard and soft acids and bases (HSAB principle) as a qualitative model can predict the changes in the DNA alkylation pattern by branched carbenium ions. PMID- 3533951 TI - Secretion of a malarial histidine-rich protein (Pf HRP II) from Plasmodium falciparum-infected erythrocytes. AB - Plasmodium falciparum-infected erythrocytes (IRBCs) synthesize several histidine rich proteins (HRPs) that accumulate high levels of [3H]histidine but very low levels of amino acids such as [3H]isoleucine or [35S]methionine. We prepared a monoclonal antibody which reacts specifically with one of these HRPs (Pf HRP II) and studied the location and synthesis of this protein during the parasite's intracellular growth. With the knob-positive Malayan Camp strain of P. falciparum, the monoclonal antibody identified a multiplet of protein bands with major species at Mr 72,000 and 69,000. Pf HRP II synthesis began with immature parasites (rings) and continued through the trophozoite stage. The Mr 72,000 band of Pf HRP II, but not the faster moving bands of the multiplet, was recovered as a water-soluble protein from the culture supernatant of intact IRBCs. Approximately 50% of the total [3H]histidine radioactivity incorporated into the Mr 72,000 band was extracellular between 2 and 24 h of culture. Immunofluorescence and cryothin-section immunoelectron microscopy localized Pf HRP II to several cell compartments including the parasite cytoplasm, as concentrated "packets" in the host erythrocyte cytoplasm and at the IRBC membrane. Our results provide evidence for an intracellular route of transport for a secreted malarial protein from the parasite through several membranes and the host cell cytoplasm. PMID- 3533952 TI - A common spectrum of polypeptides occurs in secretion granule membranes of different exocrine glands. AB - A highly purified membrane preparation from rat parotid secretion granules has been used as a comparative probe to examine the extent of compositional overlap in granule membranes of three other exocrine secretory tissues--pancreatic, lacrimal, and submandibular--from several standpoints. First, indirect immunofluorescent studies using a polyclonal polyspecific anti-parotid granule membrane antiserum has indicated a selective staining of granule membrane profiles in all acinar cells of all tissues. Second, highly purified granule membrane subfractions have been isolated from each exocrine tissue; comparative two-dimensional (isoelectric focusing; SDS) PAGE of radioiodinated granule membranes has identified 10-15 polypeptides of identical pI and apparent molecular mass. These species are likely to be integral membrane components since they are not extracted by either saponin-sodium sulfate or sodium carbonate (pH 11.5) treatments, and they do not have counterparts in the granule content. Finally, the identity among selected parotid and pancreatic radioiodinated granule membrane polypeptides has been documented using two-dimensional peptide mapping of chymotryptic and tryptic digests. These findings clearly indicate that exocrine secretory granules, irrespective of the nature of stored secretion, comprise a type of vesicular carrier with a common (and probably refined) membrane composition. Conceivably, the polypeptides identified carry out general functions related to exocrine secretion. PMID- 3533953 TI - Biogenesis of photosystem II complexes: transcriptional, translational, and posttranslational regulation. AB - The integral membrane proteins of photosystem II (PS II) reaction center complexes are encoded by chloroplast genomes. These proteins are absent from thylakoids of PS II mutants of algae and vascular plants as a result of either chloroplast or nuclear gene mutations. To resolve the molecular basis for the concurrent absence of the PS II polypeptides, protein synthesis rates and mRNA levels were measured in mutants of Chlamydomonas reinhardtii that lack PS II. The analyses show that one nuclear gene product regulates the levels of transcripts from the chloroplast gene encoding the 51-kD chlorophyll a-binding polypeptide (polypeptide 5) but is not involved in the synthesis of other chloroplast mRNAs. Another nuclear product is specifically required for translation of mRNA encoding the 32-34-kD polypeptide, D1. The absence of either D1 or polypeptide 5 does not eliminate the synthesis and thylakoid insertion of two other integral membrane proteins of PS II, the chlorophyll a-binding polypeptide of 46 kD (polypeptide 6) and the 30-kD "D1-like" protein, D2. However, these two unassembled subunits cannot be properly processed and/or are degraded in the mutants even though they reside in the membrane. In addition, pulse labeling of the nuclear mutants and a chloroplast mutant that does not synthesize D1 mRNA indicates that synthesis of polypeptide 5 and D1 is coordinated at the translational level. A model is presented to explain how absence of one of the two proteins could lead to translational arrest of the other. PMID- 3533954 TI - A-CAM: a 135-kD receptor of intercellular adherens junctions. I. Immunoelectron microscopic localization and biochemical studies. AB - The recently described adherens junction-specific 135-kD protein (Volk, T., and B. Geiger, 1984, EMBO (Eur. Mol. Biol. Organ.) J., 3:2249-2260) was localized along cardiac muscle intercalated discs by immunogold labeling of ultrathin frozen sections. Analysis of this labeling indicated that the 135-kD protein, adherens junction-specific cell adhesion molecule (A-CAM), is tightly associated with the plasma membrane unlike vinculin labeling, which was present along the membrane-bound plaques of the fascia adherens. In cultured chick lens cells, A CAM was associated with Ca2+-dependent junctions that were cleaved upon a decrease of extracellular Ca2+ concentrations to less than or equal to 0.5 mM. In the chelator-separated junction, A-CAM became exposed to exogenously added antibodies or to proteolytic enzymes. Upon addition of trypsin to EGTA-treated cells, A-CAM was cleaved into three major cell-bound antigenic peptides with apparent molecular masses of 78, 60, and 46 kD, suggesting that the extracellular domain of A-CAM has a size greater than or equal to kD. Incubation of electrophoretic gels with 125I-concanavalin A (Con A) indicated that one of the major Con A-binding proteins in chicken lens membranes is a integral of 135-kD glycoprotein that was partially purified on Con A-Sepharose column and identified as A-CAM by immunoblotting. Detergent partitioning assay using Triton X-114 biphasic system was carried out to determine whether A-CAM displays properties of an integral membrane protein. This assay indicated that the intact A-CAM molecule was recovered in the buffer phase but its cell-associated tryptic peptides, which presumably lost a great part of the A-CAM extracellular extension, readily partitioned into the detergent phase. The results obtained in this and in the following paper (Volk, T., and B. Geiger, 1986, J. Cell Biol., 103:1451-1464) strongly suggest that A-CAM is a Ca2+-dependent adherens junction-specific membrane glycoprotein that is involved in intercellular adhesion in these sites. PMID- 3533955 TI - The dynamic state of heat shock proteins in chicken embryo fibroblasts. AB - Subcellular fractionation and immunofluorescence microscopy have been used to study the intracellular distributions of the major heat shock proteins, hsp 89, hsp 70, and hsp 24, in chicken embryo fibroblasts stressed by heat shock, allowed to recover and then restressed. Hsp 89 was localized primarily to the cytoplasm except during the restress when a portion of this protein concentrated in the nuclear region. Under all conditions, hsp 89 was readily extracted from cells by detergent. During stress and restress, significant amounts of hsp 70 moved to the nucleus and became resistant to detergent extraction. Some of this hsp 70 was released from the insoluble form in an ATP-dependent reaction. Hsp 24 was confined to the cytoplasm and, during restress, aggregated to detergent-insoluble perinuclear phase-dense granules. These granules dissociated during recovery and hsp 24 could be solubilized by detergent. The nuclear hsps reappeared in the cytoplasm in cells allowed to recover at normal temperatures. Sodium arsenite also induces hsps and their distributions were similar to that observed after a heat shock, except for hsp 89, which remained cytoplasmic. We also examined by immunofluorescence the cytoskeletal systems of chicken embryo fibroblasts subjected to heat shock and found no gross morphological changes in cytoplasmic microfilaments or microtubules. However, the intermediate filament network was very sensitive and collapsed around the nucleus very shortly after a heat shock. The normal intermediate filament morphology reformed when cells were allowed to recover from the stress. Inclusion of actinomycin D during the heat shock--a condition that prevents synthesis of the hsps--did not affect the intermediate filament collapse, but recovery of the normal morphology did not occur. We suggest that an hsp(s) may aid in the formation of the intermediate filament network after stress. PMID- 3533956 TI - Microtubules and the endoplasmic reticulum are highly interdependent structures. AB - The interrelationships of the endoplasmic reticulum (ER), microtubules, and intermediate filaments were studied in the peripheral regions of thin, spread fibroblasts, epithelial, and vascular endothelial cells in culture. We combined a fluorescent dye staining technique to localize the ER with immunofluorescence to localize microtubules or intermediate filaments in the same cell. Microtubules and the ER are sparse in the lamellipodia, but intermediate filaments are usually completely absent. These relationships indicate that microtubules and the ER advance into the lamellipodia before intermediate filaments. We observed that microtubules and tubules of the ER have nearly identical distributions in lamellipodia, where new extensions of both are taking place. We perturbed microtubules by nocodazole, cold temperature, or hypotonic shock, and observed the effects on the ER distribution. On the basis of our observations in untreated cells and our experiments with microtubule perturbation, we conclude that microtubules and the ER are highly interdependent in two ways: (a) polymerization of individual microtubules and extension of individual ER tubules occur together at the level of resolution of the fluorescence microscope, and (b) depolymerization of microtubules does not disrupt the ER network in the short term (15 min), but prolonged absence of microtubules (2 h) leads to a slow retraction of the ER network towards the cell center, indicating that over longer periods of time, the extended state of the entire ER network requires the microtubule system. PMID- 3533957 TI - Correction of abnormal matrix formed by cmd/cmd chondrocytes in culture by exogenously added cartilage proteoglycan. AB - The cartilage matrix deficiency (cmd/cmd) mouse fails to synthesize the core protein of cartilage-characteristic proteoglycan (cartilage PG). Chondrocytes from the cmd/cmd cartilage cultured in vitro produced nodules with greatly reduced extracellular matrix. Immunofluorescence staining revealed that the nodules of mutant cells differed from the normal in lacking cartilage PG and in uneven and reduced deposition of type II collagen. Exogenously added cartilage PG prepared from either normal mouse cartilage or Swarm rat chondrosarcoma to the culture medium was incorporated exclusively into the extracellular matrices of the nodules, with a concurrent correction of the abnormal distribution pattern of type II collagen. The incorporation of cartilage PG into the matrix was disturbed by hyaluronic acid or decasaccharide derived therefrom, suggesting that the incorporation process involves the interaction of added proteoglycan with hyaluronic acid. Both the hyaluronic acid-binding region and the protein-enriched core molecule prepared from rat chondrosarcoma cartilage PG could also be incorporated but, unlike the intact cartilage PG, they were distributed equally in the surrounding zones where fibroblast-like cells predominate. The results indicate that the intact form of cartilage PG is required for specific incorporation into the chondrocyte nodules, and further suggest that cartilage PG plays a regulatory role in the assembly of the matrix macromolecules. PMID- 3533958 TI - Rat cerebral microvascular smooth muscle cells in culture. AB - This report describes the development and establishment of long-term serial cultures of adult rat vascular smooth muscle cells (SMC) derived from cerebrocortical resistance vessels (small arteries and arterioles). Electron microscopic examination of microvessels isolated off a 150 microns nylon mesh sieve clearly demonstrated the predominance of these vessel types. Initial outgrowth from collagenase-elastase-treated microvessel fragments yielded both endothelium and smooth muscle cells. However, at confluency (2-3 weeks) these cultures consisted of a homogeneous population of broad, polygonal cells that grew in a multilayered "hill and valley" pattern typical of SMC in vitro. For comparative morphological and functional studies, SMC cultures were also initiated from rat thoracic aortas utilizing ring segments as explants. The smooth muscle origin of cultures derived from both resistance vessel (RV) and aorta (RA) was further demonstrated by positive immunofluorescent staining by the specific smooth muscle alpha-actin and myosin antibodies. Ultrastructural examination of these SMC cultures revealed similar morphologic features consisting of typical cytoplasmic myofilament bundles with associated dense bodies and numerous pinocytotic vesicles. Cell growth studies on early (less than P 15)- and late (greater than P 15)-passage RV- and RA-SMC populations revealed markedly different cell growth responses. Representative growth curves of early- and late-passage RA-SMC showed a significantly higher growth rate (two- to fourfold) than RV-SMC cultures. Both cultures, however, exhibited a marked increase in growth potential at higher passage levels. Heparin, at a concentration of 100 micrograms/ml inhibited the growth of RV-SMC during the first 3 days after addition in both exponential and growth-arrested culture states, whereas RA-SMC cultures showed no inhibitory response. These studies indicate that long-term RV-SMC cultures can serve as a useful model system to study functional and metabolic properties of this cell type and provide the means to explore further the heterogeneity of SMC derived from different vasculatures in normal as well as various disease states. PMID- 3533959 TI - Ion-sensitive microelectrode measurements of free intracellular chloride and potassium concentrations in hyperthermia-treated neuroblastoma cells. AB - Murine NG108-15 neuroblastoma cells were heated for times of 5-40 min at 45.5 degrees C, and survival ranged from 0.7-0.0015, respectively. Ion-sensitive microelectrodes (ISM) were used to measure the free intracellular concentrations of Cl- and K+ immediately after heating and up to 30 hr later. The free intracellular Cl- and K+ concentrations, [Cl-]i and [K+]i respectively, of the heated cells remained identical to those of the controls for the first 10 hr after heating. At later times, some cells had increased [Cl-]i values and decreased [K+]i values identical to those of the extracellular medium. These cells had a mottled morphology, no longer excluded the vital stain trypan blue, and had no membrane potential. The number of these dye-including, physiologically dead cells increased with time, and was always greater following longer heating times. No changes in mean cellular volume were observed until 25 hr after heating. All trypan-blue-excluding, physiologically live cells had the same [Cl ]i and [K+]i as the control cells, even when the majority of them were destined for clonogenic death. PMID- 3533960 TI - Role of lipoproteins in growth of human adult arterial endothelial and smooth muscle cells in low lipoprotein-deficient serum. AB - Recently improved culture conditions for human adult arterial endothelial and smooth muscle cells from a wide variety of donors have been used to study the effects of lipoproteins on proliferation of both cell types in low serum culture medium. Optimal growth of endothelial and smooth muscle cells in an optimal nutrient medium (MCDB 107) containing epidermal growth factor, a partially purified fraction from bovine brain, and 1% (v/v) lipoprotein-deficient serum was dependent on either high- or low-density lipoprotein. High- and low-density lipoprotein stimulated cell growth by three- and five-fold, respectively, over a 6-day period. Optimal stimulation of both endothelial and smooth muscle cell growth occurred between 20 and 60 micrograms/ml of high- and low-density lipoproteins, respectively. No correlation between the activation of 3-hydroxyl-3 methylglutaryl coenzyme. A reductase activity and lipoprotein-stimulated cell proliferation was observed. Lipid-free total apolipoproteins or apolipoprotein C peptides from high-density lipoprotein were partially effective and together with oleic acid effectively replaced native high-density lipoprotein for the support of endothelial cell growth. In contrast, apolipoproteins or apolipoprotein C peptides from high-density lipoprotein alone or with oleic acid had no effect on smooth muscle cell proliferation. The results suggest a functional role of high- and low-density lipoproteins and apolipoproteins in the proliferation of human adult endothelial and smooth muscle cells. PMID- 3533961 TI - Reversible alterations in cultured pulmonary artery endothelial cell monolayer morphology and albumin permeability induced by ionizing radiation. AB - The effects of ionizing irradiation (0, 600, 1,500, or 3,000 rads) on the permeability of pulmonary endothelial monolayers to albumin were studied. Pulmonary endothelial cells were grown to confluence on gelatin-coated polycarbonate filters, placed in serum-free medium, and exposed to a 60Co source. The monolayers were placed in modified flux chambers 24 hours after irradiation; 125I-albumin was added to the upper well, and both the upper and lower wells were serially sampled over 4 hours. The amount of albumin transferred from the upper well/hour over the period of steady-state clearance (90-240 min after addition of 125I-albumin) was 2.8 +/- 0.2% in control monolayers and was increased in monolayers exposed to 1,500 or 3,000 rads (increase of 63 +/- 10% and 61 +/- 10%, respectively, P less than 0.01). No increase was found in monolayers exposed to 600 rads. The increases in endothelial albumin transfer rates were associated with morphologic evidence of monolayer disruption and endothelial injury which paralleled the changes in albumin permeability. Dose-dependent alterations in endothelial actin filament organization were also found. Incubation of the monolayers exposed to 3,000 rads with medium supplemented with 10% fetal calf serum for 24 hours resulted in normalization of albumin permeability, improvement in morphologic appearance of the monolayers, and reorganization of the actin filament structure. These studies demonstrate that ionizing radiation is an active principle in the reversible disorganization of cultured pulmonary endothelial cell monolayers without the need of other cell types or serum components. PMID- 3533962 TI - Regulation of gonadotropin receptors, gonadotropin responsiveness, and cell multiplication by somatomedin-C and insulin in cultured pig Leydig cells. AB - We have investigated the effects of insulin and somatomedin-C/insulinlike growth factor I(Sm-C) in purified porcine Leydig cells in vitro on gonadotrophins (hCG) receptor number, hCG responsiveness (cAMP and testosterone production), and thymidine incorporation into DNA. Leydig cells cultured in a serum-free medium containing transferrin, vitamin E, and insulin (5 micrograms/ml) maintained fairly constant both hCG receptors and hCG responsiveness. When they were cultured for 3 days in the same medium without insulin, there was a dramatic decline (more than 80%) in both hCG receptor number and hCG responsiveness. However the cAMP but not the testosterone response to forskolin was normal. Both insulin and Sm-C at nanomolar concentrations prevent the decline of both hCG receptors and hCG-induced cAMP production. This effect of both peptides was dose dependent with an ED50 of about 1 ng/ml and 5 ng/ml for SM-C and insulin, respectively. Insulin and Sm-C had no additive effect on these parameters. At nanomolar concentrations, Sm-C and insulin enhanced hCG-induced testosterone production but the effect of Sm-C was significantly higher than that of insulin. However, the effect of insulin at higher concentrations (5 micrograms/ml) was significantly higher than that of Sm-C at 50 ng/ml. In contrast, at nanomolar concentrations only Sm-C stimulated [3H]-thymidine incorporation into DNA and cell multiplication, the stimulatory effect of insulin on these parameters, was seen only at micromolar concentrations. These results indicate that both Sm-C and insulin acting through their own receptors increase Leydig cell steroidogenic responsiveness to hCG by increasing hCG receptor number and improving some step beyond cAMP formation. In contrast, the mitogenic effects of insulin are mediated only through Sm-C receptors. PMID- 3533963 TI - Henri-Francois Secretan. AB - Henri-Francois Secretan was a Swiss physician. He described hard edema of the hand in 1901 in a report that went unnoticed until interest in this condition revived in recent decades. PMID- 3533964 TI - Occupational dermatology of the hand. AB - This article focuses on the various types and causes of occupational hand dermatitis. Salient features of several common occupations at risk for developing industrial hand dermatoses also are presented. PMID- 3533965 TI - Radiology of the occupationally injured hand. AB - A large number of finger, hand, and wrist injuries occur each year at both work and home, resulting in a loss of productivity for both employee and employer. Early radiographic evaluation, recognition, and assessment of these injuries will enable the referring physician to treat them accordingly. PMID- 3533966 TI - Carpal tunnel syndrome. AB - Carpal tunnel syndrome is a multifactorial median nerve dysfunction syndrome that requires clinical analysis to treat appropriately. Evaluation procedures are described to estimate the probable cause of individual patient's symptoms. Although carpal tunnel release results in good symptomatic relief, it is not required in all cases. PMID- 3533967 TI - Skin coverage in occupational hand injuries. AB - Intact skin is vital after occupational hand injuries. The best bone, tendon, and neurovascular repairs are meaningless without suitable skin coverage to protect them. This article presents various methods of providing skin coverage in the hand after occupational injuries and follows the same thought process that surgeons should use in selecting the most appropriate method of repair. PMID- 3533968 TI - Expression of epidermal growth factor receptor and associated glycoprotein on cultured human brain tumor cells. AB - The expression of epidermal growth factor (EGF-R) in normal glial and glioma cells grown in culture was examined by using several independent assays. Immunoprecipitation with the monoclonal antibody R1 of extracts from metabolically labeled glial and glioma cells revealed a protein of Mr approximately 170,000, with a migration in sodium dodecyl sulfate-polyacrylamide gels identical to the EGR-R of A431 epidermal carcinoma cells. Furthermore, in the majority of glioma extracts, a protein of Mr approximately 190,000 was specifically immunoprecipitated by this antibody. Similar results were obtained by immunoblotting with a second antibody directed against a synthetic peptide in the sequence of the v-erb-B oncogene. In cell lines expressing both proteins, each was specifically phosphorylated on tyrosine in immune complex kinase assays. The majority of glioma cells bound between 40,000 to 80,000 125I-labeled epidermal growth factor molecules per cell. These results suggest that the expression of EGF-R is common in cultured human glioma cells. In addition, a structurally related protein, is expressed in some of these cells. PMID- 3533969 TI - The versatility of proteolytic enzymes. AB - The growing realization of their physiological importance has generated renewed interest in the study of proteolytic enzymes. Modern methods of protein chemistry and molecular biology have revealed new insights into the protein and gene structure of a variety of protein precursors and their processing by limited proteolysis. Examples are given in this review for transmembrane processes and the role of signal peptidases of both eukaryotic and prokaryotic origin, the processing of prohormones and precursors of growth factors, protein components of blood coagulation, fibrinolysis, and of the complement system, and a group of granulocyte proteases, including the mast cell serine proteases. The relationship of homologous domains found in many of these proteases and their zymogens to protein evolution is a recurrent theme of this discussion. PMID- 3533970 TI - [Enteropexy (the Reymond procedure) in the treatment of small-intestine obstruction. The experience of 133 cases]. AB - The indication for a pexis operation is entirely dependent on the condition of the intestinal peritoneum. If detachment of peritoneum is absent or very superficial then pexis is not indicated (prophylactic pexis). If, however, multiple regions of peritoneal detachment extending to the subperitoneal layer exist then curative pexis is justified, and must extend to the whole or almost the whole of the small intestine, and be performed using absorbable suture thread. PMID- 3533971 TI - Simplified quantitative determination of plasma phenytoin: on-line pre-column high-performance liquid immunoaffinity chromatography with sample pre purification. AB - A method for on-line high-performance liquid immunoaffinity chromatographic analysis of 5,5-diphenylhydantoin (phenytoin) in human plasma is described. The technique is simple and does not require sample preparation or addition of an internal standard, and the phenytoin is eluted from the columns in 12 min. A phenytoin-specific polyclonal immunoglobulin was attached to an organic silane derivative on silica. The immunosorbent was packed into a short liquid chromatography column and installed in a modified high-performance liquid chromatography system for on-line sample pre-purification. Standard curve linearity of plasma phenytoin was obtained at concentrations up to 160 mumol/l. When compared to conventional high-performance liquid chromatography, plasma phenytoin levels gave a correlation coefficient of 0.993. The phenytoin is highly bound to plasma proteins (ca. 87%). When plasma is injected onto the pre-column, a dissociation and partition of phenytoin from plasma proteins to a complete association with on-column insolubilized antibodies results. PMID- 3533972 TI - Inhibition of Semliki Forest virus multiplication by ribavirin: a potential method for the monitoring of antiviral agents in serum. AB - An enzyme immunoassay (EIA) to determine 50% inhibitory concentrations of ribavirin which suppresses Semliki Forest virus (SFV) multiplication in L-cells is described. Inhibition of SFV replication by ribavirin was measured by detection of viral glycoprotein, on the surface of infected L-cell monolayers, with a horseradish peroxidase labeled monoclonal antibody with specificity for the E2 glycoprotein of SFV. The concentration of ribavirin in culture fluid associated with 50% reduction of control absorbance values was defined as the 50% inhibitory concentration (IC50). The IC50 of ribavirin measured with EIA was mainly influenced by the multiplicity of infection (MOI). At MOI values of 3, 6 and 12 reduction of absorbance values was already obvious at 4.5 h of infection. Furthermore reduction of absorbance values correlated with inhibition of virus production as determined by plaque titration of culture fluids. When the EIA was used for the determination of active ribavirin in serum from treated animals the drug was detectable 1 h after intravenous administration of 4 mg of ribavirin to a concentration of 8 micrograms per ml serum. The results indicate that this simple EIA is suitable for the monitoring of active antiviral drugs in body fluids. PMID- 3533973 TI - Natural killer-cell activity, interferon-alpha 2 production, and interleukin-2 production in cyclosporine-treated and conventionally immunosuppressed human allograft recipients. AB - Natural killer (NK) activity, interferon (IFN)-alpha production, and interleukin 2 (IL-2) production were measured in renal transplant recipients undergoing immunosuppression with either azathioprine and steroids (Az + P) or cyclosporine (CyA). Overall, both IFN-alpha production and IL-2 production were impaired in these two groups compared with identical studies in healthy individuals. However, on the basis of control data these two patient groups were divided into those with "normal" NK activity and those with "low" NK activity. In the CyA group those with a low NK reaction produced less IL-2 and IFN-alpha than those with normal NK activity. No such relationship between cytokine production and NK activity was discerned in the Az + P group. These data conflict with in vitro studies, which have failed to demonstrate any effect of CyA on IFN-alpha production. In addition, they suggest that whereas cyclosporine influences NK activity in vivo by inhibiting cytokine production, other factors may play a role in impairing NK activity in conventionally immunosuppressed patients. PMID- 3533974 TI - Effect of medium composition on results of macrobroth dilution antifungal susceptibility testing of yeasts. AB - A total of 62 different clinical yeast isolates were examined for susceptibility to four antifungal agents, amphotericin B, 5-fluorocytosine (5-FC), ketoconazole, and miconazole, using synthetic amino acid medium-fungi (SAAM-F), buffered yeast nitrogen broth (BYNB), Kimmig broth, casein-yeast-glucose broth (CYG), antibiotic medium 3-FDA (ANTI-3), and tryptic soy broth (TSB). A macrobroth dilution format was used with MICs determined after incubation for 24 and 48 h. All analyses were performed in duplicate. In general, MICs were more reproducible after 48 h of incubation. Furthermore, with certain medium-antifungal agent combinations, MICs determined after incubation for 48 h were significantly higher than those determined after 24 h. For instance, with 5-FC irrespective of the medium used, greater than 25% of all 48-h MICs were more than one twofold dilution higher than the corresponding MICs determined after incubation for 24 h. Similar observations were made with amphotericin B when tested with BYNB and CYG and with the imidazoles when tested in all of the media except CYG. The actual MICs obtained with the different antifungal agents were clearly influenced by the test medium used. The rank order of amphotericin B MICs according to test medium was as follows: BYNB greater than SAAM-F = Kimmig = CYG = ANTI-3 = TSB. With 5-FC, the following pattern was observed: Kimmig = ANTI-3 greater than SAAM-F = CYG = TSB greater than BYNB. For both imidazoles, ketoconazole and miconazole, the rank order of MICs according to test medium was BYNB = Kimmig = CYG = ANTI-3 = TSB greater than SAAM-F. The results of this investigation suggested that broth dilution susceptibility testing of yeasts is best performed with an incubation period of 48 h. Furthermore, medium composition can significantly influence the results of such testing. PMID- 3533975 TI - Candida detection system (CAND-TEC) to differentiate between Candida albicans colonization and disease. AB - Eighty-three serum specimens from 24 patients infected with Candida albicans were examined for circulating Candida protein antigens with the Candida Detection System (CAND-TEC; Ramco Laboratories, Inc., Houston, Tex.). The medical records of each patient were reviewed for clinical evidence of Candida colonization or disease, predisposing factors for infection, underlying illness, the presence of a contaminated indwelling venous catheter, intravenous amphotericin B therapy, and outcome. Forty-nine serum specimens with antigen titers of 1:2 or less were obtained either from colonized patients or at a time when disseminated disease was not yet clinically suspected. Except for five specimens from two colonized patients, one with a contaminated arterial line, the other specimens with titers of 1:8 or greater (n = 14) were obtained from patients who had been clinically diagnosed and treated for disseminated candidiasis. Serum specimens with titers of 1:4 were often from patients with deep-seated candidal infection but were not uniformly diagnostic; in this situation additional specimens should be tested for Candida antigen titers. Only 1 of 24 serum specimens from patients with no evidence of C. albicans infection had a Candida protein antigen titer of 1:8. With a 1:8 or greater titer as a criterion for dissemination, the sensitivity of the CAND-TEC system was 71%, with a specificity of 98%. If the 1:8 titer for the colonized patient with a contaminated arterial line is not considered a false positive result, the CAND-TEC sensitivity was 83%. The latex agglutination assay appears to be a useful, rapid, and noninvasive means of laboratory diagnosis of systemic candidiasis. The recovery of C. albicans from at least three body sites may also be a useful predictor of disseminated disease. PMID- 3533976 TI - Characterization of Wolinella spp., Campylobacter concisus, Bacteroides gracilis, and Eikenella corrodens by polyacrylamide gel electrophoresis. AB - The small asaccharolytic, nonpigmenting gram-negative rods of the human oral cavity are difficult to differentiate from each other. Protein profiles of sonicated cells of Wolinella species, Campylobacter concisus, Bacteroides gracilis, and Eikenella corrodens were obtained by sodium dodecyl sulfate polyacrylamide gel electrophoresis and visualized with a silver stain. The gels were scanned with a laser densitometer, and the similarity of strains was computed by determining correlation coefficients of normalized densities along the gels. The strains were grouped by cluster analysis of the correlation coefficients. All species were distinct from each other. Several groups were found within E. corrodens. A colored silver stain was found to highlight species differences and appears to be useful in the rapid identification of fresh isolates. PMID- 3533978 TI - Hemadsorption and enzyme-linked immunosorbent assay nitrocellulose replica methods for identification of colonization factor antigen (CFA)-positive Escherichia coli colonies and for isolation of CFA-negative mutants. AB - Methods were developed that allow demonstration of individual colonies carrying colonization factor antigen (CFA) I or CFA/II or E8775-type antigen in mixed bacterial cultures on solid media. These methods are based on mannose-resistant hemadsorption or CFA enzyme-linked immunosorbent assay (ELISA) on nitrocellulose replicas of the cultures allowing simultaneous analysis of up to 200 colonies per plate. The sensitivity and specificity of the CFA ELISA nitrocellulose replica method were 97 and 99%, respectively, for CFA/I-carrying colonies and 99 and 100% for CFA/II-positive colonies; corresponding figures for the quicker and simpler hemadsorption modification were somewhat lower. Both methods seem to be useful for studying excretion of CFA-carrying bacteria in feces, as indicated by studies in rabbits infected with enterotoxin-producing Escherichia coli in a nonligated intestine model. By initially absorbing CFA-carrying bacteria on erythrocytes and then performing nitrocellulose replicas of agar colonies of the nonabsorbed bacteria, CFA-deficient mutants could be identified by the hemadsorption method, as well as by the CFA ELISA. Treatment of CFA-carrying bacteria with antiserum against CFA and complement also resulted in enrichment of spontaneous CFA deficient mutants that could be identified by the replica methods. Several stable CFA-deficient mutants from enterotoxin-producing E. coli carrying CFA/I, CFA/II, or E8775 were isolated by these approaches. PMID- 3533977 TI - Serological tests for detecting Rift Valley fever viral antibodies in sheep from the Nile Delta. AB - To determine the accuracy of serological methods in detecting Rift Valley fever (RVF) viral antibodies, we examined serum samples obtained from 418 sheep in the Nile Delta by using five tests. The plaque reduction neutralization test (PRNT) was considered the standard serological method against which the four other tests were compared. Twenty-four serum samples had RVF viral antibodies detected by PRNT. Hemagglutination inhibition and enzyme-linked immunosorbent assay antibodies to RVF virus were also present in the same 24 serum samples. Indirect immunofluorescence was less sensitive in comparison with PRNT, and complement fixation was the least sensitive. These results extend observations made with laboratory animals to a large field-collected group of Egyptian sheep. PMID- 3533979 TI - Rapid determination of neutralizing antibodies to Semliki Forest virus in serum by enzyme immunoassay in cell culture with virus-specific monoclonal antibodies. AB - We describe in this study a rapid enzyme immunoassay for the titration of neutralizing antibodies in serum against Semliki Forest virus. For this assay L cells were added to preincubated virus-antiserum mixtures to form monolayers. Six hours after infection by residual, nonneutralized virus, the monolayers were fixed, and the E2 glycoprotein of Semliki Forest virus on the surface of infected cells was quantified with an E2-specific, peroxidase-labeled monoclonal antibody (UM 5.1). The serum antibody titer was defined arbitrarily as the inverse value of that dilution of serum associated with a 25% inhibition of control absorbance values. These titers of both early and later mouse immune sera were similar to those determined in simultaneously performed 50% plaque reduction tests. The results indicate that the enzyme immunoassay (duration, 9 h) is reliable and compares favorably with the conventional plaque reduction test (duration, 25 h) in rapidity, ease of performance, and objectivity. PMID- 3533980 TI - Rapid detection of influenza virus by shell vial assay with monoclonal antibodies. AB - Of 45 influenza virus strains (43 type A and 2 type B) detected in conventional tube cell cultures (average time, 4 days), 25 (56%) were detected by immunofluorescence in the shell vial assay 24 h postinoculation. The specific fluorescence produced should allow this procedure to be readily adapted by laboratories with various degrees of experience with immunofluorescence methodology. PMID- 3533981 TI - Review of frequency-pulsed electron-capture gas-liquid chromatography studies of diarrheal diseases caused by members of the family Enterobacteriaceae, Clostridium difficile, and rotavirus. PMID- 3533982 TI - Detection of Campylobacter pyloridis in patients with antrum gastritis and peptic ulcers by culture, complement fixation test, and immunoblot. AB - The association of Campylobacter pyloridis with antrum gastritis and peptic ulcers was described. We investigated antral biopsies from 180 patients who underwent gastroscopy. By culture or Gram stain or both, we found overall 98 (54%) of them to be positive for C. pyloridis. In the various groups the following percentages were found to be positive: normal antral mucosa 3% (n = 30); moderate superficial antrum gastritis, 49% (n = 83); severe superficial antrum gastritis, 86% (n = 44); duodenal ulcer, 83% (n = 54); and gastric ulcer, 72% (n = 18). A serological screening that used a complement fixation test yielded the following results: highest rates of positive complement fixation titers were seen in patients with severe gastritis and those with duodenal ulcers, both with 79%; the lowest incidence was in a group of 20 blood donors, with 5%. Positive complement fixation titers in gastritis patients also correlated well with characteristic patterns on immunoglobulin G and A immunoblots, while there was no specific reactivity observed on immunoglobulin M immunoblots. PMID- 3533983 TI - Accuracy of immunoglobulin M immunoassay for diagnosis of chlamydial infections in infants and adults. AB - An improved solid-phase enzyme immunoassay (EIA) with Chlamydia trachomatis L2 434/Bu elementary bodies was developed for the measurement of immunoglobulin M (IgM) antibody to C. trachomatis in serum. Comparison of EIA and microimmunofluorescence IgM antibody titers of 156 serum samples revealed an EIA sensitivity and specificity of 100% for infants, but reduced sensitivity (85%) and specificity (76%) for sera from adults. Sera containing IgM class rheumatoid factor produced false-positive IgM results which could easily be eliminated by pretreatment of the sera with anti-human IgG. Analysis of sera from infants with chlamydial infections revealed that 17 of 17 infants with C. trachomatis pneumonia had high IgM antibody titers (geometric mean titer, 1:64,812), whereas two infants with conjunctivitis only lacked detectable IgM antibody. EIA detected IgM antibody to several serovar groups in serum, including serovars B, BDE, FG, and J. IgM antibody to C. trachomatis in serum was detected as early as 5 days after the infection that was acquired at delivery and persisted for 3 months. The availability of an EIA possessing good sensitivity and specificity for the detection of IgM antibody to C. trachomatis may permit more laboratories to diagnose perinatal chlamydial infections. PMID- 3533984 TI - Detection of immunoglobulin M in cerebrospinal fluid from syphilis patients by enzyme-linked immunosorbent assay. AB - Cerebrospinal fluid (CSF) samples were evaluated in an immunoglobulin M enzyme linked immunosorbent assay (IgM ELISA) for syphilis with sonic extracts of Treponema pallidum coated on polystyrene plates. The ELISA procedure was reproducible, and T. pallidum antigens were stable., A total of 15 CSF samples from patients with neurosyphilis, 18 CSF samples from patients with syphilis, 12 CSF samples from patients treated for syphilis, and 494 CSF samples from patients with neurologic or other systemic diseases were tested. The IgM ELISA gave reactive results in all of six symptomatic and congenital neurosyphilitic patients and none of nine asymptomatic neurosyphilitic patients. Of 524 CSF samples from nonneurosyphilitic individuals, 513 were nonreactive, resulting in 98% test specificity. The IgM ELISA in CSF should prove to be useful for confirmation of symptomatic neurosyphilis. PMID- 3533985 TI - GM1 erythroimmunoassay for detection and titration of Escherichia coli heat labile enterotoxin. AB - A GM1 ganglioside erythroimmunoassay for the detection of heat-labile Escherichia coli enterotoxin (LT) was developed for use in poorly equipped laboratories in developing countries. This assay is based on the immunological similarity between Vibrio cholerae toxin and LT and uses cholera toxin antiserum and sheep anti rabbit immunoglobulin covalently coupled to sheep erythrocytes as conjugate. This assay has the following advantages over other currently available techniques: the reagents it uses are stable, in particular, tanned and sensitized sheep erythrocytes; GM1 ganglioside is commercially available; erythro-adsorption can be read with the naked eye; the test can be completed in 1 day; and as little as 4 ng of V. cholerae toxin or LT per ml can be detected accurately. The GM1 ganglioside erythroimmunoassay showed good quantitative and qualitative correlation with the Vero cell assay and the conventional GM1 enzyme-linked immunosorbent assay. The GM1 ganglioside erythroimmunoassay was somewhat less sensitive than the GM1 enzyme-linked immunosorbent assay but more sensitive than the Vero cell assay. Results obtained for 12 LT-positive and 138 LT-negative E. coli strains correlated with results obtained with GM1 enzyme-linked immunosorbent and Vero cell assays. PMID- 3533986 TI - Blinded, two-laboratory comparative analysis of Escherichia coli heat-stable enterotoxin production by using monoclonal antibody enzyme-linked immunosorbent assay, radioimmunoassay, suckling mouse assay, and gene probes. AB - Heat-stable enterotoxin (ST)-producing enterotoxigenic Escherichia coli (ETEC) can be identified by a variety of assays, including the suckling mouse assay (SMA), radioimmunoassay (RIA), polyclonal or monoclonal antibody enzyme-linked immunosorbent assay (ELISA), and DNA hybridization with STh and STp gene probes. To compare the sensitivity and reliability of these assays, 100 coded ETEC and non-ETEC isolates were blindly tested in two independent laboratories. SMA, RIA, and monoclonal ELISA were performed in Cincinnati, Ohio, while gene probe analysis was performed in Baltimore, Md. The method of storage of organisms had a profound effect on the stability of plasmids in certain strains. Hybridization experiments to determine the presence or absence of the enterotoxin gene showed that strains stored on Dorset egg medium at room temperature better retained their plasmids than strains stored frozen in skim milk. Forty-four of the 100 organisms obtained from the skim milk stock were found to produce STa in liquid culture by the RIA, SMA, and monoclonal ELISA (100% agreement). However, 50 of 54 of the strains stored on Dorset egg medium which were originally classified as STa+ or ST+ LT+ (positive for both heat-stable and heat-labile [LT] enterotoxins) were found to produce STa and retain the plasmid by each of these assays. Three additional strains were found which harbored the plasmid but did not elaborate STa by any of the assays (3% discrepancy). The monoclonal antibody ELISA appears to be highly reliable for determination of STa production by ETEC and can be easily scored visually even by untrained personnel. Furthermore, when this STa assay is coupled with a polyclonal antibody assay, it is possible to predict the genotype of STh- and STp-producing organisms. PMID- 3533987 TI - Rapid double-sandwich enzyme-linked immunosorbent assay for detection of human immunoglobulin M anti-Toxoplasma gondii antibodies. AB - The double-sandwich enzyme-linked immunosorbent assay has been compared with the indirect fluorescence assay for the detection of immunoglobulin M antibodies against Toxoplasma gondii in humans. Incubation times have been shortened, permitting the test to be completed within 2 h. The double-sandwich enzyme-linked immunosorbent assay is confirmed to be more sensitive and more specific than the immunofluorescence assay. PMID- 3533988 TI - Evaluation of a xylene substitute in Ehrlich indole test. AB - Hemo-De (PMP Medical Industries, Inc., Irving, Tex.) was evaluated and found to be a suitable substitute for xylene in the Ehrlich modification of the indole test. PMID- 3533989 TI - Disseminated cryptococcosis presenting as cellulitis with necrotizing vasculitis. AB - Patients with disseminated cryptococcosis infrequently present with cutaneous involvement. Skin lesions, when present, are usually multiple and polymorphous in appearance. Cellulitis caused by Cryptococcus neoformans is rare, and necrotizing vasculitis associated with cryptococcal vascular invasion has not to our knowledge been reported. We report here a case of disseminated cryptococcosis in a renal transplant recipient who had cellulitis and necrotizing vasculitis and in whom a diagnostic skin biopsy allowed for early therapy with cure and salvage of the renal allograft. PMID- 3533990 TI - Direct immunofluorescence microscopy for rapid screening of Campylobacter enteritis. AB - Diagnostic use of a direct fluorescent-antibody test for detection of Campylobacter jejuni and C. coli in human fecal specimens (n = 497) was compared with detection by culturing (specificity, 99.7%; sensitivity, 40%). Conjugates were prepared from immunoglobulin G antibody against 22 Lior C. jejuni and C. coli reference strains (H. Lior, D. L. Woodward, J. A. Edgar, L. J. Laroche, and P. Gill, J. Clin. Microbiol. 15:761-768, 1982). Interestingly, the serotypes of cultures tested by the direct fluorescent antibody test were different from those of cultures tested by Lior slide agglutination, although the antisera used were common to both test systems. PMID- 3533991 TI - Torulopsis candida, a new opportunistic pathogen. AB - We described the first documented case of intravenous-catheter-associated fungemia caused by Torulopsis candida (Candida famata). The microorganism was isolated from two blood cultures and one intravenous catheter tip in a bone marrow transplant patient. Both the intravascular cannula and the immunological status of the patient are believed to have played major roles in predisposing the patient to such an infection. Uneventful recovery occurred after the removal of the catheter and amphotericin B therapy. PMID- 3533992 TI - Clinical comparison of lysis-centrifugation and radiometric resin systems for blood culture. AB - The Isolator 10 lysis-centrifugation blood culture system (E. I. du Pont de Nemours & Co., Inc., Wilmington, Del.) and the BACTEC 16B-17D radiometric resin system (Johnston Laboratories, Inc., Towson, Md.) both remove antimicrobial agents from the blood for culture. We compared these two systems for recovery of aerobic bacteria, facultatively anaerobic bacteria, and yeasts. A total of 5,000 blood cultures yielded 467 clinically significant isolates. Both systems recovered 350 (75%) organisms, 56 (12%) were detected by Isolator only, and 61 (13%) were detected by BACTEC resin bottles only. No group of organisms was isolated significantly more often from either system. PMID- 3533993 TI - Effective murolytic solubilization of streptococcal-group-specific antigen. AB - Streptococcal-group-specific antigens were solubilized with a murolytic enzyme contained in the culture supernatant of Streptomyces globisporus. This facilitated the effective serogrouping of streptococci from humans and animals. PMID- 3533994 TI - Toward a national medical care system: II. The historical background. PMID- 3533995 TI - A historical overview of the ministries of public health and the medical programs of the social security systems in Latin America. PMID- 3533997 TI - Human platelet aggregation is initiated by peripheral blood mononuclear cells exposed to bacterial lipopolysaccharide in vitro. AB - Platelet consumption is a prominent feature of disseminated intravascular coagulation. We investigated whether monocyte procoagulant activity (PCA) might play a role in platelet consumption associated with gram-negative septicemia. Human mononuclear cells exposed in vitro to lipopolysaccharide demonstrated parallel dose-dependent increases in PCA and ability to induce platelet aggregation. Induction of platelet aggregation required the generation of thrombin dependent on coagulation Factors VII, X, and II, and calcium. This is consistent with monocyte tissue factor initiating thrombin generation. A specific monoclonal antimonocyte antibody was used to identify monocytes via indirect immunofluorescence, and demonstrated that all monocytes were included in platelet aggregates. Mononuclear cells that did not express PCA did not induce platelet aggregation and monocytes were not surrounded by platelet clumps. These data suggest that monocytes induced to express tissue factor on their surface may be important mediators of endotoxin-induced platelet, as well as fibrinogen, consumption. PMID- 3533998 TI - Identification of a major sialoprotein in the glycocalyx of human visceral glomerular epithelial cells. AB - Glomerular visceral epithelial cells are endowed with a sialic acid-rich surface coat (the "glomerular epithelial polyanion"), which in rat tissue contains the sialoprotein podocalyxin. We have identified a major membrane sialoprotein in human glomeruli that is similar to rat podocalyxin in its sialic acid-dependent binding of wheat germ agglutinin and in its localization on the surface of glomerular epithelial and endothelial cells, as shown by immunoelectron microscopy, using the monoclonal antibody PHM5. Differences in the sialoproteins of the two species are indicated by the discrepancy of their apparent molecular weights in sodium dodecyl sulfate gels, by the lack of cross reactivity of their specific antibodies, and by the lack of homology of their proteolytic peptide maps. It is therefore possible that the human glomerular sialoprotein and rat podocalyxin are evolutionarily distinct, but have similar functions. PMID- 3533996 TI - Cancer chemotherapy: new strategies for success. PMID- 3533999 TI - Sodium regulation of angiotensinogen mRNA expression in rat kidney cortex and medulla. AB - Rat liver angiotensinogen cDNA (pRang 3) and mouse renin cDNA (pDD-1D2) were used to identify angiotensinogen and renin mRNA sequences in rat kidney cortex and medulla in rats on high and low salt diet. Angiotensinogen mRNA sequences were present in renal cortex and medulla in apparently equal proportions, whereas renin mRNA sequences were found primarily in renal cortex. Average relative signal of rat liver to whole kidney angiotensinogen mRNA was 100:3. Densitometric analysis of Northern blots demonstrated that renal cortical angiotensinogen mRNA concentrations increased 3.5-fold (P less than 0.001) and medulla, 1.5-fold (P less than 0.005) on low sodium compared with high sodium diet, whereas renal cortex renin mRNA levels increased 6.8-fold (P less than 0.0005). Dietary sodium did not significantly influence liver angiotensinogen mRNA levels. These findings provide evidence for sodium regulation of renal renin and angiotensinogen mRNA expressions, which supports potential existence of an intrarenally regulated RAS and suggest that different factors regulate renal and hepatic angiotensinogen. PMID- 3534000 TI - Effect of dexamethasone on hepatic glucose and insulin metabolism after oral glucose in conscious dogs. AB - To examine whether hyperinsulinemia associated with glucocorticoid treatment results solely from hypersecretion of insulin or also involves altered fractional hepatic extraction, oral glucose (1 g/kg body wt) was administered to dogs with or without dexamethasone treatment (2 mg/d for 2 d). Dexamethasone significantly increased basal glucose and insulin concentrations in the portal vein, hepatic vein, and femoral artery, reduced basal fractional hepatic extraction of insulin from 43 +/- 4% to 22 +/- 4%, and, after oral glucose, increased retention by the liver of net glucose released into the portal system from 27 +/- 4% to 53 +/- 13%. Intraportal insulin infusion (1 and 2 mU/kg per min) after 7 d of dexamethasone treatment (2 mg/d) caused less suppression of endogenous glucose production, and less exogenous glucose was required to maintain an euglycemic clamp than in control animals. Dexamethasone treatment is associated with: decreased basal fractional hepatic insulin extraction contributing to hyperinsulinemia; and less suppression of endogenous glucose production and increase in peripheral uptake in response to insulin, but no reduction in net hepatic glucose uptake after oral glucose. PMID- 3534001 TI - Abnormal cytolytic activity of lymphocyte function-associated antigen-1-deficient human cytolytic T lymphocyte clones. AB - The involvement of the lymphocyte function-associated antigen-1 (LFA-1) membrane molecule in cytolytic T lymphocyte (CTL) interactions with lymphoid target cells was investigated using CTL clones derived from two patients with a heritable deficiency of LFA-1. LFA-1 surface expression on the CTL clones was 1% of the normal level of LFA-1, unchanged with prolonged culture, and identical on 14 different CTL clones. The function of the LFA-1 molecule was addressed using the LFA-1-deficient CTL clones and LFA-1-deficient lymphoid target cells. The lytic activity of the LFA-1-deficient CTL clones was 43% of control when tested against a target cell line expressing normal levels of LFA-1 and less than 10% of control when tested against an LFA-1-deficient target cell line. These results demonstrate a direct involvement of LFA-1 in CTL-mediated cytolysis and suggest a more general dependence on LFA-1 in lymphoid cell-cell interactions. PMID- 3534002 TI - Prevention of lethal murine graft versus host disease by treatment of donor cells with L-leucyl-L-leucine methyl ester. AB - Graft vs. host disease (GVHD) remains one of the main problems associated with bone marrow transplantation. The current studies were undertaken to determine whether treatment of the donor inoculum with the anticytotoxic cell compound L leucyl-L-leucine methyl ester (Leu-Leu-OMe) would alter the development of GVHD in a murine model. Irradiated recipient mice transplanted with a mixture of control bone marrow and spleen cells from naive semiallogeneic donors died rapidly from GVHD, whereas the recipients of cells incubated with 250 microM Leu Leu-OMe all survived. In addition, Leu-Leu-OMe treatment of cells obtained from donors immunized against host alloantigens resulted in significantly prolonged survival. Phenotypic characterization of spleen cells from the various groups of mice that had received Leu-Leu-OMe-treated cells and survived consistently revealed the donor phenotype. Treatment of marrow cells with 250 microM Leu-Leu OMe appeared to have no adverse effects on stem cell function. Erythropoiesis was undiminished, as assayed by splenic 5-iodo-2'-deoxyuridine-125I uptake. Moreover, granulocytic and megakaryocytic regeneration were histologically equivalent in the spleens of recipients of control or Leu-Leu-OMe-treated cells. Treatment of the donor inoculum with Leu-Leu-OMe thus prevents GVHD in this murine strain combination with no apparent stem cell toxicity. PMID- 3534004 TI - Enzyme activity in human gingival crevicular fluid: considerations in data reporting based on analysis of individual crevicular sites. AB - Using a reproducible approach to collection, processing and analysis of gingival crevicular fluid (GCF), this study examined 284 fluid samples from individual crevicular sites for the presence of the enzymes lactate dehydrogenase (LDH), B glucuronidase (BG) and arylsulfatase (AS). 88 of the sites were from periodontally healthy individuals (probing depth 1-3 mm), while 98 sites from patients with periodontitis were examined before and 2 weeks after scaling and root planing (probing depths 1-3 mm, 4-6 mm and 7-10 mm). This study demonstrated the sensitivity of the enzyme assays. When GCF was collected with a 30-s insertion of the filter strip, 90% of the sites from the control subjects demonstrated LDH activity, 85% demonstrated BG activity and 73% demonstrated AS activity. For the 1-3 mm sites from the patients with periodontitis, 100% of sites from which fluid was collected demonstrated LDH and BG activity, and 90% of sites had AS activity before therapy. After therapy, 100% of sites demonstrated LDH activity, 90% had BG activity and 83% had AS activity. All sites in the 4-6 mm and 7-10 mm categories demonstrated activity of all 3 enzymes. The data were analyzed in terms of enzyme activity/30-s sample and as concentration of enzyme in a standard volume of GCF. Enzyme activity/30-s sample was a different and possibly more sensitive indicator of periodontal pathology than standard clinical parameters. There was a disassociation between clinical parameters and the data for enzyme analysis when it was reported as concentration. PMID- 3534003 TI - Subgingival microflora in bleeding and nonbleeding pockets. AB - The subgingival flora of bleeding and nonbleeding 4-6 mm pockets was investigated using phase-contrast microscopy. Subgingival plaque was sampled from 11 patients with generalized moderate periodontitis. 4 subgingival samples were obtained from each patient, 2 from sites that bled upon standardized probing force and 2 from sites that did not. The amounts of gingival inflammation, supragingival plaque, attachment level and pocket depth were also assessed at each site. The %s of 4 bacterial morphotypes were assessed using phase-contrast microscopy. No significant differences were found in the %s of cocci, motile rods, or spirochetes between bleeding and nonbleeding sites. Significant correlations were found, however, between the % of spirochetes and probing depth, attachment level, and gingival inflammation. The observations indicate that the use of bleeding on probing may not be justified as an indicator of infection by those "periodontopathic" bacteria identifiable by phase-contrast microscopy. However, limitations in the microscopic method may have prevented us from observing differences between the 2 types of sites on a species level. PMID- 3534006 TI - Community health centers and the elderly: a potential new alliance. AB - Community health centers (CHCs) are experiencing the effects of federal policy changes that are promoting an autonomous existence for many agencies. These policy shifts also challenge the original structure and mission of CHCs to serve underserved and/or low-income clientele. CHCs now need not only a stable clientele, but also a reimburseable clientele. Both of these criteria can be met by the elderly population with Medicare coverage. The needs of the CHCs are balanced by the growing needs of the elderly who are using CHCs more, according to the authors' research in 32 communities across the country. The most dramatic increases in CHC clientele between 1983 and 1984 was in the 75 years and older categories. This article reviews the factors underlying CHCs strategic advantage in expanding services to the elderly, the evolution of federal policy toward CHCs, and their response to the current policy environment. The discussion is based on findings from studies conducted between 1982 and 1985. PMID- 3534005 TI - The dexamethasone suppression test and response to placebo. AB - The predictive value of the dexamethasone suppression test (DST) was evaluated in two consecutive double-blind, placebo-controlled trials evaluating 61 depressed inpatients randomized to either one of two drugs, sertraline or oxaprotiline, or placebo over a 4-week clinical trial. For 30 patients who completed at least 3 weeks of double-blind treatment on either drug, the initial DST was not predictive of response to drug treatment. For the 17 patients who completed at least 3 weeks of double-blind treatment on placebo, the presence of a positive DST predicted a statistically significantly poorer response to placebo as opposed to a negative DST. These preliminary findings suggest that for depressed individuals who present with a positive DST, remission without active medication is less likely and somatic treatment should be considered. PMID- 3534007 TI - Malaria parasitemia in healthy Africans in North Mara, Tanzania. AB - Peripheral blood smears were examined for asymptomatic malaria parasitemia among 406 objectively healthy subjects in North Mara, Tanzania. A total of 33(8.1%) of subjects were found to have asymptomatic malaria parasitemia. Prevalence rates for parasitemia were highest among the youngest age groups and lowest in those 35 years of age and older. Of the 33 positive smears, 21 (63.6%) contained Plasmodium falciparum, 9(27.2%) plasmodium malariae and 3(9.2%) mixed infections of the two. General population surveys for asymptomatic malaria parasitemia in North Mara have shown much higher prevalence rates than those found in the present study. The lower prevalence rates in this study are accounted for by the fact that the population sample consisted of subjects determined to be healthy by objective criteria and lacking hepatomegaly and splenomegaly. The absence of splenomegaly and hepatomegaly in this group suggests that they represent a portion of the population who have already developed significant immunity levels to malarial infections. PMID- 3534008 TI - Structural and functional changes of normal aging skin. AB - Solar-induced cutaneous changes are more prevalent and profound in older persons and, thus, are often inappropriately attributed to the aging process, per se. Structural and functional alterations caused by intrinsic aging and independent of environmental insults are now recognized in the skin of elderly individuals. Structurally the aged epidermis likely becomes thinner, the corneocytes become less adherent to one another, and there is flattening of the dermoepidermal interface. The number of melanocytes and Langerhans cells is decreased. The dermis becomes atrophic and it is relatively acellular and avascular. Dermal collagen, elastin, and glycosaminoglycans are altered. The subcutaneous tissue is diminished in some areas, especially the face, shins, hands, and feet, while in others, particularly the abdomen in men and the thighs in women, it is increased. The number of eccrine glands is reduced and both the eccrine and apocrine glands undergo attenuation. Sebaceous glands tend to increase in size but paradoxically their secretory output is lessened. The nail plate is generally thinned, the surface ridged and lusterless, and the lunula decreased in size. There is a progressive reduction in the density of hair follicles per unit area on the face and scalp, independent of male-pattern alopecia. The hair shaft diameter is generally reduced but in some areas, especially the ears, nose, and eyebrows of men and the upper lip and chin in women, it is increased as vellus hairs convert to cosmetically compromising terminal hairs. Functional alterations noted in the skin of elderly persons include a decreased growth rate of the epidermis, hair, and nails, delayed wound healing, reduced dermal clearance of fluids and foreign materials, and compromised vascular responsiveness. Eccrine and apocrine secretions are diminished. The cutaneous immune and inflammatory responses are impaired, particularly cell-mediated immunity. Clinical correlates of these intrinsic aging changes of the skin include alopecia, pallor, xerosis, an increased number of benign and malignant epidermal neoplasms, increased susceptibility to blister formation, predisposition to injury of the dermis and underlying tissues, delayed onset and resolution of blisters and wheals, persistent contact dermatitis, impaired tanning response to ultraviolet light, increased risk for wound infections, prolongation of therapy necessary for onychomycosis, and thermoregulatory disturbances. PMID- 3534009 TI - T-cell growth factor receptor (Tac-antigen) expression in cutaneous lymphoid infiltrates. AB - A total of ninety-four biopsies from normal skin, benign dermatoses, and lesions of human T cell lymphotropic virus type I (HTLV-I)-positive and -negative cutaneous T cell disorders have been examined immunohistologically for reactivity with anti-Tac (monoclonal anti-T cell growth factor receptor). Tac-positive T cells were plentiful in approximately half the specimens, and they were equally frequent in benign and malignant disorders and in HTLV-I-positive and -negative cutaneous T cell disorders. Furthermore, in diseased skin, reactivity with anti Tac was not confined to T lymphocytes, since it was also a property of dermal macrophages and Langerhans cells, as shown by examination of serial and/or double stained sections. Comparison with other markers linked to T cell activation and proliferation (i.e., HLA-DR, OKT10 antigen, transferrin receptor, and the Ki-67 nuclear antigen) showed that Tac-antigen expression did not correlate clearly with any of these markers. These data indicate that anti-Tac forms a useful supplement to other monoclonal antibodies for the identification of activated cell subsets in cutaneous lymphoid infiltrates, but they also show that the use of this reagent on cutaneous biopsy specimens is of only limited diagnostic value. PMID- 3534010 TI - Anticentromere antibody in localized scleroderma. AB - Using metaphase chromosome spreads as substrate for indirect immunofluorescence technic, we observed anticentromere antibody in three of twenty-five patients affected with various clinical forms of localized scleroderma. Anticentromere antibody is generally considered a serologic marker of the CREST syndrome, a more benign subset of systemic sclerosis. However, none of the three anticentromere antibody-positive patients with localized scleroderma had Raynaud's phenomenon, acrosclerosis, or any signs or symptoms of systemic disease; on physical and laboratory examination, they showed only typical cutaneous features of localized scleroderma: two showed linear scleroderma, and one showed localized morphea. A 2 year 8-month follow-up of two patients did not disclose any clinical evidence of systemic sclerosis. The occurrence of anticentromere antibody in patients with localized scleroderma seems to offer supportive evidence that a relationship exists between localized scleroderma and systemic sclerosis. PMID- 3534011 TI - Cutaneous pheomorphic T cell lymphoma. Immunologic, virologic, and T-cell receptor gene rearrangement studies in one European case with initial pseudolymphoma presentation. AB - An unusual case of cutaneous nodular T cell lymphoma evolving for 4 years with massive eosinophilia and greatly increased IgE levels is discussed. Repeated histologic and immunohistologic examinations could not ascertain malignancy because tumors were composed of a granuloma-like, highly polymorphic cellular infiltrate with mature immunotype and no significant nuclear abnormalities nor epidermotropism. T cell lymphoma was evidenced by the T cell receptor beta-chain gene study, which showed a clonal rearrangement. Final histologic classification was "pleomorphic T cell lymphoma" because further biopsy samples displayed numerous lymphoid cells with pleomorphic convoluted nuclei. The T-cell receptor gene probe is a major tool for the early diagnosis of some T cell lymphomas. The case we report shares many features with the smoldering type of human T cell lymphotropic virus type I-associated Japanese endemic pleomorphic T cell lymphoma. Our virologic study confirms that in nonendemic Western countries, pleomorphic T cell lymphomas do not show evidence of a retrovirus association. PMID- 3534012 TI - Henoch-Schonlein vasculitis: direct immunofluorescence study of uninvolved skin. AB - Henoch-Schonlein purpura is a multisystem disease believed to be a consequence of entrapment of circulating IgA-containing immune complexes in blood vessel walls throughout the skin, kidney, and gastrointestinal tract. In this direct immunofluorescence study, twenty-five skin biopsy specimens from twenty patients with Henoch-Schonlein purpura were examined (9 from uninvolved, normal-appearing skin). A distinct stippled pattern of vascular fluorescence was found in 87% of lesion biopsies; 75% of these contained deposits of IgA. In uninvolved skin, seven (78%) showed immunoglobulin in vessel walls and six (67%) contained IgA, suggesting that immune complexes are deposited with equal frequency in normal appearing and lesional skin of patients with Henoch-Schonlein purpura. Biopsy of uninvolved, rather than of purpuric, skin for direct immunofluorescence studies may be more helpful in confirming the diagnosis of Henoch-Schonlein purpura because tissue morphology is usually of better quality. PMID- 3534013 TI - Iontophoresis in dermatology. A review. AB - Iontophoresis, the process of increasing the penetration of drugs into surface tissues by the application of an electric current, has been applied to a great many disease conditions over its 200-year history. Although its greatest success has been in the treatment of hyperhidrosis, it is steadily finding new applications. Many aspects of the mechanisms of iontophoresis have yet to be studied before the technic is both fully understood and maximally utilized. In this article we review the literature on iontophoresis as it pertains to dermatology, including the basic principles, engineering aspects. PMID- 3534014 TI - Light on the persistent light reaction-photosensitivity dermatitis-actinic reticuloid syndrome. AB - In this article are reviewed the various hypotheses concerning the etiology of the persistent light reaction and photosensitivity dermatitis, which occurs among older people and is characterized by an extreme photosensitivity that sometimes evolves into a pseudolymphoma, that is, actinic reticuloid. An etiologic agent can sometimes be demonstrated, but the precise pathogenetic mechanism is unknown. Clinical experience and experimental research indicate that the cause is most probably multifactoral: contact allergenic, photoallergenic, phototoxic, immunologic, and metabolic factors are involved, but their precise roles in the origin of the extreme photosensitivity are still unclear. Localized persistent light reactivity could result from the continued effects of the original photoallergen, but generalized photosensitivity is more difficult to account for. Among the many different hypotheses, two are of special interest: autosensitization of skin proteins with endogenous photosensitizers and cellular hypersensitivity to light, as is manifested by fibroblast cultures of actinic reticuloid patients. PMID- 3534015 TI - Development of dermatopathology and Paul Gerson Unna. PMID- 3534016 TI - Historical perspectives of tretinoin. AB - The vitamin A acid story began when topical application of vitamin A (retinol) produced no therapeutic results in dyskeratotic conditions. It was logical to try metabolites of retinol topically. I published results of studies in 1962 that showed that topical tretinoin was beneficial in ichthyosis, actinic keratoses, and other hyperkeratotic conditions. It was reported in 1969 that topical tretinoin was effective in acne vulgaris, principally by preventing and dislodging comedones. It was subsequently demonstrated that tretinoin produced a distinctive kind of hyperplasia of human epidermis that was associated with early shedding of horny cells. Knowledge that the keratinization process was being profoundly altered stimulated interest in synthesizing retinol derivatives (retinoids) that could be administered orally. The development of 13-cis-retinoic acid was an outcome of this interest, a compound that astonished dermatologists by often producing permanent clearing of acne conglobata. The antitumor effects of tretinoin were already demonstrated by 1974, when it was shown to cause regression in many basal cell cancers. Today the cancer chemopreventive capability of retinoids is being intensively investigated in various organs. An international symposium held in Flims, Switzerland in 1975 demonstrated keen awareness of the therapeutic potential of tretinoin and the rapid growth of basic knowledge of the pharmacology of retinoids. From extensive clinical experience new applications for topical tretinoin came to light, ranging from the treatment of flat warts, lichen planus, and Darier's disease, and most recently in retarding photoaging. Perhaps for the first time in history, dermatologists can take credit for pioneering a drug development program that has had a profound influence on medical practice. PMID- 3534017 TI - All-trans-retinoic acid and cutaneous cancers. AB - All-trans-retinoic acid (tretinoin) is a biologically active metabolite of vitamin A. Topical tretinoin has been shown to have antineoplastic activity in a variety of experimentally induced and naturally occurring tumors. In some animal studies it has inhibited the development of ultraviolet-induced carcinomas. However, in other studies it accelerated such ultraviolet tumorigenesis. Other work has shown that the drug can eradicate chemically induced papillomas and carcinomas. These various effects may stem from tretinoin's influences on deoxyribonucleic acid synthesis, polyamine enzyme systems, sister-chromatid exchanges, oncogene expression, or lysosome lability. In clinical trials, tretinoin removed premalignant actinic keratoses from the face. Combined with 5 fluorouracil, it is also quite effective in the treatment of such lesions on the forearms and hands, areas where neither agent alone has much effect. It should be emphasized that tretinoin has not been shown to be carcinogenic in either animals or humans. After more than a decade of topical use of tretinoin on human skin, there is no evidence that the drug either initiates or promotes carcinogenesis in humans. PMID- 3534019 TI - Vitamin A and wound healing. AB - Retinoids have long been associated with wound healing, but objective data, until recently, have been scarce. Vitamin A deficiency retards repair. Secondly, retinoids restore steroid-retarded repair toward normal. Because vitamin A tends to suppress fibroblasts in cell culture and stimulate steroid-treated macrophages to initiate reparative behavior in tissue, we favor the hypothesis that retinoids are particularly important in macrophagic inflammation, which plays a central role in the control of wound healing. Probably all patients who take anti inflammatory steroids should control their retinoid intake, but how they should control it is as yet unknown. PMID- 3534018 TI - Techniques for assessing the activity of topically applied retinoids. AB - The retinoid drugs have profound effects on many aspects of skin biology. The exact activity profile depends on the particular analog and its route of administration. The topical retinoids used at present have marked therapeutic effects on epidermal cell production and desquamation. All-trans-retinoic acid (tretinoin) also acts on dermal connective tissue and microvasculature in a way that is less well established but may also be of therapeutic benefit. We investigated both tretinoin and motretinide in normal subjects and in patients with ichthyosis. The quantitative dansyl chloride test has been particularly useful in monitoring the desquamatory action of these topically applied retinoids. Both compounds resulted in enhanced rates of epidermopoiesis and desquamation. Marked changes in the cytochemical profile of the epidermis were also detected, changes that differed somewhat from the alterations induced by the systemic administration of etretinate. Changes in dermal structure and vascularization were monitored by A-scan ultrasound and laser Doppler flowmetry. However, only minor changes were recorded, probably because of the comparatively short application time. These newer techniques for investigating skin structure and function offer considerable opportunities for delineating the action of retinoids. PMID- 3534020 TI - Role of topical tretinoin in melanoma and dysplastic nevi. AB - The retinoids have been investigated extensively as chemopreventive and therapeutic agents in a variety of neoplasms. They have been shown to inhibit the proliferation of transformed cell lines in vitro and transplanted tumors in vivo. In cultured murine melanoma cells, retinoids inhibit proliferation and induce differentiation. Human melanoma cell lines have shown a mixed response. The clinical experience with retinoids in melanoma has been limited. Previously we investigated the activity of topical B-all-trans-retinoic acid (Retin-A, vitamin A acid, retinoic acid, and tretinoin) against intracutaneous metastases from malignant melanoma. We saw complete remission of multiple lesions in one individual and regression of several lesions in a second patient. This experience led us to conduct the present pilot trial of topical tretinoin in dysplastic nevus syndrome. The latter is a precursor of malignant melanoma. We saw regression of some of the treated lesions to benign nevi showing minimal or no dysplasia. Thus topical tretinoin appears to possess some activity against melanoma and at least one of its precursor conditions. In view of these preliminary results, more extensive trials are warranted to better define the role of tretinoin in the chemoprevention of malignant melanoma in high-risk lesions. PMID- 3534021 TI - Clinical experience with topical tretinoin in the treatment of cervical dysplasia. AB - Dysplasia of the uterine cervix is a recognized preneoplastic condition. Because of the observed ability of retinoids to reverse other dysplastic conditions in vitro and in vivo, a number of clinical studies have been carried out of the effect of these agents on cervical dysplasia, with the object of developing a means of chemoprevention of cervical malignancies in women at risk. We have conducted phase I and II trials of topical tretinoin (retinoic acid and Retin-A) delivered by means of a cervical cap and inert collagen sponge system. The results of these studies warranted a phase III trial, which is now underway. The outcome of the latter investigation will have important implications, not only for the management of patients with cervical dysplasia but also for therapeutic approaches to other precancerous conditions. PMID- 3534022 TI - Topical tretinoin in actinic keratosis and basal cell carcinoma. AB - In several studies between 1962 and 1978, topical tretinoin was proved capable of producing complete regression of actinic keratosis and basal cell carcinoma. But because its efficacy is not comparable to that of other modalities, topical tretinoin is currently used only as an adjunct to topical 5-fluorouracil in the treatment of actinic keratosis. One recent report found topical tretinoin ineffective in the chemoprevention of actinic keratosis. Although the oral synthetic retinoids isotretinoin and etretinate have been used in the prevention and treatment of cutaneous malignancy, the potential exists for chronic toxicity from the prolonged systemic therapy that appears necessary for maintaining the chemopreventive effect. For this reason, it may be appropriate to study further the preventive as well as therapeutic effects of topical tretinoin and other retinoids for actinic keratosis and skin cancer. If they prove safe and effective, the use of topical retinoids in the prevention and treatment of cutaneous tumors may be the most significant clinical application of these drugs. PMID- 3534023 TI - Topical tretinoin treatment for severe dry-eye disorders. AB - Despite the diverse causes of dry-eye disorders, the ocular surface epithelia in these diseases all undergo squamous metaplasia, manifested by loss of goblet cells, mucin deficiency, and keratinization. These changes account for tearfilm instability, which leads to various ocular symptoms and corneal complications. This article reviews research in the use of topical tretinoin to treat severe dry eye disorders. To classify squamous metaplasia into stages, a modified impression cytology technique was used to monitor the therapeutic effect of topical tretinoin ointment (0.01% or 0.1%, w/w) in 22 patients. This population had severe dry-eye disorders, including keratoconjunctivitis sicca, Stevens-Johnson syndrome, inactive ocular pemphigoid, drug-induced pseudopemphigoid, and surgery- or radiation-induced dry eyes. After treatment, clinical improvements were correlated with the reversal of squamous metaplasia as evidenced by the impression cytology technique. Tretinoin may also be effective in treating conjunctival keratinization without dry eyes, as illustrated by a case study. This may represent the first reported attempt to treat ocular surface disorders by reversing diseased epithelium. PMID- 3534024 TI - Selected therapeutic applications of topical tretinoin. AB - Since topical retinoic acid was first used for acne in 1959, many additional uses have been described for lesions on the skin, oral mucosa, and ocular surface epithelia. The topical application of retinoic acid has been shown to be effective in the treatment of several disorders of keratinization, keloids and hypertrophic scars, and various infections and inflammatory, pigmentation, and malignant and premalignant disorders. This article briefly reviews the use of topical retinoic acid for selected cutaneous conditions. PMID- 3534025 TI - Usefulness of retinoic acid in the treatment of melasma. AB - Melasma is a circumscribed brown macular hypermelanosis of the areas of the face and neck that are exposed to light. Clinical trials with various depigmenting formulations containing hydroquinone were conducted to determine the ideal concentration of hydroquinone, retinoic acid, and corticosteroids for the treatment of melasma. The compounds were tested with and without the concomitant use of topical sunscreen preparations. Based on the results of the trials and our earlier clinical experience, we conclude that treatment of melasma should involve the following: avoidance of sun exposure, constant use of broad-spectrum sunscreens, and topical application of a cream or lotion containing 2% hydroquinone and 0.05% to 0.1% retinoic acid (tretinoin). Patients should suspend use of oral contraceptives and other agents that promote skin pigmentation. The monobenzyl ether of hydroquinone should never be used in melasma therapy. PMID- 3534026 TI - Nuclear vacuolar acantholytic vesicular dermatitis associated with leukocytoclastic vasculitis. AB - A 48-year-old obese white woman had had a recurrent vesicular eruption for the previous 5 years. This eruption involved almost all parts of the body, including vaginal mucosa. The plantar and palmar surfaces were not involved. Eruptions start with a prodromal phase: 24 to 48 hours prior to the eruption, the normal appearing skin becomes painful. A reddish discoloration occurs, and vesicles form within a half hour. The histologic features of the vesicles are unique in that they contain acantholytic cells. The nuclei of these cells are vacuolated and contain a reddish, "target"-appearing substance. The underlying corium shows a necrotizing leukocytoclastic vasculitis. They only effective medication for this disease is cyclophosphamide. Pathogenesis is discussed and is compared with that of other vesiculo-bullous acantholytic lesions with that of leukocytoclastic vasculitis. To the best of our knowledge, this disease appears to be unique. PMID- 3534027 TI - Intrauterine herpes simplex infection resembling mechanobullous disease in a newborn infant. AB - We present a case of transplacentally acquired intrauterine herpes simplex virus infection in a newborn delivered at 36 weeks' gestation by cesarean section because of intrauterine growth retardation and maternal preeclampsia. The mother experienced a single episode of serotype 2 herpes progenitalis at 14 weeks' gestation. At birth the infant manifested clinical findings of herpes simplex virus infection, which resembled epidermolysis bullosa and aplasia cutis congenita. Preexisting cutaneous lesions and intact fetal membranes at delivery strongly support a transplacentally acquired intrauterine herpes simplex virus infection. Repeated Tzanck smears, viral cultures, and immunohistochemical studies of the skin were required to confirm the diagnosis. Intrauterine herpes simplex virus infection is associated with significant morbidity and mortality but responds to antiviral therapy. Therefore this diagnosis must be considered in the neonate born with bullous or eroded skin lesions. PMID- 3534028 TI - Giant cell fibroblastoma: an immunohistochemical study. AB - Giant cell fibroblastoma is a rare, benign soft tissue tumor occurring in childhood. A 34-year-old woman presented with a giant cell fibroblastoma involving the chest wall. Histologic features include an infiltrating spindle cell tumor involving the dermis and subcutaneous fat containing characteristic sinusoidal spaces rimmed by spindle cells and multinucleate giant cells. Immunohistochemical studies support a fibrohistiocytic differentiation. PMID- 3534029 TI - Conditioned aversive responses in cancer chemotherapy patients: theoretical and developmental analysis. PMID- 3534030 TI - Acute and chronic pain in adults and children with cancer. PMID- 3534031 TI - Psychology in cancer medicine: a perspective and overview. PMID- 3534032 TI - A comparison of cognitive-behavioral therapy and relaxation training for the treatment of depression in adolescents. PMID- 3534034 TI - Bonding: helpful hints for better results. PMID- 3534033 TI - Effects of anger management training with mentally retarded adults in group treatment. PMID- 3534035 TI - Veterans' access to oral health services. PMID- 3534036 TI - Use of lasers for closure of cutaneous wounds: experience with Nd:YAG, argon and CO2 lasers. AB - The concept of tissue fusion by laser has been recently established. In this study, we have examined the skin welding by laser and tested the efficacy of four different lasers for this application. The results attest to the feasibility of the procedure and suggest that laser welding may represent an alternative for closure of cutaneous wounds. PMID- 3534037 TI - Clinical evaluation of a nonadhering wound dressing. PMID- 3534038 TI - Plasma fibronectin: relevance for anesthesiology and intensive care. AB - Plasma fibronectin has been postulated to be an essential mediator of normal reticuloendothelial system (RES) function. The acute depletion of fibronectin is thought to impair RES function, whereas its repletion in states of deficiency has been reported to improve RES function. In vitro studies have documented fibronectin's ability to bind to some nonbacterial microaggregates and to promote the phagocytosis of bound targets by the RES. These properties may, however, be influenced by the in vivo milieu. There is substantial evidence for a parallelism between RES function and plasma fibronectin levels following blunt trauma in animal models; however, this association is not seen in experimentally induced intravascular coagulation, acute inflammation, and sepsis. Clinically, subnormal fibronectin levels are clearly associated with the triad of intravascular coagulation, organ failure and sepsis. Fibronectin is, however, not the only plasma protein reduced in these patients, nor is it an outstanding predictor of such complications. The therapeutic efficacy of fibronectin administration remains controversial. Whereas initial reports suggested therapeutic benefits of fibronectin-enriched cryoprecipitates, subsequent studies have produced negative results. Prospective, randomized, controlled clinical trials with purified fibronectin are needed before fibronectin should be recommended as an adjunct to the established principles of intensive care. PMID- 3534039 TI - Fibronectin and the critically ill patient: current status. AB - In summary, deficiency of plasma fibronectin has now been documented in a variety of clinical entities. Persistently low fibronectin may have prognostic value, and in certain patients may provide a clue to occult sepsis and potential organ failure. The clinical benefit of infusion of fibronectin-rich cryoprecipitate or purified human plasma fibronectin has yet to be determined in well-controlled randomized clinical trials. However, if such results become available then infusion of plasma fibronectin may provide a valuable therapeutic modality in the care of the critically-ill patient. PMID- 3534040 TI - Added inspiratory work of breathing during CPAP ventilation: comparison of two demand-valve devices with a continuous flow-system. AB - Measurements of added inspiratory work (AIW) of breathing imposed by three different CPAP systems were performed in 10 patients. One system was a continuous flow system while the two others were demand flow systems separated from respirators (Ohmeda VD 101 and Draeger CPAP 800 devices). AIW was calculated from pressure and flow signals recorded at the mouthpiece level. The AIW calculated with the two demand-flow systems was found to be the same as the AIW calculated with the continuous flow system although the results obtained by the Draeger device were less constant. The results obtained with the Ohmeda device in our patients conflicted with data previously published using a lung model. PMID- 3534041 TI - A stress management programme for inflammatory bowel disease patients. AB - This randomized controlled trial was designed to determine whether practising stress management techniques would decrease activity and promote psychosocial functioning in inflammatory bowel disease patients. Eighty ambulatory adults received a pre-intervention interview, at which time baseline data about disease activity and psychosocial functioning were collected. They were then randomly assigned to either the intervention or control group. The intervention group received six classes on stress management which included autogenics, personal planning skills and communication techniques. All 80 subjects were followed up at 4-month intervals for 1 year by interviewers who were blind to group designation. The data collection instruments, which were used at all assessment points, comprised three questionnaires: the Crohn's Disease Activity Index (CDAI) and the Inflammatory Bowel Disease (IBD) Stress Index. These instruments produced scores which decreased with improvement in physical and psychosocial well-being. At all assessment points, both the CDAI and IBD Stress Index scores dropped significantly (P less than 0.05) from baseline in the treatment group. However, there was no significant change in the scores of the control group throughout the study year. There were no significant changes in medications at any assessment point in either group that could account for changes in the scores. The results of this study indicate that stress management techniques may have therapeutic benefits for IBD patients. PMID- 3534042 TI - The Presidents. Harry Lyons 1956-1957. PMID- 3534043 TI - Closing anterior diastemas with cosmetic bonding. PMID- 3534044 TI - Use of transcutaneous electrical nerve stimulation in dentistry. AB - The literature on the use of transcutaneous electrical nerve stimulation in dentistry is reviewed, and what effect, if any, this method has on the dentist's ability to control pain is considered. PMID- 3534045 TI - Effects of volume expansion and contraction on potassium homeostasis in normal and hypertensive humans. AB - To investigate the role of potassium on blood pressure we measured serum potassium, urinary excretion of potassium and sodium, fractional excretion of potassium, urinary sodium:potassium ratio, plasma renin activity, aldosterone, and norepinephrine during dynamic maneuvers in normotensive and hypertensive subjects. After baseline measurements, we expanded intravascular volume with infusion of intravenous saline and then induced sodium and volume depletion by diuretic administration during a low sodium salt diet. These studies were performed in 431 normotensive and 478 hypertensive subjects enabling evaluation of the effects of age, race, and sex, as well as blood pressure, on the results. Among normotensives, we found that white subjects had significantly P less than 0.05) higher levels of serum and urine potassium, fractional potassium excretion and lower urinary sodium:potassium ratios than black subjects and that males had the same patterns of differences compared to females. Similar, but less consistent racial differences were seen among the hypertensive subjects. We also observed significant (P less than .05) correlations between urinary potassium excretion and body weight in both normal and hypertensive groups. In normal subjects, a significant correlation was observed between the urinary sodium:potassium ratio and blood pressure that was not seen in the hypertensives. The latter, however, displayed a significant (P less than .05) inverse relationship between serum potassium and blood pressure. Multiple regression analysis revealed that urinary potassium excretion was influenced by age, race, sex, body weight, blood pressure, creatinine clearance, renin, and aldosterone. These observations reveal important relationships between potassium homeostasis and blood pressure control that deserve further study. PMID- 3534046 TI - Hormonal responses to complete or hydrolyzed protein diets in patients after upper gastrointestinal surgery. AB - Six gastrointestinal hormones were measured in the plasma of six healthy controls and long-term changes were evaluated in six patients 2-20 years after upper gastrointestinal surgery. In a metabolic unit study we determined fasting hormonal levels, the time to peak hormonal response, and a 135-minute hormonal response to the meal. Test meals were isocaloric, 500 kcal, and isonitrogenous, consisting either of natural breakfast components or of complete liquid diets with intact protein (Ensure) or hydrolyzed protein (Vital). Postsurgical subjects were in good health and had no postcibal complaints. Nevertheless, their hemoglobin and serum albumin were significantly lower than in controls. Postsurgical subjects had higher fasting gastrin (121.3 +/- 11.6 vs 65.4 +/- 6.6 pg/ml, P less than .01) and motilin (148.7 +/- 32.9 vs 70.4 +/- 13.1 pg/ml, P less than .05) than controls. In postsurgical patients the peak gastrin and pancreatic glucagon responses to meals were obtained in significantly shorter time. Their total response to motilin and secretin to meals was significantly lower than in controls. Fasting glucose and the meal-induced responses of insulin and vasoactive intestinal polypeptide were not different from controls. The nature of dietary protein did not significantly affect hormonal responses to feeding. We conclude that gastrointestinal hormonal changes persist many years after surgery. These changes are probably related to faster transit of meals with a generally weaker total hormonal response to feeding. Although these differences from normal may be nutritionally well compensated, they may become important in periods of metabolic stress. PMID- 3534047 TI - Osteoporosis and aging: gastrointestinal aspects. PMID- 3534048 TI - Occupational asthma. AB - Occupational asthma accounts for a significant percentage of all asthma. Prevalence varies markedly, depending on host factors, the agent, and the manufacturing facility. The number of agents capable of inducing occupational asthma is large and will continue to increase as new agents are introduced into the workplace. Once an individual is sensitized, very low concentrations of the agent can initiate an asthmatic response. In many cases the mechanisms of the asthma are yet to be determined. The ultimate outcome of both the specific asthmatic response and the nonspecific bronchial hyperreactivity that usually occurs is variable, but in some cases it can continue for decades. Future needs are a better understanding of the prevalence of occupational asthma and the causative mechanisms involved in the disease and prophylactic or "desensitizing" measures. Environmental experts should explore methods to decrease the exposure of workers, and manufacturers should also begin to explore the possibility that chemical modification of their products may reduce their asthmatic potential (e.g., MDI, which has a vapor pressure 1000 times less than TDI, appears to be a significantly less potent inducer of occupational asthma). Finally, the physician, by identifying individuals with occupational asthma, will help improve our understanding of the disease, the mechanisms involved, and the development of therapeutic and preventive modalities. PMID- 3534049 TI - Levels of IgE in serum from normal children and allergic children as measured by an enzyme immunoassay. AB - Serum IgE levels of 346 nonallergic and 301 allergic children were measured by an enzyme immunoassay. The data are presented as the geometric mean +/- 95% confidence interval for each age from less than 1 to 12 years of age with those 13 to 16 years of age, pooled. The geometric mean for nonallergic patients increases from 0.9 IU/ml at less than 1 year of age to 45.4 IU/ml at 13 to 16 years of age. By use of an IgE value between confidence intervals of allergic and nonallergic subjects, a cutoff value for each age was established to differentiate allergic from nonallergic children. This value increases from 10 IU/ml at less than 1 year to 100 IU/ml at 13 to 16 years of age. The diagnostic sensitivity and specificity of the assay, based on the cutoff values, average 83% and 91%, respectively. PMID- 3534050 TI - Increase in gastroesophageal reflux during methacholine-induced bronchospasm. AB - There is an increased incidence in gastroesophageal reflux (GER) in subjects with asthma. The cause-effect relationship remains controversial. We compared 15 subjects with mild asthma to 15 control subjects (nonasthmatic) to ascertain if GER might be induced by bronchospasm. Continuous monitoring of lower esophageal sphincter pressure and pH at 5 cm above the lower esophageal sphincter was performed in seated subjects for 3 hours in total: 1 hour of baseline measurements, 1 hour of methacholine inhalation with a dosimeter, and 1 hour after the inhalation of 200 micrograms of salbutamol (albuterol). During bronchospasm, subjects with asthma had more episodes of GER (3.9 +/- 1.5) and dropped their pH to lower levels (pH 2.23 +/- 0.3) than did the control subjects (0.8 +/- 0.3 episodes, pH 3.22 +/- 0.3) p less than 0.05. We conclude that in these subjects with mild asthma, methacholine-induced bronchospasm produced GER episodes of greater frequency and severity. PMID- 3534051 TI - Physiologic considerations in drug absorption from the gastrointestinal tract. AB - The dynamic interaction between variables within the gastrointestinal tract and the physiochemical properties of a drug in a delivery system determine the rate and extent of absorption of that drug. Among the major physiologic variables are pH, gastric emptying time, and intestinal transit time. Some physicochemical properties of interest include solubility, particle size, and chemical form of the drug. Attributes of the formulation such as controlled-release mechanism, pH sensitivity, and size, shape, and density of the product can also affect absorption. Food has also been reported to influence the absorption from some but not all controlled-release products. As a more thorough understanding of the many factors involved in drug absorption is developed, the formulation of more sophisticated oral drug delivery systems will be possible. PMID- 3534052 TI - Erratic absorption of theophylline from slow-release products in children. AB - Sustained-release theophylline formulations are designed to provide consistent serum theophylline concentrations (STCs) by influencing the rate of theophylline absorption. The objective in developing these formulations is to minimize fluctuations in STC and improve patient compliance. Recent information, however, suggests that certain patients are susceptible to significant day-to-day and dose to-dose variations in STC. The purpose of this discussion is to review information on conditions that affect theophylline absorption. These factors include the formulation, dosing interval, age of the patient, absence or presence of food, and gastrointestinal physiology. Appreciation of the potential variation in STC, secondary to inconsistencies in theophylline absorption, is important in the accurate interpretation of STC obtained during routine therapeutic monitoring. PMID- 3534053 TI - Dose-dependent kinetics of theophylline. AB - This article reviews the background and current status of knowledge regarding the nonlinear kinetics of theophylline. The metabolic and renal mechanisms of nonlinearity and their significance with respect to single and multiple doses of theophylline are reviewed. Major implications of nonlinearity in theophylline kinetics with respect to bioavailability studies, predictions of steady-state serum theophylline concentrations, and dosage adjustments at steady state are presented in detail. PMID- 3534054 TI - Effect of disease states on theophylline elimination. AB - Host factors play an important role in the dosing requirements of theophylline. Theophylline metabolism and clearance depend principally on liver cell function rather than on hepatic flow. The effects of acute hypoxemia require more study; however, patients with chronic obstructive pulmonary disease who have chronic hypoxemia appear to have some impairment of clearance. Clearance is variably and sometimes drastically reduced in patients with liver disease and heart failure, and is reduced by some viral infections. It is not impaired by renal failure. Current split-virus vaccine mixtures do not appear to affect clearance. Clearance is increased in patients with cystic fibrosis and hyperthyroidism. The depressed clearance seen in the severely ill patients who require intensive care improves with improvement in the patient's condition, but the individual factors involved have not been identified. An area requiring more study is the effect of pH on the apparent distribution volume for theophylline. In the presence of liver disease, heart failure, or serious illness, caution must be applied in theophylline dosing, with frequent monitoring of serum levels. Stable patients also warrant an initially conservative dose until serum levels are obtained to guide further dose adjustments. PMID- 3534055 TI - Selection of a slow-release theophylline product. AB - Slow-release formulations of theophylline, if absorbed completely, consistently, and at a sufficiently slow rate, provide more stable serum concentrations at longer dosing intervals than plain uncoated tablets or liquids and thus have the potential to improve efficacy, safety, and compliance. However, clinically important differences in extent and rate of absorption exist among the 15 slow release formations available under 29 different brand names or as generic products in the United States. Moreover, food has different effects on the various formulations. Whereas some formulations are little affected by food with only a slight delay in absorption, others undergo malabsorption in either the presence or absence of food, depending on as yet unidentified but specific formulation factors. Because fluctuations in serum concentrations at any selected dosing interval are a function of the rate of elimination of theophylline from the patient and the rate of absorption of theophylline from the formulation, selection of a product and dosing interval needs to be an individualized clinical decision independent of marketing or regulatory influences. Most formulations with claims for twice-daily dosing cannot reliably maintain fluctuations in serum concentration whereby the peak will not exceed twice the trough. Moreover, of the three products approved for once-a-day dosing, fluctuations in serum concentration are more likely to be larger than are clinically optimal, and malabsorption occurs with two of the three approved formulations unless taken after food; one, in fact, has such a large increase in rate and extent of absorption when taken with food that its postprandial absorption characteristics are aptly described as "dose-dumping." PMID- 3534057 TI - Therapeutic effect and dosing strategies for theophylline in the treatment of chronic asthma. AB - Theophylline has demonstrated a very high degree of clinical efficacy as a prophylactic maintenance drug for chronic asthma when dose levels maintain serum concentrations of 10 to 20 micrograms/ml. Once established, such doses appear to be well tolerated and free of clinically apparent side effects, although minor neuropsychological and physiologic abnormalities can be detected. In general, while there appears to be little clinical effect from these minor side effects, the possibility of bothersome symptoms in selected patients cannot be excluded and requires further study. The data argue strongly that formulations and dosage intervals should aim for the most stable serum concentrations practically attainable, even though clinicians will certainly make justifiable compromises in individual clinical situations. The wide variability in theophylline elimination rate and the relationship between effect and serum concentration dictate that dosage be individualized and that final dosage is best guided by measurement of serum concentration. Slow clinical titration decreases the frequency of caffeine like side effects from greater than 50% of patients when therapeutic levels are rapidly attained to only 1% or 2%. Finally, although some physiologic variables and drug interactions may alter theophylline elimination and thus pose clinical risks, it is reassuring that dosage requirements generally remain stable over extended periods. PMID- 3534056 TI - Kinetics of drug action: an overview. AB - The intensity and time course of action of directly and reversibly acting drugs are related to and determined largely by the time course of drug and active drug metabolite concentrations in the body. When the pharmacokinetics and the concentration-effect relationship of a drug are known, it is often possible to predict the temporal pattern of its pharmacologic effect(s), including the maximum intensity and duration of action. Sites of action may not be immediately accessible to a drug even if it is injected intravenously; this may be reflected by a gradual increase in the intensity of effect despite decreasing drug concentrations in plasma, with maximum effects occurring later than maximum drug concentrations in plasma. Pharmacologic effects may persist well beyond the time when drug concentrations in plasma are no longer determinable; this is often caused by localization of the drug in an extravascular compartment. Drug distribution kinetics, pharmacologically active metabolites, and development of functional (as opposed to metabolic) tolerance may be responsible for time dependent changes in drug concentration--pharmacologic effect relationships. Interindividual differences in patients' response to drug therapy may have a pharmacokinetic basis, a pharmacodynamic basis, or both. In clinical assessments of pharmacologic response, it is important to measure the therapeutically relevant effect, to determine interindividual and intraindividual variability, and to explore the possible influence of underlying diseases and other physiologic variables on drug concentration-effect relationships. PMID- 3534058 TI - Pharmacologic effects of theophylline in the newborn. AB - Theophylline is an effective respiratory stimulant for apnea of prematurity. In the newborn, theophylline stimulates the central nervous system, particularly the respiratory center, leading to decreased apnea frequency and increased ventilation. Neonates appear to be more sensitive to the cardiovascular effect of theophylline; tachycardia occurs at plasma concentrations of 13 mg/L. Minimal effects on renal and gastrointestinal function are observed at therapeutic doses. Augmentation in oxygen consumption and alteration in glucose homeostasis may occur, even at therapeutic doses. If used appropriately, the drug is safe and effective for the treatment of neonatal apnea. PMID- 3534059 TI - Effect of theophylline on diaphragmatic and other skeletal muscle function. AB - Methylxanthines and particularly caffeine are known to increase skeletal muscle contractility. Recently, it has been shown that theophylline improves diaphragmatic contractility of the respiratory muscles both in isolated muscle preparations and in animals and normal human beings. Furthermore, it has been demonstrated that theophylline reverses diaphragmatic fatigue and prevents fatigue of the diaphragm when it is given prophylactically. Finally, recent evidence indicates that theophylline improves diaphragmatic function in patients with chronic obstructive pulmonary disease, all of whom retained CO2 (PaCO2 43 +/ 3 mm Hg) and had hypoxia (PaO2 57 +/- 8 mm Hg). Patients both improved transdiaphragmatic pressure and were less susceptible to fatigue. These data strongly suggest that theophylline, which increases respiratory muscle strength and delays the onset of diaphragmatic fatigue, could be a very useful agent in the treatment of patients with chronic airway obstruction. PMID- 3534060 TI - Theophylline improves global cardiac function and reduces dyspnea in chronic obstructive lung disease. AB - Theophylline has been utilized widely as a bronchodilator, but only in recent years have its positive cardiovascular effects been recognized in patients with chronic obstructive pulmonary disease. After intravenous administration of aminophylline, pulmonary artery pressures and pulmonary vascular resistance are reduced, and both right and left ventricular ejection fraction are increased. Similar short- and long-term enhancement of biventricular performance is produced by orally administered long-acting theophylline. Possible mechanisms for this theophylline-induced improvement in right and left ventricular systolic pump performance include enhanced ventricular inotropy and reduced ventricular afterload. A recent study has established that orally administered theophylline also reduces dyspnea in patients with chronic obstructive pulmonary disease. Accordingly, in patients with chronic obstructive pulmonary disease theophylline may be useful for reducing pulmonary artery pressure and pulmonary vascular resistance, treating right or left heart failure, reducing dyspnea, and partially reversing airway obstruction. PMID- 3534061 TI - Treatment of theophylline intoxication. AB - The treatment of theophylline intoxication is reviewed. Efforts should be made to decrease the absorption of theophylline from the gastrointestinal tract by the oral administration of activated charcoal and sorbitol; stomach emptying procedures are recommended only in limited circumstances. Patients should receive intensive supportive care and appropriate treatment for complications of intoxication, including metabolic and cardiovascular abnormalities and seizures. Despite these treatments, morbidity (including residual neurological deficits) and mortality may occur. Therefore, efforts to actively remove theophylline from the body before complications occur should be considered in an attempt to reduce morbidity and mortality. The oral administration of multiple doses of activated charcoal (which increases theophylline clearance) is recommended for nearly all patients with theophylline intoxication. Although controversial, hemoperfusion- an efficient but invasive active removal procedure--is recommended in severely intoxicated patients who satisfy specific indications; the prophylactic administration of phenobarbital to prevent seizures should also be considered in these patients. Although these recommendations are rationally based on the extant evidence, controlled clinical trials in patients with theophylline intoxication are needed to prove their utility. PMID- 3534062 TI - Development of safer xanthine drugs for treatment of obstructive airways disease. AB - Antiasthma drug development, for the most part, seems based on three classes of therapeutic agents. Many new sympathomimetic and corticosteroid drugs with increased specificity for the lung have been introduced. The third class of drugs, the xanthines, is still best represented by the prototype drug theophylline. After a brief review of the chemical history of antiasthma xanthines (the first limited attempts to develop novel derivatives 30 to 40 years ago), and some recent structure-activity findings, this article discusses the pharmacology of a selected xanthine derivative, enprofylline (3-propylxanthine). In various experimental systems and in patients, enprofylline shares antiasthmatic effects with theophylline; however, enprofylline is the more potent of the two (greater than 1 to 2 micrograms/ml plasma are effective concentrations of enprofylline). At present, enprofylline, which lacks diaphragmatic and central nervous system stimulatory actions, has been shown to be at least as clinically efficacious as theophylline in obstructive lung disease. Further work is needed to elucidate the target cells and mechanism(s) of action involved in bronchodilatory and anti-inflammatory effects of the xanthines. Growing numbers of animal and human pharmacologic studies show that enprofylline is without many of theophylline's extrapulmonary effects--in particular the excitatory ones. Perhaps most significantly, enprofylline does not produce central nervous system stimulant behavioral effects, including seizures. If and when enprofylline becomes available as an alternative drug, increased attention will probably be focused on the significance of other theophylline actions (gastric secretion, release of free fatty acids, vasoconstriction, diuresis, etc.) that are not shared by enprofylline.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3534063 TI - Nutrition in American Indian health: past, present, and future. AB - In addition to benefiting from public health programs for all Americans, American Indians and Alaska Natives are eligible for health services from the Indian Health Service (IHS), U.S. Public Health Service. Indian Health Service provides comprehensive health services, including nutrition and dietetics, to American Indians and Alaska Natives living on or near federal Indian reservations or in traditional Indian territory, such as Oklahoma and Alaska. Dramatic improvements have occurred in the health of native Americans since IHS was transferred to the Public Health Service in 1955. Infant mortality rate, maternal deaths, and deaths related to infectious diseases have all decreased. Chronic diseases are now major causes of death. Nutritional factors contribute to at least 4 of the 10 leading causes of American Indian and Alaska Native deaths--heart disease, cancer, cirrhosis, and diabetes--and to the prevalence of overweight, obesity, hypertension, and dental caries. There is still incomplete information on nutritional status and present dietary patterns, nutritive values of native foods, and nutrition education knowledge of the population. Priority nutrition objectives have been developed to address those issues. PMID- 3534064 TI - Co-encapsulation of cyclosporin and insulin by liposomes. AB - Evidence for an association of both hydrophilic insulin and hydrophobic cyclosporin with liposomes prepared from egg yolk lecithin, cholesterol, and stearylamine (7:2:2.25 molar ratio) was obtained by Sepharose-4B gel filtration. The method used to prepare unilamellar liposomes containing 29.7 nmol cyclosporin and 2.3 nmol insulin per mu mol of liposomal lecithin is described. PMID- 3534066 TI - [Results of the surgical treatment of pterygium apropos of 102 cases]. AB - After reviewing the anatomical, pathological and clinical features of pterygium, the authors describe the various surgical techniques. Simple resection, resection combined with oral and mucous membrane or conjunctival graft, derivation autoplasty, central or peripheral lamellar keratoplasty. 102 cases are presented, operated by the various techniques. A statistical study of successes and recurrences, considering the evolution stages and the follow up, is presented. Operative indications are outlined: simple resection in very wild cases, conjunctival autoplasty in intermediate cases, actually the most frequent, lamellar keratoplasty, in so called "malignant" pterygium or recurrent pterygium. PMID- 3534065 TI - [Technics and results of autografts in surgery of pterygium. Study based on 34 grafts]. AB - The first procedure consists of corneal autograft sampled at noon or six o'clock on the pterygium's excision bed, combined to a conjunctival flaps translation. The second technique consists of a monoblock corneoconjunctival graft with a limbic hinge. The operative difficulties, post-surgical complications and results are discussed. The results seem very promising: one recurring case out of 34 grafts performed. The recurring risk, more acute in tropical environment where it is frequently impossible to obtain corneal homografts is greatly reduced by autografts. PMID- 3534067 TI - Client-related risk factors of nursing home entry among elderly adults. AB - We estimated the relative importance of various client characteristics related to nursing home entry for a national probability sample of Medicare recipients and developed predictive models of nursing home entry that account for the interactive effects among variables. In contrast with previous research, we focused on the characteristics of nursing home entrants, not residents. By using a national sample we ensured that the influence of regional variations in the configuration of long-term care services would not confound estimates of the relative effect of client-related factors. Nine variables emerged as statistically significant predictors: age, being confined to a bed, requiring help to get around, requiring aid getting around, being widowed, never married, welfare as a payment source, insurance as a payment source, and perceived health status. When these factors were controlled for, sex, geographic region, and educational status were not statistically significant. PMID- 3534068 TI - The realities of body image. PMID- 3534069 TI - Mammography and ultrasonography for breast cancer detection. PMID- 3534071 TI - Medieval and Renaissance medicine: continuity and diversity. PMID- 3534070 TI - Bee sting nephropathy in a transplant patient. PMID- 3534072 TI - Sin and the etiology of disease in pre-Crusade Europe. PMID- 3534073 TI - Sleep: theory and practice in the late Renaissance. PMID- 3534074 TI - Bartolomeo Eustachio: his influence on Albinus and the anatomical models at La Specola, Florence. PMID- 3534075 TI - "Lively lustre, kindly dew:" William Heberden's "Of Perspiration". PMID- 3534076 TI - Immunohistochemical localization of ornithine aminotransferase in normal rat tissues by Fab'-horseradish peroxidase conjugates. AB - Immunohistochemical localization of ornithine aminotransferase (L-ornithine: 2 oxo-acid aminotransferase, EC 2.6.1.13), a mitochondrial enzyme whose hereditary absence induces gyrate atrophy of the choroid and retina, was elucidated by a direct immunoperoxidase method using Fab'-horseradish peroxidase conjugates. In immunodiffusion studies, the antibodies raised with the re-crystallized enzyme were highly specific to ornithine aminotransferase. To show localization of ornithine aminotransferase in normal rat tissues, clear immunohistochemical staining of this enzyme through the inner mitochondrial membrane in paraffin sections was achieved with Fab'-horseradish peroxidase conjugates. Strong immunoreactivity was present in cerebral neurons, hepatocytes, and epithelial cells of renal tubuli, gut mucous membranes, and ocular tissues. Specific distribution of ornithine aminotransferase was found in ependymal cell groups: namely, epithelial cells of the choroid plexus, pigmented and nonpigmented epithelial cells of the ciliary body. and Muller cells and pigment epithelium of the retina. PMID- 3534077 TI - Quantitation in immunocytochemistry: correlation of immunogold labeling to absolute number of membrane antigens. AB - Baby hamster kidney cells infected with Semliki Forest virus were used as a model system for quantitative immunocytochemical labeling studies. In this system, a well-characterized membrane protein complex is present in different concentrations in three separate locations. Using immunogold labeling of cryosections, we compared the number of gold particles labeling the membranes of endoplasmic reticulum, Golgi stack, and fully formed virions at the plasma membrane to the biochemically determined concentrations. The efficiency of labeling was 40, 13, and 14% for the three structures, respectively. In a comparative study, Lowicryl K4M sections were found to give significantly lower levels of labeling. PMID- 3534078 TI - Improved immunoelectron microscopic method for localizing cytoskeletal proteins in Lowicryl K4M embedded tissues. AB - We have modified the Lowicryl K4M low-temperature dehydration and embedding procedure for immunoelectron microscopy to provide improved ultrastructural detail and facilitate the localization of actin and tubulin in isolated rat adrenocortical cells, chick spinal cord with attached dorsal root ganglia (SC DRG), and cultured dorsal root ganglia (DRG). Cells and tissues were fixed for immunocytochemistry either in a mixture of 2% paraformaldehyde and 0.25% glutaraldehyde (0.1 M PIPES buffer, pH 7.3) or in a mixture of 0.3% glutaraldehyde and 1.0% ethyldimethylaminopropylcarbodiimide (0.1 M phosphate buffered saline, pH 7.3). Dehydration was in ethanol at progressively lower temperatures to -35 degrees C. Infiltration at -35 degrees C was followed by ultraviolet polymerization at -20 degrees C. Comparable samples were fixed in glutaraldehyde and osmium tetroxide and embedded in Epon 812 or Epon-Araldite. Post-embedding immunostaining of thin sections utilized commercially available monoclonal antibodies to tubulin and actin followed by the protein A-gold technique (Roth et al., Endocrinology 108:247, 1981). Actin immunoreactivity was observed at the periphery of mitochondria and between mitochondria and lipid droplets in rat adrenocortical cells and at the periphery of neuronal cell processes of SC-DRG. Tubulin immunoreactivity was associated with microtubules throughout neurites of cultured DRG. Our modified technique allows preservation of ultrastructural details as well as localization of antigens by immunoelectron microscopy. PMID- 3534079 TI - Application of avidin-biotin-peroxidase complex method with a monoclonal antibody to human Ia-like antigen in immunoelectron microscopy. AB - Monoclonal antibody (MAb) to human Ia-like (HLA-DR) antigen was applied with the avidin-biotin-peroxidase complex (ABC) immunostaining method to localize the Ia like antigen at the electron microscopic level. Our results indicated that in human tonsils and adenoids fixed with 4-6% phosphate-buffered paraformaldehyde for 4-6 hr, sharply delineated electron-dense products of the antigen and antibody complex were detectable on the outer cell membranes of lymphoblasts, lymphocytes, reticular cells, and macrophages. In our study, the vibratome sections of the paraformaldehyde-fixed, pre-embedding immunostained tissues consistently showed more satisfactory morphology than frozen sections. The combined use of the anti-human Ia monoclonal antibody and the ABC procedure with paraformaldehyde fixation provides a simple and sensitive method to study at the ultrastructural level the Ia-like antigen-bearing cells, which are vital in the immune response. PMID- 3534080 TI - Femininity in men and masculinity in women: American psychiatry and psychology portray homosexuality in the 1930's. AB - Two influential studies of homosexuality are reviewed. Both were conducted in the United States in the 1930s and involved rather large samples of homosexual men and women. Each investigation concluded that homosexuality was linked to cross gender identification. Consequently, these studies served as a justification for perpetuating a clear distinction between masculine and feminine roles. Consideration is given to the intellectual and social context within which the association of gender deviation and homosexuality was promulgated. PMID- 3534081 TI - Heterosexual bias in psychological research on lesbianism and male homosexuality (1979-1983), utilizing the bibliographic and taxonomic system of Morin (1977). AB - Utilizing the concept of heterosexual bias, recent research on homosexuality is evaluated to see if this bias has lessened in recent years. In 1977 the suggestion was made that a new vision of homosexuality as an alternate and equally valid lifestyle would result in changes in the questions posed, the data collected, and the interpretations made in research on homosexuality. Recent journal article abstracts are examined and weighed to find the extend to which they reflect a change in the social values of the behavior under study. These findings are compared to those of the original study in 1977 and assessed to see if the predicted changes have come about. Strong evidence of such a change was found. PMID- 3534082 TI - A radiation-hygienic appraisal of biosphere contamination with 129I. AB - Data are reviewed supplied by the author and other investigators on 129I formation, migration, the level of foodstuffs contamination and biological effectiveness of the nuclide. An appraisal is made of the biological hazards associated with environmental contamination with a view to the prospective development of the nuclear energy industry. It is concluded that the contribution of 129I to the radiation dose humans receive is extremely small as compared to other anthropogenic sources of radiation. In the light of the current knowledge, the possibility of somatic and genetic effects due to the contamination of the biosphere with 129I is negligible. PMID- 3534083 TI - Fatty acid composition of bacteria as a chemotaxonomic criterion. AB - The paper reviews data on the fatty acid composition of bacteria as a taxonomic criterion useful for the identification of bacteria and specifying their classification. Variations in the fatty acid composition of bacteria associated with culturing conditions and due largely to the adaptive role of fatty acids in the bacterial cell require that standard conditions be maintained while examining that character. In some cases, adjustment of culturing conditions may be a factor providing for the identification of specificities in the fatty acid profile of bacteria of related species. The use of data on the fatty acid composition of bacteria has promising applications in confirming and establishing their phylogenetic relationship, that being accomplished not only on the basis of similarity in the character under consideration which correlates with similarity in genotypic and other phenotypic characters, but by analyzing its adaptive variability as well. The latter approach is especially promising for creating a natural classification. It is pointed out that the determination of the fatty acid composition of the lipid component of lipopolysaccharides from Gram-negative bacteria is useful as it supplies additional taxonomic information. PMID- 3534084 TI - Polyclonal activation of lymphocytes. AB - Literary data (48 references) on the phenomenon of polyclonal activation (PA) of lymphocytes are analysed and PA inductors of various nature are classified. A new trend in the study of PA is pointed out--the recording of nonspecific reactions to not only exogenous, but also endogenous antigens (mostly autologous erythrocytes and DNA). The problems of the mechanism of PA, the role of the normal autoimmune system, T-cells and macrophages, increased synthesis of specific and nonspecific immunoglobulins and cell proliferation are discussed. The great protective significance of PA as the quickest humoral reaction of the organism on the intrusion of antigenic products or their endogenous synthesis is emphasized. The possibility of using PA for the characterization of the function of B-cells and the normal system of autoimmunity is pointed out. In the study of PA, a standard complex of antigens should be used which should invariably include the cells of microbial autoflora of the body as well as tissue antigens for the detection of autoimmune reaction. PMID- 3534085 TI - Immunomodulating effect of autohaemotherapy (a literature review). AB - An analysis is presented of experimental and clinical data from different authors on the stimulating effect of autohaemotherapy with regard to the immunological reactivity of humans and animals as well as in vitro experiments with lymphocytes. Erythrolysate has been found to exert a more powerful effect than intact erythrocytes. The stimulating effect of autohaemotherapy on both irradiated and non-irradiated animals manifests itself in an increase in resistance to infection (increased LD50 in experimental infection), enhanced production of antibodies to microbial and tissue antigens and activated functioning of cell-mediated immune defence mechanisms. The favourable influences on radioresistance and the antitumour effect of authohaemotherapy are described. Induced desensitization plays an important part in the mechanism of action of autohaemotherapy. The administration of large doses of erythrocytes or of erythrolysate results in immunosuppression. Autohaemotherapy does not cause side effects and is feasible both on an in-and out-patient basis. PMID- 3534086 TI - The renin-angiotensin system and long-term regulation of arterial pressure. PMID- 3534087 TI - Changing the Mediterranean diet: effects on blood pressure. AB - An increase in the polyunsaturated to saturated fatty acid ratio (P:S) in the diet has been reported to reduce blood pressure in man. We have investigated whether an increase in the percentage of saturated fatty acids in the typical Mediterranean diet would affect blood pressure in a sample of healthy rural population of southern Italy. Fifty-seven non-hospitalized normotensive volunteers (29 male, 28 female, aged 30-50 years) were studied. After a 2-week baseline period on their customary diet (P:S = 0.44), they underwent a 6-week isocaloric dietary intervention with a 70% increase in energy from saturated fatty acids and a corresponding decrease in carbohydrate and mono-unsaturated fat (P:S = 0.23). Thereafter they returned to their usual diet and were followed-up for 6 more weeks (switch-back period). By the end of the intervention period, systolic pressure was increased by 2.6 mmHg in men (P less than 0.05) and by 4.8 mmHg in women (P less than 0.01). Diastolic pressure was not significantly increased, although a significant linear regression of the group average blood pressure over time was observed for both systolic (0.161 mmHg, P less than 0.01) and diastolic pressure (0.107 mmHg, P less than 0.01). After returning to their customary diet, blood pressure returned to baseline (-0.212 mmHg, P less than 0.05 systolic and -0.226 mmHg, P less than 0.01 diastolic). No significant change in body weight occurred throughout the study. These findings suggest that changes in the saturated fatty acid content of the diet with moderate change in the dietary P:S ratio can influence blood pressure to a significant extent. PMID- 3534088 TI - STOP-hypertension: Swedish trial in old patients with hypertension. PMID- 3534089 TI - Evaluation of a commercial immunoenzymometric assay for human prolactin. AB - A commercially available immunoenzymometric assay for human prolactin based on two monoclonal antibodies, one bound to a solid-phase bead and the other conjugated to alkaline phosphatase, was evaluated. The assay had a lower limit of detection of 2 ng/ml and between-batch coefficients of variation of less than 10% for prolactin concentrations in the range 7-152 ng/ml. Assay accuracy as judged by comparison of patient samples analysed by a RIA, assay of quality control samples and recovery experiments, was good. No significant cross-reactivities or interferences were found. The assay is precise, accurate, fast and robust with the advantage of using a non-isotopic label. PMID- 3534090 TI - A rapid, simple method for leukemia immunophenotyping using air-dried blood and bone marrow smears. AB - This paper describes a modification of the peroxidase technique by which immunophenotyping may be carried out on routinely air-dried blood and bone marrow (BM) smears. The method is simple and quick, requires no special equipment, can be performed on fresh or stored specimens and gives a standard of morphological detail equal to that of routine blood films. With a monoclonal anti-HLA-DR antibody as a prototype, it was possible to demonstrate reliably, the presence of positively and negatively stained cells of appropriate morphological types in the peripheral blood of leukemia patients. Although only about one-third of antibodies tested were effective with the technique, we identified monoclonal antibodies capable of demonstrating myelomonocyte, granulocyte, monocyte, pan leukocyte, transferrin, platelet, pan-T, 'cALLA plus B cell' and other antigens. However, we have not yet found antibodies able to identify T cell subsets, nor to distinguish 'common' acute lymphoblastic leukemia from its rare B-cell counterpart. With these limitations the method is suitable for routine use alongside cytochemistry in the differential diagnosis of leukemias and lymphomas. PMID- 3534091 TI - Synthetic peptides as antigens for the detection of humoral immunity to Plasmodium falciparum sporozoites. AB - The presence of antibodies against P. falciparum sporozoites in humans living in malaria-endemic areas was measured using as antigen the synthetic peptide (NANP)3, which represents the immunodominant region of the circumsporozoite (CS) protein. By using a competitive binding assay it was determined that antibodies which recognize (NANP)3 do not react with a 22-Mer synthetic peptide representing a cross-reacting epitope present in an antigen (5.1) from the blood stages of the parasite. Antibodies present in human sera which react with the 5.1 peptide did not react with (NANP)3. This strongly suggests that antibodies to (NANP)3 found in sera of individuals living in endemic areas are a reflection of exposure to P. falciparum sporozoites. These results validate the use of (NANP)3 for epidemiological studies to detect and measure humoral immunity to P. falciparum sporozoites. PMID- 3534092 TI - Development of an enzyme-linked immunosorbent assay for staphylococcal protein A produced in Escherichia coli by pUC8 based plasmids containing the Staphylococcus aureus Cowan I protein A gene. AB - Staphylococcal protein A, a cell wall component of several strains of Staphylococcus aureus has found many uses as a research tool, as a diagnostic reagent and even as a possible therapeutic agent in cancer. These uses have arisen exclusively out of its almost unique property of binding specifically to the Fc region of many immunoglobulin molecules. As Staphylococcus aureus is pathogenic, it has been desirable for industrial purposes to clone the gene coding for protein A into Escherichia coli and to develop a sensitive assay free from interference by bacterial components. We describe an ELISA assay which is capable of detecting staphylococcal protein A in bacterial lysates at levels as low as 1.0 ng/ml and which is free of interference from lysozyme, lysostaphin, endogenous peroxidases or other bacterial antigens. PMID- 3534093 TI - ELISA using whole Legionella pneumophila cell as antigen. Comparison between monovalent and polyvalent antigens for the serodiagnosis of human legionellosis. AB - An indirect enzyme-linked immunosorbent assay (ELISA) using the six serogroups of whole L. pneumophila bound to microtitre plate wells is described for the serodiagnosis of legionellosis. Comparative studies using monovalent antigen indicated a high correlation between ELISA and indirect immunofluorescence antibody (IFA) tests (r = 0.90, P less than 0.001). Testing 196 human sera by ELISA using both monovalent and polyvalent antigens have established the efficiency of the polyvalent antigen for screening purposes. The ELISA test system exhibited rapidity, sensitivity and reproducibility and should be considered as an alternative to the IFA test for routine serodiagnosis of legionellosis. PMID- 3534094 TI - Use of monoclonal antibodies to quantify subclasses of human IgG. I. Development of two-site immunoenzymometric assays for total IgG subclass determinations. AB - Dissection of the IgG antibody response into its subclass components has been difficult largely because of the lack of adequate supplies of specific reagents. The development of monoclonal antibodies (Mcab) promises to overcome this problem, but the use of such antibodies has certain inherent problems. It has been shown recently that Mcabs which were avid, potent and specific for well defined epitopes may partially or completely lose their activity depending on the assay system in which they were used. In order to identify Mcabs that would be specific and useful as capture antibodies in a simple two-site enzymometric assay, a panel of 18 Mcabs was screened and one Mcab to each of the four IgG subclasses was identified for quantitation of subclass levels in human serum. PMID- 3534095 TI - Enumeration of antibody-secreting cells by immunoprinting: sequential readout of different antibody isotypes on individual cell monolayers employing the ELISA plaque assay. AB - A technique is described for obtaining 'prints' of the antibody output of individual antibody-secreting cells (ASC), by repeated exposure of an immobilized ASC monolayer to coverslips coated with antigen. Zones of bound antibody on the coverslips (each being the 'print' of an individual ASC) are subsequently visualized by ELISA technology. PMID- 3534096 TI - Fingerprinting Candida albicans. AB - A new method of typing Candida albicans based on immunoblotting is described. Isolates were disrupted by a mixture of enzymic pretreatment with alpha mannosidase followed by sonication. They were then stained using a modified ELISA system by a rabbit hyperimmune serum raised against a single isolate, C. albicans NCTC 3153. The 190 isolates examined from the London Hospital produced 16 different types. Type 1 accounted for 43% of the isolates and was the commonest type outside the intensive care unit. Type 2 caused an outbreak of systemic candidosis on the intensive care unit. The technique was much more sensitive than the serotyping and morphotyping methods and lacked the phenotypic variability of the biotyping procedure previously used to define the outbreak. The gel-to-gel variation precludes its use in large scale epidemiological work. Its value lies in identification of outbreaks so that they can be controlled by the introduction of measures to prevent cross-infection. PMID- 3534097 TI - A simple indirect immunofluorescence micromethod for cell typing. AB - We describe a simple indirect immunofluorescence micromethod for cell typing. Cells are layered on 18-well immunofluorescence slides coated with high polymer poly-L-lysine. Expressed cell surface membrane markers are detected by indirect immunofluorescence using monoclonal antibodies and the cells are stained with Evans blue dye to permit easy morphological identification under fluorescence and light microscopy. We compared this method with a conventional method for lymphocyte typing in 16 blood samples and 10 bronchoalveolar lavage samples. The results of the two methods did not differ and correlated closely (r = 0.988 for blood samples; r = 0.995 for bronchoalveolar lavage samples). The principal advantages of this micromethod are: the small amounts of cells (10(4) cells) and reagents needed, the ease with which numerous antibodies can be tested and the convenience offered by fixation and staining of cell preparations for reading. PMID- 3534098 TI - The application of glucose oxidase-labeled antibodies for the detection of proteins on nitrocellulose. AB - We have evaluated the sensitivity of immunostaining with glucose oxidase for the detection of monomeric human serum albumin (HSA) and monomeric human immunoglobulin G (IgG). A modification of a histochemical procedure was utilized by replacing phenazine methosulfate (PMS) with 1-methoxyphenazine methosulfate (mPMS) and by replacing Tris-HCl with Tris-citrate to improve the solubility of the tetrazolium compounds tested. mPMS is less sensitive to light, and may be stored for long periods in solution; it is now used routinely by histochemists in place of PMS in dehydrogenase cytochemistry. pH values of 6.3-8.3 were tested, with the reaction at pH 8.3 providing a slight increase in sensitivity. The reaction rate increased markedly as the pH became more alkaline. The minimum quantity of HSA detected was 3 ng applied directly to nitrocellulose and 10 ng when blotted. Human IgG was routinely detected at 250 pg and occasionally at 100 pg when dotted on the nitrocellulose. PMID- 3534099 TI - In vitro stimulation prior to fusion generates antigen-binding human-human hybridomas. AB - Production of useful human monoclonal antibodies has been limited by the inability to reliably generate and isolate antigen-specific B cells by in vivo immunization. An in vitro culture system employing antigen and mitogen to stimulate lymphocytes derived from solid lymphoid organs has been developed. Human tonsilar or splenic lymphocytes were stimulated in vitro with antigen and mitogen in short term culture and then fused with either of two enzyme deficient human B cell lines. This approach appears to expand antigen-specific B cell clones prior to fusion resulting in the production of a significant number of antigen-binding human hybridoma antibodies. The system has been effective in the production of human monoclonal antibodies following stimulation with KLH-ARS, a soluble antigen, and intact group B streptococcus, a particulate antigen. Hybridomas have been produced by fusion with two distinct parental human B cell lines supporting the previously reported observation that human B lymphoblastoid cell lines representing different stages of B cell differentiation may be useful fusion partners. The utility of the in vitro stimulation system in producing human-human hybridomas secreting antibody directed against two distinct classes of antigens establishes this approach as a generally useful method for the production of human monoclonal antibodies. PMID- 3534100 TI - Nephrotic syndrome in poststreptococcal glomerulonephritis. PMID- 3534101 TI - [Hydatid cyst of the kidney. Apropos of 30 cases]. AB - Symptomatology in thirty patients with hydatid cyst of kidney treated in the Urologic Clinic, UHC, Avicenne, Rabat, was florid (83% with pain and 43% with a mass in the flank) and sometimes specific (27% of cases). Associated hypertension was an exceptional finding. Preoperative diagnostic investigations included ultrasound and CT scan imaging, replacing arteriography to a great extent. Approach to surgical treatment was usually by a lombotomy (64%) or even a Baraya incision (23%), followed by treatment of the renal cyst itself (a case of silent kidney on IVU treated by resection of a protruding dome). Nephrectomy was frequently necessary (47%) for renal lesions. When conservative therapy appeared sufficient the only procedure adopted, apart from specific cases, was resection of a protruding dome even when the hydatid cyst was discharging into excretory pathways. Splenectomy was sometimes necessary (2 of 22 cases) for hydatid cyst of left kidney. This series emphasizes the safety of surgery for hydatid cyst of kidney since the only death reported occurred 2 months after operation in a patient with an associated renal sarcoma. PMID- 3534102 TI - Hydrocortisone reduces both constitutive and UV-elicited release of epidermal thymocyte activating factor (ETAF) by cultured keratinocytes. AB - Epidermal thymocyte activating factor (ETAF) is spontaneously released into the media by PAM 212 and A 431 cell lines and cultured normal human keratinocytes. ETAF from all 3 cell types can substitute for interleukin 1 (IL-1) in the augmentation of proliferation of a helper T-cell clone (D10.G4.1) induced by mitogen. Hydrocortisone (HC) substantially reduces the release of ETAF by these keratinocytes and, further, appears to induce the release of an inhibitor of lymphocyte activating factor activity of IL-1. Irradiation with UVC causes increased ETAF release into the media. Hydrocortisone abrogates this effect. Thus HC reduces both constitutive and elicited release of ETAF. ETAF plays a major role in inflammation; the ability of HC to block ETAF release by keratinocytes may account for the anti-inflammatory effect of glucocorticosteroids on the skin. PMID- 3534103 TI - A monoclonal antibody specifically reactive to human Langerhans cells. AB - We prepared a mouse monoclonal antibody that reacts specifically to human Langerhans cells (LC). The protein recognized by this antibody was mainly in the membranes of Birbeck granules and related structures. Using this antibody, we could identify LC in various tissues; these cells were in the skin, stratified squamous mucosal epithelia, lymph nodes, and the thymus. The antibody did not react with monocytes, tissue macrophages, lymphoid dendritic cells, follicular dendritic cells, or interdigitating cells. The antigen purified with this antibody was a heterogeneously glycosylated protein of Mr approximately 40,000 without interchain disulfide bonds. This antibody may be useful for identifying LC in various human tissues with or without abnormalities, and for studying the origin and fate of Birbeck granules of LC. PMID- 3534104 TI - Melanoma-associated antigens in deparaffinized tissue sections. PMID- 3534105 TI - M cells and host defense. PMID- 3534106 TI - Pathogenesis of IgA1 protease-producing and -nonproducing Haemophilus influenzae in human nasopharyngeal organ cultures. AB - We evaluated mucosal attachment, colonization, and invasion by Haemophilus influenzae in an experimental model of human nasopharyngeal tissue in organ culture. Nonpiliated, encapsulated, and nonencapsulated, IgA1 protease-deficient mutants of H. influenzae were compared with their isogenic IgA1 protease producing parents. Damage to peripheral ciliary activity was first noted 6 hr after infection and was associated with sloughing of ciliated cells to which H. influenzae were not attached. Infection of organ cultures with each strain resulted in similar degrees and rates of ciliary damage. H. influenzae attached selectively to nonciliated epithelial cells or was associated with surface mucus. Later, disruption of epithelial tight junctions was observed, and clusters of H. influenzae were found between epithelial cells. Organisms were also seen within phagocytic vacuoles of mononuclear cells located above and below the basement membrane. In summary, encapsulated and nonencapsulated H. influenzae damaged the ciliary function of human nasopharyngeal organ cultures, attached to the mucosal surface, and invaded the epithelium. H. influenzae IgA1 protease, however, was not essential for the pathogenic steps observed in this human nasopharyngeal organ culture model. PMID- 3534107 TI - Experimental proctitis due to rectal infection with Chlamydia trachomatis in nonhuman primates. AB - To serially examine the immunopathogenesis and histopathology of rectal infection with Chlamydia trachomatis, we inoculated five cynomolgus monkeys with C. trachomatis serovar E (non-LGV) and five with serovar L2 (LGV). After inoculation, C. trachomatis was isolated from rectal cultures in three of five non-LGV-infected monkeys and in all five LGV-infected monkeys for a period of 10 weeks. LGV-infected monkeys developed a severe hemorrhagic ulcerative proctitis, in contrast to a mild proctitis in the non-LGV-infected monkeys. Hyperplasia of lymphoid follicles and a mucosal polymorphonuclear leukocyte and mononuclear cell infiltrate were evident in all infected monkeys. Crypt abscesses with giant cells and a rare granuloma formation were present in two of five LGV-infected monkeys. C. trachomatis inclusions were initially present in epithelial cells and later in tissue histiocytes. Experimental primate infection with C. trachomatis appears to clinically and histopathologically mimic rectal infection in humans and provides a model for immunopathogenesis studies in chlamydial proctitis and granulomatous proctitis. PMID- 3534108 TI - Neurotoxicity due to adenine arabinoside therapy during varicella-zoster virus infections in immunocompromised children. PMID- 3534109 TI - The kinetics of terminal deoxynucleotidyl transferase-positive cells in the mixed colony assay. AB - Human bone marrow was treated with cytolytic monoclonal antibodies BA-1, BA-2 and BA-3 and examined for terminal deoxynucleotidyl transferase-positive (TdT+) cells during culture in the mixed colony assay. The kinetics of TdT+ cells was compared with untreated bone marrow controls over a 14-day culture period. In control cultures a progressive decline in the number of TdT+ cells occurred during the first three days and by day 4 no TdT+ cells were observed. In antibody-treated cell cultures in which all or the majority of TdT+ cells were removed, no TdT+ cells were detectable after 24 h. Both control and antibody-treated cultures showed comparable colony formation from myeloid, erythroid and multipotential progenitor cells by day 14. The results therefore suggest that the mixed colony assay does not support the growth of TdT+ cells or the production of TdT+ cells from TdT- precursors. PMID- 3534110 TI - Characterization of the in vitro stromal microenvironment of human bone marrow. AB - Utilizing long-term in vitro culture techniques, we characterized the cellular composition and functional attributes of the human in vitro bone marrow stromal microenvironment. Morphologic, specific cytochemical and immunologic methods demonstrated that the marrow stromal adherent layer (AL) reached confluency at two to three weeks, and was comprised of 60%-70% fibroblastic cells, 10%-20% endothelial cells, 10%-20% monocyte/macrophages and 5%-10% fat-laden adherent cells. These proportions of cell types persisted for at least three months concomitant with proliferation of CFU-gm and BFU-e. In contrast, umbilical cord blood cells did not form a stromal AL despite persistence of hemopoietic progenitor cell proliferation. These findings provide a basis for improved understanding of cellular interactions regulating hemopoiesis. PMID- 3534111 TI - Rapid method for permanent slide preparation of colonies in soft agar cultures. AB - A method is presented for preparing permanent microscopic slides from colony bearing agar layers in soft agar cultures. The main advantages of this technique are its simplicity, rapidity and accurate colony preservation. This method could have broad applications in the human tumor clonogenic assay (HTCA), particularly in the quantitative morphological, cytochemical and immunocytochemical assessment of colonies that form in both control and drug-treated cultures. Thus, this method opens up possibilities for using cytopathological criteria as a quantitative endpoint of the HTCA. PMID- 3534112 TI - Production of recombinant mouse beta-interferon. AB - A plasmid was constructed to express a mouse beta-interferon (IFN-beta) in Escherichia coli under the control of the modified tryptophan (trp) promoter. E. coli carrying the plasmid were cultivated in a minijar fermentor and synthesized up to 2.7 X 10(6) IU/ml of antiviral activity. At the end of the cultivation the cells became elongated and curved. PMID- 3534113 TI - Morphological observations on the formation and stability of the crystalline arrays in the plasma membrane of Saccharomyces cerevisiae. AB - Two-dimensional crystalline arrays of freeze-fracture particles are known to occur in abundant quantities in the plasma membrane of stationary state yeast cells. Although these crystalline arrays are seen only infrequently in cells during mid-exponential growth, we now observe that formation of crystalline arrays can be induced in such cells by a "metabolic starvation" protocol. Surprisingly, starvation-induced formation of crystalline patches can be prevented by inhibition of new protein synthesis during the starvation period. The size and quantity of crystalline arrays can be increased by removal of the cell wall prior to starvation. Induction of crystalline arrays in protoplasts has made it possible to investigate the surface morphology of the crystalline particles in isolated membranes as well as at the extracellular surface of intact protoplasts. The stability of isolated crystalline arrays to several detergents has been investigated and conditions have been found that result in improved morphological purity of the isolated crystalline patches. PMID- 3534114 TI - [Experimental evaluation of prostacyclin for preventing hyperacute rejection in cross-species heterotopic heart transplantation]. PMID- 3534115 TI - [Functional evaluation of the ischemic lung with six hours cooling]. PMID- 3534116 TI - [Immunohistochemical study on human colostral cells]. AB - Colostrum contains a large number of cells and humoral defence factors that play an important role in the protection of neonates. While colostral cells have been characterized by immunohistochemical criteria, the function of these cells has been poorly understood. In this study, localization of immunoglobulins and other components in human colostral cells was examined by an immunofluorescence technique. The results obtained were as follows: Colostral cells reactive with polyvalent anti-human immunoglobulins were neutrophils and macrophages with a granular staining pattern. The predominant immunoglobulin in colostral cells was IgA, followed by IgM. A small amount of IgG was also found in these cells. The distribution of SC was similar to that of IgA and J-chain, suggesting the presence of secretory IgA in colostral cells. Coincidence of kappa chain and lambda chain in the same granules of neutrophils and macrophages suggests that these immunoglobulins were phagocytosed by neutrophils and macrophages. This conclusion was supported the results of the experiment which showed that incubation of peripheral blood neutrophils and monocytes with cell free colostrum resulted in the appearance of immunoglobulins in granules. PMID- 3534117 TI - [Electron microscopical and immunohistochemical study of human endometrial carcinoma with special reference to localization of estrogen receptors and carcinoembryonic antigen]. AB - Human endometrium, endometrial hyperplasia and endometrial carcinoma were observed by light microscope. Endometrial carcinoma was histologically divided into Grade I (53 cases), Grade II (10 cases), and Grade III (7 cases). According to the results of electron microscopical analysis, cancer cells in GIII were smaller and showed a higher N/C rate and less mitochondria in the cytoplasma than those of GI and GII. Rough endoplasmic reticula were well developed in GI and GII compared with GIII. Immunohistochemically, ER localized in 54% cases of endometrial carcinoma, and decreased in positive rates of undifferentiated carcinoma. The metaplastic area in carcinoma showed the localization of ER and CEA. A close correlation between ER and CEA was demonstrated in endometrial carcinoma. Ultrastructurally, rough endoplasmic reticula were well developed in the cytoplasma of cancer cells in the strong positive cases of ER and CEA. It has been proved that histological detection of ER and CEA in endometrial carcinoma is very important in deciding the diagnosis, prognosis and therapy. PMID- 3534118 TI - [Evaluation of fetal development and well-being with the ultrasonic Doppler fetal actocardiograph]. AB - Fetal development and well-being were investigated during pregnancy with respect to the relation between fetal movement (FM) and fetal heart rate (FHR) in 192 normal and 43 high-risk fetuses in the antepartum period utilizing ultrasonic Doppler fetal actocardiograph that enabled the simultaneous and continuous recording of FM and FHR by single ultrasonic probe. The analysis of simultaneously obtained records of FHR and the movements of fetal trunk and legs revealed that gross fetal trunk movement was mainly related with FHR acceleration. The number of FM signal bursts, which was accompanied by fetal trunk rotating movements, showed a peak at 30-31 weeks of gestation and decreased in the other stage of pregnancy. The synchronization rate of FM signal bursts to transient FHR rises increased with gestational age, and the amplitude and inclination of the rise accompanied by bursts increased linear from the 24th to the 38th week of gestation. Fetuses of high-risk pregnancy produced on antepartum actocardiogram with low FM and FHR values. The changes were particularly remarkable in the cases of intrauterine growth retardation and/or gestosis. PMID- 3534119 TI - [Studies on the interaction between trophoblastic invasion and maternal immune cell infiltration at the implantation site in early human pregnancy by means of double immunoperoxidase technic using monoclonal antibodies]. AB - Interaction between trophoblastic invasion and maternal immune cell infiltration at the implantation sites in early human pregnancy was analyzed by means of a double immunoperoxidase technique using Troma-1, a rat monoclonal antibody, which recognizes trophoblastic cells and a set of mouse monoclonal antibodies to react with various immune cells. The results were as follows. The most prominent immune cells in the implantation sites were monocytes/macrophages, which were positive for HLA-DR. These cells were adjacent to trophoblastic cells which were infiltrating into the decidua basalis. It therefore appeared that these cells function as "antigen presenting cells" which recognize and present the processed fetal information to maternal T cells. A small number of cells with mature T cell markers were found to be infiltrating around the anchoring villi and the extra villous trophoblastic cells in the decidua compacta. But a larger number of T cells were adjacent to the villi in the decidua spongiosa and the extra-villous trophoblastic cells invading the decidua spongiosa and the myometrium. These cells may therefore play a role in preventing trophoblastic cells from invading the myometrium in the implantation sites. A relatively large number of cells with E rosette receptors but without mature T cell markers were observed in the decidua basalis, but few were found in the myometrium, into which a larger number of mature T cells were infiltrating. The distribution of particular cells was similar to that of endometrial granulocytes studied in our laboratory. There were thus likely to be immune cells in humans equivalent to non-T granulated suppressor cells in mice, which have been shown to suppress the generation of cytotoxic T cells (Clark et al.). PMID- 3534120 TI - Purification of placental alkaline phosphatase and its monoclonal antibody. AB - Monoclonal antibodies (MAbs) to placental alkaline phosphatase (PAlP) were raised by using the hybridoma technique. Spleen cells from immunized mice were fused with the mouse myeloma line NS-1 using 50% polyethylene glycol and cultured in a selection medium. Antibodies were screened by the enzyme immunoassay using immobilized solid-phase antigen and anti-mouse immunogloblin Fab' (rabbit)-beta-D galactosidase complex. Four double-cloned hybridomas were obtained. The cross reactivity with different kinds of alkaline phosphatases of the raised MAbs was examined. At first, MAb 11-D-10, with which placenta was stained but liver and small intestine were not stained in indirect immunofluorescence, was selected. Then, the cross-reactivity of MAb 11-D-10 was further investigated by immunoblotting (Western blotting). MAb 11-D-10 reacted with PAlP but did not react with hepatic and intestinal alkaline phosphatase at all. The binding activity of 125I-labeled MAb 11-D-10 with different choriocarcinoma cell lines (SCH, BeWo, NaUCC-1, NaUCC-2, and NaUCC-3) was highest in SCH, then in the order of BeWo, NaUCC-3, NaUCC-1 and NaUCC-2, and correlated to the PAlP content of the cells (SCH greater than BeWo greater than NaUCC-3 greater than NaUCC-1 greater than NaUCC-2). Also the intensity of indirect immunofluorescence of the above cell lines with MAb 11-D-10 correlated with the PAlP content of each cell. PMID- 3534121 TI - [Detection of 6-keto-prostaglandin F1 alpha and thromboxane B2 in human placental tissues]. PMID- 3534122 TI - [The idea of studies on dental polymers]. PMID- 3534123 TI - [New development in bonding to the dentin]. PMID- 3534124 TI - Hyperferremia in immunosuppressed patients with acute nonlymphocytic leukemia and the risk of infection. AB - Hypothesizing that any effect of an increased serum iron and transferrin saturation on the risk of bacterial infection would be particularly important in immunosuppressed patients, we reexamined the effect of hyperferremia on bacterial growth in vitro and studied the pattern and prevalence of hyperferremia in patients receiving treatment for acute nonlymphocytic leukemia (ANLL). Growth of inocula of Escherichia coli and Staphylococcus aureus was significantly greater (1.3- to 5.8-fold) in fresh or heat-inactivated sera obtained from 10 healthy volunteers 3 hours after oral ingestion of ferrous sulfate (mean +/- SEM transferrin saturation 95% +/- 3%) than before (transferrin saturation 34% +/- 10%). Similarly, in heat-inactivated serum samples obtained from six patients with various malignancies, growth of E. coli was significantly greater (2.3- to 5.5-fold) with the elevated transferrin saturation (97% +/- 3%) present 1 to 7 days after receiving chemotherapy than with the normal transferrin saturation (33% +/- 9%) present before. In a prospective evaluation of serial serum iron studies in 12 patients receiving treatment for ANLL, five patients had normal serum iron concentrations initially, but in each patient the transferrin saturation was elevated after receiving chemotherapy, usually to greater than 90% for greater than 15 days in conjunction with prolonged, profound granulocytopenia and fever. PMID- 3534125 TI - The first university-owned hospital (1869): Ann Arbor, Michigan. PMID- 3534126 TI - Prosthetic management following bilateral total or subtotal maxillectomy. PMID- 3534127 TI - Naturally acquired leprosy in the nine-banded armadillo: a decade of experience 1975-1985. AB - A decade has passed since our first report of naturally acquired leprosy in the nine-banded armadillo. Our studies and those of others during this period confirm the identification of the etiologic agent as Mycobacterium leprae. Confirmation is based on the results of histopathologic examination and microbiologic evaluations that included attempts to culture the organism, flourescent antibody studies, mycolic acid analysis, and DNA determinations demonstrating complete relatedness between the natural agent and M. leprae. Surveys involving large numbers of animals demonstrate a significant prevalence of the disease in armadillos captured in Louisiana and Texas. The discovery of naturally acquired leprosy in a chimpanzee in 1977 and a sooty mangabey monkey in 1979 reinforce the concept of leprosy as a zoonosis. Extensive contact with armadillos has been implicated by other observers in seven patients with leprosy in Texas. We believe the prevalence of leprosy in wild armadillos requires that they be considered a source of infection in patients from geographic areas where leprosy and armadillos co-exist. PMID- 3534128 TI - [False aneurysms in prostheses of the aortic bifurcation. Apropos of 34 case reports]. AB - Thrombosis, infection, false aneurysm and hemorrhage are all complications occurring following reconstructive arterial surgery. The authors study what is certainly the most unusual of these complications, i. e. development of false aneurysms of prostheses of the aortic bifurcation. They describe the various etiological factors responsible for their onset and also new diagnostic features and the principles of re-operation as well as results. This study is based upon a series of 34 cases of false aneurysm of prostheses of the aortic bifurcation inserted over a ten year period from 1974 to 1984. During this period, 1,400 prostheses of aortic bifurcation were inserted, essentially for two indications: chronic obliterative arterial disease of the lower limbs and aneurysmal disease. The mean latent period of onset of the complication was four and a half years. Removal followed by insertion of a new prosthetic graft is the basic treatment, overall mortality being 4% and morbidity being 30%, dominated by secondary thrombosis in 19% of cases, local infection in 8% of cases and recurrence of aneurysm in the same percentage of individuals. The overall figure of very good results was 70%. Whilst discussion is dominated by the role of different etiological factors, it nevertheless remains important to note that only progress in prosthetic and suture materials can allow a future decrease in the percentage of such false aneurysms, the factor inherent in the vascular surgeon, i. e. operative technique itself, being much easier to deal with on principle. This complication nevertheless remains very serious, best dealt with by surgery since the natural history of this false aneurysm is completely different from that of a classical femoral or popliteal aneurysm. PMID- 3534129 TI - [Evaluation of the neurological risk of asymptomatic carotid stenosis and discussion of the value of carotid surgery in stage 0. Apropos of a study of 123 obliterative lesions]. AB - The authors analyzed neurological risk on the basis of the study of 123 asymptomatic obstructive carotid lesions. Patients were divided into two groups: Group A (54 patients undergoing prophylactic endarterectomy). Group B (69 patients not undergoing surgery). Definition of the carotid lesion was based upon a combination of Doppler, sonography and arteriography results. Assessment of comparative neurological risk, on the basis of a hemodynamic definition of the stenosis, in the two patient groups, led to definition of appropriate management of an asymptomatic carotid stenosis. In group A, operative mortality was nil and there was one transient ischemic accident. In group B, there were 12 accidents, 9 transient and 3 permanent. In this latter group there was one neurological death, i. e. mortality of neurological origin of 1.5%. Evaluation of risk initially requires definition of the stenosis. The presence of a carotid bruit alone is inadequate. Doppler and sonography, followed where necessary by arteriography, define the degree of stenosis which is the primordial prognostic feature. The difference of risk between a population undergoing surgery or not is statistically significant, in particular in hemodynamically tight stenosis. Finally, the degree of stenosis influences the severity of any subsequent accident, although this has not been proved statistically. In the majority of cases, the initial accident would appear to be regressive. In total, 4 concepts have been defined: the risk of carotid surgery at stage 0 is low, being of the order of 0. Overall neurological risk is less in the long term in asymptomatic patients who have undergone surgery than in those who have not been operated upon.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3534130 TI - [A swollen leg disclosing a popliteal cyst. Apropos of a misleading case]. AB - A patient was admitted with a clinical suspicion of left sural thrombophlebitis. Analysis of the clinical features and the results of rheoplethysmography, phlebography, arteriography and, most importantly, ultrasonography led to the diagnosis of popliteal synovial cyst and demonstrated the vascular repercussions of this lesions responsible for the swollen leg. A review of the literature confirms the frequently misleading clinical features of popliteal cysts. The authors present a strategy for the investigation of these cases, based on vascular functional investigations and in particular ultrasonography. PMID- 3534131 TI - Conversion of an M- group A streptococcus to M+ by transfer of a plasmid containing an M6 gene. AB - An M28-derived group A streptococcal strain deleted for the gene encoding M protein was converted to M+ by introduction of a plasmid carrying emm6, the structural gene for type 6 M protein from strain D471. The reconstituted M+ strain, JRS2, resists phagocytosis in human blood and is opsonized by anti-M6 hyperimmune serum, but not by anti-M28 serum. Immunofluorescent microscopy and ELISA demonstrate the presence of M protein on its surface. In addition, JRS2 removes opsonic antibodies from hyperimmune rabbit sera generated by immunization with purified ColiM6 protein and with a synthetic amino-terminal peptide derived from M6. Immunization of rabbits with JRS2 generates opsonic anti-M6 antibodies. These results indicate that the cloned emm6 gene contains the information necessary to convert a phagocytosis-sensitive streptococcus to phagocytosis resistance. Furthermore, it also contains the determinants for M type specificity and those required to elicit opsonic antibodies. It thus appears to determine all the traits associated with M protein. PMID- 3534132 TI - [Results of a multicenter evaluation of enzyme immunoassays for thyrotropin (TSH)]. AB - This paper summarises the results of the evaluation of an enzyme immunoassay for thyrotropin by a group of 17 laboratories. This sandwich enzyme immunoassay is based on the specific binding of the beta-subunit of thyrotropin by monoclonal antibodies coated on polystyrene tubes. Thyrotropin, bound to the tube wall, is determined with horse radish peroxidase coupled to the Fab fragment of a polyclonal sheep antibody against the alpha-subunit of thyrotropin. The lower limit of detection of 0.5 mU/1 was adequate, and the precision of the enzyme immunoassay was comparable with that found in radioimmunoassays for thyrotropin. The intraassay CV was in the range of 2 to 10% for a serum containing 1.5 to 5 mU/1 thyrotropin. The interassay CV was in the range of 5 to 10% for a serum containing about 6 mU/1. The recovery of thyrotropin standards in human thyrotropin-free serum was between 93% and 101%. Cross-reactions with human choriongonadotropin and gonadotropins were excluded. There were no interferences in haemolytic and lipaemic samples or by high bilirubin concentrations. Comparison of thyrotropin levels measured with different radioimmunoassays and with the enzyme immunoassay gave correlation coefficients in the range of 0.925 and 0.995. Advantages of the enzyme immunoassay are the absence of radioactive substances and the short incubation period of 3 hours. Incubation overnight results in a higher sensitivity of 0.18 mU/1. This assay can therefore be regarded as one of the new highly sensitive thyrotropin assays (Bernutz, C. et al. (1985) Clin. Chem. 31, 289-292). PMID- 3534133 TI - Evaluation of the fluorescent test for office-based detection of group A beta hemolytic streptococci infection. AB - Primary care physicians are frequently called upon to diagnose and treat streptococcal illness. Group A beta-hemolytic species have been associated with serious complications, making accurate diagnosis important to the clinician. This study was designed to compare a new test using a fluorescent tag with the traditional blood agar-bacitracin disc method and the capillary precipitin test. The fluorescent test for group A beta-hemolytic streptococci has been shown to be rapid and simple to perform. More important, the sensitivity and specificity appear to be equal to the capillary precipitin test and superior to the commonly used blood agar-bacitracin disc method. PMID- 3534134 TI - Oxytocin: pharmacology and clinical application. AB - Oxytocin is a potent uterine stimulant that is used for the induction and augmentation of labor, antenatal fetal assessment, and control of postpartum hemorrhage. If used improperly, oxytocin can lead to such complications as uterine hypercontractility with fetal distress, uterine rupture, maternal hypotension, water intoxication, and iatrogenic prematurity. These complications can almost always be avoided if oxytocin is given in proper dosages and with careful fetal and maternal monitoring. Recent interest in active management of labor policies has resulted in a reexamination of the use of oxytocin in the augmentation of the labors of nulliparous women. PMID- 3534135 TI - Characterization of Aspergillus nidulans mutants in carbon metabolism isolated after D-galacturonate enrichment. AB - A selective method for the isolation of Aspergillus nidulans mutants defective in the pyruvate dehydrogenase complex was devised. The essential steps in the procedure were a mutagenic treatment of conidia with X-rays to about 50% survival, followed by filtration enrichment in minimal medium with D galacturonate as sole carbon source, and rescue on complete medium with acetate. The mutants thus isolated were phenotypically characterized on the basis of growth tests, and different genotypes were assigned on the basis of complementation tests. The majority of the mutants that were unable to utilize galacturonate were defective in one of the components of the pyruvate dehydrogenase complex. In addition, mutants defective in pyruvate carboxylase, mutants defective in glycerol catabolism and some novel mutants which were only unable to use D-galacturonate as carbon source were found. At least two genes were shown to be involved in D-galacturonate metabolism. PMID- 3534136 TI - Effects of in vitro growth phase on the pathogenesis of Salmonella typhimurium in mice. AB - The growth phase of a bacterial (Salmonella typhimurium) culture was shown to have pronounced effects on the pathogenic properties of the harvested bacteria. Salmonellae obtained from a culture in primary (exponential) growth phase (PP) were more readily cleared from the blood and more readily killed by phagocytes than were salmonellae obtained from a more slowly growing secondary growth phase (SP) culture. PP salmonellae were observed to cause death of mice sooner than SP salmonellae. This appeared to be because the more rapid growth of PP, as compared to SP, salmonellae continued in the liver and spleen for several hours following intravenous injection, and more than compensated for their high in vivo death rate. As a result, within 4 h there were approximately 10-fold more live salmonellae in the spleens and livers of mice that had received PP, as compared to SP, salmonellae. This 10-fold difference was maintained until the death of the mice, indicating that after the first 4 h post-inoculation, the net in vivo growth of the salmonellae was the same regardless of their growth phase in the inoculating culture. This transition between PP and SP salmonellae occurred long before a dense stationary phase culture was obtained. Salmonellae grown in minimal media exhibited the biological properties of SP salmonellae and never entered as rapid a growth phase as did salmonellae in complete media. PMID- 3534137 TI - The rate of killing of Escherichia coli by beta-lactam antibiotics is strictly proportional to the rate of bacterial growth. AB - Nongrowing bacteria evade the bactericidal activity of beta-lactam antibiotics. We sought to determine if slow growth rate also alters bactericidal activity. The bactericidal activity of two beta-lactams on Escherichia coli grown in glucose limited chemostats was compared for generation times ranging from 0.7 to 12 h. The degree of killing varied with drug structure and with E. coli strain. However, all killing rates were a constant function of the bacterial generation time: slowly growing bacteria became progressively more phenotypically tolerant to beta-lactam antibiotics as the generation time was extended. PMID- 3534138 TI - Glycogen and trehalose accumulation during colony development in Streptomyces antibioticus. AB - Streptomyces antibioticus accumulated glycogen and trehalose in a characteristic way during growth on solid medium. Glycogen storage in the substrate mycelium took place during development of the aerial mycelium. The concentration of nitrogen source in the culture medium influenced the time at which accumulation started as well as the maximum levels of polysaccharide stored. Degradation of these glycogen reserves was observed near the beginning of sporulation. The onset of sporogenesis was always accompanied by a new accumulation of glycogen in sporulating hyphae. During spore maturation the accumulated polysaccharide was degraded. No glycogen was observed in aerial non-sporulating hyphae or in mature spores. Trehalose was detected during all phases of colony development. A preferential accumulation was found in aerial hyphae and spores, where it reached levels up to 12% of the cell dry weight. The possible roles of both carbohydrates in the developmental cycle of Streptomyces are discussed. PMID- 3534139 TI - Monoclonal radioimmunoassay for hepatitis B surface antigen in sera of children with acute leukemia. AB - Hepatitis B surface antigen (HBsAg) was detected by a monoclonal antibody radioimmunoassay in sera from five of 43 children (11.6%) with acute leukemia, who were negative by conventional assay. None of the nine positive sera had evidence of reactivity for HBV-DNA or DNA-polymerase activity. No correlation was found between the presence of HBsAg in serum by monoclonal RIA and the behaviour of anti-viral antibodies. Twenty-two children could be studied for liver HBsAg by immunofluorescence, and nine of them (40.9%) were positive, including three patients having HBsAg reactivity in serum. These data indicate that monoclonal antibodies increase the sensitivity of RIA for the detection of serum HBsAg in children with acute leukemia, who previously have frequently been found to have an atypical hepatitis B virus (HBV) serology. PMID- 3534140 TI - Comparative trial of acyclovir and vidarabine in disseminated varicella-zoster virus infections in immunocompromised patients. AB - A comparative assessment of vidarabine and acyclovir in the treatment of varicella and disseminated zoster in immunosuppressed patients was undertaken. Thirty-eight immunosuppressed patients with varicella (N = 18) or disseminated zoster (N = 20) were treated intravenously with 10 mg/kg/day of vidarabine or 30 mg/kg/day of acyclovir for 5 days according to a preestablished code within each diagnosis group--varicella and disseminated zoster. Two deaths, although not directly related to VZV infection, were observed in the vidarabine-treated varicella group. The times to cessation of formation of new lesions and to the disappearance of fever were similar for vidarabine and acyclovir in each group. In the varicella group, VZV was isolated on day 5 in four out of five vidarabine patients versus one out of five acyclovir patients. No severe adverse effects were observed with either drug. Neutropenia present in patients of both drug groups was transitory and most often related to previous cytolytic chemotherapy. These data suggest that either vidarabine or acyclovir could be used in the treatment of severe VZV infections in immunosuppressed patients, although a larger number of patients would be required for definitive conclusion. Because of the large amount of solute required for vidarabine administration, acyclovir may be preferred when the risk of cardiorespiratory failure is high. PMID- 3534141 TI - Treatment of mental disorders in pregnancy. A review of psychotropic drug risks and benefits. AB - Pregnancy can be complicated by affective or psychotic illnesses severe enough to threaten the health and life of both mother and fetus. In many cases, nonbiological interventions like psychotherapy or hospitalization in a supportive milieu will be insufficient, and use of a psychotropic drug will be indicated. This paper outlines the characteristics of maternal and fetal physiology that influence drug risks and then reviews the specific risks and benefits associated with antipsychotics, antidepressants, and lithium. PMID- 3534142 TI - Turnover of glial filaments in mouse spinal cord. AB - Twenty-day-old mice received a single tail vein injection of [guanido 14C]arginine. The cytoskeleton was extracted from the spinal cords at varying lengths of time thereafter. Glial fibrillary acidic protein (GFAP) formed a distinct, broad band that was widely separated from other protein bands in one dimensional polyacrylamide gels. The purity of the GFAP band was verified by Western blot analysis of one- and two-dimensional electrophoretic patterns. In addition, enzyme-linked immunosorbent assay and quantitative Western blot analysis indicated that 95% of the total spinal cord GFAP was extracted in the cytoskeletal preparation. The specific activity of GFAP was obtained by eluting the protein from the cytoskeletal GFAP band in preparative one-dimensional gels. Specific activity reached a peak 2 h after injection with [14C]arginine. Forty percent of the incorporated radioactivity was still present in cytoskeletal GFAP at 9 weeks, indicating that a significant proportion of glial filaments turns over relatively slowly in vivo. PMID- 3534144 TI - Prospects for the therapeutic use of human monoclonal antibodies. AB - Despite much recent progress, human monoclonal antibodies (HuMAbs) are currently more difficult to generate than conventional rodent monoclonals. Clinical trials using rodent monoclonals suggest that they can be given safely, but that the human antimouse immune response can limit their efficacy. We review the human monoclonals that have been generated to date, and explore the clinical uses that will be made of these reagents in the near future. PMID- 3534143 TI - Clinical correlates of enzyme-immunoassay versus radioimmunoassay measurements of antibody against acetylcholine receptor in patients with myasthenia gravis. AB - Antibody against human nicotinic acetylcholine receptor [Ab(AcChR)] was measured in the sera obtained from 55 patients with myasthenia gravis (MG) using both radioimmunoassay (RIA) and enzyme-linked immunosorbent assay (ELISA). By at least one assay, 91% of the patients had elevated Ab(AcChR). We found no correlation between the amount of Ab(AcChR) measured by RIA and that measured by ELISA. Patient subpopulations defined by ELISA- or RIA-measured Ab(AcChR) were associated with different disease durations. All of those who had high Ab(AcChR) levels by both assays had experienced symptoms for less than 2 years. 87% of those with high Ab(AcChR) levels by ELISA had had MG for less than 4 years. Those patients with high Ab(AcChR) only by RIA had a mean disease duration of over 8 years. With regard to correlations of Ab(AcChR) with patient age and sex, females under 50 years of age had high levels of Ab(AcChR) by RIA, but had lower levels by ELISA, whereas men over 50 had high Ab(AcChR) levels by ELISA. Using either assay, no relationship was established between concentrations of Ab(AcChR) and the patient's functional status, previous thymectomy, or current therapy. In this study, 16% of the MG patients with elevated Ab(AcChR) would have been considered within the non-disease range of Ab(AcChR) had only the RIA been performed, thus recommending the routine use of both assays for diagnostic purposes. PMID- 3534145 TI - The immunohistochemical application of three anti-GFAP monoclonal antibodies to formalin-fixed, paraffin-embedded, normal and neoplastic brain tissues. AB - The intermediate filament, glial fibrillary acidic protein (GFAP) has proven to be an important glial marker in diagnostic neuropathology. We report the histochemical application of three monoclonal antibodies (Mab) produced in this laboratory, 1B4, 2E1, and 4A11, which are monospecific to GFAP by radioimmunoassay, immunoblot electrophoresis, and immunoperoxidase histochemistry. The goal of this study was to compare the specificity and sensitivity of these Mab to GFAP on surgical brain biopsy specimens which had been routinely processed for diagnostic neuropathology with that of a high titer, highly specific, reference polyvalent anti-GFAP antiserum. The Mab stained astrocytes specifically in normal brain. When combined in a "cocktail" preparation, the quality of the immunoperoxidase detection of GFAP by these Mab closely approached that of the reference serum in 71 intracranial and intraspinal neoplasms. As these three Mab represent a continuous supply of a well defined, monospecific reagent, the monoclonal "cocktail" represents a standard reagent for large multi-institutional studies and for studies extending over a period of time. PMID- 3534146 TI - Decontamination of formaldehyde-fixed tissues of Creutzfeldt-Jakob disease. PMID- 3534147 TI - Anatomical evidence for enkephalin immunoreactive climbing fibres in the cerebellar cortex of the opossum. AB - Enkephalin immunoreactivity is present in the cerebellum of the adult opossum within axonal arbors that resemble mature climbing fibres. In the developing cerebellum, enkephalinergic axons form pericellular nests around the perikarya of Purkinje cells in a manner which resembles developing climbing fibres seen in Golgi impregnations. Serial electron micrographs of adult climbing fibres reveal elongate enkephalin immunoreactive profiles that contain synaptic vesicles and make contact with the thorns and shafts of Purkinje cell dendrites. These results suggest that a peptide, enkephalin or an enkephalin-like substance may mediate synaptic interactions between certain populations of climbing fibres and Purkinje cells in the cerebellum of the opossum. Enkephalin immunoreactive axonal arbors, present in the molecular layer, are localized in restricted areas of vermal lobules II-VIII and X. The intermediate cortex and hemispheres are devoid of enkephalinergic climbing fibres except in restricted areas of the paramedian lobule, paraflocculus and the flocculus. In an attempt to establish the origin of enkephalin axons in the cerebellum, a double labelling technique that combines retrograde labelling of cells with horseradish peroxidase and enkephalin immunohistochemistry has been employed. Enkephalin immunoreactive neurons within specific portions of the medial accessory olive are retrogradely labelled in this paradigm. The presence of enkephalin immunoreactivity in selected climbing fibres provides evidence for chemical heterogeneity within one of the major afferent systems to the cerebellum previously thought to be uniform in its transmitter content. PMID- 3534148 TI - Immunocytochemical localization of choline acetyltransferase in rat ventral striatum: a light and electron microscopic study. AB - The ventral striatum, previously defined as including the nucleus accumbens, substriatal grey, olfactory tubercle and striatal cell bridges has been examined in an immunocytochemical study with monoclonal antibodies to choline acetyltransferase (ChAT) in order to identify putative cholinergic neurons and synaptic junctions within the region. Light microscopy revealed ChAT-positive neurons with similar morphological characteristics in all divisions of ventral striatum. The somata of immunoreactive neurons were round or elongated in shape, approximately 10 X 21 microns in size and had two to four dendrites that coursed long distances and occasionally branched. Electron microscopy of ChAT-positive neurons in substriatal grey initially studied by light microscopy revealed that unlabelled boutons occasionally formed synapses with immunoreactive somata and proximal dendrites, but were more numerous along distal dendrites. Light microscopy demonstrated that ventral striatal neuropil contained numerous ChAT positive fibres and punctate structures that varied in concentration from moderate to very dense. The lateral border of the substriatal grey and the area within, and adjacent to, all islands of Calleja exhibited the most dense ChAT positive punctate staining. Additionally, the medial portion of nucleus accumbens was more densely ChAT-positive than the lateral, and the olfactory tubercle displayed laminar variations of immunoreaction product. Counterstained immunocytochemical specimens demonstrated that some areas of dense ChAT-positive punctate staining were associated with clusters of ChAT-negative, medium-sized neurons. Furthermore, electron microscopic observations of substriatal grey revealed that ChAT-positive dense regions were associated with numerous immunoreactive boutons, some of which established synapses with unlabelled somata, dendritic shafts and spines. These results suggest that the densely ChAT positive neuropil areas within ventral striatum receive more cholinergic innervation than the more lightly stained neuropil areas. There are numerous similarities in the morphological characteristics of ChAT-positive neurons and synapses observed in ventral striatum when compared with those previously described in dorsal striatum. However, some differences were observed, such as smaller somal sizes in ventral, as contrasted with dorsal striatum, and a substantial variation in ChAT-positive fibre and punctate neuropil staining seen within the ventral but not the dorsal striatum. Such differences suggest that the ventral striatum may exhibit greater heterogeneity of cholinergic function than the dorsal striatum. PMID- 3534149 TI - Morphological characterization of cholinergic neurons in the horizontal limb of the diagonal band of Broca in the basal forebrain of the rat. AB - A monoclonal antibody against choline acetyltransferase (ChAT), the acetylcholine synthesizing enzyme, was used to identify cholinergic neurons in the nucleus of the horizontal limb of the diagonal band of Broca at the light and electron microscopic levels. ChAT-labelled somata were fusiform, triangular or round in shape and varied considerably in size. Depending on the type of the cell, one to four dendrites emerged from the soma, but an axon could rarely be seen. The nuclei of most cells were round or oval, showed invaginations and displayed prominent nucleoli. The karyoplasm of the larger fusiform and triangular neurons contained abundant organelles including parallel arrays of granular endoplasmic reticulum. The synaptic input to labelled perikarya and proximal dendrites was sparse. It consisted chiefly of asymmetrical synaptic contacts, sometimes with postjunctional densities, but a few symmetrical synapses were also noted. ChAT positive axon terminals were not identified which suggests that axon collaterals are rare within the nucleus of the horizontal limb of the diagonal band of Broca. PMID- 3534150 TI - Electron microscopy of glutamate decarboxylase (GAD) immunoreactivity in the inner plexiform layer of the rhesus monkey retina. AB - With indirect immunofluorescence, glutamate decarboxylase (GAD), the GABA synthesizing enzyme, was localized to cell bodies in the inner half of the inner nuclear layer and a few in the outer tier of the ganglion cell layer in the rhesus monkey retina. In the inner plexiform layer there were three strongly GAD immunoreactive laminae separated by two less immunoreactive laminae. Electron microscopy demonstrated that the GAD was contained in amacrine cells and these GAD-immunoreactive amacrines were primarily pre- and postsynaptic to biopolar cell axon terminals. The GAD-containing processes possessed small synaptic vesicles and formed synapses that could be characterized as symmetrical. Large, dense-cored vesicles were often found in the cell bodies and synaptic processes of the GAD-immunoreactive amacrine cells. As the vast majority of the synaptic input and output of the GAD-containing amacrine cells was to and from bipolar cells and the strongest GAD-immunoreactivity correlated with the endings of bipolar cells that connect with a single cone, the functional effects of GABA in the primate retina are likely to be found in the responses of single cone pathways in the inner plexiform layer. PMID- 3534151 TI - History of treatment of coronary artery disease. PMID- 3534152 TI - Laser coronary angioplasty. PMID- 3534153 TI - New frontiers in cancer chemotherapy? PMID- 3534154 TI - Phase II trial of high-dose melphalan and autologous bone marrow transplantation for metastatic colon carcinoma. AB - Colon carcinoma, the second leading cause of cancer-related deaths in the United States, is resistant to chemotherapy in a large majority of cases. Single-agent and combination chemotherapy have failed to prolong survival. New approaches are clearly needed. In experimental models, a steep dose-response curve for colorectal cancer has been demonstrated using various agents. The hematopoietic toxicity of high-dose therapy with these drugs can be circumvented by autologous bone marrow transplantation. We investigated the use of high-dose melphalan with autologous bone marrow rescue in 20 patients with metastatic colon carcinoma. Each patient received melphalan, 180 mg/m2 intravenously (IV), followed eight hours later by bone marrow infusion. Median duration of granulocytopenia (less than 500 neutrophils/microL) was twelve days (range, 5 to 35 days), while transfusion-dependent thrombocytopenia (less than 20,000 platelets/microL) had a median duration of eight days (range, 3 to 23 days). Time to bone marrow engraftment was not affected by prior 5-fluorouracil therapy. Nausea and vomiting occurred in 14 patients but was generally short lived. Mild stomatitis, esophagitis, and diarrhea were common. Severe gastrointestinal (GI) side effects did not occur. One treatment-related death occurred secondary to intramural tumor necrosis, which resulted in massive lower GI bleeding. Complete responses were observed in three patients (15%) and partial responses in six patients (30%), for an overall response rate of 45%. Median survival was 198 days in this group of patients with extensive disease. High-dose melphalan therapy for metastatic colon carcinoma, when used with autologous bone marrow transplantation, appears to achieve a high response rate with tolerable toxicity. Further investigation is needed to define the role of this therapy in the care of advanced colon carcinoma. PMID- 3534155 TI - High-dose combination alkylating agent chemotherapy with autologous bone marrow support for metastatic breast cancer. AB - Seventeen patients with metastatic breast cancer were treated with a high-dose combination chemotherapy regimen and autologous bone marrow support. Thirteen patients had prior combination chemotherapy. Fifteen patients were treated with a phase II regimen of cyclophosphamide (5.625 g/m2), cisplatin (165 mg/m2), and BCNU (600 mg/m2). Bone marrow harvest and reconstitution were uncomplicated. All patients became profoundly myelosuppressed. Fourteen of 16 evaluable patients (88%) responded, including six complete responses (CRs) (38%). The median time to tumor progression was 5 months. The median survival was 8 months. CRs occurred more frequently in patients with no prior chemotherapy for metastatic disease, inflammatory breast cancer; and patients treated within 3 months of first recurrence. The rate of tumor regression was rapid, with a median of 11 days to partial response (PR) and 12 days to CR. Those patients achieving a PR by day 7 had a greater likelihood (P = .03) of attaining a CR than those patients whose PR occurred later. Three deaths (18%) occurred, all in women with inflammatory breast cancer treated with prior chemotherapy. High-dose combined alkylating agent therapy produced high PR and CR rates in metastatic breast cancer patients, most of whom had failed prior chemotherapy. The rate of tumor regression was rapid. Current efforts are directed at developing a regimen using drugs specifically active in breast cancer, with an intent of combining an effective high-dose regimen with additional modalities of therapy in the treatment of breast cancer. PMID- 3534156 TI - Ten-year analysis of the NSABP B-50 study. PMID- 3534157 TI - Quantitative autoradiographic localization of the D1 and D2 subtypes of dopamine receptors in rat brain. AB - The distribution of D1 and D2 receptors was studied in coronal sections of rat brain, using quantitative autoradiography. D1 receptors were labeled with 1.8 nM 3H-SKF-83566 (a brominated analog of 3H-SCH-23390), while D2 receptors were labeled with 1.0 nM 3H-spiroperidol (3H-SPD). The binding of both ligands to sections from brain and from a homogenate of caudate putamen (CPu mash) reached equilibrium within 80 min at 37 degrees C. CPu mash provided a virtually unlimited number of homogeneous sections that contained a high density of both D1 and D2 receptors. Sections of CPu mash were used in competition studies that confirmed that the specific binding of 3H-SKF-83566 was selective for D1 receptors, and that the binding of 3H-SPD was selective for D2 receptors. Scatchard analysis of equilibrium binding of the 2 ligands in the CPu in horizontal sections of rat brain revealed Kd values of 1.1 +/- 0.07 nM for 3H-SKF 83566 and 0.7 +/- 0.09 nM for 3H-SPD. Studies of the distribution of D1 and D2 receptors were carried out in coronal sections of brains from 5 rats. D1 receptors were found throughout the forebrain and were present in greater density than were D2 receptors in all regions examined except the olfactory nerve layer. In the CPu, nucleus accumbens, and olfactory tubercle, the densities of D1 and D2 receptors were, respectively, approximately 2,500 and 600-800 fmol/mg protein. In the substantia nigra, the density of D1 receptors was approximately 2,500 fmol/mg protein in both the compacta and the reticulata, but the density of D2 receptors was 230 fmol/mg protein in the compacta and 70 fmol/mg protein in the reticulata. The ventral tegmental area contained only 90 fmol/mg protein of D1 receptors, and D2 receptors were undetectable. The entopeduncular nucleus, zona incerta, and region of the ventral internal capsule had densities of D1 receptors of 550-950 fmol/mg protein and D2 receptor densities of less than 100 fmol/mg protein. Densities of D1 and D2 receptors were, respectively, 2,700 and 900 fmol/mg protein in the choroid plexus. Knowledge of the differences in the relative distributions of D1 and D2 receptors in various brain regions may increase our understanding of the functions of brain dopaminergic systems and may aid in the development of new therapeutic approaches for neuropsychiatric disorders. PMID- 3534158 TI - Predictable implants--osseointegration and the Core-Vent implant system. PMID- 3534159 TI - Stereotactic diagnosis and treatment of tumours of the pineal region. PMID- 3534160 TI - Cerebral protection. AB - Cerebral protection from an ischemic/hypoxic insult implies that tissue injury can be controlled or even prevented by certain therapeutic maneuvers. For example, physiological thresholds may be altered so that tissue vulnerability to the insult is reduced, or the intensity of an insult may be blunted by enhancing brain homeostasis. Such a therapeutic maneuver is carotid endarterectomy to improve blood flow in the disordered hemisphere. Alternatively, drugs with protective properties can be used before or even after the insult to "stabilize" injured tissue and prevent the harmful secondary effects that often follow. Various past and present approaches to cerebral protection employing physiological, pharmacological, and surgical intervention are reviewed. The mechanisms by which each allegedly protects the brain from ischemia and hypoxia are discussed briefly. Promising, but not always successful, approaches used in the past have pointed the way for new and more rational therapies. Truly effective protection of the brain from ischemia and hypoxia depends directly upon our capability to explore basic mechanisms of injury and our willingness to measure accurately and objectively the outcome of newly developed protective measures. PMID- 3534161 TI - Intraspinal lipomas with spina bifida. Prognosis and treatment in 73 cases. AB - The authors present a series of 73 cases of intraspinal lipomas in the lumbosacral region. Sixty-four patients were operated on, 43 of these under intraoperative monitoring of neural function. The results of this series and of major series published in the past 10 years demonstrate both the potential severity of these lesions (which are responsible for progressive neurological deficits in 56% of affected cases) and the benignity of their surgical treatment. The authors emphasize the usefulness of systematic early surgical treatment of these lesions. PMID- 3534162 TI - Cortex perfusion index: a sensitive detector of acute rejection crisis in transplanted kidneys. AB - Damage to the renal cortical microcirculation, an early event in the course of acute rejection crisis (ARC), usually precedes measurable functional derangements in the transplanted kidney. Direct assessment of cortical blood flow by radionuclide renography may provide a sensitive and reliable index to the diagnosis of ARC, with particular regard to the differential diagnosis of ARC and ATN. Computer generated time-activity curves of global, cortical, and medullary renal blood flow were analyzed in 67 instances (35 patients) of renal allograft dysfunction and correlated with needle biopsy of these kidneys. No increase in cortex perfusion index (CPI), i.e., decrease in cortical perfusion, was found when the patients were suffering from ureteral obstruction or drug and viral nephropathy (mean perfusion index (PI) increase (8%). In contrast, a marked increase in CPI of 193% was noted in ARC. Global and medullary PI increased only 116%. As a result, global and medullary PI were capable of diagnosing ARC in only 73% and 55% of the cases, respectively, whereby cortex PI correctly diagnosed ARC in 94% of the cases. Selective analysis of cortical perfusion may thus enhance the accuracy of [99mTc]DTPA scans (radionuclide renograph) for the early detection of ARC and in differentiating ARC from nonimmunological causes of kidney allograft dysfunction. PMID- 3534163 TI - Correlation of radionuclide imaging and diagnostic ultrasound in scrotal diseases. AB - A retrospective study was performed to evaluate the comparative usefulness of scrotal ultrasound imaging (SU) and radionuclide scrotal imaging (RSI) in 46 patients. The final diagnosis included four late phase and one early testicular torsion (TT), 11 acute epididymitis (AE), four subacute epididymitis (SE), six malignant tumors, ten hydroceles or other cystic lesions, and ten miscellaneous lesions. In patients with scrotal pain, 3/4 with late phase TT were correctly diagnosed by SU, while one with early TT and 11/15 with AE or SE were not diagnosed. All of them were correctly diagnosed with RSI except one with scrotal cyst. SU was able to separate cystic masses (n = 10) from solid masses (n = 9), but could not separate malignant from benign lesions. RSI had difficulty in separating cystic from solid lesions. We concluded that SU is useful in patients with scrotal mass to separate solid from cystic lesions. However, SU is unable to differentiate acute epididymitis from early testicular torsion. Therefore, in patients with acute scrotal pain, RSI should still be the first study performed. PMID- 3534164 TI - Neurobehavioral testing in monitoring hazardous workplace exposures. AB - Exposure to workplace toxins, particularly organic solvents, lead, and pesticides, has been shown to cause both transient and persistent derangements of CNS function. Neurobehavioral testing is described as a means of evaluating the health effects of exposure to toxic chemicals. The use of neurobehavioral testing is most appropriate where an exposure has been characterized and the diseases of interest specified. Most investigators use batteries of tests to evaluate psychomotor function, memory, verbal ability, mood, and visual/spatial abilities. Because of the shortcoming of the interviewer-administered test batteries, existing neurobehavioral tests have been adapted to a computer-administered format. This tool offers promise for future efforts to monitor CNS function in exposed workers. PMID- 3534165 TI - Risk of seroconversion for acquired immunodeficiency syndrome (AIDS) in San Francisco health workers. AB - The occupational risk of acquiring acquired immunodeficiency syndrome (AIDS) virus infection in health workers exposed to AIDS patients and specimens was assessed by a serologic study at San Francisco General Hospital and collaborating research laboratories. A total of 101 medical workers without risk factors for AIDS were examined for antibodies to two isolates of the AIDS retrovirus (AIDS associated retrovirus 2[ARV-2] and human T cell lymphotropic virus III). Most had heavy, long-term exposure to AIDS patients and 29 had been exposed by needlestick or mucocutaneous accident. None of the 101 had antibodies to ARV-2 by immunofluorescence or to HTLV-III by enzyme-linked immunosorbent assay and Western Blot. PMID- 3534167 TI - Challenges facing general internal medicine in the 99th Congress. AB - Since 1976, federal support for training in general internal medicine has been provided through the primary care residency programs under Title VII of the Public Health Service Act. Continuation of these programs is now in jeopardy because of severe fiscal pressures and the response of Congress to the resulting budgetary stringency. General internal medicine faces immediate problems in the budgetary, authorization, and appropriations arenas. However, Congressional proposals for changing the method by which Medicare pays for all graduate medical education may provide an important opportunity. Under a revised method of financing graduate medical education, general internal medicine could eliminate its historical dependence on increasingly unstable federal grant funds and could contribute to the development of new federal incentives for training in the primary care specialties. PMID- 3534166 TI - The prediction of streptococcal pharyngitis in adults. AB - The usefulness of clinical and laboratory findings for prediction of the presence of Group A streptococci on throat culture and of an increase in antistreptococcal antibodies was investigated in 693 adult patients. Several findings were shown to increase the likelihood of streptococcal isolation, alone and in combination: tonsillar exudate, tonsillar enlargement, tender anterior cervical adenopathy, myalgias, and a positive throat culture in the preceding year. Compared with a frequency of 9.7% in all patients, the probabilities of a positive culture were quite different (ranging from 2 to 53%) in subgroups of patients with different combinations of these clinical findings. The results of a leukocyte count and measurement of C-reactive protein added little additional predictive information. While clinical findings can never predict perfectly the results of a throat culture, they nevertheless can provide useful information--particularly in tending to "rule out" streptococcal infection--in adult patients with pharyngitis. PMID- 3534168 TI - A controlled trial to decrease the unnecessary use of diagnostic tests. AB - A controlled trial evaluated a program to decrease the unnecessary use of inpatient testing by medical residents in a university medical center. The program included education, concurrent feedback, and resident participation in program planning. Using specific criteria for 7,891 chart audits of patients who had repeat tests within seven days, the authors measured change in testing among 44 residents in the first year and 43 in the second year. There were no significant differences related to the program. They conclude that substantial overuse of diagnostic tests did occur, that it varied from hospital to hospital, and that the program could not overcome powerful counteracting influences. Future studies, using control groups and chart audits, should evaluate interventions other than education. PMID- 3534169 TI - Ambulatory care and the poor: tracking the impact of changes in federal policy. PMID- 3534170 TI - Evaluation and care of elderly patients with dementia. PMID- 3534171 TI - Atrial fibrillation, stroke and anticoagulation: what is to be done? PMID- 3534172 TI - Blood glucose and diabetic retinopathy: a critical appraisal of new evidence. AB - The relationship between blood glucose and diabetic retinopathy remains controversial. To obtain a proper perspective on this issue, a critical appraisal of clinical evidence published between 1974 and 1984 was done using standard methodologic criteria. Thirteen cohort studies and four intervention trials were found which provided the following new information: systolic hypertension, alcohol ingestion, female sex, and obesity were implicated as potential adverse prognostic factors related to retinopathy development. Although initial diagnostic blood glucose concentration was associated with subsequent retinopathy development, the reviewed studies did not provide evidence that tight glucose control prevented or retarded its development and progression. Some funduscopic and angiographic lesions deteriorated with tight control. PMID- 3534174 TI - Annotated bibliography: interdisciplinary research. PMID- 3534173 TI - The evaluation and treatment of hypercholesterolemia in primary care practice. PMID- 3534175 TI - Rapid diagnosis of streptococcal pharyngitis in adult emergency room patients. AB - A rapid latex agglutination slide test for group A beta-hemolytic streptococcal throat infections was prospectively evaluated. Resident physicians, working in an adult non-acute emergency room, recorded clinical data and collected throat swabs from 729 adult patients with sore throats. Research assistants obtained throat swabs from 329 control patients. Sensitivity and specificity, compared with routine cultures, were 96% and 97%, respectively. Analyses of clinical predictions and of test results for control patients, however, suggest that this test may perform better than routine culture. The test provides a rapid, accurate, potentially useful alternative for diagnosing group A beta-hemolytic streptococcal pharyngitis in adults. PMID- 3534177 TI - Research uses of computer-stored practice records in general medicine. PMID- 3534178 TI - Prospective payment under Medicare: what are its effects? PMID- 3534179 TI - The renal origin of hypertension: progress over 50 years. A symposium commemorating the 50th anniversary of the experimental production of renal hypertension by Harry Goldblatt, M.D. October 1984, Toledo, Ohio, USA. PMID- 3534176 TI - Noninvasive tests for diagnosing the presence and extent of coronary artery disease: exercise electrocardiography, thallium scintigraphy, and radionuclide ventriculography. PMID- 3534180 TI - Thoughts and studies on purification of the angiotensin II receptor. AB - The angiotensin receptor is the only macromolecular component of the renin angiotensin system which has not yet been purified and characterized in the isolated state. A purified preparation could be useful for identifying the amino acid residues it preferentially recognizes in various positions of defined peptide ligands, and for elucidating the proximate molecular mechanism by which the binding event is transduced into a cellular response. Such knowledge should expedite the development of receptor antagonists which might be more physiologically specific than other inhibitors of the system. This paper elaborates on these thoughts, and describes some recent progress in purification of the rabbit hepatic receptor. PMID- 3534181 TI - Reminiscences and reflections. AB - Some of Dr. Goldblatt's important contributions during a notable research career of more than 50 years are reviewed. The research on rickets (1922-1932), culminating in the discovery of the antirachitic effect of sterol irradiated with ultraviolet light. The research on cancer (1930-1974), demonstrating the malignant transformation of normal fibroblasts caused by hypoxia and prevented by increased availability of oxygen. The production of benign and chronic experimental hypertension by renal ischaemia (1934-1976). The large-scale isolation of human and animal renin (1943-1976). The production of antirenin by immunization with heterologous or chemical only modified homologous renin. Antirenin successfully reversed both acute and chronic experimental renal hypertension, thereby demonstrating the primary role of the renin-angiotensin system in maintaining the elevated blood pressure and that this type of hypertension is reversible even in the chronic phase of 6 years. PMID- 3534183 TI - Current concepts and historical perspectives of renal pressor mechanisms. PMID- 3534182 TI - Renal medullary system of blood pressure control. AB - The renal medulla contains cells in its papillary portion, the renomedullary interstitial cells (RIC), that secrete a blood pressure-controlling hormone. This hormone system has been identified by classic types of experiments as developed by Bayliss and Starling, Goldblatt, Byrom and Dodson and Berthold. The antihypertensive neutral renomedullary lipid is the putative hormone. This hormonal system is antagonized by angiotensin II. It antagonizes the blood pressure (BP) elevating effects of salt. PMID- 3534184 TI - Vasodepressor mechanisms in experimental hypertension: studies using chemical medullectomy. AB - There is evidence that neither activation of the renin-angiotensin system nor changes in sodium balance can fully explain the maintenance of blood pressure in Goldblatt hypertension. Thus, in Goldblatt two-kidney, one clip hypertension in the rat sodium balance is negative and in hypertension of a few months' duration plasma renin initially elevated has returned to normal. When hypertension is reversed by removal of the constricting clip from the renal artery, blood pressure falls within a matter of hours even when hypertension has been present for many months, suggesting that the effect of structural changes in vascular resistance vessels has been overcome. In addition, blockade of the renin angiotensin system during renal artery declipping does not influence the pattern of the blood pressure fall. We investigated the role of the renomedullary vasodepressor system by inducing medullary necrosis with 2-bromo-ethylamine hydrobromide. This causes a moderate blood pressure increase in normal rats, and partly inhibits the fall of blood pressure in Goldblatt two-kidney, one clip hypertension when the renal clip is removed. Chemical medullectomy is associated with a slightly negative sodium balance, plasma volume contraction, a reduction in plasma renin activity and urinary PGE2, and a minimal elevation in plasma vasopressin. Blood pressure elevation appears to be attributable to inhibition of a vasodepressor system based on the renal medulla. Chemical medullectomy offers a valuable tool for investigating the role of this medullary vasodepressor system. PMID- 3534185 TI - Current concepts and perspectives of renal volume regulation in relationship to hypertension. AB - The renal-body fluid mechanism for arterial pressure control is almost certainly the most primitive of all the pressure-regulating mechanisms in animals. Through the stages of evolution, the system has been greatly improved. Nervous controls provide rapid pressure-control mechanisms that function almost instantaneously, many hours or days before the renal-body fluid mechanism can act fully. The renin angiotensin-aldosterone system plays another important role: this system ensures that very large changes in salt intake, from as little as one-tenth normal up to as high as 10 times normal, have very little effect on the regulated level of the arterial pressure. Finally, the long-term autoregulatory mechanism helps to dissociate the long-term control of cardiac output from long-term control of arterial pressure; it also makes it possible for extremely slight increases in body fluid volume to cause chronic volume-loading hypertension. PMID- 3534186 TI - Renovascular hypertension: a paradigm for all hypertension. PMID- 3534187 TI - The pathophysiology of renovascular hypertension. AB - In hypertension associated with renal artery stenosis, the evolution of the raised blood pressure can conveniently be considered in three phases. In the first phase, blood pressure is raised by the direct pressor action of elevated peripheral plasma angiotensin II. In the second phase, circulating angiotensin II may be more modestly raised, but probably is still important in pathogenesis. Occasionally in phase II there is rapidly advancing elevation of renin, angiotensin II and aldosterone and severe hypertension, with sodium and potassium depletion. In the much later third phase, angiotensin II is not elevated, and the renin system may no longer be concerned in the hypertension. In phases I and II, but not in phase III, relief of the stenosis, removal of the affected kidney, or lowering of angiotensin II with converting enzyme inhibitors, can correct the hypertension. In the affected kidney with renal artery stenosis, the intrarenal content of renin is raised and its distribution altered; these changes represent compensatory local actions. The affected kidney secretes both active and inactive renin, while there is suppression of renin secretion by the contralateral kidney which becomes a net extractor of angiotensin II. PMID- 3534188 TI - Keeping it simple--an overdenture technique.